• 【产中胎儿窒息:定义,诊断和分类。】 复制标题 收藏 收藏
    DOI:10.1016/s0002-9378(97)70385-5 复制DOI
    作者列表:Low JA
    BACKGROUND & AIMS: Evidence of a significant metabolic acidosis, an umbilical artery base deficit > 12 mmol/L, confirms that an asphyxial exposure has occurred. This is observed at delivery in approximately 2% of all pregnancies. Classification of the severity of the asphyxial exposure is difficult because the duration and nature of the exposure and the characteristics of the fetal cardiovascular response to the asphyxia in the affected fetus is usually not known. A classification is proposed in which the exposure to asphyxia is confirmed by a blood gas and acid-base assessment with evidence of a significant metabolic acidosis and the severity is defined by newborn encephalopathy and other organ system complications. Outstanding issues that may enhance this classification are identified.

    背景与目标: 明显的代谢性酸中毒,脐动脉基础缺损> 12 mmol / L的证据证实发生了窒息。大约有2%的孕妇在分娩时观察到这种情况。窒息暴露严重程度的分类很困难,因为通常不知道暴露的持续时间和性质以及胎儿对窒息对窒息的心血管反应特征。提出了一种分类,其中通过血气和酸碱评估证实窒息暴露,并伴有明显的代谢性酸中毒,严重程度则由新生儿脑病和其他器官系统并发症定义。确定了可能会增强此分类的突出问题。

  • 【标记PAP-PSA在前列腺癌诊断中的作用】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Petrone U,Gaspari G,Marascia G,Magnocavallo N,Petrone D,Tucci C
    BACKGROUND & AIMS: :The Authors report their personal experience relating to diagnostic screening for prostatic carcinoma using serum assays for specific markers of this tumour: prostatic acid phosphatase (PAP) and prostatic specific antigen (PSA). They underline the importance of high serum values of these substances, especially in tumors in an advanced state, and point out that these markers can play a role both in the diagnosis and in the follow-up of prostatic carcinoma.
    背景与目标: :作者报告了他们的个人经验,涉及使用血清检测该肿瘤的特定标志物(前列腺酸磷酸酶(PAP)和前列腺特异抗原(PSA))进行前列腺癌的诊断筛查。他们强调了这些物质的高血清值的重要性,尤其是在晚期肿瘤中,并指出这些标志物可以在前列腺癌的诊断和随访中发挥作用。
  • 【具有维生素B12代谢的cblJ先天性错误的非典型患者的症状较晚发作:外显子组测序揭示了诊断和新突变。】 复制标题 收藏 收藏
    DOI:10.1016/j.ymgme.2012.10.005 复制DOI
    作者列表:Kim JC,Lee NC,Hwu PW,Chien YH,Fahiminiya S,Majewski J,Watkins D,Rosenblatt DS
    BACKGROUND & AIMS: :Inborn errors of vitamin B(12) (cobalamin) metabolism are characterized by decreased production of active cobalamin cofactors and subsequent deficiencies in the activities of methionine synthase and methylmalonyl-CoA mutase. With the recent discovery of the cblJ defect in two patients with phenotypes mimicking the cblF defect, there are nine genes known to be involved in cobalamin metabolism. The new defect is caused by mutations in the ABCD4 gene, encoding an ABC transporter. At the moment, there is no clear distinction between the cblJ and cblF defects either clinically or biochemically, and both defects result in blocks in the transport of cobalamin from the lysosome to the cytoplasm. A patient was diagnosed with hyperhomocysteinemia and methylmalonic aciduria at the age of 8 years. Incorporations of both [(14)C]propionate and [(14)C]methyltetrahydrofolate in cultured fibroblasts were within reference ranges and thus too high to allow for complementation analysis. We observed decreased synthesis of both adenosylcobalamin and methylcobalamin and accumulation of unmetabolized cyanocobalamin. Exome sequencing was performed to identify causative mutation(s) and Sanger re-sequencing was performed to validate segregation of mutation in the family. By this approach, a homozygous mutation, c.423C>G, in the ABCD4 gene was identified. Here, we report the successful application of exome sequencing for diagnosis of a rare inborn error of vitamin B(12) metabolism in a patient whose unusual presentation precluded diagnosis using standard biochemical and genetic approaches. The patient represents only the third known patient with the cblJ disorder.
    背景与目标: :维生素B(12)(钴胺素)代谢的先天性错误的特征在于活性钴胺素辅因子的产生减少以及蛋氨酸合酶和甲基丙二酰辅酶A突变酶的活性随后不足。随着最近在两名模仿cblF缺陷的表型患者中发现cblJ缺陷,已知有9个基因与钴胺素代谢有关。新的缺陷是由编码ABC转运蛋白的ABCD4基因突变引起的。目前,在临床或生化方面,cblJ和cblF缺陷之间尚无明确区分,并且两种缺陷均导致钴胺素从溶酶体到细胞质的转运受阻。一名患者在8岁时被诊断出患有高同型半胱氨酸血症和甲基丙二酸尿症。 [(14)C]丙酸酯和[(14)C]甲基四氢叶酸在培养的成纤维细胞中的掺入均在参考范围内,因此含量过高,无法进行互补分析。我们观察到腺苷钴胺素和甲基钴胺素的合成减少以及未代谢的氰钴胺素的积累。进行了外显子组测序以鉴定致病突变,并进行了桑格重测序以验证家族中突变的分离。通过这种方法,鉴定出ABCD4基因中的纯合突变,即c.423C> G。在这里,我们报告外显子组测序在维生素B(12)代谢的罕见先天性错误的诊断中成功应用,该患者的异常表现排除了使用标准生化和遗传方法进行诊断的可能性。该患者仅代表第三位已知的cblJ疾病患者。
  • 【评估荷兰亨廷顿氏病的排除性产前和排除性植入前遗传学诊断。】 复制标题 收藏 收藏
    DOI:10.1111/cge.12058 复制DOI
    作者列表:van Rij MC,de Die-Smulders CE,Bijlsma EK,de Wert GM,Geraedts JP,Roos RA,Tibben A
    BACKGROUND & AIMS: :Individuals at 50% risk of Huntington's disease (HD) who prefer not to know their carrier status, might opt for exclusion prenatal diagnosis (ePND) or exclusion preimplantation genetic diagnosis (ePGD). This study aims to provide a better understanding of couples' motives for choosing ePND or ePND, and surveys couples' experiences in order to make recommendations for the improvement of counselling for exclusion testing. This qualitative retrospective interview study focussed on couples who underwent ePND or ePGD for HD in the period 1996-2010. Seventeen couples were included of which 13 had experienced ePND and 6 ePGD. Mean time-interval since exclusion-testing was 3.9 years. Couples' moral reservations regarding termination of pregnancy (TOP) or discarding healthy embryos were counterbalanced by the wish to protect their future child against HD. Seven couples had terminated a total of 11 pregnancies with a 50% HD risk, none showed regret. ePGD was used by couples who wanted to avoid (another) TOP. ePND and ePGD are acceptable reproductive options for a specific group of counsellees. To guarantee sound standards of care, it is imperative that candidate couples be given in-depth non-directive counselling about all possible scenarios, and adequate professional and psychological support prior to, during and after ePND/ePGD.
    背景与目标: :那些不知道自己的携带者状况,患亨廷顿氏病(HD)风险为50%的个体,可能会选择排除产前诊断(ePND)或排除植入前遗传学诊断(ePGD)。这项研究旨在更好地了解夫妻选择ePND或ePND的动机,并调查夫妻的经历,以便为改善排除测试的咨询意见提供建议。这项定性的回顾性访谈研究的重点是在1996-2010年期间接受HD的ePND或ePGD的夫妇。其中包括17对夫妇,其中13对有ePND经历和6对ePGD。自排除测试以来的平均时间间隔为3.9年。保护夫妻免于高清的愿望抵消了夫妻在终止妊娠(TOP)或丢弃健康胚胎方面的道德保留。 7对夫妇共终止了11例妊娠,HD风险为50%,没有人表示遗憾。希望避免使用(另一种)TOP的夫妇使用了ePGD。 ePND和ePGD是特定人群的可接受的生殖选择。为了保证合理的护理标准,在ePND / ePGD之前,之中和之后,必须为候选夫妇提供有关所有可能情况的深入非指导性咨询,并提供适当的专业和心理支持。
  • 【血清补体C1q在急性缺血性中风的诊断中的价值。】 复制标题 收藏 收藏
    DOI:10.7754/Clin.Lab.2016.161033 复制DOI
    作者列表:Zhao X,Wang C,Pang B,Zhu Y,Zhang Y
    BACKGROUND & AIMS: BACKGROUND:To investigate the relationship between the levels of serum complement C1q and the risk and severity of acute ischemic stroke, a total of 154 patients with acute ischemic stroke and 42 healthy volunteers as normal controls were enrolled in the present study. METHODS:According to the onset time of stroke, patients were divided into three groups. Using an immune transmission turbidity method, the levels of serum complement C1q were detected to investigate the relationship between the level of serum complement C1q and the incidence and severity of acute ischemic stroke. The risk factors of these groups were calculated using a conditional logistic regression model. The assessment of neurological function impairment was carried out according to the National Institute of Health Stroke Scale. Then correlation anal- ysis was carried out between the level of serum complement C1q among patients with acute ischemic stroke and the degree of neurological function impairment. RESULTS:The results showed that the level of serum complement C1q was higher in the ischemic stroke group than in the control group. Using a conditional logistic regression model it was discovered that serum complement C1q was the independent pathogenic factor of cerebral infarction. There also was a decreasing trend in the level of serum complement C1q with the extension of the onset time and an increasing trend in the level of serum complement C1q with the increase in the maximum diameter of infarction volume. CONCLUSIONS:Serum complement C1q is an independent risk factor for acute outbreak of ischemic stroke, whose level is closely related to the outbreak and infarct size and neurological function impairment.
    背景与目标: 背景:为了研究血清补体C1q水平与急性缺血性中风的风险和严重程度之间的关系,本研究共纳入154例急性缺血性中风患者和42名健康志愿者作为正常对照。
    方法:根据中风的发作时间,将患者分为三组。采用免疫传递浊度法检测血清补体C1q水平,以探讨血清补体C1q水平与急性缺血性脑卒中的发生率和严重程度之间的关系。使用条件逻辑回归模型计算这些组的危险因素。根据美国国立卫生研究院卒中量表对神经功能损害进行评估。然后在急性缺血性中风患者的血清补体C1q水平与神经功能损害程度之间进行相关分析。
    结果:缺血性中风组血清补体C1q水平高于对照组。使用条件逻辑回归模型,发现血清补体C1q是脑梗死的独立致病因素。随着发作时间的延长,血清补体C1q的水平也有降低的趋势,并且随着梗塞体积的最大直径的增加,血清补体C1q的水平也有增加的趋势。
    结论:血清补体C1q是缺血性卒中急性发作的独立危险因素,其水平与发作,梗死面积和神经功能损害密切相关。
  • 【林奇综合症:病史,病因,诊断,治疗和预防(CAPP2试验)。】 复制标题 收藏 收藏
    DOI:10.1159/000341892 复制DOI
    作者列表:Burn J,Mathers J,Bishop DT
    BACKGROUND & AIMS: :Hereditary cancer due to pathological mutations in the mismatch repair gene family is now known as Lynch syndrome and affects at least 1 in 1,000 people, resulting in a 30-50% cancer risk most often involving the colorectum and endometrium. Annual or biennial colonoscopy reduces cancer deaths and many offer gynaecological surveillance, but most other associated cancers are not amenable to early detection. As microsatellite instability testing and tumour immunohistochemistry become routine, case finding will improve. Our recent demonstration that 600 mg aspirin per day for at least 2 years reduces the cancer burden by 63% after a 3-year lag period reinforces the need to identify gene carriers and introduce them to chemoprevention. CaPP3 will test different doses of aspirin in at least 3,000 gene carriers to determine whether low-dose aspirin is as effective.
    背景与目标: :由于失配修复基因家族中的病理突变而引起的遗传性癌症现在被称为Lynch综合征,它影响至少1,000人中的1个人,导致30-50%的癌症风险最常涉及结直肠癌和子宫内膜癌。一年一次或每两年一次的结肠镜检查可以减少癌症死亡,并且许多可以提供妇科检查,但是大多数其他相关的癌症不适合早期发现。随着微卫星不稳定性测试和肿瘤免疫组织化学成为常规方法,病例发现将得到改善。我们最近的研究表明,在3年的滞后期后,每天至少2年每天服用600毫克阿司匹林可将癌症负担降低63%,这增强了识别基因载体并将其引入化学预防的需求。 CaPP3将在至少3,000个基因携带者中测试不同剂量的阿司匹林,以确定低剂量阿司匹林是否有效。
  • 【常染色体显性多囊肾疾病患者的囊肿感染诊断:当前模式的属性和局限性。】 复制标题 收藏 收藏
    DOI:10.1093/ndt/gfs352 复制DOI
    作者列表:Jouret F,Lhommel R,Devuyst O,Annet L,Pirson Y,Hassoun Z,Kanaan N
    BACKGROUND & AIMS: :Cyst infection is a diagnostic challenge in patients with autosomal dominant polycystic kidney disease (ADPKD) because of the lack of specific manifestations and limitations of conventional imaging procedures. Still, recent clinical observations and series have highlighted common criteria for this condition. Cyst infection is diagnosed if confirmed by cyst fluid analysis showing bacteria and neutrophils, and as a probable diagnosis if all four of the following criteria are concomitantly met: temperature of >38°C for >3 days, loin or liver tenderness, C-reactive protein plasma level of >5 mg/dL and no evidence for intracystic bleeding on computed tomography (CT). In addition, the elevation of serum carbohydrate antigen 19-9 (CA19-9) has been proposed as a biomarker for hepatic cyst infection. Positron-emission tomography after intravenous injection of 18-fluorodeoxyglucose, combined with CT, proved superior to radiological imaging techniques for the identification and localization of kidney and liver pyocyst. This review summarizes the attributes and limitations of these recent clinical, biological and imaging advances in the diagnosis of cyst infection in patients with ADPKD.
    背景与目标: :由于常染色体显性多囊肾病(ADPKD)患者缺乏特异​​性表现和常规影像学检查的局限性,因此对囊性感染的诊断是一项挑战。尽管如此,最近的临床观察和系列研究突显了这种情况的共同标准。如果囊肿液分析证实存在细菌和中性粒细胞,则可以诊断为囊肿感染,并且如果同时满足以下四个标准,则可能诊断为囊肿:温度> 38°C持续3天以上,腰部或肝脏压痛,C反应血浆血浆蛋白水平> 5 mg / dL,计算机断层扫描(CT)尚无囊内出血的证据。另外,已经提出血清碳水化合物抗原19-9(CA19-9)的升高作为肝囊肿感染的生物标志物。静脉注射18-氟脱氧葡萄糖后结合CT进行正电子发射断层扫描,事实证明其优于放射成像技术可用于肾脏和肝囊肿的鉴定和定位。这篇综述总结了ADPKD患者囊肿感染诊断中这些最新的临床,生物学和影像学进展的属性和局限性。
  • 【威斯康星州诊断乳腺癌(WDBC)数据集的特征选择的改进的蝙蝠算法】 复制标题 收藏 收藏
    DOI:10.22034/APJCP.2017.18.5.1257 复制DOI
    作者列表:Jeyasingh S,Veluchamy M
    BACKGROUND & AIMS: :Early diagnosis of breast cancer is essential to save lives of patients. Usually, medical datasets include a large variety of data that can lead to confusion during diagnosis. The Knowledge Discovery on Database (KDD) process helps to improve efficiency. It requires elimination of inappropriate and repeated data from the dataset before final diagnosis. This can be done using any of the feature selection algorithms available in data mining. Feature selection is considered as a vital step to increase the classification accuracy. This paper proposes a Modified Bat Algorithm (MBA) for feature selection to eliminate irrelevant features from an original dataset. The Bat algorithm was modified using simple random sampling to select the random instances from the dataset. Ranking was with the global best features to recognize the predominant features available in the dataset. The selected features are used to train a Random Forest (RF) classification algorithm. The MBA feature selection algorithm enhanced the classification accuracy of RF in identifying the occurrence of breast cancer. The Wisconsin Diagnosis Breast Cancer Dataset (WDBC) was used for estimating the performance analysis of the proposed MBA feature selection algorithm. The proposed algorithm achieved better performance in terms of Kappa statistic, Mathew’s Correlation Coefficient, Precision, F-measure, Recall, Mean Absolute Error (MAE), Root Mean Square Error (RMSE), Relative Absolute Error (RAE) and Root Relative Squared Error (RRSE).
    背景与目标: :早期诊断乳腺癌对于挽救患者生命至关重要。通常,医学数据集包括各种各样
    可能导致诊断过程中混乱的数据。数据库知识发现(KDD)流程有助于
    提高效率。在最终诊断之前,需要从数据集中消除不适当和重复的数据。
    这可以使用数据挖掘中可用的任何特征选择算法来完成。考虑功能选择
    作为提高分类准确性的重要步骤。本文针对特征提出了一种改进的Bat算法(MBA)
    选择以从原始数据集中消除不相关的特征。使用简单随机算法修改了Bat算法
    采样以从数据集中选择随机实例。排名具有全球最佳功能,可识别
    数据集中可用的主要特征。所选要素用于训练随机森林(RF)分类
    算法。 MBA特征选择算法提高了RF在识别事件中的分类精度
    乳腺癌。威斯康星州诊断乳腺癌数据集(WDBC)用于评估性能
    提出的MBA特征选择算法的分析。提出的算法取得了较好的性能。
    Kappa统计数据,Mathew的相关系数,精度,F度量,召回率,平均绝对误差(MAE),
    均方根误差(RMSE),相对绝对误差(RAE)和均方根误差(RRSE)。
  • 【个性化医学:诊断和治疗肾脏疾病的新观点。】 复制标题 收藏 收藏
    DOI:10.3390/ijms18061248 复制DOI
    作者列表:Gluba-Brzózka A,Franczyk B,Olszewski R,Banach M,Rysz J
    BACKGROUND & AIMS: :The prevalence of renal diseases is rising and reaching 5-15% of the adult population. Renal damage is associated with disturbances of body homeostasis and the loss of equilibrium between exogenous and endogenous elements including drugs and metabolites. Studies indicate that renal diseases are influenced not only by environmental but also by genetic factors. In some cases the disease is caused by mutation in a single gene and at that time severity depends on the presence of one or two mutated alleles. In other cases, renal disease is associated with the presence of alteration within a gene or genes, but environmental factors are also necessary for the development of disease. Therefore, it seems that the analysis of genetic aspects should be a natural component of clinical and experimental studies. The goal of personalized medicine is to determine the right drug, for the right patient, at the right time. Whole-genome examinations may help to change the approach to the disease and the patient resulting in the creation of "personalized medicine" with new diagnostic and treatment strategies designed on the basis of genetic background of each individual. The identification of high-risk patients in pharmacogenomics analyses will help to avoid many unwarranted side effects while optimizing treatment efficacy for individual patients. Personalized therapies for kidney diseases are still at the preliminary stage mainly due to high costs of such analyses and the complex nature of human genome. This review will focus on several areas of interest: renal disease pathogenesis, diagnosis, treatment, rate of progression and the prediction of prognosis.
    背景与目标: :肾脏疾病的患病率正在上升,并达到成年人口的5-15%。肾脏损害与体内稳态紊乱以及包括药物和代谢产物在内的外源性和内源性元素之间失去平衡有关。研究表明,肾脏疾病不仅受环境影响,而且受遗传因素影响。在某些情况下,该疾病是由单个基因的突变引起的,当时的严重程度取决于一个或两个突变等位基因的存在。在其他情况下,肾脏疾病与一个或多个基因内的改变的存在有关,但是环境因素对于疾病的发展也是必不可少的。因此,似乎遗传方面的分析应该是临床和实验研究的自然组成部分。个性化医学的目标是在正确的时间为正确的患者确定正确的药物。全基因组检查可能有助于改变疾病和患者的治疗方法,从而通过根据每个人的遗传背景设计新的诊断和治疗策略来创建“个性化药物”。在药物基因组学分析中识别高危患者将有助于避免许多不必要的副作用,同时优化单个患者的治疗效果。肾脏疾病的个性化治疗仍处于初步阶段,这主要是由于此类分析的高昂费用和人类基因组的复杂性。这项审查将集中在几个感兴趣的领域:肾脏疾病的发病机制,诊断,治疗,进展的速度和预后的预测。
  • 【人类微孢子虫病的光学显微镜诊断和对奥曲肽的可变反应。】 复制标题 收藏 收藏
    DOI:10.1016/0016-5085(91)90613-p 复制DOI
    作者列表:Simon D,Weiss LM,Tanowitz HB,Cali A,Jones J,Wittner M
    BACKGROUND & AIMS: :Microsporida are protozoan parasites that have recently been identified as a cause of human disease in immunocompromised patients. Because of their small size, they have been recognized primarily by electron microscopy. This has limited the study of their prevalence, incidence, and association with large-volume diarrhea. The present report describes two cases of Enterocytozoon bieneusi infection of the small intestine in patients with intractable diarrhea in whom the diagnosis was made by light microscopy and confirmed by electron microscopy. Both patients were treated with octreotide, and one had a good response.
    背景与目标: 小孢子虫是原生动物的寄生虫,最近被鉴定为免疫功能低下患者的人类疾病原因。由于它们的尺寸小,它们主要被电子显微镜识别。这限制了对它们的患病率,发病率以及与大剂量腹泻的关系的研究。本报告介绍了2例顽固性腹泻患者小肠小肠肠杆菌感染的病例,其中光学显微镜确诊,电子显微镜确诊。两名患者均接受奥曲肽治疗,其中一名患者反应良好。
  • 【侵袭性和恶性泌乳素垂体瘤:病理诊断和患者管理。】 复制标题 收藏 收藏
    DOI:10.1007/s11102-012-0448-y 复制DOI
    作者列表:Zemmoura I,Wierinckx A,Vasiljevic A,Jan M,Trouillas J,François P
    BACKGROUND & AIMS: :According to the World Health Organization classification of pituitary tumors, only tumors with systemic metastasis must be considered as carcinomas. Invasive tumors with multiple recurrences are only classified as aggressive tumors or "atypical adenomas". To illustrate the problems encountered in the pathological diagnosis of pituitary carcinoma and in patient management, we present two male patients operated on for an aggressive prolactin pituitary adenoma with and without metastasis. In case 1, 5 surgeries, 3 irradiations, increased doses of dopamine agonists, and trials of temozolomide and carboplatine-VP16 failed to control tumor progression and the appearance of metastases which lead to death 16 years after onset. In case 2, based on the initial diagnosis of an aggressive-invasive adenoma that was resistant to dopamine agonists, gamma-Knife irradiation was initially performed on the intra-cavernous remnant. Eight years after onset, the remnant remained stabilized and the plasma PRL normalized under dopamine agonist. From these 2 cases alongside other cases found in the literature, we propose that the association of certain clinical signs (male sex, dopamine-resistant hyperprolactinemia), radiological signs (invasive macro or giant tumor on MRI) and histological signs (angiogenesis, Ki-67 > 3%, p53 positive, mitoses >2 per high power field, vascular invasion, up-regulation of genes related to invasion and proliferation, and allelic loss of chromosome 11) might suggest aggressiveness and be suspicious of malignancy before the appearance of metastasis. The early detection of an aggressive phenotype of a prolactin pituitary tumor should permit the earlier establishment of the optimum therapeutic strategy associating surgery and radiotherapy to delay or inhibit metastasis.
    背景与目标: :根据世界卫生组织垂体瘤分类,只有具有全身转移的肿瘤才可被视为癌。具有多次复发的浸润性肿瘤仅分类为浸润性肿瘤或“非典型腺瘤”。为了说明在垂体癌的病理诊断和患者管理中遇到的问题,我们介绍了两名男性患者,他们患有侵袭性催乳素垂体腺瘤,有或没有转移。在病例1、5的手术,3的放射线,增加的多巴胺激动剂剂量以及替莫唑胺和卡铂-VP16的试验中,未能控制肿瘤的进展和转移的出现,从而导致发病后16年死亡。在案例2中,基于对多巴胺激动剂有抵抗力的侵略性腺瘤的初步诊断,最初对海绵体内残余物进行了伽玛刀照射。发病八年后,在多巴胺激动剂作用下,残余物保持稳定,血浆PRL正常化。从这2例病例以及文献中发现的其他病例中,我们建议将某些临床体征(男性,多巴胺耐药性高泌乳素血症),放射体征象(MRI上的浸润性大肿瘤或巨瘤)与组织学征象(血管生成,Ki- 67> 3%,p53阳性,每个高倍视野中的有丝分裂> 2,血管浸润,与浸润和增殖相关的基因上调,以及11号染色体的等位基因丢失,这可能表明其具有侵略性,并且在出现转移之前怀疑是恶性的。泌乳素垂体瘤侵袭性表型的早期检测应允许较早建立最佳的治疗策略,以结合手术和放疗来延迟或抑制转移。
  • 【剧烈的颈部按摩后颈部肿胀。诊断:颈淋巴结肿大。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Ceylan A,Akçam T,Karatas E,Celenk F
    BACKGROUND & AIMS: -2
    背景与目标: -2
  • 【磁共振成像在变性和炎性颞下颌关节疾病诊断中的功效:系统的文献综述。】 复制标题 收藏 收藏
    DOI:10.1016/j.tripleo.2006.02.001 复制DOI
    作者列表:Limchaichana N,Petersson A,Rohlin M
    BACKGROUND & AIMS: OBJECTIVE:To evaluate the evidence for the efficacy of magnetic resonance imaging (MRI) in the diagnosis of disk position and configuration, disk perforation, joint effusion, and osseous and bone marrow changes in the temporomandibular joint. STUDY DESIGN:A PubMed literature search with specific indexing terms and a hand search were made. Two reviewers assessed the level of evidence of relevant publications as high, moderate, or low. Based on this, the evidence grade for diagnostic efficacy was rated as strong, moderately strong, limited, or insufficient. RESULTS:The literature search yielded 494 titles, of which 22 were relevant. No publication had a high level of evidence, and 12 had moderate and 10 low levels of evidence. The evidence grade for diagnostic efficacy expressed as sensitivity, specificity, and predictive values was insufficient. CONCLUSION:That evidence is insufficient emphasizes the need for high-quality studies on the diagnostic efficacy of MRI, incorporating accepted methodologic criteria.
    背景与目标: 目的:评估磁共振成像(MRI)在诊断椎间盘位置和结构,椎间盘穿孔,关节积液以及颞下颌关节骨和骨髓变化方面的有效性的证据。
    研究设计:进行了PubMed文献检索,包括特定的索引词和人工检索。两名审稿人对相关出版物的证据水平进行了评估,等级为高,中或低。基于此,诊断功效的证据等级被评为强,中度强,有限或不足。
    结果:文献检索产生494种图书,其中22种具有相关性。没有出版物具有高水平的证据,有12种具有中等水平的证据,有10种低水平的证据。以敏感性,特异性和预测值表示的诊断功效的证据等级不足。
    结论:证据不足,强调需要结合公认的方法学标准对MRI的诊断功效进行高质量的研究。
  • 【EUS指导的FNA诊断胰腺结核。】 复制标题 收藏 收藏
    DOI:10.1016/j.gie.2006.04.004 复制DOI
    作者列表:Cheng R,Grieco VS,Shuhart MC,Rulyak SJ
    BACKGROUND & AIMS: -2
    背景与目标: -2
  • 【内镜经乳头内胆囊引流管胆汁细胞学检查对厚壁胆囊的术前诊断和处理。】 复制标题 收藏 收藏
    DOI:10.1016/j.gie.2006.01.024 复制DOI
    作者列表:Itoi T,Sofuni A,Itokawa F,Kurihara T,Tsuchiya T,Moriyasu F,Yamagishi T,Serizawa H
    BACKGROUND & AIMS: BACKGROUND:It is often difficult to distinguish gallbladder cancers (GBC) from benign gallbladder diseases, which show thickened walls. OBJECTIVES:To evaluate the efficacy of bile cytology using endoscopic transpapillary gallbladder drainage (ETGD) and CT. DESIGN:Retrospective study. SETTING:Division of Gastroenterology, Tokyo Medical University, Tokyo, Japan. PATIENTS AND INTERVENTIONS:Eighty-five patients with gallbladder diseases, consisting of 27 GBC and 58 benign gallbladder diseases, were reviewed. A pigtail-type nasobilliary drainage tube was left indwelling in the gallbladder, and through this drainage tube washing cytology was performed with an ETGD tube. MAIN OUTCOME MEASUREMENTS:Diagnostic accuracy of CT and cytology. Complications and outcome were also evaluated. RESULTS:CT and cytology with the ETGD tube had 81% and 81% sensitivity, 91% and 83% specificity, and 88% and 82% accuracy, respectively (P > .05). Looking only at the 71 successful ETGD cases, CT and ETGD cytology had 82% and 100% sensitivity, 92% and 98% specificity, and 89% and 99% accuracy, respectively (P = .036 and .025, respectively). Four patients with GBC in whom CT showed benign findings underwent open cholecystectomy because ETGD cytology revealed malignant findings. In contrast, 4 patients with benign diseases in whom CT suggested malignant finding underwent LC because the findings of ETGD cytology suggested benign disease. CONCLUSIONS:Cytology using an ETGD tube is very useful in the diagnosis and management of gallbladder diseases.
    背景与目标: 背景:通常很难将胆囊癌(GBC)与良性胆囊疾病相鉴别,后者显示壁增厚。
    目的:通过内镜经乳头胆囊引流术(ETGD)和CT评估胆汁细胞学的疗效。
    设计:回顾性研究。
    单位:日本东京医科大学胃肠病学系。
    病人与干预措施:对包括27例GBC和58例良性胆囊疾病的85例胆囊疾病患者进行了回顾。一根猪尾型鼻腔引流管留在胆囊中,并通过该引流管用ETGD管进行洗涤细胞学检查。
    主要观察指标:CT和细胞学检查的诊断准确性。并发症和结局也进行了评估。
    结果:ETGD管的CT和细胞学检查分别具有81%和81%的敏感性,91%和83%的特异性以及88%和82%的准确性(P> 0.05)。仅查看71例成功的ETGD患者,CT和ETGD细胞学检查分别具有82%和100%的敏感性,92%和98%的特异性以及89%和99%的准确性(分别为P = .036和.025)。因为ETGD细胞学检查显示恶性,所以4例CT表现为良性病变的GBC患者接受了开腹胆囊切除术。相比之下,有4例CT提示有恶性发现的良性疾病患者进行了LC检查,因为ETGD细胞学检查结果表明存在良性疾病。
    结论:使用ETGD管进行细胞学检查对胆囊疾病的诊断和治疗非常有用。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录