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Nian Liu ◽  
Yuzhen Tseng ◽  
Huilu Zhang ◽  
Jian Chen

Purpose. Exhaled determination can detect metabolite hydrogen sulfide in the intestine. We aim to analyze the predictive value of hydrogen sulfide in the diagnosis of colorectal adenoma. Methods. We recruited seventy patients diagnosed with colorectal adenoma as the observation group and sixty-six healthy subjects as the control group. The colorectal adenoma was diagnosed by colonoscopy at the Endoscopy Center of Huashan Hospital affiliated to Fudan University from June 2018 to November 2019. Exhaled gas was collected through the nose and mouth, respectively, and hydrogen sulfide in exhaled gas was determined according to the manufacturer’s instructions. Results. Receiver operating characteristic (ROC) curve was analyzed based on the exhaled data of the observation group and the control group. The ROC curve showed an area under ROC curve (AUC) 0.724 for nasal exhaled H2S, which had a diagnostic value. When nasal exhaled H2S was >13.3 part per billion (ppb), the sensitivity and the specificity of predicting colorectal adenoma were 57% and 78%, respectively. The exhaled H2S of the observation group was significantly different from that of the control group. The AUC value was 0.716 as a prognostic factor of colorectal adenoma. As exhaled H2S was >28.8 ppb, the sensitivity and the specificity of predicting colorectal adenoma were 63% and 77%, respectively. Conclusion. Exhaled and nasal H2S determination has a predictive value for colorectal adenoma as a novel and noninvasive method. Therefore, it is worth conducting more research to analyze exhaled and nasal H2S.

2021 ◽  
Vol 1 (5) ◽  
Fan Zheng ◽  
Xiao Wanjun ◽  
Wang Shuaishuai ◽  
Wang Tong ◽  
Zou Lue

2021 ◽  
Qinglong Wang ◽  
Zhe Zhao ◽  
Wantao Wang ◽  
Zhipeng Huang ◽  
Wenbo Wang

Abstract Background: Kashin-Beck disease (KBD) is currently an endemic form of osteoarthritis. In this study, we explored novel KBD diagnostic biomarkers.Methods: The GSE59446 dataset was used to conduct Weighted Gene Co-expression Network Analysis (WGCNA) and differentially expressed genes (DEGs) analysis with peripheral blood samples of 100 healthy individuals and 100 KBD patients. As part of the gene ontology pathway enrichment analysis, genes related to SONFH and DEGs were selected from the extraction module. Then, central DEGs were selected for LASSO analysis, and, based on SVM-RFE and DEG results, overlapping genes were identified as key KBD genes. Next, we analyzed the correlations between the selected genes and age, gender, and other factors to eliminate their influences on gene expression. Finally, we evaluated the diagnostic value of key KBD genes using case information collected by us.Results: Seven gene co-expression modules were created using WGCNA. The turquoise module was identified as a KBD key module since it showed the highest correlation to KBD. The functional enrichment analysis revealed that the genes associated with this key module were mainly involved in mitochondrial reactions, protein heterooligomerization, and negatively regulating cysteine-type endopeptidase-dependent apoptotic processes. Additionally, 12 key genes were identified using the LASSO analysis, 5 major genes using SVM-RFE analysis, and 36 DEGs were screened through the "limma" R package. The GLRX5 gene - pivotal in DEGs, LASSO, and SVM-RFE - was further aggregated as the key KBD gene. Correlation analyses confirmed the GLRX5 diagnostic value for KBD and that it was not related to age, gender, and other factors. Finally, data from our patients demonstrated that GLRX5 can be a KBD diagnostic biomarker.Conclusions: We demonstrated that the target gene GLRX5 can be a KBD non-invasive diagnosis biomarker.

2021 ◽  
Vol In Press (In Press) ◽  
Keliang Li ◽  
Yan Jiao ◽  
Jingjing Liang ◽  
Pingping Pan ◽  
Yanji Zhu ◽  

Background: The current study was done to identify key genes associated with Kawasaki disease (KD). Methods: Three datasets were collected from Gene Expression Omnibus (GEO) database. Then, differentially expressed genes (DEGs) analysis, gene ontology (GO) annotation, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were performed. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to determine the expression levels of DEGs in KD. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic value of DEGs. Results: In total, 2923 DEGs (1239 up- and 1684 down-regulated genes) were detected in KD. Ribosome, Leishmaniasis, and Tuberculosis significantly enriched KEGG pathways of DEGs. Six DEGs, including ADM, S100A12, ZNF438, MYD88, FCGR2A, and FCGR3B, were selected for qRT-PCR validation. Except for MYD88, the qRT-PCR results displayed similar expression patterns with that in our integrated analysis. ROC analysis revealed the diagnostic value of the six DEGs. Conclusions: Our study was expected to provide clues toward understanding the pathophysiology of KD inflammation.

2021 ◽  
Vol 14 (11) ◽  
Gholamali Godazandeh ◽  
Reza Alizadeh-Navaei ◽  
Amir Shamshirian ◽  
Keyvan Heydari ◽  
Leyla Shojaee

Context: According to previous studies, using the frozen section procedure during breast surgery reduces the rate of error and the need for re-surgery. We aimed at performing a comprehensive systematic review and meta-analysis to provide reliable evidence on the diagnostic value of frozen section procedures in breast-conserving surgery (BCS). Data Sources: A thorough search was performed in PubMed, Embase, Cochrane Library, and Web of Science databases for human diagnostic studies that used the frozen section in BCS. Meta-analyses were done to find the sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR). Study Selection: Human diagnostic studies used the frozen section in breast-conserving surgery and studies that reported the sensitivity and specificity of the frozen section in BCS or contained data that could be calculated the desired parameters were selected for this meta-analysis. Data Extraction: Assessment of studies quality was done and data was extracted from included papers. Then, the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of included papers. Results: Thirty-five papers were entered into our study. The meta-analysis indicated the high sensitivity (83.47, 95%CI 79.61 - 87.32) and specificity (99.29, 95%CI 98.89 - 99.68) for the frozen section in BCS, which resulted in an accuracy of 93.77 (95%CI 92.45 - 95.10). We also found a significant PPV (93.26, 95%CI 91.25 - 95.27), NPV (92.17, 95%CI 90.22 - 94.11), PLR (7.99, 95%CI 6.01 - 9.96), and NLR (0.18, 95%CI 0.14 - 0.23). Conclusions: The findings showed that intraoperative frozen section analysis has high sensitivity and specificity for evaluating lumpectomy margins in patients with early-stage breast cancer and significantly reduces the need for re-operation. Accordingly, re-operation costs are not imposed on the patient and reduce the anxiety of the patients.

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260357
Adelina Staicu ◽  
Camelia Albu ◽  
Roxana Popa-Stanila ◽  
Cosmina Ioana Bondor ◽  
Ioana Cristina Rotar ◽  

Objective To determine the diagnostic value of virtual autopsy using post mortem-MRI (pm-MRI) at 3Tesla (T) compared to classic autopsy for the confirmation of fetal structural anomalies and secondly to establish which cases of termination of pregnancy would benefit mostly from a virtual autopsy. Methods In each of 32 fetuses included in the study, 32 anatomical structures were assessed, after termination of pregnancy in the second trimester. All cases were evaluated by prenatal ultrasonography, virtual autopsy and classic autopsy, and then divided into four groups: Cerebral Group, Cardiac Group, Renal Group and Other Group (miscellaneous group). The concordance of virtual autopsy with classic autopsy was calculated overall and for each group and each structural item. Also, the concordance between the two methods was assessed using a diagnostic error score (DgE_score), calculated as the absolute value of the difference between the number of malformations detected by classic autopsy per case (CA score) and the number of malformations detected at virtual autopsy per case (VA score). Results Overall virtual autopsy demonstrated a diagnostic sensitivity (Se) compared to classic autopsy of 67.33% [95% CI 57.28–76.33], with a specificity (Sp) of 98.37% [95% CI 97.33–99.09], a positive predictive value (PPV) of 81.93% [95% CI 71.95–89.52], a negative predictive value (NPV) of 96.49% [95% CI 95.11–97.57] achieving a diagnostic accuracy of 95.31% [95% CI 93.83–96.52]. Overall, no statistic significant correlation was demonstrated between DgE_score and the gestational age of the fetuses or between DgE_score and the weight of the fetuses, but a significant correlation was revealed between the virtual autopsy and classic autopsy score. The diagnostic utility of virtual autopsy using pm-MRI at 3 T as compared to classic autopsy for each category of termination of pregnancy revealed in the Cerebral Group a Se of 80.00% [95% CI 28.36–99.49], with a 96.30% [95% CI 81.03–99.91], a PPV of 80.00% [95% CI 35.75–96.64] a NPV of 96.30% [95% CI 81.81–99.34], with a diagnostic accuracy of 93.75% [95% CI 79.19% to 99.23] and a Cohen’s Kappa coefficient of 0.76 [95% CI 0.4494–1.0765]; in the Renal Group a Se and Sp of 100%, but in the Cardiac Group the Se was only 60.00% [95% CI 26.24–87.84], Sp 75% [95% CI 34.91–96.81], the PPV 75.00% [95% CI 44.92–91.69], NPV 60% [95% CI 38.87–77.96], with a diagnostic accuracy of 66.67% [95% CI 40.99–86.66] and a Cohen’s Kappa coefficient of 0.32 [95% CI -0.07–0.76]. Conclusions The results support virtual autopsy using pm-MRI at 3T as a reliable alternative to classic autopsy for the non-forensic analysis of second trimester fetuses. Analyzing the diagnostic utility of virtual autopsy using pm-MRI at 3 T for the confirmation of prenatal ultrasound findings in second trimester fetuses as compared to classic autopsy, the best results were obtained in the Cerebral and Renal Group. Reserved results were found in the Cardiac Group. Therefore, for the pregnancies with termination of pregnancy for cerebral or renal abnormalities, virtual autopsy by pm-MRI at 3T can be taken into consideration as a first-line investigation to confirm the prenatal findings.

2021 ◽  
Vol 16 (1) ◽  
Jian Yao ◽  
Tao Bai ◽  
Bo Yang ◽  
Lizhong Sun

Abstract Objective This study aims to evaluate the diagnostic value of D-dimer for acute aortic dissection (AAD) by the method of meta-analysis. Methods PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases from the establishment of the databases to December 2020 were systematically searched, and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) system was used to evaluate the quality of the literature. STATA 15.0 software was applied to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (+LR), negative likelihood ratio (−LR) to draw summary receiver operating characteristics (SROC) curve and calculate the area under the curve (AUC). Meta-regression and subgroup analyses were used to explore the source of heterogeneity. Results A total of 16 clinical studies were enrolled in this study, including 1135 patients. The results of the meta-analysis showed that the pooled sensitivity was 0.96 (95% CI 0.91–0.98), the pooled specificity was 0.70 (95% CI 0.57–0.81), and the pooled DOR was 56.57 (95% CI 25.11–127.44), the pooled +LR was 3.25 (95% CI 2.18–4.85), the pooled −LR was 0.06 (95% CI 0.03–0.12), and the AUC was 0.94 (95% CI 0.91–0.95). Meta-regression and subgroup analysis results showed that publication year, sample size and cutoff value might be sources of heterogeneity. When the concentration of D-dimer was less than or equal to 500 ng/ml, the sensitivity significantly increased. Conclusion D-dimer has an excellent diagnostic value for AAD. It is a useful tool for detecting suspected AAD because of the excellent pooled sensitivity. D-dimer ≤ 500 ng/ml increases the potential to identify the suspected patients with AAD.

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Tinglong Huang ◽  
Xuelan Zheng ◽  
Lisui He ◽  
Zhiliang Chen

The study aimed to explore the diagnostic value of computed tomography (CT) images based on cavity convolution U-Net algorithm for patients with severe pulmonary infection. A new lung CT image segmentation algorithm (U-Net+ deep convolution (DC)) was proposed based on U-Net network and compared with convolutional neural network (CNN) algorithm. Then, it was applied to CT image diagnosis of 100 patients with severe lung infection in The Second Affiliated Hospital of Fujian Medical University hospital and compared with traditional methods, and its sensitivity, specificity, and accuracy were compared. It was found that the single training time and loss of U-Net + DC algorithm were reduced by 59.4% and 9.8%, respectively, compared with CNN algorithm, while Dice increased by 3.6%. The lung contour segmented by the proposed model was smooth, which was the closest to the gold standard. Fungal infection, bacterial infection, viral infection, tuberculosis infection, and mixed infection accounted for 28%, 18%, 7%, 7%, and 40%, respectively. 36%, 38%, 26%, 17%, and 20% of the patients had ground-glass shadow, solid shadow, nodule or mass shadow, reticular or linear shadow, and hollow shadow in CT, respectively. The incidence of various CT characteristics in patients with fungal and bacterial infections was statistically significant ( P < 0.05 ). The specificity (94.32%) and accuracy (97.22%) of CT image diagnosis based on U-Net + DC algorithm were significantly higher than traditional diagnostic method (75.74% and 74.23%), and the differences were statistically significant ( P < 0.05 ). The network of the algorithm in this study demonstrated excellent image segmentation effect. The CT image based on the U-Net + DC algorithm can be used for the diagnosis of patients with severe pulmonary infection, with high diagnostic value.

2021 ◽  
Vol 21 (1) ◽  
Yang Li ◽  
Lanfang Min ◽  
Xin Zhang

Abstract Background There is a lack of studies comparing PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections. It is necessary to explore the correlation between above markers and different types of ARTI. Methods 108 children with confirmed bacterial infection were regarded as group A, 116 children with virus infection were regarded as group B, and 122 children with mycoplasmal infection were regarded as group C. The levels of PCT, CRP and WBC of the three groups were detected and compared. Results The levels of PCT, CRP and WBC in group A were significantly higher than those in groups B and C (p < 0.05). The positive rate of combined detection of PCT, CRP and WBC was significant higher than that of single detection. There was no significant difference in PCT, CRP and WBC levels between the group of G+ bacterial infection and G− bacterial infection (p > 0.05). ROC curve results showed that the AUC of PCT, CRP and WBC for the diagnosis of bacterial respiratory infections were 0.65, 0.55, and 0.58, respectively. Conclusions PCT, CRP and WBC can be combined as effective indicators for the identification of acute bacterial or no-bacterial infections in children. The levels of PCT and CRP have higher differential diagnostic value than that of WBC in infection, and the combined examination of the three is more valuable in clinic.

2021 ◽  
pp. 68-72
I. N. Sonkin ◽  
L. I. Syromyatnikova ◽  
E. Kh. Alieva ◽  
S. A. Mehryakov

Goal. Consider the management of patients with effort thrombosis (Paget-Schretter syndrome).The article presents the modern vision of the problem of effort thrombosis. This review is aimed at describing the epidemiology, pathophysiology, diagnosis and treatment of patients with Paget-Schretter syndrome. SPS occurs spontaneously, as a rule, in young, healthy and active patients aged 20-30 years after strenuous physical activity. The ratio of men and women is 2:1, recently there has been a growing trend among women. The main complaints of patients with SPS include swelling of the affected limb, discomfort when moving the affected arm, pain and heaviness when trying to raise the arm up. When examining these patients, attention is paid to hyperemia of the skin or their cyanotic nature, pasty limbs, as well as an enhanced venous pattern on the shoulder, the so-called Arshel sign. The diagnosis is based on the data of anamnesis, physical examination, the “gold standard of diagnostics” – ultrasound examination of veins, the sensitivity and specificity of which is 70-100%. The first step in the diagnosis can be the evaluation of the D-dimer, with its negative values, the SPSH is rejected. With an obvious clinic and controversial results of serial ultrasound examinations, other imaging methods are used, such as computed contrast tomography, magnetic resonance imaging, the diagnostic value of which is especially significant in occlusive venous thrombosis.SPS differs not only from DVT of the lower extremities, but also from secondary DVT of the upper extremities, which determines the peculiarities of management of this category of patients, including surgical treatment aimed at preventing subclavian vein compression in the future. The article summarizes the experience in the management of patients with blood thrombosis.

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