Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of...Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of various organs, including the liver. Alcoholic liver disease includes different injuries ranging from steatosis to cirrhosis and implicates a diagnostic assessment of the liver disease and of its possible complications. There is growing interest in the possible different tools for assessing previous alcohol consumption and for establishing the severity of liver injury, especially by noninvasive methods.展开更多
A previous diagnosis of gestational diabetes(GDM)carries a lifetime risk of progression to type 2 diabetes of up to 60%.Identification of those women at higher risk of progression to diabetes allows the timely introdu...A previous diagnosis of gestational diabetes(GDM)carries a lifetime risk of progression to type 2 diabetes of up to 60%.Identification of those women at higher risk of progression to diabetes allows the timely introduction of measures to delay or prevent diabetes onset.However,there is a large degree of variability in the literature with regard to the proportion of women with a history of GDM who go on to develop diabetes.Heterogeneity between cohorts with regard to diagnostic criteria used,duration of follow-up,and the characteristics of the study population limit the ability to make meaningful comparisons across studies.As the new International Association for Diabetes in Pregnancy Study Group criteria are increasingly adopted worldwide,the prevalence of GDM is set to increase by two-to three-fold.Here,we review the literature to examine the evolution of diagnostic criteria for GDM,the implications of changing criteria on the proportion of women with previous GDM progressing to diabetes,and how the use of different diagnostic criteria may influence the development of appropriate follow-up strategies.展开更多
BACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus(GDM)are still a subject of debate,mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the r...BACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus(GDM)are still a subject of debate,mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the risk profile of the women newly diagnosed.AIM To estimate the impact of the World Health Organization(WHO)2013 criteria compared with the WHO 1999 criteria on the incidence of gestational diabetes mellitus as well as to determine the diagnostic accuracy for detecting adverse pregnancy outcomes.METHODS We retrospectively analyzed a single center Dutch cohort of 3338 women undergoing a 75 g oral glucose tolerance test where the WHO 1999 criteria to diagnose GDM were clinically applied.Women were categorized into four groups:non-GDM by both criteria,GDM by WHO 1999 only(excluded from GDM),GDM by WHO 2013 only(newly diagnosed)and GDM by both criteria.We compared maternal characteristics,pregnancy outcomes and likelihood ratios for adverse pregnancy outcomes.RESULTS Retrospectively applying the WHO 2013 criteria increased the cohort incidence by 13.1%,from 19.3%to 32.4%.Discordant diagnoses occurred in 21.3%;4.1%would no longer be labelled as GDM,and 17.2%were newly diagnosed.Compared to the non-GDM group,women newly diagnosed were older,had higher rates of obesity,higher diastolic blood pressure and higher rates of caesarean deliveries.Their infants were more often delivered preterm,large-for-gestational-age and were at higher risk of a 5 min Apgar score<7.Women excluded from GDM were older and had similar pregnancy outcomes compared to the non-GDM group,except for higher rates of shoulder dystocia(4.3%vs 1.3%,P=0.015).Positive likelihood ratios for adverse outcomes in all groups were generally low,ranging from 0.54 to 2.95.CONCLUSION Applying the WHO 2013 criteria would result in a substantial increase in GDM diagnoses.Newly diagnosed women are at increased risk for pregnancy adverse outcomes.This risk,however,seems to be lower than those identified by the WHO 1999 criteria.This could potentially influence the treatment effect that can be achieved in this group.Evidence on treatment effects in newly diagnosed women is urgently needed.展开更多
To discuss whether the capillary whole blood glucose （CBG） test can be used in glucose screening test （GST） for gestational diabetes mellitus （GDM） compared to the venous plasma glucose （ VPG） method, and to d...To discuss whether the capillary whole blood glucose （CBG） test can be used in glucose screening test （GST） for gestational diabetes mellitus （GDM） compared to the venous plasma glucose （ VPG） method, and to determine the cutoff value of CBG. Methods This was a self-control test. The 50-g oral GST was conducted among 1 557 pregnant women between 24-28 weeks. Every woman was measured CBG and VPG at the same time and same arm. Three hundred and forty women underwent 100-g 3-h oral glucose tolerance test （OGTT）. Receiver operation curve （ROC） was used to determine the potential cutoff level of CBG and VPG. Diagnose criteria of GDM was based on NDDG criteria. OGTT diagnosed GDM and VPG ≥ 7. 8 mmol/L were used as golden standard for ROC. Results There was good relationship between CBG and VPG （ P 〈0.01 ）. Correlation coefficient was O. 86. The value of CBG was lower than VPG. The statistical and high-sensitivity cutoff values were 7. 4 mmol/L in CBG and 7. 8 mmol/L in VPG when GDM was used as golden standard. Cutoff value of CBG was 7. 0 mmol/L when VPG≥7. 8 mmol/L was used as golden standard. The pregnant outcomes of positive cases of three thresholds had no significant differences. But it was better in case of the pregnant woman when the CBG value was more than 7. 4 mmol/L. Conclusion CBG can be used in GST, the threshold of CBG was suggested as 7. 4 mmol/L. CBG test was more convenience and effective than VPG test.展开更多
Based on digital land use data from 1995 to 2000 and road data, the land use and landscape changes of Golmud, Qumaleb and Zhidoi are studied on a macro-scale. Land use and landscape changes in highway buffer zones and...Based on digital land use data from 1995 to 2000 and road data, the land use and landscape changes of Golmud, Qumaleb and Zhidoi are studied on a macro-scale. Land use and landscape changes in highway buffer zones and city expansion are special subjects. A new formula is used to define the exact degree of dynamic land use. To adequately define land use and landscape pattern changes, the buffer zones, illustrating the changes at different distances from the road, are recognized with ArcGIS 8.1 software. Prominent changes took place in land use and landscape patterns from 1995 to 2000, and the area of built-up land increased by 323.8%. The comprehensive degree of dynamic land use is 2.25, and the degree of dynamic land use of built-up land is the highest, followed by cultivated land. Woodland has the lowest value. The used degree index of land resources declined by 38.8 from 1995 to 2000. Landscape changed dramatically which influenced ecological processes immensely. Different from the corridor effect of other traffic routes, the corridor effect of this section of road is not obvious and its “point” radiation effect can be easily seen. The expanding range of Golmud City is confined to a 3 km buffer, while for Wudaoliang, it is 1 km. No land use change happened in the Nanshankou buffer.展开更多
AIM: To investigate if there is a correlation between electrical activity measured by electrogastrography (EGG) and contractile activity of the stomach as measured by antroduodenal manometry (ADM). We also studied whe...AIM: To investigate if there is a correlation between electrical activity measured by electrogastrography (EGG) and contractile activity of the stomach as measured by antroduodenal manometry (ADM). We also studied whether the underlying motility disorder could be predicted from EGG parameters. METHODS: We compared 21 parameters measured from EGG with 8 parameters measured from ADM. The ability of EGG to identify the underlying diagnosis was tested by comparing EGG parameters for each diagnosis group against other patients. The study comprised recordings from 148 patients and 125 females. Their median age was 45 (range 17-76) years. RESULTS: We found few and weak correlations between EGG and ADM. Specifically the correlation between parameters reflecting the response to meal was poor (r = -0.07, P = 0.39). The discriminatory power of EGG for underlying motility disorder was also low. Patients with slow transit constipation (STC) showed a lower postprandial power in normogastric (3.7 ± 0.5 vs 4.0 ± 0.5) and tachygastric (3.5 ± 0.4 vs 3.7 ± 0.4) regions, a lower percentage of time with normogastria [87.2 (56.5-100)% vs 95.7 (0-100)%], and a higher percentage of time with tachygastria [9.3 (0-33)% vs 3.5 (0-100)%] and bradygastria [1.8 (0-20)% vs 0 (0-17.1)%]. Patients with irritable bowel syndrome had a higher percentage of time with normogastria [96.5 (62.5-100)% vs 93.3 (0-100)%] and a less unstable dominant frequency as measured by the instability coefficient [15 (3-77) vs 24 (2-72)]. CONCLUSION: EGG and ADM seem to measure different aspects of gastric motor activity but cannot show a spatial correlation. The diagnostic value of EGG is poor, but EGG may have some value for the identification of patients with STC.展开更多
目的分析糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)单一及联合检验诊断糖尿病的价值。方法以72例疑似有糖尿病的患者作为临床研究对象,均接受HbA1c、FPG、2 h PG检验,以糖耐量测定为诊断“金标准”。比较HbA1c、FPG、2 ...目的分析糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)单一及联合检验诊断糖尿病的价值。方法以72例疑似有糖尿病的患者作为临床研究对象,均接受HbA1c、FPG、2 h PG检验,以糖耐量测定为诊断“金标准”。比较HbA1c、FPG、2 h PG单一及联合检验的灵敏度、特异度、准确度。结果72例受检者中有58例患者确诊为糖尿病。联合检验的诊断灵敏度、特异度、准确度分别为94.83%、92.86%、94.44%;HbA1c检验的诊断灵敏度、特异度、准确度分别为75.86%、28.57%、66.67%;FPG检验的诊断灵敏度、特异度、准确度分别为81.03%、35.71%、72.22%;2 h PG检验的诊断灵敏度、特异度、准确度分别为77.59%、42.86%、70.83%。联合检验诊断的灵敏度、特异度及准确度均高于其他HbA1c、FPG、2 h PG单一诊断的灵敏度、特异度及准确度,具有统计学意义(P<0.05)。结论HbA1c、FPG、2 h PG联合检验相较单一检验诊断糖尿病具有较高的临床价值,能够为临床治疗提供有价值的参考依据。展开更多
This paper reports a study of complex focussing acoustic fields of a convex phased array probe widely used in ultrasonic diagnostic B-scanner. The time delay necessary for electronic focussing and for geometric focuss...This paper reports a study of complex focussing acoustic fields of a convex phased array probe widely used in ultrasonic diagnostic B-scanner. The time delay necessary for electronic focussing and for geometric focussing of complex focussing is given. By means of Helmholtz's integral formula, the expressions of acoustic fields were obtained for the electronic focussing and complex focussing.With Simpson's numerical integral, a great deal of computations was carried out with an 86 / 330 computer. By means of using different parameters, an optimum focal range and beam width of a 4 sequences electronic and complex focussing acoustic system was selected. With an EUB-40 ultrasound diagnostic B-scanner produced by the Hitachi company, the lateral focussing acoustic field and lateral resolution in an echoic tank were photographed by latticing method and the experimental result is consistent with the theory.展开更多
Objective To compare the diagnostic efficiency of the thyroid imaging reporting and data system(TIRADS),the Bethesda system for reporting thyroid cytopathology(BSRTC)and BRAFV600Edetection,and their combined use in th...Objective To compare the diagnostic efficiency of the thyroid imaging reporting and data system(TIRADS),the Bethesda system for reporting thyroid cytopathology(BSRTC)and BRAFV600Edetection,and their combined use in the differentiation between benign and malignant thyroid nodules.Methods One hundred展开更多
文摘Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of various organs, including the liver. Alcoholic liver disease includes different injuries ranging from steatosis to cirrhosis and implicates a diagnostic assessment of the liver disease and of its possible complications. There is growing interest in the possible different tools for assessing previous alcohol consumption and for establishing the severity of liver injury, especially by noninvasive methods.
文摘A previous diagnosis of gestational diabetes(GDM)carries a lifetime risk of progression to type 2 diabetes of up to 60%.Identification of those women at higher risk of progression to diabetes allows the timely introduction of measures to delay or prevent diabetes onset.However,there is a large degree of variability in the literature with regard to the proportion of women with a history of GDM who go on to develop diabetes.Heterogeneity between cohorts with regard to diagnostic criteria used,duration of follow-up,and the characteristics of the study population limit the ability to make meaningful comparisons across studies.As the new International Association for Diabetes in Pregnancy Study Group criteria are increasingly adopted worldwide,the prevalence of GDM is set to increase by two-to three-fold.Here,we review the literature to examine the evolution of diagnostic criteria for GDM,the implications of changing criteria on the proportion of women with previous GDM progressing to diabetes,and how the use of different diagnostic criteria may influence the development of appropriate follow-up strategies.
文摘BACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus(GDM)are still a subject of debate,mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the risk profile of the women newly diagnosed.AIM To estimate the impact of the World Health Organization(WHO)2013 criteria compared with the WHO 1999 criteria on the incidence of gestational diabetes mellitus as well as to determine the diagnostic accuracy for detecting adverse pregnancy outcomes.METHODS We retrospectively analyzed a single center Dutch cohort of 3338 women undergoing a 75 g oral glucose tolerance test where the WHO 1999 criteria to diagnose GDM were clinically applied.Women were categorized into four groups:non-GDM by both criteria,GDM by WHO 1999 only(excluded from GDM),GDM by WHO 2013 only(newly diagnosed)and GDM by both criteria.We compared maternal characteristics,pregnancy outcomes and likelihood ratios for adverse pregnancy outcomes.RESULTS Retrospectively applying the WHO 2013 criteria increased the cohort incidence by 13.1%,from 19.3%to 32.4%.Discordant diagnoses occurred in 21.3%;4.1%would no longer be labelled as GDM,and 17.2%were newly diagnosed.Compared to the non-GDM group,women newly diagnosed were older,had higher rates of obesity,higher diastolic blood pressure and higher rates of caesarean deliveries.Their infants were more often delivered preterm,large-for-gestational-age and were at higher risk of a 5 min Apgar score<7.Women excluded from GDM were older and had similar pregnancy outcomes compared to the non-GDM group,except for higher rates of shoulder dystocia(4.3%vs 1.3%,P=0.015).Positive likelihood ratios for adverse outcomes in all groups were generally low,ranging from 0.54 to 2.95.CONCLUSION Applying the WHO 2013 criteria would result in a substantial increase in GDM diagnoses.Newly diagnosed women are at increased risk for pregnancy adverse outcomes.This risk,however,seems to be lower than those identified by the WHO 1999 criteria.This could potentially influence the treatment effect that can be achieved in this group.Evidence on treatment effects in newly diagnosed women is urgently needed.
基金Supported by grants from the Natrual Science Foundation of Shanghai, China (99ZB14071).
文摘To discuss whether the capillary whole blood glucose （CBG） test can be used in glucose screening test （GST） for gestational diabetes mellitus （GDM） compared to the venous plasma glucose （ VPG） method, and to determine the cutoff value of CBG. Methods This was a self-control test. The 50-g oral GST was conducted among 1 557 pregnant women between 24-28 weeks. Every woman was measured CBG and VPG at the same time and same arm. Three hundred and forty women underwent 100-g 3-h oral glucose tolerance test （OGTT）. Receiver operation curve （ROC） was used to determine the potential cutoff level of CBG and VPG. Diagnose criteria of GDM was based on NDDG criteria. OGTT diagnosed GDM and VPG ≥ 7. 8 mmol/L were used as golden standard for ROC. Results There was good relationship between CBG and VPG （ P 〈0.01 ）. Correlation coefficient was O. 86. The value of CBG was lower than VPG. The statistical and high-sensitivity cutoff values were 7. 4 mmol/L in CBG and 7. 8 mmol/L in VPG when GDM was used as golden standard. Cutoff value of CBG was 7. 0 mmol/L when VPG≥7. 8 mmol/L was used as golden standard. The pregnant outcomes of positive cases of three thresholds had no significant differences. But it was better in case of the pregnant woman when the CBG value was more than 7. 4 mmol/L. Conclusion CBG can be used in GST, the threshold of CBG was suggested as 7. 4 mmol/L. CBG test was more convenience and effective than VPG test.
基金The National Key Basic Research Special Fund, No.Gl 998040800 The Core Project of Institute of Geographic Sciences and Natural Resources Research of CAS for Knowledge Innovation, No. CXIOG-E01-01,No.CXIOG-A00-03-02.
文摘Based on digital land use data from 1995 to 2000 and road data, the land use and landscape changes of Golmud, Qumaleb and Zhidoi are studied on a macro-scale. Land use and landscape changes in highway buffer zones and city expansion are special subjects. A new formula is used to define the exact degree of dynamic land use. To adequately define land use and landscape pattern changes, the buffer zones, illustrating the changes at different distances from the road, are recognized with ArcGIS 8.1 software. Prominent changes took place in land use and landscape patterns from 1995 to 2000, and the area of built-up land increased by 323.8%. The comprehensive degree of dynamic land use is 2.25, and the degree of dynamic land use of built-up land is the highest, followed by cultivated land. Woodland has the lowest value. The used degree index of land resources declined by 38.8 from 1995 to 2000. Landscape changed dramatically which influenced ecological processes immensely. Different from the corridor effect of other traffic routes, the corridor effect of this section of road is not obvious and its “point” radiation effect can be easily seen. The expanding range of Golmud City is confined to a 3 km buffer, while for Wudaoliang, it is 1 km. No land use change happened in the Nanshankou buffer.
基金Supported by funds from the Swedish Research Council (grant 2002-5489) and the Swedish Society of Medicine (Ihre’s fond)
文摘AIM: To investigate if there is a correlation between electrical activity measured by electrogastrography (EGG) and contractile activity of the stomach as measured by antroduodenal manometry (ADM). We also studied whether the underlying motility disorder could be predicted from EGG parameters. METHODS: We compared 21 parameters measured from EGG with 8 parameters measured from ADM. The ability of EGG to identify the underlying diagnosis was tested by comparing EGG parameters for each diagnosis group against other patients. The study comprised recordings from 148 patients and 125 females. Their median age was 45 (range 17-76) years. RESULTS: We found few and weak correlations between EGG and ADM. Specifically the correlation between parameters reflecting the response to meal was poor (r = -0.07, P = 0.39). The discriminatory power of EGG for underlying motility disorder was also low. Patients with slow transit constipation (STC) showed a lower postprandial power in normogastric (3.7 ± 0.5 vs 4.0 ± 0.5) and tachygastric (3.5 ± 0.4 vs 3.7 ± 0.4) regions, a lower percentage of time with normogastria [87.2 (56.5-100)% vs 95.7 (0-100)%], and a higher percentage of time with tachygastria [9.3 (0-33)% vs 3.5 (0-100)%] and bradygastria [1.8 (0-20)% vs 0 (0-17.1)%]. Patients with irritable bowel syndrome had a higher percentage of time with normogastria [96.5 (62.5-100)% vs 93.3 (0-100)%] and a less unstable dominant frequency as measured by the instability coefficient [15 (3-77) vs 24 (2-72)]. CONCLUSION: EGG and ADM seem to measure different aspects of gastric motor activity but cannot show a spatial correlation. The diagnostic value of EGG is poor, but EGG may have some value for the identification of patients with STC.
文摘目的分析糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)单一及联合检验诊断糖尿病的价值。方法以72例疑似有糖尿病的患者作为临床研究对象,均接受HbA1c、FPG、2 h PG检验,以糖耐量测定为诊断“金标准”。比较HbA1c、FPG、2 h PG单一及联合检验的灵敏度、特异度、准确度。结果72例受检者中有58例患者确诊为糖尿病。联合检验的诊断灵敏度、特异度、准确度分别为94.83%、92.86%、94.44%;HbA1c检验的诊断灵敏度、特异度、准确度分别为75.86%、28.57%、66.67%;FPG检验的诊断灵敏度、特异度、准确度分别为81.03%、35.71%、72.22%;2 h PG检验的诊断灵敏度、特异度、准确度分别为77.59%、42.86%、70.83%。联合检验诊断的灵敏度、特异度及准确度均高于其他HbA1c、FPG、2 h PG单一诊断的灵敏度、特异度及准确度,具有统计学意义(P<0.05)。结论HbA1c、FPG、2 h PG联合检验相较单一检验诊断糖尿病具有较高的临床价值,能够为临床治疗提供有价值的参考依据。
文摘This paper reports a study of complex focussing acoustic fields of a convex phased array probe widely used in ultrasonic diagnostic B-scanner. The time delay necessary for electronic focussing and for geometric focussing of complex focussing is given. By means of Helmholtz's integral formula, the expressions of acoustic fields were obtained for the electronic focussing and complex focussing.With Simpson's numerical integral, a great deal of computations was carried out with an 86 / 330 computer. By means of using different parameters, an optimum focal range and beam width of a 4 sequences electronic and complex focussing acoustic system was selected. With an EUB-40 ultrasound diagnostic B-scanner produced by the Hitachi company, the lateral focussing acoustic field and lateral resolution in an echoic tank were photographed by latticing method and the experimental result is consistent with the theory.
文摘Objective To compare the diagnostic efficiency of the thyroid imaging reporting and data system(TIRADS),the Bethesda system for reporting thyroid cytopathology(BSRTC)and BRAFV600Edetection,and their combined use in the differentiation between benign and malignant thyroid nodules.Methods One hundred
