目的:探究第2.1版前列腺影像报告与数据系统(prostate imaging reporting and data system,PI-RADS v2.1)联合前列腺特异抗原(prostate specific antigen,PSA)、前列腺特异抗原密度(prostate specific antigen density,PSAD)在前列腺癌(...目的:探究第2.1版前列腺影像报告与数据系统(prostate imaging reporting and data system,PI-RADS v2.1)联合前列腺特异抗原(prostate specific antigen,PSA)、前列腺特异抗原密度(prostate specific antigen density,PSAD)在前列腺癌(prostate cancer,PCa)诊断中的应用价值。方法:选择2016年5月—2021年6月于南通市第二人民医院进行治疗的90例疑似前列腺癌患者作为研究对象。90例患者分别进行多参数核磁共振(mp-MRI)检查,对患者的前列腺图像进行PIRADS v2.1评分及PI-RADS v2.1评分联合PSA、PSAD诊断。以患者前列腺穿刺取组织进行病理检查结果为金标准,分析患者的PSA、PSAD水平及PI-RADS v2.1评分联合PSA、PSAD对前列腺癌的敏感度、特异度、阳性预测值和阴性预测值。结果:90例疑似PCa患者,病理学诊断结果:恶性肿瘤42例,良性肿瘤48例。良性患者和恶性患者游离前列腺特异性抗原(f-PSA)对比,差异无统计学意义(P>0.05),良性患者PSAD、总前列腺特异性抗原(t-PSA)低于恶性肿瘤,f-PSA/t-PSA高于恶性肿瘤,差异均有统计学意义(P<0.05)。PI-RADS v2.1评分联合PSA、PSAD诊断准确率高于PI-RADS v2.1评分,差异有统计学意义(P<0.05)。PI-RADS v2.1评分联合PSA、PSAD检测的敏感度、特异度、阳性预测值、阴性预测值均高于PI-RADS v2.1评分,差异均有统计学意义(P<0.05)。结论:对前列腺癌患者的诊断中,PI-RADS v2.1评分具有较高的准确性,但PI-RADS v2.1评分联合PSA、PSAD检测在敏感度、特异度和准确度更有参考价值。展开更多
The albumin-bilirubin(ALBI)score,which was proposed to assess the prognosis of patients with hepatocellular carcinoma,has gradually been extended to other liver diseases in recent years,including primary biliary chola...The albumin-bilirubin(ALBI)score,which was proposed to assess the prognosis of patients with hepatocellular carcinoma,has gradually been extended to other liver diseases in recent years,including primary biliary cholangitis,liver cirrhosis,hepatitis,liver transplantation,and liver injury.The ALBI score is often compared with classical scores such as the Child-Pugh and model for end-stage liver disease scores or other noninvasive prediction models.It is widely employed because of its immunity to subjective evaluation indicators and ease of obtaining detection indicators.An increasing number of studies have confirmed that it is highly accurate for assessing the prognosis of patients with chronic liver disease;additionally,it has demonstrated good predictive performance for outcomes beyond survival in patients with liver diseases,such as decompensation events.This article presents a review of the application of ALBI scores in various non-malignant liver diseases.展开更多
目的 基于前列腺影像报告和数据系统2.1版(Prostate Imaging Report and Data System version 2.1, PI-RADS v2.1)的双参数磁共振成像(biparametric MRI, bp-MRI)和前列腺特异性抗原(prostate specific antigen, PSA)等临床指标,构建鉴...目的 基于前列腺影像报告和数据系统2.1版(Prostate Imaging Report and Data System version 2.1, PI-RADS v2.1)的双参数磁共振成像(biparametric MRI, bp-MRI)和前列腺特异性抗原(prostate specific antigen, PSA)等临床指标,构建鉴别诊断PSA(4-20 ng/mL)前列腺癌(prostate cancer, PCa)的列线图模型。材料与方法 回顾性分析宁夏医科大学总医院2017年10月至2022年2月206例行bp-MRI检查并有病理学结果的患者资料。根据病理结果分为PCa组(n=66)和前列腺增生和(或)炎症组(n=140),经单、多因素logistic回归分析筛选PSA (4-20 ng/mL) PCa患者的独立危险因素,随后使用R软件构建列线图模型,并用决策曲线分析(decision curve analysis, DCA)其临床净效益。以受试者工作特征(receiver operating characteristic, ROC)曲线下面积(area under the curve, AUC)、敏感度和特异度评价诊断效能,并通过DeLong检验比较AUC值间的差异。结果 年龄、总前列腺特异性抗原(total prostate specific antigen, tPSA)、前列腺体积(prostate volume, PV)、PI-RADS v2.1是预测PSA (4-20 ng/mL) PCa的独立危险因素。基于上述4个独立指标构建的列线图模型诊断效能最好(AUC=0.945),明显高于PI-RADS v2.1(AUC=0.816)、PV(AUC=0.772)、tPSA(AUC=0.737)、年龄(AUC=0.680)。结论 基于bp-MRI的PI-RADS v2.1评分联合临床相关指标建立的列线图模型,预测PSA (4–20 ng/mL) PCa的诊断效能明显优于单一指标,可作为一种无创精准化预测工具,将更全面、准确地预测罹患PCa的风险概率,为临床提供有效的诊疗指导。展开更多
Managing inflammatory bowel disease(IBD)is becoming increasingly complex and personalized,considering the advent of new advanced therapies with distinct mechanisms of action.Achieving mucosal healing(MH)is a pivotal t...Managing inflammatory bowel disease(IBD)is becoming increasingly complex and personalized,considering the advent of new advanced therapies with distinct mechanisms of action.Achieving mucosal healing(MH)is a pivotal therapeutic goal in IBD management and can prevent IBD progression and reduce flares,hospitalization,surgery,intestinal damage,and colorectal cancer.Employing proactive disease and therapy assessment is essential to achieve better control of intestinal inflammation,even if subclinical,to alter the natural course of IBD.Periodic monitoring of fecal calprotectin(FC)levels and interval endoscopic evaluations are cornerstones for evaluating response/remission to advanced therapies targeting IBD,assessing MH,and detecting subclinical recurrence.Here,we comment on the article by Ishida et al Moreover,this editorial aimed to review the role of FC and endoscopic scores in predicting MH in patients with IBD.Furthermore,we intend to present some evidence on the role of these markers in future targets,such as histological and transmural healing.Additional prospective multicenter studies with a stricter MH criterion,standardized endoscopic and histopathological analyses,and virtual chromoscopy,potentially including artificial intelligence and other biomarkers,are desired.展开更多
BACKGROUND The success of liver resection relies on the ability of the remnant liver to regenerate.Most of the knowledge regarding the pathophysiological basis of liver regeneration comes from rodent studies,and data ...BACKGROUND The success of liver resection relies on the ability of the remnant liver to regenerate.Most of the knowledge regarding the pathophysiological basis of liver regeneration comes from rodent studies,and data on humans are scarce.Additionally,there is limited knowledge about the preoperative factors that influence postoperative regeneration.AIM To quantify postoperative remnant liver volume by the latest volumetric software and investigate perioperative factors that affect posthepatectomy liver regenera-tion.METHODS A total of 268 patients who received partial hepatectomy were enrolled.Patients were grouped into right hepatectomy/trisegmentectomy(RH/Tri),left hepa-tectomy(LH),segmentectomy(Seg),and subsegmentectomy/nonanatomical hepatectomy(Sub/Non)groups.The regeneration index(RI)and late rege-neration rate were defined as(postoperative liver volume)/[total functional liver volume(TFLV)]×100 and(RI at 6-months-RI at 3-months)/RI at 6-months,respectively.The lower 25th percentile of RI and the higher 25th percentile of late regeneration rate in each group were defined as“low regeneration”and“delayed regeneration”.“Restoration to the original size”was defined as regeneration of the liver volume by more than 90%of the TFLV at 12 months postsurgery.RESULTS The numbers of patients in the RH/Tri,LH,Seg,and Sub/Non groups were 41,53,99 and 75,respectively.The RI plateaued at 3 months in the LH,Seg,and Sub/Non groups,whereas the RI increased until 12 months in the RH/Tri group.According to our multivariate analysis,the preoperative albumin-bilirubin(ALBI)score was an independent factor for low regeneration at 3 months[odds ratio(OR)95%CI=2.80(1.17-6.69),P=0.02;per 1.0 up]and 12 months[OR=2.27(1.01-5.09),P=0.04;per 1.0 up].Multivariate analysis revealed that only liver resection percentage[OR=1.03(1.00-1.05),P=0.04]was associated with delayed regeneration.Furthermore,multivariate analysis demonstrated that the preoperative ALBI score[OR=2.63(1.00-1.05),P=0.02;per 1.0 up]and liver resection percentage[OR=1.02(1.00-1.05),P=0.04;per 1.0 up]were found to be independent risk factors associated with volume restoration failure.CONCLUSION Liver regeneration posthepatectomy was determined by the resection percentage and preoperative ALBI score.This knowledge helps surgeons decide the timing and type of rehepatectomy for recurrent cases.展开更多
目前,各社会团体积极参与中医药标准的制定和发布,特别是“十四五”以来,中医药团体标准化工作更是迎来了提质增效的关键阶段。深入评估社会团体发布的中医药标准质量,是推进中医药团体标准工作的关键环节和重点任务。前期已研制并形成...目前,各社会团体积极参与中医药标准的制定和发布,特别是“十四五”以来,中医药团体标准化工作更是迎来了提质增效的关键阶段。深入评估社会团体发布的中医药标准质量,是推进中医药团体标准工作的关键环节和重点任务。前期已研制并形成了中医药团体标准评价体系(System of Consortium Standards Rating and Evaluation of Traditional Chinese Medicine, SCORETCM)。在上述背景下,本研究通过专家共识法,设计了一套基于SCORE-TCM的中医药团体标准抽样评价方案,应用场景为对于特定社会团体发布的标准,或各团体发布的特定技术类别的标准进行快速评估。该方案涵盖了标准抽样、材料收集、标准评价、结果解读的完整流程,为中医药团体标准的抽样评价工作提供了参考方案。展开更多
本文全面解读了中医药团体标准评价体系(System of Consortium Standards Rating and Evaluation of Traditional Chinese Medicine,SCORE-TCM)。SCORE-TCM是结合定性与定量评价,全面评估中医药团体标准在制定主体、文本编写、技术内容...本文全面解读了中医药团体标准评价体系(System of Consortium Standards Rating and Evaluation of Traditional Chinese Medicine,SCORE-TCM)。SCORE-TCM是结合定性与定量评价,全面评估中医药团体标准在制定主体、文本编写、技术内容、推广应用和实施效益等几方面特征的综合评价工具。文中详述了SCORE-TCM的构建目的、定义和构建过程,解释了评价指标体系中的各项指标,并对每项指标的评价材料进行介绍。本文旨在帮助中医药团体标准的制定者、第三方评价机构和其他相关方更好地理解SCORE-TCM各评价条目的含义,更有效地运用于中医药团体标准的自评价或第三方评价,SCORE-TCM将为《中医药团体标准管理办法》的贯彻实施,以及中医药团体标准的高质量发展提供技术支持。展开更多
文摘The albumin-bilirubin(ALBI)score,which was proposed to assess the prognosis of patients with hepatocellular carcinoma,has gradually been extended to other liver diseases in recent years,including primary biliary cholangitis,liver cirrhosis,hepatitis,liver transplantation,and liver injury.The ALBI score is often compared with classical scores such as the Child-Pugh and model for end-stage liver disease scores or other noninvasive prediction models.It is widely employed because of its immunity to subjective evaluation indicators and ease of obtaining detection indicators.An increasing number of studies have confirmed that it is highly accurate for assessing the prognosis of patients with chronic liver disease;additionally,it has demonstrated good predictive performance for outcomes beyond survival in patients with liver diseases,such as decompensation events.This article presents a review of the application of ALBI scores in various non-malignant liver diseases.
文摘Managing inflammatory bowel disease(IBD)is becoming increasingly complex and personalized,considering the advent of new advanced therapies with distinct mechanisms of action.Achieving mucosal healing(MH)is a pivotal therapeutic goal in IBD management and can prevent IBD progression and reduce flares,hospitalization,surgery,intestinal damage,and colorectal cancer.Employing proactive disease and therapy assessment is essential to achieve better control of intestinal inflammation,even if subclinical,to alter the natural course of IBD.Periodic monitoring of fecal calprotectin(FC)levels and interval endoscopic evaluations are cornerstones for evaluating response/remission to advanced therapies targeting IBD,assessing MH,and detecting subclinical recurrence.Here,we comment on the article by Ishida et al Moreover,this editorial aimed to review the role of FC and endoscopic scores in predicting MH in patients with IBD.Furthermore,we intend to present some evidence on the role of these markers in future targets,such as histological and transmural healing.Additional prospective multicenter studies with a stricter MH criterion,standardized endoscopic and histopathological analyses,and virtual chromoscopy,potentially including artificial intelligence and other biomarkers,are desired.
文摘BACKGROUND The success of liver resection relies on the ability of the remnant liver to regenerate.Most of the knowledge regarding the pathophysiological basis of liver regeneration comes from rodent studies,and data on humans are scarce.Additionally,there is limited knowledge about the preoperative factors that influence postoperative regeneration.AIM To quantify postoperative remnant liver volume by the latest volumetric software and investigate perioperative factors that affect posthepatectomy liver regenera-tion.METHODS A total of 268 patients who received partial hepatectomy were enrolled.Patients were grouped into right hepatectomy/trisegmentectomy(RH/Tri),left hepa-tectomy(LH),segmentectomy(Seg),and subsegmentectomy/nonanatomical hepatectomy(Sub/Non)groups.The regeneration index(RI)and late rege-neration rate were defined as(postoperative liver volume)/[total functional liver volume(TFLV)]×100 and(RI at 6-months-RI at 3-months)/RI at 6-months,respectively.The lower 25th percentile of RI and the higher 25th percentile of late regeneration rate in each group were defined as“low regeneration”and“delayed regeneration”.“Restoration to the original size”was defined as regeneration of the liver volume by more than 90%of the TFLV at 12 months postsurgery.RESULTS The numbers of patients in the RH/Tri,LH,Seg,and Sub/Non groups were 41,53,99 and 75,respectively.The RI plateaued at 3 months in the LH,Seg,and Sub/Non groups,whereas the RI increased until 12 months in the RH/Tri group.According to our multivariate analysis,the preoperative albumin-bilirubin(ALBI)score was an independent factor for low regeneration at 3 months[odds ratio(OR)95%CI=2.80(1.17-6.69),P=0.02;per 1.0 up]and 12 months[OR=2.27(1.01-5.09),P=0.04;per 1.0 up].Multivariate analysis revealed that only liver resection percentage[OR=1.03(1.00-1.05),P=0.04]was associated with delayed regeneration.Furthermore,multivariate analysis demonstrated that the preoperative ALBI score[OR=2.63(1.00-1.05),P=0.02;per 1.0 up]and liver resection percentage[OR=1.02(1.00-1.05),P=0.04;per 1.0 up]were found to be independent risk factors associated with volume restoration failure.CONCLUSION Liver regeneration posthepatectomy was determined by the resection percentage and preoperative ALBI score.This knowledge helps surgeons decide the timing and type of rehepatectomy for recurrent cases.
文摘目前,各社会团体积极参与中医药标准的制定和发布,特别是“十四五”以来,中医药团体标准化工作更是迎来了提质增效的关键阶段。深入评估社会团体发布的中医药标准质量,是推进中医药团体标准工作的关键环节和重点任务。前期已研制并形成了中医药团体标准评价体系(System of Consortium Standards Rating and Evaluation of Traditional Chinese Medicine, SCORETCM)。在上述背景下,本研究通过专家共识法,设计了一套基于SCORE-TCM的中医药团体标准抽样评价方案,应用场景为对于特定社会团体发布的标准,或各团体发布的特定技术类别的标准进行快速评估。该方案涵盖了标准抽样、材料收集、标准评价、结果解读的完整流程,为中医药团体标准的抽样评价工作提供了参考方案。
文摘本文全面解读了中医药团体标准评价体系(System of Consortium Standards Rating and Evaluation of Traditional Chinese Medicine,SCORE-TCM)。SCORE-TCM是结合定性与定量评价,全面评估中医药团体标准在制定主体、文本编写、技术内容、推广应用和实施效益等几方面特征的综合评价工具。文中详述了SCORE-TCM的构建目的、定义和构建过程,解释了评价指标体系中的各项指标,并对每项指标的评价材料进行介绍。本文旨在帮助中医药团体标准的制定者、第三方评价机构和其他相关方更好地理解SCORE-TCM各评价条目的含义,更有效地运用于中医药团体标准的自评价或第三方评价,SCORE-TCM将为《中医药团体标准管理办法》的贯彻实施,以及中医药团体标准的高质量发展提供技术支持。
