Diagnostic challenges in alcohol use disorder and alcoholic liver disease

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.

Intraprocedural gastric juice analysis as compared to rapid urease test for real-time detection of Helicobacter pylori

BACKGROUND Endofaster is an innovative technology that can be combined with upper gastrointestinal endoscopy(UGE)to perform gastric juice analysis and real-time detection of Helicobacter pylori(H.pylori).AIM To assess the diagnostic performance of this technology and its impact on the management of H.pylori in the real-life clinical setting.METHODS Patients undergoing routine UGE were prospectively recruited.Biopsies were taken to assess gastric histology according to the updated Sydney system and for rapid urease test(RUT).Gastric juice sampling and analysis was performed using the Endofaster,and the diagnosis of H.pylori was based on real-time ammonium measurements.Histological detection of H.pylori served as the diagnostic gold standard for comparing Endofaster-based H.pylori diagnosis with RUT-based H.pylori detection.RESULTS A total of 198 patients were prospectively enrolled in an H.pylori diagnostic study by Endofasterbased gastric juice analysis(EGJA)during the UGE.Biopsies for RUT and histological assessment were performed on 161 patients(82 men and 79 women,mean age 54.8±19.2 years).H.pylori infection was detected by histology in 47(29.2%)patients.Overall,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value(NPV)for H.pylori diagnosis by EGJA were 91.5%,93.0%,92.6%,84.3%,and 96.4%,respectively.In patients on treatment with proton pump inhibitors,diagnostic sensitivity was reduced by 27.3%,while specificity and NPV were unaffected.EGJA and RUT were comparable in diagnostic performance and highly concordant in H.pylori detection(κ-value=0.85).CONCLUSION Endofaster allows for rapid and highly accurate detection of H.pylori during gastroscopy.This may guide taking additional biopsies for antibiotic susceptibility testing during the same procedure and then selecting an individually tailored eradication regimen.

Recent Advances on the Technologies to Increase Fertilizer Use Efficiency

To increase fertilizer use efficiency （FUE） and to minimize its negative impact on environment have been the focal points in the world for a long time. It is very important to increase FUE in China for its relatively low FUE and serious losses of nutrients. Recent advances of the technologies to increase FUE are reviewed in this article. These include site-specific and real-time nitrogen management, non-destructive quick test of the nitrogen status of plants, new types of slow release and controlled release fertilizers, site-specific nutrient management, and use of urease inhibitor and nitrification inhibitor to decrease nitrogen losses. Future outlook in technologies related to FUE improvement is also discussed.

Land use and landscape pattern change: a linkage to the construction of the Qinghai-Xizang Highway

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.

Electrogastrography: Poor correlation with antro-duodenal manometry and doubtful clinical usefulness in adults

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.

The study of complex focussing acoustic field of a convex phased array probe used in ultrasonic diagnostic B-scanner

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.

Comparison of diagnostic value of TIRADS,BSRTC,BRAF^(V600E) mutation detection and their combined use in differentiating thyroid nodules

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

幽门螺杆菌尿素酶依赖性试验

幽门螺杆菌(Helicobacter pylori,Hp)是人类最常见的一种致病菌,是慢性胃炎和消化性溃疡的重要致病因素之一,并且与胃癌的发生密切相关,世界卫生组织国际癌症研究机构已将该菌纳入第一类致癌原,因此,Hp 日益受到各国学者的高度重视.Hp 的重要生物学特征之一是含有丰富及高活性的尿素酶.目前临床对 Hp 感染的诊断主要是利用 Hp 的这一特性.现就 Hp 尿素酶依赖性试验进行评价.

尿素呼气试验和粪便抗原检测对消化性溃疡出血患者幽门螺杆菌感染诊断价值的Meta分析

背景在消化性溃疡出血(PUB)患者中,抑酸药物的使用以及出血状态等会对幽门螺杆菌(H.pylori)感染的诊断造成干扰,关于尿素呼气试验(UBT)和粪便抗原检测(SAT)应用于出血患者的诊断准确性报道并不一致。目的明确UBT和SAT用于PUB患者H.pylori感染的准确性。方法计算机检索PubMed、EMBase、the Cochrane Library、Web of Science、中国知网、万方数据知识服务平台、中国生物医学文献服务系统(CBM),收集有关PUB患者运用UBT和/或SAT诊断H.pylori感染的诊断准确性试验,检索时间为建库至2021-03-31。提取资料并应用QUADAS-2工具进行文献质量评价;运用双变量混合效应模型和网络Meta分析模型(NMA)合并诊断试验效应量;采用Meta回归和亚组分析的方法探究异质性的来源。结果共纳入18篇文献,总计25项研究,包含1105例患者。Meta分析结果显示,UBT、SAT诊断PUB患者H.pylori感染的合并灵敏度为0.90[95%CI(0.79,0.95)]、0.89[95%CI(0.81,0.94)],合并特异度为0.91[95%CI(0.86,0.95)]、0.75[95%CI(0.59,0.87)],合并诊断比值比为88.89[95%CI(31.01,254.82)]、24.35[95%CI(13.76,43.09)],合并阳性似然比为10.07[95%CI(6.07,16.71)]、3.60[95%CI(2.11,6.12)],合并阴性似然比为0.11[95%CI(0.05,0.24)]、0.15[95%CI(0.09,0.24)],综合受试者工作特征(SROC)曲线下面积为0.93[95%CI(0.90,0.95)]、0.91[95%CI(0.88,0.93)]。Meta回归提示,取样时间对UBT和SAT的灵敏度异质性存在影响,取样时间和H.pylori感染判定标准对UBT的合并特异度异质性存在影响。Deek漏斗图提示纳入研究间不存在潜在发表偏倚(P_(UBT)=0.53,P_(SAT)=0.64)。结论UBT具有更好地发现PUB患者H.pylori感染的能力,对疾病诊断的帮助优于SAT。鉴于SAT的假阳性结果,针对PUB患者不推荐单独使用SAT,同时依据取样时间与诊断效能的负相关性,为尽量避免质子泵抑制剂对检测结果的影响,推荐血流动力学稳定条件下尽早完善H.pylori相关检测。

Evolution of gastrointestinal double contrast radiography in China:researches,application and popularization

ＥｖｏｌｕｔｉｏｎｏｆｇａｓｔｒｏｉｎｔｅｓｔｉｎａｌｄｏｕｂｌｅｃｏｎｔｒａｓｔｒａｄｉｏｇｒａｐｈｙｉｎＣｈｉｎａ：ｒｅｓｅａｒｃｈｅｓ，ａｐｐｌｉｃａｔｉｏｎａｎｄｐｏｐｕｌａｒｉｚａｔｉｏｎＳＨＡＮＧＫｅ－Ｚｈｏｎｇｕｂｊｅｃｔｈｅａｄｉｎｇ...

Factors influencing the yield of mesenteric angiography in lower gastrointestinal bleed

AIM: To assess if certain triaging rules could be established to optimize the yield of mesenteric angiography. METHODS: Medical records of 101 patients were retrospectively reviewed and parameters relating to age, gender, pulse rate, blood pressure, serum hemoglobin, intensive care unit(ICU) admission, and the number of packed red blood cells(PRBC) transfused in the 12 and 24 h prior to the angiography were tabulated in two groups with positive and negative angiography results. RESULTS: We found no correlation between gender, pulse rate, blood pressure or serum hemoglobin and positivity of the mesenteric angiogram. But patients with positive angiogram were found to be on average 7 years older(73.2 years vs 65.9 years old)(P = 0.02). Angiogram was positive in 39.3 %(11/28) of patientsadmitted in ICU vs 23.2%(17/73) who were admitted elsewhere in the hospital(P = 0.03). In the 12 and 24 h prior to angiography, patients with a positive angiogram received a mean of 2.7 ± 2.3 and 3.3 ± 2.6 units of PRBC s respectively, while patients with a negative angiogram had a mean of 1.6 ± 1.9(P = 0.02) and 2.1 ± 2.6 units(P = 0.04) received respectively in the same period. CONCLUSION: Older age, ICU admission, having received at least 4 units PRBC over 12 h or 5 units over 24 h prior to angiogram are leading indicators for a positive study.

The Effects of Stabilized Urea and Split-Applied Nitrogen on Sunflower Yield and Oil Content

Sunflower is an efficient nitrogen (N) accumulator due to its aggressive taproot and extensive root system. While N rate studies in sunflower have shown a yield response, the response is often highly variable and difficult to predict in many instances. Additionally, since most sunflower production is intended for the oil market, surplus nitrogen tends to decrease oil content. Therefore, it is critical to hone nitrogen rates to maximize both yield and oil production and to incorporate alternative approaches to fertilizer application, which includes timing and method of application. The objective of the present study was to assess the efficacy of a split-application of N at either the V4 or R1 growth stage to increase yield and/or oil content in sunflower. A second objective was to examine whether a urease inhibitor could be used to retain soil N longer and achieve a similar effect as a split-application. Studies were conducted at two locations over two growing seasons in South Dakota, USA. A target rate of 90 kg·ha-1 was applied as urea-ammonium nitrate (UAN) either as an at-planting application or split-applied. Overall, N additions did significantly increase yield over a control. On average, the urease inhibitor tended to increase grain yields over split-applying N at either growth stage, however, there was no statistical effect on either grain yield or oil content. Based on 15N analysis, approximately 27% of the N in the grain was derived from the UAN fertilizer, which indicates a relatively large reliance upon soil N for grain N content. The addition of a urease inhibitor significantly increased average fertilizer uptake by nearly 6% to 32.7%.

幽门螺杆菌感染诊断方法的评价

幽门螺杆菌感染诊断方法的评价张玲霞张沥ＳｕｂｊｅｃｔｈｅａｄｉｎｇｓＨｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ；ｈｅｌｉｃｏｂａｃｔｅｒｉｎｆｅｃｔｉｏｎｓ／ｄｉａｇｎｏｓｉｓ；ｕｒｅａｓｅ／ｄｉａｇｎｏｓｔｉｃｕｓｅ主题词螺杆菌，幽门；螺杆菌感染／诊...

检测胃粘膜幽门螺杆菌感染不同方法之比较

目的研究适合临床使用的检测幽门螺杆菌（Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ，Ｈｐ）的方法．方法患有胃炎、消化性溃疡或恶性肿瘤的患者１５０例，其中男８４例，女６６例，年龄１８岁～８０岁，平均４５岁．经内镜取胃窦粘膜３～４块，分别行病理切片染色法、尿素酶法（ＵＴ）及快速尿素酶法（ＲＵＴ）检测和血清学ＨｐＩｇＧ检测．结果血清ＨｐＩｇＧ，ＵＴ，ＲＵＴ病理ＷＳ染色法的Ｈｐ检出率分别为７８７％（１１８／１５０），４８７％（７３／１５０），４８０％（７２／１５０），５８０％（８７／１５０）．ＲＵＴ的敏感性为８２８％，特异性为１００％．ＲＵＴ一点与二点取材的敏感性分别为８６４％和７９１％，无显著性差异．结论ＲＵＴ的敏感性（８２８％）和特异性（１００％）稳定，操作简单，价廉，适合临床使用．

Evaluation of cardiac betaadrenergic receptor function in chi ldren by dobutamine stress echocardiography

Objective To investigate the role of dobutamine stree echocardiography in evaluating cardiac betaadrenergic receptor (AR) function and responsive ness in children Methods Left ventricular ejection fraction (EF), fractional shortening (FS), left ventricular end systolic volume index (ESVI), the ratio of systolic b lood pressure and ESVI (SP/ESVI) were measured by dobutamine stress echocardiogr aphy (DSE) in 30 children with AR hypersensitivity, 15 children with dilated cardiomyopathy and 30 normal children respectively Results Before pharmacological stress, EF and FS were 072 and 039 r es pectively in AR hypersensitivity group versus 070 and 035 respectively i n control group There was no difference of the indices between the two groups ( P >005) SP/ESVI was 076, higher than the value of 066 in co ntro l group ( P <005); EF, FS and SP/ESVI were 041, 015 and 01 0 re spectively, which were significantly lower than those in control group After d o butamine stress of 5?gkg-1min-1 and 10?gkg-1min -1, EF, FS and SP/ESVI were sig nificantly increased in patients with AR hypersensitivity and there were no changes in children with dilated cardiomyopathy compared with values of baseline Conclusion Cardiac AR function and responsiveness can be evaluated by dobutamine stress echocardiography