Characterization of the key aroma compounds in four varieties of pomegranate juice by gas chromatography-mass spectrometry(GC-MS),gas chromatography-olfactometry(GC-O),odor activity value(OAV),aroma recombination,and omission tests

P omegranate(Punica granatum L.)has attracted considerable attention in world markets due to its valuable nutrients and highly appreciated sensory properties.The aroma profiles of 4 varieties of pomegranate juice,including Dahongtian(DP),Jingpitian(JP),Luyudan(LP),and Tianhonngdan(TP),were investigated via gas chromatography-mass spectrometry(GC-MS)and gas chromatography-olfactometry(GC-O)analyses.A total of 43 volatile compounds were identified by using GC-MS.Among these compounds,16 were considered as potential aroma-active compounds as detected by GC-O.These compounds belonged to the classes of terpinenes,alcohols,and aldehydes.Eleven volatile compounds were defined as the main contributors to the overall aroma of pomegranate juice due to their high odor activity values(OAVs≥1).Aroma recombination and omission tests confirmed thatβ-myrcene,1-hexanol,and(Z)-3-hexen-1-ol were the key aroma compounds,and limonene,1-octen-3-ol,linalool,and hexanal were important aroma-active compounds in DP samples.

Predictive value of hypo-osmotic swelling test to identifyviable non-motile sperm

Aim: To determine the predictive value of the hypo-osmotic swelling (HOS) test to identify viable, non-motile sperm. Methods: Semen samples from 20 men with severe asthenozoospermia underwent traditional seminal analysis, eosin-nigrosin (EN) staining and the HOS test. A further EN stain was then performed on a HOS pre-treated aliquot and a total of 2000 further sperm examined. Results: The median sperm density was 5.1 million/mL (IQR 4.3-13.1) and the median motility was 3.0 % (IQR 0-7). Seven samples showed complete asthenozoospermia. Initial EN staining showed 59 % viability (range 48-69) despite the poor standard parameters and 47 % (range 33-61) in the complete asthenozoospermia subgroup. The HOS test showed 49.9 % reacted overall (range 40-59) and 41.7 % (range 22-61) in the complete asthenozoospermia subgroup. The combined HOS/EN stain showed the positive predictive value of the HOS test to identify viable sperm was 84.2 % overall and 79.7 % in the complete asthenozoospermia subgroup. Conclusion: The HOS test can effectively predict sperm viability in patients with severe and complete asthenozoospermia.

An Intercomparison of Rules for Testing the Significance of Coupled Modes of Singular Value Decomposition Analysis

This paper clarifies the essence of the significance test of singular value decomposition analysis （SVD）, and investigates four rules for testing the significance of coupled modes of SVD, including parallel analysis, nonparametric bootstrap, random-phase test, and a new rule named modified parallel analysis. A numerical experiment is conducted to quantitatively compare the performance of the four rules in judging whether a coupled mode of SVD is significant as parameters such as the sample size, the number of grid points, and the signal-to-noise ratio vary. The results show that the four rules perform better with lower ratio of the number of grid points to sample size. Modified parallel analysis and nonparametric bootstrap perform best to abandon the spurious coupled modes, but the latter is better than the former to retain the significant coupled modes when the sample size is not much larger than the number of grid points. Parallel analysis and random-phase test are robust to abandon the spurious coupled modes only when either （1） the observations at the grid points are spatially uncorrelated, or （2） the coupled signal is very strong for parallel analysis and is not weak for random-phase test. The reasons affecting the accuracy of the test rules are discussed.

Parker Test for Heteroskedasticity Based on Sample Fitted Values

To address the drawbacks of the traditional Parker test in multivariate linear models: the process is cumbersome and computationally intensive, we propose a new heteroscedasticity test. A new heteroskedasticity test is proposed using the fitted values of the samples as new explanatory variables, reconstructing the regression model, and giving a new heteroskedasticity test based on the significance test of the coefficients, it is also compared with the existing Parker test which is improved using the principal component idea. Numerical simulations and empirical analyses show that the improved Parker test with the fitted values of the samples proposed in this paper is superior.

Relation of predictive value to sensitivity and specificity of a diagnostic test

This paper discusses how the positive and negative predictive values vary withcontrary variations of sensitivity and specificity at a certain disease prevalence.Let thesensitiviy be Se and the specificity be Sp at the initial cutoff point,correspondingly Se’and Sp’ at a new cutoff point:A=Se’/Se:B-(1-Sp’)/(1-Sp):C=Sp’/Sp;D=(I-Se’)/(I-Se).Moving the cutoff point from the initial point to the new point,if the contrary variationsof the sensitivity and specificity satisfy the inequality A】B,then the positive predictivevalue increases,otherwise it decreases or remains unchanged.If the variations satisfy theinequality C】D,then the negative prcdictive value increases,otherwise it decreasses or re-mains unchanged.

Comparison of the diagnostic value of four tests for superior labrum anterior and posterior lesions of the shoulde

To compare the diagnostic value of four signs for superior labrum anterior and posterior (SLAP) lesions of the shoulder.Methods The physical examination was performed randomly on 81 cases with abnormalities of the shoulder.There were four tests,including Kibler anterior sliding test,Liu crank test,O’Brien active compression test and Kim biceps load test Ⅱ.The arthroscopic examination were also performed.The result of the arthroscopic examination was considered as a golden standard,so that we could estimate the diagnosis value of the four tests according to the method of evaluation of diagnosis test on clinical epidemiology,their sensitivity,specificity,positive and negative predictive value,accuracy.Results There were 21 cases diagnosed as SLAP lesions by arthroscopy.The diagnosis value of Kim biceps load test Ⅱ was the highest among the four tests,in which 19 of true positive,59 of true negative,1 of false positive,only 2 of false negative cases;while the sensitivity was 90.48%,specificity was 98.33%,positive predictive value was 95.00%,negative predictive value was 96.72%,and accuracy was 96.30%.However the sensitivity,specificity,positive predicitive value,negative predictive vale and accuracy of Kibler anterior sliding test were 76.19%,96.67%,88.89%,92.06%,91.33%;and those of Liu crank test were 85.71%,93.33%,81.82%,94.92%,91.35%;those of O’Brien active compression test were 80.95%,91.66%,77.27%,93.22%,88.89%.Conclusion Kim Biceps load test Ⅱ may be the best for clinical diagnosis of SLAP lesions of the shoulder.9 refs,4 figs,2 tabs.

Defining laboratory reference values and decision limits＇ populations, intervals, and interpretations

This article provides a brief overview of various approaches that may be utilized for the analysis of human semen test results. Reference intervals are the most widely used tool for the interpretation of clinical laboratory results. Reference interval development has classically relied on concepts elaborated by the International Federation of Clinical Chemistry Expert Panel on Reference Values during the 1980s. These guidelines involve obtaining and classifying samples from a healthy population of at least 120 individuals and then identifying the outermost 5% of observations to use in defining limits for two-sided or one-sided reference intervals. More recently, decision limits based on epidemiological outcome analysis have also been introduced to aid in test interpretation. The reference population must be carefully defined on the basis of the intended clinical use of the underlying test. To determine appropriate reference intervals for use in male fertility assessment, a reference population of men with documented time to pregnancy of 〈 12 months would be most suitable. However, for epidemiological assessment of semen testing results, a reference population made up ofunselected healthy men would be preferred. Although reference and decision limits derived for individual semen analysis test results will undoubtedly be the interpretational tools of choice in the near future, in the long term, multivariate methods for the interpretation of semen analysis alone or in combination with information from the female partner seem to represent better means for assessing the likelihood of achieving a successful pregnancy in a subfertile couple.

Calorific values and ash contents of different parts of Masson pine trees in southern China

Calorific value of plants is an important parameter for evalu- ating and indexing material cycles and energy conversion in forest eco- systems. Based on mensuration data of 150 sample sets, we analyzed the calorific value （CV） and ash content （AC） of different parts of Masson pine （Pinus massoniana） trees in southern China using hypothesis testing and regression analysis. CV and AC of different tree parts were almost significantly different （P〈0.05）. In descending order, ash-free calorific value （AFCV） ranked as foliage 〉 branch 〉 stem bark 〉 root 〉 stem wood, and AC ranked as foliage 〉 stem bark 〉 root 〉 branch 〉 stem wood. CV and AC of stem wood from the top, middle and lower sections of trees differed significantly. CV increased from the top to the lower sections of the tnmk while AC decreased. Mean gross calorific value （GCV） and AFCV of aboveground parts were significantly higher than those of belowground parts （roots）. The mean GCV, AFCV and AC of a whole tree of Masson pine were 21.54 kJ/g, 21.74 kJ/g and 0.90%, re- spectively. CV and AC of different tree parts were, to some extent, cor- related with tree diameter, height and origin.

Determination of hydrophilic–lipophilic balance value and emulsion properties of sacha inchi oil

Objective: To determine hydrophilic–lipophilic balance(HLB) value, stability of formulate emulsion and properties of sacha inchi oil.Methods: The physiochemical characteristics of sacha inchi oil were first investigated.Free radical scavenging property was studied by DPPH assay. HLB value of sacha inchi oil was experimentally determined by preparing the emulsion using emulsifiers at different HLB value. Sacha inchi oil emulsion was prepared using the obtained HLB and its stability was conducted by centrifugation, temperature cycling, and accelerated stability test. The efficiency of the prepared emulsion was clinically investigated by 15 volunteers. The primary skin irritation was performed using closed patch test. Subjective sensory assessment was evaluated by using 5-point hedonic scale method.Results: Peroxide value of sacha inchi oil was 18.40 meq O2/kg oil and acid value was1.86 KOH/g oil. The major fatty acids are omega-3(44%), omega-6(35%) and omega-9(9%). The vitamin E content was 226 mg/100 g oil. Moreover, sacha inchi oil(167 ppm)and its emulsion showed 85% and 89% DPPH inhibition, respectively. The experimental HLB value of sacha inchi oil was 8.5. The sacha inchi oil emulsion exhibited good stability after stability test. The emulsion was classified as non-irritant after tested by primary skin irritation method. The skin hydration value significantly increased from38.59 to 45.21(P < 0.05) after applying sacha inchi oil emulsion for 1 month and the overall product satisfaction of volunteers after use was with score of 4.2.Conclusions: This work provides information on HLB value and emulsion properties of sacha inchi oil which is useful for cosmetic and pharmaceutical application.

Performance value of high risk factors in colorectal cancer screening in China

AIM:To analyze the performance value of high risk factors in population-based colorectal cancer(CRC) screening in China.METHODS:We compared the performance value of the immunochemical fecal occult blood test(iFOBT) and other high risk factors questionnaire in a population sample of 13 214 community residents who completed both the iFOBT and questionnaire investigation.Patients with either a positive iFOBT and/or questionnaire were regarded as a high risk population and those eligible were asked to undergo colonoscopy.RESULTS:The iFOBT had the highest positive predictive value and negative predictive value in screening for advanced neoplasia.The iFOBT had the highest sensitivity,lowest number of extra false positive results associated with the detection of one extra abnormality for screening advanced neoplasias and adenomas.A history of chronic cholecystitis or cholecystectomy,chronic appendicitis or appendectomy,and chronic diarrhea also had a higher sensitivity than a history of adenomatous polyps in screening for advanced neoplasias and adenomas.The sensitivity of a history of chronic cholecystitis or cholecystectomy was highest among the 10 high risk factors in screening for nonadenomatous polyps.A history of chronic appendicitis or appendectomy,chronic constipation,chronic diarrhea,mucous and bloody stool,CRC in first degree relatives,malignant tumor and a positive iFOBT also had higher sensitivities than a history of adenomas polyps in screening for non-adenomatous polyps.Except for a history of malignant tumor in screening for non-adenomatous polyps,the gain in sensitivity was associated with an increase in extra false positive results associated with the detection of one extra abnormality.CONCLUSION:The iFOBT may be the best marker for screening for advanced neoplasias and adenomas.Some unique high risk factors may play an important role in CRC screening in China.

Evaluation of the immunochromatographic strip test for the rapid diagnosis of antenatal syphilis in women in Eldoret,Kenya

Objective： This study compared the performance of the immunochromatographic strip （ICS） to the Venereal Disease Research Laboratory （VDRL） test and Treponema pallidum haemagglutination assay （TPHA） at a primary health care setting. Methods： The study group was comprised of 150 females randomly drawn from a population of pregnant women attending their first antenatal visit or follow-up visits at West Maternity Hospital in Eldoret Kenya, but without a previous syphilis test during that pregnancy. On-site VDRL, ICS and TPHA tests were performed and immediate treatment provided where appropriate. The performance of the three tests was compared, Results： The sero-prevalence of syphilis as determined by the VDRL test was 3%. There was no significant difference between the ICS and the VDRL test （P 〉 0.05）. The sensitivity and specificity of the ICS test were 80% and 98.6% respectively, while the negative predictive value （NPV） and positive predictive value （PPV） were both 100%. On the other hand, the sensitivity and specificity of the VDRL test were 66.7% and 99.3%, while the NPV and PPV were 80% and 98.6% respectively. The Treponema pallidum haemagglutination assay was used as a reference test and had sensitivity, specificity, NPV and PPV of 100%. Conclusion： The diagnostic accuracy of the ICS compared favorably with theVDRL gold standard. The use of the ICS in Kenya can improve the diagnosis of syphilis in health facilities both with and without laboratories and allow community health care workers to make a rapid diagnosis of the disease, and consequently make immediate therapeutic decisions.

Analysis of the Dynamic Relationship among Financial Fund for Agriculture, Agricultural Output Value and Farmers' income

By using the methods of co-integration, impulse response function and variance decomposition, I conduct the empirical research on the dynamic relationship among China's financial fund for agriculture, agricultural output value, and farmers' income from the year 1978 to the year 2009. The results indicate that the government's financial fund for agriculture plays the significant role in promoting agricultural output value and farmers' income in the long run, but this role of promoting is not prominent in the short run; in the mean time, agricultural output value plays insignificant role in promoting farmers' income and the government's financial fund for agriculture; farmers' income plays the significant role in promoting agricultural output value and the government's financial fund for agriculture.

Diagnosis of Helicobacter pylori Infection in Low Out-Outcome Country: Rapid Urease Test, Serological Test, versus Direct Microbiological Examination with Gram Stain

Introduction: Helicobacter pylori is a gram-negative bacillus responsible for numerous gastroduodenal pathologies, and this infection is a public health problem. The prevalence of infection with this bacterium remains high in countries with limited resources. Diagnosis relies mainly on numerous invasive and noninvasive methods. The aim of this work was to evaluate the different indirect diagnostic methods using bacterial cultures. Methods: We conducted a cross-sectional and analytical study from January to May 2022 in the gastroenterology departments of Douala General Hospital and Douala Military Hospital. All patients aged 18 years and older who were in the gastroenterology consultation and agreed to participate were included in our study. Sociodemographic, clinical, and paraclinical data were collected. Urease, liquid urea, and culture tests were performed from the specimens obtained by fibroscopy. Serological tests were performed on the blood sample. Results: 101 patients were included, 58 were female and 43 were male, for a sex ratio of 1.3. The mean age was 44.2 ± 16 years. The prevalence of infection was 90.5%, 44.1%, 40.6% and 21.8% for serology, direct microbiological examination, RUT (rapid urea test) and culture, respectively. Comparison of the different tests showed sensitivity and specificity of 67.1% and 64%, respectively, for RUT, 100% and 73.7%, respectively, for direct microbiological examination, and 100% and 14.8%, respectively, for serology. The positive and negative predictive values were 39.5% and 100% for serology, 39% and 85% for RUT, and 55.6% and 100% for direct microbiological examination, respectively. Conclusion: The prevalence of Helicobacter pylori infection depends on the type of test used. Direct examination is more reliable than RUT and serology.

Predictive value of symptoms and demographics in diagnosing malignancy or peptic stricture

AIM:To determine which features of history and demographics predict a diagnosis of malignancy or peptic stricture in patients presenting with dysphagia.METHODS:A prospective case-control study of 2000 consecutive referrals(1031 female,age range:17-103 years) to a rapid access service for dysphagia,based in a teaching hospital within the United Kingdom,over 7 years.The service consists of a nurse-led telephone triage followed by investigation(barium swallow or gastroscopy),if appropriate,within 2 wk.Logistic regression analysis of demographic and clinical variables was performed.This includes age,sex,duration of dysphagia,whether to liquids or solids,and whether there are associated features(reflux,odynophagia,weight loss,regurgitation).We determined odds ratio(OR) for these variables for the diagnoses of malignancy and peptic stricture.We determined the value of the Edinburgh Dysphagia Score(EDS) in predicting cancer in our cohort.Multivariate logistic regression was performed and P < 0.05 considered significant.The local ethics committee confirmed ethics approval was not required(audit).RESULTS:The commonest diagnosis is gastro-esophageal reflux disease(41.3%).Malignancy(11.0%) and peptic stricture(10.0%) were also relatively common.Malignancies were diagnosed by histology(97%) or on radiological criteria,either sequential barium swallows showing progression of disease or unequivocal evidence of malignancy on computed tomography.The majority of malignancies were esophago-gastric in origin but ear,nose and throat tumors,pancreatic cancer and extrinsic compression from lung or mediastinal metastatic cancer were also found.Malignancy was statistically more frequent in older patients(aged >73 years,OR 1.1-3.3,age < 60 years 6.5%,60-73 years 11.2%,> 73 years 11.8%,P < 0.05),males(OR 2.2-4.8,males 14.5%,females 5.6%,P < 0.0005),short duration of dysphagia(≤ 8 wk,OR 4.5-20.7,16.6%,8-26 wk 14.5%,> 26 wk 2.5%,P < 0.0005),progressive symptoms(OR 1.3-2.6:progressive 14.8%,intermittent 9.3%,P < 0.001),with weight loss of ≥ 2 kg(OR 2.5-5.1,weight loss 22.1%,without weight loss 6.4%,P < 0.0005) and without reflux(OR 1.2-2.5,reflux 7.2%,no reflux 15.5%,P < 0.0005).The likelihood of malignancy was greater in those who described true dysphagia(food or drink sticking within 5 s of swallowing than those who did not(15.1%vs 5.2% respectively,P < 0.001).The sensitivity,specificity,positive predictive value and negative predictive value of the EDS were 98.4%,9.3%,11.8% and 98.0% respectively.Three patients with an EDS of 3(high risk EDS ≥ 3.5) had malignancy.Unlike the original validation cohort,there was no difference in likelihood of malignancy based on level of dysphagia(pharyngeal level dysphagia 11.9% vs mid sternal or lower sternal dysphagia 12.4%).Peptic stricture was statistically more frequent in those with longer duration of symptoms(> 6 mo,OR 1.2-2.9,≤ 8 wk 9.8%,8-26 wk 10.6%,> 26 wk 15.7%,P < 0.05) and over 60 s(OR 1.2-3.0,age < 60 years 6.2%,60-73 years 10.2%,> 73 years 10.6%,P < 0.05).CONCLUSION:Malignancy and peptic stricture are frequent findings in those referred with dysphagia.The predictive value for associated features could help determine need for fast track investigation whilst reducing service pressures.

Estimation of Dynamic VaR in Chinese Stock Markets Based on Time Scale and Extreme Value Theory

The accuracy and time scale invariance of value-at-risk （VaR） measurement methods for different stock indices and at different confidence levels are tested. Extreme value theory （EVT） is applied to model the extreme tail of standardized residual series of daily/weekly indices losses, and parametric and nonparametric methods are used to estimate parameters of the general Pareto distribution （GPD）, and dynamic VaR for indices of three stock markets in China. The accuracy and time scale invariance of risk measurement methods through back-testing approach are also examined. Results show that not all the indices accept time scale invariance; there are some differences in accuracy between different indices at various confidence levels. The most powerful dynamic VaR estimation methods are EVT-GJR-Hill at 97.5% level for weekly loss to Shanghai stock market, and EVT-GARCH-MLE （Hill） at 99.0% level for weekly loss to Taiwan and Hong Kong stock markets, respectively.

Study of the Effect of Bacterial Resistance Monitoring in Clinical Microbiology Testing

Objective:To observe and analyze the effect of bacterial resistance monitoring in clinical microbiology testing.Methods:600 microbial specimens collected in our hospital in the past year(April 2021 to April 2022)were used as the test subjects of this study.The specimens were divided into Group A(control group)and Group B(research group),with 300 cases in each group.Group A consisted of blood culture specimens,while Group B consisted of sputum specimens.After the tests were completed,the rates of unfavorable and favorable results,bacterial species distribution,and bacterial drug resistance of the specimens in both groups were compared.Results:Among group A specimens,29 cases were positive(9.67%)and 271 cases were negative(90.33%);among group B specimens,99 cases were positive(33.00%)and 201 cases were negative(66.00%);the difference between the two groups of data was statistically significant(P<0.05).As for the distribution of the types of bacteria,there were 472 cases of Gram-negative bacteria and 128 cases of Gram-positive bacteria.Conclusion:Bacterial resistance monitoring is helpful in clinical microbiology testing.Through proper monitoring,bacterial resistance can be well understood.In this way,patients get to receive appropriate treatment measures and suitable antibacterial prescriptions,thereby improving the patient outcome.

Frequency Dependence of the <i>b</i>-Value Used for Acoustic Emission Analysis of Glass Fiber Reinforced Plastics

Acoustic Emission Testing (AT) is one of the major non-destructive testing methods used for severity evaluation of structures. Amplitude distributions of AE signals are characterized by b-value and the value is mainly used for the severity evaluation of concrete structures until now. The value is assumed to be independent with propagation distance between acoustic emission sources to AE sensors. We evaluate the influence of the wide frequency band encountered in the fracture behavior of glass fiber reinforced plastic (GFRP) on the b-value analysis. In tensile tests, the b-value was determined from an acoustic emission (AE) source generated near a centered hole in a specimen of GFRP. At 15 mm from the hole, the b-value analysis indicated a decreasing trend with increasing tensile stress. At a propagation length of 45 mm, farthest from the hole, a?small number of AE signals were received. The attenuation is more rapid for high-frequency AE signals. Thus, the amplitude distribution bandwidth is wide and the b-value changes. This change in b-value for GFRPs is investigated by analyzing the spectral components of the AE signals. For a single-frequency AE source, the b-value is unchanged with propagation length. In contrast, multiple-frequency AE sources produce changes in b-value proportional to the fraction of each spectral component in the received signal. This is due to the frequency dependence of the attenuation with propagation length.?From these results, the b-value analysis cannot be applied to considering frequency dependence of AE attenuation.

纤支镜下刷检薄层液基细胞学检查在肺癌诊断价值的研究

目的:研究纤支镜下刷检薄层液基细胞学检查(LCT)在肺癌诊断价值。方法:选取2023年4月到2024年3月间江门市新会区人民医院呼吸与危重症医学科首诊患者80名,所有患者均采用传统支气管镜活检、刷检涂片细胞学检查和刷检LCT检查的方法。传统刷检涂片细胞学检查(CS)为对照组,支气管镜刷检LCT检查为液基组,支气管镜活检为钳检组。对比各组对肺癌诊断阳性率,分析液基组及对照组对肺癌组织类型的检查情况,对比两组对肺癌组织类型的检查结果。结果:液基组对肺癌诊断的阳性率为40.00%(32/80),较对照组的25.00%(20/80)明显更高(P<0.05)。但液基组与钳检组比较,差异不显著(P>0.05)。LCT对肺癌鳞癌诊断的符合率为83.33%(10/12),对腺癌的诊断符合率为42.86%(6/14),对小细胞癌的诊断符合率为75.00%(9/12)。CS对肺癌鳞癌诊断的符合率为41.67%(5/12),对腺癌的诊断符合率为66.67%(8/12),对小细胞癌的诊断符合率为35.71%(5/14)。液基组对于肺癌组织类型为鳞癌以及小细胞癌的符合率较对照组更高(P<0.05),但两组对腺癌的符合率比较,差异不显著(P>0.05)。结论:应用纤支镜下刷检LCT检查在肺癌的诊断价值较高,且值得在临床诊断过程中给予推广。

“z值评价-风险评估-技术核验”统计评价模型用于低样本量能力验证——以水质监测为例

为解决低样本量下的能力验证z比分数评价结果可能偏离参加者真实能力水平的问题,建立了“z值评价-风险评估-技术核验”统计评价模型,以“一带一路”共建国家“水中铁和氟化物的检测”国际能力验证项目为例进行了验证。结果显示:样本量为14家(低样本量)、指定值与样本真值相对误差的绝对值大于4%时,铁检测项目获得“满意”评价结果的14家参加者中,5家存在数据“不准确”中/高风险;氟化物检测项目获得“满意”评价结果的11家参加者中,7家存在数据“不准确”中/高风险。技术核验反映出的突出问题是参加者未按照检测方法的要求实施质量控制措施,标准曲线绘制、试剂配制、关键仪器参数设置记录缺失,原始记录可追溯性较差。由此证实了数据风险点的存在,同时也印证了该统计评价模型的可靠性和必要性。

超声联合染色体检测在诊断胎儿心脏发育异常中的价值

目的本研究旨在探讨超声联合染色体检测对于诊断胎儿心脏发育异常的临床价值。方法前瞻性选取2022年1月至2022年12月在上海交通大学医学院附属国际和平妇幼保健院进行建档产检的孕妇进行超声检查,将高度疑似胎儿发育异常的96例孕妇纳入研究中。均接受染色体检测,以分娩后新生儿结局或引产诊断结果为金标准,对超声及染色体检测的诊断价值进行探究。结果对纳入研究的96例孕妇进行追踪随访(至分娩完成新生儿接受超声诊断或引产后接受病理诊断止),共追踪到29例胎儿心脏发育表现正常,67例胎儿心脏发育异常。经超声检查,32例产妇未见胎儿心脏发育异常,其他64例诊出胎儿心脏发育异常;经染色体检查,共诊出正常染色体36例,染色体异常64例。以分娩后新生儿结局或引产病理诊断结果为诊断金标准,超声检查真阳性(心脏发育异常)59例,真阴性(心脏发育异常)24例,超声联合染色体检测真阳性(心脏发育异常)63例,真阴性(心脏发育异常)23例。超声联合染色体检测诊断胎儿心脏发育异常的灵敏度、准确率分别为94.03%、89.58%,分别高于单独的超声检查(88.06%、86.46%),AUC值(95%CI)为0.854(0.762~0.946),优于单独的超声检查[0.878(0.773~0.960)]。结论超声联合染色体检测在诊断胎儿心脏发育异常方面具有较高的诊断价值和临床应用前景。相较于单独的超声检查,超声联合染色体检测展现出更高的灵敏度以及更优的准确率,可作为诊断胎儿心脏发育异常的有力工具。