Application value of Qisexingtai hand diagnostic method in diagnosis of coronary artery disease

OBJECTIVE:To evaluate the diagnostic efficacy of Qisexingtai hand diagnostic method in the diagnosis of coronary artery disease(CAD).METHODS:This was an investigator-initiated,prospective,multi-center,cross-sectional study.All the participants from three hospitals in China had been diagnosed by both Qisexingtai hand diagnostic method and coronary angiography.We compared the two diagnostic methods to calculate the sensitivity,the specificity,the omission diagnostic rate,the mistaken diagnostic rate and accuracy in order to evaluate the diagnostic efficacy of Qisexingtai hand diagnostic method for CAD.RESULTS:A total of 326 subjects were enrolled,diagnosed by both Qisexingtai hand diagnostic method and coronary angiography.As a result,there were 166 positive cases according to Qisexingtai hand diagnostic method,and 131 positive cases according to coronary angiography.Compared with the results of coronary angiography,the sensitivity of Qisexingtai hand diagnostic method was 80.2%,the specificity was 68.7%,the omission diagnostic rate was 19.8%,the mistaken diagnostic rate was 31.3%,and the accuracy was 73.3%.Area under the receiver operating characteristic curve was estimated as 0.735 for all,and 0.718,0.735,0.783 for the three sub-centers.CONCLUSION:Qisexingtai hand diagnostic method with high accuracy and sensitivity has certain application value in the diagnosis of CAD.

普通白光胃镜与放大胃镜结合窄带成像技术在萎缩性胃炎和早期胃癌中的诊断价值

目的探究普通白光胃镜与放大胃镜结合窄带成像技术(ME-NBI)在萎缩性胃炎和早期胃癌中的诊断价值。方法回顾性选取2016年3月到2017年3月至复旦大学附属中山医院徐汇医院就诊的人群的资料,共计243例。经过受试人员同意后对患者行白光胃镜检查,之后再对患者行放大胃镜结合窄带成像技术检查,采集可疑部位组织进行病理学检查,比较两种检查方式灵敏度、特异度、阳性预测值、阴性预测值和准确性的差异。结果 243例受试人员中,行常规白光胃镜检查结果发现内镜下存在有可疑病灶,经胃镜下多点取活检标本病理证实:萎缩性胃炎226例;早期胃癌17例。普通白光胃镜检测显示,萎缩性胃炎检出率为94.7%(214/226),早期胃癌的检出率为29.4%(5/17);放大胃镜结合窄带成像技术检测显示,萎缩性胃炎检出率为99.6%,早期胃癌的检出率为88.2%(15/17),两组检查方法检出率差异具有统计学意义(P<0.05)。普通白光胃镜组对早期胃癌诊断的灵敏度、特异度、阳性预测值、阴性预测值和准确性分别为93.2%、53.5%、25.3%、97.4%、54.0%,而放大胃镜结合窄带成像技术组对早期胃癌诊断的灵敏度、特异度、阳性预测值、阴性预测值和准确性分别为88.2%、99.4%、97.3%、94.3%、97.0%,后者准确性显著高于前者,且差异具有统计学意义(P<0.05)。结论放大胃镜结合窄带成像技术可以显著提高萎缩性胃炎和胃癌患者的检出率,且对早期胃癌患者检测准确率高,操作简便,可执行性强,有助于早期筛查和诊断工作的进行。