Cut-off value of glycated hemoglobin A1c for detecting diabetic retinopathy in the Chinese population

BACKGROUND Glycated hemoglobin A1c(HbA1c)is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience.However,the effect of HbA1c on diabetic retinopathy(DR)in the Han and Korean populations in Jilin,China,remains inconclusive.AIM To determine the best cut-off of HbA1c for diagnosing DR among the Chinese.METHODS This cross-sectional study included 1933 participants from the Yanbian area of Jilin Province,China.Trained investigators employed a questionnaire-based survey,physical examination,laboratory tests,and fundus photography for the investigation.The best cut-off value for HbA1c was established via the receiver operating characteristic curve.The factors associated with HbA1c-associated risk factors were determined via linear regression.RESULTS The analysis included 887 eligible Chinese Han and Korean participants,591 of whom were assigned randomly to the training set and 296 to the validation set.The prevalence of DR was 3.27% in the total population.HbA1c of 6.2% was the best cut-off value in the training set,while it was 5.9% in the validation set.In both Chinese Han and Korean populations,an HbA1c level of 6.2% was the best cut-off value.The optimal cut-off values of fasting blood glucose(FBG)≥7 mmol/L and<7 mmol/L were 8.1% and 6.2% respectively in Han populations,while those in Korean populations were 6.9%and 5.3%,respectively.Age,body mass index,and FBG were determined as the risk factors impacting HbA1c levels.CONCLUSION HbA1c may serve as a useful diagnostic indicator for DR.An HbA1c level of 6.2% may be an appropriate cut-off value for DR detection in the Chinese population.

Multifractal estimation of NMR T_(2) cut-off value in low-permeability rocks considering spectrum kurtosis: SMOTE-based oversampling integrated with machine learning

The transverse relaxation time (T_(2)) cut-off value plays a crucial role in nuclear magnetic resonance for identifying movable and immovable boundaries, evaluating permeability, and determining fluid saturation in petrophysical characterization of petroleum reservoirs. This study focuses on the systematic analysis of T_(2) spectra and T_(2) cut-off values in low-permeability reservoir rocks. Analysis of 36 low-permeability cores revealed a wide distribution of T_(2) cut-off values, ranging from 7 to 50 ms. Additionally, the T_(2) spectra exhibited multimodal characteristics, predominantly displaying unimodal and bimodal morphologies, with a few trimodal morphologies, which are inherently influenced by different pore types. Fractal characteristics of pore structure in fully water-saturated cores were captured through the T_(2) spectra, which were calculated using generalized fractal and multifractal theories. To augment the limited dataset of 36 cores, the synthetic minority oversampling technique was employed. Models for evaluating the T_(2) cut-off value were separately developed based on the classified T_(2) spectra, considering the number of peaks, and utilizing generalized fractal dimensions at the weight <0 and the singular intensity range. The underlying mechanism is that the singular intensity and generalized fractal dimensions at the weight <0 can detect the T_(2) spectral shift. However, the T_(2) spectral shift has negligible effects on multifractal spectrum function difference and generalized fractal dimensions at the weight >0. The primary objective of this work is to gain insights into the relationship between the kurtosis of the T_(2) spectrum and pore types, as well as to predict the T_(2) cut-off value of low-permeability rocks using machine learning and data augmentation techniques.

Dynamic monitoring of menopause hormone therapy and defining the cut-off value of endometrial thickness during uterine bleeding

The aim of this study was to evaluate the effects of low-dose tibolone therapy on ovarian area, uterine volume and endometrial thickness, and define the cut-off value of endometrial thickness for curettage during uterine bleeding. We followed 619 postmenopausal women, aged 40-60 years, for two years. There were 301 subjects in the low-dose tibolone treatment group and 318 subjects in the control group. The ovarian area, uterine volume and endometrial thickness in all participants were measured by transvaginal ultrasound prior to, one and two years post enrollment, respectively. Endometrial specimens were collected from all subjects with abnormal uterine bleeding during the follow-up period. We found that the uterine volume in the treatment group was greater than that in the control group, and the difference was significant （P〈0.05）, but there were no significant differences in ovarian area and endometrial thickness between the two groups （P〉0.05）. When the cut-off value for endometrial thickness was 7.35 ram, the sensitivity and specificity were 100% and 79.07%, respectively, and 85.71% and 93.02% when 7.55 mm was set as the cut-offduring tibolone therapy. The results indicate that low-dose tibolone therapy may postpone uterine atrophy and the cut-off value of endometrial thickness may be appropriately adjusted for curettage.

Cut-off Values of Diagnostic Indices to Detect Iron Deficiency in Chinese Breast-fed Infants

Iron deficiency anemia is one of the most prevalent nutritional deficiency worldwide. The commonly used cut-off values for identifying iron deficiency are extrapolated from older children and may not be suitable for infants. Therefore, our study aimed to establish appropriate cut-off values for the evaluation of iron status in Chinese infants. Pregnant women who delivered at 〉37 gestational weeks with normal iron status were recruited. Later, infants with normal birth weight and who were breastfed in the first 4 months were selected. Blood samples were collected to assess hemoglobin, serum ferritin, soluble transferrin receptor, mean corpuscular volume and free erythrocyte protoporphyrin. Cut-offs of all iron indices were determined as the limit of 95% confidence interval.

Wild-type MIC Distribution and Epidemiological Cut-off Value and Resistant Characteristics of Colistin Against Escherichia Coli from Chickens

The aim of the present study was to investigate minimum inhibitory concentration(MIC)distributions by broth microdilution(BMD)method and to determine the preliminary epidemiological cut-off value(ECV)of colistin by epidemiological cut-off(ECOFF)finder against E.coli from chickens in China.Anal swabs were collected from chicken farms in China.BMD method was used to measure MIC50 and MIC90 of colistin which were 2 and 4μg•mL^(-1),respectively.MIC frequency distributions for colistin were used to estimate preliminary ECV(8μg•mL^(-1)).High percentages of resistance to ampicillin(94.12%),nalidixic acid(94.12%),enrofloxacin(94.12%),tetracycline(94.12%),ciprofloxacin(88.24%),florfenicol(88.24%),neomycin(64.71%),gentamicin(58.82%),levofloxacin(58.82%),doxycycline(88.24%)and cefalexin(76.47%)were found.In addition,low percentages of resistance to amikacin(5.88%),spectinomycin(17.65%)and fosfomycin(41.18%)were noted.Notably,amoxicillin,sulfisoxazole and trimethoprim resulted in a 100%resistance generation efficacy rate.Prevalence of mcr-1 in E.coli(9/17)in chromosomal DNA was higher than mcr-4(2/17)gene,and mcr-1(5/17)was higher than mcr-4(3/17)in plasmid.

The Diagnostic Value of Serum TgAb in the Tg-Negative and TgAb-Positive DTC Patients after Successful Ablation

Objective: The aim of this retrospective study was to evaluate diagnostic accuracy of serum thyroglobulin antibody (TgAb) in thyroglobulin (Tg)-negative and TgAb-positive (Tg-TgAb+) patients with differentiated thyroid carcinoma (DTC). Method: We studied 341 patients with histologically confirmed DTC who had undergone remnant ablation and showed Tg-TgAb+ assessed by electrochemiluminescence immunoassay (ECLIA). The cases were divided into two groups, including recurrence group 119 cases and no evidence of disease (NED) group 222 cases. Receiver operating characteristic (ROC) curve analysis was carried out. The symmetric measures of the two diagnostic methods (the golden standard and the diagnostic standard as serum TgAb level alone) were analyzed using McNemar test and measure of agreement Kappa. Results: Serum TgAb level (1381.292 ± 1017.221) IU/ml of patients with recurrent group was significantly higher than that (125.559 ± 314.047) IU/ml of NED group (P = 0.000 0.001). The area under the ROC curve was 0.962 and its asymptotic 95% confidence interval (CI) was (0.942, 0.982) that was high statistical significance. The cut-off value of TgAb was determined and interpreted at 246.695 IU/ml with sensitivity (92.40%) and specificity (92.30%). McNemar test showed that the diagnostic results of the two methods were not significant difference (P = 0.230 > 0.05). Measure of agreement Kappa was 0.841, P = 0.000 0.001 that showed the agreement of the two diagnostic methods was significant. Conclusion: Serum TgAb is a useful tumor marker for recurrence in Tg-negative and TgAb-positive DTC patients who underwent thyroidectomy and remnant ablation. The cut-off value of TgAb is 246.695 IU/ml, that is to say, serum TgAb level upon 246.695 IU/ml may be associated with the persistence or recurrence of DTC.

超声造影、DWI及血清TPO-Ab、TSH、TGA对甲状腺乳头状癌的诊断价值分析

目的 探讨超声造影(CEUS)、磁共振扩散加权成像(DWI)及血清抗甲状腺过氧化物酶抗体(TPO-Ab)、促甲状腺激素(TSH)、抗甲状腺球蛋白抗体(TGA)对甲状腺乳头状癌(PTC)的诊断价值。方法 收集我院2019年1月至2022年1月92例经病理证实为PTC患者作为PTC组,92例为甲状腺良性肿瘤患者作为良性组。比较两组的血清TPO-Ab、 TSH、TG A水平、超声征象与表观扩散系数(ADC)值,评估血清TPO-Ab、TSH、TGA、CEUS以及DWI单项以及联合诊断与病理诊断结果 ,同时分析血清TPOAb、TSH、TGA、CEUS以及DWI对PTC的诊断价值。结果 PTC组的血清TPO-Ab、TSH、TGA水平均高于良性组(P<0.05);PTC组的淋巴肿大、钙化、回声不均匀、边界不清、形态不规则比例高于良性组(P<0.05);PTC组血流分级以Ⅱ-Ⅲ级为主,良性组以Ⅰ-Ⅱ级为主,两组血流分级比较,差异有统计学意义(P<0.05);PTC组的ADC值低于良性组(P<0.05)。本研究经Kappa一致性检测结果 显示,血清TPO-Ab诊断结果 和病理诊断结果 为一致性中等(P<0.05);血清TSH、TGA、CEUS、DWI诊断结果 和病理诊断结果 为高度一致性(P<0.05);联合检测诊断结果 和病理诊断结果 为一致性完全相同(P<0.05),并且联合检测的一致性最高。联合诊断的灵敏度(86.96%)、阴性预测值(86.36%)分别高于血清TPO-Ab、TSH、TGA、CEUS以及DWI的单一指标诊断。结论 PTC患者血清TPO-Ab、TSH、TGA水平升高,CEUS、DWI联合血清TPO-Ab、TSH、TGA在PTC诊断中具有较高的临床应用价值,可以提高诊断准确率。

新生儿脐带血TSH正常值范围的探讨

目的 为解决新生儿脐带血 TSH水平与其它指标的分离现象 ,建立新生儿脐带血 TSH正常值范围。方法 选择 1999年全国碘缺乏病监测部分省份的监测结果 ,将盐碘合格率 >90 % ,儿童尿碘中位数 >10 0 μg/ L,并且未投服过碘油的地区认定为碘营养正常地区 ,采用百分位数法确定新生儿脐带血 TSH正常值范围。结果 全国碘营养正常地区新生儿脐带血 TSH正常值 (第 97%分位值 )为 11.6 9m U/ L,六大行政区间结果有差异 ,出生方式对新生儿脐带血 TSH有影响 ,新生儿性别对新生儿脐带血 TSH无影响。结论 建立新生儿脐带血

云南省6州/市先天性甲状腺功能减低症筛查中TSH切值的确立

目的探讨制定合理的新生儿遗传代谢病筛查中心实验室先天性甲状腺功能减低症(congenital hypothyroidism,CH)的筛查切值,减少漏诊率,同时降低假阳性率.方法新生儿于出生72 h后采集足跟血,滴于专用S&S903号滤纸上,在规定的时间内递送到新生儿遗传代谢病筛查中心,采用时间分辨荧光免疫分析方法(Tr-FIA),检测滤纸干血片促甲状腺激素(TSH)浓度.结果 2012至2016年度共检测529 918份新生儿足跟血标本,TSH水平呈正偏态分布,检出正常新生儿数为529645,确诊CH患儿203例,高TSH血症患儿70例,总检出率为1:1941,CH发病率为1:2 610.根据筛查结果,确定实验室时间分辨荧光免疫法筛查CH的TSH参考切值为9.0 m IU/L,其灵敏度达100%,特异度98.38%,漏诊率0%.结论新生儿遗传代谢病筛查中心实验室CH的筛查切值定为9.0 m IU/L,较适合云南省6州/市人群,也为实验室今后的新生儿CH筛查提供了依据.

浙江省新生儿脐带血TSH切点值的探讨

目的为解决新生儿脐带血TSH水平与其他指标的分离现象,建立新生儿脐带血TSH切点值。方法选择近年来开展新生儿TSH筛查的部分市县,将盐碘合格率>90%,儿童尿碘中位数>100μg/L,并且未投服过碘油的地区认定为碘营养正常地区,采用百分位数法确定新生儿脐带血TSH切点值。结果浙江省正常地区新生儿脐带血TSH切点值(第97%分位值)为9.72mU/L,高于国际标准5mU/L。各地区间结果有差异,新生儿性别对新生儿脐带血TSH无影响。结论建立新生儿脐带血TSH切点值对碘缺乏病监测及新生儿甲低筛查均有重要意义,有必要建立适合本地区的新生儿脐带血TSH切点值。

应用受试者操作特征曲线确立新生儿甲低筛查中TSH切值及召回参考值

目的确立筛查新生儿先天性甲状腺功能低下症(con鄄genitalhypothyroidsm)中促甲状腺素(TSH)的诊断切值及召回参考值。方法采用时间分辨荧光免疫分析方法(DELFI鄄A),将随访的469例小儿的TSH连续变量,设定成不同的临界值,用受试者操作特征曲线(Receiveroperatingcharacteris鄄ticcurve)及曲线下面积(Areaunderthecurve)确定最佳临界值及评价试验的准确性。结果新生儿筛查CH的TSH最佳临界值为20mu/L,其敏感度为93.15%,特异度为89.14%,阳性预测值为61.3%,阴性预测值为95.65%,实验准确性为89.77%,阳性拟然比为8.58,召回复查率为1.45‰。次佳临界值为TSH为15mu/L,其敏感度为100%,特异度为80.56%,阳性预测值为48.7%,阴性预测值为100%,实验准确性为83.58%,阳性拟然比为5.14,召回复查率为2.0‰;百分位数法制定正常参考值TSH水平99%可信限在8.25mu/L以下,召回复查率为9.97‰;AUC为0.98。结论本法具有较高的准确性;新生儿筛查CH的TSH诊断切值为20mu/L,召回参考值为15mu/L,新生儿的TSH正常范围是≤8.25mu/L。

IRMA法新生儿滤纸血斑TSH分界值的讨论

本文通过 IRMA (免疫放射 )、 EL ISA (酶联免疫 )、 IFMA (荧光免疫 )三种方法测定 6 0 3例新生儿滤纸脐带血斑的 TSH值和安徽省全民普食碘盐前后碘缺乏病抽样调查结果 ,提出将评估碘缺乏危害程度的 TSH分界值改定为9.7m IU / L。

TSH及TG水平对甲状腺癌病程及预后评估价值

目的探讨促甲状腺素(TSH)及甲状腺球蛋白(TG)水平对甲状腺癌病程及预后评估中的应用价值。方法选择接受治疗的144例甲状腺癌患者为研究组,选取50例良性甲状腺病变患者为良性病变组,选取同期接受体格检查的50例健康个体为对照组,分别检测其血清TSH及TG水平,将研究组患者分别按照病程及随访12个月预后分组,对比各组间患者血清TSH及TG水平。结果研究组患者TSH及TG水平明显高于良性病变组(P<0.05),良性病变组明显高于对照组(P<0.05);随着甲状腺癌患者病程的加重,其血清TSH和TG水平也呈现逐步上升趋势,Ⅲ期、Ⅳ期患者血清TSH及TG水平明显高于Ⅰ期和Ⅱ期(P<0.05),Ⅰ期与Ⅱ期对比差异无统计学意义(P>0.05);随访12个月发现,甲状腺癌死亡组患者(21例)血清TSH及TG水平明显高于存活组(123例)患者(P<0.05)。结论TSH及TG水平与甲状腺癌患者病程及预后具有密切的相关性,患者TSH及TG水平越高,其病变就越严重,预后越差。

甲状腺功能异常患者FT3、FT4、TSH与T3、T4联合检测的临床价值

目的对游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)与甲状腺激素(T4)联合检测的临床价值进行探讨。方法抽取我院2010年7月-2018年7月甲状腺功能异常者46例以及对照组23例进行研究,甲状腺功能异常者中包含23例甲状腺功能亢进者即甲亢组和23例甲状腺功能衰退者即甲减组,对3组进行FT3、FT4、TSH、T3与T4联合检测,同时对检测结果进行比较。结果甲亢组的FT3、FT4、T3及T4水平较对照组及甲减组高,且组间对比差异明显,具有统计学意义(P<0.05)。甲亢组的TSH水平较对照组与甲减组水平低,组间对比差异明显,具有统计学意义(P<0.05)。甲减组的FT3、FT4、T3与T4的水平较甲亢组及对照组低,组间对比差异明显,但TSH水平高于甲亢组,低于对照组,且各项组间差异明显,具有统计学意义(P<0.05)。结论通过对甲状腺功能异常患者进行FT3、FT4、TSH、T3与T4联合检测,可以实现病情的较好判断。

贵阳城区40岁及以上TSH正常水平人群短期心血管事件发病率的队列研究

目的探讨贵阳地区40岁及以上人群中促甲状腺激素(TSH)正常水平与短期心血管事件发病率的关系。方法选取贵阳市云岩区40岁及以上年龄、且血清TSH水平在正常范围内的居民7445人,分为第1组(TSH 0.550~1.499 mU/L,1241人)、第2组(TSH 1.500~2.499 mU/L,2553人)、第3组(TSH 2.500~3.499 mU/L,2118人)及第4组(TSH 3.500~4.780 mU/L,1533人),收集4组居民随访前(基线)的一般情况[性别、年龄、收缩压(SBP)、舒张压(DBP)等],统一仪器测量身高、体质量、腰围并计算体质量指数(BMI);采集空腹静脉血5 mL,2 mL用于检测血糖(FBG),2 mL分离血清后检测高密度脂蛋白(HDL-c)、低密度脂蛋白(LDL-c)、甘油三酯(TG)及总胆固醇(TC),1 mL分离血清后检测血清TSH水平,同时记录4组居民心血管事件(冠心病、心肌梗死、心力衰竭)和脑血管事件(脑出血、脑梗死)发生情况;随访2.97~3.17年,收集4组居民中首次发生心脑血管事件和因首次心脑血管事件而死亡情况,采用Logistic回归分析参考范围内TSH水平对心脑血管事件发病率的影响。结果4组随访居民女性构成、TC、TG及LDL-c水平的差异有统计学意义(P<0.05);4组随访居民标化后心脑血管事件发病率分别为2.13%、2.32%、2.62%及3.01%,差异无统计学意义(P>0.05);Logistic线性回归分析结果表明,TSH水平不是短期心脑血管事件发病率的影响因素(P>0.05)。结论贵阳地区40岁及以上TSH不同参考值水平人群的短期心血管事件发病率相似,未发现降低TSH参考范围上限值对降低心血管事件短期发病率有益的证据。

检验甲状腺激素T3、T4、TSH在甲状腺疾病中的临床价值

目的探讨甲状腺激素T3、T4、TSH在甲状腺疾病临床诊断中的应用价值。方法以2017年11月—2018年8月该院120名甲状腺疾病患者为实验组,依据甲状腺功能分为实验1组(甲亢组)和实验2组(甲减组),每组各60例。另择取同期该院120例健康体检志愿者为对照组。清晨空腹抽取3组静脉血液样本,以化学发光免疫分析法检测血清T3、T4、TSH水平并进行对比观察。结果实验1组T3(7.93±2.24)ng/mL、T4(57.42±9.93)μg/dL高于对照组,TSH (0.14±0.06)m IU/L低于对照组,差异有统计学意义(t=5.124,P=0.035;t=12.310,P=0.007,t=3.735,P=0.042)。实验2组T3(0.41±0.17)ng/mL、T4(2.95±0.13)μg/dL低于对照组,TSH(54.22±17.63)mIU/L高于对照组,差异有统计学意义(t=3.035,P=0.047;t=4.117,P=0.030,t=7.635,P=0.018)。结论甲状腺疾病患者多伴不同程度甲状腺功能亢进或减退,甲状腺激素T3、T4、TSH能够反映患者甲状腺功能,为甲状腺疾病临床诊断和鉴别提供依据参考,值得临床推广使用。

探讨TSH、TPOAb、TRAb及TG-Ab联合检测诊断甲状腺疾病的临床价值

目的探讨TSH、TPOAb、TRAb及TG-Ab联合检测诊断甲状腺疾病的临床价值。方法将2019年2月—2020年2月来该院的60例甲状腺疾病患者作为研究对象,并将其设定为研究组,同时选取60名来该院进行健康检查的人员作为对照组,研究组和对照组均采用TSH、TPOAb、TRAb及TG-Ab联合检测诊断,检测后对比患者甲状腺功能、TSH、TPOAb、TRAb及TG-Ab水平及其上述指标阳性检出率。结果患者甲状腺功能:研究组患者FT3相较对照组差异无统计学意义(P>0.05);研究组患者TT3 (1.58±0.52)pmol/L、TT4 (9.25±1.54)pmol/L、FT4(9.25±1.54)pmol/L相较对照组偏高,差异有统计学意义(t=6.134、3.123、3.054,P<0.05)。TSH、TPOAb、TRAb及TGAb水平:研究组TSH、TPOAb、TRAb及TG-Ab水平(2.51±0.97)mIU/mL,(106.33±12.07)IU/mL,(16.38±5.03)IU/m L,(59.64±10.12)IU/mL,均高于对照组,差异有统计学意义(P<0.05)。TSH、TPOAb、TRAb及TG-Ab阳性检出率:研究组患者TSH、TPOAb、TRAb及TG-Ab阳性检出率81.67%、65.00%、78.33%、66.67%高于对照组,差异有统计学意义(χ^2=10.978、4.089、6.419、5.711,P<0.05)。结论 TSH、TPOAb、TRAb及TG-Ab联合检测在甲状腺疾病中具有显著的临床诊断价值,且疾病检出率及特异性较高。

Cut-off values of lesion and vessel quantitative flow ratio in de novo coronary lesion post-drug-coated balloon therapy predicting vessel restenosis at mid-term follow-up

Background:Drug-coated balloons(DCBs)have emerged as potential alternatives to drug-eluting stents in specific lesion subsets for de novo coronary lesions.Quantitative flow ratio(QFR)is a method based on the three-dimensional quantitative coronary angiography and contrast flow velocity during coronary angiography(CAG),obviating the need for an invasive fractional flow reserve procedural.This study aimed to assess the serial angiographic changes of de novo lesions post-DCB therapy and further explore the cut-off values of lesion and vessel QFR,which predict vessel restenosis(diameter stenosis[DS]≥50%)at mid-term follow-up.Methods:The data of patients who underwent DCB therapy between January 2014 and December 2019 from the multicenter hospital were retrospectively collected for QFR analysis.From their QFR performances,which were analyzed by CAG images at follow-up,we divided them into two groups:group A,showing target vessel DS≥50%,and group B,showing target vessel DS<50%.The median follow-up time was 287 days in group A and 227 days in group B.We compared the clinical characteristics,parameters during DCB therapy,and QFR performances,which were analyzed by CAG images between the two groups,in need to explore the cut-off value of lesion/vessel QFR which can predict vessel restenosis.Student's t test was used for the comparison of normally distributed continuous data,Mann-Whitney U test for the comparison of non-normally distributed continuous data,and receiver operating characteristic(ROC)curves for the evaluation of QFR performance which can predict vessel restenosis(DS≥50%)at mid-term follow-up using the area under the curve(AUC).Results:A total of 112 patients with 112 target vessels were enrolled in this study.Group A had 41 patients,while group B had 71.Vessel QFR and lesion QFR were lower in group A than in group B post-DCB therapy,and the cut-off values of lesion QFR and vessel QFR in the ROC analysis to predict target vessel DS≥50%post-DCB therapy were 0.905(AUC,0.741[95%confidence interval,CI:0.645,0.837];sensitivity,0.817;specificity,0.561;P<0.001)and 0.890(AUC,0.796[95%CI:0.709,0.882];sensitivity,0.746;specificity,0.780;P<0.001).Conclusions:The cut-off values of lesion QFR and vessel QFR can assist in predicting the angiographic changes post-DCB therapy.When lesion/vessel QFR values are<0.905/0.890 post-DCB therapy,a higher risk of vessel restenosis is potentially predicted at follow-up.

Hemoglobin cut-off values in healthy Turkish infants

Background:Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality.This study was undertaken to determine the cut-off value of hemoglobin for infant anemia.Methods:A cross-sectional retrospective study was carried out at well-baby clinics of a tertiary care hospital.A total of 1484 healthy infants aged between 4 to 24 months were included in the study.The relationship of hemoglobin(Hb)levels with mother age,birth weight,weight gain rate,feeding,and gender was evaluated.Results:The Hb levels were assessed in four age groups(4 months,6 months,9-12 months,and 15-24 months)and the cut-off values of Hb were determined.Hb cut-off values(5th percentile for age)were detected as 97 g/L and 93 g/L at 4 months and 6 months,respectively.In older infants,the 5th percentile was 90.5 g/L and 93.4 g/L at 9-12 months and 15-24 months,respectively.The two values were lower than the World Health Organization criteria for anemia,which could partly due to the lack of information on iron status in our population.However,this difference highlights the need for further studies on normal Hb levels in healthy infants in developing countries.Hb levels of females were higher in all age groups;however,a statistically significant difference was found in gender in only 6 month-old infants.No statistically significant difference was found among Hb levels,mother's age,birth weight,weight gain rate,and nutritional status.Conclusion:Hb cut-off values in infants should be re-evaluated and be compatible with growth and development of children in that community.

甲功五项对甲状腺功能紊乱的诊断价值及临床意义研究

目的:探讨甲功五项对甲状腺功能紊乱的诊断价值及临床意义,旨为临床甲状腺疾病的诊治提供理论基础。方法:选取2015年2月-2017年2月就诊于本院内分泌科的甲状腺功能亢进患者为甲亢组和甲状腺功能减退患者为甲减组,每组90例,选取同期健康体检患者100例作为对照组,检测所有研究对象的血清游离三碘甲状腺氨酸(FT_3)、游离甲状腺素(FT_4)、三碘甲状腺原氨酸(T_3)、甲状腺素(T4)、促甲状腺激素(TSH)。观察对比各组患者甲状腺功能指标的差异,并采用ROC曲线评估各指标对甲亢和甲减的诊断价值。结果:甲亢组的FT_3、FT_4、T_3和T4均高于对照组,而TSH小于对照组,甲减组的FT_3、FT_4、T_3和T4均低于对照组,而TSH高于对照组,差异均有统计学意义(P<0.05)。FT_3、FT_4、T_3、T4和TSH联合检测诊断甲亢的AUC为0.928,高于各指标单用时的0.844、0.825、0.812、0.802和0.788,其敏感性为86%,特异性为100%,而各指标联合诊断甲减的AUC为0.949,高于各指标单用时:FT_3为0.821,FT_4为0.857,T_3为0.789,T4为0.802,TSH为0.870,其敏感性为90%,特异性为94%。结论:FT_3、FT_4、T_3、T4和TSH联合诊断甲亢和甲减的临床诊断价值高于各指标单用时,其诊断敏感性和特异性均可靠,对临床甲状腺功能的评估具有重要意义。