Controversies in the diagnosis and management of early gastric cancer

Early diagnosis and treatment is the key to improving the prognosis of gastric cancer. The past decades have wimessed the rapid advances in the diagnosis and management of early gastric cancer （EGC）： endoscopy has played an increasingly important role, whereas laparoscopic techniques have also been introduced for EGC treatment. In China, the proportion of EGC is gradually increasing, and this condition will soon become a hot research topic. In this article, we will elucidate some major controversies in the diagnosis and management of EGC.

2016 Chinese expert consensus and guidelines for the diagnosis and treatment of papillary thyroid microcarcinoma

The incidence of papillary thyroid carcinoma(PTC)has exponentially increased in recent years.Papillary thyroid microcarcinoma(PTMC)accounts for the majority of the reported cases of PTC.The debates and crucial issues in PTMC management have received researchers'attention.To further improve the clinical management of PTMC in China,

Evaluation of Xpert MTB/RIF for the Diagnosis of Extrapulmonary Tuberculosis in China

We evaluate the performance of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis （EPTB） in China. The performance of Xpert was evaluated compared to the composite reference standard （CRS）, drug susceptibility testing （DST）, and imaging examination. The overall sensitivity and specificity of Xpert were 64.1% （195/304） and 100% （24/24）, respectively, using CRS as the gold standard. The sensitivity was significantly higher than that of culture for pus （P〈0.05）. The proportion of EPTB-positive cases diagnosed by imaging was two times more than that diagnosed using Xpert; however, 6 out of 19 cases may have been overdiagnosed by imaging.

THE USEFULNESS OF ^(99)Tc-PMT DELAYED HEPATOBILIARY IMAGING IN THE DIAGNOSIS OF SMALL HEPATOCELLULAR CARCINOMA

This investigation was aimed to assess the usefulness of delayed hepalobillary Imaging in the diagnosis of small hepatocellular carcinoma (HCC). Sixty-two patients with this hepatic cancer were Included in the study. 56 males and 6 females, with a mean age of 50. 6 yr. (32 - 72 years old). All patients were performed by surgery, verified histologically, and these tumors were smaller than 5 cm. Liver scans were performed 5 minutes, 2 hours and 5 hours after the administration of radlopharmaceutices. In 31 of the 62 patients (50%), the tumor exhibited equal radioactivity uptake or greater radioactivity uptake than the surrounding liver in delayed imaging. And the sensitivity was 33. 3% (2/6), 41.2% (7/17), 60.0% (9/15) and 54.2% (13/24) In the tumor size was ≤2 cm, 2-3cm, 3-4 cm and 4 - 5 cm, respectively. The smallest mass to be detected was only 1. 2 cm. The uptake of radiopharmaceutic was nonsignificantly related to serum AFP level and hepatic cirrhosis (P>0. 05). These results show that 99-Tc-PMT delayed hepatobiliary imaging can be useful in the diagnosis of small hepatocellular carcinoma.

ENZYME-LINKED IMMUNOSORBENT ASSAY OF HUMAN PLACENTA TYPE GLUTATHIONE S-TRANSFERASE AND ITS APPLICATION IN THE DIAGNOSIS OF HEPATOCARCINOMA

GST-π was purified from human placenta and its antiserum was raised in rabbits. The antibody IgC was purified and degraded into Fab' fragment which was conjugated with horseradish peroxidase (HRP) using N-succinimidyl-4-(N-maleimido-methyl) cyclo-hexane-1-carboxylate (SMCC) as crosslinking reagent to produce Fab'-HRP conjugate. A sandwich ELISA was established for the microquantitative determination of GST-π. The sensitivity was 11 pg/tube, which was far more sensitive than the radioimmunoassay so far reported. Using this method, the serum GST-π of 41 cases normal adult was found to be 1.06±0.94 ng/ml. The upper limit of the normal value was 2.6 ng/ml. In 30 cases of primary hepatocarcinoma, the level of serum GST-π was 24.4± 17.4 ng/ml, which was 23 times higher than the normal average value (P<0.01). The positive rate was 90%. In contrast, serum GST-π in 25 cases of chronic hepatitis was determined to be 1.74±1.16 ng/ml, which was not significantly different from the normal value (P>0.05). The pseudo-positive rate was 12.0%.

CLINICAL EVALUATION OF MONOCLONAL ANTIBODIES AGAINST ALDOLASE-A IN THE DIAGNOSIS OF HEPATO-CELLULAR CARCINOMA

Serum ALD-A of 57 patients with HCC and 43 of other diseases were measured by ALD-A-McAb linked with 425I-staphylococcus A protein. The results showed that the ALD-A in patient with HCC was significantly elevated as compared with controls and that in patients with cholangiocarcinoma, gastrointestinal cancer without hepatic metastasis, cirrhosis. CAH and benign GI diseases. There was no statistical difference between ALD-A in patients with HCC and that in cases of cirrhosis with liver failure and that in cases of metastatic liver carcinoma. It was noted that diagnostic sensitivity of ALD-A in AFP (+) HCC was 73.9% and that in AFP (-) HCC was 81.8% 1-6 patients with HCC were treated by hepatic arterial embolization combined with chemotherapy. ALD-A in patients after the treatment decreased significantly than that before treatment, furthermore, advantages of the method are discussed.

THE VALUE OF M_2-TYPE PYRUVATE KINASE IMMUNOASSAY IN THE DIAGNOSIS OF HEPATOCARCINOMA

By using Fab'-enzyme labelled immuno absorbent assay (ELISA) with sensitivity of picogram (10-12 g or pg) level, the M-type pyruvate kinase (M-PyK) in plasma was determined in 47 cases of normal healthy adult and 26 cases of hepatocellular carcinoma (HCC) patient. It was found that the upper limits of normal male and female were 1.1 and 1.4 ng/ml (expressed as M2-PyK) respectively. The plasma M-PyK in HCC patients was significant increased to above 5 times of average normal level, the positive rate was about 95%. In 6 cases of subclinical small hepatocarcinoma and 7 cases of HCC patient with normal serum alpha-fetal protein level, the mean plasma M-PyK value was also increased. Whereas the plasma M-PyK level in acute or chronic hepatitis and other benign diseases were normal. After the HCC being resected, the plasma M-PyK returned to normal, but increased again in the cases of recurrent hepatocarcinoma, suggesting that the increased M-PyK in the plasma of HCC patient was criginated from M2-type PyK in HCC tissue. Therefore, plasma M-PyK may become a new micro-level index of hepatocarcinoma.

The role of B-type natriuretic peptide in the diagnosis and treatment of decompensated heart failure

Heart failure (HF) is a common disease associated with increasing age. B-type natriuretic peptide (BNP), is a cardiac neurohormone, and is released as prepro BNP and then enzyrnatically cleaved to the Ntenninal-proBNP (NT-proBNP) and BNP upon ventricular myocyte stretch. Blood measurements of BNP have been used to identify patients with I-IF. The BNP assay is currently used as a diagnostic and prognostic aid in HF. In general, a BNP level below 100 pg/mL excludes acutely decompensated HF and levels ＞ 500 pg/ml indicate decompensation. Recombinant human BNP (hBNP, nesiritide) is an approved intravenous treatment for acute,decompensated -HF. Nesiritide given in supraphysiologic doses causes vasodilation, natriuresis, diuresis, and improved symptoms over the course of a 48-hour infusion. This paper will sort out the literature concerning the use of this peptide both as a diagnostic test and as an intravenous therapy.

Evaluation of hepatic fibrosis parameter model and elastic modulus of liver and spleen for the diagnosis of hepatic fibrosis in chronic hepatitis b

Objective Toinvestigate the diagnostic value of hepatic fibrosis parameter model and elastic modulus of liver and spleen in hepatic fibrosis of chronic hepatitis b.Methods 77 patients with hepatic fibrosis of chronic hepatitis in the infection clinic were recruited from July 2016 to December 2018.According to the classification of hepatic fibrosis,23 patients were classified as S1,20 as S2,18 as S3 and 16 as S4.The serum indexes of liver function in all patients were tested,FIB-4,APRI and GPR model indexes were calculated.SWE values of liver and spleen were evaluated,and the correlation between FIB-4,APRI,GPR and SWE was analyzed.Results The SWE values of liver and spleen in the study group were significantly higher than those in the normal group(P<0.01),and the differences in serum GGT,PLT,AST and portal vein velocity between the two groups were statistically significant(P<0.01).GGT and PLT were correlated with SWE values of liver and spleen,which were statistically significant(P<0.01).The model indexes of fib-4,APRI and GPR in the study group were all higher than those in the normal group,with statistically significant differences(P<0.01).Pearson correlation analysis showed that liver SWE value and spleen SWE value were positively correlated with fib-4,APRI and GPR,and the differences were significant(P<0.01),with a higher correlation with GPR.Conclusion GGT,PLT and GPR are positively correlated with SWE of liver and spleen,and combined detection can improve the early diagnosis accuracy of liver fibrosis.

The diagnosis for the tropical Pacific Ocean conditions in 1990

In this paper, on the basis of the observational hydrographic data obtained from the eighth cruise of PRC-USA bilateral air-sea interaction program, and combined with the sea surface temperature (SST) charts provided by NOAA, the data obtained from moored thermistor chains supplied by L. J. Mangum and sea level data provided by K. Wyrtki, the ocean conditions since October, 1989 in the western tropical Pacific are exposed, which indicate that 1990 is a year with weak El Nino event similar to the 1980 El Nino event, and the North Equatorial Countercurrent (NECC) has made a good contribution to the propagation of warm water from the Western to the Central and Eastern Pacific, a characteristic similar to that of the 1976 El Nino event. The 1990 weak El Nino event will soon fall into decay.

THE DIAGNOSIS OF MESENTERY TUMOR (CLINIC-PATHOLAGIC ANALYSIS OF 171 CASES)

One hundred and seventy one patients with mesentery tumors confirmed by surgery and/or pathology in five hospitals of Hubei Province from 1966 to 1986 are analyzed retrospectively. The main manifestations were abdominal pain, abdominal mass and emaciation. Cyst and leiomyomas were common in benign tumors. Malignant lymphoma, leiomyosarcoma and liposarcoma were predominant in malignant tumors. The morbidity, clinicopatholo-gic characteristics, diagnosis and differential diagnosis of this group of tumor are discussed.

THE APPLICATION OF SEROTONIN AND 5-HVDROXYINDOLE-3-ACETIC ACID IN THE DIAGNOSIS OF APUDOMA

In our report, the values of whole blood serotonin (5-HT) in 87 apudoma patients (diagnosed by operation and pathology) were summarized. Among them, the levels of urinary 5-hydroxyindole-3-acetic acid (5-HIAA) of 44 patients were also tested. The results showed that both parametres of apudoma patients were higher than those of non-apudoma, post-operative patients of apudoma as well as the normal. The increasing extent of the levels of whole blood 5-HT and urinary 5-HIAA in small intestinal carcihoid was the most obvious one but that of rectum was not. The referable diagnostic values suggested were: 5-HT>130 ng ml, 5-HIAA>30 mg/ 24 hours.

A Preliminary Study of C-reactive Protein in the Diagnosis and Monitoring of Lyme Disease

Concentrations of C-reactive protein (CRP) in the serum of 14 patients suffering from Lyme diseasc were measured. 86% of these patients were found to have abnormally high concentrations of serum CRP (range 14-158 mg/L). The CRP concentration of a 60-yearold patient abated from 29 mg/L to 13 mg/L after treatrnent. Results suggest that serum CRP concentration can provide a valuable and accurate means for the clinical diagnosis and monitoring of Lyme disease

RADIONUCLIDE WHOLE BODY BONE IMAGING IN THE DIAGNOSIS OF SKELETAL METASTASES

Of 628 patients with extra-osseous malignancies diagnosed by surgery and/or pathology, 207 (33.0%) were identified as having skeletal metastasis by bone imaging. There was statistical significant difference in the incidence of metastasis in different malignancies (P<0.02). The metastatic rates of nasopharyn-geal, lung, prostate and breast cancers were higher than gastrointestinal, kidney, and other malignancies. There was significant differences in the different sites of skeletal metastasis (P<0.01). They were thorax, spine, pelvis, limbs and skull in order of incidence. Solitary metastatic rate was 15.9%. Biopsy is advised for patients suspected to have metastatic disease but with only one single 'hot spot' in skeletal imaging, particularly in the rib.

DETECTION OF CANCER-ASSOCIATED ANTIGEN IN FECES USING MONOCLONAL ANTIBODIES IN THE DIAGNOSIS OF COLON CARCINOMA

Monoclonal antibodies against colon and pancreatic cancer, CL-2, CL-3, PS-9, PS-10, were used to detect the associated antigens in feces of patients with gastrointestinal carcinoma and non-cancer diseases. Binding inhibition test by SABC-ELISA method were performed for the measurement of the antigen level. Results showed that the associated antigen detected in feces of patients with colon cancer were significantly higher than that of non-cancer disease or normal subjects. The positive rates were 61.1% as detected with CL-2; 53.4% with CL-3; 55.0%, PS-9; and 53.3% PS-10 in cancer patients while that in normal subjects were 7%; 9%; 8%; and 8% respectively. When 'cocktail' of CL-2, PS-9 and PS-10 were used, the positive rates were 92.5% in colon cancer and 14% in normal subjects. In seven out of the sixty patients with colon cancer studied who were graded as Dukes A, the results were all positive. The results seem superior to the serologic detection and may provide a promising new approach in the early diagnosis of colon cancer.

Chinese Expert Consensus for the Diagnosis and Treatmentof Cholestatic Liver Disease

Cholestatic liver disease (CLD) is a common problem in clinical practice with the main manifestation being cholestasis.Recently,there has been a steady increase in knowledge associated with the diagnosis and treatment of CLD.Therefore,the experts in China were organized by the editorial board of Chinese Journal of Experimental and Clinical Infectious Diseases (Electronic Edition),Chinese Journal of Liver Diseases (Electronic Edition) and Infection International (Electronic Edition) to collect and analyze relevant research,ultimately resulting in the development of this work (Chinese Expert consensus for the diagnosis and treatment of CLDs,also abbreviated as consensus).

Discussion on Certain Issues of the Diagnosis and Treatment of Functional Constipation

Functional constipation (FC) is a common condition in the clinics.It is often recurrent and frequently has drug resistance and drug addiction.Its therapeutic costs are high as well. Therefore,the quality of

Thinking and Strategy on the Diagnosis and Treatment of Functional Gastrointestinal Disorders with Integrative Medicine

The functional gastrointestinal disorders (FGIDs) are a group of diseases mainly manifested as gastrointestinal functional disorders,including 45 kinds of different diseases,such as functional dyspepsia(FD), irritable bowel syndrome (IBS),functional constipation

Prospective Study of Color Doppler Ultrasonography in the Diagnosis of Breast Disease.

One hundred and four cases of breast disease were examined by color Doppler ultrasonography (CDUS). Malignant lesions were rich in blood blow signal and 56% of +++-++++grade while benign lesions had little blood flow signal

CURRENT MEANS IN THE DIAGNOSIS AND TREATMENT OF ORAL AND MAXILLOFACIAL TUMORS IN CHINA

Oral and maxillofacial tumors (OMT) constitute a great number in tumors of head and neck as a whole. The incidence of OMT in China is rather low. but. owing to our big population, the absolute number of the patients is high. The diagnosis and treatment of OMT in China with special emphasis on malignancies are briefly introduced below.