Soluble ST2:A Novel Biomarker for Diagnosis and Prognosis of Cardiovascular Disease

The increasing incidence of cardiovascular disease(CVD)is a significant global health concern,affecting millions of individuals each year.Accurate diagnosis of acute CVD poses a formidable challenge,as misdiagnosis can significantly decrease patient survival rates.Traditional biomarkers have played a vital role in the diagnosis and prognosis of CVDs,but they can be influenced by various factors,such as age,sex,and renal function.Soluble ST2(sST2)is a novel biomarker that is closely associated with different CVDs.Its low reference change value makes it suitable for continuous measurement,unaffected by age,kidney function,and other confounding factors,facilitating risk stratification of CVDs.Furthermore,the combination of sST2 with other biomarkers can enhance diagnostic accuracy and prognostic value.This review aims to provide a comprehensive overview of sST2,focusing on its diagnostic and prognostic value as a myocardial marker for different types of CVDs and discussing the current limitations of sST2.

Combined detection tumor markers for diagnosis and prognosis of gallbladder cancer

AIM: To clarify the value of combined use of markers for the diagnosis of gallbladder cancer and prediction of its prognosis. METHODS: Serum cancer antigens (CA) 199, CA242, carcinoembryonic antigen (CEA), and CA125 levels were measured in 78 patients with gallbladder cancer (GBC), 78 patients with benign gallbladder diseases, and 78 healthy controls using electrochemiluminescence. CA199, CA242, CEA, and CA125 levels and positive rates were analyzed and evaluated pre-and post-operatively. Receiver operator characteristic curves were used to determine diagnostic sensitivity and specificity of GBC. Survival time analysis, including survival curves, and multivariate survival analysis of a Cox proportional hazards model was performed to evaluate independent prognostic factors. RESULTS: Serum CA242, CA125, and CA199 levels in the GBC group were significantly higher when compared with those in the benign gallbladder disease and healthy control groups (P < 0.01). With a single tumor marker for GBC diagnosis, the sensitivity of CA199 was the highest (71.7%), with the highest specificity being in CA242 (98.7%). Diagnostic accuracy was highest with a combination of CA199, CA242, and CA125 (69.2%). CA242 could be regarded as a tumor marker of GBC infiltration in the early stage. The sensitivity of CA199 and CA242 increased with progression of GBC and advanced lymph node metastasis (P < 0.05). The 78 GBC patients were followed up for 6-12 mo (mean: 8 mo), during which time serum CA199, CA125, and CA242 levels in the recurrence group were significantly higher than in patients without recurrence (P < 0.01). The post-operative serum CA199, CA125, and CA242 levels in the non- recurrence group were significantly lower than those in the GBC group (P < 0.01). Multivariate survival analysis using a Cox proportional hazards model showed that cancer of the gallbladder neck and CA199 expression level were independent prognostic factors. CONCLUSION: CA242 is a marker of GBC infiltration in the early stage. CA199 and cancer of the gallbladder neck are therapeutic and prognostic markers. (C) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.

CLINICOPATHOLOGIC FEATURES AND DIAGNOSISOF COMBINED HEPATOCELLULAR ANDCHOLANGIOCARCINOMA

Hepatoma cases(N=130) were analyzed through histochemical and immunohistochemical staining. There were 99 cases of hepatocellular carcinoma(HCC), 15 cholangiocarcinoma(CC), and 16 combined HCC and CC (HCC+CC). The clinical features and the cases accompanied with hepatitis and/or liver cirrhosis in the non-tumor liver tissue of HCC+CC Group were between HCC GrouP and CC Group. Histologically, there were 4 cases with trabecular, 4 with pseudoglandula, 3 with solid type in HCCWC Group. In these 11 cases, the CC area was less than 10% of the neoplasm- The cases were classified as HCCWC type I. There was no obvious stroma fibrosis. The rest 5 cases of HCC+CC showed tubular carcinoma. The CC area took up over 10% of the tumor. These cases were designed as HCC+CC type II. There was significant fibrosis in the stroma so that its CC area is indistinguishable from that of CC cases. The CC area of all HCC+CC cases was positive to mucin and EMA staining, the same to that of CC cases. Near 70% of the HCC+CC cases had intracytoplasmic glycogen in the HCC area. The HCC area was mucin and EMA negative, similar to that of HCC cases- We also observed transition areas between HCC and CC in both of the type I and type II HCC+CC cases. The areas were mucin negative but EMA positive. We concluded that HCC+CC bad HCC and CC area. with the characteristics of HCC of CC respectively. Histochemical mucin staining and immunohistochemical EMA staining were valuable in detection and diagnosis of the HCC+CC.

COMBINED IMAGING DIAGNOSIS OF PAROTID MASSES

Computed tomography (CT), ultrasonography, sialography, and 99mTc scintigraphy were applied before operation to 108 patients with parotid masses. The results of each technique and the combined study of them were compared with the pathological diagnosis. Ultrasonography was found to be a very effective diagnostic aid in determining the presence of space-occupying lesion in the parotid. CT was the best technique to provide adequately reliable informations regarding the location of the tumor and the relationship between tumor and surrounding tissues. For diagnosing the nature of tumors, ultrasonography combined with sialography was reliable. 99mTc scintigraphy was better than other techniques in diagnosis of adenolymphoma. The diagnostic accuracy of combined diagnosis (90.7%) was higher than those of ultrasonography (83%), CT (80.5%), sialography (79%), and 99mTc scintigraphy (13.9%) alone. The advantage of combined diagnosis was particularly obvious for the diagnosis of low-grade malignant tumors.

Diagnosis and one stage surgical treatment of lower thoracic ossification of ligamentum flavum combined with lumbar spinal stenosis

Objective To study the diagnosis and treatment of lower thoracic ossification of ligamentum flavum(OLF) combined with lumbar spinal stenosis.Methods Retrospective analysis was carried out on 11 cases of lower thoracic OLF combined with

Combination of acoustic radiation force impulse imaging, serological indexes and contrast-enhanced ultrasound for diagnosis of liver lesions

AIM To assess the value of combined acoustic radiation force impulse(ARFI) imaging, serological indexes and contrast-enhanced ultrasound(CEUS) in distinguishing between benign and malignant liver lesions. METHODS Patients with liver lesions treated at our hospital were included in this study. The lesions were divided into either a malignant tumor group or a benign tumor group according to pathological or radiological findings. ARFI quantitative detection, serological testing and CEUS quantitative detection were performed and compared. A comparative analysis of the measured indexes was performed between these groups. Receiver operating characteristic(ROC) curves were constructed to compare the diagnostic accuracy of ARFI imaging, serological indexes and CEUS, alone or in different combinations, in identifying benign and malignant liver lesions. RESULTS A total of 112 liver lesions in 43 patients were included, of which 78 were malignant and 34 were benign. Shear wave velocity(SWV) value, serum alpha-fetoprotein(AFP) content and enhancement rate were significantly higher in the malignant tumor group than in the benign tumor group(2.39 ± 1.20 m/s vs 1.50 ± 0.49 m/s, 18.02 ± 5.01 ng/m L vs 15.96 ± 4.33 ng/m L, 2.14 ± 0.21 d B/s vs 2.01 ± 0.31 d B/s; P < 0.05). The ROC curve analysis revealed that the areas under the curves(AUCs) of SWV value alone, AFP content alone, enhancement rate alone, SWV value + AFP content, SWV value + enhancement rate, AFP content + enhancement rate and SWV value + AFP content + enhancement rate were 85.1%, 72.1%, 74.5%, 88.3%, 90.4%, 82.0% and 92.3%, respectively. The AUC of SWV value + AFP content + enhancement rate was higher than those of SWV value + AFP content and SWV value + enhancement rate, and significantly higher than those of any single parameter or the combination of any two of parameters.CONCLUSION The combination of SWV, AFP and enhancement rate had better diagnostic performance in distinguishing between benign and malignant liver lesions than the use of any single parameter or the combination of any two of parameters. It is expected that this would provide a tool for the differential diagnosis of benign and malignant liver lesions.

Update on the Diagnosis and Treatment of Combined Hepatocellular Cholangiocarcinoma

Combined hepatocellular-cholangiocarcinoma(cHCC-CCA)is a unique type of liver tumor that contains both hepatocellular carcinoma and cholangiocarcinoma components within a single tumor.The fifth edition of the World Health Organization classification provides a definition and diagnostic criteria for cHCC-CCA.However,the heterogeneous histomorphology and presentation resulting from variation of the proportion of each component poses challenges for clinical diagnosis and treatment.A diagnosis of cHCC-CCA may be suggested by the synchronous elevation of serum tumor markers for hepatocellular carcinoma and cholangiocarcinoma,a mixed enhancement pattern on imaging,and a discrepancy between the elevation of tumor marker and the imaging enhancement pattern.Histopathological examination using hematoxylin and eosin staining is considered the gold standard for diagnosing cHCC-CCA,and comprehensive examination of resection or biopsy specimens is crucial for an accurate diagnosis.Currently,there is no standard treatment for cHCC-CCA,and surgery is the mainstay.Anatomic hepatectomy with lymphadenectomy is among the recommended surgical procedures.The role of liver transplantation in the management of cHCC-CCA is still uncertain.Transarterial chemoembolization may be effective for unresectable cHCC-CCA,particularly for hypervascular tumors.However,the available evidence does not support systemic therapy for advanced cHCC-CCA.The prognosis of cHCC-CCA is generally poor,and there is no established staging system.Further research is needed to better understand the histogenesis and clinical management of cHCC-CCA.This review provides an overview of the current literature on cHCC-CCA with a focus on its clinical characteristics,pathological diagnosis,and management.

Mortality and Morbidity Following Surgery for Primary Malignant Musculoskeletal Tumors in the Pelvis and Limbs: A Retrospective Analysis Using the Japanese Diagnosis Procedure Combination Database

Introduction: Resection of malignant pelvic tumors has long been considered to be associated with higher postoperative mortality and morbidity than resection of malignant limb tumors. We compared the postoperative adverse events of pelvic tumor surgery and limb tumor surgery using a national inpatient database. Methods: We identified patients who underwent surgery for primary musculoskeletal malignant tumors of the pelvis or limbs between July and December in 2007- 2010 using the Japanese Diagnosis Procedure Combination inpatient database. We calculated the risk-adjusted odds ratio for the occurrence of postoperative complications following pelvic tumor surgery with reference to limb tumor surgery using a multivariable logistic regression analysis. Results: Of 3255 eligible patients, 3116 underwent limb tumor surgery and 139 underwent pelvic tumor surgery. In-hospital mortality was 0.6% and 0.7% and postoperative complication rates were 8.2% and 18.7%, respectively. The rate of blood transfusion and duration of anesthesia over 480 min were higher in the pelvic tumor group. Blood transfusion volume and duration of anesthesia were independently associated with worse outcomes, but there was no significant association between tumor location and occurrence of postoperative complications (odds ratio 1.18, 95% confidence interval 0.73 - 1.88, p = 0.502). Conclusions: Blood transfusion volume and duration of anesthesia were significant predictors of outcome. Our data demonstrate that the higher morbidity rate after pelvic tumor resection could result from the larger blood transfusion volume and longer anesthesia duration.

A Case Report on Treating Progressive Supranuclear Palsy with a Combination of Chinese and Western Medicine

A case of progressive supranuclear palsy in a 66-year-old woman is presented.The patient complained of“progressive stiffness of both lower limbs for five years,accompanied by choking and coughing for more than 1 year,”and was diagnosed with paralysis in traditional Chinese medicine(TCM),which was characterized by a deficiency of liver and kidney,and phlegm and blood stasis blocking the collaterals.Western medicine diagnosed it as progressive supranuclear palsy.The patient was diagnosed with“Parkinson’s disease”several times in the past and was given“polybasic hydrazide”and“amantadine hydrochloride tablets,”etc.The patient did not have significant symptomatic relief,so she sought further treatment with a combination of traditional Chinese and Western medicine.Based on the concept of deficiency and excess,this disease is categorized as a paralytic disease in Chinese medicine,and the onset of the disease is closely related to the deficiency of the body after a long period of illness,with wind,phlegm,blood stasis,and deficiency as the main pathogenetic mechanism.The treatment is based on the combination of disease and evidence,with traditional Chinese medicine and acupuncture as the main treatments,supplemented by intermediate-frequency pulsed electrical stimulation,transcranial repetitive magnetic stimulation,medicated canisters,wax therapy,traditional Chinese medicine guasha,and acupoint injections.Western medicine is based on symptomatic treatment,and the patient’s symptoms were relieved significantly after the combination of Chinese and Western medicine.

Detection of serum tumor markers in the diagnosis and treatment of patients with pancreatic cancer

BACKGROUND: Although a variety of tumor markers areavailable for diagnosis of pancreatic cancer, their sensitivityand specificity have not yet been ideal. The aims of thisstudy was to detect a panel of serum tumor markers and toevaluate their significance in the diagnosis and prognosis ofpancreatic cancer patients.METHODS: Eight serum tumor markers including AFP,CEA, CA-50, CA72-4, CA-125, CA153, CA19-9 and CA242were detected in 129 patients with pancreatic cancer by usingchemiluminescence immunoassay, immunofluorescence as-say and immunoradiometric assay, respectively. The levelsof these markers were compared in 99 patients with non-pancreatic malignant tumor, 63 patients with other benigndiseases, and 27 patients with pancreatic cancer after pan-createctomy.RESULTS: Among the 8 tumor markers, CA19-9, CA242,CA-50, and CA72-4 were more sensitive in the diagnosis ofpancreatic cancer. Parallel combined testing could increasethe diagnostic sensitivity to 89.2%, and serial combined exa-mination could increase the diagnostic specificity to 92.3%.The serum tumor markers levels were decreased significant-ly after radical tumor resection.CONCLUSIONS: Serum CA19-9, CA242, CA-50, andCA72-4 are the preferred tumor markers to be used in thediagnosis and follow-up of operated cases of pancreaticcancer. Testing of a panel of multiple serum tumor mark-ers may increase the sensitivity and specificity in the diag-nosis of pancreatic cancer.

Contrast-enhanced ultrasound in association with serum biomarkers for differentiating combined hepatocellular-cholangiocarcinoma from hepatocellular carcinoma and intrahepatic cholangiocarcinoma

BACKGROUND Combined hepatocellular-cholangiocarcinoma(CHC)is a rare type of primary liver cancer.Due to its complex histopathological characteristics,the imaging features of CHC can overlap with those of hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC).AIM To investigate the possibility and efficacy of differentiating CHC from HCC and ICC by using contrast-enhanced ultrasound(CEUS)Liver Imaging Reporting and Data System(LI-RADS)and tumor biomarkers.METHODS Between January 2016 and December 2019,patients with histologically confirmed CHC,ICC and HCC with chronic liver disease were enrolled.The diagnostic formula for CHC was as follows:(1)LR-5 or LR-M with elevated alphafetoprotein(AFP)and carbohydrate antigen 19-9(CA19-9);(2)LR-M with elevated AFP and normal CA19-9;or(3)LR-5 with elevated CA19-9 and normal AFP.The sensitivity,specificity,accuracy and area under the receiver operating characteristic curve were calculated to determine the diagnostic value of the criteria.RESULTS After propensity score matching,134 patients(mean age of 51.4±9.4 years,108 men)were enrolled,including 35 CHC,29 ICC and 70 HCC patients.Based on CEUS LI-RADS classification,74.3%(26/35)and 25.7%(9/35)of CHC lesions were assessed as LR-M and LR-5,respectively.The rates of elevated AFP and CA19-9 in CHC patients were 51.4%and 11.4%,respectively,and simultaneous elevations of AFP and CA19-9 were found in 8.6%(3/35)of CHC patients.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and area under the receiver operating characteristic curve of the aforementioned diagnostic criteria for discriminating CHC from HCC and ICC were 40.0%,89.9%,58.3%,80.9%,76.9%and 0.649,respectively.When considering the reported prevalence of CHC(0.4%-14.2%),the positive predictive value and NPV were revised to 1.6%-39.6%and 90.1%-99.7%,respectively.CONCLUSION CHCs are more likely to be classified as LR-M than LR-5 by CEUS LI-RADS.The combination of the CEUS LI-RADS classification with serum tumor markers shows high specificity but low sensitivity for the diagnosis of CHC.Moreover,CHC could be confidently excluded with high NPV.

Further understanding of an uncommon disease of combined small cell lung cancer： clinical features and prognostic factors of 114 cases

Objective： Combined small cell lung cancer （C-SCLC） is an uncommon subgroup of small cell lung cancer （SCLC） and few clinical data can be referred. Our study is to investigate the clinical features and prognostic factors of C-SCLC, as well as the role of multimodality treatment.Methods： Between January 2004 and December 2012, patients with histologically diagnosed C-SCLC were retrospectively analyzed. The survivals were evaluated with the Kaplan-Meier method. Univariate and multivariate analyses were used to evaluate potential prognostic factors.Results： One hundred and fourteen patients were enrolled, with a median age of 59 （range： 20-79） years old. The most common combined component was squamous cell carcinoma （52.6%）. Among these patients, the disease was stage I, II, III and IV in 9.6%, 19.3%, 46.5% and 24.6% of the patients, respectively. Eighty patients （70.2%） received at least two of the three modalities containing chemotherapy, radiotherapy and surgery. The median follow-up was 32.5 months. The median time of overall survival （OS） was 26.2 months. On univariate analysis, smoking （P=0.029）, Karnofsky performance score （KPS） 〈80 （P=0.000）, advanced TNM stage （P=0.000）, no surgery （P=0.010）, positive resection margin （P=0.000）, positive lymph nodes ≥4 （P=0.000）, positive lymph node ratio 〉10% （P=0.000） and non-multimodality treatment （P=0.004） were associated with poor OS. Multivariate analysis confirmed that smoking, advanced TNM stage, positive resection margin and positive lymph nodes ratio 〉 10% were poor prognostic features. Conclusions： C-SCLC has a relatively early stage and good prognosis, which may due to the underestimated diagnosis in non-surgical patients. Multimodality therapy is recommended, especially for limited disease. Smoking, advanced TNM stage, positive resection margin and positive lymph nodes ratio 〉10% are poor prognostic factors.

A new combined criterion to better predict malignant lesions in patients with pancreatic cystic neoplasms

Objective:Cystic lesions of the pancreas have been increasingly recognized.Some lesions exhibit benign behavior,while others have unequivocal malignant potential.Thus,accurate identification of malignancy in patients diagnosed with pancreatic cystic neoplasms(PCNs)remains a major challenge.The aim of this study was to define a combined criterion to better predict malignant lesions in patients with PCNs.Methods:We retrospectively analyzed 165 patients who underwent resection of PCNs from October 2011 to May 2017.The relationship among malignancy and serum carbohydrate antigen 19-9(CA19-9),preoperative neutrophil-to-lymphocyte ratio(NLR),and the presence of enhanced solid component on imaging was analyzed.Results:NLR before surgery in patients with malignant PCNs(2.81±2.14)was significantly higher than that in patients diagnosed with pancreatic neuroendocrine tumor(1.90±0.69,P=0.013)or healthy volunteers(1.40±0.48;P<0.001).Serum CA19-9≥39U/m L,NLR>1.976 and presence of enhanced solid component were independent predictors of PCN malignancy.A combined criterion meeting any two or more of the three elements including CA19-9≥39 U/m L,NLR>1.976,and presence of enhanced solid component on computed tomography imaging is an indicator with a high positive predictive value of 80.5%and a high negative predictive value of 87.9%,and thus,represents a highly accurate test(86.1%).Conclusions:The new combined criterion is an effective predictor of tumor malignancy in patients with PCNs.

Research on the method of dual-frequency microwave diagnosis of plasma for solving phase integer ambiguity

In this work,microwaves and terahertz waves have performed a dual-frequency combineddiagnosis in high-temperature,large-scale plasma.According to the attenuation and phase shift of electromagnetic waves in the plasma,the electron density and collision frequency of theplasma can be inversely calculated.However,when the plasma size is large and the electron density is high,the phase shift of the electromagnetic wave is large(multiple times 2πperiod).Due to the limitations of the test equipment,the true phase shift is difficult to test accurately or to recover reality.That is,there is a problem of phase integer ambiguity.In order to obtain a phase shift of less than 180°,a higher electromagnetic wave frequency(terahertz wave with 890 GHz)is used for diagnosis.However,the attenuation of the terahertz wave diagnosis is too small(less than 0.1 d B),only the electron density can be obtained,and the collision frequency cannot be accurately obtained.Therefore,a combined diagnosis was carried out by combining twofrequencies(microwave with 36 GHz,terahertz wave with 890 GHz)to obtain electron density and collision frequency.The diagnosis result shows that the electron density is in the range of(0.65–1.5)×1019m^(-3),the collision frequency is in the range of 0.65–2 GHz,and the diagnostic accuracy is about 60%.

Clinical Intelligent Diagnosis Path Based on the Chief Complaint

Goals of traditional Chinese medicine(TCM)include precision,accuracy,and recognition by clinical practice.Establishment of a diagnosis and treatment system that closely conforms to the principle-method-recipe-medicines system and derivation of an accurate diagnosis and treatment plan should be considerations of TCM.Artificial intelligence research based on computer technology is one of the effective ways to solve this problem.In the research of intelligent diagnosis path,reflecting the characteristics of the overall view and dialectical treatment of TCM such as"Combination of four diagnostic methods""overall examination""combination of disease and syndrome"and"treatment individualized to patient,season and locality"are key for successful research of artificial intelligence in TCM diagnosis or recognition by clinical practice.

Exploiting structural similarity of log files in fault diagnosis for Web service composition

With increasing deployment of Web services, the research on the dependability and availability of Web service composition becomes more and more active. Since unexpected faults of Web service composition may occur in different levels at runtime, log analysis as a typical data- driven approach for fault diagnosis is more applicable and scalable in various architectures. Considering the trend that more and more service logs are represented using XML or JSON format which has good flexibility and interoperability, fault classification problem of semi-structured logs is considered as a challenging issue in this area. However, most existing approaches focus on the log content analysis but ignore the structural information and lead to poor performance. To improve the accuracy of fault classification, we exploit structural similarity of log files and propose a similarity based Bayesian learning approach for semi-structured logs in this paper. Our solution estimates degrees of similarity among structural elements from heterogeneous log data, constructs combined Bayesian network （CBN）, uses similarity based learning algorithm to compute probabilities in CBN, and classifies test log data into most probable fault categories based on the generated CBN. Experimental results show that our approach outperforms other learning approaches on structural log datasets.

Multi-factor combined biomarker screening strategy to rapidly diagnose Alzheimer's disease and evaluate drug effect based on a rat model

Alzheimer's disease(AD)represents the main form of dementia;however,valid diagnosis and treatment measures are lacking.The discovery of valuable biomarkers through omics technologies can help solve this problem.For this reason,metabolomic analysis using ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS)was carried out on plasma,hippocampus,and cortex samples of an AD rat model.Based on the metabolomic data,we report a multi-factor combined biomarker screening strategy to rapidly and accurately identify potential biomarkers.Compared with the usual procedure,our strategy can identify fewer biomarkers with higher diagnostic specificity and sensitivity.In addition to diagnosis,the potential biomarkers identified using our strategy were also beneficial for drug evaluation.Multi-factor combined biomarker screening strategy was used to identify differential metabolites from a rat model of amyloid beta peptide 1e40(Aβ_(1-40))plus ibotenic acid-induced AD(compared with the controls)for the first time;lysophosphatidylcholine(LysoPC)and intermediates of sphingolipid metabolism were screened as potential biomarkers.Subsequently,the effects of donepezil and pine nut were successfully reflected by regulating the levels of the abovementioned biomarkers and metabolic profile distribution in partial least squaresdiscriminant analysis(PLS-DA).This novel biomarker screening strategy can be used to analyze other metabolomic data to simultaneously enable disease diagnosis and drug evaluation.

Innovative combined therapy for multiple keloidal dermatofibromas of the chest wall: A novel case report

Dermatofibromas are benign soft tissue tumors that predominantly affect the limbs, and more rarely the chest.Keloidal dermatofibroma is a rare subtype with distinct clinicopathological features and an aggressive clinical course. By researching the evolution of the disease in this study, we aimed to summarize our experience of managing a rare patient who underwent five surgeries for keloidal dermatofibroma that developed sequentially in the upper arm and chest and propose a novel treatment for keloidal dermatofibroma. We concluded that keloidal dermatofibroma involving larger areas, high tension sites, and multiple localizations can be treated using the principles of pathological scar management.

超声征象联合诊断在儿童急性阑尾炎中的临床意义

目的探讨在急性阑尾炎患儿诊断中,超声征象的特点及诊断意义。方法以81例急性阑尾炎患儿为研究对象,将81例急性阑尾炎患儿依病理检测结果分为2组:进展性阑尾炎患儿34例(41.98%),单纯性阑尾炎患儿47例(58.02%)。通过超声检测的间接征象、直接征象,以及病理检查资料,并借助ROC曲线分析超声征象联合应用的曲线下面积(area under curve,AUC),进行综合分析,对患儿超声检查结果进行评分。结果进展组患儿超声检测的管壁连续性中断/层次清晰度不高、管腔积液、阑尾周围或腹腔积液、阑尾周围高回声、盲肠、回肠壁增厚检出率均高于单纯组(P<0.05);进展组超声间接征象、直接征象、联合征象评分均高于单纯组(P<0.05);ROC(receiver oprating characteristic)曲线下,联合征象诊断灵敏度、特异度、阳性预测值和阴性预测值分别为98.77%、97.53%、98.77%、96.30%均高于间接征象、直接征象,AUC为0.902高于间接征象、直接征象(P<0.05)。结论超声检测征象联合诊断,能够为急性阑尾炎患儿的早期诊断提供客观证据,且还可实现对疾病动态监测,从而有利于临床治疗方案的制定。

创新视野下基础联合应用的教学模式在产前超声诊断继续医学教育中的应用价值

目的探讨创新视野下基础联合应用的教学模式在产前超声诊断继续医学教育中的应用价值。方法选取2020年1月—2021年12月于新疆医科大学第一附属医院超声科接受继续医学教育培训的30名学员,根据盲抽法将其分为观察组与对照组,各15名学员。对照组采用传统教学方法,观察组采用创新视野下基础联合应用的教学模式。比较2组培训前、培训3个月后的考核理论成绩、考核技能成绩以及2组对教学方法的总满意度。结果培训3个月后,观察组的超声基础原理[(8.67±1.15)分]、相关疾病鉴定诊断[(17.35±2.14)分]、疾病超声诊断[(27.68±2.01)分]、图像辨别[(8.69±1.04)分]、病例分析[(26.46±3.05)分]评分及总分[(88.85±7.62)分]均高于对照组[(6.46±1.08)分、(13.22±2.66)分、(24.26±3.21)分、(6.05±1.65)分、(22.84±2.95)分、(72.83±7.21)分],差异有统计学意义(P<0.05);培训3个月后,观察组的标准切面[(36.65±2.41)分]、操作手法[(16.26±2.55)分]、疾病诊断与鉴别[(17.95±2.16)分]、报告书写[(17.24±2.01)分]评分及总分[(88.10±8.51)分]均高于对照组[(32.56±2.47)分、(14.36±2.01)分、(14.26±2.01)分、(14.66±2.51)分、(76.04±7.32)分],差异有统计学意义(P<0.05);培训3个月后,观察组学员的总满意度为86.67%,与对照组的66.67%比较,差异无统计学意义(P>0.05)。结论创新视野下基础联合应用的教学模式在产前超声诊断继续医学教育中的应用价值较高,可提高学员理论、技能水平。