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Could the Level in Parasitaemia of <i>Plasmodium</i>Determine Sensitivity to Various diagnostic tests?

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American Journal of Molecular Biology 2020年第3期10卷 224-245页

作者： Obed Nanjul Goselle Godwin Yandu Ajiji Anvou Jambol Joseph Terhema Sunday Ojochemi Sunday Idoko Shedrach Sunday Udoh Oliseemeka Charles Ejete Yahaya Mbaya Ahmadu Henrietta Oluwatoyin Awobode Godwin Nyiutaha Imandeh Bernard Malau Matur Applied Entomology and Parasitology Unit Department of Zoology University of Jos Jos Nigeria National Veterinary Research Institute Vom Nigeria Health and Development Support Programme Jos Nigeria Department of Zoology University of Ibadan Ibadan Nigeria Department of Zoology Federal University of Agriculture Makurdi Nigeria

The discovery of Plasmodium parasites and its incrimination as the principal cause of malaria in humans has continued to excite researchers towards inventing possible easier methods of diagnosing and identifying these pathological agents in order to mitigate, control and eliminate its continuous scourge to humanity. Currently, three diagnostic methods have been proposed, but agreements as to whether the level of parasitaemia in an individual could connote likely confirmations in the three methods i.e. gold standard, RDTs’ and PCR/NESTED PCR, have continued to be a subject of debate. To lay to rest the debate as reported in many studies, we collected blood samples from 100 symptomatic patients who reported to the Jos-Nigeria hospital and using the gold standard methods, we were able to confirm that 30 (30%) samples out of the 100 blood samples collected were positive to P. falciparum, chiefly recorded among duffy-negative Africans. Excited with our findings, we prepared the thick blood films for each sample and used it to estimate the levels of parasitaemia (parasites density) per μl of blood (i.e. 1+;2+;3+ and 4+) per 100 high power fields (|HPF). We then subjected the individually confirmed parasite density samples to the other two methods i.e. Rapid diagnostic Test (one-step RTD and optimal-IT® RDT) and to molecular assay (PCR and the nested PCR). Interestingly, of the 30 positive samples, 18 (60%) were confirmed positive to the one-step and optimal-IT® RDTS, while 3 (30%) out of the 10 (100%) samples of various parasite density subjected to molecular assay (PCR and the nested PCR) were positive to only P. falciparum. Statistical analysis of variance based on single factor computed using SPSS indicates a no significant difference (P > 0.05) in the parasitaemia levels of the four groups/categories of patients;i.e. variance ratio of 0.011976 calculated was less t

关键词： Plasmodium Parasitaemia diagnostic tests Malaria Sensitivity

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

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Journal of Traditional Chinese Medicine 2022年第5期42卷 833-838页

作者： LIU Qian ZHAO Zhupei GUO Hua WANG Shiheng HAO Mingzhao QIN Peijie WANG Liuqing LIU Xuechun ZHANG Fengxia AN Hong LI Yu SHI Xueqin ZHU Tingyu LIU Jianfeng WANG Liying XU Tao ZHANG Limei ZOU Xu Institute for the History of Chinese Medicine and Medical Literature China Academy of Chinese Medical SciencesBeijing 100700China Graduate School of China Academy of Chinese Medical Sciences Beijing 100700China Institute of Basic Research in Clinical Medicine China Academy of Chinese Medical SciencesBeijing 100700China China Chest Pain Center The Second Affiliated Hospital of Guizhou University of Traditional Chinese MedicineGuizhou 550003China Guang'anmen Hospital China Academy of Chinese Medical SciencesBeijing 100053China Department of Cardiovascular Diseases Guangdong Provincial Hospital of Traditional Chinese MedicineGuangzhou 510120China

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.

关键词： hand diagnosis coronary artery disease diagnostic tests routine Qisexingtai

Protocol to establish auxiliary diagnostic model for knee osteoarthritis functional testing equipment

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Journal of Traditional Chinese Medicine 2023年第2期43卷 379-385页

作者： GUO Zhuang WANG Junwen LI Zhonglong CHEN Zhongjie CHEN Li YAN Shiyan LU Hongrong LI Zhigeng LI Guanying Institute of Basic Theory of Chinese Medicine China Academy of Chinese Medical ScienceBeijing 100700China Institute of Acupuncture and Moxibustion China Academy of Chinese Medical SciencesBeijing 100700China Department of Acupuncture Moxibustion and MassageBeijing HospitalBeijing 100000China Department of Acupuncture Moxibustion and MassageWuhan Hongshan Chinese Medicine HospitalHubei 430070China School of Humanities Beijing University of Chinese MedicineBeijing 100029China

In China,50%of Knee Osteoarthritis(KOA)patients will be treated with Traditional Chinese Medicine or a combination of Traditional Chinese and Western Medicine,which call for objective efficacy evaluation methods.The collection,processing and fusion of multisource data were taken as the main methods,with 150 KOA patients and 100 healthy people as an example to design prospective clinical tests.Data were collected with tongue inspection APP,infrared instrument and channel instrument,etc.And the analysis,screening,fusion and modelling of multi-source data were conducted.The traditional clinical tests have been combined with the customized information platform in this study,which is convenient for clinical tests,medical follow-ups and timely feedback to statistical analysis of data.

关键词： osteoarthritis knee multi-source data efficacy evaluation prospective clinical test diagnostic tests routine protocol

Clinical utility of two-dimensional shear-wave elastography in monitoring disease course in autoimmune hepatitis-primary biliary cholangitis overlap syndrome

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World Journal of Gastroenterology 2022年第18期28卷 2021-2033页

作者： Yu-Ling Yan Xian Xing Yi Wang Xiao-Ze Wang Zhi Wang Li Yang Department of Gastroenterology and Hepatology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Sichuan University University of Oxford Huaxi Joint for Gastrointestinal Cancer CentreChengdu 610207Sichuan ProvinceChina

BACKGROUND Autoimmune hepatitis-primary biliary cholangitis(AIH-PBC)overlap syndrome has a worse prognosis than AIH or PBC alone.Therefore,accurately staging liver fibrosis and dynamically monitoring disease progression are essential.AIM To investigate the performance of two-dimensional shear-wave elastography(2DSWE)for noninvasively staging liver fibrosis and assessing the clinical utility of repeated 2D-SWE for monitoring treatment response in AIH-PBC overlap syndrome.METHODS A total of 148 patients diagnosed with AIH-PBC overlap syndrome were retrospectively enrolled.Among them,82 patients had a 2D-SWE follow-up time of more than 1 year.The Scheuer scoring system was used to evaluate stages of hepatic inflammation and liver fibrosis.The performance of 2D-SWE for staging liver fibrosis was evaluated with the liver biopsy.Changes in liver stiffness(LS)measured by 2D-SWE in patients with or without complete biochemical remission were evaluated.RESULTS LS value was strongly correlated with liver fibrosis stage(Spearman r=0.84,P<0.0001).The areas under the receiver operating characteristic curves of LS for diagnosing significant fibrosis(≥S2),severe fibrosis(≥S3),and cirrhosis(S4)were 0.91,0.97,and 0.96,respectively.Patients with complete biochemical remission had a considerable decrease in LS values(P<0.0001).More importantly,the declined LS in patients with S0-S2 was significantly lower than that in patients with S3-S4(P=0.0002).In contrast,patients who failed to achieve biochemical remission had a slight but not significant decrease in LS(P=0.37).CONCLUSION LS measured by 2D-SWE is an accurate and reliable method in assessing liver fibrosis,especially for diagnosing severe fibrosis(≥3)and monitoring treatment response in patients with AIH-PBC overlap syndrome.

关键词： Liver fibrosis Liver biopsy diagnostic tests Autoimmune hepatitis Primary biliary cholangitis Inflammation

Weighted Youden index and its two-independent-sample comparison based on weighted sensitivity and specificity

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Chinese Medical Journal 2013年第6期126卷 1150-1154页

作者： LI Dan-ling SHEN Frank YIN Yue PENG Jun-xiang CHEN Ping-yan Department of Biostatistics School of Public Health and Tropical Medicine Southern Medical University Guangzhou Guangdong 510515 China Shanghai Roche Pharmaceuticals Ltd. Roche ProductDevelopment in Asia Pacific Shanghai 201203 China

Background Most indices for evaluating a diagnostic test can be expressed as functions of sensitivity （SEN） and specificity （SPE）. Practically, all existing methods suffer from the inability to weight sensitivity and specificity relative to their importance. In this paper, we developed a novel index, the weighted Youden index, that allows Youden index to be a combination of sensitivity and specificity with user-defined weights. Methods The weighted Youden index Jw is defined as Jw=2（wxSEN＋（1-w）SPE）-I （0 〈w 〈1）. It has three properties：（1） the sum of the weights which are attached to sensitivity and specificity should be equal to 1; （2） the range of Jw should be within [-1, 1], which is the range of the Youden index J; （3） Jw should be equal to J when sensitivity and specificity have equal weights. According to the central limit theorem, we obtain the standard error of Jw, and propose a statistical inference method to compare two weighted Youden indices. The monotonicity of the test statistic was discussed. Results An example of comparing two diagnostic tests for pheochromocytoma was used to demonstrate the weighted Youden index method. Weighted Youden index, the confidence interval for each test and the hypothesis test of comparing two independent diagnostic tests were presented. Assigning the weights is essential to the weighted Youden index approach. Conclusion The weighted Youden index can broaden further research in weighting sensitivity and specificity exp ts applications in diagnostic test development and motivate icitly.

关键词： Youden index diagnostic tests weights sensitivity specificity

Technetium-99m-labeled macroaggregated albumin lung perfusion scan for diagnosis of hepatopulmonary syndrome: A prospective study comparing brain uptake and whole-body uptake

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World Journal of Gastroenterology 2020年第10期26卷 1088-1097页

作者： He Zhao Jiaywei Tsauo Xiao-Wu Zhang Huai-Yuan Ma Ning-Na Weng Gong-Shun Tang Xiao Li Department of Interventional Therapy National Cancer Center/National Clinical Research Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Gastroenterology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Nuclear Medicine West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Hepatopulmonary syndrome (HPS) is an arterial oxygenation defect induced by intrapulmonary vascular dilatation (IPVD) in the setting of liver disease and/or portal hypertension.This syndrome occurs most often in cirrhotic patients(4%-32%) and has been shown to be detrimental to functional status,quality of life,and survival.The diagnosis of HPS in the setting of liver disease and/or portal hypertension requires the demonstration of IPVD (i.e.,diffuse or localized abnormally dilated pulmonary capillaries and pulmonary and pleural arteriovenous communications) and arterial oxygenation defects,preferably by contrast-enhanced echocardiography and measurement of the alveolar-arterial oxygen gradient,respectively.AIM To compare brain and whole-body uptake of technetium for diagnosing HPS.METHODS Sixty-nine patients with chronic liver disease and/or portal hypertension were prospectively included.Brain uptake and whole-body uptake were calculated using the geometric mean of technetium counts in the brain and lungs and in the entire body and lungs,respectively.RESULTS Thirty-two (46%) patients had IPVD as detected by contrast-enhancedechocardiography.The demographics and clinical characteristics of the patients with and without IPVD were not significantly different with the exception of the creatinine level (0.71±0.18 mg/dL vs 0.83±0.23 mg/dL;P=0.041),alveolararterial oxygen gradient (23.2±13.3 mmHg vs 16.4±14.1 mmHg;P=0.043),and arterial partial pressure of oxygen (81.0±12.1 mmHg vs 90.1±12.8 mmHg;P=0.004).Whole-body uptake was significantly higher in patients with IPVD than in patients without IPVD (48.0%±6.1%vs 40.1%±8.1%;P=0.001).The area under the curve of whole-body uptake for detecting IPVD was significantly higher than that of brain uptake (0.75 vs 0.54;P=0.025).The optimal cut-off values of brain uptake and whole-body uptake for detecting IPVD were 5.7%and 42.5%,respectively,based on Youden’s index.The sensitivity,specificity,and accuracy of brain uptake> 5.7%and whole-body uptake> 42.5%for detecting

关键词： Portal hypertension Intrapulmonary vascular dilations Radionuclide imaging Technetium-99m-labeled macroaggregated albumin lung perfusion scan diagnostic tests Sensitivity and specificity

A Comprehensive Overview of the Paradigm of Laboratory Findings in the Diagnosis of the Pandemic Coronavirus Disease 2019 (COVID-19) in India

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Open Journal of Pathology 2022年第1期12卷 12-21页

作者： Ravi Gautam Anshu Gupta Department of Pathology Swami Dayanand Hospital Delhi India Department of Pathology and In-Charge Emergency Laboratory Institute of Human Behavior and Allied Sciences (IHBAS) Delhi India

COVID-19 is a pandemic disease caused by 2019 Novel Coronavirus or SARS-CoV-2. As this disease is highly contagious and rapidly spreading, so all countries have to increase their level of preparedness, alert, and response to identify, manage, and care for new cases of COVID-19;laboratory testing is an integral part of this strategy. Accurate results by laboratory diagnosis are beneficial for public health.

关键词： COVID-19 SARS-CoV-2 Laboratory Diagnosis Molecular Testing Diagnosis diagnostic tests

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

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Open Journal of Gastroenterology 2023年第6期13卷 199-208页

作者： Winnie Tatiana Bekolo Nga Guy Roger Nsenga Djapa Kelly Ilinga Meme Mamende Antonin Wilson Ndjitoyap Ndam David Sepo Sepo Agnès Malongue Firmin Ankouane Andoulo Oudou Njoya Henry Luma Namme Elie Claude Ndjitoyap Ndam Carole Else Eboumbou Servais Albert Fiacre Eloumou Bagnaka Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Medecine Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Department of Internal Medecine Douala Military Hospital Douala Cameroon

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.

关键词： Helicobacter pylori diagnostic tests Sensitivity Specificity Positive and Negative Predictive Value