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Chinese Journal of Integrative Medicine 2019年第7期25卷 515-520页

作者： LIU Xiao-qi PENG Dan-hong WANG Yan-ping XIE Rong CHEN Xin-lin YU Chun-quan LI Xian-tao School of Basic Medical Science Guangzhou University of Chinese Medicine Guangzhou (510006) China Journal Editorial Board Tianjin University of Traditional Chinese Medicine Tianjin (300193) China

Background Phlegm and blood stasis syndrome(PBSS) is one of the main syndromes in coronary heart disease(CHD). Syndromes of Chinese medicine(CM) are lack of quantitative and easyimplementation diagnosis standards. To quantify and standardize the diagnosis of PBSS, scales are usually applied. Objective: To evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. Methods: Six hundred patients with stable angina pectoris of CHD, 300 in case group and 300 in control group, will be recruited from 5 hospitals across China. Diagnosis from 2 experts will be considered as the "gold standard". The study design consists of 2 phases: pilot test is used to evaluate the reliability and validity, and diagnostic test is used to assess the diagnostic accuracy of the scale, including sensitivity, specificity, likelihood ratio and area under the receiver operator characteristic(ROC) curve. Discussion: This study will evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. The consensus of 2 experts may not be ideal as a "gold standard", and itself still requires further study.(No. ChiCTR-OOC-15006599).

关键词： diagnostic accuracy phlegm and blood stasis diagnosis scale syndrome differentiation coronary heart disease study protocol

The diagnostic conundrum in necrotizing otitis externa

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 59-65页

作者： Abiya A.Ahmed Shaan Rashid Vinay K.Gupta Neil C.Molony Keshav K.Gupta Bradford Royal Infirmary Bradford Teaching Hospitals NHS Foundation TrustWest BromwichWest YorkshireUK Sandwell and West Birmingham Hospitals NHS Trust West BromwichUK Russells Hall Hospital DudleyUK

Necrotizing otitis externa(NOE)is an aggressive and fast‐evolving infection of the external auditory canal.Late diagnoses and untreated cases can lead to severe,even fatal consequences and so early diagnosis and treatment are paramount.NOE is a notoriously challenging diagnosis to make.It is therefore important to understand what diagnostic modalities are available and how otolaryngologists can use them to accurately treat such an aggressive disease.This review aims to evaluate the different diagnostic options available in NOE and discuss their advantages and limitations,thus,providing an up‐to‐date picture of the multimodal approach required in the diagnosis of this disease.

关键词： diagnostic malignant otitis externa necrotizing osteomyelitis skull base osteomyelitis temporal bone osteomyelitis

diagnostic and prognostic potential of tissue and circulating long non-coding RNAs in colorectal tumors

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World Journal of Gastroenterology 2019年第34期25卷 5026-5048页

作者： Orsolya Galamb Barbara K Barták Alexandra Kalmár Zsófia B Nagy Krisztina A Szigeti Zsolt Tulassay Peter Igaz Béla Molnár Molecular Medicine Research Group Hungarian Academy of SciencesBudapest H-1088Hungary 2nd Department of Internal Medicine Semmelweis UniversityBudapest H-1088Hungary

Long non-coding RNAs(lncRNAs)are members of the non-protein coding RNA family longer than 200 nucleotides.They participate in the regulation of gene and protein expression influencing apoptosis,cell proliferation and immune responses,thereby playing a critical role in the development and progression of various cancers,including colorectal cancer(CRC).As CRC is one of the most frequently diagnosed malignancies worldwide with high mortality,its screening and early detection are crucial,so the identification of disease-specific biomarkers is necessary.LncRNAs are promising candidates as they are involved in carcinogenesis,and certain lncRNAs(e.g.,CCAT1,CRNDE,CRCAL1-4)show altered expression in adenomas,making them potential early diagnostic markers.In addition to being useful as tissue-specific markers,analysis of circulating lncRNAs(e.g.,CCAT1,CCAT2,BLACAT1,CRNDE,NEAT1,UCA1)in peripheral blood offers the possibility to establish minimally invasive,liquid biopsy-based diagnostic tests.This review article aims to describe the origin,structure,and functions of lncRNAs and to discuss their contribution to CRC development.Moreover,our purpose is to summarise lncRNAs showing altered expression levels during tumor formation in both colon tissue and plasma/serum samples and to demonstrate their clinical implications as diagnostic or prognostic biomarkers for CRC.

关键词： Long non-coding RNA Colorectal cancer Colorectal adenoma Circulating long non-coding RNAs Exosome Biomarker diagnostic marker Prognostic marker

diagnostic delay in inflammatory bowel disease increases the risk of intestinal surgery

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World Journal of Gastroenterology 2017年第35期23卷 6474-6481页

作者： Dong-won Lee Ja Seol Koo Jung Wan Choe Sang Jun Suh Seung Young Kim Jong Jin Hyun Sung Woo Jung Young Kul Jung Hyung Joon Yim Sang Woo Lee Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University Ansan Hospital

AIM To investigate the factors affecting diagnostic delay and outcomes of diagnostic delay in inflammatory bowel disease(IBD) METHODS We retrospectively studied 165 patients with Crohn's disease(CD) and 130 patients with ulcerative colitis(UC) who were diagnosed and had follow up durations > 6 mo at Korea University Ansan Hospital from January 2000 to December 2015. A diagnostic delay was defined as the time interval between the first symptom onset and IBD diagnosis in which the 76^(th) to 100^(th) percentiles of patients were diagnosed.RESULTS The median diagnostic time interval was 6.2 and 2.4 mo in the patients with CD and UC, respectively. Among the initial symptoms, perianal discomfort before diagnosis(OR = 10.2, 95%CI: 1.93-54.3, P = 0.006) was associated with diagnostic delays in patients with CD; however, no clinical factor was associated with diagnostic delays in patients with UC. diagnostic delays, stricturing type, and penetrating type were associated with increased intestinal surgery risks in CD(OR = 2.54, 95%CI: 1.06-6.09; OR = 4.44, 95%CI: 1.67-11.8; OR = 3.79, 95%CI: 1.14-12.6, respectively). In UC, a diagnostic delay was the only factor associated increased intestinal surgery risks(OR = 6.81, 95%CI: 1.12-41.4).CONCLUSION A diagnostic delay was associated with poor outcomes, such as increased intestinal surgery risks in patients with CD and UC.

关键词： diagnostic delay Intestinal surgery Inflammatory bowel disease Crohn’s disease Ulcerative colitis

diagnostic value of high-resolution micro-endoscopy for theclassification of colon polyps

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World Journal of Gastroenterology 2016年第5期22卷 1869-1876页

作者： Tao Tan Ya-Wei Qu Juan Shu Min-Li Liu Ling Zhang Hai-Feng Liu Department of Gastroenterology General Hospital of Chinese People’s Armed Police ForcesBeijing 100039China

AIM: To study a new imaging equipment, highresolution micro-endoscopy(HRME), in the diagnosis and pathological classification of colon polyps.METHODS: We selected 114 specimens of colon polyps, 30 of which were colon polyps with known pathological types and 84 that were prospective polyp specimens; 10 normal colon mucosa specimens served as controls. We obtained images of 30 colon polyp specimens with known pathological types using HRME and analyzed the characteristics of these images to develop HRME diagnostic criteria for different pathological types of colon polyps. Based on these criteria, we performed a prospective study of 84 colon polyp specimens using HRME and compared the results with those of the pathological examination to evaluate the diagnostic value of HRME in the pathological classification of different types of colon polyps. RESULTS: In the 30 cases of known pathological type of colon polyp samples, there were 21 cases of adenomatous polyps, which comprised nine cases of tubular adenoma, seven cases of villous adenoma and five cases of mixed adenomas. The nine cases of non-adenomatous polyps included four cases of inflammatory polyps and five cases of hyperplastic polyps five. Ten cases of normal colonic mucosa were confirmed pathologically. In a prospective study of 84 cases using HRME, 23 cases were diagnosed as inflammatory polyps, 11 cases as hyperplastic polyps, 18 cases as tubular adenoma, eight cases as villous adenoma and 24 cases as mixed adenomas. After pathological examination, 24 cases were diagnosed as inflammatory polyps, 11 cases as hyperplastic polyps, 19 cases as tubular adenoma, eight cases as villous adenoma and 22 cases as mixed adenomas. Compared with the pathological examinations, the sensitivities, specificities, accuracies, and positive and negative predictive values of HRME in diagnosing inflammatory polyps(87.5%, 96.7%, 94.0%, 91.3% and 95.1%), hyperplastic polyps(72.7%, 95.9%, 92.9%, 72.7% and 95.9%), tubular adenomas(73.7%, 93.8%, 89.3%, 77.8% and 92.4%), villous adenom

关键词： High-resolution micro-endoscopy Colonpolyps Pathology diagnostic criteria

diagnostic imaging and radiation exposure in inflammatorybowel disease

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World Journal of Gastroenterology 2016年第7期22卷 2165-2178页

作者： Nekisa Zakeri Richard CG Pollok Department of Gastroenterology St George’s HospitalLondon SW17 0QTUnited Kingdom Department of Gastroenterology Consultant Gastroenterologist and Honorary Senior LecturerSt George’s HospitalLondon SW17 0QTUnited Kingdom

diagnostic imaging plays a key role in the diagnosis and management of inflammatory bowel disease(IBD). However due to the relapsing nature of IBD, there is growing concern that IBD patients may be exposed to potentially harmful cumulative levels of ionising radiation in their lifetime, increasing malignant potential in a population already at risk. In this review we explore the proportion of IBD patients exposed to high cumulative radiation doses, the risk factors associated with higher radiation exposures, and we compare conventional diagnostic imaging with newer radiation-free imaging techniques used in the evaluation of patients with IBD. While computed tomography(CT) performs well as an imaging modality for IBD, the effective radiation dose is considerably higher than other abdominal imaging modalities. It is increasingly recognised that CT imaging remains responsible for the majority of diagnostic medical radiation to which IBD patients are exposed. Magnetic resonance imaging(MRI) and small intestine contrast enhanced ultrasonography(SICUS) have now emerged as suitable radiation-free alternatives to CT imaging, with comparable diagnostic accuracy. The routine use of MRI and SICUS for the clinical evaluation of patients with known or suspected small bowel Crohn's disease is to be encouraged wherever possible. More provision is needed for out-of-hours radiation-free imaging modalities to reduce the need for CT.

关键词： diagnostic medical radiation Inflammatorybowel disease Small bowel follow-through Computerisedtomography Nuclear medicine Magneticresonance enterography Small intestine contrastenhancedultrasonography

diagnostic issue on spontaneous osteonecrosis of medial tibial plateau

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Chinese Medical Journal 2019年第6期132卷 755-756页

作者： Jun Jiang Jian Chen Arthritis Clinic and Research Center Peking University People Hospital Beijing 100044 China

To the Editor: I read with great interest the recent report of Yang et al[1],“Clinical Characteristics and Treatment of Spontaneous Osteonecrosis of Medial Tibial Plateau: A retrospective case study”(published on November 5, 2018, Chin Med J, page 2544-2550), because there have been very few reports on isolated spontaneous medial tibial plateau osteonecrosis and little is known about osteonecrosis of the tibial plateau. I would like to comment on diagnostic issues in this letter.

关键词： diagnostic issue spontaneous osteonecrosis medial tibial plateau

diagnostic Value of Sensitive Biomarkers for Early Kidney Damage in Diabetic Patients with Normoalbuminuria

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Chinese Medical Journal 2018年第23期131卷 2891-2892页

作者： Dong Zhang Qiu-Xia Han Ming-Hui Wu Wan-Jun Shen Xiao-Li Yang Jia Guo Shao-Kang Pan Zhang-Suo Liu Li Tang Guang-Yan Cai Xiang-Mei Chen Han-Yu Zhu Department of Nephrology Chinese People's Liberation Army General HospitalChinese People's Liberation Army Institute of NephrologyState Key Laboratory of Kidney DiseasesNational Clinical Research Center for Kidney DiseasesBeijing Key Laboratory of Kidney DiseasesBeijing 100853China Department of Nephrology The First Affiliated Hospital of Zhengzhou UniversityResearch institute of Nephrology in Zhengzhou UniversityKey Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan ProvinceZhengzhouHenan 450052China

To the Editor:Diabetic kidney disease (DKD)is the most common cause of end-stage renal disease (ESRD);however,the onset of DKD is difficult to detect.[1]When persistent microalbuminuria becomes detectable,DKD has already progressed to the third disease stage,and finding biomarkers that are more sensitive than microalbuminuria is therefore necessary to indicate kidney damage at an earlier stage of DKD.[2]Both glomerular and tubulointerstitial damages have been repeatedly demonstrated to be important factors in the pathophysiology of DKD.[3] Therefore,we investigated the expression levels of six markers closely related to the glomerulus and renal tubule.

关键词： diagnostic Value Sensitive Biomarkers Early Kidney Damage Diabetic Patients with Normoalbuminuria

Plasma-metabolite-based machine learning is a promising diagnostic approach for esophageal squamous cell carcinoma investigation

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Journal of Pharmaceutical Analysis 2021年第4期11卷 505-514页

作者： Zhongjian Chen Xiancong Huang Yun Gao Su Zeng Weimin Mao Laboratory of Pharmaceutical Analysis and Drug Metabolism College of Pharmaceutical SciencesZhejiang UniversityHangzhou310058China The Cancer Research Institute The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital)Institute of Basic Medicine and Cancer(IBMC)Chinese Academy of SciencesHangzhou310022China

The aim of this study was to develop a diagnostic strategy for esophageal squamous cell carcinoma(ESCC)that combines plasma metabolomics with machine learning algorithms.Plasma-based untargeted metabolomics analysis was performed with samples derived from 88 ESCC patients and 52 healthy controls.The dataset was split into a training set and a test set.After identification of differential metabolites in training set,single-metabolite-based receiver operating characteristic(ROC)curves and multiple-metabolite-based machine learning models were used to distinguish between ESCC patients and healthy controls.Kaplan-Meier survival analysis and Cox proportional hazards regression analysis were performed to investigate the prognostic significance of the plasma metabolites.Finally,twelve differential plasma metabolites(six up-regulated and six down-regulated)were annotated.The predictive performance of the six most prevalent diagnostic metabolites through the diagnostic models in the test set were as follows:arachidonic acid(accuracy:0.887),sebacic acid(accuracy:0.867),indoxyl sulfate(accuracy:0.850),phosphatidylcholine(PC)(14:0/0:0)(accuracy:0.825),deoxycholic acid(accuracy:0.773),and trimethylamine N-oxide(accuracy:0.653).The prediction accuracies of the machine learning models in the test set were partial least-square(accuracy:0.947),random forest(accuracy:0.947),gradient boosting machine(accuracy:0.960),and support vector machine(accuracy:0.980).Additionally,survival analysis demonstrated that acetoacetic acid was an unfavorable prognostic factor(hazard ratio(HR):1.752),while PC(14:0/0:0)(HR:0.577)was a favorable prognostic factor for ESCC.This study devised an innovative strategy for ESCC diagnosis by combining plasma metabolomics with machine learning algorithms and revealed its potential to become a novel screening test for ESCC.

关键词： diagnostic Esophageal squamous cell carcinoma(ESCC) Metabolomics Machine learning Prognostic

diagnostic accuracy of≥16-slice spiral computed tomography for local staging of colon cancer:A systematic review and metaanalysis

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World Journal of Clinical Cases 2022年第19期10卷 6483-6495页

作者： Dan Liu Lin-Mei Sun Jing-Hua Liang Lei Song Xiao-Pei Liu Xi’an Hospital of Traditional Chinese Medicine Xi’an 710021Shaanxi ProvinceChina Shenzhen Traditional Chinese Medicine Anorectal Hospital Shenzhen 518000Guangdong ProvinceChina School of Basic Medicine Shaanxi University of Chinese MedicineXianyang 710021Shaanxi ProvinceChina

BACKGROUND Colorectal cancer is one of the most common cancers worldwide with high mortality and is classified as a single entity,although colon cancer and rectal cancer have largely different diagnoses,treatments,surgical methods,and recurrence rates.≥16-slice spiral computed tomography(SCT)is mostly applied to detect the local stage of colon cancer;however,its diagnostic accuracy and whether it is conducive to distinguishing between high-risk and low-risk colon cancer are unclear.AIM To systematically review the diagnostic accuracy of≥16-slice SCT for local staging of colon cancer.METHODS Based on the PubMed,EMBASE,Cochrane Library,and Web of Science databases,computers were used to search the literature from the establishment of the database to April 2021,and the results of the diagnostic tests on≥16-slice SCT for local staging of colon cancer were collected according to the inclusion criteria.The data were then extracted and assessed on the basis of the Quality Assessment Checklist of the Institute of Economics of Canada,Reference Citation Analysis(https://***/).Afterward,a meta-analysis was performed using the statistical software Meta-disc 14.0 and Stata 15.0.RESULTS Eleven studies that provided data on 1613 subjects with computed tomography diagnostic tests were included in this study.Meta-analysis revealed that the pooled sensitivity,pooled specificity,pooled negative likelihood ratio(LR),pooled diagnostic odds ratio,and area under the fitted receiver operating characteristic(ROC)curve of≥16-slice SCT for colon cancer T staging were 0.67(95%CI:0.65-0.70),0.81(95%CI:0.80-0.83),4.13(95%CI:2.66-6.41),0.39(95%CI:0.31-0.49),10.81(95%CI:7.33-15.94),and 0.829,respectively,while the specificity,negative LR,diagnostic odds ratio,and area under the fitted ROC curve of≥16-slice SCT for N staging of colon cancer were 0.54(95%CI:0.49-0.59),0.74(95%CI:0.70-0.77),1.92(95%CI:1.36-2.70),0.67(95%CI:0.51-0.87),3.74(95%CI:1.76-7.94),and 0.829 respectively.The sensitivity and specificity of≥16-slice SCT for colon cancer T sta

关键词： ≥16-detector CT diagnostic Colon cancer Systematic review Meta-analysis