Search

Purpose: This research is intended to evaluate the correlations of serum IL-6 and TGF-β1 concentrations with bone density and turnover markers as well as their diagnostic value in elderly male patients with osteoporosis (OP). Methods: A retrospective analysis was conducted on 335 elderly men (≥ 60 years; 90 with normal bone mass, 120 osteopenia cases, and 125 OP cases). Lumbar spine/femoral neck BMD values were measured using dual-energy X-ray absorptiometry. Correlations of serum IL-6 and TGF-β1 concentrations with bone density and bone turnover markers in OP patients were analyzed utilizing Pearson or Spearman correlation coefficients. Independent influencing factors for OP were identified by logistic multivariate regression analysis. The diagnostic value of serum IL-6 and TGF-β1 was assessed with ROC curves and MedCalc software. Results: Smoking history, drinking history, lumbar spine BMD, femoral neck BMD, PINP, and β-CTX markedly differed among the normal bone mass, osteopenia, and OP groups. Elevated IL-6 and reduced TGF-β1 concentrations were observed in serum samples of OP. Serum IL-6 concentrations was inversely associated with bone density markers but positively lined to bone turnover markers. Conversely, serum TGF-β1 was positively related to bone density markers but negatively associated with bone turnover markers. Smoking history, PINP, and IL-6, were identified as independent risk factors while lumbar spine BMD, femoral neck BMD, and TGF-β1 were independent protective markers for OP. The combined assessment of serum IL-6 and TGF-β1 showed superior diagnostic performance for OP. Conclusion: Serum IL-6 in combination with TGF-β1 exhibits good diagnostic performance for OP. Level of evidence: Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding [ABSTRACT FROM AUTHOR]

Background: Adrenocorticotropin (ACTH)-dependent Cushing’s syndrome can arise from a pituitary tumour (Cushing’s disease) or an ectopic ACTH-secreting tumour, making precise differentiation essential for effective treatment. Bilateral inferior petrosal sinus sampling (BIPSS) is the gold standard for this differentiation, but false-negative results can limit its accuracy. Adding prolactin (PRL) measurement to BIPSS has been proposed to improve diagnostic precision. This meta-analysis evaluates how correction for prolactin levels (‘prolactin adjustment’) affects the diagnostic value of BIPSS in distinguishing Cushing’s disease from ectopic ACTH syndrome. Methods: A systematic literature search was conducted in PubMed, Scopus, EMBASE, Web of Science, and Google Scholar up to July 2024. Studies were included if they provided data on BIPSS with and without PRL adjustment for ACTH-dependent Cushing’s syndrome. Data extraction and quality assessment were performed, and diagnostic accuracy metrics were analysed using bivariate generalised linear mixed modelling. Results: A total of 10 studies with 310 participants were included. The pooled sensitivity and specificity of BIPSS with PRL adjustment were 0.96 (95% CI: 0.93–0.98) and 0.68 (95% CI: 0.52–0.81), respectively. The diagnostic odds ratio (DOR) was 48.0 (95% CI: 19.0–123.0), with a positive likelihood ratio (LR) of 3.00 (95% CI: 1.9–4.7) and a negative LR of 0.06 (95% CI: 0.03–0.12). The area under the summary receiver operating characteristic (SROC) curve was 0.95 (95% CI: 0.93–0.97). For BIPSS without PRL adjustment, the pooled sensitivity was 0.90 (95% CI: 0.86–0.93) and specificity was 0.74 (95% CI: 0.59–0.85), with a DOR of 27.0 (95% CI: 13.0–59.0). The SROC curve area was 0.92 (95% CI: 0.89–0.94). Prolactin adjustment improved sensitivity (P < 0.01) without a significant change in specificity (P = 0.13). Conclusions: Prolactin adjustment in BIPSS slightly improves sensitivity for diagnosing Cushing’s disease but does not enhance specificity for ectopic ACTH syndrome. This highlights the value of PRL measurement in improving diagnostic accuracy and reducing false negatives, while BIPSS remains crucial for ruling out EAS in clinical practice. [ABSTRACT FROM AUTHOR]

This study aimed to explore the diagnostic value of the two cytology techniques, including liquid-based cytology of mammary ductal lavage fluid and nipple discharge smear cytology, in the intraductal lesions in patients with pathological nipple discharge (PND). This retrospective analysis included 119 patients with PND who underwent surgical treatment. At the same time, they all underwent fiberoptic ductoscopy (FDS), nipple discharge smear cytology and liquid-based cytology of ductal lavage fluid before surgery. With postoperative pathological diagnosis as the gold standard, we compared the clinical diagnostic efficacy of the two cytology techniques applied independently and combined with FDS to evaluate their diagnostic value in intraductal lesions. Finally, the receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to evaluate the diagnostic value of each examination method. There were 22 breast malignant tumors, 75 intraductal papillomas and 22 non-tumorous lesions among the 119 PND patients. The cell types of liquid-based cytology of ductal lavage fluid was significantly more abundant than that of smear cytology, and the detection rate of tumor cells, atypia cells and atypical hyperplasia cells was significantly increased. The diagnostic accuracy and sensitivity of liquid-based cytology of ductal lavage fluid were significantly higher than that of smear cytology (P < 0.05). At the same time, the accuracy of liquid-based cytology was superior to that of smear cytology when combined with FDS (P < 0.05), and the diagnostic efficiency was excellent. FDS combined with liquid-based cytology of ductal lavage fluid was more effective than the other methods (AUC = 0.8182). When diagnosing the intraductal space-occupying lesions in PND patients, liquid-based cytology of ductal lavage fluid can obtain more abundant intraductal shed cells. This advantage can compensate for the limitation of FDS for diagnosing terminal ductal unit lesions and significantly improve the early diagnosis rate of intraductal lesions, especially intraductal malignant tumors. [ABSTRACT FROM AUTHOR]

Background: Severe pneumonia is a common disease in children, with rapid progression and easy complications of respiratory failure, endangering the lives of children. This study aimed to elucidate the clinical significance of miR-193a-5p in severe pneumonia and to provide a new biomarker for the disease. Methods: A total of 150 children with severe pneumonia and an equal number of healthy children were selected for analysis. Serum miR-193a-5p levels were detected by RT-qPCR. The correlation of miR-193a-5p with CRP, WBC, neutrophil count, and NLR was assessed by Spearman analysis. The diagnostic and prognostic value of miR-193a-5p in severe pneumonia was analyzed using ROC curves. The relationship between miR-193a-5p and the prognosis of severe pneumonia was evaluated using the Kaplan-Meier curve and a multivariate logistic analysis. Results: Serum levels of miR-193a-5p were markedly elevated in children with severe pneumonia and exhibited a positive correlation with CRP, WBC, neutrophil count, and NLR. miR-193a-5p could effectively distinguish children with severe pneumonia from healthy children, with an AUC, sensitivity, and specificity of 0.862, 70.67%, and 88.67%, respectively. Serum miR-193a-5p expression was increased in children with poor prognosis and had a predictive value for patient prognosis. High expression of miR-193a-5p was linked to survival in children with severe pneumonia and was a risk factor for adverse prognosis. Conclusion: Serum levels of miR-193a-5p were markedly elevated in children with severe pneumonia, which may be of significance for the early diagnosis of the disease and prognostic assessment. [ABSTRACT FROM AUTHOR]

Background and aim: Ulcerative colitis (UC) is characterized by complex immunological interactions involving CD4 T cell subsets and the NLRP3 inflammasome, which influence inflammatory responses. This investigation focused on delineating the activation profiles of these components and their correlation with disease severity and activity, assessing their diagnostic implications in UC. Methods: We conducted immunohistochemistry and ELISA assays to measure markers expression of CD4 T cell subsets and the NLRP3 inflammasome in UC patients versus controls. Findings were validated using correlation analysis, molecular docking and ROC curves. Results: UC patients displayed increased Th1 (T-bet, TNF-α), Th2 (GATA3, IL-6), and Th17 (RORγt, IL-17, IL-22, IL-23) markers versus controls. Additionally, Th1 and Th2 cytokines (IL-2 and IL-4) were significantly elevated in severe UC, while Treg markers (FOXP3, IL-10, TGF-β1) were elevated only in mild-to-moderate UC. Enhanced NLRP3 inflammasome activation, indicated by elevated NLRP3, Caspase-1, and IL-1β levels. These molecular patterns, confirmed through correlation analysis and molecular docking, underscored strong correlations among NLRP3, T-bet, and GATA3, supporting the proposed NLRP3/T-bet/GATA3 axis. This axis, along with other biomarkers, showed strong associations with UC severity, Mayo score, UCEIS, demonstrated relatively high diagnostic value. Conclusion: The NLRP3/T-bet/GATA3 axis provides a referable strategy for multi-targeted combined treatment of UC and may serve as potential biomarkers for enhancing diagnostic accuracy and guiding therapy. [ABSTRACT FROM AUTHOR]

AbstractIn the early stages, chronic kidney disease (CKD) can be asymptomatic, marking diagnosis difficult. This study aimed to investigate the diagnostic role and potential regulatory mechanisms of nucleolar protein 14 (NOP14) -antisense RNA 1 (AS1) in patients with CKD. Herein, 68 patients with CKD, 65 patients with CKD undergoing peridialysis, and 80 healthy adults were included. The real-time reverse transcription-quantitative polymerase chain reaction was performed to assess NOP14-AS1 levels, and its diagnostic value was evaluated using receiver operating characteristic curves. Additionally, cell proliferation and apoptosis were assessed by Cell Counting Kit-8 assay. and flow cytometry, respectively. Oxidative stress levels were determined using superoxide dismutase and malondialdehyde MDA kits, and the dual-luciferase reporter assay was performed to determine the relationship between NOP14-AS1 and microRNA-326 (miR-326) target binding. Lastly, the potential mechanism underlying miR-326 target gene regulation in CKD progression were explored utilizing Gene Ontology and Kyoto Encyclopedia of Genes and Genomes databases. Notably, patients with CKD exhibited decreasedNOP14-AS1 levels and upregulated miR-326 levels. NOP14-AS1 and miR-326 exhibited combined effects on cell proliferation, apoptosis, inflammatory factors, and oxidative stress levels. Furthermore, the target genes of miR-326 showed enrichment in CKD-associated rat sarcoma and phosphoinositide 3-kinase protein kinase B pathways. Altogether, the findings of this study show the potential of NOP14-AS1 as a diagnostic marker in CKD. Overall, NOP14-AS1 regulates the miR-326 expression, which, in turn, regulates various miR-326 target gene-associated signaling pathways, thereby affecting the occurrence and development of CKD. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore the accuracy of third-generation nanopore sequencing to diagnose extrapulmonary tuberculosis (EPTB). Methods: Samples were collected from the lesions of 67 patients with suspected EPTB admitted between April 2022 and August 2023. Nanopore sequencing, acid-fast bacilli (AFB) staining, DNA testing, and X-pert and mycobacterial cultures were performed. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operating characteristic curve (AUC) were calculated for different diagnostic methods, and their diagnostic accuracies were compared. Results: Nanopore sequencing demonstrated the highest correct diagnosis rate among 50 positive EPTB cases, independently diagnosing 19 positive cases missed by conventional methods. Its sensitivity (62.00%), specificity (94.10%), PPV (96.90%), NPV (45.70%) and AUC (0.781, 95% CI: 0.67–0.89) were superior to those of conventional methods, such as AFB staining, DNA testing, X-pert, and solid culture, indicating its significantly efficient advantage in EPTB detection. Conclusion: Nanopore sequencing technology significantly outperforms conventional methods such as AFB staining, DNA testing, X-pert, and mycobacterial culture to diagnose EPTB, promising to improve the diagnosis of EPTB. [ABSTRACT FROM AUTHOR]

This study aimed to identify important clotting associated genes (CRGs) associated with septic shock in children and explore possible important mechanisms of the disease. Five hub genes with diagnostic performance were identified using GEO database and data from literature. These hub genes have strong correlation with immune cells. ceRNA network was constructed to explore potential pathogenic mechanisms. Ten candidate small molecule compounds were identified. In summary, the hub genes may play an important role in the immunity and disease development of septic shock, providing new ideas and strategies for future diagnosis and mechanism evaluation of children with septic shock. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although intracoronary electrocardiography (IC-ECG) offers direct electrophysiological insights into myocardial ischemia caused by insufficient coronary blood supply, compared to common diagnostic methods like electrocardiography (ECG), it lacks widespread adoption and robust clinical research. OBJECTIVE: To analyze the value and accuracy of intracoronary electrocardiogram in myocardial ischemia diagnosis in coronary heart disease patients. METHODS: Three hundred patients treated at our hospital were included in the study. Patients were categorized into non-ischemic group A (Fraction Flow Reserve [FFR] > 0.8) and ischemic group B (FFR < 0.75) based on FFR examination results. Both groups underwent IC-ECG examination. The ischemic group received percutaneous coronary intervention (PCI) treatment followed by another FFR examination, dividing them into non-ischemic subgroup B1 (FFR > 0.8) and ischemic subgroup B2 (FFR < 0.75). Both subgroups underwent IC-ECG examination. Receiver operating curves were constructed using FFR to assess the clinical utility of different IC-ECG parameters. RESULTS: Group A patients showed a significant decrease in ST-segment shift at J-point, ST-segment integral, T-peak, T-wave integral, and T-peak to end-time, while the Corrected Q-T interval (QTc-time) was significantly higher in the B group (p < 0.05). The parameters, including ST-segment shift at J-point, ST-segment integral, T-wave integral, T-peak, T-peak to end-time, and QTc-time, were found to have clinical significance in predicting the occurrence of myocardial ischemia (p < 0.05). CONCLUSION: Intracoronary electrocardiogram QT interval dispersion and Q-T peak (QTp) interval dispersion have a high diagnostic accuracy for myocardial ischemia in coronary heart disease. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the diagnostic value of 7-tumor associated autoantibodies (7-TAAB) and to evaluate the relationship between 7-TAAB and clinical features in esophageal squamous cell carcinoma (ESCC), which can be used to guide clinical diagnosis and treatment and achieve its clinical value. Methods: (1) Blood specimens were collected from patients with ESCC who had not previously received antitumor therapy (ESCC group) and those who had normal medical check-ups in the hospital during the same period (control group). The concentrations of 7-TAAB (P53, PGP9.5, SOX2, GAGE7, GBU4-5, MAGE A1, and CAGE) in serum were determined by enzyme-linked immunosorbent assay. The concentrations of 7-TAAB were compared between the ESCC and control groups, and the positive rate of 7-TAAB was calculated to determine the sensitivity, specificity, and accuracy of 7-TAAB. The diagnostic value of 7-TAAB was analyzed using the receiver operating characteristic (ROC) curve. (2) The clinical data of patients with ESCC were collected and the correlation between the rate of 7-TAAB and clinical features was analyzed. Results: (1) The serum levels and positivity rates of five antibodies (PGP9.5, SOX2, GBU4-5, MAGE-A1, and CAGE) were higher in the ESCC group than in the control group (P < 0.05) and the positive expression rate of the combined serum 7-TAAB in the ESCC group was significantly higher than that in the control group (P < 0.05). (2) The sensitivity of single antibody detection was 4.20%–17.65%, with a specificity of 96.49%–100%, and accuracy of 51.07%–57.94%. The sensitivity of 7-TAAB combined detection was 49.58%, the specificity was 92.98%, and the accuracy was 70.81%. (3) The ROC curve showed that the 7-TAAB combined test had a certain diagnostic value for ESCC and that its diagnostic efficacy was significantly higher than that of the single autoantibody tests. The diagnostic efficacy of the combined test with the remaining five antibodies (PGP9.5, SOX2, GBU4-5, MAGE-A1, and CAGE) was similar to that of the 7-TAAB combined test after eliminating the two antibodies with low expression rates. (4) Univariate analysis revealed significant differences in the positive expression rates of the 7-TAAB combination test in terms of age, hemoglobin level, albumin level, tumor location, tumor length, lymph node stage, and tumor clinical stage (P < 0.05), and multivariate analysis revealed that age and lymph node stage were independent factors affecting antibody expression. Conclusion: The multi-tumor-associated autoantibody combination test not only has a good auxiliary diagnostic value but also closely correlates with the clinical features of ESCC. [ABSTRACT FROM AUTHOR]

In the diagnosis of gynecological tumors, determining the benign or malignant nature of adnexal masses is a crucial and complex issue. Contrast‐enhanced ultrasound (CEUS) is a relatively novel and increasingly used diagnostic method. Therefore, this study evaluated the diagnostic value of CEUS in differentiating benign and malignant adnexal masses through meta‐analysis and systematic review. We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for studies published up to April 2024 regarding the use of CEUS in diagnosing benign and malignant adnexal masses. STATA 14.0 software was used for data analysis, pooling the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) of eligible studies. After initial screening, 305 studies were identified, 13 of which met the inclusion criteria and were analyzed in this meta‐analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR of CEUS for the diagnosis of benign and malignant adnexal masses were 0.92 (95% confidence interval [CI]: 0.88–0.95), 0.88 (95% CI: 0.82–0.93), 8.00 (95% CI: 5.00–12.90), 0.09 (95% CI: 0.06–0.14), and 91.00 (95% CI: 45.00–185.00), respectively. The area under the summary receiver operating characteristic curve (AUC) was 0.95 (95% CI: 0.93–0.97). CEUS is a noninvasive, nonradiative imaging modality with high accuracy and reliability in the diagnosis of benign and malignant adnexal masses. To provide an effective adjunct tool in the clinic, future studies can further explore the specific application value of CEUS and its performance in different populations. [ABSTRACT FROM AUTHOR]

Haifei Liu,1,2,&ast; Junling Han,3,&ast; Weijie Ni,2 Yuan Lu,2 Xinhui Hu,2 Jing Wang,2 Yan Zhou,2 Ze Wang,4 Jingyuan Cao,1 Hong Liu2 1Department of Nephrology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, 225300, People’s Republic of China; 2Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, 210009, People’s Republic of China; 3Clinical Laboratory, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, 225300, People’s Republic of China; 4Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hong Liu; Jingyuan Cao, Email jstzliu@sina.com; caojingyuan1989@163.comObjective: This study evaluated the diagnostic value of plasma Neutrophil extracellular traps (NETs) levels and the index of cardiac electrophysiological balance (iCEB) in identifying silent myocardial ischemia (SMI) in maintenance hemodialysis (MHD) patients.Methods: This cross-sectional observational study involved patients receiving MHD treatment. Data were collected on coronary angiography performed in our hospital from February 2023 to February 2024. Patients diagnosed with myocardial ischemia via coronary angiography but without obvious symptoms were grouped as the SMI group, while those without SMI were grouped as the control group. Plasma NETs levels were assessed using markers indicative of NETs components including double-stranded DNA (dsDNA), circulating free DNA (cfDNA) and myeloperoxidase, while iCEB (QT/QRS) and electrocardiographic findings were obtained. Additionally, echocardiographic parameters, inflammatory markers, and cardiac biomarkers were analyzed. Receiver operating characteristic (ROC) analysis were employed to evaluate the diagnostic accuracy of plasma NETs levels and iCEB in identifying SMI.Results: A total of 114 patients were included, with 79 participants in the control group and 35 participants in the SMI group. The SMI group exhibited significantly elevated levels of NETs associated components (dsDNA(37.89± 4.55 vs 31.64± 5.32, P< 0.001), cfDNA(11.27± 2.03 vs 8.91± 1.84, P< 0.001), MPO-DNA(23.69± 4.01 vs 17.52± 3.41, P< 0.001)), as well as higher iCEB compared to the control group(56.45± 7.67 vs 45.89± 6.23, P< 0.001). Furthermore, electrocardiography findings, echocardiographic parameters, inflammatory markers, and cardiac biomarkers showed significant differences between the two groups. The ROC analysis demonstrated the potential diagnostic accuracies of NETs levels and iCEB, with an area under the curve (AUC) of 0.908, sensitivity of 0.987, and specificity of 0.829 for identifying SMI.Conclusion: The study highlights the combined diagnostic value of plasma NETs levels and iCEB in identifying SMI in MHD patients, providing valuable insights into potential early detection and risk stratification strategies for this population.Keywords: silent myocardial ischemia, hemodialysis, neutrophil extracellular traps, index of cardiac electrophysiological balance, diagnostic value, cardiovascular complications

Abstract Background Terminal ileal intubation (TII) demonstrates a complete colonoscopy, but whether it should be performed in routine colonoscopies remains uncertain. We aimed to explore the diagnostic yield of TII in routine colonoscopy and investigate the association of TII and the detection of lesion. Methods We conducted a retrospective study included patients who underwent colonoscopy with cecal intubation at our endoscopic center between November 1 2022 and July 31 2023. Macroscopic and histologic findings of terminal ileum were recorded. We used propensity score matching to adjust for differences between groups and further analyzed the difference of polyp detection rate (PDR), adenoma detection rate (ADR), sessile serrated lesion detection rate (SSDR) and lesion detection rate of right-sided colon, cecum and ascending colon between patients underwent TII or not. Results There were 13,372 patients with cecal intubation colonoscopy, including 7599 (56.8%) with TII and 5773 (43.2%) without TII. Abnormal endoscopic findings were observed in 150 of 7599 unselected individuals and only 7 of these cases were regarded as pathologically significant. Likewise, abnormal endoscopic findings were found in 62 of 3502 asymptomatic individuals with 54 nonspecific ileitis determined by histopathology. After PSM, there were no significant differences in PDR (52.0% vs. 52.3%, P = 0.761), ADR (30.9% vs. 32.2%, P = 0.208), SSDR (1.6% vs. 1.5%, P = 0.541), right-sided lesion detection rate (16.9% vs. 16.8%, P = 0.908), lesion detection rate of cecum (4.9% vs. 4.7%, P = 0.613) and ascending colon (13.5% vs. 13.2%, P = 0.656) between the two groups. Conclusion TII was not necessary in routine colonoscopy, owing to the limited diagnostic value and lack of superiority on lesion detection.

Abstract Background Inflammatory bowel disease (IBD) is a chronic, inflammatory, and autoimmune disorder, and its incidence of comorbid with major depressive disorder (MDD) is significantly higher than the general population. However, many patients lack proper recognition and necessary psychological health treatments. We aimed to identify potential biomarkers and mechanisms involved in the development of IBD comorbid with MDD (IBD-MDD). Methods We utilized IBD and MDD-related datasets from the GEO database for differential gene expression analysis, protein-protein interaction (PPI) and pathway enrichment analysis, random forest algorithm, LASSO regression analysis, and construction of a disease prediction model. We assessed the accuracy of the model using ROC curve, explored potential mechanisms through immune infiltration analysis, and validated candidate biomarkers using peripheral blood samples from patients in our center’s cohort. Results We identified 484 IBD-related secreted proteins and 142 key module genes associated with MDD. PPI analysis revealed two crucial modules primarily involved in inflammation and immune regulation. We identified four diagnostic genes (HGF, SPARC, ADAM12, and MMP8) from the 21 shared genes between IBD-related secreted proteins and MDD key module genes, constructed a nomogram model and confirmed its accuracy using ROC curve from an external independent dataset. Immune infiltration analysis revealed significant associations between the four diagnostic genes, and cellular immune dysregulation in MDD. Finally, we validated the expression patterns of the four diagnostic genes in our cohort. Conclusions Our study discovered four candidate biomarkers for IBD-MDD, providing new insights for the diagnosis and therapeutic intervention of serum-based IBD comorbid with MDD.

Lili Wang,1,&ast; Pingping Liu,2,&ast; Yidi Han1 1Department of Liver Disease, Qingdao Sixth People’s Hospital, Qingdao, Shandong, 266033, People’s Republic of China; 2Clinical Laboratory, Qingdao Sixth People’s Hospital, Qingdao, Shandong, 266033, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yidi Han, Department of Liver Disease, Qingdao Sixth People’s Hospital, No. 9 Fushun Road, Shibei District, Qingdao, Shandong, 266033, People’s Republic of China, Tel +86-0532-81636700, Email Hanyidi1370@163.comObjective: This paper examined miR-181a expression in the serum of patients with acute liver failure (ALF) and investigated the impact of its expression in the prognosis of ALF patients.Methods: A total of 112 ALF patients (ALF group) and 100 healthy controls during the same period (control group) were recruited as study subjects, and ALF patients were separated into the survival group and the death group. Serum ALT, AST, SCr, TBil, PTA, and International Normalized Ratio (INR) indices as well as serum miR-181a expression were assessed by using a fully automated biochemistry analyzer and RT-qPCR. Patients in the ALF group were evaluated using the Model for End-Stage Liver Disease (MELD) score. Correlation between serum miR-181a expression and MELD scores of ALF patients was processed by Pearson correlation analysis, and the diagnostic value of miR-181a level for the occurrence of ALF was estimated by ROC curve analysis. Multivariate logistic regression analysis was executed to assess the factors influencing the occurrence of death in ALF patients.Results: ALF patients had higher levels of ALT, AST, TBiL, SCr, INR and miR-181a and lower PTA levels in comparison to healthy controls. Serum miR-181a expression level in ALF patients revealed a significant positive correlation with MELD score. Multivariate logistic regression analysis unveiled that TBil, INR, SCr, and miR-181a were the independent risk factors for the occurrence of death in ALF patients, and that PTA was an independent protective factor for the prognosis of ALF patients. miR-181a exhibited a favorable diagnostic value in ALF and its prognosis.Conclusion: miR-181a expression is upregulated in the serum of ALF patients, and it can be utilized as an indicator for ALF diagnostic and prognostic assessment.Keywords: acute liver failure, microRNA-181a, prognosis, influencing factors, diagnostic value, model for end-stage liver disease, multivariate logistic regression analysis, Pearson correlation analysis

Objective To evaluate the diagnostic value of total serum immunoglobulin E （IgE） levels， eosinophil （EOS） count and percentage in the diagnosis of allergic rhinitis （AR）， and to construct a diagnostic model for preliminary diagnosis of AR by combining total serum IgE and EOS. Methods Clinical data of 305 AR patients and 256 non-AR patients admitted to Department of Otolaryngology at the First Affiliated Hospital of Chongqing Medical University from April 2023 to April 2024 were retrospectively analyzed. The general information， total serum IgE level， EOS count and percentage were compared between two groups. Binary logistic regression analysis was used to screen for suitable indicators to construct the predictive model， and the receiver operating characteristic （ROC） curve was plotted. The area under the ROC curve （AUC） was used to determine the predictive value of this model. Clinical data from 216 patients with and without AR admitted to Department of Otolaryngology at the First Affiliated Hospital of Chongqing Medical University from June 2019 to June 2022 were collected for external validation. Stratification analysis was performed according to age [adolescent group （≤ 18 years old）， youth group （19-45 years old）， middle-aged group （46-60 years old）， and elderly group （> 60 years old）]， respectively. Results The percentage of EOS and total serum IgE level were the influencing factors of AR in the overall and all age groups. The combined diagnostic model for all patients was： Logit P = -4.174+6.856EOS count+ 0.048total serum IgE. Diagnostic model in adolescent group was： Logit P = -4.472+0.637EOS percentage+0.034total serum IgE； youth group： Logit P = -4.491+0.372EOS percentage+0.068total serum IgE； middle-aged group： Logit P = -4.759+5.768EOS count+ 0.062total serum IgE； elderly group： Logit P = -4.888+0.855EOS percentage+0.028total serum IgE， respectively. Hosmer-Lemeshow goodness-of-fit test， ROC curve analysis and external validation all indicated that this model had high diagnostic value. Conclusion The combination of total serum IgE levels and EOS count demonstrates good diagnostic value for AR in different age groups， which can be used to guide preliminary diagnosis of AR.

The leaching of phosphorus (P), together with nitrogen (N), into deep water and runoff from fields into surface water has caused the dangerous phenomenon of eutrophication, which threatens the Baltic Sea. This process has led to a revision of fertilizer recommendations for farmers in most European countries. The basis for proper recommendations is the determination of soil P using a soil test. There are many different soil tests used in Europe for the determination of plant-available P in soil, which is primarily the result of the different soil conditions in the individual countries. In Poland, two soil P tests are currently used: the Egner–Riehm DL (DL) test and the Mehlich 3 (M3) test. The aim of our study was to determine the extraction efficiency of the DL and M3 tests, to explore the possibility of converting the results of one test to another, and to compare the diagnostic value of the tests. For this purpose, a collection of 237 soil–plant sample pairs was taken from maize fields in Poland. The phosphorus content was determined in all the soil and plant samples, with two methods used in the soil samples: DL and M3. The results of our study show that it is not possible to state unequivocally which test extracts more P from the soil. The extraction efficiency of the tests depends on the specific soil properties, particularly pH and texture. The most reliable conversion of DL test results to M3 is possible for soils that contain a 21–35% fraction characterized by particles less than 0.02 mm in diameter, regardless of soil pH. Furthermore, the DL test has better diagnostic value than M3, especially for alkaline soils. [ABSTRACT FROM AUTHOR]

Objectives: To explore the diagnostic value of dual‐energy computed tomography (DECT) in patients with gouty arthritis. Methods: A total of 160 patients with gouty arthritis who were treated in our hospital from January 2023 to October 2023 were selected as the research subjects. The participants were randomly divided into two groups: an observation group and a control group. Each group had 80 cases. Observation group performed DECT examination and control group performed X‐ray examination. The researchers recorded the general information of the participants in both groups and conducted single‐factor analysis. They compared the detection of positive diseased joints between the two groups, as well as compared the distribution of positive diseased joints. In addition, the number of joint lesions was compared in the two groups. Results: There were not any statistically great differences between the two groups in gender, age, BMI, disease duration, blood uric acid, and erythrocyte sedimentation rate (p > 0.05). During the DECT examination, a total of 82 positive diseased joints were identified in the observation group. The observation group also had a positive rate of 85.42% (82/96) in the DECT examination. While the control group had a total of 55 positive diseased joints during the X‐ray examination with a positive rate of 59.78% (55/92). The difference between the two groups of patients in the positive rate of two kinds of examination was statistically significant (χ2 = 15.616, p < 0.001). No statistical significance was found in the distribution of the number of positive diseased joints between two groups (χ2 = 1.986, p = 0.851). Both DECT and X‐ray examinations of patients in the two groups revealed that the lesions were primarily located in the soft tissues or ligaments surrounding the distal small joints of the limbs, such as metatarsophalangeal joints, ankle joints, and proximal interphalangeal joints. Compared with the X‐ray examination of the patients, the DECT examination of the patients showed a great increase in the number of bone destruction, gout nodules, and soft tissue swelling (χ2 = 7.712, 10.441, 5.389, p = 0.005, 0.001, 0.020). Moreover, the DECT examination of patients showed the presence of urate crystals and joint effusion, while the X‐ray examination of patients in the control group did not show any. Conclusions: Siemens dual‐source 64‐slice CT dual‐energy imaging has better diagnostic value for gouty arthritis than X‐ray and has higher specificity for detecting urate crystals and joint effusion. Therefore, Siemens dual‐source 64‐slice CT dual‐energy imaging examination may serve as a promising new noninvasive technique for early diagnosis, clinical screening, and follow‐up of gout in the future. [ABSTRACT FROM AUTHOR]

We study the clinical value of peripheral blood immunoglobulin G (IgG) and immunoglobulin M (IgM) combined with ultrasonic echo parameters of substantia nigra (SN) in the diagnosis of Parkinson's disease (PD). The clinical data of 121 patients with PD (case group) in our hospital from November 2020 to November 2022 were selected for retrospective analysis, and 9 patients with poor sound transmission of temporal window were excluded. Finally, this study included 112 patients with PD and selected 108 health examination population in the same period (control group). The levels of IgG and IgM in both groups were detected, and ultrasound examination was carried out to observe the structure of SN and obtain strong echo area of SN, midbrain area and strong echo area of SN/midbrain area. The receiver operator characteristic curve of serum IgG and IgM combined with ultrasonic echo parameters of SN in the diagnosis of PD was drawn to evaluate the clinical efficacy of single diagnosis and combined diagnosis. Compared with the control group, the serum levels of IgG and IgM, strong echo area of SN, midbrain area and strong echo area of SN/midbrain area in the case group were obviously higher (P < 0.001), while the folic acid level was notably lower (P < 0.05). The AUC value, Youden index and sensitivity of combined diagnosis were higher than those of single detection. Peripheral blood IgG and IgM combined with ultrasonic echo parameters of SN have high clinical value in the diagnosis of PD, which can provide a new direction for the subsequent diagnosis of PD. [ABSTRACT FROM AUTHOR]

Objective: To address the clinical diagnostic value of CRISPR-Cas13a-based molecular technology for tuberculosis (TB). Methods: The 189 suspected TB patients were simultaneously sent for acid-fast staining smear of bronchoalveolar lavage fluid, MGIT 960 cultures, Xpert MTB/RIF assay, and CRISPR-Cas13a assay. Using the final clinical diagnosis as the gold standard, the TB and non-TB groups were determined, and the diagnostic values of the four assays and the combined test in TB were compared. Using MGIT 960 culture as the gold standard, the diagnostic value of CRISPR-Cas13a assay was explored in TB, and the concordance between the CRISPR-Cas13a assay and MGIT 960 culture was compared. Results: The 189 preliminary diagnosed patients with suspected TB were diagnosed, with 147 in the TB group and 42 in the non-TB group. Taking the final clinical diagnosis as the gold standard, the sensitivity, negative predictive value, and accuracy of CRISPR-Cas13a assay, MGIT 960 culture, and XpertMTB/RIF assay were higher than those of acid-fast staining smear; by comparing the area under the ROC curve, the diagnostic value of the CRISPR-Cas13a assay, MGIT 960 culture, and XpertMTB/RIF assay was superior to that of acid-fast staining smear (all P < 0.05). Using the MGIT 960 culture results as the gold standard, there was a moderate concordance between the CRISPR-Cas13a assay and the MGIT 960 culture (kappa = 0.666). Conclusion: Bronchoalveolar lavage fluid CRISPR-Cas13a assay has high application value in the clinical diagnosis of TB and can be recommended for the initial screening of patients with suspected TB. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this article was to investigate the value of combined MRI, enhanced CT and 18F-FDG PET/CT in the diagnosis of recurrence and metastasis after surgery for ovarian cancer. Methods: Ninety-five ovarian cancer patients were selected as the study subjects, all of them underwent surgical treatment, and MRI, enhanced CT and 18F-FDG PET/CT were performed on all of them in the postoperative follow-up, and the pathological results after the second operation were used as the diagnostic "gold standard". The diagnostic value (sensitivity, specificity, accuracy, negative predictive value and positive predictive value) of the three examination methods alone or in combination for the diagnosis of postoperative recurrence and metastasis of ovarian cancer was compared, and the detection rate was calculated when the lesion was the unit of study, so as to compare the efficacy of the three methods in the diagnosis of postoperative recurrent metastatic lesions of ovarian cancer. Results: The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the combined group were higher than those of MRI and enhanced CT for recurrence and metastasis of ovarian cancer after surgery, and the specificity, accuracy and positive predictive value of the combined group were higher than those of the 18F-FDG PET/CT group, and those of the 18F-FDG PET/CT group were higher than those of the enhanced CT group (all P < 0.05). When the postoperative recurrent metastatic lesions of ovarian cancer were used as the study unit, the detection rate of lesions in the combined group was higher than that of the three examinations detected individually, and the detection rate of lesions in 18F-FDG PET/CT was higher than that of enhanced CT and MRI (P < 0.05). Conclusion: The combination of MRI, enhanced CT and 18F-FDG PET/CT can accurately diagnose recurrence and metastasis of ovarian cancer after surgery, detect recurrent metastatic lesions as early as possible, and improve patients' prognosis. [ABSTRACT FROM AUTHOR]

Background: Terminal ileal intubation (TII) demonstrates a complete colonoscopy, but whether it should be performed in routine colonoscopies remains uncertain. We aimed to explore the diagnostic yield of TII in routine colonoscopy and investigate the association of TII and the detection of lesion. Methods: We conducted a retrospective study included patients who underwent colonoscopy with cecal intubation at our endoscopic center between November 1 2022 and July 31 2023. Macroscopic and histologic findings of terminal ileum were recorded. We used propensity score matching to adjust for differences between groups and further analyzed the difference of polyp detection rate (PDR), adenoma detection rate (ADR), sessile serrated lesion detection rate (SSDR) and lesion detection rate of right-sided colon, cecum and ascending colon between patients underwent TII or not. Results: There were 13,372 patients with cecal intubation colonoscopy, including 7599 (56.8%) with TII and 5773 (43.2%) without TII. Abnormal endoscopic findings were observed in 150 of 7599 unselected individuals and only 7 of these cases were regarded as pathologically significant. Likewise, abnormal endoscopic findings were found in 62 of 3502 asymptomatic individuals with 54 nonspecific ileitis determined by histopathology. After PSM, there were no significant differences in PDR (52.0% vs. 52.3%, P = 0.761), ADR (30.9% vs. 32.2%, P = 0.208), SSDR (1.6% vs. 1.5%, P = 0.541), right-sided lesion detection rate (16.9% vs. 16.8%, P = 0.908), lesion detection rate of cecum (4.9% vs. 4.7%, P = 0.613) and ascending colon (13.5% vs. 13.2%, P = 0.656) between the two groups. Conclusion: TII was not necessary in routine colonoscopy, owing to the limited diagnostic value and lack of superiority on lesion detection. [ABSTRACT FROM AUTHOR]

Objective This study aimed to investigate the diagnostic value of stress-induced phosphoprotein 1 (STIP1) in serum for hepatocellular carcinoma (HCC) and alpha-fetoprotein (AFP)–negative HCC (ANHC). Methods In this study, serum samples were collected from 158 HCC patients and 63 non-HCC patients. Logistic regression analysis was performed to identify independent risk factors associated with HCC and ANHC. The diagnostic values of each index for HCC and ANHC were analyzed using receiver operating characteristic (ROC) curve analysis. Results The STIP1, des-γ-carboxy prothrombin (DCP), and AFP levels were higher in the HCC groups than in the non-HCC groups (P <.05). Age, DCP, STIP1, and hepatitis B virus infection were independent predictors of HCC (P <.05). The diagnostic value of STIP1 for HCC was higher than that of DCP. Additionally, age, STIP1, and hepatitis B virus infection were independent predictors for ANHC patients. The ROC curve exhibited an area under the curve value of 0.919 for STIP1, with a diagnostic cutoff value of 68.5 U/mL. Moreover, 36 ANHC patients and 19 AFP-negative non-HCC patients were included to validate the diagnostic model. A total of 20 patients had STIP1 levels greater than 68.5 U/mL, resulting in diagnostic accuracy of 67.3%, sensitivity of 55.6%, and specificity of 89.5%. Conclusion STIP1 demonstrates excellent diagnostic value for HCC and ANHC. [ABSTRACT FROM AUTHOR]

Background: C-reactive protein (CRP) is a pentameric protein commonly used as a biomarker of inflammation or stress response which can be obtained during routine blood tests. Therefore, we conducted a systematic review and meta-analysis to explore its ability to predict the severity of acute pancreatitis (AP). This meta-analysis was registered in the PROSPERO system (registration number: CRD42022353769). Methods: 41 studies with 6156 cases of acute pancreatitis, retrieved from PubMed, Cochrane Library, Springer, and Embase databases, were incorporated. We calculated the pooled estimates for predicting the severity of acute pancreatitis based on CRP levels. We also calculated the combined negative likelihood ratio (NLR), combined positive likelihood ratio (PLR) and combined diagnostic odds ratio (DOR) using a bivariate mixed model. Sensitivity analysis was used to examine the robustness of the results. Factors associated with heterogeneity were identified by meta-regression analysis. A summary operating characteristic (SROC) curve was generated to assess the diagnostic value of CRP in predicting severe acute pancreatitis. Fagan's test was used to calculate likelihood ratios and post-test probabilities, and publication bias was gauged by asymmetry tests. Results: SROC analysis yielded an AUC of 0.85 (95%CI: 0.81–0.88) with a sensitivity of 0.76 (95%CI: 0.69–0.83) and specificity of 0.79 (95%CI: 0.74–0.83). The combined NLR, PLR and DOR were 0.30 (0.23–0.40), 3.66 (2.94–4.55) and 12.19 (8.05–18.44) respectively. Sensitivity analysis demonstrated the stability of our results after omitting any study. Finally, meta-regression analysis indicated that the description of the reference test, prospective design, blinding method and spectrum of the disease could account for heterogeneity in this meta-analysis. Conclusion: CRP has significant value as a biomarker for assessing AP severity. Besides, other parameters such as patient history, physical signs, and imaging should be considered to determine disease severity. [ABSTRACT FROM AUTHOR]

Background: Inflammatory bowel disease (IBD) is a chronic, inflammatory, and autoimmune disorder, and its incidence of comorbid with major depressive disorder (MDD) is significantly higher than the general population. However, many patients lack proper recognition and necessary psychological health treatments. We aimed to identify potential biomarkers and mechanisms involved in the development of IBD comorbid with MDD (IBD-MDD). Methods: We utilized IBD and MDD-related datasets from the GEO database for differential gene expression analysis, protein-protein interaction (PPI) and pathway enrichment analysis, random forest algorithm, LASSO regression analysis, and construction of a disease prediction model. We assessed the accuracy of the model using ROC curve, explored potential mechanisms through immune infiltration analysis, and validated candidate biomarkers using peripheral blood samples from patients in our center's cohort. Results: We identified 484 IBD-related secreted proteins and 142 key module genes associated with MDD. PPI analysis revealed two crucial modules primarily involved in inflammation and immune regulation. We identified four diagnostic genes (HGF, SPARC, ADAM12, and MMP8) from the 21 shared genes between IBD-related secreted proteins and MDD key module genes, constructed a nomogram model and confirmed its accuracy using ROC curve from an external independent dataset. Immune infiltration analysis revealed significant associations between the four diagnostic genes, and cellular immune dysregulation in MDD. Finally, we validated the expression patterns of the four diagnostic genes in our cohort. Conclusions: Our study discovered four candidate biomarkers for IBD-MDD, providing new insights for the diagnosis and therapeutic intervention of serum-based IBD comorbid with MDD. [ABSTRACT FROM AUTHOR]

Periapical radiography is a regular radiographic procedure performed by dentists. However, at times, it may not be possible to position the image receptor into a patient's mouth in an optimized or practical way. For these cases, some dentists advocated the use of extraoral periapical radiography (EOPA). This literature review aimed to review the dental literature on the use of EOPA. In October 2023, PubMed, Web of Science, and Scopus were searched to identify papers that reported on the use of EOPA, supplemented by manual reference tracing and Google Scholar searches. After screening, 18 papers published between 2003 and 2022 were identified, including 14 original articles and 4 reviews. From very limited and conflicting evidence, it was found that root length/working length measurements between EOPA and IOPA did not significantly differ or EOPA showed inferiority. No data were available to compare EOPA with other extraoral modalities such as panoramic radiography. The technique used in EOPA to visualize posterior teeth in the maxilla and mandible varied across studies, such as the vertical angulation of the primary beam, whether mouth should be opened or closed, and whether a holder should be used or not. At the current time, EOPA probably should not be advocated for regular use. [ABSTRACT FROM AUTHOR]

Lung ultrasound (LUS) is an effective tool for diagnosing acute heart failure (AHF). However, several imaging protocols currently exist and how to best use LUS remains undefined. We aimed at developing a lung ultrasound-based model for AHF diagnosis using machine learning. Random forest and decision trees were generated using the LUS data (via an 8-zone scanning protocol) in patients with acute dyspnea admitted to the Emergency Department (PLUME study, N = 117) and subsequently validated in an external dataset (80 controls from the REMI study, 50 cases from the Nancy AHF cohort). Using the random forest model, total B-line sum (i.e., in both hemithoraces) was the most significant variable for identifying AHF, followed by the difference in B-line sum between the superior and inferior lung areas. The decision tree algorithm had a good diagnostic accuracy [area under the curve (AUC) = 0.865] and identified three risk groups (i.e., low 24%, high 70%, and very high-risk 96%) for AHF. The very high-risk group was defined by the presence of 14 or more B-lines in both hemithoraces while the high-risk group was described as having either B-lines mostly localized in superior points or in the right hemithorax. Accuracy in the validation cohort was excellent (AUC = 0.906). Importantly, adding the algorithm on top of a validated clinical score and classical definition of positive LUS scanning for AHF resulted in a significant improvement in diagnostic accuracy (continuous net reclassification improvement = 1.21, P < 0.001). Our simple lung ultrasound-based machine learning algorithm features an excellent performance and may constitute a validated strategy to diagnose AHF. [ABSTRACT FROM AUTHOR]

Objective To investigate the diagnostic value of serum programmed cell death protein 4 (PDCD4) and heat shock protein 70 (HSP70) levels in lymph node metastasis (LNM) of early cervical cancer, in order to provide more evidence for the diagnosis of LNM of early cervical cancer. Methods A total of 132 patients with early cervical cancer (observation group) were selected, and sentinel lymph node biopsy was performed during the operation. Histopathological examination was performed to determine whether LNM occurred, and 60 healthy female volunteers (control group) were selected during the same period. Fasting peripheral venous blood of all subjects was collected and serum was retained by centrifugation. Serum PDCD4 and HSP70 levels were detected by ELISA. The clinical data of patients with early cervical cancer were collected and the risk factors for LNM of early cervical cancer were analyzed by multivariate Logistic regression model. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of serum PDCD4 and HSP70 levels in LNM of early cervical cancer. Results The serum PDCD4 level in the observation group was lower than that in the control group, and the serum HSP70 level was higher than that in the control group (both P<0. 05). Among 132 patients with early cervical cancer, 25 had LNM and 107 did not have LNM. Univariate analysis showed that maximum tumor diameter, depth of cervical interstitial infiltration, FIGO stage and serum PDCD4 and HSP70 levels might be related to LNM of early cervical cancer (all P<0. 05). Multivariate Logistic regression analysis showed that cervical interstitial infiltration depth ≥1/2 cervical muscle wall, FIGO stage IIA and increased serum HSP70 level were independent risk factors for LNM of early cervical cancer, while increased serum PDCD4 level was independent protective factor (all P<0. 05). ROC curve analysis showed that the area under the curve (AUC) of serum PDCD4 and HSP70 levels alone and combined in predicting LNM of early cervical cancer were 0. 810, 0. 817 and 0. 876, respectively, and the AUC of serum PDCD4 and HSP70 levels combined in predicting LNM of early cervical cancer was greater than that of the two alone (both P<0. 05). Conclusions The decrease of serum PDCD4 level and the increase of serum HSP70 level are closely related to LNM of early cervical cancer. Serum PDCD4 and HSP70 levels have certain diagnostic value for early cervical cancer LNM, and their combined diagnosis value is higher. [ABSTRACT FROM AUTHOR]

Purpose: To explore the diagnostic value of serum apolipoprotein B100 (Apo B100) combined with hippocampal volume in Alzheimer's disease (AD). Methods: A total of 59 AD patients and 59 healthy subjects were selected. The Mini‐Mental State Examination (MMSE) was used for neuropsychological assessment. Blood glucose and serum lipid levels were detected by biochemical analyzer. Polymerase chain reaction (PCR) was used to detect apolipoprotein E (Apo E) ε3/ε4 genotypes in the plasma. Hippocampal volume was calculated using Slicer software. Independent‐sample t test or Mann–Whitney U test were used to compare the levels of various indicators between the two groups. Spearman's correlation analysis was used to analyze the correlation between each level. The receiver operating characteristic curve (ROC) was plotted, and the area under the curve (AUC) was calculated to compare the diagnostic efficacy of individual and combined detection of serum Apo B100 levels and hippocampal volume in AD. Results: Compared with the healthy control group, the levels of serum total cholesterol (TC), low‐density lipoprotein (LDL), Apo B100, and plasma Apo E ε3/ε4 were higher in the AD group, and serum high‐density lipoprotein (HDL) level was lower in the AD group (both p < 0.05). The hippocampal volume in the AD group was lower than in the control group (p < 0.01). The serum Apo B100 level was negatively correlated with MMSE score (r = −0.646), whereas hippocampal volume was positively correlated with MMSE score (r = 0.630). ROC curve analysis showed that the AUC of the combined serum Apo B100 level and hippocampal volume for AD was higher than that of either alone (AUC = 0.821, p < 0.01). Conclusion: Serum Apo B100 level is elevated, and the hippocampal volume is reduced in AD patients. The combined detection of the two has a higher diagnostic efficiency for AD than other alone and has the potential to become an important indicator for the diagnosis of AD in the future. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the diagnostic potential of the Antibody concentration ratio in identifying treatment-refractory myasthenia gravis (MG). Methods: A retrospective analysis was conducted on 116 MG patients who underwent antibody detection at least twice between June 1, 2015, and June 1, 2023. Demographic and clinical characteristics were collated to ascertain their association with refractory MG. The Antibody Concentration Ratio was applied to determine treatment response, using the International Consensus Guidance criteria as the reference standard. The area under nonparametric receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy were calculated to assess the diagnostic efficacy of the Antibody concentration ratio following consecutive immunotherapy relative to initial antibody concentrations for refractory MG. Results: 19 out of 116 patients were unequivocally diagnosed with refractory MG. A significant correlation was found between the Antibody Concentration Ratio and refractory MG status in treatment-refractory and treatment-responsive patients. Subsequently, the AUC demonstrated the robust diagnostic capability of the Antibody concentration ratio for refractory MG, with an AUC of 0.8709 (95% CI: 0.7995–0.9422, p < 0.0001). The optimal cut-off value stood at 0.8903, exhibiting a sensitivity of 94.74% (95% CI: 75.36%-99.73%), a specificity of 68.04% (95% CI: 58.23%-76.48%), and accuracy of 72.41% (95% CI: 64.28%-80.54%). Conclusion: Elevated Antibody Concentration Ratio is intrinsically linked with refractory MG and exhibits potential as an diagnostic biomarker for the condition. [ABSTRACT FROM AUTHOR]

Introduction: Considering the importance of early diagnosis of ectopic pregnancy to prevent its complications and mortality, the present study was conducted with aim to determine the diagnostic value of transvaginal ultrasonography in the evaluation of ectopic pregnancy with β-hCG levels lower than 1000 mIU/ml. Methods: This prospective study was conducted in 2020-2021 to determine the diagnostic value of transvaginal sonography in the evaluation of ectopic pregnancy in women referred to the clinic or department of gynecology in Afzalipour Hospital, Kerman. The inclusion criteria were the presence of one or more of the triad symptoms of ectopic pregnancy, i.e. abdominal or pelvic pain, amenorrhea and unusual vaginal bleeding, and serum β-hCG level less than 1000 mIU/mL. If no intrauterine gestational sac was seen and a mass indicative of ectopic pregnancy was found, or if no intrauterine gestational sac was seen without other findings outside the uterus, patients were followed up by measuring serum β-hCG levels every 48 hours until a definitive diagnosis was made. Data analysis was done using SPSS statistical software (version 22). P<0.05 was considered significant. Results: The mean gestational age in individuals with a correct diagnosis of ectopic pregnancy was 5.91±1.48 weeks .The sensitivity and specificity of transvaginal ultrasound were 50% and 66%, respectively. Positive and negative predictive values were measured as 78.26% and 35.71%, respectively. Conclusion: In the present study, the sensitivity and specificity of transvaginal ultrasound in diagnosing ectopic pregnancy at β-hCG levels less than 1000 mIU/ml were reported as 50% and 66%, respectively. As a result, efforts to find a more accurate diagnostic method for early diagnosis of ectopic pregnancy are still needed. [ABSTRACT FROM AUTHOR]

The role of chest computed tomography (CT) in distinguishing the causative pathogens of pulmonary infections in patients with hematological malignancies (HM) is unclear. The aim of our study was to compare and assess the clinical characteristics, radiologic features and potential differential diagnostic value of CT in HM patients and other different immune statuses patients with pulmonary infections. Methods: Patients were divided into immunocompetent (105 cases) and immunocompromised groups (99 cases) according to immune status. Immunocompromised patients included the HM group (63 cases) and the non-HM group (42 cases). The basic clinical data and CT findings were collected and statistically analyzed. Results: Regarding the pathogen distribution, viral, Pneumocystis jirovecii and mixed infections were more common in the immunocompromised group than the immunocompetent (p < 0.01), but viral infections were more common in the HM group than in the non-HM group (p=0.013). Immunocompromised patients had more diverse CT findings and more serious lesions (mostly graded 2– 4) than immunocompetent patients. The most common CT findings in HM patients were consolidation and ground-glass opacities (GGO), which were also found in the non-HM group. The overall diagnostic accuracy of CT was lower in immunocompromised patients than in immunocompetent patients (25.7% vs 50.5%, p< 0.01). CT had better diagnostic efficacy for fungi and Pneumocystis jirovecii in HM patients. Conclusion: CT diagnosis is less efficient in distinguishing the causative pathogens of HM patients. However, CT can help distinguish fungal pneumonia and Pneumocystis jirovecii pneumonia in HM patients. Clinical Relevance Statement: Our study might facilitate clinical decision-making in fungal pneumonia and Pneumocystis jirovecii pneumonia in HM patients. [ABSTRACT FROM AUTHOR]

Despite the substantial advancements in imaging techniques for the diagnosis and differential diagnosis of acute appendicitis (AA) over recent decades, the specificity and sensitivity of widely utilized laboratory biomarkers in clinical practice remain inadequate.This study aimed to investigate the diagnostic utility of commonly employed blood inflammatory markers for AA. Methods: A total of 399 participants who either sought medical care or underwent health examinations were enrolled in this prospective study. The cohort comprised 200 patients diagnosed with AA (AA group), 100 patients presenting with abdominal pain but without AA (AP group), and 99 healthy individuals undergoing routine health check-ups (HC group). For all subjects, the following biomarkers were measured: plasma neutrophil gelatinase-associated lipocalin (NGAL), white blood cell count (WBC), neutrophil count (NEU), percentage of neutrophils (NEU%), neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP). The diagnostic performance of the observed indicators, both individually and in combination, was assessed for the diagnosis of AA using Receiver Operating Characteristic (ROC) curves analysis and Delong's test. Results: The laboratory indicators demonstrated a progressive increase from the HC group to the AP group, and further to the AA group (all p< 0.05). Multifactorial logistic regression analysis identified NEU% and plasma NGAL as significant risk factors for the occurrence of AA. ROC curve analysis and Delong's test indicated that, in distinguishing the AA group from the HC group, the diagnostic performance of plasma NGAL, CRP, and NLR was equally substantial and superior to that of NEU and WBC. Within the AP group, plasma NGAL and CRP exhibited comparable diagnostic efficacy, outperforming NEU, WBC, and NLR. When differentiating AA in the non-appendicitis group (ie HC group + AP group), NGAL and CRP demonstrated comparable diagnostic efficacy, surpassing that of NEU, white WBC, and NLR. While the integration of multiple diagnostic tests can potentially improve overall diagnostic accuracy, the observed enhancement in the AUC is not statistically significant. Conclusion: NGAL, CRP, WBC, NEU% and NLR were significantly increased in patients with acute abdomen. NGAL and NEU% may function as independent risk factors for predicting the incidence of AA, with NGAL and CRP demonstrating similar and favorable diagnostic performance. While the combined evaluation of these biomarkers may enhance the diagnostic value for AA, the improvement in the area under the curve (AUC) is not substantial. [ABSTRACT FROM AUTHOR]

Copyright of Journal of New Medicine is the property of Sun Yat Sen University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To explore the diagnostic value of glycated CD59 (gCD59) in gestational diabetes mellitus (GDM). Methods: A total of 707 pregnant women who underwent the first visit in the obstetric outpatient clinic of the Affliated Suqian Hospital of Xuzhou Medical University from January 2022 to July 2023 were included, and were grouped according to the International Association of the Diabetes and Pregnancy Study Groups(IADPSG) diagnostic criteria, and finally 113 cases in the GDM group and 559 cases in the normal glucose tolerance (NGT) group were included, and the concentration of gCD59 was determined by enzyme-linked immunosorbent assay (ELISA). The baseline data characteristics of the two groups were compared, the risk factors for GDM were explored by multivariate binary logistic analysis, and the diagnostic value of gCD59 in predicting GDM was explored by receiver operating characteristic (ROC) curve analysis. Results: The level of gCD59 in the GDM group was significantly higher than that in the NGT group (1.49 SPU vs 0.87 SPU). Multivariate regression analysis showed that gCD59, diastolic blood pressure (DBP) and thyroid stimulating hormone (TSH) were independent risk factors for GDM.The area under the curve (AUC) of gCD59 for the diagnosis of GDM was 0.681 (95% CI: 0.583-0.717), with a sensitivity of 71.7% and a specificity of 58.3%. In combination with fasting glucose, gCD59 effectively diagnosed GDM with higher AUC of 0.871 (95% CI: 0.708-1.000). Conclusion: gCD59 is an independent risk factor for GDM and a good biomarker for the diagnosis of GDM. [ABSTRACT FROM AUTHOR]

BackgroundDespite advancements in medical examination equipment and techniques, fever of unknown origin (FUO) remains challenging in internal medicine.PurposeThis study evaluates the diagnostic efficacy and necessity of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with FUO.MethodsWe retrospectively analyzed the results of 18F-FDG PET/CT in a cohort of 284 patients with FUO admitted to the Department of Infection at the First Hospital of Jilin University between January 2018 and March 2024. All patients received a final clinical diagnosis after various treatments, which helped determine the diagnostic relevance of identified lesions using 18F-FDG PET/CT. Additionally, univariate and multivariate logistic regression analyses were performed to evaluate the predictive value of relevant laboratory indices on the true-positive results of 18F-FDG PET/CT. The diagnostic performance for different etiologies of FUO was assessed by calculating the area under the receiver operating characteristic curve.ResultsOf the 284 enrolled patients, infectious diseases were diagnosed in 53 (18.7%), non-infectious inflammatory diseases in 76 (26.8%), malignant tumors in 66 (23.2%), and 89 (31.3%) remained undiagnosed. The final diagnoses of 136 patients (47.9%) correlated with their 18F-FDG PET/CT results, yielding a sensitivity of 79.5%, specificity of 61.1%, positive predictive value of 75.6%, and negative predictive value of 66.3%. Furthermore, a correlation was found between localized pain, prolonged activated partial thromboplastin time, and true-positive 18F-FDG PET/CT results.ConclusionThe high diagnostic efficacy of 18F-FDG PET/CT in FUO suggests its potential as a routine imaging modality, which could enhance patient management and reduce the need for costly and unnecessary invasive procedures. The identification of clinical factors that are predictive of true-positive diagnosis could facilitate more effective allocation of PET/CT imaging.

ObjectiveTo investigate the features of gut microbiota in cirrhotic patients with myosteatosis and identify specific bacterial species that may be involved in the pathogenesis of myosteatosis.Methods80 patients with liver cirrhosis were categorized into the myosteatosis group (n = 44) and the non-myosteatosis group (n = 36). Metagenomic sequencing was used to analyze the differences in gut microbiota composition between the two groups. Subsequently, the value of meaningful gut microbiota in the diagnosis of myosteatosis in patients with liver cirrhosis was analyzed.ResultsAt the species level, however, 15 bacterial species exhibited significant differences in relative abundance between these two groups. The relative abundance of Roseburia hominis and Subdoligranulum unclassified was inversely associated with mean muscle attenuation density at the L3 level (p

BackgroundThis study aimed to explore the accuracy of third-generation nanopore sequencing to diagnose extrapulmonary tuberculosis (EPTB).MethodsSamples were collected from the lesions of 67 patients with suspected EPTB admitted between April 2022 and August 2023. Nanopore sequencing, acid-fast bacilli (AFB) staining, DNA testing, and X-pert and mycobacterial cultures were performed. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operating characteristic curve (AUC) were calculated for different diagnostic methods, and their diagnostic accuracies were compared.ResultsNanopore sequencing demonstrated the highest correct diagnosis rate among 50 positive EPTB cases, independently diagnosing 19 positive cases missed by conventional methods. Its sensitivity (62.00%), specificity (94.10%), PPV (96.90%), NPV (45.70%) and AUC (0.781, 95% CI: 0.67–0.89) were superior to those of conventional methods, such as AFB staining, DNA testing, X-pert, and solid culture, indicating its significantly efficient advantage in EPTB detection.ConclusionNanopore sequencing technology significantly outperforms conventional methods such as AFB staining, DNA testing, X-pert, and mycobacterial culture to diagnose EPTB, promising to improve the diagnosis of EPTB.

AIM: To analyze the diagnostic value of optical coherence tomography angiography(OCTA)in evaluating the parameters of foveal avascular zone(FAZ)in early diabetic retinopathy(DR).METHODS: Retrospective study. A total of 209 cases(209 eyes)of type 2 diabetes mellitus(T2DM)with DR admitted to our hospital from June 2019 to December 2022 were selected as DR group. The DR group was divided into three groups, with 115 cases(115 eyes)in mild group, 54 cases(54 eyes)in moderate group, and 40 cases(40 eyes)in severe group according to stage. Another 100 cases(100 eyes)of T2DM patients without DR were selected as No-DR group, and 70 cases(70 eyes)of healthy people were selected as control group for physical examination at the same time, all of whom underwent OCTA examination. The DR group was enrolled according to the disease degree, one eye was randomly taken for the study if the degree in both eyes was the same, while the control group and the No-DR group were randomly selected for one eye to be included in the study. The perimeter of the foveal avascular area(PERIM), FAZ transverse diameter, FAZ vertical diameter, FAZ area, macular fovea retinal thickness(MFRT), acircularity index(AI), full layer retinal blood flow density within a range of 300 μm around the FAZ(FD-300), and changes in FAZ vascular density(VD)levels among different groups of subjects were compared. Furthermore, Pearson correlation analysis was used to determine the correlation between general data and FAZ related indicators, and receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of macular FAZ indicators for DR.RESULTS: The levels of FBG, MFRT, FAZ area, and PERIM in patients with mild, moderate, and severe DR were significantly higher than those in the No-DR group and the control group, while the levels of AI and VD were significantly lower than those in the No-DR group(all P

Kai Huang,&ast; Jie Lu,&ast; Qin Li, Chuyi Wang, Sufan Ding, Xiangyang Xu, Lin Han Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Lin Han, Email sh_hanlin@hotmail.comBackground: The accumulation of epicardial adipose tissue (EAT) is associated with cardiometabolic risks and adverse outcomes in heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF). This study aims to identify genes secreted by EAT that contribute to the shared pathogenesis of HFpEF and AF, potentially serving as biomarkers for diagnosis.Methods: Data sets from the GEO database for HFpEF-EAT, HFpEF-heart tissue, AF-EAT, AF-PBMC, and AF-heart tissue were analyzed. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) identified key genes in EAT linked to HFpEF and AF. Functional enrichment and connectivity map analyses explored common pathways and therapeutic targets. Machine learning techniques, including LASSO regression, random forest, and support vector machine, identified shared biomarkers. CIBERSORT was used to assess immune cell infiltration, while gene set enrichment analysis identified pathways related to hub genes. Receiver operating characteristic (ROC) curve analysis and experimental validation assessed the bioinformatics findings.Results: In the HFpEF dataset, 200 key genes were identified by intersecting HFpEF-EAT, HFpEF-heart tissue, WGCNA analyses, and secretory proteins. For AF, 232 related genes were identified through similar methods. Thirteen genes were common between HFpEF and AF, with two central genes, ITPKA and WNT9B, selected as potential biomarkers through machine learning and ROC analysis. Immune cell infiltration and gene set enrichment analysis revealed pathways related to ITPKA/WNT9B. These patterns were confirmed in human samples.Conclusion: This study identified EAT-derived secretory proteins as potential biomarkers for HFpEF and AF, with ITPKA and WNT9B as central hub genes. These findings offer insights into potential diagnostic and therapeutic strategies for HFpEF and AF.Keywords: heart failure with preserved ejection fraction, atrial fibrillation, epicardial adipose tissue, diagnostic value, secretory proteins

Abstract Objective We conducted a systematic review and meta-analysis to assess the diagnostic value of the electrocardiogram (ECG) method in detecting cardiac amyloidosis (CA) to indicate its clinical application. Methods We searched PubMed, Web of Science, OVID Medline, and Cochrane Library databases for clinical trials assessing the diagnostic performance of ECG in detecting CA. We employed the risk ratio and 95% confidence interval (CI) to explicit estimates. QUADAS-2 was applied to evaluate the bias risk and the clinical applicability of the included studies. Reviewer Manager (RevMan) 5.3 and Stata 16.0 were employed to complete all statistical analyses. Results This meta-analysis included ten studies (N = 6353 patients). Overall, the findings of the study exposed that, for CA patients in whom the ECG method was used, the sensitivity and specificity were 0.49 and 0.91, respectively. The positive likelihood ratio (LR) and negative LR were 5.17 and 0.57, respectively. The diagnostic odds ratio (DOR) and diagnostic score of the ECG in detecting CA were 9.11 and 2.21. The area under the curve (AUC) was 0.83(95% CI = 0.79–0.86). The hierarchical summary receiver operating characteristic (HSROC) curve further confirmed the diagnostic accuracy of the ECG, demonstrating a high prediction and confidence interval for the pooled estimate. No significant publication bias was detected, as confirmed by funnel plot analysis. Sensitivity analysis confirmed that the pooled estimates for ECG remained stable after the exclusion of individual studies, underscoring the robustness of the findings. The combined DOR and diagnostic score were 9.11 and 2.21, respectively. Conclusions ECM has low sensitivity and high specificity in the diagnosis of CA. AUC > 0.5, indicating that ECM has accuracy and diagnostic value in the diagnosis of CA to some extent.

Abstract A precise quantification of mitral regurgitation (MR) severity is essential for treatment and outcome of patients with MR. 3D echocardiography facilitates estimation of MR but selection of patients with necessity of invasive treatment remains challenging. We investigate effective regurgitation orifice area (EROA) quantification by 3D compared to 2D echocardiography in patients with MR and highlight the improved discrimination of MR severity. We consecutively enrolled fifty patients with primary or secondary and at least moderate MR undergoing 2D and 3D colour Doppler echocardiography prior to transcatheter edge-to-edge repair (TEER). Improved accuracy of MR grading using 3D vena contracta area (VCA) as an estimate of EROA was compared to 2D proximal isovelocity surface area (PISA) quantification method and a multiparameter reference standard. Quantification of EROA remarkably varies between 2D and 3D echocardiography and the discrimination between moderate and severe MR was significantly (p = 0.001) different using 2D PISA or 3D VCA, respectively. 3D VCA correlated significantly (r = 0.501, p

AIM: To detect the expression levels of long non-coding RNA(lncRNA)X-inactive specific transcript(XIST)and silencing information regulatory factor 2 associated enzyme 1(SIRT1)in serum of patients with type 2 diabetes mellitus(T2DM), and to explore their correlation with diabetic retinopathy(DR)and their diagnostic value. METHODS: Prospective study. A total of 214 patients with T2DM admitted to our hospital from January 2022 to February 2023 were selected as the research subjects. Based on whether retinopathy occurred, they were divided into 126 cases(126 eyes)in the non-DR group and 88 cases(88 eyes)in the DR group. An additional 130 healthy individuals who underwent a physical examination during the same period were selected as the control group. The serum levels of lncRNA XIST and SIRT1 in the three groups were measured and compared. The relationship between lncRNA XIST and SIRT1 expression with DR was analyzed using Pearson's method. The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum lncRNA XIST, SIRT1, and their combination for DR. Multivariate Logistic regression analysis was performed to investigate the factors affecting the occurrence of DR in T2DM patients.RESULTS: Compared with the control group, the levels of serum lncRNA XIST and SIRT1 in the non-DR group and DR group were successively decreased(all P

Abstract Objective To clarify the efficacy of artificial intelligence (AI)-assisted imaging in the diagnosis of developmental dysplasia of the hip (DDH) through a meta-analysis. Methods Relevant literature on AI for early DDH diagnosis was searched in PubMed, Web of Science, Embase, and The Cochrane Library databases until April 4, 2024. The Quality Assessment of Diagnostic Accuracy Studies tool was used to assess the quality of included studies. Revman5.4 and StataSE-64 software were used to calculate the combined sensitivity, specificity, AUC value, and DOC value of AI-assisted imaging for DDH diagnosis. Results The meta-analysis included 13 studies (6 prospective and 7 retrospective) with 28 AI models and a total of 10,673 samples. The summary sensitivity, specificity, AUC value, and DOC value were 99.0% (95% CI: 97.0-100.0%), 94.0% (95% CI: 89.0–96.0%), 99.0% (95% CI: 98.0-100.0%), and 1342 (95% CI: 469–3842), respectively. Conclusion AI-assisted imaging demonstrates high diagnostic efficacy for DDH detection, improving the accuracy of early DDH imaging examination. More prospective studies are needed to further confirm the value of AI-assisted imaging for early DDH diagnosis.