Chinese men should have a higher prostate-specific antigen （PSA） ＂gray zone＂ than the traditional value of 2.5-10.0 ng ml-1 since the incidence of prostate cancer （PCa） in Chinese men is relative low. We hypothe...Chinese men should have a higher prostate-specific antigen （PSA） ＂gray zone＂ than the traditional value of 2.5-10.0 ng ml-1 since the incidence of prostate cancer （PCa） in Chinese men is relative low. We hypothesized that PSA density （PSAD） could improve the rate of PCa detection in Chinese men with a PSA higher than the traditional PSA ＂gray zone.＂ A total of 461 men with a PSA between 2.5 and 20.0 ng ml-1, who had undergone prostatic biopsy at two Chinese centers were included in the analysis. The men were then further divided into groups with a PSA between 2.5-10.0 ng ml-1 and 10.1-20.0 ng ml-1. Receiver operating characteristic （ROC） curve was used to evaluate the efficacy of PSA and PSAD for the diagnosis of PCa. In men with a PSA of 2.5-10.0 ng ml-1 or 10.1-20.0 ng ml-z, the areas under the ROC curve were higher for PSAD than for PSA. This was consistent across both centers and the cohort overall. When the entire cohort was considered, the optimal PSAD cut-off for predicting PCa in men with a PSA of 2.5-10.0 ng m1-1 was 0.15 ng ml-2 ml-2, with a sensitivity of 64.4% and specificity of 64.6%. The optimal cut-off for PSAD in men with a PSA of 10.1-20.0 ng m1-1 was 0.33 ng ml-1 ml-1, with a sensitivity of 60.3% and specificity of 82.7%. PSAD can improve the effectiveness for PCa detection in Chinese men with a PSA of 2.5-10.0 ng ml-1 （traditional Western PSA ＂gray zone＂） and 10.1-20.0 ng ml-2 （Chinese PSA ＂gray zone＂）.展开更多
Background： Cirrhosis is a common complication of chronic hepatitis B. It remains unclear if viral and biochemical parameters at baseline affect virological response to entecavir and therefore warrant investigation. ...Background： Cirrhosis is a common complication of chronic hepatitis B. It remains unclear if viral and biochemical parameters at baseline affect virological response to entecavir and therefore warrant investigation. In the present study, we aimed to eval uate the efficacy of entecavir therapy by monitoring virological response at the end of the 3^rd month of treatment and try to figure out whether baseline factors could help predict it in a cohort of hepatitis B virus （HBV） compensated cirrhosis patients and to determine the cut-off value of a predicting parameter.Methods： A total of 91 nucleos（t）ide-naive patients with HBV induced cirrhosis （compensatory stage） were enrolled in a prospective cohort. HBV DNA and alanine aminotransferase （ALT） were tested at baseline and monitored every 3-6 months after starting therapy. Results： Of all 91 patients, the median follow-up time was 12 （9-24） months. Overall, 64 patients （70.3%） achieved virological response in the 3^rd month. Univariate analysis showed that the 3^rd month virological response can be predicted by baseline HBV DNA levels （P 〈 0.001, odds ratio [OR]： 2.13, 95% confidence interval [CI]： 1.44-3.15）, ALT value （P = 0.023, OR： 1.01, 95% CI： 1.00 1.01 ） and hepatitis B e antigen （HBeAg） negativity （P = 0.016, OR： 0.30, 95% CI： 0.11-0.80）. Multiple regression analysis showed baseline H BV DNA level was the only parameter related to full virological response. Higher baseline HBV DNA strata indicated a higher probability that HBV DNA remains detectable at the 3^rd month （P = 0.001）. Area under receiver operating characteristic curve for determining the 3^rd month virological response by baseline HBV DNA was 77.6% （95% CI： 66.7-85.2%）, with a best cut-offvalue of 5.8 log10. Conclusions： Baseline HBV DNA, HBeAg negativity, and ALT were independent factors contributing to virological response at the 3^rt month. Further, multiple regression showed that HBV DNA level was the only parameter predi展开更多
在临床应用中需要限制扫描时间和药物剂量,这往往会使正电子发射断层扫描(PET)的图像的分辨率变低,噪声变多。为提供可供临床诊断的图像,去噪是一个必须的手段,而在重建后增加一个滤波器是目前最常用的去噪方法。因此对不同滤波器滤波...在临床应用中需要限制扫描时间和药物剂量,这往往会使正电子发射断层扫描(PET)的图像的分辨率变低,噪声变多。为提供可供临床诊断的图像,去噪是一个必须的手段,而在重建后增加一个滤波器是目前最常用的去噪方法。因此对不同滤波器滤波效果的比较是PET图像重建中的重要环节,其中最关键的是滤波参数的选取。目前采用的信噪比(SNR)以及恢复系数(RC)等评估方法可以用来非定量地选取参数,研究者们只能凭经验选取最优参数。而通道化霍特林观察器(CHO)作为一个比较通用的数字观察器,已被用于与PET图像质量相关的各种参数的选择,如重建算法参数、系统设计参数、临床协议参数等,然而其在评估不同滤波方法对图像重建质量的影响中的应用研究还比较少。通过比较CHO计算得到的ROC(receiver operating characteristic)曲线下面积(area under the ROC curve,AUC),选择两种常用的滤波器(即高斯滤波器和非局部均值(Non-Local Mean,NLM)滤波器)的最优参数,并评估它们在PET中的滤波效果。结果表明,对于13 mm球体,σ为1.1~1.4的高斯滤波器和f为0.5~0.9的NLM滤波器可以达到最大的检测能力值,而对于10 mm球体,σ为1.4~2.0的高斯滤波器和f为0.5~0.9的NLM滤波器可以达到最大的检测能力值。虽然两个滤波器所对应的AUC值都能高达0.9,但是NLM滤波器的AUC值高于高斯滤波器。通过IEC图像和病人图像也能发现,NLM滤波后的PET图像中的亮点比高斯滤波的更加清晰,噪声更少。该结论和传统滤波器评估方法得到的结论一致,这说明在PET的病灶检测任务中,CHO能够准确地比较这两种滤波器的性能。展开更多
目的:探讨颅脑损伤患者入院时凝血指标与病情严重程度的相关关系。方法:收集2017年10月至2018年10月入住于我院神经外科的87例颅脑损伤患者的病历资料,用入院时格拉斯哥评分(Glasgow Coma Scale,GCS)评价患者伤情严重程度,应用双变量回...目的:探讨颅脑损伤患者入院时凝血指标与病情严重程度的相关关系。方法:收集2017年10月至2018年10月入住于我院神经外科的87例颅脑损伤患者的病历资料,用入院时格拉斯哥评分(Glasgow Coma Scale,GCS)评价患者伤情严重程度,应用双变量回归分析、建立多元线性回归方程、绘制受试者工作特征曲线(area under the receiver-operating characteristic curve,ROC)等方法,分析患者入院时凝血指标与病情严重程度的相关性。结果:经双变量相关分析,入院时GCS与血凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,FIB)、D-二聚体(D-Dimer,D-D)、白蛋白(albumin,ALB)及血糖(glucose,GLU)值均有相关性,差异均有统计学意义(P<0.05)。经逐步拟合,有三个自变量选入最优多元回归分析方程,即为D-D、PT和GLU,R=0.836,R2=0.615。绘制ROC曲线分析结果示:D-D、PT和GLU预测颅脑损伤患者入院GCS值的ROC曲线下面积分别为0.863、0.736和0.727,说明当患者入院时的血D-D值≥4.58ug/ml、血PT值≥13.55s血GLU值≥8.29mmol/L时,提示患者伤情较重。结论:在颅脑损伤患者早期的病情判断中,凝血指标的变化对患者的伤情具有预测意义,可结合患者伤后血D-D、PT、GLU值协助判断患者病情,及时给予相应处理。展开更多
文摘Chinese men should have a higher prostate-specific antigen （PSA） ＂gray zone＂ than the traditional value of 2.5-10.0 ng ml-1 since the incidence of prostate cancer （PCa） in Chinese men is relative low. We hypothesized that PSA density （PSAD） could improve the rate of PCa detection in Chinese men with a PSA higher than the traditional PSA ＂gray zone.＂ A total of 461 men with a PSA between 2.5 and 20.0 ng ml-1, who had undergone prostatic biopsy at two Chinese centers were included in the analysis. The men were then further divided into groups with a PSA between 2.5-10.0 ng ml-1 and 10.1-20.0 ng ml-1. Receiver operating characteristic （ROC） curve was used to evaluate the efficacy of PSA and PSAD for the diagnosis of PCa. In men with a PSA of 2.5-10.0 ng ml-1 or 10.1-20.0 ng ml-z, the areas under the ROC curve were higher for PSAD than for PSA. This was consistent across both centers and the cohort overall. When the entire cohort was considered, the optimal PSAD cut-off for predicting PCa in men with a PSA of 2.5-10.0 ng m1-1 was 0.15 ng ml-2 ml-2, with a sensitivity of 64.4% and specificity of 64.6%. The optimal cut-off for PSAD in men with a PSA of 10.1-20.0 ng m1-1 was 0.33 ng ml-1 ml-1, with a sensitivity of 60.3% and specificity of 82.7%. PSAD can improve the effectiveness for PCa detection in Chinese men with a PSA of 2.5-10.0 ng ml-1 （traditional Western PSA ＂gray zone＂） and 10.1-20.0 ng ml-2 （Chinese PSA ＂gray zone＂）.
文摘Background： Cirrhosis is a common complication of chronic hepatitis B. It remains unclear if viral and biochemical parameters at baseline affect virological response to entecavir and therefore warrant investigation. In the present study, we aimed to eval uate the efficacy of entecavir therapy by monitoring virological response at the end of the 3^rd month of treatment and try to figure out whether baseline factors could help predict it in a cohort of hepatitis B virus （HBV） compensated cirrhosis patients and to determine the cut-off value of a predicting parameter.Methods： A total of 91 nucleos（t）ide-naive patients with HBV induced cirrhosis （compensatory stage） were enrolled in a prospective cohort. HBV DNA and alanine aminotransferase （ALT） were tested at baseline and monitored every 3-6 months after starting therapy. Results： Of all 91 patients, the median follow-up time was 12 （9-24） months. Overall, 64 patients （70.3%） achieved virological response in the 3^rd month. Univariate analysis showed that the 3^rd month virological response can be predicted by baseline HBV DNA levels （P 〈 0.001, odds ratio [OR]： 2.13, 95% confidence interval [CI]： 1.44-3.15）, ALT value （P = 0.023, OR： 1.01, 95% CI： 1.00 1.01 ） and hepatitis B e antigen （HBeAg） negativity （P = 0.016, OR： 0.30, 95% CI： 0.11-0.80）. Multiple regression analysis showed baseline H BV DNA level was the only parameter related to full virological response. Higher baseline HBV DNA strata indicated a higher probability that HBV DNA remains detectable at the 3^rd month （P = 0.001）. Area under receiver operating characteristic curve for determining the 3^rd month virological response by baseline HBV DNA was 77.6% （95% CI： 66.7-85.2%）, with a best cut-offvalue of 5.8 log10. Conclusions： Baseline HBV DNA, HBeAg negativity, and ALT were independent factors contributing to virological response at the 3^rt month. Further, multiple regression showed that HBV DNA level was the only parameter predi
文摘目的探讨肾小管及肾小球相关标志物在2型糖尿病(type 2 diabetes mellitus,T2DM)患者不同肾损伤阶段的诊断价值。方法选取于2018年4月1日至2019年10月31日入住首都医科大学附属北京同仁医院内分泌科的T2DM患者272例,完善临床生化指标及尿蛋白四项:尿微量白蛋白/肌酐(urinary albumin to creatinine ratio,ACR)、α1-微球蛋白/肌酐(urinary α1-microglobulin to creatinine ratio,UA1CR)、免疫球蛋白G/肌酐(urinary immunoglobulin G to creatinine ratio,UIGG)、转铁蛋白/肌酐(urinary transferrin to creatinine ratio,UTRF);进行眼底照相、核医学99mTc-EC检测肾有效血浆流量(effective renal plasma flow,ERPF)和99mTc-DTPA检测肾小球滤过率(glomerular filtration rate,GFR)。根据ACR和眼底检查结果分为4组:正常蛋白尿无糖尿病视网膜病变(diabetic retinopathy,DR)132例,即对照组(ACR≤30 mg/g);正常蛋白尿合并DR 32例,为糖尿病肾病(diabetic kidney disease,DKD)前期组;微量蛋白尿组78例(30<ACR≤300 mg/g)和大量蛋白尿组30例(ACR>300 mg/g)。比较四组间尿蛋白四项和ERPF、GFR的水平,通过受试者工作特征(receiver operating characteristic,ROC)曲线评价上述各指标在不同肾损伤阶段的诊断价值。结果尿蛋白四项和ERPF、GFR的水平在不同组间差异有统计学意义(P<0.05)。在尿蛋白正常组中,DR组中肾小管功能标志物UA1CR较对照组明显升高(P<0.01);肾小球功能标志物ACR、UTRF和GFR在两组间差异无统计学意义(P>0.05),DR组UIGG较对照组升高(P<0.01)。在微量蛋白尿组和大量蛋白尿组,尿蛋白四项随肾损伤程度增加而增加,而ERPF和GFR随肾损伤程度增加而降低。ROC曲线分析显示,在尿蛋白排出正常的T2DM患者中合并DR组中肾小管功能标志物UA1CR和ERPF的曲线下面积(area under the curve,AUC)分别为68.2%(P<0.01)和60.5%(P<0.05),而肾小球功能标志物ACR和GFR的AUC均小于60%,差异无统计学意义(P>0.05)。尿蛋白四项及GFR在微量和
文摘在临床应用中需要限制扫描时间和药物剂量,这往往会使正电子发射断层扫描(PET)的图像的分辨率变低,噪声变多。为提供可供临床诊断的图像,去噪是一个必须的手段,而在重建后增加一个滤波器是目前最常用的去噪方法。因此对不同滤波器滤波效果的比较是PET图像重建中的重要环节,其中最关键的是滤波参数的选取。目前采用的信噪比(SNR)以及恢复系数(RC)等评估方法可以用来非定量地选取参数,研究者们只能凭经验选取最优参数。而通道化霍特林观察器(CHO)作为一个比较通用的数字观察器,已被用于与PET图像质量相关的各种参数的选择,如重建算法参数、系统设计参数、临床协议参数等,然而其在评估不同滤波方法对图像重建质量的影响中的应用研究还比较少。通过比较CHO计算得到的ROC(receiver operating characteristic)曲线下面积(area under the ROC curve,AUC),选择两种常用的滤波器(即高斯滤波器和非局部均值(Non-Local Mean,NLM)滤波器)的最优参数,并评估它们在PET中的滤波效果。结果表明,对于13 mm球体,σ为1.1~1.4的高斯滤波器和f为0.5~0.9的NLM滤波器可以达到最大的检测能力值,而对于10 mm球体,σ为1.4~2.0的高斯滤波器和f为0.5~0.9的NLM滤波器可以达到最大的检测能力值。虽然两个滤波器所对应的AUC值都能高达0.9,但是NLM滤波器的AUC值高于高斯滤波器。通过IEC图像和病人图像也能发现,NLM滤波后的PET图像中的亮点比高斯滤波的更加清晰,噪声更少。该结论和传统滤波器评估方法得到的结论一致,这说明在PET的病灶检测任务中,CHO能够准确地比较这两种滤波器的性能。
文摘目的:探讨颅脑损伤患者入院时凝血指标与病情严重程度的相关关系。方法:收集2017年10月至2018年10月入住于我院神经外科的87例颅脑损伤患者的病历资料,用入院时格拉斯哥评分(Glasgow Coma Scale,GCS)评价患者伤情严重程度,应用双变量回归分析、建立多元线性回归方程、绘制受试者工作特征曲线(area under the receiver-operating characteristic curve,ROC)等方法,分析患者入院时凝血指标与病情严重程度的相关性。结果:经双变量相关分析,入院时GCS与血凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,FIB)、D-二聚体(D-Dimer,D-D)、白蛋白(albumin,ALB)及血糖(glucose,GLU)值均有相关性,差异均有统计学意义(P<0.05)。经逐步拟合,有三个自变量选入最优多元回归分析方程,即为D-D、PT和GLU,R=0.836,R2=0.615。绘制ROC曲线分析结果示:D-D、PT和GLU预测颅脑损伤患者入院GCS值的ROC曲线下面积分别为0.863、0.736和0.727,说明当患者入院时的血D-D值≥4.58ug/ml、血PT值≥13.55s血GLU值≥8.29mmol/L时,提示患者伤情较重。结论:在颅脑损伤患者早期的病情判断中,凝血指标的变化对患者的伤情具有预测意义,可结合患者伤后血D-D、PT、GLU值协助判断患者病情,及时给予相应处理。
