BACKGROUND Rapid urinary trypsinogen-2 dipstick test and levels of urinary trypsinogen-2 and trypsinogen activation peptide(TAP)concentration have been reported as prognostic markers for the diagnosis of acute pancrea...BACKGROUND Rapid urinary trypsinogen-2 dipstick test and levels of urinary trypsinogen-2 and trypsinogen activation peptide(TAP)concentration have been reported as prognostic markers for the diagnosis of acute pancreatitis.AIM To reconfirm the validity of all these markers in the diagnosis of acute pancreatitis by undertaking a multi-center study in Japan.METHODS Patients with acute abdominal pain were recruited from 17 medical institutions in Japan from April 2009 to December 2012.Urinary and serum samples were collected twice,at enrollment and on the following day for measuring target markers.The diagnosis and severity assessment of acute pancreatitis were assessed based on prognostic factors and computed tomography(CT)Grade of the Japanese Ministry of Health,Labour,and Welfare criteria.RESULTS A total of 94 patients were enrolled during the study period.The trypsinogen-2 dipstick test was positive in 57 of 78 patients with acute pancreatitis(sensitivity,73.1%)and in 6 of 16 patients with abdominal pain but without any evidence of acute pancreatitis(specificity,62.5%).The area under the curve(AUC)score of urinary trypsinogen-2 according to prognostic factors was 0.704,which was highest in all parameter.The AUC scores of urinary trypsinogen-2 and TAP according to CT Grade were 0.701 and 0.692,respectively,which shows higher than other pancreatic enzymes.The levels of urinary trypsinogen-2 and TAP were significantly higher in patients with extended extra-pancreatic inflammation as evaluated by CT Grade.CONCLUSION We reconfirmed urinary trypsinogen-2 dipstick test is useful as a marker for the diagnosis of acute pancreatitis.Urinary trypsinogen-2 and TAP may be considered as useful markers to determine extra-pancreatic inflammation in acute pancreatitis.展开更多
BACKGROUND: Currently, serum amylase and lipase are the most popular laboratory markers for early diagnosis of acute pancreatitis with reasonable sensitivity and specificity. Urinary trypsinogen-2 (UT-2) has been incr...BACKGROUND: Currently, serum amylase and lipase are the most popular laboratory markers for early diagnosis of acute pancreatitis with reasonable sensitivity and specificity. Urinary trypsinogen-2 (UT-2) has been increasingly used but its clinical value for the diagnosis of acute pancreatitis and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis has not yet been systematically assessed. DATA SOURCES: A comprehensive search was carried out using PubMed (MEDLINE), Embase, and Web of Science for clinical trials, which studied the usefulness of UT-2 as a diagnostic marker for acute pancreatitis. Sensitivity, specificity and the diagnostic odds ratios (DORs) with 95% confidence interval (CI) were calculated for each study and were compared with serum amylase and lipase. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated. RESULTS: A total of 18 studies were included. The pooled sensitivity and specificity of UT-2 for the diagnosis of acute pancreatitis were 80% and 92%, respectively (AUC=0.96, DOR=65.63, 95% CI: 31.65-139.09). The diagnostic value of UT-2 was comparable to serum amylase but was weaker than serum lipase. The pooled sensitivity and specificity for the diagnosis of post-ERCP pancreatitis were 86% and 94%, respectively (AUC=0.92, DOR=77.68, 95% CI: 24.99-241.48).CONCLUSIONS: UT-2 as a rapid test could be potentially used for the diagnosis of post-ERCP pancreatitis and to an extent, acute pancreatitis. Further studies are warranted to confirm these results.展开更多
Background: Acute pancreatitis is one of the most serious complications of ERCP. Early diagnosis of post ERCP pancreatitis helps physicians to provide intensive care and possible medical treatment as early as possible...Background: Acute pancreatitis is one of the most serious complications of ERCP. Early diagnosis of post ERCP pancreatitis helps physicians to provide intensive care and possible medical treatment as early as possible. Trypsinogen-2 in urine is a good diagnostic and prognostic marker of acute pancreatitis. Objectives: To evaluate the diagnostic value of urinary trypsinogen-2 dipstick test for early diagnosis of post ERCP pancreatitis. Methods: A total of 37 patients with obstructive jaundice were tested with the urinary trypsinogen-2 dipstick test and serum levels of amylase and lipase before ERCP and 6 hours after ERCP. Results: Post ERCP pancreatitis was diagnosed in 6 (16%) of 37 patients. The sensitivity, specificity, positive predictive value and negative predictive value of urinary trypsinogen-2 dipstick test at 6 hours after ERCP were 100%, 97%, 86%, 100% respectively. At the cutoff level (130 U/L) for lipase, the positive predictive value and negative predictive value all were (100%), however, the positive predictive value and negative predictive value for amylase levels at cutoff (122 U/L) were 60%, 100% respectively. Serum lipase level was the best test for diagnosing post ERCP pancreatitis followed by the urinary trypsinogen-2 dipstick test. Conclusions: The urinary trypsinogen-2 dipstick test can be used as a rapid and easy test for early diagnosis of post ERCP pancreatitis with high sensitivity and specificity.展开更多
AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP),and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnos...AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP),and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnosisof acute pancreatitis.METHODS: Patients with acute abdominal pain and hospitalized within 24 h after the onset of symptoms were prospectively studied. Urinary trypsinogen-2 was considered positive when a clear blue line was observed (detection limit 50 μg/L). Urinary TAP was measured using a quantitative solid-phase ELISA, and serum and urinary CAPAP by a radioimmunoassay method.RESULTS: Acute abdominal pain was due to acute pancreatitis in 50 patients and turned out to be extrapancreatic in origin in 22 patients. Patients with acute pancreatitis showed significantly higher median levels of serum and urinary CAPAP levels, as well as amylase and lipase than extrapancreatic controls. Median TAP levels were similar in both groups. The urinary trypsinogen-2 test strip was positive in 68% of patients with acute pancreatitis and 13.6% in extrapancreatic controls (P<0.01). Urinary CAPAP was the most reliable test for the diagnosis of acute pancreatitis (sensitivity 66.7%, specificity 95.5%, positive and negative predictive values 96.6% and 56.7%, respectively), with a 14.6 positive likelihood ratio for a cut-off value of 2.32 nmol/L.CONCLUSION: In patients with acute abdominal pain,hospitalized within 24 h of symptom onset, CAPAP in serum and urine was a reliable diagnostic marker of acute pancreatitis. Urinary trypsinogen-2 test strip showed a clinical value similar to amylase and lipase.Urinary TAP was not a useful screening test for the diagnosis of acute pancreatitis.展开更多
Background:Studies have shown that individuals who receive early treatment for rheumatoid arthritis(RA)are more likely to approach life positively,avoiding joint damage and the need for joint replacement surgery.The d...Background:Studies have shown that individuals who receive early treatment for rheumatoid arthritis(RA)are more likely to approach life positively,avoiding joint damage and the need for joint replacement surgery.The diagnosis of early rheumatoid arthritis(ERA)is crucial for effective treatment and prognosis of patients.Urine,as a diagnostic medium,offers the advantages of non-invasive diagnosis.Urinary metabolites can serve as biomarkers for diagnosis,prognosis,and risk prediction,improving specificity and accuracy.Methods:We recruited 37 ERA patients with a history of less than 3 months and a score of 6,26 osteoarthritis(OA)patients,and 30 healthy controls(HC).Urine samples were collected for 16S rRNA sequencing,and untargeted liquid chromatography-mass spectrometry(LC-MS)was used to detect metabolites.Bioinformatics approaches were employed to identify pathogenic metabolites as specific risk factors for ERA precisely.Results:2-methylnaphthalene was identified as a biomarker for ERA in urine.Prevotella,a major part of the urinary microbiome in ERA patients,exhibited a positive correlation with 2-methylnaphthalene.Notably,there were significant variations in urine metabolites among patients with ERA,OA,and HC.2-Methylnaphthalene was found to be significantly enriched in ERA.Besides,inflammatory factors were elevated in ERA patients.The research further demonstrated a positive correlation between rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and the metabolite 2-methylnaphthalene.Conclusion:The urine metabolite 2-methylnaphthalene can be a risk factor for early urinary tract infections and may contribute to accurately screening early-risk metabolites in ERA.展开更多
Objective Coronavirus disease 2019(COVID-19)can result in fatigue and post-exertional malaise;however,whether severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection exacerbates lower urinary tract sympto...Objective Coronavirus disease 2019(COVID-19)can result in fatigue and post-exertional malaise;however,whether severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection exacerbates lower urinary tract symptoms(LUTS)is unclear.This study investigated the association between prenatal SARS-CoV-2 infection and postpartum LUTS.Methods A multicenter,retrospective cohort study was conducted at two tertiary hospitals in China from November 1,2022,to November 1,2023.Participants were classified into infected and uninfected groups based on SARS-CoV-2 antigen results.LUTS prevalence and severity were assessed using self-reported symptoms and the Incontinence Impact Questionnaire-Short Form(IIQ-7).Pelvic floor muscle activity was measured using electromyography following the Glazer protocol.Group comparisons were performed to evaluate the association of SARS-CoV-2 infection with LUTS and electromyography parameters,with stratified analyses conducted using SPSS version 26.0.Results Among 3,652 participants(681 infected,2,971 uninfected),no significant differences in LUTS prevalence or IIQ-7 scores were observed.However,SARS-CoV-2 infection was an independent factor influencing the electromyographic activity of the pelvic floor muscles(mean tonic contraction amplitudes),regardless of delivery mode(P=0.001).Conclusion Prenatal SARS-CoV-2 infection was not significantly associated with an increased risk of postpartum LUTS but independently altered pelvic floor muscle electromyographic activity,suggesting potential neuromuscular effects.展开更多
BACKGROUND Postpartum stress urinary incontinence(SUI)symptoms affect a patient’s daily activities and quality of life and increase the negative emotions that they experience.At present,there is no research on the ef...BACKGROUND Postpartum stress urinary incontinence(SUI)symptoms affect a patient’s daily activities and quality of life and increase the negative emotions that they experience.At present,there is no research on the effect of fractional CO_(2)laser treatment combined with Kegel exercise on postpartum SUI and postpartum depression and anxiety.AIM To investigate the effect of lattice CO_(2)laser treatment combined with Kegel exercise on mild to moderate postpartum SUI and its influence on postpartum depression and anxiety.METHODS Using a retrospective study,data from 82 cases of mild to moderate postpartum SUI in Huzhou Maternal&Child Health Care Hospital from January to April 2024 were retrospectively collected.The cases were divided into groups according to the different treatment methods,namely Group S(41 cases,only receiving lattice CO_(2)laser treatment)and Group L(41 cases,receiving lattice CO_(2)laser combined with Kegel exercise treatment).The baseline data of the two groups were compared.In addition,we analyzed and compared the scores of the international commission on urinary incontinence questionnaire short form(ICI-Q-SF),incontinence quality of life questionnaire(I-QOL),Edinburgh postnatal depression scale(EPDS),and postpartum specific anxiety scale(PSAS)before treatment,at the end of treatment,and 3 months after the end of treatment between the two groups.Furthermore,the clinical efficacy and adverse reactions of the two groups were analyzed and compared at the end of treatment and 3 months after the end of treatment.RESULTS There was no significant difference in the baseline data and the ICI-Q-SF,I-QOL,EPDS,and PSAS scores between the two groups before treatment.However,at the end of treatment,the ICI-Q-SF,I-QOL,EPDS,and PSAS scores between Groups L and S were significantly different.The overall effective rate of treatment in Group L was significantly higher than that in Group S.During the 3-month follow-up after treatment,it was found that the ICIQ-SF,EPDS,and PSAS scores of Group L were still lower than those of Group S.In comparison,the I-QOL score and total effective rate of treatment were still higher in Group L than those in Group S,and this difference was significant.There was no significant difference in the adverse reactions between Group L and Group S.CONCLUSION The combination of dot lattice CO_(2)laser and Kegel exercise has a significant therapeutic effect on mild to moderate postpartum SUI.It can prolong the duration of therapeutic effects,improve a patient’s quality of life,and alleviate postpartum depression and anxiety.展开更多
文摘BACKGROUND Rapid urinary trypsinogen-2 dipstick test and levels of urinary trypsinogen-2 and trypsinogen activation peptide(TAP)concentration have been reported as prognostic markers for the diagnosis of acute pancreatitis.AIM To reconfirm the validity of all these markers in the diagnosis of acute pancreatitis by undertaking a multi-center study in Japan.METHODS Patients with acute abdominal pain were recruited from 17 medical institutions in Japan from April 2009 to December 2012.Urinary and serum samples were collected twice,at enrollment and on the following day for measuring target markers.The diagnosis and severity assessment of acute pancreatitis were assessed based on prognostic factors and computed tomography(CT)Grade of the Japanese Ministry of Health,Labour,and Welfare criteria.RESULTS A total of 94 patients were enrolled during the study period.The trypsinogen-2 dipstick test was positive in 57 of 78 patients with acute pancreatitis(sensitivity,73.1%)and in 6 of 16 patients with abdominal pain but without any evidence of acute pancreatitis(specificity,62.5%).The area under the curve(AUC)score of urinary trypsinogen-2 according to prognostic factors was 0.704,which was highest in all parameter.The AUC scores of urinary trypsinogen-2 and TAP according to CT Grade were 0.701 and 0.692,respectively,which shows higher than other pancreatic enzymes.The levels of urinary trypsinogen-2 and TAP were significantly higher in patients with extended extra-pancreatic inflammation as evaluated by CT Grade.CONCLUSION We reconfirmed urinary trypsinogen-2 dipstick test is useful as a marker for the diagnosis of acute pancreatitis.Urinary trypsinogen-2 and TAP may be considered as useful markers to determine extra-pancreatic inflammation in acute pancreatitis.
基金supported by grants from the National Natural Science Foundation of China(2009SZ0201)National Institute of Health Research UK
文摘BACKGROUND: Currently, serum amylase and lipase are the most popular laboratory markers for early diagnosis of acute pancreatitis with reasonable sensitivity and specificity. Urinary trypsinogen-2 (UT-2) has been increasingly used but its clinical value for the diagnosis of acute pancreatitis and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis has not yet been systematically assessed. DATA SOURCES: A comprehensive search was carried out using PubMed (MEDLINE), Embase, and Web of Science for clinical trials, which studied the usefulness of UT-2 as a diagnostic marker for acute pancreatitis. Sensitivity, specificity and the diagnostic odds ratios (DORs) with 95% confidence interval (CI) were calculated for each study and were compared with serum amylase and lipase. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated. RESULTS: A total of 18 studies were included. The pooled sensitivity and specificity of UT-2 for the diagnosis of acute pancreatitis were 80% and 92%, respectively (AUC=0.96, DOR=65.63, 95% CI: 31.65-139.09). The diagnostic value of UT-2 was comparable to serum amylase but was weaker than serum lipase. The pooled sensitivity and specificity for the diagnosis of post-ERCP pancreatitis were 86% and 94%, respectively (AUC=0.92, DOR=77.68, 95% CI: 24.99-241.48).CONCLUSIONS: UT-2 as a rapid test could be potentially used for the diagnosis of post-ERCP pancreatitis and to an extent, acute pancreatitis. Further studies are warranted to confirm these results.
文摘Background: Acute pancreatitis is one of the most serious complications of ERCP. Early diagnosis of post ERCP pancreatitis helps physicians to provide intensive care and possible medical treatment as early as possible. Trypsinogen-2 in urine is a good diagnostic and prognostic marker of acute pancreatitis. Objectives: To evaluate the diagnostic value of urinary trypsinogen-2 dipstick test for early diagnosis of post ERCP pancreatitis. Methods: A total of 37 patients with obstructive jaundice were tested with the urinary trypsinogen-2 dipstick test and serum levels of amylase and lipase before ERCP and 6 hours after ERCP. Results: Post ERCP pancreatitis was diagnosed in 6 (16%) of 37 patients. The sensitivity, specificity, positive predictive value and negative predictive value of urinary trypsinogen-2 dipstick test at 6 hours after ERCP were 100%, 97%, 86%, 100% respectively. At the cutoff level (130 U/L) for lipase, the positive predictive value and negative predictive value all were (100%), however, the positive predictive value and negative predictive value for amylase levels at cutoff (122 U/L) were 60%, 100% respectively. Serum lipase level was the best test for diagnosing post ERCP pancreatitis followed by the urinary trypsinogen-2 dipstick test. Conclusions: The urinary trypsinogen-2 dipstick test can be used as a rapid and easy test for early diagnosis of post ERCP pancreatitis with high sensitivity and specificity.
基金Supported by grants from the Institute de Salud Carlos III No.C03/02,No. G03/156
文摘AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP),and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnosisof acute pancreatitis.METHODS: Patients with acute abdominal pain and hospitalized within 24 h after the onset of symptoms were prospectively studied. Urinary trypsinogen-2 was considered positive when a clear blue line was observed (detection limit 50 μg/L). Urinary TAP was measured using a quantitative solid-phase ELISA, and serum and urinary CAPAP by a radioimmunoassay method.RESULTS: Acute abdominal pain was due to acute pancreatitis in 50 patients and turned out to be extrapancreatic in origin in 22 patients. Patients with acute pancreatitis showed significantly higher median levels of serum and urinary CAPAP levels, as well as amylase and lipase than extrapancreatic controls. Median TAP levels were similar in both groups. The urinary trypsinogen-2 test strip was positive in 68% of patients with acute pancreatitis and 13.6% in extrapancreatic controls (P<0.01). Urinary CAPAP was the most reliable test for the diagnosis of acute pancreatitis (sensitivity 66.7%, specificity 95.5%, positive and negative predictive values 96.6% and 56.7%, respectively), with a 14.6 positive likelihood ratio for a cut-off value of 2.32 nmol/L.CONCLUSION: In patients with acute abdominal pain,hospitalized within 24 h of symptom onset, CAPAP in serum and urine was a reliable diagnostic marker of acute pancreatitis. Urinary trypsinogen-2 test strip showed a clinical value similar to amylase and lipase.Urinary TAP was not a useful screening test for the diagnosis of acute pancreatitis.
基金financially supported by the Natural Science Foundation of China(No.82003766)Taishan Scholars Program(NO.tsqn202211219)+1 种基金the Key Research and Development Project of Shandong Province(No.2021ZDSYS27)Shandong Province nature fund surface project(Grant No.ZR2024MH088)。
文摘Background:Studies have shown that individuals who receive early treatment for rheumatoid arthritis(RA)are more likely to approach life positively,avoiding joint damage and the need for joint replacement surgery.The diagnosis of early rheumatoid arthritis(ERA)is crucial for effective treatment and prognosis of patients.Urine,as a diagnostic medium,offers the advantages of non-invasive diagnosis.Urinary metabolites can serve as biomarkers for diagnosis,prognosis,and risk prediction,improving specificity and accuracy.Methods:We recruited 37 ERA patients with a history of less than 3 months and a score of 6,26 osteoarthritis(OA)patients,and 30 healthy controls(HC).Urine samples were collected for 16S rRNA sequencing,and untargeted liquid chromatography-mass spectrometry(LC-MS)was used to detect metabolites.Bioinformatics approaches were employed to identify pathogenic metabolites as specific risk factors for ERA precisely.Results:2-methylnaphthalene was identified as a biomarker for ERA in urine.Prevotella,a major part of the urinary microbiome in ERA patients,exhibited a positive correlation with 2-methylnaphthalene.Notably,there were significant variations in urine metabolites among patients with ERA,OA,and HC.2-Methylnaphthalene was found to be significantly enriched in ERA.Besides,inflammatory factors were elevated in ERA patients.The research further demonstrated a positive correlation between rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and the metabolite 2-methylnaphthalene.Conclusion:The urine metabolite 2-methylnaphthalene can be a risk factor for early urinary tract infections and may contribute to accurately screening early-risk metabolites in ERA.
基金supported by National High Level Hospital Clinical Research Funding[BJ-2023-112,BJ-2018-204]Central Government Guidance Fund for Local Science and Technology Development[202407AB110013].
文摘Objective Coronavirus disease 2019(COVID-19)can result in fatigue and post-exertional malaise;however,whether severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection exacerbates lower urinary tract symptoms(LUTS)is unclear.This study investigated the association between prenatal SARS-CoV-2 infection and postpartum LUTS.Methods A multicenter,retrospective cohort study was conducted at two tertiary hospitals in China from November 1,2022,to November 1,2023.Participants were classified into infected and uninfected groups based on SARS-CoV-2 antigen results.LUTS prevalence and severity were assessed using self-reported symptoms and the Incontinence Impact Questionnaire-Short Form(IIQ-7).Pelvic floor muscle activity was measured using electromyography following the Glazer protocol.Group comparisons were performed to evaluate the association of SARS-CoV-2 infection with LUTS and electromyography parameters,with stratified analyses conducted using SPSS version 26.0.Results Among 3,652 participants(681 infected,2,971 uninfected),no significant differences in LUTS prevalence or IIQ-7 scores were observed.However,SARS-CoV-2 infection was an independent factor influencing the electromyographic activity of the pelvic floor muscles(mean tonic contraction amplitudes),regardless of delivery mode(P=0.001).Conclusion Prenatal SARS-CoV-2 infection was not significantly associated with an increased risk of postpartum LUTS but independently altered pelvic floor muscle electromyographic activity,suggesting potential neuromuscular effects.
基金Supported by Huzhou Science and Technology Bureau,No.2023GYB16.
文摘BACKGROUND Postpartum stress urinary incontinence(SUI)symptoms affect a patient’s daily activities and quality of life and increase the negative emotions that they experience.At present,there is no research on the effect of fractional CO_(2)laser treatment combined with Kegel exercise on postpartum SUI and postpartum depression and anxiety.AIM To investigate the effect of lattice CO_(2)laser treatment combined with Kegel exercise on mild to moderate postpartum SUI and its influence on postpartum depression and anxiety.METHODS Using a retrospective study,data from 82 cases of mild to moderate postpartum SUI in Huzhou Maternal&Child Health Care Hospital from January to April 2024 were retrospectively collected.The cases were divided into groups according to the different treatment methods,namely Group S(41 cases,only receiving lattice CO_(2)laser treatment)and Group L(41 cases,receiving lattice CO_(2)laser combined with Kegel exercise treatment).The baseline data of the two groups were compared.In addition,we analyzed and compared the scores of the international commission on urinary incontinence questionnaire short form(ICI-Q-SF),incontinence quality of life questionnaire(I-QOL),Edinburgh postnatal depression scale(EPDS),and postpartum specific anxiety scale(PSAS)before treatment,at the end of treatment,and 3 months after the end of treatment between the two groups.Furthermore,the clinical efficacy and adverse reactions of the two groups were analyzed and compared at the end of treatment and 3 months after the end of treatment.RESULTS There was no significant difference in the baseline data and the ICI-Q-SF,I-QOL,EPDS,and PSAS scores between the two groups before treatment.However,at the end of treatment,the ICI-Q-SF,I-QOL,EPDS,and PSAS scores between Groups L and S were significantly different.The overall effective rate of treatment in Group L was significantly higher than that in Group S.During the 3-month follow-up after treatment,it was found that the ICIQ-SF,EPDS,and PSAS scores of Group L were still lower than those of Group S.In comparison,the I-QOL score and total effective rate of treatment were still higher in Group L than those in Group S,and this difference was significant.There was no significant difference in the adverse reactions between Group L and Group S.CONCLUSION The combination of dot lattice CO_(2)laser and Kegel exercise has a significant therapeutic effect on mild to moderate postpartum SUI.It can prolong the duration of therapeutic effects,improve a patient’s quality of life,and alleviate postpartum depression and anxiety.
