AIM:To compare the imaging results with histology and to evaluate the diagnostic sensitivity of imaging modalities for hepatocellular carcinoma(HCC)smaller than 2 cm.METHODS:Nodules smaller than 2 cm(n=34)revealed by ...AIM:To compare the imaging results with histology and to evaluate the diagnostic sensitivity of imaging modalities for hepatocellular carcinoma(HCC)smaller than 2 cm.METHODS:Nodules smaller than 2 cm(n=34)revealed by ultrasonography(US)in 29 patients with liver cirrhosis were analyzed.Histological diagnosis of HCC was performed by ultrasonographic guidance:moderately-differentiated HCC(n=24);well-differentiated HCC(n=10).The patterns disclosed by the four imaging modalities defined the conclusive diagnosis of HCC:(1)contrast-enhanced computed tomography(CECT),hypervascularity in the arterial phase and washout in the equilibrium phase;(2)Sonazoid contrast-enhanced US(CEUS),hypervascularity in the early vascular phase and defect in the Kupffer phase;(3)gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid(Gd-EOBDTPA)-enhanced magnetic resonance imaging(MRI),hypervascularity in the arterial phase and/or defect in the hepatobiliary phase;and(4)CT arterioportal angiography:hypervascularity by CT during arteriography and/ or perfusion defect by CT during arterial portography.RESULTS:Overall,the sensitivity of diagnosing HCC smaller than 2 cm was 52.9%(18/34)(95%CI:35.170.2)by CECT;67.6%(23/34)(95%CI:49.5-82.6)by Sonazoid CEUS;76.5%(26/34)(95%CI:58.8-89.3) by Gd-EOB-DTPA MRI;and 88.2%(30/34)(95%CI: 72.5-96.7)by CT arterioportal angiography.The diagnostic sensitivity of detecting moderately-differentiated HCC by CECT,Sonazoid CEUS,Gd-EOB-DTPA MRI and CT arterioportal angiography was 62.5%(15/24)(95%CI: 40.6-81.2),79.2%(19/24)(95%CI:57.8-92.9),75.0% (18/24)(95%CI:53.3-90.2)and 95.8%(23/24)(95% CI:78.9-99.9),respectively.A significant difference(P< 0.05)was observed between CECT and CT arterioportal angiography in all nodules.There was no difference between Sonazoid CEUS,Gd-EOB-DTPA MRI,and CT arterioportal angiography.The combined sensitivity of Sonazoid CEUS and Gd-EOB-DTPA MRI was 94.1%(32/34).CONCLUSION:Changing the main diagnostic modality for HCC smaller than 2 cm from CT arterioportal angiography to Sonazoid CEUS and Gd-EOB-DTPA MRI is recommended.展开更多
This study aimed to evaluate the sensitivity and specificity of the new clinical diagnostic and classification criteria for Kashin-Beck disease （KBD） using six clinical markers： flexion of the distal part of finger...This study aimed to evaluate the sensitivity and specificity of the new clinical diagnostic and classification criteria for Kashin-Beck disease （KBD） using six clinical markers： flexion of the distal part of fingers, deformed fingers, enlarged finger joints, shortened fingers, squat down, and dwarfism. One-third of the total population in Linyou County was sampled by stratified random sampling.展开更多
Clinical genomic surveillance is regarded as the gold standard for monitoring SARS-CoV-2 variants globally.However,as the pandemic wanes,reduced testing poses a risk to effectively tracking the trajectory of these var...Clinical genomic surveillance is regarded as the gold standard for monitoring SARS-CoV-2 variants globally.However,as the pandemic wanes,reduced testing poses a risk to effectively tracking the trajectory of these variants within populations.Wastewater-based genomic surveillance that estimates variant frequency based on its defining set of alleles derived from clinical genomic surveillance has been successfully implemented.This method has its challenges,and allele-specific(AS)RT-qPCR or RT-dPCR may instead be used as a complementary method for estimating variant prevalence.Demonstrating equivalent performance of these methods is a prerequisite for their continued application in current and future pandemics.Here,we compared single-allele frequency using ASRT-qPCR,to single-allele or haplotype frequency estimations derived from amplicon-based sequencing to estimate variant prevalence in wastewater during emergent and prevalent periods of Delta,Omicron,and two sub-lineages of Omicron.We found that all three methods of frequency estimation were concordant and contained sufficient information to describe the trajectory of variant prevalence.We further confirmed the accuracy of these methods by quantifying the diagnostic performance through Youden's index.The Youden's index of AS-RT-qPCR was reduced during the low prevalence period of a particular variant while the same allele in sequencing was negatively influenced due to insufficient read depth.Youden's index of haplotype-based calls was negatively influenced when alleles were common between variants.Coupling AS-RT-qPCR with sequencing can overcome the shortcomings of either platform and provide a comprehensive picture to the stakeholders for public health responses.展开更多
文摘AIM:To compare the imaging results with histology and to evaluate the diagnostic sensitivity of imaging modalities for hepatocellular carcinoma(HCC)smaller than 2 cm.METHODS:Nodules smaller than 2 cm(n=34)revealed by ultrasonography(US)in 29 patients with liver cirrhosis were analyzed.Histological diagnosis of HCC was performed by ultrasonographic guidance:moderately-differentiated HCC(n=24);well-differentiated HCC(n=10).The patterns disclosed by the four imaging modalities defined the conclusive diagnosis of HCC:(1)contrast-enhanced computed tomography(CECT),hypervascularity in the arterial phase and washout in the equilibrium phase;(2)Sonazoid contrast-enhanced US(CEUS),hypervascularity in the early vascular phase and defect in the Kupffer phase;(3)gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid(Gd-EOBDTPA)-enhanced magnetic resonance imaging(MRI),hypervascularity in the arterial phase and/or defect in the hepatobiliary phase;and(4)CT arterioportal angiography:hypervascularity by CT during arteriography and/ or perfusion defect by CT during arterial portography.RESULTS:Overall,the sensitivity of diagnosing HCC smaller than 2 cm was 52.9%(18/34)(95%CI:35.170.2)by CECT;67.6%(23/34)(95%CI:49.5-82.6)by Sonazoid CEUS;76.5%(26/34)(95%CI:58.8-89.3) by Gd-EOB-DTPA MRI;and 88.2%(30/34)(95%CI: 72.5-96.7)by CT arterioportal angiography.The diagnostic sensitivity of detecting moderately-differentiated HCC by CECT,Sonazoid CEUS,Gd-EOB-DTPA MRI and CT arterioportal angiography was 62.5%(15/24)(95%CI: 40.6-81.2),79.2%(19/24)(95%CI:57.8-92.9),75.0% (18/24)(95%CI:53.3-90.2)and 95.8%(23/24)(95% CI:78.9-99.9),respectively.A significant difference(P< 0.05)was observed between CECT and CT arterioportal angiography in all nodules.There was no difference between Sonazoid CEUS,Gd-EOB-DTPA MRI,and CT arterioportal angiography.The combined sensitivity of Sonazoid CEUS and Gd-EOB-DTPA MRI was 94.1%(32/34).CONCLUSION:Changing the main diagnostic modality for HCC smaller than 2 cm from CT arterioportal angiography to Sonazoid CEUS and Gd-EOB-DTPA MRI is recommended.
基金supported by the National Natural Scientific Foundation of China(81472924,81620108026)the Fundamental Research Funds for the Central Universities in 2015
文摘This study aimed to evaluate the sensitivity and specificity of the new clinical diagnostic and classification criteria for Kashin-Beck disease （KBD） using six clinical markers： flexion of the distal part of fingers, deformed fingers, enlarged finger joints, shortened fingers, squat down, and dwarfism. One-third of the total population in Linyou County was sampled by stratified random sampling.
基金funded and supported by Ontario's Ministry of Environment,Conservation,and Parks SARS-CoV-2 surveillance initiative(awarded to the University of Ottawa)by CHEO(Children's Hospital of Eastern Ontario)CHAMO(Children's Hospital Academic Medical Organization).
文摘Clinical genomic surveillance is regarded as the gold standard for monitoring SARS-CoV-2 variants globally.However,as the pandemic wanes,reduced testing poses a risk to effectively tracking the trajectory of these variants within populations.Wastewater-based genomic surveillance that estimates variant frequency based on its defining set of alleles derived from clinical genomic surveillance has been successfully implemented.This method has its challenges,and allele-specific(AS)RT-qPCR or RT-dPCR may instead be used as a complementary method for estimating variant prevalence.Demonstrating equivalent performance of these methods is a prerequisite for their continued application in current and future pandemics.Here,we compared single-allele frequency using ASRT-qPCR,to single-allele or haplotype frequency estimations derived from amplicon-based sequencing to estimate variant prevalence in wastewater during emergent and prevalent periods of Delta,Omicron,and two sub-lineages of Omicron.We found that all three methods of frequency estimation were concordant and contained sufficient information to describe the trajectory of variant prevalence.We further confirmed the accuracy of these methods by quantifying the diagnostic performance through Youden's index.The Youden's index of AS-RT-qPCR was reduced during the low prevalence period of a particular variant while the same allele in sequencing was negatively influenced due to insufficient read depth.Youden's index of haplotype-based calls was negatively influenced when alleles were common between variants.Coupling AS-RT-qPCR with sequencing can overcome the shortcomings of either platform and provide a comprehensive picture to the stakeholders for public health responses.
