Objective To systemically evaluate the accuracy of f/t-PSA for diagnosing prostate cancer with a t-PSA level of 4-10ng/mL through meta-analysis. Methods A literature search of CBM, VIP, CNKI and Wanfang Data from 1999 to 2009 was performed. Related journals were also searched manually. Two reviewers independently assessed trial quality according to QUADAS items. Heterogenous studies and meta-analysis were conducted by Meta-Disc1.4 software. The analysis was based on different critical values of f/t-PSA (0.1, 0.15, 0.2, 0.25, and 0.3). Results Total 18 studies involving 2217 subjects were included. No threshold effect was found. But there was heterogeneity due to other factors. The meta–analysis showed that, the sensitivity of f/t-PSA with the critical value of 0.15 for the diagnosis of prostate cancer with a t-PSA level of 4-10ng/mL was 75% (95%CI 70%-79%), and the specificity was 81% (95%CI 78%-84%). The area under SROC curve was 0.883 5, and the Q index was 0.814 0. Conclusion The f/t-PSA is a better index for diagnosing prostate cancer with t-PSA levels between 4 and 10ng/mL. And it is reasonable to consider 0.15 as a more suitable critical value.
【摘要】 目的 探讨常规MRI扫描及胰胆管造影（MRCP）对胆管梗阻性疾病的临床诊断价值。 方法 2006年4月-2010年6月，对59例胆管梗阻性疾病患者行常规MRI及MRCP检查，其中18例行动态增强扫描，并与临床诊断或手术、病理结果对照分析。MRCP采用不屏气厚层快速自旋回波（FSE）序列重度T2WI扫描，原始图像以最大信号强度投影（MIP）法进行三维重建。 结果 MRI及MRCP对胆管梗阻程度的判断和定位诊断准确率为100.0%，定性诊断准确率为91.5%，其中MRCP诊断胆管结石和恶性胆管梗阻的准确率分别为96.8%和86.9%。 结论 MRCP对胆管梗阻的定位诊断准确，结合3D原始图像、常规MRI扫描及动态增强扫描，对胆管结石和恶性胆管梗阻的定性诊断有很高的准确性。【Abstract】 Objective To evaluate the clinical diagnosis value of MRI and cholangiopancreatography (MRCP) in diagnosis of biliary obstructive disease. Methods Routine MRI and MRCP were performed on 59 patients between April 2006 and June 2010, in which dynamic enhance scan was performed on 18 patients. The results were compared with clinical diagnosis or surgical findings and pathological examination. Non-breath-hold thick slices heavy T2 weighted TSE sequence was used. The original images were reconstructed by using three-dimensional maximum-intensity-projection (MIP) algorithm. Results The accuracy of MRI and MRCP in the detection of the degree and level of bile duct obstruction was 100.0 % and the accuracy for evaluating the causes of obstruction was 91.5 %. In the diagnosis of bile duct stone and malignant biliary obstruction, the diagnostic rate of MRCP was 96.8 % and 86.9%. Conclusion Routine MRI and MRCP examination can accurately define the level of bile duct obstruction. Combining with the original images and routine images and dynamic enhance scan, the specificity for the diagnosis of bile duct stone and malignant biliary obstruction is high.
ObjectiveThe aim of this study was to assess the disease burden of non-COVID-19 lower respiratory infection (LRI) in China during the period 1990−2021, particularly during the period 2019−2021. MethodsData on the burden of disease for LRI in China were obtained from the GBD2021 database. A Joinpoint regression model was used to describe the changes in disease burden trends of LRI in China from 1990 to 2021, and the results are presented in terms of average annual percentage change (AAPC). ResultsIn 2021, the age-standardized incidence rate of LRI in China was 2 853.31/100 000, the age-standardized rate of DALY was 347.67/100 000, and the age-standardized mortality rate was 14.03/100 000. Compared with 1990, the AAPC were: −2.13%, −6.89% and −4.10% respectively. In contrast, during the COVID-19 pandemic, both showed a decreasing and then increasing trend, except for the age-standardized incidence rate, which showed a decreasing trend. Children under 5 years of age have experienced the greatest reduction in the burden of disease over the past decades, while the burden of disease has increased in absolute terms for the elderly over 70 years of age. Compared with 1990, the disease burden of LRI in China due to each pathogenic microorganism has decreased. And during 2019−2021, all pathogens showed an increasing trend, except for ASMR caused by influenza (APC=−55.21%) and respiratory syncytial virus (APC=−53.35%). In 2021, the primary attributable risk factors for LRI mortality in China shifted from household air pollution due to solid fuels, childhood underweight, and childhood stunting in 1990 to ambient particulate matter pollution, smoking, and secondhand smoke. ConclusionThe disease burden of LRIs in China showed an overall decreasing trend from 1990 to 2021, but with large variations between age groups and pathogens. During the two years following the outbreak of the COVID-19 pandemic, the incidence of LRI in China, along with the disease burden caused by influenza and respiratory syncytial virus, significantly declined. Over the past few decades, the attributable risk factors for mortality and DALYs have undergone substantial changes. To address this phenomenon, targeted measures should be implemented to reduce the burden of LRI on the population caused by air pollution and smoking.