目的 探讨胰性脑病的可能的发病机制、发病情况及防治措施.方法 计算机检索中文科技期刊全文数据库(1989～2004),收集有关胰性脑病的临床研究,并进行统计分析.结果 共纳入43篇文献,435例患者.胰性脑病在重症急性胰腺炎中的发病率远高于轻症急性胰腺炎;发病年龄趋向中、老年;病死率为43.67%;病因仍以胆系疾病为主;伴发低氧的几率不高于未并发胰性脑病患者.结论 胰性脑病的发生可能是多因素共同作用的结果,仍需进一步探讨其发病机制.血清髓鞘碱性蛋白有望成为有价值的诊断指标.防治以治疗原发病急性胰腺炎为主,重在预防.胰酶抑制剂和早期营养支持有一定预防作用.
Objective To explore the relationship between different diagnostic criteria (ATPIII2002, IDF2005 and CDS2007 criteria) for metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD). Methods A total of 666 elderly males admitted to West China Hospital for routine physical examination were involved in this study in May, 2010. The diagnostic agreement rates of different criteria were compared, along with the relationship between different diagnostic criteria for MS and NALFD. Results The diagnostic agreement of CDS2007 criteria with either IDF2005 or ATPIII2002 criteria was good. However, the agreement of ATPIII2002 with IDF2005 was compromised. The prevalence of NAFLD in MS group was significantly higher than that of non-MS group (Plt;0.01). On the basis of CDS2007 criteria, there was significant correlation between NAFLD and MS (Plt;0.000). Conclusion There is a close relation between NAFLD and all three diagnostic criteria of MS. NAFLD is one of the most important risk factors of MS. The diagnostic agreement of CDS2007 criteria with the other two is good, and there is significant correlation between NAFLD and criteria CDS2007 of MS. CDS2007 is found to be of high accuracy and applicability in the diagnosis of MS in Chinese population including the elderly.
The significant increase in mortality after tuberculosis (TB) progression to severe disease is a major obstacle to achieving the goal of ending the TB epidemic by 2035. Up to now, there is no clear definition and diagnostic criteria for adult severe tuberculosis at home or abroad, which has a significant adverse impact on the early diagnosis and timely treatment of patients with severe tuberculosis. In order to improve the treatment level of patients with severe pulmonary tuberculosis, reduce mortality and improve prognosis. The Professional Committee of Tuberculosis Science of the Chinese Society of Research Hospitals and Shenzhen Third People's Hospital/National Clinical Medical Research Center of Infectious Diseases/Shenzhen Tuberculosis Clinical Medical Research Center led the formulation of "Guidelines for definition and diagnosis of severe pulmonary tuberculosis in adults in China (2023)", aiming to guide and standardize the definition and diagnosis of severe tuberculosis. So as to improve the level of diagnosis and treatment of severe pulmonary tuberculosis in our country, to maximize the benefit of patients.
目的 采用已有的4种国际非孕弥散性血管内凝血（DIC）诊断评分标准对产科DIC的诊断进行评估，探索更适合产科DIC诊断的“金标准”。 方法 选择2009年6月－2012年6月期间产科拟诊DIC的孕产妇为研究对象，用日本卫生福利部（JMHW）提出的JMHW、日本危重病协会（JAAM）提出的JAAM、国际血栓与止血委员会（ISTH）提出的ISTH显性和ISTH非显性4种诊断评分标准联合诊断和构建“金标准”，以此评价4种诊断标准对产科DIC诊断的特性。 结果 受试者工作特征（ROC）曲线分析显示ISTH非显性标准、ISTH显性标准、JMHW、JAAM的ROC曲线下面积分别为0.939、0.865、0.867、0.867，ISTH非显性标准灵敏度和特异度与“金标准”在不同诊断界值时较一致，同时优于其他3种诊断标准。 结论 ISTH非显性标准较适合作为临床产科DIC诊断，其对产科这一特殊发病人群的DIC诊断具有更科学的临床诊断价值。
COPD是以不完全可逆性气流受限为特征的进展性肺疾病， 与肺部对香烟烟雾等有害气体或有害颗粒的异常炎症反应有关。病理改变存在于外周气道、中央气道、肺实质和肺血管系统等， 也可引起肺外的不良效应， 但外周气道病变和功能异常是导致不完全可逆气流受限的主要原因。国内外采用吸入支气管舒张剂后一秒率( FEV1／FVC) 小于70％来进行定性诊断。
On September 27, 2022, the first international standard of Diagnosis and Classification of Optic Neuritis was published online in Lancet Neurology, the top journal of neurology. The publication of this standard fills the gap in the international diagnosis and classification of optic neuritis (ON), promotes the consistency of the global diagnosis classification of ON, and helps ophthalmologists and neurologists to diagnose ON more accurately in the future. In recent decades, although Chinese ophthalmologists have made great progress in their understanding of ON and diagnosis and treatment level, it is still necessary to continue to strengthen the standardized training of Chinese neuro-ophthalmologist specialists, cooperate to establish a national ON clinical epidemiology database, carry out Chinese multi-center clinical studies, and further verify and optimize the international ON diagnostic system in future clinical practice. The ON diagnostic standards and treatment standards are gradually improved for China.
Infective endocarditis (IE) is a potentially fatal disease. Although pathological examination is the gold standard for the diagnosis of IE, only a small number of patients undergo this examination. The clinical diagnosis of IE still mainly relies on its clinical symptoms. However, the systemic manifestations of IE are diverse and often non-cardiac specific, which poses a great challenge to diagnosis. Based on the clinical presentations, imaging characteristics, and etiological data of IE, experts at home and abroad have developed a variety of diagnostic tools. Over the past thirty years, there have been significant changes in the microbiological and epidemiological characteristics of IE, and at the same time, the advancement of imaging and laboratory diagnostic technologies has also had an important impact on diagnostic methods, leading to the continuous evolution of diagnostic criteria and tools. This article reviews and interprets the main diagnostic criteria for IE, analyzes its development history, current changes, and efficacy, aiming to provide a perspective on the historical evolution of diagnostic tools and to offer prospects for future research directions.