Objective:To compare the efficacy and clinical practicality of fluorescence in situ hybridization (FISH), thinprep cytology test (TCT), urine nuclear matrix protein 22 (NMP22) and urine cytology test in the diagnosis of upper tract urothelial carcinoma (UTUC). Methods:A retrospective analysis was conducted on the clinical data of 62 patients who underwent surgical treatment (biopsy or partial urothelial resection) for suspected UTUC in the Department of Urology, Peking University Third Hospital from January 2021 to December 2023, and received paraffin pathological diagnosis. Taking the pathological examination results as the diagnostic criteria, the sensitivity, specificity, Youden index, positive predictive value and negative predictive value of the four detection methods in the diagnosis of UTUC were calculated, and the cost-effectiveness analysis was performed. Combine the four detection methods in pairs, calculate the sensitivity, specificity and Youden index after the combination, and conduct a cost-effectiveness analysis. The comparison of sensitivity, specificity and Youden index of the four detection methods was conducted using Chi-test or Fisher exact probability method. The comparison between groups after pairwise combinations was also conducted using Chi-test or Fisher exact probability method. The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was calculated.Results:The sensitivity (81.1%, 77.4%) and Youden index (0.700, 0.774) of FISH group and TCT group were significantly higher than those of NMP22 group and urine cytology group (39.6%, 43.4%; 0.174, 0.434), and the differences were statistically significant ( P<0.008 3). There were no statistically significant in the specificity (88.9%, 100.0%, 77.8%, 100.0%), positive predictive value (97.7%, 100.0%, 91.3%, 100.0%) and negative predictive value (44.4%, 42.9%, 17.9%, 23.1%) of the four groups ( P>0.008 3). The cost-effectiveness of the FISH group (3 256.4) was significantly higher than that of the TCT group (409.4), the NMP22 group (398.2) and the urine cytology group (627.9). After being combined in pairs, the net sensitivity of NMP22+ urine cytology (45.3%) was significantly lower than that of FISH+ TCT(88.7%), TCT+ NMP22(81.1%), FISH+ NMP22(86.8%), FISH + urine cytology (84.9%), TCT+ urine cytology (86.8%), and the difference was statistically significant ( P<0.008 3). The net specificities of the above combinations were 77.8%, 88.9%, 77.8%, 88.9%, 100.0%, respectively, and the differences were not statistically significant ( P>0.008 3). The cost-effectiveness was 1 008.0, 3 393.5, 632.8, 3 345.0, 3 513.5, and 737.3, respectively. Conclusions:In the diagnosis of UTUC, TCT has the highest diagnostic efficacy and relatively low cost, and is recommended for widespread promotion and application in clinical practice. If the patients economic conditions permit, it is recommended to combine TCT with urine cytology.

Objective To compare the curative effect with high frequent oscillation ventilation (HFOV) and with HFOV + inhaled nitric oxide (iNO) in the treatment of neonatal hypoxic respiratory failure (NRHF).Methods Data of 60 NHRF patients in the People's Hospital of Dehong Prefecture from January 2015 to December 2016 were retrospectively analyzed.The patients were divided into HFOV group (32 cases) and HFOV + iNO group (28 cases) according to the treatment methods.The comparison between the 2 groups was established as following:oxygenation index(OI),arterial partial pressure of carbon dioxide [Pa (CO2)] and complications.Results There was no significant difference between the 2 groups in time of birth,gestational age,birth weight,gender ratio and original diseases (all P ＞ 0.05).As for OI there was no significant difference at 0 h between the 2 groups (27.8 ± 3.5 vs.27.6 ± 3.7) (t =0.04,P ＞ 0.05);OI of HFOV + iNO group (11.2 ± 3.4,7.3 ± 3.0,7.0 ± 2.6,respectively) was more significantly decreased than that in the HFOV group (14.5 ± 3.3,9.6 ± 3.0,8.5 ± 2.8,respectively) at 8 h,16 h,24 h,and there were significant differences between the 2 groups (t =3.81,5.16,2.14,all P ＜ 0.05).As for P a (CO2) there was no significant difference at 0 h [(65.14 ± 14.97) mmHg vs.(64.79 ± 13.40) mmHg] (t =0.095,P ＞ 0.05);the changes in Pa (CO2) had no statistically significance difference between HFOV + iNO group and HFOV group at 8 h,16 h,24 h [8 h:(50.71 ± 10.49) mmHg vs.(49.02 ± 11.74) mmHg,16 h:(40.99 ± 12.38) mmHg vs.(40.02 ± 12.04) mmHg,and 24 h:(39.01 ±9.80) mmHg vs.(38.00 ±7.85) mmHg,all P ＞0.05].As for the complications,there was no difference between the 2 groups in pulmonary air leak,pneumorrhagia,intracranial hemorrhage,blood platelet ＜100 × 109/L,methemoglobin concentration ＞ 3％,or dysfunction of blood coagulation (all P ＞ 0.05).Conclusion Both HFOV and HFOV + iNO methods are effective for NRHF.Treatment with HFOV + iNO method is more effective.Treatment for NHRF with HFOV + iNO is safe,effective,without complication increase in a short term.