Objective:To evaluate the role of histogram analysis based on amide proton transfer weighted (APTw) and apparent diffusion coefficient (ADC) imaging in predicting alpha-thalassemia/mental retardation syndrome X-linked ( ATRX) mutation in isocitrate dehydrogenase ( IDH)-mutant WHO grading 2/3 gliomas. Methods:Seventy-eight patients with IDH-mutant WHO grading 2/3 gliomas, admitted to and confirmed by surgical pathology in Department of Functional Neurosurgery, Neurosurgery Center, Zhujiang Hospital, Southern Medical University from June 2017 to October 2023, including 52 with ATRX wild and 26 with ATRX mutant-type, were selected. Preoperative 3D-APTw and ADC imaging data were collected; after post-processing, the lesions were segmented using lesion outlining method based on inclusion of peri-tumor edema and lesion outlining method based on tumor entity, respectively; after that, the histogram features (the 10 th percentile, 90 th percentile, maximum, mean, median, minimum, skewness, kurtosis, entropy, range, uniformity, and variance) were extracted from 3D-APTw and ADC imaging, respectively. Univariate Logistic regression was used to compare the differences in histogram features between patients in the ATRX mutant group and ATRX wild-type group, and multivariate Logistic regression was used to screen the independent predictors for ATRX mutation (a Logistic regression prediction model was constructed). Predictive values of independent predictors and Logistic regression prediction models in ATRX mutation were evaluated by receiver operating characteristic (ROC) curve. Results:(1) With lesion outlining method based on inclusion of peri-tumor edema, univariate analysis indicated significant difference between ATRX mutant group and ATRX wild-type group in 9 histogram features: relative 3D-APTw minimum, 3D-APTw skewness, relative ADC 90 th percentile, relative ADC mean, relative ADC median, ADC kurtosis, ADC skewness, ADC uniformity, and ADC entropy ( P<0.05). With lesion outlining method based on tumor entity, univariate analysis indicated significant difference between ATRX mutant group and ATRX wild-type group in 9 histogram features: relative 3D-APTw 90 th percentile, 3D-APTw skewness, relative ADC 90 th percentile, relative ADC mean, relative ADC median, ADC kurtosis, ADC skewness, ADC uniformity and ADC entropy ( P<0.05). (2) With lesion outlining method based on inclusion of peri-tumor edema, multivariate Logistic regression showed that 3D-APTw skewness and ADC kurtosis were the independent predictor for ATRX mutation in IDH mutant WHO grading 2/3 glioma patients ( OR=0.168, 95% CI: 0.034-0.800, P=0.025; OR=0.508, 95% CI: 0.319-0.807, P=0.004). The constructed Logistic regression prediction model was P(Y=1|X)=1/1+e -(1.827-1.785×3D-APTw skewness-0.678×ADC kurtosis). With lesion outlining method based on tumor entity, multivariate Logistic regression showed that 3D-APTw skewness and ADC kurtosis were independent predictors for ATRX mutation in IDH mutant WHO grading 2/3 glioma patients ( OR=0.164, 95% CI: 0.034-0.791, P=0.024; OR=0.496, 95% CI: 0.312-0.788, P=0.003); the constructed Logistic regression prediction model was P(Y=1|X)=1/1+e -(1.585-1.810×3D-APTw skewness-0.702×ADC kurtosis). (3) ROC curve analysis showed that, with lesion outlining method based on inclusion of peri-tumor edema, area under ROC curve (AUC) of 3D-APTw skewness and ADC kurtosis was 0.725 (95% CI: 0.608-0.842, P=0.001) and 0.794 (95% CI: 0.685-0.904), respectively ( P<0.001); AUC of Logistic regression prediction model was 0.836 (95% CI: 0.729-0.942, P<0.001), and its sensitivity and specificity were 73.10% and 90.40% when the best threshold was 0.505. ROC curve showed that, with lesion outlining method based on tumor entity, AUC of 3D-APTw skewness and ADC kurtosis was 0.705 (95% CI: 0.587-0.823, P=0.003) and 0.808 (95% CI: 0.704-0.913), respectively ( P<0.001); AUC of Logistic regression prediction model was 0.844 (95% CI: 0.739-0.949, P<0.001), and its sensitivity and specificity were 84.60% and 80.80% when the best threshold was 0.399. Conclusion:Histogram analysis based on 3D-APTw and ADC imaging can predict ATRX mutation in IDH mutant WHO grading 2/3 gliomas to a certain extent.

Objective:To improve work efficiency and reduce errors through intelligent pre-analytical process reengineering.Methods:Tumor and infection marker test samples from outpatients at Peking University Shenzhen Hospital from December 2021 to February 2023 were collected. The process was integrated with sample transportation, sample sorting and secondary transfer, and laboratory automation systems, while achieving full-process information monitoring. The number of manual intervention nodes, the turnaround time (TAT) from sample collection to testing and from collection to reporting, the proportion of intelligent pre-dilution, and the number of pre-analytical errors automatically identified were compared before and after the intelligent pre-analytical process reengineering to evaluate the effect of the reengineering. Chi-square test, Fisher′s exact probability method, and Mann-Whitney U test were used for statistical analysis.Results:After implementing the intelligent process reengineering, the number of manual intervention nodes has been reduced from 13 to 2. For outpatient tumor marker samples, after the first stage of reengineering, the median TAT from collection to reporting decreased from 185 (141, 242) min to 137 (102, 183) min ( Z=-54.932, P<0.001). After the second stage of reengineering, the median TAT from collection to reporting further decreased from 137 (102, 183) min to 100 (64, 150) min ( Z=-61.346, P<0.001). For infection marker samples, after the first stage of reengineering, the median TAT from collection to reporting decreased from 392 (282, 1386) min to 229 (176, 323) min ( Z=-68.636, P<0.001). After the second stage of reengineering, the median TAT from collection to reporting further decreased from 229 (176, 323) min to 160 (110, 236) min ( Z=-62.15, P<0.001). Conclusion:Intelligent pre-analytical process reengineering can optimize workflows, improve efficiency, and reduce errors.

Objective To study the clinical significance of antinuclear antibody (ANA),anti-thyroid peroxidase antibody (TPO-Ab) and antithyroglobulin antibody (Tg-Ab),thyroid stimulating hormone (TSH),free triiodothyronine (FT3),free thyroxine (FT4) in patients with recurrent spontaneous abortion (RSA).Methods 46 women with RSA diagnosis in out patient department in Peking University Shenzhen Hospital from March 2015 to December 2016 were recruited as the study group,20 women with normal childbirth history were enrolled as the control group,ANA was detected by indirect immunofluorescence (IIF) assay and ELISA,TSH,FT3 and FT4 were detected by chemiluminescence immunoassay technology.Results The positive rates of ANA(IIF),TPO-Ab and Tg-Ab in patients with RSA were 24％,24％ and 15％ respectively which were significantly higher than those in healthy control (P＜0.05).Serum levels of TSH,TPO-Ab and Tg-Ab in patients with RSA were 2.70 ± 1.38 mIU/L,38.99 ± 10.18 IU/ml and 3.07 ± 1.69 IU/ml respectively,which were significantly higher than those in healthy cases (P＜0.05).Conclusion ANA and antithyroid antibodies were closely related with RSA.It is very important to screen ANA and antithyroid antibodies for etiological diagnosis and appropriate intervention in patients with RSA to reduce the incidence of abortion.

Objective To detect hs‐cTnT and cTnI for exploring their application value in the early diagnosis of acute myocardial infarction(AMI) .Methods From October 2015 to March 2016 ,100 patients with AMI in the cardiology department of our hospital were selected as the observation group(AMI group) and contemporaneous 100 adults undergoing physical examination as the con‐trol group .The chemiluminescence immunoassay was used to detect the levels of hs‐cTnT and cTnI .The positive rate ,sensitivity and specificity of the hs‐cTnT and cTnI in the AMI group for early diagnosis of AMI were compared .Results The level of hs‐cT‐nT in the AMI group was (4 .89 ± 1 .83)ng/mL ,which was higher than that in the healthy population by 99 percentile value 0 .014 ng/mL ;the cTnI level in the AMI group was (28 .82 ± 12 .32)ng/mL ,which was higher than that in the healthy population by the upper limit of normal reference value 0 .4 ng/mL ,both of them were significantly higher than those in the control group ( P<0 .05) ,the positive rate and sensitivity of hs‐cTnT was both 92 .0% ,which was significantly higher than 79 .0% of cTnI both(P<0 .05) ,the specificity of cTnI was 96 .0% ,which was significantly higher than 76 .0% of hs‐cTnT(P<0 .05) .Conclusion The pos‐itive rate and the sensitivity of hs‐cTnT are high ,the specificity of cTnI is high ,their joint detection has an important significance for the early diagnosis of AMI .

Objective To investigate the diagnostic value of combined detection of neutrophil CD64 index and C reactive protein (CRP) levels in newborn bacterial infectious diseases .Methods The retrospective analysis was performed on 139 neonates admitted to the neonatal department of our hospital from January to December 2015 ,including 72 cases in the bacterial infection group and 67 cases in the viral infection group ,and 50 healthy neonates were selected as the control group .The levels of CD64 and CRP and the positive rates were compared among 3 groups and analyzed .The sensitivity ,specificity ,positive predictive value and negative predictive value of CD64 and CRP in the diagnosis of bacterial infection were analyzed .Results The CD64 index and CRP levels had statistical difference between the bacterial infection with the viral infection group and normal control group (P<0 .05) ,the CD64 index and CRP levels after treatment in the bacterial infection group were significantly decreased ,the differences were statistieally significant(P<0 .05) .The sensitivity ,specificity ,positive predictive value and negative predictive value of CD64 index in the diag‐nosis of bacterial infection were 91 .7% ,92 .5% ,93 .0% and 91 .2% respectively ,which were significantly higher than those of CRP ,the differences were statistically significant (P< 0 .05).CD64 index was positively correlated with CRP (r= 0 .781 ,P<0 .01) .Conclusion The combined detection of CD64 index and CRP level helps to early diagnosis ,differential diagnosis and the therapeutic effect evaluation of bacterial infection in neonates ,moreover the diagnostic efficiency of CD64 is obviously better than that of CRP .

Objective To explore the application value of serum procalcitonin (PCT ) and amyloid protein A (SAA ) in the early diagnosis and curative evaluation of bacterial infectious diseases among preschool children in order to improve the clinical diagnosis level of early bacterial infection .Methods A total of 120 cases of pediatric infectious diseases in our hospital from January to De‐cember 2015 were selected and divided into the bacterial infection group (60 cases) and viral infection group (60 cases) ,meanwhile 50 children undergoing the physical examination were selected as the control group .The serum levels of PCT and SAA were ob‐served and compared among the three groups ,and the statistical analysis was performed by using the SPSS 19 .0 software .Results The levels of PCT and SAA in the bacterial infection group were significantly increased compared with the viral infection group and the healthy control group(P<0 .05) ,both PCT and SAA levels after effective antibiotic treatment were significantly decreased (P<0 .05);the positive rates of PCT and SAA in the bacterial infection group were 91 .7% and 95 .0% respectively ,which were signifi‐cantly higher than those in the viral infection group and the healthy control group (P<0 .05) ,the sensitivity of PCT in the diagno‐sis of bacterial infection was lower than that of SAA ,but the specificity ,positive predictive value and negative predictive value were all higher than those of SAA ,the correlation analysis showed that PCT level in the bacterial infection group was positively correla‐ted with and the SAA level(r=0 .782 ,P<0 .01) .Conclusion Detecting the PCT and SAA levels is conducive to early diagnosis , judgment of the disease condition and guidance of rational medication in bacterial infection among preschool children ,in which the efficiency of PCT for diagnosing bacterial infection is superior to SAA .

Objective To explore the effect on metabolism of glucose and lipids, potential toxicity mechanism and possible biomarker candidates by analyzing urine metabonome changes of rats after oral administration of polychlorinated biphenyl congeners( PCBs) and high fat diet alone or in combination.Methods Male SD rats were divided randomly into control group,high fat diet group, PCBs group and combination group of PCBs and high fat diet.Urine samples were collected after 6-week treatment, 1 H NMR spectra were performed and analyzed by principal component analysis ( PCA) . Results The PCA scores plot of urine 1 H NMR data showed that the combined group could be easily distinguished from the other three groups, suggesting great difference in metabolism.The loading plot of the PCA revealed significant increase in the levels of lactate, glucose, creatine, 2-hydroxy-isovaleric acid and reduction in the levels of citrate, succinate, taurine, hippurate and trimethylamine oxide ( TMAO) in the combined exposure group after six-week exposure.Conclusion The altered levels of metabolites induced by combined exposure of PCBs and high fat diet may be related to the injury to mitochondrial function, reduction of energy metabolism in tricarboxylic acid cycle (TAC).These effects possibly lead to perturbations in the metabolism of glucose, lipid and amino acids.The altered metabolites may be considered biomarker candidates of toxicity induced by exposure to PCBs and high fat diet.

OBJECTIVETo assess the predictive value of Neuropad test on occurrence of diabetic foot ulceration (DFU) among type 2 diabetic patients.

METHODSWe divided 725 cases of type 2 diabetic patients into the high-risk and the non-high-risk groups of DFU based on the results of vibration perception thresholds(VPT) examination, which was widely used as a criteria for predicting DFU. Receiver operating characteristic (ROC) analysis was used to compare the effectiveness of Neuropad with 10 g Semmes-Weinstein monofilament (10 g SWMF) testing in predicting the risk of DFU.

RESULTSAmong 725 patients of type 2 diabetes, 6.1% were at a high risk of DFU. Compared to non-high-risk group, patients in high-risk group had older age, longer diabetes duration, higher values of complete colour change time (CCC time) of Neuropad and higher abnormal rate of 10 g SWMF (P<0.01). CCC time of Neuropad was shown to be better in predicting the risk of DFU than 10 g SWMF, and the area under the ROC curve was about 0.8, and the best cut-off value was 22.25 min.

CONCLUSIONNeuropad is an effective means for predicting of the risk of DFU, and can be used to prevent diabetic foot ulceration.

Adult ; Aged ; Diabetic Foot ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Neurologic Examination ; methods ; Predictive Value of Tests ; Risk Assessment

Objective To assess the predictive value of Neuropad test on occurrence of diabetic foot ulceration (DFU) among type 2 diabetic patients. Methods We divided 725 cases of type 2 diabetic patients into the high-risk and the non-high-risk groups of DFU based on the results of vibration perception thresholds(VPT) examination, which was widely used as a criteria for predicting DFU. Receiver operating characteristic (ROC) analysis was used to compare the effectiveness of Neuropad with 10 g Semmes-Weinstein monofilament (10 g SWMF) testing in predicting the risk of DFU. Results Among 725 patients of type 2 diabetes, 6.1% were at a high risk of DFU. Compared to non-high-risk group, patients in high-risk group had older age, longer diabetes duration, higher values of complete colour change time (CCC time) of Neuropad and higher abnormal rate of 10 g SWMF (P<0.01). CCC time of Neuropad was shown to be better in predicting the risk of DFU than 10 g SWMF, and the area under the ROC curve was about 0.8, and the best cut-off value was 22.25 min. Conclusion Neuropad is an effective means for predicting of the risk of DFU, and can be used to prevent diabetic foot ulceration.

Objective To assess the predictive value of Neuropad test on occurrence of diabetic foot ulceration (DFU) among type 2 diabetic patients. Methods We divided 725 cases of type 2 diabetic patients into the high-risk and the non-high-risk groups of DFU based on the results of vibration perception thresholds(VPT) examination, which was widely used as a criteria for predicting DFU. Receiver operating characteristic (ROC) analysis was used to compare the effectiveness of Neuropad with 10 g Semmes-Weinstein monofilament (10 g SWMF) testing in predicting the risk of DFU. Results Among 725 patients of type 2 diabetes, 6.1% were at a high risk of DFU. Compared to non-high-risk group, patients in high-risk group had older age, longer diabetes duration, higher values of complete colour change time (CCC time) of Neuropad and higher abnormal rate of 10 g SWMF (P<0.01). CCC time of Neuropad was shown to be better in predicting the risk of DFU than 10 g SWMF, and the area under the ROC curve was about 0.8, and the best cut-off value was 22.25 min. Conclusion Neuropad is an effective means for predicting of the risk of DFU, and can be used to prevent diabetic foot ulceration.