Since a lot of people get involved by COVID-19 infection and died and lots of them obliged to stay at home and teleworking due to its unknown contagious pneumonia in February and March 2020 in Iran and the world;and t...Since a lot of people get involved by COVID-19 infection and died and lots of them obliged to stay at home and teleworking due to its unknown contagious pneumonia in February and March 2020 in Iran and the world;and this number is growing,it seems necessary to study the diagnostic criteria of this virus,based on the recently published articles,and then compare them with Severe acute respiratory syndrome(SARS)and Middle East respiratory syndrome(MERS).Corona viruses are the largest known RNA viruses able to infect humans and birds.These viruses can cause more serious respiratory diseases in elderly,or immunocompromised individuals.In this article,by comparing COVID-19,SARS and MERS viruses,we aim to find similarities and differences between these three which are from the same family and by expressing their diagnostic criteria,help care units to find patients faster and have enough time for treating them.展开更多
BACKGROUND Sarcopenia is an age-related decline in skeletal muscle mass,which depends on an assessment of muscle strength and muscle mass.The diagnostic definition of sarcopenia varies by region.AIM To determine the o...BACKGROUND Sarcopenia is an age-related decline in skeletal muscle mass,which depends on an assessment of muscle strength and muscle mass.The diagnostic definition of sarcopenia varies by region.AIM To determine the optimal diagnostic criteria for sarcopenia in a plateau population.Cut off values for the components of diagnostic algorithms for sarcopenia in plateau populations should consider altitude.METHODS One hundred and fifty subjects aged>60 years attending a tertiary comprehensive hospital in the city of Xining(elevation:2260 m)between October and December 2018 were enrolled.Handgrip strength,muscle mass,and physical performance were measured.Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia(AWGS)2019 criteria,Beijing criteria,and Lasha criteria.RESULTS Across diagnostic criteria,there were significant differences in the prevalence of sarcopenia in the overall population and stratified by gender.The prevalence of sarcopenia measured by the AWGS 2019 or Lasha criteria was significantly higher in female compared to male subjects.In males,the prevalence of sarcopenia measured by the Beijing criteria was significantly higher in subjects who identified as Han compared to Minority.In females,there were no significant differences in the prevalence of sarcopenia by ethnicity according to any criteria.CONCLUSION The Lasha criteria provided a lower prevalence of sarcopenia(males,8.7%;females,22.41%;overall,14%)and were able to differentiate between males and females.The Lasha criteria are likely most appropriate for detection of sarcopenia in this plateau population.We recommend the Lasha criteria for detection of sarcopenia in Xining.展开更多
BACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus(GDM)are still a subject of debate,mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the r...BACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus(GDM)are still a subject of debate,mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the risk profile of the women newly diagnosed.AIM To estimate the impact of the World Health Organization(WHO)2013 criteria compared with the WHO 1999 criteria on the incidence of gestational diabetes mellitus as well as to determine the diagnostic accuracy for detecting adverse pregnancy outcomes.METHODS We retrospectively analyzed a single center Dutch cohort of 3338 women undergoing a 75 g oral glucose tolerance test where the WHO 1999 criteria to diagnose GDM were clinically applied.Women were categorized into four groups:non-GDM by both criteria,GDM by WHO 1999 only(excluded from GDM),GDM by WHO 2013 only(newly diagnosed)and GDM by both criteria.We compared maternal characteristics,pregnancy outcomes and likelihood ratios for adverse pregnancy outcomes.RESULTS Retrospectively applying the WHO 2013 criteria increased the cohort incidence by 13.1%,from 19.3%to 32.4%.Discordant diagnoses occurred in 21.3%;4.1%would no longer be labelled as GDM,and 17.2%were newly diagnosed.Compared to the non-GDM group,women newly diagnosed were older,had higher rates of obesity,higher diastolic blood pressure and higher rates of caesarean deliveries.Their infants were more often delivered preterm,large-for-gestational-age and were at higher risk of a 5 min Apgar score<7.Women excluded from GDM were older and had similar pregnancy outcomes compared to the non-GDM group,except for higher rates of shoulder dystocia(4.3%vs 1.3%,P=0.015).Positive likelihood ratios for adverse outcomes in all groups were generally low,ranging from 0.54 to 2.95.CONCLUSION Applying the WHO 2013 criteria would result in a substantial increase in GDM diagnoses.Newly diagnosed women are at increased risk for pregnancy adverse outcomes.This risk,however,seems to be lower than those identified by the WHO 1999 criteria.This could potentially influence the treatment effect that can be achieved in this group.Evidence on treatment effects in newly diagnosed women is urgently needed.展开更多
A previous diagnosis of gestational diabetes(GDM)carries a lifetime risk of progression to type 2 diabetes of up to 60%.Identification of those women at higher risk of progression to diabetes allows the timely introdu...A previous diagnosis of gestational diabetes(GDM)carries a lifetime risk of progression to type 2 diabetes of up to 60%.Identification of those women at higher risk of progression to diabetes allows the timely introduction of measures to delay or prevent diabetes onset.However,there is a large degree of variability in the literature with regard to the proportion of women with a history of GDM who go on to develop diabetes.Heterogeneity between cohorts with regard to diagnostic criteria used,duration of follow-up,and the characteristics of the study population limit the ability to make meaningful comparisons across studies.As the new International Association for Diabetes in Pregnancy Study Group criteria are increasingly adopted worldwide,the prevalence of GDM is set to increase by two-to three-fold.Here,we review the literature to examine the evolution of diagnostic criteria for GDM,the implications of changing criteria on the proportion of women with previous GDM progressing to diabetes,and how the use of different diagnostic criteria may influence the development of appropriate follow-up strategies.展开更多
The approach to screening and diagnosis of gestational diabetes mellitus(GDM) around the world is disorderly. The protocols for diagnosis vary not only in-between countries, but also within countries. Furthermore, in ...The approach to screening and diagnosis of gestational diabetes mellitus(GDM) around the world is disorderly. The protocols for diagnosis vary not only in-between countries, but also within countries. Furthermore, in any country, this disparity occurs in-between its hospitals and often exists within a single hospital. There are many reasons for these differences. There is the lack of an international consensus among preeminent health organizations(e.g., American College of Gynecologists and World Health Organization). Often there is a disagreement between the country's national diabetes organization, its local health society and its regional obstetric organization with each one recommending a different option for approaching GDM. Sometimes the causes for following an alternate approach are very obvious, e.g., a resource strapped hospital is unable to follow the ivory-tower demanding recommendation of its obstetric organization. But more often than not, the rationale for following or not following a guideline, or following different guideline within the same geographic area is without any perceivable explanation. This review is an attempt to understand the problems afflicting the screening and diagnosis of GDM globally. It traces the major temporal changes in the diagnostic criteria of(1) some respected health organizations; and(2) a few selected countries. With an understanding of the reasons for this disparity, a way forward can be found to reach the ultimate goal: a single global guideline for GDM followed worldwide.展开更多
Pre-diabetes, which is typically defined as blood glucose concentrations higher than normal but lower than thediabetes threshold, is a high-risk state for diabetes and cardiovascular disease development. As such, it r...Pre-diabetes, which is typically defined as blood glucose concentrations higher than normal but lower than thediabetes threshold, is a high-risk state for diabetes and cardiovascular disease development. As such, it represents three groups of individuals: Those with impaired fasting glucose(IFG), those with impaired glucose tolerance(IGT) and those with a glycated haemoglobin(HbA1c) between 39-46 mmol/mol. Several clinical trials have shown the important role of IFG, IGT and HbA1c -pre-diabetes as predictive tools for the risk of developing type 2 diabetes. Moreover, with regard to cardiovascular disease, pre-diabetes is associated with more advanced vascular damage compared with normoglycaemia, independently of confounding factors. In view of these observations, diagnosis of pre-diabetes is mandatory to prevent or delay the development of the disease and its complications; however, a number of previous studies reported that the concordance between pre-diabetes diagnoses made by IFG, IGT or HbA1c is scarce and there are conflicting data as to which of these methods best predicts cardiovascular disease. This review highlights recent studies and cur-rent controversies in the field. In consideration of the expected increased use of HbA1c as a screening tool to identify individuals with alteration of glycaemic homeo-stasis, we focused on the evidence regarding the ability of HbA1c as a diagnostic tool for pre-diabetes and as a useful marker in identifying patients who have an increased risk for cardiovascular disease. Finally, we reviewed the current evidence regarding non-traditional glycaemic biomarkers and their use as alternatives to or additions to traditional ones.展开更多
Autoimmune pancreatitis (AIP) is a particular type of pancreatitis of presumed autoimmune etiology. Currently, AIP should be diagnosed based on combination of clinical, serological, morphological, and histopathologica...Autoimmune pancreatitis (AIP) is a particular type of pancreatitis of presumed autoimmune etiology. Currently, AIP should be diagnosed based on combination of clinical, serological, morphological, and histopathological features. When diagnosing AIP, it is most important to differentiate it from pancreatic cancer. Diagnostic criteria for AIP, proposed by the Japan Pancreas Society in 2002 first in the world, were revised in 2006. The criteria are based on the minimum consensus of AIP and aim to avoid misdiagnosing pancreatic cancer as far as possible, but not for screening AIP. The criteria consist of the following radiological, serological, and histopathological items: (1) radiological imaging showing narrowing of the main pancreatic duct and enlargement of the pancreas, which are characteristic of the disease; (2) laboratory data showing abnormally elevated levels of serum γ-globulin, IgG or IgG4, or the presence of autoantibodies; (3) histopathological examination of the pancreas demonstrating marked fibrosis and prominent infiltration of lymphocytes and plasma cells, which is called lymphoplasmacytic sclerosing pancreatitis (LPSP). For a diagnosis of AIP, criterion 1 must be present, together with criterion 2 and/ or criterion 3. However, it is necessary to exclude malignant diseases such as pancreatic or biliary cancer.展开更多
Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria. Methods: This study was conducted using epidemiologic...Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria. Methods: This study was conducted using epidemiological surveys and a multi-center randomized controlled clinical trial. A total of 3011 subjects were studied, and the following indices were collected after their return to low altitude areas from the plateau: general health status, blood, urine and stool samples, myo-cardial enzyme levels, liver and kidney function, nerve function, sex hormone levels, microalbuminuria, electrocardiogram (ECG), echocardiography, pulmonary function, and hemorheological markers. These data were compared to those of randomized healthy subjects in the same age range who lived at the same altitude to determine the characteristics of high altitude de-acclimatization syndrome. Based on these characteristics, diagnostic criteria for high altitude de-acclimatization syndrome were formulated. Results: This study demonstrated that the incidence of high altitude de-acclimatization syndrome was 84.36%. Sixty percent of the cases were mild, 30% were medium, and 10% were severe. The incidence was higher among those who returned to a place of lower altitude, resided at a high altitude for a longer period of time, or engaged in heavy labor while at high altitude. Patients with high altitude de-acclimatization syndrome manifested hematological abnormalities and abnormal ventricular function, notably a right ventricular diastolic function, which recovered to baseline function after one to five years. Exposure to long-term hypoxia often caused obvious changes in cardiac morphology, i.e., left and right ventricular hypertrophy, particularly within the right ventricle. In addition, patients with high altitude de-acclimatization syndrome often presented with low blood pressure, low pulse pressure, and microalbuminuria. A few patients presented with occult blood in their feces. The diagnosis of high altitude de-acclimatization syndrome can be made if a patient who recently returns to the plain from the plateau complains of dizziness, weakness, sleepiness, chest tightness, edema, memory loss, and other symptoms and signs that do not alleviate under short-term rehabilitation or symptomatic treatment, and if organic diseases of the heart, lung, kidney, and other organs have been excluded. Conclusion: The diagnosis of high altitude de-acclimatization syndrome should be made after a comprehensive analysis of the patient’s clinical symptoms and signs.展开更多
We studied Chinese and Uighur medicines and create an automated computer diagnostics system according to principals of Uighur medicine for evaluation of bronchial asthma patient′s state.498 patients with bronchial as...We studied Chinese and Uighur medicines and create an automated computer diagnostics system according to principals of Uighur medicine for evaluation of bronchial asthma patient′s state.498 patients with bronchial asthma were enrolled the automated computer diagnostic program.304 patients were evaluated in the process of drug and non-drug treatment.Savda asthma type of Uighur medicine do not corresponds with any of the defined clinico-pathogenetic variants of the disease.Thus,prevailing of atopic bronchial asthma with probability of 0.7 is defined with Savda categories with such as 'Lungs energy deficiency','Spleen energy deficiency' and 'Kidneys Yin deficiency'(P<0.01) variants in Chinese Medicine.The combination of infectious-dependent variant of bronchial asthma Abnormal Savda syndrome with atopy with a probability of 0.8 is accompanied by the categories of 'Hot and Full' asthma with such variants as 'Lungs energy deficiency' 'Spleen energy deficiency','Kidneys Yin deficiency'(P<0.01).Patients with an easier case of Abnormal Savda syndrome bronchial asthma in 71% of cases have prevailing diagnostic categories of 'External,Full and Cold' asthma.Patients with a harder case of Abnormal Savda in 74% of cases belongs to the categories of 'Internal,Empty and Hot' asthma.So,hormone dependency of the disease in 69% of cases is accompanied by the 'Kidneys Yin deficiency' variant and,if there is an aspirin component in the pathogenesis of mixed asthma,in 83% of cases 'Kidneys Yin deficiency' and 'Kidneys Yang deficiency' variants are defined.展开更多
Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria.Methods: This study was conducted using epidemiologica...Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria.Methods: This study was conducted using epidemiological surveys and a multi-center randomized controlled clinical trial. A total of 3,011 subjects were studied, and the following indices were collected after their return to low altitude areas from the plateau: general health status, blood, urine and stool samples, myocardial enzyme levels, liver and kidney function, nerve function, sex hormone levels, microalbuminuria, electrocardiogram(ECG), echocardiography, pulmonary function, and hemorheological markers. These data were compared to those of randomized healthy subjects in the same age range who lived at the same altitude to determine the characteristics of high altitude deacclimatization syndrome. Based on these characteristics, diagnostic criteria for high altitude de-acclimatization syndrome were formulated.Results: This study demonstrated that the incidence of high altitude de-acclimatization syndrome was 84.36%. Sixty percent of the cases were mild, 30% were medium, and 10% were severe. The incidence was higher among those who returned to a place of lower altitude, resided at a high altitude for a longer period of time, or engaged in heavy labor while at high altitude. Patients with high altitude de-acclimatization syndrome manifested hematological abnormalities and abnormal ventricular function, notably a right ventricular diastolic function, which recovered to baseline function after one to five years. Exposure to long-term hypoxia often caused obvious changes in cardiac morphology, i.e., left and right ventricular hypertrophy, particularly within the right ventricle. In addition, patients with high altitude de-acclimatization syndrome often presented with low blood pressure, low pulse pressure, and microalbuminuria. A few patients presented with occult blood in their feces. The diagnosis of high altitude deacclimatization syndrome can be made if a patient who recently returns to the plain from the plateau complains of dizziness, weakness, sleepiness, chest tightness, edema, memory loss, and other symptoms and signs that do not alleviate under short-term rehabilitation or symptomatic treatment, and if organic diseases of the heart, lung, kidney, and other organs have been excluded.Conclusion: The diagnosis of high altitude de-acclimatization syndrome should be made after a comprehensive analysis of the patient's clinical symptoms and signs.展开更多
Ocular rosacea is an important and underdiagnosed chronic inflammatory disorder observed in children. A clinical spectrum ranging from chronic eyelid inflammation, recurrent ocular redness, photophobia and/or hordeola...Ocular rosacea is an important and underdiagnosed chronic inflammatory disorder observed in children. A clinical spectrum ranging from chronic eyelid inflammation, recurrent ocular redness, photophobia and/or hordeola/chalazions and conjunctival/corneal phlyctenules evolving to neovascularization and scarring may occur. Visual impairment and consequent amblyopia are frequent and corneal perforation although rare is the most feared complication. Ocular manifestations usually precede cutaneous lesions. Although few cases of pediatric ocular rosacea(POR) have been reported in the literature, many cases must have been underdiagnosed or misdiagnosed. The delay in diagnosis is greater than one year in the large majority of cases and may lead to serious ocular sequelae. This review aims to highlight the clinical features of POR, its epidemiology, easy diagnosis and effective treatment. We also propose new diagnostic criteria, in which at least three of the five clinical criteria must be present:(1) Chronic or recurrent keratoconjunctivitis and/or red eye and/or photophobia;(2) Chronic or recurrent blepharitis and/or chalazia/hordeola;(3) Eyelid telangiectasia documented by an ophthalmologist;(4) Primary periorificial dermatitis and/or primary features of rosacea; and (5) Positive familial history of cutaneous and/or ocular rosacea.展开更多
In order to compare the validity of threediagnostic criteria for neurosis we re-diagnosed139 neurotics diagnosed with diagnostic criteriafor neurosis used in epidemiologieal investiga-tion, using the diagnostic criter...In order to compare the validity of threediagnostic criteria for neurosis we re-diagnosed139 neurotics diagnosed with diagnostic criteriafor neurosis used in epidemiologieal investiga-tion, using the diagnostic criteria for severaltypes of neurosis suggested by Xu Youxin anddiagnostic criteria for neurosis proposed by展开更多
In the last decade,many investigators including us have reported the negative impact of preoperative sarcopenia or low skeletal muscle mass on outcomes after surgery including hepato-biliary-pancreatic(HBP)surgery suc...In the last decade,many investigators including us have reported the negative impact of preoperative sarcopenia or low skeletal muscle mass on outcomes after surgery including hepato-biliary-pancreatic(HBP)surgery such as liver transplantation,liver surgery,biliary surgery,and pancreatic surgery(1-5).In addition to low skeletal muscle mass,the abnormality of body compositions,decreased muscle quality and visceral obesity,has been clarified to be also negatively associated with poor outcomes after HBP surgery(2-5).Consequently,it was easily supposed that co-existence of sarcopenia and obesity,called sarcopenic obesity(SO),had more strong negative impact on outcomes.Actually,not a few studies have demonstrated negative clinical impact of SO on outcomes after HBP surgery using various definitions for SO(6-10).We reported that patients with SO,defined by low skeletal muscle mass with high visceral fat to subcutaneous fat ratio evaluated by preoperative computed tomography(CT)image,had significant worse survival than non-sarcopenia patients and patients with sarcopenia only after liver transplantation,hepatic resection,and pancreatic resection(6-9).展开更多
Hydrological models are very useful tools for evaluating water resources, and the hydroclimatic hazards associated with the water cycle. However, their calibration and validation require the use of performance criteri...Hydrological models are very useful tools for evaluating water resources, and the hydroclimatic hazards associated with the water cycle. However, their calibration and validation require the use of performance criteria which choice is not straightforward. This paper aims to evaluate the influence of the performance criteria on water balance components and water extremes using two global rainfall-runoff models (HBV and GR4J) over the Ouémé watershed at the Bonou and Savè outlets. Three (3) Efficacy criteria (Nash, coefficient of determination, and KGE) were considered for calibration and validation. The results show that the Nash criterion provides a good assessment of the simulation of the different parts of the hydrograph. KGE is better for simulating peak flows and water balance elements than other efficiency criteria. This study could serve as a basis for the choice of performance criteria in hydrological modelling.展开更多
Interpreting experimental diagnostics data in tokamaks,while considering non-ideal effects,is challenging due to the complexity of plasmas.To address this challenge,a general synthetic diagnostics(GSD)platform has bee...Interpreting experimental diagnostics data in tokamaks,while considering non-ideal effects,is challenging due to the complexity of plasmas.To address this challenge,a general synthetic diagnostics(GSD)platform has been established that facilitates microwave imaging reflectometry and electron cyclotron emission imaging.This platform utilizes plasma profiles as input and incorporates the finite-difference time domain,ray tracing and the radiative transfer equation to calculate the propagation of plasma spontaneous radiation and the external electromagnetic field in plasmas.Benchmark tests for classical cases have been conducted to verify the accuracy of every core module in the GSD platform.Finally,2D imaging of a typical electron temperature distribution is reproduced by this platform and the results are consistent with the given real experimental data.This platform also has the potential to be extended to 3D electromagnetic field simulations and other microwave diagnostics such as cross-polarization scattering.展开更多
A multi-channel polarimeter-interferometer has been developed on the Keda Torus eXperiment(KTX)for the study of equilibrium dynamics and internal magnetic fluctuations.A three-wave technique based on terahertz solid-s...A multi-channel polarimeter-interferometer has been developed on the Keda Torus eXperiment(KTX)for the study of equilibrium dynamics and internal magnetic fluctuations.A three-wave technique based on terahertz solid-state sources(-650 GHz)is applied for simultaneous measurements of electron density and Faraday rotation angle.The output power of the microwave source is 2 mW.Faraday rotation effect using a rotating wave plate is tested with phase noise less than 0.8°,and the density phase noise is less than 0.9°.Measurement of Faraday rotation angle and density for discharges on KTX have demonstrated high sensitivity to internal MHD activities.展开更多
To investigate the potential of utilizing visible spectral imaging for controlling the plasma boundary shape during stable operation of plasma in future tokamak, a D_α band symmetric visible light diagnostic system w...To investigate the potential of utilizing visible spectral imaging for controlling the plasma boundary shape during stable operation of plasma in future tokamak, a D_α band symmetric visible light diagnostic system was designed and implemented on the Experimental Advanced Superconducting Tokamak(EAST). This system leverages two symmetric optics for joint plasma imaging. The optical system exhibits a spatial resolution less than 2 mm at the poloidal cross-section, distortion within the field of view below 10%, and relative illumination of 91%.The high-quality images obtained enable clear observation of both the plasma boundary position and the characteristics of components within the vacuum vessel. Following system calibration and coordinate transformation, the image coordinate boundary features are mapped to the tokamak coordinate system. Utilizing this system, the plasma boundary was reconstructed, and the resulting representation showed alignment with the EFIT(Equilibrium Fitting) results. This underscores the system's superior performance in boundary reconstruction applications and provides a diagnostic foundation for boundary shape control based on visible spectral imaging.展开更多
文摘Since a lot of people get involved by COVID-19 infection and died and lots of them obliged to stay at home and teleworking due to its unknown contagious pneumonia in February and March 2020 in Iran and the world;and this number is growing,it seems necessary to study the diagnostic criteria of this virus,based on the recently published articles,and then compare them with Severe acute respiratory syndrome(SARS)and Middle East respiratory syndrome(MERS).Corona viruses are the largest known RNA viruses able to infect humans and birds.These viruses can cause more serious respiratory diseases in elderly,or immunocompromised individuals.In this article,by comparing COVID-19,SARS and MERS viruses,we aim to find similarities and differences between these three which are from the same family and by expressing their diagnostic criteria,help care units to find patients faster and have enough time for treating them.
基金Supported by the Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,No.2018PT33001.
文摘BACKGROUND Sarcopenia is an age-related decline in skeletal muscle mass,which depends on an assessment of muscle strength and muscle mass.The diagnostic definition of sarcopenia varies by region.AIM To determine the optimal diagnostic criteria for sarcopenia in a plateau population.Cut off values for the components of diagnostic algorithms for sarcopenia in plateau populations should consider altitude.METHODS One hundred and fifty subjects aged>60 years attending a tertiary comprehensive hospital in the city of Xining(elevation:2260 m)between October and December 2018 were enrolled.Handgrip strength,muscle mass,and physical performance were measured.Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia(AWGS)2019 criteria,Beijing criteria,and Lasha criteria.RESULTS Across diagnostic criteria,there were significant differences in the prevalence of sarcopenia in the overall population and stratified by gender.The prevalence of sarcopenia measured by the AWGS 2019 or Lasha criteria was significantly higher in female compared to male subjects.In males,the prevalence of sarcopenia measured by the Beijing criteria was significantly higher in subjects who identified as Han compared to Minority.In females,there were no significant differences in the prevalence of sarcopenia by ethnicity according to any criteria.CONCLUSION The Lasha criteria provided a lower prevalence of sarcopenia(males,8.7%;females,22.41%;overall,14%)and were able to differentiate between males and females.The Lasha criteria are likely most appropriate for detection of sarcopenia in this plateau population.We recommend the Lasha criteria for detection of sarcopenia in Xining.
文摘BACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus(GDM)are still a subject of debate,mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the risk profile of the women newly diagnosed.AIM To estimate the impact of the World Health Organization(WHO)2013 criteria compared with the WHO 1999 criteria on the incidence of gestational diabetes mellitus as well as to determine the diagnostic accuracy for detecting adverse pregnancy outcomes.METHODS We retrospectively analyzed a single center Dutch cohort of 3338 women undergoing a 75 g oral glucose tolerance test where the WHO 1999 criteria to diagnose GDM were clinically applied.Women were categorized into four groups:non-GDM by both criteria,GDM by WHO 1999 only(excluded from GDM),GDM by WHO 2013 only(newly diagnosed)and GDM by both criteria.We compared maternal characteristics,pregnancy outcomes and likelihood ratios for adverse pregnancy outcomes.RESULTS Retrospectively applying the WHO 2013 criteria increased the cohort incidence by 13.1%,from 19.3%to 32.4%.Discordant diagnoses occurred in 21.3%;4.1%would no longer be labelled as GDM,and 17.2%were newly diagnosed.Compared to the non-GDM group,women newly diagnosed were older,had higher rates of obesity,higher diastolic blood pressure and higher rates of caesarean deliveries.Their infants were more often delivered preterm,large-for-gestational-age and were at higher risk of a 5 min Apgar score<7.Women excluded from GDM were older and had similar pregnancy outcomes compared to the non-GDM group,except for higher rates of shoulder dystocia(4.3%vs 1.3%,P=0.015).Positive likelihood ratios for adverse outcomes in all groups were generally low,ranging from 0.54 to 2.95.CONCLUSION Applying the WHO 2013 criteria would result in a substantial increase in GDM diagnoses.Newly diagnosed women are at increased risk for pregnancy adverse outcomes.This risk,however,seems to be lower than those identified by the WHO 1999 criteria.This could potentially influence the treatment effect that can be achieved in this group.Evidence on treatment effects in newly diagnosed women is urgently needed.
文摘A previous diagnosis of gestational diabetes(GDM)carries a lifetime risk of progression to type 2 diabetes of up to 60%.Identification of those women at higher risk of progression to diabetes allows the timely introduction of measures to delay or prevent diabetes onset.However,there is a large degree of variability in the literature with regard to the proportion of women with a history of GDM who go on to develop diabetes.Heterogeneity between cohorts with regard to diagnostic criteria used,duration of follow-up,and the characteristics of the study population limit the ability to make meaningful comparisons across studies.As the new International Association for Diabetes in Pregnancy Study Group criteria are increasingly adopted worldwide,the prevalence of GDM is set to increase by two-to three-fold.Here,we review the literature to examine the evolution of diagnostic criteria for GDM,the implications of changing criteria on the proportion of women with previous GDM progressing to diabetes,and how the use of different diagnostic criteria may influence the development of appropriate follow-up strategies.
文摘The approach to screening and diagnosis of gestational diabetes mellitus(GDM) around the world is disorderly. The protocols for diagnosis vary not only in-between countries, but also within countries. Furthermore, in any country, this disparity occurs in-between its hospitals and often exists within a single hospital. There are many reasons for these differences. There is the lack of an international consensus among preeminent health organizations(e.g., American College of Gynecologists and World Health Organization). Often there is a disagreement between the country's national diabetes organization, its local health society and its regional obstetric organization with each one recommending a different option for approaching GDM. Sometimes the causes for following an alternate approach are very obvious, e.g., a resource strapped hospital is unable to follow the ivory-tower demanding recommendation of its obstetric organization. But more often than not, the rationale for following or not following a guideline, or following different guideline within the same geographic area is without any perceivable explanation. This review is an attempt to understand the problems afflicting the screening and diagnosis of GDM globally. It traces the major temporal changes in the diagnostic criteria of(1) some respected health organizations; and(2) a few selected countries. With an understanding of the reasons for this disparity, a way forward can be found to reach the ultimate goal: a single global guideline for GDM followed worldwide.
基金Scientific Bureau of the University of Catania for language support
文摘Pre-diabetes, which is typically defined as blood glucose concentrations higher than normal but lower than thediabetes threshold, is a high-risk state for diabetes and cardiovascular disease development. As such, it represents three groups of individuals: Those with impaired fasting glucose(IFG), those with impaired glucose tolerance(IGT) and those with a glycated haemoglobin(HbA1c) between 39-46 mmol/mol. Several clinical trials have shown the important role of IFG, IGT and HbA1c -pre-diabetes as predictive tools for the risk of developing type 2 diabetes. Moreover, with regard to cardiovascular disease, pre-diabetes is associated with more advanced vascular damage compared with normoglycaemia, independently of confounding factors. In view of these observations, diagnosis of pre-diabetes is mandatory to prevent or delay the development of the disease and its complications; however, a number of previous studies reported that the concordance between pre-diabetes diagnoses made by IFG, IGT or HbA1c is scarce and there are conflicting data as to which of these methods best predicts cardiovascular disease. This review highlights recent studies and cur-rent controversies in the field. In consideration of the expected increased use of HbA1c as a screening tool to identify individuals with alteration of glycaemic homeo-stasis, we focused on the evidence regarding the ability of HbA1c as a diagnostic tool for pre-diabetes and as a useful marker in identifying patients who have an increased risk for cardiovascular disease. Finally, we reviewed the current evidence regarding non-traditional glycaemic biomarkers and their use as alternatives to or additions to traditional ones.
基金Research for Intractable Disease of the Pancreas, Ministry of Health, Labor and Welfare of Japan
文摘Autoimmune pancreatitis (AIP) is a particular type of pancreatitis of presumed autoimmune etiology. Currently, AIP should be diagnosed based on combination of clinical, serological, morphological, and histopathological features. When diagnosing AIP, it is most important to differentiate it from pancreatic cancer. Diagnostic criteria for AIP, proposed by the Japan Pancreas Society in 2002 first in the world, were revised in 2006. The criteria are based on the minimum consensus of AIP and aim to avoid misdiagnosing pancreatic cancer as far as possible, but not for screening AIP. The criteria consist of the following radiological, serological, and histopathological items: (1) radiological imaging showing narrowing of the main pancreatic duct and enlargement of the pancreas, which are characteristic of the disease; (2) laboratory data showing abnormally elevated levels of serum γ-globulin, IgG or IgG4, or the presence of autoantibodies; (3) histopathological examination of the pancreas demonstrating marked fibrosis and prominent infiltration of lymphocytes and plasma cells, which is called lymphoplasmacytic sclerosing pancreatitis (LPSP). For a diagnosis of AIP, criterion 1 must be present, together with criterion 2 and/ or criterion 3. However, it is necessary to exclude malignant diseases such as pancreatic or biliary cancer.
文摘Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria. Methods: This study was conducted using epidemiological surveys and a multi-center randomized controlled clinical trial. A total of 3011 subjects were studied, and the following indices were collected after their return to low altitude areas from the plateau: general health status, blood, urine and stool samples, myo-cardial enzyme levels, liver and kidney function, nerve function, sex hormone levels, microalbuminuria, electrocardiogram (ECG), echocardiography, pulmonary function, and hemorheological markers. These data were compared to those of randomized healthy subjects in the same age range who lived at the same altitude to determine the characteristics of high altitude de-acclimatization syndrome. Based on these characteristics, diagnostic criteria for high altitude de-acclimatization syndrome were formulated. Results: This study demonstrated that the incidence of high altitude de-acclimatization syndrome was 84.36%. Sixty percent of the cases were mild, 30% were medium, and 10% were severe. The incidence was higher among those who returned to a place of lower altitude, resided at a high altitude for a longer period of time, or engaged in heavy labor while at high altitude. Patients with high altitude de-acclimatization syndrome manifested hematological abnormalities and abnormal ventricular function, notably a right ventricular diastolic function, which recovered to baseline function after one to five years. Exposure to long-term hypoxia often caused obvious changes in cardiac morphology, i.e., left and right ventricular hypertrophy, particularly within the right ventricle. In addition, patients with high altitude de-acclimatization syndrome often presented with low blood pressure, low pulse pressure, and microalbuminuria. A few patients presented with occult blood in their feces. The diagnosis of high altitude de-acclimatization syndrome can be made if a patient who recently returns to the plain from the plateau complains of dizziness, weakness, sleepiness, chest tightness, edema, memory loss, and other symptoms and signs that do not alleviate under short-term rehabilitation or symptomatic treatment, and if organic diseases of the heart, lung, kidney, and other organs have been excluded. Conclusion: The diagnosis of high altitude de-acclimatization syndrome should be made after a comprehensive analysis of the patient’s clinical symptoms and signs.
基金supported by the Prophase Research of National Basic Research Program of China(973 Program,2011CB 512004)Research program of the Top-Level Foreigner Experts of 2012(Culture and Education Category,GDW20126500222)
文摘We studied Chinese and Uighur medicines and create an automated computer diagnostics system according to principals of Uighur medicine for evaluation of bronchial asthma patient′s state.498 patients with bronchial asthma were enrolled the automated computer diagnostic program.304 patients were evaluated in the process of drug and non-drug treatment.Savda asthma type of Uighur medicine do not corresponds with any of the defined clinico-pathogenetic variants of the disease.Thus,prevailing of atopic bronchial asthma with probability of 0.7 is defined with Savda categories with such as 'Lungs energy deficiency','Spleen energy deficiency' and 'Kidneys Yin deficiency'(P<0.01) variants in Chinese Medicine.The combination of infectious-dependent variant of bronchial asthma Abnormal Savda syndrome with atopy with a probability of 0.8 is accompanied by the categories of 'Hot and Full' asthma with such variants as 'Lungs energy deficiency' 'Spleen energy deficiency','Kidneys Yin deficiency'(P<0.01).Patients with an easier case of Abnormal Savda syndrome bronchial asthma in 71% of cases have prevailing diagnostic categories of 'External,Full and Cold' asthma.Patients with a harder case of Abnormal Savda in 74% of cases belongs to the categories of 'Internal,Empty and Hot' asthma.So,hormone dependency of the disease in 69% of cases is accompanied by the 'Kidneys Yin deficiency' variant and,if there is an aspirin component in the pathogenesis of mixed asthma,in 83% of cases 'Kidneys Yin deficiency' and 'Kidneys Yang deficiency' variants are defined.
基金supported by the National Key Technology Research and Development Program of China (2009BAI85B03)Health Subject of Chinese PLA (2013BJZ032)
文摘Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria.Methods: This study was conducted using epidemiological surveys and a multi-center randomized controlled clinical trial. A total of 3,011 subjects were studied, and the following indices were collected after their return to low altitude areas from the plateau: general health status, blood, urine and stool samples, myocardial enzyme levels, liver and kidney function, nerve function, sex hormone levels, microalbuminuria, electrocardiogram(ECG), echocardiography, pulmonary function, and hemorheological markers. These data were compared to those of randomized healthy subjects in the same age range who lived at the same altitude to determine the characteristics of high altitude deacclimatization syndrome. Based on these characteristics, diagnostic criteria for high altitude de-acclimatization syndrome were formulated.Results: This study demonstrated that the incidence of high altitude de-acclimatization syndrome was 84.36%. Sixty percent of the cases were mild, 30% were medium, and 10% were severe. The incidence was higher among those who returned to a place of lower altitude, resided at a high altitude for a longer period of time, or engaged in heavy labor while at high altitude. Patients with high altitude de-acclimatization syndrome manifested hematological abnormalities and abnormal ventricular function, notably a right ventricular diastolic function, which recovered to baseline function after one to five years. Exposure to long-term hypoxia often caused obvious changes in cardiac morphology, i.e., left and right ventricular hypertrophy, particularly within the right ventricle. In addition, patients with high altitude de-acclimatization syndrome often presented with low blood pressure, low pulse pressure, and microalbuminuria. A few patients presented with occult blood in their feces. The diagnosis of high altitude deacclimatization syndrome can be made if a patient who recently returns to the plain from the plateau complains of dizziness, weakness, sleepiness, chest tightness, edema, memory loss, and other symptoms and signs that do not alleviate under short-term rehabilitation or symptomatic treatment, and if organic diseases of the heart, lung, kidney, and other organs have been excluded.Conclusion: The diagnosis of high altitude de-acclimatization syndrome should be made after a comprehensive analysis of the patient's clinical symptoms and signs.
文摘Ocular rosacea is an important and underdiagnosed chronic inflammatory disorder observed in children. A clinical spectrum ranging from chronic eyelid inflammation, recurrent ocular redness, photophobia and/or hordeola/chalazions and conjunctival/corneal phlyctenules evolving to neovascularization and scarring may occur. Visual impairment and consequent amblyopia are frequent and corneal perforation although rare is the most feared complication. Ocular manifestations usually precede cutaneous lesions. Although few cases of pediatric ocular rosacea(POR) have been reported in the literature, many cases must have been underdiagnosed or misdiagnosed. The delay in diagnosis is greater than one year in the large majority of cases and may lead to serious ocular sequelae. This review aims to highlight the clinical features of POR, its epidemiology, easy diagnosis and effective treatment. We also propose new diagnostic criteria, in which at least three of the five clinical criteria must be present:(1) Chronic or recurrent keratoconjunctivitis and/or red eye and/or photophobia;(2) Chronic or recurrent blepharitis and/or chalazia/hordeola;(3) Eyelid telangiectasia documented by an ophthalmologist;(4) Primary periorificial dermatitis and/or primary features of rosacea; and (5) Positive familial history of cutaneous and/or ocular rosacea.
文摘In order to compare the validity of threediagnostic criteria for neurosis we re-diagnosed139 neurotics diagnosed with diagnostic criteriafor neurosis used in epidemiologieal investiga-tion, using the diagnostic criteria for severaltypes of neurosis suggested by Xu Youxin anddiagnostic criteria for neurosis proposed by
文摘In the last decade,many investigators including us have reported the negative impact of preoperative sarcopenia or low skeletal muscle mass on outcomes after surgery including hepato-biliary-pancreatic(HBP)surgery such as liver transplantation,liver surgery,biliary surgery,and pancreatic surgery(1-5).In addition to low skeletal muscle mass,the abnormality of body compositions,decreased muscle quality and visceral obesity,has been clarified to be also negatively associated with poor outcomes after HBP surgery(2-5).Consequently,it was easily supposed that co-existence of sarcopenia and obesity,called sarcopenic obesity(SO),had more strong negative impact on outcomes.Actually,not a few studies have demonstrated negative clinical impact of SO on outcomes after HBP surgery using various definitions for SO(6-10).We reported that patients with SO,defined by low skeletal muscle mass with high visceral fat to subcutaneous fat ratio evaluated by preoperative computed tomography(CT)image,had significant worse survival than non-sarcopenia patients and patients with sarcopenia only after liver transplantation,hepatic resection,and pancreatic resection(6-9).
文摘Hydrological models are very useful tools for evaluating water resources, and the hydroclimatic hazards associated with the water cycle. However, their calibration and validation require the use of performance criteria which choice is not straightforward. This paper aims to evaluate the influence of the performance criteria on water balance components and water extremes using two global rainfall-runoff models (HBV and GR4J) over the Ouémé watershed at the Bonou and Savè outlets. Three (3) Efficacy criteria (Nash, coefficient of determination, and KGE) were considered for calibration and validation. The results show that the Nash criterion provides a good assessment of the simulation of the different parts of the hydrograph. KGE is better for simulating peak flows and water balance elements than other efficiency criteria. This study could serve as a basis for the choice of performance criteria in hydrological modelling.
基金supported by the National Magnetic Confinement Fusion Energy Program of China(No.2019YFE03020001)the Collaborative Innovation Program of Hefei Science Center,CAS(No.2021HSC-CIP010)the Fundamental Research Funds for the Central Universities。
文摘Interpreting experimental diagnostics data in tokamaks,while considering non-ideal effects,is challenging due to the complexity of plasmas.To address this challenge,a general synthetic diagnostics(GSD)platform has been established that facilitates microwave imaging reflectometry and electron cyclotron emission imaging.This platform utilizes plasma profiles as input and incorporates the finite-difference time domain,ray tracing and the radiative transfer equation to calculate the propagation of plasma spontaneous radiation and the external electromagnetic field in plasmas.Benchmark tests for classical cases have been conducted to verify the accuracy of every core module in the GSD platform.Finally,2D imaging of a typical electron temperature distribution is reproduced by this platform and the results are consistent with the given real experimental data.This platform also has the potential to be extended to 3D electromagnetic field simulations and other microwave diagnostics such as cross-polarization scattering.
基金supported by National Natural Science Foundation of China(No.12175227)the Fundamental Research Funds for the Central Universities(No.USTC 20210079)the Collaborative Innovation Program of Hefei Science Center,CAS(No.2022HSC-CIP022)。
文摘A multi-channel polarimeter-interferometer has been developed on the Keda Torus eXperiment(KTX)for the study of equilibrium dynamics and internal magnetic fluctuations.A three-wave technique based on terahertz solid-state sources(-650 GHz)is applied for simultaneous measurements of electron density and Faraday rotation angle.The output power of the microwave source is 2 mW.Faraday rotation effect using a rotating wave plate is tested with phase noise less than 0.8°,and the density phase noise is less than 0.9°.Measurement of Faraday rotation angle and density for discharges on KTX have demonstrated high sensitivity to internal MHD activities.
基金supported by the National MCF Energy R&D Program of China (Nos. 2018YFE0302103 and 2018YFE 0302100)National Natural Science Foundation of China (Nos. 12205195 and 11975277)。
文摘To investigate the potential of utilizing visible spectral imaging for controlling the plasma boundary shape during stable operation of plasma in future tokamak, a D_α band symmetric visible light diagnostic system was designed and implemented on the Experimental Advanced Superconducting Tokamak(EAST). This system leverages two symmetric optics for joint plasma imaging. The optical system exhibits a spatial resolution less than 2 mm at the poloidal cross-section, distortion within the field of view below 10%, and relative illumination of 91%.The high-quality images obtained enable clear observation of both the plasma boundary position and the characteristics of components within the vacuum vessel. Following system calibration and coordinate transformation, the image coordinate boundary features are mapped to the tokamak coordinate system. Utilizing this system, the plasma boundary was reconstructed, and the resulting representation showed alignment with the EFIT(Equilibrium Fitting) results. This underscores the system's superior performance in boundary reconstruction applications and provides a diagnostic foundation for boundary shape control based on visible spectral imaging.
