Objective To investigate inter-observer reproducibility in the pathologic diagnosis of breast intraductal proliferative lesions (BDPL). Methods Forty three BDPL patients were diagnosed by criterion of Page. Every specimen from each case was sorted randomly. All slides were classified as mild usual hyperplasia, moderate-severe usual hyperplasia, mild atypical hyperplasia, moderate-severe atypical hyperplasia, ductal carcinoma in situ, or ductal carcinoma in situ with invasion. Inter-observer agreement of the two groups was statistically analyzed using Kappa test. Then we compared all the diagnoses of individual pathologist with the consensus opinion confirmed by two breast pathologists to analyze the diagnostic accuracy and undue diagnosis. Results Inter-observer reproducibility of the trial group was higher than that of the control group (The total K value of 6, 3, and 2 diagnoses in the two groups were 0.289 3, 0.337 1, 0.492 8, 0.100 3, 0.150 3 and 0.340 3, respectively). When the categories were simplified, inter-observer reproducibility increased. There were still undue diagnoses of different degrees among pathologists of the trial group. Conclusion Using the same criteria is an important method to increase the diagnostic reproducibility and accuracy. More practice is needed to familiarize with these criteria.
目的 探討胰性腦病的可能的發病機制、發病情況及防治措施.方法 計算機檢索中文科技期刊全文數據庫(1989～2004),收集有關胰性腦病的臨床研究,并進行統計分析.結果 共納入43篇文獻,435例患者.胰性腦病在重癥急性胰腺炎中的發病率遠高于輕癥急性胰腺炎;發病年齡趨向中、老年;病死率為43.67%;病因仍以膽系疾病為主;伴發低氧的幾率不高于未并發胰性腦病患者.結論 胰性腦病的發生可能是多因素共同作用的結果,仍需進一步探討其發病機制.血清髓鞘堿性蛋白有望成為有價值的診斷指標.防治以治療原發病急性胰腺炎為主,重在預防.胰酶抑制劑和早期營養支持有一定預防作用.
The scientific establishment of traditional Chinese medicine (TCM) syndrome diagnostic criteria is the basic link to achieve standardization and normalization of TCM diagnosis and treatment. The ambiguous idea and method, incomplete key technology, and unformed development standard of the establishment of TCM syndrome diagnostic criteria restrict its development and application. Therefore, project team drafted the development guideline of TCM syndrome diagnostic criteria and modified it according to expert opinions, which was based on the technical system established previously. This guideline could be used as a reference for formulating diagnostic criteria. It is also applicable to clinical, teaching, and scientific research related to syndrome diagnostic criteria that professional personnel from various levels of TCM (integrated traditional Chinese and Western medicine) medical, teaching institutions, and research institutes participated.
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.
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.
Acute pharyngitis belongs to the category of "acute throat impediment" in traditional Chinese medicine (TCM), which has a high incidence and is easy to recur. In clinical practice of TCM, Chinese patent medicines with the effects of clearing heat and detoxifying, reducing swelling and relieving pain are widely used in the treatment of acute pharyngitis. These medicines have the advantages of definite efficacy, low side effects, and low risk of developing drug resistance. However, at present, there are no standardized clinical diagnostic and therapeutic evaluation norms for acute pharyngitis in TCM, which has hindered the application of TCM in the prevention and treatment of acute pharyngitis and the development of new TCM preparations. Therefore, the China Association of Chinese Medicine initiated this expert consensus, which was led the formulation by Xiyuan Hospital, China Academy of Chinese Medical Sciences. This expert consensus integrates the current best evidence and extensive clinical expert experience from the front line, covering seven aspects: applicable scope, diagnosis in both Chinese and Western medicine, syndrome classification and evaluation scales, basis for efficacy evaluation, and time for efficacy evaluation. It has formed 8 types of TCM syndromes for acute pharyngitis, as well as the diagnostic criteria, syndrome classification and evaluation scales, evaluation basis for efficacy, and scoring standards for syndromes and diseases. This expert consensus can be used to standardize the diagnosis of the TCM syndromes of acute pharyngitis, as well as the core indicators and evaluation methods for syndrome and disease efficacy, with the aim of providing references for clinical practice and scientific research on acute pharyngitis.