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| 1 | AGNP精神科治疗药物监测共识指南:2011显示文摘治疗药物监测(Therapeutic drug monitoring,TDM),如通过定量测定血清或血浆药物浓度指导用药剂量优化,已经成为对患者进行精神药物治疗的很有价值的工具。在患者用药依从性难以判断、药物耐受性不佳、治疗剂量下无效以及可能存在药代动力学药物-药物相互作用等情况下,测定药物浓度是很有用的。在精神科,有可能明显获益于TDM的主要患者群体包括儿童、孕妇、老年患者、智力障碍患者、涉及司法的患者、已知或怀疑携带药代动力学相关基因变异的患者,以及合并躯体疾病影响药代动力学的患者。然而,只有将TDM充分整合到临床治疗过程中去,才能发挥其优化药物治疗的潜在优势。为了促进TDM的合理应用,神经精神药理学与药物精神病学协会(Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie,AGNP)的TDM专家组在2004年发表了精神药物治疗药物监测指南。之后,随着知识不断更新,又有许多可能需要进行TDM的新药上市。因此,本次更新将神经精神药物的种类扩展到了128种,并将其TDM必要性划分为从'强烈推荐'到'可能有用'的四个等级。经过大量细致且全面的文献检索与分门别类的汇总整理,将基于循证医学理念的'治疗参考浓度范围'和'剂量相关参考浓度范围'呈现给大家。本共识指南引入了'实验室警戒浓度'的新概念,即实验室需要马上告知治疗医生的药物浓度上限。本共识指南还给出了诸如药物作为细胞色素P450酶的底物和抑制剂的性质,代谢物与母药浓度比值的常见范围,以及与结果解释相关的内容,还提供了何时将TDM与遗传药理学检测相结合的建议。遵循本指南,有助于改善许多患者精神药物治疗的效果,特别是那些存在药代动力学异常的患者。TDM是一门交叉学科,有时针对看起来不一致的数据,需要多学科坦诚地讨论,只有这样,患者才能从这种合作中获益。 | Hiemke C Baumann P Bergemann N Conca A Dietmaier O Egberts K Fric M Gerlach M Greiner C Gründer G Haen E Havemann-Reinecke U Jaquenoud Sirot E Kirchherr H Laux G Lutz UC Messer T Müller MJ Pfuhlmann B Rambeck B Riederer P Schoppek B Stingl J Uhr M Ulrich S Waschgler R Zernig G 李文标(译) 果伟(译) 阮灿军(译) 贺静(译) 汤宜朗(审校) 王传跃(审校) | 2016 | 实用药物与临床2016，19，10： | 37 |
| 2 | 文献快报(8):芬兰学龄前儿童抗生素使用与其肠道菌群的相关性研究显示文摘有研究表明,早期抗生素的使用增加了儿童肠炎、超重和哮喘的风险。成人试验研究表明,口服抗生素能明显改变肠道微生物菌群,减少菌群的多样性,改变菌群的构成,但其样本量非常有限。在新生儿中使用抗生素治疗者和未使用抗生素治疗者其体内肠道微生物菌群存在较大差异,但至今尚不清楚早期使用抗生素对儿童肠道微生物菌群的远期影响。 | korpela k salonen a virta l j 苏普玉(译) | 2016 | 中国学校卫生2016，37，8： | 31 |
| 3 | 尿钠排泄、血压、心血管病与死亡率的关系:社区前瞻性流行病学队列研究显示文摘WHO建议人群钠摄人<2 g/d作为预防心血管病的措施之一,但这一目标在任何国家都没有实现。该建议主要基于短期血压试验的个体水平数据,没有来自随机试验或观察性研究的关于低钠摄入与降低心血管事件的数据。前瞻性城市农村流行病学研究目前正在21个国家进行。该文对其中18个国家的数据进行分析,其中包含了临床结果数据。 | Mente A O'Donnell M Rangarajan S McQueen M Dagenais G Wielgosz A Lear S Ah STL Wei L Diaz R Avezum A Lopez-Jaramillo P Lanas F Mony P Szuba A Iqbal R Yusuf R Mohammadifard N Khatib R Yusoff K Ismail N Gulec S Rosengren A Yusufali A Kruger L Tsolekile LP Chifamba J Dans A Alhabib KF Yeates K Teo K Yusuf S 刘莉 叶鹏 | 2018 | 中华高血压杂志2018，26，12： | 29 |
| 4 | 高地应力特厚煤层“蠕变型”冲击机理研究显示文摘多起'蠕变型'冲击事故分析表明:该类冲击属于典型的隐蔽性灾害,具有自发性和时滞性的特点,发生机理的不明导致其防治极具挑战,给深部特厚煤层的安全开采造成了严重威胁。'蠕变型'冲击与不稳定蠕变密切相关,通过建立蠕变模型和三维蠕变方程,得到高地应力与特厚煤层为不稳定蠕变的形成提供了有利的孕育条件;分析了巷道围岩不稳定蠕变破坏的过程,认为不稳定蠕变通过强度'腐蚀'和应力解除2方面实现启动冲击和减小阻抗,从而在受外部静态应力叠加影响的巷道薄弱区域形成'蠕变型'冲击,并提出了判别其发生可能性的评估公式。针对这类冲击的发生机理,提出了针对性的防治措施建议:合理布置巷道、加强主动支护、优化卸压参数和长期监测。 | 姜福兴 | 2015 | 岩土工程学报2015，37，10： | 30 |
| 5 | 急性缺血性卒中的血管内治疗:神经介入外科学学会实践标准委员会的报告显示文摘目的总结采用血管内技术治疗急性缺血性卒中的有关证据并等级分类。方法对美国心脏协会(American Heart Association,AHA)以前发表的推荐意见进行审查并作为当前流程的基础。在此这基础上,进行系统的文献回顾以评估支持急性缺血性卒中血管内治疗的证据。根据AHA卒中委员会和牛津大学循证医学中心提出的循证医学证据分级指南进行评估。对操作安全性、技术效果以及对临床转归的影响进行特别审核。 | K A Blackham P M Meyers T A Abruzzo F C Alberquerque D Fiorella J Fraser D Frei C D Gandhi D V Heck J A Hirsch D P Hsu M Jayaraman S Narayanan C Prestigiacomo J L Sunshine 包元飞(译) 李永坤(译) 刘新峰(译) | 2012 | 国际脑血管病杂志2012，20，12： | 28 |
| 6 | History of the infantile hepatic hemangioma:From imaging to generating a differential diagnosis显示文摘We aim to provide an up-to-date summary of infantile hepatic hemangioma(IHH) and its misnomers and to dialectically present the differential diagnosis of these rare entities of the liver.Eligible peer-reviewed articles on hepatic infantile hemangiomas,published between 2000 and 2015,were reviewed for this study.IHH is the most common hepatic vascular tumor in children.Once a liver mass is identified in an infant,the differential diagnosis ranges from vascular malformations to benign and malignant tumors including mesenchymal hamartoma,hepatoblastoma,metastatic neuroblastoma,so careful physical examination,imaging studies,and,if indicated,tumor markers and biopsy,are of pivotal importance to ascertain the correct diagnosis.Despite the benign nature of IHHs,some of these lesions may demand medical and/or surgical intervention,especially for multiple and diffuse IHH.Complications can include hepatomegaly,hypothyroidism and cardiac failure.Therefore,a close follow-up is required until complete involution of the lesions.We propose an algorithm to guide the physicians towards the proper management of hepatic lesions. | Maria Gnarra Gerald Behr Alison Kitajewski June K Wu Sudha A Anupindi Carrie J Shawber Nick Zavras Dimitrios Schizas Chris Salakos Konstantinos P Economopoulos | 2016 | World Journal of Clinical Pediatrics2016，5，3： | 27 |
| 7 | 世界卫生组织(WHO)造血与淋巴组织肿瘤分类方案:临床顾问委员会会议报告显示文摘引言 :从 1995年开始 ,欧洲病理学工作者协会和血液病理学会一直致力于制定一个新的世界卫生组织 (WHO)血液恶性肿瘤分类方案 ,该分类方案包括淋巴系肿瘤、髓系肿瘤、组织细胞肿瘤和肥大细胞肿瘤。 材料与方法 :此项 WHO计划共组成十个病理学工作者委员会 ,负责确定病种和作出定义。另外还成立一个由国际血液学家和肿瘤学家组成的临床顾问委员会 (CAC)以保证该分类的临床实用性。 1997年 11月召开会议讨论了与该分类有关的临床问题。 结果 :WHO采纳了 1994年国际淋巴瘤研究组 (IL SG)报告的修订欧美淋巴系肿瘤分类 (REAL)方案作为淋巴系肿瘤的分类方案。该方案的分类方法遵循以下原则 :分类应是联合应用形态学、免疫表型、遗传特征及临床特征能够清楚界定的“真实存在”(“real”)病种的名录 ,上述各项特征的相对重要性因病种不同而异 ,不存在任何“金标准”。 WHO将 REAL分类原则延用于髓系肿瘤和组织细胞肿瘤 ,髓系肿瘤的分类包括联合应用细胞形态学和细胞遗传学异常能够界定的各个病种。围绕一系列临床问题召集的这次 CAC会议 ,就提交的大多数问题达成共识 ,这些问题及共识将详述于下。对于另外一些问题 ,CAC认为淋巴系肿瘤临床分组既无必要也不必需 ,患者的治疗取决于淋巴瘤的具体类型 ,如有? | N L Harris E S Jaffe J Diebold G Flandrin H K Muller-Hermelink J Vardiman T A Lister C D Bloomfield 张凤奎 郝玉书 | 2001 | 白血病.淋巴瘤2001，10，3： | 20 |
| 8 | Coordinated peak expression of MMP-26 and TIMP-4 in preinvasive human prostate tumor显示文摘因为早察觉和治疗为病人的医药管理是批评的,为早前列腺癌症诊断的新奇简历标记的鉴定是高度重要的。在基础房间层和地下室膜的连续性的混乱为高级职业人员静电干扰 intraepithelial 瘤形成(HGPIN ) 的前进是必要的到在人的前列腺的侵略腺癌。涉及变换到侵略显型的分子是强烈审查的题目。我们以前报导了矩阵 metalloproteinase-26 (MMP-26 ) 经由地下室膜蛋白质并且由激活 MMP-9 的酶原形式的劈开支持人的前列腺癌症房间的侵略。而且,我们发现了 metalloproteinases-4 (TIMP-4 ) 的那个织物禁止者是大多数有势力 MMP-26 的内长的禁止者。这里,我们更高示威(p<0.0001 ) 在 HGPIN 和癌症的 MMP-26 和 TIMP-4 表示,与非肿瘤的 acini 相比。他们的表示层次在 HGPIN 是最高的,但是在一样的纸巾在侵略癌症(为各个的 p<0.001 ) 衰退。连续前列腺癌症织物节染色的 Immunohistochemical 建议 MMP-26 和 TIMP-4 的 colocalization。现在的学习显示 MMP-26 和 TIMP-4 可以在 HGPIN 的变换期间起一个不可分的作用到侵略癌症并且可以也为早前列腺癌症诊断用作标记。房间研究(2006 ) 16:750-758。做 i:10.1038/sj .cr.7310089;出版联机 2006 年 8 月 29 日。 | Seakwoo Lee Kevin K Desai Kenneth A Iczkowski Robert G Newcomer Kevin J WU Yun-Ge Zhao Winston W Tan Mark D Roycik Qing-Xiang Amy Sang | 2006 | Cell Research2006，16，9： | 18 |
| 9 | 介绍一种新的具有重要临床意义的浸润性子宫颈管腺癌分类系统显示文摘最近,新子宫颈管腺癌分类系统被提出。该系统将肿瘤分为三型。A型:肿瘤常由界限清楚的呈巢、簇状腺体排列的小叶状结构;B型:肿瘤表现为局部破坏性浸润,显示促纤维增生间质围绕不规则或边界不清或不完整的腺体,间质中散在单个或小簇状肿瘤细胞;C型:肿瘤表现为弥漫浸润性生长,伴广泛的促纤维间质反应。 | Roma A A Diaz De Vivar A Park K J 康锶鹏 余英豪 | 2015 | 临床与实验病理学杂志2015，31，11： | 17 |
| 10 | Radioembolization for the treatment of unresectable hepatocellular carcinoma:A clinical review显示文摘Hepatocellular carcinoma(HCC)is the sixth most common cancer in the world.The majority of patients with HCC present with unresectable disease.These patients have historically had limited treatment options secondary to HCC demonstrating chemoresistance to the currently available systemic therapies.Additionally, normal liver parenchyma has shown intolerance to tumoricidal radiation doses,limiting the use of external beam radiation.Because of these limitations,novel percutaneous liver-directed therapies have emerged. The targeted infusion of radioactive microspheres (radioembolization)represents one such therapy. Radioembolization is a minimally invasive transcatheter therapy through which radioactive microspheres are infused into the hepatic arteries that supply tumor. Once infused,these microspheres traverse the hepatic vascular plexus and selectively implant within the tumor arterioles.Embedded within the arterioles, the 90Y impregnated microspheres emit high energy and low penetrating radiation doses selectively to the tumor.Radioembolization has recently shown promise for the treatment of patients with unresectable HCC. The objective of this review article is to highlight twocurrently available radioembolic devices(90Y,188Rh)and provide the reader with a recent review of the literature. | Saad M Ibrahim Robert J Lewandowski Kent T Sato Vanessa L Gates Laura Kulik Mary F Mulcahy Robert K Ryu Reed A Omary Riad Salem | 2008 | World Journal of Gastroenterology2008，14，11： | 14 |
| 11 | P16免疫染色可以提高子宫平滑肌肿瘤的组织学分类显示文摘 | Atkins K A Arronte N Darus C J 黄文斌(摘译) | 2008 | 临床与实验病理学杂志2008，24，1： | 13 |
| 12 | Diffusion-weighted magnetic resonance imaging to predict response of hepatocellular carcinoma to chemoembolization显示文摘AIM: To investigate whether intra-procedural diffusion- weighted magnetic resonance imaging can predict response of hepatocellular carcinoma (HCC) during trans- catheter arterial chemoembolization (TACE). METHODS: Sixteen patients (15 male), aged 59 ±11 years (range: 42-81 years) underwent a total of 21 separate treatments for unresectable HCC in a hybrid magnetic resonance/interventional radiology suite. Ana- tomical imaging and diffusion-weighted imaging (b = 0, 500 s/mm2) were performed on a 1.5-T unit. Tumor enhancement and apparent diffusion coefficient (ADC, mm2/s) values were assessed immediately before and at 1 and 3 mo after TACE. We calculated the percent change (PC) in ADC values at all time points. We compared follow-up ADC values to baseline values using a paired t test (α = 0.05). RESULTS: The intra-procedural sensitivity, specificity, and positive and negative predictive values (%) for detecting a complete or partial 1-mo tumor response using ADC PC thresholds of ±5%, ±10%, and ±15% were 77, 67, 91, and 40; 54, 67, 88, and 25; and 46, 100, 100, and 30, respectively. There was no clear predictive value for the 3-mo follow-up. Compared to baseline, the immediate post-procedure and 1-mo mean ADC values both increased; the latter obtaining statistical significance (1.48 ± 0.29 mm2/s vs 1.65 ± 0.35 × 10-3 mm2/s, P < 0.014). CONCLUSION: Intra-procedural ADC changes of > 15% predicted 1-mo anatomical HCC response with the greatest accuracy, and can provide valuable feedback at the time of TACE. | Johnathan C Chung Neel K Naik Robert J Lewandowski Mary F Mulcahy Laura M Kulik Kent T Sato Robert K Ryu Riad Salem Andrew C Larson Reed A Omary | 2010 | World Journal of Gastroenterology2010，16，25： | 13 |
| 13 | 世界家庭医生组织(WONCA)研究论文摘要汇编——有氧运动缓解产后抑郁效果的系统性综述与荟萃分析显示文摘背景当前英美国家尚无运动方法治疗产后抑郁方面的专门指导,而且国际上在此方面的指导也不尽相同。目的评价有氧运动治疗产后抑郁的效果。设计与场所本研究为系统性综述及荟萃分析,无研究地点。方法使用计算机检索MEDLINE、EMBASE、Cochrane Library、Psyc INFO、Sport Discus、Scr Clinical Trials.gov以及World Health Organization International Clinical Trials Registry Platform数据库,收集评估产妇分娩后1年内抑郁状况的随机对照试验、有氧运动和常规护理或者其他护理方式改善产后抑郁效果的比较研究的摘要及全文。使用Cochrane协作组推荐使用的偏倚风险评估工具对纳入的文献进行偏倚风险评估。对纳入的文献进行荟萃分析。对纳入文献之间存在的异质性进行预设亚组分析。结果共纳入13篇文献,包括1 734例患者。整体来看,有氧运动可以显著缓解产后抑郁[SMD=-0.44,95%CI=(-0.75,-0.12)]。异质性分析发现,有氧运动干预效果在可能患有抑郁的产妇间及一般产妇间不存在统计学差异;只采用有氧运动取得的干预效果与采用有氧运动结合其他方式取得的干预效果不存在统计学差异;群体有氧运动与配置有氧运动咨询的干预效果不存在统计学差异。结论本项系统性综述为有氧运动具有缓解产后抑郁的效果提供了证据支持。群体运动、研究对象自己选择运动方式、运动结合其他干预方式均是有效缓解产后抑郁的方法。但是由于纳入文献存在显著异质性和高偏倚风险,故此研究结果应谨慎参考。 | PRITCHETT R V DALEY A J JOLLY K 本刊编辑部 | 2017 | 中国全科医学2017，20，30： | 12 |
| 14 | 欧洲心脏杂志研究称:空气污染导致每年全球880万人死亡,因心血管病死亡是呼吸疾病的两倍显示文摘根据发表在《欧洲心脏杂志》上的一项研究,2015年,空气污染(PM2.5和臭氧)在整个欧洲造成了79万人死亡,在这些死亡中,40%.80%死于心血管疾病。空气污染导致的心血管疾病死亡人数是呼吸系统疾病死亡人数的两倍。研究人员还发现,全球大气污染造成的死亡人数估计为880万,而不是先前估计的450万。这意味着空气污染每年造成的额外死亡比吸烟多,世界卫生组织估计吸烟导致额外720万人死亡。 | Lelieveld J Klingmüller K Pozzer A | 2019 | 疾病监测2019，34，3： | 12 |
| 15 | 卵巢成熟性畸胎瘤伴发的黏液上皮性肿瘤形态学异质性及其与腹膜假黏液瘤的关系显示文摘 | McKenney J K Soslow R A Longacre T A 王文军(摘译) 张帆(审校) | 2008 | 临床与实验病理学杂志2008，24，4： | 10 |
| 16 | Alcoholic pancreatitis:New insights into the pathogenesisand treatment显示文摘Acute pancreatitis is a necro-inflammatory disease of the exocrine pancreas that is characterized by inappropriate activation of zymogens, infiltration of the pancreas by inflammatory cells, and destruction of the pancreatic exocrine cells. Acute pancreatitis can progress to a severe life-threatening disease. Currently there is no pharmacotherapy to prevent or treat acute pancreatitis. One of the more common factors associated with acute pancreatitis is alcohol abuse. Although commonly associated with pancreatitis alcohol alone is unable to cause pancreatitis. Instead, it appears that alcohol and its metabolic by-products predispose the pancreas to damage from agents that normally do not cause pancreatitis, or to more severe disease from agents that normally cause mild pancreatic damage. Over the last 10 to 20 years, a tremendous amount of work has defined a number of alcohol-mediated biochemical changes in pancreatic cells. Among these changes are: Sustained levels of intracellular calcium, activation of the mitochondrial permeability transition pore, endoplasmic reticulum stress, impairment in autophagy, alteration in the activity of transcriptional activators, and colocalization of lysosomal and pancreatic digestive enzymes. Elucidation of these changes has led to a deeper understanding of the mechanisms by which ethanol predisposes acinar cells to damage. This greater understanding has revealed a number of promising targets for therapeutic intervention. It is hoped that further investigation of these targets will lead to the development of pharmacotherapy that is effective in treating and preventing the progression of acute pancreatitis. | Dahn L Clemens Katrina J Schneider Christopher K Arkfeld Jaclyn R Grode Mark A Wells Shailender Singh | 2016 | World Journal of Gastrointestinal Pathophysiology2016，7，1： | 10 |
| 17 | Diagnostic yield of small bowel capsule endoscopy depends on the small bowel transit time显示文摘AIM:To investigate whether the small bowel transit time(SBTT)influences the diagnostic yield of capsule endoscopy(CE).METHODS:Six hundred and ninety-one consecutive CE procedures collected in a database were analyzed.SBTT and CE findings were recorded.A running mean for the SBTT was calculated and correlated to the diagnostic yield with a Spearman's correlation test.Subgroup analyses were performed for the various indications for the procedure.RESULTS:There was a positive correlation between the diagnostic yield and SBTT(Spearman's rho 0.58,P <0.01).Positive correlations between diagnostic yield and SBTT were found for the indication obscure gastrointestinal bleeding(r=0.54,P<0.01),for polyposis and carcinoid combined(r=0.56,P<0.01)and for the other indications(r=0.90,P<0.01),but not for suspected Crohn's disease(r=-0.40).CONCLUSION:The diagnostic yield in small bowel capsule endoscopy is positively correlated with the small bowel transit time.This is true for all indications except for suspected Crohn's disease. | Jessie Westerhof Jan J Koornstra Reinier A Hoedemaker Wim J Sluiter Jan H Kleibeuker Rinse K Weersma | 2012 | World Journal of Gastroenterology2012，18，13： | 10 |
| 18 | 酒精摄入、心脏生物标志物和心房颤动风险与不良结局显示文摘酒精摄入和新发心房颤动相关性证据不一,尤其是在低剂量下。该研究评估欧洲队列在整个饮酒范围内酒精摄入、生物标志物和新发心房颤动的关系。方法和结果:在一个以社区为基础的汇集队列中,研究者随访107845人,以评估酒精摄入(酒精种类和饮酒方式)与新发心房颤动的关系。研究者收集经典心血管病危险因素和新发心力衰竭的信息,并检测生物标记物氨基末端脑钠肽前体和高敏肌钙蛋白I。 | 陈嘉睿(译) 练桂丽((审校) Csengeri D Sprünker NA Di Castelnuovo A Niiranen T Vishram-Nielsen JK Costanzo S S derberg S Jensen SM Vartiainen E Donati MB Magnussen C Camen S Gianfagna F L chen ML Kee F Kontto J Mathiesen EB Koenig W Stefan B de Gaetano G J rgensen T Kuulasmaa K Zeller T Salomaa V Iacoviello L Schnabel RB | 2021 | 中华高血压杂志2021，29，2： | 9 |
| 19 | 热处理豆粕饲喂生长猪的氨基酸消化率显示文摘为测定热处理对豆粕(SBM)表观回肠消化率和标准回肠消化率(SID)的影响,本试验将常规去壳豆粕(48.5%蛋白)分成4组,一份未经额外热处理,一份在125℃下高压蒸汽处理15 min,一份在125℃下高压蒸汽处理30 min,另一份在125℃下烘箱烘干30 min。制定四种豆粕-玉米淀粉型日粮配方,且每个配方只能使用上述四种豆粕中的一种,作为每种日粮中唯一氨基酸来源。用无氮日粮配方来估算基础内源性氨基酸损失。分别在初始体重为(25.3±2.0)kg的10头阉公猪回肠末端安装一个T-型瘘管。采用5×5拉丁方设计法,将试验猪分成5个日粮处理组,5个重复处理周期。每个处理周期持续7 d,在第6天和第7天收集回肠食糜。试验结果表明,随着高压蒸汽处理时间(0~30 min)的延长,蛋白质和所有氨基酸的表观回肠消化率和标准回肠消化率呈线性降低(P<0.01)。糠氨酸含量和豆粕样品的颜色表明高压蒸汽处理导致豆粕产生美拉德反应。然而,125℃烘箱干燥30min并未改变豆粕中蛋白和氨基酸标准回肠消化率,也没有改变SBM的糠氨酸含量(P>0.10),且烘箱处理的样品颜色表明该样品并未受到热处理破坏。总之,热蒸汽处理时间从0 min增至30 min,高压蒸汽处理豆粕的氨基酸消化率呈线性降低,降低原因很可能是由于125℃高压蒸汽处理导致豆粕产生美拉德反应。 | González-Vega J C Kim B G Htoo J K Lemme A Stein H H | 2015 | 中国饲料2015，，24： | 8 |
| 20 | Concordance of non-invasive mechanical and serum tests for liver fibrosis evaluation in chronic hepatitis C显示文摘AIM To determine the sensitivity and specificity of liver stiffness measurement(LSM) and serum markers(SM) for liver fibrosis evaluation in chronic hepatitis C.METHODS Between 2012 and 2014,81 consecutive hepatitis C virus(HCV) patients had METAVIR score from liver biopsy compared with concurrent results from LSM [transient elastography(TE) [FibroS can~/ARFI technology(Virtual Touch~)] and SM [FIB-4/aspartate aminotransferase-toplatelet ratio index(APRI)].The diagnostic performance of these tests was assessed using receiver operating characteristic curves.The optimal cut-off levels of each test were chosen to define fibrosis stages F ≥ 2,F ≥ 3 and F = 4.The Kappa index set the concordance analysis.RESULTS Fifty point six percent were female and the median age was 51 years(30-78).Fifty-six patients(70%) weretreatment-na?ve.The optimal cut-off values for predicting F ≥ 2 stage fibrosis assessed by TE were 6.6 kP a,for acoustic radiation force impulse(ARFI) 1.22 m/s,for APRI 0.75 and for FIB-4 1.47.For F ≥ 3 TE was 8.9 kP a,ARFI was 1.48 m/s,APRI was 0.75,and FIB-4 was 2.For F = 4,TE was 12.2 kP a,ARFI was 1.77 m/s,APRI was 1.46,and FIB-4 was 3.91.The APRI could not distinguish between F2 and F3,P = 0.92.The negative predictive value for F = 4 for TE and ARFI was 100%.Kappa index values for F ≥ 3 METAVIR score for TE,ARFI and FIB-4 were 0.687,0.606 and 0.654,respectively.This demonstrates strong concordance between all three screening methods,and moderate to strong concordance between them and APRI(Kappa index = 0.507).CONCLUSION Given the costs and accessibility of LSM methods,and the similarity with the outcomes of SM,we suggest that FIB-4 as well as TE and ARFI may be useful indicators of the degree of liver fibrosis.This is of particular importance to developing countries. | Denise C Paranaguá-Vezozzo Adriana Andrade Daniel F C Mazo Vinicius Nunes Ana L Guedes Taisa G Ragazzo Renata Moutinho Lucas S Nacif Suzane K Ono Venancio A F Alves Flair J Carrilho | 2017 | World Journal of Hepatology2017，9，8： | 7 |
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