3.Biomarkers for early screening and diagnosis of breast cancer: a review.
Youfeng LIANG ; Mingxuan HAO ; Rui GUO ; Xiaoning LI ; Yongchao LI ; Changyuan YU ; Zhao YANG
Chinese Journal of Biotechnology 2023;39(4):1425-1444
		                        		
		                        			
		                        			The estimated new cases of breast cancer (BC) patients were 2.26 million in 2020, which accounted for 11.7% of all cancer patients, making it the most prevalent cancer worldwide. Early detection, diagnosis and treatment are crucial to reduce the mortality, and improve the prognosis of BC patients. Despite the widespread use of mammography screening as a tool for BC screening, the false positive, radiation, and overdiagnosis are still pressing issues that need to be addressed. Therefore, it is urgent to develop accessible, stable, and reliable biomarkers for non-invasive screening and diagnosis of BC. Recent studies indicated that the circulating tumor cell DNA (ctDNA), carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA15-3), extracellular vesicles (EV), circulating miRNAs and BRCA gene from blood, and the phospholipid, miRNAs, hypnone and hexadecane from urine, nipple aspirate fluid (NAF) and volatile organic compounds (VOCs) in exhaled gas were closely related to the early screening and diagnosis of BC. This review summarizes the advances of the above biomarkers in the early screening and diagnosis of BC.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Biomarkers, Tumor
		                        			;
		                        		
		                        			Early Detection of Cancer
		                        			;
		                        		
		                        			Breast Neoplasms/diagnosis*
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			MicroRNAs/genetics*
		                        			
		                        		
		                        	
4.Application of microfluidic assays for cardiovascular disease markers in early warning and rapid diagnosis.
Tai Ju CHEN ; Rui Ning LIU ; Hong ZHANG ; Hua Ming MOU ; Yang LUO
Chinese Journal of Preventive Medicine 2023;57(7):1115-1123
		                        		
		                        			
		                        			Cardiovascular disease is a major threat to human health and has become the leading cause of death worldwide; therefore, early diagnosis and treatment are of great value. Due to its miniaturization, integration, and ease of operation, microfluidic technology enables the rapid, multi-target detection of cardiovascular disease markers and significantly facilitates the early and rapid diagnosis of cardiovascular disease. This article reviews the research progress of microfluidics in cardiovascular disease detection, analyzes its advantages and weaknesses in the rapid detection of protein, lipid, and nucleic acid biomarkers, hopes to provide a reference to promote the quick detection technology of cardiovascular disease, and thus proposes new considerations for the early management of cardiovascular disease.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Microfluidics
		                        			;
		                        		
		                        			Cardiovascular Diseases/diagnosis*
		                        			;
		                        		
		                        			Biomarkers
		                        			;
		                        		
		                        			Early Diagnosis
		                        			
		                        		
		                        	
6.Methylated SDC2 testing in stool DNA for early screening of colorectal cancer in Shipai Town, Dongguan City.
Xian He KONG ; Zhi ZHANG ; Da Hong DENG ; Zhi Qiang YU ; Kai ZHAN ; Xiao Sheng HE
Chinese Journal of Gastrointestinal Surgery 2023;26(4):372-379
		                        		
		                        			
		                        			Objective: To explore the utility of stool-based DNA test of methylated SDC2 (mSDC2) for colorectal cancer (CRC) screening in residents of Shipai Town, Dongguan City. Methods: This was a cross-sectional study. Using a cluster sampling method, residents of 18 villages in Shipai Town, Dongguan City were screened for CRC from May 2021 to February 2022. In this study, mSDC2 testing was employed as a preliminary screening method. Colonoscopy examination was recommended for individuals identified as high-risk based on the positive mSDC2 tests. The final screening results, including the rate of positive mSDC2 tests, the rate of colonoscopy compliance, the rate of lesions detection, and the cost-effectiveness of screening, were analyzed to explore the benefits of this screening strategy. Results: A total of 10 708 residents were enrolled and completed mSDC2 testing, giving a participation rate of 54.99% (10 708/19 474) and a pass rate of 97.87% (10 708/10 941). These individuals included 4 713 men (44.01%) and 5 995 women (55.99%) with a mean age of (54.52±9.64) years. The participants were allocated to four age groups (40-49, 50-59, 60-69, and 70-74 years), comprising 35.21%(3770/10 708), 36.25% (3882/10 708), 18.84% (2017/10 708), and 9.70% (1039/10 708) of all participants, respectively. mSDC2 testing was positive in 821/10 708 (7.67%) participants, 521 of whom underwent colonoscopy, resulting in a compliance rate of 63.46% (521/821). After eliminating of 8 individuals without pathology results, data from 513 individuals were finally analyzed. Colonoscopy detection rate differed significantly between age groups (χ2=23.155, P<0.001),ranging from a low of 60.74% in the 40-49 year age group to a high of 86.11% in the 70-74 year age group. Colonoscopies resulted in the diagnosis of 25 (4.87%) CRCs, 192 (37.43%) advanced adenomas, 67 (13.06%) early adenomas, 15 (2.92%) serrated polyps, and 86 (16.76%) non- adenomatous polyps. The 25 CRCs were Stage 0 in 14 (56.0%) individuals, stage I in 4 (16.0%), and Stage II in 7(28.0%). Thus, 18 of the detected CRCs were at an early stage. The early detection rate of CRCs and advanced adenomas was 96.77% (210/217). The rate of mSDC2 testing for all intestinal lesions was 75.05% (385/513). In particular, the financial benefit of this screening was 32.64 million yuan, and the benefit-cost ratio was 6.0. Conclusion: Screening for CRCs using stool-based mSDC2 testing combined with colonoscopy has a high lesion detection rate and a high cost-effectiveness ratio. This is a CRC screening strategy that deserves to be promoted in China.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Early Detection of Cancer/methods*
		                        			;
		                        		
		                        			Colorectal Neoplasms/pathology*
		                        			;
		                        		
		                        			Colonoscopy/methods*
		                        			;
		                        		
		                        			Mass Screening/methods*
		                        			;
		                        		
		                        			Adenoma/diagnosis*
		                        			;
		                        		
		                        			DNA
		                        			;
		                        		
		                        			Syndecan-2/genetics*
		                        			
		                        		
		                        	
7.Value of basal luteinizing hormone level combined with uterine volume measurement in the early diagnosis of central precocious puberty in girls with different Tanner stages.
Wei WANG ; Niu-Niu CAO ; Ya XIAO ; Yan WANG ; Yi-Fan WANG ; Jun SUN
Chinese Journal of Contemporary Pediatrics 2023;25(2):159-165
		                        		
		                        			OBJECTIVES:
		                        			To study the value of basal luteinizing hormone (LH) level combined with uterine volume measurement in the early diagnosis of central precocious puberty (CPP) in girls with different Tanner stages.
		                        		
		                        			METHODS:
		                        			A retrospective analysis was performed on the girls who presented with breast development before the age of 8 years and attended the Third Affiliated Hospital of Zhengzhou University from January 2017 to September 2022. According to the results of gonadotropin-releasing hormone (GnRH) agonist test, the girls with peak LH ≥5.0 IU/L and peak LH/follicle stimulating hormone ≥0.6 were enrolled as the positive group, and the other girls were enrolled as the negative group. The two groups were compared in terms of the basal LH level and uterine volume. The receiver operating characteristic (ROC) curve was used to analyze their value in the early diagnosis of CPP.
		                        		
		                        			RESULTS:
		                        			For the girls with Tanner B2 and B3 stages, the positive group had significantly higher basal LH level and uterine volume than the negative group (P<0.05). The basal LH level had an optimal cut-off value of 0.325 IU/L and 0.505 IU/L respectively in the diagnosis of Tanner stage B2/B3 CPP, while uterine volume had an optimal cut-off value of 1.639 mL and 2.158 mL respectively. Basal LH level combined with uterine volume measurement had a significantly larger area under the ROC curve than uterine volume measurement alone (P<0.001), but with no significant difference compared with that of basal LH level measurement alone (P>0.05).
		                        		
		                        			CONCLUSIONS
		                        			Basal LH level combined with uterine volume measurement is valuable in the early diagnosis of CPP in girls with different Tanner stages, which provides a basis and guiding significance for clinical diagnosis of CPP.
		                        		
		                        		
		                        		
		                        			Child
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Early Diagnosis
		                        			;
		                        		
		                        			Luteinizing Hormone/chemistry*
		                        			;
		                        		
		                        			Puberty, Precocious/diagnosis*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Uterus/pathology*
		                        			
		                        		
		                        	
8.Comparison of four early warning scores in predicting the prognosis of critically ill patients in secondary hospitals.
Xiaoqin SU ; Hongyan ZHANG ; Wenjun YUAN ; Meng YI ; Chenghao FU ; Jiawei JIANG ; Hongmei GAO
Chinese Critical Care Medicine 2023;35(10):1093-1098
		                        		
		                        			OBJECTIVE:
		                        			To explore the predictive value of acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA), quick sequential organ failure assessment (qSOFA) and modified early warning score (MEWS) in evaluating the prognosis of patients in intensive care unit (ICU) of secondary hospitals, and to provide guidance for clinical application.
		                        		
		                        			METHODS:
		                        			The clinical data of adult critical patients admitted to the ICU of Wanzhou District First People's Hospital from October 2022 to April 2023 were retrospectively analyzed. According to the clinical outcome of ICU, the patients were divided into improvement group and death group. The general information, blood routine, heart, liver and kidney function indicators, coagulation indicators, blood gas analysis, APACHE II score, SOFA score, qSOFA score, MEWS score at the time of admission to the ICU, the number of cases of invasive mechanical ventilation (IMV) and continuous blood purification (CBP) were compared between the two groups. Univariate analysis was performed, and multivariate Logistic regression analysis was used to analyze the related factors of death. Receiver operator characteristic curve (ROC curve) was used to analyze the predictive value of the four scores in ICU patients.
		                        		
		                        			RESULTS:
		                        			A total of 126 patients were included, of which 45 patients died in the ICU and 81 patients improved and transferred out. Univariate analysis of death-related critically ill patients showed that procalcitonin (PCT), serum creatinine (SCr), blood urea nitrogen (BUN), albumin (ALB), prothrombin time (PT), activated partial prothrombin time (APTT), D-dimer, pH value, HCO3-, blood lactic acid (Lac), number of patients treated with IMV and CBP, APACHE II score, SOFA score, qSOFA score and MEWS score were significantly different between the two groups (all P < 0.05). Multivariate Logistic regression analysis showed that the APACHE II score [odds ratio (OR) = 1.115, 95% confidence interval (95%CI) was 1.025-1.213, P = 0.011], SOFA score (OR = 1.204, 95%CI was 1.037-1.398, P = 0.015), MEWS score (OR = 1.464, 95%CI was 1.102-1.946, P = 0.009), and APTT (OR = 1.081, 95%CI was 1.015-1.152, P = 0.016) were independent risk factors affecting the mortality of critically ill patients in the ICU. ROC curve analysis showed that APACHE II, SOFA, qSOFA, and MEWS scores could predict the prognosis of critically ill ICU patients, among which SOFA score had the strongest predictive effect, and the area under the curve (AUC) was 0.808. There was a statistically significant difference in the time required for the four scores (F = 117.333, P < 0.001), among which the MEWS scoring required the shortest time [(1.03±0.39) minutes], and the APACHE II scoring required the longest time [(2.81±1.04) minutes].
		                        		
		                        			CONCLUSIONS
		                        			APACHE II, SOFA, qSOFA, and MEWS scores can be used to assess the severity of critically ill patients and predict in-hospital mortality. The SOFA score is superior to other scores in predicting severity. The MEWS is preferred because its assessment time is shortest. Early warning score can help secondary hospitals to detect potentially critical patients early and provide help for clinical rapid urgent emergency decision-making.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Sepsis/diagnosis*
		                        			;
		                        		
		                        			ROC Curve
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Critical Illness
		                        			;
		                        		
		                        			Early Warning Score
		                        			;
		                        		
		                        			Organ Dysfunction Scores
		                        			;
		                        		
		                        			Intensive Care Units
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Hospitals
		                        			
		                        		
		                        	
9.Precision diagnosis of hepatocellular carcinoma.
Zhenxiao WANG ; Hanjiao QIN ; Shui LIU ; Jiyao SHENG ; Xuewen ZHANG
Chinese Medical Journal 2023;136(10):1155-1165
		                        		
		                        			
		                        			Hepatocellular carcinoma (HCC) is the most common type of primary hepatocellular carcinoma (PHC). Early diagnosis of HCC remains the key to improve the prognosis. In recent years, with the promotion of the concept of precision medicine and more in-depth analysis of the biological mechanism underlying HCC, new diagnostic methods, including emerging serum markers, liquid biopsies, molecular diagnosis, and advances in imaging (novel contrast agents and radiomics), have emerged one after another. Herein, we reviewed and analyzed scientific advances in the early diagnosis of HCC and discussed their application and shortcomings. This review aimed to provide a reference for scientific research and clinical practice of HCC.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Carcinoma, Hepatocellular/pathology*
		                        			;
		                        		
		                        			Liver Neoplasms/pathology*
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Early Diagnosis
		                        			;
		                        		
		                        			Precision Medicine
		                        			
		                        		
		                        	
10.Malignant Melanoma of the Foot: The Tip of an Iceberg – A Creeping Danger that Lurks Beneath the Surface
Eyrique Boay Heong Goh ; Surendra A/L Sabramaniam ; Serene Soo Lin Teo ; Muhammad Syamil Ibrahim ; Noorriyanti Fazreen Al Shaari
International e-Journal of Science, Medicine and Education 2023;17(1):19-21
		                        		
		                        			
		                        			This is a report of a patient who presented with a
history of what resembled a skin-tag on the plantar
aspect of his left foot, which later grew in four months,
causing discomfort during ambulation. Little did we
know that the growth was just the tip of the iceberg
of a vicious malignant melanoma (MM) lurking
underneath with metastasis.
Upon clinical suspicion, a biopsy was scheduled
to obtain histopathological examination (HPE).
Magnetic resonance imaging (MRI) reported the
lesion to be a malignant melanoma and contrast
enhance computed tomography of the thorax
abdomen and pelvic (CECT TAP) surveillance and
positron-emission tomography (PET) were requested
to stage and guide the treatment modalities. A wide
surgical resection was performed and wound was left
to heal via secondary intention.
The aim of this report is to create awareness of early
suspicions and detection of MM and treatment, which
could lead to a better prognosis and the acceptance of
post excision allowing for wound to heal via secondary
intention healing.
		                        		
		                        		
		                        		
		                        			Melanoma
		                        			;
		                        		
		                        			 Early Diagnosis
		                        			;
		                        		
		                        			 Biopsy
		                        			;
		                        		
		                        			 Prognosis
		                        			
		                        		
		                        	
            

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