Differences in the system accuracy acceptability of four types of blood glucose monitoring systems against five different standards

Objective:This study aimed to evaluate the system accuracy of four types of blood glucose monitoring systems(BGMSs)and explore the differences in the system accuracy acceptability of each BGMS against five different standards.Methods:The glucose measurement values obtained from four types of BGMSs(Roche Accu-Chek® Performa,Bayer Contour™ TS,Sinomedisite Glupad® H1 Plus,and Sinocare® Gold-Accu)were evaluated against the reference values obtained from the biochemical analyzer of the central laboratory.The system accuracy acceptability of each BGMS was determined using the criteria specified in five standards,namely the International Organization for Standardization(ISO)15197:2003,Clinical Laboratory Standards Institute(CLSI)POCT12-A3,ISO 15197:2013,Chinese Society of Laboratory Medicine(CSLM)consensus,and US Food and Drug Administration(FDA)guidelines.Results:From 2018 to 2022,10,980 pairs of measurement values were obtained from 366 glucose meters of four types of BGMSs.Significant correlations were observed between the glucose measurement values from the BGMSs and the reference values from the biochemical analyzer of the central laboratory.The correlation coefficient r was 0.995 for Roche Accu-Chek® Performa,0.994 for Bayer Contour™ TS,0.983 for Sinomedisite Glupad® H1 Plus,and 0.997 for SinocareR Gold-Accu.The acceptability criteria specified in ISO 15197:2003 were met by 100.00%(135/135)of the glucose meters of Roche Accu-Chek® Performa,100.00%(109/109)of Bayer Contour™ TS,81.61%(71/87)of Sinomedisite Glupad® H1 Plus,and 100.00%(35/35)of SinocareR Gold-Accu.Whereas,the acceptability criteria specified in ISO 15197:2013 were met by 99.26%(134/135)of the glucose meters of Roche Accu-Chek® Performa,88.07%(96/109)of Bayer Contour™ TS,58.62%(51/87)of Sinomedisite Glupad R H1 Plus,and 91.43%(32/35)of SinocareR Gold-Accu.Conclusions:Among the four types of BGMSs evaluated,the glucose meters of Roche Accu-Chek® Performa exhibited superior system accuracy.The system accuracy acceptability of each BGMS varied significantly against the acceptability criteria specified in the five different standards.

Concomitant and sequential administration of nirmatrelvir-ritonavir and azvudine in patients with COVID-19 caused by the Omicron variant: Safety and efficacy

Background:This study assessed the safety and efficacy of nirmatrelvir-ritonavir(Paxlovid®)and azvudine when administered sequentially or concomitantly in patients with coronavirus 2019(COVID-19)caused by the Omicron variant.Methods:Ninety-three patients confirmed to be infected with the Omicron variant by nucleic acid detection were retrospectively investigated.Informa-tion was collected on general health status,medication,and adverse drug reactions(ADRs)according to whether nirmatrelvir-ritonavir and azvudine were administered sequentially or concomitantly.Data on times of onset,clinical manifestations,and outcomes of ADRs and on conversion to a nega-tive nucleic acid test were also recorded.Results:Possible ADRs were recorded in 41 patients(44.1%).There were 22 gastrointestinal reactions in 18 patients and 18 hematological abnormalities in 16 after sequential or concomitant treatment with nirmatrelvir-ritonavir and azvudine.Liver enzyme levels increased in nine cases and creatinine clearance decreased in two.Cases of atrial fibrillation(n=1),sleep disorder(n=2),rash(n=2),dizziness(n=1),and weakness(n=5)were also documented.Only vomiting,poor appetite,diarrhea,xerostomia,bitter taste,and rash were considered probable ADRs;others were thought to be possible ADRs.In all cases,the nucleic acid test did not turn negative after the first antiviral was applied.The nucleic acid test of 28 patients did not turn negative before discharge.The remaining 65 patients(69.9%)returned a negative nucleic acid test after receiving the second antiviral agent.Conclusions:Treatment with nirmatrelvir-ritonavir and azvudine is safe and effective whether administered sequentially or concomitantly in patients with COVID-19 caused by the Omicron variant.

Successful treatment of severe monkeypox case with advanced HIV infection using plasma from smallpoxvaccinated healthy population:A case report

Since the first reported case of monkeypox in the UK in May 2022,there has been an upward trend in monkeypox cases and a global outbreak.However,reports of severe cases are relatively limited.In this study,we report a case of severe monkeypox in a patient with HIV.The patient presented with skin lesions that started on his face and around the penis and persisted for several months.Throughout the course of the disease,he received systematic symp-tomatic supportive treatment,topical remedies,and special care for the rash.He also underwent cidofovir antiviral therapy and smallpox‐vaccinated healthy population‐derived plasma therapy in succession,with the condition ultimately showing improvement after plasma treatment.After more than 3 months of hospitalization,he fully recovered.To the best of our knowledge,this is the first reported use of smallpox‐vaccinated healthy population‐derived plasma in the treatment of severe monkeypox cases.

A preliminary study of the mechanism of compound hearing loss caused by ototoxic drugs combined with impulse noise

Background:Hearing loss(HL)is becoming increasingly common and is more commonly caused by noise,ototoxic substances,or a combination of ototoxic factors.However,so far,few studies have examined the mechanism by which compound factors cause HL.The only relevant study is about occupational ototoxic substances combined with environmental noise at 85-110 dB SPL.In this study,to address the shortcomings of existing research,we innovatively focused on HL induced by loud noise(impulse noise,>160 dB SPL)combined with common ototoxic drugs.The aim of this study was to establish and validate a mature animal model,and then to compare the characteristics of audiology,pathomorphology and molecular features,and to preliminarily predict pathogenesis in compound HL.Materials and Methods:We selected guinea pigs to construct in vivo HL model groups for different extents of exposure,including a blank control group,a single-drug group,a single-impulse noise group,and a compound group.The animal model of the mature compound HL group was established using gentamicin combined with impulse noise.We then performed audio-logical and pathological verification.We analyzed the auditory brainstem response(ABR),pathological morphology of the cochlea,and molecules(including important self-radicals,cytokines,and apoptosis signal trans-duction pathway proteins in the pathogenesis of drug-and noise-induced HL),compared the effect of different extents of exposure on HL,and preliminarily predict the pathogenic mechanism of compound HL.Results:Four groups of animal models were established successfully and verified by audiology and pathology.Regarding audiology,there were no sig-nificant differences in the ABR thresholds before exposure(p>0.05),but differences emerged among the groups after exposure.Notably,after 3,7,and 14 days of exposure,there were significant differences in the ABR thresholds between the compound group and both the drug and noise groups(p<0.01),and after 14 days,the HL of the compound group was much more severe(greater than the linear sum of single-factor HL group).Regarding the patho-morphology,compared with the control group,the cochleae were damaged to different degrees in the factor exposure groups.The drug group had the least severe HL,the noise group had serious HL(p<0.05),and the compound group had the most severe HL(p<0.01).The compound group's damage was greater than the linear sum of the single-factor group in many ways,such as the loss and damage of hair cells and cilia,disturbed morphology and arrangement of hair cells,protein metabolism,cell function,and structural defects on the epidermal plate(p<0.01).From a molecular perspective,the trend was similar to pathology and audiology,and the synergistic effect of ototoxic drugs and impulse noise significantly increased cytokine levels(IL-6,ICAM-1,8-OHDG,IL-1,and TNF-α),free radicals Malondialdehyde([MDA],▪OH,LPO,O•2ˉ),and the apoptosis signal transduction pathway protein.There were significant differences between the compound group and single-factor groups(p<0.05).Conclusion:Gentamicin,impulse noise,and compound factors were used to induce HL in animal models,which were verified by audiology and pathology,laying a foundation for future studies.After constructing the animal models,we found that 50 mg/kg of gentamicin for 10 days was a subinjury dose,and 50�impulse noise caused partial HL,but the two factors combined had a significant synergistic ototoxicity effect,which increased the level of oxidative stress and the waterfall response of inflammatory cytokines in the cochleae and enhanced the expression of apoptosis-related proteins,resulting in syn-ergistic pathomorphological and audiological injury.We preliminarily analyzed the pathogenic mechanism of compound HL,establishing the basis for further study of the mechanism,prevention,and treatment of this increasing global problem.

Pseudomonas aeruginosa infections and improper storage conditions influence the performance of 1,3‐β‐D‐glucan in diagnosis of invasive fungal infections

Background:The association between 1,3-β-D-glucan(BDG)levels and in-fections caused by Pseudomonas aeruginosa or Streptococcus pneumoniae,and the stability of BDG under different storage conditions are unclear.Methods:Strains of Pseudomonas aeruginosa and S.pneumoniae were grown in medium and human serum.The BDG concentrations in culture superna-tants were measured.The specificity and stability of BDG were also evaluated.Results:P.aeruginosa produced high levels of BDG in Luria-Bertani medium(>4×10^(4)pg/mL)and human serum(527.0 pg/mL),whereas S.pneumoniae produced low levels of BDG in THY medium(175.6 pg/mL)and human serum(78.3 pg/mL).The BDG produced by these two bacteria was specifically degraded by 1,3-β-D-glucanase.BDG was degraded when stored at different temperatures,decreasing by 22.5%and 9.3%at−20℃and−70℃,respectively,for 63 days;by 30.7%at 4℃for 12 days;and by 12.6%and 22.0%at 37℃for 6 and 12 h.Conclusion:BDG false-positivity must be considered in patients with bacteremia caused by P.aeruginosa when diagnosing invasive fungal infection.Human serum samples for the BDG test in medical facilities should be tested as soon as possible or stored at low temperatures before testing.

Biomarkers for predicting efficacy of chimeric antigen receptor T cell therapy and their detection methods

Cancer immunotherapy has emerged as the fourth most prevalent approach to tumor treatment,alongside surgery,radiotherapy,and chemotherapy.After several decades of development,chimeric antigen receptor T(CAR-T)cell therapy,a promising branch of adoptive T-cell therapy,has demonstrated superior efficacy and safety in comparison to other cell therapies in the treatment of cancer.At present,CAR-T cells are predominantly used to treat hematological malignancies,although their application in solid tumors is being readily investigated.Although numerous studies have examined the biomarkers associated with the safety of CAR-T cell therapy,few have evaluated predictors of CAR-T cell therapeutic efficacy.Thus,the primary objective of this review article was to provide a comprehensive overview of the factors predicting the efficacy of CAR-T cell therapy,with a particular focus on biomarkers and their detection methods.

Hypermethylation of GSTM5 and its effect on oxidation in myelodysplastic syndrome

Background:Hypermethylation of glutathione-S-transferase 5(GSTM5)and its effect on oxidation in the pathogenesis of myelodysplastic syndrome(MDS)were investigated.Methods:GSTM5 methylation was detected in bone marrow(BM)samples from MDS patients,acute myeloid leukemia(AML)patients,and control in-dividuals using methylation-specific PCR and MassARRAY analysis.Bisulfite sequencing PCR was performed to verify methylation levels,while mRNA levels were determined using reverse transcription polymerase chain reaction.Correlations between GSTM5 methylation and clinical parameters were analyzed.The MDS cell line,SKM-1,was treated with decitabine,buthionine sulfoximine,or overexpression of GSTM5,and the glutathione level and cell viability were detected.Results:The MassARRAY analysis revealed significant differences in GSTM5 methylation levels between the MDS and control groups.GSTM5 methylation levels were significantly increased in the high-risk subgroup and showed a significant association with MDS progression to AML(hazard ratio=3.6).Levels of GSTM5 mRNA were significantly decreased in the MDS group,exhibiting a negative correlation with the GSTM5 gene methylation level.Normal BM HS-5 cells exhibited significantly lower levels of GSTM5 methylation than SKM-1 cells.Overexpression of GSTM5 in SKM-1 cells or treatment with buthionine sulfoximine or decitabine resul-ted in inhibition of proliferation and significantly decreased glutathione levels.Conclusions:GSTM5 plays an anti-oxidative role in MDS and the tumor suppressor effect of GSTM5 may be mediated by reducing glutathione levels.GSTM5 hypermethylation and low levels of GSTM5 expression may be prog-nostic markers for MDS.

Diagnostic approaches for monkeypox virus

Mpox(formerly Monkeypox)is a zoonotic infection caused by Monkeypox virus(MPXV).Since 2022,Mpox epidemics have occurred in many nonendemic countries and regions,leading the World Health Organization to declare a public health emergency of international concern.With the persistent transmission and evolution of MPXV,symptoms of Mpox have become milder,with some infections being asymptomatic.In addition,MPXV has become more contagious.Therefore,rapid and accurate diagnosis and screening of MPXV is vital to prevent and control MPXV epidemics.Here,we review and summarize the technical details,application scenarios,and the advantages and disadvantages of MPXV‐specific diagnostic methods.

The exploration of cell population data in clinical use: Beyond infectious diseases

Cell population data(CPD)is regarded as the fingerprint of a blood cell at a given moment.CPD parameters harbor information associated with cell morphology and can be automatically generated using modern hematological analyzers.Various studies have revealed many unique clinical applications for CPD,especially for infectious diseases,such as sepsis.For example,one monocyte-related CPD parameter is the monocyte distribution width(MDW),which can be generated using a Beckman Coulter hematological analyzer.MDW has received FDA and CE approval for aiding in sepsis diagnosis in adult patients in the emergency department.Additionally,MDW can serve as a diagnostic biomarker in patients infected with SARS-CoV-2.CPD has also been widely explored for possible clinical applications beyond infectious dis-eases,such as for predicting myelodysplastic syndromes,screening for he-matological malignancies,and detecting sterile inflammation.CPD parameter measurements are easily obtained and quite cost-effective,making them practical for clinical use.However,there are some potential drawbacks of CPD parameters.Some pre-analytical conditions can affect CPD values.Further-more,CPD are specific to certain hematological analyzers and the result cannot be transferred between different analyzers.The practical usefulness of CPD reference intervals is also still questionable.In this review,wesummarize the current studies related to CPD and its clinical applications.Additional well-designed clinical studies related to CPD are still expected.

Identification of new diagnostic targets for hepatitis B virus‐induced liver fibrosis

Background:Liver fibrosis is a transitional stage from hepatitis to cirrhosis,and hepatitis B virus(HBV)is the most common cause of liver disease.Transcriptome sequencing technology and bioinformatics analysis are increasingly being used to screen diagnostic targets for liver fibrosis.Methods:The GSE171294 dataset of HBV-induced liver fibrosis tissue and normal tissue was obtained from the Gene Expression Omnibus(GEO)public database and used to screen for differentially expressed mRNAs using R software.mRNAs with|log fold change|>1 and p<0.05 were considered to be differentially expressed.A heat map was drawn to visualize the expression patterns of the differentially expressed mRNAs.To screen for candidate target mRNAs,the differentially expressed mRNAs were annotated by Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)functional enrichment analysis.Finally,a protein-protein interaction(PPI)network was constructed to analyze the relationships between the differen-tially expressed mRNAs.Results:A total of 243 differentially expressed mRNAs were identified(p<0.05);129 were up-regulated and 114 were down-regulated.The up-regulated and down-regulated mRNAs were significantly enriched in 16 and 8 KEGG pathways,respectively.The enriched KEGG pathways included Sal-monella infection,Protein processing in the endoplasmic reticulum,IL-17 signaling pathway,and Aldosterone synthesis and secretion.The enriched GO terms were related mainly to cell proliferation,apoptosis,endoplasmic reticulum complex assembly,and myosin synthesis.The PPI network con-tained 161 nodes and 120 pairs of interactions.The top 10 key nodes were CAV1,CD4,NR3C1,PDIA3,EZR,IRF4,SOX9,HSP90AB1,CD40,and SEC13.Conclusions:Bioinformatics analysis of the transcriptome sequencing data in the GSE171294 dataset identified CD4,NR3C1,and EZR and other genes at key nodes as new targets for the treatment of liver fibrosis caused by HBV.These results provide new insights for HBV‐induced liver fibrosis research and clinical treatment.

Candidate reference measurement procedure for serum 17-hydroxyprogesterone quantification via isotope dilution liquid chromatography–tandem mass spectrometry

Background:Accurate quantification of 17-hydroxyprogesterone(17-OHP)in serum is vital for clinical and research applications.However,inter-laboratory variability in test results exists owing to the lack of a standardized reference measurement procedure(RMP).Therefore,in this study,we developed a highly accurate,cost-effective,and user-friendly candidate RMP(cRMP)for analyzing 17-OHP in serum.Methods:We quantified 17-OHP in serum using a one-step liquid–liquid extraction method with the addition of 17-OHP-^(13)C_(3),followed by liquid chromatography–tandem mass spectrometry.The ability of these methods to suppress interference was evaluated by chromatographic analysis.We assessed accuracy,specificity,the lower limit of quantitation,linearity,and matrix effects by following the standards specified by the Clinical and Laboratory Standards Institute.The consistency between the developed cRMP and the chemiluminescence method was evaluated through experiments with 120 clinical samples.Results:The developed cRMP required only 8 min for accurate quantification of serum 17-OHP without bias from matrix effects or interference from 19 metabolites added as potential interferents.The method exhibited favorable measurement performance,with a quantitation limit of 0.086 ng/mL,linear range of 0.1–400 ng/mL,a total imprecision of≤2.90%,spike recovery of 100.1%–100.6%,and relative deviations from assigned target values(RfB Institution)of−2.91%to 1.10%.The cRMP demonstrated good consistency with the conventional assay(chemiluminescence method),with a correlation coefficient R of 0.96977.Conclusion:A cRMP with high accuracy,cost-effectiveness,and convenient operation was developed for quantifying 17-OHP in serum.Its simplicity and robust performance make it an invaluable addition to the arsenal of analytical tools available for laboratories.This method can enhance the accuracy and reliability of 17-OHP measurements across various laboratories.

Clinical characteristics and risk factors for mortality in Candida auris infections

Background:Candida auris infections pose a threat to public health,necessitating increased awareness in China.This study aimed to analyze the strains of C.auris,assess the infection status,and investigate clinical characteristics and risk factors for mortality.Methods:A retrospective analysis was conducted on 18 patients with Candida auris infection.We focused on evaluating basic characteristics,strain sources,and antibacterial susceptibility test results.Statistical methods were used to determine clinical features and identify risk factors for death.Results:The strain type,composition ratio,and specimen source of C.auris were not associated with mortality.Neither the infection index nor the length of hospitalization showed an association with the prognosis.However,significant risk factors for mortality included cerebral infarction,cardiac disease,renal dysfunction,hypoproteinemia,and anemia(all p<0.05).Conclusions:Cerebral infarction,cardiac disease,renal dysfunction,hypoproteinemia,and anemia are significant risk factors for death in C.auris infections.These findings indicate the importance of recognizing and addressing these factors in the clinical management of C.auris infection.

From bench to bedside:Opportunities and challenges for iLABMED

Since the new iLABMED was founded in June 2023,it has published three issues with 21 articles(till Dec 2023).As a journal majored in laboratory medicine,iLABMED also has to face many opportunities and challenges of laboratory medicine.This editorial summarized the main opportunities and challenges faced by iLABMED.The future prospects of laboratory medicine,which must be highlighted by iLABMED were also discussed based on a brief review of the current advances in laboratory medicine.iLABMED will continue to provide a useful platform for general‐interested,insightful,and informative articles with high quality.

EDITORIAL BOARD

Honorable Editors-in-Chief Jiahong Dong,Ph.D.,M.D.,Tsinghua University,Beijing,China Guanghui Ma,Ph.D.,Institute of Process Engineering,Chinese Academy of Sciences,Beijing,China.

Bridging the divide: Harmonizing polarized clinical laboratory medicine practices

In today's healthcare,clinical laboratory medicine stands as a cornerstone of patient care,providing vital diagnostic insights that inform decisions in disease management.Yet,within this crucial field,a dichotomy persists between two predominant models of laboratory testing to support clinical practice:point-of-care testing(PoCT)and central laboratory testing[1].This schism,while born of practical necessity and evolving technology,presents both opportunities and challenges that warrant closer examination.

iLABMED,why now and how in the future?

Nowadays,public health is facing many challenges,mainly including non‐communicable diseases and communicable diseases.Communicable diseases,particularly emerging infectious diseases,have also attracted attention due to their enormous impact on public health and the global economy.The most prominent example is the current global Coronavirus Disease 2019(COVID‐19)pandemic.The unprece-dented and ongoing COVID‐19 pandemic has high-lighted the necessity for readily available,accurate,and rapid laboratory medicine(LM)practices.Nevertheless,current LMs and journals in particular have a window for improvement.First,there are limited numbers of professionals available in this field compared to the other disciplines.The current status quo is that most LM manuscripts must be submitted to comprehensive journals or other journals related to the research disease.Second,most LM journals are run by laboratory personnel who are often more concerned with technical advances than with clinical needs.Lastly,several young LM scientists expressed their desire to have a dedicated platform to discuss,communicate,and publish their works on LM.We were therefore motivated to launch iLABMED,an international public forum dedicated to LMs.The establishment of iLABMED adopts the“four I”strat-egy,namely“Innovation,”“Intelligence,”“Integra-tion,”and“International.”We are attempting to establish a top‐tier journal in the field of LM.

Overview of the epidemic characteristics of Mycoplasma pneumoniae infection around COVID pandemic

Mycoplasma pneumoniae(M.pneumoniae)is a cell wall‐less respiratory pathogen causing community‐acquired pneumonia and extrapulmonary manifestations.It is transmitted through close contact and shows periodic regional outbreaks.The coronavirus disease(COVID‐19)pandemic interfered with the global spread of M.pneumoniae.A large‐scale post‐COVID outbreak is currently ongoing in China.To help physicians better understand and manage this epidemic,we provide this review summarizing current knowl-edge on the pathogenesis,epidemic characteristics,macrolide resistance,diagnostic methods,and clinical treatment strategies for this pathogen.

Clinical application of intelligent technologies and integration in medical laboratories

With the development of scientific technology,the transition to the intelligent era of digitalization and automation is an irresistible trend for medical laboratories.Medical diagnosis systems have undergone significant changes as a result of intelligent technologies,such as machine learning,artificial intelligence,and the Internet of Things,from the collection,transmission,and detection of test samples to the review of reports and the provision of clinical feedback.In addition to significantly enhancing the efficiency,consistency,and accuracy of medical laboratory testing,these technologies also assist the improvement of individualized healthcare and medical expert systems,as well as the early detection and treatment of diseases.The future development of medical laboratories will focus on integrating big data and diverse intelligent resources,cooperating more closely with clinical departments,and realizing the effective pathway of patient‐centered care.The purpose of this review is to illustrate the current state of intelligent technology integration in medical laboratories and provide a preliminary discussion about the potential future influences of intelligent technology development on the evolution of medical laboratories.

Clinical utility of six serum tumor markers for the diagnosis of lung cancer

Background:With the increasing prevalence of lung cancer,it has become imperative to identify reliable biomarkers that can aid in early detection and prognosis assessment.Therefore,we sought to investigate the potential utility of six serum tumor markers as diagnostic and prognostic tools for lung cancer patients.By analyzing a large cohort of patients with different stages and subtypes of lung cancer,we hoped to shed light on the predictive value and accuracy of each marker individually,as well as their combined performance.This study should not only provide valuable insights into the biology and pathogenesis of lung cancer but also pave the way for personalized treatment strategies based on individual patient profiles.Methods:The serum levels of the tumor markers progastrin-releasing peptide(ProGRP),carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),cytokeratin 19 fragment(CYFRA21-1),carbohydrate antigen 19-9(CA19-9)and squamous cell carcinoma antigen(SCCA)were meticulously assessed in a cohort comprising 324 individuals diagnosed with lung cancer and an additional 51 patients with benign lung disease.The measurements were conducted using cutting-edge techniques such as ELISA,electrochemical luminescence,and chemiluminescence methods.Differences between groups and the impact of these markers on lung cancer diagnosis were analyzed.Results:The serum levels of ProGRP,NSE,and CEA were significantly higher in lung cancer patients than in patients with benign lung disease(p<0.01).NSE had the highest sensitivity for squamous cell carcinomas(SC),while CEA had the highest sensitivity for adenocarcinomas(AC).ProGRP and NSE had higher sensitivities than other markers for small cell carcinomas(SCC).Combining the six tumor markers resulted in higher sensitivities for SC(70.6%),AC(77.4%),and SCC(80%)compared with any single test.Receiver operator characteristic analysis showed that ProGRP and NSE had a greater area under the curve(AUC)in SCC(0.886 and 0.775)than SC and AC,while CEA had a higher AUC in AC(0.716),and NSE had a higher AUC than other markers in SC(0.719).Conclusions:ProGRP and NSE are effective serum tumor markers for SCC,whereas CEA and NSE may aid in the diagnosis of AC and SC.Combining the detection of ProGRP,NSE,CYFRA21-1,CEA,and SCCA significantly improves sensitivity when diagnosing lung cancer.

The important role of skin biopsies in the diagnosis of mpox

Human monkeypox(mpox)is an emerging zoonosis endemic in several Central and West African countries[1].There are two known clades of mpox virus—one that originated in Central Africa(Clade I)and one that originated in West Africa(Clade II).However,cases of mpox have been reported from countries where the disease is not endemic,especially during the 2003 outbreak in the U.S.[2]and the 2022 global outbreak[3,4].The mpox virus in the 2003 U.S.outbreak was transmitted from imported African rodents to domestic North American prairie dogs and subsequently to humans in contact with infected animals[5].No evidence of human‐to‐human transmission was identified,and most of the human cases presented with scattered skin lesions.The transmission route of the 2022 global outbreak,on the contrary,was mainly through intimate human‐to‐human contact,and many cases showed abundant skin lesions with mucosal involvement[6–8].