Clinical Efficacy and Adverse Reactions of Photodynamic Therapy in the Treatment of Malignant Skin Tumors and Precancerous Skin Diseases

The purpose of the study was to investigate the efficacy and safety of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases.First of all,100 patients with malignant skin tumor and pre-cancer skin disease admitted to our hospital from January 20,2018 to September 18,2018 were selected,and all of them adopted photodynamic therapy.The 100 patients included 40 cases of basal cell carcinoma,14 cases of squamous cell carcinoma,7 cases of proliferative erythema,9 cases of Bowen’s disease and 39 cases of solar keratosis.Among the 100 patients,77 cases had excellent curative effect,18 cases had good effect and 5 cases had poor effect,and the overall effective rate was 95%(95/100).After 6 months of follow-up,5 cases of basal cell carcinoma,2 cases of squamous cell carcinoma,0 cases of proliferative erythra,1 case of Bowen’s disease and 3 cases of solar keratosis recurred,with an overall recurrence rate of 14%(14/100).The adverse reactions of pruritus were 90%(90/100),81%(81/100),90%(90/100)and 3%(3/100).Therefore,the application of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases is not only effective,but also safe and not easy to relapse.

Treatment of Skin Reaction Induced by Nivolumab Combined with Radiotherapy in Non-small Cell Lung Cancer:A Case Report

Skin reaction or dermatological toxicities induced by immunotherapy is common.It usually manifests skin rash or erythema and can be cured by skin lotion or steroid.Nivolumab,a human IgG4 programmed cell death protein 1(PD-1)inhibitor,blocks T cells activation preventing signal and allows the immune system to clear cancer cells.Nivolumab was approved in the second-line therapy in squamous cell lung cancer by FDA,with less than 10%unusual skin reaction,like sensory neuropathy,peeling skin,erythema multiforme,vitiligo,and psoriasis.Radiotherapy could aggravate this skin reaction through inflammatory response and promotion of immunity.The combined treatment of anti-PD-1 and radiotherapy represented a new promising therapeutic approach in many studies,but the risk of side effects may be high.We reported a patient with advanced squamous cell lung cancer who suffered from serious skin immune-related adverse events when he was treated with nivolumab and radiotherapy.The immune overreaction of the treatment of anti-PD-1 treatment and radiotherapy might cause these serious skin adverse events.Our report warranted careful workup to reduce the risk of side effects by combinative therapy with anti-PD-1 and radiotherapy.

Multikinase inhibitor-associated hand-foot skin reaction as a predictor of outcomes in patients with hepatocellular carcinoma treated with sorafenib

AIM To investigate the relationship between the onsets of multikinase inhibitor(MKI)-associated hand-foot skin reaction(HFSR) and prognosis under intervention by pharmacists after the introduction of sorafenib.METHODS We conducted a retrospective study involving 40 patients treated with sorafenib. Intervention by pharmacists began at the time of treatment introduction and continued until the appearance of symptomatic exacerbation or non-permissible adverse reactions. We examined the relationship between MKI-associated HFSR and overall survival(OS) after the initiation of treatment.RESULTS The median OS was 10.9 mo in the MKI-associated HFSR group and 3.4 mo in the no HFSR group, showing a significant difference in multivariate analysis. A multivariate analysis of the time to treatment failure indicated that the intervention by pharmacists and MKI-associated HFSR were significant factors. The median cumulative dose and the mean medication possession ratio were significantly higher in the intervention group than in the non-intervention group. A borderline significant difference was observed in terms of OS in this group.CONCLUSION Intervention by pharmacists increased drug adherence. Under increased adherence, MKI-associated HFSR was an advantageous surrogate marker. Intervention by healthcare providers needs to be performed for adequate sorafenib treatment.

Traditional Chinese Medicine for Treatment of Apatinib-induced Hand and Foot Skin Reaction:A case report

Squamous cell carcinoma arising at maxillary sinus is a rare neoplasm, characterized by aggressive growth pattern and glooming prognosis. A 78-year-old woman presented with left maxillary sinus carcinoma. The patient received four courses of chemotherapy after surgery in our center. Eight months after treatment, the patient experienced local progress, severe gastrointestinal reactions and asthenia. Then apatinib was used as third-line treatment. Good curative effect was achieved with 250 mg apatinib per day, while adverse reaction such as hand and foot skin reaction affected the quality of her life. Traditional Chinese medicine exhibits good results and no obvious side effects in relieving hand and foot skin reaction. Traditional Chinese medicine is Chinese treasure, it remains challenging, and further investigations are needed.

Pharmacodynamics of frigid zone plant Taxus cuspidata S.et Z.against skin melanin deposition,oxidation,inflammation and allergy

Background:Taxus cuspidata S.et Z.is a precious species of frigid zone plant belonging to the Taxaceae family,which possesses anticancer,anti-inflammatory,hypoglycemic,and antibacterial pharmacological properties.While taxane extracted from Taxus chinensis has been reported to elicit antioxidant activities,whether Taxus cuspidata S.et Z.has skin-protective actions against injuries remained unknown.This study aims to explore the pharmacological effects of three Taxus extracts on skin melanin deposition,oxidation,inflammation,and allergy so as to provide new ideas for the prevention and treatment of various diseases related to skin damage.Methods:Skin melanin deposition was evaluated by measuring melanin content in the skin of guinea pigs by alkali lysis method.Antioxidant capacity was evaluated by measuring superoxide dismutase(SOD)concentration and glutathione(GSH)content in skin tissue homogenates of Kunming mice by SOD assay kit and micro reduced GSH assay kit.The quantitative real-time polymerase chain reaction(qRT-PCR)and western blotting were used to examine the levels of both SOD and recombinant glutathione peroxidase 4(GPX4).Skin inflammation was evaluated by xylene-induced ear swelling test and egg-white-induced paw swelling test in mice.In a mouse model of skin allergy induced by 4-aminopyridine(4-AP),allergy was determined by licking body counts and histamine concentrations in tissue homogenates using enzyme-linked immunosorbent assay(ELISA)kits.Two proinflammatory factors tumor necrosis factor(TNF)-αand interleukin(IL)-1βwere measured by qRT-PCR.Hematoxylin and eosin(HE)staining was conducted to assess the degree of skin lesion.Results:All three Taxus extracts including Taxus chinensis essential oil,Taxus chinensis extract and Taxus chinensis extract compound reduced the melanin deposits in the back skin relative to the non-treated control animals,of which Taxus chinensis essential oil produced the greatest effect.In contrast,the three Taxus extracts elevated SOD and GSH levels in the skin tissues,and the highest increase was seen with Taxus chinensis essential oil.Three Taxus extracts,especially Taxus chinensis essential oil,effectively reduce the rate of ear and paw swelling.All three Taxus extracts reduced the number of body licks,the levels of TNF-αand IL-1β,and the histamine content in tissue homogenates of mice and alleviated skin damage.Consistently,Taxus chinensis essential oil yielded the greatest magnitude of decreases.Conclusion:While all three Taxus extracts possessed the anti-skin melanin deposition,oxidation,and allergy properties,Taxus chinensis essential oil produced the superior effects.

Configurational information entropy analysis of fragment mass cross distributions to determine the neutron skin thickness of projectile nuclei

Configurational information entropy(CIE)analysis has been shown to be applicable for determining the neutron skin thickness(δnp)of neutron-rich nuclei from fragment production in projectile fragmentation reactions.The BNN+FRACS machine learning model was adopted to predict the fragment mass cross-sections(σ_(A))of the projectile fragmentation reactions induced by calcium isotopes from ^(36)Ca to ^(56)Ca on a ^(9)Be target at 140MeV/u.The fast Fourier transform was adopted to decompose the possible information compositions inσA distributions and determine the quantity of CIE(S_(A)[f]).It was found that the range of fragments significantly influences the quantity of S_(A)[f],which results in different trends of S_(A)[f]~δnp correlation.The linear S_(A)[f]~δnp correlation in a previous study[Nucl.Sci.Tech.33,6(2022)]could be reproduced using fragments with relatively large mass fragments,which verifies that S_(A)[f]determined from fragmentσAis sensitive to the neutron skin thickness of neutron-rich isotopes.

Sequence Analysis of Attachment Gene of Lumpy Skin Disease and Sheep Poxviruses

In Egypt,protection of cattle against lumpy skin disease (LSD) was carried out using a sheep poxvirus (Kenyan strain) vaccination strategy.In the present study 15 skin nodules from LSD suspected cows and 5 scab samples from sheep pox (SP) suspected sheep were collected.Hyperimmune rabbit sera to Lumpy skin disease virus (LSDV)/Ismailyia88 strain and sheep pox virus (SPV)/ Kenyan vaccinal strain were prepared.The causative agent in the collected samples was identified using immunoflourescence (IF) and immunoperoxidase techniques.Of the 15 skin nodules suspected of LSD,10 showed a positive reaction and 3 out of 5 skin scabs suspected of sheeppox were found to be positive.An antigenic correlation between field skin isolate of LSDV,tissue culture adapted LSDV/Ismailyia88 strain,field skin isolate of SPV and SPV/Kenyan vaccinal strain was studied using prepared hyperimmune sera.Also,nucleotide sequence of the PCR amplified attachment gene fragments of field skin isolate of LSDV,tissue culture adapted LSDV/Ismailyia88 strain,field skin isolate of SPV and SPV /Kenyan vaccinal strain were compared.The results revealed that the four used viruses were antigenically identical.Sequence analysis indicated that field skin LSDV isolate is more related to tissue culture adapted LSDV/Ismailyia88 strain than to vaccinal SPV/ Kenyan strain and the skin isolate of SPV is more closely related to field skin isolate of LSDV than to SPV/Kenyan vaccinal strain.Thus,further study should be applied on the advantage of a LSD vaccine prepared from LSDV in protection of cattle against LSD compared to the commonly used sheep pox vaccine.

Clinical Effect of Photodynamic Therapy Combined Cryotherapy on Nonmelanoma Skin Cancer

The purpose of this study was to investigate the clinical efficacy of photodynamic combined freezing in patients with non-melanoma skin cancer(NMSC).First,according to the treatment regimen,96 patients with NMSC were divided into study group(n=50)and control group(n=46).The control group was treated with 5-amino-ketovalic acid photodynamic therapy(ALAPDT),while the study group was treated with ala-PDT combined with cryotherapy.Visual analogue scale(VAS)scores,visual satisfaction,clinical efficacy,adverse reactions,and progression-free survival were compared between the two groups.The results showed that VAS score in the study group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).The appearance satisfaction and total effective rate of patients in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the study group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).3 years progressionfree survival time and 3 years progression-free survival rate were compared between the two groups,and the difference was not statistically significant(P>0.05).Therefore,the combination of PDT and cryotherapy for non-melanoma skin cancer has a good clinical effect,which is conducive to the recovery of skin lesions,high patient satisfaction,fewer adverse reactions,and longer progression-free survival.In addition,the combined therapy can provide a new treatment idea for non-melanoma skin cancer patients who are not suitable for surgical treatment.

Food intolerance and skin prick test in treated and untreated irritable bowel syndrome

AIM： To correlate the clinical features of treated and untreated patients with irritable bowel syndrome （IBS） to the results of skin prick test （SPT） for food and inhalant allergens. METHODS： We recruited 105 subjects to form three different target groups： treated group （n=44） undergoing treatment for IBS, untreated group （n =31） meeting the Rome Ⅱ criteria without treatment for IBS, control group （n = 30） with no IBS symptoms. RESULTS： SPT results were different among the three groups in which SPT was positive in 17 （38.6%） treated patients, in 5 （16.1%） untreated patients and in 1 （3.3%） control （P〈0.01）. The number of positive SPTs was greater in the IBS group than in the control group （P〈 0.001）. The number of positive food SPTs was higher in the treated IBS group than in the untreated IBS group （P= 0.03）. CONCLUSION： Positive food SPT is higher in IBS patients than in controls.

Preliminary Observation and Significance of Changes on Rash of Skin Prick Test during SLIT

Objective: To observe the changes on skin wheal and erythema of skin prick test for the patients with allergic rhinitis during SLIT. Methods: Since March 2010 the 103 cases of SLIT attacked by allergic rhinitis patients, divided into four age groups, respectively measured the diameter of skin wheal and erythema before treatment, six months, one year and 2 years after SLIT. The data were analyzed by analysis of variance method;P Results: The results showed that the most changes of skin erythema diameter were statistically significant in N1, N2, N3 age group during test observation compare with the data before SLIT (p Conclusion: Although most of the skin test wheal did not change significantly during the treatment of SLIT, the erythema reaction decreased to a certain extent, indicating that the intensity of histamine release may be reduced during the treatment.

Adverse Skin Reactions to Personal Protective Equipment Among Health-Care Workers During COVID-19 Pandemic: A Multicenter Cross-sectional Study in Indonesia

Objective:Health-care workers(HCWs)in Indonesia have been participating in the war against the coronavirus disease-2019 since March 2020.Ever since HCWs were exposed to the regular use of personal protective equipment(PPE)with varying levels and maintain hand hygiene more as recommended by the World Health Organization.Adverse skin reactions to PPE in Indonesia has yet to be acknowledged.This study aimed to study the prevalence and characteristics-,possible risk factors-,and suggest possible solutions towards adverse skin reactions to PPE among HCWs in a multi-center setting of Indonesia.Methods:A cross-sectional survey was conducted online among HCWs in the Siloam Hospitals Group of Banten province.HCWs of Banten Province were surveyed from June 1 to August 31,2020.The data was obtained using avalidated online survey questionnaire including(1)demographic characteristics;(2)occupational-related characteristics;(3)adverse skin reactions.Results:A response rate of 40.2%was obtained and 200 valid respondents were yielded.The mean age of respondents was(26.94±7.23)years old.Adverse skin reactions(66.5%)were reported primarily in female(73.7%)working as doctors(82.7%)of a non-referral center for coronavirus disease-2019(60.2%)wearing level 2 and 3 PPE(43.6% and 37.6%,respectively).The cheeks and chin was the most common site involved(69.9%)with dryness/tightness(63.9%)and acne(77.4%)as the highest symptoms and signs reported.Sex,age group classification,level of PPE worn,hand hygiene frequency,and duration of PPE worn daily were factors considerably associated with adverse skin reactions to PPE(P<0.05).Conclusions:Adverse skin reactions to PPE are common among HCWs in Indonesia.Comprehensive strengthening of the skin condition and awareness on adverse skin reactions should be advocated.

A Case Report:Severe Bullous Skin Reaction Induced by Anti-PD-1 Antibody(Toripalimab)Therapy in a Patient with Thymic Carcinoma

The development of immune checkpoint inhibitors,such as those targeting programmed cell death protein 1(PD-1),represents a major breakthrough in cancer therapy.Although immune checkpoint blockade therapy has a favorable risk/benefit ratio,it causes significant immune-related adverse events(irAEs),such as cutaneous reactions,in particular,severe bullous skin reactions and toxic epidermal necrolysis.Here,we report a case of a 51-year-old woman with malignant thymoma who developed a severe bullous skin reaction(characterized by a systemic rash,bullae,epidermal desquamation,and Stevens-Johnson syndrome)as a result of treatment with the PD-1 inhibitor toripalimab.The patient was treated with high doses of glucocorticoid,intravenous immunoglobulin,and intensive care,and eventually recovered from the severe irAEs.The intravenous injection of anti-PD-1 antibodies induces cutaneous reactions,which are associated with higher mortality rates.High doses of glucocorticoid combined with intravenous immunoglobulin are effective in alleviating such irAEs.Thus,improving the level of care and preventing skin infections can effectively reduce the risk of death.

Association between Skin Reactions and Efficacy of Summer Acupoint Application Treatment on Chronic Pulmonary Disease:A Prospective Study

Objective： To examine the variations in the prevalence of skin reactions and the association between skin reactions and efficacy of summer acupoint application treatment （SAAT） on chronic pulmonary disease （CPD）. Methods： A total of 2,038 patients with CPD were enrolled at 3 independent hospitals （defined as Groups A, B and C, respectively） in China. All patients were treated by SAAT, as applying a herbal paste onto the acupoints of Fengmen （BL 12） and Feishu （BL 13） on the dog days of summer, according to the lunar calendar, in 2008. Ten days after treatment, skin reaction data （no reaction, itching, stinging, blistering, and infection） were obtained via face-to-face interviews. Patients were retreated in the same hospital one year later, thereby allowing doctors to assess treatment efficacy based on the patients＇ symptoms, the severity of the spirometric abnormalities, and the concomitant medications used. Results： A large number of patients （85.3%） displayed reactive symptoms; however, the marked associations between reactive symptoms and age or gender were not observed. An increased number of patients from Group B （99.3%） and Group C （76.5%） displayed reactive symptoms due to the increased mass of crude Semen Sinapis Albae. The effective rate of SPAT was as high as 90.4% for patients of Group B, which was followed by Group A （70.9%） and Group C （42.2%）. Using stratified analyses, a convincing association between reactive symptoms and therapeutic efficacy was observed for patients with asthma [itching： odds ratio （OR）=2,17, 95% confidence interval （CI）： 1.49 to 3.14; blistering： OR=0.43, 95% Ch 0.25 to 0.73; and no reaction： OR=0.56, 95% CI： 0.35 to 0.90]. However, the same tendency was not observed for patients with chronic bronchitis and chronic obstructive pulmonary disease. Conclusions： SAAT can induce very mild skin reactions for patients with CPD, among which patients with asthma displayed a strong association between skin reactions and therapeutic efficacy. The skin reactions may be induced by the crude Semen Sinapis Albae.

RNA-seq profiling reveals differentially expressed genes as potential markers for vital reaction in skin contusion: a pilot study

Detection of the vitality of wounds is essential in forensic practice.The present study used Illumina RNA-seq technology to determine gene expression profiles in contused mouse skin.In obtained high quality sequencing reads,the reads were mapped onto a reference transcriptome (Mus_musculus.GRCm38.83).The results revealed that there were 659 upregulated and 996 down-regulated differentially expressed genes (DEGs) in contused mouse skin.The DEGs were further analyzed using the Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes databases.Genes from different functional categories and signalling pathways were enriched,including the immune system process,immune response,defense response,cytokine-cytokine receptor interaction,complement and coagulation cascades and chemokine signalling pathway.Expression patterns of 11 DEGs were verified by RT-qPCR in mice skins.In addition,alterations of five DEGs were also analyzed in postmortem human wound samples.The results were in concordance with the results of RNA-seq.These findings suggest that RNA-seq is a powerful tool to reveal DEGs as potential markers for vital reaction in terms of forensic practices.

Skin reactions caused by bone-anchored hearing aid(BAHA) implantation

Objective: To report a case of intractable skin reactions caused by bone-anchored hearing aid (BAHA) implantation to improve our under-standing and treatment of BAHA implantation-caused skin reactions. Methods:We reported a case of severe skin reactions caused by BAHA implantation. Related literature were also reviewed. Results:We found grade IV skin reactions, including hyperplasia around the implant, which led to the removal of the BAHA implant 10 months after implantation. The findings indicated poor skin hygiene, allergy to titanium and inadequate surgicals skills as the possible causes of the skin reaction. Conclusion: Skin adverse reactions, usually rare in BAHA implantation patients, may cause implant removal and implantation failure. We suggest to further investigate the mechanisms underlying titanium allergy. Copyright ? 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

MiR-711 and miR-183-3p as potential markers for vital reaction of burned skin

In forensic practice,the identification of antemortem burns and postmortem burns is of the utmost importance.Reports from previous studies have shown that miRNAs,with lengths stretching over 18–25 nucleotides,are highly stable and resistant to degradation.However,there has been little research into the application of miRNAs in identifying antemortem and postmortem burns.This study compared the expression of miR-711 and miR-183-3p levels in mouse and postmortem human burned skins using RT-qPCR assay.RT-qPCR examination of burned mouse skins showed that increased miR-711 and miR-183-3p expression in comparison to intact skin tissues.The increased expressions of these two miRNAs were observed until 120 h after death in burned mouse skins,whereas no significant changes were found in postmortem burned skins.In human burned skins,the increased levels of these two miRNAs at 48 h following autopsy occurred in 19 of 26 subjects,which appeared to be related to the severity of the burn.These findings suggest that miR-711 and miR-183-3p may act as biomarkers for vital reaction of skin burn.

Ineffectiveness of Skin Tests in Predicting Allergic Reactions Induced by Chinese Herbal Injections

Objective:To evaluate whether skin tests are suitable to predict the allergy reactions induced by Chinese herbal injections(CHIs).Methods:The skin tests including skin prick tests(SPT),intradermal tests(IDT)and provocation tests including subcutaneous tests and intravenous tests were administered to 249 healthy subjects and 180 allergic patients for 3 CHIs,including ginkgolide injection,diterpene ginkgolide meglumine injection and Salvianolate lyophilized injection.The results of the provocation tests were used as the"gold standard"to determine the sensitivity and specificity of the skin tests.Results:The results did not show any significant differences between the healthy and allergy groups in both skin tests and provocation tests(P>0.05).The specificities of SPT and IDT were 0.976 and 0.797,respectively,and the sensitivities of both SPT and IDT were 0.Conclusion:Skin tests are insufficient to predict the likelihood of allergic reactions resulting from CHIs.(ChiCTR-CPC-15006921)

A fifteen-year review of skin allergy testing in Irish patients with symptomatic rhinitis

Objective:Our objective was to review skin prick allergy testing(SPAT)results in patients with symptomatic rhinitis in an Irish population.Methods:A fifteen-year retrospective review of our database of symptomatic patients with rhinitis was performed.All patients who had SPAT performed during this interval were included.Data was analysed in terms of demographics and dominant allergens.Results:1158 patients were included.617 Females vs 541 Males.Age range five to eighty-five years old.Mean age thirty-four years.49%of our patients tested positive to at least one aeroallergen.The most common allergens were dust mites(23%)and timothy grass(22%).Patients born during the Irish pollen season(April-July)were between 5 and 7 times more likely to be sensitive to timothy and ryegrass pollens compared to others tested.241 patients had both SPAT and serum allergen specific IgE testing(SASIgET)performed;positive results were consistent between both groups.Conclusion:Results demonstrated that half of our patients with symptomatic rhinitis had allergen sensitisation.Dust mites and grass were the main allergens in our area.Our nurse led clinic has allowed efficient patient education and the development of a unique Irish SPAT database.Retesting a patient with a known allergy test result it is not indicated.

Assessment of a Case of Immediate-Type Allergy against Human Insulin in a Type 2 Diabetic Patient and Allergic Reactions to Human Insulin in Japan

We report a 64-year-old female patient with an insulin allergy. She was treated with a combination of oral antihistamines, topical hydrocortisone cream, and moisturizing agents, which resulted in the improvement of eczema and intense pruritus. To evaluate insulin allergy, intradermal skin tests were performed with several insulin agents for clinical use and 0.9% NaCl. Skin testing with semisynthetic human insulin resulted in local, immediate skin reactions such as itchy erythema and wheals. Furthermore, we analyzed our case and 25 Japanese cases of insulin allergy previously reported in the literature as far as we know. Interestingly, the number of male patients was approximately two times higher than that of female, and the insulin-specific IgE antibody test was positive in 21 patients. We should keep the possibility of human insulin allergy in mind and prepare for it when initiating human insulin therapy.

UniCAP100和Allergy Screen两种过敏原检测方法的一致性研究

目的以UniCAPl00过敏原检测方法（CAP）为“金标准”与Allergy Screen（敏筛）过敏原检测方法进行对比研究，为其临床应用提供试验依据。方法随机抽取的111份过敏患者标本，其中男性61例，女性50例；年龄4～77岁，平均年龄46岁。应用瑞典Pharmacia UniCAP100过敏原检测系统、德国Allergy Screen（敏筛）过敏原检测系统同时检测特异性IgE抗体，并用SPSS14．O统计软件包进行统计学分析。结果两种检验方法对12种特异性过敏原IgE抗体检测结果有很高的符合率，其中屋尘、矮豚草、鸡蛋白、蛋黄、腰果、花生、黄豆、小麦符合率为100％，户尘螨95％，蒿97％，猫皮屑97％，狗皮屑97％，牛奶99％，蟹83％。虾83％，分枝孢90％，链格孢90％，二者一致性极好（K〉0．75）。结论两种检测方法的结果显示出很好的一致性．临床医生和实验室可根据具体情况选择适宜的筛查方法。