Serum M2-pyruvate kinase: A promising non-invasive biomarker for colorectal cancer mass screening

AIM: To explore the value of serum M2-pyruvate kinase (M2-PK) in colorectal cancer (CRC) mass screening. METHODS: We conducted a molecular epidemiology study in Hangzhou, China, from year 2006 to year 2008. Serum samples were collected from 93 CRC, 41 advanced adenomas, 137 adenomas, 47 non-adenomatous polyps, and 158 normal participants in a community setting. Serum M2-PK and carcinoembryonic antigen (CEA) were measured using Enzyme-linked immunosorbent assay. SPSS 16.0 software was used to perform data analysis. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificities were estimated for serum M2-PK in diagnosis of colorectal lesions and compared with CEA. RESULTS: Average serum M2-PK value among 158 normal people was 2.96 U/mL and not affected by gender (P = 0.47) or age (P = 0.59). Average serum M2-PK (U/mL) was 14.75 among stage III and 13.10 among stage?I?and II CRC patients, about 4 times higher than that among normal people. Average serum M2-PK was 8.58, 6.70, 5.13 and 2.51 U/mL among advanced adenoma, adenomas, non-adenomatous polyps, and inflammatory bowel disease patients, respectively. AUC for serum M2-PK was greater than that for CEA among all colorectal lesions. AUC for serum M2-PK was 0.89 (0.84, 0.94) (95% confidence interval), higher than that for CEA [0.70 (0.62-0.79)] in CRC stage?I?and II, 0.89 (0.84-0.94) vs 0.73 (0.63-0.83) in CRC stage III, 0.81 (0.74-0.86) vs 0.63 (0.53 - 0.73) in advanced adenomas, 0.69 (0.64-0.76) vs 0.54 (0.47-0.60) in adenomas, and 0.69 (0.62-0.78) vs 0.58 (0.48-0.68) in non-adenomatous polyps. The diagnostic sensitivity for all colorectal lesions increased with decrease in the cut-off value of serum M2-PK. The diagnostic sensitivity (%) of serum M2-PK was 100.00 for CRC, 95.12 advanced adenoma, 82.48 adenoma, and 82.98 non-adenomatous polyp. There were no CRC cases missed and 40.51% of unnecessary colonoscopies were avoided when the cut-off value was 2.00 U/mL. CONCLUSION: Serum M2-PK can be used as a primary screening test in CRC mass screening. It may be a promising non-invasive biomarker for CRC early detection.

Decreasing trend in prostate cancer with high serum prostate-specific antigen levels detected at first prostate-specific antigen-based population screening in Japan

To clarify the recent trends in prostate-specific antigen （PSA） distribution in men in Japan, we analyzed the PSA distributions of men undergoing PSA-based population screening. We summarized the annual individual data of PSA-based population screening in Kanazawa, Japan, from 2000 to 2011, and analyzed baseline serum PSA values of the participants at the first population screening. Serum PSA distributions were estimated in all participants and those excluding prostate cancer patients according to age. From 2000 to 2011, 19 620 men participated aged 54-69 years old in this screening program. Mean baseline serum PSA level of all participants at the first screening was 2.64 ng m1-1 in 2000, and gradually decreased to approximately 1.30 ng ml-I in 2006. That of participants excluding prostate cancer patients was 1.46 ng m1-1 in 2000, and there was no remarkable change during the study period. The 95t＂ percentiles in the participants excluding prostate cancer patients detected at the first population screening of men aged 54-59, 60-64, and 65-69 years old were 2.90, 3.60, and 4.50 ng m1-1, respectively. After the commencement of population screening, the proportion of prostate cancer patients with high serum PSA levels decreased. However, there were no changes in serum PSA levels in men without prostate cancer. Age-specific PSA reference level of men without prostate cancer in Japan was similar to that in China and Korea.

Equidistant combination wavelength screening and step-by-step phase-out method for the near-infrared spectroscopic analysis of serum urea nitrogen

We applied near-infrared(NIR)spectroscopy with chemometrics for the rapid and reagent-fee analysis of serum urea nitrogen(SUN).The modeling is based on the average effect of multiple sample partitions to achieve parameter selection with stability.A multiparameter optimization platform with Norris derivative filter-partial least squares(Norris-PLS)was developed to select the most suitable mode(d=2,s=33,g=15).Using equidistant combination PLS(EC-PLS)with four parameters(initial wavelength I,number of wavelengths N,number of wavelength gaps G and latent variables LV),we performed wavelength screening after eliminating high-absorption wavebands.The optimal EC-PLS parameters were I=1228 nm,N=26,G=16 and LV=12.The root-mean square error(SEP),correlation coefficient(R_(p))for prediction and ratio of performance-to-deviation(RPD)for validation were 1.03 mmol L^(-1),0.992 and 7.6,respectively.We proposed the wavelength step-by-step phase-out PLS(WSP-PLS)to remove redun-dant wavelengths in the top 100 EC-PLS models with improved prediction performance.The combination of 19 wavelengths was identifed as the optimal model for SUN.The SEP,Rp and RPD in validation were 1.01 mmol L^(-1),0.992 and 7.7,respectively.The prediction effect and wavelength complexity were better than those of EC-PIS.Our results showed that NIR spectroscopy combined with the EC-PLS and WSP-PLS methods enabled the high-precision analysis ofSUN.WSP-PLS is a secondary optimization method that can further optimize any wavelength moc odel obtained through other continuous or discrete strategies to establish a simple and better model.

Study on a noninvasive method for rapid screening Human Serum albumin injectables by Raman spectroscopy

Human serum albumin(HSA)injectable product is a severely afflicted area on drug safety due to its high price and restricted supply.Raman spectroscopy performances high specificity on HSA detection and it is even possible to determine HSA injectable products noninvasively.In this study,we developed a noninvasive rapid screening method for of HSA injectable products by using portable Raman spectrometer.Qualitative models were established by using principal component analysis combined with classical least squares(PCA-CLS)algorithm,while quanti-tative model was established by using partial least squares(PLS)algorithm.Model transfer in different instruments of both the same and different apparatus modules was further discussed in this paper.A total of 34 HSA injectable samples collected from markets were used for verification.The identification results showed 100%accuracy and the predicted concentrations of those identified as true HSA were consistent with their labeled concentrations.The quantitative results also indicated that model transfer was excellent in the same apparatus modules of Raman spectrometer at all concentration levels,and still good enough in the different apparatus modules although the relative standard deviation(RSD)value showed a little increasing trend at low HSA concentration level.In conclusion,the method was proved to be feasible and efficient for screening HSA injections,especially on its screening speed and the consideration of glass containers.Moreover,with inspiring results on the model transfer,the method could be used as a universal screening mean to different Raman instruments.

Assessing Moroccan physician knowledge and practices regarding maternal obesity's impact on childhood obesity:Implications for prevention and intervention

BACKGROUND Childhood obesity is a growing global concern with far-reaching health implications.This study focuses on evaluating the knowledge and practices of physicians in Morocco regarding the link between maternal obesity and childhood obesity.Despite the increasing prevalence of childhood obesity worldwide,this issue remains inadequately addressed in the Moroccan context.AIM To assess the awareness and practices of physicians in Morocco concerning the connection between maternal obesity and childhood obesity.METHODS The research encompasses a comprehensive survey of practicing physicians,revealing significant gaps in awareness and practices related to maternal obesity.RESULTS Notably,a significant portion of doctors do not provide adequate guidance to overweight pregnant women,highlighting the urgency for targeted educational programs.CONCLUSION In conclusion,this research illuminates critical areas for improvement in tackling childhood obesity in Morocco.By addressing these gaps,fostering awareness,and enhancing medical practices,the healthcare system can contribute significantly to preventing childhood obesity and improving the overall health of future generations.

Current issues and future perspectives of gastric cancer screening

Gastric cancer remains the second leading cause of cancer death worldwide. About half of the incidence of gastric cancer is observed in East Asian countries, which show a higher mortality than other countries. The effectiveness of 3 new gastric cancer screening techniques, namely, upper gastrointestinal endoscopy, serological testing, and “screen and treat” method were extensively reviewed. Moreover, the phases of development for cancer screening were analyzed on the basis of the biomarker development road map. Several observational studies have reported the effectiveness of endoscopic screening in reducing mortality from gastric cancer. On the other hand, serologic testing has mainly been used for targeting the high-risk group for gastric cancer. To date, the effectiveness of new techniques for gastric cancer screening has remained limited. However, endoscopic screening is presently in the last trial phase of development before their introduction to population-based screening. To effectively introduce new techniques for gastric cancer screening in a community, incidence and mortality reduction from gastric cancer must be initially and thoroughly evaluated by conducting reliable studies. In addition to effectiveness evaluation, the balance of benefits and harms must be carefully assessed before introducing these new techniques for population-based screening.

Potential of soluble CD26 as a serum marker for colorectal cancer detection

Colorectal cancer is characterized by a low survival rate even though the basis for colon cancer development,which involves the evolution of adenomas to carcinoma,is known.Moreover,the mortality rates continue to rise in economically transitioning countries although there is the opportunity to intervene in the natural history of the adenoma–cancer sequence through risk factors,screening,and treatment.Screening in particular accounted for most of the decline in colorectal cancer mortality achieved in the USA during the period 1975-2000.Patients show a better prognosis when the neoplasm is diagnosed early.Among the variety of screening strategies,the methods range from invasive and costly procedures such as colonoscopy to more low-cost and non-invasive tests such as the fecal occult blood test(guaiac and immunochemical).As a non-invasive biological serum marker would be of great benefit because of the performance of the test,several biomarkers,including cytologic assays,DNA and mRNA,and soluble proteins,have been studied.We found that the soluble CD26(sCD26)concentration is diminished in serum of colorectal cancer patients compared to healthy donors,suggesting the potential utility of a sCD26 immunochemical detection test for early diagnosis.sCD26 originates from plasma membrane CD26 lacking its transmembrane and cytoplasmic domains.Some 90%–95%of sCD26 has been associated with serum dipeptidyl peptidase IV(DPPIV)activity.DPP-IV,assigned to the CD26 cluster,is a pleiotropic enzyme expressed mainly on epithelial cells and lymphocytes.Our studies intended to validate this test for population screening to detect colorectal cancer and advanced adenomas are reviewed here.

Concentrations of Polybrominated Diphenyl Ethers in Maternal Blood,Placental Size,and Risk for Fetal Growth Restriction:A Nested Case-control Study

Objective To explore the effects of prenatal exposure to polybrominated diphenyl ethers(PBDEs)on placental size and birth outcomes.Methods Based on the perspective Wenzhou Birth Cohort,this nested case-control study included 101 fetal growth restriction(FGR)and 101 healthy newborns.Maternal serum samples were collected during the third trimester and measured for PBDEs by gas chromatography tandem mass spectrometry.The basic information of mother-newborn pairs was collected from questionnaires,whereas the placental size and birth outcomes of newborns were obtained from hospital records.Results A total of 19 brominated diphenyle ether(BDE)congeners were detected in maternal serum samples.Higher concentrations of BDE-207,-208,-209,and∑19PBDEs were detected in FGR cases than in controls.Increased BDE-207,-208,-209,and∑19PBDEs levels in maternal serum were related to decreased placental length,breadth,surface area,birth weight,birth length,gestational age,and Quetelet index of newborns.After adjusting for confounders,BDE-207 and∑19PBDE concentrations in maternal serum were significantly associated with an increased risk of FGR.Conclusion A negative association was found between PBDE levels in maternal serum and placental size and birth outcomes.Prenatal PBDE exposure may be associated with elevated risk of the incidence of FGR birth.

Relationship of the preoperative NRS 2002 score,PG-SGA score,and serum indices with postoperative complications in patients with gastric cancer

Objective To examine the utility of the Nutrition Risk Screening 2002(NRS 2002),Patient-Generated Subjective Global Assessment(PG-SGA)and serum factors for the preoperative evaluation of gastric cancer patients.Methods We examined 181 gastric cancer patients treated at the First Affiliated Hospital of Guangxi Medical University from January 2015 to January 2018.Nutritional assessments were administered within 48 h of admission.The body mass index(BMI)and serum factors were measured,and information on preoperative nutritional support and postoperative complications was recorded.Results Both the NRS 2002 and PG-SGA had positive correlations with age(P<0.05),and negative correlations with albumin,prealbumin,transferrin,hemoglobin,BMI,and bodyweight(P<0.05).The NRS 2002 and PG-SGA scores were positively correlated with each other(r=0.683,P<0.01),but had poor consistency(κ=0.357,P<0.01).During the preoperative period,33.2%of patients received nutritional support,mainly enteral nutrition.The nutritional risk group(NRS 2002≥3)received more support than the group without nutritional risk(NRS 2002<3;P<0.05).Patients with nutritional risk or malnutrition who received preoperative nutritional support had fewer postoperative complications than unsupported patients.The overall rate of complications was 12.2%,and the rate of severe complications(gradeⅢor above)was 5.5%.The malnutrition and nutritional risk groups had higher rates of severe complications.Conclusions The combined application of the NRS 2002,PG-SGA,BMI,and serum nutritional indices was useful for the nutritional screening and assessment of preoperative gastric cancer patients.The NRS 2002 and PG-SGA provided guidance on the need for nutritional support during the preoperative period.

Correlation between Transcutaneous Bilirubinemia and Blood Bilirubinemia in Screening Term Newborn for Neonatal Jaundice at the Essos Hospital Centre (EHC), Yaoundé, Cameroon

Background: Early and non-invasive diagnosis of neonatal hyperbilirubinemia remains critical in dark skinned babies of low resource settings. Objective: To assess correlation/agreement between transcutaneous bilirubin (Tcb) and serum bilirubin (Tsb) values in full term neonates with jaundice. Methodology: An analytical cross-sectional study was conducted at the neonatology unit of the Essos Hospital Centre (EHC) from January to June 2019. All full-term neonates aged 0 to 7 days with suspected jaundice who did not receive phototherapy were eligible for the study. The enrolled neonates in the study were assessed clinically, then with the MBJ20 transcutaneous bilirubinometer (TcB). The MBJ20 transcutaneous bilirubinometer highest measurement over the forehead and the sternum were compared to TsB. Data were entered and then analysed with the CsPro7.2 and R (version 3.6.0) software. Correlation was captured by Bland & Alman plots and Concordance Correlation Coefficient (CCC) estimates. The Pearson correlation coefficient and Student test for paired data were used for descriptions purposes, and the significance level was 5%. Results: We recruited 88 neonates. The sex ratio of the babies included was 1.25 favouring males. Median Post-natal age was 3 days with 62% aged 72 hours or more. The mean TcB corresponding to the maximum average between frontal and sternal measurement was 153 mg/dl ± 48 and the average Tsb was 123.80 mg/dl ± 50.48. A good linear correlation was found between TcB and total serum bilirubin level r = 0.86 [0.80;0.91]. Positive correlation was noted between both (forehead and sternum) TcB measurements sites, namely r = 0.78 and r = 0.86. The Bland & Altman plot measured the bias at -29.68 mg/l (confidence interval at 95%, 21.14 - 80.50). The CCC estimate was 0.2 varying from -0.22 to 0.76 according to TcB measurement threshold and post-natal age. The ROC area under the curve value for a threshold < 100 mg/l equals 90% proving to be a good predictor for this threshold. Conclusion: A good linear correlation was found despite a poor agreement between TcB and Tsb. TcB method systematically overestimated the value of TsB.

Incidence of chromosome abnormalities at a second-trimester genetic amniocentesis for Mainland Chinese women of advanced maternal age:a study of 6,584 cases

Objective:The aim of this study was to calculate the expected incidence of chromosomal aneuploidy at second trimester genetic amniocentesis in China's Mainland in women aged 35 and older. Methods:We reviewed the genetic amniocenteses data in Peking Union Medical College Hospital between January 2001 to June 2011.The indication for genetic amniocentesis was solely advanced maternal age(AMA).A total of 6,584 cases were included in this study.The AMA women was divided into two groups by maternal age,the group of 35-39 years old and the group of≥40 years old.The incidence of fetal Down syndrome was compared between the two groups by chi-square test. Results:A total of 121 cases were diagnosed to be chromosomally abnormal,giving an overall incidence of 18.38‰(121/6,584).The abnormal karyotypes included 111 cases of various aneuploidies and 10 cases with various structural abnormalities.The aneuploidies(mosaicism included) were 59 cases of(47,+ 21),25 cases of (47,+ 18),2 cases of(47,+ 13),8 cases of(45,X),3 cases of(47,XXX),13 cases of(47,XXY) and 1 case of(47,XYY).The karyotype of(47,+21) was the most frequent chromosomal abnormality,with an overall incidence of 8.96‰,account for 53.1%of all aneuploidies.Sex chromosome aneuploidies were the next most common,with a total incidence of 3.80‰.The incidence of fetal Down syndrome was significantly higher in the group of≥40 years old than that of the group of 35-39 years old(P = 0.047). Conclusions:The incidence of chromosomal aneuploidy found in this study is the first data published for China's Mainland and will be helpful for the counseling of pregnant women in this age group.Consideration may be given to prenatal screening versus prenatal diagnosis in women of advanced maternal age in China's Mainland.

干酪乳杆菌对母婴分离诱导子代抑郁大鼠外周及中枢神经炎症的影响

目的观察干酪乳杆菌对产后进行母婴分离(maternal separation,MS)诱导子代大鼠抑郁样行为的影响,探索益生菌改善抑郁样行为潜在的中枢神经炎症的作用机制。方法采用母婴分离应激方法建立子代抑郁动物模型,并将SD子鼠采用随机数字表法分为对照组(CON组)、母婴分离组(MS组)、母婴分离+干酪乳杆菌组(MS+干酪乳杆菌组),每组8只。其中对照组雌鼠在产后与子鼠不进行母婴分离干预;母婴分离组雌鼠在正常分娩后与子鼠每天分离3 h,连续分离14 d;MS+干酪乳杆菌组的子鼠在MS组基础上给予为期4周的干酪乳杆菌干预,每天按体质量灌胃8×10^(8) CFU/(kg·d)。采用糖水偏好实验(SPT)和强迫游泳实验(FST)评估各组子代大鼠的抑郁样行为,采用ELISA法测定各组子代大鼠血清和海马组织中TNF-α、IL-6、IL-1β、IL-10的水平,采用荧光实时定量PCR法检测各组子代大鼠海马组织中IDO1及5-HT mRNA的表达水平。结果与对照组相比,母婴分离组子代大鼠的糖水偏好百分比明显降低(P<0.05),虽然自发活动实验中穿格次数的减少差异无统计学意义,但强迫游泳实验中的不动时间显著延长(P<0.05),说明母婴分离组子代大鼠产生了明显的抑郁样行为。而干酪乳杆菌显著改善了母婴分离应激引起的子代大鼠的行为学变化,明显提高了糖水偏好百分比(P<0.05),缩短了强迫游泳的不动时间(P<0.05)。与MS组相比,MS+干酪乳杆菌组子代大鼠海马和外周血中IL-6、IL-1β、TNF-α的含量显著降低(P<0.01),IL-10的含量显著增加(P<0.05);子代大鼠海马中IDO1 mRNA的表达显著降低(P<0.01),5-HT mRNA的表达显著升高(P<0.01)。结论母婴分离诱导子代大鼠产生了抑郁样行为,干酪乳杆菌通过调节外周血和海马炎性因子的表达,抑制海马中IDO1的表达、增加海马中5-HT的表达,可改善子代大鼠抑郁样行为。

超声检查联合NIPT在高龄孕妇产前筛查中的应用价值

目的探讨超声检查联合无创产前DNA检测(NIPT)在高龄孕妇中对胎儿染色体异常筛查的临床应用价值。方法选取2020-2023年在宝鸡市妇幼保健院接受产前检查的3820例高龄孕妇作为研究对象,所有孕妇均接受超声检查及NIPT,以羊膜腔穿刺结果或妊娠结局作为胎儿染色体异常的诊断标准,比较超声检查、NIPT及二者联合应用对胎儿染色体异常的诊断情况。结果3820例高龄孕妇中NIPT筛查出高风险57例;超声检查软指标异常95例,结构异常63例;超声检查联合NIPT诊断胎儿染色体异常的灵敏度、特异度和阳性预测值分别为93.18%、99.89%、91.11%。结论高龄孕妇胎儿染色体产前筛查中,超声检查联合NIPT可以相互补充参考,可有效提高染色体异常检出的灵敏度、特异度,降低假阳性率和假阴性率,实现对出生缺陷的早发现、早诊断及早干预。

基于同步辐射X射线荧光光谱与一维卷积神经网络的癌症筛查方法

癌症是全球范围内引起高发病率与高死亡率的疾病之一。现有癌症检测方法耗时、昂贵、专业人员依赖性强,开发一种无损、快速筛查方法非常重要。在前期工作基础上,发展了基于同步辐射X射线荧光光谱技术(SRXRF)与深度学习技术结合的一种非靶标金属组学方法筛查癌症患者。首先,分析控制组与癌症组共269份血清样本的SRXRF谱线,得到Ca、Mn、Zn、Ge、Br在两类人群中具有代表性差异,可以作为癌症筛查的标志物;其次,对于平均光谱进行归一化(Normalization)、迭代自适应加权惩罚最小二乘法(airPLS)、Savitzky-Golay平滑(SG)、标准正态变换(SNV)的预处理,并建立偏最小二乘判别分析(PLSDA)、K近邻法(KNN)、软独立建模分类法(SIMCA)的化学计量学模型,三种模型对癌症筛查的最优准确率分别为89.89%、93.26%、90.95%;最后,基于像素级光谱,搭建三种一维卷积神经网络(1DCNN)模型,三种模型准确率分别为93.56%、95.24%、93.27%,相对于化学计量学模型均有所提高,增加卷积层的数量有助于数据特征提取,模型准确率提高了1.68%。将三种模型卷积层提取获得的特征进行t-分布随机邻域嵌入算法(tSNE)降维可视化,得到1DCNN提取的特征具有显著可分性,SRXRF结合1DCNN模型开发的非靶标金属组学方法在实现癌症的快速筛查方面具有潜力。

NT与血清β-hCG、PAPP-A、ADAM12单独及联合检测对孕早期DS的诊断价值

目的:探讨颈部透明层厚度(NT)与血清人绒毛膜促性腺激素(β-hCG)、妊娠相关蛋白A(PAPP-A)及解整合素金属蛋白酶12(ADAM12)单独及联合检测对孕早期唐氏综合征(DS)的诊断价值。方法:选取2019年1月—2023年1月在厦门大学附属第一医院杏林分院经羊膜穿刺确诊的47例DS孕妇作为DS组,另选取同期49例产前检查正常的孕产妇作为对照组,检测并比较两组NT及血清β-hCG、PAPP-A、ADAM12水平,并采用受试者工作特征(ROC)曲线分析NT与血清β-hCG、PAPP-A、ADAM12单独及联合检测对DS的诊断价值。结果:DS组NT及血清β-hCG水平高于对照组,PAPP-A、ADAM12水平均低于对照组,差异有统计学意义(P<0.05)。ROC曲线分析显示,NT与血清β-hCG、PAPP-A、ADAM12联合检测诊断DS的曲线下面积为0.993,预测敏感度、特异度分别为95.7%、98.0%,均高于上述指标单独检测。结论:NT与血清β-hCG、PAPP-A、ADAM12检测对孕早期DS均具有一定的诊断价值,且联合应用诊断效果更高,可作为孕早期DS筛查的有效指标。

不同血清总胆汁酸水平对妊娠肝内胆汁淤积症患者肝功能和母婴结局的影响

目的分析不同血清总胆汁酸(TBA)水平对妊娠肝内胆汁淤积症(ICP)患者肝功能和母婴结局的影响。方法选取2021年1月至12月珠海市妇幼保健院收治的60例ICP患者为研究对象,根据TBA水平分为对照组(30例,TBA<40μmol/L)、观察组(30例,TBA≥40μmol/L)。比较两组血清总胆红素(TBiL)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰基转移酶(γ-GGT)水平和母婴结局。结果观察组血清TBiL、ALT、AST、ALP、γ-GGT水平高于对照组,差异有统计学意义(P<0.05);观察组羊水污染率高于对照组,差异有统计学意义(P<0.05);观察组早产、新生儿窒息率高于对照组,差异有统计学意义(P<0.05);观察组新生儿出生后1、10 min的Apgar评分低于对照组,差异有统计学意义(P<0.05)。结论高水平TBA的ICP患者肝功能损害更加严重,羊水污染、早产、新生儿窒息等不良母婴结局的发生率更高。

阿托西班联合地塞米松对胎膜早破孕妇的治疗效果及对8-iso-PG、Cor、NE水平的影响

目的探讨阿托西班联合地塞米松对胎膜早破孕妇的治疗效果及对氧化应激反应指标[8-异前列腺素(8-iso-PG)、皮质醇(Cor)、去甲肾上腺素(NE)]水平的影响。方法选取2019年10月至2021年10月河北省保定市第二医院收治的110例胎膜早破患者作为研究对象。按照随机数字表法分为观察组与对照组,每组55例。两组均给予胎膜早破的常规治疗,对照组在常规治疗基础上增加地塞米松治疗,观察组在对照组基础上联合阿托西班治疗。比较两组治疗后临床疗效、症状改善指标、不良母婴结局、氧化应激指标、治疗安全性。结果治疗后观察组治疗总有效率为92.73%(51/55),高于对照组的76.36%(42/55),差异有统计学意义(P<0.05)。治疗后观察组药物显效时间、宫缩抑制时间均短于对照组(P<0.05),孕期延长时间长于对照组(P<0.05)。治疗后观察组剖宫产、产后出血、羊膜腔感染、胎儿窘迫、新生儿窒息等发生率均低于对照组(P<0.05)。两组治疗后8-iso-PG、Cor、NE水平均低于同组治疗前(P<0.05),且观察组治疗后8-iso-PG、Cor、NE水平均低于对照组(P<0.05)。治疗期间观察组、对照组不良反应发生率分别为14.55%(8/55)、9.09%(5/55),两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论阿托西班联合地塞米松对胎膜早破患者的治疗效果良好,可抑制患者的宫缩,延长孕期时间,改善孕产妇的母婴结局,抑制8-iso-PG、Cor、NE水平,且治疗安全性较好。

基于多靶点粪便FIT-DNA联合检测技术的结直肠癌早筛应用研究

目的评价多靶点粪便FIT-DNA联合检测技术在结直肠癌早期筛查中的效果并进一步分析其应用前景。方法选取内蒙古医科大学附属医院就诊人群,每位受试者分别行血清肿瘤标志物检测、多靶点粪便FIT-DNA联合检测、肠镜检查,以接受多靶点粪便FIT-DNA联合检测人群为实验组,以接受肠镜检查及血清肿瘤标志物检测人群为对照组,以病理结果为金标准,评价新型粪便分子检测技术对于结直肠癌筛查的效果,对筛出的阳性人群给予及时干预。结果共分析了115例患者。血清肿瘤标志物检测敏感度63.2%(43/68),特异度74.5%(35/47);肠镜检查敏感度97.1%(66/68),特异度80.7%(38/47);而多靶点粪便FIT-DNA联合检测敏感度89.7%(61/68),特异度87.2%(41/47)。多靶点粪便FIT-DNA联合检测敏感度、特异度等均优于血清肿瘤标志物检测,敏感度虽低于肠镜检查,但相较肠镜检查操作简单,可居家自测。

围产期抑郁筛查指南概要

该文通过归纳世界卫生组织(WHO)及5个国家相关组织或机构发布的关于围产期抑郁症筛查指南建议,概述了围产期抑郁症筛查的最新研究进展,阐述了“早筛查、早发现、早干预”原则对于促进母婴健康、预防并发症及改善预后的重要性,并强调目前围产期抑郁症筛查的最佳时机和频次尚不明确,仍需进一步加强筛查后续的干预措施。该文建议未来需要关注筛查工具和干预方法的优化,为中国实施系统、科学的围产期常规抑郁症筛查提供指导及参考依据,以期全面提升围产期心理健康服务水平。