Diagnosing early-stage pancreatic cancer(PC)remains a clinical challenge.Hence,studying novel imaging aspects that could enhance the diagnostic accuracy of malignant pancreatic precursor lesions is imperative.This art...Diagnosing early-stage pancreatic cancer(PC)remains a clinical challenge.Hence,studying novel imaging aspects that could enhance the diagnostic accuracy of malignant pancreatic precursor lesions is imperative.This article aims to un-derscore the promising role of emerging imaging aspects that may facilitate the earlier diagnosis of PC,thereby improving its management and prognosis.展开更多
BACKGROUND Villous adenoma is a rare tumor in the urinary system that usually occurs in the bladder.It is extremely uncommon in the renal pelvis.Most of the previously reported cases have been diagnosed with severe hy...BACKGROUND Villous adenoma is a rare tumor in the urinary system that usually occurs in the bladder.It is extremely uncommon in the renal pelvis.Most of the previously reported cases have been diagnosed with severe hydronephrosis associated with renal parenchyma atrophy prior to surgery.Because of its rarity,available information on the pathogenesis,diagnosis,treatment and prognosis of the disease is limited.We reported a case of kidney stones with hydronephrosis.During percutaneous nephroscopic lithotripsy,a renal pelvis tumor was found.Biopsy confirmed that the tumor was a villous adenoma of the renal pelvis.CASE SUMMARY A 68-year-old female was admitted to the hospital due to right kidney stones with right hydronephrosis.After admission,a urinary system plain computed tomography scan was performed,which revealed right kidney stones with right hydronephrosis and right upper ureteral dilatation.Multiple new cauliflower-like papillary masses were then discovered in the renal pelvis and calyces during right percutaneous nephroscopic lithotripsy.Biopsy results indicated villous adenoma with high-grade glandular intraepithelial neoplasia.The patient underwent laparoscopic radical resection of the right kidney and ureter.Based on histopathological and immunohistochemical examination,the patient was diagnosed with villous adenoma without adenocarcinoma.CONCLUSION Villous adenoma is rare in the urinary system.We reported a case of renal pelvis villous adenoma,which may provide useful information for the early diagnosis and treatment of this tumor.展开更多
BACKGROUND:Early reperfusion can effectively treat acute myocardial infarction(AMI) and reduce the mortality signif icantly. This study aimed to compare the role of plasma microRNA-1(miR-1) and cardiac troponin T(cTnT...BACKGROUND:Early reperfusion can effectively treat acute myocardial infarction(AMI) and reduce the mortality signif icantly. This study aimed to compare the role of plasma microRNA-1(miR-1) and cardiac troponin T(cTnT) in early diagnosis of AMI patients.METHODS:From May 2011 to May 2012,plasma samples were collected from 56 AMI patients and 28 non-AMI controls. The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction(qRT-PCR),and the level of plasma cTnT was measured using electrochemiluminescence-based methods on an Elecsys 2010 Immunoassay Analyzer. SPSS 16.0 was used for the statistical analysis of the results. Data were expressed as mean±standard deviation unless otherwise described. The differences about clinical characteristics between the AMI patients and controls were tested using Student's t test or Fisher's exact test. The Mann-Whitney U test was conducted to compare the expression of microRNAs between the AMI patients and controls. MicroRNAs expression between different intervals of the AMI patients was compared using Wilcoxon's signed-rank test. The receiver operating characteristic(ROC) curve was established to discriminate the AMI patients from the controls.RESULTS:In the present study,the expression of plasma miR-1 was signifi cantly increased in the AMI patients compared with the healthy controls(P<0.01). The plasma miR-1 in the AMI patients decreased to the normal level at 14 days(P>0.05). The expression of plasma miR-1 was not related to the clinical characteristics of the study population(P>0.05). ROC curve analyses demonstrated that miR-1 was specifi c and sensitive for the early diagnosis of AMI,but not superior to cTnT.CONCLUSION:Plasma miR-1 could be used in the early diagnosis of AMI,but it is similar to cTnT.展开更多
While great strides in improving survival rates have been made for most cancers in recent years,pancreatic ductal adenocarcinoma(PDAC)remains one of the solid tumors with the worst prognosis.PDAC mortality often overl...While great strides in improving survival rates have been made for most cancers in recent years,pancreatic ductal adenocarcinoma(PDAC)remains one of the solid tumors with the worst prognosis.PDAC mortality often overlaps with incidence.Surgical resection is the only potentially curative treatment,but it can be performed in a very limited number of cases.In order to improve the prognosis of PDAC,there are ideally two possible ways:the discovery of new strategies or drugs that will make it possible to treat the tumor more successfully or an earlier diagnosis that will allow patients to be operated on at a less advanced stage.The aim of this review was to summarize all the possible strategies available today for the early diagnosis of PDAC and the paths that research needs to take to make this goal ever closer.All the most recent studies on risk factors and screening modalities,new laboratory tests including liquid biopsy,new imaging methods and possible applications of artificial intelligence and machine learning were reviewed and commented on.Unfortunately,in 2022 the results for this type of cancer still remain discouraging,while a catastrophic increase in cases is expected in the coming years.The article was also written with the aim of highlighting the urgency of devoting more attention and resources to this pathology in order to reach a solution that seems more and more unreachable every day.展开更多
Although lactation mastitis(LM)has been extensively researched,the incidence rate of LM remains a salient clinical problem.To reduce this incidence rate and achieve a better prognosis,early and specific quantitative i...Although lactation mastitis(LM)has been extensively researched,the incidence rate of LM remains a salient clinical problem.To reduce this incidence rate and achieve a better prognosis,early and specific quantitative indicators are particularly important.It has been found that milk electrolyte concentrations(chloride,potassium,and sodium)and electrical conductivity(EC)significantly change in the early stages of LM in an animal model.Several studies have evaluated EC for the detection of subclinical mastitis in cows.EC,chloride,and sodium content of milk were more accurate for predicting infection status than were other variables.In the early stages of LM,lactic sodium,chloride,and EC increase,but potassium decreases.However,these indicators have not been reported in the diagnosis of LM in humans.This review summarizes the pathogenesis and the mechanism of LM in terms of milk electrolyte concentration and EC,and aim to provide new ideas for the detection of sub-clinical mastitis in humans.展开更多
BACKGROUND Although the presentations of Sjögren’s syndrome(SS)are variable,ranging from mild dryness to wider systemic involvement,ranulas as early clinical signs were scarcely reported.Here,we present an adult...BACKGROUND Although the presentations of Sjögren’s syndrome(SS)are variable,ranging from mild dryness to wider systemic involvement,ranulas as early clinical signs were scarcely reported.Here,we present an adult patient with SS,who developed a unilateral simple ranula and was diagnosed primary SS 3 years later.We also provide a review of cases of SS and ranulas from 1980 to 2020.CASE SUMMARY A 22-year-old girl was found to have a left painless floor-of-mouth lesion 3 years ago,without obvious trauma or inducement.The diagnosis of a unilateral(left)simple ranula was made,and the ranula was surgically treated.Within 3 years after the ranula surgery,she developed acute lymphadenectasis in unilateral parotid twice without inducement,and ultrasonic examination revealed diffuse lesions in bilateral parotids and submandibular glands,which strongly suggested SS.Serologic tests and the unstimulated whole saliva flow rate confirmed the SS diagnosis.CONCLUSION Our study underlines that ranulas are early clinical signs of SS.As early diagnosis and early intervention of SS are important to obtain better outcomes,our findings underline the need for histopathological test after sublingual adenectomy and imaging detection of exocrine glands for the patients with ranulas.展开更多
BACKGROUND The elevation of plasma von Willebrand factor(vWF)has been proposed to be a predictor of lung cancer.Type 2 diabetes mellitus(T2DM)causes endothelial activation,resulting in the secretion of vWF.However,the...BACKGROUND The elevation of plasma von Willebrand factor(vWF)has been proposed to be a predictor of lung cancer.Type 2 diabetes mellitus(T2DM)causes endothelial activation,resulting in the secretion of vWF.However,the role of vWF in patients with T2DM complicated with lung cancer remains unclear.AIM To investigate the clinical value of serum vWF as a tumor marker in patients with T2DM combined with lung adenocarcinoma in situ(AIS).METHODS This study enrolled 43 patients with T2DM combined with lung AIS(T2DM+AIS group),43 patients with T2DM alone(T2DM group),43 patients with lung AIS alone(AIS group),and 43 healthy volunteers(control group).The serum levels of vWF,insulin-like growth factor 1,and insulin-like growth factor binding protein 3 were determined.Multiple linear stepwise regression was performed to determine the correlations among variables.RESULTS Serum concentration of vWF in the T2DM+AIS group was significantly higher than those in the T2DM,AIS,and control groups(P<0.05).Serum vWF levels in the T2DM and AIS groups were significantly higher than that in the control group(P<0.05).There was no significant difference in serum vWF level between the T2DM and AIS groups.In the T2DM+AIS group,serum vWF was independently associated and positively correlated with serum levels of insulinlike growth factor 1 and insulin-like growth factor binding protein 3(P<0.05).CONCLUSION Serum vWF level may represent a novel biomarker for the early diagnosis of lung AIS.展开更多
Objective:autism spectrum disorder(ASD),a serious disorder that begins early in life,con-tinues throughout the lifespan.Children with ASD who are diagnosed early are more responsive to therapeutic interventions and ha...Objective:autism spectrum disorder(ASD),a serious disorder that begins early in life,con-tinues throughout the lifespan.Children with ASD who are diagnosed early are more responsive to therapeutic interventions and have less social and language impair-ment than children diagnosed later;however,current di-agnostic measures are mostly applied to children older than one year and lack the appropriate biological markers for early diagnosis of ASD.Using bioinformatic analy-sis,this study explores the molecular information mech-anism of ASD.Method:in this study,we used dataset GSE6575 from Gene Expression Omnibus(GEO)to an-alyze the mRNA expression profile of ASD,including 35 ASD samples and 12 normal control samples looking for different genes and we did enrichment analysis of those genes.We then used the STRING database to construct a protein-protein interaction(PPI)network of differential genes.Finally,Cytoscape plug-in cytoHubba was used to search for hub genes.The diagnostic value of the hub genes was verified by subject operating characteristic curves.Result:we looked for 50 different genes and did an enrichment analysis of those genes.The results of the enrichment analysis showed that these differential genes were mainly concentrated in the response to viruses,the immune regulation of inflammation and energy metabo-lism.Using Cytoscape plug-in cytoHubba,we found ten different genes.We drew ROC curves for all ten genes among which two genes,interleukin 2 receptor subunit beta(IL2Rβ)and perforin 1(PRF1),had good sensitivity and specificity for the early diagnosis of autism.The ar-eas under the ROC curves were 0.855,0.830 for IL2Rβ,PRF1.Conclusion:data analysis using the GEO data-base can provide new insights into the etiology of ASD as well as some possible biomarkers and therapeutic targets for early diagnosis and treatment of ASD.展开更多
Introduction: Early diagnosis and treatment of injuries of the diaphragm are important both because of high incidence of concomitant injuries and since they may lead to life-threatening intestinal and gastric strangul...Introduction: Early diagnosis and treatment of injuries of the diaphragm are important both because of high incidence of concomitant injuries and since they may lead to life-threatening intestinal and gastric strangulation in the late term. Herein, cases with diaphragmatic injury that have been diagnosed and operated in the early period after injury or during surgery were presented. Methods: Data of 14 cases, which have been diagnosed with diaphragmatic injury after trauma or during surgical procedure that was performed because of concomitant abdominal or intra-thoracic injury between January 2008 and April 2013, were retrospectively reviewed. Results: Of the traumatic diaphragmatic injuries, 10 (71.4%) have occurred due to penetrating trauma, whereas 4 (28.5%) have occurred due to blunt trauma. Diagnosis was made using I.V. contrast-enhanced whole abdominal and thoracic tomography in all 3 pediatric cases (21.4%) and during surgery in the others (78.5%). Conclusion: All of the diaphragmatic injuries have been accompanied by intra-abdominal or intra-thoracic organ injury that requires surgery. In these cases, the diagnosis was made on suspicion of diaphragmatic injury in the course of surgical procedure performed for concomitant organ injury. Computed tomography was diagnostic for diaphragmatic injuries in the pediatric cases.展开更多
Objective To study the early diagnosis and treatment of pulmonary embolism (PE) after total joint replacement (TJR). Methods From April 1987 to December 2001, we performed 1 336 total knee replacements (TKR) in 926 pa...Objective To study the early diagnosis and treatment of pulmonary embolism (PE) after total joint replacement (TJR). Methods From April 1987 to December 2001, we performed 1 336 total knee replacements (TKR) in 926 patients and 1 745 total hip replacements (RHRs) in 1 566 patients. In this group there were 5 PE patients after operation. Two patients died (all after TKR), and 3 patients salvaged successfully (2 after TKR, 1 after THR). Results The total incidence of PE after TJR was 0. 2% (5/2 492), the incidence of PE after TKR was 0. 4% (4/926), and the incidence of PE after THR was 0.06% (1/1 556). In the patients who suffered PE, 2 died. The incidence of PE before 2000 was 0%. Conclusion Death after total joint replacement is due to pulmonary embolism ( PE), especially massive PE. The incidence of PE after TKR is higher than that after THR. Pulmonary angiography is the gold standard for the diagnosis of PE. With more understanding on PE and more popularity of joint replacement, the diagnosis of PE展开更多
Objective To evaluate the clinical value of three dimensional computerized tomography angiography in the diagnosis and treatment of spontaneous subarachnoid hemorrhage. Methods 616 cases were diagnosed as suspected in...Objective To evaluate the clinical value of three dimensional computerized tomography angiography in the diagnosis and treatment of spontaneous subarachnoid hemorrhage. Methods 616 cases were diagnosed as suspected intracranial aneurysms in 3D CTA system. Computed tomographic scans and CTA studies were展开更多
Background:The search for biomarkers suitable for early diagnosis of Crohn's disease(CD)is challenging.This study investigated the efficacy of serological markers for the early diagnosis of CD.Methods:This was a r...Background:The search for biomarkers suitable for early diagnosis of Crohn's disease(CD)is challenging.This study investigated the efficacy of serological markers for the early diagnosis of CD.Methods:This was a retrospective nested cohort study.Indirect immuno-fluorescence and enzyme‐linked immunosorbent assay were used to detect ASCA IgG,ASCA IgA,AYMA IgG,AYCA IgG,FI2Y IgG,p‐ANCA IgG,GAB IgG and PAB IgG in patient serum samples.Results:The positive rates of ASCA IgG,ASCA IgA,AYMA IgG,AYCA IgG,FI2Y IgG,p‐ANCA IgG,GAB IgG and PAB IgG in patients with early CD,advanced CD and other intestinal diseases were 37.0%versus 56.8%versus 27.8%;3.7%versus 20.5%versus 19.4%;14.8%versus 2.3%versus 2.8%;25.9%versus 9.1%versus 8.3%;18.5%versus 15.9%versus 8.3%;0.0%versus 2.8%,18.5%;13.6%versus 18.2%versus 16.7%;and 7.4%versus 20.5%versus 0.0%,respectively.The positive rates of ASCA IgG,AYCA IgG and PAB IgG were significantly different among the three groups(p<0.05).In 85.2%of early CD patients,at least one antibody was detected 1 year before diagnosis.The sensitivity of the ASCA/AYMA/AYCA/FI2Y/GAB combination for early diagnosis was 85.2%.The sensitivity of the ASCA/AYMA/AYCA/FI2Y/GAB/PAB/PANCA combination for differentiating CD from other diseases was 87.3%.Conclusions:ASCA IgG and AYCA IgG have potential value in identifying the course of CD.AYCA IgG may be a potential marker for the early diagnosis of CD,and ASCA IgG indicates an advanced stage.The combination of ASCA,AYMA,AYCA,FI2Y,and GAB improves early diagnostic accuracy of CD.展开更多
BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of hepatectomy.The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the...BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of hepatectomy.The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative bleeding.Therefore,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after hepatectomy.AIM To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after hepatectomy.METHODS The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively analyzed.Patients were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower extremities.Clinicopathological factors,including demographic data and perioperative D-dimer values,were compared between the two groups.Receiver operating characteristic curve analysis was performed to determine the D-dimer cutoff value.Univariate and multivariate analyses were performed using logistic regression analysis to identify significant predictors.RESULTS In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE group.In the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after hepatectomy.CONCLUSION Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the postoperative period.展开更多
Hepatocellular carcinoma(HCC)is one of the most prevalent cancers globally.In contrast to the declining death rates observed for all other common cancers such as breast,lung,and prostate cancers,the death rates for HC...Hepatocellular carcinoma(HCC)is one of the most prevalent cancers globally.In contrast to the declining death rates observed for all other common cancers such as breast,lung,and prostate cancers,the death rates for HCC continue to increase by^2e3%per year because HCC is frequently diagnosed late and there is no curative therapy for an advanced HCC.The early diagnosis of HCC is truly a big challenge.Over the past years,the early diagnosis of HCC has relied on surveillance with ultrasonography(US)and serological assessments of alpha-fetoprotein(AFP).However,the specificity and sensitivity of US/AFP is not satisfactory enough to detect early onset HCC.Recent technological advancements offer hope for early HCC diagnosis.Herein,we review the progress made in HCC diagnostics,with a focus on emerging imaging techniques and biomarkers for early disease diagnosis.展开更多
Purpose::To investigate the clinical value of urine interleukin-18(IL-8),neutrophil gelatinase-associated lipocalin(NGAL)and kidney injury molecule-1(KIM-1)for the early diagnosis of acute kidney injury(AKI)in patient...Purpose::To investigate the clinical value of urine interleukin-18(IL-8),neutrophil gelatinase-associated lipocalin(NGAL)and kidney injury molecule-1(KIM-1)for the early diagnosis of acute kidney injury(AKI)in patients with ureteroscopic lithotripsy(URL)related urosepsis.Methods::A retrospective study was carried out in 157 patients with urosepsis after URL.The patients were divided into AKI group and non-AKI group according to the Kidigo guideline and urine IL-8,NGAL and KIM-1 levels were detected by enzyme-linked immunosorbent assay at 0,4,12,24 and 48 h after the surgery.Receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of these three biomarkers for postoperative AKI.Results::The level of urine IL-8,NGAL and KIM-1 in AKI group was significantly higher than that in non-AKI group at 4,12,24 and 48 h(p<0.01).The ROC analysis showed the combined detection of urine IL-8,NGAL and KIM-1 at 12 h had a larger area under curve(AUC)than a single marker(0.997,95%CI:0.991-0.998),and the sensitivity and specificity were 98.2%and 96.7%,respectively.Pearson correlation analysis showed that the levels of urine NGAL at 4,12,24 and 48 h in AKI patients were positively correlated with the levels of urine KIM-1 and IL-18(p<0.01).Conclusion::AKI could be quickly recognized by the elevated level of urine IL-8,NGAL and KIM-1 in patients with URL-related urosepsis.Combined detection of the three urine biomarkers at 12 h after surgery had a better diagnostic performance,which may be an important reference for the early diagnosis of AKI.展开更多
Objective:To identify potential early diagnostic markers for hepatitis B progression to primary liver carcinoma using routine immunological tests based on 6 cytokine combinations.Methods:Eight hundred and ninety-nine ...Objective:To identify potential early diagnostic markers for hepatitis B progression to primary liver carcinoma using routine immunological tests based on 6 cytokine combinations.Methods:Eight hundred and ninety-nine patients with hepatitis B progressing to early primary liver carcinoma admitted to and treated at Changhai Hospital,Naval Military Medical University,Shanghai,China between March 2015 and June 2017 were included in this observational study,including 666 patients with HBsAg^(+),HBeAb^(+),HBcAb^(+)liver carcinoma and 233 patients with HBsAg+,HBeAg+,HBcAb+liver carcinoma.Receiver operating characteristic(ROC)curves were used to evaluate the efficiency of the different cytokine in the diagnosis of hepatocellular carcinoma in patients with hepatitis B.This study was approved by the Institutional Review Board of Changhai Hospital,Naval Military Medical University,China(approval No.CHEC2020-080)on June 6,2020.Results:Changed levels of interleukin(IL)-1β,IL-2R,IL-8,and tumor necrosis factor(TNF)-a were statistically significant(P<0.05).The area under the ROC curve,sensitivity,specificity,positive predictive value,negative predictive value,and Youden index for the diagnosis of primary liver carcinoma using the combination of IL-1β,IL-2R,IL-8,and TNF-α were 0.938,79.2%,96.7%,96%,82.0%,0.759,respectively.The serum alpha-fetoprotein level in patients with primary liver carcinoma was positively correlated with IL-2R(r=0.3502,P<0.001),IL-8(r=0.1558,P=0.0273),and TNF-α(r=0.2544,P<0.001)levels.The equation fitted to the results was logit(P)=0.086+0.01IL-2R–0.001IL-8–0.033TNF-α–0.041IL-1β.Conclusion:Our study establishes a novel,potentially valuable diagnostic model based on four cytokines related to the early stages of liver carcinoma.展开更多
The incidence and mortality of hepatic carcinoma(HCC)remain high,and early diagnosis of HCC is seen as a key approach in improving clinical outcomes.However,the sensitivity and specificity of current early screening m...The incidence and mortality of hepatic carcinoma(HCC)remain high,and early diagnosis of HCC is seen as a key approach in improving clinical outcomes.However,the sensitivity and specificity of current early screening methods for HCC are not satisfactory.In recent years,research around exosomal miRNA has gradually increased,and these molecules have emerged as attractive candidates for early diagnosis and treatment of HCC.This review summarizes the feasibility of using miRNAs in peripheral blood exosomes as early diagnostic tools for HCC.展开更多
BACKGROUND Conjoined twins are a rare occurrence,and the majority of these malformations are detected during second trimester screening.CASE SUMMARY Herein we report a case of conjoined twins,which was diagnosed by ul...BACKGROUND Conjoined twins are a rare occurrence,and the majority of these malformations are detected during second trimester screening.CASE SUMMARY Herein we report a case of conjoined twins,which was diagnosed by ultrasound at 8 wk gestation and was normal at 7 wk gestation.The two fetuses shared one heart and were diagnosed as thoracopagus twins.This is the first report of conjoined twins diagnosed at 8 wk gestation.The pregnancy was terminated electively at 9 wk gestation.Because some congenital malformations can be diagnosed earlier,a prenatal ultrasound examination at an early gestational stage cannot be dismissed.CONCLUSION This case demonstrates that a 7-8 wk gestation might be the earliest period when conjoined twins can be diagnosed by ultrasound.展开更多
Early diagnosis and treatment is important to improve the cure rate of lung cancer. In addition to the improvement of surgical techniques and methods, the rapid development of artificial intelligence, liquid biopsy an...Early diagnosis and treatment is important to improve the cure rate of lung cancer. In addition to the improvement of surgical techniques and methods, the rapid development of artificial intelligence, liquid biopsy and other technologies in recent years have brought new breakthroughs in the diagnosis of lung cancer. In this paper, we systematically review the international progress in the diagnosis and treatment of early lung cancer in terms of screening, diagnosis, molecular characteristics, neoadjuvant/adjuvant therapy and postoperative monitoring.展开更多
文摘Diagnosing early-stage pancreatic cancer(PC)remains a clinical challenge.Hence,studying novel imaging aspects that could enhance the diagnostic accuracy of malignant pancreatic precursor lesions is imperative.This article aims to un-derscore the promising role of emerging imaging aspects that may facilitate the earlier diagnosis of PC,thereby improving its management and prognosis.
基金Anhui Province Key Clinical Specialty(Urology 2022).
文摘BACKGROUND Villous adenoma is a rare tumor in the urinary system that usually occurs in the bladder.It is extremely uncommon in the renal pelvis.Most of the previously reported cases have been diagnosed with severe hydronephrosis associated with renal parenchyma atrophy prior to surgery.Because of its rarity,available information on the pathogenesis,diagnosis,treatment and prognosis of the disease is limited.We reported a case of kidney stones with hydronephrosis.During percutaneous nephroscopic lithotripsy,a renal pelvis tumor was found.Biopsy confirmed that the tumor was a villous adenoma of the renal pelvis.CASE SUMMARY A 68-year-old female was admitted to the hospital due to right kidney stones with right hydronephrosis.After admission,a urinary system plain computed tomography scan was performed,which revealed right kidney stones with right hydronephrosis and right upper ureteral dilatation.Multiple new cauliflower-like papillary masses were then discovered in the renal pelvis and calyces during right percutaneous nephroscopic lithotripsy.Biopsy results indicated villous adenoma with high-grade glandular intraepithelial neoplasia.The patient underwent laparoscopic radical resection of the right kidney and ureter.Based on histopathological and immunohistochemical examination,the patient was diagnosed with villous adenoma without adenocarcinoma.CONCLUSION Villous adenoma is rare in the urinary system.We reported a case of renal pelvis villous adenoma,which may provide useful information for the early diagnosis and treatment of this tumor.
基金supported by grants from the National Natural Science Foundation of China(81071030)the Science and Technology Foundation of Guangdong Province(2011B080701006)
文摘BACKGROUND:Early reperfusion can effectively treat acute myocardial infarction(AMI) and reduce the mortality signif icantly. This study aimed to compare the role of plasma microRNA-1(miR-1) and cardiac troponin T(cTnT) in early diagnosis of AMI patients.METHODS:From May 2011 to May 2012,plasma samples were collected from 56 AMI patients and 28 non-AMI controls. The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction(qRT-PCR),and the level of plasma cTnT was measured using electrochemiluminescence-based methods on an Elecsys 2010 Immunoassay Analyzer. SPSS 16.0 was used for the statistical analysis of the results. Data were expressed as mean±standard deviation unless otherwise described. The differences about clinical characteristics between the AMI patients and controls were tested using Student's t test or Fisher's exact test. The Mann-Whitney U test was conducted to compare the expression of microRNAs between the AMI patients and controls. MicroRNAs expression between different intervals of the AMI patients was compared using Wilcoxon's signed-rank test. The receiver operating characteristic(ROC) curve was established to discriminate the AMI patients from the controls.RESULTS:In the present study,the expression of plasma miR-1 was signifi cantly increased in the AMI patients compared with the healthy controls(P<0.01). The plasma miR-1 in the AMI patients decreased to the normal level at 14 days(P>0.05). The expression of plasma miR-1 was not related to the clinical characteristics of the study population(P>0.05). ROC curve analyses demonstrated that miR-1 was specifi c and sensitive for the early diagnosis of AMI,but not superior to cTnT.CONCLUSION:Plasma miR-1 could be used in the early diagnosis of AMI,but it is similar to cTnT.
文摘While great strides in improving survival rates have been made for most cancers in recent years,pancreatic ductal adenocarcinoma(PDAC)remains one of the solid tumors with the worst prognosis.PDAC mortality often overlaps with incidence.Surgical resection is the only potentially curative treatment,but it can be performed in a very limited number of cases.In order to improve the prognosis of PDAC,there are ideally two possible ways:the discovery of new strategies or drugs that will make it possible to treat the tumor more successfully or an earlier diagnosis that will allow patients to be operated on at a less advanced stage.The aim of this review was to summarize all the possible strategies available today for the early diagnosis of PDAC and the paths that research needs to take to make this goal ever closer.All the most recent studies on risk factors and screening modalities,new laboratory tests including liquid biopsy,new imaging methods and possible applications of artificial intelligence and machine learning were reviewed and commented on.Unfortunately,in 2022 the results for this type of cancer still remain discouraging,while a catastrophic increase in cases is expected in the coming years.The article was also written with the aim of highlighting the urgency of devoting more attention and resources to this pathology in order to reach a solution that seems more and more unreachable every day.
文摘Although lactation mastitis(LM)has been extensively researched,the incidence rate of LM remains a salient clinical problem.To reduce this incidence rate and achieve a better prognosis,early and specific quantitative indicators are particularly important.It has been found that milk electrolyte concentrations(chloride,potassium,and sodium)and electrical conductivity(EC)significantly change in the early stages of LM in an animal model.Several studies have evaluated EC for the detection of subclinical mastitis in cows.EC,chloride,and sodium content of milk were more accurate for predicting infection status than were other variables.In the early stages of LM,lactic sodium,chloride,and EC increase,but potassium decreases.However,these indicators have not been reported in the diagnosis of LM in humans.This review summarizes the pathogenesis and the mechanism of LM in terms of milk electrolyte concentration and EC,and aim to provide new ideas for the detection of sub-clinical mastitis in humans.
基金Supported by the National Natural Science Foundation of China,No.81801600。
文摘BACKGROUND Although the presentations of Sjögren’s syndrome(SS)are variable,ranging from mild dryness to wider systemic involvement,ranulas as early clinical signs were scarcely reported.Here,we present an adult patient with SS,who developed a unilateral simple ranula and was diagnosed primary SS 3 years later.We also provide a review of cases of SS and ranulas from 1980 to 2020.CASE SUMMARY A 22-year-old girl was found to have a left painless floor-of-mouth lesion 3 years ago,without obvious trauma or inducement.The diagnosis of a unilateral(left)simple ranula was made,and the ranula was surgically treated.Within 3 years after the ranula surgery,she developed acute lymphadenectasis in unilateral parotid twice without inducement,and ultrasonic examination revealed diffuse lesions in bilateral parotids and submandibular glands,which strongly suggested SS.Serologic tests and the unstimulated whole saliva flow rate confirmed the SS diagnosis.CONCLUSION Our study underlines that ranulas are early clinical signs of SS.As early diagnosis and early intervention of SS are important to obtain better outcomes,our findings underline the need for histopathological test after sublingual adenectomy and imaging detection of exocrine glands for the patients with ranulas.
文摘BACKGROUND The elevation of plasma von Willebrand factor(vWF)has been proposed to be a predictor of lung cancer.Type 2 diabetes mellitus(T2DM)causes endothelial activation,resulting in the secretion of vWF.However,the role of vWF in patients with T2DM complicated with lung cancer remains unclear.AIM To investigate the clinical value of serum vWF as a tumor marker in patients with T2DM combined with lung adenocarcinoma in situ(AIS).METHODS This study enrolled 43 patients with T2DM combined with lung AIS(T2DM+AIS group),43 patients with T2DM alone(T2DM group),43 patients with lung AIS alone(AIS group),and 43 healthy volunteers(control group).The serum levels of vWF,insulin-like growth factor 1,and insulin-like growth factor binding protein 3 were determined.Multiple linear stepwise regression was performed to determine the correlations among variables.RESULTS Serum concentration of vWF in the T2DM+AIS group was significantly higher than those in the T2DM,AIS,and control groups(P<0.05).Serum vWF levels in the T2DM and AIS groups were significantly higher than that in the control group(P<0.05).There was no significant difference in serum vWF level between the T2DM and AIS groups.In the T2DM+AIS group,serum vWF was independently associated and positively correlated with serum levels of insulinlike growth factor 1 and insulin-like growth factor binding protein 3(P<0.05).CONCLUSION Serum vWF level may represent a novel biomarker for the early diagnosis of lung AIS.
文摘Objective:autism spectrum disorder(ASD),a serious disorder that begins early in life,con-tinues throughout the lifespan.Children with ASD who are diagnosed early are more responsive to therapeutic interventions and have less social and language impair-ment than children diagnosed later;however,current di-agnostic measures are mostly applied to children older than one year and lack the appropriate biological markers for early diagnosis of ASD.Using bioinformatic analy-sis,this study explores the molecular information mech-anism of ASD.Method:in this study,we used dataset GSE6575 from Gene Expression Omnibus(GEO)to an-alyze the mRNA expression profile of ASD,including 35 ASD samples and 12 normal control samples looking for different genes and we did enrichment analysis of those genes.We then used the STRING database to construct a protein-protein interaction(PPI)network of differential genes.Finally,Cytoscape plug-in cytoHubba was used to search for hub genes.The diagnostic value of the hub genes was verified by subject operating characteristic curves.Result:we looked for 50 different genes and did an enrichment analysis of those genes.The results of the enrichment analysis showed that these differential genes were mainly concentrated in the response to viruses,the immune regulation of inflammation and energy metabo-lism.Using Cytoscape plug-in cytoHubba,we found ten different genes.We drew ROC curves for all ten genes among which two genes,interleukin 2 receptor subunit beta(IL2Rβ)and perforin 1(PRF1),had good sensitivity and specificity for the early diagnosis of autism.The ar-eas under the ROC curves were 0.855,0.830 for IL2Rβ,PRF1.Conclusion:data analysis using the GEO data-base can provide new insights into the etiology of ASD as well as some possible biomarkers and therapeutic targets for early diagnosis and treatment of ASD.
文摘Introduction: Early diagnosis and treatment of injuries of the diaphragm are important both because of high incidence of concomitant injuries and since they may lead to life-threatening intestinal and gastric strangulation in the late term. Herein, cases with diaphragmatic injury that have been diagnosed and operated in the early period after injury or during surgery were presented. Methods: Data of 14 cases, which have been diagnosed with diaphragmatic injury after trauma or during surgical procedure that was performed because of concomitant abdominal or intra-thoracic injury between January 2008 and April 2013, were retrospectively reviewed. Results: Of the traumatic diaphragmatic injuries, 10 (71.4%) have occurred due to penetrating trauma, whereas 4 (28.5%) have occurred due to blunt trauma. Diagnosis was made using I.V. contrast-enhanced whole abdominal and thoracic tomography in all 3 pediatric cases (21.4%) and during surgery in the others (78.5%). Conclusion: All of the diaphragmatic injuries have been accompanied by intra-abdominal or intra-thoracic organ injury that requires surgery. In these cases, the diagnosis was made on suspicion of diaphragmatic injury in the course of surgical procedure performed for concomitant organ injury. Computed tomography was diagnostic for diaphragmatic injuries in the pediatric cases.
文摘Objective To study the early diagnosis and treatment of pulmonary embolism (PE) after total joint replacement (TJR). Methods From April 1987 to December 2001, we performed 1 336 total knee replacements (TKR) in 926 patients and 1 745 total hip replacements (RHRs) in 1 566 patients. In this group there were 5 PE patients after operation. Two patients died (all after TKR), and 3 patients salvaged successfully (2 after TKR, 1 after THR). Results The total incidence of PE after TJR was 0. 2% (5/2 492), the incidence of PE after TKR was 0. 4% (4/926), and the incidence of PE after THR was 0.06% (1/1 556). In the patients who suffered PE, 2 died. The incidence of PE before 2000 was 0%. Conclusion Death after total joint replacement is due to pulmonary embolism ( PE), especially massive PE. The incidence of PE after TKR is higher than that after THR. Pulmonary angiography is the gold standard for the diagnosis of PE. With more understanding on PE and more popularity of joint replacement, the diagnosis of PE
文摘Objective To evaluate the clinical value of three dimensional computerized tomography angiography in the diagnosis and treatment of spontaneous subarachnoid hemorrhage. Methods 616 cases were diagnosed as suspected intracranial aneurysms in 3D CTA system. Computed tomographic scans and CTA studies were
文摘Background:The search for biomarkers suitable for early diagnosis of Crohn's disease(CD)is challenging.This study investigated the efficacy of serological markers for the early diagnosis of CD.Methods:This was a retrospective nested cohort study.Indirect immuno-fluorescence and enzyme‐linked immunosorbent assay were used to detect ASCA IgG,ASCA IgA,AYMA IgG,AYCA IgG,FI2Y IgG,p‐ANCA IgG,GAB IgG and PAB IgG in patient serum samples.Results:The positive rates of ASCA IgG,ASCA IgA,AYMA IgG,AYCA IgG,FI2Y IgG,p‐ANCA IgG,GAB IgG and PAB IgG in patients with early CD,advanced CD and other intestinal diseases were 37.0%versus 56.8%versus 27.8%;3.7%versus 20.5%versus 19.4%;14.8%versus 2.3%versus 2.8%;25.9%versus 9.1%versus 8.3%;18.5%versus 15.9%versus 8.3%;0.0%versus 2.8%,18.5%;13.6%versus 18.2%versus 16.7%;and 7.4%versus 20.5%versus 0.0%,respectively.The positive rates of ASCA IgG,AYCA IgG and PAB IgG were significantly different among the three groups(p<0.05).In 85.2%of early CD patients,at least one antibody was detected 1 year before diagnosis.The sensitivity of the ASCA/AYMA/AYCA/FI2Y/GAB combination for early diagnosis was 85.2%.The sensitivity of the ASCA/AYMA/AYCA/FI2Y/GAB/PAB/PANCA combination for differentiating CD from other diseases was 87.3%.Conclusions:ASCA IgG and AYCA IgG have potential value in identifying the course of CD.AYCA IgG may be a potential marker for the early diagnosis of CD,and ASCA IgG indicates an advanced stage.The combination of ASCA,AYMA,AYCA,FI2Y,and GAB improves early diagnostic accuracy of CD.
基金This study was reviewed and approved by the Ethics Committee of the Kobe University Graduate School of Medicine(Provided ID Number:B210306).
文摘BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of hepatectomy.The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative bleeding.Therefore,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after hepatectomy.AIM To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after hepatectomy.METHODS The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively analyzed.Patients were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower extremities.Clinicopathological factors,including demographic data and perioperative D-dimer values,were compared between the two groups.Receiver operating characteristic curve analysis was performed to determine the D-dimer cutoff value.Univariate and multivariate analyses were performed using logistic regression analysis to identify significant predictors.RESULTS In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE group.In the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after hepatectomy.CONCLUSION Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the postoperative period.
文摘Hepatocellular carcinoma(HCC)is one of the most prevalent cancers globally.In contrast to the declining death rates observed for all other common cancers such as breast,lung,and prostate cancers,the death rates for HCC continue to increase by^2e3%per year because HCC is frequently diagnosed late and there is no curative therapy for an advanced HCC.The early diagnosis of HCC is truly a big challenge.Over the past years,the early diagnosis of HCC has relied on surveillance with ultrasonography(US)and serological assessments of alpha-fetoprotein(AFP).However,the specificity and sensitivity of US/AFP is not satisfactory enough to detect early onset HCC.Recent technological advancements offer hope for early HCC diagnosis.Herein,we review the progress made in HCC diagnostics,with a focus on emerging imaging techniques and biomarkers for early disease diagnosis.
基金This article was sponsored by Medical Research Foundation of Chongqing,China(2019MSXM034).
文摘Purpose::To investigate the clinical value of urine interleukin-18(IL-8),neutrophil gelatinase-associated lipocalin(NGAL)and kidney injury molecule-1(KIM-1)for the early diagnosis of acute kidney injury(AKI)in patients with ureteroscopic lithotripsy(URL)related urosepsis.Methods::A retrospective study was carried out in 157 patients with urosepsis after URL.The patients were divided into AKI group and non-AKI group according to the Kidigo guideline and urine IL-8,NGAL and KIM-1 levels were detected by enzyme-linked immunosorbent assay at 0,4,12,24 and 48 h after the surgery.Receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of these three biomarkers for postoperative AKI.Results::The level of urine IL-8,NGAL and KIM-1 in AKI group was significantly higher than that in non-AKI group at 4,12,24 and 48 h(p<0.01).The ROC analysis showed the combined detection of urine IL-8,NGAL and KIM-1 at 12 h had a larger area under curve(AUC)than a single marker(0.997,95%CI:0.991-0.998),and the sensitivity and specificity were 98.2%and 96.7%,respectively.Pearson correlation analysis showed that the levels of urine NGAL at 4,12,24 and 48 h in AKI patients were positively correlated with the levels of urine KIM-1 and IL-18(p<0.01).Conclusion::AKI could be quickly recognized by the elevated level of urine IL-8,NGAL and KIM-1 in patients with URL-related urosepsis.Combined detection of the three urine biomarkers at 12 h after surgery had a better diagnostic performance,which may be an important reference for the early diagnosis of AKI.
基金This work was supported by the State Key Program of National Natural Science Foundation of China(No.82030073,to SL)the National Natural Science Foundation of China(No.81501401,to CH)Shanghai Science and Technology Committee(No.18XD1405300,to SL).
文摘Objective:To identify potential early diagnostic markers for hepatitis B progression to primary liver carcinoma using routine immunological tests based on 6 cytokine combinations.Methods:Eight hundred and ninety-nine patients with hepatitis B progressing to early primary liver carcinoma admitted to and treated at Changhai Hospital,Naval Military Medical University,Shanghai,China between March 2015 and June 2017 were included in this observational study,including 666 patients with HBsAg^(+),HBeAb^(+),HBcAb^(+)liver carcinoma and 233 patients with HBsAg+,HBeAg+,HBcAb+liver carcinoma.Receiver operating characteristic(ROC)curves were used to evaluate the efficiency of the different cytokine in the diagnosis of hepatocellular carcinoma in patients with hepatitis B.This study was approved by the Institutional Review Board of Changhai Hospital,Naval Military Medical University,China(approval No.CHEC2020-080)on June 6,2020.Results:Changed levels of interleukin(IL)-1β,IL-2R,IL-8,and tumor necrosis factor(TNF)-a were statistically significant(P<0.05).The area under the ROC curve,sensitivity,specificity,positive predictive value,negative predictive value,and Youden index for the diagnosis of primary liver carcinoma using the combination of IL-1β,IL-2R,IL-8,and TNF-α were 0.938,79.2%,96.7%,96%,82.0%,0.759,respectively.The serum alpha-fetoprotein level in patients with primary liver carcinoma was positively correlated with IL-2R(r=0.3502,P<0.001),IL-8(r=0.1558,P=0.0273),and TNF-α(r=0.2544,P<0.001)levels.The equation fitted to the results was logit(P)=0.086+0.01IL-2R–0.001IL-8–0.033TNF-α–0.041IL-1β.Conclusion:Our study establishes a novel,potentially valuable diagnostic model based on four cytokines related to the early stages of liver carcinoma.
基金Supported by the Quzhou Science and Technology Guided Project Planning,No.2019133。
文摘The incidence and mortality of hepatic carcinoma(HCC)remain high,and early diagnosis of HCC is seen as a key approach in improving clinical outcomes.However,the sensitivity and specificity of current early screening methods for HCC are not satisfactory.In recent years,research around exosomal miRNA has gradually increased,and these molecules have emerged as attractive candidates for early diagnosis and treatment of HCC.This review summarizes the feasibility of using miRNAs in peripheral blood exosomes as early diagnostic tools for HCC.
基金Supported by Major Research Projects of Universities in Guangdong Province,No.2019KZDZX1032the Open Laboratory Project of Guangzhou Medical University in 2019,No.C195015026Youth Foundation of Scientific Research of the Third Affiliated Hospital of Guangzhou Medical University,No.2018Q18.
文摘BACKGROUND Conjoined twins are a rare occurrence,and the majority of these malformations are detected during second trimester screening.CASE SUMMARY Herein we report a case of conjoined twins,which was diagnosed by ultrasound at 8 wk gestation and was normal at 7 wk gestation.The two fetuses shared one heart and were diagnosed as thoracopagus twins.This is the first report of conjoined twins diagnosed at 8 wk gestation.The pregnancy was terminated electively at 9 wk gestation.Because some congenital malformations can be diagnosed earlier,a prenatal ultrasound examination at an early gestational stage cannot be dismissed.CONCLUSION This case demonstrates that a 7-8 wk gestation might be the earliest period when conjoined twins can be diagnosed by ultrasound.
基金Peking University People's Hospital Research and Development Funds(RS2019-01)。
文摘Early diagnosis and treatment is important to improve the cure rate of lung cancer. In addition to the improvement of surgical techniques and methods, the rapid development of artificial intelligence, liquid biopsy and other technologies in recent years have brought new breakthroughs in the diagnosis of lung cancer. In this paper, we systematically review the international progress in the diagnosis and treatment of early lung cancer in terms of screening, diagnosis, molecular characteristics, neoadjuvant/adjuvant therapy and postoperative monitoring.
