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
The currently developed instrumental approaches for detecting pathological changes in the body have a number of disadvantages. The most important of them is that the equipment is sensitive to the detection of diseases...The currently developed instrumental approaches for detecting pathological changes in the body have a number of disadvantages. The most important of them is that the equipment is sensitive to the detection of diseases only from a certain threshold level of destructive changes in the body. The present article discusses the possibility of using the new instrumental complex “Bioscope” for early and non-invasive diagnosis of the beginning of the formation of ontological neoplasm’s in the body.展开更多
In vivo imaging of cerebral ischemia/reperfusion injury remains an important challenge.We injected porous Ag/Au@SiO_(2) bimetallic hollow nanoshells carrying anti-tropomyosin 4 as a molecular probe into mice with cere...In vivo imaging of cerebral ischemia/reperfusion injury remains an important challenge.We injected porous Ag/Au@SiO_(2) bimetallic hollow nanoshells carrying anti-tropomyosin 4 as a molecular probe into mice with cerebral ischemia/reperfusion injury and observed microvascular changes in the brain using photoacoustic imaging with ultrasonography.At each measured time point,the total photoacoustic signal was significantly higher on the affected side than on the healthy side.Twelve hours after reperfusion,cerebral perfusion on the affected side increased,cerebrovascular injury worsened,and anti-tropomyosin 4 expression increased.Twenty-four hours after reperfusion and later,perfusion on the affected side declined slowly and stabilized after 1 week;brain injury was also alleviated.Histopathological and immunohistochemical examinations confirmed the brain injury tissue changes.The nanoshell molecular probe carrying anti-tropomyosin 4 has potential for use in early diagnosis of cerebral ischemia/reperfusion injury and evaluating its progression.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
Gastric cancer(GC) remains an important cause of cancer death worldwide with a high mortality rate due to the fact that the majority of GC cases are diagnosed at an advanced stage when the prognosis is poor and the tr...Gastric cancer(GC) remains an important cause of cancer death worldwide with a high mortality rate due to the fact that the majority of GC cases are diagnosed at an advanced stage when the prognosis is poor and the treatment options are limited. Unfortunately, the existing circulating biomarkers for GC diagnosis and prognosis display low sensitivity and specificity and the GC diagnosis is based only on the invasive procedures such as upper digestive endoscopy. There is a huge need for less invasive or non-invasive tests but also highly specific biomarkers in case of GC. Body fluids such as peripheral blood, urine or saliva,stomach wash/gastric juice could be a source of specific biomarkers, providing important data for screening and diagnosis in GC. This review summarized the recently discovered circulating molecules such as microRNAs, long non-coding RNAs, circular RNAs, which hold the promise to develop new strategies for early diagnosis of GC.展开更多
BACKGROUND: Cystadenocarcinoma of the pancreas is insensitive to radiotherapy and chemotherapy, and surgery is at present the definitive treatment. Early and accurate diagnosis of cystadenocarcinoma is crucial for inc...BACKGROUND: Cystadenocarcinoma of the pancreas is insensitive to radiotherapy and chemotherapy, and surgery is at present the definitive treatment. Early and accurate diagnosis of cystadenocarcinoma is crucial for increasing the five-year survival rate and the resectable rate. There is no definitive and effective method of early diagnosis of cystadenocarcinoma of the pancreas in China and other countries. METHODS: We compared endoscopic ultrasonography- guided (EUS-guided) fine needle aspiration biopsy combined with cyst fluid carcinoembryonic antigen (CEA), CA19-9 examination with computed tomography (CT), B-ultrasonography (B-US) and serum CEA and CA19-9, to explore methods of early diagnosis of cystadenocarcinoma of the pancreas. Retrospective analysis was made on the clinical data of 126 cases of benign pancreatic lesion (90 cases) and cystadenocarcinoma (36). RESULTS: The sensitivity of B-US and CT for cystadeno- carcinoma was 52.8% and 77.8%, while the specificity was 78.9% and 86.7%, respectively. When measurement of CEA and CA19-9 of cyst fluid was combined with EUS-guided fine needle aspiration biopsy, the sensitivity was 94.4%, higher than that of B-US and CT (P<0.05). The sensitivity of cyst fluid CEA, CA19-9 examinations was considerably higher than that of serum CEA, CA19-9 (P<0.05). Upper gastrointestinal barium meal and endoscopic retrograde cholangiopancreatography (ERCP) had low sensitivity and specificity. CONCLUSIONS: EUS-guided fine needle aspiration biopsy combined with examination of cyst fluid CEA, CA19-9 is a credible means for early diagnosis of cystadenocarcinoma of the pancreas. B-US, CT and serumCEA, CA19-9 measurements are in common use, their findings are also very important.展开更多
This critical review of the literature assembles and compares available data on breast cancer clinical stage, time intervals to care, and access barriers in different countries. It provides evidence that while more th...This critical review of the literature assembles and compares available data on breast cancer clinical stage, time intervals to care, and access barriers in different countries. It provides evidence that while more than 70% of breast cancer patients in most high-income countries are diagnosed in stages Ⅰ and Ⅱ, only 20%-50% patients in the majority of low- and middleincome countries are diagnosed in these earlier stages. Most studies in the developed world show an association between an advanced clinical stage of breast cancer and delays greater than three months between symptom discovery and treatment start. The evidence assembled in this review shows that the median of this interval is 30-48 d in high-income countries but 3-8 mo in low- and middle-income countries. The longest delays occur between the first medical consultation and the beginning of treatment, known as the provider interval. The little available evidence suggests that access barriers and quality deficiencies in cancer care are determinants of provider delay in low- and middle-income countries. Research on specific access barriers and deficiencies in quality of care for the early diagnosis and treatment of breast cancer is practically non-existentin these countries, where it is the most needed for the design of cost-effective public policies that strengthen health systems to tackle this expensive and deadly disease.展开更多
BACKGROUND: Pancreatic cancer remains a devastating disease with a 5-year survival rate of less than 5%. Recent advances in diagnostic methods and therapeutic approaches have increased the possibility of improving the...BACKGROUND: Pancreatic cancer remains a devastating disease with a 5-year survival rate of less than 5%. Recent advances in diagnostic methods and therapeutic approaches have increased the possibility of improving the existing poor prognosis. DATA SOURCES: English-language articles reporting early diagnosis and therapy of pancreatic cancer were searched from the MEDLINE and PubMed databases, Chinese-language articles were from CHKD (China Hospital Knowledge Database) RESULT: The current literature about pancreatic cancer was reviewed from three aspects: statistics, screening and early detection, and therapy. CONCLUSIONS: Early detection and screening of pancreatic cancer currently should be limited to high risk patients Surgical resection is the only curative approach available, with some recent improvement in outcomes. Gemcitabine has been a standard treatment during the last decade. Gemcitabine based combination treatment, especially combined with newer molecular targeted agents, is promising. The rationale for radiotherapy is controversial, but with the recent development of modern radiation delivery techniques, radiotherapy should be intensified. Patients with borderline pancreatic cancer could benefit from neoadjuvant therapy but more evidence is needed and the best neoadjuvant regimen is still to be determined.展开更多
AIM:To develop a panel of blood-based diagnostic biomarkers consisting of circulating microRNAs for the detection of pancreatic cancer at an early stage.METHODS:Blood-based circulating microRNAs were profiled by high ...AIM:To develop a panel of blood-based diagnostic biomarkers consisting of circulating microRNAs for the detection of pancreatic cancer at an early stage.METHODS:Blood-based circulating microRNAs were profiled by high throughput screening using microarray analysis,comparing differential expression between early stage pancreatic cancer patients(n = 8) and healthy controls(n = 11).A panel of candidate microRNAs was generated based on the microarray signature profiling,including unsupervised clustering and statistical analysis of differential expression levels,and findings from the published literature.The selected candidate microRNAs were then confirmed using TaqMan real-time quantitative reverse transcription polymerase chain reaction(RT-qPCR) to further narrow down to a three-microRNA diagnostic panel.The three-microRNA diagnostic panel was validated with independent experimental proce-dures and instrumentation of RT-qPCR at an independent venue with a new cohort of cancer patients(n = 11),healthy controls(n = 11),and a group of high risk controls(n = 11).Receiver operating characteristic curve analysis was performed to assess the diagnostic capability of the three-microRNA panel.RESULTS:In the initial high throughput screening,1220 known human microRNAs were screened for differential expression in pancreatic cancer patients versus controls.A subset of 42 microRNAs was then generated based on this data analysis and current published literature.Eight microRNAs were selected from the list of 42 targets for confirmation study,and three-microRNAs,miR-642b,miR-885-5p,and miR-22,were confirmed to show consistent expression between microarray and RT-qPCR.These three microRNAs were then validated and evaluated as a diagnostic panel with a new cohort of patients and controls and found to yield high sensitivity(91%) and specificity(91%) with an area under the curve of 0.97(P < 0.001).Compared to the CA19-9 marker at 73%,the three-microRNA panel has higher sensitivity although CA19-9 has higher specificity of 100%.CONCLUSION:The identified panel of three microRNA biomarkers can potentially be used as a diagnostic tool for early stage pancreatic cancer.展开更多
Objective: To improve early diagnosis of primarygallbladder carcinoma (PGC) and the understandingof its pathogenesis, pathological stages and progno-sis.Methods: The data from 679 patients with PGC trea-ted in our hos...Objective: To improve early diagnosis of primarygallbladder carcinoma (PGC) and the understandingof its pathogenesis, pathological stages and progno-sis.Methods: The data from 679 patients with PGC trea-ted in our hospital from 1956 to 1998 were analyzedretrospectively.Results: The incidence of PGC has been increasing inrecent years, and the treatment is not satisfactory.Upon diagnosis, most patients with PGC were at ad-vanced stage. PGC was usually found in elderlywomen. The ratio of man to woman was 1:3. Thegallstone, closely related to PGC, was found in 60%of the patients with PGC. The diagnostic accordancerate before and after operation was Iow. In most pa-tients, PGC was found unexpectedly during opera-tion for gallstone or acute cholecystitis. Many pa-tients with PGC missed the opportunity of diagnosisand therapy because doctor only noticed the diagnosisof gallstone. Pathological classification revealed thatPGC in most patients (84.4%) were adenocarcino-ma. Imaging helped to find early-stage cases and im-prove prognosis.Conclusions: Understanding of pathogenesis, patho-logical stages and prognosis of PGC and proper useof various examinations are essential to the early di-agnosis and treatment of the disease.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.
文摘The currently developed instrumental approaches for detecting pathological changes in the body have a number of disadvantages. The most important of them is that the equipment is sensitive to the detection of diseases only from a certain threshold level of destructive changes in the body. The present article discusses the possibility of using the new instrumental complex “Bioscope” for early and non-invasive diagnosis of the beginning of the formation of ontological neoplasm’s in the body.
基金supported by the National Natural Science Foundation of China,No.81730050(to WH).
文摘In vivo imaging of cerebral ischemia/reperfusion injury remains an important challenge.We injected porous Ag/Au@SiO_(2) bimetallic hollow nanoshells carrying anti-tropomyosin 4 as a molecular probe into mice with cerebral ischemia/reperfusion injury and observed microvascular changes in the brain using photoacoustic imaging with ultrasonography.At each measured time point,the total photoacoustic signal was significantly higher on the affected side than on the healthy side.Twelve hours after reperfusion,cerebral perfusion on the affected side increased,cerebrovascular injury worsened,and anti-tropomyosin 4 expression increased.Twenty-four hours after reperfusion and later,perfusion on the affected side declined slowly and stabilized after 1 week;brain injury was also alleviated.Histopathological and immunohistochemical examinations confirmed the brain injury tissue changes.The nanoshell molecular probe carrying anti-tropomyosin 4 has potential for use in early diagnosis of cerebral ischemia/reperfusion injury and evaluating its progression.
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
基金Supported by a grant of the Romanian National Authority for Scientific Research and Innovation,CNCS-UEFISCDI,No.PN-Ⅲ-P4-ID-PCCF2016-0158(contract PCCF17/2018)within PNCDI Ⅲ
文摘Gastric cancer(GC) remains an important cause of cancer death worldwide with a high mortality rate due to the fact that the majority of GC cases are diagnosed at an advanced stage when the prognosis is poor and the treatment options are limited. Unfortunately, the existing circulating biomarkers for GC diagnosis and prognosis display low sensitivity and specificity and the GC diagnosis is based only on the invasive procedures such as upper digestive endoscopy. There is a huge need for less invasive or non-invasive tests but also highly specific biomarkers in case of GC. Body fluids such as peripheral blood, urine or saliva,stomach wash/gastric juice could be a source of specific biomarkers, providing important data for screening and diagnosis in GC. This review summarized the recently discovered circulating molecules such as microRNAs, long non-coding RNAs, circular RNAs, which hold the promise to develop new strategies for early diagnosis of GC.
文摘BACKGROUND: Cystadenocarcinoma of the pancreas is insensitive to radiotherapy and chemotherapy, and surgery is at present the definitive treatment. Early and accurate diagnosis of cystadenocarcinoma is crucial for increasing the five-year survival rate and the resectable rate. There is no definitive and effective method of early diagnosis of cystadenocarcinoma of the pancreas in China and other countries. METHODS: We compared endoscopic ultrasonography- guided (EUS-guided) fine needle aspiration biopsy combined with cyst fluid carcinoembryonic antigen (CEA), CA19-9 examination with computed tomography (CT), B-ultrasonography (B-US) and serum CEA and CA19-9, to explore methods of early diagnosis of cystadenocarcinoma of the pancreas. Retrospective analysis was made on the clinical data of 126 cases of benign pancreatic lesion (90 cases) and cystadenocarcinoma (36). RESULTS: The sensitivity of B-US and CT for cystadeno- carcinoma was 52.8% and 77.8%, while the specificity was 78.9% and 86.7%, respectively. When measurement of CEA and CA19-9 of cyst fluid was combined with EUS-guided fine needle aspiration biopsy, the sensitivity was 94.4%, higher than that of B-US and CT (P<0.05). The sensitivity of cyst fluid CEA, CA19-9 examinations was considerably higher than that of serum CEA, CA19-9 (P<0.05). Upper gastrointestinal barium meal and endoscopic retrograde cholangiopancreatography (ERCP) had low sensitivity and specificity. CONCLUSIONS: EUS-guided fine needle aspiration biopsy combined with examination of cyst fluid CEA, CA19-9 is a credible means for early diagnosis of cystadenocarcinoma of the pancreas. B-US, CT and serumCEA, CA19-9 measurements are in common use, their findings are also very important.
文摘This critical review of the literature assembles and compares available data on breast cancer clinical stage, time intervals to care, and access barriers in different countries. It provides evidence that while more than 70% of breast cancer patients in most high-income countries are diagnosed in stages Ⅰ and Ⅱ, only 20%-50% patients in the majority of low- and middleincome countries are diagnosed in these earlier stages. Most studies in the developed world show an association between an advanced clinical stage of breast cancer and delays greater than three months between symptom discovery and treatment start. The evidence assembled in this review shows that the median of this interval is 30-48 d in high-income countries but 3-8 mo in low- and middle-income countries. The longest delays occur between the first medical consultation and the beginning of treatment, known as the provider interval. The little available evidence suggests that access barriers and quality deficiencies in cancer care are determinants of provider delay in low- and middle-income countries. Research on specific access barriers and deficiencies in quality of care for the early diagnosis and treatment of breast cancer is practically non-existentin these countries, where it is the most needed for the design of cost-effective public policies that strengthen health systems to tackle this expensive and deadly disease.
文摘BACKGROUND: Pancreatic cancer remains a devastating disease with a 5-year survival rate of less than 5%. Recent advances in diagnostic methods and therapeutic approaches have increased the possibility of improving the existing poor prognosis. DATA SOURCES: English-language articles reporting early diagnosis and therapy of pancreatic cancer were searched from the MEDLINE and PubMed databases, Chinese-language articles were from CHKD (China Hospital Knowledge Database) RESULT: The current literature about pancreatic cancer was reviewed from three aspects: statistics, screening and early detection, and therapy. CONCLUSIONS: Early detection and screening of pancreatic cancer currently should be limited to high risk patients Surgical resection is the only curative approach available, with some recent improvement in outcomes. Gemcitabine has been a standard treatment during the last decade. Gemcitabine based combination treatment, especially combined with newer molecular targeted agents, is promising. The rationale for radiotherapy is controversial, but with the recent development of modern radiation delivery techniques, radiotherapy should be intensified. Patients with borderline pancreatic cancer could benefit from neoadjuvant therapy but more evidence is needed and the best neoadjuvant regimen is still to be determined.
基金Supported by The Valley Hospital Foundation Research Fund and private donations
文摘AIM:To develop a panel of blood-based diagnostic biomarkers consisting of circulating microRNAs for the detection of pancreatic cancer at an early stage.METHODS:Blood-based circulating microRNAs were profiled by high throughput screening using microarray analysis,comparing differential expression between early stage pancreatic cancer patients(n = 8) and healthy controls(n = 11).A panel of candidate microRNAs was generated based on the microarray signature profiling,including unsupervised clustering and statistical analysis of differential expression levels,and findings from the published literature.The selected candidate microRNAs were then confirmed using TaqMan real-time quantitative reverse transcription polymerase chain reaction(RT-qPCR) to further narrow down to a three-microRNA diagnostic panel.The three-microRNA diagnostic panel was validated with independent experimental proce-dures and instrumentation of RT-qPCR at an independent venue with a new cohort of cancer patients(n = 11),healthy controls(n = 11),and a group of high risk controls(n = 11).Receiver operating characteristic curve analysis was performed to assess the diagnostic capability of the three-microRNA panel.RESULTS:In the initial high throughput screening,1220 known human microRNAs were screened for differential expression in pancreatic cancer patients versus controls.A subset of 42 microRNAs was then generated based on this data analysis and current published literature.Eight microRNAs were selected from the list of 42 targets for confirmation study,and three-microRNAs,miR-642b,miR-885-5p,and miR-22,were confirmed to show consistent expression between microarray and RT-qPCR.These three microRNAs were then validated and evaluated as a diagnostic panel with a new cohort of patients and controls and found to yield high sensitivity(91%) and specificity(91%) with an area under the curve of 0.97(P < 0.001).Compared to the CA19-9 marker at 73%,the three-microRNA panel has higher sensitivity although CA19-9 has higher specificity of 100%.CONCLUSION:The identified panel of three microRNA biomarkers can potentially be used as a diagnostic tool for early stage pancreatic cancer.
文摘Objective: To improve early diagnosis of primarygallbladder carcinoma (PGC) and the understandingof its pathogenesis, pathological stages and progno-sis.Methods: The data from 679 patients with PGC trea-ted in our hospital from 1956 to 1998 were analyzedretrospectively.Results: The incidence of PGC has been increasing inrecent years, and the treatment is not satisfactory.Upon diagnosis, most patients with PGC were at ad-vanced stage. PGC was usually found in elderlywomen. The ratio of man to woman was 1:3. Thegallstone, closely related to PGC, was found in 60%of the patients with PGC. The diagnostic accordancerate before and after operation was Iow. In most pa-tients, PGC was found unexpectedly during opera-tion for gallstone or acute cholecystitis. Many pa-tients with PGC missed the opportunity of diagnosisand therapy because doctor only noticed the diagnosisof gallstone. Pathological classification revealed thatPGC in most patients (84.4%) were adenocarcino-ma. Imaging helped to find early-stage cases and im-prove prognosis.Conclusions: Understanding of pathogenesis, patho-logical stages and prognosis of PGC and proper useof various examinations are essential to the early di-agnosis and treatment of the disease.
