BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated wit...BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated with false-positive and false-negative FIT results.METHODS This retrospective study was based on the database of the Tianjin Colorectal Cancer Screening Program from 2012 to 2020.A total of 4129947 residents aged 40-74 years completed at least one FIT.Of these,24890 asymptomatic participants who underwent colonoscopy examinations and completed lifestyle questionnaires were included in the analysis.Multivariable logistic regression was performed to identify the factors associated with false FIT results.RESULTS Among the overall screening population,88687(2.15%)participants tested positive for FIT.The sensitivity,specificity,positive predictive value,and negative predictive value of FIT for advanced neoplasms were 58.2%,44.8%,9.7%,and 91.3%,respectively.Older age,female sex,smoking,alcohol consumption,higher body mass index,and hemorrhoids were significantly associated with increased odds of false-positive and lower odds of falsenegative FIT results.Moreover,features of high-grade dysplasia or villous for advanced adenoma and the presence of cancer were also associated with lower odds of false-negative results,while irregular exercise and diverticulum were associated with higher odds of false-positive results.CONCLUSION FIT results may be inaccurate in certain subgroups.Our results provide important evidence for further individualization of screening strategies.展开更多
AIM To evaluate the diagnostic value of fecal occult blood testing in mass screening for colorectal cancer. METHODS The reversed passive hemagglutination reaction fecal occult blood testing (RPHA FOBT) and colore...AIM To evaluate the diagnostic value of fecal occult blood testing in mass screening for colorectal cancer. METHODS The reversed passive hemagglutination reaction fecal occult blood testing (RPHA FOBT) and colorectal cancer′s risk factor quantitative method as the preliminary screening, and 60 cm fiberoptic colonoscopy as the accurate screening were used to detect colorectal cancer in a natural community of 75813 subjects in this study. RESULTS As compared with the 60cm fiberoptic colonoscopy as a standard reference, FOBT has a sensitivity of 41 9%, specificity of 95 8%, Youden′s index 0 38, and positive predictive value of 0 68%, these results went up with age in the subjects from the first detection. A 3 year follow up in the target mass showed that all new cases were once FOBT negative. CONCLUSION Values in FOBT as an indicator of mass screening for colorectal cancer were limited.展开更多
AIM： To detect tumor-associated DNA changes in stool samples among Iranian patients with colorectal cancer （CRC） compared to healthy individuals using BAT-26, p16 hypermethylation and long DNA markers. METHODS： St...AIM： To detect tumor-associated DNA changes in stool samples among Iranian patients with colorectal cancer （CRC） compared to healthy individuals using BAT-26, p16 hypermethylation and long DNA markers. METHODS： Stool DNA was isolated from 45 subjects including 25 CRC patients and 20 healthy individuals using a new, fast and easy extraction method. Long DNA associated with tumor was detected using polymerase chain reaction method. Microsatellite studies were performed utilizing denaturating polyacrylamide gel to determine the instability of BAT-26. Methylation status of p16 promoter was analyzed using methylation-specific PCR （MSP）. RESULTS： The results showed a significant difference in existence of long DNA （16 in patients vs 1 in controls, P 〈 0.001） and p16 （5 in patients vs none in controls, P = 0.043） in the stool samples of two groups. Long DNA was detected in 64% of CRC patients; whereas just one of the healthy individuals was positive for Long DNA. p16 methylation was found in 20% of patients and in none of healthy individuals. Instability of BATo26 was not detected in any of stool samples. CONCLUSION： We could detect colorectal cancer related genetic alterations by analyzing stool DNA with a sensitivity of 64% and 20% and a specificity of 95% and 100% for Long DNA and p16 respectively. A non- invasive molecular stool-based DNA testing can provide a screening strategy in high-risk individuals. However, additional testing on more samples is necessary from Iranian subjects to determine the exact specificity and sensitivity of these markers.展开更多
BACKGROUND Malnutrition exacerbates the deterioration in patients with advanced gas-trointestinal tumors.AIM To analyze the effect of enteral nutritional support based on Nutrition Risk Screening 2002(NRS2002)risk ass...BACKGROUND Malnutrition exacerbates the deterioration in patients with advanced gas-trointestinal tumors.AIM To analyze the effect of enteral nutritional support based on Nutrition Risk Screening 2002(NRS2002)risk assessment on nutritional function in patients with gastrointestinal tumors.METHODS One hundred twelve patients from April 2022 to April 2024 were included for observation and were divided into a control group and an observation group by random number method,56 each.Both groups received treatment for four consecutive weeks.The control group received routine enteral nutrition support,while the observation group received enteral nutrition support based on the NRS2002 risk assessment.Nutritional function,intestinal mucosal barrier function,quality of life,and complication rate were compared between the two groups.Statistical analysis was completed using SPSS26.0 and Excel.RESULTS After nutritional intervention,transferrin,albumin,hemoglobin,and diamine oxidase levels in the observation group were higher than those in the control group,while C-reactive protein,tumor necrosis factorα,and quality of life scores were lower,with significant differences(P<0.05).There was no significant difference in complications between groups(P>0.05),but the complication rate was lower in the observation group.CONCLUSION Enteral nutritional support based on NRS2002 risk assessment for patients with gastrointestinal tumors positively impacts nutritional status and promotes intestinal mucosal barrier function recovery.Patients’quality of life improved,and the incidence of adverse reactions decreased,indicating clinical promotion and application value.展开更多
According to the World Health Organization,an estimated 58 million people worldwide are chronically infected with hepatitis C virus(HCV),yet only about 20%have been formally diagnosed.Traditional laboratory–based ant...According to the World Health Organization,an estimated 58 million people worldwide are chronically infected with hepatitis C virus(HCV),yet only about 20%have been formally diagnosed.Traditional laboratory–based antibody and RNA assays require infrastructure and trained personnel,limiting their uptake in resource-limited and hard-to-reach settings.The OraQuick HCV self-test(HCVST)is the first World Health Organization-prequalified HCVST,which delivers results in 20-40 min via an easy-to-use gum-swab format.Field evaluations report a sensitivity of about 97%–98%and a specificity of about 99%–100%that are comparable with those of blood-based lateral-flow assays(e.g.,Alere Truline,SD Bioline).Usability studies demonstrated an acceptability rate of over 90%and a correct self-test completion rate of over 85%in key populations.HCVST with the Ora-Quick HCVST kit provides a practical,evidence-based approach to closing diagnostic gaps,particularly among underserved or stigmatized populations.To maximize the public health impact,programs should integrate self-testing into national screening algorithms,ensure linkage to RNA confirmation and treatment,and consider economic and operational contexts.展开更多
Background: To assess the validity of Human Papillomavirus (HPV) testing in a group of women at high risk for developing cervical cancer, a screening intervention was applied to a population of jail inmates in Rome, I...Background: To assess the validity of Human Papillomavirus (HPV) testing in a group of women at high risk for developing cervical cancer, a screening intervention was applied to a population of jail inmates in Rome, Italy. This cross-sectional study provided also new insights on the risk factors and on the HPV genotype distribution. Methods: We have invited 350 inmates to the preliminary stage of the screening program and 98 inmates decided to participate to the study and filled out a questionnaire for the history of attendance to previous cervical screening and for the known risk factors for cervical malignancies. HPV DNA test, conventional Pap smear and HPV genotyping were performed. Results: The percentage of women with High Risk (HR) HPV positivity were 19.3%. The inmates with LSIL/ HSIL status showed a significantly higher pre- valence of HR-HPV positivity (100% vs. 16.3%;p < 0.001) and of multiple HPV types (60% vs. 1.2%;p < 0.001) compared to women with normal/ASCUS Pap smear. HPV16 was the predominant genotype in either single or multiple infections. Conclusions: The results indicated that HPV DNA-based approach is a strategy useful for incarcerated women which do not have the opportunity or the social and cultural environment to receive preventive care.展开更多
The early detection of colorectal cancer with effective screening is essential for reduction of cancer-specific mortality. The addition of fecal DNA testing in the armamentarium of screening methods already in clinica...The early detection of colorectal cancer with effective screening is essential for reduction of cancer-specific mortality. The addition of fecal DNA testing in the armamentarium of screening methods already in clinical use launches a new era in the noninvasive part of colorectal cancer screening and emanates from a large number of previous and ongoing clinical investigations and technological advancements. In this review, we discuss the molecular rational and most important genetic alterations hallmarking the early colorectal carcinogenesis process. Also, representative DNA targets-markers and key aspects of their testing at the clinical level in comparison or/and association with other screening methods are described. Finally, a critical view of the strengths and limitations of fecal DNA tests is provided, along with anticipated barriers and suggestions for further exploitation of their use.展开更多
Inappropriate testing for HPV types on healthy subjects increases costs without benefit and potentially results in overtreatment. HPV testing also has a negative psychosocial impact on women, increasing anxiety, stres...Inappropriate testing for HPV types on healthy subjects increases costs without benefit and potentially results in overtreatment. HPV testing also has a negative psychosocial impact on women, increasing anxiety, stress, and concerns on sexual relationships. Giving the fact that HPV testing has been shown to have similar sensitivity but more overdiagnosis than cytology, and also giving the fact that false negative results may be higher than previously suspected, primary screening with HPV tests in European countries should be reconsidered. Resources saved in molecular testing may well be addressed in implementing vaccination strategies which are still underused, and may possibly include males as well as women.展开更多
Background: Zimbabwe recorded a 55% increase in HIV testing from 2011 to 2018 but with decreasing HIV-testing yields from 20% to 6% respectively as we aim to identify the narrowing gap of undiagnosed people living wit...Background: Zimbabwe recorded a 55% increase in HIV testing from 2011 to 2018 but with decreasing HIV-testing yields from 20% to 6% respectively as we aim to identify the narrowing gap of undiagnosed people living with HIV. As such adoption of screening tools during targeted HIV testing services improves efficiency by identifying individuals who are likely to test positive. Effective utilization of screening tools requires an understanding of health care worker perception and willingness to use the tools. Methods: We conducted a qualitative study among healthcare workers at 8 selected primary healthcare facilities in Zimbabwe. Interviewer-guided, in-depth interviews were conducted with healthcare workers and their immediate supervisors. Thematic analysis was performed following a framework built around the grounded theory model to describe perspectives that influence the utilization of HIV screening tools and suggestions for improved eligibility screening. Results: Behavioural factors facilitating the utilisation of the screening tool included motivation to adhere to standard practice, awareness of screening in targeting testing, and its ability to manage workload through screening out ineligible clients. This was evident across service delivery levels. Barriers included limited healthcare capacity, confidentiality space, multiple screening tools and opaque screening in/out criteria and the potential of clients not responding to screening questions truthfully. Conclusions: Across geographical and service delivery levels, placing screening tools at HIV testing entry points, healthcare worker knowledge on screening in/out criteria emerged as enablers for correct and consistent utilization. Further, standardizing the tools and adopting a decision aid algorithm would improve the accurate utilisation of screening tools.展开更多
Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introdu...Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.展开更多
BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detect...BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detection has garnered significant attention as a novel method for CRC screening.Colonoscopy and fecal occult blood tests,when combined,can improve screening accuracy and early detection rates,thereby facilitating early intervention and treatment.However,certain risks and costs accompany it,making the establishment of a risk classification model crucial for accurate classification and management of screened subjects.AIM To evaluate the feasibility and effectiveness of colonoscopy,immune fecal occult blood test(FIT),and risk-graded screening strategies in CRC screening.METHODS Based on the randomized controlled trial of CRC screening in the population conducted by our hospital May 2020 to May 2023,participants who met the requirements were randomly assigned to a colonoscopy group,an FIT group,or a graded screening group at a ratio of 1:2:2(after risk assessment,the high-risk group received colonoscopy,the low-risk group received an FIT test,and the FITpositive group received colonoscopy).The three groups received CRC screening with different protocols,among which the colonoscopy group only received baseline screening,and the FIT group and the graded screening group received annual follow-up screening based on baseline screening.The primary outcome was the detection rate of advanced tumors,including CRC and advanced adenoma.The population participation rate,advanced tumor detection rate,and colonoscopy load of the three screening programs were compared.RESULTS A total of 19373 subjects who met the inclusion and exclusion criteria were enrolled,including 8082 males(41.7%)and 11291 females(58.3%).The mean age was 60.05±6.5 years.Among them,3883 patients were enrolled in the colonoscopy group,7793 in the FIT group,and 7697 in the graded screening group.Two rounds of follow-up screening were completed in the FIT group and the graded screening group.The graded screening group(89.2%)and the colonoscopy group(42.3%)had the lowest overall screening participation rates,while the FIT group had the highest(99.3%).The results of the intentional analysis showed that the detection rate of advanced tumors in the colonoscopy group was greater than that of the FIT group[2.76%vs 2.17%,odds ratio(OR)=1.30,95%confidence interval(CI):1.01-1.65,P=0.037].There was no significant difference in the detection rate of advanced tumors between the colonoscopy group and the graded screening group(2.76%vs 2.35%,OR=1.9,95%CI:0.93-1.51,P=0.156),as well as between the graded screening group and the FIT group(2.35%vs 2.17%,OR=1.09%,95%CI:0.88-1.34,P=0.440).The number of colonoscopy examinations required for each patient with advanced tumors was used as an index to evaluate the colonoscopy load during population screening.The graded screening group had the highest colonoscopy load(15.4 times),followed by the colonoscopy group(10.2 times),and the FIT group had the lowest(7.8 times).CONCLUSION A hierarchical screening strategy based on CRC risk assessment is feasible for screening for CRC in the population.It can be used as an effective supplement to traditional colonoscopy and FIT screening programs.展开更多
As a zinc-dependent enzyme, metal-β-lactamase L1 contributes to the development of β-lactam antibiotic resistance. The metal-β-lactamase inhibitor can restore the efficacy of β-lactam antibiotics, and its developm...As a zinc-dependent enzyme, metal-β-lactamase L1 contributes to the development of β-lactam antibiotic resistance. The metal-β-lactamase inhibitor can restore the efficacy of β-lactam antibiotics, and its development has attracted much attention. In the present study, we used four widely-used virtual screening programs to screen 7035 small molecules to identify potential L1 inhibitors, and a high-throughput experimental model of L1 inhibitors was established. In this high-throughput testing model, the inhibition rate of 163 compounds on L1 exceeded 40%. The results of virtual screening of 7035 small molecules using the following four programs showed that among the top 1.35% of the compounds, their hit rates were ranked as Schr?dinger’s(5.26%), DS(1.05%), and Sybyl-x 2.0(1.05%), and Smina(2.11%).展开更多
The incidence of anal cancer in HIV-infected men who have sex with men (MSM) is increasing and screening is advo-cated. In a cross-sectional study anal cytology specimens from 58 HIV-infected MSM were analyzed for ade...The incidence of anal cancer in HIV-infected men who have sex with men (MSM) is increasing and screening is advo-cated. In a cross-sectional study anal cytology specimens from 58 HIV-infected MSM were analyzed for adequacy, cy-tology and HPV DNA testing results and compared to findings on anoscopy. The adequacy of cytology specimens was high. In 34 (63%) of anal swab samples any grade of dysplasia was observed compared to 41 (71%) of biopsy speci-mens. The cytology specimens revealed high-grade dysplasia in 4 (7%) compared to 29 (50%) of biopsy specimens. The prevalence of high-risk HPV types was 90% by using the SPF10 PCR and 81% by using the Hybrid Capture II assay. Because of the high HPV prevalence, HPV DNA testing alone is not a suitable diagnostic screening tool for detecting anogenital lesions in this specific MSM population. Screening should include both anal cytology and anoscopy.展开更多
Objective: <span lang="EN-US" style="font-family:;" "=""><span style="font-family:Verdana;">To understand the application of serum ferritin combined with blood ...Objective: <span lang="EN-US" style="font-family:;" "=""><span style="font-family:Verdana;">To understand the application of serum ferritin combined with blood routine testing in the screening of obstetrics and gynecology diseases in this region. <span style="font-family:Verdana;">Methods: <span style="font-family:Verdana;">From January 1, 2017, to October 28, 2020, all obstetric pregnant women, inpatient maternal, gynecological outpatient, and gynecological inpatients in our hospital’s outpatient and inpatient clinics were collected for serum ferritin determination and blood routine related index detection and analysis Changes in results. The application value of serum special protein in gynecological and obstetrical disease screening was put forward. <span style="font-family:Verdana;">Results:<span style="font-family:Verdana;"> A total of 15,656 cases of obstetrics and gynecology patients were collected, of which 15,300 were pregnant women. Comparing maternity checkups with hospitalized puerpera, the difference of all indexes except RBC was statistically significant (P < 0.05);Comparison of various indicators between gynecological outpatient clinics and gynecological hospitalizations, maternity checkups and gynecological outpatient clinics, inpatient maternal and gynecological hospitalizations, etc.;there was no statistically significant difference in all indicators (P > 0.05). Comparison of hospitalized puerpera and gynecological hospitalization, the difference of other indexes except for MCV, MCH was statistically significant (P < 0.05);Comparing hospitalized puerpera and gynecological clinics, the difference of HGB results was statistically significant (P < 0.05), but the difference of other indexes was not statistically significant (P > 0.05). <span style="font-family:Verdana;">Conclusion: <span style="font-family:Verdana;">During the maternity check-up period, the ferritin consumption is too large, the blood volume increases, and the blood routine-related items are reduced. The consumption is greater for a period of time after delivery, and recovery requires a certain process, which is relatively low;The ferritin in the body slowly recovered and the ferritin concentration increased. This process is a process of physiological change and does not involve related diseases, but from this result, we are also required to strengthen nutrition for pregnant women in order to give birth to healthier babies. The ferritin test of gynecological patients is mainly a screening of related diseases, and the results of this time did not screen out serious diseases.展开更多
Cervical cancer is the second most common type of cancer among women worldwide. In Sweden cervical cancer is the fifteenth most common cancer among women and accounts for 1.9 percent of all female cancers. The Swedish...Cervical cancer is the second most common type of cancer among women worldwide. In Sweden cervical cancer is the fifteenth most common cancer among women and accounts for 1.9 percent of all female cancers. The Swedish Pap smear screening program is enabling early detection of cell changes in order that treatment may be administered to prevent the development of cancerous cells. There are approximately four hundred and fifty cases of cervical cancer detected each year in Sweden and of these cases, approximately seventy five percent occur in women who do not participate in the screening and testing program. The purpose of this study was to illustrate and examine the reasons why women did not participate in the program even though they had received a notice that they had an appointment for a Pap smear test. In the study fourteen women from a district in the west of Sweden were interviewed. In order to analyse the interviews a qualitative content analysis according to Lundman and Graneheim was used. The analysis resulted in the development of three categories which were identified as communication, treatment and subterfuge (reasons or excuses for not participating). The theme of the study was the professional treatment of the women’s conditions. In the interviews the women emphasize the importance of professional treatment that is administered with respectful and sympathetic care throughout the whole healthcare system regardless of where and when the visit was conducted. Efficient organization and clear communication would minimize the inconvenience for the women during their visit.展开更多
<strong>Introduction:</strong> Viral hepatitis is a major public health challenge that requires an urgent response. Reducing mortality requires major scale-up in prevention, testing and treatment access;co...<strong>Introduction:</strong> Viral hepatitis is a major public health challenge that requires an urgent response. Reducing mortality requires major scale-up in prevention, testing and treatment access;coverage in HBV vaccination, testing and treatment is low and must accelerate massively to achieve the 2030 targets. Less than 1% of HBV-infected individuals are diagnosed in Sub-Sahara Africa, despite the availability of rapid tests with good diagnostic accuracy. <strong>Materials and Methods:</strong> This was retrospective cross sectional study conducted in Federal Teaching Hospital Gombe, in North East Nigeria. All children and adults who presented to the out-patient departments, and those that were admitted irrespective of their HIV and or Hepatitis C virus status and had Hepatitis B and/or Hepatitis B envelope antigen test were conducted between 2000 to 2015. All children and adults were tested using the Hospital standard for Hepatitis B surface antigen test strip. <strong>Results:</strong> Between 2000 and 2014, 739,456 children and adults were admitted and reviewed in the outpatient units of the Federal Teaching Hospital Gombe;there were 685,552 adults and 53,904 children. Children constituted 7.3% (53,904/739,456) of admissions and outpatient consultations. 2.8% (210/7570), 3.3% (773/23,783), 3.6% (1145/32,142), 5.2% (1694/33,043), 3.3% (986/29,216), 1.9% (661/3321), 0.1% (53/41,626), 0.2% (113/46,634), 2.6% (1418/54,423), 5.4% (3717/69,696), 3.7% (2332/62,086), 3.5% (3241/90,623), 3.2% (2881/89,398), 3.8% (2428/62,687), 2.8% (1835/63,208) of children and adults were tested for HBsAg in 2000, 2001, 20002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013 and 2014 respectively. 23,487 children and adults were tested for HBsAg with a cumulative testing rate of 3%. Overall 4465/23,487 children and adults were seropositive for HBsAg giving a cumulative prevalence of 19%. <strong>Conclusion:</strong> HBV screening in our health facility is very low. Massive scale up in awareness and HBV vaccination are required. Provider initiated testing and counseling for HBV in health facilities needs support for implementation in Health Facilities in Sub Saharan Africa.展开更多
Objective To assess whether quick cognitive screening test （QCST） could quickly identify mild cognitive impairment （MCI）. Methods QCST and a full set of standardized neuropsychological tests, including mini-mental...Objective To assess whether quick cognitive screening test （QCST） could quickly identify mild cognitive impairment （MCI）. Methods QCST and a full set of standardized neuropsychological tests, including mini-mental state examination （MMSE） and montreal cognitive assessment （MoCA） were performed. A total number of 121 cases of MCI [41 cases of amnestic MCI-single domain （aMCI-s）; 44 of amnestic MCI-multiple domain （aMCI-m）; 36 of nonamnestic MCI （naMCI）], 79 cases of mild Alzheimer’s disease （AD） and 186 healthy elderly volunteers were employed in the present study. All the participants （55-85 years old） had an educational level no less than 5 years. QCST subtests included word list recall, naming test, animal fluency test, similarity test, color trail-1min, clock drawing test, finger construction test, and digit span test. The total score of QCST was 90 points, 10 points for each index of subtests. Results The total scores of QCST in MCI, AD and the control groups were （58.13±8.18）, （44.53±10.54） and （72.92±6.85） points, respectively. According to the educational level, the cut off scores of participants with an educational level of 5-8 years, 9-12 years and more than 13 years were 63, 65 and 68 points, respectively. The sensitivity and specificity of QCST in detection of MCI were 87.6% （85.7% for aMCI-s, 90.1% for aMCI-m and 89.5% for naMCI） and 84.3%, respectively. The area under the curve was 0.923 （95% CI： 0.892-0.953）. Delayed memory, color trail-1min and similarity test could help distinguish between aMCI and naMCI. Conclusion QCST may have a good sensitivity and specificity for MCI detection, which warrants its further clinical application.展开更多
基金Supported by Natural Science Foundation of Tianjin,No.21JCZDJC00060 and No.21JCYBJC00180Tianjin Health and Medical Science and Technology Project,No.TJWJ2023QN040National Key Research and Development Program,No.2017YFC1700606 and No.2017YFC1700604.
文摘BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated with false-positive and false-negative FIT results.METHODS This retrospective study was based on the database of the Tianjin Colorectal Cancer Screening Program from 2012 to 2020.A total of 4129947 residents aged 40-74 years completed at least one FIT.Of these,24890 asymptomatic participants who underwent colonoscopy examinations and completed lifestyle questionnaires were included in the analysis.Multivariable logistic regression was performed to identify the factors associated with false FIT results.RESULTS Among the overall screening population,88687(2.15%)participants tested positive for FIT.The sensitivity,specificity,positive predictive value,and negative predictive value of FIT for advanced neoplasms were 58.2%,44.8%,9.7%,and 91.3%,respectively.Older age,female sex,smoking,alcohol consumption,higher body mass index,and hemorrhoids were significantly associated with increased odds of false-positive and lower odds of falsenegative FIT results.Moreover,features of high-grade dysplasia or villous for advanced adenoma and the presence of cancer were also associated with lower odds of false-negative results,while irregular exercise and diverticulum were associated with higher odds of false-positive results.CONCLUSION FIT results may be inaccurate in certain subgroups.Our results provide important evidence for further individualization of screening strategies.
文摘AIM To evaluate the diagnostic value of fecal occult blood testing in mass screening for colorectal cancer. METHODS The reversed passive hemagglutination reaction fecal occult blood testing (RPHA FOBT) and colorectal cancer′s risk factor quantitative method as the preliminary screening, and 60 cm fiberoptic colonoscopy as the accurate screening were used to detect colorectal cancer in a natural community of 75813 subjects in this study. RESULTS As compared with the 60cm fiberoptic colonoscopy as a standard reference, FOBT has a sensitivity of 41 9%, specificity of 95 8%, Youden′s index 0 38, and positive predictive value of 0 68%, these results went up with age in the subjects from the first detection. A 3 year follow up in the target mass showed that all new cases were once FOBT negative. CONCLUSION Values in FOBT as an indicator of mass screening for colorectal cancer were limited.
基金Supported by a grant from the vice chancellor for research at Mashhad University of Medical Sciences,NO. 84082
文摘AIM： To detect tumor-associated DNA changes in stool samples among Iranian patients with colorectal cancer （CRC） compared to healthy individuals using BAT-26, p16 hypermethylation and long DNA markers. METHODS： Stool DNA was isolated from 45 subjects including 25 CRC patients and 20 healthy individuals using a new, fast and easy extraction method. Long DNA associated with tumor was detected using polymerase chain reaction method. Microsatellite studies were performed utilizing denaturating polyacrylamide gel to determine the instability of BAT-26. Methylation status of p16 promoter was analyzed using methylation-specific PCR （MSP）. RESULTS： The results showed a significant difference in existence of long DNA （16 in patients vs 1 in controls, P 〈 0.001） and p16 （5 in patients vs none in controls, P = 0.043） in the stool samples of two groups. Long DNA was detected in 64% of CRC patients; whereas just one of the healthy individuals was positive for Long DNA. p16 methylation was found in 20% of patients and in none of healthy individuals. Instability of BATo26 was not detected in any of stool samples. CONCLUSION： We could detect colorectal cancer related genetic alterations by analyzing stool DNA with a sensitivity of 64% and 20% and a specificity of 95% and 100% for Long DNA and p16 respectively. A non- invasive molecular stool-based DNA testing can provide a screening strategy in high-risk individuals. However, additional testing on more samples is necessary from Iranian subjects to determine the exact specificity and sensitivity of these markers.
文摘BACKGROUND Malnutrition exacerbates the deterioration in patients with advanced gas-trointestinal tumors.AIM To analyze the effect of enteral nutritional support based on Nutrition Risk Screening 2002(NRS2002)risk assessment on nutritional function in patients with gastrointestinal tumors.METHODS One hundred twelve patients from April 2022 to April 2024 were included for observation and were divided into a control group and an observation group by random number method,56 each.Both groups received treatment for four consecutive weeks.The control group received routine enteral nutrition support,while the observation group received enteral nutrition support based on the NRS2002 risk assessment.Nutritional function,intestinal mucosal barrier function,quality of life,and complication rate were compared between the two groups.Statistical analysis was completed using SPSS26.0 and Excel.RESULTS After nutritional intervention,transferrin,albumin,hemoglobin,and diamine oxidase levels in the observation group were higher than those in the control group,while C-reactive protein,tumor necrosis factorα,and quality of life scores were lower,with significant differences(P<0.05).There was no significant difference in complications between groups(P>0.05),but the complication rate was lower in the observation group.CONCLUSION Enteral nutritional support based on NRS2002 risk assessment for patients with gastrointestinal tumors positively impacts nutritional status and promotes intestinal mucosal barrier function recovery.Patients’quality of life improved,and the incidence of adverse reactions decreased,indicating clinical promotion and application value.
文摘According to the World Health Organization,an estimated 58 million people worldwide are chronically infected with hepatitis C virus(HCV),yet only about 20%have been formally diagnosed.Traditional laboratory–based antibody and RNA assays require infrastructure and trained personnel,limiting their uptake in resource-limited and hard-to-reach settings.The OraQuick HCV self-test(HCVST)is the first World Health Organization-prequalified HCVST,which delivers results in 20-40 min via an easy-to-use gum-swab format.Field evaluations report a sensitivity of about 97%–98%and a specificity of about 99%–100%that are comparable with those of blood-based lateral-flow assays(e.g.,Alere Truline,SD Bioline).Usability studies demonstrated an acceptability rate of over 90%and a correct self-test completion rate of over 85%in key populations.HCVST with the Ora-Quick HCVST kit provides a practical,evidence-based approach to closing diagnostic gaps,particularly among underserved or stigmatized populations.To maximize the public health impact,programs should integrate self-testing into national screening algorithms,ensure linkage to RNA confirmation and treatment,and consider economic and operational contexts.
文摘Background: To assess the validity of Human Papillomavirus (HPV) testing in a group of women at high risk for developing cervical cancer, a screening intervention was applied to a population of jail inmates in Rome, Italy. This cross-sectional study provided also new insights on the risk factors and on the HPV genotype distribution. Methods: We have invited 350 inmates to the preliminary stage of the screening program and 98 inmates decided to participate to the study and filled out a questionnaire for the history of attendance to previous cervical screening and for the known risk factors for cervical malignancies. HPV DNA test, conventional Pap smear and HPV genotyping were performed. Results: The percentage of women with High Risk (HR) HPV positivity were 19.3%. The inmates with LSIL/ HSIL status showed a significantly higher pre- valence of HR-HPV positivity (100% vs. 16.3%;p < 0.001) and of multiple HPV types (60% vs. 1.2%;p < 0.001) compared to women with normal/ASCUS Pap smear. HPV16 was the predominant genotype in either single or multiple infections. Conclusions: The results indicated that HPV DNA-based approach is a strategy useful for incarcerated women which do not have the opportunity or the social and cultural environment to receive preventive care.
文摘The early detection of colorectal cancer with effective screening is essential for reduction of cancer-specific mortality. The addition of fecal DNA testing in the armamentarium of screening methods already in clinical use launches a new era in the noninvasive part of colorectal cancer screening and emanates from a large number of previous and ongoing clinical investigations and technological advancements. In this review, we discuss the molecular rational and most important genetic alterations hallmarking the early colorectal carcinogenesis process. Also, representative DNA targets-markers and key aspects of their testing at the clinical level in comparison or/and association with other screening methods are described. Finally, a critical view of the strengths and limitations of fecal DNA tests is provided, along with anticipated barriers and suggestions for further exploitation of their use.
文摘Inappropriate testing for HPV types on healthy subjects increases costs without benefit and potentially results in overtreatment. HPV testing also has a negative psychosocial impact on women, increasing anxiety, stress, and concerns on sexual relationships. Giving the fact that HPV testing has been shown to have similar sensitivity but more overdiagnosis than cytology, and also giving the fact that false negative results may be higher than previously suspected, primary screening with HPV tests in European countries should be reconsidered. Resources saved in molecular testing may well be addressed in implementing vaccination strategies which are still underused, and may possibly include males as well as women.
文摘Background: Zimbabwe recorded a 55% increase in HIV testing from 2011 to 2018 but with decreasing HIV-testing yields from 20% to 6% respectively as we aim to identify the narrowing gap of undiagnosed people living with HIV. As such adoption of screening tools during targeted HIV testing services improves efficiency by identifying individuals who are likely to test positive. Effective utilization of screening tools requires an understanding of health care worker perception and willingness to use the tools. Methods: We conducted a qualitative study among healthcare workers at 8 selected primary healthcare facilities in Zimbabwe. Interviewer-guided, in-depth interviews were conducted with healthcare workers and their immediate supervisors. Thematic analysis was performed following a framework built around the grounded theory model to describe perspectives that influence the utilization of HIV screening tools and suggestions for improved eligibility screening. Results: Behavioural factors facilitating the utilisation of the screening tool included motivation to adhere to standard practice, awareness of screening in targeting testing, and its ability to manage workload through screening out ineligible clients. This was evident across service delivery levels. Barriers included limited healthcare capacity, confidentiality space, multiple screening tools and opaque screening in/out criteria and the potential of clients not responding to screening questions truthfully. Conclusions: Across geographical and service delivery levels, placing screening tools at HIV testing entry points, healthcare worker knowledge on screening in/out criteria emerged as enablers for correct and consistent utilization. Further, standardizing the tools and adopting a decision aid algorithm would improve the accurate utilisation of screening tools.
文摘Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.
文摘BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detection has garnered significant attention as a novel method for CRC screening.Colonoscopy and fecal occult blood tests,when combined,can improve screening accuracy and early detection rates,thereby facilitating early intervention and treatment.However,certain risks and costs accompany it,making the establishment of a risk classification model crucial for accurate classification and management of screened subjects.AIM To evaluate the feasibility and effectiveness of colonoscopy,immune fecal occult blood test(FIT),and risk-graded screening strategies in CRC screening.METHODS Based on the randomized controlled trial of CRC screening in the population conducted by our hospital May 2020 to May 2023,participants who met the requirements were randomly assigned to a colonoscopy group,an FIT group,or a graded screening group at a ratio of 1:2:2(after risk assessment,the high-risk group received colonoscopy,the low-risk group received an FIT test,and the FITpositive group received colonoscopy).The three groups received CRC screening with different protocols,among which the colonoscopy group only received baseline screening,and the FIT group and the graded screening group received annual follow-up screening based on baseline screening.The primary outcome was the detection rate of advanced tumors,including CRC and advanced adenoma.The population participation rate,advanced tumor detection rate,and colonoscopy load of the three screening programs were compared.RESULTS A total of 19373 subjects who met the inclusion and exclusion criteria were enrolled,including 8082 males(41.7%)and 11291 females(58.3%).The mean age was 60.05±6.5 years.Among them,3883 patients were enrolled in the colonoscopy group,7793 in the FIT group,and 7697 in the graded screening group.Two rounds of follow-up screening were completed in the FIT group and the graded screening group.The graded screening group(89.2%)and the colonoscopy group(42.3%)had the lowest overall screening participation rates,while the FIT group had the highest(99.3%).The results of the intentional analysis showed that the detection rate of advanced tumors in the colonoscopy group was greater than that of the FIT group[2.76%vs 2.17%,odds ratio(OR)=1.30,95%confidence interval(CI):1.01-1.65,P=0.037].There was no significant difference in the detection rate of advanced tumors between the colonoscopy group and the graded screening group(2.76%vs 2.35%,OR=1.9,95%CI:0.93-1.51,P=0.156),as well as between the graded screening group and the FIT group(2.35%vs 2.17%,OR=1.09%,95%CI:0.88-1.34,P=0.440).The number of colonoscopy examinations required for each patient with advanced tumors was used as an index to evaluate the colonoscopy load during population screening.The graded screening group had the highest colonoscopy load(15.4 times),followed by the colonoscopy group(10.2 times),and the FIT group had the lowest(7.8 times).CONCLUSION A hierarchical screening strategy based on CRC risk assessment is feasible for screening for CRC in the population.It can be used as an effective supplement to traditional colonoscopy and FIT screening programs.
基金Natural Sciences Foundation of China (Grant No. 81872913)National High-tech R&D Program (863 Program, Grant No. 2015AA020911)。
文摘As a zinc-dependent enzyme, metal-β-lactamase L1 contributes to the development of β-lactam antibiotic resistance. The metal-β-lactamase inhibitor can restore the efficacy of β-lactam antibiotics, and its development has attracted much attention. In the present study, we used four widely-used virtual screening programs to screen 7035 small molecules to identify potential L1 inhibitors, and a high-throughput experimental model of L1 inhibitors was established. In this high-throughput testing model, the inhibition rate of 163 compounds on L1 exceeded 40%. The results of virtual screening of 7035 small molecules using the following four programs showed that among the top 1.35% of the compounds, their hit rates were ranked as Schr?dinger’s(5.26%), DS(1.05%), and Sybyl-x 2.0(1.05%), and Smina(2.11%).
文摘The incidence of anal cancer in HIV-infected men who have sex with men (MSM) is increasing and screening is advo-cated. In a cross-sectional study anal cytology specimens from 58 HIV-infected MSM were analyzed for adequacy, cy-tology and HPV DNA testing results and compared to findings on anoscopy. The adequacy of cytology specimens was high. In 34 (63%) of anal swab samples any grade of dysplasia was observed compared to 41 (71%) of biopsy speci-mens. The cytology specimens revealed high-grade dysplasia in 4 (7%) compared to 29 (50%) of biopsy specimens. The prevalence of high-risk HPV types was 90% by using the SPF10 PCR and 81% by using the Hybrid Capture II assay. Because of the high HPV prevalence, HPV DNA testing alone is not a suitable diagnostic screening tool for detecting anogenital lesions in this specific MSM population. Screening should include both anal cytology and anoscopy.
文摘Objective: <span lang="EN-US" style="font-family:;" "=""><span style="font-family:Verdana;">To understand the application of serum ferritin combined with blood routine testing in the screening of obstetrics and gynecology diseases in this region. <span style="font-family:Verdana;">Methods: <span style="font-family:Verdana;">From January 1, 2017, to October 28, 2020, all obstetric pregnant women, inpatient maternal, gynecological outpatient, and gynecological inpatients in our hospital’s outpatient and inpatient clinics were collected for serum ferritin determination and blood routine related index detection and analysis Changes in results. The application value of serum special protein in gynecological and obstetrical disease screening was put forward. <span style="font-family:Verdana;">Results:<span style="font-family:Verdana;"> A total of 15,656 cases of obstetrics and gynecology patients were collected, of which 15,300 were pregnant women. Comparing maternity checkups with hospitalized puerpera, the difference of all indexes except RBC was statistically significant (P < 0.05);Comparison of various indicators between gynecological outpatient clinics and gynecological hospitalizations, maternity checkups and gynecological outpatient clinics, inpatient maternal and gynecological hospitalizations, etc.;there was no statistically significant difference in all indicators (P > 0.05). Comparison of hospitalized puerpera and gynecological hospitalization, the difference of other indexes except for MCV, MCH was statistically significant (P < 0.05);Comparing hospitalized puerpera and gynecological clinics, the difference of HGB results was statistically significant (P < 0.05), but the difference of other indexes was not statistically significant (P > 0.05). <span style="font-family:Verdana;">Conclusion: <span style="font-family:Verdana;">During the maternity check-up period, the ferritin consumption is too large, the blood volume increases, and the blood routine-related items are reduced. The consumption is greater for a period of time after delivery, and recovery requires a certain process, which is relatively low;The ferritin in the body slowly recovered and the ferritin concentration increased. This process is a process of physiological change and does not involve related diseases, but from this result, we are also required to strengthen nutrition for pregnant women in order to give birth to healthier babies. The ferritin test of gynecological patients is mainly a screening of related diseases, and the results of this time did not screen out serious diseases.
文摘Cervical cancer is the second most common type of cancer among women worldwide. In Sweden cervical cancer is the fifteenth most common cancer among women and accounts for 1.9 percent of all female cancers. The Swedish Pap smear screening program is enabling early detection of cell changes in order that treatment may be administered to prevent the development of cancerous cells. There are approximately four hundred and fifty cases of cervical cancer detected each year in Sweden and of these cases, approximately seventy five percent occur in women who do not participate in the screening and testing program. The purpose of this study was to illustrate and examine the reasons why women did not participate in the program even though they had received a notice that they had an appointment for a Pap smear test. In the study fourteen women from a district in the west of Sweden were interviewed. In order to analyse the interviews a qualitative content analysis according to Lundman and Graneheim was used. The analysis resulted in the development of three categories which were identified as communication, treatment and subterfuge (reasons or excuses for not participating). The theme of the study was the professional treatment of the women’s conditions. In the interviews the women emphasize the importance of professional treatment that is administered with respectful and sympathetic care throughout the whole healthcare system regardless of where and when the visit was conducted. Efficient organization and clear communication would minimize the inconvenience for the women during their visit.
文摘<strong>Introduction:</strong> Viral hepatitis is a major public health challenge that requires an urgent response. Reducing mortality requires major scale-up in prevention, testing and treatment access;coverage in HBV vaccination, testing and treatment is low and must accelerate massively to achieve the 2030 targets. Less than 1% of HBV-infected individuals are diagnosed in Sub-Sahara Africa, despite the availability of rapid tests with good diagnostic accuracy. <strong>Materials and Methods:</strong> This was retrospective cross sectional study conducted in Federal Teaching Hospital Gombe, in North East Nigeria. All children and adults who presented to the out-patient departments, and those that were admitted irrespective of their HIV and or Hepatitis C virus status and had Hepatitis B and/or Hepatitis B envelope antigen test were conducted between 2000 to 2015. All children and adults were tested using the Hospital standard for Hepatitis B surface antigen test strip. <strong>Results:</strong> Between 2000 and 2014, 739,456 children and adults were admitted and reviewed in the outpatient units of the Federal Teaching Hospital Gombe;there were 685,552 adults and 53,904 children. Children constituted 7.3% (53,904/739,456) of admissions and outpatient consultations. 2.8% (210/7570), 3.3% (773/23,783), 3.6% (1145/32,142), 5.2% (1694/33,043), 3.3% (986/29,216), 1.9% (661/3321), 0.1% (53/41,626), 0.2% (113/46,634), 2.6% (1418/54,423), 5.4% (3717/69,696), 3.7% (2332/62,086), 3.5% (3241/90,623), 3.2% (2881/89,398), 3.8% (2428/62,687), 2.8% (1835/63,208) of children and adults were tested for HBsAg in 2000, 2001, 20002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013 and 2014 respectively. 23,487 children and adults were tested for HBsAg with a cumulative testing rate of 3%. Overall 4465/23,487 children and adults were seropositive for HBsAg giving a cumulative prevalence of 19%. <strong>Conclusion:</strong> HBV screening in our health facility is very low. Massive scale up in awareness and HBV vaccination are required. Provider initiated testing and counseling for HBV in health facilities needs support for implementation in Health Facilities in Sub Saharan Africa.
基金supported by the National Natural Science Foundation of China (No. 30570601)
文摘Objective To assess whether quick cognitive screening test （QCST） could quickly identify mild cognitive impairment （MCI）. Methods QCST and a full set of standardized neuropsychological tests, including mini-mental state examination （MMSE） and montreal cognitive assessment （MoCA） were performed. A total number of 121 cases of MCI [41 cases of amnestic MCI-single domain （aMCI-s）; 44 of amnestic MCI-multiple domain （aMCI-m）; 36 of nonamnestic MCI （naMCI）], 79 cases of mild Alzheimer’s disease （AD） and 186 healthy elderly volunteers were employed in the present study. All the participants （55-85 years old） had an educational level no less than 5 years. QCST subtests included word list recall, naming test, animal fluency test, similarity test, color trail-1min, clock drawing test, finger construction test, and digit span test. The total score of QCST was 90 points, 10 points for each index of subtests. Results The total scores of QCST in MCI, AD and the control groups were （58.13±8.18）, （44.53±10.54） and （72.92±6.85） points, respectively. According to the educational level, the cut off scores of participants with an educational level of 5-8 years, 9-12 years and more than 13 years were 63, 65 and 68 points, respectively. The sensitivity and specificity of QCST in detection of MCI were 87.6% （85.7% for aMCI-s, 90.1% for aMCI-m and 89.5% for naMCI） and 84.3%, respectively. The area under the curve was 0.923 （95% CI： 0.892-0.953）. Delayed memory, color trail-1min and similarity test could help distinguish between aMCI and naMCI. Conclusion QCST may have a good sensitivity and specificity for MCI detection, which warrants its further clinical application.
