BACKGROUND Confined placental mosaicism(CPM)is one of the major reasons for discrepancies between the results of non-invasive prenatal testing(NIPT)and fetal karyotype analysis.CASE SUMMARY We encountered a primiparou...BACKGROUND Confined placental mosaicism(CPM)is one of the major reasons for discrepancies between the results of non-invasive prenatal testing(NIPT)and fetal karyotype analysis.CASE SUMMARY We encountered a primiparous singleton pregnant woman with a rare CPM consisting of 47,XY,+21;47,XXY;and 46,XY,who obtained a false-positive result on NIPT with a high risk for trisomy 21.Copy-number variation sequencing on amniotic fluid cells,fetal tissue,and placental biopsies showed that the fetal karyotype was 47,XXY,while the placenta was a rare mosaic of 47,XY,+21;47,XXY;and 46,XY.CONCLUSION The patient had a rare CPM consisting of 47,XY,+21;47,XXY;and 46,XY,which caused a discrepancy between the result of NIPT and the actual fetal karyotype.It is important to remember that NIPT is a screening test,not a diagnostic test.Any positive result should be confirmed with invasive testing,and routine ultrasound examination is still necessary after a negative result.展开更多
Over the past few years, many researchers have attempted to develop non-invasive prenatal testing methods in order to investigate the genetic status of the fetus. The aim is to avoid invasive procedures such as chorio...Over the past few years, many researchers have attempted to develop non-invasive prenatal testing methods in order to investigate the genetic status of the fetus. The aim is to avoid invasive procedures such as chorionic villus and amniotic fluid sampling, which result in a significant risk for pregnancy loss. The discovery of cell free fetal DNA circulating in the maternal blood has great potential for the development of non-invasive prenatal testing(NIPT) methodologies. Such strategies have been successfully applied for the determination of the fetal rhesus status and inherited monogenic disease but the field of fetal aneuploidy investigation seems to be more challenging. The main reason for this is that the maternal cell free DNA in the mother's plasma is far more abundant, and because it is identical to half of the corresponding fetal DNA. Approaches developed are mainly based on next generation sequencing(NGS) technologies and epigenetic genetic modifications, such as fetal-maternal DNA differential methylation. At present, genetic services for non-invasive fetal aneuploidy detection are offered using NGS-based approaches but, for reasons that are presented herein, they still serve as screening tests which are not readily accessed by the majority of couples. Here we discuss the limitations of both strategies for NIPT and the future potential of the methods developed.展开更多
Objective:To analyze the clinical value of non-invasive prenatal testing(NIPT)in detecting chromosomal copy number variations(CNVs)and to explore the relationship between gene expression and clinical manifestations of...Objective:To analyze the clinical value of non-invasive prenatal testing(NIPT)in detecting chromosomal copy number variations(CNVs)and to explore the relationship between gene expression and clinical manifestations of chromosomal copy number variations.Methods:3551 naturally conceived singleton pregnant women who underwent NIPT were included in this study.The NIPT revealed abnormalities other than sex chromosome abnormalities and trisomy 13,18,and 21.Pregnant women with chromosome copy number variations underwent genetic counseling and prenatal ultrasound examination.Interventional prenatal diagnosis and chromosome microarray analysis(CMA)were performed.The clinical phenotypes and pregnancy outcomes of different prenatal diagnoses were analyzed.Additionally,a follow-up was conducted by telephone to track fetal development after birth,at six months,and one year post-birth.Results:A total of 53 cases among 3551 cases showed chromosomal copy number variation.Interventional prenatal diagnosis was performed in 36 cases:27 cases were negative and 8 were consistent with the NIPT test results.This indicates that NIPT’s positive predictive value(PPV)in CNVs is 22.22%.Conclusion:NIPT has certain clinical significance in screening chromosome copy number variations and is expected to become a routine screening for chromosomal microdeletions and microduplications.However,further interventional prenatal diagnosis is still needed to identify fetal CNVs.展开更多
Hepatocellular carcinoma(HCC)is one of the most common malignancies in the world and it is one of the main complications of cirrhosis and portal hypertension.Even in the presence of a well-established follow-up protoc...Hepatocellular carcinoma(HCC)is one of the most common malignancies in the world and it is one of the main complications of cirrhosis and portal hypertension.Even in the presence of a well-established follow-up protocol for cirrhotic patients,to date poor data are available on predictive markers for primary HCC occurrence in the setting of compensated advanced chronic liver disease patients(cACLD).The gold standard method to evaluate the prognosis of patients with cACLD,beyond liver fibrosis assessed with histology,is the measurement of the hepatic venous pressure gradient(HVPG).An HVPG≥10 mmHg has been related to an increased risk of HCC in cACLD patients.However,these methods are burdened by additional costs and risks for patients and are mostly available only in referral centers.In the last decade increasing research has focused on the evaluation of several,simple,non-invasive tests(NITs)as predictors of HCC development.We reviewed the currently available literature on biochemical and ultrasound-based scores developed for the noninvasive evaluation of liver fibrosis and portal hypertension in predicting primary HCC.We found that the most reliable methods to assess HCC risk were the liver stiffness measurement,the aspartate aminotransferase to platelet ratio index score and the fibrosis-4 index.Other promising NITs need further investigations and validation for different liver disease aetiologies.展开更多
AIM To explore the effect of alanine aminotransferase(ALT) on the performance of non-invasive fibrosis tests in chronic hepatitis B(CHB) patients. METHODS A total of 599 treatment-naive and biopsy-proven CHB patients ...AIM To explore the effect of alanine aminotransferase(ALT) on the performance of non-invasive fibrosis tests in chronic hepatitis B(CHB) patients. METHODS A total of 599 treatment-naive and biopsy-proven CHB patients were included in the study. The cohort was divided into the following three groups: Normal ALT(ALT ≤ 40), slightly elevated ALT(40 < ALT ≤ 80) and elevated ALT(ALT > 80). The diagnostic performance of five common non-invasive fibrosis tests for liver fibrosis(stages S2-4), including the aspartate aminotransferase(AST)-to-platelet(PLT) ratio index(APRI), fibrosis index based on 4 factors(FIB-4), King's score, Forns index and gamma-glutamyl transpeptidase(GGT)-to-PLT ratio(GPR), were evaluated for each group. RESULTS Higher ALT levels were associated with higher non-invasive fibrosis test scores. Patients with the same fibrosis stage but higher ALT levels showed higher noninvasive test scores. The areas under the receiver operating characteristics curves(AUROCs) of the noninvasive tests for prediction of ≥ S2 were higher for patients with ALT ≤ 40 U/L(range 0.705-0.755) and 40 < ALT ≤ 80 U/L(range 0.726-0.79) than for patients with ALT > 80 U/L(range 0.604-0.701). The AUROCs for predicting ≥ S3 and S4 were higher in patients with ALT ≤ 40 U/L(range 0.736-0.814 for ≥ S3, 0.79-0.833 for S4) than in patients with 40 < ALT ≤ 80 U/L(range 0.732-0.754 for ≥ S3, range 0.626-0.723 for S4) and ALT > 80 U/L(range 0.7-0.784 for ≥ S3, range 0.662-0.719 for S4). The diagnostic accuracy of the non-invasive tests decreased in a stepwise manner with the increase in ALT.CONCLUSION ALT has a significant effect on the diagnostic performance of non-invasive fibrosis tests. The ALT level should be considered before performing these noninvasive tests.展开更多
In this article,we comment on the article by Peta et al.This study evaluates the diagnostic performance of FibroTest-Actitest,transient elastography,and the fibrosis-4 index against a histological reference.Using the ...In this article,we comment on the article by Peta et al.This study evaluates the diagnostic performance of FibroTest-Actitest,transient elastography,and the fibrosis-4 index against a histological reference.Using the Obuchowski measure,the authors demonstrate that FibroTest and vibration-controlled transient elastography outperform the fibrosis-4 index in detecting fibrosis.Additionally,Actitest offers superior estimation of inflammatory activity compared to conventional biomarkers.Assessing liver fibrosis is crucial for managing autoimmune hepatitis(AIH),yet reliance on invasive liver biopsy remains higher than in other liver diseases.This is partly due to more complex diagnostic criteria for AIH,the lack of standardized scoring for non-invasive testing,and the presence of inflammation,which can lead to falsely elevated results with non-invasive tests.A Bayesian latent class model further supports the reliability of these non-invasive tests,highlighting their potential to complement biopsy,particularly for longterm disease monitoring.These findings underscore the importance of noninvasive diagnostics in optimizing AIH management.展开更多
AIM:To develop an integrated approach for monitoring gastrointestinal motility and inflammation state suitable for application in long-term spaceflights.METHODS:Breath tests based on the oral administration of 13 C-la...AIM:To develop an integrated approach for monitoring gastrointestinal motility and inflammation state suitable for application in long-term spaceflights.METHODS:Breath tests based on the oral administration of 13 C-labeled or hydrogen-producing substrates followed by the detection of their metabolites(13 CO 2 or H 2) in breath were used to measure gastrointestinal motility parameters during the 520-d spaceflight ground simulation within the MARS-500 Project.In particular,the gastric emptying rates of solid and liquid contents were evaluated by 13 C-octanoic acid and 13 Cacetate breath tests,respectively,whereas the orocecal transit time was assessed by an inulin H 2-breath test,which was performed simultaneously with the 13 C-octanoic acid breath test.A ready-to-eat,standardized pre-packaged muffin containing 100 mg of 13 C-octanoic acid was used in the 13 C-octanoic acid breath test to avoid the extemporaneous preparation of solid meals.In addition,a cassette-type lateral flow immunoassay was employed to detect fecal calprotectin,a biomarker of intestinal inflammation.Because no items could be introduced into the simulator during the experiment,all materials and instrumentation required for test performance during the entire mission simulation had to be provided at the beginning of the experiment.RESULTS:The experiments planned during the simulation of a manned flight to Mars could be successfully performed by the crewmembers without any external assistance.No evident alterations(i.e.,increasing or decreasing trends) in the gastric emptying rates were detected using the 13 C-breath tests during the mission simulation,as the gastric emptying half-times were in the range of those reported for healthy subjects.In contrast to the 13 C-breath tests,the results of the inulin H 2-breath test were difficult to interpret because of the high variability of the H 2 concentration in the breath samples,even within the same subject.This variability suggested that the H 2-breath test was strongly affected by external factors,which may have been related to the diet of the crewmembers or to environmental conditions(e.g.,the accumulation of hydrogen in the simulator microenvironment).At least in closed microenvironments such as the MARS-500 simulator,13 C-breath tests should therefore be preferred to H 2-breath tests.Finally,the fecal calprotectin test showed significant alterations during the mission simulation:all of the crewmembers were negative for the test at the beginning of the simulation but showed various degrees of positivity in at least one of the subsequent tests,thus indicating the onset of an intestinal inflammation.CONCLUSION:Breath tests,especially those 13 Cbased,proved suitable for monitoring gastrointestinal motility in the 520-d isolation experiment withinMARS-500 project and can be applied in long-term spaceflights.展开更多
The purpose of this study is to analyze the application of ultrasonic non-destructive testing technology in bridge engineering.During the research phase,based on literature collection and reading,as well as the analys...The purpose of this study is to analyze the application of ultrasonic non-destructive testing technology in bridge engineering.During the research phase,based on literature collection and reading,as well as the analysis of bridge inspection materials,the principle of ultrasonic non-destructive testing technology and its adaptability to bridge engineering are elaborated.Subsequently,starting from the preparation work before inspection until damage assessment,the entire process of ultrasonic non-destructive testing is studied,and finally,a technical system of ultrasonic non-destructive testing for bridge engineering that runs through the entire process is formed.It is hoped that this article can provide technical reference value for relevant units in China,and promote the high-quality development of China’s bridge engineering from a macro perspective.展开更多
Objective To test Calcium ion(Ca2+) flow at the head and end of outer hair cells(OHCs) in resting state and in response to Nimodipine treatment.Methods Non-invasive micro-test techniques were used to study Ca2+ in iso...Objective To test Calcium ion(Ca2+) flow at the head and end of outer hair cells(OHCs) in resting state and in response to Nimodipine treatment.Methods Non-invasive micro-test techniques were used to study Ca2+ in isolated OHCs in adult guinea pigs.Results Four types of Ca2+ transport were identified in OHCs on basilar membrane tissue fragments:influx at the head of with efflux at the bottom(type 1):efflux at the head of OHCs with influx at the bottom(type 2);influx at the both head and bottom(type 3);and efflux at the both head and bottom(type 4).However,only type 1 and type 3 of Ca2+ ion transport were detected in the cochlea.We propose that Ca2+ ion transport exists in adult guinea pig cochlear OHCs in resting state and is variable.Ca2 + flow in OHC can be inhibited by Nimodipine in resting state.展开更多
AIM:To evaluate the performance of commercially available immunochromatographic (ICT) and immunoblot tests covering the current infection marker CIM and conventional ELISA for the diagnosis of H pylori infection in ad...AIM:To evaluate the performance of commercially available immunochromatographic (ICT) and immunoblot tests covering the current infection marker CIM and conventional ELISA for the diagnosis of H pylori infection in adult dyspeptic patients. METHODS:Consecutive non-treated dyspeptic patients undergoing diagnostic endoscopy were tested for H pylori infection by culture, rapid urease test, and histology of gastric biopsy specimens. Serum from 61 H pylori infected and 21 non-infected patients were tested for anti-H pylori IgG antibodies by commercial ELISA (AccuBindTM ELISA, Monobind, USA), ICT (Assure H pylori Rapid Test, Genelabs Diagnostics, Singapore), and immunoblot (Helico Blot 2.1, Genelabs Diagnostics, Singapore) assays. ICT and immunoblot kits cover CIM among other parameters and their performance with and without CIM was evaluated separately. RESULTS:Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ELISA were 96.7%, 42.8%, 83.1%, 81.8%, and 82.9%, of ICT were 90.1%, 80.9%, 93.2%, 73.9%, and 87.8%, of ICT with CIM were 88.5%, 90.4%, 96.4%, 73.0%, and 89.0%, of immunoblot were 98.3%, 80.9%, 93.7%, 94.4%, and 93.9%, and of immunoblot with CIM were 98.3%, 90.4%, 96.7%, 95.0%, and 96.3%, respectively. CONCLUSION:Immunoblot with CIM had the best performance. ICT with CIM was found to be more specific and accurate than the conventional ELISA and may be useful for non-invasive diagnosis of H pylori infection.展开更多
AIM： To explore the possibility of using the Noninvasive Micro-test Technique （NMT） to investigate the role of Transient Receptor Potential Canonical 1 （TRPC1） in regulating Ca^2＋ influxes in HL-7702 cells, a no...AIM： To explore the possibility of using the Noninvasive Micro-test Technique （NMT） to investigate the role of Transient Receptor Potential Canonical 1 （TRPC1） in regulating Ca^2＋ influxes in HL-7702 cells, a normal human liver cell line.METHODS： Net Ca^2＋ fluxes were measured with NMT, a technology that can obtain dynamic information of specific/selective ionic/molecular activities on material surfaces, non-invasively. The expression levels of TRPCl were increased by liposomal transfection, whose effectiveness was evaluated by Western-blotting and single cell reverse transcription-polymerase chain reaction.RESULTS： Ca^2＋ influxes could be elicited by adding 1 mmol/L CaCl2 to the test solution of HL-7702 cells. They were enhanced by addition of 20 μmol/L noradrenalin and inhibited by 100 μmol/L LaCl3 （a non-selective Ca^2＋ channel blocker）; 5 μmol/L nifedipine did not induce any change. Overexpression of TRPCl caused increased Ca^2＋ influx. Five micromoles per liter nifedipine did not inhibit this elevation, whereas 100 μmol/L LaCI3 did.CONCLUSION： In HL-7702 cells, there is a type of TRPCl-dependent Ca^2＋ channel, which could be detected v/a NMT and inhibited by La^3＋.展开更多
With the depletion of fossil fuels and increasing environmental concerns,the development of renewable energy,such as wave energy,has become a critical component of global energy strategies.However,challenges persist i...With the depletion of fossil fuels and increasing environmental concerns,the development of renewable energy,such as wave energy,has become a critical component of global energy strategies.However,challenges persist in the field testing methodologies for wave energy converters(WECs).In this paper,a numerical wave field of the Dawanshan Island Sea Area in Zhuhai City is constructed based on the MIKE21 SW wave model and by using an NCEP wind field driving model.In conjunction with the IEC-62600-100 standard,by taking site testing of the“Wanshan”wave energy converter on which a sea trial has been conducted in Dawanshan Island of Zhuhai city as an example,research on-site testing method for a wave energy converter has been carried out.The wave measurement position for the“Wanshan”converter was determined by combining statistically analyzed field data with a validated numerical wave model.By comparing a valid wave height at the position where a wave rider is located with a valid wave height at the position where the“Wanshan”wave energy converter is situated,the correlation coefficient between simulation and observed data reached 0.90,with a root-mean-square error of 0.19.The representativeness of wave measurement data during site testing is verified and can be used as a basis for calculating the input energy of the“Wanshan”wave energy converter.展开更多
AIM: To evaluate the impact of a preoperative "triple non-invasive diagnostic test" for diagnosis and/or exclusion of common bile duct stones. METHODS: All patients with symptomatic gallstone disease, operat...AIM: To evaluate the impact of a preoperative "triple non-invasive diagnostic test" for diagnosis and/or exclusion of common bile duct stones. METHODS: All patients with symptomatic gallstone disease, operated on by laparoscopic cholecystectomy from March 2004 to March 2006 were studied retrospectively. Two hundred patients were included and reviewed by using a triple diagnostic test including: patient's medical history, routine liver function tests and routine ultrasonography. All patients were followed up 2-24 mo after surgery to evaluate the impact of triple diagnostic test. RESULTS: Twenty-five patients were identified to have common bile duct stones. Lack of history of stones, negative laboratory tests and normal ultrasonography alone was proven to exclude common bile duct stones in some patients. However, a combination of these three components (triple diagnostic), was proven to be the most statistically significant test to exclude common bile duct stones in patients with gallstone disease. CONCLUSION: Using a combination of routinely used diagnostic components as triple diagnostic modality would increase the diagnostic accuracy of common bile duct stones preoperatively. This triple non-invasive test is recommended for excluding common bile duct stones and to identify patients in need for other investigations.展开更多
Subgrade engineering is a fundamental aspect of infrastructure construction in China.As the primary structural element responsible for bearing and distributing traffic loads,the subgrade must not only withstand the su...Subgrade engineering is a fundamental aspect of infrastructure construction in China.As the primary structural element responsible for bearing and distributing traffic loads,the subgrade must not only withstand the substantial pressures exerted by vehicles,trains,and other forms of transportation,but also efficiently transfer these loads to the underlying foundation,ensuring the stability and longevity of the roadway.In recent years,advancements in subgrade engineering technology have propelled the industry towards smarter,greener,and more sustainable practices,particularly in the areas of intelligent monitoring,disaster management,and innovative construction methods.This paper reviews the application and methodologies of intelligent testing equipment,including cone penetration testing(CPT)devices,soil resistivity testers,and intelligent rebound testers,in subgrade engineering.It examines the operating principles,advantages,limitations,and application ranges of these tools in subgrade testing.Additionally,the paper evaluates the practical use of advanced equipment from both domestic and international perspectives,addressing the challenges encountered by various instruments in realworld applications.These devices enable precise,comprehensive testing and evaluation of subgrade conditions at different stages,providing real-time data analysis and intelligent early warnings.This supports effective subgrade health management and maintenance.As intelligent technologies continue to evolve and integrate,these tools will increasingly enhance the accuracy,efficiency,and sustainability of subgrade monitoring.展开更多
AIM To assess the diagnostic accuracy of a new fecal test for detecting Helicobacter pylori(H.pylori),using^(13)Curea breath test as the reference standard,and explore bacterial antibiotic resistance.METHODS We conduc...AIM To assess the diagnostic accuracy of a new fecal test for detecting Helicobacter pylori(H.pylori),using^(13)Curea breath test as the reference standard,and explore bacterial antibiotic resistance.METHODS We conducted a prospective two-center diagnostic test accuracy study.We enrolled consecutive people≥18 years without previous diagnosis of H.pylori infection,referred for dyspepsia between February and October 2017.At enrollment,all participants underwent 13 C-urea breath test.Participants aged over 50 years were scheduled to undergo upper endoscopy with histology.Participants collected stool samples 1-3 d after enrollment for a new fecal investigation(THD fecal test).The detection of bacterial 23 S rRNA subunit gene indicated H.pylori infection.We also used the index diagnostic test to examine mutations conferring resistance to clarithromycin and levofloxacin.Independent investigators analyzed index test and reference test standard results blinded to the other test findings.We estimated sensitivity,specificity,positive(PPV)and negative(NPV)predictive value,diagnostic accuracy,positive and negative likelihood ratio(LR),together with 95%confidence intervals(CI).RESULTS We enrolled 294 consecutive participants(age:Median 37.0 years,IQR:29.0-46.0 years;men:39.8%).Ninetyfive(32.3%)participants had a positive^(13)C-urea breath test.Twenty-three(7.8%)participants underwent upper endoscopy with histology,with a full concordance between^(13)C-urea breath test and histology in detecting H.pylori infection.Four(1.4%)out of the 294 participants withdrew from the study after the enrollment visit and did not undergo THD fecal testing.In the 290 participants who completed the study,the THD fecal test sensitivity was 90.2%(CI:84.2%-96.3%),specificity 98.5%(CI:96.8%-100%),PPV 96.5%(CI:92.6%-100%),NPV 95.6%(CI:92.8%-98.4%),accuracy 95.9%(CI:93.6%-98.2%),positive LR 59.5(CI:19.3-183.4),negative LR 0.10(CI:0.05-0.18).Out of 83 infected participants identified with the THD fecal test,34(41.0%)had bacterial genotypic changes consistent with antibiotic-resistant H.pylori infection.Of these,27(32.5%)had bacterial strains resistant to clarithromycin,3(3.6%)to levofloxacin,and 4(4.8%)to both antibiotics.CONCLUSION The THD fecal test has high performance for the non-invasive diagnosis of H.pylori infection while additionally enabling the assessment of bacterial antibiotic resistances.展开更多
BACKGROUND Liver fibrosis leads to liver-related events in patients with chronic hepatitis C(CHC)infection.Although non-invasive tests(NITs)are critical to early detection of the development of liver fibrosis,the prog...BACKGROUND Liver fibrosis leads to liver-related events in patients with chronic hepatitis C(CHC)infection.Although non-invasive tests(NITs)are critical to early detection of the development of liver fibrosis,the prognostic role of NITs remains unclear due to the limited types of NITs and liver outcomes explored in previous studies.AIM To determine the prognostic value of NITs for risk stratification in CHC patients.METHODS The protocol was registered in PROSPERO(International Prospective Register of Systematic Reviews;no.CRD42019128176).The systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Search was performed using MEDLINE and EMBASE databases under a timeframe from the inception of the databases through February 25,2020.We restricted our search to CHC cohort studies reporting an association between liver fibrosis assessed by NITs and the development of hepatocellular carcinoma,decompensation,or mortality.Pooled hazard ratios(HR)and area under the receiver operating characteristic(AUROC)for each NIT were estimated using a random effects model.Subgroup analyses were performed for NITs assessed at pre-treatment or post-treatment with sustained virologic response(SVR),treatment with either pegylated interferon and ribavirin or direct acting antiviral,Eastern or Western countries,and different cutoff points.RESULTS The present meta-analysis included 29 cohort studies,enrolling 69339 CHC patients.Fibrosis-4(FIB-4)index,aspartate aminotransferase to platelet ratio(APRI)score,and liver stiffness measurement(LSM)were found to have hepatocellular carcinoma predictive potential with pooled adjusted HRs of 2.48[95%confidence interval(CI):1.91-3.23,I2=96%],4.24(95%CI:2.15-8.38,I2=20%)and 7.90(95%CI:3.98-15.68,I2=52%)and AUROCs of 0.81(95%CI:0.73-0.89,I2=77%),0.81(95%CI:0.75-0.87,I2=68%),and 0.79(95%CI:0.63-0.96,I2=90%),respectively.Pooled adjusted HR with a pre-treatment FIB-4 cutoff of 3.25 was 3.22(95%CI:2.32-4.47,I2=80%).Pooled adjusted HRs for post-treatment with SVR FIB-4,APRI,and LSM were 3.01(95%CI:0.32-28.61,I2=89%),9.88(95%CI:2.21-44.17,I2=24%),and 6.33(95%CI:2.57-15.59,I2=17%),respectively.Pooled adjusted HRs for LSM in patients with SVR following direct acting antiviral therapy was 5.55(95%CI:1.47-21.02,I2=36%).Pooled AUROCs for post-treatment with SVR FIB-4 and LSM were 0.75(95%CI:0.55-0.95,I2=88%)and 0.84(95%CI:0.66-1.03,I2=88%),respectively.Additionally,FIB-4 and LSM were associated with overall mortality,with pooled adjusted HRs of 2.07(95%CI:1.49-2.88,I2=27%)and 4.04(95%CI:2.40-6.80,I2=63%),respectively.CONCLUSION FIB-4,APRI,and LSM showed potential for risk stratification in CHC patients.Cutoff levels need further validation.展开更多
Point-of-care testing(POCT)refers to a category of diagnostic tests that are performed at or near to the site of the patients(also called bedside testing)and is capable of obtaining accurate results in a short time by...Point-of-care testing(POCT)refers to a category of diagnostic tests that are performed at or near to the site of the patients(also called bedside testing)and is capable of obtaining accurate results in a short time by using portable diagnostic devices,avoiding sending samples to the medical laboratories.It has been extensively explored for diagnosing and monitoring patients’diseases and health conditions with the assistance of development in biochemistry and microfluidics.Microfluidic paper-based analytical devices(μPADs)have gained dramatic popularity in POCT because of their simplicity,user-friendly,fast and accurate result reading and low cost.SeveralμPADs have been successfully commercialized and received excellent feedback during the past several decades.This review briefly discusses the main types ofμPADs,preparation methods and their detection principles,followed by a few representative examples.The future perspectives of the development inμPADs are also provided.展开更多
BACKGROUND Despite the developments in the field of kidney transplantation,the already existing diagnostic techniques for patient monitoring are considered insufficient.Protein biomarkers that can be derived from mode...BACKGROUND Despite the developments in the field of kidney transplantation,the already existing diagnostic techniques for patient monitoring are considered insufficient.Protein biomarkers that can be derived from modern approaches of proteomic analysis of liquid biopsies(serum,urine)represent a promising innovation in the monitoring of kidney transplant recipients.AIM To investigate the diagnostic utility of protein biomarkers derived from proteomics approaches in renal allograft assessment.METHODS A systematic review was conducted in accordance with PRISMA guidelines,based on research results from the PubMed and Scopus databases.The primary focus was on evaluating the role of biomarkers in the non-invasive diagnosis of transplant-related com-plications.Eligibility criteria included protein biomarkers and urine and blood samples,while exclusion criteria were language other than English and the use of low resolution and sensitivity methods.The selected research articles,were categorized based on the biological sample,condition and methodology and the significantly and reproducibly differentiated proteins were manually selected and extracted.Functional and network analysis of the selected proteins was performed.RESULTS In 17 included studies,58 proteins were studied,with the cytokine CXCL10 being the most investigated.Biological pathways related to immune response and fibrosis have shown to be enriched.Applications of biomarkers for the assessment of renal damage as well as the prediction of short-term and long-term function of the graft were reported.Overall,all studies have shown satisfactory diagnostic accuracy of proteins alone or in combination with conventional methods,as far as renal graft assessment is concerned.CONCLUSION Our review suggests that protein biomarkers,evaluated in specific biological fluids,can make a significant contribution to the timely,valid and non-invasive assessment of kidney graft.展开更多
BACKGROUND Stable angina pectoris,a clinical manifestation of coronary artery disease(CAD),is commonly evaluated using non-invasive diagnostic tools.Traditionally,stress testing modalities such as exercise electrocard...BACKGROUND Stable angina pectoris,a clinical manifestation of coronary artery disease(CAD),is commonly evaluated using non-invasive diagnostic tools.Traditionally,stress testing modalities such as exercise electrocardiography(ECG),myocardial per-fusion imaging(MPI),and stress echocardiography have been the first-line stra-tegies.However,coronary computed tomography angiography(CCTA),an anatomic imaging modality,is increasingly used for its ability to directly visualize coronary artery stenoses and plaque burden.Despite growing adoption,the comparative effectiveness of CCTA and stress testing in terms of diagnostic accuracy,prognostic value,and clinical outcomes in stable angina remains an area of active debate.AIM To compare the diagnostic and prognostic performance of CCTA with various forms of stress testing in adult patients presenting with suspected or confirmed stable angina.METHODS A comprehensive literature search was performed across PubMed,EMBASE,Scopus,and the Cochrane Central Register of Controlled Trials in accordance with the PRISMA guidelines.Only randomized controlled trials(RCT)published in English within the last 15 years were included.Studies involving adult patients(≥18 years)with stable angina or low-risk chest pain were selected.The intervention was CCTA,and the comparators included ECG,MPI,and stress echocardiography.Data were extracted using a standardized process,and study quality was assessed using the Cochrane Risk of Bias 2.0 tool.Due to heterogeneity in outcome measures and modalities,narrative synthesis was employed.RESULTS Five high-quality RCTs encompassing a total of 5551 patients were included.CCTA demonstrated superior diagnostic accuracy and prognostic capability across multiple studies.It was more effective in predicting major adverse cardiac events,including myocardial infarction and cardiac death,and was associated with fewer un-necessary invasive coronary angiographies and better event-free survival.Studies also reported improved revascu-larization rates in patients evaluated with CCTA,particularly within tiered diagnostic protocols.Stress testing,while useful,showed limitations in sensitivity and downstream clinical decision-making.CONCLUSION CCTA offers a diagnostically superior and clinically impactful strategy for the initial evaluation of patients with stable angina,especially those with intermediate pretest probability of CAD.Compared to conventional stress testing,it enhances risk stratification,reduces unnecessary procedures,and may improve long-term outcomes.These findings support its broader integration into diagnostic pathways for stable angina.展开更多
Gastric cancer(GC),a multifaceted and highly aggressive malignancy,represents challenging healthcare burdens globally,with a high incidence and mortality rate.Although endoscopy,combined with histological examination,...Gastric cancer(GC),a multifaceted and highly aggressive malignancy,represents challenging healthcare burdens globally,with a high incidence and mortality rate.Although endoscopy,combined with histological examination,is the gold stan-dard for GC diagnosis,its high cost,invasiveness,and specialized requirements hinder widespread use for screening.With the emergence of innovative techno-logies such as advanced imaging,liquid biopsy,and breath tests,the landscape of GC diagnosis is poised for radical transformation,becoming more accessible,less invasive,and more efficient.As the non-invasive diagnostic techniques continue to advance and undergo rigorous clinical validation,they hold the promise of sig-nificantly impacting patient outcomes,ultimately leading to better treatment results and improved quality of life for patients with GC.展开更多
基金Supported by the 345 Talent Project of Shengjing Hospital,No.M0298.
文摘BACKGROUND Confined placental mosaicism(CPM)is one of the major reasons for discrepancies between the results of non-invasive prenatal testing(NIPT)and fetal karyotype analysis.CASE SUMMARY We encountered a primiparous singleton pregnant woman with a rare CPM consisting of 47,XY,+21;47,XXY;and 46,XY,who obtained a false-positive result on NIPT with a high risk for trisomy 21.Copy-number variation sequencing on amniotic fluid cells,fetal tissue,and placental biopsies showed that the fetal karyotype was 47,XXY,while the placenta was a rare mosaic of 47,XY,+21;47,XXY;and 46,XY.CONCLUSION The patient had a rare CPM consisting of 47,XY,+21;47,XXY;and 46,XY,which caused a discrepancy between the result of NIPT and the actual fetal karyotype.It is important to remember that NIPT is a screening test,not a diagnostic test.Any positive result should be confirmed with invasive testing,and routine ultrasound examination is still necessary after a negative result.
文摘Over the past few years, many researchers have attempted to develop non-invasive prenatal testing methods in order to investigate the genetic status of the fetus. The aim is to avoid invasive procedures such as chorionic villus and amniotic fluid sampling, which result in a significant risk for pregnancy loss. The discovery of cell free fetal DNA circulating in the maternal blood has great potential for the development of non-invasive prenatal testing(NIPT) methodologies. Such strategies have been successfully applied for the determination of the fetal rhesus status and inherited monogenic disease but the field of fetal aneuploidy investigation seems to be more challenging. The main reason for this is that the maternal cell free DNA in the mother's plasma is far more abundant, and because it is identical to half of the corresponding fetal DNA. Approaches developed are mainly based on next generation sequencing(NGS) technologies and epigenetic genetic modifications, such as fetal-maternal DNA differential methylation. At present, genetic services for non-invasive fetal aneuploidy detection are offered using NGS-based approaches but, for reasons that are presented herein, they still serve as screening tests which are not readily accessed by the majority of couples. Here we discuss the limitations of both strategies for NIPT and the future potential of the methods developed.
基金Dongguan City Social Development Project(Project number:20161081101023)。
文摘Objective:To analyze the clinical value of non-invasive prenatal testing(NIPT)in detecting chromosomal copy number variations(CNVs)and to explore the relationship between gene expression and clinical manifestations of chromosomal copy number variations.Methods:3551 naturally conceived singleton pregnant women who underwent NIPT were included in this study.The NIPT revealed abnormalities other than sex chromosome abnormalities and trisomy 13,18,and 21.Pregnant women with chromosome copy number variations underwent genetic counseling and prenatal ultrasound examination.Interventional prenatal diagnosis and chromosome microarray analysis(CMA)were performed.The clinical phenotypes and pregnancy outcomes of different prenatal diagnoses were analyzed.Additionally,a follow-up was conducted by telephone to track fetal development after birth,at six months,and one year post-birth.Results:A total of 53 cases among 3551 cases showed chromosomal copy number variation.Interventional prenatal diagnosis was performed in 36 cases:27 cases were negative and 8 were consistent with the NIPT test results.This indicates that NIPT’s positive predictive value(PPV)in CNVs is 22.22%.Conclusion:NIPT has certain clinical significance in screening chromosome copy number variations and is expected to become a routine screening for chromosomal microdeletions and microduplications.However,further interventional prenatal diagnosis is still needed to identify fetal CNVs.
文摘Hepatocellular carcinoma(HCC)is one of the most common malignancies in the world and it is one of the main complications of cirrhosis and portal hypertension.Even in the presence of a well-established follow-up protocol for cirrhotic patients,to date poor data are available on predictive markers for primary HCC occurrence in the setting of compensated advanced chronic liver disease patients(cACLD).The gold standard method to evaluate the prognosis of patients with cACLD,beyond liver fibrosis assessed with histology,is the measurement of the hepatic venous pressure gradient(HVPG).An HVPG≥10 mmHg has been related to an increased risk of HCC in cACLD patients.However,these methods are burdened by additional costs and risks for patients and are mostly available only in referral centers.In the last decade increasing research has focused on the evaluation of several,simple,non-invasive tests(NITs)as predictors of HCC development.We reviewed the currently available literature on biochemical and ultrasound-based scores developed for the noninvasive evaluation of liver fibrosis and portal hypertension in predicting primary HCC.We found that the most reliable methods to assess HCC risk were the liver stiffness measurement,the aspartate aminotransferase to platelet ratio index score and the fibrosis-4 index.Other promising NITs need further investigations and validation for different liver disease aetiologies.
基金Supported by the Liaoning Provincial Science and Technology Key Project for Translational Medicine,No.2014225020Outstanding Scientific Fund of Shengjing Hospital,No.201102+1 种基金Liaoning Provincial Science and Technology Key Project for Translational Medicine,No.2016509National Science and Technology Major Project,Nos.2017ZX10201201,2017ZX10202202,2017ZX10202203
文摘AIM To explore the effect of alanine aminotransferase(ALT) on the performance of non-invasive fibrosis tests in chronic hepatitis B(CHB) patients. METHODS A total of 599 treatment-naive and biopsy-proven CHB patients were included in the study. The cohort was divided into the following three groups: Normal ALT(ALT ≤ 40), slightly elevated ALT(40 < ALT ≤ 80) and elevated ALT(ALT > 80). The diagnostic performance of five common non-invasive fibrosis tests for liver fibrosis(stages S2-4), including the aspartate aminotransferase(AST)-to-platelet(PLT) ratio index(APRI), fibrosis index based on 4 factors(FIB-4), King's score, Forns index and gamma-glutamyl transpeptidase(GGT)-to-PLT ratio(GPR), were evaluated for each group. RESULTS Higher ALT levels were associated with higher non-invasive fibrosis test scores. Patients with the same fibrosis stage but higher ALT levels showed higher noninvasive test scores. The areas under the receiver operating characteristics curves(AUROCs) of the noninvasive tests for prediction of ≥ S2 were higher for patients with ALT ≤ 40 U/L(range 0.705-0.755) and 40 < ALT ≤ 80 U/L(range 0.726-0.79) than for patients with ALT > 80 U/L(range 0.604-0.701). The AUROCs for predicting ≥ S3 and S4 were higher in patients with ALT ≤ 40 U/L(range 0.736-0.814 for ≥ S3, 0.79-0.833 for S4) than in patients with 40 < ALT ≤ 80 U/L(range 0.732-0.754 for ≥ S3, range 0.626-0.723 for S4) and ALT > 80 U/L(range 0.7-0.784 for ≥ S3, range 0.662-0.719 for S4). The diagnostic accuracy of the non-invasive tests decreased in a stepwise manner with the increase in ALT.CONCLUSION ALT has a significant effect on the diagnostic performance of non-invasive fibrosis tests. The ALT level should be considered before performing these noninvasive tests.
文摘In this article,we comment on the article by Peta et al.This study evaluates the diagnostic performance of FibroTest-Actitest,transient elastography,and the fibrosis-4 index against a histological reference.Using the Obuchowski measure,the authors demonstrate that FibroTest and vibration-controlled transient elastography outperform the fibrosis-4 index in detecting fibrosis.Additionally,Actitest offers superior estimation of inflammatory activity compared to conventional biomarkers.Assessing liver fibrosis is crucial for managing autoimmune hepatitis(AIH),yet reliance on invasive liver biopsy remains higher than in other liver diseases.This is partly due to more complex diagnostic criteria for AIH,the lack of standardized scoring for non-invasive testing,and the presence of inflammation,which can lead to falsely elevated results with non-invasive tests.A Bayesian latent class model further supports the reliability of these non-invasive tests,highlighting their potential to complement biopsy,particularly for longterm disease monitoring.These findings underscore the importance of noninvasive diagnostics in optimizing AIH management.
文摘AIM:To develop an integrated approach for monitoring gastrointestinal motility and inflammation state suitable for application in long-term spaceflights.METHODS:Breath tests based on the oral administration of 13 C-labeled or hydrogen-producing substrates followed by the detection of their metabolites(13 CO 2 or H 2) in breath were used to measure gastrointestinal motility parameters during the 520-d spaceflight ground simulation within the MARS-500 Project.In particular,the gastric emptying rates of solid and liquid contents were evaluated by 13 C-octanoic acid and 13 Cacetate breath tests,respectively,whereas the orocecal transit time was assessed by an inulin H 2-breath test,which was performed simultaneously with the 13 C-octanoic acid breath test.A ready-to-eat,standardized pre-packaged muffin containing 100 mg of 13 C-octanoic acid was used in the 13 C-octanoic acid breath test to avoid the extemporaneous preparation of solid meals.In addition,a cassette-type lateral flow immunoassay was employed to detect fecal calprotectin,a biomarker of intestinal inflammation.Because no items could be introduced into the simulator during the experiment,all materials and instrumentation required for test performance during the entire mission simulation had to be provided at the beginning of the experiment.RESULTS:The experiments planned during the simulation of a manned flight to Mars could be successfully performed by the crewmembers without any external assistance.No evident alterations(i.e.,increasing or decreasing trends) in the gastric emptying rates were detected using the 13 C-breath tests during the mission simulation,as the gastric emptying half-times were in the range of those reported for healthy subjects.In contrast to the 13 C-breath tests,the results of the inulin H 2-breath test were difficult to interpret because of the high variability of the H 2 concentration in the breath samples,even within the same subject.This variability suggested that the H 2-breath test was strongly affected by external factors,which may have been related to the diet of the crewmembers or to environmental conditions(e.g.,the accumulation of hydrogen in the simulator microenvironment).At least in closed microenvironments such as the MARS-500 simulator,13 C-breath tests should therefore be preferred to H 2-breath tests.Finally,the fecal calprotectin test showed significant alterations during the mission simulation:all of the crewmembers were negative for the test at the beginning of the simulation but showed various degrees of positivity in at least one of the subsequent tests,thus indicating the onset of an intestinal inflammation.CONCLUSION:Breath tests,especially those 13 Cbased,proved suitable for monitoring gastrointestinal motility in the 520-d isolation experiment withinMARS-500 project and can be applied in long-term spaceflights.
文摘The purpose of this study is to analyze the application of ultrasonic non-destructive testing technology in bridge engineering.During the research phase,based on literature collection and reading,as well as the analysis of bridge inspection materials,the principle of ultrasonic non-destructive testing technology and its adaptability to bridge engineering are elaborated.Subsequently,starting from the preparation work before inspection until damage assessment,the entire process of ultrasonic non-destructive testing is studied,and finally,a technical system of ultrasonic non-destructive testing for bridge engineering that runs through the entire process is formed.It is hoped that this article can provide technical reference value for relevant units in China,and promote the high-quality development of China’s bridge engineering from a macro perspective.
文摘Objective To test Calcium ion(Ca2+) flow at the head and end of outer hair cells(OHCs) in resting state and in response to Nimodipine treatment.Methods Non-invasive micro-test techniques were used to study Ca2+ in isolated OHCs in adult guinea pigs.Results Four types of Ca2+ transport were identified in OHCs on basilar membrane tissue fragments:influx at the head of with efflux at the bottom(type 1):efflux at the head of OHCs with influx at the bottom(type 2);influx at the both head and bottom(type 3);and efflux at the both head and bottom(type 4).However,only type 1 and type 3 of Ca2+ ion transport were detected in the cochlea.We propose that Ca2+ ion transport exists in adult guinea pig cochlear OHCs in resting state and is variable.Ca2 + flow in OHC can be inhibited by Nimodipine in resting state.
文摘AIM:To evaluate the performance of commercially available immunochromatographic (ICT) and immunoblot tests covering the current infection marker CIM and conventional ELISA for the diagnosis of H pylori infection in adult dyspeptic patients. METHODS:Consecutive non-treated dyspeptic patients undergoing diagnostic endoscopy were tested for H pylori infection by culture, rapid urease test, and histology of gastric biopsy specimens. Serum from 61 H pylori infected and 21 non-infected patients were tested for anti-H pylori IgG antibodies by commercial ELISA (AccuBindTM ELISA, Monobind, USA), ICT (Assure H pylori Rapid Test, Genelabs Diagnostics, Singapore), and immunoblot (Helico Blot 2.1, Genelabs Diagnostics, Singapore) assays. ICT and immunoblot kits cover CIM among other parameters and their performance with and without CIM was evaluated separately. RESULTS:Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ELISA were 96.7%, 42.8%, 83.1%, 81.8%, and 82.9%, of ICT were 90.1%, 80.9%, 93.2%, 73.9%, and 87.8%, of ICT with CIM were 88.5%, 90.4%, 96.4%, 73.0%, and 89.0%, of immunoblot were 98.3%, 80.9%, 93.7%, 94.4%, and 93.9%, and of immunoblot with CIM were 98.3%, 90.4%, 96.7%, 95.0%, and 96.3%, respectively. CONCLUSION:Immunoblot with CIM had the best performance. ICT with CIM was found to be more specific and accurate than the conventional ELISA and may be useful for non-invasive diagnosis of H pylori infection.
基金Supported by The National Natural Science Foundation of China,No.30270532 and No.30670774Tsinghua-Yue-Yuen Medical Science Foundation,No.20240000531 and No.20240000547
文摘AIM： To explore the possibility of using the Noninvasive Micro-test Technique （NMT） to investigate the role of Transient Receptor Potential Canonical 1 （TRPC1） in regulating Ca^2＋ influxes in HL-7702 cells, a normal human liver cell line.METHODS： Net Ca^2＋ fluxes were measured with NMT, a technology that can obtain dynamic information of specific/selective ionic/molecular activities on material surfaces, non-invasively. The expression levels of TRPCl were increased by liposomal transfection, whose effectiveness was evaluated by Western-blotting and single cell reverse transcription-polymerase chain reaction.RESULTS： Ca^2＋ influxes could be elicited by adding 1 mmol/L CaCl2 to the test solution of HL-7702 cells. They were enhanced by addition of 20 μmol/L noradrenalin and inhibited by 100 μmol/L LaCl3 （a non-selective Ca^2＋ channel blocker）; 5 μmol/L nifedipine did not induce any change. Overexpression of TRPCl caused increased Ca^2＋ influx. Five micromoles per liter nifedipine did not inhibit this elevation, whereas 100 μmol/L LaCI3 did.CONCLUSION： In HL-7702 cells, there is a type of TRPCl-dependent Ca^2＋ channel, which could be detected v/a NMT and inhibited by La^3＋.
基金supported by the“National Ocean Technology Center Innovation Fund”under Project No.N3220Z002,led by Ning Jia.The official website of the National Ocean Technology Center is accessible at:http://www.notcsoa.org.cn/.
文摘With the depletion of fossil fuels and increasing environmental concerns,the development of renewable energy,such as wave energy,has become a critical component of global energy strategies.However,challenges persist in the field testing methodologies for wave energy converters(WECs).In this paper,a numerical wave field of the Dawanshan Island Sea Area in Zhuhai City is constructed based on the MIKE21 SW wave model and by using an NCEP wind field driving model.In conjunction with the IEC-62600-100 standard,by taking site testing of the“Wanshan”wave energy converter on which a sea trial has been conducted in Dawanshan Island of Zhuhai city as an example,research on-site testing method for a wave energy converter has been carried out.The wave measurement position for the“Wanshan”converter was determined by combining statistically analyzed field data with a validated numerical wave model.By comparing a valid wave height at the position where a wave rider is located with a valid wave height at the position where the“Wanshan”wave energy converter is situated,the correlation coefficient between simulation and observed data reached 0.90,with a root-mean-square error of 0.19.The representativeness of wave measurement data during site testing is verified and can be used as a basis for calculating the input energy of the“Wanshan”wave energy converter.
文摘AIM: To evaluate the impact of a preoperative "triple non-invasive diagnostic test" for diagnosis and/or exclusion of common bile duct stones. METHODS: All patients with symptomatic gallstone disease, operated on by laparoscopic cholecystectomy from March 2004 to March 2006 were studied retrospectively. Two hundred patients were included and reviewed by using a triple diagnostic test including: patient's medical history, routine liver function tests and routine ultrasonography. All patients were followed up 2-24 mo after surgery to evaluate the impact of triple diagnostic test. RESULTS: Twenty-five patients were identified to have common bile duct stones. Lack of history of stones, negative laboratory tests and normal ultrasonography alone was proven to exclude common bile duct stones in some patients. However, a combination of these three components (triple diagnostic), was proven to be the most statistically significant test to exclude common bile duct stones in patients with gallstone disease. CONCLUSION: Using a combination of routinely used diagnostic components as triple diagnostic modality would increase the diagnostic accuracy of common bile duct stones preoperatively. This triple non-invasive test is recommended for excluding common bile duct stones and to identify patients in need for other investigations.
基金supported by the National Natural Science Foundation of China for Distinguished Young Scholars(Grant No.42225206)National Natural Science Foundation of China(42207180,42477209,42302320).
文摘Subgrade engineering is a fundamental aspect of infrastructure construction in China.As the primary structural element responsible for bearing and distributing traffic loads,the subgrade must not only withstand the substantial pressures exerted by vehicles,trains,and other forms of transportation,but also efficiently transfer these loads to the underlying foundation,ensuring the stability and longevity of the roadway.In recent years,advancements in subgrade engineering technology have propelled the industry towards smarter,greener,and more sustainable practices,particularly in the areas of intelligent monitoring,disaster management,and innovative construction methods.This paper reviews the application and methodologies of intelligent testing equipment,including cone penetration testing(CPT)devices,soil resistivity testers,and intelligent rebound testers,in subgrade engineering.It examines the operating principles,advantages,limitations,and application ranges of these tools in subgrade testing.Additionally,the paper evaluates the practical use of advanced equipment from both domestic and international perspectives,addressing the challenges encountered by various instruments in realworld applications.These devices enable precise,comprehensive testing and evaluation of subgrade conditions at different stages,providing real-time data analysis and intelligent early warnings.This supports effective subgrade health management and maintenance.As intelligent technologies continue to evolve and integrate,these tools will increasingly enhance the accuracy,efficiency,and sustainability of subgrade monitoring.
文摘AIM To assess the diagnostic accuracy of a new fecal test for detecting Helicobacter pylori(H.pylori),using^(13)Curea breath test as the reference standard,and explore bacterial antibiotic resistance.METHODS We conducted a prospective two-center diagnostic test accuracy study.We enrolled consecutive people≥18 years without previous diagnosis of H.pylori infection,referred for dyspepsia between February and October 2017.At enrollment,all participants underwent 13 C-urea breath test.Participants aged over 50 years were scheduled to undergo upper endoscopy with histology.Participants collected stool samples 1-3 d after enrollment for a new fecal investigation(THD fecal test).The detection of bacterial 23 S rRNA subunit gene indicated H.pylori infection.We also used the index diagnostic test to examine mutations conferring resistance to clarithromycin and levofloxacin.Independent investigators analyzed index test and reference test standard results blinded to the other test findings.We estimated sensitivity,specificity,positive(PPV)and negative(NPV)predictive value,diagnostic accuracy,positive and negative likelihood ratio(LR),together with 95%confidence intervals(CI).RESULTS We enrolled 294 consecutive participants(age:Median 37.0 years,IQR:29.0-46.0 years;men:39.8%).Ninetyfive(32.3%)participants had a positive^(13)C-urea breath test.Twenty-three(7.8%)participants underwent upper endoscopy with histology,with a full concordance between^(13)C-urea breath test and histology in detecting H.pylori infection.Four(1.4%)out of the 294 participants withdrew from the study after the enrollment visit and did not undergo THD fecal testing.In the 290 participants who completed the study,the THD fecal test sensitivity was 90.2%(CI:84.2%-96.3%),specificity 98.5%(CI:96.8%-100%),PPV 96.5%(CI:92.6%-100%),NPV 95.6%(CI:92.8%-98.4%),accuracy 95.9%(CI:93.6%-98.2%),positive LR 59.5(CI:19.3-183.4),negative LR 0.10(CI:0.05-0.18).Out of 83 infected participants identified with the THD fecal test,34(41.0%)had bacterial genotypic changes consistent with antibiotic-resistant H.pylori infection.Of these,27(32.5%)had bacterial strains resistant to clarithromycin,3(3.6%)to levofloxacin,and 4(4.8%)to both antibiotics.CONCLUSION The THD fecal test has high performance for the non-invasive diagnosis of H.pylori infection while additionally enabling the assessment of bacterial antibiotic resistances.
基金Supported by Research Grant for New Scholar Ratchadaphiseksomphot Endowment Fund Chulalongkorn University,No.RGN_2559_055_10_30.
文摘BACKGROUND Liver fibrosis leads to liver-related events in patients with chronic hepatitis C(CHC)infection.Although non-invasive tests(NITs)are critical to early detection of the development of liver fibrosis,the prognostic role of NITs remains unclear due to the limited types of NITs and liver outcomes explored in previous studies.AIM To determine the prognostic value of NITs for risk stratification in CHC patients.METHODS The protocol was registered in PROSPERO(International Prospective Register of Systematic Reviews;no.CRD42019128176).The systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Search was performed using MEDLINE and EMBASE databases under a timeframe from the inception of the databases through February 25,2020.We restricted our search to CHC cohort studies reporting an association between liver fibrosis assessed by NITs and the development of hepatocellular carcinoma,decompensation,or mortality.Pooled hazard ratios(HR)and area under the receiver operating characteristic(AUROC)for each NIT were estimated using a random effects model.Subgroup analyses were performed for NITs assessed at pre-treatment or post-treatment with sustained virologic response(SVR),treatment with either pegylated interferon and ribavirin or direct acting antiviral,Eastern or Western countries,and different cutoff points.RESULTS The present meta-analysis included 29 cohort studies,enrolling 69339 CHC patients.Fibrosis-4(FIB-4)index,aspartate aminotransferase to platelet ratio(APRI)score,and liver stiffness measurement(LSM)were found to have hepatocellular carcinoma predictive potential with pooled adjusted HRs of 2.48[95%confidence interval(CI):1.91-3.23,I2=96%],4.24(95%CI:2.15-8.38,I2=20%)and 7.90(95%CI:3.98-15.68,I2=52%)and AUROCs of 0.81(95%CI:0.73-0.89,I2=77%),0.81(95%CI:0.75-0.87,I2=68%),and 0.79(95%CI:0.63-0.96,I2=90%),respectively.Pooled adjusted HR with a pre-treatment FIB-4 cutoff of 3.25 was 3.22(95%CI:2.32-4.47,I2=80%).Pooled adjusted HRs for post-treatment with SVR FIB-4,APRI,and LSM were 3.01(95%CI:0.32-28.61,I2=89%),9.88(95%CI:2.21-44.17,I2=24%),and 6.33(95%CI:2.57-15.59,I2=17%),respectively.Pooled adjusted HRs for LSM in patients with SVR following direct acting antiviral therapy was 5.55(95%CI:1.47-21.02,I2=36%).Pooled AUROCs for post-treatment with SVR FIB-4 and LSM were 0.75(95%CI:0.55-0.95,I2=88%)and 0.84(95%CI:0.66-1.03,I2=88%),respectively.Additionally,FIB-4 and LSM were associated with overall mortality,with pooled adjusted HRs of 2.07(95%CI:1.49-2.88,I2=27%)and 4.04(95%CI:2.40-6.80,I2=63%),respectively.CONCLUSION FIB-4,APRI,and LSM showed potential for risk stratification in CHC patients.Cutoff levels need further validation.
文摘Point-of-care testing(POCT)refers to a category of diagnostic tests that are performed at or near to the site of the patients(also called bedside testing)and is capable of obtaining accurate results in a short time by using portable diagnostic devices,avoiding sending samples to the medical laboratories.It has been extensively explored for diagnosing and monitoring patients’diseases and health conditions with the assistance of development in biochemistry and microfluidics.Microfluidic paper-based analytical devices(μPADs)have gained dramatic popularity in POCT because of their simplicity,user-friendly,fast and accurate result reading and low cost.SeveralμPADs have been successfully commercialized and received excellent feedback during the past several decades.This review briefly discusses the main types ofμPADs,preparation methods and their detection principles,followed by a few representative examples.The future perspectives of the development inμPADs are also provided.
文摘BACKGROUND Despite the developments in the field of kidney transplantation,the already existing diagnostic techniques for patient monitoring are considered insufficient.Protein biomarkers that can be derived from modern approaches of proteomic analysis of liquid biopsies(serum,urine)represent a promising innovation in the monitoring of kidney transplant recipients.AIM To investigate the diagnostic utility of protein biomarkers derived from proteomics approaches in renal allograft assessment.METHODS A systematic review was conducted in accordance with PRISMA guidelines,based on research results from the PubMed and Scopus databases.The primary focus was on evaluating the role of biomarkers in the non-invasive diagnosis of transplant-related com-plications.Eligibility criteria included protein biomarkers and urine and blood samples,while exclusion criteria were language other than English and the use of low resolution and sensitivity methods.The selected research articles,were categorized based on the biological sample,condition and methodology and the significantly and reproducibly differentiated proteins were manually selected and extracted.Functional and network analysis of the selected proteins was performed.RESULTS In 17 included studies,58 proteins were studied,with the cytokine CXCL10 being the most investigated.Biological pathways related to immune response and fibrosis have shown to be enriched.Applications of biomarkers for the assessment of renal damage as well as the prediction of short-term and long-term function of the graft were reported.Overall,all studies have shown satisfactory diagnostic accuracy of proteins alone or in combination with conventional methods,as far as renal graft assessment is concerned.CONCLUSION Our review suggests that protein biomarkers,evaluated in specific biological fluids,can make a significant contribution to the timely,valid and non-invasive assessment of kidney graft.
文摘BACKGROUND Stable angina pectoris,a clinical manifestation of coronary artery disease(CAD),is commonly evaluated using non-invasive diagnostic tools.Traditionally,stress testing modalities such as exercise electrocardiography(ECG),myocardial per-fusion imaging(MPI),and stress echocardiography have been the first-line stra-tegies.However,coronary computed tomography angiography(CCTA),an anatomic imaging modality,is increasingly used for its ability to directly visualize coronary artery stenoses and plaque burden.Despite growing adoption,the comparative effectiveness of CCTA and stress testing in terms of diagnostic accuracy,prognostic value,and clinical outcomes in stable angina remains an area of active debate.AIM To compare the diagnostic and prognostic performance of CCTA with various forms of stress testing in adult patients presenting with suspected or confirmed stable angina.METHODS A comprehensive literature search was performed across PubMed,EMBASE,Scopus,and the Cochrane Central Register of Controlled Trials in accordance with the PRISMA guidelines.Only randomized controlled trials(RCT)published in English within the last 15 years were included.Studies involving adult patients(≥18 years)with stable angina or low-risk chest pain were selected.The intervention was CCTA,and the comparators included ECG,MPI,and stress echocardiography.Data were extracted using a standardized process,and study quality was assessed using the Cochrane Risk of Bias 2.0 tool.Due to heterogeneity in outcome measures and modalities,narrative synthesis was employed.RESULTS Five high-quality RCTs encompassing a total of 5551 patients were included.CCTA demonstrated superior diagnostic accuracy and prognostic capability across multiple studies.It was more effective in predicting major adverse cardiac events,including myocardial infarction and cardiac death,and was associated with fewer un-necessary invasive coronary angiographies and better event-free survival.Studies also reported improved revascu-larization rates in patients evaluated with CCTA,particularly within tiered diagnostic protocols.Stress testing,while useful,showed limitations in sensitivity and downstream clinical decision-making.CONCLUSION CCTA offers a diagnostically superior and clinically impactful strategy for the initial evaluation of patients with stable angina,especially those with intermediate pretest probability of CAD.Compared to conventional stress testing,it enhances risk stratification,reduces unnecessary procedures,and may improve long-term outcomes.These findings support its broader integration into diagnostic pathways for stable angina.
基金Supported by National Natural Science Foundation of China,No.82300451Research Foundation of Wuhan Union Hospital,No.2022xhyn050.
文摘Gastric cancer(GC),a multifaceted and highly aggressive malignancy,represents challenging healthcare burdens globally,with a high incidence and mortality rate.Although endoscopy,combined with histological examination,is the gold stan-dard for GC diagnosis,its high cost,invasiveness,and specialized requirements hinder widespread use for screening.With the emergence of innovative techno-logies such as advanced imaging,liquid biopsy,and breath tests,the landscape of GC diagnosis is poised for radical transformation,becoming more accessible,less invasive,and more efficient.As the non-invasive diagnostic techniques continue to advance and undergo rigorous clinical validation,they hold the promise of sig-nificantly impacting patient outcomes,ultimately leading to better treatment results and improved quality of life for patients with GC.
