Clinical significance of circulating microRNAs as diagnostic biomarkers for coronary artery disease

Coronary artery disease (CAD) is one of the biggest threats to human life. Circulating microRNAs (miRNAs) have been reported to be linked to the pathogenesis of CAD, indicating the possible role in CAD diagnosis. The present study aimed to explore the expression profile of plasma miRNAs and estimate their value in diagnosis for CAD. 67 Non‐CAD control subjects and 88 CAD patients were enrolled. We conducted careful evaluation by RT‐PCR analysis, Spearman rank correlation coefficients analysis, Receiver Operating Characteristic (ROC) curves analysis and so on. The plasma levels of six miRNAs known to be related to CAD were measured and three of them showed obvious expression change. Circulating miR‐29a‐3p, miR‐574‐3p and miR‐574‐5p were all significantly increased. ROC analysis revealed the probability of the three miRNAs as biomarkers with AUCs (areas under the ROC curve) of 0.830, 0.792 and 0.789, respectively. They were significantly correlated with each other in CAD patients, suggesting the possibility of joint diagnosis. The combined AUC was 0.915, much higher than each single miRNA. Therefore, our study revealed three promising biomarkers for early diagnosis of CAD. The combination of these miRNAs may act more effectively than individual ones for CAD diagnosis.     

胰腺癌患者血清CEA、CA242、CA199水平变化及联合诊断的ROC曲线分析

目的:探讨胰腺癌患者血清癌胚抗原(CEA)、糖类抗原242(CA242)、糖类抗原199(CA199)水平变化,并分析上述指标对胰腺癌的联合诊断价值,为胰腺癌的临床诊断提供参考。方法:选择2014年2月至2018年2月我院收治的186例胰腺癌患者(胰腺癌组)、89例胰腺炎患者(胰腺炎组)作为研究对象,并取同期来我院检查的268例健康人作为对照组。比较三组受试者的血清CEA、CA242、CA199水平变化,对比分析血清CEA、CA242、CA199的单一以及联合诊断的准确度、特异度以及灵敏度,并绘制ROC曲线以分析上述指标的诊断价值。结果:三组受试者血清CEA、CA242、CA199水平差异具有统计学意义(P<0.05)。且胰腺炎组和胰腺癌组的血清CEA、CA242、CA199水平明显高于对照组,胰腺癌组患者的血清CEA、CA242、CA199水平明显高于胰腺炎组,差异均有统计学意义(P<0.05)。ROC曲线结果显示,CEA诊断价值最大,CA199诊断价值最小。CEA是胰腺癌单项肿瘤标志物中敏感度最高的,为85.48%;特异度最高的为CA242(96.72%);三项肿瘤标志物联合诊断的准确度增加至92.27%,敏感度增加至95.16%,特异度相比略有下降。结论:与单一肿瘤标记物诊断胰腺癌相比,CEA、CA242、CA199联合诊断的敏感度和准确度均明显升高,可以明显改善胰腺癌的漏诊率,提高患者的生存率,具有较好的临床应用价值。     

对新型冠状病毒肺炎继发真菌感染的思考

新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)疫情十分严重,给民众的健康带来了巨大威胁。COVID-19患者可能继发侵袭性真菌感染,会严重威胁患者的生命,因此,在诊治策略上应该给予重视。除了加强高危患者中病原真菌的常规检查外,还应加大力度支持和扶持病原真菌先进检测技术的研发;此外,还应重点支持针对医疗单位、公共场所和家庭等常温环境以及体表和器物表面灭活病毒、细菌、真菌等病原体的新型技术和方法的研发。最终为国家战胜COVID-19和继发感染疫情提供新措施和新策略。     

CT联合MRI在早期肝癌诊断临床价值分析

摘要 目的：探究CT联合MRI在早期肝癌诊断中的应用价值。方法：选择2016年6月至2019年6月于我院接受诊断治疗的78例已知或疑似肝癌患者,分别对其实施CT及MRI检测,以病灶部位病理学检查结果为金标准（50例确诊为早期肝癌,28例为良性病变）,分别评估CT、MRI、CT联合MRI对早期肝癌的诊断价值,将确诊为肝癌的50例患者按照病灶大小区分为直径≤3 cm组（21例）和>3 cm组（29例）,对比CT与MRI对不同直径肝癌诊断率。结果：（1）检测发现,CT对早期肝癌诊断一致性为73.08 %,灵敏度为72.00 %,特异度为75.00 %;（2）MRI对早期肝癌诊断一致性为82.05 %,灵敏度为82.00 %,特异度为82.14 %;（3）CT联合MRI检测对早期肝癌诊断一致性为93.59 %,灵敏度为92.00 %,特异度为96.43 %;（4）对比发现,对直径≤3 cm的早期肝癌患者,MRI诊断率明显高于CT（95.24 % vs 76.19 %,P<0.05）。结论：CT及MRI对早期肝癌均具有较好的诊断价值,但联合检测明显优于任一单独检测,同时对病灶直径≤3 cm的早期肝癌患者,MRI诊断准确率更高。     

Use of milk electrical conductivity for the differentiation of mastitis causing pathogens in Holstein cows

Mastitis is one of the most prevalent and costly diseases in dairy cattle. Key components for adequate mastitis control are the detection of early stages of infection, as well as the selection of appropriate management interventions and therapies based on the causal pathogens associated with the infection. The objective was to characterize the pattern of electrical conductivity (EC) in milk during intramammary infection, considering specific mastitis-causing pathogen groups involvement. Cows (n = 200) identified by an in-line mastitis detection system with a positive deviation ≥15% in the manufacturer’s proprietary algorithm for EC (high electrical conductivity (HEC)) were considered cases and enrolled in the study at the subsequent milking. One control (CON) cow, within normal ranges for EC, was matched to each case. A composite milk sample was collected aseptically from each cow for bacteriological culture. Milk yield (MY) and EC were recorded for each milking during ±7 days relative to enrollment. Milk cultures were categorized into gram positive (GP), gram negative (GN), other (OTH) and no growth (NOG). Data were submitted for repeated-measures analysis with EC as the dependent variable and EC status at day −1, bacteriological culture category, parity number, stage of lactation and days relative to sampling as main independent variables. Average (± standard error (SE)) EC was greater in HEC than in CON cows (12.5 ± 0.5 v. 10.8 ± 0.5 mS/cm) on the day of identification (day −1). Milk yield on day −1 was greater in CON than in HEC (37.6 ± 5.1 v. 33.5 ± 5.2 kg). For practical management purposes, average EC on day −1 was similar for the different bacteriological culture categories: 11.4 ± 0.6, 11.7 ± 0.5, 12.3 ± 0.8 and 11.7 ± 0.5 mS/cm in GN, GP, OTH and NOG, respectively. Parity number was only associated with day −1 EC in HEC group, with the greatest EC values in parity 3 (12.3 ± 0.3 mS/cm), followed by parity 2 (11.9 ± 0.2 mS/cm), parity >3 (11.6 ± 0.5 mS/cm) and primiparous cows (11.2 ± 0.2 mS/cm). An effect on EC for the interaction of day relative to identification by pathogen gram category was observed. The same interaction effect was observed on daily MY. Overall, the level of variation for MY and EC between- and within-cows was substantial, and as indicated by the model diagnostic procedures, the magnitude of the variance in the cows in the CON group resulted in deviations from normality in the residuals. We concluded that characteristic temporal patterns in EC and MY in particular pathogen groups may provide indications for differentiation of groups of mastitis-causing pathogens. Further research to build detection models including EC, MY and cow-level factors is required for accurate differentiation.     

Review: Helicobacter pylori infection in children

Helicobacter pylori infection in children and adolescents differs in comparison to adults with respect to epidemiology, host responses, and disease manifestations. Furthermore, treatment options are limited in this population and antibiotic resistance rates continue to increase. Therefore, ongoing research is vital to understand disease pathogenesis and provide optimal management of children with infection. This review summarizes relevant publications from April 2019 to March 2020. Similar to adults, recent studies show a decreasing prevalence of infection in the pediatric population. Studies of pathogenesis investigated serum immune responses and the potential inverse association of infection and allergy. Several studies investigated the effect of H pylori and related inflammation on the gut microbiome. The recommendation of endoscopy‐based testing to identify the cause of symptoms and not just H pylori, reserving noninvasive UBT or stool antigen tests for post‐eradication follow‐up, was supported by the current literature.     

Fungal co-infection in COVID-19 patients: Should we be concerned?

Critically ill COVID-19 patients have higher pro-inflammatory (IL-1, IL-2, IL-6, tumor necrosis alpha) and anti-inflammatory (IL-4, IL-10) cytokine levels, less CD₄ interferon-gamma expression, and fewer CD₄ and CD₈ cells. This severe clinical situation increases the risk of serious fungal infections, such as invasive pulmonary aspergillosis, invasive candidiasis or Pneumocystis jirovecii pneumonia. However, few studies have investigated fungal coinfections in this population. We describe an update on published reports on fungal coinfections and our personal experience in three Spanish hospitals. We can conclude that despite the serious disease caused by SARS-CoV-2 in many patients, the scarcity of invasive mycoses is probably due to the few bronchoscopies and necropsies performed in these patients because of the high risk in aerosol generation. However, the presence of fungal markers in clinically relevant specimens, with the exception of bronchopulmonary colonization by Candida, should make it advisable to early implement antifungal therapy.     

基于CRISPR/Cas9的基因分析方法研究进展

自2012年首次证明了CRISPR/Cas9可以在体外进行DNA切割试验以来,CRISPR技术逐渐在基因编辑研究中获得了迅速的发展,除了应用于基因编辑领域之外,它在基因表达调控、基因成像、基因分析等方面也展现出了巨大的应用潜力。尤其在基因分析领域,CRISPR技术由于其精确的基因识别、室温的反应条件、易设计性和操作性等特色,使得一系列新型的基因检测技术得以发展,并取得了超越常规技术的一些检测参数。本文以Cas9蛋白为对象,综述了近些年来在该领域取得的研究进展。主要论述Cas9蛋白的功能、改造、引导RNA(sgRNA)的设计及其在基因分析方法上的应用。     

Plasmonic Biosensor Controlled by DNAzyme for On‐Site Genetic Detection of Pathogens

On‐site predetection of pathogens could significantly decrease of a disease outbreak or national loss in most of the countries. However, conventional detection techniques are limited in use for on‐site detection due to the necessity of specialized skill or equipment. Therefore, it is necessary to develop a new technique that can predetect pathogens in the field without special skills or equipment. Here, a DNAzyme strategy to control a plasmonic biosensor for rapid and simple visual detection of Salmonella choleraesuis is adopted. Multicomponent DNAzyme formed by target addition can cleave the linker effectively at 50 °C. Linker cleavage induces dispersion of two DNA‐immobilized gold nanoparticles and color change. Under optimized assay conditions, the target could be detected via visual discrimination sensitively and specifically. Moreover, the biosensor shows the possibility of practical use with contaminants and a 16S rRNA real target. As a result, the proposed plasmonic biosensor can visually detect S. choleraesuis without unstable enzymes, a specialized technique, or equipment. Therefore, these advantages could allow that this biosensor would be used for on‐site predetection to lower the risk of transmission of infectious diseases.     

血清sST2在心力衰竭诊断、预后中的应用价值

心力衰竭(心衰)的发病率正随着人口老龄化的加速而显著上升,目前仍然是一个重大的公共健康问题。尽管近年来在心衰治疗方面取得了显著成效,但患者的生存率依旧很低,预后差,确诊心衰后5年内死亡率高达50%。如果能够对心衰进行快速有效的诊断并按危险程度进行合理分层,将为临床医生制定治疗方案提供重要的参考依据。生物标志物在心衰的诊断、疗效评估及预后判断方面都具有重要的意义。心力衰竭是一种复杂的疾病,涉及多种生理病理过程。心力衰竭时,神经内分泌系统被激活,同时伴随着血容量和心室壁压力增加,心室肌细胞分泌NT-proBNP/BNP,因此,其可作为心衰诊断和预后生物标志物。然而血浆中NT-proBNP/BNP易受到年龄、性别、体型、左室肥大、心动过速、右心室过载、低氧血症、肾脏功能等诸多因素影响。sST2作为一种新型心力衰竭标志物,近年来备受关注,它不仅能够反映心肌纤维化程度并预测是否发生心室重构,且不受年龄、性别、肾功能等因素的影响,同时具有更低的参考变化值和个体指数,更适合用于连续监测和指导治疗,是评价心力衰竭的理想指标之一。文中对近年来sST2在心衰诊断和预后方面的研究进展进行总结归纳,并对其发展趋势进行展望。