Research progress of early screening and clinical prevention services for high-risk population with cardiovascular diseases / 公共卫生与预防医学

Cardiovascular diseases are preventable and controllable, and the disease burden caused by them can be reduced after preventive intervention. Attentions should be paid to the prevention of disease causes. For high-risk population, it is necessary to conduct early screening of cardiovascular diseases, control risk factors, reduce exposure level, prevent and control the occurrence or progression of diseases. Clinical prevention services are to evaluate risk factors of health in clinical sites, which can prevent diseases by personalized intervention measures. Clinical prevention services for high-risk population with cardiovascular diseases are generally at a low level in China. This article reviews the early screening, risk factors and clinical prevention services for high-risk population with cardiovascular diseases.

Prevalence and influencing factors of mild cognitive impairment in the elderly in Songjiang District, Shanghai / 环境与职业医学

Background With the aging of China's population, cognitive impairment in the elderly is receiving increasing public attention. Screening and intervention of people with mild cognitive impairment (MCI) are of great significance to prevent and reduce the occurrence of cognitive impairment. Objective To understand the prevalence and explore potential influencing factors of MCI in the elderly in Songjiang District, Shanghai, and to provide scientific basis for promoting early screening of cognitive impairment and precise intervention of MCI in the elderly in this area. Methods A cross-sectional study design was adopted. From August to October 2022, using multi-stage random sampling, 1800 elderly residents aged 60 years and above were screened for cognitive impairment in 6 neighborhood/village committees in 6 towns in Songjiang District. The survey questionnaires included a sociodemographic questionnaire, a health status and lifestyle questionnaire, the Instrumental Activities of Daily Living (IADL), the Patient Health Questionnaire (PHQ-9), and the Mini-Mental State Examination (MMSE). Prevalence rates of MCI among the elderly by selected social demographic characteristics, health status, and lifestyle were estimated, and potential influencing factors of MCI were evaluated by binary logistic regression. Results A total of 209 elderly residents with MCI and 1591 healthy elderly residents were detected, and the prevalence of MCI in the elderly aged 60 and above was 11.6% in Songjiang District. Being physically active (OR=0.556, 95%CI: 0.399, 0.774) reduced the risk of MCI. Illiteracy (OR=1.810, 95%CI: 1.239, 2.644), primary school education level (OR=3.454, 95%CI: 2.342, 5.092), non-participation in social activities (OR=1.945, 95%CI: 1.360, 2.781), IADL damaged (OR=3.173, 95%CI: 2.137, 4.712), and depression (OR=1.957, 95%CI: 1.112, 3.443) increased the risk of MCI (P＜0.05). Conclusion The prevalence of MCI among the elderly in Songjiang District is lower than the national average. Educational level, physical activity, participation in social activities, IADL, and depression may be the influencing factors of MCI in the elderly. It is recommended to carry out early screening, early detection, and early intervention for cognitive impairment in the elderly. Improving involvement in physical exercise and increasing participation in social activities are encouraged. Special attention should be paid to the needs of vulnerable groups such as low education level and disabled elderly during a community MCI intervention program.

Lung Cancer Prevalence among Staff in a Cancer Hospital / 中山大学学报(医学科学版)

ObjectiveTo investigate the prevalence of lung cancer among medical staff in a hospital and promote the level of cancer prevention and treatment. MethodsThe annual physical examination data， follow-up pathology and survival data from 2009 to 2021 in a tertiary cancer hospital were collected and then compared with data of lung cancer in China from the global burden of disease database （GBD database）. ResultsThe age-standardized prevalence of lung cancer have been continuously increasing in both populations in recent years. The age-standardized prevalence of lung cancer among medical staff was higher than that in Chinese population， but the age-standardized mortality was lower. The Average Annual Percent Change （AAPC） of lung cancer prevalence among staff was higher than that in Chinese population （13.0% vs. 4.1%）， indicating a higher growth rate. The proportion of newly diagnosed early-stage lung cancer in 2014-2021 was significantly higher than that before adding plain chest CT scan in routine physical examination （2009-2013）， suggesting the benefit of chest CT scan for early screening of lung cancer. ConclusionThe prevalence and growth rate of lung cancer among the staff were higher than those in Chinese population， but the mortality was lower. Plain chest CT scan is essential for early screening and treatment of lung cancer.

Early screening tools for autism spectrum disorder in the past two decades: a visualized analysis / 中国康复理论与实践

ObjectiveTo analyze the research hotspots and frontier trends in the field of early screening tools of autism spectrum disorder (ASD) over the past two decades. MethodsThe literature on early screening tools for ASD was searched in Web of Science core collection database from 2002 to 2022. CiteSpace was used for cluster analysis of keywords, to draw knowledge mapping. Research disciplines were analyzed and comprehensively interpreted. ResultsA total of 115 articles were included. The number of researches on early screening tools for ASD had been increasing over the past two decades. The research disciplines with higher publication volume included pediatrics, neurology and neuroscience, and psychology. A total of 191 keywords were identified, and the LLR keyword clustering analysis yielded eleven clusters. ConclusionModified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) and Brief Infant-Toddler Social and Emotional Assessment (BITSEA) have been subjected to large-scale sample screening and follow-up observation for validity, demonstrating good psychometric properties and high clinical diagnostic value. The development of new early screening tools for ASD, validation of the reliability and validity of different language versions of the M-CHAT-R/F, and research on digital and networked M-CHAT-R/F are current research hotspots. Cultural adaptation of early screening tools for ASD and their application within the developmental monitoring framework may represent frontier research trends.

Biomarkers for early screening and diagnosis of breast cancer: a review / 生物工程学报

The estimated new cases of breast cancer (BC) patients were 2.26 million in 2020, which accounted for 11.7% of all cancer patients, making it the most prevalent cancer worldwide. Early detection, diagnosis and treatment are crucial to reduce the mortality, and improve the prognosis of BC patients. Despite the widespread use of mammography screening as a tool for BC screening, the false positive, radiation, and overdiagnosis are still pressing issues that need to be addressed. Therefore, it is urgent to develop accessible, stable, and reliable biomarkers for non-invasive screening and diagnosis of BC. Recent studies indicated that the circulating tumor cell DNA (ctDNA), carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA15-3), extracellular vesicles (EV), circulating miRNAs and BRCA gene from blood, and the phospholipid, miRNAs, hypnone and hexadecane from urine, nipple aspirate fluid (NAF) and volatile organic compounds (VOCs) in exhaled gas were closely related to the early screening and diagnosis of BC. This review summarizes the advances of the above biomarkers in the early screening and diagnosis of BC.

Application of a light-weighted convolutional neural network for automatic recognition of coal workers' pneumoconiosis in the early stage / 中华劳动卫生职业病杂志

Objective: To construct and verify a light-weighted convolutional neural network (CNN), and explore its application value for screening the early stage (subcategory 0/1 and stage Ⅰ of pneumoconiosis) of coal workers' pneumoconiosis (CWP) from digital chest radiography (DR) . Methods: A total of 1225 DR images of coal workers who were examined at an Occupational Disease Prevention and Control Institute in Anhui Province from October 2018 to March 2021 were retrospectively collected. All DR images were collectively diagnosed by 3 radiologists with diagnostic qualifications and gave diagnostic results. There were 692 DR images with small opacity profusion 0/- or 0/0 and 533 DR images with small opacity profusion 0/1 to stage Ⅲ of pneumoconiosis. The original chest radiographs were preprocessed differently to generate four datasets, namely 16-bit grayscale original image set (Origin16), 8-bit grayscale original image set (Origin 8), 16-bit grayscale histogram equalized image set (HE16) and 8-bit grayscale histogram equalized image set (HE8). The light-weighted CNN, ShuffleNet, was applied to train the generated prediction model on the four datasets separately. The performance of the four models for pneumoconiosis prediction was evaluated on a test set containing 130 DR images using measures such as the receiver operating characteristic (ROC) curve, accuracy, sensitivity, specificity, and Youden index. The Kappa consistency test was used to compare the agreement between the model predictions and the physician diagnosed pneumoconiosis results. Results: Origin16 model achieved the highest ROC area under the curve (AUC=0.958), accuracy (92.3%), specificity (92.9%), and Youden index (0.8452) for predicting pneumoconiosis, with a sensitivity of 91.7%. And the highest consistency between identification and physician diagnosis was observed for Origin16 model (Kappa value was 0.845, 95%CI: 0.753-0.937, P<0.001). HE16 model had the highest sensitivity (98.3%) . Conclusion: The light-weighted CNN ShuffleNet model can efficiently identify the early stages of CWP, and its application in the early screening of CWP can effectively improve physicians' work efficiency.

Multicenter study on the effect of early screening skills training for autism spectrum disorders in primary care hospitals in Chengdu / 四川精神卫生

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

Research Status of Biomarkers in Early Screening and Early Diagnosis of Lung Cancer / 肿瘤防治研究

Lung cancer is one of the most malignant tumors in the world. In China, the mortality rate of lung cancer has been in the first place for many years. Early screening and early diagnosis of lung cancer is the premise of prolonging the survival time of patients with lung cancer. In recent years, liquid biopsy technology, which is considered to have a bright future, has attracted more and more attention, and its value in the early diagnosis of lung cancer is worth discussing. This paper reviews the application of biomarkers in early screening and early diagnosis of lung cancer, looks for specific biomarkers from multi-omics, and discusses their significance in early diagnosis of lung cancer.

Validity of the clinical dementia rating for early screening of Alzheimer's disease in community / 中华行为医学与脑科学杂志

Objective:To verify the validity of the clinical dementia rating(CDR) for early screening of Alzheimer's disease in the community.Methods:One thousand two hundred and eighty-one community volunteers (580 males and 701 females) came to hospital for clinical interviews, laboratory tests and a series of psychological assessment, including CDR, brief elderly cognitive screening inventory (BECSI), quickly cognitive screening scale for elderly (QCSS-E), mini-mental state examination (MMSE) and core neurocognitive test (CNT). According to clinical interview, assessment and DSM-5 criteria, 623 normal cognition, 570 mild cognitive impairment (MCI) and 88 dementia with Alzheimer's type (DAT) were screened.Results:(1) The results of CDR-global scores (CDR-GS)in the community volunteers showed that 506 (39.5%) scored 0, 688 (53.7%) scored 0.5, 72 (5.6%) scored 1, and 15 (1.2%) scored 2 or more.(2) There were significantly differences on the BECSI score, QCSS-E score, MMSE score and CNT score among people with different CDR-GS ( P<0.01). In the total or dementia sample, CDR-sum of box score (CDR-SB) and CDR-GS were significantly correlated with BECSI score ( r=0.577-0.639), QCSS-E score ( r=-0.586--0.680), MMSE score ( r=-0.570--0.764) and CNT score ( r=-0.244--0.357)( P<0.01). (3) The accuracy (95.8%) and specificity (99.8%) of the CDR-GS screening DAT were slightly higher than those of the CDR-SB(91.1%, 92.0%), and its sensitivity (65.9%) was lower than that of CDR-SB(82.5%). The accuracy (72.6%), sensitivity (81.9%) and specificity (64.0%)of the CDR-GS were close to those of CDR-SB(72.1%, 83.3%, and 61.8% respectively) in screening MCI. Conclusion:The CDR can be used for screening of AD in community populations.CDR-GS and CDR-SB have their own advantages, and combination of both advantages can improve the screening efficiency.

Current Status and Progress of Early Lung Cancer Screening under the Normal State of COVID-19 Epidemic Prevention and Control / 中国肺癌杂志

Lung cancer is the malignant tumor with the highest incidence in China. Early detection and identification of symptomatic lung cancer patients and timely screen out asymptomatic patients from high-risk groups require multiple cooperation. At present, although combined imaging, serology, genomics, proteomics and other methods have been combined to screen for suspected lung cancer, there are still problems such as missed diagnosis and misdiagnosis. Meanwhile, the spread of the corona virus disease 2019 (COVID-19) epidemic has brought new challenges to early lung cancer screening. Under the normalization of epidemic prevention and control, the work of early lung cancer screening should be changed accordingly: improve the population's awareness of cancer prevention and control, strengthen the management of medical procedures, improve the efficiency of tumor detection, optimize detection technology, and utilize internet and big data platforms rationally. We should establish an ideal model, combining multiple screening methods, which is streamlined and efficient for early lung cancer screening under normal epidemic prevention and control.
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Pulmonary Nodules/Lung Cancer Comprehensive Management Mode: Design and Application / 中国肺癌杂志

BACKGROUND@#Mortality of lung cancer can be decreased by early screening effectively. However, consistent and proficient standards & methods have not been established in China. This study was based on pulmonary nodules/lung cancer comprehensive management platform established by West China Hospital, Sichuan University. Early screening of pulmonary nodules was integrated into standard healthcare of lung cancer system, aiming to improve survivals of lung cancer patients.@*METHODS@#Three cohorts were established: healthy populations, pulmonary nodules cohort and lung cancer patients cohort, and related clinical data will be collected and analyzed. Preliminary plan includes verifying effect of pulmonary nodules screening module.@*RESULTS@#Pulmonary nodules screening was performed in 2,836 employers (>40 years old) of West China Hospital. Lung cancers were diagnosed in 66 participants, all receiving surgery to remove the lesions. 65 of them were with early stage diseases, 1 with lung cancer and brain metastasis.@*CONCLUSIONS@#Proficient screening, follow-up and healthcare can be achieved via pulmonary nodules/lung cancer comprehensive management mode, which will be extended all over west China region in future.

Clinical Value of Exosome Circular RNA in Early Screening of Colorectal Cancer / 胃肠病学

Exosomes are nanoscale membranous vesicles that can be released by any type of cells. They contain proteins, lipids and nucleic acids, and are released from multiple vesicles after fusion with the cell membrane. As a signal transmitting molecule, exosomes can deliver bioinformation-containing contents to target cells and play a specific role. Circular RNA (circRNA) is a new type of long non-coding RNA. Since circRNA is a closed circular structure RNA without a 5'cap and a 3' tail, it is not affected by exonuclease and exists stably. Recently, more and more studies have shown that circRNA is closely related to the occurrence, development and prognosis of colorectal cancer (CRC). Detection of serum circRNA may have important clinical value for early screening of CRC. This article reviewed the clinical value of exosome circRNA in early screening of CRC.

Establishment of methylation detection method for Septin 9 gene and its application in plasma specimen detection in colorectal cancer / 国际检验医学杂志

Objective To establish the blood Septin9 methylation detection system for early screening of colorectal cancer based on fluorescence PCR technology .Methods The PCR primer of Septin9 was designed by searching the CpG island site of Septin9 methylation in the NCBI database .The high methylation site of Septin9 gene promoter region was confirmed by PCR amplification and sequencing after extracting DNA from colorectal cancer and para-carcinoma tissues .The fluorescence PCR and TaqMan probe detection technique was designed by aiming at high methylation site for constructing the plasma sample methylation detection sys-tem .Then its accuracy ,specificity ,repeatability and minimum detectable amount were performed the assess-ment and analysis .The SETP9 methylation detection was performed in plasma samples from 57 cases of color-ectal cancer and 30 healthy persons .Results The high methylation site of Septin9 gene in tissue samples was confirmed by sequencing .This site served as the target for designing fluorescence PCR detection system .After assessment ,the accuracy ,specificity and repeatability of this detection system were 100％ ,the lowest detection amount reached 0 .1 ng/μL .Among the plasma samples in 57 cases of colorectal cancer ,the positive rate of Septin9 methylation site detection was 71 .92％ (41/57) and the positive rate of in the patients with pathologi-cal stage Ⅰ and Ⅱ of colorectal cancer reached 64 .2％ .But Septin9 gene had no methylation in plasma of healthy population .Conclusion The plasma fluorescence PCR detection system with Septin9 gene methylation as the target has the characteristics of high sensitivity ,high specificity and high accuracy ,which is the reliable detection technique for the early screening of colorectal cancer and has good clinical application prospect .

The Progress of Non-invasive Screening Methods for Colorectal Cancer / 现代生物医学进展

Early detection and treatment of high-risk adenomas and colorectal cancer (CRC) can reduce mortality of this disease.CRC screening is aimed at minimizing its harm and colonoscopy is presently the gold standard for it.However,colonoscopy needs bowel preparation and is invasive with high risk of intestinal perforation,causing a bad compliance,which is unfavorable to its popularization and application.Recently,non-invasive detection methods for CRC have gone through a rapid development.Tests based on CRC-related biomarkers in fecal and blood samples provide new options for non-invasive CRC screening.However,detection methods for these biomarkers still need further research and improvement because of the complex composition of feces and blood.In the two aspects of fecal tests and blood tests,the progress of recent studies on non-invasive screening methods for CRC was reviewed in this article.

Study of value of TCT, human papillomavirus DNA and colposcopy in the early screening of cervical cancer / 中国生化药物杂志

Objective To study the value of TCT, human papillomavirus DNA combined with colposcopy in the early screening of cervical cancer. Methods The clinical data of 80 cases of patients with cervical lesions in our hospital from January 2011 to January 2017 were retrospectively analyzed. Results Among the 80 cases of patients, ASCUS was detected by TCT 8 cases, LSIL6 cases, HSIL4 cases, SCC2 cases, the detection rate of cervical lesions was 25.0% (20/80); Normal and inflammatory 60 cases, accounting for 75.0% (60/80) of the total. HPV-DNA positive 28 cases, negative 52 cases, the positive rate was 35.0% (28/80); The detection rate of TCT (+) HPV (+) was significantly higher than TCT (+) HPV (-), TCT (-) HPV (+), TCT (-) HPV (-) (P<0.05), the detection rate of SCC reached 100.0%; The detection rate of CIN I, CIN II, CIN III of TCT examination, HPV-DNA examination combined with colposcopy were significantly higher than TCT+HPV-DNA examination (P<0.05), but the difference of detection rates of SCC between the two was not significant. Conclusion The value of TCT, human papillomavirus DNA and colposcopy in the early screening of cervical cancer is higher, so is worthy of promotion and use in the clinical.

A Study on Practitioner's Perceptions on Early Screening of Autism Spectrum Disorder

OBJECTIVES: The purpose of this study is to investigate the professional knowledge and perceptions of the early screening of Autism Spectrum Disorder (ASD) in practitioners who have contact with patients with ASD. METHODS: A survey was carried out among 674 practitioners in total, where practitioners are defined as those who work at primary medical centers, public institutions, educational institutions and treatment institutions. The survey was carried out both online and offline, and it mainly focused on 1) knowledge about ASD symptoms, 2) knowledge about the early screening of ASD, 3) measures taken after ASD detection, 4) thoughts on the development of early screening tools for ASD, and 5) the current status of ASD treatment. The data collected were analyzed through descriptive statistics, analysis of frequency and cross tabulation analysis using SPSS WIN 22.0. RESULTS: The results of this study suggest that the practitioners were not aware of the exact symptoms of ASD and their professional knowledge and the environment for early screening were insufficient. Furthermore, very few and inappropriate measures were taken after the detection of ASD. In addition, there was a high demand for early ASD screening tools to be used on site and, regarding treatment, the significance of the implementation of evidence based treatments as well as the continuity of relevant research came to the fore. CONCLUSION: It seems that there is a lack of knowledge and perception of the early screening of ASD and that education and training among practitioners is urgently required. This issue is discussed in more detail in the paper.

Analysis on early screening of developmental dysplasia of the hip in Shapingba of Chongqing / 局解手术学杂志

Objective To analyze the present situation about early screening of developmental dysplasia of the hip( DDH) of infants in Shapingba district of Chongqing,and to explore the methods to improve the rate of diagnosis about DDH. Methods A total of 2 066 infants among 0~6 months old living in Shapingba district of Chongqing,were examined with clinical and ultrasound method on hip. Results Six infants with DDH were discovered among the 2 066 infants,which was more common in the female baby. The deficiency of hospital in which can exam hip with ultrasound method and the deficiency about DDH were the significant factors affecting the low detection rate. Conclusion Necessary measure must be taken to improve the low detection rate of DDH.

Care of neonatal cholestasis:opportunities to improve early diagnosis of biliary atresia / 中华实用儿科临床杂志

The early screening and early diagnosis of biliary atresia is the key to improve the 5-year native liver survival rate,jaundice-free-native-liver survival rate and overall survival rate.So far,the neonatal jaundice,especially that caused by surgical cholestasis exists the lack of awareness.Because of this reason,the delay depletion jaundice patients did not receive early diagnosis and treatment until the severe complications happened.So,it has often missed the best period of operation for the biliary atresia.Called for local medical health governments to formulate the effective early screening methods of biliary atresia and the reasonable schedule of postnatal follow-up,and improving the ability of basic unit medical staff in well understanding cholestasis disease in order to achieve early diagnosis and treatment.Consequently,it will improve the situation of diagnosis and treatment of biliary atresia in our country.

The Status of iron deficiency anemia and its effect on growth and development among infants / 预防医学

Objective To know the prevalence rate of iron deficiency anemia and its effect on growth and development among infants under 6 months. Methods A total of 341 infants who were born from July 2011 to June 2012 were enrolled. The information of blood routine examination,growth index,feeding patterns was collected at age of 42 days and 6 months,respectively. Developmental screening test was conducted at age of 6 months. Results The prevalence rate of anemia at 42 days was 37. 54%,and there was no significant difference between males(40. 54%)and females(33. 97%) (P>0. 05). The prevalence rate of iron deficiency anemia at 6 months was 19. 35%,in which 48. 48% were new cases. At age of 42 days,there was no significant difference between different feeding patterns in anemia prevalence( breast feeding:30. 82%,mixed feeding:41. 40%,artificial feeding:47. 37%,P>0. 05). While at age of 6 months,the anemia prevalence of breast feeding group was higher( 38. 20%)than that of the other two groups( mixed feeding:16. 38%;artificial feeding:9. 56%;P<0. 05 ). The rate of developmental quotient below 70 was 11. 76% in the anemia cases whose hemoglobin was continuously low from 42 days to 6 months,which was higher than that of new onset anemia cases (3. 13%)and normal hemoglobin controls(1. 82%)(P<0. 05). Conclusion Continuously low hemoglobin at early age of 42 days to 6 months is potentially harmful to neuropsychological development of infants. Early screening of hemoglobin is urgently needed for intervention of iron deficiency anemia among infants.

Detection of human recombinant HIV-p24 antigen by Immuno-polymerase chain reaction / 中国输血杂志

Objective To describe a highly sensitive immuno-polymerase chain reaction (immuno-PCR) assay for the detection of human recombinant HIV-p24 antigen. Methods We used gold-magnetic particles as the carriers,mouse anti-p24 monoclonal antibody as the capture antibody and biotinylated goat anti-p24 polyclonal antibody as the detection antibody. The reporter DNA was initially generated by PCR amplification using a biotinylated primer,and was bound with streptavidin to biotinylated polyclonal antibody. Human recombinant p24 antigen sandwiched by antibodies was detected by amplifying the reporter DNA using PCR. The optimal concentration of sreptavidin and DNA label were determined using square titration. The electrophoresis gels were imaged and analyzed by Quantity One software. Results The optimal concentration of sreptavidin and DNA label were determined to be 0.1 mg/ L and 10 ng/ L,respectively. The detection limit of the immuno-PCR assay was 0.1 ng/L,higher than that of the conventional ELISA. Conclusion A highly sensitive immuno-PCR for human recombinant HIV-p24 antigen was indicated to be an available method for early screening of HIV infectors in blood donors.