Sickle cell nephropathy: A review of novel biomarkers and their potential roles in early detection of renal involvement

Whether the underlying mutations are homozygous, heterozygous, or co-inherited with other hemoglobinopathies, sickle cell disease is known to afflict the kidneys, leading to the clinical entity known as sickle cell nephropathy (SCN). Although common, SCN remains diagnostically elusive. Conventional studies performed in the context of renal disorders often fail to detect early stage SCN. This makes the quest for early diagnosis and treatment more challenging, and it increases the burden of chronic kidney disease-related morbidity among patients. Novel diagnostic tools have been employed to overcome this limitation. In this study, we discuss various biomarkers of SCN, including those employed in clinical practice and others recently identified in experimental settings, such as markers of vascular injury, endothelial dysfunction, tubulo-glomerular damage, and oxidative stress. These include kidney injury molecule-1, monocyte chemoattractant protein-1, N-acetyl-B-D-glucosaminidase, ceruloplasmin, orosomucoid, nephrin, and cation channels, among others. Furthermore, we explore the potential of novel biomarkers for refining diagnostic and therapeutic approaches and describe some obstacles that still need to be overcome. We highlight the importance of a collaborative approach to standardize the use of promising new biomarkers. Finally, we outline the limitations of conventional markers of renal damage as extensions of the pathogenic process occurring at the level of the organ and its functional subunits, with a discussion of the expected pattern of clinical and biochemical progression among patients with SCN.     

腹部超声联合阴道灌注0.9%氯化钠诊断幼女阴道异物的临床价值

目的 分析腹部超声联合阴道灌注0.9%氯化钠对幼女阴道异物的诊断价值。方法 回顾性分析2018年1月—2021年12月就诊于赣州市妇幼保健院妇科的102例疑似阴道异物幼女临床资料。患儿均接受经腹部超声、阴道灌注0.9%氯化钠检查。以宫腔镜诊治结果作为金标准，分析经腹部超声单独检测或腹部超声联合阴道灌注0.9%氯化钠诊断阴道异物的准确性、有效性。结果 宫腔镜结果显示，患儿中阴道炎有21例（20.59%），阴道异物有81例（79.42%），其中棉絮状物、谷物、头发丝等线状物最为常见；单独诊断、联合诊断出阴道异物分别有69例和79例，与宫腔镜诊断结果的K值分别为0.689和0.897。将宫腔镜诊断结果作为金标准，单独诊断、联合诊断阴道异物的敏感性分别为0.765（95% CI：0.594，0.816）、0.951（95% CI：0.826，0.995），特异性分别为0.667（95% CI：0.563，0.786）、0.905（95% CI：0.795，0.972），准确度分别为0.745（95% CI：0.586，0.813）、0.941（95% CI：0.817，0.984），单独诊断、联合诊断的敏感性、特异性、准确度可信区间无重叠，说明有统计学意义。结论 阴道灌注0.9%氯化钠可增强幼女阴道异物在超声下的显影，提升诊断准确性、有效性，且操作简单、损伤小，起到清洁阴道作用。     

发达国家医学生器官捐献意愿研究现状的范围综述

目的了解发达国家医学生器官捐献意愿研究的目的、结果、障碍因素和解决对策。 方法以主题词和自由词联合的方式对PubMed、Web of Science、Ovid MEDLINE、Ovid EMBASE(Excerpta Medica)、EBSCOhost Complete和Cochrane Library等已发表文献数据库，以及灰色文献数据库York Centre for Reviews and Dissemination、Open Grey、ProQuest Dissertation and Theses和Mednar进行系统、全面地检索，并采用Arksey和O′Malley提出的范围综述框架进行文献资料整合。 结果共纳入17项发达国家医学生器官捐献意愿研究。研究背景主要为医学生未来对于公众器官捐献有着重要影响。研究结果表明，大多数医学生器官捐献意愿性良好，但不同亚组的研究结果不一；其最主要的障碍因素为医学生器官捐献相关知识的缺乏；解决对策主要为施予系统化、结构化和可评价的教育课程。 结论21世纪以来发达国家医学生器官捐献意愿研究方兴未艾，其研究的多层面、多角度以及揭示的问题、寻求的解决对策，可对我国现阶段医学生器官捐献的研究提供一定参考。     

Go-Ichi-Ni-San 2: A potential biomarker and therapeutic target in human cancers

Cancer incidence and mortality are increasing globally, leading to its rising status as a leading cause of death. The Go-Ichi-Ni-San (GINS) complex plays a crucial role in DNA replication and the cell cycle. The GINS complex consists of four subunits encoded by the GINS1, GINS2, GINS3, and GINS4 genes. Recent findings have shown that GINS2 expression is upregulated in many diseases, particularly tumors. For example, increased GINS2 expression has been found in cervical cancer, gastric adenocarcinoma, glioma, non-small cell lung cancer, and pancreatic cancer. It correlates with the clinicopathological characteristics of the tumors. In addition, high GINS2 expression plays a pro-carcinogenic role in tumor development by promoting tumor cell proliferation and migration, inhibiting tumor cell apoptosis, and blocking the cell cycle. This review describes the upregulation of GINS2 expression in most human tumors and the pathway of GINS2 in tumor development. GINS2 may serve as a new marker for tumor diagnosis and a new biological target for therapy.     

Contribution of cost to treatment nonadherence in the US breast cancer survivors: a population-based analysis

Breast Cancer Research and Treatment - Breast cancer survivors are often prescribed medications for at least 5 years to reduce recurrence risk, yet some forego this treatment due to cost....     

定量分析对常规超声联合超声造影定性误诊甲状腺结节的诊断价值

摘要：目的：探讨超声造影（CEUS）定量分析对常规超声联合CEUS定性诊断误诊为恶性的甲状腺结节与甲状腺乳头状癌的鉴别诊断价值。方法：选取2018年7月至2021年11月在我院超声科行甲状腺常规超声及CEUS检查，术前联合超声诊断为恶性（C-TIRADS≥4b 或 CEUS 表现为低增强和快速消退任一征像）而病理为良性的35位患者共35个结节为研究组；选择同期联合超声诊断与病理一致的甲状腺乳头状癌患者47例做为对照组。分析常规超声及CEUS特征，并将结节整体、中央部、边缘部及邻近正常甲状腺实质作为感兴趣区分别绘制时间-强度曲线（TIC）进行定量分析，比较两组结节各定量参数之间的差异。结果：研究组整体相对上升时间（△RT）以0.45为截断值，诊断恶性结节的敏感度为97.9%，特异度为85.7%，受试者工作（ROC）曲线下面积为0.96；研究组中央区△RT以0.55为截断值，诊断恶性结节的敏感度为95.7%，特异度为82.9%，ROC曲线下面积为0.87；研究组边缘区△RT以0.25为截断值，诊断恶性结节的敏感度为89.4%，特异度为77.1%，ROC曲线下面积为0.89。结论：CEUS定量分析在常规超声联合CEUS定性误诊甲状腺结节的诊断中具有一定的鉴别诊断价值。     

Analysis of the correlation between P27 expression and Helicobacter pylori infection in gastric cancer

We aimed to explore the correlation between P27 expression and Helicobacter pylori (H. pylori) infection in gastric cancer, so as to provide evidence for understanding the pathogenesis of gastric cancer caused by H. pylori infection. A total of 82 samples of gastric cancer tissues and 56 samples of tumor-adjacent normal tissues collected from the gastrectomy were enrolled in this study. Then, 14C-urease breathing test was carried out to evaluate the infection of H. pylori in gastric cancer tissues, the expression of P27 in the tissue samples was detected by the immunohistochemistry staining, and the correlation between the H. pylori infection and P27 expression in gastric cancer was analyzed. Of 82 gastric cancer patients, there were 53 patients with H. pylori infection (64.63%). Among the patients with highly or moderately differentiated gastric cancer, the expression of P27 was much higher than that of patients with poorly differentiated gastric cancer (p < 0.01). Besides, comparison of the P27 expression between males and females, among different age groups, tumor sizes, TNM stages, tumor infiltration degrees, or lymph node metastasis, showed no significant differences (p > 0.05). Analysis of the correlation revealed that P27 expression was negatively correlated with the infection of H. pylori (p < 0.01). Multifactorial logistics regression analysis indicated that tumor differentiation was a risk factor of P27-positive expression in gastric cancer tissues (p < 0.01). In addition, P27 expression in the gastric cancer tissues was lower than that in the tumor-adjacent normal tissues (p < 0.01). In gastric cancer patients, expression of P27 is correlated with H. pylori infection which, via downregulating P27, can cause the cancerization of gastric mucosa, and P27, for its role in the development and progression of gastric cancer, is a potential auxiliary indicator for clinical diagnosis whether gastric cancer is complicated with H. pylori infection. So, P27 is a key indicator for diagnosis, treatment, and prognostic evaluation of disease in the advanced stage.