简介：Cancerscreeningisasourceofmuchdebate.Attheinterfacebetweenpublichealth,specialistcare,economicsandpolicy,itcreatestensionsbetweenprofessionalgroups,politicians,themediaandthepublic.Ascreeningtestmaybecheap,butapplyingittoapopulation(withrigorousqualitycontrolandeffectiveprocessingofpatientswithabnormalresults)createsahugeworkloadandthereforecost.Screeningcanalsohavepsychologicaleffectsonindividualswithfalse-positiveresultswhorequireinvestigationbutareeventuallyfoundnottohavecancer.

简介：AbstractBreast cancer (BC) is the most prevalent malignancy worldwide, and a continued upward trend has been predicted in the coming decades. Screening in selected targeted populations, which is effective in reducing cancer-related mortality, has been widely implemented in many countries. This review summarizes the advances in BC screening techniques, organized or opportunistic BC screening programs across different countries, and screening modalities recommended by different academic authorities. Mammography is the most widely used and effective technique for BC screening. Other complementary techniques include ultrasound, clinical breast examination, and magnetic resonance imaging. Novel screening tests, including digital breast tomosynthesis and liquid biopsies, are still under development. Globally, the implementation status of BC screening programs is uneven, which is reflected by differences in screening modes, techniques, and population coverage. The recommended optimal screening strategies varied according to the authoritative guidelines. The effectiveness of current screening programs is influenced by several factors, including low detection rate, high false-positive rate, and unsatisfactory coverage and uptake rates. Exploration of accurate BC risk prediction models and the development of risk-stratified screening strategies are highly warranted in future research.

简介：AbstractOver the past 50 years, the scope and extent of prenatal diagnosis and screening for genetic disorders have improved geometrically. There has been a pendulum like swing from testing to screening back and forth as new technologies emerge. The concurrent developments of cell free fetal DNA analysis of maternal blood has dramatically changed patient’s choices towards screening. However, with the use of array comparative genomic hybridization of fetal DNA that requires diagnostic procedures (Chorionic villus sampling and amniocentesis), much more extensive diagnosis can be obtained. Until noninvasive methods can replicate what can be done with diagnostic procedures there still will be a "price to be paid" for opting for the non-invasive methods.

简介：Theriskofbreastcancer(BC)overdiagnosisattributedtomammographyscreeningisanunresolvedissue,complicatedbyheterogeneityinthemethodologyofquantifyingitsmagnitude,andbothpoliticalandscientificelementssurroundinginterpretationoftheevidenceonthisphenomenon.EvidencefromrandomizedtrialsandalsofromobservationalstudiesshowsthatmammographyscreeningreducestheriskofBCdeath;similarly,thesestudiesprovidesufficientevidencethatoverdiagnosisrepresentsaseriousharmfrompopulationbreastscreening.Forboththeseoutcomesofscreening,BCmortalityreductionandoverdiagnosis,estimatesofmagnitudevarybetweenstudieshoweveroverdiagnosisestimatesareassociatedwithsubstantialuncertainty.Thetrade-offbetweenthebenefitandthecollectiveharmsofBCscreening,includingfalse-positivesandoverdiagnosis,ismorefinelybalancedthaninitiallyrecognized,howeverthesnapshotofevidencepresentedonoverdiagnosisdoesnotmeanthatbreastscreeningisworthless.Futureeffortsshouldbedirectedtowards(a)ensuringthatanychangesintheimplementationofBCscreeningoptimizethebalancebetweenbenefitandharms,includingassessinghowplannedoractualchangesmodifytheriskofoverdiagnosis;(b)informingwomenofalltheoutcomesthatmayaffectthemwhentheyparticipateinscreeningusingwell-craftedandbalancedinformation;and(c)investinginresearchthatwillhelpdefineandreducetheensuingovertreatmentofscreen-detectedBC.

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简介：AbstractObjective:To compare and analyze the pass rate and screening strategy of hearing rescreening for newborns with high risk factors.Methods:Retrospective chart review of high-risk newborns who failed their initial newborn hearing screen and subsequently underwent secondary hearing tests from June 2011 to June 2018 in Guangzhou Women and Children's Medical Center were performed.Results:Eight hundred and sixty-eight newborns with high risk factors were included in the study. The 57-70 days (83.5%) and 71-84 days (83.4%) group had the highest pass rate compared with 42-56 days (75.8%) and < 42 days (68.3%) group. As for different screening strategies, the pass rate of OAE(otoacoustic emissions), AABR (auto auditory brainstem response) and OAE + AABR was the highest in 57-70 days group and 71-84 days group, respectively. The OAE + AABR had the lowest pass rate compared to the other two modalities. When the pass rate was compared as different risk factors, the 57-70 days and 71-84 days group also had the highest pass rate compared with 42-56 days and < 42 days group and the pass rate had no significant differences among various risk factors group.Conclusion:Our results showed that all the pass rate of OAE, AABR and OAE+ AABR was the highest in 57-70 days group and 71-84 days group with significant difference, suggesting that the delayed screening time (>57 days) may increase the re-screening pass rate and reduce anxiety of parents, which is of great significance for clinical work.

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简介：DiabetesMellitus(DM)isametabolicdisorderresultingfrommanyfactorsandcharacterizedbychronicelevatedbloodsugar.DM'scausesarenownotabsolutelyknown,butitisknownasasyndromeassociatedwithheredity,self-immuneandenvironmentalfactors.IntraditionalChinesemedicine,DMbelongstothecategoryof"XiaoKe"andistypedinto"ShangXiao',"ZhongXiao"and"XiaXiao"inthelightofthediseasedlocation.

简介：AbstractImportance:There are a variety of musculoskeletal malformations and injuries that can occur in newborns. These can be a significant cause of perinatal death or a reason for miscarriage and can lead to long-term functional issues if not managed appropriately. There is no systematic and well-established screening program for neonatal musculoskeletal malformations and injuries in China now.Objective:To report the incidence and types of congenital musculoskeletal malformations in two hospitals in Shenzhen City, to explore and discuss the details of the screening procedure and improve future prevention and treatment.Methods:From October 2013 to May 2014, 2564 one-day-old newborns were screened by a pediatric orthopedic physical examination, in combination with ultrasonography when required, and the incidence and variety of diseases were recorded statistically.Results:Among 2564 screened newborns, the following musculoskeletal conditions were identified: congenital muscular torticollis (CMT) (seven cases, 0.27%), hip subluxation (four cases, 0.16%), hip dysplasia (47 cases, 1.83%), congenital talipes equinovarus (CTEV) (two cases, 0.08%), congenital talipes calcaneovalgus (15 cases, 0.58%), polydactyly (nine cases, 0.35%), syndactyly (one case, 0.04%), and spinal hemivertebra (one case, 0.04%). Additionally, there were five (0.19%) neonates with birth injuries.Interpretation:It is feasible to carry out neonatal screening and identification of musculoskeletal malformations and birth injuries in China. This is helpful as timely detection and early intervention for many of these conditions can avoid permanent functional impairment in these children.

简介：AbstractGestational diabetes mellitus (GDM) is a growing public health problem worldwide that threatens both maternal and fetal health. Identifying individuals at high risk for GDM and diabetes after GDM is particularly useful for early intervention and prevention of disease progression. In the last decades, a number of studies have used metabolomics, genomics, and proteomic approaches to investigate associations between biomolecules and GDM progression. These studies clearly demonstrate that various biomarkers reflect pathological changes in GDM. The established markers have potential use as screening and diagnostic tools in GDM and in postpartum diabetes research. In the present review, we summarize recent studies of metabolites, single-nucleotide polymorphisms, microRNAs, and proteins associated with GDM and its transition to postpartum diabetes, with a focus on their predictive value in screening and diagnosis.

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简介：AbstractPreeclampsia (PE) is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. This disorder has profound short-term and long-term impacts on both the affected woman’s and her child’s health. Early-onset PE requiring preterm delivery (preterm PE) is of particular importance because it is associated with a higher risk of adverse pregnancy outcomes than term PE. First trimester screening model developed by the Fetal Medicine Foundation (FMF), which uses Bayes-theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, has been proven to be effective and have superior screening performance to that of traditional risk factor-based approach for the prediction of PE. Identification of high risk pregnant women for preterm PE and giving aspirin prophylaxis before 16th week of gestation would reduce the incidence of preterm PE. In Asia, although the prevalence of PE is slightly lower than the global estimation, early screening and prevention of this life-threatening condition is still crucial. The FMF Bayestheorem based screening method has been validated in a large-scale prospective Asia-wide study and revealed that the first trimester triple test achieves the highest detection rate, compared with the traditional risk factor-based approaches, and that the screening performance is comparable to the published data from the FMF in East Asian women. However, in order to achieve optimal screening performance, the key is to establish standardized methods for biomarker measurements and regular biomarker quality assessment, as each biomarker is susceptible to inaccurate measurement, thus affecting performance of screening. Furthermore, it is of great importance to emphasize that the optimal preventive effect of aspirin on preterm PE is clearly associated with good compliance to treatment. In conclusion, global implementation of an effective first trimester "screen and prevent" program for preterm PE would provide the opportunity to reduce the risk of both short-term maternal and perinatal morbidity and mortality, with the possibility of intergenerational prevention of future chronic diseases for both the mother and her offspring.

简介：AbstractStillbirth is a devastating pregnancy complication that still affects many women, particularly from low and middle-income countries. It is often labeled as "unexplained" and therefore unpreventable, despite the knowledge that placental dysfunction has been identified as a leading cause of antepartum stillbirth. Currently, screening for pregnancies at high-risk for placental dysfunction relies on checklists of maternal risk factors and serial measurement of symphyseal-fundal height to identify small for gestational age fetuses. More recently, the first-trimester combined screening algorithm developed by the Fetal Medicine Foundation has emerged as a better tool to predict and prevent early-onset placental dysfunction and its main outcomes of preterm preeclampsia, fetal growth restriction and stillbirth by the appropriate use of Aspirin therapy, serial growth scans and induction of labour from 40 weeks for women identified at high-risk by such screening. There is currently no equivalent to predict and prevent late-onset placental dysfunction, although algorithms combining an ultrasound-based estimation of fetal weight, assessment of maternal and fetal Doppler indices, and maternal serum biomarkers show promise as emerging new screening tools to optimize pregnancy monitoring and timing of delivery to prevent stillbirth. In this review we discuss the strategies to predict and prevent stillbirths based on first-trimester screening as well as fetal growth and wellbeing assessment in the second and third trimesters.

简介：Introduction:Frequencydoublingtechnology(FDT)providesascreeningprogramforthedetectionofglaucomatousopticnervedamage.Theexaminationtimeusingthisprogramisveryshort,lessthanoneminutepereye.High-passresolutionperime-try(HRP)isknowntobesensitiveforearlyglaucomadamageandhasbeenreportedtodetectchangeearlier,thanconvention-

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简介：Medicaltherapyfortype2diabetesmellitusisineffectiveinthelongtermduetotheprogressivenatureofthedisease,whichrequiresincreasingmedicationdosesandpolypharmacy.Conversely,bariatricsurgeryhasemergedasacost-effectivestrategyforobesediabeticindividuals;ithaslowcomplicationratesandresultsindurableweightloss,glycemiccontrolandimprovementsinthequalityoflife,obesity-relatedco-morbidityandoverallsurvival.Thefindingthatglucosehomeostasiscanbeachievedwithaweightloss-independentmechanismimmediatelyafterbariatricsurgery,especiallygastricbypass,hasledtotheparadigmofmetabolicsurgery.However,theprimaryfocusofmetabolicsurgeryisthealterationofthephysio-anatomyofthegastrointestinaltracttoachieveglycemiccontrol,metaboliccontrolandcardio-metabolicriskreduction.Todate,metabolicsurgeryisstillnotwelldefined,asitisusedmostfrequentlyforlessobesepatientswithpoorlycontrolleddiabetes.Themechanismofglycemiccontrolisstillincompletelyunderstood.Publishedresearchfindingsonmetabolicsurgeryarepromising,butmanyaspectsstillneedtobedefined.Thispaperexaminestheproposedmechanismofdiabetesremission,theefficacyofdifferenttypesofmetabolicprocedures,thedurabilityofglucosecontrol,andtherisksandcomplicationsassociatedwiththisprocedure.Weproposeatailoredapproachfortheselectionoftheidealmetabolicprocedurefordifferentgroupsofpatients,consideringtheindicationsandprognosticfactorsfordiabetesremission.

简介：Thelengthsofmesocotylintheseedlingsof84lowlandricevarietiesand12uplandricevarietiesweremeasuredfollowingthetreatmentsofdaylightanddarknessduringgermination.Theelongationofmesocotylinthevarietiestestedwasinhibitedunderdaylightcondition,andthemesocotylofallthevarietieselongatedvariablyunderdarknesscondition.Theelongatedlengthsofthemesocotylinuplandrice,rangingfrom0.36cmto1.61cmwithanaverageof0.81cm,wasobviouslylongerthanthoseinlowlandrice,rangingfrom0.12cmto1.56cmwithanaverageof0.42cm.Among14ricevarietieswithover1cmofmesocotyllength,fivebelongedtouplandrice,andninetolowlandrice.Thepossibleutilizationoftheelongated-mesocotylricegermplasminvarietalimprovement,direct-seededplantingandseedpuritytestingwerediscussed.

简介：基于安德森杂质模型和前後一致的途径，我们为在graphene和对系统的电子性质的片刻的影响由电子屏蔽一本地磁性的时刻调查条件。在graphene的一张有限的表上执行的数字计算的结果看那费密精力什么时候在单个占有精力上面并且在本地杂质的双占有精力下面，一个磁性的状态是可能的。在库仑精力U和费密精力跨越的一个参数空格的一张阶段图被获得为杂质的磁性、无磁性的状态区分参数区域。我们发现杂质和有限尺寸的联合效果在有限graphene表的边附近在大费用密度完成结果。状态的密度在被在表的之字形边局部性的边状态的外观引起的迪拉克点展出一座山峰。

简介：Colorectalcancer(CRC)isasignificantcauseofmorbidityandmortalityworldwide.However,coloncancerincidenceandmortalityisdecliningoverthepastdecadeowingtoadoptionofeffectivescreeningprograms.Nevertheless,insomepartsoftheworld,CRCincidenceandmortalityremainontherise,likelyduetofactorsincluding'westernized'diet,lifestyle,andlackofhealth-careinfrastructureandresources.Participationandadherencetodifferentnationalscreeningprogramsremainobstacleslimitingtheachievementofscreeninggoals.Differentmodalitiesareavailablerangingfromstoolbasedteststoradiologyandendoscopywithvaryingsensitivityandspecificity.However,theavailabilityofthesetestsislimitedtoareaswithhigheconomicresources.Recently,FDAapprovedablood-basedtest(Epiprocolon?)forCRCscreening.Thisbloodbasedtestmayservetoincreasetheparticipationandadherencerates.Hence,leadingtoincreaseincoloncancerdetectionandprevention.ThisarticlewilldiscussvariousCRCscreeningtestswithaparticularfocusonthedataregardingthenewapprovedbloodtest.Finally,wewillproposeanalgorithmforasimplecost-effectiveCRCscreeningprogram.