Precision medicine is a novel medical modality based on genome sequencing, bioinformatics and big data science. The studies regarding tuberculosis always concentrated on the bacteria and host in the setting of precision medicine. This review mainly introduces the application of precision medicine in the diagnosis and treatment of tuberculosis. The limits of the Chinese studies with respect to precision medicine in tuberculosis are also discussed. Moreover, the article predicates its future development.
Precision medicine is a personalized medical system based on patients' individual biological information, clinical symptoms and signs, forming a new clinical research model and medical practice path. The basic idea of traditional Chinese medicine and the concept of precision medicine share many similarities. The basket trial developed for precision medicine is also suitable for clinical trials and evaluation of the efficacy of traditional Chinese medicine syndrome differentiation and treatment systems. Basket trials are used to evaluate the efficacy of a drug in the treatment of multiple diseases or disease subtypes. It has the advantages of sharing a master protocol, unifying management of subsidiary studies, simplifying the test implementation process, unifying statistical analysis, saving resources, reducing budgets and accelerating the drug evaluation progress. This is similar to the concept of using the "same treatment for different diseases" found in traditional Chinese medicine. This paper introduced the concept and method of basket trials and explored their application and advantages in clinical research into traditional Chinese medicine. This study is expected to provide references for the methodological innovation of clinical research into traditional Chinese medicine.
In order to promote the responsible development of precision medicine in China, the current situation of precision medicine in three major fields (clinical, research and commercial) was briefly introduced, and key ethical issues or disputes in each field (including informed consent, return of incidental findings, and allocation of medical resources in the clinical field; informed consent, return of research results, and data use and sharing in the research field; genetic counseling, clinical utility of genetic testing, and use of data in the field of direct-to-consumer genetic testing) were discussed. It is necessary to actively meet these ethical challenges for the development of precision medicine in China.
How to accurately identify factors of cancer occurrence and to provide intervention early are the key issues that urgently need to be addressed in cancer prevention and treatment. Mendelian randomization (MR) analysis uses genetic variants as instrument variables for exposures of interest, which compensates the shortcomings of traditional observational studies and clinical trials. This review introduced the current application status of MR analysis in cancer etiology and treatment researches in details, including assessment of cancer risk factors, exploration of cancer treatment targets, and evaluation of drug efficiency and adverse reactions. The scopes and dimensions of cancer etiology and treatment researches are greatly expanded because of various MR designs and abundant high-level omics data. As well, it provides a practical and feasible method for constructing cancer etiology networks and drug targeted databases, which are promising for supporting the development of precision cancer prevention and treatment.
This article introduces the exploration and practice of the “West China Hospital of Sichuan University-Zhenxiong model”, discusses the model of medical precision poverty alleviation work in the new era. Through in office and online service, the counterpart assistance measures will be deeply integrated with the reality of Zhenxiong, to effectively radiate the high-quality medical resources of West China Hospital of Sichuan University to Zhenxiong, and gradually promote the county to form a cross-regional medical alliance of “West China Hospital of Sichuan University + Zhenxiong medical community”, so as to practice the national medical reform policy. It is hoped that through the practice of this model, non-Communist parties can learn from the experience of participating in poverty alleviation.
The prevention and control of hospital infection should be precise. Otherwise, a lot of medical resources will be wasted. To achieve accuracy, prevention and control should be considered from the microbial level to enhance its scientific nature. It is specifically reflected in the need of having knowledge of microorganisms, understanding the pathogens of infection and their transmission routes, therefore to carry out prevention and control work contrapuntally. Specific measures include infection surveillance at the microbial level, establishing the idea and habits of infection diagnosis from the microbial level, being familiar with microbial perspective to identify infection risks and vulnerabilities, implementing evidence-based prevention and control measures for different pathogens, encouraging researches on infection control and management at the microbial level, and developing precise prevention and control regulations, standards, or guidelines for specific pathogens.
The application of precision medicine in the field of tuberculosis is still in its infancy. The precision medicine of tuberculosis cannot be separated from the rapid and accurate diagnosis, the effective anti-tuberculosis drugs, and the comprehensive application of new cutting-edge technologies. In recent years, the precision medicine of tuberculosis has focused on drug-resistant tuberculosis, host-directed therapy and nano-targeted therapy, which has achieved certain results, providing an important mean for the treatment of tuberculosis, especially for the drug-resistant tuberculosis. In the future, the development of new drugs and the application of emerging technologies are the focus of precision medicine of tuberculosis. It is necessary to gradually carry out relevant clinical trial research and objectively evaluate its application value and prospects.
Mixed reality technology is new digital holographic imaging technology that generates three-dimensional simulation images through computers and anchors the virtual images to the real world. Compared with traditional imaging diagnosis and treatment methods, mixed reality technology is more conducive to the advantages of precision medicine, helps to promote the development of medical clinical application, teaching and scientific research in the field of orthopedics, and will further promote the progress of clinical orthopedics toward standardization, digitization and precision. This article briefly introduces the mixed reality technology, reviews its application in the perioperative period, teaching and diagnosis and treatment standardization and dataization in the field of orthopedics, and discusses its technical advantages, aiming to provide a reference for the better use of mixed reality technology in orthopedics.
Breast cancer is one of the most common malignant tumors among women. Typically, the operation of breast cancer should include breast surgery and axillary lymph node surgery since breast cancer first metastasizes to regional axillary lymph nodes. However, postoperative breast cancer-related lymphedema (BCRL) in upper limb is the most common long-term complication. The injury to upper limb lymphatic system contributes to causing the postoperative BCRL. Therefore, precision medicine in the extent of axillary lymph node surgery plays an important role in preventing BCRL which can improve the quality of life in breast cancer patients.
ObjectiveTo evaluate the complete blood count performance quality of Sysmex-XN automatic hematology analyzer.
MethodsWe investigated the precision rate, residual contamination rate, analytic linearity range, and background counting of Sysmex-XN-B3 analyzer.
ResultsThe inner and inter-group precision test showed that the inaccuracy of the analyzer was lower than the allowable standard of 1/4 (CLIA'88). The highest level of residual contamination rate was 0.12%, lower than the standard of manufacturer (≤1%). Linearity evaluation showed that the white blood cell count analytic linear range was from 0.51×109/L to 393.40×109/L, the red blood cell count analytic linear range was from 0.51×1012/L to 8.15×1012/L, the hemoglobin analytic linear range from 15.0 g/L to 244.5 g/L, and the platelet count analytic linear range was from 3.0×109/L to 2 072.5×109/L. Background counting was also lower than the standard of manufacturer. Comparison between the two different series of analyzers showed that the inaccuracy rate of Sysmex-XN-B3 was not only lower than the standard of National Center for Clinical Laboratories, but also lower than the standard of 1/2 (CLIA'88).
ConclusionSysmex-XN automatic hematology analyzer has a high performance in capability evaluation. It is an excellent tool for routine hematologic blood examination.
