Objective To explore a novel method for early lung cancer screening based on exhaled breath analysis. MethodsThis study enrolled patients with suspected pulmonary malignancies and healthy individuals undergoing physical examinations at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine (Qingchun and Qiantang campuses) from September 2023 to June 2024. Enrolled subjects were categorized into a lung cancer group, a benign nodule/tumor group, and a healthy control group. Exhaled breath samples were collected using a sensor array constructed from multiple graphene composite materials to capture breath fingerprints. Based on the collected data, screening and diagnostic models for lung cancer were developed and their performance was evaluated. ResultsA total of 4 580 subjects were included. Among them, 3 195 were pathologically diagnosed with pulmonary malignancies, including 1 394 males and 1 801 females with a mean age of (58.93±12.37) years, 599 were diagnosed with benign nodules/tumors including 339 males and 260 females with a mean age of (57.10±11.06) years, and 786 were healthy controls with no pulmonary nodules detected on chest CT including 420 males and 366 females with a mean age of (29.75±9.32) years. The screening model for high-risk populations (distinguishing patients with lung cancer/high-risk pulmonary nodules from healthy individuals) demonstrated excellent performance, with an area under the receiver operating characteristic curve (AUC) of 0.926. At the optimal Youden’s index (cutoff threshold of 63.5%), the external test set achieved a specificity of 85.2%, a sensitivity of 88.4%, and an accuracy of 86.8%. The diagnostic model (distinguishing patients with lung cancer/premalignant lesions from those with benign pulmonary nodules/healthy individuals) achieved an AUC of 0.818. At its optimal Youden’s index (cutoff threshold of 47.0%), the external test set showed a specificity of 71.7%, a sensitivity of 77.3%, and an accuracy of 74.5%. ConclusionThe non-invasive breath analysis platform based on a sensor array, developed in this study, can achieve rapid and relatively accurate lung cancer screening by analyzing breath fingerprints. This confirms the feasibility of this technology for early lung cancer screening and holds promise for facilitating the early detection and intervention of lung cancer.
ObjectiveTo evaluate the efficacy of single intravitreal injection of C3F8 in treating vitremacular traction (VMT) syndrome.MethodsA retrospective case series of 38 eyes of 36 patients affected with VMT syndrome in Department of Ophthalmology, Central Theater Command General Hospital from March 2016 to June 2017 were enrolled in this study. There were 16 males (16 eyes) and 20 females (22 eyes), with the mean age of 64.11±9.49 years and the mean courses of 151.55±127.87 days. All the patients received an intravitreal injection of 0.3 ml of 100% C3F8 within one week. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. The severity of metamorphopsia was detected using M-charts. The extent of vitreomacular adhesion (VMA), central macular thickness (CMT) and the status of ellipsoid zone (EZ) were assessed with spectral-domain OCT at baseline and each month after treatment. The average BCVA was 0.58±0.22. The mean horizontal metamorphopsia (MH) and vertical metamorphopsia (MV) were 0.34±0.30 and 0.50±0.42, respectively. The mean CMT was 415.15±89.59 μm. The mean horizontal VMA was 1168.68±400.61 μm (30 eyes with VMA≤1500 μm and 8 eyes with VMA＞1500 μm). The mean vertical VMA was 976.89±295.92 μm. There were 22 eyes with integrity EZ and 16 eyes without integrity EZ, 33 eyes with crystalline lens and 5 eyes with IOL. The mean follow-up time was 10.7 months. The differences in BCVA, MH, MV, CMT, the integrity of EZ before and after treatment were analyzed. The VMT release rates were assessed. The Spearman rank correlation analysis was performed to investigate the relationship of VMT release rates with the data at baseline.ResultsVitreomacular traction release occurred in 29 of 38 eyes by the final follow-up visit, the VMT release rate was 76.3%. VMT release occurred and the average time of VMT release occurred was 2.2 weeks. VMT persisted in 7 eyes, in the rest two eyes, one eye developed a retinal detachment and another eye formed macular hole, both eyes responded to vitrectomy. At 6 months after treatment, the average logMAR BCVA was 0.43±0.23, the mean MH and MV were 0.25±0.23 and 0.24±0.23, the mean CMT was 310.61±63.10 μm. Among 16 eyes without integrity EZ before treatment, there were 9 eyes with integrity EZ at 6 months after treatment. There were 16 eyes with integrity EZ and 9 Compared with baseline, the mean BCVA at 6 months after treatment was significantly increased (F=3.779, P=0.037), but the MV (F=4.958, P =0.003) and CMT (F=13.419, P＜0.001) were significantly decreased, the integrity of EZ was improved significantly (χ2=5.050, P=0.025). The VMT release correlated inversely with the extent of horizontal VMA, BCVA, and CMT at baseline (r=-0.514, -0.348, -0.429; P=0.009, 0.001, 0.038).ConclusionIntravitreal injection of C3F8 can induce a posterior vitreous detachment and release vitreomacular traction, it is an efficient and safe treatment for VMT syndrome. It can improve the visual acuity, metamorphopsia and foveal morphology in patients with VMT syndrome.
Objective To compare the outcome of C3F8 versus silicone oil intraocular tamponade after pars plana vitrectomy (PPV) for the treatment of severe highly myopic macular hole retinal detachment (MHRD). Methods Thirty-two highly myopic MHRD patients (32 eyes) with extreme long axial lengths (ge;29.0 mm), quot;severequot; retina pigment epithelium (RPE) and chorioretinal atrophy, and posterior staphyloma who underwent PPV, were enrolled in this study. The patients were divided into two groups according to different intraocular tamponade agents: C3F8 (group A, 15 eyes) and silicone oil (group B, 17 eyes). The patients with retinal re-detachment after surgery received PPV again. The differences of sex (P=1.000), age (t=0.444, P=0.660), best-corrected visual acuity (t=0.084, P=0.934), diopter (t=0.449, P=0.978), lens state (P=1.000), time of the symptoms (t=0.375, P=0.710) and degree of retinal detachment (chi;2=0.014, P=0.907) between group A and B were not statistically significant. The anatomic reattachment of the retina, macular hole closure, and vision acuity were observed at one week, one, three, six and 12 months after surgery. Results The rates of retinal reattachment and macular hole closure were 60.00% and 13.33 % in group A, 82.35% and 29.41% in group B in the first time of surgery. There was no difference in rates of retinal reattachment and macular hole closure between two groups (P=0.243, 0.402). The rates of retinal reattachment and macular hole closure were 86.67% and 20.00% in group A, 94.12% and 29.41% in group B in the second time of surgery. There was no difference in rates of retinal reattachment and macular hole closure between two groups (P=0.589, 0.691). Twelve months after surgery, the vision acuity improved in five eyes, unchanged in seven eyes , and decreased in three eyes in group A; the vision acuity improved in seven eyes , unchanged in eight eyes , and decreased in two eyes in group B. The differences of vision result was not statistically significant between two groups (chi;2=0.209, P=0.647). Conclusion The rates of retinal reattachment and macular hole closure with silicone oil tamponade was higher than that with C3F8 tamponade in eyes with severe highly myopic MHRD, but the differences are not statistically significant.
ObjectiveTo explore the diagnostic value of exhaled volatile organic compounds (VOCs) for cystic fibrosis (CF). MethodsA systematic search was conducted in PubMed, EMbase, Web of Science, Cochrane Library, CNKI, Wanfang, VIP, and SinoMed databases up to August 7, 2024. Studies that met the inclusion criteria were selected for data extraction and quality assessment. The quality of included studies was assessed by the Newcastle-Ottawa Scale (NOS), and the risk of bias and applicability of included prediction model studies were assessed by the prediction model risk of bias assessment tool (PROBAST). ResultsA total of 10 studies were included, among which 5 studies only identified specific exhaled VOCs in CF patients, and another 5 developed 7 CF risk prediction models based on the identification of VOCs in CF. The included studies reported a total of 75 exhaled VOCs, most of which belonged to the categories of acylcarnitines, aldehydes, acids, and esters. Most models (n=6, 85.7%) only included exhaled VOCs as predictive factors, and only one model included factors other than VOCs, including forced expiratory flow at 75% of forced vital capacity (FEF75) and modified Medical Research Council scale for the assessment of dyspnea (mMRC). The accuracy of the models ranged from 77% to 100%, and the area under the receiver operating characteristic curve ranged from 0.771 to 0.988. None of the included studies provided information on the calibration of the models. The results of the Prediction Model Risk of Bias Assessment Tool (PROBAST) showed that the overall bias risk of all predictive model studies was high, and the overall applicability was unclear. ConclusionThe exhaled VOCs reported in the included studies showed significant heterogeneity, and more research is needed to explore specific compounds for CF. In addition, risk prediction models based on exhaled VOCs have certain value in the diagnosis of CF, but the overall bias risk is relatively high and needs further optimization from aspects such as model construction and validation.