RESUMO
Low-dimensional semiconductor-based field-effect transistor (FET) biosensors are promising for label-free detection of biotargets while facing challenges in mass fabrication of devices and reliable reading of small signals. Here, we construct a reliable technology for mass production of semiconducting carbon nanotube (CNT) film and FET biosensors. High-uniformity randomly oriented CNT films were prepared through an improved immersion coating technique, and then, CNT FETs were fabricated with coefficient of performance variations within 6% on 4-in. wafers (within 9% interwafer) based on an industrial standard-level process. The CNT FET-based ion sensors demonstrated threshold voltage standard deviations within 5.1 mV at each ion concentration, enabling direct reading of the concentration information based on the drain current. By integrating bioprobes, we achieved detection of biosignals as low as 100 aM through a plug-and-play portable detection system. The reliable technology will contribute to commercial applications of CNT FET biosensors, especially in point-of-care tests.
Assuntos
Técnicas Biossensoriais , Nanotubos de Carbono , Transistores Eletrônicos , Nanotubos de Carbono/química , Técnicas Biossensoriais/instrumentação , Sistemas Automatizados de Assistência Junto ao Leito , Testes Imediatos , Nanotecnologia/instrumentação , Desenho de EquipamentoRESUMO
BACKGROUND: In the context of the present global aging phenomenon, the senior population and pace of aging in China have emerged as prominent issues on the worldwide stage. Frailty, a complicated condition that is closely linked to the clinical syndrome of advancing age, poses a considerable health risk to older individuals. Frailty status was assessed by the frailty index (FI) ranging from 0 to 1, pre-frailty was defined as >0.10 to <0.25, and frailty was defined as ≥0.25. To look at the connection between modifiable risk factors and frailty progression among individuals in the pre-frailty population. METHODS: Using pre-frailty patients as characterized by the 32-frailty index, the study focused on middle-aged and elderly persons from China and ultimately recruited 5,411 participants for analysis. The relationship between modifiable factors and changes in pre-frailty status throughout follow-up was investigated. Modifiable factors were body mass index (BMI), abdominal obesity, smoking status, alcohol use, and sleep status. We employed logistic regression to examine the relationships between modifiable risk factors and changes in pre-frailty status, as well as the associations between modifiable factors scores and the corresponding pre-frailty progression. Additionally, we generated the modifiable factors scores and examined how these related to modifications in the pre-frailty stage. RESULTS: In this study, after a mean follow-up of 6 years, (OR = 0.59, 95%CI: 0.48-0.71) for BMI ≥ 25 kg/m2 and (OR = 0.74, 95%CI: 0.63-0.89) for concomitant abdominal obesity were significantly associated with lower reversal to a healthy state; (OR = 1.24, 95%CI:1.07-1.44) and (OR = 1.25, 95%CI: 1.10-1.42) for the group that negatively progressed further to frailty were significantly associated with increased frailty progression profile. Subsequently, investigation of modifiable factor scores and changes of pre-frailty status found that as scores increased further, frailty developed (OR = 1.12, 95%CI:1.05-1.18), with scores of 3 and 4 of (OR = 1.38, 95%CI: 1.08-1.77) and (OR = 1.52, 95%CI:1.09-2.14). Finally, we also performed a series of stratified analyses and found that rural unmarried men aged 45 to 60 years with less than a high school degree were more likely to develop a frailty state once they developed abdominal obesity. CONCLUSION: In pre-frailty individuals, maintaining more favorable controllable variables considerably enhances the chance of return to normal and, conversely, increase the risk of progressing to the frailty.
Assuntos
Índice de Massa Corporal , Progressão da Doença , Idoso Fragilizado , Fragilidade , Avaliação Geriátrica , Humanos , Masculino , Fatores de Risco , Fragilidade/epidemiologia , Idoso , Feminino , Pessoa de Meia-Idade , China/epidemiologia , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Modelos Logísticos , Fumar/epidemiologia , Fumar/efeitos adversos , Idoso de 80 Anos ou mais , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/complicações , Sono/fisiologia , Envelhecimento/fisiologiaRESUMO
BACKGROUND: Retroperitoneal liposarcoma (RPLS) is known for its propensity for local recurrence and short survival time. We aimed to identify a credible and specific prognostic biomarker for RPLS. METHODS: Cases from The Cancer Genome Atlas (TCGA) sarcoma dataset were included as the training group. Co-expression modules were constructed using weighted gene co-expression network analysis (WGCNA) to explore associations between modules and survival. Survival analysis of hub genes was performed using the Kaplan-Meier method. In addition, independent external validation was performed on a cohort of 135 Chinese RPLS patients from the REtroperitoneal SArcoma Registry (RESAR) study (NCT03838718). RESULTS: A total of 19 co-expression modules were constructed based on the expression levels of 26,497 RNAs in the TCGA cohort. Among these modules, the green module exhibited a positive correlation with overall survival (OS, p = 0.10) and disease-free survival (DFS, p = 0.06). Gene set enrichment analysis showed that the green module was associated with endocytosis and soft-tissue sarcomas. Survival analysis demonstrated that NINJ1, a hub gene within the green module, was positively associated with OS (p = 0.019) in the TCGA cohort. Moreover, in the validation cohort, patients with higher NINJ1 expression levels displayed a higher probability of survival for both OS (p = 0.023) and DFS (p = 0.012). Multivariable Cox analysis further confirmed the independent prognostic significance of NINJ1. CONCLUSIONS: We here provide a foundation for the establishment of a consensus prognostic biomarker for RPLS, which should not only facilitate medical treatment but also guide the development of novel targeted drugs.
RESUMO
Foodborne diseases caused by Salmonella enterica (S. enterica) and Staphylococcus aureus (S. aureus) significantly impact public health, underscoring the imperative for highly sensitive, rapid, and accurate detection technologies to ensure food safety and prevent human diseases. Nanomaterials hold great promise in the development of high-sensitivity transistor biosensors. In this work, field-effect transistor (FET) comprising high-purity carbon nanotubes (CNTs) were fabricated and modified with corresponding nucleic acid aptamers for the high-affinity and selective capture of S. enterica and S. aureus. The aptamer-functionalized CNT-FET biosensor demonstrated ultra-sensitive and rapid detection of these foodborne pathogens. Experimental results indicated that the biosensor could detect S. enterica at a limit of detection (LOD) as low as 1 CFU in PBS buffer, and S. aureus at an LOD of 1.2 CFUs, achieving single-cell level detection accuracy with exceptional specificity. The biosensor exhibited a rapid response time, completing single detections within 200 s. Even in the presence of interference from six complex food matrices, the biosensor maintained its ultra-sensitive (3.1 CFUs) and rapid response (within 200 s) characteristics for both pathogens. The developed aptamer-functionalized CNT-FET biosensor demonstrates a capability for low-cost, ultra-sensitive, label-free, and rapid detection of low-abundance S. enterica and S. aureus in both buffer solutions and complex environments. This innovation holds significant potential for applying this detection technology to on-site rapid testing scenarios, offering a promising solution to the pressing need for efficient and reliable pathogen monitoring in various settings.
Assuntos
Aptâmeros de Nucleotídeos , Técnicas Biossensoriais , Limite de Detecção , Nanotubos de Carbono , Salmonella enterica , Staphylococcus aureus , Transistores Eletrônicos , Nanotubos de Carbono/química , Salmonella enterica/isolamento & purificação , Staphylococcus aureus/isolamento & purificação , Técnicas Biossensoriais/instrumentação , Aptâmeros de Nucleotídeos/química , Humanos , Microbiologia de Alimentos/instrumentação , Análise de Célula Única/instrumentaçãoRESUMO
The point-of-care diagnosis of acute myocardial infarction (AMI), an extremely lethal disease with only a few hours of golden rescue time, is significant and urgently required. Here, we describe a plug-and-play carbon nanotube field effect transistor (CNT-FET) bio-chip supported with a smart portable readout for ultrasensitive and on-site testing of cardiac troponin I (cTnI), which is one of the most specific and valuable biomarkers of AMI. A modified clustered regularly interspaced short palindromic repeats (CRISPR)/Cas12a system, featuring the G-triplex structured reporter, was first combined with the CNT-FET to realize non-nucleic acid detection. Such a unique CNT-FET biosensor achieved the high sensitivity (LOD: 0.33 fg/mL), which is expected to give timely warning in the early stage of myocardial injury. In addition, a bilayer gate dielectric consisting of Y2O3/HfO2, employed into the passivation process, enabled the high environmental stability and repeatability of CNT-FET. More importantly, the homemade compact chip readout forged a field-deployable cTnI analytical tool, realizing "plasma-to-answer" performance for AMI patients in point-of-care testing scenarios. The developed technology holds promise to help doctors make clinical decisions faster, especially in remote areas.
Assuntos
Técnicas Biossensoriais , Infarto do Miocárdio , Humanos , Sistemas Automatizados de Assistência Junto ao Leito , Sistemas CRISPR-Cas/genética , Troponina I , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/genéticaRESUMO
Retroperitoneal liposarcoma (RLPS) is the main subtype of retroperitoneal soft sarcoma (RSTS) and has a poor prognosis and few treatment options, except for surgery. The proteomic and metabolic profiles of RLPS have remained unclear. The aim of our study was to reveal the metabolic profile of RLPS. Here, we performed proteomic analysis (n = 10), metabolomic analysis (n = 51), and lipidomic analysis (n = 50) of retroperitoneal dedifferentiated liposarcoma (RDDLPS) and retroperitoneal well-differentiated liposarcoma (RWDLPS) tissue and paired adjacent adipose tissue obtained during surgery. Data analysis mainly revealed that glycolysis, purine metabolism, pyrimidine metabolism and phospholipid formation were upregulated in both RDDLPS and RWDLPS tissue compared with the adjacent adipose tissue, whereas the tricarboxylic acid (TCA) cycle, lipid absorption and synthesis, fatty acid degradation and biosynthesis, as well as glycine, serine, and threonine metabolism were downregulated. Of particular importance, the glycolytic inhibitor 2-deoxy-D-glucose and pentose phosphate pathway (PPP) inhibitor RRX-001 significantly promoted the antitumor effects of the MDM2 inhibitor RG7112 and CDK4 inhibitor abemaciclib. Our study not only describes the metabolic profiles of RDDLPS and RWDLPS, but also offers potential therapeutic targets and strategies for RLPS.
Assuntos
Lipossarcoma , Neoplasias Retroperitoneais , Humanos , Neoplasias Retroperitoneais/metabolismo , Lipossarcoma/metabolismo , Masculino , Pessoa de Meia-Idade , Feminino , Proteômica , Metabolômica , Idoso , Metaboloma , Adulto , MultiômicaRESUMO
Continuous glucose monitoring (CGM), which is significant for the daily management of diabetes, requires a low-power-consumption sensor system that can track low nanomolar levels of glucose in physiological fluids, such as sweat and tears. However, traditional electrochemical methods are limited to analytes in micromolar to millimolar ranges and entail high power consumption. Carbon nanotube (CNT) film field-effect transistors (FETs) are promising for constructing extremely sensitive biosensors, but their wide applications in CGM are limited by the strong screening effect of physiological fluids and the zero charge of glucose molecules. In this study, we demonstrate a glucose aptamer-modified CNT FET biosensor to realize a highly sensitive CGM system with sub-nW power consumption by applying a suitable gate voltage. A positive gate voltage can enlarge the effective Debye screening length at the double layer to reduce the local ion population nearby and then improve the sensitivity of the FET-based biosensors by 5 times. We construct CNT FET sensors for CGM with a limit of detection of 0.5 fM, a record dynamic range up to 109, and a power consumption down to â¼100 pW. The proposed field-modulated sensing performance scheme is applicable to other aptamer-based FET biosensors for detecting neutral or less charged molecules and opens opportunities to develop facilely modulated, highly sensitive, low-power, and noninvasive CGM systems.
Assuntos
Técnicas Biossensoriais , Nanotubos de Carbono , Nanotubos de Carbono/química , Glucose , Automonitorização da Glicemia , Glicemia , Técnicas Biossensoriais/métodos , Oligonucleotídeos , Transistores EletrônicosRESUMO
Since the exosomal protein level is related to many diseases, sensitive detection of exosomal protein is highly desirable. Here, we describe a polymer-sorted high-purity semiconducting carbon nanotubes (CNTs) films-based field-effect transistor (FET) biosensor for ultrasensitive and label-free detection of MUC1, a transmembrane protein highly expressed in breast cancer exosomes. Polymer-sorted semiconducting CNTs hold advantages including high purity (>99%), high CNT concentration, and short processing time (<1 h), but they are difficult to be stably functionalized with biomolecules because of lacking hanging bonds on their surface. To solve this issue, poly-lysine (PLL) was employed to modify the CNT films after they were deposited on the sensing channel surface of the fabricated FET chip. To specifically recognize the exosomal protein, sulfhydryl aptamer probes were immobilized on the gold nanoparticles (AuNPs) surface that was assembled on PLL substrate. The aptamer-modified CNT FET was capable of sensitively and selectively detecting exosomal MUC1 as high as 0.34 fg/mL. Moreover, the CNT FET biosensor was able to recognize breast cancer patients from healthy individuals by comparing the expression level of exosomal MUC1. The developed CNT FET biosensor is expected to be a novel assay for early diagnosis of cancer.
Assuntos
Técnicas Biossensoriais , Neoplasias da Mama , Nanopartículas Metálicas , Nanotubos de Carbono , Humanos , Feminino , Ouro/química , Nanotubos de Carbono/química , Nanopartículas Metálicas/química , Proteínas , Neoplasias da Mama/diagnósticoRESUMO
In food safety analysis, the detection and control of foodborne pathogens and their toxins are of great importance. Monitoring of virus transmission is equally important, especially in light of recent findings that coronaviruses have been detected in frozen foods and packages during the current global epidemic of coronavirus disease 2019. In recent years, field-effect transistor (FET) biosensors have attracted considerable scholarly attention for pathogenic microorganisms and toxins detection and sensing due to their rapid response time, high sensitivity, wide dynamic range, high specificity, label-free detection, portability, and cost-effectiveness. FET-based biosensors can be modified with specific recognition elements, thus providing real-time qualitative and semiquantitative analysis. Furthermore, with advances in nanotechnology and device design, various high-performance nanomaterials are gradually applied in the detection of FET-based biosensors. In this article, we review specific detection in different biological recognition elements are immobilized on FET biosensors for the detection of pathogenic microorganisms and toxins, and we also discuss nonspecific detection by FET biosensors. In addition, there are still unresolved challenges in the development and application of FET biosensors for achieving efficient, multiplexed, in situ detection of pathogenic microorganisms and toxins. Therefore, directions for future FET biosensor research and applications are discussed.
RESUMO
Semiconducting carbon nanotube (CNT) film is a promising material for constructing high-performance complementary metal-oxide-semiconductor (CMOS) integrated circuits (ICs) and highly sensitive field-effect transistor (FET) bio/chemical sensors. Moreover, CNT logic transistors and sensors can be integrated through a compatible low-temperature fabrication process, providing enough thermal budget to construct monolithic three-dimensional (M3D) systems for smart sensors. However, an M3D sensing chip based on CNT film has not yet been demonstrated. In this work, we develop M3D technology to fabricate CNT CMOS ICs and CNT sensor arrays in two different layers; then, we demonstrate a preliminary M3D sensing system comprising CNT CMOS interfacing ICs in the bottom layer and CNT sensors in the upper layer through interlayer vias as links. As a typical example, a highly sensitive hydrogen sensing IC has been demonstrated to perform in situ sensing and processing functions through upper-layer FET-based hydrogen sensors exposed to the environment and bottom-layer CNT CMOS voltage-controlled oscillator (VCO) interfacing circuits. The M3D CNT sensing ICs convert hydrogen concentration information (8-128 ppm) to digital frequency information (0.78-1.11 GHz) with a sensitivity of 2.75 MHz/ppm. M3D sensing technology is expected to provide a universal sensing system for future smart sensing chips, including multitarget detection and ultralow power sensors.
RESUMO
The rapid and sensitive detection of trace-level viruses in a simple and reliable way is of great importance for epidemic prevention and control. Here, a multi-functionalized floating gate carbon nanotube field effect transistor (FG-CNT FET) based biosensor is reported for the single virus level detection of SARS-CoV-2 virus antigen and RNA rapidly with a portable sensing platform. The aptamers functionalized sensors can detect SARS-CoV-2 antigens from unprocessed nasopharyngeal swab samples within 1 min. Meanwhile, enhanced by a multi-probe strategy, the FG-CNT FET-based biosensor can detect the long chain RNA directly without amplification down to single virus level within 1 min. The device, constructed with packaged sensor chips and a portable sensing terminal, can distinguish 10 COVID-19 patients from 10 healthy individuals in clinical tests both by the RNAs and antigens by a combination detection strategy with an combined overall percent agreement (OPA) close to 100%. The results provide a general and simple method to enhance the sensitivity of FET-based biochemical sensors for the detection of nucleic acid molecules and demonstrate that the CNT FG FET biosensor is a versatile and reliable integrated platform for ultrasensitive multibiomarker detection without amplification and has great potential for point-of-care (POC) clinical tests.
Assuntos
Técnicas Biossensoriais , COVID-19 , Nanotubos de Carbono , Humanos , SARS-CoV-2 , COVID-19/diagnóstico , Nanotubos de Carbono/química , Técnicas Biossensoriais/métodosRESUMO
Epitaxial growth and controllable doping of wafer-scale atomically thin semiconductor single crystals are two central tasks to tackle the scaling challenge of transistors. Despite considerable efforts are devoted, addressing such crucial issues simultaneously under 2D confinement is yet to be realized. Here, an ingenious strategy to synthesize record-breaking 4 in. length Fe-doped transition-metal dichalcogenides (TMDCs) single crystals on industry-compatible c-plane sapphire without special miscut angle is designed. Atomically thin transistors with high electron mobility (≈146 cm2 V-1 s-1 ) and remarkable on/off current ratio (≈109 ) are fabricated based on 4 in. length Fe-MoS2 single crystals, due to the ultralow contact resistance (≈489 Ω µm). In-depth characterizations and theoretical calculations reveal that the introduction of Fe significantly decreases the formation energy of parallel steps on sapphire surfaces and contributes to the edge-nucleation of unidirectional alignment TMDCs domains (>99%). This work represents a substantial leap in terms of bridging synthesis and doping of wafer-scale 2D semiconductor single crystals, which should promote the further device downscaling and extension of Moore's law.
RESUMO
Blood-based tests have sparked tremendous attention in non-invasive early diagnosis of Alzheimer's disease (AD), a most prevalent neurodegenerative malady worldwide. Despite significant progress in the methodologies for detecting AD core biomarkers such as Aß42 from serum/plasma, there remains cautious optimism going forward due to its controversial diagnostic value and disease relevance. Here, a graphene electrolyte-gated transistor biosensor is reported for the detection of serum neuron-derived exosomal Aß42 (NDE-Aß42), which is an emerging, compelling trove of blood biomarker for AD. Assisted by the antifouling strategy with the dual-blocking process, the noise against complex biological background was considerably reduced, forging an impressive sensitivity gain with a limit of detection of 447 ag/mL. An accurate detection of SH-SY5Y-derived exosomal Aß42 was also achieved with highly conformable enzyme-linked immunosorbent assay results. Importantly, the clinical analysis for 27 subjects revealed the immense diagnostic value of NDE-Aß42, which can outclass that of serum Aß42. The developed electronic assay demonstrates, for the first time, nanosensor-driven NDE-Aß42 detection, which enables a reliable discrimination of AD patients from non-AD individuals and even the differential diagnosis between AD and vascular dementia patients, with an accuracy of 100% and a Youden index of 1. This NDE-Aß42 biosensor defines a robust approach for blood-based confident AD ascertain.
Assuntos
Doença de Alzheimer , Grafite , Neuroblastoma , Humanos , Doença de Alzheimer/diagnóstico , Peptídeos beta-Amiloides , Neurônios , Biomarcadores , Fragmentos de Peptídeos , Proteínas tauRESUMO
The development of biosensors based on field-effect transistors (FETs) using atomically thick carbon nanotubes (CNTs) as a channel material has the potential to revolutionize the related field due to their small size, high sensitivity, label-free detection, and real-time monitoring capabilities. Despite extensive research efforts to improve the sensitivity, selectivity, and practicality of CNT FET-based biosensors, their commercialization has not yet been achieved due to the non-uniform and unstable device performance, difficulties in their fabrication, the immaturity of sensor packaging processes, and a lack of reliable modification methods. This review article focuses on the practical applications of CNT-based FET biosensors for the detection of ultra-low concentrations of biologically relevant molecules. We discuss the various factors that affect the sensors' performance in terms of materials, device architecture, and sensor packaging, highlighting the need for a robust commercial process that prioritizes product performance. Additionally, we review recent advances in the application of CNT FET biosensors for the ultra-sensitive detection of various biomarkers. Finally, we examine the key obstacles that currently hinder the large-scale deployment of these biosensors, aiming to identify the challenges that must be addressed for the future industrialization of CNT FET sensors.
Assuntos
Técnicas Biossensoriais , Nanotubos de Carbono , Biomarcadores , Técnicas Biossensoriais/métodos , Transistores EletrônicosRESUMO
Staphylococcal enterotoxin C (SEC) is an enterotoxin produced by Staphylococcus aureus, which can cause intestinal diseases. Therefore, it is of great significance to develop a sensitive detection method for SEC to ensure food safety and prevent foodborne diseases in humans. A field-effect transistor (FET) based on high-purity carbon nanotubes (CNTs) was used as a transducer, and a nucleic acid aptamer with high affinity was used for recognition to capture the target. The results indicated that the biosensor achieved an ultra-low theoretical detection limit of 1.25 fg/mL in PBS, and its good specificity was verified by detecting target analogs. Three typical food homogenates were used as the solution to be measured to verify that the biosensor had a swift response time (within 5 min after sample addition). An additional study with a more significant basa fish sample response also showed excellent sensitivity (theoretical detection limit of 8.15 fg/mL) and a stable detection ratio. In summary, this CNT-FET biosensor enabled the label-free, ultra-sensitive, and fast detection of SEC in complex samples. The FET biosensors could be further used as a universal biosensor platform for the ultrasensitive detection of multiple biological toxic pollutants, thus considerably stopping the spread of harmful substances.
Assuntos
Técnicas Biossensoriais , Nanotubos de Carbono , Humanos , Animais , Enterotoxinas , Alimentos , Staphylococcus aureus , Técnicas Biossensoriais/métodosRESUMO
Sarcopenia is a progressive skeletal muscle disorder involving the loss of muscle mass and function, associated with an increased risk of disability and frailty. Though its prevalence in dementia has been studied, its occurrence in mild cognitive impairment (MCI) has not been well established. As MCI is often a prelude to dementia, our study aims to investigate the prevalence of MCI among individuals with sarcopenia and to also ascertain whether sarcopenia is independently associated with MCI. The Cochrane Library, PubMed, Ovid, Embase and Web of Science were systematically searched for articles on MCI and/or sarcopenia published from inception to 1 February 2022. We reviewed the available literature on the number of individuals with MCI and/or sarcopenia and calculated odds ratios (ORs) of sarcopenia in MCI and MCI in sarcopenia, respectively. Statistical analyses were performed using the meta package in Stata, Version 12.0. A total of 13 studies and 27 428 patients were included in our analysis. The pooled prevalence of MCI in participants with sarcopenia was 20.5% (95% confidence interval [CI]: 0.140-0.269) in a total sample of 2923 cases with a high level of heterogeneity (P < 0.001; I2 = 95.4%). The overall prevalence of sarcopenia with MCI was 9.1% (95% CI: 0.047-0.134, P < 0.001; I2 = 93.0%). For overall ORs, there were 23 364 subjects with a mean age of 73 years; the overall adjusted OR between MCI and sarcopenia was 1.46 (95% CI: 1.31-1.62). Slight heterogeneity in both adjusted ORs (P = 0.46; I2 = 0%) was noted across the studies. The prevalence of MCI is relatively high in patients with sarcopenia, and sarcopenia may be a risk factor for MCI.
Assuntos
Disfunção Cognitiva , Demência , Sarcopenia , Humanos , Idoso , Sarcopenia/epidemiologia , Sarcopenia/complicações , Prevalência , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/complicações , Fatores de Risco , Demência/complicaçõesRESUMO
BACKGROUND: Neoadjuvant radiotherapy (NRT) for resectable retroperitoneal sarcoma (RPS) has been shown to be systematically feasible. Whether NRT has equivalent or better clinical effects compared to surgery alone for RPS patients remains controversial. METHODS: We performed a systematic literature search of PubMed, Web of Science, Embase, ASCO Abstracts, and Cochrane library databases for studies in humans with defined search terms. Articles were independently assessed by 2 reviewers, and only randomized controlled trials and cohort studies were included. The hazard ratios (HRs) of overall survival (OS), recurrence-free survival (RFS), and local recurrence (LR) were extracted from included studies. Heterogeneity among study-specific HRs was assessed by the Q statistic and I2 statistic. Overall HR was assessed by random-effects or fixed-effects models. Publication bias was tested by Begg's tests, and the quality of each study was assessed with the Newcastle Ottawa Scale. RESULTS: A total of 12 eligible studies with 7778 resectable RPS patients were finally included in this study. The pooled analysis revealed the distinct advantages of NRT as compared to surgery alone, including longer OS (HR = 0.81, P < 0.001), longer RFS (HR = 0.58, P = 0.04), and lower LR (HR = 0.70, P = 0.03). No evidence of publication bias was observed. CONCLUSION: NRT is likely to be beneficial for resectable RPS patients in terms of OS and RFS. However, more multicenter clinical trials are needed to confirm these findings.
Assuntos
Neoplasias Retroperitoneais , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Estudos Multicêntricos como Assunto , Terapia Neoadjuvante , Neoplasias Retroperitoneais/radioterapia , Neoplasias Retroperitoneais/cirurgia , Sarcoma/radioterapia , Sarcoma/cirurgiaRESUMO
BACKGROUND: Studies have reported frailty as an independent risk factor of mortality in patients with inflammatory bowel disease (IBD). However, no systematic review and meta-analysis has been conducted to determine the relationship of frailty and IBD. We aimed to investigate the prevalence of frailty in patients with IBD and the impact of frailty on the clinical prognosis of these patients. METHODS: We systematically searched PubMed, Ovid (Medline), Embase, Web of Science, and Cochrane Library from database inception until October 2022. This systematic review included observational studies describing IBD and frailty. We performed meta-analysis for the frailty prevalence in patients with IBD. We analyzed primary outcomes (mortality) and secondary outcomes (infections, hospitalizations, readmission, and IBD-related surgery). RESULTS: Nine studies with a total of 1,495,695 participants were included in our meta-analysis. The prevalence of frailty was 18% in patients with IBD. The combined effect analysis showed that frail patients with IBD had a higher risk of mortality (adjusted hazard ratio = 2.25, 95% confidence interval: 1.11-4.55) than non-frail patients with IBD. The hazard ratio for infections (HR = 1.23, 0.94-1.60), hospitalizations (HR = 1.72, 0.88-3.36), readmission (HR = 1.21, 1.17-1.25) and IBD-related surgery (HR = 0.78, 0.66-0.91) in frail patients with IBD. CONCLUSIONS: We demonstrated that frailty is a significant independent predictor of mortality in patients with IBD. Our work supports the importance of implementing frailty screening upon admission in patients with IBD. More prospective studies are needed to investigate the influence of frailty on patients with IBD and improve the poor prognosis of patients with frailty and IBD.
Assuntos
Fragilidade , Doenças Inflamatórias Intestinais , Humanos , Idoso , Fragilidade/epidemiologia , Fragilidade/diagnóstico , Idoso Fragilizado , Prevalência , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/epidemiologia , Fatores de RiscoRESUMO
The path toward field-effect transistor (FET) application from laboratory to clinic has delivered a compelling push in the biomedical domain, yet ultrasensitive and timely pathogen identification without PCR remains a long-lasting challenge. Herein, we create a generic check station termed "CRISPR-FET", first incorporating the CRISPR/Cas13a system within the FET modality, for accelerated and unamplified detection of viral RNA. Unlike conventional FETs bearing target-specific receptors, this sensor holds three unique advancements: (i) an ingenious sensing mechanism is used, which converts the signal of a large-sized analyte into an on-chip cleavage response of an immobilized CRISPR reporter, enabling signal generation events to occur all within the Debye length; (ii) the multipurpose inspection of the CoV ORF1ab, CoV N gene, and HCV RNA unveils the potential for "one-for-all" scalable FET-based molecular diagnostics; and (iii) it is shown that Cas13a-crRNAs targeting different sites of the viral genome can be deployed in tandem to amplify the FET response, empowering the detection limit down to 1.56 aM, which is a world-record level of sensitivity in the FET for direct viral gene sensing. Notably, a brilliant clinical applicability was made in distinguishing HCV-infected patients from normal controls. Overall, this study sheds new insights into FET-based nucleic acid sensing technology and invokes a vision for its possible future roles in diagnosis of various viral diseases.