Volume 134 · Issue 07 · 2021

Reviving patients with prolonged disorders of consciousness (DOCs) has always been focused and challenging in medical research. Owing to the limited effectiveness of available medicine, recent research has increasingly turned towards neuromodulatory therapies, involving the stimulation of neural circuits. We summarised the progression of research regarding neuromodulatory therapies in the field of DOCs, compared the differences among different studies, in an attempt to explore optimal stimulation patterns and parameters, and analyzed the major limitations of the relevant studies to facilitate future research.

We performed a search in the PubMed database, using the concepts of DOCs and neuromodulation. Inclusion criteria were: articles in English, published after 2002, and reporting clinical trials of neuromodulatory therapies in human patients with DOCs.

Overall, 187 published articles met the search criteria, and 60 articles met the inclusion criteria. There are differences among these studies regarding the clinical efficacies of neurostimulation techniques for patients with DOCs, and large-sample studies are still lacking.

Neuromodulatory techniques were used as trial therapies for DOCs wherein their curative effects were controversial. The difficulties in detecting residual consciousness, the confounding effect between the natural course of the disease and therapeutic effect, and the heterogeneity across patients are the major limitations. Large-sample, well-designed studies, and innovations for both treatment and assessment are anticipated in future research.

慢性肝病（CLD）每年导致约214万（2.06-2.30）人死亡；因此，代表着沉重的全球健康负担。^[1]目前，慢性乙型肝炎（CHB）、丙型肝炎、酒精相关肝病和非酒精性肝病（NAFLD）分别占全球肝硬化相关死亡的29%、26%、25%和9%。^[1]尽管疫苗接种降低了乙型肝炎表面抗原的血清流行率和肝脏相关死亡率的总体流行率，但CHB仍然是肝病的主要原因，尤其是在中国。^[2]然而，近年来，无论是在中国还是在世界范围内，NAFLD的患病率都急剧上升。此外，丙型肝炎病毒（HCV）炎症相关肝纤维化的评估对于CLD的管理和预后是重要的。尽管肝活检可用于同时评估患者的炎症特征和纤维化评分，但其侵入性和相对较高的采样错误频率阻碍了其在常规临床实践中的重复使用。循环生物标志物被认为是反映肝脏炎症和纤维化严重程度的有吸引力且负担得起的替代物。

在世界范围内，肺癌是最常见的恶性肿瘤，也是癌症相关死亡的主要原因。在经历了化疗、放疗、分子靶向治疗时代后，晚期肺癌的治疗进入了以免疫检查点抑制剂（ICIs）为代表的免疫治疗新时代，包括程序性细胞死亡蛋白-1/程序性细胞死亡蛋白配体-1（PD-1/PD-L1）抑制剂和细胞毒性T淋巴细胞相关抗原-4（CTLA-4）抑制剂。^[1]然而，接受ICIs治疗的患者可能会出现意外的全身毒性，有些是致命的。因此，管理免疫疗法相关毒性在肺癌患者中变得越来越重要。在此，我们就肺癌患者免疫治疗相关毒性的临床特征和处理的最新进展进行综述，以促进肺癌免疫治疗的规范化。

Cancer is one of the leading causes of death globally, but its burden is not uniform. GLOBOCAN 2020 has newly updated the estimates of cancer burden. This study summarizes the most recent changing profiles of cancer burden worldwide and in China and compares the cancer data of China with those of other regions.

We conducted a descriptive secondary analysis of the GLOBOCAN 2020 data. To depict the changing global profile of the leading cancer types in 2020 compared with 2018, we extracted the numbers of cases and deaths in 2018 from GLOBOCAN 2018. We also obtained cancer incidence and mortality from the 2015 National Cancer Registry Report in China when sorting the leading cancer types by new cases and deaths. For the leading cancer types according to sex in China, we summarized the estimated numbers of incidence and mortality, and calculated China’s percentage of the global new cases and deaths.

Breast cancer displaced lung cancer to become the most leading diagnosed cancer worldwide in 2020. Lung, liver, stomach, breast, and colon cancers were the top five leading causes of cancer-related death, among which liver cancer changed from the third-highest cancer mortality in 2018 to the second-highest in 2020. China accounted for 24% of newly diagnosed cases and 30% of the cancer-related deaths worldwide in 2020. Among the 185 countries included in the database, China’s age-standardized incidence rate (204.8 per 100,000) ranked 65th and the age-standardized mortality rate (129.4 per 100,000) ranked 13th. The two rates were above the global average. Lung cancer remained the most common cancer type and the leading cause of cancer death in China. However, breast cancer became the most frequent cancer type among women if the incidence was stratified by sex. Incidences of colorectal cancer and breast cancer increased rapidly. The leading causes of cancer death varied minimally in ranking from 2015 to 2020 in China. Gastrointestinal cancers, including stomach, colorectal, liver, and esophageal cancers, contributed to a massive burden of cancer for both sexes.

The burden of breast cancer is increasing globally. China is undergoing cancer transition with an increasing burden of lung cancer, gastrointestinal cancer, and breast cancers. The mortality rate of cancer in China is high. Comprehensive strategies are urgently needed to target China’s changing profiles of the cancer burden.

Norepinephrine infusion decreases hypotension after spinal anesthesia during cesarean section. This study aimed to compare the efficacy of norepinephrine infusion and ephedrine bolus against post-spinal hypotension in parturients.

In this double-blinded, randomized controlled clinical trial, parturients scheduled for elective cesarean section were randomly allocated to receive norepinephrine infusion (0.05 μg·kg^-1·min^-1) just before spinal anesthesia continuing for 30 min or ephedrine bolus (0.15 mg/kg) just before spinal anesthesia. A rescue bolus (5 μg norepinephrine for the norepinephrine group, and 5 mg ephedrine for the ephedrine group) was administered whenever hypotension occurred. Our primary outcome was the incidence of hypotension within 30 min of spinal anesthesia administration. Secondary outcomes included maternal and neonatal outcomes 30 min after spinal block, and neonatal cerebral oxygenation 10 min after birth.

In total, 190 patients were enrolled; of these patients, 177 were included in the final analysis. Fewer patients suffered hypotension in the norepinephrine group than in the ephedrine group (29.5% vs. 44.9%, odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.28-0.95, P = 0.034). Moreover, the tachycardia frequency was lower in the norepinephrine group than in the ephedrine group (OR: 0.22, 95% CI: 0.11-0.44, P < 0.001), and patients suffered less nausea and vomiting (OR: 0.28, 95% CI: 0.11-0.70, P = 0.004). There was no difference in Apgar scores and umbilical arterial blood gas analysis between the two groups. However, neonatal cerebral regional saturations were significantly higher after birth in the norepinephrine group than in the ephedrine group (mean difference: 2.0%, 95% CI: 0.55%-3.45%, P = 0.008).

In patients undergoing elective cesarean section with spinal anesthesia, norepinephrine infusion compared to ephedrine bolus resulted in less hypotension and tachycardia, and exhibited potential neonatal benefits.

ClinicalTrials.gov, NCT02542748; https://clinicaltrials.gov/ct2/show/record/NCT02542748

It is currently unknown whether patients with a fever after controlled ovulation during egg retrieval could increase the risk of pelvic infection or not, and fever itself may affect endometrial receptivity or embryo quality with poor pregnancy outcomes. The aim of this study was to analyze the outcomes of patients with fever during oocyte retrieval after the first frozen-thawed embryo transfer (FET) cycle.

This was a 1:3 retrospective paired study matched for age. In this study, 58 infertility patients (Group 1) had a fever during the control ovulation, and the time of the oocyte retrieval was within 72 hours, they underwent ovum pick up and whole embryo freezing ( "freeze-all" strategy). The control subjects (Group 2) are 174 patients matched for age who underwent whole embryo freezing for other reasons. The baseline characteristics, clinical data of ovarian stimulation, and outcomes, such as the clinical pregnancy rate, ongoing clinical pregnancy rate were compared between the two groups in the subsequent FET cycle.

All patients had no pelvic inflammatory disease after oocyte retrieval. Anti-Mullerian hormone (AMH) levels (4.2 vs. 2.2, P <0.001) were higher in group 2, and the number of oocytes retrieved, and fertilization rate were lower in group 1 (P < 0.001), but the endometrial thickness, the number of embryo transfers, and the type of luteal support supplementation were similar between the two groups. Regarding pregnancy outcomes in the subsequent FET cycle, the implantation rate, clinical pregnancy rate, early spontaneous rate, ectopic pregnancy rate, and ongoing pregnancy rate were all not significantly different. Further regression analyses showed that the clinical pregnancy rate and ongoing pregnancy rate were also not significantly different.

Transvaginal ultrasound-guided follicular puncture for oocyte retrieval is a safe and minimally invasive method for patients with fever. Moreover, the fever had almost no effect on embryo quality.

Mastectomy techniques have been extended to nipple-sparing mastectomy (NSM). This study aimed to assess the actual application of NSM in China and identify the factors influencing postoperative complications.

The clinical data of 615 patients (641 surgeries) undergoing NSM from January 1st, 2018 to December 31st, 2018 at 28 centers nationwide were retrospectively analyzed to obtain the rate of NSM and investigate factors related to NSM surgery.

The proportion of NSM surgery performed in this study was 2.67% (17/641). Malignant breast tumors accounted for the majority of NSM surgery (559/641, 87.2%). A total of 475 (77.3%) patients underwent NSM combined with reconstructive surgery. The rate of reconstruction decreased with age in our study, and implants were the most common option (344/641, 53.7%) in reconstruction. Radial incision was the most selected method regardless of reconstruction. However, for those who underwent reconstruction surgery, 18.4% (85/462) of cases also chose curvilinear incision, while in the simple NSM surgery group, more patients chose circumareolar incision (26/136, 19.1%). The tumor-to-nipple distance (TND) influenced postoperative complications (P = 0.004). There were no relationships between postoperative complications and tumor size, tumor location, histologic grade, molecular subtype, nipple discharge, and axillary lymph nodes.

NSM surgery is feasible and only TND influenced postoperative complications of NSM surgery. But the proportion of NSM surgery performed is still low in nationwide centers of China. The selection criteria for appropriate surgical methods are important for NSM in clinical practice. To optimize clinical applications of NSM, further multicenter prospective randomized controlled studies are needed.

ChiCTR.org.cn, ChiCTR1900027423; http://www.chictr.org.cn/showprojen.aspx?proj=38739

Vitamin D deficiency has been reported to be associated with diabetic microvascular complications, but previous studies have only focused on the relationship between vitamin D and specific complications. Therefore, we aimed to explore the relationship between vitamin D level and diabetic microvascular complications in general, including diabetic retinopathy (DR), diabetic nephropathy (DN), and diabetic peripheral neuropathy (DPN).

This was a cross-sectional study of 815 patients with type 2 diabetes mellitus (T2DM). Clinical information and laboratory results were collected from the medical records. The relationship between vitamin D and the three diabetic microvascular complications was investigated.

The serum 25-hydroxyvitamin D (25 [OH] D) level of patients with DPN and/or DN was significantly lower than that of T2DM patients without any microvascular complications (P < 0.01). Univariate analysis showed that the 25 (OH) D level was related to DPN and DN, but not DR. After adjustment, the 25 (OH) D level was confirmed to be an independent protective factor for DPN (odds ratio [OR]: 0.968, P = 0.004]) and DN (OR: 0.962, P = 0.006). The prevalence of DPN and DN increased significantly as the serum 25 (OH) D levels decreased. Furthermore, patients with both DPN and DN had the lowest concentration of serum 25 (OH) D (P < 0.001), and the prevalence of macroalbuminuria increased more abruptly than that of microalbuminuria across the 25 (OH) D tertiles. Among the patients with vitamin D insufficiency, those with DPN presented more comorbid macroalbuminuria than those without DPN (15.32% vs. 4.91%; P = 0.001).

Vitamin D deficiency is independently associated with higher risk of DPN and DN, but not DR, in T2DM patients. Further, it may be a potential predictor for both the occurrence and severity of DPN and DN.

Colorectal cancer is harmful to the patient’s life. The treatment of patients is determined by accurate preoperative staging. Magnetic resonance imaging (MRI) played an important role in the preoperative examination of patients with rectal cancer, and artificial intelligence (AI) in the learning of images made significant achievements in recent years. Introducing AI into MRI recognition, a stable platform for image recognition and judgment can be established in a short period. This study aimed to establish an automatic diagnostic platform for predicting preoperative T staging of rectal cancer through a deep neural network.

A total of 183 rectal cancer patients’ data were collected retrospectively as research objects. Faster region-based convolutional neural networks (Faster R-CNN) were used to build the platform. And the platform was evaluated according to the receiver operating characteristic (ROC) curve.

An automatic diagnosis platform for T staging of rectal cancer was established through the study of MRI. The areas under the ROC curve (AUC) were 0.99 in the horizontal plane, 0.97 in the sagittal plane, and 0.98 in the coronal plane. In the horizontal plane, the AUC of T1 stage was 1, AUC of T2 stage was 1, AUC of T3 stage was 1, AUC of T4 stage was 1. In the coronal plane, AUC of T1 stage was 0.96, AUC of T2 stage was 0.97, AUC of T3 stage was 0.97, AUC of T4 stage was 0.97. In the sagittal plane, AUC of T1 stage was 0.95, AUC of T2 stage was 0.99, AUC of T3 stage was 0.96, and AUC of T4 stage was 1.00.

Faster R-CNN AI might be an effective and objective method to build the platform for predicting rectal cancer T-staging.

chictr.org.cn: ChiCTR1900023575; http://www.chictr.org.cn/showproj.aspx?proj=39665.

MicroRNAs are closely associated with the progression and outcomes of multiple human diseases, including sepsis. In this study, we examined the role of miR-23a in septic injury.

Lipopolysaccharide (LPS) was used to induce sepsis in a rat model and H9C2 and HK-2 cells. miR-23a expression was evaluated in rat myocardial and kidney tissues, as well as H9C2 and HK-2 cells. A miR-23a mimic was introduced into cells to identify the role of miR-23a in cell viability, apoptosis, and the secretion of inflammatory cytokines. Furthermore, the effect of Rho-associated kinase 1 (ROCK1), a miR-23a target, on cell damage was evaluated, and molecules involved in the underlying mechanism were identified.

In the rat model, miR-23a was poorly expressed in myocardial (sham vs. sepsis 1.00 ± 0.06 vs. 0.27 ± 0.03, P < 0.01) and kidney tissues (sham vs. sepsis 0.27 ± 0.03 vs. 1.00 ± 0.06, P < 0.01). Artificial overexpression of miR-23a resulted in increased proliferative activity (DNA replication rate: Control vs. LPS vs. LPS + Mock vs. LPS + miR-23a: H9C2 cells: 34.13 ± 3.12 vs. 12.94 ± 1.21 vs. 13.31 ± 1.43 vs. 22.94 ± 2.26, P < 0.05; HK-2 cells: 15.17 ± 1.43 vs. 34.52 ± 3.46 vs. 35.19 ± 3.12 vs. 19.87 ± 1.52, P < 0.05), decreased cell apoptosis (Control vs. LPS vs. LPS + Mock vs. LPS + miR-23a: H9C2 cells: 11.39 ± 1.04 vs. 32.57 ± 2.29 vs. 33.08 ± 3.12 vs. 21.63 ± 2.35, P < 0.05; HK-2 cells: 15.17 ± 1.43 vs. 34.52 ± 3.46 vs. 35.19 ± 3.12 vs. 19.87 ± 1.52, P < 0.05), and decreased production of inflammatory cytokines, including interleukin-6 (Control vs. LPS vs. LPS + Mock vs. LPS + miR-23a: H9C2 cells: 59.61 ± 5.14 vs. 113.54 ± 12.30 vs. 116.51 ± 10.69 vs. 87.69 ± 2.97 ng/mL; P < 0.05, F = 12.67, HK-2 cells: 68.12 ± 6.44 vs. 139.65 ± 16.62 vs. 143.51 ± 13.64 vs. 100.82 ± 9.74 ng/mL, P < 0.05, F = 9.83) and tumor necrosis factor-α (Control vs. LPS vs. LPS + Mock vs. LPS + miR-23a: H9C2 cells: 103.20 ± 10.31 vs. 169.67 ± 18.84 vs. 173.61 ± 15.91 vs. 133.36 ± 12.32 ng/mL, P < 0.05, F = 12.67, HK-2 cells: 132.51 ± 13.37 vs. 187.47 ± 16.74 vs. 143.51 ± 13.64 vs. 155.79 ± 15.31 ng/mL, P < 0.05, F = 9.83) in cells. However, ROCK1 was identified as a miR-23a target, and further up-regulation of ROCK1 mitigated the protective function of miR-23a in LPS-treated H9C2 and HK-2 cells. Moreover, ROCK1 suppressed sirtuin-1 (SIRT1) expression to promote the phosphorylation of nuclear factor-kappa B (NF-κB) p65, indicating the possible involvement of this signaling pathway in miR-23a-mediated events.

Our results indicate that miR-23a could suppress LPS-induced cell damage and inflammatory cytokine secretion by binding to ROCK1, mediated through the potential participation of the SIRT1/NF-κB signaling pathway.

家族性高胆固醇血症（FH）是一种常见的常染色体显性脂质代谢紊乱。低密度脂蛋白受体基因突变（LDLR）代表了大多数FH病例。LDLR突变是共显性遗传。通常，与杂合突变相关的临床表型相对较轻，而纯合突变、复合杂合突变和双基因突变LDLR导致严重的表型。然而，一些杂合子FH（HeFH）和纯合子FH（HoFH）患者具有相似的脂质水平。由于这些患者的预后和治疗方法差异很大，准确的诊断尤为重要。基因检测在FH的诊断中起着至关重要的作用，但通过基因检测找到合适的突变并不总是简单的。

为了解决皮肤移植后颜色、质地不匹配和感觉缺失的问题，Brent于1980年将组织扩张技术应用于小耳畸形重建。最近，来自中国和韩国的几个小组报告了他们成功的软组织扩张技术在小耳畸形重建中的经验，效果良好，并发症发生率低。^[1]其中一个关键问题是扩张后是否有足够的皮肤。不幸的是，这个问题可能只能通过经验丰富的外科医生的经验判断来回答。在本文中，作者介绍了一种新的客观定量测量系统的初步结果，该系统使用三维（3D）表面扫描技术来帮助外科医生用组织扩张技术重建小耳畸形。

尽管抗逆转录病毒疗法（ART）在抑制人类免疫缺陷病毒1型（HIV-1）复制方面是有效的，但HIV-1感染仍然是一个全球性的公共卫生问题。HIV-1辅助蛋白病毒蛋白R（Vpr）是一种多功能蛋白，在调节细胞凋亡中起主要作用。^[1]Vpr C末端的氨基酸（aa）位置52-96被鉴定为凋亡调节结构域。^[2,3]在这项研究中，我们从获得性免疫缺陷综合征（AIDS）期的HIV患者中发现了一种在54 aa位置截短的天然Vpr变体（*54Vpr），它通过与不同的腺嘌呤核苷酸易位子相互作用来介导促凋亡和抗凋亡细胞效应（蚂蚁）亚型。在Vpr N末端的23-37个氨基酸位置进一步鉴定了一个新的凋亡调节结构域。

致编辑：目前，在早期诊断和临床治疗方面已经采取了许多方法，但肝细胞癌（HCC）患者的总生存期（OS）仍然不令人满意。^[1]因此，识别新的预后生物标志物并更好地找到有前途的治疗靶点具有重要意义。

致编辑：男性雄激素性脱发（MAA）是最常见的脱发疾病，其特征是毛囊小型化和进行性脱发。^[1]虽然口服药物、局部药物和激光疗法可以促进毛发生长，但米诺地尔是美国食品药品监督管理局批准的唯一局部疗法。成纤维细胞生长因子（FGFs）具有广泛的生物学功能。碱性FGF（bFGF）促进小鼠毛囊的生长，表明其作为MAA治疗剂的潜力。^[2]纳米微针是一种能促进外用药物透皮吸收的新型器械，^[3]并将药物渗透率提高10或20倍。在这项研究中，我们比较了局部米诺地尔、纳米微针辅助FGF以及两者联合使用的安全性和有效性。

致编辑：2018年，一名31岁女性在我院就诊，有10年慢性关节炎和慢性肾病（CKD）病史。她的左脚踝外伤后发生了关节炎。然后给她开了止痛药，症状很快就消失了。她的血清尿酸（sUA）和血清肌酐（SCr）均轻度升高。后来，患者多次出现关节痛；疼痛是由脚踝拉伤或食用海鲜引发的，在夜间最为明显。每次疼痛发作时，症状在24 h内迅速发展，伴有皮肤发红和关节肿胀，一周内减轻。在接下来的几年里，她的右脚踝、手腕以及手脚的多个小关节都经历了类似的攻击，但之前没有外伤。该患者随后在当地诊所被诊断为痛风和慢性肾病。她间歇性服用苯溴马隆和消炎药治疗痛风（苯溴马隆已于8年前停用），申帅宁（中成药）治疗CKD。

致编辑：支气管动脉瘤（BAA）是一种罕见但可能致命的疾病。在所有选择性支气管动脉造影中，不到1%报告了BAA。^[1]主要治疗是血管内治疗，包括经导管动脉栓塞或主动脉覆膜支架置入。治疗失败、复发或有血管内治疗禁忌症的患者可考虑手术治疗。在此，我们报告了一例罕见的异位纵隔支气管动脉动脉瘤，通过电视辅助胸外科（VATS）成功切除。

致编辑：前列腺癌是男性生殖系统最常见的恶性肿瘤之一，2012年约有110万新发病例。^[1]当前列腺癌仍局限于前列腺时，对前列腺癌的准确诊断导致更好的成功治疗机会。格里森分级(GD)系统由唐纳德·格里森在1966年至1974年间首次建立。^[2,3]格里森模式的范围从1到5。评分越高对应分化越差，表明预后越差，转移可能性越高。总分是用优势格里森模式的前半部分和基于非优势模式的后半部分计算的。

致编辑：子宫肌瘤切除术是切除子宫肌瘤的重要治疗选择，同时使用子宫肌层内加压素以减少术中出血。^[1,2]然而，有时它会导致危及生命的并发症。^[3]我们报告了两例罕见的子宫肌瘤切除术中肌层内注射加压素后突然严重心动过缓的病例。

致编辑：大疱性类天疱疮（BP）是一种自身免疫性水疱性疾病，由自身抗体引起，与补体激活有关。^[1]自身抗体介导的补体激活参与了BP的发病机制。包括CD35、CD46、CD55和CD59的补体调节蛋白(CRP)构成补体系统中控制酶级联、膜攻击复合物组装和补体系统稳态的重要一类调节蛋白。^[2]传统上，CD55和CD46都通过抑制新的C3和C5转化酶的产生并加速已经形成的转化酶的降解来负调节补体系统激活，从而保护细胞免受补体激活诱导的损伤。迄今为止，不同CRP的分子融合已被用于产生具有新功能的嵌合分子。^[3]在这项研究中，我们产生了一种新的衰变加速因子和膜辅因子蛋白（DAF-MCP，CD55-CD46）融合蛋白，以实现对BP更高的抑制活性。

致编辑：在儿童生长过程中，定期监测生长指数，如儿童的体重、身高和其他身体测量，有助于早期诊断营养风险和异常生长。^[1]几项研究表明，住院儿童，即使是那些临床症状轻微的儿童，也有患营养不良的风险。早期确定有营养不良风险的儿童可能会避免或减少营养相关并发症，并减少住院时间。营养状况和生长风险筛查工具（STRONGkids）工具是根据最新的欧洲肠外和肠内营养学会（ESPEN）指南开发的^[2]并被证明与荷兰儿科人群的当前营养状况和住院时间（LOS）以及英国一小群住院儿童后期营养干预的风险有很好的相关性。

致编辑：冠状动脉计算机断层血管造影（CCTA）被认为是诊断冠状动脉疾病（CAD）最重要的无创成像方式之一。^[1]CCTA的现代扫描仪可以提供精确的冠状动脉粥样硬化斑块信息，显示出改善的诊断准确性和敏感性，以更好的时间和空间分辨率识别阻塞性CAD。几项研究已经证明了CCTA对预测未来不良CAD事件的预后价值。^[2]然而，这些发现大多是基于CCTA和发达国家的旧扫描仪。另一方面，人工智能（AI）和机器学习有望影响诊断和治疗。^[3]心血管成像，尤其是CT成像，肯定需要一个庞大的数据集，才能融入人工智能技术，进一步增强CAD的管理。

致编辑：癌症是中国人死亡的主要原因。^[1]随着经济的快速发展，用于无症状患者癌症筛查的18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）在中国越来越受欢迎。PET/CT是分子成像技术的一种，它使用特定的示踪剂在分子水平上对疾病进行定位和定量。^[2]然而，这种筛查的效用仍然存在争议。^[3]基于过去的临床经验，对之前的体检方案进行了优化，在笔者的研究中心设立了经典的体检方案。到目前为止，没有证据表明哪种方法更适合无症状个体的癌症筛查。