iLABMED最新文献

One of the challenges in anatomic pathology laboratories is to meet the increasing need for pathological diagnosis, using quality management (QM) activities and systems to ensure that patients receive their accurate and timely pathology report. The aim of this paper is to review anatomic pathology QM from both management and technical perspectives, including the past, present, and future opportunities. First, the evolution of the QM concept and scope will be discussed. Next, current QM system implementation and laboratory accreditations will be discussed from the management perspective, and common medical errors in anatomic pathology in different testing cycles will be analyzed. Finally, selected future management systems to improve the level of total QM worldwide for patient safety and the potential of informatics to be used as an auxiliary tool in anatomic pathology will be discussed.

Infectious diseases are a serious threat to human health, and accurate, rapid and convenient early detection of pathogens is the first step of active treatment. Technologies that detect pathogens have advanced significantly because of the development of fundamental disciplines and the integration of multidisciplinary fields. Among these technologies, nucleic acid detection technology is preferred because of its rapid measurement, accuracy and high sensitivity. The CRISPR/Cas system, consisting of Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) and CRISPR-associated (Cas), is an adaptive immune system that specifically recognizes, binds and cleaves exogenous invasive nucleic acids. The CRISPR/Cas system is widely found in bacteria and archaea. Researchers have developed nucleic acid detection technologies with single-molecule sensitivity, single-base precision specificity, portability and low cost based on the specific cleavage and trans-cleavage activities of the CRISPR/Cas system. The next generation of in-vitro diagnostics is shifting to nucleic acid technology because this technology shows promise in a wide range of applications in resource-constrained environments. In this review, the development and mechanism of the CRISPR/Cas system are presented together with representative CRISPR/Cas applications in nucleic acid detection. Additionally, the review summarizes future perspectives and trends of the CRISPR/Cas system in nucleic acid detection.

Tuberculosis (TB) remains a leading cause of deaths among patients with acquired immunodeficiency syndrome patients. Early diagnosis of TB is essential for administering timely anti-TB therapy and improving health outcomes, particularly in the people living with HIV. However, conventional techniques used to detect Mycobacterium tuberculosis have significant drawbacks: for example, sputum smear microscopy has low sensitivity, and liquid culture is time-consuming in patients with HIV-TB co-infection due to low sputum production. In addition, while immunological-based methods involving tuberculin skin testing and interferon gamma release assays are commonly used for auxiliary TB diagnosis, they are often inaccurate in immunodeficient patients. Molecular techniques such as line probe assays, Xpert MTB, and lipoarabinomannan assay are recommended for early diagnosis by World Health Organization. However, no single technique is sufficicent for diagnosing HIV/TB co-infection, suggesting that multiple diagnostic tests should be used to detect TB. Here, we summarize the drawbacks and advantages of existing TB-diagnostic methods, as well as their applications to diagnosing HIV/TB co-infection. We describe newly emerging technologies such as whole genome sequencing and mass spectrometry, with the aim of providing updated guidelines and alternative strategies for TB diagnosis, and particularly HIV/TB diagnosis.

Due to the limitations of existing approaches, a rapid, sensitive, accurate, comprehensive, and generally applicable strategy to diagnose and treat bacterial and fungal infections remains a major challenge. Here, based on the ramanome technology platform, we propose a culture-free, one cell resolution, phenome-genome-combined strategy called single-cell identification, viability and vitality tests and source tracking (SCIVVS). For each cell directly extracted from a clinical specimen, the fingerprint region of the D₂O-probed single cell Raman spectrum (SCRS) enables species-level identification based on a reference SCRS database of pathogen species, whereas the C-D band accurately quantifies viability, metabolic vitality, phenotypic susceptibility to antimicrobials, and their intercellular heterogeneity. Moreover, to source track a cell, Raman-activated cell sorting followed by sequencing or cultivation proceeds, producinging an indexed, high coverage genome assembly or a pure culture from precisely one pathogenic cell. Finally, an integrated SCIVVS workflow that features automated profiling and sorting of metabolic and morphological phenomes can complete the entire process in only a few hours. Because it resolves heterogeneity for both the metabolic phenome and genome, targets functions, can be automated, and is orders-of-magnitude faster while cost-effective, SCIVVS is a new technological and data framework to diagnose and treat bacterial and fungal infections in various clinical and disease control settings.

With the development of scientific technology, the transition to the intelligent era of digitalization and automation is an irresistible trend for medical laboratories. Medical diagnosis systems have undergone significant changes as a result of intelligent technologies, such as machine learning, artificial intelligence, and the Internet of Things, from the collection, transmission, and detection of test samples to the review of reports and the provision of clinical feedback. In addition to significantly enhancing the efficiency, consistency, and accuracy of medical laboratory testing, these technologies also assist the improvement of individualized healthcare and medical expert systems, as well as the early detection and treatment of diseases. The future development of medical laboratories will focus on integrating big data and diverse intelligent resources, cooperating more closely with clinical departments, and realizing the effective pathway of patient-centered care. The purpose of this review is to illustrate the current state of intelligent technology integration in medical laboratories and provide a preliminary discussion about the potential future influences of intelligent technology development on the evolution of medical laboratories.

Nowadays, public health is facing many challenges, mainly including non-communicable diseases and communicable diseases. Communicable diseases, particularly emerging infectious diseases, have also attracted attention due to their enormous impact on public health and the global economy. The most prominent example is the current global Coronavirus Disease 2019 (COVID-19) pandemic. The unprecedented and ongoing COVID-19 pandemic has highlighted the necessity for readily available, accurate, and rapid laboratory medicine (LM) practices. Nevertheless, current LMs and journals in particular have a window for improvement. First, there are limited numbers of professionals available in this field compared to the other disciplines. The current status quo is that most LM manuscripts must be submitted to comprehensive journals or other journals related to the research disease. Second, most LM journals are run by laboratory personnel who are often more concerned with technical advances than with clinical needs. Lastly, several young LM scientists expressed their desire to have a dedicated platform to discuss, communicate, and publish their works on LM. We were therefore motivated to launch iLABMED, an international public forum dedicated to LMs. The establishment of iLABMED adopts the “four I” strategy, namely “Innovation,” “Intelligence,” “Integration,” and “International.” We are attempting to establish a top-tier journal in the field of LM.