New diagnostic technology promises to achieve "personalized medical"

medicine is often referred to as the youngest scienceAlthough in recent years with the application of various new technologies and the rapid development of the pharmaceutical level, doctors to diagnose and treatdisease sayinglevel of rapid improvement, but in many cases, doctors ofdiseasediagnosis and treatment still have a great blindnessFebruary 2005
three
elderlywere found dead in a day after ain a nursing home in Victoria, Canada, from a respiratory infectionSoon, the local Centers for Disease Control used the most advanced real-time PCR technology to analyze more than a dozen pathogens that the deceased might have been infected with, but the results were negativeDoctors can't find targeted methods, and other patients' conditions can't be effectively controlledIt wasn't until theChildren'sHospital in Vancouverexamining more than two dozen possible pathogens using tem-PCR technology at the same time that it was known that the patient had died of Streptococcus pneumoniae infection, a disease that could easily be treated once the cause was known The case of Dr Han Jian
, the lead researcher of the Hudson Alpha Institute of Biotechnology, who introduced the new invention to the university, is a good illustration of the importance of diagnostic technology to medical care In laboratory diagnosis, the multi-PCR technology was used more widely PCR (
Polymerase Chain Reaction) refers to the process dna of the subchain complementary to the female chain template DNA in vitro reproduction through the steps of denatured , annealing , extension, etc., under the catalyst of DNA polymerase, with the mother chain DNA as the template, and with specific primers as the extension starting point This is a DNA in vitro synthesis amplification technology, can quickly and especially in vitro to amplify any purpose of DNA, can be used in gene separation cloning , sequence analysis
, gene expression regulation, gene polymorphism research and many other aspects Multiple PCR is a simple and fast screening method in clinical and basic research that amplification of multiple genes at the same time in the same response However, multiple PCR technology also has some limitations: First, the technical operation is more complex, and second, its multi-pair primer design, it is necessary to ensure that many pairs of primer between the formation of primer dipolymer - primer and target template region is highly specific, which is more difficult The newly invented tem-PCR technology overcomes the obstacles of the development of traditional multi-PCR test, so that the same reaction tube can be specifically , and efficient amplification of multiple target genes, which makes multi-molecular differential diagnosis possible, realizethed the real value from molecular biology technology to clinical applications, and bring revolutionary changes to clinical differential diagnostic methods This new technology may be a change in the way clinicians are treated Many people have experienced the fact that when they feel uncomfortable or have a fever at hospital , they are diagnosed with infection after a quick blood routine check-up found that white blood cells are high But what exactly causes the infection? To further check this, spend more time, money does not say , may not be able to check out at all So , doctor scans a wide range of antibiotic , try , if it doesn't work well for a , doctor will switch other antibiotics for patients to keep trying In short, many times treatment is based on percentage or probability This kind of treatment with a great blindness, there are at least three important disadvantages: first, the cause diagnosis is not clear, may miss the best treatment time; Thus, in order to solve these problems, the concept of "personalized medical treatment" emerged The so-called "personalized medicine" has two meanings: one is to make a rapid and accurate diagnosis of the individual patient, and the other is to make the most effective and economical treatment around diagnosis Han Jian said that this "personalized medical treatment" needs a fast and accurate diagnostic means as the basis, tem-PCR molecular diagnostic technology can provide a strong support for this Many diseases show the same symptoms, in fact, the causes contained are different, the treatment required is also different Therefore, before doctors can provide treatment options to patients, they first need to clearly understand the cause of the patient, need to take samples and produce enough sample sizes in the laboratory, behind the testing on different diagnostic equipment, which often delays the best time for treatment; One of the main features of tem-PCR molecular diagnostic technology is the ability to quickly and accurately detect multiple molecular indicators simultaneously from a specimen, and to design indicators of multiple etiologys on the same device in the shortest possible time with one sample at the same time Until then, molecular testing was usually only a single target Tem-PCR molecular diagnostic technology can not only determine the cause of the disease in the shortest possible time, but also detect which drug is most sensitive to the pathogen, helping the clinical first time to choose the most effective treatment At the same time, because the use of drugs is targeted, it can also reduce bacterial variation due to antibiotic abuse Han Jian told reporters, in fact, bacteria mutated resistance, but also a passive adaptation to the environment process, if you can reduce the abuse of antibiotics, some of the original has mutated drug resistance bacteria, may also be reduced, which makes some of the original failed antibiotics can be reused High-tech is not equal to high price
so is this new technology very expensive for clinical use? After all, medical costs are a very sensitive topic in every country and a general focus of attention Han Jian said the testing equipment is about $60,000, and the preparation used is very cheap Although a single test may be more expensive than the test method used today, it is cheaper to single-test because of the high rate of positive testing To put it mildly, we are now seeing a doctor, doing a check-up that is negative, and continuing to do various tests until the problem is finally found, the cumulative cost is higher than the use of tem-PCR molecular diagnostic technology What's more, from the perspective of pharmacoeconomics, tem-PCR molecular diagnostics can shorten the course of the disease and therefore be the most economical In fact, the most appropriate drug is not necessarily the most expensive For example, the use of tem-PCR molecular diagnostic technology, it can be found that pathogens are sensitive to the cheapest antibiotic penicillin, if sensitive, the most suitable drug is penicillin At the same time, the technology's judgment of drug effectiveness is not limited to antibiotics For example, there is currently only one drug to treat in a clinical condition, but the fairly expensive drug has a cure rate of only about 40% By using tem-PCR molecular diagnostics, patients can be helped to determine whether the drug is effective and whether it will be used at an expensive cost So when will the technology become popular at home? When will we be able to enjoy "personalized medical care"? Han Jian said that the current technology in China mainly in the use of disease prevention and control departments, its popularity in the clinic, but also need the support of national health care policy, and clinicians on the technology's awareness and the general patient's concept of the conversion, also need a process (
Zhang Xu)