Team:YiYe-China/Human Practices
Human Practices
Survey Data Analysis
We have received a total of 182 valid questionnaires. Among all respondents, more than 60% are aged between 31 and 74 years old, which is the common age group suffering from CRC. Based on the data, we could claim that most people, 3/5 of them, have a basic understanding of what CRC is, what the symptoms are, and how to prevent and get tested. Moreover, up to 73% indicated their willingness to get tested right after feeling sick. Nevertheless, despite people's awareness of CRC, that it remains the fifth cause of death in China makes us wonder what leads to the high death rate.
From the statistics on the satisfaction rate, we could tell that 23% gave an 8 out of 10. Though it seems to be a relatively good appraisal, 21% gave a score of 5, and nearly 10% offered a number under 5. Thus, it is evident that people, in general, are not so satisfied with the current detection tests. When we asked the participants the top three leading factors they consider regarding tests, accuracy is the predominant (66% believe it as the most essential). Then come the side effects and the degree of discomfort during the tests, with 64% and 62% of consensus. In other words, though many gastroenterologists regard colonoscopy as the most accurate detection method, people's uneasiness of its side effects and pain result in their overall dissatisfaction towards testing. And this is one of the most significant motivations for our project.
Our project--the non-invasive test of CRC--not only allows people to get tested with no side effect or discomfort but also facilitates the testing. Moreover, the fourth essential factor people stated is the fee of testing. Therefore, how to minimalize the cost is another issue we need to take into consideration. Since no advanced equipment is required to test stool samples, our project could be applied to all hospitals, including those in developing areas. Such application is essential for countries with a massive population, such as China. While it may be impossible to ask everyone to have a colonoscopy, our project, an aided examination, encourages more to get screening, which increases the rate of early detection.
Lastly, about 85% of the participants support our project, and more than half (54%) show great confidence in us. If our project succeeds and sells on the market, most of the population would be willing to try it, signifying that our project is beneficial and meaningful.
Visiting and learning
Kindstar global company is a listed testing company with more than hundreds of testing laboratories. The company is equipped with a series of high-precision equipment, such as first-generation and second-generation sequencers, fluorescent quantitative PCR machines, and flow cytometers.
During our visit, we learned that nowadays the detection equuipemnts are extremely expensive and not portbable. For insance, most of the equipemnts cost over hundreds of thousands. While non-invasive detections cost less and are more convenient, we further realize the importance to advocate them.
Integrated Human Practices
With the improvement of people's living standards in recent years, people are more and more concerned about their health. However, it isn't easy to detect some diseases' existences. Colorectal cancer is one of them. It is well known that the most common colorectal cancer detection methods are colonoscopy and CT, but these methods inevitably cause specific harm to the human body. Although there are some non-invasive detection methods, these methods are expensive and require the use of some advanced instruments, which may be inaccessible for primary care health centers.
Our original intention was to find a non-invasive and comfortable colorectal cancer detection method through experiments and then develop an affordable detection product that does not require advanced machines while providing precise results. Although we have found the toehold method (a prospective one that will be easier to implement in the future) through extensive data analysis and believed that we only needed to find the DNA that expresses differentiation, we did not find suitable DNA that could directly express differentiation after reading a lot of documents. If we want to reach our goal, we must detect the degree of DNA methylation. However, how to link methylation analysis and toehold is another problem. Fortunately, we found that we could connect the two through bisulfite conversion. Finally, the plan was made.
However, as the experiment progressed in full swing, we unavoidably encountered some obstacles and blockages in thinking. For example, we didn't see the band after running the DNA gel, and the experiment was interrupted, which made everyone a little frustrated. To regain confidence, we decided to consult professor Xiaoqing Li,expert in the clinical detection and reserch in leukemia cytogenetics as well as molecular genetics. CEO of Kindstar Global Internationa Inc.
After meeting with Professor Xiaoqing Li, we told him the series of problems we had encountered. Through talking, professor Li realized our frustration about the labs and comforted us that doing biological experiments was a microscopic process that may consume a lot of time and energy. Only after the test can you know whether you are successful. "It is common to encounter difficulties and failures, so you must maintain a positive attitude," he said, "Don't be discouraged. "He gave us an example of himself at work. He said that when he felt frustrated, he would wander around the hospital. Seeing other people suffering from all sorts of illnesses, he felt a surge of emotion. He said, "Whenever I see these people, I feel grateful that I still have a strong body. I feel a sense of responsibility that inspires me to delve into research to help those lying in bed get better soon. Every time I think about this, I feel motivated." Professor Li's words made us musing and hopeful.
It was rare to interview such an expert, so we asked another question in which we expressed great interest in how to improve the accuracy of methylation detection. When we thought that Professor Li would give us a solution to improve the accuracy, he gave us an unexpected answer. Primarily, he emphasized the benefits of improving test accuracy. At the beginning, whereas we planned to test only one type of DNA, he said that we could conduct a combined genetic tests, and when comparing the results among the tests, we could tell which gene would be the most effective to enhance our accuracy. In our case, it would be both TFPI-2 and SDC2. Professor Li offered us a great suggestion. For the present, we only did detection on DNA TFPI-2, which showed valid results to prove our lab successful. So based on Li, we could did the same thing to DNA SDC2.
Professor Li helped us come up with a new way of thinking for our lab. For the present, we only did detection on DNA TFPI-2, which showed valid results to prove our lab successful. So based on Li, we could did the same thing to DNA SDC2. If they both showed similar results, our project could be more accurate.
Consultation with Dr. Qiang Tong
After consulting with professor Li, the lab went back on the right track. .Meanwhile, other teammates came up with another question: We should ask our end user--the doctor’s opinipn on our project.
Through the referral of our instructor Dr zhou, we decided to interview Professor QiangTong, who works in Wuhan People's Hospital. we successfully got in touch with Director Tong, the Director of Gastrointestinal Surgery of Hubei Provincial People's Hospital. We decided to interview Professor Qiang Tong.
Our interview took place on a sunny morning. At first, Professor Tong did not show enough interest in our arrival, so we asked him a few questions to break the ice. We asked him why he picked gastroenterology among so many studies. He replied, "Maybe being a surgeon is a dream for every medical student, but it is really by chance that I eventually decided to dedicate myself to gastroenterology. You know, it is always a coincidence. " He winked. After breaking the deadlock, we briefly introduced iGEM and our project. Unlike Professor Li's interview, Professor Tong cut right into the main topic, showing his seriousness and meticulousness as a doctor. He inquired about the method, the specific DNA we used, and our final goal, and we responded all. Since the beginning, the interview went smoothly. We asked him a few questions. But, when we asked whether he would be willing to use our product if it succeeds, there was some hesitation.
Professor Tong explained seriously that currently, there are no other methods that can detect colorectal cancer cells as accurately as colonoscopy. "When you detect that the persons' methylated DNA is positive, you can't 100% guarantee that this person has CRC. Likewise, if the result is negative, it doesn't mean this person must be healthy. I am sorry to say, but there is no DNA that could detect cancer polyps without any mistake." We all felt a little discouraged after listening to him. Does it mean that our lab is worthless?
But, Professor Tong said that: Scientific research itself is a tough process. It all starts with nothing, then a little discovery, and then to the final result. But keep in mind to remain positive despite some failures." He promised that he would definitely support our product if we could figure out the DNA representing all traits of CRC and have a substantial amount of data confirming our discovery. "By then, it would be a huge benefit for all people!"
On August 6th, we had a virtual interview with Dr. Sheng, who used to be an oncologist in the Secondary Auxiliary Hospital of Tsinghua University. He delved into oncological research for more than 20 years. After his retirement, in 2006, he created his company Beijing Viicare Medical Co., Ltd, which originated from aerospace precise tumor therapy technology and aimed to change the existing intuitive medical model and look at the future innovative medical model. Besides, Dr. Sheng is also a member of the Chinese Anti-Cancer Association. Having the opportunity to talk with such an expert, we felt honored.
After presenting a slideshow of our project to Dr. Sheng, he showed great interest in our idea. We learned that many years ago, Dr. Sheng operated on a patient with liver tumors. However, instead of using traditional treatment, such as chemotherapy or radiation therapy, he used a steel needle to remove the tumor. Using microwave thermal ablation, Dr. Sheng ensured that the tumor would be eliminated under extremely high temperatures and that other organs' immune systems would be unscathed. We all felt impressed after this recount.
He told us that though this method has succeeded in treating more than 80,000 cancer patients and is internationally leading today, most people were against it back then. People's lack of knowledge and their ignorance made them fear trying new methods. Therefore, after hearing about our project, a novel detection method, Dr. Sheng encouraged us to remain positive. It is common to have people doubtful of our project, but he believed that data would prove things right in the long run. He insisted that whatever he did, he would think of what people would benefit the most first, and then he would find a substantial amount of statistics to support the theory.
What Dr. Sheng said made us contemplate. We are still young; we have enough time to try, make mistakes, and amend them. Thus, if we have an idea, there is no need to be afraid. Just move forward and see what it could bring us.
Lastly, Dr. Sheng asked what our envision of our project looks like, if it will be applied to clinical use or simply open to the public. He explained that it might be challenging to do both because our project will likely have false positive/negative consequences, so it needs more research and data to corroborate our theory before meeting the requirements for clinical use. Nevertheless, if our goal is the public, our project will be cut and dry. To clarify his statement, he gave us an example of pregnancy test strips. Though they do not guarantee 100% accuracy, they offered people a clear idea of their early pregnancy status. If it shows the stripes, they will immediately go to the hospital.
Dr. Sheng's suggestion led us to a new train of thought. After talking with him, we couldn't wait starting our conception for our test strip. We envision that the test strip will be composed of two parts. We put control reactant solution in sample hole 1 and put the solution of our trigger DNA in sample hole 2. We could read our results through the color shown by detection hole 2. If the both holes show red, that means the sample is porivistve. The patient is very likely to have CRC. If If hole1 red while hole2 is clear, that shows a negative sampple. Last but not least, if hole 1 is clear, it means the failure of detection. The patient have to either retest or use alternative detection methods.
Detecting DNA methylation through stool samples, our project is a fabulous aided detection method to notice people. We feel hopeful that more people could get a warning of their bodies by using our product, therefore decreasing the death rate of CRC.
HP Info.
This is our Human Practices page, this part contains two parts HP and IHP
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HP
Survey Data Analysis
Visiting and learning
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IHP
Expert interview-Dr Li
Expert interview-Dr Tong
Expert interview-Dr Sheng