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1.
Zhonghua Zhong Liu Za Zhi ; 46: 1-11, 2024 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-38764329

RESUMO

Objective: To provide supports for the cancer prevention and control strategies in China by comparing the disease burden, epidemic trends, 5-year relative survival rate and major determinants of common cancers between China and the United States. Methods: A descriptive secondary analysis was conducted using data extracted from the GLOBOCAN database, the Surveillance, Epidemiology, and End Results database, Global Burden of disease 2019 database, and previous studies. The main indicators included the cases of malignant tumors in different sites, the cases of deaths, the age-standardized incidence (world standard incidence) and mortality (world standard mortality), the 5-year relative survival rate, and population attributable fraction (PAF). Results: In 2022, an estimated 4.825 million new cases and 2.574 million deaths of malignant neoplasms in China. The world standard incidence rate (201.6/100 000) in China was lower than that in the United States (367.0/100 000), and the world standard mortality rate (96.5/100 000) was higher than that in the United States (82.3/100 000). Lung cancer ranked first in the disease burden of malignant tumors in China, the new cases and deaths accounted for 22.0% and 28.5% of all malignant tumors, respectively. The top three malignant tumors in China were breast cancer (11.5%), prostate cancer (9.7%) and lung cancer (9.5%), which were also among the top five causes of death. However, the second to fifth leading causes of death from malignant tumors in China were digestive system tumors (liver cancer 12.3%, stomach cancer 10.1%, colorectal cancer 9.3%, and esophageal cancer 7.3%). From 2000 to 2018, the world standard incidence of malignant tumors showed an increasing trend and the world standard mortality of malignant tumors showed a decreasing trend in China, while the world standard incidence and mortality of malignant tumors in the United States showed a significant decreasing trend after 2000. The incidence of breast cancer, colorectal cancer and thyroid cancer increased rapidly in China, while the incidence and mortality of stomach cancer, liver cancer and esophageal cancer decreased, but they still had a heavy disease burden. From 2003 to 2015, the overall 5-year relative survival rate of malignant tumors increased from 30.9% to 40.5% in China. However, with the exception of esophageal cancer, the 5-year relative survival rates of other major malignant tumors were lower than those in the United States. In 2019, the PAF of malignant tumors death attributable to potential modifiable risk factors was 48.3% in China, which was similar to the United States (49.8%). Of these, smoking was the most important attributable risk factor, and the PAF was more than 30% both in China and the United States. In addition, about 18.8% of malignant tumors were caused by preventable chronic infections, such as hepatitis B virus and Helicobacter pylori, while less than 4% of malignant tumors in the United States were caused by infection. Conclusions: China has made great progress in the prevention and treatment of malignant tumors, but it still faces a serious disease burden. The cancer spectrum is changing from developing countries to developed countries. We should pay attention to modifiable factors, take comprehensive measures, and prevent cancer scientifically.

2.
Zhonghua Zhong Liu Za Zhi ; 46(4): 354-364, 2024 Apr 23.
Artigo em Chinês | MEDLINE | ID: mdl-38644271

RESUMO

Objective: To determine the total and age-specific cut-off values of total prostate specific antigen (tPSA) and the ratio of free PSA divided total PSA (fPSA/tPSA) for screening prostate cancer in China. Methods: Based on the Chinese Colorectal, Breast, Lung, Liver, and Stomach cancer Screening Trial (C-BLAST) and the Tianjin Common Cancer Case Cohort (TJ4C), males who were not diagnosed with any cancers at baseline since 2017 and received both tPSA and fPSA testes were selected. Based on Cox regression, the overall and age-specific (<60, 60-<70, and ≥70 years) accuracy and optimal cut-off values of tPSA and fPSA/tPSA ratio for screening prostate cancer were evaluated with time-dependent receiver operating characteristic curve (tdROC) and area under curve (AUC). Bootstrap resampling was used to internally validate the stability of the optimal cut-off value, and the PLCO study was used to externally validate the accuracy under different cut-off values. Results: A total of 5 180 participants were included in the study, and after a median follow-up of 1.48 years, a total of 332 prostate cancer patients were included. In the total population, the tdAUC of tPSA and fPSA/tPSA screening for prostate cancer were 0.852 and 0.748, respectively, with the optimal cut-off values of 5.08 ng/ml and 0.173, respectively. After age stratification, the age specific cut-off values of tPSA in the <60, 60-<70, and ≥70 age groups were 3.13, 4.82, and 11.54 ng/ml, respectively, while the age-specific cut-off values of fPSA/tPSA were 0.153, 0.135, and 0.130, respectively. Under the age-specific cut-off values, the sensitivities of tPSA screening for prostate cancer in males <60, 60-70, and ≥70 years old were 92.3%, 82.0%, and 77.6%, respectively, while the specificities were 84.7%, 81.3%, and 75.4%, respectively. The age-specific sensitivities of fPSA/tPSA for screening prostate cancer were 74.4%, 53.3%, and 55.9%, respectively, while the specificities were 83.8%, 83.7%, and 83.7%, respectively. Both bootstrap's internal validation and PLCO external validation provided similar results. The combination of tPSA and fPSA/tPSA could further improve the accuracy of screening. Conclusion: To improve the screening effects, it is recommended that age-specific cut-off values of tPSA and fPSA/tPSA should be used to screen for prostate cancer in the general risk population.


Assuntos
Detecção Precoce de Câncer , Antígeno Prostático Específico , Neoplasias da Próstata , Humanos , Masculino , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/sangue , Antígeno Prostático Específico/sangue , Idoso , Pessoa de Meia-Idade , Detecção Precoce de Câncer/métodos , Fatores Etários , Curva ROC , China , Sensibilidade e Especificidade , Programas de Rastreamento/métodos , Área Sob a Curva
3.
Beijing Da Xue Xue Bao Yi Xue Ban ; 55(4): 676-683, 2023 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-37534651

RESUMO

OBJECTIVE: To evaluate the effect of equal temperature bladder irrigation on bladder spasm, postoperative bleeding, vital signs and discomfort of chills in patients of transurethral resection of prostate using meta-analysis. METHODS: Several electronic databases included Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biology Medicine (CBM) were searched systematically for published randomized controlled trial about equal temperature bladder irrigation in patients with transurethral resection of prostate before November 20, 2019. Two reviewers selected independently the literature in the light of the inclusion and exclusion criteria, assessed the risk of bias by quality assessment and extracted data which were consisted of clinical efficacy indexes, such as incidence of bladder spasm, severity of bladder spasm, incidence of tube plugging, amount of bladder flushing fluid, time of bladder flushing, heart rate, systolic pressure, diastolic pressure, and incidence of chills. Data were pooled using fixed-effects model or random-effects model, and the summary effect measure was calculated by risk ratio (RR) or mean difference (MD) and 95% confidence interval (95%CI). Meta-analysis was performed by Review Manager 5.3 Software. RESULTS: In the study, 13 randomized controlled trails met the requirement with a total of 2 033 patients of transurethral resection of prostate were included, of whom 1 015 were carried out with equal temperature bladder irrigation and 1 018 with room temperature bladder irrigation. The results of meta-analysis showed that incidence of bladder spasm [RR=0.51, 95%CI (0.45, 0.57), P < 0.001], severity of bladder spasm [MD=-1.61, 95%CI (-2.00, -1.23), P < 0.001], incidence of urinary blockage [RR=0.29, 95%CI (0.19, 0.44), P < 0.001], dosage of bladder irrigation [MD=-6.75, 95%CI (-7.33, -6.17), P < 0.001], time of bladder rinse [MD=-7.60, 95%CI (-11.91, -3.29), P < 0.001], heart rate [MD=-13.68, 95%CI (-15.19, -12.17), P < 0.001], systolic pressure [MD=-29.26, 95%CI (-31.92, -26.59), P < 0.001], diastolic pressure [MD=-29.36, 95%CI (-31.75, -26.98), P < 0.001], incidence of chills and discomfort [MD=0.37, 95%CI (0.31, 0.44), P < 0.001] in equal temperature group of the patients with transurethral resection of prostate had significantly statistical difference compared with room temperature group. CONCLUSION: Based on current available evidence, equal temperature bladder irrigation reduced the incidence of bladder spasm and urinary blockage, relieved bladder spasm, reduced dosage and time of bladder irrigation, and hardly affected normal vital signs and increased the patient' s comfort.


Assuntos
Hiperplasia Prostática , Ressecção Transuretral da Próstata , Masculino , Humanos , Ressecção Transuretral da Próstata/efeitos adversos , Ressecção Transuretral da Próstata/métodos , Bexiga Urinária/cirurgia , Calafrios , Temperatura , Hiperplasia Prostática/cirurgia , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
Beijing Da Xue Xue Bao Yi Xue Ban ; 54(4): 621-627, 2022 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-35950383

RESUMO

OBJECTIVE: To investigate the correlation between drinking habits and pathological characteristics of patients with upper tract urothelial carcinoma (UTUC). METHODS: A preoperative questionnaire survey was conducted to understand the drinking habits of UTUC patients who were admitted to the Department of Urology, Peking University First Hospital for radical nephroureterectomy within one year from August 2020 to July 2021, and statistical analysis was performed in combination with their postoperative pathological characteristics. The statistical procedure was performed using SPSS 22.0 software, and firstly, the preliminary analysis was performed one by one using the columnar χ2 test on the pathological characteristics of UTUC tumors as the dependent variable and the factors related to patients' general information, past history and drinking habits as the independent variables, and the independent variables that met P < 0.2 between the case and control groups for each dependent variable were specified for screening. The screened variables were included in the binary Logistic regression analysis. A difference of P < 0.05 was used to indicate a statistically significant difference. RESULTS: A total of 239 patients, 134 males and 105 females, with a mean age of (68.1±9.98)years and a median disease duration of 4.8 months, were included in this study. Multifactorial Logistic regression results suggested that after adjusting for the effects of other variables, UTUC patients who had the habit of drinking at least once every hour during the daytime had a significantly increased risk of high grade (G3) tumors(OR=1.941, 95%CI: 0.352-1.029, P < 0.01); these patients also had a significantly decreased risk of multifocal UTUC tumors (OR=0.344, 95% CI: 1.18-5.582, P=0.004). The patients who had the habit of drinking over 100 mL water each time had a significantly decreased risk of mutifocal UTUC incidence (OR=0.477, 95%CI: 0.225-1.012, P=0.046). Patients who pay attention to daily water intakes had a significantly increased risk of renipelvic carcinoma (OR=2.530, 95%CI: 1.434-4.463, P=0.001) and a significantly decreased risk of ureteral carcinoma (OR=0.314, 95%CI: 0.172-0.573, P < 0.01). Other variables included in the regression model did not differ significantly in their effects on the occurrence of tumor pathological characteristics. CONCLUSION: Having the awareness of drinking water every 1 h during the day, drinking over 100 mL water each time, having the awareness of daily drinking habits correlated significantly with pathological characteristics of UTUC such as the presence of G3 tumor, multifocal tumors and location of the tumor. This conclusion still needs to be verified by subsequent trials with higher levels of evidence.


Assuntos
Carcinoma de Células de Transição , Neoplasias Ureterais , Neoplasias da Bexiga Urinária , Carcinoma de Células de Transição/cirurgia , Feminino , Hábitos , Humanos , Masculino , Recidiva Local de Neoplasia/epidemiologia , Estudos Retrospectivos , Neoplasias Ureterais/epidemiologia , Neoplasias Ureterais/cirurgia , Neoplasias da Bexiga Urinária/cirurgia , Água
5.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(12): 1524-1529, 2021 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-34963255

RESUMO

The traditional proportional hazard model is commonly used to investigate the association between main outcome and predictor variables. However, the endpoints in medical studies are often not unique. The analyses of labeling other competing outcomes other than the main outcome as censored data will theoretically lead to a biased estimate of the risk of main outcome. Although the traditional competitive risk model can adjust the influence of other outcomes on the risk of the main outcome, it can not directly compare the differences on the risks of different outcomes. The multi-state competing risk model provides a relatively suitable solution for this problem. In this study, based on a previously published follow-up data set for prostate cancer patients, we developed traditional proportional hazard model, traditional competitive risk model, and multi-state competing risk model, respectively. By comparing the advantages and disadvantages of the three models with the same survival data, we clarified the clinical application value of the multi-state competitive risk model in survival data with multiple outcomes.


Assuntos
Neoplasias da Próstata , Humanos , Masculino , Modelos de Riscos Proporcionais , Risco , Medição de Risco , Fatores de Risco , Análise de Sobrevida
6.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(10): 1203-1208, 2021 Oct 06.
Artigo em Chinês | MEDLINE | ID: mdl-34706505

RESUMO

Objective: To investigate the potential pleiotropism of cancer-related single nucleotide polymorphisms (SNPs) among Chinese population. Methods: Based on the catalogue of GWAS jointly constructed by the National Human Genome Research Institute and the European Institute of Bioinformatics, according to population origin (Chinese population and non-Chinese population) and disease traits (cancer and non-cancer traits). All SNPs found by GWAS before August 2020 were divided into four categories: cancer in Chinese population, non-cancer in Chinese population, cancer in non-Chinese population and non-cancer in non-Chinese population. The number, correlation and linkage of the four categories of SNPs were described. Results: By August 2020, a total of 196 813 SNPs from 4 096 GWAS were included in the GWAS directory. The information that SNPs refer to unknown or were not related to the disease was excluded, and 117 441 independent SNPs were finally included. There were 619 SNPs related to cancer and 9 569 SNPs related to non-cancer disease in Chinese population, respectively. There were 4 624 SNPs related to cancer and 106 448 SNPs related to non-cancer disease (trait) in non-Chinese population, respectively. Three SNPs, rs2736100, rs6983267 and rs401681, were associated with two or more types of cancer in both Chinese and non-Chinese populations. Seven SNPs, rs7705526, rs2736100, rs10993994, rs2735839, rs4430796, rs174537 and rs9271588, were associated with cancer and non-cancer diseases in both Chinese and non-Chinese populations, respectively. Conclusion: There is a potential pleiotropism of cancer-related SNPs in Chinese population.


Assuntos
Neoplasias , Polimorfismo de Nucleotídeo Único , China , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Neoplasias/genética , Fenótipo
8.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(10): 977-983, 2019 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-31630497

RESUMO

Objective: To explore the value of dual-energy CT-based volumetric iodine-uptake (VIU) in the evaluation of chemotherapy efficacy in advanced gastric cancer. Methods: Inclusion criteria of subjects: (1) without previous systematic therapy; (2) with complete clinical information before and after chemotherapy; (3) without contraindications of chemotherapy. Exclusion criteria of subjects: (1) unfinished duration and times of chemotherapy; (2) unmeasurable primary lesions; (3) poor imaging quality or poor gastric filling. Clinical and image data of 52 patients with advanced gastric cancer who were diagnosed by pathology from gastroscopic biopsy, and needed chemotherapy evaluated by imaging and clinical information in the First Affiliated Hospital of Wenzhou Medical University from February 2017 to February 2018 were collected and analyzed. Of 52 patients, 38 were male and 14 were female with the median age of 65 (31-88) years old. All the patients underwent a dual-energy, dual phase-enhanced CT scanning before chemotherapy and after the third chemotherapy session. The parameters of the lesions measured before and after chemotherapy in portal vein phase were as follows: the maximum diameter (the largest diameter among those measured in the cross-sectional, coronal, and sagittal planes), average CT value (the regions of interest were manually pinpointed under cross-sectional planes with largest diameter of the tumor, which did not include regions less than 2 mm to the edge of the tumor) and VIU (lesion volume × iodine concentration). The change rates of maximum lesion diameter, average CT value and VIU before and after chemotherapy were calculated [(post-chemotherapy parameters-pre-chemotherapy parameters)/ pre-chemotherapy parameters]. The efficacy of chemotherapy was evaluated by RECIST 1.1 (the change of maximum tumor diameter after chemotherapy), Choi (the change of average CT value after chemotherapy) and VIU (the change of VIU after chemotherapy), respectively, which was categorized by complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Patients with CR, PR, and SD were assigned to the effective group, while those with PD were classified as the ineffective group. Paired t - test or Wilcoxon signed ranks test was used to compare the changes of parameters before and after chemotherapy, whereas Spearman correlation analysis and Kappa test were used for the correlation analysis and the consistency test between the three evaluation criteria (Kappa≥0.75 indicated good consistency). Results: After chemotherapy, the average CT value [(74.01±16.75) HU vs. (81.06±15.87) HU, t=2.202, P=0.030] and median VIU (668.53×10(2) µg vs. 272.52×10(2) µg, Z=4.761, P<0.001) decreased significantly, while the difference of the maximum diameter was not statistically significant [(66.71±34.49) mm vs. (78.45±35.62) mm, t=1.708, P=0.091]. The median change rate of VIU (-53.33%) was greater than that of CT values (-5.75%) with significant difference (Z=-5.408, P<0.001). According to the RECIST 1.1 criteria, 47 patients (90.4%, including 19 with PR and 28 with SD) were effective and 5 patients (9.6%) were ineffective. According to the Choi criteria, 45 patients (86.5%, including 37 with PR and 8 with SD) were effective and 7 patients (13.5%) were ineffective. According to the VIU criteria, 46 patients (88.5%, including 41 with PR and 5 with SD) were effective and 6 patients (11.5%) were ineffective. Efficacy comparison among these three criteria showed no significant difference (χ(2)=0.377, P=0.828). As compared to RECIST 1.1 evaluation, the proportion of PR evaluated by Choi and VIU was significantly higher (χ(2)=16.861, P<0.001), whereas the proportion of SD was significantly lower (χ(2)=24.089, P<0.001). There was no significant difference in the proportions of PR and SD between VIU and Choi criteria (χ(2)=0.887, P=0.346). Consistency and correlation analysis showed that the VIU and Choi evaluation criteria presented the highest consistency and correlation (Kappa=0.912, P<0.001; r=0.916, P<0.001). Conclusion: VIU is a feasible parameter for the evaluation of chemotherapy efficacy in advanced gastric cancer, and may be more sensitive than the evaluation criteria based on maximum diameter or change of CT value in the tumor.


Assuntos
Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/tratamento farmacológico , Tomografia Computadorizada por Raios X/métodos , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Radioisótopos do Iodo/farmacologia , Masculino , Pessoa de Meia-Idade , Compostos Radiofarmacêuticos/farmacologia , Indução de Remissão , Neoplasias Gástricas/patologia , Resultado do Tratamento
9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 713-718, 2019 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-31238625

RESUMO

Objective: To investigate the potential application values of screening on breast cancer, using the single-nucleotide polymorphisms (SNPs) that were identified from the genome- wide association studies (GWASs). Methods: Two million Chinese women aged 35-69 years were simulated, based on both age distributions, age-specific incidence rates of breast cancer and the distribution of known risk factors, in 2013. Twenty-three SNPs identified from GWAS were further simulated. Both genetic-related risks explained by each SNPs and the improvement on the risks under reclassification, were used to select SNPs for the prediction on breast cancer among the targeted high-risk population. Further analyses were conducted to investigate the following items as: improvements on detection rates of breast cancer among the high-risk populations, areas under the curve (AUC) and the odds ratio (OR) among women at high risk. Results: A total of 12 SNPs were eligible for targeting the high-risk population of breast cancer. When high-risk populations were defined as women whose predicted risks were higher than the 95(th) predicted risk of the whole population, the detection rate (146.99/100 000) among high-risked women predicted by 12 SNPs would be significantly lower than 177.46/100 000, which was predicted by the known risk factors (P<0.001), among the high-risked women. Among those women at high risk, the detection rate (229.00/100 000) predicted by integrating known risk factors and 12 SNPs was significantly higher than that predicted by known risk factors (P<0.001). Also, the AUC increased from 64.4% to 67.8% (P<0.001), and the OR of increased from 3.32 to 4.33, predicted by integrating known risk factors and 12 SNPs, for women at high risk on breast cancer. Conclusion: Targeted SNPs that were identified from genome- wide association studies could be used to improve the detection rates as well as the overall accuracy of risk prediction so as to identify the potential high-risk women on breast cancer before carrying on the screening program.


Assuntos
Povo Asiático/genética , Neoplasias da Mama/genética , Detecção Precoce de Câncer/métodos , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Polimorfismo de Nucleotídeo Único/genética , Adulto , Idoso , Área Sob a Curva , Neoplasias da Mama/diagnóstico por imagem , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco
10.
Zhonghua Yi Xue Za Zhi ; 99(12): 943-946, 2019 Mar 26.
Artigo em Chinês | MEDLINE | ID: mdl-30917446

RESUMO

Objective: To evaluate the prognosis and surgical complication of the recanalization treatments for internal carotid artery (ICA) occlusion by using one-step hybrid carotid endarterectomy and endovascular surgery. Methods: Retrospective analysis was performed on the clinical data and follow-up data of 22 patients with occluded ICA treated by one-step hybrid surgery. Difference in Barthel score and occurrence of ischemic stroke were compared with surgical group and conventional group which was treated by oral taking anti-platelet drugs. Further, the complications were analyzed to evaluate the safety and effectiveness of the surgery. Results: The difference in ischemic event rate and Barthel scores improvement between the two groups were significant. Occlusive ICAs in 19 cases were recanalized successfully. The possibility of brain hyperperfusion related to the surgery was 10.5% (2/19) while the possibility of carotid artery cavernous fistula was 9.1% (2/22). We also observed rare dissecting ICA caused by the treatment (4.5%) and distal restenosis (5.3%). Conclusions: One-step hybrid carotid endarterectomy and endovascular surgery could help recanalize the ICA, improve the blood supply and improve the prognosis. It's a safe and effective treatment for ICA occlusion.


Assuntos
Estenose das Carótidas , Endarterectomia das Carótidas , Artéria Carótida Interna , Estenose das Carótidas/cirurgia , Humanos , Estudos Retrospectivos , Stents , Resultado do Tratamento
11.
J Clin Pharm Ther ; 43(2): 256-264, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29119581

RESUMO

WHAT IS KNOWN AND OBJECTIVE: Patients with rheumatic disease are at risk for infections. Evaluating antitumour necrosis factor (anti-TNF) drug-associated risk of infections requires justification of baseline risk in the population at high risk of infection. We examined the incidence of active tuberculosis (TB) and its risk factors in patients with rheumatic disease started with anti-TNF-α therapy or with existing disease-modifying antirheumatic drug (DMARD) therapy. METHODS: A retrospective cohort study of anti-TNF-α therapy new users (anti-TNF-α group) and those starting with a DMARD after the failure of at least one other DMARD or who had added to existing DMARD treatment (DMARD group) for rheumatic disease in the largest medical setting in Taiwan from 1 January 2005 through 31 November 2013 was conducted to determine relative risk of TB between patient groups. Patients in the DMARD group were stratified into "mild" and "severe" disease severity as proxies for low and high background risk of infection. RESULTS AND DISCUSSION: A total of 3640 patients were enrolled (anti-TNF: 955; DMARD: 2685). The incidence of TB was 903.9/100 000 patient-years for anti-TNF-α new users and 391.7/100 000 patient-years for DMARD switchers. In Cox regression model, adjusted HR for TB in the anti-TNF-α group was higher than for the entire DMARD group (aHR, 2.41; 95% confidence interval [CI], 1.2-4.85), subgroup with mild disease (2.91; 1.31-6.47) and subgroup with severe disease (1.65; 0.68-4.03). Significant independent risk factors for TB were being male, age ≥60 years, history of respiratory disease, glucocorticoids dose >7.5 mg/d and living in a TB-prevalent region. WHAT IS NEW AND CONCLUSION: Anti-TNF-α therapy was independently associated with increased risk of TB in patients with mild disease, but it was not significantly correlated in patients with severe disease after adjusting for confounders.


Assuntos
Antirreumáticos/efeitos adversos , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Tuberculose/etiologia , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adulto , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doenças Reumáticas/tratamento farmacológico , Doenças Reumáticas/metabolismo , Fatores de Risco , Taiwan , Tuberculose/metabolismo , Adulto Jovem
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(11): 1574-1578, 2017 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-29141352

RESUMO

Screening has been always considered as a double-edged sword. Cancer screening could save lives in some cases, however, in other cases, it might also turn people into overdiagnosis. Overdiagnosis is the diagnosis of cancer that will never cause symptoms or death during a patient's lifetime. Therefore, overdiagnosis might lead to unnecessary treatments and lifetime surveillance, and then increase economic burden and psychological burden. In this review, we focus on how to correctly evaluate the overdiagnosis rate, and how to avoid or reduce the harms caused by overdiagnosis in the future according to the reasons associated with overdiagnosis. After systematically reviewing the previous studies, we will try to identify the potential reasons associated with overdiagnosis in breast cancer screening with mammography, address how to correctly evaluate the overdiagnosis rate, and finally provide some suggestions to reduce the overdiagnosis.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Detecção Precoce de Câncer/estatística & dados numéricos , Mamografia , Programas de Rastreamento , Uso Excessivo dos Serviços de Saúde/estatística & dados numéricos , Feminino , Humanos , Uso Excessivo dos Serviços de Saúde/prevenção & controle , Medição de Risco , Ultrassonografia Mamária
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 37(7): 1039-43, 2016 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-27453120

RESUMO

Cancer screening has been considered as double-edged sword with both advantages and disadvantages. For decades, there have been strong interests in screening strategies for the early detection of cancers to reduce the mortality, especially breast X-ray(mammography)screening. However, several evidences also suggested that the benefit of reduction of breast-cancer mortality with mammography might become a problem due to the repeat mammography, subsequent biopsies, and overdiagnosis. And different screening strategies with different models, different intervals, and different target populations also incurred debates. After systematical analysis and discussion, we suggested to focus on high-risk population, improve the accuracy of screening technique, conduct the informed consent of participants, and explore individual screening mode in the screening of breast cancer.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Detecção Precoce de Câncer/métodos , Mamografia , Programas de Rastreamento/métodos , China , Humanos , Mamografia/normas
14.
J Biomed Sci ; 23: 30, 2016 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-26922801

RESUMO

BACKGROUND: TGF-ß is a key modulator in the regulation of cell proliferation and migration, and is also involved in the process of cancer development and progression. Previous studies have indicated that TGF-ß responsiveness is determined by TGF-ß receptor partitioning between lipid raft/caveolae-mediated and clathrin-mediated endocytosis. Lipid raft/caveolae-mediated endocytosis facilitates TGF-ß degradation and thus suppressing TGF-ß responsiveness. By contrast, clathrin-mediated endocytosis results in Smad2/3-dependent endosomal signaling, thereby promoting TGF-ß responsiveness. Because betulinic acid shares a similar chemical structure with cholesterol and has been reported to insert into the plasma membrane, we speculate that betulinic acid changes the fluidity of the plasma membrane and modulates the signaling pathway associated with membrane microdomains. We propose that betulinic acid modulates TGF-ß responsiveness by changing the partitioning of TGF-ß receptor between lipid-raft/caveolae and non-caveolae microdomain on plasma membrane. METHODS: We employed sucrose-density gradient ultracentrifugation and confocal microscopy to determine membrane localization of TGF-ß receptors and used a luciferase assay to examine the effects of betulinic acid in TGF-ß-stimulated promoter activation. In addition, we perform western blotting to test TGF-ß-induced Smad2 phosphorylation and fibronectin production. RESULTS AND CONCLUSIONS: Betulinic acid induces translocation of TGF-ß receptors from lipid raft/caveolae to non-caveolae microdomains without changing total level of TGF-ß receptors. The betulinic acid-induced TGF-ß receptors translocation is rapid and correlate with the TGF-ß-induced PAI-1 reporter gene activation and growth inhibition in Mv1Lu cells.


Assuntos
Células Epiteliais/metabolismo , Pulmão/metabolismo , Microdomínios da Membrana/metabolismo , Receptores de Fatores de Crescimento Transformadores beta/metabolismo , Transdução de Sinais/efeitos dos fármacos , Fator de Crescimento Transformador beta/metabolismo , Triterpenos/farmacologia , Animais , Linhagem Celular , Células Epiteliais/citologia , Pulmão/citologia , Vison , Triterpenos Pentacíclicos , Ácido Betulínico
15.
Genet Mol Res ; 14(4): 15276-84, 2015 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-26634491

RESUMO

The leaves of tobacco plants were used to analyze differences in protein content of tobacco grown in the four main flue-cured tobacco-producing areas of Sichuan Province, China. An improved protein extraction method, isoelectric focusing/sodium dodecyl sulfate-polyacrylamide gel electrophoresis two-dimensional gel electrophoretic separation, was used to extract and separate total protein from tobacco leaves. Proteomic maps with relatively high resolution and repeatability were produced. At isoelectric points 4 to 7 and molecular weight ranging from 20-100 kDa, we detected 1032, 1030, 1019, and 1011 clearly visible protein spots in tobacco leaves from the four study areas. Proteome comparison between these protein spots showed that 119 spots with a greater than 2-fold change in expression quantity contributed to the variation in expression. Of which, 115 were successfully identified and annotated. According to the annotation results, these proteins participate in photosynthesis, energy metabolism, mineral nutrition, terpene metabolism, defensive reaction, and other physiological and biochemical processes. This study preliminarily explains the effects of ecological conditions on the physiological metabolism of tobacco leaves and how such effects directly or indirectly contribute to tobacco leaf quality.


Assuntos
Nicotiana/genética , Folhas de Planta/genética , Proteínas de Plantas/genética , Processamento de Proteína Pós-Traducional/genética , Proteoma/genética , China , Metabolismo Energético/genética , Anotação de Sequência Molecular/métodos , Fotossíntese/genética , Proteômica/métodos
16.
Br J Pharmacol ; 171(24): 5541-54, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25420930

RESUMO

UNLABELLED: Reorganization of the actin cytoskeleton is essential for cell motility and chemotaxis. Actin-binding proteins (ABPs) and membrane lipids, especially phosphoinositides PI(4,5)P2 and PI(3,4,5)P3 are involved in the regulation of this reorganization. At least 15 ABPs have been reported to interact with, or regulated by phosphoinositides (PIPs) whose synthesis is regulated by extracellular signals. Recent studies have uncovered several parallel intracellular signalling pathways that crosstalk in chemotaxing cells. Here, we review the roles of ABPs and phosphoinositides in chemotaxis and cell migration. LINKED ARTICLES: This article is part of a themed section on Cytoskeleton, Extracellular Matrix, Cell Migration, Wound Healing and Related Topics. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-24.


Assuntos
Citoesqueleto de Actina/metabolismo , Quimiotaxia/fisiologia , Proteínas dos Microfilamentos/metabolismo , Fosfatidilinositóis/metabolismo , Movimento Celular/fisiologia , Humanos , PTEN Fosfo-Hidrolase/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Transdução de Sinais/fisiologia
17.
Genet Mol Res ; 11(2): 1169-77, 2012 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-22614343

RESUMO

To better understand genomic DNA methylation in sibling plant cultivars, methylation-sensitive amplification polymorphism analysis was used to investigate two sibling tobacco cultivars, Yunyan85 and Yunyan87, and their two parents, K326 and Yunyan No. 2. Differences in the degree of genomic DNA methylation were found among the four tobacco cultivars. Compared with parents, the two sibling cultivars had fewer methylated sites. Twenty-nine methylation-sensitive amplification polymorphism fragments that exhibited methylation alteration in the four tobacco cultivars were recovered and sequenced. BLAST (nucleotide BLAST) searches showed that two of the 29 sequences have 99% similarity with nucleotides 1442-1694 of the nia-1 gene and the other 27 sequences contain GC, CAAT or TATA box. The nitrate reductase genes from Yunyan87, K326 and Yunyan No. 2 were found to be identical; however, the third intron of the nitrate reductase gene from Yunyan85 was different compared to the third introns of Yunyan87, K326 and Yunyan No. 2. We conclude that methylation alteration of promoter regions could be responsible for the different phenotypes in tobacco and that introns of the nitrate reductase gene can vary as a result of intra-species crossing in tobacco.


Assuntos
Metilação de DNA , Variação Genética , Nicotiana/genética , Nitrato Redutase/genética , Sequência de Bases , Primers do DNA , DNA de Plantas/metabolismo , Dados de Sequência Molecular , Homologia de Sequência do Ácido Nucleico , Nicotiana/enzimologia
18.
J Int Med Res ; 38(4): 1389-403, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20926012

RESUMO

Cathepsin L enhances angiogenesis by increasing extracellular matrix degradation and remodelling. This study investigated whether plasma cathepsin L could be used as a biomarker to predict collateral formation in patients with coronary heart disease (CHD). Patients with CHD (n = 218; aged 67 ± 11 years) underwent coronary angiography and were categorized as having either 'poor' or 'rich' collaterals. Plasma cathepsin L, the proangiogenic placenta growth factor (PLGF) and the antiangiogenic factors, cystatin C and endostatin, were measured. Elevated cathepsin L and PLGF levels were independently and significantly associated with enhanced collateral formation in patients with CHD; subgroup analyses also showed a significant correlation in patients with diabetes and acute coronary syndrome. Plasma endostatin and cystatin C levels were not significantly correlated with coronary collateral formation. Plasma cathepsin L and PLGF, acting as important modulators of angiogenesis, could be used as biomarkers to predict coronary collateral formation in patients with CHD.


Assuntos
Indutores da Angiogênese/sangue , Inibidores da Angiogênese/sangue , Catepsina L/sangue , Circulação Colateral/fisiologia , Circulação Coronária/fisiologia , Doença das Coronárias/sangue , Doença das Coronárias/fisiopatologia , Síndrome Coronariana Aguda/sangue , Síndrome Coronariana Aguda/complicações , Síndrome Coronariana Aguda/diagnóstico por imagem , Síndrome Coronariana Aguda/fisiopatologia , Idoso , Angiografia Coronária , Doença das Coronárias/complicações , Doença das Coronárias/diagnóstico por imagem , Cistatina C/sangue , Demografia , Complicações do Diabetes/sangue , Complicações do Diabetes/complicações , Endostatinas/sangue , Feminino , Humanos , Masculino , Fator de Crescimento Placentário , Proteínas da Gravidez/sangue , Curva ROC
20.
Clin Exp Dermatol ; 34(8): e907-9, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20055864

RESUMO

Aquagenic syringeal acrokeratoderma (ASA) is a rare acquired disorder that develops predominantly in young women. It is clinically characterized by a burning sensation and whitish discolouration on the hands and rarely on the soles after brief immersion in water, which resolves within a short time after drying. Topical aluminium chloride and salicylic acid are reportedly beneficial in some cases. In total, 20 female and 8 male patients with ASA have been reported previously. We present another male patient, who failed to respond to treatment with antihistamines and topical steroids, but responded well to formalin 3% in alcohol without any side-effects.


Assuntos
Formaldeído/administração & dosagem , Hiperidrose/patologia , Imersão/efeitos adversos , Ceratodermia Palmar e Plantar/patologia , Adulto , Humanos , Hiperidrose/complicações , Hiperidrose/tratamento farmacológico , Ceratodermia Palmar e Plantar/tratamento farmacológico , Ceratodermia Palmar e Plantar/etiologia , Masculino , Água
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