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Objective: To describe the distribution characteristics of hyperlipidemia in adult twins in the Chinese National Twin Registry (CNTR) and explore the effect of genetic and environmental factors on hyperlipidemia. Methods: Twins recruited from the CNTR in 11 project areas across China were included in the study. A total of 69 130 (34 565 pairs) of adult twins with complete information on hyperlipidemia were selected for analysis. The random effect model was used to characterize the population and regional distribution of hyperlipidemia among twins. The concordance rates of hyperlipidemia were calculated in monozygotic twins (MZ) and dizygotic twins (DZ), respectively, to estimate the heritability. Results: The age of all participants was (34.2±12.4) years. This study's prevalence of hyperlipidemia was 1.3% (895/69 130). Twin pairs who were men, older, living in urban areas, married,had junior college degree or above, overweight, obese, insufficient physical activity, current smokers, ex-smokers, current drinkers, and ex-drinkers had a higher prevalence of hyperlipidemia (P<0.05). In within-pair analysis, the concordance rate of hyperlipidemia was 29.1% (118/405) in MZ and 18.1% (57/315) in DZ, and the difference was statistically significant (P<0.05). Stratified by gender, age, and region, the concordance rate of hyperlipidemia in MZ was still higher than that in DZ. Further, in within-same-sex twin pair analyses, the heritability of hyperlipidemia was 13.04% (95%CI: 2.61%-23.47%) in the northern group and 18.59% (95%CI: 4.43%-32.74%) in the female group, respectively. Conclusions: Adult twins were included in this study and were found to have a lower prevalence of hyperlipidemia than in the general population study, with population and regional differences. Genetic factors influence hyperlipidemia, but the genetic effect may vary with gender and area.
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , China/epidemiologia , Doenças em Gêmeos/genética , Hiperlipidemias/genética , Doenças Metabólicas , Gêmeos Dizigóticos , Gêmeos Monozigóticos/genéticaRESUMO
Objective: To assess the association of genetic polymorphisms and circulating levels of chemokine monocyte chemoattractant protein-1 (MCP1) with risk of breast cancer. Methods: A total of 820 patients with pathologically confirmed breast cancer and 900 age-and area-of-residence-matched healthy controls who visited the hospital for routine health screening during the same period were included in this case-control study. Mendelian randomization analysis was performed using three widely followed functional single nucleotide polymorphisms (SNPs) of the MCP1 gene rs1024611, rs2857656 and rs4586 to construct instrumental variables . Results: MCP1 rs1024611 (OR=1.26, P=0.002), rs2857656 (OR=1.23, P=0.006) and rs4586 (OR=1.23, P=0.003) were significantly associated with increased risk of breast cancer. SNP rs1024611 (β=1.194, P<0.001), rs2857656 (β=1.221, P<0.001) and rs4586 (β=1.137, P<0.001) were positively correlated with higher circulating level of MCP1. The case-control study showed that an increase of 23.7 pg/ml of circulating levels of MCP1 was associated with a 0.25-fold increased risk of breast cancer. MR analysis confirmed that the genetic predicted circulating levels of MCP1 were associated with an increased risk of breast cancer, and the risk of breast cancer increased by 0.20 times with an increase of 23.7 pg/ml in MCP1. Conclusion: Genetic variants and circulating levels of MCP1 are significantly associated with the risk of breast cancer and can be used as a biomarker for early prediction of breast cancer.
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Feminino , Humanos , Neoplasias da Mama/genética , Estudos de Casos e Controles , Quimiocina CCL2/genética , Análise da Randomização Mendeliana , Polimorfismo de Nucleotídeo ÚnicoRESUMO
Objective: To systematically summarize and analyze the clinical research progress of therapeutic vaccines for cervical cancer or precancerous lesions. Methods: English databases (PubMed, Embase, Web of Science, Cochrane library, Proquest, and ClinicalTrails.gov) and Chinese databases (SinoMed, CNKI, WanFang, and VIP Database) were systematically searched to collect literature on therapeutic vaccines for cervical cancer or precancerous lesions from inception to February 18, 2021. After screening, we evaluated the risk of bias of included studies, and combed the basic information of the literature, research designs, information of vaccines, study patients, outcome indicators and so on, qualitatively summarized the clinical research progress. Results: A total of 71 studies were included in this systematic review, including 14 random controlled trials, 15 quasi-random controlled trials, 4 cohort studies, 1 case-control study, 34 case series studies and 3 case reports. The study patients included women aged 15~79 with cervical cancer or precancerous lesions in 18 countries from 1989 to 2021. On the one hand, there were 40 studies on therapeutic vaccines for cervical precancerous lesions (22 867 participants), involving 21 kinds of vaccines in 6 categories. Results showed 3 marketed vaccines (Cervarix, Gardasil, Gardasil 9) as adjuvant immunotherapies were significant effective in preventing the recurrence of precancerous lesions compared with the conization only. In addition, MVA E2 vaccine had been in phase Ⅲ clinical trials as a specific therapeutic vaccine, with relative literature showing it could eliminate most high-grade precancerous lesions. Therapeutic vaccines for precancerous lesions all showed good safety. On the other hand, there were 31 studies on therapeutic vaccines for cervical cancer (781 participants), involving 19 kinds of vaccines in 7categories, with none had been marketed. 25 studies were with no control group, showing the vaccines could effectively eliminate solid tumors, prevent recurrence, and prolong the median survival time. However, the vaccines effectiveness couldn't be statistically calculated due to the lack of a control group. As for the safety of therapeutic vaccines for cervical cancer, 9 studies showed that patients experienced serious adverse events after treatments, where 7 studies reported that serious adverse events occurred in patients couldn't be ruled out as the results of therapeutic vaccines. Conclusions: The literature review shows that the literature evidence for the therapeutic vaccines for cervical precancerous lesions is relatively mature compared with the therapeutic vaccines for cervical cancer. The four kinds of vaccines on the market are all therapeutic vaccines for precancerous lesions, but they are generally used as vaginal infection treatments or adjuvant immunotherapies for cervical precancerous lesions, not used for the specific treatments of cervical precancerous lesions. Other specific therapeutic vaccines are in the early stage of clinical trials, mainly phase Ⅰ/Ⅱ clinical trials with small sample size. The effectiveness and safety data are limited, and further research is still needed.
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Feminino , Humanos , Vacinas Anticâncer/uso terapêutico , Displasia do Colo do Útero/prevenção & controle , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Lesões Pré-Cancerosas/terapia , Neoplasias do Colo do Útero/prevenção & controleRESUMO
DECIDE-Diet trial was taken as a case to introduce the methods of blinding and blinding assessment for feeding trials, report the details of blinding, conduct a blinding survey and calculate Jame's BI and Bang's BI. Jame's BI was 0.683 (95% CI: 0.593~0.772). The Bang's BI for the intervention group was 0.340 (95% CI: 0.199~0.481), and for the control group was 0.086 (95% CI: -0.060~0.231). The blinding of the DECIDE)-Diet was generally successful, but the intervention group may infer their group to a certain extent. Feeding trials should report the details of blinding and consider blinding assessment.
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Objective To investigate the effect of glutamine on the serum carcino embryonie antigen (CEA) , alpha fetal protein (AFP) and T cell immune function in postoperative patients with gastric cancer.Methods 52 postoperative patients with gastric cancer from Yiwu Central Hospital were selected and randomly divided into control group and experimenal group, 26 cases in each group.The control group received routine nutritional therapy, and experimental group received alanyl -glutamine injection on the basis of control group.The serum nutritional parameters, CEA, AFP, CD4 +T, CD8 +T levels were compared post-treatment.Results Compared with control group post-treatment, the serum albumin (ALB) and pre-albumin (PA) levels were higher (P<0.05), the CEA and AFP levels were lower (P<0.05),the serum levels of CD4 +T and CD4 +T/CD8 +T were higher (P<0.05),CD8 +T level were lower (P<0.05).Conclusion Glutamine could significantly improve the clinical symptoms of patients with gastric cancer after surgery,and it is speculated that the mechanism may be the increase of serum ALB, PA levels, the decrease of CEA, AFP levels and the improvement of immune function.
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Objective To analyse effect of ShenQi FuZheng injection on serum carbohydrate antigen 19-9(CA19-9), C-reaction protein(CRP) and CD4 +lymphocyte subsets in patients after laparoscopic radical resection of colon cancer.Methods 58 patients after laparoscopic radical resection of colon cancer were collected.All patients were randomly divided into experimental group and control group according to the different drugs, 29 cases in each group.Patients were given the corresponding drug treatment after operation, after the treatment, the serum levels of CA19-9, CRP and venous blood T lymphocyte level were detected in all patients.Results Compared with before treatment, CA19-9 and CRP level in serum were lower (P<0.05) , CD4 +cells, CD4 +/CD8 +, and NK cells were higher(P<0.05);Compared with control group after treatment, the serum CA19-9 and CRP level were lower in the experimental group (P<0.05); the levels of venousblood CD4 +cells, CD4 +/CD8 +and NK cells were higher in the experimental group (P<0.05).Conclusion ShenQi FuZheng injection can significantly reduce the serum CRP and CA19-9 levels in patients after laparoscopic radical resection of colon cancer, improve the levels of venous blood CD4 +cells, CD4 +/CD8 +and NK cells, improve immune function, and have a guiding significance for clinica.
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Objective Although aspirin resistance has been recognized to occur in patients with diabetes mellitus, the prevalence and related risk factors for aspirin resistance in elderly patients with diabetes mellitus have not been reported yet. The purpose of the present study was to evaluate the prevalence and potential risk factors for aspirin resistance in elderly patients with type 2 diabetes.Methods The 140 elderly patients [aged from 60 to 92 years, mean age (73.8±8. 0) years] with type 2 diabetes receiving daily aspirin therapy (≥ 75 mg) over one month were recruited. Platelet aggregation was measured by light transmittance aggregometry (LTA) and thrombelastograph (TEG)platelet mapping assay. Results By LTA, 6 patients (4.3%) of the diabetic patients were found to be resistant to aspirin therapy, 44 patients (31.4 %) were semi-responders. By TEG, 31 patients (22. 1%) were aspirin resistant. Among the 31 patients who were aspirin resistant by TEG, 3 were aspirin resistant by LTA. In the multivariate logistic regression analysis, female gender (OR= 5. 54,95%CI: 1.17-27.47, P=0.036) and homocysteine level (OR=1.15, 95%CI: 1.00-1.35, P=0. 043) were statistically significant risk factors for aspirin resistance by TEG. Conclusions The prevalence of aspirin resistance in elderly patients with type 2 diabetes is considerably higher in elderly female patients and in elderly patients with higher serum homocysteine level.
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Objective To investigate the changes of sex hormone and androgen receptor levels and evaluate the relationship of the sex hormones and androgen receptor with coronary heart disease (CHD) in elderly men. Methods A cross-sectional study was performed in 539 elderly men, including 400 healthy people aged 62-92 years and 139 CHD patients aged 60-88 years. The plasma concentrations of total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG), estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were measured. The androgen receptor (AR) level was tested by flow cytometry. Results The fluorescence intensity of DHEAS, TT, SHBG, FT and AR were significantly lower in CHD group than in healthy group (P<0.01);however, FSH and E2 in CHD group were higher(P(0.01). Age was negatively correlated with TT(r=-0.28,P<0.01) and FT (r=-0.17,P<0.05), and positively correlated with SHBG(r=0.14,P<0.05) and E2 (r=0.33, P<0.01). AR fluorescence intensity was negatively correlated with systolic blood pressure (r=-0.12,P<0.01). Logistic regression analysis indicated that TT (OR=1.065,9% CI: 1.012~1.121,P<0.05), SHBG(OR=0.994,95% CI:0.990~0.998,P<0.01) and AR (OR=0.971,95%CI:0.956~0.986, P<0.01)were significantly associated with CHD in elderly male patients. Conclusions The levels of DHEAS, TT, SHBG, FT and AR are lower in elderly men with CHD than in elderly healthy men;however, the FSH and E2 concentrations are higher. Low levels of TT, SHBG and AR may be the independent risk factors for CHD in elderly men.