早期肠内营养对胃癌术后近期免疫和营养状况的影响

目的:比较早期肠内(EN)与肠外营养(PN)对胃癌术后免疫和营养状况的影响.方法:将72例胃癌病人随机分为EN组26例、PN组26例及常规输液(对照)组20例.术后24 h开始给予EN或PN,分别检测术前和术后第9天营养和免疫指标,并观察术后严重并发症及肠功能的恢复.结果:EN组和PN组术后体质量、前清蛋白、清蛋白、IgG、IgM及IgA均显著高于对照组(P＜0.05).而EN组与PN组间差异无显著性意义;EN组、PN组术后CD3 、CD4 、CD4 /CD8 均显著高于对照组(P＜0.01),并且EN组术后CD4 、CD4 /CD8 亦显著高于PN组(P＜0.05);EN组胃肠功能恢复时间明显短于PN组和对照组(P＜0.001).结论:早期肠内营养可明显改善胃癌术后近期的营养和免疫状况,在术后细胞免疫和肠功能恢复方面明显优于肠外营养.     

消化道肿瘤术后早期营养对免疫和应激反应的作用

目的 比较消化道恶性肿瘤术后早期肠内营养（EEN）＋肠外营养（PN）与术后早期完全胃肠外营养（TPN）对患者应激和免疫指标的影响。方法将择期进行消化道恶性肿瘤根治手术患者随机分为EEN＋PN组（22例）和TPN组（24例），两组患者分别于术后24小时开始等热量、等氮营养治疗。比较两组患者术前与术后1周CD3、CD4、CD8、CD4／CD8、IgA、IgG、IgM、C-反应蛋白（CRP）、肿瘤坏死因子α（TNFα）、白介素2（IL2）水平的差异。结果EEN＋PN组术后7天CD3、CD4、IgM显著高于TPN组（P〈0．05）；TPN组术后1天IL2显著高于EEN＋PN组（P〈0．05）。两组患者术前、术后7天CD8、CD4／CD8、IgA、IgG、CRP、TNFα差异均无显著性（P＞0.05）。结论EEN＋PN在改善应激和免疫指标方面优于TPN，可成为消化道肿瘤患者术后首选的营养方式。     

老年恶性消化道肿瘤患者术后应用肠内营养的安全性及疗效

目的 评价老年恶性消化道肿瘤患者术后应用肠内营养支持的安全性及临床疗效。方法 将108例老年恶性消化道肿瘤患者随机分为肠内营养（EN）组（45例）、肠外营养（PN）组（45例）及对照组（常规输液）组（18例），EN组术后24小时输注肠内营养液，PN组经外周静脉输注营养液。观察临床和测定营养支持前后患者的血糖、肝肾功能和电解质以及营养和免疫指标的变化。结果 EN组肠功能恢复时间明显短于PN组和对照组（P＜0．001）；血糖、肝肾功能、电解质、补体C3、C4和总补体溶血活性在各组问差异无显著性；EN、PN组治疗后体重、前白蛋白、白蛋白、IgG、IgM、IgA及C-反应蛋白均显著高于对照组（P＜0．05，P＜0．01），而EN组与PN组间差异无显著性；EN组、PN组治疗后CD3^＋、CD4^＋、CD4^＋／CD8^＋均显著高于对照组（P＜0．01），且EN组治疗后CD4^＋、CD4^＋／CD8^＋亦高于PN组（P＜0．05）。结论 肠内营养安全、实用有效，对体质差、年龄大的恶性消化道肿瘤患者更为适合。     

老年胃肿瘤病人术后早期肠内营养的应用

目的:探讨早期肠内营养对改善老年胃肿瘤病人术后的营养免疫状况及减少并发症的作用.方法:将84例老年胃肿瘤病人随机分为肠内营养(EN)组及肠外营养(PN)组,于术后24 h开始予以相同热量及氮量营养支持,分别观察营养支持前后的营养和免疫指标及术后并发症.结果:两组的营养及免疫指标于营养支持后明显改善(P＜0.05),免疫指标EN组较PN组明显提高(P＜0.05);EN组与PN组相比,明显促进病人术后胃肠道功能恢复,减少并发症的发生及住院费用.结论:老年胃肿瘤病人术后早期肠内营养是一种安全、有效、简便、经济和理想的营养治疗方法.     

消化道恶性肿瘤术后早期肠内与肠外营养治疗的比较

目的探讨消化道恶性肿瘤术后早期肠内营养(EEN) 肠外营养(PN)可行性,并将其与完全胃肠外营养(TPN)对患者营养状况和免疫功能的影响进行比较。方法将2001年10月～2003年3月在本院普外科行择期消化道恶性肿瘤手术患者随机分为EEN PN组(22例)和TPN组(24例),于术后24h开始营养治疗,他们在获得能量与氮量方面差异无显著性。术前、术后第1、3、7天测定血前白蛋白(PA)、白蛋白(ALB)和血色素(Hb)水平;术前、术后第7天测定血IgA、IgG、IgM、T淋巴细胞亚群CD3、CD4、CD8及CD4/CD8水平;术后第1～7天每日测定氮平衡(NB)。比较两组上述指标在术后的差异。结果两组间在术前、术后第1、3、7天测定的血PA、ALB、Hb及术后第1～7天测定的NB比较,差异均无显著性(P>0.05)。术后第7天EEN PN组CD3、CD4水平明显高于TPN组(P<0.05熏P<0.01),而两组在CD8及CD4/CD8的差异无显著性(P>0.05)。术后第7天EEN PN组IgM明显高于TPN组(P<0.05),而两组在IgA、IgG的差异无显著性(P>0.05)。结论EEN PN是腹部术后安全有效的营养途径。由于EEN PN在改善免疫功能方面明显优于TPN,因此它应成为消化道肿瘤患者术后首选的营养方式。     

免疫肠内营养在高龄胃癌病人术后免疫调节作用的观察

目的:观察免疫肠内营养对高龄胃癌病人术后恢复、免疫功能、营养状况的影响。方法:将68例高龄胃癌病人(70岁)手术后随机分为免疫肠内+肠外营养(EN+PN)组和肠外营养(PN)组。于术前1 d、术后第1和第7天检测相关的营养和免疫血清指标,观察术后恢复情况,并比较和分析。结果:两组病人术后第1天血清总蛋白(TP)、清蛋白(ALB)、前清蛋白(PA)、Ig G、Ig A水平以及CD3、CD4、CD4/CD8较术前1 d有显著下降。术后7天EN+PN组血清TP、ALB、PA、Ig G、Ig A以及CD3、CD4、CD4/CD8与PN组比有显著性差异(P0.01)。术后EN+PN组和PN组发生术后并发症无显著性差异。结论:早期使用肠内免疫营养制剂,可改善高龄胃癌病人手术后的免疫功能和营养状态。     

老年人胃癌全胃切除术后早期肠内营养及对免疫功能影响的观察

目的 评价老年人胃癌全胃切除术后早期肠内营养(EEN)支持的安全性及对术后营养状况、免疫功能的影响.方法 66例老年人胃癌全胃切除术后患者随机分为两组,EEN组和肠外营养(PN)组,每组各33例.EEN组术中放置空肠造口管,术后24 h以内管喂肠内营养液肠内高营养多聚合剂(能全力),PN组给予等氮、等热量的标准PN,总热量为125kJ/(kg·d).术前1 d、术后第1、10天观察并比较两组营养免疫指标、胃肠功能恢复时间和营养支持费用.结果 所有病例无手术死亡、无严重并发症发生;在术后第10天前白蛋白和转铁蛋白以及白细胞介素(IL)-2水平EEN组较PN组均明显升高(P＜0.05).术后第1天两组患者IgM、IgA、IgG水平均下降,术后第10天EEN组IgA水平明显高于PN组(P＜0.05).EEN组较PN组术后肠道功能恢复早、住院时间短.结论 老年人胃癌全胃切除术后EEN安全、有效,且价格低廉;可促进术后免疫功能早期恢复,是值得推广的营养支持方式.     

复合乳酸菌对重症急性胰腺炎大鼠细胞因子平衡的影响

目的构建大鼠重症急性胰腺炎(SAP)模型,探讨复合乳酸菌对SAP大鼠细胞因子和肠道免疫屏障的影响。方法96只Sprague-Dawley大鼠,体重(200±10)g,随机分为12组(n=8),包括假手术早期肠内营养治疗(Sham-EEN)4天、7天组、早期肠内营养治疗(EEN)4天、7天组、早期肠内营养加复合乳酸菌治疗(EEN Lac)4天、7天组;假手术肠外营养治疗(Sham-PN)4天、7天组、肠外营养治疗(PN)4天、7天组、肠外营养加复合乳酸菌治疗(PN Lac)4天、7天组。采用胰腺被膜下均匀注射3.8%牛磺胆酸钠1ml的方法建立大鼠SAP模型。分别于第4和7天取材,检测血清肿瘤坏死因子-α(TNF-α)和白介素-10(IL-10)的水平,评价IL-10/TNF-α的平衡状态;并检测小肠黏液SIgA含量。结果(1)血清TNF-α水平各SAP模型组均显著高于假手术组(P<0.05);PN组显著高于EEN组和EEN Lac组(P<0.05);EEN组显著高于EEN Lac组(P<0.05);PN组显著高于PN Lac组(P<0.05);各SAP模型4天组显著高于7天组(P<0.05)。(2)血清IL-10水平各SAP模型组均显著高于假手术组(P<0.05);PN组显著低于EEN组和EEN Lac组(P<0.05);PN4天组低于PN Lac组(P<0.05);各SAP模型4天组显著高于7天组(P<0.05)。(3)血清IL-10/TNF-α比值PN组显著低于EEN组、EEN Lac组(P<0.05);EEN组低于EEN Lac组(P<0.05);各SAP4天组低于7天组(P<0.01)。(4)小肠黏液SIgA含量SAP模型组除了EEN Lac7天组外,其他各组均显著低于假手术组(P<0.01);各SAP模型4天组显著低于7天组(P<0.05);EEN Lac组显著高于EEN组(P<0.05),EEN Lac和EEN组显著高于PN组(P<0.05),EEN Lac组显著高于PN Lac组(P<0.05)。结论复合乳酸菌可改善SAP大鼠促炎和抗炎细胞因子的平衡状态和肠道的免疫功能;EEN在改善SAP大鼠机体炎症状态和肠道免疫功能方面优于PN。     

肠内营养联合肠外营养对结肠癌手术后患者免疫功能的影响

目的比较结肠癌术后肠内营养(EN)联合肠外营养(PN)与全肠外营养(TPN)对患者术后应激和免疫指标的影响。方法将64例结肠癌患者随机分成两组,术后分别接受肠内外联合营养(EN+PN)和全肠外营养(TPN),所有患者分别于术前1d和术后第1、第7d测定补体C3,IgA,IgM,IgG,CD3,CD4,CD8,CD4/CD8。结果 6d后补体C3,IgA,IgM,IgG,CD3,CD4,CD8,CD4/CD8的恢复程度,EN+PN组与TPN组差异有统计学意义(P0.05)。结论与TPN对比,联合使用EN和PN更能有效促进结肠癌术后机体免疫功能的恢复。     

早期肠内营养支持在危重症病人中的应用

目的:探讨早期肠内营养(EEN)支持在危重症病人中的应用效果. 方法:将ICU中65例危重症病人随机分为EEN组(35例)和肠外营养(PN)组(30例),并将营养支持情况进行对比分析. 结果:经EEN支持后血清清蛋白(ALB)和血红蛋白(Hb)较治疗前升高(P＜0.05),而经PN支持后各指标差异无显著性意义.两组对比EEN组病人ALB高于PN组(P＜0.05).EEN组在肱三头肌皮皱厚度(TSF)和上臂肌围(AMC)与PN组无显著性差异(P＞0.05),在Hb及氮平衡方面则明显优于PN组(P＜0.05). 结论:对于危重症病人,EEN较PN有更好的营养效果和代谢效应.     

人源性宫颈癌、子宫内膜癌、卵巢癌异种移植动物模型的建立

目的构建人来源的宫颈癌(cervical cancer,CC)、子宫内膜癌(endometrial cancer,EC)、卵巢癌(ovarian cancer,OC)人源性肿瘤异种移植动物模型,为研究和开发新药及个体化治疗提供实验模型。方法收集2018年2月至2019年4月新疆医科大学第一附属医院CC、EC、OC患者各5例的新鲜手术切除标本,移植至重度免疫缺陷(immunodeficiency,NOG)小鼠和非肥胖糖尿病/重症联合免疫缺陷(non-obese diabetes/severe combined immunodeficiency,NOD/SCLD)小鼠皮下,监测荷瘤小鼠体重和肿瘤体积,对长至500~1 000 mm^3大小的肿瘤进行传代移植,通过苏木精-伊红染色法(hematoxylin-eosin staining,HE)染色及免疫组化(immunohistochemistry,IHC)验证移植肿瘤组织与患者肿瘤组织的病理学一致性。结果本研究收集并移植15例CC、EC、OC肿瘤标本,成功构建CC、EC、OC PDX模型8例,建模成功率为53%。结论模型较好地保留了原发肿瘤的特征,为后续研究开发CC、EC、OC新的治疗方案、临床药物筛选以及个体化治疗提供了实验平台。     

Persisting risk of nickel related lung cancer and nasal cancer among Clydach refiners

Objective

To evaluate the risk of lung cancer and nasal cancer among workers employed at the Clydach nickel refinery, South Wales since 1930 by combining data from the two most recently published papers on this cohort.

Methods

Observed and expected numbers of cancer deaths were extracted for workers who had a minimum of five years service and were employed for the first time between 1902 and 1992. Standardised mortality ratios (SMR) were calculated for subgroups according to year of employment, time since first employment, and process work.

Results

A persisting excess of respiratory cancer was found for workers employed in the period 1930–92, with a lung cancer SMR of 133 (95% CI 103 to 172) and a SMR for nasal cancer of 870 (95% CI 105 to 3141). The lung cancer excess was most clearly seen 20 years or more after first employment and seemed to be confined to process workers. There was no indication of a further reduction in risk since 1930.

Conclusion

The extreme nickel related cancer hazard at the refinery before 1920 was greatly reduced during subsequent years. Some of the carcinogenic exposures seem to have remained after 1930, producing an elevated risk of nasal cancer and a 30% excess of lung cancer in the workforce. There was evidence of a persisting risk among process workers first employed since 1953.     

番茄红素抗癌作用研究现状

许多流行病学研究表明，番茄制品可以降低癌的危险性，尤其是胃肠道和前列腺癌。番茄红素是番茄制品的主要类胡萝卜素，本文对番茄红素的分子结构、代谢等生物学特征、番茄红素的抗癌作用及其机制进行了综述。     

肺癌及癌旁组织中微量元素含量分析

目的 :探讨肺癌患者的癌、癌旁和正常组织中微量元素含量的变化。方法 :收集 2 0例肺癌患者癌组织、癌旁组织及正常组织 ,用等离子体发射光谱仪测定Se、Zn、Cu、Fe、Mg、Mn含量。结果 :肺癌患者的正常组织、癌旁组织、癌组织Se、Zn、Mg的含量和Se/Zn的比值逐渐降低 ,但Cu、Fe、Mn的含量和Cu/Zn、Fe/Zn、Mn/Zn的比值则相反而逐渐升高 (P <0 .0 1)。结论 :微量元素含量的变化与肺癌发生、发展有一定的关系 ,对癌变过程的研究和临床治疗的指导具有重要意义     

Community knowledge of cancer

Since major opportunities for the prevention and early detectionof cancer rely on changing the behaviour of individuals, publiceducation is a major focus of many cancer control organizations.Some public education messages in Australia have been constantfor over a decade. Despite this, many people still do not followrecommendations for cancer prevention and early detection. Littleinformation is available on the extent to which the communityhas assimilated the educational messages produced by cancereducation agencies. A randomly selected community sample (n=76)were surveyed regarding their knowledge of five common cancers;lung bowel, melanoma, breast and cervical Areas of knowledgecommonly included in educational material were considereth thelifetime risk of developing each cancer, five year survival,preventable risk factors and the methods for early detectionof each cancer. Results indicate that respondents tended tooverestimate the lifetime risk of developing each cancer. Survivalfrom lung cancer was greatly overestimated by a high proportionof respondents. Smoking as a risk factor for lungcancerwa.swell recognized, as was sun exposurefor the risk of developingmelanoma. Despite this, these two cancers were not viewed aspreventable by a high proportion of respondents. Symptoms formelanoma, bowel cancer and breast cancer were well known, however,the tests to detect these cancers were not equally well known.The importance of early detection for increased survival waswell recognized. The implications of these results for publkeducation strategies are discussed.     

Formaldehyde and cancer: a critical review

Formaldehyde is a naturally occurring chemical found in every human cell. It has been in widespread use for over a century as a disinfectant and preservative agent, and more recently in a number of industrial products. Animal studies indicate that formaldehyde is a rat carcinogen at high levels (>_ 10 ppm) of exposure. Results for lower levels of exposure show less clear-cut carcinogenic effects, and some species, such as mice and hamsters, appear much less sensitive to any carcinogenic potential of formaldehyde. Epidemiologic studies of the effects of formaldehyde exposure among humans provide inconsistent results. In general, these nonexperimental studies suffer from a number of biases and flaws. The epidemiologic studies fall into three categories: formaldehyde industry workers, case-control studies, and studies of professionals who use formaldehyde. Studies of industry workers with known exposure to formaldehyde report little evidence of an excess cancer risk. Nasopharyngeal cancer, the one cancer considered most strongly linked to formaldehyde among humans, appears after close examination to be likely a result of multiple subgroup analyses and misclassification. The case-control studies usually lack any direct measure of formaldehyde exposure and rely instead on hypothetical exposure based on occupational exposure matrices. Most of these studies, after adjustment for confounding factors, fail to find a significant association with putative formaldehyde exposure. The studies that do report a significant association suffer from methodologic problems limiting their interpretation. The investigations of professionals who use formaldehyde in their work, such as embalmers, pathologists, and anatomists, have the advantage over case-control studies of a much higher likelihood of actual formaldehyde exposure. The findings among these individuals, however, are at odds with those of the other two groups, with excesses of deaths from cancer of the brain and leukemia. The inconsistency between professionals and formaldehyde industry workers in cancer risk patterns suggest that formaldehyde is not the etiologic agent. When the epidemiologic data on formaldehyde and human cancer are examined in light of the widely accepted causal criteria of strength of the association, consistency and specificity of results, dose-response effects, and biologic coherence and plausibility, the studies published so far fail to provide credible causal evidence.     

胃癌患者复发恐惧及其与抑郁的相关性研究

目的 探讨胃癌患者癌症复发恐惧及其与抑郁之间的关系,为进一步干预提供依据。方法 采用一般资料问卷、癌症患者恐惧疾病进展简化量表（FoP - Q - SF）、抑郁自评量表(SDS)对212例胃癌患者进行调查分析。结果 胃癌患者癌症复发恐惧总得分(35.43±10.44)分,抑郁程度得分为（57.05±9.52）分。FoP - Q - SF各维度与SDS各维度均呈正相关;多重线性回归分析显示患者年龄、病程、家庭人均收入、FoP - Q - SF是抑郁的影响因素,可解释总体变异度的58.5%,其中FoP - Q - SF独立影响抑郁水平总体变异的36.7%。结论 本研究中胃癌患者癌症复发恐惧处于中等水平,推测可通过降低复发恐惧水平来降低抑郁的发生。     

Oropharyngeal cancer epidemic and human papillomavirus

A growing body of research shows that human papillomavirus (HPV) is a common and increasing cause of oropharyngeal squamous cell carcinoma (OSCC). Thus, the International Agency for Research against Cancer has acknowledged HPV as a risk factor for OSCC, in addition to smoking and alcohol consumption. Recently, in Finland, the United Kingdom, the Netherlands, the United States, and Sweden, incidence of OSCC has increased, and an increase in the proportion of HPV-positive tumors was noted. On the basis of these data and reports indicating that patients with HPV-positive cancer have their first sexual experience at a young age and have multiple partners, we postulate that increased incidence of OSCC in the United States and some countries in northern Europe is because of a new, primarily sexually transmitted HPV epidemic. We also suggest that individualized treatment modalities and preventive vaccination should be further explored.