传统双生长棒技术治疗先天性早发性脊柱侧凸的内固定相关并发症及其危险因素分析

目的:观察传统双生长棒技术(traditional dual growing rods,TDGR)治疗先天性早发性脊柱侧凸(con-genital early onset scoliosis,CEOS)的内固定相关并发症,并对其相关危险因素进行分析.方法:回顾性研究接受TDGR治疗的CEOS患者.所有患者至少接受2次生...     

Early onset colorectal cancer in Canterbury,New Zealand

Background

The overall incidence of colorectal cancer is decreasing in much of the world, yet the incidence in those under 50 years of age is increasing (early onset colorectal cancer (EOCRC)). The reasons for this are unclear. This study was undertaken to describe the clinical, pathological and familial characteristics of patients with EOCRC and their oncological outcomes and compare this with previously published data on late onset colorectal cancer (LOCRC).

Methods

A retrospective review of all patients diagnosed with EOCRC in Canterbury between 2010 and 2017 was conducted. Data was collected on demographics, family history, treatment, and oncologic outcomes. Kaplan–Meier survival curves were calculated to assess overall survival based on disease stage.

Results

During the study period (2010–2017) there were 3340 colorectal cancers diagnosed in Canterbury, of which 201 (6%) were in patients under 50 years (range: 17–49). Of these, 87 (43.3%) were female and 125 (62.2%) were aged between 40 and 49 years. 28 (13.9%) were associated with hereditary conditions. Of the 201 patients, 139 (69.2%) had rectal or left-sided cancers. 142 (70.6%) patients presented with either stage 3 or 4 disease and the 5-year overall survival by stage was 79.1% and 14.4%, respectively.

Conclusion

EOCRC is increasing and usually presents as distal left sided cancers, and often at an advanced stage. They do not appear to have the common risk factors of family history or inherited pre-disposition for colorectal cancer. Planning by healthcare providers for this epidemiological change is imperative in investigating symptomatic patients under 50 and optimizing early detection and prevention.     

鸦胆子油乳注射液联合CapeOx方案治疗早发型结肠癌的临床研究

目的 探讨鸦胆子油乳注射液联合CapeOx方案治疗早发型结肠癌的临床疗效。方法 选取2017年6月—2021年5月徐州医科大学附属连云港医院收治的96例早发型结肠癌患者，按随机数字表法将所有患者分为对照组和治疗组，每组各48例。对照组患者给予CapeOx方案化疗，化疗第1～14天餐后30 min口服卡培他滨片，1 g/m²，2次/d；第1天静脉滴注注射用奥沙利铂，130 mg/m²加入5%葡萄糖注射液250 mL中后给药，1次/d，每次滴注2 h。治疗组在对照组治疗基础上化疗第1～14天静脉滴注鸦胆子油乳注射液，30 mL/次加入0.9%氯化钠注射液250 mL中后给药，1次/d。两组均以21 d为1个周期，且均连续治疗2个周期。观察两组的临床疗效，比较治疗前后两组血清肿瘤标志物[癌胚抗原（CEA）、糖类抗原（CA）199、CA72-4、CA50]和血管内皮生长因子（VEGF）水平、大肠癌患者生命质量测定量表（FACT-C）评分。统计两组不良反应情况。结果 治疗后，治疗组客观缓解率（ORR）是47.92%，较对照组的35.42%有所提高，但差异无统计学意义；治疗组疾病控制率（DCR）是87.50%显著高于对照组的70.83%（P＜0.05）。治疗后，两组FACT-C中生理状况评分、情感状况评分、附加关注领域评分及量表总评分均显著增加（P＜0.05）；且均以治疗组患者增加更显著（P＜0.05）；功能状况和社会/家庭状况领域评分组内治疗前后及组间同期比较差异均无统计学意义。治疗后，两组血清CEA、CA199、CA72-4、CA50和VEGF水平均显著下降（P＜0.05）；均以治疗组降低更显著（P＜0.05）。治疗过程中，治疗组白细胞减少、肝肾损害、血小板减少的发生率分别为18.75%、10.42%、14.58%，显著低于对照组的37.50%、27.08%、33.33%（P＜0.05）。结论 鸦胆子油乳注射液联合CapeOx方案治疗早发型结肠癌具有一定的增效减毒作用，能有效提高患者近期疗效、下调血清肿瘤标志物水平及抑制肿瘤血管生成，并提高化疗耐受性，改善患者生命质量，值得临床推广应用。     

A two-stage genome-wide association study identified four potential early-onset nonsmall cell lung cancer risk loci based on 26,652 participants in Chinese population

Early-onset lung cancer is rare with an increasing incidence rate. Although several genetic variants have been identified for it with candidate gene approaches, no genome-wide association study (GWAS) has been reported. In this study, a two-stage strategy was adopted: firstly we performed a GWAS to identify variants associated with early-onset nonsmall-cell lung cancer (NSCLC) risk using 2556 cases (age ≤ 50 years) and 13,327 controls by logistic regression model. To further discriminate younger cases from older ones, we took a case–case analysis for the promising variants with above early-onset cases and 10,769 cases (age > 50 years) by Cox regression model. After combining these results, we identified four early-onset NSCLC susceptibility loci at 5p15.33 (rs2853677, odds ratio [OR] = 1.48, 95% confidence interval [CI]: 1.36–1.60, P_case-control = 3.58 × 10⁻²¹; hazard ratio [HR] = 1.10, 95% CI: 1.04–1.16, P_case–case = 6.77 × 10⁻⁴), 5p15.1 (rs2055817, OR = 1.24, 95% CI: 1.15–1.35, P_{case–control} = 1.39 × 10⁻⁷; HR = 1.08, 95% CI: 1.02–1.14, P_case–case = 6.90 × 10⁻³), 6q24.2 (rs9403497, OR = 1.24, 95% CI: 1.15–1.35, P_{case–control} = 1.61 × 10⁻⁷; HR = 1.11, 95% CI: 1.05–1.17, P_case–case = 3.60 × 10⁻⁴) and 12q14.3 (rs4762093, OR = 1.31, 95% CI: 1.18–1.45, P_{case–control} = 1.90 × 10⁻⁷; HR = 1.10, 95% CI: 1.03–1.18, P_case–case = 7.49 × 10⁻³). Except for 5p15.33, other loci were found to be associated with NSCLC risk for the first time. All of them had stronger effects in younger patients than in older ones. These results provide a promising overview for early-onset NSCLC genetics.     

子痫前期孕妇外周血NOX2和胎盘组织中NOX2、ROS的表达及其临床意义

目的 探讨子痫前期孕妇外周血、胎盘组织中还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶2(NOX2)及胎盘组织中活性氧（ROS）的表达及其临床意义。方法 选取2021年3月—2022年10月在徐州医科大学附属徐州妇幼保健院就诊的子痫前期孕妇60例，其中早发型子痫前期孕妇30例（早发组），晚发型子痫前期孕妇30例（晚发组），另取同期在该院就诊的健康孕妇30例作为对照（正常组）。检测各组外周血NOX2、胎盘组织中NOX2 mRNA相对表达量和ROS表达。结果 早发组外周血NOX2、胎盘组织NOX2阳性表达率、NOX2mRNA相对表达量、ROS阳性表达率均高于对照组和晚发组（P <0.0125）；晚发组与对照组外周血NOX2、胎盘组织NOX2阳性表达率、NOX2 mRNA相对表达量、ROS阳性表达率比较，差异均无统计学意义（P>0.05）。早发组≥30岁孕妇外周血NOX2高于<30岁孕妇（P <0.05）。早发组不同体质量指数、孕妇类型、严重程度孕妇外周血NOX2、胎盘组织NOX2阳性表达率、NOX2 mRNA相对表达量、ROS阳性表达率比较，差异均无统计学意义（P>0....