How do people with chronic kidney disease value cancer‐related quality of life?

Objectives: To estimate the utility‐based quality of life (QOL) of people with chronic kidney disease (CKD) and to estimate the QOL associated with two hypothetical colorectal cancer health states. Methods: A cross‐sectional study was conducted in people with CKD (stages 3–5, transplant recipients and those on dialysis) from three centres in Sydney, Australia. We measured participants' own QOL and that of two hypothetical colorectal cancer health states using a rating scale, and a utility‐based QOL measure, the time trade‐off, with extremes of 0 (death) and 1 (full health). Results: Recipients of kidney transplants (n = 79) had the highest mean QOL weights of 0.79 (standard deviation (SD) = 0.34) compared with participants with CKD 3–5 (n = 53) with mean QOL weights of 0.70 (SD = 0.39), and those on dialysis (n = 89), who had the lowest mean QOL weights of 0.62 (SD = 0.41) (P = 0.02). Having early and advanced stage colorectal cancers were valued at mean QOL weights of 0.44 (SD = 0.41) and 0.12 (SD = 0.25) among people with moderate stage CKD; 0.45 (SD = 0.39) and 0.11 (SD = 0.24) among dialysis patients; 0.62 (SD = 0.36) and 0.18 (SD = 0.29) among kidney transplant recipients. Conclusions: People with CKD have poor QOL. Having coexistent illnesses such as cancer further reduces the overall well‐being of individuals with kidney disease. In addition to the development of effective screening and treatment programs to improve cancer outcomes in people with CKD, our study also highlights the need for effective interventions to improve the QOL in people with CKD, particularly those with major comorbidities like cancer.     

二甲双胍联合顺铂对人肺癌裸鼠移植瘤治疗作用的研究

目的 研究二甲双胍联合常用的化疗药物顺铂对于人肺癌裸鼠移植瘤的抑瘤作用及对生存素(Survivin)、基质金属蛋白酶2(MMP-2)和Ki67分子表达的影响,致力于探索治疗肺癌的新的有效药物.方法 建立肺癌裸鼠移植瘤模型,将裸鼠随机分为二甲双胍组、顺铂组、二甲双胍联合顺铂组及对照组,给药42 d后,处死动物,留取肿瘤组织,免疫组织化学法及实时荧光定量PCR法检测肿瘤组织中Survivin、MMP-2和Ki67蛋白及mRNA的表达.结果 二甲双胍组、顺铂组和二甲双胍联合顺铂组抑瘤率分别为28.97％、35.34％和54.65％.与对照组比较,顺铂组及二甲双胍联合顺铂组Survivin、MMP-2和Ki67蛋白及mRNA表达水平均降低(P值均＜0.05),二甲双胍组MMP-2蛋白及mRNA表达水平降低(P值均＜0.05);与二甲双胍组、顺铂组比较,二甲双胍联合顺铂组Survivin、MMP-2和Ki67蛋白及mRNA表达水平均降低(P值均＜0.05).结论 二甲双胍组可抑制MMP-2的表达,顺铂组及二甲双胍联合顺铂组均可抑制Survivin、MMP-2和Ki67的表达,二甲双胍和顺铂联合应用可以增强抗肿瘤的疗效.     

用抗人结肠癌单克隆抗体检测血清和粪便中大肠癌相关抗原的研究

目的 研究抗人结肠癌MAb检测血清及粪液中癌相关抗原的价值。 方法 采用抗人结肠癌单抗SC_(3A)和SC_6检测47例结直肠癌、33例结直肠腺瘤、15例增生性息肉、14例炎性息肉及60例正常人群的血清和粪便中癌相关抗原。经ELISA双抗体夹心法检测。 结果 血清和粪便阳性率在结直肠癌组分别为66.0％和72.3％;腺瘤组为63.6％和60.6％;增生性息肉组为35.7％和57.1％;炎性息肉组为40.0％和33.3％;而正常对照组仅为11.7％和13.3％。45例大肠癌Dukes分期进行检测,早期癌粪便检测的阳性率为72.2％,而血清为50.0％。 结论 ELISA法检测不仅对大肠癌及癌前病变具有较好的敏感性,而且对早期癌及癌前期病变检测较血清学检测意义更大。此外,随腺瘤不典型增生程度加重而检测阳性率增高。粪便中检测大肠癌相关抗原,方法简便,取材容易,具较好敏感性,对大规模人群普查大肠癌具有一定的应用价值。     

Sodium Butyrate Induces Apoptosis of Human Colon Cancer Cells by Modulating ERK and Sphingosine Kinase 2

Objective To investigate the role of extracellular signal-regulated kinase （ERK） in apoptosis of human colon cancer （HCT116） cells. Methods After the HCT116 cells were pretreated with specific ERK inhibitor （U0126） or specific siRNA and exposed to 10 mmol/L sodium butyrate （NaBT） for 24 h, their apoptosis was detected by flow cytometry, levels of SphK2 and ERK protein were measured by Western blot, and translocation of SphK2 was assayed by immunofluorescence microscopy. Results The U0126 and siRNAs specific for SphK2 blocked the export of SphK2 from nuclei to cytoplasm and increased the apoptosis of HCT116 cells following NaBT exposure. Over-expression of PKD decreased NaBT-induced apoptosis of HCT116 cells, which was reversed by U0126. Furthermore, transfection of HCT116 cells with constitutively activated PKD plasmids recovered the UO126-blocked export of SphK2. Conclusion ERK regulates the export of SphK2 and apoptosis of HCT116 cells by modulating PKD. Modulation of these molecules may help increase the sensitivity of colon cancer cells to the physiologic anti-colon cancer agent, NaBT.     

肺癌合并慢性阻塞性肺病和手术方式对患者术后快速康复及治疗费用的影响

目的探索影响肺癌患者术后快速康复的相关临床因素及治疗费用,探讨术后快速康复的临床途径及其临床价值。方法回顾性分析华西医院同一医疗组从2010年1月至2011年3月的所有入院,连续129例行肺癌切除术患者的临床资料。按是否合并慢性阻塞性肺疾病将患者分为合并慢性阻塞性肺病组[COPD组,53例,其中男39例、女14例,平均年龄（56．3l±10．51）]岁和非慢性阻塞性肺病组[非COPD组,76例,其中男37例、女39例,平均年龄（65．92±7．85）]岁;根据手术方式不同将患者分为全胸腔镜手术组（VATS组,83例,其中男44例、女39例,平均年龄（61．62±10．80）]岁和开胸组[46例,其中男32例、女14例,平均年龄（62．95±9．97）]岁;分析不同组患者的术后并发症发生率、平均住院时间及各项费用。结果COPD组和非COPD组术后并发症发生率（53％VS．40％,P=0．134）和平均住院时间[（7．66±2．95）dVS．（7．36±2．74）d,P=0．539]差异均无统计学意义。VATS组术后并发症发生率（34％VS．65％,P〈0．001）和平均住院时间[（6．67±2．52）dVS．（8．6l±3．01）d,P〈0．001]均低于开胸组,且差异有统计学意义。VATS组平均住院总费用[（44542．26±11447．50）元VS．（23634．13±6014．35）元,P〈0．001]和材料费[（37352．53±11807．81）元VS．（12763．08±7124．76）元;P〈0．001]均显著高于开胸组,且差异有统计学意义。VATS组平均西药费显著低于开胸组[（7473．54±4523．70）元VS．（10176．7l±6371．12）元,P〈0．001],而两组其它费用差异均无统计学意义。结论VATS肺癌肺叶切除术可以促进术后快速康复,但增加了手术材料费用。而肺癌患者合并COPD与术后快速康复及费用均无关。     

超声引导下经皮射频消融治疗中晚期肝癌的临床研究

目的评价B超引导下冷循环射频肿瘤治疗仪射频消融(RFA)治疗中晚期肝癌的临床疗效及并发症。方法采用超声引导下经皮穿刺冷循环RFA治疗中晚期肝癌25例,其中转移性肝癌8例,原发性肝癌17例。每个病灶进行RFA1～2次。其中8例患者术前给予3次TACE治疗。术后通过增强CT扫描评价疗效。结果10个病灶完全坏死,余15个病灶大部分坏死。随访半年,25例患者现全部存活且生存质量明显提高。结论超声引导下经皮穿刺冷循环RFA治疗中晚期肝癌短期效果满意,值得推广。     

胸腔镜辅助微创切口与传统开胸肺癌根治术的比较

目的探讨电视胸腔镜辅助微创切口肺癌根治术的临床应用价值。方法比较我科自2006年6月-2008年12月29例胸腔镜辅助微创切口(VAMT组)与32例传统开胸(传统开胸组)行肺癌根治术的术中及术后情况。结果 VAMT组29例,其中1例(3.4%)中转常规切口。VAMT组术后胸腔闭式引流留置时间、术后住院时间、离床活动时间以及镇痛次数均明显少于传统开胸组(P<0.05);VAMT组手术时间、淋巴结清扫数与阳性率、病理学分期与传统开胸组相当;VAMT组并发症少于传统开胸组,但无统计学差异。结论 VAMT手术创伤小,安全可行,具有广阔的应用前景     

Medical mushrooms used for biochemical failure after radical treatment for prostate cancer: An open‐label study

Objective: The aim of this study was to assess the efficacy and safety of two different types of medical mushrooms in patients with prostate cancer in Japan. Methods: Patients with biochemical failure after radical treatment for non‐metastasized prostate cancer were enrolled in this open‐label study. For 6 months they ingested one of the two following supplements: Senseiro, containing extracts from the Agaricus blazei Murill mushroom; and Rokkaku Reishi, containing the Ganoderma lucidum mushroom. Levels of serum prostate‐specific antigen (PSA) level and PSA doubling time were examined before and after study entry to assess the impact of these supplements on disease progression. The primary end‐point of this study was partial response rate (50% or more decrease of serum PSA). Hormonal status, represented by serum testosterone levels, and toxicity were also assessed. Results: A total of 51 patients were enrolled following radical prostatectomy. Forty‐seven completed the protocol and could be assessed. Thirty‐two patients received Senseiro and the remaining 15 received Rokkaku Reishi. No partial response in terms of PSA was observed. Alteration of PSA doubling time did not correlate with that of serum testosterone levels. Serious adverse effects were not observed. Conclusions: No significant anticancer effects were observed with the intake of these two medical mushrooms.     

CacyBP/SIP nuclear translocation induced by gastrin promotes gastric cancer cell proliferation

AIM:To investigate the role of nuclear translocation of calcyclin binding protein,also called Siah-1 interacting protein(CacyBP/SIP),in gastric carcinogenesis.METHODS:The expression of CacyBP/SIP protein in gastric cancer cell lines was detected by Western blot.Immunofluorescence experiments were performed on gastric cancer cell lines that had been either unstimulated or stimulated with gastrin.To confirm the immunofluorescence findings,the relative abundance of CacyBP/SIP in nuclear and cytoplasmic compartments was assessed by Western blot.The effect of nuclear translocation of CacyBP/SIP on cell proliferation was examined using MTT assay.The colony formation assay was used to measure clonogenic cell survival.The effect of CacyBP/SIP nuclear translocation on cell cycle progression was investigated.Two CacyBP/SIPspecific siRNA vectors were designed and constructed to inhibit CacyBP/SIP expression in order to reduce the nuclear translocation of CacyBP/SIP,and the expression of CacyBP/SIP in stably transfected cells was determined by Western blot.The effect of inhibiting CacyBP/SIP nuclear translocation on cell proliferation was then assessed.RESULTS:CacyBP/SIP protein was present in most of gastric cancer cell lines.In unstimulated cells,CacyBP/SIP was distributed throughout the cytoplasm;while in stimulated cells,CacyBP/SIP was found mainly in the perinuclear region.CacyBP/SIP nuclear translocation generated a growth-stimulatory effect on cells.The number of colonies in the CacyBP/SIP nuclear translocation group was significantly higher than that in the control group.The percentage of stimulated cells in G1phase was significantly lower than that of control cells(69.70%±0.46%and 65.80%±0.60%,control cells and gastrin-treated SGC7901 cells,P=0.008;72.99%±0.46%and 69.36%±0.51%,control cells and gastrin-treated MKN45 cells,P=0.022).CacyBP/SIPsi1effectively down-regulated the expression of CacyBP/SIP,and cells stably transfected by CacyBP/SIPsi1 were then chosen for further cellular assays.In CacyBP/SIPsi1 stably transfected cells,CacyBP/SIP was shown to be distributed throughout the cytoplasm,irregardless of whether they were stimulated or not.After CacyBP/SIP nuclear translocation was reduced,there had no major effect on cell proliferation,as shown by MTT assay.There had no enhanced anchoragedependent growth upon stimulation,as indicated by colony formation in flat plates.No changes appeared in the percentage of cells in G0-G1 phase in either cell line(71.09%±0.16%and 70.86%±0.25%,control cells and gastrin-treated SGC7901-CacyBP/SIPsi1 cells,P=0.101;74.17%±1.04%and 73.07%±1.00%,control cells and gastrin-treated MKN45-CacyBP/SIPsi1cells,P=0.225).CONCLUSION:CacyBP/SIP nuclear translocation promotes the proliferation and cell cycle progression of gastric cancer cells.     

非小细胞肺癌纵隔淋巴结转移特点临床探讨

目的在可切除的非小细胞肺癌（non-small cell lung cancer,NSCLC）患者手术治疗中,对纵隔淋巴结的清扫范围国内外学者仍有较大争议。本研究目的在于总结NSCLC纵隔淋巴结转移特点,为手术治疗NSCLC时正确处理纵隔淋巴结提供理论依据。方法按Naruke等肺癌淋巴结分布图对168例NSCLC施行肺叶（全肺）切除加同侧纵隔淋巴结系统性廓清术,分析病理证实的纵隔淋巴结转移频度及分布情况。结果手术共清除纵隔淋巴结1143组,平均每例清扫6.8组,病理证实有纵膈淋巴结癌细胞转移（N2）的332组,N2转移率29.0％。最大径≤3cm（T1）肿瘤和最大径〉3cm（T2）肿瘤间淋巴结转移差异有统计学意义（P〈0.05）。鳞癌、腺癌发生3组或3组以上纵隔淋巴结转移者分别为33.3％、42.4％。N2跳跃式转移发生率为14.3％。结论在上叶癌以上纵隔淋巴结转移居多,中下叶癌则跨区域转移居多。淋巴结转移具有跳跃性、跨区域性和多发性特点。