Associations of Nut Intakes with Incident Sporadic Colorectal Adenoma: A Pooled Case-Control Study

Introduction: Consumption of nuts, which contain multiple anti-carcinogenic components, has been inversely associated with colorectal cancer (CRC), particularly among women, but has not been investigated in relation to colorectal adenoma, the immediate precursor to most CRCs.

Methods: We pooled data from three case-control studies of incident, sporadic colorectal adenoma (n?=?785 cases, 2107 controls) in which dietary intakes were assessed using food frequency questionnaires, and analyzed the data using multivariable unconditional logistic regression.

Results: Among men and women combined, the multivariable-adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association of total nut product (all nuts and peanut butter combined) intakes, for those who consumed 0.5–1.5, 2.0–5.5, and ≥6 servings/week relative to no nut consumption were 0.81 (0.58, 1.12), 0.86 (0.61, 1.23), and 0.93 (0.65, 1.31), respectively. However, among women, the corresponding ORs and 95% CIs were 0.62 (0.40, 0.97), 0.57 (0.35, 0.94), and 0.78 (0.48, 1.25), respectively.

Conclusions: These results suggest that moderate nut consumption may be associated with lower risk for colorectal adenoma, primarily among women.     

不同浓度罗哌卡因复合舒芬太尼分娩镇痛对产妇产间发热的影响

目的研究不同浓度罗哌卡因复合舒芬太尼硬膜外注射用于分娩镇痛对产妇产间发热及致热因子的影响。方法适合阴道分娩、自愿要求分娩镇痛的初产妇120例,孕37～41周,年龄20～35岁,ASA I或Ⅱ级,随机分为三组:0.075%罗哌卡因组(A组)、0.1%罗哌卡因组(B组)和0.125%罗哌卡因组(C组),每组40例。宫口扩张至3 cm时实施硬膜外分娩镇痛,A组0.075%罗哌卡因+舒芬太尼0.5μg/ml;B组0.1%罗哌卡因+舒芬太尼0.5μg/ml;C组0.125%罗哌卡因+舒芬太尼0.5μg/ml。记录镇痛后1、2、3、4和5 h、胎儿娩出即刻、分娩后2 h产妇鼓膜温度;分别在镇痛前、胎儿娩出即刻及分娩后2 h采集产妇静脉血,测定血清IL-1β、IL-6、TNF-α浓度;记录产程时间;采用改良Bromage法评定三组产妇在镇痛后1 h及胎儿娩出即刻的运动神经阻滞程度。结果与镇痛前比较,镇痛后5 h及胎儿娩出即刻三组鼓膜温度明显升高,C组发热率明显高于A组和B组(P0.05)。与镇痛前比较,胎儿娩出即刻三组血清IL-1β、IL-6、TNF-α浓度明显升高(P0.05)。C组第二产程和镇痛时间明显长于A组和B组,B组第二产程和镇痛时间明显长于A组(P0.05)。三组运动神经阻滞程度差异无统计学意义。结论不同浓度罗哌卡因复合舒芬太尼硬膜外注射用于分娩镇痛均能产生良好的镇痛效果,低浓度罗哌卡因分娩镇痛产妇发热率低,产妇分娩期间发热与致热因子水平升高相关。     

Clinical and pathological features of immunoglobulin A nephropathy patients with nephrotic syndrome

Clinical and Experimental Medicine - IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide. The classic manifestation of IgAN is episodic hematuria and proteinuria. Nephrotic...     

新生儿重症监护室护士经历道德困扰体验的现象学研究

目的了解新生儿重症监护室护士经历道德困扰的心理体验及应对方式。方法采用现象学研究方法,对14名新生儿重症监护室护士进行一对一的半结构式访谈,访谈内容根据Colaizzi的资料分析方法进行整理、提炼主题。结果新生儿重症监护室护士经历道德困扰的心理体验包括:失落与气愤、伤心与难过、无力与受挫、麻木与淡漠;应对方式包括:被动接受、心理弹性、寻求措施。结论由于照护对象的特殊性,新生儿重症监护室护士产生道德困扰的情境较为复杂,易给护士带来消极情绪,但却很少受到管理者重视。今后应进一步探究减轻护士道德困扰的干预方法,以合理利用人力资源,提高护理质量。     

Anthocyanin Consumption and Risk of Colorectal Cancer: A Meta-Analysis of Observational Studies

This meta-analysis aimed to summarize the association between anthocyanin consumption and the risk of colorectal cancer.

All relative articles were located on online databases, including PubMed, Embase, and the Cochrane Library as of June 11, 2018. Risk ratios (RRs) or odds ratio and their 95% confidence intervals (CIs) were calculated through the STATA 12.0 software package.

A total of seven studies were included in the meta-analysis. A significant inverse association was found between total anthocyanin consumption and colorectal cancer risk (RR?=?0.78; 95% CI, 0.64–0.95). Likewise, there was significant evidence of a relationship between anthocyanin intake and colorectal cancer in the colon site (RR?=?0.81; 95% CI, 0.71–0.92); men (RR?=?0.88; 95% CI, 0.81–0.95), and case-control studies (RR?=?0.69; 95% CI, 0.60–0.78). A dose–response relationship was not found in this meta-analysis. The Grades of Recommendations Assessment, Development, and Evaluation quality in our study was very low.

This meta-analysis indicates that anthocyanin consumption is inversely associated with the risk of colorectal cancer. Anthocyanins may play an active role in the prevention of colorectal cancer.

Key teaching points:

• Some epidemiological studies found an inverse correlation between the high consumption of anthocyanins and low risk of colorectal cancer.

• Because of this structure, anthocyanins/anthocyanidins have a powerful capability of donating electrons, which can be characterized as antioxidant properties.

• Anthocyanins can also inhibit colon cancer by interfering in the cell cycle and inducing the effect of anti-proliferation and apoptosis. The formation of cytoplasmic vacuoles in cells also indicates that anthocyanins may induce autophagy.

• From the findings of nonrandomized controlled trials, anthocyanins may play an active role in the prevention of colorectal cancer.