MiRNA let-7a对人喉鳞癌细胞增殖的抑制作用CSCD

目的探讨miRNA let-7a调控高迁移率族蛋白2(HMGA2)对人喉鳞癌细胞株TU212增殖的影响。方法合成let-7a模拟体(let-7a mimics)并采用阳离子脂质体法瞬时转染入喉癌TU212细胞,裸鼠皮下注射TU212细胞,构建裸鼠移植瘤模型。RT-qPCR和Western blot法分别检测转染后TU212细胞及移植瘤内let-7a和HMGA2的表达。结果在过表达let-7a的喉癌TU212细胞中,HMGA2的转录和翻译水平下调,细胞增殖能力降低。体外成瘤实验证实,与let-7a NC组和空白对照组相比,转染let-7a mimics的喉癌细胞TU212成瘤组织的质量和体积均显著下降;let-7a过表达的TU212成瘤组织中HMGA2的mRNA和蛋白水平均明显下调。结论let-7a能显著抑制HMGA2的mRNA和蛋白表达,进而显著抑制喉癌细胞的增殖。     

Clinical,radiological and physiological assessment of anorectal function

The maintenance of anorectal continence and defaecation is complex. The disruption of these mechanisms can result in symptoms of either faecal incontinence or obstructive defaecation. Both conditions can have significant impact on quality of life. This article details the clinical assessment of presenting patients to establish potential causes, grade the severity of the symptoms and to assess the impact on their quality of life. The appropriate specialized radiological and physiological investigations aim to evaluate the structural integrity and function of the anal sphincter, the anorectal and pelvic floor musculature and measure the transitory function of the colon.     

Myelodysplastic/myeloproliferative neoplasms: are morphology and immunophenotyping still relevant?

The term myelodysplastic/myeloproliferative neoplasm (MDS/MPN) refers to a group of clonal hematopoietic neoplasms with overlapping clinical, morphologic and genetic myelodysplastic and myeloproliferative features observed at the time of first presentation. Impaired hematopoiesis morphologically associated with evidence of myelodysplasia manifests clinically with cytopenia/s. Simultaneously, myeloproliferation is seen within the bone marrow and leads to cytosis in the peripheral blood.The diagnostic category of MDS/MPN encompasses a heterogeneous group of diseases which share similarities among them, but at the same time have distinct clinical and pathologic features and eventually diverse prognosis; such differences justify their separation in a classification scheme.In the era of genetic and genomic tests, their distinction from conventional myelodysplastic syndromes or myeloproliferative neoplasms still relies on close clinocopathological correlation, with evaluation of both peripheral blood and bone marrow samples being essential in this sense. A multiparametric integration of clinicopathologic data and cytogenetics and molecular genetics results is the preferred diagnostic approach.     

Disparities in Stage at Diagnosis in an Equal-access Integrated Delivery System: A Retrospective Cohort Study of 7244 Patients With Bladder Cancer

BackgroundDisparities in bladder cancer survival by race/ethnicity and gender are likely related to differences in diagnosis. We assessed disparities in stage at diagnosis and potential contributing factors within a large, integrated delivery system.Patients and MethodsWe conducted a retrospective cohort study of 7244 patients with bladder cancer age ≥ 21 years diagnosed from January 2001 to June 2015 within Kaiser Permanente Southern California. Bivariate analyses compared stage at diagnosis – as well as comorbidities, health plan membership length, and health care utilization prior to diagnosis – by race/ethnicity, gender, and age. Multivariable generalized linear mixed models with urologist as a random effect were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for diagnosis of muscle-invasive bladder cancer (MIBC) versus non–muscle-invasive bladder cancer.ResultsIn multivariable analyses, stage at diagnosis varied significantly by race/ethnicity (P < .001). Non-Hispanic black patients had significantly higher odds of being diagnosed with MIBC than non-Hispanic white patients (OR, 1.33; 95% CI, 1.05-1.67), whereas Asian patients had significantly lower odds (OR, 0.67; 95% CI, 0.49-0.91). Women were significantly more likely to be diagnosed with MIBC than men (OR, 1.40; 95% CI, 1.22-1.61). Non-Hispanic black women had the highest proportion (39%) of MIBC diagnoses. Among Hispanic and Asian patients, a greater proportion of diagnoses occurred at younger ages.ConclusionsHealth care coverage within an equal-access system did not eliminate disparities in stage at diagnosis by race/ethnicity or gender. Studies are needed to identify etiologic factors and aspects of care delivery (eg, patient-physician interactions) that may affect the diagnostic process to inform efforts to improve health equity.     

纤维蛋白原/白蛋白比值比对可手术乳腺癌患者预后的影响

目的探讨纤维蛋白原/白蛋白比值比(FAR)对可手术乳腺癌患者预后的影响。 方法依据纳入、排除标准，收集中国医学科学院北京协和医院2013年1～12月收治的520例Ⅰ～Ⅲ期可手术乳腺癌患者临床资料进行回顾性研究。在术前检测血浆纤维蛋白原和白蛋白水平。将纤维蛋白原与白蛋白质量浓度比值乘以100定义为FAR。根据受试者工作特征曲线确定FAR最佳临界值，并依据最佳临界值将受试者分为高FAR组(FAR>6.99)147例和低FAR组(FAR≤6.99)343例。采用Kaplan-Meier法和log-rank检验评估2组患者的DFS和OS，用Cox比例风险回归模型分析患者DFS和OS的影响因素。 结果log-rank检验显示，高FAR组患者的DFS和OS均比低FAR组差(χ²＝32.885、16.320，P均<0.001)。Cox比例风险回归模型单因素分析和多因素分析均显示：高FAR为患者DFS的独立危险因素(HR＝4.092，95%CI：2.425～6.903，P<0.001；HR＝4.226，95%CI：2.476～7.212，P<0.001);高FAR为患者OS的独立危险因素(HR＝3.907，95%CI：1.913～7.978，P<0.001；HR＝4.320，95%CI：2.087～8.942，P<0.001)。 结论术前高FAR患者的无疾病进展时间更短，OS率更低。术前FAR水平有望成为预测乳腺癌患者预后的有效指标。     

未来提高胰腺癌临床诊治效果的十大方向

胰腺癌是恶性程度极高的消化系统肿瘤。近10年来, 由于治疗理念的更新和有效治疗方案的普及, 其治疗效果有所提高。然而, 胰腺癌总体疗效仍不尽如人意, 患者5年生存率仍仅为10%左右。如何进一步提高胰腺癌诊治水平, 是未来肿瘤学研究和临床实践的头等大事。作者团队基于既往临床和科研经验, 针对胰腺癌早期预防、早诊早治、分子分型、精准治疗、新药开发、方案联合、手术技术和策略改变、模型建立和数据库开发、传统中医药的创新和治疗理念的突破等, 提出十大热点和未来方向供大家参考。期待未来十年中, 胰腺癌诊治研究有突破性进展, 真正做到"可防可控"。