典型地区慢性病管理的主要做法及成效*

在慢性非传染性疾病管理方面，我国一些典型地区在组织管理、服务流程、服务方式、信息互联互通等方面均进行了积极探索，并取得了较好成效。其中，高血压、糖尿病管理人群血压或血糖控制率较高，规范管理人群控制效果明显高于总体人群。调研发现的问题是，部分地区慢性非传染性疾病管理人群就医费用水平较低，甚至有下降趋势。     

1972—2016年江苏省启东市胃癌死亡流行特征分析

目的分析江苏省启东市1972—2016年胃癌死亡流行特征。方法收集启东市1972—2016年恶性肿瘤死亡登记数据库及历年人口资料, 计算死亡率、中国人口标化率(中标率)、世界人口标化率(世标率)、35～64岁截缩率、0～74岁累积死亡率、累积死亡风险、变化百分比、死亡率年均变化百分比。结果 1972—2016年启东市胃癌死亡例数为15 863例, 占全部恶性肿瘤死亡例数的16.04%, 胃癌死亡率为31.37/10万, 中标率为12.97/10万, 世标率为21.39/10万, 35～64岁截缩死亡率为28.86/10万, 0～74岁累积死亡率为2.54%, 胃癌死亡累积风险为2.51%。男性死亡10 114例, 男性死亡率、中标率、世标率分别为40.53/10万、17.98/10万和30.13/10万;女性死亡5 749例, 女性死亡率、中标率、世标率分别为22.45/10万、8.52/10万和13.92/10万。25岁以下各年龄组的死亡率<1/10万, 死亡率随年龄的增长而升高, 50～岁组达到并超过人群的平均死亡率水平, 80～岁组达到死亡高峰。1972—2016年间胃癌死...     

Special issue “The advance of solid tumor research in China”: Multi-omics analysis based on 1311 clear cell renal cell carcinoma samples identifies a glycolysis signature associated with prognosis and treatment response

In clear cell renal cell carcinoma (ccRCC), glycolysis is enhanced mainly because of the increased expression of key enzymes in glycolysis. Hence, the discovery of new molecular biomarkers for glycolysis may help guide and establish a precise system of diagnosis and treatment for ccRCC. Expression profiles of 1079 tumor samples of ccRCC patients (including 311 patients treated with everolimus or nivolumab) were downloaded from public databases. Proteomic profiles of 232 ccRCC samples were obtained from Fudan University Shanghai Cancer Center (FUSCC). Biological changes, tumor microenvironment and prognostic differences were explored between samples with various glycolysis characteristics. There were significant differences in CD8⁺ effector T cells, epithelial-to-mesenchymal transition and pan-fibroblast TGFb between the Low and High glyScore groups. The tumor mutation burden of the Low glyScore group was lower than that of the High glyScore group. And higher glyScore was significantly associated with worse overall survival (OS) in 768 ccRCC patients (P < .0001). External validation in FUSCC cohort also indicated that glyScore was of strong ability for predicting OS (P < .05). GlyScore may serve as a biomarker for predicting everolimus response in ccRCC patients due to its significant associations with progression-free survival (PFS). And glyScore may also predict overall survival in patients treated with nivolumab. We calculated the glyScore in ccRCC and the defined glyScore was of strong ability for predicting OS. In addition, glyScore may also serve as a biomarker for predicting PFS in patients treated with everolimus and could predict OS in patients treated with nivolumab.     

术前控制营养状态评分与肝细胞癌肝切除术后预后的研究进展

肝细胞癌(HCC)是最常见的恶性肿瘤之一。尽管在早期诊断和个体化治疗方面取得了进展,但经根治性切除等治疗后,HCC患者的临床预后仍不佳,复发率高。因此,在HCC患者中识别准确可靠的预后标志物是必要的。作为一种新的免疫营养生物标志物,控制营养状态(CONUT)评分已被报道用于预测癌症患者的预后。本文将对术前CONUT评分与HCC肝切除术后预后的研究进展进行综述。     

荔枝草治疗急性咽炎有效部位筛选＊

目的 筛选荔枝草治疗急性咽炎的有效部位，研究治疗急性咽炎的作用机制，为荔枝草资源的药食两用开发提供理论依据。方法 通过二甲苯致小鼠耳肿胀试验筛选荔枝草抗炎有效部位，采用氨水刺激喉部法建立大鼠急性咽炎模型，通过行为学观察、ELISA双抗夹心检测、病理形态学观察和咽部组织蛋白表达研究乙酸乙酯部位对大鼠急性咽炎的治疗效果。结果 荔枝草乙酸乙酯提取物对二甲苯致小鼠耳肿胀有明显的抑制作用，氨水刺激建立的急性咽炎模型符合急性咽炎动物模型特征，乙酸乙酯部位提取物可显著改善急性咽炎大鼠的咽部病理形态学表现。不同剂量治疗组大鼠血清及咽部组织中IL-1β、IL-6及TNF-α炎性因子数量均下降，高剂量组下降最为明显。荔枝草乙酸乙酯提取物可明显增加大鼠咽部组织IκBα蛋白表达，降低NF-κBp65蛋白表达。结论 荔枝草乙酸乙酯部位提取物对急性咽炎具有治疗作用，可能与抑制咽部炎症病理改变的发生，能调节血液中炎症因子、抑制NF-κB表达和IκBα解离有关。     

基于UHPLC-MS/MS的药用植物内源性激素含量检测方法及黄花蒿不同器官激素的测定

目的 激素是调控植物活性次生代谢产物合成途径的核心调控因子，内源激素结构多样、含量极低，检测难度高，缺乏高效、准确的检测方法。本研究利用超高效液相色谱串联质谱（UHPLC-MS/MS）技术构建了对黄花蒿中茉莉酸、细胞分裂素、赤霉素、生长素、脱落酸等多类植物内源性激素高效定量检测方法。方法 使用Agilent Poroshell 120 EC-C18（2.7 μm， 3.0×150 mm）色谱柱，流动相为0.05%甲酸水-乙腈溶液，梯度洗脱，采用多反应监测模式验证方法可行性，并对黄花蒿不同器官中植物激素进行定量分析。结果 本方法中检测的16种植物激素均呈良好线性，加样回收率、精密度和稳定性均符合植物样品的测定要求。利用此方法测定青蒿不同器官的激素含量，结果表明脱落酸、茉莉酸、茉莉酸甲酯均在叶中含量较高，赤霉素和生长素在根部含量高，细胞分裂素在叶和茎中含量高。结论 青蒿不同器官的激素测定结果可进一步印证脱落酸、茉莉酸、茉莉酸甲酯在调控青蒿素合成中起着重要作用的相关报道，同时表明该方法检测性良好。本文构建的植物内源性激素的检测方法为进一步探究植物生长发育、抵御外界胁迫的相关机制及次生代谢产物的合成等方面提供了手段。     

Diffusion-weighted magnetic resonance imaging in rat kidney using two-dimensional navigated,interleaved echo-planar imaging at 7.0 T

The purpose of this study was to investigate the feasibility of two-dimensional (2D) navigated, interleaved multishot echo-planar imaging (EPI) to enhance kidney diffusion-weighted imaging (DWI) in rats at 7.0 T. Fully sampled interleaved four-shot EPI with 2D navigators was tailored for kidney DWI (Sprague–Dawley rats, n = 7) on a 7.0-T small bore preclinical scanner. The image quality of four-shot EPI was compared with T₂-weighted rapid acquisition with relaxation enhancement (RARE) (reference) and single-shot EPI (ss-EPI) without and with parallel imaging (PI). The contrast-to-noise ratio (CNR) was examined to assess the image quality for the EPI approaches. The Dice similarity coefficient and the Hausdorff distance were used for evaluation of image distortion. Mean diffusivity (MD) and fractional anisotropy (FA) were calculated for renal cortex and medulla for all DWI approaches. The corticomedullary difference of MD and FA were assessed by Wilcoxon signed-rank test. Four-shot EPI showed the highest CNR among the three EPI variants and lowest geometric distortion versus T₂-weighted RARE (mean Dice: 0.77 for ss-EPI without PI, 0.88 for ss-EPI with twofold undersampling, and 0.92 for four-shot EPI). The FA map derived from four-shot EPI clearly identified a highly anisotropic region corresponding to the inner stripe of the outer medulla. Four-shot EPI successfully discerned differences in both MD and FA between renal cortex and medulla. In conclusion, 2D navigated, interleaved multishot EPI facilitates high-quality rat kidney DWI with clearly depicted intralayer and interlayer structure and substantially reduced image distortion. This approach enables the anatomic integrity of DWI-MRI in small rodents and has the potential to benefit the characterization of renal microstructure in preclinical studies.