大肠癌腹腔灌洗液CK 20及CEA mRNA的表达及意义

目的 探讨大肠癌腹腔灌洗液细胞角蛋白20(CK 20)及癌胚抗原(CEA)mRNA的表达及意义.方法 收集44例大肠肿瘤患者的术中腹腔灌洗液,其中大肠癌36例(大肠癌组),大肠良性病变8例(对照组),用逆转录聚合酶链反应(RT-PCR)方法测定腹腔灌洗液中游离细胞的CK 20 mRNA和CEA mRNA的表达.结果 大肠癌组腹腔灌洗液CK 20 mRNA和CEA mRNA表达阳性率分别为52.8%(19/36)、63.9%(23/36);总阳性率为80.6%(29/36);对照组CK 20mRNA及CEA mRNA结果均为阴性.CK 20 mRNA和CEA mRNA的阳性率与有无淋巴结转移、有无浆膜侵犯、肿瘤分化程度和Dukes分期有关(P＜0.05),与患者年龄、性别无关(P＞0.05).结论 随着Dukes分期的进展,大肠癌患者发生腹腔微转移的几率增加;CK 20与CEA一样,可作为检测大肠癌患者腹腔微转移的指标;二者联合应用,可提高大肠癌腹腔微转移的检出率.     

逆转录聚合酶链反应检测大肠癌患者外周血CK—20mRNA

目的 检测大肠癌患者外周血CK－20mRNA并评价其临床意义。方法 应用逆转录聚合酶链反应（RT－PCR）检测肿瘤细胞株及大肠癌患者外周血CK－20mRNA。结果 大肠癌细胞株CK－20mRNA阳性；肺癌、肝癌、乳腺癌等肿瘤细胞株及20例健康志愿者外周血中未见CK－20mRNA的表达。51例大肠癌患者外周血中25例CK－20mRNA表达阳性，阳性率为49．0％。大肠癌患者外周血CK－20mRNA的表达与临床分期关系为：A期14．3％（1／7）、B期25．0％（3／12）、C期55．0％（11／20）、D期83．3（10／12）；其中C、D期与A、B期相比有显著性差异（P＜0．01）。结论 CK－20mRNA可以作为对大肠癌血行转移进行早期诊断的生物学标志物，并能监测大肠癌的疗效。     

RECK和MMP-9在大肠癌组织中的表达及其相互关系

目的检测RECK和基质金属蛋白酶-9（MMP-9）在大肠癌及正常大肠黏膜组织中的表达，探讨其在大肠癌的发生、发展及浸润和转移中的作用。方法应用免疫组织化学法检测50例大肠癌组织和20例正常大肠黏膜组织中RECK和MMP-9的表达情况。结果RECK在大肠癌组织中的阳性表达率为64％（32／50），明显低于在正常大肠黏膜组织中的阳性表达率（100％，20／20）（P〈0．05），并随肿瘤分化程度的降低、Dukes分期的增高而降低。MMP-9在大肠癌组织中阳性表达率为68％（34／50），明显高于在正常大肠黏膜组织中的阳性表达率（20％，4/20）（P〈0．05），并随肿瘤分化程度的降低、Dukes分期的增高而增高。大肠癌组织中RECK与MMP-9的表达呈负相关（r=-0．480，P〈0．05）。结论大肠癌组织中RECK低表达，MMP-9高表达。RECK可能在大肠癌的浸润和转移过程中起重要作用，有望成为判断大肠癌预后的分子指标之一。     

Notch1在大肠癌中的表达及临床意义

目的研究大肠癌中Noteh1蛋白的表达以及Noteh1蛋白与大肠癌的临床病理关系。方法对30例大肠癌标本组织及18例正常大肠黏膜组织用免疫组织化学S—P方法检测其Noteh1蛋白的表达情况。结果Noteh1蛋白在大肠癌中高表达，其平均阳性率为（45．5±0．7）％，Noteh1蛋白在正常大肠黏膜中低表达，其平均阳性率为（6．8±0．9）％，两者差异有统计学意义（P〈0.05）。Noteh1蛋白在不同年龄，性别，肿瘤部位、有无淋巴结转移及Dukes分期中的表达差异无统计学意义（P〉0．05），但Noteh1蛋白在不同分化程度的大肠癌中的表达差异有统计学意义（P〈0．05）。结论Noteh1蛋白与大肠癌的发生有关，是潜在的致癌基因。Noteh1有望成为大肠癌治疗新的靶基因。     

大肠癌患者外周血CK20表达及p53基因突变的研究

目的建立高效、快速的外周血中细胞角蛋白20(Cytokeratin 20，CZK20)表达的检测方法，探讨大肠癌患者外周血中CK20的表达与微转移的关系，研究大肠癌与p53基因突变的关系。方法运用荧光监测技术结合RT—PCR，检测36例大肠癌患者术前和术后不同时间外周血中的CK20的表达。用SSCP技术对大肠癌患者进行p53基因的突变检测。结果36例患者的外周血中检出CK20表达的有27例，阳性率为75％，手术后24h患者外周血中检出CK20表达的有30例，阳性率为83.3％，术后早期化疗结束后仅13例为阳性，阳性率为36％。36例患者的p53基因的SSCP突变检测中未检测到突变。结论运用荧光PCR技术检测外周血中CK20的表达可以监测癌症微转移的发生，简便快速，检出率高。     

大肠癌根治术后肝转移的预测因素分析

目的探讨大肠癌根治术后肝转移的预测因素。方法回顾性总结了124例大肠癌病人术前骨髓中微转移、CEA水平、临床病理因素与术后肝转移之间的关系。结果结果显示术前骨髓癌细胞微转移阳性与阴性肝转移的发生率分别是69．6％（32／46）和7．7％（6／78）、外周血CEA升高与正常者肝转移发生率分另066．7％（26／39）和14．1％（12／85）、淋巴结转移阳性与阴性患者术后肝转移发生率分别为52．7％（30／57）和11，9％（8／67），具有统计学意义。通过Logistic多因素分析；结果显示骨髓微转移是影响术后肝转移的独立因素。结论骨髓微转移阳性患者要进行密切随访以早期发现肝转移。     

大肠癌患者外周血中CK19、CK20基因表达的检测及临床意义

[目的]探讨细胞角蛋白19(CK19)、细胞角蛋白20(CK20)在正常对照组和大肠癌患者外周血中表达情况及其临床意义。[方法]采用RT-PCR方法检测正常对照组和大肠癌患者外周血中CK19、CK20mRNA表达。[结果]CK19、CK20mRNA在正常对照组中均无表达,在大肠癌中患者中阳性率分别为31.7%、41.3%,且CK19、CK20mR-NA阳性表达率与患者性别、年龄、细胞分化程度无明显相关,而与Dukes分期及淋巴结转移有明显的相关性(P<0.05)。[结论]大肠癌患者外周血中CK19、CK20随Dukes分期的增加而表达率增加,可作为预测肿瘤细胞转移的评估指标。     

腹腔灌洗液中端粒酶活性和CA125水平的测定在诊断胃癌腹膜转移中的应用

目的比较胃癌患者腹腔灌洗液中端粒酶活性与CA125水平在诊断胃癌腹膜转移中的灵敏度。方法应用端粒酶重复序列扩增程序（TRAP）-酶联免疫吸附试验（ELISA）法检测46例胃癌腹腔灌洗液中的端粒酶活性，同时对其行腹腔灌洗液CA125水平检测。结果46例胃癌患者腹腔灌洗液中端粒酶活性检测阳性率为47．8％，PT1—2、PT3和PT4胃癌分别为0、55．6％和92．3％；浆膜未受累、受累面积〈10cm^2、10—20cm^2和〉20cm^2患者，分别为5．3％、25．0％、76．9％和100．0％；无肉眼可见腹膜转移（P0）患者为42．9％；肉眼可见腹膜转移（P1—3）患者为100．0％。而46例胃癌患者腹腔灌洗液中CA125阳性率为34．8％，PT1—2、PT3、PT4胃癌分别为20．0％、33．3％、53．8％；浆膜未受累、受累面积〈10cm^2、10—20cm^2和〉20cm^2患者，分别为10．5％、25．0％、38．5％和80．0％；P0患者为28．6％，P1-3患者为100．0％。腹腔灌洗液中端粒酶活性检测的阳性率较CA125有显著提高（P〈0．05）。结论腹腔灌洗液中端粒酶活性与胃癌腹膜转移呈正相关，其活性测定可用于胃癌腹膜转移的早期诊断。     

大肠癌患者血清HGF、CEA表达水平与临床浸润转移关系的研究

目的探讨大肠癌患者血清HGF及CEA表达水平与临床病理资料的相关性。方法应用ELISA法检测62例大肠癌患者血清HGF、CEA表达水，并分析其与临床病理资料的相关性，初步评估单一与联舍HGF、CEA在诊断大肠癌肝转移中的价值。结果大肠癌患者血清HGF表达水平与患者性别、年龄无显著相关，与肿瘤组织学分级、浸润深度、淋巴结转移、肝转移及Dukes分期密切相关；CEA表达水平与患者性别、年龄无显著相关，与肿瘤组织学分级、淋巴结转移、肝转移及Dukes分期密切相关。联合检测血清HGF、CEA对诊断大肠癌肝转移敏感性可达80．0％。结论HGF和CEA与大肠癌的病情发展、浸润和转移密切相关，临床血清HGF、CEA表达水平可能作为了解大肠癌生物学行为和判断预后的指标。并可能有助于早期发现大肠癌肝转移。     

荧光定量逆转录聚合酶链式反应检测宫颈癌患者外周血CK19mRNA表达的临床意义

目的探讨宫颈癌患者外周血中CK19mRNA的表达及其临床意义。方法应用荧光定量逆转录聚合酶链式反应（FQ—RT—PCR）技术检测138例经病理证实的宫颈癌及36例妇科良性肿瘤（对照组）外周血液中CK19mRNA的表达,并分析其与临床病理因素的关系。结果138例宫颈癌组外周血CK19阳性率（69．6％）高于对照组（13．9％,X2=36．34,P=0．000）。宫颈癌组中早期宫颈癌（I-ⅡA期）外周血CK19mRNA阳性率（57．9％）低于中晚期宫颈癌（Ⅱb-Ⅳ期,80．6％,x。=8．14,P=0．004）。早期宫颈癌患者CK19mRNA的表达与年龄（〈40岁、≥40岁）、肿瘤大小（〈4cm、≥4cm）、病理类型（鳞癌、非鳞癌）、浸润深度、淋巴转移（＋／-）均无关（P〉0．05）;与肿瘤分期（IA、IB、ⅡA）、组织分化（G1-2、G3）、脉管瘤栓（＋／-）有关（x。=9．59,7．27,9．94,P〈0．01）。早期宫颈癌患者Logistica多因素分析示CK19mRNA的表达与脉管瘤栓相关（x2=5．29,P=0．021）。结论荧光定量RT—PCR技术可检测出各期宫颈癌患者外周血中CK19的表达,其敏感性和特异性高,可作为检测宫颈癌微转移的生物学指标,对判断宫颈癌的预后具有一定指导意义。     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

Car ownership and the association between fruit and vegetable availability and diet

Objective

Nearly all research on the food environment and diet has not accounted for car ownership — a potential key modifying factor. This study examined the modifying effect of car ownership on the relationship between neighborhood fruit and vegetable availability and intake.

Methods

Data on respondents' (n = 760) fruit and vegetable intake, car ownership, and demographics came from the 2008 New Orleans Behavioral Risk Factor Surveillance System. Shelf space data on fresh, frozen, and canned fruits and vegetables were collected in 2008 from a random sample of New Orleans stores (n = 114). Availability measures were constructed by summing the amount of fruit and vegetable shelf space in all stores within defined distances from respondent households. Regression analyses controlled for demographics and were run separately for respondents with and without a car.

Results

Fruit and vegetable availability was positively associated with intake among non-car owners. An additional 100 m of shelf space within 2 km of a residence was predictive of a half-serving/day increase in fruit and vegetable intake. Availability was not associated with intake among car owners.

Conclusions

Future research and interventions to increase neighborhood healthy food options should consider car ownership rates in their target areas as an important modifying factor.