脂联素在心血管疾病中的研究进展

脂联素（Adiponectin,APN）是由脂肪细胞分泌的一种血浆蛋白,其血浆中含量丰富,大约为5—30mg／1。目前的研究证实,脂联素在2型糖尿病,冠心病,高血压病中降低,在心力衰竭中显著升高,脂联素水平能预示2型糖尿病和冠心病的发展,并在临床试验中表现出增强胰岛素敏感性、抗动脉粥样硬化、抗炎,预测死亡率等作用,本文就脂联素及其在心血管疾病中的研究进展做一综述。     

脂联素对心血管保护作用的研究进展

脂联素由脂肪组织分泌参与调节多种代谢过程的脂肪细胞因子。临床和基础科学研究确定了脂联素的心血管保护作用,其主要有抗动脉粥样硬化、促血管再生及心肌细胞保护等。故将详细描述脂联素在心血管疾病保护中的重要作用,及目前其分子机制的研究热点、方向和成果,并展望脂联素未来研究方向和潜在的临床应用前景。     

脂联素对骨形成的调节及其机制的研究新进展

脂联素为脂肪细胞分泌的一种细胞因子,对改善胰岛素抵抗有重要的作用。近年来的研究显示脂联素及其受体在成骨细胞和破骨细胞均存在表达。本文对脂联素骨调节及其机制进行了综述。研究证实脂联素可通过多种调节通路,自分泌、旁分泌和内分泌三种作用途径来影响成骨与破骨细胞的活性及增殖、分化。但在脂联素基因敲除/过表达模型动物和临床研究中,脂联素对骨形成的作用仍存在争议。最新的研究和我们目前正在进行的研究认为,脂联素作用的不同部位、疗程和时机,有可能导致了脂联素对骨代谢平衡调节的不同。脂联素对调节骨代谢平衡有着重要作用。深入地研究脂联素促进骨形成的作用及调节机制将有可能为临床相关疾病的治疗提供新的临床思路及临床途径。     

脂联素在胰岛素抵抗中的作用

目的通过检测脂联素在肥胖及2型糖尿病大鼠腹部脂肪组织中的表达,明确它在胰岛素抵抗中的作用。方法用半定量RT-PCR测定正常、肥胖以及2型糖尿病大鼠内脏脂肪组织中脂联素的表达。结果肥胖及2型糖尿病大鼠脂联素的mRNA表达较对照组显著下降。脂联素与空腹血清胰岛素、血甘油三酯、体重和胰岛素敏感指数负相关。结论脂联素可能在肥胖和2型糖尿病相关的胰岛素抵抗中发挥重要作用。本研究通过对实验性2型糖尿病大鼠以及单纯肥胖大鼠脂肪组织中脂联素表达的分析,探讨它在肥胖及2型糖尿病中所起的作用。     

冠心病患者血清脂联素及抵抗素变化的分析

冠心病是严重危害人们健康的疾病,本研究通过检测冠心病不稳定心绞痛患者血清脂联素、抵抗素水平及治疗前后的变化,探讨脂联素、抵抗素在AS发生发展中的可能作用机制。     

脂联素在终末期肾衰中的意义

脂联素具有降低血脂、增加胰岛素敏感性、抗炎和抗粥样硬化等作用,在终末期肾衰(ESRD)病人中显著增高.现就脂联素与影响ESRD病人生存质量的相关因素作一综述.     

脂联素及TNF-α与2型糖尿病视网膜病变的关系

目的探讨脂联素(adiponectin)及肿瘤坏死因子α(TNF-α)在2型糖尿病(DM)视网膜病变(DR)发病中的作用。方法应用酶联免疫吸附方法(ELISA)对90例2型糖尿病患者(再分为无DR组、背景组DR组和增殖期DR组)及40名健康人血清中的脂联素及TNF-α进行测定。结果①DM组血清脂联素及TNF-α的含量低于对照组(P<0.05);②BDR组的脂联素及TNF-α含量低于NDR组(P<0.05);③PDR组的脂联素及TNF-α含量低于NDR组(P<0.01);④PDR组的脂联素含量及TNF-α低于BDR组(P<0.05);⑤DR的严重程度与脂联素水平呈负相关(r=-0.428,P<0.01)。结论脂联素及TNF-α的降低在DM的发病机制中起重要作用,而2型糖尿病合并视网膜病变时,血中脂联素及TNF-α水平更低,脂联素及TNF-α可能参与了DR的发生和发展。     

大鼠深Ⅱ度烫伤后血浆脂联素水平变化及其乌司他丁的抗炎作用

目的观察烫伤大鼠血浆脂联素水平变化规律以及抗炎药物乌司他丁（UTI）的作用。方法 Wistar大鼠随机分为烧伤对照组,UTI治疗组和正常对照组,其中烧伤对照组、UTI治疗组大鼠均造成30%TBSA深Ⅱ度烫伤创面,并于伤后3h、6h、12h、24h、48h收集血浆,采用ELISA法检测大鼠血浆中脂联素水平。结果烫伤后大鼠第三～四十八小时各时相点脂联素水平不同程度降低,以伤后6h脂联素水平下降幅度最大;随后有所升高,但在观察期内仍低于正常对照组,UTI组脂联素水平高于烧伤组（P〈0.05）,但仍低于正常组（P〈0.05）。结论严重烧伤后可导致抗炎介质脂联素明显下降,乌司他丁能明显地提高脂联素水平,达到调控机体炎症反应的作用。     

原发性高血压与脂联素、C反应蛋白关系及机制的研究进展

近年的研究证实,原发性高血压(EH)患者存在血管壁炎性反应,炎性反应可能参与了高血压的发生发展。脂联素具有抗炎及抗动脉硬化作用[1,2]。C反应蛋白(CRP)是参与动脉粥样硬化形成的重要炎性因子[3],目前国内外学者开始探讨EH与脂联素、CRP之间的关系,其可能成为治疗EH的新靶点。本文对近年来EH与脂联素、CRP关系及可能机制作一综述。     

慢性乙肝患者血清脂联素水平在进展期肝纤维化中升高而在纤维化减轻时降低

背景及目标：尽管脂联素可能在肝硬化的发病机理中起着一定作用．但目前有关其在不同肝纤维化阶段病人中的数据尚缺乏．我们研究了脂联素在两组慢性乙肝患者中的作用。方法：用酶联免疫吸附法（enzyme—linked immunosorbent assay,ELISA）测定血清脂联素水平。     

上皮间质转化在肺癌诊治中的应用进展

上皮间质转化是当前诊治恶性肿瘤的热点话题。本研究回顾性分析上皮间质转化与肺癌诊治等的相关研究成果,探讨上皮间质转化的应用进展及其在肺癌诊治中的重要性等,以期为新时期医院在加强治愈肺癌方面提供重要的参考依据。     

Clinical trials and biomarker research on lung cancer in China

INTRODUCTION: Over the past 10 years, there have been significant advances in clinical trials and translation research on lung cancer in China. These advances have changed the clinical practice of lung cancer treatment. Translation research has clarified many molecular mechanisms of lung cancer development, growth and metastasis. Based on these results, a few cancer-driving molecular targets were identified. Many new compounds that directly or indirectly target these driver genes have been developed and tested. AREAS COVERED: Studies from the literature and ongoing work from the author's group were reviewed. This was with the aim of outlining the current state of a clinical trial cooperative group for lung cancer and highlighting some important clinical trials and biomarker research that have changed lung cancer clinical practice in China. EXPERT OPINION: For biomarker-driven clinical research, it is important to identify subgroups of patients who are most likely to benefit from given targeted therapies. In this setting, the rapid identification and translation of validated biomarkers will be integral to the treatment of lung cancer. It is also important to utilize results from high-quality clinical research groups to enrich patients lives and to perform these challenging clinical trials.     

作用于Met靶点的非小细胞肺癌治疗药物研究进展

继表皮生长因子受体(EGFR)基因突变和间变性淋巴瘤激酶(ALK)基因融合之后,Met基因激活突变和扩增被认为是非小细胞肺癌(NSCLC)下一个重要的驱动基因,它与肿瘤的增殖、侵袭、转移及血管生成密切相关,已成为靶向治疗领域研究的一大亮点。主要靶向治疗药物可分为抗HGF单克隆抗体、抗c-Met单克隆抗体和小分子抑制剂3类,并多已进入临床试验阶段。对作用于Met靶点的非小细胞肺癌治疗药物的研究进展进行综述。     

表皮生长因子受体酪氨酸激酶抑制剂在肺癌以外的应用进展

表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinase inhibitor,EGFR-TKIs)主要用于晚期非小细胞肺癌的分子靶向治疗,随着EGFR-TKIs的越来越深入研究,发现EGFR及其配体参与了包括乳腺癌、胰腺癌等在内的不同人类癌症发病过程。因此,EGFR-TKIs的治疗对象也不再局限于晚期非小细胞肺癌,其对乳腺癌、胰腺癌、头颈癌、食管癌和宫颈癌等恶性肿瘤也有较好的抑制作用,并且与EGFR-TKIs联合用药往往比单独用药效果更好。该文讨论了EGFR-TKIs在治疗肺癌以外其他癌症的应用研究,以及EGFR-TKIs与其他药物联合治疗乳腺癌、胰腺癌等恶性肿瘤的潜在应用前景。     

Project Transform: engaging patient advocates to share their perspectives on improving research,treatment and policy

Objective: Incorporating the patient perspective into lung cancer research, policy and treatment is becoming increasingly recognized as important. This project sought to create an engagement partnership with lung cancer patient advocates and to explore their views on transforming lung cancer healthcare systems, treatment and policy to be more patient centered.

Methods: A patient action committee (PAC) of patient advocates living with lung cancer was engaged through group meetings, in-person and phone interviews, and email correspondence. Group meetings (two 1?hour meetings, one 3?hour meeting) served to discuss engagement strategies and project goals, while individual interviews (n?=?19) (30–75?minutes) provided in-depth exploration of individuals’ perspectives. Meetings and interviews were recorded to identify priorities for addressing issues within lung cancer research, treatment and policy. PAC members corroborated the results through email and in-person meetings.

Results: PAC members identified three general objectives: (i) for healthcare systems, increasing access to care through accessible, coordinated and affordable care, (ii) for treatment, addressing patient needs in treatment and research through patient education, shared decisions and clinical trials, and (iii) for policy, shining a light on lung cancer through screening policies, public awareness and research funding.

Conclusion: Patient advocates expressed their views that lung cancer is a neglected disease that is not highly prioritized in healthcare systems, treatment approaches and public perceptions. This project represents an integral step in developing an ongoing partnership between researchers and these advocates.     

Lung cancer--epidemiology, prognosis and therapy

Lung cancer is one of the most common cancer diagnoses, sadly with a bad prognosis. The main risk factor is smoking. There are two major types of lung cancer: non-small cell lung cancer und small cell lung cancer. The difference is important for prognosis and therapy. The prognosis for patients with small-cell lung cancer is worse; the treatment is based on chemotherapy. In patients with non-small cell lung cancer surgery and radiotherapy are more important.     

吉非替尼在非小细胞肺癌治疗中的疗效分离现象的特点及对策

目的：探讨吉非替尼在治疗非小细胞肺癌过程中的疗效分离现象特点及对策。方法非小细胞肺癌患者96例,采用吉非替尼口服药物治疗,对其治疗过程中出现的疗效分离现象的11例患者进行分析讨论。结果分离现象发生率为11.46%,4例发生肺癌原发病灶转移,2例患者脑转移病灶扩大;5例患者出现部分病灶改变不均。结论非小细胞肺癌患者应用吉非替尼治疗过程中会出现疗效分离现象,生物靶向治疗药物并不完全适用于所有癌症,其发生机制及有效对策还有待进一步研究,需在分子靶向的基础上建立进行分子学的机制研究,进一步制定治疗方案。     

肺癌肿瘤标志物早期诊断研究进展

肺癌是一种常见的恶性肿瘤,其发病率及死亡率已占全球恶性肿瘤的首位。肺恶性肿瘤目前常用的诊断工具是CT扫描、支气管镜检查、痰病理细胞学检查及肿瘤标志物检测,但在早期肺癌的诊断中尚缺乏敏感的诊断方法。为了提高肺癌的诊断治疗,近年来许多肿瘤标志物已经被应用于肺癌领域。因为晚期肺癌预后很差,人们正在尝试进行肺癌筛查,所以寻找合适的肿瘤标志物在肺癌的早期诊断中变得尤为重要。     

放射性肺损伤的发生机制及防治进展

胸部恶性肿瘤的发病率及病死率长期居高不下,最新发表的中国癌症数据显示,所有癌症患者中肺癌的发病率及病死率所占比例均超半数,仍占据着主导地位。放疗作为非小细胞肺癌、食管癌、乳腺癌等胸部恶性肿瘤的极其重要的一种治疗手段,其所带来的严重不良反应之一便是放射性肺损伤（RILI）。RILI由于其后期进行性、不可逆地发展为肺纤维化的临床特点,吸引着越来越多的临床及科研工作者对其发生机制及相应治疗方案进行探索。本文就RILI的病理生理、发生发展过程中涉及的重要细胞、分子及预防治疗进展作一综述。     

Smoking and lung cancer: future research directions

The aim of future research in this area is to provide the mechanistic understanding and the tools for effective prevention, early diagnosis, and therapy of lung cancer. With the established causal link between cigarette smoking and the risk of developing lung cancer, the most effective prevention is certainly not to smoke. A much better mechanistic understanding of lung cancer and its variability will support the development and evaluation of potentially reduced risk products for those who maintain smoking as well as for the development of early diagnostic tools and targeted therapies. Because of the complexity of lung cancer and the long duration for its development, nonclinical and clinical research efforts need to complement each other. Recent promising advances in this research area are the understanding of the interaction between genotoxic and epigenetic effects of smoking, the development of laboratory animal models for lung tumorigenesis by smoke inhalation, the unraveling of molecular pathways and signatures in clinical lung cancer research useful for developing diagnostic tools and therapeutic approaches, and the first successful therapy for lung cancer - although less suitable for smokers. The above - in combination with emerging data sets from explorative non-clinical and clinical studies as well as improved modeling approaches - are setting the stage for accelerated progress towards developing successful early diagnostic tools and therapies as well as for the assessment of new consumer products with potentially reduced risk.