Cohort Studies on Cancer Mortality Among Workers Exposed Only to Chrysotile Asbestos： a Meta-analysis

Objective To determine whether there was excessive risk of cancer among workers exposed to chrysotile fiber alone by applying a meta-analysis technique. Methods All data meeting the criteria of cohort studies on cancer mortality among workers exposed only to chrysotile were incorporated into meta-analysis. Pooled standardized mortality ratios (SMRs) and their corresponding 95% confidence intervals (CIs) for main cancer sites were calculated using two approaches of unweighted ratio and random effect model. The heterogeneity and its sources of the results were examined with a Q-statistic and Z-score test. The dose-response effect as reflected in the percentage of all deaths due to mesothelioma served as a proxy measure of chrysotile exposure. Results A cohort of twenty six workers exposed to chrysotile alone was summarized. The significantly elevated meta-SMRs for all deaths (1.27), all cancers (1.28), cancers of respiratory organs (2.51), cancers of lung (2.35) and cancers of stomach (1.24) were observed. The significantly elevated meta-SMRs for lung cancer within occupational strata were observed among textile workers (3.55), asbestos product manufacturers (3.30), miners and millers (2.24), cement product workers (1.22), and for stomach cancer among asbestos product manufacturers (1.49). Meta-SMRs for cancers at other sites were not significant. Meta-SMR for lung cancer showed an increasing trend with an elevated percentage of all deaths from mesothelioma, but no such trend for stomach cancer. Conclusion There are excessiverisks of lung cancer and mesothelioma among workers exposed to chrysotile fiber alone, and likely no convincing indication of an etiological association between chrysotile exposure and cancers at other sites.     

中国医用X射线工作者恶性肿瘤危险评价

本研究总结和分析我国24省,直辖市,自治区1950－1980年间在职的27011名医用X射线工作者和同期25782名非放射科室医务人员在1950－1995年间恶性肿瘤发病资料,用回顾剂量学方法估算其累积受照剂量,并据此评价癌患风险,结果表明,X射线工作者恶性肿瘤的发病率明显高于对照组医务人员,相对危险（RR）为1．2：1．2,1．8和2．7,对X射线工作者患恶性肿瘤相对危险与开始从事X射线工作后的年限,开始从事X射线工作时的年龄和年伐,累积受照剂量进行分析表明：X射线工作者的白血病,皮肤癌,妇女乳腺癌,可能还有甲状腺癌危险的增高与职业X射线照射有关,当累积剂量达到一定水平时,这些肿瘤的危险明显增高。     

Analysis of mortality in chrysotile asbestos miners in China

In order to investigate the mortality of a cohort of chrysotile asbestos miners in China and evaluate its association with exposure to chrysotile,a fixed cohort of 1932 workers in chrysotile asbes-tos mine was established in 1981 and followed till June 1,2010.Information on vital status,cause of death and smoking habits was collected.The workers were divided into two groups according to their exposure status.The exposed group was composed of frontline workers who worked directly on mining or processing asbestos products.The control group consisted of those who were not directly exposed to asbestos in their work.Standardized mortality ratio (SMR) was calculated according to Chinese national death rates.Cox proportional hazards model was applied to estimate the adjusted relative risks of deaths from major causes in exposed and control groups.The results of this study showed that main causes of mortality were malignant neoplasm,cardiovascular disease,cerebrovascular disease and respiratory disease for chrysotile miners.The mortality rate was 939.20 per 100 000 person-years for workers.The SMR for all causes of death was 1.46 in the cohort.Statistically significant mortality excesses were found for lung cancer (SMR=1.51),pulmonary heart disease (SMR=2.70),respiratory disease (SMR=1.93),asbestosis (SMR=9.62),and accident (SMR=1.59).The mortalities from malignant neo-plasm,lung cancer,cerebrovascular disease and digestive disease in the exposed group were signifi-cantly higher than those in the control group.The findings indicate that chrysotile exposure is a risk factor for lung cancer,respiratory disease,cerebrovascular disease and digestive disease.     

Alcohol Drinking,Dyslipidemia, and Diabetes:A Population-based Prospective Cohort Study among Inner Mongolians in China

ObjectiveNo previous studies have evaluated the association between dyslipidemia, alcohol drinking, and diabetes in an Inner Mongolian population. We aimed to evaluate the co-effects of drinking and dyslipidemia on diabetes incidence in this population. MethodsThe present study was based on 1880 participants from a population-based prospective cohort study among Inner Mongolians living in China. Participants were classified into four subgroups according to their drinking status and dyslipidemia. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used to evaluate the association between alcohol drinking, dyslipidemia, and diabetes. ResultsDuring the follow-up period, 203 participants were found to have developed diabetes. The multivariable-adjusted odds ratios (95% confidence interval) for the incidence of non-dyslipidemia/drinkers, dyslipidemia/non-drinkers, and dyslipidemia/drinkers in diabetic patients were 1.40 (0.82-2.37), 1.73 (1.17-2.55), and 2.31 (1.38-3.87), respectively, when compared with non-dyslipidemia/non-drinkers. The area under the ROC curvefor a model containing dyslipidemia and drinking status along with conventional factors (AUC=0.746) was significantly (P=0.003) larger than the one containing only conventional factors (AUC=0.711). ConclusionThe present study showed that dyslipidemia was an independent risk factor for diabetes, and that drinkers with dyslipidemia had the highest risk of diabetes in the Mongolian population. These findings suggest that dyslipidemia and drinking status may be valuable in predicting diabetes incidence.     

A study on the dose-response relationship between asbestos exposure level and asbestosis among workers in a Chinese chrysotile product factory

The dose-response relationship for asbestos exposure in a chrysotile product factory was studied. The past gravimetric dust concentration values, obtained from different worksites, were converted into fiber concentration values according to conversion factors that were worked out by simultaneous sampling in this study. The conversions were made so that exposure could be expressed in fiber-years (f-yr). Asbestosis was diagnosed on the basis of chest radiographs and occupational histories. Cumulative dust exposure (f-yr) was calculated up to the date of diagnosis for asbestosis patients, and up to September 1982 for the remaining workers. A dose-response relationship expressed as fiber-years exposed vs cumulative prevalence of asbestosis was established by the life table method on the basis of these data. Predicted 3 and 1% prevalence of asbestosis corresponded to 43 and 22 f-yr exposure, respectively. Considering that a worker can work for 35 years, these doses are commensurate with dust concentrations of 1.22 and 0.63 f/ml, respectively. It is recommended that 1 f/ml be taken as the maximum allowable concentration of airborne asbestos dust for the workplace with an anticipated prevalence of about 2% asbestosis after 35 years of exposure.     

Association between time in range and cancer mortality among patients with type 2 diabetes: a prospective cohort study

Background: Little was known about the association among time in range (TIR), time above range (TAR), time below range (TBR), and cancer mortality among patients with type 2 diabetes. We aimed to investigate the association among TIR, TAR, TBR, and the risk of cancer mortality among patients with type 2 diabetes.Methods: A total of 6225 patients with type 2 diabetes were prospectively recruited in Shanghai, China. TIR was measured with continuous glucose monitoring at baseline and was defined as...     

Association between serum uric acid level and mortality in China

Background:Whether there is an association between serum uric acid (SUA) level and risk of mortality in the general population remains unclear. Based on the China National Survey of Chronic Kidney Disease linked to mortality data, a population-based cohort study was performed to investigate the association between SUA level and all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality in China.Methods:The survival status of participants in the cross-sectional survey was identified from January 1, 2006 to December 31, 2017. Only 33,268 individuals with complete SUA data among the 47,204 participants were included in the analysis. We determined the rates of all-cause mortality, CVD mortality, and cancer mortality. We used Cox proportional hazards regression models to evaluate the effect of the SUA level on mortality.Results:During a total of 297,538.4 person-years of follow-up, 1282 deaths occurred. In the Cox proportional hazards regression model, the rate of all-cause mortality, CVD mortality, and cancer mortality had a U-shaped association with SUA levels only in men, whereas no significant associations were detected in women. For all-cause mortality in men, the multivariable-adjusted hazard ratios (HRs) in the first, second, and fourth quartiles compared with the third quartile were 1.31 (95% confidence interval [CI] 1.04–1.67), 1.17 (95% CI 0.92–1.47), and 1.55 (95% CI 1.24–1.93), respectively. For CVD mortality, the corresponding HRs were 1.47 (95% CI 1.00–2.18), 1.17 (95% CI 0.79–1.75), and 1.67 (95% CI 1.16–2.43), respectively. For the cancer mortality rate, only a marginally significant association was detected in the fourth quartile compared with the third quartile with an HR of 1.43 (95% CI 0.99–2.08).Conclusions:The association between SUA and mortality differed by sex. We demonstrated a U-shaped association with SUA levels for all-cause and CVD mortalities among men in China.     

Role of blood pressure on stroke-related mortality: a 45-year follow-up study in China

Background: Hypertension is associated with stroke-related mortality. However, the long-term association of blood pressure (BP) and the risk of stroke-related mortality and the influence path of BP on stroke-related death remain unknown. The current study aimed to estimate the long-term causal associations between BP and stroke-related mortality and the potential mediating and moderated mediating model of the associations.Methods: This is a 45-year follow-up cohort study and a total of 1696 subj...     

中药抗肺癌转移的实验研究进展

中药可以直接抑制肺癌细胞的侵袭、黏附能力,并通过调节细胞外基质金属蛋白酶水平影响癌细胞的转移,还能调控肿瘤转移相关基因的表达、抑制肺癌肿瘤新生血管生成。     

中医体质学及现代医学对肺癌发病机理研究的探讨

中医体质的研究历经了理论、临床到实践的漫长岁月的发展后,已经取得了重大进展。从肿瘤发病来看,与人体体质状况有着密切的联系,体质偏颇也是肿瘤的发展的重要因素。作者拟通过中医体质辨证对肿瘤发生发展的认识,结合现代医学对肿瘤病因的研究,并以肺癌为例,对肿瘤的发病机理进行概述。     

HMGBl在AECOPD、肺炎、肺癌患者中的表达变化

目的：探讨分析HMGBl在AECOPD（慢性阻塞性肺疾病急性加重期）、肺炎、肺癌患者中的表达变化。方法该文研究对象方便选取该院2014年2月—2015年2月收治的AECOPD患者40例、肺炎患者40例、肺癌患者40例,同时选取来该院自愿接受检查的30例研究者为对照组,抽取4组研究对象全血,检测其外周血白细胞（WBC）计数、HMGB1水平、C-反应蛋白水平及肺癌标志物等。结果 AECOPD患者血清HMGB1、WBC、CRP水平明显高于对照组,两组差异有统计学意义（P<0.05）。和对照组相比,肺炎组患者的血清HMGB1、WBC、CRP水平均较高,两组差异对比有意义（P<0.05）。肺癌患者血清HMGB1和CEA水平明显高于对照组（P<0.05）。结论HMGBl在AECOPD、肺炎、肺癌患者中的显著升高,说明该指标可能参与呼吸系统炎症性病、肺癌疾病发病机制,同时可能提示疾病的严重程度。     

炎症和炎性微环境在肺癌发生、发展及转移中的作用

炎症与相当一部分肿瘤密切相关,近年来炎症在肿瘤发生、发展及转移中的作用越来越受到重视,但对于肺癌中的炎症研究仍相对较少。炎症可以直接或者间接地通过促进血管生成、细胞增殖、转移,从而促进肺癌的进展。其主要通过炎性因子、炎性信号通路及上皮间质转化而发挥作用。现就近年来炎症及炎性微环境在肺癌发生、发展中的作用予以综述。     

微RNA与肺癌治疗的研究进展

微RNA(miRNA)是一种内源性长为18²5个核苷酸的小分子非编码RNA,通过与特定mRNA 3'UTR(非编码区)结合抑制蛋白质表达参与生物的发育、代谢及肿瘤的发生、发展等生命现象。近年来,越来越多的研究显示miRNA几乎在肺肿瘤癌变的每一个过程(如肿瘤的发生、侵袭和转移)以及抗癌药物等方面产生影响,miRNA在肺癌中发挥原癌基因的作用及抑癌基因的作用。因此,miRNA很有可能成为肺癌靶向治疗的有效靶点,为肺癌的治疗提供新方法。该文结合国内外最新报道,论述miRNA在肺癌治疗方面的研究进展。     

CT在诊断肺癌分期中的作用

目的　探讨CT在肺癌术前诊断及分期的应用价值。方法　搜集 2 0例采用螺旋CT检查经手术或穿刺病理证实的肺癌分析其CT表现。结果　术前CT诊断与TNM分期符合率 90 % (1 8/ 2 0 ) ,CT较病理分期偏高。结论　CT与病理分期有较高的符合性 ,对指导临床医师合理选择和设计治疗程序 ,如手术或放化疗等具有重要意义     

多药耐药基因表达的检测在肺癌治疗中的意义

目的研究肺癌患者化疗前与化疗后外周血中多药耐药（Multidrug Resistance,MDR）基因的表达,并探讨其临床意义。方法取肺癌患者化疗前及化疗结束一周后的外周血,用流式细胞仪检测MDR的表达水平,进行定量分析。结果肺癌患者化疗前MDR明显低于化疗后（t值分别为：19.45、21.84、10.43、17.40、8.22,均P〈0.01）。随着化疗次数的增多,MDR逐渐升高,手术后可使MDR再次降低（P〈0.01）。结论肺癌患者在化疗期间监测其外周血中MDR表达水平,有助于判断化疗效果及患者的预后。     

河南居民常见癌症死亡率及其流行趋势分析(1974～1999)

目的 :研究河南人口常见恶性肿瘤死亡率及其流行特征。方法 :收集河南省 1974～ 1976年全人口死亡回顾调查资料和 1983～ 1999年 1/ 10人口 ( 15市县 )居民死亡登记报告资料 ,按《中国恶性肿瘤登记报告试行规范》的统计方法 ,分析常见恶性肿瘤死亡率及动态特征并对未来趋势进行预测。结果 :近 2 6年来 ,河南居民总癌死亡率变化不大 ,而食管癌则呈下降趋势 ,胃癌相对稳定 ,肝癌、肺癌上升明显 ,子宫颈癌下降很快。结论 :建立以人群为基础的癌症登记报告系统 ,对于了解和掌握恶性肿瘤流行动态及其进行肿瘤控制是非常必要的     

增殖细胞核抗原,癌基因在肺癌的表达及其意义

本研究采用免疫组织化学方法观察了ＰＣＮＡ，Ｐ２１和Ｃ－ｅｒＢ－２基因产物在６０例肺癌中的表达及其与肺癌的关系。结果表明，这３种被测物在不同组织类型的肺癌都存在高表达。ＰＣ－ＮＡ阳性细胞染色位于核区，而Ｐ２１和Ｃ－ｅｒｂＢ－２位于细胞浆。３种被测物的阳性细胞的定位与癌组织类型无关。但与癌的发生和发展关系密切。这３种被测物的高表达说明癌细胞的增殖活性增强，癌基因活化或发生突变，我们认为，检测肺癌组织中     

LncRNA HOTAIR、HOTTIP及其下游HOXD10、HOXA13基因在肺癌中的表达研究

目的探讨HOTAIR和HOTTIP及其下游HOXD10和HOXA13基因在肺癌中的表达特征以及相互调控的关系.方法选择47例肺癌患者并收集癌组织和癌旁正常组织,利用TRIzol提取总RNA,实时荧光定量PCR检测基因相对表达量.结果 HOTAIR在癌组织中的相对表达量（4.12±4.58）,显著低于癌旁正常组织（7.43±4.20）,（P〈0.01）,HOXA13在癌组织中的相对表达量（8.64±1.21）,显著降低低于癌旁正常组织（9.43±1.58）,（P〈0.01）,其他两个基因表达无显著变化.在有淋巴转移的个体中,癌组织中HOXD10 mRNA表达为（9.01±1.22）,显著高于无转移的患者（7.81±2.15）,（P=0.02）.HOTTIP与下游HOXA13基因RNA在癌组织（r=0.78,P=0.00）和癌旁正常组织（r=0.70,P〈0.01）中均存在正相关关系;HOTAIR与下游HOXD10基因mRNA在癌旁正常组织中成正相关（r=0.37,P〈0.01）,在癌组织中却不存在相关关系（r=0.12,P=0.47）.结论提示在肺癌中HOTTIP与HOXA13调控关系正常;HOTAIR在癌组织中表达降低,且可能丧失对下游基因HOXD10的正常调控.     

肺癌与肺部感染患者自身抗体谱的特点比较

目的探讨肺癌、肺部感染患者血清抗核抗体（ANA）谱、类风湿因子（RF）的表现特点。方法采用免疫印迹法检测抗核抗体谱,免疫散射比浊法检测类风湿因子,对照分析90例肺癌患者（均经病理组织学或细胞学检查确诊）、100例肺部感染患者及36例健康人血清抗核抗体谱、类风湿因子的表现特点。结果肺癌患者ANA谱阳性率显著高于健康人群,60岁以上老年肺癌患者ANA谱阳性率显著高于同年龄段健康人群及肺部感染患者,同时,60岁以上老年肺癌患者ANA谱阳性率显著高于60岁以下肺癌患者。肺部感染患者ANA谱阳性率在各年龄组间无明显差异,虽然数据表明随年龄增大阳性率增高,但未取得统计学数据支持。RF阳性率各年龄段无明显差异,肺癌患者与肺部感染患者及健康人群相比,亦无明显差异。结论肺癌与抗核抗体谱有关,肺部感染无明显相关。     

NP和MVP方案治疗晚期非小细胞肺癌的对比研究

目的 对比NP和MVP两组方案治疗晚期非小细胞肺癌的疗效和毒性。方法 通过NP和MVP两个联合化疗方案,每（21－28天／周期）对收治的晚期非小细胞肺癌48例全身给药。其中腺癌30例,鳞癌18例。初始29例,复治19例。结果 NP组和MVP组有效率分别为40．0％（10／25）和34．78％（8／23）,两组无显著性差异（P＞0．05）。毒副作用主要为骨髓抑制。Ⅲ-Ⅳ度白细胞下降率NP组为56％,MVP组为39．13％,两组间有显著差异（P＞0．05）。结论 NP和MVP两方案治疗晚期非小细胞肺癌有效率较高且相近,白细胞下降的副反应均可耐受。因此,从不同的需要和考虑出发,两者均可作为治疗晚期非小细胞肺癌的首选方案。