3-Year Follow-up of Lower Risk Cannabis Use Patterns: Evidence from a Longitudinal Survey

Objectives:Following recommendations from the Lower Risk Cannabis Use Guidelines, we evaluated how lower risk cannabis use (late initiation and low use frequency) was associated with the risk of developing cannabis abuse/dependence over a 3-year follow-up period compared to 12-month abstinence (controls) or higher risk cannabis use (early initiation and higher use frequency). We also explored the effect of cannabis quantity.Methods:Data were obtained from the U.S. nationally representative survey, National Epidemiologic Survey on Alcohol and Related Conditions wave I (2001 to 2002) and wave II (2004 to 2005), which included 31,464 respondents with no lifetime history of cannabis abuse/dependence at the first interview. We applied multiple logistic regression and propensity score matching analyses to examine the association between different use patterns at wave I and cannabis abuse/dependence at wave II, adjusting for covariates. Lower risk cannabis use and the transition to higher use frequency were also assessed.Results:For propensity score analysis, lower risk cannabis use at wave I was associated with higher risk of cannabis use/dependence at wave II compared to controls (odds ratio [OR]: 4.27; 95% confidence interval [95% CI], 1.57 to 11.61); however, there was no association with use frequency increase (OR: 2.52; 95% CI, 0.88 to 7.17). Higher risk use had a greater risk of cannabis use/dependence than controls (OR: 6.27; 95% CI, 2.56 to 15.38) and lower risk use (OR: 2.69; 95% CI, 1.12 to 6.47). Logistic regression analyses showed similar results, except that lower risk use was significantly associated with use frequency increase (OR: 2.49; 95% CI, 1.22 to 5.08). For the lower risk use group, 1 to 3 joints/day of use was significantly associated with cannabis abuse/dependence.Conclusions:We found that following recommended use patterns can significantly lower one’s risk of cannabis abuse/dependence. However, risk of cannabis abuse/dependence is still 4 times higher than staying abstinent. Updated recommendations on safe cannabis exposure levels are needed to guide cannabis use in the general population after cannabis legalization.     

Diagnostic value of periostin in lung cancer‐related malignant pleural effusion

BackgroundPeriostin (POSTN) is an extracellular matrix protein that is overexpressed in lung cancer and is considered an effective diagnostic and prognostic biomarker for lung cancer. The purpose of this study was to investigate the diagnostic performance of POSTN and to further evaluate the diagnostic value of POSTN combined with carcinoembryonic antigen (CEA) and cancer ratio [CR: serum lactate dehydrogenase (LDH)/pleural effusion adenosine deaminase (PE ADA)] in lung cancer‐related malignant PE (MPE).MethodsA total of 108 patients with PE, including 54 with lung cancer and 54 with benign lung disease, were enrolled in this study. The POSTN levels of PE and serum were detected using an enzyme‐linked immunosorbent assay. Information on the expression of PE and serum CEA, serum LDH, and PE ADA was collected from medical records.ResultsThe levels of PE POSTN in MPE of patients with lung cancer were significantly higher than those in patients with benign PE (p < 0.0001). The receiver operating characteristic (ROC) curve indicated that the diagnostic sensitivity and specificity of PE POSTN for lung cancer‐related MPE were respectively 77.78% and 68.52% when the cutoff value was determined to be 53.45 ng/ml. The ROC curve analysis demonstrated that PE POSTN has a high diagnostic value in MPE associated with lung cancer [area under the curve (AUC) = 0.764], and the combination of PE POSTN, PE CEA, and CR can improve the diagnostic accuracy of lung cancer‐related MPE (AUC = 0.948).ConclusionPOSTN can be used as a potential marker for lung cancer‐related MPE diagnosis.     

Plastin 1 drives metastasis of colorectal cancer through the IQGAP1/Rac1/ERK pathway

Tumor metastasis is the dominant cause of death in colorectal cancer (CRC) patients, and it often involves dysregulation of various cytoskeletal proteins. Plastin 1 (PLS1) is an actin‐bundling protein that has been implicated in the structure of intestinal epithelial microvilli; however, its role in CRC metastasis has not yet been determined. In this study, we demonstrated that PLS1 is highly expressed in 33.3% (45/135) of CRC patients and is correlated with lymph node metastasis and poor survival. In in vitro and in vivo experiments, PLS1 induced the migration and invasion of CRC cells and the metastases to the liver and lung in mice. Moreover, the expressions of key factors for CRC metastases, matrix metalloproteinase (MMP) 9 and 2, were enhanced by PLS1, which was dependent on phosphorylating ERK1/2 activated by IQGAP1/Rac1 signaling. The connection between these signals and PLS1 was further confirmed in CRC tissues of patients and the metastatic nodules from a mouse model. These findings suggest that PLS1 promotes CRC metastasis through the IQGAP1/Rac1/ERK pathway. Targeting PLS1 may provide a potential approach to inhibit the metastasis of CRC cells.     

微信订阅在泌尿外科根治性全膀胱切除回肠膀胱术患者院外延续性护理中的应用

目的探讨微信订阅在全膀胱切除回肠膀胱术后患者院外延续性护理中的应用评价。方法采用便利抽样方法,选取2015年6-12月上海市某三级甲等医院泌尿外科80例行根治性全膀胱切除回肠膀胱术患者为研究对象。采用随机序列法,按患者就诊先后顺序,奇数者为观察组,偶数者为对照组,各40例。对照组患者给予常规延续性护理,观察组患者给予在常规延续性护理的基础上结合微信订阅的延续性护理指导。干预前后对患者的服药依从性、疾病知识掌握度、护理工作满意度进行调查。结果观察组在服药依从性、疾病知识掌握度及护理满意度方面均优于对照组,差异有统计学意义(P0.05)。结论微信订阅应用于全膀胱切除回肠膀胱术患者院外延续性护理中,可提高患者服药依从性、相关疾病知识掌握度和护理质量的满意度,对改善患者预后,促进其早日康复、正确的疾病认知、密切护患关系有着积极的作用。     

情景式健康教育在初产妇母乳喂养培训中的应用

目的 探讨情景式健康教育在初产妇母乳喂养知识与技能培训中的有效性.方法 将120例初产妇按随机数字表法分为观察组与对照组各60例,对照组采用传统模式对初产妇进行母乳喂养健康教育,观察组进行情景式健康教育,比较两组健康教育的效果.结果 观察组初产妇母乳喂养知识、技能掌握及实践能力显著优于对照组(均P＜0.01);产妇对健康教育效果的满意度显著优于对照组(P＜0.01).结论 情景式健康教育可促进初产妇母乳喂养知识与技能的掌握,提高其实践能力;提高患者满意度,促进护患和谐.     

缝隙连接蛋白26在肺腺癌相关成纤维细胞中的表达及临床意义

目的 探讨缝隙连接蛋白26(connexin 26,Cx26)在肺腺癌相关成纤维细胞中的表达及其临床意义.方法 收集2018年11月至2019年5月于广西医科大学附属肿瘤医院6例手术切除肺腺癌癌组织及相应癌旁组织,分离原代肿瘤相关成纤维细胞(cancer-associated fibroblasts,CAFs)和正常肺...     

硬质合金粉尘致肺纤维化作用的流行病学调查

对我国有代表性的４家硬质合金生产厂及２家工具研磨厂的１ ２３７名单纯接触硬质合金粉尘工人及５０２名对照工人进行分析。结果表明，接触组呼吸系统症状、肺功能异常检出率、血清铜蓝蛋白及尿钴含量均明显高于对照组。Ｘ线胸片检查发现８例尘肺，患病率为０．６５％，发病平均接尘工龄为２５．２年。上述结果说明，硬质合金粉尘具有致肺纤维化作用，并可引起尘肺。     

Identification of genes over-expressed in small cell lung carcinoma using suppression subtractive hybridization and cDNA microarray expression analysis

To identify genes that are differentially over-expressed in Small Cell Lung Carcinoma (SCLC) we have used a combination of suppression subtractive hybridization and cDNA microarray to analyse the expression profiles of 2400 cDNAs clones. Genes that are over-expressed in SCLC were identified using 32 pairs of fluorescence-labeled cDNA samples representing various lung tumors and normal tissues. This comprehensive approach has resulted in the identification of 209 genes that are differentially over-expressed in SCLC. Quantitative real-time PCR was used to further validate the expression of 43 genes in SCLC tumors and various normal tissues. Discussed in this report are nine genes, which showed the most promising SCLC tumor to normal tissue differential expression profiles, including seven known and two novel genes. The large number of differentially expressed genes identified from this analysis and the characterization of these genes will provide valuable information in better understanding the biology of SCLC and help us in developing these gene products as potential targets for diagnostic as well as therapeutic usage.     

Frequency of under-corrected refractive errors in elderly Chinese in Beijing

Purpose The aim of the study was to evaluate the prevalence of under-corrected refractive error among elderly Chinese in the Beijing area.Methods The population-based, cross-sectional, cohort study comprised 4,439 subjects out of 5,324 subjects asked to participate (response rate 83.4%) with an age of 40+ years. It was divided into a rural part [1,973 (44.4%) subjects] and an urban part [2,466 (55.6%) subjects]. Habitual and best-corrected visual acuity was measured. Under-corrected refractive error was defined as an improvement in visual acuity of the better eye of at least two lines with best possible refractive correction.Results The rate of under-corrected refractive error was 19.4% (95% confidence interval, 18.2, 20.6). In a multiple regression analysis, prevalence and size of under-corrected refractive error in the better eye was significantly associated with lower level of education (P<0.001), female gender (P<0.001), and age (P=0.001).Conclusions Under-correction of refractive error is relatively common among elderly Chinese in the Beijing area when compared with data from other populations.