AXL表达与乳腺癌预后及临床病理特征关系的Meta分析

目的 探讨受体酪氨酸激酶AXL蛋白的表达对乳腺癌患者预后及临床病理特征的意义。方法 在中国知网(CNKI)、万方医学网(Wanfang Data)、 Cochrane Library、Embase、PubMed和Medline数据库中,搜索国内外公开发表的有关AXL与乳腺癌预后关系的文献,检索时限均为从建库至2019年10月。2位研究者按纳入和排除标准独立筛选文献、提取资料和评价纳入研究的偏倚风险,并进行Meta分析。结果 共纳入7篇文献,包括933例乳腺癌患者。AXL高表达组的乳腺癌患者总生存期(overall survival,OS)明显低于低表达组(HR=2.36,95%CI 1.60~3.46,P<0.000 1),但其表达在无复发生存期(relapse free survival,RFS)和无疾病生存期(disease free survival,DFS)中差异无统计学意义,且与乳腺癌的年龄、临床分期、组织分级、淋巴结转移及受体表达的相关性分析无统计学意义。结论 AXL的阳性表达与乳腺癌患者预后不良有关,是乳腺癌个体化治疗的潜在分子标志物。     

The effect of cardiac rehabilitation exercise programs on feelings of energy and fatigue: a meta-analysis of research from 1945 to 2005.

BACKGROUND: Physical activity is a healthful behavior that has promise for combating feelings of low energy and fatigue. Despite evidence suggesting that fatigue is a prodromal symptom of major cardiac events, improvements in feelings of energy and fatigue have largely been ignored by reviewers of cardiac rehabilitation literature who have focused on anxiety, depression and general measures of quality of life. DESIGN: A meta-analytical review. METHODS AND RESULTS: Computer databases were searched from January 1945 to May 2005 to identify relevant literature. A total of 36 studies consisting of 4765 subjects were included. Cardiac rehabilitation exercise programs were consistently associated with increases in energy and decreases in fatigue. The magnitude of the effect was moderately large (mean delta 0.51; 95% confidence interval 0.42-0.61) but was heterogeneous and modified by features of the research design. Comparison of effect sizes in cardiac rehabilitation studies concurrently measuring energy/fatigue, anxiety and depression suggest that exercise-based cardiac rehabilitation programs have larger effects on feelings of energy and fatigue compared with anxiety and depression. CONCLUSION: This review quantifies the potential benefit of cardiac rehabilitation exercise programs on feelings of energy and fatigue, and suggests that cardiac rehabilitation researchers and practitioners may benefit from examining, and perhaps even focusing on, feelings of energy and fatigue as an important outcome variable. A greater understanding of the effect of cardiac rehabilitation exercise programs on feelings of energy and fatigue will be reached when more true experiments are conducted thereby avoiding the primary limitation of the literature reviewed; that is, the frequent use of non-experimental research designs.     

Diabetes im Kindes- und Jugendalter

Type 1 diabetes is one of the commonest chronic disorders encountered in children and adolescents. When it first becomes apparent in children, approximately 20% of them have clinical and biochemical signs of ketoacidosis (DKA). In the presence of unusual clinical symptoms it is necessary to consider the possibility of associated conditions, such as coeliac disease, immunothyroiditis and Addison’s disease. Children with diabetes must be treated by a multidisciplinary team made up of paediatrician, paediatric diabetes specialist, psychologist, social worker, ophthalmologist, dietitian, nurse and diabetes counsellor, making it essential for them to be treated in regional specialised centres. They are treated in their own psychosocial environment and their families are involved in the therapy. Comprehensive, multidisciplinary treatment strategies have now made it possible for these patients to enjoy normal physical wellbeing and near-normal psychosocial development. Prevention and early treatment of of disturbances associated with diabetes remain an important concern. The fact that type 2 diabetes must now be looked for in overweight children and adolescents is a new aspect of diabetes medicine.