妊娠对乙型肝炎肝郁脾虚型患者血清细胞因子浓度的影响及临床意义

目的 :探讨妊娠对慢性乙型肝炎 (乙肝 )肝郁脾虚型患者血清白细胞介素 - 10、12 (IL - 10、IL - 12 )、γ-干扰素 (IFN-γ)浓度的影响及临床意义。方法 :用酶联免疫法 (EL ISA)检测孕期和非孕期患者 IL - 10、IL - 12及 IFN -γ血清浓度 ,并作同期肝功能指标检查。患者分为早孕期 (2 6例 )、晚孕期 (32例 )、非孕期 (31例 ) 3组。 2 0例非孕期健康者为对照组。结果 :早孕期组 IL - 10水平 [(2 6 .0± 9.8) ng/ L ]较非孕期组 [(18.0± 1.3) ng/ L ]升高 (P <0 .0 5 ) ,而与对照组 [(2 9.4± 5 .1) ng/ L ]相近 (P >0 .0 5 )。IL - 12、IFN -γ分别为 (5 4 .1± 2 6 .0 ) ng/ L和 (45 .5± 17.3) ng/ L ,较对照组 [(8.2± 2 .1) ng/ L、(2 4 .5± 6 .1) ng/ L ]和非孕期组 [(8.0± 2 .7) ng/ L、(16 .7± 3.7) ng/ L ]均明显升高 (均P <0 .0 1)。晚孕期组与其他各组比较 ,IL - 10 [(9.4± 1.9) ng/ L ]明显下降 (P <0 .0 1) ,但 IL - 12 [(16 6 8.0± 318.2 )ng/ L ]、IFN -γ[(46 1.0± 10 3.3) ng/ L ]显著升高。结论 :妊娠可使慢性乙肝肝郁脾虚型患者血清 IL - 12、IFN-γ浓度升高 ,在晚孕期表现更为明显。     

Identification of Endoglin as an epigenetically regulated tumour-suppressor gene in lung cancer

Background:

The transforming growth factor-beta (TGF- β) pathway has been implicated in proliferation, migration and invasion of various cancers. Endoglin is a TGF-β accessory receptor that modulates signalling. We identified Endoglin as an epigenetically silenced tumour-suppressor gene in lung cancer by means of a genome-wide screening approach, then sought to characterise its effect on lung cancer progression.

Methods:

Methylation microarray and RNA sequencing were carried out on lung cancer cell lines. Epigenetic silencing of Endoglin was confirmed by methylation and expression analyses. An expression vector and a 20-gene expression panel were used to evaluate Endoglin function. Pyrosequencing was carried out on two independent cohorts comprising 112 and 202 NSCLC cases, respectively, and the impact of Endoglin methylation on overall survival (OS) was evaluated.

Results:

Methylation in the promoter region resulted in silencing of Endoglin, which could be reactivated by demethylation. Increased invasion coupled with altered EMT marker expression was observed in cell lines with an epithelial-like, but not those with a mesenchymal-like, profile when Endoglin was absent. Methylation was associated with decreased OS in stage I but not in stages II–III disease.

Conclusions:

We show that Endoglin is a common target of epigenetic silencing in lung cancer. We reveal a link between Endoglin silencing and EMT progression that might be associated with decreased survival in stage I disease.     

Association of Suboptimal Health Status and Cardiovascular Risk Factors in Urban Chinese Workers

Suboptimal health status (SHS) has become a new public health challenge in urban China. Despite indications that SHS may be associated with progression or development of chronic diseases such as cardiovascular and metabolic diseases, there are few reports on SHS investigations. To explore the relationship between SHS and traditional cardiovascular risk factors, a cross-sectional study was conducted in a sample of 4,881 workers employed in 21 companies in urban Beijing. Blood pressure, glucose, lipid levels (total cholesterol, high-density lipoprotein [HDL] cholesterol, low-density lipoprotein [LDL] cholesterol and triglycerides), cortisol, and body mass index were measured. SHS score was derived from data collection in the SHS questionnaire (SHSQ-25). Univariate analysis and linear two-level model were used to analyze the association of SHS with the cardiovascular risk factors. Serum cortisol level was much higher among the SHS high-score group than that among the low SHS score group (204.31 versus 161.33 ng/ml, P < 0.001). In a linear two-level model, we found correlation between SHS and systolic blood pressure, diastolic blood pressure, plasma glucose, total cholesterol, and HDL cholesterol among men, and correlation between SHS and systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, and HDL cholesterol among women after controlling for age, education background, occupation, smoking, and physical activity. SHS is associated with cardiovascular risk factors and contributes to the development of cardiovascular disease. SHS should be recognized in the health care system, especially in primary care.     

垂体瘤合并视功能损害患者生存质量现状的调查

目的调查有视功能损害的垂体瘤患者的生存质量现状并进行分析,为提高和改善患者的生活质量提供依据。方法选择有视功能损害的垂体瘤患者50例,所有患者行视力、矫正视力、Octopus视野计检查。采用视功能损害眼病患者生存质量量表在术前对患者进行问卷调查,分析调查结果。结果50例有视功能损害的垂体瘤患者生存质量总分为（114．54±30．11）分,其中症状与视功能得分为（46．70±14．50）分,身体机能得分为（24．00±5．41）分,社会得分为（23．28±5．76）分,精神心理得分为（20．54±6．92）分。视力轻度下降组、视力中度下降组和视力重度下降组生存质量总得分分别为（138．38±10．92）,（125．68±12．52）,（75．00±18．75）分,三组比较差异有统计学意义（F=86．04,P〈0．01）。结论随着视力损害程度加重,垂体瘤患者生存质量下降明显,护理人员应当从建立良好护患关系、心理疏导等方面来提高和改善患者的生活质量。     

Predictive clinicopathologic factors for limited response of T3 rectal cancer to combined modality therapy

Purpose The response of T3 rectal cancer to combined modality therapy (CMT) is highly predictive of long-term outcome following surgery. The aim of this study was to identify pretreatment factors associated with poor tumor response to neoadjuvant chemoradiation. Methods A prospective institutional database at Memorial Sloan-Kettering Cancer Center was queried for endorectal ultrasound (ERUS) stage T3N0–2 rectal cancer patients, treated with CMT followed by surgical resection, between 1998 and 2003. Preoperative clinicopathologic factors determined by biopsy, ERUS, proctoscopy, and digital rectal examination were correlated with the degree of downstaging of the primary mural lesion (tumor downstaging) in response to neoadjuvant therapy. Associations were analyzed by chi-square, Kaplan–Meier, and logistic regression. Results Of 274 patients, 51% obtained tumor downstaging in response to preoperative treatment, i.e., lower pathologic T-stage compared with pretreatment ERUS. Five-year recurrence-free survival was 89% in the cohort that obtained tumor downstaging compared with only 45% in the cohort that obtained no tumor downstaging. Factors significantly associated with limited or lack of tumor downstaging after CMT included: fixed tumor on digital rectal examination (p < 0.021), near-circumferential tumor (p < 0.011), tumor stenosis (p < 0.025), metastatic disease (p < 0.012), biopsy-proven poorly differentiated pathology (p < 0.002), and radial extension >2.5 mm on ERUS (p < 0.031). On multivariate analysis, deep radial extension on ERUS, metastatic disease, and poorly differentiated pathology were in each, independently associated with limited or lack of tumor downstaging. Conclusions Pretreatment evaluation with biopsy, proctoscopy, and ERUS can identify T3 rectal cancer patients unlikely to respond well to CMT. These patients may be considered for alternative protocols and their tumors studied to ascertain the molecular events responsible for resistance to chemoradiation. Presented at Presented at the 2006 annual meeting of The American Society of Colon and Rectal Surgeons, June 3–7, 2006, Seattle, WA, USA.     

The influence of professional commitment on turnover intention

This study investigated the influence of professional commitment on turnover intentions of nurses. The study also examined the relationships between demographic data, work-related variables and the professional commitment. The self-administered questionnaires were distributed to one fifth of Southern Taiwan's population of nurses (n = 4,000). A total of 2,543 subjects completed the questionnaires with a 63.6% response rate. The nurses exhibited a medium-high degree of overall professional commitment. Age, salary, years in profession and years in organization were correlated significantly with professional commitment by Pearson's correlation. There were significant correlations between professional commitment and marital status, educational level, status of the youngest child, level of position, and family support in Spearman's correlations. Family support, age, level of position and status of hospital were the significant predictors in the final regression analysis model. The discriminant analysis showed that 45.4% of nursing professional commitment was correctly classified in predicting intention to leave the profession and 33.1% in predicting the intention to leave the organization. The study recommended that nursing professional commitment is an important moderator to affect the turnover intention of staff nurses.