Trends in cancer incidence by socioeconomic deprivation in Germany in 2007 to 2018: An ecological registry-based study

Age-standardized cancer incidence has decreased over the last years for many cancer sites in developed countries. Whether these trends led to narrowing or widening socioeconomic inequalities in cancer incidence is unknown. Using cancer registry data covering 48 million inhabitants in Germany, the ecological association between age-standardized total and site specific (colorectal, lung, prostate and breast) cancer incidence in 2007 to 2018 and a deprivation index on district level (aggregated to quintiles) was investigated. Incidence in the most and least deprived districts were compared using Poisson models. Average annual percentage changes (AAPCs) and differences in AAPCs between deprivation quintiles were assessed using Joinpoint regression analyses. Age-standardized incidence decreased strongly between 2007 and 2018 for total cancer and all cancer sites (except female lung cancer), irrespective of the level of deprivation. However, differences in the magnitude of trends across deprivation quintiles resulted in increasing inequalities over time for total cancer, colorectal and lung cancer. For total cancer, the incidence rate ratio between the most and least deprived quintile increased from 1.07 (95% confidence interval: 1.01-1.12) to 1.23 (1.12-1.32) in men and from 1.07 (1.01-1.13) to 1.20 (1.14-1.26) in women. Largest inequalities were observed for lung cancer with 82% (men) and 88% (women) higher incidence in the most vs the least deprived regions in 2018. The observed increase in inequalities in cancer incidence is in alignment with trends in inequalities in risk factor prevalence and partly utilization of screening. Intervention programs targeted at socioeconomically deprived and urban regions are highly needed.     

Kaposiform hemangioendothelioma with overlapping features of rapidly involuting congenital hemangioma and a delayed complication of necrotizing fasciitis

We report the case of a male infant born at term with kaposiform hemangioendothelioma (KHE) of the right forearm and coagulopathy. Our case was unusual as it involuted leaving subcutaneous atrophy and prominent veins, which are more commonly observed in rapidly involuting congenital hemangioma. At 3 years of age, the child developed recurrent superficial thrombophlebitis localized to the area where the KHE had regressed. Subsequently, he developed necrotizing fasciitis and thrombotic veins in the same location and group A streptococcal septic shock.     

强化血糖监测在冠脉旁路移植术后患者血糖管理中的应用

目的探讨强化血糖监测护理方案对冠脉旁路移植术(CABG)术后转入普通病房的患者血糖变异性的影响。方法采用便利抽样法,选取北京安贞医院2018年6—12月入院行CABG于72 h内转出ICU的冠心病合并高血糖患者106例,按照随机数字表法分为对照组(54例)和研究组(52例)。对照组给予常规护理,研究组在对照组的基础上采用强化血糖监测在内的综合护理策略。比较两组CABG术后患者转至普通病房3 d内每日平均血糖水平(MGL)、血糖标准差(SD)、日内平均血糖波动幅度(MAGE)、血糖变异系数(CV)。结果患者从ICU转入普通病房后的MGL存在时间效应、组间效应以及时间和组间的交互效应;SD存在组间效应;MAGE存在时间和组间效应;CV存在组间效应以及时间和组间的交互效应。结论在患者转出ICU到普通病房术后1~3 d内,与常规护理组相比较,继续给予强化血糖监测与护理能够减少血糖变异程度。     

SMILE术中第二术眼不同保护措施泪膜稳定性的对比研究

目的通过应用Keratograph 5M眼表综合分析仪对飞秒激光小切口角膜基质透镜取出手术(SMILE)术中第二术眼不同保护措施的首次泪膜破裂时间(NIKBUTf)和平均泪膜破裂时间(NIKBUTav)变化情况进行对比研究,观察不同保护措施对泪膜稳定性的影响。方法选取2019年6月至2019年11月在重庆眼视光眼科医院行SMILE手术的患者作为研究对象。患者左眼为观察眼,SMILE术中在右眼行手术时,左眼按照不同处理方法分为3组,分别给予小牛血去蛋白眼用凝胶点眼、使用眼罩,以及空白对照。并分别在右眼手术前后,使用Keratograph 5M眼表综合分析仪,完成左眼NIKBUTf和NIKBUTav检测,进行对比研究。采用SPSS 25.0进行统计学分析。结果共35例患者(35左眼)纳入研究,其中小牛血去蛋白眼用凝胶组12例,眼罩组11例,空白对照组12例。重复测量方差分析NIKBUTf和NIKBUTav均存在时间效应和分组效应,且时间与分组存在交互作用(P<0.05)。凝胶组左眼NIKBUTf在右眼手术前和右眼手术后即刻无统计学差异(P>0.05),凝胶组左眼NIKBUTav在右眼SMILE手术后即刻较右眼手术前延长(P<0.05)。眼罩组和对照组(空白)左眼NIKBUTf和NIKBUTav在右眼手术后即刻均缩短(P<0.05)。对照组NIKBUTf和NIKBUTav缩短最明显(P<0.05)。结论不同保护措施和时间变化均对NIKBUTf和NIKBUTav产生了影响,小牛血去蛋白提取物眼用凝胶应用于SMILE术中第二术眼的保护措施起到了保护泪膜稳定性的作用。眼罩对第二术眼的泪膜保护作用并不明显,常规手术操作对第二术眼无保护措施的情况下泪膜稳定性最差。     

Evaluation of the anti-inflammatory and antioxidant pharmcodynamic compoents of naoxintong capsules as a basis of broad spectrum effects

ContextNaoxintong capsule (NXT) is one of the most prevalent Traditional Chinese Medicine formulations in the treatment of coronary heart disease (CHD), yet the action of pharmacodynamic components remains unclear.ObjectiveTo determine the basis by which pharmacodynamic components of NXT may be effective in the treatment of CHD.Materials and methodsThe protective effect of NXT (0.01–100 μg/mL) on 293 T and hy926 cells was determined by MTT assay for 24 h. Afterwards, to investigate the pharmacodynamic material basis of NXT in anti-inflammatory and antioxidant effects, based on previous UPLC/Q-TOF analysis, 293 T and hy926 cells were divided into control (treated with solvent), model (incubated with TNF-α, LPS or H₂O₂), intervention (treated with UPLC components) and positive groups. After 24 h of treatment, all cells were tested to verify the screening results. MOE software was applied to dock bioactive compounds with phosphoinositide 3-kinase (PI3K), then the protein expression and phosphate levels were determined by western blotting.ResultsNXT could significantly inhibit the expression of NF-κB, MMP-9 and NO in cells with IC₅₀ values of 0.1178, 0.1182 and 0.1094 μg/mL. Based on the screening results, six components of NXT were identified (calycosin, ferulic acid, salvianolic acid B, ononin, salvianolic acid E, and salvianolic acid F) which can inhibit NF-κB, MMP-9, and NO simultaneously, while exerting cytoprotective effects by inhibiting the activation of the PI3K/AKT pathway under different conditions by virtue of their advantageous interaction with PI3K.ConclusionsThese ingredients have outstanding therapeutic potential and may provide a scientific basis for the future application and research of NXT.     

利用论文被引频次基准线遴选学者代表作的方法——以河南省学者论文为例

【目的】根据论文被引频次百分位创建不同学科论文被引频次基准线,探讨基于被引频次基准线遴选论文代表作的方法。【方法】以河南省科学技术领域学者为研究对象,以WoS数据库的学科分类为依据,建立不同学科论文被引频次基准线。依据该基准线对河南省各学科学者2009—2018年发表的每篇研究论文确定PR8分值,PR8分值≥3为论文代表作遴选的最低标准,其中PR8分值≥6者为第Ⅰ层次代表作,PR8分值≥5者为第Ⅱ层次代表作,PR8分值≥3者为第Ⅲ层次代表作。对不同层次代表作遴选的优秀学者进行比较。【结果】创建了177个学科论文被引频次基准线,根据代表作遴选标准确定了河南省学者7707篇代表作。采用代表作论文和全部论文以及采用不同层次代表作论文遴选优秀学者的结果明显不同。【结论】论文被引频次基准线在跨学科学术评价中具有重要意义,可以简单、明确地界定不同学科论文代表作;代表作评价制度的推行势在必行。     

Interleukin-1β Regulates Lipid Homeostasis in Human Glomerular Mesangial Cells

Recent studies have shown that hyperlipidemia is closely related to the progression of kidney disease and glomerulosclerosis has similar pathophysiological mechanisms with atherosclerosis. Atherosclerosis is essentially a chronic inflammatory process and various kidney diseases are characterized by a micro-inflammatory state. Hyperlipidemia levels are not parallel to the degree of glomerulosclerosis, inflammatory factors together with lipids may contribute to the pathogenesis of glomerulosclerosis. Therefore, it is key to clarify lipid-mediated renal injury through studying the mechanism by which inflammation affects cholesterol homeostasis at the cellular level. Intracellular lipid homeostasis involves both lipid uptake and excretion, therefore in this study, we aimed to explore whether interleukin-1β (IL-1β) promotes the uptake of oxidized low-density lipoprotein (Ox-LDL) to increase in intracellular lipid levels, and to clarify the effect of IL-1β on the expression of lectin-like oxidized LDL receptor 1 (LOX-1) and ATP-binding cassette transporter A1 (ABCA1), which may regulate cholesterol homeostasis in human mesangial cells (HMCs). The effect of IL-1β on uptake of Ox-LDL labeled with fluorescent Dil (Dil-Ox-LDL) by HMCs was observed using laser confocal microscopy. The effect of IL-1β on LOX-1 and ABCA1 expression in HMCs was detected by polymerase chain reaction and western blotting. Laser confocal microscopy revealed that HMCs took up Dil-Ox-LDL. Treatment of HMCs with 5 ng/ml IL-1β for 24 h significantly increased uptake of Dil-Ox-LDL. IL-1β also promoted LOX-1 mRNA and protein expression in a dose-dependent manner. Moreover, ABCA1 mRNA and protein expression were reduced by IL-1β in lipid-loaded HMCs in a dose-dependent manner. IL-1β promotes the uptake of Ox-LDL and expression of LOX-1 in HMCs, whereas it inhibits expression of ABCA1 under lipid load. The imbalance in intracellular cholesterol resulted by IL-1β can in turn transform HMCs into foam cells and aggravate glomerulosclerosis.     

Clinicians versus patients subjective adverse events assessment: based on patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE)

Quality of Life Research - Adverse events (AEs) assessment by clinicians is a standard practice in a clinical setting. However, studies have found clinicians tend to report fewer AEs, especially...     

基于RBRVS的医技科室绩效分配实践与思考

随着医药卫生体制改革的不断深入,公立医院薪酬制度改革也逐步开展。武汉某三甲医院基于RBRVS的理念,以工作量为基础,以可控成本作为重点,综合BSC（平衡积分卡）四个维度进行考评,建立了适合医技科室的绩效方案。该方案能客观反映医务人员的工作强度、工作难度和工作风险,激活了医技科室人员工作的积极性和创造性,有效提升了医院的管理效能