Cannabis smoking and lung cancer risk: Pooled analysis in the International Lung Cancer Consortium

To investigate the association between cannabis smoking and lung cancer risk, data on 2,159 lung cancer cases and 2,985 controls were pooled from 6 case‐control studies in the US, Canada, UK, and New Zealand within the International Lung Cancer Consortium. Study‐specific associations between cannabis smoking and lung cancer were estimated using unconditional logistic regression adjusting for sociodemographic factors, tobacco smoking status and pack‐years; odds‐ratio estimates were pooled using random effects models. Subgroup analyses were done for sex, histology and tobacco smoking status. The shapes of dose‐response associations were examined using restricted cubic spline regression. The overall pooled OR for habitual versus nonhabitual or never users was 0.96 (95% CI: 0.66–1.38). Compared to nonhabitual or never users, the summary OR was 0.88 (95%CI: 0.63–1.24) for individuals who smoked 1 or more joint‐equivalents of cannabis per day and 0.94 (95%CI: 0.67–1.32) for those consumed at least 10 joint‐years. For adenocarcinoma cases the ORs were 1.73 (95%CI: 0.75–4.00) and 1.74 (95%CI: 0.85–3.55), respectively. However, no association was found for the squamous cell carcinoma based on small numbers. Weak associations between cannabis smoking and lung cancer were observed in never tobacco smokers. Spline modeling indicated a weak positive monotonic association between cumulative cannabis use and lung cancer, but precision was low at high exposure levels. Results from our pooled analyses provide little evidence for an increased risk of lung cancer among habitual or long‐term cannabis smokers, although the possibility of potential adverse effect for heavy consumption cannot be excluded.     

MDR1/P-gp在膀胱移行细胞癌中的表达及与Fas和Survivin蛋白表达的关系

目的：探讨膀胱移行细胞癌中MDR1基因（P-糖蛋白）与Fas、Survivin表达的相互关系及其与膀耽癌生物学行为的相关性。方法：应用免疫组织化学方法检测64例膀耽移行细胞癌和12例正常膀胱粘膜中P—GP、Fas、Survivin的表达。结果：膀胱移行细胞癌中P—GP、Survivin的表达阳性率高于正常粘膜，与膀胱癌的分级有关（P〈0．01）;而Fas在膀胱正常粘膜中表达高于移行细胞癌，差异有统计学意义（P〈0．01）复发性膀胱癌P-GP的阳性表达率高于初发膀胱癌（P〈0．01）、膀胱移行细胞癌P—GP的表达与Fas呈负相关．而与Survivin表达无关.结论：膀胱移行细胞癌的MDR1（多药耐药基因）与Fas的表达密切相关．而与凋亡抑制蛋白Sureivin的表达无关.本研究为采用MDR逆转剂或Fas干扰剂以增加膀胱移行细胞癌的化疗敏感性提供实验依据。     

Apatinib in gastric carcinoma: A case report of partial response for first‐line treatment in advanced disease

Gastric cancer (GC) is the most common gastrointestinal malignant tumor, with a gradual increasing incidence throughout the world. Mostly GC is diagnosed in its late stage. To date, there is no usable standardized treatment regimen for patients with advanced GC. Apatinib mesylate, small‐molecule vascular endothelial growth factor receptor‐2 (VEGFR‐2) tyrosine kinase inhibitor (TKI), has been approved as third‐line treatment for patients with advanced gastric adenocarcinoma in China, October, 2014. Till now, there is no case report about apatinib as first‐line treatment for patients with advanced GC in literature. We present an 83‐year‐old Chinese man with advanced gastric adenocarcinoma, who received apatinib as first‐line option and obtained clinical benefit within 2 weeks. The lung metastases disappeared completely and the liver metastases shrank significantly. The patient's progression‐free survival was 163 days and overall survival was 201 days. This paper reviews and discusses apatinib as a new targeted drug for patients with advanced GC by comparison with other effective molecular‐targeted therapy.     

Serum lipid levels and the risk of biliary tract cancers and biliary stones: A population-based study in China

Biliary tract cancers, encompassing the gallbladder, extrahepatic bile ducts and ampulla of Vater, are rare but highly fatal malignancies. Gallstones, the predominant risk factor for biliary cancers, are linked with hyperlipidemia. As part of a population-based case-control study conducted in Shanghai, China, we examined the associations of serum lipid levels with biliary stones and cancers. We included 460 biliary cancer cases (264 gallbladder, 141 extrahepatic bile duct, and 55 ampulla of Vater), 981 biliary stone cases and 858 healthy individuals randomly selected from the population. Participants completed an in-person interview and gave overnight fasting blood samples. Participants in the highest quintile of triglycerides (>/=160 mg/dl) had a 1.4-fold risk of biliary stones (95% CI = 1.1-1.9), a 1.9-fold risk of gallbladder cancer (95% CI = 1.3-2.8), and a 4.8-fold risk of bile duct cancer (95% CI = 2.8-8.1), compared to the reference group (third quintile: 90-124 mg/dl). Participants in the lowest quintile of high-density lipoprotein (HDL) (<30 mg/dl) had a 4.2-fold risk of biliary stones (95% CI = 3.0-6.0), an 11.6-fold risk of gallbladder cancer (95% CI = 7.3-18.5), and a 16.8-fold risk of bile duct cancer (95% CI = 9.1-30.9), relative to the reference group (third quintile: 40-49 mg/dl). In addition, total cholesterol, low-density lipoprotein (LDL) and apolipoprotein A (apo A) were inversely associated with biliary stones; whereas low levels as well as high levels of total cholesterol, LDL, apo A and apolipoprotein B (apo B) were associated with excess risks of biliary tract cancers. Our findings support a role for serum lipids in gallstone development and biliary carcinogenesis.     

高强度聚焦超声联合立体定向放疗治疗晚期结肠癌肝转移的疗效观察

目的:对比观察高强度聚焦超声与立体定向放疗治疗晚期结肠癌肝转移的临床效果.方法:2013年2月到2015年8月选择在我院诊治的晚期结肠癌肝转移患者78例,根据平行分组的原则分为观察组与对照组各39例,对照组给予立体定向放射治疗,观察组给予高强度聚焦超声与立体定向放射治疗,都治疗观察4周,记录与随访预后情况.结果:观察组与对照组的治疗有效率分别为69.2%和38.5%,观察组的治疗有效率明显高于对照组(P<0.05).治疗期间两组的粒细胞减少、贫血、胃肠道反应、手足综合征等毒副反应发生情况对比无明显差异(P>0.05).观察组与对照组治疗后的NK细胞含量分别为(25.10±3.49)%和(20.14±4.67)%,都明显高于治疗前的(12.45±2.01)%和(12.24±2.20)%(P<0.05),治疗后观察组的NK细胞含量明显多于对照组(P<0.05).随访至今,观察组与对照组的无进展生存时间为(18.23±4.19)个月和(14.89±3.82)个月,观察组明显长于对照组(t=3.491,P<0.05).结论:高强度聚焦超声与立体定向放疗治疗晚期结肠癌肝转移的合用能提高近期疗效,不会增加毒副反应的发生,延长患者的生存时间,且作用机制可能与有效改善外周血免疫功能有关.     

双克隆型多发性骨髓瘤3例并文献复习

目的:探讨双克隆型多发性骨髓瘤(multiple myeloma,MM)的临床特征.方法:分析我院诊断的3例双克隆型MM,并进行文献复习.结果:病例1患者抗SSA强阳性(++),SSB(+),抗Ro-52强阳性(++),被诊断为IgG-KAP并IgA-LAM型MM合并干燥综合征.经VAD方案化疗后IgG-KAP型M蛋白消失,出院后给以TCD方案维持治疗,目前病情平稳.病例2患者被诊断为IgG-KAP并游离KAP型MM,给予VAD方案化疗后IgG降至正常水平,出院后给以TCD方案维持治疗,目前病情平稳;病例3患者诊断为IgG-KAP并IgA-KAP型MM,合并肾功能不全及高钙血症,给予TCD方案并结合透析治疗,1个月后死于肾功能衰竭;结论:双克隆型MM罕见,临床表现多样,预后可能较差,尚需更多的病例以总结其临床特征.     

Glutathione-S-transferases M1 (GSTM1) and GSTT1 genotype,smoking, consumption of alcohol and tea and risk of esophageal and stomach cancers: a case-control study of a high-incidence area in Jiangsu Province,China

To evaluate interactions between lifestyle factors and glutathione-S-transferases M1 (GSTM1) and GSTT1 genotypes with reference to development of esophageal and stomach cancers, we conducted a case-control study of 141 cases of esophageal cancer, 153 cases of stomach cancer and 223 population-based controls in Huaian City of Jiangsu Province, China. GSTM1 and GSTT1 genotypes were identified by multiplex polymerase chain reaction. The GSTM1 null genotype was associated with an increased odds ratio for esophageal cancer (2.17, 95% confidence interval=1.35-3.50), but not for stomach cancer. A combined effect was also observed between smoking and the GSTM1 null genotype with regard to esophageal risk. Tea drinking was a protective factor for both cancers, its effect being independent of the GSTT1 and GSTM1 genotypes. These findings suggest the GSTM1 polymorphism is involved in the susceptibility to esophageal cancer development, and tea consumption reduces the risk of esophageal and stomach cancers.     

Annexin-1与BFGF在精原细胞癌中表达及临床意义

目的:研究膜联蛋白-1(Annexin-1)与BFGF在精原细胞癌组织中的表达情况,探讨其临床意义。方法:应用免疫组织化学SABC法检测25例精原细胞癌组织,25例正常睾丸组织中膜联蛋白-1与BFGF的表达情况,并对膜联蛋白-1与精原细胞癌的关系进行分析。结果:正常睾丸组织及精原细胞癌中膜联蛋白-1与BFGF阳性率分别为76.00%、16.00%和20.00%、88.00%。膜联蛋白-1的表达与肿瘤的临床分期和肿瘤分化程度无关(P>0.05)。结论:联合检测Annexin-1、BFGF有助于提高精原细胞癌的早期诊断率。     

Wnt/β-catenin信号通路在阿尔茨海默病神经元变性中的研究进展

目的：阿尔茨海默病(Alzheimer’s disease,AD)是目前老年人最常见的痴呆类型,由于AD发病机制复杂,迄今尚未完全阐明。AD最重要的神经病理学特征是β淀粉样蛋白（amyloid-beta eptide, Aβ）沉积、Tau蛋白过度磷酸化形成神经纤维缠结以及脑内神经炎症反应的激活,并伴随着神经元的损伤及学习记忆功能受损。越来越多的研究指出Wnt/β-连环蛋白（Wnt/β-catenin）信号通路在神经退行性疾病中,尤其是AD中发挥了重要作用。为明确Wnt/β-catenin信号通路与AD发病、Aβ沉积、Tau 蛋白和神经炎症的相关性及其机制,对相关文献进行综述。方法：选择Wnt/β-catenin信号通路与AD、Aβ神经毒性、Tau 蛋白磷酸化及神经炎症相关的国内外相关文献进行综述。结果：研究表明Wnt/β-catenin信号通路参与AD的发生和发展,当该通路激活时可以抑制Aβ的沉积、Tau的过度磷酸化及神经炎症,反之则促进Aβ的产生、聚集以及Tau蛋白的磷酸化,神经炎症的发生。结论：本文就Wnt/β-catenin信号途径在AD发病中的重要性加以概述,为AD机制的研究提供了理论基础,也提示激活Wnt信号传导途径可以作为治疗AD的潜在治疗靶点。dismutase,SOD）、丙二醛（malondialdehyde,MDA）和过氧化氢酶（catalase,CAT）水平采用试剂盒检测。qPCR和Western blot检测血浆Klotho的表达。Klotho表达量与氧化应激的相关性采用Pearson相关性分析。甲基化特异性PCR（MS-PCR）检测Klotho甲基化水平。CpG岛甲基化率采用焦磷酸盐测序法。结果：相对于对照组[（94.56±16.40） mU/L],观察组SOD含量[（79.86±18.24） mU/L]明显降低（t=4.487,P=0.000）,观察组MDA水平[（2.87±2.26） pg/mL]与对照组[（2.52±1.06） pg/mL]无统计学差异（t=1.675,P=0.097）,观察组CAT水平[（18.50±4.62） U/mg]与对照组[（25.26±3.54） U/mg]相比明显降低（t=8.605,P=0.000）。观察组（0.66±0.16）比对照组（1.04±0.10）血浆Klotho基因（t=14.93,P=0.000）降低;观察组（0.70±0.20）比对照组（1.04±0.10）血浆Klotho蛋白表达（t=10.92,P=0.000）降低,且Klotho蛋白表达量与SOD水平（r=0.768,P=0.000）和CAT水平（r=0.708,P=0.000）呈正相关。观察组Klotho启动子CpG岛甲基化水平升高。结论：Klotho甲基化可能是NSCLC患者血浆氧化应激状态的一个临床标志物。