广州市2015-2016年50~74岁社区人群大肠癌筛查结果分析

目的 分析广州市开展现行大肠癌筛查策略的效果。方法 收集、整理2015－2016年广州市大肠癌筛查数据，评价问卷调查、便隐血检查和全结肠镜检查的筛查效果。结果 2015－2016年广州市50～74岁重点人群完成初筛220 834人，初筛阳性37 040例（16.77%）。全结肠镜检7 821人，肠镜检查顺应率为21.12%（7 821/37 040）。发现各类肠道病变4 126例（52.76%），其中进展性腺瘤614例（7.85%）、伴中/重度异型增生的其他病变73例（0.93%），大肠癌230例（2.94%）；各类病变中男性检出率均高于女性（P<0.01）。病变早诊率为87.24%；筛查发现早期癌99例，占总大肠癌的46.26%。大肠癌筛查发现率为104.15/10万，明显高于相应年龄段（50～74岁）大肠癌监测发病率81.18/10万（P<0.001），表现为≤69岁年龄段大肠癌发现率明显高于相应发病率，≥70岁年龄段则相反。结论 广州市大肠癌筛查策略可以发现大肠癌高危人群，提高全结肠镜病变检出率、癌前病变早诊率和早期大肠癌的诊断比例，≤69岁人群受益高于70～74岁人群，是大肠癌筛查重点关注人群，应需进一步促进高危人群肠镜检查顺应性。     

脂多糖受体簇和大电导Ca2+活K+通道在脂多糖信号识别中的作用

背景 细菌脂多糖(lipopolysaccharide,LPS)可激活细胞合成和释放多种细胞因子,导致全身炎症反应.LPS识别及跨膜信号转导是引起细胞效应的关键,成为近年的研究热点.目的 对新近提出的“LPS受体簇”理论和大电导Ca2+激活K+通道(MaxiK)在LPS信号识别中的作用研究进展进行综述.内容 LPS与CD14结合后,不同的信号分子在脂质筏内聚集,LPS被释放到脂质双分子层,并与由多种受体分子组成的受体簇相互作用.根据不同的细胞类型和细菌刺激,形成了不同的LPS受体簇.MaxiK通道在LPS诱导的巨噬细胞信号转导过程的早期即被激活.并且以IκB-α/NF-κB为中心的促炎症反应依赖MaxiK的功能.趋向 需要进一步研究来阐明LPS受体簇在细胞膜特定区域内形成的确切分子机制,以及组成受体簇的几种蛋白分子在刺激识别和信号转导过程中的作用.     

Melatonin attenuated retinal neovascularization and neuroglial dysfunction by inhibition of HIF‐1α‐VEGF pathway in oxygen‐induced retinopathy mice

Retinopathy of prematurity (ROP) is a retinopathy characterized by retinal neovascularization (RNV) occurring in preterm infants treated with high concentrations of oxygen and may lead to blindness in severe cases. Currently, anti‐VEGF therapy is a major treatment for ROP, but it is costly and may cause serious complications. The previous study has demonstrated that melatonin exerted neuroprotective effect against retinal ganglion cell death induced by hypoxia in neonatal rats. However, whether melatonin is anti‐angiogenic and neuroglial protective in the progression of ROP remains unknown. Thus, this study was to investigate the effect of melatonin on RNV and neuroglia in the retina of oxygen‐induced retinopathy (OIR) mice. The results showed a reduction in retinal vascular leakage in OIR mice after melatonin treatment. Besides, the size of retinal neovascular and avascular areas, the number of preretinal neovascular cell nuclei, and the number of proliferative vascular endothelial cells within the neovascular area were significantly decreased in mice treated with melatonin. After oxygen‐induced injury, the density of astrocytes was decreased, accompanied by morphologic and functional changes of astrocytes. Besides, retinal microglia were also activated. Meanwhile, the levels of inflammatory factors were elevated. However, these pathologic processes were all hindered by melatonin treatment. Furthermore, HIF‐1α‐VEGF pathway was activated in the retina of OIR mice, yet was suppressed in melatonin‐treated OIR mice retinas. In conclusion, melatonin prevented pathologic neovascularization, protected neuroglial cells, and exerts anti‐inflammation effect via inhibition of HIF‐1α‐VEGF pathway in OIR retinas, suggesting that melatonin could be a promising therapeutic agent for ROP.     

单中心乳腺癌术后乳房重建的影响因素

背景与目的：乳腺癌手术方式的选择受到诸多因素影响，本研究旨在分析乳腺癌患者选择乳房重建手术的影响因素，重点探讨居住地距离与乳房重建的关系。方法：回顾性分析了1999年1月—2015年12月复旦大学附属肿瘤医院收治的因单侧或双侧0～Ⅱ期乳腺癌行全乳切除术的女性患者临床资料，分析居住地距离与乳房重建比例的关系。结果：非上海患者选择全乳切除术后乳房重建比例高于上海患者(6.1% vs 4.5%，P<0.001)。居住地距离影响乳房重建比例(P=0.035)。单因素分析显示，居住地距离越远，选择乳房重建手术比例越高，而年龄、体质量指数(body mass index，BMI)、TNM分期与乳房重建的选择呈负相关(P均<0.001)。多因素分析显示，年龄增长、BMI增加、TNM分期较晚是拒绝行乳房重建的独立影响因素(P均<0.001)，而居住地距离不是乳房重建的独立影响因素(P>0.05)，且与具体乳房重建方式无交互作用。年龄与居住地距离呈负相关(P<0.001)。结论：乳腺癌患者的居住地距离与乳房重建比例呈线性相关；年龄、BMI和疾病分期是影响乳房重建的主要因素。