EEFSEC基因、染色体17q24和染色体11q13.2基因变异与前列腺癌的关联研究

目的探索EEFSEC基因(rs10934853,A)、染色体17q24区(rs1859962,T)和染色体11q13.2(rs7931342,T)的基因变异类型与前列腺癌患病发病风险的关联,分析这些基因型与前列腺癌患者临床特征的关系。方法采用病例对照研究设计,比较病例组中124例患者和对照组中138例正常对照者的EEFSEC基因(rs10934853,A)、染色体17q24区(rs1859962,T)和染色体11q13.2(rs7931342,T)等位基因和基因型频率的差异,并探讨各基因变异与患者的确诊年龄,BMI,Gleason评分,PSA浓度,肿瘤分期等临床特征之间的关联。结果 EEFSEC基因(rs10934853,A)、染色体17q24区(rs1859962,T)和染色体11q13.2(rs7931342,T)的基因型和等位基因在病例组和对照组中的频率分布差异均无统计学意义(P0.05),然而,EEFSEC基因(rs10934853,A)和染色体17q24区(rs1859962,T)存在更强的基因-基因协同的交互作用(P=0.0396,OR=1.722,95%CI=1.0244~2.8944);病例组基因型-表型观察指标关联分析表明,3个SNPs与PCa患者的年龄、Gleason评分、PSA浓度及烟酒均无关联(P0.05),然而,染色体17q24区(rs1859962,T)位点与食用蛋类有关(P=0.005)。结论 EEFSEC基因(rs10934853,A),17q24(rs1859962,T)和11q13.2(rs7931342,T)位点可能与我国北方人群前列腺癌的发病风险无关联,但是存在有基因之间增加PCa发病风险的协同效应。     

4个单核苷酸多态性位点与前列腺癌的关联性研究

目的探索THADA基因(rs1465618,G/A),(rs2660753,A/G),LOC101929491基因(rs7679673,A/C)和PRNCR1基因(rs1016343,C/T)等4个单核苷酸多态性位点(SNPs)的常见变异与中国北方人群前列腺癌(PCa)的关联。方法采集来自北京医院的138名正常对照和125例PCa患者的血液样本和临床信息。提取样本DNA,用高分辨率熔解曲线分析技术(HRM)对4个SNP(rs1465618,rs2660753,rs7679673和rs101634343)进行基因分型。结果 rs1465618的GG基因型与AG和AA基因型在病例组与对照组间存在显著性差异(P=0.015,OR=1.985;95%CI=1.012~7.732),病例组与对照组间其余3个SNP位点rs2660753(P=0.545),rs7679673(P=0.634),rs1016343(P=0.705)的各个基因型分布没有统计学意义(P0.05)。病例组不同基因型间的表型和环境影响因素分析观察到,rs1465618与常食用蛋类有关(P=0.004),rs2660753与常食用豆制品有关(P=0.04),rs7679673与Gleason评分等级(P=0.034)、PSA浓度等级(P=0.035)及自觉营养状况(P=0.019)均有关,rs1016343与年龄有关(P=0.019)。数量性状分析表明,rs2660753与PCa患者的病程有关(P=0.023),rs1016343与PCa患者食用蛋类数量有关(P=0.002)。结论 rs1465618与中国北方人群的PCa患病显著关联,而rs2660753、rs7679673和rs1016343的常见变异与中国北方人群PCa患病表型和环境影响因素有明显关联。     

TP与GP化疗方案对肺癌患者骨髓抑制影响的Meta分析

目的通过Meta分析对紫杉醇+顺铂(TP)与吉西他滨+顺铂(GP)化疗方案对肺癌抗肿瘤药物治疗患者骨髓抑制的影响进行系统分析,探讨TP和GP的骨髓抑制差别。方法通过荟萃分析对TP与GP的骨髓抑制研究进行同质性检验和合并效应量的估计。结果同质性检验:χ2=91.84,自由度为29,P0.00001;合并效应量的估计:OR合并=1.36,OR合并95%可信限为0.90~2.04。OR合并的检验Z=1.482.41,P=0.14。结论 TP与GP化疗时对患者的骨髓抑制不良反应情况没有本质区别。     

TKI治疗老年晚期非小细胞肺癌的临床研究

目的进行吉非替尼治疗老年晚期非小细胞肺癌的疗效和毒性反应的临床研究。方法 102例晚期非小细胞肺癌,其中52例给予吉非替尼150mg口服,每日1次,每28天重复。50例予单药吉西他滨1000mg/m2,d1,d8,d15,每28天重复。结果吉非替尼组CR、PR、SD、有效率、疾病控制率、1年生存率分别为3.85%,21.15%,38.46%,38.46%,25.00%,64.50%和28.85%。吉西他滨组CR、PR、SD、有效率、疾病控制率、1年生存率分别为0,24%,32%,24%,56%和26%。两者之间无统计学差异。吉非替尼治疗常见的毒副作用为皮疹和腹泻,总的皮疹发生率为46.15%,腹泻发生率为26.9%,未见间质性肺病和常见的血液学毒性出现。而吉西他滨组的不良反应主要为骨髓抑制和消化道反应。在血液学毒性方面吉西他滨明显高于吉非替尼组,具有统计学差异(P0.05)。结论吉非替尼和吉西他滨单药治疗老年非小细胞肺癌疗效确切并相当。吉非替尼不仅延长了患者的生存,而且不良反应较轻,值得在临床老年非小细胞肺癌中应用。     

Reanalysis of the DEMS Nested Case‐Control Study of Lung Cancer and Diesel Exhaust: Suitability for Quantitative Risk Assessment

The International Agency for Research on Cancer (IARC) in 2012 upgraded its hazard characterization of diesel engine exhaust (DEE) to “carcinogenic to humans.” The Diesel Exhaust in Miners Study (DEMS) cohort and nested case‐control studies of lung cancer mortality in eight U.S. nonmetal mines were influential in IARC's determination. We conducted a reanalysis of the DEMS case‐control data to evaluate its suitability for quantitative risk assessment (QRA). Our reanalysis used conditional logistic regression and adjusted for cigarette smoking in a manner similar to the original DEMS analysis. However, we included additional estimates of DEE exposure and adjustment for radon exposure. In addition to applying three DEE exposure estimates developed by DEMS, we applied six alternative estimates. Without adjusting for radon, our results were similar to those in the original DEMS analysis: all but one of the nine DEE exposure estimates showed evidence of an association between DEE exposure and lung cancer mortality, with trend slopes differing only by about a factor of two. When exposure to radon was adjusted, the evidence for a DEE effect was greatly diminished, but was still present in some analyses that utilized the three original DEMS DEE exposure estimates. A DEE effect was not observed when the six alternative DEE exposure estimates were utilized and radon was adjusted. No consistent evidence of a DEE effect was found among miners who worked only underground. This article highlights some issues that should be addressed in any use of the DEMS data in developing a QRA for DEE.     

Diesel Engine Exhaust and Lung Cancer Mortality: Time‐Related Factors in Exposure and Risk

To develop a quantitative exposure‐response relationship between concentrations and durations of inhaled diesel engine exhaust (DEE) and increases in lung cancer risks, we examined the role of temporal factors in modifying the estimated effects of exposure to DEE on lung cancer mortality and characterized risk by mine type in the Diesel Exhaust in Miners Study (DEMS) cohort, which followed 12,315 workers through December 1997. We analyzed the data using parametric functions based on concepts of multistage carcinogenesis to directly estimate the hazard functions associated with estimated exposure to a surrogate marker of DEE, respirable elemental carbon (REC). The REC‐associated risk of lung cancer mortality in DEMS is driven by increased risk in only one of four mine types (limestone), with statistically significant heterogeneity by mine type and no significant exposure‐response relationship after removal of the limestone mine workers. Temporal factors, such as duration of exposure, play an important role in determining the risk of lung cancer mortality following exposure to REC, and the relative risk declines after exposure to REC stops. There is evidence of effect modification of risk by attained age. The modifying impact of temporal factors and effect modification by age should be addressed in any quantitative risk assessment (QRA) of DEE. Until there is a better understanding of why the risk appears to be confined to a single mine type, data from DEMS cannot reliably be used for QRA.     

Social Work with the Osteoporotic Woman

A chronic, progressive, and potentially debilitating condition, osteoporosis has a multitude of currently untapped implications for effective social work practice. A working knowledge of the medical framework of the disease process itself is a prerequisite to informed practice. This article presents such information, along with the psychological and social components, in order to provide the social worker with the comprehensive biopsyehosaial knowledge base necessary for effective practice with the osteoporotic woman and her family.     

Evaluating the effectiveness of the first breast cancer awareness campaign in the United Arab Emirates: Lessons learned and next steps

Following an innovative breast cancer awareness campaign in the United Arab Emirates, a dual language survey of 500 women and in-depth interviews were conducted. The study found television advertising to be the most optimal awareness communication method, particularly among Emirati and other Arab women respondents. The research also found strong support for a year-long awareness campaign.     

Unifying CRM and EWOC designs for phase I cancer clinical trials

The main goal of phase I cancer clinical trials is to determine the highest dose of a new therapy associated with an acceptable level of toxicity for the use in a subsequent phase II trial. The continual reassessment method (CRM) [O’Quigley, J., Pepe, M., Fisher, L., 1990. Continual reassessment method: a practical design for phase I clinical trials in cancer. Biometrics 46, 33–48] and escalation with overdose control (EWOC) [Babb, J., Rogatko, A., Zacks, S., 1998. Cancer phase I clinical trials: efficient dose escalation with overdose control. Statist. Med. 17 (10), 1103–1120] are two model-based designs used for phase I cancer clinical trials. A few modifications of the (original) CRM and EWOC have been made by many authors. In this paper, we show how CRM and EWOC can be unified and present a hybrid design. We study the characteristics of the approach of the hybrid design. The comparisons of the three designs (CRM, EWOC, and the hybrid design) are presented by convergence rates and overdose proportions. The simulation results show that the hybrid design generally has faster convergence rates than EWOC and smaller overdose proportions than CRM, especially when the true maximum tolerated dose (MTD) is above the mid-level of the dose range considered. The performance of these three designs is also evaluated in terms of sensitivity to outliers.