让“高危”人群远离悲哀

在世界卫生组织公布的报表中,病死率连占鳌头的,仍然是癌症和心脑血管病,在人们一个个惊讶之后,我们看到了站在死亡边缘上的,生命“高危期”人群。

Review of screening for pancreatic cancer in high risk individuals

Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival.Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation.Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer.Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups.This article reviews high-risk groups,screening methods,and current screening programs and their results.

The Relationship between AIDS High Risk Behaviors and Childhood Status, Perception of Gender Orientation and Rare Experiences/Psychology among Chinese Gays

Objectives: To probe some more important factors affecting the HIV epidemic by surveying the relationshipbetween AIDS high risk behaviors and childhood status,attitude/perception to gender of male/sex orientation andrare experiences/Psy-chology among Chinese gays. Methods: Data were collected from 240 Chinese gays whowere attracted by their same gender. Results: The extent of sex among China's Mainland gays issimilar to that of industrialized countries, and behaviorsthat exacerbate the HIV epidemic are universal.Perceptions 'being a girl is better',' Dislike toys likeswords or pistols in early childhood were predictors topassive anal intercourse in adulthood. Those gay men whobegan sexual intercourse younger than 16 years old tendedto have more sex partners and suffered more pain. Thosedisliked gender of male or self-regarded as female tended tohave more passive anal intercourse and related to childhoodcross-gender experience/psychology while those were raised as girls by their parentsdid not take on e above characters. Individuals who experienced sex coercion and drug abuse were the twosubgroups with the greatest high-risk behaviors. Individualswho had sex with females had the greatest number of malesex partners and were more prone to group sex. Individualswith pedophilia or gerontophilia had more casual sexpartners. Psychological problems encountered by Chinese Conclusions: The prospect of an extensive AIDSepidemic among Chinese gays does exist and somesubgroups of gays play more important roles in theepidemic. Some high risk behaviors among adult gays canbe foreseen explicitly by the predictors taking on inchildhood, and closely relate to attitude/perception, togender of male, to some rare experience/psychology.

Risk factors for prehypertension in Xinjiang Uygur population

Objective To assess the risk factors for prehypertension in Xinjiang Uygur population. Methods A cross-section study was conducted in a Xinjiang Uygur population（438 males and 716 females,aged 30 to 70 years）.The fasting lipid profiles,serum glucose,insulin,and uric acid were determined.Homeostasis model assessment of insulin resistance（HOMA-IR）index was used to assess insulin resistance（IR）.Binary logistic regression analysis was performed to determine risk factors for prehypertension.Blood pressure levels ofnormotensives and prehypertensives in different body mass index（BMI）categories were compared. Results Binary logistic regression analysis performed after adjustment for gender,lipids profiles,waist-to-hip ratio,uric acid,HOMA-IR,and lifestyle（alcohol drinking and smoking）showed a significantly increasing prevalence of prehypertension with BMI.The odds ratios for prehypertension against the lowest BMI group（separated by 24 and 28）were 1.934 and 2.490（95% confidence interval：1.435-2.606 and 1.825-3.399,respectively）.Age was independently correlated to the increasing prevalence of prehypertension.HOMA-IR was not associated with prehypertensive.The mean diastolic blood pressure（DBP）was significantly increased with BMI categories in either normotensives or prehypertensives（P〈0.001）while the mean systolic blood pressure（SBP）was significantly increased with BMI only in normotensives（P〈0.001）. Conclusions In Xinjiang Uygurs,BMI and age was the risk factors for prehypertension.DBP is significantly increased with BMI.IR is not associated with prehypertension.These findings emphasize the importance of management of obesity for the control of blood pressure and other cardiovascular complications.

STUDY ON SMALL HEPATOCELLULAR CARCINOMAAND ITS EXTENSION

This paper summarizes the 'study On small hepatocellular carcinoma and its extensionII in Liver CancerInstitute, Zhongshan Hospital Of Shanghai MedicaI University during the past 25 years. The results 1ndl-cated that it was an impOrtant approach to obtain long-term HCC survivOrs, of the 239 patients with 5-yearsurvival, small HCC resection accounted for 51. 4 %. It was an effective apprOach to lmprove the prognosisof HCC in the entire series, the 5-year survlval of lnpatients treated ln authorsI institution was 4. 8% in1958~1970, l2. 2 % in 197l ~ 1983, and 46. 7 % in l984~ 1995; which were correlated to the increaseProportion of small HCC resection in the series; it was more effective as compared to large HCC resection,the 5 year survival was 6l. 3 % (n= 645 ) versus 33. 6 % (n= 950). ExtensiOns of small HCC study includ-ed early detection and treatment of small recurrent HCC, Of the l47 patients wlth re-resection, the 5-yearsurvival was 48. 9% caIculated frOm the time Of first resectiOn. Another extenslon was conversiOn Of largeHCC intO small HCC, using multimodality combination treatment, 72 out of the 663 patients wlth surgical-ly verified unresectable HCCs have been converted to resectable, 5-year survival being 62' l %, wh1ch wascomparable tO that of small HCC resection. Studies on related basic aspect of small HCC such as cell originof recurrence, and mOlecular aspect of small HCC, indicated that biOlOgical characterlstics, particularly thetumor invasiveness, remalned the key link for further prolong survival after small HCC resection. Recent-ly, a'patient-like' human HCC metastatic medel in nude mice has been established. Experimental inter-ventions have also been tried. Clinical trials fOr preventiOn of recurrence after small HCC resection haveshown preliminary encouraging results. However, the IIcOst-effectivenessn Of screening, the invasiveness ofHCC, the multicentric origin, the coexisted Child C cirrhosis, etc., remained great chal1enge.