Lots of Fruit in Childhood Cuts Adult Cancer Risk

选注者言:本文的标题似乎可以译成:少时多食水果,老来少患癌症。这个结论 并非研究人员主观臆断,而是基于调查基础之上。文章的末句告诉我们这个研 究视角确实新颖。

Spatiotemporal switching signals for cancer stem cell activation in pediatric origins of adulthood cancer:Towards a watch-and-wait lifetime strategy for cancer treatment

Pediatric origin of cancer stem cell hypothesis holds great promise and potential in adult cancer treatment, however; the road to innovation is full of obstacles as there are plenty of questions left unanswered. First, the key question is to characterize the nature of such stem cells (concept). Second, the quantitative imaging of pediatric stem cells should be implemented(technology). Conceptually, pediatric stem cell origins of adult cancer are based on the notion that plasticity in early life developmental programming evolves local environments to cancer. Technologically, such imaging in children is lacking as all imaging is designed for adult patients. We postulate that the need for quantitative imaging to measure space-time changes of plasticity in early life developmental programming in children may trigger research and development of the imaging technology. Such quantitative imaging of pediatric origin of adulthood cancer will help develop a spatiotemporal monitoring system to determine cancer initiation and progression. Clinical validation of such speculative hypothesis-that cancer originates in a pediatric environment-will help implement a wait-andwatch strategy for cancer treatment.

A long adult intussusception secondary to transverse colon cancer

The occurrence of adult intussusception arising from colorectal cancer is quite rare. We present the case of a 76-year-old man with sudden abdominal pain and vomiting. Clinical symptoms included severe abdominal distension and tenderness. Computed tomography scan of the abdomen revealed left-sided colocolic intussusception with a lead point. The patient underwent a left hemicolectomy with right transverse colostomy. Pathologic evaluation revealed moderately differentiated adenocarcinoma invading the muscularis propria; the regional lymph nodes were negative for cancer cells. The postoperative course was uneventful.

Adult Kidney Cancer in Mauritania: Clinical and Therapeutic Aspects

Introduction: since its creation, our urology department has taken care of tumor pathologies in particular kidney cancer in adults;our goal is to study the clinical and therapeutic epidemiological profiles of adult kidney cancer in Mauritania. Materials and Methods: We carried out a retrospective study over a period of six years, from January 1, 2012 to December 31, 2017, including all cases of adult kidney cancer registered in the urology-andrology departments of the Cheikh Zayed Hospital and Pathological Anatomy of the National Hospital of Nouakchott (Mauritania). Results: we collected 50 cases of kidney cancer. The average annual incidence was 8.3 cases. The average age of the patients was 52.98 years with extremes of 18 and 84 years. There was a female predominance (52%) or 29 women for 21 men. Lumbar pain was the most frequent clinical expression, more than half of the patients had symptoms over a period of at least 12 months before the first consultation. The left kidney was the most frequently affected. The right localization was demonstrated in 23 patients, the extension assessment was made with thoraco-abdomino-pelvic CT in 40 patients. Twelve patients had a tumor localized in the kidney. The extension assessment had made it possible to objectify the existence of metastases in 17 of our patients (37%). The preferred locations of these metastases were pulmonary and hepatic. Surgical intervention was performed in 44 patients (88%), of whom 36 underwent radical nephrectomy (72%), and two patients underwent partial nephrectomy (4.5%). Surgical abstention was decided from the outset in 6 patients (13.6%). None of our patients had received treatment with anti-angiogenics. The histological type most observed in our patients was renal cell carcinoma, observed in 34 patients, or 77.72%. At the time of the study, more than a third of the patients had died. The mortality rate in our series had reached 24%. A specific survival rate could not be assessed due to lack of information in the files and significant numbers of patients lost to follow-up at the time of the study. Conclusion: adult kidney cancer in Mauritania is characterized by its low incidence, its occurrence in a relatively young population, its female predominance, its often late diagnosis at locally advanced and metastatic stages, and the treatment is the most often surgical.

Anti-Oxidant Status of Male Adults with and without Prostate Cancer in Ibadan, Nigeria

Background: Recent studies show increasing prostate cancer incidence in Nigeria. Significant correlations identified between diet and prostate cancer occurrence, indicate that low antioxidant status could contribute to the aetiology of prostate cancer. Methods: This cross-sectional study determined selected antioxidants (lycopene, beta-carotene and retinol) status of 10 (Experimental group) and 17 (Control) male adults with and without PC, recruited from the Urological Section of the Surgical Out-patients’ Department, University College Hospital and the General Out-patient Clinic of the Ring Road State Hospital, Ibadan, Oyo State, Nigeria. Demographic characteristics were assessed using a semi-structured, interviewer-administered questionnaire. Daily antioxidant intakes were assessed and analyzed using 24-hour dietary recall, and an adapted version of the food database “Total Diet Assessment”. Serum lycopene, beta-carotene and retinol were determined using High Performance Liquid Chromatography. Results: The mean age of the PC and the control (72.8 ± 6.2 years and 59.8 ± 4.8 years) was significantly different (p = 0.001). Mean daily lycopene intake (1408.4 ± 233.2 μg) of the PC was significantly lower (P = 0.030) than the controls (3862.3±316.2μg). The mean serum lycopene (19.8 ± 13.2 ng/ml), beta-carotene (43.6 ± 26.0 ng/ml) and retinol (362.2 ± 304.3ng/ml) of the PC were significantly lower (p = 0.008, 0.040 and 0.033 respectively) than the values (70.8 ± 49.8 ng/ml, 57.6 ± 47.7 ng/ml and 395.4 ± 275.6 ng/ml respectively) of the controls. Significant inverse correlations were observed between the dietary lycopene intake (r = -0.396, p = 0.041) and serum lycopene (r =-0.502, p = 0.008) with PC;while a significant positive association was observed between dietary intake of retinol with PC (r = 0.394, p = 0.042). Conclusion: The study has revealed low anti-oxidant status, and an inverse association between lycopene status and prostate cancer in the elderly men.

Investigation of Specifics of Self-Management towards Dealing with Cancer Pain among Adult Outpatients

Purpose: This study aimed to identify specifics of self-management towards dealing with cancer pains among adult outpatients. Methods: Semi-structured interviews were conducted with 16 adult outpatients (9 males and 7 females) who suffered from cancer pain and the data obtained were analyzed using the qualitative synthesis method of KJ Ho. Results: An analysis of the results revealed these key findings for the following symbolic wording of the semi-structured interviews: Cooperative relationship with medical professionals;Problems originating from cancer pain;Self-regulation of analgesic medications based on the interactions with medical professionals;Self-regulation of the analgesic medications based on the physical perceptions of the effects;Self-regulation to maintain a balanced and calm mind, Fulfilling life by the pain alleviation and liberation from the restrictions imposed by the cancer;and Efforts to maintain their lives by themselves. Conclusion: Based on the cooperative relationship established with medical professionals, the patient carried out the self-regulation of cancer pain using analgesics, and self-regulation to maintain a balanced and calm mind. Nurses must therefore sufficiently educate patients regarding how to communicate successfully with medical professionals in order to improve cancer patients’ pain management regarding both physical and mental aspects.

COMPARISON OF SERUM TRACE ELEMENT SPECTRUM BETWEEN LIVER CANCER PATIENTS AND HEALTHY ADULTS

The study of the relationship between trace element and health and disease has attracted more and more interests of scientists. As well known there exist complex interaction between the trace elements, and the trace elements and other substances, so the trace element research must be involved to the com-prehensive effect of multifactors, other than single element. We determined the contents of fifteen trace elements in serum from thirty patients with liver cancer and thirty healthy adults by ICP-AES analysis. The obtained data were analysed statistically by not only routine statistical test bat also multi-variate discrimination analysis, multi-variate stepwise regression and non-linear mapping algorithm. It is hoped that it can provide some valuable informations for investigation on relationship betwecn trace elements and cancer.

Growth Hormone Replacement Therapy in Adult Growth Hormone Deficiency and Risk of Cancer: A Meta-Analysis

The growth hormone (GH) replacement therapy in adult growth hormone deficiency (AGHD) is now well developed, nevertheless, the safety of GH replacement, especially the incidence of cancer in these patients remains to be further clarified. To summarize the evidence on the safety of using GH in AGHD, we conduct this meta-analysis to assess the relationship between the risk of cancer and GH replacement therapy. Randomized controlled trials and cohort studies involved in GH therapy for AGHD were selected. Meta-analysis was performed and risk ratio (RR) was pooled with 95% confidence interval (CI) to investigate the relationship between GH replacement and the risk of cancer. The result indicated that there was no evidence to draw a conclusion that GH replacement therapy will increase the risk of cancer (P = 0.001, RR = 0.77, 95% CI [0.65, 0.90]). Meanwhile, according to the calculated analysis, the replacement therapy might even reduce the risk of cancer. Furthermore, subgroup analysis demonstrated that there was no correlation between replacement therapy of GH and the risk of cancer both in prospective and retrospective cohort design research, and in prospective group, the risk of cancer even decreased (P = 0.0002, RR = 0.71, 95%CI [0.59, 0.85]). In conclusion, our study corroborates evidence from previous studies showing that GH replacement therapy in AGHD patients would not increase the risk of cancer;instead, it might be even decrease cancer risk. The results suggested that GH replacement therapy in AGHD patients was safe.

Adult intussusception with cecal adenocarcinoma:Successful treatment by laparoscopy-assisted surgery following preoperative reduction

We report a case of adult intussusception caused by cecal adenocarcinoma that was treated by laparoscopyassisted ileocecal resection following reduction by contrast enema and preoperative colonoscopy.A 68-yearold male with cecal cancer was admitted to our hospital because of colicky abdominal pain after taking a laxative.His abdomen was distended,and a mass was palpable in the right upper quadrant,which appeared as a target-or sausage-shaped lesion by ultrasonograhpy and computed tomography.A contrast enema using water-soluble material showed a cup-shaped filling defect characterized by intussusception in the ascending colon.This round defect with a clear margin was pushed gradually back into the cecum by the enema pressure.Re-occurrence of the intussusception is easilyreleased by colonoscopy.We performed laparoscopyassisted ileocecal resection of a protruding tumor measuring 6.5 cm × 5.0 cm × 3.5 cm from the cecum,with D3 lymph node dissection.Histological examination revealed a well-differentiated adenocarcinoma that had invaded the serosa without permeating the lymphatic or venous capillaries,as well as lymph node metastasis.The postoperative course was uneventful,and the patient has been well without evidence of disease recurrence for 5 years following the operation.Preliminary reduction of adult colonic intussusception before surgical resection is therefore an option in cases of an early and correct diagnosis of intussusception.

Management of Kidney Cancers in Urology Department of the Gabriel Toure University Hospital/Bamako

Objective: to report our experience in the management of adult kidney cancer. Patients and Methods: This was a prospective and descriptive study, carried out in the Urology Department of Gabriel Touré University Hospital, during the period from January 1, 2001 to December 31, 2017 for a period of six years, interesting all the medical records of 24 adult patients diagnosed with kidney cancer. Results: During the study period, 24 patients met our inclusion criteria;the mean age was 48.23 ± 8.02 years with extreme ranging from 17 to 82 years. Most of our patients were female (58.3%), and were referred or consulted for lumbar mass in 66.7% of cases. The average tumor size was 13.6 ± 5.8 cm with extremes of 7.8 to 21.1 cm. Management included total nephrectomy in 50% and total nephrectomy expanded in 50% of cases. The histological type found was renal cell carcinoma in 23 patients and papillary carcinoma in one patient. Conclusion: Kidney cancer is rare in our context, its clinical and histological characteristics remain the same for two decades. Its management is largely based on enlarged total nephrectomy.

Adult neural stem cells in the mammalian central nervous system

Neural stem cells （NSCs） are present not only during the embryonic development but also in the adult brain of all mammalian species, including humans. Stem cell niche architecture in vivo enables adult NSCs to continuously generate functional neurons in specific brain regions throughout life. The adult neurogenesis process is subject to dynamic regulation by various physiological, pathological and pharmacological stimuli. Multipotent adult NSCs also appear to be intrinsically plastic, amenable to genetic programing during normal differentiation, and to epigenetic reprograming during de-differentiation into pluripotency. Increasing evidence suggests that adult NSCs significantly contribute to specialized neural functions under physiological and pathological conditions. Fully understanding the biology of adult NSCs will provide crucial insights into both the etiology and potential therapeutic interventions of major brain disorders. Here, we review recent progress on adult NSCs of the mammalian central nervous system, including topics on their identity, niche, function, plasticity, and emerging roles in cancer and regenerative medicine.

成人肿瘤患者癌症复发恐惧症状管理的循证实践

目的 探讨成人肿瘤患者癌症复发恐惧(FCR)症状管理的循证实践效果。方法 采用便利抽样法选取2022年3月至8月南京医科大学附属淮安第一医院150例成人肿瘤患者进行研究。根据JBI循证实践模式中3个阶段检索成人肿瘤患者FCR症状管理的最佳证据,制订并实施症状管理。比较肿瘤患者症状管理前后FCR评分、纽卡斯尔护理满意度量表(NSNS)评分;以150名患者家属、8名医师及32名护师为质量审查对象,比较症状管理前后对FCR症状管理的依从性。结果 症状管理后,肿瘤患者FCR评分低于症状管理前,NSNS评分高于症状管理前,差异有统计学意义(P<0.05)。症状管理后,审查对象质量审查的依从性高于症状管理前,差异有统计学意义(P<0.05)。结论 通过循证实践可明确成人肿瘤患者FCR症状管理的最佳证据,应用于实践后可完善症状管理方案,对改善其FCR症状管理水平具有重要作用,同时还可提升患者对护理的满意度。

青少年与年轻成人癌症患者预立医疗照护计划干预方案构建

目的构建适用于我国青少年与年轻成人癌症患者的预立医疗照护计划干预方案,提高该人群预立医疗照护计划实践效果。方法基于跨理论模型,通过文献回顾、焦点小组访谈、半结构化访谈设计青少年与年轻成人癌症患者预立医疗照护计划干预方案,采用德尔菲法对15名专家进行专家函询。结果2轮函询问卷的有效回收率均为100%,专家权威系数为0.865;第2轮专家函询后,指标肯德尔和谐系数为0.238~0.394(均P<0.05)。最终形成的青少年与年轻成人癌症患者预立医疗照护计划干预方案包括前意向阶段、意向阶段、准备阶段、行动阶段、维持阶段,具体实施细则包括干预时机、干预主题、干预内容、干预目标、干预方式、评价指标。结论基于跨理论模型构建的青少年与年轻成人癌症患者预立医疗照护计划干预方案具有较好的专家认可度,但需进一步开展实证研究进行验证。

成人癌症病人家庭抗逆力影响因素的范围综述

目的:对成人癌症病人家庭抗逆力的影响因素进行范围综述,为其家庭危机的预防和家庭抗逆力干预项目的构建提供参考。方法:系统检索10个中英文数据库建库至2022年12月31日文献进行筛选,对纳入的文献进行数据提取、收集、总结和讨论。结果:共纳入16篇文献,家庭抗逆力的影响因素包括社会人口学因素、癌症相关因素、个体心理因素、家庭和社会因素。结论:国内外成人癌症病人的家庭抗逆力受诸多复杂因素影响,有必要对其进行归纳总结,为干预措施的制定提供理论依据,以促进成人癌症病人及照顾者特定家庭进程和适应癌症经历。

青年肝癌发病特征及危险因素的思考

肝癌是死亡率最高的恶性肿瘤之一,好发于中老年。随着社会的发展,青年肝癌的发病率逐渐上升且死亡率居高不下。本文从青年肝癌的流行病学、临床分子特征、危险因素等方面进行归纳总结和系统分析,发现青年肝癌具有独特的发病特征和危险因素,可作为一种独立的疾病实体。目前迫切需要针对性的诊疗方式来提高青年肝癌患者的早诊和生存率,从而减轻青年人群的肝癌负担。

青少年和年轻人结直肠癌特点及诊疗的研究进展

结直肠癌是较为常见的消化系统恶性肿瘤。近年来,随着人们生活方式、饮食结构的改变及环境污染的加剧,青少年和年轻人(AYAs)结直肠癌的发生率明显升高。AYAs是指15~39岁人群,与老年癌症患者相比,AYAs癌症患者具有更高的长期和晚期风险,预后更差,结直肠癌也成为导致AYAs死亡的重要原因。本研究以结直肠癌为切入点,分析AYAs结直肠癌的发病危险因素、临床特点,探讨AYAs结直肠癌的诊疗方法,以期为临床拟订防控措施提供依据。

成年结直肠癌住院患者营养不良与术后并发症的相关性分析

目的:依据全球营养不良领导倡议(the global leadership initiative on malnutrition,GLIM)的营养不良诊断标准,分析成年结直肠癌住院患者营养不良与临床结局的相关性。方法:回顾性分析2019年6月—2020年12月惠州市中心人民医院确诊医治的170例成年结直肠癌住院患者临床资料,入院48 h内均接受营养状况评估,参考GLIM标准,统计全体患者营养不良发生情况,通过logistic回归分析筛选成年结直肠癌住院患者并发症发生的相关因素。结果:(1)本组170例患者中,GLIM标准评估结果显示,57例患者营养良好(33.53%),将其归在无营养不良组;113例患者存在营养不良(66.47%),将其归在营养不良组。其中无营养不良组男性、女性分别为31例、26例;年龄48~76岁,平均(62.48±5.68)岁。营养不良组男性、女性分别为62例、51例;年龄49~74岁,平均(62.25±5.82)岁。(2)客观指标比较可知,在营养风险筛查-2002评分、患者主观整体评估量表评分、血前白蛋白、血白蛋白水平、体重指数、上臂围、三头肌皮褶厚度、上臂肌围方面,营养不良组与无营养不良组之间差异均有统计学意义(P<0.05)。(3)临床结局指标比较可知,在术后并发症、住院时间、住院费用、无计划30 d内返院方面,营养不良组与无营养不良组之间差异均有统计学意义(P<0.05)。(4)logistic回归分析可知,营养不良为成年结直肠癌住院患者并发症发生的独立相关因素(P<0.05)。结论:成年结直肠癌住院患者营养不良会提高并发症风险,延长住院时间。

癌症患者对未成年子女养育忧虑的现状及影响因素分析

目的了解癌症患者对未成年子女养育忧虑的现状并分析其影响因素,为改善癌症患者养育忧虑提供参考。方法便利抽取372例癌症患者为研究对象,使用一般资料调查表、养育忧虑问卷、痛苦表露指数量表、感知伴侣回应性量表和育儿胜任感量表进行调查。结果癌症患者对未成年子女的养育忧虑总分为32.00(24.00,41.00)分。广义线性回归分析结果显示,文化程度、最小未成年子女的年龄、子女健康状况、是否出现转移或复发、痛苦表露、感知伴侣回应性和育儿胜任感是癌症患者对未成年子女养育忧虑水平的影响因素(均P<0.05)。结论癌症患者对未成年子女的养育忧虑处于中等偏低水平,医护人员应根据影响因素制定针对性的干预措施,缓解癌症患者养育忧虑。

社会支持在中青年肺癌术后患者自我调节疲劳与工作生活质量间的中介效应分析

目的:探讨中青年肺癌术后患者社会支持在自我调节疲劳与工作生活质量之间的中介作用。方法:采用便利抽样法,选取就诊于天津市某三级甲等肿瘤专科医院的中青年肺癌术后重返工作岗位时间≥1个月的患者为研究对象,采用一般资料调查表、自我调节疲劳量表、领悟社会支持量表及癌症患者工作生活质量量表对其进行调查,采用SPSS 22.0及Process插件,用Bootstrap法分析中青年肺癌术后患者社会支持在自我调节疲劳与工作生活质量间的中介作用。结果:224例中青年肺癌术后患者工作生活质量总分为(51.93±24.31)分。Pearson相关分析显示,中青年肺癌患者工作生活质量与自我调节疲劳呈负相关(r=-0.133,P<0.05)、与社会支持呈正相关(r=0.319,P<0.01)。中介效应分析显示,社会支持在自我调节疲劳与工作生活质量中起到完全中介作用,效应值为-0.251(P<0.05),95%置信区间为-0.529~-0.011,中介效应占总效应的34.813%。结论:中青年肺癌术后患者的工作生活质量水平有待提高,社会支持在自我调节疲劳和工作生活质量中起完全中介作用,家庭、社会及医护人员应尽早采取积极应对措施,开展个性化的延续护理措施,提高其工作生活质量。

成人癌症患者失眠诊疗专家建议

失眠是成人癌症患者的常见症状之一,在癌症病程的各个阶段都很常见,不仅影响患者的生活质量,甚至会影响到抗癌治疗和疾病结局。为进一步规范成人癌症患者失眠的诊治,中国癌症基金会肿瘤心理学协作组组织肿瘤科、精神科和以科室名称“肿瘤心理科”等开展精神卫生临床工作的多学科专家,结合国内外相关诊疗指南、循证医学证据和专家临床经验撰写本专家建议,内容包括流行病学、病因、失眠对癌症及其治疗的影响、评估及治疗过程,以及诊疗要点和注意事项,旨在引发肿瘤临床医护人员对成人癌症患者失眠问题的关注,并为成人癌症患者失眠的诊治提供指导。