AIM:To analyze the benefits and harms of pancreatic cancer screening in familial high-risk individuals(HRIs).METHODS:Studies were identified by searching PubMed,EBSCO,ClinicalTrials.gov and the Cochrane database from ...AIM:To analyze the benefits and harms of pancreatic cancer screening in familial high-risk individuals(HRIs).METHODS:Studies were identified by searching PubMed,EBSCO,ClinicalTrials.gov and the Cochrane database from database inception to June 2014.We also obtained papers from the reference lists of pertinent studies and systematic reviews.Englishlanguage trials and observational studies were searched.The key words used as search terms were "screening" and "surveillance".Cost-effectiveness,diagnostic rate,survival rate,mortality and adverse events were the outcomes of interest.Age,sex,lifestyle and other confounding factors were also considered.However,anticipating only a few of these studies,we also included observational studies with or without control groups.We also included studies concerning the anxiety associated with pancreatic cancer risk and other psychological changes in familial HRIs.We extracted details on study design,objectives,population characteristics,inclusion criteria,year of enrollment,method of screening,adjusted and unadjusted mortality,cost-effectiveness and adverse events from the included studies.Studies were assessed using the Reporting of Observational studies in Epidemiology(STROBE) checklist.RESULTS:Sixteen studies on pancreatic cancer screening were included.Five studies included control groups,nine were observational studies without control groups,and the other two studies investigated the worry associated with pancreatic cancer risk.We found that pancreatic cancer screening resulted in a high curative resection rate(60%vs 25%,P = 0.011),longer median survival time(14.5 mo vs 4 mo,P < 0.001),and higher 3-year survival rate(20%vs 15.0%,P =0.624).We also found that familial HRIs had a higher diagnostic rate of pancreatic tumors than controls(34%vs 7.2%,P< 0.001).In patients who underwent regular physical examinations,more stage I pancreatic cancers were observed(19%vs 2.6%,P= 0.001).In addition,endoscopic ultrasonography,which was the main means of detection,diagnosed 64.3%of pancreatic cancers.In comparison,endoscopic retrograde cannulation of the pancreas,magnetic resonance imaging,and computed tomography diagnosed 28.6%,42.9%,and21.4%,respectively.For mass lesions,instant surgery was recommended because of the beneficial effects of post-operative chemotherapy.However,in patients with intraductal papillary mucinous neoplasms,we did not find a significant difference in outcome between surgery and follow-up without treatment.Moreover,pancreatic cancer screening in familial HRIs had a greater perceived risk of pancreatic cancer(P< 0.0001),higher levels of anxiety regarding pancreatic cancer(P< 0.0001),and increased economic burden.CONCLUSION:Pancreatic cancer screening in familial HRIs is associated with a higher detection rate and longer survival,although screening may influence psychological function and increase the economic burden.展开更多
Pancreatic ductal adenocarcinoma(PDAC) is a lethal neoplasia, for which secondary prevention(i.e., screening) is advisable for high-risk individuals with "familiar pancreatic cancer" and with other specific ...Pancreatic ductal adenocarcinoma(PDAC) is a lethal neoplasia, for which secondary prevention(i.e., screening) is advisable for high-risk individuals with "familiar pancreatic cancer" and with other specific genetic syndromes(Peutz-Jeghers, p16, BRCA2, PALB and mismatch repair gene mutation carriers). There is limited evidence regarding the accuracy of screening tests, their acceptability, costs and availability, and agreement on whom to treat. Successful target of screening are small resectable PDAC, intraductal papillary mucinous neoplasms with high-grade dysplasia and advanced pancreatic intraepithelial neoplasia. Both magnetic resonance imaging(MRI) and endoscopic ultrasound(EUS) are employed for screening, and the overall yield for pre-malignant or malignant pancreatic lesions is of about 20% with EUS and 14% with MRI/magnetic resonance colangiopancreatography. EUS performs better for solid and MRI for cystic lesions. However, only 2% of these detected lesions can be considered a successful target, and there are insufficient data demonstrating that resection of benign or low grade lesions improves survival. Many patients in the published studies therefore seemed to have received an overtreatment by undergoing surgery. It is crucial to better stratify the risk of malignancy individually, and to better define optimal screening intervals and methods either with computerized tools or molecular biomarkers, possibly in large multicentre studies. At the moment, screening should be carefully performed within research protocols at experienced centres, offering involved individuals medical and psychological advice.展开更多
Western culture emphasizes on individualism,individual freedom and personal choice,while Chinese people put more emphasis on collectivism.Collectivism-Individualism value differences can also be reflected in Chinese a...Western culture emphasizes on individualism,individual freedom and personal choice,while Chinese people put more emphasis on collectivism.Collectivism-Individualism value differences can also be reflected in Chinese and Western Family Relationships,which may sometimes lead to conflicts between the couples in the cross-cultural marriage and their families.展开更多
There is substantial individual variation in the growth rates of sea cucumber Apostichopus japonicus individuals. This necessitates additional work to grade the seed stock and lengthens the production period. We evalu...There is substantial individual variation in the growth rates of sea cucumber Apostichopus japonicus individuals. This necessitates additional work to grade the seed stock and lengthens the production period. We evaluated the infl uence of three culture methods(free-mixed, isolated-mixed, isolated-alone) on individual variation in growth and assessed the relationship between feeding, energy conversion efficiency, and individual growth variation in individually cultured sea cucumbers. Of the different culture methods, animals grew best when reared in the isolated-mixed treatment(i.e., size classes were held separately), though there was no difference in individual variation in growth between rearing treatment groups. The individual variation in growth was primarily attributed to genetic factors. The difference in food conversion efficiency caused by genetic differences among individuals was thought to be the origin of the variance. The level of individual growth variation may be altered by interactions among individuals and environmental heterogeneity. Our results suggest that, in addition to traditional seed grading, design of a new kind of substrate that changes the spatial distribution of sea cucumbers would effectively enhance growth and reduce individual variation in growth of sea cucumbers in culture.展开更多
Promoting women’s employment is not only the need of social and economic development,but also the historical mission of liberating women.This paper uses data from the 1%Population Sample Survey,taken in Guangdong Pro...Promoting women’s employment is not only the need of social and economic development,but also the historical mission of liberating women.This paper uses data from the 1%Population Sample Survey,taken in Guangdong Province in 2015,to explore how women’s marital status,education,and family environment affect the female non-agricultural employment rate(FNAER)on a county scale using a spatial-lag model.The results show that:1)The female non-agricultural employment rate in counties of Guangdong Province is low,with more than three-quarters of counties having female non-agricultural employment rate less than 50%.Moreover,the spatial distribution of FNAER is uneven,with the high-value areas concentrated in the southeast and the low-value areas mainly distributed in the central and western parts of Guangdong Province.2)From the perspective of industry,there are significant spatial differences among women.In the southeast,women are mainly engaged in the secondary industry,while in the central and western regions,women are mainly engaged in the tertiary industry.3)Women having better skills and more effective support from the elderly can improve the FNAER.Women having lower skills,smaller-scale families,a higher fertility rate,and households with two or more elderly members have a negative effect on the FNAER.4)Public policies suggest that improving women’s education and their family environment,building social welfare facilities,and repairing the family environment will increase the FNAER.展开更多
文摘AIM:To analyze the benefits and harms of pancreatic cancer screening in familial high-risk individuals(HRIs).METHODS:Studies were identified by searching PubMed,EBSCO,ClinicalTrials.gov and the Cochrane database from database inception to June 2014.We also obtained papers from the reference lists of pertinent studies and systematic reviews.Englishlanguage trials and observational studies were searched.The key words used as search terms were "screening" and "surveillance".Cost-effectiveness,diagnostic rate,survival rate,mortality and adverse events were the outcomes of interest.Age,sex,lifestyle and other confounding factors were also considered.However,anticipating only a few of these studies,we also included observational studies with or without control groups.We also included studies concerning the anxiety associated with pancreatic cancer risk and other psychological changes in familial HRIs.We extracted details on study design,objectives,population characteristics,inclusion criteria,year of enrollment,method of screening,adjusted and unadjusted mortality,cost-effectiveness and adverse events from the included studies.Studies were assessed using the Reporting of Observational studies in Epidemiology(STROBE) checklist.RESULTS:Sixteen studies on pancreatic cancer screening were included.Five studies included control groups,nine were observational studies without control groups,and the other two studies investigated the worry associated with pancreatic cancer risk.We found that pancreatic cancer screening resulted in a high curative resection rate(60%vs 25%,P = 0.011),longer median survival time(14.5 mo vs 4 mo,P < 0.001),and higher 3-year survival rate(20%vs 15.0%,P =0.624).We also found that familial HRIs had a higher diagnostic rate of pancreatic tumors than controls(34%vs 7.2%,P< 0.001).In patients who underwent regular physical examinations,more stage I pancreatic cancers were observed(19%vs 2.6%,P= 0.001).In addition,endoscopic ultrasonography,which was the main means of detection,diagnosed 64.3%of pancreatic cancers.In comparison,endoscopic retrograde cannulation of the pancreas,magnetic resonance imaging,and computed tomography diagnosed 28.6%,42.9%,and21.4%,respectively.For mass lesions,instant surgery was recommended because of the beneficial effects of post-operative chemotherapy.However,in patients with intraductal papillary mucinous neoplasms,we did not find a significant difference in outcome between surgery and follow-up without treatment.Moreover,pancreatic cancer screening in familial HRIs had a greater perceived risk of pancreatic cancer(P< 0.0001),higher levels of anxiety regarding pancreatic cancer(P< 0.0001),and increased economic burden.CONCLUSION:Pancreatic cancer screening in familial HRIs is associated with a higher detection rate and longer survival,although screening may influence psychological function and increase the economic burden.
文摘Pancreatic ductal adenocarcinoma(PDAC) is a lethal neoplasia, for which secondary prevention(i.e., screening) is advisable for high-risk individuals with "familiar pancreatic cancer" and with other specific genetic syndromes(Peutz-Jeghers, p16, BRCA2, PALB and mismatch repair gene mutation carriers). There is limited evidence regarding the accuracy of screening tests, their acceptability, costs and availability, and agreement on whom to treat. Successful target of screening are small resectable PDAC, intraductal papillary mucinous neoplasms with high-grade dysplasia and advanced pancreatic intraepithelial neoplasia. Both magnetic resonance imaging(MRI) and endoscopic ultrasound(EUS) are employed for screening, and the overall yield for pre-malignant or malignant pancreatic lesions is of about 20% with EUS and 14% with MRI/magnetic resonance colangiopancreatography. EUS performs better for solid and MRI for cystic lesions. However, only 2% of these detected lesions can be considered a successful target, and there are insufficient data demonstrating that resection of benign or low grade lesions improves survival. Many patients in the published studies therefore seemed to have received an overtreatment by undergoing surgery. It is crucial to better stratify the risk of malignancy individually, and to better define optimal screening intervals and methods either with computerized tools or molecular biomarkers, possibly in large multicentre studies. At the moment, screening should be carefully performed within research protocols at experienced centres, offering involved individuals medical and psychological advice.
文摘Western culture emphasizes on individualism,individual freedom and personal choice,while Chinese people put more emphasis on collectivism.Collectivism-Individualism value differences can also be reflected in Chinese and Western Family Relationships,which may sometimes lead to conflicts between the couples in the cross-cultural marriage and their families.
基金Supported by the National Natural Science Foundation of China(No.41106134)the National Marine Public Welfare Research Project of China(No.201305043)+1 种基金the National High Technology Research and Development Program of China(863 Program)(No.2012AA10A412)the Agriculture Science Technology Achievement Transformation Fund(No.2012GB24910656)
文摘There is substantial individual variation in the growth rates of sea cucumber Apostichopus japonicus individuals. This necessitates additional work to grade the seed stock and lengthens the production period. We evaluated the infl uence of three culture methods(free-mixed, isolated-mixed, isolated-alone) on individual variation in growth and assessed the relationship between feeding, energy conversion efficiency, and individual growth variation in individually cultured sea cucumbers. Of the different culture methods, animals grew best when reared in the isolated-mixed treatment(i.e., size classes were held separately), though there was no difference in individual variation in growth between rearing treatment groups. The individual variation in growth was primarily attributed to genetic factors. The difference in food conversion efficiency caused by genetic differences among individuals was thought to be the origin of the variance. The level of individual growth variation may be altered by interactions among individuals and environmental heterogeneity. Our results suggest that, in addition to traditional seed grading, design of a new kind of substrate that changes the spatial distribution of sea cucumbers would effectively enhance growth and reduce individual variation in growth of sea cucumbers in culture.
基金Under the auspices of National Natural Science Foundation of China(No.41471111)。
文摘Promoting women’s employment is not only the need of social and economic development,but also the historical mission of liberating women.This paper uses data from the 1%Population Sample Survey,taken in Guangdong Province in 2015,to explore how women’s marital status,education,and family environment affect the female non-agricultural employment rate(FNAER)on a county scale using a spatial-lag model.The results show that:1)The female non-agricultural employment rate in counties of Guangdong Province is low,with more than three-quarters of counties having female non-agricultural employment rate less than 50%.Moreover,the spatial distribution of FNAER is uneven,with the high-value areas concentrated in the southeast and the low-value areas mainly distributed in the central and western parts of Guangdong Province.2)From the perspective of industry,there are significant spatial differences among women.In the southeast,women are mainly engaged in the secondary industry,while in the central and western regions,women are mainly engaged in the tertiary industry.3)Women having better skills and more effective support from the elderly can improve the FNAER.Women having lower skills,smaller-scale families,a higher fertility rate,and households with two or more elderly members have a negative effect on the FNAER.4)Public policies suggest that improving women’s education and their family environment,building social welfare facilities,and repairing the family environment will increase the FNAER.
