As the leading cause of disease-related deaths,cancer is a major public health threat worldwide.Surgical resection is still the first-line therapy for patients with early-stage cancers.However,postoperative relapse an...As the leading cause of disease-related deaths,cancer is a major public health threat worldwide.Surgical resection is still the first-line therapy for patients with early-stage cancers.However,postoperative relapse and metastasis remain the cause of 90%of deaths of patients with solid organ malignancies,including hepatocellular carcinoma(HCC).With the rapid development of molecular biology techniques in recent years,molecularly targeted therapies using monoclonal antibodies,small molecules,and vaccines have become a milestone in cancer therapeutic by significantly improv-ing the survival of cancer patients,and have opened a window of hope for patients with advanced cancer.Hypervascularization is a major characteristic of HCC.It has been reported that anti-angiogenic treatments,which inhibit blood vessel formation,are highly effective for treating HCC.However,the efficacy and safety of anti-angiogenesis therapies remain controversial.Sorafenib is an oral multikinase inhibitor with antiproliferative and anti-angiogenic effects and is the first molecular target drug approved for the treatment of advanced HCC.While sorafenib has shown promising therapeutic effects,substantial evidence of primary and acquired resistance to sorafenib has been reported.Numerous clinical trials have been conducted to evaluate a large number of molecularly targeted drugs for treating HCC,but most drugs exhibited less efficacy and/or higher toxicity compared to sorafenib.Therefore,understanding the mechanism(s)underlying sorafenib resistance of cancer cells is highlighted for efficiently treating HCC.This concise review aims to provide an overview of anti-angiogenesis therapy in the management of HCC and to discuss the common mechanisms of resistance to anti-angiogenesis therapies.展开更多
目的了解2019年中国乙型肝炎的疾病负担情况并对2020—2030年乙型肝炎的疾病负担发展趋势进行预测。方法在2019全球疾病负担研究数据库(Global Burden of Disease 2019,GBD 2019)中下载中国乙型肝炎数据。利用患病率、发病率、死亡率、...目的了解2019年中国乙型肝炎的疾病负担情况并对2020—2030年乙型肝炎的疾病负担发展趋势进行预测。方法在2019全球疾病负担研究数据库(Global Burden of Disease 2019,GBD 2019)中下载中国乙型肝炎数据。利用患病率、发病率、死亡率、伤残调整寿命年(disability-adjusted life year,DALY)、早死损失寿命年(years of life lost,YLL)、伤残损失寿命年(years lived with disability,YLD)及年龄标化率等指标描述2019年中国乙型肝炎的疾病负担情况,利用估计年百分比变化(estimated annual percentage change,EAPC)描述中国乙型肝炎疾病负担1990—2019年的变化趋势。采用R4.2.1构建贝叶斯年龄-时期-队列模型对2020—2030年中国乙型肝炎总体发病、死亡、DALY和YLD情况进行预测。结果1990—2019年中国乙型肝炎的总体疾病负担呈下降趋势,中国乙型肝炎的总体标化患病率为6566.1/10万、标化发病率为1397.3/10万、标化死亡率为8.1/10万、标化DALY率为247.7/10万、标化YLL率为241.5/10万、标化YLD率为6.2/10万,与1990年相比分别下降2.34%、2.35%、4.92%、5.15%、5.20%、2.71%。女性居民的疾病负担指标均低于同时期的男性居民。乙型肝炎的患病率在20~24岁最高,发病率在25~29岁最高,死亡率随着年龄增长而升高。根据贝叶斯模型预测,2020—2030年中国乙型肝炎发病人数约为1486.56万人,死亡人数约为11.18万人,DALY约为634.9万人年,YLD约为12.1万人年。结论尽管在1990—2019年之间中国乙型肝炎疾病负担呈下降趋势,但在2030年消除乙型肝炎病毒这一公共威胁的目标仍然面临挑战。因此,有必要扩大诊断覆盖范围、减轻患者经济负担,进一步推进健康中国建设。展开更多
Background: Cervical cancer is the fourth most common cancer among women globally, the second most common cancer in Nigeria and the most common cause of cancer-related death in Africa. In 2020, World Health Organizati...Background: Cervical cancer is the fourth most common cancer among women globally, the second most common cancer in Nigeria and the most common cause of cancer-related death in Africa. In 2020, World Health Organization in its updated guidelines recommended cervical cancer screening using HPV DNA, HPV mRNA tests and subsequent treatment as appropriate. However, in resource-poor settings, Visual Inspections with Acetic Acid (VIA), Lugol’s Iodine (VILI) and subsequent treatment of precancerous lesions with thermal ablation remain the practical approaches. Objectives: To determine the prevalence of precancerous cervical lesions and associated risk factors among Women Living with HIV (WLHIV). Methods: A retrospective study on sexually active WLHIV aged 16 - 55 years screened for cervical cancer using VIA and VILI within 16 months period in Faith Alive Hospital Jos. Data were analyzed using IBM-SPSS 26. Sociodemographic characteristics of the study participants and the screening results were presented in frequency tables, and logistic regression was performed to determine risk factors of pre-cancerous lesions. Results: 1113 women were screened for cervical cancer using VIA/VILI. 994 (89.3%) were negative, 101 (9.1%) were positive for precancerous lesions, and 18 (1.6%) were suspicious of cervical cancer. The mean age of clients with pre-cancerous lesions was 41.32 ± 9.89 years. A higher positivity yield (69.4%) was found in ages between 36 and ≥55 years while a less positivity yield (30.6%) was found in age’s ≤ 35 years. History of STI had 1.64 fold risk association with precancerous lesions. Conclusion: Our study demonstrated a high prevalence of precancerous cervical lesions among WLHIV;bimodal age distribution for cancer-suspicious lesions and risk associated with STI. Thus, a “screen-and-treat” approach to cervical cancer prevention by VIA and thermal ablation in resource-poor settings should be undertaken until widespread HPV testing to triage clients is feasible.展开更多
基金Supported by The Special Research Foundation of the National Nature Science Foundation of China,No.81302143the Natural Science Foundation of Guangdong Province,China,No.S2013040015045
文摘As the leading cause of disease-related deaths,cancer is a major public health threat worldwide.Surgical resection is still the first-line therapy for patients with early-stage cancers.However,postoperative relapse and metastasis remain the cause of 90%of deaths of patients with solid organ malignancies,including hepatocellular carcinoma(HCC).With the rapid development of molecular biology techniques in recent years,molecularly targeted therapies using monoclonal antibodies,small molecules,and vaccines have become a milestone in cancer therapeutic by significantly improv-ing the survival of cancer patients,and have opened a window of hope for patients with advanced cancer.Hypervascularization is a major characteristic of HCC.It has been reported that anti-angiogenic treatments,which inhibit blood vessel formation,are highly effective for treating HCC.However,the efficacy and safety of anti-angiogenesis therapies remain controversial.Sorafenib is an oral multikinase inhibitor with antiproliferative and anti-angiogenic effects and is the first molecular target drug approved for the treatment of advanced HCC.While sorafenib has shown promising therapeutic effects,substantial evidence of primary and acquired resistance to sorafenib has been reported.Numerous clinical trials have been conducted to evaluate a large number of molecularly targeted drugs for treating HCC,but most drugs exhibited less efficacy and/or higher toxicity compared to sorafenib.Therefore,understanding the mechanism(s)underlying sorafenib resistance of cancer cells is highlighted for efficiently treating HCC.This concise review aims to provide an overview of anti-angiogenesis therapy in the management of HCC and to discuss the common mechanisms of resistance to anti-angiogenesis therapies.
文摘目的了解2019年中国乙型肝炎的疾病负担情况并对2020—2030年乙型肝炎的疾病负担发展趋势进行预测。方法在2019全球疾病负担研究数据库(Global Burden of Disease 2019,GBD 2019)中下载中国乙型肝炎数据。利用患病率、发病率、死亡率、伤残调整寿命年(disability-adjusted life year,DALY)、早死损失寿命年(years of life lost,YLL)、伤残损失寿命年(years lived with disability,YLD)及年龄标化率等指标描述2019年中国乙型肝炎的疾病负担情况,利用估计年百分比变化(estimated annual percentage change,EAPC)描述中国乙型肝炎疾病负担1990—2019年的变化趋势。采用R4.2.1构建贝叶斯年龄-时期-队列模型对2020—2030年中国乙型肝炎总体发病、死亡、DALY和YLD情况进行预测。结果1990—2019年中国乙型肝炎的总体疾病负担呈下降趋势,中国乙型肝炎的总体标化患病率为6566.1/10万、标化发病率为1397.3/10万、标化死亡率为8.1/10万、标化DALY率为247.7/10万、标化YLL率为241.5/10万、标化YLD率为6.2/10万,与1990年相比分别下降2.34%、2.35%、4.92%、5.15%、5.20%、2.71%。女性居民的疾病负担指标均低于同时期的男性居民。乙型肝炎的患病率在20~24岁最高,发病率在25~29岁最高,死亡率随着年龄增长而升高。根据贝叶斯模型预测,2020—2030年中国乙型肝炎发病人数约为1486.56万人,死亡人数约为11.18万人,DALY约为634.9万人年,YLD约为12.1万人年。结论尽管在1990—2019年之间中国乙型肝炎疾病负担呈下降趋势,但在2030年消除乙型肝炎病毒这一公共威胁的目标仍然面临挑战。因此,有必要扩大诊断覆盖范围、减轻患者经济负担,进一步推进健康中国建设。
文摘Background: Cervical cancer is the fourth most common cancer among women globally, the second most common cancer in Nigeria and the most common cause of cancer-related death in Africa. In 2020, World Health Organization in its updated guidelines recommended cervical cancer screening using HPV DNA, HPV mRNA tests and subsequent treatment as appropriate. However, in resource-poor settings, Visual Inspections with Acetic Acid (VIA), Lugol’s Iodine (VILI) and subsequent treatment of precancerous lesions with thermal ablation remain the practical approaches. Objectives: To determine the prevalence of precancerous cervical lesions and associated risk factors among Women Living with HIV (WLHIV). Methods: A retrospective study on sexually active WLHIV aged 16 - 55 years screened for cervical cancer using VIA and VILI within 16 months period in Faith Alive Hospital Jos. Data were analyzed using IBM-SPSS 26. Sociodemographic characteristics of the study participants and the screening results were presented in frequency tables, and logistic regression was performed to determine risk factors of pre-cancerous lesions. Results: 1113 women were screened for cervical cancer using VIA/VILI. 994 (89.3%) were negative, 101 (9.1%) were positive for precancerous lesions, and 18 (1.6%) were suspicious of cervical cancer. The mean age of clients with pre-cancerous lesions was 41.32 ± 9.89 years. A higher positivity yield (69.4%) was found in ages between 36 and ≥55 years while a less positivity yield (30.6%) was found in age’s ≤ 35 years. History of STI had 1.64 fold risk association with precancerous lesions. Conclusion: Our study demonstrated a high prevalence of precancerous cervical lesions among WLHIV;bimodal age distribution for cancer-suspicious lesions and risk associated with STI. Thus, a “screen-and-treat” approach to cervical cancer prevention by VIA and thermal ablation in resource-poor settings should be undertaken until widespread HPV testing to triage clients is feasible.
