Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-01-12 Cooperative journals: 《中国全科医学》
Abstract： Background Gallbladder cancer is featured by difficult early detection，poor treatment effectiveness and high mortality. An in-depth epidemiology research of gallbladder cancer can provide valuable data for the formulation of prevention and treatment strategies for gallbladder cancer. Objective To analyze the trend of disease burden of gallbladder cancer in China from 1990 to 2019，and to estimate its onset age，period，cohort effects and future trends. Methods Data of disease burden of gallbladder cancer，including the incidence，prevalence，mortality，disability adjusted life year（DALY）rate and corresponding standardized rates in China from 1990 to 2019 were extracted from the 2019 Global Burden of Disease Research （GBD 2019）database from March to June 2023. The annual percentage change（APC）and average annual percentage change （AAPC）were calculated using Joinpoint to analyze the trend of disease burden of gallbladder cancer in China from 1990 to 2019. A Bayesian age-period-cohort analysis（BAPC）model was created to predict the incidence of gallbladder cancer in China from 2020 to 2030. Results From 1990 to 2019，the standardized incidence rate of gallbladder cancer in China significantly rose from 1.58/100 000 in 1990 to 2.01/100 000 in 2019，with the AAPC of 0.82%（95%CI=0.65%-1.00%，P<0.001）. The standardized prevalence significantly rose from 1.64/100 000 in 1990 to 2.40/100 000 in 2019，with the AAPC of 1.34%（95%CI=1.14%- 1.54%，P<0.001）. The standardized mortality significantly rose from 1.61/100 000 in 1990 to 1.82/100 000 in 2019，with the AAPC of 0.40%（95%CI=0.24%-0.56%，P<0.001）. The standardized DALY rate significantly rose from 35.18/100 000 in 1990 to 37.71/100 000 in 2019，with the AAPC of 0.25%（95%CI=0.12%-0.38%，P<0.001）. The BAPC model revealed that the net drift values for the incidence and mortality of gallbladder cancer in China from 1990 to 2019 were 0.99（95%CI=0.81-1.18） and 0.42 （95%CI=0.21-0.63），respectively. The incidence and mortality of gallbladder cancer increased with age，and the incidence of gallbladder cancer achieved the peak in people aged 80 years and above. The risk of onset and death of gallbladder cancer showed a decreasing trend at first and then an increasing trend followed by a decreasing trend over time，both of which peaked from 2005 to 2009. In addition，the risk of onset and death of gallbladder cancer showed an increasing trend at first and then a decreasing trend over the time of birth cohort. The BAPC model predicted that the standardized incidence，morbidity，mortality and DALY rate of gallbladder cancer in China will show a slight upward trend from 2020 to 2030. Conclusion From 1990 to 2019，the standardized incidence，prevalence，mortality and DALY rate of gallbladder cancer in China showed an upward trend，and the disease burden was still serious. The prevention and treatment of gallbladder cancer among men and the elderly，and vigorous propaganda of medical knowledge about cancer prevention，biliary disease control and promotion of healthy lifestyles should be strengthen to reduce the disease burden of gallbladder cancer.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-07-10 Cooperative journals: 《中国全科医学》
Abstract： Gastric cancer（GC）is one of the most heterogeneous and aggressive malignant tumors of the digestive system. Traditional chemotherapy drugs and epidermal growth factor receptor 2（HER2）targeted drugs such as Trastuzumab still have the disadvantages of high incidence of drug resistance，high toxic side effects and poor tolerance of patients. Therefore，it is imperative to develop more effective anti GC drugs. Novel targeted drugs against HER2 are currently available，but are ineffective or resistance in some cases，which is related to the low expression of HER2（HER2 IHC1+ or IHC2+/ISH-） in certain GC cells，accounting for about 40%-60% of all types. However，in clinical practice，these patients are still reported as HER2-negative GC. Therefore，accurate detection of HER2 expression is crucial to identify patients who may benefit from trastuzumab therapy. The emergence of antibody drug conjugates（ADC）provides a new therapeutic option for HER2-positive GC and it is expected to replace traditional GC chemotherapy in the future by its precise and efficient anti-tumor effect. Recent studies have found that ADC may have potential anti-tumor activity in HER2 low-expression GC，and related clinical studies are evaluating its effectiveness and safety in HER2 low-expression GC treatment. This article reviews the application and the latest research progress of ADC in HER2 low-expression GC patients in the era of targeted therapy and discusses the challenges faced in the application and development of HER2-targeted ADCs.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-07-05 Cooperative journals: 《中国全科医学》
Abstract： Background Postoperative sore throat （POST） is one of the common mild but unpleasant postoperative complications after general anaesthesia. There is evidence that Glycyrrhiza Radix can effectively reduce the incidence of POST，but its effective fraction remains unclear. Objective To screen the effective fraction of Glycyrrhiza Radix on preventing respiratory tract injury induced by endotracheal intubation. Methods From April 2021 to July 2022，60 SPF-grade Wistar rats were randomized into the control group，endotracheal intubation group，lidocaine group，total polysaccharides group，total saponins group，total flavonoids group based on random number table method，with 10 rats in each group. The endotracheal intubation model was prepared for all groups except the control group. Before intubation，each treatment group was sprayed with a solution consisting of 1% lidocaine，total polysaccharides，total saponins，and total flavonoids at 1 mL/100 g（by body weight）to permeate the uvula and peri-soft palate tissue of rats，respectively. The control and endotracheal intubation groups were sprayed with an equal volume of 0.9% saline. After 2 hours of mechanical ventilation，the endotracheal tube was removed，and the pharyngeal mucosa tissues and blood samples of rats were collected under deep anesthesia. Pathological changes of rat pharyngeal mucosa and the expression levels of Toll-like receptor 2 （TLR2） and Toll-like receptor 4 （TLR4） were observed by hematoxylin-eosin staining （HE staining） and immunohistochemistry （IHC）; the expression levels of inflammatory cytokines including serum tumor necrosis factor-α （TNF-α），interleukin-2（IL-2），interleukin-4（IL-4），interleukin-10（IL-10），superoxide dismutase（SOD），malondialdehyde（MDA），total antioxidant capacity（T-AOC），and stress hormones including cortisol（Cor），epinephrine （E），and norepinephrine（NE） were measured by enzyme-linked immunosorbent assay （ELISA）. Results HE staining showed mucosal shedding and severe damage of submucosal structure accompanied by a large number of inflammatory cells infiltrated in the endotracheal intubation group; while milder damage of mucosal structure and less inflammatory cells were significantly reduced in the total saponins group. ELISA results showed that compared with the control group，the levels of TNF-α and IL-2 in the serum of rats increased significantly，and the levels of IL-4 and IL-10 decreased significantly in the endotracheal intubation group （P<0.05）; compared with the endotracheal intubation group，the serum levels of TNF-α and IL-2 decreased，and the levels of IL-4 and IL-10 increased in the total saponins group（P<0.05）. Compared with the control group，the MDA level in the serum of rats was significantly increased，and the SOD and T-AOC levels were significantly decreased in the endotracheal intubation group（P<0.05）; compared with the endotracheal intubation group，the MDA level decreased and the levels of SOD and T-AOC increased in the total saponins and flavonoids groups（P<0.05）. Compared with the control group，serum Cor，E，and NE levels significantly increased in the endotracheal intubation group （P<0.05）; compared with the tracheal intubation group，serum Cor，E and NE levels were decreased in the total saponins group rats （P<0.05）. The IHC results showed that the average optical density （AOD） expressed by TLR2 and TLR4 in the endotracheal intubation group was higher than the control group（P<0.05）. The AOD expressed by TLR4 in the pharyngeal mucosal tissue of rats in the total saponins group was significantly lower than that of the endotracheal intubation group（P<0.05）. Conclusion Total saponin is the main effective fraction of Glycyrrhiza Radix for the prevention of respiratory tract injury caused by endotracheal intubation under general anesthesia.
Hits
Hits
Downloads
Comment