营养不良对恶性肿瘤患者的不利影响贯穿其整个病程.肿瘤患者的营养状况如何未见大样本报道,而且已有报道差异很大,本研究旨在调查中国常见恶性肿瘤患者营养不良状况及营养治疗现状.本次观察性多中心研究采用两阶段随机抽样方法抽取全国2...营养不良对恶性肿瘤患者的不利影响贯穿其整个病程.肿瘤患者的营养状况如何未见大样本报道,而且已有报道差异很大,本研究旨在调查中国常见恶性肿瘤患者营养不良状况及营养治疗现状.本次观察性多中心研究采用两阶段随机抽样方法抽取全国22个主要省市80家三甲医院共47488例16种常见恶性肿瘤住院患者,以患者主观整体评估(Patient-Generated Subjective Global Assessment,PG-SGA)评估患者营养状况,以定量评估区分营养不良严重程度:0~1分无营养不良,2~3分、4~8分、≥9分分别定义为可疑/轻度、中度、重度营养不良.方差分析比较不同特征肿瘤患者PG-SGA评分.肿瘤患者中、重度营养不良的发病率为58.2%(中度32.1%、重度26.1%),22.2%为可疑/轻度营养不良,只有19.6%的患者无营养不良.营养不良的发病存在瘤种、年龄、性别、肿瘤分期、治疗情况及地区差异:胰腺癌患者PG-SGA评分最高(9.58±5.74),乳腺癌患者PG-SGA评分最低(3.51±3.49);<45岁年龄组患者PG-SGA评分最低(4.84±4.50),≥70岁年龄组患者PG-SGA评分最高(7.82±5.10);女性肺癌(5.87vs.5.60,P=0.006)和胃癌(8.36 vs.7.81,P<0.001)PG-SGA评分高于男性;TNM分期较高的患者其PG-SGA评分也较高,其中胰腺癌Ⅲ、Ⅳ期患者PG-SGA评分最高,乳腺癌Ⅰ~Ⅲ期患者PG-SGA评分均低于4分(3.05±2.83);接受手术治疗的患者PG-SGA评分最高(6.22±4.74),而目前还没有接受任何治疗的患者评分最低(5.61±4.68);华中区域PG-SGA评分最低(4.82±4.16),华东区域PG-SGA评分最高(7.31±5.53).此外,在某些肿瘤类型中,不同医疗保险类型、受教育水平、职业、居住地、民族的患者PG-SGA评分也有显著差异,农民、小学及以下低教育水平患者营养状况最差.68.78%的肿瘤患者没有获得任何营养治疗,重度营养不良(PG-SGA≥9)肿瘤患者的无营养治疗比例仍然高达55.03%.以上结果说明,中国常见恶性肿瘤患者营养不良发生率展开更多
Herbal medicines have recently been recognized as the second most common cause of drug-induced liver injury （DILI） in the United States. However, reliable methods to identify the DILl causality of some herbs, such a...Herbal medicines have recently been recognized as the second most common cause of drug-induced liver injury （DILI） in the United States. However, reliable methods to identify the DILl causality of some herbs, such as Heshouwu （dried root ofPolygonum multiflorum）, remain lacking. In this study, a total of 12 307 inpatients with liver dysfunction and 147 literature-reported cases of Heshouwu DILI were screened. A general algorithm indicated that only 22.5% （9/40） and 30.6% （45/147） of all hospitalization and literature case reports, respectively, demonstrate the high probability of DILI causality of Heshouwu. By contrast, 95% （19/20） of all cases prospectively investigated by pharmacognosy, phytochemistry, and metabolomic tests exhibited highly probable causality, including a patient who was previously incorrectly attributed and a case that was excluded from Heshouwu causality by pharmacognostic evidence. Toxin （heavy metals, pesticides, and mycotoxins） contamination was also excluded from Heshouwu DILI causality. The objectivity of these screening methods for Heshouwu DILI diagnosis addresses safety concerns regarding stilbene-containing herbal medicines and dietary supplements.展开更多
Dear Editor, Grain length （size） and weight are essential components of crop yield. To date, many QTLs/genes for these traits have been identified. GS3 encodes a putative transmembrane protein and functions as a neg...Dear Editor, Grain length （size） and weight are essential components of crop yield. To date, many QTLs/genes for these traits have been identified. GS3 encodes a putative transmembrane protein and functions as a negative regulator, and its larger-grain allele contains a nonsense mutation causing a 178-aa truncation （Fan et al., 2006）. GL3.1/qGL3 encodes a putative protein phosphatase and also acts as a negative regulator of grain size （Qi et al., 2012; Zhang et al., 2012）. Another negative regulator of grain size and weight is TGW6, which hydrolyzes indole-3-acetic acid （IAA）-glucose into IAA and glucose （Ishimaru et al., 2013）.展开更多
status, the incidence of complications, and completion rate of radiotherapy were evaluated. Besides, the length of hospital stay （LOS） and the in-patient cost were also compared between these two groups. Results： A...status, the incidence of complications, and completion rate of radiotherapy were evaluated. Besides, the length of hospital stay （LOS） and the in-patient cost were also compared between these two groups. Results： At the completion of CRF, the nutritional status in the NST group were much better than those in the control group, as evidenced by prealbumin （ALB）, transferrin, and ALB parameters （P = 0.001, 0.000, and 0.000, respectively）. The complication incidences, including bone marrow suppression （20% vs. 48%, P = 0.037） and complications related infections （ 12% vs. 44%, P = 0.012）, in the NST group were lower and significantly different from the control group. In addition, only one patient in the NST group did not complete the planned radiotherapy while 6 patients in the control group had interrupted or delayed radiotherapy （96% vs. 76%, P - 0.103）. Furthemlore, the average LOS was decreased by 4.5 days （P = 0.001 ） and in-patient cost was reduced to 1.26 ± 0.75 thousand US dollars person-times （P 〉 0.05） in the NST group. Conelusions： A NST could provide positive effects in esophageal cancer patients during concurrent CRT on maintaining their nutrition status and improving the compliance of CRF. Moreover, the NST could be helpful on reducing LOS and in-patient costs.展开更多
INTRODUCTIONThe prevalence of hyperuricenlia （HUA） has increased in China in the recent years in relation to socioeconomic developments and changing lifestyles and diets, with a trend toward onset at younger age. HU...INTRODUCTIONThe prevalence of hyperuricenlia （HUA） has increased in China in the recent years in relation to socioeconomic developments and changing lifestyles and diets, with a trend toward onset at younger age. HUA has become the second most common metabolic disease after diabetes mellitus. Like gout, HUA is also associated with the occurrence and progression of disorders of the urinary, endocrine, metabolic, cardio-cerebrovascular, and other systems.展开更多
Background:On May 8,2018,the China National Medical Products Administration(NMPA)approved anlotinib,an orally administered anti-angiogenesis inhibitor,for the treatment of patients with advanced non-small cell lung ca...Background:On May 8,2018,the China National Medical Products Administration(NMPA)approved anlotinib,an orally administered anti-angiogenesis inhibitor,for the treatment of patients with advanced non-small cell lung can-cer(NSCLC)who have progressed after treatment with two or more lines of prior systemic chemotherapy.Main body of the abstract:China NMPA reviewed and inspected a regional double-blinded,placebo-controlled,Phase III trial comparing the overall survival(OS)of NSCLC patients between the anlotinib and placebo arms.A total of 437 patients were randomized(2:1)to receive either anlotinib(n=294)or placebo(n=143)once daily on a 2-week on and 1-week off schedule.Patients with epidermal growth factor receptor(EGFR)or activating anaplastic lymphoma kinase(ALK)genomic tumor aberrations should have disease progression on NMPA-approved therapy.Anlotinib is the first NMPA-approved drug for patients with advanced NSCLC who have progressed on at least two lines of prior systemic chemotherapies in China.The approval was based on a statistically and clinically significant improvement in median OS with anlotinib(9.46 months)compared with placebo[6.37 months;hazard ratio(HR])=0.70,95%confidence interval(CI)=0.55-0.89;two-sided log-rank P=0.002].The confirmed objective response rate(ORR)was 9.2%in the anlotinib arm and 0.7%in the placebo arm.The median duration of response(DoR)was 4.83 months,with a 95%CI of 3.31-6.97 months.The toxicity profile of anlotinib was consistent with that of known anti-angiogenesis inhibitors.Common adverse drug reactions(ADRs)in anlotinib-treated patients included hypertension(67.4%),hand-foot syndrome(43.9%),hemoptysis(14.0%),thyroid stimulating hormone(TSH)elevation(46.6%),and corrected QT interval(QTc)prolongation(26.2%).Short conclusion:Anlotinib demonstrated a clinically significant OS prolongation as a novel therapeutic option for advanced or metastatic NSCLC following at least two lines of chemotherapy.展开更多
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 conti...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.展开更多
文摘营养不良对恶性肿瘤患者的不利影响贯穿其整个病程.肿瘤患者的营养状况如何未见大样本报道,而且已有报道差异很大,本研究旨在调查中国常见恶性肿瘤患者营养不良状况及营养治疗现状.本次观察性多中心研究采用两阶段随机抽样方法抽取全国22个主要省市80家三甲医院共47488例16种常见恶性肿瘤住院患者,以患者主观整体评估(Patient-Generated Subjective Global Assessment,PG-SGA)评估患者营养状况,以定量评估区分营养不良严重程度:0~1分无营养不良,2~3分、4~8分、≥9分分别定义为可疑/轻度、中度、重度营养不良.方差分析比较不同特征肿瘤患者PG-SGA评分.肿瘤患者中、重度营养不良的发病率为58.2%(中度32.1%、重度26.1%),22.2%为可疑/轻度营养不良,只有19.6%的患者无营养不良.营养不良的发病存在瘤种、年龄、性别、肿瘤分期、治疗情况及地区差异:胰腺癌患者PG-SGA评分最高(9.58±5.74),乳腺癌患者PG-SGA评分最低(3.51±3.49);<45岁年龄组患者PG-SGA评分最低(4.84±4.50),≥70岁年龄组患者PG-SGA评分最高(7.82±5.10);女性肺癌(5.87vs.5.60,P=0.006)和胃癌(8.36 vs.7.81,P<0.001)PG-SGA评分高于男性;TNM分期较高的患者其PG-SGA评分也较高,其中胰腺癌Ⅲ、Ⅳ期患者PG-SGA评分最高,乳腺癌Ⅰ~Ⅲ期患者PG-SGA评分均低于4分(3.05±2.83);接受手术治疗的患者PG-SGA评分最高(6.22±4.74),而目前还没有接受任何治疗的患者评分最低(5.61±4.68);华中区域PG-SGA评分最低(4.82±4.16),华东区域PG-SGA评分最高(7.31±5.53).此外,在某些肿瘤类型中,不同医疗保险类型、受教育水平、职业、居住地、民族的患者PG-SGA评分也有显著差异,农民、小学及以下低教育水平患者营养状况最差.68.78%的肿瘤患者没有获得任何营养治疗,重度营养不良(PG-SGA≥9)肿瘤患者的无营养治疗比例仍然高达55.03%.以上结果说明,中国常见恶性肿瘤患者营养不良发生率
基金Acknowledgements This work was supported by the National Key Technology R＆D Program （No. 2015ZX09501-004-001-008）, the National TCM Industry Science and Technology Program （No. 201507004-04）, the National Natural Science Foundation of China （Nos. 81373984, 81503350, and 81403126）, and the Beijing Natural Science Foundation （No. 7152142）. The authors wish to acknowledge Jiyan Chen for providing photographs of fraudulent Heshouwu, Yonghe Zhang for determining the pesticides, and Dongping Xu for his suggestion regarding the scale table of ECCIA.
文摘Herbal medicines have recently been recognized as the second most common cause of drug-induced liver injury （DILI） in the United States. However, reliable methods to identify the DILl causality of some herbs, such as Heshouwu （dried root ofPolygonum multiflorum）, remain lacking. In this study, a total of 12 307 inpatients with liver dysfunction and 147 literature-reported cases of Heshouwu DILI were screened. A general algorithm indicated that only 22.5% （9/40） and 30.6% （45/147） of all hospitalization and literature case reports, respectively, demonstrate the high probability of DILI causality of Heshouwu. By contrast, 95% （19/20） of all cases prospectively investigated by pharmacognosy, phytochemistry, and metabolomic tests exhibited highly probable causality, including a patient who was previously incorrectly attributed and a case that was excluded from Heshouwu causality by pharmacognostic evidence. Toxin （heavy metals, pesticides, and mycotoxins） contamination was also excluded from Heshouwu DILI causality. The objectivity of these screening methods for Heshouwu DILI diagnosis addresses safety concerns regarding stilbene-containing herbal medicines and dietary supplements.
基金This work was supported by grants from the Chinese Academy of Sciences （XDA08020108-3）, the National Natural Science Foundation of China （91435113, 31371605）, National Program on Key Basic Research Project （973 Project, 2014CB943404） and Chinese High-yielding Transgenic Program （2016ZX08001-004）,
文摘Dear Editor, Grain length （size） and weight are essential components of crop yield. To date, many QTLs/genes for these traits have been identified. GS3 encodes a putative transmembrane protein and functions as a negative regulator, and its larger-grain allele contains a nonsense mutation causing a 178-aa truncation （Fan et al., 2006）. GL3.1/qGL3 encodes a putative protein phosphatase and also acts as a negative regulator of grain size （Qi et al., 2012; Zhang et al., 2012）. Another negative regulator of grain size and weight is TGW6, which hydrolyzes indole-3-acetic acid （IAA）-glucose into IAA and glucose （Ishimaru et al., 2013）.
文摘status, the incidence of complications, and completion rate of radiotherapy were evaluated. Besides, the length of hospital stay （LOS） and the in-patient cost were also compared between these two groups. Results： At the completion of CRF, the nutritional status in the NST group were much better than those in the control group, as evidenced by prealbumin （ALB）, transferrin, and ALB parameters （P = 0.001, 0.000, and 0.000, respectively）. The complication incidences, including bone marrow suppression （20% vs. 48%, P = 0.037） and complications related infections （ 12% vs. 44%, P = 0.012）, in the NST group were lower and significantly different from the control group. In addition, only one patient in the NST group did not complete the planned radiotherapy while 6 patients in the control group had interrupted or delayed radiotherapy （96% vs. 76%, P - 0.103）. Furthemlore, the average LOS was decreased by 4.5 days （P = 0.001 ） and in-patient cost was reduced to 1.26 ± 0.75 thousand US dollars person-times （P 〉 0.05） in the NST group. Conelusions： A NST could provide positive effects in esophageal cancer patients during concurrent CRT on maintaining their nutrition status and improving the compliance of CRF. Moreover, the NST could be helpful on reducing LOS and in-patient costs.
文摘INTRODUCTIONThe prevalence of hyperuricenlia （HUA） has increased in China in the recent years in relation to socioeconomic developments and changing lifestyles and diets, with a trend toward onset at younger age. HUA has become the second most common metabolic disease after diabetes mellitus. Like gout, HUA is also associated with the occurrence and progression of disorders of the urinary, endocrine, metabolic, cardio-cerebrovascular, and other systems.
基金This work was supported by the Grant from Chinese National Major Project for New Drug Innovation(Grant No.2017ZX09304015)
文摘Background:On May 8,2018,the China National Medical Products Administration(NMPA)approved anlotinib,an orally administered anti-angiogenesis inhibitor,for the treatment of patients with advanced non-small cell lung can-cer(NSCLC)who have progressed after treatment with two or more lines of prior systemic chemotherapy.Main body of the abstract:China NMPA reviewed and inspected a regional double-blinded,placebo-controlled,Phase III trial comparing the overall survival(OS)of NSCLC patients between the anlotinib and placebo arms.A total of 437 patients were randomized(2:1)to receive either anlotinib(n=294)or placebo(n=143)once daily on a 2-week on and 1-week off schedule.Patients with epidermal growth factor receptor(EGFR)or activating anaplastic lymphoma kinase(ALK)genomic tumor aberrations should have disease progression on NMPA-approved therapy.Anlotinib is the first NMPA-approved drug for patients with advanced NSCLC who have progressed on at least two lines of prior systemic chemotherapies in China.The approval was based on a statistically and clinically significant improvement in median OS with anlotinib(9.46 months)compared with placebo[6.37 months;hazard ratio(HR])=0.70,95%confidence interval(CI)=0.55-0.89;two-sided log-rank P=0.002].The confirmed objective response rate(ORR)was 9.2%in the anlotinib arm and 0.7%in the placebo arm.The median duration of response(DoR)was 4.83 months,with a 95%CI of 3.31-6.97 months.The toxicity profile of anlotinib was consistent with that of known anti-angiogenesis inhibitors.Common adverse drug reactions(ADRs)in anlotinib-treated patients included hypertension(67.4%),hand-foot syndrome(43.9%),hemoptysis(14.0%),thyroid stimulating hormone(TSH)elevation(46.6%),and corrected QT interval(QTc)prolongation(26.2%).Short conclusion:Anlotinib demonstrated a clinically significant OS prolongation as a novel therapeutic option for advanced or metastatic NSCLC following at least two lines of chemotherapy.
文摘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.
