目的探讨家庭参与式综合管理(FICare)对新生儿重症监护病房(NICU)住院早产儿肠道菌群的影响。方法采用前瞻性、观察性研究,研究对象为2015年7月至2017年6月在中南大学湘雅三医院NICU住院的早产儿44例(其中男23例,占52%)分为FICare组和非...目的探讨家庭参与式综合管理(FICare)对新生儿重症监护病房(NICU)住院早产儿肠道菌群的影响。方法采用前瞻性、观察性研究,研究对象为2015年7月至2017年6月在中南大学湘雅三医院NICU住院的早产儿44例(其中男23例,占52%)分为FICare组和非FICare组,同期儿童保健门诊满月体检的足月儿20名(其中男11名,占55%)作为对照组。所有新生儿均为全肠内喂养且出生后未接触肠道益生菌,收集临床数据。FICare组于在FICare超过2周且未接触抗菌药物1周时留取双份新鲜粪便,非FICare组与FICare组在相对应的时间点、对照组在新生儿4周龄时留取双份新鲜粪便,-80 ℃冰冻保存,标本统一进行高通量16 S rRNA肠道菌群高通量测序。应用Paired End Reads肠道菌群RNA读取软件对数据经过质量过滤,统计各样品操作分类单元(OTU)的丰度信息,以Shannon指数作为肠道菌群多样性的指标。采用单因素方差分析或非参数检验的Kruskal-Wallis H法及连续校正χ^2检验或似然比χ^2检验进行组间统计学比较。结果FICare组、非FICare组和对照组的男婴比例[52%(11/21)比52%(12/23)比55%(11/20)]、本院出生比例[90%(19/21)比87%(20/23)比85%(17/20)]及5 min Apgar评分<7分比例[14%(3/21)比9%(2/23)比5%(1/20)]的差异均无统计学意义(χ^2=0.041、0.000、0.120,P=0.980、1.000、0.729)。FICare组与非FICare组的出生胎龄、出生体重、中位开奶日龄、奶量达120 ml/(kg·d)中位日龄差异均无统计学意义[(29.7±1.8)比(29.9±1.7)周、(1 266±310)比(1 326±318)g、4比4日龄、13比11日龄,t=0.378、0.631,Z=0.666、1.014,P=0.707、0.531、0.505、0.310]。FICare组与非FICare组的母乳喂养率分别为86%(18/21)比35%(8/23),差异有统计学意义(t=11.780,P=0.001)。对照组、FICare组、非FICare组新生儿的肠道菌群多样性Shannon指数分别为0.72(0.27,2.66)、0.61(0.18,1.83)、0.52(0.08,1.71),差异无统计学意义(H=1.823,P=0.402)。FICare组、非FICare组和对展开更多
Esophageal squamous cell carcinoma continues to heavily burden clinicians worldwide. Researchers have discovered the genomic landscape of esophageal squamous cell carcinoma, which holds promise for an era of personali...Esophageal squamous cell carcinoma continues to heavily burden clinicians worldwide. Researchers have discovered the genomic landscape of esophageal squamous cell carcinoma, which holds promise for an era of personalized oncology care. One of the most pressing problems facing this issue is to improve the understanding of the newly available genomic data, and identify the driver-gene mutations, pathways, and networks. The emergence of a legion of novel targeted agents has generated much hope and hype regarding more potent treatment regimens, but the accuracy of drug selection is still arguable. Other problems, such as cancer heterogeneity, drug resistance, exceptional responders, and side effects, have to be surmounted. Evolving topics in personalized oncology, such as interpretation of genomics data, issues in targeted therapy, research approaches for targeted therapy, and future perspectives, will be discussed in this editorial.展开更多
Early screening for colorectal cancer(CRC) holds the key to combat and control the increasing global burden of CRC morbidity and mortality. However, the current available screening modalities are severely inadequate b...Early screening for colorectal cancer(CRC) holds the key to combat and control the increasing global burden of CRC morbidity and mortality. However, the current available screening modalities are severely inadequate because of their high cost and cumbersome preparatory procedures that ultimately lead to a low participation rate. People simply do not like to have colonoscopies. It would be ideal, therefore, to develop an alternative modality based on blood biomarkers as the first line screening test. This will allow for the differentiation of the general population from high risk individuals. Colonoscopy would then become the secondary test, to further screen the high risk segment of the population. This will encourage participation and therefore help to reach the goal of early detection and thereby reduce the anticipated increasing global CRC incidence rate. A blood-based screening test is anappealing alternative as it is non-invasive and poses minimal risk to patients. It is easy to perform, can be repeated at shorter intervals, and therefore would likely lead to a much higher participation rate. This review surveys various blood-based test strategies currently under investigation, discusses the potency of what is available, and assesses how new technology may contribute to future test design.展开更多
文摘目的探讨家庭参与式综合管理(FICare)对新生儿重症监护病房(NICU)住院早产儿肠道菌群的影响。方法采用前瞻性、观察性研究,研究对象为2015年7月至2017年6月在中南大学湘雅三医院NICU住院的早产儿44例(其中男23例,占52%)分为FICare组和非FICare组,同期儿童保健门诊满月体检的足月儿20名(其中男11名,占55%)作为对照组。所有新生儿均为全肠内喂养且出生后未接触肠道益生菌,收集临床数据。FICare组于在FICare超过2周且未接触抗菌药物1周时留取双份新鲜粪便,非FICare组与FICare组在相对应的时间点、对照组在新生儿4周龄时留取双份新鲜粪便,-80 ℃冰冻保存,标本统一进行高通量16 S rRNA肠道菌群高通量测序。应用Paired End Reads肠道菌群RNA读取软件对数据经过质量过滤,统计各样品操作分类单元(OTU)的丰度信息,以Shannon指数作为肠道菌群多样性的指标。采用单因素方差分析或非参数检验的Kruskal-Wallis H法及连续校正χ^2检验或似然比χ^2检验进行组间统计学比较。结果FICare组、非FICare组和对照组的男婴比例[52%(11/21)比52%(12/23)比55%(11/20)]、本院出生比例[90%(19/21)比87%(20/23)比85%(17/20)]及5 min Apgar评分<7分比例[14%(3/21)比9%(2/23)比5%(1/20)]的差异均无统计学意义(χ^2=0.041、0.000、0.120,P=0.980、1.000、0.729)。FICare组与非FICare组的出生胎龄、出生体重、中位开奶日龄、奶量达120 ml/(kg·d)中位日龄差异均无统计学意义[(29.7±1.8)比(29.9±1.7)周、(1 266±310)比(1 326±318)g、4比4日龄、13比11日龄,t=0.378、0.631,Z=0.666、1.014,P=0.707、0.531、0.505、0.310]。FICare组与非FICare组的母乳喂养率分别为86%(18/21)比35%(8/23),差异有统计学意义(t=11.780,P=0.001)。对照组、FICare组、非FICare组新生儿的肠道菌群多样性Shannon指数分别为0.72(0.27,2.66)、0.61(0.18,1.83)、0.52(0.08,1.71),差异无统计学意义(H=1.823,P=0.402)。FICare组、非FICare组和对
文摘目的探讨早产极低出生体重儿(VLBWI)坏死性小肠结肠炎(NEC)发生前肠道菌群结构特征变化。方法采用前瞻性巢式病例对照研究。将2018年4月20日至11月20日生后24 h内收住苏州大学附属儿童医院或苏州市立医院新生儿重症监护病房(NICU)且出生体重<1500 g、出生胎龄<35周的46例早产VLBWI作为研究对象,采集所有早产VLBWI基本临床资料及粪便样本,粪便样本留取时间节点为生后1周内第1、4、7日龄,之后每周留取1次,留取终点为NEC发生或出院或生后第8周(以先到者为终点),粪便样本通过16 S rDNA高通量核苷酸测序。根据有无NEC发生分为NEC组和对照组,对照组按1∶1的比例匹配。分析2组粪便样本菌群的操作分类单元(OTU)组成、序列数及多样性shannon指数。采用t检验或非参数检验,χ^(2)检验或Fisher确切概率法进行组间比较。结果NEC组23例,其中男13例(57%),出生胎龄(29.4±1.8)周;对照组23例,其中男11例(48%),出生胎龄(29.9±1.6)周。物种丰度差异分析显示,2组厚壁菌门在7日龄均有一过性下降,对照组随日龄增加有升高趋势,而NEC组无此趋势;2组变形菌门均于7日龄升高,对照组随日龄增加丰度逐渐减低,而NEC组持续增高;NEC组菌群与对照组比较,7日龄变形菌门、γ-变形菌纲、肠杆菌科丰度均低,14日龄粪杆菌属明显高,21日龄梭菌属、链球菌属均低,28日龄厚壁菌门、梭菌纲、产气荚膜梭菌均低,变形菌门、γ-变形菌纲均高,差异均有统计学意义(U=43.00、43.00、45.00、80.00、74.00、76.00、19.00、8.00、36.00、25.00、25.00,均P<0.05)。α多样性分析结果显示,NEC组shannon指数在21、28日龄均低于对照组[2.4(1.4,3.0)比3.1(2.6,4.0),2.4(1.4,2.8)比3.9(3.3,4.2),U=67.00、12.00,P=0.027、0.001]。结论早产VLBWI在发展为NEC之前肠道菌群定植模式已改变,差异菌群的出现及菌群多样性的减低为早期识别和预防NEC发生提供可能。
基金Supported by Grants from Beijing Academic Leaders Program,NO.2009-2-17Beijing Natural Science Foundation,No.7102029+5 种基金Capital Medical Developed Research Fund,No.2007-1023New Scholar Star Program of Ministry of EducationNational Basic Research Program of China,No.2011CB504300Specialized Research Fund for the Doctoral Program of Higher Education,No.20130001110108National Natural Science Foundation for Distinguished Young Scholars,No.81301748Science Fund for Creative Research Groups of the National Natural Science Foundation of China,No.IRT13003 and No.NIH/NCI U54 CA156735
文摘Esophageal squamous cell carcinoma continues to heavily burden clinicians worldwide. Researchers have discovered the genomic landscape of esophageal squamous cell carcinoma, which holds promise for an era of personalized oncology care. One of the most pressing problems facing this issue is to improve the understanding of the newly available genomic data, and identify the driver-gene mutations, pathways, and networks. The emergence of a legion of novel targeted agents has generated much hope and hype regarding more potent treatment regimens, but the accuracy of drug selection is still arguable. Other problems, such as cancer heterogeneity, drug resistance, exceptional responders, and side effects, have to be surmounted. Evolving topics in personalized oncology, such as interpretation of genomics data, issues in targeted therapy, research approaches for targeted therapy, and future perspectives, will be discussed in this editorial.
基金Supported by The Valley Hospital Foundation Research FundThe community of The Valley Hospital in Ridgewood,NJ,especially Ms.Audrey Meyers,CEO,Mr.Anastasios Kozaitis,president of the Valley Hospital Foundation
文摘Early screening for colorectal cancer(CRC) holds the key to combat and control the increasing global burden of CRC morbidity and mortality. However, the current available screening modalities are severely inadequate because of their high cost and cumbersome preparatory procedures that ultimately lead to a low participation rate. People simply do not like to have colonoscopies. It would be ideal, therefore, to develop an alternative modality based on blood biomarkers as the first line screening test. This will allow for the differentiation of the general population from high risk individuals. Colonoscopy would then become the secondary test, to further screen the high risk segment of the population. This will encourage participation and therefore help to reach the goal of early detection and thereby reduce the anticipated increasing global CRC incidence rate. A blood-based screening test is anappealing alternative as it is non-invasive and poses minimal risk to patients. It is easy to perform, can be repeated at shorter intervals, and therefore would likely lead to a much higher participation rate. This review surveys various blood-based test strategies currently under investigation, discusses the potency of what is available, and assesses how new technology may contribute to future test design.
