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Can patients with mild non-neoplastic lesions diagnosed at baseline screening be safely exempt from surveillance: evidence from multicenter community-based cohorts

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Science China Life Sciences 2024年

作者： Siyi He Zhiyi Zhang Guohui Song Zhenhai Wang chunyun dai Shipeng Yan Kun Jiang Bingbing Song He Li Maomao Cao Dianqin Sun Fan Yang Xinxin Yan Shaoli Zhang Yi Teng Qianru Li Changfa Xia Wanqing Chen Office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Department of Gastroenterology Gansu Wuwei Tumor Hospital Cixian Cancer Institute Linzhou Cancer Hospital Center for Disease Control and Prevention of Sheyang County Department of Cancer Prevention and Control Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine Central South University Luoshan Center for Disease Control and Prevention Office for Cancer Control and Research Affiliated Cancer Hospital of Harbin Medical University

Surveillance recommendations for gastric cancer(GC) in current guidelines focused on advanced precancerous lesions and were based on precise diagnosis of severity/extent of baseline lesions. We aimed to develop a less endoscopy-related equipment-dependent risk-stratification tool, and assessed whether mild-precursor-lesion patients can be safely exempt from surveillance. In the multicenter communitybased cohort, 75,051 participants receiving baseline endoscopy were enrolled during 2015–2017 and followed-up until 2021. Cumulative incidence rates(CIRs) of GC for precancerous-conditions were calculated by Kaplan-Meier method and compared by Log-rank tests. Mixedeffects Cox regression models were used to detect potential factors for progression towards GC. A risk score was calculated as counts of selected factors. An independent cohort, including 26,586 participants was used for external validation. During a median follow-up of6.25 years, CIRs of GC were 0.302%, 0.436%, and 4.756% for normal group, non-neoplastic(atrophic gastritis/intestinal metaplasia) and neoplastic lesions(low-grade/high-grade dysplasia), respectively(Ptrend<0.001). Four predictors, including male, ≥60 years, smoking, and limited vegetable consumption, were selected for risk-stratification. High-risk patients(≥3 risk factors) with non-neoplastic lesions showed higher GC risks(adjusted HR=7.73, 95%CI: 4.29–13.92), and their four-year CIR reached the one-year CIR of neoplastic lesions. Further categorizing non-neoplastic lesions by histological grade, both patients with moderate-to-severe lesions(aHR=3.07, 95%CI: 1.67–5.64) and high-risk patients with mild lesions(aHR=7.29, 95%CI: 3.58–14.86) showed higher risks. Consistent trends were observed in validation cohort. High-risk mild-precursor-lesion patients should receive surveillance within 3–5 years after baseline screening. Our study provides evidence on supplementing current guideline recommendations.

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Efficacy of ctDNA methylation combined with traditional detection modality to detect liver cancer among high-risk patients:A multicenter diagnostic trial

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Chinese Journal of Cancer Research 2023年第1期35卷 58-65页

作者： Maomao Cao Jufang Shi Changfa Xia He Li Wei Cai Xianyun Qi chunyun dai Wanqing Chen Office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Prevention and Control of Chronic Noncommunicable Diseases Binhai County Center for Disease Control and PreventionBinhai 224521China Chronic Noncommunicable Diseases Prevention and Treatment Department Yingdong District Center for Disease Control and PreventionFuyang 236142China Department for Chronic Noncommunicable Diseases Control Sheyang Center for Disease Control and PreventionSheyang 224300China

Objective:Circulating tumor DNA(ctDNA)and alpha-fetoprotein(AFP)plus ultrasound(US)have been considered to have high diagnostic accuracy for cancer detection,however,the efficacy of ctDNA methylation combined with the traditional detection modality of liver cancer has not been tested in a Chinese independent ***:The high-risk individuals aged between 35 and 70 years who were diagnosed with liver cirrhosis or had moderate and severe fatty liver were eligible for *** participants were invited to receive a traditional examination[referring to AFP plus US],and ctDNA methylation,*** sensitivity and specificity of different diagnostic tools were *** logistic regression model was applied to estimate the area under the curve(AUC),which was further validated by 10-fold internal ***:A total of 1,205 individuals were recruited in our study,and 39 participants were diagnosed with liver *** sensitivity of AFP,US,US plus AFP,and the combination of US,AFP,and ctDNA methylation was33.33%,56.41%,66.67%,and 87.18%,*** corresponding specificity of AFP,US,US plus AFP,and the combination of all modalities was 98.20%,99.31%,97.68%,and 97.68%,*** AUCs of AFP,US,US plus AFP,and the combination of AFP,US,and ctDNA methylation were 65.77%,77.86%,82.18%,and92.43%,*** internally validated AUCs of AFP,US,US plus AFP,and the combination of AFP,US,and ctDNA methylation were 67.57%,83.26%,86.54%,and 93.35%,***:The ctDNA methylation is a good complementary to AFP and US for the detection of liver cancer.

关键词： Liver cancer detection ctDNA methylation diagnostic performance

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A male-ABCD algorithm for hepatocellular carcinoma risk prediction in HBs Ag carriers

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Chinese Journal of Cancer Research 2021年第3期33卷 352-363页

作者： Yuting Wang Minjie Wang He Li Kun Chen Hongmei Zeng Xinyu Bi Zheng Zhu Yuchen Jiao Yong Wang Jian Zhu Hui Zhao Xiang Liu chunyun dai Chunsun Fan Can Zhao Deyin Guo Hong Zhao Jianguo Zhou Dongmei Wang Zhiyuan Wu Xinming Zhao Wei Cui Xuehong Zhang Jianqiang Cai Wanqing Chen Chunfeng Qu State Key Lab of Molecular Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Clinical Laboratory National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China National Central Cancer Registry National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Hepatobiliary Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Diagnostic Radiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Ultrasonography National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Qidong Liver Cancer Institute&Qidong People’s Hospital Qidong 226200China Lingbi Center for Disease Control and Prevention Suzhou 234200China Mengcheng Center for Disease Control and Prevention Bozhou 233500China Sheyang Center for Disease Control and Prevention Yancheng 224300China Shenqiu County Center for Disease Control and Prevention Zhoukou 411624China Dancheng Center for Disease Control and Prevention Zhoukou 477150China Channing Division of Network Medicine Department of MedicineBrigham and Womens Hospital and Harvard Medical SchoolBostonMA 02115USA Department of Nutrition T

Objective: Hepatocellular carcinoma(HCC) development among hepatitis B surface antigen(HBs Ag) carriers shows gender disparity, influenced by underlying liver diseases that display variations in laboratory tests. We aimed to construct a risk-stratified HCC prediction model for HBs Ag-positive male ***: HBs Ag-positive males of 35-69 years old(N=6,153) were included from a multi-center populationbased liver cancer screening study. Randomly, three centers were set as training, the other three centers as validation. Within 2 years since initiation, we administrated at least two rounds of HCC screening using Bultrasonography and α-fetoprotein(AFP). We used logistic regression models to determine potential risk factors,built and examined the operating characteristics of a point-based algorithm for HCC risk ***: With 2 years of follow-up, 302 HCC cases were diagnosed. A male-ABCD algorithm was constructed including participant's age, blood levels of GGT(γ-glutamyl-transpeptidase), counts of platelets, white cells,concentration of DCP(des-γ-carboxy-prothrombin) and AFP, with scores ranging from 0 to 18.3. The area under receiver operating characteristic was 0.91(0.90-0.93), larger than existing models. At 1.5 points of risk score,26.10% of the participants in training cohort and 14.94% in validation cohort were recognized at low risk, with sensitivity of identifying HCC remained 100%. At 2.5 points, 46.51% of the participants in training cohort and 33.68% in validation cohort were recognized at low risk with 99.06% and 97.78% of sensitivity, respectively. At 4.5 points, only 20.86% of participants in training cohort and 23.73% in validation cohort were recognized at high risk,with positive prediction value of 22.85% and 12.35%, ***: Male-ABCD algorithm identified individual's risk for HCC occurrence within short term for their HCC precision surveillance.

关键词： Hepatocellular carcinoma asymptotic HBs Ag carriers risk prediction model screening laboratory tests

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原发性高血压患者血压变异性与血浆神经肽Y及神经降压素水平关系研究

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现代医药卫生 2018年第20期34卷 3132-3134页

作者：何杰普春云戴亨华重钢总医院心血管内科重庆400080 重庆医科大学附属第一医院心血管内科重庆400016

目的探讨原发性高血压患者血压变异性(BPV)与血浆神经肽Y(NPY)及神经降压素(NT)水平关系。方法选择2014年12月至2016年6月重钢总医院收治的原发性高血压患者60例,根据血压水平分为原发性高血压1级(高血压1组,22例)、原发性高血压2级(高... 详细信息

目的探讨原发性高血压患者血压变异性(BPV)与血浆神经肽Y(NPY)及神经降压素(NT)水平关系。方法选择2014年12月至2016年6月重钢总医院收治的原发性高血压患者60例,根据血压水平分为原发性高血压1级(高血压1组,22例)、原发性高血压2级(高血压2组,20例)及原发性高血压3级(高血压3组,18例),同时选择健康体检者20例作为对照组。各组均进行24 h动态血压监测,同时检测血浆NPY及NT水平。结果高血压患者(高血压1、2、3组)的24小时收缩压变异(24hSBPV)、昼间收缩压变异(DSBPV)、夜间收缩压变异(NSBPV)、24小时舒张压变异(24hDBPV)、昼间舒张压变异(DDBPV)、夜间舒张压变异(NDBPV)均高于对照组,高血压3组以上指标均显著高于高血压1、2组,高血压2组以上指标显著高于高血压1组,差异均有统计学意义(P<0.05);高血压患者(高血压1、2、3组)的血浆NPY水平均高于对照组,高血压3组均显著高于高血压1、2组,高血压2组显著高于1组,差异均有统计学意义(P<0.05);高血压患者(高血压1、2、3组)的血浆NT水平均低于对照组,高血压3组均显著低于高血压1、2组,高血压2组显著低于高血压1组,差异均有统计学意义(P<0.05)。Pearson相关性分析显示,24hSBPV、DSBPV、NSBPV、24hDBPV、DDBPV、NDBPV均与NPY呈正相关(P<0.05),与NT呈负相关(P<0.05)。结论血压变异性升高与NPY存呈正相关,与NT呈负相关,NPY及NT可能参与了血压变异发病机制。

关键词：高血压神经肽Y 变异性神经降压素

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风场对鄱阳湖丰水期表层蓝藻密度的影响

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湖泊科学 2024年第2期36卷 377-388页

作者：杨平刘聚涛胡芳温春云文慧吴桨付莎莎戴国飞江西省水利科学院南昌330029 江西省鄱阳湖流域生态水利技术创新中心南昌330029

目前,在风场对蓝藻的影响研究方面,国内针对太湖、滇池、巢湖等浅水湖泊的研究较多,针对鄱阳湖的研究则多集中于蓝藻群落特征及其与营养盐之间的关系。近年来,作为长江流域重要的通江湖泊,处于轻度富营养化状态的鄱阳湖水体蓝藻水华在... 详细信息

目前,在风场对蓝藻的影响研究方面,国内针对太湖、滇池、巢湖等浅水湖泊的研究较多,针对鄱阳湖的研究则多集中于蓝藻群落特征及其与营养盐之间的关系。近年来,作为长江流域重要的通江湖泊,处于轻度富营养化状态的鄱阳湖水体蓝藻水华在局部库湾和部分水域出现,风场如何影响鄱阳湖表层蓝藻密度是一个值得探讨的问题。20192021年,在鄱阳湖布设13~49个采样点,于平水期、丰水期和枯水期现场采集各个点位表层水样、藻类、风场和流场数据,分析风场对鄱阳湖丰水期表层蓝藻密度的影响。结果表明,20192021年鄱阳湖丰水期风速与表层蓝藻密度呈显著正相关性,风场对水体的充分混合及驱动水体形成的风生流是促进蓝藻生长的原因之一。在流速较高(>0.05 m/s)的区域,无论风速高于还是低于临界风速(3~4 m/s),鄱阳湖表层蓝藻密度的空间分布受流场的影响更大;在流速较低(<0.05 m/s)的区域,风速在临界风速以下时,鄱阳湖表层蓝藻密度的空间分布受风场影响更大。20192021年鄱阳湖丰水期蓝藻密度超过水华暴发的阈值,但在高风速高流速的共同作用下未能发生大范围的蓝藻水华,仅能在风速适宜(<3~4 m/s)、流速较低(<0.05 m/s)的内湾、尾闾区等区域发生小面积的蓝藻水华。鄱阳湖丰水期水体处于长江顶托的低流速且微风条件下时,发生大面积蓝藻水华的概率可能会明显上升。

关键词：鄱阳湖丰水期蓝藻水华风场

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浅谈当前农村土地流转过程中存在的问题及对策建议

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安徽农学通报 2011年第2期17卷 6-6,31页

作者：代春云冠县辛集乡政府山东冠县252514

分析了当前农村土地流转过程中存在的主要问题,并提出了相应的对策建议,主要包括:提高认识,加大对土地流转政策的宣传;规范土地流转程序;培育土地流转服务中介组织,健全土地流转机制;建立和完善农村社会保障体系等。

关键词：农村土地流转问题对策

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中国2个城市和2个农村地区上消化道肿瘤高危人群分布及内镜筛查依从情况分析

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中华肿瘤杂志 2022年第6期44卷 531-539页

作者：李贺曹毛毛孙殿钦何思怡严鑫鑫杨帆张绍丽宋冰冰颜仕鹏江坤戴春云陈万青国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院癌症早诊早治办公室北京100021 黑龙江省癌症中心哈尔滨150081 湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院湖南省肿瘤防治研究办公室长沙410013 罗山县疾病预防控制中心河南省罗山县464200 射阳县疾病预防控制中心江苏省射阳县224300

目的分析城乡上消化道肿瘤高危人群的分布, 探讨上消化道肿瘤影响内镜筛查依从情况的影响因素。方法 2015—2017年, 以中国2个农村地区(河南省罗山县、江苏省射阳县)和2个城市地区(湖南省长沙市、黑龙江省哈尔滨市)为研究现场, 以现场... 详细信息

目的分析城乡上消化道肿瘤高危人群的分布, 探讨上消化道肿瘤影响内镜筛查依从情况的影响因素。方法 2015—2017年, 以中国2个农村地区(河南省罗山县、江苏省射阳县)和2个城市地区(湖南省长沙市、黑龙江省哈尔滨市)为研究现场, 以现场面对面访谈的方式对40~69岁居民开展流行病学调查及上消化道肿瘤风险评估, 并对上消化道肿瘤高危人群开展内镜筛查。采用χ^(2)检验比较农村和城市地区人群上消化道肿瘤高危者占比的差异, 农村和城市地区人群上消化道肿瘤高危人群内镜筛查依从率的影响因素分析采用多因素logistic回归分析。结果参与上消化道肿瘤筛查的40~69岁居民共48 310人, 其中, 农村地区人群占比为47.34%(22 870人), 城市地区人群占比为52.66%(25 440人)。上消化道肿瘤高危人群占比为48.71%(23 532/48 310), 农村地区高危人群占比(56.17%, 12 845/22 870)高于城市地区(42.01%, 10 687/25 440)。上消化道肿瘤高危人群参加内镜筛查依从率为46.62%(10 971/23 532), 农村和城市地区高危人群内镜筛查依从率分别为45.15%(5 799/12 845)和48.40%(5 172/10 687)。多因素logistic回归分析结果显示, 在农村地区人群中, 女性、50~69岁、学历为小学及以上、高收入、有上消化道肿瘤家族史、有胃十二指肠溃疡史、有反流性食管炎史、有浅表性胃炎史的人群有更高的内镜筛查依从率, 但有吸烟史人群的内镜筛查依从率较低(均P<0.05);城市地区人群中, 40~49岁、未接受过学校教育、低收入、有上消化道肿瘤家族史、有反流性食管炎史、有浅表性胃炎史的人群内镜参筛查依从率较高, 有吸烟史的人群内镜筛查依从率较低(均P<0.05)。结论农村人群上消化道肿瘤高危者占比高于城市人群;城市和农村上消化道肿瘤高危人群内镜筛查依从率较低, 且影响城乡人群内镜筛查依从的因素存在一定差异。

关键词：上消化道肿瘤危险因素内镜筛查依从性

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基于基本心理需要理论的孕妇分娩恐惧心理体验的质性研究

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护士进修杂志 2024年第8期39卷 860-864页

作者：王圆圆刘洪园戴佳旸郭璐余晓萍张艳朱春云孔祥仪征市人民医院江苏仪征211400 扬州大学护理学院公共卫生学院江苏扬州225009 江苏省苏北人民医院江苏扬州225009 扬州大学临床医学院江苏扬州225009

目的了解基于基本心理需要理论(BPNT)的孕妇分娩恐惧(FOC)心理体验。方法采用目的抽样法,选取2022年2-5月在扬州市3所三级医院产检的13例FOC孕妇,采用现象学分析法进行半结构式访谈,运用Colaizzi 7步分析法分析访谈资料并提炼主题。结... 详细信息

目的了解基于基本心理需要理论(BPNT)的孕妇分娩恐惧(FOC)心理体验。方法采用目的抽样法,选取2022年2-5月在扬州市3所三级医院产检的13例FOC孕妇,采用现象学分析法进行半结构式访谈,运用Colaizzi 7步分析法分析访谈资料并提炼主题。结果提炼出4个主题和7个亚主题:自主需要未满足(分娩计划参与度低、产程中自控感低)、胜任需要未满足(缺乏分娩相关知识、分娩自我效能低)、归属需要未满足(医务人员支持需要未满足、家庭支持需要未满足、同伴支持需要未满足)、积极与消极应对共存。结论医务人员应促进孕妇参与分娩计划,减少分娩失控感,提升自主需要满足;提供多形式信息支持,提升分娩自我效能,促进胜任需要满足;促进多方社会支持,提升归属需要满足;改善消极应对策略,提升基本心理需要满足,促进围产期心理健康。

关键词：孕妇分娩恐惧基本心理需要质性研究护理

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几何结构对圆内开缝圆自然对流的影响

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化工学报 2016年第S1期67卷 84-90页

作者：申春赟陆廷康戴正华杨茉上海理工大学能源与动力工程学院上海200093 上海市浦东新区特种设备监督检验所上海200136

采用SIMPLE算法,对不同几何结构圆内开缝圆自然对流换热进行数值模拟,研究了开缝度、半径比改变对流动换热的影响。结果表明,在相同条件下计算数值结果与已有的实验结果吻合良好;把内圆开缝可以强化换热,但并非开缝度越大换热越好;半径... 详细信息

采用SIMPLE算法,对不同几何结构圆内开缝圆自然对流换热进行数值模拟,研究了开缝度、半径比改变对流动换热的影响。结果表明,在相同条件下计算数值结果与已有的实验结果吻合良好;把内圆开缝可以强化换热,但并非开缝度越大换热越好;半径比对换热效果产生影响,表现为半径比越小,环形空间越窄,换热效果越差。随着半径比的增大,Keq显著增加,当半径比超过2.0时,Keq基本保持不变。

关键词：自然对流非线性动力学计算机模拟开缝度半径比

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甘蓝型油菜GPAT6基因在酵母和拟南芥中的表达分析

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分子植物育种 2023年第7期21卷 2125-2131页

作者：刘勇刘聪戴晨曦熊兴华官春云湖南农业大学农学院湖南省水稻油菜抗病育种重点实验室长沙410128

利用同源克隆法获得‘湘油15’中长度为1506 bp的GPAT6基因,并通过酿酒酵母质粒YES2.0和特异性启动子Napin构建了酵母表达载体和植物种子特异表达载体,分别转化酵母和拟南芥。气相色谱分析表明:转BnGPAT6基因的酵母中C14:0脂肪酸比对照... 详细信息

利用同源克隆法获得‘湘油15’中长度为1506 bp的GPAT6基因,并通过酿酒酵母质粒YES2.0和特异性启动子Napin构建了酵母表达载体和植物种子特异表达载体,分别转化酵母和拟南芥。气相色谱分析表明:转BnGPAT6基因的酵母中C14:0脂肪酸比对照高一倍,而C16:0,C16:1,C18:0和C18:1所占比例均明显下降。转基因拟南芥4个株系中种子的总含油量均下降,其中C16:0、C18:2和C18:3的比例略有升高。推测BnGPAT6在油菜中的功能与含油量关系不大,可能参与几丁质、软木脂等物质的生物合成途径。

关键词： GPAT6 甘蓝型油菜酵母表达拟南芥表达脂肪酸分析

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