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一周研究进展荟萃:轻中度饮酒亦增加患癌风险,但男女有别

2015-09-21 MedSci MedSci原创

1.BMJ:轻、中度饮酒确实增加癌症风险,但男女有差别 研究人员进行此项研究的目的是分别量化女性和男性各个层面饮酒的总体癌症风险,重点在于轻至中度饮酒和不吸烟者;并评估饮酒模式对总体癌症风险的影响。 女性和男性参与者中分别有19269和7571(不包括非晚期前列腺癌)例癌症事件,研究超过3144853人/年。对于在男性中预先定义的酒精与癌症相关,风险并没有在轻,



1.BMJ:轻、中度饮酒确实增加癌症风险,但男女有差别

研究人员进行此项研究的目的是分别量化女性和男性各个层面饮酒的总体癌症风险,重点在于轻至中度饮酒和不吸烟者;并评估饮酒模式对总体癌症风险的影响。

女性和男性参与者中分别有19269和7571(不包括非晚期前列腺癌)例癌症事件,研究超过3144853人/年。对于在男性中预先定义的酒精与癌症相关,风险并没有在轻,中度饮酒并且不吸烟者中增加(Ptrend=0.18)。然而,对于女性,即使酒精摄入量5-14.9g/天增加了酒精相关的癌症风险(相对风险1.13(95%置信区间1.06至1.20)),例如乳腺癌。在调整总酒精摄入量后,更加频繁和大量的饮酒不会进一步与总癌症风险相关。

轻、中度饮酒与癌症总风险略有增加有关。对于男性不吸烟者,轻度和中度饮酒(每天最多两杯)没有明显增加酒精有关的癌症风险。然而,对于从不吸烟的女性,甚至每天的饮酒量在含酒精饮料的范围内也会增加相关癌症的风险(主要是乳腺癌)。




2. J Neurosci:科学家发现了大脑中的“酗酒神经元”

近日,科学家表示,已经发现了大脑中一群神经元是否可影响人们酗酒成瘾,最终找到治愈酗酒及其他成瘾的方法。

研究发现:背侧纹状体是驱动目标导向行为的区域,酒精可“持续改变此区域神经元的形态。

神经的物理结构改变

多巴胺D1神经元激活的改变可能与亚细胞水平的物理改变有关。重度饮酒可引起D1-MSNs中谷氨酰胺能突触的塑性变形,但并不会引起背侧纹状体内D2-MSNs的塑性改变。而这种改变可促进酒精的进一步消耗。Dr. Wang说道:“如果我们抑制D1受体的活性,那么我们便有可能抑制酒精的消耗。

研究人员提出了药物治疗酒精中毒的前景:“阻断这些群神经元的活性可减少酒精的摄入。”




3.J Phys Chem B:辣椒素是如何杀死癌细胞的?

辣椒素是辣椒中“产热”的成分,可用来缓解疼痛。近日有研究表明,大剂量的辣椒素可杀死前列腺癌细胞。

研究人员已经发现,结合至细胞表面并可影响细胞膜的分子可围绕在细胞周围并保护细胞。

通过监测细胞的自然荧光科学家们识别出了辣椒素与细胞膜之间的相互作用。该研究表明,辣椒素可集中在细胞的周围,待辣椒素的水平达到一定的程度后,辣椒素可导致细胞膜的破裂。在更多的研究的帮助下,该研究发现或可为癌症或其他疾病的治疗带来新的治疗方法。




4.Circulation:吸烟显著增加糖尿病患者的总死亡率及心血管事件发生率

背景:糖尿病患者抽烟较为普遍,量化抽烟与患者死亡率和发病率危险因素的相关性,对糖尿病患者的管理非常重要。

方法和结果:搜索2015年5月之前MEDLINE和EMBASE数据库中的文献,应用随机效应模型得到多变量校正相对危险度。一共包括89个队列研究。与未吸烟者相比,吸烟患者总死亡率(1.19; 1.11-1.28),心血管疾病患者(1.15; 1.00-1.32),CVD患者(1.09; 1.05-1.13),CHD患者 (1.14; 1.00-1.30)的死亡率轻度升高。但是,卒中患者死亡率没有影响(1.04; 0.87-1.23)。

结论:抽烟显著增加糖尿病患者总死亡率以及心血管事件发生,与当前抽烟患者相比,戒烟与患者死亡率以及心血管事件危险因素下降有关。这项研究为推荐糖尿病患者戒烟提供了强有力的证据。




5. Infect Immun:牙周致病菌可导致动脉粥样硬化的发生

牙周炎是心脏病发生的一个危险因素,目前有研究表明,牙周致病菌可引起机体基因表达的改变,促进主动脉平滑肌细胞炎症及动脉粥样硬化的发生。

牙龈卟啉单胞菌是牙周的一个主要致病菌,目前已在心脏病患者的动脉斑块中发现。研究发现牙龈卟啉单胞菌可引起并加速冠状动脉及主动脉粥样硬化斑块的形成。

牙龈卟啉单胞菌所产生的毒力因子——牙龈蛋白酶(Gingipains),可增加平滑肌细胞内促炎性血管生成素2的表达抑制促炎性血管生成素1的表达。而炎症在动脉粥样硬化的发展过程中扮演了重要的角色。

与牙龈蛋白酶一样,肿瘤坏死因子(TNF),炎性细胞因子以及心血管发生的危险因子也可通过两种血管生成素诱导并促进动脉粥样硬化的发生。然而,研究人员发现,牙龈素可独立于TNF之外诱导并促进动脉粥样硬化的发生。




6.Lancet Dia& Endo:远离糖尿病,预防很重要!(DPP试验)

有效的预防世界性流行疾病--2型糖尿病是必要的。研究人员在糖尿病预防计划研究(DPP)的3年里调查了生活方式干预和二甲双胍对预防糖尿病长期有益的影响程度,并评估这些干预措施能否降低糖尿病相关的微血管并发症。

DPP(1996-2001)是一项随机试验,在一组被选为有糖尿病风险的人群中比较了密集的生活方式干预或二甲双胍与安慰剂的效果。

生活方式干预或二甲双胍显著减轻了糖尿病超过15年的发展。在治疗组之间的微血管结果总体上没有差异;然而,这些没有患糖尿病的参与者比那些患糖尿病的参与者的微血管并发症发病率较低。该结果支持了预防糖尿病的重要性。

MedSci点评:

这项研究结果与中国的大型研究结果类似,生活方式干预对糖尿病进程具有重要的阻止作用,其保护作用可能能持续达15年!因此,生活方式干预有必要在人群中进行广泛推行!




7.Lancet:憋气并抬高双腿:能有效终止室上速(REVERT试验)

Valsalva动作,也称瓦氏试验,因其简单无创,首次急诊的室上性心动过速患者常常使用,但是由于做得不到位,成功率较低只有5%~20%。

而近期发表的REVERT研究改进了Valsalva动作:让患者在半卧位憋气之后立即平卧,并由他人抬高其双腿。而且证明这种改进很有成效。

研究表明,这一改进的Valsalva动作,较之传统半卧位可显著提高室上性心动过速,前者仅有17%成功恢复窦性心律,而改进动作后,治疗成功率达43.5%。

这项随机对照研究,共纳入10个急诊室就诊的433例室上性心动过速患者进行了研究,包括房颤和房扑患者。主要了解改变Valsalva动作的姿势是否可以改善治疗成功率,主要研究终点为干预后1分钟恢复窦性心律。


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  3. 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  4. 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href='/topic/show?id=3f225299942' target=_blank style='color:#2F92EE;'>#患癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52999, encryptionId=3f225299942, topicName=患癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b2c2959841, createdName=zzc2212, createdTime=Wed Sep 23 07:09:00 CST 2015, time=2015-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1601357, encodeId=4da8160135e61, content=<a href='/topic/show?id=5baa5299111' target=_blank style='color:#2F92EE;'>#患癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52991, encryptionId=5baa5299111, topicName=患癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Sep 23 07:09:00 CST 2015, time=2015-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37154, encodeId=24113e154fe, content=非常不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=154, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7ceOChkqicg6SzjqymjoEtLx55A9HNpmV1quNDdicpmTPZp1WXCq35u64iaCjRhibmrEPN5JHdvOZt9Ajj4MxzLbJ9/0, createdBy=ddf3111026, createdName=jawel, createdTime=Tue Sep 22 21:25:00 CST 2015, time=2015-09-22, status=1, ipAttribution=)]
    2015-10-31 sjq027
  5. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37154, encodeId=24113e154fe, content=非常不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=154, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7ceOChkqicg6SzjqymjoEtLx55A9HNpmV1quNDdicpmTPZp1WXCq35u64iaCjRhibmrEPN5JHdvOZt9Ajj4MxzLbJ9/0, createdBy=ddf3111026, createdName=jawel, createdTime=Tue Sep 22 21:25:00 CST 2015, time=2015-09-22, status=1, ipAttribution=)]
    2015-10-11 hlycom3356

    感谢作者分享

    0

  6. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37154, encodeId=24113e154fe, content=非常不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=154, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7ceOChkqicg6SzjqymjoEtLx55A9HNpmV1quNDdicpmTPZp1WXCq35u64iaCjRhibmrEPN5JHdvOZt9Ajj4MxzLbJ9/0, createdBy=ddf3111026, createdName=jawel, createdTime=Tue Sep 22 21:25:00 CST 2015, time=2015-09-22, status=1, ipAttribution=)]
    2015-09-23 x35042875

    解读EMPA-REG OUTCOME研究 作者:河北省人民医院 郭艺芳 在2015年EASD年会期间,揭晓了举世瞩目的降糖治疗试验EMPA-REG OUTCOME研究结果。

    0

  7. 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  8. 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    2015-09-23 zhaojie88
  10. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37154, encodeId=24113e154fe, content=非常不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=154, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7ceOChkqicg6SzjqymjoEtLx55A9HNpmV1quNDdicpmTPZp1WXCq35u64iaCjRhibmrEPN5JHdvOZt9Ajj4MxzLbJ9/0, createdBy=ddf3111026, createdName=jawel, createdTime=Tue Sep 22 21:25:00 CST 2015, time=2015-09-22, status=1, ipAttribution=)]
    2015-09-22 jawel

    非常不错!

    0

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