结直肠癌肝转移患者血清OPN、YKL-40、HGF和VEGF-A水平及其危险因素分析

目的:检测结直肠癌肝转移患者血清骨桥蛋白(Osteopontin,OPN)、人类软骨糖蛋白-39(Human cartilage gp-39,YKL-40)、肝细胞生长因子(Hepatocyte growth factor,HGF)和血管内皮生长因子A(Vascular endothelial growth factor A,VEGF-A)水平,并分析直肠癌患者发生肝转移的危险因素。方法:收集56例发生肝转移的直结肠癌患者和50例未发生肝转移的直结肠癌患者,采用酶联免疫法检测两组患者血清OPN、YKL-40、HGF和VEGF-A的水平。收集所有患者的临床资料,分析直肠癌患者发生肝转移的危险因素。结果:结直肠癌肝转移患者血清OPN、YKL-40、HGF和VEGF-A水平均显著高于未发生肝转移的直结肠癌患者(P0.05);糖尿病、肿瘤最大直径、病理类型、分化程度、浸润深度、淋巴结转移、盆腹膜种植、肝外转移、吸烟史均与结直肠癌发生肝转移相关(P0.05);而HGF、VEGF-A、糖尿病、肿瘤最大直径≥5 cm、淋巴结转移、盆腹膜种植、肝外转移是直肠癌发生肝转移的独立危险因素(P0.05)。结论:结直肠癌肝转移患者血清OPN、YKL-40、HGF和VEGF-A明显升高,HGF、VEGF-A、糖尿病、肿瘤最大直径≥5 cm、淋巴结转移、盆腹膜种植、肝外转移是直肠癌发生肝转移的独立危险因素。     

肺癌患者生活质量调查及化疗期间发生抑郁的影响因素分析

目的:探讨肺癌患者化疗前后生活质量的变化及化疗期间发生抑郁的影响因素。方法:将2015年1月～2019年12月我院收治的80例肺癌患者纳入研究。所有患者均接受化疗干预,采用健康状况调查简表(SF-36)评分评估患者化疗前后生活质量,以抑郁自评量表(SDS)评估患者抑郁发生情况。对肺癌患者化疗期间发生抑郁的影响因素进行单因素以及多因素Logistic回归分析。结果:化疗后患者的各项生活质量评分均低于化疗前(P0.05)。80例肺癌患者化疗期间出现46例抑郁症,抑郁症发生率为57.50%。经单因素分析发现:性别、受教育程度、家庭月收入、疼痛程度、知晓病情均与肺癌患者化疗期间发生抑郁有关(P0.05)。经多因素Logistic回归分析可得:女性、家庭月收入2500元、Ⅰ度及以上疼痛、知晓病情均是肺癌患者化疗期间发生抑郁的独立危险因素(OR=7.295、1.692、3.952、4.015,P0.05)。结论:化疗会在一定程度上降低肺癌患者的生活质量,同时会增加患者抑郁症发生风险,女性、家庭月收入2500元、Ⅰ度及以上疼痛、知晓病情均是肺癌患者化疗期间发生抑郁的独立危险因素。     

腔隙性脑梗死伴脑白质病变患者血清miR-146a和NSE水平与MoCA评分的关系研究

摘要 目的：研究腔隙性脑梗死（LI）伴脑白质病变（WML）患者血清miR-146a和神经元特异性烯纯化酶（NSE）水平与蒙特利尔认知评估量表（MoCA）评分的关系。方法：纳入我院从2017年3月～2019年3月收治的LI伴WML患者108例进行研究,记作LI伴WML组。另取同期收治的单纯WML患者与单纯LI患者各100例,分别记作WML组与LI组,再取同期于我院进行体检的健康人员100例作为对照组。比较四组人员的血清miR-146a和NSE水平、MoCA评分,并作相关性分析。结果：LI伴WML组、WML组、LI组血清miR-146a相对表达量均低于对照组,而LI伴WML组血清miR-146a相对表达量又显著低于WML组、LI组（均P＜0.05）;LI伴WML组、WML组、LI组血清NSE水平均显著高于对照组,且LI伴WML组血清NSE水平均显著高于WML组、LI组（均P＜0.05）。LI伴WML组MoCA总分显著低于WML组与LI组,且WML组与LI组MoCA总分显著低于对照组（均P＜0.05）。经Pearson相关性分析可得：LI伴WML组患者血清miR-146a相对表达量与MoCA总分呈正相关关系（P＜0.05）,而血清NSE水平与MoCA总分呈负相关关系（P＜0.05）。结论：LI伴WML患者的血清miR-146a水平存在明显低表达,而NSE水平存在明显高表达,并与MoCA评分相关,两者可能在认知功能损伤的发生、发展过程中起着至关重要的作用。     

食管癌调强放射治疗的初期疗效及急性放射性肺损伤的影响因素分析

摘要 目的：探讨食管癌调强放射治疗的初期疗效及急性放射性肺损伤的影响因素。方法：选取2015年1月-2019年1月在我院进行调强放射治疗的食管癌患者322例,评价食管癌调强放射治疗后一个月的疗效;按照是否发生急性放射性肺损伤（RILI）分为急性RILI组和无急性RILI组,采用多因素Logistic回归分析分析急性RILI的影响因素。结果：调强放射治疗的完全缓解和部分缓解的患者占98.45%;322例患者中90例（27.95%）出现急性RILI,其中36例（11.18%）出现2级及以上的急性RILI;急性RILI组和无急性RILI组间卡氏（KPS）评分、淋巴结转移、基础肺疾病、V5、V10、V20、V30和全肺平均剂量（MLD）差异有统计学意义（P<0.05）;多因素Logistic回归分析显示,KPS评分<80分、有淋巴结转移、有基础肺疾病,V5≥60%、V10≥40%、V20≥28%、V30≥20%和MLD≥10Gy是食管癌调强放射治疗后急性放射性肺损伤的危险因素（P<0.05）。结论：使用调强放射治疗技术治疗食管癌的初期疗效较好,治疗过程中,应充分考虑病患的临床特征,优化放疗方案和靶区,减少急性RILI的发生,提高食管癌患者放疗后的生存质量。     

Analysis of Alkylphenol ethoxylates (APEOs) from tannery sediments using LC–MS and their environmental risks

Alkyl phenol polyethoxylates (APEOs) are a major group of high production volume chemicals, extensively used as nonionic surfactants in industrial, agricultural and domestic sectors. These surfactants and its respective metabolites are found to be persistent and toxic. Mainly, they act as endocrine disruptors by mimicking the natural hormones. India being a developing country, witnesses pollution due to various industries including tannery. In the present study, sediment samples were collected from the Vellore district of Tamil Nadu, India to investigate the occurrence of APEOs. The sediments were extracted by ultrasonication and analyzed in a liquid chromatography mass spectrometer. Octyl phenol ethoxylates (OPEOs) were not observed in any of the samples. Nonyl phenol ethoxylates (NPEOs) were detected in the range of ND – 36 mg/kg with 85 % detection frequency. The occurrence of NPEOs in sediment indicates its wide usage in tannery and its partitioning behavior in environment. The levels of NPEOs in the study were found to be unsafe according to the sediment guidelines of various studies. Since NPEOs were observed in sediment samples, possibilities of occurrence of their monomers and metabolites cannot be ruled out. Therefore, further studies are warranted for understanding the levels of monomers and metabolites in order to ascertain the environmental risks more appropriately.     

Prospects for incorporation of epigenetic biomarkers in human health and environmental risk assessment of chemicals

Epigenetic mechanisms have gained relevance in human health and environmental studies, due to their pivotal role in disease, gene × environment interactions and adaptation to environmental change and/or contamination. Epigenetic mechanisms are highly responsive to external stimuli and a wide range of chemicals has been shown to determine specific epigenetic patterns in several organisms. Furthermore, the mitotic/meiotic inheritance of such epigenetic marks as well as the resulting changes in gene expression and cell/organismal phenotypes has now been demonstrated. Therefore, epigenetic signatures are interesting candidates for linking environmental exposures to disease as well as informing on past exposures to stressors. Accordingly, epigenetic biomarkers could be useful tools in both prospective and retrospective risk assessment but epigenetic endpoints are currently not yet incorporated into risk assessments. Achieving a better understanding on this apparent impasse, as well as identifying routes to promote the application of epigenetic biomarkers within environmental risk assessment frameworks are the objectives of this review. We first compile evidence from human health studies supporting the use of epigenetic exposure‐associated changes as reliable biomarkers of exposure. Then, specifically focusing on environmental science, we examine the potential and challenges of developing epigenetic biomarkers for environmental fields, and discuss useful organisms and appropriate sequencing techniques to foster their development in this context. Finally, we discuss the practical incorporation of epigenetic biomarkers in the environmental risk assessment of chemicals, highlighting critical data gaps and making key recommendations for future research within a regulatory context.     

Review of impact categories and environmental indicators for life cycle assessment of geotechnical systems

Life cycle assessment (LCA) has only had limited application in the geotechnical engineering discipline, though it has been widely applied to civil engineering systems such as pavements and roadways. A review of previous geotechnical LCAs showed that most studies have tracked a small set of impact categories, such as energy and global warming potential. Accordingly, currently reported environmental indicators may not effectively or fully capture important environmental impacts and tradeoffs associated with geotechnical systems, including those associated with land and soil resources. This research reviewed previous studies, methods, and models for assessment of land use and soil‐related impacts to understand their applicability to geotechnical LCA. The results of this review show that critical gaps remain in current knowledge and practice. In particular, further development or refinement of environmental indicators, impact categories, and cause–effect pathways is needed as they pertain to geotechnical applications—specifically those related to soil quality, soil functions, and the ecosystem services soils provide. In addition, many existing methods emerge from research on land use and land use change related to other disciplines (e.g., agriculture). For applicability to geotechnical projects, the resolution of many of these methods and resulting indicators need to be downscaled from the landscape/macro scale to the project scale. In the near term, practitioners of geotechnical LCA should begin tracking changes to soil properties and report impacts to land and soil resources qualitatively.     

Life cycle assessment of emerging technologies at the lab scale: The case of nanowire‐based solar cells

Nanomaterials are expected to play an important role in the development of sustainable products. The use of nanomaterials in solar cells has the potential to increase their conversion efficiency. In this study, we performed a life cycle assessment (LCA) for an emerging nanowire‐based solar technology. Two lab‐scale manufacturing routes for the production of nanowire‐based solar cells have been compared—the direct growth of GaInP nanowires on silicon substrate and the growth of InP nanowires on native substrate, peel off, and transfer to silicon substrate. The analysis revealed critical raw materials and processes of the current lab‐scale manufacturing routes such as the use of trifluoromethane (CHF₃), gold, and an InP wafer and a stamp, which are used and discarded. The environmental performance of the two production routes under different scenarios has been assessed. The scenarios include the use of an alternative process to reduce the gold requirements—electroplating instead of metallization, recovery of gold, and reuse of the InP wafer and the stamp. A number of suggestions, based on the LCA results—including minimization of the use of gold and further exploration for upscaling of the electroplating process, the increase in the lifetimes of the wafer and the stamp, and the use of fluorine‐free etching materials—have been communicated to the researchers in order to improve the environmental performance of the technology. Finally, the usefulness and limitations of lab‐scale LCA as a tool to guide the sustainable development of emerging technologies are discussed.     

Using anticipatory life cycle assessment to enable future sustainable construction

The built environment is the largest single emitter of CO₂ and an important consumer of energy. Much research has gone into the improved efficiency of building operation and construction products. Life Cycle Assessment (LCA) is commonly used to assess existing buildings or building products. Classic LCA, however, is not suited for evaluating the environmental performance of developing technologies. A new approach, anticipatory LCA (a‐LCA), promises various advantages and can be used as a design constraint during the product development stage. It helps overcome four challenges: (i) data availability, (ii) stakeholder inclusion, (iii) risk assessment, and (iv) multi‐criteria problems. This article's contribution to the line of research is twofold: first, it adapts the a‐LCA approach for construction‐specific purposes in theoretical terms for the four challenges. Second, it applies the method to an innovative prefabricated modular envelope system, the CleanTechBlock (CTB), focusing on challenge (i). Thirty‐six CTB designs are tested and compared to conventional walls. Inclusion of technology foresight is achieved through structured scenario analysis. Moreover, challenge (iv) is tackled through the analysis of different environmental impact categories, transport‐related impacts, and thickness of the wall assemblies of the CTB. The case study results show that optimized material choice and product design is needed to reach the lowest environmental impact. Methodological findings highlight the importance of context‐specific solutions and the need for benchmarking new products.