全球人口老龄化问题正在对包括经济、就业、福利和医疗保健等许多社会领域造成新的挑战.对于肿瘤学家而言,大多数国家人口老龄化问题造成的主要影响是患者人数的增加.肿瘤学家观察到的大多数年龄超过75岁的患者都是从年龄或生物学角度所称的老年人(这里定义为“年迈的老年人”).这些患者往往身体虚弱,有多种非癌症合并症和/或由于其他原因导致的与癌症不相关的相对有限的预期寿命.对于这些“年迈的老年”患者而言,谨慎选择治疗方法有助于确保治疗的益处(包括生存率和生活质量)大于副作用.这种决策不能仅仅依据临床试验结果,因为大部分的临床试验是在年轻患者和相对健康的患者人群中进行的.相比之下,还有其他年龄较大的患者,他们的生物年龄比实际年龄更年轻、更健康,他们被称为“年轻的老年人”.对这类患者,临床试验结果可能仍然适用.因为管理方法不同,肿瘤学家必须区分这些“年迈的老年人”和“年轻的老年人”.此外,新证据表明,生活方式干预可以减缓“年轻的老年人”个体的生物老化,也可以降低肿瘤患者的癌症发病、进展和复发率.

[目的]探讨以癫痫为初发症状的低级别胶质瘤(LGG)患者行外科治疗的癫痫缓解效果及其影响因素.[方法]回顾性分析2009年1月至2015年12月本院收治的83例行手术治疗的以癫痫为初发症状的LGG患者的临床资料,根据其术后6个月内的Engel分级分为有效组(Ⅰ~Ⅱ级)和无效组(Ⅲ~Ⅳ级),比较两组的临床病理资料,采用多因素logistic回归分析筛选出患者手术疗效的独立影响因素.[结果]所有患者均完成外科手术,随访结果表明术后6个月内的Engel分级结果为Ⅰ级37例(44.6%)、Ⅱ级29例(34.9%)、Ⅲ级13例(15.7%)、Ⅳ级4例(4.8%).有效组的WHO分级为Ⅰ级、肿瘤位于额叶运动区、术中应用皮层脑电监测(ECoG)监测的比例显著高于无效组,术前发作频率≥1次/日的比例显著低于无效组,差异均有统计学意义(P<0.05).多因素logistic回归分析结果表明,术前发作频率≥1次/日是患者手术无效的独立危险因素,术中应用ECoG监测是其独立保护因素(P<0.05).[结论]对于以癫痫为初发症状的LGG患者而言,外科治疗的癫痫缓解效果较好,术前癫痫发作频率与术中是否应用ECoG监测这两个因素可影响手术疗效.

Objective To explore the expression of TRIM29, caspase-8 andβ-catenin in non-small-cell lung cancer (NSCLC) and their clinical significance. Method Immunohistoehemical assay was used to detect the gene expression of TRIM29, caspase-8 and β-catenin in tumor tissues (NSCLC group) and adjacent normal tissues (control group) of 254 NSCLC patients, and the correlation with patient's clinicopathological features was analyzed. Result The positive ex-pression rate of TRIM29 and abnormal expression rate ofβ-catenin in NSCLC tissues were significantly higher than that in control group, but the study group had lower expression rate of caspase-8 than control group (P<0.01);TRIM29 ex-pression in lung squamous carcinoma was higher than that in lung adenocarcinoma and the abnormal expression rate ofβ-catenin was lower in lung squamous carcinoma, while the caspase-8 expression in these two tissues was of no significant difference;Survival time of patients with positive TRIM29 and caspase-8 expressions was significantly lower than that of negative patients, and survival time of patients withβ-catenin expression was significantly lower than that of low-expres-sion patients (P<0.01). Cox multi-variate analysis showed that lymph node metastasis, tumor stage, TRIM29, caspase-8 and β-catenin expression levels were independent prognostic factors influencing the survival of patients. Conclusion The expression of TRIM29, caspase-8 and β-catenin were abnormal in NSCLC, and is closely correlated with NSCLC lymph node metastasis, pathological classification, clinical stage, as well as the patients'survival time, which can be used as references for pathological classification, clinical staging and prognosis of patients with NSCLC.

Objective To observe the curative effect and side effect of recombinent human tomor necrosis factor(rhTNF) injection on treating malignant ascites.Methods After all ascites was sucked from abdominal cavity,rhTNF was injected into abdominal cavity,three times a week until ascites didn't come out.Results Among 30 patients with malignent ascites,12 patients obtained complete response(CR),14 partial response(PR) and 4 no change(NC),the overall response rate was(86.6%).Conclusions The rhTNF is effective on malignent ascites without obvious side effect,and it can improve patients' life quality,especially suitable for patients who couldn't able to endure chemical therapy.