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Hepatocellular carcinoma (HCC) is a kind of primary liver cancer with a high mortality rate. In China, the incidence ratio in males to females with HCC is 2:1–5:1. The difference in sex hormone pathways between males and females and the interaction between androgen/androgen receptors and HBV can lead to an incidence difference between males and females with HCC. Hence, the androgen/androgen receptor oncogenic pathway in hepatocellular carcinoma has received considerable attention. This review mainly summarizes the recent research progress on the androgen/androgen receptor oncogenic pathway in hepatocellular carcinoma.
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Statistics plays an important role in medical research， and the selection of appropriate statistical methods is crucial for drawing reliable and valuable conclusions. This paper provides a brief introduction to commonly used statistical analysis methods for medical data， covering descriptive analysis， parametric test， nonparametric test， correlation analysis， regression analysis， and analysis of survival data. It focuses on discussing the assumptions of multiple linear regression， logistic regression and Cox proportional risk regression， as well as how to choose the appropriate statistical methods for analyzing and interpreting medical data based on different research objectives and data types.
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Malignant tumors can be classified into three categories， rapidly progressing tumors， slowly progressing tumors， and "indolent" tumors. Rapidly progressing tumors （such as liver cancer， pancreatic cancer， and cholangiocarcinoma） have acute onset， shorter time duration from onset to death， and poorer treatment effects， which warrants primary prevention. Slowly progressing tumors （such as lung cancer， colorectal cancer， breast cancer， and gastric cancer） have slow onset， clear precancerous lesions， longer time duration from onset to death， and better therapeutic effects， which is accordingly suitable for secondary prevention. “Indolent” tumors （such as prostate and thyroid cancer） do not affect the life expectancy and are suitable for tertiary prevention. Early screening of “indolent” tumors may lead to overtreatment. Furthermore， early screening of rapidly progressing tumors is difficult to identify early cancers， which results in low cost-effectiveness. In contrast， for slowly progressing tumors suitable for secondary prevention， early screening may have cost-effectiveness， though there might be over-diagnosis. It is crucial to adopt appropriate prevention and treatment strategies for diverse types of tumors. Currently， large-scale cohort studies and randomized controlled clinical trials with complete follow-up may accurately evaluate the effect of cancer prevention strategies. This review discusses the significance of screening in precision prevention of tumors based on the characteristics of tumor progression and patients’ prognosis.
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Objective The effect of different doses of ethylnitrosourea(ENU)and cyclophosphamide(CP)on the loss rate of CD59 on peripheral blood erythrocytes was explored to optimize the detection method of Pig-a gene mutation. Methods According to the weight and loss rate of CD59 on peripheral blood erythrocytes,rats were divided into 4 groups:the control group,CP 40 mg/kg group,ENU 10 mg/kg group and ENU 40 mg/kg group(n=6). The control group was injected i.p. with PBS,other groups were injected i.p. with corresponding solutions. The body weight of rats on days 0,7,14,21, 28, 42 and 56 were recorded. At the same time, blood samples were collected and incubated with antibodies,and the loss rate of RBCCD59-was detected by flow cytometry. Results Compared with the control group, at different time points, the body weight and weight gain of ENU 10 mg/kg group and ENU 40 mg/kg group had no statistically significant difference(P > 0.05),while those in the CP 40 mg/kg group were significantly decreased(P <0.05). The loss rate of RBCCD59-was significantly increased in the CP 40 mg/kg group at 28,42 and 56 days, ENU 10 mg/kg group at 42 and 56 days,and ENU 40 mg/kg group at 7,14,21,28,42 and 56 days,(P < 0.05). The results showed a dose-response relationship. Conclusions Under the conditions of this Pig-a mutation detection method,ENU is superior to CP on raising loss rate of RBCCD59-,ENU 40 mg/kg is better than 10 mg/kg,and 28 days is suitable as the test period.
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[Objective]To study the effects of Caspase-1 specific inhibitor AC-YVAD-CMK on intimal hyperplasia after carotid artery balloon injury in rats and its possible mechanism.[Methods]A total of 33 male adult SD rats were randomly divided into sham group,balloon injury group and balloon injury+AC-YVAD-CMK group. Using the method of balloon injury to establish rat carotid ar?tery intimal hyperplasia animal model,rats were sacrificed and blood vessels were harvested 14 days after operation. Fifteen vascular segments embedded in OCT and the intima to media(I/M)area ratio of neointima was measured by hematoxylin-eosin(HE)staining;18 vascular segments were harvested and the expression of NLRP3 inflammasome,cleaved-Caspase-1,interleukin(IL)-1βand IL-18 were measured by Western blot.[Results]HE staining showed that AC-YVAD-CMK significantly inhibited the degree of intimal hyperplasia compared with the balloon injury group[(0.78 ± 0.13)vs(1.52 ± 0.14);P=0.000]. The expression of NLRP3 inflamma?some was increased in balloon injury group while the AC-YVAD-CMK attenuates the expression of NLRP3(P=0.009);The expres?sion of cleaved-Caspase-1 was in line with the expression of NLRP3(P=0.000). The levels of pro-inflammatory cytokines IL-1βand IL-18 in balloon injury+AC-YVAD-CMK group were significantly lower than those in the balloon injury group(P=0.000).[Conclusion]AC-YVAD-CMK can attenuate intimal hyperplasia after balloon injury of carotid artery in rats,which might be related to its effect on inhibiting the activation of Caspase-1,which could affect the release of pro-inflammatory cytokine of IL-1βand IL-18.
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Purpose To explore the effect of speckle tracking imaging (STI) in early detection of coronary artery disease (CAD) in patients with hypertension (HT),and to intervene early to alleviate or delay the progression of CAD.This would provide theoretical evidence in controlling the development and improving the prognosis of CAD.Materials and Methods From January 2013 to April 2015,a total of 166 cases of hospitalized patients from the First Affiliated Hospital of Sun Yat-sen and Jiangmen Central Hospital were retrospectively analyzed,including HT group (n=42),CAD group (n=35),HT+CAD group (n=49) and control group (n=40).Conventional measurement and STI were used to analyze the conventional values and the 17 section peak strain value of the left ventricle.Results The total mean strain,average peak strain of lesion segment and minimum peak strain in CAD group and HT+CAD group were significantly lower (P＜0.05) compared to the control group.ROC analyses showed that the AUC for total mean strain,average peak strain of lesion segment and minimum peak strain value were 0.71,0.76,and 0.70,respectively.Using a combined cut-off of ≥-18％ of average peak strain of lesion segment,≥-19％ of total mean strain and ≥-6％ of minimum peak strain value,the performance of CHD diagnosis had a sensitivity of 91.3％ and a specificity of 83.5％.Conclusion Speckle tracking automatic function imaging can be used to quantitatively analyze abnormal left ventricular segmental wall movement.It improves the detection in hypertension patients with coronary artery disease.
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Objective To explore the anticancer mechanism of esophageal cancer vaccines and clinical effect.Methods Esophagus cancer cells (Eca109) were cultured and the soluble antigen were extracted from the cells.Esophagus cancer vaccine was constructed with the antigen and superantigen SEC.Lymphocytes were isolated from peripheral blood and then stimulated with the vaccine in vitro.Phenotypes of the cells were checked by FCM and killing activity was tested with cytotoxic assays.One hundred and six early esophageal cancer patients were selected after surgery,who were divided into the observation group of 53 cases with esophageal cancer vaccine therapy and 53 cases in the control group with conventional treatment.Then clinical effect was observated and 3 year follow-up survival rate was observed of the of two groups of patients.Results Proliferation of vaccine stimulated lymphocyte group was the strongest,and high peaked at 72 h (A =0.22),and raise CD8+ T cell populations of CTLs.The killing activity of lymphocyte group stimulated by the vaccine against target cells was significantly higher than that of lymphocyte group ((97.36±2.11) ％) vs.(79.27±5.57) ％,F =38.62,P＜0.01).Three years follow up shows that the survival rates of experiment group were 48.27％ (male) and 45.83％ (female) respectively,and control group were 21.43％ (male) and 24.00％ (female),and the difference was significant (x2 =5.06,6.28,P ＜ 0.05).Conclusion The tumor vaccine constructed with esophagus cancer antigen and superantigen SEC can induce PBMC to activate and proliferate into CD8+ CTL with specific cytotoxicity against the cells which the antigen comes from.The vaccine may raise the survival rate of the patients with Esophagus cancer.
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Objective To investigate the clinical value of detection of procalcitonin(PCT ) and high sensitivity C-reactive protein (hs-CRP) in early diagnosis of bloodstream infection(BSI) .Methods The serum levels of PCT and hs-CRP of 58 BSI patients(test group) and 58 non BSI patients(control group) were detected .The early diagnosis value of PCT and hs-CRP was evaluated by ROC curve .Results There were significant difference between the serum PCT and hs-CRP levels of test group and control group(P<0 .05) .The ROC AUC of PCT and hs-CRP were 0 .902(95% CI:0 .850-0 .955) and 0 .706(95% CI:0 .611-0 .801) ,respectively . With 2 .24 ng/mL being the diagnostic cut-off value ,the diagnostic sensitivity ,specificity ,positive predictive value ,and negative pre-dictive value of PCT were 77 .6% ,91 .4% ,90 .0% ,and 80 .3% ,respectively .With 64 .83 mg/L being the diagnostic cut-off value ,the di-agnostic sensitivity ,specificity ,positive predictive value ,and negative predictive value of hs-CRP were 74 .1% ,62 .1% ,54 .4% ,and 59 .5% , respectively .Conclusion Detection of serum PCT and hs-CRP has important clinical value in early diagnosis of BSI .
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Objective To explore the clinical accuracy of urine cellular components of RBC,WBC,etc.detected by the Urit-1500 urine analyzer.Methods 1 085 urine samples in this hospital from June to October 2013 were selected and detected by the Urit-1500 urine analyzer and the microscope detection respectively.The results of urine cellular components detected by the urine analy-zer were analyzed.Results In 1 085 urine samples,the coincidence rate of two detection methods in detecting RBC and WBC was 93.8%(1 018/1 085)and 94.0%(1 020/1 085)respectively.In 295 RBC positive urine samples tested by the urine analyzer,the number of negative results tested by microscopy was 49,accounting for 16.6%.In 790 RBC negative urine samples tested by the u-rine analyzer,the number of negative results tested by microscopy was 18,accounting for 2.3%.In 197 WBC positive urine samples tested by urine analyzer,the number of negative results tested by microscopy was 28,accounting for 14.2%.In 888 WBC negative urine samples by urine analyzer,the number of negative results tested by microscopy was 37,accounting for 4.2%.Conclusion De-tecting urine RBC and WBC by using the Urit-1500 urine analyzer should combined with the microscopy and other test indexes and even clinical data to conduct the comprehensive analysis for reducing the misdiagnosis and missed diagnosis as far as possible.
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Objective:To analyze the effects of the clinical applications of vaccine for esophageal cancer to provide treatment ba-sis. Methods:Tumor-soluble antigen was extracted from clinical samples of esophageal cancer tissue. Vaccine for esophageal cancer was prepared using antigen and superantigen staphylococcal enterotoxin C (SEC). One group of patients with esophageal cancer was treated with vaccine after surgery (treatment group). Another group of patients with esophageal cancer was treated using routine meth-ods (control group). After five years, the patients were followed up to analyze survival. Results:After five years of follow up, the sur-vival rates of treatment and control groups were 173/328 (49.71%) and 67/326 (20.55%), respectively. Survival rates significantly dif-fered between the two groups (P<0.05). Furthermore, the survival rates of the female patients were higher than those of the male pa-tients (P<0.05). In the treatment group, the survival rates of patients with low-differentiation cancer were higher than those of patients with high-differentiation cancer (P<0.05). In the control group, the survival rates of patients with low-differentiation cancer were lower than those of patients with high-differentiation cancer (P<0.05). Conclusion:Tumor vaccine prepared with esophageal cancer antigen and superantigen SEC could increase the survival rate of patients with esophageal cancer, particularly female patients and those with low-differentiation cancer.
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ObjectiveTo explore the clinical results of endoscopic resection of the frontal benign tumors.MethodsNineteen cases of benign tumors in the frontal area were rcsected using endo scopic techniques.The tumors were diagnosed as benign according to complaint,history and physical examination.ResultsAll 19 tumors were totally resected.The pathological examination revealed 11cases of lipoma,3 cases of sebaceous cyst,3 cases of sebaceous cyst and 2 cases of dermoid cyst.During 6 months to 2 years of follow-up,no tumor recurred.Local concavity was noticed in all patients but all resolved within 6 months except 2 patients.They received granular fat graft of the concavities 6months late and were satisfied with the results.ConclusionsBenign tumors near eyebrows and in glabella area can be treated by minimally invasive endoscopic technique.Compared with traditional surgery,this technique offers inconspicuous scar and fast recovery.
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Objective To evaluate the value of endothelial function of brachial artery in predicting coronary artery disease in elderly patients. Methods Flow-mediated vasodilation (FMD)and nitroglycerin mediated dilation (NMD) were measured by high-frequency ultrasound in 98 patients with coronary artery disease and 37 controls. All the subjects were diagnosed by coronary arteriography. They were divided into coronary artery blockages ＜ 50% subgroup, 50%-75%subgroup, ＞75% subgroup or coronary blockages in 0, 1, 2, 3 branch (es) subgroups. The correlations between FMD or NMD and the pathological extent or branches of coronary artery were studied and the predictive value of FMD and NMD were analyzed with ROC curve. Results In coronary artery disease group, FMD and NMD were significantly decreased as compared with the control group. They were closely related with coronary artery disease (r= -0. 54, -0. 52, P＜0.01), and were weakly correlated with severity and range of coronary arterial lesion (P＜0. 01).With ROC curve analysis, FMD and NMD could be used to predict coronary artery disease.Conclusions Endothelial function can be used as an index to predict coronary artery disease.
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Objective: Vascular dilation dysfunction has been linked with risk of cardiovascular disease. This study was undertaken to investigate the relationship between physical activity and vascular dilation function in healthy middle-aged adults to help explaining the effect of physical activity on preventing cardiovascular disease. Method: We recruited 91 healthy middle-aged adults to complete a serf-report 7-day physical activity recall questionnaire and an exam of brachial artery flow-mediated dilation(FMD) and Nitroglycerin-mediated dilation (NMD) detected by ultrasound. The relationship between physical activity level (PAL) and FMD and NMD were explored. Result: Physical activity showed a significant and positive relationship with the brachial artery FMD, even after adjustment for possible confounding factors (r=0.363, P<0.01). The group of high physical activity level had the highest FMD. The means of FMD (%) in low, moderate and high PAL groups were respectively 8.70%±3.93%,9.01%±3.22% and 12.38±5.67% with significant difference between individuals of low and high PAL and between moderate and high PAL group(P<0.01). The means of NMD (%) is 25.13%±6.52%,24.38%±5.44% and 29.50%±7.25% respectively (P> 0.05) and there was no significant difference among three groups. There was no positive relation between PAL and FMD in premenopausal females but in men and postmenopausal females. Although individuals of high PAL have the best FMD, the moderate PAL can also retard FMD decrease with ageing. Conclusion: Maintaining high physical activity level can enhance endothelial-dependent vascular dilation, and moderate or high physical activity level can prevent endothelial-dependent vaseular dilation declining with aging, which may contribute to decrease risk of cardiovascular disease in healthy middle-aged adults.
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Objective To investigate the micminnammatory state and its relationship with atherosclerosis and cardiac function in patients on continuous ambulatory peritoneal dialysis(CAPD). Methods Sixty-seven CAPD patients,27 non-dialytic stage 5 chronic kidney disease(CKD 5)patients and 27 gender and age matched healthy controls wore enrolled in this cross-sectional study.Clinical data and biochemical parameters were collected.Serum interleukin-6(IL-6)and IL-10 levels were measured by enzyme-linked immunosorbent assay(ELISA).High-sensitivity C-reactive protein(hs-CRP)was measured by immunoturbidimetry.Prevalence of atherosclerosis was detected by carotid uhrasonography while cardiac function was detected by echocardiography. Results Serum levels of inflammatory biomarkers were elevated significantly in CAPI)and CKD 5 patients as compared with healthy controls[IL-6(ng/L):2.400,1.515 vs 0.698;IL-10(ng/L):1.988,1.958 vs 0.277;hs-CRP(mg/L):1.090,1.345 vs 0].Left ventricular mass index(LVMI),myocardial performance index(Tei index 0.75±0.31,0.66±O.27 vs 0.52±0.23)in CAPD and CKD 5 patients increased significantly.The prevalence of carotid artery atherosclerosis and left ventricular hypertrophy(LVH)in CAPD and CKD 5 patients was significantly higher than that in healthy controls.No significant difference of the ultrasonic parameters was found between CAPD and CKD 5 patients.In CAPD patients,IL-6 was positively correlated with Tei index,whereas IL-10 was negatively correlated with INMI and was positively correlaled with ejection fraction(EF).In a multiple regression model,IL-6,self-rating depressive scale(SDS)score and pulse pressure were independent predictors of carotid artery atherosclerosis.Similarly,IL-6 and primary hypertension were independent correlates of Tei index in CAPD patients. Conclusions Microinflammatory state exists in either non-dialytic CKD 5 patients or CAPD patients and it is associated with atherosclerosis and cardiac distunetion.IL-6 is an independent risk factor of atherosclerosis and increased Tei index in CAPD patients.