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Objective@#To learn HIV related stigma and its associated factors among the patients on antiretroviral therapy ( ART ) in Wenshan Prefecture, Yunnan Province, so as to provide evidence for eliminating HIV discrimination.@*Methods@#A total of 419 subjects were recruited by convenience sampling from three ART clinics in Wenshan City and Maguan County between October 2017 and January 2018. HIV/AIDS Related Stigma and Discrimination Scale developed by Li Xianhong et al was employed. The multivariate linear regression model were used to explore the influencing factors for HIV stigma. @*Results@#The median scores of disclosure concern, public rejection, family stigma, internalized stigma, health service providers＇ stigma were 24.00, 6.00, 10.00, 20.00, 2.00, respectively, and the overall was 68.00. The multivariate linear regression analysis showed that female patients ( standardized β=0.135 ) , patients with opportunistic infection ( standardized β=0.120 ), patients had no HIV infected family member ( standardized β=-0.128 ) , patients without family support ( standardized β=-0.175 ) , patients received gift from ART clinics ( standardized β=0.124 ) , patients scored lower in ART knowledge ( standardized β=-0.117 ) were likely to scored higher in HIV stigma. @*Conclusions@#The stigma on disclosure concern and internalized stigma dimensions are grievous among ART patients in Wenshan Prefecture. Gender, opportunistic infection, HIV infection in family, family support, receiving incentive gifts from clinics and awareness of ART are associated with HIV stigma.
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Objective: To study whether a deep residual neural network can detect small bowel obstruction patterns on upright abdominal radiographs. Methods:The data of training set and test set used in this study were obtained from The First Affiliated Hospital of Xi'an Jiaotong University and No.215 Hospital of Shaanxi Nuclear Industry; the data of validation set came from No.215 Hospital of Shaanxi Nuclear Industry. Totally 3 298 clinical upright abdominal radiographs obtained from two hospitals were classified into obstructive and non-obstructive categories independently by two radiologists on the basis of the four signs on upright abdominal radiographs, who discussed and reached consensus when disagreements arose. Among them, 569(17.3%) images were found to be consistent with small bowel obstruction, and 2 729 (82.7%) images had no small bowel obstruction. A total of 2 305 training sets and 993 test sets (training set: test set = 2.3:1) were composed of data from the two groups, including 405 cases (17.6%) of small bowel obstruction, 1 900 cases (82.4%) of non-small bowel obstruction, 164 cases (16.5%) of small bowel obstruction, and 829 cases (83.5%) of non-small bowel obstruction. The diagnosis of small bowel obstruction in training and testing sets was based on experienced radiologists' evaluation. Totally 861 abdominal upright abdominal radiographs constituted the validation set (99 with small bowel obstruction and 762 with no small bowel obstruction); the surgical results and clinical diagnosis were set as the gold standard. In this study, the image 2012 large-scale visual recognition challenge data set (ILSVRC2012) was used for pre-training the deep residual neural network (ResNet38). The retraining of deep residual network (ResNet38) with training set data was used to establish the diagnostic model. The test set was mainly used in the learning algorithm process to adjust the algorithm parameters to modify the network, so as to make the network model more efficient. Results: After training, the deep residual neural network achieved an AUC of 0.83 on the test set (95% CI 0.82-0.92). The sensitivity of the system for small bowel obstruction was 84.1%, with a specificity of 65.0%. And on validation set it achieved an AUC of 0.87 (95% CI 0.82-0.92), the sensitivity of the system for small bowel obstruction was 89.9%, with a specificity of 68.0%. Conclusion: Transfer learning with deep residual neural network may be used to train a detector for small bowel obstruction on upright abdominal radiographs even with limited training data.
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Objective To understand the etiology and clinical characteristics of candidemia, and the diagnostic value of(1, 3)-β-Dglucan. Methods This analysis included 31 patients with candidemia, 39 patients with Candida deep colonization, and 50 healthy subjects, who were enrolled from Wuyi Chinese Hospital Affiliated to Jinan University during the period from September 2015 to March 2018. Clinical data such as fungal culture, clinical features, and serum(1, 3)-β-D-glucan level were analyzed and compared between groups. Results Overall, 13 strains of Candida albicans and 18 strains of non-albicans Candida were isolated from the 31 patients with candidemia. The incidence of candidemia was associated with old age(>65 years), prior surgery(≤7 days), indwelling catheter(≥2 catheters and lasting ≥5 days), duration of mechanical ventilation(≥5 days)(P<0.05), but not associated with sex, underlying disease, prior use of anmicrobial and antifungal agents, immunosuppressant or glucocorticoid, or hypoproteinemia(P>0.05). Serum level of(1, 3)-β-D-glucan was significantly higher in candidemia patients than in the patients with candida deep colonization and healthy controls(P<0.05). The sensitivity and specificity of(1, 3)-β-D-glucan in diagnosing candidemia were 87.1％ and 96.0％, respectively. The level of(1, 3)-β-D-glucan was significantly higher in candidemia with bacterial infection than candidemia without bacterial infection(P<0.05). The level of of(1, 3)-β-D-glucan was also significantly higher in the candidemia caused by Candida albicans alone than that caused by non-albicans Candida alone(P<0.05). Conclusions Non-albicans Candida is more prevalent than Candida albicans in candidiasis, but Candida albicans is still the most important Candida species. The incidence of candidemia is asociated with advanced age(>65 years), prior surgery within 7 days, indwelling catheters(≥2 catheters and lasting ≥5 days), and mechanical ventilation(≥5 days). Serum(1, 3)-β-D-glucan level is valuable for early diagnosis of candidemia.
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ABSTRACT We conducted a systematic review and meta-analysis of the literature on the efficacy of the targeted therapies in the treatment of advanced RCC and, via an indirect comparison, to provide an optimal treatment among these agents. A systematic search of Medline, Scopus, Cochrane Library and Clinical Trials unpublished was performed up to Jan 1, 2015 to identify eligible randomized trials. Outcomes of interest assessing a targeted agent included progression free survival (PFS), overall survival (OS) and objective response rate (ORR). Thirty eligible randomized controlled studies, total twentyfourth trails (5110 cases and 4626 controls) were identified. Compared with placebo and IFN-α, single vascular epithelial growth factor (receptor) tyrosine kinase inhibitor and mammalian target of rapamycin agent (VEGF(r)-TKI & mTOR inhibitor) were associated with improved PFS, improved OS and higher ORR, respectively. Comparing sorafenib combination vs sorafenib, there was no significant difference with regard to PFS and OS, but with a higher ORR. Comparing single or combination VEGF(r)-TKI & mTOR inhibitor vs BEV + IFN-α, there was no significant difference with regard to PFS, OS, or ORR. Our network ITC meta-analysis also indicated a superior PFS of axitinib and everolimus compared to sorafenib. Our data suggest that targeted therapy with VEGF(r)-TKI & mTOR inhibitor is associated with superior efficacy for treating advanced RCC with improved PFS, OS and higher ORR compared to placebo and IFN-α. In summary, here we give a comprehensive overview of current targeted therapies of advanced RCC that may provide evidence for the adequate targeted therapy selecting.
Subject(s)
Humans , Carcinoma, Renal Cell/drug therapy , Molecular Targeted Therapy/methods , Kidney Neoplasms/drug therapy , Carcinoma, Renal Cell/pathology , Randomized Controlled Trials as Topic , Disease-Free Survival , Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors , Vascular Endothelial Growth Factor A/antagonists & inhibitors , ErbB Receptors/antagonists & inhibitors , Kidney Neoplasms/pathologyABSTRACT
Objective To study the expression and the clinical significance of glyican-3 (GPC3)in hepatocellular carcinoma (HCC)tissues.Methods Immunohistochemical method was performed to evaluate the expression of GPC3 in 54 cases of HCC tissues,46 cases of para-carcinoma tissues,22 cases of cirrhosis tissues,12 cases of normal liver tissues,the correlation between expression levels of GPC3 and clinicopathologic factors was analyzed.Results GPC3 protein was not expressed in normal livers tissues,the levels of GPC3 (7.39±3.64)and the positive rate (81.48%)in HCC tissues were significantly higher than para-carcinoma tissues (1.15±0.99,13.04%),cirrhosis tissues (0.32±0.56,4.54%),the difference was sta-tistically significant (P 0.05);the positive rate in HCC tissues was independent of sex,age, serum HBsAg,alpha-fetoprotein (AFP),tumor diameter,metastasis,clinical stage (P >0.05),only related to the cirrhosis (P <0.05).The high expression rate of GPC3 in HCC tissues was correlated with AFP,tumor diameter,cirrhosis,metasta-sis,clinical stage (P <0.05).Conclusion GPC3 has important clinical significance in the diagnosis of HCC,the expression level of GPC3 associated with the progression of HCC.
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Objective To investigate the expressions of cellular proliferative antigen (Ki-67)and androgen receptor (AR)in triple-negative breast cancer (TNBC)and their relationships with recurrence. Methods Sixty-six cases of TNBC and two hundred and fifteen cases of non triple-negative breast cancer (NTNBC)tissues between January 2006 and December 2010 in Jiangmen Hospital Affiliated to Sun Yat-sen University were collected,the expressions of Ki-67 and AR were detected by immunohistochemical,and through follow-up the relationships between TNBC recurrence and the expressions of Ki-67 and AR were analyzed.SPSS 19.0 was used to analyze the results.Results The positive rate of Ki-67 in TNBC (75.76%,50 /66)was significantly higher than that in NTNBC (62.33%,134 /215,χ2 =4.031,P =0.045),and Ki-67 expression was correlated with histological grade (χ2 =6.031,P =0.049),tumor diameter (χ2 =6.630,P =0.036)and lymph node metastasis (χ2 =5.440,P =0.020).The positive rate of AR in TNBC (31.82%,21 /66)was significantly lower than that in NTNBC (76.28%,164 /215,χ2 =44.382,P <0.001),and AR expression was correlated with menopausal status (χ2 =5.341,P =0.021 )and body mass index (χ2 =4.369,P =0.037).TNBC recurrence was related to Ki-67 expression (χ2 =4.125,P =0.042),and was not related to AR expression (χ2 =1.257,P =0.262).Conclusion High expression level of Ki-67 and low expression level of AR are characteristics of TNBC.Ki-67 positive patients are more likely to relapse,and it can be used as an indicator to predict TNBC recurrence.
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Objective To study the diagnostic and distinguishing diagnostic value in primary hepatic carcinoma (PHC)and metastatic hepatic carcinoma (MHC)by the serum sialic acid (SA)detection.Methods During January 2012 to June 2014, 100 cases of patients with PHC,91 cases of patients with MHC,155 cases of benign liver disease patients,and 139 healthy people in Wuyi Traditional Chinese Medicine Hospital were included into the study.The concentration of serum SA and AFP were detected by chemical enzymatic method and chemiluminescence method,SPSS1 9.0 was used to analysis the results.Re-sults The concentration of serum SA in PHC patients (701.08±189.33 mg/L)were significantly higher than benign liver disease patients (588.38±98.51 mg/L)and healthy people (572.37±89.13 mg/L),there was statistical significance (P=0.000),the significantly statistical differences were also in MHC (790.20±162.29 mg/L)and PHC patients (P=0.027). Serum SA in the diagnosis of MHC sensitivity,specificity and AUC were 84.6%,85.2% and 0.895,compared with serum AFP (sensitivity 22.2%,specificity 29.6% and AUC 0.301)had statistically significance (P=0.000).Conclusion The se-rum SA has important clinical significance in the diagnosis and distinguishing diagnosis of PHC and MHC.
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In order to examine the effect of GRIM 19 on colon cancer cell SW480, the recombinant adenovirus carrying GRIM19 gene was constructed and transfected into SW480 cells. GRIMI9 cDNA was amplified by PCR with the template pcxn2-GRlMl9 and cloned into the shuttle plasmid pAdTrack-CMV. The plasmid pAdTrack-CMV-GRIM19 was linearized by PmeI and homologously recombined with bone plasmid pAdEasy-1 in BJ5183, followed by identification by enzyme diges- tion. After transfection of linearized pAd-GRIM19 with PacI into HEK293 cells, Ad-GRIMI9 was obtained and amplified by 3 circles. SW480 cells were infected with Ad-GRIM19. The apoptosis rate was detected by flow cytometry. Agarose electrophoresis revealed the bands of recombinant plasmids identified by enzyme digestion were in the right range corresponding with expectation. Under the fluorescent microscopy, the package of Ad-GRIM19 in HEK293 cells and the expression of Ad-GRIM19 in SW480 cells were observed. The transfection of Ad-GRIM19 into SW480 cells in-creased the apoptosis rate of SW480 cells as compared with controls. It was concluded that Ad-GRIM19 was successfully constructed and the overexpression of GRIM19 in colon cancer cell lines could promote the apoptotic cell death.
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<p><b>OBJECTIVE</b>To probe into eliminating action of mild moxibustion combined with cupping therapy on athletic fatigue.</p><p><b>METHODS</b>Observe changes of serum creatine kinase activity in gym-athletes with once great intensity training or periodic great intensity training, and the interfering effect of mild moxibustion combined with cupping therapy.</p><p><b>RESULTS</b>The mild moxibustion combined with cupping therapy has a significant promoting action on recovery of the increased serum creatine kinase activity induced by once great intensity training or periodic great intensity training in gym-athletes.</p><p><b>CONCLUSION</b>The method has a better action of eliminating athletic fatigue.</p>