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Objective:To investigate the effect of transcatheter arterial chemoembolization (TACE) combined with ultrasound-guided radiofrequency ablation (RFA) on the efficacy and immune function in patients with primary liver cancer.Methods:The clinical data of 152 patients with primary liver cancer from February 2019 to February 2021 in the Second Affiliated Hospital of Xi′an Jiaotong University were retrospectively analyzed. Among them, 76 patients were treated with TACE combined with RFA (combined group), and 76 patients were treated with TACE (control group). The efficacy was compared; the α-L fucosidase, T lymphocyte subsets (CD 3, CD 4, CD 8 and CD 4/CD 8), B lymphocyte subsets (CD 19) and tumor markers (alpha-fetoprotein, AFP; carcinoembryonic antigen, CEA; carbohydrate antigen 125, CA125) before treatment and 1 month after treatment were detected. Results:The total clinical effective rate in combined group was significantly higher than that in control group: 81.58% (62/76) vs. 52.63% (40/76), and there was statistical difference ( χ2 = 4.54, P<0.05). There were no statistical difference in all indexes before treatment between 2 groups ( P>0.05); the α-L fucosidase, AFP and CD 8 1 month after treatment in combined group were significantly lower than those in control group: (18.06 ± 5.33) U/L vs. (26.58 ± 7.75) U/L, (87.93 ± 22.55) μg/L vs. (146.83 ± 21.85) μg/L and 0.295 ± 0.052 vs. 0.367 ± 0.064, the CD 3, CD 4 and CD 4/CD 8 were significantly higher than those in control group (0.489 ± 0.054 vs. 0.462 ± 0.063, 0.363 ± 0.059 vs. 0.303 ± 0.075 and 1.43 ± 0.27 vs. 0.89 ± 0.14), and there were statistical differences ( P<0.01 or<0.05); there was no statistical difference in CEA, CA125 and CD 19 1 month after treatment between 2 groups ( P>0.05). Conclusions:TACE combined with RFA in the treatment of primary liver cancer patients can not only improve the total clinical effective rate, but also significantly improve the immune function, and help to reduce level of the liver tumor marker of AFP.
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【Objective】 To construct and verify a model for predicting the prognosis of liver cancer patients with autophagy-related long non-coding RNA (LncRNA) expression. 【Methods】 LncRNA expression spectrum, mRNA expression spectrum and clinical characteristics of 374 patients with liver cancer were obtained from the Cancer Genome Atlas (TCGA) Database. The expression levels of autophagy-related genes (from the Human Autophagy Database) were extracted from the mRNA expression profile, and the LncRNA was screened to obtain the highly relevant autophagy-related genes by correlation analysis with the LncRNA expression profile. Differential expression analysis and single factor analysis were conducted between the expressions of the above established autophagy-related LncRNA in 374 cancer tissues and 50 normal tissues to screen autophagy LncRNAs which were differentially expressed and was associated with a significant liver cancer prognosis. The above screened LncRNA were included in the risk of Cox proportional model selection and the prognosis of patients with liver cancer prediction model was established. The risk index (risk score) was calculated according to the forecast model and patients could be divided into high-risk and low-risk groups. Kaplan-Meier survival analysis, Cox regression analysis and receiver operating characteristic curve (ROC) were conducted to evaluate the prognostic value of the model. Gene set enrichment analysis (GSEA) was carried out to analyze the signal pathway of gene enrichment in patients with a high or a low risk. 【Results】 We screened 582 autophagy LncRNAs (R≥0.6, P<0.001) to obtain 23 LncRNAs which were differentially expressed and associated with a significant liver cancer prognosis. A prognostic model consisting of 6 LncRNAs, namely, MKLN1-AS, AC012360.3, AC145207.5, AL513320.1, AC099850.3 and AL049840.2 were constructed. KM survival analysis showed that the survival time of the high-risk group was significantly lower than that of the low-risk group (median survival time: 6.937 years and 2.323 years, P<0.001). Cox regression analysis showed that the survival time of patients in the high-risk group was significantly lower than that in the low-risk group (HR=3.773, 95% CI: 2.252-6.322, P<0.001); the area under the time dependent ROC curve for 1, 2, 3, 4, 5 and 6-year overall survival was 0.760, 0.729, 0.731, 0.722, 0.696 and 0.685. GSEA analysis showed that the genes in the high-risk group were mainly concentrated in cell cycle, autophagy, tumor, ubiquitin-mediated proteolysis, and RNA degradation. 【Conclusion】 The prognostic model composed of MKLN1-AS, AC012360.3, AC145207.5, AL513320.1, AC099850.3 and AL049840.2 can be used to predict the prognosis of liver cancer patients, which is expected to guide clinical treatment.
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Objective To investigate the protective effect and mechanism of active vitamin D3 on podocyte injury in type 1 diabetic rats.Methods Animals were randomly divided into normal control group (NC group),diabetic nephropathy group (DN group),diabetes nephropathy plus active vitamin D3 group (DN + VD group).Random tail vein blood glucose was measured and 24 hours of urine was collected every 3 weeks to observe the dynamic changes of blood glucose and 24-hour urine volume and urinary albumin.Rats were sacrificed at the end of 18th week,the kidney weight to body weight ratio,serum creatinine,blood urea nitrogen,serum calcium,and serum phosphorus levels were measured.Pathological in glomeruli were observed by PAS staining.Immunohistochemistry and Western blotting were used to observe the expression of slit diaphragms proteins including Nephrin,Podocin,and vitamin D receptor protein VDR.The mRNA level of autophagy-related protein P62 was detected by realtime quantitative PCR,and expression of autophagy-related protein including LC3B/A,Beclin1,and P62 were detected by Western blotting.Ultrastructure of podocytes and autopbagosomes in podocytes were observed by electron microscopy.Results Levels of serum creatinine,blood urea nitrogen,and blood glucose in diabetic rats were higher than those in NC group (P＜0.05),but without significant difference between DN and DN+VD groups (P＞0.05).Compared with the DN group,the urinary protein and kidney weight to body weight ratio in the DN +VD group were significantly lower (P＜ 0.05).Mesangial matrix hyperplasia and basement membrane thickening were improved,and podocyte fusion and shedding were partially reversed.The expressions of Nephrin,Podocin,VDR,LC3B/A and Beclin1 were increased,and P62 mRNA and protein were down-regulated (P ＜ 0.05).The number of autophagosomes in podocytes increased.Besides,positive correlations were found between Nephrin and Beclin 1 (r =0.939 8,P＜0.05),as well as Nephrin and VDR (r=0.948 3,P＜0.05),and Beclin1 andVDR (r=0.9093,P＜0.05).Conclusion Active vitamin D3 inhibits the injury of diabetic nephropathy podocytes by up-regulating VDR expression and enhancing autophagy activity,thereby reducing proteinuria and delaying the development of diabetic nephropathy.
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Objective To explore the effect of food improvement on the retention time of nasogastric tube in stroke patients with dysphagia. Methods Sixty cases were assigned to the control group(30 cases) and the experimental group(30 cases) by random digits table method, the control group received routine nasogastric feeding, and the experimental group were given texture modified foods and thickened liquid to try to help them eating through the mouth. The feeding tube was pull out when the person in experimental group was capable of taking texture modified foods and thickened liquid without difficulty,while the tube was pull out when the person in control group was able to eat regular food and drink regular fluids. The retention time of nasogastric tube of two groups was compared. Results The retention time of nasogastric tube was(6.13±2.96)d in the experimental group and(18.93±7.58)d in the control group, there was significant difference (t =-8.162, P<0.01). Conclusions Food improvement can effectively shortenthe retention time of nasogastric tube in stroke patients with dysphagia.
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Objective To analyze factors affecting quality of life (QOL)in patients with chronic hepatitis B (CHB),and provide reference for improving QOL of patients. Methods The MOS 36-item short form health sur-vey (SF-36)was adopted to survey QOL of patients with CHB,Morisky medication adherence scale was used to measure patients'adherence to medication,factors affecting QOL of patients with CHB were analyzed. Results Of 357 CHB patients,271(75.91% )were married,107(29.97% )received college or above education,163(45.66% ) patients'average household monthly income were ￥ 2000-￥ 5000,138(38.66% )patients'family members were also with CHB,198 (55.46% )patients smoked,150 (42.02% )drank. The average score of CHB patients' adherence to medication was (2.15±1.29). Factors affecting QOL in patients with CHB were age,education level, duration of disease,whether or not hospitalized,whether or not drink,as well as adherence to medication. Age, drink,and duration of hepatitis B,and previous hospitalization were negative factors affecting QOL in patients with CHB,education level and adherence to medication were positive factors affecting QOL in patients with CHB. Conclusion Strengthening CHB patients'understanding on disease and improving their medication adherence can help them to improve QOL.
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@#Objective To simulate and evaluate the upper and lower limbs posture on rehabilitation devices training with the Computer Aided Tri-Dimensional Interface Application (CATIA) man-machine analysis module. Methods The human body sizes were determined as the 95th percentile Chinese men. Based on the ergonomics analysis of CATIA, three-dimensional human body was constructed in the upper and lower limbs rehabilitation equipment. Virtual human relationship was established. The attitude of the upper and lower limbs in rehabilitation equipment was simulated and evaluated. Results The human limbs model moved in the normal range and the scores were more than 90 which meant comfortable. The forces of various parts of the body was under the stress limit, as well as the force moment. The arm tension was 3-5 points with the rapid upper limb assessment, which meant the rehabilitation equipment was acceptable. Conclusion Rehabilitation robot may be optimized through the model of the human upper extremity stretch domain analysis, body posture assessment, rapid upper limb assessment and biomechanical analysis under CATIA.
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<p><b>OBJECTIVE</b>To investigate the efficacy and safety of antiviral treatment in patients with hepatitis C virus (HCV) infection and decompensated cirrhosis and determine the effects of virological response on long-term prognosis.</p><p><b>METHODS</b>Sixty-six consecutive,interferon (IFN)-na(i)ve patients with HCV infection and decompensated cirrhosis were enrolled in this prospective study. All patients were given a 48-to 72-week course of IFN plus ribavirin (RBV) combined therapy,with a low accelerating dosage regimen using either:pegylated (PEG)-IFNa-2b at 1.0-1.5 mug/kg/week,PEG-IFNa-2a at 90-180 mug,or standard IFN-a-2b at 3MU,every other day.RBV was given at 800 to 1000 mg/day. All patients were routinely monitored for adverse drug reactions and virological response.Effects of treatments on patient survival were assessed by Kaplan-Meier analysis.</p><p><b>RESULTS</b>At the end of treatment,74.2% of patients were HCV RNA-negative,with 45.5% having achieved sustained virological response and 28.8% having relapsed;the remaining 25.7% of patients showed non-virological response (NVR). Among the patients with HCV genotype 1, 65.9% achieved end-of-treatment virological response (ETVR) and 34.1% achieved SVR;among the patients with HCV genotype 2,90.9% achieved ETVR and 68.2% achieved SVR. The positive and negative predictive values of early virological response (EVR) for ETVR were 95.7% and 75.0% respectively, and for SVR were 65.2% and 100% respectively. Compared with baseline,patients who achieved ETVR had better liver function,as evidenced by changes in levels of total bilirubin,alanine aminotransferase and albumin,as well as prothrombin activity and Child-Pugh score (t =4.564,11.486,2.303,2.699,3.694 respectively, all P less than 0.05).Compared with the NVR patients, the ETVR patients had lower risk of hepatic decompensation and hepatocellular carcinoma, and had improved survival (x2=18.756,6.992,7.580, respectively, all P less than 0.05).Twelve (18.2%) patients experienced serious adverse events,with 10 requiring premature treatment withdrawal and 2 dying.</p><p><b>CONCLUSION</b>Antiviral treatment for patients with HCV infection and decompensated cirrhosis using interferon in a low accelerating dosage regimen in combination with ribavirin is feasible.Patients who achieved ETVR had significantly improved long-term prognosis.</p>
Subject(s)
Humans , Alanine Transaminase , Antiviral Agents , Therapeutic Uses , Carcinoma, Hepatocellular , Drug Therapy, Combination , Genotype , Hepacivirus , Genetics , Hepatitis C , Diagnosis , Drug Therapy , Interferon-alpha , Therapeutic Uses , Kaplan-Meier Estimate , Liver Cirrhosis , Drug Therapy , Virology , Liver Neoplasms , Polyethylene Glycols , Therapeutic Uses , Prospective Studies , Recombinant Proteins , Therapeutic Uses , Ribavirin , Therapeutic Uses , Treatment OutcomeABSTRACT
Because of the specificity of infectious diseases , the the medical ethics education and concepts need to be paid more attention to .During the clinical teaching of infectious diseases , pay attention to teachers′medical ethics accomplishment level of ascension , teaching teachers should play the role of shape model , encourage interac-tion, eliminate the fear and discrimination interns and strengthen medical ethics consciousness and the combination of legal concepts , promote the medical students medical ethics consciousness of the form .
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Objective To simulate and evaluate the upper and lower limbs posture on rehabilitation devices training with the Computer Aided Tri-Dimensional Interface Application (CATIA) man-machine analysis module. Methods The human body sizes were determined as the 95th percentile Chinese men. Based on the ergonomics analysis of CATIA, three-dimensional human body was constructed in the upper and lower limbs rehabilitation equipment. Virtual human relationship was established. The attitude of the upper and lower limbs in rehabilita-tion equipment was simulated and evaluated. Results The human limbs model moved in the normal range and the scores were more than 90 which meant comfortable. The forces of various parts of the body was under the stress limit, as well as the force moment. The arm tension was 3-5 points with the rapid upper limb assessment, which meant the rehabilitation equipment was acceptable. Conclusion Rehabilitation robot may be optimized through the model of the human upper extremity stretch domain analysis, body posture assessment, rapid upper limb assessment and biomechanical analysis under CATIA.
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@# Objective To observe the effect of E-LINK system on hand function of patients with stroke. Methods 30 stroke patients were divided into treatment group (n=16) and control group (n=14). All the patients accepted routine rehabilitation, while the treatment group was trained additionally with the E-LINK system for 12 weeks. Results The strength of grip and pinch, the scores of Barthel index and Fugl-Meyer assessment of upper limb, and the range of supination of forearm improved more in the treatment group than in the control group (P<0.05). Conclusion Training with E-LINK system can improve the motor function of upper limb and activities of daily living of stroke patients.
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OBJECTIVE To investigate the protein kinase C (PKC) activity in peripheral blood T lymphocytes and its significance in patients with allergic rhinitis (AR) and the relationship between PKC activity and Th2 cytokines, interleukin 4 (IL-4) and interleukin 5 (IL-5) . METHODS Twenty seasona allergic rhinitis patients and 20 normal control persons participated in the study. T lymphocytes isolated and purified from blood of each person were divided into 2 groups:stimulated with and without phorbol 12-myristate 13-acetate (PMA) . The total PKC activity was detected by non-radioactive assay. The expression of IL-4 and IL-5 protein in supernatants was measured with ELISA RESULTS PKC activity, the expression of IL-4 and IL-5 protein in supernatants in AR T lymphocyte stimulated with PMA were significantly higher than those of AR T lymphocyte stimulated without PMA and those of norma (P
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OBJECTIVE:To observe the clinical outcome of lipid microspheres prostaglandin E 1 (Lipo-PGE 1 )injection in combination with diammonium glycyrrhizinate injection plus combined therapy in the treatment of chronic severe hepati-tis.METHODS:68patents with severe hepatitis B were assigned to receive lipid Lipo-PGE 1 injection in combination with di-ammonium glycyrrhizinate injection(treatment group)besides the necessary combined therapy as in the control group for4weeks,the clinical outcome and biochemical indicators were compared between2groups.RESULTS:As compared with the control group,the treatment group had a significantly alleviated clinical symptoms after treatment for2weeks and4weeks(P
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OBJECTIVE:To study the preventive effect of emodin and astragalus polysaccharides on experimental hepato-carcinoma in rats.METHODS:The experimental rats were randomly divided into the normal group,model group,emodin group,and emodin combined with astragalus polysaccharides group.hepatocarcinogenesis in rat models were induced by di-ethylnitrosamine,while at the same time all the groups were administered with pre-set drugs by stomach irrigation.Rat's we_ ight,serum indices of ALT,ALP,?-GT,?-L-fucoxidase were determined,and pathological examination was made before and after administration.RESULTS:The group administered with emodin and astragalus polysaccharides improved more than any other groups in terms of rat's weight,serum indices,onset time of hepatocarcinogenesis,and pathological grade.CONCLU_ SION:Emodin combined with astragalus polysaccharides have certain preventive effect on experimental hepatocarcinoma in rats.