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@#[Abstract] Objective: To explore the regulatory relationship between enhancer and miRNA and the characteristics of the enhancers that regulate miRNA in hepatic carcinoma and normal hepatic tissues, and to screen the differentially expressed miRNAs regulated by enhancers as well as their association with the treatment targets in liver cancer. Methods: Based on the TCGA and FANTOM5 databases, Co-expression and 3D genomic analysis were performed on 417 samples of enhancers and miRNAs in liver cancer and normal liver tissues. The difference in signal value of the enhancer that regulates miRNA was analyzed by ChIP-seq data of histone modification and transcription factor in liver cancer and normal liver tissues in ENCODE database. The differentially expressed miRNAs regulated by enhancers were screened out, and the correlation analysis was performed on the patient's survival and treatment targets. Results: 93 and 40 pairs of enhancer-miRNA were identified in liver cancer and normal liver tissues, respectively. ChIP-seqdata comparison analysis found that the signal of H3K27ac, H3K4me1 and sH3K4me3 histone modification in the region of enhancers regulating miRNA was significantly higher than that in the region of enhancers not regulating miRNA (|rho|>0.3, P<0.05). Moreover, the enrichment of multiple transcription factors in liver cancer-related enhancers was significantly lower than that in normal liver tissue-realted enhancers (|rho|>0.3, P<0.05). Differential expression analysis of enhancer-regulated miRNAs identified 6 miRNAs related to the survival of liver cancer patients(hsa-miR-4664, hsa-miR-5003,hsa-miR-1915,hsa-miR-3619,hsa-miR-4745, hsa-miR-6728),and found that these miRNAs were significantly associated with 87 genes for targeted therapy and 8 tumor immune checkpoint genes (|rho|>0.1, FDR<0.05). Conclusion: The enhancer-miRNA regulatory pairs and the characteristics of the enhancer that regulates miRNA were successfully identified in liver cancer. The miRNAs regulated by enhancers and related to the therapeutic targets and survival of patients with liver cancer were also screened out. It provides a valuable preliminary basis for future in-depth basic and clinical research in hepatic carcinoma.
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OBJECTIVE@#To compare the efficacy and safety of high-dose dexamethasone in treating new-diagnosed primary immune thrombocytopenia (ITP) in monocycle, di-cycle, tri-cycle.@*METHODS@#Divided by the ratio of 1:1:1, 93 newly diagnosed patients were randomly accepted monocycle (Group A:dexamethasone 40 mg once a day, from day1 to day4), dicycle (Group B:dexamethasone 40 mg once a day, from day 1 to day 4, day 15 to day 18), tri-cycle (Group C:dexamethasone 40 mg once a day, from day 1 to day 4, day 15 to day 18, day 29 to day 32) of high-dose dexamethasone treatment. Its efficacy and safety on the patients in three groups were compared.@*RESULTS@#Ninety-three newly patients with new-diagnosed ITP were divided into Group A, B, and C, 31 patients in each group. In terms of short-term benefits, there was no statistically significant difference among the 7th and 14th day complete response rate after end of treatment. However, there was statistically significant difference after the end of treatment on the 7th day response rate (41.9% 70.0% 90.0%, <0.01) and the 14th day response rate (16.1% 36.70% 63.3%, < 0.01); in terms of long-term benefits, there was no statistically significant difference among the 120-day response rate, the complete response rate within the treatment on the 60th, 90th and 120th day and the relapse rate at 90th and 120th day; however, there was statistically significant difference among the 60- day response rate (10.0% 26.6% 53.3%, <0.01), 90-day(0.0% 13.3% 30.0%, <0.01) and 60-day relapse rate(88.9% 73.3% 46.7%, <0.01). Mostly of the treatment-related adverse reactions in the three groups were mild, and most patients are tolerable.@*CONCLUSIONS@#Although the complete response rate of ITP patients did not improved by increasing the cycle of high-dose dexamethasone, but improved response rate in three months, and adverse reactions were tolerable, which could be used as a reference for clinical use.
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Humans , Dexamethasone , Purpura, Thrombocytopenic, Idiopathic , Recurrence , Treatment OutcomeABSTRACT
BACKGROUND: To determine the technical feasibility and success rate of percutaneous radiologic gastrostomy (PRG) after failure of percutaneous endoscopic gastrostomy (PEG). METHODS: Consecutive patients referred for PRG after failure of PEG between May 2011 and June 2016 were included in this study. The reasons for the failure of PEG, as well as the technical success and complications of PRG were noted. RESULTS: Fifteen patients (14 men, 1 woman; age, 27-93 years) were included. The most common reasons for PEG failure were esophageal stricture due to malignancies (n = 8), unfavorable abdominal wall conditions (n = 3), unstable patient condition during endoscopy (n = 2), and other miscellaneous conditions (n = 2). PRG placement was technically successful in all 15 cases. In one case, early slip-out of the gastrostomy tube occurred, which required removal and repositioning. No mortality was noted. CONCLUSION: PRG is technically feasible in patients with failed PEG insertion, and has advantages over PEG and a high overall success rate.