ABSTRACT
There is still a lack of effective strategies for the prevention and treatment of liver cancer, and a deep understanding of its pathogenesis may help to develop new treatment methods. Due to the abnormal changes of lipid metabolism in the development and progression of liver cancer, such process is closely associated with the "phlegm-turbidity" theory in traditional Chinese medicine (TCM). Starting from the changes of lipid metabolism in hepatocellular carcinoma microenvironment, this article discusses the association of the abnormal changes of lipid metabolism in tumor cells and immune cells with the "phlegm-turbidity" theory and the clinical efficacy of phlegm-eliminating therapies in clinical practice. Since the "phlegm-turbidity" theory in TCM plays an important role in the pathogenesis and pathological changes of liver cancer, the analysis of its theoretical connotation helps to clarify pathological mechanism, thereby providing a theoretical basis for the role of TCM in the prevention and treatment of liver cancer.
ABSTRACT
OBJECTIVE To evaluate the cost-effectiveness of sintilimab combined with chemotherapy than single-use chemotherapy in the first-line treatment of advanced， recurrent or metastatic esophageal squamous cell carcinoma （ESCC） from the perspective of health system of our country， and provide reference for rational use of drug in clinic. METHODS Based on ORIENT-15 study data， TreeAge Pro 2011 software was used to establish a three-state Markov model of non-progressive survival （PFS）， disease progression and death for cost-utility analysis. The model period was 3 weeks， the research time limit was 10 years， and the discount rate was 5%. The main outputs of the model were total cost， quality-adjusted life year （QALY） and incremental cost-effectiveness ratio （ICER）. The 1-3 times of China’s GDP per capita in 2021 was taken as the threshold of willing- ness to pay （WTP）. The uncertainty of the parameters was analyzed by single factor sensitivity analysis and probability sensitivity analysis， and the cost-effectiveness of the two schemes was discussed under three situations： different discount rates， comparison with other similar treatment schemes and charitable drug donation schemes. RESULTS The results of basic analysis showed that compared with chemotherapy plan alone， the ICER of sintilimab combined with chemotherapy was 64 208.75 yuan/QALY， which was less than WTP threshold. The results of single factor sensitivity analysis show that PFS state utility value， cycle cost of sintilimab and discount rate had relatively great influence on the results. Probability sensitivity analysis showed that when WTP≥120 000 yuan， the economic probability of sintilimab combined with chemotherapy plan was 100%. The results of situational analysis showed that sintilimab combined chemotherapy was more cost- effective than single-use chemotherapy. CONCLUSIONS Sintilimab combined with chemotherapy is more cost-effective than single-use chemotherapy in the first-line treatment of advanced， recurrent or metastatic ESCC.
ABSTRACT
ObjectiveTo evaluate the efficacy and influencing factors of Biejiajianwan in the treatment of primary liver cancer based on real-world data of traditional Chinese medicine （TCM）. MethodClinical diagnosis and treatment data of patients with primary liver cancer admitted to five Grade-A tertiary hospitals in Henan Province from January 2015 to December 2020 were collected from the medical electronic database. The patients treated with Biejiajianwan for ≥30 days were assigned to the exposure group and those without treatment with Biejiajianwan or treated with Biejiajianwan for <30 days to the non-exposure group. The propensity score matching model was used to balance confounding factors between the two groups according to the 1∶1 genetic matching method. Kaplan-Meier method was used for survival analysis and survival curve plotting. Log-rank was used to test the difference in survival rate between the two groups. Univariate analysis of Biejiajianwan in the treatment of primary liver cancer was performed by Log-rank test combined with the Kaplan-Meier method. The factors with statistical significance （P<0.05） were combined with unbalanced factors by the propensity score matching model， and at the same time， clinical common sense and relevant prognostic factors by literature search were considered， which were subjected to multivariate analysis by Cox proportional hazards regression model. ResultA total of 2 207 electronic cases were collected，including 174 cases in the exposure group （Biejiajianwan group） and 2 033 cases in the non-exposure group. After propensity score matching， there were 174 cases in the exposure group and 174 cases in the non-exposure group. The Kaplan-Meier method was used for survival analysis on the matched data， and the Log-rank test results showed that the survival rate of patients with primary liver cancer in the Biejiajianwan group was higher than that in the control group （χ2=12.193， P<0.01）. Cox proportional hazards regression model analysis showed that the regression coefficient of Biejiajianwan was -0.916 4 with the hazard ratio （HR） ［95% confidence interval （CI）］=0.4 （0.239 5-0.668 0）， P<0.01， and the regression coefficient of radiofrequency ablation treatment was -0.976 5 with HR （95% CI）=0.376 6 （0.172 8-0.821 1， P<0.05）. Fibrinogen （FIB） abnormal regression coefficient was 0.481 4 with HR （95% CI）=1.618 4（1.022 0-2.562 9），P<0.05. ConclusionBiejiajianwan can prolong the survival period of patients with primary liver cancer. Radiofrequency ablation is an independent protective factor for Biejiajianwan in the treatment of primary liver cancer，while abnormal FIB are independent risk factors for Biejiajianwan in the treatment of primary liver cancer.
ABSTRACT
Autoantibodies play an important role in aiding to the diagnosis, as well as judging diseases activity and monitoring treatment of autoimmune disorders. The combined detection of multiple autoantibodies is the current mainstream detection method. However, results are frequently reported as qualitative or semi-quantitative. The newly released diagnostic/classification standards for autoimmune diseases require quantitative detection data about the level of autoantibodies. The higher the level of autoantibodies is, the more likely the patient is to be diagnosed as an autoimmune disease, and it may be more relevant to the activity of the autoimmune disease. This article makes an introduction about the clinical value of accurate quantitative detection of autoantibodies as well as the current statues and challenges at the moment.
ABSTRACT
Objective:To analyze the molecular characteristics of Echovirus 11 (Echo11) strains isolated in Xiangyang, Hubei Province from 2016 to 2017 based on the sequences of VP1 gene.Methods:Rectal and throat swab specimens were collected from children with hand, foot and mouth disease (HFMD) in Xiangyang from 2016 to 2017. Echo11 strains were detected by real-time reverse transcriptase PCR (RT-PCR) and isolated after cultured in human rhabdosarcoma (RD) cells. The VP1 regions of Echo11 strains isolated from RD cells and the whole genomes of three representative Echo11 strains were amplified by conventional RT-PCR and the sequences were analyzed. DNAStar7.0 (MegAlign) and MEGA6.0 (Data) were used to analyze the homology and mutation sites in nucleotide and amino acid sequences. Neighbor-joining method was used to construct phylogenetic trees. Recombination analysis was performed with SimPlot software (BootScanning).Results:A total of 11 Echo11 strains were isolated from 3 494 HFMD cases, accounting for 0.31%. They were highly homologous in the VP1 gene. These strains shared 98.4%-100.0% homology in nucleotide sequences and 98.3%-100.0% homology in amino acid sequences. The homology between the 11 Echo11 strains and the prototype strain (Echo11/Gregory, X80059) was 73.9%-74.8% in nucleotide sequences and 87.7%-88.7% in amino acid sequences. All of the Echo11 strains circulating in Xiangyang were classified into lineage D, having a similarity to the strains circulating in some regions of mainland China since 2013. In multiple regions of the genome, the Echo11 strains isolated in Xiangyang were highly similar to the Henan Echo1 strains in 2010 and the Hubei Echo6 strains in 2015, suggesting there was recombination within the genome of Echo11 strains in Xiangyang.Conclusions:The Echo11 strains circulating in Xiangyang from 2016 to 2017 belonged to lineage D and were recombinant strains.
ABSTRACT
ObjectiveTo investigate the expression levels of forkhead box A2 (FOXA2) and forkhead box J2 (FOXJ2) in hepatocellular carcinoma (HCC) tissue and the association of FOXA2 and FOXJ2 with HCC. MethodsClinical data and pathological tissue samples were collected from 54 patients with pathologically confirmed HCC in The First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2014 to July 2019. The immunohistochemical SP method was used to measure the protein expression levels of FOXA2 and FOXJ2 in HCC tissue, and their association with HCC-related clinicopathological features and patient prognosis was analyzed. The chi-square test and the adjusted chi-square test were used for comparison of categorical data; a Spearman correlation analysis was performed to investigate the correlation between the expression of FOXA2 and FOXJ2; the Kaplan-Meier method was used for survival analysis; Image-Pro Plus was used to perform the semi-quantitative analysis of the expression of FOXA2 and FOXJ2; the Wilcoxon rank-sum test was used for comparison between groups. ResultsThe positive rates of the protein expression of FOXA2 and FOXJ2 in HCC tissue were 70.37% (38/54) and 75.92% (41/54), respectively, and there was a significant positive correlation between the expression levels of FOXA2 and FOXJ2 (rs=0.648, P＜0.001). In both negative and positive groups, the expression level of FOXA2 was associated with tumor diameter, degree of tumor differentiation, number of tumors, and alpha-fetoprotein (χ2=5.440, 4.113, 4.352, and 3.865, P=0.020, 0.043, 0037, and 0.049), and the expression level of FOXJ2 was associated with the degree of tumor differentiation (χ2=9.267, P=0.002). The group with positive expression of FOXA2 and FOXJ2 had a significantly higher cumulative survival rate than the group with negative expression of FOXA2 and FOXJ2 (P＜0.01). ConclusionThe expression levels of FOXA2 and FOXJ2 are associated with the development, progression, and prognosis of HCC, and they have a synergistic effect in the development and progression of HCC.
ABSTRACT
Dengue virus ( DENV) threatens the lives of hundreds of millions of people every year. Animal model is an effective tool for virus pathogenesis research and vaccine evaluation. At present, the de-velopment of animal models of DENV infection and disease has been challenging, as epidemic DENV does not naturally infect non-human species. Animal models of dengue virus infection are mainly non-human pri-mate ( NHP) model and mouse model. NHPs have been used to study dengue infection and candidate vac-cines because they can sustain viral replication in relevant cell types and develop a robust immune response, but they do not develop overt disease. However, NHP models are not suitable for early preclinical studies be-cause the cost of using these animals is high. In contrast, mouse models that are established mainly by using wild-type and immunodeficient mice can be more economical for preclinical evaluation of dengue vaccines. Overall, every model has its advantages and disadvantages and is differentially suited for studies of dengue pathogenesis and immunopathogenesis and/or preclinical testing of antiviral drugs.
ABSTRACT
Dengue virus ( DENV) threatens the lives of hundreds of millions of people every year. Animal model is an effective tool for virus pathogenesis research and vaccine evaluation. At present, the de-velopment of animal models of DENV infection and disease has been challenging, as epidemic DENV does not naturally infect non-human species. Animal models of dengue virus infection are mainly non-human pri-mate ( NHP) model and mouse model. NHPs have been used to study dengue infection and candidate vac-cines because they can sustain viral replication in relevant cell types and develop a robust immune response, but they do not develop overt disease. However, NHP models are not suitable for early preclinical studies be-cause the cost of using these animals is high. In contrast, mouse models that are established mainly by using wild-type and immunodeficient mice can be more economical for preclinical evaluation of dengue vaccines. Overall, every model has its advantages and disadvantages and is differentially suited for studies of dengue pathogenesis and immunopathogenesis and/or preclinical testing of antiviral drugs.
ABSTRACT
Objective To explore the effect of microRNA-32 (miRNA-32)on the biological behaviors of gastric cancer cell and its mechanism.Methods Gastric cancer cell line SGC-7901 cells were transiently transfected with miRNA-32 analogue,miRNA-32 inhibitor and empty plasmid vectors by lipofectamine and divided into analogue transfection group,inhibitor transfection group,empty plasmid transfection group and non-transfection group.The expression of green fluorescent protein was observed under fluorescent microscopy.The expression of miRNA-32 at mRNA level was detected by quantificational real-time polymerase chain reaction.The cell proliferation was evaluated by CCK-8 assay.The cell migration ability was measured by scratch test and Transwell chamber assays.The data were analyzed by one-way ANOVA.Results Compared with empty plasmid transfection group and non-transfection group,the expression of miRNA-32 mRNA of miRNA-32 analogue transfection group (relative quantitative value:2.327) was significantly up-regulated and that of miRNA-32 inhibitor transfection group (relative quantitative value:0.402) was significantly down regulated (F=11.238,P＜0.05).The width of scratch of miRNA-32 analogue transfection group was (61.39± 2.21) μm at 24 hours; miRNA-32 inhibitor transfection group was (29.97±0.66) μm.The migration distance of inhibitor transfection group was far than that of analogue transfection group (F=9.371,P＜0.05).After transfection for 48 hours,the cell number of migrated cells of analogue transfection group was significantly less than that of non transfection group,which was 16.93±4.63 and 93.93± 7.09,respectively (F=6.853,P＜0.05).After transfection for 48 hours and 72 hours,the cell growth inhibiting rate of miRNA 32 analogue transfection group was (43.474 ± 18.636)％ and (45.050±23.764)％,respectively,the cell growth was significantly inhibited (F=7.986 and 8.635,P=0.028 and 0.032).Conclusion The cell growth and migration ability of human gastric cancer cell line SGC-7901 are obviously inhibited through upregulating the expression of miRNA-32.
ABSTRACT
Objective To investigate the efficacy and safety of leflunomide as induction and mainten-ance therapy for class Ⅴ lupus nephritis. Methods Sixteen patients with lupus nephritis (of which, three proven with Ⅴ +Ⅲ, six with Ⅴ+Ⅳ ), proven by renal biopsies, were included in this study. ALL patients rec-eived LEF plus prednisone treatment. For induction therapy, all patients were given an initial loading dose of LEF 60 mg daily for three days, followed by 20 mg daily for the whole induction treatment period. Prednisone was given starting from 0.8 mg per kilogram daily, then tapered four weeks later. After twenty-four weeks, the dosages of LEF and prednisone were 10 mg/d, 5～10 mg/d respectively during maintenance therapy. We asses-sed total remission rates in the end of twenty-four weeks, as well as the changes of system lupus erythematosus disease activity index (SLEDAI), urinary protein per twenty-four hours (24 h Upr), serum albumin, serum creatinine level, complement C3, complement C4, C reactive protein, serum titer of ANA and anti-dsDNA be-fore treatment, 12 weeks, 24 weeks and 48 weeks after treatment respectively. Meanwhile, seven patients received repeated renal biopsies after completing induction therapy, so we compared pathological activity index (AI) and chroniciry index (CI) between pre-therapy and post-therapy at the same time. T and t' test were selected. Results Sixteen patients were followed-up. After 24 weeks induction therapy, the total remission rate was 75.0%; SLEDAI was significantly lower than pre-therapy [(15.4±3.5) vs (6.9±1.7), P<0.05]; 24 h Upr was also significantly lower than pre-therapy [(5.8±2.2) g vs (l.3±0.5) g, P<0.01 ]. Unfortunately, all seven patients performed repeated renal biopsies with class Ⅴ lupus nephritis again histologically, of which two were transformed other cater-ofies. Comparing with that of pre-therapy, AI was improved after therapy [(2.4±0.9) vs (1.7±0.8), P<0.05]. However, CI indicated no difference. Adverse events including major infection occurred in four patients. The adverse events happened at the 12 th week after treatment. Conclusion The efficacy of LEF plus corticoster-oids as induction and maintenance therapy for class Ⅴ lupus nephritis is remarkable and the tolerance of patients is good.
ABSTRACT
Objective To study CT and MR imaging features of pulmonary carcinoma of mediastinal type.Methods CT and MRI data (including anatomic site,size,shape,margin of the tumors and the relationship between tumors and mediastinum) of 15 patients with pulmonary carcinoma of mediastinal type confirmed by surgery and pathology were analyzed retrospectively.All patients underwent plain CT scans,and 11 of them also underwent contrast-enhanced CT scans,and 3 of them underwent plain MR scans and Gd-DTPA enhanced MR scans.Results On CT and MRI,the single mass was located subpleural of mediastinum with wide base.There were 5 cases of small cell lung carcinoma,8 squamous carcinoma,1 adenocarcinoma and 1 adenosquamous carcinoma.The majority of tumors manifested as ellipse.The tumors were lobulated in 12 and spicular margins in nine.8 tumors located in superior mediastinum,5 in medium mediastinum,2 in infra mediastinum and 12 in the borderline between the anterior mediastinum and medinum mediastinum.The tumors and enlarged lymph nodes of hilar and mediastinum connected closely in 7 cases.The bronchus were stenosed or obstructed by the tumors in 9 cases,and metastatic bone destruction of thoracic cage in 4 cases.Conclusion The pulmonary carcinoma of mediastinal type is easy misdiagnosed,CT and MRI findings in combination with clinical data can improve its diagnostic rate.
ABSTRACT
Based on the foreign experience of communication skills training for medical students and the present situation of communication skill training in China, this paper analyses the aim and model of communication skills training for medical students, and provides some advice on the reform of medical education and cultivation of medical talents.
ABSTRACT
5#. The hybridoma cell lines grew well after continuous culture for more than three months or after being stored in liquid nitrogen for six months, and the titers of secreting McAbs were stable.Conclusion:The McAbs against respiratory syncytial virus are obtained. It lay a foundation for early diagnosis and further study of RSV.
ABSTRACT
Objective To explore the clinical application and the relative factors that effect on the diagnostic accuracy in CT-guided percutaneous puncture biopsy(PPB) of pulmonary masses.Methods PPB in 72 cases with pulmonary masses were performed.The results ofsurgery,pathology, image,and the relative factors that effect on the diagnostic accuracy of PPB were analyzed.Results The punctureaccuracy was 100%,the diagnostic accuracy was 89.6%(61/72),the rate of complication was 11.1%(8/72) in CT-guided percutaneous puncture biopsy of pulmonary masses.The determining factors that effect on the diagnostic accuracy and the rate of complication were age of patients,present of emphysema,size and internal content of pulmonary masses in CT-guided percutaneous puncture biopsy.Conclusion CT-guided percutaneous puncture biopsy was a safe,accurate and simple mean of diagnosis and differential diagnosis for pulmonary masses.To improve the accuracy and reduce complication ,the related factors of patients ,lesion,and the technique should be attended.