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Aristolochic acids (AAs) have long been considered as a potent carcinogen due to its nephrotoxicity. Aristolochic acid I (AAI) reacts with DNA to form covalent aristolactam (AL)-DNA adducts, leading to subsequent A to T transversion mutation, commonly referred as AA mutational signature. Previous research inferred that AAs were widely implicated in liver cancer throughout Asia. In this study, we explored whether AAs exposure was the main cause of liver cancer in the context of HBV infection in mainland China. Totally 1256 liver cancer samples were randomly retrieved from 3 medical centers and a refined bioanalytical method was used to detect AAI-DNA adducts. 5.10% of these samples could be identified as AAI positive exposure. Whole genome sequencing suggested 8.41% of 107 liver cancer patients exhibited the dominant AA mutational signature, indicating a relatively low overall AAI exposure rate. In animal models, long-term administration of AAI barely increased liver tumorigenesis in adult mice, opposite from its tumor-inducing role when subjected to infant mice. Furthermore, AAI induced dose-dependent accumulation of AA-DNA adduct in target organs in adult mice, with the most detected in kidney instead of liver. Taken together, our data indicate that AA exposure was not the major threat of liver cancer in adulthood.
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Objective:To explore hepatitis B virus (HBV) infection rate of breast feeding to newborn babies of HBV carrying parturient women with hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) double positive.Methods:A prospective cohort study was conducted to include HBsAg and HBeAg double-positive HBV carrying parturient women and their babies born from February 2016 to May 2018 at the Women′s Hospital, Zhejiang University School of Medicine, and 323 parturient women and 323 babies were enrolled. The babies were divided into breast feeding group and artificial feeding group. Chemiluminescence immunoassay and polymerase chain reaction-fluorescent probe method were used to detect the positive rates of serum HBV markers and HBV DNA levels in the newborns <24 h and seven-month-old age, respectively. The statistical method was performed using χ2 test. Results:A total of 297 parturient women were finally included for the analysis, including 149 in the breast feeding group and 148 in the artificial feeding group. There were no significant differences in the positive rates of HBsAg, hepatitis B surface antibody (anti-HBs), HBeAg and HBV DNA>100 IU/mL between the two groups at birth <24 h and seven months of age (all P>0.05). The positive rate of anti-HBs in newborns in the breast feeding group at birth <24 h was 58.39%(87/149), which was lower than 95.97%(143/149) at seven months of age. The HBeAg-positive group was 65.10%(97/149) at birth <24 h in the breast feeding group, which was higher than 13.42%(20/149) at seven months of age. The differences were both statistically significant ( χ2=59.75 and 40.49, respectively, both P<0.01). The positive rates of HBsAg and HBV DNA>100 IU/mL in newborns in the breast feeding group were 2.01%(3/149) and 2.68%(4/149) at birth <24 h, respectively, and those at seven months were 2.68%(4/149) and 2.68%(4/149), respectively. There were no significant differences between the two time points (both P>0.05). In the artificial feeding group, the positive rate of anti-HBs in newborns was 47.97%(71/148) at birth <24 h, which was lower than 95.94% (142/148) at seven months of age. The positive rate of HBeAg in the artificial feeding group was 55.41%(82/148) in newborns at birth <24 h, which was higher than 19.59%(29/148) at seven months of age. The differences were statistically significant ( χ2=85.37 and 39.84, respectively, both P<0.01). The positive rates of HBsAg and HBV DNA>100 IU/mL in newborns in the artificial feeding group at birth <24 h were 4.73%(7/148) and 1.35%(2/148), respectively, and those at seven months were 1.35%(2/148) and 1.35%(2/148), respectively. There were no significant differences between the two time points (both P>0.05). Conclusions:Breast feeding is not a decisive factor for the risk of vertical transmission in HBsAg and HBeAg double-positive HBV carriers. It is recommended that such women could breastfeed under formal precautions.
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Objective@#To explore hepatitis B virus (HBV) infection rate of breast feeding to newborn babies of HBV carrying parturient women with hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) double positive.@*Methods@#A prospective cohort study was conducted to include HBsAg and HBeAg double-positive HBV carrying parturient women and their babies born from February 2016 to May 2018 at the Women′s Hospital, Zhejiang University School of Medicine, and 323 parturient women and 323 babies were enrolled. The babies were divided into breast feeding group and artificial feeding group. Chemiluminescence immunoassay and polymerase chain reaction-fluorescent probe method were used to detect the positive rates of serum HBV markers and HBV DNA levels in the newborns <24 h and seven-month-old age, respectively. The statistical method was performed using χ2 test.@*Results@#A total of 297 parturient women were finally included for the analysis, including 149 in the breast feeding group and 148 in the artificial feeding group. There were no significant differences in the positive rates of HBsAg, hepatitis B surface antibody (anti-HBs), HBeAg and HBV DNA>100 IU/mL between the two groups at birth <24 h and seven months of age (all P>0.05). The positive rate of anti-HBs in newborns in the breast feeding group at birth <24 h was 58.39%(87/149), which was lower than 95.97%(143/149) at seven months of age. The HBeAg-positive group was 65.10%(97/149) at birth <24 h in the breast feeding group, which was higher than 13.42%(20/149) at seven months of age. The differences were both statistically significant (χ2=59.75 and 40.49, respectively, both P<0.01). The positive rates of HBsAg and HBV DNA>100 IU/mL in newborns in the breast feeding group were 2.01%(3/149) and 2.68%(4/149) at birth <24 h, respectively, and those at seven months were 2.68%(4/149) and 2.68%(4/149), respectively. There were no significant differences between the two time points (both P>0.05). In the artificial feeding group, the positive rate of anti-HBs in newborns was 47.97%(71/148) at birth <24 h, which was lower than 95.94% (142/148) at seven months of age. The positive rate of HBeAg in the artificial feeding group was 55.41%(82/148) in newborns at birth <24 h, which was higher than 19.59%(29/148) at seven months of age. The differences were statistically significant (χ2=85.37 and 39.84, respectively, both P<0.01). The positive rates of HBsAg and HBV DNA>100 IU/mL in newborns in the artificial feeding group at birth <24 h were 4.73%(7/148) and 1.35%(2/148), respectively, and those at seven months were 1.35%(2/148) and 1.35%(2/148), respectively. There were no significant differences between the two time points (both P>0.05).@*Conclusions@#Breast feeding is not a decisive factor for the risk of vertical transmission in HBsAg and HBeAg double-positive HBV carriers. It is recommended that such women could breastfeed under formal precautions.
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Objective To observe the clinical efficacy and safety of sodium glycididazole injection combined with concurrent chemoradiotherapy in treatment of primary advanced cervical cancer.Methods A total of 84 patients with primary advanced cervical cancer were selected from November 2010 to November 2016 in Qinghai Provincial People's Hospital.All the patients were divided into the control group (n =42) and the experimental group (n =42) according to random number table method.The control group was treated with routine chemoradiotherapy,and the experimental group was treated with sodium glycididazole injection based on the control group.The curative effects,levels of serum tumor markers such as squamous cell carcinoma associated antigen (SCC),tissue polypeptide specific antigen (TPS),soluble human major histocompatibility complex-Ⅰ molecular chain related gene A protein (sMICA),hypoxia inducible factor-1α (HIF-1α),human epidermal growth factor receptor 2 (Her-2) and adverse reactions of the two groups were compared.Results Four months after treatment,the total effective rates of the experimental group and the control group were 73.81％ (31/42) and 50.00％ (21/42).The total effective rate in the experimental group was higher than that in the control group,and the difference was statistically significant (x2 =5.048,P =0.025).Four months after treatment,the levels of SCC [(2.67±0.76) ng/ml vs.(4.10±0.94) ng/ml],TPS [(56.85±6.39) U/L vs.(86.69±12.62) U/L],sMICA [(90.31 ±11.25) ng/L vs.(129.46±16.60)ng/L],HIF-1α [(55.47±7.04) ng/Lvs.(68.07±7.97) ng/L] and Her-2 [(44.64±4.96) U/L vs.(53.07±6.56) U/L] in the experimental group were lower than those in the control group,with statistically significant differences (t =7.667,P ＜ 0.001;t =13.671,P ＜0.001;t =12.653,P＜0.001;t =7.679,P＜0.001;t =6.643,P＜0.001).The occurrence rates of bone marrow suppression of the experimental group and the control group were 23.81％ (10/42) and 21.43％ (9/42),the occurrence rates of gastrointestinal reaction were 19.05％ (8/42) and 14.29％ (6/42),the occurrence rates of abnormal electrocardiogram were 4.76％ (2/42) and 2.38％ (1/42),and the tatal adverse reaction rates were 47.62％ (20/42) and 38.10％ (16/42).The difference of the total adverse reaction rates between the experimental group and the control group was not statistically significant (x2 =0.778,P =0.378).Conclusion The clinical efficacy of sodium glycididazole injection combined with concurrent chemoradiotherapy is definite for primary advanced cervical cancer.This treatment regimen can reduce serum levels of SCC,TPS,sMICA,HIF-1α and Her-2,and not increase the incidence of adverse reactions.
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Objective To explore and observe the clinical characteristics and laboratory testing results of children with infectious mononuclear cells syndrome (IM),in order to improve diagnostic level.Methods 152 children with IM were selected,and the clinical manifestations,laboratory testing were retrospectively analyzed.Results There were a variety of clinical symptoms,the main clinical manifestations included fever 138 cases(90.8％),swollen lymph nodes 145 cases(95.4％),angina 112 cases (73.7％),hepatosplenomegaly 28 cases(18.4％),double eyelid edema 25 cases(16.4％),rash 7 cases(4.6％).Laboratory-testing of white blood cell count ＞ 10 × 109/L in 125 cases (82.2 ％),atypicallymphocyte proportion were more than or equal to 10％ in 48 cases (31.5 ％),liver function damage in 58 cases (38.2％),myocardial damage in 38 cases (25％),abnormal urine analysis in 30 cases (19.7％),thrombocytopenia 2 cases (3.4％).Conclusion Clinical symptoms of IM children are diversity,in some cases the clinical sympotoms are not typical,to improve the understanding of this disease can reduce the rates of missed diagnosis and misdiagnosis.