RESUMO
Objective: To further improve the understanding of paroxysmal nocturnal hemoglobinuria (PNH), we retrospectively analyzed and summarized the clinical characteristics, treatment status, and survival status of patients with PNH in Zhejiang Province. Methods: This study included 289 patients with PNH who visited 20 hospitals in Zhejiang Province. Their clinical characteristics, comorbidity, laboratory test results, and medications were analyzed and summarized. Results: Among the 289 patients with PNH, 148 males and 141 females, with a median onset age of 45 (16-87) years and a peak onset age of 20-49 years (57.8% ). The median lactic dehydrogenase (LDH) level was 1 142 (604-1 925) U/L. Classified by type, 70.9% (166/234) were classical, 24.4% (57/234) were PNH/bone marrow failure (BMF), and 4.7% (11/234) were subclinical. The main clinical manifestations included fatigue or weakness (80.8%, 235/289), dizziness (73.4%, 212/289), darkened urine color (66.2%, 179/272), and jaundice (46.2%, 126/270). Common comorbidities were hemoglobinuria (58.7% ), renal dysfunction (17.6% ), and thrombosis (15.0% ). Moreover, 82.3% of the patients received glucocorticoid therapy, 70.9% required blood transfusion, 30.7% used immunosuppressive agents, 13.8% received anticoagulant therapy, and 6.3% received allogeneic hematopoietic stem cell transplantation. The 10-year overall survival (OS) rate was 84.4% (95% CI 78.0% -91.3% ) . Conclusion: Patients with PNH are more common in young and middle-aged people, with a similar incidence rate between men and women. Common clinical manifestations include fatigue, hemoglobinuria, jaundice, renal dysfunction, and recurrent thrombosis. The 10-year OS of this group is similar to reports from other centers in China.
Assuntos
Hemoglobinúria Paroxística , Humanos , Hemoglobinúria Paroxística/epidemiologia , Hemoglobinúria Paroxística/diagnóstico , Hemoglobinúria Paroxística/terapia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adolescente , Estudos Retrospectivos , Adulto Jovem , Idoso , China/epidemiologia , Idoso de 80 Anos ou maisRESUMO
Anthocyanidin is a group of flavonoid compounds used as a vegetable pigment and plays an important role in flower coloration and environmental adaptations of the Chinese ornamental plant Scutellaria viscidula. We determined the cDNA sequences of phenylalanine ammonia-lyase (SvPAL), flavanone 3-hydroxylase (SvF3H) and dihydroflavonol 4-reductase (SvDFR) genes in S. viscidula. Comparative analysis showed that the protein products of these three genes did not have a transit peptide at their N-terminal portion, which indicated that these enzymes were directly involved in the substrate conversion in the cytoplasmic matrix. Bioinformatic analysis further revealed that Svpal, Svf3h and Svdfr were the members of flavonoid biosynthetic genes with highly conserved motifs. Based on phylogenetic tree analysis, it appears that PAL, F3H or DFR from different plants might have originated from the same ancestor. This study can help to map and regulate the important stages involved in anthocyanidin biosynthesis by genetic engineering to diversify flower color and improve the ornamental value of S. viscidula.
Assuntos
Oxirredutases do Álcool/genética , Antocianinas/genética , Genes de Plantas/genética , Oxigenases de Função Mista/genética , Fenilalanina Amônia-Liase/genética , Scutellaria/genética , Oxirredutases do Álcool/química , Oxirredutases do Álcool/isolamento & purificação , Sequência de Aminoácidos , Antocianinas/biossíntese , Sequência de Bases , Vias Biossintéticas/genética , Clonagem Molecular , Sequência Conservada/genética , DNA Complementar/genética , Evolução Molecular , Oxigenases de Função Mista/química , Oxigenases de Função Mista/isolamento & purificação , Modelos Moleculares , Dados de Sequência Molecular , Fenilalanina Amônia-Liase/química , Fenilalanina Amônia-Liase/isolamento & purificação , Filogenia , Proteínas de Plantas/química , Proteínas de Plantas/genética , Estrutura Terciária de Proteína , Scutellaria/enzimologia , Alinhamento de SequênciaRESUMO
OBJECTIVE: To investigate the effectiveness of a new health education pathway for echinococcosis control among primary school students in regions highly prevalent for echinococcosis in China. METHODS: Six primary schools were randomly selected from echinococcosis hyper-endemic regions, with 13 classes assigned to the intervention group and 9 to the control group, and all students in these 21 classes were recruited as the study subjects. Echinococcosis health education was performed through the pathway of assessing the current status-strengthening the building of teaching resources-focusing on practices in the intervention group, while routine health education was given in the control group. A questionnaire survey was performed to assess the score of echinococcosis control knowledge (including theoretical knowledge score and mean daily practical capability score) before and after the health education interventions to evaluate the effectiveness of this new health education pathway for echinococcosis control. RESULTS: The mean score of echinococcosis control knowledge was 68.86 ± 18.70 points at baseline, with the mean theoretical knowledge score of 40.97 ± 10.75 points, and the mean daily practical capability score of 27.89 ± 12.50 points. Clustering analysis showed three types of populations, including "unsatisfactory", "learn and apply creatively", and "rote learning", which accounted for 24.62% (240/975), 45.74% (446/975) and 29.64% (289/975), respectively. The mean score of echinococcosis control knowledge was 81.08 ± 18.15 points in the intervention group during the final assessment, with the mean theoretical knowledge score of 43.65 ± 9.40 points, and the mean daily practical capability score of 37.43 ± 12.22 points, and both were significantly higher relative to baseline (t = -4.201 and -15.202, both P values < 0.01). The mean score of echinococcosis control knowledge was comparable between at baseline (70.55 ± 19.46 points) and final assessment (71.74 ± 19.37 points) in the control group (t = -0.87, P > 0.05). CONCLUSIONS: The awareness of echinococcosis control knowledge is fair among primary school students in echinococcosis hyper-endemic regions; however, the capability of combining theoretical learning and practices requires to be improved. The health education mode based on the pathway of assessing the current status-strengthening the building of teaching resources-focusing on practices seems to remarkably improve the understanding of echinococcosis control knowledge among primary school students in echinococcosis hyper-endemic regions.