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OBJECTIVES@#Gonadal hormone is essential for the health of postmenopausal women, however, few studies have focused on the epidemiological distribution of gonadal hormones in postmenopausal women in very late postmenopausal women. This study aims to investigate and analyze the differences of serum gonadal hormone content and its influential factors among female centenarians in Hainan, China.@*METHODS@#The questionnaire and physical examination data of 741 female centenarians and 401 elderly females in Hainan Province were collected, and venous blood samples were taken to detect the indexes of lipid metabolism, bone metabolism, and gonadal hormone. The differences of gonadal hormones and relavant factors in female centenarians were analyzed and compared.@*RESULTS@#The serum levels of estradiol and progesterone of female centenarians were significantly higher than those of the elderly females (both P<0.001). The serum levels of estradiol and testosterone of ethnic minority centenarians were higher than those in Han nationality (P<0.001), and the serum estradiol and testosterone concentrations were relatively higher when the daily activities were more than 10 min (both P<0.05). Serum estradiol concentration was negatively correlated with apolipoprotein A-I, high density lipoprotein, triglyceride and bone formation markers such as calcium, inorganic phosphorus and vitamin D3, and was positively correlated with the special sequence of β-collagen (markers of bone resorption) (all P<0.01).@*CONCLUSIONS@#For the extremely late postmenopausal women (such as centenarians), there may be characteristic expressions of gonadal hormones, especially estradiol. There is an unprotective correlation of serum estradiol with lipid metabolism index and bone metabolism index in female centenarians, so it is necessary to evaluate the estrogen content and the use of estrogen therapy in postmenopausal women.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Centenarians , China , Cross-Sectional Studies , Estradiol , Estrogens , Ethnicity , Minority Groups , TestosteroneABSTRACT
Objective:To investigate the effects of centromere protein-A (CENP-A) on the invasion and migration of ovarian cancer (OC) cells and explore the related mechanism.Methods:OC cell line A2780 was cultured in vitro, and they were divided into Ng Group (Blank Control Group) , pcDNA group (negative transfection group:PCDNA vector plasmid) , pcDNA-CENP-A group (over-expression Group: pcDNA-CENP-A Vector Plasmid) and pathway inhibitor group (TRANSFECTION-CENP-A+ PI3K pathway inhibitor LY294002) . The cell proliferation was detected by CCK-8 method; the cell migration and invasion was detected by Scratch test and Transwell test; the expression of CENP-A, E-cadherin, N-cadherin and phosphatidylinositol 3-kinase/protein kinase B/nuclear factor-kappa B (PI3K/AKT/NF-κB) pathway related proteins was detected by Western blot.Results:A2780 cells were successfully transfected. After 24 hours, with the extension of culture time, compared with that in NG group [ (0.50±0.07) , (0.72±0.11) , (0.99±0.14) ] and pcDNA group [ (0.55±0.08) , (0.78±0.12) , (1.02±0.15) ], the viability of A2780 cells in pcDNA-CENP-A group [ (0.78±0.12) , (1.03±0.15) , (1.67±0.25) ] and pathway inhibitor group [ (0.63±0.09) , (0.87±0.13) , (1.39±0.20) ] increased significantly ( P<0.05) , compared with that in the pcDNA-CENP-A group, the viability of A2780 cells in the pathway inhibitor group was significantly decreased ( P<0.05) , in a time-dependent manner. Compared with those in NG group [ (15.83±1.46) %, (105.32±15.78) individual] and pcDNA group [ (16.79±1.46) %, (108.98±16.35) individual], the migration rate [ (37.96±5.80) %, (25.15± 2.19) %] and invasion number [ (327.87±49.18) individual, 206.53±30.97) individual] of A2780 cells, protein expression of CENP-A, N-cadherin, Vimentin, p-PI3K/PI3K, p-AKT/AKT, NF-κB, interleukin (IL-1β) , tumor necrosis factor-α (TNF-α) in pcDNA-CENP-A group and pathway inhibitor group were significantly higher ( P<0.05) , the expression of E-cadherin was significantly lower ( P<0.05) ; compared with those in the pcDNA-CENP-A group, the migration rate and invasion number of A2780 cells, protein expression of CENP-A, N-cadherin, Vimentin, p-PI3K/PI3K, p-AKT/AKT, NF-κB, interleukin (IL-1β) , tumor necrosis factor-α (TNF-α) in pathway inhibitor group were significantly lower ( P<0.05) , and the expression of E-cadherin was significantly higher ( P<0.05) . Conclusion:Overexpression of CENP-A can promote the proliferation, invasion and migration of ovarian cancer cells, which may be achieved by activating PI3K/AKT/NF-κB signaling pathway.
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Objective:To study the Epstein-Barr virus (EBV) activity and its clinical characteristics in patients with hemorrhagic fever with renal syndrome (HFRS). Methods:From January 2016 to August 2017, patients with HFRS who were hospitalized in the First Affiliated Hospital of Harbin Medical University were routinely tested by EBV serology, and were divided into two groups according to their presence or absence of EBV infection, namely EBV active group and non-EBV active group. The clinical data between the two groups were compared and analyzed by SPSS 18.0.Results:A total of 188 HFRS patients were enrolled, including 73 cases in EBV active group and 115 cases in non-EBV active group. The EBV active rate of HFRS patients was 38.83% (73/188). The incidences of lumbago [57.53% (42/73) vs 42.61% (49/115)], abdominal pain [42.47% (31/73) vs 20.00% (23/115)], skin and mucosa congestion [57.53% (42/73) vs 39.13% (45/115)], and conjunctiva edema [50.68% (37/73) vs 28.70% (33/115)] in EBV active group were significantly higher than those in non-EBV active group (χ 2 = 3.983, 11.008, 6.083, 9.239, P < 0.05). There were 10, 7 and 43 patients with acute kidney injury (AKI) stage 1, 2 and 3 in EBV active group and 5, 13 and 53 patients in non-EBV active group. Degree of AKI in EBV active group was higher than that in non-EBV active group, and the difference was statistically significant (χ 2 = 12.615, P < 0.05). In EBV active group, the proportion of patients whose renal function recovery over 15 days [23.29% (17/73)] and white blood cell count [11.26 (3.39 ~ 54.23) × 10 9/L] were significantly higher than those in non-EBV active group [6.96% (8/115), 10.03 (2.91 ~ 66.99) × 10 9/L], and the differences were statistically significant (χ 2 = 10.330, Z = - 2.003, P < 0.05). Conclusion:HFRS patients may cause latent EBV activity, complicate their clinical features, cause severe renal damage and prolong the recovery time of renal function.
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Objective:To investigate the characteristics of serum immunoglobulin and complement levels in centenarians in Hainan.Methods:Fasting venous blood samples from 969 centenarians in Hainan province were collected and from 364 seniors serving as the control group.Levels of serum immunoglobulin A, G, M and E, immunoglobulin light chain κ and λ, and complement C3 and C4 were measured.Serum immunoglobulin and complement levels were analyzed in subjects based on age, sex, ethnicity, diet and smoking.Results:Serum levels of immunoglobulin G and E, and immunoglobulin light chain κ were higher in the centenarian group than in the control group[15.9(13.8, 18.3)g/L vs.14.9(13.1, 16.9)g/L; 270.0(85.5, 851.0) vs.180.5 kU/L(58.0, 556.2)kU/L, 4.1(3.5, 4.9)g/L vs.4.0(3.1, 4.6)g/L, P<0.05]. Serum levels of immunoglobulin M, and complement C3 and C4 were lower in the centenarian group than in the control group[1.0(0.7, 1.4)g/L vs.1.1(0.8, 1.5)g/L, 1.0(0.9, 1.2) vs.1.1(1.0, 1.3), 0.2(0.2, 0.3) vs.0.3(0.2, 0.3), P<0.05]. Serum levels of immunoglobulin M and complement C3 were higher in female centenarians than in male centenarians[1.1(0.7, 1.4) vs.1.0(0.7, 1.3), 1.0(0.9, 1.1) vs.1.0(0.8, 1.1), P<0.05]. There were significant differences in immunoglobulin A, G and E, and immunoglobulin light chain κ and λ between centenarians of different ethnicities( P<0.01). Serum immunoglobulin M levels were higher in centenarians with a long history of milk-drinking than in those without the history[1.2(0.8, 1.5) vs.1.0(0.7, 1.4), P<0.01]. Conclusions:Serum levels of immunoglobulins and complements are different among centenarians of different ages, genders, ethnicities and diet habits.Factors such as advanced age, female gender, ethnic minority and milk drinking tend to promote the expression of immunoglobulins and complements.
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Objective:To investigate the clinical value of preoperative selective arterial embolization for spinal tumors.Methods:The clinical data of 42 consecutive patients who underwent spinal tumor resection in department of orthopedics Shengjing Hospital of China Medical University from January 2017 to December 2018 were retrospectively analyzed. Patients were divided into embolization group (20 cases) and non-embolization group (22 cases) according to whether they underwent arterial embolization before tumor resection. Two surgical treatments including vertebral resection and laminectomy were performed. The embolization group included 12 cases of vertebral resection and 8 cases of laminectomy; while the non-embolization group included 13 cases of vertebral resection and 9 cases of laminectomy. The difference of intraoperative estimated blood loss, total number of transfused packed red blood cell, calibrated estimated blood loss, operation time and hospitalization time were compared using independent sample t test. Results:Twenty patients in the embolization group underwent successful interventional embolization without serious complications. There were no significant differences between the embolization group and the non-embolization group in terms of intraoperative estimated blood loss, total number of transfused packed red blood cell, calibrated estimated blood loss, operation time, and hospitalization time ( P>0.05). Among the patients who underwent vertebral resection, intraoperative estimated blood loss, total number of transfused packed red blood cell and calibrated estimated blood loss were (1 966.7±898.8) ml, (7.42±3.27) U and (91.3±39.2) g/L in the embolization group, and (2 838.5±1 143.5) ml, (11.04±4.08) U and (133.0±46.4) g/L in the non-embolization group, respectively, with statistically significant differences ( t=-2.107, -2.436, -2.419, P<0.05). However, there was no significant difference in the operation time and hospitalization time between the two subgroups ( t=-0.780, -0.549, P>0.05). Among the patients who underwent laminectomy, there were no significant differences in the above-mentioned indicators between the embolization group and the non-embolization group ( P>0.05). Conclusion:Selective arterial embolization for spinal tumors is a relatively safe interventional procedure. Preoperative embolization does not significantly reduce the amount of blood loss during surgical procedures. After the surgical procedures were differentiated, preoperative embolization significantly reduces the amount of blood loss in patients underwent vertebral resection, while patients who underwent laminectomy do not benefit significantly.
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Objective@#To investigate the clinical value of preoperative selective arterial embolization for spinal tumors.@*Methods@#The clinical data of 42 consecutive patients who underwent spinal tumor resection in department of orthopedics Shengjing Hospital of China Medical University from January 2017 to December 2018 were retrospectively analyzed. Patients were divided into embolization group (20 cases) and non-embolization group (22 cases) according to whether they underwent arterial embolization before tumor resection. Two surgical treatments including vertebral resection and laminectomy were performed. The embolization group included 12 cases of vertebral resection and 8 cases of laminectomy; while the non-embolization group included 13 cases of vertebral resection and 9 cases of laminectomy. The difference of intraoperative estimated blood loss, total number of transfused packed red blood cell, calibrated estimated blood loss, operation time and hospitalization time were compared using independent sample t test.@*Results@#Twenty patients in the embolization group underwent successful interventional embolization without serious complications. There were no significant differences between the embolization group and the non-embolization group in terms of intraoperative estimated blood loss, total number of transfused packed red blood cell, calibrated estimated blood loss, operation time, and hospitalization time (P>0.05). Among the patients who underwent vertebral resection, intraoperative estimated blood loss, total number of transfused packed red blood cell and calibrated estimated blood loss were (1 966.7±898.8) ml, (7.42±3.27) U and (91.3±39.2) g/L in the embolization group, and (2 838.5±1 143.5) ml, (11.04±4.08) U and (133.0±46.4) g/L in the non-embolization group, respectively, with statistically significant differences (t=-2.107, -2.436, -2.419, P<0.05). However, there was no significant difference in the operation time and hospitalization time between the two subgroups (t=-0.780, -0.549, P>0.05). Among the patients who underwent laminectomy, there were no significant differences in the above-mentioned indicators between the embolization group and the non-embolization group (P>0.05).@*Conclusion@#Selective arterial embolization for spinal tumors is a relatively safe interventional procedure. Preoperative embolization does not significantly reduce the amount of blood loss during surgical procedures. After the surgical procedures were differentiated, preoperative embolization significantly reduces the amount of blood loss in patients underwent vertebral resection, while patients who underwent laminectomy do not benefit significantly.
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Objective@#The aim of this study is to evaluate the diagnostic value of turbo spin-echo(TSE) diffusion weighted imaging(DWI) in temporal bone cholesteatoma. @*Method@#A prospective evaluated of 76 patients with suspected sacral cholesteatoma was performed using a Philips Ingenia 3.0T superconducting magnetic resonance scanner and a 32-channel head coil with turbo spin-echo diffusion weighted imaging(TSE-DWI) sequence and conventional magnetic resonance scan, and underwent surgery within the next two weeks. The pathological result is the gold standard, and the imaging diagnosis and surgery are performed. The intraoperative observation and pathological results were compared. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of TSE-DWI sequence in the diagnosis of temporal bone cholesteatoma were calculated. @*Result@#Of the 76 patients with suspected temporal bone cholesteatoma, TSE-DWI scan was performed, 44 cases were diagnosed as cholesteatoma and 32 cases were non-cholesteatoma. Based on the pathology results, 46 cases were diagnosed as cholesteatoma, 30 cases were non-cholesteatoma. The accuracy of TSW-DWI sequence in the diagnosis of cholesteatoma was 89.47%, 3 cases were false negative and 5 cases was false positive. The sensitivity, specificity, positive predictive value and negative predictive value of TSE-DWI in the diagnosis of temporal bone cholesteatoma were 89.13%, 90.00%, 93.18%, and 84.38%, respectively. @*Conclusion@#The TSE-DWI sequence has high signal-to-noise ratio and can improve the diagnostic accuracy and specificity. TSE-DWI sequence is of great value in clinical diagnosis and treatment.
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The aim of this study is to evaluate the diagnostic value of turbo spin-echo(TSE) diffusion weighted imaging(DWI) in temporal bone cholesteatoma. A prospective evaluated of 76 patients with suspected sacral cholesteatoma was performed using a Philips Ingenia 3.0T superconducting magnetic resonance scanner and a 32-channel head coil with turbo spin-echo diffusion weighted imaging(TSE-DWI) sequence and conventional magnetic resonance scan, and underwent surgery within the next two weeks. The pathological result is the gold standard, and the imaging diagnosis and surgery are performed. The intraoperative observation and pathological results were compared. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of TSE-DWI sequence in the diagnosis of temporal bone cholesteatoma were calculated. Of the 76 patients with suspected temporal bone cholesteatoma, TSE-DWI scan was performed, 44 cases were diagnosed as cholesteatoma and 32 cases were non-cholesteatoma. Based on the pathology results, 46 cases were diagnosed as cholesteatoma, 30 cases were non-cholesteatoma. The accuracy of TSW-DWI sequence in the diagnosis of cholesteatoma was 89.47%, 3 cases were false negative and 5 cases was false positive. The sensitivity, specificity, positive predictive value and negative predictive value of TSE-DWI in the diagnosis of temporal bone cholesteatoma were 89.13%, 90.00%, 93.18%, and 84.38%, respectively. The TSE-DWI sequence has high signal-to-noise ratio and can improve the diagnostic accuracy and specificity. TSE-DWI sequence is of great value in clinical diagnosis and treatment.
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Ojbective To predicte the HLAⅠrestricted CTL epitopes and B cell antigen epitopes derived from tumor antigen SCCAg. Methods The linear B cell epitopes and conformational B cell epitopes of tumor antigen SCCAg were predicted by Ellipro program. In addition, the HLAⅠrestricted CTL epitopes of SCCAg were predicted by NetCTL, Prot-Param and so on. Results B cell epitopes analysis revealed that SCCAg had 10 potential linear B cell epitopes and 5 conformational B cell epitopes; Combined with peptide HLAⅠbinding, proteasomal C - terminal cleavage and TAP transport efficiency, the NetCTL predicts that multiple HLAⅠrestricted CTL epitopes were present in the tumor antigen SCCAg. Conclusion The B cell epitopes and HLAⅠrestricted CTL epitopes can be predicted by multiple methods, which may lay the foundation for the further research on immunotherapy for targeting SCCAg.
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Objective To investigate the characteristics of serum lipid levels in centenarians in Hainan province.Methods A total of 899 centenarians were enrolled.Fasting venous blood samples were collected,and serum levels of total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol (HDL-C),apolipoprotein A-1 (Apo A1),apolipoprotein B(Apo B) and lipoprotein (a) [Lp (a)] were determined.Characteristics of serum lipid levels in centenarians with different age and gender were analyzed.Results The ratio of male to female in this study was 1 ∶ 4,101 years of age comprised the largest proportion(20.4 %,183 cases),and the highest age was 109 years old for men and 116 years old for women.People aged 102 years had the highest levels of TC,TG,LDL-C and Apo B,and also had the lowest levels of HDL-C and Apo A1.Serum levels of TC and LDL-C reached the peak at the age of 102 years and showed downward trends year by year.Serum levels of TC,TG,LDL-C,Apo A1 and Apo B were lower in males than in females(P<0.01),and HDL-C had no significant difference between males and females(P >0.05).The detection rates for abnormal serum lipid levels were higher in females than in males(P<0.01).Serum Lp(a) level was higher in females than in males.Conclusions Serum lipid levels show a peak expression at a certain age in centenarians of Hainan,and the types and ratio of abnormal blood lipids are higher in female centenarians than in male centenarians.
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Objective To investigate the effect of knockdown or overexpression of G6PD on proliferation, growth and migration of human hepatocellular carcinoma cell PLC/PRF/5. Methods Lentivirus-mediated knock-down or overexpression of G6PD was achieved in human hepatocellular carcinoma cell line PLC/PRF/5. RT-PCR and Western blotting assay were used to detect the overexpression or knockdown of G6PD.Cell proliferation and mi-gration curves were recorded by real-time cell analysis system(RTCA),the cell proportion in the DNA replication phase can be directly displayed with EDU experiment,cell growth ability was detected by colony forming assay. Results The doubling time of cells in G6PD knockdown group was longer than that of the control group,and the cell growth rate decreased significantly,the proportion of cells in proliferative phase(43.2%)was lower than that in the control group,but the rates colony formation and migration were significantly decreased(P<0.05,respective-ly),and the migration curves separated apparently.While no significant differences in proliferation,growth and mi-gration of PLC/PRF/5 cells were found between the over-expressed strain and the control group. Conclusion The reduction of G6PD expression in HCC cells inhibits the proliferation and growth of HCC,which may lay a foun-dation for the further study of the pathogenesis and treatment of HCC.
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Objective To evaluate the effect and safety of drug-coated balloon (DCB) for treating femoropopliteal arteriosclerosis obliterans.Methods Totally 54 patients with femoropopliteal arteriosclerosis obliterans who underwent percutaneous translurninal angioplasty (PTA) were randomly divided into test group and control group after successful predilation during operation.Patients in test group were treated with DCB,while those in control group were treated with uncoated balloon (UCB) during PTA.A 6-month follow-up was performed after operation.The treatment effect and safety between the two groups were compared.Additional analysis among patients who had a non-flow-limiting dissection during PTA in each group was done.Results Six months after PTA,there were 26 patients in test group and 20 patients in control group after getting rid of 8 patients lost to follow-up.The ankle brachial index (ABI) and minimal lumen diameter (MLD) of target lesion were higher (both P<0.05),and the Rutherford stage,degree of target lesion stenosis,late lumen lose (LLL),the rate of restenosis and target lesion revascularization (TLR) were lower (all P<0.05) in test group than those in control group.There were 14 patients in test group (subgroup A) and 8 patients in control group (subgroup B) who had a non-flow-limiting dissection.Except for the ABI and Rutherford stage 6 months after PTA (both P>0.05),the other effect indexes were statistically different between the two subgroups (all P<0.05).The rates of major adverse events and amputation were similar between test group and control group (both P>0.05).Conclusion DCB has better short-term effect than UCB for treating femoropopliteal arteriosclerosis obliterans as safe as UCB.Meanwhile,DCB is better than UCB in patients with a non-flow-limiting dissection during PTA.
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Objective To explore the potential clinical value of mean platelet volume (MPV) in predicting the curative effect of TACE for hepatocellular carcinoma (HCC). Methods The clinical data of 263 HCC patients, who were treated with TACE at authors' hospital during the period from January 2012 to June 2016, were collected. The MPV data before initial TACE, before and after each repeated TACE were recorded. The time of tumor progression (TTP; referring to mRECIST standard), was documented. Based on the MPV determined before initial TACE, the patients were divided into low - MPV group and high - MPV group, and the TTP between the two groups was compared. Results A total of 263 patients were enrolled in this study. In HCC patients, the MPV determined before initial TACE was (9. 45±1. 24) fL, while the MPV determined after initial TACE was (9. 01±1. 11) fL, the difference between the two was statistically significant (t=4. 344, P<0. 05). The MPV determined at the time when HCC lesion first developed progression was (9. 38±1. 16) fL, which was significantly different with the MPV of (9. 01±1. 11) fL that was obtained after initial TACE (t=3. 498, P<0. 05). Taking the median value of MPV determined before initial TACE (9. 3 fL) as the cutoff value, the patients were divided into the low - MPV group and the high - MPV group according to patient' s MPV determined before initial TACE. Statistically significant difference in the time when HCC lesion first developed progression existed between the low - MPV group and the high - MPV group (P<0. 05). COX regression analysis showed that BCLC stage B and C, MPV value before initial TACE were the independent risk predictors of tumor progression. Conclusion The pre-TACE and post-TACE MPV values in HCC patients treated with TACE has certain clinical significance in evaluating the curative effect of TACE. Moreover, MPV value before initial TACE has some value in predicting the time of HCC progression after TACE. (J Intervent Radiol, 2018, 27:257-262)
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The infrapopliteal arteriosclerosis occlusive disease mainly involves the anterior tibial artery,posterior tibial artery and fibular artery.For the arteriosclerosis occlusive disease of larger arteries of lower extremity,such as iliac artery,femoral artery,etc.,the interventional therapy pattern has been already very mature.However,as the infrapopliteal artery is fine in diameter and the lesion is usually wide with extensive calcification,it is hard to effectively treat the infrapopliteal arteriosclerosis occlusive disease with routine interventional therapy.The therapeutic methods of infrapopliteal arteriosclerosis occlusive disease mainly include surgical treatment,endovascular treatment,drug therapy,and the autologous stem cell transplantation therapy that is still in the research stage at present.This paper aims to introduce the latest progress in interventional therapy for the treatment of infrapopliteal arteriosclerosis occlusive disease in recent years,and to make a prospect for clinical practice in future.
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Objective To compare and analyze the primary and secondary structures and antigenic epitopes of the two allergens: Der p 2 and Der f 2. Methods The protein sequences of Der p 2 and Der f 2 were downloaded online. The primary and secondary structures of the dust mite allergens were compared and analyzed bioinformatically to determine the potential epitope and signal peptide sites. Results Both Der p 2 and Der f 2 contained 146 amino acids and 9 potential protein binding sites with a secondary structure that mainly contains [3 - sheets, and there might be signal peptides site at the 1st 17th segment of the N - terminus. B cell epitopes analysis revealed that both Der p 2 and Der f 2 have 9 potential linear B epitopes and 2 conformational B epitopes. NetMHCⅡserver prediction showed Der p 2 contains 6 high affinity sites, whereas Der f 2 0nly contains 5. Conclusion This study may lay the foundation for further research of the biochemical function of the 2 allergens and contribute to vaccine development for allergen - specific immunotherapy.
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Hepatocellular carcinoma (HCC) has an insidious onset and when a confirmed diagnosis is made,most patients lose the chance for surgery and are given transarterial chemoembolization (TACE) as palliative treatment.However,repeated TACE may lead to overexpression of hypoxia-inducible factor 1 α (HIF-1 α) and vascular endothelial growth factor (VEGF),liver injury,and reduced immune function and has poor long-term efficacy.The introduction of Huai'er granules may help to change the current status.Studies in China and foreign countries have shown that Huai'er granules exert a remarkable anti-tumor effect by blocking cell cycle,inducing cell apoptosis,inhibiting cell proliferation and invasion,and blocking the hepatitis B-hepatocellular carcinoma pathway.Meanwhile,as an adjuvant drug for HCC,Huai'er granules cover the shortcomings of TACE from multiple aspects and can effectively inhibit the overexpression of HIF-1o and VEGF,improve liver injury and immunity,enhance the effect of chemotherapy drugs,and reverse drug resistance.Many clinical studies have confirmed the remarkable advantages of Huai'er granules combined with TACE,and their synergistic effect helps to enhance anti-tumor effect and improve short-and long-term survival rates.
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Objective To analyze the clinical efficacy of balloon occlusion of distal abdominal aorta for patients with pernicious placenta previa and placenta accreta.Methods Data of 72 patients with pernicious placenta previa and placenta accreta were retrospectively analyzed.There were 53 cases (occlusion group) reserved balloon occlusion in abdominal aorta before cesarean section,which can temporarily blocked abdominal aortic blood flow during operation.The other 19 cases (non-occlusion group) underwent cesarean section without balloon occlusion of abdominal aorta.The intraoperative,post operative situations and the birth state of newborn of the two groups were compared.Results The bleeding,blood transfusion and hysterectomy rate during the operation in occlusion group were less than those in non-occlusion group (all P< 0.05).Differences of the rate of postoperative transferring to intensive care unit (ICU) and the time in ICU were statistically significant between two groups (both P <0.05).No statistical difference of operation time,postoperative total hospital stay time and the rate of postoperative infection was found between two groups (both P>0.05).There was no statistical difference of newborns weight and Apgar scores (5 min and 10 min after birth) between two groups (all P>0.05).Conclusion The balloon occlusion of distal abdominal aorta in cesarean section for patients with pernicious placenta previa and placenta accreta is safe and feasible,which can effectively reduce the intraoperative bleeding,the blood transfusion and the risk of hysterectomy.
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Objective To discuss the clinical significance of the changes in plasma D-dimer levels in patients with primary hepatic carcinoma (PHC) after receiving transcatheter arterial chemoembolization (TACE).Methods The clinical data of 69 PHC patients were collected.According to mRECIST criteria,the patients were divided into disease-controlled group,i.e.(CR+PR+SD) patients,(group A,n=41) and disease progression group,i.e.PD patients,(group B,n=28).The plasma D-dimer levels were determined before and after TACE in all patients.The differences in plasma D-dimer levels were determined with ranksum test,and receiver operating characteristic (ROC) curve was used to evaluate the potency of D-dimer levels in judging TACE efficacy.Results The pre-TACE and post-TACE plasma D-dimer levels in group A were 124.00 μg/L (88.00-212.00 μg/L) and 190.00 μg/L (75.00-273.00 μg/L) respectively,the difference was not statistically significant (P>0.05),while those in group B were 261.50 μg/L (138.25-559.50 μg/L) and 554.50 μg/L (398.25-1 080.00 μg/L) respectively.The pre-TACE plasma D-dimer level in group B was significantly higher than that in group A (P<0.05),besides,in group B the plasma D-dimer level showed a further rise after TACE,the difference was statistically significant when compared with the pre-TACE level (P<0.05).ROC curve analysis showed that the areas under ROC of pre-TACE and post-TACE plasma D-dimer levels used to determine the postoperative efficacy were 0.737 and 0.907 respectively.When taking 181.5 μg/L and 339.0 μg/L as the cut-off values,the sensitivity and specificity for judging the postoperative efficacy were 71.4%,70.7% and 85.7%,87.8%,respectively.Conclusion The changes in plasma D-dimer levels have certain value in assessing PHC patient's condition as well as in evaluating the curative effect of TACE.The increase in plasma D-dimer level means that the patient's condition is serious and TACE efficacy will be poor.
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Objective Color-coded digital substraction angiography (CC-DSA) was based on DSA and takes image postprocessing via corresponding software (iFlow or Angioviz).It can observe the change of datas,which will be used to analysis the hemodynamics.CC-DSA has advantages of high temporal and spatal resolution.Meanwhile it spends less time and dose not increase the quantity of contrast-medium and X-ray.The application of CC-DSA in recent years were reviewed in this paper.
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Objective To evaluate the efficacy of superselective renal artery embolization in the treatment of iatrogenic renal hemorrhage. Methods The clinical data of 31 iatrogenic renal hemorrhage patients who had underwent superselective renal artery embolization were retrospectively analyzed. Results All patients were found to have bleeding site by contrast examination, including pseudoaneurysm in 21 cases, renal arteriovenous fistula in 3 cases, extravasation of contrast media in 4 cases, and pseudoaneurysm and renal arteriovenous fistula in 3 cases. Microcoil embolization was used in 20 patients, and microcoil embolization combined with gelatin sponge was used in 12 patients. Thirty patients got successful embolization once, and success rate was 96.8%(30/31). One patient got successful embolization in the second time. There were no serious complications and no recurrence of renal hemorrhage. Conclusions Superselective renal artery embolization in the treatment of iatrogenic renal hemorrhage has the advantages of exact hemostasis, less trauma and fewer complication, and can retain the normal renal tissue maximumly.