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Objectives: To investigate the survival and tumor recurrence after en bloc spondylectomy of spinal tumor and analyze the risk factors of postoperative tumor recurrence. Methods: This is a retrospective case series study. Data of 101 patients undergoing en bloc spondylectomy of spinal tumors in the Musculoskeletal Tumor Center, Peking University People's Hospital from December 2006 to 2006 to June 2022 were analyzed. There were 58 males and 43 females, aged (38.2±15.8) years (range: 10 to 79 years) at the time of surgery; the follow-up time was(44.0±36.0) months (range: 12 to 171 months).Among them, there were 25 relapsed patients, with 7 females and 18 males; aged (34.8±16.3) years (range: 12 to 66 years) at the time of surgery. The types of tumors included 5 giant cell tumors of bone, 6 osteosarcoma, 1 chordoma, 5 chondrosarcoma, 1 undifferentiated sarcoma, 1 fibrosarcoma, 2 Ewing sarcoma, 3 metastases and 1 malignant giant cell tumor of bone. Survival analysis of overall and relapsed patients were performed using the Kaplan-Meier curves. A segmented regression model was used to fit the sequence of recurrence rate changes over time since admission and identify change points for further analysis on risk factors. Univariate and multivariate Logistic regression analysis were performed to assess risk factors associated with recurrence rate; results from multivariate regression analysis are presented using a forest plot. Results The tumor recurrence rate after en bloc spondylectomy was 24.8% (25/101).The overall median recurrence-free survival after en bloc spondylectomy was 161 months (95%CI: 92 months to NA).The median recurrence-free survival of recurrent patients was 13 months (95%CI: 12 to 27 months).Regarding the classification based on tumor malignancy, and relapse-free survival of metastatic tumors was significantly shorter (P=0.007); and among the surgical margin groups, relapse-free survival of R0 group was significantly better than the R1 and R2 groups (P<0.01). According to the segmented regression model, the tumor recurrence rate for en bloc spondylectomy showed a significant downward trend over time, with relatively higher recurrence rates before 2009 and a relatively stable trend after 2014. The results of univariate analysis showed that surgical margin and time of admission were the influencing factors of patient recurrence. The results of multivariate analysis showed that the R1 boundary(OR=13.453,95%CI:2.897 to 97.941,P=0.002) and R2 boundary(OR=11.379,95%CI:2.658 to 79.429,P=0.003) were independent influencing factor affecting patient recurrence. Conclusions The overall tumor recurrence rate after en bloc spondylectomy was high. The surgical margin of tumor resection is an independent risk factor affecting tumor recurrence. Specifically, R2 and R1 resections significantly increase the risk of tumor recurrence.
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Managing cirrhosis complications is an important measure for improving patients' clinical outcomes. Therefore, in order to provide a complete disease assessment and comprehensive treatment, improve quality of life, and improve the prognosis for patients with cirrhosis, it is necessary to pay attention to complications such as thrombocytopenia and portal vein thrombosis in addition to common or severe complications such as ascites, esophagogastric variceal bleeding, hepatic encephalopathy, and hepatorenal syndrome. The relevant concept that an effective albumin concentration is more helpful in predicting the cirrhosis outcome is gradually being accepted; however, the detection method still needs further standardization and commercialization.
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Encefalopatía Hepática , Cirrosis Hepática , Humanos , Cirrosis Hepática/complicaciones , Cirrosis Hepática/diagnóstico , Encefalopatía Hepática/etiología , Encefalopatía Hepática/diagnóstico , Encefalopatía Hepática/terapia , Síndrome Hepatorrenal/etiología , Síndrome Hepatorrenal/diagnóstico , Síndrome Hepatorrenal/terapia , Ascitis/etiología , Ascitis/terapia , Ascitis/diagnóstico , Trombocitopenia/etiología , Trombocitopenia/diagnóstico , Trombocitopenia/terapia , Várices Esofágicas y Gástricas/diagnóstico , Várices Esofágicas y Gástricas/etiología , Várices Esofágicas y Gástricas/terapia , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/terapiaRESUMEN
Objective: To explore the related factors of thrombocytopenia (TCP) occurrence in patients with cirrhosis. Methods: A cross-sectional study was conducted. Inpatients with an initial diagnosis of cirrhosis at Peking University First Hospital from January 1, 2010 to December 31, 2020 were included. Clinical data such as demographic characteristics, etiology of cirrhosis, complications of cirrhosis, laboratory indicators, Child-Pugh grade, invasive procedures, and mortality during hospitalization were collected. A logistic regression model was used to explore the related factors of TCP occurrence in patients with cirrhosis. Categorical variables were compared by the χ(2) test. The inter-group comparison was performed using continuous variables, a t-test, one-way analysis of variance (ANOVA), or a nonparametric test. Results: There were a total of 2 592 cases of cirrhosis. 75 cases with incomplete clinical data were excluded. 2 517 cases were included for analysis. The median age was 58 (50, 67) years. Males accounted for 64%. 1 435 cases (57.0%) developed TCP, and 434 cases (17.2%) had grade 3-4 TCP. Gender, primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and concomitant esophagogastric varices (EGV) were the major factors associated with TCP. Females were more prone to combine with TCP (OR=1.32, 95%CI: 1.12-1.56, P=0.001). Patients combined with EGV (OR=3.09, 95%CI: 2.63-3.65, P<0.001) were more prone to develop TCP, which was associated with the increased incidence of hypersplenism (P<0.001). Patients with PBC (OR=0.64, 95%CI: 0.50-0.82, P<0.001) and PSC (OR=0.23, 95%CI: 0.06-0.65, P=0.010) were less prone to develop TCP, which was due to the shorter prothrombin time and better coagulation function of PBC patients (P<0.001), and the lower proportion of hypersplenism in combined PSC patients (P=0.004). Patients with TCP and grade 3-4 TCP had a higher rate of hemostatic procedures (P<0.05), but a lower rate of liver biopsy (P<0.05). Patients with grade 3-4 TCP had a higher nosocomial mortality rate compared to those without (P=0.004). Conclusion: TCP is common in patients with cirrhosis. However, TCP occurrence is higher in female patients with EGV and lower in patients combined with PBC and PSC. TCP affects invasive procedures and is associated with adverse outcomes.
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Cirrosis Hepática , Trombocitopenia , Humanos , Estudios Transversales , Trombocitopenia/etiología , Masculino , Persona de Mediana Edad , Femenino , Cirrosis Hepática/complicaciones , Anciano , Factores de Riesgo , Modelos Logísticos , Cirrosis Hepática Biliar/complicaciones , AdultoRESUMEN
Allergic diseases are affected by both genetic background and environmental factors.In recent years, many studies have shown that allergic diseases are closely related to the gut microbiome.This article will elaborate on the composition of gut microbiome in early life and its relationship with allergies, the mechanism of action, and the influence of gut microbiome colonization on the atopic march, in order to improve the understanding of the relationship between allergy prevention or treatment and gut microbiome in children, and provide new ideas for the early prevention of allergic diseases and the early intervention of allergic processes.
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Hipersensibilidad , Humanos , Hipersensibilidad/microbiología , Microbiota , Niño , Microbioma Gastrointestinal , Tracto Gastrointestinal/microbiologíaRESUMEN
This study reports a family of patients with 11ß-hydroxylase deficiency (11ß-OHD) caused by a novel mutation in the CYP11B1 gene, and analyzes its clinical and genetic characteristics. The clinical data of a patient with intractable hypertension at Air Force Medical Center on May 16, 2014 were retrospectively analyzed. The patient was clinically diagnosed with congenital adrenal cortical hyperplasia. The clinical data of the patient were further collected and the peripheral blood samples of the patient, his parents and his sister were collected for CYP11B1(NM_000497) gene sequencing, suggesting that the patient had compound heterozygous mutations in exon 1:c.199delG, p.Glu67Lysfs*9 and exon 5:c.905_907 delATGinsTT, p.Asp302Valfs*23, both of which were pathogenic variants. The patient's father and sister carried heterozygous mutations in exon 1:c.199delG, p.Glu67Lysfs*9, and the mother carried heterozygous mutations in exon 5:c.905_907delATGinsTT, p.Asp302Valfs*23. This study is the first to report a new compound heterozygous mutation in exon 1:c.199delG and exon 5 c.905_907 delATGinsTT of CYP11B1 gene, enriching the database of 11ß-OHD mutations and providing information to further understand the genetic mechanism of the disease.
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Hiperplasia Suprarrenal Congénita , Mutación , Esteroide 11-beta-Hidroxilasa , Humanos , Esteroide 11-beta-Hidroxilasa/genética , Hiperplasia Suprarrenal Congénita/genética , Masculino , Femenino , Estudios Retrospectivos , Exones , Heterocigoto , LinajeAsunto(s)
Úlcera Duodenal , Humanos , Úlcera Duodenal/complicaciones , Úlcera Duodenal/cirugía , Úlcera , Duodeno , HemorragiaRESUMEN
En bloc resection of spine tumor is the essential treatment method for primary malignant spine tumor,primary aggressive spine tumor and solitary spine metastasis.It can achieve good local control and improve the prognosis.However,given the complex anatomic structure and major adjacent tissue and organ of the spine,en bloc resection of spine tumor remains the research hotspot in surgical treatment of spine tumor.On the basis of adequate surgical classification and surgical strategy,experienced surgical team for spine tumor can achieve good surgical margin while decreasing the morbidity of the en bloc resection of spine tumor.However,the details of surgical classification and surgical strategy require further study.
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Previously, liver lesions in cirrhosis were considered irreversible, especially because the condition aggravated gradually after entering the decompensated phase, thus making it difficult to return to the compensated phase. At present, more and more evidence shows that some patients with decompensated liver cirrhosis can be recompensated after the cause is controlled and complications are managed. This article explores the research progress related to LC reversal and recompensation from three aspects: liver histopathology, liver function, and clinical complications.
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Cirrosis Hepática , Humanos , Cirrosis Hepática/complicacionesRESUMEN
Trimethyltin chloride is a highly toxic substance, which is absorbed through respiratory tract, skin and digestive tract, with central nervous system injury as the main clinical manifestations, and can be accompanied by damage to various organs. In this paper, the treatment process of 3 patients with acute trimethyltin chloride poisoning was reviewed, and their clinical manifestations, auxiliary examination, diagnosis and treatment were analyzed. Three patients were misdiagnosed as mental abnormality, encephalitis, and hepatic encephalopathy in different hospitals in the early stage of medical treatment, suggesting that clinicians should pay attention to the occupational contact history of poisoned patients and conduct toxicant detection in time to avoid misdiagnosis and mistreatment.
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Despite over 40 years of research on the human immunodeficiency virus type 1 (HIV-1) vaccine, we still lack a considerable progress. Equine infectious anemia virus (EIAV) is a lentivirus in the Retroviridae family, akin to HIV-1 in genome structure and antigenicity. EIA is an important infectious disease in equids, characterized by anemia, persistent infection, and repeated fevers. The EIAV attenuated vaccine in China is the only lentiviral vaccine used on a large scale. Elucidating the mechanism of waning and induction of protective immunity from this attenuated vaccine strain will provide a critical theoretical basis and reference point for vaccine research, particularly in the development of lentivirus vaccines, with far-reaching scientific value and social significance. In this paper, we summarize the information related to EIAV integration site selection, particularly for the Chinese EIAV attenuated vaccine strains on the equine genome. This may improve our mechanistic understanding of EIAV virulence reduction at the host genome level. The obtained data may help elucidate the biological characteristics of EIAV, particularly the Chinese attenuated EIAV vaccine strain, and provide valuable information regarding retroviral infections, particularly lentiviral infection and associated therapeutic vectors.
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Anemia Infecciosa Equina , Enfermedades de los Caballos , Virus de la Anemia Infecciosa Equina , Vacunas Virales , Animales , Humanos , Anemia Infecciosa Equina/prevención & control , Caballos , Virus de la Anemia Infecciosa Equina/genética , Lentivirus Equinos , Vacunas Atenuadas/genéticaRESUMEN
SOX2 is a transcription factor involved in multiple stages of embryonic development. In related reports, SOX2 was found to be abnormally expressed in tumor tissues and correlated with clinical features such as TNM staging, tumor grade, and prognosis in patients with various cancer types. In most cancer types, SOX2 is a tumor-promoting factor that regulates tumor progression and metastasis primarily by maintaining the stemness of cancer cells. In addition, SOX2 also regulates the proliferation, apoptosis, invasion, migration, ferroptosis and drug resistance of cancer cells. However, SOX2 acts as a tumor suppressor in some cases in certain cancer types, such as gastric and lung cancer. These key regulatory functions of SOX2 involve complex regulatory networks, including protein-protein and protein-nucleic acid interactions through signaling pathways and noncoding RNA interactions, modulating SOX2 expression may be a potential therapeutic strategy for clinical cancer patients. Therefore, we sorted out the phenotypes related to SOX2 in cancer, hoping to provide a basis for further clinical translation.
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Neoplasias Pulmonares , Transducción de Señal , Humanos , Neoplasias Pulmonares/patología , Estadificación de Neoplasias , Factores de Transcripción/metabolismo , Factores de Transcripción SOXB1/genética , Línea Celular Tumoral , Regulación Neoplásica de la Expresión Génica , Proliferación CelularRESUMEN
The existing dentin bonding systems based on acid-etching technique lead to the loss of both extrafibrillar and intrafibrillar minerals from dentin collagen, causing excessive demineralization. Because resin monomers can not infiltrate the intrafibrillar spaces of demineralized collagen matrix, degradation of exposed collagen and resin hydrolysis subsequently occur within the hybrid layer, which seriously jeopardizing the longevity of resin-dentin bonding. Collagen extrafibrillar demineralization can effectively avoid the structural defects within the resin-dentin interface caused by acid-etching technique and improve the durability of resin-dentin bonding, by preserving intrafibrillar minerals and selectively demineralizing extrafibrillar dentin. The mechanism and research progress of collagen extrafibrillar demineralization in dentin bonding are reviewed in the paper.
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Recubrimiento Dental Adhesivo , Desmineralización Dental , Humanos , Colágeno , Dentina/química , Recubrimientos Dentinarios/química , Ensayo de Materiales , Minerales , Cementos de Resina/químicaRESUMEN
African swine fever (ASF) is an acute, hemorrhagic, and devastating viral infectious disease that causes important economic losses to the swine industry. Currently, there are no effective vaccines or drugs available. Epigenetic mechanisms, especially cytosine methylation of cytosine- -phosphate-guanine (CpG) islands, have a significant impact on the life cycle of several viruses. Hence, drugs targeting DNA methylation may potentially be used for the treatment of ASF. Here, we selected the inner core, core shell, inner membrane, capsid, and external envelope membrane, to analyze the characteristics of CpG islands in the ASF virus (ASFV) genomes. Furthermore, we analyzed the promoters and CpG islands in the upstream regions of these genes. Results showed that the CpG islands of seven genes were conserved in the genomes of two genotype of ASFV strains, whereas the CpG islands of other genes were relatively conserved (ASFV strains differed mainly in the quantity of CpG islands). The different distribution of CpG islands in the genomes of different ASFV strains may affect their methylation status, which may in turn affect the regulation of viral gene expression, leading to different clinical outcomes. In addition, the predicted promoter regions based on the upstream sequences of most genes overlapped with CpG island positions. Methylation of the binding sites of the promoter regions inhibits the binding of the transcription factors to the promoters, thus inhibiting the activation of the promoters and limiting the synthesis of viral proteins. The results of this study provide a basis for exploring new antiviral therapeutic strategies from an epigenetic perspective.
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Virus de la Fiebre Porcina Africana , Fiebre Porcina Africana , Enfermedades de los Porcinos , Virus de la Fiebre Porcina Africana/genética , Animales , Antivirales/farmacología , Islas de CpG , Citosina/metabolismo , Citosina/farmacología , Genotipo , Guanina/metabolismo , Guanina/farmacología , Fosfatos , Porcinos , Enfermedades de los Porcinos/genética , Factores de Transcripción/genética , Factores de Transcripción/metabolismo , Factores de Transcripción/farmacología , Proteínas Virales/metabolismoRESUMEN
Thymus, an important central immune organ in pigs, is the site of T lymphocyte development and maturation and an important target organ for infection and replication of various pathogens. Highly pathogenic porcine reproductive and respiratory syndrome virus (HP-PRRSV) infection results in severe thymic atrophy in piglets. This study aimed to explore the effects of HP-PRRSV on the thymic structure of piglets to elucidate the pathogenesis of thymic atrophy induced by HP-PRRSV. In this study, histopathological techniques and immunofluorescence double staining techniques were used to analyze thymic tissues infected by HP-PRRSV to explore the structural changes of thymus caused by the viral infection and its target cell types. An antibody of cluster of differentiation (CD) 3 (CD3), CD20, CD80, or calgranulin + calprotectin was applied to identify T cells, B cells, dendritic cells (DCs), and macrophages, respectively. The results indicated that a variety of cell components in the thymic tissue were diffusely damaged after viral infection. In the infected thymic tissue, CD80- or calgranulin + calprotectin- -labeled cells supported the HP-PRRSV infection, whereas CD3-labeled T cells and CD20- -labeled B cells did not support the viral infection. The results showed that HP-PRRSV caused the reduction of visible cell components in the thymic tissue, and the virus attacked CD80- and calgranulin + calprotectin-positive cells (such as DCs and macrophages) in the thymic tissue, which played an important role in the pathogenesis of thymus atrophy. These results lay the foundation for elucidating the immunosuppression of piglets after infection with HP-PRRSV.
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Síndrome Respiratorio y de la Reproducción Porcina , Virus del Síndrome Respiratorio y Reproductivo Porcino , Enfermedades de los Porcinos , Animales , Atrofia/patología , Atrofia/veterinaria , Complejo de Antígeno L1 de Leucocito , Porcinos , Enfermedades de los Porcinos/patología , Linfocitos TRESUMEN
Objective: To understand the clinical characteristics of hospitalized patients with liver cirrhosis, so as to provide theoretical basis for disease diagnosis and treatment, formulation of intervention measures, and improve the level of disease diagnosis and treatment. Methods: Hospitalized patients who were initially diagnosed with liver cirrhosis at Peking University First Hospital from August 2017 to December 2018 were selected retrospectively as the research objects. Liver cirrhosis demographic data, etiology, severity classification, incidence of complications, diagnosis and prognosis were recorded. Statistical analysis was performed using SPSS software. Results: Among all liver cirrhosis cases, there were 291 males and 209 females, with a male-to-female ratio of 1.4:1 and an age of 59.5±12.9 years as at August 2017 to December 2018. HBV infection, alcoholic liver disease, and autoimmune liver diseases were the most common etiology of liver cirrhosis. HBV infection alone, HBV infection combined with other factors, alcoholic liver disease alone, alcoholic liver disease combined with other factors, autoimmune liver disease alone, and autoimmune liver disease combined with other factors were presented in 163 (32.6%), 57 (11.4%), 47 (9.4%), 63 (12.6%), 85 (17.0%), and 22 (4.4.0%) cases, respectively. Ascites (221 cases, 44.2%), followed by esophagogastric varices (214 cases, 42.8%), and other including hypersplenism (137 cases), liver cancer (126 cases), upper digestive system tract hemorrhage (66 cases), hepatic encephalopathy (40 cases), infection (37 cases), portal vein thrombosis (23 cases), hepatorenal syndrome (20 cases) were the most common complications. The most common site of infection was the abdominal cavity (20 cases), accounting for 54.1%; followed by respiratory tract infection (8 cases), accounting for 21.6% in patients with liver cirrhosis with concurrent infection. Among them, there were 32 cases of bacterial infection alone, one case of bacterial infection combined with fungal infection, one case of bacterial infection combined with viral infection, and three cases of unknown pathogens. There were 69 cases in Child Pugh grade C, and the average hospitalization times were 12.6 days in terms of prognosis. There were total seven cases of death, of which five cases were due to upper gastrointestinal hemorrhage and two due to hepatic encephalopathy. Conclusion: HBV infection, ascites, and upper gastrointestinal bleeding were the most common etiologies, complications, and causes of death in patients with liver cirrhosis at our hospital.
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Encefalopatía Hepática , Cirrosis Hepática , Hepatopatías Alcohólicas , Neoplasias Hepáticas , Anciano , Ascitis/complicaciones , Infecciones Bacterianas/complicaciones , Beijing/epidemiología , Femenino , Hemorragia Gastrointestinal/etiología , Encefalopatía Hepática/complicaciones , Humanos , Cirrosis Hepática/complicaciones , Hepatopatías Alcohólicas/complicaciones , Neoplasias Hepáticas/complicaciones , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Centros de Atención TerciariaAsunto(s)
Oxigenación por Membrana Extracorpórea , Insuficiencia Respiratoria , Cánula , Cateterismo , Vena Femoral , HumanosRESUMEN
Patients with chronic (hepatitis B virus,HBV) infection can be divided into immunotolerant, immunoclearance (HBeAg-positive, immune-active), immunocontrol (inactive), and reactivation (HBeAg-negative, immune-active) phases according to HBV serological markers, HBV DNA, alanine aminotransferase, and liver pathology results. Chronic HBV infection is considered indeterminate when the above four phasing criteria are not met. The Chinese "Guidelines" recommend antiviral B treatment for chronic HBV-infected patients with elevated alanine aminotransferase levels after excluding other potential causes. As a result, patients with chronic HBV infection in the immunoclearance and reactivation phases are included in the indication population for antiviral therapy, and the expanded indications are mainly for other infected individuals beyond these two phases: immunotolerant, immunocontrol, and indeterminate. Antiviral therapy may benefit individuals in an indeterminate phase, because they are at a relatively high risk of disease progression.
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Hepatitis B Crónica , Hepatitis B , Humanos , Antígenos e de la Hepatitis B , Alanina Transaminasa , Virus de la Hepatitis B/genética , Antivirales/uso terapéutico , ADN Viral , Hepatitis B/tratamiento farmacológicoRESUMEN
Epstein-Barr virus (EBV) infection is closely associated to liver injury with diverse clinical features in adolescents and adults. It is often manifested as infectious mononucleosis syndrome, sometimes causing self-limited acute hepatitis, with mild to moderate elevation of liver transaminases, and relative increase in age-related conditions. EBV infection can also cause cholestatic hepatitis, with elevated alkaline phosphatase and γ-glutamyltransferase as the main manifestations, accompanied by varying degrees of jaundice. A small number of patients with severe EBV infection may experience liver failure, and if left untreated in time, it may lead to high mortality. In addition, EBV infection is also associated with chronic hepatitis, liver cirrhosis, autoimmune liver disease, etc.