RESUMEN
OBJECTIVE: To evaluate the safety and efficacy of allogeneic natural killer (NK) cells in the treatment of primary hepatocellular carcinoma (HCC), and to elucidate the mechanism of NK cells therapy. METHODS: Twenty-one patients with primary HCC treated with allogeneic NK cells at the Fifth Medical Center of the PLA General Hospital were followed up for 1 year. Peripheral blood mononuclear cells (PBMCs) were isolated from patient-related donors and cultured in vitro for 15 days and infused to the patients in two consecutive days. Clinical data and laboratory data were collected and analyzed, including survival, clinical features, imaging changes, hematology, immunology, and biochemical indicators to evaluate the safety and efficacy of allogeneic NK cell therapy. The changes of peripheral blood lymphocyte subsets after treatment were also analyzed to explore the possible anti-tumor mechanisms. RESULTS: (1) Of the 21 patients with primary HCC, 11 patients were treated once, 5 patients were treated twice, and 5 patients were treated 3 times. After allogeneic NK cells infusion, 10 patients had fever, 1 patient had slight hepatalgia and 1 patient had slight headache, no other adverse events occurred including acute and chronic graft-versus-host disease (GVHD). They resolved spontaneously within 8 hours without other treatment. (2) The total disease control rate was 76.2% during one-year follow-up. Among them, the patients with Barcelona clinic liver cancer (BCLC) stage A had a disease control rate of 100%, stable disease (SD) in 10 cases; BCLC stage B patients had a disease control rate of 60%, partial response (PR) in 1 case, and SD 2 in cases; BCLC stage C patients had a disease control rate of 50%, complete response (CR) in 1 case, and 2 cases of PR. (3) The frequencies of NK cells and CD8+ T cells in peripheral blood were significantly lower than that before at 24 hours after treatment, and the frequencies of CD4+ T cells and CD4/CD8 were significantly higher than the baseline. CONCLUSION: Allogeneic NK cells have good safety and efficacy in the treatment of primary HCC. The anti-tumor effect of the allogeneic NK cells may play an important role in the activation of the patient's natural immune system and delay disease progression, suggesting that allogeneic NK cells combined with sorafenib may be a very effective treatment for advanced HCC, and further large-sample multicenter randomized controlled clinical trials are needed to validate this result.
Asunto(s)
Carcinoma Hepatocelular , Enfermedad Injerto contra Huésped , Neoplasias Hepáticas , Humanos , Células Asesinas Naturales , Leucocitos MononuclearesRESUMEN
Retreatment of tuberculosis (TB) often fails in China, yet the risk factors associated with the failure remain unclear. To identify risk factors for the treatment failure of retreated pulmonary tuberculosis (PTB) patients, we analyzed the data of 395 retreated PTB patients who received retreatment between July 2009 and July 2011 in China. PTB patients were categorized into 'success' and 'failure' groups by their treatment outcome. Univariable and multivariable logistic regression were used to evaluate the association between treatment outcome and socio-demographic as well as clinical factors. We also created an optimized risk score model to evaluate the predictive values of these risk factors on treatment failure. Of 395 patients, 99 (25·1%) were diagnosed as retreatment failure. Our results showed that risk factors associated with treatment failure included drug resistance, low education level, low body mass index (6 months), standard treatment regimen, retreatment type, positive culture result after 2 months of treatment, and the place where the first medicine was taken. An Optimized Framingham risk model was then used to calculate the risk scores of these factors. Place where first medicine was taken (temporary living places) received a score of 6, which was highest among all the factors. The predicted probability of treatment failure increases as risk score increases. Ten out of 359 patients had a risk score >9, which corresponded to an estimated probability of treatment failure >70%. In conclusion, we have identified multiple clinical and socio-demographic factors that are associated with treatment failure of retreated PTB patients. We also created an optimized risk score model that was effective in predicting the retreatment failure. These results provide novel insights for the prognosis and improvement of treatment for retreated PTB patients.
Asunto(s)
Antituberculosos/administración & dosificación , Modelos Teóricos , Tuberculosis Pulmonar/tratamiento farmacológico , Adulto , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Retratamiento/estadística & datos numéricos , Factores de Riesgo , Insuficiencia del TratamientoRESUMEN
Globally, the incidence of early-onset colorectal cancer (EOCRC) among individuals younger than 50 is escalating. Compared to late-onset colorectal cancer, EOCRC exhibits distinct clinical, pathological, and molecular features, with a higher prevalence in the left colon and rectum. However, the occurrence and development of EOCRC is a multi-factor and multi-stage evolution process, which is the result of the mutual effect of environmental, genetic and biological factors, and involves the multi-level regulation mechanism of other organisms. With the development and improvement of high-throughput sequencing technology, the application of multi-omics analysis has become an important development direction to resolve the pathogenesis of complex diseases and individualized treatment plans. This article aims to review the research progress of EOCRC at the multi-omics level, providing a theoretical foundation for earlier diagnosis and more precise treatment of this diseases.
Asunto(s)
Neoplasias Colorrectales , Humanos , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/diagnóstico , Genómica , Secuenciación de Nucleótidos de Alto Rendimiento , Proteómica/métodos , Edad de Inicio , Metabolómica , MultiómicaRESUMEN
We describe current pubertal development in healthy urban Chinese boys. A cross-sectional study of the pubertal development of 18,807 urban Chinese boys aged from 3.50 to 18.49years was conducted between 2003 and 2005. Testicular volume was evaluated with a Prader orchidometer. Pubic hair development was assessed according to the Tanner method. Data on spermarche were collected using the status quo method. Probit analysis was used to calculate the median age and 95% CI at different stages of testicular development, pubic hair development and spermarche. By age 9, 12.99% of the boys had a testicular volume of 4mL or greater. The median age of onset of puberty defined as the age at attainment of testicular volume of 4mL or greater was 10.55 (95% CI 10.27-10.79) years. The median age for onset of pubic hair development (PH(2) ) and spermarche was 12.78 (95%CI 12.67-12.89) years and 14.05 (95%CI 13.80-14.32) years, respectively. Pubertal onset in urban Chinese boys is earlier than currently used clinical norms but their pubic hair development occurs relatively late in comparison with the reported data from numerous other countries. There is also evidence of a secular trend towards an earlier age of spermarche since 1979 in Chinese urban boys.
Asunto(s)
Pubertad , Maduración Sexual , Adolescente , Factores de Edad , Pueblo Asiatico , Índice de Masa Corporal , Niño , Preescolar , China , Humanos , Masculino , Caracteres Sexuales , Testículo/crecimiento & desarrolloRESUMEN
We report a theoretical study of the escape rates of the Hénon-Heiles system above threshold. An analytic formula for the escape rate as a function of energy is presented. We also simulated the escaping process by following the motions of a large number of particles. Two algorithms are employed to solve the equations of motion. One is the Runge-Kutta-Fehlberg method, and another is a recently proposed fourth order symplectic method. Our simulations show the escape of Hénon-Heiles system follows exponential laws. We extracted the escape rates from the time dependence of particle numbers in the Hénon-Heiles potential. The extracted escape rates agree with the analytic result. Close to threshold we find the rate alpha(DeltaE) can be written as a series expansion, the first term of this expansion is 4/3DeltaE.
RESUMEN
The fine dissection of nerves and blood vessels in the tarsal tunnel is necessary for clinical operations to provide anatomical information. A total of 60 feet from 30 cadavers were dissected. Two imaginary reference lines that passed through the tip of the medial malleolus were applied. A detailed description of the branch pattern and the corresponding position of the posterior tibial nerve, posterior tibial artery, medial calcaneal nerve and medial calcaneal artery was provided, and the measured data were analyzed. Our results can be summarized as follows. I. A total of 81.67% of the bifurcation points of the posterior tibial nerve, which was divided into the medial and lateral plantar nerves, were located within the tarsal tunnel, not distal to the tarsal tunnel. II. The bifurcation points of the posterior tibial artery were all located in the tarsal tunnel. Almost all of the bifurcation points of the posterior tibial artery were lower than those of the posterior tibial nerve. The bifurcation point of the posterior tibial artery situated distal to the tarsal tunnel was not found. III. The number and the origin of the medial calcaneal nerves and arteries were highly variable.
Asunto(s)
Disección , Síndrome del Túnel Tarsiano/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Síndrome del Túnel Tarsiano/patología , Síndrome del Túnel Tarsiano/fisiopatología , Arterias Tibiales/patología , Arterias Tibiales/fisiopatología , Nervio Tibial/patología , Nervio Tibial/fisiopatología , Adulto JovenRESUMEN
Classical swine fever (CSF) is a devastating infectious disease of pigs caused by classical swine fever virus (CSFV). In China, CSF has been under control owing to extensive vaccination with the lapinized attenuated vaccine (C-strain) since 1950s, despite sporadic or endemic in many regions. However, recently, CSF outbreaks occurred in a large number of swine herds in China. Here, we isolated 15 CSFV strains from diverse C-strain-vaccinated pig farms in China and characterized the genetic variations and antigenicity of the new isolates. The new strains showed unique variations in the E2 protein and were clustered to the subgenotype 2.1d of CSFV recently emerging in China in the phylogenetic tree. Cross-neutralization test showed that the neutralizing titres of porcine anti-C-strain sera against the new isolates were substantially lower than those against both the highly virulent Shimen strain and the subgenotype 2.1b strains that were isolated in China in 2006 and 2009, respectively. In addition, experimental animal infection showed that the HLJZZ2014 strain-infected pigs displayed lower mortality and less severe clinical signs and pathological changes compared with the Shimen strain-infected pigs. The HLJZZ2014 strain was defined to be moderately virulent based on a previously established assessment system for CSFV virulence evaluation, and the virus shedding and the viral load in various tissues of the CSFV HLJZZ2014 strain-infected pigs were significantly lower than those of the Shimen strain-infected pigs. Taken together, the subgenotype 2.1d isolate of CSFV is a moderately virulent strain with molecular variations and antigenic alterations.
Asunto(s)
Virus de la Fiebre Porcina Clásica/inmunología , Peste Porcina Clásica/virología , Variación Genética , Vacunas Virales/inmunología , Animales , Variación Antigénica , China/epidemiología , Peste Porcina Clásica/epidemiología , Peste Porcina Clásica/prevención & control , Virus de la Fiebre Porcina Clásica/genética , Virus de la Fiebre Porcina Clásica/aislamiento & purificación , Virus de la Fiebre Porcina Clásica/patogenicidad , Genotipo , Filogenia , Distribución Aleatoria , Porcinos , Vacunación/veterinaria , Vacunas Atenuadas , VirulenciaRESUMEN
OBJECTIVE: To summarize the characterization of ovarian adrenal rest tumors (OART) in children and adolescent females with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD). METHOD: We have diagnosed 4 cases of CAH 21-OHD with OART in the recent 5 years in pediatric endocrinology unit of the first affiliated hospital of Sun Yat-Sen University. Clinical characterizations were summarized, including symptoms, growth patterns and bone age advancements, serum steroid concentrations, imaging results and the follow-up data. RESULT: The 4 cases of OART accounted for 2.5 % of the CAH 21-OHD girls, which was much lower than the detection rate, 29.5%, of testicular ART in our patient group during the same period. The 4 cases included 3 salt wasters and 1 with simple virilizm. OART were diagnosed at the age of 8.9 years, 15.8 years, 21.4 years and 9.3 years, respectively. Before the diagnosis of OART, their daily hydrocortisone doses reached 16 mg/(m(2)·d)to 24 mg/(m(2)·d). The patients presented with deteriorated acne, deepened voice, amenorrhea (2 cases), accelerated growth and advanced bone age, ΔBA/ΔCA reached 1.2(during GnRHa treatment)and 2.0. Their serum adrenal steroids increased significantly and hyperplasia of adrenal glands were found in all patients. The diagnosis could be confirmed before the operation in only 1 case. The diagnosis could not be made until the planned sub-total adrenalectomy in the other 3 cases. The follow-up periods of OART were 4.8, 4.7, 3.8 and 2.7 years, respectively. Removal of OART resulted in symptoms relief at least partialy and lowered daily hydrocortisone doses, 14 to 19 mg/(m(2)·d). CONCLUSION: The detection rate of OART was much lower than testicular ART. Before the diagnosis of OART, the patients presented with deteriorated virilescence, accelerated growth and advanced bone age, elevated serum adrenal steroids and hyperplasia of adrenal glands. Removal of the OART resulted in symptoms relief at least partialy.
Asunto(s)
Hiperplasia Suprarrenal Congénita/diagnóstico , Tumor de Resto Suprarrenal/diagnóstico , Neoplasias Ováricas/diagnóstico , Adolescente , Glándulas Suprarrenales/patología , Hiperplasia Suprarrenal Congénita/patología , Hiperplasia Suprarrenal Congénita/terapia , Tumor de Resto Suprarrenal/patología , Tumor de Resto Suprarrenal/cirugía , Niño , Femenino , Humanos , Hidrocortisona/administración & dosificación , Hidrocortisona/uso terapéutico , Hiperplasia , Neoplasias Ováricas/patología , Neoplasias Ováricas/cirugía , Esteroides/sangre , Adulto JovenRESUMEN
Objective: To describe the status and related factors of self-reported pain among working-age population in Inner Mongolia Autonomous Region (Inner Mongolia). Methods: A cross-sectional study was conducted. Data was from the Inner Mongolia fifth health services survey. SPSS 19.0 software package was used for data analysis and χ2 test was to compare the prevalence of self-reported pain in population with different characteristics. Unconditional logistic regression model was used to analyze the related factors on self-reported pain. Results: A total of 11 480 working-age population was involved in this survey, with prevalence of self-reported pain among working age population as 12.3%. The prevalence rates of moderate and severe pain were 11.6% and 0.7%, respectively. Results from the unconditional logistic regression analysis showed that, in the economically poor population, the risk of self-reported pain was 1.718 times of the relatively rich people (OR=1.718, 95%CI: 1.381-2.831). In the rural areas, the risk of self-reported pain was higher than that in the urban population (OR=2.506, 95%CI: 2.030-3.092) and people with chronic illnesses had 2.880 times higher risk than those who did not have the diseases (OR=2.880, 95% CI: 2.474-3.352). There was an interaction noticed between gender and age. Women at or above 45 years old were more likely to develop self-report pain (OR=1.300, 95% CI: 1.072-1.577). Again, factors as people who were current or former smokers, who were suffering from anxiety or depression, being skinny etc. appeared as independently related to the self-reported pain. Conclusion: In working age population of Inner Mongolia, a high prevalence of self-reported pain was seen. Data showed that people who were poor, age at 45 or older, having history of smoking, with chronic diseases and anxiety/depression were risk factors related to self-reported pain.
Asunto(s)
Dolor , China , Enfermedad Crónica , Estudios Transversales , Trastorno Depresivo , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Autoinforme , Fumar , Encuestas y Cuestionarios , Población UrbanaRESUMEN
A negative ion irradiated by a laser provides a coherent source of electrons propagating out from the location of the negative ion. The total escape rates of the electrons when the negative ion is placed inside an open cavity in the shape of a wedge are studied. It is shown that the wedge induces significant oscillations in the total escape rates because of quantum interference effects. In particular, it is shown that, for a wedge with an opening angle of π/N, where N is an arbitrary positive integer, there are (2N-1) induced oscillations in the rates. As a demonstration, the case for a wedge with an opening angle π/5 is calculated and analyzed in detail.