Child ; Child, Preschool ; Female ; Humans ; Male ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Genetic ; Sleep Apnea, Obstructive ; genetics ; physiopathology

Objective To explore the effect of sequential therapy of transcatheter arterial chemoembolization (TACE) followed by percutaneous microwave coagulation therapy (PMCT) in treating early-stage primary hepatocellular carcinoma (PHC), and to analyze the factors that may affect the prognosis. Methods During the period from Jan. 2011 to Apr. 2014, a total of 66 patients with early-stage PHC were admitted to authors’ hospital. TACE was carried out in all patients, which was followed by PMCT in 5 -7 days. All patients were followed up regularly. CT, MR, ultrasonography, AFP, liver function and other related laboratory tests were performed. Kaplan-Meier estimation was used for the analysis of disease-free survival time. The high-risk factors were analyzed by Chi-square test. Multivariate analysis was conducted by using logistic analysis method. Results After TACE the serum levels of ALT, TBIL and DBIL were increased significantly when compared with preoperative ones (P< 0.01). After sequential PMCT the serum levels of AST, ALT and DBIL were increased significantly when compared with preoperative ones (P< 0.01). When compared with TACE, after sequential PMCT the serum level of AST was increased (P< 0.01), while serum levels of TBIL and DBIL were decreased (P< 0.01). Compared with TACE and preoperative data, the post-PMCT AFP level was decreased (P < 0.01). During the follow-up period one patient died. The 3-year cumulative survival rate was 98.5%. Recurrence was seen in 19 cases. The one-year, 2-year and 3-year disease-free cumulative survival rate was 70.3%, 50.8% and 41.6% respectively. Univariate and multivariate analysis indicated that the risk factors of recurrence in early-stage PHC included AFP ≥ 100 μg/L, viral load≥103 copies/ml and irregularity of tumor border (P<0.05). Conclusion Sequential therapy of TACE followed by PMCT is an ideal treatment for early-stage PHC, sequential PMCT after TACE does not affect liver recovery process. AFP ≥ 100 μg/L, viral load ≥ 103 copies/ml and irregularity of tumor border are the risk factors of recurrence.

Objective To evaluate diagnostic value of diffusion tensor imaging(DTI)in ringlike- enhanced lesions.Methods Nine abscesses,12 glioblastomas,10 metastases confirmed clinically or pathologically underwent conventional MRI and DTI.Average diffusion coefficient(ADC)value,fractional anisotropy(FA)value and maps were calculated in the central portion and peripheral edema of the lesions. Results On DTI,the abscesses displayed as hyperintense signal with hypointense or isointense signal of edema;but glioblastomas and metastases all showed as hypointense signal with isointense or hypointense signal of edema.On ADC map,the abscesses showed as hypointense signal,the mean ADC value was (0.66?0.07)x10~(-3)mm~2/s,The mean ADC value were(2.50?0.11)x10~(-3)mm~2/s and(2.37?0.52)x10~(-3)mm~2/s for the glioblastomas and metastases,respectively,all demonstrated as hyperintense signal with slightly hyperintense signal of edema.The difference between abscess and necrotic tumors was statistically significant(F=108.80,P

OBJECTIVETo explore the distribution laws of TCM syndrome types and to analyze the distribution of dynamic blood pressure curve, atherosclerosis, and age in senile hypertension patients.

METHODSTotally 1 131 senile hypertension patients were recruited from 7 provinces and municipal cities. Features of TCM syndromes, classification and distribution curves, and syndrome distribution laws were observed. The distribution curves of dynamic blood pressure, carotid atherosclerosis, and age were compared in each TCM syndrome types.

RESULTSThere were four main syndrome types in 736 cases (56.15%), i.e., excessive accumulation of phlegm-dampness syndrome (210 cases, 16.02%), yin deficiency and hyperactivity of yang syndrome (177 cases, 13.50%), Gan-Shen yin deficiency syndrome (79 cases, 6.03%), and deficiency of qi and yin syndrome (252 cases, 19.22%). Besides, there were two more sub-types, i.e., collateral obstruction by blood stasis syndrome and collateral obstruction by phlegm and stasis. Circadian blood pressure monitor was completed in 211 cases. Of them, abnormal circadian blood pressure occurred in 152 cases (accounting for 72. 38%); yin deficiency and hyperactivity of yang syndrome, excessive accumulation of phlegm-dampness syndrome, deficiency of qi and yin syndrome plus collateral obstruction by blood stasis syndrome were most often seen. Color ultrasound of carotid artery was performed in 660 patients of main syndromes. The incidence was quite higher in those of excessive accumulation of phlegm-dampness syndrome (182 cases, 27. 58%), deficiency of qi and yin syndrome plus collateral obstruction by blood stasis syndrome or collateral obstruction by phlegm and stasis (322 cases, 48.79%). Yin deficiency and hyperactivity of yang syndrome was dominant in patients 60 -79 years old, while deficiency of qi and yin syndrome and Gan-Shen yin deficiency syndrome were dominant in patients older than 80 years.

CONCLUSIONSExcessive accumulation of phlegm-dampness syndrome, yin deficiency and hyperactivity of yang syndrome, Gan-Shen yin deficiency syndrome, and deficiency of qi and yin syndrome were main syndrome types in senile hypertension patients. There was statistical difference in the distribution curves of blood pressure, atherosclerosis, and age of various TCM syndrome types.

Aged ; Asian Continental Ancestry Group ; Atherosclerosis ; epidemiology ; Biomedical Research ; Blood Pressure ; Humans ; Hypertension ; epidemiology ; Medicine, Chinese Traditional ; Qi ; Research Design ; Risk Factors ; Yin Deficiency ; epidemiology

OBJECTIVETo explore the effect of compound qizhu granule (CQG) on cellular immunity of chronic hepatitis B (CHB) patients.

METHODSTotally 103 CHB patients treated with lamivudin (LAM) for 6 months, who had partial virological response (HBeAg positive) were randomly assigned to two groups, 50 in the treatment group and 53 in the control group. All patients took LAM 100 mg (once a day) plus ADV 10 mg (once a day). Patients in the treatment group additionally took CQG, one dose per day. After one-year treatment hepatitis B virus (HBV) DNA negative rates, HBeAg seroconversion, levels of HBV specific cytotoxic T lymphocyte (CTL), non-specific CTL and natural killing (NK) cells were compared between the two groups.

RESULTSAfter 1-year treatment, HBV DNA negative rate of the treatment group was 88: 0% in 44 cases, slightly higher than that of the control group (41 cases, 77.4%), but with no statistical difference (P >0.05). HBeAg seroconversion of the treatment group was 32.0% in 16 cases, higher than that of the control group (8 cases, 15.1%), with statistical difference (P <0.05). Levels of HBV specific CTL (0.79%±0. 07%), non-specific CTL (19.4%±1.8%) and NK cells (14. 1%± 1.5%) of the treatment group were higher than those of the control group (0.58% ± 0.08%, 17.5% ± 1.7%, and 11.1%±1.5%, respectively; allP <0.01).

CONCLUSIONTreating CHB patients with partial virological response by ADV plus CQG could improve specific and non-specific cellular immunity, thereby elevating HBeAg seroconversion rate.

Drugs, Chinese Herbal ; therapeutic use ; Hepatitis B e Antigens ; immunology ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; drug therapy ; immunology ; Humans ; Immunity, Cellular ; immunology ; T-Lymphocytes, Cytotoxic ; drug effects

Diosgenin can inhibit the growth of A375 and K562 cell lines and induce their apoptosis with an effect on pro-apoptotic members of Bcl-2 family. To study the SAR of diosgenin derivatives, and to improve the anti-tumor activity of diosgenin, a series of novel diosgenin derivatives were designed and synthesized. Their anti-tumor activities in vitro were evaluated. The results revealed that most of the new derivatives had potent effects against K562, A375 and A549 (three tumor cell lines) in vitro, and had no or less effect against H293 and L02 (two normal cell lines). Particularly, some compounds (e.g. 1, 6-8) showed excellent activities on K562 with IC50 values ranging from 1.96 to 4.35 micromol x L(-1).
Antineoplastic Agents ; chemical synthesis ; chemistry ; pharmacology ; Cell Line, Tumor ; Diosgenin ; analogs & derivatives ; chemical synthesis ; chemistry ; pharmacology ; Drug Design ; Humans

Objective Todiscussandestablishaquantitativesupervisionindexoffoodsafetyforlarge-scaleoutdoor activities,andtoprovidescientificbasisforthestudyofsupervisionsystemforfoodsafety.Methods Delphiexpert consultation method was used to establish the supervision index system of food safety for large-scale outdoor activities,and the weight of the indicators were determined.Indexes were screened based on 5 -point liker scale,and weight was determinedonthebasisofproportionmethod.Results Theaverageserviceyearofthe21expertswere21.52±9.05.The response rates were both 1 00% in two rounds of consultation,and the average authoritative coefficients were 0.78 ±0.03 and 0.79 ±0.03,respectively.Kendall's coefficient was 0.46 in the first round and 0.51 in the second round.The secondary indicators was 0.38 in the first round and 0.33 in second round (P <0.01 ).A total of 6 primary and 32 secondary indicators were identified and at the same time their weights were measured.The alert line was 75 .Conclusion Foodsafetyriskoflarge-scaleoutdooractivitieswassignificantlyhigherthanthatoflarge-scaleindooractivities.The study of quantitative supervision index system of food safety for large-scale outdoor is practical.It can provide scientific evidence and technical support for the supervision of food safety.

Objective To analyze the clinical and epidemiological characteristics of human avian influenza A (H7N9 ) epidemic in Jiaxing City,and to provide scientific basis for the control and prevention of the disease.Methods The epidemiological and clinical information of 15 cases of human infection with avian influenza A (H7N9)reported from April, 2013 to May,2015 were collected.Sample of patients and external environmental samples of suspected exposure were collected and detected by real-time PCR.The epidemic distribution and clinical characteristics were analyzed.Results Fifteen cases of human infection with H7N9 were confirmed from April,2013 to May,2015,including 11 cases of death (77.33%).The confirmed cases mostly reported in winter and spring,and 9 confirmed cases were over 60 years,and male case proportion was higher than women (1.5∶1 ).Most of cases (66.67%)were sporadic and occurred in rural areas,but no epidemiological association was observed among the cases.Fever (100%),cough (66.67%),and wheezing and tightness in chest (33.33%)were common initial symptoms.The chest imaging examination of patients showed ground glass opacity and patchy consolidation,and 7 cases had simple pleural effusion.Twelve of confirmed cases had other chronic diseases.Eleven cases of death had appeared multiple medical comorbidities,such as respiratory failure (6/1 1 ),pulmonary embolism (4/1 1 ),multiple systemic organ failure (3/1 1 ),and heart cerebrovascular embolization (2/11).Twelve cases had been exposed to the live poultry markets where the positive rate of novel influenza A (H7N9) virus in environmental specimens was 7.69%(25/325).One of the 252 close contacts to confirmed cases appeared mild flu-like symptoms.No positive result related to novel influenza A (H7N9)virus nucleic acid was detected from each close contact's throat swabs.Conclusion Human infections with avian influenza A (H7N9)virus showed obvious seasonal distribution in Jiaxing.Elderly men,especially those with chronic diseases were the high risk people of human infection with H7N9 avian influenza.The infection might be associated with the exposure to live birds.Standard management of live poultry markets is the key measure in preventing and controlling H7N9 virus infection among population.

Objective: To investigate the clinicopathologic and prognostic features of Claudin-low breast cancers (CLBC). Methods: Tissue microarray sections were scored semiquantitatively for the immunohistochemical expression of claudin-1, -3, -4, -7 and -8 in 233 cases of invasive breast cancers collected from Qingdao Central Hospital from January 2010 to December 2011. Results: The expression rate of Claudin-3 (72/212, 33.9%) and -4 (56/212, 45.2%) was most similar, and Claudin-4 showed the highest expression. Twenty one cases (21/212, 9.0%) were diagnosed as CLBC, with triple-negative breast cancer (TNBC) accounted for the highest proportion (11/21, 52.4%). Among the CLBC cases, the invasive carcinoma no special type (66.7%, 14/21) and metaplastic carcinoma (14.3%, 3/21) were mostly seen, while metaplastic squamous carcinoma did not show Claudin-low pattern. Compared to the non CLBC in this cohort, CLBC had higher proportion of histologic grade 3 and tumors larger than 2 cm, and the proportions were slightly lower than TNBC. Patients with CLBC had lower 5 year disease-free(P>0.05) and overall survival rates(P=0.018). Conclusion CLBC shows distinct clinicopathologic and prognostic features comparing to other subtypes, and is associated with poor prognosis.

Objective: A subset of intractable allergic rhinitis (iAR) patients experience severe symptoms which cannot be effectively controlled by standard drug therapy and/or antigen specific immunotherapy. In recent decades, endoscopy vidian neurectomy and posterior nasal nerve neurectomy (PNNN) were introduced as treatments of iAR that have shown to be highly successful at symptom management in a number of patients. But some patients experience relapse or suboptimal symptom control postoperation. To improve the effectiveness of PNNN to control iAR, a modified PNNN surgical approach (mPNNN) combined with accessory posterior nasal nerve neurectomy (aPNNN), which called as mPNNN-aPNNN was used. This study aims to compare the effects between mPNNN-aPNNN and PNNN on controlling the symptoms of iAR and evaluate the surgical effectiveness and safety of mPNNN-aPNNN. Methods: The patients with iAR experienced mPNNN-aPNNN or PNNN surgery at the department of Otolaryngology Head and Neck Surgery of the Second Xiangya Hospital, Central South University from January 2018 to December 2019 were analyzed retrospectively. The approach of PNNN, a selective resection of the posterior nasal nerve branches, was modified to the neurectomy of total branches of posterior nasal nerve at the sphenopalatine foramen, and combined the operation of aPNNN in which the accessory posterior nasal nerve at the palatine bone perpendicular plate was resect in our study. Daily Nasal Symptom Scores (DNSS), Total Rhinitis Medication Score (TRMS), and the Rhinoconjunctivitis Qualities of Life Questionnaires Scores (RQLQS) were used to evaluate the complications during the operation and after the operation at the 3rd, 6th, 12th, and 24th month postoperatively. Total Nasal Symptom Scores (TNSS) was used to assess the total effective rate and markedly effective rate of the operations. Results: A total of 140 iAR patients experienced mPNNN-aPNNN or PNNN. Those with concomitant septoplasty and/or inferior turbinate reduction, and were absent during the postoperative follow-up were excluded. The final 62 patients with mPNNN-aPNNN and 34 with PNNN were enrolled. DNSS, TNSS, TRMS, and RQLQS at the postoperation were significantly improved compared with the preoperation in all patients (all P<0.001). Compared with PNNN, the postoperative DNSS, TNSS, and TRMS of mPNNN-aPNNN were obviously improved (all P<0.001). There was a persisted relief of symptoms at the postoperation in all patients with mPNNN-aPNNN. The total effective rate and markedly effective rate at the postoperative 24th month were 100％ and 83.3％, respectively. Furthermore, the postoperative RQLQS decreased significantly (P<0.001). Only 5 sides of all patients (5/192, 2.6％) reported upper palate numbness during the first week after operation, with all recovered spontaneously in 1 month without treatment. No other postoperative complications occurred in mPNNN-aPNNN and PNNN.Conclusion: The surgery of mPNNN-aPNNN improve TNSS more significantly than PNNN. The operation of mPNNN-aPNNN is safe and effective to control iAR symptoms.