Objective To evaluate the safety and efficacy of adefovir dipivoxil made in China for treating hepatitis B e antigen(HBeAg)-positive chronic hepatitis B patients.Methods This was a multicenter,double-blinded,randomized controlled trial.Two hundred and thirty-eight patients with HBeAg-positive chronic hepatitis B were assigned to receive either adefovir dipivoxil(10 mg/d,120 patients)or placebo(118 patients)for 12 weeks in 5 medical centers in China.Then,both groups of patients entered 36 weeks open-labeled adefovir dipivoxil treatment phase(10 mg/d),The rates of serum HBV DNA clearances,alanine aminotransferase levels(ALT)normalization,HBeAg loss and anti-HBe seroconversion were evaluated respectively during and post the 48-week treatment.Results After 12 weeks of treatment,the rates of serum HBV DNA clearance(real-time fluorescent quanti- tative polymerase chain reaction,the detection limit was 1?10~4 copy per milliliter),ALT normaliza- tion,HBeAg loss and anti-HBe seroconversion of adefovir dipivoxil group were all significantly higher than those of placebo group(50.0% vs 5.1%,35.0% vs 8.5%,12.5% vs 2.5% and 5.8% vs 0, respectively,x~2=59.89,24.52,P0.05).The safety profile of adefovir dipivoxil was similar to that of placebo. Conclusions The safety profile and efficacy of domestic adefovir dipivoxil for treating HBeAg-positive chronic hepatitis B patients are similar to its counterparts that have been licensed aboard.

Objective To study antimicrobial resistance and genotyping of methicillin-resistant Staphylococcus au-reus(MRSA). Methods A total of 967 no-repetitive strains of Staphylococcus aureus(S.aureus)isolated from a hospital between January 2014 and November 2015 were collected,antimicrobial susceptibility testing,mecA gene,and Panton-Valentine leukocidin gene(PVL gene)were detected;staphylococcal cassette chromosome mec(SCCmec)typing,multilocus sequence typing(MLST),S.aureus protein A(spa)gene typing,and S.aureus ac-cessory gene regulator(agr)typing were performed with multiplex polymerase chain reaction. Results Of 967 strains of S.aureus,210(21.72%)were MRSA;detection rate of MRSA from sputum specimen was higher than that of skin and soft tissue specimen(68.09% vs 1 1.83% ,P<0.05);vancomycin- and linezolid-resistant S.aureus strains were not found,susceptibility rates of MRSA to gentamicin,tetracycline,erythromycin,clindamycin,levo-floxacin,ciprofloxacin,moxifloxacin,nitrofurantoin,and rifampicin were all lower than those of methicillin-sensi-tive Staphylococcus aureus(MSSA),differences were all statistically significant(all P<0.05);antimicrobial sus-ceptibility rate of MRSA to compound sulfamethoxazole was higher than MSSA,difference was significant(P<0.05). Susceptibility rates of MRSA isolated from skin and soft tissue to gentamicin,levofloxacin,ciprofloxacin,moxifloxacin,and rifampicin were 86.90% -95.24%,while MRSA isolated from sputum were only 1.56% -15.63%.Of 967 strains of S.aureus,210 harbored mecA gene,10 harbored PVL gene,8(3.81%)of 210 MRSA strains weren't typed. The main types of MLST,SCCmec,spa,and agr were ST 239(n= 177 strains),type Ⅲ(n= 177 strains),t 030(n= 177 strains),and typeⅠ(n= 196 strains)respectively.Conclusion The main epidemic clone of MRSA strain in this hospital is ST239-MRSA-SCCmec III-t030,antimicrobial resistance is serious,monitoring on drug-resistant strains in hospital should be strengthened.

OBJECTIVETo investigate the triterpenoids from root of Achyranthes bidentata in Henan.

METHODSephadex, normal-and reversed-phase column chromatographies were applied for the isolation and purification. The structure determinations were performed by means of physiochemical properties, MS and NMR data analyses.

RESULTSeven compounds were isolated from the water soluble fraction in root of A. bidentata, and determined as achyranthoside A (1), achyranthoside E (2), momordin Ib (3), chikusetsusaponin IVa (4), chikusetsusaponin IVa methyl ester (5), chikusetsusaponin V (6), chikusetsusaponin V methyl ester (7).

CONCLUSIONCompounds 1 and 2 were isolated from the natural resources for the first time.

Achyranthes ; chemistry ; Molecular Conformation ; Molecular Structure ; Oleanolic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Saponins ; chemistry ; isolation & purification

Objective To investigate the diagnostic value of macrophage migration inhibitory factor (MIF) for hepatocellular carcinoma (HCC).MethodsThe research was divided into 2 parts,including testing research and confirmatory research.The clinical data of 269 patients with HCC ( group A) and 390 individuals (including 135 patients with hepatic cirrhosis,106 with benign hepatic diseases and 149 healthy individuals,control group A) who were admitted to the Zhongshan Hospital of Fudan University from January to May,2004,and 173 patients with hepatic cancer (group B) and 257 individuals (including 86 patients with hepatic cirrhosis,79 with benign hepatic diseases and 92 healthy individuals,control group B ) who were admitted from August to December,2004,and 80 patients with HCC who received radical hepatic resection in January 2005 were retrospectively analyzed.Samples of plasma of patients in the group A and individuals in the control group A were collected before operation.Samples of plasma of patients received radical hepatic resection were collected preoperatively and at postoperative day 3,7 and 30.HCC and adjacent issues of patients in the group A were collected.The levels of MIF in the plasma and tissues were detected by enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry,respectively.Non-normal distribution data were described as M( QR).Differences between the groups were analyzed by using the Mann-Whitney U test,and the relationship between the levels of MIF in the plasma and tissues was detected by the Spearman correlation coefficient.The diagnostic value of MIF was analyzed by the ROC curve.ResultsThe levels of MIF in the plasma of patients in the group A and individuals in the control group A were 85.7 μg/L (58.8 μg/L) and 15.5 μg/L(31.6 μg/L),respectively.The levels of MIF in the plasma of the patients with hepatic cirrhosis,benign hepatic diseases and healthy individuals were 24.9 μg/L (12.6 μg/L),12.5 μg/L(7.3 μg/L) and 13.2 μg/L (7.7 μg/L),respectively.There was a significant difference in the level of MIF between the group A and the control group A (F =54.235,P ＜ 0.05 ).The area under the ROC curve reached peak when the level of MIF in the plasma was 35.3μg/L.Compared with the control group B,the vdues of AUC,sensitivity and specificity were 92.1％,90.7％ and 93.4％ in the group B.The levels of MIF of the patients with HCC before operation and at 3,7,and 30 days after operation were 81.0 μg/L(54.0 μg/L),76.1 μg/L(47.5 μg/L),50.9 μg/L (40.7 μg/L) and 18.7 μg/L ( 15.1 μg/L),respectively.The levels of MIF decreased with time passed by,and were back to normal at 30 days after the operation.The median expressions of MIF in the HCC and adjacent issues were 0.083 and 0.007,respectively,with a significant difference ( U =3.975,P ＜ 0.05).The expression of MIF in the plasma was positively correlated with its expression in the HCC tissue ( r =0.759,P ＜ 0.05 ).ConclusionMIF plays an important role in the genesis and development of HCC and has potential to be one of the molecular markers for the diagnosis of HCC.

Objective By analyzing the expression of cluster of differentiation 74 (CD74) in hepatocellular carcinoma (HCC) and HCC cell lines,the correlation between the level of CD74 expression and the patients' prognosis was investigated.MethodsThe expression of CD74 in high metastatic potential HCC cell lines(MHCC-LM3,MHCC-97H),low metastatic potential HCC cell line( MHCC-97L),and no metastatic potential HCC cell line(Hep-G2) were estimated by Western blot.The paraffin embedded tissues which include intra-tumor and paratumor tissues were collected from 320 patients who had received HCC curative surgical resection and 5 normal liver tissues from the donors of liver tranplantation.The high density tissue micro-array was made of these specimens. Immunol-histochemistry was applied to discover the different levels of CD74 in tumor,paratumor and normal liver tissues.Survival curves were generated by the Kaplan-Meier method and verified by the Logrank test.Cox proportional hazards regression analysis was applied to estimate the prognostic factors in multivariate analysis.ResultsThe expression level of CD74 was significantly higher in low metastatic potential and no metastatic potential HCC cell lines (MHCC-97L 1.224 ±0.014,Hep-G2 1.374 ±0.006) than that in high metastatic potential ones( MHCC-LM3 0.622 ±0.078,MHCC-97H 0.732 ± 0.083 ).Significant differences can be found between the groups (t =- 13.308,- 16.849,- 10.177,- 13.436,- 17.057; P ＜0.01 ).Meanwhile,in tumor tissues,the CD74 was expressed positively in 221 patients and negatively in 99 patients.But CD74 was expressed slightly in paratumor and negatively in 5 normal liver tissues.There's no significant differences between the groups categorization according to age,HBsAg,cirrhosis,AFP level,tumor number,tumor size,tumor capsule,blood vessel invasion,Edmondson Grades and tumor nodes metastasis classification (TNM) stages (x2 =0.053,0.141,1.200,0.000,0.277,1.975,0.263,1.044,0.000,0.433 ; P ＞ 0.05 ),except gender (x2 =3.954,P ＜ 0.05).Kaplan-Meier method showed that patients with positively expression of CD74 had better prognosis than others (x2 =5.620,P ＜ 0.05 ).Cox proportional hazards regression analysis showed that CD74 was a significant and independent prognostic factor of survival [ hazard ratio (HR) =0.721,95％confidence interval (CI) =0.522 - 0.996,P ＜ 0.05 ].Conclusion The expression of CD74 in hepatocellular carcinoma could be a biomarker of the prognosis and there's some potential correlation with cancer cell apoptosis.

Objective To evaluate the prognosis and management of recurrent primary clear cell carcinoma of liver (PCCCL).Methods 214 patients with PCCCL treated by curative resection from January 1996 to March 2006 were retrospectively studied.Tumour recurrences were classified into early (≤1 year) and late (＞1 year) recurrences.Results Of 99 patients who developed recurrences,28 developed early recurrence while 71 developed late recurrence.The patients with recurrences were treated with re-resection (n=33),percutaneous ethanol injection (PEI,n=7),radiofrequency ablation (RFA,n=10),transcatheter arterial chemoembolization (TACE,n =27),systemic chemotherapy (n=1),Chinese medicine (n=1),and conservative management (n=20).The re-resection rate was higher in the late than in the early recurrence group (P=0.04).In this study,reresection,PEI,and RFA were considered as curative therapies.There was no significant difference in the overall survival (OS) for patients who received these different curative therapeutic procedures (P=0.68).The 1,3-,and 5-year OS of patients with recurrences who were treated with curative treatment were comparable to those patients who did not develop recurrences (100％,86.0％,63.5％ vs 85.2％,72.2％,64.3％,P=0.71).The 1-,3-,and 5-year OS of patients who received TACE for recurrences were 100％,66.7％,and 44.4％ respectively.The results were poorer than patients who received curative treatment for recurrences (P=0.03),but were better than those who received conservative management after recurrences (80.0 ％,25.0 ％,and 10.0 ％,P＜ 0.01).Conclusions Reresection,PEI and RFA are optimal curative methods for recurrent PCCCL.TACE plays an important role in the management of patients with recurrent PCCCL who cannot be treated with curative methods.

This study aims to investigate the virological impact of the stalk region and cysteine (C) in neuraminidase (NA) of influenza A/Anhui/1/05 (H5N1) and A/Ohio/07/2009 (H1N1) viruses. The NA of A/ Anhui/1/05 (H5N1), defined as AH N1, lacked 20 amino acids (including C, defined as s20) as compared with NA of A/Ohio/07/2009 (H1N1) (defined as 09N1). We deleted s20 of 09N1 to construct 09N1-s20, and inserted s20 into AH N1 to construct AH N1+s20. To investigate the impact of C on the biological function of NA, we deleted C in 09N1 to construct 09N1-C and inserted C into AH N1 to construct AH N1-C. The pseudo-type viral particle (pp) system was used to evaluate the impact of these mutants on virology. The combination of 09N1-C and 09H1 (defined as 09H1::09N1-C) showed an infectivity 8 times that of the wild type 09H1::09N1, while the infectivity of the combination of AH N1+C and AH H5 (defined as AH H5::AH N1+C) was much lower than that of the wild type AH H5::AH N1. The infectivity of the combination of 09N1-s20 and 09H1 (defined as 09H1::09N1-s20) was 4 times that of the wild type 09H1::09N1; the infectivity of the combination of AH N1+s20 and AH H5 (defined as AH H5:: AH N1+s20) was 1/7 that of the wild type AH H5::AH N1. The co-existence of 09N1-C and AH H5 displayed 6 times the infectivity of AH H5::09N1, while the infectivity of 09H1::AH N1+C was very low. Multimer analysis showed that in the wild type 09N1, the forms of NA were dimer > tetramer > monomer; the major component of NA in 09N1-C was monomer; in 09N1-s20, the forms of NA were monomer > dimer. AH N1 was mainly composed of monomer; in AH N1+s20, the forms of NA were dimer > monomer > tetramer; in AH N1+C, the forms of NA were dimer > tetramer. Deletion of C or s20 from 09N1 did not change the expression of NA. The study suggested that deletion of C from the stalk region of NA in A/Ohio/07/2009 (H1N1) increases infectivity. Insertion of C into NA's stalk region of A/ Anhui/1/05 (H5N1) significantly decreases infectivity. Cysteine deletion in the stalk region is important for the infectivity of A/Anhui/1/05 (H5N1) and A/Ohio/07/2009 (H1N1). It may interfere with the infectivity via changes in NA polymerization.
Amino Acid Motifs ; Humans ; Influenza A Virus, H1N1 Subtype ; chemistry ; enzymology ; genetics ; pathogenicity ; Influenza A Virus, H5N1 Subtype ; chemistry ; enzymology ; genetics ; pathogenicity ; Influenza, Human ; virology ; Neuraminidase ; chemistry ; genetics ; metabolism ; Viral Proteins ; chemistry ; genetics ; metabolism ; Virulence

Humans ; Metals ; Microwaves ; adverse effects ; Occupational Exposure ; adverse effects ; analysis ; Workplace

Carcinoma, Hepatocellular ; genetics ; metabolism ; Humans ; Liver Neoplasms ; genetics ; metabolism ; Signal Transduction

Cervical spondylotic myelopathy (CSM) is a common cause of spinal cord dysfunction clinical disease. Surgery is the main therapeutic tool for CSM. However, there are obvious differences in clinical functional recovery after operation. For the past few years, the influence factors of prognosis in cervical spondylosis myelopathic has been widely concerned. Age, nerve function, course of desease, imaging findings,surgical method and related factors became the investigative point for prognosis of cervical spondylotic myelopathy. Present viewpoint showed that the older patient, preoperative worse nerve function, longer the course of disease would result in worse outcomes. Imaging examination maybe can indicate the prognosis, but the correlation is unclear. Selection of surgical method and approach should be based on the principles of sufficient decompression, stabilize the alignment of the cervical spine, keeping backward extension of cervical spine, maintain effective decompression, preventing complications. Therefore, the treatment of cervical spondylotic myelopathy should be on the basis of pathogenic condition and imaging examination at early stage and a suitable usrgical procedure should be performed to obtain a better prognosis.
Cervical Vertebrae ; surgery ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Radiography ; Spinal Cord Diseases ; diagnosis ; diagnostic imaging ; surgery ; Spondylosis ; diagnosis ; diagnostic imaging ; surgery