目的 比较拉米夫定+阿德福韦酯联合治疗与阿德福韦酯单药治疗对阿德福韦酯停药后出现病毒学反弹而无基因型耐药变异患者的疗效及安全性。 方法 回顾研究2007年1月－2012年1月在传染科门诊就诊的67例阿德福韦酯治疗获得病毒学应答但停药后出现病毒学反弹的e抗原阳性慢性乙型肝炎患者，分别给予拉米夫定+阿德福韦酯联合治疗（联合组，n=35）和阿德福韦酯单药治疗（单药组，n=32）。 结果 治疗1年后，联合组（32例，85.7%）较单药组（21例，65.6%）有更多的患者重新获得了丙氨酸转氨酶复常（P=0.009），联合组34例（97.1%）乙型肝炎病毒DNA阴转，单药组22例（68.8%）阴转，两组差异有统计学意义（P=0.002）；在血清学转换方面，联合组和单药组分别有4例（11.4%）和1例（3.1%）患者获得了e抗原的血清学转换。在治疗中所有患者均未发生任何严重不良反应。 结论 阿德福韦酯停药后出现病毒学反弹，选择拉米夫定与阿德福韦酯联合治疗可使患者重新获得较好的生化学和病毒学应答。
The competing endogenous RNA (ceRNA) hypothesis is a new pattern of gene posttranscriptional regulation. Encoding mRNA, long noncoding RNA (lncRNA), pseudogene transcript, circular RNA (circRNA), etc. can regulate gene expression by binding microRNA (miRNA). According to the research, ceRNA regulatory network participates in the maintenance of normal physiological state, occurrence and development of diseases. This paper reviewed ceRNA with the following respects: the proposal of ceRNA hypothesis, members of ceRNA regulatory network, research status, limitations and future development directions of this hypothesis. It will contribute to clarify the pathogenesis of much diseases including tumor and provide a new strategy for the diagnosis and treatment of disease.
ObjectiveTo describe the imaging and clinical features of vaccinia virus induced pneumonia by long-term follow-up.MethodsThe clinical data, imaging features and long-term follow-up of 5 patients with vaccinia virus pneumonia admitted to Wuxi People's Hospital Affiliated to Nanjing Medical University were analyzed.ResultsAll the 5 patients were male, aged between 21 and 54 years. The latent period of the disease was 2 to 5 days. All the patients had fever and pneumonia, while 3 of them had herpes. Two patients with severe pneumonia showed extensive patchy and nodular shadows in both lungs. Chest CT findings of the other three patients showed scattered small nodules in both lungs. All patients were followed up by telephone every half a year for 3 years. The prognosis of all patients was good. The patients reported in the English literature were clinically clustered, with fever, vomiting and rash as the main symptoms.ConclusionsVaccinia virus may cause different clinical symptoms through different transmission routes, and its infectivity is strong. Biological protection should be strengthened in laboratory and working environment.
Objective To investigate the changes of stem cell factor（SCF） level in serum of asthma patients before and after acute exacerbation.Methods The serum SCF was detected in 30 asthma patients respectively in the onset period and catabasis by ELISA.The SCF levels were also determined in 20 normal subjects as control.Results the content of serum SCF of the asthma patients during the acute attack was increased significantly than normal subjects [（156.8±82.6）pmol/L vs （61.5±15.4）pmol/L，Plt;0.001]，and decreased significantly in remission [（66.2±15.8）pmol/L，Plt;0.001].Conclusions SCF may participate in the pathogenesis of asthma.
ObjectiveTo observe the impacts of initial therapy on clinical outcome of patients with community-acquired thoracic infection by retrospective analysis. MethodsClinical data of acute community-acquired thoracic infection patients who met the British Thoracic Society diagnostic criteria were collected. The patients were divided into two groups according to whether adequate initial antibiotic therapy and pleural effusion drainage were performed, namely an adequate group (31 patients) and an inadequate group (17 patients). Clinical manifestations, inflammatory markers, hospital stay and hospital costs were analyzed between the two groups. ResultsFor age, gender, infection sites, and coincident diseases, there were no significant differences between the two groups. Compared with the inadequate group, temperature of the adequate group was significantly decreased, especially on hospital day 5, 6, 7[(37.4±0.1)℃ vs. (38.3±0.2)℃, P < 0.001; (37.4±0.1)℃ vs. (37.9±0.1)℃, P < 0.05; (37.4±0.1)℃ vs. (38.1±0.2)℃, P < 0.01]. The level of serum C-reactive protein (CRP) in first week was also significantly reduced in the adequate group[(123.1±13.8) mg/L vs. (182.7±25.3) mg/L, P < 0.05]. However, there were no differences in white cell counts, percentage of neutrophils, or erythrocyte sedimentation rate between the two groups in six-week follow-up. The adequate group had shorter hospital stay[(25±4) days vs. (34±4) days, P < 0.05] and lower hospital costs[(28 367±3 328) yuan vs. (43 334±7 134) yuan, P < 0.05] compared with the inadequate group. ConclusionsThe initial therapy with appropriate antibiotics and effective thoracic drainage can significantly decrease the temperature and CRP of patients with thoracic infection, as well as the cost of hospitalization and the length of stay. Our study reveals that the temperature which is lower than 37.5℃ on the 5th day of therapy and the CRP in the first follow-up week are sensitive predictors of initial treatment effect, which may be helpful to guide the following therapeutic strategies.
Objective To investigate the effects and underlying mechanisms of human pituitary tumor-transforming gene 1 (hPTTG1) small interfering RNA (siRNA) on apoptosis of ovarian cancer cell line A2780. Methods hPTTG1 siRNA was transfected into A2780 with lipofectamine (the hPTTG1 siRNA group), and the normal group and the negative control group were set up. Detections were conducted 48 hours after transfection: the interfering efficiency of hPTTG1 mRNA was measured by real-time polymerase chain reaction, the expression of survivin gene and survivin protein was examined by semiquantitative reverse transcriptase-polymerase chain reaction and Western blot, cell apoptosis was detected by DNA fragmentation gel electrophoresis and propidium iodide staining kit, and the activity of caspase-3 was assayed by caspases colorimetric assay kit. Results The expression of hPTTG1 mRNA was expressly inhibited after hPTTG1 siRNA transfection. DNA ladder was observed in the hPTTG1 siRNA group. The apoptotic rate of hPTTG1 siRNA transfection in the hPTTG1 siRNA group was (17.53±2.17)%, higher than those in the normal group and the negative control group [(8.97±1.56)% and (9.64±1.31)%, respectively], with statistically significant differences between them (P<0.05). The expression levels of survivin mRNA and survivin protein were down-regulated. The activity of caspase-3 was raised. Conclusions siRNA targeting hPTTG1 could induce apoptosis of A2780 by inhibition of survivin expression and activation of caspase-3. It may be a potential target for gene therapy of ovarian cancer.