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  • 简介:AbstractBackground:Due to sustained control activities, the prevalence of Schistosoma japonicum infection in humans, livestock and snails has decreased significantly in P. R. China, and the target has shifted from control to elimination according to the Outline of Healthy China 2030 Plan. Applying highly sensitive methods to explore the presence of S. japonicum infection in its intermediate host will benefit to assess the endemicity or verify the transmission interruption of schistosomiasis accurately. The aim of this study was to access the presence of S. japonicum infection by a loop-mediated isothermal amplification (LAMP) method through a 5-year longitudinal study in five lake provinces along the Yangtze River.Methods:Based on previous epidemiological data, about 260 villages with potential transmission risk of schistosomiasis were selected from endemic counties in five lake provinces along the Yangtze River annually from 2015 to 2019. Snail surveys were conducted in selected villages by systematic sampling method and/or environmental sampling method each year. All live snails collected from field were detected by microscopic dissection method, and then about one third of them were detected by LAMP method to assess the presence of S. japonicum infection with a single blind manner. The infection rate and nucleic acid positive rate of schistosomes in snails, as well as the indicators reflecting the snails’ distribution were calculated and analyzed. Fisher’s exact test was used to examine any change of positive rate of schistosomes in snails over time.Results:The 5-year survey covered 94,241 ha of environment with 33,897 ha of snail habitats detected accumulatively. Totally 145.3 ha new snail habitats and 524.4 ha re-emergent snail habitats were found during 2015-2019. The percentage of frames with snails decreased from 5.93% [45,152/761,492, 95% confidence intervals (CI): 5.88-5.98%] in 2015 to 5.25% (30,947/589,583, 95% CI: 5.19-5.31%) in 2019, while the mean density of living snails fluctuated but presented a downward trend generally from 0.20 snails/frame (155,622/761,492, 95% CI: 0.17-0.37) in 2015 to 0.13 snails/frame (76,144/589,583, 95% CI: 0.11-0.39) in 2019. A total of 555,393 live snails were collected, none of them was positive by dissection method. Totally 17 pooling snail samples were determined as positives by LAMP method among 8716 pooling samples with 174,822 of living snails, distributed in 12 villages of Hubei, Hunan, Jiangxi and Anhui provinces. The annual average positive rate was 0.41% (95% CI: 0.13-0.69%) in 2015, 0% in 2016, 0.36% (95% CI: 0.09-0.63%) in 2017, 0.05% (95% CI: 0-0.16%) in 2018, 0.05% (95% CI: 0-0.15%) in 2019, respectively, presenting a downward trend from 2015 to 2019 with statistical significance (χ2 = 11.64, P < 0.05).Conclusions:The results suggest that S. japonicum infection still persisted in nature along the Yangtze River and traditional techniques might underestimate the prevalence of schistosomiasis in its intermediate hosts. Exploring and integrating molecular techniques into national surveillance programme could improve the sensitivity of surveillance system and provide guidance on taking actions against schistosomiasis.

  • 标签: Schistosoma japonicum Dissection Loop-mediated isothermal amplification The Yangtze River Transmission risk Low endemic area
  • 简介:摘要目的根据中国各省市登记处上报的2015年肿瘤登记数据,估算2015年中国子宫体癌发病与死亡情况。方法收集整理中国501个登记处上报的2015年肿瘤登记数据,对数据进行质量审核和评估,将符合标准的368个登记处数据纳入分析,按地区(城市、农村、东部、中部和西部)和年龄等因素分层,计算子宫体癌的发病率和死亡率,结合2015年全国人口数据估算全国子宫体癌发病和死亡数据。标化率分别采用2000年全国普查人口和Segi′s世界标准人口计算。结果2015年纳入分析的368个登记处覆盖309 553 499人口,占全国2015年年末人口的22.52%。估计全国子宫体癌新发病例数约6.89万,发病率为10.28/10万,中标率为6.86/10万,世标率为6.66/10万。城市地区发病率(11.35/10万)高于农村地区(8.90/10万),东部地区发病率(12.12/10万)高于中部地区(9.94/10万)和西部地区(8.25/10万)。估计2015年全国因子宫体癌死亡病例数约1.60万,死亡率为2.39/10万,中标率为1.49/10万,世标率为1.47/10万。城市地区死亡率(2.40/10万)与农村地区(2.39/10万)相似;中部地区死亡率(2.55/10万)高于东部地区(2.32/10万)和西部地区(2.31/10万)。结论中国子宫体癌发病不断上升且有年轻化趋势,威胁女性健康,疾病负担逐渐加重。中国子宫体癌发病存在城乡和区域差异,应有针对性地开展防控工作。

  • 标签: 子宫体肿瘤 发病率 死亡率 肿瘤登记 中国
  • 简介:摘要目的分析2015—2019年我国省级疾病预防控制中心横向科研课题情况,并对东中西部地区进行比较,提供疾控机构科研管理建议。方法通过问卷调查,对2015—2019年我国省级疾控中心获得的横向科研课题数量和经费进行回顾性分析。使用多元线性回归模型,检验横向科研课题经费的变化趋势。使用方差分析方法比较东中西部地区差异。结果2015—2019年我国省级疾控中心获得的横向科研课题经费共1.243亿元,其中,企业资助的课题经费占51.9%,牵头承担的课题经费占86.9%;5年间横向科研课题经费变化无统计学意义(F=0.46,P=0.764);东部地区省级疾控中心承担、参与的横向科研课题数量都比中西部地区多(F=5.85,P=0.004;F=5.03,P=0.008)。结论近年来,我国省级疾控中心获得的横向科研课题保持稳定且地区间分布不均衡,建议探索创新科研管理方式,促进跨机构、跨部门、跨地区合作。

  • 标签: 省级疾控中心 横向科研课题 趋势
  • 简介:摘要本文主要利用自动站观测资料以及NCEP再分析资料等相关资料,对郑州机场2015年5月6日出现的一次雷雨天气过程进行分析。结果表明,此次雷雨天气具备突发性强、来势凶猛、危害性大等特点,给机场航班的正常运行带来不利影响。在低层切变以及上层干、下层湿的对流不稳定层结的配合影响下,源于西北一带的对流云团朝我国华中上空区域移动中持续变强,促进了郑州机场发生雷雨天气。高层冷平流在低层暖平流互相叠加的垂直结构充分表明大气层结存在不稳定性,为雷雨天气的发生发展给予良好的条件。由地面至925hPa高度层区域有逆温层分布,这充分表明这个时候有较强的不稳定能量积聚,同时配合较强的垂直风切变,共同推动了雷雨天气发生。中高层干、低层湿的条件为雷雨天气的出现不但给予了水汽条件,而且也提供了大气层结的不稳定性条件,郑州机场自1000hPa至500hPa的

  • 标签: 郑州机场 雷雨 天气形势 物理量
  • 简介:摘要目的了解云南省家畜阿卡斑病毒(akabane virus, AKAV)的流行情况。方法2015年4月在云南省芒市设立5只山羊和10头黄牛作为哨兵动物进行家畜虫媒病毒监测,5~10月份每周采集动物血液,标本经实验室处理后接种BHK-21细胞进行病毒分离,对病毒分离物进行病毒基因(RT-PCR)扩增、核苷酸序测定及分析。结果1只哨兵山羊血液样品接种BHK-21细胞48 h后产生明显细胞病变,取细胞培养物上清液脑内接种1日龄乳鼠,3 d后乳鼠开始发病死亡,经RT-PCR鉴定和S片段基因序列测定分析,分离毒株为AKAV(毒株编号16415)。16415毒株S片段基因全长856nt,编码N蛋白233aa和Ns蛋白91aa,遗传进化分析结果显示新分离16415毒株与国内外分离的AKAV位于同一进化分支内,核苷酸同源性在83.8%~97.7%之间;进一步分析发现16415株与广西2013年从竹鼠脑内分离到的AKAV亲缘关系最近,核苷酸和氨基酸同源性分别为97.7%、99.6%;与日本AKAV OBE-1毒株相比,16415株、广西竹鼠分离毒株和德宏迷糊按蚊分离毒株在N蛋白上存在2个共同的差异位点,分别是N115位和N206位。结论在云南省芒市地区设置的哨兵山羊血液标本分离到AKAV,具有重要的流行病学意义。

  • 标签: 阿卡斑病毒 山羊 病毒分离 S基因
  • 简介:摘要目的根据中国各省市登记处上报的2015年肿瘤登记数据,估算2015年中国子宫体癌发病与死亡情况。方法收集整理中国501个登记处上报的2015年肿瘤登记数据,对数据进行质量审核和评估,将符合标准的368个登记处数据纳入分析,按地区(城市、农村、东部、中部和西部)和年龄等因素分层,计算子宫体癌的发病率和死亡率,结合2015年全国人口数据估算全国子宫体癌发病和死亡数据。标化率分别采用2000年全国普查人口和Segi′s世界标准人口计算。结果2015年纳入分析的368个登记处覆盖309 553 499人口,占全国2015年年末人口的22.52%。估计全国子宫体癌新发病例数约6.89万,发病率为10.28/10万,中标率为6.86/10万,世标率为6.66/10万。城市地区发病率(11.35/10万)高于农村地区(8.90/10万),东部地区发病率(12.12/10万)高于中部地区(9.94/10万)和西部地区(8.25/10万)。估计2015年全国因子宫体癌死亡病例数约1.60万,死亡率为2.39/10万,中标率为1.49/10万,世标率为1.47/10万。城市地区死亡率(2.40/10万)与农村地区(2.39/10万)相似;中部地区死亡率(2.55/10万)高于东部地区(2.32/10万)和西部地区(2.31/10万)。结论中国子宫体癌发病不断上升且有年轻化趋势,威胁女性健康,疾病负担逐渐加重。中国子宫体癌发病存在城乡和区域差异,应有针对性地开展防控工作。

  • 标签: 子宫体肿瘤 发病率 死亡率 肿瘤登记 中国
  • 简介:摘要目的了解嘉兴市2015—2018流感年度哨点医院患者的流行情况。方法对嘉兴市国家级哨点监测点嘉兴市第一医院就诊患者进行监测采样,对流感样病例(ILI)样本,采用实时荧光定量RT-PCR方法进行病毒核酸检测,并对结果信息进行统计分析。结果2015—2018年共检测4 286份ILI样本,流感病毒核酸阳性804份,阳性率为18.76%;流感高发季以冬春季为主,个别年份出现夏季高峰;流行型别主要是甲型H1N1、甲型H3N2,2015年以甲型H3N2为主,2016年以甲型H1N1型为主,2017年、2018年继续交替变换;男女流感病毒阳性率差异无统计学意义;0~4岁组占比(32.34%)最高。结论嘉兴市流感在2015—2018年度中以冬春季流行为主,个别年份出现夏季流行,甲型H1N1和甲型H3N2隔年交替出现,0~4岁组儿童为发病高危人群。

  • 标签: 流感,人 监测 核酸检测
  • 简介:AbstractBackground:Innovative coronavirus disease 2019 (COVID-19) vaccines, with elevated global manufacturing capacity, enhanced safety and efficacy, simplified dosing regimens, and distribution that is less cold chain-dependent, are still global imperatives for tackling the ongoing pandemic. A previous phase I trial indicated that the recombinant COVID-19 vaccine (V-01), which contains a fusion protein (IFN-PADRE-RBD-Fc dimer) as its antigen, is safe and well tolerated, capable of inducing rapid and robust immune responses, and warranted further testing in additional clinical trials. Herein, we aimed to assess the immunogenicity and safety of V-01, providing rationales of appropriate dose regimen for further efficacy study.Methods:A randomized, double-blind, placebo-controlled phase II clinical trial was initiated at the Gaozhou Municipal Centre for Disease Control and Prevention (Guangdong, China) in March 2021. Both younger (n = 440; 18-59 years of age) and older (n = 440; ≥60 years of age) adult participants in this trial were sequentially recruited into two distinct groups: two-dose regimen group in which participants were randomized either to follow a 10 or 25 μg of V-01 or placebo given intramuscularly 21 days apart (allocation ratio, 3:3:1, n = 120, 120, 40 for each regimen, respectively), or one-dose regimen groups in which participants were randomized either to receive a single injection of 50 μg of V-01 or placebo (allocation ratio, 3:1, n = 120, 40, respectively). The primary immunogenicity endpoints were the geometric mean titers of neutralizing antibodies against live severe acute respiratory syndrome coronavirus 2, and specific binding antibodies to the receptor binding domain (RBD). The primary safety endpoint evaluation was the frequencies and percentages of overall adverse events (AEs) within 30 days after full immunization.Results:V-01 provoked substantial immune responses in the two-dose group, achieving encouragingly high titers of neutralizing antibody and anti-RBD immunoglobulin, which peaked at day 35 (161.9 [95% confidence interval [CI]: 133.3-196.7] and 149.3 [95% CI: 123.9-179.9] in 10 and 25 μg V-01 group of younger adults, respectively; 111.6 [95%CI: 89.6-139.1] and 111.1 [95%CI: 89.2-138.4] in 10 and 25 μg V-01 group of older adults, respectively), and remained high at day 49 after a day-21 second dose; these levels significantly exceed those in convalescent serum from symptomatic COVID-19 patients (53.6, 95%CI: 31.3-91.7). Our preliminary data show that V-01 is safe and well tolerated, with reactogenicity predominantly being absent or mild in severity and only one vaccine-related grade 3 or worse AE being observed within 30 days. The older adult participants demonstrated a more favorable safety profile compared with those in the younger adult group: with AEs percentages of 19.2%, 25.8%, 17.5% in older adults vs. 34.2%, 23.3%, 26.7% in younger adults at the 10, 25 μg V-01 two-dose group, and 50 μg V-01 one-dose group, respectively.Conclusions:The vaccine candidate V-01 appears to be safe and immunogenic. The preliminary findings support the advancement of the two-dose, 10 μg V-01 regimen to a phase III trial for a large-scale population-based evaluation of safety and efficacy.Trial Registration:http://www.chictr.org.cn/index.aspx (No. ChiCTR2100045107, http://www.chictr.org.cn/showproj.aspx? proj=124702).

  • 标签: COVID-19 Phase II Clinical trial Recombinant fusion protein vaccine Safety Immunogenicity
  • 作者: 陈宇 周平辉 管晶晶 梁梦想 张莉 毛颖基
  • 学科: 医药卫生 >
  • 创建时间:2020-08-10
  • 出处:《中华整形外科杂志》 2020年第05期
  • 机构:蚌埠医学院第一附属医院整形外科 233004;蚌埠医学院生命科学学院 233030 ,蚌埠医学院第一附属医院骨科 233004;蚌埠医学院安徽省组织移植重点实验室 233030 ,蚌埠医学院第一附属医院医学检验中心 233004 ,蚌埠医学院生命科学学院 233030 ,蚌埠医学院第一附属医院整形外科 233004 ,蚌埠医学院生命科学学院 233030;蚌埠医学院安徽省组织移植重点实验室 233030
  • 简介:摘要目的探讨寡脱氧核苷酸 (ODN) MT01对大鼠骨髓间充质干细胞 (BMSCs) 形态、增殖及成骨分化的影响。方法4周龄清洁级SD雄性大鼠5只,以全骨髓贴壁法培养SD大鼠BMSCs,通过观察不同代次的细胞形态、流式细胞仪检测表面相关标志物和成骨分化潜能,对所提取的干细胞进行鉴定。设立PBS组(对照组)和不同浓度 (0.5、1.0、2.0、4.0 μg/ml) ODN MT01组进行对照研究,每组实验重复3次。通过DAPI和鬼笔环肽荧光染色观察各组BMSCs细胞核及骨架的形态变化;通过CCK-8法检测不同时间各组BMSCs的增殖活性;成骨诱导培养基培养7 d和21 d, 分别行碱性磷酸酶染色及其活性检测和茜素红染色鉴定各组BMSCs的成骨分化程度。组间两两比较采用 t 检验,多组间比较采用单因素方差分析,P<0.05为差异有统计学意义。结果随着代次增加,BMSCs纯度越来越高,第3代细胞整体呈鱼群样分布。流式细胞仪分析结果显示,细胞高表达CD29 (99.8%)、CD44 (96.1%),低表达CD11b (1.03%)、CD45 (1.74%)。成骨诱导7 d后碱性磷酸酶染色及21 d后茜素红染色均为阳性。细胞核及骨架染色显示,ODN MT01浓度为4.0 μg/ml时会导致BMSCs皱缩并降低伸展性。CCK-8结果显示,培养4 d时对照组吸光度值为0.446±0.018,1.0、2.0 μg/ml ODN MT01组分别为0.505±0.019、0.528±0.014,与对照组比较差异有统计学意义 (t=2.954、4.083,P=0.033、0.008),培养7 d时对照组吸光度值为0.514±0.027,1.0、2.0 μg/ml ODN MT01组分别为0.607±0.007、0.636±0.023,与对照组比较差异有统计学意义 (t=4.664、6.091,P=0.009、0.008),BMSCs增殖能力较对照组明显升高,而4.0 μg/ml ODN MT01 (0.427±0.013) 对BMSCs增殖能力具有抑制作用 (t=4.332,P=0.015);诱导BMSCs成骨分化过程中随着ODN MT01浓度的升高,蓝色团块和矿化结节均显著增加,培养7 d后的碱性磷酸酶活性升高趋势与ALP染色结果相类似,对照组碱性磷酸酶活性为1.207±0.023,0.5、1.0、2.0、4.0 μg/ml ODN MT01组分别为1.747±0.095、2.200±0.136、3.560±0.088、3.490±0.144,与对照组比较差异均有统计学意义 (t=4.313、7.934、18.800、18.240,P=0.005、0.001、<0.001、<0.001),而2.0、4.0 μg/ml组的诱导效果相比基本无差异 (t=0.562,P=0.590)。结论在不影响BMSCs形态的情况下,浓度为2.0 μg/ml的ODN MT01可显著促进BMSCs的增殖和成骨分化。

  • 标签: 寡脱氧核苷酸 骨髓间充质干细胞 形态学 细胞增殖 成骨分化
  • 简介:AbstractAlthough significant achievements have shown that the coronavirus disease 2019 (COVID-19) resurgence in Beijing, China, was initiated by contaminated frozen products and transported via cold chain transportation, international travelers with asymptomatic symptoms or false-negative nucleic acid may have another possible transmission mode that spread the virus to Beijing. One of the key differences between these two assumptions was whether the virus actively replicated since, so far, no reports showed viruses could stop evolution in alive hosts. We studied severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequences in this outbreak by a modified leaf-dating method with the Bayes factor. The numbers of single nucleotide variants (SNVs) found in SARS-CoV-2 sequences were significantly lower than those called from B.1.1 records collected at the matching time worldwide (P = 0.047). In addition, results of the leaf-dating method showed ages of viruses sampled from this outbreak were earlier than their recorded dates of collection (Bayes factors > 10), while control sequences (selected randomly with ten replicates) showed no differences in their collection dates (Bayes factors < 10). Our results which indicated that the re-emergence of SARS-CoV-2 in Beijing in June 2020 was caused by a virus that exhibited a lack of evolutionary changes compared to viruses collected at the corresponding time, provided evolutionary evidence to the contaminated imported frozen food should be responsible for the reappearance of COVID-19 cases in Beijing. The method developed here might also be helpful to provide the very first clues for potential sources of COVID-19 cases in the future.

  • 标签: Molecular clock Frozen virus Leaf-dating Bayes factors SARS-CoV-2
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  • 简介:AbstractBackground:COVID-19 can lead to increased psychological symptoms such as post-traumatic stress disorder (PTSD), depression, and anxiety among patients with COVID-19. Based on the previous mindfulness-based interventions proved to be effective, this protocol reports a design of a randomized controlled trial aiming to explore the efficacy and possible mechanism of a mindful living with challenge (MLWC) intervention developed for COVID-19 survivors in alleviating their psychological problems caused by both the disease and the pandemic.Methods:In April 2021, more than 1600 eligible participants from Hubei Province of China will be assigned 1:1 to an online MLWC intervention group or a waitlist control group. All participants will be asked to complete online questionnaires at baseline, post-program, and 3-month follow-up. The differences of mental health status (e.g. PTSD) and physical symptoms including fatigue and sleeplessness between the COVID-19 survivors who receiving the online MLWC intervention and the control group will be assessed. In addition, the possible mediators and moderators of the link between the MLWC intervention and target outcomes will be evaluated by related verified scales, such as the Five Facets Mindfulness Questionnaire. Data will be analyzed based on an intention-to-treat approach, and SPSS software will be used to perform statistical analysis.Discussion:The efficacy and potential mechanism of MLWC intervention in improving the quality of life and psychological status of COVID-19 survivors in China are expected to be reported. Findings from this study will shed light on a novel and feasible model in improving the psychological well-being of people during such public health emergencies.Trial registrationChinese Clinical Trial Registry (ChiCTR), ChiCTR2000037524; Registered on August 29, 2020, http://www.chictr.org.cn/showproj.aspx?proj=60034.

  • 标签: COVID-19 Internet Mindfulness-based intervention Mental health Randomized controlled trial China
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  • 简介:AbstractBackground:The incubation period is a crucial index of epidemiology in understanding the spread of the emerging Coronavirus disease 2019 (COVID-19). In this study, we aimed to describe the incubation period of COVID-19 globally and in the mainland of China.Methods:The searched studies were published from December 1, 2019 to May 26, 2021 in CNKI, Wanfang, PubMed, and Embase databases. A random-effect model was used to pool the mean incubation period. Meta-regression was used to explore the sources of heterogeneity. Meanwhile, we collected 11 545 patients in the mainland of China outside Hubei from January 19, 2020 to September 21, 2020. The incubation period fitted with the Log-normal model by the coarseDataTools package.Results:A total of 3235 articles were searched, 53 of which were included in the meta-analysis. The pooled mean incubation period of COVID-19 was 6.0 days (95% confidence interval [CI]: 5.6-6.5) globally, 6.5 days (95% CI: 6.1-6.9) in the mainland of China, and 4.6 days (95% CI: 4.1-5.1) outside the mainland of China (P=0.006). The incubation period varied with age (P=0.005). Meanwhile, in 11 545 patients, the mean incubation period was 7.1 days (95% CI: 7.0-7.2), which was similar to the finding in our meta-analysis.Conclusions:For COVID-19, the mean incubation period was 6.0 days globally but near 7.0 days in the mainland of China, which will help identify the time of infection and make disease control decisions. Furthermore, attention should also be paid to the region- or age-specific incubation period.

  • 标签: COVID-19 Incubation period Meta-analysis
  • 简介:摘要糖类抗原19-9(CA19-9)是目前诊断胰腺癌和监测胰腺癌复发、判断预后的最佳肿瘤标志物。近年来在胰腺炎和糖尿病发生发展及胰腺炎向胰腺癌转化的相关研究中,CA19-9也逐渐受到关注。本文就CA19-9在AP、CP和糖尿病中的表达及作用做一综述。

  • 标签: CA19-9 胰腺炎 糖尿病
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  • 简介:摘要本文回顾性分析2013年1月至2019年12月在首都医科大学附属北京朝阳医院肝胆外科因胰头癌行胰十二指肠切除术的154例患者的临床及随访资料。根据患者术前CA19-9/GGT与1年生存情况绘制ROC曲线,确定CA19-9/GGT的最佳cut-off值,并以此将患者分为低比值组和高比值组。单因素及多因素分析筛选出CA19-9/GGT(RR=1.842,95%CI:1.081~3.193)和淋巴结转移(RR=1.780,95%CI:1.118~2.835)是影响胰头癌术后远期生存的独立预后因素。本研究显示CA19-9/GGT相对于单纯CA19-9而言,在判断胰头癌远期生存方面更具有价值。

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  • 简介:摘要目的分析以急性肝功能衰竭(ALF)起病的肝豆状核变性(WD)患儿的临床特点。方法回顾性分析2016年1月至2021年4月于西安市儿童医院诊断的以ALF起病的19例WD患儿的临床资料,包括患儿一般情况、临床表现、实验室检查、基因检测等。根据患儿临床结局分为死亡组和存活组,选取同期收治的非ALF起病的肝型WD患儿作为对照。比较死亡组与存活组、以ALF起病组与非ALF起病组的一般情况与实验室检查指标。组间比较采用t检验、Mann-Whitney U检验或χ²检验。结果19例患儿中女10例、男9例,入院年龄(10.1±2.6)岁,初次就诊时起病时间9(4,15)d。以ALF起病的WD患儿中失访4例,死亡5例(死亡组),存活10例(存活组),死亡组的铜蓝蛋白高于存活组[0.078(0.055,0.105)比0.033(0.027,0.058)g/L,Z=-2.33,P=0.020]。非ALF起病组95例,ALF起病组的入院年龄[9.9(8.0,11.1)比5.4(3.7,6.9)岁,Z=-5.25,P<0.001]、铜蓝蛋白[0.060(0.030,0.078)比0.024(0.006,0.060)g/L,Z=-3.11,P=0.002]、24 h尿铜[674(205,1803)比149(108,206)μg,Z=-4.25,P<0.001]、K-F环阳性率[17/19比7%(7/95),χ²=50.17,P<0.001]均高于非ALF起病组,初次就诊时起病时间低于非ALF起病组[0.3(0.1,0.5)比1.0(0.7,6.0)个月,Z=-4.28,P<0.001];2组性别差异无统计学意义[9/19比61%(58/95),χ²=1.22,P=0.269]。19例ALF起病组中有13例行ATP7B基因检测,共检出15种已被报道的变异,高发变异位点为c.2333G>T(p.Arg778Leu)、c.2621C>T(p.Ala874Val)及c.2975C>T(p.Pro992Leu),等位基因频率分别为6/26(23%)、4/26(15%)及3/26(12%)。结论以ALF起病的WD患儿,均为学龄期及以上儿童,起病急,病程短,预后差。K-F环阳性率、铜蓝蛋白、尿铜高于其他肝型WD患儿。

  • 标签: 肝豆状核变性 肝功能衰竭,急性 儿童
  • 简介:摘要目的探讨CK19和COX-2表达与甲状腺乳头状癌(papillary thyroid carcinoma,PTC)临床病理指标的关系。方法选取2017年5月至2020年12月手术切除的PTC标本,采用EliVisionTMplus免疫组化2步法检测CK19和COX-2在120例癌组织及30例癌旁甲状腺组织中的表达,分析PTC组织中的表达与患者年龄、TI-RADS分级、TNM分期、癌浸润、淋巴结转移5项临床病理指标的关系。运用SPSS 22.0软件分析,计数资料用例(%)表示,组间比较及相关性分析,P<0.05为差异有统计学意义。结果CK19和COX-2蛋白阳性染色均主要定位于细胞质。癌组织CK19和COX-2阳性率分别为87.50%(105/120)和72.50%(87/120),癌旁甲状腺组织分别为10.00%(3/30)和3.33%(1/30),差异有统计学意义(P均<0.05)。年龄<45岁组与≥45岁组,CK19阳性率分别为88.16%(67/76)、86.36%(38/44),COX-2阳性率分别为69.74%(53/76)、77.27%(34/44)。TI-RADS(4级+5级)组与6级组,CK19阳性率分别为85.26%(81/95)、96.00%(24/25),COX-2阳性率分别为69.47%(66/95)、84.00%(21/25),上述组间差异无统计学意义(P均>0.05)。TNM(T1期+T2期)组与T3期组,CK19阳性率分别为82.28%(65/79)、97.56%(40/41),COX-2阳性率分别为65.82%(52/79)、85.36%(35/41)。有癌浸润组与无浸润组,CK19阳性率分别为94.44%(68/72)、77.08%(37/48),COX-2阳性率分别为83.33%(60/72)、56.25%(27/48)。有淋巴结转移组与无转移组,CK19阳性率分别为95.59%(65/68)、76.92%(40/52),COX-2阳性率分别为83.82%(57/68)、57.69%(30/52),通过组间比较差异有统计学意义(P均<0.05)。120例CK19和COX-2共阳率为70.83%(85/120),共阴率为10.83%(13/120),通过列联系数进行相关性分析,2者表达呈正相关(r=0.45,P<0.05)。结论CK19和COX-2表达阳性率与患者年龄和TI-RADS分级无关,与TNM分期、癌浸润和淋巴结转移密切相关,2者表达上调均预示癌组织分期高,浸润性强,易发生淋巴结转移。

  • 标签: 甲状腺乳头状癌 CK19 COX-2 浸润 肿瘤转移