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1.
目的研究蚌埠地区女性宫颈人乳头瘤病毒(HPV)感染状况及基因亚型分布特征,为该地区疫苗接种、宫颈癌早期防治提供数据参考。方法选取2016年7月至2019年12月在蚌埠市第一人民医院及周边社区医院进行HPV检测的门诊、住院患者及健康体检女性3408例,采用聚合酶链反应(PCR)-膜杂交法进行HPV 21种基因分型检测,并对结果进行统计分析。结果3408例受检者中共检测出HPV感染阳性患者810例,总检出率为23.77%,各年龄段比较差异有统计学意义(χ2=1.712,P<0.05),单一感染模式人数最多,占全部阳性患者的73.09%,主要亚型为HPV16型;多重感染模式中,以二重感染人数居首,占全部阳性患者的19.39%,占全部参检人数的4.61%,主要亚型组合为HPV16型+HPV52型;亚型分布中高危型占85.31%,低危型占14.69%,高危型位列前五名的分别是HPV16(4.67%)、HPV52(3.55%)、HPV58(2.88%)、HPV51(2.73%)、HPV53(2.61%);低危型位列前三名的分别是HPV6(1.41%)、HPV11(1.32%)、HPVCP8304(1.17%)。结论蚌埠地区HPV感染率较高,亚型分布丰富且以高危型为主,卫生部门应加强防治措施,建议适龄女性定期筛查并接种多价疫苗。  相似文献   
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Objective: Tumor response to neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients is a predictor foroverall survival. The aim of our study was to determine a relationship between the neutrophil to lymphocyte ratio(NLR) prior to NAC, BC subtypes and the probability of a pathologic complete response (pCR). Materials andMethods: Medical records were collected retrospectively from Centro de Cancer at Red Salud UC-Christus. Clinicaldata collected included peripheral blood cell counts, BC subtype at diagnosis and the pathology report of surgeryafter chemotherapy. Results: A total of 88 patients were analyzed. Approximately, a 25% had a pCR, and displayed asignificant correlation between BC subtype and pCR (p= 0.0138 Chi2); this was more frequent in epidermal growthfactor receptor type 2 (HER2) enriched subtype patients (54%). Luminal B BC patients with a pCR had significantlylower NLR levels (t test, p= 0.0181). Conclusions: HER2-enriched tumors had a higher probability of pCR. In LuminalB tumors, NLR had a statistically significant relationship with the probability of pCR. In this subtype, NLR could bea useful biomarker to predict tumor response to NAC. Further studies including other clinical parameters for systemicinflammation such as platelet counts, intratumoral NLR or body mass index could help identify patients that wouldget the most benefit from NAC.  相似文献   
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IntroductionRecent trials have suggested predictive biomarkers in advanced clear-cell renal cell carcinoma (accRCC): International Metastatic RCC Database Consortium (IMDC) good risk or angiogenic gene signature for sunitinib and IMDC intermediate/poor risk for ipilimumab-nivolumab and T-effector cell signature or sarcomatoid dedifferentiation for atezolizumab-bevacizumab. We hypothesized that earlier described molecular subtypes, ccrcc1 to ccrcc4, could provide similar information as a single generic biomarker and molecularly characterize the heterogeneous intermediate-risk group.Patients and MethodsPatients with accRCC treated with systemic therapies were included. We assessed associations between the 5 biomarkers and their impact on progression-free survival (PFS) and response rate (RR) on first-line sunitinib or pazopanib. The cutoff percentage of sarcomatoid dedifferentiation with optimal discriminative value was determined.ResultsIn total, 430 patients were included (163 with molecular data). The molecular ccrcc2 subtype identified tumors with higher angiogenic gene expression across IMDC risk groups: prevalence was high in IMDC good risk and low in IMDC poor risk (P < .001). Molecular subtype, IMDC, and angiogenic gene expression had comparable C-indices to predict PFS and RR (range, 60%-66%). The ccrcc2 subtype and angiogenic gene expression were positive predictors of PFS in IMDC intermediate-risk patients (P = .006; P = .04). Immune signature did not differ between IMDC groups, but was strongly correlated with molecular subtype (P = .8 and P = .0007). A cutoff value of 25% sarcomatoid differentiation discriminated tumors with distinct molecular characteristics and therapeutic sensitivity.ConclusionIn accRCC, molecular subtypes can explain differences in IMDC risk group, expression of angiogenesis and immune response genes, and sarcomatoid dedifferentiation. They can identify molecularly different patient populations within the heterogeneous IMDC intermediate group and select patients for systemic therapies.  相似文献   
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IntroductionThere is insufficient understanding of diagnosis of etiologic dementia subtypes and contact with specialized dementia care among older Americans.MethodsWe quantified dementia diagnoses and subsequent health care over five years by etiologic subtype and physician specialty among Medicare beneficiaries with incident dementia diagnosis in 2008/09 (226,604 persons/714,015 person-years).ResultsEighty-five percent of people were diagnosed by a nondementia specialist physician. Use of dementia specialists within one year (22%) and five years (36%) of diagnosis was low. “Unspecified” dementia diagnosis was common, higher among those diagnosed by nondementia specialists (33.2%) than dementia specialists (21.6%). Half of diagnoses were Alzheimer's disease.DiscussionAscertainment of etiologic dementia subtype may inform hereditary risk and facilitate financial and care planning. Use of dementia specialty care was low, particularly for Hispanics and Asians, and associated with more detection of etiological subtype. Dementia-related professional development for nonspecialists is urgent given their central role in dementia diagnosis and care.  相似文献   
7.
目的观察血清白细胞介素-32(interleukin-32,IL-32)、白细胞介素-33(interleukin-33,IL-33)、白细胞介素-35(interleukin-35,IL-35)水平与不同亚型幽门螺杆菌(Helicobacter pylori,Hp)感染之间的关系,并探讨胃癌患者血清IL-32、IL-33、IL-35水平的变化及意义。方法选取胃癌(GC)患者46例、慢性萎缩性胃炎(CAG)患者40例及慢性非萎缩性胃炎(CNAG)患者114例作为研究对象。采用酶联免疫吸附试验(ELISA)定量检测患者血清IL-32、IL-33、IL-35水平。比较各组患者血清IL-32、IL-33、IL-35水平与Hp感染率及其亚型之间的关系。结果1)3组患者血清IL-32、IL-33、IL-35水平的比较:GC组患者血清IL-32、IL-33、IL-35水平均明显高于CAG组及CNAG组(P<0.01);CAG组患者血清IL-32、IL-33水平均明显高于CNAG组患者(P<0.05);CAG组患者血清IL-35水平与CNAG组患者比较无明显差异(P>0.05)。2)3组患者Hp感染率的比较:GC组患者Hp感染率及Ⅰ型Hp感染率均明显高于CNAG患者(P<0.05),Hp感染率及Ⅰ型Hp感染率在GC组与CAG组、CAG组与CNAG组之间比较无显著统计学差异(P>0.05)。3)血清IL-32、IL-33、IL-35水平与不同亚型Hp感染之间的关系:在3组患者中,Ⅰ型Hp感染组血清IL-32、IL-33、IL-35水平均明显高于Ⅱ型Hp感染组及Hp阴性组(P<0.05),Ⅱ型Hp感染组血清IL-32、IL-33水平与Hp阴性组比较均无明显差异(P>0.05)。在CNAG组患者中,Ⅱ型Hp感染组血清IL-35水平明显高于Hp阴性组(P<0.05)。结论1)Ⅰ型Hp感染者发生GC的风险增加。2)在CNAG、CAG及GC患者中,Ⅰ型Hp感染者血清IL-32、IL-33、IL-35水平均显著升高。3)血清IL-32、IL-33、IL-35水平在GC患者中明显升高,其水平变化有利于提高GC的确诊率。  相似文献   
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目的开展2016-2018年长沙市人群感染和活禽市场(live poultry markets,LPMs)环境污染H5N6亚型禽流感病毒(avian influenza virus,AIV)监测,为防控人感染H5N6亚型AIV提供实验室数据。方法采集2016-2018年长沙市流感样病例和不明原因肺炎病例咽拭子6909份及LPMs环境样品1719份,利用实时RT-PCR进行A型、H5、H7、H9和N6亚型AIV核酸扩增,并对82份AIV核酸阳性样品进行高通量核苷酸测序,然后对测序结果进行BLAST比对和氨基酸(amino acids,aa)关键位点分析。结果从6909份病例的咽拭子样品中检出H5N6亚型AIV核酸阳性1份,从1719份LPMs环境样品中检出A型AIV核酸阳性927份(53.93%),H5N6亚型AIV核酸阳性193份(11.23%)。高通量核苷酸测序获得14株H5N6亚型AIV的基因组序列,aa关键位点分析显示病毒血凝素(hemagglutinin,HA)蛋白连接肽第338~347位出现6个碱性aa,对禽表现为高致病性的分子特征,受体结合位点(receptor binding site,RBS)第238~240位aa(对应H3型流感病毒第226~228位编码aa)为QSG或QRG,受体特征为禽源。神经氨酸酶(neuraminidase,NA)蛋白第290位耐药基因位点aa未出现R290K突变现象,对NA抑制剂(达菲/磷酸奥司他韦)敏感;病毒PB2蛋白发生E627K和D701N(I)突变,表明病毒致病力强。结论长沙市人群感染H5N6亚型AIV为偶发,LPMs环境H5N6亚型AIV污染较重,需要进一步加强LPMs环境AIV监测。  相似文献   
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Objective:The aim of this study was to explore the association between occupational exposure to diesel exhaust and polycyclic aromatic hydrocarbons (PAH), respectively, and breast cancer subtypes.Methods:The study included 38 375 women <70 years with incident breast cancer, identified in the Danish Cancer Registry, and 5 breast cancer-free controls per case who were randomly selected from the Danish Civil Registration System and matched on year of birth. Full employment history was obtained for all study subjects from a nationwide pension fund, and exposure to diesel exhaust and PAH was assessed using a job exposure matrix. Conditional logistic regression was used for estimation of odds ratios (OR) with adjustment for reproductive factors and socioeconomic status.Results:No noteworthy associations were observed for overall breast cancer in women exposed to diesel exhaust. However, diesel exhaust modestly elevated the risk of estrogen receptor negative breast tumors before age 50 [OR 1.26, 95% confidence interval (CI) 1.09–1.46]. Duration– and dose–response relationships were further observed for this subtype in this age group. No notable risk patterns were generally observed for PAH exposure.Conclusion:Occupational exposure to diesel exhaust may increase the risk of early-onset estrogen receptor negative breast tumors in women. Future studies exploring this association are warranted.  相似文献   
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