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1.
CA125检测对活动性肺结核判定及疗效评估作用的研究   总被引:17,自引:0,他引:17  
有关肺结核患者血清CA12 5测定的病例对照研究报告甚少。本研究旨在通过对活动性及非活动性肺结核患者血清中CA12 5的检测 ,进一步探讨CA12 5测定在活动性肺结核的判定及治疗效果评估中的价值。对象与方法 收集我院 1998年 8月至 2 0 0 1年 8月门诊及住院患者 6 0例 ,非医疗职业健康体检者 30人 ,分为三组 :(1)活动性肺结核组 :为新近确诊的初治活动性肺结核 30例 (女 10例 ,男 2 0例 ,年龄 19~ 6 1岁 ,平均 31岁 )。所有患者均依据 3次痰涂片抗酸染色阳性 ,一次痰结核分支杆菌培养阳性确诊。 (2 )非活动性肺结核组 :为 30例非活动…  相似文献   

2.
目的探讨OPN、IFN-γ、IL-10检测对活动性肺结核病情及预后判定的临床意义。方法选择2015年1月-2018年1月我院收治的92例活动性肺结核患者作为实验组,并选择同期50例门诊健康体检者作为对照组,采用酶联免疫吸附法(ELISA)检测所有研究对象血清OPN、IFN-γ、IL-10的水平;并比较治愈患者与未治愈患者在治疗前后血清OPN、IFN-γ、IL-10的水平变化情况。结果实验组患者的血清OPN、IFN-γ、IL-10的水平均明显高于对照组(P 0. 05);且痰菌阳性患者的血清OPN、IFN-γ、IL-10的水平均明显高于痰菌阴性患者(P 0. 05);治疗前,治愈患者与未治愈患者的血清OPN、IFN-γ、IL-10的水平无明显差异(P0. 05),治疗后所有患者各细胞因子水平均较治疗前明显降低(P 0. 05),但治愈患者各细胞因子水平明显低于未治愈患者(P 0. 05)。结论活动性肺结核患者血清OPN、IFN-γ、IL-10的水平显著升高,对患者病情及预后评估具有重要价值。  相似文献   

3.
目的探讨血清铁在结核患者治疗过程中的改变及其临床意义。方法用比色终点方法分别检测95例活动性肺结核患者、7例陈旧性肺结核患者、6例肺部感染患者以及95例健康体检者血清铁(Fe)水平,同时观察活动性肺结核患者在治疗后1周、2周血清铁(Fe)水平变化。结果结核病人治疗前血清铁水平显著低于治疗一周和治疗2周水平(P值均〈0.01),同时低于陈旧性肺结核组、正常对照组(P值均〈0.01),但与肺部感染组无差异(P值均〉0.05);各组人群中血清铁阳性率因血清铁值界点取不同而有所差异;不同临床类型结核患者血清铁水平比较无明显差异;涂阳活动性肺结核患者的血清铁平均水平低于涂阴患者(P〈0.05)。结论血清铁水平检测在结核病诊断及结核疗效判断中有参考意义。血清铁水平检测可作为结核病诊断、疗效、活动判断的重要的辅助指标之一。  相似文献   

4.
武忠长 《临床肺科杂志》2016,(11):2101-2104
目的分析抗结核治疗前后肺结核患者外周血(CD3+CD4+IL-17+)辅助性T细胞17(Th17)和(CD4+CD25+Foxp3+)调节性T细胞(Treg)平衡状态的变化及其临床意义。方法收集本院2014年10月至2015年5月感染科收治的肺结核患者80例,选择30例健康体检者作为对照组。流式细胞术检测患者抗结核药物治疗前、治疗6个月以及对照组的外周血Th17细胞和Treg细胞的表达,ELISA检测外周血中IL-17A的表达。结果流式结果显示,治疗前肺结核患者外周血Th17细胞,Treg细胞表达率为分别为(1.18±0.74)%、(7.68±0.92)%,均明显低于健康体检者((3.95±1.17)%,(4.17±1.12)%,P0.05);治疗6个月后肺结核患者外周血Th17细胞,Treg细胞表达率分别为(2.98±1.42)%,(5.26±0.72)%,均明显高于治疗前、但仍显著低于健康体检者(P0.05)。治疗前肺结核患者Th17/Treg为0.15±0.21,明显低于健康体检者(0.95±0.45,P0.05);治疗6个月后肺结核患者Th17/Treg为0.56±0.39,明显高于治疗前、但仍显著低于健康体检者(P0.05)。ELISA检测结果显示,治疗6个月后肺结核患者外周血IL-17A表达水平为39.06±5.83 pg/m L,明显高于治疗前、但仍显著低于健康体检者(P0.05)。结论结核分枝杆菌可破坏肺结核患者机体Th17/Treg平衡,抗结核治疗可缓解患者外周血Th17/Treg失衡状态。  相似文献   

5.
目的 通过检测中晚期非小细胞肺癌(NSCLC)患者接受吉非替尼治疗前的血清CA125水平,以判断血清CA125基线水平对患者疗效及预后的影响。方法采用EL/SA法检测104例中晚期NSCLC患者的CA125水平。结果治疗前CA125水平升高患者的客观缓解率及疾病控制率均低于水平正常的患者(P=0.035、0.036)。治疗前血清CA125水平升高的患者较正常者预后差,中位生存时间分别为14.3个月和7.3个月(P=0.001)。Cox模型多因素分析表明,性别、Ps评分及CA125水平均为预后的独立影响因素。治疗前血清CA125水平≥35U/ml、女性及PS评分≥2分的患者,治疗后死亡的相对危险度分别为1.679、0.587和3.809。结论治疗前血清CA125水平可能可以预测接受吉非替尼治疗的中晚期NSCLC患者的疗效及预后。  相似文献   

6.
血清瘦素与肺结核病患者的营养状况   总被引:2,自引:0,他引:2  
目的 探讨肺结核患者的血清瘦素水平变化与疗效关系。方法 对23例初治菌阳肺结核患者,根据其体重指数(BMl)分为慢性能量缺乏组(CED组)及非慢性能量缺乏组(NCED组)。观察抗结核治疗前后的血清瘦素水平及营养状况变化。并以同期在我院健康体检者22例为对照组。结果 肺结核组在治疗前LEP、LMP均明显低于对照组,TNF-α明显高于对照组;CED组治疗前LEP、BMI及ALB均明显低于NCED组,而TNF-α明显高于NCED组。肺结核患者强化治疗2个月后,LEP及TNF-α均不同程度的改善;ALB及LMP明显改善。结论 肺结核患者处于慢性能量缺乏状态,其血清瘦素水平明显低于健康人,而血TNF-α水平高于健康人;经过2个月的强化治疗后,其蛋白质营养状况改善明显优于能量状况的改善。  相似文献   

7.
目的探讨肺结核患者血清降钙素原(PCT)、超敏C反应蛋白(HS-CRP)和血浆纤维蛋白原(FIB)检测的临床意义。方法选取52例痰菌涂片阳性或痰TB-PCR阳性肺结核患者作为A组、55例痰菌涂片阴性且痰TB-PCR阴性肺结核患者作为B组,测定两组患者治疗前和治疗3个月PCT、HS-CRP、FIB水平变化;选择30例健康体检人群作对照组。结果两组治疗前PCT、HS-CRP和FIB水平均显著高于对照组(P0.05),其中A组HS-CRP水平显著高于B组(P0.05)。两组治疗后PCT、HS-CRP和FIB水平均显著低于治疗前(P0.05),其中B组上述三项指标与对照组比较均无显著差异(P0.05),A组HS-CRP、FIB水平仍显著高于对照组(P0.05)。结论肺结核患者PCT水平恢复早于HS-CRP和FIB,但敏感性低;HS-CRP和FIB水平随治疗进程而发生变化,可用于辅助临床进行病情转归的判定。  相似文献   

8.
张延安 《山东医药》2014,(25):57-58
目的:观察莫西沙星对耐多药肺结核患者血清降钙素原(PCT)和C-反应蛋白(CRP)的影响。方法将76例耐多药肺结核患者按照随机数字表法随机分为观察组及对照组各38例,观察组在常规化疗的基础上加用莫西沙星;对照组在常规化疗的基础上加用左氧氟沙星。统计两组治疗后3、6、12个月的痰菌转阴率。治疗后12个月观察患者肺部X线变化。测定两组治疗前、治疗后3、6、12个月血清PCT和CRP。结果观察组治疗后3、6、12个月的痰菌转阴率均高于对照组( P均<0.05)。治疗后12个月,观察组病灶吸收率、空洞改善率明显高于对照组(P均<0.05)。观察组治疗后3、6、12个月血清PCT、CRP均低于对照组(P均<0.05)。结论莫西沙星可以明显减少耐多药肺结核患者血清PCT和CRP的表达。  相似文献   

9.
目的研究肺结核患者支气管肺泡灌洗液(BALF)中γ干扰素(IFN-γ)、白细胞介素12(IL-12)、白细胞介素4(IL-4)、白细胞介素10(IL-10)水平的变化及其临床意义。方法采用双抗体夹心ELISA法检测60例活动性肺结核患者、33例非活动性肺结核患者BALF中IFN-γ、IL-12、IL-4、IL-10的水平,对其中32例活动性肺结核患者抗结核治疗后的上述细胞因子水平进行随访。组间比较采用t检验。结果活动性肺结核病例BALF中IFN-γ、IL-12的水平要显著高于非活动性肺结核病例(P0.01),而IL-4、IL-10的水平两组间无明显差异(P0.05)。菌阳及重症肺结核的IFN-γ、IL-4、IL-12水平要明显高于菌阴及轻症(P0.05),IL-10值无明显差异(P0.05)。32例活动性肺结核的病例在抗痨治疗一个月后复查支气管镜,BALF中IFN-γ、IL-4、IL-12的水平均较治疗前有明显的下降(P0.01)。而IL-10值亦有所下降,但差异无统计学意义(P0.05)。结论肺结核患者BALF中IFN-γ、IL-4、IL-12水平的检测可作为了解病灶活动性、严重程度、监测疗效的参考。  相似文献   

10.
目的观察晚期非小细胞肺癌(NSCLC)患者吉非替尼治疗前后血清癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角质片段抗原(CYFRA21-1)及神经元特异性稀化醇(NSE)的水平变化,并探讨其意义。方法选择晚期NSCLC患者55例,均予吉非替尼治疗;分别于治疗前及治疗后2、4、6、8、12个月,检测血清CEA、CA125、CYFRA21-1、NSE水平。结果治疗2个月后,本组完全控制率(DSR)达74.55%;治疗2、4、6个月,血清CEA、CA125水平较治疗前逐渐降低(P均<0.05),而NSE、CYFRA21-1无明显变化(P均>0.05);治疗8个月时,血清CEA、CA125水平较治疗6个月时增加(P均<0.05);CEA>5 ng/mL患者的DCR为80.95%,高于<5 ng/mL者的53.85%(P<0.05)。结论晚期NSCLC患者吉非替尼治疗后较治疗前血清CEA、CA125水平明显降低,CYFRA21-1、NSE水平变化不明显;CEA检测有助于吉非替尼疗效的判断。  相似文献   

11.
The value of Ca 125 in the evaluation of tuberculosis activity.   总被引:1,自引:0,他引:1  
The aim of the present study was to investigate the value of Ca 125, a tumour marker, in evaluation of pulmonary tuberculosis activity. This study included 96 subjects who were divided into three groups. Group 1 consisted of 40 patients with active pulmonary tuberculosis. Group 2 included 20 patients with inactive pulmonary tuberculosis. There were 36 healthy subjects in group 3. While measurement of serum Ca 125 level was performed only once in groups 2 and 3, Ca 125 levels were measured five times in group 1. The measurements were performed before the treatment, at the second, fourth and sixth months and the third year following the end of the treatment. Mean +/- SD serum Ca 125 concentrations were 109.7 +/- 86.9 U ml(-1) in group 1, 14.5 +/- 7.8 U ml(-1) in group 2 and 10.5 +/- 7.3 U ml(-1) in group 3. Serum Ca 125 levels were significantly higher in group 1 than in the other groups (P < 0.0001), but there was no significant statistical difference between the values of groups 2 and 3 (P > 0.05). Ca 125 levels in group 1 showed a significant decrease after treatment (P < 0.0001). For estimation of the activity of tuberculosis, the sensitivity and specificity of Ca 125 were found 97.5% and 100%, respectively at a 31 U ml(-1) cut-off point. Our results suggest that Ca 125 is beneficial in the determinaton of tuberculosis activity and in differentiation between active and inactive pulmonary tuberculosis.  相似文献   

12.
CA125在肺结核、结核性胸膜炎与肺癌鉴别诊断中的价值   总被引:2,自引:1,他引:1  
韩丹  陈志飞  邱鸣 《临床肺科杂志》2008,13(9):1160-1161
目的讨论CA125测定在肺结核、结核性胸膜炎与肺癌鉴别诊断中的价值。方法对27例菌阳肺结核、21例结核性胸膜炎及18例肺癌患者的血清CA125进行检测,同时检测其他11项肿瘤标记物的血清浓度(如CEA、CA199、CA242等),对以上3组的检测结果进行分析。结果结核性胸膜炎组血CA125浓度(75.43±28.74KU/L)高于肺癌组(42.09±16.41KU/L)及肺结核组(23.26±7.59KU/L),统计学有显著性差异(P〈0.05)。肺癌组CA125高于肺结核组,两组比较有显著性差异(P〈0.05)。其他肿瘤标记物阳性率:肺癌组(38.9%)高于肺结核组(3.7%)和结核性胸膜炎组(4.76%),差异有显著性(P〈0.05)。结论血CA125检测在肺结核及肺癌鉴别诊断中有重要的临床价值,结合肿瘤标记物其他项目的检测结果及动态观察CA125浓度的变化更有利于明确诊断。  相似文献   

13.
The aim of the current study was to determine the possible crucial role of cancer antigen 125 (CA125) in the diagnosis of pulmonary tuberculosis (PTB). The CA125 levels of study and control groups were statistically compared. In a total of 146 patients that were included in the current study, 30 had active PTB, 37 inactive PTB, 28 community-acquired pneumonia (CAP), 25 pleural or pulmonary malignancies, and 13 patients exacerbation of chronic obstructive pulmonary disease. The mean CA125 levels in PTB, inactive PTB, CAP, and pleural-pulmonary malignancies were 118.46 +/- 248.41, 40.80 +/- 50.95, 47.76 +/- 60.76, and 57.77 +/- 65.59, respectively. For active-inactive discrimination of PTB, with a cut-off level of >35 U/ml, the sensitivity, specificity, positive predictive value, and negative predictive value of CA125 were 63, 59, 56, and 67%, respectively. Increased CA125 levels were detected in active PTB in the current results. The current results also show that high level CA125 should be reconsidered in the prediagnosis and/or discrimination of active and inactive PTB patients.  相似文献   

14.
Alatas F  Alatas O  Metintas M  Ozarslan A  Erginel S  Yildirim H 《Chest》2004,125(6):2156-2159
BACKGROUND: Vascular endothelial growth factor (VEGF) is a mediator with potent angiogenic, mitogenic, and vascular permeability-enhancing activities that are specific for endothelial cells. Intense angiogenesis has been found in active pulmonary tuberculosis lesions. OBJECTIVES: To determine whether active pulmonary tuberculosis is associated with increased serum levels of VEGF compared with inactive tuberculosis and VEGF levels in healthy subjects, and to assess the changes in serum VEGF levels before and after therapy. DESIGN: Prospective clinical study. SETTING: Chest clinic of a university hospital, Eskisehir, Turkey. PATIENTS AND MEASUREMENTS: Serum VEGF levels of 44 patients with active pulmonary tuberculosis, 24 patients with inactive pulmonary tuberculosis, and 20 healthy subjects were determined. RESULTS: VEGF levels were increased in active pulmonary tuberculosis patients (mean [+/- SD] VEGF level, 598.03 +/- 298.25 pg/mL) compared to both inactive pulmonary tuberculosis patients (mean VEGF level, 296.98 +/- 115.31 pg/mL) and control subjects (mean VEGF level, 339.67 +/- 74.65 pg/mL). The increase in VEGF level observed in patients with active tuberculosis was statistically significant when compared with levels in two other groups (p < 0.001 for both). Serum VEGF levels were statistically different before treatment and after treatment in 10 patients who were observed from diagnosis to the end of treatment (p < 0.01). CONCLUSIONS: Increased serum VEGF levels may be an indicator of active pulmonary tuberculosis, since levels were higher in patients with active pulmonary tuberculosis and were lower after successful treatment. The role of VEGF-mediated angiogenesis in the pathogenesis and progression of pulmonary tuberculosis lesions should be further elucidated.  相似文献   

15.
目的 探讨血清糖类抗原125(Carbohydrate antigen 125,CA125)、鳞状细胞相关癌抗原(Squamous cell associated oncoantigen,SCCA)在肺结核与肺癌患者表达含量,为临床辅助鉴别诊断肺结核与肺癌提供实验依据.方法 选取2019年6月至2019年12月于该院确...  相似文献   

16.
肺结核患者血清前炎细胞因子及其受体的变化   总被引:10,自引:0,他引:10  
目的 探讨肺结核患者血清TNF-α及受体、IL-1β及受体、IL-6及受体的特征及其临床意义,并明确其在结核病免疫发病中的作用。方法 采用双抗体夹心ABC-ELISA法检测41例活动性肺结核患者、21例非活动性肺结核患者和20名正常人血清TNF-α、sTNF-RⅠ、IL-1β、IL-1R、IL-6、IL-6R的水平,同时对17例活动性肺结核患者抗结核治疗后上述CK水平进行了随访。结果 活动性肺结核组和非活动性肺结核组血清TNF-α、sTNF-RⅠ、IL-1β、IL-1R、IL-6、IL-6R水平及TNF-α/sTNF-RⅠ比值均显著高于正常对照组(P<0.01-0.05)。活动性肺结核组血清TNF-α、sTNF-RⅠ、IL-1β、IL-1R、IL-6、IL-6R水平及TNF-α/sTNF-RⅠ比值显著高于非活动性肺结核组(P<0.01-0.05)。空洞组血清TNF-α、sTNF-RⅠ、IL-1β、IL-6水平及TNF-α/sTNF-RⅠ比值低于无空洞组(P<0.01-0.05)。抗结核治疗2月末,17例患者中有15例患者血清TNF-α、sTNF-RⅠ、IL-1β、IL-1R、IL-6、IL-6R水平及TNF-α/sTNF-RⅠ比值均较治疗前明显降低(P<0.01-0.05),且上述患者临床症状改善,痰菌阴转,胸片病灶吸收好转、空洞缩小或闭合。但有2例患者血清上述CK水平较治疗前未明显降低,痰菌未阴转。结论 TNF-α、sTNF-R、IL-1β、IL-1R、IL-6、IL-6R等均参与结核病免疫发病过程。肺结核患者血清前炎细胞因子及受体水平的检测有助于了解疾病的活动性,判断病情及预后,监测抗结核治疗的效果。  相似文献   

17.
Background and objective: Although cancer antigen 125 (CA‐125) is a useful marker for the diagnosis of ovarian cancer, CA‐125 levels are elevated in many benign conditions, including tuberculosis (TB). The clinical significance of serum CA‐125 measurements in patients with non‐tuberculous mycobacterial (NTM) lung disease was evaluated. Methods: Patients with NTM lung disease (n = 53), in whom serum CA‐125 levels had been measured, were retrospectively enrolled in the study. Twenty‐eight patients with pulmonary TB were included as a comparison group. Clinical, radiological and bacteriological parameters were assessed according to serum CA‐125 status. Results: Among 53 patients with NTM lung disease, serum CA‐125 levels were elevated in 28 (52.8%), and this proportion was not significantly different from that of the TB patients (44.8%). Cavitation and upper lobe cavitary type disease were more frequent in NTM patients with elevated serum CA‐125 levels compared with those without increased CA‐125 levels (P < 0.05 for both). The clinical course of NTM lung disease was correlated with changes in serum CA‐125 levels. Conclusions: Serum CA‐125 levels were increased in significant proportions of NTM patients, as well as TB patients. Further studies are needed to investigate the usefulness of serum CA‐125 measurements in patients with NTM pulmonary disease.  相似文献   

18.
目的 探讨慢性充血性心力衰竭 (CHF)患者血清中CA12 5和肿瘤坏死因子α(TNFα)的浓度与心功能和心脏扩大的关系。方法  10 2例心力衰竭患者根据纽约心脏病学会心功能分级标准分为心功能Ⅱ~Ⅳ级组 ,根据超声心动图检查结果分为左室常大组 (左室舒张末期容积≤ 5 5mm)和左室扩大组 (左室舒张末期容积 >5 5mm)。用酶联免疫吸附测定法测定CA12 5和TNFα的血清浓度。并选 2 0名正常人作为对照。结果 CHF患者CA12 5和TNFα的浓度明显高于正常对照组 (P<0 .0 5 ~ 0 .0 1) ,心功能Ⅲ、Ⅳ级的血清浓度高于Ⅱ级 (P <0 .0 1)。左室扩大组较左室常大组CA12 5和TNFα的血清浓度显著升高 (P <0 .0 1) ,CA12 5和TNFα的血清浓度与心力衰竭患者的心脏扩大呈正相关 (r=0 .6 2 1及 0 .5 4,P <0 .0 5 )。结论 CHF患者血清中CA12 5和TNFα的血清浓度升高 ,升高水平与CHF患者心脏扩大呈正相关。  相似文献   

19.
The rise in allergic disorders over the past three decades has been suggested to be related to the decrease in infectious diseases. Recently, a negative association between tuberculin responses and atopic disorders has also been reported. We planned to investigate the effect of natural exposure to Mycobacterium tuberculosis on atopic status in patients with active tuberculosis and to compare the findings with the data of patients with inactive disease. A total of 97 subjects were divided into two groups. Group 1, patients with proven active pulmonary tuberculosis (n = 66); group 2, subjects who had a history of previous tuberculous disease, with negative bacteriologic studies and no clinical and/or roentgenographic evidence of current disease (n = 31). Current history of allergic diseases was recorded by a physician with the use of a questionnaire adapted from the European Community Respiratory Health Survey (ECRHS), and skin-prick tests (SPTs) were performed using a standardized panel. Total IgE and Phadiatop were measured by the Pharmacia uniCAP system. The rate of one or more positive SPTs was significantly lower in the patients with active tuberculosis than the inactive group (15% versus 48.4%, p < 0.001). The current history of atopic diseases was 7.6% and 29% in the active and inactive tuberculosis groups, respectively (p = 0.002). The rate of positive skin tests to inhalant allergens in patients with inactive disease was higher than the rate of healthy adult Turkish people (48.4% versus 25%, p = 0.001). Geometric mean of total IgE levels were lower in patients with inactive disease than patients with active pulmonary tuberculosis (74.97 kU/L versus 106.3 kU/L, p = 0.05). The ratios of Phadiatop positivity were 21% and 38.7% in the active and inactive tuberculosis groups, respectively (p = 0.008). We found lower atopy rates in patients with active pulmonary tuberculosis than subjects with inactive disease. Although our data support the hypothesis that M. tuberculosis may prevent the development of atopic disorders by inducing the production of cytokines antagonistic to Th2 development, we believe prospective and experimental studies are needed before attributing a direct cause-effect link to this association.  相似文献   

20.
Elevated serum CA 125 levels in mitral stenotic patients with heart failure   总被引:5,自引:0,他引:5  
BACKGROUND: Elevated tumor marker levels have been reported in heart failure patients with left ventricular (LV) systolic dysfunction and enlargement. The levels of several tumor markers, including CA 125, CA 19-9, CA 15-3 and CEA, in rheumatic mitral stenotic patients were compared to the control group. MATERIALS AND METHODS: Tumor markers were measured in 60 mitral stenotic patients and in 30 normal subjects who served as the control group. Mitral stenotic patients were classified into two categories of cardiac dysfunction based on the classification of the New York Heart Association (NYHA). Group I consisted of 31 patients in NYHA class 3-4 and group II of 29 patients in NYHA class 1-2. Echocardiographic examinations and invasive hemodynamic monitoring were performed in all patients. RESULTS: Group I patients had decreased mitral valve area (p = 0.004) and higher left atrial diameter (p = 0.003) than group II patients. Right atrial, mean pulmonary artery and pulmonary capillary wedge pressures and transmitral gradient were higher in group I than in group II (p = 0.010, 0.0001, 0.0001 and 0.0001, respectively). CA 125 levels were statistically higher in mitral stenotic patient groups than in the control group (p < 0.0001). No statistically significant differences were shown for the other tumor markers. Group I patients had higher CA 125 levels compared to group II (p < 0.0001). CONCLUSION: Elevated CA 125 levels may be due to venous congestion and activation of peritoneal mesothelium or increased signal peptides.  相似文献   

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