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Pan Y.,Capital Medical University | Wang A.,Capital Medical University | Liu G.,Capital Medical University | Zhao X.,Capital Medical University | And 122 more authors.
Journal of the American Heart Association | Year: 2014

Background: Treatment with the combination of clopidogrel and aspirin taken soon after a transient ischemic attack (TIA) or minor stroke was shown to reduce the 90-day risk of stroke in a large trial in China, but the cost-effectiveness is unknown. This study sought to estimate the cost-effectiveness of the clopidogrel-aspirin regimen for acute TIA or minor stroke. Methods and Results: A Markov model was created to determine the cost-effectiveness of treatment of acute TIA or minor stroke patients with clopidogrel-aspirin compared with aspirin alone. Inputs for the model were obtained from clinical trial data, claims databases, and the published literature. The main outcome measure was cost per quality-adjusted life-years (QALYs) gained. Oneway and multivariable probabilistic sensitivity analyses were performed to test the robustness of the findings. Compared with aspirin alone, clopidogrel-aspirin resulted in a lifetime gain of 0.037 QALYs at an additional cost of CNY 1250 (US$ 192), yielding an incremental cost-effectiveness ratio of CNY 33 800 (US$ 5200) per QALY gained. Probabilistic sensitivity analysis showed that clopidogrel-aspirin therapy was more cost-effective in 95.7% of the simulations at a willingness-to-pay threshold recommended by the World Health Organization of CNY 105 000 (US$ 16 200) per QALY. Conclusions: Early 90-day clopidogrel-aspirin regimen for acute TIA or minor stroke is highly cost-effective in China. Although clopidogrel is generic, Plavix is brand in China. If Plavix were generic, treatment with clopidogrel-aspirin would have been cost saving. © 2014 The Authors.


Yin S.,Tianjin Tianhe Hospital | Cao J.,Tianjin Tianhe Hospital | Huang M.,Tianjin Tianhe Hospital | Zhang X.,Tianjin Tianhe Hospital | Li J.,Tianjin Tianhe Hospital
Chinese Journal of Clinical Oncology | Year: 2013

Objective: To discuss the safety and effectiveness of superior vena cava filter (SVCF) placement in cancer patients with upper extremity deep vein thrombosis (UEDVT). Methods: Retrospective analysis of the data from 20 cancer patients with UEDVT was conducted. Of the 20 patients, 6 had lung cancer, 4 had gastric cancer, and 2 had breast cancer. The remaining eight cases were ovarian cancer, pancreatic cancer, nasopharyngeal carcinoma, leukemia, malignant lymphoma, esophageal cancer, gastric cardia cancer, and metastasis to the neck after surgery for thymoma. Results: The SVCF was successfully implanted in all patients. The deep-vein catheter was successfully removed from the patients who underwent deep venous catheterization without surgical complications. Complications such as post-operative asymptomatic pulmonary embolism, filter migration, and superior vena cava syndrome did not occur in any of the cases within the 6 months to 24 months of follow up. Conclusion: Malignant tumors and deep venous catheterization are the most important causes of UEDVT. SVCF placement is safe and effective in preventing pulmonary embolism in the cancer patients with UEDVT.


Wang F.,Tianjin Medical University | Geng Y.,Tianjin TianHe Hospital | Geng Y.,Tianjin Medical University | Zhang W.-M.,Tianjin Medical University | Geng X.,Tianjin Medical University
Advanced Materials Research | Year: 2012

To Analyze the structure and function of Zinc-alpha-2-glycoprotein (ZAG), a highly expressed serum protein in the patients with hepatocellular carcinoma (HCC). The serum proteome of the patients from HCC, liver cirrhosis and healthy donors were separated and identified by twodimensional electrophoresis and MALDI-TOF-MS. RT-PCR and Western blotting analysis were used to confirm ZAG highly expressed in HCC. Bioinformatics technologies were used to analyze the structure character of ZAG protein. Five differentially expressed proteins were identified. Albumin, Serotransferrin, CD5 antigen-like precursor ( IgM - associated peptide) were downregulated in HCC, ZAG and Ig gamma-1 chain C region were up-regulated in HCC. Zinc-alpha-2-glycoprotein (ZAG), a lipid mobilizing factor, is a member of the major histocompatibility complex (MHC) class I family of protein. ZAG protein might be a potential serological biomarker for HCC early diagnosis. © (2012) Trans Tech Publications, Switzerland.


Wang F.,Tianjin Medical University | Geng Y.,Tianjin TianHe Hospital | Geng Y.,Tianjin Medical University | Zhang W.-M.,Tianjin Medical University | Geng X.,Tianjin Medical University
Advanced Materials Research | Year: 2012

To identify Zinc-alpha-2-glycoprotein (ZAG) expression in HCC for serum biomarker, by analyzing the serum proteome of the patients suffering from primary hepatocellular carcinoma (HCC), liver cirrhosis and healthy donors. The serum proteome of the patients from HCC, liver cirrhosis and healthy donors were separated and identified by two-dimensional electrophoresis. The differentially expressed proteins were analyzed by peptide mass fingerprint based on MALDI-TOFMS and SWISS-PROT or BLAST nr database searching. RT-PCR and Western blotting analysis were used to confirm expression of ZAG in HCC. Five differentially expressed proteins were identified. Albumin, Serotransferrin, CD5 antigen-like precursor ( IgM - associated peptide) were down-regulated in HCC, ZAG and Ig gamma-1 chain C region were up-regulated in HCC. ZAG, a lipid mobilizing factor, is a member of the major histocompatibility complex (MHC) class I family of protein. Five proteins which were found differentially expressed in HCC provided useful information for screening diagnostic tumor markers of human HCC. ZAG might be a novel candidate serum biomarker for HCC early diagnosis. © (2012) Trans Tech Publications, Switzerland.


Liang S.,Tianjin Huanhu Hospital | Chen L.,Tianjin Tianhe Hospital | Huang H.,Tianjin Huanhu Hospital | Zhi D.,Tianjin Huanhu Hospital
Turkish Neurosurgery | Year: 2013

Aim: We investigated the differential miRNA expression in pituitary adenomas (both non-functioning and gonadotropin-secreting) and normal pituitaries. Material and Methods: RNA was extracted and purified from pituitary adenomas (10 non-functioning and 10 gonadotropin-secreting) and from two normal pituitary tissue samples. The samples were analyzed by miRNA microarray. Gene expression was measured using realtime RT-PCR with SYBR GREEN I. Results: In non-functioning pituitary adenomas, 25 miRNA genes were up-regulated (six by over 5-fold) and 15 were down-regulated (six by more than 10-fold). miR-124a was the most up-regulated gene (38.58-fold), and miR-31 the most down-regulated gene (21.5-fold). In gonadotropin-secreting pituitary adenomas, 16 miRNA genes were up-regulated (six by over 4-fold) and 13 were down-regulated (seven by more than 10-fold). miR-10b was the most up-regulated gene (48.73-fold), and miR-503 the most down-regulated gene (39.8-fold). Five genes were up-regulated in both subtypes: miR-523, miR-10b, miR-520b, miR-422a, and miR-422b. The RT-PCR results were consistent with those of the gene chips. ConclusIon: We established miRNA expression maps of non-functioning and gonadotropin-secreting pituitary adenomas. The most strongly differentially expressed genes were miR-124a and miR-31 in non-functioning pituitary adenomas, and miR-10b and miR-503 in gonadotropin-secreting pituitary adenomas.


Objective: To initially investigate the expressing regularity and effect of enterocyte NOD like receptors on gut mucosal barrier during early phase of acute intra-abdominal infection. Methods: Sprague-Dawley (SD) rats were randomly allocated into control group (n=6) and experimental group (n=24). Acute intra-abdominal infection model was induced by cecal ligation and puncture (CLP). The level of NOD2 and NOD like receptor 3 (NLRP3) mRNA expression in gut mucosa was determined using fluorescent polymerase chain reaction (PCR); the expression of caspase-1 and tight junction protein was determined by Western blotting; the activity of nuclear factor-κB (NF-κB) was determined by electrophoretic mobility shift assay (EMSA); the level of serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) was determined by enzyme linked immunosorbent assay (ELISA). The dead cell percentage of enterocyte was observed by terminaldeoxynucleoitidyl transferase mediated nick end labeling, and the gut mucosal permeability using an in situ loop preparation of gut with fluorescence isothiocyanate-conjugated dextran was determined. Results: NOD2 mRNA expression was quickly increased to a very high apex at 2 hours after operation, compared with the control group, the difference was statistically significant (75.50 ± 13.03 vs. 1.00 ± 0.00, P<0.01), and quickly descended at 6 hours, and then slowing descended. The expression of NLRP3 mRNA was decreased at 2 hours after the operation, then increased gradually, and peaked at 12 hours, which was significantly higher than that in control group (4.03 ± 0.71 vs. 1.00 ± 0.00, P<0.05). The level of caspase-1 was significantly higher than that in control group at 2 hours (3.56 ± 0.14 vs. 2.10 ± 0.11, P<0.01) and then gradually increased. The levels of Occludin, ZO-1 and Claudin-4 were obviously lowered than that in control group at 2-6 hours (2 hours Occludin: 7.24 ± 1.13 vs. 12.72 ± 1.34, 6 hours ZO-1: 0.47 ± 0.09 vs. 1.57 ± 0.17, 2 hours Claudin-4: 1.63 ± 0.28 vs. 3.40 ± 0.34, P<0.05 or P<0.01), and then all slowly decreased. The activity of NF-κB was quickly increased at 2 hours, obviously higher than that in control group (24.85 ± 0.57 vs. 12.42 ± 0.73, P<0.01), and then slowly decreased at a state of high expression. The expression of IL-6 in experimental group had a peak at 6 hours (compared with the control group, 3088.07 ± 330.03 vs. 26.19 ± 7.58, P<0.01), and then slowly decreased. The level of TNF-α was significantly higher than that in control group at 2 hours (110.75 ± 19.18 vs. 7.86 ± 3.58, P<0.01), and then gradually increased. The percentage of dead enterocyte was higher than that in control group with infection progress (0.12 ± 0.02 vs. 0.03 ± 0.01, P<0.05), and then gradually increased, so mucosal permeability was gradually increased too. Compared with the control group, the difference was statistically significant through 2 hours [glucosans: (35.75 ± 4.66)% vs. (2.84 ± 0.35)%, P<0.01]. The relevance analysis showed that NLRP3 have a little higher correlation with mucosal permeability and caspase-1 protein expression than other targets. Caspase-1 had a strong correlation with the percentage of dead cell, TNF-α and gut mucosal permeability. Gut mucosal permeability had highest correlation with the expression of caspase-1 protein. Conclusions: The data of our study suggested that NOD2 and NLRP3 take role in early phase of intra-abdominal infection, the huge wave of the expression level of NOD2 hinted that it was feed backed by some accurate mechanism in case of its express was too strong or too weak. The correlation of NLRP3, caspase-1, and percentage of dead cell imply they maybe have some extent of causation, and the percentage of dead cell in gut mucosa was as important as tight junction protein in maintaining the function of intestinal mucosal barrier.


Gu L.,Tianjin Medical University | Gu L.,Tianjin University of Traditional Chinese Medicine | Liu H.,Tianjin Haihe Hospital | Fan L.,Tianjin Medical University | And 7 more authors.
Journal of Cancer Research and Clinical Oncology | Year: 2014

Purpose: To evaluate the effectiveness comparing the combination of TACE with local ablative therapy and monotherapy on the treatment of HCC using meta-analytical techniques. Methods: Randomized controlled trials and clinical studies comparing TACE plus local ablative therapy with monotherapy for HCC were included in this meta-analysis. Response rate, 1-, 2-, 3-, and 5-year survival rate, and overall survival (OS) were analyzed and compared. Results: Eighteen studies included a total of 2,120 patients with HCC 1,071 and 1,049 patients for treatment with combination therapy and monotherapy, respectively. The combination therapy group had a significantly better survival in terms of 1-, 2-, 3-, and 5-year survival rate (RR 1.10, 95 % CI 1.03-1.18, P = 0.005; RR 1.20, 95 % CI 1.10-1.30, P < 0.0001; RR 1.43, 95 % CI 1.18-1.73, P < 0.0001; RR 1.40, 95 % CI 1.22-1.61, P < 0.0001, respectively), OS (HR 0.66, 95 % CI 0.51-0.85, P = 0.001), and response rate (RR 1.54, 95 % CI 1.09-2.18, P = 0.013) than that monotherapy group in patients with HCC. Conclusions: The meta-analysis indicates that the combination of TACE with local ablative therapy was superior to monotherapy in the treatment for patients with HCC. © 2013 Springer-Verlag Berlin Heidelberg.


Long L.,Tianjin University | Yuan X.,Tianjin University | Li Z.,Tianjin University | Li K.,Tianjin University | And 3 more authors.
Materials Chemistry and Physics | Year: 2014

Anti-fouling properties are important for both pharmaceutical and biomedical applications of polylactic acid (PLA). In this study, highly hydrated hydrophilic bilayers containing phosphatidylcholine (PC) and polyethylene glycol (PEG) were applied to PLA films to prevent the protein adsorption and blood platelet adhesion. The PLA films were coated with three PLA copolymers of PC and PEG, namely, a PLA-b-PEG block copolymer with a PC group on the end of a PEG chain (PC-PEG-PLA), a poly[2-methacryloyloxyethyl phosphatidylcholine (MPC)]-PLA graft copolymer (PMPC-g-PLA), and a PMPC-PLA graft copolymer with PEG serving as a spacer (PMPC-g-(PEG-b-PLA)). The influence of the copolymer structure on the anti-fouling properties of PLA film was then investigated. The results showed that the introduction of PC and PEG polar copolymers decreased the water-contact angle (WCA) and increased the equilibrated degree of hydration (Heq) of the PLA surface significantly. The PMPC-g-(PEG-b-PLA) copolymer achieved the lowest WCA value and the highest Heq value as it provided a higher density of PC on the outer surface. In addition, the strong hydration of the PEG and PC groups efficiently suppressed the bovine serum albumin (BSA) and fibrinogen (Fg) adsorption and subsequently inhibited platelet adhesion. The above results demonstrated that a good "anti-fouling" surface layer on the PLA substrate could be achieved by a combination of PEG and PC in copolymers. © 2013 Elsevier B.V. All rights reserved.


PubMed | Tianjin Tianhe Hospital
Type: Journal Article | Journal: Zhonghua wei zhong bing ji jiu yi xue | Year: 2013

To initially investigate the expressing regularity and effect of enterocyte NOD like receptors on gut mucosal barrier during early phase of acute intra-abdominal infection.Sprague-Dawley (SD) rats were randomly allocated into control group (n=6) and experimental group (n=24). Acute intra-abdominal infection model was induced by cecal ligation and puncture (CLP). The level of NOD2 and NOD like receptor 3 (NLRP3) mRNA expression in gut mucosa was determined using fluorescent polymerase chain reaction (PCR); the expression of caspase-1 and tight junction protein was determined by Western blotting; the activity of nuclear factor-B (NF-B) was determined by electrophoretic mobility shift assay (EMSA); the level of serum interleukin-6 (IL-6) and tumor necrosis factor- (TNF-) was determined by enzyme linked immunosorbent assay (ELISA). The dead cell percentage of enterocyte was observed by terminal deoxynucleotidyl transferase mediated nick end labeling, and the gut mucosal permeability using an in situ loop preparation of gut with fluorescence isothiocyanate-conjugated dextran was determined.NOD2 mRNA expression was quickly increased to a very high apex at 2 hours after operation, compared with the control group, the difference was statistically significant (75.5013.03 vs. 1.000.00, P<0.01), and quickly descended at 6 hours, and then slowing descended. The expression of NLRP3 mRNA was decreased at 2 hours after the operation, then increased gradually, and peaked at 12 hours, which was significantly higher than that in control group (4.030.71 vs. 1.000.00,P<0.05). The level of caspase-1 was significantly higher than that in control group at 2 hours (3.560.14 vs. 2.100.11,P<0.01) and then gradually increased. The levels of Occludin, ZO-1 and Claudin-4 were obviously lowered than that in control group at 2-6 hours (2 hours Occludin: 7.241.13 vs. 12.721.34, 6 hours ZO-1: 0.470.09 vs. 1.570.17, 2 hours Claudin-4: 1.630.28 vs. 3.400.34, P<0.05 or P<0.01), and then all slowly decreased. The activity of NF-B was quickly increased at 2 hours, obviously higher than that in control group (24.850.57 vs. 12.420.73, P<0.01), and then slowly decreased at a state of high expression. The expression of IL-6 in experimental group had a peak at 6 hours (compared with the control group, 3088.07330.03 vs. 26.197.58,P<0.01), and then slowly decreased. The level of TNF- was significantly higher than that in control group at 2 hours (110.7519.18 vs. 7.863.58,P<0.01), and then gradually increased. The percentage of dead enterocyte was higher than that in control group with infection progress (0.120.02 vs. 0.030.01,P<0.05), and then gradually increased, so mucosal permeability was gradually increased too. Compared with the control group, the difference was statistically significant through 2 hours [glucosans: (35.754.66)% vs. (2.840.35)%, P<0.01]. The relevance analysis showed that NLRP3 have a little higher correlation with mucosal permeability and caspase-1 protein expression than other targets. Caspase-1 had a strong correlation with the percentage of dead cell, TNF- and gut mucosal permeability. Gut mucosal permeability had highest correlation with the expression of caspase-1 protein.The data of our study suggested that NOD2 and NLRP3 take role in early phase of intra-abdominal infection, the huge wave of the expression level of NOD2 hinted that it was feed backed by some accurate mechanism in case of its express was too strong or too weak. The correlation of NLRP3, caspase-1, and percentage of dead cell imply they maybe have some extent of causation, and the percentage of dead cell in gut mucosa was as important as tight junction protein in maintaining the function of intestinal mucosal barrier.

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