AIM:To evaluate the efficacy of antiviral or corticosteroid treatment on hepatitis B virus-associated glomerulonephritis(HBV-GN) . METHODS:Six and five trials were used respectively to evaluate the efficacy of either ...AIM:To evaluate the efficacy of antiviral or corticosteroid treatment on hepatitis B virus-associated glomerulonephritis(HBV-GN) . METHODS:Six and five trials were used respectively to evaluate the efficacy of either antiviral or corticosteroid treatment on HBV-GN.Pediatric patients were pooled separately to assess their response to the above treatment modalities.The primary and secondary outcomes were remission of proteinuria and clearance of Hepatitis B e-antigen(HBeAg) ,respectively.A fixed or random effect model was established to collect the data. RESULTS:The remission rate of proteinuria(RR=1.69,95%CI:1.08-2.65) and the clearance rate of HBeAg(RR =6.44,95%CI:3.11-13.35) were significantly higher in antiviral treatment group than in control group.The proteinuria remission was significantly associated with HBeAg clearance(P=0.002) .However,the difference in proteinuria remission rate was not statistically significant between corticosteroid treatment group and controlgroup(RR=1.45,95%CI:0.68-3.11) .Antiviral therapy could significantly promote the HBeAg clearance in pediatric patients,but neither antiviral nor corticosteroid therapy could significantly decrease proteinuria in pediatric patients compared to controls. CONCLUSION:Antiviral but not corticosteroid treatment can decrease proteinuria and promote HBeAg clearance in HBV-GN patients.展开更多
AIM To determine the prevalence of epstein-barr virus(eb V)-associated gastric carcinomas in the North Region of Portugal and to study its clinicopathological characteristics. METHODS We have performed a retrospective...AIM To determine the prevalence of epstein-barr virus(eb V)-associated gastric carcinomas in the North Region of Portugal and to study its clinicopathological characteristics. METHODS We have performed a retrospective study including a total of 179 consecutive patients with gastric cancer(GC) submitted to gastrectomy during 2011 at the Portuguese Oncology Institute of Porto. Clinical and pathological data was collected from individual clinical records and inserted on a database with unique codification. Tumour tissues were collected from the institutional tumour bank. eb V was detected by in situ hybridization for the detection of eb V-encoded small RNAs(ebe Rs) and eb V latent proteins(LMP1 and LMP2 A) were detected by immunohistochemistry.RESULTS The analysis showed that eb V-associated gastric carcinomas(eb Va GC) represents 8.4%(15/179) of all GC cases, with a significant differential distribution among histological types(P < 0.001): 100%(3/3) of medullary carcinomas, 100%(1/1) of adenosquamous carcinoma, 8.7%(8/92) of tubular adenocarcinomas, 8.0%(2/25) of mixed carcinomas and 2%(1/51) in poorly cohesive carcinomas. The analysis revealed a higher predominance of eb Va GC in the upper third and middle(cardia, fundus and body) of the stomach(P = 0.041), a significant lower number of regional lymph nodes invasion(P = 0.025) and a tendency for better prognosis(P = 0.222). eb V latent protein expression revealed that all eb Va GC cases were LMP1-negative, nevertheless 6 cases(40%) expressed LPM2 A, which reveals that these cases show a distinct eb V-Latency profile(latency II-like).CONCLUSION eb Va GC represents 8.4% of all GC in the North Region of Portugal. The eb V-infected patients have specific clinic-pathological features that should be further explored to develop new strategies of management and treatment.展开更多
Epstein-Barr virus(EBV)-associated gastric cancer(EBVaGC)cells originate from a single-cell clone infected with EBV.However,more than 95%of patients with gastric cancer have a history of Helicobacter pylori(H.pylori)i...Epstein-Barr virus(EBV)-associated gastric cancer(EBVaGC)cells originate from a single-cell clone infected with EBV.However,more than 95%of patients with gastric cancer have a history of Helicobacter pylori(H.pylori)infection,and H.pylori is a major causative agent of gastric cancer.Therefore,it has long been argued that H.pylori infection may affect the development of EBVaGC,a subtype of gastric cancer.Atrophic gastrointestinal inflammation,a symptom of H.pylori infection,is observed in the gastric mucosa of EBVaGC.Therefore,it remains unclear whether H.pylori infection is a cofactor for gastric carcinogenesis caused by EBV infection or whether H.pylori and EBV infections act independently on gastric cancer formation.It has been reported that EBV infection assists in the oncogenesis of gastric cancer caused by H.pylori infection.In contrast,several studies have reported that H.pylori infection accelerates tumorigenesis initiated by EBV infection.By reviewing both clinical epidemiological and experimental data,we reorganized the role of H.pylori and EBV infections in gastric cancer formation.展开更多
A 19-year-old female was diagnosed with ulcerative colitis when she presented with persistent melena, and has been treated with 5-aminosalicylic acid for 4 years, with additional azathioprine for 2 years at our hospit...A 19-year-old female was diagnosed with ulcerative colitis when she presented with persistent melena, and has been treated with 5-aminosalicylic acid for 4 years, with additional azathioprine for 2 years at our hospital. The patient experienced high-grade fevers, chills, and cough fve d prior to presenting to the outpatient unit. At frst, the patient was suspected to have developed neutropenic fever; however, she was diagnosed with Epstein-Barr virus-associated hemophagocytic syndr-ome （EB-VAHS） upon fulfilling the diagnostic criteria after bone marrow aspiration. When patients withinflammatory bowel disease treated with immunomo-dulators, such as thiopurine preparations, develop fever, EB-VAHS should be considered in the differential diagnosis.展开更多
Modern immunosuppression has led to a decrease in rejection rates and improved survival rates after solid organ transplantation.Increasing the potency of immunosuppression promotes post-transplant viral infections and...Modern immunosuppression has led to a decrease in rejection rates and improved survival rates after solid organ transplantation.Increasing the potency of immunosuppression promotes post-transplant viral infections and associated cancers by impairing immune response against viruses and cancer immunoediting.This review reflects the magnitude,etiology and immunological characteristics of various virus-related post-transplant malignancies,emphasizing the need for future research.A multidisciplinary and strategic approach may serve best but overall literature evidence targeting it is sparse.However,the authors attempted to provide a more detailed update of the literature consensus for the prevention,diagnosis,management and surveillance of post-transplant viral infections and associated malignancies,with a focus on the current role of adoptive immunotherapy and the way forward.In order to achieve long-term patient and graft survival as well as superior post-transplant outcomes,collaborative research on holistic care of organ recipients is imperative.展开更多
Objective:To assess the efficacy and safety of Erzhu Jiedu Decoction(EZJDD)Granules in treating mid-advanced hepatitis B virus-associated primary liver cancer(HBV-PLC)patients with Pi(Spleen)-deficiency and dampness-h...Objective:To assess the efficacy and safety of Erzhu Jiedu Decoction(EZJDD)Granules in treating mid-advanced hepatitis B virus-associated primary liver cancer(HBV-PLC)patients with Pi(Spleen)-deficiency and dampness-heat syndrome.Methods:From January 2021 to June 2023,a cohort of 132 patients were enrolled and randomly assigned to a control group or a EZJDD group according to the random numbers,with 66 patients in each group.The patients in the control group received conventional treatment for 3 months,followed by a3-month follow-up.In addition to the conventional treatment,patients in the EZJDD group were administered EZJDD Granules(10.9 g/pack,2 packs twice per day)orally for same duration.Progression-free survival(PFS)as primary outcome was evaluated by Kaplan Meier method.Karnofsky performance status(KPS)scores were used to assess the quality of life in two groups before and after treatment,and survival rates were determined as well.The efficacy of Chinese medicine syndrome was calculated with Nimodipine method.Liver function,tumor indicators and T lymphocyte subsets were measured,respectively.Safety indicators were recorded and assessed.Results:Of the 116 patients who completed the study,57 were in the control group and 59 in the EZJDD group.The median PFS was 3.53 months(106 days)in the EZJDD group compared to 2.33 months(70 days)in the control group(P=0.005).Six-month survival rate was 52.63%(30/57)in the control group and 69.49%(41/59)in the EZJDD group(P=0.039).The median KPS score in the EZJDD group[70(63,90)]was higher than that in the control group[70(60,80)](P=0.013).The total effective rate of CM syndrome was 52.63%(30/57)in the control group and 77.97%(46/59)in the EZJDD group(P=0.005).The levels of alpha fetoprotein,alpha fetoprotein-L3,alpha-L-fucosidase and protein induced by Vitamin K absence or antagonist-Ⅱin the EZJDD group increased less than the control group(P>0.05).CD8+levels were decreased,while CD3^(+)and CD4^(+)levels,as well as CD4^(+)/CD8^(+)ratio were significantly increased in the EZZJD group(P<0.05).No treatment-related adverse reactions were observed during the study.Conclusion:EZJDD Granules significantly prolonged the median PFS and improved6-month survival rate in patients with mid-advanced HBV-PLC(Registration No.ChiCTR2200056922).展开更多
Epstein-Barr virus(EBV),a linear double-stranded DNA herpesvirus,is universally prevalent in humans.Infection is mostly invisible in early childhood,subsequently leading to a latent infection in the B-lymphatic system...Epstein-Barr virus(EBV),a linear double-stranded DNA herpesvirus,is universally prevalent in humans.Infection is mostly invisible in early childhood,subsequently leading to a latent infection in the B-lymphatic system that persists throughout life.However,in immunocompromised hosts,it may infect more cell types,especially epithelial cells.Furthermore,EBV can reactivate and employ multiple mechanisms to evade the immune system,and it can also induce host immune dysfunction,leading to exacerbation or triggering of the inflammatory process.Inflammatory bowel disease(IBD),an immune-mediated gastrointestinal inflammatory,is increasingly recognized as having multiple stages of development,similar to other inflammatory diseases(systemic lupus erythematosus and rheumatoid arthritis).EBV,a commonly encountered opportunistic infection in IBD,can cause rapid disease progression loss of response to drug treatment,and induction of lymphoid tissue proliferative diseases or EBV-associated lymphomas,and may even lead to death in affected patients.To comprehend the complex interactions between EBV and the different stages of IBD disease progression,we comprehensively review the current evidence of the relevance of EBV to the clinical stages of IBD,including the risk,initiation,and development stages,with the aim of developing a more comprehensive predictive and therapeutic strategy for IBD.展开更多
BACKGROUND Chronic diarrhoea in people living with human immunodeficiency virus(PLHIV)/acquired immunodeficiency syndrome presents a diagnostic challenge,often resulting from opportunistic infections(OIs),malignancies...BACKGROUND Chronic diarrhoea in people living with human immunodeficiency virus(PLHIV)/acquired immunodeficiency syndrome presents a diagnostic challenge,often resulting from opportunistic infections(OIs),malignancies,or disease progression itself.We present a case of an advanced human immunodeficiency virus(HIV)patient with chronic diarrhoea,significant weight loss,and antiretroviral therapy(ART)non-compliance,highlighting the diagnostic dilemma between HIV wasting syndrome,OIs,and malignancy.CASE SUMMARY A 36-year-old female,diagnosed with HIV five years ago on family screening,presented with three months of profuse watery diarrhoea,associated with crampy abdominal pain and weight loss(14 kg,30%in 3 months).She was non-compliant with ART.There was no history of recent travel,food contamination,or tuberculosis contact.Fever episodes were mild and transient.Physical examination revealed pallor and bilateral pedal oedema without lymphadenopathy or organomegaly.Genital examination was unremarkable.Routine investigations revealed severe anaemia and confirmed PLHIV status.CD4 count was<36 cells/μL.Empirical treatment with nitazoxanide was initiated for possible cryptosporidiosis.After ruling out OIs,ART was restarted.With treatment,her diarrhoea resolved,and she tolerated oral intake.Nutritional support was provided,and she was discharged in stable condition with ART,prophylactic antibiotics,and followup instructions for further evaluation.CONCLUSION In ART-noncompliant PLHIV with chronic diarrhoea,distinguishing between HIV wasting syndrome,OIs(Cryptosporidium,Mycobacterium avium complex,cytomegalovirus colitis)and malignancies(non-Hodgkin lymphoma and anal carcinoma)are critical.Gradual CD4 decline,systemic inflammation,and malnutrition favour progressive HIV/acquired immunodeficiency syndrome rather than an acute OI or malignancy.Early recognition and management,including ART reinitiation and nutritional support,are crucial for prognosis.展开更多
Fatty liver, which frequently coexists with necroinflammatory and fibrotic changes, may occur in the setting of nonalcoholic fatty liver disease(NAFLD) and chronic infections due to either hepatitis C virus(HCV) or hu...Fatty liver, which frequently coexists with necroinflammatory and fibrotic changes, may occur in the setting of nonalcoholic fatty liver disease(NAFLD) and chronic infections due to either hepatitis C virus(HCV) or human immunodeficiency virus(HIV). These three pathologic conditions are associated with an increased prevalence and incidence of cardiovascular disease(CVD) and type 2 diabetes(T2D). In this multidisciplinary clinical review, we aim to discuss the ever-expanding wealth of clinical and epidemiological evidence supporting a key role of fatty liver in the development of T2 D and CVD in patients with NAFLD and in those with HCV or HIV infections. For each of these three common diseases, the epidemiological features, pathophysiologic mechanisms and clinical implications of the presence of fatty liver in predicting the risk of incident T2 D and CVD are examined in depth. Collectively, the data discussed in this updated review, which follows an innovative comparative approach, further reinforce the conclusion that the presence of fatty/inflamed/fibrotic liver might be a shared important determinant for the development of T2 D and CVD in patients with NAFLD, HCV or HIV. This review may also open new avenues in the clinical and research arenas and paves the way for the planning of future, well-designed prospective and intervention studies.展开更多
Curcumin improves the learning and memory deficits in rats induced by the gp120 V3 loop. The present study cultured rat hippocampal neurons with 1 nM gp120 V3 loop and 1 μM curcumin for 24 hours. The results showed t...Curcumin improves the learning and memory deficits in rats induced by the gp120 V3 loop. The present study cultured rat hippocampal neurons with 1 nM gp120 V3 loop and 1 μM curcumin for 24 hours. The results showed that curcumin inhibited the gp120 V3 loop-induced mitochondrial membrane potential decrease, reduced the mRNA expression of the pro-apoptotic gene caspase-3, and attenuated hippocampal neuronal injury.展开更多
BACKGROUND Epstein-Barr virus(EBV)-associated carcinoma is a gastric cancer subtype with a morphology characterized by gastric carcinoma with lymphoid stroma(GCLS).Clinicopathological studies have indicated a better p...BACKGROUND Epstein-Barr virus(EBV)-associated carcinoma is a gastric cancer subtype with a morphology characterized by gastric carcinoma with lymphoid stroma(GCLS).Clinicopathological studies have indicated a better prognosis for GCLS than for common gastric carcinomas.Some previous cases of early gastric cancer associated with EBV had been diagnosed by endoscopic resection.CASE SUMMARY We present two GCLS cases subjected to endoscopic submucosal dissection(ESD)for a definitive diagnosis.A protruded gastric lesion was identified by routine endoscopic examination,but forceps biopsy showed no atypical cells before ESD.The resected specimen showed a poorly differentiated adenocarcinoma with lymphoid cells involving the mucosa and submucosa.The final diagnosis was submucosa-invasive poorly differentiated gastric adenocarcinoma.Accordingly,additional gastrectomy was recommended to obtain a complete cure.One patient underwent additional distal gastrectomy with lymph node dissection,but the other was refused because of cardiovascular complications.Both patients remained in remission for more than half a year.EBV positivity was determined by EBV-encoded RNA in situ hybridization.We also conducted a literature review of cases of early gastric cancer associated with EBV that had been diagnosed by ESD.CONCLUSION Submucosa-invasive GCLS could be dissected using ESD,and EBV positivity should be subsequently assessed to determine whether or not any additional curative surgery is required.Further prospective investigations on the prevalence of lymph node metastasis in EBV-associated carcinoma should be performed to expand the indications for endoscopic resection.展开更多
Antiretroviral therapy has markedly reduced acquired immune deficiency syndrome-related deaths and opportunistic infectious diseases. This has resulted in prolonged survival of individuals infected with the human immu...Antiretroviral therapy has markedly reduced acquired immune deficiency syndrome-related deaths and opportunistic infectious diseases. This has resulted in prolonged survival of individuals infected with the human immunodefciency virus （HIV）. However, this improvement in survival has been accompanied by an increase in the incidence of chronic kidney disease （CKD） and end-stage renal disease. CKD is now epidemic among HIV-infected populations in both Western and Eastern countries. Risk factors associated with CKD in HIV-infected populations include aging, hypertension, diabetes mellitus, co-infection with hepatitis C virus, a low CD4 cell count, and a high HIV viral load. Clinical experience has shown that HIV-infected individuals often have one or more concurrent risk factors for CKD. The cumulative effect of multiple risk factors on the development of CKD should be noted in this population. Glomerular disease directly related to HIV infection, so-called HIV-associated nephropathy, remains an important cause of CKD among a limited HIV population of African descent, but is less likely to be common among other urban HIV populations. The impact of exposure to nephrotoxic antiretroviral agents on the development of kidney disease is both an old and a new concern. In particular, the association of tenofovir with kidney tubular injury has been an area of great interest. The fndings regarding tenofovir’s adverse effect on long-term kidney function vary among studies. The early identifcation and treatment of CKD is recommended for reducing the burden of patients requiring dialysis in HIV-infected populations. Periodic monitoring of urinary concentrations of albumin, protein, and tubular injury markers such as low-molecular-weight proteins may be useful for the early diagnosis of patients at risk for incident CKD. This review focuses on recent epidemiology, clinical characteristics, and management of CKD in a contemporary HIV-infected population.展开更多
Chronic kidney disease （CKD） is a major public health problem worldwide with the estimated incidence growing by approximately 6% annually. There are striking ethnic differences in the prevalence of CKD such that, in...Chronic kidney disease （CKD） is a major public health problem worldwide with the estimated incidence growing by approximately 6% annually. There are striking ethnic differences in the prevalence of CKD such that, in the United States, African Americans have the highest prevalence of CKD, four times the incidence of end stage renal disease when compared to Americans of European ancestry suggestive of genetic predisposition. Diabetes mellitus, hypertension and human immunodeficiency virus （HIV） infection are the major causes of CKD. HIV-associated nephropathy （HIVAN） is an irreversible form of CKD with considerable morbidity and mortality and is present predominantly in people of African ancestry. The APOL1 G1 and G2 alleles were more strongly associated with the risk for CKD than the previously examined MYH9 E1risk haplotype in individuals of African ancestry. A strong association was reported in HIVAN, suggesting that 50% of African Americans with two APOL1 risk alleles, if untreated, would develop HIVAN. However these two variants are not enough to cause disease. The prevailing belief is that modifying factors or second hits （including genetic hits） underlie the pathogenesis of kidney disease. This work reviews the history of genetic susceptibility of CKD and outlines current theories regarding the role for APOL1 in CKD in the HIV era.展开更多
As obligate intracellular parasites,viruses need a host cell to provide a milieu favorable to viral replication.Consequently,viruses often adopt mechanisms to subvert host cellular signaling processes.While beneficial...As obligate intracellular parasites,viruses need a host cell to provide a milieu favorable to viral replication.Consequently,viruses often adopt mechanisms to subvert host cellular signaling processes.While beneficial for the viral replication cycle,virus-induced deregulation of host cellular signaling processes can be detrimental to host cell physiology and can lead to virus-associated pathogenesis,including,for oncogenic viruses,cell transformation and cancer progression.Included among these oncogenic viruses is the hepatitis B virus(HBV).Despite the availability of an HBV vaccine,350-500 million people worldwide are chronically infected with HBV,and a significant number of these chronically infected individuals will develop hepatocellular carcinoma(HCC).Epidemiological studies indicate that chronic infection with HBV is the leading risk factor for the development of HCC.Globally,HCC is the second highest cause of cancer-associated deaths,underscoring the need for understanding mechanisms that regulate HBV replication and the development of HBV-associated HCC.HBV is the prototype member of the Hepadnaviridae family;members of this family of viruses have a narrow host range and predominately infect hepatocytes in their respective hosts.The extremely small and compact hepadnaviral genome,the unique arrangement of open reading frames,and a replication strategy utilizing reverse transcription of an RNA intermediate to generate the DNA genome are distinguishing features of the Hepadnaviridae.In this review,the authors provide a comprehensive description of HBV biology,summarize the model systems used for studying HBV infections,and highlight potential mechanisms that link a chronic HBV-infection to the development of HCC.For example,the HBV X protein(HBx),a key regulatory HBV protein that is important for HBV replication,is thought to play a cofactor role in the development of HBV-induced HCC,and the authors highlight the functions of HBx that may contribute to the development of HBV-associated HCC.展开更多
Since the beginning of 2017,Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology,which spark diverse thoughts,interesting communications,and potential collab...Since the beginning of 2017,Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology,which spark diverse thoughts,interesting communications,and potential collabora-tions among researchers all over the world.In this article,8 more questions are presented as follows.Question 86.In which circumstances is good supportive care associated with a survival advantage in patients with cancer?Question 87.Can we develop animal models to mimic immunotherapy response of cancer patients?Question 88.What are the mechanisms underlying hepatitis B virus-associated non-hepatocellular cancers?Question 89.Can we more pre-cisely target tumor metabolism by identifying individual patients who would benefit from the treatment?Question 90.What type of cranial irradiation-based prophylactic therapy combination can dramatically improve the survival of patients with extensive small-cell lung cancer?Question 91.How can postoperative radiotherapy prolong overall survival of the patients with resected pIIIA-N2 non-small cell lung cancer?Question 92.What are the key molecular events that drive oral leukoplakia or erythroplakia into oral cancer?Question 93.How could we track the chemothera-peutics-driven evolution of tumor genome in non-small cell lung cancer for more effective treatment?展开更多
基金Supported by National Natural Science Foundation of China,No.30772360
文摘AIM:To evaluate the efficacy of antiviral or corticosteroid treatment on hepatitis B virus-associated glomerulonephritis(HBV-GN) . METHODS:Six and five trials were used respectively to evaluate the efficacy of either antiviral or corticosteroid treatment on HBV-GN.Pediatric patients were pooled separately to assess their response to the above treatment modalities.The primary and secondary outcomes were remission of proteinuria and clearance of Hepatitis B e-antigen(HBeAg) ,respectively.A fixed or random effect model was established to collect the data. RESULTS:The remission rate of proteinuria(RR=1.69,95%CI:1.08-2.65) and the clearance rate of HBeAg(RR =6.44,95%CI:3.11-13.35) were significantly higher in antiviral treatment group than in control group.The proteinuria remission was significantly associated with HBeAg clearance(P=0.002) .However,the difference in proteinuria remission rate was not statistically significant between corticosteroid treatment group and controlgroup(RR=1.45,95%CI:0.68-3.11) .Antiviral therapy could significantly promote the HBeAg clearance in pediatric patients,but neither antiviral nor corticosteroid therapy could significantly decrease proteinuria in pediatric patients compared to controls. CONCLUSION:Antiviral but not corticosteroid treatment can decrease proteinuria and promote HBeAg clearance in HBV-GN patients.
基金supported by FEDER through the operation POCI-01-0145-FEDER-007746 funded by the Programa Operacional Competitividade e Internacionalizacao–COMPETE2020by National Funds through FCT-Fundacao para a Ciencia e a Tecnologia within CINTESIS,R&D Unit(reference UID/IC/4255/2013)Joana Ribeiro has been granted with a Ph D Scholarship(SFRH/BD/107740/2015)from FCT-Fundacao para Ciencia e Tecnologia
文摘AIM To determine the prevalence of epstein-barr virus(eb V)-associated gastric carcinomas in the North Region of Portugal and to study its clinicopathological characteristics. METHODS We have performed a retrospective study including a total of 179 consecutive patients with gastric cancer(GC) submitted to gastrectomy during 2011 at the Portuguese Oncology Institute of Porto. Clinical and pathological data was collected from individual clinical records and inserted on a database with unique codification. Tumour tissues were collected from the institutional tumour bank. eb V was detected by in situ hybridization for the detection of eb V-encoded small RNAs(ebe Rs) and eb V latent proteins(LMP1 and LMP2 A) were detected by immunohistochemistry.RESULTS The analysis showed that eb V-associated gastric carcinomas(eb Va GC) represents 8.4%(15/179) of all GC cases, with a significant differential distribution among histological types(P < 0.001): 100%(3/3) of medullary carcinomas, 100%(1/1) of adenosquamous carcinoma, 8.7%(8/92) of tubular adenocarcinomas, 8.0%(2/25) of mixed carcinomas and 2%(1/51) in poorly cohesive carcinomas. The analysis revealed a higher predominance of eb Va GC in the upper third and middle(cardia, fundus and body) of the stomach(P = 0.041), a significant lower number of regional lymph nodes invasion(P = 0.025) and a tendency for better prognosis(P = 0.222). eb V latent protein expression revealed that all eb Va GC cases were LMP1-negative, nevertheless 6 cases(40%) expressed LPM2 A, which reveals that these cases show a distinct eb V-Latency profile(latency II-like).CONCLUSION eb Va GC represents 8.4% of all GC in the North Region of Portugal. The eb V-infected patients have specific clinic-pathological features that should be further explored to develop new strategies of management and treatment.
基金Supported by Grant-in-Aid for Scientific Research From the Ministry of Education,Culture,Science and Technology of Japan,No.21K07054(Hironori Yoshiyama)and No.22K07101(Hisashi Iizasa).
文摘Epstein-Barr virus(EBV)-associated gastric cancer(EBVaGC)cells originate from a single-cell clone infected with EBV.However,more than 95%of patients with gastric cancer have a history of Helicobacter pylori(H.pylori)infection,and H.pylori is a major causative agent of gastric cancer.Therefore,it has long been argued that H.pylori infection may affect the development of EBVaGC,a subtype of gastric cancer.Atrophic gastrointestinal inflammation,a symptom of H.pylori infection,is observed in the gastric mucosa of EBVaGC.Therefore,it remains unclear whether H.pylori infection is a cofactor for gastric carcinogenesis caused by EBV infection or whether H.pylori and EBV infections act independently on gastric cancer formation.It has been reported that EBV infection assists in the oncogenesis of gastric cancer caused by H.pylori infection.In contrast,several studies have reported that H.pylori infection accelerates tumorigenesis initiated by EBV infection.By reviewing both clinical epidemiological and experimental data,we reorganized the role of H.pylori and EBV infections in gastric cancer formation.
文摘A 19-year-old female was diagnosed with ulcerative colitis when she presented with persistent melena, and has been treated with 5-aminosalicylic acid for 4 years, with additional azathioprine for 2 years at our hospital. The patient experienced high-grade fevers, chills, and cough fve d prior to presenting to the outpatient unit. At frst, the patient was suspected to have developed neutropenic fever; however, she was diagnosed with Epstein-Barr virus-associated hemophagocytic syndr-ome （EB-VAHS） upon fulfilling the diagnostic criteria after bone marrow aspiration. When patients withinflammatory bowel disease treated with immunomo-dulators, such as thiopurine preparations, develop fever, EB-VAHS should be considered in the differential diagnosis.
文摘Modern immunosuppression has led to a decrease in rejection rates and improved survival rates after solid organ transplantation.Increasing the potency of immunosuppression promotes post-transplant viral infections and associated cancers by impairing immune response against viruses and cancer immunoediting.This review reflects the magnitude,etiology and immunological characteristics of various virus-related post-transplant malignancies,emphasizing the need for future research.A multidisciplinary and strategic approach may serve best but overall literature evidence targeting it is sparse.However,the authors attempted to provide a more detailed update of the literature consensus for the prevention,diagnosis,management and surveillance of post-transplant viral infections and associated malignancies,with a focus on the current role of adoptive immunotherapy and the way forward.In order to achieve long-term patient and graft survival as well as superior post-transplant outcomes,collaborative research on holistic care of organ recipients is imperative.
基金Supported by Shanghai Municipal Science and Technology Commission Foundation(No.21Y11922800)National Natural Science Foundation of China(No.82374189)。
文摘Objective:To assess the efficacy and safety of Erzhu Jiedu Decoction(EZJDD)Granules in treating mid-advanced hepatitis B virus-associated primary liver cancer(HBV-PLC)patients with Pi(Spleen)-deficiency and dampness-heat syndrome.Methods:From January 2021 to June 2023,a cohort of 132 patients were enrolled and randomly assigned to a control group or a EZJDD group according to the random numbers,with 66 patients in each group.The patients in the control group received conventional treatment for 3 months,followed by a3-month follow-up.In addition to the conventional treatment,patients in the EZJDD group were administered EZJDD Granules(10.9 g/pack,2 packs twice per day)orally for same duration.Progression-free survival(PFS)as primary outcome was evaluated by Kaplan Meier method.Karnofsky performance status(KPS)scores were used to assess the quality of life in two groups before and after treatment,and survival rates were determined as well.The efficacy of Chinese medicine syndrome was calculated with Nimodipine method.Liver function,tumor indicators and T lymphocyte subsets were measured,respectively.Safety indicators were recorded and assessed.Results:Of the 116 patients who completed the study,57 were in the control group and 59 in the EZJDD group.The median PFS was 3.53 months(106 days)in the EZJDD group compared to 2.33 months(70 days)in the control group(P=0.005).Six-month survival rate was 52.63%(30/57)in the control group and 69.49%(41/59)in the EZJDD group(P=0.039).The median KPS score in the EZJDD group[70(63,90)]was higher than that in the control group[70(60,80)](P=0.013).The total effective rate of CM syndrome was 52.63%(30/57)in the control group and 77.97%(46/59)in the EZJDD group(P=0.005).The levels of alpha fetoprotein,alpha fetoprotein-L3,alpha-L-fucosidase and protein induced by Vitamin K absence or antagonist-Ⅱin the EZJDD group increased less than the control group(P>0.05).CD8+levels were decreased,while CD3^(+)and CD4^(+)levels,as well as CD4^(+)/CD8^(+)ratio were significantly increased in the EZZJD group(P<0.05).No treatment-related adverse reactions were observed during the study.Conclusion:EZJDD Granules significantly prolonged the median PFS and improved6-month survival rate in patients with mid-advanced HBV-PLC(Registration No.ChiCTR2200056922).
基金Supported by National Natural Science Foundation of China,No.81873250.
文摘Epstein-Barr virus(EBV),a linear double-stranded DNA herpesvirus,is universally prevalent in humans.Infection is mostly invisible in early childhood,subsequently leading to a latent infection in the B-lymphatic system that persists throughout life.However,in immunocompromised hosts,it may infect more cell types,especially epithelial cells.Furthermore,EBV can reactivate and employ multiple mechanisms to evade the immune system,and it can also induce host immune dysfunction,leading to exacerbation or triggering of the inflammatory process.Inflammatory bowel disease(IBD),an immune-mediated gastrointestinal inflammatory,is increasingly recognized as having multiple stages of development,similar to other inflammatory diseases(systemic lupus erythematosus and rheumatoid arthritis).EBV,a commonly encountered opportunistic infection in IBD,can cause rapid disease progression loss of response to drug treatment,and induction of lymphoid tissue proliferative diseases or EBV-associated lymphomas,and may even lead to death in affected patients.To comprehend the complex interactions between EBV and the different stages of IBD disease progression,we comprehensively review the current evidence of the relevance of EBV to the clinical stages of IBD,including the risk,initiation,and development stages,with the aim of developing a more comprehensive predictive and therapeutic strategy for IBD.
文摘BACKGROUND Chronic diarrhoea in people living with human immunodeficiency virus(PLHIV)/acquired immunodeficiency syndrome presents a diagnostic challenge,often resulting from opportunistic infections(OIs),malignancies,or disease progression itself.We present a case of an advanced human immunodeficiency virus(HIV)patient with chronic diarrhoea,significant weight loss,and antiretroviral therapy(ART)non-compliance,highlighting the diagnostic dilemma between HIV wasting syndrome,OIs,and malignancy.CASE SUMMARY A 36-year-old female,diagnosed with HIV five years ago on family screening,presented with three months of profuse watery diarrhoea,associated with crampy abdominal pain and weight loss(14 kg,30%in 3 months).She was non-compliant with ART.There was no history of recent travel,food contamination,or tuberculosis contact.Fever episodes were mild and transient.Physical examination revealed pallor and bilateral pedal oedema without lymphadenopathy or organomegaly.Genital examination was unremarkable.Routine investigations revealed severe anaemia and confirmed PLHIV status.CD4 count was<36 cells/μL.Empirical treatment with nitazoxanide was initiated for possible cryptosporidiosis.After ruling out OIs,ART was restarted.With treatment,her diarrhoea resolved,and she tolerated oral intake.Nutritional support was provided,and she was discharged in stable condition with ART,prophylactic antibiotics,and followup instructions for further evaluation.CONCLUSION In ART-noncompliant PLHIV with chronic diarrhoea,distinguishing between HIV wasting syndrome,OIs(Cryptosporidium,Mycobacterium avium complex,cytomegalovirus colitis)and malignancies(non-Hodgkin lymphoma and anal carcinoma)are critical.Gradual CD4 decline,systemic inflammation,and malnutrition favour progressive HIV/acquired immunodeficiency syndrome rather than an acute OI or malignancy.Early recognition and management,including ART reinitiation and nutritional support,are crucial for prognosis.
文摘Fatty liver, which frequently coexists with necroinflammatory and fibrotic changes, may occur in the setting of nonalcoholic fatty liver disease(NAFLD) and chronic infections due to either hepatitis C virus(HCV) or human immunodeficiency virus(HIV). These three pathologic conditions are associated with an increased prevalence and incidence of cardiovascular disease(CVD) and type 2 diabetes(T2D). In this multidisciplinary clinical review, we aim to discuss the ever-expanding wealth of clinical and epidemiological evidence supporting a key role of fatty liver in the development of T2 D and CVD in patients with NAFLD and in those with HCV or HIV infections. For each of these three common diseases, the epidemiological features, pathophysiologic mechanisms and clinical implications of the presence of fatty liver in predicting the risk of incident T2 D and CVD are examined in depth. Collectively, the data discussed in this updated review, which follows an innovative comparative approach, further reinforce the conclusion that the presence of fatty/inflamed/fibrotic liver might be a shared important determinant for the development of T2 D and CVD in patients with NAFLD, HCV or HIV. This review may also open new avenues in the clinical and research arenas and paves the way for the planning of future, well-designed prospective and intervention studies.
基金supported by the Natural Science Foundation of Guangdong Province, No. 9151040701000, 061050246the Science and Technology Project of Guangdong Province, No. 2010B030700016+1 种基金the Science and Technology Project of Guangzhou, No. 2010Y1-C291the National Natural Science Foundation of China, No. 81171134
文摘Curcumin improves the learning and memory deficits in rats induced by the gp120 V3 loop. The present study cultured rat hippocampal neurons with 1 nM gp120 V3 loop and 1 μM curcumin for 24 hours. The results showed that curcumin inhibited the gp120 V3 loop-induced mitochondrial membrane potential decrease, reduced the mRNA expression of the pro-apoptotic gene caspase-3, and attenuated hippocampal neuronal injury.
文摘BACKGROUND Epstein-Barr virus(EBV)-associated carcinoma is a gastric cancer subtype with a morphology characterized by gastric carcinoma with lymphoid stroma(GCLS).Clinicopathological studies have indicated a better prognosis for GCLS than for common gastric carcinomas.Some previous cases of early gastric cancer associated with EBV had been diagnosed by endoscopic resection.CASE SUMMARY We present two GCLS cases subjected to endoscopic submucosal dissection(ESD)for a definitive diagnosis.A protruded gastric lesion was identified by routine endoscopic examination,but forceps biopsy showed no atypical cells before ESD.The resected specimen showed a poorly differentiated adenocarcinoma with lymphoid cells involving the mucosa and submucosa.The final diagnosis was submucosa-invasive poorly differentiated gastric adenocarcinoma.Accordingly,additional gastrectomy was recommended to obtain a complete cure.One patient underwent additional distal gastrectomy with lymph node dissection,but the other was refused because of cardiovascular complications.Both patients remained in remission for more than half a year.EBV positivity was determined by EBV-encoded RNA in situ hybridization.We also conducted a literature review of cases of early gastric cancer associated with EBV that had been diagnosed by ESD.CONCLUSION Submucosa-invasive GCLS could be dissected using ESD,and EBV positivity should be subsequently assessed to determine whether or not any additional curative surgery is required.Further prospective investigations on the prevalence of lymph node metastasis in EBV-associated carcinoma should be performed to expand the indications for endoscopic resection.
文摘Antiretroviral therapy has markedly reduced acquired immune deficiency syndrome-related deaths and opportunistic infectious diseases. This has resulted in prolonged survival of individuals infected with the human immunodefciency virus （HIV）. However, this improvement in survival has been accompanied by an increase in the incidence of chronic kidney disease （CKD） and end-stage renal disease. CKD is now epidemic among HIV-infected populations in both Western and Eastern countries. Risk factors associated with CKD in HIV-infected populations include aging, hypertension, diabetes mellitus, co-infection with hepatitis C virus, a low CD4 cell count, and a high HIV viral load. Clinical experience has shown that HIV-infected individuals often have one or more concurrent risk factors for CKD. The cumulative effect of multiple risk factors on the development of CKD should be noted in this population. Glomerular disease directly related to HIV infection, so-called HIV-associated nephropathy, remains an important cause of CKD among a limited HIV population of African descent, but is less likely to be common among other urban HIV populations. The impact of exposure to nephrotoxic antiretroviral agents on the development of kidney disease is both an old and a new concern. In particular, the association of tenofovir with kidney tubular injury has been an area of great interest. The fndings regarding tenofovir’s adverse effect on long-term kidney function vary among studies. The early identifcation and treatment of CKD is recommended for reducing the burden of patients requiring dialysis in HIV-infected populations. Periodic monitoring of urinary concentrations of albumin, protein, and tubular injury markers such as low-molecular-weight proteins may be useful for the early diagnosis of patients at risk for incident CKD. This review focuses on recent epidemiology, clinical characteristics, and management of CKD in a contemporary HIV-infected population.
基金Supported by NIH Fogarty International Center Grant,No.1D43TW008330-01A1Millennium Promise Award,Noncommunicable Chronic Diseases Leadership Training Program,NHLS Research Trust,Division of Nephrology Research Fund,University of the Witwatersrand,Johannesburg and FRC Individual grant,University of the Witwatersrand,Johannesburg
文摘Chronic kidney disease （CKD） is a major public health problem worldwide with the estimated incidence growing by approximately 6% annually. There are striking ethnic differences in the prevalence of CKD such that, in the United States, African Americans have the highest prevalence of CKD, four times the incidence of end stage renal disease when compared to Americans of European ancestry suggestive of genetic predisposition. Diabetes mellitus, hypertension and human immunodeficiency virus （HIV） infection are the major causes of CKD. HIV-associated nephropathy （HIVAN） is an irreversible form of CKD with considerable morbidity and mortality and is present predominantly in people of African ancestry. The APOL1 G1 and G2 alleles were more strongly associated with the risk for CKD than the previously examined MYH9 E1risk haplotype in individuals of African ancestry. A strong association was reported in HIVAN, suggesting that 50% of African Americans with two APOL1 risk alleles, if untreated, would develop HIVAN. However these two variants are not enough to cause disease. The prevailing belief is that modifying factors or second hits （including genetic hits） underlie the pathogenesis of kidney disease. This work reviews the history of genetic susceptibility of CKD and outlines current theories regarding the role for APOL1 in CKD in the HIV era.
基金supported by an NIH predoctoral fellowship to RJLthe grant number is F31CA171712.
文摘As obligate intracellular parasites,viruses need a host cell to provide a milieu favorable to viral replication.Consequently,viruses often adopt mechanisms to subvert host cellular signaling processes.While beneficial for the viral replication cycle,virus-induced deregulation of host cellular signaling processes can be detrimental to host cell physiology and can lead to virus-associated pathogenesis,including,for oncogenic viruses,cell transformation and cancer progression.Included among these oncogenic viruses is the hepatitis B virus(HBV).Despite the availability of an HBV vaccine,350-500 million people worldwide are chronically infected with HBV,and a significant number of these chronically infected individuals will develop hepatocellular carcinoma(HCC).Epidemiological studies indicate that chronic infection with HBV is the leading risk factor for the development of HCC.Globally,HCC is the second highest cause of cancer-associated deaths,underscoring the need for understanding mechanisms that regulate HBV replication and the development of HBV-associated HCC.HBV is the prototype member of the Hepadnaviridae family;members of this family of viruses have a narrow host range and predominately infect hepatocytes in their respective hosts.The extremely small and compact hepadnaviral genome,the unique arrangement of open reading frames,and a replication strategy utilizing reverse transcription of an RNA intermediate to generate the DNA genome are distinguishing features of the Hepadnaviridae.In this review,the authors provide a comprehensive description of HBV biology,summarize the model systems used for studying HBV infections,and highlight potential mechanisms that link a chronic HBV-infection to the development of HCC.For example,the HBV X protein(HBx),a key regulatory HBV protein that is important for HBV replication,is thought to play a cofactor role in the development of HBV-induced HCC,and the authors highlight the functions of HBx that may contribute to the development of HBV-associated HCC.
文摘Since the beginning of 2017,Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology,which spark diverse thoughts,interesting communications,and potential collabora-tions among researchers all over the world.In this article,8 more questions are presented as follows.Question 86.In which circumstances is good supportive care associated with a survival advantage in patients with cancer?Question 87.Can we develop animal models to mimic immunotherapy response of cancer patients?Question 88.What are the mechanisms underlying hepatitis B virus-associated non-hepatocellular cancers?Question 89.Can we more pre-cisely target tumor metabolism by identifying individual patients who would benefit from the treatment?Question 90.What type of cranial irradiation-based prophylactic therapy combination can dramatically improve the survival of patients with extensive small-cell lung cancer?Question 91.How can postoperative radiotherapy prolong overall survival of the patients with resected pIIIA-N2 non-small cell lung cancer?Question 92.What are the key molecular events that drive oral leukoplakia or erythroplakia into oral cancer?Question 93.How could we track the chemothera-peutics-driven evolution of tumor genome in non-small cell lung cancer for more effective treatment?
