当时仅仅是的肝的一个小百分比树枝状的房间，他们在肝免疫的规定起一个主要作用。树枝状的房间子集的四种主要类型包括 myeloid CD8-B220- ，淋巴的 CD8+B220- ， plasmacytoid CD8-B220+ ，和生来的杀手有 CD8-B220-NK1.1+ 显型的树枝状的房间。尽管这些子集有稍微不同的特征，他们都是差的 na (i) ve T 房间激发器。在为他们为 allostimulation 的减少的能力的交换，肝的 DC 与响应 TLR 刺激分泌 cytokines 的一个提高的能力被装备。另外，他们增加了吞噬作用的水平。这两个特点作为天生的免疫系统的部分建议肝的 DC。与到饮食、共栖的抗原的暴露的如此的高率，当维持一个 tolerogenic 状态避免长期的发炎时，肝的 DC 有提高的天生的回答是重要的。仅仅在第二等的传染性之上，肝的 DC 为复发的快速的根除激活记忆 T 房间病原体。在另一方面，过分肝的 DC 的 tolerogenic 特征可能为 autoimmunity 或肝恶意的增加流行负责。
The known factors that have contributed to the decline of Helicobacter pylori(H.pylori)eradication rate include antibiotic resistance,poor compliance,high gastric acidity,high bacterial load,and cytochrome P450 2C19(CYP2C19)polymorphism.Proton pump inhibitor(PPI)is important in the eradication regimen.The principal enzyme implicated in the metabolism of PPIs is CYP2C19.The effects of PPI depend on metabolic enzyme,cytochrome P450 enzymes,and CYP2C19 with genetic differences in the activity of this enzyme(the homozygous EM,heterozygous EM(Het EM),and poor metabolizer).The frequency of the CYP2C19 polymorphism is highly varied among different ethnic populations.The CYP2C19genotype is a cardinal factor of H.pylori eradication in patients taking omeprazole-based or lansoprazolebased triple therapies.In contrast,the CYP2C19 polymorphism has no significant effect on the rabeprazolebased or esomeprazole-based triple therapies.The efficacy of levofloxacin-based rescue triple therapy might be also affected by the CYP2C19 polymorphism,but CYP2C19 genotypes did not show obvious impact on other levofloxacin-based rescue therapies.Choice of different PPIs and/or increasing doses of PPIs should be individualized based on the pharmacogenetics background of each patient and pharmacological profile of each drug.Other possible factors influencing gastric acid secretion(e.g.,IL-1β-511 polymorphism)would be also under consideration.
AIM: To compare the effectiveness of hybrid therapy with other recommended regimens using metaanalysis.METHODS: Bibliographical searches for randomized trials comparing hybrid and other therapies were performed in Pubmed, the Cochrane Library and relevant congresses up to February 2015 using the following keywords(all fields and/or me SH):('Helicobacter pylori ' or 'H. pylori') and('hybrid therapy' or 'sequential-concomitant therapy'). metaanalyses were performed with Cochrane Review manager 5.1. The random effect model proposed by Der Simonian and Laird and the mantel-Haenszel method were used to estimate the pooled relative risk and 95%CI of the efficacy outcomes between hybrid therapy and other eradication therapies. RESULTS: Eight studies(2516 subjects) met entry criteria. The antimicrobial resistance in the study groups ranged from 6.9% to 23.5%. The mean cure rates of hybrid therapy by intention-to-treat(ITT) and perprotocol analyses were 88.5%(n = 1207; range: 80.0% to 97.4%) and 93.3%(n = 1109; range: 85.7% to99.1%), respectively. meta-analysis showed there was no significant difference in ITT eradication rate between hybrid and sequential therapy(relative risk: 1.01; 95%CI: 0.92-1.11). Subgroup analysis revealed hybrid therapy was more effective than sequential therapy in the non-Italian populations(95%CI: 1.01-1.18) and was only less effective in one, Italian population(95%CI: 0.83-0.98). There was no significant difference in eradication rate between hybrid therapy and concomitant therapy(95%CI: 0.93-1.02). No head-tohead comparisons of hybrid therapy and standard triple therapy or bismuth quadruple therapy were found. However, a multicenter, randomized trial showed that reverse hybrid therapy was superior to standard triple therapy(95.5% vs 88.6% ITT; P = 0.011).CONCLUSION: Hybrid therapy appears to be an effective, safe, and well-tolerated treatment for H. pylori infection in the era of increasing antibiotic resistance.
AIM:To investigate whether hepatitis B virus(HBV)and hepatitis C virus(HCV)increase risk of pancreatic ductal adenocarcinoma(PDAC).METHODS:We recruited 585 patients with cytological and/or pathologically confirmed PDAC in National Taiwan University Hospital from September 2000 to September 2013,and 1716 age-,sex-,and race-matched controls who received a screening program in a community located in Northern Taiwan.Blood samples were tested for the presence of HCV antibodies(anti-HCV),HBV surface antigen(HBsAg),antibodies against HBsAg(anti-HBs),and hepatitis B core antigen(anti-HBc)in all cases and controls.The odds ratio(OR)of PDAC was estimated by logistic regression analysis with adjustment diabetes mellitus(DM)and smoking.RESULTS:HBsAg was positive in 73 cases(12.5%)and 213 controls(12.4%).Anti-HCV was positive in22 cases(3.8%)and 45 controls(2.6%).Anti-HBs was positive in 338 cases(57.8%)and 1047 controls(61.0%).The estimated ORs of PDAC in multivariate analysis were as follows:DM,2.08(95%CI:1.56-2.76,P<0.001),smoking,1.36(95%CI:1.02-1.80,P=0.035),HBsAg+/anti-HBc+/anti-HBs-,0.89(95%CI:0.89-1.68,P=0.219),HBsAg-/anti-HBc+/anti-HBs+,1.03(95%CI:0.84-1.25,P=0.802).CONCLUSION:HBV and HCV infection are not associated with risk of PDCA after adjustment for age,sex,DM and smoking,which were independent risk factors of PDAC.
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