Isolated Syphilitic Cervical Lymphadenopathy: Report of Two Cases and Review of the Literature

Isolated syphilitic cervical lymphaden -opathy (SCL) is a rare presentation of syphilis. Two patients with isolated SCL are presented here with a review of the literature. The first patient was a 72-year-old man with a mass (diameter 5 cm) in the right neck region for 26 days. Serological tests, imaging studies and pathological examination of the mass after surgical excision confirmed the diagnosis of isolated SCL. The second patient was a 48-year-old man with a mass (diameter 4 cm) in the right neck region for 1 month. The diagnosis of isolated SCL was made on the basis of serological tests, cervical ultrasound and pathological examination of the mass after surgical excision. Complete excision resulted in a satisfactory outcome in both patients. Isolated neck masses without associated clinical manifestations or adverse personal history are a diagnostic challenge, and SCL is easily overlooked in the differential diagnosis. Unusual masses should always remind clinicians of this infectious disease and a comprehensive diagnostic strategy is recommended. Nonroutine syphilitic serological tests should be performed in patients suspected of having SCL, and the histopathological and immunohistochemical characteristics may help to confirm the diagnosis.

Association between serum growth hormone levels and nonalcoholic fatty liver disease: a cross-sectional study

Growth hormone (GH) is an important regulator of metabolism and body composition. GH deficiency is associated with increased visceral body fat and other features of the metabolic syndrome. Here we performed a cross-sectional study to explore the association of GH levels with nonalcoholic fatty liver disease (NAFLD), which is considered to be the hepatic manifestation of the metabolic syndrome. A total of 1,667 subjects were diagnosed as NAFLD according the diagnostic criteria, and 5,479 subjects were defined as the controls. The subjects with NAFLD had significantly lower levels of serum GH than the controls. Those with low GH levels had a higher prevalence of NAFLD and the metabolic syndrome. A stepwise logistic regression analysis showed that GH levels were significantly associated with the risk factor for NAFLD (OR = 0.651, 95%CI = 0.574–0.738, P<0.001). Our results showed a significant association between lower serum GH levels and NAFLD.

Flagellin-PAc fusion protein is a high-efficacy anti-caries mucosal vaccine

We previously demonstrated that an anti-caries DNA vaccine intranasally administered with recombinant flagellin protein as a mucosal adjuvant enhanced salivary IgA response and conferred better protection against caries. However, the relatively weak immunogenicity of DNA vaccines and the necessity for a large quantity of antigens remain significant challenges. Here, we fused the flagellin derived from E. coli (KF) and target antigen PAc containing the A-P fragment of PAc from S. mutans (rPAc) to produce a single recombinant protein (KF-rPAc). The abilities of KF-rPAc to induce rPAc-specific mucosal and systemic responses and protective efficiency against caries following intranasal immunization were compared with those of rPAc alone or a mixture of rPAc and KF (KF + rPAc) in rats. Results showed that KF-rPAc promoted significantly higher rPAc-specific antibodies in serum as well as in saliva than did an equivalent dose of rPAc alone or a mixture of KF + rPAc. Intranasal immunization of 8.5 µg KF-rPAc could achieve 64.2% reduction of dental caries in rats. In conclusion, our study demonstrated that flagellin and PAc fusion strategy is promising for anti-caries vaccine development, and KF-rPAc could be used as an anti-caries mucosal vaccine.

Inhibition of hepatitis B virus gene expression by small interfering RNAs targeting cccDNA and X antigen

To test the possible inhibition of hepatitis B virus (HBV) replication and expression by small interfering RNAs (siRNAs) targeting simultaneously covalenthy closed circular DNA (dnacccDNA) and X antigen, corresponding recombinant plasmids were transfected into HepG2.2.15 cells and the levels of cccDNA, HBXAg, HBcAg, and HBeAg were assayed at various times post transfection. As expected, the single siRNAs showed marked inhibitory effects but their combination was even more efficient. These results provide a new insight into the development of a potential anti-HBV strategy of enhancing the efficacy of individual antivirals and overcoming the high mutation rate of HBV.

Stability in brain glucose metabolism following brown adipose tissue inactivation in chinese adults

BACKGROUND AND PURPOSE

The thermogenesis of BAT is believed to be controlled through some pathways initiated in the brain, though the changes in brain activity among different states of BAT-positive subjects are still unclear. We hypothesized that some significant differences of regional cerebral metabolism between various groups were related to the BAT activities regardless of temperature changes.

MATERIALS AND METHODS

Relative regional cerebral glucose metabolism was compared between 15 healthy subjects with activated BAT and 30 healthy controls without activated BAT by using a brain FDG-PET scan. A follow-up PET scan was performed to assess metabolic changes of the brain when BAT activity was eliminated by heat exposure.

RESULTS

Compared with controls, BAT-positive subjects exhibited lower activity in the inferior parietal lobule, limbic system, and frontal lobe and higher activity in the precuneus before heat exposure. Compared with the BAT elimination status, subjects with activated BAT showed a decreased metabolism in the parietal lobe, frontal lobe, culmen, cingulate gyrus, and sublobar region. Compared with controls, BAT-positive subjects after BAT inactivation had significant hypometabolic areas in the temporal lobe and limbic lobe and hypermetabolic areas in the parietal lobe.

CONCLUSIONS

Our findings illustrate that changes of regional cerebral metabolism are related to BAT activities regardless of temperature changes. This before-after controlled study supports the finding that the brain responses appear to be active in modulating the metabolic function of BAT activity.

Decreased levels of active SMAD2 correlate with poor prognosis in gastric cancer

BACKGROUND

TGF-β plays a dual role in the progression of human cancer. During the early stages of carcinogenesis, TGF-β functions as a tumor suppressor. During the late stages of tumor development, however, TGF-β can promote tumor growth and metastasis. A shift in Smad2/3 phosphorylation from the carboxy terminus to linker sites is a key event determining biological function of TGF-β in colorectal and hepatocellular carcinoma. In the present study, we investigated the potential role of differential Smad2/3 phosphorylation in gastric adenocarcinoma.

METHODOLOGY

Immunohistochemical staining with anti-P-Smad2/3C and P-Smad2/3L antibodies was performed on 130 paraffin-embedded gastric adenocarcinoma specimens. The relationship between P-Smad2/3C and P-Smad2/3L immunohistochemical score and clinicopathologic characteristics of patients was analyzed. Real time PCR was used to measure mRNA expression of Smad2 and Smad3 in cancer and surrounding non-tumor tissue.

PRINCIPAL FINDINGS

No significant P-Smad2L and/or P-Smad3L positive staining was detected in the majority of specimens (positive staining in 18/130 samples). Positive P-Smad2/3L staining was not associated with a decrease in carboxyterminal phosphorylation staining. Loss of P-Smad2C remarkably correlated with depth of tumor infiltration and poor differentiation of cancer cells in patients with gastric cancer. No correlation was detectable between P-Smad3C and clinicopathologic characteristics of gastric adenocarcinoma. However, co-staining analysis revealed that P-Smad3C co-localised with α-SMA and collagen I in gastric cancer cells, indicating a potential link between P-Smad3C and epithelial-to-mesenchymal transition of cancer. Real time PCR demonstrated reduced mRNA expression of Smad2 in gastric cancer when compared with surrounding non-tumor tissue in 15/16 patients.

CONCLUSIONS

Loss of P-Smad2C tightly correlated with cancer invasion and poor differentiation in gastric cancer. Contrary to colorectal and hepatocellular carcinoma, canonical carboxy-terminal phosphorylation, but not linker phosphorylation, of Smad2 is critical for gastric cancer.

Transition from hepatic steatosis to steatohepatitis: unique microRNA patterns and potential downstream functions and pathways

BACKGROUND AND AIM

This study aimed to explore the unique miRNA responsible for transition from hepatic steatosis to steatohepatitis and to investigate the functions and pathways of their downstream targets.

METHODS

Microarray and stem-loop reverse transcription-polymerase chain reaction were utilized to detect dysregulated miRNA in a rat model. SAM, PAM and clustering analysis were jointly applied to calculate significantly changed miRNA. The targets of miRNA were predicted through web server "microrna." The functions and pathways of those predicted genes were analyzed using databases of Gene Ontology and KEGG by the web server "DAVID."

RESULTS

Fourteen upregulated and six downregulated miRNA were selected as an accurate molecular signature in distinguishing hepatic steatohepatitis from steatosis. Through Gene ontology, 499 and 287 enriched functional categories were found for the target genes of upregulated and downregulated miRNA, including ion homeostasis, protein transport and so on. Through KEGG, 46 and 41 enriched pathways were collected for the target genes of upregulated and downregulated miRNA, including apoptosis, fatty acid metabolism and so on. Analysis of common target genes of all downregulated miRNA revealed potential involvement of ion transport and the membrane structure in steatohepatitis.

CONCLUSION

We reported the dysregulated miRNA in transition from hepatic steatosis to steatohepatitis and showed potential clinical application in disease differentiation. This study provided data reservoir for miRNA exploration and revealed novel disease-specific Gene Ontology functions and KEGG pathways such as uncoupling-protein-guided membrane change. Our data contributes to further researches on the pathogenesis and treatment of non-alcoholic steatohepatitis.

[Double balloon endoscopy in diagnosis of patients with obscure gastrointestinal bleeding]

OBJECTIVE

To assess the diagnostic value of double balloon endoscopy (DBE) for obscure gastrointestinal bleeding (OGIB) METHODS: The data of 103 OGIB patients who underwent DBE from January 2007 to September 2010 in the First Affiliated Hospital, Zhejiang University School of Medicine were retrospectively analyzed.

RESULTS

DBE was successfully performed in all 103 patients without complications. Of 103 patients, 66(64.1 %) had positive DBE findings and 28 had surgery procedures(27.2 %). Ninety-four patients finally acquired positive diagnosis, including small intestine tumor(31.1 %), angiodysplasia(22.3 %), exulceratio simplex(9.7 %), Crohn's disease(6.8 %), diverticulum(4.9 %), abdominal purpure(4.9 %), etc. Lesions occurred more frequently in proximal small intestine than in distal small intestine (56.3 % Compared with 30.1 %, P<0.001).

CONCLUSION

DBE is a safe, effective and reliable procedure for the diagnosis of OGIB.

Serum proteomic analysis revealed diagnostic value of hemoglobin for nonalcoholic fatty liver disease

BACKGROUND & AIMS

Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide. The two linked studies presented herein aimed to identify and verify new biomarkers for NAFLD.

METHODS

First, 70 serum samples were analyzed using proteomics approaches to identify potential biomarkers for NAFLD. Second, a total of 6944 initial NAFLD-free subjects were followed up for 3 years to evaluate the predictive value of hemoglobin for NAFLD.

RESULTS

In the first study, 20 differentially expressed protein peaks (11 up-regulated and nine down-regulated) were observed in NAFLD patients upon comparison to the controls. With the aid of bioinformatic tools, we established a biomarker pattern for NAFLD with a sensitivity of 89% and a specificity of 83%. Further analysis suggested a protein peak to be hemoglobin subunit alpha. In the second study, prospective analysis showed that subjects with higher baseline hemoglobin levels were associated with higher incidence of NAFLD. Cox proportional hazards regression analyses showed that the age, gender, and body mass index adjusted hazard ratio (95% CI) for subjects with baseline hemoglobin level in quintile 2, 3, 4, and 5 vs. quintile 1 was 1.36 (1.02-1.81), 1.66 (1.23-2.25), 1.76 (1.28-2.41), and 1.83 (1.33-2.53), respectively.

CONCLUSIONS

Our study showed that serum hemoglobin may have significant predictive value for NAFLD.

Association between thyroid function and nonalcoholic fatty liver disease in euthyroid elderly Chinese

OBJECTIVE

Thyroid dysfunction commonly occurs in the elderly population and overt thyroid dysfunction is associated with some liver abnormalities. This study aimed to investigate the association of thyroid function with nonalcoholic fatty liver disease (NAFLD) in euthyroid elderly Chinese.

METHODS

A cross-sectional study was performed among 878 euthyroid elderly Chinese who took their annual healthy examination at Zhenhai Lianhua Hospital, Ningbo, China.

RESULTS

A total of 227 (25·85%) subjects fulfilled the diagnostic criteria of NAFLD. Patients with NAFLD had significantly lower levels of serum-free thyroxine (FT4) than controls (11·12 ± 1·43 vs 11·58 ± 1·47 pmol/l; P < 0·001). The prevalence rate of NAFLD decreased along with progressively higher serum FT4 levels (P for trend < 0·001). Age, gender and smoking status-adjusted correlation analysis showed that serum FT4 level was negatively correlated with body mass index, waist circumference, triglyceride and serum uric acid levels (All with P < 0·05). Stepwise logistic regression analysis showed that serum FT4 level was significantly associated with the risk for NAFLD [odds ratio (OR): 0·847, 95% confidence interval (CI): 0·743 - 0·966; P = 0·013].

CONCLUSION

Our findings suggest that thyroid function, even within the reference range, is associated with NAFLD in elderly Chinese.

A class-wide phylogenetic assessment of Dothideomycetes

We present a comprehensive phylogeny derived from 5 genes, nucSSU, nucLSU rDNA, TEF1, RPB1 and RPB2, for 356 isolates and 41 families (six newly described in this volume) in Dothideomycetes. All currently accepted orders in the class are represented for the first time in addition to numerous previously unplaced lineages. Subclass Pleosporomycetidae is expanded to include the aquatic order Jahnulales. An ancestral reconstruction of basic nutritional modes supports numerous transitions from saprobic life histories to plant associated and lichenised modes and a transition from terrestrial to aquatic habitats are confirmed. Finally, a genomic comparison of 6 dothideomycete genomes with other fungi finds a high level of unique protein associated with the class, supporting its delineation as a separate taxon.

The metabolic syndrome is associated with complicated gallstone disease

An association between cholecystectomy and metabolic syndrome has not been fully established. Here we analyzed the association between cholecystectomy and metabolic syndrome in a Chinese population of 5672 subjects who undergone annual health checkups at the First Affiliated Hospital, College of Medicine, Zhejiang University between January 2011 and December 2012. The prevalences of gallstones, cholecystectomy and metabolic syndrome were 6.0%, 3.6%, and 32.5%, respectively. The prevalence of metabolic syndrome was significantly higher in subjects with a history of cholecystectomy (63.5%) than in those with gallstones (47.0%) or in those without gallstone disease (30.3%; P<0.01 for both). Multivariate logistic regression analysis showed that cholecystectomy was significantly associated with increased risk of metabolic syndrome (OR = 1.872; 95% CI: 1.193–2.937). However, the association of gallstones with metabolic syndrome was not statistically significant (OR = 1.267; 95% CI: 0.901–1.782). Altogether, our results suggest that cholecystectomy significantly increases the risk of metabolic syndrome.

Reversible changes in brain glucose metabolism following thyroid function normalization in hyperthyroidism

BACKGROUND AND PURPOSE

Patients with hyperthyroidism frequently present with regional cerebral metabolic changes, but the consequences of endocrine-induced brain changes after thyroid function normalization are unclear. We hypothesized that the changes of regional cerebral glucose metabolism are related to thyroid hormone levels in patients with hyperthyroid, and some of these changes can be reversed with antithyroid therapy.

MATERIALS AND METHODS

Relative regional cerebral glucose metabolism was compared between 10 new-onset untreated patients with hyperthyroidism and 20 healthy control participants by using brain FDG-PET scans. Levels of emotional distress were evaluated by using the SAS and SDS. Patients were treated with methimazole. A follow-up PET scan was performed to assess metabolic changes of the brain when thyroid functions normalized.

RESULTS

Compared with controls, patients exhibited lower activity in the limbic system, frontal lobes, and temporal lobes before antithyroid treatment. There were positive correlations between scores of depression and regional metabolism in the cingulate and paracentral lobule. The severity of depression and anxiety covaried negatively with pretreatment activity in the inferior temporal and inferior parietal gyri respectively. Compared with the hyperthyroid status, patients with normalized thyroid functions showed an increased metabolism in the left parahippocampal, fusiform, and right superior frontal gyri. The decrease in both FT3 and FT4 was associated with increased activity in the left parahippocampal and right superior frontal gyri.

CONCLUSIONS

The changes of regional cerebral glucose metabolism are related to thyroid hormone levels in patients with hyperthyroidism, and some cerebral hypometabolism can be improved after antithyroid therapy.

A proton nuclear magnetic resonance metabonomics approach for biomarker discovery in nonalcoholic fatty liver disease

This study was undertaken to discover novel biomarkers for the noninvasive early diagnosis of nonalcoholic fatty liver disease (NAFLD). A methionine and choline deficient (MCD) diet was used to represent different stages of NAFLD in male C57BL/6 mice. (1)H NMR spectroscopy and principal components analysis (PCA) were used to investigate the time-related biochemical changes in mice sera induced by the MCD diet. Many serum metabolites' concentrations changed between control and MCD-fed mice. Hierarchical cluster analysis (HCA) and artificial neural networks (ANNs) were used to select the least number of metabolites to be used for the noninvasive diagnosis of various stages of NAFLD; four potential biomarkers, serum glucose, lactate, glutamate/glutamine, and taurine were selected. To verify the diagnostic accuracy of these selected metabolites, their serum concentrations were measured in healthy controls (n = 28), NAFLD patients with steatosis (n = 15), steatosis patients with necro-inflammatory disease (n = 11), and NASH patients (n = 6). On the basis of results from MCD-fed mice model, clinical tests, and previous reports, we propose using the levels of the four metabolites for diagnosing NAFLD at various stages. Furthermore, the probability of developing NAFLD at a particular stage was assessed by multinomial logistic regression (MLR) based on the clinical results of the four serum metabolites.

[General characteristics and clinical practices of Chinese patients with non-alcoholic fatty liver disease]

OBJECTIVE

To assess the characteristics and daily treatment compliance of non-alcoholic fatty liver disease (NAFLD) patients in China.

METHODS

NAFLD adult patients from 21 clinics of 12 cities in China were enrolled in this registry. Physical examination such as demographic characteristics (height, weight, waist circumference measurement), blood pressure and clinical laboratory and ultrasonographic examination of liver were undertaken. Daily practice including life style and medication were recorded and assessed in accordance with 2006 Chinese NAFLD treatment guidelines.

RESULTS

A total of 1656 patients were enrolled (1146 male and 510 female), mean of 45.8 ± 12.6 years old, mean duration of NAFLD history was (47.2 ± 47.7) months. 44.9% of NAFLD were suffering from metabolic syndromes. Patients with central obesity have higher incidence of hypertension and lower level of high-density lipoprotein cholesterol (HDL-C) than those without central obesity, P < 0.05. Body mass index (BMI), waist circumference, triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) in ALT abnormal group were higher than those in ALT normal group (P < 0.05), HDL-C was lower in ALT abnormal group (P < 0.05). Significant differences existed between the BMI, female waist circumference, TG, fast insulin, HOMA index, ALT, AST and HDL-C among subgroups with mild, moderate and severe steatosis. Majority of the patients did not follow recommendations of NAFLD treatment guidelines. Among targeted population only 15.3% of patients used insulin sensitizers and 23.8% took lipid lowering medicine according to the guideline.

CONCLUSION

Data indicated that nearly half of NAFLD patients co-morbid with metabolic disorders. Therapy compliance was unsatisfactory and the gap between current practice and Chinese NAFLD treatment guidelines was not optimal.

Inflammatory bowel disease unclassified

OBJECTIVE

Inflammatory bowel diseases (IBDs) are idiopathic, chronic, and inflammatory intestinal disorders. The two main types, ulcerative colitis (UC) and Crohn's disease (CD), sometimes mimic each other and are not readily distinguishable. The purpose of this study was to present a series of hospitalized cases, which could not initially be classified as a subtype of IBD, and to try to note roles of the terms indeterminate colitis (IC) and inflammatory bowel disease unclassified (IBDU) when such a dilemma arises.

METHODS

Medical records of 477 patients hospitalized due to IBD, during the period of January 2002 to April 2009, were retrospectively studied in the present paper. All available previous biopsies from endoscopies of these patients were reanalyzed.

RESULTS

Twenty-seven of 477 IBD patients (5.7%) had been initially diagnosed as having IBDU. Of them, 23 received colonoscopy and histological examinations in our hospital. A total of 90% (9/10) and 66.7% (4/6) of patients, respectively, had a positive finding via wireless capsule endoscopy (CE) and double-balloon enteroscopy (DBE). The barium-swallow or small bowel follow-through (SBFT) was performed on 11 patients. Positive changes were observed under computer tomographic (CT) scanning in 89.5% (17/19) of patients. Reasonable treatment strategies were employed for all patients.

CONCLUSIONS

Our data indicate that IBDU accounts for 5.7% of initial diagnoses of IBD. The definition of IBDU is valuable in clinical practice. For those who had no clear clinical, endoscopic, histological, or other features affording a diagnosis of either UC or CD, IBDU could be used parenthetically.

Levofloxacin susceptibility testing for Helicobacter pylori in China: comparison of E-test and disk diffusion method

BACKGROUND

 The aims of this study were to compare disk diffusion with E-test method for levofloxacin susceptibility testing of Helicobacter pylori and standardized breakpoints for disk diffusion as a stable and reliable method for determining qualitative levofloxacin susceptibility.

MATERIALS AND METHODS

 We determined the levofloxacin susceptibility of 45 H. pylori strains isolated from Chinese patients by the E-test method. Disk diffusion was evaluated as an alternative method to determine susceptibility and compared with the E-test results by linear regression analysis.

RESULTS

 The minimum inhibitory concentration (MIC) values tested by E-test method ranged from 0.047 to 32 μg/mL. Resistance to levofloxacin was detected in 16 (35.6%) isolates. The levofloxacin disk zone sizes obtained by disk diffusion method correlated well (r² = .877) with the MICs obtained by E-test method. As a consequence of regression analysis, isolates with inhibition diameters < 12 mm were considered resistant to levofloxacin. There was 100% agreement between the two methods for levofloxacin, applying the regression-based breakpoints.

CONCLUSIONS

The disk diffusion method is equivalent to the E-test method for testing levofloxacin susceptibility of H. pylori strains; it is more practical and inexpensive, and it is suitable for the analysis of a small number of isolates compared with the E-test method.

Optical Properties and Structure of Microcrystalline Silicon

The optical properties of thin film microcrystalline silicon (μc-Si:H) prepared by plasma-enhanced chemical vapor deposition (PECVD) have been studied by real time spectroscopie ellipsometry in the nucleation regime as isolated crystalline particles increase in size. A simple geometric model of nucleation allows us to remove the dominant effect of voids and extract the dielectric functions of the crystallites themselves. We find that the results can be understood in terms of a classical size effect whereby limitations on the electron mean free path by scattering at crystallite surfaces control the absorption onset from 2.0 to 3.0 eV. Finally, we describe how well-ordered, continuous 15 Å c-Si films can be prepared on metal substrates.

3 T MR cholangiopancreatography appearances of biliary ascariasis

AIM

To evaluate the 3 T MR cholangiopancreatography (MRCP) appearances of biliary ascariasis.

MATERIALS AND METHODS

Nine patients with a MRCP diagnosis of biliary ascariasis were reviewed. All patients had endoscopic retrograde cholangiopancreatography (ERCP) or surgical confirmation of the disease.

RESULTS

On thin-slab MRCP imaging, Ascaris worms are clearly demarcated within the biliary tree. All the identified worms demonstrated a characteristic three-parallel-lines appearance. The middle high-signal intensity line is sandwiched between two low-signal intensity lines and they are in turn surrounded by high signal bile. On thick-slab MRCP the worms also show the three-line sign but with less clarity. However, thick-slab MRCP has the advantage of providing three-dimensional ERCP-like images of the pancreaticobiliary system.

CONCLUSION

The "three-line" sign appears to be a characteristic sign of biliary ascariasis on 3 T MRCP.

Is short-term therapy really sufficient to eradicate Helicobacter pylori infection?

OBJECTIVE

The aim of our study was to perform a systematic review and meta-analysis of the efficacy of short-term protocols for Helicobacter pylori eradication and to review the safety and adverse profiles of these eradication protocols.

METHODS

Literatures were located through electronic searches by PubMed, Medline, ISI Web of Knowledge, and Cochrane Library using the relevant terms. Abstracts of important meetings were searched manually in some journal supplements. Additional bibliographies were identified from the reference lists of identified studies. Three independent reviewers systemically identified randomized controlled trials (RCTs) comparing short-duration protocols vs. 7-d proton pump inhibitor (PPI)-based triple protocols, as well as studies reporting eradication rates of short-duration protocols for H. pylori. Summary effect size was calculated as relative risk (RR) and 95% confidence intervals (CI) using Review Manager 4.2, and P<0.05 was defined as statistically significant in all analyses.

RESULTS

Among 90 abstracts retrieved, 15 studies were analyzed, including a total of 30 treatment regimens with 1856 subjects. Mean intention-to-treat (ITT) cure rates of 63.2% and 81.3% were achieved with short-term protocols and 7-d PPI-containing protocols, respectively. Per-protocol (PP)-based overall cure rates were 66.6% and 86.1%, respectively. Short-term therapy was inferior to 7-d triple regimen (P<0.00001). After sub-analysis, however, comparing the effects of > or = 3-d protocols and 7-d triple protocols, the cumulative ITT RR was 0.95 (P=0.26), and PP RR was 0.95 (P=0.10), without significant heterogeneity. Moreover, slightly fewer adverse-effects were found in short-term protocols.

CONCLUSIONS

Although more economical, short-duration protocols are inferior to 7-d PPI-based triple protocols with regarding to eradication rate of H. pylori. Protocols of more than 3 d, however, may be equivalent to 7-d protocols.

Treatment of linear alkylbenzene sulfonate (LAS) wastewater by internal electrolysis--biological contact oxidation process

Surfactant wastewater is usually difficult to treat due to its toxicity and poor biodegradability. A separate physico-chemical or biochemical treatment method achieves a satisfactory effect with difficulty. In this study, treatment of the wastewater collected from a daily chemical plant by the combination processes of Fe/C internal electrolysis and biological contact oxidation was investigated. For the internal electrolysis process, the optimal conditions were: pH = 4-5, Fe/C = (10-15):1, air-water ratio = (10-20):1 and hydraulic retention time (HRT)= 2 h. For the biological contact oxidation process, the optimal conditions were: HRT = 12 h, DO = 4.0-5.0 mg/L. Treated by the above combined processes, the effluent could meet the I-grade criteria specified in Integrated Wastewater Discharge Standard of China (GB 8978-1996). The results provide valuable information for full-scale linear alkylbenzene sulfonate wastewater treatment.

Removal and fate of estrogens in an anaerobic-anoxic-oxic activated sludge system

Laboratory-scale experiments were conducted to investigate the removal and fate of estrogens 17β-estradiol (E2) and 17α-ethinylestradiol (EE2) in an anaerobic-anoxic-oxic (AAO) activated sludge system. Estrogen concentrations in the aqueous and solid phases in each reactor of AAO system were analyzed separately. E2 was not detected in the final effluent. The anaerobic, anoxic and oxic reactors accounted for 71%, 7% and 22% of the overall E2 removal, respectively. The overall EE2 removal efficiency was about 80%, and the anaerobic, anoxic and oxic reactors were responsible for 44%, 8% and 48% of the overall EE2 removal, respectively. In anaerobic unit, sorption was the dominant mechanism for the removal of E2 and EE2. While E2 was degraded in all the three units of the AAO system, EE2 was only degraded in the anoxic and aerobic units. Biodegradation is important for the fate of E2 compared to sorption. Of the total influent E2 in the AAO system, 99.99% was biodegraded and 0.01% remained in the waste sludge. Nevertheless, both sorption and biodegradation play important roles in the removal of EE2. Of the total influent EE2, 79.1% was degraded by activated sludge, 19.9% was discharged in the effluent and 1% remained in the waste sludge.

Genetic epistasis analysis of 10 peroxisome proliferator-activated receptor γ-correlated genes in broiler lines divergently selected for abdominal fat content

Chicken peroxisome proliferator-activated receptor γ (PPARγ), which is highly expressed in adipose tissues, is a key factor in fat accumulation in the abdominal fat pad. In this study, association and pairwise epistasis analyses were performed for all the polymorphisms detected in PPARγ and for 9 genes from PPARγ-correlated lipid metabolic pathways for abdominal fat weight (AFW) in 10th-generation populations of Northeast Agricultural University broiler lines divergently selected for abdominal fat content. Epistatic networks were then reconstructed with the identified epistatic effects. Single-marker association analyses showed that 5 of the 20 screened polymorphisms were significantly associated with AFW (P < 0.05), and CCAAT/enhancer-binding protein α (C/EBPα) c.552G>A was 1 of the 5 significant loci. Pairwise interaction analyses showed that 15 pairs of polymorphisms reached a significance level of P < 2.64 × 10(-4) (adjusted by Bonferroni correction) in the lean line, 41 pairs reached significance in the fat line, and 7 pairs reached significance in both lines. Interestingly, many other loci interacted with C/EBPα c.552G>A in both lines. In epistatic network analyses, C/EBPα c.552G>A seemed to behave as a hub for the epistatic network in both lines. All these results revealed that the genetic architecture of C/EBPα c.552G>A for AFW seemed to be an apparent individual main-effect QTL but that it could be dissected into a genetic epistatic network. Our results suggest that C/EBPα c.552G>A might be the most important locus contributing to phenotypic variation in AFW among all the polymorphisms detected in this study.

Is alcohol consumption associated with gastroesophageal reflux disease?

Gastroesophageal reflux disease (GERD) is one of the most common disorders with an increasing incidence and prevalence. Alcohol consumption may be a risk factor for GERD; however, the relationship remains to be fully elucidated. The results of different studies are diverse and contradictory. Systematic investigations concerning this matter are inappropriate and further well-designed prospective studies are needed to clarify the effect of alcohol on GERD.