[Anti-HBs persistence after revaccination with three doses of hepatitis B vaccine among non-responsive adults: a 4-year of follow-up study]

OBJECTIVE

To explore anti-HBs persistence four years after revaccination with hepatitis B vaccine (HepB) among adults who were non-responsive to HepB primary immunization.

METHODS

A total of 24 237 healthy adults who had no history of hepatitis B infection and hepatitis B vaccination, resided in the local area for more than six months and aged 18-49 years were selected from 79 villages of Zhangqiu County, Shandong Province, China in 2009. Blood samples were obtained and hepatitis B surface antigen (HBsAg), antibody against hepatitis B surface antigen (anti-HBs) and antibody against hepatitis B core antigen (anti-HBc) were detected using ELISA method. A total of 11 590 persons who were negative for all of these indicators were divided into four groups by cluster sampling methods. Each group was vaccinated with one of the following four types of HepB at 0-1-6months schedule: 20 μg HepB derived in Saccharomyces cerevisiae (HepB-SC), 20 μg HepB derived in Chinese hamster ovary cell (HepB-CHO), 10 μg HepB-SC and 10 μg HepB derived in Hansenula polymorpha (HepB-HP). Blood samples were collected one month after the third dose of primary immunization and tested for anti-HBs using chemiluminescence microparticle immunoassay (CMIA). The non-responders were followed up and their basic information and the histories of hepatitis B infection, HepB vaccination, smoking and drinking were investigated. Then they were revaccinated with three doses of HepB with the same schedule as the primary immunization. Blood samples were collected from all of them one month (T1), two years and four years after revaccination and anti-HBs, anti-HBc and HBsAg were detected by CMIA. A total of 356 participants were followed up from 645 low-responders four years after revaccination, and the ratio was 55.2%. The risk factors associated with the positive rate and geometric mean concentration (GMC) of anti-HBs after four years of revaccination were analyzed using multivariate unconditional logistic regression model and multivariate linear regression model, respectively.

RESULTS

Among 356 participants, 172 (48.3%) were males and 184 (51.7%) were females. The anti-HBs positive rate was 90.4% (322 cases) at T1 and was 55.9% (199 cases) four years after revaccination. The GMC of anti-HBs was 240.5 (95% CI: 186.4-310.4)mU/ml at T1 and decreased to 15.0 (95%CI: 12.2-18.5) mU/ml four years after revaccination. The average annual decreasing rate of GMC was 50.63% from one month after revaccination to four years after revaccination. The corresponding rate was 64.89% in the first two years, which was 2.12 times the rate in the latter two years (30.57%). When compared with those whose anti-HBs titer was less than 99 mU/ml at T1, the significantly higher anti-HBs four years after revaccination was observed in those whose anti-HBs titer at T1 was 100-999 mU/ml and those whose anti-HBs titer at T1 was ≥1 000 mU/ml. The OR (95%CI) was 7.14 (3.90-13.05) and 28.40 (13.16-61.30) respectively. When compared with those whose anti-HBs titer was ≤99 mU/ml at T1, the GMC of anti-HBs four years after revaccination was also significantly higher among those whose anti-HBs titer at T1 was 100-999 mU/ml and those whose anti-HBs titer at T1 was ≥1 000 mU/ml. The b (95%CI) was 1.66 (1.26-2.05) and 3.16 (2.72-3.60), respectively.

CONCLUSION

The positive rate and GMC of anti-HBs decreased four years after revaccination among non-responsive adults, but still kept anti-HBs above protective level. The immunity durability after revaccination is mainly associated with anti-HBs titer one month after revaccination.

[Antibody persistence following primary vaccination with hepatitis B vaccine among normal and high-responder adults: a 5-year follow-up study]

OBJECTIVE

To evaluate the 5-year antibody persistence and the risk factors associated with the persistence after primary vaccination of hepatitis B vaccine (HepB) among normal or high-response adults.

METHODS

A total of 24 237 healthy adults who had no histories of hepatitis B infection and hepatitis B vaccination, resided in the local area for more than six months and were aged 18-49 years were selected from 79 villages in north of Zhangqiu county, Shandong province, China in 2009. Blood samples were obtained and hepatitis B surface antigen (HBsAg), antibody against hepatitis B surface antigen (anti-HBs) and antibody against hepatitis B core antigen (anti-HBc) were detected using ELISA method. A total of 11 590 persons who were negative for all of these indicators were divided into four groups by cluster sampling methods. Each group was vaccinated with one of the following four types of HepB at 0-1-6 months schedule: 20 μg HepB derived in Saccharomyces cerevisiae (HepB-SC), 20 μg HepB derived in Chinese hamster ovary cell (HepB-CHO), 10 μg HepB-SC and 10 μg HepB derived in Hansenula polymorpha (HepB-HP). The normal and high-responder was followed up and their demographic characteristic (including age, gender), histories of hepatitis B infection, hepatitis B vaccination, smoking, drinking and chronic diseases were investigated. Blood samples were collected one month (T1) and five years (T2) and anti-HBs, anti-HBc and HBsAg (if anti-HBs<10 mU/ml) were detected by CMIA. A total of 1 902 participants were followed up and the risk factors associated with positive rate of anti-HBs and GMC of anti-HBs were identified by multiple logistic regression analysis and multifactor linear regression model analysis, respectively.

RESULTS

Among 1 902 adults, 824 (43.32%) were male and 1 078 (56.68%) were female. The anti-HBs positive rate was 100% at T1 and it decreased to 73.29% (1 394 cases) at T2. The corresponding GMC was decreased from 1 527.15 (95%CI: 1 437.84-1 622.01) mU/ml at T1 to 35.07 (95%CI: 32.20-38.19) mU/ml at T2. When comparing with those vaccinated 20 μg HepB-SC, the significantly lower positive rate at T2 was observed in those vaccinated 10 μg HepB-SC group and 10 μg HepB-HP group. The OR (95% CI) was 0.41 (0.28-0.61) and 0.27 (0.18-0.39), respectively. The GMC of anti-HBs was also significantly lower among those vaccinated 10 μg HepB-SC and 10 μg HepB-HP. The b (95%CI) was -0.20 (-0.28- -0.12) and -0.36 (-0.44- -0.29) , respectively. When comparing with those occasionally drinking, the significantly lower positive rate at T2 was observed in those regular drinking. The OR(95%CI) was 0.51(0.30-0.87). The GMC of anti-HBs in age group of 18-29 was significantly higher than those in 40-49 age group; the b (95%CI) was -0.10(-0.18- -0.01). When comparing with those whose anti-HBs titer was less than 999 mU/ml at T1, the significantly higher positive rate of anti-HBs at T2 was observed in those whose anti-HBs titer was 1 000-1 999 mU/ml, those whose anti-HBs titer was 2 000-2 999 mU/ml and those whose anti-HBs titer was ≥10 000 mU/ml. The OR (95%CI) was 10.11 (6.90-14.82), 20.42 (13.98-29.82) and 54.58 (22.08-134.92), respectively. When comparing with those whose anti-HBs titer was ≤999 mU/ml at T1, the GMC of anti-HBs at T2 was also significantly higher among those whose anti-HBs titer at T1 was 1 000-1 999 mU/ml, those whose anti-HBs titer at T1 was 2 000-2 999 mU/ml and those whose anti-HBs titer at T1 was ≥10 000 mU/ml. The b (95%CI) was 0.55 (0.47-0.62), 0.94 (0.88-1.00) and 1.63 (1.54-1.72), respectively. Nobody was found positive to HBsAg at T2 and the conversion rate of anti-HBc was 3.89% (74/1 902) at T2.

CONCLUSION

Anti-HBs GMC decreased rapidly at T2 among normal and high-responder adults, while the positive rate of anti-HBs still kept at a high level. The antibody persistence among normal and high-responder adults at T2 was associated with HepB type, age, history of drinking and GMC of anti-HBs at T1.

[Anti-HBs persistence following revaccination with three doses of hepatitis B vaccine among low-responsive adults after primary vaccination: a 4-year follow-up study]

OBJECTIVE

To assess the 4-year anti-HBs persistence after revaccination with 3-dose of hepatitis B vaccine (HepB) among low-responsive adults.

METHODS

A total of 24 237 healthy adults who had no history of hepatitis B infection and hepatitis B vaccination, resided in the local area for more than six months and were aged 18-49 years were selected from 79 villages of Zhangqiu county, Shandong province, China in 2009. Blood samples were obtained and hepatitis B surface antigen (HBsAg), antibody against hepatitis B surface antigen (anti-HBs) and antibody against hepatitis B core antigen (anti-HBc) were detected using ELISA method. A total of 11 590 persons who were negative for all of these indicators were divided into four groups by cluster sampling method. Each group was vaccinated with one of the following four types of HepB at 0-1-6 months schedule: 20 μg HepB derived in Saccharomyces cerevisiae (HepB-SC), 20 μg HepB derived in Chinese hamster ovary cell (HepB-CHO), 10 μg HepB-SC and 10 μg HepB derived in Hansenula polymorpha (HepB-HP). Blood samples were collected one month after the third dose of primary immunization and tested for anti-HBs using chemiluminescence microparticle immunoassay (CMIA). The 892 low-responders were revaccinated with three doses of HepB at 0-1-6 months schedule and the type of HepB was the same as which was used for primary immunization. During the follow-up to low-responders, the following informations were collected: the demographic characteristics (including age, gender), histories of hepatitis B infection, hepatitis B vaccination, smoking, drinking and chronic diseases. Blood samples were collected one month (T1) and four years after revaccination and anti-HBs, anti-HBc and HBsAg (if anti-HBs <10 mU/ml) were detected by CMIA. The risk factors associated with positive rate of anti-HBs and GMC of anti-HBs were identified by multiple logistic regression analysis and multifactor linear regression model analysis respectively. Anti-HBs titer at T1 was grouped according to the level and was considered as the independent variable in the model analysis.

RESULTS

A total of 529 participants were identified from 892 low-responders. Among 529 participants, 276 (52.2%) were males and 253 (47.8%) were females. The positive rate was 82.6% (437/529) at T1 and it decreased to 28.2% (149/529) four years after revaccination. The corresponding GMC decreased from 542.06 (95% CI: 466.72-629.56) mU/ml to 27.69 (95% CI: 23.08-33.23) mU/ml. Multivariable analysis showed the positive rate of anti-HBs 4 years after revaccination was independently associated with anti-HBs titer at T1. The positive rate among those whose anti-HBs titer more than 1 000 mU/ml at T1 was significantly higher than those whose anti-HBs titer less than 100 mU/ml. The OR (95%CI) was 39.67 (13.81-114.01). The GMC was associated with HepB type for revaccination and anti-HBs titer at T1. The GMC among those revaccinated 20 μg HepB was significantly higher than those revaccinated 20 μg HepB-CHO, 10 μg HepB-SC and 10 μg HepB-HP. The b (95% CI) was -0.40 (-0.78--0.02), -0.57 (-1.01- -0.15) and -0.63 (-1.03- -0.23), respectively. The GMC among those whose anti-HBs titer 100-999 mU/ml and those whose anti-HBs titer ≥1 000 mU/ml at T1 were higher than those whose anti-HBs titer <100 mU/ml. The b (95% CI) was 0.93 (0.53-1.33) and 3.31 (2.88-3.73) respectively.

CONCLUSION

Anti-HBs GMC decreased rapidly 4 years after revaccination among low-responsive adults, but still kept good protecion. The anti-HBs persistence after revaccination was associated with HepB type for revaccination and anti-HBs level of titer one month after revaccination.

Anomalies in the Optical Index of Refraction of Spun Cast Polystyrene Thin Films

We used x-ray reflectivity in combination with optical ellipsometry to measure the optical index of refraction, n, in thin spun cast polystyrene films. We have found that n is independent of the molecular weight, but is a sharp function of the film thickness for films less than 100 nm. In all cases the deviation from the bulk, Δ n, is negative and varies linearly with wavelength in the visible region. The magnitude of Δ n, was found to be as large as 0.25 for films 7 nm thick. The bulk index of refraction was recovered in all films after annealing for2habove Tg at 160 °C. X-ray reflectivity measurements of the scattering critical angle show minimal density deviations from the bulk (less than 0.5%) between the annealed and unannealed films. Consequently the large molecular-weight-independent value of Δ n is interpreted as being due to a radially symmetric segmental orientation induced by the spinning process.

Effectiveness of neuromuscular electrical stimulation for the rehabilitation of moderate-to-severe COPD: a meta-analysis

PURPOSE

Patients with COPD often experience skeletal muscle dysfunction. For those who are unable or unwilling to undertake physical training, neuromuscular electrical stimulation (NMES) may provide an alternative method of rehabilitation. The purpose of this meta-analysis was to investigate the controversial topic of whether this therapy is effective in patients with moderate-to-severe COPD.

PATIENTS AND METHODS

We pooled data from nine trials published between January 9, 2002 and January 4, 2016 across PubMed, Embase, Cochrane Central Register of Controlled Trials, Google Scholar, and relevant websites for randomized controlled trials. In these trials, patients with moderate-to-severe COPD were randomly allocated to receive NMES. Primary outcomes were quadricep strength and exercise capacity. The secondary outcome was health-related quality of life.

RESULTS

We extracted data from 276 patients. NMES contributed to statistically improved quadricep strength (standardized mean difference 1.12, 95% confidence interval [CI] 0.64-1.59, I²=54%; P<0.00001) and exercise capacity, including longer exercise distance (weighted mean difference 51.53, 95% CI 20.13-82.93, I²=90%; P=0.001), and longer exercise endurance (standardized mean difference 1.11, 95% CI 0.14-2.08, I²=85%; P=0.02). There was no significant difference in St George's Respiratory Questionnaire scores (weighted mean difference -0.07, 95% CI -2.44 to 2.30, I²=56%; P=0.95).

CONCLUSION

NMES appears an effectual means of enhancing quadricep strength and exercise capacity in moderate-to-severe COPD patients. Further research is demanded to clarify its effect on other outcomes and determine the optimal parameters for an NMES program.

[The influence of condensate in the piezometric tube on patient ventilator interaction during noninvasive positive pressure ventilation]

OBJECTIVE

To study the effects of condensate in the piezometric tube on patient ventilator interaction during noninvasive positive pressure ventilation.

METHODS

Eleven healthy adults volunteered to receive noninvasive positive pressure ventilation. Different capacity of physiological saline was injected gradually into the piezometric tube until the volunteers could not trigger the ventilator or the total volume of the water reached 1.5 ml. The dynamic changes of the pressure of mask(Pmask), piezometric tube near mask (Ppro), piezometric tube near breathing machine(Pdis), and the flow were observed.

RESULTS

With increasing volume of saline injected, the trigger time TItri(Pmask) increased from 0.09(0.07-0.11) to 0.31(0.22-0.39)s, the trigger pressure TPtri(Pmask) increased from 0.26(0.15-0.33) to 2.29(1.76-3.09)cmH2O, and the pressure-time product PTP (Pmask) increased from 0.02(0.01-0.03) to 0.55(0.41-0.68) cmH2O·s. Ineffective triggering rate increased from 0 up to 9 times/min, and spurious triggering rate increased from 0 up to 33 times/min. The plateau pressure of Pmask and Ppro exceeded the preset parameters, increased significantly as compared with 0 ml, from (9.74±0.34)to (15.79±3.10) cmH2O and from(9.80±0.31) to(15.44±3.47) cmH2O. The change of plateau pressure of Pdis was not significant [from (9.85±0.29)to (12.58±2.64)cmH2O]. The baseline pressure of Pmask, Ppro and Pdis changed from (3.67±0.36) to (8.40±3.22) cmH2O, from (3.71±0.32) to (8.13±3.55) cmH2O and from( 3.77±0.32) to (5.36±1.25) cmH2O, respectively. The pressure fluctuation of platform of Pmask increased significantly compare with 0 ml, from 0.60(0.48-0.71) to 7.94(7.11-8.63)cmH2O. The frequency of fluctuation of platform increased as many as 7 times during a single respiratory period. The time when the pressure of the Pdis began to change was delayed to Pmask and Ppro, 0.11(0.08-0.12)s compared with 0 ml.

CONCLUSION

Condensate in the piezometric tube during noninvasive positive pressure ventilation could influence patient-ventilator synchrony. To improve patient ventilator interaction in noninvasive positive pressure ventilation, condensate in the piezometric tube should be avoided.

Analysis of the genetic diversity of beach plums by simple sequence repeat markers

The purpose of this study was to measure the genetic diversity of wild beach plum and cultivated species, and to determine the species relationships using SSRs markers. An analysis of genetic diversity from ten beach plum germplasms was carried out using 11 simple sequence repeat (SSR) primers selected from 35 primers to generate distinct PCR products. From this plant material, 44 allele variations were detected, with 3-5 alleles identified from each primer. The analysis showed that the genetic similarity coefficient varied from 0.721 ± 0.155 to 0.848 ± 0.136 within each of the ten beach plum germplasms and changed within the range of 0.551 ± 0.084 to 0.695 ± 0.073 between any two pairs of germplasms. According to the genetic dissimilarity coefficient matrix, a cluster analysis of SSRs using the unweighted pair group mean average method in the NTSYSpc 2.10 software revealed that the ten germplasms could be divided into two groups at the dissimilarity coefficient of 0.606. Class I included 77.8, 12.5, 30, and 33.3% of MM, MI, NY, and CM, respectively. Class II contains the remaining 9 beach plum germplasms. The markers generated by 11 SSR primers proved very effective in distinguishing the beach plum germplasm resources. It was clear that the geographical distribution did not correspond with the genetic relationships among the different beach plum strains. This result will be of value to beach plum breeding programs.

Correlation of spicule sign on computed tomography scans with peripheral lung cancers associated with interstitial lung disease and chronic obstructive pulmonary disease

The objective of this study was to investigate the correlation between spicular signs on computed tomography (CT) scans and peripheral lung cancer (PLC) that is associated with interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD). We analyzed clinical data from 96 PLC cases and grouped patients based on whether they had interstitial pneumonia into either ILD/COPD group or non-ILD/COPD group. The occurrence rate of spicule sign was 90.3% in the ILD/COPD group and 61.8% in the non-ILD/COPD group, respectively. There was a significant difference between these groups (P < 0.05). There were no significant differences in the occurrence rate of spicular signs among patients with different pathological types of PLC. The severity of ILD affected the spicular morphology on CT scans directly. There was a significant correlation between the appearance of spicule sign on CT scans and PLC that was associated with ILD/COPD.

A health risk assessment of reclaimed municipal wastewater for industrial and miscellaneous use

The study evaluated the safety of reclaimed water using health risk assessment and biotoxicity tests. The reclaimed water was produced from reverse osmosis and used in industrial and miscellaneous purposes. The health risk assessment was conducted based on the concentrations of detectable pollutants in reclaimed water in a hypothetical scenario. The estimated carcinogenic and non-carcinogenic risks are lower than the generally accepted level. Biotoxicity evaluation included three genotoxicity tests, a chronic toxicity test using medaka fishes, and a subchronic toxicity test using mice. The reclaimed water is not genetically toxic, and does not cause significant chronic effects on these model organisms. These results confirm the safety of using reclaimed water from municipal wastewater treatment plants.

A novel intronic mutation and a missense mutation of MEN1 identified in two Chinese families with multiple endocrine neoplasia type 1

BACKGROUND

Multiple endocrine neoplasia type 1 (MEN1) caused by MEN1 mutation is widely recognized. To date, 14 novel mutations were reported in Chinese and intronic mutations are getting more attention.

AIM

To explore clinical features and MEN1 mutations in two Chinese families suffering from MEN1.

METHODS

Nineteen individuals (10 males and 9 females) from two unrelated families with MEN1 were studied. Mutations of MEN1 were analyzed by direct sequencing of PCR products. In vitro splicing analysis was also performed with minigenes containing both wildtype and novel mutant fragments. Through the RNAstructure program, we analyzed the secondary structure of the wild type MEN1 pre-mRNA and then introduced T>G mutation at +2 donor splice site of intron 7.

RESULTS

Clinical features of 3 patients in two families were described, and 5 individuals were proven to be carriers of MEN1 mutation without apparent symptoms. A novel splicing site mutation of the intron 7 (IVS7+2 T→G) was identified in the first family. In vitro analysis also verified this mutation caused the aberrant splicing of MEN1 mRNA. With the RNAstructure program, we could figure out that the global secondary structure as well as the number of stems and loops of pre-mRNA greatly changed after this mutation. The mutation c. 1227 C>A (C409X) was identified in another family, which also caused the truncation of menin.

CONCLUSION

We reported a novel intronic mutation and a missense mutations in two Chinese families suffering from MEN1.

Serological survey of antibodies to influenza A viruses in a group of people without a history of influenza vaccination

A serological survey for antibodies to influenza viruses was performed in China on a group of people without a history of influenza vaccination. Using the haemagglutination inhibition (HI) assay, we found seropositivity rates for seasonal H3N2 to be significantly higher than those for seasonal H1N1. Samples positive for antibodies to the pandemic (H1N1) 2009 virus increased from 0.6% pre-outbreak to 4.5% (p <0.01) at 1 year post-outbreak. Interestingly, HI and neutralization tests showed that 1.4% of people in the group have antibodies recognizing H9N2 avian influenza viruses, suggesting that infection with this subtype may be more common than previously thought.

Over-expression of NYGGF4 (PID1) inhibits glucose transport in skeletal myotubes by blocking the IRS1/PI3K/AKT insulin pathway

INTRODUCTION

Defects in insulin-stimulated glucose uptake in muscle are the important early events in the pathogenesis of insulin resistance. NYGGF4 (also named PID1) is a recently discovered gene which is suggested to be associated with obesity-associated insulin resistance. In this study, we aimed to investigate the effects of NYGGF4 on glucose uptake and insulin signaling in rat skeletal muscle cells.

METHODS

Rat L6 myoblasts were transfected with either an empty vector or an NYGGF4-expressing vector and induced to differentiate into mature L6 skeletal myotubes. Glucose uptake was determined by measuring uptake of 2-deoxy-d-[(3)H] glucose. Immunoblotting was performed to detect the translocation of insulin-sensitive glucose transporter 4 (GLUT4). Immunoblotting was also used to measure phosphorylation and total protein levels of the insulin signaling proteins including insulin receptor (IR), insulin receptor substrate 1 (IRS1), Akt, extracellular signal-regulated kinase 1 and 2 (ERK1/2), p38, and c-Jun-N-terminal kinase (JNK).

RESULTS

NYGGF4 over-expression in L6 skeletal myotubes reduced insulin-stimulated glucose uptake and impaired insulin-stimulated GLUT4 translocation. It also diminished insulin-stimulated tyrosine phosphorylation of IRS1 and serine phosphorylation of Akt without affecting the phosphorylation of IR, ERK1/2, p38, or JNK.

CONCLUSIONS

Over-expression of NYGGF4 inhibits glucose transport in skeletal myotubes by blocking the IRS1/PI3K/AKT insulin pathway. These observations highlight the potential role of NYGGF4 in glucose homeostasis and the development of insulin resistance in obesity.

Infection of immunocompromised patients by avian H9N2 influenza A virus

Avian influenza A (H9N2) virus is transmitted sporadically from avian species to human causing mild diseases in immunocompetent person. We report two cases of human infection in immunocompromised patients in Hong Kong between 2008 and 2009. One patient had uneventful recovery with viral shedding at day 10 after symptom onset despite her underlying acute lymphoblastic leukaemia. The other patient with post-bone marrow transplant chronic graft-versus-host disease and bronhioltis obliterans went into respiratory failure. Genetic analysis revealed that these cases were caused by different genetic variants which are circulating in poultry in this region. Review of literature identified another 9 human cases reported in Southern China since 1988. It is possible that human infection with H9N2 is more common than what has been recognized. Continuous surveillance of H9N2 influenza virus infection in human is warranted.

Effect of bilateral reaching on affected arm motor control in stroke – with and without loading on unaffected arm

PURPOSE

To investigate the effect of bilateral reaching, with/without inertial loading on the unaffected arm, on hemiparetic arm motor control in stroke.

METHODS

Twenty unilateral stroke patients were recruited. A three-dimensional optical motion capture system was used to measure the movement trajectory of the hemiparetic arm while performing three tasks: affected limb reaching forward; two-limb reaching forward; and two-limb reaching forward with inertia loading of 25% upper limb weight on the unaffected limb, respectively. Kinematical parameters were utilized to quantify the reaching performance of the affected arm.

RESULTS

No matter whether loading was applied on the unaffected arm or not, the bilateral reaching task did not significantly facilitate smoother and faster movement. Furthermore, during bilateral reaching task with/without loading on the unaffected arm, stroke patients showed slower movement, lower maximal movement velocity, feedback control dominant and discontinuous movements in the affected arm than the same task with unilateral reaching. Subjects showed the greatest active upper extremity range of motion in proximal joints during the bilateral reaching task without unaffected arm loading. The amount of trunk movement also increased during bilateral reaching either with or without loading on the unaffected arm. Patients with moderate upper extremity motor impairment performed more discontinuous movements and less active elbow range of motion during bilateral reaching tasks; however, those with mild upper extremity motor impairment performed smoother movements and demonstrated greater active elbow range of motion during bilateral reaching tasks.

CONCLUSIONS

Bilateral reaching tasks with/without loading on the unaffected arm could be considered as adding challenges during motor control training. Training with bilateral arm movements may be considered as a treatment strategy, and can be incorporated in stroke rehabilitation to facilitate greater arm active movement and improve motor control performance in the affected arm.

Association of vitamin D receptor gene polymorphisms in Chinese patients with generalized aggressive periodontitis

BACKGROUND AND OBJECTIVE

The clinical features suggest that genetic factors may have a strong influence on susceptibility to aggressive periodontitis. The aim of this study was to investigate the association of vitamin D receptor gene polymorphisms with generalized aggressive periodontitis in Chinese patients.

MATERIAL AND METHODS

A restriction fragment length polymorphism (RFLP) for 10,438,141 C to T (rs1544410, BsmI), 10,382,063 A to G (rs731236, TaqI), 10,382,143 C to A (rs7975232, ApaI) and 10,416,201 A to G (rs2228570, FokI) of vitamin D receptor gene was analysed by polymerase chain reaction, followed by digestion with restriction enzymes and gel electrophoresis. The genotypes of 51 generalized aggressive periodontitis patients and 53 periodontally healthy control subjects were analysed. The genotypic and allelic frequencies of each polymorphism site for the patients and control subjects were compared.

RESULTS

The distribution of vitamin D receptor FokI genotypes and alleles between the two groups was significantly different (p = 0.043 and p = 0.012, respectively). The F allele seemed to increase the susceptibility of aggressive periodontitis (odds ratio = 2.02, 95% confidence interval = 1.16-3.50) in Chinese patients. There was no significant difference in the genotype distribution or the allele frequencies of vitamin D receptor BsmI, ApaI and TaqI between two groups.

CONCLUSION

The study indicates that FokI polymorphism of vitamin D receptor gene might be associated with generalized aggressive periodontitis in Chinese patients. In addition, the carriage of F allele increases the risk of developing generalized aggressive periodontitis.

Avian influenza A (H5N1) infection in a patient in China, 2006

BACKGROUND

Highly pathogenic avian influenza H5N1 virus has caused increasing human infection in Eurasia since 2004. So far, H5N1 human infection has been associated with over 50% mortality that is partly because of delay of diagnosis and treatment.

OBJECTIVES AND METHODS

Here, we report that an H5N1 influenza virus infected a 31-year-old patient in Shenzhen in June 2006. To identify the possible source of the infection, the human isolate and other H5N1 influenza viruses obtained from poultry and wild birds in southern China during the same period of time were characterized.

RESULTS

Genetic and antigenic analyses revealed that the human H5N1 influenza virus, Shenzhen/406H/06, is of purely avian origin and is most closely related to viruses detected in poultry and wild birds in Hong Kong in early 2006.

CONCLUSIONS

The findings of the present study suggest that the continued endemicity of H5N1 influenza virus in the poultry in southern China increases the chance for introduction of the virus to humans. This highlights the importance of continued surveillance of poultry and wild birds for determining the source for human H5N1 infection.

Characterization of low-pathogenic H5 subtype influenza viruses from Eurasia: implications for the origin of highly pathogenic H5N1 viruses

Highly pathogenic avian influenza (HPAI) H5N1 viruses are now endemic in many Asian countries, resulting in repeated outbreaks in poultry and increased cases of human infection. The immediate precursor of these HPAI viruses is believed to be A/goose/Guangdong/1/96 (Gs/GD)-like H5N1 HPAI viruses first detected in Guangdong, China, in 1996. From 2000 onwards, many novel reassortant H5N1 influenza viruses or genotypes have emerged in southern China. However, precursors of the Gs/GD-like viruses and their subsequent reassortants have not been fully determined. Here we characterize low-pathogenic avian influenza (LPAI) H5 subtype viruses isolated from poultry and migratory birds in southern China and Europe from the 1970s to the 2000s. Phylogenetic analyses revealed that Gs/GD-like virus was likely derived from an LPAI H5 virus in migratory birds. However, its variants arose from multiple reassortments between Gs/GD-like virus and viruses from migratory birds or with those Eurasian viruses isolated in the 1970s. It is of note that unlike HPAI H5N1 viruses, those recent LPAI H5 viruses have not become established in aquatic or terrestrial poultry. Phylogenetic analyses revealed the dynamic nature of the influenza virus gene pool in Eurasia with repeated transmissions between the eastern and western extremities of the continent. The data also show reassortment between influenza viruses from domestic and migratory birds in this region that has contributed to the expanded diversity of the influenza virus gene pool among poultry in Eurasia.

Mobility of polymer chains confined at a free surface

Dynamic secondary ion mass spectrometry was used to investigate the chain mobility of polystyrene (MW ranging from 4.3 to 957 kg/mol) at the free surface. The data show that the diffusion coefficient was reduced relative to the bulk value within a distance, d < or = 4R(g), from the surface and scaled as 1/N(2.5) at fixed d. These results are in excellent agreement with self-consistent field calculations of the surface segmental distribution and provide the first direct confirmation of various theoretical models that predict asymmetric segmental fluctuation which arises from surface induced orientation of polymer chains.

A simple electrolyte for determination of small cations in natural waters by capillary electrophoresis

Three simple electrolyte systems were tested for determination of four alkali and alkaline earth cations (K+, Na+, Ca2+, Mg2+) in aqueous sulfate solutions. The separation was achieved in a system of 5 mM 4-aminopyridine and 5% v/v methanol with indirect UV detection at 214 nm, in which the electrolyte pH was adjusted to be 4.30 by adding 1 M glycolic acid. Four cations were well separated within 5 min at an applied voltage of 15 kV. Linear relationships of the calibration curves were obtained up to 50 ppm for all four cations. To evaluate this electrolyte system, the determination of these cations was also conducted for real rain waters.

Potential of the genetic algorithm neural network in the assessment of gait patterns in ankle arthrodesis

The aim of this study was to develop an empirical model of parameter-based gait data, based on an artificial neural network and a genetic algorithm, for the assessment of patients after ankle arthrodesis. Ground reaction force vectors were measured by force platforms during level walking. Nine force parameters expressed in percentage of body weight and their chronologic incidence of occurrence expressed in percentage of stance phase period were used in modeling. Ten healthy persons and ten patients who had solid arthrodesis of the ankle were recruited in this study for developing the model. By applying the genetic algorithm neural network, the percentage of correct classification was 98.8% and the subset of discriminant parameters was be reduced to 9 out of 18. These key parameters were mainly related to the loading response and propulsive phase. This indicates that there was a reduction in the abilities in cushion impact and push off in the patients after ankle arthrodesis. Finally, the relative distance (Dr) was defined in this study and used in two new patients' examinations to demonstrate its clinical utility.

Cesarean delivery in Shantou, China: a retrospective analysis of 1922 women

BACKGROUND

In China the cesarean section rate increased significantly during the past four decades. This study examined the frequency and indications of cesarean birth in Shantou, a southern city in China.

METHODS

An analysis was conducted of the medical records of 1922 women who had cesarean deliveries at Shantou City 2nd People's Hospital between January 1990 and December 1997. The medical records of 10,490 women who gave birth during this period were examined.

RESULTS

The average rate of cesarean delivery during the 8-year period was 19.4 +/- 2.3 percent (means +/- standard error). From 1990 to 1997 the cesarean delivery rates ranged from 11.05 to 29.9 percent, respectively, although during this period the total annual number of deliveries decreased significantly from 1683 to 951. The rates of the most common indications per 100 women for cesarean delivery were failure to progress (23%), premature rupture of membranes (20%), fetal distress (19.4%), breech presentation (18.1%), uterine scar (14.6%), and prolonged pregnancy (11.3%).

CONCLUSION

The cesarean delivery rate in Shantou, China, has increased steadily and significantly between 1990 and 1997, despite a decrease in the total number of births during the same period. This study showed that on an individual basis vaginal delivery was often possible and reduction of the cesarean delivery rate could be achieved safely by paying greater heed to appropriate indications.

Modulation of the Ca(2+)-activated Cl(-) channel by 14-3-3epsilon

We have previously reported an association of 14-3-3epsilon isoform with calmodulin. Using the voltage-clamp technique, the present study investigated the potential role of 14-3-3 in modulating the Ca(2+)-activated Cl(-) channel (CaCC) endogenously expressed in Xenopus oocytes. Injection of 14-3-3epsilon antisense oligodeoxynucleotides resulted in potentiation of the ionomycin-induced Cl(-) current, while 14-3-3 peptide and calmodulin inhibitor, W13, suppressed the antisense-potentiated current. The data suggest that 14-3-3epsilon plays an inhibitory role in modulating the CaCC by interacting with the calmodulin-dependent pathway. The potential role of 14-3-3epsilon in other tissues and its therapeutic potential for cystic fibrosis are discussed.