[Role of nuclear factor-κB activation in sepsis-induced myocardial dysfunction]

As a common complication in patients with sepsis, cardiac dysfunction may significantly increase mortality of these patients, but its mechanism is still unclear. Nuclear factor-κB (NF-κB) is a pleiotropic transcription inducing factor, which involves in the regulation of multiple biological phenomena and disease status. NF-κB activation participates in cardiomyocyte apoptosis, cardiomyocyte autophagy, and release of inflammatory cytokines in patients with sepsis, indicating its important role in sepsis-induced myocardial dysfunction.

[Diagnostic value of endobronchial ultrasonography with a guide sheath for peripheral pulmonary ground glass opacity]

Objective: To explore the diagnostic value of endobronchial ultrasonography with a guide sheath (EBUS-GS) for peripheral pulmonary ground glass opacity (GGO). Methods: The clinical data of 27 consecutive patients with 27 GGOs diagnosed by EBUS-GS between November 2014 to December 2015 in our Cancer Hospital were retrospectively analyzed. The average age of these 27 patients, including 9 males and 18 females, was 59±11 years. The median lesion size of the 27 GGOs was 2.9±1.2 cm, including 24 mixed GGOs and 3 pure GGOs. EBUS images of all 27 GGOs were evaluated, cytological, histological and combination diagnosis analyzed, and complications observed. Results: Under thin bronchoscope, 2 out of 27 cases showed bronchial stenosis, 1 showed bronchial stenosis with mucosal swelling, and the other 24 did not show abnormalities. Twenty-five out of 27 GGOs were found by EBUS, including 22 cases of mGGO and 3 of pGGO. In these ultrasonic images of 22 mGGOs, 18 showed mixed blizzard sign, 3 showed diffusely heterogeneous acoustic shadow and 1showed blizzard sign. Ultrasonic images of 3 pGGOs all appeared as blizzard sign. Twenty-six cytological specimens were obtained, and 16 were diagnosed clearly. All 27 histological specimens were collected, and 18 were diagnosed clearly. Nineteen of 27 cases were diagnosed by combination of cytological and histological specimens. One complication of EBUS-GS with mild bleeding was observed, and hemorrhage was terminated by conservative treatment. Conclusions: EBUS-GS is valuable for GGO diagnosis with less complications and higher safety. GGO ultrasonic image manifested as mixed blizzard sign, blizzard sign or diffusely heterogeneous acoustic shadow.

[Efficacy and safety of pegylated interferon α-2b injection (Y shape, 40 kD) in treatment of patients with genotype 1/6 chronic hepatitis C]

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion: In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.

[Risk factors and survival analysis for synchronous esophageal carcinoma in patients with hypopharyngeal carcinoma]

Objective: To investigate the risk factors and survival status of hypopharyngeal carcinoma with synchronous second primary carcinoma of the esophagus. Methods: One hundred and sixty patients with newly diagnosed hypopharyngeal carcinoma from January 2009 to December 2012 were retrospectively reviewed. The clinical data, tumor-related information and follow-up results were collected and analyzed. Results: Forty-three synchronous esophageal carcinomas (27%) were detected in 160 patients with hypopharyngeal carcinoma, and most patients (72%) were at an early stage. On univariate analysis, the median age of less than 55 years old (χ(2)=4.525, P=0.033), excessive alcohol consumption (χ(2)=6.942, P=0.008) and invasion site more than 3 anatomical regions (χ(2)=21.503, P=0.000) had a significant correlation with the occurrence of synchronous esophageal carcinomas. Multivariate analysis showed that excessive alcohol consumption (OR=4.787, P=0.029) and invasion site more than 3 anatomical regions (OR=14.391, P=0.000) were independent risk factors. The median survival time was 26 months in 43 patients with synchronous esophageal carcinomas, which was significantly lower than that (58 months) in patients without secondary primary esophageal carcinomas (χ(2)=11.981, P=0.001). Conclusions: There is a high incidence of synchronous esophageal carcinoma in hypopharyngeal carcinoma patients, affecting the prognosis of hypopharyngeal carcinoma. Surveillance for esophageal carcinomas in patients with hypopharyngeal carcinoma, especially in excessive alcohol drinkers, is warranted.

HPV genotype analysis for women in Shaanxi Province of China

The aim of this study was to examine the subtype distribution of human papilloma virus (HPV) in women in the Shaanxi Province of China. A DNA chip, along with polymerase chain reaction amplification and reverse dot blot technology, was adopted to analyze the HPV genotypes of 22,937 cases of cervical cell specimens. The HPV infection rate was 18.70%, wherein high-risk, low-risk, and high- and low-risk multiple infection rates were 15.75, 2.96 and 1.91%, respectively. High-risk infections accounted for 84.20% of total infections. The rate of HPV infection in women with rural residence, high school education or less, a low income, or age over 40 years was significantly higher than that in the control group (negative HPV infection women). Of the 18 detected high-risk HPV subtypes, the most common in single infections were, in the order of prevalence, HPV16, 58, 18, 52, 33, and 56. For multiple high-risk infections, the most common subtypes in the order of prevalence were HPV16, 52, 58, 18, 56, and 33. Age was a factor in the rate of infection, as the 41-50-year age group had a significantly higher risk of infection than the other groups (P < 0.05). In multiple infections, double infections were common, accounting for 77.10% of multiple infections, and triple or more infections were more common in women aged 51-60 years. In Shaanxi Province, high-risk HPV infection in women was mainly attributed to rural residence, age over 40 years, low income, and low education level.

[Value of endobronchial ultrasound-guided transbronchial needle aspiration of enlarged mediastinal lymph nodes and analysis of false negative results]

Objective: To explore the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results of EBUS-TBNA. Methods: A retrospective analysis of the clinical and imaging data of 389 patients who underwent EBUS-TBNA for sampling enlarged hilar and mediastinal lymph nodes from October 2009 to October 2015 in Shandong Tumor Hospital, to evaluate its significance in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results. Results: Among the 389 collected cases, positive biopsy results were obtained in 362 cases, and false negative results in 27 cases. The sensitivity, specificity, positive predictive value and negative predictive value were 92.9%, 100%, 100% and 25.0%, respectively. There was a positive correlation between the size of lymph node and biopsy positive rate (P=0.021). The subcarinal lymph nodes had the highest positive rate (97.7%), followed by the paratracheal lymph nodes (91.2%), with a statistically significant difference (P=0.006). The positive rates obtained by cytology (88.7%) and pathology (92.5%, ) showed no significant difference (P=0.065). The positive rate of EBUS-TBNA was not correlated with pathological types (P=0.932). Needle types (21G, 22G) had no significant effect on diagnosis accuracy (P=0.142). Conclusions: EBUS-TBNA is a practical technology for diagnosis of enlarged mediastinal lymph nodes, with unique characteristics such as minimally invasiveness, local anesthesia, good safety and repeatability. Along with the accumulation of surgical experience, improvement of operative skills, more close cooperation between surgeons, cytologists and pathologists, false negative results will be reduced and positive rate of EBUS-TBNA examination will be further improved.

[Laparoscopic versus open wedge resection of gastric gastrointestinal stromal tumors: a non-randomized case-matched study]

OBJECTIVE

To investigate the safety and feasibility of laparoscopic wedge resection for gastric gastrointestinal stromal tumors (GIST).

METHODS

One hundred GIST patients treated in our department between 2010 and 2014 were retrospectively enrolled, and their clinicopathological data were reviewed. Fifty patients underwent laparoscopic wedge resection, and open surgery cases were 1∶1 matched by tumor diameter. The clinicopathological characteristics, perioperative related factors, postoperative nutritional status and short-term outcome were compared between the two groups.

RESULTS

Among the clinicopathological characteristics, only the age was of statistical significance (61.58±10.43 vs. 56.40±9.82, P=0.012). Over fifty percent of the tumors occurred in the gastric body. Although the short-term survival did not show statistical significance, the laparoscopic group showed predominant advantages in estimated blood loss [(48.60±48.89) ml vs. (137.60±140.69) ml, P<0.001], average hospital stay[ (12.14±4.32) d vs.(17.22±7.11) d, P<0.001], oral intake time[ (3.76±1.73)d vs. (6.28±3.73)d, P<0.01], decline of prealbumin [(0.07±0.04)g/L vs. (0.11±0.05)g/L, P<0.001)], decline of transferrin [(0.51±0.29)g/L vs. (0.64±0.30)g/L, P=0.034]and complication (2.0% vs. 14.0%, P=0.027).

CONCLUSION

Laparoscopic wedge resection is feasible and safe for GIST surgery, allows a rapid recovery and having a better nutritional status in patients, and is a less invasive approach for patients.

Screening of anti-mitochondrial antibody subtype M2 in residents at least 18 years of age in an urban district of Shanghai, China

OBJECTIVE

To analyze the prevalence of anti-mitochondrial antibody subtype M2 (AMA-M2) in a healthy population, and characterize the clinical features and risk factors of primary biliary cirrhosis (PBC).

PATIENTS AND METHODS

AMA-M2 was screened by enzyme-linked immunosorbent assay (ELISA) in 19012 residents who received health checkup in Xuhui District of Shanghai. Other relevant liver biochemical markers and responses to questionnaires were reviewed and analyzed.

RESULTS

Total 133 residents (about 0.73% of the 19012 residents) were detected AMA-M2, including 33 males (0.40%) and 100 females (0.94%). PBC was confirmed in 25 residents. Pollution and household smoking were found to be related to PBC. In addition, the prevalence of M2 antibody was found significantly higher in the residents living near viaducts, especially the intersection region of multiple viaducts, than those who lives in other regions.

CONCLUSIONS

Although the incidence of PBC is low, it is not a rare disease, and PBC may be associated with the living environment and genetic factors.

Prevalence of human papillomavirus genotypes among women with cervical lesions in the Shaanxi Province of China

This study aimed to investigate human papilloma virus (HPV) genotypes among women with cervical lesions in Shaanxi Province, China, to obtain information regarding cervical lesion prevention and treatment. The study included 4508 HPV-positive subjects; cervical swab specimens were collected and tested for HPV infection status and HPV genotypes using polymerase chain reaction and reverse dot-blot hybridization. Women positive for HPV with cervical lesions, including chronic cervicitis, cervical intraepithelial neoplasia, and cervical squamous cell carcinoma (SCC), were examined; HPV-positive women with no cervical lesions were controls. Data were pooled and weighted estimates have been presented. For women with no cervical lesions and positive for one HPV genotype, HPV 52, 16, 58, 81, 33, and 56 were the most common; for multiple-HPV genotype infection, HPV 16, 52, 6, 18, 58, and 66 were the most common. Collectively, HPV 16, 58, 52, 18, 33, and 81 were the most common in women with cervical lesions. HPV 16 comprised 26.71% of single-genotype and 15.64% of multiple-genotype infections. The proportion of HPV-16-positive cases was 29.15%, which was the highest among all HPV genotypes (P < 0.01). Single-HPV genotype infection was the most common in cervical HPV infection (77.48%); infection with two HPV genotypes comprised 72.22% of multiple-genotype infections. The proportion of single-low-risk HPV genotype infections decreased with increase in cervical lesion severity; there were no single- or multiple-low-risk genotype HPV infections in cervical SCC patients. The proportion of multiple-genotype HPV infections with at least one high-risk genotype increased with cervical lesion severity.

Stimulation of bacterial biofilms on Th17 immune cells

We investigated the role of bacterial biofilms in stimulating T helper 17 (Th17) cells in infected organisms. The formation of bacterial biofilms isolated from clinical lavage fluid samples was measured. Th17 cells and interleukin 17 (IL-17) levels in the peripheral blood of healthy individuals, people infected by biofilm bacteria, people infected by non-biofilm bacteria, and in the lavage fluid from people infected by bacteria were determined. Differences in those data were tested using the SPSS 17.0 statistical software. Th17 cells and IL-17 levels in the peripheral blood of biofilm bacteria-infected people, non-biofilm bacteria-infected people, and healthy controls were 0.59 ± 0.18% and 108.8 ± 20.5 pg/mL; 0.58 ± 0.18% and 100.1 ± 20.7 pg/mL; and 0.55 ± 0.17% and 100.0 ± 21.4 pg/mL, respectively; there were no statistically significant differences (P > 0.05). Th17 cells and IL-17 levels in the lavage fluid of biofilm bacteria-infected people and non-biofilm bacteria-infected people were 1.37 ± 0.34% and 157.4 ± 30.8 pg/mL; and 1.11 ± 0.21% and 136.2 ± 24.3 mg/mL, respectively; the differences were statistically significant (P < 0.05). Bacterial biofilms can increase the expression levels of Th17 cells and IL-17 in local infections; this may be the mechanism by which chronic injuries are caused by biofilm infections.

Using hydrological simulation to detect human-disturbed epoch in runoff series

Runoff in major rivers in China has been decreasing in recent decades, mainly due to climate change and human activity. River basin managers have a critical interest in detecting and diagnosing non-stationaries in runoff time series. Here we use a rainfall runoff model-based approach to identify the human-disturbed periods of the record. The method is applied to the Kuye River catchment, located in the Loess Plateau, China. The SimHyd model performs well for simulation of monthly natural discharges, and the method suggests that discernable human influence began in 1980. Anthropogenic effects were detectable several years earlier at the downstream stations than the upstream stations, consistent with pace and timing of soil and water conservation measures implemented across the Kuye River catchment.

The Metabolizable Energy Value, Standardized Ileal Digestibility of Amino Acids in Soybean Meal, Soy Protein Concentrate and Fermented Soybean Meal, and the Application of These Products in Early-weaned Piglets

Three experiments were conducted to evaluate the metabolizable energy (ME) value, standardized ileal digestibility (SID) of amino acids (AA) of soybean meal (SBM), soy protein concentrate (SPC) and fermented soybean meal (FSBM), and the application of these products in early-weaned piglets. In Exp. 1, four barrows with initial body weight (BW) of 14.2±1.4 kg were used in a 4×4 Latin square design. The diet 1 contained corn as the only energy source. The other three diets replaced 25% of corn in diet 1 with one of the three soybean products, and the digestable energy (DE) and ME contents were determined by difference. In Exp. 2, four barrows (initial BW of 18.2±1.5 kg) were fitted with ileal T-cannulas and allotted to a 4×4 Latin square design. Three cornstarch-based diets were formulated using each of the soybean products as the sole source of AA. A nitrogen-free diet was also formulated to measure endogenous losses of AA. In Exp. 3, ninety six piglets (initial BW of 5.6±0.9 kg) weaned at 21±2 d were blocked by weight and assigned to one of three treatments for a 21-d growth performance study. The control diet was based on corn and SBM, the two treatments’ diets contained either 10% SPC or FSBM and were formulated to same SID lysine to ME ratio of 3.6 g/Mcal. The results showed that the ME content of SPC was greater than SBM (p<0.05). The SID of most AA in SPC was greater than the SID of AA in SBM (p<0.05). For the essential AA, the SID of histidine, isoleucine, leucine, lysine and threonine in FSBM were greater than in SBM (p<0.05). Even though they were fed same SID lysine to ME ratio of 3.6 g/Mcal diets, pigs fed SPC and FSBM diets had greater weight gain, G:F (p<0.05) and better fecal score (p<0.05) than pigs fed SBM diet. In conclusion, SPC showed a higher ME content and SID of AA than the SBM. SID of some essential AA in FSBM was higher than SBM and was similar with SPC. But the lower antigenic proteins and anti-nutritional factors content in SPC and FSBM may be the main factors affecting the performance of early-weaned piglets rather than the increased ME content and SID of AA.

Effects of single cell protein replacing fish meal in diet on growth performance, nutrient digestibility and intestinal morphology in weaned pigs

Three experiments were conducted to evaluate the ME value, standardized ileal digestibility (SID) of amino acids (AA) of fish meal, and the effects of single cell protein (Prosin and Protide) replacing fish meal in diet on growth performance, nutrient digestibility and intestinal morphology in weaned piglets. In Exp. 1, twenty-four barrows with initial BW of 30.8±2.6 kg were allotted to one of four dietary treatments. Diet 1 contained corn as the only energy source. The other three diets replaced 20% of the corn in diet 1 with one of the three protein feeds (fish meal, Prosin and Protide), and the DE and ME contents were determined by difference. In Exp. 2, eight barrows (initial BW of 25.6±3.2 kg) were fitted with ileal T-cannulas and allotted to a replicated 4×4 Latin square design. Three cornstarch-based diets were formulated using each of the protein feeds as the sole source of AA. A nitrogen-free diet was also formulated to measure endogenous losses of AA. In Exp. 3, one hundred and eighty piglets (initial BW of 7.95±1.59 kg) weaned at 28±2 d were blocked by weight and assigned to one of five treatments for a 28-d growth performance study, each treatment was fed to six pens with six pigs (three barrows and three gilts) per pen. The five treatments consisted of the control group (CON), which was a corn-soybean meal diet containing 5% fish meal, and the other four treatments, which replaced a set amount of fish meal with either Prosin (2.5% or 5%) or Protide (2.5% or 5%). The diets were formulated to provide same nutrient levels. The results showed that on a DM basis, both of the DE and ME contents were lower in Prosin and Protide than that of fish meal (p<0.05). The SID of CP and all essential AA were greater in fish meal than in Prosin and Protide (p<0.05). The pigs fed CON diet had greater weight gain and lower feed conversion rate (FCR) than pigs fed 5% Prosin and 5% Protide diets (p<0.05). The digestibility of CP was greater in pigs fed CON, 2.5% Prosin and 2.5% Protide diets than the pigs fed 5% Prosin and 5% Protide diets (p<0.05). Villus height in jejunum and ileum, and villus height to crypt depth ratio in the jejunum were higher (p<0.05) in pigs fed CON, 2.5% Prosin and 2.5% Protide diets compared with the 5% Prosin and 5% Protide diets. Pigs fed CON diet had greater villus height to crypt depth ratio in the ileum than the pigs fed 5% Prosin and 5% Protide diets (p<0.05). In conclusion, although Prosin and Protide contained lower ME content and SID of AA than fish meal, Prosin and Protide replacing 50% of fish meal in diet with identical nutrient levels could obtain similar performance, nutrient digestibility and intestinal morphology in weaned pigs.

Prognostic value of clinical and immunological markers in acute phase of SFTS virus infection

SFTS virus (SFTSV) is a novel bunyavirus that causes severe fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease that occurred in China in recent years, with an average case fatality rate of 10-12%. Intervention in the early clinical stage is the most effective measure to reduce the mortality rate of disease. To elucidate the natural course of and immune mechanisms associated with the pathogenesis of SFTSV, 59 laboratory-confirmed SFTS patients in the acute phase, who were hospitalized between October 2010 and September 2011, were enrolled in this study, and the patients sera were dynamically collected and tested for SFTSV viral RNA load, 34 cytokines or chemokines and other related laboratory parameters. All clinical diagnostic factors in the acute phase of SFTS were evaluated and assessed. The study showed that the severity of the disease in 11 (18.6%) patients was associated with abdominal pain (p 0.007; OR = 21.95; 95% CI, 2.32-208.11) and gingival bleeding (p 0.001; OR=122.11; 95% CI, 6.41-2328). The IP-10, TNF-α, IL-6, IL-10, granzyme B and HSP70 levels were higher over the 7-8 days in severe cases, accompanied by altered AST, CK and LDH levels. HSP70 (p 0.012; OR=8.29; 95% CI, 1.58-43.40) was independently correlated with the severity of the early acute phase of SFTSV infection. The severity of SFTS can be predicted based on the presence of symptoms such as abdominal pain and gingival bleeding and on the level of HSP70 in the acute phase of the disease.

Step terrace tuned anisotropic transport properties of highly epitaxial LaBaCo2O5.5+δ thin films on vicinal SrTiO3 substrates

Highly epitaxial LaBaCo2O5.5+δ (LBCO) thin films were grown on different miscut (001) SrTiO3 substrates (miscut angle of 0.5°, 3.0°, and 5.0°) to study the substrate surface step terrace effect on the in-plane electrical transport properties. The microstructure studies by X-ray diffraction and transmission electron microscopy indicate that the as-grown films are A-site disordered cubic perovskite structures with the c-axis highly oriented along the film growth direction. The four-probe scanning tunneling microscopy (STM) studies show that the LBCO thin films grown on the vicinal SrTiO3 substrates have a typical semiconductor behavior with the substrate surface terrace step inducing anisotropic electronic transport properties. These results indicate that in highly epitaxial thin films the surface terrace step induced local strains can play an important role in controlling the electronic transport properties and the anisotropic nature.

Telbivudine treatment is associated with high hepatitis B e antigen seroconversion and immune modulatory effects in chronic hepatitis B patients

Chronic hepatitis B (CHB) is characterized by an impaired immune response to hepatitis B virus. Among the nucleos(t)ides used in CHB treatment, telbivudine is associated with the highest rates of hepatitis B e antigen (HBeAg) seroconversion rates, which are similar to those observed with pegylated interferon (PegIFN). Besides direct antiviral effect, modulation of the immune system may be an additional benefit for telbivudine-treated patients. Indeed, there is much clinical data indicating an IFN-like behaviour for telbivudine in contrast to other oral nucleos(t)ides, such as high HBeAg seroconversion, similar hepatitis B surface antigen (HBsAg) decline and biphasic viral kinetics. Clinical studies, animal models and in vitro studies suggest that both the innate and adaptive immune system responses contribute to high HBeAg seroconversion during telbivudine treatment through modulation of the function and/or expression of CD4+/CD8+ T cells, Th1/Th2, Treg, PD-1/PD-L1, Th17, IL-21 and TFH. The results described in this review suggest that the antiviral effect of telbivudine may be attributable not only to direct suppression of hepatitis B virus, but also to immunoregulatory effects. Hypothetically, telbivudine shares some common signal pathways with IFN.

Rapid downregulation of programmed death-1 and interferon-γ-inducible protein-10 expression is associated with favourable outcome during antiviral treatment of chronic hepatitis B

The dynamics of programmed death-1 (PD-1) as well as cytokine/chemokine expression and its correlation with virological response in patients with chronic hepatitis B (CHB) is unclear. This study was conducted in 29 treatment-naïve patients undergoing telbivudine treatment for 52 weeks. The results showed that PD-1 expression on both CD4+ and CD8+ T cells was positively correlated with hepatitis B virus (HBV) DNA levels (r = 0.621, P < 0.0001; r = 0.548, P = 0.002, respectively), and in virological responders, this decrease was directly correlated with a decrease in HBV DNA levels (r = 0.664, P = 0.002; r = 0.572, P = 0.01, respectively). Furthermore, at the end of 52 weeks, in virological responders, the decreased rate in the frequency of PD-1+ CD8+ T cells was significantly higher than in non-virological responders (58.3% vs 25.7%, P = 0.001), and at weeks 24 and 52, in virological responders, PD-1 expression on CD4+ and CD8+ T cells was lower than in non-virological responders (P = 0.01 and P = 0.035; P < 0.0001 and P < 0.0001, respectively). In 34 cytokines/chemokines detected in serum, IP-10 expression was positively correlated with viral load, level of ALT and PD-1 expression on CD8+ and CD4+ T cells at baseline (r = 0.36, P = 0.055, r = 0.635, P < 0.0001, r = 0.414, P = 0.026, and r = 0.402, P = 0.030, respectively). Moreover, the decrease in IP-10 in serum directly correlated with a decrease in ALT levels (r = 0.751, P < 0.0001). At weeks 24 and 25, IP-10 expression was significantly lower than baseline in virological responders (both P = 0.005); however, this was not observed in nonresponders. Based on the above findings, PD-1 and IP-10 may be used as predictors for virological response, and blockade of their pathway may improve the outcome of patients with CHB.

A pilot randomized controlled trial of dual-plasmid HBV DNA vaccine mediated by in vivo electroporation in chronic hepatitis B patients under lamivudine chemotherapy

A DNA vaccine against the hepatitis B virus (HBV), enhanced by IL-2/IFN-γ fusion protein expression from a plasmid construct and mediated by in vivo electroporation, was evaluated in a total of 39 HBeAg-positive patients with chronic hepatitis B (CHB). The six of 39 patients with a serum alanine aminotransferase (ALT) value of 1-2 times upper limit of normal (ULN) were assigned to the open-label arm (Group01) receiving vaccine monotherapy; the remaining 33 patients with an ALT of more than two times ULN were enroled to the randomized and controlled arm (Group02) receiving lamivudine (LAM) monotherapy (LAM+placebo) or combined therapy (LAM+DNA vaccine) in 1:2 ratio. In Group01, a significant elevation of HBV-specific IFN-γ-secreting T-cell counts in comparison with baseline was observed. In Group02, the proportion of patients with HBV DNA suppression was higher with LAM+DNA vaccine than with LAM monotherapy at each visit time point after the final injection of DNA vaccine at week 36, revealing a significant difference between the two groups (P = 0.03) at week 60. The incidence of dual-site mutations of rtM204/I/S+rtL180M was significantly lower (P = 0.03) with an identified lower virological breakthrough (VBT) rate (P = 0.03) in patients receiving LAM+DNA vaccine than LAM monotherapy, accompanied with a significant higher positive T-cell response rate in patients receiving LAM+DNA vaccine (P = 0.03). In conclusion, this study provides evidence that HBV DNA vaccination is safe and immunologically effective, and that the HBV-specific T-cell responses induced by DNA vaccination under LAM chemotherapy showed a correlation with the suppression of viral replication in patients with CHB.

The influence of different movements on ambulatory blood pressure in hypertensive subacute stroke patients

OBJECTIVE

This study evaluated variation in blood pressure (BP) in hypertensive subacute stroke patients performing eight different types of active movement, and variations in BP over time.

METHODS

The study included 35 subacute stroke patients (60 - 74 years old) and 15 age-matched healthy volunteers. Ambulatory systolic and diastolic BP was measured over 4 consecutive days, before and during active movement.

RESULTS

The greatest effect of the different active movements in stroke patients was on mean systolic BP variability (BPV). There was a significant difference in systolic and diastolic BPV between stroke patients at different time-points and compared with healthy volunteers. Systolic BPV during shifting from the ward to the rehabilitation centre was significantly higher than for all other active movements. Mean systolic BPVs during the sessions on the first and second days were significantly higher than for the sessions on the third and fourth days in stroke patients and compared with healthy volunteers.

CONCLUSIONS

Systolic BP was found to be increased in hypertensive subacute stroke patients during their first and/or second attempts at performing active movements. Therapists should consider the BP of hypertensive subacute stroke patients during these first two attempts, especially for activities involving the patient moving from the ward to the rehabilitation centre.

Metabolisable Energy, In situ Rumen Degradation and In vitro Fermentation Characteristics of Linted Cottonseed Hulls, Delinted Cottonseed Hulls and Cottonseed Linter Residue

Dietary supplementation with conventional linted cottonseed hulls (LCSH) is a common practice in livestock production all over the world. However, supplementation with mechanically delinted cottonseed hulls (DCSH) and cottonseed linter residue (CLR) is uncommon. Cottonseed by-products, including LCSH, DCSH and CLR, were assessed by chemical analysis, an in situ nylon bag technique, an in vitro cumulative gas production technique and in vitro enzyme procedure. The crude protein (CP) content of CLR (302 g/kg dry matter (DM)) was approximately 3 times that of LCSH and 5 times that of DCSH. The crude fat content was approximately 3 times higher in CLR (269 g/kg DM) than in LCSH and 4 times higher than in DCSH. Neutral detergent fibre (311 g/kg DM) and acid detergent fibre (243 g/kg DM) contents of CLR were less than half those of DCSH or LCSH. Metabolisable energy, estimated by in vitro gas production and chemical analyses, ranked as follows: CLR (12.69 kJ/kg DM)>LCSH (7.32 kJ/kg DM)>DCSH (5.82 kJ/kg DM). The in situ degradation trial showed that the highest values of effective degradability of DM and CP were obtained for CLR (p<0.05). The in vitro disappearance of ruminal DM ranked as follows: CLR>LCSH>DCSH (p<0.05). The lowest digestibility was observed for DCSH with a two-step in vitro digestion procedure (p<0.05). The potential gas production in the batch cultures did not differ for any of the three cottonseed by-product feeds. The highest concentration of total volatile fatty acids was observed in CLR after a 72 h incubation (p<0.05). The molar portions of methane were similar between all three treatments, with an average gas production of 22% (molar). The CLR contained a higher level of CP than did LCSH and DCSH, and CLR fermentation produced more propionate. The DCSH and LCSH had more NDF and ADF, which fermented into greater amounts of acetate.

Using an abnormal increase in postexercise systolic blood pressure to diagnose coronary artery disease in gerontal patients

Data from 66 patients ≥ 60 years old with suspected coronary artery disease (CAD) were studied to determine the diagnostic value of an abnormal increase in postexercise systolic blood pressure (SBP) for detecting CAD in gerontal patients. Treadmill exercise testing (TET) and selective coronary angiography (CAG) were carried out and SBP was measured pre-TET and at each minute during a 6-min post-TET recovery phase. Abnormal increase in postexercise SBP was defined as a higher SBP compared with that measured earlier during the 6-min post-TET period. An abnormal increase of ≥ 7 mmHg in postexercise SBP had a statistically significantly better specificity, and also showed higher sensitivity and accuracy, than ST-segment depression ≥ 1 mV in identifying gerontal patients with CAD. The combination of ST-segment depression and abnormal SBP resulted in further improvement of the specificity for detecting CAD. It is concluded that measurement of abnormal increase in postexercise SBP may be a sensitive indicator of gerontal CAD.

First report of human infection by Rhodoplanes sp., Alphaproteobacteria in China

We isolated a novel strain of Alphaproteobacteria from a patient, who had medical history of chronic rhinitis for more than twenty years and recently experienced local skin abscess and ulcer. He eventually died of multiple organ failure due to multi-antibiotics resistance. We identified the microorganism by 16SrRNA sequencing and found that it belonged to the genus Rhodoplanes. It was named as Rhodoplanes sp. strain ZLJ-0. It is resumed that Rhodoplanes sp. strain ZLJ-0 might be an emerging human pathogen involving in unknown febrile conditions and could cause local infection of any tissues or organs. Differential diagnosis of febrile patients should be conducted in clinical practice and research on emerging pathogens of Alphaproteobacteria should be performed to determine the epidemiology, clinical symptoms and pathogenic features of these pathogens.

An experimental method to verify soil conservation by check dams on the Loess Plateau, China

A successful experiment with a physical model requires necessary conditions of similarity. This study presents an experimental method with a semi-scale physical model. The model is used to monitor and verify soil conservation by check dams in a small watershed on the Loess Plateau of China. During experiments, the model-prototype ratio of geomorphic variables was kept constant under each rainfall event. Consequently, experimental data are available for verification of soil erosion processes in the field and for predicting soil loss in a model watershed with check dams. Thus, it can predict the amount of soil loss in a catchment. This study also mentions four criteria: similarities of watershed geometry, grain size and bare land, Froude number (Fr) for rainfall event, and soil erosion in downscaled models. The efficacy of the proposed method was confirmed using these criteria in two different downscaled model experiments. The B-Model, a large scale model, simulates watershed prototype. The two small scale models, D(a) and D(b), have different erosion rates, but are the same size. These two models simulate hydraulic processes in the B-Model. Experiment results show that while soil loss in the small scale models was converted by multiplying the soil loss scale number, it was very close to that of the B-Model. Obviously, with a semi-scale physical model, experiments are available to verify and predict soil loss in a small watershed area with check dam system on the Loess Plateau, China.

Hyper-methylation of RIZ1 tumor suppressor gene is involved in the early tumorigenesis of hepatocellular carcinoma

The retinoblastoma protein-interacting zinc finger gene RIZ1 is a putative tumor suppressor gene, and the inactivation of the RIZ1 is frequently found in tumors through a loss of mRNA expression. In order to understand the role of RIZ1 inactivation in the tumorigenesis of hepatocellular carcinoma (HCC), we detected the RIZ1 promoter methylation status in 39 HCCs using a methylation specific PCR (MSP) method, and carried out LOH study with marker P704. We also assessed the associations between the methylation status and clinicopathological parameters, tumor size, tumor differentiation, and fractional allelic loss (FAL). The results showed that the RIZ1 promoter methylated both in advanced tumors (>3 cm), (18/31, 58.0%) and in early tumors (<3 cm), (4/8, 50.0%). There were 54.6% (12/22) tumors with hyper-methylation in the low FAL group and 45.5% (10/22) in the high FAL group. Moreover, the DNA methylation of the RIZ1 promoter was found not only in the poorly differentiated tumors (12/22, 54.6%), but also in the well differentiated tumors (10/22, 45.5%). Among the 22 HCCs (22/39, 56.4%) that showed hyper-methylation at the RIZ1 promoter region, 3 cases showed biallelic methylation. Interestingly, one case showed hyper-methylation on one allele and a loss of heterozygosity (LOH) on the other allele. In other words, 4 HCCs showed the biallelic inactivation of the RIZ1. These results suggest that the inactivation of the RIZ1 by DNA methylation at its promoter region is involved in the tumorigenesis of HCC, particularly in the early stage of disease.