Epidemiological comparison of clinical manifestations according to HLA-B*27 carrier status of Chinese ankylosing spondylitis patients

The aim of the study was to investigate and compare the clinical manifestations between HLA-B27(+) and HLA-B27(-) ankylosing spondylitis (AS) patients in order to obtain knowledge of the impact of HLA-B27 status on AS, and to inform clinical treatment. A nationwide epidemiological investigation was performed from November 2008 to October 2010. The demographic data and clinical characteristics, and the status of HLA-B27 were collected using questionnaires and laboratory assay, respectively. A total of 2144 patients (78.5% males and 78.4% HLA-B27(+) AS patients) participated in this study. The percentages of males, patients with family history, and involvement of lumbar spine, thoracic spine and hip joints, were observed to be significantly higher in the HLA-B27(+) AS patients than in their HLA-B27(-) AS peers.

Genes relevant with osteoarthritis by comparison gene expression profiles of synovial membrane of osteoarthritis patients at different stages

BACKGROUND

This study aimed to identify biological markers about osteoarthritis (OA) which is a polygenic disease by investigating the gene expression profiles of the synovium samples from early-stage and end-stage OA patients for the diagnosis and treatment of OA.

METHODS

The gene expression profile of GSE32317 was downloaded from Gene Expression Omnibus (GEO) database, including 10 samples from early-stage OA patients and 9 samples from end-stage OA patients. The differentially expressed genes (DEGs) were identified by Significance Analysis of Microarrays. The co-expression network of DEGs was constructed by Pearson correlation test. Then, modules in the constructed co-expression network were selected by MCODE Plugin. What's more, EASE (Expression Analysis Systematic Explorer) was used to define the significant functions and pathways in the identified modules.

RESULTS

Total 419 DEGs were identified, among which 112 were up-regulated and 307 down-regulated. We selected 7 statistically significant modules with gene number above 10 and phenotypic correlation test of modules showed that all the modules had significant correlation with OA (p < 0.05). The genes of module 1, module 2 and module 7 were significantly related to immune system functions, protein glycosylation functions, bone, chondrocytes and cartilage functions, respectively. The most significant pathway in module 3 and module 5 was Wnt signal pathway, and in module 4 was Toll-like receptor signal pathway.

CONCLUSIONS

DEGs related to immune response, cartilage development, protein glycosylation, muscle development, and DEGs participated in the Wnt signaling pathway and Toll-like receptor (TLR) signaling pathway might be the potential target genes for the OA treatment.

Association of the methylenetetrahydrofolate reductase gene A1298C polymorphism with stroke risk based on a meta-analysis

Several independent studies have reported the role of the methylenetetrahydrofolate reductase gene (MTHFR) A1298C polymorphism in strokes, but the results are inconclusive. To derive a more precise estimation of the relationship, a meta-analysis was performed in the present study. In this meta-analysis, a total of 13 studies, including 1974 cases and 2660 controls, were selected to evaluate the possible association. Crude odds ratios (ORs) with 95% confidence intervals (CI) were used to assess the strength of the association in additive, dominant, and recessive models. The overall analysis showed that MTHFR A1298C was associated with a significant increase in the risk of stroke in the heterozygote comparison (AC vs AA: OR = 1.17; 95%CI = 1.03-1.34) and in the dominant model (AC/CC vs AA: OR = 1.22; 95%CI = 1.01-1.49). Stratified analysis showed a significantly strong association between the MTHFR A1298C polymorphism and stroke risk in Asian populations (OR = 1.32 for AC vs AA; OR = 1.94 for CC vs AA; OR = 1.37 for AC/CC vs AA; OR = 1.33 for C vs A allele), but not in Caucasian populations. Additionally, the MTHFR 1298C allele was found to be a risk factor for developing ischemic strokes. However, no statistically significant increased risk of hemorrhagic stroke was found in any of the genetic models. In conclusion, this meta-analysis supported that the MTHFR A1298C polymorphism could be capable of increasing stroke susceptibility in Asian, but not in Caucasian, populations.

Short communication: evaluation of Brucella infection of cows by PCR detection of Brucella DNA in raw milk

The collection of serum samples from cows is frequently difficult to implement in large-scale surveys, and may involve a high risk of occupational infection. This study assessed the potential of using raw milk sampling as a suitable method for use in a pilot survey of Brucella abortus infection status in cattle. Raw milk samples from 816 cows were examined. Polymerase chain reaction assays of raw milk, with primers derived from the IS711 element of the Brucella genome, were used. Of the cows, 55 were Brucella positive based on serum agglutination test (SAT) results. Polymerase chain reaction amplified Brucella DNA in 25 (45%) of the 55 SAT-positive cows. All of the 689 SAT-negative cows were found to be negative in PCR assays of their milk. Brucella infection status based on PCR results was then predicted for 72 cows from private h erds in which the brucellosis status was unknown. Subsequently, SAT verification of Brucella status was performed. There was no significant difference between predicted and actual SAT-positive rates in those 72 cows. This study indicates a relationship between Brucella detection levels obtained using milk-based PCR results and SAT results. The specific, rapid, and easy sampling procedure within milk-based PCR assaying for brucellosis detection makes the milk PCR method an attractive alternative for evaluation of B. abortus infection in cows, particularly if used as a routine screening and surveillance tool to reduce brucellosis outbreaks.

Randomized clinical trial of Chinese herbal medications to reduce wound complications after mastectomy for breast carcinoma

BACKGROUND

Ischaemia and necrosis of skin flaps is a common complication after mastectomy. This study evaluated the influence of anisodamine and Salvia miltiorrhiza on wound complications after mastectomy for breast cancer.

METHODS

Ninety patients undergoing mastectomy for breast carcinoma were divided into three groups. Group 1 received routine wound care, group 2 received intravenous Salvia miltiorrhiza after surgery for 3 days and group 3 similarly received intravenous anisodamine. Skin flaps were observed on postoperative days 4 and 8; areas of wound ischaemia and necrosis were graded and adverse events recorded.

RESULTS

There was no difference in demographic characteristics between the groups. At 4 days after surgery the rate of ischaemia and necrosis in groups 2 and 3 was significantly reduced compared with that in control group 1 (median wound score 6·80 versus 23·38, P = 0·002, and 3·76 versus 23·38, P < 0·001, respectively). This improvement in groups 2 and 3 continued to postoperative day 8 (both P < 0·001), but wound scores at this stage were better in group 3 than in group 2 (1·82 versus 6·92 respectively; P = 0·022). The volume of wound drainage was lower in group 3 than in group 1 (P = 0·004). The incidence of adverse effects was highest in group 3, and two patients in this group discontinued treatment. No significant complications were noted in group 2.

CONCLUSION

Anisodamine and S. miltiorrhiza were both effective in reducing skin flap ischaemia and necrosis after mastectomy, although anisodamine was associated with a higher rate of adverse effects.

Abstract P4-11-10: A Study of Intraoperative Radiotherapy with Electrons in Breast-Conserving Surgery in China: 3 Year Results

Background:The standard treatment for most localised breast cancer patients is the breast-conservating sugery followed by postoperative radiation worldwide. Preliminary studies of intraoperative radiotherapy with electrons(ELIOT) in selected patients, mainly in Europe since 1999, have shown good local control, less toxicity and satisfatory cosmetic apperance. However few studies have been conducted among non-western populations. To investigate the feasibility of ELIOT in China, we introduced ELIOT in selected early breast cancer patients. Risk of local relapse is the main outcome objective, toxicity and cosmetic results are also studied.

Patients and Methods:From June 2007 to May 2010, 51 patients diagnosed with unifocal breast carcinoma up to a diameter of 3cm received a wide excision of the primary tumor followed by a radiotherapy of 21Gy delivered to the breast tissue at the surface of the tumor bed, biologically equivalent to 58 to 60 Gy in standard fractionation.

The median age of the treated patients was 47 years, with 38/51(74.5%) patients younger than 50. 8 patients(15.7%) were found to have positive axillary I-nodes(six patients had one node involved, one patient had two and one had three positive nodes). Pathologic free margins ≥10 mm were obtained in all patients. Patients were evaluated semiannunally after surgery, and thereafter every 6 months for cosmetic results, complications and other events.

Results: After a follow-up from 4 to 36 months(median time12 months), 3 patients developed fat deliquescence, 16 patients showed wound edema and excess fluid and no one had incision infection or hematoma. Two patients developed local relapses. One was comfirmed unrecognised multi-focal cancer in other quadrants of the breast remain dormant. The other patient was confirmed ipsilateral positive axillary III-nodes and no relapse was found in the same quadrant. Neither contralateral breast cancer nor distant metastases were observed. No replase was found in patients aged &lt;50. Accodring to the JCRT standard, cosmetic result was excellent in 73.1% and 90.9% patients at one year and two year checkup respectively, and good was found in 15.4% and 9.1% patients.

Conclusion:The incidence of breast cancer remains to increase in China with the aging of society and changes of lifestyle, and the highest incidence is found in the age group 45-50 years.Our study suggested the toxicity and cosmetic evalution were good. Data on local control were encouraging, especially for those under 50. ELIOT of 21Gy was a well-tolerated treatment in early stage Chinese breast cancer patients. And further follow up is still needed.

Special communication: China's first historic efforts to develop a tobacco control advocacy workforce via schools of public health

This paper provides an overview of a recent 18-month project which set out for the first time to introduce training on tobacco control into the curricula of public health courses in Chinese universities. The aim was to produce graduates with appropriate knowledge and skills to be effective in advocating for policies that could lead to the reduction of tobacco use. Results from this initial project involving seven universities have been encouraging and the new curriculum is to be implemented, with some changes, on a wider scale throughout China. Each of the universities also successfully introduced a smoke-free campus policy and the aim is to extend this policy.

Protective effects of sirolimus by attenuating connective tissue growth factor expression in human chronic allograft nephropathy

BACKGROUND

Chronic allograft nephropathy (CAN) remains a great challenge for the transplant clinician. The introduction of sirolimus (RAPA) with cyclosporine (CsA) reduction maybe shed new light to improve graft survival. The aim of this study was to investigate the overall effects of sirolimus conversion on biopsy-proven CAN.

METHODS

One hundred and ten renal transplant recipients with biopsy-proven CAN were randomized into two groups: 54 for CsA reduction and 56 for sirolimus conversion treatment. After 24-month follow-up, the outcome variables included graft function and survival as well as CAN Banff grading and intrarenal expression of connective tissue growth factor (CTGF) via repeated biopsy.

RESULTS

Graft function and survival rate were significantly better in the RAPA group. CAN grading worsened in the CsA group, whereas they were stable in the RAPA group. There was weak expression in the RAPA group but significant, increased expression of CTGF in glomeruli and interstitial area in the CSA group (P < .01) both by immunohistochemical staining or real-time polymerase chain reaction detection.

CONCLUSION

Sirolimus conversion provided a beneficial strategy to improve long-term graft survival in CAN. Attenuation of renal CTGF expression may be one of its antifibrotic and antiproliferation effects.

Ischemic preconditioning negatively regulates plenty of SH3s-mixed lineage kinase 3-Rac1 complex and c-Jun N-terminal kinase 3 signaling via activation of Akt

Activation of Akt/protein kinase B has been recently reported to play an important role in ischemic tolerance. We here demonstrate that the decreased protein expression and phosphorylation of phosphatase and tensin homolog deleted from chromosome 10 (PTEN) underlie the increased Akt-Ser-473 phosphorylation in the hippocampal CA1 subfield in ischemic preconditioning (IPC). Co-immunoprecipitation analysis reveals that Akt physically interacts with Rac1, a small Rho family GTPase required for mixed lineage kinase 3 (MLK3) autophosphorylation, and both this interaction and Rac1-Ser-71 phosphorylation induced by Akt are promoted in preconditioned rats. In addition, we show that Akt activation results in the disassembly of the plenty of SH3s (POSH)-MLK3-Rac1 signaling complex and down-regulation of the activation of MLK3/c-Jun N-terminal kinase (JNK) pathway. Akt activation results in decreased serine phosphorylation of 14-3-3, a cytoplasmic anchor of Bax, and prevents ischemia-induced mitochondrial translocation of Bax, release of cytochrome c, and activation of caspase-3. The expression of Fas ligand is also decreased in the CA1 region. Akt activation protects against apoptotic neuronal death as shown in TUNEL staining following IPC. Intracerebral infusion of LY294002 before IPC reverses the increase in Akt phosphorylation and the decrease in JNK signaling activation, as well as the neuroprotective action of IPC. Our results suggest that activation of pro-apoptotic MLK3/JNK3 cascade can be suppressed through activating anti-apoptotic phosphoinositide 3-kinase/Akt pathway induced by a sublethal ischemic insult, which provides a functional link between Akt and the JNK family of stress-activated kinases in ischemic tolerance.

FCGR3B polymorphism in three ethnic Chinese populations

Fc gamma RIIIb receptor is expressed primarily on neutrophils as three polymorphic antigens (HNA-1a, HNA-1b, and HNA-1c) that are encoded by alleles FCGR3B*1, FCGR3B*2, and FCGR3B*3, respectively. These antigens play an important role in immune neutropenia; their absence predisposes individuals who lack them to life-threatening infections. This study investigated the FCGR3B gene frequencies in three ethnic Chinese populations: Han, She, and Tajik. FCGR3B*1, FCGR3B*2, and FCGR3B*3 were genotyped by PCR using sequence specific primers (PCR-SSP). The results showed the gene frequencies were 0.55 for FCGR3B*1 and 0.45 for FCGR3B*2 in 177 Han individuals, 0.69 for FCGR3B*1 and 0.31 for FCGR3B*2 in 87 She individuals, and 0.35 for FCGR3B*1 and 0.65 for FCGR3B*2 in 99 Tajik individuals, respectively. The FCGR3Bnull genotype was not found, but the FCGR3B*3 allele was identified in only three individuals in the Tajik population. DNA clone and sequencing confirmed that these individuals had the C ==>A mutation at position 266 on exon 3. This study found that the gene frequencies in Han and She ethnic groups were similar to those previously reported in the Asian population, but the FCGR3B allele frequencies in the Tajik population were more similar to that of Caucasians.

Effect of phenolic alkaloids from Menispermum dauricum on myocardial-cerebral ischemia-reperfusion injury in rabbits

AIM

To explore the mechanism underlying the effect of phenolic alkaloids from Menispermum dauricum (PAMd) on simultaneous myocardial-cerebral ischemia-reperfusion injury in rabbits.

METHODS

Both left anterior descending coronary artery and bilateral carotid arteries were occluded to induce myocardial-cerebral ischemia-reperfusion injury in rabbits. At 30 min after ischemia, the occlusion was removed and shed blood was rapidly reinfused. Two mL of blood was taken fr om femoral artery at 10 min before ischemia, 1, 10, and 30 min after ischemia, and 1, 10, 30, 60, 120, 180, and 240 min after reperfusion. Each rabbit was sacrificed at the end of reperfusion, and left ventricle, hippocampus, cortex, and cerebellum were taken out. Malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were determined.

RESULTS

At 10 min after reperfusion, MDA content in serum was significantly higher and SOD activity was lower in ischemia-reperfusion (I-R) group than those of control group (P < 0.05). After administration of PAMd, MDA content was lower and SOD activity was higher in serum than those of I-R group (P < 0.05). Both MDA content and SOD activity in tissues had the similar results with those in serum.

CONCLUSION

PAMd could attenuate the injury induced by lipid peroxidation and enhance the activity of SOD, thus PAMd might play a protective role in simultaneous myocardial-cerebral ischemia-reperfusion injury.

Electrospray ionization mass spectra of amino acid phosphoramidates of adenosine

Amino acid phosphoramidates of adenosine were synthesized and determined by positive and negative ion electrospray ionization mass spectrometry (ESI-MS) in conjunction with tandem mass spectrometry (MS/MS). The fragmentation pathways were investigated. In the positive ion mass spectra abundant characteristic fragment ions appeared, and many complementary ions were found. In the negative ion mass spectra only a few fragment ions were observed, and most of them contained phosphoryl groups. The results show that ESI-MS is a useful tool for structural determination of amino acid phosphoramidates of nucleosides.