Molecular prenatal diagnosis of alpha and beta thalassemia in pregnant Hakka women in southern China

BACKGROUND

To date, there has been no systematic study of DNA-based prenatal diagnosis of thalassemia in pregnant Hakka women in southern China.

METHODS

A total of 279 pregnant Hakka women with confirmed cases of thalassemia who had been treated at the Meizhou People's Hospital in China's Guangdong Province from January 2014 to December 2016 were here enrolled. Genomic DNA was extracted from peripheral blood of couples and villus, amniotic fluid, or fetal cord blood. DNA-based diagnosis was performed on the tissues of fetuses whose parents had tested positive for α- and β-globin gene mutations were found using polymerase chain reaction (PCR) and flow-through hybridization technique. Follow-up visits were performed 6 months after the fetuses were born. Prenatal diagnosis was performed on 279 fetuses in at-risk pregnancies.

RESULTS

Here, 211 α-thalassemia fetuses were confirmed, including 41 (19.43%) that tested positive for Bart's hydrops syndrome and 15 (7.11%) for Hb H disease. There were 103 (48.81%) heterozygotes. β-thalassemia was confirmed in 68 fetuses, including 23 (33.82%) with severe thalassemia and 27 (39.71%) heterozygotes. Another 12 cases were confirmed with α+β-thalassemia, including three cases of severe β-thalassemia. DNA-based testing prenatal diagnosis of thalassemia was found to be highly reliable.

CONCLUSIONS

Our findings provide key information for clinical genetic counseling of prenatal diagnosis for major thalassemia in pregnant Hakka women in southern China.

Clinical Characteristics of Juvenile Myasthenia Gravis in Southern China

Objectives

To describe the clinical profile, clinical outcomes and factors that may affect the outcome of juvenile myasthenia gravis (JMG) patients in southern China.

Methods

We reviewed information relating to JMG patients treated and evaluated at the First Affiliated Hospital, Sun Yat-sen University, between 1998 and 2015. The study involved 327 JMG patients who had been followed up for ≥1 year.

Results

Overall, 77.4% patients showed initial symptoms in the prepubertal period (<12 years). 306 patients showed only ocular symptoms at onset. By the final follow-up, 61 ocular myasthenia gravis (OMG) patients (61/306, 19.9%) had developed generalized myasthenia gravis (GMG). Anti-acetylcholine receptor antibodies (AChR-Ab) titer was an independent risk factor for generalization. Eleven patients (3.4%) experienced spontaneous remission, but four relapsed. Low-dose oral prednisone (0.25 mg/kg) was administered when symptoms did not significantly improve after pyridostigmine treatment. Immunosuppressants were administered when prednisone was unsatisfactory. Optimal outcome was achieved in 59.6% of patients. Specifically, 60 patients (18.3%) attained complete stable remission (CSR), 12 (3.7%) attained pharmaceutical remission (PR), and 123 (37.6%) attained minimal manifestation (MM). In total, 53 OMG patients (21.5%) attained CSR, a significantly higher proportion than among the GMG patients (8.6%, P = 0.009). Moreover, 67.2% of patients with duration <2 years showed significant clinical improvement compared with 46.3% of those with duration >2 years (P < 0.001). Thymectomy did not exhibit definite efficacy for JMG patients.

Conclusion

There was a low frequency of cases positive for AChR-Ab in the Chinese population. AChR-Ab titer was revealed as an independent risk factor for generalization. Low doses of prednisone could treat JMG effectively with few side effects.

Insights into the epidemic characteristics and evolutionary history of the novel porcine circovirus type 3 in southern China

Porcine circovirus type 3 (PCV3) is a newly identified circovirus from swine in the USA, China and Poland. This novel circovirus has been associated with porcine dermatitis and nephropathy syndrome (PDNS), reproductive failure and multisystemic inflammation; moreover, PCV3 poses a potential threat to the swine industry. In this retrospective study, a phylogenetic analysis was conducted to address the epidemiology and evolutionary dynamics of this novel circovirus. The total positive sample rate of PCV3 was 26.7% (76/285) and has increased gradually over the past 3 years. Of these PCV3-positive samples, 22.3% (17/76) were coinfected with PCV2. PCV3 can be detected in multiple sample types with different positive rates, and the positive rate is highest among stillborn. We also divide PCV3 into three clades (PCV3a, PCV3b and PCV3c) based on two amino acid mutations (A24V and R27K) on the cap protein in this study. In addition, the origin of PCV3 was approximately 1966 and may have originated from a bat-associated circovirus. Our results suggested that PCV3 is widely distributed in southern China and has been circulating in swine herds for nearly half a century. PCV3 has evolved into different clades caused by mutations in cap proteins; thus, further research on PCV3 epidemiology should be conducted.

A biogeographical study on tropical flora of southern China

The tropical climate in China exists in southeastern Xizang (Tibet), southwestern to southeastern Yunnan, southwestern Guangxi, southern Guangdon, southern Taiwan, and Hainan, and these southern Chinese areas contain tropical floras. I checked and synonymized native seed plants from these tropical areas in China and recognized 12,844 species of seed plants included in 2,181 genera and 227 families. In the tropical flora of southern China, the families are mainly distributed in tropical areas and extend into temperate zones and contribute to the majority of the taxa present. The genera with tropical distributions also make up the most of the total flora. In terms of geographical elements, the genera with tropical Asian distribution constitute the highest proportion, which implies tropical Asian or Indo-Malaysia affinity. Floristic composition and geographical elements are conspicuous from region to region due to different geological history and ecological environments, although floristic similarities from these regions are more than 90% and 64% at the family and generic levels, respectively, but lower than 50% at specific level. These differences in the regional floras could be influenced by historical events associated with the uplift of the Himalayas, such as the southeastward extrusion of the Indochina geoblock, clockwise rotation and southeastward movement of Lanping-Simao geoblock, and southeastward movement of Hainan Island. The similarity coefficients between the flora of southern China and those of Indochina countries are more than 96% and 80% at family and generic levels, indicating their close floristic affinity and inclusion in the same biogeographically floristic unit.

Three new cavernicolous species of the millipede genus Trichopeltis Pocock, 1894 from southern China (Diplopoda, Polydesmida, Cryptodesmidae)

Three new species of Trichopeltis are described from caves in southern China: T.bellussp. n., T.intricatussp. n., and T.reflexussp. n., all presumed troglobites. The former two come from Yunnan Province, the latter one from Hunan Province. An updated key to all eleven currently known species of Trichopeltis is provided.

Reappearance of buffalo-origin-like porcine circovirus type 2 strains in swine herds in southern China

Previously, we identified three porcine circovirus type 2 (PCV2) strains in buffalo meat samples from southern China. In this study, we confirmed the reappearance of those buffalo-origin-like PCV2 strains in swine herds in this region, which supported the possible cross-species infection of PCV2 between buffalos and pigs under field conditions.

Quantification of familial risk of nasopharyngeal carcinoma in a high-incidence area

BACKGROUND

To the authors' knowledge, no studies to date have explored familial risks of nasopharyngeal carcinoma (NPC) in detail and quantified its lifetime risk in high-incidence populations.

METHODS

The authors conducted a population-based case-control study of 2499 NPC cases and 2576 controls randomly selected in southern China from 2010 through 2014. Unconditional logistic regression was used to estimate multivariable-adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) associated with a family history of NPC. In addition, the authors compiled a reconstructed cohort comprising 40,781 first-degree relatives of cases and controls to calculate the lifetime cumulative risk of NPC.

RESULTS

Individuals with a first-degree family history of NPC were found to be at a >4-fold risk of NPC (OR, 4.6; 95% CI, 3.5-6.1) compared with those without such a history, but had no excess risk of other malignancies. The excess risk was higher for a maternal than a paternal history and was slightly stronger for a sibling compared with a parental history, and for a sororal than a fraternal history. Among relatives of cases, the cumulative risk of NPC up to age 74 years was 3.7% (95% CI, 3.3%-4.2%), whereas that among relatives of controls was 0.9% (95% CI, 0.7%-1.2%). Cumulative risk was higher in siblings than in parents among relatives of cases, whereas no such difference was noted among relatives of controls.

CONCLUSIONS

Individuals with a family history of NPC have a substantially higher risk of NPC. These relative and cumulative risk estimates can guide the development of strategies for early detection and clinical consultation in populations with a high incidence of NPC. Cancer 2017;123:2716-25. © 2017 American Cancer Society.

Predicting the responses of forest distribution and aboveground biomass to climate change under RCP scenarios in southern China

In the past three decades, our global climate has been experiencing unprecedented warming. This warming has and will continue to significantly influence the structure and function of forest ecosystems. While studies have been conducted to explore the possible responses of forest landscapes to future climate change, the representative concentration pathways (RCPs) scenarios under the framework of the Coupled Model Intercomparison Project Phase 5 (CMIP5) have not been widely used in quantitative modeling research of forest landscapes. We used LANDIS-II, a forest dynamic landscape model, coupled with a forest ecosystem process model (PnET-II), to simulate spatial interactions and ecological succession processes under RCP scenarios, RCP2.6, RCP4.5 and RCP8.5, respectively. We also modeled a control scenario of extrapolating current climate conditions to examine changes in distribution and aboveground biomass (AGB) among five different forest types for the period of 2010-2100 in Taihe County in southern China, where subtropical coniferous plantations dominate. The results of the simulation show that climate change will significantly influence forest distribution and AGB. (i) Evergreen broad-leaved forests will expand into Chinese fir and Chinese weeping cypress forests. The area percentages of evergreen broad-leaved forests under RCP2.6, RCP4.5, RCP8.5 and the control scenarios account for 18.25%, 18.71%, 18.85% and 17.46% of total forest area, respectively. (ii) The total AGB under RCP4.5 will reach its highest level by the year 2100. Compared with the control scenarios, the total AGB under RCP2.6, RCP4.5 and RCP8.5 increases by 24.1%, 64.2% and 29.8%, respectively. (iii) The forest total AGB increases rapidly at first and then decreases slowly on the temporal dimension. (iv) Even though the fluctuation patterns of total AGB will remain consistent under various future climatic scenarios, there will be certain responsive differences among various forest types.

Effect of Live Poultry Market Closure on Avian Influenza A(H7N9) Virus Activity in Guangzhou, China, 2014

Temporary closure and disinfection can rapidly reduce levels of infectious virus in these settings.

We assessed the effect of closing live poultry markets in China on influenza A(H7N9) virus detection and viability. Intensive sampling was carried out before, during, and after a 2-week citywide market closure; the markets were cleaned and disinfected at the beginning of the closure period. Swab samples were collected at different sites within the markets and tested for H7N9 by real-time reverse transcription PCR and culture. During the closure, H7N9 viral RNA detection and isolation rates in retail markets decreased by 79% (95% CI 64%–88%) and 92% (95% CI 58%–98%), respectively. However, viable H7N9 virus could be cultured from wastewater samples collected up to 2 days after the market closure began. Our findings indicates that poultry workers and the general population are constantly exposed to H7N9 virus at these markets and that market closure and disinfection rapidly reduces the amount of viable virus.

Six new species of dragon millipedes, genus Desmoxytes Chamberlin, 1923, mostly from caves in China (Diplopoda, Polydesmida, Paradoxosomatidae)

Six new species of Desmoxytes are described from southern China: Desmoxytes laticollis sp. n., Desmoxytes simplipoda sp. n., and Desmoxytes similis sp. n., all three from caves in Guangdong Province; Desmoxytes phasmoides sp. n. also from a cave, and both epigean Desmoxytes spiniterga sp. n. and Desmoxytes variabilis sp. n., the latter trio from Guangxi Zhuang Autonomous Region. A modified key to all 20 Desmoxytes species currently known to occur in China is given.

A new species of Pseudomegischus van Achterberg from China, with a key to the species (Hymenoptera, Stephanidae)

The genus Pseudomegischus van Achterberg, 2002, is newly reported from China. A new species, Pseudomegischusnotiochinensissp. n., is described and illustrated from southern China. A key to the species of Pseudomegischus is included.

Sex and Age Differences in Mortality in Southern China, 2004-2010

The purpose of this study was to describe the mortality patterns in the southern provinces of China, and to provide epidemiologic data on sex and age differences of death outcomes. Reliable mortality and population data from January 2004 to December 2010 were obtained from 12 Disease Surveillance Point (DSP) sites in four provinces of China. Death data from all causes and respiratory disease, chronic obstructive pulmonary disease (COPD), pneumonia and influenza, circulatory disease, and ischemic heart disease, were stratified by year, month of death occurrence and sex, seven age groups, and summarized by descriptive statistics. The mean annual mortality rates of the selected 12 DSP sites in the southernmost provinces of China were 543.9 (range: 423.9-593.6) deaths per 100,000 population. The death rates show that noted sex differences were higher in the male population for all-cause, COPD and circulatory diseases. Pneumonia and influenza death rates present a different sex- and age-related distribution, with higher rates in male aged 65-74 years; whereas the death rates were opposite in elderly aged ≥75 years, and relatively higher in young children. This study had practical implications for recommending target groups for public health interventions.

Clinical patterns and characteristics of uveitis in a secondary hospital in southern China

AIM

To investigate the characteristics of uveitis in a secondary hospital in southern China.

METHODS

We reviewed all records of patients with uveitis at Hengli Hospital from January 2008 to December 2011. Demographic data, past history, ophthalmic examinations and other laboratory tests were analyzed.

RESULTS

One hundred and ninety-nine uveitis patients were enrolled in this study, including 134 (67.3%) males and 65 females (32.7%) with an average age of 41.0±15.1y. The anatomical distribution included 103 (51.8%) cases of anterior uveitis, followed by panuveitis (65, 32.7%), posterior uveitis (29, 14.6%) and intermediate uveitis (2, 1.0%). Of the 98 (49.2%) non-idiopathic cases, there were 10.1% Behcet's disease, 9.5% Vogt-Koyanagi-Harada (VKH) syndrome, 7.5%infectious uveitis, 7.5% traumatic uveitis and 3.5% postoperative uveitis.

CONCLUSION

Idiopathic anterior and posterior uveitis, Behcet's disease, VKH syndrome, infectious uveitis and traumatic uveitis are the most common uveitis entities in a secondary hospital in southern China. Additional measures should be taken to prevent infectious and traumatic uveitis.

General practice education and training in southern China: recent development and ongoing challenges under the health care reform

China has launched a general practice (GP)-orientated primary care reform in 2009 to develop a more productive, coordinated, and cost-effective system to maintain and improve the health and well-being of one-fifth of the world population. The restructure of the health care system with a focus on primary care requires practitioners working on GP as gatekeepers for service delivery that is responsive to the needs of people. It is particularly prioritised to establish a sound education and training system to ensure that the competencies of practitioners are aligned with local health care needs. This article aims to provide a brief review of the development of GP, including exemplary model of education and training currently implemented in southern China, as well as the challenges to be addressed in the next step. There is a shortage of well-trained and qualified general practitioners in China where more than half of the licensed clinicians in primary care are educated below the undergraduate level. Although there is a stepwise increase in recognition that the capacity of GP is pivotal to the success of primary care development in China, challenges coming from resource restriction, rural and urban disparity, social attitude, and community involvement are highlighted as major bottlenecks that currently hinder the rapid development of GP in China. Supportive policy and guidelines are necessary to build up strong GP recognition and ensure adequate resources to underpin a robust primary care system to deliver affordable and effective health care services for the world's largest population. It might share some similar experiences with other countries that are struggling to develop a GP-based primary care system.

Species differentiation of Chinese mollitrichosiphum (Aphididae: greenideinae) driven by geographical isolation and host plant acquirement

The impact of both the uplift of the Qinghai-Tibetan Plateau (QTP) and the separation of the Taiwan and Hainan Islands on the evolution of the fauna and flora in adjacent regions has been a topic of considerable interest. Mollitrichosiphum is a polyphagous insect group with a wide range of host plants (14 families) and distributions restricted to Southeast Asia. Based on the mitochondrial Cytochrome C Oxidase Subunit I (COI) and Cytochrome b (Cytb) genes, the nuclear elongation factor-1α (EF-1α) gene, and the detailed distribution and host plant data, we investigated the species differentiation modes of the Chinese Mollitrichosiphum species. Phylogenetic analyses supported the monophyly of Mollitrichosiphum. The divergence time of Mollitrichosiphum tenuicorpus (c. 11.0 mya (million years ago)), Mollitrichosiphum nandii and Mollitrichosiphum montanum (c. 10.6 mya) was within the time frame of the uplift of the QTP. Additionally, basal species mainly fed on Fagaceae, while species that fed on multiple plants diverged considerably later. Ancestral state reconstruction suggests that Fagaceae may be the first acquired host, and the acquisition of new hosts and the expansion of host range may have promoted species differentiation within this genus. Overall, it can be concluded that geographical isolation and the expansion of the host plant range may be the main factors driving species differentiation of Mollitrichosiphum.