Non-fatal injury rates among the "left-behind children" of rural China

OBJECTIVE

To investigate patterns of non-fatal unintentional injuries among "left-behind children" in Macheng, China.

METHODS

A cross-sectional survey was conducted in September and October, 2006. Age-specific and sex-specific injury rates were calculated.

RESULTS

3019 students were interviewed in six schools. Of these, 1182 were identified as "left-behind"; 62.3% had both parents away from home, and 37.7% had one parent away from home. The annual injury rate per 1000 among left-behind children was more than twice that of children living with both parents: 252.9 (95% CI 233.0 to 273.0) and 119.8 (95% CI 105 to 134), respectively. Male left-behind children had the highest annual injury rate: 316.4 (95% CI 295 to 338) per 1000. The three leading external causes of injury were similar for both groups of children: falls (33.8%); mechanical injuries (16.2%); and animal bites (14.5%).The location where injuries occurred were home (32.0%), school (26.0%) and roadways (23.9%) for left-behind children. There were no significant associations between the identified guardian and injury mechanism.

CONCLUSIONS

A large proportion of students in the schools of rural Macheng are left-behind children. Left-behind children have a higher injury rate than those in the care of both parents. This may be important in the development of injury prevention strategies in rural communities in China.

Differential effects of smoking on lung cancer mortality before and after household stove improvement in Xuanwei, China

Background:

In Xuanwei County, Yunnan Province, China, lung cancer mortality rates in both males and females are among the highest in China.

Methods:

We evaluated differential effects of smoking on lung cancer mortality before and after household stove improvement with chimney to reduce exposure to smoky coal emissions in the unique cohort in Xuanwei, China. Effects of independent variables on lung cancer mortality were measured as hazard ratios and 95% confidence intervals using a multivariable Cox regression model that included separate time-dependent variables for smoking duration (years) before and after stove improvement.

Results and conclusion:

We found that the effect of smoking on lung cancer risk becomes considerably stronger after chimney installation and consequent reduction of indoor coal smoke exposure.

Diffuse alveolar hemorrhage in systemic lupus erythematosus: a retrospective study in China

The objective of this study was to determine the clinical features of systemic lupus erythematosus (SLE) patients with diffuse alveolar hemorrhage (DAH). The medical records of 29 patients with DAH among 2133 SLE patients admitted to Peking Union Medical College Hospital from January 2004 to January 2009 were reviewed in this retrospective study. It was found that hypoxemia (100%), dyspnea (90%), cough (79%) and fever (72%), rather than hemoptysis (66%), were the most common symptoms. The most common extrapulmonary presentation was renal involvement (90%). In about 60% of patients nosocomial infection was also present. The mean drop in hemoglobin was 32 ± 10.9 g/l. Mean Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was 17 ± 9. All patients received high-dose corticosteroid therapy and most were also given immunosuppressive agents. Rates of concomitant nosocomial infection and mechanical ventilation in non-survivors were higher than those of survivors (p < 0.05). DAH is a rare and catastrophic event in SLE. DAH can occur at any stage of the disease course; it usually occurs in patients with active SLE, and is frequently complicated by lupus nephritis. Some patients may have no hemoptysis. Early aggressive management with high-dose steroids and cyclophosphamide is advocated.

Association between genetic variants in VEGF, ERCC3 and occupational benzene haematotoxicity

INTRODUCTION

Benzene is an established human haematotoxin, with substantial interindividual variation in benzene-induced toxicity.

METHODS

To further examine if genetic variation contributes to benzene haematotoxicity, we analysed 1023 tagSNPs in 121 gene regions important for benzene metabolism, haematopoiesis, leukaemia and lymphoma among 250 workers exposed to benzene and 140 unexposed controls in a cross-sectional study carried out in China. Linear regression was used to analyse the relationship between genetic polymorphisms and total white blood cell (WBC) count and its subtypes, adjusting for potential confounders and occupational exposure to benzene and toluene among exposed workers. The minp test assessed the association on the gene region level. The false discovery rate method was used to control for multiple comparisons.

RESULTS

VEGF (minp = 0.0030) and ERCC3 (minp = 0.0042) were the most significantly associated gene regions with altered WBC counts among benzene-exposed workers, after accounting for multiple comparisons. Highly significant changes were also found for WBC subtype counts, including granulocytes, CD4+ T cells and lymphocytes for VEGF and granulocytes and NK cells for ERCC3. Further, in workers exposed to <1 ppm, a SNP in VEGF was associated with changes in WBC and granulocyte counts, and SNPs in ERCC3 were associated with changes in WBC, NK cell and granulocyte counts.

DISCUSSION

Our findings suggest that genetic variation in VEGF, which plays an important role in blood vessel growth, and ERCC3, which is a member of the DNA repair pathway and is responsible for repairing bulky DNA adducts formed by chemicals, may contribute to individual susceptibility to benzene-induced haematotoxicity at relatively low levels of benzene exposure.

Polymorphisms in the interleukin 3 gene show strong association with susceptibility to Graves' disease in Chinese population

Graves' disease (GD) is a common organ-specific autoimmune disorder, which is multifactorial and develops in genetically susceptible individuals. We had earlier mapped a susceptibility locus for GD to chromosome 5q31-33 in a linkage study. Here we used tag single-nucleotide polymorphisms (SNPs) to search for genetic variants associated with GD, and examined 19 functional candidate genes in this chromosomal region. We identified 192 polymorphisms by re-sequencing the candidate genes, and selected 51 tagSNPs to genotype in a case-control collection of 1118 south Han Chinese subjects (428 cases and 690 controls). Initial analysis suggested that a non-synonymous SNP rs40401 (P27S) of interleukin 3 (IL3) was associated with GD, and further fine-mapping showed that rs40401, or its perfect proxy SNP rs31480 in the 5' flanking region of IL3, fully accounted for the association signal at this locus. We replicated significant association of rs40401 with GD in an independent sample collection of 839 north Han Chinese subjects. A combined analysis revealed strong validation of this association (odds ratio (OR(common))=1.63, combined P (P(comb))=4 x 10(-6) in the Recessive disease model). This study provides convincing evidence that the IL3 gene is a susceptibility locus for GD in the Chinese population.

Portable stove use is associated with lower lung cancer mortality risk in lifetime smoky coal users

Domestic fuel combustion from cooking and heating, to which about 3 billion people worldwide are exposed, is associated with increased lung cancer risk. Lung cancer incidence in Xuanwei is the highest in China, and the attributable risk of lung cancer from unvented smoky coal burning is greater than 90%. To evaluate any lung cancer mortality reduction after changing from unvented stoves to portable stoves, we used lifetime smoky coal users in a retrospective cohort of all farmers born during 1917–1951 and residing in Xuanwei in 1976. Of the 42 422 enrolled farmers, 4054 lifetime smoky coal users changed to portable stoves, 4364 did not change, and 1074 died of lung cancer. Lung cancer morality associated with stove change was assessed by product-limit survival curves and multivariate Cox regression models. Both men (P<0.0001) and women (P<0.0001) who changed to portable stoves had a significantly increased probability of survival compared with those who did not change. Portable stoves were associated with decreased risk of lung cancer mortality in male participants (hazard ratio (HR)=0.62, 95% confidence interval (CI)=0.46–0.82) and female participants (HR=0.41, 95% CI=0.29–0.57). Portable stove use is associated with reduced lung cancer mortality risk, highlighting a cost-effective intervention that could substantially benefit health in developing countries.

Statins decrease the aberrant HLA-DR expression on thyrocytes from patients with Hashimoto's thyroiditis

Statins have been found to exert anti-inflammatory and immune modulatory effects. It seems likely that these drugs may improve thyroid function in patients with Hashimoto's thyroiditis (HT). The objective of our study was to investigate the effect of statins on HLA-DR (human leukocyte antigen D-related) expression of thyrocytes from patients with HT hypothyroidism. Thyroid tissues were obtained from surgical specimens. Thyrocytes were cultured in the presence or absence of IFN-gamma (50 ng/ml) with or without statins (simvastatin 10 microM or atorvastatin 10 microM) for 72 hours. HLA-DR expression was detected by flow cytometry. Normal thyrocytes were used for controls. HLA-DR expression of HT thyrocytes was much higher than that of normal thyrocytes (41.2+/-4.5% vs. 2.7+/-2.1%, p<0.01), which could be further increased by IFN-gamma stimulation in both groups (p<0.01). However, simvastatin and atorvastatin could significantly inhibit the "aberrant" HLA-DR expression on HT thyrocytes and decrease IFN-gamma- induced HLA-DR expression in both HT and normal thyroid cells (p<0.01). Statins can repress HLA-DR expression of HT thyrocytes, which might inhibit the subsequent lymphocyte activation and ameliorate the immune disturbance of HT.

Mismatch negativity in paranoid, schizotypal, and antisocial personality disorders

AIMS

The mismatch negativity (MMN) to frequency deviant tones has yielded conflicting results in patients with schizophrenia. This might be because Axis I schizophrenia overlaps with Axis II diagnoses such as paranoid or schizotypal personality disorders. This study was designed to address this issue.

METHODS

We evaluated the auditory MMN to frequency deviance in 17 patients with paranoid, 15 schizotypal, and 16 antisocial personality disorders. These were compared to 25 healthy subjects.

RESULTS

N1 to both deviant and standard tones was shorter in the paranoid group when compared to healthy controls. MMN latencies were shorter at Fz, Cz, and Pz in the paranoid group when compared to healthy controls, schizotypal, and antisocial groups. MMN amplitudes were higher at Fz and Cz in the schizotypal and antisocial groups when compared to healthy controls and the paranoid group.

CONCLUSIONS

Patients with paranoid personality disorder had faster automatic detection of auditory stimuli and of their change, but normal inhibition of irrelevant stimuli. By contrast, patients with schizotypal and antisocial personality disorders had normal discrimination of the auditory stimuli, but might have a deficit in inhibition on irrelevant stimuli. Our results might help differentiate these personality types, and clarify some MMN findings in schizophrenia.

Instantaneous frequency estimate of nonstationary phonocardiograph signals using hilbert spectrum

A method for analyzing the nonlinear and non-stationary processes and investigating the instantaneous frequency of the practical medical signals is presented. The aim of this contribution is to explore the role that both empirical mode decomposition and Hilbert transform can be applied to play in phonocardiograph (PCG) signals. Hilbert transform is used to each intrinsic mode function to obtain the global time-frequency distribution of the underlying signal with a point of view of instantaneous frequency. Two kinds of clinical phonocardiograph signals with normal and abnormal cardiac functions were analyzed by using the proposed approach. The instantaneous frequency distributions of the PCG signals were also compared with the results by using the Morlet wavelet transform. Both simulation and experimental results were presented and discussed to demonstrate the power and effectiveness of the proposed approach.

Living environment and schooling of children with HIV-infected parents in southwest China

A cross-sectional household survey was conducted in Longchuan County, China, to study the lives of children with HIV-infected parents. Registered HIV-infected drug users and their households were approached and information about the living environment of children < or =15 years of age was collected. Of the 266 households interviewed, there were 213 children < or =15 years old. Forty percent of the children had lost at least one parent. Most of the children resided in a household with low economic status and a high dependency ratio. One-half of the children experienced discordant family relations, family anxiety and shame. Compared to orphans, non-orphans and their families were less likely to receive social support from the community. Orphans and older children were less likely to attend school and more likely to be truant if enrolled in school. Findings in the current study suggest that many children whose parents are infected with HIV or have died from HIV are living in stressful environments with minimal support from the community. Efforts should be taken to provide support and supervision to these children.

Influence of the Plasmodium falciparum P-glycoprotein homologue 1 (pfmdr1 gene product) on the antimalarial action of cyclosporin

BACKGROUND AND OBJECTIVES

The immunosuppressant cyclosporin A and a number of other cyclosporins have potent and selective antimalarial activity. Their exact mechanism of antimalarial action is unknown but the structure-activity relationships for malarial parasite inhibition and immunosuppression differ markedly. The 3'-keto derivative of cyclosporin D (valspodar) is particularly potent against the human malarial parasite Plasmodium falciparum in culture but causes negligible immunosuppression. Multidrug resistance in mammalian cancer cells, the result of overproduction of the P-glycoprotein, can be reversed by certain cyclosporins, particularly valspodar. We therefore investigated the possibility that the antimalarial target of cyclosporin might be a P-glycoprotein homologue. P. falciparum P-glycoprotein homologue 1 (Pgh1; the pfmdr1 gene product) is located in the digestive vacuole (DV) membrane of the parasite. Its function is unknown but it modulates the susceptibility of parasites to quinolines and related antimalarial drugs, including quinine, mefloquine, halofantrine and chloroquine, and to artemisinin.

METHODS AND RESULTS

Here we demonstrate that (i) sequence polymorphisms in pfmdr1 altered the susceptibility of parasites to cyclosporin A and (ii) pfmdr1-overexpressing strains were slightly less susceptible to the drug. Furthermore, we found synergistic antimalarial interactions between cyclosporin A and quinine, mefloquine or halofantrine and antagonism between cyclosporin A and chloroquine. However, we were unable to detect a direct interaction between cyclosporin and Pgh1.

CONCLUSIONS

The amino acid sequence and copy number of Pgh1 may influence cyclosporin susceptibility as a result of a direct interaction between the drug and the protein, or via indirect effects on the physiology of the DV.

B7-H1 expression is upregulated in peripheral blood CD14+ monocytes of patients with chronic hepatitis B virus infection, which correlates with higher serum IL-10 levels

Chronicity in hepatitis B virus (HBV) infection is maintained by increased type 2 T-helper cell response, possibly because of increased interleukin-10 (IL-10) productions. B7-H1 can negatively regulate T-cell responses via its receptor, programmed death 1. Ligation of B7-H1 to T-cells can result in the preferential secretion of IL-10. In this study, we investigated whether there was an upregulated expression of B7-H1 in peripheral blood mononuclear cells in patients chronically infected by HBV and further explored the correlation between B7-H1 expression and serum interleukin 2, interferon-gamma, IL-10, HBeAg, alanine aminotransferase (ALT) levels and viral load. Fifty-five patients with chronic HBV infection and 20 healthy controls (HCs) were enrolled in the present study. The results showed that in patients with chronic hepatitis B CD14+ monocytes but not CD3+ and CD19+ cells had a significantly increased expression of B7-H1 compared with HCs, which positively correlates with serum IL-10 levels and the presence of HBeAg and negatively correlates with serum ALT levels. In conclusion, chronic HBV patients harbour an increased B7-H1 expression in CD14+ monocytes compared with controls, which may be responsible for the increased serum IL-10 levels. This might be an important way by which HBV evades an adequate immune response, leading to viral persistence and disease chronicity.

Mycophenolic Acid Upregulates B7-DC Expression on Dendritic Cells, Which Is Associated With Impaired Allostimulatory Capacity of Dendritic Cells

In addition to its effects on lymphocytes, mycophenolic acid (MPA) may inhibit the allostimulatory capacity of dendritic cells (DC) via unknown mechanisms. B7-H1 and B7-DC surface markers on DC negatively regulate T-cell responses via the receptor PD-1. In this study, we sought to investigate whether B7-H1 and B7-DC are responsible for the inhibitory functions of MPA on DC. Mouse bone marrow-derived DC were cultured with recombinant granulocyte macrophage colony-stimulating factor (GM-CSF) and interleukin (IL)-4 in the presence or absence of MPA (0.01 micromol and 0.1 micromol). The DC phenotype was assessed by flow cytometry, their immunostimulatory capacity measured by mixed lymphocyte reaction (MLR), and cytokine production by ELISA. The results showed that MPA not only inhibited the expression of major histocompatibility complex (MHC) class II and costimulatory molecules CD80 and CD86 but upregulated B7-DC expression on mature DC induced by LPS. These findings were associated with a reduced allostimulatory ability and an altered cytokine secretion pattern of DC. Thus, we suggest that MPA upregulates B7-DC expression during DC maturation induced by LPS in vitro, an effect that may be responsible for MPA-mediated inhibitory effects on the allostimulatory capacity of DC.

Long-term outcome and neuroradiological findings of 31 patients with 6-pyruvoyltetrahydropterin synthase deficiency

Tetrahydrobiopterin (BH(4)) deficiency is an autosomal recessive disorder caused by enzyme defects in the biosynthesis or recycling of BH(4). Patients with BH(4) deficiency present with severe neurological signs and symptoms and require a different treatment from classical phenylketonuria. During the last 12 years, 31 cases of BH(4) deficiency were identified in our department. They were all classified as 6-pyruvoyl-tetrahydropterin synthase (PTPS) deficiency. They were diagnosed at the ages of 2.5-48 months and treated with BH(4), L-dopa and 5-hydroxytryptophan immediately after diagnosis. The average development quotients (DQ) at diagnosis and after treatment for more than 3 years were 53+/- 16, and 78+/- 15, respectively. A significant negative correlation was observed between the level of the DQ and the age at which treatment was commenced (r = -0.751, p = 0.002). Developmental profiles were uneven. Language, adaptability and at later age mathematics were particularly weak areas. Only two patients achieved a good performance in mathematics. Eleven patients who were treated with drugs from ages of 2.9-48 months had neuroradiological scanning. Computed tomography disclosed calcification in lentiform nuclei in one patient and magnetic resonance imaging disclosed delayed myelination and abnormal high intensity signal in cerebral white matter in all of them. Even though most of abnormalities were reversible, small patchy or spotted areas were still present on these regions after treatment for 10-46 months. In summary, our study supports the substantial efficacy of the current therapeutic approach in PTPS deficiency of normalizing amine neurotransmitters with three drugs as early as possible. For the first time, calcifications could be detected in patients with PTPS deficiency. Abnormalities in white matter on magnetic resonance imaging were not related to clinical manifestations and most were reversible.

Complete nucleotide sequence of Kashmir bee virus and comparison with acute bee paralysis virus

The complete nucleotide sequence of a novel virus is presented here together with serological evidence that it belongs to Kashmir bee virus (KBV). Analysis reveals that KBV is a cricket paralysis-like virus (family Dicistroviridae: genus Cripavirus), with a non-structural polyprotein open reading frame in the 5' portion of the genome separated by an intergenic region from a structural polyprotein open reading frame in the 3' part of the genome. The genome also has a polyadenylated tail at the 3' terminus. KBV is one of several related viruses that also includes acute bee paralysis virus (ABPV). Although KBV and ABPV are about 70 % identical over the entire genome, there are considerable differences between them in significant areas of the genome, such as the 5' non-translated region (42 % nucleotide identity), between the helicase and 3C-protease domains of the non-structural polyprotein (57 % amino acid identity) and in a 90 aa stretch of the structural polyprotein (33 % amino acid identity). Phylogenetic analyses show that KBV and ABPV isolates fall into clearly separated clades with moderate evolutionary distance between them. Whether these genomic and evolutionary differences are sufficient to classify KBV and ABPV as separate species remains to be determined.

Classified fingerprinting: A method of comprehensive analysis for comparing megabase genomes

The objective of the work we describe is to establish elementary methods for investigating the functions of genes; specifically, a fingerprinting method for analyzing entire DNA fragments in a mixture. Our goal is to develop a method for comparing genes with a size of several megabases. We improved a method of amplified fragment length polymorphism (AFLP) so that it could be used to analyze all the restriction fragments in a mixture. This method could be used to detect 90% of the DNA fragments produced from 100-kb model genomes by using a four-base cutter enzyme.

Quantitative analysis of binary adsorbed protein films by time of flight secondary ion mass spectrometry

Time of flight secondary ion mass spectrometry (ToF-SIMS) is an ideal technique for the analysis of adsorbed protein films because of its surface sensitivity and chemical specificity. In this study, we examined ToF-SIMS with the multivariate calibration method partial least squares regression (PLSR) for the determination of the relative abundance of the components in binary protein films adsorbed onto mica, PTFE, and heptyl amine plasma polymer substrates. These results have been compared with independently measured 125I-radiolabeled protein adsorption experiments. By applying PLSR to the ToF-SIMS data, the relative abundance of the components in the binary adsorbed protein films was quantified, and the agreement between the ToF-SIMS and 125I-radiolabeling data was measured by the root mean square prediction error (RMSPE). Differences in protein quantification by PLSR and 125I-radiolabeling ranged from 5 to 25 mass % RMSPE and were highly dependent on the structure of the adsorbed protein film, the substrate surface chemistry and morphology, and the number of latent variables retained in the PLSR model. The limit of detection for the minor component in the adsorbed protein film was found to be approximately 10 mass %. This study demonstrates that the combination of ToF-SIMS and multivariate calibration provide complementary information to 125I-radiolabeling about the composition and structure of binary adsorbed protein films.

[Regulation of p53 and bcl-2 proteins to apoptosis and cell proliferation in liver cirrhosis and hepatocellular carcinoma]

In situ apoptosis labelling was used for detecting apoptotic cells, and immunohistochemistry for p53, bcl-2 proteins and proliferation cell nuclear antigen(PCNA) in hepatocellular carcinoma(HCC) and liver cirrhosis tissues. The results were that in HCC, the number of apoptotic cells was higher, the density of proliferation cells lower, and expressions of p53 and bcl-2 protein were stronger than that in liver cirrhosis, and they were related to differentiation degree of HCC. The data indicate that overexpression of bcl-2 and mutant p53 proteins, which causes imbalance between cell proliferation and apoptosis, may bring about genesis and development of HCC by selecting proliferation of cells.

[Abuse of "pheticol" and its interference to the analysis of methamphetamine]

The study was to eliminate interference from ephedrine in the analysis of methamphetamine. The extraction procedure for methamphetamine was modified to include an oxidation step (2 ml urine specimen was treated with 0.5 ml of 1 mol/L phosphate buffer (pH 6.8) and 0.5 ml 0.3 mol/L sodium periodate). Results showed that ephedrine could be oxidized in the presence of periodate ions into smaller fragments while leaving methamphetamine intact. It is recommended that specimens be treated with sodium periodate prior to extraction in order to eliminate any interference caused by ephedrine.