Human pathogenic fungi in China--emerging trends from ongoing national survey for 1986, 1996, and 2006

This epidemiological survey was a retrospective study on three nodes during the past three decades on fungal infections representing the China, including Taiwan. Owing to rare publications reporting on dynamic epidemiological trends in the pathogen epidemiology in China, we surveyed the isolation rates and pathogenic fungi from 8 representative districts in China using uniform identification with uniform methodology. The pathogenic fungi isolation rates and species obtained from 1986 (n=9,096), 1996 (n=19,009), and 2006 (n=33,022) suggested that Trichophyton rubrum was the commonest organism cultured in 1980s (45.4%) and 1990s (34.5%), but Candida albicans increased significantly and reaching to its peak (26.9%) in 2006s' survey, and has become the most common isolate of fungal infections in China currently. In addition, Candida glabrata became the most common non-albicans species of Candida in 2006s' survey. At the same time, the incidence of molds also gradually increased. According to comparative analysis of the results of these three surveys, we found apparent differences in the isolation rates of different pathogenic fungi and the forefront 10 species in China varied significantly, and the dermatophytes decreased markedly, while yeasts, especially the Candida species and the molds, increased gradually during the past three decades. Less dermatophytic infections may suggest better access to healthcare or increase in Candida species indicated higher incidence of hospital acquired infections.

Down-regulation of TSG101 by small interfering RNA inhibits the proliferation of breast cancer cells through the MAPK/ERK signal pathway

We designed to investigate the effects of down-regulating the tumor susceptibility gene 101 (TSG101) on the proliferation and apoptosis of the human breast cancer MCF-7 cell line, and the role of the MAPK/ERK signal pathway in this process. The siRNA against TSG101 was transfected into the breast cancer MCF-7 cell line using Lipofectamine 2000. After TSG101 knockdown, the proliferation of MCF-7 cells was measured by the MTT assay. The cell cycle distribution and apoptosis were examined by using flow cytometry while cell migration was measured using a transwell assay. The protein level of p-ERK was further assessed by immunofluorescence and western blotting. Our results are as following, the MCF-7 cells transfected with TSG101 siRNA proliferated significantly slower and exhibited significantly increased rates of apoptosis compared to the control cells. In the TSG101 siRNA transfected cells, the percentage of cells in the G₀/G₁ and S phase of the cell cycle was significantly higher and lower, respectively, compared to the control cells. Moreover, the migration ability of TSG101 siRNA transfected cells was lower than the control groups. Lastly, the level of p-ERK protein in TSG101 siRNA transfected cells was significantly decreased compared with the control cells. In conclusion, TSG101 knockdown in breast cancer cells induces apoptosis and inhibits proliferation. The TSG101 depleted cells are arrested at the G₁/S transition of the cell cycle. The migration of breast cancer cells is also impaired by TSG101 siRNA. TSG101 may play a biological role through modulation of the MAPK/ERK signaling pathway in breast cancer.

Clinical outcomes of ovulation induction with metformin, clomiphene citrate and human menopausal gonadotrophin in polycystic ovary syndrome

This pilot study evaluated the effects of coadministration of metformin with clomiphene citrate (CC) and human menopausal gonadotrophin (HMG) in women with CC-resistant polycystic ovary syndrome (PCOS). Sixty women with PCOS were randomly assigned to receive 3 months' treatment with metformin or placebo together with CC and HMG. Transvaginal ultrasound was used to monitor follicular development and ovulation was induced by human chorionic gonadotrophin (HCG). The number of dominant follicles, the oestradiol level on the day HCG was given and the amount of HMG required were significantly lower in the metformin group than in the placebo group, whereas the mono-ovulatory rate and pregnancy rate in the third cycle were significantly higher. The cumulative pregnancy rate in the metformin group (43.3%) was higher than in the placebo group (20.0%), but this difference did not reach statistical significance. In conclusion, coadministration of metformin with CC and HMG reduced the amount of HMG required and increased the mono-ovulatory rate and pregnancy rate.

Overexpression of CDR1 and CDR2 genes plays an important role in fluconazole resistance in Candida albicans with G487T and T916C mutations

This study was designed to investigate potential resistance mechanisms by studying the expression of resistant genes in 14 fluconazole-resistant Candida albicans isolates, with G487T and T916C mutations in the 14alpha-demethylase (ERG11) gene, collected from human immunodeficiency virus uninfected patients and a fluconazole-susceptible control strain. The in vitro susceptibilities of the C. albicans isolates to fluconazole were determined using the broth microdilution method and a disc diffusion assay. Expression of Candida drug resistance (CDR)1, CDR2, ERG11, fluconazole resistance (FLU)1 and multidrug resistance (MDR)1 genes was measured using real-time reverse transcription-polymerase chain reaction and evaluated relative to the expression of the control gene 18SrRNA. The CDR1 and CDR2 genes were upregulated in all the fluconazole-resistant C. albicans isolates, whereas only a few isolates showed high expression of MDR1, FLU1 and ERG11 genes compared with the control strain. In conclusion, overexpression of the CDR1 and CDR2 genes may play an important role in fluconazole-resistant C. albicans with G487T and T916C mutations.

Functional polymorphisms of the FAS/FASLG genes are associated with risk of alopecia areata in a Chinese population: a case-control analysis

BACKGROUND

The Fas/Fas ligand system plays a key role in regulating cell growth and apoptosis. Previous findings have suggested that FAS and FASLG polymorphisms are associated with systemic lupus erythematosus, autoimmune hepatitis, vitiligo and other autoimmune-related disorders. However, to the best of our knowledge, there is no reported study on the associations between FAS and FASLG polymorphisms and the risk of alopecia areata.

OBJECTIVES

To investigate the associations between FAS and FASLG polymorphisms and the risk of alopecia areata in a Chinese Han population.

METHODS

In a hospital-based case-control study of 84 patients with alopecia areata and 84 controls, we genotyped FAS 1377G>A, FAS 670A>G and FASLG 844T>C polymorphisms and assessed their association with alopecia areata risk.

RESULTS

We found that a reduced risk of alopecia areata appeared to be associated with the FAS 670AG genotype [adjusted odds ratio (OR) 0.43; 95% confidence interval (CI) 0.22-0.86] when compared with the FAS 670AA genotype, but no risk was associated with any of the FAS 1377G>A and FASLG 844T>C genotypes. In the combined analysis, we found that the presence in individuals of two at-risk alleles of the three FAS/FASLG polymorphisms was associated with a lower risk of alopecia areata (adjusted OR 0.21; 95% CI 0.05-0.89) when compared with the presence of six at-risk alleles.

CONCLUSIONS

These results suggest that genetic variants in the FAS and FASLG genes may contribute to the aetiology of alopecia areata.

Establishment and cryopreservation of a fibroblast cell line derived from Bengal tiger (Panthera tigris tigris)

The Bengal tiger ear marginal tissue fibroblasts cell line (BTF22), containing 157 tubes of frozen cells, was successfully established by using primary explants technique and cell cryoconservation technology. Biological analysis showed that the population doubling time (PDT) for revival cells was approximately 28 h. Measurement of LDH and MDH isoenzymes showed no cross-contamination among the cells. Karyotyping showed that the frequency of cells with chromosome number 2n = 38 was 90.6-92.2%. Tests for bacteria, fungi, viruses and mycoplasma were negative. Plasmids encoding the fluorescent proteins pEGFP-N3, pEGFP-C1, pECFP-N1, pECFP-mito, pDsRed1-N1, and pEYFP-N1 were transfected into cells to study exogenous gene expression in the cells. The plasmid transfection efficiency was between 4.4% and 31.9%. Every index of the BTF22 cell line meets all the standard quality controls of American type Culture Collection (ATCC). Not only has the germline of this important Bengal tiger species been preserved at the cell level, but also valuable material had been provided for genome, postgenome and somacloning research. Moreover, the establishment of this technical platform would provide both technical and theoretical support for storing the genetic resources of other animals and poultry at the cell level.

Mississippi River flood of 2008: observations of a large freshwater diversion on physical, chemical, and biological characteristics of a shallow estuarine lake

High nitrogen (N) loading to coastal aquatic systems can be expressed as increased algal production and subsequent low dissolved oxygen. In April, 2008, predictions for extreme flood stage for the Lower Mississippi River triggered the opening of the Bonnet Carré Spillway, a major release valve for the river. The spillway diverted approximately 8 km3 of water over one month of operation into Lake Pontchartrain with a concomitant 10000 t of NO3-N. Satellite imagery, physical, water quality, and chlorophyll a (chl a) measurements show that the Mississippi River plume mixed with < 40% of the lake during this time, and much of the nutrient load was transported to the coastal ocean. Nitrate, dissolved reactive phosphorus (P), and dissolved silica (Si) concentrations were 4.8, 5.0, and 3.2 times higher, respectively, within the river plume when compared with those of the lake water. Despite the high nutrient concentrations within the river plume, phytoplankton biomass, evidenced by chl a concentrations, was low. Much of the nutrient load appeared to bypass the lake and was transported to the coastal ocean during the opening of the diversion. The potential removal of a total of 7.6% of the N load from the Mississippi River during the one month of flood level flow may have been a contributing factor in the lower than predicted hypoxia zone off the Louisiana coast during the summer of 2008.

Decreased methionine sulphoxide reductase A expression renders melanocytes more sensitive to oxidative stress: a possible cause for melanocyte loss in vitiligo

BACKGROUND

Methionine is one of the major targets of reactive oxygen species (ROS). It is readily oxidized to methionine-S-sulphoxide and methionine-R-sulphoxide, which can be reduced by methionine sulphoxide reductase (MSR) A and B, respectively. MSR represents a unique repair mechanism in the skin antioxidant network. It functions both as a protein repairer and as a ROS scavenger. However, the expression and activity of MSR are significantly reduced in vitiligo.

OBJECTIVES

To investigate whether the decreased expression of MSRA is one of the reasons why melanocytes are especially vulnerable to oxidative stress in vitiligo. Methods We downregulated MSRA expression in immortalized human epidermal melanocyte cell line PIG1 by using the short interfering RNA (siRNA)-targeted gene silencing method. We checked the changes in MSRA transcript and protein level by using reverse transcriptase-polymerase chain reaction and Western blot, respectively. Then we monitored the viability of MSRA-silenced melanocytes under oxidative stress. All statistical analysis was performed by unpaired two-tailed Student's t-test.

RESULTS

The siRNA specific for MSRA successfully suppressed MSRA expression in melanocytes. The lower MSRA expression in melanocytes led to an increased sensitivity to oxidative stress, resulting in more cell death. Furthermore, a remarkable loss of viable cells was found in MSRA-silenced melanocytes even in the absence of exogenously added oxidative stress.

CONCLUSIONS

MSRA is crucial for melanocytes to fight against oxidative stress in vitiligo. In addition, it is also important for normal cell survival. Any means to enhance MSRA appears to have therapeutic potential for the treatment of vitiligo.

Identifying uncontrolled asthma in young children: clinical scores or objective variables?

OBJECTIVE

Several international asthma guidelines emphasize the importance of assessing asthma control. However, there is limited data on the usefulness of available assessment tools in indicating disease control in young asthmatics. This study investigated the ability of Chinese version of Childhood Asthma Control Test (C-ACT) and other disease-related factors in identifying uncontrolled asthma (UA) in young children.

METHODS

During the same clinic visit, asthma patients 4 to 11 years of age completed C-ACT and underwent exhaled nitric oxide and spirometric measurements. Blinded to these results, the same investigator assigned Disease Severity Score (DSS) and rated asthma control according to Global Initiative for Asthma.

RESULTS

The mean (SD) age of 113 recruited patients was 9.1 (2.0) years, and 35% of them had UA. C-ACT, DSS and forced expiratory volume in 1 second (FEV(1)) differed among patients with different control status (p < 0.001 for C-ACT and DSS; p = 0.014 for FEV(1)). Logistic regression confirmed that UA was associated with DSS (p < 0.001), PEF (p = 0.002), C-ACT (p = 0.011), and FEV(1) (p = 0.012). By ROC analysis, C-ACT and DSS were the best predictors for UA (p < 0.001), followed by PEF (p = 0.006) and FEV(1) (p = 0.007). When analyzed by the Classification and Regression Tree (CART) approach, the sequential use of DSS and C-ACT had 77% sensitivity and 84% specificity in identifying UA.

CONCLUSIONS

C-ACT is better than objective parameters in identifying young Chinese children with UA.

Asthma and atopy are associated with DEFB1 polymorphisms in Chinese children

Human beta-defensin (HBD)-1 is constitutively expressed in the airway, and hBD-1 plays crucial roles in innate immunity against respiratory pathogens. Asthma was associated with DEFB1 polymorphisms in Caucasians. This study investigates whether three single nucleotide polymorphisms (SNPs) in 5'-untranslated region of DEFB1 are associated with asthma phenotypes in Chinese children. Subjects aged 5-18 years were recruited from general pediatric clinics. Plasma IgE concentrations were measured by immunoassays. DEFB1 SNPs were characterized by restriction fragment length polymorphism. In all, 305 asthmatics and 156 controls were recruited. For asthma diagnosis, atopy and plasma total IgE, higher percentages of subjects with these outcomes had the minor alleles -20A and -52G (P = 0.041-0.0002). For log-transformed total IgE, the covariate was positive and significant for G-20A under recessive model (P = 0.001) and for G-52A under both recessive and codominant models (P = 0.008 and 0.035). The recessive model covariate was also positive and significant (P = 0.020) for C-44G on peripheral blood eosinophil count. The GCA haplotype of DEFB1 was significantly associated with asthma (odds ratio (95% confidence interval): 1.64 (1.05-2.57); P = 0.029). These results suggest that DEFB1 is a candidate gene for asthma and atopy in children.

Quality-of-life assessment in Chinese families with food-allergic children

BACKGROUND

Caucasian families with food-allergic children have a compromised quality of life (QoL) for fear of life-threatening food reactions. Such data are limited in Asian children. Based on our recent questionnaire-based survey, 8.1% of young children recruited from local nurseries and kindergartens had parent-reported adverse food reactions (AFRs).

OBJECTIVE

This study tested the robustness of the Chinese Food Allergy Quality of Life-Parental Burden questionnaire (FAQL-PB) and assessed QoL in families with childhood AFR. The correlations among FAQL-PB items were evaluated by factor analysis.

METHODS

Two hundred and ninety-eight of 3677 children aged 2-7 years had parent-reported AFR, and 197 (66.1%) of them completed the 17 items of our self-administered FAQL-PB. Six hundred and thirty-nine (18.9%) children without AFR returned this questionnaire. Factor analysis was used to delineate the inter-relationship among the FAQL-PB items.

RESULTS

Cronbach alpha for our Chinese FAQL-PB was 0.976, and the median (interquartile range) FAQL-PB scores of children with and without parent-reported AFR were 0.10 (0.02-0.32) and 0 (0-0.18), respectively (P < 0.001). Factor analysis confirmed excellent correlations between FAQL-PB items. The 17 items were clustered into two factors, which explained 79.7% of the total variance. Among children with AFR, FAQL-PB scores increased with increasing numbers of foods that caused AFRs (P < 0.001 for trend). Thirty (15.2%) children had impaired QoL, defined as average item FAQL-PB score > or = 0.5. Impaired QoL was associated with AFR that was caused by >3 foods (P = 0.001), current food avoidance (P = 0.005) and AFR caused by peanut (P = 0.003), egg (P = 0.011) and cow's milk (P = 0.028), and current flexural dermatitis (P = 0.011).

CONCLUSIONS

FAQL-PB is a robust measure of AFR-specific parental QoL, which is impaired in Chinese children with parent-reported AFR. Flexural dermatitis, current food avoidance and AFR caused by multiple foods are independent risk factors for lower parental QoL.

A study for maternal thyroid hormone deficiency during the first half of pregnancy in China

BACKGROUND

Maternal thyroid hormone deficiency is the most common disorder of thyroid function during pregnancy and can influence the outcome for mother and foetus. The purpose of this study was to investigate the prevalence of thyroid hormone deficiency during the first half of pregnancy in iodine sufficient areas of China.

MATERIALS AND METHODS

Four thousand eight hundred pregnant women from 10 hospitals during the first 20 weeks of gestation were enrolled in this study. All sera obtained from pregnant women were measured for thyrotropin, free thyroxine and thyroid peroxidase antibody. Screening for thyroid hormone deficiency was performed on pregnant women using gestational age-specific reference intervals or non-pregnant population reference intervals.

RESULTS

With gestational age-specific reference intervals as the criterion, the prevalence of subclinical hypothyroidism at 4, 8, 12,16 and 20 weeks of gestation was 4.59%, 6.15%, 4.68%, 4.53% and 5.96%, respectively, and the prevalence of hypothyroxinaemia was 3.69%, 1.11%, 2.92%, 1.29% and 2.29%, respectively. Different prevalence was obtained when non-pregnant population reference intervals was used as the criterion. If non-pregnant population reference intervals were used, the percentage of potentially misclassified cases of subclinical hypothyroidism were 0.18%, 2.85%, 4.1%, 3.24%, and 3.21%, respectively, and 3.45%, 0.66%, 2.34%, 1.29%, and 1.83%, respectively, in potentially misclassified cases of hypothyroxinaemia.

CONCLUSIONS

The percentage of potentially misclassified cases of subclinical hypothyroidism and hypothyroxinaemia in pregnant women decreased by using the gestational age-specific reference intervals as a diagnostic criteria during the first half of pregnancy.

Study of gene-gene interactions for endophenotypic quantitative traits in Chinese asthmatic children

BACKGROUND

Asthma is a complex disease resulting from interactions between multiple genes and environmental factors. Study of gene-gene interactions could provide insight into the pathophysiology of asthma.

METHODS

We investigated the interactions among 18 single-nucleotide polymorphisms in eight candidate genes for plasma total immunoglobulin E (IgE) concentration and peripheral blood (PB) eosinophil count in 298 Chinese asthmatic children and 175 controls. Generalized multifactor dimensionality reduction and generalized linear model were used to analyze gene-gene interactions for the quantitative traits.

RESULTS

A significant interaction was found between R130Q in IL13 and I50V in IL4RA for plasma total IgE concentration, with a cross-validation (CV) consistency of nine of 10 and a prediction error of 41.1% (P = 0.013). Plasma total IgE concentration was significantly higher in the high-risk than the low-risk groups (P < 0.0001). For PB eosinophil count, significant interaction was found between C-431T in TARC and RsaI_in2 in FCERIB, with a CV consistency of nine of 10 and a prediction error of 40.2% (P = 0.009). PB eosinophil count was significantly higher in the high-risk group than the low-risk groups (P < 0.0001). Generalized linear model also revealed significant gene-gene interaction for the above two endophenotypes with P = 0.013 for plasma total IgE concentration and P = 0.029 for PB eosinophil count respectively.

CONCLUSIONS

Our data suggest significant interactions between IL13 and IL4RA for plasma total IgE concentration, and this is the first report to show significant interaction between TARC and FCERIB for PB eosinophil count in Chinese asthmatic children.

Socio-economic inequalities in low-birth weight, full-term babies from singleton pregnancies in Taiwan

OBJECTIVES

This study investigated the chronological trend of low-birth weight in full-term babies (TLBW) in Taiwan in the 1980s and 1990s when the nation experienced a rapid economic advancement, and assessed the association between TLBW and parental education and marital status.

DESIGN

Data from liveborn singletons from Taiwan's birth registry, born between 1978 and 1997, were used to calculate overall and socio-economic factor-specific rates of TLBW for every 2-year interval in this 20-year period.

METHODS

Logistic regression models were used to assess the trend of TLBW rates, and the interaction between secular time, selected demographic factors and other predictors.

RESULTS

Among 6,159,070 full-term, liveborn singletons, 208,729 were TLBW. The average annual rate of TLBW was 3.39% in the study period. The period-specific TLBW declined monotonically from 4.41% in 1978-1979 to 2.49% in 1996-1997, representing a 43% deduction. Multiple logistic regression demonstrated persistent declining trends irrespective of the educational level or marital status of the parents. However, the decline was slower for populations of lower socio-economic status, such as less-educated parents and unmarried mothers, which enhanced the inequalities of TLBW risk across populations. The TLBW risk ratios of the least-educated mothers to the most-educated mothers increased from 1.43 in 1978-1979 to 2.05 in 1996-1997. Unmarried status was an independent predictor of elevated risk of TLBW.

CONCLUSIONS

The association between socio-economic inequality and the risk of TLBW infants was sustained over the 1980s and 1990s in Taiwan. Interventions are necessary to promote antenatal care and educational attainment, particularly for lower socio-economic and socially deprived populations in Taiwan.

Low JAK2V617F allele burden in primary myelofibrosis, compared to either a higher allele burden or unmutated status, is associated with inferior overall and leukemia-free survival

The clinical relevance of JAK2V617F allele burden in primary myelofibrosis (PMF) has not been previously studied. Bone marrow-derived DNA from 199 patients with PMF was subjected to qualitative (n=199) and quantitative (n=129) analysis for V617F. Mutational frequency was 58% and median mutant allele burden ratio in V617F-positive patients was 29% (range, 1-74%). Multivariable analysis identified older age, platelet count > or =100 x 10(9) l(-1) and peripheral blood blast percentage <3% as being associated with a positive mutational status. The mere presence of the mutation did not affect the incidence of thrombosis (P=0.78), overall survival (P=0.22) or leukemia-free survival (P=0.5). The 129 patients with allele burden information were divided into four groups: V617F-negative (n=53) and V617F-positive with mutant allele burden in the lower quartile (n=19), middle quartiles (n=38) or upper quartile (n=19) range. Kaplan-Meier plots revealed significantly shortened overall (P=0.0008) and leukemia-free (P=0.01) survival for the lower quartile, but not for upper quartile allele burden group; independent prognostic relevance was validated by multivariable analysis. We conclude that low V617F allele burden in PMF might indicate the presence of an overriding V617F-negative clone that confers a more aggressive disease phenotype.

Association between candidate genes and lung function growth in Chinese asthmatic children

BACKGROUND

Asthma is caused by a complex interaction between multiple candidate genes and environmental factors. The Childhood Asthma Management Program reported lung function decline in a significant proportion of Caucasian asthmatic children, but such a relation has not been studied in other populations. Our group recently reported that interleukin-13 (IL13), interleukin-4 receptor-alpha and thymus and the activation-regulated chemokine interacted to influence asthma and raised plasma total IgE. However, there has not been any study that has addressed the genetic influences for longitudinal lung function growth.

OBJECTIVE

We studied the longitudinal changes in spirometric variables in Chinese asthmatic children, and investigated the influence and interactions between eight different loci in six candidate genes as well as environmental factors affecting lung function growth in these children.

METHODS

Spirometry was performed at baseline and study completion. Genotyping was performed by restriction fragment length polymorphism. Multi-factor dimensionality reduction (MDR) was used to detect any gene-gene or gene-environment interaction.

RESULTS

We prospectively followed 131 Chinese children, aged 9.9 (3.0) years, for 4.5 (0.8) years. Their mean (standard deviation) baseline forced expiratory volume in 1 s (FEV1) was 98.6 (20.6)% of predicted, and FEV1 to forced vital capacity (FVC) ratio was 77.8 (11.3)%. FEV1 and FVC increased by 210 (115) and 248 (148) mL/year during this study, and these changes were significantly larger among males (P<0.0001). Univariate analysis revealed a significant association between annual FEV1 change and C1570T of signal transducer and activator of transcription 6 gene (STAT6; P=0.009). Linear regression confirmed this finding (P=0.041). Using MDR, we detected a significant 3-locus interaction between IL13 R130Q, ADRB2 R16G and STAT6 C1570T for determining change in FVC (P=0.045).

CONCLUSION

Our data suggest that STAT6 may influence lung function growth in asthmatic children. We also found significant interactions among several atopy-related genetic polymorphisms for influencing FVC change.

A phase II trial of tipifarnib in myelofibrosis: primary, post-polycythemia vera and post-essential thrombocythemia

Patients with primary myelofibrosis (PMF) or post-polycythemia vera or post-essential thrombocythemia myelofibrosis (post-PV/ET MF) have limited therapeutic options. The farnesyltransferase-inhibitor tipifarnib inhibits in vitro proliferation of myeloid progenitors from such patients. In the current phase II clinical trial, single-agent oral tipifarnib (300 mg twice daily x 21 of 28 days) was given to 34 symptomatic patients with either PMF (n=28) or post-PV/ET MF (n=6). Median time to discontinuation of protocol therapy was 4.6 months; reasons for early termination (n=19; 56%) included disease progression (21%) and adverse drug effects (18%). Toxicities (>/=grade 3) included myelosuppression (n=16), neuropathy (n=2), fatigue (n=1), rash (n=1) and hyponatremia (n=1). Response rate was 33% for hepatosplenomegaly and 38% for transfusion-requiring anemia. No favorable changes occurred in bone marrow fibrosis, angiogenesis or cytogenetic status. Pre- and post-treatment patient sample analysis for in vitro myeloid colony growth revealed substantial reduction in the latter. Clinical response did not correlate with either degree of colony growth, measurable decrease in quantitative JAK2(V617F) levels or tipifarnib IC(50) values (median 11.8 nM) seen in pretreatment samples. The current study indicates both in vitro and in vivo tipifarnib activity in PMF and post-PV/ET MF.

Identification of stage-specifically expressed genes ofTrichinella spiralisby suppression subtractive hybridization

Newborn larvae (NBL) and adult (Ad) stage-specifically expressed genes or members of gene families ofTrichinella spiraliswere identified by suppression subtractive hybridization (SSH)†. Six cDNA clones were identified as NBL stage-specific, including 1 member of theT. spiralisgene family encoding glutamic acid-rich proteins, 2 clones encoding novel serine proteases, 2 closely related clones encoding proteins that are members of a deoxyribonuclease II (DNase II)-like family and 1 clone with no similarity to known genes. Four stage-specific clones encoding homologues of retinoid X receptor, caveolin, C2H2 type zinc finger protein and a putative protein with no homology to known sequences were obtained from 3-day-old adult worms. One gene specifically up-regulated in the 5-day-old adult worms encoding a putative cuticle collagen was also identified.

Monocytosis is an adverse prognostic factor for survival in younger patients with primary myelofibrosis

We recently developed a modified Dupriez prognostic scoring system (PSS) that effectively discriminated between high-, intermediate-, and low-risk young patients (age < or =60 years) with primary myelofibrosis (PMF) based on the respective presence of none, one, or two or more of the following parameters: hemoglobin <10 g/dL, leukocyte count <4 or >30 x 10(9)L(-1), and platelet count <100 x 10(9)L(-1). The current study (n=129; median age, 52 years; 69 males) reveals, on multivariable analysis, that an absolute monocyte count of > or =1 x 10(9)L(-1) carries an independent predictive value (p=0.02), for an inferior survival, in addition to that provided by hemoglobin level (p=0.002), platelet count (0.02), and leukocyte count (p=0.16). The inclusion of the monocyte count as a fourth risk factor enabled the construction of a new and improved Mayo PSS; median survival was 173, 61, and 26 months in the absence of all four (low-risk), three (intermediate-risk), or two or less (high-risk) adverse features, respectively (p<0.0001). The independent prognostic value of monocytosis was validated in a separate database of 97 patients with PMF from another institution.

Oxidative stress in midpregnancy as a predictor of gestational hypertension and pre-eclampsia

OBJECTIVES

To explore the relationship between the levels of maternal oxidative stress and glycaemia during pregnancy and to compare the predictive values of 8-epimer of prostaglandin F(2alpha) (8-isoPGF(2alpha)) and mean arterial pressure (MAP) in midpregnancy for the development of hypertensive complications in later pregnancy.

DESIGN

Prospective observational study as an ancillary study to the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) study.

SETTING

Obstetric clinics and wards of a university teaching hospital in Hong Kong.

POPULATION

Selected women with singleton pregnancies attending the antenatal clinic.

METHODS

Pregnant women who met HAPO inclusion criteria were recruited for the study. Glucose tolerance was assessed by a 75-g 2-hour oral glucose tolerance test (OGTT) at 24-32 weeks of gestation. Fasting plasma samples for 8-isoPGF(2alpha) estimation and urine samples for 8-isoPGF(2alpha) and 2,3-dinor 8-isoPGF(2alpha) assays were collected and blood pressures measured during the OGTT visit. Random plasma and urine samples were also obtained at 34-37 weeks. Glucose results were unblinded to the attending obstetrician if limits preset under the HAPO protocol were met.

MAIN OUTCOME MEASURES

Maternal plasma 8-isoPGF(2alpha) and urinary 8-isoPGF(2alpha) and 2,3-dinor 8-isoPGF(2alpha) both at the time of OGTT (24-32 weeks) and at 34-37 weeks of gestation. Incidence of pre-eclampsia and gestational hypertension.

RESULTS

Of the 408 women who attended for OGTT at 24-32 weeks, two met the glucose criteria for unblinding and 25 had missing 8-isoPGF(2alpha) values and thus were excluded from analysis. Of the 381 women, 338 (88.7%) attended for random plasma samples at 34-37 weeks. Significant correlations were observed between maternal fasting plasma isoprostane and both fasting (r= 0.20; P < 0.001) and 2-hour (r= 0.39; P < 0.001) plasma glucose levels at the time of OGTT. Gestational hypertension/pre-eclampsia occurred in 17 (4.2%) women, and at the time of OGTT, they had significantly higher fasting plasma 8-isoPGF(2alpha) (P < 0.001), urine 8-isoPGF(2alpha) (P < 0.005) and urine 2,3-dinor 8-isoPGF(2alpha) to creatinine ratios (P < 0.001), as well as higher MAP (P < 0.001) than women who remained normotensive. At 34-37 weeks, only random plasma 8-isoPGF(2alpha) was significantly higher (P < 0.001) among the women with gestational hypertension/pre-eclampsia.

CONCLUSIONS

Plasma markers of oxidative stress were positively correlated with plasma glucose at the time of OGTT (24-32 weeks). Women who subsequently developed gestational hypertension/pre-eclampsia had significantly higher plasma and urine markers of oxidative stress at the time of OGTT but only higher plasma markers at 34-37 weeks. Plasma 8-isoPGF(2alpha) appears to be a very good predictor of subsequent gestational hypertension/pre-eclampsia when measured at the time of OGTT, but its ability to discriminate deteriorates as pregnancy advances.

Status of anti-thyroid peroxidase during normal pregnancy and in patients with hyperemesis gravidarum

Autoimmune thyroid diseases (AITD) comprising Hashimoto's thyroiditis, primary myxedema, and Graves' disease are associated with autoantibodies directed against thyroglobulin and thyroid peroxidase (anti-TPO). Anti-TPO occur in 10% of pregnant women, half of whom reportedly develop postpartum thyroid dysfunction. We recently published data on the thyroid function reference ranges in pregnant Chinese but the AITD status of our cohort was unknown. In view of this missing information we have measured anti-TPO in specimens from our cohort stored at -80 degrees C, and compared these to those of patients with hyperemesis gravidarum (HG) and nonpregnant controls. After eliminating 3 outliers from 47 nonpregnant controls, the anti-TPO concentration range was 2.2-14.7 kIU/L (n = 44). In 282 pregnant control subjects, the anti-TPO levels were less than 14.7 kIU/L (upper limit of nonpregnant controls) in 189 (67%); between 14.7-55 kIU/L in 82 (29.1%); and greater than 55 kIU/L in 11 (3.9%). The percentage of women with anti-TPO greater than 14.7 kIU/L during the first, second, and third trimesters were 47% (30/64), 39% (49/126), and 16% (15/92), respectively. Anti-TPO level was significantly higher in pregnant controls compared to nonpregnant controls and patients with HG. With reference to other studies in which anti-TPO levels greater than 60 kIU/L were considered pathologic, we conclude that more than 96% of our pregnant controls were without AITD and the data on thyroid function reference ranges we previously reported remain valid.

Nitric oxide synthase polymorphisms and asthma phenotypes in Chinese children

BACKGROUND

Nitric oxide (NO) is a key factor for balancing T-helper type 1/T-helper type 2 immunity. Single nucleotide polymorphisms (SNPs) in nitric oxide synthase (NOS) genes have been associated with atopy and exhaled NO concentrations in Caucasians. We investigated the association between asthma traits and genetic polymorphisms in neuronal NO synthase (NOS1) and endothelial NO synthase (NOS3) in Chinese children.

METHODS

Asthmatic children between 5 and 18 years of age and non-allergic controls were recruited. Plasma total IgE was measured by microparticle immunoassay, whereas allergen-specific IgEs were measured by fluorescent enzyme immunoassay. Fractional exhaled NO concentration (FeNO) was measured by a chemiluminescence analyser. NOS1 C5266T and NOS3 G894T were genotyped by restriction fragment length polymorphism, and (AAT)n polymorphism in intron 20 of NOS1 was determined by GeneScan analysis.

RESULTS

The mean (SD) ages of 295 asthmatics and 174 controls were 11.1 (3.8) years and 11.6 (4.0) years, respectively (P=0.162). NOS1 C5266T and NOS3 G894T were not associated with asthma, atopy or FeNO. However, significantly more subjects with T/T in NOS1 C5266T had increased plasma total IgE as compared with those with C/T or C/C (P=0.017). This SNP was also associated with sensitization to Dermatophagoides pteronyssinus (P=0.049). Among asthmatic patients, log-transformed plasma total IgE levels were significantly higher among those homozygous for 5266T of NOS1 [mean (SD): 2.84 (0.44) for T/T, 2.68 (0.42) for C/T, 2.59 (0.69) for C/C; P=0.021]. This study found a significant inter-ethnic difference in the allele frequencies of AAT repeats, and this polymorphism was associated with high plasma total IgE levels (P=0.044) but not FeNO (P=0.158). NOS3 G894T was not associated with any asthma or atopy phenotype.

CONCLUSIONS

NOS1 C5266T and AAT repeats affect plasma IgE concentrations in Chinese children. On the other hand, neither NOS1 nor NOS3 SNP was associated with FeNO or the risk of having asthma.

Molecular epidemiology of Mycobacterium tuberculosis in China: a nationwide random survey in 2000

OBJECTIVE

To determine the contribution of the Mycobacterium tuberculosis (TB) Beijing genotype to the population structure of M. tuberculosis complex in China.

DESIGN

Genotypes of 441 mycobacterial isolates were determined by spoligotyping and IS6110 restriction fragment length polymorphism (RFLP). The isolates were from a nationwide random survey for the epidemiology of TB conducted in 2000, and the drug susceptibility patterns and epidemiological data were known.

RESULT

A total of 408 samples contained M. tuberculosis as determined by spoligotyping. Of the M. tuberculosis strains, 64.9% (265/408) were of the Beijing genotype. Using the chi-squared test, no statistically significant differences were observed in the proportion of Beijing genotype TB in patients of different sex, age or living in different areas of the country, but a significant difference was observed with multidrug-resistant (MDR) TB: 77.8% (42/ 54) of MDR isolates were of the Beijing genotype vs. 60.2% (213/354) of the drug-susceptible isolates. In the multivariate logistic regression model, the Beijing genotype was significantly associated with region and not with MDR.

CONCLUSION

The M. tuberculosis Beijing genotype has prevailed in China for at least five decades and is associated with region.

Midazolam attenuates adenosine diphosphate-induced P-selectin expression and platelet-leucocyte aggregation

BACKGROUND AND OBJECTIVE

The expression of P-selectin on the surface of platelets and platelet-leucocyte conjugate formation are considered to be an indicator of platelet activation in thrombotic and inflammatory disease. Midazolam is a widely used sedative and anaesthetic induction agent. It may inhibit platelet aggregation and suppress interleukin-6 and -8 response in human leucocytes, but any effect on the adhesion of activated platelets to leucocytes remains obscure. We have examined the influence of midazolam on adenosine diphosphate (ADP)-induced platelet surface P-selectin expression and platelet-leucocyte aggregation in whole blood.

METHODS

Human whole blood was stimulated with 2 x 10(-5)M ADP in the presence of midazolam (3 x 10(-4) to 3 x 10(-6)M). Samples were stained with a fluorochrome-conjugated CD62P and CD41a antibody for detecting human platelet P-selectin antigens. The leucocyte subpopulations were separately gated and platelet-leucocyte aggregates were defined as cells found positive for CD45 and CD62P. All samples were analysed and were electronically separated into specific cell types (platelets, neutrophils, monocytes and lymphocytes) according to their typical forward/side scattering by flow cytometry.

RESULTS

Midazolam significantly inhibited ADP-induced platelet P-selectin expression and attenuated platelet-leucocyte aggregation (mainly in neutrophils and monocytes) in a dose-dependent manner with a maximum inhibitory effect at 3 x 10(-4)M (P < 0.01).

CONCLUSIONS

This study demonstrated that midazolam decreases the ADP-induced expression of platelet surface P-selectin and platelet-leucocyte aggregation.

Microbial populations and activities in the rhizoplane of rock-weathering desert plants. I. Root colonization and weathering of igneous rocks

Dense layers of bacteria and fungi in the rhizoplane of three species of cactus (Pachycereus pringlei, Stenocereus thurberi, Opuntia cholla) and a wild fig tree (Ficus palmeri) growing in rocks devoid of soil were revealed by bright-field and fluorescence microscopy and field emission scanning electron microscopy. These desert plants are responsible for rock weathering in an ancient lava flow at La Purisima-San Isidro and in sedimentary rock in the Sierra de La Paz, both in Baja California Sur, Mexico. The dominant bacterial groups colonizing the rhizoplane were fluorescent pseudomonads and bacilli. Seven of these bacterial species were identified by the 16S rRNA molecular method. Unidentified fungal and actimomycete species were also present. Some of the root-colonizing microorganisms fixed in vitro N(2), produced volatile and non-volatile organic acids that subsequently reduced the pH of the rock medium in which the bacteria grew, and significantly dissolved insoluble phosphates, extrusive igneous rock, marble, and limestone. The bacteria were able to release significant amounts of useful minerals, such as P, K, Mg, Mn, Fe, Cu, and Zn from the rocks and were thermo-tolerant, halo-tolerant, and drought-tolerant. The microbial community survived in the rhizoplane of cacti during the annual 10-month dry season. This study indicates that rhizoplane bacteria on cacti roots in rock may be involved in chemical weathering in hot, subtropical deserts.