Changes in DNA Methylation of Glucocorticoid-Induced Tumor Necrosis Factor Receptor and Its Ligand in Liver Transplantation

Liver transplantation (LT) is the criterion standard of care in patients with end-stage liver disease and those with tumors of hepatic origin in the setting of liver dysfunction. Chronic immune rejection of the liver transplant can lead to bad prognosis for patients. Glucocorticoid-induced tumor necrosis factor receptor (GITR) play a key role in dominant immunologic self-tolerance maintained by CD25+/CD4+ regulatory T cells. Here, we investigated the DNA methylation variations of GITR and GITR ligand (GITRL) using pyrosequencing by analyzing blood DNA samples of patients after LT. Our results showed that the methylation level of certain CpGs, such as CpG_13, in GITRL was significantly reduced after LT. Furthermore, we found that the GITRL methylation statuses of cohorts with no chronic immune rejection were significantly lower compared with cohorts with chronic immune rejection after LT treatment. However, the methylation statuses of GITR were less varied. Using linear regression analysis, we further found that factors such as upper gastrointestinal hemorrhage, splenectomy, and creatinine might affect DNA methylation patterns in chronic immune rejection cohorts. These findings provide novel insights into the pivotal role of GITRL as a potential molecular biomarker for the triage of liver transplantation.

[The social marketing models and policy advices for HIV rapid testing initiated by non-govermental organization]

Currently, a growing number of community-based organizations are providing rapid HIV testing service in various forms, some people with specific needs also purchase HIV rapid test papers through online sales channels, those imply that the demand of HIV self-test is in increasing year by year.In this paper, aims to understand the current situation of HIV rapid test led by CBOs and the approach, strategies and results of social marketing by means of expert interviews and site visits. Hope to illustrate the current situation, and make recommendations for future work.

School beverage environment and children's energy expenditure associated with physical education class: an agent-based model simulation

BACKGROUND

Physical activity contributes to children's energy expenditure and prevents excess weight gain, but fluid replacement with sugar-sweetened beverages (SSBs) may diminish this benefit.

OBJECTIVE

The aim of this study was to explore the net energy expenditure (EE) after physical education (PE) class given the competition between water and SSB consumption for rehydration and explore environmental factors that may influence the net EE, e.g. PE duration, affordability of SSB and students' SSB preference.

METHODS

We built an agent-based model that simulates the behaviour of 13-year-old children in a PE class with nearby water fountains and SSB vending machines available.

RESULTS

A longer PE class contributed to greater prevalence of dehydration and required more time for rehydration. The energy cost of a PE class with activity intensity equivalent to 45 min of jogging is about 300 kcal on average, i.e. 10-15% of average 13-year-old children's total daily EE. Adding an SSB vending machine could offset PE energy expenditure by as much as 90 kcal per child, which was associated with PE duration, students' pocket money and SSB preference.

CONCLUSIONS

Sugar-sweetened beverage vending machines in school may offset some of the EE in PE classes. This could be avoided if water is the only readily available source for children's fluid replacement after class.

Local Structure and Short-Range Order in a NiCoCr Solid Solution Alloy

Multielement solid solution alloys are intrinsically disordered on the atomic scale, and many of their advanced properties originate from the local structural characteristics. The local structure of a NiCoCr solid solution alloy is measured with x-ray or neutron total scattering and extended x-ray absorption fine structure (EXAFS) techniques. The atomic pair distribution function analysis does not exhibit an observable structural distortion. However, an EXAFS analysis suggests that the Cr atoms are favorably bonded with Ni and Co in the solid solution alloys. This short-range order (SRO) may make an important contribution to the low values of the electrical and thermal conductivities of the Cr-alloyed solid solutions. In addition, an EXAFS analysis of Ni ion irradiated samples reveals that the degree of SRO in NiCoCr alloys is enhanced after irradiation.

Applications of geographic information systems (GIS) data and methods in obesity-related research

Geographic information systems (GIS) data/methods offer good promise for public health programs including obesity-related research. This study systematically examined their applications and identified gaps and limitations in current obesity-related research. A systematic search of PubMed for studies published before 20 May 2016, utilizing synonyms for GIS in combination with synonyms for obesity as search terms, identified 121 studies that met our inclusion criteria. We found primary applications of GIS data/methods in obesity-related research included (i) visualization of spatial distribution of obesity and obesity-related phenomena, and basic obesogenic environmental features, and (ii) construction of advanced obesogenic environmental indicators. We found high spatial heterogeneity in obesity prevalence/risk and obesogenic environmental factors. Also, study design and characteristics varied considerably across studies because of lack of established guidance and protocols in the field, which may also have contributed to the mixed findings about environmental impacts on obesity. Existing findings regarding built environment are more robust than those regarding food environment. Applications of GIS data/methods in obesity research are still limited, and related research faces many challenges. More and better GIS data and more friendly analysis methods are needed to expand future GIS applications in obesity-related research.

First case of hepatopancreatic necrosis disease in pond-reared Chinese mitten crab, Eriocheir sinensis, associated with microsporidian

An epidemic of hepatopancreatic necrosis disease (HPND) with a high mortality rate (40%-50%) recently occurred in the cultured Chinese mitten crab, Eriocheir sinensis, which is a very important economic crustacean species in China. Histology revealed infection by a microsporidian parasite within the cytoplasm of the epithelial cells of the hepatopancreas. Numerous discrete inclusions in the infected cells and presumably free parasite spores were also observed. By negative staining using electron microscopy, a typical morphology of spores was observed with a protuberant front of the anchoring disc. Infection was confined to the epithelial cells of the hepatopancreas, with no other organ implicated. By sequencing the PCR products using specific primers based on conserved regions of microsporidian small subunit (18S) ribosomal DNA, it was revealed that the parasite from HPND ponds had 99% sequence identity to that of Hepatospora eriocheir. Phylogentic analysis also placed the microsporidian in the same lineage as H. eriocheir. This study reported the first case of widespread infections of H. eriocheir associated with HPND found in the pond-reared Chinese mitten crab, E. sinensis. The description of microsporidian in this important commercial host is fundamental for future consideration of factors affecting stock health and sustainability.

[Prediction value of deceleration capacity of rate and GRACE risk score on major adverse cardiac events in patients with acute myocardial infarction]

OBJECTIVE

To investigate the prediction value of deceleration capacity of rate (DC) and GRACE risk score for cardiovascular events in AMI patients.

METHODS

Consecutive AMI patients with sinus rhythm hospitalized in our department during August 2012 to August 2013 were included in this prospective study. 24-hour ECG Holter monitoring was performed within 1 week, and the DC value was analyzed, GRACE risk score was acquired with the application of GRACE risk score calculator. Patients were followed up for more than 1 year and major adverse cardiac events (MACE) were obtained. Analysised the Kaplan Meier survival according to DC and GRACE score risk stratification respectively.

RESULTS

A total of 157 patients were enrolled in the study (average age: (58.9±12.7)years old). The average follow-up was (20.54±2.85) months. Mortality during follow-up was significantly higher in patients with DC>2.5 compared to patients with DC≤2.5 (P<0.01). In terms of early warning cardiac death, the area under ROC curve of DC risk stratification was 0.898 (95%CI 0.840-0.940, P<0.01), the sensitivity was 84.6%, and the specificity was 84.0%. The area under ROC curve of GRACE risk stratification was 0.786 (95%CI 0.714-0.847, P<0.01), the sensitivity was 84.6%, and the specificity was 74.3%. In terms of early warning cardiac adverse events, the ROC curve of DC was 0.747(95%CI 0.672-0.813, P<0.01), with the 90.0% sensitivity and 67.7% specificity. The GRACE risk stratification was 0.708 (95%CI 0.652-0.769, P<0.01), with the 63.3% sensitivity and 75.6% specificity. Subgroup analysis showed that mortality during follow-up was significantly higher in high risk patients than those with intermediate and low risk patients according to DC risk stratification in intermediate and low risk patients by GRACE risk stratification (P<0.01).

CONCLUSION

DC could predict cardiac death and MACE in patients with AMI. DC risk stratification is superior to GRACE risk score on outcome assessment in this AMI patient cohort.

Autologous hematopoietic stem cell transplantation in patients with end-stage liver disease: a 5-year follow-up study of 48 patients

OBJECTIVE

To investigate the long-term therapeutic effect of autologous hematopoietic stem cell transplantation in patients with End-stage Liver Disease (ESLD).

PATIENTS AND METHODS

Forty-eight ESLD patients underwent autologous CD34+ stem cell transplantation were retrospectively reviewed. Changes in clinical and biochemical data, complications, and quality of life were monitored at 3, 6, 12, 36, and 60 months following the stem cell transplantation. Liver biopsies were obtained for histopathological analysis using Ishak system.

RESULTS

Marked improvement in clinical and biochemical data was observed during the long-term follow-up. Serum albumin was significantly increased (p<0.001), while total serum bilirubin, prothrombin time (PT), and international normalized ratio (INR) were all significantly decreased (p<0.001). Ishak inflammation and fibrosis scores were significantly decreased with the increased time (p<0.001). The number of patients with ascites, model of end-stage liver disease (MELD) score, Child-Pugh class, and indocyanine green (ICG) score were all markedly reduced with increased time. Meanwhile, the quality of life score of the patients was significantly increased (p<0.001). Six patients died during the 5-years follow-up, and complications occurred in 17 patients. The incidence of complications was significantly associated with mortality of the patients (p<0.05).

CONCLUSIONS

The study provided the evidence that autologous CD34+ stem cell transplantation could offer a long-term therapeutic benefit to patients with ESLD. The complications occurred during the process was significantly associated with survival of the patients. Future studies on a large cohort of patients are needed to confirm the long-term effect of stem cell therapy on ESLD.

[Cross-sectional study of differential effects with age on non-invasive central hemodynamics and peripheral arterial stiffness of healthy people in Beijing communities]

OBJECTIVE

To observe the variation of central hemodynamics and peripheral arterial stiffness in different ages and to investigate the parameters of differential effects in younger individuals (≤60y) and older individuals (>60y).

METHODS

We conducted a population-based cross-sectional study in eight regions by random cluster sampling, from April to July 2014 in Beijing, China.Central hemodynamics and peripheral arterial stiffness parameters were determined in 861 healthy (372 male), normotensive individuals, aged 20 to 91(56±14) years.The main observed indexes were central systolic blood pressure (cSBP), arterial augmentation index (AI), augmentation pressure (AP), heart-ankle pulse wave velocity (haPWV) and brachial-ankle PWV (baPWV). Subjects were divided into six groups by 10 aged segment.Differences between groups and age tendency were observed.

RESULTS

The mean values of cSBP, AI, AP, haPWV and baPWV were (113±12) mmHg, (90±18)%, (-5±9) mmHg, (987±144) cm/s and (1 382±254) cm/s, respectively.cSBP, AI, AP, haPWV and baPWV increased with age (P<0.001). In average, cSBP, baPWV and haPWV increased 3 mmHg, 97 cm/s and 62 cm/s by additional 10 years, respectively.cSBP, AI and AP increased slowly after 60 years old, while haPWV and baPWV increased significantly with age (P<0.001). Stepwise regression analysis showed: cSBP was mainly relevant with mean arterial pressure(b=0.990, P<0.001), while baPWV and haPWV were relevant with age(b=8.858, 5.971; P<0.001). AI and AP were associated with height and rest heart rate (b=-0.676, -0.660 and b=-0.361, -0.341, P<0.001). Individuals were divided into two groups by age 60.The age-related changes in AI were significant in under 60-year-old; while the changes in baPWV were more prominent in over 60-year-old.However there was no significant difference in cSBP between two groups.

CONCLUSIONS

In healthy people, there are obvious differences of age tendency in central hemodynamics and peripheral arterial stiffness parameters.AI might be a good predictor of cardiovascular disease for early stage, especially for early coronary artery disease.

Role of IL-10 gene polymorphisms in the development of acute pancreatitis

Recent studies have suggested that chemokines contribute to the initiation and development of acute pancreatitis. We evaluated the relationship between IL-10 gene polymorphisms (-1082A/G and -819T/C) and development of acute pancreatitis in the Chinese population, in order to provide data for screening high-risk Chinese individuals. In total, 182 patients with confirmed cases of acute pancreatitis and 262 control subjects were recruited from the Shaanxi Provincial People's Hospital between April 2012 and December 2014. IL-10 gene polymorphisms at positions -1082A/G and -819T/C were examined using the polymerase chain reaction-restriction fragment length polymorphism method. Through multiple-logistic regression analysis, the GG genotype in IL-10 -1082A/G could influence the susceptibility to acute pancreatitis compared to the AA genotype, and the adjusted OR (95%CI) was 2.68 (1.34-5.39) (P = 0.002). Individuals who carried the AG+GG genotype of IL-10 -1082A/G were associated with greater risk for acute pancreatitis compared to the wide-type genotype, and the adjusted OR (95%CI) was 1.64 (1.09-2.46). However, no significant difference in susceptibility to acute pancreatitis was found between the IL-10 gene polymorphism at -819T/C. In conclusion, this study demonstrates that the IL-10 -1082A/G gene polymorphism contributes to the development of acute pancreatitis.

Lipid Accumulation Product: a Simple and Accurate Index for Predicting Metabolic Syndrome in Patients with Adult Growth Hormone Deficiency

PURPOSE

It has been demonstrated that metabolic risk factors were increased in adult growth hormone deficiency (AGHD) patients. Lipid accumulation product (LAP) is a novel biomarker of central lipid accumulation related to risk of metabolic syndrome (MS), diabetes and cardiovascular disease. The aim of this study was to investigate the ability of LAP to identify MS in AGHD Patients.

MATERIALS AND METHODS

In this cross-sectional study, 75 AGHD patients and 75 controls matched with age and gender were enrolled. The general anthropometries and blood biochemical indexes were measured. Body mass index(BMI), waist-hip ratio (WHR), LAP, HOMA-IR were calculated. Receiver operating characteristic (ROC) analysis was used to find out the cut-off points of LAP to predict MS.

RESULTS

Compared with control group, waist circumference (WC), WHR, Systolic blood pressure (SBP), Diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG) and LAP were increased in AGHD group, while high density lipoprotein cholesterol (HDL-c) level was lower in AGHD group (P<0.05). The prevalence of MS was 41.3% in AGHD patients. AGHD patients with MS had significantly higher LAP levels compared to those without MS. LAP was highly correlated with components of MS. ROC analysis showed that LAP was a significant discriminator for MS in AGHD patients, and the optimal cutoff point of LAP to predict MS was 44.96 (96.8% sensitivity, 86.4% specificity).

CONCLUSIONS

LAP was associated with MS and had a strong and reliable diagnostic accuracy for MS in AGHD patients.

[Establishment and evaluation of a prognostic model for acute pulmonary embolism]

OBJECTIVE

To identify the factors influencing the prognosis of patients with acute pulmonary embolism(PE) and to establish a prognostic model.

METHODS

The clinical data of 331 patients (141 males and 190 females, aged 9 to 87 years ) with acute PE in Fujian Hospital from January 2007 to September 2013 were analyzed. Univariate analysis and logistic regression analysis were used for selecting the independent prognostic factors for acute PE. Based on logistic regression analysis, a prognostic model for PE was established.

RESULTS

Univariate analysis showed that statistically significant (all P<0.05) factors influencing the prognosis of PE were diabetes, tricuspid systolic murmur, body temperature, respiratory rate, heart rate, aspartate aminotransferase, triglycerides, abnormal ECG, mechanical ventilation, circulatory failure during hospitalization, risk stratification of PE, types of treatment, and use of low-molecular-weight heparin and Warfarin. Logistic regression analysis showed that recent (<1 month) operation or fracture, tricuspid systolic murmur, high triglyceride level, circulatory failure during hospitalization and mechanical ventilation were independent factors for poor prognosis of PE, while combined use of low-molecular-weight heparin and Warfarin was a protective factor for the prognosis of PE. The Fisher prognostic model equation was y=0.144+ 1.266x1+ 0.869x2+ 1.794x3-0.517x4+ 3.555x5+ 0.661x6. The accuracy of the Fisher discriminant function was 93.0%.

CONCLUSION

Recent (<1 month) operation or fracture, tricuspid systolic murmur, high triglyceride level, shock during hospitalization and mechanical ventilation were signs of poor prognosis for PE, while combined use of low-molecular-weight heparin and Warfarin were beneficial for the prognosis. The discriminant function based on these data can be helpful for predicting the prognosis of patients with PE.

Direct visualization of the novel pathogen, Spiroplasma eriocheiris, in the freshwater crayfish Procambarus clarkii (Girard) using fluorescence in situ hybridization

Spiroplasma eriocheiris is the first spiroplasma strain known to be pathogenic to freshwater crustaceans. It has caused considerable economic losses both in the freshwater crayfish Procambarus clarkii (Girard) and in some other crustaceans. The monitoring of the pathogen in crustacean populations and study of its behaviour in the laboratory require the development of reliable diagnostic tools. In this article, we improved microscopic identification of S. eriocheiris by combining in situ hybridization with specific fluorescently labelled oligonucleotide probes. The established fluorescence in situ hybridization (FISH) allowed simultaneous visualization, identification and localization of S. eriocheiris in the tissues of diseased crayfish P. clarkii and exhibited low background autofluorescence and ideal signal-to-noise ratio. With the advantages of better tissue penetration, potentially more specific and stable, we designed three species-specific oligonucleotide probes utilizing the sequences of 16S-23S rRNA intergenic spacer regions (ISRs) of S. eriocheiris. Positive hybridization signals were visualized in haemocytes and connective tissues of hepatopancreas, cardiac muscle and gill from diseased crayfish. This unique distribution pattern matched the pathological changes when diagnosed by H&E staining and indicated that S. eriocheiris probably spread throughout the tissues in P. clarkii by hemokinesis. This assay will facilitate our understanding of the pathogenesis of S. eriocheiris and enhance the early diagnosis of the novel pathogen.

Analysis of prognostic risk factors in children with Epstein-Barr virus-associated hemophagocytic syndrome

AIM

This study aims to analyze the prognostic risk factors in children with Epstein-Barr virus-associated haemophagocytic lymphohistiocytosis (EBV-HLH).

METHODS

Seventy-four EBV-HLH patients were divided into two groups according to the specificity: clinical remission after four-week inductive therapy group and active disease group; death group and survival group. The risk factors that affect early efficacy and prognosis were analyzed.

RESULTS

Overall survival rate of the 74 children was 75.7%, while the recurrence rate was 13.5%. The one-year survival rate was 71.4±5.6%, and the three-year survival rate was 65.9±6.6%, with a median survival rate of 40±19.9 months. The multivariate logistic regression analysis showed that age was the primary risk factor that affected the first 4 weeks alleviation, and the severity of splenomegaly and WBC level upon hospitalization were the risk factors that affected the prognosis. Patients with spleen>4 cm had shorter survival time than those with spleen≤4 cm, and patients with WBC≥3×10(9)/L had longer survival time than those with WBC<3×10(9)/L, which exhibited significant differences.

CONCLUSION

Age negatively influences the early remission of EBV-HLH. WBC<3×10(9)/L and spleen>4 cm exhibited high correlation with the prognosis of EBV-HLH.

Risk stratification and prognostic value of GRACE and TIMI risk scores for female patients with non-ST segment elevation acute coronary syndrome

AIM

The aim of this paper was to investigate the value of Global Registry of Acute Coronary Events (GRACE) and thrombolysis in myocardial infarction (TIMI) risk scores for risk stratification and prognosis in female patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS).

METHODS

Non-elderly (<65 years) and elderly (≥65 years) female patients with NSTE-ACS (totally 869 cases) were enrolled in this study. The patients were further divided into low, intermediate and high-risk groups according to their GRACE and TIMI scores. Patients were followed up for 1 year to record the mortality and incidence of major adverse cardiac events (MACE). Differences in mortality and MACE incidence between the two scoring systems were compared by the area under the ROC curve.

RESULTS

The area under ROC curve (AUC) corresponding to the mortality and MACE incidence in any period by the GRACE scoring system was significantly larger than the TIMI scoring system in the elderly patients at 1 year of follow-up (AUC of mortality, 0.79 vs. 0.68; AUC of MACE, 0.78 vs. 0.72; P<0.05). Mortality and MACE incidence increased in parallel with the scores. Risk ratio values of Cox regression analysis based on GRACE and TIMI scores were greater than 1 (P<0.001).

CONCLUSION

Both GRACE and TIMI were adoptable in clinical risk stratification and prognosis of female patients with NSTE-ACS at different age groups. GRACE showed better accuracy than the TIMI scores.

Hydrogen sulfide improves the endothelial dysfunction in renovascular hypertensive rats

As a novel gasotransmitter, hydrogen sulfide (H(2)S) has vasodilating and antihypertensive effects in cardiovascular system. Thus, we hypothesized that H(2)S might have beneficial effects on thoracic endothelial function in two-kidney one-clip (2K1C) rats, a model of renovascular hypertension. Sodium hydrosulfide (NaHS, 56 micromol/kg/day) was administrated intra-peritoneally from the third day after the 2K1C operation. Along with the development of hypertension, the systolic blood pressure (SBP) was measured before the operation and each week thereafter. The oxidative stress was determined by measurement of malondialdehyde (MDA) concentration, superoxide dismutase (SOD) activity and protein expression of oxidative stress-related proteins (AT(1)R, NADPH oxidase subunits). Acetylcholine (ACh)-induced vasorelaxation and angiotensin II (Ang II)-induced vasocontraction were performed on isolated thoracic aorta. The SBP was significantly increased from the first week after operation, and was lowered by NaHS. NaHS supplementation ameliorated endothelial dysfunction. The protein expression of oxidative stress-related proteins were downregulated, while SOD activity upregulated. In conclusion, improvement of endothelial function is involved in the antihypertensive mechanism of H(2)S. The protective effect of H(2)S is attributable to suppression of vascular oxidative stress that involves inhibition of Ang II-AT(1)R action, downregulation of oxidases, as well as upregulation of antioxidant enzyme.

3-T diffusion tensor imaging (DTI) of normal uterus in young and middle-aged females during the menstrual cycle: evaluation of the cyclic changes of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values

OBJECTIVE

To evaluate cyclic changes of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of normal uterus in different age groups during the menstrual cycle, and the correlation with serum female hormone levels.

METHODS

29 normal volunteers accepted diffusion tensor imaging of the uterus on menstrual phase (MP), follicular phase (FP), ovulatory phase (OP) and luteal phase. FA and ADC values of different uterine layers on midsagittal images were measured. Differences between two age groups during the menstrual cycle were evaluated using liner mixed models and one-way analysis of variance. Pearson correlation analysis compared variation of FA and ADC values with serum female hormone levels measured in MP.

RESULTS

During menstrual cycle, endometrial FA values declined, whereas ADC values increased with significant differences (p < 0.05). Serum oestradiol (E) levels correlated moderately with variations of FA values between MP-FP (p = 0.045; r = 0.389) and MP-OP (p = 0.008; r = 0.511). FA and ADC values of junctional zones showed no significant difference (p > 0.05) as well as FA values of myometrium (p = 0.0961), while ADC values of myometrium showed significant increase from menstrual phase to luteal phase (p < 0.05). FA and ADC values of uterine three zonal structures showed significant differences (p < 0.05) at each phase during the menstrual cycle. No significant difference of FA and ADC values was found between age groups (p > 0.05).

CONCLUSION

Dynamic changes of uterine FA and ADC values were observed during menstrual cycle. Variation of FA values between MP-FP, MP-OP correlated moderately with serum E levels.

ADVANCES IN KNOWLEDGE

No publications on the relationship between FA and ADC values and the female hormone levels were found; our study prospectively investigated the cyclic changes of FA and ADC values of the normal uterus and the correlation with the basic serum female hormone levels in MP.