Knockdown of CHPF suppresses cell progression of non-small-cell lung cancer

Purpose: The aim of the present study was to explore the role of CHPF in non-small-cell lung cancer (NSCLC) and to develop an shRNA vector-based therapy to repress the expression of CHPF gene in NSCLC cell lines.

Methods: In this study, we used immunohistochemical staining to verify the expression of CHPF in NSCLC tissue. Then, we determined the expression of CHPF gene in different NSCLC cell lines with RT-PCR and Western blotting. Specific CHPF shRNA was used to knockdown the expression of CHPF. Celigo image cytometry, cell cycle analysis, and flow cytometry assay were performed.

Results: The results showed that expression level of CHPF was higher in NSCLC tissues than normal lung tissues. Further, we established that CHPF expression knockdown in NSCLC cells could substantially restrain the cell proliferation, apoptosis, and cell cycle in vitro.

Conclusion: On the basis of these results, we concluded that CHPF expression has an important role in the progression of human NSCLC cells. Therefore, its interference could possibly be used as a potential therapeutic target against NSCLC.

[Expression and Clinical Significance of C/EBPα Gene in Elderly Multiple Myeloma]

OBJECTIVE

To investigate the expression of C/EBPα gene in elderly patients with multiple myeloma （MM） and its prognostic significance.

METHODS

Sixty-nine olderly patients with multiple myeloma (MM) treated in our hospital from February 2015 to October 2017 were selected and enrolled in the MM group, 38 healthy persons received physical examination were selected and enrolled in the control group. The bone marrow of 2 groups was collected and the mononuclear cells were isolated.The mRNA expression level of C/EBPα gene in mononuclear cells was determined by RT-PCR, the Western blot was used to detect the protin expression level of PBMNC C/EBPα, and the protein level of C/EBPα in bone marrow was detected by immunohistochemistry. The correlations of C/EBPα gene expression with the clinical characteristics and survival time in MM patients were analyzed.

RESULTS

The expression level of mRNA and protein of C/EBPα in MM patients was significantly lower than that in the control group (P<0.05). The expression level of C/EBPα gene significantly correlated with the ISS stage, CRP, Calcium, β2-MG, LDH and the percentage of myeloma cells in MM patients (P<0.05). The expression of C/EBPα gene was not correlate with sex, age, immunoglobulin typing, Hb in MM patients (P>0.05).Immunohistochemical staining showed that the bone marrow samples of the control group were stained more deeply, and the staining intensity in bone marrow samples of MM patients with CR, PR and relapse was successively descended. The protein level of C/EBPα in CR patients with MM was significantly higher than that in PR and relapsed patients by Western blot (P<0.05). Kaplan-Meier survival analysis showed that OS and DFS in the patients with high expression of C/EBPα gene were higher than those in low expression group (P<0.05). Multivariate Cox regression analysis showed that CRP,ratio of myeloma cells and C/EBPα gene were independent factors affecting OS and PFS (P<0.05).

CONCLUSION

The expression level of C/EBPα gene in MM patients is low that may stimulate the genesis of MM, and the expression of C/EBPα gene closely relates with the development of MM disease.

Diagnosis of Spinal Muscular Atrophy: A Simple Method for Quantifying the Relative Amount of Survival Motor Neuron Gene 1/2 Using Sanger DNA Sequencing

Background:

Spinal muscular atrophy (SMA) is caused by homozygous deletion or compound heterozygous mutation of survival motor neuron gene 1 (SMN1), which is the key to diagnose SMA. The study was to establish and evaluate a new diagnostic method for SMA.

Methods:

A total of 1494 children suspected with SMA were enrolled in this study. Traditional strategy, including multiplexed ligation-dependent probe amplification (MLPA) and TA cloning, was used in 1364 suspected SMA children from 2003 to 2014, and the 130 suspected SMA children were tested by a new strategy from 2015 to 2016, who were also verified by MLPA combined with TA cloning. The SMN1 and SMN2 were simultaneously amplified by polymerase chain reaction using the same primers. Mutation Surveyor software was used to detect and quantify the SMN1 variants by calculating allelic proportions in Sanger sequencing. Finally, turnaround time and cost of these two strategies were compared.

Results:

Among 1364 suspected SMA children, 576 children had SMN1 homozygous deletion and 27 children had SMN1 compound heterozygous mutation. Among the 130 cases, 59 had SMN1 homozygous deletion and 8 had heterozygous deletion: the SMN1-specific peak proportion on exon 7 was 34.6 ± 1.0% and 25.5 ± 0.5%, representing SMN1:SMN2 to be 1:2 and 1:3, respectively. Moreover, five variations, including p.Ser8Lysfs *23 (in two cases), p.Leu228*, p.Pro218Hisfs *26, p.Ser143Phefs*5, and p.Tyr276His, were detected in 6/8 cases with heterozygous deletion, the mutant allele proportion was 31.9%, 23.9%, 37.6%, 32.8%, 24.5%, and 23.6%, which was similar to that of the SMN1-specific site on exon 7, suggesting that those subtle mutations were located in SMN1. All these results were consistent with MLPA and TA cloning. The turnaround times of two strategies were 7.5 h and 266.5 h, respectively. Cost of a new strategy was only 28.5% of the traditional strategy.

Conclusion:

Sanger sequencing combined with Mutation Surveyor analysis has potential application in SMA diagnosis.

Borrelia miyamotoi Infections in Humans and Ticks, Northeastern China

We conducted an investigation of Borrelia miyamotoi infections in humans and ticks in northeastern China. Of 984 patients reporting recent tick bites, 14 (1.4%) were found to be infected with B. miyamotoi by PCR and genomic sequencing. The 14 patients had nonspecific febrile manifestations, including fever, headache, anorexia, asthenia, and arthralgia. Rash, eschar, and regional lymphadenopathy were each observed in 1 patient. Four (28.6%) patients were hospitalized because of severe disease. B. miyamotoi was detected in 3.0% (19/627) of Ixodes persulcatus, 1 (2.8%) of 36 Haemaphysalis concinna, and none of 29 Dermacentor silvarum ticks. Phylogenetic analyses based on sequences of a nearly entire 16s rRNA gene, a partial flagellin gene, and the glycerophosphodiester phosphodiesterase gene revealed that B. miyamotoi identified in patients and ticks were clustered in the group of the Siberian type. These findings indicate that B. miyamotoi is endemic in northeastern China and its public health significance deserves further investigation.

An asymmetric iminium ion catalysis-enabled cascade cycloaddition reaction of chromone-oxindole synthons with enals: construction of a spirooxindole–hexahydroxanthone framework

We report the first asymmetric iminium ion catalysis-enabled cascade cycloaddition reaction of bifunctional chromone-oxindole synthons and α,β-unsaturated aldehydes.

[Textual research on Дх.09319, a fragment of Dunhuang literature preserved in Russia]

Дх.09319, a fragment collected in the page 150 of Volume 14 of Dunhuang Literature Preserved in Russia, is damaged around the page, and only 6 lines of the text are remained. It is one of versions of San bu jiu hou lun (Treatise on Three Positions and Nine Indicators) in Su wen (Plain Questions), and different from another version of Dunhuang, Дх.00613+ P.3287. The two versions cannot be spliced together, but the former can supplement the texts of the latter. In addition, Дх.09319 is also significant to the collation of the missing popular version of San bu jiu hou lun of later generation.

[3D computed tomographic study of concha bullosa drainage pathway]

Objective:The aim of this study is to study the related structures with concha bullosa drainage passway in inpatients with concha bullosa disease. Method:A total of 90 patients with peritubular middle turbinate (144 sides) were examined by 16-slice spiral CT. The distribution of the middle turbinate and the distribution of the drainage channel were analyzed by three-dimensional reconstruction technique and image workstation software. Result:The distribution of the morphology and drainage channel of 144 concha bullosa have statistically significant (P<0.05). There are 3 types of bubble in the middle turbinate: extensive gasification, lamina gasification, and globular gasification. We found that the mainly type was extensive gasification and the drainage pathways to anterior ethmoid sinus were much more than posterior ethmoid sinus. Individual concha bullosas had double way drainages to ethmoid sinus. Conclusion:The three-dimensional reconstruction technique and image workstation software can be more precisely analyze anatomical characteristics of concha bullosa, and clarify the clinical diagnosis of the turbinate middle turbinate disease and strengthen endoscopic surgical techniques.

Genetic Diversity and the Spatio-Temporal Analyses of Hantaviruses in Shandong Province, China

Hemorrhagic fever with renal syndrome (HFRS) is a serious public health problem in Shandong Province, China. We conducted an epizootiologic investigation and phylogeographic and phylodynamic analyses to infer the phylogenetic relationships of hantaviruses in space and time, and gain further insights into their evolutionary dynamics in Shandong Province. Our data indicated that the Seoul virus (SEOV) is distributed throughout Shandong, whereas Hantaan virus (HTNV) co-circulates with SEOV in the eastern and southern areas of Shandong. Their distribution showed strong geographic clustering. In addition, our analyses indicated multiple evolutionary paths, long-distance transmission, and demographic expansion events for SEOV in some areas. Selection pressure analyses revealed that negative selection on hantaviruses acted as the principal evolutionary force, whereas a little evidence of positive selection exists. We found that several positively selected sites were located within major functional regions and indicated the importance of these residues for adaptive evolution of hantaviruses.

[Study of the association between interleukin-1 polymorphisms and genetic susceptibility of coal workers' pneumoconiosis and silicosis]

Objective: To evaluate the relationship between IL-1 gene polymorphisms and coal workers' pneumoconiosis and silicosis susceptibility. Methods: We searched published full-text from PubMed, Web of Science, CNKI, VIP and Wanfang to collect case-control study on IL-1 gene polymorphisms with coal workers' pneumoconiosis and silicosis susceptibility. Eight articles, including 10 case-control studies were included in our study. All analyses were performed using the Stata version 12.0 software. Results: The IL-1RA (+2018) TC or CC variant genotypes were associated with coal workers' pneumoconiosis and silicosis risk (OR=1.65, 95%CI: 1.11-2.46) . In further stratified analyses, the IL-1RA (+2018) TC or CC variant genotypes were associated with an increased silicosis risk (OR=2.07, 95%CI: 1.45-2.95) , which were also associated with increased coal workers' pneumoconiosis and silicosis risk in Caucasians (OR=1.74, 95%CI: 1.22-2.47) . No significant association between IL-1β (+3953) , IL-1β (-511) , IL-1α (+4845) and coal workers' pneumoconiosis and silicosis risk was found either in the overall study or in the stratified analysis. Conclusion: These findings suggested that IL-1RA (+2018) may modify coal workers' pneumoconiosis and silicosis susceptibility. Further replication studies with large sample sizes are warranted to re-evaluate the relationship between IL-1RA (+2018) and coal workers' pneumoconiosis and silicosis risk.

[Clinical features and diagnosis of childhood leukoencephalopathy with cerebral calcifications and cysts in four cases]

Objective: To investigate the clinical features and diagnostic bases of childhood leukoencephalopathy with cerebral calcifications and cysts (LCC). Methods: The clinical data involving manifestations and laboratory examinations of 4 children with LCC admitted to Beijing Children's Hospital Affiliated to Capital Medical University from 2012 to 2017 were retrospectively summarized. Each patient had a follow-up visit ranging from 4 months to 5 years and 9 months after initial examination. Results: Patients consisted of 2 males and 2 females, whose age of onset was respectively 2 years and 9 months, 6 years and 2 months, 7 years and 10 months, and 5 years and 1 month. The main clinical symptoms of these cases included headache, dizziness, partial seizure and claudication, and two of these cases had insidious onset. Cerebral calcifications and cysts with leukoencephalopathy were detected by neuroimaging in all patients. In addition, multifocal microhemorrhages and calcifications were observed by magnetic susceptibility-weighted imaging (SWI) series in 3 patients. Brain biopsy performed on 1 case disclosed a neuronal reduction in the cerebral cortex, loosening of focal white matter, multifocal lymphocyte infiltration, fresh hemorrhages, and gliosis, as well as angiomatous changes of blood vessels with hyalinized thicken-wall, stenotic or occlusive lumina and calcification deposits. The compound heterozygous mutations of n.*10G>A and n.82A>G in SNORD118 were identified in 1 case by target-capture next-generation sequencing. Sanger sequencing verified that the variant n.*10G>A was a novel mutation and it was of paternal-origin, while the variant n.82A>G was of maternal-origin, which had already been reported to be pathogenic to LCC. Follow-up study had shown continued partial seizure in 1 case and remissive claudication in another, while the remaining 2 cases had a relatively favorable outcome without obvious neurological symptoms at present time. Conclusions: The clinical manifestations of LCC are nonspecific, and the onset of the disease tends to be insidious. The triad neuroimaging findings of cerebral calcifications, cysts and leukoencephalopathy are essential to the diagnosis of the disease, and the signals of microhemorrhages revealed by SWI series provide another eloquent reference for the diagnosis. As biopsy is invasive and usually unavailable in the early stage, gene assessment, instead of pathological data, should be the gold standard in the diagnosis of LCC.

[Clinical characteristics of 13 neuroendocrine prostate cancer patients]

Objective: To explore the radiological, pathological features and clinical characteristics of neuroendocrine prostate cancer patients(NEPC). Methods: The clinical characteristics and pathology data of 13 neuroendocrine prostate cancer patients treated in the Affiliated Hospital of Tianjin Medical University from January 2004 to January 2015 were analyzed retrospectively. Results: Of all 13 patients, three cases were primally diagnosed small cell cancer, and 10 cases were translated to neuroendocrine type from adenocarcinoma after endocrine therapy. Frequent urination, urgency, nocturia, and dysuria were main symptoms. Serum prostate-specific antigen (PSA) was (14.5±3.2)μg/L; the volume of prostate was enlarged, mean volume, range 28-176(45±4)ml. The lesion was moderately low signal intensity in T(2)WI, while slightly higher signal in DWI. Signal characteristic of dynamic enhanced MRI was "fast in fast out" . The expression of Synaptophysin, Chromogranin A , CD56 and Ki-67 in NEPC were highly expressed by immunohistochemistry analysis. Among them, five patients accepted intravenous chemotherapy, two cases received external radiation therapy, three cases received cryoablation and three cases received palliative therapy. Median survival time in all 13 patients was 10 months, while median survival time in patients treated by chemotherapy was 16 months . Conclusion: NEPC is a highly aggressive subtype of prostate cancer characterized by rapid disease progression, lack of treatment and worse prognosis. Therefore, patients with NEPC may benefit from early diagnosis and comprehensive treatment with chemotherapy.

[Expert consensus on the diagnosis and treatment of cryptococcal meningitis]

Cryptococcal meningitis is a common and refractory central nervous system infection, with high rates of mortality and disability. The experts of the Society of Infectious Diseases of Chinese Medical Association have reached this consensus after a thorough discussion. Based on the current situation of cryptococcal meningitis in China, the management of cryptococcal meningitis includes 6 aspects: introduction, microorganism identification, clinical manifestations and diagnosis, principles of antifungal therapy, treatment of refractory and recurrent meningitis, treatment of intracranial hypertension. There is not a separate consensus on human immunodeficiency virus (HIV) infection in patients with cryptococcal meningitis. This article focuses on different antifungal regimens and reducing intracranial pressure by reference to Infectious Disease Society of America (IDSA) guidelines. The importance of early diagnosis, combined long-term antifungal therapy, control of intracranial hypertension are emphasized.

[Clinical and genetic characteristics of congenital myasthenia syndrome with episodic apnea caused by CHAT gene mutation: a report of 2 cases]

Objective: To investigate the clinical and genetic features of congenital myasthenia syndrome with episodic apnea (CMS-EA) caused by gene mutation of choline acetyltransferase (CHAT) Methods: The clinical data of 2 patients with congenital myasthenia syndrome were collected, and both were diagnosed from 2013 to 2015 in Beijing Children's Hospital, Capital Medical University. The clinical features and gene mutation characteristics were analyzed, and the patients were followed-up for therapeutic efficacy. Results: The two patients (case 1 and case 2) had the onset soon after birth and at 3 months after birth respectively. The two patients were admitted to the PICU due to dyspnea, cyanotic episodes that required intubation. The patients had repeated apnea and became ventilator dependent. Case 1 died due to refusal of any treatment. Case 2 had a tracheotomy, and gradually weaned from ventilator after using pyridostigmine. The hospitalization of case 2 lasted 162 days. Case 2 was followed up to the age of 3 years and 4 months, and was extubated and was maintained on oral neostigmine but still had fluctuating ptosis and minor physical and mental retardation. Both cases were negative for anti-AChR, anti-acetylcholinesterase, anti-MuSK antibodies. Neostigmine test was negative in case 1 and suspiciously positive in case 2. Low-frequency repetitive nerve stimulation testing of case 2 was negative. Cranial MRI scans of both cases showed brain atrophy-like change. Genetic testing showed compound heterozygous deletions (exon 4, 5, 6) and pathogenic variant c.914T>C (p.I305T) in CHAT in case 1, compound heterozygous variants c.1007T>C (p.I336T) and c.64C>T (p.Q22X) in CHAT in case 2. To our knowledge, compound heterozygous deletions (exon 4, 5, 6) and p.Q22X were novel, previously unreported variants. Conclusion: CMS-EA usually presents at birth or in the neonatal period with hypotonia, ptosis, dysphagia due to severe bulbar weakness, and respiratory insufficiency with cyanosis and apnea. Early treatment with pyridostigmine is helpful to the improvement of clinical symptoms and prognosis.

Superconducting ECR ion source: From 24-28 GHz SECRAL to 45 GHz fourth generation ECR

The development of superconducting ECR source with higher magnetic fields and higher microwave frequency is the most straight forward path to achieve higher beam intensity and higher charge state performance. SECRAL, a superconducting third generation ECR ion source, is designed for 24-28 GHz microwave frequency operation with an innovative magnet configuration of sextupole coils located outside the three solenoids. SECRAL at 24 GHz has already produced a number of record beam intensities, such as ⁴⁰Ar¹²⁺ 1.4 emA, ¹²⁹Xe²⁶⁺ 1.1 emA, ¹²⁹Xe³⁰⁺ 0.36 emA, and ²⁰⁹Bi³¹⁺ 0.68 emA. SECRAL-II, an upgraded version of SECRAL, was built successfully in less than 3 years and has recently been commissioned at full power of a 28 GHz gyrotron and three-frequency heating (28 + 45 + 18 GHz). New record beam intensities for highly charged ion production have been achieved, such as 620 eμA ⁴⁰Ar¹⁶⁺, 15 eμA ⁴⁰Ar¹⁸⁺, 146 eμA ⁸⁶Kr²⁸⁺, 0.5 eμA ⁸⁶Kr³³⁺, 53 eμA ¹²⁹Xe³⁸⁺, and 17 eμA ¹²⁹Xe⁴²⁺. Recent beam test results at SECRAL and SECRAL II have demonstrated that the production of more intense highly charged heavy ion beams needs higher microwave power and higher frequency, as the scaling law predicted. A 45 GHz superconducting ECR ion source FECR (a first fourth generation ECR ion source) is being built at IMP. FECR will be the world's first Nb₃Sn superconducting-magnet-based ECR ion source with 6.5 T axial mirror field, 3.5 T sextupole field on the plasma chamber inner wall, and 20 kW at a 45 GHz microwave coupling system. This paper will focus on SECRAL performance studies at 24-28 GHz and technical design of 45 GHz FECR, which demonstrates a technical path for highly charged ion beam production from 24 to 28 GHz SECRAL to 45 GHz FECR.

[A preliminary research on the exosome influenced by virus infection in the renal transplantation recipients]

Objective: Virus infection is a common complication of transplantation.With the research and application of exosome is becoming more popular, this study focused on whether the virus particles and nucleic acids exist in the exosomes extracted from the plasma of recipients with virus infection after renal transplantation. Methods: A total of 10 independent transplantation recipients at Institute of Organ Transplantation, 309th Hospital of Chinese People's Liberation Army from January 2015 to July 2017 were studied in this study.5 cases of positive or suspected positive in granulocytes HCMV pp65 antigen detection and positive in plasma HCMV DNA test, and the other 5 cases of positive results in plasma BK DNA test were adopted.Exosomes were extracted from the collected plasma samples with SBI kit.Electron microscopy and nanoparticles tracing analyzer (NTA) were used for exosome analysis.Quantitative real-time PCR method was used to inspect and compare virus DNA copies number in plasma, exosome and effluent. Results: Typical exosome-like vesicle structure was observed.NTA put forward the sample concentration data from 1.2 to 4.5×10(12) particles/ml, and the particle diameters were 30-200 nm.In the qRT-PCR assays, the viral DNA quantitative results of exosome samples are lower but on the same magnitude compared with that of the plasma, and sharply decreased in effluent. Conclusions: Virus DNAs in exosome samples of recipients with viral infection after transplantation were detected in great quantities.This not only hints the spread of the virus may take advantage of the biological formation process of exosomes, but also warns that the limitation of the existing way to extract exosmes from virus infected population may be a bottleneck in research.

[Anatomy research of cervical laminoplasty with preservation of the posterior ligament complex.]

Objective: To evaluate the feasibility of cervical laminoplasty with preservation of the posterior ligament complex for enlarging the spinal canal. Methods: Six up-to-standard human corpse specimens were divided into two groups by simple randomization (start from C4 group, S4; start from C5 group, S5; 3 corpses in each group). Decompression operation of C3-C6 level was performed in a predetermined sequence by using the new procedure with preservation of the posterior ligament complex.The basic depth of spinal canal was measured with a depth gauge at fixed point after the right bone groove of single level was completed.The operation of the contralateral bone groove was continued, and then the spinal canal was measured again when the spinous process was pulled backward by using a tissue forceps until the ligament complex was just tight.Retreat value (RV) of vertebral lamina was obtained by calculating the difference between the two measurements.The earlier measured levels needed to be remeasured when the operation area increased by one level. Two independent sample and one-sample t test were used to analyze the measurement results. Results: RV of vertebral lamina was small after finishing the first level of the decompression operation [S4: (0.87±0.72) mm; S5: (1.83±0.29) mm], and the value reached its maximum after the completion of C3-C6 level.The overall average RVmaxs from C3 to C6 level were (2.37±0.52) mm, (4.27±0.78) mm, (3.73±0.93) mm and (2.16±0.77) mm, respectively.The overall average retreat rates (RR) were 17%±7%, 32%±9%, 29%±10% and 16%±6%, respectively. The overall average RVmax of C4 and C5 level reached or exceeded the decompression threshold value of 4 mm (t=0.839, -0.703, both P>0.05). The average RVmax of C4/C5 level was similar in the two groups (t=-1.204, 1.189, both P>0.05); however, the difference of average RVmax between C3 and C6 level was significant (t=-4.429, 4.196, both P<0.05). Conclusions: Cervical laminoplasty with preservation of the posterior ligament complex can enlarge the sagittal diameter of spinal canal and relieve the compression of spinal cord.In addition, RV of each level increases as the number of the operation level increases, and the ability of vertebral lamina to retreat is quite different from C3 to C6 level.The decompression effect in the middle of the operation area is better than that on the cranial and tail side.

[The potential use of serum HBV RNA to guide the functional cure of chronic hepatitis B]

Hepatitis B virus (HBV) covalently closed circular DNA (cccDNA) in infected hepatocytes is the main cause of off-therapy viral rebound. The half-life of cccDNA is only 33-50 days, so the conversion of newly synthesized rcDNA to cccDNA in the nucleus is essential for the maintenance of cccDNA pool in infected hepatocytes. Though not directly targeting the existing cccDNA, current nucleos(t)ide analogues (NAs) may exhaust the cccDNA reservoir by blocking the rcDNA formation. Indeed, a prolonged consolidation therapy post loss of serum HBV DNA can achieve sustained remission and thus safe drug discontinuation in a small proportion of chronic hepatitis B (CHB) patients. In recent studies, we and others have demonstrated that it is the serum HBV RNA that reflects the cccDNA activity in infected hepatocytes, particularly among the patients on NAs. Here we suggest that instead of measuring serum HBV DNA only, simultaneous measurement of both viral DNA and RNA would improve the accuracy to reflect the cccDNA activity; therefore, the virological response should be redefined as consistent loss (less than the lower limit of detection) of both serum HBV DNA and RNA, which indicates the safety of drug discontinuation. Accumulating evidence has suggested that for the CHB patients with lower serum HBsAg, switch-to or add-on pegylated interferon (Peg-IFN) treatment would result in loss of serum HBsAg in a relatively large proportion of CHB patients. Since serum HBV RNA is an ideal biomarker to reflect the intrahepatic cccDNA activity, for the patients with a serum HBsAg level lower than 1 500 IU/ml after long-term NAs treatment, the serum HBV RNA should be measured. If serum HBV RNA is detected, peg-IFN should be added on; if serum HBV RNA is not detected, NAs treatment should be switched to peg-IFN treatment. We believe the therapy based on serum HBV RNA would make the functional cure of CHB (serum HBsAg loss or even conversion to anti-HBs) more efficient.

[Clinical and genetic characteristics of children with Leigh syndrome]

Objective: To investigate the clinically and genetic characteristics of children with Leigh syndrome. Method: Patients with clinically diagnosed Leigh syndrome(LS)in the department of Neurology, Beijing Children's Hospital from January 2013 to February 2016 underwent the mitochondrial DNA (mtDNA) and nuclear DNA (nDNA) detecting with next generation sequencing (NGS) technology. The clinical data of gene confirmed cases were retrospectively collected and analyzed. The differences in the onset age, clinical manifestations, lactic acid level and MRI results between the mtDNA variation and nDNA variation were compared and analyzed.t test, Chi-square test and Fisher's exact test were used for statistical analysis. Result: Thirty-five cases were diagnosed by gene detection, including 20 males and 15 females. The median onset age was 1 year (ranging from the neonatal period to 4.4 years old). The age of onset within 2 years accounted for 74%(26 cases). The onset age of initial symptoms, including developmental delay, developmental regression, and seizures, were 6 (4, 12) months, 12 (8, 14) months, and 6 (1, 23) months respectively. The onset age of ptosis, extrapyramidal symptoms and ataxia were 26 (18, 44) months, 28 (23, 40) months and 28 (19, 35) months, respectively. There were significant differences in the onset age between the three groups (H=21.919, P=0.01). Within the 35 cases, 29 were manifested with developmental delay (83%), 26 with dystonia (74%), 18 with growth retardation, 15 with myasthenia, 13 with developmental regression, 11 with dysphagia, 10 with feeding difficulties, 4 with skeletal dysplasia, and 2 with digestive tract symptoms; nystagmus and respiratory abnormalities were observed in 9 cases respectively; extrapyramidal symptoms, peripheral nerve injury, ptosis, seizures were observed in 8 cases respectively; and ataxia, ophthalmoplegia and hypertrichiasis were found in 5 cases respectively.The blood lactic acid was measured in 32 LS patients, within which 23 cases (72%) had increased results; 8 out of 11 cases who underwent were cerebrospinal fluid lactic acid test had increased results. The results of neuroimaging revealed that all the patients were involved in the brainstem and (or) basal ganglia, of whom 27 (77%) had brainstem involvement, 24 (69%) had basal ganglia involvement. Thirteen out of 14 patients who had medulla oblongata involvement had nDNA variation; while 7 out of 8 patients with cerebellar involvement had nDNA variation. Genetic etiology was confirmed in all patients, among whom there were 17 cases (49%) with mtDNA mutation, including 8993T>C/G (n=5), 14487T>C (n=4), 13513G>A (n=2), 9176T>C, 10158T>C, 3697G>A, 10191T>C, 14459A>G and 11777C>A (n=1) respectively. Remaining 18 cases(51%) had nDNA mutation, including SURF1 gene(n=10), PDHA1 gene(n=3) and one case each of NDUFV1, NDUFAF6, NDUFAF5, NDUFS1 and COQ7 genes. In this study, 27 types of mutations were founded, 15 of which had not been previously reported. Respiratory chain gene mutations have been found in 31 cases(89%); 3 cases had PDHc gene mutations, and 1 case had other mutation. Conclusion: LS usually occurs in infants. The most common primary symptoms are age-dependent abnormal movements, ocular symptoms, and seizures. Respiratory chain defects is the most common causes of LS.SURF1 is the most common variation, followed by 8993T>C/G, 14487 T>C and 13513G>A mutation.

[Risk factors for congenital heart disease in Chinese neonates: a Meta analysis]

OBJECTIVE

To investigate the major risk factors for congenital heart disease (CHD) in Chinese neonates and to provide a reference for the prevention of CHD.

METHODS

A literature search was performed to collect the case-control studies on the risk factors for CHD in Chinese neonates published in 2001-2016. The relevant data were extracted accordingly. The quality of included studies was assessed by Newcastle-Ottawa Scale. Sensitivity analysis was conducted using different models to analyze the same data. The publication bias was assessed by Egger's test.

RESULTS

A total of 17 case-control studies involving 2 930 cases and 4 952 controls were included. The Meta analysis showed that the major risk factors for CHD in Chinese neonates were as follows: mother with advanced age (OR=2.649, 95%CI: 1.675-4.189), cold or fever (OR=4.558, 95%CI: 2.901-7.162), medication use in early pregnancy (OR=3.961, 95%CI: 2.816-5.573), passive smoking (OR=2.766, 95%CI: 1.982-3.859), abnormal childbearing history (OR=2.992, 95%CI: 1.529-5.856), noise exposure (OR=3.030, 95%CI: 1.476-6.217), radiation exposure (OR=2.363, 95%CI: 1.212-4.607), decoration (OR=4.979, 95%CI: 3.240-7.653), gestational diabetes (OR=5.090, 95%CI: 3.132-8.274), and pet raising (OR=2.048, 95%CI: 1.385-3.029).

CONCLUSIONS

Mothers with advanced age, cold or fever, medication use in early pregnancy, passive smoking, abnormal childbearing history, noise exposure, radiation exposure, decoration, gestational diabetes, and pet raising may increase the risk of CHD in Chinese neonates.

[Risk factors for congenital heart disease in Chinese neonates: a Meta analysis]

OBJECTIVE

To investigate the major risk factors for congenital heart disease (CHD) in Chinese neonates and to provide a reference for the prevention of CHD.

METHODS

A literature search was performed to collect the case-control studies on the risk factors for CHD in Chinese neonates published in 2001-2016. The relevant data were extracted accordingly. The quality of included studies was assessed by Newcastle-Ottawa Scale. Sensitivity analysis was conducted using different models to analyze the same data. The publication bias was assessed by Egger's test.

RESULTS

A total of 17 case-control studies involving 2 930 cases and 4 952 controls were included. The Meta analysis showed that the major risk factors for CHD in Chinese neonates were as follows: mother with advanced age (OR=2.649, 95%CI: 1.675-4.189), cold or fever (OR=4.558, 95%CI: 2.901-7.162), medication use in early pregnancy (OR=3.961, 95%CI: 2.816-5.573), passive smoking (OR=2.766, 95%CI: 1.982-3.859), abnormal childbearing history (OR=2.992, 95%CI: 1.529-5.856), noise exposure (OR=3.030, 95%CI: 1.476-6.217), radiation exposure (OR=2.363, 95%CI: 1.212-4.607), decoration (OR=4.979, 95%CI: 3.240-7.653), gestational diabetes (OR=5.090, 95%CI: 3.132-8.274), and pet raising (OR=2.048, 95%CI: 1.385-3.029).

CONCLUSIONS

Mothers with advanced age, cold or fever, medication use in early pregnancy, passive smoking, abnormal childbearing history, noise exposure, radiation exposure, decoration, gestational diabetes, and pet raising may increase the risk of CHD in Chinese neonates.

[Changes in genotype prevalence of human papillomavirus over 10-year follow-up of a cervical cancer screening cohort]

Objective: To evaluate the dynamic variation of genotypes distribution of human papillomavirus (HPV) over 10-year follow-up in a cervical cancer screening cohort. Methods: Based on the Shanxi Province Cervical Cancer Screening Study Ⅰ cohort, we detected HPV genotypes on the well-preserved exfoliated cervical cells from women who were tested HPV positive from year 2005 to year 2014 using reverse linear probe hybridization assay. The changes of prevalence of type-specific HPV over time among the overall population were estimated using linear mixed models. The association between the type-specific HPV and cervical intraepithelial neoplasia grade 2 or worse (CIN2 +) was calculated by linear Chi-square test. Finally, the trends of multiple infections of HPV with the increase of the age were analyzed. Results: During the cervical cancer screening of the overall population from 2005 to 2014, the most common genotypes among the population were HPV16 and 52. The prevalence of HPV16 decreased over time from 4.6% in 2005 to 2.2% in 2010 and 2014 (F=8.125, P<0.001). The prevalence of HPV52 remained pretty stable and HPV33, 51 and 58 slightly decreased then apparently increased. Further stratification analysis by pathological lesions showed the same trend of the HPV prevalence for the histology normal women with the overall population. Of note, for those women with the cervical intraepithelial neoplasia (CIN2 +), the detection rate of HPV16 decreased from 65.22% in 2005 to 41.03% in 2010 and finally to 31.58% in 2014 (χ(2)=4.420, P=0.036) and that of HPV33 substantially increased. No significant variation was found for other types of HPV. Multiple infection rate varied with the growing age of the women. Conclusions: The genotypes prevalence of HPV tended to vary over time during cervical cancer screening in the context of regular screening combining with immediate treatment for those CIN2 + women. HPV16 prevalence significantly decreased over time, which indicated that the variation of type-specific HPV prevalence should be considered when regular cervical cancer screening was organized using HPV technique.