Systemic risk factors correlated with hyperhomocysteinemia for specific MTHFR C677T genotypes and sex in the Chinese population

Evaluation of acquired and hereditary risk factors for the development of thromboembolism in patients with systemic lupus erythematosus

Although the contribution of antiphospholipid antibodies (aPL) to thrombolembolism in systemic lupus erythematosus (SLE) is well known, there is not enough data on the contribution of various hereditary thrombophilic factors. In this study, we aimed to determine acquired and hereditary thrombophilic factors in adult patients with SLE. A total of 93 SLE patients (87 women and 6 men) were included. Data on clinical, demographic and laboratory characteristics, and disease activity scores (SLEDAI) of the patients were evaluated. The patients were analyzed with a screen, including lupus anticoagulant, anticardiolipin antibodies (aCL), antithrombin III, protein C, protein S, and homocysteine levels; factor V Leiden ( FVL ), methylenetetrahydrofolate reductase ( MTHFR ) and prothrombin G20210A gene mutations. A total of 23 thromboembolic events were reported in 17 (18.3%) of the patients. The frequency of pregnancy complications and SLEDAI scores were significantly higher in SLE patients who had a thromboembolism event ( P  < 0.05). Thromboembolism was detected in 12 (32.4%) of 37 patients with positive aPL antibody and 5 (8.9%) of 56 patients with negative aPL antibody ( P  = 0.006). In addition, thromboembolism developed in 11 (32.3%) of 34 lupus anticoagulant-positive patients and 6 (10.1%) of 59 lupus anticoagulant-negative patients ( P  = 0.012). Moreover, protein C levels were significantly lower in patients who developed thromboembolism ( P  < 0.05). Patients with and without thromboembolism were similar in terms of genetic thrombophilia factors ( MTHFR A1298C, MTHFR C677T, FVL and Prothrombin G20210A ) ( P  > 0.05). In conclusion, in the current study, some acquired (aPL, lupus anticoagulant and cCL IGG) and hereditary (protein C deficiency) thrombophilic factors were shown to be associated with the development of thrombosis in SLE patients. However, the effect of other hereditary factors on the development of thromboembolism could not be demonstrated. According to the data of this study, genetic screening seems inappropriate in terms of the risk of thromboembolism in patients with SLE.

Lactobacillus treatment as adjuvant for geographic tongue and fissured tongue with gastritis: case report

Background

Geographic tongue and fissured tongue are both common oral mucous membrane diseases relatively. The treatment of this disease is typically causative therapy because of the unknown etiology, and other afflictions. Gastrointestinal disease is one of the factors that induce geographic tongue with a fissured tongue. As an adjuvant drug that can inhibit the growth of Helicobacter pylori, the most common pathogen of chronic gastritis, Lactobacillus is widely used in clinic. However, there are seldom studies about Lactobacillus used in the treatment of geographic tongue and fissured tongue. Therefore, this case we used typically causative therapy with Lactobacillus as adjuvant to treat patient with a geographic tongue and fissured tongue with gastrointestinal disease and explore the effectiveness for further application.

Case Description

A 33-year-old female patient presented with a geographic tongue and fissured tongue with dysgeusia. At the first visit, there were smooth red lesions on the back of the tongue with the hyperplasia of the surrounding filiform papilla. The cracks in the middle of the tongue had a crack of about 2.5 cm long and 0.8 cm deep, and 5-6 light cracks on the tip of the tongue. The patient reported a history of chronic gastritis for 1 year, often with soft stool and gastroesophageal reflux disease. We administered drug treatment, including sodium bicarbonate tablets, Kangfuxin solution, compound chlorhexidine solution, and stomatitis spray. In addition, we suggested the patient use a yogurt machine to make and drink fresh yogurt with Lactobacillus as adjuvant everyday day and suggested a daily regimen of a light diet with no stimulating food, regular work, and sufficient rest. Ten days after the first visit, the symptoms were obviously alleviated. Twenty days after the initial diagnosis, the geographic tongue lesions had disappeared and the cracks had basically healed. The patient reported that the gastric symptoms had improved, and there was no soft stool or stomach discomfort.

Conclusions

This study used Lactobacillus as the adjuvant with typically causative therapy in the treatment of geographic tongue and fissured tongue.

Distribution and Determinants of Plasma Homocysteine Levels in a Preconception Population: A Retrospective Single-Center Study

BACKGROUND Raised plasma homocysteine (Hcy) levels have been associated with various diseases and pregnancy complications. Preconception is the primary prevention period to prevent birth defects. This retrospective study aimed to investigate the distribution of plasma Hcy levels among men and women at preconception and further evaluate the factors influencing plasma Hcy levels in a Southern China population. MATERIAL AND METHODS Sex, age, serum folate levels, plasma Hcy levels, and the time of Hcy and folate detection were obtained by medical records. Univariate analysis and multi-factor mixed virtual linear regression were used to explore the distribution and determinants of plasma Hcy levels. RESULTS A total of 3031 participants (1091 men [35.99%] and 1940 women [64.01%]) were included. The average levels of Hcy and the rates of hyperhomocysteinemia (HHcy) in men were higher than those in women (P<0.05). Hcy levels were observed to be lowest during autumn and highest during winter (P<0.05). In the normal Hcy (NHcy) group, serum folate levels were higher than in the HHcy group (P<0.05). Regression analysis suggested that sex, season, and serum folate levels had an effect on Hcy levels, but age was not an influencing factor of Hcy level in the preconception population. CONCLUSIONS This retrospective study showed that Hcy levels are higher in men and in the winter season. Sex, season, and serum folate levels were the influencing factors of Hcy in the preconception population.