[Hemodynamic response in cirrhotic patients with transjugular intrahepatic portosystemic shunt]

Objective: To discuss the effects of transjugular intrahepatic portosystemic shunt (TIPS) procedure on hemodynamics in cirrhotic patients. Methods: A total of 23 cirrhotic patients for TIPS insertion were enrolled from January 2018 to October 2018. Serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), transthoracic echocardiography and non-invasive cardiac output measurement based on impedance cardiogram were carried out before and 24h, 1 month, 6 months after TIPS in order to observe cardiac function and hemodynamic changes after TIPS. Results: Significant increases in right atrial area [(17.2±4.0) cm(2) vs. (15.0±3.4) cm(2), P<0.05], right ventricular area [(15.1±3.8) cm(2) vs. (13.7±3.5) cm(2), P<0.05] and left ventricular volume [(97.4±21.5) ml vs. (91.1±22.7) ml, P<0.05] were observed 24 h after TIPS. These changes were accompanied with significant reduction in collapsible index of inferior vena cava [(20.7± 8.1)% vs. (28.6±11.3)%, P<0.01] and elevation in pulmonary arterial systolic pressure [(36.0±8.4) mmHg (1 mmHg=0.133 kPa) vs. (31.8±5.4) mmHg, P<0.01]. There also existed significantly elevated serum NT-proBNP [(551.2±325.1) ng/L vs. (124.2±94.4) ng/L, P<0.01], cardiac output [(5.82±0.96) L/min vs. (5.12±1.28) L/min, P<0.01], cardiac index [(3.47±0.64) L·min(-1)·m(-2) vs. (3.05±0.78) L·min(-1)·m(-2), P<0.01], early diastolic filling rate [(59.0±14.3)% vs. (54.5±11.0)%, P<0.05], and reduced systemic vascular resistance index (SVRi) [(1 798.4±357.3) dyne·s·cm(-5)·m(-2) vs. (2 195.7±508.7) dyne·s·cm(-5)·m(-2), P<0.01] 24 h after TIPS. At the end of 6-month follow-up, all these parameters, but not SVRi, returned towards baseline values. Moreover, peak early to late diastolic tissue velocity ratio at the level of lateral mitral annulus (E'/A') was significantly higher at the end of 6-month follow-up than that at baseline (1.06±0.32 vs. 0.90±0.45, P<0.05). Neither the right ventricular fractional area changes nor the left ventricular ejection fractions during the follow-up period were different from those at baseline (P>0.05). Conclusion: Cirrhotic patients who had no cardiovascular pathologies had adequate adaptation and good compensation ability to reach a new hemodynamic homeostasis for the increased volume load after TIPS insertion.

[National health information and its role in prevention and control of chronic diseases: framework design of person-centered and whole life recycle surveillance system for chronic diseases]

In the perspective of promoting the strategic goal of healthy China, this study reviewed the informatization process of disease prevention and control in China and clarified the important role of national health information in chronic disease information surveillance throughout the life cycle. Guided by goals, needs, and problems, it is proposed that when basic personal electronic health record (EHR) are not well-established, personal electronic disease record (EDR) could be established to support business collaboration. Driven by the construction of national health informatization, this study proposed the relationship between the national health and chronic disease prevention and control coverage and described the architecture design of an integrated and restructured national disease prevention and control information system and its life-cycle monitoring and information management model for chronic disease health events.

[Effects of two standards on the overweight trend of infants and toddlers in urban Shanghai]

Objective: To observe and compare the effects of two standards on the overweight trend in urban Shanghai infants and young children. Methods: A cluster randomized controlled trial was conducted in 19 communities in two districts of Shanghai, and the subjects (n=15 019) were divided into S-group and W-group by sealed envelope randomization. The subjects were newborns born between November 2013 and December 2014. The 2005 Shanghai growth standard was applied in the S-group and the 2006 WHO growth standard was used in the W-group. At each follow-up time point age of 1, 2, 4, 6, 9, 12 and 18 months, the outpatient physician assessed the length and weight of the infants according to the standard adopted by each group and provided feeding guidance. The weight-for-age Z scores (WAZ), length-for-age Z scores (LAZ) and weight-for-length Z scores (WLZ) were calculated according to the WHO standard. Weight, length, WAZ, LAZ, WLZ and overweight ratio (WLZ≥2) were compared between the two groups using t test, Wilcoxon test and χ(2) test. Results: A total of 6 509 infants (3 391 were boys, 3 118 were girls) were in the W-group, and 8 510 infants (4 374 were boys, 4 136 were girls) were in the S-group. Among the boys, the weight values at the age of 4, 6, 9, 12, 18 months in the W-group were all lower than those in the S-group ((7.5±0.8) vs. (7.7±0.8) kg, (8.6±0.8) vs. (8.7±0.8) kg, (9.6±0.9) vs. (9.7±0.9) kg, (10.4±1.0) vs. (10.5±1.0) kg, (11.5±1.1) vs.(11.7±1.1) kg; t=4.329, 2.422, 3.739, 2.451, 2.736; P<0.01, 0.015,<0.01, 0.014, 0.009). The length had no significant difference between two groups at all months of age(all P>0.05). The overweight ratio in the W-group was lower than that in the S-group at the age of 9, 12, 18 months(3.3% (71/2 170) vs. 4.9% (143/2 927), 2.5% (51/2 037) vs. 4.5% (126/2 818), 0.8% (7/832) vs. 3.1% (39/1 266); χ(2)=6.520, 14.209, 12.350; P=0.011,<0.01,<0.01).Among the girls, except at the age of 2 months (W-group (5.6±0.6) vs. S-group (5.7±0.6), t=2.935, P=0.003), weight values had no significant difference between the two groups at other age months (all P>0.05).The length in the W-group was higher than that in the S-group at 12 and 18 months of age ((75.6±2.4) vs.(75.5±2.3)cm, (82.4±2.9) vs.(82.2±2.7) cm; t=2.351, 2.197; P=0.019, 0.028). The ratio of overweight in the W-group was lower than that of S-group at the age of 12 and 18 months (1.8% (33/1 871) vs.3.0% (80/2 658), 0.6% (5/790) vs.1.7% (20/1 178); χ(2)=6.764,4.276; P=0.009, 0.039). Conclusions: The application of WHO growth standard can help to reduce the weight gain rate of boys, promote the linear growth of girls, and thus alleviate the overweight trend of infants within 18 months. It suggested that 2006 WHO growth standard should be applied to infants within 1 year of age in Shanghai.

[Study on direct economic burden and influencing factors in patients with cervical cancer and precancerous lesions]

Objective: To account the direct cost of uterine cervix carcinoma treatment in China and to explore the related factors which influence the direct financial burden of the disease. Methods: Data was collected through the medical record system and telephone interviews in 14 county-level hospitals and 9 provincial and municipal hospitals from 14 provinces/municipalities enrolled in the Chinese National Health Industry Research Project in 2015. The direct financial burden of uterine cervix carcinoma treatment consisted of the direct medical cost and the direct non-medical cost of treatment in different pathological cervical cancer stages and precancerous lesions. Multiple liner regression method was used to analyze the factors affecting the costs. Results: The age of the 3 246 patients was (46.40±10.43) years, including 2 423 patients from provincial and municipal hospitals and 823 patients from county-level hospitals. The direct financial burden for one patient of pathological uterine cervix carcinoma stage or precancerous lesion ranged from 10 156.3 yuan to 75 716.4 yuan in provincial and municipal hospitals, and for patients from county-level hospitals, the cost was between 4 927.9 yuan and 47 524.8 yuan per person. There was a wide gap between the direct financial burden of patients in different disease stages. The direct financial burden of patients with precancerous lesions ranged from 4 927.9 yuan per person to 11 243.0 yuan per person, as for patients of pathological uterine cervix carcinoma stages, the direct financial burden was between 29 274.6 yuan and 75 716.4 yuan per person. The factors which influence direct financial burden would include: the levels of the hospital, pathological period, medicare reimbursement, days of treatment, and the methods of treatment (P<0.001). Conclusion: The direct financial burden of diseases in patients with pathological uterine cervix carcinoma stage or precancerous lesion differed in different levels of hospital and pathological periods. In addition, medicare reimbursement, days of treatment, and the methods of treatment all had impact on it.

[Relationship between the Change Rules of Volatile Organic Compounds in Rat Muscle and Postmortem Interval]

OBJECTIVES

To explore the relationship between the change rules of volatile organic compounds （VOCs） in rat muscle and postmortem interval （PMI）.

METHODS

A total of 120 healthy rats were divided randomly into 12 groups （10 for each group）. After the rats were sacrificed by cervical dislocation, the bodies were kept at （25±1） ℃. Rat muscle samples were separately obtained at 12 PMI points, including 0, 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 d. The VOCs in rat muscles were collected, detected and analyzed by headspace solid-phase microextraction （HS-SPME） coupled to gas chromatography-mass spectrometer （GC-MS）.

RESULTS

In total, 15 species of VOCs were identified, including 9 aromatic compounds, 3 sulfur compounds, 2 aliphatic acids and 1 heterocyclic compound. The species of VOCs increased with PMI： no species were detected within 1 day, 3 species were detected on day 2, 9 on day 3, 11 on day 4, 14 from day 5 to 7, and 15 from day 8 to 10. Total peak area of 15 species of VOCs was significantly correlated to PMI （adjusted R²=0.15-0.96）： the regression function was y=-17.05 x²+ 164.36 x-246.36 （adjusted R²=0.96） from day 2 to 5, and y=2.24 x+101.13 （adjusted R²=0.97） from day 6 to 10.

CONCLUSIONS

The change rules of VOCs in rat muscle are helpful for PMI estimation.

[Big data analysis of flow of tuberculosis cases in China, 2014]

OBJECTIVE

To describe the flow of tuberculosis(TB)cases for medical care in China in 2014.

METHODS

The analysis and visualization of reported flow of TB cases were conducted with software R to indicate the case distribution/flow and the levels of hospital where TB cases sought medical care in different provinces.

RESULTS

In a province, the TB cases mainly flowed to the province capital, but the inter-provincial flow was mainly to neighbor provinces and from central or western provinces to eastern provinces(municipality), such as Beijing, Shanghai and Guangdong. The grade Ⅲ(A)hospitals were the choice of most TB cases seeking medical care in other provinces.

CONCLUSION

The epidemic situation of TB in China is still serious, and the flow of TB cases would facilitate the spread of the disease. It is necessary to strengthen the research on influence of TB case flow for seeking medical care on the spread of TB to provide evidence for better TB prevention and control.

Genistein-induced apoptosis is mediated by endoplasmic reticulum stress in cervical cancer cells

OBJECTIVE

Genistein, a major isoflavone found in soybeans, exhibits anti-cancer activity. Endoplasmic reticulum (ER) stress is known to be implicated in apoptosis induced by anti-cancer drugs. This study aimed to characterize the role of ER stress in genistein-induced apoptosis in cervical cancer.

MATERIALS AND METHODS

HeLa cells were treated with genistein or/and 4-phenylbutyric acid. Cell viability and apoptosis were evaluated by MTT assay and flow cytometry. Protein levels were detected by Western blot analysis.

RESULTS

Genistein suppressed the viability of HeLa cells in a dose dependent manner. In addition, genistein caused apoptosis in HeLa cells in a dose dependent manner. Genistein triggered ER stress in HeLa cells, as indicated by the upregulation of glucose-regulated protein 78 (GRP78) and CHOP expression. Furthermore, ER stress inhibitor 4-phenylbutyric acid alleviated genistein-induced apoptosis and ER stress in HeLa cells.

CONCLUSIONS

Our results suggest that ER stress contributes to genistein-induced apoptosis in cervical cancer cells, and genistein is a promising agent for cervical cancer therapy.

Association of BMP4 polymorphisms with isolated tooth agenesis in a Chinese Han population: a case-control study

OBJECTIVE

Tooth agenesis is a common craniofacial anomaly in human beings. Mounting evidence has demonstrated that the bone morphogenetic protein 4 gene (BMP4) plays an important role in tooth development. This case-control study was designed to evaluate the association of the polymorphism rs17563 in BMP4 gene with susceptibility of isolated human tooth agenesis in a Chinese Han population.

PATIENTS AND METHODS

335 tooth agenesis cases and 444 healthy controls were included in this study.

RESULTS

Although no significant association was observed either in the overall or stratified analysis between the types and the severity of missing teeth. However, significant difference was observed between the anterior and posterior tooth agenesis (APTA) cases and the controls (p = 0.018 for allele distribution and OR = 0.39, 95% CI = 0.15-0.99). Furthermore, the heterozygote (TC) and dominant model (CC+TC) were associated with decreased risk of APTA compared with the control (phet = 0.018, ORhet = 0.39, 95% CIhet = 0.15-0.99 and pdom = 0.042, ORdom = 0.34, 95% CIdom = 0.13-0.87, respectively).

CONCLUSIONS

These results indicated that rs17563 in BMP4 gene was potentially associated with APTA in Chinese Han population and further independent studies are required to verify these findings.

The inhibitory effect of extracts from Fructus lycii and Rhizoma polygonati on in vitro DNA breakage by alternariol

Alternariol caused DNA single-strand breakage. Conversion of the closed circular double-stranded supercoiled DNA (pBR 322) to the nicked circular form and linear form was used to investigate the effect of extracts of some Chinese medical herbs on DNA nicking induced by alternariol. Some substances in the extracts of Rhizoma polygonati (RP) and Fructus lycii (FL) were shown to protect DNA from the attack by alternariol. Some substance in the RP may bind to plasmid DNA, and this binding reduces the electrophoretic mobility of DNA. These results indicate that substances from FL and RP may be used as DNA protectors. It is possible that they play an important role in preventing cancer.

Sequence homologies between bovine papillomavirus genomes mapped by a novel low-stringency heteroduplex method

The bovine papillomaviruses (BPVs) types 1, 2, and 5 cause fibropapillomas whereas BPVs types 3, 4, and 6 cause true papillomas. A novel method of heteroduplex mapping at low stringency of hybridisation has identified the position and relative orientation of distantly related sequences in the genomes of these viruses. The genomes of BPV-1 and BPV-2 are closely related but both show a high degree of sequence divergence from the BPV-5 genome. A 1.25-kb sequence adjacent to the unique BamHI site of the BPV-5 genome hybridised to BPV-1 and to the equivalent region of BPV-2. The hybridising sequence in the BPV-1 genome mapped to the C-terminal region of the E1 open reading frame (ORF) and the N-terminal region of the E2 ORF. The BPV-3, BPV-4, and BPV-6 genomes show moderate homology to each other but minimal homology to the fibropapillomavirus genomes. Low-stringency heteroduplex mapping revealed that overlapping sequences in the BPV-1 E1 and L1 ORFs (or the equivalent regions in BPV-2) hybridised to sequences in BPV-3, BPV-4, and BPV-6. Hybrid regions were less than 1 kb long and were sometimes interrupted by short nonhybridising segments. The hybridising sequences in BPV-3 and BPV-4 are positioned in a way that parallels the spacing of the E1 and L1 ORFs in BPV-1. These data suggest that the bovine fibropapilloma viruses and true papilloma viruses share a similar genomic organization, but have undergone extensive sequence divergence.