Association between trajectories of systolic blood pressure and frailty outcome in middle-aged and older adults

OBJECTIVES

The association between blood pressure and frailty outcome in the middle-aged and older population remains controversial. This study aimed to examine the relationship between trajectories of systolic blood pressure (SBP) and new-onset frailty.

DESIGN

Cohort study with a 7-year follow-up.

SETTING AND PARTICIPANTS

Data were derived from 4 waves (2011, 2013, 2015 and 2018) of the China Health and Retirement Longitudinal Study and 6168 participants aged ≥45 years were included in the study.

METHODS

The frailty index (FI) was constructed based on 40 scored items, with FI ≥ 0.25 defined as frailty. We identified the 5-year trajectory of SBP by latent class trajectory modeling. The association between SBP trajectories and frailty was explored based on hazard ratios (HR) by four Cox proportional hazards models. Furthermore, we also investigated the relationship between mean SBP and systolic blood pressure variability (SBPV) and frailty.

RESULTS

6168 participants were included in this study with a mean age of 59 years. We identified five trajectories based on SBP, which are maintained low-stable SBP (T0), moderate-stable SBP (T1), remitting then increasing SBP (T2), increasing then remitting SBP (T3), and remaining stable at high SBP levels (T4). During the 7-year follow-up period, frailty outcome occurred in 1415 participants. After adjusting for other confounders, the two trajectories labeled "T2" and "T4" were associated with a higher risk of frailty compared with T0. In addition, elevated SBP and increased SBPV were associated with risk of frailty.

CONCLUSIONS

Higher risk of frailty occurred in two trajectories, remitting then increasing and remaining stable at high SBP levels, were associated with a relatively higher risk of frailty.

Genetic deletion or pharmacological inhibition of soluble epoxide hydrolase attenuated particulate matter 2.5 exposure mediated lung injury

Air pollution represented by particulate matter 2.5 (PM2.5) is closely related to diseases of the respiratory system. Although the understanding of its mechanism is limited, pulmonary inflammation is closely correlated with PM2.5-mediated lung injury. Soluble epoxide hydrolase (sEH) and epoxy fatty acids play a vital role in the inflammation. Herein, we attempted to use the metabolomics of oxidized lipids for analyzing the relationship of oxylipins with lung injury in a PM2.5-mediated mouse model, and found that the cytochrome P450 oxidases/sEH mediated metabolic pathway was involved in lung injury. Furthermore, the sEH overexpression was revealed in lung injury mice. Interestingly, sEH genetic deletion or the selective sEH inhibitor TPPU increased levels of epoxyeicosatrienoic acids (EETs) in lung injury mice, and inactivated pulmonary macrophages based on the MAPK/NF-κB pathway, resulting in protection against PM2.5-mediated lung injury. Additionally, a natural sEH inhibitor luteolin from Inula japonica displayed a pulmonary protective effect towards lung injury mediated by PM2.5 as well. Our results are consistent with the sEH message and protein being both a marker and mechanism for PM2.5-induced inflammation, which suggest its potential as a pharmaceutical target for treating diseases of the respiratory system.

[Effects of slope position and aspect on structure and species diversity of shrub community in the Jiajin Mountains, Sichuan Province, China]

We examined the impacts of slope direction and position on the community structure and species diversity of shrub community in Jiajin Mountains. The results showed that a total of 186 vascular plant species belonging to 50 families and 127 genera were recorded in the 24 sample plots. 32 species belonging to 14 families, 22 genera were recorded in the shrubs layer, with most species distributed at lower position of the shady slope. 154 species belonging to 43 families and 109 genera were recorded in the herbaceous layer, with the species number being the lowest on the shady slope. The average height of the shrub layer showed a decreasing order of sunny slope, semi-sunny slope, and shady slope, while an opposite order was observed for the average density. The average height of the herb layer was in the decreasing order of the shady slope, semi-sunny slope, sunny slope, whereas no significant changes were observed for the average density. The slope position had significant effect only on the average height of the herbaceous layer on the sunny slope. The overall level of species diversity in the shrub layer on the shady slope was relatively high, while that in the herbaceous layer was relatively high at the lower position of the sunny slope and at the middle position of the shady slope. Slope aspect had significant effect on species richness index, Shannon diversity index, Simpson dominance index, Pielou evenness index of shrub and herb layers except for Simpson index of herb layer. Slope position did not affect these indices. The interaction effect of slope aspect and position on the diversity index for herb layer was greater than that for the shrub layer. Results from redundancy analysis showed that species diversity was related to sin(aspect), cos(aspect), and community structure.

[Molecular epidemiology of norovirus associated with pediatric acute gastroenteritis in Beijing in 2020]

Objective: To investigate the molecular epidemiology of norovirus associated with pediatric acute gastroenteritis in Beijing under the Working Mechanism for Joint Prevention and Control of the Epidemic in 2020. Methods: This was a retrospective, repeated cross-sectional study. Fecal or vomit samples (1 213 cases) were collected from children visited the Capital Institute of Pediatrics Affiliated Children's Hospital for acute gastroenteritis from January 1 to December 31, 2020. First, real-time reverse PCR (RT-PCR) was used to screen the samples for norovirus, and then RdRp gene and capsid gene VP1 of norovirus-positive samples were amplified by conventional RT-PCR for genotyping based on the nucleotide sequence. The χ² test was used to compare the positive rates and genotypes of norovirus among different specimen types, genders of children, and different age groups. Results: Among the 1 213 samples were collected, 215 samples were positive for norovirus, with a positivity rate of 17.7% for the whole year. The peak of norovirus infection observed mainly in the cold seasons, as the positive rates were 28.6% (18/63), 26.2% (16/61), 22.8% (77/338) and 17.1% (89/520) in January, October, November and December, respectively. The positive rate of norovirus in fecal sample was significantly higher than that in vomit sample (χ² = 9.692, P<0.01). There was no significant difference between genders (χ²=0.041, P>0.05), but significant difference was found between age groups with the highest rate in the 6-48 months group (χ²=103.112, P<0.01). Three genogroups (GⅠ, GⅡ and GⅨ) of the circulating virus were detected by G-gene typing, and GⅡgenogroup was predominant, accounting for 98.5% (196/199). Among the GⅡ positive samples, genotype GⅡ.4 Sydney (55.1%, 108/196) was the most common, followed by GⅡ.2 (29.6%, 58/196), while the GⅡ.3 norovirus (10.2%, 20/196) which was common in previous years was not as much as before. Based on the P-type, GⅡ.P16 was predominant (61.5%, 96/156), followed by GII.P31 (19.9%, 31/156). The dual genotyping revealed that GⅡ.4 Sydney [P16] (36.4%, 56/154) and GⅡ.2 [P16] (24.7%, 38/154) were predominant. Conclusion: The prevalence of norovirus in children in 2020 in Beijing is not much different from those of the previous years, but the genotypes composition has changed significantly, and there are multiple genotypes circulating simultaneously.

[Seroepidemiology of pertussis in healthy population in Ningbo, 2019]

Objective: To understand the seroepidemiological characteristics of pertussis in healthy population in Ningbo, and estimate the overall incidence of pertussis. Methods: A cross-sectional survey method was used in this study. A total of 1 206 healthy residents in 9 age groups were stratified randomly selected from 3 counties of Ningbo. Serum samples were collected from the subjects, and the pertussis toxin immunoglobulin G antibody (PT-IgG) levels were measured quantitatively by enzyme-linked immunosorbent assay (ELISA). Results: The mean PT-IgG seropositive rate in the subjects was 0.91% (95%CI:0.45%-1.63%) with a geometric mean titer (GMT) of 3.10 (95%CI:2.86-3.36) IU/ml. The seropositive rates ranged from 0.00% to 1.68%, and the GMTs ranged from 2.08 IU/ml to 5.28 IU/ml in 9 age groups. The incidence rate of pertussis was estimated to be 4 572.81 per 100 000 in age group ≥5 years (95%CI:1 807.30 per 100 000-9 348.12 per 100 000), and the peak of estimated incidence rates were found in age group 5- years (9 301.62 per 100 000, 95%CI:1 121.77 per 100 000-33 154.68 per 100 000) and age group ≥50 years old (8 967.02 per 100 000, 95%CI: 1 059.45 per 100 000-31 845.94 per 100 000). Conclusions: The actual incidence of pertussis was high in Ningbo in 2019. As a result of waning immunity after vaccination, pertussis can occur in adolescents and adults. The pertussis surveillance should be strengthened and the pertussis vaccination strategy should be improved.

[Midterm outcome comparison between patients with bicuspid or tricuspid aortic stenosis undergoing transcatheter aortic valve replacement]

Objective: To compare the prognosis of transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV) stenosis. Methods: This was a retrospective study. Patients with symptomatic severe aortic stenosis, who underwent TAVR with follow-up time more than one year in Guangdong Provincial People's Hospital from April 2016 to August 2018, were included. According to aortic CT angiography, the patients were divided into BAV group and TAV group. The primary endpoint was the composite event of all-cause death and stroke, and the secondary endpoints were TAVR-related complications. Incidence of clinical endpoints and parameters derived from echocardiography were compared between the groups, and Kaplan-Meier survival analysis was used to compare the composite event between the two groups. Results: A total of 49 patients were included. The age was (73.6±6.3) years, and 25(51.0%) were male. There were 32 patients in BAV group and 17 in TAV group, the follow-up time was 466 (390, 664) days. The incidence of composite endpoint of death and stroke at one year were comparable in BAV and TAV groups (6.3% (2/32) vs. 5.9% (1/17), P=1.00). Kaplan-Meier curves also showed a similar risk of the composite endpoint(HR=1.03，95%CI 0.09-11.24，Log-rank P=0.98) between two groups. The incidence of all-cause death, stroke, myocardial infarction, severe bleeding, major vascular complications, new-onset atrial fibrillation or atrial flutter, and permanent pacemaker implantation were all similar between the two groups(all P>0.05), and there was no acute kidney injury (stage 2 or 3) in both groups. Echocardiographic parameters at one year were similar between the two groups (all P>0.05). Conclusions: The midterm prognosis of TAVR in patients with BAV and TAV stenosis is similar. Clinical trials of large sample size with long-term follow-up are warranted to verify our findings.

[Relations between high risk sexual behavior and HIV infection among men who have sex with men in ways of meeting male partners]

Objective: To understand the relations between high risk sexual behavior and HIV infection among MSM in ways of finding male partners in Ningbo. Methods: A cross-sectional study was conducted in Ningbo between April and November in 2018. Data related to socio-demographics, ways of finding male partners, adoption of gay apps and sexual behaviors were collected by snowball method. Blood samples were drawn for HIV antibody testing. Classified data was evaluated by chi-square test. Related factors on HIV infection were analyzed by multivariate logistic regression. Results: A total of 735 participants were included in this study. Ways of finding male partners would through gay apps (60.8%, 447/735), QQ/Wechat (32.3%, 237/735) and gay-places (6.9%, 51/735). Related information on high risk sexual behavior and HIV infection among gay apps users were found as: 16.8%(75) had sexual behavior once per week in the past 6 months, 41.8% (187/447) had multiple sexual partners, 12.1% (54/447) had unprotected anal intercourse in the last time, 52.3% (234/447) having had unprotected anal intercourse in the past 6 months. The overall HIV prevalence rate was 12.1%(54/447). Among the HIV cases who got infected within the two years, 68.6%(24/35) of them had used gay apps for less than two years. Results from the, multivariate logistic regression analysis showed that gay apps users were more susceptible to infected HIV than those who used the QQ/Wechat (OR=3.03, 95%CI: 1.30-7.07). Conclusions: Gay apps was popularly known among the Ningbo MSM, and was associated with the high risk sexual behaviors and HIV infection. HIV control and prevention programs should be strengthened in the MSM population who used the gay apps. Related surveillance and intervention programs for MSM, who use the gay apps, need to be further reinforced.

Effect of intra-uterine growth restriction on long-term fertility in boars

The present study assessed the effect of birthweight on reproductive performance, including a possible mechanism, in male pigs. Ten newborn male piglets, including five normal birthweight (NBW) piglets and five intra-uterine growth restricted (IUGR) piglets, were used in the study. All piglets were weaned on Day 28 and fed the same diet during the experiment (10 months). Average daily weight gain, feed intake and the feed conversion ratio were higher in NBW than IUGR piglets. Similarly, testis volume and the number of Leydig and Sertoli cells in the distal portion of the testes were higher in NBW than IUGR piglets (P<0.05). Semen volume (P<0.05) and the total number of spermatozoa per ejaculate (P=0.08) were lower in IUGR boars. Testosterone concentrations on Day 141 and prostaglandin E₂ concentrations on Days 82 and 141 were higher in IUGR than NBW boars (P<0.05). The malondialdehyde content of seminal plasma was higher in IUGR boars, whereas sperm glutathione peroxidase activity was lower in IUGR versus NBW boars (P<0.05). Expression of DNA methyltransferase (Dnmt) genes Dnmt1, Dnmt3a, histone-lysine N-methyltransferase (Suv39h2), and lysine (K)-specific demethylase Kdm4a was upregulated in testes from IUGR boars. These findings suggest that growth restriction affects sperm production via reproductive organ development and epigenetic regulation.

Homogeneous (Cu, Ni)6Sn5 intermetallic compound joints rapidly formed in asymmetrical Ni/Sn/Cu system using ultrasound-induced transient liquid phase soldering process

Homogeneous (Cu, Ni)₆Sn₅ intermetallic compound (IMC) joints were rapidly formed in asymmetrical Ni/Sn/Cu system by an ultrasound-induced transient liquid phase (TLP) soldering process. In the traditional TLP soldering process, the intermetallic joints formed in Ni/Sn/Cu system consisted of major (Cu, Ni)₆Sn₅ and minor Cu₃Sn IMCs, and the grain morphology of (Cu, Ni)₆Sn₅ IMCs subsequently exhibited fine rounded, needlelike and coarse rounded shapes from the Ni side to the Cu side, which was highly in accordance with the Ni concentration gradient across the joints. However, in the ultrasound-induced TLP soldering process, the intermetallic joints formed in Ni/Sn/Cu system only consisted of the (Cu, Ni)₆Sn₅ IMCs which exhibited an uniform grain morphology of rounded shape with a remarkably narrowed Ni concentration gradient. The ultrasound-induced homogeneous intermetallic joints exhibited higher shear strength (61.6 MPa) than the traditional heterogeneous intermetallic joints (49.8 MPa).

[Expanding test and normalization for HIV/AIDS prevention and control]

Expanding real-name HIV test is the basis of the real-time reporting system in China, and it plays an important role for the progress. In year of 2003, there were 45 092 cases of HIV positives reported cumulatively, which accounted for only 5.4% of the estimated population of HIV positives. Since implementation of real-name HIV test and establishment, real-time reporting system, up to year 2005, the total of reported HIV positives was 577 000, which took up 67.9% of the estimated HIV positives. Also among reported cases, 387 000 cases have received the anti-retroviral treatment. Normalization of HIV prevention and control will pave the way to medical insurance for HIV positives. It is a goal that all the people have medical insurance in China, and the normalization is an ideal working condition, and real-name HIV test is a measure for it. The both are very closely connected and improving each anther.

Rapid formation of Ni3Sn4 joints for die attachment of SiC-based high temperature power devices using ultrasound-induced transient liquid phase bonding process

High melting point Ni₃Sn₄ joints for the die attachment of SiC-based high temperature power devices was successfully achieved using an ultrasound-induced transient liquid phase (TLP) bonding process within a remarkably short bonding time of 8s. The formed intermetallic joints, which are completely composed of the refined equiaxial Ni₃Sn₄ grains with the average diameter of 2μm, perform the average shear strength of 26.7MPa. The sonochemical effects of ultrasonic waves dominate the mechanism and kinetics of the rapid formation of Ni₃Sn₄ joints.

Construction and enhanced photocatalytic activities of a hydrogenated TiO2 nanobelt coated with CDs/MoS2 nanosheets

The CDs (carbon dots)/MoS₂ nanosheets coated hydrogenated TiO₂ nanobelt heterostructures—referred to as CDs/MoS₂@H-TiO₂—with a three-dimensional hierarchical configuration were prepared via hydrothermal reaction.

Molecular cloning and characterization of a C-type lectin in yellow catfish Tachysurus fulvidraco

This study represents the first report of a C-type lectin (ctl) in yellow catfish Tachysurus fulvidraco. The complete sequence of ctl complementary (c)DNA consisted of 685 nucleotides. The open reading frame potentially encoded a protein of 177 amino acids with a calculated molecular mass of c.y 20.204 kDa. The deduced amino-acid sequence contained a signal peptide and a single carbohydrate recognition domain with four cysteine residues and GlnProAsp (QPD) and TrpAsnAsp (WND) motifs. Ctl showed the highest identity (56.0%) to the predicted lactose binding lectin from channel catfish Ictalurus punctatus. Quantitative real-time (qrt)-PCR analysis showed that ctl messenger (m)RNA was constitutively expressed in all examined tissues in normal fish, with high expression in trunk kidney and head kidney, which was increased following Aeromonas hydrophila challenge in a duration-dependent manner. Purified recombinant Ctl (rCtl) from Escherichia coli BL21 was able to bind and agglutinate Gram-positive and Gram-negative bacteria in a calcium-dependent manner. These results suggested that Ctl might be a C-type lectin of T. fulvidraco involved in innate immune responses as receptors (PRR).

Epidemiological characteristics of malaria in Ningbo City, China 2000-2011

The objective of this study was to explore the trend and the epidemiological characteristics of malaria in Ningbo from 2000 through 2011 and provide scientific evidence for the prevention and control. Using the retrospective study, data relating to malaria epidemics during 2000-2011 in Ningbo were collected through the questionnaires of the cases and other important surveillance data. Adult mosquitoes were collected using CDC light traps baited with CO2. Results showed that Plasmodium vivax was the main species, and Anopheles sinensis was the only vector species of malaria. The annual incidence rates (per 100000) ranged from 0.156 to 3.224, and about 95.41% of the cases were imported. The cases occurred mainly between May and November and the incidence showed two peaks, and the local transmission of malaria was determined by vector density. Considering the vast majority of these infections were imported vivax malaria cases from domestic endemic areas (particularly Anhui province), and may lead to limited local transmission, strengthening the routine monitoring of imported malaria, ensuring timely diagnosis, improving case detection rate, giving a standardized treatment to patients and intensifying public health education on malaria prevention are extremely important to malaria prevention and control activities.

[Epidemiological and etiological characteristics of hand-foot-mouth disease in Ningbo, Zhejiang province, 2008-2011]

OBJECTIVE

To analyze the epidemiological characteristics of hand foot and mouth disease (HFMD) in Ningbo.

METHODS

A descriptive analysis was conducted through the surveillance data of HFMD in Ningbo, Zhejiang province, from 2008 to 2011. Genes on EV71 and Cox A16 were amplified with RT-PCT from the stool samples of HFMD patients. Sequences were analyzed by bioinformatics software.

RESULTS

37 524 cases of HFMD were reported from 2008 to 2011, including 196 severe cases and 12 deaths. The reported incidence was 145.26 per 100 000 and the case fatality was 0.03%. Cases in children aged 5 or younger accounted for 95.89%, and the scattered cases accounted for 64.10%. Xiangshan and Ninghai counties had the highest incidence rates in Ningbo. The peak of incidence was from April to July. The number of male patients was obviously higher than females. 2394 cases of HFMD were laboratory confirmed and EV71 with the predominant epidemic strain. Data from phylogenetic analysis revealed that EV71 isolated from HFMD patients in Ningbo belonged to C4a evolution branch of C4 sub-genotype, with several transmission chains. Cox A16 belonged to B1 evolution branch. 53.48% of the healthy children in Ningbo showed EV71 antibody positive. The geometric mean of the antibody titer (GMT) was 11.23 (8.33 - 14.98) in healthy children. Cox A16 antibody was detected at 63.18% of the healthy children in Ningbo. GMT in healthy children was 12.61 (6.70 - 16.52).

CONCLUSION

HFMD was highly endemic in Ningbo, with children under 5 years old were at high-risk. The major etiologic agent was EV71 which belonged to C4a in the C4 sub-genotypes. Cox A16 belonged to the B1 evolution branch, which were in line with the predominant virus circulating in the mainland of China.

Development of a cell immobilization technique for the conversion of polysialogangliosides to monosialotetrahexosylganglioside

CONTEXT

Monosialotetrahexosylganglioside (GM₁) prepared from the brain of pig or bovine is an effective clinical drug in the treatment of different nervous system diseases. Generally, polysialogangliosides are transformed into GM₁ by enzymic or chemical hydrolysis due to the very poor level of natural GM₁.

OBJECTIVE

To continuously obtain GM₁ by cell immobilization in a packed-bed reactor.

MATERIALS AND METHODS

Brevibacterium casei, which is Gram-positive bacteria belonging to the order Actinomyces and family Brevibacteriaceae, can produce high-activity sialidase, are encapsulated in silk fibroin hydrogel, and subsequently packed into a reactor. The crude ganglioside is pumped into the reactor and continuously turned to GM₁.

RESULTS

The optimal silk fibroin concentration for hydrogel preparation is 6.0% (w/v). The optimal initial biomass for immobilization is ~12% (wet weight). The optimal conversion conditions are 35 °C and 6  mL/min of flow rate. Under above conditions, the maximum GM₁ productive strength and conversion ratio can reach to 4.2 g/L·h and 313.5%, respectively.

DISCUSSION

Silk fibroin is a promising material for cell immobilization because it has predominant characteristics of higher permeability and intensity. Cell immobilization for continuous GM₁ transformation could eliminate the asialo GM₁ and decrease the foreign matter from transfer medium and metabolism product.

CONCLUSION

In the packed-bed reactor, continuous production of GM₁ had been under effective running at least for 15 days indicating a potential for industrial production. It is significant that this is a first report on cell immobilization for GM₁ production.

[Study on characteristic of current measles wild-type strains after continuous passage from Vero cells]

OBJECTIVE

To investigate the change on infection capacity of measles epidemic strain after continuous passage from Vero cell line, and to analyze the possible reasons in genetic level that caused change on cell-recognition site.

METHODS

Measles virus epidemic strain Ningbo 05-2 was continuous passaged from Vero cells and Cytopathic Effect (CPE) was observed and recorded. After confirmation by real-time Reverse Transcription-Polymerase Chain Reaction (RT-PCR), hemagglutinating activity of Ningbo 05-2/P18 was detected using hemagglutination (HA) test and the completed sequences within Hemagglutinin (H) and Necleoprotein (N) gene were amplified by RT-PCR.

RESULTS

Measles epidemic strain Ningbo 05-2 has been continuous cultured for 17 times (P18) on Vero cells, but CPE began to be observed from the 13th passage. Although the passaged strains were confirmed as measles virus by real-time RT-PCR, the hemagglutinating activity of Ningbo 05-2/P18 was still negative. Compared with the Ningbo 05-2, there were three amino acid mutations within H protein of Ningbo 05-2/P18 (312aa, 314aa, 546aa), which changed the beta-sheet on the 311aa and the beta-turn during 312aa to 316aa to the alpha-helix. Phylogenetic tree based on H gene indicated the Ningbo 05-2/P18 still belonged to sub-genotype H(1b), locating at the same branch with the original strain. However, sequences of the original and passaged strains were identical within N protein.

CONCLUSIONS

Only a few amino acid mutations within H protein could results in cell-recognition site alternative of measles epidemic strain after continuous culture in Vero cell line, and consequently affecting the infection of measles virus.

HBV genotype C is independently associated with cirrhosis in community-based population

AIM: To determine the association of hepatitis B virus (HBV) genotypes with probable cirrhosis and fatty liver in community-based populations.

METHODS: A multi-stage cluster probability sampling method was applied to recruit 10 167 subjects aged between 6 and 72 years from our epidemiological bases in Eastern China. After excluding the subjects co-infected with hepatitis C or hepatitis D viruses, the hepatitis B surface antigen (HBsAg)-positive subjects were examined for HBV genotype, serum viral load, alanine aminotransferase (ALT), hepatitis B e antigen (HBeAg) status, and ultrasonographic changes. Logistic regression models were used to determine the factors associated with probable cirrhosis and fatty liver.

RESULTS: Of 634 HBsAg-positive subjects with HBV genotype determined, 82 had probable cirrhosis (ultrasonographic score ≥ 5), 42 had ultrasonographic fatty liver. Probable cirrhosis was only found in the HBeAg-negative subjects, and more frequently found in the subjects with genotype C than in those with genotype B (14.8% vs 8.0%, P = 0.018). In HBeAg-negative subjects, high viral load was frequently associated with abnormal ALT level, while ALT abnormality was more frequent in those with probable cirrhosis than those without (19.5% vs 7.8%, P = 0.001). Univariate analysis showed that age, sex, HBV genotypes, and viral load were not significantly associated with ultrasonographic fatty liver, whereas ALT abnormality was significantly related to ultrasonographic fatty liver (OR = 4.54, 95% CI: 2.11-9.75, P < 0.001). Multivariate analysis demonstrated that HBV genotype C, age (≥ 45 years), male sex, and ALT abnormality were independently associated with probable cirrhosis (AOR = 2.30, 95% CI: 1.26-4.19; AOR = 1.81, 95% CI: 1.10-2.99; AOR = 1.74, 95% CI: 1.03-2.95; AOR = 2.98, 95% CI: 1.48-5.99, respectively).

CONCLUSION: A crude prevalence of probable cirrhosis is 12.9% in the community-based HBV-infected subjects. HBV genotype C is independently associated with probable cirrhosis in the HBeAg-negative subjects.

[Epidemiological and etiological characteristics of typhoid and paratyphoid fever in Ningbo during 1988 - 2007]

OBJECTIVE

To study the epidemiological and etiological characteristics of typhoid and paratyphoid fever in high epidemic areas.

METHODS

Reported data on typhoid and paratyphoid fever during 1988-2007 in Ningbo were analyzed epidemiologically. Shellfish from the market was collected for laboratory testing and Salmonella typhi strains collected from the patients were also studied.

RESULTS

Number of reported cases on both typhoid and paratyphoid fever was 19 404 with 7 deaths, from 1988 to 2007. The annual mean incidence was 17.68 per one hundred thousand with the fatality rate as 0.36 per thousand. Most cases were among adults aged 20-50 years and an obvious regional distribution was observed with high incidence seen in winter and spring. Since 1990s, the advantage strain had changed from Salmonella typhi to Salmonella paratyphi A. Etiologic studies showed that raw Anadara subcrenata and oyster were the main risk factors. One Salmonella paratyphi A strain was detected in both Anadara subcrenata and oysters collected from the market, which contained TEM-1 drug resistance gene. PFGE genotyping showed that PFGE-X2 was the strain which causing pandemic in Ningbo.

CONCLUSION

Eating contaminated raw shellfish like oysters and hairy clams was the primary risk factor, responsible for the outbreaks. Salmonella paratyphi A was the advantages pandemic strain in Ningbo. Strategies as supervision on personal hygiene and health education should be strengthened.

[Study on spectral properties of Ca2B5O9Cl : Eu prepared with hydrothermal method and solid method]

Effects of preparation methods (hydrothermal method and high temperature solid method), excitation condition, and Eu ions concentration on spectral properties of Ca2B5O9Cl : Eu phosphor were studied. The effects of preparation condition on crystal photographs were also discussed. The result showed that the Ca2B5O9Cl : Eu phosphors prepared with hydrothermal method had mainly 5 D0 --> 7F(J) (J = 1, 2, 3, 4) emission of Eu3+ with 254 nm excitation and 4 f6 5d1 --> 8S(7/2) emission of Eu2+ with 365 nm excitation, the one prepared with high temperature solid method had mainly 4 f6 5d1 --> 8S(7/2) emission of Eu2+ with 365 nm excitation and very weak emissions of Eu2+ and Eu3+ with 254 nm excitation. Eu ions concentration hardly affected spectral properties, but the preparation method and excitation conditions had remarkable influence on the properties. SEM revealed that the products prepared both in the air and reductive atmosphere had consummate crystal, slippery surface and appropriate size (0.82-1.06 microm).

[Analysis on the proportion of reported hepatitis B cases through pilot surveillance in China during 2006]

OBJECTIVE

To better understand the proportions of reported hepatitis B cases in pilot surveillance cites through investigation and laboratory testing.

METHODS

To confirm the reported cases of hepatitis B by collecting blood specimen and laboratory testing on HBsAg, IgM of Anti-HBc, Anti-HAV in 18 pilot surveillance counties.

RESULTS

Among 2858 cases of hepatitis B reported in 2006, 23.97% of them were reported as suspected acute cases, 14.87% as acute cases, 20.33% as suspected chronic cases, 34.67% as chronic cases, 4.09% as cirrhosis and 2.06% as HCC. Among 1681 reported hepatitis B cases confirmed by laboratory testing, results showed that 24.16% of them were diagnosed as acute hepatitis B, but only 15.37% were confirmed as acute hepatitis B. Although the proportion confirmed as hepatitis B kept consistent as before, misclassification was found.

CONCLUSION

In current surveillance system, reported hepatitis B cases were mainly chronic, only up to one third belonged to acute hepatitis B. The reported incidence of hepatitis B did not reflect the real incidence due to misclassification. To better define the burden on hepatitis B disease, it was necessary and urgent to revise the diagnostic criteria and to conduct surveillance on hepatitis B, under separate reporting categories which including acute and chronic cases of the disease.

Report and analysis of a scarlet fever outbreak among adults through food-borne transmission in China

BACKGROUND

Scarlet fever is caused by group A beta-hemolytic streptococci (GAS). The clinical syndrome has receded in recent years, but occasionally explosive outbreaks do occur likely due to the emergence of GAS with virulence factors peculiar to this syndrome.

METHODS

Following the notification of an unexpectedly large number of scarlet fever cases amongst adults associated with a school in Ningbo, China, in June 2006, the epidemiological and clinical features of the outbreak were investigated. Logistic regression was conducted to investigate the risk factors of the outbreak and its transmission route.

RESULTS

Forty five individuals suffered scarlet fever with an attack rate of 4.98% (45/904). There was a single peak in the epidemic curve, with the majority of the cases occurring during the first two days of the outbreak. The median age of cases was 35.5 years (range 17-65). Most patients had fever (43/45), sore throat (40/45), scarlatinoid rash (39/45) and strawberry-like tongue (30/45). In laboratory detection, 45 cases' throat swabs samples were collected and GAS were isolated from 8 throat swabs samples. All of the cases, except for 2, had eaten the Plain Boiled Chicken (PBC) for lunch on June 6th, and teaching staff and students who had not eaten the PBC were not affected by the epidemic. Logistic regression analysis indicated that PBC was a key risk factor (OR=21.0, P<0.05). The chef of the school refectory was responsible for washing, braising, cutting, and distributing the PBC, and was identified as the likely source.

CONCLUSIONS

We describe an outbreak of scarlet fever caused by GAS-contaminated food.

DOTS in China - removing barriers or moving barriers?

In 1992, China initiated its modern National TB Control Programme (NTP) with DOTS strategy through a project funded by a World Bank loan. Key motives for the revised NTP-DOTS were to reduce financial barriers to patients by removing fee charges for diagnosis and treatment, and to address regressive suppliers' incentives for appropriate referrals. This study aims to assess to what extent China's NTP subsidies are achieving the objective of removing financial barriers to care in terms of patients' expenditure. One county with NTP-DOTS - Jianhu - and one county without - Funing - were selected. A cohort of 493 tuberculosis patients newly diagnosed in 2002 was interviewed by questionnaire. The main outcome measure was tuberculosis patients' expenditure on medical care and transportation/accommodation from the onset of symptoms to treatment completion. During the follow-up period, Funing started implementing NTP-DOTS, which offered a possibility of longitudinal comparison both between counties and within county. Ninety-four per cent (465/493) of subjects were followed-up. The mean total patient's expenditure on TB medical care and transportation/accommodation before TB diagnosis was higher in Jianhu than in Funing (715 vs. 256CNY), whereas it was higher in Funing (835 vs. 157CNY) after diagnosis. After implementing NTP-DOTS in Funing, expenditure after diagnosis decreased slightly whereas expenditure before diagnosis increased remarkably. We found that the market incentive structures in the reformed health system appear to have a stronger regressive effect and may result in prolonged delays before effective treatment can be given. We believe that doctors adapt to new incentive structures, with bonus income being linked to the hospitals' fee-for-service revenue, and find new ways of keeping revenue at the old levels, which reduce or eliminate the intended effect of the subsidies. TB patients suffer a heavy economic burden even in counties where NTP-DOTS treatment is subsidized. The total patient expenditure was reduced only marginally, but shifted substantially from after diagnosis to before diagnosis. The shift could imply delays in diagnosis and treatment with an increased risk of infection transmission.

Combined effects of temozolomide and the ribonucleotide reductase inhibitors didox and trimidox in malignant brain tumor cells

PURPOSE

Temozolomide (TMZ), an oral alkylating agent with good penetration of the blood-brain barrier, has shown efficacy in the treatment of malignant brain tumors. Ribonucleotide reductase (RR), the rate-limiting enzyme of DNA synthesis, seems to be a complementary target for combination chemotherapy of brain tumors. Trimidox (TX) and didox (DX) are two recently synthesized specific inhibitors of RR. The combinations of TMZ with TX or DX as a basis for synergistic chemotherapy protocols were tested in this study.

METHODS

The effects of the single drugs TMZ, DX, and TX, and the combinations TMZ/DX and TMZ/TX were evaluated in the human malignant glioma cell lines U87MG, T98G, LNZ308, and wt1119. In the latter, experiments were carried out in the presence or absence of wild-type p53 protein expressed under the control of a tetracycline-responsive transgene system. Cytotoxicity was evaluated by MTT assays. The isobologram and combination index (CI) method of Chou-Talalay were used to evaluate interactions between drugs.

RESULTS

All drugs demonstrated cytotoxicity in brain tumor cells. Synergistic cytotoxic effects (CI<1) for TMZ and TX or DX at different dose levels were demonstrated in most of the examined cell lines. In some instances, however, drug combinations resulted in additive or even antagonistic effects. Toxicity of the single agents and synergy of the combinations did not correlate with wild-type p53 expression in the tumor cells.

CONCLUSION

The tumor toxicity of TMZ as a single agent may be modified by combinations with the novel RR inhibitors DX and TX, and is synergistically enhanced in most cases. Depending on the combination ratio, the doses for each drug for a given degree of effect in the combination may be drastically reduced.

Distinct phenotypes distinguish the molecular classes of Angelman syndrome

BACKGROUND

Angelman syndrome (AS) is a severe neurobehavioural disorder caused by defects in the maternally derived imprinted domain located on 15q11-q13. Most patients acquire AS by one of five mechanisms: (1) a large interstitial deletion of 15q11-q13; (2) paternal uniparental disomy (UPD) of chromosome 15; (3) an imprinting defect (ID); (4) a mutation in the E3 ubiquitin protein ligase gene (UBE3A); or (5) unidentified mechanism(s). All classical patients from these classes exhibit four cardinal features, including severe developmental delay and/or mental retardation, profound speech impairment, a movement and balance disorder, and AS specific behaviour typified by an easily excitable personality with an inappropriately happy affect. In addition, patients can display other characteristics, including microcephaly, hypopigmentation, and seizures.

METHODS

We restricted the present study to 104 patients (93 families) with a classical AS phenotype. All of our patients were evaluated for 22 clinical variables including growth parameters, acquisition of motor skills, and history of seizures. In addition, molecular and cytogenetic analyses were used to assign a molecular class (I-V) to each patient for genotype-phenotype correlations.

RESULTS

In our patient repository, 22% of our families had normal DNA methylation analyses along 15q11-q13. Of these, 44% of sporadic patients had mutations within UBE3A, the largest percentage found to date. Our data indicate that the five molecular classes can be divided into four phenotypic groups: deletions, UPD and ID patients, UBE3A mutation patients, and subjects with unknown aetiology. Deletion patients are the most severely affected, while UPD and ID patients are the least. Differences in body mass index, head circumference, and seizure activity are the most pronounced among the classes.

CONCLUSIONS

Clinically, we were unable to distinguish between UPD and ID patients, suggesting that 15q11-q13 contains the only significant maternally expressed imprinted genes on chromosome 15.

[Simultaneous observation of parameter of intraventricular pressure and energy metabolism in rat hearts using nuclear magnetic resonance]

A technique for simultaneous observation of parameters of intraventricular pressure and energy metabolic status in isovolumic rat hearts was described. The parameters of intraventricular pressure were collected and processed using a computerized monitoring system for heart function, and myocardial energy metabolism was investigated by collecting the 31P NMR spectra. The preparation was stable metabolically and functionally for 2 h under the NMR experimental conditions.

Calcification in chronic maxillary sinusitis: comparison of CT findings with histopathologic results

BACKGROUND AND PURPOSE

It is important to differentiate fungal from nonfungal sinusitis in order to determine the optimal treatment for chronic sinusitis. The purpose of this study was to describe the CT findings of calcifications in chronic fungal and nonfungal maxillary sinusitis.

METHODS

Five hundred ten patients with pathologically proved chronic maxillary sinusitis were studied with unenhanced CT before undergoing sinonasal surgery. In 36 patients, the CT scans were reviewed retrospectively to ascertain the shape and location of intrasinus calcifications.

RESULTS

Calcifications were found in 20 (51%) of 39 patients with fungal sinusitis and in 16 (3%) of 471 patients with nonfungal sinusitis. Direct histopathologic correlation was performed in two of 16 patients with nonfungal sinusitis who had intrasinus calcification. The location of intrasinus calcification was central in 95% of the patients with fungal sinusitis and peripheral in 81% of those with nonfungal sinusitis. Although calcifications with a nodular or linear shape were seen in both fungal and nonfungal sinusitis, fine punctate type calcifications were seen only in those with fungal sinusitis (50%) and round or eggshell type calcifications only in those with nonfungal sinusitis (19%).

CONCLUSION

Intrasinus calcifications are different in location and shape between fungal and nonfungal maxillary sinusitis. Although intrasinus calcification is uncommon in nonfungal sinusitis, the CT finding of intrasinus calcification may be helpful for differentiating fungal from nonfungal maxillary sinusitis.

Effects of tea polyphenols on cardiac function and myocardial ultrastructure in rats after repeated +Gz stress

Objective. To observe the effects of tea polyphenols (TP) on cardiac function and myocardial ultrastructure in rats after repeated +10 Gz stress. Method. Twenty four male Wistar rats were randomly divided into three groups (n=8 each): group A (control), group B (+10 Gz), group C (+Gz with TP). Group B and C were repeatedly exposed to +10 Gz (each for 30 s, onset rate about 0.5 G/s, 3 times/d with +1 Gz 1 min intervals, 3 d/wk, 4 weeks in total), but group A was only submitted to +1 Gz. TP (200 mg kg-1) was given orally to group C about 1 h prior to the +Gz experiment, and distilled water was given to group A and B. Function of isolated rat working hearts and myocardial ultrastructure were observed. Result. A significant decrease of left ventricular systolic pressure (LVSP) and injury of myocardial structure in rats were demonstrated after repeated +10 Gz stress. But TP could remarkably elevate the LVSP and improve myocardial ultrastructural injury in +10 Gz stressed rats. Conclusion. These results indicated that repeated high G exposure may produce cardiac structural and functional injuries in rats which might be partly related to free radical metabolism; and antioxidant TP had significant protective effects on the hearts of +Gz stressed rats.

Regulation of human leukocyte p21-activated kinases through G protein--coupled receptors

The Rac guanosine 5'-triphosphate (GTP)-binding proteins regulate oxidant production by phagocytic leukocytes. Two Ste20-related p21-activated kinases (PAKs) were identified as targets of Rac in human neutrophils. Activity of the approximately 65- and approximately 68-kilodalton PAKs was rapidly stimulated by chemoattractants acting through pertussis toxin-sensitive heterotrimeric GTP-binding proteins (G proteins). Native and recombinant PAKs phosphorylated the p47phox reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase component in a Rac-GTP-dependent manner. The action of PAKs during phagocyte activation by G protein-coupled pathways may contribute to regulation of NADPH oxidase activity.

Effect of hypoxia on angiotensin II content and its receptor in guinea pig aorta

AIM

To study the effects of hypoxia on the vasoconstrictive response and the angiotensin II (Ang II) content and its receptor.

METHODS

Hypoxia was induced in isolated aorta of guinea pig by gassing N2. The vasoconstrictive response of aorta to Ang II was recorded. Ang II content and its receptor were measured by radioimmuoassay.

RESULTS

Ang 3-3000 nmol L-1 increased the contractile response of aorta. Hypoxia amplified the vasoconstrictive effect of Ang II. The concentration of Ang II were 44 +/- 24 and 50 +/- 17 pg/g wet wt (n = 10), respectively in non-hypoxic and hypoxic aortae. The receptor density in non-hypoxic aorta was 17 +/- 3 fmol mg-1, and that in hypoxia was 33 +/- 5 fmol mg-1 (P < 0.01).

CONCLUSION

The enhancement of the vasoconstrictive action of Ang II by hypoxia is due to the increase in the angiotensin receptor density, but not associated with the changes in the Ang II content in hypoxic aorta of guinea pig.

Histiocytosis X. S-100 protein, peanut agglutinin, and transmission electron microscopy study

Twenty-seven cases of histiocytosis X (HX) for which paraffin blocks were available were studied with the use of S-100 protein immunohistochemistry, peanut agglutinin affinity histochemistry, and transmission electron microscopy. The results show that these techniques did enable identification of Langerhans'-type histiocytes in 88.5%, 75%, and 47.4% of cases, respectively. All techniques were proved to be of some diagnostic value for HX, but none was able to confirm the diagnosis in all instances and none could foretell the prognosis of the patients. This study shows that besides the Langerhans' cells, the indeterminate cells of the skin and the interdigitating dendritic reticulum cells of the lymph node may also be involved in this process. Moreover, some multinucleate giant cells and foamy cells may be derived from Langerhans' and related cells.

[The analysis of the affecting of season factor on mortality in Shanghai County (1975-1986)]

This paper analysed the affect of season on mortality in Shanghai County (a rural area) using the Moving Average Method. The advantage of the method is that it can balance the periodical change, long-term change and random change of mortality, so it can analyse the affecting of pure season factor on mortality. The results showed a relationship between mortality and season. The mortality of 0 years old was high in December, possibly due to the cold. The mortality of preschool children was high in summer, farm-busy-time, possible reasons were drowning and parents did not have much time to care for children. The mortality of middle-age, old people, and patients with cardiovascular disease, cerebrovascular disease and disease of respiratory system, was high in winter and summer, possible reason was cold attacks. The mortality of accidental death was high in Summer, possible reason due to drowning.

[Endodermal sinus tumor (yolk sac tumor)--report of 52 cases and review of the literature of 1224 cases]

52 cases of endodermal sinus tumors (EST) are reported and 1224 cases from the Chinese and foreign literature are reviewed. This tumor, occurring usually in the gonads and rarely at extragonadal sites, comprised 10-17.1% of the former. It is located on or along the mid-line of the body including the orbit and other organs. In this paper, there are two cases with the tumor located at the orifice of urethra and one case between the pubic bone and the urinary bladder which has never been reported. EST often occurs in people under the age of 35. EST in the gonadal sites is divided into infant-childhood and adult groups. In the former group the prognosis is better than that of the adult group when the tumor is located in the testis as well as those in the vagina. There is sex and age difference for some EST in extragonadal sites. Those in the mediastinum almost always occur in young males. Diagnosis is easily made by pathology and by serum alpha-fetal protein (SAFP). Pathologically it is divided into two types: simple EST and EST element mixed with other germ cell tumors which give the same prognosis. The authors suggest that SAFP be done for any patients with teratomata in order to avoid misdiagnosis. SAFP is not only diagnostic but also prognostic by monitering postoperative course. EST is a highly malignant tumor, rapidly growing and poor in prognosis. Recent reports show that operated patients supplemented by chemotherapy give much better results than by radiotherapy.