Echinococcosis Is Associated with the Increased Prevalence of Intestinal Blastocystis Infection in Tibetans and Host Susceptibility to the Blastocystis in Mice

Blastocystis is a common human intestinal protozoan parasite. Little is known about its prevalence in echinococcosis. This study tested whether Echinococcus multilocularis infection would increase host susceptibility to Blastocystis. A total of 114 fecal samples (68 hydatid disease patients and 46 healthy people) were collected from Tibetans in the Qinghai province in China. The presence of Blastocystis was identified by sequencing of the small subunit (SSU) rRNA gene. Balb/c mice were co-infected with Blastocystis and E. multilocularis and tested for host susceptibility to Blastocystis. The overall Blastocystis prevalence was 12.3%; 16.2% in the patients and 4.4% in healthy people (p < 0.05). Sequence analysis identified three known Blastocystis genotypes, including ST1, ST2, and ST3, and one unknown genotype. Experimental dual infection significantly reduced mouse survival rate (20%), induced more severe signs, and increased intestinal damages with a higher intestinal colonization level of Blastocystis. The mouse model showed that E. multilocularis infection increases host susceptibility to Blastocystis. Our study shows a significantly higher prevalence of Blastocystis in patients with liver echinococcosis and reveals that non-intestinal E. multilocularis infection increases host susceptibility to the Blastocystis. Our results highlight that E. multilocularis infection is associated with Blastocystis. These findings remind us that more attention should be paid to the gut health of the patients with a helminth infection during clinical patient care.

Taenia saginata Infection Misdiagnosed as Acute Cholecystitis in a Tibetan Patient, in China

The present study reports a rare case of Taenia saginata infection, which was initially diagnosed as acute cholecystitis in a Tibetan patient at the Qinghai-Tibetan Plateau pastoral area, China. A 45-year-old female was initially diagnosed with acute cholecystitis at a hospital in China. She had a slight fever, weight loss and constipation and complained of pain in the upper abdomen and left back areas. Increase of monocyte, eosinophil and basophil levels were shown. Taenia sp. eggs were detected in a fecal examination. An adult tapeworm approximately 146 cm in length, whitish-yellow color, was collected from the patient after treatment with traditional Chinese medicine. The adult tapeworm had a scolex and proglottids with genital pores. The scolex was rectangular shape with 4 suckers and rostellum without hooklet. The cox1 gene sequence shared 99.5-99.8% homology with that of T. saginata from other regions in China. The patient was diagnosed finally infected with T. saginata by morphological and molecular charateristics.

[Progress of researches on the development of non-benzimidazoles for the treatment of echinococcosis]

The long-term use of benzimidazoles for the treatment of echinococcosis may cause multiple adverse reactions and low compliance. A search for novel agents, as an alternative of benzimidazoles, is therefore of great significance for the treatment of echinococcosis. This review focuses on the progress of researches on non-benzimidazoles for the clinical treatment of echinococcosis, including anti-parasitic agents, anti-proliferative agents and plant extracts, so as to provide insights into the further development of non-benzimidazoles.

[A sub-cohort study design of the maternal and infant microbes in China National Birth Cohort]

The importance of gut microbes to human health has gradually attracted attention. With the use of animal models, it has been revealed that maternal microbes during pregnancy could influence their children's health outcomes through shaping their microbial composition and regulating the development of their metabolic and immune system. However, the physiological mechanism of the human body is more complex and is affected by the interaction of multiple factors. The research results obtained from animal models are often inconsistent with human studies. At present, the influence of maternal intestinal microbes during pregnancy on the microbial colonization in their offspring and on a series of children's health outcomes is still unclear. Establishing a sub-cohort to detect the microbiome of the women across pregnancy and of their offspring, and further to integrate with variety of environmental and behavioral exposures can better provide reliable support for the research on the mechanism of children's health and diseases. This paper briefly introduces the research objectives, content, progress, strength and limitations of the sub-cohort study.

[Evaluation of the diagnostic efficiency of three anti-Echinococcus antibody-based assays for the serodiagnosis of echinococcosis]

OBJECTIVE

To evaluate the efficiency of three Chinese commercial anti-Echinococcus antibody-based assays for the serodiagnosis of echinococcosis.

METHODS

A total of 142 sera from cystic echinococcosis patients, 89 sera from alveolar echinococcosis and 39 sera from healthy controls were sampled, and detected by kits A (ELISA), B (ELISA) and C (colloidal gold immunoassay). The routine blood testing results and biochemical parameters were compared between the cystic and alveolar echinococcosis patients, and the associations of the absorbance (A value) of the serum specific antibody detected by A and B kits with the routine blood testing results and biochemical parameters were examined in echinococcosis patients. In addition, the performance of these three assays for the serodiagnosis of echinococcosis was evaluated.

RESULTS

There were no significant differences between the cystic and alveolar echinococcosis patients in terms of the median white blood cell count (WBC), neutrophil count (NEU), monocyte count (MONO), basophil count (BASO), alanine aminotransferase concentration (ALT), aspirate aminotransferase concentration (AST), total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL) (all P values > 0.05), and higher median lymphocyte count (LYM) and albumin levels (ALB) were detected in cystic echinococcosis patients than in alveolar echinococcosis patients (both P values < 0.05), while the median eosinophil count (EOS) was greater in the alveolar echinococcosis patients than in the cystic echinococcosis patients (P < 0.01). The A value of the serum specific antibody detected by kit A showed a linear positive correlation with WBC (rs = 0.153, P < 0.05) and EOS (rs = 0.174, P < 0.05), and a linear negative correlation with TBIL (rs = -0.134, P < 0.05) and IBIL (rs = -0.146, P < 0.05), while the A value of the serum specific antibody detected by kit B showed a linear positive correlation with WBC (rs = 0.257, P < 0.01), NEU (rs = 0.203, P < 0.01), MONO (rs = 0.159, P < 0.05), EOS (rs = 0.330, P < 0.01), ALT (rs = 0.171, P < 0.01) and AST (rs = 0.160, P < 0.05), and a linear negative correlation with ALB (rs = -0.168, P < 0.05). The overall coincidence rate, sensitivity, specificity, Youden's index and Kappa value of A, B and C kits were 86.30%, 69.63% and 91.48%; 84.42%, 64.94% and 92.21%; 97.44%, 97.44% and 87.18%; 0.82, 0.62 and 0.79; and 0.600, 0.337 and 0.750 for the diagnosis of echinococcosis, respectively. The overall coincidence rate, sensitivity, specificity and Youden's index of A, B and C kits were 84.54%, 64.64% and 71.82%; 80.99%, 55.63% and 68.31%; 97.44%, 97.44% and 87.18%; and 0.78, 0.53 and 0.56 for the diagnosis of cystic echinococcosis, respectively, while the overall coincidence rate, sensitivity, specificity and Youden's index of A, B and C kits were 92.19%, 85.16% and 85.16%; 89.89%, 79.78% and 84.27%; 97.44%, 97.44% and 87.18%; and 0.87, 0.77 and 0.72 for the diagnosis of alveolar echinococcosis, respectively. The C kit showed cross-reactions in the serodiagnosis of cystic echinococcosis and alveolar echinococcosis. There were no significant difference in the area under the receiver operating characteristic curve (ROC) between A and B kits for the diagnosis of echinococcosis (0.970 vs. 0.948, Z = 1.618, P > 0.05), and there was a high agreement between A and B kits in the diagnosis of echinococcosis (Kappa = 0.585, P < 0.01).

CONCLUSIONS

The three commercial anti-Echinococcus antibody-based kits exhibit a higher serodiagnostic efficiency for alveolar echinococcosis than for cystic echinococcosis. The A kit shows a high sensitivity and specificity for the diagnosis of echinococcosis, and has a relatively stable diagnostic performance and fewer influencing factors, which is suitable for the pre-surgical preliminary diagnosis and post-surgical follow-up monitoring of serum anti-Echinococcus antibody, while the C kit shows a high sensitivity and specificity for the diagnosis of echinococcosis, and is easy to perform and high in reporting rate, which is feasible for initial screening of echinococcosis.

[Hepatic cystic and alveolar echinococcosis co-infections: a report of 3 cases]

OBJECTIVE

To investigate the diagnosis and surgical treatment of co-infection with hepatic cystic and alveolar echinococcosis, so as to provide insights into the diagnosis and treatment of these patients.

METHODS

The clinical data of patients with co-infections of hepatic cystic and alveolar echinococcosis in Qinghai Provincial People's Hospital between 2017 and 2018 were retrospectively analyzed.

RESULTS

Three patients were diagnosed with co-infection of hepatic cystic and alveolar echinococcosis. One patient was diagnosed by preoperative CT scan, and confirmed intraoperatively. The other two cases were diagnosed as cystic echinococcosis by preoperative color ultrasonography and imaging examinations, and were definitively diagnosed as co-infection of hepatic cystic and alveolar echinococcosis by intraoperative examination of the lesion morphology and postoperative pathology. Two patients were given radical surgery, and another case was given removal of the internal capsule and subtotal excision of the outer capsule of Echinococcus granulous in the liver following exploration.

CONCLUSIONS

Co-infection with hepatic cystic and alveolar echinococcosis is easy for missed diagnosis and misdiagnosis prior to operation, and the definitive diagnosis may be made by means of imaging examinations combined with postoperative pathology. The surgery is relatively complicated and difficult for patients with co-infection of hepatic cystic and alveolar echinococcosis, and individualized surgical treatment regimen should be employed for patients with various types of infections.

[Phylogenetic analysis of Echinococcus granulosus genotypes based on the GenBank database]

OBJECTIVE

To analyze the sequences of the cytochrome C oxidase subunit I (Cox1) gene of various Echinococcus granulosus genotypes that are currently recorded in the GenBank database, so as to investigate the genetic variation and differentiation of the E. granulosus genotypes across the world.

METHODS

The sequences of the Cox1 gene of various E. granulosus genotypes that are currently recorded in the GenBank database were collected, and the same sequences of the Cox1 gene identified from a region were excluded. The mutation sites among the Cox1 gene sequences were identified and a phylogenetic tree was created based on the Cox1 gene.

RESULTS

Transversion mutation was the predominant type of mutation in the Cox1 gene of E. granulosus. The same Cox1 gene sequence was found in E. granulosus G1, G6 and G7 genotypes isolated from various geographical locations across the world, with the corresponding GenBank accession numbers of KY766891, MH300971 and MH301007, respectively. Phylogenetic analysis revealed that E. granulosus G10 genotype had a remarkable geographical aggregation.

CONCLUSIONS

E. granulosus G1, G6 and G7 genotypes have primitive Cox1 gene sequences. There is a geographical aggregation of the E. granulosus G10 genotype in the phylogenetic tree, which has a tendency towards reproductive isolation.

[Study on the molecular phylogeny of Echinococcus multilocularis in Qinghai Province]

OBJECTIVE

To amplify and sequence Coxl and Nadl genes in Echinococcus multilocularis isolates from Qinghai Province, and to create phylogenetic trees and molecular clocks, so as to provide evidence for estimating the evolutionary relationships and origins of E. multilocularis in Qinghai Province.

METHODS

Twenty-two post-surgical specimens of patients with hepatic alveolar echinococcosis were sampled from Qinghai Provincial People's Hospital in 2017. The Coxl and Nadl genes were amplified from E. multilocularis samples and sequenced. Then, the gene sequences were aligned to the Coxl and Nadl genes of Echinococcus species in GenBank database. The intra-species variation was observed, and the phylogenetic tree and molecular clock were created.

RESULTS

All E. multilocularis samples shared more than 99% genetic homology with the sequences of Coxl and Nadl genes from the E. multilocularis Asian strain in the GenBank database. A total of 6 genotypes were identified, including 2 isolates that had no 100% homology with the sequences of known genes in the GenBank database. Phylogenetic tree analysis revealed remarkable clustering of the E. multilocularis samples with the E. multilocularis Asian strain, and the E. multilocularis isolates from Qinghai Province were estimated to date back to 94 000 years ago by the molecular clock.

CONCLUSIONS

The present study characterizes 6 E. multilocularis genotypes in Qinghai Province, including 2 novel genotypes. Asian strain is the predominant strain of E. multilocularis in Qinghai Province, and the E. multilocularis isolates from Qinghai Province date back to 94 000 years ago.

[Present situation and progress of comprehensive treatments for hepatic alveolar echinococcosis]

Alveolar echinococcosis is a parasitic zoonosis that severely damages human health. Currently, radical surgical resection is the first choice for hepatic alveolar echinococcosis. For the advanced hepatic echinococcosis patients with refractory radical resection, the palliative surgery combined with chemotherapy, liver transplantation, drug therapy, and radiofrequency microwave ablation may provide comprehensive tools. This article reviews the current situation and progress of comprehensive treatments for hepatic alveolar echinococcosis.

[Application value of Revolution CT combining three-dimensional visualization technique in precision resection of hepatic alveolar echinococcosis]

OBJECTIVE

To explore the application value of Revolution CT combining three -dimensional visualization technique in the precision resection of hepatic alveolar echinococcosis.

METHODS

Totally 12 patients with surgical treatment and pathologically confirmed hepatic alveolar echinococcosis in Qinghai Provincial People's Hospital were retrospectively analyzed. All the patients underwent the Revolution CT plain and enhancement scan before surgery, and the 0.625 millimeter scan data were obtained. The DICOM format data were imported into MI-3DVS for three-dimensional reconstruction, simulated cutting, volume measurement, and surgical planning.

RESULTS

The data of 12 patients were reconstructed successfully, and the sizes and locations of the lesions as well as the hepatic vascular systems were clearly displayed. The liver volume, hydatid volume, simulated resection volume, and residual liver ratio were measured accurately. The average whole liver volume and the lesion volume of the 11 surgical treated patients were (2 429.8 ± 335.9) mL and (919.6 ± 262.8) mL respectively. The average actually removed volume was highly associated with the average simulated resection volume (r = 0.979, P < 0.01).

CONCLUSIONS

Revolution CT combining three-dimensional visualization technique can achieve accurate diagnosis as well as optimal surgical planning before operation, which is of great value for the precision resection of difficult hepatic alveolar echinococcosis.

[Safety and efficacy of transcatheter closure of ruptured sinus of Valsalva aneurysm]

Objective: To investigate the safety and efficacy of transcatheter closure of ruptured sinus of Valsava aneurysm(RSVA). Methods: A total of 33 RSVA patients underwent transcatheter closure from January 2006 to March 2017 in our hospital were included in this retrospective study. The RSVA was diagnosed by echocardiography.Different type of occluders were applied for transcatheter closure based on the aortography results. All the patients were followed up after the procedure. Results: The patients were (37.6±12.1) years old,and the male patients accounted for 78.8%(26 cases).RSVA from right coronary sinus was found in 25 patients,and draining chamber was right atrium in 13 cases, right ventricle in 12 cases. RSVA from noncoronary sinus was diagnosed in 8 patients,and the draining chamber was right atrium. Aortography defined the narrowest diameter at the rupture site was (6.4±1.7)mm. The ratio of Qp/Qs was 2.2±0.5,and the mean pressure of pulmonary artery was 24.0(21.2,33.7)mmHg(1 mmHg=0.133 kPa). One patient developed serious occluder related aortic regurgitation and underwent surgery, transcatheter closure was successfully performed in 32 patients. The success rate of transcatheter closure was 97.0%. Two types of device were used in the study including small-waist double-disk ventricular septal defect(VSD) occluders in 20 cases and patent ductus arteriosus(PDA) occluders in 12 cases. During a median follow-up of 73.5(28.3,89.5) months, there were no infective endocarditis, residual shunt, thrombosis, device displacement,serious aortic regurgitation, serious arrhythmia or death.At the last follow-up, the left atrial diameter((37.4±6.5) mm vs. (41.5±5.3)mm,P<0.01),right atrial diameter((42.4±3.0) mm vs. (48.5±6.0)mm,P<0.01), right ventricular diameter((22.2±3.8) mm vs. (27.7±7.2)mm,P<0.01) and left ventricular end-diastolic diameter((51.3±4.9) mm vs.(55.0±4.3)mm,P<0.01)measured by echocardiography were all smaller than pre-procedural level. Conclusion: Transcatheter closure of RVSA is a safe and effective strategy and associated with a good long-term outcome.

Lasiopodomys fuscus as an important intermediate host for Echinococcus multilocularis: isolation and phylogenetic identification of the parasite

BACKGROUND

Echinococcus multilocularis causes alveolar echinococcosis (AE) and is widely prevalent in Qinghai Province, China, where a number of different species have been identified as hosts. However, limited information is available on the Qinghai vole (Lasiopodomys fuscus), which is hyper endemic to Qinghai Province and may represent a potential intermediate host of E. multilocularis. Thus, L. fuscus could contribute to the endemicity of AE in the area.

METHODS

Fifty Qinghai voles were captured from Jigzhi County in Qinghai Province for the clinical identification of E. multilocularis infection via anatomical examination. Hydatid fluid was collected from vesicles of the livers in suspected voles and subjected to a microscopic examination and PCR assay based on the barcoding gene of cox 1. PCR-amplified segments were sequenced for a phylogenetic analysis. E. multilocularis-infected Qinghai voles were morphologically identified and subjected to a phylogenetic analysis to confirm their identities.

RESULTS

Seventeen of the 50 Qinghai voles had E. multilocularis-infection-like vesicles in their livers. Eleven out of the 17 Qinghai voles presented E. multilocularis infection, which was detected by PCR and sequencing. The phylogenetic analysis showed that all 11 positive samples belonged to the E. multilocularis Asian genotype. A morphological identification and phylogenetic analysis of the E. multilocularis-infected Qinghai voles confirmed that all captured animals were L. fuscus.

CONCLUSIONS

L. fuscus can be infected with E. multilocularis and plays a potential role in the life cycle and epidemiology of E. multilocularis in the Qinghai-Tibetan Plateau of China.

Coexisting ventricular septal defect affects the features of ruptured sinus of Valsalva aneurysms

Objectives:

To determine the correlation exists between ventricular septal defect (VSD) and ruptured sinus of Valsalva aneurysm (RSVA).

Methods:

Between September 2003 and April 2014, 80 RSVA patients underwent surgical repair. These patients were retrospectively divided into two groups: the VSD group (38 cases) and the non-VSD group (42 cases).

Results:

Rupture points of SVA originated more frequently in the right coronary sinus (RCS) of patients in the VSD group than those in the non-VSD group (p=0.002). In the VSD group, more than 92.1% tended to rupture into the right ventricular outflow tract. The rupture points are diverse in the non-VSD group. A significant difference was found in rupture points of RSVA between the two groups (p<0.001). Patients in the VSD group presented with aortic valve disease more often than those in the non-VSD group (p<0.001). A total of 67 patients were repaired with a patch at the opening of RSVA; of those, all patients in VSD group and 29 patients in non-VSD group were repaired with a patch. Nine patients in non-VSD group received transcatheter closure of RSVA.

Conclusion:

The presence or absence of VSD affects the rupture points of SVA, aortic valve disease involved, and therapeutic schedule. Ruptured sinus of Valsalva aneurysm type should be clinically modified on the basis of presence or absence of VSD.

[Therapeutic effect of severe thrombocytopenia in patients underwent transcatheter patent ductus arteriosus occlusion]

Objective: To investigate the therapeutic effect of severe thrombocytopenia in patients underwent transcatheter patent ductus arteriosus occlusion. Methods: Clinical data of 80 pure patent ductus arteriosus patients who underwent interventional occlusion between February 2011 and November 2014 in General Hospital of Shenyang Military Region were retrospective analyzed.A bolus of heparin calcium (80 U/kg) was administered by intravenous injection during the procedure.Blood test was conducted in all patients before and after the procedure.The patients with both platelet reduction rate ≥ 5% and platelet count <100×10⁹/L(severe thrombocytopenia) were treated by following strategies: bed rest, avoidance of activities, intensive control of blood pressure through sodium nitroprusside administration, and inhibition of presumed immunological reaction by glucocorticoids and human immunoglobulin administration.Follow-up ended in May 2015. Results: (1) A total of 54 cases (67.5%) were diagnosed as thrombocytopenia in second days after the procedure.The reduction rate of platelet in 41 out of 54 patients was equal or more than 5% on the second day, and the diameter of occludes were equal or more than 14 mm in 35 out of these 54 patients.Severe thrombocytopenia occurred in 14 patients and the occluder diameter was ≥ 14 mm in these 14 patients.Severe thrombocytopenia did not occur in patients with occlude diameter <14 mm or with reduction rate of platelet <5%.(2) A total of 14 severe thrombocytopenia patients were treated.No bleeding events occurred in hospital and during the whole follow-up period.The the lowest value of platelet count of patients was seen on the 4.5 (3.8, 6.0) days post the procedure.The lowest numbers were 16.5 (7.5, 37.3)×10⁹/L.The platelet count of patients restored to more than 30×10⁹/L on the 8.0 (4.8, 9.5) days and restore to more than 100×10⁹/L on the 12.0 (9.8, 39.3) days post procedure.The average hospitalization day of the patients were 15.5 (11.8, 21.5) days.The platelet counts of severe thrombocytopenia patients were normal during the end of follow up (median 3.8 (1.0, 4.9) years). Conclusion: The patients with very severe thrombocytopenia after transcatheter occlusion of patent ductus arteriosus are associated with a benign outcome in case of timely and proper treatment.

[Survey on fungi contamination and natural occurrence of mycotoxins in 94 corn feed ingredients collected from China]

Objective: To investigate fungi contamination and the natural occurrence of mycotoxins in corn feed ingredients collected from China. Methods: A total of 94 corn feed ingredient samples were collected from 8 Chinese provinces(i.e., Anhui, Hebei, Heilongjiang, Jilin, Jiangsu, Liaoning, Inner Mongolia, and Shandong)in February 2014. A tandem ultra-performance liquid chromatographymass spectrometry method was used for simultaneous detection of twelve kinds of mycotoxins, including aflatoxin(AF), type A and type B tricothecenes, and zearalenone(ZEN). Contaminated fungi were also identified and counted. Results: AF was detected in 36.2%(34/94)of samples; the concentration of AFB₁ was the highest in the four AFs with the range: 0.3~181.3 μg/kg; and then followed by AFB₂(range: 1.0-74.3 μg/kg). There were 7 samples(7.5%)with AFB₁ concentrations higher than the tolerance limit of 50 μg/kg. The concentration of type A tricothecenes in all samples was lower(0.1-10.5 μg/kg). DON had the most serious contamination than other kind of type B tricothecenes(range: 0.7-606.6 μg/kg; median: 66.3 μg/kg). The DON concentration in all samples was below the tolerance limit of 1 000 μg/kg. ZEN was detected in 76.6%(72/ 94)of samples(median: 36.9 μg/kg), with 3 samples having ZEN concentrations higher than the tolerance limit of 500 μg/kg. The survey on fungi contamination showed that all samples were contaminated by fungi(range: 5.0-1.4×10⁵ CFU/g). There were 18 and 3 samples with quantities of fungi higher than the tolerance and forbidden limits, respectively. The Aspergillus, Penicillium, Fusarium, Trichoderma and Mucor genuses were the predominant fungi in corn feed ingredients, with detection rates of 71.3%(67), 60.6%(57), 71.3%(67), 27.7%(26), and 24.5%(23), respectively. The detection rate of Fusarium moniliforme, 73.4%(69/94)was higher than that of Aspergillus flavus, 41.5%(39/94). Conclusion: In this survey, the corn feed ingredients were not seriously contaminated by AF and type A tricothecenes but mainly contaminated by type B trichothecenes, including DON and its derivatives, as well as ZEN. They were also contaminated by fungi such as Aspergillus, Penicillium, and Fusarium.

An alternative mebendazole formulation for cystic echinococcosis: the treatment efficacy, pharmacokinetics and safety in mice

Background

Cystic echinococcosis is a serious zoonotic infection worldwide caused by metacestodes of Echinococcus gruanulosus. Mebendazole and albendazole are the only two drugs used in the treatment of this disease with cure rates only about 30% due to the poor oral absorption. Thus an alternative treatment for this disease is needed.

Methods

A mebendazole oily suspension (MBZ-OS) was prepared and orally administrated to mice infected with echinococcus cysts for 8 months at 12.5 mg/kg and 25 mg/kg for 14 consecutive days. Mebendazole suspended in 1% tragacanth (MBZ-1% tragacanth) served as treated control. In addition, liver and serum samples were collected from these treated mice (25 mg/kg) for histopathology examination and liver function test. For pharmacokinetic analysis, plasma, parasite (cyst wall and cyst fluid) and tissue samples were collected at 0.25, 0.5, 1, 2, 4, 8, 16 and 24 h after orally administrating MBZ-OS and MBZ-1% tragacanth to E. granulosus-infected mice at 25 mg/kg. These samples were then processed and quantitatively analyzed by HPLC.

Results

The administration of MBZ-OS resulted in a treatment efficacy with the cyst weight reductions higher than 80%, significantly better than the corresponding MBZ-1% tragacanth groups. The better treatment efficacy of MBZ-OS was related to the higher drug concentration in plasma, parasites and tissues. It was also shown that the injury of the liver was not significantly altered by taking MBZ-OS compared to the untreated control.

Conclusion

These findings demonstrate that MBZ-OS is a promising new formulation of MBZ for treatment of hydatid diseases without showing significantly liver toxicity.

Electronic supplementary material

The online version of this article (doi:10.1186/s13071-014-0589-0) contains supplementary material, which is available to authorized users.

[Survey on human soil-borne nematode infection in Xining City]

Five fields were selected from Xining City by stratified cluster sampling method for the survey. 4589 people above 3 years old were examined for nematode infections using Kato-Katz method and children under 12 years old were detected for pinworm infection using transparent tape method from June to August in 2011. The results showed that the total nematode infection rate was 3.0% (136/4 589) with the highest of 3.8% (123/3284) in rural area. The major species was Ascaris lumbricoides, and the infection rate in 15-20 age group was 1.5% (4/264), which was significantly lower than that of the age groups of 60-70 (6.9%, 23/335), above 70 (5.3%, 6/114) and of 10-15 (5.1%, 19/372)(P<0.05). The prevalence of A. lumbricoides among the preschool children (9.5%, 12/127) was statistically higher than those in other occupation groups (P<0.05), and the infection rate showed no statistical significance by gender, ethnic and degree of education (P>0.05). Pinworm infection in children under 12 years old was only 0.5% (2/437).

Initial experience of occluding special type patent ductus arterioses using the Amplatzer vascular plug

BACKGROUND

Occluders licensed for clinical use are not fit for some special Krichenko E patent ductus arterioses. The Amplatzer vascular plug I (AVP1) has not been licensed for use for closure of patent ductus arteriose. We report our initial experience to occluding special type patent ductus arterioses with the AVP1-a single lobe device of single layer Nitinol mesh for short vessel landing zones.

METHODS

Patients referred with small and long Krichenko E patent ductus arterioses 1 mm to 3 mm in diameter underwent occlusion using AVP1. All cases underwent pre-, intra- and post-procedural echocardiography and chest X-ray at the completion of the procedure, the next day and at a 30-day, 3-month and 6-month follow-up visits. Device sizing for device waist diameter and length was based on aortography.

RESULTS

From April 2008 to June 2012, 26 patients with a mean age of (7.6 ± 8.0) years (range 6 months-32 years) and a mean weight of (23.8 ± 14.8) kg (range 7-67 kg) underwent successful patent ductus arteriose closure. The mean ductus diameter was (2.1 ± 0.7) mm (range 1-3 mm). Transpulmonary (22/26) and transaortic approaches (4/26) were used. No persistent patency was observed after 24 hours and after one month. No device displacement, residual flow and iatrogenic coarctation of the aorta were observed after three months and six months.

CONCLUSIONS

The AVP1 makes it easy to close some Krichenko E patent ductus arterioses. Smaller delivery catheter profile and symmetric cylindrical device shape allow for use for small and long Krichenko E patent ductus arterioses 1 mm to 3 mm in diameter and small patients through transaortic approaches. Broader experience is required to further delineate device and patient selection as well as to document its long-term efficacy and safety.

[Cloning, expression and bioinformatics analysis of cyclophilin of Echinococcus granulosus]

OBJECTIVE

To clone and express EgCyP gene of Echinococcus granulosas and analyze EgCyP using bioinformatics.

METHODS

Total RNAS of adult E. granulosus was extracted and reversedly transcripted to cDNA. EgCyP gene was amplified from cDNA and inserted into vector pET28a. Recombinant plasmid pET28a-EgCyP was transformed into E. coli BL21 (DE3) for expression under the induction of IPTG. The expressed product was identified by SDS-PAGE and Western blotting. EgCyP was analyzed by the bioinformatics software.

RESULTS

The EgCyP gene was successfully amplified from cDNA of adult E. granulosus and a fusion protein was expressed in E .coli BL21 (DE3). The molecular weight of the expressed protein was about 22 kDa. The Western blotting indicated that the antigenicity of the protein was specific. The bioinformatics analysis revealed that there were 7 antigen epitopes in EgCyP.

CONCLUSION

EgCyP of E. granulosus is cloned and expressed in E. coli BL21 (DE3) successfully, which might be the foundation for the further study of its immunogenicity.

[Geographical distribution of echinococcosis among children in Qinghai Province]

OBJECTIVE

To analyze the epidemiological status of echinococcosis among children in three different zones of Qinghai Province.

METHODS

B-ultrasound and ELISA were used in the survey to evaluate echinococcus infection among 6 to 15 year old children in the three zones, namely, Qinghai southern plateau, Qilian mountain-Hehuang valley and Chaidamu basin.

RESULTS

The prevalence of echinococcus infection scanned by B-ultrasound and sera positive rate detected by ELISA in children were 1.5% (320/20 730) and 6.5% (1024/15 762) respectively, and the prevalence of cystic echinococcosis and alveolar echinococcosis by ultrasound were 1.0% (206/20730) and 0.6% (114/20730), respectively. The prevalence and sera positive rate were 9.5% (707/7 453) and 2.3% (269/11 618) in Qinghai southern plateau, 3.8%(289/7 544) and 0.6% (50/8 275) in Qilian mountain-Hehuang valley, and 3.7% (28/765) and 0.1% (1/837) in Chaidamu basin, respectively. The southern plateau showed the highest prevalence, with a significant statistical difference among the three areas (P < 0.01). The prevalence of alveolar echinococcosis was 1.0% (114/11 618) in the southern plateau, but no alveolar echinococcosis patients were found in other two areas. Correlation analysis showed that the prevalence increased with the altitude (r(s-e) = 0.96, P < 0.05, R2 = 0.93; r(p-e) = 0.82, P < 0.05, R2 = 0.67).

CONCLUSION

The prevalence of echinococcosis among children shows an apparent geographical difference in Qinghai Province.

Study on energy transfer and energy migration of Ca2Gd8(SiO4)6O2:Dy3+ phosphor films

Being a kind of rare-earth-metal silicate with oxidapatite structure, Ca2R8(SiO4)6O2 (R = Y, Gd, La) is a promising material doped with rare earth, and widely used as phosphors. In this thesis, Ca2Gd8(SiO4)6O2:Dy3+ films were prepared by the sol-gel method. X-ray diffraction (XRD), atomic force microscopy (AFM), photoluminescence (PL) spectra, and lifetimes were used to characterize the resulting films. AFM study indicated that the phosphor films consisted of 120 nm homogeneous particles. By combining the model of Burshtein for donor-donor migration and the V-F-B model for donor-acceptor energy transfer, the experimental luminescence decay curve of 6P(J) state of Gd3+ was re-simulated. It is found that concentration quenching of Gd3+ can be due to the result of the joint action of donor-donor (Gd3+-Gd3+) energy migration and donor-acceptor (Gd3+-Dy3+) energy transfer.

[Cloning, expression and immunodiagnostic evaluation of antigen EPC1 from Echinococcus granulosus]

OBJECTIVE

To clone and express EPCl gene of Echinococcus granulosus, and investigate its immunogenicity and diagnostic value.

METHODS

Total RNA was extracted from hydatid cyst protoscoleces and EPC1 gene of Echinococcus granulosus was amplified by RT-PCR. The PCR product was cloned into pGEM-T vector, and then subcloned into the prokaryotic expression vector PET28a(+). The positive recombinants were transformed into Escherichia coli BL21 (DE3), and followed by expression of the protein induced by IPTG. The recombinant protein was identified by SDS-PAGE and Western blotting, and used to establish ELISA. Serum samples from patients with cystic echinococcosis (60 cases), alve-olar echinococcosis (37 cases), cysticercosis (16 cases), clonorchiasis sinensis (7 cases), schistosomiasis japonica (4 cases) and healthy persons (33 cases) were examined.

RESULTS

The recombinant plasmid PET28a-EgEPC1 was identified by restriction enzyme digestion and sequencing. SDS-PAGE result showed that the recombinant containing recombinant plasmid PET28a-EgEPC1 expressed a soluble fission protein of EgEPC1 (about M, 11 000). The protein was recognized by pool sera of cystic echinococcosis patients. The overall sensitivity and specificity of diagnosis by ELISA for cystic echinococcosis were 78.3% (47/60), and 98.3% (59/60), respectively. The cross reaction with sera of alveolar echinococcosis was 40.5% (15/37).

CONCLUSION

The recombinant EgEPC1 antigen has diagnostic value in cystic echinococcosis.

[Cloning and expression of echinococcus granulosus Eg18 and preliminary evaluation of immunological assay with recombinant antigen]

OBJECTIVE

To clone and express Echinococcus granulosus Eg18 gene and evaluate the immunoreactivity of the recombinant protein.

METHODS

Eg18 coding sequence was amplified by RT-PCR using primers designed according to the sequence of Eg18 in GenBank from total RNA extracted from Echinococcus granulosus protoscoleces isolated from infected sheep in Qinhai Province and cloned into the prokaryotic expression vector pET-28a(+). The recombinant expression vector was transformed to Escherichia coli BL21 (DE) and induced to express by IPTG. The expressed products were analyzed by SDS-PAGE and purified with Ni-IDA agarose affinity chromatography. rEg18 was evaluated for its reactivity with the sera from the patients infected with hydatid and other helminthes by Western blotting and ELISA.

RESULTS

The sequence of cloned Eg18 was completely identical wit the original sequences of Eg18 and Em18 deposited in GenBank. The recombinant protein strongly reacted to the sera from the patients with alveolar echinococcosis, cystic echinococcosis, and cysticercosis, and weakly reacted to the sera from the patients with nematodiasis, schistosomiasis and clonorchiasis. The detection of specific IgG4 was much more specific than that of IgG.

CONCLUSION

Eg18/Em18 is the common antigen of cestode and its specific IgG4 is a serum marker of alveolar echinococcosis.

Transcatheter closure of congenital coronary artery fistulae: immediate and long-term follow-up results

BACKGROUND

Transcatheter closure of coronary artery fistulae (CAF) has emerged as an alternative to surgery, but there are no long-term outcome results.

OBJECTIVE

We report immediate and long-term results in 24 patients after transcatheter closure of congenital CAF.

METHODS

A total of 24 patients aged 5 to 56 years old with congenital CAF underwent attempted percutaneous transcatheter closure using various devices between November 1998 and August 2008. The immediate closure results and clinical follow-up were reviewed.

RESULTS

Of the 24 patients, 20 (83.3%) underwent successful transcatheter closure using various devices. An angiogram right after device deployment revealed complete occlusion in 15 patients (75%) and trivial- to mild- residual flow in 5 patients (25%). Four patients (20%) had transient ST-T wave changes after the procedure. The left ventricular end-diastolic volume decreased from 165+/-31.4 mm3 to 128.6+/-24.4 mm3 (P = 0.012) 24 hours after procedure, and the cardiothoracic ratio from 0.57+/-0.02 to 0.53+/-0.01 (P = 0.003). Follow-up was 100% complete and ranged from 3 months to 10 years. There were no early or late deaths. All patients were asymptomatic with complete closure of CAF except 1 patient (5%) who had a recurrence of shunt at 6-month follow-up, which was re-closed by percutaneous technique.

CONCLUSION

Transcatheter closure of CAF is feasible and safe in anatomically suitable vessels and is a promising alternative to surgery in most patients.

[Effects of transcatheter closure of patent ductus arteriosus in 139 adult patients]

OBJECTIVE

To analyze the clinical feature and the effects of transcatheter closure of adult patients with patent ductus arteriosus (PDA).

METHODS

Between January 2000 and April 2009, 139 patients [22 male, aged from 40 to 74: (49.8 +/- 6.8) years] with PDA were hospitalized in our hospital. Clinical data and effects of transcatheter closure of PDA were analyzed.

RESULTS

There were 64 patients with NYHA classI, 53 with class II, 16 with class III and 6 with class IV before procedure. In 139 patients, pulmonary arterial hypertension (PAH) was found in 107 out of 139 patients (77.0%). Transcatheter PDA closure was not performed in 3 patients due to severe PAH and successfully performed in the remaining 136 patients (97.8%) without major complications. Post procedure aortic angiography evidenced minor residual shunt in 14 cases, small residual shunt in 2 cases and moderate shunt in 1 case. The NYHA class was significantly improved and the PAH significantly reduced [sPAP: (47.3 +/- 23.9) mm Hg (1 mm Hg = 0.133 kPa) vs. (28.1 +/- 12.3) mm Hg, P < 0.01] post procedure.

CONCLUSION

PAH and heart failure were commonly associated with PDA in adult patients. Transcatheter PDA closure is safe and effective in these patients except those with severe PAH.

[Short- and mid-term outcomes of arrhythmia after transcatheter and surgical closure of membranous ventricular septal defects: a comparative analysis]

OBJECTIVE

To evaluate the short- and mid-term outcomes of arrhythmia in patients undergoing transcatheter and surgical closure of membraneous ventricular septal defect (VSD).

METHODS

358 VSD patients, 161 male and 197 female, aged (11 +/- 8), underwent transcatheter closure and 50 sex, age, body weight, size of membranous VSD, and percentage of complicated membranous aneurysm-matched VSD patients underwent surgical closure. Electrocardiography was conducted 1, 3, 6, and 12 months after VSD closure.

RESULTS

Except bundle branch block other kinds of arrhythmia were resolved in all the patients prior to discharge. The arrhythmias occurring in the patients who underwent transcatheter closure of VSD included complete right bundle branch block (CRBBB, 4 5%), incomplete right bundle branch block (IRBBB, 10.1%), left anterior fascicular block (LAFB, 2.8%), IRBBB complicated with LAFB (1.7%), and CRBBB complicated with LAFB (0.6%), while in the patients who underwent surgical closure included CRBBB (26%) and IRBBB (28%). At the end of 12 months of follow-up, of the 180 patients who had undergone interventional therapy 6 showed CRBBB (3.3%), 6 showed IRBBB (3.3%), 3 showed CRBBB complicated with LAFB (1.7%) and one showed third degree auriculo-ventricular block (0.56%) s, however, no significant change in the ECG findings occurred in the patients who had undergone surgical closure.

CONCLUSION

Transcatheter occlusion of membraneous VSD is safer than surgical closure. IRBBB and LAFB caused by interventional therapy are benign, the majority of which may resolve itself 6 - 12 months after the procedure. However, CRBBB and CRBBB complicated with LAFB need a long-term follow-up.

Plasma caffeine metabolite ratio (17X/137X) in vivo associated with G-2964A and C734A polymorphisms of human CYP1A2

Either G-2964 or A734 in the human CYP1A2 gene was confirmed to be associated with high inducible enzyme activity in smokers, but not in nonsmokers. In this study, for the first time, we observed an association between phenotypes and genotypes of CYP1A2 with respect to the two genetic polymorphisms in 163 healthy Chinese volunteers living in Qidong. The ratio of plasma 17X/137X at 6 h after oral administration of 300 mg caffeine was employed in CYP1A2 phenotyping analysis, while genotyping analysis was carried out by polymerase chain reaction-restriction fragment length polymorphism. The allele frequencies of A at -2964 and A at 734 in 139 non-smoking subjects were 0.25 and 0.67, respectively. The A/A-2964C/C734, G/A-2964C/C734 or A/A-2964C/A734 genotype that was thought to have lower inducibility/activity of CYP1A2 than the other genotypes did not exist in the tested Chinese subjects. The ratio of 17X/137X was 0.46 +/- 0.26 in G/G-2964A/A734 genotypes (n = 22) and 0.36 +/- 0.19 in non-G/G-2964A/A734 (n = 117). In addition, there was significant difference between them (P = 0.036). A similar result was also achieved in 24 smokers. Since Qidong is a special region with particularly high incidence of hepatocellular carcinoma in China, the association of phenotypes with genotypes of CYP1A2 in the Qidong population might result from some inducible environmental factors such as those of cigarettes in smokers.

G-2964A and C734A genetic polymorphisms of CYP1A2 in Chinese population

AIM

To observe the G-2964A and C734A genetic polymorphisms of human CYP1A2 in Chinese population.

METHODS

Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was employed in genotyping analysis.

RESULTS

The allele frequencies of A-2964 were 0.25 and 0.22 in Qidong and Changsha populations, respectively. The incidences of A734 were 0.68 in Qidong population and 0.66 in Changsha population. No more than two low-inducibility/activity alleles were presented in one person.

CONCLUSION

The distribution of the G-2964A and C734A genetic polymorphisms did not show significant difference between Chinese and Japanese populations. The incidence of C734A in Chinese was also similar to that in Caucasian population.

Polymorphism of CYP450 and cancer susceptibility

CYP450s form a superfamily involved in the metabolism of many endogenous and exogenous substrates. In this review, the substrates, probe drugs, genetic polymorphisms, and associated cancers of CYP1A1, CYP1A2, CYP2C19, CYP2D6, CYP2E1, and CYP3A4 are summarized.

[Quantitative analysis of 200 human tongue pictures]

Photoelectricity integration was applied to detect and analyse the colorimetric tongue pictures in 200 human beings. The results showed that among various tongue pictures there were evident differences in colorimetric features. This method could also assess the thickness of tongue coating, thus obtaining the colorimetric features including color of tongue proper, color of coating as well as thickness index in common tongue pictures. Therefore it might provide scientific basis for objective and quantitative assessment of tongue pictures in TCM.

Human immunodeficiency virus type 1 Tat-mediated trans activation correlates with the phosphorylation state of a cellular TAR RNA stem-binding factor

Protein kinase C (PKC) is involved in the mitogenic stimulation of cell proliferation and has recently been reported to be essential for Tat-mediated trans activation. We have determined that RNA binding of a cellular factor which specifically interacts with the trans-activation response region (TAR) is blocked in cells depleted of PKC activity by chronic phorbol myristate acetate stimulation. We also show that nuclear extracts can be depleted of the cellular TAR-binding factor by in vitro treatment with purified protein phosphatase 2A. Furthermore, TAR RNA-binding activity can be partially restored to depleted nuclear extracts in vitro by addition of PKC. Chimeric constructs in which the Tat protein is artificially tethered to viral RNA show PKC independence for Tat-mediated trans activation. Specific mutations in the TAR RNA stem region which cause reduced binding of host cell factor in vitro also cause reduced Tat-mediated trans activation in vivo. Together, these results suggest that phosphorylation-dependent binding of a cellular cofactor to TAR RNA is an essential step in Tat-mediated trans activation. Deciphering the regulation of Tat-mediated trans activation by phosphorylation will be critical in fully understanding the regulation of human immunodeficiency virus type 1 activation.

[Simultaneous detection of the platelet aggregation and release in patients with cardio-cerebral vascular diseases associated with blood stasis and their clinical significance]

The authors determined the platelet aggregation(PA) activity respectively with electric impedance and photoelectric turbidimetry in patients with ischemic cardio-cerebral vascular diseases associated with blood stasis. The results showed the PA activities were elevated both in whole blood and plasma. Then, the authors detected simultaneously the PA activity and amount of post-aggregation beta-thromboglobulin(beta-TG) releasing and also in vivo amount of spontaneous plasma releasing of beta-TG with photoelectric turbidimetry and RIA methods with blood stasis. The results showed, during the acute phase of stroke, a high activated state of platelet existed, expressed as significant elevation both of the amount of beta-TG releasing of post-aggregation and plasma beta-TG level. However, no definite correlation between rate of PA and subsequent amount of beta-TG releasing was found, and detection of aggregation rate alone did not disclose the state of activation. As compared with the acute phase, during the recovery stage of stroke in which the clinical symptom of blood stasis was improved, the plasma beta-TG level declined significantly, however, was still higher than in normal controls; amount of releasing beta-TG was declining which denoted that the platelet functions were reducing then, but were still in a higher state of activation. These results suggested that there were changes both in number and quality of platelet in patients with blood stasis.

[Plasma tissue-type plasminogen activator and plasminogen activator inhibitor activities and their ratio in patients with ischemic stroke associated with stagnation of blood during various stages]

The studies showed that t-PA activity was elevated during the acute phase, remained elevated during the recovery stage and declined during the sequelar stage. Lowering of PAI activity was found during the acute phase, which was reversed during the recovery phase and remained significantly elevated during the sequelar stage compared with the controls (P less than 0.001), F test showed that both t-PA and PAI activities changed significantly during various stages (t-PA, P less than 0.01; PAI, P less than 0.001). Because of these changes, the ratio of PAI and t-PA fluctuated during different stages of the disease. This ratio decreased during the acute stage and came close to the normal levels during the recovery phase. The ratio, however, elevated abnormally during the sequelar stage, compared with healthy controls (P less than 0.05), In addition, the result of correlation test and linear regression analysis of serum t-PA and PAI activities in 54 cases showed a significant negative correlation (P less than 0.001) existed between t-PA and PAI activities. The balance of plasma t-PA and PAI activities have the function in maintaining the normal bloodstream in human body. In the process of disease, the abnormality of plasma t-PA and PAI activities may be the different pathological characteristics involved in this stagnation process. If coordinated with differentiation of syndrome in TCM, it may have the important significance to follow-up, and determine prognosis and early diagnosis for certain potential clinical stagnation of blood.

[Determination of plasma tissue type plasminogen activator and plasminogen activator inhibitor activity in patients with ischemic stroke]

Plasma tissue-type plasminogen activator and plasminogen activator inhibitor were determined during the acute, recovery and sequelae stages of patients with ischemic stroke by chromophoric substrate assay. The result showed that t-PA activity was elevated during the acute phase, remained elevated during the recovery stage and declined during the sequelae stage. Lowering of PAI activity was found during acute phase, which reversed during recovery phase and remained significantly elevated during sequelae stage. As a result, the ratio of PAI/t-PA fluctuated during different stages of the disease. Significant elevation of PAI and PAI/t-PA ratio during sequelae stage may be one of the risk factors of further thrombosis and contribute partly to the high relapsing rate of the disease. In addition, a positive correlation was found between PAI and serum cholesterol content.

[Quantitative detection of microcirculation and multi-factorial analysis of patients with cardio-cerebrovascular diseases with blood-stasis syndrome]

The studies, which applied the Laser Doppler Micro-detection technique and other multi-factors analysis in patients with cardio-cerebrovascular diseases with blood-stasis syndrome, suggested that the speed of microcirculatory flow were slowed down obviously. The change of this value in patients comparing with healthy adults and the aged showed evident difference accompanied with many changes such as hemorheology, red cell deformability (RCD) and platelet aggregation (PA). Relativity analysis showed that there was linear relativity in degree of microcirculatory obstacle and PA and RCD. Further comparison and analysis with multi-factors for mechanism in microcirculatory obstacles illustrated that those might be the result of many pathological factors' action. In clinical treatment, using anti-platelet drugs and comprehensive measures to enhance RCD and lower viscosity of blood, could be effective in improvement of microcirculatory functions.

Suppression of glioma growth in vitro and in vivo by glia maturation factor

Glia maturation factor (GMF), a 14,000 Mr acidic protein of the brain, is capable of promoting differentiation of cultured astroblasts. In this study we report the effect of GMF on two glioma cell lines: the C6 line, of rodent origin, and the HG-1 line, of human origin. When tested in culture, GMF promotes the initial growth of the two cell lines when the cells are sparse but limits proliferation by restoring contact inhibition when the cells are confluent. Cell cycle analysis confirms the arrest of the cells at the G0/G1 phase when the tumor cells are contact inhibited by GMF. When C6 cells are inoculated into the athymic (nude) mice at a s.c. site, a single solid tumor grows out with a 100% take. Intraperitoneal injection of GMF leads to the slowing down of tumor growth. That the in vivo effect of GMF is not due to cytotoxicity is evidenced by the lack of necrosis and by the appearance of more mature astrocytic cells in the tumors. The results lend support to the concept of GMF as a cellular regulator and suggest the therapeutic potential of GMF for brain tumors.