The relationship between heart-carotid pulse transit time and carotid intima-media thickness in hypertensive patients

The study aimed to investigate the relationship between heart-carotid pulse transit time and carotid intima-media thickness (CIMT) in hypertensive patients, and whether including the pre-ejection period (PEP) in heart-carotid pulse transit time would affect this correlation. A total of 62 hypertensive patients were included in this study. They were divided into the normal CIMT group (n=33, CIMT⩽0.8 mm) and the thickened CIMT group (n=29, CIMT>0.8 mm). The noninvasive ultrasound method was used to measure CIMT, electrocardiogram R-wave-based heart-carotid pulse transit time (rcPTT) and PEP. Aortic valve-carotid artery pulse transit time (acPTT) was calculated by subtracting PEP from rcPTT. Simple linear analysis showed that CIMT was negatively associated with rcPTT and acPTT (r=-0.57, P<0.0001; r=-0.41, P=0.016) in the normal CIMT group as well as in the thickened CIMT group (r=-0.50, P=0.0053; r=-0.59, P=0.001). These relationships were eliminated in the normal CIMT group after adjusting for age, gender, smoking behaviour, systolic blood pressure, diastolic blood pressure and cholesterol levels. However, rcPTT and acPTT still showed significant correlations with CIMT in the thickened CIMT group. In conclusion, rcPTT and acPTT were associated with CIMT, independent of well-known clinical confounders in thickened CIMT hypertensive patients. Therefore, rcPTT and acPTT might be useful markers for atherosclerosis evaluation.

Cytokine expression patterns and mesenchymal stem cell karyotypes from the bone marrow microenvironment of patients with myelodysplastic syndromes

The purpose of this study was to explore cytokine expression patterns and cytogenetic abnormalities of mesenchymal stem cells (MSCs) from the bone marrow microenvironment of Chinese patients with myelodysplastic syndromes (MDS). Bone marrow samples were obtained from 30 cases of MDS (MDS group) and 30 healthy donors (control group). The expression pattern of cytokines was detected by customized protein array. The karyotypes of MSCs were analyzed using fluorescence in situ hybridization. Compared with the control group, leukemia inhibitory factor, stem cell factor (SCF), stromal cell-derived factor (SDF-1), bone morphogenetic protein 4, hematopoietic stem cell (HSC) stimulating factor, and transforming growth factor-β in the MDS group were significantly downregulated (P<0.05), while interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), and programmed death ligand (B7-H1) were significantly upregulated (P<0.05). For chromosome abnormality analysis, the detection rate of abnormal karyotypes (+8, -8, -20, 20q-, -Y, -7, 5q-) was 30% in the MDS group and 0% in the control group. In conclusion, the up- and downregulated expression of these cytokines might play a key role in the pathogenesis of MDS. Among them, SCF and SDF-1 may play roles in the apoptosis of HSCs in MDS; and IFN-γ, TNF-α, and B7-H1 may be associated with apoptosis of bone marrow cells in MDS. In addition, the abnormal karyotypes might be actively involved in the pathogenesis of MDS. Further studies are required to determine the role of abnormal karyotypes in the occurrence and development of MDS.

Effect of nitric oxide inhalation combined with high-frequency oscillatory ventilation on the prognosis of neonatal severe hypoxemia

OBJECTIVE

The current study aimed to analyze the short-term and long-term curative effects of nitric oxide (NO) inhalation combined with high-frequency oscillatory ventilation (HFOV) on neonatal severe hypoxemia.

MATERIALS AND METHODS

A total of 98 neonates meeting the inclusion criteria were retrospectively analyzed. The control group comprised of 48 neonates and the NO inhalation group consisted of 50 neonates. In the control group, conventional mechanical ventilation was replaced by HFOV. In the experimental group, NO inhalation combined with HFOV was performed. The death rates within 28 days, mechanical ventilation and oxygen therapy time, and complications in both groups were observed. The survivors in both groups were followed up for 18 months for neural development evaluation.

RESULTS

The treatment group showed a significantly lower death rate and noticeably shorter mechanical ventilation and oxygen therapy time than the control group (8% vs. 22.9% with t = 4.20 andp < 0.05; 5.84 ± 3.36 days vs. 8.05 ± 5.48 days with t = 2.42 and p < 0.05; and 8.02 ± 4.31 days vs. 12.45 ± 5.14 days with t = 4.63 and p < 0.001). They did not show significant differences with regards to the complications and the incidences of cerebral palsy, hearing and visual impairments, and severe nervous damage (p > 0.05).

CONCLUSION

NO inhalation combined with HFOV significantly decreases the death rate of neonates with severe hypoxemia and reduces their mechanical ventilation and oxygen therapy time. It does not increase early adverse effects or affect long-term neurodevelopment.

High-level production of β-1,3-1,4-glucanase by Rhizomucor miehei under solid-state fermentation and its potential application in the brewing industry

AIMS

To improve the β-1,3-1,4-glucanase production by Rhizomucor miehei under solid-state fermentation (SSF) for industrial application.

METHODS AND RESULTS

The fermentation conditions for β-1,3-1,4-glucanase production by R. miehei CAU432 under SSF were optimized using a 'one-factor-at-a-time' method. Under the optimized fermentation conditions, viz. oatmeal (0·45-0·9 mm) as sole carbon source, 5% (w/w) peptone as sole nitrogen source, initial moisture of 80% (w/w), initial culture pH of 5·0, incubation temperature of 50°C and incubation time of 6 days, the highest β-1,3-1,4-glucanase activity of 20,025 U g(-1) dry substrate was achieved, which represents the highest yield for β-1,3-1,4-glucanase production ever reported. The crude enzyme was extracted and purified to homogeneity with a purification fold of 4·6 and a recovery yield of 9·0%. The addition of the purified β-1,3-1,4-glucanase in mash obviously reduced its filtration time (24·6%) and viscosity (2·61%).

CONCLUSIONS

The optimal fermentation conditions for maximal β-1,3-1,4-glucanase production under SSF was obtained, and the enzyme was suitable for application in the malting process.

SIGNIFICANCE AND IMPACT OF THE STUDY

The high production yield and excellent capability of the enzyme may enable it great potential in industries, especially in brewing industry.

SNPs in Entire Mitochondrial Genome Sequences (≈15.4 kb) and cox1 Sequences (≈486 bp) Resolve Body and Head Lice From Doubly Infected People From Ethiopia, China, Nepal, and Iran But Not France

Some people host lice on the clothing as well as the head. Whether body lice and head lice are distinct species or merely variants of the same species remains contentious. We sought to ascertain the extent to which lice from these different habitats might interbreed on doubly infected people by comparing their entire mitochondrial genome sequences. Toward this end, we analyzed two sets of published genetic data from double-infections of body lice and head lice: 1) entire mitochondrial coding regions (≈15.4 kb) from body lice and head lice from seven doubly infected people from Ethiopia, China, and France; and 2) part of the cox1 gene (≈486 bp) from body lice and head lice from a further nine doubly infected people from China, Nepal, and Iran. These mitochondrial data, from 65 lice, revealed extraordinary variation in the number of single nucleotide polymorphisms between the individual body lice and individual head lice of double-infections: from 1.096 kb of 15.4 kb (7.6%) to 2 bps of 15.4 kb (0.01%). We detected coinfections of lice of Clades A and C on the scalp hair of three of the eight people from Nepal: one person of the two people from Kathmandu and two of the six people from Pokhara. Lice of Clades A and B coinfected the scalp hair of one person from Atherton, Far North Queensland, Australia. These findings argue for additional large-scale studies of the body lice and head lice of double-infected people.

Racial disparities in the association between diabetes mellitus-associated polymorphic locus rs4430796 of the HNF1β gene and prostate cancer: a systematic review and meta-analysis

Polymorphism 17q12 rs4430796 within HNF1β is a genetic variant associated with both diabetes mellitus and prostate cancer, but findings on the correlations of rs4430796 with prostate cancer risk specifically are not in agreement, especially among diverse populations. To shed some light on the contradictory findings, therefore, we carried out a meta-analysis by pooling the odds ratios (ORs) with corresponding 95% confidence intervals (CIs) of all currently available case-control studies located within PubMed and Embase databases up to December 2012. A total of 16 studies comprising 30 datasets that collectively involved 25,535 prostate cancer patients and 25,726 controls were ultimately included in this analysis. The meta-analysis of all the studies revealed that the rs4430796 polymorphism was significantly associated with an increased risk of prostate cancer in all contrast models (ORA vs G = 1.25, 95%CI = 1.21-1.30, POR < 0.001; ORAA vs GG = 1.53, 95%CI = 1.45-1.62, POR < 0.001; ORAG vs GG = 1.24, 95%CI = 1.16-1.34, POR < 0.001; ORAA vs AG+GG = 1.36, 95%CI = 1.30-1.42, POR < 0.001; ORAA+AG vs GG = 1.37, 95%CI = 1.30-1.44, POR < 0.001). After subgroup analyses stratified by ethnicity, however, the rs4430796 polymorphism was significantly associated with prostate cancer in both Caucasians and Asians but not in African-Americans. In conclusion, our meta-analysis identified a significant association between the 17q12 rs4430796 polymorphism and prostate cancer risk, although the degree of this association and frequency of the causative allele varied among men of different races.

Second-generation sequencing of entire mitochondrial coding-regions (∼15.4 kb) holds promise for study of the phylogeny and taxonomy of human body lice and head lice

The Illumina Hiseq platform was used to sequence the entire mitochondrial coding-regions of 20 body lice, Pediculus humanus Linnaeus, and head lice, P. capitis De Geer (Phthiraptera: Pediculidae), from eight towns and cities in five countries: Ethiopia, France, China, Australia and the U.S.A. These data (∼310 kb) were used to see how much more informative entire mitochondrial coding-region sequences were than partial mitochondrial coding-region sequences, and thus to guide the design of future studies of the phylogeny, origin, evolution and taxonomy of body lice and head lice. Phylogenies were compared from entire coding-region sequences (∼15.4 kb), entire cox1 (∼1.5 kb), partial cox1 (∼700 bp) and partial cytb (∼600 bp) sequences. On the one hand, phylogenies from entire mitochondrial coding-region sequences (∼15.4 kb) were much more informative than phylogenies from entire cox1 sequences (∼1.5 kb) and partial gene sequences (∼600 to ∼700 bp). For example, 19 branches had > 95% bootstrap support in our maximum likelihood tree from the entire mitochondrial coding-regions (∼15.4 kb) whereas the tree from 700 bp cox1 had only two branches with bootstrap support > 95%. Yet, by contrast, partial cytb (∼600 bp) and partial cox1 (∼486 bp) sequences were sufficient to genotype lice to Clade A, B or C. The sequences of the mitochondrial genomes of the P. humanus, P. capitis and P. schaeffi Fahrenholz studied are in NCBI GenBank under the accession numbers KC660761-800, KC685631-6330, KC241882-97, EU219988-95, HM241895-8 and JX080388-407.

Survival of recipients of livers from donation after circulatory death who are relisted and undergo retransplant for graft failure

Use of grafts from donation after circulatory death (DCD) as a strategy to increase the pool of transplantable livers has been limited due to poorer recipient outcomes compared with donation after brain death (DBD). We examined outcomes of recipients of failed DCD grafts who were selected for relisting with regard to waitlist mortality and patient and graft survival after retransplant. From the Scientific Registry of Transplant Recipients database, we identified 1820 adults who underwent first deceased donor liver transplant January 1, 2004 to June 30, 2011, and were relisted due to graft failure; 12.7% were DCD recipients. Compared with DBD recipients, DCD recipients had better waitlist survival (90-day mortality: 8%, DCD recipients; 14-21%, DBD recipients). Of 950 retransplant patients, 14.5% were prior DCD recipients. Graft survival after second liver transplant was similar for prior DCD (28% graft failure within 1 year) and DBD recipients (30%). Patient survival was slightly better for prior DCD (25% death within 1 year) than DBD recipients (28%). Despite higher overall graft failure and morbidity rates, survival of prior DCD recipients who were selected for relisting and retransplant was not worse than survival of DBD recipients.

Misdiagnosis and long-term outcome of 13 patients with acute thallium poisoning in China

PURPOSE

To analyze clinical feature and evaluate long-term outcome of patients with thallium poisoning.

MATERIALS AND METHODS

An observational series of cases with acute thallium poisoning was analyzed retrospectively in West China Hospital of Sichuan University between 2000 and 2010. The clinical data including symptom, determination of thallium level, treatment, neurophysiological examination, and neuropsychological evaluation were analyzed. The patients were followed up until December 2012.

RESULTS

Seven men and six women were enrolled in the study. The median patient age was 37 years (range: 15-53 years). The median duration of hospitalization was 44 days (range: 7-72). All the patients were misdiagnosed initially. One patient died in the hospital. The other 12 patients were followed for a median of 7 years (range: 1-12 years) after discharge from hospital. One patient died from leukemia in the first year of follow-up. Long-term outcome results showed peripheral neuropathy improved substantially. However, many patients have mild or moderate sequelae in sensory nerve fibers of distal lower extremity. A sural nerve biopsy in one patient revealed shrunken axons, distorted myelin sheath, and myelinated fibers loss. During follow-up period, problem of intelligence (4/12 patients, 33%), memory impairment (4/12, 33%), anxiety (6/12, 50%), and depression (5/12, 42%) were demonstrated.

CONCLUSIONS

Neurological symptoms may lead to misdiagnosis of thallium poisoning. Mild or moderate neurological sequelae may last for a long time after thallium poisoning.

Predicting end-stage renal disease after liver transplant

Few equations have been developed to predict end-stage renal disease (ESRD) after deceased donor liver transplant. This retrospective observational cohort study analyzed all adult deceased donor liver transplant recipients in the Scientific Registry of Transplant Recipients (SRTR) database, 1995-2010. The prediction equation for ESRD was developed using candidate predictor variables available in SRTR after implementation of the allocation policy based on the model for end-stage liver disease. ESRD was defined as initiation of maintenance dialysis therapy, kidney transplant or registration on the kidney transplant waiting list. We used Cox proportional hazard models to develop separate equations for assessing risk of ESRD by 6 months posttransplant and between 6 months and 5 years posttransplant. Variables in the 6-month equation included recipient age, history of diabetes, history of dialysis before liver transplant, history of malignancy, body mass index, serum creatinine and liver donor risk index. Variables in the 6-month to 5-year equation included recipient race, history of diabetes, hepatitis C status, serum albumin, serum bilirubin and serum creatinine. The prediction equations have good calibration and discrimination (C statistics 0.74-0.78). We have produced risk prediction equations that can be used to aid in understanding the risk of ESRD after liver transplant.

Expression of a cytokine, interleukin-23, in experimental periapical lesions

AIM

To investigate the expression of interleukin (IL)-23, a new member of the IL-12 family, in experimental periapical lesions.

METHODOLOGY

Periapical lesions were induced in Wistar rats by occlusal surface pulp exposure in mandibular first molars. The rats were randomly sacrificed 0, 7, 14, 21, 28, 35, 42 and 56 days after pulp exposure. The jaws that contained the first molars were obtained and routinely prepared for radiographic, histological, enzyme histochemical, immunohistochemical and double immunofluorescence analyses. Data were analysed by one-way analysis of variance and the Pearson correlation test.

RESULTS

The number of IL-23-positive cells increased from day 7 to day 35 and then gradually decreased. The number of osteoclasts increased and peaked on day 14 and then gradually decreased from day 21 to day 56. A significant positive correlation existed between the number of IL-23 positive cells and the size of bone resorption in periapical lesions from day 7 to day 56 (r = 0.875, P < 0.01).

CONCLUSIONS

Interleukin-23 can be observed and may be associated with inflammatory response and bone resorption in periapical lesions.

Transvaginal removal of ectopic pregnancy tissue and repair of uterine defect for cesarean scar pregnancy

PURPOSE

This work aimed to introduce a new surgical operation for cesarean scar pregnancy (CSP).

MATERIALS AND METHODS

Transvaginal removal of ectopic pregnancy tissue and repair of a uterine defect were performed in 17 CSP patients.

RESULTS

The new surgical operation was performed successfully in all cases.

CONCLUSIONS

The new surgery operation is safe, effective, and minimally invasive in CSP patients.