A Review: Cytochrome P450 in Alcoholic and Non-Alcoholic Fatty Liver Disease

Alcoholic fatty liver disease (FALD) and non-alcoholic fatty liver disease (NAFLD) have similar pathological spectra, both of which are associated with a series of symptoms, including steatosis, inflammation, and fibrosis. These clinical manifestations are caused by hepatic lipid synthesis and metabolism dysregulation and affect human health. Despite having been studied extensively, targeted therapies remain elusive. The Cytochrome P450 (CYP450) family is the most important drug-metabolising enzyme in the body, primarily in the liver. It is responsible for the metabolism of endogenous and exogenous compounds, completing biological transformation. This process is relevant to the occurrence and development of AFLD and NAFLD. In this review, the correlation between CYP450 and liver lipid metabolic diseases is summarised, providing new insights for the treatment of AFLD and NAFLD.

[Porphyromonas gingivalis outer membrane vesicles activate Toll-like receptor 2 to promote osteoclast differentiation by carrying lipopolysaccharide]

Objective: To investigate the effects of Porphyromonas gingivalis derived outer membrane vesicles (Pg OMV) on osteoclast differentiation of macrophages and its underlying mechanisms. Methods: The morphology and the size distribution of Pg OMV were analyzed by transmission electron microscopy and nanoparticle tracing analysis, respectively. The osteoclast precursors were treated with 1, 3 and 10 mg/L Pg OMV (1, 3 and 10 mg/L OMV treatment group) or phosphate buffer solution (PBS)(control group). The formation of osteoclasts was analyzed by tartrate-resistant acid phosphase (TRAP) staining and F-actin staining and real-time quantitative PCR (RT-qPCR) were used to detect the expression of Fos and matrix metallopeptidase 9 (MMP9). Polymyxin B (PMB) was used to block lipopolysaccharide (LPS) and then Pg OMV was used to treat osteoclast precursor (PMB-OMV treatment group), and OMV treatment group was used as control. TRAP and F-actin staining were used to observe the formation of osteoclasts and actin rings. The effect of Pg OMV on the expression of Toll-like receptor (TLR) 2 and TLR4 in preosteoclasts was detected by Western blotting. The osteoclast precursors were pretreated with 10, 50, 100 and 200 μmol/L C29, an inhibitor of TLR2, and then treated with Pg OMV(OMV+10, 50, 100 and 200 μmol/L C29 treatment group) and OMV treatment group without C29 pretreatment was control. TRAP and F-actin staining were used to observe the formation of osteoclasts and actin rings. The osteoclast precursor cells were treated with OMV (OMV treatment group) and OMV incubated with PMB (PMB-OMV treatment group) and the expression of TLR2 in osteoclast precursor was detected by Western blotting. Results: Pg OMV showed classical vesicular structures, and the average particle size of Pg OMV were 179.2 nm. A large number of actin rings were observed in the 3 and 10 mg/L OMV treatment groups. The percentages of TRAP-positive osteoclast area in 3 mg/L OMV treatment group [(22.6±2.1)%] and 10 mg/L OMV treatment group [(32.0±2.3)%] were significantly increased compared with control group [(4.9±0.5)%] (P<0.001). Compared with the control group (1.000±0.029), the mRNA relative expression of Fos in 3 mg/L OMV treatment group (1.491±0.114) and 10 mg/L OMV treatment group (1.726±0.254) was significantly increased (P=0.013, P=0.001). Compared with the control group (1.007±0.148), the mRNA relative expression of MMP9 in the group of 10 mg/L OMV (2.232±0.097) was significantly increased (P<0.001). Actin ring formation was less in PMB-OMV treatment groups than in OMV treatment groups. The proportion of TRAP-positive osteoclasts area [(14.8±3.8)%] in PMB-OMV treatment group was significantly lower than OMV treatment group [(31.5±6.7) %] (P=0.004). The relative expression of TLR2 in OMV treatment group (1.359±0.134) was significantly higher than that in the control group (1.000±0.000) (t=4.62, P=0.044). Compared with the OMV treatment group [(29.4±1.7)%], 50, 100 and 200 μmol/L C29 significantly decreased the formation of osteoclasts [(24.0±1.7)%, (18.5±2.1)%, (9.1±1.3) %] (P=0.026, P<0.001, P<0.001). TLR2 protein expression in PMB-OMV group (0.780±0.046) was significantly lower than that in OMV group (1.000±0.000)(t=8.32, P=0.001). Conclusions: Pg OMV can promote osteoclast differentiation by carrying LPS, TLR2 plays an important role in Pg OMV mediated osteoclast differentiation.

[Association between gestational diabetes mellitus and preterm birth subtypes]

Objective: To investigate the association between gestational diabetes mellitus (GDM) and preterm birth subtypes. Methods: Based on the cohort of pregnant women in Anqing Prefectural Hospital, the pregnant women who received prenatal screening in the first or second trimesters were recruited into baseline cohorts; and followed up for them was conducted until delivery, and the information about their pregnancy status and outcomes were obtained through electronic medical record system and questionnaire surveys. The log-binomial regression model was used to explore the association between GDM and preterm birth [iatrogenic preterm birth, spontaneous preterm birth (preterm premature rupture of membranes and preterm labor)]. For multiple confounding factors, the propensity score correction model was used to compute the adjusted association. Results: Among the 2 031 pregnant women with a singleton delivery, the incidence of GDM and preterm birth were 10.0% (204 cases) and 4.4% (90 cases) respectively. The proportions of iatrogenic preterm birth and spontaneous preterm birth in the GDM group (n=204) were 1.5% and 5.9% respectively, while the proportions in non-GDM group (n=1 827) were 0.9% and 3.2% respectively, and the difference in the proportion of spontaneous preterm birth between the two groups was significant (P=0.048). Subtypes of spontaneous preterm were further analyzed, and the results showed that the proportions of preterm premature rupture of membranes and preterm labor in the GDM group were 4.9% and 1.0% respectively, while the proportions in the non-GDM group were 2.1% and 1.1% respectively. It showed that the risk of preterm premature rupture of membranes in GDM pregnant women was 2.34 times (aRR=2.34, 95%CI: 1.16-4.69) higher than that in non-GDM pregnant women. Conclusions: Our results showed that GDM might increase the risk of preterm premature rupture of membranes. No significant increase in the proportion of preterm labor in pregnant women with GDM was found.

[The directionality of measurement bias: a directed acyclic graph-based structural perspective]

Measurement bias (MB) has been described in causal structures but is still not entirely clear. In practice, the correctness of substitution estimate (SE) of effect is a prerequisite for causal inference, usually based on a bidirectionally non-differential misclassification between the measured exposure and the measured outcome. Based on a directed acyclic graph (DAG), this paper proposes a structure for the single-variable measure, where its MB is derived from the choice of an imperfect, "input/output device-like" measurement system. The MB of the SE is influenced both by the measurement system itself and by factors outside the measurement system: while the independence or dependence mechanism of the measurement system still ensures that the MB of the SE is bidirectionally non-differential; however, the misclassification can be bidirectionally non-differential, unidirectionally differential, or bidirectionally differential resulted from the factors outside the measurement system. In addition, reverse causality should be defined at the level of measurement, where measured exposures can influence measured outcomes and vice versa. Combined with temporal relationships, DAGs help elucidate MB's structures, mechanisms, and directionality.

[Acute toluene, xylene and ethylbenzene poisoning leads to neurological sequelae: a case report]

This article reports a poisoning case after occupational exposure to toluene, xylene, and ethylbenzene for 3 days. The main clinical manifestation of the patient was consciousness disorder. After dehydration, cerebral awakening, anti-epileptic and anti-myoclonic treatment, the patient had secondary epilepsy and cerebellar ataxia for a long time. According to diagnostic criteria, the patient was diagnosed with occupational acute chemical poisoning (severe) , occupational acute chemical poisoning sequelae. It is suggested that the clinical awareness of benzene compound poisoning should be strengthened, early diagnosis and early treatment should be carried out to improve the prognosis of patients.

[Analysis on epidemiological characteristics of dengue fever and E gene evolution of dengue virus in Guangzhou, 2020]

Objective: To assess the incidence of dengue fever and E gene evolution of dengue virus in Guangzhou in 2020 and understand the local epidemiological characteristics of dengue fever and spreading of dengue virus. Methods: The information of dengue fever cases in Guangzhou in 2020 was collected from Notifiable Infectious Disease System of Chinese Center for Disease Control and Prevention Information System. Serum samples from the cases were detected by real-time PCR. The E gene was sequenced and analyzed. Maximum likelihood phylogenetic trees were constructed using software MEGA 5.05. The statistical analysis was conducted using software SPSS 20.0. Results: A total of 33 dengue fever cases were reported in Guangzhou in 2020, including 31 (93.94%) imported cases and 2 (6.06%) local cases. Compared with the data during 2016 to 2019, the number of cases, overall incidence and local incidence all decreased with statistically significant differences (all P<0.05). The imported cases from Southeast Asia constituted 90.32% (28/31) of imported cases. The E gene sequences and the phylogenetic trees of imported and local cases demonstrated close relationship with the virus sequences from Southeast Asian, and they were less homologous with the sequences of dengue virus isolated in Guangzhou in previous years. Conclusions: The incidence of dengue in Guangzhou in 2020 was significantly affected by the imported cases, especially those from Southeast Asian countries. The study result demonstrated that dengue fever was not endemic in Guangzhou and it was caused by imported ones.

[Spatial autocorrelation of dengue cases and molecular biological characteristics of envelope gene of dengue virus in Guangzhou, 2019]

Objective: Analyze epidemiological situation of dengue fever,and survey impacts of four serotypes dengue viruses in Guangzhou, 2019. Methods: Information of patients was collected in Notifiable Infectious Disease Report System (NIDRS). Spatial autocorrelation of dengue cases was evaluated using ArcGIS version 10.2. Serum samples were tested by real-time PCR. Virus strains were isolated from positive sera. Then E gene was sequenced. Phylogenetic trees were including PhyMLsoftwarev 3.1. Results: A total of 1 655 dengue cases, consisted of 1 382 local cases and 273 imported cases, was confirmed in 2019. The incidence was 11.10 per 100 000 dengue cases were autocorrelated in Guangzhou. There were 18 high-high clusters. Most of the imported dengue cases were imported from Southeast Asian countries (86.08%,235/273) and African countries (2.56%,7/273). Of 749 serum samples detected by real-time PCR, the positive rate was 93.06% (697/749). Four hundred and sixty-four dengue virus strains had been isolated in 2019. Compared with data from the genotype tree of the former years, no genotype shift was discovered. Serotype 1 was still predominant. Serotype 2 was the significant strain in Baiyun district and Liwan district. Conclusions: Dengue fever was spreading all over Guangzhou in 2019. The suburban areas, which played a more critical role in causing the spread and outbreak of dengue fever, should be given more prominence. Inspection at ports should be enforced to prevent importing cases from African countries and Southeast Asian countries. The risk of serotype 2 cannot be overlooked. Four serotypes dengue viruses prevailed simultaneously in Guangzhou, which warns us to take precaution of severe dengue outbreaks.

[Prognosis analysis of local recurrence after excision of breast phyllodes tumors]

Objective: To examine treatment outcomes of breast phyllodes tumors and the prognosis factors of local recurrence. Methods: This retrospective cohort study included 276 patients who underwent surgical resection at Breast Center, Peking University People's Hospital from January 2011 to December 2019. Tumor subtype and histopathological features were determined from pathology reports, and the deadline of follow-up was September 30^th, 2020. All 276 patients underwent open surgery, including 17 patients of mastectomy, and 259 patients of lumpectomy. The enrolled patients were all female, with age of (41.5±11.3) years (rang: 11 to 76 years), and tumor diameter of 35(28) mm (M(Q_R)). The Kaplan-Meier method and Log-rank test were used for survival analysis. The multivariate analysis was implemented using the Cox proportional hazard model. Results: According the pathologic test, there were 191 patients of benign phyllodes tumor, 67 patients of borderline tumor and 18 patients of malignant tumor. There were 249 patients with a follow-up of more than 6 months, and 14.1% (35/249) had local recurrence. The time-to-recurrence was (28.6±22.2) months (range: 2 to 96 months), (29.1±18.1) months (range: 2 to 80 months), (32.1±30.1) months (range: 5 to 96 months) and (12.0±6.9) months (range: 8 to 20 months) for benign, borderline and malignant phyllodes tumors. Tumor diameter (≥100 mm vs.<50 mm, HR=3.968, 95%CI: 1.550 to 10.158, P=0.004) and malignant heterologous element (yes vs. no, HR=26.933, 95%CI: 3.105 to 233.600, P=0.003) were prognosis factors of local recurrence. One death from malignant phyllodes occurred after distant metastasis. The 3-year disease-free survival rates of benign, borderline and malignant phyllodes tumor were 88.2%, 81.7% and 81.4% (P=0.300). Conclusion: Phyllodes tumors have a considerable local recurrence rate, which may be associated with tumor diameter and malignant heterologous element.

[Incidence of silicosis among excavation workers]

Objective: To assess the incidence of silicosis among excavation workers in Suzhou city. Methods: In 2011-2016, we investigated the incidence of silicosis among 3190 excavation workers who participated in the mining operations from 1971 to 1974 in Suzhou city. To compare the general condition, complications, blood indexes and pulmonary function between different stages of silicosis patients. Results: Among all the participants, 144 cases were diagnosed as silicosis, and the incidence of silicosis was 4.51%, including 138 stage I cases (95.83%) , 4 stage II cases (2.78%) , and 2 stage III cases (1.39%) . Both systolic blood pressure (154.17±14.74 mmHg) and diastolic blood pressure (96.67±10.25 mmHg) of silicosis patients in stage II-III were significantly higher than that of patients in stage I (134.64±15.41 mmHg, 82.20±10.62 mmHg) (P<0.05) . Hypertension (54 cases, 37.50%) were the most commonly complication of silicosis patients, followed by abnormal electrocardiogram (38 cases, 26.39%) , diabetes (22 cases, 15.28%) , malignant tumor (10 cases, 6.94%) , hepatitis B (8 cases, 5.56%) and tuberculosis (8 cases, 5.56%) . The serum levels of red blood cell count (RBC) , hemoglobin (Hb) , albumin (ALB) , magnesium (Mg) and sodium (Na) in stage I silicosis patients were significantly higher than stage II-III patients (P<0.05) . While the serum levels of C-reactive protein (CRP) and carbohydrate antigen 199 (CA199) in stage I silicosis patients were significantly lower than stage II-III patients (P<0.05) . The proportions of normal pulmonary function, mild airflow limitation, moderate airflow limitation and severe airflow limitation in silicosis patients were 44.03% (59/134) , 18.66% (25/134) , 29.85% (40/134) and 7.46% (10/134) , respectively. Conclusion: Our data obviously show that the excavation workers has a high incidence of silicosis. It is necessary to strengthen the occupational health surveillance of silicosis patients, reduce complications and improve their quality of life.

[Study on the health effects of occupational exposure to lead exceeded]

Objective: The main purpose of this study was to explore the health effects of occupational exposure to lead exceeded. Methods: We collected 114 inpatients who exposure to lead, and diagnosed lead toxicity by No. 5 Suzhou People's Hospital from January 2011 to May 2018. Samples were selected according to 1:4 of the lead exceeded group and the control group. The age and gender of the lead exce eded group were matchied, and balanced between the two groups. Lead exceeded group: 84 inpatients occupational exposure to lead, whose blood or urinary lead exceeded. Control group: 336 healthy checkup persons who did not contact with any toxic or hazardous substances. Results: The diastolic blood pressure of lead exceeded group was significantly higher than control group (P<0.05) . The red blood cell count, hemoglobin, mean red blood cell volume, mean hemoglobin content, mean hemoglobin concentration, the platelet count, and the lymphocyte count levels of lead exceeded group were significantly lower than control group (P<0.05) , while the average platelet volume level of lead exceeded group was significantly higher than control group (P<0.05) . The aspartate aminotransferase, glucose and the urea nitrogen levels of lead exceeded group were significantly higher than control group, while the creatinine of lead exceeded group was significantly lower than control group (P<0.05) . The total protein, albumin, cholesterol and low density lipoprotein levels of lead exceeded group were significantly lower than control group (P<0.05) . The abnormal rate of electrocardiogram and spleen B (24.4%, 8.33%) in lead exceeded group were significantly higher than control group (11.04%, 0.6%) (P<0.05) . The abnormal rate of liver B ultrasound, and gallbladder B ultrasound (23.81%、8.32%) in lead exceeded group were significantly lower than control group (41.32%、21.06%) (P<0.05) . Conclusion: Occupational exposure to lead exceeded not only has a significant impact on red blood cell related indicators, but also has a certain impact on cardiac function and liver and kidney functions. It is suggested that lead exprsure may have some effect on health of occupational population.

[Study on the health effects of occupational exposure to low concentrations of benzene]

Objective: The main purpose of this study was to ascertain whether (or not) exposure to benzene, toluene, xylene and ethylbenzene (BTXE) , under normal working conditions, was associated with any health effects. Methods: From January to December 2014, the workplaces concentrations of BTXE were measured of 71 enterprises in Suzhou Industrial Park. Occupational health examination were investigated on 764 employees who exposed to BTXE, as well as 4409 employees of the corresponding enterprises who unexposed to BTXE, and analyzed the data of the two groups. Results: A total of 6 monitoring sites in 3 enterprises BTXE concentrations excess of the standards, the unexposed group was under the limit of detection. The means of red blood cell count, hemoglobin, hematocrit, intermediate cell count and percentage of intermediate cells were significantly higher in exposed group than in unexposed group (P<0.05) . Conversely, platelet count was significantly lower in exposed group than in unexposed group (P<0.05) . The proportion of red blood cell volume, lymphocyte count and percentage of intermediate cells were significantly lower in exposed group than in unexposed group (P<0.05) . Both means and proportion of glutamic pyruvic transaminase and urea nitrogen were significantly higher in exposed group than in unexposed group (P<0.05) . The positive rate of protein, urine, urine red blood cell were significantly higher in exposed group than in unexposed group (P<0.05) . The abnormal rate of electrocardiogram, liver and kidney B scan were significantly higher in exposed group than in unexposed group (P<0.05) . Multivariate logistic regression analysis revealed that percentage of intermediate cells increased, urea nitrogen increased, urine protein positived, urine red blood cells positived in exposed group the OR values were 1.689, 3.291, 3.163 and 1.743 (P<0.05) . Conclusion: Occupational exposure to low concentrations of BTXE had a certain impact on the blood system and liver and kidney function of the employees, occupational health surveillance for such people should be strengthened.

[Phylogenetic analysis of envelope gene of dengue virus serotype 2 in Guangzhou, 2001-2015]

Objective: To investigate the molecular characteristics of dengue virus serotype 2 (DENV2) in Guangzhou during 2001-2015, and analyze the E gene of the strains isolated, the phylogenetic tree and molecular clock were constructed to know about the evolution of the strains. Methods: The serum samples of the patients were detected by real time PCR, and positive samples were used to isolate dengue virus by using C6/36 cells. The E gene of the isolated strains were sequenced. The phylogenetic tree was constructed by using software Mega 4.0, and the molecular clock was drawn by using software BEASTv1.8.2. Results: Twenty-six dengue virus strains were isolated between 2001 and 2015. They were all clustered into 2 genotypes, i.e. cosmopolitan genotype and Asian genotype Ⅰ. The strains isolated in Guangzhou shared high homology with Southeast Asian strains. The cosmopolitan genotype was divided into 2 sub-genotype at about 46 and 35 years ago. The substitution rate of dengue virus serotype 2 in Guangzhou was 7.1 × 10(-4) per year per site. Conclusions: There were close relationship between the Guangzhou strains and Southeast Asian strains. Guangzhou was at high risk of imported dengue fever, outbreak of dengue hemorrhagic fever and dengue shock syndrome. There might be two ways of introduction of cosmopolitan genotype. The substitution rate of the strains in Guangzhou was similar to that in the neighbor countries.

[Epidemiological study on the relationship between the siesta and blood pressure]

OBJECTIVE

Use epidemiological approaches to investigate the correlation between the siesta and blood pressure.

METHOD

From March 1(st,) 2011 to June 30(th) 2013, a total of 950 people were collected from East Jiaozhou Qingdao region using variable sampling methods including stratified method, the entire group method, random and proportional methods. Medical professionals conducted a person-to-person survey, collecting the data and inputting it into computers, after which a database was established using STATA 12.0. We analyzed the correlation between the siesta time and blood pressure/hypertension by using rank correlation method (Spearman). Logistic regression method was used to analyze the relationship between high blood pressure and different time and habit of the siesta after adjusting age, sex and BMI.

RESULTS

There was a negative correlation between the time of siesta and the systolic pressure with r=-0.18, P<0.001; there was no relationship between the time of siesta and the diastolic pressure with r=-0.07, P=0.02; also, there is a negative correlation between the time of siesta and the hypertension morbidity, with r=-0.22, P<0.001. In the Logistic regression analysis about the period of time to take a nap and the risk of hypertension, it was found that the relative risk factors for hypertension were more than 60-year-old, BMI >25 kg/m(2) and no siesta habits.

CONCLUSIONS

The time of siesta is negatively correlated to the systolic pressure, rather than the diastolic pressure, and it can generally reduce the incidence of hypertension. The relative risk factors of hypertension are more than 60-year-old, BMI >25 kg/m(2) and no siesta habits in all four seasons. We recommend that take a nap a day, or it might be even better for systolic blood pressure to take longer siesta.

[Dynamic maternal measles antibody level in infants: a longitudinal study]

OBJECTIVE

To understand the dynamic maternal measles antibody level in infants in Guangzhou.

METHOD

Women who delivered babies in a maternal and child health care hospital in Guangzhou and their infants who were never affected by measles were included in our study. All the serum samples collected from mothers and infants were tested by using enzyme linked immunosorbent assay(ELISA)for the quantitative measurement of measles IgG antibodies. A longitudinal sero-epidemiological study was conducted to investigate the duration of the presence of measles maternal antibodies in infants based on the measurement at different time points(0, 3, 5, 7 month).

RESULT

A total of 689 mothers and their 691 infants(two pairs of twins)were included in the study. The concentration and the sero-positivity rate of measles antibody in mothers was 513.8 mIU/ml and 81.6% respectively. The concentration and the sero-positivity rate of measles antibody in infants was 732.8 mIU/ml and 87.3%, respectively. The measles antibody levels of newborns were positively associated with those of mothers(r=0.917 5, P<0.001), which declined rapidly at 3 months after birth and mostly turned to be negative at 7 months after birth. Measles antibody turned be negative at 3 months after birth in low, middle level groups, but remained to be positive in high level group at 5 months after birth.

CONCLUSION

The maternal measles antibody could rarely protect infants at age of 8 months even though mother had been vaccinated or acquired natural immunity. It is suggested to adjust the time of the first dose measles vaccination in infants and increase the measles antibody level of child bearing aged women to reduce the incidence of measles in infants.

Evaluation of the potential anti-allergic effects of heat-inactivated Lactobacillus paracasei V0151 in vitro, ex vivo, and in vivo

The efficacy of Lactobacillus paracasei V0151 (V0151), isolated from the faeces of a child, to modulate immune responses was investigated. In RAW 264.7 cells expressing an inducible nitric oxide synthase (iNOS)-directed luciferase gene, heat-inactivated V0151 stimulated iNOS expression followed by nitric oxide production. V0151 significantly elevated interferon gamma, interleukin (IL)-10, tumour necrosis factor alpha, and IL-1β production in human peripheral blood mononuclear cells. In splenocytes isolated from ovalbumin (OVA)-sensitised BALB/c mice treated with OVA and V0151 at different bacterium-to-cell ratios (1:1, 10:1, and 20:1) for 96 h, IL-2, IL-4, IL-5, and IL-13 production was dose-dependently downregulated, whereas IL-12 was dose-dependently upregulated. Collectively, our findings indicate that V0151 might regulate pro-inflammatory factors in macrophages and splenocytes. Furthermore, the T helper 1/T helper 2 (Th1/Th2) balance was also skewed toward Th1 dominance through the elevation of Th1 cytokine production.

Effects of exercise training on left ventricular remodelling in heart failure patients: an updated meta-analysis of randomised controlled trials

Objectives:  The purpose of this updated meta-analysis was to determine whether exercise training reversed left ventricular remodelling in heart failure patients. Methods:  Articles were searched in MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, EMBASE and PubMed (up until October, 2011). The anti-remodelling benefit of exercise training was assessed by ejection fraction (EF), end-diastolic volume (EDV) and end-systolic volume (ESV). Standardised mean difference (SMD) together with 95% confidence intervals (CI) was calculated. Subgroup meta-analysis with exercise duration was also conducted. Results:  Fifteen randomised controlled trials with 813 patients were included. Aerobic exercise training improved EF (SMD = 0.44; 95% CI 0.28 to 0.61), EDV (SMD = -0.33; 95% CI -0.49 to -0.16) and ESV (SMD = -0.40; 95% CI -0.57 to -0.23). Subgroup analysis indicated that long-term aerobic exercise (≥6 months) had a marked positive effect on EF (SMD = 0.5; 95% confidence interval 0.31 to 0.69), EDV (SMD = -0.38; 95% CI -0.57 to -0.19) and ESV (SMD = -0.48; 95% CI -0.67 to -0.29), but there was no evidence of benefit with short-term aerobic exercise (<6 months): EF (SMD = 0.27; 95% CI -0.08 to 0.61), EDV (SMD = -0.14; 95% CI -0.48 to 0.21) and ESV (SMD = -0.08; 95% CI -0.47 to 0.30). Strength training (alone or plus aerobic training) was not associated with improvements in EDV and ESV, with all confidence intervals including 0. Conclusions:  Aerobic exercise training, especially long-term duration (≥6 months) reverses left ventricular remodelling in clinically stable patients with heart failure. Strength training (alone or plus aerobic training) did not improve or worsen ventricular remodelling.

The high molecular mass rhoptry protein, RhopH1, is encoded by members of the clag multigene family in Plasmodium falciparum and Plasmodium yoelii

Malarial merozoite rhoptries contain a high molecular mass protein complex called RhopH. RhopH is composed of three polypeptides, RhopH1, RhopH2, and RhopH3, encoded by distinct genes. Using monoclonal antibody-purified protein complex from both Plasmodium falciparum and Plasmodium yoelii, peptides were obtained by digestion of RhopH1 and their sequence determined either by mass spectrometry or Edman degradation. In both species the genes encoding RhopH1 were identified as members of the cytoadherence linked asexual gene (clag) family. In P. falciparum the family members on chromosome 3 were identified as encoding RhopH1. In P. yoelii two related genes were identified and sequenced. One of the genes, pyrhoph1a, was positively identified as encoding RhopH1 by the peptide analysis and the other gene, pyrhoph1a-p, was at least transcribed. Genes in the clag family present in both parasite species have a number of conserved features. The size and location of the P. yoelii protein complex in the rhoptries was confirmed. The first clag gene identified on chromosome 9 was implicated in cytoadherence, the binding of infected erythrocytes to host endothelial cells; this study shows that other members of the family encode merozoite rhoptry proteins, proteins that may be involved in merozoite-erythrocyte interactions. We propose that the family should be renamed as rhoph1/clag.

Sequence polymorphism in two novel Plasmodium vivax ookinete surface proteins, Pvs25 and Pvs28, that are malaria transmission-blocking vaccine candidates

BACKGROUND

For many malarious regions outside of Africa, development of effective transmission-blocking vaccines will require coverage against both Plasmodium falciparum and P. vivax. Work on P. vivax transmission-blocking vaccines has been hampered by the inability to clone the vaccine candidate genes from this parasite.

MATERIALS AND METHODS

To search for genes encoding the ookinete surface proteins from P. vivax, the DNA sequences of the eight known proteins in the P25 subfamily (Pfs25, Pgs25, Pys25, Pbs25) and in the P21/28 subfamily (Pfs28, Pgs28, Pys21, Pbs21) of zygote/ookinete surface proteins were aligned. Regions of highest identity were used to design degenerate PCR oligonucleotides. Genomic DNA from the Sal I strain of P. vivax and genomic and splinkerette DNA libraries were used as PCR templates. To characterize the polymorphisms of Pvs25 and Pvs28, these two genes were PCR amplified and the DNA sequences were determined from genomic DNA extracted from patients infected with P. vivax.

RESULTS

Analysis of the deduced amino acid sequence of Pvs28 revealed a secretory signal sequence, four epidermal growth factor (EGF)-like domains, six copies of the heptad amino acid repeat (GSGGE/D), and a short hydrophobic region. Because the fourth EGF-like domain has four rather than six cysteines, the gene designated Pvs28 is the presumed homologue of P21/28 subfamily members. Analysis of the deduced amino acid sequence of Pvs25 revealed a similar structure to that of Pvs28. The presence of six rather than four cysteines in the fourth EGF-like domain suggested that Pvs25 is the homologue of P25 subfamily members. Several regions of genetic polymorphisms in Pvs25 and Pvs28 were identified in field isolates of P. vivax.

CONCLUSIONS

The genes encoding two ookinete surface proteins, Pvs28 and Pvs25, from P. vivax have been isolated and sequenced. Comparison of the primary structures of Pvs25, Pvs28, Pfs25, and Pfs28 suggest that there are regions of genetic polymorphism in the P25 and P21/28 subfamilies.

[Effect of jiawei dachaihu decoction on blood T lymphocyte subsets and tumor necrosis factor in patients with obstructive jaundice]

OBJECTIVE

To observe the effect of the preoperative Jiawei Dachaihu decoction in improving cellular immune functions in patients with obstructive jaundice.

METHODS

Forty patients were randomly divided into two groups with (group B) and without (group A) the herbal therapy. And their preoperative T lymphocyte subsets, TNF and the postoperative dynamic changes were measured.

RESULTS

CD3, CD4 and CD4/CD8 decreased and TNF increased in the patients. CD3, CD4 and CD4/CD8 decreased much less and were lower than preoperative levels 2 days after the operation. CD3, CD4 and CD4/CD8 were higher and TNF lower than preoperative levels in group A after 20 days of the operation (all of them P < 0.05).

CONCLUSIONS

The operation could be helpful to recover immune functions of T lymphocyte and decrease TNF levels. The perioperative herbal therapy is an important adjuvant measure.

Randomized, controlled trial of high-dose intravenous pyridoxine in the treatment of recurrent seizures in children

To determine the efficacy of pyridoxine in treating seizures, 90 infants and children with recurrent convulsions primarily due to acute infectious diseases were enrolled in the present study. Forty patients were treated with high-dose pyridoxine (30 or 50 mg/kg/day) by intravenous infusion, and 50 subjects served as controls. Antiepileptic drugs and other therapies were similar in the two groups except for pyridoxine. Clinical efficacy criteria were based on the frequency of convulsions per day and on the duration of individual seizures after therapy was initiated. The results indicated that total response rates in the pyridoxine group and control group were 92.5% and 64%, respectively (chi-square = 14.68, P < .001). After initiation of therapy, seizures resolved after 2.4 +/- 1.4 days in the pyridoxine group and after 3.7 +/- 2.0 days in the control group (t = 3.67, P < .001). No adverse effects of pyridoxine were apparent during the observation period. We conclude that pyridoxine is an effective, safe, well-tolerated, and relatively inexpensive adjunct to routine antiepileptic drugs for treatment of recurrent seizures in children.

Two antigens on zygotes and ookinetes of Plasmodium yoelii and Plasmodium berghei that are distinct targets of transmission-blocking immunity

We have developed transmission-blocking monoclonal antibodies (MAbs) against Plasmodium yoelii 21-kDa (Pys21) and 28-kDa (Pys25) ookinete surface proteins. These MAbs block infectivity of P. yoelii to Anopheles stephensi. One MAb, 14, cross-reacted by Western blotting with a 28-kDa surface protein (Pbs25) of P. berghei ookinetes and blocked oocyst development, as assayed by direct mosquito feeds on passively immunized P. berghei-infected mice. In total, we have identified two ookinete surface proteins in P. yoelii, one of which is also present in P. berghei. The transmission-blocking activity of the anti-Pys25 MAb 4 was complete and more potent than that of the anti-Pys21 MAb 2. Moreover, Fab fragments of MAb 4 had transmission-blocking activity in mice. In comparison, Fab fragments of MAb 2 did not have detectable transmission-blocking effect, although F(ab')2 did. Furthermore, MAb 2 and MAb 4 appeared to block the in vitro formation and development of zygotes as well.

Murine complement reduces infectivity of Plasmodium yoelii to mosquitoes

The alternative pathway of complement in the mouse serum significantly reduced, but did not eliminate, the infectivity of Plasmodium yoelii to Anopheles stephensi. The reduction of the infectivity is mainly due to the inability of the zygote to transform into the ookinete in the mosquito midgut.