[Application of anti-HCV and HCV RNA detection in intravenous drug users].

Objective: To explore the diagnostic value of anti-HCV and HCV RNA so as to provide an accurate and efficient detection strategy for the diagnosis of HCV in intravenous drug users. Methods: 527 plasma samples from intravenous drug users were collected, and preliminary anti-HCV ELISA screening test was performed. A recombinant immunoblot assay (RIBA) was used as confirmatory assay for reactive antibody samples. All samples were tested for HCV RNA, followed by analysis of anti-HCV screening test, RIBA and HCV nucleic acid test results. Results: Anti-HCV ELISA results were reactive in 386 out of 527 intravenous drug users and non-reactive in 141. Among the 386 reactive antibody samples detected by RIBA, 370 cases were anti-HCV positive, 6 cases were anti-HCV indeterminate and 10 cases were anti-HCV negative. Anti-HCV ELISA and RIBA positive coincidence detection rate was 95.85% (370/386), and 70.21% (370/527) among intravenous drug users. HCV RNA was negative in all 10 anti-HCV RIBA non-reactive samples. 376 anti-HCV RIBA-positive and indeterminate samples were tested for HCV RNA, of which 56.93% (300/527) were current HCV infection, and 14.42% (76/527) were past HCV infection. Among 141 anti-HCV ELISA negative samples, the residual risk by anti-HCV ELISA screening for HCV RNA was 1.52% (8/527). HCV viral load distribution among intravenous drug users showed that the high viral load value (>10(7) IU/ml) and low viral load values (< 10(2) IU/ml) accounted for 1.95% and 2.27%, respectively, while the samples with viral load value of 1×10(2) ~ 1×10(7) IU/ mL accounted for 95.78% (295/308), and were mainly distributed in 1×10(5) ~ 1×10(6) IU/ml (37.99%). ELISA + RIBA + NAT assay detection strategies had differentiated 300 cases of current HCV infection, 76 cases of past HCV infection and 10 cases of false positive anti-HCV results, while ELISA+NAT assay detection strategies had only detected 300 cases of current HCV infection. However, of the 386 positive subjects screened for antibodies, 10 (2.59%) were undifferentiated false positives. Conclusion: Intravenous drug users are the high-risk population of HCV infection with high prevalence and high viral load. Anti-HCV screening for intravenous drug users will have a certain degree of residual risk. Therefore, anti-HCV ELISA screening and nucleic acid detection strategy can accurately diagnose the current infected patients; however, it cannot distinguish the false positive results of antibody screening.

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

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

Molecular characterization of fibroblast growth factor-16 and its role in promoting the differentiation of intramuscular preadipocytes in goat.

Fat metabolism is an important and complex biochemical reaction in vivo and is regulated by many factors. Recently, the findings on high expression of fibroblast growth factor-16 (FGF16) in brown adipose tissue have led to an interest in exploring its role in lipogenesis and lipid metabolism. The study cloned the goat's FGF16 gene 624 bp long, including the complete open reading frame that encodes 207 amino acids. We found that FGF16 expression is highest in goat kidneys and hearts, followed by subcutaneous fat and triceps. Moreover, the expression of FGF16 reached its peak on the 2nd day of adipocyte differentiation (P < 0.01) and then decreased significantly. We used overexpression and interference to study the function of FGF16 gene in goat intramuscular preadipocytes. Silencing of FGF16 decreased adipocytes lipid droplet aggregation and triglyceride synthesis. This is in contrast to the situation where FGF16 is overexpressed. Furthermore, knockdown of FGF16 also caused down-regulated expression of genes associated with adipocyte differentiation including CCAAT enhancer-binding protein beta (P < 0.01), fatty acid-binding protein-2 (P < 0.01) and sterol regulatory element binding protein-1 (P < 0.05), but the preadipocyte factor-1 was up-regulated. At the same time, the genes adipose triglyceride lipase (P < 0.01) and hormone-sensitive lipase (P < 0.05) associated with triglyceride breakdown were highly expressed. Next, we locked the fibroblast growth factor receptor-4 (FGFR4) through the protein interaction network and interfering with FGF16 to significantly reduce FGFR4 expression. It was found that the expression profile of FGFR4 in adipocyte differentiation was highly similar to that of FGF16. Overexpression and interference methods confirmed that FGFR4 and FGF16 have the same promoting function in adipocyte differentiation. Finally, using co-transfection technology, pc-FGF16 and siRNA-FGFR4, siRNA2-FGF16 and siRNA-FGFR4 were combined to treat adipocytes separately. It was found that in the case of overexpression of FGF16, cell lipid secretion and triglyceride synthesis showed a trend of first increase and then decrease with increasing interference concentration. In the case of interference with FGF16, lipid secretion and triglyceride synthesis showed a downward trend with the increase of interference concentration. These findings illustrated that FGF16 mediates adipocyte differentiation via receptor FGFR4 expression and contributed to further study of the functional role of FGF16 in goat fat formation.

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

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

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

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

[Cost-effectiveness analysis of cervical cancer screening strategies in urban China].

Objective: To explore the most economically feasible cervical cancer screening strategies in urban China. Methods: A series of Markov models were constructed to evaluate health and economic outcomes of different screening strategies. There were 24 screening strategies including four screening methods: liquid-based cytology (LBC), human papillomavirus (HPV) DNA genotyping, HPV DNA genotyping with LBC triage (HPV DNA+ LBC), HPV DNA genotyping and LBC co-testing (HPV DNA-LBC), along with three intervals (every 1, 3 or 5 years) and two starting age for screening (30 or 35 years old) were compared. Models parameters were obtained from a cervical cancer screening study in urban China and literature reviews. Results: The cumulative incidence and mortality risk of cervical cancer declined over 69% and 82% respectively for each screening strategy as compared with the no screening scenario. LBC every five years starting from 35 years old strategy cost the least (RMB 690 per capita) and could save life years compared with no screening. The cost effectiveness ratios of 24 strategies ranged from -10 903 to 117 992 RMB per life year saved. All strategies were cost-effective compared to no screening. In the incremental cost-effectiveness analysis, LBC every 5 years starting from 30 strategy, HPV DNA genotyping every 3 years starting from 30 strategy, LBC every 3 years starting from 30 strategy and LBC every year starting from 30 strategy were dominant strategies. Conclusions: Screening can effectively prevent cervical cancer. In urban Chinese areas with insufficient socioeconomic resources, LBC every 5 years from 35 years old strategy is recommended. In relatively more affluent areas, LBC every 5 years from 30 years old strategy, LBC every 3 years from 30 years old strategy, HPV DNA genotyping every 3 years from 30 years old strategy, and LBC every year from 30 years old strategy are recommended successively.

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

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

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

OBJECTIVES: To explore the relationship between the change rules of volatile organic compounds （VOCs） in rat muscle and postmortem interval （PMI）. METHODS: A total of 120 healthy rats were divided randomly into 12 groups （10 for each group）. After the rats were sacrificed by cervical dislocation, the bodies were kept at （25±1） ℃. Rat muscle samples were separately obtained at 12 PMI points, including 0, 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 d. The VOCs in rat muscles were collected, detected and analyzed by headspace solid-phase microextraction （HS-SPME） coupled to gas chromatography-mass spectrometer （GC-MS）. RESULTS: In total, 15 species of VOCs were identified, including 9 aromatic compounds, 3 sulfur compounds, 2 aliphatic acids and 1 heterocyclic compound. The species of VOCs increased with PMI： no species were detected within 1 day, 3 species were detected on day 2, 9 on day 3, 11 on day 4, 14 from day 5 to 7, and 15 from day 8 to 10. Total peak area of 15 species of VOCs was significantly correlated to PMI （adjusted R²=0.15-0.96）： the regression function was y=-17.05 x²+ 164.36 x-246.36 （adjusted R²=0.96） from day 2 to 5, and y=2.24 x+101.13 （adjusted R²=0.97） from day 6 to 10. CONCLUSIONS: The change rules of VOCs in rat muscle are helpful for PMI estimation.

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

OBJECTIVE: Genistein, a major isoflavone found in soybeans, exhibits anti-cancer activity. Endoplasmic reticulum (ER) stress is known to be implicated in apoptosis induced by anti-cancer drugs. This study aimed to characterize the role of ER stress in genistein-induced apoptosis in cervical cancer. MATERIALS AND METHODS: HeLa cells were treated with genistein or/and 4-phenylbutyric acid. Cell viability and apoptosis were evaluated by MTT assay and flow cytometry. Protein levels were detected by Western blot analysis. RESULTS: Genistein suppressed the viability of HeLa cells in a dose dependent manner. In addition, genistein caused apoptosis in HeLa cells in a dose dependent manner. Genistein triggered ER stress in HeLa cells, as indicated by the upregulation of glucose-regulated protein 78 (GRP78) and CHOP expression. Furthermore, ER stress inhibitor 4-phenylbutyric acid alleviated genistein-induced apoptosis and ER stress in HeLa cells. CONCLUSIONS: Our results suggest that ER stress contributes to genistein-induced apoptosis in cervical cancer cells, and genistein is a promising agent for cervical cancer therapy.

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

OBJECTIVE: To describe the flow of tuberculosis(TB)cases for medical care in China in 2014. METHODS: The analysis and visualization of reported flow of TB cases were conducted with software R to indicate the case distribution/flow and the levels of hospital where TB cases sought medical care in different provinces. RESULTS: In a province, the TB cases mainly flowed to the province capital, but the inter-provincial flow was mainly to neighbor provinces and from central or western provinces to eastern provinces(municipality), such as Beijing, Shanghai and Guangdong. The grade Ⅲ(A)hospitals were the choice of most TB cases seeking medical care in other provinces. CONCLUSION: The epidemic situation of TB in China is still serious, and the flow of TB cases would facilitate the spread of the disease. It is necessary to strengthen the research on influence of TB case flow for seeking medical care on the spread of TB to provide evidence for better TB prevention and control.

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

OBJECTIVE: Tooth agenesis is a common craniofacial anomaly in human beings. Mounting evidence has demonstrated that the bone morphogenetic protein 4 gene (BMP4) plays an important role in tooth development. This case-control study was designed to evaluate the association of the polymorphism rs17563 in BMP4 gene with susceptibility of isolated human tooth agenesis in a Chinese Han population. PATIENTS AND METHODS: 335 tooth agenesis cases and 444 healthy controls were included in this study. RESULTS: Although no significant association was observed either in the overall or stratified analysis between the types and the severity of missing teeth. However, significant difference was observed between the anterior and posterior tooth agenesis (APTA) cases and the controls (p = 0.018 for allele distribution and OR = 0.39, 95% CI = 0.15-0.99). Furthermore, the heterozygote (TC) and dominant model (CC+TC) were associated with decreased risk of APTA compared with the control (phet = 0.018, ORhet = 0.39, 95% CIhet = 0.15-0.99 and pdom = 0.042, ORdom = 0.34, 95% CIdom = 0.13-0.87, respectively). CONCLUSIONS: These results indicated that rs17563 in BMP4 gene was potentially associated with APTA in Chinese Han population and further independent studies are required to verify these findings.

Periostin-like-factor-induced bone formation within orthopedic maxillary expansion.

OBJECTIVE: To examine whether periostin-like factor (PLF) stimulation of the expanded palatal suture would accelerate mineral formation of bone. MATERIALS AND METHODS: Expanded palates of 6-week-old male C57BL/6 mice were maintained in an organ culture system, and tissue was either unstimulated or stimulated with PLF or BMP-7 for 8 days. Bone mineral formation was assessed by Raman microspectroscopy analysis and histological examination. RESULTS: Raman microspectroscopy analysis demonstrated that unstimulated palates maintained their bone mineral concentration within the palatal suture over 8 days (%increase = 11.29 ± 2.34). In comparison, palates exposed to either PLF (%increase = 29.33 ± 1.61, p = 0.012) or BMP-7 (% increase = 25.49 ± 1.09, p = 0.016) formed significantly more bone at the osteogenic fronts of the palatal suture compared with unstimulated samples at day 8. Alkaline phosphatase activity along the bone edges was markedly greater in the PLF and BMP-7 groups compared with that in unstimulated groups at day 0 and day 8. The levels of osteocalcin proteins in the palatal suture tissues of the PLF and BMP-7 groups were significantly higher than those in the unstimulated group. CONCLUSION: PLF can increase bone mineral formation within the expanded palatal suture.

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

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

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

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