Assessment of lipid metabolism-disrupting effects of non-phthalate plasticizer diisobutyl adipate through in silico and in vitro approaches.

Diisobutyl adipate (DIBA), as a novel non-phthalate plasticizer, is widely used in various products. However, little effort has been made to investigate whether DIBA might have adverse effects on human health. In this study, we integrated an in silico and in vitro strategy to assess the impact of DIBA on cellular homeostasis. Since numerous plasticizers could activate peroxisome proliferator-activated receptor γ (PPARγ) pathway to interrupt metabolism systems, we first utilized molecular docking to analyze interaction between DIBA and PPARγ. Results indicated that DIBA had strong affinity with the ligand-binding domain of PPARγ (PPARγ-LBD) at Histidine 499. Afterwards, we used cellular models to investigate in vitro effects of DIBA. Results demonstrated that DIBA exposure increased intracellular lipid content in murine and human hepatocytes, and altered transcriptional expression of genes related to PPARγ signaling and lipid metabolism pathways. At last, target genes regulated by DIBA were predicted and enriched for Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Protein-protein interaction (PPI) network and transcriptional factors (TFs)-genes network were established accordingly. Target genes were enriched in Phospholipase D signaling pathway, phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) and Epidermal growth factor receptor (EGFR) signaling pathway which were related to lipid metabolism. These findings suggested that DIBA exposure might disturb intracellular lipid metabolism homeostasis via targeting PPARγ. This study also demonstrated that this integrated in silico and in vitro methodology could be utilized as a high throughput, cost-saving and effective tool to assess the potential risk of various environmental chemicals on human health.

Sociodemographic Inequalities in Urinary Tract Infection in 2 Large California Health Systems.

BACKGROUND: Urinary tract infection (UTI) accounts for a substantial portion of outpatient visits and antibiotic prescriptions in the United States. Few studies have considered sociodemographic factors including low socioeconomic status (SES)-which may increase residential crowding, inappropriate antibiotic prescribing, or comorbidities-as UTI or multidrug-resistant (MDR) UTI risk factors. METHODS: We used 2015-2017 electronic health record data from 2 California health care systems to assess whether 3 sociodemographic factors-use of Medicaid, use of an interpreter, and census tract-level deprivation-were associated with overall UTI or MDR UTI. UTIs resistant to ≥3 antibiotic classes were considered MDR. RESULTS: Analyses included 601 352 UTI cases, 1 303 455 controls, and 424 977 urinary Escherichia coli isolates from Kaiser Permanente Southern California (KPSC) and Sutter Health in Northern California. The MDR prevalence was 10.4% at KPSC and 12.8% at Sutter Health. All 3 sociodemographic factors (ie, use of Medicaid, using an interpreter, and community deprivation) were associated increased risk of MDR UTI. For example, using an interpreter was associated with a 36% (relative risk [RR], 1.36; 95% CI, 1.31 to 1.40) and 28% (RR, 1.28; 95% CI, 1.22 to 1.34) increased risk of MDR UTI at KPSC and Sutter Health, respectively, adjusted for SES and other potential confounding variables. The 3 sociodemographic factors were only weakly associated with UTI overall. CONCLUSIONS: We found low SES and use of an interpreter to be novel risk factors for MDR UTI in the United States.

Antibiotic body burden of elderly Chinese population and health risk assessment: A human biomonitoring-based study.

Recently, the widespread use of antibiotic has raised concerns about the potential health risks associated with their microbiological effect. In the present study, we investigated 990 elderly individuals (age ≥ 60 years) from the Cohort of Elderly Health and Environment Controllable Factors in West Anhui, China. A total of 45 representative antibiotics and two antibiotic metabolites were monitored in urine samples through liquid chromatography electrospray tandem mass spectrometry. The results revealed that 34 antibiotics were detected in 93.0% of all urine samples and the detection frequencies of each antibiotic varied between 0.2% and 35.5%. The overall detection frequencies of seven human antibiotics (HAs), 10 veterinary antibiotics (VAs), three antibiotics preferred as HAs (PHAs), and 14 preferred as VAs (PVAs) in urines were 27.4%, 62.9%, 30.9% and 72.7%, respectively. Notably, the samples with concentrations of six PVAs (sulfamethoxazole, trimethoprim, oxytetracycline, danofloxacin, norfloxacin and lincomycin) above 5000 ng/mL accounted for 1.7% of all urine samples. Additionally, in 62.7% of urine samples, the total antibiotic concentration was in the range of the limits of detection to 20.0 ng/mL. Furthermore, the elderly individuals with the sum of estimated daily intakes of VAs and PVAs more than 1 µg/kg/day accounted for 15.2% of all participants, and a health risk related to change in gut microbiota under antibiotic stimulation was expected in 6.7% of the elderly individuals. Especially, ciprofloxacin was the foremost contributor to the health risk, and its hazard quotient value was more than one in 3.5% of all subjects. Taken together, the elderly Chinese people were extensively exposed to VAs, and some elderly individuals may have a health risk associated with dysbiosis of the gut microbiota.

Trends in Statin Use 2009-2015 in a Large Integrated Health System: Pre- and Post-2013 ACC/AHA Guideline on Treatment of Blood Cholesterol.

PURPOSE: Implementation of the 2013 ACC/AHA cholesterol treatment guideline is likely to vary by statin benefit group. The aim of this study was to document trends in statin use before and after introduction of the ACC/AHA guideline. METHODS: We conducted a retrospective study with annual cohorts from 2009 to 2015 among members of Kaiser Permanente Southern California aged ≥ 21 years. Members were categorized into four mutually exclusive statin benefit groups: atherosclerotic cardiovascular disease (ASCVD), LDL-C ≥ 190 mg/dL in the last year, diabetes (aged 40-75 years), and 10-year ASCVD risk ≥ 7.5% (aged 40-75 years). RESULTS: The cohorts ranged from 1,993,755 members in 2009 to 2,440,429 in 2015. Approximately 5% of patients had ASCVD, 1% had LDL-C ≥ 190 mg/dL, 6% had diabetes, and 10% had a 10-year ASCVD risk ≥ 7.5% each year. Trends in statin use were stable for adults with ASCVD (2009 78%; 2015 80%), recent LDL-C ≥ 190 mg/dL (2009 45%; 2015 44%), and diabetes (2009 74%; 2015 73%), but increased for patients with 10-year ASCVD risk ≥ 7.5% (2009 36%; 2015 47%). High-intensity statin use also increased 142% and 54% among patients with LDL-C ≥ 190 mg/dL and those with ASCVD ≤ 75 years of age, respectively. Moderate-to-high intensity statin utilization increased over 50% among those with a 10-year ASCVD risk ≥ 7.5%. CONCLUSIONS: Statin use increased substantially among patients with 10-year ASCVD risk ≥ 7.5% and use of appropriate statin dosage increased in each of the four statin benefit groups between 2009 and 2015; however, there is room for improvement.

A Retrospective Analysis to Evaluate Seasonal Pressure Injury Incidence Differences Among Hip Fracture Patients in a Tertiary Hospital in East China.

Patients with a hip fracture are at high risk for pressure injury. A retrospective review of the electronic medical records of consecutive patients with a hip fracture treated in 2016 in a single tertiary hospital in east China were examined to investigate whether time of year affected the incidence of hospital-acquired pressure injury. Data collected included demographic characteristics (patient name, hospital number, age, gender, and body mass index); possible risk factors for pressure injury, such as presence of diabetes mellitus, admission hemoglobin, admission albumin, length of surgery, and the lowest and/or last Braden Scale score before pressure injury developed; and pressure injury information, which included time of occurrence (days after surgery), location (sacrum and coccyx, ischial tuberosity, or heel), stage, and treatment outcome. Pressure injury incidence was calculated with 95% confidence intervals (CIs) in each month and season (spring, summer, autumn, and winter). Odds ratios (ORs) and 95% CIs were calculated as estimates of risk. Multivariate logistic regression was used for risk factors. Of the 235 patients with a hip fracture included in the study, 95 (40.4%) were male, 140 (59.6%) were female, and mean age was 70.4 ± 10.5 (range 48-81) years. Thirty-one (31) patients (13.2%, 95% CI 9.1%-18.2%) developed 37 pressure injuries, 30 of which (81.1%) were Stage 1. The incidence of pressure injury was lowest in November (5.0%; 95% CI: 0.0%-24.9%) and highest in June (22.7%; 95% CI: 7.8%-45.4%). Average Braden Scale scores (14.2 ± 3.2) were lower in June than in November (16.6 ± 3.5), owing to differences in the Braden Scale skin moisture subscale. Seasonally, the incidence of pressure ulcers was 20.8% (95% CI: 12.2%-32.0%) in the summer compared to 7.5% (2.5%-16.6%) in autumn (crude OR 3.3; 95% CI:1.0-12.1; P = .025). Multivariate logistic regression analysis showed the Braden Scale score was the only independent risk factor (P <.05) for pressure injury incidence. Adjusting for the Braden score, the OR of summer season was 1.537 (95% CI: 0.964-2.872). The findings suggest that humidity and temperature levels, which are very high in the summer in China, may affect pressure injury incidence and that the Braden Scale score - especially the skin-moisture level subscore - is a valid predictor of pressure injury risk in this population. While more research is needed, additional pressure injury prevention strategies should be provided for patients hospitalized with a hip fracture in the summer months.

Unmet Patient Need in Statin Intolerance: the Clinical Characteristics and Management.

PURPOSE: A substantial percentage of patients report intolerance or side effects of statin treatment leading to treatment changes or discontinuation. The purpose of this study was to examine statin therapy changes and subsequent effects on low-density lipoprotein cholesterol (LDL-C) among patients with statin intolerance (SI). METHODS: We identified 45,037 adults from Kaiser Permanente Southern California with SI documented between 2006 and 2012. Changes in statin therapy in the year before and after the SI index date were examined. We categorized patients into those who initiated statin therapy, discontinued, up-titrated, down-titrated, or did not switch therapy. We calculated the percentage change in LDL-C from the year before to the year after SI, and the percentage of patients attaining LDL-C < 100 and < 70 mg/dL. RESULTS: In the year prior to the SI date, 77.8% of patients filled a statin prescription. Following SI, 44.6% had no treatment change, 25.5% discontinued, and 30.0% altered their statin therapy. Of those who altered statin therapy, 52.6% down-titrated and 17.2% up-titrated their dose. Rhabdomyolysis was documented in < 1% of the cohort. The largest changes in LDL-C were experienced by patients who were on a high-intensity statin then discontinued treatment (35.6% increase) and those who initiated a high-intensity statin (25.5% decrease). The proportion of patients achieving LDL-C < 100 mg/dL and LDL-C < 70 mg/dL was the lowest among those who discontinued therapy. CONCLUSIONS: Although adjustments to the statin dosage may be appropriate upon documentation of SI, many of these patients will have high LDL-C. Strategies for LDL-C reduction in patients with SI may be necessary.

Development and Assessment of Risk Scores for Carbapenem and Extensive ß-Lactam Resistance Among Adult Hospitalized Patients With Pseudomonas aeruginosa Infection.

Importance: Treatment of patients with infections due to Pseudomonas aeruginosa has been complicated by increased antibiotic resistance rates, which contribute to delayed appropriate treatment and deleterious outcomes. Objective: To develop 2 clinical risk scores based on variables available at clinical presentation to estimate the risk of carbapenem resistance (CR) or extensive ß-lactam resistance (EBR) among hospitalized, adult patients with P aeruginosa infections. Design, Setting, and Participants: This retrospective cohort study included adult (age, ≥18 years) members of Kaiser Permanente Southern California (KPSC) with a P aeruginosa infection during hospitalization from September 1, 2011, through August 31, 2016, who received antibiotic therapy within 2 days of the culture date. Data were analyzed from July 2, 2017, through August 15, 2018. Exposures: Demographic, clinical, and laboratory covariates 1 year before the index culture date were evaluated. Main Outcomes and Measures: Pseudomonas aeruginosa was categorized as antibiotic susceptible, CR, or EBR (nonsusceptibility to carbapenems, ceftazidime, and combined piperacillin sodium and tazobactam sodium). Patients were randomly split (1:1) into training and validation data sets. The training data set was used to develop 2 prediction models using high-performance logistic regression with variable selection by Schwarz-Bayesian criterion. The models were translated into risk scores, with risk score points equaling the weighted sums of regression coefficients from the prediction model. The patient's risk was estimated as the inverse logit of the risk score. Results: Of the 7775 patients with 11 502 P aeruginosa infections included in the analysis, most were male (4308 [55.4%]) and non-Hispanic white (3927 [50.5%]). The mean (SD) age was 70.3 (15.5) years. Among 11 502 P aeruginosa infections, 2324 (20.2%) were CR, 9178 (79.8%) were non-CR, 1033 (9.0%) were EBR, and 10 469 were non-EBR (91.0%). The strongest predictors of resistance in the CR and EBR models were history of CR P aeruginosa infection (odds ratios [ORs], 8.80 [95% CI, 6.74-11.49] and 5.04 [95% CI, 3.88-6.54], respectively), tracheostomy (ORs, 3.49 [95% CI, 2.92-4.16] and 3.13 [95% CI, 2.50-3.91], respectively), and carbapenem use in the prior 30 days (ORs, 4.18 [95% CI, 3.29-5.31] and 2.26 [95% CI, 1.74-2.93], respectively). The models for CR and EBR performed well, with areas under the receiver operating characteristics curve of 0.81 or greater for the training and validation data sets. Conclusions and Relevance: The findings of this study suggest that parsimonious risk scores can aid physicians in appropriate treatment selection during the critical period when P aeruginosa infection is suspected but antibiotic susceptibility results are not yet available.

A Comprehensive Assessment Across the Healthcare Continuum: Risk of Hospital-Associated Clostridium difficile Infection Due to Outpatient and Inpatient Antibiotic Exposure.

BACKGROUND: Limitations in sample size, overly inclusive antibiotic classes, lack of adjustment of key risk variables, and inadequate assessment of cases contribute to widely ranging estimates of risk factors for Clostridium difficile infection (CDI). OBJECTIVE: To incorporate all key CDI risk factors in addition to 27 antibiotic classes into a single comprehensive model. DESIGN: Retrospective cohort study. SETTING: Kaiser Permanente Southern California. PATIENTS: Members of Kaiser Permanente Southern California at least 18 years old admitted to any of its 14 hospitals from January 1, 2011, through December 31, 2012. METHODS: Hospital-acquired CDI cases were identified by polymerase chain reaction assay. Exposure to major outpatient antibiotics (10 classes) and those administered during inpatient stays (27 classes) was assessed. Age, sex, self-identified race/ethnicity, Charlson Comorbidity Score, previous hospitalization, transfer from a skilled nursing facility, number of different antibiotic classes, statin use, and proton pump inhibitor use were also assessed. Poisson regression estimated adjusted risk of CDI. RESULTS: A total of 401,234 patients with 2,638 cases of incident CDI (0.7%) were detected. The final model demonstrated highest CDI risk associated with increasing age, exposure to multiple antibiotic classes, and skilled nursing facility transfer. Factors conferring the most reduced CDI risk were inpatient exposure to tetracyclines and first-generation cephalosporins, and outpatient macrolides. CONCLUSIONS Although type and aggregate antibiotic exposure are important, the factors that increase the likelihood of environmental spore acquisition should not be underestimated. Operationally, our findings have implications for antibiotic stewardship efforts and can inform empirical and culture-driven treatment approaches.

[The relationship between socioeconomic status and overweight and obesity among elementary school children in China].

OBJECTIVE: To analyze the relationship between socioeconomic status (SES) and overweight and obesity among elementary school children. METHODS: This cross-sectional study was conducted from September to November, 2010. A stratified random cluster sampling was used from sampling frame of eight provinces by the geographical and economic development distributions in mainland China. A total of 19 934 students aged 7-12 years old participated in this study. All subjects were evaluated the status of overweight and obesity. Green's scoring SES was used to evaluate the SES of the participants. Multivariate logistic regression analysis was performed to examine the relationship between SES and overweight and obesity among children. RESULTS: According to the scores of Green's SES, the participants' SES were divided into three levels, the prevalence of overweight were 7.4% (538/7295), 9.3% (560/6013) and 12.6% (832/6626), and the prevalence of obesity were 4.4% (321/7295) , 6.4% (387/6013) and 10.2% (677/6626) from low to high SES level, respectively (χ(2) value were 133.82, 180.27, respectively, P < 0.01). After adjusted by age, urban and rural and economic regions, compared with the participants with low SES, the OR (95%CI) of having overweight and obesity among participants with high SES were 1.83(1.61-2.08) for boys and 1.67(1.42-2.00) for girls; the OR (95%CI) with middle SES were 1.30(1.15-1.48) for boys and 1.23(1.04-1.46) for girls. CONCLUSION: The prevalence of overweight and obesity rises with the family's SES levels. There was a positive correlation between SES and overweight and obesity among school-aged children.

Establishing a web-based integrated surveillance system for early detection of infectious disease epidemic in rural China: a field experimental study.

BACKGROUND: A crucial goal of infectious disease surveillance is the early detection of epidemics, which is essential for disease control. In China, the current surveillance system is based on confirmed case reports. In rural China, it is not practical for health units to perform laboratory tests to confirm disease and people are more likely to get 'old' and emerging infectious diseases due to poor living conditions and closer contacts with wild animals and poultry. Syndromic surveillance, which collects non-specific syndromes before diagnosis, has great advantages in promoting the early detection of epidemics and reducing the necessities of disease confirmation. It will be especially effective for surveillance in resource poor settings. METHODS/DESIGN: This is a field experimental study. The experimental tool is an innovative electronic surveillance system, combining syndromic surveillance with the existing case report surveillance in four selected counties in China. In the added syndromic surveillance, three types of data are collected including patients' major symptoms from health clinics, pharmaceutical sales from pharmacies and absenteeism information from primary school. In order to evaluate the early warning capability of the new added syndromic surveillance, the timelines and validity of the alert signals will be analyzed in comparison with the traditional case reporting system. The acceptability, feasibility and economic evaluation of the whole integrated surveillance system will be conducted in a before and after study design. DISCUSSIONS: Although syndromic surveillance system has mostly been established in developed areas, there are opportunities and advantages of developing it in rural China. The project will contribute to knowledge, experience and evidence on the establishment of an integrated surveillance system, which aims to provide early warning of disease epidemics in developing countries.

Assessment of the antibacterial activity and the antidiarrheal function of flavonoids from bayberry fruit.

Chinese bayberry fruits are used as a folk medicine to cure diarrhea. However, the active compounds have not yet been reported. We found that bayberry fruit extract showed significant antibacterial activity against Salmonella, Listeria, and Shigella, and the minimal inhibitory concentration (MIC) ranged from 2.07 to 8.28 mg/mL. Positive relationships were found between the antibacterial activity and the total polyphenol (r = 0.88) and flavonoid contents (r = 0.92) of samples using different extraction times. The active compounds showed green or blue fluorescence under UV light using the bioautography method and were purified using a polyamide column. The fraction F1 with the most activity was comprised of flavonoids, which included cyanidin-3-O-glucoside, myricetin deoxyhexoside, quercetin-3-O-glucoside, and quercetin deoxyhexoside, and it also possessed an antidiarrheal activity (p < 0.10) at 80 mg/kg in mice. These findings provide scientific evidence for the antidiarrheal function of bayberry.

[Report and analysis of periodicals of oral science in China].

OBJECTIVE: To review and analyze the history and current situation of stomatological journals in China from 1949 to 2009. METHODS: The data from journal database, web sites and yearbooks were collected, and the information on Chinese dental journals, national economic indicators and the development in dental disciplines from 1949 to 2009 were obtained. RESULTS: The dental journals numbered one kind, four issues in 1949 and 32 kinds, 204 issues in 2009. China's gross domestic product (GDP) was from 67.9 billion Yuan in 1949 to 30.067 trillion Yuan in 2008. CONCLUSIONS: The quantity of stomatological journals in China has increased remarkably over the past 60 years.

[Comparative assessment of individualized multifocal intraocular lens implantation].

OBJECTIVE: To evaluate the visual quality after combined implantation of refractive and diffractive multifocal intraocular lens (MIOLs) in both eyes (CustomMatch pattern). METHODS: Prospective, nonrandomized study. Zhongshan Ophthalmic Center, Sun yat-sen university, P.R. China. Age-related cataract patients, selected according to the inclusion criteria and divided into MIOL group and monofocal intraocular lens (SIOL) group, received phacoemulsification and were implanted with combined a ReZoom NXG1 IOL in the dominant eye and a Tecnis ZM900 IOL in the fellow eye or bilateral Sensar AR40e IOLs. Monocular and binocular testing one month after surgery included uncorrected and best-spectacle corrected visual acuity at far, intermediate and near distances under 100 cd/m(2) and 6 cd/m(2), reading visual acuity and reading speed, defocus curve, and subjective vision-related quality of life using questionnaire. RESULTS: Under 100 cd/m(2) and 6 cd/m(2), binocular mean uncorrected visual acuity at 500 cm in MIOL group was logMAR 0.013 +/- 0.149 and logMAR 0.163 +/- 0.220 and binocular mean best-spectacle corrected visual acuity was logMAR -0.027 +/- 0.092 and logMAR 0.109 +/- 0.175 respectively. The mean refraction spherical equivalent for best distance corrected visual acuity was (-0.18 +/- 0.85) D and (-0.32 +/- 0.90) D respectively. Under 100 cd/m(2), better uncorrected visual acuity (decimal 0.63) at 40 cm, 63 cm and 100 cm was achieved in MIOL group. Under 6 cd/m(2), the uncorrected visual acuities in MIOL group at 40 cm and 63 cm distance were significantly higher than those in SIOL group although there were no statistically difference at 100 cm. Uncorrected reading visual acuity and reading speed in MIOL group were better than those in SIOL group, while the results in reading ability were similar when MIOL group without correction compared with SIOL group with correction. The depth of focus was 5.5 diopter in MIOL group. No patient in both groups wore glasses for distance and 70% patients in MIOL group did not need to wear glasses for intermediate and near distances after surgery. CONCLUSION: CustomMatch pattern could provide a satisfactory vision at a full range of near, intermediate and far distance and improve the life quality to a certain extent.

[Comparative assessment of visual quality after combined implantation of multifocal intraocular lens].

OBJECTIVE: To evaluate the visual quality after combined implantation of refractive and diffractive multifocal intraocular lenses (IOL) in both eyes. METHODS: Prospective, nonrandomized study. Age-related cataract patients were divided into multifocal IOL group (MIOL group) and monofocal IOL group (SIOL group) and received phacoemulsification. In MIOL group, a ReZoom NXG1 IOL and a Tecnis Z M900 IOL were implanted into the dominant eye and the fellow eye, respectively. In SIOL group, Sensar AR40e IOLs were implanted into both eyes. Monocular or binocular test was performed one month after surgery, including wavefront aberration, contrast sensitivity with or without glare and near stereoacuity. RESULTS: The root mean square of spherical aberration at pupil diameter of 5 mm was 0.058 +/- 0.159 microm in NXG1 eyes and 0.005 +/- 0.169 microm in ZM900 eyes, both of them were significantly lower than 0.408 +/- 0.160 microm achieved in AR40e eyes (F = 11.734; P = 0.001, 0.000). There was no significant difference in the total ocular aberration, contrast sensitivity and high-order aberration among eyes with these different IOLs. The uncorrected near stereoacuity in MIOL group was (45.60 +/- 35.04) seconds of arc, which was significantly better than (110.00 +/- 41.23) seconds of arc achieved in SIOL group (F = 2.923; P = 0.010). CONCLUSION: Combined implantation of multifocal ReZoom NXG1 IOL and Tecnis ZM900 IOL provides a good visual quality with reduced spherical aberration and satisfactory near stereoacuity.

U.S. decennial life tables for 1999-2001: methodology of the United States Life Tables.

OBJECTIVES: This report describes the methodology used in the preparation of the 1999-2001 decennial life tables for the United States. METHODS: Data used to prepare these life tables include population data by age on the census date April 1, 2000; deaths occurring in the 3-year period 1999-2001 classified by age at death; births for each of the years 1997-2001; and Medicare data for ages 66-100 years from the years 1999-2001. Methods that were kept the same as those of previous decennial tables include data sources used in constructing tables, the preliminary adjustment for misreported ages, the smoothing techniques for vital statistics and census data, and the calculations of death rates in different age groups. Two significant changes were made to the methodology used to estimate mortality for the populations aged 66 years and over. First, Medicare data were used to supplement vital statistics (number of deaths) and census data (population estimates) starting at age 66 years instead of age 85 years as was done in the estimation of previous U.S. decennial life tables. Second, smoothing and extrapolation of death rates for ages 66-109 was performed using a mathematical model given by Heligman and Pollard, instead of a Whittaker-Henderson Type B formula or modified Gompertz method.

Patterns of T-cell reconstitution by assessment of T-cell receptor excision circle and T-cell receptor clonal repertoire after allogeneic hematopoietic stem cell transplantation in leukemia patients--a study in Chinese patients.

OBJECTIVE: Successful allogeneic hematopoietic stem cell transplantation (HSCT) requires reconstitution normal T-cell immunity. Measurement of T-cell receptor excision circles (TRECs) and T-cell receptor beta (TCRBV) CDR3 repertoire is a means of quantifying recent thymic T-cell production and reflecting antigen-specific T-cell clones proliferation. METHODS: We used real-time quantitative PCR to detect TRECs from 43 Chinese patients who underwent three kind of allo-HSCT without T-cell depletion. RT-PCR was performed to amplify 24 subfamily genes of TCRBV in 24 patients of them. RESULTS: For haploidentical-D group, the TRECs numbers were lower up to 24 months. For matched-sibling donor (MSD) group, the recovery of TRECs was faster than those of other two groups. TRECs values in matched-unrelated donor (MUD) were in the middle. During 2-19 months after transplantation, there were 6-16 BV subfamilies expressed and 33-48% of them were polyclones. The usage rate of TCRBV and percentage of polyclones in haploidentical-D were less than those of other two groups. Twenty-three CDR3 molecules were obtained from nine patients who were potentially associated with GVHD or CMV infection. CONCLUSIONS: Analyzing the changes of TCRBV repertoire and measuring TRECs during immune reconstitution would be useful to determine the host's current immune status and ability of T-cell immune reconstitution and also to find antigen-specific T-cell clones in the three kinds of HSCT.

[Quality of life assessment in children with congenital bilateral cataract].

OBJECTIVE: To study the influence of congenital bilateral cataract on visual-related quality of life (QoL) in children. METHODS: The scale of QoL for children with congenital bilateral cataract was used to evaluate the QoL of 81 children with congenital bilateral cataract and 28 healthy children with normal visual acuity. The average age of congenital bilateral cataract candidates was 9.8 years (from 8 to 15 years) and 37 patients were female. Thirty-six cataract children took part in the both preoperative and postoperative investigations. The patients' QoL were also categorized by age, gender, score, visual acuity, surgery and density of cataract. Multiple-linear regression model was applied to analyze the influence factors of QoL. RESULTS: Statistically significant difference was found at the QoL between healthy children and children with congenital bilateral cataract (P = 0.00). The QoL in children with non-dense cataract was increased after cataract surgery (P = 0.00). A high correlation was found between visual acuity and QoL (r = 0.53, P = 0.00). A statistically significant difference was found in QoL between dense and non-dense cataract (P = 0.00). Three variances enrolled in the multiple-linear regression equation included the density of cataract, surgery and visual acuity. Their partial regression coefficients were 6.14 (P = 0.00), 3.21 (P = 0.01) and 1.07 (P = 0.01) respectively. CONCLUSIONS: Compared with the healthy children, the QoL score was severely impaired in children with congenital bilateral cataract, which was influenced by the density of cataract, surgery and visual acuity. Visual acuity is the most critical factor influencing the QoL.