A Case Report of Corynebacterium Tuberculostearicum Infection.

BACKGROUND: The goal was to report a rare case of lymphadenitis caused by Corynebacterium tuberculostearicum, and the laboratory's coping approach in the isolation and identification of this rare pathogen to improve the understanding of the disease. METHODS: Lymph node biopsy was performed in a patient with suspected tuberculous lymphadenitis, and the biopsy tissue was isolated and cultured. RESULTS: The culture was Gram positive Corynebacterium, which was identified as Corynebacterium tuberculostearicum by microbial mass spectrometry and 16S rRNA gene sequencing. Antimicrobial susceptibility test showed that the drug was sensitive to daptomycin, doxycycline, gentamicin, linezolid, vancomycin, and meropenem, but resistant to ciprofloxacin, clindamycin, erythromycin, rifampicin, compound sulfamethoxazole, ceftriaxone, and cefepime. CONCLUSIONS: This is a case of Corynebacterium tuberculostearicum infection. Case reports of Corynebacterium tuberculostearicum infection are relatively rare in China. Through case study, we can provide help for laboratory isolation, identification, clinical diagnosis, and treatment.

Molecular characteristics and antimicrobial resistance profiles of Carbapenem-Resistant Klebsiella pneumoniae isolates at a tertiary hospital in Nanning, China.

PURPOSE: Carbapenem resistant Klebsiella pneumoniae is associated with nosocomial infections and can cause high mortality, which poses great threat to human health. This study was aimed at investigating the molecular epidemiology and antimicrobial resistance profiles of carbapenem resistant Klebsiella pneumoniae isolates and providing clues for management and control of carbapenem resistant Klebsiella pneumoniae infections. METHODS: A total of 2324 Klebsiella pneumoniae strains were isolated from the First Affiliated Hospital of Guangxi Medical University from June 2018 to October 2020, and 103 carbapenem resistant Klebsiella pneumoniae strains from inpatients were collected, and the specimens mainly came from the sputum, urine, secretions, and blood. The antimicrobial susceptibility tests were performed using the VITEK 2 Compact system or the Kirby-Bauer disk-diffusion method. The resistance genes were detected by polymerase chain reaction and sequencing. The homology analysis of carbapenem resistant Klebsiella pneumoniae strains was performed by multilocus sequence typing. RESULTS: Antimicrobial susceptibility results showed that the 103 carbapenem resistant Klebsiella pneumoniae strains were resistant to most common antibiotics. Resistance genes detection showed that the carbapenem resistant Klebsiella pneumoniae isolates mainly carried metallo-beta-lactamase, and the predominant gene was NDM-1. The homology analysis found that the major ST type were ST11, follow by ST15 and ST17. CONCLUSION: The carbapenem resistant Klebsiella pneumoniae isolates in our study shown resistance to most common antibiotics. Of the 103 carbapenem resistant Klebsiella pneumoniae strains, 91 strains (88.35%) carried carbapenemases genes, and NDM was the predominant carbapenemase gene detected. ST11 was the major ST typing of carbapenem resistant Klebsiella pneumoniae in our hospital. Our finding may play a role in control and management of the carbapenem resistant Klebsiella pneumoniae infections and guiding clinical antibiotic therapy. In addition, metallo-beta-lactamase should be served as a key target to be monitored in carbapenem resistant Klebsiella pneumoniae infection.

Prevalence and treatment of venous thromboembolism in patients with solid tumors.

Cancer-associated venous thromboembolism (VTE) has exhibited a rising incidence rate. Research focusing on cancer-associated VTE and current anticoagulation therapy strategies is limited. The present study aimed to investigate the prevalence, characteristics and anticoagulation therapy strategies of cancer-associated VTE. The study was performed on patients with major solid tumors who were admitted to The First Affiliated Hospital of Guangxi Medical University (Nanning, China) between January 2020 and December 2020. The medical records of the patients' demographic characteristics, disease and treatment were extracted from the medical record data system and reviewed. The prevalence of cancer-associated VTE was calculated, followed by statistical analysis. Patients who received anticoagulation therapy for cancer-associated VTE were followed up for 1 year. The characteristics and efficacy of anticoagulation therapy strategies were compared and analyzed. A total of 4,926 patients with major solid tumors (mean age, 55.86±11.97 years) were included in the analysis, of which 117 (2.4%; 117/4,926) were diagnosed with cancer-associated VTE. Patients with pancreatic cancer exhibited the highest prevalence of VTE (10.2%; 5/49), followed by patients with ovarian cancer (5.8%; 9/156) and lung cancer (3.3; 73/2,237). Multivariate analysis identified hypertension comorbidity [odds ratio (OR), 1.661; 95% CI, 1.031-2.674; P=0.037)] and cancer stage (OR, 1.266; 95% CI, 1.079-1.486; P=0.004) as independent risk factors for cancer-associated VTE. Deep vein thrombosis (DVT) of the lower extremity accounted for 62.0%; 62/100) of all DVTs. Moreover, pulmonary embolism (PE) with lower extremity DVT accounted for 53.5% (23/43) of all PE cases. The majority of cancer-associated VTE cases (63.2%; 74/117) developed 30 days before or after a cancer diagnosis. In addition, cancer-associated VTE was dominated by symptomatic VTE (59.8%; 70/117). Only 74.4% (87/117) of patients with VTE received anticoagulant treatment, with a median duration of 79 days. The most common anticoagulant treatment strategies were heparin during hospitalization and direct oral anticoagulants (rivaroxaban) after discharge. The anticoagulants associated with bleeding events were rivaroxaban (4.2%; 3/72) and enoxaparin (1.9%; 1/54). In total, 62.1% (36/58) of the patients received anticoagulant treatment for <90 days. In conclusion, the results indicated that the prevalence of cancer-associated VTE is common and exhibits numerous characteristics. Rivaroxaban has been widely used in cancer-associated VTE treatment. However, compliance with long-term anticoagulant treatment is not adequate at present, while the efficacy and safety of rivaroxaban must be evaluated to improve long-term medication monitoring and follow-up among patients with cancer-associated VTE.

Meningitis patients with pneumonia: correlation between blood parameters and clinical features.

Background: This research aimed to explore the possible relationship between the main experimental parameters and clinical status in meningitis patients with pneumonia infection. Methods: A retrospective analysis of the demographic characteristics, clinical features and laboratory parameters of meningitis patients was performed. Results: D-dimer, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) exhibited good diagnostic ability for meningitis complicated with pneumonia. Additionally, we observed a positive correlation between D-dimer and CRP in cases of meningitis with pneumonia infection. D-dimer, ESR and Streptococcus pneumoniae (S. pneumoniae) were independently associated with meningitis patients with pneumonia infection. Conclusion: D-dimer, CRP, ESR and S. pneumoniae infection may effectively anticipate disease progression and adverse consequences in meningitis patients with pneumonia infection.

D-dimer has an early and rapid diagnostic value for the hypercoagulation state. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) have been widely used laboratory parameters for inflammatory diseases. In our study, we observed increased D-dimer, CRP and ESR levels in patients with meningitis, which were more pronounced in patients with meningitis complicated with pneumonia. It is worth noting that D-dimer and CRP showed a positive correlation in patients with meningitis. D-dimer, CRP and ESR in patients with meningitis can effectively monitor disease progression.

Bioinformatic and biochemical studies of formononetin against liver injure.

Formononetin is a promising bioactive phytoestrogen with evident pharmacological properties. However, the potential hepatoprotective benefit is evidenced limitedly in experiments. This study was designed to investigate the hepatoprotective mechanism and benefit of formononetin against liver injury via network pharmacology combined with biochemical determination. The computational data from network pharmacology identified the crucial genes of formononetin against liver injury, listed as TNF-α, NFκB-p65, TLR3, RELA, TRAF6, IKBKG, IKBKB, TNFRSF1A. And the anti-liver injury of formononetin were mainly involved in suppression of inflammatory pathways, including TNF signaling pathway, NF-κB signaling pathway, Toll-like receptor signaling pathway. In animal investigation, formononetin-dosed mice showed reduced body weight loss and hepatomegaly, meliorated liver function, suppressed hepatotoxicity and inflammatory reaction. Furthermore, the down-regulated expressions of TNF-α, NFκB-p65, TLR3 mRNAs and proteins in the livers of formononetin-dosed mice were detected accordingly. Therefore, we concluded that computational findings based on network pharmacology reveal the pharmacological targets, biological processes, and molecular mechanisms of formononetin against liver injury before some of findings were partially certified in vivo. Overall, formononetin may be a potential active component to prevent or treat liver injury.

Serum Proteomic Analysis by Tandem Mass Tags (TMT) Based Quantitative Proteomics in Gastric Cancer Patients.

BACKGROUND: To use the tandem mass tags (TMT) based quantitative proteomics technique and bioinformatics method to identify potential serum diagnostic biomarkers for gastric cancer (GC). METHODS: This study enrolled GC patients and healthy control subjects. Mixed serum samples were pooled with 10 individual samples. The high-abundance proteins depleted serum proteins were collected by removing abundance albumin and immunoglobulin G (IgG). After desalting and ultrafiltration, the trypsin digested proteins were analyzed using TMT based quantitative proteomics system. The differential proteins were screened using the cutoff value of 1.2-fold change for up-regulation or down-regulation. The gene ontology (GO) was further analyzed using the UniProtKB/Swiss-Prot database. Then the differentially expressed protein ITIH4, S100A8, CD59, and COF1 were conducted using western blot. RESULTS: A total of 594 distinct serum proteins were identified between the GC group and the healthy controls. Forty-eight proteins were up-regulated and 57 were down-regulated using the cutoff value of 1.2-fold change. Using bioinformatics analysis, we found that the differentially expressed proteins were mainly concentrated in the extracellular exosome, extracellular region, extracellular space, and plasma membrane; their biological process activities included antigen binding, calcium ion binding, and protein homodimerization. In addition, the western blotting results showed that four differentially expressed proteins were completely coincident with the TMT quantification trend. CONCLUSIONS: The results showed that we were able to successfully create the differentially expressed protein database of GC using TMT technology. These proteins are potential molecular markers that could help us understand the potential molecular mechanism of GC.

Glycoprofiling of Early Gastric Cancer Using Lectin Microarray Technology.

BACKGROUND: Recently, studies have reported that protein glycosylation plays an important role in the occurrence and development of cancer. Gastric cancer is a common cancer with high morbidity and mortality owing to most gastric cancers are discovered only at an advanced stage. Here, we aim to discover novel specific serum glycanbased biomarkers for gastric cancer. METHODS: A lectin microarray with 50 kinds of tumor-associated lectin was used to detect the glycan profiles of serum samples between early gastric cancer and healthy controls. Then lectin blot was performed to validate the differences. RESULTS: The result of the lectin microarray showed that the signal intensities of 13 lectins showed significant differences between the healthy controls and early gastric cancer. Compared to the healthy, the normalized fluorescent intensities of the lectins PWA, LEL, and STL were significantly increased, and it implied that their specifically recognized GlcNAc showed an especially elevated expression in early gastric cancer. Moreover, the binding affinity of the lectins EEL, RCA-II, RCA-I, VAL, DSA, PHA-L, UEA, and CAL were higher in the early gastric cancer than in healthy controls. These glycan structures containing GalNAc, terminal Galß 1-4 GlcNAc, Tri/tetraantennary N-glycan, ß-1, 6GlcNAc branching structure, α-linked fucose residues, and Tn antigen were elevated in gastric cancer. While the two lectins CFL GNL reduced their binding ability. In addition, their specifically recognized N-acetyl-D-galactosamine structure and (α-1,3) mannose residues were decreased in early gastric cancer. Furthermore, lectin blot results of LEL, STL, PHA-L, RCA-I were consistent with the results of the lectin microarray. CONCLUSIONS: The findings of our study clarify the specific alterations for glycosylation during the pathogenesis of gastric cancer. The specific high expression of GlcNAc structure may act as a potential early diagnostic marker for gastric cancer.

Increased Red Blood Cell Volume Distribution Width: Important Clinical Implications in Predicting Gastric Diseases.

BACKGROUND: The red blood cell distribution width (RDW) is a blood analyzer marker showing the peripheral blood erythrocyte volume heterogeneity parameters. It is a normal diagnosis index of many diseases. This study was performed to evaluate the relationship between the RDW and gastric diseases. METHODS: A total of 189 patients with GC, 68 patients with gastric ulcers, 92 patients with chronic gastritis, and 157 healthy controls were enrolled in this study. Each patient's RDW and other biomarkers were recorded. All of the statistical analyses and comparisons between each group were determined using SPSS16.0 software. The statistical significance level was set to a p-value < 0.05. RESULTS: The RDW was significantly higher in those patients with gastric diseases when compared to the control group (p < 0.05). In addition, the RDW was independently correlated with the presence of GC and gastric ulcers. Significantly positive correlations between the RDW, platelets, and platelet distribution width (PDW) were observed in those patients with GC and gastric ulcers, although there were negative correlations with the red blood cells (RBCs), hemoglobin, and mean corpuscular volume (MCV) (p < 0.05). In the chronic gastritis group, elevated RDW values were closely associated with the hemoglobin, platelet, and MCV values (p < 0.05). The specificities of the gastric diseases groups were greater than 90%. CONCLUSIONS: In cases of gastric diseases, the RDW values were increased and were associated with several laboratory parameters. These finding may have important clinical implications in predicting gastric diseases.

The effect of MDR1 C3435T polymorphism on the eradication rate of H. pylori infection in PPI-based triple therapy: A meta-analysis.

BACKGROUND: Several studies have reported that multidrug resistance gene 1 (MDR1) C3435T polymorphism was associated with the rate of Helicobacter pylori (H. pylori) eradication in proton pump inhibitor (PPI)-based triple therapy. However, the conclusions were inconsistent. Therefore, this meta-analysis was conducted to evaluate the impact of MDR1 C3435T polymorphism on H. pylori eradication by PPI-based triple therapy. METHODS: Seven eligible studies published up to August 2016 and including 1019 patients were identified by searching the Chinese Biomedical Literature database, Wan fang, PubMed, and the Web of Science electronic databases. Consequently, a meta-analysis was conducted with STATA software, using summary odds ratios (OR) and a 95% confidence interval (CI). RESULTS: Overall, there was no significant difference between MDR1 C3435T polymorphism and the eradication rate of H. pylori in the entire genetic model, irrespective of the PPI used. Furthermore, in Asian populations, the TT genotype decreased H. pylori eradication (TT vs CT+CC: OR=0.411, 95% CI = 0.280-0.602, P = 0.000). In addition, a significantly low eradication rate was observed in a recessive model, in which either lansoprazole (TT vs CT+CC: OR = 0.305, 95% CI = 0.184-0.504, P = 0.000) or omeprazole (TT vs CT+CC: OR = 0.229, 95% CI = 0.069-0.763, P = 0.016) was taken, in a subanalysis of individual PPIs. In the analyses that were stratified by disease type, no significant difference was observed in the peptic ulcer group and the combined diseases subgroup. CONCLUSION: This meta-analysis indicated that the TT genotype of the MDR1 C3435T polymorphism decreased H. pylori eradication in Asian populations and was also associated with a low cure rate of H. pylori in patients taking lansoprazole- and omeprazole-based triple therapies. However, future studies using larger sample sizes are required.

Effect of RAGE gene polymorphisms and circulating sRAGE levels on susceptibility to gastric cancer: a case-control study.

BACKGROUND: To investigate the influence of polymorphisms in the receptor for advanced glycation end products (RAGE) gene and circulating soluble RAGE (sRAGE) levels on susceptibility to gastric cancer, and identify whether these polymorphisms were correlated with serum sRAGE levels. METHODS: We performed a hospital-based case-control study involving 200 gastric cancer patients and 207 cancer-free controls. Four well-characterized RAGE genetic polymorphisms, namely, rs1800624, rs1800625, rs184003, and rs2070600 were genotyped by PCR-RFLP. RESULTS: The rs2070600 AG genotype might play a predominant role in the development of gastric cancer (adjusted OR 1.62, 95% CI 1.03-2.58). In contrast, the rs184003 GT genotype represented significantly reduced risk for gastric cancer (adjusted OR 0.62, 95% CI 0.39-0.99). Subgroup analysis demonstrated that rs2070600 AG variant genotype enhanced the gastric cancer risk among nonsmokers (OR 1.71, 95% CI 1.01-2.91), nondrinkers (OR 1.75, 95% CI 1.03-2.97), and patients with tumor stage III (OR 2.00, 95% CI 1.13-3.56). The average sRAGE levels in the gastric cancer patients were significantly decreased compared with those of the healthy controls. Subjects carrying the rs2070600 AG genotype had a decreased ability to produce sRAGE. Subjects carrying the rs184003 T variant allele had an increased ability to sRAGE. CONCLUSIONS: These findings suggested that the variant genotypes of rs184003 and rs2070600 in the RAGE gene exhibit significant associations with gastric cancer risk and circulating sRAGE levels inverse change simultaneously, leading to a marked causal estimate between lowered sRAGE levels and increased gastric cancer risk.

The Relationship between Inflammatory Marker Levels and Hepatitis C Virus Severity.

Background. Red cell distribution width (RDW) and platelet-lymphocyte ratio (PLR) have been studied in a variety of etiological diseases. We aim to investigate the relationship between RDW and PLR and the severity of hepatitis C virus- (HCV-) related liver disease. Methods. We included fifty-two chronic HCV and 42 HCV-related cirrhosis patients and 84 healthy controls. Hematological and virological parameters and liver function biomarkers of HCV-related patients at admission were recorded. Results. RDW, RDW-to-platelet (RPR), and 1/PLR values in HCV-related cirrhosis patients were significantly higher than in chronic HCV patients and healthy controls (all P < 0.001). The aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AAR), AST-to-platelet ratio index (APRI), and fibrosis index based on the four factors (FIB-4) scores in HCV-related cirrhosis patients were significantly higher than in chronic HCV patients (all P < 0.001). The areas under the curve of the RDW, RPR, and 1/PLR for predicting cirrhosis were 0.791, 0.960, and 0.713, respectively. Bivariate logistic regression analysis showed that RDW could independently predict the presence of cirrhosis in chronic HCV patients. Conclusions. RDW, RPR, and PLR may be potential markers for estimating HCV severity.

[Expression and affinity purification of Mycobacterium tuberculosis His-LprG-FLAG in HEK293T cells].

OBJECTIVE: To construct a eukaryotic expressing vector of Mycobacterium tuberculosis lipoprotein G (LprG), and express and purify the recombinant protein in HEK293T cells by affinity chromatography. METHODS: The LprG gene was amplified by PCR from the genome of MTB strain H37Rv. The subsequent PCR product and eukaryotic expressing vector pcDNA3.1 were digested by certain restriction enzymes. The recombinant vector, pcDNA3.1-His-LprG-FLAG, was constructed by ligation of target genes and the vector. After identified by enzymes digestion and DNA sequencing analysis, the correct recombinant vector was applied for transfection of HEK293T cells. The expression of His-LprG-FLAG was examined by Western blotting. The target fusion protein successfully expressed in HEK293T cells was purified by Ni(2+) affinity chromatography, and the purification and concentration of the protein was evaluated by SDS-PAGE and Western blotting. RESULTS: The recombinant vector pcDNA3.1-His-LprG-FLAG was successfully constructed, which was identified by double enzyme digestion and DNA sequencing. Western blotting indicated that the fusion protein was expressed in HEK293T cells transfected with the vector, with the molecular mass (Mr) being 27 000. By Ni2+ affinity chromatography, the fusion protein could be purified to a high concentration, as evaluated by SDS-PAGE and Western blotting. CONCLUSION: Fusion protein His-LprG-FLAG has been successfully prepared and expressed in HEK293T cells.

Interferon Gamma +874T/A Polymorphism Increases the Risk of Hepatitis Virus-Related Diseases: Evidence from a Meta-Analysis.

BACKGROUND: Interferon gamma (IFN-γ) is a key regulatory cytokine, which plays an important role in antiviral defense of an infected host. However, the association between the IFN-γ +874T/A gene polymorphism and hepatitis virus-related diseases is heterogeneous. METHODS: Based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement, a comprehensive literature search of eligible studies in Embase, Pubmed, and the Cochrane Library was undertaken through November 2014. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were used to measure the strength of the models. RESULTS: Seventeen case-control articles, including 24 studies with 5503 individuals, met the inclusion criteria. The results indicated a statistically significant association between the IFN-γ +874T/A polymorphism and hepatitis virus-related diseases in a recessive gene model (AA vs. TT+TA: OR=1.350, 95% CI=1.101-1.657, P=0.004, I2%=54.3, and PQ=0.001 for heterogeneity), especially in Asians (OR=1.407, 95% CI=1.035-1.911, P=0.029, I2%=61.9, and PQ=0.005 for heterogeneity) and hepatitis B virus (HBV)-related disease (OR=1.486, 95% CI=1.195-1.849, P=0.000, I2%=40.4, and PQ=0.053 for heterogeneity). CONCLUSIONS: The evidence suggests that the IFN-γ +874T/A polymorphism increases the risk of hepatitis virus-related diseases, especially in Asians and HBV-related diseases. Further studies on this topic in different ethnicities, especially genome-wide association studies, should be conducted to strengthen our results.

Interferon gamma +874 T/A polymorphism increases the risk of cervical cancer: evidence from a meta-analysis.

Data from previous studies about the association between interferon gamma (IFN-γ) +874 T/A (rs2430561) polymorphism and cervical cancer risk offer controversial results. To obtain a more dependable conclusion, this meta-analysis was performed. We selected eight articles including nine case-control studies with 1,116 cases and 1,290 controls, odds ratios (OR) with 95 % confidence intervals (CI) were used to assess the strength of the association. Subgroup analysis was carried out by ethnicity, source of controls, genotyping methods, and score of quality assessment. Our meta-analysis indicated that the IFN-γ (+874 T/A) polymorphism significantly increased the risk of cervical cancer in the codominant model (TA vs. TT: OR = 1.471, 95 % CI = 1.137-1.903, P = 0.003, I (2) % = 0.0, P Q = 0.785) and the dominant model (TA + AA vs. TT: OR = 1.399, 95 % CI = 1.097-1.784, P = 0.007, I (2) % = 0.0, P Q = 0.486) in the overall population. Stratified analysis by ethnicity indicated a significantly increased risk of cervical cancer in Asians in the codominant model (TA vs. TT: OR = 1.494, 95 % CI = 1.069-2.087, P = 0.019, I (2) % = 0.0, P Q = 0.440) and the dominant model (OR = 1.455, 95 % CI = 1.062-1.993, P = 0.019, I (2) % = 42.9, P Q = 0.154). Thus, the IFN-γ (+874 T/A) polymorphism is likely to increase the risk of cervical cancer. Because of the limited studies and sample sizes included in our meta-analysis, further well-designed and large-scale studies are demanded to confirm our results.

Association between polymorphism of the interleukin-13 gene and susceptibility to hepatocellular carcinoma in the Chinese population.

OBJECTIVE: Interleukin-13 (IL-13) is a potent pleiotropic cytokine that is produced by activated CD4 T cells. This study was undertaken to determine the relationship between two IL-13 gene single nucleotide polymorphisms (SNP rs1800925 and SNP rs20541) and the incidence of hepatitis B virus-related (HBV) hepatocellular carcinoma (HCC). METHOD: Three hundred and ninety-eight HBV-positive individuals (192 HCC and 206 patients with chronic hepatitis) and one hundred and ninety-two healthy participants from the First Affiliated Hospital of Guangxi Medical University were enrolled in this study. RESULTS: The results showed no significant differences between the genotype and allele frequencies of the IL-13 gene rs1800925 and rs20541 polymorphisms and chronic hepatitis B risk after adjusting for age, sex, tobacco use, and alcohol intake using binary logistic regression analyses. Regarding the rs20541 SNP, the GA genotype was significantly related to a decreased risk of HCC after adjusting for age, sex, tobacco use, and alcohol intake using binary logistic regression analyses (The odds ratio (OR) = 0.54, 95% confidence intervals (CI) 0.34-0.87). The adjusted OR for the GA and AA genotypes combined was 0.68 (95% CI 0.39-0.90). CONCLUSION: This study indicates that the functional IL-13 rs20541 polymorphism may contribute to the risk of HCC and that the rs20541 polymorphism is a protective factor for HCC.

Impact of gamma-glutamyl carboxylase gene polymorphisms on warfarin dose requirement: a systematic review and meta-analysis.

BACKGROUND: The Gamma-glutamyl carboxylase (GGCX) gene, as with Vitamin K Epoxide Reductase Complex Subunit 1 (VKORC1), CytochromeP450 Complex Subunit 14 F2 (CYP4F2) and CytochromeP450 Complex Subunit2C9 (CYP2C9), is a candidate predictor for appropriate maintenance warfarin dose. However, the association between GGCX gene polymorphisms and warfarin dose requirement is still controversial. To quantify the influence of GGCX polymorphisms on warfarin dose requirements, we performed a systematic review and meta-analysis. METHODS: According to PRISRM statement (Preferred reporting items for systematic reviews and meta-analyses), a comprehensive literature search was undertaken through August 2014 looking for eligible studies in Embase, Pubmed,Web of Science and the Cochrane Library. The impact of GGCX polymorphisms on mean daily warfarin dose (MDWD) was counted by means of Z test. RevMan 5.2.7 software (developed by the Cochrane Collaboration) was applied to analyze the relationship between GGCX gene polymorphisms and warfarin dose requirements. RESULTS: Nineteen articles including 21 studies with a total of 6957 patients were included in the meta-analysis. Among three investigated single nucleotide polymorphisms (SNPs), rs11676382 showed higher CC genotype frequencies in Asian than those in Caucasian (97.7% vs. 86.9%); patients who were "G carriers" (that is, carried the GGCX rs11676382 CG or GG genotypes) required 27% lower warfarin dose than CC genotype [95%Confidence Interval (CI)=17%-37%, P=0.000, I(2)%=82.0 and PQ=0.000], moreover, stratified analysis by ethnicity showed similar results in Caucasian (23% lower, 95%CI=12%-33%), but not in Asian. With respect to genetic variation of rs699664 and rs121714145 SNPs, no significant impact on warfarin dose requirements were demonstrated. CONCLUSIONS: This meta-analysis suggested that GGCX rs11676382 polymorphism may be one of factors affecting the dose of warfarin requirement, and the effects are different in different ethnicities. Further studies about this topic in different ethnicities with larger samples are expected to be conducted to validate our results.

Risk of primary liver cancer associated with gallstones and cholecystectomy: a meta-analysis.

BACKGROUND: Recent epidemiological evidence points to an association between gallstones or cholecystectomy and the incidence risk of liver cancer, but the results are inconsistent. We present a meta-analysis of observational studies to explore this association. METHODS: We identified studies by a literature search of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and relevant conference proceedings up to March 2014. A random-effects model was used to generate pooled multivariable adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Between-study heterogeneity was assessed using Cochran's Q statistic and the I2. RESULTS: Fifteen studies (five case-control and 10 cohort studies) were included in this analysis. There were 4,487,662 subjects in total, 17,945 diagnoses of liver cancer, 328,420 exposed to gallstones, and 884,507 exposed to cholecystectomy. Pooled results indicated a significant increased risk of liver cancer in patients with a history of gallstones (OR = 2.54; 95% CI, 1.71-3.79; n = 11 studies), as well as cholecystectomy (OR = 1.62; 95% CI, 1.29-2.02; n = 12 studies), but there was considerable heterogeneity among these studies. The effects estimates did not vary markedly when stratified by gender, study design, study region, and study quality. The multivariate meta-regression analysis suggested that study region and study quality appeared to explain the heterogeneity observed in the cholecystectomy analysis. CONCLUSIONS: Our results suggest that individuals with a history of gallstones and cholecystectomy may have an increased risk of liver cancer.

Establishing reference values for blood urea nitrogen and serum creatinine in Chinese Han ethnic adult men.

BACKGROUND: The aim was to calculate the two-sided 95th percentile reference values for blood urea nitrogen (BUN) and serum creatinine (SCr) in Chinese Han ethnic adult men. METHODS: Serum samples were collected from Chinese Han ethnic adult men aged 20 - 69 years. After screening based on the inclusion and exclusion criteria, a total of 1575 individuals were enrolled in our study. BUN and SCr values were measured on an automatic analyzer (Dade Behring, USA). The data was analyzed and calculated using nonparametric statistical methods. RESULTS: BUN and SCr values were not normally distributed. The reference values were in the range 3.3 - 7.5 mmol/L for BUN and 64 - 113 micromol/L for SCr. BUN levels were significantly lower in the smoking group than the non-smoking group (Z = -4.52, p < 10(-5)). An increase with age was observed in BUN levels (r(s) = 0.172, p < 0(-5)) and lower SCr levels were weakly associated with the older subjects (r(s) = -0.071, p = 0.005). Moreover, it was found that higher Body Mass Index (BMI) tended toward higher levels of SCr (r(s) = 0.118, p < 10(-5)). CONCLUSIONS: The reference values established for BUN and SCr exhibit a slight deviation compared to those developed in previous studies. We propose reference values of BUN for smokers and non-smokers be constructed, and age- and BMI-specific reference values be applied in clinical laboratories.

Effects of storage time on Cytomegalovirus DNA stability in plasma determined by quantitative real-time PCR.

Quantitative real-time PCR (QRT-PCR) assays are faster, more precise, and more sensitive quantitative laboratory methods for monitoring serial CMV DNA viral load in patients undergoing organ or hematopoietic stem cell transplantation. Clinical laboratories often face practical concerns about the storage of specimens from these patients to ensure the accuracy and reproducibility of CMV viral load test results. Different studies that have assessed CMV DNA stability have shown mixed results. Therefore, we analyzed CMV DNA stability of 30 EDTA plasma samples in samples containing between 300 and 100,000copies/ml over a 21 day period. The concentration of CMV DNA in all samples stored at 4°C for 21 days did not differ significantly from the baseline viral load (t=0.242, p=0.810), and no trend was evident to indicate continued degradation over a 2 week period.