[Diagnostic value of high frequency oscillation in localization of type â ¡ focal cortical dysplasia epilepsy].

Retrospective analysis was conducted on 9 patients with type Ⅱ focal cortical dysplasia (FCD) who underwent stereo-electroencephalography (SEEG) implantation in the Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical University from November 2020 to February 2023. The onset area, onset time, and frequency of high-frequency oscillations (HFO) were analyzed and the correlation of HFOs with interictal, preictal, and ictal periods. SEEG recordings of 80-500 Hz HFOs were observed in both interictal and ictal periods in 9 patients, with 6 patients exhibiting fast ripples (FR) in the range of 250-500 Hz. Surgical resection of the seizure onset area and FR-generating electrodes was performed, and postoperative follow-up for over 2 years indicated Engel I in 5 cases. 6 patients showed continuous discharge during the preictal period, and the distribution index of continuous discharge was positively correlated with seizure frequency. HFOs in the range of 80-500 Hz were present in all four seizure onset patterns during the ictal period. The onset area and FR-emitting electrode were surgically removed in 6 patients with continuous discharge and overlapping HFOs during the preictal period, with 5 cases of Engel I. Type Ⅱ FCD discharges exhibited complexity, high discharge indices, and a close association with HFOs. Compared with the spike wave, the electrode range of HF is more limited, and the incidence of HF before attack is significantly increased, which is closely correlated with the onset area. The simultaneous occurrence of HFO and the spike waves has higher diagnostic value than the individual occurrence, effectively enhancing surgical efficacy.

[Postoperative outcomes and influencing factors of diffuse low-grade glioma-related epilepsy].

The clinical and pathological features and postoperative outcomes of 49 patients with diffuse low-grade glioma -related epilepsy who were admitted to the Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical University from January 2015 to December 2018 were analyzed. After 1-year follow-up, 33 patients (67.3%) in the good prognosis group and 16 patients (32.7%) in the poor prognosis group were enrolled. Multivariate logistic regression analysis indicatedthat subtotal tumor resection (OR=5.56, 95%CI:1.21-25.44,P=0.027) and no postoperative radiotherapy (OR=9.24, 95%CI:2.05-41.75, P=0.004) were the risk factors for poor prognosis of postoperative epilepsy. Therefore, for patients with diffuse low-grade glioma-related epilepsy, total tumor resection and postoperative radiotherapy are beneficial to the control of epilepsy.

Parenthood and risk of hip fracture: a 10-year follow-up prospective study of middle-aged women and men in China.

This prospective study of Chinese adults demonstrated an inverse J-shaped association of number of children with risk of hip fracture in both men and postmenopausal women aged 50 years or older. Women with 2 or 3 children and men with 4 children had the lowest risk of hip fracture. INTRODUCTION: Women have higher absolute risks of fracture than men, which is believed to reflect differences in oestrogen exposure. The aim of this study was to compare the associations of number of children with risk of hip fracture between men and women aged over 50 years. METHODS: The China Kadoorie Biobank (CKB) recruited 133,399 women and 110,296 men, aged 50 years or older between 2004 and 2008. During 10-year follow-up, 2068 participants (1394 women and 674 men) suffered a hip fracture. Cox regression analysis was used to estimate sex-specific adjusted hazard ratios (HRs) and 95% CI for incident hip fracture. RESULTS: Over 98% of both subsets of men and women aged 50 or older reported having children. Women who had 2 or 3 children had the lowest risks of hip fracture compared with other groups. Compared with nulliparous women, the adjusted HR for hip fracture were 0.89 (95% CI; 0.72, 1.10) for 1 child, 0.79 (0.70, 0.90) for 2 children, 0.79 (0.72, 0.87) for 3 children, 0.81 (0.72, 0.91) for 4 children, and 0.95 (0.83, 1.10) for those with 5 or more children. The associations of number of children with hip fracture were broadly consistent in men of a similar age. CONCLUSIONS: The concordant effects of the number of children with risk of hip fracture between men and women suggest that the lower risks in multiparous women are not due to differences in oestrogen exposure or other biological effects, but may reflect residual confounding by socioeconomic or lifestyle factors.

Publisher Correction: Parenthood and risk of hip fracture: a 10-year follow-up prospective study of middle-aged women and men in China.

The original version of this article, published on 25 November 2019, unfortunately contained a mistake.

[Quality assessment of guidelines and consensus in lung cancer chemotherapy].

Objective: To understand the current status of clinical guidelines and consensus for lung cancer chemotherapy, evaluate and analyze the quality of lung cancer chemotherapy treatment guidelines, and provide references for the revision and improvement of lung cancer chemotherapy clinical decision-making and guidelines. Methods: Search Pubmed, EMbase, Cochrane Library (Cochrane Library), China Knowledge Network, Wanfang Database, China Biomedical Literature Database and other related databases and clinical practice guidelines related to lung cancer chemotherapy, and screen the literatures according to the established inclusion exclusion criteria. Use the appraisal of guidelines for research and evaluation Ⅱ (AGREE Ⅱ) and reporting items for practice guidelines in healthcare (RIGHT) tools to compare and evaluate the quality of the included guides and the level of reporting specifications. Results: A total of 14 guidelines were included. The assessment results of AGREE Ⅱ showed that the average score of scope and purpose was 94 points, the average score of stakeholder involvement was 60 points, the average score of rigour of development was 43 points, the average score of clarity of presentation was 88 points, the average score of applicability was 50 points, the average score of editorial independence was 61 points. Seven guidelines were evaluated as A level, 6 guidelines were evaluated as B level, 1 guideline was evaluated as C level. The assessment results of RIGHT showed that, in addition to the basic information, the included guidelines have many deficiencies in 6 areas including background, evidence, recommendation, review and quality assurance, funding, declaration and management of interests and other information, and the normative gap between domestic and foreign guides was large. Conclusions: The overall quality of clinical guidelines for lung cancer chemotherapy is high, but the standardization needs to be strengthened. There is a big gap between the quality and standardization of domestic and foreign guides. Further developments of high-quality clinical practice guidelines and guidelines consistent with our country's actual situation are needed.

[Clinicopathologic characteristics and causes of difficulty in locating the "difficult to locate" intractable epilepsy].

Objective: To summarize the clinicopathological characteristics of "difficult to locate" intractable epilepsy patients, and investigate the causes of difficulty in their location. Method: Retrospective analysis was performed on the clinical data of 58 patients who underwent resection of the epileptogenic zones after intracranial electroencephalography (iEEG) detection at the Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical University from January 2010 to December 2018. Clinicopathological characteristics and lesion lobes of "difficult to locate" intractable epilepsy were summarized. The prognosis of patients was assessed according to Engel grading.Univariate and multivariate logistic regression analysis were used to investigate the relevant factors affecting the prognosis of patients with "difficult to locate" intractable epilepsy related to malformation of cortical development(MCD). Results: Among the 58 patients, there were 47 cases of MCD (12 cases with mild malformation of cortical development (mMCD), 35 cases with focal cortical dysplasia (FCD)), and 11 cases of other types. Among the 47 MCD cases, univariate analysis showed that patients with preoperative magnetic resonance imaging(MRI) positive and completed resection of the epileptogenic zones had better prognosis (P<0.05). Multivariate analysis indicated that completed resection of epileptogenic zones was an independent factor affecting the postoperative efficacy of MCD (P=0.013,Wald χ(2)=6.149, 95%CI: 0.07-0.56). And among the 47 MCD cases, 18 cases were with mono-lobar lesions and 29 cases were with multi-lobar lesions, however, there was no significant difference of the efficacy between the two groups (P=0.511). Conclusions: MCD, especially FCD, is the main pathological types of patients with "difficult to locate" intractable epilepsy. Multi-lobar pathological changes, especially multi-lobar MCD, are the main reasons of being difficult to locate, however, accurate locating of epileptogenic zones and functional areas via effective use of iEEG can achieve satisfactory efficacy in these patients after resection of the epileptogenic zones.

[Systematic review of methodological quality and reporting quality in gastric cancer screening guidelines].

Objective: To systematically evaluate the quality of gastric cancer screening guidelines/recommendations, and provide a reference for the update of gastric cancer screening guidelines/recommendations in China. Methods: "guidelines/consensus/specifications/standards" , "stomach/gastric tumors" , "screening/diagnosis" , "guideline/recommendation" , "gastric cancer/gastric tumor," "early detection of cancer/screening" were searched as keywords in PubMed, Embase, Web of knowledge, China Knowledge Network, Wanfang, China Biomedical Literature Database, and Cochrane Library, as well as the US Preventive Services Working Group, the American Cancer Society, the International Agency for Research on Cancer, the Australia Cancer Council and the International Guide Collaboration Network at the end of July 2018. The inclusion criteria were independent guidelines/recommendation documents for gastric cancer screening. The exclusion criteria were guideline abstracts, interpretation and evaluation literature, duplicate publications, updated original guidelines, and clinical treatment or practice guidelines for gastric cancer. The language was limited to Chinese and English. The European Guide to Research and Evaluation Tools (AGREE Ⅱ) and Practice Guideline Reporting Standard (RIGHT) for Gastric Cancer Screening Guidelines/Recommendations were used to compare and evaluate the quality and reporting standard of gastric cancer screening guidelines/recommendations. Results: A total of five guides/recommendations were included. The results of the AGREE Ⅱ quality evaluation showed that the overall quality of five guides/recommendations was different, including one recommended for "A", one for "B", and three for "C". Each guide/recommendation scored higher in the scope and purpose, clarity, and scores were more significant in the areas of rigor and independence. In the participants, the application field scores were generally low. The RIGHT evaluation results showed that the quality of five guides/recommendations should be improved. The six items with poor report quality were background, evidence, recommendations, review and quality assurance, funding and conflict of interest statement and management, and other aspects. Conclusion: The quality of the included gastric cancer screening guidelines/recommendations is generally low, and the standardization should be strengthened.

[Study on the role and possible mechanism of hemeoxygenase-1/carbon monoxide system in protection of quercetin against ethanol-induced hepatocytes oxidative injury].

Objective: To study the protective effect and potential mechanism of heme oxygenase (HO-1)/carbon monoxide (CO)-mediated quercetin on alcoholic oxidative damage of primary rat hepatocytes. Methods: Primary rat hepatocytes were isolated and cultured by two-step collagenase technique. Ethanol exposed primary rat hepatocytes were simultaneously added with quercetin (100 µmol/L) and/or hemoglobin (100 µmol/L) or different doses of CO-releasing molecules (CORM-2, 5-50 µmol/L) for their combined action. After polling, LDH, AST activities and MDA and GSH levels were measured in the supernatant of cell culture. The alone or combined effects of quercetin, CORM-2, hemoglobin and zinc protoporphyrin IX exposed to ethanol were detected by the activity of CYP2E1 in liver microsomes. Statistical analysis of data was performed by analysis of variance (ANOVA) and intergroup comparison was done by SNK-test. Results: Simultaneous addition of 100 µmol/L quercetin had significantly reduced ethanol-induced AST and LDH release, and GSH consumption and MDA elevation extent. Moreover, quercetin had not only lost the hemoglobin (CO blocker) protective effect but also had further exacerbated ethanol-induced lipid peroxidation. CORM-2 had reduced ethanol-induced AST and LDH release, and GSH consumption and MDA production in liver cells, and thus had dose-dependent protective effect. Ethanol had increased significantly CYP2E1 activity. Quercetin or CORM-2 had inhibited CYP2E1 activity, while hemoglobin or protoporphyrin IX had eliminated quercetin inhibitory effect and had increased the CYP2E1 activity. Quercetin, and CYP2E1 activity was constant as compared to ethanol group when CORM-2, zinc protoporphyrin IX and ethanol were incubated with hepatocytes, but the CYP2E1 activity was significantly decreased (P < 0.05), and the differences were statistically significant. Conclusion: CO/HO-1 metabolite mediates the protective effect of quercetin on alcoholic oxidative damage of hepatocytes, which may be related to the inhibition of CYP2E1 activity.

[Association of ICOS and CD28 single nucleotide polymorphisms with pulmonary tuberculosis susceptibility].

Objective: To investigate the association of inducible co-stimulator (ICOS) and CD28 gene polymorphisms with pulmonary tuberculosis susceptibility. Methods: In this case-control study, from Mar 2015 to Sep 2016, peripheral venous blood of 100 pulmonary tuberculosis patients (pulmonary tuberculosis group) in the Jintan People's Hospital of Changzhou and 100 community physical examination volunteers (health control group) were collected. A total of 56 single nucleotide polymorphisms (SNP) in ICOS and CD28 sequences were selected and SNP genotype and allele frequency were analyzed using the next-generation sequencing technology. Association of these SNP with pulmonary tuberculosis susceptibility was investigated using linkage disequilibrium (LD) analysis and genetic models. Results: Among these 56 SNP, 23 SNP with Hardy-Weinberg equilibrium P (HWE-P) value<0.001 or minimum allele frequency<0.05 were kicked out. The frequencies of T allele and TT genotype of ICOS gene SNP locus (rs55663036), and GG genotype of CD28 gene locus (rs45620941) in tuberculosis group were significantly higher than those in healthy control group (all P<0.05). There was a strong linkage imbalance between rs45620941 at CD28 locus and rs56262258 (r(2)=0.757). Conclusion: The polymorphisms of rs55663036 of ICOS gene and rs45620941 of CD28 gene are significantly associated with the risk of pulmonary tuberculosis.

[Different anthropometric indices and incident risk of hypertension in elderly population: a prospective cohort study].

Objective: To explore the relationship between anthropometric indices and the incident risk of hypertension, compare novel anthropometric indices with traditional indices in hypertension prediction and establish hypertension prediction models among elderly Chinese. Methods: A total of 27 009 retirees from the Dongfeng Motor Corporation were recruited at baseline in 2008 and the first follow-up was conducted in 2013. After the exclusion of participants less than 60 years old, participants with hypertension, coronary heart disease, stroke, cancer, and those with missing data, a total of 6 784 elderly participants were enrolled in this study. A multivariate logistic regression model was used to analyze the relationship between traditional anthropometric indices, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), novel anthropometric indices, visceral adiposity index (VAI), body shape index (ABSI), body roundness index (BRI), and the incident risk of hypertension. Meanwhile, a multivariate logistic regression model was used to establish hypertension prediction models. Receiver operating characteristic (ROC) curve was applied to compare the prediction ability of different models. Results: A total of 1 787 incident cases of hypertension were identified, with the incidence of hypertension about 27.59%. Significant positive associations were detected between BMI, WC, WHtR, VAI, BRI and the incident risk of hypertension after adjusting for potential confounders (all P values<0.05). In men, the OR (95%CI) (upper tertile vs lower tertile) was 1.45 (1.22-1.73) for VAI, and 1.86 (1.55-2.23) for BRI. In women, the OR (95% CI) (upper tertile vs lower tertile) was 1.55 (1.22-1.96) for VAI, and 1.60 (1.27-2.01) for BRI. For ABSI, no significant association was observed in either men (OR (95%CI): 1.07 (0.90-1.28)) or women (OR (95%CI): 1.03 (0.82-1.29), both P values >0.05). The basic hypertension prediction model included age, drinking (only in men), education status (only in men), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose levels. Based on the basic prediction model, BMI (in men: AUC=0.697) and BRI (only in men: AUC=0.696) improved area under ROC curve (AUC) significantly (P<0.05). BMI was the strongest predictor in both men (AUC=0.697) and women (AUC=0.685) in the extended model. Conclusion: Significant positive associations were detected between BMI, WC, WHtR, VAI, BRI and the incident risk of hypertension among elderly Chinese. BMI was the strongest predictor in hypertension prediction model compared with other anthropometric indices.

[Systematic review of the methodology quality and reporting quality in colorectal cancer screening guidelines].

Objective: To systematically review the quality and reporting quality of colorectal cancer screening guidelines, and to provide reference for the update of colorectal cancer screening guidelines and colorectal cancer screening in China. Methods: "Colorectal cancer", "colorectal tumor", "screening", "screening", "guide", "consensus", "Colorectal cancer", "Colorectal neoplasms", "Screening", "Early Detection of Cancer", "Guideline" and "recommendation" were used as search keywords. The literature retrieval for all the Chinese and English guidelines published before April 2018 was conducted by using PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, China Biology Medicine disc (CBMdisc), Cochrane Library, Guideline International Network, China Guidelines Clearinghouse (CGC) and the official website of the US Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), International Agency for Research on Cancer (IARC), Australia Cancer Council (ACC) and Association of Coloproctology of Great Britain & Ireland (ACPGBI). The inclusion criteria were independent guidance documents for colorectal cancer screening. The language is limited to Chinese and English. The exclusion criteria were literature on interpretation, evaluation, introduction, etc., as well as the translated version of the guide and old guides. The quality and reporting norms of colorectal cancer screening guidelines were compared and evaluated using the European Guideline Research and Assessment Tool (AGREE Ⅱ) and the Practice Guideline Reporting Standard (RIGHT). Results: A total of 15 guides were included. The results of the AGREE Ⅱ quality evaluation showed that the overall quality of 15 guides was high. Among them, there were 9 guides with an overall score of 50 or more, 10 with a recommendation level of "A", and 2 with a rating of "B". There were 3 guides for "C"; each guide scores higher in scope and purpose, and clarity, and scores vary greatly in the areas of participants, rigor, applicability, and independence. The results of the RIGHT evaluation showed that 15 guides were insufficient in six areas except for background information, evidence, recommendations, reviews and quality assurance, funding and conflict of interest statements and management, and other aspects. Conclusion: The overall quality of included guidelines for colorectal cancer screening is high, but the normative nature needs to be strengthened.

Inverse association between plasma homocysteine concentrations and type 2 diabetes mellitus among a middle-aged and elderly Chinese population.

BACKGROUND AND AIMS: Plasma homocysteine concentrations have been reported to be associated with type 2 diabetes mellitus (T2DM) with controversial findings. The aim of the present study was to investigate the association between plasma homocysteine concentrations and T2DM. METHODS AND RESULTS: A cross-sectional study including 19,085 eligible participants derived from the Dongfeng-Tongji cohort was conducted. Plasma homocysteine concentrations were measured by Abbott Architect i2000 Automatic analyzer and T2DM was defined according to American Diabetes Association criteria. Logistic regression model was used to explore the association between plasma homocysteine concentrations and T2DM. The prevalence of T2DM was 19.0% in the whole population (mean age 62.9 years), 21.8% in males, and 17.1% in females. In the multivariable logistic regression analyses, compared with those in the lowest quintile, the OR (95% CI) of T2DM was 1.05 (0.92-1.21), 0.99 (0.86-1.14), 0.90 (0.78-1.05), and 0.77 (0.66-0.90) for quintile 2 to quintile 5 of homocysteine concentrations after adjustment for potential confounders (P for trend < 0.0001). Homocysteine concentrations were associated with decreased T2DM prevalence risk (OR = 0.88 per SD increase of homocysteine concentration; 95% CI: 0.84-0.93). A significant interaction between homocysteine concentrations and drinking status on T2DM prevalence risk was observed (P for interaction = 0.03). The inverse association of plasma homocysteine concentrations with T2DM prevalence risk was observed in non-drinkers but not in current drinkers. CONCLUSION: Plasma homocysteine concentrations were inversely correlated with T2DM among a middle-aged and elderly Chinese population.

Associations between daily cooking duration and the prevalence of diabetes and prediabetes in a middle-aged and elderly Chinese population: A cross-sectional study.

Experimental and epidemiological studies indicated that ambient air pollution was positively associated with diabetes. Few studies investigated the associations between household air pollution, for example, daily cooking duration and diabetes or prediabetes. We conducted a cross-sectional study to investigate the associations of daily cooking duration with the prevalence of diabetes and prediabetes among a middle-aged and elderly population. A total of 26 089 individuals (11 250 males and 14 839 females) derived from the Dongfeng-Tongji cohort study were included. Daily cooking duration was assessed by questionnaire. Diabetes and prediabetes were identified according to the criterion of American Diabetes Association. No significant association was observed between daily cooking duration and the prevalence risk of diabetes (odds ratio[OR] = 0.97, 95% confidence interval[CI]: [0.81-1.16], P for trend = .74); however, longer daily cooking duration was associated with higher prevalence risk of prediabetes (OR = 1.26, 95% CI: 1.07-1.47; P for trend = .003) and hyperglycemia (OR = 1.21, 95% CI: 1.05-1.41; P for trend = .005). Our study suggested that daily cooking duration was not associated with diabetes but with higher prevalence risk of prediabetes/hyperglycemia in a middle-aged and elderly Chinese population.

[Analysis of 2 cases of dyspnea happening after tracheotomy and the clinical application of Mimics 10.01].

Post-intubation tracheal stenosis was a late time complication after tracheotomy but the happening of dyspnea was unusual. Diagnosing tracheal stenosis after incubation, and figuring out the location and causes of the stenosis were important. Treatment of post-incubation tracheal stenosis relied on accurate diagnosis of the type of tracheal stenosis. Computed tomography (CT) and laryngoscope could be used for detecting the stenosis but not enough. Two patients who were already under the urgent tracheotomy over 1 year were reported. However apnea was found on these two patients for a long time after traheotomy. Obviously laryngeal obstruction appeared. CT virtual bronchoscope and laryngoscope examination showed that the cannula was obstructed and plenty of granulation tissue blocked the orificium. But the exact location of the cannula and the adjacent relationship of the tissue around the cannula was equivocal. Mimics 10.01 software was used to analyze the data of the CT scan and found that a pseudo cavity was formed by granulation tissue which partly blocked the cannula in 1 case; granulation tissue occupation and scar formation in the trachea were the reason of tracheal stenosis but not the collapse of the cartilage in case 2. The purpose of this report is to discuss the cause of dyspnea after emergency tracheotomy, its diagnostic method and their management. CT virtual bronchoscope and laryngoscope should be used as a regular examination after tracheotomy to clarify the location of cannula and avoid the failure of airway opening caused by the dislocation of cannula and the complication. Trachea tissue should be protected properly during and after the tracheotomy which might decline the rate of the tissue remodeling, tracheal stenosis and dyspnea after surgery. The clinical use of Mimics 10.01 made it possible to observe morphology more directly by invasive examination and provided a significant clue to make the operation plan so that it should be used widely. Meanwhile, the method to put the cannula into its right way under the guidance of rigid endoscope and the excision of granulation tissue by semiconductor laser should become one of the best treatments of this disease. Following the method above, laryngeal obstruction was relieved after the surgery. Postoperative follow-up lasted for 1 year and recurrence was not found.

Review of cattle ticks (Acari, Ixodida) in Ivory Coast and geographic distribution of Rhipicephalus (Boophilus) microplus, an emerging tick in West Africa.

The exotic tick Rhipicephalus (Boophilus) microplus was discovered in Ivory Coast in 2007 and then gradually in other countries in West Africa. It is known to induce significant losses in farming and to replace other species of the same genus. In order to contribute to improve health and productivity of cattle in Ivory Coast regarding the emergence of this dreaded tick, a study was conducted to determine the current geographic distribution of the tick R. (B.) microplus and review cattle ticks in general. To this end, 23,460 ticks were collected from 180 farms located throughout the country. Ten species of ticks belonging to the genus Rhipicephalus (including those of the subgenus Boophilus), Hyalomma and Ambyomma were identified. It was found that the exotic tick R. (B.) microplus has invaded the entire Ivorian territory and is now the main cattle tick (63.6% of ticks collected), followed by Amblyomma variegatum that remains still dominant in the North. The population of indigenous species of Rhipicephalus (Boophilus) is in drastic decline.

[Association of PD-1, TIM-3 and TREM-1 single nucleotide polymorphisms with pulmonary tuberculosis susceptibility].

Objective: To investigate the association of programmed cell death 1(PD-1), T cell immunoglobulin mucin 3 (TIM-3) and triggering receptor expressed on myeloid cells-1 (TREM-1) genes polymorphisms with pulmonary tuberculosis susceptibility. Methods: In this case-control study, peripheral venous blood of 100 pulmonary tuberculosis patients (pulmonary tuberculosis group) in the Jintan People's Hospital of Changzhou and of community physical examination volunteers (health control group) was collected from Mar 2015 to Sep 2016. A total of 66 single nucleotide polymorphisms (SNP) in PD-1, TIM-3 and TREM1 sequences were selected and SNP genotype and allele frequency were analyzed using the next-generation sequencing technology. Association of these SNP with pulmonary tuberculosis susceptibility was investigated using linkage disequilibrium (LD) analysis and genetic models. Results: Among these 66 SNP, 24 SNP with Hardy-Weinberg equilibrium P (HWE-P) value <0.001 or minimum allele frequency (MAF) <0.05 were kicked out. The remaining 42 SNP were analyzed with LD analysis and genetic models. There was no significant difference in genotype frequencies between pulmonary tuberculosis group and health control group (all P>0.05). Five SNP (rs41435650, rs28539662, rs13023138, rs75565781, rs36084323) in PD-1 were identified in a significant haplotype (TACGC) between pulmonary tuberculosis group and health control group (P=0.014). Among these haplotypes, strong LD was observed between rs28539662 and rs75565781 (r(2)=0.871), as well as rs36084323 (r(2)=0.864). Rs75565781 showed highest correlation with rs36084323 (r(2)=0.966). Conclusion: These SNP in PD-1, TIM-3 and TREM-1 genes are not associated with the susceptibility of pulmonary tuberculosis.

Anti-D alloimmunisation in pregnant women with DEL phenotype in China.

OBJECTIVES: To analyse anti-D alloimmunisation in pregnant women with D-elute (DEL) phenotype in China, for developing a predictive model to evaluate whether a person with the DEL phenotype can receive RhD-positive blood. BACKGROUND: Alloanti-D acquired by pregnancy or transfusion is one of the major causes of both haemolytic disease among newborns and haemolytic transfusion reactions. To date, there is little data available about the antigenic properties and immunogenicity of extremely weak D variants known as DEL. METHODS: RHD genotyping and D epitope mapping were performed using gene sequencing and comprehensive immunohaematological methods, respectively. DEL pregnant women carrying an RhD-positive fetus were tested for the presence of alloanti-D. RESULTS: A total of 130 of 142 (91·5%) pregnant women with a DEL phenotype were confirmed to carry the RHD (K409K) allele. Among 12 DEL women who appeared to have RHD-CE-D hybrid alleles, there were 1 RHD-CE (4-7)-D, 7 RHD-CE(4-9)-D, and 4 RHD-CE (2-5)-D alleles. Alloanti-D antibodies were detected in 6 of 142 DEL women, and all the six women had the partial DEL phenotype. CONCLUSION: The data indicate that partial DEL women appear at risk of alloimmunization to the D antigen. RhD immune globulin prophylaxis is necessary for partial DEL women. Partial DEL patients should receive only RhD-negative RBCs, whereas DEL patients with complete expression of antigen can safely receive RhD-positive RBCs.

High-mobility group box 1 inhibition alleviates lupus-like disease in BXSB mice.

High-mobility group box 1 protein (HMGB1), a ubiquitous nuclear DNA-binding protein, functions as a potent proinflammatory factor. In this study, we evaluated the effects of HMGB1 inhibition on murine lupus using the lupus-prone model. We treated male BXSB mice with neutralizing anti-HMGB1 monoclonal antibody (HMGB1 mAb) from age 16 weeks to 26 weeks. The control group received the same amount of control IgG. Lupus-prone male BXSB mice treated with HMGB1mAb showed attenuated proteinuria, glomerulonephritis, circulating anti-dsDNA and immune complex deposition. Levels of serum IL-1ß, IL-6, IL-17 and IL-18 were also significantly decreased by administration of HMGB1mAb in lupus-prone BXSB mice. HMGB1mAb treatment also decreased the caspase-1 activity in the kidneys of BXSB mice and reduced the mouse mortality. Our study supports that HMGB1 inhibition alleviates lupus-like disease in BXSB mice and might be a potential treatment option for human SLE.

The value of early renal biopsy in systemic lupus erythematosus patients presenting with renal involvement.

BACKGROUND: The goal of this study is to determine the value of early renal biopsy as a therapeutic guide in systemic lupus erythematosus (SLE) patients presenting with renal involvement. METHODS: We retrospectively analyzed renal biopsies findings in SLE patients between January 2000 and December 2009 encountered at a medical center in Taiwan. An additional criterion for inclusion in this study was kidney biopsy done within 3 months of the first detection of sign(s) of renal disease. RESULTS: There were 131 patients enrolled in this study. In patients presenting with acute renal failure, 91% of patients had proliferative lupus nephritis (Class IV, mixed Class V+III) and 9% had non-proliferative lupus nephropathy (pure Class V). In patients presenting with nephrotic range proteinuria, proliferative lupus nephritis (Class III, IV, mixed Class V+III) and non-proliferative lupus nephropathy (Class II, pure Class V) accounted for 55% and 36% of patients, respectively; and 9% had non-lupus nephropathy. In this group, except that elevated anti-double-stranded DNA antibody levels were more common in proliferative lupus nephritis (p = 0.043), no clinical findings could predict the renal morphology. In patients presenting with subnephrotic proteinuria, 49% of patients had proliferative lupus nephritis (Class III, IV, mixed Class V+III) and 51% had non-proliferative lupus nephropathy (Class II, pure Class V), and decreased C4 levels were more common in patients with proliferative lupus nephritis (p = 0.031). In patients presenting with isolated hematuria, all were not active forms of nephropathy. Immunosuppressive therapy was intensified because of biopsy findings in 29% of patients presenting with acute renal failure, 43% with nephrotic range proteinuria, and 53% with sub-nephrotic proteinuria. CONCLUSIONS: Our data suggested that similar clinical renal manifestations may be observed despite very different classes of lupus nephritis. Clinicians tended to wait for histological identification of severe lupus nephritis before initiating potential harmful treatment with aggressive immunosuppressive therapy. Therefore, in SLE patients with clinical sign(s) of renal disease, early renal biopsy may be helpful in planning treatment.