Diagnostic, Prognostic, and Immunological Roles of FABP4 in Pancancer: A Bioinformatics Analysis.

Background: Fatty acid binding protein 4 (FABP4) is mainly involved in the regulation of systemic metabolism through various lipid signaling pathways. Metabolic reprogramming is one of the important factors in the development and progression of cancer. It has been recently reported that FABP4 is closely related to the development of cancer and may be involved in tumor invasion and metastasis. Methods: In this study, we explored the expression pattern of FABP4 in pancancer through TCGA and CPTAC. Using TCGA, Kaplan-Meier Plotter, and STRING databases, to explore its diagnostic and prognostic value, and function through GO/KEGG and GSEA. Then, using the TIMER2.0 database, we investigated the correlation between FABP4 expression and immune infiltration in cancers, especially stomach adenocarcinomas (STAD) and colorectal adenocarcinoma (COADREAD). Results: Compared with normal tissues, the expression of FABP4 in more than 10 tumor tissues was lower (p < 0.05). Through the receiver operating characteristic (ROC) curve, the diagnostic value was found higher in colorectal cancer, breast cancer, thyroid cancer, and lung cancer, with the area under the curve (AUC) > 0.9. Through the K-M curve, FABP4 was found to correlate to the prognosis of various cancers. The results of gastric cancer and colorectal cancer are consistent. The low-expression group has a better prognosis than the high-expression group, and the expression of FABP4 in the early T and N stages of gastrointestinal tumors is lower. FABP4 highly expressed gene set is mostly enriched in extracellular matrix degradation and cell adhesion functions. Gastrointestinal tumors with high expression of FABP4 may have more immunosuppressive effects on macrophages and have a worse prognosis. Conclusion: FABP4 can be used as a diagnostic and prognostic biomarker in pancancer, and its high expression in gastrointestinal tumors suggests poor prognosis. This may be correlated to the immune infiltration of macrophages and epithelial-mesenchymal transition.

Effect of Parental Myopia on Change in Refraction in Shanghai Preschoolers: A 1-Year Prospective Study.

Background: To investigate the risk factors for change in refraction and refractive components in preschoolers. Methods: Preschool children aged 3-5 years old, from the junior and the middle grades of seven randomly selected kindergartens in Jia Ding District, Shanghai, were followed for 1 year. Cycloplegic autorefraction (1% cyclopentolate) and axial length (AL) were measured at baseline and at 1-year follow-up. Questionnaires about parental myopia and environmental risk factors, such as time of outdoors and near work, were collected. Results: A total of 603 right eyes of 603 children were included. Parental myopia was not associated with a change in refraction, but two myopic parents were associated with a longer change in AL (coefficient = 0.153, p = 0.006), after adjusted for baseline spherical refraction, age, gender, change in height, change in weight, and environment risk factors. In the multivariate analyses, boys showed a more myopic refraction shift than girls in 1 year (coefficient = -0.150, p = 0.008) and a quicker AL elongation (coefficient = 0.120, p = 0.008). Time of near work, such as watching television, using computer, reading and writing, and time of outdoor activities, was not associated with a change in refraction or AL. Conclusions: In preschool age, environmental risk factors were not strongly associated with the change in refraction or refractive components. Parental myopia influences the refractive development of children continuously from infancy to preschool age, which might be the biological basis of school myopia.

Reactive Oxygen Species-Responsive Nanococktail With Self-Amplificated Drug Release for Efficient Co-Delivery of Paclitaxel/Cucurbitacin B and Synergistic Treatment of Gastric Cancer.

Application of drug combinations is a powerful strategy for the therapy of advanced gastric cancer. However, the clinical use of such combinations is greatly limited by the occurrence of severe systemic toxicity. Although polymeric-prodrug-based nanococktails can significantly reduce toxicity of drugs, they have been shown to have low intracellular drug release. To balance between efficacy and safety during application of polymeric-prodrug-based nanococktails, a reactive oxygen species (ROS)-responsive nanococktail (PCM) with self-amplification drug release was developed in this study. In summary, PCM micelles were co-assembled from ROS-sensitive cucurbitacin B (CuB) and paclitaxel (PTX) polymeric prodrug, which were fabricated by covalently grafting PTX and CuB to dextran via an ROS-sensitive linkage. To minimize the side effects of the PCM micelles, a polymeric-prodrug strategy was employed to prevent premature leakage. Once it entered cancer cells, PCM released CuB and PTX in response to ROS. Moreover, the released CuB further promoted ROS generation, which in turn enhanced drug release for better therapeutic effects. In vivo antitumor experiments showed that the PCM-treated group had lower tumor burden (tumor weight was reduced by 92%), but bodyweight loss was not significant. These results indicate that the developed polymeric prodrug, with a self-amplification drug release nanococktail strategy, can be an effective and safe strategy for cancer management.

Distance to highway and factory density related to lung cancer death and associated spatial heterogeneity in effects in Jiading District, Shanghai.

This study aimed to determine the spatial effects of traffic- and industrial-related pollution on the mortality for lung cancer (LC). We conducted a retrospective cohort study by using the data from LC registry in Jiading District for the period from 2002 to 2012. Standard parametric model with Weibull distribution was used for spatial survival analysis. Shorter distance to highway (adjusted odds ratio (aOR) = 1.15, 95% confidence interval (CI): 1.03-1.30) and higher factory density (aOR = 1.20, 95% CI: 1.05-1.37) were significantly associated with an increased risk of LC death, and there was a spatial difference in the associations between northern and southern areas of Jiading District. The risk was high in suburbs as compared with urban areas. Traffic- and industrial-related pollution were significantly associated with an increased risk of LC death, which showed a spatial variation. Further studies are needed to better understand the current LC status in the suburbs and to reduce health disparities.

Eyes grow towards mild hyperopia rather than emmetropia in Chinese preschool children.

PURPOSE: To document one-year changes in refraction and refractive components in preschool children. METHODS: Children, 3-5 years old, in the Jiading District, Shanghai, were followed for one year. At each visit, axial length (AL), refraction under cycloplegia (1% cyclopentolate), spherical dioptres (DS), cylinder dioptres (DC), spherical equivalent refraction (SER) and corneal curvature radius (CR) were measured. RESULTS: The study included 458 right eyes of 458 children. The mean changes in DS, DC and SER were 0.02 ± 0.35 D, -0.02 ± 0.33 D and 0.01 ± 0.37 D, while the mean changes in AL, CR and lens power (LP) were 0.27 ± 0.10 mm, 0.00 ± 0.04 mm and - 0.93 ± 0.49 D. The change in the SER was linearly correlated with the baseline SER (coefficient = -0.147, p < 0.001). When the baseline SER was at 1.05 D (95% CI = 0.21 to 2.16), the change in SER was 0 D. The baseline SER was also linearly associated with the change in LP (coefficient = 0.104, p = 0.013), but not with the change in AL (p = 0.957) or with the change in CR (p = 0.263). CONCLUSION: In eyes with a baseline SER less than +1.00 D, LP loss was higher compared to axial elongation, leading to hyperopic shifts in refraction, whereas for those with baseline SER over this range, loss of LP compared to axial elongation was reduced, leading to myopic shifts. This model indicated the homeostasis of human refraction and explained how refractive development leads to a preferred state of mild hyperopia.

Inequalities in changing mortality and life expectancy in Jiading District, Shanghai, 2002-2018.

BACKGROUND: Improvements of population health in China have been unevenly distributed among different sexes and regions. Mortality Registration System provides an opportunity for timely assessments of mortality trend and inequalities. METHODS: Causes of death were reclassified following the method of Global Burden of Disease Study (GBD). Age-standardized mortality rate (ASMR) and ring-map of the rate by town were used to describe inequalities in changing mortality. Life expectancy (LE) and cause-deleted LE were calculated on the basis of life table technique. RESULTS: The burden of death from 2002 to 2018 was dominated by cardiovascular diseases (CVD), neoplasms, chronic respiratory diseases and injuries in Jiading district, accounting for almost 80% of total deaths. The overall ASMR dropped from 407.6/100000 to 227.1/100000, and LE increased from 77.86 years to 82.31 years. Women lived about 3.0-3.5 years longer than men. Besides, a cluster of lower LE was found for CVD in the southeast corner and one cluster for neoplasms in the southern corner of the district. The largest individual contributor to increment in LE was neoplasms, ranged from 2.41 to 3.63 years for males, and from 1.60 to 2.36 years for females. CONCLUSIONS: Improvement in health was mainly attributed to the decline of deaths caused by CVD and neoplasms, but was distributed with sex and town. This study served as a reflection of health inequality, is conducive to formulate localized health policies and measures.

Geographical Variation of COPD Mortality and Related Risk Factors in Jiading District, Shanghai.

Background: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in China. Although numerous studies have been conducted to determine the risk factors for COPD mortality such as ambient air pollution, the results are not fully consistent. Methods: This study included mortality analysis and a case-control design by using the data extracted from the Mortality Registration System in Jiading District, Shanghai. Traditional logistic regression, geographically weighted logistic regression (GWLR), and spatial scan statistical analysis were performed to explore the geographic variation of COPD mortality and the possible influencing factors. Results: Traditional logistic regression showed that extreme lower temperature in the month prior to death, shorter distance to highway, lower GDP level were associated with increased COPD mortality. GWRL model further demonstrated obvious geographical discrepancies for the above associations. We additionally identified a significant cluster of low COPD mortality (OR = 0.36, P = 0.002) in the southwest region of Jiading District with a radius of 3.55 km by using the Bernoulli model. The geographical variation in age-standardized mortality rate for COPD in Jiading District was explained to a certain degree by these factors. Conclusion: The risk of COPD mortality in Jiading District showed obvious geographical variation, which were partially explained by the geographical variations in effects of the extreme low temperature in the month prior to death, residential proximity to highway, and GDP level.

The interaction on hypertension between family history and diabetes and other risk factors.

To explore the individual effect and interaction of diabetes and family history and other risk factors on hypertension in Han in Shanghai China. The method of case-control study with l:l matched pairs was used, 342 cases of hypertension and 342 controls were selected and investigate their exposed factors with face-to-face. The method of epidemiology research was used to explore the individual effect and interaction of diabetes and family history and other risk factors on hypertension. The individual effect of family history (OR = 4.103, 95%CI 2.660-6.330), diabetes (OR = 4.219, 95%CI 2.926-6.083), personal taste (OR = 1.256, 95%CI 1.091-1.593), drinking behavior (OR = 1.391, 95%CI 1.010-1.914) and smoking behavior (OR = 1.057, 95%CI 1.00-1.117) were significant (p < 0.05). But individual effect of sex, education, occupation, work/life pressure, environmental noise, sleeping time and sports habit were not significant (p > 0.05). The OR of interaction between FH and DM to hypertension was 16.537 (95%CI 10.070-21.157), between FH and drinking behavior was 4.0 (95%CI 2.461-6.502), FH and sport habit was 7.668 (95%CI 3.598-16.344), FH and personal taste was 6.521 (95%CI 3.858-11.024), FH and smoking behavior was 5.526 (95%CI 3.404-8.972), FH and work/life pressure was 4.087 (95%CI 2.144-7.788). The SI of FH and DM was 2.27, RERI was 8.68, AP was 52.48% and PAP was 55.86%. FH and DM, personal taste, smoking behavior had positive interaction on hypertension, but FH and sport habits, drinking behavior, work/life pressure had reverse interaction on hypertension. FH and diabetes were very important risk factors with significant effect for hypertension. FH and diabetes, personal taste, smoking behavior had positive interaction on hypertension, but FH and sport habits, drinking behavior, work/life pressure had reverse interaction on hypertension.

Influence of coarse particulate matter on chickenpox in Jiading District, Shanghai, 2009-2018: A distributed lag non-linear time series analysis.

Although the link between ambient air pollution and some infectious diseases has been studied, few studies have explored so far, the relationship between chickenpox and particulate matter. Daily chickenpox counts in Jiading District, Shanghai, were collected from 2009 to 2018. Time series analysis was conducted to describe the trends of the daily number of chickenpox cases and the concentration of particulate matter 10 µm or less (PM10). The distributed lag non-linear model (DLNM) was developed to assess the lag and non-linear relationship between the number of chickenpox cases and PM10 concentration adjusting for meteorological factors and other pollutants. Spatiotemporal scanning was used to detect the clustering of chickenpox cases. There was a concomitant relationship between the number of chickenpox cases and PM10 concentration, especially in the period of high PM10 concentration. DLNM results showed a nonlinear relationship between the number of chickenpox cases and PM10 concentration with the maximum effect of PM10 being lagged for 13-14 days, which was consistent with the average incubation period of chickenpox. PM10 was significantly associated with the daily number of chickenpox cases when above 300 µg/m3. The risk of chickenpox increased with increasing PM10 concentration and the association was strongest at the lag of 14 day (RR = 1.13, 95% CI: 1.04-1.23) for PM10 concentration of 500 µg/m3 versus 50 µg/m3. The study provides evidence that high PM10 concentration increases the risk of chickenpox spreading.

Cohort profile: protocol and baseline survey for the Shanghai Suburban Adult Cohort and Biobank (SSACB) study.

PURPOSE: The Shanghai Suburban Adult Cohort and Biobank (SSACB) was established to identify environmental, lifestyle and genetic risk factors for non-communicable chronic diseases (NCDs) in adults (20-74 years old) living in a suburban area of Shanghai with rapid urbanisation. PARTICIPANTS: Two of eight suburban district were purposely selected according to participant willingness, health service facilities, population, geographic region and electronic medical record system. From these suburban districts, four communities were selected based on economic level and population size. At stage three, one-third of the committees/villages were randomly selected from each community. All residents aged 20-74 years old were invited as study participants. FINDINGS TO DATE: The baseline data on demographics, lifestyle and physical health-related factors were collected using a face-to-face questionnaire interview. All participants completed physical examinations and had blood and urine tests. Blood and urine samples from these tests were stored in a biobank. From 6 April 2016 through 31 October 2017, we conducted face-to-face interviews and clinical examinations in 44 887 participants: 35 727 from Songjiang District and 9160 from Jiading District. The average age of participants was 56.4±11.2 years in Songjiang and 56.6±10.5 years in Jiading. The prevalence of hypertension, diabetes and dyslipidaemia was 34.0%, 8.2% and 11.1%, respectively. FUTURE PLANS: In-person surveys will be conducted every 5 years. For annual tracking, baseline data was linked to the local health information system, which was composed of an electronic medical record system, a chronic disease management system, a cancer registry system, an infectious disease report system and a death registry system. The data of the SSACB cohort is located in the School of Public Health, Fudan University. International and domestic collaborative research projects are encouraged and inherent in the project.

Impact of statin use on cancer-specific mortality and recurrence: A meta-analysis of 60 observational studies.

This meta-analysis mainly summarized the studies reporting an association between statin use and cancer-specific mortality and recurrence or progression of cancer patients.We systematically searched for studies about the statin used in cancer patients in electronic databases, including PubMed, Web of Science, Cochrane, Clinical Trials, from inception through the November 2019. A total of 60 studies which included 953,177 participants were eligible with 233,322 cancer patients used statin. Our analysis selected studies presented with outcome based on hazard ratios (HRs) and 95% confidence intervals (CIs) of cancer-specific mortality and cancer recurrence-free survival or progression-free survival. Heterogeneity between the studies was examined using I statistics, and sensitivity analyses were conducted to assess the robustness of the findings. All statistical analyses were performed using RevMan software (version 5.3).The use of statin was potentially associated with a decline in cancer-specific mortality in cancer patients (HR = 0.78; 95% CI: 0.74, 0.84; n = 39; I = 85%). Furthermore, statin use was associated with improved recurrence-free survival (HR = 0.87; 95% CI: 0.78,0.97; n = 23; I = 64%), but not with improvement in progression-free survival (HR = 1.05; 95% CI: 0.95,1.16; n = 14; I2 = 38%).The meta-analysis demonstrated that statin use could exhibit potential survival benefit in the prognosis of cancer patients. But our results are conservative for statins to improve disease recurrence and progression. These findings should be assessed in a prospective randomized cohort.

The effect of body mass index and its interaction with family history on hypertension: a case-control study.

BACKGROUND: BMI is an indicator commonly used in the world to measure the weight and height of the body, it reflects the comprehensive outcome of acquired lifestyle; FH is a sign reflecting the main role of genetic factors. This study aimed to evaluate the effect of BMI and interaction with FH on hypertension risk in Shanghai adult population. METHODS: According to l:l matched pairs design, 342 cases and 342 controls were selected and investigated in this study, this study was performed in Shanghai, China. Participants received face-to-face questionnaire survey, anthropometric tests and laboratory examinations. Relevant indicators that reflect obesity including BMI and waist to hip ratio (WHR) were calculated. Multivariate logistic regression analysis was applied to explore the association between factors and hypertension risk. Interactive effect was evaluated by synergy index (SI), relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and the percentage of the interaction between the pure factors (PAP). RESULTS: Among 684 study participants aged 28-87 years old, the differences of mean age and height between case group and control group are no significant (p > 0.05), but the differences of mean of weight, WC, HC, BMI and WHR are significant (p < 0.001). The OR of FH on hypertension is 4.986 (95%CI: 2.832~ 8.877); the OR of BMI on hypertension is respectively: low weight is 1.528 (95%CI: 0.551~ 4.239), overweight is 3.333 (95%CI: 1.678~ 6.617) and obesity is 7.312 (95%CI: 3.556~ 15.035). The OR of interaction between FH and BMI to hypertension is 12.993 (95%CI: 7.426~22.734). SI is 1.90 (95% CI: 1.48~3.78), RERI is 5.67 (95% CI: 1.66~11.88), AP is 43.87% (95% CI: 12.84~91.88%), and PAP is 47.55% (95%CI: 13.91~99.58%). FH and BMI have positive interaction on hypertension. 43.87% of hypertension exposed to both FH and BMI was attributable to the interaction of them. CONCLUSIONS: FH and BMI are significant higher risks of hypertension; with the increase of BMI, the risk of hypertension will increase more. FH and BMI have positive interaction with hypertension, the interaction is greater than the sum of two independent actions.

Geographical variation in lung cancer risk associated with road traffics in Jiading District, Shanghai.

Few studies have investigated the spatial variation in road traffic indicators associated with lung cancer risk. The purpose of this study was to explore the relationship between road traffic-related indicators and lung cancer risk and to estimate its spatial variability. The population-based case control study was conducted, including all the newly diagnosed lung cancer patients (cases) and colorectal cancer patients (controls) in Jiading District, Shanghai from 2014 to 2016. Traffic intensity variable (traffic intensity in a 500 m buffer), residential distance to major road or highway, and greenness exposure at the residence were estimated for each individual. We conducted unconditional logistic regression with adjustment for age, sex, smoking status and NDVI values and geographically weighted logistic regression (GWLR). The clustering of lung cancer risk was analyzed by Bernoulli model of the SaTScan software. This study included 1461 lung cancer patients and 954 colorectal cancer patients. In multivariate logistic regression, smoking [OR 1.25 95% CI (1.15-1.35)], living <50 m from the major road [OR 1.43 95% CI (1.02-2.03)] were significantly associated with lung cancer risk. Residential Proximity to highway, residential greenness, and traffic intensity were not significantly associated with lung cancer risk. The GWLR model showed that the degree of correlation between residential proximity to major road and lung cancer risk varied geographically. The SaTScan results showed a lung cancer cluster in the southwest of Jiading District, Shanghai. Our study suggested that the distance from residence to the main road was significantly associated with lung cancer risk, which varied geographically. It is helpful to further study the traffic factors' spatial variation related to lung cancer risk and carry out reasonable regional planning.

Epidemiology and temporal trend of suicide mortality in the elderly in Jiading, Shanghai, 2003-2013: a descriptive, observational study.

OBJECTIVES: To investigate and describe the epidemiological characteristics of suicide in the elderly in Jiading, Shanghai, for the period 2003-2013. DESIGN: Retrospective, observational, epidemiological study using routinely collected data. SETTING: Jiading District, Shanghai. METHODS: Suicide data were retrieved from the Shanghai Vital Registry database for the period 2003-2013. Crude and age-standardised mortality rates were calculated for various groups according to sex and age. Joinpoint regression was performed to estimate the percentage change (PC) and annual percentage change (APC) for suicide mortality. RESULT: A total of 956 deaths due to suicide occurred among people aged ≥65 years during the study period, accounting for 76.7% (956/1247) of all suicide decedents. Among the 956 people with suicide deaths, 88.7% (848/956) had a history of a psychiatric condition. The age-standardised mortality rates for suicide without and with a psychotic history in people aged ≥65 years were much higher than those for people aged <65 years in both genders. Suicide mortality in the elderly showed a declining trend, with a PC of -51.5% for men and -47.5% for women. The APC was -29.1 in 2003-2005, 4.6 in 2005-2008 and -9.7 in 2008-2013 for aged men, and -12.2 in 2003-2006 and -5.2 in 2006-2013 for aged women, respectively. Women living in Jiading had a higher risk of suicide death than men, especially among the elderly. The mortality rate for suicide increased with age in the elderly, and was more marked for those with a psychiatric history than for those without. CONCLUSIONS: Suicide mortality declined in Jiading during the study period 2003-2013 overall, but remained high in the elderly, especially those with a psychiatric history.

Age-determined referral criteria of myopia for large-scale vision screening.

BACKGROUND: This study aimed to explore the best screening measure of myopia and its associated optimal referral criteria for children aged between 6 and 16. METHODS: After informed consent of cycloplegia was obtained, a total of 6,321 children aged between 6 and 16 from 53 primary or junior middle schools in Jiading District of Shanghai were included in our population-based study. Receiver operating characteristic (ROC) curve was performed to determine the best cutoff points, sensitivities and specificities of different screening tests, including uncorrected visual acuity (UCVA), noncycloplegic autorefraction (NCAR) and the combination of these two tests. RESULTS: There was significant difference in prevalence of myopia between boys and girls (χ2 = 6.358, P = 0.012). Compared with children of low age, the prevalence of older children was significantly higher (χ2 = 1,386.404, P < 0.001). For the combination of UCVA and NCAR, the best cutoff point was UCVA less than or equal to 0.2 logarithm of minimum angle of resolution (MAR) (20/30) and NCAR spherical equivalent refraction (SER) less than or equal to -0.75 diopters (D), with associated sensitivity and specificity of 75.0% and 85.0%, respectively, which were higher than those of UCVA and NCAR alone. After stratified by age, the best cutoff points were varied among children. The accuracy for children aged between 9 and 12 was higher than that for other ages. CONCLUSIONS: The best screening measure of myopia was the combination of UCVA and NCAR. The optimal referral criteria of myopia for children should be age-determined.

[Study on the growth of Vibrio cholerae O139 within Acanthamoeba polyphaga and its survival in the cysts in low temperature].

OBJECTIVE: To determine whether Acanthamoeba polyphaga could affect the survival and growth of Vibrio cholerae O139 in low temperature. METHODS: V. cholerae O139 was co-cultured with the Acanthamoeba polyphaga to be examined on its intracellular growth and survival rate within cysts at low temperature, using methods as Gram-staining, electron microscope and passage culture. RESULTS: V. cholerae O139 were observed to enter into the trophozoites and grow the within the vacuoles after 8 hour incubation with Acanthamoeba polyphaga. The germs survived in the vacuole and/or endo-layer of wall and could be re-isolated from the excystment of Acanthamoeba polyphaga. At 30 degrees C, V. cholerae O139 could survive for 120 days with the amoeba while less than 45 days in PAS. At 4 degrees C, the number of viable bacteria decreased and reached undetectable levels for both study and control groups after a 30-day incubation. V. cholerae O139 could be re-isolated from the 30-, 45-, 60- and 75-day's infected cysts after excystment. However the ability of excystment for 90-day's infected cysts decreased and V. cholerae O139 within the cyst could not be isolated again because the amoebae had lysed. CONCLUSION: These findings indicated that V. cholerae O139 could grow within Acanthamoeba polyphaga and the survival time could be increased in the cysts at low temperature. It seemed that Acanthamoeba can provide an environmental reservoir for V. cholerae O139.

[Survival and growth of Vibrio cholerae O139 inside Acanthamoeba].

OBJECTIVE: To study the survival and growth of Vibrio cholerae inside the Acanthamoeba polyphage. METHODS: Survival and growth of Vibro cholerae O139, co-cultured with Acanthamoeba polyphaga, was observed inside the trophozoites and cysts, using Gram stain and electron microscope. RESULTS: Viable O139 was observed inside the amoebal vacuoles in 24 hours. Vacuoles were filled with more bacteria along with the longer period of co-culture. The process of O139 infection with Amoebae would include uptake, formation of O139 vacuole, multiplication, trophozoites lysed and expel under electron microscopy. Some infected trophozoites could subsequently encyst and the surviving O139 could locate in the vesicles inside the cysts. CONCLUSION: O139 might survive and multiply in the trophozoites and reside inside the cysts of Amoebae, suggesting that Acanthamoebae might serve as one of the environmental hosts of Vibro cholerae.