Temporal Dynamics of Subclinical Malaria in Different Transmission Zones of Myanmar.

Countries in the Greater Mekong Subregion have committed to eliminate Plasmodium falciparum malaria by 2025. Subclinical malaria infections that can be detected by highly sensitive polymerase chain reaction (PCR) testing in asymptomatic individuals represent a potential impediment to this goal, although the extent to which these low-density infections contribute to transmission is unclear. To understand the temporal dynamics of subclinical malaria in this setting, a cohort of 2,705 participants from three epidemiologically distinct regions of Myanmar was screened for subclinical P. falciparum and P. vivax infection using ultrasensitive PCR (usPCR). Standard rapid diagnostic tests (RDTs) for P. falciparum were also performed. Individuals who tested positive for malaria by usPCR were followed for up to 12 weeks. Regression analysis was performed to estimate whether the baseline prevalence of infection and the count of repeated positive tests were associated with demographic, behavioral, and clinical factors. At enrollment, the prevalence of subclinical malaria infection measured by usPCR was 7.7% (1.5% P. falciparum monoinfection, 0.3% mixed P. falciparum and P. vivax, and 6.0% P. vivax monoinfection), while P. falciparum prevalence measured by RDT was just 0.2%. Prevalence varied by geography and was higher among older people and in those with outdoor exposure and travel. No difference was observed in either the prevalence or count of subclinical infection by time of year, indicating that even in low-endemicity areas, a reservoir of subclinical infection persists year-round. If low-density infections are shown to represent a significant source of transmission, identification of high-risk groups and locations may aid elimination efforts.

Radiofrequency ablation with or without ethanol injection for hepatocellular carcinoma: a systematic review and meta-analysis.

INTRODUCTION: To compare radiofrequency ablation (RFA) plus ethanol injection (EI) with RFA alone for hepatocellular carcinoma. EVIDENCE ACQUISITION: A comprehensive search of studies among PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Chinese BioMedical Literature Database (CBM) was conducted with published date from the earliest to May 1st, 2016. No language restrictions were applied, but only prospective randomized controlled trials (RCTs) or non-randomized controlled trials (non-RCTs) were eligible for a full-text review. Published trials that included a treatment group receiving RFA plus EI and a control group receiving RFA alone with data for at least 1-year survival or complete ablation rate were included. Pooled ORs with 95% confidence interval (CI) were calculated using either the fixed-effects model or random-effects model. All statistical analyses were carried out using Stata v.12.0 (Stata Corporation, College Station, TX, USA). EVIDENCE SYNTHESIS: There were 8 trials (3 RCTs) involving 969 patients. Patients receiving RFA plus EI showed significantly better in 1-year survival rate (OR=2.09, 95% CI: 1.38-3.01; P<0.001), 2-year survival rate (OR=21.84, 95% CI: 1.13-3.00; P=0.014), 3-year survival rate (OR=1.86, 95% CI: 1.35-2.57; P<0.001) and complete ablation rate (OR=2.34, 95% CI: 1.52-3.61; P<0.001). CONCLUSIONS: RFA plus EI was superior than RFA alone for treating HCC.

Abated microRNA-195 expression protected mesangial cells from apoptosis in early diabetic renal injury in mice.

BACKGROUND: MicroRNAs are a class of highly conserved, small, noncoding RNAs that tailor gene expression mainly at the posttranscriptional level. The aim of the present study was to investigate the renal expression profiles of microRNAs and their potential involvement in early diabetic nephropathy. METHODS: Diabetic models were induced with streptozotocin in DBA/2 mice. MicroRNAs were detected by microarray and subjected to bioinformatics analyses. Real-time PCR and Western blots were performed. The relationships between pathological changes and microRNA expression were evaluated by linear regression analysis. Apoptosis and proliferation of cultured mesangial cells treated with microRNA inhibitor were determined by flow cytometry and MTT assay, respectively. RESULTS: Nine microRNAs, including miR-1187, miR-320, miR-214, miR-34a, miR-762, miR-466f, miR-720, miR-744 and miR-1937b, were increased significantly. Another 9 microRNAs, including miR-1907, miR-195, miR-568, miR-26b, miR-703, miR-1196, miR-194, miR-805 and miR-192, were decreased remarkably in diabetic mice. The levels of microRNA repressing BCL2 decreased. Accordingly, BCL2 levels were found elevated and caspase-3 and caspase-8 levels decreased in the diabetic group. MicroRNA-195 expression was negatively related to glomeruli diameter, mesangial score and extracellular matrix (ECM) accumulation. Moreover, the microRNA-195 inhibitor protected mesangial cells from apoptosis and promoted the cellular proliferation in vitro. CONCLUSIONS: These results demonstrated that the abated microRNA-195 expression protected mesangial cells from apoptosis, suggesting that the antiapoptosis in a microRNA-regulated manner may play an important role in the early stages of diabetic nephropathy.

Comparison of 2-microm continuous wave laser vaporesection of the prostate and transurethral resection of the prostate: a prospective nonrandomized trial with 1-year follow-up.

OBJECTIVES: To compare the safety and efficacy of the 2-microm continuous wave (cw) laser vaporesection of the prostate with transurethral resection of prostate (TURP) in patients with symptomatic benign prostatic hyperplasia (BPH). METHODS: In this prospective study, 100 patients with a prostate weight of < 80 g underwent 2-microm cw laser vaporesection (n = 58) or TURP (n = 42). Efficacy follow-up included measurement of International Prostate Symptom Score, quality of life score, maximal urinary flow rate, and postvoid residual volume. Peri- and postoperative complications were also compared. RESULTS: The mean operative time was slightly longer in the 2-microm laser group, 54.2 +/- 20.8 minutes, than the TURP group 42.0 +/- 10.5 minutes (P <.05). No blood transfusion was needed in the 2-microm laser group. Catheter indwelling time 1.8 +/- 0.3 days vs 3.4 +/- 1.9 days, and hospitalization time 3.2 +/- 1.6 days vs 6.5 +/- 2.4 day were shorter in 2-microm laser group than in TURP group (P <.05). Within the 12-month follow-up, the mean International Prostate Symptom Score improved by 85.4% in the laser group and 81.1% in the TURP group. Mean maximal urinary flow rate increased 229.2% for the laser group and with a similar increase of 218% for the TURP group (P >.05); however, perioperative morbidity was less in the 2-microm laser group. CONCLUSIONS: The 2-microm cw laser vaporesection is a novel technology with favorable perioperative safety as well as the same therapeutic effect as TURP, and has the advantage of significantly less blood loss, shorter hospitalization, and shorter catheter indwelling time.