[Spatial-temporal characteristics and influencing factors of pulmonary tuberculosis cases in Shanghai from 2013 to 2020].

Objective: To use the spatiotemporal distribution model and INLA algorithm to study the spatiotemporal characteristics and influencing factors of tuberculosis in Shanghai and to provide a theoretical basis for formulating regional tuberculosis epidemic prevention and control measures. Methods: Based on the data of registered pulmonary tuberculosis cases in Shanghai during 2013-2020 derived from the tuberculosis management information system of China Disease Control and Prevention Information System, the hierarchical Bayesian model was adopted to fit the tuberculosis case data, identify the spatiotemporal variation characteristics of tuberculosis, and explore the potential socioeconomic characteristics and other factors related to health services and spatiotemporal characteristics. Results: From 2013 to 2020, 29 281 registered tuberculosis cases were reported in Shanghai, with an average annual incidence of 25.224/100 000. From 2013 to 2020, the incidence trend increased first and then decreased, the highest incidence was reported in 2014 (27.991/100 000). The incidence of tuberculosis in Shanghai is characterized by spatial clustering. Through the spatial characteristics and risk analysis of the reported incidence of tuberculosis, it is found that the high-risk area of tuberculosis in Shanghai is the suburban communities, whereas downtown communities are the low-risk areas. The incidence risk of pulmonary tuberculosis is associated with the gross domestic product per capita (RR=0.48), the number of beds per 10 000 persons (RR=0.56), the normalized vegetation index (RR=0.50), and the night light index (RR=0.80). Conclusions: With the steady progress of tuberculosis prevention and control in the central urban area of Shanghai, special attention should be paid to the prevention and control in the suburbs further to improve the social and economic level in the suburbs and increase the coverage rate of urban green space, to reduce the incidence of tuberculosis and reduce the disease burden of tuberculosis in Shanghai.

[Spatiotemporal characteristics of hand,foot and mouth disease and influencing factors in China from 2011 to 2018].

Objective: To analyze the spatiotemporal characteristics of hand,foot and mouth disease (HFMD) in China, explore the association of socioeconomic, population and health services factors with the incidence of HFMD in China, and provide information for the prevention and control of HFMD. Methods: Bayesian spatiotemporal model was used to fit the data of HFMD, evaluate the spatiotemporal variation of HFMD, and identify the potential association between the risk of HFMD and social, economic, population and health services. Results: From 2011 to 2018, a total of 17 118 050 HFMD cases, including 2 283 deaths, were reported in China. The reported incidence showed a fluctuating increase trend from 2011 to 2014, and a fluctuating decrease trend from 2014 to 2018. Meanwhile, there was a fluctuating decrease trend of mortality rate. The incidence of HFMD had spatial clustering, with the highest incidence in southern China with hot spot and high risk areas, and the lowest incidence in northwestern China where cold spot and low risk areas were found. The risk for HFMD was associated with GDP per capita (RR=3.54), number of industrial enterprises above designated size of 10 000 people (RR=1.61), urbanization rate (RR=3.00), birth rate (RR=2.36), number of beds in medical institutions per 10 000 people (RR=3.40), and green area in parks per capita (RR=0.57). Conclusions: The hotspot area for HFMD prevention and control in China was in the southeast coastal provinces from 2011 to 2018. In order to reduce the incidence of HFMD, it is necessary to increase the green area in parks per capita while accelerating urbanization process.

[Short-term efficacy and perioperative safety of catheter-based intervention for pulmonary vein stenosis caused by fibrosing mediastinitis].

Objective: To evaluate the short-term efficacy and perioperative safety of catheter-based intervention in patients with pulmonary vein stenosis caused by fibrosing mediastinitis (FM). Methods: It was a case series study. Consecutive patients with pulmonary vein stenosis caused by FM, who underwent percutaneous pulmonary vein angioplasty in Gansu Provincial Hospital from January 2018 to June 2020, were retrospective enrolled. The baseline characteristics, comorbidities, exercise capacity and hemodynamic data before and after treatment were compared, and the procedural related complications were evaluated. Results: A total of 30 patients ((64.3±7.1) years, 15 males) were included. Sixty-three pulmonary vein stenosis were treated by 32 percutaneous pulmonary vein angioplasty procedures. Forty-four stents were implanted in 41 pulmonary veins after balloon angioplasty, and the diameter of implanted stents was (8.3±1.2)mm. Balloon angioplasty was performed on 22 pulmonary vein stenosis, the mean balloon diameter was (4.2±2.1)mm. The pulmonary vein diameter increased from (2.6±1.3) to (6.6±2.6) mm (P<0.001) and the pressure gradient across the pulmonary vein stenotic segment reduced from 19 (12, 29) to 2 (0, 4) mmHg (1 mmHg=0.133 kPa) (P<0.001) immediately post procedure. The pulmonary vein flow grade was significantly improved compared with baseline (P<0.001). The most common operation related complications were lung injury (44.0% (11/25)) and hemoptysis (18.8% (6/32)), which did not need special treatment. During the 2.0 (1.3, 3.2) months follow-up, the WHO functional class was significantly improved (P<0.05), the 6-minute walking distance increased from (254.8±114.5) m to (342.8±72.4)m (P<0.05), the mean pulmonary arterial pressure decreased from (40.9±8.3) mmHg to (35.4±7.7) mmHg (P<0.01), 17 out of 19 patients with refractory pleural effusion experienced total remission during the follow-up period (P<0.001). CT pulmonary venography was repeated in 17 patients. The incidence of in-stent restenosis of pulmonary vein was 24.0% (6/25). Conclusions: Percutaneous pulmonary vein angioplasty is effective for the treatment of pulmonary vein stenosis caused by fibrosing mediastinitis. However, it's not so safe, procedural related complication should be paid attention to and the rate of in-stent restenosis is relative high during the short-term follow-up.

CircRNA_0016418 expedites the progression of human skin melanoma via miR-625/YY1 axis.

OBJECTIVE: Some circular RNAs (circRNAs) have been testified to play crucial roles in the regulation of skin melanoma, including circRNA_0016418 (circ0016418). However, the regulatory mechanism of circ0016418 in skin melanoma is undiscovered. MATERIALS AND METHODS: The RNA expression was examined through quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) and associated-proteins levels were measured via Western blot. Cell counting kit-8 (CCK-8) assay was used for detecting cell proliferation. Transwell assay was conducted to assess the abilities of migration and invasion. The target relation was analyzed by Dual-Luciferase reporter assay. RESULTS: The levels of circ0016418 and Yin Yang 1 (YY1) were up-regulated in skin melanoma tissues and cells. Knockdown of both circ0016418 and YY1 had suppressive effects on proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of skin melanoma cells. YY1 overexpression reverted the inhibitory effects on skin melanoma cells caused by circ0016418 knockdown. Circ0016418 negatively modulated microRNA-625 (miR-625) expression and miR-625 directly targeted YY1. Circ0016418 functioned as a competitive endogenous RNA (ceRNA) of miR-625 to regulate YY1 expression. CONCLUSIONS: Circ0016418 regulated proliferation, migration, invasion, and EMT of skin melanoma cells through miR-625/YY1 axis. Circ0016418 might be a useful indicator of the therapeutic strategies of skin melanoma.

[Feasibility and efficacy of percutaneous pulmonary vein stenting for the treatment of patients with severe pulmonary vein stenosis due to fibrosing mediastinitis].

Objective: To evaluate the feasibility and safety percutaneous pulmonary vein intervention in patients with severe pulmonary vein stenosis (PVS) caused by fibrosing mediastinitis(FM). Methods: This retrospective analysis included 5 FM patients (2 male, 3 female, 54-77 years old) confirmed by clinical presentation and chest computed tomography (CT) scan from January to June 2018 who were from Gansu Provincial Hospital and Shanghai Chest Hospital. CT pulmonary angiography (CTPA) further revealed severe PVS caused by fibrotic tissue compression in mediastinum. After selective pulmonary vein angiography, gradually balloon angioplasty was used to expand the pulmonary vein and then stents were implanted in the pre-dilated stenotic pulmonary veins. Evaluation of therapeutic effect was made at 6 months after the procedure. Results: All of 11 serious compression PVS were treated with stent implantation (diameter: 7-10 mm, length: 17-27 mm). After stenting, degree of pulmonary vein stenosis decreased from (83±16)% to (12±4)% (P<0.01). The minimal diameter of the stenotic pulmonary vein was significantly increased from (0.8±0.5)mm to (7.5±0.8)mm (P<0.01). Trans-stenotic gradient decreased from (27.0±15.1)mmHg (1 mmHg=0.133 kPa) to (2.50±0.58)mmHg (P<0.05). Mean pulmonary pressure measured by cardiac catheter decreased from (45.0±9.0)mmHg to (38.7±8.4)mmHg (P<0.05). One patient experienced cardiac arrest due to vagal nerve reflex during big sizing balloon stent dilation and recovered after cardiopulmonary resuscitation. There were no other serious procedure related complications. During the follow-up, severe stenosis at end of proximal stent was evidenced in 1 patient due to fibrotic compression, and another patient developed in-stent thrombosis due to discontinuation of prescribed anticoagulant. Conclusion: Percutaneous intervention for severe pulmonary vein stenosis caused by FM is feasible and safe, and can improve hemodynamic caused by the compression of mediastinal vascular structures in these carefully selected patients.

Risk of Parkinson disease after organophosphate or carbamate poisoning.

AIMS: Parkinson disease (PD) is a common neurodegenerative disease. The aim of this study was to evaluate the risk of PD in patients with organophosphate (OP) or carbamate (CM) poisoning by using the Taiwan National Health Insurance Research Database. METHODS: We conducted a retrospective study involving a cohort of 45 594 patients (9128 patients with a history of OP or CM poisoning and 36 466 control patients) who were selected from the Taiwan National Health Insurance Research Database. The patients were observed for a maximum of 12 years to determine the rates of new-onset PD, and a Poisson regression model was used to identify the predictors of PD. The cumulative incidence of PD between the two cohorts was plotted through Kaplan-Meier analysis. RESULTS: During the study period, the incidence rate ratio (IRR) of PD in the OP or CM poisoning patients was 1.36-fold [95% confidence interval (CI)=1.26-1.47] higher than that in the control patients in the multivariable model. The absolute incidence of PD was the highest for the group aged ≥75 years in both cohorts (77.4 vs 43.7 per 10 000 person-years). However, the age-specific relative risk was higher for the group aged <50 years (adjusted IRR=3.88; 95% CI=3.44-4.39). CONCLUSION: Our results suggest that the likelihood of developing PD is greater in patients with OP or CM poisoning than in those without poisoning. OP or CM poisoning may be an independent risk factor for PD.

[Latent tuberculosis infection and associated risk factors among the tuberculosis contacts in one of district in Shanghai].

Objective: To investigate the prevalence of latent tuberculosis infection(LTBI) and associated risk factors among the tuberculosis(TB) contacts in Minhang District of Shanghai. Methods: A self-designed questionnaire was used to acquire socio-demographic information and to assess the degree of exposure to index cases. LTBI screening was performed by T-SPOT.TB assay. Pearson chi-square test and Logistic regression analyses were used to identify the risk factors associated with LTBI among the TB contacts. Results: A total of 137 contacts from 59 mycobacterial (culture) positive pulmonary TB patients were enrolled in this study. In these contacts, there were 54 men and 83 women, with the average age of 42. LTBI was identified in 20% (27/137) of these contacts. Several risk factors were found by logistic analyses in this study. The worse the ventilation in the exposure location was, the more likely to develop LTBI. Contacts aged more than 60 (42.1%) were 3.9 times more likely to develop LTBI than those aged less than 60 (16.1%). Individuals in contact with TB patients for more than 40 h/week(25.8%) had a 4.2 times risk of LTBI as compared to those for less than 40 h/week(6.8%). Conclusion: The prevalence of LTBI was 20% among the TB contacts in this study, highlighting the need of TB screening and intervention among TB contacts.

Socioeconomic burden of hand, foot and mouth disease in children in Shanghai, China.

In the near future, the inactivated enterovirus 71 (EV71) vaccine is expected to become available on the market in China. Since EV71 is a major cause of hand, foot and mouth disease (HFMD), the vaccine is expected to significantly reduce the number of cases, as well as the detrimental economic effect of the disease. However, for a national vaccination strategy to be developed, policy-makers need more information on the socioeconomic burden of EV71 HFMD infection. Based on the 2011 population data, we estimated the clinical and economic effect of EV71 HFMD infection in children aged 0-9 years in Shanghai, China. The annual cost related to HFMD is >US$7.66 million for a population of 1·42 million children aged 0-9 years with an average cost of US$208.2/case. The extrapolated cost for EV71 HFMD infection was US$3.53 million, comprising 46·1% of the overall cost associated with HFMD. Around 97% of all of the HFMD-related expenses were paid for by the families creating a considerable economic burden. Our findings could provide the necessary recommendations on the most effective national EV71 vaccine implementation, as well as a baseline data for assessing the cost-effectiveness of the vaccine in China.

Association between serum angiopoietin-2 concentration and clinicopathological parameters in patients with colorectal cancer.

We examined the expression of angiopoietin-2 in serum samples from patients diagnosed with colorectal cancer and healthy volunteers and investigated the feasibility of using angiopoietin-2 as a potential diagnostic colorectal cancer biomarker. Enzyme-linked immunosorbent assays were used to measure the levels of angiopoietin-2 in patients with colorectal cancer and healthy control subjects. Correlations between serum angiopoietin-2 levels and clinicopathological factors were investigated. A receiver operating characteristic curve was used to predict cut-off values of the markers. Serum concentrations of angiopoietin-2 were significantly higher in patients with colorectal cancer than in controls (2896 ± 1273 vs 1554 ± 991 pg/mL, P = 0.004). Serum angiopoietin-2 expression levels were significantly positively correlated with TNM stage (P = 0.003), lymph node involvement (P = 0.04), and distant metastases (P = 0.005). Receiver operating characteristic curve analysis revealed that serum level of angiopoietin-2 was a potential biomarker for differentiating colorectal cancer patients from controls and had a receiver operating characteristic area under the curve of 0.859 (95% confidence interval = 0.740-0.978). At a cut-off value of 2710 pg/mL, the sensitivity was 79.3% and the specificity was 82.4%. Our results suggest that angiopoietin-2 can be used as a diagnostic biomarker for colorectal cancer in clinical practice. Additional studies are needed to clarify the detailed mechanism of angiopoietin-2 in the carcinogenesis and metastasis of colorectal cancer.

Phylogenetic analysis of Gansu sheeppox virus isolates based on P32, GPCR, and RPO30 genes.

Two outbreaks of sheeppox in sheep have occurred in Gansu Province, China. The P32, GPCR, and RPO30 genes were used as markers for differential diagnosis. We confirmed that the outbreaks were caused by sheeppox virus. Sequence and phylogenetic analysis of the P32, GPCR, and RPO30 genes revealed a close relationship between the 2 isolates and Chinese sheeppox viruses. Because ill sheep were imported from Jingyuan, another county of Gansu Province, our results strongly suggest the importance of veterinary surveillance prior to transportation.

Lanicemine: a low-trapping NMDA channel blocker produces sustained antidepressant efficacy with minimal psychotomimetic adverse effects.

Ketamine, an N-methyl-D-aspartate receptor (NMDAR) channel blocker, has been found to induce rapid and robust antidepressant-like effects in rodent models and in treatment-refractory depressed patients. However, the marked acute psychological side effects of ketamine complicate the interpretation of both preclinical and clinical data. Moreover, the lack of controlled data demonstrating the ability of ketamine to sustain the antidepressant response with repeated administration leaves the potential clinical utility of this class of drugs in question. Using quantitative electroencephalography (qEEG) to objectively align doses of a low-trapping NMDA channel blocker, AZD6765 (lanicemine), to that of ketamine, we demonstrate the potential for NMDA channel blockers to produce antidepressant efficacy without psychotomimetic and dissociative side effects. Furthermore, using placebo-controlled data, we show that the antidepressant response to NMDA channel blockers can be maintained with repeated and intermittent drug administration. Together, these data provide a path for the development of novel glutamatergic-based therapeutics for treatment-refractory mood disorders.

Targeted drug regulation on methylation of p53-BAX mitochondrial apoptosis pathway affects the growth of cholangiocarcinoma cells.

OBJECTIVE: To study the mechanism of 5-aza-2-deoxycytidine (DAC; a methylation inhibitor) on growth of the human cholangiocarcinoma QBC939 cell line. METHODS: A colourimetric assay was used to detect growth of QBC939 cells treated with DAC (0.1-100 µmol/l) over 24 h, 48 h and 72 h. Cell morphology was observed by transmission electron microscopy (TEM). The cell cycle and apoptosis were analysed by flow cytometry. Hypermethylation of the promoters of the p53-BAX mitochondrial apoptosis genes cyclin-dependent kinase inhibitor 2A (CDKN2A), death-associated protein kinase 1 (DAPK1) and PYD and CARD domain containing (PYCARD) was detected by methylation-specific polymerase chain reaction, with and without DAC treatment. RESULTS: DAC inhibited QBC939 cell growth with a half maximal inhibitory concentration of 5 µmol/l at 72 h. After DAC treatment, apoptosis was observed by TEM. Flow cytometric analysis of propidium iodide-positive cells demonstrated increased apoptosis of DAC-treated QBC939 cells (43.04%) compared with untreated cells (4.31%). DAC treatment resulted in demethylation of the gene promoters of CDKN2A and DAPK1 in QBC939 cells. CONCLUSIONS: DAC induces apoptosis of QBC939 cells by reactivation of hypermethylated p53-BAX mitchondrial apoptosis genes in cholangiocarcinoma cells.

Stroke after treatment with bortezomib and dexamethasone in a Chinese patient with extramedullary relapse of multiple myeloma.

Thromboembolic complications commonly occur in patients with multiple myeloma (MM). The risk of such complications may be elevated by the use of immunomodulatory agents such as thalidomide and lenalidomide as initial therapy for MM. However, arterial thrombosis after treatment with bortezomib is rare. Herein we report a case of a 70-year-old Chinese male patient with extramedullary relapse of MM. After treatment with bortezomib and dexamethasone he developed a nonfatal thrombotic stroke. Administration of bortezomib and dexamethasone was then discontinued and he obtained partial remission.

99mTc-TRODAT-1 SPECT study in early Parkinson's disease and essential tremor.

OBJECTIVE: The clinical differentiation between early Parkinson's disease (PD) and essential tremor (ET) could be difficult, therefore, the aim of this study was to investigate 99mTc-TRODAT-1 SPECT as an applicable tool in this field. METHODS: 99mTc-TRODAT-1 single photon emission computed tomography (SPECT) was performed in 10 healthy volunteers, 27 patients with idiopathic PD (Hoehn and Yahr 1-1.5) and 12 patients with ET. The ratio of striatal (99m)Tc-TRODAT-1 binding was calculated as the index of (striatum - occipital cortex)/occipital cortex. RESULTS: Compared with the striatal 99mTc-TRODAT-1 uptake in the ET group (0.49 +/- 0.07) or healthy controls (0.54 +/- 0.18), there was a significant decrease in the bilateral striatums of early PD, with a greater reduction in the contralateral striatum (0.27 +/- 0.08) than ipsilateral one (0.36 +/- 0.10, P < 0.01). Its sensitivity and specificity of differentiating early PD from ET was 96.4% and 91.7% respectively. CONCLUSION: 99mTc-TRODAT-1 SPECT can detect the dysfunction of nigrostriatal system in patients with early PD and provided a feasible tool to help differentiate early PD from ET.

Chemical synthesis and magnetic properties of well-coupled FePt/Fe composite nanotubes.

A simple two-step hydrogen reduction method was used to synthesize FePt/Fe composite nanotubes. As the first step, L1(0) FePt nanotubes were prepared by heating a porous alumina template loaded with an alcohol solution of a Fe chloride and Pt chloride mixture in flowing hydrogen at 670 degrees C. Then, FePt/Fe composite nanotubes were obtained by reducing the alcohol solution of the Fe chloride within the formed FePt nanotubes at a lower temperature, namely 470 degrees C. Through changing the concentrations of initial alcohol solutions, the FePt:Fe atomic ratios of the composite nanotubes were easily adjusted and the magnetic properties were tuned accordingly. For (FePt)(100-x)/Fe(x) composite nanotubes with x ranging between 0 and 26 at.%, the hard and soft phases were well coupled and the coercivity was tunable over a large range (1.27-2.73 T). Furthermore, the marked interdiffusion between Fe and FePt, which usually exists in FePt-based composites fabricated by using conventional methods, was not observed in the formed composite nanotubes. This indicates the two-step hydrogen reduction method to be a promising route for synthesizing nanocomposites which are difficult to fabricate by using conventional methods due to the interdiffusion between different phases.

A renal hemangiosarcoma causing hematuria in a dog.

A 14.5-year-old male dog was presented with stranguria and hematuria of 1-month duration. Hematology and blood chemistry revealed a neutrophilia, mild azotemia and a mild decrease in the packed cell volume. Urinalysis showed high specific gravity (> 1.040 g/mL), hematuria, proteinuria and mild bilirubinuria. On physical examination, a firm oval mass located caudal to the distended urinary bladder, was palpated. Differential diagnoses included prostatitis, prostatic neoplasm, prostatic hyperplasia, and abscess. The enlarged prostate was suspected to be the cause of hematuria, and a total prostatectomy was performed. Histologically, the prostate was affected by a prostatitis with cystic papillary hyperplasia of the epithelium. The dog's condition continued to deteriorate, and death occurred 1 week later. Necropsy showed a tumor mass, approximately 5 x 4 x 3 cm in size, between the abdominal aorta and the left kidney, where the adrenal glands were embedded. Lesions were found in the kidneys, adrenal gland, lungs, heart, liver, intestine, and serosa of viscera, while the spleen was spared. This hemangiosarcoma most likely arose from the renal arteries, resulting in diffuse lesions in the kidneys thought to be the cause of hematuria.

The effect of human bcl-2 and bcl-X genes on dengue virus-induced apoptosis in cultured cells.

Infection of dengue viruses (DENs) can cause human dengue fever, hemorrhagic fever, or shock syndrome. Although DEN-induced apoptosis has been implicated in pathogenesis of the DEN-related diseases, the underlying mechanism remains largely unexplored. In this study, we investigated the effect of ectopic expression of human bcl-2 and bcl-X genes on DEN-induced apoptosis in cultured cells. We employed a human isolate of DEN serotype 2 (DEN-2), PL046, which not only caused cell-cycle arrest in the G1 phase but also induced apoptosis in infected baby hamster kidney (BHK-21) cells, murine neuroblastoma N18 cells, and human neuronal NT-2 cells. Our results reveal that overexpression of bcl-2 in fibroblast-like BHK-21 cells, although not inhibiting virus yields, delayed the process of DEN-induced apoptosis, thereby permitting surviving cells to become persistently infected. In contrast, stable bcl-2 expression in neuronal N18 cells failed to block DEN-induced apoptosis. On the other hand, Bcl-X(L), expressed predominantly in the nervous system, appeared to delay DEN's killing effect in neuronal N18 cells but not in fibroblast-like BHK-21 cells. In addition, inducible expression bcl-X(s), despite its proapoptotic property in other reported system, was found to merely accelerate cell death in DEN-infected N18 but not in infected BHK-21 cells. Thus, through studying the effect of human bcl-2-related genes, our results suggest that DEN infection may trigger target cells to undergo morphologically similar but biochemically distinct apoptotic pathways in a cell-specific manner.