Serum hepatitis B surface antigen correlates with fibrosis and necroinflammation: A multicentre perspective in China.

The kinetics of serum hepatitis B surface antigen (HBsAg) during the natural history of hepatitis B virus (HBV) infection has been studied, but the factors affecting them remain unclear. We aimed to investigate the factors affecting HBsAg titres, using data from multicentre, large-sized clinical trials in China. The baseline data of 1795 patients in 3 multicentre trials were studied, and the patients were classified into 3 groups: hepatitis B early antigen (HBeAg)-positive chronic HBV infection (n = 588), HBeAg-positive chronic hepatitis B (n = 596), and HBeAg-negative chronic hepatitis B (n = 611). HBsAg titres in the different phases were compared, and multiple linear progression analyses were performed to investigate the implicated factors. HBsAg titres varied significantly in different phases (P = .000), with the highest (4.60 log10 IU/mL [10%-90% confidence interval: 3.52 log10 IU/mL-4.99 log10 IU/mL]) in patients with HBeAg-positive chronic HBV infection. In all phases, age and HBV DNA were correlated with serum HBsAg level. In HBeAg-positive chronic hepatitis B patients, a negative correlation between HBsAg titres and fibrosis stage was observed. Alanine amonitransferase or necroinflammatory activity was also correlated with HBsAg titres in HBeAg-negative chronic hepatitis B patients. In conclusion, decreased HBsAg titres may be associated with advancing fibrosis in HBeAg-positive chronic hepatitis B patients or increased necroinflammation in those with HBeAg-negative chronic hepatitis B. Our findings may help clinicians better understand the kinetics of HBsAg and provide useful insights into the management of this disease.

Total knee arthroplasty treatment of active tuberculosis of the knee: a review of 10 cases.

OBJECTIVE: To discuss the surgical methods of total knee arthroplasty (TKA) in the patients with active tuberculosis of the knee and find out its curative effect after TKA. PATIENTS AND METHODS: We analyzed 10 patients with active tuberculosis of the knee who received TKA in our department from March 2006 to March 2010, whose ages were from 22 to 64 years old (average age was 40.6 ± 1 years). The following parameters were measured in the pre- and post-operation periods: HSS score, range of motion (ROM). From x-ray to find out post-operate curative effect of TKA. RESULTS: All cases had pain and elevated ESR. Deep vein thrombosis (DVT) and nerve damage were not found in these cases. There were 4 cases that had sinuses on the skin: the skin healed before the operation took place. Pre-operation HSS average scores were 25.0 ± 2. All patients received TKA by the para-patellar medial approach. Eight cases were followed-up for 6-28 months; the average follow-up period was 14 ± 0.5 months. Post-operation we took an HSS score and X-rays to find out its curative effect after TKA operation. There were also no patients with dislocation, aseptic loosening or fracture of prosthesis, although 1 case had recurrence. Post-operation's HSS average scores were 86.75 ± 5.45. The average ROM was improved to 95 ± 5°. CONCLUSIONS: Recent clinical results indicate that TKA is effective to treat the patients with active tuberculosis of the knee joint. TKA can significantly improve the function of the joint and relieve pain, improving patients' living conditions.

Lactobacillus rhamnosus strain GG restores alkaline phosphatase activity in differentiating Caco-2 cells dosed with the potent mycotoxin deoxynivalenol.

Deoxynivalenol (DON) contamination of cereal crops occurs frequently, and may cause acute exposure at high levels or chronic more moderate exposure. DON has proven toxicity including restriction of enterocyte differentiation, which may play a part in DON induced gastroenteritis. The probiotic bacteria Lactobacillus rhamnosus strain GG (GG) can bind DON, and therefore potentially restrict bioavailability of this toxin. Binding efficacy is not significantly altered by heat treatment, and therefore this in vitro study evaluated whether heat inactivated GG could restore the differentiation process in Caco-2 cells, using alkaline phosphatase (ALP) activity as a marker of differentiation. DON (200ng/mL) caused a significant (p<0.001) 36% reduction in ALP activity (1598+/-137U/mg protein) compared to untreated cells (2502+/-80U/mg). A dose dependant restoration of ALP activity was observed where DON treated cells were co-incubated with heat inactivated GG (1719+/-84; 2007+/-142; 2272+/-160U/mg for GG at 1x10(4) (p>0.9), 1x10(7) (p<0.001), and 1x10(10)CFU/mL (p<0.001), respectively). Co-incubation of the non-binding strain, LC-705 (1x10(10)CFU/mL), with DON did not significantly restore the ALP (1841+/-97U/mg, p<0.077) compared to DON only treated cells. When viable GG were co-incubated with DON a similar restoration of ALP activity was observed as seen for heat inactivated GG. These combined data suggest that the major effect of GG on restoring ALP activity, and therefore Caco-2 cell differentiation, was due to specific binding of DON, with possibly a more minor role of non-specific bacterial interference.

Lactobacillus rhamnosus strain GG reduces aflatoxin B1 transport, metabolism, and toxicity in Caco-2 Cells.

The probiotic Lactobacillus rhamnosus GG is able to bind the potent hepatocarcinogen aflatoxin B1 (AFB1) and thus potentially restrict its rapid absorption from the intestine. In this study we investigated the potential of GG to reduce AFB1 availability in vitro in Caco-2 cells adapted to express cytochrome P-450 (CYP) 3A4, such that both transport and toxicity could be assessed. Caco-2 cells were grown as confluent monolayers on transmembrane filters for 21 days prior to all studies. AFB1 levels in culture medium were measured by high-performance liquid chromatography. In CYP 3A4-induced monolayers, AFB1 transport from the apical to the basolateral chamber was reduced from 11.1%+/-1.9% to 6.4%+/-2.5% (P=0.019) and to 3.3%+/-1.8% (P=0.002) within the first hour in monolayers coincubated with GG (1x10(10) and 5x10(10) CFU/ml, respectively). GG (1x10(10) and 5x10(10) CFU/ml) bound 40.1%+/-8.3% and 61.0%+/-6.0% of added AFB1 after 1 h, respectively. AFB1 caused significant reductions of 30.1% (P=0.01), 49.4% (P=0.004), and 64.4% (P<0.001) in transepithelial resistance after 24, 48, and 72 h, respectively. Coincubation with 1x10(10) CFU/ml GG after 24 h protected against AFB1-induced reductions in transepithelial resistance at both 24 h (P=0.002) and 48 h (P=0.04). DNA fragmentation was apparent in cells treated only with AFB1 cells but not in cells coincubated with either 1x10(10) or 5x10(10) CFU/ml GG. GG reduced AFB1 uptake and protected against both membrane and DNA damage in the Caco-2 model. These data are suggestive of a beneficial role of GG against dietary exposure to aflatoxin.

Gestational diabetes mellitus in Chinese women.

OBJECTIVE: To determine whether foreign diagnostic criteria for the diagnosis of gestational diabetes mellitus (GDM) are suitable for Chinese pregnant women. METHODS: The study participants were 340 pregnant women receiving obstetric care at the Shanghai Jiaotong University-Affiliated Sixth People's Hospital in Shanghai, China. The normal-pregnancy group comprised 190 women with no risk factor for GDM and the high-risk pregnancy group comprised 150 women who had at least one high-risk factor for GDM. All women took the diagnostic 100-g, 3-h oral glucose tolerance test (100-g 3-h OGTT) between 24 and 28 weeks of pregnancy. The results of the 100-g 3-h OGTT were classified according to three different sets of diagnostic criteria: (1) new, "Chinese" diagnostic criteria based on the results from the 100-g 3-h OGTT performed in the 190 healthy participating women; (2) the Carpenter and Coustan criteria; and (3) the National Diabetes Data Group (NDDG) criteria. Venous plasma glucose (VPG) was measured by the glucose oxidase method. A consistency check was used for analysis. Obstetric and neonatal outcomes were recorded. RESULTS: With 97.5% as the statistical cutoff value for the 100-g 3-h OGTT, the new diagnostic criteria for this study, based on data obtained from the 100-g 3-h OGTT performed on the 190 participating healthy pregnant women, were 5.2, 10.3, 8.9, and 7.7 mmol/L at 0, 60, 120, and 180 min. The e value was 0.83 for the new criteria vs. the Carpenter and Coustan criteria (P<0.001) and 0.70 for the new criteria vs. the NDDG criteria (P<0.001). In women with GDM and gestational-impaired glucose tolerance (GIGT), the incidence rates of macrosomia by the new criteria and the Carpenter and Coustan criteria were similar, but higher than the rates calculated with the NDDG criteria (P<0.05). CONCLUSION: With venous plasma glucose level measured by the glucose oxidase method, the Carpenter and Coustan criteria are applicable to Chinese pregnant women for diagnosis of GDM.

CYP4T1--a cytochrome P450 expressed in rainbow trout (Oncorhynchus mykiss) liver.

Total RNA isolated from a rainbow trout (Oncorhynchus mykiss) liver was subjected to RT/PCR using degenerate primers designed from homologous regions amongst cytochrome P450 CYP4 proteins. PCR amplification resulted in a single electrophoretic band which was excised, purified and sequenced directly, using cycle sequencing. The deduced protein sequence demonstrated the closest amino acid identity to rabbit CYP4B1 (54.6%) and rat CYP4B2 (55.4%). Phylogenic analysis of this sequence was found to be significantly different to any other CYP4 sequence and has been named CYP4T1. This represents the first CYP4 family member to be identified in an aquatic vertebrate.