[A preliminary study on the improved efficacy of mesalazine combined with vitamin D3 in ulcerative colitis].

Objective: To analyze the influence of vitamin D3 supplementation on the clinical efficacy of mesalazine in patients with ulcerative colitis (UC). Methods: From January 2015 to December 2020, patients with mild-to-moderate active UC were retrospectively and continuously enrolled, who accepted mesalazine treatment for at least 12 months at the Second Affiliated Hospital of Wenzhou Medical University. According to simultaneous supplement of vitamin D3 (125 IU/d), the patients were divided into study group and control group. Demographic and disease characteristics, serum 25-hydroxyvitamin D[25(OH)D] levels and other information were collected through retrieving hospital database. Student's t-test, Mann-Whitney U test and Chi-square test were applied for comparison of disease characteristics. The changes of modified Mayo scores[ΔMayo] and 25(OH)D[Δ25(OH)D] were compared before and after treatment by paired t-test, Wilcoxon signed rank test and Chi-square test. Multiple linear regression model was used to analyze the independent factors affecting ΔMayo and Δ25(OH)D, and variables with P-values less than 0.20 in the univariate analysis were allowed for further multivariate analysis. Results: A total of 74 UC patients (44 males, 30 females), with median age (range) 39.5 (20-76) years old, were analyzed and respectively assigned into study group (n=36) and control group (n=38). In study group, the average level of serum 25(OH)D was significantly increased at month 12 compared with that at baseline [(22.87±7.30) µg/L vs. (18.15±7.48) µg/L,P<0.001]. However, no significant elevation of serum 25(OH)D was found in control group [(19.17±8.49) µg/L vs. (19.82±9.47) µg/L,P=0.466]. Furthermore, there was a significant decrease of modified Mayo score [-3(-4.75, -1.25) vs.-2(-3.25, 0), P=0.034] and a higher clinical remission rate (55.6% vs. 28.9%, P=0.020) at month 12 in study group than those in control group. In addition, according to the baseline level of serum 25(OH)D before mesalazine treatment, 74 UC patients were divided into vitamin D deficiency group (n=38, serum 25(OH)D<20 µg/L) and non-deficiency group (n=36, serum 25(OH)D≥20 µg/L). At month 12 in vitamin D deficiency group, patients with vitamin D3 supplementation had a greater decline in modified Mayo score [-4(-5.75, -2) vs.-2(-4, 0), P=0.048] and a higher clinical remission rate (60.0% vs. 22.2%, P=0.019) compared with those without. Conclusions: In patients with mild-to-moderate active UC receiving mesalazine treatment, vitamin D3 supplementation may improve the clinical efficacy, especially in patients with vitamin D deficiency.

The Association between Tea Consumption and the Risk of Fracture: A Dose-Response Meta-Analysis of Prospective Cohort Studies.

OBJECTIVES: Inconsistent results exist on the role of tea consumption on subsequent risk of fracture. A dose-response meta-analysis was therefore conducted to assess the association of tea consumption with the risk of fracture based on prospective cohort studies. METHODS: The electronic databases of PubMed, Embase, and the Cochrane library were systematically searched to identify prospective cohort studies from inception until September 2020. The categories of high versus low and dose-response meta-analyses for tea consumption on the risk of fracture were calculated using the random-effects model. Eight prospective cohort studies recruited 774,134 individuals selected for the final meta-analysis. RESULTS: An increment of 1 cup in tea consumption was not associated with the risk of fracture [relative risk (RR), 0.98; 95% confidence interval (CI), 0.96-1.00; P = 0.102]. Moreover, the highest tea consumption category was associated with a reduced risk of fracture (RR, 0.93; 95% CI, 0.88-0.98; P = 0.005). Furthermore, heavy (RR, 0.91; 95% CI, 0.85-0.98; P = 0.008) and mild (RR, 0.97; 95% CI, 0.94-1.00; P = 0.046) tea consumption were associated with lower risk of fracture. However, moderate tea consumption was not associated with the risk of fracture (RR, 0.98; 95% CI, 0.94-1.02; P = 0.281). CONCLUSION: This study found that increased tea consumption may provide a protective role in the risk of fracture. The benefits of tea consumption should be further explored according to the characteristics of the individuals.

[The first outbreak of dengue fever and molecular tracing in Puyang, 2019].

Objective: This study retrospectively analyzed an outbreak of dengue fever in Puyang of Henan province in 2019, in order to find the sources of infection. Methods: Dengue virus IgM/IgG and NS1 antigen were tested by colloidal gold method. E gene was amplified by PCR. MegaX was used for sequences alignment to construct evolutionary distance trees. Results: After clinical and laboratory confirmation, there were 81 cases of dengue fever, 17 of which were imported case who were local farmers and worked in Combadia and Thailand, and 64 of which were indigenous cases. The E gene alignment results showed that the pathogen of this epidemic was Vietnamese 1 and highly homologous with the Vietnamese strain. After the local outbreak, dengue virus E gene developed a nucleotide site mutation which can be steadily transmission. Conclusion: The dengue fever outbreak in Puyang was a local outbreak caused by dengue virus type 1, which was associated with imported cases. Gene sequencing showed that the imported pathogen had a relatively stable and transmissible nucleotide mutation after the local epidemic.

[Association of Breg cells and Treg cells with the clinical effects of Infliximab in the treatment of Chinese patients with Crohn's disease].

Objective: To explore the associations of regulatory B cells (Breg cells) and regulatory T cells (Treg cells) with the clinical effect of Infliximab in the treatment of Chinese patients with Crohn's disease (CD). Methods: From January 2017 to June 2019, a total of 32 CD patients at active stage and 33 age and gender-matched healthy controls were collected from the Second Affiliated Hospital of Wenzhou Medical University in this study. Approximate 5 ml of peripheral fasting venous blood was obtained from every subject. Peripheral blood mononuclear cells (PBMCs) were isolated from whole blood. Then multi-color flow cytometry was applied to determine the proportion of Breg (CD3-CD19+IL-10+B cells) in B cells and the proportion of Treg (CD4+CD25+Foxp3+T cells) in CD4+T cells. Infliximab (5 mg/kg) was given intravenously at week 0, 2 and 6 to induce CD remission, and then maintained with the same dose of Infliximab every 8 weeks. And the proportions of Breg and Treg were examined at week 14 of Infliximab treatment, then compared with those of week 0. Simultaneously, C-reactive protein (CRP), leucocyte count, platelet count, erythrocyte sedimentation rate were detected in CD patients to assess the clinical effect at week 0 and 14 of Infliximab treatment. Results: Before infliximab treatment, compared with healthy controls, the proportion of Breg in B cells was significantly increased [(3.15±1.17)% vs (2.64±0.38)%, P=0.024)], and the proportion of Treg in CD4+T cells was significantly decreased [(2.15±0.49)% vs (4.25±0.41)%, P<0.001] in CD patients. And the proportion of Breg was positively related with the proportion of Treg in CD patients either at week 0 or week 14 of Infliximab treatment (r=0.628, P<0.001; r=0.749, P<0.001). At week 14 of Infliximab treatment, according to symptoms, Crohn's disease activity index (CDAI) and endoscopic mucosal healing, CD patients were classified as remission group (CDAI<150 and endoscopic mucosal healing, R group) and non-remission group (CDAI≥150 or mucosal non-healing group, N group). Compared with CD patients at week 0 of Infliximab treatment, both the proportion of Breg and Treg were significantly enhanced [(5.89±2.60)% vs (3.19±1.27)%, P<0.001; (4.59±0.72)% vs (2.08±0.47)%, P<0.001], whereas CDAI and CRP was significantly reduced [CDAI: (63.19±14.69) vs (195.62±58.13), P<0.001; CRP: (3.65±2.23) mg/L vs (29.80±30.06) mg/L, P<0.001] in R group at week 14 of Infliximab treatment. The proportions of Breg and Treg were negatively related with the CRP (r=-0.279, P=0.026; r=-0.406, P=0.001) and CDAI (r=-0.409, P=0.001; r=-0.708, P<0.001) in CD patients at week 0 and 14 of Infliximab treatment. At week 14 of Infliximab treatment, ROC curve analysis showed that the predictive value of "Breg+Treg" for the effect of Infliximab was higher than the other parameters (area under ROC: 0.782, cutoff value: 0.895 5, P=0.034). Conclusions: Breg cells and Treg cells are not only significantly correlated with CD disease activity, but the combined detection of the two types of immune cells has higher clinical value for predicting the effect of Infliximab in CD patients at active stage.

[A phase â ¢ clinical trial study on the safety and immunogenicity of ACYW135 group meningococcal conjugate vaccine inoculated in 3 month old infants].

Objective: The aim of this study was to evaluate the safety and immunogenicity of the first domestic ACYW135 meningococcal conjugate vaccine and a control vaccine named AC group meningococcal conjugate vaccine for 3 months (90-119 days) infants. Methods: From February 2017 to June 2018, a randomized, blinded, and similar vaccine-controlled clinical trial design was adopted at the Henan Vaccine Clinical Research Base. The subjects were 3 months old healthy infants, a total of 720, based on a 1∶1 ratio. The random allocation table for entry was randomly assigned to the experimental group and the control group. According to the 3, 4, and 5 month-old vaccination procedures, the subjects were vaccinated with test vaccine (ACYW135 group meningococcal conjugate vaccine) and control vaccine (group A group C meningococcal polysaccharide conjugate vaccine), of which 720 were given the first dose, 696 were given the second dose (test group: 346; control group: 350), and 692 were given the third dose (test group: 344; Control group: 348). Results: The overall adverse reaction rate of the test vaccine was 21.90% (230 cases), which was lower than the 32.04% (339 cases) of the control vaccine (P<0.001). The incidence of systemic adverse reactions was 19.52% (205 cases), which was lower than that of the control vaccine (27.69%) (293 cases) (P<0.001). The local adverse reaction rate was 3.04% (32 cases), which was lower than the control group (7.84%) (83 cases) (P<0.001). The graded adverse reaction test vaccine was 0.57% (6 cases), which was lower than the control group of 2.36% (25 cases) (P<0.001). The positive conversion rate of anti-bacterial serum antibodies showed that there was no significant difference between the test vaccine group A (91.42%), C (88.76%) and the control vaccine (92.92%) (87.02%) (P>0.05). Group Y and W135 was 88.17% (298 cases), 99.41% (336 cases), respectively. The GMT results showed that the test vaccine group A was 56.24, the control vaccine was 57.43 (P>0.05); the group C test vaccine (43.53) was higher than the control group (27.28) (P<0.001). The group Y and W135 are 89.22 and 140.66, respectively. Among them, the proportion of the group C GMT antibody ≥ 1∶128 for test vaccine (31.07%, 105 cases) was higher than the control vaccine (16.22%, 55 cases) (P<0.001). Conclusion: ACYW135 group meningococcal conjugate vaccine has more safety and immunogenicity after application to 3 month old infants.

Incidence and mortality of nasopharyngeal carcinoma: interim analysis of a cluster randomized controlled screening trial (PRO-NPC-001) in southern China.

BACKGROUND: Previous mass screening studies have shown that IgA antibodies against Epstein-Barr Virus (EBV) can facilitate early detection of nasopharyngeal carcinoma (NPC), but the impact of EBV-antibody screening for NPC-specific mortality remains unknown. PATIENTS AND METHODS: A prospective, cluster randomized, controlled trial for NPC screening (PRO-NPC-001) was conducted in 3 selected towns of Zhongshan City and 13 selected towns of Sihui City in southern China beginning in 2008. Serum samples of the screening group were tested for two previously selected anti-EBV antibodies. Subjects with serological medium risk were subsequently retested annually for 3 years, and those with serological high risk were referred to otorhinolaryngologists for diagnostic check-up. An interim analysis was carried out to evaluate the primary end points of the NPC-specific mortality and the early diagnostic rate, and the secondary end point of the NPC incidence, through linkage with the database of Zhongshan City. RESULTS: Among 70 296 total subjects, 29 413 screened participants (41.8% of the total subjects) in the screening group and 50 636 in the control group, 153 (43.3 per 100 000 person-year), 62 (55.3 per 100 000 person-year) and 99 (33.1 per 100 000 person-year) NPC cases were identified. The early diagnostic rates of NPC were significantly higher in the participants (79.0%, P < 0.0001) and the screening group (45.9%, P < 0.0001) compared with the control group (20.6%). Although no differences were found between NPC-specific mortality of the screening group and the control group [relative risk (RR)= 0.82, 95% confidence interval (CI) 0.37-1.79], lower NPC-specific mortality was noticed among participants from the screening group versus the control group (RR = 0.22, 95% CI 0.09-0.49). CONCLUSION: IgA antibodies against EBV can identify high-risk population and was effective in screening for early asymptomatic NPC. Although the mortality reduction was not significant in the primary end point, we noted encouraging evidence of a mortality reduction in screening participants in this interim analysis. CLINICAL TRIAL NUMBER: NCT00941538.

[Impact of TRAIL deficiency on Th17 cells in the mice experimental colitis induced by dextran sodium sulphate].

Objective: To investigate the impact of TNF-related apoptosis-inducing ligand (TRAIL) gene knock-out (TRAIL(-/-)) on Th17 cells in the mice colitis induced by dextran sulphate sodium (DSS). Methods: Mice were randomly assigned to 4 subgroups: wild type (WT), TRAIL(-/-), WT colitis and TRAIL(-/-)colitis (n=6/group). Colitis was induced by oral administration of 3.5% DSS for 7 consecutive days. The severity of colitis in each mouse was scored both clinically and histopathologically. Flow cytometry was performed to assess Th17 cell population in peripheral blood mononuclear cells (PBMC) and mesenteric lymph nodes (MLN). The expression levels of Th17 cell markers interleukin (IL)-17A and retinoic acid-related orphan receptor (ROR)-γt in PBMC and MLN were also examined using a quantitative polymerase chain reaction method. Results: Compared with WT group, WT colitis group displayed elevated CD4(+)IL-17A(+) Th17 cells (0.29±0.07 vs 0.08±0.03, 1.20±0.36 vs 0.40±0.11, both P<0.05) and enhanced mRNA expression of IL-17A and ROR-γt in PBMC and MLN (IL-17A: 2.43±0.87 vs 0.37±0.19, 5.03±1.77 vs 1.05±0.48, both P<0.05; ROR-γt: 2.49±0.48 vs 0.93±0.47, 23.75±7.60 vs 1.31±0.90, both P<0.05). After the DSS administration, TRAIL(-/-) group developed more severe colitis than WT group, mainly manifesting higher disease activity index, reduction of colon length and increased infiltration of inflammatory cells. In addition, TRAIL(-/-) colitis group exhibited increased proportion of CD4(+) IL-17A(+) Th17 cells (0.57±0.22 vs 0.29±0.07, P<0.001; 2.92±0.98 vs 1.20±0.36, P<0.000 1) as well as enhanced mRNA expression of IL-17A and ROR-γt in PBMC and MLN when compared with WT colitis group (IL-17A: 4.10±1.96 vs 2.43±0.87, 15.88±2.86 vs 5.03±1.77, both P<0.05; ROR-γt: 4.05±0.62 vs 2.49±0.48, 69.61±10.48 vs 23.75±7.60, both P<0.05). Conclusions: TRAIL deficiency not only promots the number and activity of Th17 cells in PBMC and in MLN, but also aggravats DSS-induced colitis in mice.

[Association of Crohn's disease with aryl hydrocarbon receptor gene polymorphisms and haplotypes].

Objective: To explore the relationship of Crohn's disease (CD) susceptibility to aryl hydrocarbon receptor (AhR) polymorphisms and haplotypes in Han population in Wenzhou city, China. Methods: A total of 310 CD patients and 573 age- and sex-matched healthy controls were enrolled in our study. Three single nucleotide polymorphisms (SNPs) of AhR(rs10249788,rs2158041,rs2066853) were determined by the improved multiple ligase detection reaction technique. Unconditional logistic regression analyses was applied to analyze the allelic and genotypic differences of each SNP between CD patients and controls, as well as their influence on the clinicopathologic characteristics in CD patients. Analyses of linkage disequilibrium and haplotype were performed by Haploview 4.2 software in all study subjects. Results: Compared with the controls, the variant allele (T) and genotype (CT+TT) of (rs2158041) were evidently decreased among CD patients (19.52% vs. 25.04%, P=0.009; 34.19% vs. 44.68%, P=0.003). According to "the Montreal Classification Standards" , CD patients were divided into different subgroups. The variant allele (T) and genotype (CT+TT) of (rs2158041) were significantly lower in patients with terminal ileum CD than in controls (16.79% vs. 25.04%, P=0.005; 28.24% vs. 44.68%, P=0.001). Similar conclusions were also drawn in patients with constricting disease when compared with the controls (15.20% vs. 25.04%, P=0.003; 28.43% vs. 44.68%, P=0.003). The three SNPs above were shown to be in a linkage disequilibrium. Compared with the controls respectively, the frequency of haplotype (CCG) was increased in CD patients (44.73% vs. 39.60%, P=0.039), whereas that of haplotype (CTG) was decreased (18.02% vs. 22.78%, P=0.047). Conclusions: AhR (rs2158041) variation might influence the risk as well as the location and behavior of CD. The haplotype (CCG) possibly increase the risk of CD development, whereas haplotype (CTG) might decrease it.

[Infection status, clinical symptoms and gene type transition of group A rotavirus in children, less than five years-of-age, with diarrhea in sentinel hospitals of Henan Province, China].

Objective: To investigate the infectious status, gene type transition and epidemiological features of rotavirus A isolated from infants and children (<59 months-of-age) in sentinel hospitals from 2008 to 2015 in Henan province, China. Methods: In total, 2 541 stool samples (each 3- 5 ml) were collected from infants and children aged less than five years in two sentinel hospitals and group A rotavirus was detected by a double antibody sandwich ELISA. Viral RNA was extracted from positive samples and G/P gene typing was performed using a two-step nested multiplex RT-PCR. Epidemiological information (including demographic information such as age, sex and clinical symptoms) was also collected from the patients and analyzed. Results: Group A rotavirus was detected in 30.9% (785/2 541) of diarrhea samples from children. The detection rate was higher in October (54.8%, 345/629) and lower in July (5%, 5/101) each year from 2008 to 2015. The group A rotavirus infection rate was higher in boys (30.6%, 451/1 476) than in girls (31.4%, 334/1 065) (χ2=0.18, P=0.664). Infection mainly occurred in 4-12 months old patients (61.3%, 481/785) (χ2=196.69, P<0.001), and the infection rate was lower in cities (26%, 258/992) compared with rural areas (34.0%, 527/1 549) (χ2=18.19, P<0.001). G typing of 785 strains of group A rotavirus revealed the following types: G1 (13.5%, 106 strains), G2 (11.1%, 87 strains), G3 (29.7%, 233 strains), and G9 (57.5%, 451 strains); P typing revealed the predominance of P[4] (11.3%, 89 strains) and P[8] (84.7%, 665 strains); gene type combinations comprised mainly G9P[8], G2P[4], G3P[8], G1P[8], respectively accounted for 52.9% (415), 9.7% (76), 17.3% (136), 11.3% (89). Gene type combinations G1 [8] and G3P[8] have been decreasing in prevalence since 2008 and G9P[8] has become the dominant gene type of group A rotavirus in Henan province. Among the group A rotavirus infection samples, the male:female infection ratio was 1.4∶1 (451/334), with no significant difference in the infection rate (χ2=0.18, P=0.664); the infection rate was higher in 4- 12 months old patients (61.3%, 481/785), with a significant difference detected between age groups (χ2=196.69, P<0.001). The rate of detection was lower in cities (26.0%, 258/992) than in rural areas (34.0%, 527/1 549) (χ2=18.19, P<0.001). Clinical analysis revealed a body temperature of below 37 degrees in 75.7% of positive cases (594 patients), 37.0- 37.5 degrees in 17.2% of cases (135 patients), 37.6-38.0 degrees in 2.0% of cases (16 patients), and above 38 degrees in 5.1% of cases (40 patients), with most cases showing no fever or a mild fever. The frequency of episodes of diarrhea among the patients was 0- 3 times (21.1%, 166 cases), 4- 6 times (65.6%, 515 cases), 7- 9 times (8.0%, 63 cases), or 10- 15 times (5.2%, 41 cases), mainly showing mild and moderate diarrhea. Vomiting also varied in frequency among the patients from no vomiting (86.9%, 682 cases), 1-2 times (11.8%, 92 cases), 3 times (6.0%, 47 cases), and more than 3 times (0.4%, 3 cases). The occurrence of dehydration varied from no dehydration (86.9%, 682 cases), mild dehydration of 1%- 5% (12.1%, 95 cases), to severe dehydration of ≥5% (1.0%, 8 cases). Conclusion: A higher infection rate of group A rotavirus was detected in children younger than five years of age with acute diarrhea in sentinel hospitals in Henan province, including part-mixed infection cases. A predominance of cases was detected in the autumn, and secondly the spring of each year. Gene type G9P[8] was most frequently isolated. The majority of patients displayed no fever, vomiting or dehydration. The cases with clinical symptoms of fever, diarrhea, vomiting and dehydration often showed mild disease.

Isolation and Characterization of a Moderately Virulent Classical Swine Fever Virus Emerging in China.

Classical swine fever (CSF) is a devastating infectious disease of pigs caused by classical swine fever virus (CSFV). In China, CSF has been under control owing to extensive vaccination with the lapinized attenuated vaccine (C-strain) since 1950s, despite sporadic or endemic in many regions. However, recently, CSF outbreaks occurred in a large number of swine herds in China. Here, we isolated 15 CSFV strains from diverse C-strain-vaccinated pig farms in China and characterized the genetic variations and antigenicity of the new isolates. The new strains showed unique variations in the E2 protein and were clustered to the subgenotype 2.1d of CSFV recently emerging in China in the phylogenetic tree. Cross-neutralization test showed that the neutralizing titres of porcine anti-C-strain sera against the new isolates were substantially lower than those against both the highly virulent Shimen strain and the subgenotype 2.1b strains that were isolated in China in 2006 and 2009, respectively. In addition, experimental animal infection showed that the HLJZZ2014 strain-infected pigs displayed lower mortality and less severe clinical signs and pathological changes compared with the Shimen strain-infected pigs. The HLJZZ2014 strain was defined to be moderately virulent based on a previously established assessment system for CSFV virulence evaluation, and the virus shedding and the viral load in various tissues of the CSFV HLJZZ2014 strain-infected pigs were significantly lower than those of the Shimen strain-infected pigs. Taken together, the subgenotype 2.1d isolate of CSFV is a moderately virulent strain with molecular variations and antigenic alterations.

[Surveillance for viral diarrhea in sentinel hospitals in Henan province, 2013-2015].

Objective: To investigate the infection status of human rotavirus, calicivirus, astrovirus and enteric adenovirus in children aged <5 years in disease surveillance areas in Henan province from 2013 to 2015. Methods: A total of 880 stool samples were collected from four sentinel hospitals and group A rotavirus was detected by ELISA and group A rotavirus G/P genotyping was performed with nested multiplex RT-PCR, while rotavirus (group B, C), calicivirus and astrovirus were detected by two-step multiplex RT-PCR and adenovirus were detected by PCR. The epidemiological data of positive cases were statistically analyzed. Results: A total of 594 positive samples were detected, including 24 mixed infection samples, 370 rotavirus positive samples (42.0%); 162 calicivirus positive samples (18.4%); 69 astrovirus positive samples (7.8%) and 17 enteric adenovirus positive samples (1.9%). The overall positive rate of four viruses was significantly higher in urban area than in rural area, but the positive rate of rotavirus was higher in males than in females and in younger age group than in older age group. G9P [8] was the major genotype of group A rotavirus, there were two seasonal infection peaks in autumn and spring. Norovirus Ⅱ was the predominant type of calicivirus and the infection peak was in spring. Viral diarrhea cases were distributed in different age groups, mainly in age groups 0-12 months (rotavirus) and 3-5 years (calicivirus). The main clinical symptoms included fever, diarrhea and vomiting. The etiological characteristics differed with gender and area. Conclusions: The infection rate of diarrheal viruses was higher in young children <5 years old in disease surveillance areas. The epidemiological and clinical features varied with the type of pathogen.

[Distribution and molecular type of Salmonella from external environment in Henan province].

Objective: To understand the distribution of Salmonella in external environment in Henan province, and explore the distribution of different serotypes of the Salmonella and their homology. Methods: A total of 4 488 samples were collected form animal dung, meat products and kitchen utensils, and identified by biochemical tests and serotyped by serum agglutination reaction. The predominant serotypes were further typed by PFGE. Results: A total of 324 Salmonella strains were detected in these samples, the detection rate was 7.21%. The 324 Salmonella isolates belonged to 39 serotypes, S. enteritidis (24.07%, 78/324) and S. derby (20.37%, 66/324) were predominant. Forty six strains of S. enteritidis and 30 strains of S. derby were divided into 12 and 17 molecular patterns by digestion with Xba Ⅰ, while chicken and swine were the predominant animal hosts. Conclusions: Serotyping of external environment Salmonella were phenotypically diverse and the serotype of Salmonella from different sources were different. The same clone was prevalent in same area. It is necessary to strengthen supervision and surveillance to ensure food safety.

[Etiology and drug resistance of non-typhi Salmonella in Henan province, 2011-2015].

Objective: To analyze the serotypes and antibiotic resistance phenotypes of non-typhi Salmonella strains in Henan province from 2011 to 2015. Methods: The stool samples were collected from diarrhea patients, and enriched with SBG enrichment broth and the pathogen isolation was conducted with CHROMAgar selective culture medium at 37 ℃ for 18-24 hours using KIA/MIU biochemical action and API20E biochemical system slab to identify Salmonella strains. The serotypes of all the positive strains were detected with SSI Salmonella typing sera. According to K-B drug susceptibility testing method published by USA clinical and Laboratory Standards Institute (CLSI), the antibiotics resistant phenotype of the positive strains were analyzed. Results: A total of 1 351 strains of non-typhi Salmonella were isolated, in which 811 were from males, 540 were from females. The ratio of men to women was 1.5∶1. Children and young adults were mainly affected. The pathogen isolation was mainly in May-October during a year. The 1 351 strains of non-typhi Salmonlla were divided into 58 serotypes. S. enteritidis, S. typhimurium, S. agona, S. derby, S. indiana, S. senftenberg and S. thompson ranked 1st-7th. The drug-resistance rate of the 1 351 strains was 46.1% to synthetic broad-spectrum penicillin ampicillin (AMP), 19.5% and 21.2% to the three generation cephalosporin ceftazidime (CAZ) and cefotaxime (CTX), 8.8% to the four generation cephalosporins cefepime (FEP), 58.7% to the one generation of quinolones nalidixic acid (NAL), 14.7% to the three generation fluoroquinolone ciprofloxacin (CIP) and norfloxacin (NOR), 25.0% and 35.6% to aminoglycoside antibiotic gentamicin (GEN) and streptomycin (STR), 35.4% to amphenicols (CHL), 31.7% to sulfonamide trimethoprim (TMP) and 37.8% to tetracycline (TET). Totally 879 strains were multidrug resistant (65.1%): 350 strains were resistant to 3-4 kinds of antibiotics (25.9%), 309 strains were resistant to 5-7 kinds of antibiotics (22.9%), 174 strains were resistant to 8-10 kinds of antibiotics (12.9%) and 48 strains were resistant to 11-12 kinds of antibiotics (3.6%). Conclusion: The serotypes of non-typhi Salmonella strains isolated from Henan province varied, some strains were resistant to 12 kinds of antibiotics commonly used in clinical treatment and the multidrug resistance has become serious.

[The etiological and molecular typing research of diarrheagenic Escherichia coli in Henan province in 2013].

OBJECTIVE: To analyze the distribution and pulsed field gel electrophoresis (PFGE) patterns of five kinds of diarrheagenic Escherichia coli (DEC) in infected diarrhea population of Henan province in 2013. METHODS: Gathering 1 037 strains of E. coli of 1 037 diarrhea patients from four sentinel hospitals of multi-pathogen monitoring system in Henan province in 2013. Stool samples were cultured with Mac agar plates and using KIA/MIU biochemical action as the preliminary method to identify E. coli strains; preparation of DNA template with thermal cracking method and using multiplex PCR to detect five kinds of DEC. According to molecular typing method published by the international PulseNet bacterial infectious disease monitoring network, the PFGE molecular characteristics of DEC strains were analyzed. RESULTS: 125 DEC positive strains were detected in 1 037 strains of E. coli, the total detection rate was 12.05%. 90 strains were enteroaggregative E.coli (EAEC), detection rate was 8.68% (n=90); 24 strains were enteropathogenic E.coli (EPEC), detection rate was 2.31%; 7 strains were enteroinvasive E.coli (EIEC), detection rate was 0.68%; 4 strains were enterotoxigenic E.coli (ETEC), detection rate was 0.39%; enterohemorrhagic E.coli (EHEC) was not detected. 639 cases of diarrhea samples were collected from male patients, 398 cases were from female patients, 94 positive cases were from male patients, the detection rate was 14.71%.The positive number of female cases were 31 cases, the detection rate was 7.79%. 97 positive cases were detected from 782 countryside cases and 28 positive cases were detected from 255 urban area cases, with detection rate 12.40% and 10.98% respectively. In 125 cases of DEC positive samples, children below 5 years old were 83 cases, accounting for 66.4%; 53 strains of EAEC were divided into 52 molecular patterns by digestion with XbaⅠ and pulsed field gel electrophoresis, each pattern contained 1-2 strains with similarity ranged from 66.3%-100%; 18 strains of EPEC were divided into 18 molecular patterns, each pattern contains 1 strain with similarity ranged from 72.6%-94.8%; 5 strains of EIEC were divided into 5 molecular patterns, each pattern contains 1 strain with similarity ranged from 71.9%-98.5%. 2 strains of ETEC were divided into 2 molecular patterns and similarity below 70%. CONCLUSION: Through the research we could find that four kinds of DEC as a pathogenic bacteria took an important component in pathogenic spectrum of bacterial diarrhea of Henan province in 2013. Four kinds of DEC carrying different virulence genes and taking multiple PFGE patterns showed diversity and complexity characteristics.

[Drug tolerance and PFGE molecular typing of Salmonella paratyphi A isolated in Dengfeng, Henan province, 2009-2015].

OBJECTIVE: To investigate the drug tolerance and PFGE patterns of Salmonella(S.)paratyphi A strains isolated from sentinel hospitals in Dengfeng, Henan province, during 2009-2015. METHODS: Venous blood samples were collected from paratyphoid patients and cultured in double phase blood culture bottle. Suspicious strains were identified and used for Salomonella. O antigen and H1/2 phase flagellum-induced serum agglutination test with API20E biochemical systems and SSI Salmonella typing sera. According to Salmonella molecular typing and K-B drug susceptibility testing method published by PulseNet China bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute, we analyzed the drug susceptibility and PFGE molecule characteristics of S. paratyphi A strains isolated from the patients. RESULTS: A total of 126 strains of S. paratyphi A were isolated from 248 blood samples, the antigen modes of them were 1, 2, 12:a:-. The resistance rate of 126 strains of S. paratyphi A was 83.3% to ampicillin; 29.4% to ceftazidime, 31.2% to cefotaxime, 17.5% to cefepime; 62.6% to nalidixic acid; 19.3% to ciprofloxacin, 26.4% to norfloxacin; 22.8% to gentamicin, 47.9% to streptomycin; 19.2% to chloramphenicol, 24.2% to methicillin benzyl ammonium, 58.6% to compound sulfamethoxazole and 46.7% to tetracycline. The 126 strains of S. paratyphi A had different levels of resistance to 8 kinds of antibiotics, 109 strains were multidrug resistant(86.5%), 9 strains were resistant to 2-3 kinds of antibiotics(7.1%), 76 strains were resistant to 5-8 kinds of antibiotics(60.3%), 17 strains were resistant to 9-10 kinds of antibiotics(13.5%), 7 strains were resistant to 11-12 kinds of antibiotics(5.6%). The 126 strains of S. paratyphi A were divided into 14 molecular patterns by digestion with XbaⅠand pulsed field gel electrophoresis. The antibiotics resistance to third generation cephalosporin(CAZ, CTX), one generation and three generation of quinolones(NAL, CIP, NOR)and aminoglycosides antibiotics(STR)showed an upward trend. Each pattern contained 1-98 strains with similarity ranged from 64.10% to 100.00%. PTYA 1, 6, 9 and 10 were the main PFGE belt types. CONCLUSION: The drug resistance of clinical isolates of S. paratyphi A was serious in Dengfeng, Henan province, PFGE patterns showed a diversity, but predominant patterns could also be found. The PFGE patterns of some strains had clustering and were related with their antidrug spectrums.

Comparative efficacy and safety of the left versus right radial approach for percutaneous coronary procedures: a meta-analysis including 6870 patients.

The radial approach is widely used in the treatment of patients with coronary artery disease. We conducted a meta-analysis of published results on the efficacy and safety of the left and right radial approaches in patients undergoing percutaneous coronary procedures. A systematic search of reference databases was conducted, and data from 14 randomized controlled trials involving 6870 participants were analyzed. The left radial approach was associated with significant reductions in fluoroscopy time [standardized mean difference (SMD)=-0.14, 95% confidence interval (CI)=-0.19 to -0.09; P<0.00001] and contrast volume (SMD=-0.07, 95%CI=-0.12 to -0.02; P=0.009). There were no significant differences in rate of procedural failure of the left and the right radial approaches [risk ratios (RR)=0.98; 95%CI=0.77-1.25; P=0.88] or procedural time (SMD=-0.05, 95%CI=0.17-0.06; P=0.38). Tortuosity of the subclavian artery (RR=0.27, 95%CI=0.14-0.50; P<0.0001) was reported more frequently with the right radial approach. A greater number of catheters were used with the left than with the right radial approach (SMD=0.25, 95%CI=0.04-0.46; P=0.02). We conclude that the left radial approach is as safe as the right radial approach, and that the left radial approach should be recommended for use in percutaneous coronary procedures, especially in percutaneous coronary angiograms.

Association of ulcerative colitis with TNF-related apoptosis inducing ligand (TRAIL) gene polymorphisms and plasma soluble TRAIL levels in Chinese Han population.

OBJECTIVE: The precise etiology of inflammatory bowel diseases (IBDs) is still unknown although dysregulation of apoptosis likely plays an important role in this pathogenesis. However, the significance of mucosal T-cell apoptosis in ulcerative colitis (UC) is unclear. In the present work we investigated the role of TNF-related apoptosis-inducing ligand (TRAIL), which is implicated in various human disorders. PATIENTS AND METHODS: Results from a total of 393 UC patients and 1292 healthy individuals were analyzed in this study. We determined the three single nucleotide polymorphisms of TRAIL in 3' untranslated regions (UTR), and examined the plasma soluble TRAIL (sTRAIL) levels by enzyme-linked immunosorbent assay. RESULTS: We found that the mutant genotypes of TRAIL (G1525A/G1588A/C1595T and G1525A and G1588A) were much lower in UC patients compared to the controls. Furthermore, mutant allele and genotype of TRAIL C1595T were more prevalent in severe UC patients than in other patients (p < 0.001; p = 0.005, respectively). The three polymorphic sites in 3'UTR were in a perfect linkage disequilibrium in our study. In contrast to controls, the GAT haplotype was increased (p < 0.001), while the AAT haplotype was decreased in UC patients (p < 0.001). Besides, the plasma levels of sTRAIL were significantly higher in UC patients than in controls (p < 0.001). CONCLUSIONS: Our findings suggested that increased occurrence of the genetic mutations of TRAIL in 3'UTR and possibly decreased plasma levels of sTRAIL might lead to a lower risk of UC attack in Chinese patients.

Polymorphism of estrogen receptor alpha (ESR1) is associated with virological response to entecavir (ETV) in nucleoside-naïve adult patients with chronic hepatitis B.

INTRODUCTION: Polymorphisms in estrogen receptor alpha (ESR1) are reported to be associated with the susceptibility to persistent HBV infection, HBV liver cirrhosis and HBV-related hepatocellular carcinoma (HCC). MATERIALS AND METHODS: To test the hypothesis that polymorphisms in estrogen receptor alpha (ESR1) might influence the virological response to entecavir (ETV) therapy, we examined two polymorphisms (PvuII and XbaI) in 76 nucleoside-naïve chronic hepatitis B (CHB) patients. All of the patients (52 HBeAg-positive and 24 HBeAg-negative) were treated with ETV 0.5 mg daily and followed up for a median time of 96 weeks (range 48-96). Polymorphisms were determined using the polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP) method. RESULTS: Under an additive model, the univariate analysis showed that patients carrying the PvuII T/C genotype might have higher virological responders than those carrying the T/T and C/C genotypes at week 48 (87.7 vs. 57.1 vs. 58.3 %; P = 0.012) and week 96 (96.7 vs. 64.3 vs. 24 87.5 %; P = 0.018), although this difference disappeared with the multiple analysis at week 48 [95 % confidence interval (CI) 0.687-3.841; P = 0.269] and week 96 (95 % CI 0.861-18.016; P = 0.077). Conversely, the univariate analysis suggests statistical significance between the recessive model of PvuII (TT vs. TC/CC) and virological response at week 48 (57.1 vs. 81.1 %; P = 0.033) and week 96 (64.3 vs. 94.7 %; P = 0.017). Multiple regression analysis affirmed the significant and independent association between the recessive model of PvuII and virological response. In other words, patients carrying at least one PvuII C allele (TC/CC) had a better likelihood of achieving virological response compared with those carrying the T/T genotype at week 48 (95 % CI 1.026-14.785, P = 0.046) and week 96 (95 % CI 1.456-57.509; P = 0.018). XbaI polymorphisms were not significantly associated with virological response. CONCLUSION: Our results suggest that the PvuII polymorphism may play an important role in determining ETV efficacy after 48 and 96 weeks of treatment, at least in this study population.

Increased CO(2) stimulates K/Rb reabsorption mediated by H-K-ATPase in CCD of potassium-restricted rabbit.

Apical H-K-ATPase in the cortical collecting duct (CCD) plays an important role in urinary acidification and K reabsorption. Our previous studies demonstrated that an H-K-ATPase mediates, in part, Rb reabsorption in rabbit CCD (Zhou X and Wingo CS. Am J Physiol Renal Fluid Electrolyte Physiol 263: F1134-F1141, 1992). The purpose of these experiments was to examine using in vitro microperfused CCD from K-restricted rabbits 1) whether an acute increase in PCO(2) and, presumably, intracellular acidosis stimulate K absorptive flux; and 2) whether this stimulation was dependent on the presence of a functional H-K-ATPase. Rb reabsorption was significantly increased after exposure to 10% CO(2) in CCD, and this effect was persistent for the entire 10% CO(2) period, whereas 10 microM SCH-28080 in the perfusate totally abolished the stimulation of Rb reabsorption by 10% CO(2). After stimulation of Rb reabsorption by 10% CO(2), subsequent addition of 0.1 mM methazolamide, an inhibitor of carbonic anhydrase, failed to affect Rb reabsorption. However, simultaneous exposure to 10% CO(2) and methazolamide prevented the stimulation of Rb reabsorption. Treatment with the intracellular calcium chelator MAPTAM (0.5 microM) inhibited the stimulation of Rb reabsorption by 10% CO(2). Similar inhibition was also observed in the presence of either a calmodulin inhibitor, W-7 (0.5 microM), or colchicine (0.5 mM), an inhibitor of tubulin polymerization. In time control studies, the perfusion time did not significantly affect Rb reabsorption. We conclude the following: 1) stimulation of Rb reabsorption on exposure to 10% CO(2) is dependent on the presence of a functional H-K-ATPase and appears to be regulated in part by the insertion of this enzyme into the apical plasma membrane by exocytosis; 2) insertion of H-K-ATPase requires changes in intracellular pH and needs a basal level of intracellular calcium concentration; and 3) H-K-ATPase insertion occurs by a microtubule-dependent process.