Analgesic effect of erector spinae plane block in adults undergoing laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Laparoscopic cholecystectomy is the gold standard surgical procedure for treating gallstone disease. Despite it being minimally invasive, various medications and methods are used to alleviate postoperative pain, and some patients still experience moderate-to-severe pain. This is a crucial problem that must be solved to avoid chronic pain. As part of postoperative multimodal analgesia, regional block is being increasingly applied in surgery under ultrasound guidance. We aimed to evaluate the analgesic effect of erector spinae plane block in adult patients undergoing laparoscopic cholecystectomy. METHODS: PubMed, Cochrane Library, EMBASE, and Web of Science were searched for randomized controlled trials investigating the efficacy of erector spinae plane block on postoperative pain after laparoscopic cholecystectomy. The primary outcome was the postoperative pain score. The secondary outcomes were the cumulative intraoperative and postoperative opioid consumption at 24 h, incidence of postoperative nausea and vomiting, and shoulder pain after surgery. The results were pooled using the fixed- or random-effects model with Review Manager 5.3. RESULTS: Fifteen randomized controlled trials involving 947 patients were included in the analysis. Postoperative pain score in the erector spinae plane block group was lower than that in the control group at postoperative 12 h (MD - 0.81, 95% CI - 1.1 to - 0.51, p < 0.00001) and 24 h (MD - 0.41, 95% CI - 0.62 to - 0.19, p = 0.0002). Cumulative opioid consumption was lower in the erector spinae plane block group than in the control group at postoperative 24 h (MD - 7.88, 95% CI - 10.17 to - 5.58, p < 0.00001). The erector spinae plane block group also experienced a lower incidence of postoperative nausea and vomiting than the control group. Opioid consumption and the incidence of postoperative nausea and vomiting were similar between the erector spinae plane block group and other block groups, including the oblique subcostal transversus abdominis plane block and quadratus lumborum block groups. CONCLUSIONS: Ultrasound-guided erector spinae plane block provides effective postoperative analgesia in adults undergoing laparoscopic cholecystectomy.

Exploring effective network design for monitoring soil pH and potentially toxic elements based on geochemical surveys in economically developed area.

Periodically visiting soil monitoring sites, i.e., sampling and analysis, is recognized as one of the most important ways to monitor soil quality. However, reconciling the monitoring costs with monitoring precision of the soil monitoring network (SMN) is a key technical problem to be solved. A statistically sound method, which depends on the spatial variation in monitoring indicators, was adopted to determine the number of monitoring sites and the monitoring interval as well as their ability to detect a particular change under an economically feasible scenario. The spatial variation in soil monitoring indicators was inquired from the "Multi-Purpose Regional Geochemical Survey in Zhejiang Province (MRGSZ)" project. Based on the data for soil pH and concentration of potentially toxic elements, the number of monitoring sites and the monitoring intervals that might be used for soil monitoring were determined with the administrative region as the monitoring unit. The results showed that there was great spatial variation in the MRGSZ region, which resulted in discrepancies in the minimum detectable changes (MDCs), monitoring site numbers, and temporal monitoring intervals for revisiting. Our research proposes a number of monitoring sites (nr) that could reconcile the monitoring costs, practicability and monitoring precision; thus, it was recommended for the design of SMNs. Under nr, the MDC values of each monitoring indicator were acceptable for all administrative regions, and the temporal monitoring intervals were practical with variations of 6.7-14.8 years.

Long-term orientation and demographics predict the willingness to quarantine: A cross-national survey in the first round of COVID-19 lockdown.

To be or not to be quarantined? That is the question posed by COVID-19 pandemic to almost every resident in the world. Approximately three months after the first application of the COVID-19 lockdown to residents in 17 Asian, African, European, American, and Oceanian countries, we carried out a cross-national survey of 26,266 residents via online platforms such as Sojump and Prolific to investigate their willingness to quarantine and its influencing factors. Findings show that 1) The willingness to quarantine is low in countries with high long-term orientation; 2) Females are more willing to be quarantined than males; 3) Gender difference on willingness to quarantine is large among people with older age and low education. Theoretical and managerial implications are discussed. Understanding how culture and demographics affect people's willingness to quarantine not only provides insight into how to respond to the current pandemic, but also helps the world prepare for future crises.

Expression and prognostic roles of PRDXs gene family in hepatocellular carcinoma.

BACKGROUND: As the fourth leading cause of cancer-related death in the world, the therapeutic effect and 5-year overall survival of hepatocellular carcinoma (HCC) are not optimistic. Previous researches indicated that the disorder of PRDXs was related to the occurrence and development of cancers. METHODS: In this study, PRDXs were found in various tumor cell lines by CCLE database analysis. The analysis results of UALCAN, HCCDB and Human Protein Atlas databases showed the expression of PRDXs mRNA and protein in HCC tissues was dysregulated. Besides, UALCAN was used to assess the correlations between PRDXs mRNA as well as methylation levels and clinical characterization. RESULTS: High expression of PRDX1 or low expression of PRDX2/3 suggested poor prognosis for HCC patients which was demonstrated by Kaplan-Meier Plotter. The genetic alterations and biological interaction network of PRDXs in HCC samples were obtained from c-Bioportal. In addition, LinkedOmics was employed to analyze PRDXs related differentially expressed genes, and on this basis, enrichment of KEGG pathway and miRNAs targets of PRDXs were conducted. The results indicated that these genes were involved in several canonical pathways and certain amino acid metabolism, some of which may effect on the progression of HCC. CONCLUSIONS: In conclusion, the disordered expression of some PRDX family members was associated with the prognosis of HCC patients, suggesting that these PRDX family members may become new molecular targets for the treatment and prognosis prediction of HCC.

Occurrence and distribution of per- and polyfluoroalkyl substances (PFASs) in human livers with liver cancer.

Per- and polyfluoroalkyl substances (PFASs) are anthropogenic compounds that are widely accumulated in human tissues, and the liver is considered a primary target organ for PFASs exposure. The occurrence and distribution of 21 PFASs in liver tissues with tumors (n = 55) and without tumors (n = 55) are investigated in this study. Eleven perfluorinated carboxylic acids (PFCAs) and five perfluorinated sulfonic acids (PFSAs) were detected at high frequencies (45.5%-100 %), while the detection frequencies of five perfluoroalkyl phosphate (PFPAs) were relatively lower (≤29.1 %). PFSAs and PFCAs accounted for up to 82.5%-92.7 % of the total PFASs. Although it was not found to be statistically significant, the concentrations of the total PFASs were slightly higher in the tumor liver samples (mean 64.3, range 5.70-303 ng/g) than those in the non-tumor liver samples (mean 62.7, range 4.08-240 ng/g).The perfluorooctanoic acid (PFOA), perfluorotridecanoic acid (PFTrDA), and perfluorobutanesulphonate (PFBS) showed significant differences (p < 0.05) between the tumor and non-tumor liver samples, and the different distribution levels of these three PFASs may have been a consequence of oxidative stress. The total concentrations of PFASs in the three age groups were in the decreasing order of middle-aged people (45-60) > old people (>60) > young people (<45). The PFASs in females were generally lower than in males, which may have been related to women's special excretion methods (such as childbirth and breastfeeding). The results should be valuable for further mechanistic studies regarding the toxic effects of PFASs in human livers.

Identification of CELSR2 as a novel prognostic biomarker for hepatocellular carcinoma.

BACKGROUND: CELSR2 is postulated to be a receptor involved in contact-mediated communication; however, the specific function of this particular member has not been determined in hepatocellular carcinoma (HCC). METHODS: Here, we explored the expression and function of CELSR2 in HCC patients through data mining and examined the results using clinical samples and in vitro experiments. RESULTS: It was found that CELSR2 mRNA and protein expression levels were significantly higher in cancerous tissue than in normal tissue. The increased mRNA expression of CELSR2 was significantly associated with overall survival (OS) in HCC patients. Moreover, the genetic alteration rate of CELSR2 gene in HCC can reach 8%, and these alterations would deeply influence its neighboring genes, then jointly affecting the occurrence and development of tumor through cell adhesion and numerous common carcinogenic pathways. Our in vitro results indicated that the depletion of CELSR2 inhibited liver cancer cell proliferation and invasion. Univariate and multivariate Cox regression analyses showed that CELSR2 could be viewed as an independent risk factor for HCC patients. CONCLUSIONS: This study demonstrated that data mining could efficiently reveal the roles of CELSR2 in HCC and its potential regulatory networks. The CELSR2 protein level may serve as a novel prognostic biomarker for HCC.

The CatLet score and outcome prediction in acute myocardial infarction for patients undergoing primary percutaneous intervention: A proof-of-concept study.

BACKGROUND: The Coronary Artery Tree description and Lesion EvaluaTion (CatLet) score accommodating the variability in coronary anatomy is a recently developed and comprehensive angiographic scoring system aimed at assisting in risk-stratification of patients with coronary artery disease. However, a validation of this angiographic scoring system is lacking. METHODS: The CatLet score was calculated retrospectively in 308 consecutively enrolled patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention. The primary endpoint, major adverse cardiac or cerebrovascular events (MACCEs), was stratified according to CatLet tertiles: CatLetlow ≤14 (n = 124), CatLetmid 15-21 (n = 82) and CatLettop ≥22 (n = 102). RESULTS: The CatLet score alone or after adjusting for a broad spectrum of risk factors, significantly predicted clinical outcomes at a median 4.3-year follow-up. Multivariable-adjusted hazard ratios (95%CI)/unit higher score were 1.05 (1.04-1.07) for MACCE, 1.06 (1.04-1.07) for cardiac death, and 1.05 (1.04-1.07) for all-cause death. When compared to the SYNTAX score, improved discrimination and better calibration of this CatLet score resulted in a significantly refined risk stratification. The overall category-free net reclassification improvement afforded by this CatLet score was as follows: 37.2% (p = .008) for MACCEs, 35.5% (p = .0249) for cardiac death, and 31.8% (p = .0316) for all-cause death. CONCLUSIONS: The ability to integrate the variability in coronary anatomy into angiographic scoring makes the CatLet score a more specific tool for outcome predictions in AMI. (http://www.chictr.org.cn. Unique identifiers: ChiCTR-POC-17013536).

Molecular epidemiological surveillance of Africa and Asia imported malaria in Wuhan, Central China: comparison of diagnostic tools during 2011-2018.

BACKGROUND: Malaria remains a serious public health problem globally. As the elimination of indigenous malaria continues in China, imported malaria has gradually become a major health hazard. Well-timed and accurate diagnoses could support the timely implementation of therapeutic schedules, reveal the prevalence of imported malaria and avoid transmission of the disease. METHODS: Blood samples were collected in Wuhan, China, from August 2011 to December 2018. All patients accepted microscopy and rapid diagnosis test (RDT) examinations. Subsequently, each of the positive or suspected positive cases was tested for four human-infectious Plasmodium species by using 18S rRNA-based nested PCR and Taqman probe-based real-time PCR. The results of the microscopy and the two molecular diagnostic methods were analysed. Importation origins were traced by country, and the prevalence of Plasmodium species was analysed by year. RESULTS: A total of 296 blood samples, including 288 that were microscopy and RDT positive, 7 RDT and Plasmodium falciparum positive, and 1 suspected case, were collected and reanalysed. After application of the two molecular methods and sequencing, 291 cases including 245 P. falciparum, 15 Plasmodium vivax, 20 Plasmodium ovale, 6 Plasmodium malariae and 5 mixed infections (3 P. falciparum + P. ovale, 2 P. vivax + P. ovale) were confirmed. These patients had returned from Africa (95.53%) and Asia (4.47%). Although the prevalence displayed a small-scale fluctuation, the overall trend of the imported cases increased yearly. CONCLUSIONS: These results emphasize the necessity of combined utilization of the four tools for malaria diagnosis in clinic and in field surveys of potential risk regions worldwide including Wuhan.

Improving spatial prediction of health risk assessment for Hg, As, Cu, and Pb in soil based on land-use regression.

Heavy-metal pollution is a significant health and environmental concern in areas of rapid industrialization in China. The accuracy of spatial mapping of pollutant is the main constraint on spatial prediction of health risks. Our study addressed the possibility of improving spatial prediction accuracy of risk assessment. We developed land-use regression (LUR) models for Hg, As, Cu, and Pb based on surface soil sampling, land-use data, and soil properties. The regression results suggested that LUR was more accurate than ordinary kriging method. Spatial prediction accuracy of Hg, As, Cu, and Pb were improved by 15%, 59%, 36%, and 20%, respectively. Then, spatial distribution of health risk was assessed by using distributions of heavy metal and exposure parameters. Chronic risk of children was controlled by distribution of Pb and carcinogenic controlled by As. The result indicated that Pb and As were the main sources of health risk for children in Kunshan. Chronic and carcinogenic risk maps could clearly show where we should pay attention to and control the risk. This study provided a simple approach to draw spatially explicit maps of health risk which were useful for pollution control and public health risk management.

Analysis of Plasmodium falciparum Na+/H+ exchanger (pfnhe1) polymorphisms among imported African malaria parasites isolated in Wuhan, Central China.

BACKGROUND: Quinine (QN) remains an effective drug for malaria treatment. However, quinine resistance (QNR) in Plasmodium falciparum has been reported in many malaria-endemic regions particularly in African countries. Genetic polymorphism of the P. falciparum Na+/H+ exchanger (pfnhe1) is considered to influence QN susceptibility. Here, ms4760 alleles of pfnhe1 were analysed from imported African P. falciparum parasites isolated from returning travellers in Wuhan, Central China. METHODS: A total of 204 dried-blood spots were collected during 2011-2016. The polymorphisms of the pfnhe1 gene were determined using nested PCR with DNA sequencing. RESULTS: Sequences were generated for 99.51% (203/204) of the PCR products and 68.63% (140/204) of the isolates were analysed successfully for the pfnhe1 ms4760 haplotypes. In total, 28 distinct ms4760 alleles containing 0 to 5 DNNND and 1 to 3 NHNDNHNNDDD repeats were identified. For the alleles, ms4760-1 (22.86%, 32/140), ms4760-3 (17.86%, 25/140), and ms4760-7 (10.71%, 15/140) were the most prevalent profiles. Furthermore, 5 undescribed ms4760 alleles were reported. CONCLUSIONS: The study offers an initial comprehensive analysis of pfnhe1 ms4760 polymorphisms from imported P. falciparum isolates in Wuhan. Pfnhe1 may constitute a good genetic marker to evaluate the prevalence of QNR in malaria-endemic and non-endemic regions.

TRIM29 prevents hepatocellular carcinoma progression by inhibiting Wnt/ß-catenin signaling pathway.

TRIM29 plays an important role in many neoplasms. In this study, we aimed to elucidate its role in hepatocellular carcinoma (HCC) and explore the corresponding potential mechanism. The expression level of TRIM29 in HCC samples and hepatoma cell lines was detected. We found that TRIM29 was down-regulated in clinical HCC samples and cultured hepatoma cell lines by western blot analysis and quantitative polymerase chain reaction. In addition, we demonstrated that higher TRIM29 expression was associated with higher differentiation grade of HCC. To explore the effect of TRIM29 on hepatoma cells and its possible mechanisms, TRIM29-knockdown and overexpression cell models were constructed. The results showed that the depletion of TRIM29 promoted liver cancer cell proliferation, clone formation, migration and invasion in vitro probably through the Wnt/ß-catenin signaling pathway. This study revealed the inhibitory roles of TRIM29 in HCC and the possible mechanisms.

Antiviral therapy predicts the outcomes following resection of hepatocellular carcinoma in patients negative for HBV DNA: a propensity score matching analysis.

BACKGROUND: The effect of antiviral therapy (AVT) on clinical outcomes in patients with hepatocellular carcinoma (HCC) who are seronegative for hepatitis B virus (HBV), defined as HBV DNA < 100 IU/ml prior to surgical resection, is unknown. The main purpose of this study was to evaluate the possible value of AVT in this cohort of patients. METHODS: From January 2006 to January 2013, 161 HCC patients with positive serum tests for HBV surface antigen (HBsAg) but negative tests for HBV DNA who had undergone hepatectomy were included and analyzed. Propensity score matching (PSM) was used to balance the heterogeneity in baseline characteristics. RESULTS: All patients were divided into the following two groups: the AVT group (n = 73, 45.34%) and the non-AVT group (n = 88, 54.66%). HBV reactivation occurred in 20 patients in the non-AVT group (22.73%) but in only 2 patients in the AVT group (2.74%, p < 0.001). After PSM, the 1-, 2-, and 3-year recurrence-free survival (RFS) rates in the AVT group and the non-AVT group were 78.38%, 72.97%, and 62.16% and 81.08%, 72.97%, and 72.97%, respectively (p = 0.564); the 1-, 2-, and 3-year overall survival (OS) rates were 97.30%, 97.3%, and 91.89% and 94.59%, 94.59%, and 86.49% in the AVT group and non-AVT group, respectively (p = 0.447). CONCLUSIONS: Antiviral therapy can reduce HBV reactivation but is not correlated with a significant increase in postoperative RFS and OS in HCC patients with HBV DNA levels < 100 IU/ml.

Surveillance of Genetic Variations Associated with Antimalarial Resistance of Plasmodium falciparum Isolates from Returned Migrant Workers in Wuhan, Central China.

Antimalarial drug resistance developed in Plasmodium falciparum has become a problem for malaria control. Evaluation of drug resistance is the first step for effective malaria control. In this study, we investigated the gene mutations of P. falciparum using blood samples from returned Chinese migrant workers in order to identify drug resistance-associated molecular markers. These workers returned from Africa and Southeast Asia (SEA) during 2011 to 2016. Polymorphisms in pfcrt, pfmdr1, and k13-propeller genes and the haplotype patterns of Pfcrt and Pfmdr1 were analyzed. The results showed the presence of four haplotypes of Pfcrt codons 72 to 76, including CVMNK (wild type), SVMNT and CVIET (mutation types), and CV M/I N/E K/T (mixed type), with 50.57%, 1.14%, 25.00%, and 23.30% prevalence, respectively. For Pfmdr1, N86Y (22.28%) and Y184F (60.01%) were the main prevalent mutations (mutations are underlined). The prevalence of mutation at position 550, 561, 575, and 589 of K13-propeller were 1.09%, 0.54%, 0.54%, and 0.54%, respectively. These data suggested that Pfcrt, Pfmdr1, and K13-propeller polymorphisms are potential markers to assess drug resistance of P. falciparum in China, Africa, and SEA.

Imaging the Infant Chest without Sedation: Feasibility of Using Single Axial Rotation with 16-cm Wide-Detector CT.

Purpose To compare image quality, patient preparation time, and radiation dose using a single axial rotation with 16-cm wide-detector computed tomography (CT) in imaging the infant chest without sedation with those in infants examined by using a 64-row CT and sedation. Materials and Methods Thirty-two infants (group 1) were prospectively enrolled to undergo nonenhanced chest CT without sedation using a single axial rotation on a 16-cm wide-detector CT scanner. Patients were imaged with automatic tube current modulation and tube voltages of 80 kVp for patients weighing 5 kg or less and 100 kVp for patients weighing more than 5 kg. Patient preparation time, CT dose index (CTDI), dose-length product (DLP), and image quality were compared with those in a historical control group consisting of 30 infants (group 2) who underwent conventional helical scanning with sedation performed by using a 64-row volume CT scanner. The Student t test for independent samples was used to assess continuous variables. The Mann-Whitney rank test and the κ test were used to evaluate image quality. Results There was no statistically significant difference in body weight, age, mean CT attenuation value, image noise, and subjective image quality score between the two groups. However, compared with the group scanned by using a 64-row volume CT scanner (group 2), group 1 experienced significantly reduced scan time by 83% (0.35 second vs 2.01 seconds ± 0.21 [standard deviation]), preparation time by 57% (41.25 minutes ± 103.78 vs 96.5 minutes ± 151.77), CTDI by 42% (2.03 mGy ± 0.4 vs 3.52 mGy ± 0.03), and DLP by 52% (27.07 mGy·cm ± 6.97 vs 55.84 mGy·cm ± 6.46) (P < .05 for all). Conclusion Compared with conventional 64-row helical CT with sedation, use of a single axial rotation with 16-cm wide-detector CT in imaging the infant chest without sedation can reduce radiation dose, preparation time, and total scan time, while providing comparable image quality. © RSNA, 2017.

Measurement of Serum and Hepatic Eicosanoids by Liquid Chromatography Tandem-Mass Spectrometry (LC-MS/MS) in a Mouse Model of Hepatocellular Carcinoma (HCC) with Delivery of c-Met and Activated ß-Catenin by Hepatocyte Hydrodynamic Injection.

BACKGROUND Most forms of cancer, including hepatocellular carcinoma (HCC), are associated with varying degrees of chronic inflammation. The association between the expression of eicosanoids, which are bioactive lipid mediators of inflammation, and HCC remains unknown. The aim of this study was to measure serum and hepatic eicosanoids in a mouse model of HCC with the delivery of c-Met and activated b-catenin by hepatocyte hydrodynamic injection. MATERIAL AND METHODS The HCC mouse model, and normal control mice, were used in this study with co-delivery of human c-Met combined with activated ß-catenin into hepatocytes through hydrodynamic injection. Liquid chromatography tandem-mass spectrometry (LC-MS/MS) analysis was used to measure serum and hepatic eicosanoid levels. RESULTS The combined activation of c-Met and ß-catenin was induced in the HCC mouse model. LC-MS/MS showed that a total of 13 eicosanoids in serum and 12 eicosanoids in liver tissue were significantly increased in the HCC mice, when compared with control mice. CONCLUSIONS In a mouse model of HCC, co-activation of the c-Met and ß-catenin signaling pathway resulted in increased levels of serum and hepatic eicosanoids.

Associating liver partition and portal vein ligation for staged hepatectomy versus conventional two-stage hepatectomy: a systematic review and meta-analysis.

BACKGROUND: It is generally accepted that an insufficient future liver remnant is a major limitation of large-scale hepatectomy for patients with primary hepatocellular carcinoma. Conventional two-stage hepatectomy (TSH) is commonly considered to accelerate future liver regeneration despite its low regeneration rate. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), which is characterized by a rapid regeneration, has brought new opportunities. METHODS: Relevant studies were identified by searching the selected databases up to September 2017. Then, a meta-analysis of regeneration efficiency, complication rate, R0 resection ratio, and short-term outcomes was performed. RESULTS: Ten studies, comprising 719 patients, were included. The overall analysis showed that ALPPS was associated with a larger hyperplastic volume and a shorter time interval (P < 0.00001) than TSH. ALPPS also exhibited a higher completion rate for second-stage operations (odds ratio, OR 9.50; P < 0.0001) and a slightly higher rate of R0 resection (OR 1.90; P = 0.11). Interestingly, there was no significant difference in 90-day mortality between the two treatments (OR 1.44; P = 0.35). CONCLUSIONS: These results indicate that compared with TSH, ALPPS possesses a stronger regenerative ability and better facilitates second-stage operations. However, the safety, patient outcomes, and patient selection for ALPPS require further study.

Melatonin mediates selenium-induced tolerance to cadmium stress in tomato plants.

Both selenium (Se) and melatonin reduce cadmium (Cd) uptake and mitigate Cd toxicity in plants. However, the relationship between Se and melatonin in Cd detoxification remains unclear. In this study, we investigated the influence of three forms of Se (selenocysteine, sodium selenite, and sodium selenate) on the biosynthesis of melatonin and the tolerance against Cd in tomato plants. Pretreatment with different forms of Se significantly induced the biosynthesis of melatonin and its precursors (tryptophan, tryptamine, and serotonin); selenocysteine had the most marked effect on melatonin biosynthesis. Furthermore, Se and melatonin supplements significantly increased plant Cd tolerance as evidenced by decreased growth inhibition, photoinhibition, and electrolyte leakage (EL). Se-induced Cd tolerance was compromised in melatonin-deficient plants following tryptophan decarboxylase (TDC) gene silencing. Se treatment increased the levels of glutathione (GSH) and phytochelatins (PCs), as well as the expression of GSH and PC biosynthetic genes in nonsilenced plants, but the effects of Se were compromised in TDC-silenced plants under Cd stress. In addition, Se and melatonin supplements reduced Cd content in leaves of nonsilenced plants, but Se-induced reduction in Cd content was compromised in leaves of TDC-silenced plants. Taken together, our results indicate that melatonin is involved in Se-induced Cd tolerance via the regulation of Cd detoxification.

[Mutations of Plasmodium falciparum Multidrug Resistance 1 Gene in Imported Plasmodium falciparum in Wuhan].

Objective: To identify Plasmodium falciparum multidrug resistance 1（Pfmdr1） point mutations in imported Plasmodium falciparum in Wuhan. Methods: Blood samples were collected from returnees infected with P. falciparum in endemic areas of Africa and Myanmar during 2010-2015 in Wuhan City. Nested PCR primers were specifically designed for Pfmdr1 gene loci 86, 1042 and 1246 of P. falciparum. The Pfmdr1 gene was then amplified by nested PCR, and the products were digested by restriction enzyme ApoⅠ, AseⅠ and EcoRⅤ, respectively. The mutation rate for loci 86, 1042 and 1246 was analyzed. Results A total of 187 patients with falciparum malaria were involved in the study. Pfmdr1 was amplified from all the blood samples. Restriction enzyme digestion revealed mutation rate of 19.3%（36/187）, 4.3% （8/187） and 9.6%（18/187） for loci 86, 1042 and 1246, respectively. In detail, the mutation rate for loci 86, 1042 and 1246 was 20.6%（36/175）, 2.9%（5/175） and 10.3%（18/175） respectively in the 175 samples from Africa, and only 3 cases with locus 1042 mutation were found in the 12 samples from Myanmar. Results: A total of 187 patients with falciparum malaria were involved in the study. Pfmdr1 was amplified from all the blood samples. Restriction enzyme digestion revealed mutation rate of 19.3%（36/187）, 4.3% （8/187） and 9.6%（18/187） for loci 86, 1042 and 1246, respectively. In detail, the mutation rate for loci 86, 1042 and 1246 was 20.6%（36/175）, 2.9%（5/175） and 10.3%（18/175） respectively in the 175 samples from Africa, and only 3 cases with locus 1042 mutation were found in the 12 samples from Myanmar. Conclusion: The loci 86, 1042 and 1246 mutations of Pfmdr1 have all been found in the samples from Africa, with only one point mutation （locus 1042） found in samples from Myanmar.

[Analysis of MSP1 Allelotypes in Imported Cases of Plasmodium falciparum Malaria from Africa].

OBJECTIVE: To understand the allelotype characteristics of the merozoite surface protein 1 (MSP1) in imported Plasmodium falciparum. METHODS: Blood samples were collected from P. falciparum-infected patients returning from African malaria endemic areas. Nested PCR was used to amplify gene fragments of MSP1 coding for block 2 and block 3 motifs of MSP1 of P. falciparum by using the MSP1-specific primers. Then the allelotype of MSPI was analyzed. RESULTS: The MSP1 allelotype was detected in 117 of 135 blood samples, with a detection rate of 86.7%. In the 117 cases with successful PCR amplification, the detection rates for MAD20, K1, RO33, MAD20+K1, MAD20+RO33, K1+RO33 and MAD20+K1+R033 were 6.0%(7/117), 36.8%(43/117), 20.5%(24/117), 6.8% (8/117), 3.4% (4/117), 17.1% (20/117) and 9.4% (11/117), respectively, wherein the mixed infection accounted for 36.8%(43/135). The mean multiplicity of infection(MOI) of MSP1 allelotype was 1.46. There was no significant difference in the proportion of patients with major severity of illness among the MAD20, K1 and RO33 genotypes. The proportions of patients with major severity of illness were 25.7%(19/74) and 32.6%(14/43) in 74 cases of singular infection and 43 cases of mixed infection, respectively. The two infection types of patients had 241 ± 176 days and 285 ± 216 days of stay abroad, with no significant difference between them. CONCLUSION: The three genotypes of MSP1 and their four types of combination exist in imported cases of P. falciparum malaria from Africa. K1 and RO33 are the dominant genotves.

[An analysis on Pf60.1 gene polymorphism of Plasmodium falciparum from imported cases].

One hundred and one imported falciparum malaria cases in Wuhan City were confirmed by microscopy and Nest-PCR, and the blood samples were collected. The Pf60.1 gene was amplified by PCR. Among 101 blood samples, three Pf60.1 fragments [313 bp (56.5%, 52/92), 340 bp (37.0%, 34/92), 313 bp+340 bp (6.5%, 6/92)] were amplified from 92 samples. Among 83 blood samples from patients returning from Africa, 313 bp fragment were found in 46 samples (55.4%, 46/83), 340 bp fragment were found in 31 samples (37.1%, 31/83), and 7.2% (6/83) was mixed-fragment (313 bp+340 bp). Among 9 samples from southeast Asia, 6 samples were with 313 bp fragment and 3 samples with 340 bp fragment. The results indicated that the most common genotype was 313 bp-genotype, and there would be polyclonal P. falciparum infections.