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The association among plasma trimethylamine-N-oxide (TMAO), FMO3 polymorphisms, and chronic heart failure (CHF) remains to be elucidated. TMAO is a microbiota-dependent metabolite from dietary choline and carnitine. A prospective study was performed including 955 consecutively diagnosed CHF patients with reduced ejection fraction, with the longest follow-up of 7 years. The concentrations of plasma TMAO and its precursors, namely, choline and carnitine, were determined by liquid chromatography-mass spectrometry, and the FMO3 E158K polymorphisms (rs2266782) were genotyped. The top tertile of plasma TMAO was associated with a significant increment in hazard ratio (HR) for the composite outcome of cardiovascular death or heart transplantation (HR = 1.47, 95% CI = 1.13-1.91, P = 0.004) compared with the lowest tertile. After adjustments of the potential confounders, higher TMAO could still be used to predict the risk of the primary endpoint (adjusted HR = 1.33, 95% CI = 1.01-1.74, P = 0.039). This result was also obtained after further adjustment for carnitine (adjusted HR = 1.33, 95% CI = 1.01-1.74, P = 0.039). The FMO3 rs2266782 polymorphism was associated with the plasma TMAO concentrations in our cohort, and lower TMAO levels were found in the AA-genotype. Thus, higher plasma TMAO levels indicated increased risk of the composite outcome of cardiovascular death or heart transplantation independent of potential confounders, and the FMO3 AA-genotype in rs2266782 was related to lower plasma TMAO levels.
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Humanos , Carnitina , Colina/metabolismo , Doença Crônica , Insuficiência Cardíaca/genética , Metilaminas , Oxigenases , Estudos ProspectivosRESUMO
Objective This study was performed to investigate the infection of Lipopolysaccharide(LPS) and its downstream cytokine High-mobility Group Box 1(HMGB1)on the transcriptional regulation of macrophage polarization.Methods The murine macrophage cell line RAW246.7 was stimulated with LPS and HMGB1 respec-tively.The levels of M1 macrophage related mRNA(NOS2,TNF-α,IL-6)and M2 related mRNA(ARG-1,RELM-α)were determined by Q-PCR.Results The expression of M1 macrophage related mRNA(NOS2,IL-6,TNF-α) was significantly upregulated(P<0.01),while the M2 macrophage related mRNA(ARG-1,RELM-α)was down-regulated(P > 0.05)after the stimulation of LPS. Both the M1 and M2 related markers were upregulated at the mRNA level in HMGB1 stimulate group,and the upregulation of NOS2,TNF-α and RELM-α was statistically sig-nificant(P<0.01).Conclusions LPS induces the M1 polarization of murine macrophage,which involved in the inflammation reaction.HMGB1,as the downstream cytokine of LPS signaling,induces both M1/M2 polarization of murine macrophage. It′s inferred that HMGB1 intensifies periodontal inflammatory responses and,at the same time,involves the negative feedback mechanism in the responses to tissue remodeling.
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Objective To investigate the value of contrast-enhanced ultrasound (CEUS) in differential diagnosis of pancreatic pseudocysts,cystadenomas and cystadenocarcinomas,so as to improve diagnostic accuracy of the condition.Methods The results of CEUS and conventional ultrasound for 71 patients with pancreatic cystic lesions were analyzed retrospectively,and compared with the finally obtained surgical-pathological examination to assess the ability of qualitative diagnosis between two methods.Results In 71 pancreatic cystic lesions,there were 32 pancreatic pseudocysts,24 cystadenomas and 15 cystadenocarcinomas.The sensitivity and accuracy of CEUS for pancreatic pseudocysts and cystadenocarcinomas were 84.4％,93.0％ and 86.7％,88.7％,which were higher than those of conventional ultrasound 56.3 ％,80.3 ％ and 53.3 ％,74.6％ (x2 =6.06,4.92,3.97,4.71,all P ＜ 0.05).Conclusion There are some similarities in terms of imaging manifestations among pancreatic pseudocysts,cystadenomas and cystadenocarcinomas.Combining conventional ultrasound with CEUS can help the differential diagnosis of pancreatic cystic lesions.
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Objective To summarize the results of a new pancreaticojejunostomy technique designed to decrease incidence of pancreatic leakage in pancreatoduodenectomy.Methods The clinical data of 11 cases of pancreatoduodenectomy using remnant pancreatico-jejunum end-to-end anastomosis with external drainage of full pancreatic juice was analyzed retrospectively.Briefly,5-0 bioabsorbable suture was penetrated through the pancreatic stump and stent and then circulated the pancreatic stump for 2 circles and ligated.Octreotide was not administered in any cases post-operation.Results The operation was simple and timespared.Neither pancreatic leakage nor postoperative bleeding occurred in the cases.From 4 months to 3 years following operation,no other complications were found in all cases.Conclusions The method was safe,feasible and effective to decrease incidence of pancreatic leakage in pancreatoduodenectomy.
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BACKGROUND:Daily flushing of dental unit waterlines (DUWLs) is believed to be the least expensive and simplest method for reducing the level of microbial contamination in DUWLs.Authorities' guidelines suggest that high-speed handpieces should be run to discharge water for 30 seconds after use on each patient.However,the guideline is inaccurate for clinicians according to the time-dependent flushing since the maximum flow rate of flushing water varied from dental chair units (DCUs).OBJECTIVE:To assess the level of microbial contamination in water effluent from the air-water syringe and the high-speed handpiece line of DCUs and prevalence of three species of bacteria detected in DUWLs at each flushing volume.Thus,practical water flushing measures could be proposed according to the effect of volume-dependent dental unit waterline flushing on the microbial contamination in DUWLs.DESIGN,TIME AND SETTING:A cross-sectional investigation was designed and conducted in Guangdong Provincial Stomatological Hospital and Laboratory of Microbiology,School of Public Health and Tropical Medicine,Southern Medical University between May 2007 and March 2008.MATERIALS:The materials used in this investigation including nutrient agar,blood plates,biochemical testing kit,agglutination testing kit and Gram staining agents.These materials were supported by Guangdong Huankai Microbiological Science and Technology Ltd.METHODS:Water sampling was conducted at 80 DCUs in a stomatologicel hospital.A total of 6 mL,2 mL for once sampling,of continuous water flushing from the air-water syringe and the high-speed handpiece line of each DCU respectively were collected aseptically after the finish of the daily clinical work on every second Friday,between May 2007 and October 2007.Standard isolation and identification technique of bacteria was adopted.MAIN OUTCOME MEASURES:Concentration of bacteria and prevalence of three species of bacteria in water effluent from the air-water syringe and the high-speed handpiece line of DCUs at each flushing volume were evaluated.RESULTS:The median concentration of bacteria in water effluent from either the air-water syringe or the high-speed handpiece line of DCUs was 5.67×10~2 cfu/mL,and there were no statistical differences among microbial concentrations of first three 2-mL flushing water samples (P>0.05).Prevalence of Staphylococcus spp.from the third 2-mL flushing water sample demonstrated an obviously higher level than that of Staphylococcus spp.from the first two 2-mL (P < 0.05),while prevalence of Streptococcus spp.and Actinomycete spp.kept at a relative stable level (P > 0.05) at each flushing volume.CONCLUSION:Volume-dependent water flushing procedure stays a more practical measure for reducing microbial contamination in DUWLs rather than time-dependent flushing,but the volume of flushing water needs to be further evaluated.
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BACKGROUND: The presence of various microorganisms in dental unit waterlines has been revealed by numerous reports previously. However, impact of different dental procedures on microbial contamination in dental unit waterlines (DUWLs) remains unclearly.OBJECTIVE: To assess the level of microbial contamination in water effluent from the high-speed handpiece line of dental chair units (DCUs) among different specialty departments in a provincial stomatological hospital. Thus, to propose individual infection control measures for different specialty departments according to their properties of microbial contamination.DESIGN, TIME AND SETTING: A cross-sectional investigation was designed and conducted in Guangdong Provincial Stomatological Hospital and Laboratory of Microbiology, School of Public Health and Tropical Medicine, Southern Medical University, between May 2007 and March 2008.MATERIALS: The materials used in this investigation including nutrient agar, blood plates, biochemical testing kit, agglutination testing kit and Gram staining agents. These materials were purchased from Guangdong Huankai Microbial Science and Technology Co., Ltd.METHODS: Water sampling was conducted at 80 DCUs of different specialty departments in Guangdong Provincial Stomatological Hospital. A total of 60 mL, with 6 mL for once sampling of water effluent from the high-speed handpiece line of each DCU were collected aseptically after the finish of the daily clinical work on every second Friday between May and October in 2007. Standard isolation and identification technique of bacteria was adopted.MAIN OUTCOME MEASURES: Concentration of bacteria and prevalence of 3 species of bacteria in water effluent from the high-speed handpiece line of DCUs among different specialty departments were evaluated.RESULTS: Concentration of bacteria in water effluent from the high-speed handpiece line of DCUs averaged 5.67×10~2 cfu/mL, ranged from 5.15×10 to 1.59×10~3 cfu/mL. The microbial concentration of water samples from Department of Periodontics was significantly higher than that from other departments, while the microbial concentration of water samples from Department of Oral Surgery was the lowest (P = 0.000).CONCLUSION: Contamination in water effluent from the high-speed handpiece line of DCUs varied from different specialty departments in the provincial stomatological hospital. It is suggested that DUWLs flushing should be performed routinely, especially for the department without frequent use of the high-speed handpiece in the daily work, and extra infection control measures should be adopted for the department with severe clinical operative contamination.