Effect of polyethylene Glycol Loxenatide (long-acting GLP-1RA) on lipid, glucose levels and weight in type 2 diabetes mellitus patients with obesity.

OBJECTIVE: To explore the effect of polyethylene glycol loxenatide (long-acting GLP-1R agonist) on the lipid, glucose levels, and weight in type 2 diabetes mellitus patients with obesity. PATIENTS AND METHODS: A total of 40 obese patients with type 2 diabetes mellitus in our hospital from July 2019 to June 2020 were randomly divided into a control group and a study group. The study group was treated with metformin and polyethylene glycol loxenatide injection, while the control group was treated with metformin. RESULTS: Before treatment, there was no significant difference in FPG (Fasting Blood Glucose) and PPG (Post Prandial Glycaemia) levels between the study group and the control group (p>0.05). After a treatment period, the FPG and PPG levels in the study group were significantly lower than those in the control group (p<0.05). With the longer treatment time, the patient's weight and BMI were lower (p<0.05). The weight and BMI of patients changed the least after one month of treatment, and the weight and BMI changed the most after more than seven months of treatment. After a period of treatment, the levels of FPG and PPG in the blood of male patients in the study group were significantly lower than those of female patients (p<0.05). After treatment, the TG level of the study group was significantly lower than that of the control group (p<0.05). In comparison, the HDL-C level was significantly higher than that of the control group (p<0.05). CONCLUSIONS: Lipid and glucose levels of type 2 diabetes mellitus patients with obesity have decreased after 12 weeks of polyethylene glycol loxanatide use. The weight of type 2 diabetes mellitus patients with obesity has changed after using polyethylene glycol loxenatide for a period of treatment. Among them, there is a certain relationship between body weight and treatment time, gender, and original body weight, which is worthy of further research and promotion in clinical practice.

Cigarette smoking and risk of herpes zoster: a population-based cohort study in Taiwan.

The effects of cigarette smoking on the risk of herpes zoster (HZ) infection remain unclear. This study aimed to examine the association between cigarette smoking and HZ. Participants were collected from four rounds (2001, 2005, 2009 and 2013) of the Taiwan National Health Interview Survey. Incident cases of HZ were identified from the Taiwanese National Health Insurance database. Of the 57 641 participants, 3346 developed HZ during the observation period. After controlling for confounders, current smokers had a lower risk of incident HZ than never-smokers (adjusted hazard ratio 0.69; 95% CI 0.62-0.77). There was a trend toward a decreased risk of HZ with increasing numbers of cigarettes per day, years of smoking and cumulative pack-years of smoking among current smokers (Ptrend < 0.001). Former smoking was not associated with risk of HZ. In conclusion, current smoking was significantly associated with a decreased risk of developing HZ.

Cigarette smoking and risk of rosacea: a nationwide population-based cohort study.

BACKGROUND: Most evidence regarding the relationship between cigarette smoking and risk of rosacea is obtained from cross-sectional or case-control studies. OBJECTIVE: To examine the association between smoking and risk of developing rosacea. METHODS: Participants were collected from four rounds (2001, 2005, 2009 and 2013) of the Taiwan National Health Interview Survey. Incident cases of rosacea were identified from the National Health Insurance database. Cox proportional hazard model was used for the analyses. RESULTS: Of the 59 973 participants, 379 developed rosacea during a mean follow-up of 10.8 years. After adjustment for potential confounders, current smokers had a lower risk of rosacea than never smokers [adjusted hazard ratio (aHR) 0.60; 95% confidence interval (CI) 0.39-0.92]. An increase in smoking intensity was associated with a decreased risk of rosacea among current smokers (Ptrend  = 0.0101). Compared with never smokers, current smokers of >15 cigarettes/day had an aHR of 0.51 (95% CI: 0.26-0.99) for rosacea. For incident rosacea, the aHRs (95% CIs) of current smokers of ≤10 years of smoking and ≤10 pack-years of smoking were 0.44 (0.22-0.88) and 0.51 (0.29-0.89), respectively. Former smoking was not associated with rosacea risk. CONCLUSION: Current smoking was significantly associated with a decreased risk of rosacea.

High expression of SHMT2 is correlated with tumor progression and predicts poor prognosis in gastrointestinal tumors.

OBJECTIVE: Gastrointestinal tumors are malignant tumors with high morbidity. Mitochondrial serine hydroxymethyltransferase 2 (SHMT2) is a key enzyme in the synthesis of serine and glycine, which has prognostic and therapeutic value for many malignant tumors. However, the role of SHMT2 in gastric cancer (GC), esophageal cancer (ESCC), and colorectal cancer (CC) has not been clarified. PATIENTS AND METHODS: The expression of SHMT2 was detected in GC, ESCC, and CC by immunohistochemistry and reverse real time transcription-polymerase chain reaction. The relationships between SHMT2 expression and clinicopathologic characteristics, recurrence-free survival (RFS), and disease-specific survival (DSS) were analyzed by the survival analysis and correlation analysis. RESULTS: The positive expression rate of SHMT2 in GC, ESCC, and CC was 74.1%, 69.2%, and 71.7%, respectively. Patients with high expression of SHMT2 had a worse prognosis. In GC, high SHMT2 expression had positive correlation with lymph node metastasis (p=0.005) and histological grade (p=0.002). In ESCC, high SHMT2 expression had positive correlation with pT classification (p=0.033) and pM classification (p=0.029). In CC, high SHMT2 expression had positive correlation with tumor size (p=0.004), lymph node metastasis (p=0.035), TNM stage (p=0.007), and histological grade (p=0.020). Notably, SHMT2 expression was an independent prognostic factor for RFS and DSS in GC, ESCC, and CC (p<0.05). CONCLUSIONS: SHMT2 is upregulated in GC, ESCC, and CC. The high expression of SHMT2 is correlated with gastrointestinal tumors progression, and poor prognosis, which is a potential new target for the diagnosis and treatment of gastrointestinal tumors.

Using latent class analysis to identify money boys at highest risk of HIV infection.

OBJECTIVES: Limited research has been conducted to investigate the characteristics of money boys (MBs) in China. This study was aimed to identify the subgroups of MBs based on sexual behaviors, Net-based venue sex-seeking, and substance abuse. STUDY DESIGN: Cross-sectional study. METHODS: Convenience sampling was used to recruit MBs from December 2014 to June 2015 in Tianjin, China. Face-to-face interviews were conducted for 330 MBs, and trained interviewers collected data. RESULTS: The laboratory-confirmed human immunodeficiency virus (HIV)-positive rate was 11.52% among 330 MBs. Four classes were identified through latent class analysis (LCA) method: 'relatively safe behavior' group, 'higher sexual risk' group, 'multiple sexual-partners' group, and 'unprotected sex and substance abuse' group, and there is a significant difference based on the HIV status. Significant differences were found in original residence, monthly income, duration in sex trade, employment, history of sexually transmitted infection (STI), HIV testing, knowledge of free antiviral treatment policy, and awareness of free AIDS testing between the four latent classes (P < 0.05). MBs who used Net-based venues to seek sexual partners; who have inconsistent condom use, substance abuse, a longer duration in sex trade, multiple sexual clients, and multiple anal sex; and who were full-time employed had the highest risk of HIV infection. CONCLUSIONS: The utility of LCA to identify subgroups based on risky behaviors attributes to formulating targeted intervention strategy.

Combined treatment of minimally invasive 23-G vitrectomy and chandelier for superior bullous rhegmatogenous retinal detachment.

OBJECTIVE: To investigate the clinical efficacy of minimally invasive 23G vitrectomy combined with chandelier for the treatment of superior bullous rhegmatogenous retinal detachment (SBRRD). PATIENTS AND METHODS: A retrospective case series study of 50 patients with SBRRD was conducted. Each of these patients received minimally invasive 23G vitrectomy in one of their eye. A trocar was indwelled with two-step 23-G incision, and the chandelier was inserted in the inferior 6 o'clock pars plana. The tear was closed with 23-G vitrectomy combined with endolaser photocoagulation and infused with perfluoropropane (C3F8) under non-contact wide-angle lens. Postoperative follow-up ranged from 5-49 months (mean 23.9±1.3 months). Intraoperative and postoperative complications, postoperative conjunctival hyperemia, eye irritation signs and inflammation reactions, retinal anatomic reduction rate, best corrected visual acuity (BCVA) and intraocular pressure (IOP) changes were analyzed. RESULTS: The intraoperative scleral incision leakage required 17 sutures (34%). No complications, such as iatrogenic retinal breaks and hemorrhage occurred. The postoperative conjunctival hyperemia, eye irritation signs and inflammation reactions were mild. Transient low IOP occurred in one eye (2%) on the first day postoperatively and recovered on the next day. Transient low IOP occurred in eyes of 16 subjects (32%) and recovered after lowering IOP therapy within an average of 4 days. No complications, such as hemorrhage, effusion, choroidal detachment and endophthalmitis were observed. Forty-nine subjects (98%) had retinal reattachment in their eyes after a single surgery, and 100% eyes showed final retinal reattachment. The preoperative and postoperative BCVAs were 4.61±0.19 and 4.70±0.19, respectively, in 8 patients without detached macula, and the difference was not statistically significant (t = 2.20, p >0.05). CONCLUSIONS: Minimally invasive 23G vitrectomy combined with chandelier is a safe and effective surgical approach for the treatment of SBRRD.

Relationship of HLA-DRB1 gene polymorphism with susceptibility to pulmonary tuberculosis: updated meta-analysis.

BACKGROUND: Studies indicate that human leukocyte antigen (HLA) gene polymorphisms are implicated in the risk of pulmonary tuberculosis (PTB). However, research findings are contradictory. OBJECTIVE: To examine the association between HLA-DRB1 alleles and PTB risk using a meta-analysis on case-control studies. METHODS: We searched for relevant studies in the PubMed and EMBASE databases. We used fixed-effects or random-effects models and reported combined odds ratios (ORs) and 95% confidence intervals (CI). The Newcastle-Ottawa Scale (NOS) was used to estimate the quality of each case-control study. RESULTS: A total of 21 individual case-control studies were identified, including studies of 14 family alleles and 28 specific alleles. Compared with controls, DRB1*15 and DRB1*08:03 were found to have significantly higher frequencies in PTB patients; however, DRB1*03, DRB1*11, DRB1*11:03 and DRB1*12:02 had significantly lower frequencies in the total population. The association between other HLA-DRB1 family alleles and specific alleles and predisposition to PTB was not statistically significant. Among Asian populations, DRB1*03 and DRB1*07:01 were associated with a reduced incidence of PTB, while DRB1*15 and DRB1*08:03 were associated with an increased incidence of PTB. CONCLUSION: We conclude that HLA-DRB1 may be a valuable marker to predict the risk for PTB, especially in Asian populations.

Effect of curcumin on p38MAPK expression in DSS-induced murine ulcerative colitis.

The aim of this study was to determine the therapeutic effect of curcumin on dextran sulfate sodium-induced ulcerative colitis (UC) and to explore the related mechanism. Sixty mice were randomly divided into 6 groups. A group was the normal control group; B group was the model group; C group was the 1.5 mg/kg dexamethasone group based on the B group; and D, E and F groups were 15, 30, and 60 mg/kg curcumin groups, respectively, based on the B group. The mice were killed 7 days after treatment; the expression of TNF-α and MPO in colon tissue was determined with ELISA, and colon p-p38MAPK and p38MAPK mRNA expression was evaluated by immunohistochemistry and RT-PCR, respectively. In the C, D, E, and F groups, TNF-α and MPO levels significantly decreased (P < 0.05), and the expression of p-p38MAPK also significantly decreased (P < 0.01). The expression of p38MAPK mRNA in the C, D, E, and F groups decreased (P < 0.01), and there was a statistically significant difference between the E and F groups (P < 0.01). Curcumin had a therapeutic effect, which probably played a role in UC treatment by inhibiting the p38MAPK signaling pathway, thereby reducing the release of TNF-α.

Effect of mannitol injection by intravenous catheter on ear vein endothelial cell apoptosis and venous thrombus in rabbits.

OBJECTIVE: To evaluate the effect of mannitol injection into the rabbit ear vein by intravenous catheter on endothelial cells apoptosis, thrombus formation, the expression of plasma tissue factor (TF) and von Willebrand factor (vWF). MATERIALS AND METHODS: Sixty-four Zealand rabbits were randomly divided into experiment and control group and received 20% mannitol or normal saline via ear margin veins, respectively. Both groups were injected daily. On days 1, 3, 5, and 7 after catheterization, rabbits were subjected to intraperitoneal anesthesia and their ear veins were isolated and then subjected to hematoxylin and eosin staining. Cell apoptosis was evaluated using TUNEL (terminal deoxynucleotide transferase mediated d-UTP nick end labeling) staining, and the levels of TF and vWF were analyzed by enzyme-linked immunosorbent assay. RESULTS: Compared with the control group, the experiment group showed significantly increased thrombus formation (p < 0.05), and a significant higher rate of apoptosis in endothelial cells (p < 0.05) on days 3, 5, and 7. In addition, the experiment group showed significant elevation of plasma TF and vWF on days 3, 5, and 7 (p < 0.05). CONCLUSIONS: Continuous mannitol injection by intravenous catheterization induces more serious venous thrombus formation and endothelial cells apoptosis and higher TF and vWF levels than normal saline injection. These data suggest that clinical use of hyperosmotic mannitol by intravenous catheter may exert direct deleterious effects on vascular endothelium.

Resveratrol appears to protect against oxidative stress and steroidogenesis collapse in mice fed high-calorie and high-cholesterol diet.

The detrimental effects on Leydig cells steroidogenesis in mice on high-calorie and high-cholesterol diet (HCD) were determined, and the possible protection conferred by resveratrol supplementation was investigated. Male C57BL/6J mice were fed high-calorie and alone (HCD group) or with resveratrol supplementation (HCD + Res group) for 18 weeks. Male C57BL/6J mice fed standard diet without or with the same dose of resveratrol served as controls. At the end of the experiment, there were significant declines of serum testosterone and luteinising hormone (LH) in HCD group as compared to controls. In line with the hormone alterations, the expressions of StAR and steroidogenic enzymes in testicular tissues were significantly down-regulated in HCD group. Resveratrol supplementation could significantly improve expressions of StAR and steroidogenic enzymes, and increase serum testosterone and LH concentrations in HCD + Res group. Mice in HCD group also showed a statistically significant down-regulation in the mRNA expressions of MnSOD and GPx4. Resveratrol supplementation improved testicular MnSOD and GPx4 expression in comparison with HCD group. We propose that resveratrol may attenuate detrimental effects on Leydig cells steroidogenesis in HCD-fed mice, and its upregulations of antioxidant defence mechanisms and LH level may play a role in its protection. Our data suggest resveratrol appears to have the potential for therapeutic approaches targeting male obesity-associated secondary hypogonadism.

The cyclic hexapeptide AcF attenuates sepsis-induced acute lung injury and mortality in rats.

OBJECTIVE: The purpose of this study was to elucidate the possible beneficial effects of AcF on acute lung injury (ALI) in a rat model of sepsis. MATERIALS AND METHODS: Male Sprague-Dawley rats were randomly divided into the following four experimental groups (n = 10 per group): animals undergoing a sham cecal ligature puncture (CLP) (Sham group); animals undergoing CLP (control group); or animals undergoing CLP and treated with saline (Saline group) and animals undergoing CLP and treated with AcF (AcF group). At 24 h after CLP, blood, bronchoalveolar lavage fluid (BALF) and lung tissue were collected. The lung wet/dry weight ratio, Protein concentration and the count of inflammatory cells or neutrophils in the BALF were determined. The pathologic changes in lungs were examined with the optical microscopy. Myeloperoxidase (MPO) activity, the expression of inflammatory cytokines were measured in lung tissue and BALF respectively. Survival rates were recorded at 120h in the four groups in another experiment. RESULTS: Histology findings revealed acute lung injury in rats in the CLP group, whereas those in the AcF-treated group had mild lung injury. Treatment with AcF significantly attenuated the CLP-induced pulmonary edema and inflammation, as it significantly decreased lung wet/dry ration, protein concentration and the infiltration of inflammatory cells and neutrophils in the lung tissues. In addition, the secretion of inflammatory cytokines, such as TNF-α, IL-6, IL-1b and macrophage inflammatory protein-2 (MIP-2) was decreased in AcF treated group compared with the control saline treated group. CONCLUSIONS: AcF administration ameliorates acute lung injury in a rat model of sepsis induced by CLP. AcF can be developed as a novel treatment for severe sepsis-induced ALI.

Dose escalation to rash for erlotinib plus gemcitabine for metastatic pancreatic cancer: the phase II RACHEL study.

BACKGROUND: This phase II, open-label, randomised study evaluated whether patients with metastatic pancreatic cancer receiving erlotinib/gemcitabine derived survival benefits from increasing the erlotinib dose. METHODS: After a 4-week run-in period (gemcitabine 1000 mg m(-2) once weekly plus erlotinib 100 mg per day), patients with metastatic pancreatic cancer who developed grade 0/1 rash were randomised to receive gemcitabine plus erlotinib dose escalation (150 mg, increasing by 50 mg every 2 weeks (maximum 250 mg); n=71) or gemcitabine plus standard-dose erlotinib (100 mg per day; n=75). The primary end point was to determine whether overall survival (OS) was improved by increasing the erlotinib dose. Secondary end points included progression-free survival (PFS), incidence of grade ⩾2 rash, and safety. RESULTS: Erlotinib dose escalation induced grade ⩾2 rash in 29 out of 71 (41.4%) patients compared with 7 out of 75 (9.3%) patients on standard dose. Efficacy was not significantly different in the dose-escalation arm compared with the standard-dose arm (OS: median 7.0 vs 8.4 months, respectively, hazard ratio (HR), 1.26, 95% confidence interval (CI): 0.88-1.80; P=0.2026; PFS: median 3.5 vs 4.5 months, respectively, HR, 1.09, 95% CI: 0.77-1.54; P=0.6298). Incidence of adverse events was comparable between randomised arms. CONCLUSION: The erlotinib dose-escalation strategy induced rash in some patients; there was no evidence that the higher dose translated into increased benefit.

A double-blind comparative study of Chinese herbal medicine Jinlianqingre Effervescent Tablets in combination with conventional therapy for the treatment of uncomplicated hand, foot, and mouth disease.

Chinese herbal medicine Jinlianqingre Effervescent Tablets (JET) are the recommended control measure for uncomplicated hand, foot, and mouth disease (HFMD) by the Ministry of Health of China. However, high-quality evidence to support this recommendation is limited. A total of 288 patients ranging in age from 1 to 13 years were randomly assigned to JET in combination with conventional therapy (mainly including the reduction of temperature by applying physical cooling paste or warm bathing), or conventional therapy with placebo group for 7 days. The objective was to test the hypothesis that JET combination therapy is more effective than conventional therapy for uncomplicated HFMD. A randomized, double-blind, placebo-controlled trial was designed. Our study showed that, compared with conventional therapy, the median time to fever resolution was significantly shorter in the JET combination therapy (8 vs. 80 h; p < 0.0001); the risk of fever resolution increased in the JET combination therapy [hazard ratio, 19.8; 95% confidence interval (CI), 12.8 to 30.7]; the median healing time of rash or oral ulcer was significantly shorter in the JET combination therapy (14 vs. 74 h; p < 0.0001); and the median symptom score for skin or oral mucosa lesions improved more rapidly in the JET combination therapy during the follow-up period. The median duration of hospital stay was 6 days in the JET combination therapy and 7 days in the conventional therapy (p < 0.0001). No significant adverse events and complications were found in both groups. The addition of JET to conventional therapy reduced fever clearance time, healing time of skin or oral mucosa lesions, and duration of hospital stay in children with uncomplicated HFMD.

2,3,7,8-Tetrachlorodibezo-p-dioxin exposure and prostate cancer: a meta-analysis of cohort studies.

OBJECTIVE: To perform a meta-analysis of cohort studies and evaluate the association between exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and prostate cancer quantitatively. STUDY DESIGN: Publications before April 2012 about populations exposed to TCDD were searched in PubMed. Only cohort studies were included. Extraction and quality assessment of included articles was performed independently by two authors using the MOOSE guidelines. METHODS: A total of 17 cohort studies on prostate cancer with information about standardized mortality ratios (SMR), risk ratio (RR), standardized incidence ratios (SIR) and TCDD exposure were included. SMRs and RRs were pooled separately after weighing each study by calculating the inverse of the estimated variance. RESULTS: Based on the 13 reported SMRs or SIRs, the meta-analysis yielded a meta-SMR of 1.26 (95% confidence interval 1.00-1.57, P = 0.046). The meta-RR, based on four reported RR from four cohorts, was 1.04 (95% confidence interval 0.85-1.28). Begg's funnel plot showed little evidence of publication bias (Egger's test P-value = 0.817). CONCLUSION: This meta-analysis suggests that exposure to TCDD is associated with increased risk of prostate cancer.

First Report of Phytophthora palmivora Causing Root Rot of Cassava in China.

Cassava (Manihot esculenta) is an economically important crop grown widely in South China. Seventy percent of the cassava grown is used for starch and ethanol production and it has become the foundation of local food and bioenergy systems. In November 2010, a new root rot disease was found on cv. HuaNan205 from a cassava plantation in Danzhou, Hainan Province. Disease occurred on 30% or less of the plants. Initially, the upper leaves wilted at noon and recovered in the evening. Eventually, infected plants no longer recovered and the whole plant wilted and died. Root rot symptoms consisting of irregular brown patches occurred on the tuberous roots. Symptomatic root rot tissue was cut into 1-cm pieces, washed in distilled water, and soaked in a solution of 1% sodium hypochlorite for 3 min. A subsection was cut from each sterilized piece, placed on a plate of V8 agar medium, and incubated at 28°C for 7 days. Pathogenicity was established by following Koch's postulates. In July 2011, 10 plants of cassava cv. HuaNan205 were selected from a disease-free plantation in Danzhou. The pathogen was cultivated on V8 agar at 28°C for 14 days. Four holes were established 15 cm from the base of the cassava plants. Five plants were inoculated with 100 mL of the mycelial suspension in each of the four spots and covered by soil. The other five plants were treated with sterile water as control. Plants were maintained for 4 months. All five of the inoculated plants wilted and two died, while the control plants grew normally. Symptoms similar to the original root lesions were observed on tuberous roots of inoculated plants, while only scars formed on tuberous roots of control plants. The pathogen was reisolated from the lesions of inoculated plants. Microscopic examination showed the sporangia as papillate and ovoid with the widest part close to the base. They were easily washed off and each detached sporangium contained a short pedicel 1.2 to 6.9 µm long, average 2.9 µm. Chlamydospores were readily observed on diseased roots and observed in pure cultures on V8 agar. Morphological characteristics of the specimen were similar to the descriptions for Phytophthora palmivora (2). Genomic DNA of this isolate was extracted with a cetyltrimethylammoniumbromide protocol (3) from mycelium and used as a template for amplification of the internal transcribed spacer (ITS) region of rDNA with primer pair ITS1/ITS4 (1). The sequence (GenBank Accession No. HE580279) exactly matched several sequences (e.g., GenBank Accession Nos. HQ237481.1, AY745750, and AY745751) of P. palmivora. To our knowledge, this is the first report of root rot caused by P. palmivora on cassava in China. References: (1) D. E. L. Cooke et al. Fungal Genet. Biol. 30:17, 2000. (2) D. C. Erwin and O. K. Ribeiro. Phytophthora Diseases Worldwide. The American Phytopathological Society, St. Paul, MN, 1996. (3) J. R. Xu et al. Genetics 143:175, 1996.

Randomised clinical trial: rabeprazole plus aspirin is not inferior to rabeprazole plus clopidogrel for the healing of aspirin-related peptic ulcer.

BACKGROUND: Clopidogrel does not inhibit prostaglandin synthesis. As a result, clopidogrel's incidence of peptic ulcer disease (PUD) and ulcer bleeding is lower than aspirin's. AIM: To compare the healing rate in aspirin-related dyspeptic ulcer patients who were given proton pump inhibitor (PPI) plus aspirin or PPI plus clopidogrel. METHODS: Patients with aspirin-related nonbleeding symptomatic ulcers were randomised to receive rabeprazole (20 mg/day) plus aspirin (100 mg/day) or rabeprazole (20 mg/day) plus clopidogrel (75 mg/day) for 12 weeks. The primary endpoint was the successful treatment of PUD as characterised by intention-to-treat at the end of therapy. RESULTS: Two hundred and eighteen patients (109 in the aspirin group and 109 in the clopidogrel group) were enrolled. There were no statistical demographic differences between the group that received aspirin and the group that received clopidogrel. The PUD treatment success rate was also statistically equal between the clopidogrel and aspirin groups (86.2% vs. 90.0%, P = 0.531). Neither group experienced ulcer-related bleeding. Multivariate logistic regression analysis showed that large ulcer size (>10 mm) (OR: 6.29, 95% CI: 2.58-15.37) and past history of PUD (OR: 3.69, 95% CI: 1.24-10.97) were important predictors of unsuccessful therapy for aspirin-related PUD. CONCLUSIONS: Rabeprazole plus aspirin is not inferior to rabeprazole plus clopidogrel in treating aspirin-related symptomatic PUD. Large ulcer size (>10 mm) and past history of PUD are important predictors of unsuccessful therapy (NCT 01037491).

Aerodigestive tract, lung and haematological cancers are risk factors for tuberculosis: an 8-year population-based study.

SETTING: The deterioration of immunity in cancer patients may be associated with a higher incidence of tuberculosis (TB). OBJECTIVE: Despite several previous studies on cancer and TB, no population-based investigation has been published. We performed a nationwide population-based study to investigate the incidence of active TB among cancer patients, and the cancer-type specific risk factors related to TB. DESIGNS: This nationwide population-based retrospective cohort study was based on data obtained from the Taiwan National Health Insurance Database. A total of 16,487 cancer patients and 65,948 controls matched for age and sex were recruited. RESULTS: The incidence of TB per 100,000 person-years was 339 in the cancer patients and 202 in the controls, which gives a crude incidence rate ratio of 1.68 (95%CI 1.42-1.98). The hazard ratio (HR) was 1.67 (95%CI 1.42-1.96) after adjusting for age, sex and comorbidity. Cox regression showed that cancers of the aerodigestive tract, including oral, nasopharyngeal and oesophageal and lung cancer (HR 3.09, 95%CI 2.42-3.94) and haematological cancers, including non-Hodgkin's lymphoma and leukaemia (HR 3.22, 95%CI 1.98-5.22), were significant risk factors for TB. CONCLUSION: Cancer patients have a higher incidence of TB than controls. Patients with aerodigestive tract, lung and haematological cancers are especially vulnerable to TB.

A phase II study of weekly docetaxel and cisplatin plus oral tegafur/uracil and leucovorin as first-line chemotherapy in patients with locally advanced or metastatic gastric cancer.

BACKGROUND: Docetaxel plus cisplatin and 5-fluorouracil has become a new standard for treating advanced gastric cancer. However, high rates of severe neutropenia limit its application. Modification of the regimen could be the solution to get similar activity but less myelosuppression. METHODS: Patients with histologically confirmed, locally advanced, or recurrent/metastatic gastric adenocarcinoma without previous chemotherapy were enrolled. This regimen consisted of docetaxel (Tyxan, TTY, Taipei, Taiwan) 30-min infusion at a dose of 36 mg m(-2), followed by cisplatin 30 mg m(-2) infusion over 1 h on days 1 and 8, and oral tegafur/uracil 300 mg m(-2) per day plus leucovorin 90 mg per day on days 1-14, every 3 weeks. Tumour response was evaluated after every 2 cycles of treatment. RESULTS: From August 2007 to March 2009, 45 patients were enrolled. The median age was 56 years (range: 22-75). Among the 40 patients evaluable for tumour response, one achieved a complete response, 22 had partial responses and 11 had stable disease. The overall response rates of the evaluable and intent-to-treat (ITT) populations were 58% (95% CI: 41-74%) and 53% (95% CI: 38-68%), respectively. The disease control rates in these populations were 85% (95% CI: 70-94%) and 82% (95% CI: 68-92%), respectively. In the ITT analysis, the median time to progression and overall survival were 6.8 and 13.9 months, respectively. Major grade 3-4 toxicities were neutropenia (51%), anaemia (22%), diarrhoea (16%), and infections (20%). No patient died of treatment-related toxicities. CONCLUSION: Concurrent weekly docetaxel and cisplatin plus oral tegafur/uracil and leucovorin are effective and well tolerated in the treatment of advanced gastric cancer.

First Report of Corynespora cassiicola Causing Leaf Spot of Cassava in China.

Cassava (Manihot esculenta) is an important economic crop in the tropical area of China. During a survey of diseases in July and September of 2009, leaf spots were observed on cassava plants at three separate plantations in Guangxi (Yunfu and Wuming) and Hainan (Baisha) provinces. Circular or irregular-shaped leaf spots were present on more than one-third of the plants. Spots were dark brown or had white papery centers delimited by dark brown rims and surrounded by a yellow halo. Usually, the main vein or small veinlets adjacent to the spots were dark. Some defoliation of plants was evident at the Wuming location. A fungus was isolated from symptomatic leaves from each of the three locations and designated CCCGX01, CCCGX02, and CCCHN01. Single-spore cultures of these isolates were incubated on potato dextrose agar (PDA) for 7 days with a 12-h light/dark cycle at a temperature of 28 ± 1°C. Conidiophores were straight to slightly curved, unbranched, and pale to light brown. Conidia were formed singly or in chains, obclavate to cylindrical, straight or curved, subhyaline-to-pale olivaceous brown, 19.6 to 150.3 µm long and 5.5 to 10.7 µm wide at the base, with 4 to 13 pseudosepta. Morphological characteristics of the specimen and their conidia were similar to the descriptions for Corynespora cassiicola (2). The isolate CCCGX01 was selected as a representative for molecular identification. Genomic DNA was extracted by the cetyltrimethylammoniumbromide protocol (3) from mycelia and used as a template for amplification of the internal transcribed spacer (ITS) region of rDNA with primer pair ITS1/ITS4. The sequence (GenBank Accession No. GU138988) exactly matched several sequences (e.g., GenBank Accession Nos. FJ852715, EF198117, and AY238606) of C. cassiicola (1). Young, healthy, and fully expanded green leaves of cassava cv. SC205 were surface sterilized. Ten leaves were inoculated with 10-µl drops of 104 ml suspension of conidia and five leaves were inoculated with the same volume of sterile water to serve as controls. After inoculation, leaves were placed in a dew and dark chamber for 36 h at 25°C and subsequently transferred to the light for 5 days. All inoculated leaves with isolates showed symptoms similar to those observed in natural conditions, whereas the controls remained symptom free. The morphological characteristics of reisolated conidia that formed on the diseased parts were identical with the nature isolates. To our knowledge, this is the first report of leaf spot caused by C. cassiicola on cassava in China. References: (1) L. J. Dixon et al. Phytopathology 99:1015, 2009. (2) M. B. Ellis et al. Corynespora cassiicola. No. 303 in: CMI Description of Pathogenic Fungi and Bacteria. Commonwealth Mycological Institute, Kew, UK 1971. (3) J. R. Xu et al. Genetics 143:175, 1996.

First Report of Leaf Spot Caused by Bipolaris setariae on Cassava in China.

Cassava (Manihot esculenta Crantz) is an important food crop in tropical regions of China. Seventy percent of the cassava output is used for starch and ethanol production and it has become the base of food and bioenergy industries. In July 2009, a new leaf spot disease was found on cv. HuaNan205 from a cassava plantation in Danzhou, Hainan Province. Disease occurred on 50% or less of the plants. Initial symptoms were elliptical, chlorotic, and water-immersion lesions of 2 to 4 mm in diameter. These lesions became dry and yellow due to the progress of the disease. A brown halo was around the lesions, and in wet conditions, a dark gray mildew often appeared in the middle of the lesion. Diseased leaves turned yellow and the plants eventually became defoliated. The pathogen was isolated and pathogenicity was established by following Koch's postulates. Young, healthy, and fully expanded green leaves of Cassava cv. HuaNan205 were surface sterilized and then inoculated by spraying them with a suspension of conidia (1 × 105 conidia per ml) of the isolate. Sterile water was used as a control. The leaves were kept in a humid chamber at 28°C for 4 days, at which time similar symptoms to those described above were observed on the leaves. The pathogen was reisolated from inoculated leaves. Microscopic examination showed the conidiophores were fasciculate and brown, septate and straight, and the basal cell was enlarged and hemispherical. Well-developed conidia were long-obclavate, obtuse at both ends, straight, brown, with five to eight transverse septa, and measured 49.7 to 117.1 × 13.3 to 17.2 µm. Genomic DNA of this isolate was extracted with a cetyltrimethylammoniumbromide protocol, and amplification and sequencing of the internal transcribed spacer (ITS) region of rDNA was performed with procedures outlined by Cooke et al. (2). The sequence of the region was deposited in GenBank (Accession No. GU290228). Comparison of the sequences available in the GenBank database revealed that the current ITS sequence differs by three base pairs from two Bipolaris setariae isolates (EF452444 and FJ606786). Morphological identification and sequence analysis of ITS rDNA showed that the pathogen was B. setariae. B. setariae is one of the most important pathogens of lawn grass, gramineous crops, and other plants (1,3). However, no leaf spot disease caused by B. setariae has been recorded previously on cassava in China or elsewhere. References: (1) P. Busey. Crop Sci. 43:1899, 2003. (2) D. E. L. Cooke et al. Fungal Genet. Biol. 30:17, 2000. (3) H. D. Wells and W. W. Hanna. Phytopathology 78:1179, 1988.