[Post-tuberculosis lung disease: a neglected disease].

Globally, the number of patients with post-tuberculosis lung disease (PTLD) is huge, with high morbidity and mortality. PTLD is defined as chronic respiratory abnormality that affects large and small airways (bronchiectasis and obstructive lung disease), lung parenchyma, pulmonary vasculature, and pleura and may be complicated, with or without symptoms, attributable at least in part to previous pulmonary tuberculosis. The aforementioned chronic respiratory abnormality may be complicated due to coinfection such as fungi and nontuberculosis mycobacteria. Risk factors for PTLD include multiple episodes of tuberculosis, drug-resistant tuberculosis, delays in diagnosis, smoking, and possible diabetes. Empirical expert opinion advocates preventive anti-tuberculosis treatment for high-risk groups of tuberculosis, early diagnosis and treatment of tuberculosis, surgical treatment for specific groups, pulmonary rehabilitation for patients after tuberculosis treatment, early identification and treatment of co-infection. It is effective to prevent the occurrence of PTLD, improve the treatment effect, and prevent the deterioration of the disease. As a high TB burden country, PTLD has been seriously neglected in China. Internationally, there is currently a lack of epidemiological survey data on post-TB pulmonary disease, and there are few studies on its clinical characteristics, risk factors, prevention, and treatment. With an emerging literature on PTLD, collaborative research is urgently needed to inform our understanding of the natural history, prevention, and treatment of PTLD, and to allow for the development of much needed evidence-based guidelines.

Genetic study of early-onset Graves' disease in the Chinese Han population.

Graves' disease (GD) is a complex autoimmune disorder in which genetic and environmental factors are both involved in the pathogenesis. Early-onset patients have a shorter exposure time to environmental factors and are, therefore, good models to help understand the genetic architecture of GD. Based on previous studies of early-onset GD, 11 single nucleotide polymorphisms (SNPs) and their related SNPs (R2 > .6), SNPs located within a ±1-Mb region of the FOXP3 gene, and 20 validated GD-risk SNPs were selected and screened for genotyping in 3735 GD and 4893 control patients to investigate whether early-onset GD is a subtype of GD with distinct susceptibility genes. Ultimately, we did not confirm the reported genetic markers of early-onset GD in our Chinese Han population but found that a GD-risk SNP located in the human leukocyte antigen class I region-rs4947296-was more strongly correlated with early-onset GD than non-early-onset GD. In addition, heterogeneity analysis of GD patients suggests that it may be more reasonable to define early-onset GD as an onset age ≤20 years.

Detection of methemoglobin in whole blood based on confocal micro-Raman spectroscopy and multivariate statistical techniques.

Raman spectroscopy has been shown to have the potential for revealing oxygenated and spin ability of hemoglobin. In this study, confocal micro-Raman spectroscopy is developed to monitor the effect of sodium nitrite on oxyhemoglobin (HbO2 ) in whole blood. We observe that the band at 1,638 cm(-1) which is sensitive to the oxidation state decreases dramatically, while the 1,586 cm(-1) (low-spin state band) reduces both in methemoglobin (MetHb) and poisoning blood. Our results show that adding in sodium nitrite lead to the transition from HbO2 (Fe(2+) ) to MetHb (Fe(3+) ) in whole blood, and the iron atom converts from the low spin state to the high spin state with a delocalization from porphyrin plane. Moreover, multivariate statistical techniques, including principal components analysis (PCA) and linear discriminant analysis (LDA) are employed to develop effective diagnostic algorithms for classification of spectra between pure blood and poisoning blood. The diagnostic algorithms based on PCA-LDA yield a diagnostic sensitivity of 100% and specificity of 100% for separating poisoning blood from normal blood. Receiver operating characteristic (ROC) curve further confirms the effectiveness of the diagnostic algorithm based on PCA-LDA technique. The results from this study demonstrate that Raman spectroscopy combined with PCA-LDA algorithms has tremendous potential for the non-invasive detection of nitrite poisoning blood.

A novel intronic mutation and a missense mutation of MEN1 identified in two Chinese families with multiple endocrine neoplasia type 1.

BACKGROUND: Multiple endocrine neoplasia type 1 (MEN1) caused by MEN1 mutation is widely recognized. To date, 14 novel mutations were reported in Chinese and intronic mutations are getting more attention. AIM: To explore clinical features and MEN1 mutations in two Chinese families suffering from MEN1. METHODS: Nineteen individuals (10 males and 9 females) from two unrelated families with MEN1 were studied. Mutations of MEN1 were analyzed by direct sequencing of PCR products. In vitro splicing analysis was also performed with minigenes containing both wildtype and novel mutant fragments. Through the RNAstructure program, we analyzed the secondary structure of the wild type MEN1 pre-mRNA and then introduced T>G mutation at +2 donor splice site of intron 7. RESULTS: Clinical features of 3 patients in two families were described, and 5 individuals were proven to be carriers of MEN1 mutation without apparent symptoms. A novel splicing site mutation of the intron 7 (IVS7+2 T→G) was identified in the first family. In vitro analysis also verified this mutation caused the aberrant splicing of MEN1 mRNA. With the RNAstructure program, we could figure out that the global secondary structure as well as the number of stems and loops of pre-mRNA greatly changed after this mutation. The mutation c. 1227 C>A (C409X) was identified in another family, which also caused the truncation of menin. CONCLUSION: We reported a novel intronic mutation and a missense mutations in two Chinese families suffering from MEN1.

[Occurrence of Pagumogonimus veocularis in Fujian Province].

OBJECTIVE: To prove that Fujian Province is also a natural focus of Pagumogonimus veocularis(Pv). METHODS: The adult worms were obtained from a cat fed with Pv metacercariae. RESULTS: Pv were found in Jianou, Fujian Province. All 1,873 Semisulcospira libertina showed negative. The positive rate of Tricula fujianensis and Erhaia jianouenesis were 0.10% (1/695) and 0.25% (5/2,038), respectively. The main crab host was S. fujianensis. Ps alone and mixed infection with Pv were found in the Sinopotamon, the infection rates were 36.8% (43/117) and 20.5% (24/117), respectively. The numbers of the metacercariae were 806 and 40, respectively. A cat was infected with 12 metacercriae of Pv, eggs were found in the stool 56 days after infection, and 6 worms were found in the lungs 68 days after infection. CONCLUSION: Fujian is one of the natural focus of Pv, cat is the adequate host. The fluke was identified as Pv according to the characteristics of the metacercariae.

Absence of relationship between Schistosoma japonicum and hepatitis B virus infection in the Dongting lake region, China.

In order to determine whether infection with Schistosoma japonicum is related to a higher rate of infection with hepatitis B virus and/or to a higher probability of HBsAg chronic carriage, a population based survey was carried out in China in which HBV markers were studied in 112 subjects with long-lasting S. japonicum infection, and 93 subjects with no S. japonicum infection 37.5% of the cases and 40.9% of controls showed no markers of HBV infection. The prevalence rate of HBsAg was 12.5% in the cases and 12.9% in the controls. For anti-HBc and anti-HBs the figures were 59.8% and 59.8%, and 27.9% and 35.0%, respectively. These data do not support the hypothesis of an interaction between infection with hepatitis B virus and S. japonicum.

The distribution of Schistosoma japonicum eggs in faeces and the effect of stirring faecal specimens.

Experiments were performed to determine whether Schistosoma japonicum eggs are randomly dispersed in faeces and the effect of stirring faecal specimens prior to sampling. For each of 13 patients infected with S. japonicum, eggs were counted in 150 subsamples from a single stool specimen, using the Kato-Katz smear technique. Eggs were non-randomly distributed in all 13 stools, and showed an aggregated distribution. In most patients there were significant differences in the distribution of eggs between the centre and the surface of the stool. Stirring of the stool prior to sampling decreased the variability of counts.

The non-randomness of the distribution of Trichuris trichiura and Ascaris lumbricoides eggs in faeces and the effect of stirring faecal specimens.

Experiments were performed to describe the distribution of Trichuris trichiura and Ascaris lumbricoides eggs in faeces and to test for the effect of stirring faecal specimens prior to sampling. For each of 5 volunteers infected with A. lumbricoides and 7 volunteers infected with T. trichiura, helminth eggs were counted in 150 samples from a single stool specimen using the Kato-Katz smear technique. No significant differences between the distribution of eggs in samples from the surface and the centre of the specimens were found. Prior to stirring, eggs were found to be aggregately distributed in four of the specimens with T. trichiura and all of the specimens with A. lumbricoides. The distributions of eggs were not significantly altered by stirring the stool prior to sampling except in the case of one volunteer infected with A. lumbricoides for whom stirring reduced variability.

The effects of temperature, light and water upon the hatching of the ova of Schistosoma japonicum.

Eggs of Schistosoma japonicum were obtained from infected patients' feces from Yujiang City, China to observe the effects of temperature, light and water on the hatching of eggs. The temperature of water and light played important roles on the hatching of S. japonicum, but the type of water did not. A constant temperature of 28 degrees C and electrical light produced the highest rate of hatching, and reproducible results, whereas a temperature of 4 degrees C or 37 degrees C, and the absence of light inhabited the hatching of eggs. The percentage of eggs hatched during the first 8 hours of 24 hours incubation was 94.90%, so that using the hatching rate of the first 8 hours could approximate the total hatching rate of samples.

The population biology and control of Necator americanus in a village community in south-eastern China.

The population dynamic parameters of Necator americanus infections were estimated from longitudinal intensity and prevalence data from a village in south-eastern China. The theoretical predictions of a deterministic model incorporating these parameters were then compared with observed, horizontal, age-prevalence data from an infected population (N = 565), and an estimate of the basic reproduction rate (R0 = 3.7) of N. americanus was obtained. The findings indicate that populations of N. americanus might be easier to control by mass-treatment chemotherapy (eradication requiring only 63% of the population to be treated every year for 4 years) than those of Ascaris lumbricoides and Trichuris trichiura.