[Epidemiological features and diagnosis of malaria cases in Nantong City from 2015 to 2020].

OBJECTIVE: To investigate the epidemiological characteristics and diagnosis of malaria cases in Nantong City from 2015 to 2020, so as to provide insights into the prevention of re-establishment of imported malaria and consolidation of malaria elimination achievements in the city. METHODS: The epidemic data of malaria in Nantong City from 2015 to 2020 were captured from the National Notifiable Disease Report System, the Information Management System for Parasitic Disease Control and individual epidemiological survey reports of malaria cases. The malaria parasite species, source of infections, population distribution, temporal distribution, spatial distribution and diagnosis of imported malaria cases were descriptively and statistically analyzed. RESULTS: A total of 241 malaria cases were reported in Nantong City from 2015 to 2020, and all were overseas imported cases, including 191 cases with Plasmodium falciparum malaria (79.25%), 8 cases with P. vivax malaria (3.32%), 33 cases with P. ovale malaria (13.69%) and 9 cases with P. malaria malaria (3.73%). Overseas imported malaria cases acquired infections from 34 countries in Asia, Africa and Latin America, and 97.93% of the cases were infected in Africa, and 90.04% (217/241) were reported in Chongchuan District, Hai'an City and Haimen District. Imported malaria cases were aged from 20 to 68 years, and a median age of 45 (13) years, and 97.10% were male. The median duration between returning to China and malaria onset was 7 (9) days among all imported malaria cases, and the median duration from initial diagnosis to definitive diagnosis was 2 (2) days. There were 167 cases that were initially diagnosed as malaria, with a correct rate of 69.29%, and 53.53 (129/241) of malaria cases were diagnosed at city-level medical institutions and 41.49% (100/241) at county-level medical institutions. In addition, the proportion of malaria cases reported by city-level medical institutions increased from 39.62% in 2015 to 81.25% in 2020 (χ2 = 6.94, P < 0.01). CONCLUSIONS: The accuracy of initial malaria diagnosis requires to be improved in Nantong City. Malaria control knowledge should be specially given to migrant workers to shorten the duration of seeking medical care, and malaria training requires to be intensified among healthcare professionals to improve the diagnostic capability of imported malaria cases and the cure of severe P. falciparum malaria cases.

Ambrisentan improves the outcome of rats with liver transplantation partially through reducing nephrotoxicity.

OBJECTIVE: Tacrolimus is a potent immunosuppressive agent mainly used for allogeneic solid organ transplantation. Although usage of tacrolimus led to a significant increase in short-term allograft survival, the long-term morbidity remains high. Endothelin-1 (ET-1) is reported to be associated with increased vascular resistance, CNI-induced nephrotoxicity and chronic rejection. MATERIALS AND METHODS: In the present study, we first detected the serum and renal ET-1 level of rats treated by tacrolimus and found strong positive correlations were existed between the ET-1 level and the tacrolimus dosage and treated time. Furthermore, we studied the protective effect of ambrisentan in liver transplantation rats when co-administrated with tacrolimus. Healthy inbred male Wistar and Sprague-Dawley (SD) rats were used in this study. The post-operative general condition, transplantation survival time, hepatic aminotransferase, serum IFN-γ and level kidney injury biochemical index were recorded and compared to evaluate the immune response and outcomes in the recipient rats after liver transplantation. RESULTS: Our results indicate that ambrisentan prevents the changes of ET-1 content in rats of non-operative treatment group and reduced the nephrotoxicity in the rats with liver transplantation. Rats from ambrisentan co-administration group exhibited good postoperative condition and prolonged survival. CONCLUSIONS: Ambrisentan reverted some effects induced by tacrolimus in the kidney and indicated a positive potential for therapeutic benefit.

Effects and mechanisms of tacrolimus on development of murine Th17 cells.

Tacrolimus (Tac, FK506) is a widely used T-cell-targeted immunosuppression drug known as a calcineurin inhibitor. However, its pharmacologic effects on T-helper type 17 (Th17) cells have not been fully elucidated. Herein, we demonstrate that Tac inhibits Th17 cell differentiation and proliferation, and expression of IL-17 messenger RNA. The proposed mechanism is that Tac inhibits calcineurin and T-cell receptor stimulation-induced cell division. Because Th17 cells participate in allograft rejection, the results of the present study suggest a novel model of immunosuppression effects of Tac. In addition, they provide further implications for the therapeutic immunosuppression effects of Tac on allograft rejection.

Liver transplantation for hepatitis B virus-related hepatocellular carcinoma: one center's experience in China.

BACKGROUND: Hepatocellular carcinoma (HCC) is the fifth most common and the third most deadly cancer worldwide, with more than half a million identified cases and about a similar number of subjects succumb to it each year. This study sought to evaluate our results of liver transplantation for HCC to identify prognostic factors. METHODS: Between December 2001 and December 2006, 224 patients (205 men, 19 women; age range, 15-75 years) with HCC underwent orthotopic liver transplantation (OLT) at our center. All grafts were from deceased donors. There were 68 cases within Milan criteria (30.3%), 32 cases beyond Milan criteria but within UCSF (University of California, San Francisco) criteria (14.3%), and 124 cases beyond UCSF criteria (55.4%). RESULTS: The overall 1-, 3-, and 5-year patient cumulative survival rates were 82.5%, 60.1%, and 51.5%, respectively. The survival rates were comparable between patients within Milan and UCSF criteria, but were significantly greater than that of patients beyond UCSF criteria. Multivariate analysis revealed alpha fetoprotein (AFP) >or= 800 microg/L, vascular invasion, and poor tumor differentiation to be independent prognostic factors. CONCLUSION: OLT is a safe and effective treatment for hepatitis B virus-related HCC. Compared with Milan criteria, UCSF criteria successfully expanded the indication without deteriorating the prognosis significantly, while preoperative AFP >or= 800 microg/L, vascular invasion, and poor tumor differentiation indicated poor survival.

Prevention of hepatitis B virus reinfection after orthotopic liver transplantation.

OBJECTIVE: We discuss the prevention of hepatitis B virus reinfection following orthotopic liver transplantation. METHODS: Sixty-eight cases of chronic fulminant hepatitis B, the end stage of liver cirrhosis and liver carcinoma complicated with HBV cirrhosis, were given antiviral drugs pre- and posttransplantation to prevent hepatitis B virus reinfection. Lamivudine was administered to two cases and lamivudine + HBIG to 63 cases. Adefovir + HBIG was administered to three cases. The serum HBV, HBV DNA, liver biopsy immunohistochemistry and clinical examinations were performed. RESULTS: One of two cases given lamivudine developed reinfection with serum HBSAg, HbeAb, HBcAb, HBV DNA, and positive and liver biopsy immunohistochemistry showing HBSAg phenotype. Two of the 63 cases given lamivudine + HBIG developed reinfection with serum HBSAg, HBeAb, HBcAb positive and liver biopsy immunohistochemistry showing HBSAg phenotype. The serum HBV DNA was positive in one of the two cases. Three cases given adefovir developed no reinfection with HBV. CONCLUSION: Orthotopic liver transplantation is an effective treatment for HBV infection; lamivudine + HBIG or adefovir + HBIG prevent hepatitis B virus reinfection.

Toxicity to transferred rat embryos after aspirin treatment during preimplantation stage in vivo.

AIM: To explore the relationship between drug-induced blastopathies and post-implantation embryotoxicity or developmental defects. METHODS: Pregnant rats on d 3 were given intragastrically aspirin (0.25, 0.5, and 1 g.kg-1). On d 4, the blastocysts were transferred into the uterine horns of pseudopregnant rats (made by mating with male rats which had been given intragastrically 3-chloro-1,2-propanediol 5 mg.kg-1 for 5 d). Uterine contents were examined at term. RESULTS: The frequency of blastocysts with morphological alterations (FBMA) was increased on d 4 of gestation. The implantation rate was lower than that of the controls. A dose-related increase in resorption (55.2%, 69.5%, and 85.2%) and malformation rate (3.8%, 44.4%, and 25%), and decrease in viability rate of fetuses (44.8%, 30.5%, and 14.8%) were observed in test groups with correlations to FBMA. CONCLUSION: Embryotoxicity and fetal malformations were induced by treatment of aspirin before implantation in a dose-dependent manner.

Antidotal effects of dimercaptosuccinic acid.

Dimercaptosuccinic acid (DMS), HOOC-CH(SH)-CH(SH)-COOH, was first developed in China as an effective antidote for poisoning from many heavy metals, such as Pb, Hg, As, Cd, Sb, Tl, Au, Zn, Ni, Pt, Ag, Co and Sn. DMS increases the excretion of Ce, Pm, Sr and Po from the body. Hundreds of patients suffering from hepatolenticular degeneration (Wilson's disease) have been treated successfully with DMS. Recently, DMS was found to be effective also in treating certain non-metallic intoxications, like some of the new non-phosphate pesticides and mushroom poisonings.

Important Chinese herbal remedies.

This review presents seven examples of effective drugs derived from the ancient Chinese therapeutics. They are artemisinin (qinghaosu) and its derivatives for malaria, henbane drugs for microcirculatory and other disturbances, tetrahydropalmatine as a dopamine receptor antagonist, yuanhuacine and yuanhuadine for abortion, trichosanthin for abortion, moles, and choriocarcinoma, indirubin for leukemia, and Tripterygium plants for autoimmune and various other diseases.