Delayed endoscopic removal of sharp foreign body in the esophagus increased clinical complications: An experience from multiple centers in China.

Foreign bodies impaction in the esophagus is a common clinical emergency. The aim of this study was to investigate the clinical features of foreign body ingestion, and to analyze the risk factors of complications during the endoscopic procedure.From 18 general hospitals in Zhejiang Province in China, 595 patients who underwent gastroscopic removal of ingested foreign bodies were prospectively recruited. Patient characteristics, clinical features, foreign body features, clinical outcomes, and complications were documented.The most common types of foreign body in the esophagus were sharp objects (75.9%), including fish bones (34.0%), chicken bones (22.1%), and fruit nuclei (17.1%). The remaining types were non-sharp objects (24.1%), including food bolus (14.6%). Most objects were lodged in the proximal esophagus (75.9%). Foreign body-related complications occurred in 63 patients (10.5%), including hemorrhage (5.0%), perforation and infection (5.5%). The complication rate was increased by 4.04- and 8.48- fold when endoscopic retrieval was performed after impacted for over 24 and 48 hours, respectively, after impaction, as compared with within 12 hours. Logistic regression analysis revealed that the patients with sharp objects developed more complications than those with non-sharp ones (odds ratio, 2.85; 95% confidence interval, 1.08-7.50; P = .034). However, complications were unrelated with the location in the esophagus or length of foreign bodies (P > .05).Sharp objects were the most frequently ingested foreign bodies in the esophagus in China. The prevalence of complications was increased in the patients with long foreign body retention time (>24 hours) and sharp objects. Sharp foreign bodies in the esophagus are recommended to be removed within 24 hours.

MicroRNA-92 promotes gastric cancer cell proliferation and invasion through targeting FXR.

MicroRNAs (miRNAs), a class of small noncoding RNAs, play critical roles in human carcinogenesis through downregulation of various target genes. In the present study, we found that miR-92 is upregulated in gastric cancer tissues compared with adjacent normal tissues. Interestingly, miR-92 expression is significantly associated with clinical characteristics of patients. Gain or loss-of-function in vitro experiments further show that miR-92 mimics significantly promoted, while its antisense oligos inhibited gastric cancer cell proliferation and invasion. Moreover, luciferase reporter assays and western blot indicated that farnesoid X receptor (FXR), is a direct target of miR-92. Therefore, our data suggest that upregulation of miR-92 may represent an important mechanism for the development of gastric cancer.

Risk factors associated with slide positivity among febrile patients in a conflict zone of north-eastern Myanmar along the China-Myanmar border.

BACKGROUND: Malaria within the Greater Mekong sub-region is extremely heterogeneous. While China and Thailand have been relatively successful in controlling malaria, Myanmar continues to see high prevalence. Coupled with the recent emergence of artemisinin-resistant malaria along the Thai-Myanmar border, this makes Myanmar an important focus of malaria within the overall region. However, accurate epidemiological data from Myanmar have been lacking, in part because of ongoing and emerging conflicts between the government and various ethnic groups. Here the results are reported from a risk analysis of malaria slide positivity in a conflict zone along the China-Myanmar border. METHODS: Surveys were conducted in 13 clinics and hospitals around Laiza City, Myanmar between April 2011 and October 2012. Demographic, occupational and educational information, as well as malaria infection history, were collected. Logistic models were used to assess risk factors for slide positivity. RESULTS: Age patterns in Plasmodium vivax infections were younger than those with Plasmodium falciparum. Furthermore, males were more likely than females to have falciparum infections. Patients who reported having been infected with malaria during the previous year were much more likely to have a current vivax infection. During the second year of the study, falciparum infections among soldiers increased signficiantly. CONCLUSIONS: These results fill some knowledge gaps with regard to risk factors associated with malaria slide positivity in this conflict region of north-eastern Myanmar. Since epidemiological studies in this region have been rare or non-existent, studies such as the current are crucial for understanding the dynamic nature of malaria in this extremely heterogeneous epidemiological landscape.

[Clinical report on 68 cases of refractory mycoplasma pneumoniae pneumonia (RMPP)].

OBJECTIVE: To summarize the early diagnose and treatment approaches of Refractory Mycoplasma Pneumoniae Pneumonia (RMPP). METHODS: Medical documents of 68 cases of RMPP were reviewed. Lab and radiology evident such as CBC, CRP, MP-IgM, X-ray, etc. were collected. RESULTS: 100% RMPP patients suffered from high fever. Positive sign of lung became clear with the development of the disease. Complications as impairment of liver function, cardiac function and rush developed in few patients. 2-4 rounds treatment of macrolides and Methyllprednisolone were necessary for RMPP while antibiotic may be considered when there were evidence of bacteria infection. Immunoglobulin was recommended to the patients when macrolides and steroid seemed ineffective. Bronchofibroscope played an active role regarding the diagnosis and treatment of RMPP. CONCLUSION: Early diagnosis is crucial in RMPP. Combination of multitreatment approaches is the key to cure RMPP.

[Function of TEP1 gene during Plasmodium yoelii infection in Anopheles dirus].

OBJECTIVE: To study the role of TEP1 gene from Anopheles dirns during Plasmodium yoelii infection by RNA interference. METHODS: TEP1 primers with T7 promoter were designed based on the sequence of An. dirus TEP1 gene from GenBank database. PCR amplification of TEP1 gene was completed with An. dirus cDNA as template. The AdTEP1 double-stranded RNA was synthesized by using in vitro transcription kit with purified PCR products. Female An. dirus emerged for 1-2 days were divided into three groups each with 200 mosquitoes: TEP1 interference group, EGFP interference group and control. Mosquitoes in TEP1 and EGFP interference groups were microinjected in chest with 147 ng of AdTEP1 and EGFP double-stranded RNA, respectively, while those of control group were untreated. Effect of TEP1 interference on P. yoelii in An. dirus was estimated through semi-quantitative PCR with internal reference AdS7 at 3 d after injection. On 4 d after injection, mosquitoes were infected by EGFP-expressing P. yoelii BY265. The infection rate and infectivity of mosquitoes were observed through anastomosing 25 midguts from each group at 9 d post-infection. RESULTS: The AdTEP1 double-stranded RNA did well in the interference of TEP1 expression in An. dirus. The infection rate in the groups of control, EGFP and TEP1 interference was (24 +/- 2.83)%, (24 +/- 0.71)%, and (80 +/- 3.54)%, respectively; and the infectivity of the three groups was 0.32 +/- 0.7, 0.44 +/- 0.85, and 5.52 +/- 4.84, respectively. CONCLUSION: AdTEP1 interference increases the infection rate and infectivity of An. dirus by P. yoelii, and raises the susceptibility of An. dirus to P. yoelii significantly. TEP1 plays a critical role in the process of P. yoelii infection.

Child injury surveillance that guides interventions: the Beijing primary healthcare experience.

OBJECTIVES: To provide feedback to guide injury prevention interventions and to test the feasibility of integrating injury surveillance into the existing primary healthcare service for children under 6 years of age. DESIGN: This surveillance system was integrated into existing primary healthcare services at the community primary healthcare centre (PHC) and community kindergartens. Parents reported injury incidents during their child's routine health services at scheduled intervals. Kindergarten nurses registered injury incidents at the absentee recording system. A total of 8358 children annually were included into the surveillance in 2006-07. Setting Two urban communities and three rural communities in Beijing, China. RESULTS: The coverage rates were 93.7% in PHCs and 98% in kindergartens. The injury incidence rates in year 1 and year 2 were 2.7% and 1.9% respectively. The leading causes were falls, being hit by blunt object, and animal injury. Major causes of injury were different between urban and rural children. Over the two-year surveillance period, injury incidence rates declined significantly from 2.7% to 1.7% in urban communities. No significant decrease was seen in rural communities. CONCLUSION: Surveillance through the primary healthcare system in Beijing was useful in child injury prevention as data collected allowed managers to design targeted interventions that resulted in decreased injury. In comparison with hospital based surveillance, PHC based surveillance demonstrated an advantage in wide access to children and allowed calculation of injury incidence rates to monitor trends over time. PHC based surveillance can serve as a useful venue to collect child injury data.

[Correlation of Anopheles TEP1 gene with melanization induced by nitroquine].

OBJECTIVE: To analyze the relationship between the TEP1 gene of Anopheles stephensi and melanotic encapsulation of Plasmodium yoelii induced by anti-malaria drug nitroquine. METHODS: Haemolymph samples from three groups of An. stephensi fed with sucrose solution, Plasmodium-infected blood and nitroquine, respectively, were collected at the 1st, 2nd, 3rd and 4th day after drug administration. Degenerate primers were designed according to the conserved amino acid sequence within TEPs of the mosquitoes. Fluorescent quantitation PCR was used to detect the variation of TEP1 gene transcript induced by nitroquine. The melanization of oocysts was observed by light microscopy. RESULTS: TEP1 gene was cloned, the predicted amino acid residues harbored a highly conserved canonical thioester motif GCGEQ. The fluorescent quantitation PCR revealed that nitroquine induced an up-regulation of TEP1 activity. The transcription of TEP1 gene in nitroquine treated group (2.423) was significantly higher than that of the infected blood-fed group(1.036) at the 3rd day after nitroquine treatment (P<0.05). At the same time, most oocysts were found to be encapsulated in nitroquine treated group, while no melanized parasites were observed in the infected blood-fed group. CONCLUSION: Transcriptional variation of TEP1 gene may be related to the melanization induced by nitroquine.

Inhibitory effect of vascular endothelial growth factors-targeted small interfering RNA on proliferation of gastric cancer cells.

AIM: To examine the effects of vascular endothelial growth factor (VEGF)-targeted small interfering RNA (siRNA) on proliferation of gastric cancer cells in vitro. METHODS: Several siRNAs were transfected into human gastric cancer cell line SGC-7901 with Lipofectamine 2000. Cells not transfected with Lipofectamine 2000 or scrambled (SCR) siRNA served as controls. The inhibitory effect of siRNA on the expression of VEGF mRNA and protein was detected by RT-PCR and ELISA. MTT assay was used to examine the inhibition rate of cell growth. The change in cell cycling of siRNA-treated cells was detected by flow cytometry. RESULTS: siRNA targeting human VEGF effectively inhibited the proliferation of gastric cancer cell line SGC-7901 and the distribution of cell cycle. The percentage of G(0)/G(1) phase was significantly higher in siRNA(1)- and siRNA(2)-transfected cells than in control cells. The expression of VEGF mRNA was significantly inhibited in siRNA(1)- and siRNA(2)-transfected cells compared with that in control cells. VEGF protein notably decreased in siRNA-transfected cells, but had no effect on SCR siRNA. CONCLUSION: VEGF siRNA inhibits proliferation of gastric cancer cells in vitro.

[Clinical study on colonic transmission time and the effect of sini powder on it in functional constipation patients].

OBJECTIVE: To investigate the characteristic of colonic transmission in functional constipation (FC) and the effect of traditional Chinese medicine (TCM) Sini Powder (SP) on it. METHODS: The colonic transmission time (CTT) of 36 patients with FC (the FC group) and 22 healthy subjects (control group) was measured through colonic transmission test, and CTT of entire colon and that of various subsections was calculated with Hinton method and Arhan method respectively. After then, the FC group was treated with SP for 7 days, and CTT was detected again after treatment. RESULTS: Before treatment, body mass index (BMI) was higher, CTT of entire colon, left half colonic section, and sigmoid-rectal section were longer in the FC group than those in the control group (P < 0.05), no statistical difference in CTT of right half colon was found between the two groups (P > 0.05). After FC patients being treated with SP, their CTT of whole colon, left half colonic section and sigmoid-rectal section were significantly shortened (P < 0.05). CONCLUSION: FC patients were characterized by increased BMI and CTT prolonged and unevenly distributed in subsections, especially in the left half colon, sigmoid and rectum; SP could shorten the CTT in FC patients.

[cDNA cloning and location of Pagumogonimus skrj abini cysteine protease].

OBJECTIVE: To clone the cysteine protease cDNA fragment from Pagumogonimus skrjabini adults and locate the tissue of the adult worm where cysteine protease is expressed. METHODS: The cysteine protease cDNA fragment was amplified by reverse transcription-polymerase chain reaction (RT-PCR) with degenerated primers. The production was TA-cloned into the pUCm-T vector and sequenced. DNASIS program was used to analyse the nucleotide sequence and deduce the amino acid sequence, which was aligned with the correlated parasite cysteine protease afterwards. The digoxin labeled cRNA probe was synthesised by in vitro transcription with the cloned cDNA as template. The frozen sections of the adult worms were analysed by hybridization in situ to locate the gene expression. RESULTS: A 495 bp cDNA fragment was amplified by RT-PCR and sequenced. An amino acid sequence was deduced by DNASIS. Sequence analysis and alignment showed significant homologies with the correlated parasite cysteine proteinases and conservation of Cys, His and Asn residues that from a catalytic triad. In the hybridization in situ analysis, intestinal epithelium was stained positively on transverse section of adult worms. CONCLUSION: The cysteine proteinase cDNA fragment from Pagumogonimus skrjabini adults was cloned. There are some key sites which are correlated to the function of cysteine protease in the cDNA fragment. Cysteine protease is mainly expressed in intestinal epithelium of P. skrjabini.

[Study on the relationship between intracellular free calcium and melanization in oocysts of Plasmodium yoelii].

OBJECTIVE: To study the change of intracellular free Ca2+ in the oocyst when it melanized and to find out the relationship between the melanized oocyst and its intracellular level of free Ca2+ in a Plasmodium-refractory strain of Anopheles dirus. METHODS: The distribution and experimental condition of the intracellular free Ca2+ in oocyst of Plasmodium yoelii was measured with Ca2+ sensitive dye Fluo-3/AM and Pluronic F-127 under confocal laser scanning microscope (CLSM) at different time. RESULTS: The best load condition was that the oocysts were incubated in 3 mumol/ml Fluo-3/AM adding 1 microliter/ml 25% Pluronic F-127 for 60 min at 37 degrees C. Fluorescent imaging of oocysts was affected by an increase or decrease of the concentration of Fluo-3/Am and incubation time. The distribution of intracellular free Ca2+ was heterogeneous in the oocysts. The mean value of Ca2+ in the mature oocysts was (137.15 +/- 7.02) nmol/L (X +/- S) but was (18.44 +/- 1.75) nmol/L in melanized oocysts with Ca2+ sedimentation in the wall of oocyst. CONCLUSION: The results suggest that the level of the intracellular free Ca2+ in oocyst decreased and excreted during its melanization in a Plasmodium-refractory anopheline mosquito species.

[The internal control role of ribosomal protein S7 in the defense of Anopheles dirus against Plasmodium infection].

OBJECTIVE: To investigate the role of ribosomal protein S7 (rpS7) in the defense of Anopheles dirus against infection. METHODS: rpS7 was amplified from Anopheles dirus hemocytes with degenerated primers designed according to the conservative region of S7, rpS7 was then cloned using T/A cloning kit and the inserted fragment was sequenced. The difference of the transcript abundance of rpS7 from Anopheles dirus hemocyte among non-blood-fed (N), normal-blood-fed (B) and Plasmodium yoelii infected groups (I) was also analyzed by RT-PCR and gel scanning system at d1, d2, d3, d4, d7 and d11 after blood feeding. RESULTS: There is no significant difference of rpS7 signal between the three groups. CONCLUSION: Anopheles dirus S7 can be used as an internal control to study the role of Anopheles dirus related immune factors in Plasmodium infection.

[Assay of haemolymph protein concentration in Anopheles stephensi].

OBJECTIVE: To ascertain the changes of haemolymph protein concentration in adult Anopheles stephensi mosquitoes under different feeding conditions. METHODS: Haemolymph samples from four groups of adult An. stephensi, fed with sucrose solution, normal blood, plasmodium-infected blood and nitroquine, respectively, were collected by expulsion method. The concentration of haemolymph protein was examined by Bradford method. The results were analyzed automatically by Excel program. RESULTS: The level of protein concentration in the infected blood-fed group was higher than the sucrose solution group and normal blood group at day 8 after Plasmodium yoelii infection, the average concentration was 4.436, 3.080 and 3.092 micrograms/microliter, respectively. The haemolymph protein concentration (2.264 micrograms/microliter) in the nitroquine-administered mosquitoes was lower than the infected blood-fed mosquitoes. CONCLUSION: The haemolymph protein concentration of the adult An. stephensi decreases after the nitroquine administration, indicating that the haemolymph proteins may be involved in the melantotic encapsulation reaction of plasmodial oocysts.