农村居民慢性病患病率及某些危险因素的探讨

农村居民慢性病患病率及某些危险因素的探讨范兴成，王少杰，何玉英，王俊杰，屈蒙，杜水泉为摸清慢性病的患病情况，于１９９０年１０月２０日～１１月２０日在疾病监测点眉县农村开展了慢性病（高血压、冠心病、脑卒中、恶性肿瘤）现患调查，报告如下：眉县有六个农村乡...

Barrett's esophagus:Prevalence and risk factors in patients with chronic GERD in Upper Egypt

AIM： To determine the prevalence and possible risk factors of Barrett＇s esophagus （BE） in patients with chronic gastroesophageal reflux disease （GERD） in EI Minya and Assuit, Upper Egypt. METHODS： One thousand consecutive patients with chronic GERD symptoms were included in the study over 2 years. They were subjected to history taking including a questionnaire for GERD symptoms, clinical examination and upper digestive tract endoscopy. Endoscopic signs suggestive of columnar-lined esophagus （CLE） were defined as mucosal tongues or an upward shift of the squamocolumnar junction. BF was diagnosed by pathological examination when specialized intestinal metaplasia was detected histologically in suspected CLE. pH was monitored in 40 patients. RESULTS： BE was present in 7.3% of patients with chronic GERD symptoms, with a mean age of 48.3 ± 8.2 years, which was significantly higher than patients with GERD without BE （37.4 ± 13.6 years）. Adenocarcinoma was detected in eight cases （0.8%）, six of them in BE patients. There was no significant difference between patients with BE and GERD regarding sex, smoking, alcohol consumption or symptoms of GERD. Patients with BE had significantly longer esophageal acid exposure time in the supine position, measured by pH monitoring. CONCLUSION： The prevalence of BE in patients with GERD who were referred for endoscopy was 7.3%. BE seems to be associated with older age and more in patients with nocturnal gastroesophageal reflux.

Prevalence of cardiovascular disease in subjects hospitalized due to chronic obstructive pulmonary disease in Beijing from 2000 to 2010

Objectives To investigate the overall prevalence of cardiovascular disease （CVD） in subjects hospitalized for chronic obstructive pulmonary disease （COPD）,and explore the prevalence of the major CVD complications and trends in patients with COPD over a 10-year period.Methods Medical records in the PLA General Hospital,Beijing Union Medical College Hospital,and Beijing Hospital from 2000/01/01 to 2010/03/03 were retrospectively reviewed.A total of 4960 patients with COPD were reviewed in the study （3570 males,mean age,72.2 ± 10.5 years; 1390 females,mean age,72.0 ± 10.4 years）.Results The prevalence of CVD in COPD patients was 51.7％.The three most prevalent CVDs were ischemic heart disease （28.9％）,heart failure （19.6％）,and arrhythmia （12.6％）.During the 10-year study period,the prevalence of various CVDs in COPD patients showed a gradual increasing trend with increasing age.There was higher morbidity due to ischemic heart disease （P ＜ 0.01） in male COPD patients than in the female counterparts.However,heart failure （P ＜ 0.01）and hypertension （P ＜ 0.01） occurred less frequently in male COPD patients than in female COPD patients.Furthermore,the prevalence of ischemic heart disease decreased year by year.In addition to heart failure,various types of CVD complications in COPD patients tended to occur in younger subjects.The prevalence of all major types of CVD in women tended to increase year by year.Conclusions The prevalence of CVD in patients hospitalized for COPD in Beijing was high.Age,sex and CVD trends,as well as life style changes,should be considered when prevention and control strategies are formulated.

Sex-specific effects of social networks on the prevalence, awareness, and control of hypertension among older Korean adults

Background Hypertension is a common chronic disease among older adults, and is associated with medical complications and mor- tality. This study aimed to examine the effects of social network characteristics on the prevalence, awareness, and control of hypertension among older adults. Methods The Korean Social Life, Health, and Aging Project （KSHAP） interviewed 814 〉 60-year-old residents and their spouses from a rural township between December 2011 and March 2012 （response rate： 95%）. We evaluated the data from 595 partici- pants. Multivariate logistic regression models were used to assess the effects of network characteristics on hypertension. Results We ob- served strong sex-specific network effects on the prevalence, awareness, and control of hypertension. Among older women, network density was associated with hypertension awareness [odds ratio （OR）： 2.63, 95% confidence interval （CI）： 1.03 5.37J and control （OR： 1.72; 95% CI 0.94-3.13）. Among older men, large networks were associated with a lower prevalence of hypertension （OR： 0.75; 95% CI： 0.58-0.96）. Compared to older women, older men with coarse networks exhibited better hypertension awareness （OR： 0.37; 95% CI： 0.14-0.95） and control （OR： 0.42; 95% CI： 0.19-0.91 ）. Network size interacted with density for hypertension control （P = 0.051）, with controlled hyperten- sion being associated with large and course networks. Conclusions A large network was associated with a lower risk for hypertension, and a coarse network was associated with hypertension awareness and control among older men. Older women with dense networks were most likely to exhibit hypertension awareness and control.

Prevalence,predictors,and clinical consequences of medical adherence in IBD:How to improve it?

Inflammatory bowel diseases(IBD)are chronic diseases with a relapsing-remitting disease course necessitating lifelong treatment.However,non-adherence has been reported in over 40%of patients,especially those in remission taking maintenance therapies for IBD. The economical impact of non-adherence to medical therapy including absenteeism,hospitalization risk, and the health care costs in chronic conditions,is enormous.The causes of medication non-adherence are complex,where the patient-doctor relationship, treatment regimen,and other disease-related factors play key roles.Moreover,subjective assessment might underestimate adherence.Poor adherence may result in more frequent relapses,a disabling disease course, in ulcerative colitis,and an increased risk for colorectal cancer.Improving medication adherence in patients is an important challenge for physicians.Understanding the different patient types,the reasons given by patients for non-adherence,simpler and more convenient dosage regimens,dynamic communication within the health care team,a self-management package incorporating enhanced patient education and physician-patient interaction,and identifying the predictors of nonadherence will help devise suitable plans to optimize patient adherence.This editorial summarizes the available literature on frequency,predictors,clinical consequences,and strategies for improving medical adherence in patients with IBD.

Serum levels of CA19-9 may be as an indicator for metastases in patients with non-small cell lung cancer

Objective:The aim of our study was to evaluate the serum levels of CA19-9 in patients with non-small cell lung cancer(NSCLC)and to analyze the relationship between serum levels of CA19-9 and metastasis.Methods:Serum levels of CA19-9 in 1200 NSCLC patients from February 2006 to August 2011 were evaluated retrospectively.The relationship between serum levels of CA19-9 and sites of metastasis were analyzed.Results:Of the 1200 patients,528 were stage IV and the positive rate of CA19-9 was 32%(169 cases)and 288 stage III,positive rate 20%(58 cases);144 stage II,positive rate 12%(17 cases);240 stage I,positive rate 3%(7 cases).There were statistical differences from stage I to stage IV(P<0.01).The total positive rate in the 1200 cases was 21%.Furthermore,of the 528 stage IV cases,350 had bone metastasis and the positive rate of CA19-9 was 43%(150 cases)in bone metastatic cases.In turn,in CA19-9 positive patients(169 cases)of stage IV, the positive rate of bone metastasis was 89%(150/169).There was no statistical difference of positive rate of CA19-9 between adenocarcinoma and squamous carcinoma(P>0.05).Conclusion:Positive rate of CA19-9 increases accordingly from stage I to stage IV.The serum levels of CA19-9 may be as an indicator for metastases in patients with NSCLC,especially for bone metastasis in stage IV diseases.

Routine modified D2 lymphadenectomy performance in pT1-T2N0 gastric cancer

AIM： To evaluate routine modified D2 lymphadenectomy in gastric cancer, based on immunohistochemicaUy detected skip micrometastases in level 11 lymph nodes. METHODS： Among 95 gastric cancer patients who were routinely submitted to curative modified D2 lymphadenectomy, from January 2004 to December 2008, 32 were classified as pN0. All level I lymph nodes of these 32 patients were submitted to immunohistochemistry for micrometastases detection. Patients in whom micrometastases were detected in the level Ⅰ lymph node stations （n = 4） were excluded from further analysis. The level 11 lymph nodes of the remaining 28 patients were studied immunohistochemically for micrometastases detection and constitute the material of the present study. RESULTS： Skip micrometastases in the level Ⅱ lymph nodes were detected in 14% （4 out of 28） of the patients. The incidence was further increased to 17% （4 out of 24） in the subgroup of T1-2 gastric cancer patients. All micrometastases were detected in the No. 7 lymph node station. Thus, the disease was upstaged from stage Ⅰ A to Ⅰ B in one patient and from stage Ⅰ B to Ⅱ in three patients. CONCLUSION： In gastric cancer, true R0 resection may not be achieved without modified D2 lymphadenectomy. Until D2＋/D3 lymphadenectomy becomes standard, modified D2 lymphadenectomy should be performed routinely.

Prevalence of and risk factors for postprandial hypotension in older Chinese men

Objective To assess the prevalence of and risk factors for postprandial hypotension （PPH） among old and very old Chinese men. Methods The study included 349 Chinese men aged 65 and older, grouped into two age categories： group 1 （old） included 163 men aged 65 to 80 years; group 2 （very old） included 186 men aged over 80 years. Blood pressure changes after meals were assessed every 15 min by ambulatory blood pressure monitoring. Symptoms after meal ingestion and after standing up and changes in the baseline condition relative to blood pressure changes were observed continuously. Additional baseline data included body mass index, medical history, and medication use Results The prevalence of PPH was 59.3% overall and was significantly higher in group 2 than group 1 （63.4% vs. 54.6%, P 〈 0.05）. In group 2, the prevalence of PPH after breakfast （33.8%） and lunch （32.1%） were higher than that after supper （20.9%）, P 〈 0.05. Hypertension and age were significant risk factors for PPH （OR = 2.188, 95% CI： 1.134-4.223, P = 0.02; OR = 1.86, 95% CI： 1.112-3.11, P = 0.018, respectively）. In contrast, acarbose use was protective against PPH （OR = 0.4, 95% CI： 0.189-0.847, P = 0.017）. The decrease in blood pres- sure during PPH was 20-40 mmHg and the maximum was 90 mmHg. PPH usually occurred at 30-60 min after a meal and lasted 30-120 rnin. Conclusions These findings demonstrate that the prevalence of PPH in men aged over 80 years is significantly higher than those in men aged 65 to 80 years, and the blood pressure decline is also higher for men aged over 80 years. In addition, hypertension and age were main risk factors for PPH in the older men, which suggest that preventing and treating PPH is worthwhile.

Prevalence and patterns of drug-resistance mutations among HIV-1 patients infected with CRF07_BC strains in Sichuan province,China

Little information is available on the prevalence of drug-resistance mutations in patients harboring the human immunodeficiency virus type 1(HIV-1) circulating recombinant form(CRF)07_BC variant in Sichuan, China. This study examined 375 plasma samples from patients with HIV-1 who were infected with the CRF07_BC strain, including 104 drug-naive participants and 271 in whom antiretroviral therapy(ART) had failed. Only one participant in the drug-naive group had a drug-resistance mutation(M46L), compared with 31.73% of those in whom ART had failed. Further analysis showed that 19.56% of strains contained mutations conferring resistance to non-nucleoside reverse transcriptase inhibitors(NNRTIs) alone, 0.74% were resistant to nucleoside reverse transcriptase inhibitors(NRTIs) alone, and 11.44% were dual-resistant to both NRTIs and NNRTIs. The most common mutation in the ART-failure group was M184V(35.88%), K103N(45.01%), Y181C(17.33%), and G190S/A(15.88%). The percentages of HIV-1 strains resistant to lamivudine, emtricitabine, efavirenz, etravirine, and nevirapine were 10.70%, 10.70%, 28.04%, 7.75%, and 26.20%, respectively. To explore site variants possibly related to drug resistance, variations in the ancestor/consensus CRF07_BC sequences from the therapy-naive and ART-failure groups were compared, and seven mutations at six positions were identified as being significantly differently distributed between the two groups(p<0.05). Detailed sequence data will provide information on CRF07_BC genetic characterizations, and improve our understanding of antiretroviral susceptibility and the evolution of drug-resistance mutations. This will be valuable in developing and implementing local public-health approaches for HIV drug-resistance prevention and treatment.

Timing of mortality in severe acute pancreatitis:Experience from 643 patients

AIM: To determine the timing of mortality after onset of severe acute pancreatitis (SAP) and the course of the disease in a large series of patients. METHODS: From July 1996 to June 2005, all patients diagnosed with acute pancreatitis at Chang Gung Memorial Hospital, Taipei, Taiwan were retrospectively studied. Three thousand two hundred and fifty episodes of acute pancreatitis were recorded in 2248 patients (1431 males and 817 females; median age, 55.6 years; range, 18-97 years). Mortality was divided into two groups: early death (≤ 14 d after admission), and late death (> 14 d after admission). The clinical features of patients in these two groups were compared. RESULTS: Although the overall mortality rate of acute pancreatitis was 3.8% (123/3250), mortality rate of SAP was as high as 16.3% (105/643). Of those 105 SAP mortalities, 44 (41.9%) deaths occurred within the first 14 d after admission and 61 (58.1%) occurred after14 d. Incidence of early death did not significantly differ from that of late death. The co-morbidities did not contribute to the timing of death. Early deaths mainly resulted from multiple organ failure. Late deaths were mainly caused by secondary complication of infected necrosis. Intra- abdominal bleeding significantly caused higher mortality in late death. CONCLUSION: Approximately half (42%) of SAP deaths occur within 14 d and most were due to multiple organ failure. The late deaths of SAP were mostly due to infected necrosis.

Influence of age on prevalence rates of chronic complications of hospitalized aged patients with hypertension -- analysis of 17,682 cases

Objective To understand the relationship between age and chronic complications in hospitalized aged patients with hypertension, to provide evidence for hypertension prevention and control. Methods To retrospectively analyze the clinical and laboratory data on 17,682 patients with essential hypertension during Jan 1 s,, 1993-Dec 12th, 2008 in PLA general hospital. Results 1） Among all of the inrolled cases, those aged 60-64 account for 27.87%, 65-69 years group account for 26.55%, 70-74 years group accounted for 23.96%, 75-79 years group accounted for 14.14%, 80-84 years group accounted for 5.26%, 85-89 years group accounted for 1.69%, 〉 90 years accounted for 0.41%. 2） The prevalence rate of chronic complications in 60-69 years group were 31.3-31.2% for diabetes and,22.6-27.0% for cerebrovascular disease, 9.5-11.1% for myocardial infarction, 6.7-9.1% for heart failure, 5.8-6.0% for renal dysfanction 4.9-6.8% for atrial fibrillation, 0.1-0.3% for multiple organ dysfunction syndrome （MODS） in the elderly（P 〈0.05 ）. 3） The first four complications of hypertension were diabetes（33.5%）, cerebrovascular disease （31.9%）, myocardial infarction（13.2%） and heart failure（12.3%） in 70-74 years group （P〈0.05）, cerebrovascular disease （42.8%）, diabetes （32.8%）, heart failure （16.5%） and myocardial infarction（15.9%） in 75-79 years group （P〈0.05）, cerebrovascular disease （45.4%）, diabetes （35.0%）, heart failure （21.1%） and myocardial infarction（l 5.9%） in 80-84 years group （P〈0.05）, cerebrovascular disease（42.5%）, diabetes （35.8%）, heart failure （23.1%） and renal dysfanction （17.7%） in 85-89 years group（P〈0.05 ）,and cerebrovascular disease （45. 2%）, heart failure（31.5%） , diabetes （26.0%） and renal dysfanction （20.5%） in patients more than 90 years group （P〈0.05）. Conclusions The prevalence rate and kinds of chronic complications in hospitalized aged patients with hypertension were changed with the increasing age, and the first kind of complication is cerebrovascular disease. It is of more importance to prevent the occurrence of renal dysfanction and heart failure in those hypertension patients who were more than 80 years old.

Esophageal duplication cysts:Endosonographic findings in asymptomatic patients

Esophageal duplication cysts are rare inherited lesions usually diagnosed in early childhood. Most of them are found in the mediastinum and manifest themselves as separate masses along or in continuity with the native esophagus. Their prevalence remains unknown and they are treated either surgically or endoscopically. In this report we describe a series of four adult patients in whom esophageal duplication cysts were Iocalised intramurally as masses pressing on the esophageal lumen and who were diagnosed with endoscopic ultrasonography. All patients were initially referred to other centres for upper gastroduodenoscopy due to nonspecific dyspeptic symptoms. After finding suspicious lesions in the esophagus their endoscopists referred them for endoscopic ultrasound examination at our centre. In two of the cases lesions mimicked esophageal varices and the other two submucosal tumours. In all four patients endoscopic ultrasonography has shown esophageal duplication cysts. Patients had no symptoms suggesting disease of the esophagusand required no treatment. As the true prevalence of esophageal cysts is unknown, it is very likely that in many patients, like in these four described by us, they may cause no symptoms, remain undetected and require no intervention. Increasing availability of new diagnostic modalities such as endoscopic ultrasonography may change the current view regarding the prevalence of esophageal duplication cysts and prove that they may1 in fact, not be such rare findings.

Prevalence of depressive and anxiety disorders in Chinese gastroenterological outpatients

AIM:To investigate the prevalence and physicians' detection rate of depressive and anxiety disorders in gastrointestinal(GI)outpatients across China. METHODS:A hospital-based cross-sectional survey was conducted in the GI outpatient departments of 13 general hospitals.A total of 1995 GI outpatients were recruited and screened with the Hospital Anxiety and Depression Scale(HADS).The physicians of the GI departments performed routine clinical diagnosis and management without knowing the HADS score results.Subjects with HADS scores≥8 were subsequently interviewed by psychiatrists using the Mini International Neuropsy-chiatric Interview(MINI)to make further diagnoses. RESULTS:There were 1059 patients with HADS score ≥8 and 674(63.64%)of them undertook the MINI interview by psychiatrists.Based on the criteria of Diagnostic and Statistical Manual of Mental Disorders (4th edition),the adjusted current prevalence for depressive disorders,anxiety disorders,and comorbidity of both disorders in the GI outpatients was 14.39%, 9.42%and 4.66%,respectively.Prevalence of depressive disorders with suicidal problems[suicide attempt or suicide-related ideation prior or current;module C (suicide)of MINI score≥1]was 5.84%in women and 1.64%in men.The GI physicians'detection rate of depressive and anxiety disorders accounted for 4.14%. CONCLUSION:While the prevalence of depressive and anxiety disorders is high in Chinese GI outpatients, the detection rate of depressive and anxiety disorders by physicians is low.

High power focused-beam microwave hyperthermia combined with intrapleural injection of Shapeilin in the treatment of patients with malignant hydrothorax

Objective:The aim of the study was to evaluate the efficacy and toxicity of high power focused-beam microwave hyperthermia with intrapleural injection of Shapeilin for patients with malignant hydrothorax.Methods:Fifty-eight patients with malignant hydrothorax were divided into group A and group B randomly.All patients underwent indwelling pleural catheter and were treated by intrapleural injection of Shapeilin once three days.Treatment was composed of 3 times injection.Patients of group B received high power focused-beam microwave hyperthermia after injection of Shapeilin.Results:The response rate of group B(79.3%) was higher than that of group A(48.3%)(P < 0.05).Incidence of main adverse reactions,associated with Shapeilin,of two groups including fever and thoracodynia were similar(P > 0.05).Patients of group B didn't encounter severe toxicities of microwave hyperthermia.Conclusion:High power focused-beam microwave hyperthermia combined with intrapleural injection of Shapeilin is effective and tolerable for patients with malignant hydrothorax.

p53 codon 72 polymorphism and liver cancer susceptibility: A meta-analysis of epidemiologic studies

AIM:To evaluate the association between p53 codon 72 polymorphism and liver cancer risk by means of meta-analysis. METHODS:Two investigators independently searched the Medline,Embase and Chinese Biomedicine databases.Summary odds ratios and 95%CI for p53 codon 72 polymorphism and liver cancer were calculated in fixedeffects model(Mantel-Haenszel method)and randomeffects model(DerSimonian and Laird method)when appropriate. RESULTS:This meta-analysis included 1115 liver cancer cases and 1778 controls.The combined results based on all studies showed that there was a statistically significant link between Pro/Pro genotype and liver cancer,but not between Arg/Arg or Pro/Arg genotype and liver cancer.When stratifying for race,similar results were obtained,i.e.patients with liver cancer had a significantly higher frequency of Pro/Pro genotype than non-cancer patients among Asians.After stratifying thevarious studies by control source,gender,family history of liver cancer and chronic hepatitis virus infection,we found that(1)patients among hospital-based studies had a significantly higher frequency of Pro/Pro and a significantly lower frequency of Arg/Arg genotype than individuals without cancer;(2)female patients with liver cancer had a significantly lower frequency of Arg/Arg and a higher frequency of Pro/Arg+Pro/Pro genotypes than female individuals without cancer;(3)subgroup analyses for family history of liver cancer did not reveal any significant association between p53 codon 72 polymorphism and liver cancer development;and(4) patients with negative hepatitis virus infection had a significantly higher frequency of Pro/Pro and a significantly lower frequency of Arg/Arg genotype than individuals without cancer. CONCLUSION:This meta-analysis suggests that the p53 codon 72 polymorphism may be associated with liver cancer among Asians.

Self-care among older Chinese people with chronic heart failure： the roles of cognitive and psychosocial characteristics

Chronic heart failure （CHF） is a complex clinical syndrome resulting from inefficient myocardial pumping, and is characterised by a typical progressively deteriorating trajectory punctuated by serious episodes of acute disease decompensation.High prevalence of hospital admission has been reported.[2] However, around 40% of hospital admissions was avoidable if patients demonstrate consistent self-care.

Low Sero-Prevalence of Toxoplasma gondii IgG and IgM Antibodies in HIV Sero-Positive Patients Attending National Hospital, Abuja, Nigeria

Several researchers have investigated the association of numerous opportunistic pathogens with HIV, little is documented on its association with T. gondii in our environment. We investigated the prevalence of T. gondii immunoglobulins G and M （IgG and IgM） in HIV positive individuals in relation to their cluster of differentiation 4 （CD4） cells count. IgG, IgM and CD4 were assayed using enzyme immunoassay （EIA） and flowcytometry respectively. 341 HIV positive individuals were studied in the present research, 30 （8.7%） of them had T. gondii IgG and IgM, 297 subjects had CD4 cells count a range of 200-400 cells/μL, 27 （9.7%） and 2 （0.6%） of which had T. gondii IgG and IgM respectively. Of the 44 HIV positive subjects with CD4 〉 400 cells/μL, one （2.2%） was positive for T. gondii IgG. In the control group, all the 177 had CD4 〉 400 cells/μL of which, one （0.5%） had T. gondii IgG. The prevalence of T. gondii infection was significantly higher in HIV positive individuals than in controls （P 〈 0.05）. Male subjects in the age bracket 18-30 years had significantly higher prevalence when compared to other groups （P 〈 0.05）. Although the present findings revealed a low prevalence of T. gondii antibodies in HIV infection, this suggests that a differential toxoplasmosis diagnosis is also necessary in cases of encephalitis in HIV infection.

Helicobacter pylori infection in bleeding peptic ulcer patients after non-steroidal antiinflammatory drug consumption

AIM： TO establish the prevalence of He/icobacterpy/on （H. pylori） infection in patients with a bleeding peptic ulcer after consumption of non-steroidal antiinflammatory drugs （NSAIDs）.METHODS： A very early upper endoscopy was performed to find the source of upper gastrointestinal bleeding and to take biopsy specimens for analysis of H. pylori infection by the rapid urease （CLO） test, his- tological examination, and bacterial culture. TgG anti- CagA were also sought. The gold standard for identifying H. pylori infection was positive culture of biopsy specimens or contemporary positivity of the CLO test and the presence of H. pylori on tissue sections.RESULTS： Eighty patients, 61 males （76.3%）, mean age 61.2 ~ 15.9 years, were consecutively enrolled. Forty-seven （58.8%） patients occasionally consumed NSAIDs, while 33 （41.3%） were on chronic treatment with low-dose aspirin （LD ASA）. Forty-four （55.0%） patients were considered infected by H. pylori. The infection rate was not different between patients who occasionally or chronically consumed NSAIDs. The culture of biopsy specimens had a sensitivity of 86.4% and a specificity of 100%; corresponding figures for histological analysis were 65.9% and 77.8%, for the CLO test were 68.2% and 75%, for the combined use of histology and the CLO test were 56.8% and 100%, and for IgG anti-CagA were 90% and 98%. The high- est accuracy （92.5%） was obtained with the culture of biopsy specimens.CONCLUSION： Patients with a bleeding peptic ulcer after NSAID/LD ASA consumption frequently have H. pylori infection. Biopsy specimen culture after an early upper gastrointestinal tract endoscopy seems the most efficient test to detect this infection.

No association between IRF3 polymorphism and susceptibility to hepatitis B virus infection in Chinese patients

AIM:To investigate the association between three tag single nucleotide polymorphisms (tagSNPs) in inter-feron regulatory factors (IRF3) and the genetic suscep-tibility to chronic hepatitis B virus (HBV) infection.METHODS:We performed a case-control study of 985 Chinese cases of chronic HBV infection and 294 self-limiting HBV-infected individuals as controls.Three tagSNPs in IRF3 (rs10415576,rs2304204,rs2304206) were genotyped with the Multiplex SNaPshot technique.The genotype and allele frequencies were calculatedand analyzed.RESULTS:The three SNPs showed no significant geno-type/allele associations with chronic HBV infection.Overall allele P values were:rs10415576,P=0.0908,odds ratio (OR) [95% confidence interval (CI)]=1.1798 (0.9740-1.4291);rs2304204,P=0.5959,OR (95% CI)=1.0597 (0.8552-1.3133);rs2304206,P=0.8372,OR (95% CI)=1.0250 (0.8097-1.2976).Overall genotype P values were:rs10415576,P=0.2106;rs2304204,P=0.8458;rs2304206,P=0.8315.There were no statisti-cally significant differences between patients with chron-ic HBV infection and controls.Haplotypes generated by these three SNPs were also not significantly different between the two groups.CONCLUSION:The three tagSNPs of IRF3 are not asso-ciated with HBV infection in the Han Chinese population.

Incidence of human papilloma virus in esophageal squamous cell carcinoma in patients from the Lublin region

AIM:To assess the prevalence of human papilloma virus(HPV) in esophageal squamous cell carcinoma(ESCC) in the south-eastern region of Poland.METHODS:The study population consisted of 56 ESCC patients and 35 controls.The controls were patients referred to our department due to other nonesophageal and non-oncological disorders with no gross or microscopic esophageal pathology as confirmed by endoscopy and histopathology.In the ESCC patients,samples were taken from normal mucosa(56 mucosa samples) and from the tumor(56 tumor samples).Tissue samples from the controls were taken from normal mucosa of the middle esophagus(35 control samples).Quantitative determination of DNA was carried out using a spectrophotometric method.Genomic DNA was isolated using the QIAamp DNA Midi Kit.HPV infection was identified following PCR amplification of the HPV gene sequence,using primers MY09 and MY11 complementary to the genome sequence of at least 33 types of HPV.The sequencing results were computationally analyzed using the basic local alignment search tool database.RESULTS:In tumor samples,HPV DNA was identified in 28 of 56 patients(50%).High risk HPV phenotypes(16 or/and 18) were found in 5 of 56 patients(8.9%),low risk in 19 of 56 patients(33.9%) and other types of HPV(37,81,97,CP6108) in 4 of 56 patients(7.1%).In mucosa samples,HPV DNA was isolated in 21 of 56 patients(37.5%).High risk HPV DNA was confirmed in 3 of 56 patients(5.3%),low risk HPV DNA in 12 of 56 patients(21.4%),and other types of HPV in 6 of 56 patients(10.7%).In control samples,HPV DNA was identified in 4 of 35 patients(11.4%) with no high risk HPV.The occurrence of HPV in ESCC patients was significantly higher than in the controls [28 of 56(50%) vs 4 of 35(11.4%),P < 0.001].In esophageal cancer patients,both in tumor and mucosa samples,the predominant HPV phenotypes were low risk HPV,isolated 4 times more frequently than high risk phenotypes [19 of 56(33.9%) vs 5 of 56(8.9%),P < 0.001].A higher prevalence of HPV was identified in female patients(71.4% vs 46.9%).Accordingly,the high risk phenotypes were isolated more frequently in female patients and this difference reached statistical significance [3 of 7(42.9%) vs 2 of 49(4.1%),P < 0.05].Of the pathological characteristics,only an infiltrative pattern of macroscopic tumor type significantly correlated with the presence of HPV DNA in ESCC samples [20 of 27(74.1%) vs 8 of 29(27.6%) for ulcerative or protruding macroscopic type,P < 0.05].The occurrence of total HPV DNA and both HPV high or low risk phenotypes did not significantly differ with regard to particular grades of cellular differentiation,phases in depth of tumor infiltration,grades of nodal involvement and stages of tumor progression.CONCLUSION:Low risk HPV phenotypes could be one of the co-activators or/and co-carcinogens in complex,progressive,multifactorial and multistep esophageal carcinogenesis.