Targeting sepsis through inflammation and oxidative metabolism

Infection is a public health problem and represents a spectrum of disease that can result in sepsis and septic shock.Sepsis is characterized by a dysregulated immune response to infection.Septic shock is the most severe form of sepsis which leads to distributive shock and high mortality rates.There have been significant advances in sepsis management mainly focusing on early identification and therapy.However,complicating matters is the lack of reliable diagnostic tools and the poor specificity and sensitivity of existing scoring tools i.e.,systemic inflammatory response syndrome criteria,sequential organ failure assessment(SOFA),or quick SOFA.These limitations have underscored the modest progress in reducing sepsis-related mortality.This review will focus on novel therapeutics such as oxidative stress targets,cytokine modulation,endothelial cell modulation,etc.,that are being conceptualized for the management of sepsis and septic shock.

Role of inflammation and infection in the pathogenesis of human acute liver failure: clinical implications for monitoring and therapy

Acute liver failure is a rare and devastating clinical condition. At present, emergency liver transplantation is the only life-saving therapy in advanced cases, yet the feasibility of transplantation is affected by the presence of systemic inflammation, infection and resultant multiorgan failure. The importance of immune dysregulation and acquisition of infection in the pathogenesis of acute liver failure and its associated complications is now recognised. In this review we discuss current thinking regarding the role of infection and inflammation in the pathogenesis of and outcome in human acute liver failure, the implications for the management of such patients and suggest directions for future research.

Microbiota and the gut-liver axis:Bacterial translocation,inflammation and infection in cirrhosis

Liver disease is associated with qualitative and quantitative changes in the intestinal microbiota. In cirrhotic patients the alteration in gut microbiota is characterized by an overgrowth of potentially pathogenic bacteria (i.e., gram negative species) and a decrease in autochthonous familiae. Here we summarize the available literature on the risk of gut dysbiosis in liver cirrhosis and its clinical consequences. We therefore described the features of the complex interaction between gut microbiota and cirrhotic host, the so called “gut-liver axis”, with a particular attention to the acquired risk of bacterial translocation, systemic inflammation and the relationship with systemic infections in the cirrhotic patient. Such knowledge might help to develop novel and innovative strategies for the prevention and therapy of gut dysbiosis and its complication in liver cirrhosis.

Long-term Impact of Intrauterine MCMV Infection on Development of Offspring Nervous System

This study examined the impacts of intrauterine murine cytomegalovirus（MCMV） infection on the long-term learning and memory of offspring.Sexually matured male and female BALB/C mice without MCMV infection were identified by ELISA and then mated.Seventy pregnant mice were randomly divided into the virus group（n=40） and the control group（n=30）,in which the pregnant mice were subjected to placenta inoculation of MCMV suspension（1 μL,1×106 PFU） or the same amount of cell culture medium,respectively,at gestational age of 12.5 days.Some pregnant mice [virus group（n=20）,control group（n=15）] were sacrificed by cervical dislocation at gestational age of 18.5 days,and the head circumference and brain weight of the mouse fetuses were measured,and the MCMV infection in their brain tissues was detected by PCR.The other pregnant mice [virus group（n=20）,control group（n=15）] delivered naturally,and the learning and memory capability of the offspring at 70-day-old was analyzed by Morris water maze test.The results showed that 28.57% mouse fetuses in the virus group developed viral infection in the brain.Their head circumference and brain weight were significantly reduced as compared with those in the control group（P0.01）.The Morris water maze test revealed that the mouse offspring in the control group found the platform with straight-line trajectories after training.In contrast,the counterparts in the virus group intended to enter the central area,but looked for the platform with a circular trajectory.And the infected mice exhibited prolonged swimming distance and swimming latency（P0.01）.It was concluded that：（1） placenta inoculation of MCMV can cause fetal brain infection and intrauterine development retardation;（2） the offspring of MCMV placenta inoculation mice showed a long-term decline in learning and memory capability.

A Study on the Traditional Chinese Medicine Jinyebaidu for Prevention and Treatment of Intrauterine Infection with Guinea Pigs Cytomegalovirus

The purpose is to study the prophylactic and therapeutic effect of the traditional Chinese Medicine （TCM）-Jinyebaidu （JYBD） to guinea pig cytomegalovirus （GPCMV） intrauterine infection. The virus-free female and male guinea pigs were screened with nest-polymerase chain reaction （N-PCR）. After inbred, pregnant guinea pigs were selected and divided into 3 groups randomly： 5 guniea pigs of the blank control group were not given either GPCMV or JYBD. 31 guniea pigs of the positive control group were inoculated 1 mL （107 TCID50 ） suspension of GPCMV intraperitoneal. 10 gunlea pigs of the experimental group were inoculated GPCMV firstly and then perfused stomach with JYBD for 14 days （Dosage in accordance with the modulus of the weight ratio of human to guniea pig）. The effects of JYBD on the intrauterine infection of GPCMV were observed. The results showed that JYBD could decrease the maternal infection rate from 100 % （31/31） to 50 % （5/10） （P〈0. 001）, the intrauterine infection rate from 100% （72/72） to 75 % （21/28） （P〈 0. 001）, and the rate of abnormal outcome of pregnancy from 64.4 % （29/45） to 25.0 % （7/28） （P〈0. 001）, the infective symptoms being relieved. It can be concluded that traditional Chinese medicine- JYBD can prevent and treat GPCMV intrauterine infection, and can be expected a prophylactic drug for HCMV intrauterine infection.

Protective Effects of Activated Protein C on Neurovascular Unit in a Rat Model of Intrauterine Infection-Induced Neonatal White Matter Injury

Summary： Activated protein C （APC）, a natural anticoagulant, has been reported to exert direct vascu- loprotective, neural protective, anti-inflammatory, and proneurogenic activities in the central nervous system. This study was aimed to explore the neuroprotective effects and potential mechanisms of APC on the neurovascular unit of neonatal rats with intrauterine infection-induced white matter injury. In- traperitoneal injection of 300 ~tg/kg lipopolysaccharide （LPS） was administered consecutively to preg- nant Sprague-Dawley rats at embryonic days 19 and 20 to establish the rat model of intrauterine infec- tion-induced white matter injury. Control rats were injected with an equivalent amount of sterile saline on the same time. APC at the dosage of 0.2 mg/kg was intraperitoneally injected to neonatal rats imme- diately after birth. Brain tissues were collected at postnatal day 7 and stained with hematoxylin and eo- sin （H＆E）. Immunohistochemistry was used to evaluate myelin basic protein （MBP） expression in the periventricular white matter region. Blood-brain barrier （BBB） permeability and brain water content ~were measured using Evens Blue dye and wet/dry weight method. Double immunofluorescence staining and real-time quantitative PCR were performed to detect microglial activation and the expression of protease activated receptor 1 （PAR1）. Typical pathological changes of white matter injury were ob- served in rat brains exposed to LPS, and MBP expression in the periventricular region was significantly decreased. BBB was disrupted and the brain water content was increased. Microglia were largely acti- vated and the mRNA and protein levels of PAR1 were elevated. APC administration ameliorated the pathological lesions of the white matter and increased MBP expression. BBB permeability and brain water content were reduced. Microglia activation was inhibited and the PAR1 mRNA and protein ex- pression levels were both down-regulated. Our results suggested that APC exerted neuroprotective ef- fects on multiple components of the neurovascular unit in neonatal rats with intrauterine infec- tion-induced white matter injury, and the underlying mechanisms might involve decreased expression of PAR1.

Risk factors for prostatic inflammation extent and infection in benign prostatic hyperplasia

Aim： To investigate the risk factors for prostatic inflammation extent and infection in patients with benign prostatic hyperplasia （BPH） so as to manage prostatic inflammation more efficiently. Methods： Sixty patients with BPH undergoing TURP between September 2005 and December 2005 in West China Hospital of Sichuan University were studied. Prostate fluid （PF） was collected for the measurement of secretory IgA （SIgA） and complement 3 （C3）. Prostate tissue were collected for testing bacterial 16S rDNA by real-time PCR, examining SIgA in the tissue and examining the inflammation. The possible clinical and immune risk factors for prostatic inflammation or infection were analyzed by using the logistic regression method. Results： Abnormal white blood cell count in urinalysis, prostatic infection and a high concentration of C3 in PF are the risk factors for prostatic inflammation extent （P = 0.025, 0.034 and 0.035, respectively and odds ratio [OR] = 18.269, 8.284 and 1.508, respectively）. Risk factors for prostatic infection include the C3 concentration and the concentration of SIgA in PF （P = 0.003 and 0.013, respectively, and OR=1.645 and 0.993, respectively）. Conclusion： The present study suggests that prostatic inflammation is associated with urinary tract infection, prostatic infection and the activated complement and that prostatic infection is associated with the activated complement and downregulated mucosal immunity in prostates of the patients with BPH. It is also suggested that individual immune regulation should be considered in the treatment of prostatic inflammation and infection of patients with BPH.

Inhibitory Effect of LPS on the Proliferation of Oligodendrocyte Precursor Cells through the Notch Signaling Pathway inIntrauterine Infection-induced Rats

Periventricular white matter injury (PWMI)is very common in survivors of premature birth,and the final outcomes are a reduction in myelinated neurons leading to white matter hypomyelination.How and (or) why the oligodendrocyte lineage develops abnormally and myelination is reduced is a hot topic in the field.This study focuses on the effect of intrauterine inflammation on the proliferation of oligodendrocyte lineage cells and the underlying mechanisms.Lipopolysaccharide (LPS)(300μg/kg)was intraperitoneally injected into pregnant Sprague-Dawley rats at embryonic days 19 and 20 to establish a rat model of intrauterine infection-induced white matter injury.Corpus callosum tissues were collected at postnatal day 14(P14)to quantify the number of oligodendrocytes,the number and proliferation of oligodendrocyte precursor cells (OPCs), and the expression of myelin proteins (MBP and PLP).Furthermore,the expression of Writ and Notch signaling-related proteins was analyzed.The results showed that the number of oligodendrocytes in the corpus callosum tissues of LPS-treated rats was reduced,and the expression levels of myelinating proteins were down-regulated.Further analysis showed that the Notch signaling pathway was down-regulated in the LPS-treated group.These results indicate that intrauterine LPS may inhibit the proliferation of OPCs by down-regulating the Notch rather than the Writ signaling pathway,leading to hypomyelination of white matter.

Holistic paradigm in carcinogenesis:Genetics,epigenetics,immunity,inflammation and oral infections

Recent debate among the experts of cancer research regarding the main causes of carcinogenesis encouraged us to review the etiology of cancer pathogenesis. The somatic mutation theory attributes carcinogenesis to random errors in DNA multiplication while the tissue organization field theory ascribes causation to environmental factors. We recognize complexity in cancer pathogenesis and accept the premise of both DNA multiplication errors and environmental factors in cancer development. Furthermore, it should also be noted that the combination of these factors and the relative importance of the each differ in various types of cancers. For example, in some cancers, genetics plays a prominent role while in others environment such as obesity plays a much stronger role. Additionally, the cancer mitigating factors should also be considered. The balance of cancer-enhancing and cancer-suppressing forces determines the cancer incidence. Ultimately, identifying the lifestyle factors that revise somatic mutations or epigenetic alterations will lead to a clear understanding of pathogenic mechanisms of cancer and to the optimal preventive strategies. This narrative review evaluates the published evidence on carcinogenesis pertaining to the whole organism(thus, holistic) incorporating genetics, epigenetics, immunology, inflammation and infections with emphasis on oral infections.

Relationship between HBV viremia level of pregnant women and intrauterine infection:neated PCR for detection of HBV DNA

IM To determine the incidence of hepatitis B virus (HBV) intrauterine infection and to explore the relationship between HBV viremia level of pregnant women and HBV intrauterine infection.METHODS Sixtynine pregnant women were divided into three groups. Group A, 41 HBsAg positive patients, 14 of them were HBeAg positive (group A1), and 27 HBeAg negative (group A2); Group B, 12 HBsAg negative patients, but positive for antiHBs and/or antiHBe and/or antiHBc; and Group C, 16 patients negative for all HBV markers. Blood samples of mothers were taken at delivery, samples of their infants were collected within 24 hours after birth (before injection of HBIG and HBV vaccine). All the serum samples were stored at -20℃. HBV serum markers were tested by radioimmunoassay and HBV NDA were detected by nested polymerase chain reaction.RESULTS In group C, all of 16 newborns were negative for HBsAg and HBV DNA. In group A, 7 infants were HBsAg positive (171%), and 17 (415%) were HBV DNA positive (P<005). The incidence of intrauterine HBV infection was much higher in group A1 than that in group A2 (HBsAg 429% vs 37%, HBV DNA 929% vs 148%, P<005). The incidence of HBV intrauterine infection was significantly different between high and low HBV viremia of mothers (933% vs 429%, P<005).CONCLUSION The incidence of HBV intrauterine infection is high when HBV DNA in newborns detected with nested PCR is used as a marker of HBV infection. It is related to HBV viremia level of mothers.

Establishment and validation of a nomogram for predicting the risk of liver inflammation in chronic HBV infection

Objective:To establish a non-invasive quantitative and visual predictive model for assessing the occurrence of significant inflammation in chronic HBV infection,and to present nomogram to validate the efficacy.Methods:A total of 180 patients with chronic HBV infection that were admitted to the Department of Infectious Liver Diseases of the First Affiliated Hospital of Hainan Medical College from January 2019 to December 2021 with informed consent and underwent liver biopsy puncture were selected,and to prevent overfitting of the model,131 patients and 49 patients were randomly divided into a model group and a validation group according to randomization,to collect the clinic information,serological examination,liver elastography and liver histopathology results.The patients were divided into non-significant inflammation and significant inflammation groups in the modeling group.The R 4.1.1 package and the rms package were used to build the column line graph model,while the Bootstrap method was applied to repeat the sampling 1000 times for internal and external validation,and the H-L goodness of fit test and ROC curve were used to assess the calibration and discrimination of the column line graph model respectively.Results:A total of 180 patients with chronic HBV infection were included,and 92 patients(51.1%)had significant inflammation.In the modeling set,67 patients(51.1%)had significant inflammation.In the modeled group,comparison of HBV DNA,PLT,ALT,AST,ALP,GGT,PAB,H.A,PⅢP,CⅣ,L.N,IL-6,LSM and HBeAg for non-significant inflammation and significant inflammation showed statistically significant differences(P<0.05).Nomogram were obtained using stepwise regression analysis to establish a predictive model for the risk of significant inflammation following chronic HBV infection.The χ^(2) values of the H-L goodness-of-fit test for the modelling and validation groups were 0.279 and 2.098,respectively,corresponding to P values of 0.87 and 0.35,suggesting that the nomogram has good predictive accuracy;the area under the ROC curve of the column line plot predicting the occurrence of significant inflammation after HBV infection for the modelling and validation groups was 0.895[95%CI(0.843-0.948)]and 0.760[95%CI(0.622-0.897)],suggesting that the column line plot model has good discrimination.Conclusion:After stepwise regression analysis,it was established that PLT,Ln(HBV-DNA),AST,C桇and LSM were more closely associated with the occurrence of significant inflammation after HBV infection,and a visualization of the occurrence of significant inflammation nomogram was established by comprehensive assessment,and the effectiveness was good.

Effects of intrauterine infection in different periods on the placenta and endometrial blood vessel formation of pregnant mice and the growth and development of fetal rats

Objective:To investigate the effects of intrauterine infection in different periods on the placenta and endometrial blood vessel formation of pregnant rats and the growth and development of fetal rats.Methods:According to the random number table method,32 pregnant rats were divided into the early infection group,the mid-term infection group,the late infection group and the control group,with 8 rats in each group.On the 3rd,9th and 15th day of pregnancy,lipopolysaccharide was injected intraperitoneally to construct intrauterine infection models.The pregnant rats in the control group were intraperitoneally injected with the same dose of 0.9%sodium chloride solution.On the 18th day of pregnancy,the inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-(TNF-)],the blood vessel density of placenta and endometrium in the placental tissues of pregnant rats,dead fetus+absorbed fetus,the inflammatory factors IL-6,TNF-and oxidation reaction indicators[malondialdehyde(MDA)and myeloperoxidase(MPO)]in the fetal rat lung and brain tissues were detected.Results:The changing trend of IL-6 and TNF-levels in the placental tissues of pregnant rats with intrauterine infection in different periods was:the control group<the late infection group<the mid-term infection group<the early infection group,the differences were statistically significant(p<.05).The changing trend of fetal rat weight,placental weight and placental coefficient in the intrauterine infection groups in different periods was:the control group>the late infection group>the mid-term infection group>the early infection group,the differences were statistically significant(p<.05).The blood vessel density of placenta and endometrium,the mean number of fetuses,brain coefficient and lung coefficient in the late infection group were significantly increased in comparison with the early infection group and the mid-term infection group.The total number and the ratio of dead fetus+absorbed fetus,the levels of IL-6,TNF-,MDA and MPO in brain and lung tissues were significantly reduced,and the differences were statistically significant(p<.05).The blood vessel density of placenta and endometrium,brain coefficient and lung coefficient of pregnant rats in the mid-term infection group were significantly increased in comparison with the early infection group,and the differences were statistically significant(p<.05).There was no statistically significant difference in the other indicators between the two groups(p>.05).Conclusions:Intrauterine infection in different periods can inhibit placental and endometrial angiogenesis,and affect the survival rate of fetal rats and the growth and development of brain and lung.The reason may be related to the aggravation of fetal inflammatory responses and oxidative stress.The earlier the intrauterine infection occurs,the severer the adverse effects on the fetal rats will be.

Inflammatory response of macrophages in infection

BACKGROUND: Macrophages are widely-distributed innate immune cells playing diverse roles in various physiological and pathological processes. The primary function of macrophages is to phagocytize and clear invading pathogens.DATA SOURCES: A systematic search of PubMed was performed to identify relevant studies in English language literature using the key words such as macrophage and inflammation. A total of 122 articles related to inflammatory response of macrophages in infection were systematically reviewed.RESULTS: The inflammatory responses of macrophages triggered by infection comprise four interrelated phases:recognition of pathogen-associated molecular patterns by pattern-recognition receptors expressed on/in macrophages;enrichment of quantity of macrophages in local infected tissue by recruitment of circulating monocytes and/or in situ proliferation; macrophage-mediation of microbicidal activity and conversion to anti-inflammatory phenotype to terminate anti-infectious response and to promote tissue repair.Complicated regulation of macrophage activation at molecular level recognized in the past decade is also reviewed, including intracellular multiple signaling molecules, membrane molecules,microRNAs and even epigenetic-associated molecules.CONCLUSION: The inflammatory response of macrophages in infection is an orderly and complicated process under elaborate regulation at molecular level.

How inflammation influences psychiatric disease

Recent studies highlight the strong correlation between infectious diseases and the development of neuropsychiatric disorders.In this editorial,we comment on the article“Anti-infective therapy durations predict psychological stress and laparoscopic surgery quality in pelvic abscess patients”by Zhang et al,published in the recent issue of the World Journal of Psychiatry 2023;13(11):903-911.Our discussion highlighted the potential consequences of anxiety,depression,and psychosis,which are all linked to bacterial,fungal,and viral infections,which are relevant to the impact of inflammation on the sequelae in mental health as those we are observing after the coronavirus disease 2019 pandemic.We focus specifically on the immune mechanisms triggered by inflammation,the primary contributor to psychiatric complications.Importantly,pathophysiological mechanisms such as organ damage,post-injury inflammation,and infectioninduced endocrine alterations,including hypocortisolism or autoantibody formation,significantly contribute to the development of chronic low-grade inflammation,promoting the emergence or development of psychiatric alterations in susceptible individuals.As inflammation can have long-term effects on patients,a multidisciplinary treatment plan can avoid complications and debilitating health issues,and it is crucial to recognize and address the mental health implications.

Pterostilbene attenuates intrauterine growth retardation-induced colon inflamm tion in piglets by modulating endoplasmic reticulum stress and autophagy

Background:Endoplasmic reticulum(ER)stress and autophagy are implicated in the pathophysiology of intestinal inflammation;however,their roles in intrauterine growth retardation(IUGR)-induced colon inflammation are unclear.This study explored the protective effects of natural stilbene pterostilbene on colon inflammation using the IUGR piglets and the tumor necrosis factor alpha(TNF-α)-treated human colonic epithelial cells(Caco-2)by targeting ER stress and autophagy.Results:Both the IUGR colon and the TNF-α-treated Caco-2 cells exhibited inflammatory responses,ER stress,and impaired autophagic flux(P<0.05).The ER stress inducer tunicamycin and the autophagy inhibitor 3-methyladenine further augmented inflammatory responses and apoptosis in the TNF-α-treated Caco-2 cells(P<0.05).Conversely,pterostilbene inhibited ER stress and restored autophagic flux in the IUGR colon and the TNF-α-treated cells(P<0.05).Pterostilbene also prevented the release of inflammatory cytokines and nuclear translocation of nuclear factor kappa B p65,reduced intestinal permeability and cell apoptosis,and facilitated the expression of intestinal tight junction proteins in the IUGR colon and the TNF-α-treated cells(P<0.05).Importantly,treatment with tunicamycin or autophagosome-lysosome binding inhibitor chloroquine blocked the positive effects of pterostilbene on inflammatory response,cell apoptosis,and intestinal barrier function in the TNF-α-exposed Caco-2 cells(P<0.05).Conclusion:Pterostilbene mitigates ER stress and promotes autophagic flux,thereby improving colon inflammation and barrier dysfunction in the IUGR piglets and the TNF-α-treated Caco-2 cells.

Captopril alleviates lung inflammation in SARS-CoV-2-infected hypertensive mice

Severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)is the etiologic agent responsible for the global coronavirus disease 2019(COVID-19)pandemic.Numerous studies have demonstrated that cardiovascular disease may affect COVID-19 progression.In the present study,we investigated the effect of hypertension on viral replication and COVID-19 progression using a hypertensive mouse model infected with SARS-Co V-2.Results revealed that SARS-Co V-2 replication was delayed in hypertensive mouse lungs.In contrast,SARS-Co V-2 replication in hypertensive mice treated with the antihypertensive drug captopril demonstrated similar virus replication as SARS-Co V-2-infected normotensive mice.

Research Progress on Infectious Inflammation Markers in Blood

Acute phase protein (APP) is a type of special protein closely related to infection inflammation. In recent years, a large number of studies have shown that multiple positive and negative APPs, including C-reactive protein, serum amyloid A, procalcitonin,haptoglobin, alpha1 acid glycoprotein, ceruloplasmin, fibrinogen, prealbumin, leptin,albumin, and plasma fibronectin, are significantly correlated to infectious inflammationand that this method is more accurate and reliable than somatic cell test, erythrocyte sedimentation rate test, enzyme activity and content change test, and the like. Therefore,APP could be used as an infectious inflammation marker.

Evaluation of systemic inflammatory and stress response in patients with COPD complicated by pulmonary infection after bronchoalveolar lavage with ambroxol hydrochloride

Objective: To evaluate the systemic inflammatory and stress response in patients with COPD complicated by pulmonary infection after bronchoalveolar lavage with ambroxol hydrochloride. Methods: A total of 78 patients with COPD complicated by acute pulmonary infection who were treated in the hospital between October 2015 and January 2017 were collected as research subjects and divided into control group (n=39) and study group (n=39) by random number table. Control group received routine treatment, and study group received the routine + bronchoalveolar lavage with ambroxol hydrochloride. The differences in serum levels of inflammatory factors and oxidative stress indexes were compared between the two groups before treatment and after 1 week of treatment. Results: There was no statistically significant difference in serum levels of inflammatory factors and oxidative stress indexes between the two groups before treatment. After 1 week of treatment, serum inflammatory factors IL-2, IL-6, IL-8, TNF- , CRP and PCT levels of study group were lower than those of control group;serum oxidation indexes MDA, MPO and AOPPs levels were lower than those of control group while anti-oxidation indexes SOD, T-AOC and GSH-Px levels were higher than those of control group. Conclusion: Bronchoalveolar lavage with ambroxol hydrochloride can significantly inhibit the systemic inflammatory and oxidative stress response and help control the disease in patients with COPD complicated by pulmonary infection.

Male accessory gland inflammation prevalence in type 2 diabetic patients With symptoms possibly reflecting autonomic neuropathy

Male accessory gland inflammation or infection （MAGI） is a potentially underdiagnosed complication of type 2 diabetes （DM2）; specifically, we reported in a recent study that the frequency of MAGI was 43% among DM2 patients. In previous studies, we have demonstrated that diabetic autonomic neuropathy （DAN） is associated with a peculiar ultrasound characterization of the seminal vesicles （SVs） in DM2 patients. The aim of the present study was to evaluate the frequency of MAGI in two different categories of DM2 patients （i.e. patients with and without symptoms that possibly reflect DAN） and the respective ultrasound characterizations. Sixty DM2 patients with a mean （± s.e.m.） age of 42.0 ± 6.0 years （range： 34-47 years） were classified according to the presence or the absence of symptoms that could possibly reflect DAN （group A： DM2 with symptoms possibly reflecting DAN, n = 28 patients and group B： DM2 without symptoms possibly reflecting DAN, n = 32 patients）. The patients in Group A exhibited a significantly higher frequency of MAGI compared with those in group B patients （P 〈 0.05）; moreover, the Group A patients exhibited a significantly higher frequency of ultrasound signs suggestive of vesiculitis （P 〈 0.05）. Finally, the concentrations of lymphocytes but not the concentrations of the leukocytes in the semen were significantly higher （P 〈 0.05） in group A compared with group B.

Innate immunity–the hallmark of Helicobacter pylori infection in pediatric chronic gastritis

BACKGROUND Innate immunity was found to be associated with both persistence of Helicobacter pylori(H.pylori)infection and increased risk of gastric cancer.AIM To identify the risk factors associated with H.pylori infection and to establish the role of TLR9 rs352140 in suppressing or promoting inflammation related to this infection in children.METHODS We performed a study of 155 children with digestive symptoms,who were divided into two groups according to the histopathological exam:Group 1–48 children with H.pylori-induced chronic gastritis,and Group 2–control group.RESULTS Rural area and poor living conditions were significantly associated with H.pylori chronic gastritis(P=0.0042/P<0.0001).Both positive immunoglobulin A anti H.pylori and the rapid urease test were significantly associated with H.pylori infection(P<0.0001).Significantly higher values of leukocytes and neutrophils within the peripheral blood were found in children with H.pylori chronic gastritis(P=0.111/P=0.284).We found a significant positive correlation between the variant TT genotype of TLR9 rs352140 polymorphism and both leucocytes and neutrophils(P=0.0225/P=0.0292).CONCLUSION Variant TT genotype carriers of the TLR9 rs352140 gene polymorphism might have a more severe degree of inflammation.