Controlled attenuation parameter for non-invasive assessment of hepatic steatosis in Chinese patients

AIM: To evaluate the performance of a novel non-invasive controlled attenuation parameter (CAP) to assess liver steatosis.

Global human genetics of HIV-1 infection and China

Genetic polymorphisms in human genes can influence the risk for HIV-1 infection and disease progression, although the reported effects of these alleles have been inconsistent. This review highlights the recent discoveries on global and Chinese genetic polymorphisms and their association with HIV-1 transmission and disease progression.

Identification of Human Hepatocyte Proliferation Related Gene C2orf69

Objective To construct the prokaryotic expression vector p ET-32a(+)-C2orf69 and induce the expression of recombinant proteins in vitro. Then the possible effects of recombinant protein on cell proliferation was observed and rabbit-anti-C2orf69 protein polyclonal antibodies was obtained.Methods Gene fragment of C2orf69 was amplified by PCR and then prokaryotic expression plasmid pE T-32a(+)-C2orf69 was constructed. Recombinant protein C2orf69 expression was identified by SDS-PAGE and Western blot. The white-ear rabbits were immunized with purified recombinant protein C2orf69, and the potency and specificity of polyclonal antibody were evaluated by enzyme-linked immunosorbent assay(ELISA) and Western blot. Also, different liver cells were incubated with recombinant protein C2orf69 in vitro. Results C2orf69 gene fragment was successfully amplified, results of gene sequencing were consistent with the sequence in Gen Bank. Recombinant protein of C2orf69 was successfully induced and expressed. The polyclonal antibody titer was up to 1︰1 280 000 through enzyme-linked immunosorbent assay. Results of cell proliferation showed that the recombinant protein could inhibit the proliferation of different liver cells. Conclusions The recombinant protein C2orf69 could inhibit the proliferation of different liver cells, and we speculated that it may be a widely roled inhibitor of hepatocyte proliferation. Our experiment showed that the proliferation inhibition of cells may be realized by G1 phase extending and S phase shortening.

Effect of Compound Glycyrrhizin Injection on Liver Function and Cellular Immunity of Children with Infectious Mononucleosis Complicated Liver Impairment

Objective： To investigate the effects of Compound Glycyrrhizin Injection （CGI） on liver function and cellular immunity of children with infectious mononucleosis complicated liver impairment （IM-LI） and to explore its clinical therapeutic effect. Methods： Forty-two patients with IM-LI were randomly assigned, according to the randomizing number table, to two groups, 20 in the control group and 22 in the treated group. All the patients were treated with conventional treatment, but to those in the treated group, CGI was given additionally once a day, at the dosage of 10 ml for children aged below 2 years, 20 ml for 2-4 years old, 30 ml for 5-7 years old and 40 ml for 8- 12 years old, in 100-200 ml of 5% glucose solution by intravenous dripping. The treatment lasted for 2 weeks. T lymphocyte subsets and serum levels of alanine transaminase （ALT）, aspartate aminotransferase （AST） and total bilirubin （TBil） were detected before and after treatment. Besides, a normal control group consisting of 20 healthy children was also set up. Results： Baseline of the percentage of CD3^＋ , CD8^＋ lymphocyte and serum levels of ALT, AST, TBiL in the children with IM-LI were markedly higher, while the percentage of CD 4^＋ lymphocyte and the CD4^＋/CD8^＋ ratio was markedly lower in IM-LI children as compared with the corresponding indices in the healthy children （ P〈0.01 ）. These indices were improved after treatment in both groups of patients, but the improvement in the treated group was better than that in the control group （P〈0.01）. Conclusion： Cellular immunity dysfunction often occurs in patients with IM-LI, and CGI treatment can not only obviously promote the recovery of liver function, but also regulate the immune function in organism.

Pseudomembranous colitis associated with a triple therapy for Helicobacter pylori eradication

Helicobacter pylori(H.pylori)is one of the most common chronic bacterial infections in humans,affecting half of world’s population.Therapy for H.pylori infection has proven to be both effective and safe.The oneweek triple therapy including proton pump inhibitor,clarithromycin,and amoxicillin or metronidazole is still recommended as a first-line treatment to eradicate H.pylori infection in countries with low clarithromycin resistance.Generally,this therapy is well-tolerated,with only a few and usually minor side effects.However,rare but severe adverse effects such as pseudomembranous colitis have been reported,Clostridium difficile(C.difficile)infection being the main causative factor in all cases.We report the cases of two women who developed pseudomembranous colitis after a 1-wk triple therapy consisting of pantoprazole 20 mg bid,clarithromycin 500 mg bid,and amoxicillin 1 g bid to eradicate H.pylori infection.A limited colonoscopy showed typical appearance of pseudomembranous colitis,and the stool test for C.difficile toxins was positive.Rapid resolution of symptoms and negative C.difficile toxins were obtained in both patients with oral vancomycin.No relapse occurred during a four and eleven-month,respectively,follow up.These cases suggest that physicians should have a high index of suspicion for pseudomembranous colitis when evaluate patients with diarrhea following H.pylori eradication therapy.

Vitamin D and Secondary Hyperparathyroidism in HIV Infected Patients Taking Antiretroviral Therapy

Objective: Due to the lack of studies assessing hypovitaminosis D and secondary hyperparathyroidism in Brazilian HIV-infected population, especially in the northeastern population, this study aimed to determine the profile of these conditions in patients infected with HIV and its correlation with immuno-virological, sociodemographic data and associated comorbidities. Methods: Comparison studies were obtained from routine clinical samples of HIV infected patients submitted for 25-OH Vitamin D, PTH and alkaline phosphatase determination. Results: A total of 78 patients were included, 42 (53.8%) males, mean age 45.7 years. Antiretroviral regimens most used in this study were Zidovudine/Lamivudine/Efavirenz 17.9%, Tenofovir/Lamivudine/Efavirenz 17.9%,Tenofovir/Lamivudine/Atazanavir-r 15.4%. The mean value CD4 count was 592.1 ± 247.2 cells/mm3, CD8 cell count was 1026.5 ± 467.3 cells/mm3, mean detectable viral load was 2220 ± 15703 copies and CD4/CD8 ratio was 0.63 ± 0.33. A total of 34 vitamin D dosages were collected with 41.2% representing sufficient amount and 58.8% insufficient. Alkaline Phosphatase (ALP) dosage was elevated in 49.3% (N=35) of the patients. Parathormone (PTH) was elevated in 18% (N = 11). Among patients with elevated PTH levels, 81.9% had elevated levels of ALP (p = 0.01). In the group of patients with high levels of ALP, 45.7% had a CD4 count 3 (p = 0.02). There was no significant difference in vitamin D related to gender (p = 0.21), age (p = 0.23), CD4 count (p = 0.26), suppressed viral load (p = 0.44) or blood glucose (p = 0.45). Conclusions: This study evidenced a high prevalence of Vitamin D insufficiency in Northeast Brazil, which suggests HIV infection correlation. A high prevalence of Hyperparathyroidism was detected and related with inflammatory condition persistence and low CD4 count. We suggest improve vitamin D follow up and measurements in this population with better CD4 count control to avoid future osteoarticular complications of HIV treatment.

Are HIV Infected People Well Prepared to Travel? Polish Experience

Introduction: This study aimed to identify knowledge about preparation for travel among Polish HIV infected patients. Materials and Methods: Our prospective questionnaire-based study assessed whether the abovementioned issues had an influence on travel plan decisions and whether HIV infected Polish people had any problems before and during travel. Results: All our 102 patients completed questionnaires. The majority sought pre-travel health advice. The mean duration of confirmed HIV infection was longer in travelers than in non-travelers (p = 0.02). More than half of travelers consulted with a physician prior to their journey but the most popular source of in-formation about the health risks of travelling was the internet while a doctor’s consultation was an alternative. Pre-travel prophylaxis was performed in less than 30% of patients. One of the most popular reasons for not travelling abroad was inadequate funds. Discussion: The situation of people with HIV in Poland is similar to that in other European countries. None of our patients had to give up their trip because of administrative barriers. HIV infected persons with a longer duration of infection were more willing to travel. One of the most popular reasons for not travelling abroad was inadequate funds. Among our patients, those afraid of potential health risks and inadequate funds are in the same proportion as in other countries. Conclusions: In our opinion, physicians should talk with HIV positive patients about their travel plans during routine visits. Polish HIV infected patients generally do not restrict their travel plans due to their HIV infection. The main sources of information for Polish HIV infected patients about possible problems during travel should be their doctor and additionally other sources of information like the internet.

Elevated exhaustion levels and reduced functional diversity of T cells in peripheral blood may predict severe progression in COVID-19 patients

The novel contagious primary atypical pneumonia epidemic,which broke out in Wuhan,China,in December 2019,is now formally called Coronavirus Disease 2019(COVID-19),with the causative virus named as Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2).1,2 Recent studies have shown that in addition to dyspnea,hypoxemia,and acute respiratory distress,lymphopenia,and cytokine release syndrome are also important clinical features in patients with severe SARS-CoV-2 infection.3 This suggests that homeostasis of the immune system plays an important role in the development of COVID-19 pneumonia.

Polymorphisms of chemokine receptors and its ligand alleles influencing genetic suscepti-bity to HIV-1 infection in eight ethnic groups in Chinese mainland

Limited genetic information is available concerning the polymorphisms of HIV-1 resistant genes in indigenous Chinese populations. The aim of this study is to identify the allelic frequencies of the chemokine and chemokine receptor genes in the Chinese mainland. Genomic DNA samples extracted from whole blood of 2318 subjects were analyzed by using PCR or PCR/restriction fragment length polymorphism (RFLP) assays, and further confirmed by direct DNA sequencing. Higher frequencies of mutant CCR2-64I (19.15%-28.79%) and SDF1-3’A (19.10% -29.86%) alleles were found in subjects of 8 ethnic groups in the Chinese mainland. In contrast, the △32 mutation in CCRS gene occurs at a very low frequency (0.0016, n=1287) in Han population. A relatively high frequency of CCR5-wt/△32 heterozygotes was observed in Uygurian and Mongolian populations. No A32 mutation allele was detected in Tibetan and other 4 ethnic groups in Yunnan Province. There was no CCR5-m303 mutation in subjects of any ethnic group in the Chinese

Identification and characterization of two human immunodeficiency virus type 1 unique recombinant forms from Yunnan, China

Dear Editor,Recombination contributes greatly to the diversity of human immunodeficiency virus type 1（HIV-1）.A large number of recombinant strains have been found in China,particularly in Yunnan,which is considered the HIV-1 epicenter of China.Surveillance of unique recombinant forms is helpful for prediction of new circulating recombinant forms.

Treatment outcomes of pulmonary tuberculosis in the past decade in the mainland of China:a meta-analysis

Due to the implementation of directly observed treatment strategy(DOTS),China has made a significant achievement in tackling the tuberculosis(TB)epidemic in the 1990s.However,only half of regions in China met or exceeded the 85%rate of treatment success target.The aim of the present study is to summarize the treatment outcomes of smear-positive pulmonary TB in the mainland of China in the past decade using meta-analysis based on systematic review of published observational studies.A total of 50 eligible articles(58 studies)were identified and included in this study.The summarized treatment success rates were 93.9%(95%CI,92.8%–94.7%)for new cases and 85.4%(95%CI,83.0%–87.6%)for previously treated cases,and the summarized cured rate were 92.2%(95%CI,90.9%–93.3%)and 81.2%(95%CI,79.1%–83.1%),respectively.A remarkable increase of rates for treatment success and cure was observed in the 1990s.After 2000,the summarized treatment outcomes were tending towards stability.In addition,geographic areas,type of the data and administrative level of the hospital were also found to influence the estimates of the treatment outcomes.Results of the present study clearly show,in general,that the pulmonary TB treatment achieved significant success in the past decade in the mainland of China.However,it needs to be further strengthened in the central and west areas.

Influence ofβ-elemene on the secretion of angiotensin II and expression of AT1R in hepatic stellate cells

This study aims to investigate the influence ofβ-elemene on the secretion of angiotensin II(ANG II)and the expression of angiotensin receptor type 1(AT1R)in hepatic stellate cells(HSCs).In vitro,HSC-T6 were cultured for 24 hours and then treated with different doses ofβ-elemene(2.5,5 and 10 mg/L).A control group was also set up.The secretion of ANG II in the supernatant was detected by radioimmunoassay.The mRNA expression of AT1R at 4,12 and 24 h after treatment was detected by reverse transcription-polymerase chain reaction(RT-PCR),respectively.The protein expression of AT1R was detected by western blot.At the 4th h,the ANG II secretion in the supernatant was significantly inhibited by 10 mg/Lβ-elemene compared with the control group(P<0.05),while 5.0 mg/L and 2.5 mg/Lβ-elemene had no inhibitory effect on the secretion of ANG II(P>0.05).At the time point of the 12th h,the secretion of ANG II in the supernatant treated with 10 mg/L and 5.0 mg/Lβ-elemene was significantly lower than the control(P<0.01,P<0.05).Following the treatment with 5.0 mg/L and 2.5 mg/Lβ-elemene for 24 h,significant inhibition of ANG II secretion was observed(P<0.05),but 10 mg/Lβ-elemene had no such effect.β-elemene significantly reduced the amount of AT1R mRNA in HSCs after the treatment for 4,12,and 24 h in a dose-dependent manner.The expression of AT1R protein also decreased after the treatment withβ-elemene for 24 h.β-elemene can inhibit the secretion of ANG II and the gene and protein expression of AT1R,which may be the mechanism by whichβ-elemene prevents the progress of hepaticfibrosis.

Human umbilical cord mesenchymal stem cell transfusion in immune non-responders with AIDS:a multicenter randomized controlled trial

We examined the safety and efficacy of human umbilical cord mesenchymal stem cell(hUC-MSC)infusion for immune nonresponder(INR)patients with chronic HIV-1 infection,who represent an unmet medical need even in the era of efficient antiretroviral therapy(ART).Seventy-two INR patients with HIV were enrolled in this phase II randomized,double-blinded,multicenter,placebo-controlled,dose-determination trial(NCT01213186)from May 2013 to March 2016.They were assigned to receive high-dose(1.5 x 106/kg body weight)or low-dose(0.5 x 106/kg body weight)hUC-MSC,or placebo.Their clinical and immunological parameters were monitored during the 96-week follow-up study.We found that hUC-MSC treatment was safe and well-tolerated.Compared with baseline,there was a statistical increase in CD4+T counts in the high-dose(P<0.001)and low-dose(P<0.001)groups after 48-week treatment,but no change was observed in the control group.Kaplan-Meier analysis revealed a higher cumulative probability of achieving an immunological response in the low-dose group compared with the control group(95.8%vs.70.8%,P=0.00A).However,no significant changes in CD4/CD84-T counts and CD4/CD8 ratios were observed among the three groups.In summary,hUC-MSC treatment is safe.However,the therapeutic efficacy of hUC-MSC treatment to improve the immune reconstitution in INR patients still needs to be further investigated in a large cohort study.