Interleukin-37 gene polymorphism and susceptibility to pulmonary tuberculosis among Iraqi patients

BackgroundControl of tuberculosis (TB) depends on a balance between host's immune factors and bacterial evasion strategies. Interleukin-37 (IL-37) is among the immunomodulatory factors that have been proposed to influence susceptibility to tuberculosis.MethodsA case–control study was conducted on 105 patients with pulmonary TB (37 active, 41 multi-drug resistant and 27 relapse) and 79 healthy controls to determine serum levels and single nucleotide polymorphisms (SNPs) of IL-37. The IL-37 level was assessed with an enzyme-linked immunosorbent kit, while DNA-sequencing was used to detect SNPs in the promoter region of IL37 gene.Results: Median level of IL-37 was markedly increased in serum of TB patients compared to controls (325.0 vs. 169.1 pg/mL; p < 0.001). This increase was universally determined in subgroups of patients distributed according to gender, age groups, and clinical type of disease, while no significant differences were found between the subgroups in patients or controls. Analysis of receiver operating characteristic curve confirmed these findings and IL-37 occupied a very good area under the curve, which was 0.816 (95% CI = 0.744–0.888; p < 0.001). At a cut-off value of 185.6 pg/mL, the sensitivity and specificity of IL-37 were 81.0 and 82.3%, respectively. Of the nine detected SNPs (rs2466449 G/A, rs2466450 A/G, rs2723168 G/A, rs3811042 G/A, rs3811045 T/C, rs3811046 G/T, rs3811047 A/G, rs3811048 G/A and rs200782323 G/A), only rs3811048 showed a significant association with TB; the G allele showed a significantly decreased frequency in TB patients compared to controls (25.2 vs. 44.9%; OR = 0.41; p < 0.001). It was possible to assign five haplotypes, and three showed significant differences between patients and controls. Frequency of haplotype A-A-G-A-C-T-G-A-G (0.331 vs. 0.213; OR = 2.10; p = 0.015) was significantly increased in TB patients compared to controls. On the contrary, frequencies of haplotypes A-A-G-A-C-T-G-G-G (0.029 vs. 0.116; OR = 0.24; p = 0.01) and A-A-G-G-T-G-A-G-G (0.140 vs. 0.275; OR = 0.45; p = 0.015) were significantly decreased in patients.ConclusionsIL-37 was up-regulated in the serum of TB patients irrespective of their gender, age or clinical type of disease. SNPs in the promoter region of IL37 gene were proposed to be associated with susceptibility to TB.     

晚期肿瘤患者三级联动安宁疗护模式的构建与应用

目的 构建晚期肿瘤患者医院-社区-居家三级联动安宁疗护模式（以下简称安宁疗护模式）,推进区域安宁疗护协同发展。 方法 在文献研究和专家小组会议的基础上,构建安宁疗护模式初稿,采用德尔菲法,邀请20名安宁疗护专家进行2轮函询,按照专家函询意见对条目进行修改。将构建的安宁疗护模式在10例肿瘤患者中进行初步应用。 结果 2轮问卷有效回收率均为100%。第2轮专家判断系数为0.84,专家熟悉程度系数为0.91,专家权威程度系数为0.93,肯德尔和谐系数为0.086~0.193。最终形成的安宁疗护模式包含7个一级指标（模式目的、实施机构、组织结构及时间界定、岗位职责及要求、服务模式实施途径、核心服务内容、评价与持续改进）、24个二级指标、30个三级指标和19个四级指标。10例肿瘤患者初步应用效果良好。 结论 该研究构建的安宁疗护模式内容全面、科学可靠,可为推动区域内晚期肿瘤患者全程照护服务提供借鉴和参考。     

HIV Testing in Substance Abusers

HIV testing among substance abusers in the United States is a significant public and individual health issue in need of further examination. We analyzed interview data gathered over 15 months in 1992 and 1993 from 2315 patients on presentation for addiction treatment to determine the frequency of and factors associated with previous HIV testing. Among this group of alcohol, heroin, and cocaine abusers, 53% (1231) reported previous HIV testing. Although in bivariate and multivariable analyses those with identifiable risk factors for HIV were more likely to have been tested, 27% of injection drug users, 38% with multiple sexual partners, and 39% of those with a history of a sexually transmitted disease (STD) had not been HIV tested. Other factors associated with previous HIV testing included having a primary care physician, the primary care physician’s awareness of the patient’s substance abuse problem, and having received prior addiction care. However, 38% of substance abusers who had previously received addiction treatment beyond detoxification had not been tested. Of those tested, 10% (n = 122) reported a positive test, and 7% (n = 81) had not received the test results. Of those with positive test results, 37% were not injection drug users. Promotion of HIV testing among alcohol and other drug abusers in both medical and substance abuse treatment settings should be a priority.     

The Northwest Public Health Information Exchange’s Accomplishments in Connecting a Health Information Exchange with Public Health

In 2007 the Centers for Disease Control and Prevention (CDC) issued a Request for Proposal for the “Situational Awareness through Health Information Exchange” project. The Situational Awareness project’s goals are to connect public health with health information exchanges (HIEs) to improve public health’s real-time understanding of communities’ population health and healthcare facility status. During this same time period the Health and Human Services’ Office of the National Coordinator for Health Information Technology released several reports identifying the growing number of communities involved in health information exchange and outlining the requirements for a Nationwide Health Information Network (NHIN). CDC saw the possibilities of using HIEs and the NHIN to accelerate the real-time sharing of clinical and facility-based resource utilization information to enhance local, state, regional, and federal public health in responding to and managing potentially catastrophic infectious disease outbreaks and other public health emergencies. HIEs would provide a unified view of a patient across health care providers and would serve as data collection points for clinical and resource utilization data while NHIN services and standards would be used to capture HIE data of importance and send those data to public health. This article discusses how automated syndromic surveillance data feeds have proven more stable and representative than existing surveillance data feeds and summarizes other accomplishments of the Northwest Public Health Information Exchange in its contribution to the advancement of the National agenda for sharing interoperable health information with public health.     

TAP2 polymorphisms in Australian multiple sclerosis patients

Polymorphism of the TAP2 gene locus, situated approximately 150 kb centromeric to the MHC class II loci HLA-DR, DQ was examined in 100 Australian patients with relapsing/remitting multiple sclerosis (MS), in 100 random controls and in 37 selected HLA-DRBl^*1501-positive controls. The results were correlated with HLA class I and class II phenotypes. TAP2 encodes a protein involved in the transport and presentation of antigenic peptides by MHC class I molecules and hence is a candidate locus for a putative MS susceptibility gene either through functional interactions with class I alleles or as an explanation, via linkage disequilibrium (LD), for the known association between MS and the alleles DRB1^*1501, DQA1^*0102, DQB1 ^* 0602. Strong LD was found between the allele TAP2 ^* 01 and DRB1 ^* 1501 in both the MS and control populations. The MS-associated haplotype can therefore be extended to DRB1^*1501, DQA1^*0102, DQB1^*0602, TAP2^*01, and the putative gene locus could reside on the centromeric side of DQ. TAP2 typing, however, could not explain the DRB1^* 1501, DQA1^* 0102, DQB1 ^* 0602-negative patients in whom, interestingly, the frequency of TAP2^* 01 was decreased compared to controls. The results of this study exclude TAP2 as a locus for a necessary MS/MHC gene but indicate that an MS gene carried by the DRB1^* 1501, DQA1^* 0102, DQB1^* 0602 haplotype could reside centromeric of DQ.     

红色素基因RFLP及其与情感性精神病关系的研究

以红色基因全长ｃＤＮＡ作探针，对２０例正常人，２６例双相型情感性精神病患者进行限制限片段长度多态性分析，ＳａｃＩ在部分正常人和部分患者中产生７．５ｋｂ，４。８ｋｂ和４．５ｋｂ，呈多态性改变的片段，正常人具有多态改变的占４５％，患者为４６．２％，按Ｘ染色体数计，正常人出现７．５ｋｂ限制性片段的频率为１４．３％，患者为３２．４％，但两者差异不显著。     

全反式视黄醇脱氢酶基因单核苷酸多态性连锁不平衡图谱的建立

目的建立全反式视黄醇脱氢酶基因单核苷酸多态性连锁不平衡图谱。方法采用变性高效液相色谱分析技术（DHPLC）,在4个汉族人DNA样品池（每个由5个样本组成）中筛查SNP,并在150个汉族人样本中测定基因频率。采用Haploview和EH软件对筛查到的常见SNP进行LD和单倍型分析。结果共筛查到15个SNP,其中10个为新发现SNP,7个为常见SNP,等位基因频率〉0．05。在3’端的4个SNP存在显著的LD（｜D’｜〉0．75且｜D’｜的置信区间估计提示强LD,r^2〉0．33,P〈0．031）,组成一个明显的单倍型区块;5’端3个SNP间的LD则不明确。结论RDH8基因区域的LD分析结果提示,在进行有关RDH8基因的关联分析时,3’端需要一个代表性SNP位点即可（RDH8E5a也许最为合适）,而在5’端则至少需要2个SNP（如RDH851）。     

胆囊结石病致病基因的定位研究

目的 寻找中国人群胆囊结石病的致病基因。方法 采用荧光标记微卫星位点,对12个胆囊结石病家系进行全基因组扫描;采用非参数分析软件GENEHUNTER和参数分析软件BATCHLINK进行连锁分析,寻找染色体上与胆囊结石病发病有关的位点。按患者发病年龄、体重指数、胆固醇和甘油三酯水平等指标,对家系进行分组分析。结果 染色体上D3S1266、D4S406、D9S1682和D1IS902位点,提示与胆囊结石病发病有关。其中D4s406和D9S1682的非参数分析优势对数值（NPL）分别为1．77（P=0．05）和1．92（P=0．04）,参数分析优势对数值（LOD）分别为1．84和2．07。D3S1266位点的LOD值为1．35。D11S902位点传递不平衡检验,P值为0．0027。高发病年龄组D3S1266位点的LOD值由1．35上升到2．71,高甘油三酯组D9S1682位点的LOD值由2．07上升到2．40。结论 3号、4号、9号和11号染色体上,可能有胆囊结石病致病的基因位点;3号染色体上的致病基因位点可能与发病年龄较大患者发生胆囊结石病有关;9号染色体上致病基因位点可能与伴有高甘油三酯患者发生胆囊结石病有关。     

Current and forthcoming perspectives in linkage to care of hepatitis C virus infection: Assessment of an Italian focus group

Hepatitis C virus (HCV) remains a significant public health problem and is one of the major causes of chronic liver disease worldwide. In recent years many new tools to facilitate widespread HCV screening and new therapeutic options with excellent efficacy and tolerability profiles and cost lowering policies have become available. To fully utilise these new tools, the link between local and specialist centres for the management of HCV infection must be reinforced. In order to GAIN further insight into these aspects, with a particular focus on the Italian scenario, a group of experts met to discuss relevant aspects and open issues on chronic HCV. As a summary of that meeting, the following aspects are here overviewed: (i) global situation of HCV; (ii) screening, diagnosis and indications for the treatment of HCV; (iii) the Italian situation of HCV referrals; (iv) ‘hard to reach’ patients; (v) treatment of HCV with extrahepatic manifestations; (vi) treatment of patients with advanced cirrhosis. It is the intention of the expert panel to further promote widespread screening and eradication policies that should be accompanied by greater interaction, by attempting to involve all healthcare providers in an organised process to facilitate linkage to care of patients with HCV infections.