Rotavirus G5P[6] in child with diarrhea, Vietnam

We detected rotavirus G5P[6] with a long RNA pattern in a Vietnamese child with diarrhea. Viral outer capsid protein VP7 and VP4 genes suggest that it likely originated from porcine rotavirus either by genetic reassortment or as whole virions. To our knowledge, this is the first report of human rotavirus G5 in Asia.     

Vivax malaria: preliminary observations following a shorter course of treatment with artesunate plus primaquine

The standard adult treatment regimen for Plasmodium vivax malaria is chloroquine (1500 mg over 3 d) plus primaquine (15 or 30 mg daily for 14 d), but patient compliance tends to be poor with the lengthy course. Preliminary observations are reported on the efficacy of a shorter treatment course - artesunate (200mg twice a day for 2 d) plus primaquine (22.5mg base twice a day for 7 d) - given to 28 adult patients infected with P. vivax in Viet Nam. All patients responded quickly to treatment with mean (SD) parasite and fever clearance times of 14.2 (4.0) and 18.6 (8.4) h, respectively. The high dose of primaquine was generally well tolerated, and only one patient (3.6%) had a recurrence of parasitaemia during 28 d of follow-up. As most patients infected with Southeast Asian strains of P. vivax have their first relapse within 28 d after treatment with rapidly eliminated blood schizonticides, the absence of parasitaemia in the remaining 27 patients suggests that this drug regimen was active against both blood and liver stages. Further studies are needed to confirm that this rapidly acting, short artesunate-primaquine regimen can result in better patient compliance and treatment outcomes than the chloroquine-primaquine regimen.     

Evaluation of Metabolic Outcomes Following SADI-S: a Systematic Review and Meta-analysis

Obesity Surgery - Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) offers a novel bariatric procedure. This systematic review and meta-analysis evaluates observational and...     

心理健康教育对女性慢性精神分裂症病人生活质量的影响

[目的]探讨心理健康教育对女性慢性精神分裂症病人生活质量的影响。[方法]将80例女性慢性精神分裂症病人随机分为研究组和对照组,两组均采用药物治疗,研究组采用常规护理和心理健康教育,对照组采用常规护理;于治疗前后分别采用住院病人护士观察量表(NOSIE-30)、生活质量综合评价问卷(GQOLI-74)进行疗效和生活质量评估。[结果]治疗结束后研究组NOSIE-30各因子分和GQOLI-74各维度评分与对照组比较差异均有统计学意义(P<0.05)。[结论]心理健康教育对女性慢性精神分裂症病人的症状改善和生活质量的提高有重要的意义。     

Participation of cyclin A in Myc-induced apoptosis.

The involvement of c-Myc in cellular proliferation or apoptosis has been linked to differential cyclin gene expression. We observed that in both proliferating cells and cells undergoing apoptosis, cyclin A (but not B, C, D1, and E) mRNA level was elevated in unsynchronized Myc-overexpressing cells when compared with parental Rat1a fibroblasts. We further demonstrated that Zn(2+)-inducible cyclin A expression was sufficient to cause apoptosis. When Myc-induced apoptosis was blocked by coexpression of Bcl-2, the levels of cyclin C, D1, and E mRNAs were also elevated. Thus, while apoptosis induced by c-Myc is associated with an elevated cyclin A mRNA level, protection from apoptosis by coexpressed Bcl-2 is associated with a complementary increase in cyclin C, D1, and E mRNAs.     

Polymorphism in transmembrane region of MICA gene and cholelithiasis

AIM: To study the significance of polymorphism of MHC class I chain-related gene A (MICA) gene in patients with cholelithiasis. METHODS: Subjects included 170 unrelated adults (83 males) with cholelithiasis and 245 randomly selected unrelated adults (130 males) as controls. DNA was extracted from peripheral leukocytes and analyzed for polymorphism of 5 alleles (A4, A5, A5.1, A6 and A9) of the MICA gene. RESULTS: There was no significant difference in phenotype, allele, and genotype frequencies of any of the 5 alleles between cholelithiasis patients and controls. CONCLUSION: This study demonstrates that MICA alleles studied bear no relation to cholelithiasis.     

Radical resection of pathological membrane for Budd-Chiari syndrome

BACKGROUND: Budd-Chiari syndrome (BCS) refers to posthepatic portal vein hypertension and/or inferior vena cava hypertension syndrome caused by obstruction of the blood flow at the portal cardinal hepatic vein and/or posterior hepatic inferior vena cava. The main surgical treatments of BCS include operations on pathological lesioned membrane, shunt, and combined operations. There are more than ten treatments available and reports on their therapeutic effects vary. As to operations on lesioned membrane, there are Kimura's finger rupture, balloon dilatation and membrane removal. With reference to our experience, the clinical value of membrane resection at normal temperature and under direct vision is discussed. METHODS: A total of 292 patients with BCS undergoing membrane resection at normal temperature and under direct vision from June 1996 to June 2005 were retrospectively analyzed. RESULTS: The short-term therapeutic effect in 256 patients was satisfactory and the effective rate was 87.7% (256/292). Within a week, ascitic fluid disappeared, the liver shrank and edema of the lower extremities was greatly relieved or even disappeared. Perioperative death occurred in 14 patients (4.8%). Of these, 3 had acute heart failure (one during the operation, one after 6 hours and one 7 days later). Six patients had thoracic cavity bleeding within 12 hours after the operation, 3 had acute respiratory distress syndrome (ARDS), 2 had disseminated intravascular coagulation (DIC), and 1 had pulmonary embolism. 158 patients were followed up for 6 months to 12 years, and 12 (7.6%) had recurrences. CONCLUSIONS: After membrane resection at normal temperature and under direct vision, hemodynamicswas found to be close to normal, damage was slight, effectiveness was evident and the recurrence rate low. So this method is effective in treating BCS.     

Reliability and validity of the Vietnamese version of the Pregnancy Physical Activity Questionnaire (PPAQ)

This study aimed to translate the Pregnancy Physical Activity Questionnaire (PPAQ) into Vietnamese, and test its reliability and validity among Vietnamese pregnant women. Intraclass correlation (ICC) and the Bland and Altman method were used to assess the test-retest reliability of the PPAQ. The Pearson correlations coefficient between the PPAQ measurements and those obtained from a pedometer that measured step counts (10-day averages) were used to determine the validity of the questionnaire. The PPAQ was successfully translated from English into Vietnamese with face validity through a rigorous process of the cross-cultural validation. For the analysis of reliability, the ICC value was 0.88 (95% CI 0.83-0.94) for total activity, 0.94 for sedentary, 0.88 for light, 0.90 for moderate, and 0.87 for vigorous activities. The Bland and Altman analysis showed that the first and second PPAQ total scores did not significantly differ from zero, and mostly fell within the range of 0 +/- 1.96 SD. The analysis of validity showed that there were moderate correlations with statistically significance (p = 0.02) between the step counts and PPAQ total. Our study indicates that the Vietnamese PPAQ is within acceptable reliability and validity.     

Dysregulation of Amphiregulin stimulates the pathogenesis of cystic lymphangioma

Along with blood vessels, lymphatic vessels play an important role in the circulation of body fluid and recruitment of immune cells. Postnatal lymphangiogenesis commonly occurs from preexisting lymphatic vessels by sprouting, which is induced by lymphangiogenic factors such as vascular endothelial growth factor C (VEGF-C). However, the key signals and cell types that stimulate pathological lymphangiogenesis, such as human cystic lymphangioma, are less well known. Here, we found that mouse dermal fibroblasts that infiltrate to sponges subcutaneously implanted express VEGF-D and sushi, Von Willebrand factor type A, EGF, and pentraxin domain containing 1 (SVEP1) in response to PDGFRβ signal. In vitro, Pdgfrb knockout (β-KO) fibroblasts had reduced expression of VEGF-D and SVEP1 and overproduced Amphiregulin. Dysregulation of these three factors was involved in the cyst-like and uneven distribution of lymphatic vessels observed in the β-KO mice. Similarly, in human cystic lymphangioma, which is one of the intractable diseases and mostly occurs in childhood, fibroblasts surrounding cystic lymphatics highly expressed Amphiregulin. Moreover, fibroblast-derived Amphiregulin could induce the expression of Amphiregulin in lymphatic endothelial cells. The dual source of Amphiregulin activated EGFR expressed on the lymphatic endothelial cells. This exacerbation cascade induced proliferation of lymphatic endothelial cells to form cystic lymphangioma. Ultimately, excessive Amphiregulin produced by fibroblasts surrounding lymphatics and by lymphatic endothelial cells per se results in pathogenesis of cystic lymphangioma and will be a fascinating therapeutic target of cystic lymphangioma.

Mammals possess two tightly interconnected vascular systems: the blood vasculature and the lymphatic vasculature. Lymphatic vessels are implicated in the absorption of the interstitial fluid (i.e., the lymph) in all peripheral organs except organs of the nervous system. Lymphangiogenesis, which indicates new growth of the lymphatic vessels, is induced in several pathophysiological conditions such as wound healing. Based on the molecular mechanisms in lymphangiogenesis, wherein physiological lymphangiogenesis requires vascular endothelial growth factor (VEGF)-C (1), pathological lymphangiogenesis is regulated by various growth factors and cytokines such as VEGF-A, -C, -D, fibroblast growth factor 2 (FGF2), hepatocyte growth factor (HGF), insulin-like growth factor 1, and angiopoietin 1 (2, 3) in combination with inflammatory cells such as macrophages (4, 5). However, the mechanism, the type of key signals, and the cell types that are involved in lymphatic vessel formation under pathophysiological conditions in vivo still remain unclear.The VEGF family and its receptors are essential regulators of both angiogenesis and lymphangiogenesis (6). During new lymphatic vessel formation, it is thought that VEGF-C and VEGF-D can bind to VEGFR3 or VEGFR2, leading to transduction of a proliferation signal (1, 7, 8). While VEGF-C is essential for lymphangiogenesis as a paracrine factor, little is known about the function of VEGF-D, which has been postulated to induce lymphatic vessel formation within tumors, leading to subsequent promotion of metastasis (9).Regarding the lymphatic vessel remodeling process, recent reports have suggested that sushi, Von Willebrand factor type A, EGF, and pentraxin domain containing 1 (SVEP1), an extracellular matrix protein, is essential for lymphatic remodeling (10, 11). SVEP1 binds integrin α9β1, a cell adhesion receptor involved in lymphangiogenesis, as a high-affinity ligand (12).Members of the EGF-EGFR system play critical roles in cell proliferation and differentiation in various developmental stages and pathogenesis of many diseases (13). EGFR signaling appeared to positively regulate angiogenesis both directly (14) and indirectly (15). Indeed, EGFR is expressed on human dermal lymphatic endothelial cells in vitro and in vivo, thereby allowing activation of lymphangiogenesis (16).Lymphangioma, a form of lymphatic malformation, is considered to be mostly benign and morphologically characterized by small and large thin-walled cysts that occur mainly during childhood (17). Lymphangioma can be sporadically observed anywhere in the body; however, it is particularly common in the head, neck, mediastinum, and axilla (18). Many cases can be treated by sclerotherapy or surgical resection (19, 20). However, severe cases are difficult to treat, and some patients have functional problems such as airway obstruction and cosmetic problems (17, 18). Cellular and molecular mechanisms of the lymphangioma have not yet been fully uncovered.In this study, we show that PDGFRβ signaling in dermal fibroblasts defines the architecture of hieratical lymphatic vessel structure. We illustrate that dermal fibroblasts express VEGF-D and SVEP1, and that deficiency of the PDGFRβ signal results in reduced production of VEGF-D and SVEP1 in dermal fibroblasts. However, such fibroblasts show overproduction of Amphiregulin, a kind of EGF family ligand. Sponge-implanted PDGFRβ conditional knockout (β-KO) mice exhibit largely dilated and uneven distribution of the formation of lymphatic vessels in vivo. Similarly, in human cystic lymphangioma, the fibroblasts surrounding cystic lymphatics, which highly express Amphiregulin, induced the expression of Amphiregulin in lymphatic endothelial cells. This cascade accelerated proliferation of lymphatic endothelial cells in cystic lymphangioma. These findings suggest that dysregulation of Amphiregulin expression is the cause of pathogenesis of cystic lymphangioma.