Ci ji yi xue za zhi = Tzu-chi medical journal最新文献

Objective: Aspergillus causes many forms of pulmonary infectious diseases ranging from colonization (noninvasive) to invasive aspergillosis. This largely depends on the underlying host's lung health and immune status. Pulmonary aspergillosis (PA), especially the invasive form, occurs as opportunistic to human immunodeficiency virus (HIV) as a result of cluster of differentiation (CD)4+ lymphopenia. The majority of patients with comorbid HIV and aspergillosis go undiagnosed. This study aimed to isolate, identify the etiologies, and determine the prevalence of PA among HIV-infected persons with a productive cough (at least <2 weeks) at the HIV Clinics of the University of Maiduguri Teaching Hospital, Nigeria.

Materials and methods: After ethical approval, three consecutive early morning sputum samples were collected from patients with negative tuberculosis results. The samples were individually inoculated onto Sabouraud dextrose agar supplemented with chloramphenicol and cycloheximide in duplicate for 7 days at 37°C and 25°C, respectively. The fungal isolates were examined morphologically and microscopically and identified using the standard biochemical reagents. CD4+ cell counts were performed using flow cytometry. Self-administered questionnaires were used to assess the patients data. All patients were antiretroviral naïve.

Results: The prevalence of PA was 12.7% in these 150 patients. Of the 19 fungal culture-positive individuals, Aspergillus fumigatus accounted for the highest proportion of the isolates (8, 42.1%) followed by Aspergillus niger (5, 26.3%), Aspergillus flavus (4, 21.1%), and Aspergillus terreus (2, 10.5%). Based on the assessment of functionality of cellular immunity, HIV participants who were negative for PA (131/150) had significantly higher mean ± standard deviation CD4 T-cell counts (245.65 ± 178.32 cells/mL) than those with aspergillosis (126.13 ± 105.27 cells/mL) (P = 0.0051). PA was relatively highest among patients with CD4+ cell counts <200 cells/mL (12. 34.3%) followed by those with CD4+ cell counts between 200 and 350 cells/mL (5, 9.6%) and least among those with CD4+ cell counts >350 cells/mL (2, 3.2%). The Chi-square test showed a significant association between the prevalence of PA and the CD4+ cell count, age, and gender (P < 0.05) but not with occupation or education level (P > 0.05).

Conclusion: The findings from this study indicate that Aspergillus spp. is a significant etiology of acute productive cough in people living with HIV and this is related to the CD4+ cell count of coinfected persons.

Mature cystic teratomas (MCTs) are common benign tumors of the ovary. Coexistence of a carcinoid tumor inside an MCT is extremely rare. We present a 40-year-old woman who had intermittent abdominal pain and urinary frequency. An adnexal mass was detected during physical examination. Ultrasound indicated a 12.3 cm × 10.7 cm left ovarian mass. Surgical excision of the mass was performed, and histopathological examination revealed an MCT with three germ layers. The microcarcinoid tumor arising from an MCT showed a cord to trabecular pattern. The pathological diagnosis was a trabecular carcinoid tumor arising in an MCT. The patient did not present with carcinoid syndrome, and no recurrence was observed after 12 months of follow-up.

Objective: The objective of this study was carried out to determine the knowledge about and preventive practices against neonatal tetanus (NNT) in young women of reproductive age.

Materials and methods: Descriptive cross-sectional study design of 380 randomly selected consenting young women of child-bearing age at a Nigerian tertiary educational institution. They completed a semi-structured questionnaire on knowledge about and risk factors for NNT, willingness to receive the vaccine, and uptake of tetanus toxoid vaccine.

Results: The mean age (standard deviation) of the women was 22.4 (4.6) years ranging from 15 to 30 years. The majority (64.5%) had poor knowledge of the causes of and risk factors for NNT with only 31% knowing that immunizing women against tetanus prevents NNT. Most of the women (58%) were unwilling to receive tetanus immunization. A total of 15.5% had received tetanus toxoid, but only 0.5% had completed the required dosage. A higher proportion of respondents with good knowledge about tetanus had tetanus toxoid immunization (28.1% vs. 8.6%; P < 0.0001).

Conclusion: Knowledge about NNT, willingness to receive the vaccine, and uptake of tetanus toxoid were unacceptably poor among respondents. There is a need for continuous education targeting young women on the link between the tetanus immunization status of women and the occurrence of NNT.

Objectives: Sentinel lymph node (SLN) sampling has become a standard practice in managing early-stage breast cancer. Lymphoscintigraphy is one of the major methods used. The radioactive tracer used in Taiwan is Tc-99m phytate. However, this agent is not commonly used around the world and the optimal imaging time has not been studied. Thus, we investigated the optimal imaging time of Tc-99m phytate lymphoscintigraphy for SLN mapping in patients with breast cancer.

Materials and methods: We retrospectively reviewed SLN Tc-99m phytate lymphoscintigraphies in 135 patients with breast cancer between August 2013 and November 2017. The time for the first SLN to be visualized after radiotracer injection was recorded to determine the optimal imaging time. If no SLN was identified on imaging, the scan was continued to 60 min. We also recorded the presurgical technical and clinical factors to analyze the risk factors for nonvisualization of SLN. Each patient's postoperative axillary lymph node status was also recorded.

Results: Axillary SLNs were identified on imaging in 94.8% of the patients. All first SLNs presented within 30 min. In 6 of 7 patients with negative imaging, SLNs were identified during surgery using either blue dye or a hand-held gamma probe. Nonvisualization of SLNs on lymphoscintigraphy was significantly associated with a lower injection dose (1.0 mCi vs. 2.0 mCi), 4-injection protocol (compared to 2-injection), and injection around an outer upper quadrant tumor. In addition, patients with axillary lymph node metastasis had a higher percentage of SLN image mapping failure, with a marginally significant difference.

Conclusion: Based on our study, 30 min after Tc-99m phytate injection is the optimal time for lymphoscintigraphy and delayed imaging beyond 30 min is not necessary. In addition, a lower injection dose, the 4-injection method, and an injection near the outer upper quadrant tumor should be avoided to minimize nonvisualization of SLNs.

Objective: To investigate the mechanism of the adaptive effect of two compounds in Lonicerae japonica flos (LJF), luteolin (LUT) and chlorogenic acid (CGA), on the expression of interleukin (IL) IL-10 and IL-6.

Materials and methods: RAW264.7 cells receiving lipopolysaccharide (LPS) were pretreated with CGA and LJF. The expression of pro-inflammatory cytokines and IL-10 was evaluated by reverse transcription-polymerase chain reaction. Moreover, the concentrations of IL-10 and IL-6 were measured by enzyme-linked immunosorbent assay in the culture medium obtained 24 h after LPS treatment. Nuclear extracts of RAW264.7 cells, pretreated with CGA or LUT and LPS, were prepared after 6 h, and C/EBPβ and C/EBPδ were measured by Western blotting. Nuclear factor-κB (NF-κB) activity was measured by electrophoretic mobility shift assay. The phosphorylated form of IκB, ERK1/2, p38, JNK, and IκB, ERK2, p38, or JNK were also measured by Western blotting.

Results: CGA enhanced the LPS-induced expression of IL-10 and IL-6, and increased NF-κB, Sp1, C/EBPβ and δ. The effect of CGA is interfered with Lut by suppressing the phosphorylation of IκB and p38, and NF-κB activity. In the event, IL-6 was suppressed and IL-10 was not influenced.

Conclusion: LUT and CGA, which are abundant in LJF that is one of the ingredients in Gingyo-san, have adaptive immunoregulative effect on the expression of IL-10.

Objectives: The objective of the study is to report the acute and late toxicity and preliminary results of localized prostate cancer treated with high-dose radiation therapy (RT).

Materials and methods: Between March 2010 and October 2018, a total of 53 patients with clinically localized prostate cancer were treated with definitive RT at our institution. All patients were planned to receive a total dose of 81 Gy with the volumetric-modulated arc therapy technique. Patients were stratified by prognostic risk groups based on the National Comprehensive Cancer Network risk classification criteria. Acute and late toxicities were scored by the Radiation Therapy Oncology Group morbidity grading scales. The definition of biochemical failure was using the 2005 ASTRO Phoenix consensus definition. Median follow-up time was 46.5 months (range: 4.7-81.0 months).

Results: The 3-year biochemical failure-free survival rates for low-, intermediate-, and high-risk group patients were 100%, 87.5%, and 84%, respectively. The 3- and 5-year overall survival rates were 83% and 62%, respectively. Three (5.6%) patients developed Grade II acute gastrointestinal (GI) toxicity. Four (7.5%) patients developed Grade II acute genitourinary (GU) toxicity, and none experienced Grade III or higher acute GI or GU symptoms. One (1.8%) patient developed Grade II or higher late GI toxicity. Six (11.3%) patients experienced Grade II late GU toxicity. No Grade III or higher late GI and GU complications have been observed.

Conclusions: Data from the current study demonstrated the feasibility of dose escalation with image-guided and volumetric-modulated arc therapy techniques for the treatment of localized prostate cancer. Minimal acute and late toxicities were observed from patients in this study. Long-term prostate-specific antigen controls are comparable to previously published results of high-dose intensity-modulated RT for localized prostate cancer. Based on this favorable outcome, dose escalation (81 Gy) has become the standard treatment for localized prostate cancer at our institution.

Objective: Institutional delivery (ID) plays a vital role for determining the outcome of pregnancy and ensuring care to mother and newborn. The present study aims to find out the correlates of ID from the eastern part of India.

Materials and methods: Data from National Family Health Survey 4 were analyzed for three states - Bihar, West Bengal, and Jharkhand, keeping district as a unit of analysis. Correlation and regression were used for finding out the determinants of ID.

Results: Overall, 67.8% of deliveries were conducted in hospitals. All the three states were able to improve performance on related health parameters like antenatal care. After adjusting for other variables, on multiple linear regression, female literacy was significantly related to ID.

Conclusions: Social parameters need to be focused for encouraging ID.

Objective: Breast cancer is one of the most common malignancies and a leading cause of cancer-related death in women worldwide. Both hormone-related factors and genetic aberrations could cause breast cancer. We investigated copy number alternations (CNAs) on four breast cancer-susceptible loci, namely 2q35-rs13387042, 3p24-rs4973768, 17q23-rs6504950, and fibroblast growth factor receptor 2 (FGFR2)-rs2981578, in Taiwanese women.

Patients and methods: Breast cancer tissues and blood samples from 66 patients and their clinical data were collected from a human biobank. The copy numbers of the germline samples (from blood) and cancer tissues from each patient on the susceptible loci - 2q35, 3p24, 17q23, and FGFR2 - were obtained using TaqMan probes in the Applied Biosystems Inc., (ABI) StepOnePlus Real-Time Polymerase Chain Reaction instrument and CopyCaller^® Software v1.0 (ABI, CA, USA).

Results: The mean copy numbers output by CopyCaller^® Software v1.0 of the cancer tissues on these susceptible loci (2q35, 3p24, 17q23, and FGFR2) from the 66 patients were higher than those of the blood samples (2.0 vs. 1.9); however, significantly higher copy numbers for cancer tissues compared with germline samples were discovered only on 2q35-rs13387042 (P = 0.035). In addition, patients with advanced breast cancers had relatively many CNAs between their cancer tissues and germline samples on 17q23-rs6504950 (P = 0.008). Multivariate analysis revealed that the risk factor for patients with advanced breast cancers was CNAs between cancer tissues and germline samples on 17q23-rs6504950 (odds ratio = 13.337, 95% confidence interval: 1.525-122.468).

Conclusions: CNAs on 17q23-rs6504950 between cancer tissues and germline samples could affect cancer progression in Taiwanese women with breast cancer. Further investigations regarding the role of CNAs on 17q23-rs6504950 in cancer progression are necessary to elucidate the pathogenesis of breast cancer.

Objective: Shewanella xiamenensis is an emerging zoonotic pathogen commonly found in aquatic ecosystem. Clustered regularly interspaced short palindromic repeats (CRISPR) and (CRISPR)-associated gene systems act as adaptive immune system of prokaryotes. Recently, growing evidence suggested their role in bacterial virulence and resistance. Despite its medical importance, little is known about the genomic characteristics of S. xiamenensis.

Materials and methods: Strain ZYW6 was isolated from Epinephelus awoara. We sequenced the 16S rRNA gene and blast against the GenBank bacterial database. Antibiotic susceptibility tests and interpretation were performed by automatic VITEK 2 system. We extracted the genomic DNA with QIAGEN Genomic-tip 100/G kit and QIAGEN Genomic DNA Buffer Set. Whole-genome shotgun sequencing was performed using the Illumina MiSeq sequencer. To identify the CRISPR-Cas System in the genome of S. xiamenensis ZYW6, the Integrated Microbial Genomes and Microbiomes and CRISPRFinder were used.

Results: We characterized the genome of a S. xiamenensis strain. The genome is 4,765,190 bp in length and encodes 4262 open-reading frames. Type I CRISPR-Cas system and serine biosynthesis genes were identified.

Conclusion: Our results demonstrate the genetic structure of CRISPR-Cas system, l-serine synthesis, and oxacillinase in S. xiamenensis. The report of antibiotics resistance genes in the study might indicate a possible reservoir of antimicrobial drug resistance determinants in food animal, resulting in potential infection source. The findings provide insights into the structure and composition of CRISPR-Cas system in S. xiamenensis and foundation for future biological validation.