OBJECTIVETo review recent developments in therapeutic DNA vaccines against tuberculosis.

DATA SOURCESThe data used in this review were obtained mainly from the studies of therapeutic DNA vaccines against tuberculosis reported from 2000 to 2006.

STUDY SELECTIONRelevant articles about studies of therapeutic DNA vaccines against tuberculosis were selected.

DATA EXTRACTIONData were mainly extracted from the 32 articles listed in the reference section of this review.

RESULTSSome DNA vaccines which previously showed to induce protective immunity against infection by Mycobacterium tuberculosis in a prophylactic manner are also surprisingly effective when used therapeutically, including persistent Mycobacterium tuberculosis and multidrug-resistant tuberculosis which are refractory to immune system and antibacterial chemotherapy alone. When used in combination with antibacterial drugs, therapeutic DNA vaccines could effectively eliminate residual bacteria in infected animals and shorten the therapy course of conventional chemotherapy. Detailed studies demonstrated that therapeutic effects of DNA vaccines may at least partly be due to the restoration of the Th(1)/Th(2) balance. Some problems have also emerged along with these exciting results.

CONCLUSIONSTherapeutic DNA vaccine is a promising strategy against tuberculosis, however developing an ideal DNA vaccine for therapy of tuberculosis will require further development.

Humans ; Tuberculosis ; therapy ; Tuberculosis Vaccines ; therapeutic use ; Vaccines, DNA ; therapeutic use

Apoptosis ; physiology ; Carcinoma, Hepatocellular ; enzymology ; pathology ; Carrier Proteins ; biosynthesis ; genetics ; DNA-Binding Proteins ; metabolism ; Gene Targeting ; Humans ; Liver Neoplasms ; enzymology ; pathology ; RNA Interference ; Telomerase ; metabolism ; Tumor Cells, Cultured

Objective To establish the test way of latex enhanced immune turbidimetric method for the concentration detection of urine free hemoglobin on the automatic biochemical analyzer,and evaluated the detection performance.Methods Prepared the detection reagents of latex enhanced immune turbidimetry method for detection of urine free hemoglobin with materials such as hemoglobin HBA0 antibody (8.5 mg/ml),80 nm carboxylic olystyrene latex microspheres (estapor,nanometer microspheres) and so on.Then,seted the project parameters on TBA120 automatic biochemical analyzer and proceeded the calibrations.Evaluated the detection performance by accuracy,precision,linear range,sensitivity,specificity and other indicators.Lastly,established the biological reference interval for urine free hemoglobin of healthy people in the region and verified it.Results To seted the project parameters on TBA120 automatic biochemical analyzer and passed the calibration.The calibration fitting curve had a smooth trend and no obvious deviation with each measuring point.In the recovery tests,added standard liquid with different concentrations of 100 mg/L and 500 mg/L to the samples with low values,the recovery rate was 95.3％ and 102.7％ respectively.Same to the samples with high values,the recovery rate was 104.2％ and 103.5％ respectively.In the precision test,samples with low and high value had a precision CV of 6.52％ and 4.18％ respectively.The linear range was 0 ～ 1 100 mg/L,analysis sensitivity was 2.8 mg/L.In the interference test,found that,samples had no obvious disturbance to the test with lower concentrations of free bilirubin,combined with bilirubin,vitamin C,animal hemoglobin lower than 342 μmol/L,342 μmol/L,0.03 g/L,500 mg/L respectively,while had significant interference when the concentration of chyle was higher than 870 FTU.Their study had established the biological reference interval of healthy people,male was 0～ 13.3 mg/L and female 0 ～ 17.1 mg/L,there was no significant difference between them by a t test (P＞0.05).Conclusion The latex enhanced immune turbidimetric method for the detection of urine free hemoglobin has the performance of testing clinical urine specimen,which not only solved the lackage problem of specificity for occult blood in the urine dry chemistry test and realized batch automation quantitative detection.The experimental data of this study provides a theoretical basis for the application of the method in other types of clinical samples.

BACKGROUNDHemangiopericytomas (HPCs) have a relentless tendency for local recurrence and metastases, differentiating between benign meningiomas and HPCs before surgery is important for both treatment planning and the prognosis appraisal. The purpose of this study was to evaluate the correlations between CT perfusion parameters and microvessel density (MVD) in extra-axial tumors and the possible role of CT perfusion imaging in preoperatively differentiating benign meningiomas and HPCs.

METHODSSeventeen patients with benign meningiomas and peritumoral edema, 12 patients with HPCs and peritumoral edema underwent 64-slice CT perfusion imaging pre-operation. Perfusion was calculated using the Patlak method. The quantitative parameters, include cerebral blood volume (CBV), permeability surface (PS) of parenchyma, peritumoral edema among benign meningiomas and HPCs were compared respectively. CBV and PS in parenchyma, peritumoral edema of benign meningiomas and HPCs were also compared to that of the contrallateral normal white matter respectively. The correlations between CBV, PS of tumoral parenchyma and MVD were examined.

RESULTSThe value of CBV and PS in parenchyma of HPCs were significantly higher than that of benign meningiomas (P < 0.05), while the values of CBV and PS in peritumoral edema of benign meningiomas and HPCs were not significantly different (P > 0.05). MVD in parenchyma of HPCs were significantly higher than that of benign meningiomas (P < 0.05). There were positive correlations between CBV and MVD (r = 0.648, P < 0.05), PS and MVD (r = 0.541, P < 0.05) respectively. Furthermore, the value of CBV and PS in parenchyma of benign meningiomas and HPCs were significantly higher than that of contrallateral normal white matter (P < 0.05), the value of CBV in peritumoral edema of benign meningiomas and HPCs were significantly lower than that of contrallateral normal white matter (P < 0.05), while the value of PS in peritumoral edema of benign meningiomas and HPCs were not significantly different with that of contrallateral normal white matter (P > 0.05).

CONCLUSIONSCT perfusion imaging can provide critical information on the vascularity of HPC and benign meningiomas. Determination of maximal CBV and corresponding PS values in the parenchyma may be useful in the preoperative differentiating HPC from benign meningiomas.

Adult ; Aged ; Female ; Hemangiopericytoma ; diagnosis ; diagnostic imaging ; Humans ; Immunohistochemistry ; Male ; Meningioma ; diagnosis ; diagnostic imaging ; Middle Aged ; Tomography, X-Ray Computed ; methods

Objective To explore the nursing intervention on cognitive behavior of patients with highrisk of diabetic feet.Methods A total of 52 patients with high risk of diabetic feet were selected.Structural interview were used to collect the data of cognitive behavior and performed a systematic intervention approach.Indicators including diabetic feet related knowledge,cognitive behavior and blood glucose were compared before and after intervention.Results The patients with apparent lack of the knowledge were account for 98.08%and unhealthy behavior were account for 66.91%before intervention.However.the changes of cognitive level and unhealthy behavior were significant after intervention.In addition.84% of those people had formed good health behavioral habits.the blood glucose control well and without diabetic feet ulcers occurred after discharge 3 to 6month.Conclusions The systematic nursing intervention can improve patients'recognition of diseases,change their unhealthy behaviors,perform good health habits and reduce incidence of diabetic feet ulcers or amputation.

BACKGROUNDIsocitrate lyase (ICL) was previously demonstrated to play a pivotal role in the intracellular metabolism of Mycobacterium tuberculosis (MTB). Presently several lines of evidence suggest that ICL from MTB (MTB-ICL) may play some roles in the interaction between MTB and host macrophage. However, there has been no research on the interaction between MTB-ICL and host macrophage.

METHODSMTB-icl and M. smegmatis (MS)-icl genes were amplified by polymerase chain reaction (PCR) and cloned into the E. coli-mycobacterium shuttle plasmid pUV15 to obtain recombinant shuttle plasmids pMTB-icl and pMS-icl. Following transformation into MS by electroporation, the expression of pMTB-icl and pMS-icl was verified by reverse transcriptase (RT)-PCR. The expression of recombinant plasmids derived from pUV15 when rMS was phagocytized by macrophage was also verified via fluorescence microscope. Ms 1 - 2c, rMS-pUV15, rMS-pMS-icl and rMS-pMTB-icl were used to infect RAW264.7 cells and the survival of intracellular MS was monitored by bacterial culture at 0, 24 and 48 hours after infection. The culture supernatants from macrophage infected by Ms 1 - 2c, rMS-pUV15, rMS-pMS-icl and rMS-pMTB-icl were collected and the interferon (IFN)-gamma and nitric oxide (NO) concentrations were measured by ELISA or by Griess assay, respectively. The apoptosis of macrophage was assayed by the in situ TUNEL technique.

RESULTSRT-PCR showed that both pMTB-icl and pMS-icl could be expressed in MS. Fluorescence microscopic observation showed that recombinant plasmids derived from pUV15 (pUV15-IG) could also be expressed in MS when MS were phagocytized by macrophage. Bacterial culture data demonstrated that rMS-pMTB-icl exhibited significantly increased intracellular survival in the murine macrophage cell line RAW264.7 compared with Ms 1 - 2c, rMS-pUV15 and rMS-pMS-icl. This increased intracellular survival was not accompanied by the upregulation of IFN-gamma and NO in host macrophage. But a lower apoptosis rate of macrophages infected with rMS-pMTB-icl was observed when compared with macrophages infected with other strains of MS.

CONCLUSIONSMTB-ICL could promote the intracellular survival of MS. Suppressing the apoptosis of host macrophage may be one of the important mechanisms involved in this increased intracellular survival.

Animals ; Apoptosis ; genetics ; physiology ; Cell Line ; In Situ Nick-End Labeling ; Interferon-gamma ; metabolism ; Isocitrate Lyase ; genetics ; metabolism ; Macrophages ; cytology ; metabolism ; microbiology ; Microbial Viability ; Microscopy, Fluorescence ; Mycobacterium smegmatis ; enzymology ; genetics ; growth & development ; Mycobacterium tuberculosis ; enzymology ; genetics ; Nitric Oxide ; metabolism ; Plasmids ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Transformation, Genetic

Objective To explore the correlations between monocyte immunodepression andthe levels of C-reactive protein (CRP) and fibrinogen (Fg) in patients with severe acute stroke. MethodsThis prospective study involved 53 consecutive patients admitted in the neurological intensive care unit(NICU) within 24 h after stroke onset. Blood samples were collected serially on days 1, 2, 4, 6 and 14after stroke to determine monocytic HLA-DR expression using flow cytometry. CRP and Fg weredetected on day 2 after the admission, and Graph_Pad PRISM 4.0 software was used to analyze thecorrelations among the variables. Thirty-nine concurrent patients admitted in the general ward, whocomplained dizziness without magnetic resonance imaging evidence of acute stroke, were enrolled toserve as the control group. Results The levels of CRP and Fg in the stroke group were significantlyhigher than those in the control group (P<0.05). The CRP and Fg levels were both found to inverselycorrelate to monocytic HLA-DR expression at different observational points. The correlations of CRP andFg to HLA-DR expression were the most obvious on day 2 and 4 after admission (r=-0.419, P=0.001;r=-0.434, P=0.001), respectively. Conclusion Immunosuppression of the monocytes in patients withsevere acute stroke is probably associated with the inflammatory reaction after stroke.

Objective To explore the relationship between clinical ischemic events and carotid calcification detected by 64 slices CT angiography. Methods We retrospectively analyzed the carotid calcified plaques in 116 patients underwent the 64 slices CT angiography. The relatinnship between the carotid calcification and the clinical ischemic events was analyzed. Results A total of 377 plaques were detected and the incidence of carotid plaque calcification was 63.40%. Incidence of plaque calcification was significantly lower in patients with ages<50 years than that in patients with ages 51-59 years, 60-69 years and higher than 70 years (P=0.003, P=0.002, P=0.000, respectively). The incidence of plaque calcification in the common carotid artery was significantly lower than the carotid bifurcation (P=0.000) and the internal carotid artery (P=0.000). The incidences of calcification in the mild, moderate and severe degree of stenosis and occlusion were 46.54%, 33.33%, 26.67% and 0% respectively. The distribution of intraplaque calcium was similar between patients with ischemic event and non-isehemic event group. However, the incidence of calcification was significantly lower patients with ischemic event than that in patients without ischemie event (30.34% vs. 43.10%, P=0.013). Calcified plaque was negatively associated with ischemie event (β=-0.688, P=0.006). Conclusion 64 slices CT angiography can analyze the characterization of carotid plaque calcium.

OBJECTIVETo observe the relationship between abdominal obesity and left ventricular weight/function.

METHODSA total of 495 patients [265 males, mean age (55 +/- 12) years] with hypertension (139), diabetes (65), metabolic syndrome (285), diabetes complicated with hypertension (11) were enrolled in this study. Visceral adipose area (VA), the subcutaneous adipose (SA), the total abdominal adipose (TA) were measured by computerized tomography (CT) and left ventricular weight and function were obtained by echocardiography. Patients were divided into three groups according to the VA (I. VA<75 cm(2), n=173, II. VA>75 and < 110 cm(2), n=153, III. VA >or= 110 cm(2), n=169).

RESULTSLeft ventricular mass (LVM) and LVM index (LVMI) increased and LVEF and E/A decreased in proportion to increasing VA. Left ventricular hypertrophy (LVH) rate was significantly higher in group II and III compared to group I and LVEF was significantly reduced in group III compared to group I and II. There are significant correlation between LVMI and VA, SA, TA as well as between LVEF and VA after adjusting gender, age and blood pressure. Logistic regression analysis showed that VA is an independent predictor for LVH.

CONCLUSIONThe abdominal adipose accumulation is closely related to the left ventricular weight and function.

Abdominal Fat ; physiology ; physiopathology ; Adult ; Aged ; Aged, 80 and over ; Diabetes Mellitus ; diagnostic imaging ; Female ; Humans ; Hypertension ; diagnostic imaging ; Inpatients ; Male ; Metabolic Syndrome ; diagnostic imaging ; Middle Aged ; Obesity ; physiopathology ; Radiography ; Ultrasonography ; Ventricular Function, Left ; Ventricular Remodeling

OBJECTIVESTo investigate the possibilities of an association between the degrees of HBV suppression with nucleoside treatments at week 24 and week 52 in hepatitis B patients and to find a useful predictor for treatment efficacy.

METHODSIn this phase III, double-blind, multicenter trial, we compared the efficacy of telbivudine treatment with lamivudine treatment in 332 Chinese compensated chronic hepatitis B patients. The patients were randomly assigned to a daily 600 mg telbivudine treatment group or daily 100 mg lamivudine group for 24 weeks. They were then categorized into 4 groups according to their serum HBV DNA levels (copies/ml) at week 24: a PCR-undetectable group (< 300 copies/ml); a QL- < 10(3) copies/ml group; a 10(3)-<10(4) copies/ml group; and a > or = 10(4) copies/ml group. The treatments were continued as they previously had been for another 28 weeks and the patients serum HBV DNA levels were examined again.

RESULTSAt week 52, mean reductions of serum HBV DNA were significantly greater in the telbivudine-treated patients than in the lamivudine-treated group (6.2 log10 vs 5.4 log10, t = 3.6, P < 0.01). Viral resistance was twice as common in lamivudine-treated patients compared to those receiving telbivudine. Telbivudine was well-tolerated with an adverse event profile similar to that of lamivudine. The lower the HBV DNA level achieved at week 24, the higher HBV DNA non-detectable by PCR. ALT normalization and HBeAg seroconversion achieved at week 52, and viral resistance at week 48 decreased parallel to the degree of HBV DNA inhibition.

CONCLUSIONHBV DNA PCR-undetectable at week 24 in nucleoside-treated hepatitis B patients suggests a better efficacy at week 52 and lower viral resistance at week 48. The degree of suppression of HBV at week 24 may be used as a predictor of 1-year outcome.

Adolescent ; Adult ; Aged ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Double-Blind Method ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Nucleosides ; therapeutic use ; Pyrimidinones ; therapeutic use ; Thymidine ; analogs & derivatives ; Treatment Outcome ; Young Adult