Objective: To understand the molecular characteristics of hemagglutinin (HA) and neuraminidase (NA) as well as the disease risk of influenza virus A H7N9 in Guizhou province. Methods: RNAs were extracted and sequenced from HA and NA genes of H7N9 virus strains obtained from 18 cases of human infection with H7N9 virus and 6 environmental swabs in Guizhou province during 2014-2017. Then the variation and the genetic evolution of the virus were analyzed by using a series of bioinformatics software package. Results: Homology analysis of HA and NA genes revealed that 2 strains detected during 2014-2015 shared 98.8%-99.2% and 99.2% similarities with vaccine strains A/Shanghai/2/2013 and A/Anhui/1/2013 recommended by WHO, respectively. Two strains detected in 2016 and 14 strains detected in 2017 shared 98.2%-99.3% and 97.6%-98.8% similarities with vaccine strain A/Hunan/02650/2016, respectively. Other 6 stains detected in 2017 shared 99.1%-99.4% and 98.9%-99.3% similarities with strain A/Guangdong/17SF003/2016, respectively. Phylogenetic analysis showed that all the strains were directly evolved in the Yangtze River Delta evolution branch, but they were derived from different small branch. PEVPKRKRTAR↓GLF was found in 6 of 24 strains cleavage site sequences of HA protein, indicating the characteristic of highly pathogenic avian influenza virus. Mutations A134V, G186V and Q226L at the receptor binding sites were found in the HA. All the strains had a stalk deletion of 5 amino acid residue "QISNT" in NA protein, and drug resistance mutation R294K occurred in strain A/Guizhou-Danzhai/18980/2017. In addition, potential glycosylation motifs mutations NCS42NCT were found in the NA of 9 of 24 strains. Conclusions: HA and NA genes of avian influenza A (H7N9) virus showed genetic divergence in Guizhou province during 2014-2017. The mutations of key sites might enhance the virulence of the virus, human beings are more susceptible to it. Hence, the risk of infection is increasing.
Animals ; Base Sequence ; Birds ; China/epidemiology* ; Genome, Viral ; Hemagglutinin Glycoproteins, Influenza Virus/immunology* ; Hemagglutinins/genetics* ; Humans ; Influenza A Virus, H7N9 Subtype/isolation & purification* ; Influenza in Birds ; Influenza, Human/virology* ; Neuraminidase/genetics* ; Phylogeny ; RNA, Viral/genetics* ; Sequence Analysis, DNA

Objective: To analyze the mobility, status of follow-up and CD(4)(+)T cell testing (CD(4) testing) programs among people living with HIV (PLHIV) between 2011 and 2015 and to improve the prevention program on HIV secondary transmission. Methods: Data were collected from both Case Reporting Cards and Follow-up Cards through the National HIV/AIDS Comprehensive Control and Prevention data system. Changes of residence among the newly reported cases and survival cases between 2011 and 2015 were analyzed by SPSS 24.0 software. Results: The number of newly reported inter-provincial mobile PLHIV had been increasing, with proportions of the total reported cases from 10.0% (5 576/55 805) in 2011 to 13.3% (15 348/115 231) in 2015. After adjusting for related confounders, percentages of follow-up and CD(4) testing were lower in inter-provincial and inter-prefectural mobile cases than those without. Conclusion: Service regarding the follow-up and CD(4) testing programs was affected by mobility of people living with HIV/AIDS. Programs on communication and personal contact should be strengthened in the follow-up management services for PLHIV. Information on potential mobility of PLHIV should be gathered timely by health workers during the subsequent follow-up period to avoid the loss of follow-up and CD(4) testing on patients.
Adult ; Anti-HIV Agents/therapeutic use* ; CD4 Lymphocyte Count ; China/epidemiology* ; Follow-Up Studies ; HIV Infections/immunology* ; Humans

Objectives: To undersand the outcomes of major intervention measures on sexual transmission among HIV sero-discordant couples. Methods: Bernoulli Process Model was applied to model the major influencing factors of HIV transmission among HIV sero-discordant couples. The major influencing factors appeared as consistent condom use, antiretroviral therapy, frequency of sexual behavior. These parameters were from the HIV sero-discordant couples in 30 counties in 4 provinces (Guangxi Zhuang Autonomous Region, Yunnan Province, Xinjiang Uygur Autonomous Region and Henan provinces) from January 1, 2011 to December 31, 2012. According to the main factors, modeling-intervention strategies and measures on reduction HIV transmission among serodiscordant couples were formed. Results: Data from the present proportion of consistent condom use (85%) modeling and the coverage of antiretroviral treatment (60%) showed that, the proportion of cumulative seroconversion among the spouses was 1.76%. Results from the sensitivity analysis on modeling the consistent condom use and the antiretroviral treatment showed that, when the coverage of antiretroviral treatment was as 90% and the proportion of consistent condom use increased from 50% to 90%, with 80.7% of the risk of spouse seroconversion could be reduced. Or, when the proportion of consistent condom use was as 90% and the coverage of antiretroviral treatment increased from 50% to 90%, with 64.5% of the risk of spouse seroconversion could be reduced. Conclusions: With measures as consistent condom use plus provision of timely antiretroviral therapy to HIV positive index spouses, the risk of sexual transmission among sero-discordant couples could be greatly reduced.
Anti-Retroviral Agents/therapeutic use* ; China/epidemiology* ; Condoms ; Female ; HIV Infections/virology* ; HIV Seronegativity ; HIV Seropositivity/epidemiology* ; Humans ; Male ; Safe Sex ; Sexual Behavior/statistics & numerical data* ; Sexual Partners ; Spouses

Humans ; Lung Neoplasms ; Soft Tissue Neoplasms

BACKGROUND AND PURPOSE: The purpose of this study was to estimate the incidence and prevalence of epilepsy among an elderly and poor population in the United States. METHODS: Arizona Medicaid claims data from January 1, 2008 to December 31, 2010 were used for this analysis. Subjects who were aged > or =65 years and were continuously enrolled in any Arizona Medicaid health plans (eligible to patients with low income) for > or =12 months between January 1, 2008 and December 31, 2009 were considered eligible for inclusion in the study cohort. In addition to meeting the aforementioned criteria, incident and prevalent cases must have had epilepsy-related healthcare claims. Furthermore, incident cases were required to have a 1-year "clean" period immediately preceding the index date. Negative binomial and logistic regression models were used to assess the factors associated with epilepsy incidence and prevalence. RESULTS: The estimated epilepsy incidence and prevalence for this population in 2009 were 7.9 and 19.3 per 1,000 person-years, respectively. The incidence and prevalence rates were significantly higher for patients with comorbid conditions that were potential risk factors for epilepsy and were of younger age than for their non-comorbid and older counterparts (p<0.05). The prevalence rates were significantly higher for non-Hispanic Blacks and male beneficiaries than for non-Hispanic Whites and female beneficiaries, respectively (p<0.05). CONCLUSIONS: This patient population had higher epilepsy incidence and prevalence compared with the general US population. These differences may be at least in part attributable to their low socioeconomic status.
African Continental Ancestry Group ; Aged* ; Arizona ; Cohort Studies ; Delivery of Health Care ; Epilepsy* ; Female ; Humans ; Incidence* ; Logistic Models ; Male ; Medicaid ; Poverty* ; Prevalence* ; Risk Factors ; Social Class ; United States*

Methods: Relevant data from the National Readmission Database in 2015–2018 were analyzed, and the computer-assisted procedures of cervical and thoracolumbar spinal surgery were identified using International Classification of Diseases 9th and 10th revision codes. Patient demographics, surgical data, readmissions, and total charges were examined. Comorbidity burden was calculated using the Charlson and Elixhauser comorbidity index. Complication rates were determined on the basis of diagnosis codes. Results: A total of 48,116 cervical cases and 27,093 thoracolumbar cases were identified using computer-assisted navigation. No major differences in sex, age, or comorbidities over time were found. The utilization of computer-assisted navigation for cervical and thoracolumbar spinal fusion cases increased from 2015 to 2018 and normalized to their respective years’ total cases (Pearson correlation coefficient=0.756, p =0.049; Pearson correlation coefficient=0.9895, p =0.010). Total charges for cervical and thoracolumbar cases increased over time (Pearson correlation coefficient=0.758, p =0.242; Pearson correlation coefficient=0.766, p =0.234). Conclusions The use of computer-assisted navigation in spinal surgery increased significantly from 2015 to 2018. The average cost grossly increased from 2015 to 2018, and it was higher than the average cost of nonnavigated spinal surgery. With the increased utilization and standardization of computer-assisted navigation in spinal surgeries, the cost of care of more patients might potentially increase. As a result, further studies should be conducted to determine whether the use of computer-assisted navigation is efficient in terms of cost and improvement of care.

OBJECTIVEFurther studies have been conducted to evaluate the roles of Ngn3 in adult islet maintenance and renewal.

METHODSIslets were isolated from 6 - 8 week old male C57BL/6 mice. After common bile duct cannulation, the pancreas was resected and digested in collagenase V (2.5 mg/ml). Islets were then handpicked and 10 - 12 islets were plated in 60 mm culture dish and cultivated with RPMI-1640, which contained 12.5 mmol/L HEPES, 5.2 mmol/L glucose and 2% fetal bovine serum (FBS). Islet cells were analyzed by immunocytochemistry methods for A6, insulin, glucagon, nestin, Ngn3 and 5-bromo-2'-deoxy-uridine (BrdU).

RESULTSThe results of these studies indicated that less than 15 percent of proliferated islet cells were Ngn3 expressing cells, in which about one third of the Ngn3 positive cells co-expressed A6. The existence of Ngn3 in cultured islet cells is consistent with the results from other's findings both in embryogenesis and adult islet studies. A significant finding of our study is that the existence of A6 and Ngn3 co-expressing cells in the cultured islet. A6 is a marker for identifying bile duct epithelial cell oriented hepatic progenitor cells. Islet-derived A6 cells are possibly born in the adult pancreatic duct and migrate into islets. A6 cells co-express Ngn3 when these cells commit to endocrine lineage within the islets. More interestingly, islet-derived A6 positive cells have the potential to transdifferentiate into hepatic cells.

CONCLUSIONThe presence of Ngn3(+) and A6(+) cells in the cultured islets suggests that the four established islet cell types arise from a common endocrine lineage residing within the adult islets. A6 and Ngn3 are useful markers for understanding intra-islet adult stem cell lineages in our future studies. This approach may allow for significant advances in understanding the IPC proliferation and differentiation, and open the possibility of using intra-islet adult stem cells for diabetes treatment.

Animals ; Basic Helix-Loop-Helix Transcription Factors ; Cell Differentiation ; Cell Lineage ; Cells, Cultured ; Islets of Langerhans ; cytology ; Male ; Mice ; Mice, Inbred C57BL ; Microfilament Proteins ; Nerve Tissue Proteins ; biosynthesis ; Protein-Tyrosine Kinases ; biosynthesis ; Stem Cells ; cytology ; metabolism

INTRODUCTIONDermatomyositis (DM) is a multisystem inflammatory disease with a strong association with malignancy. We aimed to describe a series of Asian patients with DM and identify any significant clinical factors associated with malignancy.

MATERIALS AND METHODSThis was a retrospective review of a multi-racial cohort of 69 Asian patients diagnosed with DM over an 11-year period from 1996 to 2006.

RESULTSMalignancy was detected in 15 out of 68 patients (22%), the most common of which was nasopharyngeal carcinoma (7 cases). Compared to the non-malignancy group, the malignancy-associated group was older and had more male patients. There were no statistically significant clinical, serological or laboratory factors associated with a higher risk of malignancy.

CONCLUSIONThis study highlights the importance of ongoing malignancy screening especially for nasopharyngeal carcinoma in Asian patients with DM.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma ; Confidence Intervals ; Dermatomyositis ; complications ; epidemiology ; immunology ; pathology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Muscle Weakness ; Nasopharyngeal Neoplasms ; epidemiology ; immunology ; pathology ; Odds Ratio ; Paraneoplastic Syndromes ; complications ; epidemiology ; immunology ; pathology ; Retrospective Studies ; Risk Factors ; Singapore ; epidemiology ; Young Adult

Objective: To determine the prevalence and relative factors on those who missed the follow-up service among newly reported HIV/AIDS cases that were infected by homosexual behavior. Methods: Data were extracted from both HIV/AIDS case-reporting and follow-up cards on HIV/AIDS in the Comprehensive Response Information Management System, between December 2008 and December 2015. Data was analyzed, using the generalized estimating equations (GEE) to explore the relative factors of influence. Results: Among the newly reported HIV infection among MSM, the proportion of those who missed the follow-up services was 5.06% (6 037/119 358), and decreased dramatically, from 37.57% (1 261/3 356) to 0.84% (267/31 935) (trend χ(2)=103.43, P<0.01). In MSM population, the younger than 20-year olds (OR=1.30, 95%CI: 1.11-1.52), 20-year olds (OR=1.52, 95%CI: 1.36-1.69), 30-year olds (OR=1.22, 95%CI: 1.12-1.34), 40-year olds (OR=1.10, 95%CI: 1.01-1.20) were receiving less follow-up services than those 50-year olds. Those who had received either junior (OR=1.52, 95%CI: 1.37-1.69) or senior high school education (OR=1.35, 95%CI: 1.23-1.49) were receiving less follow-up service than those who were more educated. MSM with the following characteristics as unspecified occupation (OR=2.06, 95%CI: 1.49-2.87),unemployed (OR=1.54, 95%CI: 1.30-1.83), working in commercial service (OR=1.31, 95%CI: 1.15-1.49) or being student (OR=1.34, 95%CI: 1.18-1.52) were more difficult to be traced or followed than the cadres. Cases being identified on site (OR=2.99, 95%CI: 2.26-3.95) or under special investigation (OR=1.43, 95%CI: 1.29-1.59) had received less follow-up service than those being identified through voluntary counsel testing service. Floating population (OR=1.46, 95%CI: 1.28-1.66) were getting less follow-up service than local residents. Conclusions: The prevalence of those who had missed the follow-up services in the newly discovered MSM HIV cases declined dramatically. Among the MSM HIV cases, those having the following characteristics as: younger than 50-year old, with less school education, with unspecified occupation or unemployment, working in commercial service, being student, having history of incarceration, recruited from special investigation, and floating population were prone to miss the follow-up program, suggesting that the follow-up service should be targeting on these patients.
Acquired Immunodeficiency Syndrome ; Adolescent ; Adult ; China ; Follow-Up Studies ; HIV Infections/transmission* ; Homosexuality, Male/statistics & numerical data* ; Humans ; Infections ; Lost to Follow-Up ; Male ; Middle Aged ; Patient Compliance ; Prevalence ; Sexual Behavior/ethnology* ; Young Adult

To study the characteristics and stability of new S(-) pantoprazole sodium hydrates.The X-ray single crystal diffractometer (SXRD), X-ray powder diffractometer (PXRD), thermogravimetric analysis (TG) and infrared spectrometry (IR) were used to characterize S(-) pantoprazole sodium hydrates. The stability of the hydrates was evaluated by high temperature test,affecting factors test and accelerated test.The crystalline water in S(-) pantoprazole sodium hydrates were very easy to lose and obtain, but crystal structure was not changed significantly. The transition from S(-) pantoprazole sodium trihydrate to S(-) pantoprazole sodium hemipentahydrate occurred at approximately 40 ℃ and reversible transitions from hemipentahydrate to trihydrate occurred at high humidity. Two hydrates had no significant difference in accelerated test.The crystal structure of the two hydrates are almost the same, hemipentahydrate is more stable than trihydrates at high temperature or at exposure to light(at 4500 ± 500 lx).