Background dementia has been a major public health problem. However, there has not yet been a nationwide investigation or systematic analysis of the prevalence of dementia in China from 1980 to 2004. Objectives the aim of this study was to analyse the prevalence of dementia and its major subtypes [Alzheimer disease (AD), vascular dementia (VD)] among the population aged 60 years and older in China from 1980 to 2004. Methods epidemiological investigations on dementia in China published in journals and covering the period from 1980 to 2004 were identified manually and on-line by using CBMDISK, Chongqing VIP database and CNKI database. Those reported in English journals were identified using MEDLINE. Selected studies had to describe an original study defined by strict screening and diagnostic criteria. The fixed effects model or random effects model was employed according to statistical test for homogeneity. Results twenty-five studies were selected, the statistical information of which was collected for systematic analysis. Our results showed that AD and VD were the two major subtypes of dementia in China, and the pooled prevalence of AD and VD for the population aged 60 years and older was 1.6 and 0.8%, respectively. There was a higher prevalence of AD in the illiterate elderly population (3.2%) than in those who received years of education. The chronological prevalence of AD increased significantly from 1980 to 2004. In southern and northern China, the prevalence of AD was 2.0 and 1.2%, respectively, while VD was 0.6 and 1.1%, respectively. Conclusions in the last 24 years, AD and VD were the two major subtypes of dementia in China. The prevalence of AD may be affected by sex, education, occupation or age. The prevalence of VD, which was higher in northern than in southern China, seems not to be affected by age, sex or education.

A novel platelet aggregation inhibitor, rhodocetin, was purified from the crude venom of Calloselasma rhodostoma. It inhibited collagen-induced platelet aggregation in a dose-dependent manner, with an IC50 of 41 nM. Rhodocetin has a heterodimeric structure with alpha and beta subunits, which could be separated on a nonreducing denaturing gel or reverse-phase HPLC column. Individually neither subunit inhibited platelet aggregation even at 2.0 microM concentration. Titration and reconstitution experiments showed that, when these subunits are mixed to give a 1:1 complex, most of its biological activity was recovered. The reconstituted complex inhibited platelet aggregation with an IC50 of 112 nM, about 3-fold less effective than the native molecule. Circular dichroism analysis revealed that the reconstituted complex had a spectrum similar to that of the native protein. By using surface plasmon resonance studies, we established that the stoichiometry of binding between the two subunits is 1:1 and the subunits interact with a Kd of 0.14 +/- 0.04 microM. The complete amino acid sequences of the alpha (15956.16 Da, 133 residues) and beta (15185.10 Da, 129 residues) subunits show a high degree of homology with each other (49%) and with the Ca2+-dependent lectin-related proteins (CLPs) (typically 29-48%) isolated from other snake venoms. Unlike the other members of the family in which the subunits are held together by an interchain disulfide bond, rhodocetin subunits are held together only through noncovalent interactions. The cysteinyl residues forming the intersubunit disulfide bridge in all other known CLPs are replaced by Ser-79 and Arg-75 in the alpha and beta subunits of rhodocetin, respectively. These studies support the noncovalent and synergistic interactions between the two subunits of rhodocetin. This is the first reported CLP dimer with such a novel heterodimeric structure.

Study Type – Diagnosis (systematic review) Level of Evidence 1 What's known on the subject? and What does the study add? In recent years, more attention has focused on the role of narrow band imaging (NBI) in bladder cancer detection and NBI technology has spread rapidly. It is an important method for diagnosing new or recurrent bladder cancer. But its diagnostic accuracy is still uncertain. This paper summarizes the diagnostic accuracy of NBI in bladder cancer and compares NBI with white light imaging. The results show that NBI cystoscopy significantly improves the detection accuracy in bladder cancer, compared with white light imaging. However, some limitations still exist. Multicentre randomized studies are recommended to determine whether the visual advantages of NBI can translate into real therapeutic benefit for individual patients. OBJECTIVE To assess the test performance and clinical effectiveness of narrow band imaging (NBI) cystoscopy compared with white light imaging (WLI) cystoscopy in people suspected of new or recurrent bladder cancer. METHODS Literature on NBI cystoscopy in the diagnosis of bladder cancer was searched in PubMed, EMBASE, Cochrane Library, MEDLINE and CNKI, with hand searching of relevant congress abstracts and journals. The literature was selected according to inclusion and exclusion criteria. The Meta‐DiSc1.4 software was used to review management and analysis. RESULTS Eight studies including 1022 patients assessed test performance. On a per‐person analysis, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of NBI and WLI were respectively 0.943 (95% CI 0.914−0.964) and 0.848 (95% CI 0.803−0.885), 0.847 (95% CI 0.812−0.878) and 0.870 (95% CI 0.831−0.903), 7.038 (95% CI 3.357−14.754) and 6.938 (95% CI 2.052−23.465), 0.054 (95% CI 0.012−0.237) and 0.181 (95% CI 0.091−0.361), and 185.32 (95% CI 45.714−751.26) and 42.931 (95% CI 8.088−227.88). The area under the curve and Q* of NBI and WLI were respectively 0.9781 and 0.8944, and 0.9337 and 0.8253. For the characterization of carcinoma in situ, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of NBI were 0.927 (95% CI 0.878−0.960), 0.768 (95% CI 0.730−0.802), 4.545 (95% CI 2.820−7.325), 0.125 (95% CI 0.051−0.304) and 48.884 (95% CI 15.642−152.77) on a per‐person analysis. The area under the curve and Q* were 0.9391 and 0.8763. CONCLUSION NBI is an effective method for the identification of abnormal lesions including carcinoma in situ and can provide higher diagnostic precision of bladder cancer than WLI.

Multiple studies have demonstrated the occurrences of short-chain chlorinated paraffins (SCCPs) and medium-chain chlorinated paraffins (MCCPs) in environmental matrixes, but human internal exposure to them has been studied rarely. Mass fractions and congener group patterns of SCCPs and MCCPs in paired maternal and cord serum were studied for the first time to investigate the placental transport mechanism and prenatal exposure risks of CPs. Samples were collected in Beijing, China, and analyzed using two-dimensional gas chromatography coupled to time-of-flight mass spectrometry. SCCP and MCCP mass fractions in maternal serum were 21.7-373 and 3.76-31.8 ng/g ww, respectively. They were 8.51-107 and 1.33-12.9 ng/g ww, respectively, in cord serum. Significant positive correlation between SCCP and MCCP levels in maternal serum was found ( p < 0.01), suggesting SCCPs and MCCPs may undergo similar accumulation, transfer, and transformation pathways. The predominant congener groups for SCCP and MCCP in maternal serum were CCl and CCl. The homologue profiles of CPs in cord serum were similar but with varied contribution percentage compared with those in maternal serum. By calculating and comparing cord-maternal serum ratios for each individual congener group, passive diffusion was recognized to be the possible placental transport form. The relationships between CP and thyroid hormone concentrations (THs) indicated that exposure to CPs might affect circulating TSHs. C-CPs were also detected, improving our understanding of CPs in human serum.

Interferon (IFN)-a is a first-line therapy for chronic hepatitis B (CHB) patients but only initiates a response in a minority of patients. A genetic variant, rs7574865 in STAT4, was recently reported to be associated with risk of developing CHB and hepatitis B virus-related hepatocellular carcinoma. We aimed to determine whether this variant is associated with the response to IFNa treatment for hepatitis B e antigen (HBeAg)-positive CHB patients. We studied 466 HBeAg-positive CHB patients who received either IFNa-2b (n 5 224) or pegylated IFNa-2a (n 5 242) therapy for 48 weeks and were followed for an additional 24 weeks. The rate of sustained virologic response (SVR), defined as HBeAg seroconversion along with hepatitis B virus DNA level <2000 copies/mL at week 72, was compared among patients with different genotypes of rs7574865. After 48 weeks of treatment and 24 weeks off treatment, the SVR rates in the IFNa-2b and pegylated IFNa-2a therapy groups were 30.4% and 28.9%, respectively. Compared to the rs7574865 GT/TT genotype, the GG genotype (a risk factor of CHB and hepatitis B virus-related hepatocellular carcinoma) was significantly associated with a reduced SVR rate in both patients who received IFNa-2b therapy (21.1% versus 37.2%, P 5 0.01) and those who received pegylated IFNa-2a therapy (18.0% versus 41.2%, P 5 9.74 3 10 -5 ). In joint analysis of the 466 patients, the GG genotype was associated with an approximately half SVR rate compared to the GT/TT genotype (19.3% versus 39.1%, P 5 4.15 3 10 -6 ). A multivariate logistic regression model including rs7574865 and clinical variables showed that rs7574865 was the most significant factor for the prediction of SVR. Conclusion: STAT4 rs7574865 is a reliable predictor of response to IFNa therapy for HBeAg-positive CHB patients and may be used for optimizing the treatment of CHB. (HEPATOLOGY 2016;63:1102-1111 C hronic hepatitis B (CHB) continues to be a major global health issue with more than 350 million cases worldwide and is a significant cause of cirrhosis and hepatocellular carcinoma (HCC).(1) Interferon (IFN)-a (standard and pegylated [PEG] forms) and nucleos(t)ide analogues are

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Background Vibrio parahaemolyticus AphA and OpaR are the two master quorum sensing (QS) regulators that are abundantly expressed at low cell density (LCD) and high cell density (HCD), respectively, with a feature of reciprocally gradient production of them with transition between LCD and HCD. The type VI secretion system 2 (T6SS2) gene cluster can be assigned into three putative operons, namely VPA1027-1024, VPA1043-1028, and VPA1044-1046. T6SS2 contributes to adhesion of V. parahaemolyticus to host cells.Methodology/Principal FindingsOpaR box-like sequences were found within the upstream promoter regions of all the above three operons, while none of AphA box-like elements could be identified for them. The subsequent primer extension, LacZ fusion, electrophoretic mobility shift, and DNase I footprinting assays disclosed that OpaR bound to the promoter regions of these three operons to stimulate their transcription, while AphA negatively regulated their transcription most likely through acting on OpaR. This regulation led to a gradient increase of T6SS2 transcription with transition from LCD to HCD.Conclusions/Significance V. parahaemolyticus OpaR and AphA positively and negatively regulate T6SS2 expression, respectively, leading to a gradient elevation of T6SS2 expression with transition from LCD to HCD. T6SS2 genes are thus assigned as the QS regulon members in V. parahaemolyticus.