Faculty Bibliography

OBJECTIVE:To explore the exposed level of stroke risk factors in Fengxian county of Shanghai and the relationships between risk factors and stroke. METHODS:Community based populations including 10,565 individuals aged 40 years old and over were cluster sampled from Fengxian county in 2003 or 2004. Status of exposure on common risk factors such as hypertension, cardiovascular disease, diabetes, family history of stroke, cigarette smoking, alcohol intake were gathered while cerebral vascular hemodynamic index (CVHI) was examined, with CVHI score below 75 points as abnormal. During 2003 to 2006, 78 stroke cases occurred. The relationships between risk factors and stroke were analyzed by univariate and Cox proportional hazards regression models. RESULTS:Rates of exposure regarding hypertension, cardiovascular disease, diabetes, family history of stroke, obesity (BMI > or = 28 kg/m2), smoking, drinking and CVHI score abnormal were 21.14%, 6.72%, 1.88%, 5.63%, 4.17%, 34.96%, 17.81% and 29.43%, respectively. Data from Univariate analysis indicated that relative risk (95% CI) of above-mentioned risk factors were 2.76 (1.76-4.32), 2.19 (1.16-4.14), 1.52 (0.38-6.19), 1.58 (0.69-3.62), 1.24 (0.45-3.38), 1.75 (1.12-2.73), 2.10 (1.30-3.39) and 12.72 (7.02-23.06), respectively. Results from Cox proportional hazards regression models analysis showed that cigarette smoking, CVHI score abnormal were screened into equation. CONCLUSION/CONCLUSIONS:Among all the risk factors, rate of hypertension was the highest while hypertension, cardiovascular disease, cigarette smoking, alcohol intake and abnomal CVHI score had remarkable etiological correlations to stroke. Abnormal CVHI score, cigarette smoking seemed to be the independent forecasting factors related to stroke.

The relative risk (RR) of stroke in patients with hypertension was evaluated by using synthetic index of cerebrovascular hemodynamics. A total of 7,371 patients with hypertension with ages ≥40 years were selected from a population-based cohort study of the risk factors for stroke. The data on the baseline investigation of risk factors, the determination of cerebrovascular hemodynamic parameters (CVHP), and stroke follow-up were analyzed. The RR of stroke in patients with hypertension was evaluated by CVHP scores. Univariate analysis indicated that hypertension, complicated by other risk factors, had significant statistical association with the onset of stroke. RRs for stroke when hypertension complicated with decrease of hemodynamic scores, heart disease, cigarette smoking and alcohol consumption were 4.93 (95%CI, 3.26-7.45), 1.90 (95%CI, 1.36-2.66), 1.99 (95%CI, 1.42-2.79) and 1.73 (95%CI, 1.19-2.53) respectively. In multivariate analysis, hemodynamic score, age, sex, cigarette smoking, family history of stroke and systolic blood pressure were selected by the Cox regression for inclusion in the final analysis. Among them, the RR of hemodynamic score was highest. The analysis of dose-response relationships indicated that when the hemodynamic scores in patients with hypertension were lower than 75 points, the RR of stroke at 75, 60, 45, 30 and 15 points were 2.85, 4.43, 4.54, 5.40 and 9.88, respectively. The risk of stroke in patients with hypertension is closely associated with hemodynamic impairment and the hemodynamic score may be used for quantitative evaluation of relative risks of stroke.

AIM/OBJECTIVE:The differential expression of USP2, USP14 and UBE4A between ovarian serous cystadenocarcinoma and adjacent normal tissues was investigated. METHODS:Restriction fragment differential display polymerase chain reaction (RFDD-PCR), semi-quantitative RT-PCR and immunohistochemical staining were applied to analyze the differentially expressed genes and proteins of ubiquitin specific proteases (USPs), USP2 and USP14, and ubiquitin factor E4A (UBE4A) between ovarian serous cystadenocarcinoma and adjacent normal tissues obtained from 40 patients aged from 29 to 72 years old, collected in 2005 year at excision of surgical operation with ovarian serous cystadenocarcinoma. RESULTS:USP2, USP14 and UBE4A were over-expressed (>3 folds) in ovarian serous cystadenocarcinoma tissues compared to normal tissues. CONCLUSION/CONCLUSIONS:The results suggest that the activity of ubiquitin-proteasome system is obviously enhanced in ovarian cancer.

Staphylococcus aureus is one of the most commonly isolated organisms in nosocomial infections. While the prevalence of methicillin-resistant S. aureus (MRSA) continues to increase worldwide, there is concern about an increase in vancomycin MICs among S. aureus strains. The prevalence of MRSA and vancomycin MIC trends in S. aureus from patients in a university hospital were analyzed. Clinical Laboratory Standards Institute (CLSI, formerly NCCLS) reference broth microdilution MIC testing was performed on all clinically relevant S. aureus isolates from January 2000 through December 2004. A total of 6,003 S. aureus isolates were analyzed. No vancomycin-resistant S. aureus isolates were detected. One MRSA isolate had a vancomycin MIC of 8 mug/ml and was confirmed as vancomycin-intermediate S. aureus. Among the 6,002 remaining isolates, a shift in vancomycin MICs from </=0.5 to 1.0 mug/ml was observed during the 5-year period. The percentage of S. aureus isolates with a vancomycin MIC of 1 mug/ml in 2004 was significantly higher than the percentage of isolates in 2000 (70.4% versus 19.9%; P < 0.01). This vancomycin MIC shift was more notable in methicillin-susceptible S. aureus. Our 5 years of routine testing of clinical isolates using the CLSI reference broth microdilution MIC method demonstrated a tendency toward decreasing susceptibility to vancomycin in S. aureus.

Elevated atmospheric CO2 concentration may result in a decline of leaf nutritional quality (especially N) and an increase in some kinds of defensive secondary components such as phenolic compounds. The changes in tree phytochemistry, combined with the effects of elevated CO2 per se, have a potential impact on leaf-feeding insects. This paper reviewed the effects of elevated CO2 on the performance of leaf-feeding forest insects at individual level and community level. The elevated CO2 per se had very little influence on the metabolism of insect. Over half of the tree-insect experimental system showed that under high CO2, the performance of individual insect became poorer, while the others showed that insect had little or no response to the treatments. The direction and magnitude of the changes in insect performance could be affected by various factors, and the effects of treatments were strongly species-dependant. The magnitude of the changes in phytochemistry, the sensitivity and adaptive capacity of insect to poorer leaf quality, the differences in plant growth conditions and experimental methods, and the mediated effects of other environment factors, e. g., soil NO3-, light, temperature, and O3, were all closely related to the final performance of insect. But, the larvae's consumption usually increased under enriched CO2 treatment, which was widely thought to be a compensatory response for poorer plant quality. The experiments on forest community level found identically a reduction in herbivory, which was contrary to the results from small-scale experiments. The change of insect population and the true response of consumption by leaf-feeding forest insects under CO2 enrichment environment remain unclear, and more field-based experiments need to be conducted.

OBJECTIVE:To present data from a baseline investigation on stroke-related cohort population in rural area of Shanghai. METHODS:A cross-sectional study was carried out in a cluster sampling population aged 40 years and over. General information and data on common risk factors in the population were gathered and cerebral vascular hemodynamic indexes were checked. Hemodynamic score was estimated according to single indexes by unified methods. 5335 persons who had met the inclusion criteria were enlisted in the study. Exposure level of risk factors, prevalence of stroke, and hemodynamic indexes were analyzed and distributional characteristics were described. RESULTS:Exposure rate of hypertension, heart disease, diabetes, family history of hypertension, overweight or obesity in males were 31.74%, 6.09%, 1.16%, 3.22%, 17.64%, 29.68% and were 32.76%, 9.22%, 1.55%, 3.84%, 19.22%, 29.44% in female respectively. Standard prevalence of stroke was 1167.3/100000, which in male was significantly higher than that in female (P < 0.05). The change of cerebral vascular hemodynamic indexes was significantly associated with age. Hemodynamic score in 21.3% of the subjects was below 75 points. CONCLUSIONS:Among population of 40 years old and over in rural areas, hypertension was the principal risk factor regarding the rate of stroke. Prevalence of stroke in males was significantly higher than that in females. Abnormal rate of hemodynamic score was about 20% in this population.

Human granulocytic anaplasmosis (HGA) is a potentially fatal tick-borne infection caused by Anaplasma phagocytophilum. Treatment options are limited for this entity, with doxycycline being the drug of choice. Certain fluoroquinolones such as levofloxacin are active against A. phagocytophilum in vitro. We report a hospitalized patient with HGA who improved coincident with a 13-day course of levofloxacin therapy, but clinically and microbiologically relapsed 15 days after completion of treatment. Relapse of infection after levofloxacin therapy was reproduced in a severe combined immune-deficient (SCID) mouse infection model. Quinolone therapy should not be considered curative of HGA

A large amount of knowledge has been acquired since the original descriptions of Lyme borreliosis (LB) and of its causative agent, Borrelia burgdorferi sensu stricto. The complexity of the organism and the variations in the clinical manifestations of LB caused by the different B. burgdorferi sensu lato species were not then anticipated. Considerable improvement has been achieved in detection of B. burgdorferi sensu lato by culture, particularly of blood specimens during early stages of disease. Culturing plasma and increasing the volume of material cultured have accomplished this. Further improvements might be obtained if molecular methods are used for detection of growth in culture and if culture methods are automated. Unfortunately, culture is insensitive in extracutaneous manifestations of LB. PCR and culture have high sensitivity on skin samples of patients with EM whose diagnosis is based mostly on clinical recognition of the lesion. PCR on material obtained from extracutaneous sites is in general of low sensitivity, with the exception of synovial fluid. PCR on synovial fluid has shown a sensitivity of up to >90% (when using four different primer sets) in patients with untreated or partially treated Lyme arthritis, making it a helpful confirmatory test in these patients. Currently, the best use of PCR is for confirmation of the clinical diagnosis of suspected Lyme arthritis in patients who are IgG immunoblot positive. PCR should not be used as the sole laboratory modality to support a clinical diagnosis of extracutaneous LB. PCR positivity in seronegative patients suspected of having late manifestations of LB most likely represents a false-positive result. Because of difficulties in direct methods of detection, laboratory tests currently in use are mainly those detecting antibodies to B. burgdorferi sensu lato. Tests used to detect antibodies to B. burgdorferi sensu lato have evolved from the initial formats as more knowledge on the immunodominant antigens has been collected. The recommendation for two-tier testing was an attempt to standardize testing and improve specificity in the United States. First-tier assays using whole-cell sonicates of B. burgdorferi sensu lato need to be standardized in terms of antigen composition and detection threshold of specific immunoglobulin classes. The search for improved serologic tests has stimulated the development of recombinant protein antigens and the synthesis of specific peptides from immunodominant antigens. The use of these materials alone or in combination as the source of antigen in a single-tier immunoassay may someday replace the currently recommended two-tier testing strategy. Evaluation of these assays is currently being done, and there is evidence that certain of these antigens may be broadly cross-reactive with the B. burgdorferi sensu lato species causing LB in Europe