2018 Vol. 31, No. 5

Original Articles
Optical Coherence Tomography Features of Tuberculous Serpiginous-like Choroiditis and Serpiginous Choroiditis
Xiao Na WANG, Qi Sheng YOU, Hui Ying ZHAO, Xiao Yan PENG
2018, 31(5): 327-334. doi: 10.3967/bes2018.043
Objective To investigate optical coherence tomography (OCT) characteristics of tuberculous serpiginous-like choroiditis (Tb-SLC) and serpiginous choroiditis (SC) and to perform OCT to differentiate between these conditions. Methods This retrospective, case-control study examined consecutively enrolled patients with active Tb-SLC or SC. Patients underwent comprehensive ocular examinations and imaging (OCT, color fundus photography, autofluorescence imaging, fluorescein angiography, and indocyanine green angiography). Findings were examined and compared between eyes with SC and Tb-SLC. Results Nine patients with active Tb-SLC (14 eyes) and 8 with active SC (12 eyes) were included. The following OCT findings were observed significantly more often in the Tb-SLC group than in the SC group:vitreal hyper-reflective spots [5 Tb-SLC eyes (36%), no SC eyes; P=0.02], intraretinal edema [11 Tb-SLC eyes (79%), 3 SC eyes (25%); P=0.01], sub-retinal pigment epithelium (RPE) drusenoid deposits [11 Tb-SLC eyes (79%), 2 SC eyes (17%); P < 0.01], and choroidal granulomas [8 Tb-SLC eyes (57%), 2 SC eyes (17%); P=0.03]. A hyporeflective, wedge-shaped band was observed more often in the SC group [5 Tb-SLC eyes (36%), 9 SC eyes (75%); P=0.045] than in the Tb-SLC group. The incidence of other OCT signs did not differ between the groups and included outer nuclear layer hyper-reflection, outer retinal tabulation, and choriocapillaris point-like hyper-reflection. Conclusion Vitreal hyper-reflective spots, intraretinal fluid, sub-RPE drusenoid deposits, and choroidal granulomas on OCT images may indicate Tb-SLC. Additionally, a hyporeflective, wedge-shaped band may indicate SC. Therefore, OCT is likely helpful in differentiating between Tb-SLC and SC.
Decrease in Serum Amyloid a Protein Levels Following Three-month Stays in Negatively Charged Particle-dominant Indoor Air Conditions
Lee Suni, Yamamoto Shoko, Nishimura Yasumitsu, Matsuzaki Hidenori, Yoshitome Kei, Hatayama Tamayo, Ikeda Miho, Min YU, Sada Nagisa, Kumagai-Takei Naoko, Otsuki Takemi
2018, 31(5): 335-342. doi: 10.3967/bes2018.044
Objective The changes in serum adipokines and cytokines related to oxidative stress were examined during 3 months 'Off to On' and 'On to Off' periods using negatively charged particle-dominant indoor air conditions (NCPDIAC). Methods Seven volunteers participated in the study, which included 'OFF to 3 months ON' periods (ON trials) for a total of 16 times, and 'ON to 3 months OFF' (OFF trials) periods for a total of 13 times. Results With the exception of one case, serum amyloid A (SAA) levels decreased significantly during the ON trials. Conclusion Considering that SAA is an acute phase reactive protein such as C reactive protein (CRP), this observed decrease might indicate the prevention of cardiovascular and atherosclerotic changes, since an increase in high-sensitive CRP is associated with the subsequent detection of these events.
Efficient Humoral and Cellular Immune Responses Induced by a Chimeric Virus-like Particle Displaying the Epitope of EV71 without Adjuvant
Pu LIANG, Yao YI, Qiu Dong SU, Feng QIU, Xue Ting FAN, Xue Xin LU, Sheng Li BI
2018, 31(5): 343-350. doi: 10.3967/bes2018.045
Objective To eliminate the side effects of aluminum adjuvant and His-tag, we constructed chimeric VLPs displaying the epitope of EV71 (SP70) without His-tagged. Then evaluating whether the VLPs could efficiently evoke not only humoral but also cellular immune responses against EV71 without adjuvant. Methods The fusion protein was constructed by inserting SP70 into the MIR of truncated HBcAg sequence, expressed in E. Coli, and purified through ion exchange chromatography and density gradient centrifugation. Mice were immunized with the VLPs and sera were collected afterwards. The specific antibody titers, IgG subtypes and neutralizing efficacy were detected by ELISA, neutralization assay, and EV71 lethal challenge. IFN-γ and IL-4 secreted by splenocytes were tested by ELISPOT assay. Results HBc-SP70 proteins can self-assemble into empty VLPs. After immunization with HBc-SP70 VLPs, the detectable anti-EV71 antibodies were effective in neutralizing EV71 and protected newborn mice from EV71 lethal challenge. There was no significant difference for the immune efficacy whether the aluminum adjuvant was added or not. The specific IgG subtypes were mainly IgG1 and IgG2b and splenocytes from the mice immunized produced high levels of IFN-γ and IL-4. Conclusion The fusion proteins without His-tagged was expressed and purified as soluble chimeric HBc-SP70 VLPs without renaturation. In the absence of adjuvant, they were efficient to elicit high levels of Th1/Th2 mixed immune response as well as assisted by aluminum adjuvant. Furthermore, the chimeric VLPs have potential to prevent HBV and EV71 infection simultaneously.
Genetic Diversity and Drug Susceptibility of Mycobacterium tuberculosis Isolates in a Remote Mountain Area of China
Ai Jing MA, Sheng Fen WANG, Jia Le FAN, Bing ZHAO, Guang Xue HE, Yan Lin ZHAO
2018, 31(5): 351-362. doi: 10.3967/bes2018.046
Objective We determined the genetic diversity of Mycobacterium tuberculosis (MTB) in a remote mountainous area of southwest China and evaluated the resolving ability of single nucleotide polymorphism (SNP) genotyping combined with variable number tandem repeat (VNTR) genotyping for Beijing family strains in association with drug resistance status. Methods Three hundred thirty-one MTB strains were isolated from patients living in mountainous regions of southwest China, and 8-loci SNP, VNTR-15 genotyping assays, and drug susceptibility testing of 9 drugs were performed. Results A total of 183 [55.29% (183/331)] strains were classified into the Beijing family. Of the 183 strains, 111 (60.66%) were defined as modern Beijing strains. The most predominant modern Beijing sub-lineage and ancient Beijing sub-lineage were Bmyc10 [39.34% (72/183)] and Bmyc25 [20.77% (38/183)], respectively. Of the isolates, 19.64% (65/331) were resistant to at least 1 of the 9 anti-TB drugs and 17 [4.98% (17/331)] MTB isolates were multi-drug resistant tuberculosis (MDR-TB). Two hundred sixty-one isolates showed a clustering rate of 14.18% (37/261) and a discriminatory index of 0.9990. The Beijing lineage exhibited a significantly higher prevalence of MDR-TB, as well as resistance to isoniazid (INH), rifampin (RIF), and para-aminosalicylic acid (PAS) when analyzed independently (P=0.005, P=0.017, P=0.014, and P=0.006 respectively). The Beijing lineage was not associated with genetic clustering or resistance to any drug. In addition, genetic clustering was not associated with drug resistance. Conclusion MTB strains demonstrate high genetic diversity in remote mountainous areas of southwest China. Beijing strains, especially modern Beijing strains, are predominant in remote mountainous area of China. The combination of 8-loci SNPs and VNTR-15 genotyping is a useful tool to study the molecular epidemiology of MTB strains in this area.
Subchronic Oral Toxicity Evaluation of Lanthanum: A 90-day, Repeated Dose Study in Rats
Hai Qin FANG, Zhou YU, Yuan ZHI, Jin FANG, Chen Xi LI, Yi Mei WANG, Shuang Qing PENG, Xu Dong JIA
2018, 31(5): 363-375. doi: 10.3967/bes2018.047
Objective The present study was undertaken to evaluate the subchronic toxicity of lanthanum and to determine the no observed adverse effect level (NOAEL), which is a critical factor in the establishment of an acceptable dietary intake (ADI). Methods In accordance with the Organization for Economic Co-operation and Development (OECD) testing guidelines, lanthanum nitrate was administered once daily by gavage to Sprague-Dawley (SD) rats at dose levels of 0, 1.5, 6.0, 24.0, and 144.0 mg/kg body weight (BW) per day for 90 days, followed by a recovery period of 4 weeks in the 144.0 mg/kg BW per day and normal control groups. Outcome parameters were mortality, clinical symptoms, body and organ weights, serum chemistry, and food consumption, as well as ophthalmic, urinary, hematologic, and histopathologic indicators. The benchmark dose (BMD) approach was applied to estimate a point of departure for the hazard risk assessment of lanthanum. Results Significant decreases were found in the 144.0 mg/kg BW group in the growth index, including body weight, organ weights, and food consumption. This study suggests that the NOAEL of lanthanum nitrate is 24.0 mg/kg BW per day. Importantly, the 95% lower confidence value of the benchmark dose (BMDL) was estimated as 9.4 mg/kg BW per day in females and 19.3 mg/kg BW per day in males. Conclusion The present subchronic oral exposure toxicity study may provide scientific data for the risk assessment of lanthanum and other rare earth elements (REEs).
Letters to the Editor
Prevalence and Years Lived with Disability for Dental Caries among Children Aged 0-14 Years in China, 1990-2016
Wen Zhao LIU, Ling Yu SU, Xu Dong XIE, Xue Rong XIANG, Jiao HUANG, Ping JI
2018, 31(5): 376-381. doi: 10.3967/bes2018.048
The estimate of dental caries among Chinese children at the microscale level using standard methodology remains unclear. In this study, we assessed and analyzed the disease burden of childhood dental caries in China by extracting data from the Global Burden of Disease, Injuries, and Risk Factors Study 2016 (GBD 2016). In 2016, the number of cases, prevalence, years lived with disability (YLD), and age-standardized YLD rate of dental caries was 93.0 million, 43.0%, 32, 200 person years, and 14.8 per 100, 000, respectively. Across 33 provincial units, the disease burden was highest in Hubei (YLD rate 28.6 per 100, 000), lowest in Macao (9.1 per 100, 000), while geographical clustering was not observed. Compared with 1990, the prevalence in 2016 decreased from 46.8% to 43.0%, and the YLD rate decreased from 16.5 per 100, 000 to 14.8 per 100, 000. Given the slight decrease in dental caries burden, the prevalence and disease burden remained high among Chinese children. Strategies for addressing the spatial inequity of childhood dental caries require geographical targeting.
Subjective Well-being and Family Functioning among Adolescents Left Behind by Migrating Parents in Jiangxi Province, China
Jia ZHOU, Fang HU, Jing WU, Zhi Yong ZOU, Yi Xin WANG, Hua Can PENG, Sten H VERMUND, Yi Fei HU, Ying Hua MA
2018, 31(5): 382-388. doi: 10.3967/bes2018.049
We sought to identify the differences between adolescents left behind in their home villages/towns (LBA) and non-left behind adolescents (NLB) on subjective well-being and family functioning due to parental migration in south China. We used a stratified cluster sampling method to recruit middle school students in a city experiencing population-emigration in Jiangxi Province in 2010. Participants included adolescents from families with: (1) one migrant parent, (2) both parents who migrated, or (3) non-left behind adolescents (i.e., no migrant parent). To determine predictors of subjective well-being, we used structural equation models. Adolescents left behind by both parents (LBB) were less likely to express life satisfaction (P = 0.038) in terms of their environments (P = 0.011) compared with NLB. A parent or parents who migrated predicts lower subjective well-being of adolescents (P = 0.051) and also lower academic performance. Being apart from their parents may affect family functioning negatively from an adolescent's viewpoint. Given the hundreds of millions of persons in China, many who are parents, migrating for work, there may be mental health challenges in some of the adolescents left behind.
Molecular Characterization and Correlation with β-lactam Resistance of Streptococcus pneumonia Isolates in Hangzhou, China
Mei Fen CHU, Xiao Xiang LIU, Shao Ni ZHANG, Yan Ying HUANG, Peng DU, Li Fang WANG, Lei JI, Jie YAN, Ai Hua SUN
2018, 31(5): 389-393. doi: 10.3967/bes2018.050
Penicillin-binding proteins (PBPs) are the target of β-lactam antibiotics (the major treatment for Streptococcus pneumoniae infections), and mutations in PBPs are considered as a primary mechanism for the development of β-lactam resistance in S. pneumoniae. This study was conducted to investigate the mutations in the PBPs of clinical S. pneumoniae isolates in Hangzhou, China, in correlation with β-lactam resistance. Results showed that 19F was the predominant serotype (7/27) and 14 of the S. pneumoniae isolates were resistant to both penicillin G and cephalosporin. Genotyping results suggested that β-lactam-resistant isolates primarily exhibited single-site mutations in both the STMK and SRNVP motifs of pbp1a in combination with double-site mutations in the STMK motif of pbp2x, which might be the primary mechanisms underlying the β-lactam resistance of the isolates in this study.
Association between Physical Activity and Telomere Length in a North Chinese Population: A China Suboptimal Health Cohort Study
Li Xiang DING, Yan Hong ZHANG, Xi Zhu XU, Jie ZHANG, Ming SUN, Di LIU, Zhong Yao ZHAO, Yong ZHOU, Qun ZHANG, You Xin WANG
2018, 31(5): 394-398. doi: 10.3967/bes2018.051
Several studies have demonstrated an association between physical activity and telomere length; however, the association remains inconsistent. A cross-sectional study consisting of 588 participants (375 females, median age of 33.8 years) was carried out to investigate the association between telomere length and physical activity in a general population from North China. The results show that relative telomere length is not significantly different in participants in the northern Chinese population with different levels of physical activity, either in the model only adjusted for age (F = 2.127, P = 0.120) or in the model adjusted for demographics and lifestyle (F = 1.227, P = 0.294). The gender-stratified analysis also produced insignificant results. Our study confirmed a non-significant association between physical activity and telomere length in the northern Chinese population, which adds to the inconsistent association between physical activity and telomere length across different ethnic populations.
Effects of Infrasound on Gastric Motility, Gastric Morphology and Expression of Nitric Oxide Synthase in Rat
Ju Hui ZHAO, Jin Hai WANG, Jin Yan LUO, Xiao Yan GUO, Yan WANG, Yan CHENG
2018, 31(5): 399-402. doi: 10.3967/bes2018.052
Infrasound widely exists in nature, our living condition, productive and traffic environment. Gastrointestinal tract is relatively sensitive to infrasound. However, the effect of infrasound on gastrointestinal function is unclear. Therefore, the purpose of our study was to observe the effects of infrasound on gastric motility and gastric morphology and to assess the expression of nitric oxide synthase (NOS) in gastric antrum after exposure to infrasound of 8 Hz - 130 dB for 2 hours per day for 14 consecutive days. Gastric motility was assessed by gastric fluid-emptying rate. Gastric morphology was evaluated by HE. The expression of NOS was measured by tissue microarray technology. The results would contribute to understand the role of infrasound in gastroenterology, and help to explain the mechanism of infrasound on gastroenterology.
Serosurvey of Avian metapneumovirus, Orithobacterium rhinotracheale, and Chlamydia psittaci and Their Potential Association with Avian Airsacculitis
Zong Hui ZUO, Tian Yuan ZHANG, Yong Xia GUO, Jun CHU, Guang Gang QU, Li Zhong MIAO, Zhi Qiang SHEN, Cheng HE
2018, 31(5): 403-406. doi: 10.3967/bes2018.053
Seasonal outbreaks of airsacculitis in China's poultry cause great economic losses annually. This study tried to unveil the potential role of Avian metapneumovirus (AMPV), Ornithobacterium rhinotracheale (ORT) and Chlamydia psittaci (CPS) in avian airsacculitis. A serological investigation of 673 breeder chickens and a case-controlled study of 430 birds were undertaken. Results showed that infection with AMPV, ORT, and CPS was highly associated with the disease. The correlation between AMPV and CPS were positively robust in both layers and broilers. Finally, we determined the co-infection with AMPV, ORT, and CPS was prevalent in the sampled poultry farms suffering from respiratory diseases and the outbreak of airsacculitis was closely related to simultaneous exposure to all three agents.