2017 Vol. 30, No. 6

2017-06cover
2017, 30(6): 1-1.
2017-06contents

2017, 30(6): 2-2.
Original Articles
Zinc Absorption from Representative Diet in a Chinese Elderly Population Using Stable Isotope Technique
LI Ya Jie, LI Min, LIU Xiao Bing, REN Tong Xiang, LI Wei Dong, YANG Chun, WU Meng, YANG Lin Li, MA Yu Xia, WANG Jun, PIAO Jian Hua, YANG Li Chen, YANG Xiao Guang
2017, 30(6): 391-397. doi: 10.3967/bes2017.052
Objective To determine the dietary zinc absorption in a Chinese elderly population and provide the basic data for the setting of zinc (Zn) recommended nutrient intakes (RNI) for Chinese elderly people. Methods A total of 24 elderly people were recruited for this study and were administered oral doses of 3 mg 67Zn and 1.2 mg dysprosium on the fourth day. The primary macronutrients, energy, and phytic acid in the representative diet were examined based on the Chinese National Standard Methods. Fecal samples were collected during the experimental period and analyzed for zinc content, 67Zn isotope ratio, and dysprosium content. Results The mean (±SD) zinc intake from the representative Chinese diet was 10.6±1.5 mg/d. The phytic acid-to-zinc molar ratio in the diet was 6.4. The absorption rate of 67Zn was 27.9%±9.2%. The RNI of zinc, which were calculated by the absorption rate in elderly men and women, were 10.4 and 9.2mg/d, respectively. Conclusion This study got the dietary Zn absorption in a Chinese elderly population. We found that Zn absorption was higher in elderly men than in elderly women. The current RNI in elderly female is lower than our finding, which indicates that more attention is needed regarding elderly females' zinc status and health.
Antiviral Activity of Dual-acting Hydrocarbon-stapled Peptides against HIV-1 Predominantly Circulating in China
WANG Yan, CURRELI Francesca, XU Wei Si, LI Zhen Peng, KONG De Sheng, REN Li, HONG Kun Xue, JIANG Shi Bo, SHAO Yi Ming, DEBNATH Asim K, MA Li Ying
2017, 30(6): 398-406. doi: 10.3967/bes2017.053
Objective New rationally designed i, i+7-hydrocarbon-stapled peptides that target both HIV-1 assembly and entry have been shown to have antiviral activity against HIV-1 subtypes circulating in Europe and North America. Here, we aimed to evaluate the antiviral activity of these peptides against HIV-1 subtypes predominantly circulating in China. Methods The antiviral activity of three i, i+7-hydrocarbon-stapled peptides, NYAD-36, NYAD-67, and NYAD-66, against primary HIV-1 CRF07_BC and CRF01_AE isolates was evaluated in peripheral blood mononuclear cells (PBMCs). The activity against the CRF07_BC and CRF01_AE Env-pseudotyped viruses was analyzed in TZM-bl cells. Results We found that all the stapled peptides were effective in inhibiting infection by all the primary HIV-1 isolates tested, with 50% inhibitory concentration toward viral replication (IC50) in the low micromolar range. NYAD-36 and NYAD-67 showed better antiviral activity than NYAD-66 did. We further evaluated the sensitivity of CRF01_AE and CRF07_BC Env-pseudotyped viruses to these stapled peptides in a single-cycle virus infectivity assay. As observed with the primary isolates, the IC50s were in the low micromolar range, and NYAD-66 was less effective than NYAD-36 and NYAD-67. Conclusion Hydrocarbon-stapled peptides appear to have broad antiviral activity against the predominant HIV-1 viruses in China. This finding may provide the impetus to the rational design of peptides for future antiviral therapy.
Uptake of HIV Self-testing among Men Who have Sex with Men in Beijing, China:a Cross-sectional Study
REN Xian Long, WU Zun You, MI Guo Dong, MCGOOGAN Jennifer, ROU Ke Ming, ZHAO Yan
2017, 30(6): 407-417. doi: 10.3967/bes2017.054
Objective To examine HIV self-testing uptake and its determinates among men who have sex with men (MSM) in Beijing, China. Methods A cross-sectional online survey was conducted in Beijing, China in 2016. Participants were users of a popular Chinese gay networking application and had an unknown or negative HIV status. Univariate and multivariate logistic regression analyses were conducted to examine factors associated with HIV self-testing based on adjusted odds ratio (AOR) and 95% confidence interval (CI). Results Among the 5, 996 MSM included in the study, 2, 383 (39.7%) reported to have used HIV self-testing kits. Willingness to use an HIV self-test kit in the future was expressed by 92% of the participants. High monthly income (AOR=1.49; CI=1.10-2.02; P=0.010), large number of male sex partners (≥ 2:AOR=1.24; CI=1.09-1.43; P=0.002), sexual activity with commercial male sex partners (≥ 2:AOR=1.94; CI=1.34 -2.82; P=0.001), long-term drug use (AOR=1.42; CI=1.23-1.62; P < 0.001), and long-term HIV voluntary counseling and testing (VCT) attendance (AOR=3.62; CI=3.11-4.22; P < 0.001) were all associated with increased odds of HIV self-testing uptake. Conclusion The nearly 40% rate of HIV self-testing uptake among MSM in our sample was high. In addition, an over 90% willingness to use kits in the future was encouraging. HIV self-testing could be an important solution to help China achieve the global target of having 90% of all people living with HIV diagnosed by 2020.
Comparison of Histological, Microbiological, and Molecular Methods in Diagnosis of Patients with TBLN Having Different Anti-TB Treatment Background
CHE Nan Ying, HUANG Shao Jun, MA Yan, HAN Yi, LIU Zi Chen, ZHANG Chen, MU Jing, ZHAO Dan, QU Yang, ZHANG Hai Qing, LIU Zhi Dong, XU Shao Fa
2017, 30(6): 418-425. doi: 10.3967/bes2017.055
Objective The influence of anti-tuberculosis (TB) treatment history on tuberculous lymphadenitis (TBLN) diagnosis is unclear. Therefore, this study aims to evaluate the diagnostic methods, including histology, microbiology, and molecular tests, used for TBLN. Methods In this study, suspected patients with TBLN and having different anti-TB treatment background were enrolled. All the samples were tested simultaneously by histology, Ziehl-Neelsen (ZN) staining, mycobacterial culture (culture), Xpert MTB/RIF (xpert), real-time PCR, and high-resolution melting curve PCR (HRM). Thereafter, the performance of these methods on samples with different anti-TB treatment background was assessed. Results In our study, 89 patients were prospectively included 82 patients with TBLN and 7 with other diseases. The overall sensitivities of Xpert, real-time PCR, histology, ZN staining, and culture were 86.6%, 69.5%, 58.5%, 43.9%, and 22.0%, respectively. The anti-TB treatment history revealed dramatic influences on the sensitivity of culture (P < 0.0001). In fact, the treatment that lasted over 3 months also influenced the sensitivity of Xpert (P < 0.05). However, the treatment history did not affect the performance of remaining tests (P > 0.05). For rifampicin drug susceptibility test (DST), the anti-TB treatment showed only significant influence on the success rate of culture DST (P=0.001), but not on those of Xpert and HRM tests (P > 0.05). Conclusion Other tests as well as culture should be considered for patients with TBLN having retreatment history or over 1-month treatment to avoid false negative results.
A New Method for Blood NT-proBNP Determination Based on a Near-infrared Point of Care Testing Device with High Sensitivity and Wide Scope
ZHANG Xiao Guang, SHU Yao Gen, GAO Ju, WANG Xuan, LIU Li Peng, WANG Meng, CAO Yu Xi, ZENG Yi
2017, 30(6): 426-431. doi: 10.3967/bes2017.056
Objective To develop a rapid, highly sensitive, and quantitative method for the detection of NT-proBNP levels based on a near-infrared point-of-care diagnostic (POCT) device with wide scope. Methods The lateral flow assay (LFA) strip of NT-proBNP was first prepared to achieve rapid detection. Then, the antibody pairs for NT-proBNP were screened and labeled with the near-infrared fluorescent dye Dylight-800. The capture antibody was fixed on a nitrocellulose membrane by a scribing device. Serial dilutions of serum samples were prepared using NT-proBNP-free serum series. The prepared test strips, combined with a near-infrared POCT device, were validated by known concentrations of clinical samples. The POCT device gave the output of the ratio of the intensity of the fluorescence signal of the detection line to that of the quality control line. The relationship between the ratio value and the concentration of the specimen was plotted as a work curve. The results of 62 clinical specimens obtained from our method were compared in parallel with those obtained from the Roche E411 kit. Results Based on the log-log plot, the new method demonstrated that there was a good linear relationship between the ratio value and NT-proBNP concentrations ranging from 20 pg/mL to 10 ng/mL. The results of the 62 clinical specimens measured by our method showed a good linear correlation with those measured by the Roche E411 kit. Conclusion The new LFA detection method of NT-proBNP levels based on the near-infrared POCT device was rapid and highly sensitive with wide scope and was thus suitable for rapid and early clinical diagnosis of cardiac impairment.
Acrylamide-induced Subacute Neurotoxic Effects on the Cerebral Cortex and Cerebellum at the Synapse Level in Rats
ZHANG Bin, SHAO Hua, WANG Xiu Hui, CHEN Xiao, LI Zhong Sheng, CAO Peng, ZHU Dan, YANG Yi Guang, XIAO Jing Wei, LI Bin
2017, 30(6): 432-443. doi: 10.3967/bes2017.057
Objective To investigate acrylamide (ACR)-induced subacute neurotoxic effects on the central nervous system (CNS) at the synapse level in rats. Methods Thirty-six Sprague Dawley (SD) rats were randomized into three groups, (1) a 30 mg/kg ACR-treated group, (2) a 50 mg/kg ACR-treated group, and (3) a normal saline (NS)-treated control group. Body weight and neurological changes were recorded each day. At the end of the test, cerebral cortex and cerebellum tissues were harvested and viewed using light and electron microscopy. Additionally, the expression of Synapsin Ⅰ and P-Synapsin Ⅰ in the cerebral cortex and cerebellum were investigated. Results The 50 mg/kg ACR-treated rats showed a significant reduction in body weight compared with untreated individuals (P < 0.05). Rats exposed to ACR showed a significant increase in gait scores compared with the NS control group (P < 0.05). Histological examination indicated neuronal structural damage in the 50 mg/kg ACR treatment group. The active zone distance (AZD) and the nearest neighbor distance (NND) of synaptic vesicles in the cerebral cortex and cerebellum were increased in both the 30 mg/kg and 50 mg/kg ACR treatment groups. The ratio of the distribution of synaptic vesicles in the readily releasable pool (RRP) was decreased. Furthermore, the expression levels of Synapsin Ⅰ and P-Synapsin Ⅰ in the cerebral cortex and cerebellum were decreased in both the 30 mg/kg and 50 mg/kg ACR treatment groups. Conclusion Subacute ACR exposure contributes to neuropathy in the rat CNS. Functional damage of synaptic proteins and vesicles may be a mechanism of ACR neurotoxicity.
Letters to the Editor
Description and Factors Affecting the Referral of Presumptive Tuberculosis Patients in China
LI Tao, ZHANG Hui, WANG Li Xia, PANG Yu, DU Xin
2017, 30(6): 444-449. doi: 10.3967/bes2017.058
To describe and analyze the factors affecting the referral of presumptive tuberculosis patients between health-care facilities that are not affiliated with the National TB Control Program (NTP) and NTP-designated medical facilities in China, we carried out a retrospective study based on data collected in the Tuberculosis Information Management System in 2015. Out of 324, 221 presumptive pulmonary tuberculosis (PTB) cases reported by non-NTP health-care facilities, 302, 006 (93.1%) reported cases successfully arrived at designated medical facilities and 22, 215 cases (6.9%) were lost to follow-up. The arrival rate of presumptive cases among male patients (92.9%) was slightly lower than that among female ones (93.7%), and this difference is statistically significant. The majority (73.3%) of reported cases were local permanent residents. Migrants have a higher risk of being lost to follow-up compared with local residents (adjusted odds ratios 4.126 and 5.003, respectively). Compared with farmers and herdsmen, pre-school children, unemployed laborers, retirees, and people with other occupations (adjusted odds ratios 2.361, 1.274, 1.068, and 1.993, respectively) had higher rates of loss to follow-up during the referral and tracing processes. In conclusion, this study demonstrates that the high referral rate of presumptive TB cases from non-NTP health-care facilities to designated medical facilities in China is due to implementation of effective active case identification strategies. In addition, migrant populations, pre-school children, unemployed laborers, and retirees were identified as high-risk groups that contribute to the loss to follow-up.
Regional Variations in Medication Usage for Cardiovascular Diseases at the Community Level in China (PURE-China Study)
YANG Jin Gang, GU Hong Qiu, BO Jian, WANG Yang, LI Wei
2017, 30(6): 450-454. doi: 10.3967/bes2017.059
We investigated the usage of secondary prevention drugs and traditional Chinese medicine (TCM) products in individuals with cardiovascular diseases (CVDs) at the community level in China. Among 2, 407 participants with self-reported coronary heart disease (CHD) and 872 with stroke, nearly 80% of individuals with CHD and 73% of individuals with stroke were not taking any proven secondary prevention drug. However, 32.9% of them took TCM products. Patients with CVDs in rural areas used less secondary prevention treatment, but more TCM products than their counterparts in the urban regions. After adjusting for confounding factors, lower rates of secondary prevention treatment were evident in Western China compared with Eastern China, which was more developed. Systematic change is needed to promote the development of evidence-based medicine at the community level in China.
Serum Fetuin-A Levels and Thyroid Function in Middle-aged and Elderly Chinese
DENG Xin Ru, DING Lin, WANG Tian Ge, XU Min, LU Jie Li, LI Mian, ZHAO Zhi Yun, CHEN Yu Hong, BI Yu Fang, XU Yi Ping, XU Yu
2017, 30(6): 455-459. doi: 10.3967/bes2017.060
Serum fetuin-A levels are reportedly elevated in hyperthyroidism. However, there are few relevant epidemiologic studies. We conducted a cross-sectional study in Songnan community, China in 2009 to investigate the association between serum fetuin-A concentrations and thyroid function. A total of 2, 984 participants aged 40 years and older were analyzed. Multivariable linear regression analysis revealed that serum fetuin-A concentra-tions were positively associated with log (free triiodothyronine) and were inversely associated with log (thyroid peroxidase antibody) after adjustment (both P < 0.05). Compared with the participants in the lowest tertile of free triiodo-thyronine and free thyroxine level, those in the highest tertile had higher fetuin-A concentrations. Additionally, high serum fetuin-A concentrations were related to high thyroid function (odds ratio 1.27, 95% confidence interval 1.01-1.61), after adjustment for conventional risk factors.
Molecular and Epidemiological Characterization of Infant Botulism in Beijing, China
DONG Yin Ping, WANG Wei, JIANG Tao, XU Jin, HAN Chun Hui, YAN Shao Fei, Séamus Fanning, LI Ying, MA Xiao Chen, ZHANG Di, ZHAO Yao, ZENG Biao, LI Feng Qin
2017, 30(6): 460-464. doi: 10.3967/bes2017.061
Laboratory-based pathogen isolation, identification, and toxicity determination were performed on samples from a suspected case of infant botulism. Mice injected with cultures generated from the enema sample and ingested Powered infant formula (PIF) presented typical signs of botulism. Antitoxins to polyvalent botulinum neurotoxins (BoNTs) and monovalent BoNT type B antitoxin had protective effects. Clostridium botulinum isolated from the enema and residual PIF samples were positive for type B toxin. Pulsed-field gel electrophoresis (PFGE) revealed that the two strains of C. botulinum isolated from the two samples produced indistinguishable pulsotypes. These findings confirmed this case of type B infant botulism associated with the ingestion of PIF contaminated by type B C. botulinum spores.
Policy Forum
Measurement and Assessment of Physical Activity by Information and Communication Technology
ZHANG Qun, YANG Xi, LIU Dan, ZHAO Wen Hua
2017, 30(6): 465-472. doi: 10.3967/bes2017.062
This study provides explorative insights into the information and communication technology (ICT) for promoting the physical activity level. ICT has provided innovative ideas and perspectives for PA measurement, assessment, evaluation and health intervention. ICT that aims to increase exercise for the entire population should be of a well-oriented and easy-to-use design with the options of tailored and personalized feedback, coaching, and ranking and supporting; it should be capable of setting goals and working with a schedule and be accompanied by a website to provide overviews of the users' exercise results and progress.