bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of erythromycin-resistant Streptococcus pneumoniae isolates causing invasive diseases in Chinese children
Authors: MA Xiang , YAO Kai-hu , XIE Gui-lin , ZHENG YUE-jie , WANG Chuan-qing , SHANG Yun-xiao , WANG Hui-yun , WAN Li-ya , LIU Lan , LI Chang-chong , JI Wei , XU Xi-wei , WANG Ya-ting , XU Pei-ru , YU Sang-jie , YANG Yong-hong
Published: January 2024

Background

Erythromycin-resistant Streptococcus pneumoniae isolates that causing invasive pneumococcal diseases (IPD) in Chinese children remain uncharacterized. This study aims to identify the resistance genes associated with erythromycin resistance and to determine the genetic relationships of IPD isolates in Chinese children.

Methods

A total of 171 S. pneumoniae strains were isolated from 11 medical centers in China from 2006 to 2008. All the isolates were characterized via serotyping and antibiotic susceptibility determination. The erythromycin-resistant isolates were further characterized via ermB and mefA gene detection, multi-locus sequence typing analysis, and pulsed-field gel electrophoresis.

Results

A total of 164 (95.9%) isolates showed resistance to erythromycin, of which 162 strains with high high-level resistance (MIC ≥ 256 μg/ml). A total of 104 (63.4%) isolates carry the ermB gene alone, whereas 59 (36.0%) harbor both ermB and mefA genes. Of the 59 strains, 54 were of serotypes 19A and 19F and were identified as highly clonal and related to the Taiwan19F-14 clone.

Conclusions

The erythromycin resistance rate in IPD isolates is significantly high and is predominantly mediated by the ermB gene. Isolates that carry both ermB and mefA genes are predominantly of serotypes 19A and 19F.
Endodontic bacteria from primary and persistent endodontic lesions in Chinese patients as identified by cloning and 16S ribosomal DNA gene sequencing
Authors: LI Xin , ZHU Xiao-fei , ZHANG Cheng-fei , Cathro Peter , CJ Seneviratne , SHEN Song
Published: January 2024

Background

Few literatures pertain to the 16S ribosomal DNA (16S rDNA) analysis of bacteria contributing to primary and persistent endodontic lesions, with no information available for the Chinese population. As such, we investigated endodontic bacteria associated with primary and persistent endodontic lesions in adult Chinese patients living in Beijing, China using 16S rDNA gene sequencing techniques.

Methods

Endodontic microbial samples were obtained from fourteen adult Chinese patients and subjected to DNA extraction. Pllymerase chain reaction (PCR) products were cloned and 100 clones from each generated library were randomly selected. Purified plasmid DNA with 16S rDNA gene inserts was sequenced, and the sequences were searched against GenBank databases using the BLASTN algorithm. Only significant identification with the highest-scored BLAST result and 99% minimum similarity was considered for phylotyping.

Results

More than 150 taxa were obtained. Primary endodontic infection was mainly associated with Burkholderia cepacia, Actinomyces, Aranicola spp. and Streptococcus sanguinis, whilst Burkholderia cepacia was predominant in the persistent endodontic infections.

Conclusion

There is a difference in the species profile associated with endodontic infections of Chinese patients living in Beijing in comparison to other geographical or ethnic reports.
The “time-window” effect of early allergen exposure on a rat asthma model
Authors: HU Yan , LIU Ping , LI Hai-chao , WANG Yue-dan
Published: January 2024

Background

The hygiene hypothesis has been proposed to explain the pathogenesis of asthma. Allergen exposure was shown to inhibit asthma in an animal model. But the optimal timing of allergen exposure remains unclear. This study aims to explore the time effcct of allergen exposure and the possible mechanisms.

Methods

Neonate Wistar rats were randomly divided into asthma group, control group and day 1, day 3, day 7, and day 14 groups. The day 1, day 3, day 7 and day 14 groups were injected with ovalbumin (OVA) subcutaneously on days 1, 3, 7 and 14 after birth, respectively. Six weeks later, all groups, except the control group, were sensitized and stimulated with OVA to make the asthma model. We observed the pulmonary pathologic changes, detected the regulatory T cells, and CD28 expression level in thymus and spleen by flow cytometry.

Results

The asthmatic inflammation in the day 1, day 3 and day 7 groups, but not the day 14 group, was alleviated. The asthma group and day 14 group had lower proportions of regulatory T cells in the thymus compared with the control group, day 1, day 3, and day 7 groups. There was no significant difference in the CD28 expression levels on the regulatory and conventional T cells among groups. But the control group and the day 1, day 3, and day 7 groups had relatively higher proportions of CD28 positive regulatory T cells in the thymus than the day 14 group and the asthma group.

Conclusions

There is a “time-window” for early allergen exposure. The impairment of regulatory T cells may promote the development of asthma. Allergen exposure in the “time-window” can make the thymus produce normal quantity of regulatory cells. The CD28 signal on regulatory T cells may participate in the production of regulatory T cells.
Genetic counseling, prenatal screening and diagnosis of Down syndrome in the second trimester in women of advanced maternal age: a prospective study
Authors: QI Qing-wei , JIANG Yu-lin , ZHOU Xi-ya , LIU Jun-tao , YIN Jie , BIAN Xu-ming
Published: January 2024

Background

The incidence of autosomal trisomy in livebirths is strongly dependent on maternal age. Special consideration is given to the provision of prenatal screening and cytogenetic testing to women of advanced maternal age (AMA). The aim of this study was to evaluate the effectiveness of second trimester prenatal screening and amniocentesis for Down syndrome (DS) and compare the trends of choice of screening and amniocentesis among AMA women.

Methods

A total of 5404 AMA patients with natural singleton pregnancy were recruited for this prospective study from January 2008 to December 2010. The gestational weeks were from 15 weeks to 20+6 weeks. The patients referred were grouped into a screening group (2107 cases) and an amniocentesis group (3297 cases) by their own decision. The prevalence of DS was compared between the two groups by chi-square test. Choice rates for each maternal age with trends were compared by regression analysis.

Results

There were 18 cases of fetal DS detected in the screening group with a prevalence of 8.54‰ (18/2107). Twenty-five cases of fetal DS were diagnosed in the amniocentesis group with a prevalence of 7.58‰ (25/3297). No statistical difference was observed in the prevalence of DS between the screening and amniocentesis group (P=0.928). The invasive testing rate for DS in the amniocentesis group was 5.54 times higher than that of the screening group (1/131.88 vs. 1/23.78). With the increase of the maternal age, the choice of amniocentesis increased while the choice of the screening showed an opposite trend. The choice of the AMA women between the screening and amniocentesis was significantly age relevant (P=0.012).

Conclusions

The second trimester serum screening in combination with maternal age was more effective than maternal age alone to screen for DS. We suggest educating the patients by recommending AMA women be informed of both screening and amniocentesis options.
Splenectomy protects experimental rats from cerebral damage after stroke due to anti-inflammatory effects
Authors: ZHANG Bing-jun , MEN Xue-jiao , LU Zheng-qi , LI Hai-yan , QIU Wei , HU Xue-qiang
Published: January 2024

Background

A recent study demonstrated that the inflammatory response accompanying necrotic brain injury played an important role in stroke. Thus, inhibition of this response may help to stop the expansion of infarcts. It has been also shown that the spleen, a major peripheral immune organ, plays a role in stroke-induced immune responses. This study aimed to establish rat models of middle cerebral artery occlusion (MCAO) and to investigate the effect of splenectomy and possible mechanisms in that rat models.

Methods

Infarct size in a stroke model was measured with the Nissl body staining method, numbers of inflammatory cells in ischemic regions were detected by immunofluorescence staining, and inflammatory factors were assayed by enzyme-linked immunosorbent assay and real-time polymerase chain reaction (PCR) in brain homogenates and sera. The significance of differences was determined by one-way analysis of variance (ANOVA) followed by the least significant difference post hoc test.

Results

Infarct size in the brain of rats that underwent splenectomies 2 weeks before permanent MCAO ((34.93±3.23)%) was over 50% smaller than that of rats subjected to the stroke surgery alone ((74.33±2.36)%, P <0.001; (77.30±2.62)%, P <0.001). Lower numbers of T cells, neutrophils, and macrophages in brain tissue and lower levels of pro-inflammatory cytokines, such as interleukin (IL)-1β and tumor necrosis factor (TNF)-α, were observed in rats that underwent splenectomies, compared with the two other groups, but splenectomized rats showed higher levels of the anti-inflammatory factor IL-10 in the brain.

Conclusion

The mechanism(s) by which splenectomy protects brain from damage induced by stroke may correlate with the decreased numbers of inflammatory cells and changes in inflammatory cytokines.
Efficacy of glycyrrhizin combined with cyclosporine in the treatment of non-severe aplastic anemia
Authors: REN Cui-ai , LI Yan-xiang , CUI Jing-ying , SHENG Zhi-xin , RAN Xue-hong , WANG Bao-hong , ZHANG Mao-hong
Published: January 2024

Background

Cyclosporine A (CsA) has been widely used in the treatment of aplastic anemia (AA), but the application of CsA was limited in patients who had liver diseases or abnormal liver function due to its liver toxicity. Glycyrrhizin has long been used in China in the treatment of various liver diseases to lower transaminases. In this study, we observed the efficacy and safety of glycyrrhizic acid combined with CsA in the treatment of newly diagnosed patients with non-severe AA (NSAA).

Methods

A total number of 76 patients with newly diagnosed NSAA were enrolled into the study at our hospital between July 2005 and June 2010. The patients were divided randomly into two groups: the glycyrrhizin-treatment group (group A) and the control group (group B) with 38 patients in each group. All patients received 3-5 mg·kg-1·d-1 CsA for at least 4 months and were treated either with or without glycyrrhizin for 4 months.

Results

sixty-eight patients were eligible for evaluation. In the control group, 9.09% patients (n=3) achieved a complete response while 51.52% (n=17) attained a partial response. The overall response rate was 60.61% (n=20). The remaining 13 patients (39.39%) did not have any response. In the glycyrrhizin-treatment group, complete response rate was 20% (n=7) and partial response rate was 62.86% (n=22). The overall response rate was 82.86% (n=29) and the non-response rate was 17.14% (n=6). Response rate was significantly increased with the addition of glycyrrhizin to CsA compared with CsA alone (P<0.05).

Conclusion

The combination of glycyrrhizin and cyclosporine regimen was an effective treatment for NSAA in terms of improvement of response rate, reduction in CsA-related liver injury, and attenuation of severity of nausea and other adverse events in the treatment of patients with NSAA.
Effects of competitive and noncompetitive 5f-reductase inhibitors on serum and intra-prostatic androgens in beagle dogs
Authors: ZHAO Xiao-feng , YANG Yong , WANG Wei , QIU Zhi , ZHANG Peng , WANG Biao
Published: January 2024

Background

5α-Reductase inhibitors (5α-RI) act by inhibiting the conversion of testosterone to dihydrotestosterone (DHT), thereby preventing DHT induced benign prostatic hyperplasia. The existing 5α-RIs can be classified into two types: competitive and noncompetitive. Currently, limited evidence is available concerning the effect differences between the two types of 5α-RI on androgens. The purpose of this study was to assess the effects of competitive and noncompetitive 5α-RIs on serum and intra-prostatic androgens in beagle dogs.

Methods

Twenty beagles with spontaneous benign prostatic hyperplasia were randomly allocated into two groups: epristeride group (n=10) in which beagles were treated with epristeride at 1 mg/kg once a day for 3 months, and finasteride group (n=10) in which beagles were treated with finasteride at 1 mg/kg once a day for 3 months. The levels of intra-prostatic testosterone and DHT were measured before treatment and on day one after three months medication. Serum levels of testosterone and DHT were measured at the same time points. Changes in androgen levels before and after treatment were analyzed, and comparisons were made within each treatment group and between treatment groups.

Results

After 3-month treatment, serum and intra-prostatic DHT levels all decreased significantly in both the epristeride and finasteride groups. The change of DHT in serum was significantly higher in the finasteride group (-14% and -43% in epristeride and finasteride groups respectively, with P<0.001); however there was no significant difference in the changes of intra-prostatic DHT between the two groups (-47% and -51% in epristeride and finasteride groups, respectively, P=0.304). The decreases in DHT levels were accompanied by reciprocal increases in serum and intra-prostatic testosterone levels. Changes of testosterone were significantly higher in finasteride group both in serum (20% and 42% in epristeride and finasteride groups, respectively, P<0.001) and in prostate tissue (18% and 29% in epristeride and finasteride groups, respectively, P=0.004).

Conclusions

Two types of 5T-RI have similar effects in reducing DHT in prostate tissue in beagles. Competitive 5α-RI may reduce serum DHT to a greater scale, and significantly increase testosterone in beagle serum and prostate.
Brain natriuretic peptide and copeptin levels are associated with cardiovascular disease in patients with chronic kidney disease
Authors: LI Xin , YANG Xin-chun , SUN Qian-mei , CHEN Xiang-dong , LI Yan-chun
Published: January 2024

Background

Cardiovascular disease (CVD) is the leading cause of death in patients with end-stage renal disease (ESRD). We explored the relationship between CVD, plasma brain natriuretic peptide (BNP) and copeptin in non-dialysis patients with chronic kidney disease (CKD).

Methods

BNP and copeptin were measured using ELISA in 86 non-dialysis patients with different degrees of CKD and in 20 control patients. The effects of BNP, copeptin levels and other biochemical indices on carotid ultrasound echocardiography and CVD history were determined using correlation analysis.

Results

BNP and copeptin levels were significantly higher in the CKD group than in the control group. Both indices increased progressively, in parallel with the decline in glomerular filtration rate (GFR). BNP levels were (184.25±65.18) ng/L in early phase CKD, (975.245±354.09) ng/L in middle phase CKD, and (1463.51±614.92) ng/ml in end phase CKD compared with levels of (101.56±42.76) ng/L in the control group (all P <0.01). Copeptin levels in the middle phase ((20.36±9.47) pmol/L) and end phase groups ((54.26±18.23) pmol/L were significantly higher than in the control group ((9.21±2.64) pmol/L; both P <0.01). There was no difference in copeptin levels between early phase CKD ((10.09±5.23) pmol/L) and control patients. Stepwise multiple regression analysis identified GFR, intima-media thickness (IMT), left ventricular hypertrophy (LVH), and previous history of CVD as independent risk factors for elevated BNP and copeptin levels.

Conclusion

BNP and copeptin appear to provide sensitive biological markers for the evaluation of atherosclerosis in non-dialysis patients with CKD.
HIV infection among new synthetic drug abusers: a pilot study in Beijing
Authors: LI Ping , CHEN Xiao , XIE Pei-yan , CHU Ping , LI Dong-liang , LI Qian-qian , SHAO Yi-ming , JIA Zhong-wei
Published: January 2024

Background

Following the increased human immunodeficiency virus (HIV) notification (infection) rates via sexual transmission and increased abuse of new synthetic drugs instead of heroin in China, a study on HIV infections and risk factors among synthetic drugs and heroin users in Beijing was conducted to provide a cue for further development of targets and strategies of HIV/AIDS control and prevention for different drug populations.

Methods

A total of 428 subjects including 224 heroin users and 204 new synthetic drug users was recruited from communities in Beijing by convenience sampling. A χ2 test was used to compare HIV and syphilis infections between the two subpopulations. Logistic regression models were used to evaluate factors related to HIV, syphilis infections and abuse of synthetic drugs.

Results

Unbalanced distributions of demographics were detected between the two subpopulations. Compared with heroin users, most users of synthetic drugs were migrants, single and of younger age (age ≤30 years). Ten HIV infections and twenty-four syphilis infections were confirmed among 428 subjects. No significant difference in HIV infection was found between the two subpopulations (crude odds ratio (OR) =0.46, 95% confidence interval (CI): 0.07-15.80 and adjusted odds ratio (AOR) =1.26, 95% CI: 0.09-18.28) while four times as many syphilis infections were identified among users of synthetics drugs (AOR=3.92, 95% CI: 1.06-14.56). HIV and syphilis infections appeared to work synergistically. The migrants who were of Han ethnicity, single and who had stayed in Beijing for more than six months were more likely to abuse synthetics drugs.

Conclusions

The new synthetic drug users and heroin users are different subpopulations. We optimistically speculate that HIV has not yet been introduced into the former in Beijing, but considering higher syphilis infections in synthetic drug users and the role of syphilis in HIV infection, synthetic drug users, as a possible and important driver of the HIV/AIDS epidemic in Beijing, should be paid more attention in HIV prevention and control strategies.
Exposure to heat-inactivated Trichophyton rubrum resulting in a limited immune response of human keratinocytes
Authors: HUANG Xiao-qiang , YI Jin-ling , YIN Song-chao , CHEN Rong-zhang , LI Mei-rong , GONG Zi-jian , LAI Wei , CHEN Jian
Published: January 2024

Background

Trichophyton rubrum (T. rubrum) represents the most important agent of dermatophytosis in humans. T. rubrum infection causes slight inflammation, and tends to be chronic and recurrent. It is suggested that it may result from the failure of epithelial cells to recognize T. rubrum effectively and initiate effective immune responses. The C-type lectin receptors (CLR) and toll-like receptors (TLR) are the two major pattern recognition receptors (PRRs) that recognize fungal components. Therefore, the purpose of the study was to analyze the expression of those PRRs and the cytokines in HaCaT cells stimulated with heat-inactivated T. rubrum conidia and hyphae, respectively.

Methods

HaCaT cells were unstimulated or stimulated with heat-inactivated T. rubrum conidia and hyphae (1×106 and 1.5×105 colony-forming unit (CFU) in 2 ml medium, respectively) for 6, 12 and 24 hours. The mRNA expression of PRRs involved in recognizing fungal pathogen-associated molecular patterns (PAMPs) and signaling molecules were measured by quantitative reverse transcription polymerase chain reaction (RT-PCR). Meanwhile, surface toll-like receptor (TLR) 2, TLR4 and Dectin-1 were analyzed by fluorescence-activated cell sorter (FACS) 24 hours after treatment. The cytokines were detected in cell culture supernatants of HaCaT cells in 12 and 24 hours after treatment.

Results

HaCaT cells constitutively expressed mRNA of membrane-bound TLR1, 2, 4 and 6, Dectin1 and DC-SIGN, but not Dectin-2 or Mincle. Heat-killed T. rubrum did not significantly upregulate gene transcriptions of the PRRs of HaCaT cells. Heat-inactivated T. rubrum conidia significantly reduced the surface expression of TLR2 and Dectin-1, and suppressed the secretions of interferon-inducible protein-10 (IP-10) and monocyte chemotactic protein-1 (MCP-1) of HaCaT cells, while heat-killed T. rubrum hyphae significantly induced the secretions of IP-10 and MCP-1.

Conclusion

The cell-wall antigens of T. rubrum fail to activate transcriptional expression of PRRs and induce a lower immune response of HaCaT cells by limited cytokines secretion.
JNK phosphorylation promotes degeneration of cervical endplate chondrocytes through down-regulation of the expression of ANK in humans
Authors: XU Hong-guang , SONG Jun-xing , CHENG Jia-feng , ZHANG Ping-Zhi , WANG Hong , LIU Ping , LÜ Kun , ZHONG Min
Published: January 2024

Background

C-Jun N-terminal kinase (JNK) signaling pathway and ankylosis gene (ANK) play a critical role in endplate chondrocytes degeneration. The purpose of this study was to investigate whether the expression levels of ANK was associated with the activation of JNK.

Methods

Cartilage endplates of 49 patients were divided into the control group (n=19) and the experimental group (n=30). The patients in the control group were graded 0 and those in the experimental group were graded I-III according to Miller’s classification. Endplate chondrocytes were isolated by enzyme digestion and cultured in vitro. The inverted phase contrast microscope, teluidine blue staining, HE staining, real time RT-PCR, and MTT were used to observe morphological appearances, biological characteristics, and growth curve of endplate chondrocytes from the cartilage endplate of the two groups. Real time RT-PCR and Western blotting were used to analyze the mRNA and protein expression levels of associated factors in the degeneration process in the cultured endplate chondrocytes with or without subjected SP600125.

Results

The expression levels of type II collagen, aggrecan, and ANK in endplate chondrocytes of experimental group were lower than that of control group and phosphorylation level of JNK in the experimental group which was higher than that in the control group. Application of JNK phosphorylation inhibitor to degeneration chondrocytes resulted in a marked decrease in the phosphorylation level of JNK and a significant increase in the expression levels of type II collagen, aggrecan, and ANK.

Conclusion

The degeneration of the human cervical endplate chondrocytes might be promoted by JNK phosphorylation by down-regulating the expression of ANK
A distinct pattern of memory and attention deficiency in patients with depression
Authors: Luo Lan-lan , Chen Xin , Chai Yan , Li Jin-hong , Zhang Mian , Zhang Jian-ning
Published: January 2024

Background

Depression related cognitive deficits are frequently considered as simple epiphenomena of the disorder. However, whether or not the depression might directly bring about cognitive deficits is still under investigation. This study was to investigate the distinctpattern of cognitive deficits in patients with depression by comparing the cognitive function before and after anti-depressive drug therapy.

Methods

Sixty cases of patients, first-time diagnosed with depression, were assessed by 17-item Hamilton Rating Scale for Depression (HAMD17scale). The memory ability was tested by quantitatively clinical memory scale, while the attention ability by modified Ruff 2&7 Selective Attention Test. Forty-two healthy volunteers were recruited as controls. The depressive patients were treated with Venlafaxine (75-300 mg/d), Fluoxetine (20-40 mg/d), Paroxetine (20-40 mg/d), and Sertraline (50-150 mg/d). After 12 weeks treatment, patients were tested again by HAMD17scale, quantitatively clinical memory scale, and modified Ruff 2&7 selective attention test to assess the effect of anti-depressive drugs on cognitive deficits.

Results

The memory quotient (MQ) was significantly lowered in depressive patients. The selection speed was also significantly decreased and the number of missing and error hits increased in the depression group as compared to control. However, there was no significant difference in clinical memory scale and Ruff 2&7 selective attention test between mild-to-moderate and severe depression group. Importantly, after anti-depressive drug therapy, the HAMD17 scale scores in depressive patients were significantly decreased, but the MQ, directional memory (DM), free recall (FR), associative learning (AL), and face recognition were comparable with those before the treatment. Furthermore, the selection speed and the number of missing and error hits were also not significantly different after anti-depressive drugs treatment.

Conclusions

Depressive patients suffer from short-term memory deficits, and attention extent, stability and rearrangement deficiency. Even though anti-depressive drugs sufficiently relieve the cardinal presentation of depression, they could not successfully alleviate the accompanying cognitive deficits. This might indicate a distinct pattern of cognitive deficits in patients with depression.
Thrombosis and morphology of plaque rupture using optical coherence tomography
Authors: Guo Jun , Chen Yun-dai , Tian Feng , Liu Hong-bin , Chen Lian , Sun Zhi-jun , Ren Yi-hong , Jin Qin-hua , Liu Chang-fu , Han Bao-shi , Gai Lu-yue , Yang Ting-shu
Published: January 2024

Background

Thrombosis following plaque rupture is the main cause of acute coronary syndrome, but not all plaque ruptures lead to thrombosis. There are limited in vivo data on the relationship between the morphology of ruptured plaque and thrombosis.

Methods

We used optical coherence tomography (OCT) to investigate the morphology of plaque rupture and its relation to coronary artery thrombosis in patients with coronary heart disease. Forty-two patients with coronary artery plaque rupture detected by OCT were divided into two groups (with or without thrombus) and the morphological characteristics of ruptured plaque, including fibrous cap thickness and broken cap site, were recorded.

Results

The fibrous cap of ruptured plaque with thrombus was significantly thinner compared to caps without thrombus ((57.00±17.00)μm vs. (96.00±48.00)μm; P=0.0076).

Conclusions

Plaque rupture associated with thrombosis occurs primarily in plaque covered by a thin fibrous cap. Thick fibrous caps are associated with greater stability of ruptured plaque.
Polyinosine-polycytidylic acid promotes excessive iodine intake induced thyroiditis in non-obese diabetic mice via Toll-like receptor 3 mediated inflammation
Authors: SHI Ya-nan , LIU Feng-hua , YU Xiu-jie , LIU Ze-bing , LI Qing-xin , YUAN Ji-hong , ZANG Xiao-yi , LI Lan-ying
Published: January 2024

Background

Excessive iodine intake and viral infection are recognized as both critical factors associated with autoimmune thyroid diseases. Toll-like receptors (TLRs) have been reported to play an important role in autoimmune and inflammatory disorders. In this study, we aimed to clarify the possible mechanism of TLR3 involved in polyinosine- polycytidylic acid (poly(I:C)) promoting excessive iodine intake induced thyroiditis in non-obese diabetic (NOD) mice.

Methods

Both NOD and BALB/c mice were randomly assigned to four groups: control group (n=5), high iodine intake (HI) group (n=7), poly(I:C) group (n=7) and combination of excessive iodine and poly(I:C) injection (HIP) group (n=7). After 8 weeks, mice were weighed and blood samples were collected. All the mice were sacrificed before dissection of spleen and thyroid gland. Then, thyroid histology, thyroid secreted hormone, expression of CD3+ cells and TLR3 as well as inflammatory mRNA level were evaluated.

Results

Both NOD and BALB/c mice from HI and HIP group represented goiter and increasing thyroid relative weight. Thyroid histology evidence indicated that only HIP group of NOD mice showed severe thyroiditis with lymphocytes infiltration in majority of thyroid tissue, severe damage of follicles and general fibrosis. Immunofluorescence staining results displayed a large number of CD3+ cells in HIP NOD mice. Real-time polymerase chain reaction (PCR) results suggested interferon (IFN)-α increased over 30 folds and IFN-γ expression was doubled compared with control group, but interleukin (IL)-4 remained unchanged in HIP group of NOD mice thyroid. Meanwhile, over one third decrease of blood total thyroxine (TT4) and increased thyroid-stimulating hormone (TSH) was observed in HIP group of NOD mice. Only HIP group of NOD mice represented significantly elevation of TLR3 expression.

Conclusion

Poly(I:C) enhanced excessive dietary iodine induced thyroiditis in NOD mice through increasing TLR3 mediated inflammation.
Implementing surviving sepsis campaign bundles in China: a prospective cohort study
Authors: Li Zhi-qiang , Xi Xiu-ming , Luo Xin , Li Jie , Jiang Li
Published: January 2024

Background

Surviving sepsis campaign (SSC) bundles have been demonstrated to significantly improve survival in sepsis and septic shock patients worldwide. Compliance with these protocols and resultant mortality in sepsis patients was investigated in intensive care units (ICUs) in China.

Methods

Adult patients with severe sepsis or septic shock treated from September 2007 to October 2008 in 11 ICUs of Chinese teaching hospitals were included. The primary outcome was compliance with resuscitation and management bundles. Secondary outcomes included individual bundle protocol impact and the effects of the completed bundle protocol number on 28-day mortality.

Results

Overall compliance during 6-hr resuscitation and 24-hour management bundles were 5.5% and 17.4%, respectively, and 28-day mortality was 33.0%. Compliance with protocols for blood cultures before antibiotics (42.2%), central venous pressure ≥8 mmHg (65.9%), central venous oxygen saturation ≥70% (25.0%), and optimized glucose control (82.1%), were significantly associated with decreased 28-day mortality (P <0.05). When adjusted for age, acute organ dysfunction, and APACHE II score, compliance with the blood culture before antibiotics protocol produced the most significant decrease in 28-day mortality (OR, 0.33; 95% CI, 0.16-0.70; P=0.004). Compliance with ≥5 protocols in the 6-hour resuscitation bundle was also associated with lower 28-day mortality in septic shock patients (OR, 0.17; 95% CI, 0.06-0.54; P = 0.001).

Conclusions

Compliance with resuscitation and management bundles is generally poor in China; however, when applied, 6-hour resuscitation bundle are associated with significant reductions in 28-day mortality for sepsis patients.
Anterior cruciate ligament remnants nodule: potential factor causing extension loss
Authors: Wang Jian , Ao Ying-fang
Published: January 2024

Background

Extension loss caused by anterior cruciate ligament (ACL) remnants nodule was usually reported by case reports. There is no systematic report analyzing ACL remnants nodule. The purpose of this study was to investigate the characteristics of extension loss caused by remnants of ACL after injury.

Methods

From June 2008 to December 2011, ACL remnants were observed by arthroscopy in 1012 cases with ACL injuries at the time of primary reconstruction. ACL remnants nodules were recorded. The time of extension loss occurrence caused by ACL remnants nodule, associated symptom and sign, magnetic resonance imaging (MRI), and arthroscopic findings were observed. Histological examination was performed on the lesion resected.

Results

Twenty-four cases with ACL remnants nodules were found by arthroscopy. Among them extension loss caused by remnants of ACL happened in 19 cases (male 13; female 6). The average extension loss were 9.1 (range, 5 202). The average time from injury to operation was 8.9 weeks (range, 3)26 weeks). The remnants of ACL depressed in the inter-condylar notch were found on MRI in 15 cases with extension loss. The rupture locations of ACL were all close to the upper insertion of ACL. The microscopic examination of the resected remnants of ACL revealed disorganized fibrous connective tissue and tissue of ACL ligament.

Conclusions

Among 1012 ACL injury cases, 24 ACL remnants nodules were found with arthroscopy and 19 nodules could cause knee extension loss. ACL remnants nodule should be paid attention to as a potential cause of extension loss.
Comparative outcomes between cord blood transplantation and bone marrow or peripheral blood stem cell transplantation from unrelated donors in patients with hematologic malignancies: a single-institute analysis
Authors: CHEN Yu-hong , XU Lan-ping , LIU Dai-hong , CHEN Huan , ZHANG Xiao-hui , HAN Wei , WANG Feng-rong , WANG Jin-zhi , WANG Yu , HUANG Xiao-jun , LIU Kai-yan
Published: January 2024

Background

Umbilical cord blood (UCB) has grown substantially as an alternative source of hematopoietic stem cells for unrelated donor transplantation in both adult and pediatric patients. Our aim was to assess the leukemia-free survival (LFS) and some primary results, such as hematologic recovery, risk of graft-versus-host disease (GVHD), relapse, and long-term survival, after unrelated cord blood transplantation compared with the outcomes of transplantations from other unrelated graft source.

Methods

The clinical outcomes of 112 consecutive patients with acute leukemia who received umbilical cord blood (UCBT) as a primary unrelated stem cell source (n=38), bone marrow (UBMT n=28, transplanted before January 2003), or peripheral blood stem cells (UPBSCT n=46, transplanted after January 2003) between July 2000 and July 2008 were analyzed.

Results

Except that the patients were much younger in the UCBT group (median age, 10.5 years in UCBT, 30 years in UPBSCT, and 20 years in UBMT), other pre-transplant parameters, such as gender, diagnosis, and the phase of disease, were comparable. All patients received myeloablative regimens, primarily including BUCY; however, there was less anti-thymocyte globulin (ATG) used for the UBMT patients (2/38 in UCBT, 0/46 in UPBSCT, and 8/28 in UBMT did not use ATG, P=0.000). Significant delays in engraftment occurred after UCBT for both neutrophil cells and platelets. The cumulative allo-engraftment rates were also significantly lower (87.8% vs. 97.8% vs. 100% for WBC, P=0.000; 73.0% vs. 97.5% vs. 89.5% for PLT, P=0.000) for UCBT. The incidence of Grade 2-4 and 3-4 acute graft versus host disease (aGVHD) was much higher in the UBMT group but did not differ among the other groups (51% and 13.2%, 40.2% and 10.5%, and 77.4% and 41.2%, respectively, for UCBT, UPBSCT, and UBMT, P=0.000). The occurrence of extensive chronic GVHD (cGVHD) was significantly decreased for recipients of UCBT (4%) compared with that of UPBSCT (39.1%) and UBMT (49.1%, P=0.000), although the rates of whole cGVHD were not significantly different (30.3%, 63.1%, and 60.1% for UCBT, UPBSCT, and UBMT, respectively). The patients had a similar rate of CMV infection (21/38, 28/46, and 22/28 for UCBT, UPBSCT, and UBMT, respectively), while the HC occurrence was lower after UCBT (7/38, 16/46, and 14/28 for UCBT, UPBSCT, and UBMT, respectively). As of August 2012, there was no apparent difference in 5-year overall survival (OS), LFS, or the relapse rate for each graft source (52.5%, 52.6%, and 20.8% in UCBT; 48.7%, 46.4%, and 27.9% in UPBSCT; and 46.4%, 42.9%, and 16.0% in UBMT).

Conclusion

These data support the use of UCB donors as an alternative allogeneic donor.
Impact of uncontrolled blood pressure on diagnostic accuracy of coronary flow reserve for detecting significant coronary stenosis in hypertensive patients
Authors: LI Wei-hong , XU Wei-xian , LI Zhao-ping , LI Cui-ping , WANG Xin-yu , HE Li-yun , ZHAO Wei , FENG Xin-heng , GAO Wei
Published: January 2024

Background

Impaired coronary flow reserve (CFR) in patients with hypertension may be caused by epicardial coronary stenosis or microvascular dysfunction. Antihypertensive treatment has been shown to improve coronary microvascular dysfunction. The aim of this study was to evaluate the impact of uncontrolled blood pressure (BP) on diagnostic accuracy of CFR for detecting significant coronary stenosis.

Methods

A total of 98 hypertensive patients scheduled for coronary angiography (CAG) due to chest pain were studied. Of them, 45 patients had uncontrolled BP (defined as the office BP ≥140/90 mmHg (1 mmHg=0.133 kPa) in general hypertensive patients, or ≥130/80 mmHg in hypertensive individuals with diabetes mellitus), and the remaining 53 patients had well-controlled BP. CFR was measured in the left anterior descending coronary artery (LAD) during adenosine triphosphate-induced hyperemia by non-invasive transthoracic Doppler echocardiography (TTDE) within 48 hours prior to CAG. Significant LAD stenosis was defined as >70% luminal narrowing. Diagnostic accuracy of CFR for detecting significant coronary stenosis was analyzed with a receiver operating characteristic analysis.

Results

CFR was significantly lower in patients with uncontrolled BP than in those with well-controlled BP (2.1±0.6 vs. 2.6±0.9, P <0.01). Multivariate linear regression analysis of the study showed that the value of CFR was independently associated with the angiographically determined degree of LAD stenosis (β= -0.445, P <0.0001) and the presence of uncontrolled BP (β= -0.272, P=0.014). With a receiver operating characteristic analysis, CFR <2.2 was the optimal cut-off value for detecting LAD stenosis in all hypertensive patients (AUC 0.83, 95%CI 0.75-0.91) with a sensitivity of 75%, a specificity of 78%, and an accuracy of 77%. A significant reduction of diagnostic specificity was observed in patients with uncontrolled BP compared with those with well-controlled BP (67% vs. 93%, P=0.031).

Conclusions

CFR measurement by TTDE is valuable in the diagnosis of significant coronary stenosis in hypertensive patients. However, the diagnostic specificity is reduced in patients with uncontrolled BP.
Development in mechanisms of ischemic mitral regurgitation
Authors: HUANG Wei-lin , FU Qiang
Published: January 2024

Objective

The clinical diagnosis and treatment of ischemia mitral regurgitation (IMR) remained difficult because of its unclear mechanisms. This paper reviews studies on the mechanisms of IMR during the last 20 years, and discusses the relevance of the various mechanisms.

Data sources

Data used in this review were mainly from CNKI and Pubmed in English. The search terms were “ischemia mitral regurgitation mechanism”, “myocardial infarction” AND “mitral regurgitation”.

Study selection

Articles were selected if they involved mechanisms of IMR.

Results

IMR is one of the common complications of coronary artery disease. But currently, the clinical diagnosis and treatment of IMR remained difficult because of its unclear mechanisms.

Conclusions

For now, dominating theory of ischemic mitral regurgitation mechanisms are left ventricular remodeling, imbalance of leaflet tethering and the closing force, left ventricular dysfunction, changes in spatial structure of the annulus and the dyssynchrony of the left ventricular electromechanical activity.
Efficacy of regional renal nerve blockade in patients with chronic refractory heart failure
Authors: Dai Qi-ming , Fen Yi , Lu Jing , Ma Gen-shan
Published: January 2024

Background Increased renal sympathetic nerve activity can result in diuretic resistance in patients with chronic congestive heart failure. We investigated the effect of regional renal nerve blockade on the patients with chronic refractory heart failure and diuretic resistance.

Methods Eighteen patients with chronic refractory heart failure were enrolled (mean age (64±11) years). The patients were randomly divided into two groups (renal nerve blockade group and standard therapy group, n=9 each). Renal nerve blockade was performed by percutaneous injection of local anaesthetic under computed tomographic guidance. Heart rate, mean arterial blood pressure, plasma and urine electrolytes, neurohormones, factional excretion of sodium (FENa), 24-hour urine volume were monitored at baseline and the first 24 hours after therapy. Dyspnea and oedema were also evaluated. The major adverse cardiovascular events (MACE), plasma brain natriuretic peptide (BNP) level and left ventricular ejection fraction (LVEF) were compared between the two groups during the 3-12 months follow-up period.

Results No complication was observed during the acute phase of renal nerve blockade. After renal nerve blockade, the 24-hour urine volume and FENa were significantly increased, while the level of plasma rennin, angiotensin II, aldosterone, BNP and atrial natriuretic peptide as well as dyspnea and oedema were significantly reduced in renal nerve blockade group compared with baseline and standard therapy group. During three to 12 months of follow-up, the rate of MACE and plasma BNP level were significantly lower, while LVEF was significantly higher in renal nerve blockade group than those in standard therapy group.

Conclusion Regional renal nerve blockade may be a safe and effective treatment for patients with chronic refractory heart failure.
Accelerated healing of diabetic wound using artificial dermis constructed with adipose stem cells and poly(L-glutamic acid)/chitosan scaffold
Authors: SHEN Ting , PAN Zhi-gang , ZHOU Xiao , HONG Chao-yang
Published: January 2024

Background

Diabetic wound is one of the most serious complications of diabetes mellitus. There are no significantly effective therapies for chronic non-healing diabetes ulcer so far. This study aimed to explore the feasibility of healing impaired wound using artificial dermis constructed with human adipose derived stem cells (ASCs) and poly(L-glutamic acid)/chitosan (PLGA/CS) scaffold in streptozotocin-induced diabetic mice.

Methods

ASCs were isolated from fresh human lipoaspirates and expanded ex vivo for three passages, and then cells were seeded onto PLGA/CS scaffold to form artificial dermis. Expression of VEGF and TGFβ1 by ASCs presented in artificial dermis was determined. The artificial dermis was transplanted to treat the 20 mm × 20 mm full-thickness cutaneous wound created on the back of diabetic mice. Wound treated with scaffold alone and without treatment, and wound in normal non-diabetic mice served as control.

Results

Cells growing within scaffold showed great proliferation potential, depositing abundant collagen matrix. Meanwhile, expression of VEGF and TGF-β1 by seeded ASCs maintained at a consistent high level. After treated with ASC based artificial dermis, diabetic wounds exhibited significantly higher healing rate compared with wounds treated with scaffold alone or without treatment. Histological examination also demonstrated an improvement in cutaneous restoration with matrix deposition and organization. Further quantitative analysis showed that there was a significant increase in dermis thickness and collagen content on artificial dermis treated wounds.

Conclusion

ASC/PLGA artificial dermis can effectively accelerate diabetic wound healing by promoting angiogenic growth factors and dermal collagen synthesis.
Redox factor-1 may mediate the repair of multiple organ injuries after liver transplantation
Authors: SUN Zhi-peng , HU Yu-bing , Aminbuhe  , GONG Ke , ZHU Bin , FAN Qing , LIAN Dong-bo , ZHANG Neng-wei
Published: January 2024

Background

Apurinic apyrimidinic endonuclease/redox effector factor 1 (APE1/Ref-1) is an important enzyme in the repair of reactive oxygen species-induced DNA damage, and its expression/activation can be induced by reactive oxygen species. The aim of this research was to investigate the relationship between multiple-organ injuries and expression of Ref-1 in the early period after liver transplantation.

Methods

One hundred and fifty adult male Wistar rats were divided randomly into three groups: liver transplantation, sham surgery, and untreated control. After liver transplantation, animals were sacrificed at different time points. Hepatic and renal functions were analyzed by serology. Histology, apoptotic levels, and Ref-1 expression were examined by immunohistochemistry in the liver, kidneys, intestines, and lungs.

Results

Serum levels of alanine aminotransferase and aspartate aminotransferase peaked 6 hours after liver transplantation and decreased appreciably after 12 hours in the transplantation group, suggesting that the degree of liver injury in the early period after transplantation peaked at 6 hours and then decreased. Pathological analyses showed that hepatic tissues were more severely injured in the transplantation group than in the sham and untreated groups. A considerable number of infiltrating inflammatory cells was observed around the portal vein in the transplantation group. Injuries to the kidneys, intestines, and lungs were milder after liver transplantation. Apoptotic levels increased after liver transplantation in all four organs examined. Ref-1 expression was higher in the transplantation group in the early period after liver transplantation than in the sham surgery and untreated control groups.

Conclusion

Ref-1 expression induced by ischemia-reperfusion injury may have a critical role in repairing multiple-organ injuries after liver transplantation.
Cytogenetic and molecular aberrations of multiple myeloma patients: a single-center study in Singapore
Authors: Lim Alvin Soon Tiong , Lim Tse Hui , See Karen Hsu Shien , Ng Yit Jun , Tan Yu Min , Choo Natasha Swee Lian , Lim Sherry Xin Er , Yee Yenny , Lau Lai Ching , Tien Sim Leng , Sathish Kumar , Tan Daryl Chen Lung
Published: January 2024

Background

Much is known about the cytogenetic lesions that characterize multiple myeloma (MM) patients from the USA, Europe, and East Asia. However, little has been published about the disease among Southeast Asians. The aim of this study was to determine the chromosomal abnormalities of MM patients in our Singapore population.

Methods

Forty-five newly-diagnosed, morphologically confirmed patients comprising 18 males and 27 females, aged 46-84 years (median 65 years) were investigated by karyotyping and fluorescence in situ hybridization (FISH). FISH employing standard panel probes and 1p36/1q21 and 6q21/15q22 probes was performed on diagnostic bone marrow samples.

Results

Thirty-four cases (75.6%) had karyotypic abnormalities. Including FISH, a total detection rate of 91.1% was attained. Numerical and complex structural aberrations were common to both hyperdiploid and non-hyperdiploid patients. Numerical gains of several recurring chromosomes were frequent among hyperdiploid patients while structural rearrangements of several chromosomes including 8q24.1 and 14q32 characterized non-hyperdiploid patients. With FISH, immunoglobulin heavy chain (IGH) gene rearrangements, especially fibroblast growth factor receptor 3 (FGFR3)/IGH and RB1 deletion/monosomy 13 were the most common abnormalities (43.4%). Amplification 1q21 was 10 times more frequent (42.5%) than del(1p36) and del(6q21).

Conclusions

We have successfully reported the comprehensive cytogenetic profiling of a cohort of newly-diagnosed myeloma patients in our population. This study indicates that the genetic and cytogenetic abnormalities, and their frequencies, in our study group are generally similar to other populations.