bluuebunny/crossref_metadata_2025 huggingface dataset:
First Case of COVID-19 Infection with Fulminant Myocarditis Complication: Case Report and Insights
Authors: Zeng Jia Hui , Liu Ying-Xia , Yuan Jing , Wang Fu-Xiang , Wu Wei-Bo , Li Jin-Xiu , Wang Li-Fei , Gao Hong , Wang Yao , Dong Chang-Feng , Li Yi-Jun , Xie Xiao-Juan , Feng Cheng , Liu Lei
Published: March 2020

Background: The Coronavirus Disease 2019 (COVID-19) has been demonstrated as the cause of pneumonia. Nevertheless, it has not been reported as the cause of acute myocarditis or fulminant myocarditis. Case Presentation: A 63-year-old male was admitted with pneumonia and cardiac symptoms. He was genetically confirmed as COVID-19 by testing sputum on the first day of admission. He also had an elevated troponin-I (Trop I) level and diffuse myocardial dyskinesia along with decreased left ventricular ejection fraction (LVEF) on echocardiography. The highest level of Interleukin 6 was 272.40pg/ml. Bedside chest radiograph had typical ground-glass changes of viral pneumonia. The laboratory test results of virus that can cause myocarditis are all negative. The patient conformed to the diagnostic criteria of Chinese expert consensus statement for fulminant myocarditis. After receiving antiviral therapy and mechanical life support, the Trop I reduced to 0.10 g/L, and Interleukin 6 was 7.63 pg/ml. Meanwhile the LVEF of the patient gradually recovered to 68%. Conclusion: COVID-19 patients may develop severe cardiac complications such as myocarditis and heart failure, and this is the first case of COVID-19 infection complicated with fulminant myocarditis. The mechanism of cardiac pathology caused by COVID-19 needs further study.
Pengembangan Buku Panduan Penggunaan Aplikasi Resertifikasi Kompetensi untuk Karyawan Perhimpunan Dokter Sepsialis Penyakit Dalam Seluruh Indonesia
Authors: Puguh Septiadi Nugroho  , Wargahadibrata RA Hirmana , Erry Utomo
Published: March 2020

This development research aims to produce a print media in the form of a guidebook to use of the Application “Resertifikasi Kompetensi KIPD”. This guidelines is meant to be used by employees Branch of PAPDI in Indonesia. This development research is referring to Rowntree’s model that consists of three major stages; planning; preparation of writing; writing and editing. The evaluation on this development research was conducted through expert review and one-to-one evaluation. The evaluation involving one subject matter expert, one media expert, and five users. The average value obtainded from the expert review by the subject matter expert was 3,46 overall excellent. The average value obtainded from the expert review by the media expert was 2,56 overall good. In one-to-one evaluation, obtained the average score 3,4 which signifies the overall guidance is excellent and can be used to guide the employees Branch of PAPDI to using the Application “Resertifikasi Kompetensi KIPD” correctly and precisely.
Clinical manifestations and treatment outcomes of rare genera fungal keratitis in China
Authors: Wang Xin , Lu Xiuhai , Li Suxia , Wang Ting , Jia Yanni , Wang Shuting , Wang Jingting , Dong Chunxiao , Shi Weiyun
Published: March 2020

Background: Fungal keratitis is a common cause of blindness, and although major fungal genera in China have been widely reported, little is known regarding rare genera of fungal keratitis. This study is aimed at investigating the clinical manifestations and treatment outcomes of rare genera of fungal keratitis and improving clinicians’ understanding of these genera in China.Methods: A retrospective analysis was performed at Shandong Eye Hospital from October 2008 to December 2017. The clinical manifestations, risk factors, confocal microscopic images, histopathological features, in vitro drug sensitivity tests, and treatment outcomes of 16 patients with 8 rare fungal genera were evaluated.Results: Slit lamps were used to observe Rhizopus, Pythium insidiosum, and Purpureocillium lilacinum, which presented with endothelial plaque and hypopyon. Curvularia crescentulum keratitis mainly presents with feathered edges. Cases of Colletotrichum, Exserohilum, and Bipolaris also showed these feathered edges extending to the periphery, while Sarocladium keratitis only showed obvious edema and infiltration. The mean age was 54.75±12.70 years with an increase in male preponderance. Plant trauma and foreign body scratching caused ten cases (62.5%), and six cases (37.5%) were caused without inducement. In 2/3 cases, Curvularia crescentulum keratitis was cured with antifungal medication, while in 14/16 cases (87.5%), surgery was required. An exception occurred in three cases of Pythium insidiosum, where patients with fungal recurrence and final evisceration was performed; no recurrence of infection occurred in the rest of the patients. The best-corrected visual acuity (BCVA, LogMAR) of 13 cases was 1.48 ±0.85 before treatment and 0.60 ±0.45 after treatment, and the difference was found to be statistically significant [(95 % CI, 0.33–1.43) (P=0.003)].Conclusions: We report on the rare fungal genera collected in China in order to improve the knowledge of clinicians. In our study, Curvularia crescentulum seems to respond well to antifungal drugs. Patients affected by Pythium insidiosum often need long-term recovery and multiple keratoplasty, and postoperative fungal recurrence rate is high. For fungal keratitis, the combination of early sensitive antifungal drugs and necessary surgical treatment may still be a beneficial factor in treatment.
Cloning, molecular and functional characterization by overexpression in Arabidopsis of MAPKK genes from grapevine (Vitis vinifera)
Authors: Wang Gang , Liang Ying-hai , Zhang Ji-yu , Cheng Zong-Ming (Max)
Published: March 2020

Background : The mitogen-activated protein kinases (MAPKs), as a part of the MAPKKK-MAPKK-MAPK cascade, play crucial roles in plant development as an intracellular signal transduction pathways to respond various environmental signals. However, few MAPKK have been functionally characterized in grapevine. Results : In the study, five MAPKK (MKK) members were identified in grapevine (cultivar ‘Pinot Noir’), cloned and designated as VvMKK1-VvMKK5. A phylogenetic analysis grouped them into four sub-families based on the similarity of their conserved motifs and gene structure to Arabidopsis MAPKK members. qRT-PCR results indicated that the expression of VvMKK1, VvMKK2, VvMKK4, and VvMKK5 were up-regulated in mature leaf and young blades, and roots, but exhibited low expression in leaf petioles. VvMKK2, VvMKK3, and VvMKK5 genes were differentially up-regulated when grapevine leaves were inoculated with spores of Erisyphe necator , or treated with salicylic acid (SA), ethylene (ETH), H 2 O 2, or exposed to drought, indicating that these genes may be involved in a variety of signaling pathways. Over expression of VvMKK2 and VvMKK4 genes in transgenic Arabidopsis plants resulted in the production of seeds with a significantly higher germination and survival rate, and better seedling growth under stress conditions than wild-type plants. Overexpression of VvMKK2 in Arabidopsis improved salt and drought stress tolerance while overexpression of VvMKK4 only improved salt stress tolerance. Conclusions: Results of the present investigation provide a better understanding of the interaction and function of MAPKKK-MAPKK-MAPK genes at the transcriptional level in grapevine and led to the identification of candidate genes for drought and salt stress in grapes.
Is Procalcitonin (PCT) a reliable biomarker for preoperative diagnosing of low grade Periprosthetic Joint Infection? A Prospective Study
Authors: Busch André , Jäger Marcus , Engler Harald , Haversath Marcel , Bielefeld Charlotte , Landgraeber Stefan , Wegner Alexander
Published: March 2020

Background: Since a „gold-standard“ is missing, diagnosing periprosthetic joint infection (PJI) remains a challenge in orthopedic surgery. The purpose of this study was to evaluate the accuracy of serum and synovial fluid Procalcitonin (S-PCT and SF-PCT) as a diagnostic parameter and to compare it to the biomarkers recommended in the 2018 Definition of periprosthetic hip and knee infection.Methods:Between August 2018 and July 2019, a prospective cohort study was conducted in 70 patients with painful hip, shoulder and knee arthroplasty. Besides medical history, clinical and laboratory data was gathered. PJI was diagnosed based on the 2018 Definition of periprosthetic hip and knee infection. Preoperative blood and synovial joint fluid were taken for PCT measurement. S-PCT and SF-PCT levels were measured using standard quantitative PCT enzyme immunoassays.Results: Twenty three patients (33%) were classified as the PJI group and fourty seven patient (67%) as the aseptic group. The mean levels of S-PCT were significantly (p<0.001) higher in the PJI group than those in the aseptic group (PJI 0.05 ± 0.21 ng/mL (0.0-1.03) vs. aseptic 0.02 ± 0.03 ng/mL (0.0-0.18)). In synovial fluid, the mean PCT values in the aseptic group were significantly higher (p<0.001) than those of PJI group (PJI 2.7 ± 1.4 ng/mL (0.53-9.7) vs. aseptic 8.7 ± 2.5 ng/mL (0.25-87.9)). S- PCT, with a cut-off level of 0.5 ng/mL, had a sensitivity of 13.0% and a specificity of 91.0%.SF-PCT, with a cut-off level of 5.0 ng/mL, had a sensitivity of 13.0% and a specificity of 52.0%.Conclusion: S-PCT and SF-PCT appeared to be no reliable biomarkers in the differential diagnosis of PJI from aseptic loosening in total joint arthroplasty.
A qualitative study on aspects of consent for genomic research in communities with low literacy
Authors: Bukini Daima Athumani , Mbekenga Columba , Nkya Siana , Purvis Lisa , McCurdy Sheryl , Parker Michael , Makani Julie
Published: March 2020

Background: Low literacy of study participants in Sub Saharan Africa has been associated with poor comprehension during consenting process in research participation. The concerns in comprehension are far greater when consenting to participate in genomic studies due to the complexity of the science involved. While efforts are made to explore possibilities of applying genomic technologies in diseases prevalent in Sub Saharan Africa, we ought to develop methods to improve participants’ comprehension for genomic studies.
Aim: The aim of this study was to understand different approaches that can be used to seek consent from individuals with low literacy in Sub-Saharan African countries in genomic research to improve comprehension.
Methods: Using qualitative study design, we conducted focus-group discussions, in-depth interviews and participant observations as data collection methods. This study was embedded in a hospital based genomic study on Sickle Cell Disease at Muhimbili National Hospital in Tanzania. Thematic content analysis was used to analyse the transcripts and field notes.
Results: Findings from this study show that literacy level has little influence on understanding the research details. According to the participants of this study, the methods used to provide information, the language, and time spent with the study participants were the key factors influencing understanding. The availability of group sessions held before individual consent to allow for a detailed questions and answers format was agreed to be the best method to facilitate the comprehension.
Conclusion: The quality of the consenting process of participants will be influence by a number of factors. The type of research consented for, where the research will be implemented and who are the potential study participants are amongst the factors that need to be assessed during the consenting. Measures to improve participants’ comprehension need to be developed when consenting participants with low literacy level in genomic studies.
Social inequalities in overweight and obesity, and dental caries among adolescents in Northern Norway: a cross-sectional study from the Tromsø Study Fit Futures cohort.
Authors: Stangvaltaite-Mouhat Lina , Furberg Anne-Sofie , Trovik Tordis A.
Published: March 2020

Background. Non-communicable general and oral health conditions share common social determinants. We aimed to investigate how social inequalities (based on study program, parent’s education and employment status) manifest in general health (BMI or waist circumference) and oral health (untreated caries) in a sample of adolescents from Northern Norway.

Methods. Data from 464 girls and 494 boys from the population-based Tromsø study Fit Futures, which included first-year students attending upper secondary school in 2010-2011 from two municipalities in Northern Norway (1038 participants in total, 93% participation rate) was analyzed. Multivariable binary logistic regression analyses stratified by sex was used to investigate the association between socioeconomic position indicators and body weight, waist circumference, and untreated dental caries. Comparative models were adjusted for age, birth country, household composition, and health/health behavior variables.

Results. Boys enrolled in the general studies and sports programs (versus vocational) had lower odds of being overweight/obese (OR 0.39, 95% CI 0.19-0.79 and OR 0.21, 95% CI 0.07-0.62, respectively), of having high waist circumference (OR 0.47, 95% CI 0.24-0.91 and OR 0.30, 95% CI 0.11-0.77, respectively), and more untreated caries (OR 0.54, 95% CI 0.31-0.96 and OR 0.46, 95% CI 0.22-0.97, respectively). Lower mother’s education was positively associated with overweight/obesity (OR 3.68, 95% CI 1.38-9.79) and lower father’s education was negatively associated with untreated caries (OR 0.42, 95% CI 0.18-0.98) among boys. Girls enrolled in the general studies program (versus vocational) had lower odds of having more untreated caries (OR 0.48, 95% CI 0.28-0.85).

Conclusions. Social inequalities in general health and oral health were based on different social determinants for girls and boys. Based on study program social inequalities in general health were similar to social inequalities in oral health among boys. This suggests that the relationship between overweight and obesity, and dental caries maybe be explained by common social risk factors. Our findings support the broader concept of social context as a common risk factor for general and oral health.
Therapeutic efficacy of Schistosoma japonicum cystatin on sepsis-induced cardiomyopathy in a mouse model
Authors: Gao Shifang , Li Huihui , Xie Hong , Wu Shili , Yuan Yuan , Chu Liang , Sun Siying , Yang Huijuan , Wu Lingqin , Bai Yongsheng , Zhou Qiao , Wang Xin , Zhan Bin , Cui Hu , Yang Xiaodi
Published: March 2020

Background Myocardial dysfunction is one of the most common complications of multiple organ failure in septic shock and significantly increases mortality in patients with sepsis. In spite of many studies have confirmed that helminth-derived proteins have strong immunomodulatory functions and could be used to treat inflammatory diseases, there is no report on the therapeutic effect of Schistosoma japonicum -produced cystatin ( Sj- Cys) on the sepsis-induced cardiac dysfunction. Methods A model of sepsis-induced myocardial injury was established by cecal ligation and puncture (CLP) in mouse. Upon CLP operation, each mouse was intraperitoneally treated with 10 µg of recombinant Sj -Cys (r Sj -Cys). Twelve hours after CLP operation, the systolic and diastolic functions of left ventricular were examined by echocardiography. The levels of myoglobin (Mb), cardiac troponin I (cTnI), N-terminal pro-Brain Natriuretic peptide (NT-proBNP) in sera and the activity of myeloperoxidase (MPO) in cardiac tissues were examined as biomarkers for heart injury. The heart tissue was collected for checking pathological changes, macrophages and pro-inflammatory cytokine levels. To address the signaling pathway involved in the anti-inflammatory effects of r Sj -Cys, myeloid differentiation factor 88 (MyD88) was determined by Western blot in heart tissue of mice with sepsis and LPS-stimulated H9C2 cardiomyocyte cells. In addition, the therapeutic effects of r Sj -Cys on LPS-induced cardiomyocyte apoptosis were also detected in H9C2 cells.The levels of M1 biomarker iNOS and M2 biomarker Arg-1 were detected in heart tissue. The pro-inflammatory cytokines TNF-α and IL-6 and regulatory cytokines IL-10 and TGF-β were measured in sera and their mRNA levels in heart tissue of r Sj -Cys-treated mice. Results After being treated with r Sj -Cys, the sepsis-induced heart malfunction was largely improved. The inflammation and injury of heart tissue were also significantly alleviated characterized as significantly decreased infiltration of inflammatory cells in cardiac tissues and fiber swelling, reduced levels of Mb, cTnI and NT-proBNP in sera and MPO activity in heart tissue. The therapeutic efficacy of r Sj -Cys is associated with down-regulated pro-inflammatory cytokines (TNF-α, IL-6) , as well as the decreased M1 macrophages and increased M2 macrophages, possibly through inhibiting LPS-MyD88 signal pathway. Conclusions Recombinant Sj -Cys significantly reduced sepsis-induced cardiomyopathy and could be considered as be a potential therapeutic agent for the prevention and treatment of sepsis associated cardiac dysfunction.
Genetic diversity and fingerprinting of 33 standard flue-cured tobacco varieties for use in distinctness, uniformity, and stability testing
Authors: He Binbin , Geng Ruimei , Cheng Lirui , Yang Xianbin , Ge Hongmei , Ren Min
Published: March 2020

Background: At present, the distinctness, uniformity, and stability (DUS) testing of flue-cured tobacco ( Nicotiana tabacum L.) depends on field morphological identification, which is problematic in that it is intensive, time-consuming, and susceptible to environmental impacts. In order to improve the efficiency and accuracy of tobacco DUS testing, the development of a molecular marker-based method for genetic diversity identification is urgently needed. Results: In total, 91 simple sequence repeats (SSR) markers with clear and polymorphic amplification bands were obtained with polymorphism information content, Nei index, and Shannon information index values of 0.3603, 0.4040, and 0.7228, respectively. Clustering analysis showed that the 33 study varieties, which are standard varieties for flue-cured tobacco DUS testing, could all be distinguished from one another. Further analysis showed that a minimum of 25 markers were required to identify the genetic diversity of these varieties. Following the principle of two markers per linkage group, 48 pairs of SSR markers were selected. Correlation analysis showed that the genetic relationships revealed by the 48 SSR markers were consistent with those found using the 91 SSR markers. Conclusions: The genetic fingerprints of the 33 standard varieties of flue-cured tobacco were constructed using 48 SSR markers, and an SSR marker-based identification technique for new tobacco varieties was developed. This study provides a reliable technological approach for determining the novelty of new tobacco varieties and offers a solid technical basis for the accreditation and protection of new tobacco varieties.
A Surgical Reduction Technique for Posterior Cruciate Ligament Avulsion Fracture in Total Knee Arthroplasty: A Comparison Study
Authors: Lin Wei , Niu Jinghui , Dai Yike , Zhang Huaxing , Zhu Jing , Wang Fei
Published: March 2020

Background: Posterior cruciate ligament (PCL) avulsion fracture of tibia is an uncommon but serious complication during primary cruciate retaining total knee arthroplasty (TKA). The first objective of this report was to conduct a retrospective cohort study to investigate the incidence and potential risk factors of PCL avulsion fracture in primary cruciate-retaining TKA. The second objective was to assess the functional outcomes of the knee after reduction of PCL avulsion fracture.Methods: From January 2014 to January 2016, 56 patients who experienced PCL avulsion fracture of tibia in primary cruciate-retaining TKA were included in study group. Patients in this group underwent reduction of avulsion fracture. In this period, we selected 224 patients (control group) for comparison. Patients in this group also underwent the same TKA but no PCL avulsion fracture occurred. Range of motion of the knee and Knee Society Scores were assessed. The forgotten joint score was used to analyze the ability to forget the joint. Differences were considered statistically significant at p < 0.05.Results: In our series, the incidence of PCL avulsion fracture was 4.6%. There was no significant differences with regard to preoperative or postoperative range of motion of the knee (p > 0.05). At the final follow-up of 4 years, the mean clinical scores of study and control groups were 92.4±2.7 and 93.6±1.9, respectively (p > 0.05). The mean functional scores were 85.1±1.8 and 87.1±1.2, respectively (p > 0.05). There was no significant statistical difference with regard to forgotten joint score (p > 0.05). Conclusions: The incidence of PCL avulsion fracture of tibia is relatively high. Older age and female gender were two risk factors of fracture in primary cruciate-retaining TKA. Reduction of PCL avulsion fracture with high-strength line can achieve good stability and function of the knee.
Prevalence Of Staphylococcus Aureus Colonization In Patients For Total Joint Arthroplasty In South Africa
Authors: Pietrzak Jurek Rafal Tomasz , Maharaj Zia , Mokete Lipalo
Published: March 2020

Background: Periprosthetic joint infections (PJIs) are a major source of morbidity and mortality for patients undergoing Total Joint Arthroplasty (TJA). Staphylococcus aureus (S aureus) colonization is an independent, modifiable risk factor for periprosthetic joint infections. Post-operative infections are reported to be ten times greater in S aureus carriers than in non-carriers in developed countries though recorded data is lacking for the developing world. This study aims to determine the prevalence of S aureus colonization in patients awaiting TJA in South Africa. Methods: We prospectively assessed 119 patients awaiting Total Knee Arthroplasty and Total Hip Arthroplasty between May and October 2016. We screened three separate anatomical sites on each patient for S aureus. Patients with positive cultures were treated with intranasal mupirocin ointment and chlorhexidine body wash. Univariate and comparative statistical analyses to determine risk factors for colonization was conducted using t-tests, Fisher’s exact tests, and chi square analyses. Results: The overall prevalence of Methicillin Sensitive S aureus colonization was 31.9% (n = 38). There were no patients colonized with Methicillin Resistant S aureus. Nasal swabs returned a yield of 81.6% (n=31), with groin swabs and axillary swabs at 39.5% (n=15) and 28.9% (n=11) respectively. Eradication was successful in 94.74% (n=36) after five days treatment. All patients (100%) were decolonized after counseling and repeat eradication treatment. The overall complication rate was 7.6% (n=9). The 30-day readmission rate in the S aureus -colonized group was 7.9% (n=3) as opposed to 7.4% (n=6) in the non-colonized cohort. There were no 60- and 90-day readmissions and no cases were revised at a mean follow-up of 2.26 years. Conclusions: The rate of S aureus colonization in patients undergoing elective TJA in a developing country was 31.9% and is equivalent to reported rates in developed countries. Eradication treatment with combined intranasal mupirocin ointment and chlorhexidine body wash is a successful treatment modality. A larger cohort of patients is recommended to determine risk factors and post-operative septic sequelae in this population group.
Fabry disease screening in high-risk populations in Japan: A nationwide study
Authors: Yoshida Shinichiro , Kido Jun , Sawada Takaaki , Momosaki Ken , Sugawara Keishin , Matsumoto Shirou , Endo Fumio , Nakamura Kimitoshi
Published: March 2020

Background: Fabry disease (FD) is a rare, X-linked inherited disorder caused by mutations in the GLA gene, which results in deficiency of α-galactosidase A (α-Gal A). This leads to the progressive accumulation of metabolites, which can cause malfunctions in systemic organs. A recent screening study in newborns demonstrated that the incidence of FD was more frequent than previously estimated and that there are still many undiagnosed or misdiagnosed Fabry patients. Therefore, the purpose of this study was to identify Fabry patients by performing high-risk screening in 18,171 individuals, enrolled from October 2006 to March 2019, with renal, cardiac, or neurological manifestations from all of the prefectures in Japan. A total of 601 hospitals from all the prefectures in Japan participated in this study. Results: From October 2006 to March 2019, 18,171 individuals with renal, cardiac, or neurological manifestations were enrolled. Low α-Gal A activity was detected in 846 individuals, with 224 of them diagnosed with FD by GLA sequencing. Cases with a family history of FD (n = 64) were also subjected to sequencing, without α-Gal A assay, as per individual request and 12 of them were diagnosed with a variant of FD. A total of 236 Fabry patients (97 males and 139 females) were detected from the 18,235 participants. There were 101 GLA variants, including 26 novel variants, detected in the 236 Fabry patients from 143 families, with 39 amenable variants (39%) and 79 of the 236 patients (33%) suitable for migalastat treatment. Conclusions: From the 18,235 participants, 101 GLA variants, including 26 novel variants, were identified in the 236 Fabry patients from 143 families. Migalastat was identified as a suitable treatment option in 33% of the Fabry patients and 39% of the GLA variants were detected as amenable. Therefore, the simple screening protocol, using dried blood spots, that was performed in this study could be useful for early diagnosis and selection of appropriate treatments for FD in high-risk and underdiagnosed patients suffering from various renal, cardiac, or neurological manifestations.
Evaluation of Gastrointestinal Functions in Children with Familial Mediterranean Fever Disease
Authors: Anadolulu Ali İhsan , Durakbaşa Çiğdem Ulukaya , ergüven müferret , zemheri ıtır ebru , gerçel gonca
Published: March 2020

Background The aim of this study was to evaluate the effect of amyloid deposition in colon mucosa on the results of anorectal manometry test and the use of ROME III questionnaire in patients with Familial Mediterranean Fever (FMF). Methods The files of patients diagnosed with FMF were scanned to evaluate the patients at risk for amyloid deposition. Predisposing factors were identified. The patients were sampled using anorectal manometry test, Rome III questionnaire and the rectal mucosa suction biopsy and the test results were compared. Results 17 of the patients were female (63%) and 10 were male (37%). The mean age was 12.15 ± 2.40 years. The number of patients with amyloid deposition in the rectal mucosa sample was 2 (7.4%). Both patients regularly used colchicine. Amyloid deposition was found to be high in patients with M694V homozygous mutation (p <0.028). Patients with high proteinuria levels had higher FMF history in the family (p <0.046). It was found that patients with predisposing factors required lower volume for rectoanal inhibitory reflex (RAIR) detection (p <0.037). According to the Rome III questionnaire, findings suggestive of irritable bowel syndrome was found in 5 patients and abdominal migraine was found in 3 patients. However, no statistical difference was found when the results of the Rome III questionnaire were compared with the results obtained from the anorectal manometry test (p> 0.05). Conclusions Amyloidosis can be seen due to various environmental factors, regardless of age, even when colchicine is regularly used. Anorectal manometry is an easy to perform test, helping diagnosis in this patient group. Although it has been shown that in patients with predisposing factors for amyloid deposition RAIR can be detected at lower pressures in anorectal manometry, the clinical significance of this finding is unclear. Since the Rome III questionnaire showed findings consistent with functional abdominal pain disease in one third of the patients, independent of the presence of FMF, it was found that the application of this questionnaire in patients with FMF could be misleading.
Omitting Nasogastric Tube Placement after Gastrectomy Does Not Enhance Postoperative Recovery: A Propensity Score Matched Analysis
Authors: Wu Zhouqiao , Wang Qi , Shi Jinyao , Hou Shiyang , Shan Fei , Li Shuangxi , Zhang Yan , Li Ziyu , Ji Jiafu
Published: March 2020

Background: Enhanced recovery after surgery (ERAS) program has become the main trend in gastrointestinal surgery. The aim of this study is to investigate factors influencing the decision-making of nasogastric tube (NGT) placement and its safety and efficacy in clinical practice. Methods: We analyzed our prospectively maintained database including 287 patients underwent elective gastrectomy in our department from January 1 to December 31, 2017. All cases were divided into two groups, namely, the non-nasogastric tube group and the nasogastric tube group. Logistic regression was used to analyze the factors that affect the decision of nasogastric tube placement, and propensity score matching (PSM) was later applied to balance those factors for the analysis of the safety outcomes between the groups. Results: Multivariate analysis showed that resection range ( p =0.004, proximal gastrectomy: OR=4.555, 95%CI=1.392-14.905, p =0.016; total gastrectomy: OR=1.990, 95%CI=1.205-3.287, p =0.009) was the only independent risk factors of nasogastric tube placement. NGT was omitted in the majority (58.8%) of distal gastrectomy, but only in 42.5% and 25% in total and proximal gastrectomy. After PSM, we found no significant differences between patients with or without NGT in postoperative hospital stay, time to first flatus and defecation, time to fluid and semi-fluid diet, rate of reinsertion, or hospitalization expenditure (p>0.05 respectively). The incidence of postoperative complications in the two groups were 21.7% and 23.5% respectively ( p =0.753), and the incidence of major complications were 7.0% and 9.6% ( p =0.472). Conclusions: The decision-making of NGT placement is mainly influenced by the resection range. Omitting NGT is a safe approach in all types of gastrectomy but was not able to enhance the recovery in our practice.
Maximizing the value of Korshinsk peashrub branches by the integration of Pleurotus tuoliensis cultivation and anaerobic digestion of spent mushroom substrate
Authors: Du Fang , Qu Jibin , Hu Qingxiu , Zou Yajie , Yin Guanhong , Dai Dari , Yuan Xufeng
Published: March 2020

Background: Korshinsk peashrub branches are agroforestry byproducts that accumulate in millions of tons per year and need to be rationally and efficiently utilized. To maximate the utilization value of Korshinsk peashrub branches, an integrated process was proposed and conducted by using Korshinsk peashrub branches as the main substrate ingredient for Pleurotus tuoliensis cultivation and performing anaerobic digestion of spent mushroom substrate for methane production in this study.Results: It was found that the substrate including 45% Korshinsk peashrub branches obtained higher mushroom yields than that using a commercial substrate, and anaerobic digestion of spent mushroom substrate from P. tuoliensis cultivation achieved a high cumulative methane yield. Preliminary calculation suggested that, for every kg of Korshinsk peashrub branches consumption, 1.12 kg mushroom product and 8578 L methane were produced, obtaining actual economic value of RMB 27.5 Yuan. In addition, this integrated stragety have positive ecological and social benefits.Conclusion: The value of Korshinsk peashrub branches can be maximized by P. tuoliensis cultivation and anaerobic digestion of spent mushroom substrate, which not only promote the biological conversion of Korshinsk peashrub branches to circle economy, but also be beneficial for the sustainable development of environment, energy conservation and edible fungi industry.
ITRAQ-based quantitative proteomic analysis of Fusarium moniliforme (Fusarium verticillioides) in response to Phloridzin inducers
Authors: Zhang Rong , Jiang Weitao , Liu Xin , Duan Yanan , Xiang Li , Wang Yanfang , Jiang Yuanmao , Shen Xiang , Chen Xuesen , Yin Chengmiao , Mao Zhiquan
Published: March 2020

Apple replant disease (ARD) has been reported from all major fruit-growing regions of the world, and is often caused by biotic factors (pathogen fungi) and abiotic factors (phenolic compounds). In order to clarify the proteomic differences of Fusarium moniliforme under the action of phloridzin, and to explore the potential mechanism of F. moniliforme as the pathogen of ARD, the role of Fusarium spp in ARD was further clarified. In this paper, the quantitative proteomics method iTRAQ analysis technology was used to analyze the proteomic differences of F. moniliforme before and after phloridzin treatment. A total of 4535 proteins were detected, and 293 proteins were found with more than 1.2 times (P<0.05) differences. In-depth data analysis revealed that differentially expressed proteins were influenced a variety of cellular processes, particularly metabolic processes. Among these metabolic pathways, a total of 8 significantly enriched KEGG pathways were identified with at least 2 affiliated proteins with different abundance in conidia and mycelium. Functional pathway analysis indicated that 46 up-regulated proteins were mainly distributed in amino sugar, nucleotide sugar metabolism, glycolysis/ gluconeogenesis and phagosome pathways. The results deepened our understanding of the proteome in F. moniliforme in response to phloridzin inducers and provide a basis for further exploration for improving the efficiency of the fungi as biocontrol agents to control ARD.
Patients' Preferences in Selecting Family Physician in Primary Health Centers: A Qualitative-Quantitative Approach
Authors: Khatami Farnaz , Shariati Mohammad , Khedmat Leila , Bahmani Maryam
Published: March 2020

Background The role of family physicians (FPs) in the metropolitan area is critical in identifying risk factors for diseaseprevention/controland health promotioninvarious age groups. Understanding people's preferences and interests in choosing a FP can be an effective and fundamental step in the success of this program. In this study factors affecting the FP selection by Iranian people referred to health centersin the most populous areas in the south of Tehran were assessed and ranked.Methods Asequential mixed-method (qualitative-quantitative) triangulation approach was designed with three subject groups of people, physicians, and health officials.The Framework method was used to analyze interviews transcribed verbatim. After implementing an iterative thematic process, a 26-item quantitative questionnaire with high validity and reliability was draftedto evaluatethe different factors.A convenient sampling method was usedto select 400 subjectson a population-based scale to quantitatively rank the most critical selection factors.Results The selection factors were divided into six centralized codes, including FPs' ethics,individual, professional and performance factors;patients underlying disease and individual health, and disease-related factors;clinic-office’s location and management factors;democracyfactors;economic factors; andsocial factors. After filling out the questionnaires,the most important factors in selecting FP were aspecialistdegree in family medicine (FM), performing accurate examinations, taking correct biography, and spending enough time to visit by the doctor, respectively. However, the parameters such as being a fellow-citizen, being same gender, and physician's appearance were of the least importance.Conclusion There is a necessity to expand the new medical specialty in FM because it was considered as the first people's priority. The clinical andadministrative healthcare systems should schedule the entire implementation process to oversee the doctor's professional commitment and setting the visit times of FP.
Analysis clinical features of COVID-19 infection in secondary epidemic area and report potential biomarkers in evaluation
Authors: Ji Weiping , Bishnu Gautam , Shen Xian , Cai Zhenzhai
Published: March 2020

Objective: Based on the clinical characteristics of infected patients with novel coronavirus in secondary epidemic areas, we aimed to identify potential biomarkers for the evaluation of novel coronavirus-infected patients, guide the diagnosis and treatment of this disease in secondary epidemic areas and provide a reference for the clinical prevention and control of this epidemic situation.Methods: The clinical data of 33 patients with respiratory symptoms caused by the novel coronavirus in Wenzhou city from January 15 to February 12, 2020, were thoroughly reviewed. At the onset of the disease, we found that the primary symptoms were fever, cough, fatigue, chest tightness, chest pain and specific blood test results. According to the patients’ histories, the patients were divided into two groups: those who spent time in the main epidemic area and those who did not spend time in the main epidemic area. The differences in the clinical manifestations between these two groups were analyzed.Results: The main clinical symptoms of patients infected with novel coronavirus in the secondary epidemic area were respiratory tract ailments and systemic symptoms. After grouping patients based on the presence or absence of residency in or travel history to the main epidemic area, there was no significant difference between the baseline data of these two groups, and there were no significant differences in symptoms and signs between the two groups (P>0.05). Some patients had abnormally increased serum amyloid protein A (SAA). There were statistically significant differences in the leukocyte count/C-reactive protein, monocyte ratio/C-reactive protein, neutrophil count/C-reactive protein, monocyte count/C-reactive protein and hemoglobin/C-reactive protein values between the two groups (P < 0.05).Conclusion: Respiratory tract ailments and systemic symptoms were the primary symptoms of novel coronavirus infection in the secondary epidemic area; these symptoms are not typical. The abnormal increase in serum amyloid protein (SAA) may be used as an auxiliary index for diagnosis and treatment. CRP changes before other blood parameters and thus may be an effective evaluation index for patients with COVID-19 infection.
Timing of optimal surgical intervention for vitreous hemorrhage in patients with proliferative diabetic retinopathy
Authors: Lin Li , Chen Yiqi , Wang Lin , Shen Lijun
Published: March 2020

Background：To explore the optimal timing of vitrectomy for vitreous hemorrhage in the patients with proliferative diabetic retinopathy (PDR).Method：Seventy-six PDR patients (85 eyes) who were diagnosed with vitreous hemorrhage and received vitrectomy were retrospectively enrolled into this study. The patients were categorized into 4 groups based on the timing of surgical intervention after the occurrence of hemorrhage, namely Group 1 (less than 15 days, with 28 eyes of 27 patients), Group 2 (15~30 days, with 29 eyes of 27 patients), Group 3 (30~90 days, with 14 eyes of 11 patients) and Group 4 (>90 days, with 14 eyes of 11 patients). Best corrected visual acuity (BCVA) and central macular thickness (CMT) from OCT before and at 1 mo and 3 mo after operation were collected as the main outcomes. The postoperative complications were also reported.Result: 1) BCVA (logMAR): the mean pre-operation BCVA was not significantly different among the 4 groups (P=0.139), while the mean post-operation BCVA was significantly worse in groups with longer gap between the vitreous bleeding and the vitrectomy, both at 1m and 3m after surgery (P=0.043; P<0.001). 2) CMT(μm): Although CMT was unavailable to measure in most included eyes before surgery, the mean CMT was significantly thicker in groups with postponed surgical intervention both at 1-month (P=0.001) and at 3-month (P=0.006) after surgery. 3) Complications: No severe complications were spotted in early vitrectomy groups (Group 1 and Group 2) during the follow-up period. At 3 months after the operation, three cases of ocular hypertension and another case of neovascular glaucoma in Group 3 and 4 cases of ocular hypertension and another 3 cases of neovascular glaucoma in Group 4 were observed. Conclusion: Early vitrectomy is more effective in improving BCVA and decreasing CMT in the PDR patients with vitreous hemorrhage. Moreover, the post-operation complications were spotted less in early vitrectomy groups. Thus we suggested that vitrectomy should be performed early and better within one month after the onset of vitreous hemorrhage in PDR patients.
USP18 promotes cell proliferation and suppressed apoptosis in cervical cancer cells via activating AKT signaling pathway
Authors: Diao Wenjing , Guo Qisang , Zhu Caiying , Song Yu , Feng Hua , Cao Yuankui , Du Ming , Chen Huifen
Published: March 2020

Background: The deubiquitinating (DUB) enzyme ubiquitin-specific protease 18 (USP18), also known as UBP43, is an ubiquitin-specific protease and has been linked to several human malignancies. However, the underlying function of USP18 remains unclear in human cervical cancer. In the current research, we aimed to analyze the role of USP18 and its signaling pathway in cervical cancer. Methods: Quantitative real time polymerase chain reaction (qRT-PCR) and immunohistochemical staining were performed to analyze USP18 levels in cervical cancer and adjacent-matched tissues. Moreover, RNA interference (RNAi) and lentiviral-mediated vector were performed to silence and overexpression of USP18 in cervical cancer cells. Further, Cell Counting Kit-8 (CCK-8) assay and Annexin V/PI staining were used to assess its biological function in cell proliferation and apoptosis respectively. Results: Present findings demonstrated that USP18 was overexpressed in cervical cancer specimens and cell lines. Silencing of USP18 in cervical cancer cell lines, SiHa and Caski, inhibited cell proliferation, while induced apoptosis and promoted the expression of cleaved caspase-3. On the contrary, USP18 overexpression showed reversed effects in Hela cells. Gene Set Enrichment Analysis suggested that USP18 was enriched in PI3K/AKT signaling pathway in cervical cancer. Hence, the PI3K/AKT inhibitor LY294002 was used to determine the relationship between USP18 and AKT in cervical cancer cells. Importantly, the PI3K/AKT inhibitor LY294002 deeply abolished the effects of USP18 overexpression in cervical cancer cells. Conclusions: The current study indicates USP18 was an oncogenic gene in cervical cancer. Our findings not only deepened the understanding the biological function of USP18 in the pathogenesis of cervical cancer but also provided novel insight for cervical cancer therapy. Trial registration: retrospectively registered.
Expression of membrane progesterone receptors in eutopic and ectopic endometrium of women with endometriosis
Authors: VAZQUEZ-MARTINEZ EDGAR RICARDO , Bello-Alvarez Claudia , Hermenegildo-Molina Ana Lorena , Solís-Paredes Mario , Parra-Hernandez Sandra , Cruz-Orozco Oliver , Silvestri-Tomassoni J Roberto , Escobar-Ponce Luis F , Hernandez-Lopez Luis A , Reyes-Mayoral Christian , Olguín-Ortega Andrea , Sánchez-Ramírez Brenda , Osorio-Caballero Mauricio , García-Gómez Elizabeth , Estrada-Gutiérrez Guadalupe , Cerbón Marco , Camacho-Arroyo Ignacio
Published: March 2020

Background: Endometriosis is one of the most frequent gynecological diseases in reproductive age women, but its etiology is not completely understood. Endometriosis is characterized by progesterone resistance, which has been explained in part by a decrease in the expression of the intracellular progesterone receptor in the ectopic endometrium. Progesterone action is also mediated by non-genomic mechanisms via membrane progesterone receptors that belong to the class II members of the progesterone and adipoQ receptor (PAQR) family. The aim of the present study was to evaluate the expression at mRNA and protein levels of PAQR family members in the eutopic and ectopic endometrium of women with endometriosis. Methods : Total RNA and total protein were isolated from control endometrium (17 samples), eutopic endometrium (17 samples), and ectopic endometrium (9 samples). The expression of PAQR7 ( mPRα ) , PAQR8 , (mPRβ) PAQR5 ( mPRγ ) , and PAQR6 ( mPRδ ) at mRNA and protein levels was evaluated by RT-qPCR and western blot. Statistical analysis between comparable groups was performed using one-way ANOVA followed by Tukey's multiple comparisons test with a confidence interval of 95%. Results : The analysis of gene expression showed that PAQR7 and PAQR5 expression was lower in both eutopic and ectopic endometrium as compared to the endometrium of women without endometriosis, whereas the expression of PAQR8 and PAQR6 was only reduced in eutopic endometrium. Furthermore, mPRα and mPRβ protein content was decreased in the ectopic endometrium of women with endometriosis. Conclusions : Our results demonstrate a decrease in the expression and protein content of mPRs in eutopic and ectopic endometrium of patients with endometriosis, which could contribute to the progesterone resistance observed in patients with this disease.
Genome-wide analysis of DNA methylation in hypertension-discordant monozygotic twins
Authors: Wu Zhentian , Gao Wenjing , Cao Weihua , Li Chunxiao , Yu Canqing , Lv Jun , Pang Zengchang , Cong Liming , Wang Hua , Wu Xianping , Li Liming
Published: March 2020

Background: DNA methylation has great potential for identifying the aetiology of hypertension. The aim of this study was to explore the correlation between hypertension and DNA methylation using twins discordant for hypertension in China. Methods: In this study, 43 pairs of monozygotic twins discordant for hypertension (age 31.9-72.3 years; 67.4% male) from the Chinese National Twin Registry were recruited. Genome-wide DNA methylation was measured using the Illumina Human methylation EPIC Beadchip in whole-blood-derived DNA. Standardized questionnaires were used to collect twin data on the following variables: age, gender, socioeconomic level, lifestyle factors (including smoking, alcohol drinking, vegetable intake, and physical activity). Blood pressure, height, weight, and other anthropometric indicators were obtained by physical examination. Empirical Bayes paired moderated t-test was utilized to compare the methylation data within twin pairs. Results: Four suspected significant methylation sites, cg00950476, cg08041400, cg26733338, and cg08580087 were identified. All of these four sites locate on known loci, which were LINC01252, BDP1, SYT1, and ODZ4, respectively. The main function includes transcriptional regulation, learning and cognitive, neurodevelopment. The significant sites were further replicated among two different replication population, the first replication population contained 38 hypertension concordant monozygotic twin pairs and 38 non-hypertension concordant monozygotic twin pairs matched in age, sex, region, and birth order, and the second replication group included 21 MZ twin pairs discordant for hypertension . None of them, however, were significant. The methylation variation in the above sites may influence blood pressure, independent of genetic and early-life environmental factors. Conclusions: This study found four suspected methylation sites correlated with hypertension. However, all four sites failed the replication analysis. More hypertension-discordant monozygotic twin pairs are needed to replicate these findings in the future to explore the stability of the results.