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BACKGROUND: There have been several case-control studies to assess the relationship between the transforming growth factor-1 (TGF-1) T + 869C (rs1982073)/C-509T (rs1800469) gene polymorphism and lung cancer in recent years; however, the results remain controversial. In this study, we investigated the potential correlation between the TGF-1 T + 869C/C-509T polymorphism and increased risk of lung cancer through meta-analysis.METHODS: We searched the Cochrane Library database, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, and the Wanfang Data Information Service platform to identify relevant case-control studies in strict accordance with the inclusion and exclusion criteria. The odds ratio (OR) and its 95% confidence interval (95% CI) were used to evaluate the correlation between TGF-1 gene polymorphism and lung tumor risk. Sensitivity analysis and Egger test were used to evaluate the stability of the results and possible publication bias.RESULTS: A total of 8 studies, with 3680 patients and 4018 controls, were included. The meta-analysis revealed that there was no conspicuous correlation between the TGF-1 T + 869C (rs1982073)/C-509T (rs1800469) variant and lung cancer in the overall population. For TGF-1 C-509T, a significant decreased risk was identified in patients with nonsmall-cell lung cancer (NSCLC) in the analysis stratified by disease (TT vs CT + CC: P = .02, OR = 0.49, 95% CI 0.27-0.90). However, for TGF-1 T + 869C, subgroup analysis showed no correlation between the T + 869C polymorphism and lung cancer susceptibility in patients with NSCLC. In the subgroup analysis by ethnicity, no distinct association was observed between T + 869C (rs1982073)/C-509T (rs1800469) polymorphism and lung cancer susceptibility in the Asian and Caucasian groups. Moreover, no significant association was found in the analysis of groups stratified by age, sex, and smoking history.CONCLUSION: The TGF-1 T + 869C (rs1982073) and C-509T (rs1800469) polymorphisms are not implicated in lung cancer susceptibility in the overall population. However, our analysis indicated that the C-509T (rs1800469) polymorphism decreases the risk of lung cancer in patients with NSCLC. | [
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Chronic obstructive pulmonary disease (COPD) patients are at a higher risk of development of lung cancer. Frequent exacerbations of COPD trigger the disease course to chronic inflammation which likely plays a role in the pathogenesis of lung cancer. Previous studies showed influenza virus infection is one of important causes for exacerbations of COPD. Therefore, the aim of this study was to know whether influenza vaccination could reduce the incidence of lung cancer in patients with COPD.This cohort study enrolled patients (?55 years old) with a recorded diagnosis of COPD between January 1, 2000 and December 31, 2012 by using the Taiwan Health Insurance Database. A propensity score was calculated to reduce vaccine therapy selection bias. Cox proportional hazard regressions were used to investigate the association between the influenza vaccination and lung cancer incidence after adjusting for known confounding factors. Besides, we categorized the patients into 4 groups according to vaccination status (unvaccinated, total number of vaccinations: 1, 2-3, ?4) to evaluate the dose-dependent effect on reducing lung cancer occurrence of lung cancer in COPD patients.Our study comprised of 28,752 eligible individuals from the COPD cohort database. Among them, 51% (14,630) received influenza vaccination; the rest (49%) of the COPD patients did not receive influenza vaccination. We observed that COPD patients receiving influenza vaccination had a lower risk of lung cancer (adjusted HR = 0.40, 95% CI (0.35-0.45), P < .001). We also founded comparable protective effect in both sexes and all age groups (55-64, 65-74, ?75) regardless of influenza seasonality. Furthermore, dose-dependent protective effect could be seen after stratifying patients according to the total number vaccinations, the adjusted HRs for lung cancer risk were 0.48 (0.40-0.54) and 0.24 (0.20-0.29) for patients who received 2 to 3 and ?4 vaccinations during the follow-up period.This population-based cohort study demonstrated that annual influenza vaccination administration could reduce incidence of lung cancer in COPD patients. | [
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] |
Dyspnea and exercise intolerance are usually attributed to pulmonary disease in sarcoidosis patients. However, cardiac involvement may also be responsible for these symptoms. Data regarding the impact of heart involvement on lung function in cardiac sarcoidosis (CS) is limited.The aim of study was to compare the results of pulmonary function tests (PFTs) in patients with and without heart involvement. We performed a retrospective analysis of PFTs in a group of sarcoidosis patients both with and without heart involvement evaluated by cardiovascular magnetic resonance (CMR) study. The study was performed in the period between May 2008 and April 2016.We included data of sarcoidosis patients who underwent testing for possible CS (including CMR study) at a national tertiary referral center for patients with interstitial lung diseases. All patients had histopathologicaly confirmed sarcoidosis and underwent standard evaluation with PFTs measurements including spirometry, plethysmography, lung transfer factor (TL,CO), and 6-minute walking test (6MWT) assessed using the most recent predicted values.We identified 255 sarcoidosis patients (93 women, age 42 10.7 y): 103 with CS and 152 without CS (controls). CS patients had significantly lower left ventricular ejection fraction (LVEF; 56.9 7.0 vs 60.4 5.4, P < .001). Any type of lung dysfunction was seen in 63% of CS patients compared with 31% in the controls (P = .005). Ventilatory disturbances (obstructive or restrictive pattern) and low TL,CO were more frequent in CS group (52% vs 23%, P < .001 and 38% vs 18% P < .01 respectively). CS (OR = 2.13, 95% CI: 1.11-4.07, P = .02), stage of the disease (OR = 3.13, 95% CI: 1.4-7.0, P = .006) and LVEF (coefficient = -0.068 0.027, P = .011) were independent factors associated with low FEV1 but not low TL,CO. There was a significant correlation between LVEF and FEV1 in CS group (r = 0.31, n = 89, P = .003). No significant difference in 6MWD between CS patients and controls was observed.Lung function impairment was more frequent in CS. Lower LVEF was associated with decreased values of FEV1. Relatively poor lung function may be an indication of cardiac sarcoidosis. | [
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] |
The present study is aimed to clarify the utility of magnetic resonance cholangiopancreatography (MRCP) and the additional value of diffusion-weighted imaging (DWI) in diagnosing pancreatic ductal adenocarcinoma (PDAC) concomitant with intraductal papillary mucinous neoplasm (IPMN).This retrospective study involved 38 patients with PDAC concomitant with IPMN and 114 patients (control) who were randomly selected from 320 patients with IPMN without PDAC and were matched with cases for magnetic resonance imaging (MRI) strength (1.5 T/3.0 T). Two radiologists reviewed the 2 MR image sets with relevant clinical information blinded, first MRCP alone and then combined MRI set including DWI. Diagnostic capability and interobserver agreement were assessed by using receiver operating characteristics curve (Az) analysis and weighted statistics.Az values for the 2 observers were 0.834 and 0.821 for MRCP alone and 0.964 and 0.926 for the combined MRI (P < .001 and P < .001), respectively. The sensitivity of MRCP alone was 61% (23/38), with both observers failing to diagnose PDACs located at the end of tail or away from the pancreatic duct. Meanwhile, with combined MRI, sensitivity was significantly increased for both observers (61% to 92%, P = .002; 61% to 87%, P = .004). Moreover, the interobserver agreement was higher with combined MRI ( = 0.85) than MRCP alone ( = 0.59).MRCP and DWI might be a superior option with a higher diagnostic capability of PDAC concomitant with IPMN than MRCP alone, especially for tumors away from the pancreatic duct. | [
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Fetal chromosomal abnormalities are considered to be the main cause of spontaneous abortion (SA). We aimed to determine the differences in the rates and numbers of chromosomal abnormalities between samples from women with a history of one versus more than one SA as well as between samples from first- and second-trimester SAs in women from Northeast China.In total, 1210 products of conception (POCs) from patients with a history of one or more SAs were examined. Of these 1210 samples, 434 were from women with a history of 1 SA, and 776 were from women with a history of more than 1 SA. Additionally, 1071 samples were from the first trimester, 118 were from the second trimester, and 21 were from the third trimester. We identified chromosomal abnormalities by next-generation sequencing (NGS) technology. Among the 1210 POCs in women with SA, 607 (50.17%) had fetal chromosomal abnormalities. There were no significant differences in the rates of chromosomal abnormalities according to the abortion frequency. However, first-trimester SA had a significantly higher percentage of fetal chromosomal abnormalities than second-trimester SA (P < .05). Among 663 chromosomal abnormalities, 633 abnormalities occurred in first-trimester SA; the most frequent karyotype was trisomy 16 (14.38%), followed by monosomy X (13.27%), trisomy 22 (7.90%), and trisomy 15 (5.37%). Thirty abnormalities occurred in second-trimester SA; the most frequent karyotype was trisomy 18 (26.67%), followed by monosomy X (16.67%), trisomy 21 (13.33%), and trisomy 13 (10.00%). No chromosomal abnormalities occurred in the third trimester.These findings indicate the importance of determining the genetic cause of abortion in patients with a history of SA. We also identified a trend suggesting that the percentage of fetal chromosomal abnormalities is significantly higher in first- than second-trimester SA. The detection rate of chromosomal abnormalities in POCs from SA can be increased by NGS, which is beneficial for couples with recurrent miscarriages and offers better genetic counseling in the clinical setting. | [
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BACKGROUND: The ideal ablation strategy and end point for persistent atrial fibrillation (AF) have not been well founded. Defining periprocedural AF termination as the end point of catheter ablation is still controversial. This meta-analysis aimed to analyze the differences between periprocedural AF termination and non-termination in the long-term AF recurrence rate and postoperative complications.METHODS: Randomized controlled trials (RCTs) were identified by a systematic search of electronic databases including PubMed, EMBASE, and Cochrane library from January 2008 to August 2019. The primary outcome was freedom from AF or any atrial arrhythmia without antiarrhythmic drugs at the long-term (?12 months) follow-up. The secondary outcome was overall postoperative complication rates. The risk ratio (RR) with 95% confidence interval (CI) was pooled for these outcomes. A forest plot, fixed-effects model or random-effect model, Q test, I statistic, and Egger funnel plot were used in the statistical analysis.RESULTS: Fourteen RCTs were included in this meta-analysis. Overall, no significant difference was found in freedom from AF at the long-term follow-up between patients in whom AF termination was achieved and not achieved (RR = 0.93, 95% CI = 0.78-1.09, P = .36, I = 69%). Patients with AF non-termination had a lower complication occurrence rate than those with AF termination (RR = 1.74, 95% CI = 1.11-2.73, P = .02, I = 0%).CONCLUSION: Our meta-analysis suggests that AF termination is not a reliable procedural end point during ablation of persistent AF. | [
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] |
The aim of this research is to investigate the application value of TTE in the diagnosis of the anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA).The echocardiographic findings of 11 patients with ALCAPA confirmed by surgery in our hospital from October 2007 to December 2018 were retrospectively analyzed and compared with the preoperative computed tomography angiography (CTA) diagnosis and intraoperative diagnosis.Surgery was performed in all of the patients to establish the dual coronary artery system. Four underwent the Takeuchi procedure and 7 had re-implantation of the anomalous left coronary artery. The CTA diagnoses of the 11 patients were consistent with the surgical diagnoses, and the diagnostic accuracy was 100% (11/11). Echocardiographic diagnosis showed consistent results in 10 cases, while one case was misdiagnosed as endocardial fibroelastosis; the diagnostic accuracy was 90.9% (10/11). The echocardiographic features of these patients with ALCAPA included: abnormal left coronary ostium arising from the pulmonary trunk with retrograde coronary artery flow in 10 patients; enlargement of the right coronary artery in 8 patients; abundant intercoronary septal collaterals in 6 patients; and moderate and significant mitral regurgitation in 7 patients. Echocardiography showed that the left ventricular end-diastolic diameter and left ventricular end-systolic diameter before surgery were significantly different from those after surgery (P < .05) and that the left ventricular ejection fraction and fractional shortening before surgery were not significantly different from those after surgery (P > .05).Transthoracic echocardiography can diagnose ALCAPA in a timely, accurate, and noninvasive manner, and it could be of great significance in guiding clinical operations and in predicting prognosis. | [
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STUDY DESIGN: Retrospective review.BACKGROUND: Inferior facetectomies, with the utilization of segmental pedicle screw constructs for corrective fixation, can provide adequate flexibility and post less risk of neural tissue and blood loss. We analyzed outcomes of surgical treatment for adolescent idiopathic scoliosis (AIS) using inferior facetectomies and segmental pedicle screw constructs. We hypothesized that adequate main curve correction and suitable surgical outcomes would be observed using this technique.METHODS: We reviewed 38 AIS patients who underwent inferior facetectomies and segmental pedicle screw constructs by 2 surgeons at a single institution between May 2014 and December 2016. Coronal and sagittal radiographic measurements were evaluated over 1-year follow-up by 2 trained observers not associated with the surgeries. Surgical details, complications, and hospital length of stay (LOS) were also recorded.RESULTS: Mean fusion levels were 11.0 1.7. The mean Cobb angle of main AIS curves improved from 48.6 10.1 degree preoperatively to 11.8 6.2 degree postoperatively and 12.4 6.2 degree at 1-year follow-up, which percentage correction was 75.9% and 74.6%, respectively. The mean thoracic kyphosis (T5-12) angle was 20.7 11.6 degree preoperatively, 17.4 8.0 degree postoperatively, and 16.8 8.4 degree at 1-year follow-up. The mean surgical time, estimated blood loss, and LOS were 232.4 35.7 minutes, 475.0 169.6 mL, and 3.5 1.3 days. Twelve patients received blood transfusion. There were no neurological or wound complications.CONCLUSIONS: This case series demonstrated adequate correction of main AIS curves, acceptable thoracic kyphosis and blood loss, and short surgical time and LOS in AIS patients treated with inferior facetectomies and segmental pedicle screw constructs, potentially indicating that inferior facetectomies are adequate and suitable for AIS surgery when segmental pedicle screw constructs are utilized. | [
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] |
PURPOSE: Short implants are a minimally invasive alternative in the management of alveolar bone atrophy. This study aimed to assess the influence of the surgical approach (1-stage vs 2-stage) on the 15-year survival and marginal bone loss of short implants in a fixed complete denture.MATERIALS AND METHODS: A retrospective clinical study was conducted in a single private dental clinic that included short implants placed between January 2001 and December 2002.RESULTS: Forty-one short implants supported 18 screw-retained complete dentures. The mean follow-up time was 15 3 years. The surgical approach (1-stage vs 2-stage) did not significantly affect implant survival and marginal bone loss. The implant survival rate was 90.2%.CONCLUSIONS: Short dental implants could be predictably indicated to support fixed complete dentures. The implants could be placed through a 1- or 2-stage surgery. | [
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BACKGROUND: Gastric cancer is a common malignant tumor with high morbidity and mortality worldwide, which seriously affects human health. Gramicidin is a short peptide antibiotic which could be used for treating infection induced by bacteria or fungi. However, the anti-cancer effect of gramicidin on gastric cancer cells and its underlying mechanism remains largely unknown.RESULTS: Gastric cancer cells SGC-7901, BGC-823 and normal gastric mucosal cells GES-1 were treated with different concentrations of gramicidin respectively. The results of CCK-8 experiment revealed cellular toxicity of gramicidin to cancer cells while cell colony formation assay showed that gramicidin significantly inhibited the proliferation of gastric cancer cells, but had little effect on normal gastric mucosal cells. In addition, the wound healing assay showed that gramicidin inhibited the migration of SGC-7901 cell. Meanwhile, apoptosis and cell cycle analysis revealed that gramicidin induced cell apoptosis with G2/M cell cycle inhibition. Furthermore, western blot analysis demonstrated that gramicidin down-regulated the expression of cyclinD1 and Bcl-2 as well as the FoxO1 phosphorylation.CONCLUSIONS: The current study illustrated the anti-tumor activity of gramicidin on gastric cancer cells, providing a possibility for gramicidin to be applied in clinical practice for the treatment of gastric cancer. | [
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] |
OBJECTIVES: Simultaneous, radiation-free registration of the teeth and the upper and lower jaw positions in relation to the extraoral soft tissue could improve treatment planning and documentation. The purpose of this study is to describe a workflow to solve this form of registration and surface acquisition with a mobile device.METHODS: Facial scans of ten healthy participants were taken using a blue-light LED 3D scanner (Artec Space Spider; Artec Group; Luxembourg). An impression of the maxillary dentoalveolar arch was taken simultaneously to the 3D photo using a modified impression tray with two different extraoral registration geometries (sphere vs. cross). Following, an impression of the mandibular dentoalveolar arch was taken once. Both impressions were scanned with the 3D scanner. All resulting standard tesselation language (.stl) files of the geometries were compared to the original, virtual .stl files and the root mean square errors (RMSE) were calculated for each surface (Artec Studio 13 Professional ? 64; Artec Group; Luxembourg) to determine which geometry serves as a better reference for intra-extraoral registration.RESULTS: The RMSE between the original geometries and the scanned counterfeits were statistically lower for spherical geometries (p < 0.008). Once scanned and aligned, both geometries enabled an alignment of the intra- and extraoral scan. However, the spherical geometries showed virtually better results without significance (p = 0.70).CONCLUSIONS: The presented study provides a radiation-free solution for simultaneous dentoalveolar correlations in relation to the extraoral soft tissue. Spherical geometries achieved more precise and easier intra-extraoral alignments using the applied mobile 3D scanner and workflow. | [
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On May 12, 2017, the WannaCry ransomware bug struck. The cyberattack infected more than 300,000 computer systems in 150 countries, including several U.K. National Health Service facilities. 1 The ransomware affected unpatched Windows systems, encrypting data and demanding payment to release it. A patch was available, and if it had been applied to these systems, they would not have been affected. | [
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Lubricious polymer coatings are increasingly used on intravascular devices to facilitate easier access and navigation through tortuous blood vessels. Recent reports highlight the separation and downstream embolism of polymer particles affecting the vasculature and various organs. The Food and Drug Administration (FDA) acknowledges polymer coating embolism as an iatrogenic complication of intravascular devices and continues to close gaps in standards related to coating integrity. The Association for the Advancement of Medical Instrumentation established particulate testing as an industry standard for evaluating coating integrity of intravascular devices. The FDA recognizes this standard; however, challenges exist in setting particulate limits that may compromise device function without sufficient clinical data. The microscopic nature of polymer emboli not visible with available imaging modalities has impacted reporting. This has also resulted in a reduced number of manufacturer-driven product development projects related to coating integrity. On the other hand, recent procedural trends have supported the innovation of coated devices with expanded indications, requiring particulate evaluations and release limits. This article proposes a methodology to set particulate limits for intravascular devices given existing clinical, regulatory, and manufacturing challenges. The approach with standardization requirements enables characterization, comparison, and evaluation of lubricious coatings from various manufacturers. It incorporates a step-by-step procedure that adds scrutiny to the application of coatings while ensuring device function is not impacted. Together with particulate assessments, clinicopathologic and animal studies permit an understanding of particulate ranges from commercially available devices and setting of particulate limits for new device evaluations. | [
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] |
Cyclin-dependent kinase 2 (CDK2) is the family of Ser/Thr protein kinases that has emerged as a highly selective with low toxic cancer therapy target. A multistage virtual screening method combined by SVM, protein-ligand interaction fingerprints (PLIF) pharmacophore and docking was utilised for screening the CDK2 inhibitors. The evaluation of the validation set indicated that this method can be used to screen large chemical databases because it has a high hit-rate and enrichment factor (80.1% and 332.83 respectively). Six compounds were screened out from NCI, Enamine and Pubchem database. After molecular dynamics and binding free energy calculation, two compounds had great potential as novel CDK2 inhibitors and they also showed selective inhibition against CDK2 in the kinase activity assay. | [
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Pursuing the widespread interest on multi-target drugs to combat Alzheimer?s disease (AD), a new series of hybrids was designed and developed based on the repositioning of the well-known acetylcholinesterase (AChE) inhibitor, tacrine (TAC), by its coupling to benzofuran (BF) derivatives. The BF framework aims to endow the conjugate molecules with ability for inhibition of AChE (bimodal way) and of amyloid-beta peptide aggregation, besides providing metal (Fe, Cu) chelating ability and concomitant extra anti-oxidant activity, for the hybrids with hydroxyl substitution. The new TAC-BF conjugates showed very good activity for AChE inhibition (sub-micromolar range) and good capacity for the inhibition of self- and Cu-mediated A aggregation, with dependence on the linker size and substituent groups of each main moiety. Neuroprotective effects were also found for the compounds through viability assays of neuroblastoma cells, after A1-42 induced toxicity. Structure-activity relationship analysis provides insights on the best structural parameters, to take in consideration for future studies in view of potential applications in AD therapy. | [
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The solid-state photochemically induced dynamic nuclear polarization (photo-CIDNP) effect has been studied in a quinone-depleted uniformly (u-)13C,15N-labeled photosynthetic reaction center (RC) protein from purple bacterium Rhodobacter (R.) sphaeroides wild type (WT). As a method for investigation, solid-state 15N NMR under magic-angle spinning (MAS) is applied under both continuous illumination (steady state) and nanosecond-laser flashes (time-resolved). While all previous 15N photo-CIDNP MAS NMR studies on the purple bacterial RC used the carotenoid-less mutant R26, this is the first using WT samples. The absence of further photo-CIDNP mechanisms (compared to R26) and various couplings (compared to 13C NMR experiments on 13C-labeled samples) allows the simplification of the spin-system. We report 15N signals of the three cofactors forming the spin-correlated radical pair (SCRP) and, based on density-functional theory calculations, their assignment. The simulation of photo-CIDNP intensities and time-resolved 15N photo-CIDNP MAS NMR data matches well to the frame of the mechanistic interpretation. Three spin-chemical processes, namely, radical pair mechanism, three spin mixing, and differential decay, generate emissive (negative) 15N polarization in the singlet decay channel and absorptive (positive) polarization in the triplet decay channel of the SCRP. The absorptive 15N polarization of the triplet decay channel is transiently obscured during the lifetime of the triplet state of the carotenoid (3Car); therefore, the observed 15N signals are strongly emissive. Upon decay of 3Car, the transiently obscured polarization becomes visible by reducing the excess of emissive polarization. After the decline of 3Car, the remaining nuclear hyperpolarization decays with nuclear T1 relaxation kinetics. | [
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Here, we investigate the unfolding behavior of a streptomycin-binding ribonucleic acid (RNA) aptamer under application of force in shear geometry. Using Langevin out-of-equilibrium simulations to emulate the single-molecule force spectroscopy (SMFS) experiment, we were able to understand the hierarchical unfolding process that occurs in the RNA molecule under application of stretching force and the influence of streptomycin modifying this unfolding. Subsequently, the application of the Jarzynski equality to the force profiles obtained in the pulling simulations shows that the free energies for individual systems and the difference of unfolding free energy upon streptomycin binding to the RNA free aptamer are in fair agreement with the experimental values, obtained through SMFS by Nick et al. [J. Phys. Chem. B 120, 6479 (2016)]. | [
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Osteoclasts are multinucleated, giant cells originating from myeloid hematopoetic stem cells. These are the only cells in nature which can resorb bone. Differentiation of mononucleated osteoclast progenitor cells requires stimulation with M-CSF (macrophage colony-stimulating factor) for the cells to proliferate and survive and with RANKL (receptor activator of nuclear factor kappa B ligand) for differentiation along the osteoclastic lineage to cells which eventually fuse to the mature, multinucleated osteoclasts. Therefore, most hormones and cytokines stimulating osteoclastogenesis do so indirectly by regulating the expression in osteoblasts of RANKL and its inhibitory decoy receptor OPG. Antibodies neutralizing RANKL is a common therapy to inhibit excessive osteoclast formation in diseases such as osteoporosis and malignant tumors with skeletal metastasis. Mature osteoclasts resorb bone by stimulating acid release into the resorption lacunae, followed by proteolytic degradation of bone matrix proteins. Loss-of-function mutations of proteins involved in acidification and proteolysis cause osteopetrosis, a disease with sclerotic bone due to non-functional osteoclasts. Osteoclasts are important for a healthy skeleton by removing damaged bone during remodeling of the skeleton, but are also important for modeling of bone, calcium homeostasis and tooth eruption, and possibly also for glucose and fat metabolism. Loss of bone in inflammatory disease, metastasizing tumors and osteoporosis is due to increased RANKL expression and enhanced osteoclast formation. The present overview aims to summarize how osteoclasts are formed and resorb bone in health and disease. | [
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Endogenous Cushing syndrome (CS) is a rare entity in the pediatric population. Patients usually present with height deceleration and continuous weight gain, along with other classic stigmata of CS, such as acne, striae, hirsutism and others. The diagnosis of CS involves documentation of abnormal cortisol secretion with measurement of urinary free cortisol and midnight serum or salivary cortisol, and the use of the 1mg dexamethasone suppression test. After confirmation of CS, localization of the source of hypercortisolemia, involves differentiation of ACTH-dependent versus ACTH-independent causes of CS. Surgical resection of the identified source of CS is the preferred method of treatment whenever possible. | [
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OBJECTIVES: We analyzed primary school performance of girls with Turner syndrome (TS) in two distinct countries to ascertain if the cognitive phenotype of TS causes selective learning difficulties.METHODS: The cohort comprised of 44 Czech and 50 Egyptian girls with TS who attended public schools. School reports from grades 1 to 9 were obtained retrospectively from Czech participants with TS. Only recent school reports were obtained from Egyptian participants. Two controls per participant were requested - biological sisters and/or female classmates. The results were converted into a 5-point scale (1-excellent; 5-unsatisfactory).RESULTS: Analysis of longitudinal Czech data displayed a strong time component in both subjects and controls. Showing better points in lower grades with its gradual worsening as the education complexity increased. In contrast, there was a strong statistically significant difference between groups in Mathematics (p=0.0041, p=0.0205 after Bonferroni correction) and this difference increased over time. The points for Mathematics did not differ in grades 1+2 (0.05 difference in mean grade between the two groups), however, they differed by 0.28 in grades 6+7 and by 0.32 in grades 8+9. While slightly different in character (cross-sectional vs. longitudinal), the Egyptian cohort data confirmed our findings, showing no difference in general school performance but having similar trends in Mathematics (grades 1+2: 0.11, grades 6+7: 0.54, grades 8+9: 0.68; p=0.0058, p=0.029 after Bonferroni correction).CONCLUSION: Excluding results in Mathematics, which showed pronounced worsening in relation to age in comparison with unaffected controls, girls with TS performed similarly to their controls. | [
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Species invasions are a major driver of ecological change, are very difficult to control or reverse, and will increase with climate change and global trade. Invasion sciences consider how species in invaded environments adapt, but neither scientists nor policy makers consider human adaptation to invasive species and how this affects ecosystems and well-being. To address this, a framework conceptualising autochthonous human adaptation to invasions was developed based on the Human Adaptation to Biodiversity Change framework and a case study metasynthesis. Results show that adaptation occurs within different spheres of human activity and organisation at different social-ecological scales; responses have feedbacks within and across these spheres. Adaptation to invasives and other drivers is a set of highly contextual, complex, non-linear responses that make up pathways pursued over time. Most invasive species management and adaptation occurs 'from below,' and policies and planned control efforts should support autochthonous adaptation, rather than undermining it. | [
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Introduction: According to the Hungarian law, placental examination is not mandatory, although it is known from the international practice that it can give valuable information in cases of stillbirth or in conditions, where the neonate has difficulty in the postnatal adaptation. Aim: It can be useful in the early detection of diseases, which otherwise would have gone undetected until late in life. This article is unique in Hungary, as no similar guideline exists in Hungarian language. Method: The recommendation of the Royal College of Pathologists (United Kingdom) determines those conditions where essential information can be obtained from the placental examination in not normal pregnancies. It serves as a useful guide in the medical practice. The journal titled "Placenta", first published in 1980 with impact factor above two, just underlines this statement. Results: In this article, the authors present the recent guideline of the RCPath and finish with the presentation of established clinicopathological association that might help clinicians to get the most valuable information from placental examination. Conclusion: The present article aims to summarise updated recommendations and present clinicopathological correlations. Orv Hetil. 2019; 160(48): 1894-1903. | [
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Introduction: M?ni?re's disease (MD) is a disorder that affects the inner ear, characterized by vertigo, tinnitus, hearing loss and vegetative symptoms. One of the main points of the management of the patients is the analysis of the vertigo diaries. Aim: To identify the typical characteristics of the symptoms and to highlight the importance of multidisciplinary approach. Material and method: 58 (12 male and 46 females, mean age 56.97 10.45 SD) definite MD patients were enrolled in this investigation. The vertigo diaries filled out by the patients were analysed. The statistical analysis was performed using IBM SPSS V24 software. Since the parameters did not show normal distribution, non parametric test (Mann-Whitney U test) was used. Results: Based on the diaries, the most tormenting symptom is vertigo (mean power: 5.38 2.06 SD), the second one is tinnitus (4.54 2.81 SD), and last one is headache (2.77 3.1 SD). Despite the frequent prevalence of associated headache, vestibular migraine could be ruled out in all of the cases. Another important outcome was that the attacks associated with headache were significantly stronger (p = 0.001). In the case of the vegetative symptoms, the association was even much stronger (p<0.01). According to the narrative analysis, the most frequent provocation factors of the attacks were the cold front and stress. Conclusion: Along with the treatment of vertigo, the management of the associated symptoms (headache, vegetative symptoms) is also of great importance. Monitoring the quality of life and psychiatric disorders suggests the importance of multidisciplinary approach. Orv Hetil. 2019; 160(48): 1915-1920. | [
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Introduction: The attitude to immunization and the issue of vaccine hesitancy in health care workers (HCWs) have been studied in a former survey performed by ECDC (European Centre for Disease Prevention and Control). Aim: Our aim was to study the immunization attitude of primary care paediatricians, general practitioners and primary care nurses in Hungary. Method: We studied vaccine hesitancy in HCWs by way of a questionnaire, developed on the basis of a recent similar survey by ECDC in four countries. The online survey has been performed between May and July 2017. Altogether 765 questionnaires have been returned: 189 primary care paediatricians, 375 general practitioners working in adult or mixed practices, and 201 primary care nurses. The sample has been weighted to the country-specific features - e.g., location of the practice, residence and age of the HCWs - within each of the three groups, so from this aspect it can be considered representative. Results: Our results did not differ substantially from the international ECDC data. Approximately 2/3 of the primary care doctors and about 50% of the primary care nurses were convinced of the benefit and value of vaccines. Data on vaccine hesitancy were consolingly low, though the data on recommended vaccines were somewhat higher compared to the age related/NIP (National Immunization Plan) vaccines. The well-known vaccine scares - e.g., autism-MMR, etc., known also from the literature - could hardly been detected, and it can be explained by the voluntary participation in the study. The least supported vaccine is BCG, while the highest hesitancy rates are related to MMR in Hungary. Conclusion: The need to improve immunization-related communication among primary HCWs could clearly been detected - both in gradual and in post-gradual training programs. Orv Hetil. 2019; 160(48): 1904-1914. | [
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] |
Objective: The development of these guidelines is sponsored by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPG). Methods: Recommendations are based on diligent reviews of clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols. Results: The Executive Summary of this 2019 updated guideline contains 58 numbered recommendations: 12 are Grade A (21%), 19 are Grade B (33%), 21 are Grade C (36%), and 6 are Grade D (10%). These detailed, evidence-based recommendations allow for nuance-based clinical decision-making that addresses multiple aspects of real-world care of patients. The evidence base presented in the subsequent Appendix provides relevant supporting information for the Executive Summary recommendations. This update contains 357 citations of which 51 (14%) are evidence level (EL) 1 (strong), 168 (47%) are EL 2 (intermediate), 61 (17%) are EL 3 (weak), and 77 (22%) are EL 4 (no clinical evidence). Conclusion: This CPG is a practical tool that practicing endocrinologists and regulatory bodies can refer to regarding the identification, diagnosis, and treatment of adults and patients transitioning from pediatric to adult-care services with growth hormone deficiency (GHD). It provides guidelines on assessment, screening, diagnostic testing, and treatment recommendations for a range of individuals with various causes of adult GHD. The recommendations emphasize the importance of considering testing patients with a reasonable level of clinical suspicion of GHD using appropriate growth hormone (GH) cut-points for various GH-stimulation tests to accurately diagnose adult GHD, and to exercise caution interpreting serum GH and insulin-like growth factor-1 (IGF-1) levels, as various GH and IGF-1 assays are used to support treatment decisions. The intention to treat often requires sound clinical judgment and careful assessment of the benefits and risks specific to each individual patient. Unapproved uses of GH, long-term safety, and the current status of long-acting GH preparations are also discussed in this document. LAY ABSTRACT This updated guideline provides evidence-based recommendations regarding the identification, screening, assessment, diagnosis, and treatment for a range of individuals with various causes of adult growth-hormone deficiency (GHD) and patients with childhood-onset GHD transitioning to adult care. The update summarizes the most current knowledge about the accuracy of available GH-stimulation tests, safety of recombinant human GH (rhGH) replacement, unapproved uses of rhGH related to sports and aging, and new developments such as long-acting GH preparations that use a variety of technologies to prolong GH action. Recommendations offer a framework for physicians to manage patients with GHD effectively during transition to adult care and adulthood. Establishing a correct diagnosis is essential before consideration of replacement therapy with rhGH. Since the diagnosis of GHD in adults can be challenging, GH-stimulation tests are recommended based on individual patient circumstances and use of appropriate GH cut-points. Available GH-stimulation tests are discussed regarding variability, accuracy, reproducibility, safety, and contraindications, among other factors. The regimen for starting and maintaining rhGH treatment now uses individualized dose adjustments, which has improved effectiveness and reduced reported side effects, dependent on age, gender, body mass index, and various other individual characteristics. With careful dosing of rhGH replacement, many features of adult GHD are reversible and side effects of therapy can be minimized. Scientific studies have consistently shown rhGH therapy to be beneficial for adults with GHD, including improvements in body composition and quality of life, and have demonstrated the safety of short- and long-term rhGH replacement. Abbreviations: AACE = American Association of Clinical Endocrinologists; ACE = American College of Endocrinology; AHSG = alpha-2-HS-glycoprotein; AO-GHD = adult-onset growth hormone deficiency; ARG = arginine; BEL = best evidence level; BMD = bone mineral density; BMI = body mass index; CI = confidence interval; CO-GHD = childhood-onset growth hormone deficiency; CPG = clinical practice guideline; CRP = C-reactive protein; DM = diabetes mellitus; DXA = dual-energy X-ray absorptiometry; EL = evidence level; FDA = Food and Drug Administration; FD-GST = fixed-dose glucagon stimulation test; GeNeSIS = Genetics and Neuroendocrinology of Short Stature International Study; GH = growth hormone; GHD = growth hormone deficiency; GHRH = growth hormone-releasing hormone; GST = glucagon stimulation test; HDL = high-density lipoprotein; HypoCCS = Hypopituitary Control and Complications Study; IGF-1 = insulin-like growth factor-1; IGFBP = insulin-like growth factor-binding protein; IGHD = isolated growth hormone deficiency; ITT = insulin tolerance test; KIMS = Kabi International Metabolic Surveillance; LAGH = long-acting growth hormone; LDL = low-density lipoprotein; LIF = leukemia inhibitory factor; MPHD = multiple pituitary hormone deficiencies; MRI = magnetic resonance imaging; P-III-NP = procollagen type-III amino-terminal pro-peptide; PHD = pituitary hormone deficiencies; QoL = quality of life; rhGH = recombinant human growth hormone; ROC = receiver operating characteristic; RR = relative risk; SAH = subarachnoid hemorrhage; SDS = standard deviation score; SIR = standardized incidence ratio; SN = secondary neoplasms; T3 = triiodothyronine; TBI = traumatic brain injury; VDBP = vitamin D-binding protein; WADA = World Anti-Doping Agency; WB-GST = weight-based glucagon stimulation test. | [
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Development of therapeutic preparations involves several steps, starting with the synthesis of chemical compounds and testing them in different models for selecting the most effective and safest ones to clinical trials and introduction into medical practice. Cultured animal cells (both primary and transformed) are commonly used as models for compound screening. However, cell models display a number of disadvantages, including insufficient standardization (primary cells) and disruption of cell genotypes (transformed cells). Generation of human induced pluripotent stem cells (IPSCs) offers new possibilities for the development of high-throughput test systems for screening potential therapeutic preparations with different activity spectra. Due to the capacity to differentiate into all cell types of an adult organism, IPSCs are a unique model that allows examining the activity and potential toxicity of tested compounds during the entire differentiation process in vitro. In this work, we demonstrated the efficiency of IPSCs and their neuronal derivatives for selecting substances with the neuroprotective activity using two classes of compounds - melanocortin family peptides and endocannabinoids. None of the tested compounds displayed cyto- or embryotoxicity. Both melanocortin peptides and endocannabinoids exerted neuroprotective effect in the neuronal precursors and IPSC-derived neurons subjected to hydrogen peroxide. The endocannabinoid N-docosahexaenoyl dopamine exhibited the highest neuroprotective effect (~70%) in the differentiated cultures enriched with dopaminergic neurons; the effect of melanocortin Semax was ~40%. The possibility of using other IPSC derivatives for selecting compounds with the neuroprotective activity is discussed. | [
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Genomes of photoautotrophic organisms containing type I photosynthetic reaction center were searched for the rnf genes encoding Na+-translocating ferredoxin:NAD+ oxidoreductase (RNF). These genes were absent in heliobacteria, cyanobacteria, algae, and plants; however, genomes of many green sulfur bacteria (especially marine ones) were found to contain the full rnf operon. Analysis of RNA isolated from the marine green sulfur bacterium Chlorobium phaeovibrioides revealed a high level of rnf expression. It was found that the activity of Na+-dependent flavodoxin:NAD+ oxidoreductase detected in the membrane fraction of Chl. phaeovibrioides was absent in the membrane fraction of the freshwater green sulfur bacterium Chlorobaculum limnaeum, which is closely related to Chl. phaeovibrioides but whose genome lacks the rnf genes. Illumination of the membrane fraction of Chl. phaeovibrioides but not of Cba. limnaeum resulted in the light-induced NAD+ reduction. Based on the obtained data, we concluded that in some green sulfur bacteria, RNF may be involved in the NADH formation that should increase the efficiency of light energy conservation in these microorganisms and can serve as the first example of the use of Na+ energetics in photosynthetic electron transport chains. | [
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A large body of evidence suggests that cancer stem cells (CSCs) and epithelial-mesenchymal transition (EMT), as well as expression and function of retinoid receptors, are pivotal features of tumor initiation, progression, and chemoresistance. This is also true for pancreatic ductal adenocarcinoma (PDAC), which represents a clinical challenge due to poor prognosis and increasing incidence. Understanding the above features of cancer cells could open new avenues for PDAC treatment strategies. The aim of this study was to investigate the relation between CSCs, EMT, and retinoid receptors in PDAC after treatment with the chemotherapeutic agents - gemcitabine and 5-fluorouracil. First, we demonstrated the difference in the expression levels of CSC and EMT markers and retinoid receptors in the untreated Mia PaCa-2 and Panc1 cells that also differed in the frequency of spontaneous apoptosis and distribution between the cell cycle phases. Chemotherapy reduced the number of cancer cells in the S phase. Gemcitabine and 5-fluorouracil modulated expression of CSC markers, E-cadherin, and RXR in Panc1 but not in Mia PaCa-2 cells. We suggest that these effects could be attributed to the difference in the basal levels of expression of the investigated genes. The obtained data could be interesting in the context of future preclinical research. | [
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] |
OBJECTIVES: To assess the perceived facial changes in class II division 1, convex profile patients treated with functional followed by fixed orthodontic appliances.SUBJECTS AND METHODS: The study sample consisted of 36 pairs of pre- and post-treatment photographs (frontal and profile, at rest) of 12 patients treated with activator, 12 with twin-block, and 12 controls with normal profiles, treated without functional appliances. All photographs were presented in pairs to 10 orthodontists, 10 patients, 10 parents, and 10 laypersons. Visual analog scale(VAS) ratings of changes in facial appearance were assessed.RESULTS: The patient groups were similar in sex distributions, age, and treatment duration. The different rater groups showed strong to excellent agreement. There were no significant differences among treatment groups (F = 0.91; P = 0.526; Wilks lambda = 0.93), raters (F = 1.68; P = 0.054; Wilks lambda = 0.83), and when testing the combined effect of treatment and rater on the results (F = 0.72; P = 0.866; Wilks lambda = 0.85). The raters detected slightly more positive changes in the activator and twin-block groups, compared to the control group, regarding the lower face and the lips, but these findings did not reach significance. Furthermore, their magnitude hardly exceeded 1/20th of the total VAS length.LIMITATIONS: Retrospective study design.CONCLUSIONS: The perceived facial changes of convex profile patients treated with functional, followed by fixed orthodontic appliances, did not differ from those observed in normal profile patients, when full-face frontal and profile photos were simultaneously assessed. Consequently, professionals should be skeptical regarding the improvement of a patient's facial appearance when this treatment option is used. | [
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] |
OBJECTIVE: To establish a way for screening Mycobacterium mutants through adding the screening markers into pJV53.METHODS: The sucrose counter selection gene SacB and mutant hygromycin-resistant gene hygS were inserted into pJV53; The recovery of the hygromycin-resistance indicated the successful homologous recombination in Mycobacterium smegmatis (Ms), which could serve as mutant screening marker; The sucrose counter selection could be used to screen the plasmid-free mutants.RESULTS: The recombinant plasmid pJV53-SacB-hygS were successfully constructed. The rifampin-resistant rpoB D516Y and rpoB H526Q mutants and MSMEG_4487 G188A mutant were efficiently screened out. All mutants had shed the plasmid successfully.CONCLUSION: pJV53-SacB-hygS can efficiently contribute to construct and screen the mutants and to get the mutants shedding the plasmid self, which has high value of extensive application; the D516Y and H526Q mutations in gene rpoB of Mycobacterium tuberculosis contribute to its rifampin-resistance. | [
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] |
OBJECTIVE: To investigate the mitochondrial translocation of hypoxia inducible factor-3 (HIF-3) under normoxia and hypoxia and its physiological and pathological meanings.METHODS: ? After hypoxic (1%O2) or DMOG, CoCl2 treatments mimicking the hypoxic treatment, Western blot and immunofluorescence were used to examine the HIF-3 expression in mitochondria of HeLa and ACHN cells, respectively. ?The protease sensitivity experiment was used to explore the sub-organelle localization of HIF-3 in mitochondria. ?Western blot was used to examine mitochondrial HIF-3 in the normal mouse tissues and human liver carcinoma tissues.RESULTS: ? In HeLa and ACHN cells, HIF-3 translocated to mitochondria under normoxia and hypoxia, and its mitochondrial expression was higher under hypoxia; ?The protease sensitivity of HIF-3 was similar to proteins locating in the mitochondrial outer membrane; ?Mitochondrial HIF-3 expressed in multiple normal mouse tissues; The expression of mitochondrial HIF-3 was higher in human liver carcinoma tissues than the normal and adjacent tissues.CONCLUSIONS: HIF-3 translocated to mitochondrial outer membrane under both normoxia and hypoxia, and hypoxia could up-regulated HIF-3 mitochondrial translocation. Meanwhile, the phenomenon may be involved in the process of liver carcinoma. | [
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] |
OBJECTIVE: To study the regulation role and mechanism of protein acetylation on the expression of glioblastoma-derived neurotrophic factor (GDNF) in human glioma.METHODS: Six normal brain tissue samples, six low-grade glioma brain tissue (LG-glioma), and six high-grade glioma brain tissue (HG-glioma) were collected for study. Human glioma U251 cells were treated with histone acetylase inhibitor and histone deacetylase inhibition. The mRNA level of GDNF in glioma and normal controls was detected by Real-time PCR. H3K9 acetylation level of cAMP-response element binding protein (CREB) binding region on GDNF promoter and the ability of CREB combining to GDNF promoter were detected by ChIP-PCR. The effects of histone acetylase and deacetylase inhibitors on transcription factor binding ability and GDNF expression were detected.RESULTS: The mRNA level of GDNF in HG-glioma was significantly higher than those in normal brain tissue and LG-glioma (P < 0.01). The H3K9 acetylation level of GDNF promoter region in the glioma was increased compared to that in the normal brain tissue (P < 0.01), and the acetylation level in CREB-binding region on the GDNF promoter was higher than that in the non-CREB-binding region (P < 0.01). The binding activity of CREB and GDNF promoter in HG-glioma was higher than those in normal brain tissue and LG-glioma (P < 0.05). After treatment of U251 cells with histone acetyltransferase inhibition, the level of acetylation in CREB-binding region on GDNF promoter, the binding activity of CREB and GDNF promoter was decreased, and GDNF transcription and expression were down-regulated, while histone deacetylase inhibitors had the opposite effect (P < 0.01).CONCLUSION: Histone acetylation promotes the transcription expression of GDNF in glioma by promoting the binding of transcription factor CREB to the promoter region of GDNF gene. | [
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OBJECTIVE: To investigate the molecular mechanism of apoptosis of HL60 cells induced by oncolytic virus Reovirus type 3 (Reo3).METHODS: HL60 cells were infected with Reo3 at different multiplicity of infection (MOI) with the uninfected HL60 cells as control group. After 48 h of infection, the activity of HL60 cells infected with virus at different MOI was detected by CCK8 method to investigate the influence of MOI to cell activity. Simultaneously, the apoptotic rate of HL60 cells was detected by flow cytometry, and the activation level of double-stranded RNA-dependent protein kinase (PKR) and the expression of apoptotic-related protein in HL60 cells were detected by Western blot. Before infection with Reo3 for 48 h, HL60 cells were treated with 2-aminopurine (2-AP), a specific inhibitor of PKR, for 24 h. Afterward, the apoptotic level and expression of apoptotic related proteins were detected.RESULTS: Activity of HL60 cells was obviously inhibited after infected with Reo3 with a MOI of 1 for 48 h. The cell survival rate was (24.3333.396)% and the apoptotic rate was (29.962.06)%. Both rates were all higher than those in the control group (P < 0.05). Western blot results showed that the expression levels of PKR, p-PKR, Bax, Caspase3 and cleaved Caspase3 in HL60 cells infected with Reo3 were higher than those in the control group (P < 0.05), while the expression level of Bcl-2 was lower (P < 0.05). Compared with the group without inhibitor, the apoptotic rate of HL60 cells pretreated with 2-AP decreased (P < 0.05), the phosphorylation level of PKR and the expression level of apoptotic-related protein also decreased (P < 0.05).CONCLUSION: Oncolytic virus Reo3 could activate PKR in HL60 cells and thus induce apoptosis of HL60 cells. | [
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] |
OBJECTIVE: To investigate the expression of -catenin in the skin lesions of patients with systemic scleroderma (SSc) and its effect on epithelial-mesenchymal transition (EMT) of human epidermal keratinocytes.METHODS: The expression of -catenin, Snail1 and E-cadherin in the skin lesions sample of 45 SSc patients and normal skin sample from 20 healthy adults was detected with SP immunohistochemistry. HaCaT, the human epidermal keratinocytes, were treated with different concentrations of Wnt10b (0 ng/mL (control), 2 ng/mL and 4 ng/mL) for 48 h. then detected the localization of -catenin in HaCaT cells by immunofluorescence assay, determined the mRNA levels of Snail1 and Snail2 in HaCaT cells by real-time fluorescent quantitative PCR, detected the proteins expression of -catenin, Vimentin, N-cadherin and E-cadherin in HaCaT cells by Western blot.RESULTS: The positive rates of -catenin, Snail1 and E-cadherin in skin lesions of SSc patients were 100%, 88.89% and 2.22% respectively, while in healthy adult skin, the corresponding positive rates were 0%, 10.00%, and 95.00%. The difference between the two groups was significant. Compared with control group, treatment with different concentrations of Wnt10b (2 ng/mL and 4 ng/mL) induced up-regulation of -catenin expression and promoted translocation of -catenin from cytoplasm to nucleus, increased the mRNA levels of Snail1 and Snail2 (P < 0.05), and up-regulated the proteins expression of Vimentin, N-cadherin, down-regulated the E-cadherin protein expression in HaCaT cells (P < 0.05).CONCLUSIONS: Abnormally activated Wnt/-catenin signaling pathway and abnormally expressed EMT-related proteins are observed in SSc lesions. Activation of Wnt/-catenin signaling pathway may promote EMT in HaCaT cells. | [
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OBJECTIVE: To investigate the ability of osteogenic differentiation and the expression of histone demethylases KDM6B in bone marrow mesenchymal stem cells (BMSCs) in diabetic environment.METHODS: Diabetic model rats was successfully established, and BMSCs from diabetic model rats and normal rats were isolated and cultured for further study. When cultured cells, we added high concentration of glucose and advanced glycosylation products (AGE) in the medium to imitating the diabetic environment. BMSCs were divided into 6 groups: diabetes group (derived from diabets SD rats), normal group (derived from normal SD rats), high glucose group (30 mmol/L D-glucose), normal glucose group (5.5 mmol/L D-glucose), AGE group (AGE 300 g/mL) and BSA group (BSA 300 g/mL). BMSCs in diabetes group were derived from diabetes SD rats, while others were derived from normal SD rats. After 7 d of osteogenic induction, the cells were examined the ability of osteogenic differentiation by alkaline phosphatase (ALP) staining, the transcription levels of Runt-related transcription factor 2 (Runx2) and KDM6B were determined by RT-PCR, and the expression levels of H3K27Me3 protein were examined by Western bolt.RESULTS: Compared with the control groups, the numbers of ALP stained cells and the mRNA levels of Runx2 and KDM6B in diabetes group, high glucose group and AGE group were all decreased (P < 0.05), while H3K27Me3 protein expression levels were all increased (P < 0.05).CONCLUSION: The ability of osteogenic differentiation of BMSCs in diabetic environment was weakened, and the expression of Runx2 mRNA was inhibited, which may be related to the increased expression of H3K27Me3 after the inhibition of KDM6B expression. | [
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] |
OBJECTIVE: To explore the dynamic changes of human papillomavirus (HPV) type 16 E5 gene in the development of cervical cancer and the significance of E5 mRNA in early screening of cervical cancer.METHODS: Paraffin specimens of cervical lesions were collected from 49 cases (HPV positive) during September 2015 to December 2017 According to the standard of FIGO, all cervical lesions were diagnosed as: 13 cases of cervicitis, cervical intraepithelial neoplasia disorders (CIN) ? in 5 cases, CIN ? in 18 cases, CIN ? in 5 cases, 8 cases of cervical cancer. Real-time fluorescence quantitative PCR was used to detect the integrity of E5 gene and the mRNA expression levels of E5, E6 and E 7in cervical tissues.RESULTS: All the 49 cases showed positive HPV16 infection. E5 genetic integrity in CIN?was higher than that in cervical inflammation, CIN ?and cervical cancer (P < 0.05), which was also higher than that in CIN ?, but without statistically significance (P>0.05). The mRNA levels of E5, E6, E7 were the highest in CIN ?. Compared with E6 and E7, E5 presented superior expression in all types of cervical lesions (P < 0.05), while E 6and E7 mRNA expressions only increased in CIN ? and cervical cancer.CONCLUSION: In the patients with HPV16 infection, the integrity of E5 gene in cervical tissues may be related to the occurrence and development of cervical diseases. E5 gene is expected to be the target gene for early screening of cervical cancer. | [
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OBJECTIVE: To determine the impact olanzapine (OLA) on the hippocampal neuron of model rats with depression.METHODS: Rats were divided into five groups: control, chronic unpredicted stress (CUS), OAL (0.5, 1, 2 mg/kg), si-Atg5, and OAL (2 mg/kg)+si-Atg5. Open field and sucrose preference tests were performed to evaluate rat behaviors. Cell apoptosis was detected with Tunnel. The concentrations of interleukin (IL)-1 and IL-18 were determined by ELISA. The expressions of cleaved Caspase-3, cleaved Caspase-9, LC3, Beclin1, P62, NLRP3 and cleaved Caspase-1 were measured by Western blot.RESULTS: OAL (0.5, 1, 2 mg/kg) increased the total moving distance, sucrose consumption and preference rate of CUS rats, and decreased serum IL-18, cell apoptosis and the expressions of cleaved Caspase-9, cleaved Caspase-1 and NLRP3 in the CA3 region of hippocampus. Although OAL (1, 2 mg/kg) decreased the expression of cleaved Caspase-3 and serum IL-1, OAL (0.5 mg/kg) showed no detectable effects. Si-Atg5 decreased the total moving distance, sucrose consumption and preference rate of CUS rats, enhanced the expressions of cleaved Caspase-3, cleaved Caspase-9, cleaved Caspase-1 and NLRP3, and weakened the effect of OAL (2 mg/kg). OAL (0.5, 1, 2 mg/kg) also increased the LC3?/LC3? ratio and the expression of Beclin1 in the CA3 region of hippocampus. OAL (1, 2 mg/kg) reduced the expression of p62, but not when it was reduced to 0.5 mg/kg. Si-Atg5 reduced the LC3?/LC3? ratio and the expression of Beclin1, and weakened the function of OAL (2 mg/kg).CONCLUSION: OAL can protect the hippocampal neuron of CUS rats via inhibiting NLRP3 inflammasome activation. | [
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] |
OBJECTIVE: To test the effects of Guben Zenggu Decoction on bone metabolism and bone microstructure in ovariectomized rats for the purpose of preventing and treating postmenopausal osteoporosis.METHODS: Osteoporosis rat models were established by ovariectomy. The model rats were randomly divided into control, estradiol valerate treatment, and Guben Zenggu Decoction treatment groups with high, medium and low dosages. After 12 weeks of treatments, 10 rats from each group were randomly selected for cardiac blood sampling after abdominal anesthesia. The serum levels of estradiol (E2), osteocalcin (BGP), carboxyterminal of type ? procollagen (PICP), collagen type ? pyridine crosslinking peptide (ICTP) and acid tartaric acid phosphatase-5b (TRAP-5b) were determined by ELISA. Bone histomorphometric analysis was performed on the right femoral specimen of rats using micro-CT imaging.RESULTS: The models rats had lower levels of E2, bone alkaline phosphatase (BALP) and relative bone volume fraction (BV/TV), trabecular thickness (Tb.Th), number of trabeculae (Tb.N) and connectivity density (Conn.D), and higher levels of BGP, ICTP, PICP, TRAP-5b and degree of trabecular separation (Tb.Sp), structural model index (SMI) than their normal counterparts (P < 0.05). Estradiol valerate and Guben Zenggu Decoction treatments increased the levels of E2, BALP, BV/TV, Tb.Th, Tb.N, and Conn.D significantly (P < 0.05). Higher doses of Guben Zenggu Decoction resulted in higher changes (P < 0.05).CONCLUSION: Guben Zenggu Decoction can improve bone metabolism and bone micro-structure in ovariectomized rats, thus playing a preventive and therapeutic role in postmenopausal osteoporosis. | [
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OBJECTIVE: To explore the protective effects of quercetin (QE) on triptolide (TP) induced liver injury and the relevant mechanism.METHODS: Forty C57BL/6 mice were equally divided into 4 groups, control group, TP model group, 20 mg/kg QE treatment group and 80 mg/kg QE treatment group randomly. The 20 mg/kg and 80 mg/kg QE groups were gastrointestinal administration with QE at the dose of 0.2 mL/10 g for 10 d, twice daily, while other groups were administrated with equivalent normal saline. Four hours post the last dose, animals were gastrointestinal administered with TP at a dose of 500 g/kg per mouse, except for NS control. All the mice were sacrificed 22 h later, blood and liver tissue samples were collected. The pathologic change of liver tissue was detected by HE staining. The level of aminotransferase (AST) and aspartate alanine aminotransferase (ALT) in serum, and the level of glutathione (GSH), malondialdehyde (MDA) and superoxide dismutase (SOD) in liver tissue homogenates were detected using the commercial kits. The level of interleukin (IL)-17, IL-10 and IL-6 in liver tissue homogenates was measured by ELISA. Hepatic expression of Toll-like receptor 4 (TLR4) was detected by Western blot.RESULTS: Compared with the control group, in the TP model group, hepatic lobule structure atrophied and even disappeared, hepatic cell necrosis and inflammatory cell infiltration are obvious. Additionally, in TP model group, serum ALT, AST and MDA levels were significantly increased, SOD and GSH levels were decreased, IL-6 and IL-17 levels were increased, IL-10 levels were decreased, and TLR4 protein levels were increased (P < 0.05). Compared with the TP model group, liver tissue injury and inflammatory cell infiltration were reduced in the QE group, and serum levels of ALT, AST, MDA, IL-6 and IL-17 were all decreased. TLR4 expression was down-regulated (P < 0.05) in both QE groups, and the decease levle was more significant in the high-dose QE group (P < 0.05, compared with the low-dose QE group).CONCLUSION: Quercetin can reduce TP-induced liver injury by reducing oxidative damage, promoting antioxidant and regulating cytokine secretion. | [
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OBJECTIVE: To assess changes in the cognitive function and hippocampal ultrastructure of elderly rats exposed to sevoflurane.METHODS: Ault male Sprague-Dawley rats were given subcutaneous injection of D-galactose on the neck for 40 d to establish elderly models, after 9-day behavioral training. The model rats were divided into 3 groups randomly: control group with natural air, A/O group with 6 h exposure to carrier gas (2 L/min Air+2 L/min O2), and Sev group with 6 h exposure to 3.2% sevoflurane through carrier gas. Morris Water Maze and balance beam experiment were conducted on 6 rats in each group 2 h, 1 week and 4 weeks after treatments, respectively. The hippocampal tissues of the rats were rapidly dissected and prepared by glutaraldehyde fixation, ethanol dehydration, infiltration, embedding polymerization, semimembrane section localization and staining for examinations under transmission electron microscopy. The hippocampal ultrastructure such as nucleus, cytoplasm, mitochondria, endoplasmic reticulum, medullary nerve fiber, synapse and apoptotic corpuscle were observed.RESULTS: Ethology: compared with the control and A/O groups, significant reductions in the probe trial capability were found in the rats after 2 h exposure to sevoflurane, which recovered at 1 week and 4 weeks. Sevoflurane also increased the working memory escape latency 2 h and 1 week after exposure. The balance beam experiment showed that sevoflurane prolonged the staring time of rats after 2 h exposure, which recovered at 1 week and 4 weeks. Prolonged length for going through the balance beam was found consistently in the rats exposed to sevoflurane. Transmission electron microscopy: rats in the control group were found to have clear hippocampal ultrastructure, intact nuclear membrane, no edema fluid in the cytoplasm, intact mitochondria and endoplasmic reticulum, normal medullary nerve fibers, intact synaptic structure, and no apoptotic bodies in the cells. But a small amount of edema were observed in the cytoplasm of hippocampal cells in the rats exposed to sevoflurane and A/O at 2 h, which increased at 1 week. The cytoplasmic morphology of rats in the A/O group returned to normal at 4 weeks. But further increase of edema was observed in the rats 4 weeks after exposure to sevoflurane. No abnormal morphological structures or apoptotic bodies in other organelles were found.CONCLUSIONS: Sevoflurane can induce early neurocognitive impairments in elderly rats, which may be related with changes in the hippocampus ultrastructure. | [
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] |
OBJECTIVE: To assess biventricular, especially right ventricular, function and deformationin rhesus monkeys with spontaneous type 2 diabetes mellitus (T2DM) using cardiac magnetic resonance (CMR).METHODS: Twelve male spontaneous T2DM rhesus monkeys and age, sex, body mass matched 9 healthy rhesus monkeys without hypertension and myocardial infarction were included in this study. Fasting blood glucose (FPG), glycated hemoglobin (HbA1c) and blood liquid levels were measured. Biventricular function and myocardial deformations were evaluated by CMR cine and tissue-tracking.RESULTS: Compared with control, the FPG and HbA1c levers were significantly increased in T2DM group, but there was no significant difference in body mass and age between the two groups. CMR result showed that there was no significant decrease in right ventricle and left ventricle ejection fraction in T2DM (P < 0.05). However, the absolute value of radial and circumferential global peak systolic strain, systolic strain rate and three directions global peak diastolic strain rate of the right ventricle free wall were lower in the T2DM group (P < 0.05). Also, only radial and circumferential peak systolic strain and radial diastolic strain rate of left ventricle were higher (P < 0.05).CONCLUSIONS: Right ventricle showed systolic and diastolic dysfunction which were consistent with left ventricle in T2DM by CMR-tissue tracking. | [
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] |
OBJECTIVE: To investigate the expression level of silencing information regulatory 2 (SIRT2) in cervical cancer and CIN tissues and its clinical significance.METHODS: Immunohistochemistry was carried out to examine the expression of SIRT2 in 262 cases of cervical cancer tissues, 75 cases of precancerous lesions and 75 cases of normal cervical tissues, and the clinical implications of SIRT2 was further analyzed. The protein expression level of SIRT2 in 40 cervical cancer fresh tissue samples and 20 normal cervical tissue samples was detected by Western blot. shRNA-SIRT2 virus was transfected into HeLa cells to obtain the SIRT2-down-regulated HeLa cells. And the influence of down-regulation of SIRT2 on cell proliferation and migration was investigated by MTT and Scratch test.RESULTS: Immunohistochemical results showed that SIRT2 protein expression level gradually increased in cervical cancer, CIN and normal cervix tissues (P < 0.001). Western blot confirmed that SIRT2 expression level was higher in cervical cancer tissues than in normal cervix tissues (P < 0.001). The expression level of SIRT2 in cervical cancer was correlated with some factors, such as lymph node metastasis, histological type, clinical staging and HPV infection (P < 0.05). At the same time, it was independent of some factors including age, differentiation degree, pelvic metastasis, whether involving the cervical interstitial and the involvement depth and whether involving the neck junction and vaginal ends (P>0.05). Mortality in SIRT2 high expression patient group was higher than that of SIRT2 low expression patient group (P < 0.05). shRNA interference technique could effectively inhibit the expression level of SIRT2 in HeLa cells (P < 0.05). MTT assay and Scratch test indicated that down-regulation of SIRT2 expression inhibited the proliferation and migration of HeLa cells (P < 0.05).CONCLUSION: SIRT2 may play a promoting role in the progress of cervical cancer, and SIRT2 may be related to the development of malignant degree of cervical cancer, and the inhibition of SIRT2 expression may be a potential therapeutic target for cervical cancer. | [
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] |
OBJECTIVE: To explore the relationships between plasma adiponectin levels and risk of breast cancer by molecular subtype.METHODS: A case-control study including 437 histopathologic confirmed primary breast cancer cases and 469 healthy female controls was conducted between April 2014 and May 2015. Basic information of the participants were collected using a structured questionnaire. Blood samples were collected and the plasma adiponectin levels were measured by enzyme-linked immunosorbent assay (ELASA). Analysis of variance (ANOVA) was used to compare the differences of plasma adiponectin levels among the control group and the breast cancer groups with different molecular subtypes. Multinomial logistic regression was used to investigate the association between plasma adiponectin levels and risk of breast cancer by molecular subtypes. All the statistical analyses were stratified by menopausal status.RESULTS: Among the 437 breast cancer cases, there were 310 Luminal breast cancer cases, 83 HER-2-enriched breast cancer cases and 44 basal-like breast cancer cases. The median (P25, P75) of plasma adiponectin level of the controls was 14.85 (9.69, 21.35) g/mL. The medians (P25, P75) of plasma adiponectin levels of the cases were 11.74 (8.15, 16.14) g/mL, 12.02(8.43, 16.96) g/mL and 12.67(8.25, 17.27) g/mL for Luminal, HER-2-enriched and basal-like subtype respectively, which were statistically different from the controls (P < 0.001). Multinomial logistic regression showed that, after adjustment for the confounders, the higher levels of plasma adiponectin were associated with the lower risks of pre-menopausal Luminal breast cancer (ORpre-menopausal Luminal=0.50, 95%CI: 0.27-0.92, Ptrend=0.001), post-menopausal Luminal breast cancer (ORpost-menopausal Luminal=0.06, 95%CI: 0.02-0.23, Ptrend < 0.001) and post-menopausal HER-2-enriched breast cancer (ORpost-menopausal HER-2-enriched=0.06, 95%CI: 0.01-0.62, Ptrend=0.001).CONCLUSION: Lower levels of plasma adiponectin may increase the risk of pre-menopausal and post-menopausal Luminal breast cancer and post-menopausal HER-2-enriched breast cancer. | [
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OBJECTIVE: To select and identify the bacterium which highly produces protease and -D-glucosidase from 72 strains of Shuidouchi from Sichuan, and to provide evidence for further research on its nutritional value and fermentation strain exploiting.METHODS: Casein degradation test and pNPG chemical test were applied respectively to detect the capacity to produce protease and -D-glucosidase of each strain. Characteristics of morphology, biochemistry, 16S rRNA and MALDI-TOF-MS were used to identify the fermentation strain, which genetic stability, curves of growth and enzyme producing were also obtained.RESULTS: The strain with the highest enzyme activity of -D-glucosidase (0.084 U/L) among the top 10 strains for producing protease was selected as the fermentation strain and was identified as Bacillus subtilis, which curves of growth and enzyme producing conformed as well. The result of genetic stability showed that capacity of enzyme producing was stable until the 10th generation.CONCLUSIONS: The fermentation strain which highly produced protease and -D-glucosidase was selected from 72 strains of shuidouchi from Sichuan and was identified as Bacillus subtilis. | [
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] |
OBJECTIVE: To study and compare the practical use of three prognostic predication models in clinical non-metastatic renal cell carcinoma (RCC).METHODS: We retrospectively collected the data of 1 202 clinical non-metastatic RCC patients operated on between 1999 and 2012 at West China Hospital of Sichuan University. Survival analysis method was used to establish three prognostic prediction models including SSIGN, Leibovich and UISS based on different clinical and pathological indicators. The predictive ability was evaluated by the area under receiver operating characteristic curve (AUC).RESULTS: Of the 1 202 clinical non-metastatic RCC patients, 1 030 cases were limited RCC patients, and 172 cases were locally advanced RCC patients. The median follow-up time of the patients was 63.02 months. The 2-year and 5-year overall survival rate were 94.7% and 87.6%, respectively. The 5-year overall survival rates of patients with different clinical stages and grades were significantly different. The predictive accuracies for limited RCC of UISS, SSIGN and Leibovich model were 0.667, 0.785 and 0.758, respectively. For locally advanced RCC, the predictive accuracies of the three models were all lower than 0.6.CONCLUSIONS: SSIGN has certain predictive value in clinical non-metastatic RCC. However, for the advanced RCC, all the prognostic models demonstrate limited predictive value. | [
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OBJECTIVE: To understand the relationship between obesity and depression in the elderly in China, and to explore whether there are differences between the genders.METHODS: The data were collected from the 2015 China Health and Retirement National Investigation (China Health and Retirement Longitudinal Study, CHARLS). The respondents were grouped according to depressive status. The difference of depressive status between the elderly male and female groups was examined by Chi-square test. The relationship between depression, obesity and the other sociological factors was analyzed by binary logistic regression.RESULTS: There were 4 019 valid cases, including 2 109 males (52.48%) and 1 910 females (47.52%). All the respondents were aged 60 years and over. There were 474 cases of central obesity (11.79%) and 2 418 cases of abdominal obesity (60.16%). There were significant differences in central obesity and abdominal obesity between the elderly male and female groups (P < 0.001). 1 304 cases suffered from depression, accounting for 32.45%, of which 539 cases were male (41.33%) and 765 cases were female (58.67%). Different groups of gender, central obesity and abdominal obesity had significant differences in depressive status (P < 0.001). The results of univariate analysis indicated that the characteristics of female, divorced/widowed/unmarried, in rural areas, having chronic diseases and functional loss were the risk factors for depression. The results of multivariate logistic regression analysis indicated that, in terms of the total sample, after adjustment for the confounding factors, both central obesity and abdominal obesity groups were less likely to suffer from depression. After stratified by gender, both central obesity and abdominal obesity were negatively correlated with depression.CONCLUSIONS: The elderly with central obesity or abdominal obesity are less likely to suffer from depression, regardless of gender. | [
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] |
OBJECTIVE: To develop a method for detecting nicotine and cotinine in hair by hydrophilic interaction chromatography tandem mass spectrometry.METHODS: Hair samples were hydrolyzed in sodium hydroxide solution before extraction with dichloromethane. The samples were blown to dry with nitrogen and dissolved with mobile phase. The filtrate of the samples was injected into a chromatographic-mass spectrometry system for analysis. The separation was performed by a hydrophilic column, with which methanol-0.1% ammonia was used as the mobile phase. The quantitative detection of Nicotine and Cortinine was carried out with electron spray ionization-triple quadrupole mass spectrometry. The established method was used for detecting nicotine and cotinine in 602 hair samples of pregnant women and 31 hair and urine samples of volunteers.RESULTS: A standard curve was drawn for the established method of hydrophilic liquid chromatography tandem mass spectrometry. Good linearity was obtained for detecting nicotine and cotinine in the range of 0.030-100.000 g/L, with a detection limit (MDL) of 0.007 6 g/g and 0.004 4 g/g, respectively. The inter-day and intra-day precisions reached a level of less than 10%. The recoveries of the spiked samples ranged from 81.0% to 102.0%. About 0.020-0.260 g/g nicotine and 0.004 8-0.069 0 g/g cotinine were detected in the pregnant women without exposure to secondhand smoking (SHS), compared with 0.029-0.350 g/g nicotine and 0.005 6-0.085 0 g/g cotinine in those exposed to SHS. Nicotine and cotinine were also found in the hair and urine samples of volunteers, which were correlated with smoking (P < 0.05). A dose-response relationship were found between smoking and hair nicotine.CONCLUSIONS: The proposed method is accurate and sensitive for detecting nicotine and cotinine in hair samples. Hair nicotine can be a specific biomarker for assessing exposure to tobacco smoking. | [
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OBJECTIVE: To establish SNaPShot-fluorescence capillary analysis (SNaPShot-FCA) assay for rapid detection of the genotype of aldehyde dehydrogenase 2 gene (ALDH2) rs671 locus.METHODS: The genomic DNA was extracted from peripheral blood cells. Using R6G-ddATP and cy5-ddGTP as fluorescent substrates, the ALDH2 gene was amplified by SNaPShot to generate DNA products with different fluorescent dyes at the 3' end. FCA was used to detect the products separated by agarose gel electrophoresis and recovered by gel recovery kit, and the genetype of ALDH2 polymorphism was analyzed by fluorescence spectrum. The samples were tested three times repeatedly and compared with the results of DNA sequencing.RESULTS: The optimal concentrations of R6G-ddATP and cy5-ddGTP were 1.4 mol/L and 8.0 mol/L, respectively. 106 samples were tested for ALDH2 genotype by SNaPShot-FCA under optimal conditions, including 67 of wild type (GG), 38 of hybrid type (AG), and 1 of mutant type (AA), which were consistent with the sequencing results.CONCLUSION: This study successfully established the SNaPShot-FCA for the micro-detection of ALDH2 genotype for the rapid screening and identification of ALDH2 gene. | [
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] |
OBJECTIVE: To analyze of the minimum graft-to-recipient weight ratio (GRWR) required for living donor liver transplantation (LDLT) without middle hepatic vein branch (MHVT) reconstruction.METHODS: We retrospectively collected the clinical data and outcomes of 303 LDLT patients over 16 years from 2001 to 2017. The minimum GRWR of non-middle hepatic vein reconstruction was analyzed by propensity score (PSM).RESULTS: With PSM analysis, no significant differences were observed in postoperative complications, SFSS, inpatient time, liver function, and coagulation function, but significant differences in 1-year, 3-year and 5-year survival between MHVT reconstruction and non-reconstruction group. The patients with MHVT reconstruction had better short-term and long-term survival than those without reconstruction.CONCLUSION: For LDLT patients without HMVT reconstruction, GRWR should be greater than 0.86%; for patients with HMVT reconstruction, GRWR is acceptable between 0.5% and 0.6%. | [
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] |
A healthy 52-year-old woman presented with 10-days history of back pain. Neurologic testing failed to detect any functional deficits in the upper and lower extremities, and the patient had a full range of cervical spine motion without associated pain. Spinal CT and MRI revealed a well-circumscribed intradural mass located at conus medullaris. The operation of L1 hemilaminectomy was performed, and pathological examination discovered dilatation of sweat ducts and suggested the diagnosis of ectopic sweat duct ectasia. IHC staining in epithelia immunophenotype showed: pan-cytokeratin (PCK)(+), epithelia membrane antigen (EMA)(+), P63(+), cytokeratin 5/6 (CK5/6)(+), gross cystic disease fluid protein 15 (GCDFP15)(-). Intraspinal ectopic sweat duct ectasia is extremely rare, which has not been reported in the literature to date. | [
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] |
Objective: To investigate the safety and effectiveness of radiofrequency ablation (RFA) for selective fetal reduction in complex multiple pregnancies and analyze factors affecting perinatal outcomes. Methods: This was a retrospective case series of 156 patients undergoing selective fetal reduction by RFA in Provincial Hospital Affiliated to Shandong University from July 22th, 2011 to September 12th, 2018. They were divided into five groups according to surgical indications, including 46 cases in the monochorionic twins discordant for fetal anomalies group, 42 cases in the multiple pregnancies for reducing fetal numbers group, 40 cases in the twin to twin transfusion syndrome (TTTS) group, 24 cases in the selective intrauterine growth restriction (sIUGR) group and 4 cases in the twin reversed arterial perfusion sequence (TRAPS) group. According to the gestational age at surgery, patients were divided into two groups: the gestational age at surgery <20 weeks group (75 cases) and the gestational age at surgery?20 weeks group (81 cases). According to the cycles of RFA required for surgery, patients were divided into two groups: one cycle group (124 cases) and ?2 cycles group (32 cases). Basic information of patients, surgical process, postoperative complications and pregnancy outcomes were recorded. The growth and development of survival newborns were also followed up. Factors affecting perinatal outcomes were analyzed. Results: (1) The median gestational age at procedure of 156 patients was 20 weeks (14(+5)- 29(+1) weeks). The median cycles of RFA was 1 cycle (1-3 cycles), of which one cycle accounted for 79.5% (124/156). (2) Eleven (7.1%, 11/156) patients experienced intrauterine fetal death, 27 (17.3%, 27/156) patients miscarried, and the overall survival rate was 75.6% (118/156). Premature birth rate before 34 weeks was 19.5% (23/118). There were 129 neonates. The median gestational age at delivery was 37(+3) weeks (28(+2)- 41(+1) weeks) with a mean birth weight of (2 657700) g. (3) Analysis of pregnancy outcomes based on surgical indications found that, the gestational age at delivery [38 weeks (30(+1)-41(+1) weeks), 36(+4) weeks (29- 39 weeks), 36(+4) weeks (28(+2)-39(+5) weeks), 38 weeks (31-39(+6) weeks), 38(+3) weeks (30(+4)-38(+4) weeks)] and neonatal birth weight [(2 820671), (2 435416), (2 497843), (2 998718), (2 5171 087) g] were significantly different among fetal anomalies group, reducing fetal numbers group, TTTS group, sIUGR group and TRAPS group, respectively (all P<0.05). There were no significant differences in the pregnancy outcomes between gestational age at surgery <20 weeks group and gestational age at surgery ?20 weeks group, or between one cycle group and ?2 cycles group, respectively (all P>0.05). Conclusions: RFA is a safe and effective procedure in treating complex monochorionic multiple pregnancies. Surgical indications would affect the gestational age at delivery and neonatal outcomes. | [
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] |
Objective: To assess the effectiveness of radiofrequency ablation (RFA) in the treatment of multiple pregnancies. Methods: In this retrospective study, 84 cases (total 174 fetuses) of complex monochorionic pregnancies treated with RFA for selective fetal reduction were analyzed. All cases were managed in the Guangdong Women and Children Hospital from January 2015 to January 2018. Indications for offering RFA, details of the procedure and pregnancy outcomes were collected and analyzed. Results: (1)The rate of miscarriage and fetal intrauterine death was 21% (18/84), termination of pregnancy because of fetal malformation or oligohydramnion occurred in 10% (8/84) of cases. Total live birth rate was 69% (58/84) and the gestation age at delivery was (35.03.0) weeks. (2) The live birth rate of twin reversed arterial perfusion sequence (TRAPS) was the lowest (6/11), followed by twin to twin transfusion syndrome (TTTS; 66%, 27/41), structural or genetic abnormalities of one fetus in monochorionic twin pregnancy (10/14), triplet pregnancy reduction (4/6) and selective intrauterine growth restriction (sIUGR) (11/12). (3) The live birth rate was 67% (20/30) in stage ? of TTTS and 7/11 in the stage ? of TTTS (P>0.05). The average gestational age was (33.63.0) weeks in stage ? of TTTS compared with (36.52.4) weeks in the stage ?of TTTS (P<0.05). Conclusions: RFA appears to be a reliable option for selective fetal reduction in monochorionic multiple pregnancies. The indication of RFA is an influencing factor on its pregnancy outcomes. Type ?and type ? sIUGR may choose this technique as a priority. Compared with stage ? of TTTS, the live birth rate and the gestation age at delivery in stage ? of TTTS, there are no significant differences. | [
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Objective: To explore the characteristics of maternal glucose and lipid metabolism in twin pregnancies complicated by gestational diabetes mellitus (GDM). Methods: The clinical features of twin and singleton pregnancies complicated by GDM, which delivered in Peking University First Hospital from January 1st, 2012 to December 31st, 2017 were retrospectively analyzed. A total of 286 twin pregnancies with GDM (GDM-T group) were collected, and 572 singleton pregnancies complicated by GDM (GDM-S group) which were matched by delivery time in a ratio of 1?2 among all singleton pregnancies with GDM. The characteristics of maternal glucolipid metabolism in the second trimesters of pregnancy was compared between two groups. Results: (1) Compared with GDM-S group, the maternal delivery age were lower [(324), (334) years] and prepregnancy body mass index (BMI) were higher [(244), (234) kg/m(2)] in GDM-T group, the differences were statistically significant (all P<0.05). The incidence of chronic hypertension was found no significant difference (P=0.581). (2) The 3 points of glucose values in 75 g oral glucose tolerance test (OGTT) and OGTT-area under curve (AUC) had no significant difference between GDM-T and GDM-S group.When compared with GDM-S group, the maternal glycosylated hemoglobin levels [(5.410.35)%, (5.320.28)%], the insulin resistance index (4.070.77, 2.631.50) and the proportion of insulin use (7.7%, 4.4%) were all significantly higher in GDM-T group (all P<0.05). The values of triglyceride [(3.41.4), (2.61.2) mmol/L], total cholesterol [(6.31.1), (6.01.0) mmol/L], low density lipoprotein cholesterol [(3.30.9), (3.10.8) mmol/L] were significantly higher and values of high density lipoprotein cholesterol [(1.70.4), (2.00.5) mmol/L] were significantly lower in GDM-T group than GDM-S group (all P<0.05). (3) There was no significant difference in the incidence of gestational hypertension between the two groups (P>0.05). When compared with GDM-S group, the incidences of preeclampsia and small for gestational age were both significantly higher (13.3% vs 2.4%; 28.7% vs 1.7%) and the incidence of large for gestational age was significantly lower in GDM-T group (4.5% vs 15.2%; all P<0.05). Conclusions: The insulin resistance is aggravated in twin pregnancies and the characteristics of lipid metabolism are different between singleton and twin pregnant women complicated by GDM, and there are more complications in twin GDM pregnancies. | [
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] |
Objective: To study and analyze the incidence of pelvic organ prolapse (POP) in women who underwent cesarean section. Methods: A cross-sectional study was conducted. The clinical data of the women who underwent regular antepartum examination and cesarean delivery in Peking University People's Hospital from January 2019 to June 2019 were collected, including the cervical dilatation. The incidence of POP was analyzed. Results: (1) A total of 345 women met the inclusion criteria, with cervical dilatation of 0-10 cm before cesarean section, the cervix was not dilatated in 58.6% (202/345) of the women, and the cervix was fully dilatated in 2.9% (10/345) of the women. There were 109 cases of POP stage ? or above, 13 cases of POP stage ?, and no stage ? or ?. The incidence of POP was 31.6% (109/345). (2) Statistical analysis showed that the cervical dilatation of the POP group was significantly larger than that of the non-prolapse group (median: 1.0 vs 0 cm;Z=-2.227, P=0.026). The risk of POP of vaginal trial-birth transfer to cesarean section was higher than that of elective cesarean section [42.4% (36/85) vs 28.1% (73/260), P=0.014]. However, the further analysis of Spearman correlation between cervical dilatation, elective cesarean section and POP, as well as the receiver operating characteristic curve showed that the correlation and prediction value were poor. Conclusion: Elective cesarean section has a certain protective effect on postpartum prolapse, but the protective effect of vaginal trial-birth transfer to cesarean section on pelvic floor is weakened. | [
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] |
Objective: To evaluate the clinical characteristics and diagnostic strategies of early hydatidiform mole. Methods: A retrospective cohort study was conducted of 526 women with hydatidiform mole who underwent suction curettage and were confirmed by histopathology in Dalian Maternal and ChildHealth Care Hospital from Feb. 2013 to Feb. 2018, including 484 women with gestational age less than or equal to 12 weeks (the early group) and 42 women with gestational age greater than 12 weeks (the late group). The clinical characteristics between the two groups were compared, and the pathological diagnosis and pre-evacuation ultrasound examination of the early group were further discussed. Results: Compared with the late group, the clinical characteristics of the early group tended to be atypical, and the incidence of vaginal bleeding, excessive uterine size, theca lutein cysts (>6 cm) and pregnancy complications decreased significantly (all P<0.05). The serum level of -hCG in the early group was significantly lower than that in the late group (Z=-2.382, P=0.017). While there was no significant difference in the pre-evacuation ultrasound detection rate between the two groups (53.5% vs 66.7%; (2)=2.697, P=0.101). Five hundred and fifteen patients completed the follow-up, and 38 patients with post-mole neoplasia were all cured. There was no significant difference in the malignant transformation rate of hydatidiform mole between the two groups (7.0% vs 11.9%; (2)=0.745, P=0.388). In the early group, 302 cases of complete hydatidiform mole (CHM), 179 cases of partial hydatidiform mole (PHM) and 3 cases of unclassified hydatidiform mole (UHM) were histologically diagnosed, according to pathological morphology combined with p57(KIP2) immunohistochemical staining. Compared with pathological diagnosis, the overall pre-evacuation ultrasound detection rate in the early hydatidiform mole was 53.5% (259/484), which was significantly better for complete (78.1%, 236/302) versus partial (11.7%, 21/179) hydatidiform moles ((2)=199.224, P<0.01). There was significantly weak negative correlation between the overall ultrasound detection rate and gestational age of hydatidiform mole (r=-0.211, P<0.01). The gestational age of early PHM was significantly longer than that of CHM (68.0 vs 58.5 days; Z=-8.048, P<0.01). Conclusions: The clinical presentations of early hydatidiform mole are not typical. Although ultrasound examination identifies only about half of hydatidiform moles, ultrasonography is still an important auxiliary examination method. Morphological examination combined with p57(K)IP2 immunohistochemical staining could effectively diagnose early hydatidiform mole, so as to reduce the missed diagnosis of hydatidiform mole. | [
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] |
Objective: To assess the technical success rate, stent patency, clinical efficacy and complications of stent placement for filter-related chronic occlusion of the inferior vena cava. Methods: A retrospective analysis was carried out for 12 patients with filter-related chronic occlusion of the inferior vena cava associated with severe post-thrombotic syndrome, who underwent stent placement after ineffective conservative therapy at Nanjing First Hospital from March 2016 to December 2018,9 males and 3 females, aged from 48 to 77 years, mean age 60 years, six had bilateral lower extremity symptoms and six had unilateral lower extremity symptoms.Technical success rate, stent patency, clinical efficacy and complications of stent placement were recorded. Clinical success was defined as relief of symptoms and a decrease in clinical, etiology, anatomy, and pathophysiology (CEAP) score for at least grade 1. Results: Stent placement in the unilateral or bilateral iliocaval occlusion was successful in 11 patients. The cause of technical failure in the single patient with failed stent placement was an inability to cross the occluded left iliacvein and the patient was treated with stent placement in the right iliocaval vein.There were 7 patients with inferior vena cava and unilateral iliocaval stent placement; 5 patients with inferior vena cava and bilateral iliocaval stent placement. Acute stent thrombosis occlusion occurred in 1 case after the operation, the blood flow recanalized after catheter-directed thrombolysis and re-stenting. All patients were followed up for 6 to 24 months, with an average of (136) months. During the follow-up period, CTV or venography of lower limbs showed that the blood flow in the stent was unobstructed. At the last follow-up, 12 patients were evaluated as clinically effective. Three patients had transient treatment of lateral lumbar pain during operation, which alleviated by themselves.No significant abdominal pain, severe hemorrhage, symptomatic pulmonary embolism and other complications related to treatment occurred in all patients during perioperative period and follow-up. Conclusion: Stent placement is safe and feasible in the treatment of filter-related chronic occlusion of the inferior vena cava, which can alleviate the clinical symptoms of severe post-thrombotic syndrome. | [
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Objective: To investigate the incidence and related risk factors of ulnar nerve dysfunction after open reduction and internal fixation of humeral intercondylar fractures. Methods: A total of 168 patients who underwent open reduction and plate and screw fixation of a humeral intercondylar fracture between January 2013 and May 2017 were retrospectively analyzed. There were 85 males and 83 females, aged from 14 to 77 years with a mean age of (4317) years. Diagnosis of ulnar neuropathy was defined as documentation of sensory and motor dysfunction of the ulnar nerve in the medical record. The explanatory (independent) variables included age, gender, injury type, AO typing, time from injury to surgery, surgery approach, plates fixation methods and whether the nerve was transposed. Univariate and multivariate analyses were performed to determine risk factors associated with postoperative ulnar nerve dysfunction. Results: Acute injury-related ulnar nerve neuropathy was diagnosed in 12(7.1%) of 168 patients. Among the other 156 patients without preoperative ulnar nerve neuropathy,the total postoperative ulnar neuropathy was found in 52 patients (33.3%), and in 26(16.7%) at the final follow-up, according to the McGowan grades system; 23(88.5%) of 26 patients were clinically graded as grade 1, and 3(11.5%) were graded as grade 2. Multivariate logistic analysis showed that triceps sparing approach (OR=2.639, P=0.039) and parallel double plate fixation (OR=3.089, P=0.046) were associated with a risk of postoperative ulnar nerve dysfunction. Conclusion: There is a substantial incidence of postoperative ulnar nerve dysfunction after open reduction and plate and screw fixation of humeral intercondylar fracture, postoperative ulnar neuropathy may occur from the time of injury through the long-term follow-up period, triceps sparing approach and parallel double plate fixation are the risk factors for ulnar neuropathy. | [
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] |
Objective: To investigate the application value of motor unit number index (MUNIX) for diagnosis and assessment progress in patients with amyotrophic lateral sclerosis (ALS). Method: Sixty healthy controls and 60 ALS patients in the clinic were enrolled from May 2017 to December 2018. The bilateral deltoid, abductor digiti minimi, quadriceps femoris and tibialis anterior muscles of the subjects were detected by MUNIX method, and the negative peak amplitude of compound muscle action potential (CMAP) of ulnar nerve, femoral nerve, peroneal nerve, axillary nerve in bilateral was collected. MUNIX and motor unit size index (MUSIX) of muscles were compared between ALS group and control group. The difference between the MUNIX abnormal rate of muscles and abnormal rate of the corresponding CMAP negative peak amplitude in ALS patients was further compared. Meanwhile, the correlation between the disease course of ALS patients and MUNIX and MUSIX was analyzed. Results: Compared with the control group, the MUNIX values of the deltoid, abductor digiti minimi, quadriceps femoris and tibialis anterior decreased significantly (9724 vs 18338, 4817 vs 19139, 5415 vs 15922, 4916 vs 14725, all P<0.05). MUSIX values increased ((17532) V vs (4715) V, (18934) V vs (5416) V, (17030) V vs (4913) V, (190 36) V vs (48 14) V, all P<0.05)). In ALS patients, the abnormal rate of MUNIX was respectively 81%, 87%, 75% and 89%. The negative peak amplitude abnormal rate of corresponding neuralCMAP was 35%, 40%, 31% and 36%, respectively, with a significant difference (P<0.05). There was a negative correlation between MUNIX value and the course of disease in ALS patients (P<0.05), and a positive correlation between MUSIX value and the course of disease (P<0.05). Conclusion: The MUNIX technique exhibits the features of quantifying the proximal upper and lower limb muscles and assessing the loss of motor units in motor neuron degeneration. | [
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Objective: To evaluate the value of CT in the differential diagnosis of Pseudomonas aeruginosa sinusitis and fungal ball in paranasal sinus caused by Aspergilus flavus. Methods: In this retrospective study, CT results of 74 cases of Pseudomonas aeruginosa sinusitis including 31 male cases and 43 female cases with age onset from 15 to 74 years old (meanSD was 5013) and 72 cases of fungal ball in paranasal sinus caused by Aspergilus flavus including 28 male cases and 44 female cases with age onset from 25 to 78 years old (meanSD was 5315) at Beijing Tongren Hospital confirmed by histopathology were enrolled from January 2013 to May 2017. The CT characteristics of the two groups of cases were compared using (2) test, and P<0.05 was considered statistically significant. Results: Soft tissue opacification of the involved paranasal sinus was found on CT in each case of the two groups. There were significant differences in the rate of single sinus involvement (44.6% and 90.3% respectively), the incidence of lesion associated with maxillary sinus (91.9% and 70.8% respectively), ethmoid sinus (41.9% and 2.8% respectively), frontal sinus (29.7% and 0 respectively), calcification (50.0% and 72.2% respectively), and the enlargement of maxillary sinus opening (13.2% and 35.3% respectively), in addition to the central calcification (83.8% and 59.6% respectively) between the two groups (all P<0.05). However, the incidence of sphenoid sinus involvement (32.4% and 34.7% respectively), bone sclerosis (56.8% and 62.5% respectively) or destruction(18.9% and 16.7% respectively) were not found different between the two groups (P>0.05). Conclusion: Though the CT findings are similar between the two diseases such as soft tissue opacification of the involved paranasal sinus with calcification and bone sclerosis or destruction, there are still a few characteristics on CT in differentiating the one from the other. The involvement of multi-sinuses, maxillary sinus, ethmoid sinus and frontal sinus, the central calcification are more common in the Pseudomonas aeruginosa sinusitis. However, the CT features including single sinus involvement, calcification and enlargement of maxillary sinus opening, can be seen more often in the fungal ball in paranasal sinus caused by Aspergilus flavus. | [
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] |
Objective: To explore related factors affecting evolution of recent small subcortical infarct (RSSI) with small-artery occlusion. Methods: A total of 96 RSSI patients with RSSI were admitted from Shanghai Tongji Hospital between January 2015 and December 2018. The age of patients containing 60 men was 64.5 (58-73) years, and MRI follow-up time was 11.6 (6.3-11.8) months. Clinical information of patients, images data at baseline head MRI and evolution outcomes at follow-up MRI were collected. All patients were divided into cavitation group (lacunes) and no cavitation group (white matter hyperintensities (WMH) and disappearance) to analyze related factors. Results: Fifty-nine cases (61.5%) developed to cavities, 32 cases (33.3%) were focal WMH, and 5 cases (5.2%) disappeared.In the univariate analysis, RSSI maximum diameter on the DWI or T(2)WI sequence of cavitation group was significantly higher than non-cavitation group, but male proportion was lower (11.6 (9.9-16.6) vs 8.6 (6.9-13.0) mm, 11.8 (9.7-16.2) vs 8.8 (6.7-13.1) mm, 54.2% vs 75.7%, all P<0.05). In Logistic regression analysis,the maximum diameter on DWI sequence was an independent predictor of cavity formation (P=0.022,OR=1.138).When conducting quantitative analysis of infarct diameter and taking infarct maximum diameter ?10 mm group as reference, the cavitation risk of maximum diameter>15 mm group was about 7.5 times higher (P=0.010, OR=7.464). The maximum diameter of 10-15 mm lost predictive value for cavity formation (P=0.129, OR=2.444). Conclusions: About 61.5% of RSSI develop to cavitation and 38.5% to WMH or disappear. The RSSI showing larger diameter on DWI has a greater possibility of cavitation. | [
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] |
Objective: To investigate the detection rate of pulmonary nodules and the accuracy of automated measurement in chest simulation phantom by artificial intelligent computer-aided detection of pulmonary nodules with different pre-adaptive iterative techniques (ASIR-V) in wide-spectrum CT scanning. Methods: Sixteen pulmonary nodules with different diameters, densities and shapes were placed in the chest simulation phantom from December 2017 to March 2018. The weight of ASIR-V was set at 0%, 20%, 30%, 40% and 50% respectively by using Revolution CT broadband energy spectrum scanning protocol. Spearman correlation analysis was used to analyze the dose volume CT dose index (CTDIvol) and dose length product (DLP) of each group. Scanning data were imported into Tuma Shenwei artificial pulmonary nodule analysis software to evaluate the nature of the detected nodules, and ICC was used to detect the differences among groups. Results: With the increase of ASIR-V weight, the effective dose of patients decreased gradually. CTDIvol of five groups of radiation dose volume CT dose index was 7.93, 7.24, 5.85, 5.15, 3.76 mGy,dose-length product DLP was 379, 346, 280, 246, 179 mGycm.There was a linear negative correlation between ASIR-V weights and CTDIvol as well as DLP, r value was-0.969, P<0.01.There was no significant difference in the detection rate of pulmonary nodules between AI and physicians (P>0.05). There was high intraclass correlation coefficients for the diameter, volume, CT value and malignant percentage of pulmonary nodules (ICCs:0.981-1.000). Conclusions: Radiation dose of unenhanced chest CT scan using wide detector spectral imaging decreased with the increasing of preset ASIR-V. Lung nodule detection rate and evaluation performance can be maintained well by using ASIR-V reconstructions at lower radiation dosage. | [
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Objective: To evaluate the value of Gd-BOPTA enhanced MRI in the staging of liver fibrosis. Method: Fifty male SD rats (6-week-old, 180-220 g) were divided into the modeling group (n=42) and the control group (n=8). The model of liver fibrosis in the modeling group was established by carbon tetrachloride (animal license No. SYXK (Su) 2017-0043). From week 2 to week 10, rats in the modeling group (n=4) and control group (n=1) were randomly selected to scan 1 h(RER1), 2 h(RER2) and 3 h(RER3) after injection of Gd-BOPTA, respectively, to measure the relative enhancement rate (RER) of liver parenchyma. The shape of intrahepatic bile duct and the degree of enhancement at each time point were observed. Results: Forty-two rats (34 rats in the modeling group and 8 rats in the control group) completed the experiment. RER1, RER2 and RER3 of the control group were 1.440.37, 1.220.37 and 0.840.28 respectively. RER1, RER2 and RER3 of the modeling group were respectively: S1 (n=6): 1.490.48, 1.290.39, 0.910.38;S2 (n=9): 1.480.44, 1.340.37, 1.040.40;S3 (n=11): 1.490.43, 1.370.39, 1.210.30; S4 (n=8): 1.490.44, 1.400.37, 1.240.40. There was no significant difference in RER1 and RER2 values between the control group and the liver fibrosis group (F=0.022, P=0.999; F=0.301, P=0.875). There were significant differences between the control group and RER3 values of hepatic fibrosis stage S3 and S4 (t=2.249, P=0.031; t=2.274, P=0.029), there was no significant difference between the remaining groups (all P>0.05).In the control group, the intrahepatic bile duct was obviously strengthened within 1 hour after enhancement, and walked naturally. The intrahepatic bile duct was slightly enhanced 1h after the enhancement of S3-S4 stage of hepatic fibrosis, and the intrahepatic bile duct was significantly enhanced 2-3 hours later, with distorted alignment. Conclusion: Delayed 3 hours liver parenchymal RER and intrahepatic bile duct distortion delay enhancement after Gd-BOPTA enhancement contribute to the S3-S4 diagnosis of liver fibrosis. | [
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] |
Objective: To explore the differences in epidemiology and clinical features of Guillain- Barr? syndrome (GBS) between rural and urban areas of southern China. Methods: The clinical data of 759 hospitalized GBS patients from 31 hospitals of 13 provinces/cities in southern China, between January 1st, 2013 and September 30th, 2016, were collected and analyzed retrospectively. Results: The risk of GBS was higher for males than females in rural and urban areas and the median age was 49 and 48 years, respectively. Seasonal clustering in winter and spring was noted in both rural and urban areas, and the seasonal trend was more markedly in rural areas, but the differences showed no statistical significance. There were 70.37% of patients in rural areas and 73.69% in urban areas who had antecedent respiratory infection. The median time from onset to nadir was 7 days, and Hughes Disability Scale at admission, nadir and discharge were (2.951.10 vs 2.841.15), (3.251.11 vs 3.141.21), (2.021.24 vs 2.001.31) in rural and urban areas respectively. Albuminocytologic dissociation was present in 84.34% of patients in rural areas and 84.62% of cases in urban areas. There were 8.65% and 10.94% of cases in rural and urban areas who required mechanical ventilation during hospitalization, respectively. Demyelinating GBS accounted for 53.29% and 48.77%, respectively, in patients with findings of nerve conduction studies available in rural and urban areas. Conclusions: GBS in rural areas of southern China showed male predominance and a peak of spring and winter occurrence, with respiratory infection as the predominated preceding events and demyelinating GBS being main clinical subtype. Winter and spring showed a higher incidence of GBS in rural and urban areas. There were no significant differences of sex, age, preceding events, season trend, progression of disease, clinical subtypes and cerebrospinal fluid investigations in GBS patients between rural and urban areas. | [
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] |
OBJECTIVE: To study the clinical features and prognosis of meconium aspiration syndrome (MAS) complicated by neonatal pulmonary hemorrhage (NPH) in neonates.METHODS: A retrospective analysis was performed for the clinical data of 45 neonates with MAS complicated by NPH who were admitted to the hospital from December 2015 to December 2018 (observation group). Ninety neonates with MAS who were hospitalized during the same period of time and had no pulmonary hemorrhage were enrolled as the control group. The two groups were compared in terms of clinical features and prognosis.RESULTS: The observation group had a significantly lower 1-minute Apgar score after birth than the control group (P<0.05). Compared with the control group, the observation group had significantly higher incidence rates of persistent pulmonary hypertension of the newborn, air leak syndrome and shock and a higher rate of use of pulmonary surfactant (P<0.05), as well as higher levels of C-reactive protein and oxygen index (OI) (P<0.01). In the early diagnosis of NPH, OI had a sensitivity of 80.0%, a specificity of 96.7%, and an area under the receiver operating characteristic curve of 0.959 (95% confidence interval: 0.929-0.988, P<0.001) at the cut-off value of 10.05. For the children who were cured and discharged, the observation group had significantly longer duration of ventilation, duration of oxygen inhalation and length of hospital stay than the control group (P<0.05).CONCLUSIONS: Neonates with MAS complicated by NPH tend to have a longer duration of ventilation and higher incidence rates of air leak syndrome and shock. OI may be used as an index for the early diagnosis of MAS complicated by NPH. | [
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] |
OBJECTIVE: To investigate the risk factors for poor prognosis of neonatal bacterial meningitis.METHODS: A retrospective analysis was performed for the clinical data of 152 children with neonatal bacterial meningitis. According to their prognosis, they were divided into a good prognosis group with 122 children and a poor prognosis group with 30 children. The two groups were compared in terms of general status, initial symptoms, and laboratory findings, and the risk factors for poor prognosis were analyzed.RESULTS: Compared with the good prognosis group, the poor prognosis group had a significantly higher proportion of children with a very low birth weight, a peripheral blood white blood cell count (WBC) of <5?109/L or >20?109/L, a C-reactive protein level of >50 mg/L, a cerebrospinal fluid (CSF) WBC of >500?106/L, a CSF glucose level of <1 mmol/L, or a CSF protein level of >2 g/L, as well as significantly higher positive rates of blood culture and/or CSF culture, Gram-positive bacteria, and Streptococcus agalactiae (P<0.05). The multivariate logistic regression analysis showed that a CSF glucose level of <1 mmol/L and a CSF protein level of >2 g/L were independent risk factors for poor prognosis of neonatal bacterial meningitis.CONCLUSIONS: A CSF glucose level of <1 mmol/L and a CSF protein level of >2 g/L are risk factors for poor prognosis of neonatal bacterial meningitis. | [
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] |
OBJECTIVE: To study the long-term prognosis of vesicoureteral reflux in children.METHODS: A retrospective analysis was performed for the clinical data of 138 children (218 ureters with reflux) who were diagnosed with vesicoureteral reflux for the first time from November 2005 to March 2017 and received medical treatment and regular follow-up. According to the initial grade of reflux, the ureters with reflux were divided into a low-grade group (141 ureters, grade I-III) and a high-grade group (77 ureters, grade IV-V), and the two groups were compared in terms of clinical data and follow-up results.RESULTS: Among the 138 children, there were 82 boys and 56 girls. Their age ranged from 31 days to 10 years at the time of confirmed diagnosis, with a median age of 8 months. The follow-up time ranged from 8 months to 7 years, with a median follow-up time of 1.4 years. At the time of confirmed diagnosis, the high-grade group had significantly higher levels of urinary N-acetyl--D-glucosaminidase, urinary microalbumin and urinary immunoglobulin G than the low-grade group (P<0.05). Among the 218 ureters with reflux, 132 (60.6%) achieved a reduction in the grade of reflux (among which 74 achieved complete disappearance of reflux), 43 had no change in the grade of reflux, and 43 had an increase in the grade of reflux. Compared with the high-grade group, the low-grade group had a significantly higher complete remission rate (41.1% vs 19.5%, P=0.001) and a significantly shorter time to complete remission of reflux (P=0.002).CONCLUSIONS: Most children with vesicoureteral reflux can achieve a reduction in the grade of reflux or even complete disappearance of reflux during follow-up, and the children with low-grade reflux have better prognosis than those with high-grade reflux. | [
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] |
OBJECTIVE: To study the clinical effect of the SCMC APL-2010 regimen in the treatment of acute promyelocytic leukemia (APL) in children.METHODS: A retrospective analysis was performed for the clinical data of 44 children with APL who received treatment with the SCMC APL-2010 regimen between April 2010 and July 2016. The Kaplan-Meier survival analysis was used to evaluate event-free survival (EFS) rate and overall survival (OS) rate.RESULTS: Of the 44 children with APL, 42 (95%) achieved a complete remission (CR) after one course of treatment and 1 achieved CR after two courses of treatment, with an overall CR rate of 98%. The 9-year EFS and OS rates were 96%3% and 97.7%2.2% respectively. As for adverse events, 41 (93%) had infection, 29 (66%) had granulocyte reduction, 12 (27%, 1 died) had differentiation syndrome, 16 (36%) had liver dysfunction, 12 (27%) had adverse gastrointestinal reactions, and 7 (16%) had QT prolongation, 1 (2%) had orchitis, and no secondary neoplasm was observed.CONCLUSIONS: Children with APL receiving the SCMC APL-2010 regimen have a good prognosis and can achieve a long-term survival, while treatment-related infection is commonly seen. | [
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OBJECTIVE: To study the value of red blood cell distribution width (RDW)-to-platelet count (PLT) ratio (RPR) on the first day of admission into the pediatric intensive care unit (PICU) in predicting the prognosis of children with sepsis.METHODS: A retrospective analysis was performed for the clinical data of 186 children with sepsis who were hospitalized in the PICU. According to their prognosis, they were divided into a survival group with 151 children and a death group with 35 children. Clinical data were compared between the two groups. The Cox proportional-hazards regression model analysis was used to investigate the factors influencing the prognosis. The receiver operating characteristic (ROC) curve was plotted to evaluate the value of RPR in predicting death. The children were divided into a high RPR group and a low RPR group according to the optimal cut-off value, and the Kaplan-Meier method was used to compare the 28-day survival rate between the two groups.RESULTS: Compared with the survival group, the death group had significantly higher RDW, procalcitonin (PCT) and RPR (P<0.05) and significantly lower PLT and albumin (ALB) (P<0.05). The Cox regression model analysis showed that low ALB, high PCT and high RPR were independent risk factors for the prognosis of children with sepsis (P<0.05). The ROC curve analysis showed that RPR had a certain value in predicting the prognosis of children with sepsis (P<0.05), with an area under the ROC curve of 0.937, an optimal cut-off value of 0.062, a sensitivity of 94.29%, and a specificity of 77.48%. The Kaplan-Meier survival analysis showed that the high RPR group had a significantly lower 28-day survival rate than the low RPR group (P<0.05).CONCLUSIONS: RPR on the first day of admission into the PICU is closely associated with the prognosis of children with sepsis and has an important value in predicting the prognosis of children with sepsis. | [
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] |
OBJECTIVE: To study the change in P wave on electrocardiogram and its diagnostic value in children and adolescents with cardioinhibitory vasovagal syncope (VVS-CI).METHODS: A total of 43 children and adolescents who were diagnosed with VVS-CI were enrolled as the VVS-CI group, and 43 healthy children and adolescents were enrolled as the control group. P wave duration and P wave voltage were measured by 12-lead electrocardiography in a basal state, and the changes were analyzed.RESULTS: Compared with the control group, the VVS-CI group had a significantly lower heart rate (P<0.05) and significantly longer P wave duration (Pwd), P wave maximum duration (Pmax), and corrected P wave maximum duration (Pcmax), as well as significantly higher P wave dispersion (Pd) and corrected P wave dispersion (Pcd) (P<0.05). Pwd, Pmax, Pd, Pcmax and Pcd had a certain diagnostic value in children and adolescents with VVS-CI (P<0.05): Pwd had a sensitivity of 69.77% and a specificity of 83.72% at the optimal cut-off value of 78.49 ms; Pmax had a sensitivity of 76.74% and a specificity of 90.70% at the optimal cut-off value of 93.39 ms; Pd had a sensitivity of 95.35% and a specificity of 69.77% at the optimal cut-off value of 27.42 ms; Pcmax had a sensitivity of 46.51% and a specificity of 88.37% at the optimal cut-off value of 120.90 ms; Pcd had a sensitivity of 83.72% and a specificity of 72.09% at the optimal cut-off value of 36.37 ms.CONCLUSIONS: Children and adolescents with VVS-CI have significantly increased Pwd, Pmax, Pd, Pcmax, and Pcd, which may indicate abnormal atrial electrical activity. The cut-off value of P wave has a certain diagnostic value in VVS-CI. | [
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OBJECTIVE: To study the application value of surface electromyography in children with dysphagia.METHODS: A total of 20 children with dysphagia were enrolled as the observation group, and 20 healthy children, matched for sex and age, were enrolled as the control group. Surface electromyography was used to record the electromyography integral values of the submental and infrahyoid muscle groups in the resting state and the state after water swallowing. The two groups were compared in terms of the electromyography integral values of the submental and infrahyoid muscle groups in the resting state and the state after swallowing 5 mL water. The observation group was observed in terms of the changes in the electromyography integral values of the submental and infrahyoid muscle groups after 1 month of rehabilitation treatment. A Spearman correlation analysis was used to evaluate the correlation of the degree of dysphagia with the electromyography integral values of the submental and infrahyoid muscle groups in the observation group.RESULTS: There was no significant difference between the two groups in the electromyography integral values of the submental and infrahyoid muscle groups in the resting state (P>0.05), while after water swallowing, the observation group had significantly higher electromyography integral values than the control group (P<0.05). The observation group had significant improvements in the clinical symptoms of dysphagia after treatment, with significant reductions in the electromyography integral values of the submental and infrahyoid muscle groups (P<0.05). The severity of dysphagia was positively correlated with the electromyography integral values of the submental and infrahyoid muscle groups (P<0.01).CONCLUSIONS: Surface electromyography is useful in the diagnosis and therapeutic effect evaluation for dysphagia in children. | [
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] |
This article reports the clinical features and C12orf65 gene mutations of a girl with autosomal recessive spastic paraplegia-55. The 8-year-old girl experienced disease onset at the age of 5 years and had optic atrophy as the main clinical manifestation, with slow movements in standing up and a slight duck-shaped gait. Peripheral blood DNA samples were collected from this child and her parents and brother to perform high-throughput whole-exome sequencing and high-throughput mitochondrial genome sequencing. Sanger sequencing was performed for verification. The results showed two compound heterozygous mutations, c.394C>T and c.447_449delGGAinsGT, in the C12orf65 gene. The former mutation came from her father and was a known pathogenic mutation, and the latter came from her mother and was a novel mutation which had not been reported in literature. This study expands the mutation spectrum of the C12orf65 gene and thus provides a molecular basis for the etiological diagnosis of the child and the genetic counseling of the family. | [
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OBJECTIVE: To investigate the current status of neglect in children aged 3-6 years in the rural areas of Urumqi, China and risk factors for neglect.METHODS: Stratified random cluster sampling was performed to select 1 326 children, aged 3-6 years, from 6 kindergartens in the rural areas of Urumqi. A self-designed questionnaire and "Chinese Neglect Evaluation Questionnaire for Rural Children Aged 3-6 Years" were used for investigation.RESULTS: Of the 1 326 children, the neglect rate was 51.89% (688 cases), and the degree of neglect was 496. There were significant differences in the neglect rate and the degree of neglect between the children in different age groups (P<0.01). The single-parent families and the remarried families had significantly higher child neglect rate and degree of neglect than the families of three generations under one roof and the core families (P<0.01). The children in left-behind status had a significantly higher degree of neglect (P<0.01). The multivariate logistic regression analysis showed that younger children, mothers with low education level, employment status of the mother as a migrant worker, single-parent and remarried families, low-income families, and left-behind status were risk factors for child neglect (P<0.05).CONCLUSIONS: The neglect of children aged 3-6 years in the rural areas of Urumqi is serious, and more attention should be paid to younger children, children whose mothers with low education level, left-behind children, and children from single-parent families, remarried families and low-income families. | [
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An 11-year-old girl was found to have pale complexion and anemia with gradual aggravation for one year. She was weak in the past and developed pneumonia in the right middle lung 3-5 times per year, which was improved after anti-infective therapy. She and her mother had congenital deaf-mutism. Physical examination showed the appearance of anemia, without bleeding, jaundice, hepatosplenomegaly, or lymph node enlargement. Routine blood test results showed reductions in all three blood cell lines, normocytic anemia, and megaloblastoid change in granulocytic and erythroid cell lines in bone marrow, with no obvious increase in primitive cells or metastatic tumor cells. Whole exome sequencing indicated the presence of a known pathogenic mutation for Emberger syndrome (ES), c.1084C>T (p.Arg362*) in the GATA2 gene. The girl was finally diagnosed with ES, and myelodysplastic syndrome (MDS) progressed to acute myeloid leukemia during follow-up. ES is a rare type of MDS with autosomal dominant inheritance in clinical practice, and it is difficult to make a confirmed diagnosis. ES should be considered for children with unexplained lymphedema and congenital deafness, and gene detection should be performed to make a confirmed diagnosis. | [
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] |
OBJECTIVE: To study the effect of PR-957 on the formation of A1 reactive astrocytes.METHODS: The cerebral cortices of 1-day-old female rats were obtained and cultured for primary astrocytes. These cells were divided into 3 groups: control, lipopolysaccharide (LPS), and LPS+PR-957. The LPS group was treated with LPS (at a concentration of 5 mol/L) for 48 hours; the LPS+PR-957 group was treated with PR-957 (at a final concentration of 200 nmol/L) for 1 hour and then LPS for 48 hours. Enzyme-linked immunosorbent assay was used to determine the expression of complement 3 (C3, a marker for A1 reactive astrocytes) and tumor necrosis factor alpha (TNF-). Quantitative real-time PCR was used to determine the relative mRNA expression of glypican-6 (GPC6), SPARC-like 1 (SPARCL1), and lipocalin-2 (LCN2). All the above experiments were repeated three times independently.RESULTS: C3 expression was almost not observed in the control group, but was observed in both the LPS group and the LPS+PR-957 group, with significantly lower expression observed in the LPS+PR-957 group (P<0.05). The expression of TNF- was consistent with that of C3. Compared with the control group, the LPS and the PS+PR-957 groups had significantly reduced mRNA expression levels of GPC6 and SPARCL1 but significantly increased mRNA expression level of LCN2 (P<0.001). Compared with the LPS group, the LPS+PR-957 group had significantly increased mRNA expression levels of GPC6 and SPARCL1 but significantly reduced mRNA expression level of LCN2 (P<0.001).CONCLUSIONS: LPS can induce the transformation from astrocytes to A1 reactive astrocytes, and PR-957 can inhibit the formation of LPS-induced A1 reactive astrocytes. | [
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] |
OBJECTIVE: To observe differential peptidomics in the hippocampal tissue in a rat model of premature white matter injury, and to investigate the mechanism of premature white matter injury.METHODS: Twenty neonatal Sprague-Dawley rats were randomly and equally divided into a control group and a model group. Rats in the model group underwent permanent ligation of the right common carotid artery 2 days after birth, followed by 2 hours of hypoxia. For rats in the control group, the right common carotid artery was isolated, but without ligation and hypoxia. Brain tissue samples were collected from the two groups, and hippocampal tissue was isolated. Liquid chromatography-tandem mass spectrometry combined with tandem mass spectrometry was used for peptidomic profiling of hippocampal tissue, and the differentially expressed peptides between the two groups were subjected to bioinformatics analysis to assess their possible roles in neural development and function.RESULTS: A total of 4164 peptides were identified and quantified, and 262 of them were differentially expressed (absolute fold change ?2.5), including 164 upregulated peptides and 98 downregulated peptides. The numbers of differentially expressed peptides of the precursor proteins ELN, PCLO, MYO15a, MAP4, and MAP1b were the most, and may play significant roles in the pathogenesis of premature white matter injury. CDK5 signaling pathway in the hippocampus was activated in the rat model of premature white matter injury.CONCLUSIONS: The differentially expressed peptides related to precursor proteins such as MAP1b may be key bioactive peptides involved in neural development and function in premature white matter injury, and activation of the CDK5 signaling pathway may be associated with premature white matter injury. | [
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] |
OBJECTIVE: To investigate the effects of calcium-sensitive receptors (CaSR) on the expression of 11-hydroxysteroid dehydrogenase type 2 (11-HSD2) and cortisol concentration in a neonatal mouse model of persistent pulmonary hypertension (PPH).METHODS: Fifty-six newborn C57BL/6 mice were randomly divided into a control group (n=14), a PPH group (n=14), an agonist group (n=14), and an inhibitor group (n=14). The mice in the PPH, agonist, and inhibitor groups were exposed to a 12% oxygen concentration, and the agonist group and inhibitor group were given CaSR agonist (GdCl3, 16 mg/kg) and CaSR antagonist (NPS2390, 1 mg/kg) intraperitoneally once a day, respectively. The mice in control group were exposed to air, and then injected with an equal volume of normal saline as those in the PPH group every day. All mice were treated for 14 days. Morphological examination of heart and lung tissues was performed using hematoxylin-eosin staining. The expression levels of 11-HSD2 mRNA and 11-HSD2 protein in lung tissues were measured by qRT-PCR and Western blot respectively. Brain natriuretic peptide (BNP) and cortisol levels in lung tissues were determined using ELISA.RESULTS: Compared with the control group, the PPH group had significantly increased pulmonary artery wall thickness (WT%), ratio of right to left ventricular thickness (RV/LV), alveolar mean linear intercept, and BNP concentration and a significantly reduced radial alveolar count (P<0.05); compared with the PPH group, the agonist group showed significant increases in WT% and BNP concentration, while the inhibitor group showed significant reductions in the two indicators (P<0.05). Compared with the control group, the PPH group showed significant reductions in the expression levels of 11-HSD2 mRNA and 11-HSD2 protein, but a significant increase in cortisol concentration (P<0.05); compared with the PPH group, the agonist group had significantly lower expression levels of 11-HSD2 mRNA and 11-HSD2 protein, but a significant higher cortisol concentration, while the inhibitor group showed opposite changes in these indicators (P<0.05).CONCLUSIONS: CaSR may control the development and progression of PPH in newborn mice by regulating the expression of 11-HSD2 and cortisol concentration. | [
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OBJECTIVE: To establish a congenital chloride diarrhea (CCD)-associated SLC26A3 c.392C>G (p.P131R) polymorphism-expressing cell model, and to investigate its biological function.METHODS: The sequence of the SLC26A3 gene in GenBank was used to design the upstream and downstream single-guide RNA (sgRNA) that could specifically recognize the 392 locus of the SLC26A3 gene, and the sgRNA was mixed with the pSpCas9-puro vector after enzyme digestion to construct an eukaryotic recombinant expression plasmid (pSpCas9-SLC26A3). Caco-2 cells were transfected with the recombinant plasmid and synthesized single-stranded DNA oligonucleotides (ssODNs), and Taqman genotyping assay and Sanger sequencing were used to identify the expression of SLC26A3 c.392C>G (p.P131R) in Caco-2 cells. Wild-type Caco-2 cells were selected as normal control group and the Caco-2 cells with successful expression of SLC26A3 c.392C>G (p.P131R) was selected as P131R group. Both groups were treated with 100 ng/mL tumor necrosis factor- (TNF-), and then the normal control group was named as TNF- group, and the P131R group was named as TNF-+P131R group. Electric cell-substrate impedance sensing (ECIS) assay was used to evaluate the change in the monolayer barrier function of intestinal epithelial cells in the above four groups, and Western blot was used to measure the change in the expression of SLC26A3 protein in the normal control group and the P131R group.RESULTS: The eukaryotic recombinant expression plasmid (pSpCas9-SLC26A3) was successfully constructed. Both Taqman genotyping assay and Sanger sequencing confirmed the successful establishment of the Caco-2 cell model of SLC26A3 c.392C>G (p.P131R) expression. ECIS assay showed that compared with the normal control group, the P131R group had a significant increase in the monolayer permeability of intestinal epithelial cells (P<0.05), and at the same time, the P131R group had a significantly greater increase in cell membrane permeability after the induction with 100 ng/mL TNF- (P<0.05). Western blot showed that compared with the normal control group, the P131R group had a significant reduction in the expression of SLC26A3 protein (P=0.001).CONCLUSIONS: SLC26A3 c.392C>G (p.P131R) can reduce the expression of SLC26A3 protein, increase the monolayer permeability of intestinal epithelial cells, and thus lead to diarrhea. | [
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] |
The enactment of the Water Framework Directive (WFD) initiated scientific efforts to develop reliable methods for comparing prevailing lake conditions against reference (or nonimpaired) states, using the state of a set biological elements. Drawing a distinction between impaired and natural conditions can be a challenging exercise. Another important aspect is to ensure that water quality assessment is comparable among the different Member States. In this context, the present paper offers a constructive critique of the practices followed during the WFD implementation in Greece by pinpointing methodological weaknesses and knowledge gaps that undermine our ability to classify the ecological quality of Greek lakes. One of the pillars of WDF is a valid lake typology that sets ecological standards transcending geographic regions and national boundaries. The national typology of Greek lakes has failed to take into account essential components. WFD compliance assessments based on the descriptions of phytoplankton communities are oversimplified and as such should be revisited. Exclusion of most chroococcal species from the analysis of cyanobacteria biovolume in Greek lakes/reservoirs and most reservoirs in Spain, Portugal, and Cyprus is not consistent with the distribution of those taxa in lakes. Similarly, the total biovolume reference values and the indices used in classification schemes reflect misunderstandings of WFD core principles. This hampers the comparability of ecological status across Europe and leads to quality standards that are too relaxed to provide an efficient target for the protection of Greek/transboundary lakes such as the ancient Lake Megali Prespa. | [
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During the last decade, China's agro-food production has increased rapidly and been accompanied by the challenge of increasing greenhouse gas (GHG) emissions and other environmental pollutants from fertilizers, pesticides, and intensive energy use. Understanding the energy use and environmental impacts of crop production will help identify environmentally damaging hotspots of agro-production, allowing environmental impacts to be assessed and crop management strategies optimized. Conventional farming has been widely employed in wolfberry (Lycium barbarum) cultivation in China, which is an important cash tree crop not only for the rural economy but also from an ecological standpoint. Energy use and global warming potential (GWP) were investigated in a wolfberry production system in the Yellow River irrigated Jingtai region of Gansu. In total, 52 household farms were randomly selected to conduct the investigation using questionnaires. Total energy input and output were 321,800.73 and 166,888.80 MJ ha-1, respectively, in the production system. The highest share of energy inputs was found to be electricity consumption for lifting irrigation water, accounting for 68.52%, followed by chemical fertilizer application (11.37%). Energy use efficiency was 0.52 when considering both fruit and pruned wood. Nonrenewable energy use (88.52%) was far larger than the renewable energy input. The share of GWP of different inputs were 64.52% electricity, 27.72% nitrogen (N) fertilizer, 5.07% phosphate, 2.32% diesel, and 0.37% potassium, respectively. The highest share was related to electricity consumption for irrigation, followed by N fertilizer use. Total GWP in the wolfberry planting system was 26,018.64 kg CO2 eq ha-1 and the share of CO2, N2O, and CH4 were 99.47%, 0.48%, and negligible respectively with CO2 being dominant. Pathways for reducing energy use and GHG emission mitigation include: conversion to low carbon farming to establish a sustainable and cleaner production system with options of raising water use efficiency by adopting a seasonal gradient water pricing system and advanced irrigation techniques; reducing synthetic fertilizer use; and policy support: smallholder farmland transfer (concentration) for scale production, credit (small- and low-interest credit) and tax breaks. | [
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The need to protect communities from hazardous waste is an important agenda for any nation. Although pollutant management and policy development are attempted in many developing countries, it is not always successful due to limited funds, project resources, and access to trained experts to conduct toxic site identification projects. For this reason, Pure Earth created the Toxic Site Identification Program (TSIP). The goal of the TSIP program is to provide reliable information and data that identifies location of toxic sites and the level of toxic severity. TSIP is significant because it provides developing countries a database of ranked toxic sites identified as hazardous risk to human health. For example, Azerbaijan is one of the most polluted post-Soviet nations, but has limited resources to address and manage its polluted sites. The Azerbaijani TSIP database is the first reliable data source that identifies hazardous pollutants in the country. Our study is significant because it discusses how the TSIP labels and ranks the level of toxic severity to human health. It is also the first data source in Azerbaijan that identifies which Soviet legacy toxic sites are affecting local communities. Although our study is specific to Azerbaijan, the TSIP method can be applied to nations with similar data limitations and the need for a database that identifies country specific environmental and hazardous locations. The data sampling method and results are mapped and accompanied by tables of the collected pollutant types to identify communities at greatest health-risk to legacy toxic sites. | [
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Objective To explore the functions and mechanisms of macrophages derived from PGRN gene knockout (PGRN-/- ) C57BL/6 mice in the invasion and migration of breast cancer cells. Methods Breast cancer cells were cultured in conditioned medium of macrophages derived from WT and PGRN-/- mice. TranswellTM assay and scratch assay were used to detect the invasion and migration ability of cancer cells. Western blot analysis was used to detect the expression of E-cadherin and N-cadherin in cancer cells. Cytokine array, real-time quantitative PCR and ELISA were performed to investigate the differences of cytokines secreted by macrophages derived from WT and PGRN-/- mice. Breast cancer cells were treated by the differentially expressed cytokine interleukin-6 (IL-6), and then the above methods were used to investigate its effect on cancer cells. Western blot analysis was used to verify the roles of NF-B and JAK/STAT3 signaling pathways. Results The macrophages derived from PGRN-/- mice blocked NF-B signaling pathway, reduced IL-6 secretion, and inhibited the invasion and migration of breast cancer cells. IL-6 activated JAK/STAT3 signaling pathway to promote the invasion and migration of breast cancer cells. Conclusion The macrophages derived from PGRN-/- mice can block the NF-B and JAK/STAT3 signaling pathways, down-regulate IL-6 expression, and inhibit the invasion and migration of breast cancer cells. | [
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] |
Objective To prepare inducible lupus model mice and investigate the effect of nuclear autoantigenic sperm protein (NASP) gene mutation on the autoimmune response of mice with induced systemic lupus erythematosus (SLE). Methods The 3-month wild-type B6 (B6-WT) mice were used as a control group and the NASP mutant B6 (B6-NASPM) mice as an experimental group. Mouse spleen lymphocytes were activated with concanavalin A (ConA), and the DNA was extracted as autoantigen. B6-WT mice and B6-NASPM mice were immunized three times. Serum anti-double stranded DNA (dsDNA) IgG levels were detected by ELISA. Renal lesions were detected by HE staining. Immunohistochemical staining was performed to detect the deposition of IgG and complement C3 in the renal tissues. Flow cytometry was applied to compare the spleen lymphocyte subsets in B6-WT and B6-NASPM mice and to explore the mechanism of NASP gene mutation affecting the immune response in mice. Results Compared with B6-WT mice, B6-NASPM mice showed no significant changes in body weight, kidney index and spleen index; serum anti-dsDNA IgG levels significantly increased; glomerular cell proliferation was obvious and the deposition of IgG and C3 in the renal tissues increased. The proportion of spleen CD3+ T cells and natural killer (NK) cells decreased, while the proportion of CD19+ B cells and regulatory B cells (Breg) increased. Conclusion Mutation in the NASP gene can increase the levels of anti-dsDNA IgG antibodies, promote cell proliferation in the glomerulus of the kidney, deposition of IgG antibodies and complement C3, alter the proportion of immune cells in the spleen and aggravate the autoimmune response in lupus model mice. | [
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Objective To investigate the function and differentiation of 1/17 type helper T (Th1/17) cells. Methods Bioinformatics analysis was performed using a gene chip dataset (GSE104021) in GEO which contains gene expression data from Th17 cells and Th1/17 cells of healthy human subjects. Taking Th17 cells as the control, R language software was used to analyze the differentially expressed genes (DEGs) between Th17 cells and Th1/17 cells, so as to explore the main functional molecules of Th1/17 cells. After that, gene ontology (GO) analysis and Kyoto encyclopedia of genes and genomes (KEGG) analysis of DEGs were conducted by R language software. Finally, the genes enriched into the target biological process in the GO analysis were selected for protein-protein interaction network (PPI) analysis to explore the differentiation process of Th1/17 cells. Results Analysis of DEGs showed that, compared with Th17 cells, the underexpressed genes in Th1/17 cells were interleukin 17A (IL-17A) and C-C motif chemokine receptor 4 (CCR4). The over-expressed genes were coiled-coil domain-containing 3 (CCDC3), C-C motif chemokine ligand 4 (CCL4), colony stimulating factor 2 receptor beta common subunit (CSF2RB), C-C motif chemokine ligand 5 (CCL5), interferon gamma (IFNG) and epithelial stromal interaction 1 (EPSTI1). In GO analysis, cell component analysis showed that the expression products of these DEGs were mainly located at external side of plasma membrane and the granulocyte-macrophage colony stimulating factor (GM-CSF) receptor complex; biological process analysis showed that the expression products of DEGs were involved in the upregulation of interleukin 23 (IL-23), the chemokine-mediated signaling pathway and the upregulated chemotaxis of natural killer (NK) cells; molecular function analysis showed that the expression products of these DEGs had C-C motif chemokine 5 receptor (CCR5) binding activity, cytokine activity and interferon gamma (IFN-) receptor binding activity. The results of KEGG analysis showed that the DEGs were enriched in the cytokine-cytokine receptor interaction, rheumatoid arthritis, inflammatory bowel disease and chemokine signaling pathways. The GO analysis showed that DEGs IL-17A and IFNG were enriched to the biological process of upregulating IL-23 production. PPI showed that IL-17A and IFNG had biological functions of regulating cytokine production and myeloid white blood cell differentiation. Conclusion Bioinformatics analysis showed that the protein products encoded by overexpressed genes CCL4, CSF2RB, CCL5, IFNG and EPSTI1 in Th1/17 cells were potential functional effectors of Th1/17 cells. Th1/17 cells could produce IFN- and IL-17A, which act on macrophages and dendritic cells (DCs) derived from myeloid white blood cells, thus promoting the differentiation of macrophages and DCs and the production of IL-23. IL-23 promotes trans-differentiation of Th17 cells into Th1/17 cells. | [
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] |
Objective To develop the colloidal gold immunochromatography test strip for qualitatively detecting the hemoglobin (Hb) in human feces. Methods Mouse anti-human Hb monoclonal antibody SPR-5 marked by colloidal gold was coated in glass fiber membrane, and then the mouse anti-human Hb SP-5 monoclonal antibody and goat anti-mouse IgG were immobilized in testing (T) line and control (C) line located in nitrocellulose membranes, respectively. With this double antibody sandwich technique and immunochromatography test, the Hb antigen would react with both antibodies coated in the T line and C line and cause two colour reactions if the detected sample was positive, whereas the antigen-antibody combination and colour reaction only showed up in the C line when the sample was negative. Results The minimum detection limit of this test strip for human Hb was 21 ng/mL and no cross reactions were found in chick Hb, rabbit Hb, sheep Hb, pig Hb and cow Hb. Conclusion The test strips can improve the detection rate of fecal occult blood obviously and avoid false-positive results. | [
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] |
Objective To explore the inhibitory effects of polyphenols from Toona sinensis seeds (PTSS) on neuroinflammation and the underlying mechanism in rats with Parkinson's disease (PD). Methods PD rat models were prepared by stereotaxic injection of 6-hydroxydopamine (6-OHDA) into one side of striatum of Sprague-Dawley male rats. Model rats were randomly divided into model group and PTSS group (n=10), and a normal control group was set as well (n=10). The rotational behavior of rats was induced by intraperitoneal injection of apomorphine (APO) after 30 days, and the behavioral changes of rats from each group were investigated. The morphological and quantity changes of DA neurons (tyrosine hydroxylase positive, TH-positive), microglia cells (ionized calcium binding adaptor molecule-1, Iba1-positive) and astrocytes (glial fibrillary acidic protein, GFAP-positive) in substantia nigra (SN) of rats from each group were examined by immunohistochemistry. Inducible nitric oxide synthase (iNOS), nuclear factor-B p65 (NF-Bp65), p38 mitogen-activated protein kinase (p38MAPK) and phosphor-p38 mitogen-activated protein kinase (p-p38MAPK) levels were evaluated through immunohistochemical staining. The protein levels of TH, GFAP, p38MAPK and p-p38MAPK in SN were examined by Western blot analysis. Results The number of rotations in the rats of the PTSS group was significantly reduced compared with that in the model group. The number of TH-positive cells in the model group was much less than that in the control group. The number and protein levels of TH-positive cells were enhanced significantly by PTSS intervention. Compared with the control group, the protein levels of Iba1, GFAP, iNOS, NF-B, p38MAPK and p-p38MAPK in the injured side of the model group significantly increased, which could be suppressed significantly by PTSS intervention. Conclusion PTSS demonstrates protective effects on DA neurons by inhibiting p38MAPK signaling pathway and reducing the expression of inflammatory factors in PD rats. | [
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] |
Objective To investigate the role and mechanism of histone deacetylase 3 (HDAC3) in alcohol-induced inflammation and permeability of intestinal epithelial cells. Methods To select the proper concentration of alcohol, differentiated Caco-2 cells were treated with different concentrations (10, 25, 50, 100 and 200 mmol/L) of alcohol, and then cell viability was assayed by MTT assay; the mRNA and protein levels of HDAC3 were analyzed by real-time PCR and Western blot analysis. Differentiated Caco-2 cells were divided into three groups: control group, alcohol group (treatment with 50 mmol/L alcohol for 60 minutes), and alcohol combined with HDAC3 inhibitor group (pretreatment with 2 mol/L RGFP966 1 hour before alcohol). ELISA was performed to detect tumor necrosis factor (TNF-) level in cell supernatant. Transepithelial electrical resistance (TER) was measured using a resistance meter. Western blot analysis was used to determine the protein levels relevant to tight junction (occludin and claudin-1) and NF-B activation (IB and phosphorylated NF-Bp65). Results Alcohol at 10, 25 and 50 mmol/L did not affect cell viability. The mRNA and protein expression levels of HDAC3 increased in a dose-dependent manner after alcohol treatment at these concentration s. Compared with the control group, TNF- and phosphorylated NF-Bp65 levels increased, whereas TER and protein levels of occludin, claudin-1 and IB decreased in the alcohol group. Compared with the alcohol group, TNF- and phosphorylated NF-Bp65 levels were reduced, while TER and protein levels of occludin, claudin-1 and IB were elevated in the alcohol combined with HDAC3 inhibitor group. Conclusion HDAC3 inhibition can attenuate alcohol-induced inflammation and permeability of intestinal epithelial cells, which may be related to the inactivation of NF-B. | [
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] |
Objective To explore the effect of tanshinone IIA (TSA) on hydrogen peroxide (H2O2)-induced senescence of human umbilical vein endothelial cells (HUVECs) and the underlying mechanism. Methods HUVECs were cultured in vitro and divided into the control group, model group and TSA group. The cells in the TSA group were pre-treated with TSA for 24 hours. H2O2 was used to induce cell senescence in the model and TSA groups. Transfection with SIRT1 siRNA was used for the knockdown of SIRT1 in HUVECs. CCK-8 assay was performed to detect cell viability. The expression levels of senescence-related proteins (P21 and P26), SIRT1, phosphorylated endothelial nitric oxide synthase (p-eNOS), and eNOS were detected by Western blot analysis. Senescence-associated -galactosidase (SA--gal) staining was performed to evaluate cell senescence. Results Pretreatment with TSA at low concentrations (10, 20 and 40 g/mL) for 24 hours did not affect cell viability, while high concentrations (80, 160 and 320 g/mL) decreased cell viability significantly. In addition, 10, 20 and 40 g/mL of TSA promoted H2O2-mediated cell viability of HUVECs in a concentration-dependent manner. Compared with the control group, the positive rate of SA--gal staining in the model group increased, while the positive rate in the TSA group was significantly lower than that in the model group. The expression levels of P21 and P16 protein in the model group were higher than those in the control group, while SIRT1 and p-eNOS/eNOS were lower than those in the control group. Conversely, the expression of P21 and P16 proteins in the TSA group were lower than those in the model group, and SIRT1 and p-eNOS/eNOS were higher in the TSA group than those in the model group. Transfected with SIRT1 siRNA significantly down-regulated the expression of SIRT1 in HUVECs and the positive rate of SA--gal staining was notably raised when SIRT1 was silenced in TSA-treated HUVECs. Conclusion TSA attenuates H2O2-induced endothelial cell senescence by activating SIRT1/eNOS signaling pathway. | [
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] |
Objective To investigate the effect of aldosterone (ALD) on the migration of rat hepatic stellate cells (HSC-T6) and its mechanism. Methods HSC-T6 cells were cultured and divided into control group (treated with medium only), ALD group (only 1 nmol/L ALD, 24 hours), spironolactone pre-treated group (a specific inhibitor of ALD receptor 10 nmol/L spironolactone at 1 hours before ALD treatment), Y27632 pre-treated group (a RhoA kinase inhibitor 10 nmol/L Y27632 at 1 hours before ALD treatment). A TranswellTM chamber system was used to observe the change of migration in the different groups. Changes in actin cytoskeletal organization were visualized by fluorescence staining using rhadamin-labeled phalloidin and fluorescence images were recorded using confocal microscopy. The levels of phosphorylated myosinlight chain (p-MLC) and phosphorylated moesin (p-moesin) in the RhoA/ROCK signaling pathway were evaluated by Western blotting in HSC-T6 cells. Results ALD treatment of HSC-T6 resulted in the enhancement of migration, but the effect of ALD-induced migration could be inhibited by spironolactone and Y27632. Stimulation of HSC-T6 with ALD induced a rapid morphological change conconmitant with a robust reorganization of actin cytoskeleton, while the morphological change was suppressed by spironolactone and Y27632. The effect of aldosterone on the activation of HSC migration was mediated by p-MLC and p-moesin protein expressions through the RhoA/ROCK signaling pathway. Spironolactone and Y27632 had the ability to block aldosterone-induced protein expressions in HSC-T6 cells. Conclusion ALD can induce the migration of activated HSC-T6 cells through the activation of the RhoA/ROCK signaling pathway. | [
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] |
Objective To investigate the role of RAD51 in cell proliferation, migration and chemosensitivity to temozolomide (TMZ) using U251 glioma cell line, and to clarify the underlying molecular mechanism. Methods TCGA database was utilized to analyze the expression changes of RAD51 in gliomas. RAD51 was over-expressed or knocked down in U251 glioma cells via lentivirus infection, or its activity was inhibited by small molecule inhibitors. Cell proliferation and migration ability were examined by CCK-8 assay, colony formation assay, and scratch wound-healing assay; CCK-8 assay and flow cytometry were performed to assess the effect of RAD51 on the sensitivity of glioma cells upon the treatment of temozolomide. Western blotting was used to determine the alteration of P53. Results The expression of RAD51 significantly increased in glioma tissues. RAD51 enhanced the proliferation and migration ability of U251 glioma cells; knockdown of RAD51 enhanced the sensitivity of U251 glioma cells to temozolomide. Over-expression of RAD51 increased the expression of P53, whereas knockdown of RAD51 decreased the expression of P53. Conclusion RAD51 plays an oncogene function in glioma cells. RAD51 over-expression enhances the proliferation and migration of glioma cells. RAD51 knockdown increases the sensitivity of glioma cells to temozolomide. | [
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] |
Objective To study the characteristics of the expression of aquaporin-4 (AQP4) in the brains and astrocytes of rats with thermoplegia. Methods Sixty healthy male Sprague-Dawley rats weighing (25030) g were randomly divided into control group and model group. The quiet exposure method with high temperature (40DegreesCelsius) and high humidity (70%) was used to make a typical rat model of thermoplegia to monitor rectal temperature and record onset time every 10 minutes. When the temperature of stressed rats reached 42.5 DegreesCelsius, it was regarded as onset time of the disease. The rats in both groups were placed at 26DegreesCelsius with humidity 60% later. After 5-hour observation and their behavior evaluation, the rats were killed and their brain tissues were taken for measuring the water content of the tissues. The astrocytes of the rats were cultured at 37DegreesCelsius and 41DegreesCelsius. AQP4 mRNA and protein expression were detected by reverse-transcription PCR and Western blot analysis. Results Compared with the control group, the expression of AQP4 mRNA and protein were significantly lower in the model group than in the control group. Conclusion High temperature may lead to the destruction of blood-brain barrier and the down-regulation of AQP4 mRNA and protein expression in experimental rats, which can induce the occurrence and development of cerebral edema in experimental rats. | [
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] |
Objective To investigate the correlations between the expression of vascular endothelial growth factor (VEGF) and thrombospondin 1 (TSP-1) in breast cancer and the prognosis. Methods Immunohistochemical staining was used to detect the expression of VEGF and TSP-1 in 160 cases of breast cancer tissues and adjacent tissues, and the relationships between them were analyzed. Results The expression of TSP-1 significantly decreased and the expression of VEGF significantly increased in breast cancer tissues. Low expression of TSP-1 and high expression of VEGF were significantly associated with high clinical stage, poor differentiation, and lymph node metastasis. After 3 years of follow-up, the recurrence rate was 15.6%. Spearman rank correlation analysis showed that there was a positive correlation between the prognosis recurrence rate and the positive expression rate of VEGF (r=0.459), but negatively correlated with the positive expression rate of TSP-1 (r=-0.543). Logistic regression analysis showed that TSP-1 positive expression rate, VEGF positive expression rate, lymph node metastasis and clinical stage were the main independent risk factors for prognosis and recurrence. Conclusion The high expression of VEGF and the low expression of TSP-1 in breast cancer tissues are significantly correlated with the main clinical features. The recurrence rate of patients with high expression of VEGF and low expression of TSP is high. | [
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Objective To investigate the relationship between long-chain intergenic non-coding RNA324 (LINC00324) and immunophenotype in peripheral blood leukocytes of acute myeloid leukemia (AML) patients. Methods Real-time quantitative PCR and bioinformatics databases were utilized to analyze the expression level of LINC00324 in peripheral blood leukocytes and cell lines KG-1, THP-1 and U937 in AML patients. The relationships of the expression level of LINC00324 with the red blood cell and platelet count, the expression levels of LINC00324 and immunophenotypes in 40 AML patients were analyzed by Person correlation analysis. The immunophenotypes included CD14, CD68, CD64, CD11b, CD4, CD45, CD33, HLA-DR, CD163, CD2, CD58, CD117, CD43, CD34, CD99, CD8, CD38, CD10, CD13, CD56, CD7, TdT, CD235a, CD138, CD61, MPO and CD19. Simultaneously, the cBioPortal database datasets (TCGA, NEJM 2013) were used to analyze the clinical characteristics of 173 AML patients, and to analyze the correlations between the expression level of LINC00324 and the peripheral blood blast percentage and white blood cell count in tumor samples. Results The expression of LINC00324 in peripheral blood leukocytes of AML patients was down-regulated, and its expression level was significantly correlated with immunophenotype CD33, red blood cell and platelet count. Analysis of bioinformatics database showed that LINC00324 was under-expressed in myeloid leukemia cell lines. The expression of LINC00324 in AML patients was associated with multiple immunophenotypes such as CD33, CD117, CD11b, CD14 and CD64 and was negatively correlated with peripheral blood blast percentage and white blood cell count. Conclusion LINC00324 may be involved in regulating the differentiation, development and function of immune cells, which providing a new strategy for the development of targeted drugs or treatment of AML. | [
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] |
Objective To explore the preliminary application of metabonomics in the qualitative diagnosis of non-small cell lung cancer (NSCLC). Methods According to the pathological type, 201 patients with NSCLC were divided into squamous cell carcinoma (SCC) group (n=71) and adenocarcinoma (AC) group (n=130). Immunohistochemistry was used to detect the expression of ki67, cytokeratin 5/6 (CK5/6) and CK7. Ultra-high performance liquid chromatography-time-of-flight mass spectrometry (UPLC-Q/TOF-MS) was used to detect serum metabolomics. Results SCC group showed typical SCC structure; ki67 proliferation index was 21.9%; CK5/6 expression was positive; CK7 expression was negative or weakly positive. The typical adenoid structure was found in the AC group; the proliferation index of ki67 was 17.6%; CK7 was positive; and CK5/6 was negative or weakly positive. UPLC-Q/TOF-MS screened 28 different metabolites, of which 6 were the most significant ones: L-leucine, carnitine, C16 sphinganine, 13, 16, 19-docosatrienoic acie (DA), LysoPE (18:2/0:0), PC (20:4/P-16:0). These metabolites had good diagnostic value, among which L-Leucine had the highest specificity and LysoPE had the highest sensitivity. Conclusion Metabolomic analysis of lung SCC and AC provides a new index for the differential diagnosis of NSCLC. | [
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Objective To prepare polyclonal antibodies against Shisa like 1 protein (SSL1) and study the localization of SSL1 in hepatocellular carcinoma SMMC-7721 cells. Methods Human SSL1 gene was cloned from HepG2 cells by reverse transcription PCR, and then inserted into prokaryotic expression vector pET-28a to generate the SSL1 expression vector. The recombinant plasmid pET28a-SSL1 was then transformed into E. coli BL21 (DE3) and induced to express by IPTG. Polyclonal antibody against SSL1 was generated by immunizing Kunming mouse with the purified protein by the routine method. The specificity of polyclonal antibody was verified by Western blot analysis. The expression of SSL1 in SMMC-7721 cells was detected by immunofluorescent cytochemistry. Golgi complexes were signed by Golgi-Tracker Red to analyze the subcellular localization of SSL1 protein in SMMC-7721 cells. Results The SSL1 gene was cloned and the recombinant vector pET28a-SSL1 was successfully constructed. Pure SSL1 protein expression in E. coli BL21 was confirmed and polyclonal antibodies against protein SSL1 was obtained in immunized Kunming mice. Immunofluorescent cytochemistry showed that SSL1 was expressed in the cytoplasm, and was co-localized with Golgi-Tracker Red in SMMC-7721 cells. Conclusion We have obtained SSL1 polyclonal antibodies with high specificity, which was proved situated in Golgi bodies of SMMC-7721 cells. | [
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Traumatic brain injury (TBI) affects the lives of millions of Americans each year (1). To describe the trends in TBI-related deaths among different racial/ethnic groups and by sex, CDC analyzed death data from the National Vital Statistics System (NVSS) over an 18-year period (2000-2017). Injuries were also categorized by intent, and unintentional injuries were further categorized by mechanism of injury. In 2017, TBI contributed to 61,131 deaths in the United States, representing 2.2% of approximately 2.8 million deaths that year. From 2015 to 2017, 44% of TBI-related deaths were categorized as intentional injuries (i.e., homicides or suicides). The leading category of TBI-related death varied over time and by race/ethnicity. For example, during the last 10 years of the study period, suicide surpassed unintentional motor vehicle crashes as the leading category of TBI-related death. This shift was in part driven by a 32% increase in TBI-related suicide deaths among non-Hispanic whites. Firearm injury was the underlying mechanism of injury in nearly all (97%) TBI-related suicides among all groups. An analysis of TBI-related death rates by sex and race/ethnicity found that TBI-related deaths were significantly higher among males and persons who were American Indians/Alaska Natives (AI/ANs) than among all other groups across all years. Other leading categories of TBI-related deaths included unintentional motor vehicle crashes, unintentional falls, and homicide. Understanding the leading contributors to TBI-related death and identifying groups at increased risk is important in preventing this injury. Broader implementation of evidence-based TBI prevention efforts for the leading categories of injury, such as those aimed at stemming the significant increase in TBI-related deaths from suicide, are warranted. | [
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] |
CDC, the Food and Drug Administration (FDA), state and local health departments, and public health and clinical stakeholders are investigating a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) (1). CDC has published recommendations for health care providers regarding EVALI (2-4). Recently, researchers from Utah and New York published proposed diagnosis and treatment algorithms for EVALI (5,6). EVALI remains a diagnosis of exclusion because, at present, no specific test or marker exists for its diagnosis, and evaluation should be guided by clinical judgment. Because patients with EVALI can experience symptoms similar to those associated with influenza or other respiratory infections (e.g., fever, cough, headache, myalgias, or fatigue), it might be difficult to differentiate EVALI from influenza or community-acquired pneumonia on initial assessment; EVALI might also co-occur with respiratory infections. This report summarizes recommendations for health care providers managing patients with suspected or known EVALI when respiratory infections such as influenza are more prevalent in the community than they have been in recent months (7). Recommendations include 1) asking patients with respiratory, gastrointestinal, or constitutional symptoms about the use of e-cigarette, or vaping, products; 2) evaluating those suspected to have EVALI with pulse oximetry and obtaining chest imaging, as clinically indicated; 3) considering outpatient management for clinically stable EVALI patients who meet certain criteria; 4) testing patients for influenza, particularly during influenza season, and administering antimicrobials, including antivirals, in accordance with established guidelines; 5) using caution when considering prescribing corticosteroids for outpatients, because this treatment modality has not been well studied among outpatients, and corticosteroids could worsen respiratory infections; 6) recommending evidence-based treatment strategies, including behavioral counseling, to help patients discontinue using e-cigarette, or vaping, products; and 7) emphasizing the importance of annual influenza vaccination for all persons aged ?6 months, including patients who use e-cigarette, or vaping products. | [
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Two pneumococcal vaccines are currently licensed for use in adults in the United States: a 13-valent pneumococcal conjugate vaccine (PCV13 [Prevnar 13, Pfizer, Inc.]) and a 23-valent pneumococcal polysaccharide vaccine (PPSV23 [Pneumovax 23, Merck and Co., Inc.]). In 2014, the Advisory Committee on Immunization Practices (ACIP)* recommended routine use of PCV13 in series with PPSV23 for all adults aged ?65 years based on demonstrated PCV13 safety and efficacy against PCV13-type pneumonia among adults aged ?65 years (1). At that time, ACIP recognized that there would be a need to reevaluate this recommendation because it was anticipated that PCV13 use in children would continue to reduce disease burden among adults through reduced carriage and transmission of vaccine serotypes from vaccinated children (i.e., PCV13 indirect effects). On June 26, 2019, after having reviewed the evidence accrued during the preceding 3 years (https://www.cdc.gov/vaccines/acip/recs/grade/PCV13.html), ACIP voted to remove the recommendation for routine PCV13 use among adults aged ?65 years and to recommend administration of PCV13 based on shared clinical decision-making for adults aged ?65 years who do not have an immunocompromising condition,† cerebrospinal fluid (CSF) leak, or cochlear implant, and who have not previously received PCV13. ACIP recognized that some adults aged ?65 years are potentially at increased risk for exposure to PCV13 serotypes, such as persons residing in nursing homes or other long-term care facilities and persons residing in settings with low pediatric PCV13 uptake or traveling to settings with no pediatric PCV13 program, and might attain higher than average benefit from PCV13 vaccination. When patients and vaccine providers engage in shared clinical decision-making for PCV13 use to determine whether PCV13 is right for a particular person, considerations might include both the person's risk for exposure to PCV13 serotypes and their risk for developing pneumococcal disease as a result of underlying medical conditions. All adults aged ?65 years should continue to receive 1 dose of PPSV23. If the decision is made to administer PCV13, it should be given at least 1 year before PPSV23. ACIP continues to recommend PCV13 in series with PPSV23 for adults aged ?19 years with an immunocompromising condition, CSF leak, or cochlear implant (2). | [
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Obesity negatively affects children's health because of its associations with cardiovascular disease risk factors, type 2 diabetes, asthma, fatty liver disease, victimization stemming from social stigma and bullying, and poor mental health (e.g., anxiety and depression) (1). Children who have overweight or obesity in early childhood are approximately four times as likely to have overweight or obesity in young adulthood as their normal weight peers (2). Obesity prevalence is especially high among children from low-income families (3). In 2010, the overall upward trend in obesity prevalence turned downward among children aged 2-4 years enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a program of the U.S. Department of Agriculture (USDA); prevalence decreased significantly in all racial/ethnic groups and in 34 of the 56 WIC state or territory agencies during 2010-2014 (4). A more recent study among young children enrolled in WIC reported that the overall obesity prevalence decreased from 15.9% in 2010 to 13.9% in 2016 and statistically significant decreases were observed in all age, sex, and racial/ethnic subgroups (3). However, this study did not provide obesity trends at the state level. In collaboration with USDA, CDC used data from the WIC Participant and Program Characteristics (WIC PC) to update state-specific trends through 2016. During 2010-2016, modest but statistically significant decreases in obesity prevalence among children aged 2-4 years enrolled in WIC occurred in 41 (73%) of 56 WIC state or territory agencies. Comprehensive approaches that create positive changes to promote healthy eating and physical activity for young children from all income levels,* strengthen nutrition education and breastfeeding support among young children enrolled in WIC, and encourage redemptions of healthy foods in WIC food packages could help maintain or accelerate these declining trends. | [
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] |
CDC, the Food and Drug Administration (FDA), state and local health departments, and public health and clinical stakeholders are investigating a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) (1). As of November 13, 2019, 49 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands) have reported 2,172 EVALI cases to CDC, including 42 (1.9%) EVALI-associated deaths. To inform EVALI surveillance, including during the 2019-20 influenza season, case report information supplied by states for hospitalized and nonhospitalized patients with EVALI were analyzed using data collected as of November 5, 2019. Among 2,016 EVALI patients with available data on hospitalization status, 1,906 (95%) were hospitalized, and 110 (5%) were not hospitalized. Demographic characteristics of hospitalized and nonhospitalized patients were similar; most were male (68% of hospitalized versus 65% of nonhospitalized patients), and most were aged <35 years (78% of hospitalized versus 74% of nonhospitalized patients). These patients also reported similar use of tetrahydrocannabinol (THC)-containing products (83% of hospitalized versus 84% of nonhospitalized patients). Given the similarity between hospitalized and nonhospitalized EVALI patients, the potential for large numbers of respiratory infections during the emerging 2019-20 influenza season, and the potential difficulty in distinguishing EVALI from respiratory infections, CDC will no longer collect national data on nonhospitalized EVALI patients. Further collection of data on nonhospitalized patients will be at the discretion of individual state, local, and territorial health departments. Candidates for outpatient management of EVALI should have normal oxygen saturation (?95% while breathing room air), no respiratory distress, no comorbidities that might compromise pulmonary reserve, reliable access to care, strong social support systems, and should be able to ensure follow-up within 24-48 hours of initial evaluation and to seek medical care promptly if respiratory symptoms worsen. Health care providers should emphasize the importance of annual influenza vaccination for all persons aged ?6 months, including persons who use e-cigarette, or vaping, products (2,3). | [
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BACKGROUND: The aim of the study was to assess the accuracy of commercially available software in estimating anterior tooth root inclination from digital impressions of the crowns of the teeth.SUBJECTS AND METHODS: Following sample size calculation and application of inclusion and exclusion criteria, 55 anterior natural teeth derived from 14 dry human skulls were selected. Impressions were taken and plaster study models were fabricated. Plaster models were scanned using the high-resolution mode of an Ortho Insight 3D laser scanner. The teeth on the digital scans were segmented and virtual roots were predicted and constructed by the Ortho Insight 3D software. The 55 natural teeth were removed from the dry skulls and scanned using the Identica extraoral white-light scanner in order to calculate their actual root angulation. The teeth were scanned twice, once to acquire the crown and the cervical part of the root, and a second time to acquire the remaining part of the root, including the apex. The two scanned segments were joined in software by superimposing them along their common part. The accuracy of the digital models generated by the Ortho Insight 3D scanner in predicting root angulation was assessed by comparing these results to the corresponding measurements of the 55 natural teeth. The long axes of the tooth models obtained from the software prediction and the scanning of the actual teeth were computed and the discrepancy between them was evaluated. The error of the methods was evaluated by repeating the measurements on 14 teeth and showed an acceptable range.RESULTS: The predicted tooth angulation was found to differ significantly from the actual angulation, both statistically and clinically. The angle between the predicted and actual long axes ranged from 2.0 to 37.6(average 9.7; median 7.4). No statistically significant difference was found between tooth categories.CONCLUSIONS: Further investigations and improvements of the software are needed before it can be considered clinically effective. | [
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