[Clinical outcome of combined over-the-top reconstruction with modified Lemaire procedure in one-stage revision anterior cruciate ligament reconstruction]

Objective: To investigate the clinical effect of over-the-top (OTT) reconstruction of the anterior cruciate ligament (ACL) combined with the modified Lemaire technique in one-stage ACL revision. Methods: It's a retrospective study. The clinical data of 37 patients who underwent one-stage revision of ACL using OTT combined with modified Lemaire technique from April 2020 to May 2023 in the Department of Sports Medicine of Xinhua Hospital Affiliated to Dalian University were retrospectively analyzed. There were 28 males and 9 females with a mean age of (32.7±5.7) years. The postoperative knee function and surgical revision effect were evaluated by subjective and objective evaluation indexes of the knee joint before and 3 months and 24 months after surgery. The subjective evaluation indexes included the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score; and the objective evaluation indexes included the anterior-posterior static displacement distance of the tibia, tibia-femur relative rotation angle, the Lachman test, the axial shift test, and the ratio of the loss of muscle strength of the lower limb. Results: At the final follow-up, all patients returned to pre-injury motor level, with significant improvements in IKDC scores (45.3±6.8 preoperatively, 67.5±4.7 and 93.2±2.3 at 3 months and 2 years after the operation, respectively), Lysholm scores (57.2±2.6 preoperatively, 72.6±2.9 and 89.7±3.7 at 3 months and 2 years after the operation, respectively), and Tegner scores (3.1±0.7 preoperatively, 4.9±0.6 and 5.8±1.3 at 3 months and 2 years after the operation, respectively) (all P<0.001). The anterior-posterior static displacement distance of the tibia reduced significantly [from (5.2±0.5) mm before the operation to (1.4±0.5) mm at 2 years postoperatively) (P<0.001)]; and the relative rotation angle of the tibia-femur restored to the normal physiological range, it was reduced from 6.2°±1.2° before the operation to 1.7°±0.3° 2 years after (P<0.001). The Lachman test and axial shift test at 2 years postoperatively were all negative. The muscle strength loss ratio of the affected lower limb was significantly better than that before the operation (P<0.001). Conclusion: The use of OTT reconstruction combined with modified Lemaire technique for revision of ACL in patients with ACL reconstruction failure can circumvent the tunnel problem for one-stage revision and better restore the stability and function of the knee joint, with ideal clinical results.

[Treatment strategy of congenital tracheal stenosis associated with non-vascular ring cardiac malformations]

Objective: To examine the treatment strategy of congenital tracheal stenosis associated with non-vascular ring cardiac malformations. Methods: This is a retrospective case series. Clinic data from 24 children with tracheal stenosis who underwent surgical treatment in the Department of Cardiac Surgery, Children's Hospital Affiliated to Shandong University from February 2017 to March 2023 were retrospectively collected. There were 16 males and 8 females, aged (M(IQR)) 6.5 (19.6) months (range: 2.2 to 66.3 months) and weighted 5.95 (4.76) kg (range: 3.2 to 20.0 kg). All patients had obvious respiratory symptoms. Eighteen patients underwent cardiac malformation correction and tracheoplasty at the same time (simultaneous group). Six patients in the staged operation group were treated with cardiac malformation correction in the first stage operation and tracheoplasty in the second stage operation due to missed diagnosis or delayed diagnosis of tracheal stenosis or no condition for tracheoplasty. Slide tracheoplasty was used to correct tracheal stenosis in both groups. The recovery of the children was followed. Wilcoxon sign rank test was used for comparison between the two groups. Results: There was no death during the perioperative period and hospitalization. In the simultaneous group, 1 case with delayed chest closure underwent bedside chest closure after 52 hours, 2 cases were intubated again after operation, and 1 case was implanted with an endotracheal stent. The duration of mechanical ventilation was 40.5 (39.6) hours (range: 19.0 to 438.8 hours). In the staged group, there was 1 case of re-intubation after operation, combined with left vocal cord paralysis and respiratory multidrug-resistant bacterial infection (Acinetobacter baumanii). One patient underwent 3 times of bronchoscopic balloon dilatation of the right middle bronchus, and heart rate returned to normal range. The duration of mechanical ventilation was 19.0 (21.4) hours (range: 17.1 to 96.7 hours). During follow-up, a patient in the simultaneous group was prone to respiratory infection and had good exercise tolerance, 1 patient in the staged group still had sputum stridor in the throat 3 months after the operation, and symptoms improved significantly 6 months after the operation. The other children didn't have obvious respiratory symptoms. Conclusions: The diagnosis of tracheal stenosis may be delayed or missed when tracheal stenosis is complicated by non-vascular ring cardiac malformations. One-stage correction of tracheal stenosis and cardiac malformation can achieve a good outcome.

[Surgical treatment strategy of pulmonary artery sling: a series of 110 cases]

Objective: To examine the effect of surgical treatment in children with pulmonary artery sling and the surgical treatment strategy. Methods: Relevant data of 110 children with pulmonary artery sling admitted to the Department of Cardiac Surgery, Children's Hospital Affiliated to Shandong University from February 2017 to July 2022 were retrospectively analyzed. There were 55 males and 55 females, aging (M(IQR)) 9.0 (10.6) months (range: 1 to 96 months). The weight was 7.8 (3.5) kg (range: 2.5 to 25.0 kg). Of the 110 patients, 108 had different degrees of tracheal stenosis and 2 had normal trachea. Left pulmonary artery transplantation and tracheoplasty were performed in 78 patients. Left pulmonary artery transplantation was performed in 30 patients (11 in our hospital and 19 in other hospitals) due to the lack of an early tracheoplasty technique, in which 24 patients needed stage Ⅱ tracheoplasty due to obvious respiratory symptoms and limited activity endurance, and 6 cases did not intervene. Two children with normal trachea only underwent left pulmonary artery transplantation. Results: Among the 78 children who underwent surgery in the same period, 70 cases recovered smoothly after surgery, of whom respiratory symptoms were significantly reduced or disappeared during the 1 to 65 months follow-up, with similar activity endurance to normal children of the same age. Eight cases died, including 4 cases of postoperative multi-drug resistant bacteria infection, died from tracheal anastomotic opening or septic shock, 1 cases with severe congenital heart disease died from postoperative low cardiac output syndrome difficult to correct, 1 case died from blood pressure could not be maintained due to the compressed left pulmonary artery after transplantation, 2 cases of postoperative digestive system diseases (adhesive intestinal obstruction, gastrointestinal bleeding, etc.). The 24 patients in the staging group were followed for 1 to 84 months. All patients needed stage Ⅱ tracheoplasty due to respiratory symptoms and decreased endurance to activity. Eight cases of the non-intervention tracheal group were successfully separated from the ventilator, cured and discharged in a short period of time. Conclusions: Most children with pulmonary artery sling have tracheal stenosis. Children with low degree of tracheal stenosis and inconspicuous respiratory symptoms can only undergo left pulmonary artery transplantation by lateral thoracotomy. For patients combined with severe tracheal stenosis or obvious respiratory symptoms, a simultaneous left pulmonary artery transplantat and tracheoplasty is recommended.

[Expert consensus on the biobank development of oral genetic diseases and rare diseases and storage codes of related biological samples from craniofacial and oral region]

The biological samples of oral genetic diseases and rare diseases are extremely precious. Collecting and preserving these biological samples are helpful to elucidate the mechanisms and improve the level of diagnose and treatment of oral genetic diseases and rare diseases. The standardized construction of biobanks for oral genetic diseases and rare diseases is important for achieving these goals. At present, there is very little information on the construction of these biobanks, and the standards or suggestions for the classification and coding of biological samples from oral and maxillofacial sources, and this is not conducive to the standardization and information construction of biobanks for special oral diseases. This consensus summarizes the background, necessity, principles, and key points of constructing the biobank for oral genetic diseases and rare diseases. On the base of the group standard "Classification and Coding for Human Biomaterial" (GB/T 39768-2021) issued by the National Technical Committee for Standardization of Biological Samples, we suggest 76 new coding numbers for different of biological samples from oral and maxillofacial sources. We hope the consensus may promote the standardization, and smartization on the biobank construction as well as the overall research level of oral genetic diseases and rare diseases in China.

PD-1 Carried on Small Extracellular Vesicles Leads to OSCC Metastasis

Immune checkpoint molecule PD-1, expressed on the cell surface, impairs antigen-driven activation of T cells and thus plays a critical role in tumorigenesis, progression, and the poor prognosis of oral squamous cell carcinoma (OSCC). In addition, increasing evidence indicates that PD-1 carried on small extracellular vesicles (sEVs) also mediates tumor immunity, although their contributions to OSCC are yet unclear. Here, we investigated the biological functions of sEV PD-1 in patients with OSCC. The cell cycle, proliferation, apoptosis, migration, and invasion of CAL27 cell lines treated with or without sEV PD-1 were examined in vitro. We performed mass spectrometry to investigate the underlying biological process, combined with an immunohistochemical study of SCC7-bearing mice models and OSCC patient samples. In vitro data demonstrated that sEV PD-1 induced senescence and subsequent epithelial-mesenchymal transition (EMT) in CAL27 cells by ligating with tumor cell surface PD-L1 and activating the p38 mitogen-activated protein kinase (MAPK) pathway. Comprehensive immunohistochemical analysis of the xenograft mice models and OSCC patient samples revealed a very close correlation between the level of circulating sEV PD-1 and lymph node metastasis. These results demonstrate that circulating sEV PD-1 triggers senescence-initiated EMT in a PD-L1-p38 MAPK-dependent manner, contributing to tumor metastasis. It also suggests that the inhibition of sEV PD-1 may be a promising therapeutic target for the treatment of OSCC.

ELOVL fatty acid elongase 7 (ELOVL7), upregulated by Mdr2-knockout, predicts advanced liver fibrosis in patients with chronic hepatitis B

OBJECTIVE

This study aims to investigate the correlations between gene alterations induced in Mdr2-knockout (Mdr2-/-) models and liver fibrosis.

SUBJECTS AND METHODS

The overlapping genes in Mdr2-/- models were determined and included in logistic regression analysis to identify potential candidates for predicting liver fibrosis. Correlations between the expression levels of the identified candidates and hepatic stellate cells (HSCs) were addressed. Functional enrichment of the identified candidates was also evaluated via bioinformatic analysis.

RESULTS

Twenty-two overlapping genes in the GSE4612, GSE8642 and GSE14539 datasets were identified. Univariate and multivariate analysis indicated that ELOVL fatty acid elongase 7 (ELOVL7) was significantly associated with liver fibrosis S ≥ 2 (OR = 11.8, 95% CI = 2.0 - 69.2, p = 0.006). ELOVL7 was significantly upregulated in patients with various types of liver injury including hepatitis B virus (HBV) infection and fatty liver diseases, and in multiple liver injury models, including bile duct ligation (BDL), carbon tetrachloride (CCl4) and paracetamol injection-induced liver damage models (all p < 0.05). The ELOVL7 levels were significantly higher in HSCs than in other liver cells (all p < 0.05) and were significantly upregulated in activated HSCs compared to quiescent HSCs (all p < 0.05). In addition, ELOVL7 expression was positively associated with transforming growth factor β (TGFβ) and bone morphogenic protein 9 (BMP9) expression and negatively associated with BMP7 expression. Bioinformatic analysis of functional enrichment indicated that ELOVL7 is mainly involved in fatty acid synthesis and metabolism.

CONCLUSIONS

ELOVL7 could accurately predict advanced liver fibrosis. It might be involved in the activation of HSCs and the TGFβ signaling pathway.

Vimentin (VIM) predicts advanced liver fibrosis in chronic hepatitis B patients: A random forest-derived analysis

OBJECTIVE

The crosstalk between Toll-like receptor 4 (TLR-4) and lipopolysaccharide (LPS) accounts for liver fibrosis progression. This study aimed to investigate the predictive performance of altered genes induced by TLR-4 and LPS challenge for advanced liver fibrosis.

MATERIALS AND METHODS

The overlapping differentially expressed genes (DEGs) of TLR-4 and LPS challenge models from the Gene Expression Omnibus (GEO) database were screened and included in the random forest analysis to identify potential candidates for predicting advanced liver fibrosis in the GSE84044 dataset. The roles of the identified candidates in liver injury development and activation of hepatic stellate cells (HSCs) were also addressed.

RESULTS

Among the overlapping DEGs in the GSE30485, GSE33446 and GSE166488 datasets, vimentin (VIM) was the most important gene for predicting advanced liver fibrosis (S ≥ 2) by the random forest model. In the GSE84044 dataset, VIM was positively correlated with liver fibrosis (r = 0.68, 95% CI = 0.57-0.76, p < 0.0001), and accurately predicted advanced liver fibrosis (AUC = 0.85, 95% CI = 0.78-0.91), both in males (AUC = 0.84, 95% CI = 0.76-0.92) and females (AUC = 0.87, 95% CI = 0.76-0.99). VIM was significantly upregulated in various liver diseases (cirrhosis, liver failure, chronic hepatitis B and fatty liver disease) and liver injury models (ANIT, BDL, CCl4 and DMN). Additionally, VIM was correlated with HSC regulators (TGFβ, PDGF, CTGF and BMP7) and overexpressed in activated HSCs (p < 0.05). Enrichment analysis indicated that VIM-induced gene alterations were involved in the cytosolic DNA-sensing pathway, Toll-like receptor signaling pathway, etc. CONCLUSIONS: VIM could predict advanced liver fibrosis in CHB patients and is mainly involved in the activation of HSCs and profibrotic signaling pathways.

[Time to initial diagnosis of imported malaria and its influencing factors in Jiangsu Province]

OBJECTIVE

To investigate the health-seeking behaviors of imported malaria cases after returning to China, and to investigate the factors affecting the time to initial diagnosis, so as to provide the scientific evidence for early identification of imported malaria cases and prevention of severe cases development and secondary transmission.

METHODS

The individual demographic features, and the disease onset and the time to initial diagnosis of imported malaria cases in Jiangsu Province in 2019 were captured from the National Notifiable Disease Report System and the Information Management System for Parasitic Disease Control in China. The characteristics of health-seeking behaviors and epidemiological features of imported malaria cases were descriptively analyzed, and the factors affecting the time to initial diagnosis of imported malaria cases after returning to China were identified using multivariate logistic regression analysis.

RESULTS

A total of 244 imported malaria cases were reported in Jiangsu Province in 2019, and the time to initial diagnosis of the cases were 1-12 days, with mean time of (1.53 ± 1.65) days, with median time of one day. The highest number of malaria cases seeking healthcare services were found on the day of developing primary symptoms (76 cases, 31.1%), followed by on the second day (68 cases, 27.9%), on the third day (46 cases, 18.9%), and 54 cases (22.1%) received initial diagnosis 3 days following presence of primary symptoms, including 3 cases with initial diagnosis at more than one week. High proportions of imported malaria cases with a delay in the time to initial diagnosis were seen in migrant workers who returned to China in January (14 cases, 5.7%) and December (13 cases, 5.3%) and those aged between 41 and 50 years (32 cases, 13.1%). Multivariate logistic regression analysis showed relative short time to initial diagnosis among imported malaria cases returning to China on March [odds ratio (OR) = 0.16, P = 0.03, 95% confidence interval (CI): (0.03, 0.85)] and those with a history of overseas malaria parasite infections [OR = 0.36, P = 0.001, 95% CI: (0.19, 0.67)].

CONCLUSIONS

Timely health-seeking behaviors should be improved among imported malaria cases in Jiangsu Province, patients with a history of overseas malaria infections require faster health-seeking activities.

Tyrosine Sulphation of CXCR4 Induces the Migration of Fibroblast in OSF

Oral submucous fibrosis (OSF) caused by areca nut chewing is a prevalent fibrotic disease in Asia-Pacific countries. Arecoline-induced migration of fibroblasts (FBs) plays a vital role in the development of OSF. However, the specific molecular mechanisms involved remain unclear. Many studies have shown that tyrosine sulphation of chemokines can influence cell migration. Herein, we demonstrated that arecoline stimulates tyrosine sulphation of the chemokine receptor 4 (CXCR4) through the tyrosylprotein sulphotransferase-1 (TPST-1) to enhance the migration ability of FBs. Moreover, by RNA-Seq analysis, we found that the most significantly altered pathway was the EGFR pathway after the arecoline stimulation for FBs. After the knockdown of arecoline-induced EGFR expression, the tyrosine sulphation of CXCR4 was significantly decreased by the inhibition of TPST-1 induction. Finally, in human OSF specimens, TPST-1 expression was directly correlated with the expression of CXCR4. These data indicate that the arecoline-induced tyrosine sulphation of CXCR4, which is regulated by TPST-1, might be a potential mechanism that contributes to FB migration in OSF.

[Epidemiological characteristics of imported Plasmodium ovale malaria in Jiangsu Province from 2012 to 2020]

OBJECTIVE

To analyze the epidemiological characteristics of imported cases with Plasmodium ovale infections in Jiangsu Province from 2012 to 2020, so as to provide insights into the development of the imported malaria control strategy in the province.

METHODS

All data pertaining to cases with definitive diagnosis of P. ovale malaria in Jiangsu Province from 2012 to 2020 were captured from the National Notifiable Disease Report System and the Information Management System for Parasitic Disease Control in China, including the date of going abroad and returning to China, time of malaria infections overseas, date of malaria onset, initial diagnosis and definitive diagnosis. All data pertaining to epidemic status were descriptively analyzed.

RESULTS

A total of 347 cases of P. ovale malaria were reported in Jiangsu Province from 2012 to 2020, with the highest number seen in 2015 (71 cases). All cases were laboratory-confirmed overseas imported malaria cases, accounting for 14.32% of all reported malaria cases in Jiangsu Province during the period from 2012 to 2020. The 5 cities with the highest number of imported P. ovale malaria cases included Lianyungang City (53 cases, 15.27%), Nantong City (44 cases, 12.68%), Huai'an (44 cases, 12.68%), Taizhou City (44 cases, 12.68%) and Yangzhou City (36 cases, 10.37%). The highest number of imported P. ovale malaria cases was reported in October (39 cases, 11.24%), and the lowest number was seen in December (21 cases, 6.05%). P. ovale infections mainly occurred in were Equatorial Guinea (97 cases, 37.95%), Angola (60 cases, 17.29%) and Nigeria (40 cases, 11.53%). The median duration between returning to China and malaria onset was 64 (144) days, and 7.49% (26/347) of all cases developed malaria one year after returning to China. The initial diagnosis of P. ovale malaria was mainly made at county-level medical institutions (117 cases, 33.72%), and the definitive diagnosis was mainly made at city-level medical institutions (122 cases, 35.16%). The correct rate of initial diagnosis of P. ovale malaria increased from 0 in 2012 to 78.26% in 2020, appearing a tendency towards a rise year by year (χ² = 50.90, P < 0.01).

CONCLUSIONS

Imported P. ovale malaria cases were reported in Jiangsu Province each year from 2012 to 2020, and P. ovale infections predominantly occurred in Africa. Initial and definitive diagnoses of P. ovale malaria were mainly made at city- and county-level medical institutions. Training on the detection ability of malaria parasites is recommended among grassroots microscopists to improve the diagnostic ability of P. ovale malaria, and consolidate the achievements of malaria elimination in Jiangsu Province.

Corrosion comparison of free and roller surfaces of Fe70Si8B12Nb10 amorphous ribbon

The corrosion resistance of the free surface (FS) and roller surface (RS) of Fe₇₀Si₈B₁₂Nb₁₀ amorphous ribbon was systematically compared in simulated seawater (0.6 M NaCl). The electrochemical method and scanning electron microscopy showed that the FS corrosion resistance was higher than that of the RS. XPS etching and Mott–Schottky tests indicated that the passivation films on the FS and RS were divided into outer and inner layers. In the spinning process, the elements with a higher atomic mass tend to segregate toward the FS, while the elements with a lower atomic mass segregate toward the RS. These results provide data that can be used to improve the quality of melt spinning ribbons and to optimize the manufacturing of involved electric devices.

The two surfaces of the Fe₇₀Si₈B₁₂Nb₁₀ amorphous ribbon have very different corrosion resistances due to different structures.

SIRT2 inhibits oxidative stress and inflammatory response in diabetic osteoarthritis

OBJECTIVE

Diabetes mellitus is involved in inflammation, immunity, and metabolism during osteoarthritis (OA). It destroys the normal synthesis and degradation balance of chondrocytes (CHs) and extracellular matrix (ECM). The purpose of this study was to explore the possible way of SIRT2 influencing the progress of diabetic OA.

PATIENTS AND METHODS

Proteins of diabetic OA and normal OA cartilage samples were extracted from patients undergoing knee joint operation. CHs were also isolated from the cartilage exempted from diabetes for cell culture. Glucose was used to treat CHs for imitating the microenvironment of diabetes. The expressions of SIRT2, acetylated H3K9, H3K14, and H3K56 protein were determined by Western blotting. SIRT2, 8-hydroxy-2' deoxyguanosine (8-OH), and MMP-13 expressions were analyzed using immunofluorescence. RT-PCR was performed to measure the mRNA levels of SOD1, SOD2, CAT, MMP-13, ADAMTS-4, and ADAMTS-5. Total ROS level was performed by flow cytometry assay.

RESULTS

SIRT2 expression was reduced, whereas acetylated H3K9, H3K14, and H3K56 were upregulated in diabetic cartilage compared to normal. High glucose suppressed the expression of SIRT2 but accelerated the acetylation of H3K9, H3K14, and H3K56. Besides, high glucose promoted the expression of 8-OH, and inhibited SOD1, SOD2, and CAT mRNA expressions, resulting in the up-regulated ROS level of CHs. In addition, high glucose activated the inflammatory response by upregulation of MMP-13, ADAMTS-4, and ADAMTS-5 expressions. SirReal2 suppressed SIRT2 and resulted in several acetylations of H3, more ROS, less antioxidant enzymes, and stronger inflammatory response caused by high glucose. However, supplied rh-SIRT2 reversed these negative effects of high glucose in CHs.

CONCLUSIONS

SIRT2 expression is reduced along with the diabetic OA process with increased acetylation of H3, oxidative stress, and inflammatory response. Suppression of SIRT2 accelerates the progress of diabetic OA and upregulation of SIRT2 alleviates diabetic OA development by suppressing oxidative stress and inflammatory response that are likely to be related to the deacetylation of H3.

Characterization of the rumen microbiota and its relationship with residual feed intake in sheep

Feed efficiency is a highly important economic trait in sheep production and has a significant impact on the economic benefits of sheep farming. Microbial fermentation of the rumen has a vital role in the host's nutrition; the rumen microbiota might affect host feed efficiency. However, the relationship between the rumen microbiota and feed efficiency in sheep is unclear. In the present study, the microbiota of 195 Hu sheep was investigated and their residual feed intake (RFI), a commonly used measure of feed efficiency, was determined. From birth, all sheep were subjected to the same management practices. At slaughter, samples of liquid rumen contents were collected and subjected to amplicon sequencing for the 16S rDNA gene on the IonS5™XL platform. To identify the bacterial taxa differentially represented at the genus or higher taxonomy levels, we used linear discriminant analysis coupled with effect size and curve fitting. In the sheep rumen, the four most abundant phyla were Firmicutes, Bacteroidetes, Fibrobacteres, and Proteobacteria; and the dominant genera were unidentified Prevotellaceae, Fibrobacter, unidentified Lachnospiraceae, Saccharofermentans, and Succinivibrio. Pathway analysis of the 16S rDNA sequencing data from the rumen microbiota identified that carbohydrate metabolism was enriched. Using α-diversity analysis, we further identified that Observed species, ACE, Good's coverage, and Chao1 are more abundant (P < 0.01) in the low-RFI (L-RFI) group compared to the high-RFI (H-RFI) group. High-RFI sheep had a higher abundance of three bacterial taxa (Prevotellaceae, Negativicutes, and Selenomonadales), and one taxa was overrepresented in the L-RFI sheep (Succinivibrio), respectively. Furthermore, model fitting showed that Veillonellaceae, Sphaerochaeta, Negativibacillus, Saccharofermentans, and members of the Tenericutes, Kiritimatiellaeota, Deltaproteobacteria, and Campylobacterales were correlated with the sheep RFI classification and thus were indicative of a role in animal efficiency. Tax4Fun analysis revealed that metabolic pathways such as "energy metabolism," "metabolism of cofactors and vitamins," "poorly characterized," and "replication recombination and repair proteins" were enriched in the rumen from H-RFI sheep, and "genetic information processing" and "lipopolysaccharide biosynthesis" were overrepresented in L-RFI sheep rumen. In addition, six Kyoto Encyclopedia of Genes and Genomes orthology pathways were identified as different between H-RFI and L-RFI groups. In conclusion, the low RFI phenotype (efficient animals) consistently (or characteristically) exhibited a more abundant and diverse microbiome in sheep.

[Epidemic situation of malaria in Jiangsu Province in 2019]

OBJECTIVE

To analyze the epidemic situation of malaria in Jiangsu Province in 2019, so as to provide the scientific basis for the development of the strategy for the prevention of re-introduction of imported malaria.

METHODS

The malaria case report information, epidemiological case investigation information, epidemic foci investigation and management report in Jiangsu Province in 2019 were collected, and all epidemiological data were descriptively analyzed.

RESULTS

A total of 244 malaria cases were reported in Jiangsu Province in 2019, and all cases were laboratory-confirmed overseas imported cases, including 4 cases with vivax malaria, 206 cases with falciparum malaria, 12 cases with malariae malaria and 22 cases with ovale malaria. In 2019, there were 12 malaria cases progressing into severe cases in Jiangsu Province, with one death. Nanjing, Nantong, Lianyungang, Taizhou and Changzhou cities contributed the largest number of malaria cases in 2019, with the number of malaria cases accounting for 59.84% of total cases in Jiangsu Province. The infections occurred in Papua New Guinea (2 cases), Pakistan (1 case) and 27 African countries (241 cases), including Angola, the Democratic Republic of the Congo, Nigeria, Equatorial Guinea, Cote d'Ivoire and so on. There were 77 cases (31.55%) with a visit to doctor on the day of onset, and 146 cases (59.84%) within 1 to 3 days after onset. In addition, there were 149 cases (61.06%) with definitive diagnosis at the first visit and 77 cases (31.55%) diagnosed within 1 to 3 days after the visit, and the mean duration from the visit to definitive diagnosis was (0.80 ± 1.59) d, which significantly shortened as compared to that (1.34 d ± 2.59 d) in 2018 (U = 2.53, P < 0.05).

CONCLUSIONS

Intensifying the surveillance and management of imported malaria and improving the diagnostic capability of imported malaria and the treatment of severe malaria cases are required to consolidate the achievements of malaria elimination in Jiangsu Province.

Transcriptome analysis of long noncoding RNAs ribonucleic acids from the livers of Hu sheep with different residual feed intake

Long noncoding RNAs (LncRNAs), as key regulators, have vital functions in various biological activities. However, in sheep, little has been reported concerning the genetic mechanism of LncRNA regulation of feed efficiency. In the present study, we explored the genome-wide expression of LncRNAs and transcripts of uncertain coding potential (TUCPs) in the livers of sheep with extreme residual feed intake (RFI) using RNA sequencing. We identified 1 523 TUCPs and 1 996 LncRNAs, among which 10 LncRNAs and 16 TUCPs were identified as being differentially expressed between the High-RFI and Low-RFI groups. Co-expression and co-localization methods were used to search for LncRNA and TUCP target genes, which identified 970/1 538 and 23/27 genes, respectively. Ontology and pathways analysis revealed that the LncRNAs/TUCPs that were highly expressed in the Low-RFI group are mostly concentrated in energy metabolism pathways. For example, LNC_000890 and TUCP_000582 might regulate liver tissue metabolic efficiency. The LncRNAs/TUCPs that were highly expressed in the High-RFI group are mostly enriched in immune function pathways. For example, TUCP_000832 might regulate animal health, thereby affecting feed efficiency. Subsequently, a co-expression network was established by applying the expression information of both the differentially expressed LncRNAs and TUCPs and their target mRNAs. The network indicated that differentially expressed genes targeted by the upregulated LncRNAs and TUCPs were mainly related to energy metabolism, while those genes targeted by the downregulated LncRNAs and TUCPs were mainly related to immune response. These results provide the basis for further study of LncRNA/TUCP-mediated regulation of feed efficiency.

[Isolated biceps tenodesis by double row for pulley lesions]

Objective: To explore clinical outcome of isolated arthroscopic biceps tenodesis by double row for pulley lesions. Methods: Forty-nine patients with pulley lesions were treated from July 2017 to June 2018 in the Department of Sport Medicine, the Affiliated Zhongshan Hospital of Dalian University by isolated arthroscopic biceps tenodesis by double row. Patients were divided into 2 groups according to the intraoperative damage of the pulley system. In group A, there were 16 patients with isolated superior glenohumeral ligament/coracohumeral ligament (SGHL/CHL) complex lesions, including 9 males and 7 females, aged (55±6) years. In group B, there were 33 patients (15 males and 18 females, aged (57±8) years) with SGHL/CHL complex and adjacent supraspinatus tendon and/or subscapularis tendon articular-side partly tears. Patients in two groups were treated with different isolated arthroscopic biceps tenodesis by double row. Constant-Murley shoulder score and pain visual analogue scale (VAS) score were assessed before operation and 3, 6, 12 months after the operation. Postoperative complications were also recorded in two groups. The t test was used to compare the quantitative data within and between two groups. Results: All 49 patients were followed up for 12 to 24 months with an average of (17±6) months. The first-stage healing was achieved in all incisions in the two groups. No surgical complications related to revision, infection, Popeye syndrome and cramping pain were observed in either group. There was 1 case treated by secondary arthroscopy for retrauma in group B. The Constant-Murley shoulder score in group A before the operation was 46±10, and it was increased to 89±9 at the 12 months post operation(t=-22.637, P<0.05); and it was 39±10 and 87±8 before and 12 months after the operation respectively in group B (t=-44.849, P<0.05). The VAS scores in the two groups were both decreased significantly at the 12 months post operation when compared with those before the operation (0.68±0.70 vs 5.25±0.27 and 0.72±0.83 vs 5.69±0.84, respectively) (t=29.007, 37.079, both P<0.05). Conclusion: Isolated arthroscopic biceps tenodesis by double row can relieve pain, recover functions of shoulder joint effectively, and achieve a satisfactory outcome in the treatment of pulley lesions.

[Emergency management of prevention and control of the novel coronavirus infection in departments of stomatology]

Complying with overall requirements of the government and regulations on public health emergencies, as well as the clinical features of diagnosis and treatment of oral diseases, this article reviews previous guidelines and studies on the infection control in dental practices in China and foreign countries. The emergency management protocol for the prevention and control of COVID-19 has been implemented in Nanjing Stomatological Hospital, which mainly focuses on the implementation of the training programs for dental staff and the infection control project in the hospital environment. This article could be used as a reference for rapid response and emergency management for the prevention and control of COVID-19 in the departments of stomatology.

[Epidemic situation of malaria in Jiangsu Province in 2018]

OBJECTIVE

To analyze the epidemic situation of malaria in Jiangsu Province in 2018, so as to provide scientific evidence for formulating post-elimination malaria surveillance schemes and technical measures in Jiangsu Province.

METHODS

The malaria case report cards, epidemiological individual investigation forms of malaria cases and foci data were collected from Jiangsu Province in 2018, and the epidemic situation of malaria was descriptively analyzed.

RESULTS

A total of 243 malaria cases were reported in Jiangsu Province in 2018, which increased by 1.67% in relative to in 2017 (239 cases), and these cases included 171 cases with falciparum malaria, 14 cases with vivax malaria, 15 cases with quartan malaria, 42 cases with ovale malaria and a case with mixed infection of P. vivax and P. ovale. All cases were overseas imported, and no local secondary cases were found. The malaria cases were predominantly workers (76.54%). Nantong City (48 cases), Yangzhou City (33 cases) and Taizhou City (22 cases) were the most 3 cities with the largest number of malaria cases across Jiangsu Province. The malaria infections predominantly occurred in African areas (96.30%), and the other 9 cases had infections in Asia (8 cases) and Central America (1 case). There were 125 cases (51.44%) and 91 cases (37.45%) with definitive diagnosis at the day of admission and within 1 to 3 days post-admission, respectively. The percentages of definitive diagnosis at initial diagnosis were 48.27%, 88.76% and 97.30% at township-, county- and city-level medical institutions, respectively, and the percentage of definitive diagnosis at initial diagnosis was significantly lower in township-level medical institutions than in county- (χ² = 21.47, P < 0.01) and city-level medical institutions (χ² = 32.86, P < 0.01).

CONCLUSIONS

There are no local malaria cases in Jiangsu Province; however, the number of overseas imported malaria cases remains high in China. In the future, improving the post-elimination malaria surveillance system, enhancing the awareness of malaria prevention and control knowledge among high-risk populations, increasing the diagnostic capability of malaria in medical institutions, and improving the management of imported malaria cases should be performed to consolidate the achievements of malaria elimination.

Effect of downregulated lncRNA NBAT1 on the biological behavior of glioblastoma cells

OBJECTIVE

To investigate the expression of lncRNA neuroblastoma associated transcript 1 (NBAT1) in human glioma cell lines and its underlying mechanism. Effect of NBAT1 on biological behaviors of T98 and U87 cells are also explored.

PATIENTS AND METHODS

The mRNA expressions of NBAT1 in 48 cases of glioblastoma tissues and 30 cases of normal brain tissues were accessed by Real-time fluorescence quantitative PCR (RT-PCR). The relationship between mRNA expression of NBAT1 and tumor size, malignancy, and prognosis were analyzed. Effects of NBAT1 on the proliferation of glioblastoma T98 and U87 cells were determined by CCK-8 assay and colony formation assay, respectively.

RESULTS

NBAT1 expressions in glioblastoma tissues were lower than those in normal brain tissues, which was negatively correlated with malignancy degree (p<0.01). Protein levels of Akt were decreased in T98 and U87 cells transfected with si-NBAT1. Meanwhile, proliferation abilities of T98 and U87 cells transfected with si-NBAT1 were significantly decreased as well (p<0.01), which were reversed by transfection of si-Akt.

CONCLUSIONS

Upregulated NBAT1 inhibits proliferation of T98 and U87 cells via regulating Akt, indicating that NBAT1 may be related to the malignancy and prognosis of gliomas.

Energy enhancement of the target surface electron by using a 200 TW sub-picosecond laser

One order of magnitude energy enhancement of the target surface electron beams with central energy at 11.5 MeV is achieved by using a 200 TW, 500 fs laser at an incident angle of 72° with a prepulse intensity ratio of 5×10^-6. The experimental results demonstrate the scalability of the acceleration process to high electron energy with a longer (sub-picosecond) laser pulse duration and a higher laser energy (120 J). The total charge of the beam is 400±20  pC(E>2.7  MeV). Such a high orientation and mono-energetic electron jet would be a good method to solve the problem of the large beam divergence in fast ignition schemes and to increase the laser energy deposition on the target core.

[Current status of malaria rapid diagnostic testing strips application in primary-level healthcare providers in Jiangsu Province]

Objective: To investigate the current status of malaria rapid diagnostic test (RDT) strips application and malaria laboratory technicians' evaluation about them at primary healthcare provider level in Jiangsu Province. Methods: From November to December 2016, 878 medical institutions and 118 CDCs of city, county and township/community level in Jiangsu Province were selected as study samples using stratified random sampling method. Self-designed questionnaire was distributed to investigate the institution's malaria work task, RDT strips application and evaluation status in 2015. We also investigated the socio-demographic information and collected the RDT strips evaluation score from the malaria laboratory technicians selected from the institutions investigated (one technician from each institution). Rank sum test was performed to compare the RDT strips evaluation scores between medical institutions and CDCs, and among different medical institutions and CDCs. Results: In 2015, 405 cases of malaria were reported, 362 200 person-time of malaria blood testing task was conducted, and 100 000 RDT strips were procured and provided for healthcare providers in Jiangsu province for free. Of the 996 healthcare institutions investigated, 628 used RDT strips in the year 2015 and the median (P(25), P(75)) of RDT strips volume used in these institutions was 10 (2, 25). The volume of RDT strips used in CDCs (15 (5, 52)) was significantly higher than that in medical institutions (10 (2, 25), (Z=3.42, P=0.001)). The investigated CDCs gave higher score on RDT strips' testing time per operation (10 (8.5, 10)) than medical institutions (9(8, 10), (Z=-2.20, P=0.028)). The employers of 614 investigated malaria laboratory technicians used RDT strips in 2015. The median of the scores given by CDC malaria laboratory technicians for RDT strips in terms of testing time per operation, testing operation and results judgement difficulties were 10 (9, 10), 10 (9, 10) and 10 (9, 10), respectively, which were significantly higher than those from technicians of medical institutions (9 (8, 10), 9 (8, 10), 9 (8, 10), (Z values were -2.55, -2.97 and -2.96, respectively; P values were all less than 0.05)). Conclusion: RDT strips had been widely performed in health institutions in Jiangsu Province. The amount of RDT strips used in CDCs was significantly higher than that in medical institutions. Primary-level institutions and malaria laboratory technicians generally recognized RDT strips' advantage for application in terms of testing time and operational procedure. CDCs and malaria laboratory technicians from them gave higher regards on RDT strips in terms of testing time per operation, testing operation and results judgement difficulties compared with that of medical institutions.

Use of a microvascular coupler device for end-to-side venous anastomosis in oral and maxillofacial reconstruction

The aim of this study was to compare the use of a microvascular coupler device (MCD) for end-to-side venous anastomosis (ETS group) and phleboplasties combined with MCD for end-to-end venous anastomosis (ETE group) in free tissue transfer for oral and maxillofacial reconstruction, with regard to the anastomosis time and occurrence of postoperative vascular crisis. The ETS group included 22 patients and the ETE group included 40 patients. Patient demographic data, anastomotic time, coupler size, microvascular complications, and flap survival rates were collected and analyzed. In the ETS group, the most suitable donor vessel size was greater than 2mm, varying from 2mm to 4mm. The average anastomosis time was 3.35±0.89min in the ETS group and 7.80±2.93min in the ETE group; the difference between the groups was statistically significant (p<0.0001). There were no statistically significant differences in complications or outcomes between the two groups. The ETS venous anastomosis with MCD technique is a better choice for anastomosis when the donor vessel size is greater than 2mm. In those cases with mismatched veins, ETS venous anastomosis with MCD could significantly reduce the anastomosis time compared to ETE venous anastomosis with MCD after phleboplasties.

[Cases diagnosis of imported malaria in Jiangsu province, 2014-2016]

Objective: To understand the situation related to health seeking and diagnosis of imported malaria and to provide practical measures for malaria elimination in Jiangsu province. Methods: Data on imported malaria cases in Jiangsu province was retrieved in CISDCP from 2014 to 2016. Relevant information on health seeking behavior, diagnosis and treatment of the disease was gathered. Results: A total of 1 068 imported cases were reported in Jiangsu province from 2014 to 2016. Except for one malaria case that was caused by blood transfusion, the rest patients were all recognized as 'imported'. Majority of the cases were migrant laborers working in African countries. The accurate rates on the diagnosis of ovale, vivax and quartan malaria and mixed infection were relatively low, as 79.3% (107/135), 29.5% (18/61), 52.9% (18/34) and 0.0% (0/2) at the primary health care settings, respectively. Rate of seeking health care on the same day of onset was more in 2015 than in 2014 and 2016 (χ(2)=18.6, P=0.001). While only 65.4% (699/1 068) of the patients were diagnosed correctly at the primary health care settings. There appeared no statistical difference in the 3-year-study period (χ(2)=5.4, P=0.246). Capacity on 'correct diagnosis' seemed stronger at the CDC than at the hospital levels (χ(2)=13.2, P=0.000; χ(2)=5.4, P=0.020). Totally, 72.7% (32/44) of the severe falciparum malaria cases did not immediately seek for health care when the symptoms started. Conclusions: Migrant workers returning from the high endemic malaria areas seemed to have poor awareness in seeking health care services. Capability on correct diagnosis for malaria at the primary health care settings remained unsatisfactory and staff from these settings needs to receive adequate training.

Laser opacity in underdense preplasma of solid targets due to quantum electrodynamics effects

We investigate how next-generation laser pulses at 10-200PW interact with a solid target in the presence of a relativistically underdense preplasma produced by amplified spontaneous emission (ASE). Laser hole boring and relativistic transparency are strongly restrained due to the generation of electron-positron pairs and γ-ray photons via quantum electrodynamics (QED) processes. A pair plasma with a density above the initial preplasma density is formed, counteracting the electron-free channel produced by hole boring. This pair-dominated plasma can block laser transport and trigger an avalanchelike QED cascade, efficiently transferring the laser energy to the photons. This renders a 1-μm scale-length, underdense preplasma completely opaque to laser pulses at this power level. The QED-induced opacity therefore sets much higher contrast requirements for such a pulse in solid-target experiments than expected by classical plasma physics. Our simulations show, for example, that proton acceleration from the rear of a solid with a preplasma would be strongly impaired.

[The clinicopathological characteristics of diabetic nephropathy and non-diabetic renal diseases in diabetic patients]

Objective: To analyze the clinicopathological characteristics of renal lesions in type 2 diabetic patients and to differentiate diabetic nephropathy (DN) from non-diabetic renal diseases(NDRD). Methods: Type 2 diabetic patients who received renal biopsy in Ruijin Hospital from January 2011 to December 2015 were recruited in this study. Clinical history, laboratory results and pathological data were retrospectively collected. According to the pathological findings, the patients were divided into 3 groups: DN, NDRD, DN+NDRD. Logistic model was applied to explore the independent clinical predictive factors in differentiating DN from NDRD. Results: A total of 207 type 2 diabetic patients received renal biopsy, accounting for 6.82% of all biopsy population. Fifty-one patients were diagnosed with DN, 142 with NDRD and 14 with both DN and NDRD. In NDRD, membranous nephropathy(MN)(34.5%) was the most common finding, followed by IgA nephropathy(19.7%).By contrast, NDRD patients manifested a shorter diabetic course, a higher baseline hemoglobin level, a lower baseline serum creatinine, a higher prevalence of hematuria, a lower prevalence of hypertension and diabetic retinopathy, a better control of blood glucose, better compliance of monitoring blood glucose and less family history of diabetes. In multivariate logistic model, diabetic family history(OR=4.68, P=0.04) and long history of diabetes(OR=1.01, P=0.02) were risk factors of DN. Conclusion: There is a high prevalence of NDRD in diabetic patients with renal lesions. Family history of diabetes and duration of diabetes are independent predictors of DN.