Detection and clinical significance of glomerular M-type phospholipase A2 receptor in patients with idiopathic membranous nephropathy

BACKGROUND

Glomerular M-type phospholipase A₂ receptor (PLA₂ R) is important for diagnosing idiopathic membranous nephropathy (IMN). The relation between glomerular PLA₂ R expression and response to treatment remains to be explored.

AIMS

We conducted the study to explore the positive rate and clinical significance of glomerular M-type PLA₂ R in IMN patients.

METHODS

A total of 122 IMN patients receiving neither glucocorticoid nor immunosuppressant therapy prior to renal biopsies was included and followed for more than 1 year. The control group comprised 30 patients with secondary membranous nephropathy and 100 patients with non-membranous forms of nephropathy. PLA₂ R level and IgG subclasses in glomeruli were detected. The primary end-point was the reduction of proteinuria to less than 50% of baseline value.

RESULTS

A total of 82.0% of patients with IMN had positive glomerular PLA₂ R deposits, compared with 16.7% in the secondary membranous nephropathy group (P < 0.001). Additionally, PLA₂ R-positive expression combined with IgG4 ≥ 2+ was found in 94.3% IMN patients, compared with 40.0% in secondary membranous nephropathy patients (P < 0.01). Among IMN patients, the remission rate of proteinuria after either glucocorticoid or glucocorticoid combined immunosuppressant therapy for at least 6 months was 83.9% in the PLA₂ R-positive group compared with 54.5% in the negative group (P < 0.05).

CONCLUSION

The positive rate of glomerular PLA₂ R was more prevalent in IMN patients. Both PLA₂ R and IgG4 glomerular deposits may help in discriminating between idiopathic and secondary membranous nephropathy. IMN patients with positive PLA₂ R expression probably have a more beneficial response to glucocorticoid and/or immunosuppressant therapy.

Evolving safety practices in the setting of modern complex operating room: role of nurses

Operating room (OR) nursing previously referred to patient care provided during the intra-operative phase and the service provided within the OR itself. With the expansion of responsibilities of nurses, OR nursing now includes pre-operative and post-operative periods, therefore peri-operative nursing is accepted as a nursing process in OR in the contemporary medical literature. Peri-operative nurses provide care to the surgical patients during the entire process of surgery. They have several roles including those of manager or a director, clinical practitioner (scrub nurse, circulating nurse and nurse anesthetist), educator as well as researcher. Although, utmost priority is placed on insuring patient safety and well-being, they are also expected to participate in professional organization, continuing medical education programs and participating in research activities. A Surgical Patient Safety Checklist formulated by the World Health Organization serves as a major guideline to all activities in OR, and peri-operative nurses are key personnel in its implementation. Communication among the various players of a procedure in OR is key to successful patient outcome, and peri-operative nurses have a central role in making it happen. Setting up of OR in military conflict zones or places that suffering a widespread natural disaster poses a unique challenge to nursing. This review discusses all aspects of peri-operative nursing and suggests points of improvement in patient care.

Low-Frequency Self-Powered Footstep Sensor Based on ZnO Nanowires on Paper Substrate

In this work, we design and fabricate a wireless system with the main operating device based on zinc oxide (ZnO) nanowires. The main operating device is based on piezoelectric nanogenerator (NG) achieved using ZnO nanowires grown hydrothermally on paper substrate. The fabricated NG is capable of harvesting ambient mechanical energy from various kinds of human motion, e.g., footsteps. The harvested electric output has been used to serve as a self-powered pressure sensor. Without any storage device, the signal from a single footstep has successfully triggered a wireless sensor node circuit. This study demonstrates the feasibility of using ZnO nanowire piezoelectric NG as a low-frequency self-powered sensor, with potential applications in wireless sensor networks.

Enhanced responsivity resonant RF photodetectors

The responsivity of room-temperature, semiconductor-based photodetectors consisting of resonant RF circuits coupled to microstrip buslines is investigated. The dependence of the photodetector response on the semiconductor material and RF circuit geometry is presented, as is the detector response as a function of the spatial position of the incident light. We demonstrate significant improvement in detector response by choice of photoconductive material, and for a given material, by positioning our optical signal to overlap with positions of RF field enhancement. Design of RF circuits with strong field enhancement are demonstrated to further improve detector response. The improved detector response demonstrated offers opportunities for applications in RF photonics, materials metrology, or single read-out multiplexed detector arrays.

[Clinical and electroencephalographic analysis of anti-N-methyl-D-aspartate receptor encephalitis in children]

OBJECTIVE

To study the clinical and electroencephalographic (EEG) characteristics of anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDAR encephalitis) in children.

METHOD

Retrospective analysis was performed on the clinical and EEG data of 105 patients with anti-NMDAR encephalitis treated in Beijing Children's Hospital (August 2011-March 2015). Of the 105 patients, 38 were male and 67 were female.The age of onset was from 6 months and 26 days to 15 years and 8 months (average (8±4)years). The time for confirmed diagnosis was from 4 days to 850 days (median 24.5 days). According to the modified Rankin scales, the patient's clinical conditions were assessed and underwent continuous EEG (cEEG) monitoring.The data were reviewed and analyzed.

RESULT

Based on the severity of the disease, the 105 patients were divided into three groups: mild group (12 cases), moderate group (65 cases), and severe group (28 cases). There were 91 cases(86.7%)with abnormal EEG patterns, including 28 cases (26.7%) with slow background activity in EEG, 25 cases (23.8%) with generalized or diffuse slow waves, 33 cases (31.4%) had focal slow waves, 41 cases (39.0%) had epileptic waves; 10 cases (9.5%) showed unilateral or diffuse alpha-theta band rhythms in nonrapid eye movement (NREM) sleep, 7 cases (6.7%) showed extreme delta brush waves (EDB). Accordingly, the number of patients with abnormal EEG in mild, moderate and severe groups was 5, 58 (89.2%) and 28(100.0%). Seven patients with EDB phenomenon were all in the severe group, and 10 patients with abnormal alpha-theta band rhythms were in the moderate group.

CONCLUSION

In children with anti-NMDAR encephalitis, the EEG patterns are in line with the changes of EEG in general encephalitis.The extent of EEG abnormalities correlates with the clinical severity of the disease. Extreme delta brush and alpha-theta band rhythms may be suggestive of diagnosis and clinical assessment of the disease.

Relationship between CYP17 gene polymorphisms and risk of prostate cancer

Cytochrome P450 17a-hydroxylase (CYP17) plays a critical role in androgen biosynthesis. Polymorphisms of the CYP17 promoter have been proposed as risk factors for prostate cancer; however, some studies have produced inconclusive or controversial results. We investigated the relationship between polymorphisms of the CYP17 gene and the risk of prostate cancer. A total of 176 patients with prostate cancer were enrolled in the study, and 168 healthy individuals acted as the control group. The participants were divided into those <71 years old and those ≥71 years old. Restriction fragment length polymorphism-polymerase chain reaction was used to confirm the genotype of CYP17 in the samples. The prostate-specific antigen (PSA) concentrations were also measured in all subjects. When T/C and C/C were compared with T/T, the ORs were 0.478 (P = 0.489) and 0.814 (P = 0.367), respectively. There was no significant difference in PSA concentration among the three genotypes in the <71 group, whereas there were statistically significant differences in the ≥71 group (P = 0.003 and 0.012, respectively). There was no significant difference in free PSA and total PSA levels between the three groups and the control group. The T/C and C/C genotypes were not associated with the risk of prostate cancer, and there were no significant differences between them. In the ≥71 group, the T/C and C/C genotypes were closely associated with prostate cancer, which suggests that the CYP17 gene might be a risk factor for prostate cancer in males of advanced age.

The role of ppGalNAc-T family in breast cancer development and progression

Glycosylation of proteins is an essential process in all eukaryotes. Mucin-type O-linked glycosylation is an evolutionarily conserved protein modification as a kind of glycosylation of proteins. The role of O-glycosylation was well documented in multiple cancers. While in breast cancer, the enzymes that catalyzed the initiation of O-glycosylation remained elusive. In this review, we briefly introduced the process of the initiation of O-glycosylation and summarized the roles of enzymes that catalyzed the initiation step of O-glycosylation in the breast cancer carcinogenesis, development, and progression. Finally, we summarized some attempts exploring the therapy against aberrant O-glycosylation.

A survey of outcomes and management of patients post fragility fractures in China

We found that the fragility hip and vertebral fractures caused excess mortality rates in this Chinese female population, which was unexpectedly lower than those in western countries and other Asian countries. This was the first nationwide survey relating to post-fracture outcomes conducted among Chinese population in Mainland China.

INTRODUCTION

This study aimed to investigate the mortality, self-care ability, diagnosis, and medication treatment of osteoporosis following fragility hip and vertebral fractures through a nationwide survey among female patients aged over 50 in Mainland China.

METHODS

This was a multicenter, retrospective cohort study based on medical chart review and patient questionnaire. Female patients aged 50 or older admitted for low-trauma hip or vertebral fractures and discharged from Jan 1, 2008 to Dec 31, 2012 were followed.

RESULTS

Total of 1151 subjects of hip fracture and 842 subjects of vertebral fracture were included. The mean age was 73.4 ± 10.0, and the median of duration from index fracture to interview was 2.6 years. The overall 1-year, 2-year, 3-year, 4-year, and 5-year cumulative mortality rates were 3.5, 7.0, 11.2, 13.1, and 16.9 %, respectively. The first year mortality rates in hip (3.8 %, 95% CI 3.3-4.4 %) and vertebral fracture (3.1 %, 95% CI 2.5-3.7 %) were significantly higher than that in the general population (1.6 %). Impaired self-care ability was observed in 33.2, 40.6, and 23.8 % of overall, hip fracture, and vertebral fracture group, respectively. The overall diagnosis rate of osteoporosis was 56.8 %, and bone mineral density (BMD) measurement had never been conducted in 42.0 % among these women. After the index fracture, 69.6 % of them received supplements and/or anti-osteoporotic medications, among which 39.6 % only received calcium with/without vitamin D supplementation.

CONCLUSIONS

The osteoporotic hip and vertebral fractures caused excess mortality rates in this population of Mainland China. The current diagnosis and medical treatment following the fragility fractures is still insufficient in Mainland China.

Prevalence and risk factors of Helicobacter pylori infection in asymptomatic Chinese children: a prospective, cross-sectional, population-based study

BACKGROUND

Limited research has been published on current Helicobacter pylori infection rate in asymptomatic children in China.

AIM

To assess current Helicobacter pylori infection rate, distribution characteristics and risk factors in Chinese asymptomatic children.

METHODS

A prospective, cross-sectional, population-based study was performed from 2009 to 2011 in three cities of China. Helicobacter pylori infection was diagnosed by a stool antigen test. Multi-stage cluster random sampling was used to select asymptomatic children including neonates. Socioeconomic details were obtained through a standardised questionnaire.

RESULTS

Among total of 3491 children (0-18 years), the global infection rate was 6.8% and there were no significant differences between genders. Age specific infection rate between regions was significantly different (P < 0.05). The infection rate significantly increased with age (P for trend <0.01). It was low during the newborn (0.6%) to preschool period and was significantly increased in high school students (13.5%) (P < 0.01). Multivariable regression indicated that hand sanitisation, individually served meals, higher education level of mother, above average living space and residence in urban areas were significantly protective against infection (OR 0.749, 0.698, 0.720, 0.838 and 0.770 respectively). Conversely, consuming meals in unsanitised conditions, sharing towels, receiving pre-chewed food from the mother, artificial feeding and family history of gastrointestinal disease were significantly associated with the risk of infection (OR 1.200, 1.965, 2.002, 1.071 and 2.093 respectively).

CONCLUSIONS

Helicobacter pylori infection rate increases with age in Chinese asymptomatic children and is common after 10 years of age. The rate of infection is related to socioeconomic status.

Giant piezoresistivity in aligned carbon nanotube nanocomposite: account for nanotube structural distortion at crossed tunnel junctions

High piezoresistivity is critical for multifunctional carbon nanotube polymer composites with sensing capability. By developing a new percolation network model, this work reveals theoretically that a giant piezoresistivity in the composites can be potentially achieved by controlled nanotube alignment resulting from field based alignment techniques. The tube-tube and/or tube-matrix interaction in conjunction with the aligned carbon nanotube networks are fully considered in the newly proposed model. The structural distortion of nanotubes is determined self-consistently by minimizing the pseudo-potential energy at crossed-tube junctions based on the Lennard-Jones potential and simulation of coarse grain molecular dynamics. The tunneling transport through crossed-tube junctions is calculated by the Landauer-Büttiker formula with empirical fitting by first-principle calculation. The simulation results also reveal that the piezoresistivity can be further improved by using low carbon nanotube loadings near the percolation threshold, carbon nanotubes with a small aspect ratio, high intrinsic conductivity and polymers with a small Poisson's ratio. This giant piezoresistive effect offers a tremendously promising future, which needs further thorough exploration.

Reverse-dipper pattern of blood pressure may predict lacunar infarction in patients with essential hypertension

BACKGROUND AND PURPOSE

The fluctuation of circadian blood pressure (BP) is of great diversity in patients with essential hypertension and may provide significant prognostic value for stroke. However, it remains uncertain whether reverse-dipper pattern of BP influences the incidence of lacunar infarction in hypertensive patients.

METHODS

In the current study, 362 hypertensive patients (195 males, 167 females) were enrolled. BP patterns were evaluated with 24-h ambulatory BP monitoring (ABPM). Multinomial logistic regression was applied to analyse the possible relationships between lacunar infarction and various clinical risk factors such as ABPM.

RESULTS

A total of 93 patients (25.7%) had reverse-dipper BP pattern. Non-dipper pattern of BP was observed in 179 hypertensive patients (49.4%) and dipper pattern in 90 patients (24.9%). The percentage of lacunar infarction was the highest in the patients with reverse-dipper pattern compared with pure hypertension or atherothrombotic cerebral infarction (P < 0.05). After multinomial logistic regression analysis, reverse-dipper pattern of BP (odds ratio 2.492; 95% confidence interval 1.133-5.479; P < 0.05) and age (odds ratio 1.084; 95% confidence interval 1.047-1.123; P < 0.01) were found to be directly associated with lacunar infarction.

CONCLUSIONS

Reverse-dipper BP pattern may serve as an independent risk factor for lacunar infarction and more personalized BP management should be offered to the patients who have elevated nocturnal BP.

A 32-channel photon counting module with embedded auto/cross-correlators for real-time parallel fluorescence correlation spectroscopy

Fluorescence correlation spectroscopy (FCS) is a well-established technique to study binding interactions or the diffusion of fluorescently labeled biomolecules in vitro and in vivo. Fast FCS experiments require parallel data acquisition and analysis which can be achieved by exploiting a multi-channel Single Photon Avalanche Diode (SPAD) array and a corresponding multi-input correlator. This paper reports a 32-channel FPGA based correlator able to perform 32 auto/cross-correlations simultaneously over a lag-time ranging from 10 ns up to 150 ms. The correlator is included in a 32 × 1 SPAD array module, providing a compact and flexible instrument for high throughput FCS experiments. However, some inherent features of SPAD arrays, namely afterpulsing and optical crosstalk effects, may introduce distortions in the measurement of auto- and cross-correlation functions. We investigated these limitations to assess their impact on the module and evaluate possible workarounds.

Obscure gastrointestinal bleeding: diagnostic performance of 64-section multiphase CT enterography and CT angiography compared with capsule endoscopy

OBJECTIVE

To compare the diagnostic capabilities between capsule endoscopy (CE) and multislice CT (MSCT) enterography in combination with MSCT angiography for assessment of obscure gastrointestinal bleeding (OGIB).

METHODS

A total of 127 patients with OGIB were looked at in this study. 82 patients (aged 42.7 ± 19.1 years; 34 males) were assigned to receive MSCT diagnosis and 67 patients to (aged 53.9 ± 16.2 years; 28 males) receive CE diagnosis. Among them, 22 patients (aged 54.1 ± 19.1 years; 12 males) received both examinations. Oral isotonic mannitol and intramuscular injection of anisodamine were performed; non-ionic contrast (iopromide, 370 mg I ml(-1)) was intravenously administered; and then multiphase scanning was conducted at arterial, small intestinal and portal venous phases in MSCT. The results were compared with findings of reference standards including double balloon enteroscopy, digital subtraction angiography, intraoperative pathological examination and/or clinical diagnosis.

RESULTS

Administration of anisodamine markedly increased the satisfaction rate of bowel filling (94.67% vs 28.57%; p < 0.001) but not the diagnostic yield (p = 0.293) of MSCT. Compared with MSCT, CE showed an improved overall diagnostic yield (68.66% vs 47.56%; p = 0.010), which was also observed in overt bleeding patients (i.e. patients with continued passage of visible blood) (76.19% vs 51.02%; p = 0.013) and in patients aged younger than 40 years of age (85% vs 51.28%; p = 0.024). However, CE had similar positive rates to MSCT (p > 0.05). Among the 22 cases in whom both examinations were conducted, CE showed no significantly different diagnostic capability compared with MSCT (p = 0.4597).

CONCLUSION

Both CE and MSCT are safe and effective diagnostic methods for OGIB.

ADVANCES IN KNOWLEDGE

CE is preferred for overt bleeding or patients aged younger than 40 years. The combined use of CE and MSCT is recommended in OGIB diagnosis.

Bosentan protects the spinal cord from ischemia reperfusion injury in rats through vascular endothelial growth factor receptors

STUDY DESIGN

Experimental study.

OBJECTIVES

To investigate whether Bosentan, an endothelin-A/-B dual receptor antagonist, could protect neurons after spinal cord ischemia reperfusion (SCIR) injury in rats and its underlying signaling pathway.

SETTING

Department of Neurosurgery, the Second Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi Province, China.

METHODS

Sprague-Dawley rats were randomly divided into two groups, saline group (IRS, n=48) and Bosentan group (IRB, 5 mg kg(-1), n=48). After ischemia for 1 h with occlusion of the infrarenal aorta, spinal cord were reperfused for 6h, 12h, 24h, 3d, 5d, and 7d separately. Enzyme-linked immunosorbent assay was used to detect vascular endothelial growth factor (VEGF) in serum. Immunohistochemistry was performed to detect protein expression of VEGF, VEGF receptor 1 (FLT-1) and VEGF receptor 2 (FLK-1). Gene expressions of VEGF and its receptors were evaluated using the quantitative reverse transcription polymerase chain reaction.

RESULTS

Compared with the IRS group, gene and protein expressions of VEGF, FLT-1 and FLK-1 were significantly increased (P<0.05), so was the concentration of VEGF in plasma (P<0.05). FLK-1 was expressed on spinal cord neurons.

Genetic characterization and authentication of Dimocarpus longan Lour. using an improved RAPD technique

Dimocarpus longan Lour. is an edible and traditional herb in China, commonly referred to as longon. An improved randomly amplified polymorphic DNA (RAPD) protocol was here developed in order to determine the geographical origins of D. longan samples collected from 5 provinces in the southern and southwestern areas of China, including Sichuan, Hainan, Fujian, Guangdong, and Guangxi. Generally, the improved RAPD method generated good fingerprinting of the 5 samples using the selected 17 primers. In particular, primers SBS-A5, SBS-A13, SBS-I9, SBS-I20, SBS-M1, and SBS-Q12 produced distinguishable bands that clearly separated all 5 cultivars, suggesting that there are variations in RAPD genetic sites among the samples. The similarity index ranged from 0.69 to 0.76. The Sichuan and Hainan clades clustered together with a 0.73 similarity index. The Guangxi and Fujian clades clustered together with a 0.76 similarity index, and they formed the sister clade to the Sichuan/Hainan clade with a 0.71 similarity index. The Guangdong clade was in a basal polytomy with a 0.70 similarity index. Based on the abundant DNA polymorphisms, these longan accessions are distinguishable using our improved RAPD technique. Therefore, RAPD analysis is an effective technique in distinguishing the geographical origins of D. longan. Moreover, the improved method could also be employed for a variety of applications including genetic diversity and fingerprinting analyses.

Bosentan reduces neuronal apoptosis following spinal cord ischemic reperfusion injury

STUDY DESIGN

Experimental study.

OBJECTIVES

To investigate the effects of endothelin-receptor antagonist Bosentan on the spinal neural apoptosis in rats with ischemic reperfusion (IR) injury.

SETTING

Department of Neurosurgery, the Second Affiliated Hospital, Xi'an Jiaotong University School of Medcine, Xi'an, Shaanxi Province, China:

METHODS

Sprague-Dawley Rats were randomly divided into two groups, saline (IRS, n=48) and Bosentan (IRB, n=48) treatment, respectively, when reperfused in 6 h, 12 h, 24 h, 3 days, 5 days and 7 days. Immunohistochemical staining was used to assess endothelin-1 (ET-1), endothelin receptor type A (ETRA), endothelin receptor type B (ETRB), Bcl-2, Bax, Caspase-8, Caspase-9 and Caspase-3 expression. ET-1 and its receptor in spinal cord tissue were evaluated by real-time PCR. Plasma ET-1 concentration was also detected using radioimmunoassay.

RESULTS

Compared with the group IRS, plasma concentration of ET-1 in group IRB was significantly increased at each time point (P<0.05) and peaked at 24 h (P<0.01). ETRB expression in group IRB was significantly higher than group IRS at each time point (P<0.05) and peaked at day 3 (P<0.01). The difference in the expression of ETRA was not statistically significant in the group IRS and IRB (P>0.05). The apoptosis rate in group IRB was significantly decreased at each time point (P<0.05). The protein expressions of Bcl-2, Bax, Caspase-8, Caspase-9 and Caspase-3 were significantly increased in response to Bosentan treatment after IR.

CONCLUSION

These results suggest Bosentan decreases apoptosis rate after IR injury in the spinal cord, possibly through the ET-1-ETRB signaling pathway.