The potential role of pneumococcal conjugate vaccine in reducing acute respiratory inflammation in community-acquired pneumococcal pneumonia

Background

Pneumococcal conjugate vaccine (PCV) reduces both invasive pneumococcal disease (IPD) and other pneumococcal infections worldwide. We investigated the impact of stepwise implementation of childhood PCV programs on the prevalence of pneumococcal pneumonia, severity of acute inflammation, and associations between breakthrough pneumonia and pneumococcal serotypes in Taiwan.

Methods

In total, 983 children diagnosed with community-acquired pneumococcal pneumonia were enrolled between January 2010 and December 2015.

Results

Proportions of pneumococcal vaccinations increased each year in age-stratified groups with PCV7 (32.2%) as the majority, followed by PCV13 (12.2%). The proportion of pneumococcal pneumonia decreased each year in age-stratified groups, especially in 2–5 year group. Serotype 19A is the leading serotype either in vaccinated (6.4%) or unvaccinated patients (5.2%). In particular, vaccinated patients had significantly higher lowest WBC, lower neutrophils, lower lymphocytes and lower CRP values than non-vaccinated patients (p < 0.05). After stratifying patients by breakthrough infection, those with breakthrough pneumococcal infection with vaccine coverage serotypes had more severe pneumonia disease (p < 0.05).

Conclusion

Systematic childhood pneumococcal vaccination reduced the prevalence of community-acquired pneumococcal pneumonia, especially in 2–5 year group. Serotype 19A was the major serotype for all vaccine types in patients with pneumococcal pneumonia and severity of acute inflammatory response was reduced in vaccinated patients.

Clinical characteristics and risk factors for children with norovirus gastroenteritis in Taiwan

BACKGROUND

Norovirus is a common acute gastroenteritis (AGE) pathogen across all age groups worldwide, which is difficult to differentiate from other pathogens. This study aimed to understand the clinical characteristics and risk factors of norovirus gastroenteritis among children in Taiwan.

METHODS

A prospective AGE surveillance study was conducted in children aged ≤5 years who were hospitalized in 10 major hospitals in Taiwan between 2014 and 2017. The non-AGE control group included healthy children who were matched based on age, gender, season, and geographic area.

RESULTS

Overall, 674 norovirus gastroenteritis patients were enrolled. Fever (p < 0.001), mucoid stool (p < 0.001), and bloody stool (p < 0.001) occurred less frequently among norovirus gastroenteritis patients. Norovirus gastroenteritis patients yielded lower CRP values on admission (21.78 ± 36.81 vs. 46.26 ± 58.12 mg/L, p < 0.001) than non-norovirus controls. Norovirus gastroenteritis patients were associated with higher direct contact rates with AGE patients within 1 week (30.5% vs. 0.97%, p < 0.001), lower hand wash rates before meals (21.6% vs. 15.4%, p = 0.001), lower human milk (15.8% vs. 19.8%, p = 0.045) and guava consumption rates (17.8% vs. 24.3%, p = 0.002) than non-AGE participants.

CONCLUSIONS

Body temperature, stool characteristics, and CRP value can help distinguish the norovirus from other pathogens. The major risk factor of norovirus AGE is contact with AGE patient. Higher frequency of hand wash, human milk, and guava intake may be protective against norovirus gastroenteritis.

Hospital-based surveillance of severe rotavirus gastroenteritis and rotavirus strains in young Taiwanese children

BACKGROUND/PURPOSE

Rotavirus remains a leading cause of pediatric gastroenteritis-related hospitalization. Surveillance studies have revealed that several major rotaviral genotypes are responsible for most cases of rotavirus gastroenteritis (RVGE). This study aimed to understand the characteristics of acute gastroenteritis (AGE) caused by rotavirus in young children in Taiwan.

METHODS

Ten hospitals in Taiwan were subjected to prospective hospital-based AGE surveillance during 2014-2017, and children younger than 5 years old who were hospitalized due to AGE were enrolled in the study. Medical and demographic variables were recorded and analyzed, and stool specimens were collected for rotavirus identification and genotyping via real-time RT-PCR. Non-rotavirus AGE age-matched controls were enrolled.

RESULTS

Surveillance identified 4747 young children hospitalized with AGE during this study period. The median age of these patients was 2.0 years. Rotavirus was detected in stool samples from 518 patients (10.9%). The prevalent months of RVGE in 2014, 2015, and 2017, wherein the rotavirus positivity rates exceeded 30%. The most common serotypes were G3P[8] (303/518, 58.9%) and G1P[8] (86/518, 16.6%). The percentage of G3P[8] increased from 4.9% in 2014 to 74.3% in 2016 (P < 0.0001), whereas the percentage of G1P[8] decreased from 61.0% in 2014 to 22.5% in 2015 (P < 0.0001). Compared with G3P[8], G1P[8] was associated with a significantly higher C-reactive protein level (P < 0.05).

CONCLUSION

Rotavirus remains a notable pathogenic etiology of childhood AGE and the G3P[8] serotype was dominant in Taiwan. This study highlighted the importance of rotavirus surveillance to ensure protective effectiveness against the circulating strains.

Prevalence and molecular characterizations of Staphylococcus aureus nasal colonization among patients in pediatric intensive care units in Taiwan

Background

Nasal colonization of Staphylococcus aureus is a risk factor for the pathogen transmission and the development of infections. Limited information is available on the prevalence and molecular characteristics of S. aureus colonization in pediatric intensive care unit (ICU) patients.

Methods

A cross-sectional, island-wide study was conducted in 2011. Nasal swabs were collected from pediatric ICU patients at six tertiary hospitals in Taiwan.

Results

Of 114 patients enrolled in total, nasal colonization of S. arueus was detected in 30 (26.3%) of them, among whom 20 (17.5%) with methicillin-resistant S. arueus (MRSA). The ST59/SCCmec IV and V clones were most common and accounted for 45% of MRSA isolates, followed by ST239/SCCmec III (25%) and ST45/SCCmec IV (20%) clones. Three ST59 MRSA isolates carried the Panton-Valentine Leukocidin genes.

Conclusions

The results indicated a high prevalence of S. arueus and MRSA nasal colonization among pediatric ICU patients in Taiwan. Identification of epidemic clones warrants the implement of infection control measures to reduce colonization and prevent the dissemination of MRSA in hospitals.

[Analysis of colorectal cancer screening results in Kunming from 2014 to 2017]

This study analyzed the distribution of high-risk population, the compliance and detected lesions of colorectal cancer screening from the Cancer Screening Program in urban areas of Kunming,Yunnan Province from 2014 to 2017. A total of 127 960 residents were included,of which 14 791 (11.70%) cases were diagnosed with high risk of colorectal cancer by the National Cancer Center High Risk Population Assessment System. A total of 3 484 cases completed colonoscopy clinical screening and the rate of participation was 23.55%. The screening results showed that 592 positive cases were detected, and the positive rate was 17.17%. The detection rates of polyps,adenomas,advanced adenomas,precancerous lesions and colorectal cancer were 16.27%,13.12%,7.18%,7.63% and 0.26%, with 567, 457, 250, 266 and 9 cases, respectively.

Effects of influenza vaccine and sun exposure time against laboratory-confirmed influenza hospitalizations among young children during the 2012-13 to 2015-16 influenza seasons

BACKGROUND

Influenza is a major cause of acute respiratory infection burden worldwide, leading to many hospitalizations. An annual influenza vaccine is believed to be the best way to prevent influenza-related illnesses. We focused on the efficacies of other possible preventive measures such as increasing sun exposure time and dietary supplements to prevent these illnesses.

METHODS

We conducted a matched-pair case-control study along with the Taiwan Pediatric Infectious Disease Alliance. We included influenza-related hospitalized patients with age ranging from 6 months to 5 years during the 2012-2013, 2013-2014, 2014-2015, and 2015-2016 influenza seasons. The controls were comparable to cases in age, sex, and residential area and had no influenza-related hospitalization records in the same season. We extracted data from vaccination histories and got the patients' guardians to complete questionnaires. Data were analyzed using conditional logistic regression.

RESULTS

We enrolled 1514 children (421 influenza-infected cases and 1093 controls) in the study. We found seasonal influenza vaccination to be an independent protective factor against hospitalizations owing to influenza [p < 0.01; odds ratio (OR), 0.427; 95% confidence interval (CI), 0.306-0.594]. Children with mean sun exposure time of >7 h/week had a significantly lower risk of influenza-related hospitalizations than those with the mean sun exposure time of ≤7 h/week (p < 0.05; OR, 0.667; 95% CI, 0.491-0.906).

CONCLUSIONS

Seasonal influenza vaccination effectively prevents influenza-related hospitalizations in children aged ≤5 years. Besides, >7 h of sun exposure/week may also be associated with lower risk of influenza-related hospitalizations in children.

Resveratrol treatment improves the altered metabolism and related dysbiosis of gut programed by prenatal high-fat diet and postnatal high-fat diet exposure

A maternal high-fat (HF) diet sensitizes offspring to the adverse effects of postnatal HF intake and can lead to metabolic dysregulation. Resveratrol, a natural polyphenolic compound found in grapes and red wine, could help to relieve metabolic syndrome dysregulation. Since the gut microbiota is known to be closely related to metabolic homeostasis, this study aimed to investigate the impact of a combination of maternal and postweaning HF diets on the gut microbiota and whether resveratrol could relieve the gut dysbiosis associated with metabolic dysregulation. Sprague-Dawley dams were sustained on either a chow or HF diet before mating, during pregnancy and during lactation. Their offspring were randomly fed chow or a HF diet after weaning. Four experimental groups were generated: CC (maternal/postnatal chow diet), HC (maternal HF/postnatal chow diet), CH (maternal chow/postnatal high-fat diet) and HH (maternal/postnatal HF diet). A fifth group consisted of HH with resveratrol treatment. We found that both maternal and postnatal HF exposure has a distinct effect on the gut microbiota metagenome of offspring. Maternal HF diet exposure decreased plasma acetate, propionate and butyrate level, while postnatal HF diet exposure decreased plasma acetate level in adult life. The metabolic dysregulation programed by the maternal and postnatal HF diets was related to the relevant gut microbiota. Resveratrol treatment ameliorated the altered plasma propionate level related to maternal HF and postnatal HF diet treatment. Resveratrol treatment also improved most of the altered metabolic dysregulation and related dysbiosis programmed by maternal and postnatal HF diet exposure.

Enterovirus 71 seroepidemiology in Taiwan in 2017 and comparison of those rates in 1997, 1999 and 2007

Background

During recent 20 years, enterovirus 71 (EV71) has emerged as a major concern among children, particularly in the Asia-Pacific region. To understand current EV71 serostatus, to find risk factors associated with EV71 infection and to establish future EV71 vaccine policy, we performed a seroepidemiology study in Taiwan in 2017.

Methods

After informed consent was obtained, we enrolled preschool children, 6–15-year-old students, 16–50-year-old people. They received a questionnaire and a blood sample was collected to measure the EV71 neutralization antibody.

Results

Altogether, 920 subjects were enrolled with a male-to-female ratio of 1.03. The EV71 seropositive rate was 10% (8/82) in infants, 4% (6/153) in 1-year-old children, 8% (7/83) in 2-year-old children, 8% (13/156) in 3–5-year-old children, 31% (38/122) in 6–11-year-old primary school students, 45% (54/121) in 12–15-year-old high school students and 75% (152/203) in 16-50-year-old people. Risk factors associated with EV71 seropositivity in preschool children were female gender, having siblings, more siblings, and contact with herpangina or hand-foot-and-mouth disease. The risk factor with EV71 seropositivity in 16–50-year-old people was having children in their families in addition to older age (p<0.001). Compared with the rates in 1997, 1999 and 2007, the rates in children were significantly lower in 2017.

Conclusion

EV71 seropositive rates were very low, at 4% to 10%, in preschool children and not high, at 31%, in primary school students. Preschool children are highly susceptible and need EV71 vaccine most.

Risk factors outperform intracranial large artery stenosis predicting unfavorable outcomes in patients with stroke

Background

This study examined how intracranial large artery stenosis (ILAS), symptomatic and asymptomatic ILAS, and risk factors affect unfavorable outcome events after medical treatment in routine clinical practice.

Methods

This was a 24-month prospective observational study of consecutively recruited stroke patients. All participants underwent magnetic resonance angiography, and their clinical characteristics were assessed. Outcome events were vascular outcome, recurrent stroke, and death. Cox regression analyses were performed to identify potential factors associated with an unfavorable outcome, which included demographic and clinical characteristics, the risk factors, and stenosis status.

Results

The analysis included 686 patients; among them, 371 were assessed as ILAS negative, 231 as symptomatic ILAS, and 84 as asymptomatic ILAS. Body mass index (p < .05), hypertension (p = .01), and old infarction (p = .047) were factors relating to vascular outcomes. Hypertension was the only factor for recurrent stroke (p = .035). Poor glomerular filtration rate (< 30 mL/min/1.73 m²) (p = .011) and baseline National Institutes of Health Stroke Scale scores (p < .001) were significant predictors of death.

Conclusions

This study extended previous results from clinical trials to a community-based cohort study by concurrently looking at the presence/absence of stenosis and a symptomatic/asymptomatic stenotic artery. Substantiated risk factors rather than the stenosis status were predominant determinants of adverse outcome. Although the degree of stenosis is often an indicator for treatment, we suggest risk factors, such as hypertension and renal dysfunction, should be monitored and intensively treated.

[Management and dynamic risk stratification of differentiated thyroid cancer]

Differentiated thyroid cancer (DTC) is the most frequently diagnosed thyroid cancer. With the development of the imaging technology and fine needle aspiration, early diagnosis rate of DTC is increasing. Most patients have favorable prognosis for DTC's low-invasion. TNM staging is more widely used for predicting mortality than predicting recurrence. In 2008, it was suggested that recurrence risks for DTC should be assessed based on the results of dynamic monitoring treatment response. The validity of dynamic risk stratification (DRS) has been supported by different researches in various countries and DRS is recommended in 2015 American Thyroid Association Management Guidelines. Long-term DRS in patients with DTC make individual management possible.

Aqueous-Phase Synthesis of Size-Tunable PbSe Nanocubes at Room Temperature for Optical Property Characterization

A simple aqueous-phase synthesis of PbSe nanocubes with tunable sizes has been developed by first preparing a Na₂ SeSO₃ stock solution through dissolution of selenium powder in a solution of Na₂ SO₃ at 90-100 °C for 30 min, and adding part of this solution to a mixture of lead acetate and acetic acid at room temperature with stirring for only 5-8 min to complete the nanocrystal growth. Adjusting the volume of acetic acid and Na₂ SeSO₃ solution added enabled the size of the nanocrystals to be tuned, with average edge lengths of 13 to 121 nm attained. Changes in solution color revealed very different crystal growth rates for the 13 and 121 nm nanocubes. The PbSe cubes exhibit size-dependent absorption bands in the ultraviolet and visible-light region; the band positions show progressive redshifts with increasing particle size. Slight photocatalytic activity upon 532 nm laser irradiation of the nanocubes suggests the presence of higher energy levels in the band structure of PbSe. The synthetic conditions can be easily scaled up to obtain a large quantity of PbSe nanocubes for applications.

[Reconstruction of scarring pharyngeal stenosis with forearm free flap:a case report]

A 33-year-old man presented with recurrent oral ulcers for more than 10 years,accompanying dyspnea and dysphagia for 1 year and aggravate for 1 month.Physical examination:pharyngeal cavity stenosis,mucous retention, epiglottis was extruded into the infant type. Electronic laryngoscope:Epiglottis curl,bilateral pyriform sinus disappeared.Ulcer and scar changes can be seen in the lateral wall of bilateral hypopharynx, piriform sinus and posterior annular area,and cover the throat inlet.Neck CT showed: soft tissue thickening in the posterior wall of oropharynx and laryngopharynx-prevertebral fascia, thickening in the right aryepiglottic fold and with local niche;slight uneven enhancement in enhanced scanning, and disappearance of bilateral pyriform sinus.Bilateral parapharyngeal space is clear, laryngopharyngeal wall is not thick, bilateral vocal cords are not thick, and laryngopharyngeal space is clear.Diagnosis: pharyngeal stenosis (scar?); Behcet's disease..

Polymorphisms in enterovirus 71 receptors associated with susceptibility and clinical severity

OBJECTIVE

To evaluate the association of enterovirus 71 (EV71) susceptibility and clinical severity with polymorphisms in EV71 receptors, including human scavenger receptor class B member 2 (SCARB2), P-selectin glycoprotein ligand-1 (PSGL-1), and annexin II (ANXA2).

METHODS

We enrolled laboratory-confirmed EV71 cases and healthy age- and gender-matched controls in Taiwan from 2000 to 2012. We detected genetic polymorphisms in SCARB2, PSGL-1, and ANXA2 and correlated the results with EV71 susceptibility and severity.

RESULTS

We collected 599 EV71 cases and 98 controls. Among EV71 patients, the male to female ratio was 1.61, and the mean age was 2.99±2.47 years. For clinical severity, 117 (19.6%) had severe central nervous system involvement with or without cardiopulmonary failure. For outcomes, 46 (7.7%) had sequelae, and 14 (2.3%) died. SCARB2 polymorphisms (rs6824953 and rs11097262) were associated with susceptibility to EV71 infection (OR 1.60, 95% CI 1.07-2.39; and OR 1.64, 95% CI 1.09-2.47, respectively). PSGL-1 polymorphisms (rs7137098 and rs8179137) were significantly associated with severe EV71 infection (OR 1.46, 95% CI 1.1-1.96; and OR 1.47, 95% CI 1.07-2.03, respectively).

CONCLUSIONS

SCARB2 polymorphisms (rs6824953 and rs11097262) might be associated with EV71 susceptibility. PSGL-1 polymorphisms (rs7137098 and rs8179137) were associated with severe EV71 infection.

Spontaneous Rupture of Splenic Varices: A Rare but Lethal Complication of Portal Hypertension from Cirrhosis

Intra-abdominal varices rupture is a rare but catastrophic complication in cirrhosis. We report our near-miss experience in a woman presenting with acute abdominal pain and shock. This 55-year-old cirrhotic woman presented with sudden onset of epigastric pain. On arrival, her blood pressure was 57/49 mmHg and physical examination revealed epigastric tenderness without rebounding tenderness. Emergency ultrasonography (EUS) showed intra-abdominal haemorrhage. Computed tomography revealed haemoperitoneum but no extravasation of contrast medium. She received conservative treatment first but laparotomy later for ongoing bleeding. Surgeon identified and ligated a ruptured splenic varix and she was discharged home after nine days of hospitalisation. This case report illustrates the use of bedside EUS in cirrhotic patients presenting with acute abdominal pain. (Hong Kong j.emerg.med. 2014;21:120-123)

Clinical features and dynamic ordinary laboratory tests differentiating dengue fever from other febrile illnesses in children

BACKGROUND

Dengue fever is not easily to be diagnosed before presentation of the classic symptoms. The study aimed to investigate the clinical features and dynamic laboratory tests in pediatric patients to facilitate dengue diagnosis.

METHODS

This retrospective study examined the medical records of all pediatric patients who were clinically suspected to have dengue from June to December 2014. Laboratory-positive dengue cases were confirmed by detecting non-structural protein NS1, reverse transcription-polymerase chain reaction of dengue virus, and dengue-specific IgM seroconversion.

RESULTS

Of the 317 pediatric cases clinically suspected of dengue, 205 were laboratory-positive and 112 were laboratory-negative. In laboratory-positive cases, the most common clinical manifestation was skin rash in 156 (76.1%). Leukopenia occurred on days 1-5; thrombocytopenia, on days 2-7; prolonged activated partial thromboplastin time (aPTT), on days 1-4; and elevated transaminase levels, on days 3-11; and low CRP, on days 0-14. The specificity and positive predictive value (PPV) of combining of rash, itching and petechiae increased up to 100%. The PPV of combining of leukopenia, thrombocytopenia, and elevated transaminase levels reached 100% on day 2 as well as days 6-8.

CONCLUSION

Leukopenia, thrombocytopenia, elevated aPTT, elevated transaminase levels, and low CRP could be used to differentiate dengue fever from other febrile illnesses. During dengue epidemics, combinations of the symptoms and laboratory findings are helpful to physicians for accurate diagnosis of dengue fever.

Layer-dependent electronic properties of phosphorene-like materials and phosphorene-based van der Waals heterostructures

Black phosphorus is a layered semiconducting allotrope of phosphorus with high carrier mobility. Its monolayer form, phosphorene, is an extremely fashionable two-dimensional material which has promising potential in transistors, optoelectronics and electronics. However, phosphorene-like analogues, especially phosphorene-based heterostructures and their layer-controlled electronic properties, are rarely systematically investigated. In this paper, the layer-dependent structural and electronic properties of phosphorene-like materials, i.e., mono- and few-layer MXs (M = Sn, Ge; X = S, Se), are first studied via first-principles calculations, and then the band edge position of these MXs as well as mono- and few-layer phosphorene are aligned. It is revealed that van der Waals heterostructures with a Moiré superstructure formed by mutual coupling among MXs and among MXs and few-layer phosphorene are able to show type-I or type-II characteristics and a I-II or II-I transition can be induced by adjusting the number of layers. Our work is expected to yield a new family of phosphorene-based semiconductor heterostructures with tunable electronic properties through altering the number of layers of the composite.

Elucidation of tRNA-cytochrome c interactions through hydrogen/deuterium exchange mass spectrometry

Cytochrome c (cyt c) is a mitochondrial protein responsible for transferring electrons between electron transport chain complexes III and IV. The release of cyt c from the mitochondria has been considered as a commitment step in intrinsic apoptosis. Transfer RNA (tRNA) has recently been found to interact with the released cyt c to prevent the formation of the apoptosome complex, thus preventing cell apoptosis. To understand the molecular basis of tRNA-cyt c interactions, we applied hydrogen/deuterium exchange mass spectrometry (HDXMS) to analyze the interactions between tRNA and cyt c. tRNA^Phe binding to cyt c reduced the deuteration level of cyt c in all analyzed regions, indicating that tRNA binding blocks the solvent-accessible regions and results in the formation of a more compact conformation. Substitution of the tRNA^Phe with the total tRNA from brewer's yeast in the HDXMS experiment significantly reduced deuteration in the N-terminus and the region 18-32 residue of cyt c, where all tRNAs are bound. To clarify the cause of binding, we used synthesized single-stranded oligonucleotides of 12-mer dA and dT to form complexes with cyt c. The exchange of the nucleotide bases between adenine and thymine did not affect the deuteration level of cyt c. However, the regions 1-10 and 65-82 showed minor decreases after unstructured dA or dT DNA binding. Collectively, these results reveal that cyt c maintains its globular structure to interact with tRNA. The region 18-32 selectively interacts with tRNA, and N-terminal 1-10 interacts with oligonucleotides electrostatically.

[Estradiol stimulates the growth and biofilm formation of clinical Staphylococcus epidermidis]

Objective: To investigate the effect of steroid hormones on the growth and biofilm formation of S. epidermidis. Methods: In all experiments, two S. epidermidis standard strains (ATCC12228 and ATCC35984) and two S. epidermidis clinical strains (SE101 and SE40) were incubated on the surface of silica gel in estradiol concentrations of 0, 50, 125, 250 and 500 pmol/L at 4, 6, 12, 24, 48 and 72 hours. Growth curve were drawn by means of the OD value. Formed biofilms were assessed by crystal violet staining methods. In order to observe the processes and structures of biofilm, the confocal laser scanning microscopy (CLSM) and scanning electron microscope (SEM) were used. Results: All of the four strains which were incubated with the concentrations of 125 pmol/L of estradiol had entered the logarithmic growth stage ahead of the blank control (3 h and 4 h). Crystal violet staining indicated that there was no biofilm for ATCC12228. Improved primary attachment abilities were found for ATCC35984 and SE101 in the presence of estradiol, and the OD values were 0 pmol/L (0.081±0.015 and 0.082±0.011), 50 pmol /L (0.087±0.013 and 0.088±0.010), 125 pmol/L (0.175±0.052 and 0.091±0.012), 250 pmol/L (0.153±0.036 and 0.090±0.006), 500 pmol/L (0.157±0.050 and 0.082±0.032), respectively. The thickness of biofilm reached the peak in 125 pmol/L estradiol at 24 h. CLSM and SEM found estradiol promoted the biofilm maturity and the biofilm of 125 pmol/L group was denser and thicker than that of the other concentration groups. Conclusions: Our in vitro experiments indicate that estradiol could promote the growth of S. epidermidis which exit on the surface of silica gel, and improve the ability of biofilm formation of S. epidermidis.

[Retrospective study on the efficacy of different chemotherapy regimens concurrently combined with intensity modulated radiation therapyin treatment of Ⅲ-Ⅳa stage nasopharyngeal carcinoma]

Objective:To compare the near and long term efficacy and safety of paclitaxel(TAX) plus cisplatin(DDP) (TP regimen) and DDP plus 5-FU(PF regimen) concurrently combined with IMRT in treatment of patients with advanced NPC.Method: A retrospective analysis on 108 advanced NPC cases from January 2010 to December 2012 was conducted. The patients were divided into TP group(57 cases) and PF group(51 cases) according to therapy regimen. TP group received IMRT combined with TP therapy, and PF group received IMRT combined with PF regimen, two groups were both used 4 cycles of chemotherapy, toxicity reactions during concurrent radiochemotherapy were noted. Two months after treatment, near clinical efficacies of the two groups were determined, and then, a three years followingup was conducted, during which recurrence ratio, metastasis ratio, local control ratio and survival rate were analyzed. Result: Two months after treatment, the total effective ratio of TP group(84.2% vs.76.5%) was higher than PF group,however, the difference was not statistically significant(P>0.05). Gastrointestinal reaction(70.2% vs.66.7%), marrow inhibition(75.4% vs.82.4%), liver function damage(12.3% vs.13.7%), radioactive oral and pharyngeal injury(91.2% vs.98.0%)， hearing damage(15.8% vs.15.7%) in the two groups during chemoradiotherapy had no significant differences(P>0.05). During followingup, the recurrence and metastasis ratio in TP group(33.3% vs.47.1%) was lower than PF group(χ²=2.116,P=0.146). TP group with The local control rate(73.7% vs.68.5%) and survival rate(84.2% vs.78.4%) after three years treatment in TP group were higher than PF group(χ²=0.336,P=0.562；χ²=0.596,P=0.440). Conclusion: IMRT concurrently combined with TP and PF respectively are both effective methods for treatment of advanced NPC. In this study, IMPT plus TP concurrent chemoradiotherapy has a certain superiority in near and long term clinical treatment efficacy and safety.

Development of a millimetrically scaled biodiesel transesterification device that relies on droplet-based co-axial fluidics

In this study, we investigated a fluidic system that adheres to new concepts of energy production. To improve efficiency, cost, and ease of manufacture, a millimetrically scaled device that employs a droplet-based co-axial fluidic system was devised to complete alkali-catalyzed transesterification for biodiesel production. The large surface-to-volume ratio of the droplet-based system, and the internal circulation induced inside the moving droplets, significantly enhanced the reaction rate of immiscible liquids used here – soybean oil and methanol. This device also decreased the molar ratio between methanol and oil to near the stoichiometric coefficients of a balanced chemical equation, which enhanced the total biodiesel volume produced, and decreased the costs of purification and recovery of excess methanol. In this work, the droplet-based co-axial fluidic system performed better than other methods of continuous-flow production. We achieved an efficiency that is much greater than that of reported systems. This study demonstrated the high potential of droplet-based fluidic chips for energy production. The small energy consumption and low cost of the highly purified biodiesel transesterification system described conforms to the requirements of distributed energy (inexpensive production on a moderate scale) in the world.

Characterization and identification of streptococci from golden pompano in China

Streptococcal infections cause significant mortality and high economic losses in the fish farm industry worldwide, including in the culture of golden pompano Trachinotus ovatus L., a species gaining popularity in China. A total of 9 streptococcal strains were isolated from cage-cultured diseased golden pompano in Beihai, Zhanjing, and Shenzhen, China, between 2012 and 2014. Conventional and rapid identification systems were used to determine that the isolates were Streptococcus agalactiae, S. iniae, and S. dysgalactiae subsp. dysgalactiae. All isolates were gram-positive cocci cells in pairs or short-chain, non-motile, catalase negative, α or β hemolytic cocci. The results of multiplex PCR assays and 16S rRNA BLAST analysis also showed that the β hemolytic strains were S. agalactiae and S. iniae and the α hemolytic strain was S. dysgalactiae subsp. dysgalactiae, respectively. Pathogenicity assays revealed that S. agalactiae (lethal dose [LD50]: 6.38 × 10(4) CFU ml(-1)) was more virulent for golden pompano than S. iniae (LD50: 1.47 × 10(7) CFU ml(-1)) and S. dysgalactiae subsp. dysgalactiae (LD50: 2.57 × 10(6) CFU ml(-1)) when they were challenged by intraperiotoneal (i.p.) injection. The results of antibiotic susceptibility showed that all strains were extremely susceptible to cefradine, erythromycin, and cefotaxime but resistant to gentamicin, penicillin G, novobiocin, neomycin, ciprofloxacin, roxithromycin, furazolidone, enrofloxacin, norfloxacin, kanamycin, ampicillin, tetracycline, and vancomycin This is the first report of a phenomenon of golden pompano coinfection with S. agalactiae and S. iniae, which will contribute to the diagnosis and prevention of streptococcicosis.

Effects of nuclear factor-κB and ERK signaling transduction pathway inhibitors on human melanoma cell proliferation in vitro

The present study aimed to investigate the effects of blocking nuclear factor (NF)-κB and/or extracellular signal-regulated kinase (ERK) signaling pathways on proliferation and apoptosis of melanoma cells in vitro. A375 Human melanoma cells were treated with U0126 (ERK signaling pathway inhibitor) and BMS-345541 (NF-κB inhibitor), alone or in combination. At 12, 24 and 48 h after treatment, cell viability was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, cell cycle progression and apoptosis were evaluated by flow cytometry, and Bcl-2 protein content was determined by western blot analysis. BMS-345541 and U0126 significantly inhibited A375 cell proliferation in a dose- and time-dependent manner (P<0.01). The rate of proliferation inhibition at 24 h was 35.41±1.38% for BMS-345541 alone, 30.64±2.86% for U0126 alone, and 77.27±2.70% for BMS-345541 and U0126 in combination. The difference between combination and single treatment was significantly different (P<0.01). The proportion of cells in S phase was 14.20, 18.40 and 22.64% following treatment with BMS-345541, U0126, and BMS-345541 and U0126 in combination, respectively; these values were all significantly reduced compared with the untreated control group (P<0.01). The apoptosis rate was 24.98±1.03% in the BMS-345541 group, 13.96±0.96% in the U0126 group and 38.91±1.46% in the combination group; all significantly increased compared with the control group (P<0.01). Bcl-2 protein content in A375 cells was significantly increased following treatment with BMS-345541 and U0126, alone or in combination, when compared with the untreated control group (P<0.01). Therefore, NF-κB and ERK signaling pathway inhibitors may serve as potential therapeutic targets for melanoma.