[Model and enlightenment from rescue of August 2nd Kunshan explosion casualty]

On August 2nd, 2014, a massive dust explosion occurred in a factory of Kunshan, resulting in a mass casualty involving 185 burn patients. They were transported to 20 medical institutions in Jiangsu province and Shanghai. More than one thousand of medical personnel of our country participated in this emergency rescue, and satisfactory results were achieved. In this paper, the characteristics of this accident were analyzed, the positive effects of interdisciplinary cooperation were affirmed, and the contingency plan, rescue process and pattern, and reserve, organization and management of talents during this rescue process were reviewed retrospectively.

[Discussion of laparoscopic transabdominal preperitoneal repair for recurrent inguinal hernia]

OBJECTIVE

To explore the surgical techniques and the clinical efficacy of laparoscopic transabdominal preperitoneal repair (TAPP) for recurrent inguinal hernia.

METHODS

Clinical data of 367 patients with recurrent inguinal hernia who underwent TAPP repair from Mar. 2009 to Mar. 2015 in Beijing Chao-Yang Hospital of Capital Medical University were analyzed retrospectively.

RESULTS

Laparoscopic operations were completed successfully in 365 cases, however, 2 cases were converted to open surgery.The operation time was (55.7±19.3) min (30-100 min) and the hospital stay was (4.9±2.7) d (2-12 d). The incidences of postoperative pain, hydrocele, and urinary retention were 4.1%(15/367), 13.1%(48/367), and 1.3%(5/367) respectively.Other complications such as foreign body sensation, wound infection, and intestinal obstruction.All cases were followed up from 3 to 72 months ((36.5±14.7) months), 2 recurrent cases was observed and no mesh infection and long-term chronic pain were observed.

CONCLUSIONS

Laparoscopic TAPP repair has advantages of minimal invasion and few complications, which is safe and effective for recurrent inguinal hernia.

Asian Foxtail (Uraria crinita), a New Host for Sclerotium rolfsii from Taiwan

Asian foxtail (Uraria crinita (L.) Desv. ex DC.) is an herb cultivated for the use of roots and stems in Taiwanese cuisine. In September 2013, symptoms of leaf blight and basal rot were observed on U. crinita in a commercial field in Longjing District, Taichung, Taiwan, at an incidence of approximately 20%. White mycelia and brown sclerotia formed on the surfaces of the basal stems. The infected plant gradually wilted and eventually died. Diseased lower stem tissues were surface sterilized in 0.6% NaOCl, rinsed with sterile distilled water, and transferred to potato dextrose agar plates. The cultures were incubated at 25°C in the dark. The radial mycelial growth was 9.0 mm/day during the first 4 days, and the diameter of mature sclerotia was 1.76 mm following 3 weeks of incubation. The internal transcribed spacer (ITS) sequence of the isolate was amplified by PCR using the primers ITS5 and ITS4 (2). The amplicon was cloned, sequenced, and deposited in GenBank (Accession No. KJ677121). The sequence similarity was 99% compared with that of Sclerotium rolfsii Sacc. from Spain (GU080230) (1). Based on the characteristics, the fungus was identified as S. rolfsii. The fungal isolate (BCRC FU30230) was deposited in the Bioresource Collection and Research Center, Hsinchu, Taiwan. Pathogenicity tests were conducted on six 2-month-old potted U. crinita plants in a greenhouse. Prior to infesting the plant, fungal inoculum of S. rolfsii BCRC FU30230 was prepared by inoculating the isolate on autoclaved rice (rice/water/dextrose = 50:50:1) in a flask. After 20 days incubation at room temperature, rice colonized by S. rolfsii was placed near the base of the plants (approximately 30 g/plant) in the greenhouse. Sterile rice applied to an equal number of plants served as negative controls. All inoculated plants developed blight symptoms with mycelia and sclerotia produced near the bases of each seedling 1 week after inoculation at an average temperature of 26°C. The control plants remained healthy. The pathogen re-isolated from the inoculated plants was morphologically identical to the original isolate. The pathogenicity test was repeated by inoculated healthy plants with reduced inoculum (five granules/plant). A delay of symptom development was observed and similar results were obtained. To our knowledge, this is the first report of Sclerotium rot on U. crinita in Taiwan, and the first report on U. crinita as a host for S. rolfsii. References: (1) E. Remesal et al. Plant Dis. 94:280, 2010. (2) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. M. A. Innis et al., eds. Academic Press, San Diego, 1990.

First Report of Downy Mildew Caused by Plasmopara obducens on Impatiens in Taiwan

In February 2013, single and double flowered impatiens (Impatiens walleriana Hook. f.) affected by downy mildew were observed in nurseries (cv. Accent) and in the wild in central Taiwan. More than 90% of the plants were infected in areas where the disease broke out. Symptomatic leaves showed yellowing, with white, fungal-like structure covering the lower leaf surfaces, causing the plants to become wilted and defoliated. Under microscopic observation, hyaline, thin-walled sporangiophores branched monopodially and had slightly swollen bases. Three apical branchlets were at right angles to the main axis, measuring 4.3-15.0 μm (average 8.5 μm). Sporangia were hyaline, ovoid, with an average length and width of 14.2 (10.0 to 18.0) × 12.1 (9.3 to 15.0) μm. For molecular categorization, PCR amplification of the 5' end of the large ribosomal subunit gene was performed with primers NL1 and NL4 (2). The amplicons were cloned, sequenced, and deposited in GenBank (Accession Nos. KC905620 and KC905621). The sequence similarities were 99% compared with that of Plasmopara obducens (J. Schröt.) J. Schröt from Florida (JX217746) (3). Based on morphological and molecular characters, the pathogen was identified as P. obducens. Three voucher specimens (TNM Nos. F0026644, F0026645, and F0026646) were deposited in the herbarium of the National Museum of Natural Science, Taichung, Taiwan. Pathogenicity was confirmed by inoculation of five young, potted impatiens plants with a suspension containing 1 × 10⁵ sporangia/ml in 0.05% Tween 20 (approximately 8 ml/plant). An additional five plants sprayed with 0.05% Tween 20 served as negative controls. The plants were maintained in an outdoor ambient environment. After 2 weeks incubation at an average temperature of 20°C and approximately 80% relative humidity, the inoculated plants exhibited typical downy mildew symptoms, while the control plants remained healthy. The pathogenicity test was repeated in a dew chamber under 20°C with similar results. In the Asia-Pacific region, impatiens downy mildew was recently confirmed in Korea and Japan (1,4). To our knowledge, this is the first report of downy mildew on impatiens in Taiwan. Our further surveys indicated the disease has spread to other parts of the island and will become a potential problem requiring prevention. References: (1) Y. J. Choi et. al. Plant Pathol. J. 25:433, 2009. (2) K. O'Donnell. Curr. Genet. 22:213, 1992. (3) A. J. Palmateer et. al. Plant Dis. 97:687, 2013. (4) M. Satou et. al. J. Gen. Plant Pathol. 79:205, 2013.

16,17-dihydroxycyclooctatin, a new diterpene from Streptomyces sp. LZ35

Genome sequence analysis of Streptomyces sp. LZ35 has revealed a large number of secondary metabolite pathways, including a complete gene cluster for the biosynthesis of cyclooctatin. This cluster contains four genes, cotB1-4, located in a 5-kb region. Optimization of fermentation medium for LZ35Δheng (SR107) led to the identification of cyclooctatin (1) and 16,17-dihydroxycyclooctatin (2), a new diterpene. The structures of these substances were elucidated on the basis of 1D-, 2D-NMR, and HRESIMS data. Cytotoxicity against MDA-MB-231 and A549 cell lines was also evaluated. Results demonstrated that gene cluster and pathway analysis are key to guided isolation of new natural products.

A new phenoxazine derivative isolated from marine sediment actinomycetes, Nocardiopsis sp. 236

During screening of marine actinomycetes for anti-mycobacterial activity, a new phenoxazine derivative (1) was isolated, along with 6-phenazinediol (2), 6-methoxy-1-phenazinol (3), nocardamin (4), and 3-pyridinecarboxylic acid (5), from a culture of Nocardiopsis sp. 236 collected from the west Pacific. The chemical structure of 1 was established on the basis of 1D-, 2D-NMR, and HRQ-TOF MS data. All compounds were evaluated for their anti-mycobacterial activity in vitro, and only compounds 2 and 3 exhibited weak activity.

First Report of Bacterial Spot Caused by Xanthomonas arboricola pv. pruni on Japanese Plum in Taiwan

Prunus salicina Lindl., also known as Japanese plum, is a temperate-zone fruit tree grown in mountainous areas of Taiwan. The planted area in Taiwan is approximately 3,000 ha. In June 2011, more than 20% of plum fruits harvested in an orchard in Lishan (elevation about 2,000 m) showed black, mostly circular, sunken necrotic lesions. Leaves with a shot-hole appearance and cankered branches were found when investigating the orchard. Bacteria were isolated from symptomatic fruits, leaves, and branches. Isolation on nutrient agar detected colonies that were yellow, mucoid, gram-negative, Xanthomonas-like, and induced hypersensitive responses on tomatoes. Three voucher isolates, BCRC80476, BCRC80478, and BCRC80481, obtained from the fruit, leaf, and branch, respectively, were deposited in the Bioresource Collection and Research Center, Hsinchu, Taiwan. Molecular analyses were conducted for species identification. Sequences of the gyrB gene of the three voucher isolates (GenBank Accession Nos. KC202288, KC202289, and KC202287) were 100% identical to that of Xanthomonas arboricola pv. pruni pathotype strain ICMP51 (2). In addition, DNA fragments of the xopE3 gene (an X. arboricola pv. pruni specific T3E gene, approximately 381 bp) were PCR amplified using the primer pair fw-5'CCGACATTGCCGTCAGCGATCACG3' and rv-5'AGCGTTCTTGGGTGTGTTGAGCATTTG3' (1). The bacterial isolates were identified as X. arboricola pv. pruni on the basis of the colony characteristics, sequence homology, and the specific PCR assay. Pathogenicity was confirmed by inoculation of greenhouse-potted P. salicina plants with strains BCRC80476, BCRC80478, and BCRC80481 using bacterial suspensions (6.7 × 10⁸ CFU per ml) in 0.01% Tween 20. Five plants were evenly sprayed with inoculum of each bacterial isolate and covered with plastic bags for 3 days. One week post inoculation, at an average temperature of 19°C, the 15 inoculated plants produced brown-purple spots delimited by a chlorotic margin on the leaves. Three weeks post inoculation, the necrotic leaf spots completely deteriorated, leaving a shot-hole appearance, and the branches showed lesions similar to those observed in the fields. The pathogen was reisolated from the symptomatic tissues, fulfilling Koch's postulates. Control plants sprayed with 0.01% Tween 20 remained symptomless. To our knowledge, this is the first record of X. arboricola pv. pruni causing bacterial spot on P. salicina in Taiwan. References: (1) A. Hajri et al. Appl. Environ. Microbiol. 78:371, 2012. (2) J. M. Young et al. Syst. Appl. Microbiol. 31:366, 2008.

Topoisomerase IIα, rather than IIβ, is a promising target in development of anti-cancer drugs

DNA topoisomerase II (TOP2) is a well-known anticancer target. Its inhibitors are among the most effective anticancer drugs currently in clinical use. TOP2-targeting agents fall into two major classes of "Topo poisons" and "Topo inhibitors" based on their mechanisms of action. Mammalian cells possess two genetically distinct TOP2 isoforms, TOP2α and TOP2β, that are differentially regulated and play different roles in living cells. Compared to TOP2β, TOP2α may be an efficacious and safe chemotherapeutic target for cancer treatment. This review discusses the advantage of targeting TOP2α over TOP2β and action of various agents on TOP2α.

Anti-inflammatory activities of fractions from Geranium nepalense and related polyphenols

Geranium nepalense Sweet is a common Chinese herbal medicine and has been used as influenza, dysentery, antiphlogistic and analgesic tonic, hemostatic, stomachic, and antidiabetic drugs. The anti-inflammatory effects of G. nepalense on tetradecanoyl phorbol acetate (TPA)-induced mouse ear edema were studied in this work. The results showed that ethyl acetate fraction of the water extract of G. nepalense possessed significant activity at 2.5 g/kg (p < 0.01) with aspirin as a positive control (0.6 g/kg). Six polyphenolic compounds, including three flavonoids, i.e. kaempferol, kaempferol-7-O-β-D-glucopyranoside, and quercetin-7-O-α-rhamnopyranoside, and two tannins, i.e. pyrogallol and gallic acid, and one lignin, i.e. epipinoresinol, were isolated and characterized from ethyl acetate fraction. The isolation of polyphenols provides a clue for beneficial effects of G. nepalense in the demonstrated anti-inflammatory activity.

First Report of Stem and Leaf Blight Caused by Sclerotinia sclerotiorum on Eustoma in Taiwan

Eustoma (Eustoma russellianum) is an economically important cut flower in Taiwan. Each year more than 1.7 million dozen flowers, mainly exported to Japan in the winter, are produced in greenhouses. In January 2011, eustoma plants with stem and leaf blight symptoms were observed in some greenhouses in Changhua County, Taiwan, at an incidence of 2%. Brown and rotten lesions were presented on the stem and nearby leaves, with white mycelia growing on the surface and black sclerotia (up to 7 mm long) produced inside the stem. Infected plants were completely blighted and eventually died. Diseased stem tissues collected from the field were surface sterilized for 3 min in 0.6% NaOCl, rinsed with sterilized distilled water, and plated on potato dextrose agar. White fungal colonies were consistently isolated. The cultures produced large sclerotia at the peripheries of the plates. Internal transcribed spacer (ITS) sequences of two voucher isolates were determined and deposited in GenBank (Accession Nos. JQ653934 and JQ653935). The sequences were 100% identical to that of Sclerotinia sclerotiorum strain ATCC MYA-4521 (Accession No. FJ810516). In addition, PCR amplified DNA fragments (approximately 630 bp) were obtained by the S. sclerotiorum specific primer pair MP_SsF and MP_UniR (1). On the basis of morphology, ITS sequence homology, and the specific PCR detection, the fungus was identified as S. sclerotiorum. The two fungal isolates (BCRC34830 and BCRC34831) were deposited in Bioresource Collection and Research Center, Hsinchu, Taiwan. Pathogenicity tests were conducted on 1-month-old, second flush eustoma cultivars Ex Rosa Pink Flash and Rosina Blue Ver. 2 after primary flowers had been harvested in the greenhouse. Fungal inoculum consisting of Tref horticultural substrate and wet sterilized rice colonized by S. sclerotiorum BCRC34830 (substrate-rice-water ratio of 2:1:1) was placed near the base of the plants. Ten plants of each cultivar were inoculated with about 800 g of the mixture. Sterile mixture applied to an equal number of plants served as negative controls. Eight plants of each cultivar showed blight symptoms after 1 month of incubation at an average temperature of 26°C. All control plants remained healthy. The pathogen reisolated from the inoculated stems produced sclerotia identical to those isolated in the field, fulfilling Koch's postulates. The pathogenicity test was repeated with similar results. S. sclerotiorum has been reported on eustoma in Argentina (2). To our knowledge, this is the first report of Sclerotinia blight on eustoma in Taiwan. Although the disease was not prevalent on eustoma, the inoculum could be dormant in the greenhouse soil. Awareness of the potential perennial problem could increase the quality of the flowers exported and benefit the flower industry. References: (1) S. Hirschhäuser and J. Fröhlich. Int. J. Food Microbiol. 118:151, 2007. (2) S. Wolcan et al. Plant Dis. 80:223, 1996.

First Report of Phytophthora drechsleri Associated with Stem and Foliar Blight of Gynura bicolor in Taiwan

Gynura bicolor (Roxb. ex Willd.) DC., known as Okinawa spinach or hong-feng-cai, is a commonly consumed vegetable in Asian countries. In May 2010, plants with blight and wilt symptoms were observed in commercial vegetable farms in Changhua, Taiwan. Light brown-to-black blight lesions developed from the top of the stems to the petioles and extended to the base of the leaves. Severely infected plants declined and eventually died. Disease incidence was approximately 20%. Samples of symptomatic tissues were surface sterilized in 0.6% NaOCl and plated on water agar. A Phytophthora sp. was consistently isolated and further plated on 10% unclarified V8 juice agar, with daily radial growths of 7.6, 8.6, 5.7, and 2.4 mm at 25, 30, 35, and 37°C, respectively. Four replicates were measured for each temperature. No hyphal growth was observed at 39°C. Intercalary hyphal swellings and proliferating sporangia were produced in culture plates flooded with sterile distilled water. Sporangia were nonpapillate, obpyriform to ellipsoid, base tapered or rounded, and 43.3 (27.5 to 59.3) × 27.6 (18.5 to 36.3) μm. Clamydospores and oospores were not observed. Oospores were present in dual cultures with an isolate of P. nicotianae (p731) (1) A2 mating type, indicating that the isolate was heterothallic. A portion of the internal transcribed spacer sequence was deposited in GenBank (Accession No. HQ717146). The sequence was 99% identical to that of P. drechsleri SCRP232 (ATCC46724) (3), a type isolate of the species. The pathogen was identified as P. drechsleri Tucker based on temperature growth, morphological characteristics, and ITS sequence homology (3). To evaluate pathogenicity, the isolated P. drechsleri was inoculated on greenhouse-potted G. bicolor plants. Inoculum was obtained by grinding two dishes of the pathogen cultured on potato dextrose agar (PDA) with sterile distilled water in a blender. After filtering through a gauze layer, the filtrate was aliquoted to 240 ml. The inoculum (approximately 180 sporangia/ml) was sprayed on 24 plants of G. bicolor. An equal number of plants treated with sterile PDA processed in the same way served as controls. After 1 week, incubation at an average temperature of 29°C, blight and wilt symptoms similar to those observed in the fields appeared on 12 inoculated plants. The pathogen was reisolated from the lesions of diseased stems and leaves, fulfilling Koch's postulates. The controls remained symptomless. The pathogenicity test was repeated once with similar results. G. bicolor in Taiwan has been recorded to be infected by P. cryptogea (1,2), a species that resembles P. drechsleri. The recorded isolates of P. cryptogea did not have a maximal growth temperature at or above 35°C (1,2), a distinctive characteristic to discriminate between the two species (3). To our knowledge, this is the first report of P. drechsleri being associated with stem and foliar blight of G. bicolor. References: (1) P. J. Ann. Plant Pathol. Bull. 5:146, 1996. (2) H. H. Ho et al. The Genus Phytophthora in Taiwan. Institute of Botany, Academia Sinica, Taipei, 1995. (3) R. Mostowfizadeh-Ghalamfarsa et al. Fungal Biol. 114:325, 2010.

First Report of Neofusicoccum parvum Associated with Stem Canker and Dieback of Asian Pear Trees in Taiwan

Asian pear tree (Pyrus pyrifolia) is an important fruit crop in Asian countries. Between the autumn of 2008 and the summer of 2009, stem cankers and twig diebacks of Asian pear trees were observed in middle Taiwan. Necrotic lesions extending from branch scars progressed with age, resulting in darkened vascular discoloration. Two cultivars of Asian pear, Taichung No. 2 grown in Changhwa County and Heng-shan grown in Taichung County, showed the same symptoms. Disease incidence increased rapidly after a rain or storm event, eventually exceeding 50%. Pycnidia on severely infected branches contained one-celled, fusiform to ellipsoidal, smooth- and thin-walled hyaline conidia, with an average length (L) and width (W) of 19.1 (11.3 to 24.8) × 5.9 (4.5 to 8.0) μm and a L/W ratio of 3.2 (n = 44). Diseased branch tissues collected from the two locations were surface sterilized in 0.6% NaOCl, rinsed with water, and plated on potato dextrose agar (PDA). Fungal isolates, recovered from both locations, produced white, aerial mycelium and became dull gray within a week after incubating plates at 25°C. To confirm the identities of the isolates, the internal transcribed spacer (ITS) regions amplified with primers ITS1/ITS4 were deposited in GenBank (Accession Nos. GU395186 and GU395187). Both of the sequences were 99% identical to that of Neofusicoccum parvum (Accession No. EU882162) over a 534-bp alignment. Thus, both morphological and molecular characters confirmed this species as N. parvum (3), reported as the anamorph of Botryosphaeria parva (1). The two voucher isolates (BCRC34605 and BCRC34609) were deposited in Bioresource Collection and Research Center, Hsinchu, Taiwan. Pathogenicity tests were first conducted on 2-year-old greenhouse-potted Asian pear trees utilizing N. parvum isolate BCRC34605. Ten plants of the cv. Mi-li were stem wounded with a 5-mm cork borer at a depth of 2 mm. Inoculation consisted of inserting 5-mm mycelium plugs of the pathogen into the wounds and wrapping with Parafilm. Sterile PDA plugs applied to an equal number of plants with the same methods served as the controls. After 2 months incubation at an average temperature of 21°C, all inoculated plants exhibited necrotic lesions with a mean length of 23.5 mm and the control plants remained symptomless. The pathogen was reisolated from lesions of inoculated stems, thus fulfilling Koch's postulates. Pathogenicity tests were repeated by inoculating the other N. parvum isolate (BCRC34609) on pear cv. Taichung No. 2, resulting in similar results. N. parvum has been reported causing dieback and canker in a wide range of fruit trees, including grapevine (4) and mango trees (2). To our knowledge, this is the first report of N. parvum associated with stem canker and dieback on Asian pear trees. In addition, this is a newly recorded species for the mycobiota of Taiwan. References: (1) P. W. Crous et al. Stud. Mycol. 55:235, 2006. (2) J. Javier-Alva et al. Plant Dis. 93:426, 2009. (3) S. R. Mohali et al. Fungal Divers. 25:103, 2007. (4) J. R. Urbez-Torres and W. D. Gubler. Plant Dis. 93:584, 2009.

First Report of Anthracnose Caused by Colletotrichum acutatum on Mung Bean Sprouts in Taiwan

Mung bean sprouts (Vigna radiata (L.) R. Wilczek) are a commonly consumed vegetable in Asian countries. Anthracnose lesions on mung bean sprouts (cv. You-lu-dou from Mayamar) were found in an indoor sprouting facility in Taichung County, Taiwan in May of 2009. The incidence of disease exceeded 90% in some lots. Infected hypocotyls had smooth, diamond-shaped to fusiform brown spots, which became further depressed and enlarged with age. A fungus was isolated on potato dextrose agar (PDA) from symptomatic hypocotyls after surface sterilization in 0.6% NaOCl. Fungal colonies were initially salmon to orange in color and became greenish gray on the surface within a week. Setae were not produced in acervuli that developed on PDA. Conidia in the acervuli were one-celled, cylindrical, and hyaline with an average length and width of 14.8 (7.0 to 23.7) × 4.9 (3.3 to 6.7) μm (n = 53). The internal transcribed spacer (ITS) region was amplified with primers ITS1 and ITS4 (4). The sequence was deposited in GenBank (Accession No. GQ889269). The sequence was 99% identical to that of ATCC 56816 strain of Glomerella acutata (Guerber & J. C. Correll), the teleomorph of Colletotrichum acutatum (J. H. Simmonds) over a 522-bp alignment. Thus, the mung bean pathogen was identified as C. acutatum based on morphological (1) and molecular characters. Pathogenicity of the strain was determined by inoculating mung bean seeds from I-Mei Foods Co. (imported from Australia). The seeds were disinfested in 0.6% NaOCl for 10 min, rinsed with sterile distilled water twice, and immersed in a conidial suspension (1.5 × 10⁴ conidia/ml) of C. acutatum for 10 min. Fifteen inoculated seeds were placed on moistened paper towels, distributed into three flasks, and stored in the dark at 32°C. Symptoms similar to those observed on the original sprouts appeared 3 days later on the hypocotyls of the seedlings and all seedlings were infected by day five. Conidia of C. acutatum were produced on all lesions and colonies of C. acutatum were recovered from symptomatic tissues, fulfilling Koch's postulates. Controls (seed immersed in water) remained symptomless. The pathogenicity test was repeated with similar results. The pathogen has been recorded on mung bean sprouts in Korea (2) and on other Vigna spp. in India (3). To our knowledge, this is the first report of sprout rot of mung bean caused by C. acutatum in Taiwan. References: (1) B. J. Dyko and J. E. M. Mordue. No. 630 in: Descriptions of Pathogenic Fungi and Bacteria. CMI, Kew, Surrey, UK, 1979. (2) D. K. Kim et al. Plant Pathol. J. 19:203, 2003. (3) K. P. R. Prasanna. Seed Sci. Technol. 13:821, 1985. (4) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. M. A. Innis et al., eds. Academic Press, New York, 1990.

[Detection and clinical significance of JAK2 mutation in 412 patients with chronic myeloproliferative neoplasms]

OBJECTIVE

To investigate the frequency of JAK2V617F mutation in Chinese patients with chronic myeloproliferative neoplasms (MPN) and to study the relationship between JAK2V617F mutation and clinical characteristics.

METHODS

JAK2V617F mutation was screened by allele-specific polymerase chain reaction (AS-PCR).

RESULTS

JAK2V617F mutation was detected in 277 of the 412 patients with MPN. The frequency of JAK2V617F mutation was similar among essential thrombocythemia (ET), idiopathic myelofibrosis (IMF) and chronic myeloproliferative disorders-unclassified (MPD-U) (P > 0.05), but it was significantly lower than that in polycythemia vera (PV) (P < 0.05). The presence of JAK2V617F was found to be significantly correlative with advanced age at diagnosis (P < 0.01) and with higher hemoglobin levels and higher leukocyte counts (P < 0.05). Significant difference was found in complication of vascular events between JAK2V617 positive and negative patients (P < 0.05). JAK2V617F positive MPD-U patients were more prone to progress into typical MPN compared with JAK2V617F negative MPD-U patients. The association between abnormal karyotype and JAK2V617F was not found in cytogenetical analysis of 301 patients.

CONCLUSION

The presence of JAK2V617F in MPD-U is associated with the disease development. There is a correlation between JAK2V617F mutation in MPN and advanced age, higher leukocyte counts, hemoglobin level and vascular events.

[Quantitative analysis for JAK2 mutation in 98 patients with essential thrombocythemia and its clinical significance]

The objective of this study was to identify the frequency and types of JAK2V617F mutation in chinese patients with essential thrombocythemia (ET), to quantitatively detect the level of mutation transcripts and to investigate its clinical significance. The frequency and types of JAK2V617F mutation were detected by amplification-refractory mutation sequencing polymerase chain reaction (ARMS-PCR), the transcript level of JAK2V617F mutation was determined by using capillary electrophoresis. The results indicated that the JAK2V617F mutation was detected in 59 out of 98 patient with ET, 18 of whom were homozygous mutation. The mean age of patients with homozygous and heterozygous mutation was higher than that of patients with wild type mutation (p < 0.05). The quantitative assay using capillary electrophoresis showed that the transcript level of JAK2V617F mutation in patients with homozygous mutation was (89.9 +/- 6.7)%, which was higher than that in patients with heterozygous mutation (57.1 +/- 6.7)% (p < 0.05); the transcript level of JAK2V617F mutation in patients with age < 60 years was (62.3 +/- 16.5)%, which was lower than that in patients with age > 60 years (72.4% +/- 15.8)% (p < 0.05). The rate of thrombotic complications in patients with JAK2V617F-positive was higher than that in patients with JAK2V617F-negative in which the rate of thrombotic complication in patients with homozygous mutation was higher than that in patients with heterozygous mutation (p < 0.05). Compared with patients without thrombotic events, there were higher level of transcripts of JAK2V617F mutation in patients with thrombotic events. It is concluded that the JAK2V617F positive and negative patients with ET display the different clinical features, therefore, the analysis of mutation types and detection of transcript levels not only helps to identify the disease status and progression, but also guides the treatment of ET patients.

[The quantitative assay and clinical significance of JAK2V617F mutation in 131 patients with chronic myeloproliferative disorders]

OBJECTIVE

To investigate the frequency and mutational status of JAK2V617F mutation in Chinese patients with chronic myeloproliferative disorders (CMPD) and to study the relative quantification of mutated JAK2 mRNA and the clinical significance.

METHODS

JAK2V617F mutation and the mutational status were screened with amplification-refractory mutation system polymerase chain reaction (ARMS-PCR), the relative quantification of mutated JAK2 mRNA was studied by using capillary electrophoresis.

RESULTS

A higher prevalence of JAK2V617F in either the heterozygote or homozygote status in essential thrombocythemia (ET) was observed in elderly patients with ET (P < 0.05). The presence of JAK2V617F was found to be significantly correlated with the age at diagnosis (P < 0.05); patients with age > or = 60 years showed significantly higher JAK2 mutated RNA levels than those with age < 60 years (P < 0.05); the presence of JAK2V617F in polycythemia vera (PV) and ET was found to be significantly associated with higher hemoglobin level and higher leukocyte count (P < 0.05). In addition, higher leukocyte count was observed in homozygous ET patients than in heterozygous ET patients (P < 0.05). The frequency of JAK2V617F mutation and the prevalence of homozygote in PV patients were higher than those in ET patients (P < 0.05). The differences of JAK2V617F mRNA levels among PV, ET and chronic idiopathic myelofibrosis (IMF) were not significant.

CONCLUSIONS

ARMS-PCR technique can be used to detect the frequency and mutational status of JAK2V617F mutation owing to its sensitivity and along with capillary electrophoresis, quantitative assay for mutated JAK2 mRNA, diagnosis of CMPD and judgement of prognosis become possible.

IgA antiphospholipid antibodies are an independent risk factor for thromboses

Antiphospholipid antibodies (lupus anticoagulant, anti-cardiolipin and anti-β2-glycoprotein I antibodies, mostly IgG isotype) are strong risk factors for thrombosis. Because a paucity of information on IgA isotype exists in the literature, we retrospectively evaluated the thrombotic significance of IgA antiphospholipid antibodies. We included 472 patients with clinical information on thrombotic events and complete laboratory work-up for antiphospholipid antibodies syndrome. Odds ratios (OR) of various antiphospholipid antibodies for thrombosis were calculated by univariate and multivariate analyses. Lupus anticoagulant alone was detected in 57 (12%) patients, ELISA-based antibodies (IgG, IgM, IgA) against cardiolipin, phosphatidylserine or β2-glycoprotein-I alone were detected in 131 (28%) patients, whereas 80 (17%) patients had both. Antibody isotype distribution was IgG 32%, IgM 60% and IgA 56%. Univariate analysis showed a statistically significant risk of thrombosis in patients with elevated titres of IgA of any ELISA-based antiphospholipid antibodies (OR 1.77). Stepwise logistic regression (multivariate) analysis identified elevated titres of any ELISA-based IgA antiphospholipid antibodies as an independent risk factor for thrombosis (OR 1.6) in the entire cohort, and in the subgroup of patients without concurrent presence of lupus anticoagulant (OR 1.8). IgA antiphospholipid antibodies appear to be a significant independent risk factor for thrombosis, thereby meriting evaluation in patients with unexpected thrombosis.

[Expression of JAK2V617F and MPLW515L/K mutation in 30 suspected cases of early myeloproliferative disorders]

OBJECTIVE

To investigate the prevalence of JAK2V617F and MPLW515L/K mutation in patients with slightly elevated platelets (BPC) or hemoglobin (Hb) not meeting the criteria of polycythemia vera (PV) or essential thrombocythemia (ET).

METHODS

Genomic DNA from bone marrow or blood mononuclear cells was screened with allele specific polymerase chain reaction (AS-PCR) for JAK2V617F and MPLW515L/K mutation. The history of thrombosis was assessed retrospectively by patients files.

RESULTS

Of 30 patients, 14 (46.7%) were positive for the JAK2V617F mutation, none of them had the MPLW515L/ K. Five of these 14 patients had a history of thrombosis. Follow-up results were available in 22 patients. Among them, 12 patients with JAK2V617F mutation turned out to be MPD in 6-24 months; only 2 out of 10 patients without this mutation evolved to MPD.

CONCLUSION

JAK2V617F mutation could be one of the diagnosis criteria of early MPD. No MPLW515L/K expression was found in early MPD.

[Interdigitating dendritic cell sarcoma-a case report with literature review]

OBJECTIVE

To report a case of interdigitating dendritic cell sarcoma (IDCS).

PATIENT MATERIAL

The patient was a 41-year-old man with a lymph node bulging in the left neck. Laboratory examination of peripheral blood and bone marrow was abnormal. The diagnosis of IDCS was made by immunohistochemistry and electron microscopy. Treatment of this patient with ABVD regimen (adriamycin, bleomycin, vinblastine, dacarbazine) resulted in obvious improvement, but did not control the tumor infiltration.

CONCLUSION

IDCS has no distinctive clinical or pathohistological characteristics. Immunohistochemistry and electron microscopy are crucial in distinguishing it from other histiocytic/dendritic cell neoplasms. IDCS displays an aggressive behaviour, and the responses to chemotherapy are variable.

A high-order splitting scheme for the advection-diffusion equation

A high-order splitting scheme for the advection-diffusion equation of pollutants is proposed in this paper. The multidimensional advection-diffusion equation is splitted into several one-dimensional equations that are solved by the scheme. Only three spatial grid points are needed in each direction and the scheme has fourth-order spatial accuracy. Several typically pure advection and advection-diffusion problems are simulated. Numerical results show that the accuracy of the scheme is much higher than that of the classical schemes and the scheme can be efficiently solved with little programming effort.

[The clinical and pathologic study of embeded supernumerary teeth]

OBJECTIVE

To analyse the clinic and pathologic features of 100 embedded supernumerary teeth, to find out the rule of cystic change of supernumerary teeth and its relationship to malocclusion, and to present the methods of therapy.

METHODS

Analysis of clinical data, X-ray manifestation,comparison of the findings on operation and pathological changes demonstrated the correct diagnosis of supernumerary teeth.

RESULTS

On statistics and analysis,66% of the crowns of the supernumerary teeth were showed different sizes of circular photic shades,but only 35% were proved to be cystic change by biopsies.

CONCLUSION

This study showed that 35% had cystic change among 100 cases,so if the diagnosis can be made in these cases with indication of operation the extraction of the supernumerary teeth must be done as soon as possible.

Stimulation of the epidermal growth factor receptor induces glial-specific protein expression in the human DAOY neuroectodermal cell line

Central nervous system (CNS) stem cells require epidermal growth factor (EGF) to survive and express glial-specific proteins (GSPs) under its influence. EGF and its receptor (EGF-R) therefore are involved in gliogenesis. We hypothesize that EGF selectively modulates GSP expression in pluripotential CNS cells and this effect is dependent on the degree of EGF-R activation (i.e., the amount of both EGF and the EGF-R present). In order to explore this, we investigated the effects of EGF on the expression of glial- and neuronal-specific proteins in the pluripotential human neuroectodermal cell line, DAOY. DAOY clones expressing different EGF-R levels were treated with EGF. The expression of glial fibrillary acid protein (GFAP), glutamine synthetase (GS) and neuron-specific enolase (NSE) were measured by ELISA. In a clone with low EGF-R levels (clone DAOY-YS-15), EGF selectively stimulated GSPs. In cells which express twice the EGF-R level, EGF (10(-8) M) stimulated both glial and neuronal proteins nonspecifically. In cells with higher EGF-R numbers, EGF suppressed both glial and neuronal proteins. These effects were not due to the negligible growth influences of EGF on the cells. In clone DAOY-YS-15, selective GSP expression was observed as early as 2 days after exposure to EGF (10(-9) M). In these cells, GFAP induction was also shown at the transcriptional level using a quantitative reverse transcriptase-polymerase chain reaction. This suggests one mechanism for EGF action. Our findings are therefore consistent with the hypothesis that the selective induction of GSPs in pluripotent cells is dependent on the EGF-R level and the degree of EGF-R activation.

New diterpene alkaloids from the roots of Spiraea japonica

Chemical investigation on an ethanol extract from the roots of Spiraea japonica var. acuta resulted in the isolation of three new diterpene alkaloids named spiramide (1) and spiratine A (2) and spiratine B (3). Structures of 1-3 were elucidated primarily on the basis of 1D and 2D NMR experiments.

[Repair of severe radiation-induced ulcer]

OBJECTIVE

To explore a method to repair severe radiation-induced ulcer and evaluate its clinical effects.

METHODS

From August 1988 to December 1998, 12 cases of severe radiation-induced ulcer were treated by muscular or musculocutaneous flap transfer, which included 1 case of pectoralis major muscular flap, 3 cases of three-lobed transverse rectus abdominis musculocutaneous flap, 2 cases of latissimus dorsi musculocutaneous flap, 1 case of tensor fascia lata musculocutaneous flap, 1 case of longitudinal rectus abdominis musculocutaneous and tensor fascia lata musculocutaneous flap, 1 case of gastrocnemius muscular flap, 1 case of gluteus major musculocutaneous flap, huge filleted musculocutaneous flap from lower limbs in 1 case and from upper limbs in 1 cases.

RESULTS

All the flaps survived. Primary healing occurred in 9 cases and secondary healing in 3 cases. The extensive multiple ulcers in 2 cases were repaired with filleted limb musculocutaneous flap, and patients were saved. And in other 3 cases, the chest wall defect as the result of radionecrosis were repaired with simultaneous breast reconstruction.

CONCLUSION

Muscular or musculocutaneous flaps have abundant blood supply, they are ideal tissue to fill the cavity and repair the defect, especially in repairing severe radiation-induced ulcers.