Clinical characteristics of exposures to liquid laundry detergent packets

INTRODUCTION

Our objective was to describe the characteristics of liquid laundry detergent packet (LDP) exposures and to develop referral and treatment recommendations.

METHODS

This retrospective cohort study investigated LDP exposures reported to the National Poison Data System from January 1, 2013 through June 30, 2014. Three medical toxicologists reviewed the most significant exposures (n = 450).

RESULTS

Of 17,857 reported LDP exposures, 13,307 involved only an LDP (no other substance) and were followed to a known medical outcome. The median age was 2 years (range 12 days to 100 years). Approximately 10% of exposures reported a major or moderate effect. The most common symptom was vomiting (51.7%; n = 6875), but stridor or aspiration pneumonia and respiratory depression secondary to central nervous system effects also occurred. Two pediatric and two adult deaths occurred, but no causal mechanism leading to death could be identified in any of the deaths.

CONCLUSIONS

LDPs occasionally produce a toxidrome of vomiting, stridor, hypoxia, and sedation with metabolic acidosis and respiratory failure. These symptoms and the availability of LDPs highlight the need for referral and treatment recommendations and efforts to minimize unintentional exposures. Review of data from US poison centers may provide referral and treatment recommendations that improve patient outcomes.

Melioidosis in patients with suspected tuberculosis in Cambodia: a single-center cross-sectional study

SETTING

Melioidosis-Burkholderia pseudomallei infection-is increasingly recognized in Cambodia, a country with a high incidence of tuberculosis (TB). Melioidosis and TB can be clinically indistinguishable.

OBJECTIVE

To quantify the proportion of patients with clinically suspected TB who had melioidosis by testing sputum for B. pseudomallei.

DESIGN

This was a prospective, 6-month cross-sectional single-center study at a Cambodian provincial referral hospital among patients with suspicion of TB who provided sputum specimens for testing. TB was diagnosed using sputum Xpert^® MTB/RIF molecular assay or culture; melioidosis was diagnosed using sputum culture for B. pseudomallei.

RESULTS

Of 404 patients evaluated for possible TB, 52 (12.9%, 95%CI 9.8-16.5) had TB. Four patients (1.0%, 95%CI 0.3-2.5) had melioidosis; none had concurrent TB or an existing medical risk factor for melioidosis, although two were farmers, an occupational risk factor.

CONCLUSION

One per cent of patients being evaluated for TB at a Cambodian provincial referral hospital had culture-proven respiratory melioidosis, a highly lethal infection. None had previously recognized medical conditions that would increase their risk of melioidosis. Testing for melioidosis should be considered in patients presenting with suspected TB in Cambodia.

Identification of differential abundances of mRNA transcript in cumulus cells and CCND1 associated with yak oocyte developmental competence

The development of an accurate and noninvasive preselection process for competent oocytes is essential to achieve a highly efficient in vitro production (IVP) of embryos. Cumulus cells (CCs) have important functions in oocyte growth, development, maturation, and fertilization. It, therefore, is important to know if the quality of oocytes can be ascertained by assessment of gene expression of the surrounding CCs or not. The aim of this study was to identify differentially expressed genes in yak CCs from oocytes with varying developmental competences as possible biomarkers for distinguishing oocyte competence. The isolated CCs were pooled into immature and mature groups in accordance with the maturation outcome of oocytes. A total of 9516 genes were differentially expressed in the two CC categories (P <  0.05). With a minimum change of 2.5-fold, 45 up-regulated and 79 down-regulated genes were observed in CCs belonging to the mature group compared with those in the immature group (P <  0.01). These genes were primarily enriched for the cell cycle, meiosis, cell signaling, metabolism, and apoptosis. The selected candidate genes (CCND1, BMP15, GDF9, H19, KLF4, GPC1, SYCP3, and CTSB) were validated using quantitative real-time polymerase chain reaction (RT-qPCR) and there were expression patterns similar to those detected with transcriptome analysis. The CCs from fertilized oocytes arrested at the 2-cell (2-cell group), or 8-cell (8-cell group) stages or that developed into blastocysts (the blastocyst group) had a 1.5-, 1.8-, and 2.3-fold increase, respectively, in mRNA relative abundance of CCND1 compared with CCs from unfertilized oocytes (P <  0.05). The results with the RT-qPCR analysis confirmed that the relative abundance of CCND1 mRNA in CCs was associated with oocyte developmental competence. In conclusion, RNA-Seq is useful in extracting transcriptomes and selecting markers associated with oocyte developmental competence. Furthermore, the expression of the CCND1 gene in yak CCs can be used to preselect oocytes for IVP efficiency.

Transcriptional networks in the human epididymis

BACKGROUND

The epithelial lining of the human epididymis is critical for sperm maturation. This process requires distinct specialized functions in the head, body, and tail of the duct. These region-specific properties are maintained by distinct gene expression profiles which are governed by transcription factor networks, non-coding RNAs, and other factors.

MATERIALS AND METHODS

We used genome-wide protocols including DNase-seq, RNA-seq and ChIP-seq to characterize open (active) chromatin, the transcriptome and occupancy of specific transcription factors (TFs) respectively, in caput, corpus, and cauda segments of adult human epididymis tissue and primary human epididymis epithelial (HEE) cell cultures derived from them. RNA-seq following TF depletion or activation, combined with gene ontology analysis also determined TF targets.

RESULTS

Among regional differentially expressed transcripts were epithelial-selective transcription factors (TFs), microRNAs, and antiviral response genes. Caput-enriched TFs included hepatocyte nuclear factor 1 (HNF1) and the androgen receptor (AR), both of which were also predicted to occupy cis-regulatory elements identified as open chromatin in HEE cells. HNF1 targets were identified genome-wide using ChIP-seq, in HEE cells. Next, siRNA-mediated depletion of HNF1 revealed a pivotal role for this TF in coordinating epithelial water and solute transport in caput epithelium. The importance of AR in HEE cells was shown by AR ChIP-seq, and by RNA-seq after synthetic androgen (R1881) treatment. AR has a distinct transcriptional program in the HEE cells and likely recruits different co-factors (RUNX1 and CEBPβ) in comparison to those used in prostate epithelium.

DISCUSSION AND CONCLUSION

Our data identify many transcription factors that regulate the development and differentiation of HEE cells. Moreover, a comparison between immature and adult HEE cells showed key TFs in the transition to fully differentiated function of this epithelium. These data may help identify new targets to treat male infertility and have the potential to open new avenues for male contraception.

An air quality index-based multistage type-2-fuzzy interval-stochastic programming model for energy and environmental systems management under multiple uncertainties

In this study, a multistage type-2-fuzzy interval-stochastic programming (MTIP) method is developed, which extends upon the existing multistage stochastic programming (MSP) by allowing uncertainties expressed as probabilistic distributions, interval values and type-2 fuzzy sets to be effectively incorporated within the optimization framework. Through coupling air quality index (AQI) with MTIP, an AQI-MTIP model is formulated for energy and environmental systems (EES) management of Tianjin. A number of scenarios based on changed AQIs are examined to analyze the impacts of environmental requirements on the city's energy system. Results indicate that (i) with the improvement of environmental requirement, utilization of clean energies (especially natural gas) is provoked markedly; (ii) PM_2.5 is the primary pollutant, 64.50% of which should be reduced each period to maintain the city's air quality at a health-safe level. These findings can help decision makers adjust energy structure, make effective mitigation strategy, and gain deep insight into the relationship between energy consumption and environmental requirement.

[Postoperative survival analysis of patients with stage Ⅲ-pN2 non-small cell lung cancer]

Objective: To investigate the effect of mediastinal lymph node resection, metastasis status and treatment on the prognosis of patients with stage Ⅲ-pN2 non-small cell lung cancer (NSCLC). Methods: Clinical data of 206 patients who were pathologically diagnosed as stage Ⅲ-pN2 NSCLC in Tongji Hospital from July 2006 to Dec 2009 were retrospectively analyzed and followed up. Log rank test and Cox proportional hazards regression model were used to analyze the prognostic significance of mediastinal lymph node excision, metastasis state and treatment. Results: The median overall survival (OS) time of the whole group was 29.6 months, and the median disease-free survival (DFS) time was 27.2 months. Univariate analysis showed that the less number of mediastinal lymph node stations with metastasis (single station), the less number of mediastinal lymph nodes involved (less than 2), and postoperative chemotherapy were associated with longer postoperative OS and DFS time (P<0.05 for all). The patients with skip metastasis, negative metastasis of subcarinal lymph node, the lower mediastinal lymph node metastasis rate (MLNR<33%) and postoperative radiotherapy had longer OS and DFS time than those without these factors (P<0.05 for all). Multivariate analysis showed that metastasis of subcarinal lymph node, MLNR and postoperative chemotherapy were the independent prognostic factors for patients with stage Ⅲ-pN2 NSCLC (P<0.05 for all). Conclusion: Metastasis of subcarinal lymph nodes and the higher MLNR might shorten the postoperative survival time of NSCLC patients with stage Ⅲ-pN2, whereas postoperative chemotherapy prolongs the survival time.

Quantitative determination of endogenous cardiolipin in rat cerebral tissues by high-performance liquid chromatography using standard addition method

Cardiolipin is an important cellular component, and its normal level is a key prerequisite for maintaining the structure and function of mitochondria. To accurately quantify endogenous cardiolipin content in mitochondria, a standard addition method (SAM) was developed to establish a high-performance liquid chromatographic (HPLC) technique that is both reliable and accurate. Increasing amounts of cardiolipin standards were added to a constant amount of isolated mitochondria prior to the extraction procedure, and the two were extracted together. By limiting the interference effects that occur to within an acceptable range in an analytical system examined, this procedure ensures an ideal match of the sample composition in the standards, even if the composition is extremely complex or completely unknown. Then, the desired results can be obtained by extrapolation. As such, the authentic content of the endogenous cardiolipin can be obtained with greater accuracy than with classical detection methods, e.g. external standard calibration (ESC) and internal standard calibration (ISC). This method provides an excellent means of quantifying endogenous substances in living cells. The authors expect this method to be useful for researchers working on mitochondria-related mechanisms, cell survival-related mechanisms and similar topics.

Phylogenetic and genetic variation analyses of porcine circovirus type 2 isolated from China

Porcine circovirus type 2 (PCV2) is a causative agent of PCV2-associated disease, which is a growing problem in the swine industry worldwide. High nucleotide substitution occurs in the capsid (Cap) gene of PCV2, which allows the continuous evolution and the emergence of novel PCV2 strains. In this study, we sequenced 24 Chinese PCV2 strains collected from healthy and diseased pigs between 2013 and 2015. Analyses of the genome, Cap and phylogeny classified the 24 Chinese PCV2 strains as PCV-2a (four of 24), PCV-2b (five of 24) and PCV-2d (15 of 24). All strains shared 89.5%-100% and 87.2%-100% identities with the nucleotide and amino acid (aa) sequences of Cap, respectively. Selection pressure analysis showed that five sites at the epitope regions in Cap were under positive selection. Further analysis by Jameson-Wolf antigenic index indicated that aa substitutions occurring at the epitope regions contributed to the antigenic alterations of the different PCV2 strains. High genetic variation and genotype shift to PCV2d occurred in recent years, and different genotypes coexisted in Chinese pig herds. The data provide evidence for the increased genetic diversity and insights into the molecular epidemiology of PCV2.

The effect of Echinococcus granulosus on spleen cells and TGF-β expression in the peripheral blood of BALB/c mice

Cystic echinococcosis (CE) caused by the cestode Echinococcus granulosus (E. granulosus) is a zoonotic parasitic disease. The effective immune evasion mechanisms of E. granulosus allow it to parasitize its hosts. However, the status of the innate and adaptive immune cells and their contributions to E. granulosus progression remain poorly understood. In this study, we aimed to determine the impact of E. granulosus infection on T cells, NK cell responses and TGF-β expression during the early infection phase in BALB/c mice. In E. granulosus infections, there was an increasing tendency in the percentage of CD4⁺ CD25⁺ T cells and CD4⁺ Foxp3⁺ T cells and peripheral blood TGF-β levels and relative expression of the Foxp3 gene. Moreover, there were a decreasing tendency in the percentage of NK cells and NK cell cytotoxicity and the expression of NKG2D on NK cells. The TGF-β1/Smad pathway was activated by E. granulosus in mice. Above results can be reversed by the inhibitor SB-525334 (potent activin receptor-like kinase 5 inhibitor). These results suggest that the TGF-β/Smad pathway plays an important role in changes of T-cell or NK cell responses. These results may contribute to revealing the preliminary molecular mechanisms in establishing hydatid infection.