Determination of the maximum tolerated dose of intranasal sufentanil and midazolam in Chinese: a pilot study

BACKGROUND

The purpose of this study was to determine the maximum tolerated dose (MTD, the dose of causing 10% respiratory depression) of intranasal sufentanil (SUF) and midazolam (MID) for sedation during gastroscopy by continual reassessment method (CRM).

METHODS

Patients (18-65 years old) scheduled for gastroscopy were recruited in this study. Subjects received intranasal SUF and MID for sedation. The dose of MID (5 mg) was fixed, while the dose of SUF was increased progressively (six incremental doses ranging from 0-0.60 μg/kg, n = 3 for each dose). The first cohort received a conservative, predetermined dose of 5 mg MID and 0 μg/kg SUF, subsequent cohorts received doses of SUF that were determined by the responses of all previous patients using Bayesian-based software. The dose allocated to the next cohort is the one with an updated posterior response probability closest to 10%.

RESULTS

Thirty Chinese patients scheduled for gastroscopy were included. Probability of respiratory depression at each dose was as follows: 5 mg MID + 0 μg/kg SUF, 0.4%; 5 mg MID + 0.1 μg/kg SUF, 0.8%; 5 mg MID + 0.2 μg/kg SUF, 1.8%; 5 mg MID + 0.3 μg/kg SUF, 3.7%; 5 mg MID + 0.4 μg/kg SUF, 9.9%; 5 mg MID + 0.5 μg/kg SUF, 17.8%; 5 mg MID + 0.6 μg/kg SUF, 36.0%.

CONCLUSION

The MTD of intranasal MID and SUF for sedation during gastroscopy causing 10% respiratory depression is 5 mg MID + 0.4 μg/kg SUF, based on CRM.

Down-regulation of JARID1B expression inhibits cell proliferation, induces apoptosis and blocks cell cycle in human acute lymphoblastic leukemia cells

OBJECTIVE

Acute lymphocytic leukemia (ALL) is a multi-factorial blood disease with unknown pathogenesis. Histone H3K4 methylation was significantly reduced in ALL patients, whereas jumonji AT-rich interactive domain 1B (JARID1B) was the specific demethylase of H3K4me. This study explores the expression level of JARID1B in ALL patients and down-regulated JARID1B expression in ALL cells to explore the function of JARID1B in ALL.

PATIENTS AND METHODS

JARID1B mRNA expression level in ALL patients was detected by Real-time PCR. The peripheral blood mononuclear cells from healthy volunteers were selected as control. JARID1B shRNA was transfected with MOLT-4 cells and BALL-1 cells. JARID1B protein expression and H3K4me2 and H3K4me3 levels were detected by Western blot assay. Cell proliferation was assessed by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. Cell apoptosis and cell cycle were determined by flow cytometry. Bcl-2, Bax, Procaspase 3, and cyclin P21 expressions were evaluated by Western blot assay.

RESULTS

JARID1B mRNA expression in primary bone marrow cells from ALL patients was significantly higher than that of healthy volunteers (p<0.05). The levels of histone H3K4me3 and H3K4me2 were up-regulated after JARID1B shRNA transfection. JARID1B shRNA significantly inhibited the proliferation of MOLT-4 and BALL-1 cells, induced apoptosis, and blocked cell cycle in G0/G1 phase compared with the control group (p<0.05).

CONCLUSIONS

JARID1B is highly expressed in ALL. Down-regulating its expression inhibited leukemia cell proliferation, promoted apoptosis, and blocked cell cycle in G0/G1 phase through histone H3K4 methylation. JARID1B is an oncogene in ALL.

Refractory Mycoplasma pneumoniae pneumonia with concomitant acute cerebral infarction in a child: A case report and literature review

RATIONALE

Mycoplasma pneumoniae pneumonia, a common cause of community-acquired pneumonia in children, is rarely complicated with acute cerebral infarction.

PATIENT CONCERNS

We present a 7-year-old boy with severe M pneumoniae pneumonia who developed impaired consciousness, aphasia, and reduced limb muscle power 7 days postadmission.

DIAGNOSES

Mycoplasma pneumoniae pneumonia with concomitant acute cerebral infarction.

INTERVENTIONS

The patient recovered with aggressive antibiotic therapy, antiinflammation therapy with methylprednisolone, and gamma immunoglobulin and anticoagulation therapy with aspirin and low molecular weight heparin along with rehabilitation training.

OUTCOMES

At 8 days postadmission, his consciousness was improved and at the 6-month follow-up visit, his muscle power of bilateral upper and lower limbs was normal except still poor right handgrip power.

LESSONS

Stroke or cerebral infarction should be considered and promptly managed in rare cases of M pneumoniae pneumonia with neurologic manifestations.

Correction: Physical and compositional analysis of differently cultured 3D human skin equivalents by confocal Raman spectroscopy

Correction for 'Physical and compositional analysis of differently cultured 3D human skin equivalents by confocal Raman spectroscopy' by Y. Dancik, et al., Analyst, 2018, DOI: .

A high precision flat crystal spectrometer compatible for ultra-high vacuum light source

We report on a flat crystal spectrometer (FCS) featuring a differently pumped rotary feedthrough and double detectors connected to a crystal chamber by extendable bellows built at the Shanghai EBIT Laboratory. It was designed to overcome defects such as oil contamination, little distance from the detector to the crystal and others of an early FCS equipped at the same laboratory, but still keeps a large detectable angle range of detectors and brings new features and functions such as the Bond method measurement and double-crystal measurement which are based on the two-detector and large bellow design. This new FCS could cover an energy range of measurable photons from 570 eV to 10 keV and reach a vacuum better than 6 × 10^-10 Torr and thus is compatible for coupling directly to ultra-high vacuum light sources. Off-line tests of the FCS were undertaken where Kα x-rays from solid titanium were measured and analyzed. Measurements of transitions in He-like argon ions were performed when the spectrometer was directly connected to Shanghai EBIT, and the width of the x-ray source was monitored simultaneously using an x-ray slit imaging system. An observed spectral line broadening was 0.869 eV corresponding to a resolving power of 3600, including Doppler broadening of the x-ray source. Taking account of the measured source width, we made simulations using the SHADOW 3 code and got a nominal resolving power of 6500 for the spectrometer. This high nominal resolving power is due to a longer distance from the crystal to the detector, comparing with that in the early FCS.

The association between MICA/MICB polymorphism and respiratory syncytial virus infection in children

MICA/MICB gene polymorphisms are related to several cancers and infectious diseases, but there are no reports on the association between MICA/MICB gene polymorphisms and respiratory syncytial virus (RSV) infection. To clarify the association between MICA/MICB gene polymorphisms and infection of RSV in children, we collected fresh blood samples from paediatric patients with and without pneumonia after RSV infection. The MICA/MICB alleles were characterized by PCR sequence-specific primers (PCR-SSP) and PCR sequence-based genotyping (PCR-SBT), and then, the frequency of the MICA/MICB alleles and haplotypes was calculated. The results showed that the frequencies of MICA*002:01 and MICA-A9 in RSV-infected patients were significantly lower than in controls (9% vs. 20%, pc = 0.04). The allele frequency of MICA*002:01 in pneumonia patients (8%) and nonpneumonia patients (9%) was significantly lower than in controls (20%, pc = 0.02). MICA*002:01-MICB*008(Δrel = 0.616), MICA*009-MICB*016 (Δrel = 0.506), and MICA*045-MICB*014 (Δrel = 0.700) showed linkage disequilibrium in patients infected with RSV. The haplotype frequency of MICA*002:01-MICB*005:02 in RSV-infected patients was significantly lower than in controls (10% vs. 16%, pc = 0.033). In conclusion, allele MICA*002:01/A9 and haplotype MICA*002:01-MICB*005:02 were negatively associated with RSV respiratory tract infections.

[Epidemiological characteristics of HBeAg reversion in chronic hepatitis B patients with HBeAg seroconversion in Jiangsu province, 2012-2014]

Objective: To understand characteristics and influencing factors of reversion of HBeAg in chronic hepatitis B patients with HBeAg sero-conversion, and provide epidemiological evidence for the regular management of chronic hepatitis B patients. Methods: From 2012 to 2014, a cohort study was conducted among the chronic hepatitis B patients with sero-conversion of HBeAg in Jiangsu province. Association between participants' demographics, ALT, HBV DNA and incidence of HBeAg reversion was analyzed by Cox regression model. HBV DNA changing trend between patients with HBeAg reversion and patients with persistent HBeAg sero-conversion was compared by repeated measure data variance analysis. Results: In 2012, there were 5 068 HBeAg seroconverted chronic hepatitis B patients aged (51.9 ± 12.8) years enrolled. By 2014, HBeAg had reversed in 121 cases with the rate of 1.3/100 person-years. The probability of HBeAg reversion decreased with the age of the patients. By Cox regression analysis, HBV DNA level was an important influencing factor for the progress of HBeAg reversion. The patients with HBV DNA≥200 000 IU/ml had a higher HBeAg reversion rate DNA (3.8/100 person-years) than those with HBV DNA <2 000 IU/ml (1.1 person-years) (HR=3.44, 95% CI: 1.91-6.20, P=0.000). Compared with the persistent HBeAg sero-conversion group, HBV DNA and ALT showed a more dramatic increase in the HBeAg reversion group (P=0.000). Conclusions: There was a certain HBeAg reversion rate in chronic hepatitis B patients with HBeAg sero-conversion. Younger chronic CHB patients with HBeAg sero-conversion and those with higher HBV DNA lever had higher HBeAg reversion rate. Following up and management of chronic CHB patients with HBeAg sero-conversion is important and helpful for the control of hepatitis B.

[A cohort study on the epidemiological characteristics of HBeAg sero-clearance in HBeAg positive chronic hepatitis B patients in Jiangsu province from 2012 to 2014]

Objective: To understand the epidemiological characteristics and influencing factors related to HBeAg sero-clearance in chronic hepatitis B patients so as to provide evidence for regular management on chronic HBV patients. Methods: From 2012 to 2014, a cohort study was conducted among HBeAg positive chronic HBV patients in Jiangsu province. Association between the characteristics and incidence of HBeAg sero-clearance was analyzed by Cox regression method. The changing trend on HBV DNA between patients with HBeAg sero-clearance and those with persistent HBeAg positive status was compared by repeated measure data variance analysis method. Results: In 2012, there were 721 HBeAg positive hepatitis B patients aged (45.2 ± 14.2) years enrolled in this study. By 2014, the follow-up observation period was 1 058 person-years, and 393 cases had lost their HBeAg status, with the rate as 37.2/100 person-years. The HBeAg sero-clearance rate was 32.4/100 person-years in hepatitis B patients who received antiviral treatment. The probability of HBeAg clearance in HBeAg positive hepatitis B patients aged ≥60 year (62.0/100 person-years) was higher than those of aged <20 year (7.0/100 person-years). The rate of HBeAg sero-clearance in HBeAg positive patients with HBV DNA <20 000 IU/ml (75.8/100 person-years) was higher than those whose HBV DNA were ≥200 000 IU/ml (16.1/100 person-years). By Cox regression analysis, the HBV DNA level was an important influencing factor on the progress of HBeAg sero-clearance. Patients with HBV DNA levle as ≥200 000 IU/ml, had a lower HBeAg clearance rate (HR=0.18, 95%CI: 0.13-0.23, P<0.001). Compared to the persistent HBeAg positive group, HBV DNA showed a more dramatic fall in the HBeAg-lost group (P<0.001). Conclusion: The rate of HBeAg sero-clearance among HBeAg positive hepatitis B patients was correlated with age and HBV DNA status of the patients that called for comprehensive management and intervention programs to develop for the HBeAg positive hepatitis B patients with different characteristics.

Attraction of Cerambycid Beetles to Their Aggregation-Sex Pheromones Is Influenced by Volatiles From Host Plants of Their Larvae

Here, we describe a field experiment that tested for attraction of cerambycid beetles to odors from angiosperm hosts, and whether plant volatiles also serve to enhance attraction of beetles to their aggregation-sex pheromones. Traps were baited with a blend of synthesized chemicals that are common pheromone components of species in the subfamilies Cerambycinae and Lamiinae. The source of plant volatiles was chipped wood from trees of three angiosperm species, as well as from one nonhost, gymnosperm species. Bioassays were conducted in wooded areas of east-central Illinois. Traps were baited with the pheromone blend alone, the blend + wood chips from one tree species, wood chips alone, or a solvent control lure. Seven species of cerambycids were significantly attracted to the pheromone blend, with or without wood chips. In two cases, wood chips from angiosperms appeared to enhance attraction to pheromones, whereas they inhibited attraction in another three cases. Pine chips did not strongly influence attraction of any species. Overall, our results suggest that host plant volatiles from wood chips may improve trap catch with synthesized pheromones for some cerambycid species, but the effect is not general, necessitating case-by-case testing to determine how individual target species are affected.

Characterization of retroviral infectivity and superinfection resistance during retrovirus-mediated transduction of mammalian cells

Retroviral vectors including lentiviral vectors are commonly used tools to stably express transgenes or RNA molecules in mammalian cells. Their utilities are roughly divided into two categories, stable overexpression of transgenes and RNA molecules, which requires maximal transduction efficiency, or functional selection with retrovirus (RV)-based libraries, which takes advantage of retroviral superinfection resistance. However, the dynamic features of RV-mediated transduction are not well characterized. Here, we engineered two murine stem cell virus-based retroviral vectors expressing dual fluorescence proteins and antibiotic markers, and analyzed virion production efficiency and virion stability, dynamic infectivity and superinfection resistance in different cell types, and strategies to improve transduction efficiency. We found that the highest virion production occurred between 60 and 72 h after transfection. The stability of the collected virion supernatant decreased by >60% after 3 days in storage. We found that RV infectivity varied drastically in the tested human cancer lines, while low transduction efficiency was partially overcome with increased virus titer, prolonged infection duration and/or repeated infections. Furthermore, we demonstrated that RV receptors PIT1 and PIT2 were lowly expressed in the analyzed cells, and that PIT1 and/or PIT2 overexpression significantly improved transduction efficiency in certain cell lines. Thus, our findings provide resourceful information for the optimal conditions of retroviral-mediated gene delivery.

Influence of dairy by-product waste milk on the microbiomes of different gastrointestinal tract components in pre-weaned dairy calves

The community structure of colonised bacteria in the gastrointestinal tracts (GITs) of pre-weaned calves is affected by extrinsic factors, such as the genetics and diet of the calves; however, the dietary impact is not fully understood and warrants further research. Our study revealed that a total of 6, 5, 2 and 10 bacterial genera showed biologically significant differences in the GITs of pre-weaned calves fed four waste-milk diets: acidified waste milk, pasteurised waste milk, untreated bulk milk, and untreated waste milk, respectively. Specifically, generic biomarkers were observed in the rumen (e.g., Bifidobacterium, Parabacteroides, Fibrobacter, Clostridium, etc.), caecum (e.g., Faecalibacterium, Oxalobacter, Odoribacter, etc.) and colon (e.g., Megamonas, Comamonas, Stenotrophomonas, etc.) but not in the faeces. In addition, the predicted metabolic pathways showed that the expression of genes related to metabolic diseases was increased in the calves fed untreated waste milk, which indicated that untreated waste milk is not a suitable liquid diet for pre-weaned calves. This is the first study to demonstrate how different types of waste milk fed to pre-weaned calves affect the community structure of colonised bacteria, and the results may provide insights for the intentional adjustment of diets and gastrointestinal bacterial communities.

[The expression and significance of S100A9 in oral squamous cell carcinoma]

Objective:This research intended to explore the expression levels of S100A9 protein in oral squamous cell carcinoma (OSCC), and to analyze its relation with clinicopathologic features in OSCC, then discuss its clinical significance in diagnosis and prognosis of OSCC. Method:Using immunohistochemistry and Western blot to examine S100A9 in 35 oral squamous cell carcinoma specimen and 30 normal oral tissue as control.Result:Expression of S100A9 in oral squamous cell carcinoma (77.1%) was obviously higher than that in normal organizations (46.7%, P< 0.05 ). Among it, expression of low differentiated group was higher than that of high differentiated group. Expression of oral squamous cell carcinoma group in Ⅲ-Ⅳ period was higher than that of Ⅰ-Ⅱ period. The above differences were statistically significant. Expression of S100A9 was not associated with patients'age and gender (P> 0.05). The difference had no statistical significance.Conclusion:Overexpression of S100A9 protein may play a vital role in the progression of OSCC, which can be served as a positive marker for the diagnosis and prognosis of OSCC.

Structure similarity-guided image binarization for automatic segmentation of epidermis surface microstructure images

Partitioning epidermis surface microstructure (ESM) images into skin ridge and skin furrow regions is an important preprocessing step before quantitative analyses on ESM images. Binarization segmentation is a potential technique for partitioning ESM images because of its computational simplicity and ease of implementation. However, even for some state-of-the-art binarization methods, it remains a challenge to automatically segment ESM images, because the grey-level histograms of ESM images have no obvious external features to guide automatic assessment of appropriate thresholds. Inspired by human visual perceptual functions of structural feature extraction and comparison, we propose a structure similarity-guided image binarization method. The proposed method seeks for the binary image that best approximates the input ESM image in terms of structural features. The proposed method is validated by comparing it with two recently developed automatic binarization techniques as well as a manual binarization method on 20 synthetic noisy images and 30 ESM images. The experimental results show: (1) the proposed method possesses self-adaption ability to cope with different images with same grey-level histogram; (2) compared to two automatic binarization techniques, the proposed method significantly improves average accuracy in segmenting ESM images with an acceptable decrease in computational efficiency; (3) and the proposed method is applicable for segmenting practical EMS images. (Matlab code of the proposed method can be obtained by contacting with the corresponding author.).

Diffusion-weighted imaging (DWI) of hepatocellular carcinomas: a retrospective analysis of the correlation between qualitative and quantitative DWI and tumour grade

AIM

To evaluate the application of qualitative and quantitative diffusion-weighted imaging (DWI) in predicting the histological grade of hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

Two hundred and fifty-four patients with pathologically confirmed HCC who underwent hepatic DWI on a 1.5-T platform (b = 0, 600 s/mm²) were evaluated retrospectively. HCCs were divided into well-, moderately, and poorly differentiated groups. The relationships between naked-eye signal intensity (SI), SI values, apparent diffusion coefficient (ADC) values on DWI, and the histopathological differentiation of HCC were analysed. Receiver operating characteristic (ROC) curves were drawn to determine the optimal operating points (OOPs) of the SI and ADC values to predict the tumour grade.

RESULTS

A weak negative correlation (r=-0.350, p<0.05) was obtained between naked-eye SI and histological grade. There was a significant difference in mean SI values between well- (68.32±31.71) and moderately (102.39±45.55)/poorly (114.55±32.15) differentiated HCC but not between moderately and poorly differentiated HCC. The OOP of the SI value by ROC curve analysis was 66.5 to predict well-differentiated HCC. The mean ADC values of well-, moderately, and poorly differentiated HCC were 1.67±0.13×10^-3, 1.31±0.16×10^-3, and 1.08±0.11×10^-3 mm²/s, respectively, with significant differences between any two combinations of groups. The OOPs of ADC to diagnose well- and poorly differentiated HCC were 1.5×10^-3 and 1.24×10^-3 mm²/s, respectively.

CONCLUSION

Qualitative and quantitative SI and ADC values at DWI may be useful to estimate the histological grade of HCC preoperatively and non-invasively.

Diagnosis of Peste des Petits Ruminants in Wild and Domestic Animals in Xinjiang, China, 2013-2016

Peste des petits ruminants viruses (PPRVs) re-emerged in China at the end of 2013 and then spread rapidly into 22 provinces through movement of live goats and sheep. In this study, 96 samples of domestic animals and 13 samples of wildlife were analysed for the presence of PPRV infection by ELISA or RT-PCR. Of 96 samples from sheep and goats, 91 were PPRV positive, whereas all of the 13 samples from three wild species, Capra ibex (Capra ibex sibirica), argali (Ovis ammon) and Goitered gazelle (Gazella subgutturosa), were found to be positive. Five wildlife-origin isolates from the above samples were identified as the lineage IV by a multiple alignment of the partial sequences in N gene.

[The surgery of thyrotropin-secreting pituitary adenomas and the significance of thyroid stimulating hormone level in follow-up]

Objective: To explore the clinical characteristics of thyrotropin-secreting pituitary adenomas and the effect of the transsphenoidal approach of procedure with/without drug treatment for thyrotropin-secreting pituitary adenomas, and to investigate the correlation between the prognosis of thyrotropin-secreting pituitary adenomas and the postoperative level of thyroid stimulating hormone (TSH). Methods: A total of 45 patients with thyrotropin-secreting pituitary adenoma who hospitalized in Peking Union Medical College Hospital from 2000 to 2015 were enrolled in the study.We collected the clinical features, hormone levels, imaging findings, treatment and follow-up data of these patients. Results: The average age of the patients was 40.26 years old and the average disease duration was 5.83 years.Among them, 8 cases were microadenomas and 37 cases were macroadenoma.Thirty patients were treated with somatostatin analogues before surgery.TSH level was significantly decreased after operation (P=0.012). All of them had done the pituitary surgery, including 44 transsphenoidal surgery and 1 subfrontal surgery that had recurrence one year after the transsphenoidal surgery.The TSH level of 34 cases went back to normal on the third day after surgery.The remission rates on three months and one year after surgery in patients with TSH level<0.1 mIU/L on postoperative day (POD) 3 were significantly higher than those in patients with TSH level>0.1 mIU/L on POD3.As well as the remission rates on three months and one year after surgery in patients with TSH level normal on postoperative one month were significantly higher than those in patients with TSH level abnormal on postoperative one month. Conclusions: TSH level of postoperative one month could be used to predict prognosis and monitor recurrence.

Reduced expression of SCF in serum and follicle from patients with polycystic ovary syndrome

OBJECTIVE

In humans, stem cell factor (SCF), produced by cumulus granulosa cells during the follicular phase, plays a crucial role in follicular development. Remarkably, polycystic ovary syndrome (PCOS), one of the main reasons affecting women fertility, is accompanied by some abnormal follicles. Is there a relationship between SCF and PCOS? This study aimed to compare the expression of SCF in follicle and serum from patients with and without PCOS undergoing in vitro fertilization (IVF) treatment and to investigate the potential relationship between aberrant SCF expression and PCOS.

PATIENTS AND METHODS

Serum, follicular fluid (FF) samples and granulosa cells (GCs) from 48 patients with PCOS (PCOS group) and 62 normal ovulatory patients (control group) were collected. SCF was evaluated in FF, serum, and GCs by using enzyme-linked immunosorbent assay, immunofluorescence staining, Western blot and real-time PCR. The rates of metaphase II (MII) oocyte, fertilization, embryo cleavage and high-quality embryo between PCOS group and control group were also analyzed.

RESULTS

The rates of MII oocyte and fertilization were significantly lower in PCOS group than those in control group (p < 0.05). No difference was observed for the rate of embryo cleavage and high-quality embryo in these two groups. The concentrations of SCF in serum and FF from PCOS patients were remarkably lower than those in the controls (p < 0.05). Moreover, the expressions of SCF protein and SCF mRNA in GCs from PCOS patients were also decreased compared with the controls (p < 0.05).

CONCLUSIONS

PCOS patients showed a reduced SCF expression in serum and follicle, which might be associated with oocyte dysmaturity and low fertilization rate.

[Analysis of clinical characteristics and prognosis of non-severe aplastic anemia children with chromosomal abnormalities]

Objective: To analyze the clinical characteristics and prognosis of non-severe aplastic anemia (NSAA) with chromosomal abnormalities in children. Method: A retrospective analysis of 304 cases with NSAA with successful karyotyping from 2001 to 2014 in the Institute of Hematology & Blood Disease Hospital was carried out. The treatment response, condition of blood transfusion were analyzed using χ² test, the cumulative survival was estimated by the Kaplan-Meier method. Result: Out of 304 patients, 28 patients had chromosomal abnormalities with trisomy 8 (7 cases, 25.0%), abnormalities in chromosome 7 (5 cases, 17.9%), and other types (16 cases, 57.1%). There were no significant differences in the treatment response(40.9% (9/22)vs. 58.6%(119/203), χ²=2.539, P=0.111), the rate of getting rid of blood transfusion(54.5%(6/11) vs. 65.0%(39/60), χ²=6.455, P=0.086), five-year progression-free survival (49.2% vs.70.8%, χ²=0.849, P=0.357), and five-year cumulative survival (79.1% vs. 92.8%, χ²=0.330, P=0.556) between the patients with or without chromosomal abnormalities. There were significant differences in the rate of disease progression(41.7%(10/24) vs. 22.3%(48/215), χ²=4.394, P=0.045), the incidence of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) (20.8%(5/24)vs. 0.9%(2/215), χ²=30.082, P=0.000)and the five-year cumulative incidence of MDS or AML(33.4% vs. 0.8%, χ²=17.798, P=0.000)between children with and without chromosomal abnormalities. Conclusion: The incidence of chromosomal abnormalities in children with NSAA is 9.2%. The clinical features and treatment response are similar, but children with chromosomal abnormalities have a poorer prognosis, and have higher risk of progressing to MDS or AML.

Stereochemistry of Fuscumol and Fuscumol Acetate Influences Attraction of Longhorned Beetles (Coleoptera: Cerambycidae) of the Subfamily Lamiinae

The chemical structures of aggregation-sex pheromones of longhorned beetles (Coleoptera: Cerambycidae) are often conserved among closely related taxa. In the subfamily Lamiinae, adult males and females of several species are attracted by racemic blends of (E)-6,10-dimethyl-5,9-undecadien-2-ol (termed fuscumol) and the structurally related (E)-6,10-dimethyl-5,9-undecadien-2-yl acetate (fuscumol acetate). Both compounds have a chiral center, so each can exist in two enantiomeric forms. Males of many species of longhorned beetles only produce one stereoisomer of each pheromone component, and attraction may be reduced by the presence of stereoisomers that are not produced by a particular species. In a previous publication, analysis of headspace volatiles of adult beetles of the lamiine species Astyleiopus variegatus (Haldeman) revealed that males sex-specifically produced (S)-fuscumol and (S)-fuscumol acetate. Here, we describe field trials which tested attraction of this species to single enantiomers of fuscumol and fuscumol acetate, or to blends of enantiomers. We confirmed attraction of A. variegatus to its species-specific blend, but during the course of the trials, found that several other species also were attracted. These included Aegomorphus modestus (Gyllenhall), attracted to (S)-fuscumol acetate; Astylidius parvus (LeConte), attracted to (R)-fuscumol; Astylopsis macula (Say), attracted to (S)-fuscumol; and Graphisurus fasciatus (DeGeer), attracted to a blend of (R)-fuscumol and (R)-fuscumol acetate. These results suggest that chirality may be important in the pheromone chemistry of lamiines, and that specific stereoisomers or mixtures of stereoisomers are likely produced by each species.

Genetic Polymorphisms of 21 STR Loci in Hunan Province-based Han Population

OBJECTIVES

To investigate the genetic polymorphisms of 21 short tandem repeat （STR） loci （D3S1358, D13S317, D7S820, D16S539, Penta E, D2S441, TPOX, TH01, D2S1338, CSF1PO, Penta D, D10S1248, D19S433, vWA, D21S11, D18S51, D6S1043, D8S1179, D5S818, D12S391 and FGA）.

METHODS

A total of 560 blood samples were collected from unrelated healthy individuals of Han population in Hunan Province. Chelex-100 extraction method was applied to the extraction of genomic DNA, and an AGCU EX22 Kit and 9700 STR amplification was used in amplification reactions. The products were separated and analyzed on 310 Genetic Analyzer.

RESULTS

A total of 248 alleles were observed, the allelic frequencies ranging from 0.001 to 0.518. Observation of genotype distributions for each locus showed no deviations from Hardy-Weinberg equilibrium except Penta E （P=0.023）. The combined power of discrimination, combined power of exclusion, and combined matching probability of the 21 STR loci were approximately 0.999 999 999 999 999 999 999 999 8, 0.999 999 998, and 1.36×10⁻²⁵, respectively.

CONCLUSIONS

The 21 STR loci show high polymorphisms in the Han population, which can provide valuable data and a theoretical basis for forensic individual identification and paternity testing.

Effect of ultrasound and heat on percutaneous absorption of l-ascorbic acid: human in vitro studies on Franz cell and Petri dish systems

OBJECTIVE

Percutaneous absorption of l-ascorbic acid (LAA) is limited due to its high hydrophilicity and low stability. Here, we investigated the effect of post-dosing sonophoresis (329 kHz, 20 mW cm^-2 ) and heat (36°C) on transdermal delivery of LAA.

METHODS

Ultrasound/heat, heat and control treatments were applied on skin surface for 2 and 5 min after topical application of C14-labelled LAA aqueous solution. After 15 min post-exposure, radioactivity was measured in tape-striped stratum corneum (TS-SC), epidermis, dermis and receptor fluid. As Franz diffusion cell model may have different acoustic response than in vivo human tissues, a novel Petri dish model was developed and compared with Franz cell model on the effects of ultrasound/heat treatment on the skin permeability.

RESULTS

Five-min ultrasound/heat treatment significantly accelerated skin absorption/penetration of LAA; 2-min treatment showed no enhancement effect on Franz diffusion cell model at the end of experiment. The use of Petri dish model significantly increased LAA concentrations in epidermis after 5 min of ultrasound/heat treatment, compared to the results of Franz cell model.

CONCLUSION

Combination of ultrasound (329 kHz, 20 mW cm^-2 ) and heat (36°C) significantly enhanced LAA transdermal penetration, when the time of treatment was sufficient (5 min). As Petri dish model was designed to simulate acoustic respond of dense human tissue to ultrasound, the difference between Franz cell and Petri dish models suggests that the enhancement effect of ultrasound/heat on skin penetration in vivo may be greater than that determined on in vitro Franz cell model.

Investigation and Strategic Analysis of Public Willingness and Attitudes Toward Organ Donation in East China

BACKGROUND

China officially initiated deceased organ donation in 2010. Much progress has been made since then. However, compared with the developed countries in Europe and America, there is still a large gap. In this study, we investigate the willingness and attitude of the general public in East China and the factors that affect organ donation, and propose specific recommendations for promoting it.

METHODS

A simple and random sample was questioned. The data were analyzed statistically using SPSS 19.0 software, χ(2) test, and logistic regression.

RESULTS

A total of 1200 questionnaires were issued; of these, 1105 were recovered, with 1074 effective questionnaires, for an effective rate of 89.5%. Among these, 426 respondents (39.7%) were willing to donate, 529 (49.3%) were in favor of donation but would not donate themselves; and 119 (11.1%) were against donation. Women (P < .01), persons with higher education (P < .01), those who understand organ donation (P < .01), and those who accept the concept of brain death (P < .01) had higher degrees of acceptance for organ donation. Reasons to hinder organ donation included imperfect laws and regulations, distrust on organ allocation, and insufficient promotion by relevant organizations.

CONCLUSION

Much needs to be done to promote organ donation in China; targeted publicity will help to improve the work efficiency of organ donation; improvement of relevant policies and regulations, and establishment of a fair and transparent organ allocation system are key to the development of organ donation.

[Clinical and genetic features of dyskeratosis congenital with bone marrow failure in eight patients]

目的

加深对先天性角化不良（dyskeratosis congenital，DC）伴骨髓衰竭的认识。

方法

收集2010年9月30日至2015年9月30日8例伴骨髓衰竭DC患儿的临床资料，利用二代测序技术对DKC1、TERC、TERT、NOP10、NHP2、TINF2等16种端粒相关基因进行全外显子及剪接位点测序分析。

结果

8例DC患儿中男6例、女2例，中位发病月龄为42(15~60）个月。初诊血常规：中位WBC 3.99（1.26~5.44）×10⁹/L，中位中性粒细胞计数1.11(0.38~2.15）×10⁹/L，中位RBC 2.45(0.37~3.56）×10¹²/L，中位HGB 82.5(15~127) g/L，中位PLT 27（2~112）×10⁹/L。8例患儿中6例骨髓增生减低或重度减低。3例患儿检出DKC1基因突变：c.961C>A 1例，c.1058C>T 2例；4例患儿检出TINF2基因突变：c.849delC、c.844C>T、c.811C>T、c.862T>A合并c.871delA各1例；1例患儿检出TINF2基因突变（c.848C>A）合并TERT基因突变（c.1138C>T）。其中DKC c.961C>A、TINF2 c.849delC、TINF2 c.871delA突变为首次报道。7例患儿口服雄激素治疗，其中5例血常规指标改善。1例患儿死于重症感染，其余7例患儿维持治疗。

结论

DC伴骨髓衰竭以TINF2突变和DKC1突变为主。雄激素治疗对部分病例有效。

Annual economic burden of hepatitis B virus-related diseases among hospitalized patients in twelve cities in China

A nationwide survey of hepatitis B virus (HBV)-associated economic burden has not previously been performed in China. The purpose of this study was to examine the direct, indirect, and intangible costs of HBV-related diseases within the span of one year. A random sample was taken from specialty and general hospitals across 12 cities in six provinces of China. Intangible costs were estimated based on willingness to pay or open-ended answers provided by patients. The results showed that 27 hospitals were enrolled, with a sample population of 4726 patients (77.7% response rate). The average annual costs were $4454.0 (direct), $924.3 (indirect), and $6611.10 (intangible), corresponding to 37.3%, 7.7%, and 55.1% of the total costs, respectively. The direct medical fees were substantially greater than the non-medical fees. Annual indirect costs were divided into outpatient ($112.9) and inpatient ($811.40) loss of income. The intangible costs of chronic HBV were notably higher than either the direct or indirect costs, consistent with the social stigma in China. The comparison amongst individual cities for the average ratio of direct to indirect costs revealed that the sizes of ratios were negatively correlated with the socioeconomic status of the regions. This study suggested that as a whole in China, the HBV-related diseases caused a heavy financial burden which was positively associated with disease severity. Although the intangible costs coincided with a high prevalence of discrimination against CHB patients in Chinese society, our study may serve as future reference for detailed exploration.

[Quantitative analysis of pathological voice and identification with artificial neural network]

Objective:To discuss the characteristic of the clinical pathological voice and the feasibility of computer automatic identification of pathological voice.Method:A total of 129 clinical patients with polyp of vocal cord were selected as the pathological voice group, while a total of 125 people with normal voice were selected from the community as the control group. Praat software was used to collect and analyze the related acoustic parameter values of two groups of cases, including Jitter, Shimmer, harmonic to noise ratio (HNR), signal to noise ratio (SNR), and normalized noise energy (NNE). Pathological voice group and control group were used as training set and testing set for neural network testing, and another 140 cases of pathological voice and normal voice data were selected as a validation set. SPSS Modeler was used for artificial neural network reconstruction to calculate the identification rate of pathological voice. Result:This study found according to the calculation of groups with different genders that Jitter, Shimmer and NNE were increased in pathological voice group compared with the normal group (P< 0.05), while HNR and SNR were decreased compared with the normal group (P< 0.05). Recognition rate of artificial neural network model on pathological voice is 75.7%.Conclusion:Objective voice analysis is helpful in the identification of pathological voice. Artificial neural network has higher accuracy in recognition of pathological voice, with good clinical application value.

Inhibition of human hepatocellular carcinoma tumor angiogenesis by siRNA silencing of VEGF via hepatic artery perfusion

OBJECTIVE

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China. Hepatic arterial chemoembolization transcatheter (TACE) is one of the main treatment methods for liver cancer. However, the long-term therapeutic effect of HCC after TACE is still unsatisfactory, postoperative recurrence and metastasis rate is still very high. Furthermore, TACE operation due to liver cancer tissue ischemia and hypoxia will lead to up-regulation of vascular endothelial growth factor (VEGF) expression. In the current study, we investigated the effects of suppressed VEGF on HCC and its molecular mechanism provided a basis for targeting angiogenesis.

MATERIALS AND METHODS

We established rabbits primary HCC model by in situ embedding the VX2 subcutaneous transplantation tumor. Conventional Seldinger femoral artery and hepatic artery catheterization method were used to select the catheter over the tumor-bearing hepatic artery. The different groups were divided into TACE operation, and the experimental group was performed with the VEGF-siRNA molecular preparation in the catheter. 64-slice spiral CT were used to perfusion imaging of liver cancer model before and after TACE operation. We further assessed the efficiency of VEGF silencing and its influence on VX2 cells. The expression of VEGF mRNA and protein were detected by RT-PCR and Western blotting, respectively. Intratumoral microvessel density (MVD), VEGF and CD34 were evaluated by immunohistochemistry. We detected the cell apoptotic by immunofluorescence and flow cytometry.

RESULTS

Our findings indicated that VEGF-siRNA-2# could effectively suppress the expression of VEGF expression, inhibited the proliferation capability and promoted apoptosis of VX2 cells in vitro. Silencing of VEGF expression also suppress HCC tumor growth and reduce HCC angiogenesis in rabbits primary HCC model in vivo. Furthermore, We found that phosphoinositide 3-kinase (PI3K) and protein kinase B (AKT) activation were considerably reduced while inhibition VEGF expression in VX2 cells.

CONCLUSIONS

Our data demonstrated that VEGF silencing could suppress cells proliferation, promote cells apoptosis and reduce HCC angiogenesis through inactivation of VEGF/PI3K/AKT signaling pathway.

AMP-activated protein kinase regulates autophagic protection against cisplatin-induced tissue injury in the kidney

Although the nephrotoxicity of cisplatin has been well documented as a major side effect of chemotherapy, the exact mechanism by which prosurvival and apoptotic pathways interplay to determine renal pathology remains elusive. Recent studies suggested that autophagy might serve as an adaptive mechanism to promote cell survival during acute kidney injury (AKI). We have used AKI as a disease model to investigate the mechanism regulating the cytoprotective role of autophagy in cisplatin-induced tissue damage. Pharmacological inhibitors such as chloroquine were used to manipulate autophagy during AKI, and DNA damage was evaluated by using the cellular marker γH2AX. Cisplatin induced extensive DNA damage during AKI. Autophagy activation served as a survival strategy to suppress cisplatin-induced DNA damage in the pathology of AKI both in vitro and in vivo. Interestingly, in the kidney, cisplatin treatment can activate AMP-activated protein kinase (AMPK), a signaling molecule that is also critical for p53-mediated inactivation of mammalian target of rapamycin (mTOR) pathways. As a result, inhibition or knockdown of AMPK can lead to repressed autophagy in cisplatin-induced AKI, resulting in more DNA damage. Activation of AMPK regulates autophagy during cisplatin-induced AKI. Given the fact that p53 can regulate autophagy by inactivating mTOR via AMPK, our results suggest that the p53 pathway may also play a critical role in the pathogenesis of cisplatin-induced renal damage. This study may further our understanding of the physiological roles of autophagy in the pathogenesis of renal injuries, and thus may have pathological implications in the clinical setting.

Chemotherapy combined with target drugs in the treatment of advanced colorectal cancer: a meta-analysis based on Chinese patients

BACKGROUND

Colorectal carcinoma is one of most diagnosed solid malignant carcinoma. The chemotherapy combined with target drugs in the treatment of advanced colorectal cancer in not conclusive.

METHODS

The clinical studies reporting the activity and adverse events between chemotherapy alone versus chemotherapy combined with anti-epidermal growth factor receptor drugs were screened in the databases of Medline, the Cochrane Library, Wanfang and CNKI and included in this meta-analysis. The risk ratio (RR) and its 95% confidence interval (CI) for treatment response and adverse events were pooled by random or fixed effect model.

RESULTS

A total of 10 clinical studies reporting chemotherapy combined with the target in the treatment of advanced colorectal cancer were included in this study. The pooled RR was 3.26 (95% CI: 1.74-6.11, P < 0.05), 1.49 (95% CI: 1.23-1.80) and 1.65 (95% CI: 1.37-1.98) for complete response (CR), partial response and objective response rate, respectively. For nausea and vomiting events, the RR was 1.62 (95% CI: 1.33-1.97, P < 0.05) indicating higher incidence of nausea and vomiting was observed in the combined group compared with chemotherapy alone. However, the diarrhea (RR = 1.10, 95% CI: 0.86-1.42, P > 0.05), liver function damage (RR = 1.03, 95% CI: 0.74-1.42), myelosuppression (RR = 1.04, 95% CI: 0.83-1.31) and neurotoxicity (RR = 1.12, 95% CI: 0.93-1.35) were not different between the two groups.

CONCLUSION

For Chinese patients with advanced colorectal cancer, chemotherapy combined with target drug can improve the response rate, but also increase the risk of nausea and vomiting.

Association between DEFB103 gene copy number variation and ankylosing spondylitis: a case-control study

In this brief communication, we investigate the role of DEFB103 gene copy number variation (CNV) in ankylosing spondylitis (AS) susceptibility. A total of 807 Chinese individuals including 406 AS patients and 401 controls were enrolled. The DEFB103 copy number was measured by two sets of probes to obtain a stable result in a custom-by-design Multiplex AccuCopy(™) kit (Genesky Biotechnologies Inc., Shanghai, China) based on a multiplex fluorescence competitive polymerase chain reaction (PCR) principle. The copy number of DEFB103 ranged from 2 to 6 in both AS patients and controls. Mann-Whitney U test and chi-squared test were performed to analyze the difference of DEFB103 copy number between AS patients and controls while no statistical difference has been found. We considered the copy number of DEFB103 gene may not associate with susceptibility to AS.

Colostrum quality affects immune system establishment and intestinal development of neonatal calves

The first meal of a neonatal calf after birth is crucial for survival and health. The present experiment was performed to assess the effects of colostrum quality on IgG passive transfer, immune and antioxidant status, and intestinal morphology and histology in neonatal calves. Twenty-eight Holstein neonatal male calves were used in the current study, 24 of which were assigned to 1 of 3 treatment groups: those that received colostrum (GrC), transitional milk (GrT, which was obtained after the first milking on 2-3 d after calving), and bulk tank milk (GrB) only at birth. The 4 extra neonatal calves who were not fed any milk were assigned to the control group and were killed immediately after birth to be a negative control to small intestinal morphology and histology detection. Calves in GrC gained more body weight than in GrT, whereas GrB calves lost 0.4 kg compared with the birth weight. Serum total protein, IgG, and superoxide dismutase concentrations were highest in GrC, GrT was intermediate, whereas GrB was the lowest on d 2, 3, and 7. Apparent efficiency of absorption at 48 h, serum complement 3 (C3), and complement 4 (C4) on d 2, 3, and 7 in GrB was low compared with GrC and GrT. On the contrary, malondialdehyde on d 7 increased in GrB. Calves in GrC had better villus length and width, crypt depth, villus height/crypt depth (V/C) value, and mucosal thickness in the duodenum, jejunum, and ileum, whereas GrT calves had lower villus length and width, crypt depth, and mucosal thickness than those fed colostrum. Villi of calves in GrB were nonuniform, sparse, severely atrophied, and apically abscised, and Peyer's patches and hydroncus were detected. Overall, colostrum is the best source for calves in IgG absorption, antioxidant activities, and serum growth metabolites, and promoting intestinal development. The higher quality of colostrum calves ingested, the faster immune defense mechanism and the more healthy intestinal circumstances they established.

Effects of maternal anxiety and depression during pregnancy in Chinese women on children's heart rate and blood pressure response to stress

Psychological disturbances, including anxiety and depression, are common during human pregnancy. Our objective was to determine whether these maternal disturbances influence cardiovascular responses of the offspring. The psychological status of 231 pregnant women was determined. Offspring (216) of these women were subsequently exposed to a video challenge stress when aged 7-9 years. Heart rate (HR) and blood pressure (BP) of the children were determined at rest, in response to video stress and during subsequent recovery. Children's resting and stress-induced increases in HR (bpm), systolic (SBP, mm Hg) and diastolic (DBP, mm Hg) BP were all greater in children whose mothers reported anxiety during pregnancy. Values (mean±s.d.) for resting HR, SBP and DBP were 75.15±5.87, 95.37±2.72 and 66.39±4.74 for children whose mothers reported no anxiety and an average of 81.62±6.71, 97.26±2.90 and 68.86±2.82 for children whose mothers reported anxiety at any level. Respective values for stress-induced increments in HR, SBP and DBP were 14.83.±2.14, 16.41±1.97 and 12.72±2.69 for children whose mothers reported no anxiety and 17.95±3.46, 18.74±2.46 and 14.86±2.02 for children whose mothers reported any level of anxiety. Effects of maternal depression were less consistent. The effects of maternal anxiety remained in multivariate analyses, which also included children's birth weight. The results indicate a long-term influence of maternal psychological status during pregnancy on the cardiovascular responses to stress among offspring. These effects may contribute to prenatal influences on subsequent health of the offspring.

Evaluation of clinical measurements and development of new diagnostic criteria for Takayasu arteritis in a Chinese population

OBJECTIVES

Takayasu arteritis (TA) is a chronic granulomatous large-vessel vasculitis. When diagnosing TA, the criteria designed by the American College of Rheumatology (ACR) are used commonly but they were just classification criteria. There is an urgent need for a new set of diagnostic criteria.

METHODS

One hundred and thirty-one TA patients and 132 control patients with other types of vascular disease were enrolled and both groups were distributed into a "training set" and a "validation set". All general information as well as clinical, laboratory and imaging data were collected. After comparing all the medical records of two groups in the training set, logistic regression and clinical judgment were used to form the new criteria for TA. The new criteria were tested by the validation set.

RESULTS

New TA diagnostic criteria within total score 26 include age (<40 years), female, chest pain/chest distress, amaurosis, vascular bruits, a decreased/absent pulse, involvement of the aortic arch or its major branches, and involvement of the abdominal aorta or its branches. Patients with a score ≥ 8 were diagnosed as TA. The sensitivity and specificity of our new criteria were 91.92% and 93.94%, respectively, higher than those of the ACR criteria (75.76%, 85.86%) and the Ishikawa criteria (56.57%, 94.95%). The areas under the ROC curves of the new criteria and ACR criteria were 0.981 and 0.868, respectively (p<0.001). Sensitivity and specificity tested in the validation set were 90.63% and 96.97%, respectively.

CONCLUSIONS

The new diagnostic criteria exhibited high sensitivity and specificity and have demonstrated to be feasible in the diagnosis of TA.

Peste des Petits Ruminants Viruses Re-emerging in China, 2013-2014

Re-emergence of peste des petits ruminants (PPR) was officially reported in Xinjiang Uygur Autonomous Region in north-western China in November 2013, and then along with the movements of goats and sheep, this disease rapidly spread to other provinces, autonomous regions and municipalities (P/A/M) of China. A total of 256 PPR-affected counties in 22 P/A/M were identified up to September 2014. Phylogenetic analysis revealed that the current circulating strains and Tibet strains isolated previously in 2007, both belonged to lineage IV but in different sub-branches. Nevertheless, compared with the Tibet strains, the current circulating strains shared high degree of genetic homology with those from Pakistan and Tajikistan.