[Renal clear cell carcinoma transferred to infratemporal fossa and pterygopalatine fossa: A case report]

SummaryRenal clear cell carcinoma is prone to distant metastasis, especially in the head and neck, but it is rare to transfer to infratemporal fossa and pterygopalatine fossa. We reported a 62-year-old male patient with complains of numbness and burning sensation on the left side of the face for more than 3 months. Left kidney removal was performed 8 years ago due to renal cancer. Preoperative enhancement CT showed a large blood-rich occupation in the left nasopharyngeal and pterygopalatine with adjacent paranasal sinus and skull base bone destruction. Under the general anesthesia, the anterior lacrimal recess approach was used for tumor resection. Preoperative interventional embolization of the feeding artery, intraoperative pathology, frozen section showed metastasis of renal cell carcinoma, and postoperative immunohistochemical examination, confirmed metastatic renal clear cell carcinoma（infratemporal fossa and pterygopalatine fossa）. The patients were transferred to the oncology department for further radiotherapy and chemotherapy.

[Study on the expression of FoxM1 in chronic rhinosinusitis and the effect of inflammatory factors on FoxM1 expression]

Objective: To check Forkhead box M1 (FoxM1) expression in nasal mucosal of chronic rhinosinusitis (CRS) patients and the effect of inflammatory factors on FoxM1 expression, in order to research the significance of FoxM1 in CRS. Methods: From January to October of 2018, 50 patients hospitalized in the Department of Otorhinolaryngology, Head and Neck Surgery, First Affiliated Hospital of Nanchang University were enrolled in this study. Twenty CRS patients with polyps (CRSwNP), 20 CRS patients without nasal polyps (CRSsNP) and 10 patients with simple deviation of nasal septum (the control groups) were selected. The expression of FoxM1 in nasal mucosa of these patients was detected by immunohistochemistry (IHC) and real-time fluorescent quantitative PCR (qRT-PCR). Meanwhile, HE stain was used to observe the pathologic changes in each sample. By establishing human nasal epithelium cells cultivating model in vitro and identifying via immumofluorescence method, experimental group and control group were set up, then activation factors including interleukin (IL)-1β, IL-4, IL-5, IL-17, interferon-γ (IFN-γ) and staphylococcal entemtoxin B (SEB) were added in the models after stabilizing passage, and qRT-PRC and Western blot method were applied to check the expressing change of FoxM1. Software SPSS 18.0 was used for statistical analysis. Results: HE stain showed that the mainly pathologic change in nasal mucosa of CRS patients with or without nasal polyp was mucosal epithelial cells, goblet cell and submucosal gland hyperplasia, accompanied by a large number of inflammatory cells infiltration. The result of IHC demonstrated that both of the expression of FoxM1 in nasal mucosal tissue of CRS patients in the CRSwNP and CRSsNP groups exceed that of the control group (80% vs 75% vs 20%, χ(2) value was 10.000, 8.213, respectively, all P<0.05); there was no difference of expression between the two groups of CRS patients (χ(2)=0.143, P>0.05). The result of qRT-PCR demonstrated that the expression of FoxM1 mRNA in nasal mucosa of CRSwNP and CRSsNP was increased compared with that of the control group (3.309±1.511 vs 3.261±1.336 vs 1.000±0.774, t value was 4.519, 4.928, respectively, all P<0.05), but the difference between the two groups of CRS patients had no statistic significance (t=0.107, P=0.909). Nasal mucosa epithelial cells cultivating models was established successfully. Q-RT PCR and Western blot were conducted after stimulation of 100 ng/ml IL-1β, IL-4, IL-5, IL-17, IFN-γ and SEB for 36 h, and the proteins expression levels of FoxM1 exceeded the groups without stimulation with statistic significance. Conclusions: The expression of FoxM1 in CRS increases and many types of cytokine can induce the increase of FoxM1 in human nasal epithelial cells. FoxM1 may participate in the process of pathogenesis in CRS.

[The role and research progress of exosomes in chronic inflammatory diseases of airway]

Exosomes are nanovesicles secreted by a variety of living cells, which are involved in biological processes such as inflammation,antigen presentation,tumor invasion, and cell differentiation.They are a new mechanism of intercellular communication in the body.Airway chronic inflammatory diseases such as chronic rhinosinusitis,allergic rhinitis, chronic obstructive pulmonary disease,bronchial asthma,etc.are non-specifically involved in airway intrinsic cells,inflammatory cells and inflammatory factors under various internal and external stimuli.Heterotropic inflammatory disease.Exosomes contain a variety of protein,RNA,lipid and other signal transmission media, the are important to chronic inflammation of the airways,and chronic rhinosinusitis,nasal polyps,bronchial asthma,and chronic obstructive pulmonary disease.The occurrence and development of chronic inflammation of the airway is closely related. This article summarizes the current research progress of exosomes and discusses their role in chronic inflammatory diseases of the airways.

[Analysis in diagnosis and treatment of 29 cases of cervical esophageal perforation]

Objective: To analyze and summarize the method and effect of cervical esophagus perforation. Methods: A total of 29 cervical esophageal perforation patients caused by foreign body were retrospectively analyzed from January 2012 to June 2018 in Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Nanchang University. Results: Among the 29 cervical esophageal perforation patients, 28 patients were extracted by lateral neck incision, 1 patient with carotid artery hemorrhea was rescued by repairing the fistula between carotid artery and esophage. All patients recovered and successfully discharged. There were no severe complications among all patients. Conclusions: The cervical CT scan is important for diagnosing a cervical esophageal perforation. Enhancement CT scan is necessay for a patient with haematemesis. Lateral neck incision would be first choice for patients with big foreign bodies. Inflammatory reaction and finger palpation are helpful for locating foreign bodies.

[Expression of LC3 and ECP in allergic rhinitis and their significance]

Objective:To investigate the expression of microtubuleassociated protein 1 light chain 3 beta(LC3) and eosinophil cationic protein in allergic rhinitis(AR) for further understanding of the pathogenesis of AR. Method: Twenty cases of normal nasal mucosa and 20 cases of AR nasal mucosa were collected. Histological changes of nasal mucosa were examined by hematoxylin and eosin(HE) staining. The expression of LC3 and ECP were measured by immunohistochemistry(IHC) and Western Blot(WB). Result: The tissue samples demonstrated a large number of eosinophils and lymphocytes infiltration in AR. IHC revealed that LC3 and ECP expression were higher in AR than in normal nasal mucosa(P<0.05). WB also showed that the relative expression levels of protein expression of LC3 and ECP were greater in AR than in controls. The expression level of LC3 was positively correlated with that of ECP protein in AR. Conclusion: LC3 and ECP were upregulated and positively correlated in AR, indicating that autophagy plays an important role in the toxicity of allergic rhinitis , which provides theoretical basis for the precise treatment of AR.

Genome-wide identification and expression analysis reveal the potential function of ethylene responsive factor gene family in response to Botrytis cinerea infection and ovule development in grapes (Vitis vinifera L.)

The prevention of Botrytis cinerea infection and the study of grape seedlessness are very important for grape industries. Finding correlated regulatory genes is an important approach towards understanding their molecular mechanisms. Ethylene responsive factor (ERF) gene family play critical roles in defence networks and the growth of plants. To date, no large-scale study of the ERF proteins associated with pathogen defence and ovule development has been performed in grape (Vitis vinifera L.). In the present study, we identified 113 ERF genes (VvERF) and named them based on their chromosome locations. The ERF genes could be divided into 11 groups based on a multiple sequence alignment and a phylogenetic comparison with homologues from Arabidopsis thaliana. Synteny analysis and Ka/Ks ratio calculation suggested that segmental and tandem duplications contributed to the expansion of the ERF gene family. The evolutionary relationships between the VvERF genes were investigated by exon-intron structure characterisation, and an analysis of the cis-acting regulatory elements in their promoters suggested potential regulation after stress or hormone treatments. Expression profiling after infection with the fungus, B. cinerea, indicated that ERF genes function in responses to pathogen attack. In addition, the expression levels of most ERF genes were much higher during ovule development in seedless grapes, suggesting a role in ovule abortion related to seedlessness. Taken together, these results indicate that VvERF proteins are involved in responses to Botrytis cinerea infection and in grape ovule development. This information may help guide strategies to improve grape production.

[Spectrometric analyses of larotaxel and larotaxel liposomes quantification by high performance liquid chromatography]

OBJECTIVE

Larotaxel is a new chemical structure drug, which has not been marketed worldwide. Accordingly, the standard identification and quantification methods for larotaxel remain unclear. The spectrometric analyses were performed for verifying weight molecular formula, molecular weight and chemical structure of larotaxel. Besides, a quantification method was developed for measuring larotaxel in the liposomes.

METHODS

The molecular formula, molecular weight and chemical structure of larotaxel were studied by using mass spectrometry (MS), infra-red (IR), nuclear magnetic resonance (NMR) and ultraviolet-visible (UV-vis) spectrometric techniques. The absorption wavelength of larotaxel was investigated by UV-vis spectrophotometry full-wavelength scanning. Besides, a quantification method was developed by high performance liquid chromatography (HPLC), and then validated by measuring the encapsulation efficacy of larotaxel liposomes.

RESULTS

The four spectral characteristics of larotaxel were revealed and the corresponding standard spectra were defined. It was confirmed that larotaxel had the structure of tricyclic diterpenoids, with the molecular formula of C45H53NO14, the molecular weight of 831.900 1, and the maximum absorption wavelength of 230 nm. The quantitative method of larotaxel was established by using HPLC with a reversed phase C18 column (5 μm, 250 mm×4.6 mm), a mobile phase of acetonitrile-water (75:25, volume/volume), and a detection wavelength of 230 nm. The validation study exhibited that the established HPLC method was stable, and had a high recovery and precision in the quantitative measurement of larotaxel in liposomes. In addition, a new kind of larotaxel liposomes was also successfully prepared. The particle size of the liposomes was about 105 nm, with an even size distribution. And the encapsulation efficiency of larotaxel in the liposomes was above 80%.

CONCLUSION

The present study offers reference standard spectra of larotaxel, including MS, IR, NMR, and UV-vis, and confirms the molecular formula, molecular weight and chemical structure of larotaxel. Besides, the study develops a rapid HPLC method for quality control of larotaxel liposomes.

In vitro reduction of colistin susceptibility and comparative genomics reveals multiple differences between MCR-positive and MCR-negative colistin-resistant Escherichia coli

Objectives: Although resistance to colistin is increasingly reported from clinical settings, the genetic mechanisms that lead to colistin resistance in Escherichia coli have not been fully characterized. Here, we assess the evolution of colistin resistance in clinical isolates of mobilized colistin resistance (MCR)-negative and MCR-positive Escherichia coli. Methods: Spontaneously mutated colistin-resistant progeny were evolved using a step-wise reduction of colistin susceptibility. Resistance phenotypes were confirmed by minimum inhibitory concentration (MIC) determination, and the probable resistance mechanisms were investigated using PCR and reverse transcription-quantitative PCR. Mutated genes of the laboratory-evolved mutants were identified by whole-genome sequencing and comparative genomics. Fitness costs and serum resistance of the mutants were also compared to the corresponding wild types. Results: MCR-negative isolates displayed higher increases in MICs than did MCR-positive isolates following colistin exposure. Upregulation of pmrAB and associated genes was evident among MCR-negative isolates but not MCR-positive isolates. Comparative genomic analysis of mutants and their corresponding wild-types (WTs) revealed numerous mutations in genes encoding membrane transporters and two-component systems. Additionally, MCR-negative mutants exhibited higher fitness costs than MCR-positive mutants compared with their corresponding WTs but displayed similar serum resistance. Conclusion: Our findings reveal multiple differences between MCR-positive and MCR-negative E. coli strains following colistin exposure, which provide reference values for clinical medication.

Characterization of an NDM-5 carbapenemase-producing Escherichia coli ST156 isolate from a poultry farm in Zhejiang, China

BACKGROUND

The emergence of carbapenem-resistant Enterobacteriaceae strains has posed a severe threat to public health in recent years. The mobile elements carrying the New Delhi metallo-β-lactqtamase (NDM) gene have been regarded as the major mechanism leading to the rapid increase of carbapenem-resistant Enterobacteriaceae strains isolated from clinics and animals.

RESULTS

We describe an NDM-5-producing Escherichia coli strain, ECCRA-119 (sequence type 156 [ST156]), isolated from a poultry farm in Zhejiang, China. ECCRA-119 is a multidrug-resistant (MDR) isolate that exhibited resistance to 27 antimicrobial compounds, including imipenem and meropenem, as detected by antimicrobial susceptibility testing (AST). The complete genome sequence of the ECCRA-119 isolate was also obtained using the PacBio RS II platform. Eleven acquired resistance genes were identified in the chromosome; four were detected in plasmid pTB201, while six were detected in plasmid pTB202. Importantly, the carbapenem-resistant gene blaNDM-5 was detected in the IncX3 plasmid pTB203. In addition, seven virulence genes and one metal-resistance gene were also detected. The results of conjugation experiments and the transfer regions identification indicated that the blaNDM-5-harboring plasmid pTB203 could be transferred between E. coli strains.

CONCLUSIONS

The results reflected the severe bacterial resistance in a poultry farm in Zhejiang province and increased our understanding of the presence and transmission of the blaNDM-5 gene.

Comparison of Tigecycline or Cefoperazone/Sulbactam therapy for bloodstream infection due to Carbapenem-resistant Acinetobacter baumannii

Background

We retrospectively analyzed the effect of tigecycline and cefoperazone/sulbactam therapies on the prognosis of patients with carbapenem-resistant Acinetobacter baumannii bloodstream infection (CRAB-BSI).

Methods

CRAB-BSI patients receiving tigecycline therapy or cefoperazone/sulbactam therapy between January 2012 and December 2017 was enrolled, and strict exclusion criteria were followed. The 28-day mortality of patients was analyzed. The impact of cefoperazone/sulbactam therapy on prognosis was evaluated using Cox multivariate regression analysis. The 28-day mortality of patients receiving cefoperazone/sulbactam monotherapy and cefoperazone/sulbactam-based combination therapy was also compared.

Results

Three hundred forty eight patients with CRAB-BSI were enrolled in the study. Two hundred ten patients were included after applying the exclusion criteria. Of these, 135 patients received tigecycline therapy and 75 patients received cefoperazone/sulbactam therapy. The 28-day mortality of patients in the latter group was, significantly lower than that of the tigecycline group [29.3% vs. 51.9%; P = 0.001]. Cox multivariate regression analysis revealed that cefoperazone/sulbactam therapy exerted a protective effect on the prognosis of patients [hazard ratio 0.566, 95% confidence interval (0.342–0.940); P = 0.028]. Kaplan-Meier survival curve analysis indicated that the 28-day mortality of patients receiving cefoperazone/sulbactam therapy was lower than that of patients receiving cefoperazone/sulbactam monotherapy, but the difference was not significant (22.2% vs. 40%; P = 0.074). However, the mortality of patients receiving cefoperazone/sulbactam with imipenem/cilastatin was significantly lower than that of patients receiving cefoperazone/sulbactam monotherapy (P = 0.048).

Conclusions

Patients treated with cefoperazone/sulbactam therapy had a better clinical outcome. The mortality of patients receiving cefoperazone/sulbactam with imipenem/cilastatin seems to be the lowest.

Electronic supplementary material

The online version of this article (10.1186/s13756-019-0502-x) contains supplementary material, which is available to authorized users.

[The efficacy and safety of transbronchial lung cryobiopsy in interstitial lung disease: a prospective study]

Objective: To evaluate the efficacy and safety of transbronchial lung cryobiopsy (TBCB) and conventional transbronchial lung biopsy (TBLB) in the diagnosis of interstitial lung diseases(ILD). Methods: A prospective, self-control study was conducted during January 2017 and April 2017 in First Affiliated Hospital of Guangzhou Medical University. A total of 25 patients [male 16, female 9; mean age (51±13) years, range 24 to 70 years] with inconclusive diagnosis of interstitial lung diseases were sequentially enrolled. In the study, TBCB (TBCB group) and TBLB (TBLB group) were performed successively under general anesthesia in all patients. The size of biopsy specimens, the duration of procedures, complications and pathological results were recorded. Gaussian distribution data were compared between 2 groups by using Student's t test, while abnormal distribution data were compared by using Wilcoxon rank sum test. The incidences of bleeding and pathologic diagnostic yield between the 2 groups were compared by using Pearson chi-square test. A P-value< 0.05 was assumed to be statistically significant. Results: The specimen sizes of TBCB group and TBLB group were (12.3+ 4.9) and (3.1+ 1.9) mm(2) respectively (t=-18.268, P=0.000). The duration of procedures was (7.8±3.2) and (5.4±2.1)min respectively (Z=-3.001, P=0.003). In TBCB group, the diagnostic yield was 72% (18/25), with valuable pathological results in 2 cases (8%), but in 5 cases (20%) it failed to provide valuable pathological results. In TBLB group, the diagnostic yield was 12% (3/25). There were no useful pathological results in other 22 cases. The difference in the rate of useful pathological results between TBCB group and TBLB group was significant (χ(2)=20.779, P=0.000). There was no pneumothorax or severe bleeding. The rate of mild to moderate bleeding in TBCB group and TBLB group was 47.2%(50/106) and 18.9%(20/106) (χ(2)=19.195, P=0.000) respectively. Conclusion: TBCB is superior to TBLB for lung biopsy as indicated by larger sample size, higher diagnostic yield and less complication. TBCB is valuable for the diagnosis of ILD.

Tongue coating microbiome data distinguish patients with pancreatic head cancer from healthy controls

Background: The microbiota plays a critical role in the process of human carcinogenesis. Pancreatic head carcinoma (PHC)-associated tongue coating microbiome dysbiosis has not yet been clearly defined.Objective: Our aim is to reveal the bacterial composition shifts in the microbiota of the tongue coat of PHC patients.Design: The tongue coating microbiota was analyzed in 30 PHC patients and 25 healthy controls using 16S rRNA gene sequencing technology.Results: The microbiome diversity of the tongue coat in PHC patients was significantly increased, as shown by the Shannon, Simpson, inverse Simpson, Obs and incidence-based coverage estimators. Principal component analysis revealed that PHC patients were colonized by remarkably different tongue coating microbiota than healthy controls and liver cancer patients. Linear discriminant analysis effect size revealed that Leptotrichia, Fusobacterium,Rothia, Actinomyces, Corynebacterium, Atopobium, Peptostreptococcus, Catonella, Oribacterium, Filifactor, Campylobacter, Moraxella and Tannerella were overrepresented in the tongue coating of PHC patients, and Haemophilus, Porphyromonas and Paraprevotella were enriched in the tongue coating microbiota of healthy controls. Strikingly, Haemophilus, Porphyromonas, Leptotrichia and Fusobacterium could distinguish PHC patients from healthy subjects, and Streptococcus and SR1 could distinguish PHC patients from liver cancer patients. Conclusions: These findings identified the microbiota dysbiosis of the tongue coat in PHC patients, and provide insight into the association between the human microbiome and pancreatic cancer.

A Cross-Sectional Study of the Association between Arterial Stiffness and Sarcopenia in Chinese Community-Dwelling Elderly Using the Asian Working Group for Sarcopenia Criteria

BACKGROUND

Several previous researches had found artery stiffness associated skeletal muscle mass, but not considering muscle strength and physical performance, which also were compositions of sarcopenia. This study aims to reveal the relationship of artery stiffness and sarcopenia using the Asian Working Group for Sarcopenia criteria.

METHODS

Study was performed on 1002 Chinese community dwelling participants aged ≥65 years from November 2016 to March 2017. Body composition, muscle strength, physical performance, and brachial-ankle pulse wave velocity (baPWV) considering as artery stiffness index were measured.

RESULTS

In multiple regression analysis, baPWV was associated with handgrip (β=-0.13, P=0.04) and Relative skeletal muscle mass index (ASM/Ht2) (β=-0.02, P<0.01), but not with 4-meter velocity (P=0.21). Multiple logistic regression analysis showed that 1-SD (3.50m/s) increased in baPWV was still associated with a 11% (CI, 4%-20%; P<0.01) higher odds of being sarcopenia. In the gender subgroup analysis, the relationship of baPWV and sarcopenia remain significant in men (OR, 1.23; 95% CI, 1.07-1.42, P<0.01), but not in women (P=0.07).

CONCLUSIONS

High brachial-ankle pulse wave velocity is associated with sarcopenia in Chinese community-dwelling elderly, with gender differences.

[Characteristics of Dix-Hallpike test induced nystagmus]

Objective:To retrospectively analyze the characteristics of 100 cases with Dix-Hallpike test induced nystagmus, especially the vertical downward component.Method:One hundred cases with positive Dix-Hallpike test between December 2017 and January 2018 were included in this study. Dix-Hallpike test and roll test were performed in all patients, and the max slow phase velocity (SPV), latency and duration of positional nystagmus were analyzed with SPSS 22.0 software.Result:According to the difference in the direction and duration of the nystagmus in the head-hanging position on Dix-Hallpike test, 100 patients were classified into 9 types. When only the vertical components were considered, 56 cases presented with bilateral or unilateral vertical upward component, among which 52 cases had unilateral torsional with vertical upward component, 4 cases had bilateral torsional with vertical upward component; 7 cases presented with vertically upward in one side and the vertically downward in the other side; 47 cases presented with bilateral or unilateral vertical downward component. In addition, 8 cases showed the reverse phase nystagmus. Of the 100 patients with positive Dix-hallpike, 20 cases were positive in roll test and 5 cases showing horizontal nystagmus and 15 cases showing torsional and vertical nystagmus.Conclusion:Vertical component in the positional nystagmus was common, and care should be taken to interpret the nystagmus into the underlying disorder.

[Research advance of microRNA in the pathogenesis of chronic rhinosinusitis]

Chronic rhinosinusitis (CRS) is a common disease of otorhinolaryngology head and neck surgery, manifested as nasal-sinus mucosal chronic inflammation. However, the pathogenesis of CRS is not clear. There are studies found that microRNA (miRNA) involved in CRS gene regulation. In this review, we summarize the expression of miRNAs in CRS, with the in-depth study of the role of miRNAs in CRS, and will further elucidate the pathogenesis of CRS.

[Expression of Foxm1 in chronic sinusitis and itsrelationship with MUC5AC]

Objective:To explore the expression of Forkhead box protein m1(Foxml) in the sinus mucosa of patients with chronic rhinosinusitis(CRS) and the relationship between Foxm1 and MUC5AC for further understanding of the pathogenesis of CRS.Method:We obtained the sinus mucosa from 25 CRS with polyps(CRSwNP) patients and 25 CRS without polyps (CRSsNP) patients as two experimental groups.Nasal mucosa from 15 normol cases were obtained as control group.We used HE,Periodic acid-schiff staining to observe the histopathological change of each sample.The expression of Foxm1 and MUC5AC were determined by immunohistochemistry(IHC) and qRT-PCR in each group.We also analysed the relationship between Foxm1 and MUC5AC.Result:The HE and PAS staining showed that in the CRSwNP and CRSsNP patients,the main histopathological features was the hyperplasia of goblet cell,inflammatory cell and submucosal gland.IHC showed that Foxm1 and MUC5AC expression were higher in CRSwNP and CRSsNP compared with normal sinus mucosa.qRT-PCR also revealed that Foxm1 and MUC5AC expression was higher in CRSwNP and CRSsNP than in normal mucosa(P<0.05).Foxm1 and MUC5AC had a significant positive correlation.Conclusion:The expressions of Foxm1 and MUC5AC were increased in CRS,and Foxm1 may play an important role in the process of hypersecretion of MUC5AC in CRS.

[Expression and significance of growth differentiation factor 15 and MUC5AC in chronic rhinosinusitis]

Objective:To investigate the expression of growth factor differentiation factor 15 (GDF15) in the nasal mucosa of patients with chronic rhinosinusitis (CRS) and its relationship with mucin 5AC(MUC5AC).Method:Fifteen patients with CRS and nasal polyps, 15 patients with CRS without nasal polyps and 15 patients with normal nasal mucosa were enrolled in the study. Hisological changes of sinonasal mucosa were examined by hematoxylin and eosin (HE) stainding. The expression of total mucins was evaluated by periodic acid Schiff staining(PAS). And the expression of GDF15 and MUC5AC were measured by immunohistochemistry (IHC), and reverse transcription polymerase chain reaction (RT-PCR).Result:The tissuse samples demonstrated mucaosal thicking, goblet cell hyperplasia, glandular hyperplasia and inflammatory cell infiltration in CRSwNP and CRSsNP. IHC revealed that GDF15 and MUC5AC expression higher in CRSwNP and CRSsNP than in normal sinus mucosa (P< 0.05). qRT-PCR also displays that the relative expression levles of mRNA exprssion of GDF15 and MUC5AC were higher in CRSwNP and CRSsNP than in controls.And the expression level of GDF15 was positively correlated with that of MUC5AC mRNA in CRS.Conclusion:GDF15 and MUC5AC were upregulated in CRS with or without nasal polyps, indicating that GDF15 is an important factor in the process of hypersecretion of MU5AC in CRS.

[The downbeat nystagmus in 2 cases with unilateral Meniere's disease]

We retrospectively analyzed 2 patients of unilateral Meniere's disease with downbeat nystagmus. Audiometric test, the Dix-Hallpike maneuver and the supine roll test were performed. Both patients presented with spontaneous nystagmus with downbeat components, and downbeat components were exaggerated by Dix-Hallpike maneuver. Spontaneous and positional nystagmus with downbeat component can occur in Meniere's disease, which may be resulted from excitation of three semicircular canals.

Identification of circular RNAs hsa_circ_0044235 in peripheral blood as novel biomarkers for rheumatoid arthritis

Circular RNAs (circRNAs) are a new class of RNAs that can be used as biomarkers in clinical blood samples. However, little is known about circRNAs' diagnostic values for rheumatoid arthritis (RA). In this study, the hsa_circ_0054189, hsa_circ_0008675, hsa_circ_0082689, hsa_circ_0082688, hsa_circ_0010932, hsa_circ_0002473 and hsa_circ_0044235 in peripheral blood were determined by quantitative reverse transcription–polymerase chain reaction (qRT–PCR). For hsa_circ_0044235, only one abnormal expression circRNAs in peripheral blood was selected as a targeted circRNA to explore the diagnostic value for RA. Our work demonstrated that the hsa_circ_0044235 in peripheral blood was decreased significantly in RA patients. The hsa_circ_0044235 in peripheral blood from RA patients did not correlate with C‐reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), anti‐citrullinated protein antibodies (ACPA) or disease activity score 28 (DAS28). Receiver operating characteristic (ROC) curve analysis suggested that the hsa_circ_0044235 in peripheral blood has significant value in the diagnosis of RA. The risk score based on hsa_circ_0044235 in peripheral blood also distinguished significantly the patients with RA from systemic lupus erythematosus (SLE). This study suggests that the hsa_circ_0044235 in peripheral blood may be a potential biomarker of patients with RA.