The RSNA Image Sharing Network

In the era of health information exchanges, there are trade-offs to consider when sharing a patient's medical record among all providers that a patient might choose. Exchange among in-network partners on the same electronic medical records (EMR) and other integrated information systems is trivial. The patient identifier is common, as are the relevant departmental systems, to all providers. Difficulties arise when patient records including images (and reports) must be shared among different networks and even with the patients themselves. The National Institutes of Health (NIH) challenged Radiological Society of North America (RSNA) to develop a transport method that could supersede the need for physical media (for patients or other providers), replace point-to-point private networks among providers, and enable image exchange on an ad hoc basis between arbitrary health networks without long legal delays. In concert with the evolving US health care paradigm, patient engagement was to be fundamental. With Integrating Healthcare Enterprise's (IHE's) help, the challenge has been met with an operational system.

Fractional Quantum Hall States at ν=13/5 and 12/5 and Their Non-Abelian Nature

Topological quantum states with non-Abelian Fibonacci anyonic excitations are widely sought after for the exotic fundamental physics they would exhibit, and for universal quantum computing applications. The fractional quantum Hall (FQH) state at a filling factor of ν=12/5 is a promising candidate; however, its precise nature is still under debate and no consensus has been achieved so far. Here, we investigate the nature of the FQH ν=13/5 state and its particle-hole conjugate state at 12/5 with the Coulomb interaction, and we address the issue of possible competing states. Based on a large-scale density-matrix renormalization group calculation in spherical geometry, we present evidence that the essential physics of the Coulomb ground state (GS) at ν=13/5 and 12/5 is captured by the k=3 parafermion Read-Rezayi state (RR_{3}), including a robust excitation gap and the topological fingerprint from the entanglement spectrum and topological entanglement entropy. Furthermore, by considering the infinite-cylinder geometry (topologically equivalent to torus geometry), we expose the non-Abelian GS sector corresponding to a Fibonacci anyonic quasiparticle, which serves as a signature of the RR_{3} state at 13/5 and 12/5 filling numbers.

Effects of Supplemental Levels of Saccharomyces cerevisiae Fermentation Product on Lactation Performance in Dairy Cows under Heat Stress

The objectives of this study were to evaluate the effects of different supplemental levels of Saccharomyces cerevisiae fermentation product (SCFP; Original XP; Diamond V) on lactation performance in Holstein dairy cows under heat stress. Eighty-one multiparous Holstein dairy cows were divided into 27 blocks of 3 cows each based on milk yield (23.6±0.20 kg/d), parity (2.88±0.91) and day in milk (204±46 d). The cows were randomly assigned within blocks to one of three treatments: 0 (control), 120, or 240 g/d of SCFP mixed with 240, 120, or 0 g of corn meal, respectively. The experiment was carried out during the summer season of 2014, starting from 14 July 2014 and lasting for 9 weeks with the first week as adaption period. During the experimental period, average daily temperature-humidity index (measured at 08:00, 14:00, and 20:00) was above 68, indicating that cows were exposed to heat stress throughout the study. Rectal temperatures tended to decrease linearly (p = 0.07) for cows supplemented with SCFP compared to the control cows at 14:30, but were not different at 06:30 (p>0.10). Dry matter intake was not affected by SCFP supplementation (p>0.10). Milk yield increased linearly (p<0.05) with increasing levels of SCFP. Feed efficiency (milk yield/dry matter intake) was highest (p<0.05) for cows fed 240 g/d SCFP. Cows supplemented with SCFP gained (p<0.01) body weight, while cows in the control lost body weight. Net energy balance also increased linearly (p<0.01) with increasing levels of SCFP. Concentrations of milk urea nitrogen (p<0.01) decreased linearly with increasing levels of SCFP, while no difference (p>0.10) was observed among the treatments in conversion of dietary crude protein to milk protein yield. In summary, supplementation of SCFP alleviated the negative effect of heat stress in lactating Holstein dairy cows and allowed cows to maintain higher milk production, feed efficiency and net energy balance. Effects of SCFP were dose-dependent and greater effects were observed from higher doses.

NOD2 pathway via RIPK2 and TBK1 is involved in the aberrant catabolism induced by T-2 toxin in chondrocytes

OBJECTIVE

This study aimed to identify the key intracellular pattern recognition receptor (PRR) and its role in the unbalanced extracellular matrix gene expressions of chondrocytes treated by T-2 toxin, a potential etiological factor for cartilage damages.

DESIGN

Differential expressions of intracellular PRRs after T-2 toxin treatment were screened by RT-qPCR in chondrocytes. RNAi was used to knockdown the expression of NOD2 and its two downstream signal molecules, RIPK2, and TBK1, for observing the effects of NOD2 pathway on regulation of metabolism gene expressions by RT-qPCR. The matrix metalloproteinases (MMP) activity was determined by gelatin zymography. The inhibitor of NF-κB and ROS scavenger were exploited to analyze the mechanism of NOD2 up-regulation in chondrocytes treated with T-2 toxin.

RESULTS

In chondrocytes treated with T-2 toxin, anabolism genes were down-regulated whereas catabolism genes were up-regulated, and NOD2 was identified as a significantly up-regulated gene. Intervening NOD2 expression via RNAi could ameliorate the down-regulation of anabolism genes, while inhibit the up-regulation of catablolism genes induced by T-2 toxin in chondrocytes. RNAi of RIPK2 and TBK1 in chondrocytes could obtain the similar outcome. Furthermore, up-regulation of NOD2 expression induced by T-2 toxin could be abrogated by pretreating the cells with inhibitors of NF-κB and scavenger of ROS.

CONCLUSION

T-2 toxin could up-regulate NOD2 expression via ROS/NF-κB pathway and activate NOD2 signaling pathway. The up-regulated NOD2 would affect the metabolism gene expressions and MMP activity in chondrocytes via RIPK2 and TBK1. The findings add new insights into understanding NOD2 effects on chondrocytes treated with T-2 toxin.

The significance of mild hypothermia therapy on patients with successful resuscitation of cardiac arrest

OBJECTIVE

To investigate the clinical significance of mild hypothermia therapy in patients with resuscitation of cardiac arrest and analyze the possible molecular mechanism.

PATIENTS AND METHODS

Ninety-six patients with successful resuscitation of cardiac arrest in ICU were hospitalized from June 2009 to July 2014. They were divided into a control group (n=37 cases) and an observation group (n=59 cases). All patients received high-grade life support treatment immediately after resuscitation. The treatment for the control group was combined with normal temperature treatment while the treatment for the observation group was combined with mild hypothermia therapy.

RESULTS

1. Glasgow coma scale (GCS) scores of the patients in the two groups increased gradually after treatment as the APACHE II scores decreased. Comparisons within the group showed significant differences (p < 0.05). The GCS scores of the observation group were significantly increased compared to those in the control group, and the APACHE score decreased significantly. The differences between the groups were statistically significant (p < 0.05). 2. The serum lactic acid, sCD14, S100 β protein and TNF-a level of patients in two groups all decreased after treatment. The difference was statistically significant (p < 0.05 =. 3. The 24h and 7d survival rates of patients in the observation group are higher than that in the control group (p < 0.05).

CONCLUSIONS

The early treatment of hypothermia, can improve the outcome of patients with cardiac arrest.

Angiotensin II Promotes Atherogenesis through upregulating the Expression of Connexin 43 in Dendritic Cells

It is known, for a long time, that angiotensin II (Ang II) could contribute to atherogenesis (AS) and plaque vulnerability, however the underlying mechanisms are poorly understood. Dendritic cells (DCs) are critical for the development of both inflammation and atherogenesis. In the present study, we tried to investigate the influence of AngII on the expression of connexin43 (Cx43) in DCs, as well as the effect of AngII on AS. After mouse bone marrow&mdash;derived dendritic cells (BMDCs) were treated by Ang II with or without Valsartan, the expression of Cx43 was quantified by Western Blots. The expression of Cx43 and CD40 (one marker of DCs) of DCs derived from AS plaques of ApoE&mdash;/&mdash; mice was detected by immunohistochemistry double staining. The morphology of atherosclerotic plaque was indicated by immunohistochemistry staining of smooth muscle cells. The expression of Cx43 (P &lt; 0.05) was increased significantly in mouse BMDCs after treatment with AngII. In atherosclerotic plaques from ApoE&mdash;/&mdash; mice expressing high levels of endogenous AngII, upregulation of Cx43 (P &lt; 0.01) and CD40 (P &lt; 0.01) was observed. The upregulation and pro&mdash;atherogenesis effect of Cx43 could be blocked by the AngII type 1 receptor blocker Valsartan, both in vitro and in vivo. AngII may promote atherosclerosis and plaque vulnerability by increasing the expression of Cx43 in DCs and inducing the maturation of DCs through the angiotensin II type 1 receptor.

TTAGG-repeat telomeres and characterization of telomerase in the beet armyworm, Spodoptera exigua (Lepidoptera: Noctuidae)

Telomeres are maintained usually by telomerase, a specialized reverse transcriptase that adds this sequence to chromosome ends. In this study, telomerase activity was detected in the in different somatic tissues, such as midgut and fat bodies, by the telomeric repeat amplification protocol (TRAP) in Spodoptera exigua. The structure of the telomeres of S. exigua was evaluated by sequence analysis of the TRAP products, revealing that the telomerase synthesized a (TTAGG)n repeat. The presence of a telomerase reverse transcriptase (TERT) subunit coding gene has been cloned, sequenced and expressed in vitro successively. Notably, the S. exigua telomerase (SpexTERT) gene structure lacks the N-terminal GQ motif. Telomerase contains a large RNA subunit, TER, and a protein catalytic subunit, TERT. Here we report an in vitro system that was reconstructed by all components of the telomerase complex, a purified recombinant SpexTERT without a N-terminal GQ motif and a mutant human telomerase RNA (TER), showed telomerase activity. Together, these results suggest the GQ motif is not essential for telomerase catalysis.

Visualizing polarization singularities in Bessel-Poincaré beams

We demonstrate that an annulus of light whose polarization is linear at each point, but the plane of polarization gradually rotates by π radians can be used to generate Bessel-Poincaré beams. In any transverse plane this beam exhibits concentric rings of polarization singularities in the form of L-lines, where the polarization is purely linear. Although the L-lines are invisible in terms of light intensity variations, we present a simple way to visualize them as dark rings around a sharp peak of intensity in the beam center. To do this we use a segmented polarizer whose transmission axes are oriented differently in each segment. The radius of the first L-line is always smaller than the radius of the central disk of the zero-order Bessel beam that would be produced if the annulus were homogeneously polarized and had no phase circulation along it.

Visceral fat area is associated with a high risk for early postoperative recurrence in Crohn's disease

AIM

Mesenteric hypertrophy has been recognized as an indicator of the complicated course of Crohn's disease. The aim of this study was to investigate whether the visceral fat area (VFA) is associated with postoperative clinical and endoscopic recurrence.

METHOD

Computed tomography was used to measure the subcutaneous fat area and VFA, and the mesenteric fat index (MFI) was defined as the ratio of the VFA to the subcutaneous fat area. Associations between body mass index, subcutaneous fat area, VFA and MFI and postoperative clinical and endoscopic recurrence were investigated.

RESULTS

The factors associated with postoperative endoscopic recurrence at 6 months after surgery were a high VFA value (P = 0.019) and MFI values above the median (P = 0.008). VFA values were significantly correlated with endoscopic recurrence (r = 0.895, P = 0.040) and endoscopic lesions (r = 0.617, P < 0.0001). Additionally, MFI values correlated well with endoscopic recurrence (r = 0.918, P = 0.02) and endoscopic scores (r = 0.584, P < 0.0001). Multivariate analysis indicated that VFA values above the median (hazard ratio 2.63, 95% CI 1.03-6.74) were predictive of postoperative clinical recurrence in Crohn's disease.

CONCLUSION

A high VFA value is associated with postoperative recurrence of Crohn's disease and has clinical implications with respect to optimizing prophylaxis for each individual. However, further studies are needed to confirm the predictive role of this biomarker in a different data set.

Effect of inhibiting the signal of mammalian target of rapamycin on memory T cells

BACKGROUND

Mammalian target of rapamycin (mTOR) signaling is crucial to the activation and proliferation of T cells. Memory T cells can significantly hinder the induction of transplant tolerance. Resent research demonstrates that mTOR signaling regulates the survival and function of memory T cells.

MATERIALS AND METHODS

Naïve T cells were adoptively transferred to Rag(-/-) mice to generate similar memory T cells that undergo homeostatic proliferation. These memory T cells were then used to examine the effect of mTOR inhibition on the function of memory T cells. The effect of inhibiting mTOR signaling on the apoptosis of memory T cells was also examined.

RESULTS

Quantitative reverse-transcription polymerase chain reaction analysis showed that the expression of mTOR signaling was substantially lower in memory T cells. The levels of interferon-γ, interleukin (IL)-2, IL-4, and IL-10 decreased after mTOR inhibition; the expression of Bcl-2 increased in memory CD8(+) T cells and decreased in memory CD4(+) T cells; and Bax increased in memory CD4(+) T cells and decreased in memory CD8(+) T cells. Memory CD4(+) T cells were more sensitive to apoptotic cell death in this model after mTOR inhibition. Memory CD8(+) T cells were not affected by mTOR inhibition.

CONCLUSIONS

mTOR was crucial to homeostatic proliferation-induced memory T cells. The critical mechanisms of mTOR signaling inhibition are suppressed the functions of memory T cells and promoted the apoptosis of memory CD4(+) T cells.

MMP-9 is increased in the pathogenesis of gastric cancer by the mediation of HER2

Human epidermal growth factor receptor 2 (HER2) overexpression is not only closely associated with the tumor growth, but is also related to tumor invasion. We here aimed to investigate the mechanism of HER2 mediation in the pathogenesis of gastric cancer. The human gastric cancer cell lines SGC-7901, MKN-45, AGS, the immortalized cell line GES-1 derived from normal gastric mucosa. Cell transfection and selection of stable cell lines and the gene and protein levels of HER2 and Matrix metalloproteinase-9 (MMP-9) were examined to determine the molecular relationship between them in the pathogenesis of gastric cancer. The human gastric cancer cell lines SGC-7901, MKN-45, AGS, the immortalized cell line GES-1 derived from normal gastric mucosa. Cell transfection and selection of stable cell lines and the gene and protein levels of HER2 and MMP-9 were examined to determine the molecular relationship between them in the pathogenesis of gastric cancer. We demonstrated that vector-based shRNA significantly knocked down the expression of HER2 and considerably inhibited both the migration and invasion of gastric cancer cells. HER2 knockdown resulted in the downregulation of the expression of MMP-9, whereas HER2 overexpression improved the transcription of MMP-9 through the activation of an MMP-9 promoter. The promoter region of MMP-9 between -2500 and -2000 bp was found to be crucial for the upregulation of HER2-mediated transcription. Furthermore, a truncated promoter (-70 to +63) did not display any transcriptional activity. Cell invasion activity was almost completely inhibited when MMP-9 was knocked down. Conversely, the overexpression of MMP-9 partly rescued the invasion ability of cell strains with knockdown HER2. These findings help further understanding of the molecular mechanisms through which HER2 promotes malignancy, and suggest that targeting both HER2 and MMP-9 may be required to effectively block HER2 signaling in gastric cancer therapy.

A comparative study of intensity-modulated radiotherapy and standard radiation field with concurrent chemotherapy for local advanced cervical cancer

OBJECTIVE

This study aimed to compare three-dimensional conformal radiotherapy (3D CRT) and intensity-modulated radiotherapy (IMRT) combined with concurrent chemotherapy for cervical cancer.

MATERIALS AND METHODS

A total of 72 patients with Grades IIa-IIIb cervical cancer were randomly divided into two groups, namely, the IMRT group for IMRT plan (primary lesion, 45 Gy/22; the pelvic wall lymphatic drainage area, 50 Gy/22), and the 3D CRT group (conformal pelvic radiotherapy, 45 Gy/22; subsequent supplement of pelvic wall, 6.0 Gy/3). Both groups received concurrent chemotherapy of nedaplatin 30 mg/m2 weekly for six cycles, with an after-loading therapy of 6 Gy/6 each time.

RESULTS

In the IMRT group, the grade III diarrhea rate was 5.6% and the rate in the 3D CRT group was 30.6%; both groups significantly differed. No significant difference was observed between the overall survival and disease-free survival in first, second, and third years in both groups.

CONCLUSION

Cervical cancer IMRT can significantly reduce the incidence of acute enteritis. For standard 3D CRT, no significant difference was observed in overall survival and disease-free survival.

Risk factors for respiratory failure with tetraplegia after acute traumatic cervical spinal cord injury

OBJECTIVE

To analyze risk factors for respiratory failure with tetraplegia after acute traumatic cervical spinal cord injury (CSCI).

PATIENTS AND METHODS

Total 180 tetraplegia cases after acute traumatic CSCI treated in Shanghai Changzheng Hospital from 2001 to 2011 were reviewed retrospectively and the frequency of respiratory failure in these patients were analyzed against the factors including age, gender, cause of injury, level/severity of injury, high-dose methylprednisolone (MP) therapy, and surgery intervention, using Chi-square test to look into the correlations of the prevalence of respiratory failure to those factors.

RESULTS

Of the 180 tetraplegia with acute traumatic CSCI, 29 patients (16.11%) developed respiratory failure. The factors, including age, level and severity of injury, high-dose MP therapy, and surgery intervention, were found to significantly correlate with the appearance of respiratory failure in tetraplegia after acute traumatic CSCI (p < 0.05), while no significant correlation was found between the other factors: gender and cause of injury and the frequency of respiratory failure.

CONCLUSIONS

Age, level/severity of injury, high-dose MP therapy, and surgery intervention are the four major relevant factors of respiratory failure in patients with acute traumatic CSCI. The appropriate and timing treatments involving high-dose MP therapy and surgical decompression and reconstruction can substantially increase the rates of clinical improvements and reduce the frequency of respiratory failure.

Recombinant T-cell receptor ligand RTL1000 limits inflammation and decreases infarct size after experimental ischemic stroke in middle-aged mice

We have previously demonstrated that recombinant T-cell receptor ligand 1000 (RTL1000) reduces infarct size and improves long-term functional recovery after experimental stroke in young transgenic mice expressing human leukocyte antigen DR2 (DR2-Tg). In this study, we determined the effect of RTL1000 on infarct size in 12-month-old middle-aged DR2-Tg mice, and investigated its mechanism of action. Twelve-month-old male DR2-Tg mice underwent 60min of intraluminal reversible middle cerebral artery occlusion (MCAO). Vehicle or RTL1000 was injected 4, 24, 48 and 72h after MCAO. Cortical, striatal and total hemispheric infarcts were measured 96h after stroke. Spleen and brain tissues were collected 96h after stroke for immunological analysis. Our data showed that RTL1000 significantly reduced infarct size 96h after MCAO in middle-aged male DR2-Tg mice. RTL1000 decreased the number of activated monocytes/microglia cells (CD11b(+)CD45(hi)) and CD3(+) T cells in the ischemic hemisphere. RTL1000 also reduced the percentage of total T cells and inflammatory neutrophils in the spleen. These findings suggest that RTL1000 protects against ischemic stroke in middle-aged male mice by limiting post-ischemic inflammation.

Stapled vs hand suture closure of loop ileostomy: a meta-analysis

AIM

Loop ileostomies are widely used in colorectal surgery to reduce the consequences of distal anastomotic failure. The optimal surgical technique for their closure has yet not been defined. A meta-analysis was performed to compare the outcome after stapled or hand sutured ileostomy closure.

METHOD

An electronic literature search of EMBASE, PubMed and the Cochrane Library was undertaken to identify studies reporting stapled and hand sutured ileostomy closure. End-points included postoperative small bowel obstruction (SBO), anastomotic leakage, wound infection, overall postoperative complications, operation time, hospital stay and surgery-related cost.

RESULTS

Fourteen studies including 5084 patients were identified. Meta-analysis showed that stapled closure was associated with a lower rate of SBO overall (OR = 0.56, P < 0.00001) and early (within 30 days of closure) SBO (OR = 0.51, P < 0.00001). This difference persisted for direct ileostomy closure (OR = 0.62, P = 0.02) or closure with bowel resection and hand sewn anastomosis (OR = 0.44, P < 0.00001). Stapled closure required a shorter inpatient stay (mean difference -1.22, P < 0.0001) and operating time (mean difference -11.21, P = 0.01). No significant difference was noted between the two techniques in terms of anastomotic leakage, wound infection, overall complications or cost.

CONCLUSION

Stapled side-to-side anastomosis is associated with fewer complications, especially SBO, than hand sewn ileostomy closure by direct suture or resection and anastomosis. It is quicker to perform and associated with fewer postoperative bowel obstructions.

Chronic stress causes neuroendocrine-immune disturbances without affecting renal vitamin D metabolism in rats

INTRODUCTION

Vitamin D (VD) insufficiency has been repeatedly observed in the medical conditions associated with inflammation, such as cardiovascular disease, diabetes and depression. However, contrasting to the observational evidence, randomized trials of VD supplementation failed to demonstrate such link. Given the recent evidence that the inflammatory process can in turn alter VD metabolism, it has been hypothesized that the insufficient VD status could be the result rather than the cause of chronic inflammation involved in the onset of depression and other disease conditions.

MATERIALS AND METHODS

Chronic mild stress (CMS) is a valid animal model of depression that accompanied with neuroendocrine-immune disturbances. In the present research, we assessed serum VD concentrations and renal expression of the cytochromes P450 enzymes involved in VD activation (CYP27B1) and catabolism (CYP24A1) of rats following 8-week exposure to CMS.

RESULTS

While CMS induced the rats to a depression-like state and increased serum levels of the proinflammatory cytokines and corticosterone, and the antidepressant, sertraline, mitigated depression-like behaviors and neuroendocrine-immune disturbances, neither the stress regimen nor sertraline significantly affected endocrine metabolism of VD.

CONCLUSION

Our data suggest that the stress-induced neuroendocrine-immune disturbances may account for the development of depression, but are not responsible for the insufficient VD status that frequently observed in depressed patients.

Oxygen hole states in zirconia lattices: quantitative aspects of their cathodoluminescence emission

Systematic assessments of cathodoluminescence (CL) spectroscopy, Raman spectroscopy (RS), and X-ray diffraction (XRD) are presented for pure zirconia and for a series of Y-doped zirconia powders (henceforth, simply referred to as undoped ZrO2 and YSZ powders, respectively) synthesized according to a coprecipitation method of Zr and Y chlorides. Emphasis is placed here on spectral emissions related to oxygen-vacancy sites (i.e., oxygen hole states) equally detected from undoped and Y-doped ZrO2 samples, either as intrinsic defects or, extrinsically induced, by means of cathodoluminescence. Most counterintuitively, the undoped ZrO2 sample (i.e., the one with presumably the lowest amount of oxygen vacancies) experienced the strongest CL emission. A progressive "quenching" effect on CL emission with increasing the fraction of Y(3+) dopant could also be observed because the intrinsic vacancies present in the undoped lattice are the most efficient since they can trap two electrons to gain electrical neutrality. However, as soon as Y(3+) ions are introduced in the system, those intrinsic vacancies migrate to Y-sites in next-nearest-neighbor locations, namely in a less efficient lattice location. This phenomenon is tentatively referred to as "delocalization" of vacancy sites. Moreover, the fact that Y-doped zirconia series presents quite similar CL spectra compared to the undoped zirconia could be an evidence that the radiative centers of undoped and Y-doped ZrO2 are basically the same. A fitting procedure has been made aiming to give a rational description of the variation of the spectra morphology, and a parameter able to describe the monoclinic to tetragonal phase transformation has been found. This parameter and the overall set of CL data enabled us to quantitatively assess polymorphic phase fractions by CL spectroscopy in the scanning electron microscope.

Antiatherosclerotic Potential of Rhizoma Polygonati Polysaccharide in Hyperlipidemia-induced Atherosclerotic Hamsters

The present study aimed to investigate the antiatherosclerotic effect of rhizoma polygonati polysaccharide. Adult golden hamsters (Mesocricetus auratus) were fed an atherosclerotic diet containing 1.5 mL olive oil, 8 mg (320,000 IU) vitamin D2, and 40 mg cholesterol for 60 consecutive days to induce atherosclerosis. These hamsters then orally received either the reference drug simvastatin (5 mg/kg) or rhizoma polygonati polysaccharide (0.57 g/kg or 1.14 g/kg) once daily for 60 additional days before comparison to normal and atherosclerotic controls. Treatment with rhizoma polygonati polysaccharide resulted in significant improvement (p<0.01) in serum lipid profile, apolipoproteins, and endothelial dysfunction parameters. Histomorphological studies confirmed biochemical findings. The results showed that rhizoma polygonati polysaccharide has a protective effect against hyperlipidemia-induced atherosclerosis in hamsters.

Reason and treatment of failure of proximal femoral nail antirotation internal fixation for femoral intertrochanteric fractures of senile patients

The cause of postoperative failure after the treatment of femoral intertrochanteric fracture with proximal femoral nail antirotation (PFNA) was analyzed, and the reoperative methods were examined. Nine failures of 308 femoral intertrochanteric fracture patients with PFNA were treated with femoral prosthesis total hip replacement (THR) and reoperative internal fixation. All nine patients were analyzed to determine the cause of failure. The causes of failed internal fixation in the intertrochanteric-fractured patients included perforation of the helical blade into the hip joint in three cases, cutting-out of the helical blade exit outside in two cases, and hip varus as a result of cutting-out the helical blade in two cases. Seven patients with failed internal fixation were treated with THR. Two patients who had femoral shaft fractures at the end of the nail were treated with longer PFNA. Faulty operative procedures, unsatisfactory reductions, serious osteoporosis, and incorrect positioning of the helical blade were the most important factors responsible for the failed internal fixation. Satisfactory results were achieved with THR and refixation relative to the causes of the failed internal fixation.

Partial least squares based gene expression analysis in posttraumatic stress disorder

OBJECTIVE

Posttraumatic stress disorder (PTSD) is an adverse psychological response to traumatic events. Microarray technology for large-scale gene expression analysis facilitates the identification of signatures that underlie the pathogenesis of PTSD. Previous studies mostly used variance/regression analysis without considering array specific factors. We aim to investigate the underlying mechanism of PTSD through partial least squares (PLS) based analysis.

MATERIALS AND METHODS

With a gene expression profile data set for 17 chronic PTSD patients and 16 controls recovered from psychological trauma from the Gene Expression Omnibus (GEO) database, we performed Partial Least Square (PLS) based analysis.

RESULTS

We acquired 230 down-regulated genes and 335 up-regulated genes. Significantly increased representations of dysregulated genes in immune, endocrine and nervous pathways were identified. Among the top 5 hub genes in the network, PRKCA has been reported to be related with PTSD before. Three other genes, TP53, EP300 and CALM1 might also contribute to the pathogenesis of PTSD since they are all related with other neuronal disorders.

CONCLUSIONS

Our findings shed light on expression signatures of PTSD with the hope to give further theoretical supports for future therapeutic study.

Asymmetrical cortical vessel sign on susceptibility-weighted imaging: a novel imaging marker for early neurological deterioration and unfavorable prognosis

BACKGROUND AND PURPOSE

Susceptibility-weighted imaging (SWI) is a high spatial resolution technique that can indirectly demonstrate increased cerebral oxygen extraction. Our aim was to assess whether asymmetric cortical vessel sign (ACVS) on SWI could be associated with early neurological deterioration (END) as well as 90-day unfavorable outcome in patients with acute ischaemic stroke.

MATERIALS AND METHODS

Consecutive patients with acute middle cerebral artery (MCA) territory infarction were prospectively enrolled. ACVS was defined as more and/or larger vessels with greater signal loss than those in the opposite hemisphere on minimum intensity projection of SWI. The neurofunctional fluctuation during acute phase as well as 90-day outcomes were assessed. A National Institutes of Health Stroke Scale increment ≥2 points and ≥4 points despite standard treatment in the first 72 h after admission was defined as END2 and END4, respectively.

RESULTS

In all, 572 patients were finally enrolled. ACVS on SWI was present in 39 (6.8%) subjects. Multivariate analysis indicated that ACVS is an independent predictor for END2 [odds ratio (OR) 4.47, 95% confidence interval (CI) 1.99-10.05) and END4 (OR 4.24, 95% CI 1.94-9.23). Furthermore, ACVS also correlates with 90-day unfavorable outcome defined as a modified Rankin Scale score >1 point (OR 2.93, 95% CI 1.15-7.48). Both positive and negative predictive values of ACVS for END2, END4 and 90-day prognosis were reasonable and both could be slightly enhanced as long as patients with contralateral artery stenosis or occlusion were excluded.

CONCLUSION

In patients with MCA territory acute ischaemic stroke, especially in those without contralateral internal carotid artery/MCA stenosis or occlusion, ACVS might be considered as a neuroimaging predictor for END and unfavorable prognosis.

Chromosome 12p13 variants predict recurrence of ischaemic stroke in a Chinese population

BACKGROUND AND PURPOSE

A recent genome-wide association study identified two genetic variants (rs12425791 and rs11833579) on chromosome 12p13 that confer risk of ischaemic stroke. The purpose of this study was to examine whether these two polymorphisms are associated with stroke onset and prognosis in a Chinese population.

METHODS

rs12425791 and rs11833579 were genotyped using the improved multiple ligase detection reaction in 913 patients with ischaemic stroke. Analyses of genotype association with onset and prognosis outcomes were evaluated by the Kaplan-Meier method, the log-rank test and Cox proportional hazards models.

RESULTS

rs12425791 and rs11833579 were not associated with age of stroke onset (P = 0.786 and 0.340, respectively). However, these two polymorphisms were significantly associated with risk of stroke recurrence, especially for the large-artery atherosclerosis (LAA) subtype, in recessive models [hazard ratio (HR) 2.52; 95% confidence interval (CI) 1.04-6.12 for rs12425791; HR 2.13; 95% CI 1.03-4.40 for rs11833579]. The combined genotype of these two single-nucleotide polymorphisms showed a locus-dosage effect on recurrence of LAA subtype and was an independent prognostic factor for LAA subtype in the final multivariate Cox regression model.

CONCLUSIONS

These findings indicated that rs12425791 and rs11833579 on chromosome 12p13 may be useful biomarkers for predicting the prognosis of patients with the LAA subtype of ischaemic stroke.

Oral treatment with SEW2871, a sphingosine-1-phosphate type 1 receptor agonist, ameliorates experimental colitis in interleukin-10 gene deficient mice

SEW2871, a selective sphingosine-1-phosphate type 1 receptor (S1P1) agonist, has been shown to be effective in protecting kidneys against ischaemia-reperfusion injury by reducing CD4(+) T cell infiltration in mice. However, the effects of SEW2871 on colitis remain unclear. The aim of this study was to investigate the effects of SEW2871 on established colitis in interleukin (IL)-10 gene-deficient (IL-10(-/-)) mice, a murine model of Crohn's disease (CD). SEW2871 was administered by gavage at a dose of 20 mg/kg/day for 2 weeks to IL-10(-/-) mice. Severity of colitis, serum amyloid A, tissue myeloperoxidase (MPO), T cells in blood and colon lamina propria (LP) and proinflammatory cytokine productions were evaluated. Furthermore, the phospho-signal transducer and activator of transcription (STAT)-3 (p-STAT-3) expression in lymphocytes isolated from colon LP was also assessed. The 2-week administration of SEW2871 ameliorated established colitis in IL-10(-/-) mice, associated with a reduction of serum amyloid A concentration, a decreased colon MPO concentration, a depletion of the peripheral CD4(+) CD45(+) T cells and a reduction of the homing of T cells into colon LP. Moreover, typical cytokines of T helper type 1 (Th1) and Th17 cells and p-STAT-3 expression were also suppressed by SEW2871 treatment. SEW2871 treatment ameliorates established experimental colitis in IL-10(-/-) mice, which may provide a new therapeutic approach for human CD therapy.

Genetic tuning of the novel avian influenza A(H7N9) virus during interspecies transmission, China, 2013

A novel avian influenza A(H7N9) virus causing human infection emerged in February 2013 in China. To elucidate the mechanism of interspecies transmission, we compared the signature amino acids of avian influenza A(H7N9) viruses from human and non-human hosts and analysed the reassortants of 146 influenza A(H7N9) viruses with full genome sequences. We propose a genetic tuning procedure with continuous amino acid substitutions and reassorting that mediates host adaptation and interspecies transmission. When the early influenza A(H7N9) virus, containing ancestor haemagglutinin (HA) and neuraminidase (NA) genes similar to A/Shanghai/05 virus, circulated in waterfowl and transmitted to terrestrial poultry, it acquired an NA stalk deletion at amino acid positions 69 to 73. Then, receptor binding preference was tuned to increase the affinity to human-like receptors through HA G186V and Q226L mutations in terrestrial poultry. Additional mammalian adaptations such as PB2 E627K were selected in humans. The continual reassortation between H7N9 and H9N2 viruses resulted in multiple genotypes for further host adaptation. When we analysed a potential association of mutations and reassortants with clinical outcome, only the PB2 E627K mutation slightly increased the case fatality rate. Genetic tuning may create opportunities for further adaptation of influenza A(H7N9) and its potential to cause a pandemic.

Tapering of the cervical spinal canal in patients with distended or nondistended syringes secondary to Chiari type I malformation

BACKGROUND AND PURPOSE

Steeper tapering of the cervical spinal canal as documented in recent studies is thought to have a role in the pathophysiology of Chiari malformation-associated syringomyelia. This study aimed to determine whether taper ratio of the cervical spinal canal differs between patients with distended and nondistended syringes.

MATERIALS AND METHODS

Seventy-seven adolescents (10-18 years) were divided into 2 groups: 44 with distended syrinx and 33 with nondistended syrinx. On T2-weighted MR images, anteroposterior diameter of the spinal canal was measured at each cervical level, and a linear trend line was fit by least squares regression to calculate the taper ratio. Taper ratios were compared between the 2 groups and further evaluated with respect to age and sex.

RESULTS

In the nondistended group ND, the taper ratios for C1-C7, C1-C4, and C4-C7 averaged -0.73 ± 0.57, -1.61 ± 0.98, and -0.04 ± 0.54, respectively, all of which were significantly steeper than those observed in the distended group (P = .001, .004, and .033, respectively). Regarding the average diameters plotted by cervical level, the narrowest region of the canal was found to occur at C4 in both groups. In addition, no significant differences in taper ratio were noted between males and females, or between older (>14 years) and younger patients (≤14 years).

CONCLUSIONS

Taper ratios of the cervical spinal canal were found to be different between patients with distended and nondistended syringes, indicating a reciprocal interaction between the syrinx and the cervical spine anatomy.

Carbohydrate metabolism changes in Prunus persica gummosis infected with Lasiodiplodia theobromae

Peach gummosis represents a significant global disease of stone fruit trees and a major disease in the south peach production area of the Yangtze River of China. In this study, the carbohydrate composition of peach shoots during infection by Lasiodiplodia theobromae was examined. The expression of genes related to metabolic enzymes was also investigated. Control wounded and noninoculated tissue, lesion tissue, and wounded and inoculated surrounding lesion tissue of peach shoots were analyzed. Soluble sugars, glucose, mannose, arabinose, and xylose significantly increased in inoculated tissues of peach shoots compared with control tissues at different times after inoculation. Accumulation of polysaccharides was also observed by section observation and periodic acid Schiff's reagent staining during infection. Analysis using quantitative reverse-transcription polymerase chain reaction revealed that the abundance of key transcripts on the synthesis pathway of uridine diphosphate (UDP)-D-glucuronate, UDP-D-galactose, and UDP-D-arabinose increased but the synthesis of L-galactose and guanosine diphosphate-L-galactose were inhibited. After inoculation, the transcript levels of sugar transport-related genes (namely, SUT, SOT, GMT, and UGT) was induced. These changes in sugar content and gene expression were directly associated with peach gum polysaccharide formation and may be responsible for the symptoms of peach gummosis.

Identifying non-Abelian topological order through minimal entangled states

The topological order is encoded in the pattern of long-range quantum entanglements, which cannot be measured by any local observable. Here we perform an exact diagonalization study to establish the non-Abelian topological order for topological band models through entanglement entropy measurement. We focus on the quasiparticle statistics of the non-Abelian Moore-Read and Read-Rezayi states on the lattice models with bosonic particles. We identify multiple independent minimal entangled states (MESs) in the ground state manifold on a torus. The extracted modular S matrix from MESs faithfully demonstrates the Ising anyon or Fibonacci quasiparticle statistics, including the quasiparticle quantum dimensions and the fusion rules for such systems. These findings unambiguously demonstrate the topological nature of the quantum states for these flatband models without using the knowledge of model wave functions.

Intestinal dysbacteriosis contributes to decreased intestinal mucosal barrier function and increased bacterial translocation

The purpose of this study was to determine the effect of colistin-induced intestinal dysbacteriosis on intestinal mucosal barrier function and bacterial translocation in a mouse model. Colistin or saline was administered orally for 7 days, and populations of viable organisms from the caecal mucosa and its content, the ileal segments, the mesenteric lymph nodes (MLNs) and the internal organs were prepared for examination. In the intestinal dysbacteriosis model, intestinal barrier dysfunction was observed and associated with increased bacterial translocation to extraintestinal sites. The extent of bacterial translocation to the MLNs and internal organs in the colistin group was significantly higher than in the saline group. Colistin-induced intestinal dysbacteriosis was shown to injure the intestinal mucosa barrier function and increase bacterial dislocation.

SIGNIFICANCE AND IMPACT OF THE STUDY

Colistin has been reported to be effective in selective digestive decontamination (SDD), which is an infection prevention measure used in the treatment of certain patients in intensive care. We are the first to report that colistin-induced intestinal dysbacteriosis can injure intestinal mucosal barrier function and increase bacterial translocation, whereas a high dose of colistin does not damage the intestinal mucosal barrier in germ-free (GF) mice raised in a GF environment. These results may indicate that prolonged use of a high dose of a SDD medication should be carefully considered.