A case of intracranial molluscum contagiosum virus infection diagnosed by metagenomic sequencing of cerebrospinal fluid

Molluscum contagiosum is a common, self-limiting infectious disease of the skin caused by molluscum contagiosum virus (MCV). The disease primarily affects children, sexually active adults, and immunocompromised individuals. Transmission of the virus occurs by direct skin contact. Therefore, the virus is usually detected in the skin and genitals of patients. However, the diagnosis of intracranial infection by the virus is difficult if the skin/mucosa lessons are atypical or absent, and the presence of the virus in the cerebrospinal fluid has not been reported. We report a very rare case of intracranial infection by molluscum contagiosum virus. A 25-year-old girl was admitted to our hospital due to severe headache but no fever or other symptoms. Upon examination, some small flesh-colored flattened papules on both arms were noticed. Blood tests showed slightly reduced levels of CD3 and CD4 T lymphocytes. Three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) and head magnetic resonance (MR) were both normal. Lumbar puncture was performed, and metagenomic sequencing was applied to the spinal fluid. The unique sequences of the molluscum contagiosum virus were identified in the fluid. The patient was then diagnosed with intracranial molluscum contagiosum virus infection. No special treatment was given. The headache gradually disappeared, and the patient was discharged. During our quarterly follow-up, the girl appeared normal, and her skin lesions disappeared. However, her CD3 and CD4 T lymphocyte counts were still slightly lower than the normal level. Our case shows that the application of metagenomic sequencing to cerebrospinal fluid is a sensitive and powerful means to detect pathogens causing intracranial infection. Keywords: Molluscum contagiosum; intracranial infection; metagenomics sequencing.

The interplay of transcriptional and post-transcriptional regulation of migration of mesenchymal stem cells during early stages of bone fracture healing

Bone fractures are a medical condition where the continuity of the bone is broken due to a fall or accident. The fracture may also be the result of medical conditions such as osteoporosis, cancers of bone or osteogenesis imperfect. During the bone fracture healing process, the mesenchymal stem cells (undifferentiated connective tissue cells) are recruited from local and systemic sources. The modulation of mesenchymal cell migration to the fractured site is the desired goal. Still, there are many processes that are still required to be studied and analyzed. We aimed to consolidate and review the available information on this topic.

Expression and significance of MiR-126 and VEGF in proliferative diabetic retinopathy

OBJECTIVE

To study the expression and significance of micro ribonucleic acid (miR)-126 and vascular endothelial growth factor (VEGF) in the vitreous body and proliferative membrane tissues of affected eyes and plasma in proliferative diabetic retinopathy (PDR).

PATIENTS AND METHODS

A total of 50 PDR patients admitted to our hospital from January 2017 to January 2018 were collected, including 17 cases in stage IV, 20 cases in stage V, and 13 cases in stage VI according to the DR staging criteria. Another 30 patients with an idiopathic macular hole were selected as control group. After admission, the examinations were performed, venous blood was drawn, and vitrectomy was performed, during which the vitreous body and proliferative membrane tissues were taken. The plasma VEGF content was detected via enzyme-linked immunosorbent assay (ELISA). The VEGF protein expression level was detected via Western blotting in vitreous body and proliferative membrane tissues. Moreover, the miR-126 expression was detected via quantitative polymerase chain reaction (qPCR).

RESULTS

In the vitreous body tissues, proliferative membrane tissues and plasma, the expression level of miR-126 was significantly lower in control group than that in stage IV, V, and VI groups (p<0.05). The miR-126 expression was significantly lower in stage IV group than that in stage V and VI groups (p<0.05), meanwhile, miR-126 expression was significantly lower in stage V group than that in stage VI group (p<0.05). In the vitreous body tissues, proliferative membrane tissues and plasma, the VEGF mRNA and protein expression levels were significantly higher in control group than those in stage IV, V, and VI groups (p<0.05). The VEGF expressions were significantly higher in stage IV group than those in stage V and VI groups (p<0.05). In addition, VEGF expressions were significantly higher in stage V group than those in stage VI group (p<0.05). Furthermore, the VEGF expression level was negatively correlated with the miR-126 expression level.

CONCLUSIONS

We found that the abnormally high expression of miR-126 negatively regulates VEGF, which may be one of the important mechanisms of occurrence of PDR. The miR-126 and VEGF content can serve as important predictors for the condition of PDR.

[Advances in researches of exosomes and other extracellular vesicles in parasites and parasitic diseases]

Exosomes are tiny vesicles secreted by most endogenous cells, and the extracellular vesicles (EVs) are specifically secreted by cells. Recently, it was found that exosomes contain a large quantity of important substances such as proteins, nucleic acids, and lipids, which play important roles in material exchange and information transmission in cell-cell communication, and in modulating the immune response, metabolism, and expansion, metastasis, and drug resistance of tumors. This paper summarizes the recent researches on exosomes in parasites and parasitic diseases and hopes to be helpful for improving the researches of parasites and parasitic diseases.

[Expand prelacrimal recess-maxillary ainus approach for inferior orbital walls fracture treatment]

Objective: To investigate the surgical technique and curative effect of transnasal endoscopic anterior lacrimal approach for the treatment of sacral wall fractures. Method: Retrospective clinical analysis of 5 patients with inferior orbital walls fracture treated by expanding prelacrimal recess-maxillary ainus under nasal endoscope was studied, and the surgical method and its efficacy were annalyzed. Result: After 1 year of follow-up,4 patients' diplopia symptom disappeared, and 1 patient's diplopia symptom was significantly relieved compared with preoperation, the range of eye movement was normal and enophthalmos were totally corrected.Conclusion: Expanding prelacrimal recess-maxillary ainus approach for the treatment of the inferior orbital walls fracture is an effective surgical method.It has the characteristics of less trauma,no incision on the face, clear visual field and wide space of operation, which is worthy of clinical promotion.

[The core strategies of hepatectomy: blood control technique and hepatectomy plane determination]

Blood control technology and determination of hepatectomy plane are the core techniques of liver resection, which not only affect the operative performance, but also affect the prognosis of patients.The concept of pre-control the blood vessels in the hepatic segment which should be resected can effective control of bleeding during hepatectomy.A comprehensive application of the ischemic line guidance, the intraoperative ultrasound, the segmental portal staining, fluorescent staining, the hepatic vein-oriented technique, and three-dimensional technique are helpful to precisely determine the boundary of hepatic segment to be resected and guide the hepatectomy plane.

In finger osteoarthritis, change in synovitis is associated with change in pain on a joint-level; a longitudinal magnetic resonance imaging study

OBJECTIVE

To investigate determinants of decrease and increase in joint pain in symptomatic finger osteoarthritis (OA) on magnetic resonance (MR) imaging over 2 years.

DESIGN

Eighty-five patients (81.2% women, mean age 59.2 years) with primary hand OA (89.4% fulfilling American College of Rheumatology (ACR) classification criteria) from a rheumatology outpatient clinic received contrast-enhanced MR imaging (1.5T) and physical examination of the right interphalangeal finger joints 2-5 at baseline and at follow-up 2 years later. MR images were scored paired in unknown time order, following the Hand OA MRI scoring system (HOAMRIS). Joint pain upon palpation was assessed by research nurses. Odds ratios (ORs; 95% confidence intervals) were estimated on joint level (n = 680), using generalized estimating equations (GEE) to account for the within patient effects. Additional adjustments were made for change in MR-defined osteophytes, synovitis, and bone marrow lesions (BMLs).

RESULTS

Of 116 painful joints at baseline, at follow-up: 76 had less pain, 21 less synovitis, and 13 less BMLs. A decrease in synovitis (OR = 5.9; 1.12─31.0), but not in BMLs (OR = 0.39; 0.10─1.50), was associated with less pain. Of 678 joints without maximum baseline pain, at follow-up: 115 had increased pain, 132 increased synovitis, 96 increased BMLs, and 44 increased osteophytes. Increased synovitis (OR = 1.81; 1.11─2.94), osteophytes (OR = 2.75; 1.59─4.8), but not BMLs (OR = 1.14; 0.81─1.60), was associated with increased pain. Through stratification it became apparent that BMLs were mainly acting as effect modifier of the synovitis-pain association.

CONCLUSION

Decrease in MR-defined synovitis is associated with reduced joint pain, identifying synovitis as a possible target for treatment of finger OA.

A systematic review of infectious illness Presenteeism: prevalence, reasons and risk factors

Background

Workplace presenteeism is common and leads to the spread of infectious diseases. Previous reviews have focused on presenteeism in relation to general physical or mental ill health. In this systematic review we identified the prevalence of, and reasons and risk factors for, presenteeism in relation to an infectious illness.

Method

We searched Medline, Scopus, Web of Science, PsycINFO and PsycARTICLES with terms relating to infectious illnesses and presenteeism at the work place or school; reference lists of relevant articles were also hand-searched.

Result

Our search yielded 3580 papers after deduplication. After title, abstract and full text screening, 23 papers reporting on 24 studies were included. Twenty-three studies were cross-sectional studies and one was prospective. The quality of included studies was relatively poor due to problems such as sampling and non-response bias. Presenteeism prevalence ranged from 35 to 97%. Self-reported reasons for presenteeism fell into three main themes: 1. Organisational factors (organisational policy, presenteeism culture, disciplinary action), 2. Job characteristics (lack of cover, professionalism, job demand), and 3. Personal reasons (burden on colleagues, colleague perceptions, threshold of sickness absence and financial concerns). Statistical risk factors fell into four themes: 1. Sociodemographic, 2. Health, 3. Influenza-related behaviour, and 4. Employment characteristics. Most of the risk factors had insufficient evidence to allow us to draw any firm conclusions, and evidence regarding gender and age was inconsistent. The risk factor with the most consistent findings concerned occupation type, suggesting that those who worked in the healthcare sector, and specifically physicians, were at a higher risk of infectious illness presenteeism.

Conclusion

Infectious illness presenteeism is common. To address the public health consequences, organisations should focus on promoting a positive working culture and developing sickness absence policies that reduce presenteeism. Further research is needed in non-health sector organisations and schools to identify risk factors related to different organisations, which can then be used to tailor interventions at the organisational and individual level.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7138-x) contains supplementary material, which is available to authorized users.

Expressions of TGF-β1 and EⅢA-FN after Rat Skeletal Muscle Contusion and Wound Age Estimation

Abstract

Objective To study the expressions of transforming growth factor-β1 （TGF-β1） and EⅢA-fibronectin （EⅢA-FN） at different time points of antemortem injury, antemortem injury postmortem expression and postmortem injury and to explore their application value in wound age estimation. Methods A model of rat skeletal muscle contusion was established. The rats were randomly divided into normal control group （n=5）, antemortem contusion group （n=40）, antemortem contusion postmortem expression group （n=110） and postmortem injury group （n=25）. The expressions of TGF-β1 and EⅢA-FN after rat skeletal muscles antemortem contusion were detected with immunohistochemical staining. Expression changes of TGF-β1 and EⅢA-FN mRNA in each group were analyzed with real-time fluorescence quantitative PCR. Results Immunohistochemical staining results showed that a large number of polymorphonuclear leukocyte, mononuclear cells and fibroblastic cells showed a strong expression of TGF-β1 in wounded zones 12 h-14 d after antemortem contusion. EⅢA-FN was mainly distributed in the extracellular matrix, 3 to 7 d post-traumatic. Real-time fluorescence quantitative PCR results showed that TGF-β1 and EⅢA-FN mRNA in antemortem injury group reached the peak at 3 and 5 d post-traumatic respectively. The expressions of TGF-β1 and EⅢA-FN mRNA in antemortem contusion postmortem expression group peaked at 6 h and 12 h postmortem. The expression of TGF-β1 and EⅢA-FN mRNA in postmortem injury group 0.5-12 h postmortem was significantly lower than those of the normal control group and the antemortem contusion group. Conclusion TGF-β1 and EⅢA-FN might become a reference index for skeletal muscle wound age estimation.

[Can urine albumin/creatinine ratio replace 24 hours urinary albumin?]

Objective: To analyze the correlation between urinary albumin/creatinine ratio (ACR) and 24-hour urinary microalbumin (UMA) and evaluate the predictive value of ARC for early diabetic nephropathy. Methods: A total of 368 patients with type 2 diabetes mellitus were retrospectively collected. Early diabetic nephropathy was defined as 24h UMA 30~<300 mg/24h. The correlation between ACR and 24hUMA, and the area under the receiver operating characteristic (ROC) curve of ACR in diagnosis of early diabetic nephropathy were calculated. Gender, age, course of disease, fasting venous blood glucose, glycosylated hemoglobin, blood pressure, triglyceride and total cholesterol were used as adjusting variables to establish univariate and multivariate logistic models of ACR for early diabetic nephropathy, respectively. A regression model was used to evaluate the diagnostic value of ACR for early diabetic nephropathy. Results: The correlation between ACR and 24h UMA was 0.658. The area under ROC curve of ACR for early diabetic nephropathy was 0.907 before and 0.933 after adjustments of gender, age, course of disease, fasting venous blood glucose, glycosylated hemoglobin, blood pressure, triglyceride and total cholesterol, respectively. The OR value of ACR of diabetic nephropathy was 2.016 before and 2.762 after same adjustments. The calibration of Hosmer-Lemeshow chi-square test evaluation model was 19.362 before (P=0.13) and 14.928 after adjustments (P=0.061). Conclusion: ACR is a better predictor for early diabetic nephropathy although its value is influenced by gender, age, course of disease, blood sugar, lipid, and blood pressure.

[Safety and efficacy of second generation drug eluting stents in diabetic and non-diabetic patients]

Objective: To investigate the long-term prognosis of Second generation drug-eluting stents(G2-DES) in diabetic mellitus(DM) and non-DM patients. Methods: Patients with coronary heart disease(CHD) in Fuwai Hospital from January 2013 to December 2013 who had exclusively G2-DES implantation, were consecutively included the follow-up period was 2 years. Results: A total of 6 094 patients with CHD were implanted with G2-DES, of which 1 862 patients with DM, and 4 232 patients without DM.The proportion of DM patients receiving G2-DES implantation with the following characteristics: advanced age, female, hypertension, hyperlipidemia, history of previous stroke, history of peripheral artery disease, previous history of PCI, and with triple vessel, high preoperative Syntax score, high number of target lesions, B2 or C type lesions, severe calcification lesions, and chronic occlusive disease were significantly higher than those of non-DM patients(P<0.05). The incidence of major adverse cardiac and cerebral vascular events(MACCE), target vascular revascularization(TVR) and target lesion revascularization(TLR) were higher in DM patients than in non-DM patients during 2 year's follow-up(P<0.05). The univariate COX regression analysis showed that diabetes was risk factor for MACCE in patients with CHD implanting G2-DES(HR=1.241, 95%CI: 1.053-1.463, P=0.010). However, multivariable COX analysis showed that DM was not an independent risk factor for MACCE in CHD patients with G2-DES(HR=1.125, 95%CI: 0.952-1.330, P=0.167). While age, female, preoperative Syntex score, triple vessel, B2 or C lesion were independent risk factors for poor clinical prognosis in CHD patients with G2-DES. Conclusions: (1) CHD patients with DM often accompany more clinical risk factors and complicated coronary lesions; (2) the incidence of MACCE, TVR and TLR in DM patients is significantly higher than non-DM patients with G2-DES during the 2 year's follow-up; (3) after multivariate adjustment, DM is not an independent risk factor for poor clinical prognosis in CHD patients with G2-DES, while traditional risk factors and complex coronary lesions are independent risk factors for poor clinical prognosis.

Assessment of osteoarthritic features in the thumb base with the newly developed OMERACT magnetic resonance imaging scoring system is a valid addition to standard radiography

OBJECTIVE

To investigate the construct validity of the new thumb base OA magnetic resonance imaging (MRI) scoring system (TOMS) by comparing TOMS scores with radiographic scores in patients with primary hand OA.

DESIGN

In 200 patients (83.5% women, mean (SD) age 61.0 (8.4) years), postero-anterior radiographs and MR scans (1.5 T) of the right first carpometacarpal (CMC-1) and scaphotrapeziotrapezoid (STT) joints, were scored using the OARSI atlas and TOMS, respectively. The distributions of the TOMS scores (specified in results section) were stratified for the OARSI scores of corresponding radiographic features and investigated using boxplots and non-parametric tests. Furthermore, Spearman's rank or Phi correlation coefficients (ρ/φ) were calculated.

RESULTS

For all features, especially for erosions and osteophytes, the prevalence found with MRI was higher than with radiography. TOMS osteophyte and cartilage loss scores differed statistically significant between corresponding OARSI scores in CMC-1 (0 vs 1; 1 vs 2). TOMS scores were positively correlated with radiographic scores in CMC-1 for osteophytes (coefficient [95% confidence interval], ρ = 0.75 [0.69; 0.81]), cartilage loss/joint space narrowing (ρ = 0.70 [0.62; 0.76]), subchondral bone defects (SBDs)/erosion-cyst (ρ = 0.41 [0.29; 0.52]), bone marrow lesions (BMLs)/subchondral sclerosis (ρ = 0.65 [0.56; 0.73]) and subluxation (φ = 0.65 [0.57; 0.73]); and in STT for osteophytes (ρ = 0.30 [0.17; 0.42]) and cartilage loss/joint space narrowing (ρ = 0.53 [0.42; 0.62]).

CONCLUSIONS

In patients with hand OA, TOMS scores positively correlated with radiographic scores, indicating good construct validity. However, the prevalence of features on MR images was higher compared to radiographs, suggesting that TOMS might be more sensitive than radiography. The clinical meaning of these extra MR detected cases is currently still unknown.

Quantitative factors of unenhanced CT for predicting fragmenting efficacy of extracorporeal shock wave lithotripsy on pancreatic duct stones

AIM

To find potential predictors at unenhanced computed tomography (CT) to evaluate the stone clearance rate (SCR) of pancreatic duct stones (PDS) by extracorporeal shock wave lithotripsy (ESWL).

MATERIALS AND METHODS

A total of 106 consecutive patients with multiple stones of maximal transverse length (MTL) 0.3-3.6 cm in pancreatic head region were enrolled. Unenhanced CT was performed both before and after ESWL therapy. All patients underwent ESWL therapy using an electromagnetic lithotripter, and were divided into three groups with threshold values of >90%, 50-90% and <50% of SCR. Factors including sex, age, MTL, mean stone density (MSD), standard deviation of stone density (SDSD), variation coefficient of stone density (VCSD), attenuation density (AD), pancreatic duct diameter (PDD), skin-to-stone distance (SSD), and number of ESWL sessions were analysed, and their impact on SCR was evaluated by univariate and multivariate analyses. The diagnostic threshold of the independent predicting index was further calculated, and its relationship with SCR and ESWL was analysed by drawing a trend line.

RESULTS

The only significant predictor of SCR by ESWL was MSD (p<0.05). More courses of ESWL therapy are required in PDS patients with an MSD higher than the cut-off value of 375.4 HU (mean, 2.6 versus 1.8), but with a relatively lower SCR (mean, 43.96 versus 88.68%) .

CONCLUSION

MSD on pre-treatment unenhanced CT is an independent predictor for SCR of PDS patients treated with ESWL. Using a cut-off value of 375.4 HU, patients with low MSD are good candidates for ESWL therapy.

Abstract P5-07-11: Transcriptome alteration of breast cancer cells in the process of tumor-associated macrophages-promoted metastasis

Introduction: Tumor-associated macrophages (TAMs) play an important role in the process of tumor metastasis. Previous studies have shown that TAMs induce breast cancer cells undergo epithelial-mesenchymal transition (EMT) by secreting CCL18. Reciprocally, the induced mesenchymal-like breast cancer cells activate macrophages into a TAM-like phenotype via secreting the cytokine granulocyte-macrophage colony stimulating factor (GM-CSF), forming a positive feedback loop that is essential to breast cancer metastasis.

Methods: To better understand the underlying mechanism that links this positive feedback loop to breast cancer metastasis, a TAMs-induced EMT cell model (MCF-7) was used. RNA-seq was used to compare the transcriptome of MCF-7 cells which were cocultured with TAMs and those with or without monocyte-derived macrophages (MDMs). Results were further verified by qRT-PCR.

Results: Among 811 known protein-coding genes with reliable readouts, 42 were significantly changed between groups (P&lt;0.001). Further analysis using KEGG, Reactome and Wikipathways databases found that these 42 genes were enriched in 15 signal pathways (P&lt;0.01). According to their biological function, these pathways can be divided into 5 functional groups: SUMOylation related, virus related, immune related, interferon related and cytokine related. The last 3 groups demonstrated that our model were representative and able to provide some real and useful information, while SUMOylation and virus related signal pathways have never been reported to be involved in TAMs induced breast cancer metastasis.

Conclusion: We investigated the transcriptome alteration of MCF-7 cells in the process of TAMs-promoted metastasis. Results from bioinformatic analysis indicated SUMOylation and virus related signal pathways in the process of TAMs induced breast cancer metastasis, which are yet to be confirmed.

Citation Format: Long M, Yang M, An J, Su H, Liu R. Transcriptome alteration of breast cancer cells in the process of tumor-associated macrophages-promoted metastasis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-07-11.

[Effects of PSMB5 on proliferation and bortezomib chemo-resistance in human myeloma cells and its related molecular mechanisms]

Objective: To investigate the effects of proteasome beta 5 subunit (PSMB5) on proliferation and bortezomib (BTZ) chemo-sensitivity of multiple myeloma (MM) and its related molecular mechanisms. Methods: We used two MM cell lines, RPMI 8226 and BTZ drug-resistant cell line RPMI 8226/BTZ100 (hereinafter referred to as BTZ100) , as the research object. PSMB5 was overexpressed or knocked down in two myeloma cell lines via lentivirus transfection. CCK8 assay was used to detect the impact of PSMB5 on cell viability and bortezomib sensitivity in human myeloma cells; Using flow cytometry to test the effects of PSMB5 on apoptosis rate of human myeloma cells under the treatment of bortezomib; Apoptosis-related gene expression of Bax, Bcl-2, p-Akt and cleaved caspase-3 were detected by Western blot. Results: ①PSMB5 overexpression and knockdown were successfully constructed in RPMI 8226 and BTZ100 cells. ②PSMB5 expression was positively correlated with cell proliferation of RPMI 8226 and BTZ100 cells (P<0.05) . ③The cell viability was lower after PSMB5 knockdown in RPMI 8226 cells than control cells under the same concentration of BTZ[IC(50) at 24 h: (7.01±0.47) and (9.64±0.55) nmol/L respectively, t=6.289, P=0.003]. The cell viability was higher after PSMB5 overexpression in RPMI 8226 cells than control cells under the same concentration of BTZ[IC(50) at 24 h: (10.99±0.58) and (9.51±0.37) nmol/L respectively, t=3.724, P=0.020) . PSMB5 expression was negatively correlated with the sensitivity of RPMI 8226 cells to BTZ. The results of BTZ100 cells were similar. ④The expression of PSMB5 was negatively correlated with the apoptosis of RPMI 8226 and BTZ100 under the treatment of BTZ. ⑤Meanwhile, PSMB5 knockdown could increase the expression of pro-apoptosis gene Bax and cleaved caspase-3 and decrease the expression of anti-apoptotic gene Bcl-2 and p-Akt. PSMB5 over-expression has the opposite results. Conclusion: PSMB5 knockdown could improve the bortezomib sensitivity of MM cells via activation of apoptosis signaling. PSMB5 may be a potential therapeutic target for MM.

[Predictive value of neutrophil to lymphocyte ratio on long-term outcomes of acute myocardial infarction patients with multivessel disease]

Objective: Patients with acute coronary syndrome due to multivessel disease (MVD) were at the highest risk of adverse cardiovascular events. Neutrophil to lymphocyte ratio (NLR) was proposed as a marker of cardiovascular risk. Present study evaluated the independent predictive value of NLR for acute myocardial infarction (AMI) patients with MVD. Methods: AMI patients with MVD (n=1 433) underwent percutaneous coronary intervention (PCI) between January 2013 and December 2013 were followed up for 2 years. Patients were divided into 2 sub-groups based on an optimal cut off value of NLR to predict 2-year all-cause mortality. The primary endpoint was all-cause death. The secondary endpoint was long-term major adverse cardiovascular and cerebrovascular events (MACCE). Results: By receiver operating characteristics curve analysis, the optimal cut-off value of admission NLR to predict 2-year all-cause mortality was 3.39 (area under the curve 0.765, sensitivity 71%, specificity 73%). The high NLR group(n=396) had higher prevalence of prior myocardial infarction, prior PCI and intra-aortic balloon pump use (IABP)(P<0.01). Compared to the low NLR group (n=1 037), patients in the high NLR group were older, had higher level of neutrophil count and high-sensitivity C-reactive protein (hs-CRP) (P<0.001), but lower level of lymphocyte count, estimated glomerular filtration rate (eGFR) and ejection fraction (P<0.001). During the follow-up period, rate of long-term all-cause death was significantly higher in the high NLR group than in the low NLR group (5.1% (20/396) vs. 0.8% (8/1 037), P<0.001). Cardiac death (4.0% (16/396) vs. 0.7% (7/1 037), P<0.001) and MACCE (21.7% (86/396) vs. 12.6% (131/1 037), P<0.001) were also significantly higher in the high NLR group than in the low NLR group. Multivariate Cox analysis showed that NLR ≥ 3.39 was determined as an independent predictor of 2-year all-cause mortality (HR=3.23, 95%CI 1.38-7.54, P=0.007) and MACCE (HR=1.58, 95%CI 1.19-2.10, P=0.002) in this patient cohort after adjusting for other risk factors. Correlation analysis showed that the NLR was positively correlated with hs-CRP levels (r=0.241, P<0.001). Conclusion: Our study demonstrates that admission NLR ≥ 3.39 is an independent predictor of long term all cause death and MACCE in AMI patients with MVD post PCI.

Effects of genomic selection for intramuscular fat content in breast muscle in Chinese local chickens

Improvements in living standards have resulted in consumers having higher expectations for chicken meat quality. This is particularly true in Asia, where there is high consumer preference for local breeds. Nothing is presently known about the effectiveness of using genomic selection (GS) strategies in chickens to genetically improve meat quality traits that cannot be measured in living potential parents. In this study, 724 Beijing-You chickens were used as a training population; all were genotyped using Illumina 60K SNP chips, and intramuscular fat content in breast muscle (IMFbr ) was measured. Birds in the GS line were selected based on genomic estimated breeding values, IMFbr being the sole trait. Genetic progress in one generation was compared to that from conventional family-based selection, and both were evaluated against random-bred controls. Results showed that relative to the random-bred controls, IMF percentage was improved 9.62% using GS, comparable to the 10.38% improvement using family-based selection. We quantified the effectiveness of GS when applied to a meat quality trait with low heritability in chickens. We plan to introduce custom SNP chips, appropriate for native chicken breeds in China, to assist in applying GS in local breeding and accelerate genetic gain.

Activation of the cannabinoid receptor 2 increases renal perfusion

Acute kidney injury (AKI) is an increasing clinical problem that is associated with chronic kidney disease progression. Cannabinoid receptor 2 (CB2) activation has been shown to mitigate some of the deleterious tubular effects due to AKI, but its role on the renal vasculature has not been fully described. In this study, we investigated the effects of our novel CB2 receptor agonist, SMM-295, on renal vasculature by assessing cortical perfusion with laser Doppler flowmetry and changes in luminal diameter with isolated afferent arterioles. In this study, intravenously infused SMM-295 (6 mg/kg) significantly increased cortical renal perfusion (13.8 ± 0.6%; P < 0.0001; n = 7) compared with vehicle (0.1 ± 1.5%; n = 10) normalized to baseline values in anesthetized C57BL/6J mice. This effect was not dependent upon activation of the CB1 receptor (met-anandamide; 6 mg/kg iv) and was predominantly abolished in Cnr2 knockout mice with SMM-295 (6 mg/kg iv). Ablation of the renal afferent nerves with capsaicin blocked the SMM-295-dependent increase in renal cortical perfusion, and the increased renal blood flow was not dependent upon products synthesized by cyclooxygenase or nitric oxide synthase. The increased renal perfusion by CB2 receptor activation is also attributed to a direct vascular effect, since SMM-295 (5 μM) engendered a significant 37 ± 7% increase ( P < 0.0001; n = 4) in luminal diameters of norepinephrine-preconstricted afferent arterioles. These data provide new insight into the potential benefit of SMM-295 by activating vascular and nonvascular CB2 receptors to promote renal vasodilation, and provide a new therapeutic target to treat renal injuries that impact renal blood flow dynamics.

[Advances in the research of characteristics and treatment of burns in the elderly]

With the development of society and the improvement of medical level, the average life span of human has been increasing year by year. The proportion of elderly burn patients is also increasing yearly, which has become a social problem that can not be ignored. Because of physiological characteristics, such as decreased function of heart, lung, and kidney, degenerative changes of neural system, reduced gastrointestinal function and immunological function, and mostly accompanied by primary diseases of diabetes and cardiovascular diseases, elderly burn patients suffer from high shock rate and mortality, and their wounds are not easy to heal. With the purpose of providing ideas for prevention and treatment of elderly burn patients, this review summarizes the physiological characteristics, wound treatment, fluid resuscitation, organ protection, nutrition support, and psychological guidance of elderly burn patients.