Do early postnatal body weight changes contribute to neonatal morbidities in the extremely low birth weight infants

BACKGROUND

The implications of early postnatal body weight changes (Δbw) in the morbidities related to body fluid metabolism in sick preterm infants in not well investigated. The extremely low birth weight infants (ELBW, birth weight <1000 g) have the highest incidence of such morbidities among all neonates.

AIM

To determine the relationships between Δbw and neonatal morbidities associated with body fluid metabolism in the ELBW infants.

METHODS

In an observational study, the associations between daily weight changes from birth weight (DΔ bw) and oxygen dependence on postnatal day 28 (BPD28), patent ductus arteriosus (PDA), intraventricular-periventricular hemorrhage (IVH), antenatal steroid (ANS) and gestational age (GA) were evaluated. Maximum weight loss (MΔ bw) was correlated with GA, BPD28 and BPD36 (oxygen dependence on postmenstrual 36 weeks). Pearson's correlation co-efficient and multivariate logistic regressions were performed for analysis.

RESULTS

DΔ bw correlated inversely with GA on days 1-8 of life (p <  0.01 for all, 0.06 for DOL 2). DΔ bw was associated with a lower risk of BPD28 on days 6 (OR 0.87, 95% CI 0.76-1), 10 (OR 0.86, 95% CI 0.76-0.98) and 11 (OR 0.87, 95% CI 0.77-0.99); with PDA on days 8-11 (OR ranging between 0.89 to 0.92 for the 4 days, 95% CI 0.83 to 0.99) and with IVH on day 5 (OR 0.93, 95% CI 0.86-1) after controlling for GA. DΔ bw was not identified as risk factor for the tested morbidities. ANS decreased DΔ bw on days 4 (OR 0.88, 95% CI 0.78-1) and 10 (OR 0.9, 95% CI 0.84-1). MΔbw correlated directly with BPD28 (r = 0.3, p = 0.004), which declined after controlling for GA (r = 0.2, p = 0.2).

CONCLUSIONS

DΔ bw is protective for PDA, BPD28 and IVH, independent of gestational age, whereas, the effects of MΔ bw on BPD are governed by maturation in ELBW infants. ANS decreases DΔbw, which correlates inversely with GA during the first week of life.

Quantitative characterization of T-cell repertoire in allogeneic hematopoietic stem cell transplant recipients

Allogeneic hematopoietic stem cell transplantation (HSCT) is one of curative treatment options for patients with hematologic malignancies. Although GVHD mediated by the donor's T lymphocytes remains the most challenging toxicity of allo-HSCT, graft-versus-leukemia (GVL) effect targeting leukemic cells, has an important role in affecting the overall outcome of patients with AML. Here we comprehensively characterized the TCR repertoire in patients who underwent matched donor or haplo-cord HSCT using next-generation sequencing approach. Our study defines the functional kinetics of each TCRA and TCRB clone, and changes in T-cell diversity (with identification of CDR3 sequences) and the extent of clonal expansion of certain T-cells. Using this approach, our study demonstrates that higher percentage of cord-blood cells at 30 days after transplant was correlated with higher diversity of TCR repertoire, implicating the role of cord-chimerism in enhancing immune recovery. Importantly, we found that GVHD and relapse, exclusive of each other, were correlated with lower TCR repertoire diversity and expansion of certain T-cell clones. Our results highlight novel insights into the balance between GVHD and GVL effect, suggesting that higher diversity early after transplant possibly implies lower risks of both GVHD and relapse following the HSCT transplantation.

Boronic acid-based enzyme inhibitors: a review of recent progress

Since Bortezomib was approved by US FDA as the first drug to treat multiple myeloma, various boronic acid compounds have been developed as enzyme inhibitors. This paper reviewed the progress of boronic acid-based inhibitors against enzymes including proteasome, serine protease, HDACs and other enzymes in the past decade.

Preparation and evaluation of monoclonal antibodies against chlamydial protease-like activity factor to detect Chlamydia pneumoniae antigen in early pediatric pneumonia

Chlamydia pneumoniae causes diseases in humans, including community-acquired pneumonia, bronchitis, and sinusitis. It is also associated with atherosclerosis, coronary heart disease, and hyperlipidemia. In this study, we investigated novel materials with which to develop a sensitive and specific method to identify early C. pneumoniae infection, to allow more effective clinical treatment and prevention. We prepared novel monoclonal antibodies (mAbs) against a recombinant protein equivalent to the immunodominant region of chlamydial protease-like activity factor (CPAF) from C. pneumoniae. The mAbs specifically reacted with the endogenous CPAF antigen of the C. pneumoniae type strain in immunoblotting and indirect immunofluorescence (IIF) assays, but did not react with C. trachomatis type strains or genital secretions from patients with acute C. trachomatis infection. The mAb with the highest titer was used to develop a new IIF assay and enzyme-linked immunosorbent assay (ELISA) to detect the C. pneumoniae antigen in clinical specimens from child patients suspected of pneumonia. The sensitivity, specificity, and concordance rate of the mAb-based IIF and ELISA tests were compared with those of polymerase chain reaction (PCR). Our results show that these mAbs have excellent specificity and may be used to develop new screening tools for the diagnosis of early pediatric pneumonia.

Adaptive state observer and PD control for dynamic perturbations in optical systems

High-performance objectives pose strict limitations on residual errors present in the system. External mechanical influences can induce structural vibrations in the optical system which causes a displacement of the lenses present in the system. This will influence the imaging performance, causing degraded images or broadened structures in a lithographic processes. In this paper an adaptive state observer for the detection of structural vibrations of the optical elements of an imaging system based on a series of wavefront tilt measurements is introduced. The observer output is used as an input for a closed-loop PD control to mitigate the lens displacements directly.

Anti-C1q antibodies in systemic lupus erythematosus

OBJECTIVE

Anti-C1q has been associated with systemic lupus erythematosus (SLE) and lupus nephritis in previous studies. We studied anti-C1q specificity for SLE (vs rheumatic disease controls) and the association with SLE manifestations in an international multicenter study.

METHODS

Information and blood samples were obtained in a cross-sectional study from patients with SLE (n = 308) and other rheumatologic diseases (n = 389) from 25 clinical sites (84% female, 68% Caucasian, 17% African descent, 8% Asian, 7% other). IgG anti-C1q against the collagen-like region was measured by ELISA.

RESULTS

Prevalence of anti-C1q was 28% (86/308) in patients with SLE and 13% (49/389) in controls (OR = 2.7, 95% CI: 1.8-4, p < 0.001). Anti-C1q was associated with proteinuria (OR = 3.0, 95% CI: 1.7-5.1, p < 0.001), red cell casts (OR = 2.6, 95% CI: 1.2-5.4, p = 0.015), anti-dsDNA (OR = 3.4, 95% CI: 1.9-6.1, p < 0.001) and anti-Smith (OR = 2.8, 95% CI: 1.5-5.0, p = 0.01). Anti-C1q was independently associated with renal involvement after adjustment for demographics, ANA, anti-dsDNA and low complement (OR = 2.3, 95% CI: 1.3-4.2, p < 0.01). Simultaneously positive anti-C1q, anti-dsDNA and low complement was strongly associated with renal involvement (OR = 14.9, 95% CI: 5.8-38.4, p < 0.01).

CONCLUSIONS

Anti-C1q was more common in patients with SLE and those of Asian race/ethnicity. We confirmed a significant association of anti-C1q with renal involvement, independent of demographics and other serologies. Anti-C1q in combination with anti-dsDNA and low complement was the strongest serological association with renal involvement. These data support the usefulness of anti-C1q in SLE, especially in lupus nephritis.

A mechanism study on propofol's action on middle latency auditory evoked potential by neurons in ventral partition of medial geniculate body in rats

OBJECTIVES

To investigate the effect of propofol on the middle latency auditory evoked potentials (MLAEP) by neurons in the ventral partition of medial geniculate body (MGBv) in rats and study their mechanism.

MATERIALS AND METHODS

Sprague-Dawley (SD) rats were randomly divided into 7 groups (n = 6): group normal saline (NS), group intralipid (I), and groups of different concentrations of propofol (5.6, 16.8, 56, 168, 560 µmol/L) (P1-P5). These animals were anesthetized with ether, tracheostomized, and mechanically ventilated. After anesthesia, rats were paralyzed with vecuronium and fixed. A recording needle electrode with drugs was inserted into MGBv by means of stereotaxis. After injection of 0.2 µl propofol, normal saline or intralipid, correct insertion was verified by MLAEP response to standard sound. MLAEP including amplitudes and latencies of N0, P0, Na, Pa, and Nb waves were recorded. To identify which ion channel could be impacted by propofol, SD rats were divided into Ni2+ plus propofol (A1 group), Cd2+ plus propofol (A2 group), 4-AP plus propofol (A3 grouop), and TTX plus propofol (A4 group). The changes of MLAEP were recorded between injecting 4 ion channel blockers and propofol. Whole-cell patch clamp technique was used to confirm these variations.

RESULTS

There was no significant changes in all waves of MLAEP in MGBv after drug administration as compared with the baselins before injection in group NS, I, P1, and P2. The latency of Na, Pa, and Nb wave was significantly prolonged and the amplitude of Pa wave was decreased after injection as compared with the baseline in group P3, P4, and P5. The latency of Na, Pa, and Nb waves was significantly longer and the amplitude of Pa wave was significantly lower in group P3, P4, and P5 than in group NS and I. With TTX, amplitudes were decreased in wave Na-Pa. After given propofol, waves were unchanged in Na-Pa and latency was increased in Na, Pa, and Nb. With Cd2+, latency was unchanged in Na, Pa, and Nb as well as amplitudes decreasing in Na-Pa. Nevertheless, after given Ni2+ and 4-AP, every wave of MLAEP had no changes. After injected propofol, amplitudes were decreased in wave Na-Pa and latency was increased in Na, Pa, and Nb. The results of patch clamp showed 56 µmol/L, 168 µmol/L and 560 µmol/L propofol inhibited the persistent sodium currents and high voltaged activated calcium currents in the brain slices of rats.

CONCLUSIONS

Propofol in 56 µmol/L, 168 µmol/L and 560 µmol/L can inhibit MLAEP in MGBv of rats in a dose-dependent manner and these changes may be caused by blocking the ion channel of persistent sodium currents and high voltaged activated calcium currents.

Evaluation of the therapeutic effect of treatment with intra-articular hyaluronic acid in knees for Kashin-Beck disease: a meta-analysis

OBJECTIVE

To assess the efficacy and safety of intra-articular hyaluronic acid (IAHA) injection in knee joints of patients with Kashin-Beck disease (KBD).

METHODS

We searched nine electronic databases as well as unpublished data from inception until November 30th 2013 using a combination of search terms for KBD and hyaluronic acid (HA). For dichotomous data, odds ratios (OR) and 95% confidence intervals (CI) were estimated. For continuous data, standard mean difference (SMD) was used for outcomes pooled on the difference scale using a "random-effects" or "fixed-effects" model. We also compared the mean and standard deviation of cytokine levels in post-treatment.

RESULTS

The seven eligible trials included 954 IAHA and 495 control patients. The methodological quality of included trials was low. The overall effectiveness of the IAHA group and control group were 93.7% and 62.9%, respectively. IAHA group resulted in very large treatment effects compared to pre-treatment values in 12 months, with SMD values ranging from 1.19-2.64 (all P < 0.05). Compared to controls, SMDs in IAHA group ranged from 0.19-0.64 at 1 week to 1 month (all P > 0.05) and 0.68-1.47 at 2 months to 12 months (all P < 0.05). There was significant improved of HA, cluster of differentiation44 (CD44), keratan sulfate (KS), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and nitric oxide (NO) contents in serum compared with that in the post-treatment and healthy control in non-KBD area (all P < 0.05).

CONCLUSION

IAHA for the treatment of KBD was safe and efficacious at 12 months with low and transient adverse reactions. However, more high-quality randomized controlled trials (RCTs) are needed to confirm its therapeutic effect.

Mechanism of ulinastatin protection against lung injury caused by lower limb ischemia-reperfusion

AIM

The aim of this paper was to investigate the mechanism of ulinastatin's protection of lung from injury caused by lower limb ischemia-reperfusion in a rat model.

METHODS

Male, Sprague-Dawley rats were divided into three groups: saline control (CON), lung injury group, caused by lower limb ischemia-reperfusion (LIR) by rubber band ligation of the lower limbs for 3 h, followed by reperfusion for 3 h and lung injury with ulinastatin pretreatment intravenously before ligation (UTI). Carotid arterial blood was drawn 3 h postreperfusion for gas analysis, and alveolar lavage of one lung was performed. Rats were then sacrificed and lungs were taken for pathological examination and to detect phosphorylated and total p38, JNK, ERK levels. Inflammatory cell count and cytokines TNF-α, IL-1, IL-6 were measured from the lavage fluid.

RESULTS

There was significant inflammatory cell infiltration, hemorrhaging, and edema of the lung in the LIR group, all of which were reduced significantly in the UTI group. Oxygenation index in the LIR was lower than the CON while it was higher in the UTI than the LIR group. Compared to the CON group, white blood cell count in the alveolar lavage fluid from LIR group was increased, while this is lower in the UTI. Lavage fluid TNF-α, IL-β, and IL-6 levels were higher in the LIR group than the CON group, and were significantly lower in the UTI than the LIR. LIR group exhibited increased phosphorylated ERK, JNK and p38; UTI group rats also had enhanced p-ERK levels, but had decreased p-p38 and p-JNK.

CONCLUSION

Ulinastatin pre-treatment reduces lung injury caused by lower limb ischemia-reperfusion via a mechanism that may involve inhibition of inflammatory cytokine production via p-JNK and p-p38 pathways.

Chronic urticaria in Chinese population: a hospital-based multicenter epidemiological study

BACKGROUND

The epidemiologic profiles of chronic urticaria (CU) vary considerably among regions, and few such data are available from China.

METHODS

We performed a multicenter open questionnaire investigation about the clinical and laboratory features of CU, defined as recurrent wheals with/without angioedema lasting for ≥6 weeks, among 3027 patients.

RESULTS

Female preponderance was observed (female/male ratio, 1.46 : 1). The mean age at diagnosis was 34.7 ± 13.8 years, and the mean disease duration was 18.5 ± 46.1 months (range, 1.5-127 months). Patients were classified as having chronic spontaneous urticaria (CSU, 61.0% of patients), physical urticaria (PU, 26.2%), or other urticaria types (OU, 2.3%). Nocturnal attacks were reported by 60% of cases. The Urticaria Activity Score (UAS) in patients with CSU was 3.8 ± 1.4. The mean Dermatology Life Quality Index was 7.3 ± 3.4 (range 0-30). Induction or exacerbation of wheals with alcohol drinking was reported by 55.7% of patients. Chronic hepatitis B was less prevalent in our CU patients compared with the general Chinese population (2.7% vs 7%). Positive autologous serum skin tests (ASSTs) were observed in 66.9% of patients. Patients with positive ASST had higher UAS, greater angioedema frequencies, longer disease durations, and poorer QoL compared with patients with negative ASST (P < 0.05).

CONCLUSION

In this Chinese population, CU usually affected youth, and CSU was the most common subtype. Autoreactivity and alcohol consumption were the top two triggers for CU, whereas latent infectious and chronic inflammatory diseases were not as common as in previous reports.

Exploring the FDA adverse event reporting system to generate hypotheses for monitoring of disease characteristics

The US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) is a database for postmarketing drug safety monitoring and influences changes in FDA safety guidance documents such as drug labels. The number of cases in the FAERS has rapidly increased with the improvement of submission methods and data standards and thus has become an important resource for regulatory science. Although the FAERS has been predominantly used for safety signal detection, this study explored its utility for disease characteristics.

Population genetic structure and geographical differentiation of burbot (Lota lota) in China

The burbot (Lota lota Linnaeus, 1758) is the only freshwater species of the family Gadidae. There is a long-standing controversy about taxonomic status of the burbot from the Amur River basin. It is necessary to investigate population genetic structure and geographical differentiation among burbot populations from the Irtysh River basin and Amur River basin by mitochondrial DNA nucleotide sequence analysis. A 572 bp segment of cytochrome b and 425 bp segment of control region gene were sequenced from 4 populations. The results showed that there was lower genetic diversity of burbot in China and highly significant genetic difference between populations in the Amur Riverbasin (P < 0.01). Demographic analysis indicated that the burbot from the Amur River basin experienced population expansion (Cytb: F(s) = -0.912 (P = 0.287), D = -0.399 (P = 0.375); CR: F(s) = -4.771 (P = 0.015), D = -1.523 (P = 0.03 )). The data of 4 populations in China combining with the published data representing the Eurasian and North American burbot, revealed three distinct phylogenetic lineages (labelled EB, NA, Amur).