Secondary ear reconstruction based on the Nagata method after unsatisfactory microtia surgery outcomes

BACKGROUND

Follow-up studies on auricular reconstruction procedures have reported postoperative complications; some of which can only be reversed with revision surgery. This study aims to provide a feasible surgical strategy based on the Nagata method for patients requiring secondary revision and verify mid-term aesthetic outcomes.

METHODS

Secondary auricular reconstructions based on the Nagata method were performed on seven patients seeking secondary revision between 2017 and 2021. Scores of a five-point Likert scale and artificial intelligence ratings based on convolutional nerve networks were used as outcome measures.

RESULTS

Five patients underwent complete two-stage ear reconstruction, and the other two patients underwent the first-stage microtia procedure only. Few complications were observed, except in Case 4; this patient required an additional minor surgery after frame exposure 6 weeks after the first-stage procedure. All revised ears showed clear anatomical structures, and all patients were satisfied with the aesthetic results. Statistical analysis showed a significant increase in postoperative versus preoperative scores by convolutional neural network models (p < 0.05). Cases 5 and 6, which involved projection surgeries only, had decreased artificial intelligence appearance scores postoperatively.

CONCLUSION

After adequate preoperative evaluation, secondary auricle reconstruction based on the Nagata method can achieve reliable aesthetic outcomes with few complications.

CLINICAL TRIAL REGISTRATION INFORMATION

ClinicalTrials.gov ID: NCT05604456.

Identification and validation of candidate clinical signatures of apolipoprotein L isoforms in hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a lethal malignancy worldwide with an increasing number of new cases each year. Apolipoprotein (APOL) isoforms have been explored for their associations with HCC.The GSE14520 cohort was used for training data; The Cancer Genome Atlas (TCGA) database was used for validated data. Diagnostic, prognostic significance and mechanisms were explored using these cohorts. Risk score models and nomograms were constructed using prognosis-related isoforms and clinical factors for survival prediction. Oncomine and HCCDB databases were further used for validation of diagnostic, prognostic significance. APOL1, 3, and 6 were differentially expressed in two cohorts (all P ≤ 0.05). APOL1 and APOL6 had diagnostic capacity whereas APOL3 and APOL6 had prognostic capacity in two cohorts (areas under curves [AUCs] > 0.7, P ≤ 0.05). Mechanism studies demonstrated that APOL3 and APOL6 might be involved in humoral chemokine signaling pathways (all P ≤ 0.05). Risk score models and nomograms were constructed and validated for survival prediction of HCC. Moreover, diagnostic values of APOL1 and weak APOL6 were validated in Oncomine database (AUC > 0.700, 0.694); prognostic values of APOL3 and APOL6 were validated in HCCDB database (all P < 0.05). Differentially expressed APOL1 and APOL6 might be diagnostic biomarkers; APOL3 and APOL6 might be prognostic biomarkers of RFS and OS for HCC via chemokine signaling pathways.

[Phenotype and genotype analyses of two pedigrees with inherited fibrinogen deficiency]

Objective: To analyze the phenotype and genotype of two pedigrees with inherited fibrinogen (Fg) deficiency caused by two heterozygous mutations. We also preliminarily probed the molecular pathogenesis. Methods: The prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and plasma fibrinogen activity (Fg∶C) of all family members (nine people across three generations and three people across two generations) were measured by the clotting method. Fibrinogen antigen (Fg:Ag) was measured by immunoturbidimetry. Direct DNA sequencing was performed to analyze all exons, flanking sequences, and mutated sites of FGA, FGB, and FGG for all members. Thrombin-catalyzed fibrinogen polymerization was performed. ClustalX 2.1 software was used to analyze the conservatism of the mutated sites. MutationTaster, PolyPhen-2, PROVEAN, SIFT, and LRT online bioinformatics software were applied to predict pathogenicity. Swiss PDB Viewer 4.0.1 was used to analyze the changes in protein spatial structure and molecular forces before and after mutation. Results: The Fg∶C of two probands decreased (1.28 g/L and 0.98 g/L, respectively). The Fg∶Ag of proband 1 was in the normal range of 2.20 g/L, while it was decreased to 1.01 g/L in proband 2. Through genetic analysis, we identified a heterozygous missense mutation (c.293C>A; p.BβAla98Asp) in exon 2 of proband 1 and a heterozygous nonsense mutation (c.1418C>G; p.BβSer473*) in exon 8 of proband 2. The conservatism analysis revealed that Ala98 and Ser473 presented different conservative states among homologous species. Online bioinformatics software predicted that p.BβAla98Asp and p.BβSer473* were pathogenic. Protein models demonstrated that the p.BβAla98Asp mutation influenced hydrogen bonds between amino acids, and the p.BβSer473* mutation resulted in protein truncation. Conclusion: The dysfibrinogenemia of proband 1 and the hypofibrinogenemia of proband 2 appeared to be related to the p.BβAla98Asp heterozygous missense mutation and the p.BβSer473* heterozygous nonsense mutation, respectively. This is the first ever report of these mutations.

Clinical implications of RAB13 expression in pan-cancer based on multi-databases integrative analysis

Worldwide, cancer is a huge burden, and each year sees an increase in its incidence. RAB (Ras-related in brain) 13 is crucial for a number of tumor types. But more research on RAB13's tumor-related mechanism is still required. This study's goal was to investigate RAB13's function in human pan-cancer, and we have also preliminarily explored the relevant mechanisms. To investigate the differential expression, survival prognosis, immunological checkpoints, and pathological stage of RAB13 in human pan-cancer, respectively, databases of TIMER2.0, GEPIA 2, and UALCAN were employed. CBioPortal database was used to analyze the mutation level, meanwhile, PPI network was constructed based on STRING website. The putative functions of RAB13 in immunological infiltration were investigated using single sample gene set enrichment analysis (ssGSEA). The mechanism of RAB13 in hepatocellular cancer was also briefly investigated by us using gene set enrichment analysis (GSEA). RAB13 was differentially expressed in a number of different cancers, including liver hepatocellular carcinoma (LIHC), stomach adenocarcinoma (STAD), etc. Additionally, RAB13 overexpression in LGG and LIHC is associated with a worse prognosis, including overall survival (OS) and disease-free survival (DFS). Then, we observed that early in BLCA, BRAC, CHOL, ESCA, HNSC, KICH, KIRC, LIHC, LUAD, LUSC, and STAD, the level of RAB13 expression was raised. Next, we found that "amplification" was the most common mutation in RAB13. The expression of SLC39A1, JTB, SSR2, SNAPIN, and RHOC was strongly positively linked with RAB13, according to a correlation study. RAB13 favorably regulated B cell, CD8 + T cell, CD4 + T cell, macrophage, neutrophil, and dendritic cell in LIHC, according to immune infiltration analysis. Immune checkpoint study revealed a positive correlation between RAB13 expression and PD1, PDL1, and CTLA4 in LIHC. According to GSEA, RAB13 is involved in a number of processes in LIHC, including MTORC1 signaling, MYC targets v1, G2M checkpoint, MITOTIC spindle, DNA repair, P53 pathway, glycolysis, PI3K-AKT-MTOR signaling, etc. RAB13 is a possible therapeutic target in LIHC and can be used as a prognostic marker.

Mechanisms and regulations of ferroptosis

Regulation of cell mortality for disease treatment has been the focus of research. Ferroptosis is an iron-dependent regulated cell death whose mechanism has been extensively studied since its discovery. A large number of studies have shown that regulation of ferroptosis brings new strategies for the treatment of various benign and malignant diseases. Iron excess and lipid peroxidation are its primary metabolic features. Therefore, genes involved in iron metabolism and lipid metabolism can regulate iron overload and lipid peroxidation through direct or indirect pathways, thereby regulating ferroptosis. In addition, glutathione (GSH) is the body's primary non-enzymatic antioxidants and plays a pivotal role in the struggle against lipid peroxidation. GSH functions as an auxiliary substance for glutathione peroxidase 4 (GPX4) to convert toxic lipid peroxides to their corresponding alcohols. Here, we reviewed the researches on the mechanism of ferroptosis in recent years, and comprehensively analyzed the mechanism and regulatory process of ferroptosis from iron metabolism and lipid metabolism, and then described in detail the metabolism of GPX4 and the main non-enzymatic antioxidant GSH in vivo.

[Clinical phenotype and gene mutation analysis of 12 patients with hereditary protein C deficiency in different families]

Objective: To investigate the molecular pathogenesis and clinical features of unrelated 12 patients with inherited coagulation protein C (PC) deficiency in Chinese population. Methods: The PC activity (PC:A) and PC antigen (PC:Ag) were detected by chromogenic substrate and enzyme linked immunosorbent assay, respectively. The nine exons and flanking sequences of the protein C (PROC) gene were amplified by polymerase chain reaction with direct sequencing, and the suspected mutations were validated by reverse sequencing (clone sequencing for deletion mutations) . Results: The PC:A of the 12 probands decreased significantly, ranging from 18% to 55%, and the PC:Ag of the 10 probands decreased significantly. Eleven mutations were found, out of which four mutations [c.383G>A (p.Gly128Asp) , c.997G>A (p.Ala291Thr) , c.1318C>T (p.Arg398Cys) , and c.532G>C (p.Leu278Pro) ] were discovered for the first time. Six mutations were in the serine protease domain, four mutations were located in epidermal growth factor (EGF) -like domains, and one mutation was located in activation peptide. There were two deletion mutations (p.Met364Trp fsX15 and p.Lys192del) , and the rest were missense mutations. Mutations p.Phe181Val and p.Arg189Trp were identified in three unrelated families. All mutations may be inherited, and consanguineous marriages were reported in two families. Among the probands, nine cases had venous thrombosis, two cases had poor pregnancy manifestations, and one case had purpura. Conclusion: Patients with PC deficiency caused by PROC gene defects are prone to venous thrombosis, especially when there are other thrombotic factors present at the same time.

[Analysis of a pedigree with inherited factor V deficiency caused by compound heterozygous mutation]

Objective: To explore the molecular pathogenesis of a family with hereditary factor Ⅴ (FⅤ) deficiency. Methods: All the exons, flanking sequences, 5' and 3' untranslated regions of the F5 of the proband, and the corresponding mutation sites of the family members were analyzed via direct DNA sequencing. The CAT measurement was used to detect the amount of thrombin produced. The ClustalX software was used to analyze the conservation of mutation sites. The online bioinformatics software, Mutation Taster, PolyPhen-2, PROVEAN, LRT, and SIFT were applied to predict the effects of mutation sites on protein function. The Swiss-PdbViewer software was used to analyze the changes in the protein model and intermolecular force before and after amino acid variation. Results: The proband had a heterozygous missense mutation c.1258G>T (p.Gly392Cys) in exon 8 of the F5, and a heterozygous deletion mutation c.4797delG (p.Glu1572Lys fsX19) in exon 14, which results in a frameshift and produces a truncated protein. Her grandfather and father had p.Gly392Cys heterozygous variation, whereas her maternal grandmother, mother, little aunt, and cousin all had p.Glu1572LysfsX19 heterozygous variation. The ratio of proband's thrombin generation delay to peak time was significantly increased. Conservation analysis results showed that p.Gly392 was located in a conserved region among the 10 homologous species. Five online bioinformatics software predicted that p.Gly392Cys was pathogenic, and Mutation Taster also predicted p.Glu1572Lys fsX19 as a pathogenic variant. Protein model analysis showed that the replacement of Gly392 by Cys392 can lead to the extension of the original hydrogen bond and the formation of a new steric hindrance, which affected the stability of the protein structure. Conclusion: The c.1258G>T heterozygous missense mutation in exon 8 and the c.4797delG heterozygous deletion mutation in exon 14 of the F5 may be responsible for the decrease of FⅤ levels in this family.

[Comparative study on metagenomics of esophageal flora in elderly and middle-aged esophageal squamous cell carcinoma patients]

Objective: To explore the flora characteristics and differences of esophageal tissues between elderly esophageal squamous cell carcinoma (ESCC) patients and young and middle-aged ESCC patients, so as to assist in studying the potential biomarkers of elderly ESCC patients. Methods: In this study, a retrospective study was adopted. 72 ESCC patients diagnosed in Taihe Hospital, Shiyan City, Hubei Province from July 2018 to July 2019 were selected, including 49 patients in the elderly group (≥ 60 years old, 40 males and 9 females), 23 patients in the young and middle-aged group (<60 years old, 21 males and 2 females). In the same period, 20 healthy persons without abnormal gastroscopy in endoscopy center were selected as the control group (aged 35-78 years old, median age 57 years old, 16 males and 4 females). The genomic DNA was extracted from the affected esophageal tissues of patients with ESCC and the middle esophageal samples of the control group. The V4 hypervariable region of bacterial 16SrRNA gene sequence was amplified. Illumina HiSeq sequencing technology was adopted. The flora characteristics of elderly, young and middle-aged ESCC patients was compared and analyzed. QIIME and Rstudio software were used to analyze the sequence data, and nonparametric Kruskal-Wallis test or Wilcoxon rank sum test were used for statistical methods. Results: Shannon index [5.17 (4.53, 5.95) vs. 4.79 (3.74, 5.97)], Simpson index [0.94 (0.91, 0.96) vs. 0.92 (0.83, 0.96)] and Chao1 index [343.55 (259.76, 570.59) vs. 329.16 (268.88, 648.00)] were similar in flora of two groups, and there was no significant difference (Z=-0.791, -1.057, -0.380, all P>0.05). There was no significant difference in β-diversity between the elderly group and the young and middle-aged group (PC1=19.14%, PC2=6.95%, P_PC1=0.67, P_PC2=0.42). At the phyla level, the top 5 phyla in abundance were as follows: Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria and Fusobacteria in the young and middle-aged group, while the top 5 phyla in abundance were as follows: Firmicutes, Bacteroidetes, Proteobacteria, Fusobacteria and Actinobacteria in the elderly group; the significant difference between the two groups was Fusobacteria (Q=0.596, P<0.05). At the genus level, the top 5 genera in the young and middle-aged group in abundance were as follows: Prevotella, Bacteroides, Streptococcus, Selenomonas and Veillonella. In the elderly group, Prevotella, Bacteroides, Streptococcus, Selenomonas and Haemophilus were the top 5 in abundance, and there were significant difference in Fusobacterium between the two groups (Q=0.938, P<0.05). PICRUSt function prediction showed that the abundance of Aminoacyl.tRNA.biosynthesis, Nucleotide.excision.repair, RNA.polymerase, Ribosome, Clavulanic.acid.biosynthesis, Photosynthesis and Photosynthesis. proteins in the elderly group were lower than those in the young and middle-aged group (all Q=0.734, P<0.05). Conclusion: There is no significant difference in α-diversity and β-diversity between elderly ESCC patients and young and middle-aged patients, but the abundance of Fusobacterium flora increased.

[Effects of double-catheter epidural analgesia by lidocaine injection respectively on the delivery outcomes and maternal-infant complications for persistent posterior or lateral occipital position of protracted active phase]

Objective: To evaluate the effect of dual-tube epidural segmental injection of lidocaine analgesia on the delivery outcome and maternal and infant complications of persistent posterior occipital position postpartum or lateral occipital position postpartum patients with protracted active phase. Methods: The full and single-term primiparas (n=216, 37 to 42 weeks gestation, 22 to 35 years) diagnosed as persistent posterior or lateral occipital position during the active period were selected from the Department of Obstetrics of Qingdao Municipal Hospital from January 2015 to October 2019. The subjects were randomly assigned into two groups: double-tube epidural block group (n=108) and single-tube epidural block group (n=108), 1% lidocaine was used for epidural analgesia respectively under ultrasound guidance. Senior midwife or obstetricians implement new partogram, and guide women to perform position management, and push or rotate the fetal head in a timely manner. Observation indicators: general condition, the use of non-pharmacological analgesic measures, analgesia related conditions and pain visual analogue scale (VAS) score, delivery-related indicator, cesarean section indication, anesthesia-related indicator, maternal and child complications. Results: (1) General condition: the age, weight, height, gestational age, the ratio of persistent lateral or posterior occipital position, cephalic score, and neonatal birth weight between the two groups of women were not statistically significant (all P>0.05). (2) The use of non-pharmacological analgesic measures: the women's Lamaze breathing method, Doula delivery companionship, percutaneous electrical stimulation, and other measures between two groups were compared, and there were not significant differences (all P>0.05). (3) Analgesia related conditions and VAS scores of women undergoing vaginal delivery: compared with the single-tube epidural block group (n=40), the second-partum time of the women in the double-tube epidural block group (n=59) was significantly shortened [(124±44) vs (86±33) minutes, P<0.01]; after 30 minutes of analgesia (4.4±0.5 vs 0.9±0.5, P<0.01), during forced labor in the second stage of labor (5.7±0.6 vs 1.3±0.4, P<0.01), the VAS scores of pain were also significantly reduced (P<0.01). (4) Labor-related indicators: compared with the single-tube epidural block group, the natural delivery rate (21.3% vs 49.1%) and the delivery experience satisfaction rate (51.9% vs 98.1%) of women in the double-tube epidural block group were significantly increased (all P<0.01), cesarean section rate (63.0% vs 45.4%), instrument assisted rate (15.7% vs 5.6%) decreased significantly (all P<0.05). (5) Cesarean section indications: compared with the single-tube epidural block group, the cesarean section rate caused by prolonged labor or protracted active phase of women in the double-tube epidural block group was significantly reduced (38.0% vs 22.2%； P<0.05), and the fetal distress, intrauterine infection, and social factors caused by cesarean section between the two groups were compared, while the differences were not statistically significant (all P>0.05).(6) Anesthesia related indexes: the block planes of the maternal upper tube administration in the double-tube epidural block group were mostly T7, T8, T9-L2 and L3,While,the block planes in the single-tube epidural block group were mostly T10, T11-S1, S2, S3, and the modified Bromage score were all 0. (7) Maternal and child complications: compared with the single-tube epidural block group, the postpartum hemorrhage rate (18.5% vs 7.4%), the perineal lateral cut rate (20.4% vs 5.6%), the neonatal asphyxia rate (12.0% vs 3.7%), ICU rate of transferred neonates (13.9% vs 4.6%) in the double-tube epidural block group were significantly reduced (all P<0.05). Soft birth canal injury rate, puerperal disease rate and neonatal birth rate between two groups were compared, and there were not statistically significant differences (all P>0.05). Conclusion: Dual-tube epidural segmental injection of lidocaine analgesia could increase the natural delivery rate of women with posterior occipital or lateral occipital position with active stagnation, reduce the rate of cesarean section and the rate of transvaginal instruments, and reduce the complications of mother and child.

[Application of Endo-GIA stapler in laparoscopic radicalcystectomy]

Objective: To explore the application of Endo-GIA stapler in laparoscopic radical cystectomy, especially in the treatment of lateral bladder ligament, and to evaluate its clinical feasibility and practicability. Methods: A retrospective analysis of clinical data about 38 cases of laparoscopic radical cystectomy (LRC) treated in the Department of Urology, Chaoyang Hospital of Beijing and Cancer Hospital, Chinese Academy of Medical Sciences from July 2017 to June 2019 were conducted. The patients were divided into Endo-GIA stopler group(18 cases) and non-Endo-GIA stopler group (20 cases) according to whether Endo-GIA stapler were used. The basic clinical data, operation time of bladder lateral ligament, operation time of bladder lateral wall, operation time of bladder resection, amount of bleeding during operation, pathological data after operation and related indicators of recovery after operation were compared between the two groups. Results: All 38 patients underwent radical cystectomy (RC) successfully under 3-D laparoscopy without conversion to open surgery. The operation time of bladder lateral ligament in Endo-GIA stapler group was significantly shorter than that in non-Endo-GIA stapler group [(3.25±0.75) min vs (9.20±2.95) min, P=0.042]; the operation time of bladder lateral wall in Endo-GIA stapler group was significantly shorter than that in non-Endo-GIA stapler group [(8.06±1.66) min vs (14.30±3.37) min, P=0.016]. The operation time of cystectomy in the Endo-GIA stapler group was significantly shorter than that in the non-Endo-GIA stapler group [(47.06±4.70) min vs (61.60±14.91) min,P=0.003]. The amount of bleeding in the Endo-GIA stapler group was significantly shorter than that in the non-Endo-GIA stapler group [(37.77±21.30) ml vs (114.50±39.80) ml, P=0.015]. The time of drainage tube removal in Endo-GIA group was significantly shorter than that in the non-Endo-GIA group [(5.83±1.54) d vs (7.30±3.00) d, P=0.002]. The length of post-hospitalization in Endo-GIA group was significantly shorter than that in the non-Endo-GIA group [(7.67±1.78) d vs (9.60±3.25) d,P=0.036]. However, there was no significant difference in other basic clinical data, post-operative pathology and post-operative recovery related indicators. Conclusions: Laparoscopic radical cystectomy using Endo-GIA stapler device is safe and feasible. It is easy to operate, shorten the operation time significantly, and reduce the amount of bleeding. To a certain extent, it is conducive to the recovery of patients after operation to some extent, and worthy of clinical application.

[Research progress of magnetic resonance imaging in hepatocellular carcinoma]

Hepatocellular carcinoma (HCC) is the most common malignant tumors of liver. Rational treatment in early stage of HCC can significantly increase the survival rate of patients. Detection of early-stage liver lesions through diffusion-weighted imaging, diffusion kurtosis imaging, incoherent motion within voxels, magnetic resonance spectroscopy imaging, dynamic contrast-enhanced imaging, or other functional imaging can accurately evaluate grade of malignancy and guide towards the curative effect of different treatment schemes. Volumetric interpolated breath-hold examination (VIBE) with three techniques, namely, CAIPIRINHA, Dixon, and TWIST, i.e., CDT-VIBE sequence can provide multiple sets of arterial phase images in a short time, and detect small foci transient enhancement that cannot be detected by other examinations, and the differences in initial enhancement phase of apparent lesions are of great significance for suggesting hemodynamic characteristics. In addition, magnetic resonance imaging predicts microvascular invasion of HCC, i.e., indirectly predicts HCC lesions recurrence rate, and overall survival time after liver transplantation. This article reviews the current research progress of magnetic resonance imaging technology in HCC.

[Advances in research of odontoid fractures in the elderly]

Odontoid fractures constitute the most common cervical spine fracture in the population aged. The optimal management strategy for odontoid fractures remains controversial, especially in the elderly, because of the high morbidity and mortality with both conservative and operative intervention. This review discusses the management of odontoid fractures among the elderly, with a focus on the various treatment options and their outcomes.

[Efficacy and economic evaluation of sublingual immunotherapy with Dermatophagoides farinae drops in patients with allergic rhinitis and allergic asthma]

Objective:To evaluate the efficacy and economics of sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops in patients with allergic rhinitis and allergic asthma. Method:Two hundred and three patients (aged 4-60 yr) with allergic rhinitis and allergic asthma induced by house dust mites were retrospectively analyzed. Eighty-six patients were treated by SLIT with standardized Dermatophagoides farina drops and pharmacotherapy (SLIT group), while 117 patients were treated by standardized pharmacotherapy (drug group). Patients were followed up for 2 years with one visit in every 3 months. Total nasal syptom score (TNSS), total rhinitis medicine score (TRMS), daytime asthma syptom score (DASS), nighttime asthma syptom score (NASS), total asthma medicine score (TAMS) and treatment charge were recorded at each visit. Result:There was no significant difference between two groups in TNSS, TRMS, DASS, NASS, TAMS before treatment (all P>0.05). After 1-year or 2-year duration, there were significant differences between the SLIT group and drug group in TNSS, TMSS, DASS, NASS, TAMS (all P<0.01). After 1-year or 2-year duration, the symptom scores and medication scores of SLIT group significantly decreased compared with those before treatment (all P<0.01). In terms of treatment charge, although direct cost of SLIT group was a little higher than that of drug group, the indirect cost of SLIT group was remarkably lower than that of drug group, showing significant difference (P<0.01). Conclusion:SLIT with Dermatophagoides farinae drops is effective in patients with allergic rhinitis and allergic asthma, which may also reduce indirect cost.

[Phonological assessment and voice analysis of thyroid surgery patients]

Objective:To investigate the changes of speech and voice acoustics in patients with thyroid disease before and after operation, get objective values, and conducive to guiding the clinical diagnosis and treatment and recurrent laryngeal nerve protection. Method:A total of 216 patients undergoing thyroid surgery from October 2015 to October 2016 were treated with TVQ and GRBAS at 1 day before surgery, 1 week, 1 month, and 3 months postoperatively to phonological assessment, and Praat software was used to collect and analyze the acoustic acoustics index for preoperative and postoperative comparative analysis. Result:All patients did not damage the recurrent laryngeal nerve, unilateral or bilateral thyroid subtotal resection (no exploration of recurrent laryngeal nerve) in patients with postoperative speech and voice index F0 was decreased at 1 week after surgery (P<0.05), the other indicators did not change significantly; difference was found out in single-sided total thyroidectomy+ipsilateral central area lymph node dissection, bilateral thyroidectomy+unilateral central area lymph node dissection (exploration of unilateral recurrent laryngeal nerve) in patients with TVQ, GRBAS and F0, HNR after surgery 1 week compared with preoperative (P<0.05), However, there was no significant difference 3 months; TVQ, GRBAS and F0, HNR were significantly changed in patients with bilateral thyroidectomy+bilateral central lymph node dissection (revealed bilateral recurrent laryngeal nerve) at 1 week after operation (P>0.05). F0 and HNR were lower than those before operation, and the patients were treated with Jitter and Shimmer. The patients were treated with TVQ, GRBAS, Jitter and Shimmer before operation, however, the majority of patients' TVQ, GRBAS, Jitter, Shimmer can be restored to preoperative level after surgery 3 months (P>0.05). Conclusion:The appearance of speech and voice problems in patients after thyroid surgery may increase with the expansion of the surgical range, the change in speech and voice after neck lymph node dissection is reversible.

[Impact of age-related cataract on regulation of circadian rhythm in elderly]

This review presented an introduction of the visual pathway related circadian rhythm regulation system: the intrinsically photosensitive retinal ganglion cells-suprachiasmatic nucleus-pineal gland-melatonin axis, and discussed the impact of light with different wave length and irradiation received by retina on circadian rhythm and sleep habit. A hypothesis was proposed consequently that the high morbidity of sleep disorder in elderly might be partially attributable to the long-term blue light blocking status induced by age-related cataract. A number of relative literatures were reviewed and a novel research direction was advanced on improving circadian rhythm and sleep condition in elderly based on the current knowledge. (Chin J Ophthalmol, 2016, 52: 309-314).

Follow-up observational study of "bi-ring method" breast surgery for treating hypermastia and mastoptosis

PURPOSE

This study investigated the efficacy and patient satisfaction of "bi-ring method" breast surgery in 46 patients with hypermastia and/or mastoptosis.

MATERIALS AND METHODS

A questionnaire survey, objective data measurements, visual analysis system survey, and various scoring scales were used to qualitatively and quantitatively assess the patients' indicators before and after surgery.

RESULTS

Statistical analysis showed the following: symptoms and signs in patients with macromastia improved significantly; all patients' breast shapes improved significantly and became more symmetrical and durable; all patients had minor hidden scars; the nipples and areolas had good feeling postoperatively, and there were relatively few mild complications.

CONCLUSIONS

The patients' overall satisfaction was high, indicating that the "bi-ring method" of breast plastic surgery could not only improve the breast shape and boast concealed scars but could significantly improve the patients' signs and symptoms of hypermastia, but the nipples and areolas had good postoperative feeling and there were few complications. Thus, this is a reasonable surgical approach that is worthy of promotion.

Supplementation dietary zinc levels on growth performance, carcass traits, and intramuscular fat deposition in weaned piglets

This study was conducted to estimate dietary zinc (Zn) levels on growth performance, carcass traits, and intramuscular fat (IMF) deposition in weaned piglets. Sixty piglets were randomly divided into five groups, as follows: control (basal diet), Zn250, Zn380, Zn570, and Zn760 with supplementation of 250, 380, 570, and 760 mg Zn/kg of the basal diet, respectively. The final weight, average daily gain (ADG), gain/feed (G/F), lean meat percentage, fat meat percentage, lean eye area, backfat thickness, and IMF content were dose-dependently increased in all groups of Zn treatment. The serum total triglycerides (TG) and free fatty acid (FFA) were significantly higher in all Zn treatments than in the control. The enzyme activities of lipoprotein lipase (LPL), fatty acid synthase (FAS), and acetyl-CoA carboxylase (ACC) were markedly higher, while enzyme activities of hormone-sensitive lipase (HSL) and carnitine palmitoyltransferase-1 (CPT-1) were significantly lower in all Zn treatments than in the control. The messenger RNA (mRNA) levels of sterol regulatory element-binding protein 1 (SREBP-1), stearoyl-CoA desaturase (SCD), FAS, ACC, peroxisome proliferator-activated receptor γ (PPARγ), LPL, and adipocyte fatty acid-binding protein (A-FABP) were significantly higher, while the mRNA levels of CPT-1 and HSL were significantly lower in all Zn treatments compared with the control. These results indicated that high levels of Zn increased IMF accumulation by up-regulating intramuscular lipogenic and fatty acid transport gene expression and enzyme activities while down-regulating lipolytic gene expression and enzyme activities.

Detection, differentiation, and VP1 sequencing of duck hepatitis A virus type 1 and type 3 by a 1-step duplex reverse-transcription PCR assay

Duck hepatitis A virus (DHAV) is an infectious pathogen causing fatal duck viral hepatitis in ducklings. Although both the inactivated vaccines and live attenuated vaccines have been used to protect ducklings, DHAV-1 and DHAV-3 still cause significant serious damage to the duck industry in China and South Korea. For rapid detection, differentiation, and epidemic investigation of DHAV in China, a genotype-specific 1-step duplex reverse-transcription (RT) PCR assay was established in this study. The sensitivity and specificity of the developed RT-PCR assay was evaluated with nucleic acids extracted from 2 DHAV reference strains, and 9 other infectious viruses and bacteria. The genotype-specific primers amplified different size DNA fragments encompassing the complete VP1 gene of the DHAV-1 or DHAV-3. The assay detected the liver samples collected from experimentally infected ducklings and dead ducklings collected from different regions of China. Sequence analysis of these DNA fragments indicated that VP1 sequences of DHAV-1 can be used to distinguish wild type and vaccine strains. The phylogenetic analysis of VP1 sequences indicated that the developed RT-PCR assay can be used for epidemic investigation of DHAV-1 and DHAV-3. The developed RT-PCR assay can be used as a specific molecular tool for simultaneous detection, differentiation, and sequencing the VP1 gene of DHAV-1 and DHAV-3, which can be used for understanding the epidemiology and evolution of DHAV.

Cladosporium cladosporioides Identified in China on Tobacco Seeds

Tobacco (Nicotiana tabacum L.) is a leafy, annual, solanaceous plant grown commercially for its leaves. China is the biggest single tobacco market and accounts for more than 40% of the global tobacco consumption (1). Tobacco seed harvested in Guiyang, Guizhou Province, China, are commonly contaminated or infected by various fungal pathogens, which can cause abnormal seedlings with dark brown lesions and stunting of roots and decayed seeds. In 2013, five samples of 500 seeds from tobacco cv. Guiyan 4 were tested for germination on moistened paper on petri dishes. On average, 35% of the seeds from all five samples developed into abnormal seedlings or were decayed and were plated onto potato dextrose agar media and grown for 5 days at 25°C in darkness to confirm the presence of a pathogen. However, one fungus was isolated from an average of 10% of the 500 seeds sampled. It was identified morphologically as Cladosporium cladosporioides (Fresen.) de Vries based on the velvety olive-brown with almost black reverse colony color and dimensions and color of conidia and conidiophores. Conidia formed in long branched chains that readily disarticulate, single celled, elliptical to limoniform, 2 to 8 (avg. 4.3) × 2 to 3 (avg. 2.1) μm. Conidia were pale to olive brown and smooth to verruculose. Ramoconidia were 0 to 1 septate, 7 to 14 (avg. 9.2) × 2 to 4 (avg. 2.6) μm, smooth or sometimes minutely verruculose. Conidiophores were pale to olive brown, macro- and micronemateus, smooth or sometimes verruculose, and of various lengths up to 320 μm long and 2 to 5 μm wide. Primer pair ITS1 and ITS4 was employed to amplify the regions of ITS1-5.8s-ITS2 of the pathogens. Sequences of all three isolates (G3, G10, and G18) (Accession Nos. KF841547, KF841554, and KF841560) were identical to each other and to four sequences in GenBank (JX230994.1, JQ768317.1, JQ768322.1, and AB763555.1). Pathogenicity of the three isolates of C. cladosporioides was verified on tobacco seedlings of 3-week-old grown on wet filter paper in the petri dishes (9 cm in diameter). For each isolate, 20 seedlings incubated in one plate were inoculated with 0.5 ml of a suspension of 10⁵ conidia/ml. Twenty seedlings were treated with sterile water as control treatment. After inoculation, the petri dishes were incubated at 25°C, 100 to 120 μEm^-2 S^-1, RH > 80%, and 16 h light per day for disease development. At 96 h after inoculation, symptoms comprising medium brown to black lesions on the roots were clearly visible on inoculated plants but not on the control plants. All seedlings inoculated died 9 days after inoculation whereas control seedlings remained symptomless. Re-isolation attempts on PDA from roots demonstrated C. cladosporioides to be present in symptomatic seedlings but not in roots of the control plants. Moreover, the characteristics of the cultured fungi were exactly the same as those originally isolated. Isolates G3, G10, and G18 (KF841547, KF841554, and KF841560) were deposited with the Tobacco Diseased Fungi, Guizhou Academy of Tobacco Sciences, Guizhou, China. Previously, C. cladosporioides has also been isolated from macadamia (Macadamia integrifolia Maiden & Betche) racemes in South Africa (4), from diseased papaya (Carica papaya L.) in Taiwan province of China (2), and from seeds of Amaranthus spp. in Poland (3). To the best of our knowledge, this is the first report of C. cladosporioides causing seed disease on tobacco in China and the disease should be considered in existing disease management practices. References: (1) British American Tobacco Annual Report, 8, 2012. (2) R. S. Chen, et al. Plant Dis. 93:426, 2009. (3) W. Pusz. Phytopathologia 54:15, 2009. (4) N. van den Berg et al. Plant Dis. 92:484, 2008.

Bioinformatic analysis and characteristics of glycoprotein C encoded by the newly identified UL44 gene of duck plague virus

Glycoprotein C is one of the duck plague virus (DPV) glycoproteins and is encoded by the DPV UL44 gene. DPV glycoprotein C (DPV-gC) comprises 431 amino acids with a putative molecular mass of 47.35 kDa. Sequence analysis indicated that the protein possesses typical characteristics of type-I membrane glycoproteins, containing an N-terminal signal sequence, an external domain, a C-terminal membrane anchor region, and a short cytoplasmic domain. Comparisons of 22 alphaherpesvirus-gC protein sequences revealed eight conservative Cys-residue sites, which may play a crucial role in the biological functions and structural stabilization of the DPV-gC protein. Estimates of potential antigenic epitopes and secondary structure identified four B cell dominant epitopes, which are located at amino acids 68-71, 87-91, 369-352, and 372-374. A model for the structure of DPV-gC was derived by associating its predicted secondary and three-dimensional structures. In conclusion, these results will provide a basis for further functional studies of DPV-gC, establishing novel clinical diagnoses of DPV, and in the development of a new DPV vaccine.

Comparison of FIB-4 and APRI in Chinese HBV-infected patients with persistently normal ALT and mildly elevated ALT

Significant liver disease has been reported in chronic hepatitis B patients with normal alanine aminotransferase (ALT). Liver biopsy (LB) is the current gold standard for assessing hepatic inflammation and fibrosis in patients with chronic HBV. However, associated risks have led to the development of noninvasive models. Their utility in patients with normal ALT is unknown. FIB-4 and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) were calculated for patients with chronic HBV infection undergoing biopsy. The performance of each model and AUROC for predicting significant fibrosis (Scheuer's score ≥ S2) were determined for the entire cohort and stratified by elevated (≥50 U/L) and normal ALT. Two-hundred and thirty-one liver biopsies were included. The number of patient with normal ALT was 140, and 22.1% had significant fibrosis. The AUROC curve for patients with normal ALT was 0.81 for FIB-4 and 0.80 for APRI, compared with 0.71 for FIB-4 and 0.72 for APRI for those with mildly elevated ALT level. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FIB-4 were 0.63, 0.88, 0.61 and 0.93, for patients with normal ALT; the values for APRI were 0.40, 0.88, 0.33 and 0.93. Both FIB-4 and APRI are useful for identification of those without significant fibrosis. However, because they have poor PPV, LB will continue to be used for assessment of HBV-infected patients with normal ALT and mildly elevated ALT.

Adhesion and invasion to duck embryo fibroblast cells by Riemerella anatipestifer

Here, we investigated adhesion and invasion of Riemerella anatipestifer (RA) to primary duck embryo fibroblast (DEF) cells. The ability of RA to adhere to, and more importantly, to invade DEF cells was demonstrated by using a gentamicin invasion assay and was confirmed by transmission electron microscopy (TEM). Adhesion of RA could be found by TEM after 1 h of inoculation. Both apoptosis and necrocytosis of DEF were indicated by TEM after 10 h of incubation, which suggested a complex mechanism of DEF cell death induced by RA. Our results showed that internalized RA had the ability to leave the DEF cells. Inhibition studies indicated that RA proteins play a role in adhesion. Moreover, invasion of RA to DEF cells was shown to require rearrangement of actin microfilaments and microtubular cytoskeletal elements. Because the adhesion and invasion ability of RA to DEF cells could be demonstrated in vitro, similar processes might occur in vivo, where DEF cells play a crucial role in the diffusion of RA in ducks.

Phylogenetic analysis of parvoviruses isolated in Taiwan from ducks and geese

Two major outbreaks of parvovirus infection occurred in domestic waterfowls in Taiwan in the last two decades; the first was in 1982 and the second in 1989/1990. Parvoviruses isolated in the two outbreaks were sequenced between nucleotides 142 and 680 of the VP3 gene. Sequence comparisons reveal that these viruses could be divided into two groups respectively related to goose parvovirus (GPV) and Muscovy duck parvovirus (MDPV). Nucleotide differences between ''GPV'' and ''MDPV'' groups range from 16.2% to 19.4%. In comparison, the differences within the ''GPV'' group are only 0-6.5%, while those within the ''MDPV'' group are only 0.2-1.7%. Phylogenetic analysis reveals that parvoviruses isolated in the 1982 outbreak in Taiwan are all GPV-related, whereas those isolated in the 1989/1990 outbreak are all MDPV-related. GPV-related isolates from Taiwan were separated into two groups, Thai group and European group. In comparison, all MDPV-related isolates from Taiwan are clustered in a single group that is closely related to a French MDPV isolate. The MDPV-related infection in Taiwan occurred at almost the same time in 1989 as the MDPV outbreak in France. The close phylogenetic relationship between the ''MDPV'' Taiwanese isolates and the French MDPV isolate exhibited on the VP3 fragment investigated suggests that they should be compared more deeply, to look for a possible common origin. The MDPV-related 1985 isolate might be a candidate.

Efficacy study and field application of an inactivated new type gosling viral enteritis virus vaccine for domestic geese

New type gosling viral enteritis virus (NGVEV) caused a serious disease in naive juvenile goslings. In the described studies the performance of 2 vaccines was analyzed: a vaccine containing adjuvanted inactivated NGVEV and a vaccine containing adjuvanted inactivated NGVEV and recombinant goose IL-2. Breeder geese were subcutaneously vaccinated at the beginning of the egg production period with the vaccines. Breeder geese sham vaccinated with PBS served as control. The cellular and humoral immune responses of the vaccinated breeder geese, as well as the presence of maternally derived antibody to NGVEV, were investigated by ELISA, virus neutralization test, and lymphocyte proliferation assay, respectively. A significantly higher immunogenicity (P < 0.05) was induced by the inactivated NGVEV-recombinant goose IL-2 adjuvant vaccine compared with the inactivated NGVEV vaccine. The offspring of the vaccinated birds were challenged with virulent NGVEV (100 50% lethal dose) and the protective efficacy of the vaccines was determined. Furthermore, in a field trial the efficacy of the inactivated NGVEV vaccine was recorded from years 2003 to 2007. No clinical signs or abnormal health status were observed in the vaccinated breeder geese and the progeny. After a single application, >80% protection was shown in the progeny of geese vaccinated against NGVEV challenge for approximately 5 mo. The extensive field trials further demonstrated that vaccination of breeder geese with the inactivated NGVEV vaccine could be a safe and efficacious means to control NGVE disease. Moreover, the level of maternally derived NGVEV antibody titer in the egg yolk reflected the level of NGVEV antibodies in the breeder geese, suggesting that the egg yolk could be used to monitor the vaccination efficacy in commercial goose breeder flocks.

Development and application of an indirect immunohistochemical method for the detection of duck plague virus vaccine antigens in paraffin sections and localization in the vaccinated duckling tissues

The objective of the present study was to develop and apply a streptavidin-alkaline phosphatase labeling system of indirect immunohistochemistry (SP-IHC) to detect antigenic distribution and localization regularity of duck plague virus (DPV) vaccine antigens in paraformaldehyde-fixed paraffin-embedded tissues of experimentally vaccinated ducklings. Male New Zealand rabbits were immunized with purified DPV antigens, which were engaged by a combination of differential centrifugation and sucrose-density gradient ultracentrifugation. The rabbit anti-DPV polyclonal antibodies were purified and used as the primary antibodies. Forty-eight 28-d-old DPV-free Pekin ducklings were subcutaneously inoculated with attenuated DPV vaccine in the immunization group and sterile PBS in the control group. The tissues were collected at sequential time points between 4 h and 18 wk postvaccination (PV) and were prepared for SP-IHC observation. The presence of DPV-specific antigens was first observed in the liver and spleen at 12 h PV; in the bursa of Fabricius, thymus, Harderian gland, esophagus, and intestinal tract at 1 d PV; and in the heart, lung, kidney, pancreas, and brain at 3 d PV. The positive staining reaction could be detected in the vaccinated duckling tissues until 18 wk PV, and no positive staining cells could be observed in the controls. The highest levels of positive staining reaction were found in the liver, spleen, bursa of Fabricius, thymus, and intestinal tract, whereas a few DPV vaccine antigens were distributed in the heart, pancreas, and esophagus. The target cells had a ubiquitous distribution, especially in the mucosal epithelial cells, lamina propria cells, macrophages, hepatocytes, and lymphocytes, which served as the principal sites for antigen localization. These findings demonstrated that SP-IHC was a reliable method for detecting antigenic distribution and localization regularity of DPV vaccine antigens in routine paraffin sections. The present study may be useful for describing proliferation and distribution regularity of DPV vaccine in the vaccinated duckling tissues and enhance further studies and clinical application of attenuated DPV vaccine.

Humoral and cellular immune responses in adult geese induced by an inactivated vaccine against new type gosling viral enteritis virus

To assess the immunogenicity of an inactivated new type gosling viral enteritis virus (NGVEV) vaccine, we investigated 3 different doses of the inactivated vaccine and the inactivated vaccine in conjunction with 3 different doses of recombinant goose interleukin-2 (rGoIL-2) adjuvant. A virus concentration of 10(5) 50% embryo infective dose/mL was subcutaneously inoculated into adult geese divided into 6 groups. The dynamic changes of the humoral and cellular immunity responses elicited by the vaccines in the adult geese postvaccination (PV) were investigated using ELISA, virus neutralization test, and lymphocyte proliferation assay. The clearance of virus from the intestines of geese (175 d PV) was studied by histopathological examination and indirect immunofluorescence assay after virulent NGVEV challenge. This study showed that the inactivated NGVEV vaccine elicits strong humoral and cellular responses in the vaccinated adult geese. The absorbance values of specific anti-NGVEV antibodies, the neutralization antibody titer, and the lymphocyte proliferation index rapidly increased, peaked at about 28 d PV, progressed to the plateau stage, and then decreased slightly. The rGoIL-2 adjuvant enhanced the immune response, and this adjuvant in conjunction with the inactivated NGVEV vaccine induces a significantly higher specific anti-NGVEV antibody absorbance value, neutralization antibody titer, and lymphocyte proliferation index than the non-adjuvant-inactivated NGVEV vaccine (P < 0.05). The inactivated NGVEV vaccine conferred adequate efficient ability to clear NGVEV in vaccinated geese even in the last phase of the vaccination period (175 d PV). The inactivated NGVEV vaccine (0.5 mL/goose) with 1,000 units of rGoIL-2 adjuvant/goose is the most effective dose, thereby eliciting the strongest humoral and cellular immunity responses and providing the most efficacious clearance of NGVEV in vivo.

Source reconstruction of brain electromagnetic fields--source iteration of minimum norm (SIMN)

A recursive scheme aiming at obtaining sparse and focal brain electromagnetic source distribution is proposed based on the interpretation that the weighted minimum norm is the minimum norm estimates of amplitudes on grid points for the source distribution specified by the diagonal elements of the weight matrix. The source distribution is updated so that, at each grid point, the number of current dipoles equals the total source strength estimate of the pre-specified current dipoles. The source strength of a pre-specified current dipole is estimated by projecting the vector of minimum norm estimate to the space spanned by the three column vectors, corresponding to the three amplitudes of the current dipole, of the resolution matrix. The norm of the projected vector yields the source strength estimate of the current dipole. Exact inverse solutions are obtained by this source iteration of minimum norm (SIMN) algorithm for noiseless MEG signals from multi-point sources provided the sources are sufficiently sparse and there are no substantial cancellations among the signals of the sources. For noisy data, a set of "noise sources" is introduced. The diagonal matrix formed by the "noise source numbers" plays the role of regularization matrix and Tikhonov regularization is applied to initialize the "noise source numbers". Application to the source localization of real EEG data is also presented.

Quantitative analysis of Salmonella Enteritidis loads in ducklings after nasal inoculation

The distribution patterns of Salmonella Enteritidis in systemic organs, which have not been described previously, should be studied to better understand its pathogenesis in vivo. We inoculated the ducklings with Salmonella Enteritidis via the nasal route and performed a real-time PCR assay for determining the concentration of Salmonella Enteritidis DNA and studied the histopathology of various tissues postinoculation. The results show that the Salmonella Enteritidis load in systemic organs has a close correlation with the progression of disease. Further, rapid dissemination and active replication of Salmonella Enteritidis in multiple systemic organs accelerated the progression of disease.

The pathogenesis of Salmonella enteritidis in experimentally infected ducks: a quantitative time-course study using taqman polymerase chain reaction

Ducks were subcutaneously infected with a high-virulence strain of Salmonella enterica ssp. enterica serovar Enteritidis (Salmonella Enteritidis). The kinetics of the Salmonella Enteritidis genomic DNA loads, the immunohistochemical localization of the bacterial antigens, and the histopathological examination in various tissues were investigated. The results showed that the time course of the appearance of the Salmonella Enteritidis bacterial antigens and the lesions in various tissues was coincident with the bacterial load of the organism in various infected tissues. This suggests that Salmonella Enteritidis loads in systemic organs are closely correlated with the progression of the infection.

Replication kinetics of Salmonella enteritidis in internal organs of ducklings after oral challenge: a quantitative time-course study using real-time PCR

This research was undertaken to understand the replication kinetics of Salmonella enteritidis (S. enteritidis) in the internal organs of ducklings after oral challenge over a 2 wk period. A serovar-specific real-time, fluorescence-based quantitative polymerase chain reaction (FQ-PCR) assay was used to detect genomic DNA of S. enteritidis in the blood and the internal organs at different time points respectively. The results showed that the spleen was positive at 12 h post inoculation (PI) and the blood was at 14 h PI. The organism was detected in the liver and heart at 16 h PI, the pancreas and kidney were positive at 20 h PI, and the final organ to show a positive results was the gallbladder at 22 h PI. The copy number of S. enteritidis DNA in each tissue reached a peak at 24 h-36 h PI, with the liver and spleen containing the highest concentration of S. enteritidis. The blood, heart, kidney, pancreas, and gallbladder had low concentrations. S. enteritidis populations began to decrease and were not detectable at 3 d PI, but were still present up to 2 wk for the spleen without causing apparent symptoms. To make the results meaningful, a side-by-side bacteriology method (IFA) was performed. The results of IFA were similar to the FQ-PCR assay. This research provided a significant data for understanding the life cycle of S. enteritidis in the internal organs, and may help to understand the pathogenesis of S.entertidis in the future.

Electron field emission characteristics and field evaporation of a single carbon nanotube

Direct transmission electron microscope (TEM) observations of the field emission and evaporation process of emitting carbon nanotubes (CNTs) shown that the tip structure of the CNT is in general composed of irregular shaped graphitic sheets which extend typically more than 10 nm from the end of the CNT. It is found that the irregular shaped graphitic sheets at the tip of the CNT may greatly enhance the field emission characteristics of the CNT when compared with that having an ideal circular edge. The field evaporation of the CNT proceeds typically via the removal of the irregular shaped graphitic sheets from the tip of the CNT, and field emission characteristics of a CNT depend far more sensitively on the tip structure than on the geometric length of the CNT.

NAD(+) and axon degeneration revisited: Nmnat1 cannot substitute for Wld(S) to delay Wallerian degeneration

The slow Wallerian degeneration protein (Wld(S)), a fusion protein incorporating full-length nicotinamide mononucleotide adenylyltransferase 1 (Nmnat1), delays axon degeneration caused by injury, toxins and genetic mutation. Nmnat1 overexpression is reported to protect axons in vitro, but its effect in vivo and its potency remain unclear. We generated Nmnat1-overexpressing transgenic mice whose Nmnat activities closely match that of Wld(S) mice. Nmnat1 overexpression in five lines of transgenic mice failed to delay Wallerian degeneration in transected sciatic nerves in contrast to Wld(S) mice where nearly all axons were protected. Transected neurites in Nmnat1 transgenic dorsal root ganglion explant cultures also degenerated rapidly. The delay in vincristine-induced neurite degeneration following lentiviral overexpression of Nmnat1 was significantly less potent than for Wld(S), and lentiviral overexpressed enzyme-dead Wld(S) still displayed residual neurite protection. Thus, Nmnat1 is significantly weaker than Wld(S) at protecting axons against traumatic or toxic injury in vitro, and has no detectable effect in vivo. The full protective effect of Wld(S) requires more N-terminal sequences of the protein.

Quantitative Analysis of Electron Field-Emission Characteristics of Individual Carbon Nanotubes: The Importance of the Tip Structure

Electron field-emission measurements on individual carbon nanotubes (CNTs) were performed inside the transmission electron microscope (TEM). The field-emission characteristics of CNTs with different tip structures were compared, and their field conversion factor and emission area were studied systematically. It was found that the field-emission characteristics of a CNT depend sensitively on its tip structure, and in particular an opened CNT was shown to be superior to a capped CNT. High-resolution TEM observations revealed that the tip of an opened CNT may, in general, be regarded as being composed of irregular shaped graphitic sheets, and these graphitic sheets have been found to improve dramatically the field-emission characteristics, but the sharp edge may result in larger error in the calculated emission area. The influence of uncertainty in the work function of the CNTs on the field conversion factor and emission area calculation was also investigated.

Pain model and fuzzy logic patient-controlled analgesia in shock-wave lithotripsy

Pain control in conscious patients was investigated using a push-button, demand-driven supply of drugs. A fuzzy logic patient-controlled analgesia (PCA) algorithm was compared with a conventional algorithm, for alfentanil administration in extracorporeal shock-wave lithotripsy. The conventional PCA algorithm used an initial dose of 0.25mg, a fixed infusion rate of 60 mg h(-1) and a fixed bolus size of 0.2 mg with a 1 min lockout. The fuzzy logic PCA algorithm used an initial dose of 0.25 mg, a changeable infusion rate and a bolus size of 0.1 or 0.05 mg. The infusion rate was adjusted according to a look-up table that accepted the button-pressing history over the last three lockout intervals. The look-up table was designed using fuzzy logic. The bolus size was adjusted according to the button-pressing history over the past two lockout intervals. Twelve patients were treated using conventional PCA, and thirteen were treated with PCA + fuzzy logic control (FLC). PCA + FLC patients consumed 45% less drug. Also, PCA + FLC patients had a mean delivery/demand ratio of 82%, compared with 60% in conventional PCA. When the pain intensity scale was analysed, PCA + FLC patients had acceptable pain intensity at 62%, compared with 44% in conventional PCA.

The WldS protein protects against axonal degeneration: a model of gene therapy for peripheral neuropathy

The WldS mouse is a spontaneous mutant that is characterized by the phenotype of delayed degeneration of transected nerves (slow Wallerian degeneration). Molecular genetic analysis identified a mutation in this animal that codes for a unique protein expressed in brain tissue of WldS mice. We asked whether the WldS phenotype, in addition to delaying axonal degeneration after axotomy, might provide neuroprotection against toxic neuropathy. In dorsal root ganglia (DRG) cultures, neurites from WldS transiently exposed to vincristine not only resisted axonal degeneration but resumed growth after withdrawal of the toxin. Neurites from wild type mice died rapidly and did not recover. To prove that the identified mutation and its protein product are responsible for the WldS phenotype, we used an adenoviral gene transfer system to deliver the WldS to rat DRG neurons. Rat neurons expressing the WldS protein were resistant to vincristine-induced axonal degeneration, confirming the functional significance of the identified gene mutation. These data provide evidence that the WldS protein can be neuroprotective against vincristine neuropathy, and possibly other disorders characterized by axonal degeneration. In addition, delivery of this gene to wild type cells can transfer the WldS phenotype, providing the possibility of "gene therapy" for peripheral neuropathy.

Pathogenic and pathological characteristic of new type gosling viral enteritis first observed in China

AIM: To study the purifying method and characteristics of new gosling viral enteritis virus (NGVEV), the etiological agent of new gosling viral enteritis (NGVE) which was first recognized in China, as well as the pathomorphological development in goslings infected artificially with NGVEV.

METHODS: ① NGVEV virions were purified by the procedure of treatment with chloroform and ammonium sulfate precipitation, dialysis to remove the sulfate radical and ammonium ion and separation by gel filtration chromatography, and SDS-PAGE. ② Forty 2-day-old White Sichuan goslings were orally administered with NGVEV and 24 h later 2 birds were randomly selected and killed at 24 h intervals until death occurred. Specimens (duodenum, ileum, liver, heart, kidney, spleen, lung, proventriculus, pancreas, esophagus, and the intestinal embolus) were taken until all birds in this group died and were sectioned and stained with hemotoxylin and eosin and studied by light microscope.

RESULTS: NGVEV shared the typical characteristics of Adenovirus and which structural proteins consisted of 15 polypeptides. Necrosis and sloughing of the epithelial cells covering the villus tips of the duodenum were first observed in goslings 2 d postinfection artificially with NGVEV. With the progress of infection, this lesion rapidly occurred in the epithelium at the base of the villus and with infiltration of the inflammatory cells, the jejunum tended to be involved. With the intensification of mucosa necrosis and inflammatory exudation of the small intestine, fibrinonecrotic enteritis was further developed and embolus composed of either intestinal contents wrapped by pseudomembrane or of the mixture of fibrous exudate and necrotic intestinal mucosa were observed in the middle-lower part of the small intestine. This structure occluded the intestinal tract and made the intestine dilated in appearance. The intestinal glandular cells underwent degeneration, necrosis and might be found sloughed into the lumen. Hemorrhage and hyperemia could be observed on the lung and kidney. Epithelial cells of the renal tubular underwent degeneration. In some cases, granular degeneration and fatty degeneration could be found in the liver and in some cases at a later stage of this disease the epithelial cells of trachea and proventriculus might be found sloughed. In some cases at an early stage of this disease, cardiac hyperemia and hemorrhage could be observed. Esophagus, pancreas and brain were found normal. Analyses and comparisons between the pathologic lesions of NGVE and Gosling Plague (GP) were available in this paper as well.

CONCLUSION: ① NGVEV is adenovirus. ② Pathological characteristic could be as the data for NGVE diagnosis.

Natural frequency analysis of periodontal conditions in human anterior teeth

The purpose of this study was to evaluate the possibility of using natural frequency (NF) analysis to detect the attachment loss of periodontal tissue. In this study, 698 anterior teeth were examined by a conventional probing method and also by NF analysis. The teeth were triggered to vibrate with an impulse hammer, and the vibrational response was detected by an acoustic sensor. Our results demonstrate no significant difference in NF values between the upper-lower/left-right quadrants of the tested teeth, although the mean natural frequency value of central incisors with periodontal disease was found to be 1.24 +/- 0.11 kHz which is significantly lower than that of teeth in a healthy condition (1.34 +/- 0.20kHz; p < 0.01). On the other hand, the mean frequency for periodontal disease involving canines (1.28 +/- 0.09 kHz) was also significantly lower than the corresponding value for healthy analogs (1.35 +/- 0.17 kHz; p < 0.05). These results suggest that NF analysis appears to be an effective method for assessing the periodontal condition of anterior teeth. Moreover, since this method is noninvasive, nondestructive, and necessitates minimal tooth contact, it can serve as an effective method for the early quantifiable testing and prevention of periodontal disease.

Factors influencing the dynamic behaviour of human teeth

Modal analysis is carried out to test the natural frequencies of certain human teeth, including central incisors (CIs), canines (CAs), first premolars (FPs) and first molars (FMs). A total number of 1007 teeth are tested, taking into account tooth type, oral location, age and gender, to analyse the effects of the above-mentioned factors on the natural frequency of the sample teeth. The results reveal that no significant difference in the natural frequency is noted among teeth in the four different intra-oral quadrants. Nevertheless, tooth type and age elicit an effect upon the value of the natural frequency of teeth. On the other hand, the mean value for the natural frequency of CIs (1.27 +/- 0.15 kHz), CAs (1.30 +/- 0.15 kHz), FPs (1.27 +/- 0.15 kHz) and FMs (1.16 +/- 0.12 kHz) for males are significantly lower (p < 0.01) than the analogous figure for females (1.41 +/- 0.21 kHz for CIs, 1.40 +/- 0.18 kHz for CAs, 1.37 +/- 0.20 kHz for FPs, and 1.25 +/- 0.16 kHz for FMs). Moreover, the natural frequency of teeth in male subjects varies with age (p < 0.05). The highest mean frequency of CIs, CAs and FPs for the male subjects is found for the group aged between 40 and 49 years. On the other hand, the natural frequency for the similar set of teeth for the female subjects is shown to be in no way associated with age.

[The effect of functional endoscopic sinus surgery on mucociliary clearance]

OBJECTIVE

To explore the effect of functional endoscopic sinus surgery(FESS) on the mucociliary clearance of nasal mucosa.

METHOD

105 patients suffered from chronic sinusitis and undergone FESS from Jan. 1998 to Dec. 1998 were staged and analyzed according to the standard set up in Haikou in 1997. The nasal mucociliary transport rate (MTR) was measured by "saccharin" before, three months and six months after surgery.

RESULT

1. The difference of the stages for chronic sinusitis affected directly the surgical result. 2. The difference of properties, limits and extents of pathological changes in sinuses was significantly associated with the MTR. The MTR showed a marked reduction in stage II-II, II-III and III. The MTR was increased after surgery. 3. The difference of the stages affected directly the recovery of MTR. The MTR in stage I-I, I-II, I-III and II-I recovered more quickly.

CONCLUSION

The MTR of nasal mucosa tended to recover after FESS. The study confirmed that the present staging system for chronic sinusitis was seasonable. We therefore propose the "saccharin" technique as a simple, safe, reliable and objective method of assessing the results of surgery.

Pathogenesis of axonal degeneration: parallels between Wallerian degeneration and vincristine neuropathy

Peripheral neuropathies and Wallerian degeneration share a number of pathological features; the most prominent of which is axonal degeneration. We asked whether common pathophysiologic mechanisms are involved in these 2 disorders by directly comparing in vitro models of axonal degeneration after axotomy or exposure to the neurotoxin vincristine. Embryonic rat dorsal root ganglia (DRG) were allowed to extend neurites for 5 days in culture, and then were either axotomized or exposed to 0.01 microM vincristine. Neurites universally degenerated by 3 days after axotomy or after 6 days of vincristine exposure. The neuroprotective effects of a low calcium environment or pharmacologic inhibition of the cysteine protease calpain were compared in these 2 models of axonal degeneration. Addition of EGTA or growth in zero-calcium media provided significant protection against axonal degeneration after either axotomy or vincristine exposure. Treatment with the experimental calpain inhibitor AK295 was equally protective in both models. Chronic exposure to AK295 was not toxic to the cultures. These data suggest that common mechanisms involving calcium and calpains are involved in both axotomy-induced and vincristine-induced axonal degeneration. In addition, calpain inhibition may provide a strategy for preventing axonal degeneration and preserving neurologic function in a variety of PNS and CNS disorders.

[Study on the coagulation state of sudden deafness]

OBJECTIVE

To explore the coagulation, anticoagulation and fibrinolyic activity in sudden deafness (SD).

METHOD

The plasma samples from 42 patients with SD before treatment, 23 patients after treatment and 32 normal controls were examined for coagulation factors, anticoagulation, fibrinolyic activity and platelet functions.

RESULT

The functions of coagulation and platelet enhanced, the functions of anticoagulation and fibrinolyic system decreased in 42 patients with SD before treatment. We treated with vitamin, dextranum, energetic compound, vasodialator, antiviral ect in 23 patients for a month. The functions of coagulation, anticoagulation and platelet were no significant difference between the after treatment group and control group (P > 0.05). The level of D-dimer obviously elevated (P < 0.01).

CONCLUSION

The functions of coagulation and platelet enhanced, the functions of anticoagulation and fibrinolyic system decreased in SD before treatment, The secondary fibrinolyic activity enhanced after treatment. The thrombosis is one of important pathogenesis of SD.

FK506 increases the regeneration of spinal cord axons in a predegenerated peripheral nerve autograft

The authors examined the ability of FK506 to accelerate axonal regeneration of rat spinal cord axons in a peripheral nerve (PN) graft. Predegenerated autografts were produced by transecting the left tibial nerve 1 week prior to spinal cord implantation into the lumbar (L-3-L-4) spinal cord. Rats were given daily injections of either FK506 (5 mg/kg, subcutaneous) or vehicle for 21 days. The PN grafts from FK506-treated rats contained larger sized regenerating axons compared with vehicle-treated controls, and mean axonal areas increased by 25% at 7.5 mm along the PN graft. Fluoro-Gold retrograde labeling confirmed that the regenerating axons originated from the central nervous system. Unexpectedly, the majority (>50%) of neurons in the red nucleus were retrogradely labeled in the FK506-treated animals only. The results indicate that FK506 not only accelerates the elongation of spinal cord axons but also promotes regeneration of rubrospinal neurons.

PROFILE: An Integrated Framework for Public Sector Environmental Management in Developing Countries

/ Achieving successful and well-integrated environmental management depends on principled and orderly assignment of responsibilities within and between public sector organizations. Guidelines for making these assignments can be found by considering different modes of public response in light of a framework based on some distinguishable patterns in the complexity they exhibit. The basic dimensions of environmental problems can be used to identify these patterns. Two examples from current environmental problems in Taiwan are given, illustrating how this framework can be put to use.

Clinical and molecular findings in two patients with russell-silver syndrome and UPD7: comparison with non-UPD7 cases

The clinical presentation of prenatal and postnatal growth deficiency, triangular face, relative macrocephaly, and body asymmetry is frequently diagnosed as Russell-Silver syndrome (RSS). Maternal uniparental disomy (UPD) of chromosome 7 was reported previously in a small subset of individuals with RSS phenotype or primordial growth retardation. The primary purpose of this study was to identify RSS patients with UPD7 and determine whether or not they present phenotypic findings that distinguish them from RSS patients without UPD7. UPD7 testing was performed in 40 patients with unexplained growth retardation, including 21 patients with a diagnosis of RSS. In addition, a subset of patients was screened with markers spanning chromosome 7 to detect potential microdeletions or segmental uniparental disomy. Two of the RSS cases were identified to have maternal UPD7; no cases with deletion or partial UPD were detected. Together with previously published studies, UPD7 was identified in 11/120 (9%) of individuals with classical RSS phenotype. Our patients with UPD7 and those previously published had a classical RSS phenotype and were not clinically distinguishable from other children diagnosed with RSS.

Validation of the Brief Pain Inventory in a Taiwanese population

Assessment of pain in cancer patients is very important to all health care professionals. This paper describes the development of a Taiwanese version of the Brief Pain Inventory (BPI-T) and discusses its psychometric properties in Taiwan. The BPI-T was developed from the original BPI using back-translation and committee review. A total of 534 cytologically or pathologically diagnosed cancer patients in three medical centers in Taiwan were interviewed between July 1992 and October 1997. The intraclass correlation coefficient for the test-retest reliability was 0.79 for the pain severity scale and 0.81 for the pain interference scale. The explained variance for the within-scale factor analyses was larger than 60% in both scales. The coefficient alpha for the internal reliability was 0.81 for the severity scale and 0.89 for the interference scale. Confirmatory factor analysis of the BPI-T clearly identified the same two scales (severity and interference scales) in the 299 adult patients (age between 20-64) with high education (education years > 9) or patients at an early stage of disease. However, in the 235 nonadult patients with distant metastasis or low education patients with distant metastasis, the "most severe pain" item loaded more to the interference scale than the severity scale. Convergent validity of the pain severity was demonstrated by significant correlations with stage of disease (National Cancer Institute's Surveillance, Epidemiology, and End Results Program [SEER]), performance status (Eastern Cooperative Oncology Group [ECOG]), and pain interference. In conclusion, interviewer-administered BPI-T was a reliable instrument for cancer pain severity and its interference in Taiwan. Additionally, it was a valid instrument on adult cancer patients with high education or patients at an early stage of disease.

Molecular and clinical correlation study of Williams-Beuren syndrome: No evidence of molecular factors in the deletion region or imprinting affecting clinical outcome

Williams-Beuren syndrome (WBS) results from a deletion of 7q11.23 in 90-95% of all clinically typical cases. Clinical manifestation can be variable and therefore, deletion size, inherited elastin (ELN) and LIM kinase 1 (LIMK1) alleles, gender, and parental origin of deletion have been investigated for associations with clinical outcome. In an analysis of 85 confirmed deletion cases, no statistically significant associations were found after Bonferroni's correction for multiple pairwise comparisons. Furthermore, the present data do not support presence of imprinted genes in the WBS common deletion despite a nonsignificant excess of maternal over paternal deletions. Maternal deletion cases were more likely to have a large head circumference in the present data. Also, pairwise comparisons between individual WBS clinical features have been conducted and revealed significant associations between (1) low birth weight and poor postnatal weight gain (<10th percentile at the time of examination) and (2) transient infantile hypercalcemia and a stellate iris pattern. The latter association could indicate a common underlying etiology.