[Analysis of the clinical predictive value of lactate on the prognosis of patients with acute-on-chronic liver failure combined with infection]

Objective: To explore the predictive value of lactic acid for the adverse prognostic outcomes in patients with acute-on-chronic liver failure combined with infection. Methods: A retrospective analysis was conducted on the clinical data of 208 cases of ACLF combined with infection who were hospitalized from January 2014 to March 2016. Patients were divided into a survival group (n = 83) and a mortality group (n = 125) according to the results of a 90-day follow-up. The clinical data were statistically analyzed between the two groups. Multivariate logistic regression with two categorical variables was used to analyze the independent risk factors for 90-day disease mortality and establish a new prediction model. The receiver operating characteristic curve (ROC curve) was used to evaluate the predictive value of lactic acid, the MELD score, the MELD-Na score, lactic acid combined with the MELD score, lactic acid combined with the MELD-Na score, and the new model. Results: The 90-day mortality rate of 208 cases of ACLF combined with infection was 60.1%. There were statistically significant differences in white blood cell count, neutrophil count, total bilirubin (TBil), serum creatinine (Cr), blood urea nitrogen (BUN), blood ammonia, the international normalized ratio (INR), lactic acid (LAC), procalcitonin, the MELD score, the MELD-Na score, hepatic encephalopathy (HE), acute kidney injury (AKI), and bleeding between the two groups. Multivariate logistic regression analysis showed that TBil, INR, LAC, HE, and bleeding were independent risk factors for 90-day mortality in patients with ACLF combined with infection. After the establishment of MELD-LAC, MELD-Na-LAC, and a new prediction model, the ROC curve revealed that the AUC (95% confidence interval) of MELD-LAC and MELD-Na LAC were 0.819 (0.759 ~ 0.870) and 0.838 (0.780 ~ 0.886), respectively, and was superior than the MELD score [0.766 (0.702 ~ 0.823)] and MELD-Na score [0.788 (0.726 ~ 0.843)], with P < 0.05, while the new model had an AUC of 0.924, the sensitivity of 83.9%, specificity of 89.9%, and accuracy of 87.8%, which was higher than LAC, MELD score, MELD-Na score, MELD-LAC, and MELD-Na-LAC (P < 0.01). Conclusion: Lactic acid is an independent risk factor for mortality in patients with ACLF combined with infection, and it improves the clinical predictive value of MELD and MELD-Na for the prognosis of mortality.

Tetrandrine induces microRNA differential expression in human hypertrophic scar fibroblasts in vitro

MicroRNAs (miRNAs) have recently been shown to play a role in normal wound healing process. miRNAs may be linked to pathologic wound healing and closely related to the formation of hypertrophic scars. This study aimed to explore the effects of tetrandrine on the miRNA expression profile in human hypertrophic scar fibroblasts (HSFs) in vitro. HSFs were randomly divided into two groups: the tetrandrine treatment group and the control group. The experimental and control groups were collected and analyzed by miRNA array after a 48-h culture. Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) was performed to confirm the array results. The targets of differentially expressed miRNA were functionally annotated using bioinformatic approaches. miRNA microarray analysis identified 193 differentially expressed miRNAs and the expression of 186 miRNAs in the experimental group decreased while that of 7 miRNAs increased compared to the control group. The most significantly downregulated miRNA was hsa-miR-1246, and hsa-miR-27b had the highest expression level. Significant differentially expressed miRNAs were predicted to be related to several important signaling pathways related to scar wound healing. The differential miRNA expression identified in this study provides the experimental basis for further understanding the anti-fibrosis effect of tetrandrine.

First Report of Leaf Spot Disease Caused by Glomerella magna on Lobelia chinensis in China

Lobelia chinensis is a perennial herbaceous plant in the family Campanulaceae that is native to China, where it grows well in moist to wet soils. It is commonly used as a Chinese herbal medicine. In May 2012, symptoms of leaf spot were observed on leaves of L. chinensis in Nanning, Guangxi Zhuang Autonomous Region, China. The leaf lesions began as small, water-soaked, pale greenish to grayish spots, which enlarged to gray to pale yellowish spots, 4 to 6 mm in diameter. At later stages, numerous acervuli appeared on the lesions. Acervuli were mostly epiphyllous, and 40 to 196 μm in diameter. On potato dextrose agar (PDA), a fungus was consistently recovered from symptomatic leaf samples, with a 93% isolation rate from 60 leaf pieces that were surface sterilized in 75% ethanol for 30 s and then in 0.1% mercuric chloride for 45 s. Three single-spore isolates were used to evaluate cultural and morphological characteristics of the pathogen. Setae were two to three septate, dark brown at the base, acicular, and up to 90 μm long. Conidia were long oblong-elliptical, guttulate, hyaline, and 11 to 20 × 4.1 to 6.3 μm (mean 15.2 × 5.1 μm). These morphological characteristics of the fungus were consistent with the description of Colletotrichum magna (teleomorph Glomerella magna Jenkins & Winstead) (1). The rDNA internal transcribed spacer (ITS) region of one isolate, LC-1, was sequenced (GenBank Accession No. KC815123), and it showed 100% identity to G. magna, GenBank HM163187.1, an isolate from Brazil cultured from papaya (2). Although KC815123 was identified as G. magna, it shows 99% identity to GenBank sequences from isolates of C. magna, and more research is needed to elucidate the relationships between these taxa, especially with consideration to host specificity. Pathogenicity tests were performed with each of the three isolates by spraying conidial suspensions (1 × 10⁶ conidia/ml) containing 0.1% Tween 20 onto the surfaces of leaves of 30-day-old and 6- to 8-cm-high plants. For each isolate, 30 leaves from five replicate plants were treated. Control plants were treated with sterilized water containing 0.1% Tween 20. All plants were incubated for 36 h at 25°C and 90% relative humidity in an artificial climate chamber, and then moved into a greenhouse. Seven days after inoculation, gray spots typical of field symptoms were observed on all inoculated leaves, but no symptoms were seen on water-treated control plants. Koch's postulates were fulfilled by reisolation of G. magna from diseased leaves. To our knowledge, this is the first report of G. magna infecting L. chinensis worldwide. References: (1) M. Z. Du et al. Mycologia 97:641, 2005. (2) R. J. Nascimento et al. Plant Dis. 94:1506, 2010.

First Report of Leaf Spot Caused by Corynespora cassiicola on Baphicacanthus cusia in China

Baphicacanthus cusia is a perennial herbaceous plant in the family Acanthaceae that is native to China, where it grows in warm temperate mountainous or hilly regions. It is commonly used as a Chinese herbal medicine. In March 2012, symptoms of leaf spot were observed on leaves of B. cusia in Long'an County, Guangxi, China, where this plant is extensively cultivated. Symptoms were initially small brown dots which developed into irregular to circular leaf spots. These spots enlarged and overlapped, extending until the 7- to 9-cm-long and 3- to 4-cm-wide leaves withered entirely, mostly within 2 months. On potato dextrose agar (PDA), the same fungus was cultured from 92% of 75 symptomatic leaf samples that had been surface sterilized in a 45-second dip in 0.1% mercuric chloride. Fungal structures were observed on diseased leaves: conidiophores (85 to 460 × 4 to 8 μm) were erect, brown, single or in clusters, and conidia (36 to 90 × 5 to 16 μm) were single or in chains of two to four, brown, cylindrical or obclavate, straight or slightly curved, with 3 to 18 pseudosepta and a conspicuous hilum. Three single-spore isolates were identified as Corynespora cassiicola (Berk & Curt.) Wei based on morphological and cultural characteristics (1). The rDNA internal transcribed spacer (ITS) region of one isolate, ZY-1, was sequenced (GenBank Accession No. JX908713), and it showed 100% identity to C. cassiicola, GenBank FJ852716, an isolate from Micronesia cultured from Ipomoea batatas (2). Pathogenicity tests were performed with each of the three isolates by spraying conidial suspensions (5 × 10⁴ conidia/ml) containing 0.1% Tween 20 onto the surfaces of leaves of 60-day-old, 20-cm tall plants. For each isolate, 30 leaves from five replicate plants were treated. Control plants were treated with sterilized water containing 0.1% Tween 20. All plants were incubated for 36 h at 25°C and 90% relative humidity in an artificial climate chamber, and then moved into a greenhouse. Seven days after inoculation, dark brown spots typical of field symptoms were observed on all inoculated leaves, but no symptoms were seen on water-treated control plants. Koch's postulates were fulfilled by reisolation of C. cassiicola from diseased leaves. To our knowledge, this is the first report of C. cassiicola infecting B. cusia worldwide. References: (1) M. B. Ellis. Dematiaceous Hyphomycetes. Commonwealth Mycological Institute: Kew, Surrey, England, 1971. (2) L. J. Dixon et al. Phytopathology 99:1015, 2009.

An Outbreak of Gummosis of Mango Trees Caused by Lasiodiplodia theobromae in Guangxi, South China

Mango (Mangifera indica L.) is an economically important fruit in southern provinces of China. In May 2012, field surveys including 2,250 mango trees were done in nine orchards of five different counties in Guangxi Province. An outbreak of gummosis was observed in the province involving over 30,000 ha with an average of 50% disease incidence (DI) and a maximum of 70% in some orchards. Until then, gummosis had been considered a common but not serious disease. In 2012, high temperatures in April and extensive rain in May favored increased disease development. Infected plants showed abundant gum secretion from branches, stems, and main trunks. Some branches died from the disease. During the early stages of infection, branches or stems turned brown followed by xylem necrosis and exudation of a milky sap. The sap turned yellow and finally formed amber gum within several days. Initially, the gum appeared as small droplets, increasing in number, and covering most of the branches and the trunk with bark cracking under severe conditions. On potato dextrose agar (PDA), isolates with similar morphology were consistently recovered from symptomatic plant tissues after surface sterilization in 75% ethanol for 30 seconds and then in 0.1% mercuric chloride for 1 min. Five single-spore isolates from five different locations in Guangxi Province were used to evaluate characteristics of the pathogen. On PDA, cultures were gray with an irregularly distributed, fast-growing, and fluffy aerial mycelium, showing a dark underside as the colony changed from greenish to black after 5 days at 28°C. After 1 month, cultures produced globose pycnidia. Conidia were elliptical and hyaline when immature, becoming dark brown and one-septate, longitudinally striate when mature, and ranged from 20.0 to 28.0 × 10.5 to 16.0 μm (average 23.3 × 13.7 μm). Paraphyses produced within the tissues of pycnidia were hyaline, cylindrical, nonseptate, and up to 61 μm long. The fungus was identified as Lasiodiplodia theobromae (Pat.) Griffon & Maubl. (=Botryosphaeria rhodina (Cooke) Arx) based on morphological and cultural characteristics (1,2). The rDNA internal transcribed spacer region of one isolate showed 100% identity to L. theobromae (GenBank HM346876.2) and was deposited in GenBank (JX982240). Pathogenicity of the five isolates was tested in the field on healthy tissues in June 2012. Five green twigs and five 3-year-old branches were used. Three wounds were made on each twig or branch with a sterilized needle. Mycelial plugs were placed on wounds and covered with Parafilm. Uncolonized PDA plugs were used as controls. Two weeks later, typical brown lesions were observed on inoculated branches, and gum exuded from infected wounds. No symptoms were seen on the controls. Koch's postulates were fulfilled by reisolation of L. theobromae from diseased branches. L. theobromae is well documented as a pathogen of mango. In China, the disease was observed in the 1990s in Hainan Province, and the causal agents were identified as L. theobromae and Colletotrichum gloeosporioides Penz. & Sacc based on morphological observation (3). To our knowledge, this is the most severe outbreak reported from China. References: (1) V. S. de Oliveira Costa et al. Eur. J. Plant Pathol. 127:509, 2010. (2) F. Wang et al. Plant Dis. 95:1378, 2011. (3) Q. C. Xiao et al. Tropical Crops Research (in Chinese) 2:25, 1995.

Short communication: evaluation of Brucella infection of cows by PCR detection of Brucella DNA in raw milk

The collection of serum samples from cows is frequently difficult to implement in large-scale surveys, and may involve a high risk of occupational infection. This study assessed the potential of using raw milk sampling as a suitable method for use in a pilot survey of Brucella abortus infection status in cattle. Raw milk samples from 816 cows were examined. Polymerase chain reaction assays of raw milk, with primers derived from the IS711 element of the Brucella genome, were used. Of the cows, 55 were Brucella positive based on serum agglutination test (SAT) results. Polymerase chain reaction amplified Brucella DNA in 25 (45%) of the 55 SAT-positive cows. All of the 689 SAT-negative cows were found to be negative in PCR assays of their milk. Brucella infection status based on PCR results was then predicted for 72 cows from private h erds in which the brucellosis status was unknown. Subsequently, SAT verification of Brucella status was performed. There was no significant difference between predicted and actual SAT-positive rates in those 72 cows. This study indicates a relationship between Brucella detection levels obtained using milk-based PCR results and SAT results. The specific, rapid, and easy sampling procedure within milk-based PCR assaying for brucellosis detection makes the milk PCR method an attractive alternative for evaluation of B. abortus infection in cows, particularly if used as a routine screening and surveillance tool to reduce brucellosis outbreaks.

Compact grating interferometer for producing photoresist gratings with incoherent light

An achromatic interferometer was developed to produce 1200-lines/mm crossed-line photoresist gratings with a mercury arc light source. It is a compact reflection system of outstanding stability. Alignment procedures are described. The most stringent requirement, coplanar alignment of two folding gratings, was accomplished with the aid of a Twyman-Green interferometer. The grating interferometer produced crossed-line photoresist gratings with first-order diffraction efficiency exceeding 20%.