[Characteristics of Guyton's exaggerated forced duction test (FDT) and torsional FDT in congenital superior oblique palsy]

Objective: To investigate the characteristics of Guyton's exaggerated forced duction test (FDT) and torsional FDT in patients with congenital superior oblique palsy (CSOP) and their correlation with clinical features. Methods: This cross-sectional study included single-eye CSOP patients and intermittent exotropia (IXT) patients scheduled for strabismus correction surgery at Tianjin Eye Hospital from September 2021 to March 2022. Prior to surgery, measurements of fovea-disc angle (FDA) and maximum cross-sectional area of the superior oblique muscle (max-CSA) were obtained in both eyes of the patients. The Guyton's exaggerated FDT and torsional FDT were performed intraoperatively to assess the degree of superior oblique muscle relaxation. The characteristics of the two FDT tests and their correlation with vertical strabismus angle, FDA, and max-CSA were analyzed. Statistical analyses were conducted using t-test, ANOVA, Tukey's test, Mann-Whitney U test, and chi-square test. Results: A total of 42 patients (84 eyes) were included in the study, including 19 IXT patients (38 eyes) and 23 CSOP patients (46 eyes, 23 eyes with palsy and 23 eyes without palsy). There were no statistically significant differences in gender composition or age between the IXT and CSOP patients (all P>0.05). The degrees of superior oblique muscle relaxation measured by the Guyton's exaggerated FDT were (-2.52±1.20), (-0.35±0.71), and (-0.03±0.16) for the palsy eye, non-palsy eye, and IXT eyes, respectively, showing significant differences (F=88.10, P<0.001). The torsional FDT measurements yielded external rotation angles of 48.70°±9.67°, 37.39°±5.40°, and 38.95°±2.88° for the palsy eye, non-palsy eye, and IXT eyes, respectively, showing significant differences (F=16.67, P<0.001). There was no statistically significant difference in internal rotation angles (F=2.36, P=0.100). The FDA values were-12.11°±7.42° for IXT patients and-19.02°±4.95° for CSOP patients, while the max-CSA values for the palsy eye and non-palsy eye of CSOP patients were (7.59±4.69) mm² and (11.63±3.64) mm², respectively, all showing significant differences (all P<0.001). The degree of superior oblique muscle tendon relaxation assessed by the Guyton's exaggerated FDT was negatively correlated with the external rotation angle measured by the torsional FDT (r=-0.64, P=0.001). They were positively correlated with max-CSA (r=0.45, P=0.030) and negatively correlated with max-CSA (r=-0.52, P=0.011). However, there was no correlation with vertical and rotational strabismus angle (r=-0.12, P=0.579; r=0.33, P=0.126) and FDA (r=-0.02, P=0.921; r=-0.23, P=0.309). Conclusions: Guyton's exaggerated FDT and torsional FDT can both assess the degree of superior oblique muscle relaxation in patients with CSOP. Furthermore, these two tests are correlated with changes in superior oblique muscle morphology. However, FDT cannot reflect the degree of vertical and rotational strabismus in patients.

Effects of sea salt intake on metabolites, steroid hormones, and gut microbiota in rats

High salt intake is positively linked to many health problems, but the effect of mineral-rich sea salt (SS) has rarely been studied. To better understand the physiological effects of SS intake, the changes in general characteristics, metabolites, steroid hormones, and gut microbiota of SS-fed rats were investigated. Male rats were fed either a normal diet (ND, control) or ND containing 1% SS or 4% SS for 5 weeks. SS intake decreased fat, spleen, liver, and body weight, and increased blood urea nitrogen (BUN), water intake, and gut salt content. Accumulated gut salt content led to a decrease in beneficial bacteria, such as Lachnospiraceae and Lactobacillus, but an increase in potentially harmful bacteria, resulting in a change in lipid metabolites associated with gut health. Interestingly, most renal lysophosphatidylcholines (LPCs) associated with many renal functions were dramatically decreased and female hormones, such as estrogens, were significantly more altered than the male hormones by high SS intake. Although further investigation is needed, these data suggest that high SS intake could be positively linked to kidney dysfunction and gut health problems, and salt-related physiological changes may be sex-specific. Additionally, these data will be useful to better under-stand the physiological effects of SS intake.

[Clinical study of Chinese Medicine fumigation combined with "Zhuyuan Decoction" in the treatment of chronic rhinosinusitis]

Objective:To investigate the clinical efficacy of "Zhuyuan soup" by combination with fumigation and oral administration on chronic rhinosinusitis（CRS）, further exploring effective Chinese medicine for the disease, and giving full play to the unique advantages of external treatment of traditional Chinese medicine. Method:By using randomized and positive drug controlled methods, patients with moderate-to-severe chronic rhinosinusitis were randomly divided into western medicine group and traditional Chinese medicine group, 30 cases in each group. In the western medicine group, the nasal spray hormone Budesonide was used, and the patients in the traditional Chinese medicine group were treated with the traditional Chinese medicine prescription"Zhuyuan soup"by combination with fumigation and oral administration. All of the above patients were followed up for 2 weeks, and 1 course for 1 month. Visual analogue scores were taken at each follow-up, and CT and nasal endoscopy were performed before and after treatment. Result:The total effective of "Zhuyuan soup" group was 67.1%, which was higher than that of western medicine group（59.6%）, but there was no statistically significant difference（P>0.05）. After treatment, there were no significant differences between the two groups with regard to the symptom of nasal congestion, dizziness, facial pain or fullness, dysosmia, nasal discharge or postnasal drip, total sensation, total symptom score（P>0.05）. According to the total symptom score, the effect of the two groups of patients was not significantly correlated with the gender, age, course of disease, alcohol and tobacco hobbies, previous medication and surgery（P>0.05）. Based on the results of the study, we found that the Chinese medicine group is superior to the western medicine group in improving the total feeling of the disease, dizziness or headache, facial pain or fullness, and postnasal drip, olfactory disorder. Conclusion:Both traditional Chinese medicine and western medicine are effective methods for treating chronic rhinosinusitis. Clinically, individualized comprehensive treatment should be carried out according to the patient's condition. The above methods may be applied alone or in combination with Chinese and Western medicine. Further optimization and improvement of the combination of traditional Chinese and Western medicine in chronic sinusitis can help improve the clinical efficacy and satisfaction of patients, which deserves further study.

[A multicenter, retrospective study of pathogenic bacteria distribution and drug resistance in febrile neutropenic patients with hematological diseases in Shanghai]

目的

了解上海地区中性粒细胞缺乏（粒缺）伴发热血液病患者致病细菌的分布及耐药情况。

方法

回顾性分析2012年1月至2014年12月上海市12家医院血液科粒缺伴发热住院患者的临床分离菌株，用纸片扩散法进行药敏试验，WHONET 5.6软件分析病原菌分布及药敏数据。

结果

从上海地区粒缺伴发热患者中共分离出1 260株细菌，其中革兰阳性菌420株（33.3%），革兰阴性菌840株（66.7%）。排在前七位的分别是肺炎克雷伯菌158株（12.5%）、嗜麦芽窄食单胞菌120株（9.5%）、大肠埃希菌115株（9.1%）、铜绿假单胞菌109株（8.7%）、鲍曼不动杆菌83株（6.6%）、金黄色葡萄球菌70株（5.6%）和屎肠球菌63株（5.0%）。呼吸道分泌物标本中，非发酵菌占56.2%（350/623）。其中嗜麦芽窄食单胞菌占15.3%（95/623）。血液标本中，肠杆菌科细菌占42.3%（104/246），凝固酶阴性葡萄球菌占34.6%（85/246）。脓液标本中肠杆菌科细菌占39.4%（76/193），肠球菌属细菌占28.5%（55/193）。耐甲氧西林金黄色葡萄球菌葡萄球菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）的检出率分别为54.3%和82.5%，未发现耐利奈唑胺、万古霉素、替考拉宁葡萄球菌属菌株，耐万古霉素屎肠球菌的检出率为8.9%，肠球菌属未检出耐利奈唑胺的菌株。肠杆菌科细菌对碳青霉烯类药物高度敏感。铜绿假单胞菌对亚胺培南和美罗培南的耐药率已分别达34.1%和15.8%。嗜麦芽窄食单胞菌对米诺环素、左氧氟沙星、复方磺胺甲恶唑等药物敏感。鲍曼不动杆菌仅对头孢哌酮/舒巴坦的耐药率低于10.0%。肺炎克雷伯菌、嗜麦芽窄食单胞菌、铜绿假单胞菌、鲍曼不动杆菌等革兰阴性菌对大多常用抗菌药物的耐药率低于CHINET监测的数据。

结论

粒缺伴感染患者常见感染部位致病菌株分布有其特点，细菌耐药率整体低于CHINET全国医院大样本监测。

High-energy scale revival and giant kink in the dispersion of a cuprate superconductor

In the present photoemission study of a cuprate superconductor Bi1.74Pb0.38Sr1.88CuO6+delta, we discovered a large scale dispersion of the lowest band, which unexpectedly follows the band structure calculation very well. Similar behavior observed in blue bronze and the Mott insulator Ca2CuO2Cl2 suggests that the origin of hopping-dominated dispersion in an overdoped cuprate might be quite complicated. A giant kink in the dispersion is observed, and the complete self-energy containing all interaction information is extracted for a doped cuprate. These results recovered significant missing pieces in our current understanding of the electronic structure of cuprates.

First EBV vaccine trial in humans using recombinant vaccinia virus expressing the major membrane antigen

In the absence of a truly representative animal model, the question of whether EBV-related diseases can be prevented by a vaccine has been studied for the first time in humans. A live recombinant virus based on the licensed vaccinia strain Tien Tan, expressing under the 11K vaccinia promoter the major EBV membrane antigen BNLF-1 MA (gp 220-340), was constructed and tested in three different human populations: EBV-positive and vaccinia-virus-exposed adults; EBV-positive, non-vaccinia-virus-exposed juveniles; and EBV and vaccinia virus-naive infants. No significant titre variations for EBV were observed in the adults, but EBV-neutralising titres increased in the vaccinated juveniles, while antibodies to VCA of EBV remained unchanged. All nine vaccinated infants developed antibodies to MA (membrane antigen) with neutralising properties in vitro; three of these infants were infected by EBV via natural routes over a period of 16 months after vaccination and all ten unvaccinated control infants became infected. It has been shown for the first time that protection against and/or delay of EBV infection by the natural route is possible in humans and that live vaccinia vectors can be used and are efficacious.

The Epstein-Barr virus-encoded glycoprotein gp 110 (BALF 4) can serve as a target for antibody-dependent cell-mediated cytotoxicity (ADCC)

Antibody-dependent cell-mediated cytotoxicity (ADCC) is thought to play a major role in controlling the spread of the Epstein-Barr virus (EBV) in an infected individual. Recently, the viral membrane protein gp 350/220, which is also expressed at the surface of the virus producing cell, was identified as a target for ADCC reactions. Due to its glycoprotein nature, the EBV protein gp 110 is another possible ADCC target. It is one of the most abundant proteins found during the late phase of viral replication; until now, however, researchers have not been able to localize it on the surface of EBV positive cells. By means of recombinant vaccinia viruses containing the genes for gp 350/220 and gp 110, respectively, we expressed these proteins in lymphoblastoid cells, which were then used as targets in ADCC studies with sera from EBV-positive and -negative individuals. In these experiments we were able to demonstrate the feasibility of our approach for the investigation of EBV-specific ADCC reactions and could confirm the role of gp 350/220 as an ADCC target. Furthermore, we were able to show that gp 110 can also be recognized in an ADCC reaction, proving that at least some gp 110 molecules must be expressed at the cell surface.

Sandwich nucleic acid hybridization: a method with a universally usable labeled probe for various specific tests

Nucleic acid hybridization is widely used for scientific applications but essentially restricted to specialized laboratories. The use of recombinant m 13 phages as hybridization probes (Hu and Messing (1980) Gene 17, 271; Messing (1983) Methods Enzymol. 101, 20) offers a considerable advantage over the commonly used recombinant plasmids as the preparation of the DNA probe is very simple and it can easily be labeled directly, e.g. with isotopes with long half-life like 125I (Commerford (1971) Biochemistry 10, 11 (1983); Gu et al. (1983) Cancer (China) 2, 129; Han and Harding (1983) Nucleic Acids Res. 11, 14) and used for hybridization. However, as the application of nucleic acid hybridization for diagnostic and epidemiological purposes becomes almost unavoidable, the logistic problems of keeping numerous individually labeled hybridization probes increase considerably and may reach prohibitory levels in less well-equipped laboratories. In a new sandwich technique, the first step involves hybridization with an unlabeled recombinant m 13 DNA carrying an insert of the desired specificity. In a second step a universally usable labeled probe directed against the m 13 part of the recombinant phage DNA is applied. This reduces considerably the problems of preparing and keeping multiple labeled probes in stock.

[Labelling of DNA by iodination and its application on the detection of EBV-DNA]

The authors developed a simple and efficient method--the iodination of the single-stranded DNA catalyzed by thallium chloride in vitro. The 125I-labelled DNA has a specific activity higher than 10(8) cpm/micrograms DNA. This reaction does not involve any enzyme. The optimal conditions of the iodinating reaction, including the high temperature, low pH and the concentrations of DNA and iodine, are described. 125I-labelled DNA inserted with the fragment of EBV-DNA are used to detect EBV-DNA by blot and spot and in situ hybridization.

New developments in nucleic acid hybridization

Nucleic acid hybridization is widely used for scientific applications in specialized laboratories. This paper describes hybridization probes that can be prepared with less specialized equipment. A new indirect 'sandwich' hybridization test is described which allows the use of only one universally usable labelled probe for hybridization tests with specificities for various sequences. The use of different labels and hybridization techniques is also discussed and critically compared. For in situ hybridization, the usability of fixed and embedded materials is tested and evaluated.