[A case of fungal keratitis caused by Petriella setifera infection]

The patient, a 66-year-old male, suffered from redness, blurred vision, photophobia, and tearing in the right eye after being injured by a wooden board. Anti-inflammatory treatment showed poor effectiveness. A 4 mm × 4 mm infiltrate with white deposits on the surface was observed in the central cornea of the right eye. Microscopic examination of corneal scrapings, fungal culture, and in vivo confocal microscopy all indicated fungal infection. The isolated strain was identified as Scedosporium apiospermum through microscopic morphology and confirmed as Petriella setifera by gene sequencing. The patient received corneal debridement combined with routine anti-inflammatory and antifungal treatment in the outpatient clinic. During the follow-up period, the condition continued to improve. Slit lamp examination at the revisit 40 days after the initial diagnosis revealed thinning of the corneal stroma, basic healing of the epithelium, and an increase in uncorrected visual acuity from 0.3 to 0.6.

First Report of Root-knot Nematode, Meloidogyne enterolobii on Passiflora edulis in Yulin, China

Passion fruit (Passiflora edulis), a medicinal plant, was introduced into China in the early 19th century, is mainly cultivated in southern provinces (Liang et al. 2019). During March 2023, a survey was carried out and 167 samples were taken from passion fruit cultivated area in Yulin (22.6570263°E; 110.1765019°N) apart from the planting base appeared yellow leaves, stunted growth, and distinctive galls on the roots. Within the galls, Meloidogyne sp. females and egg masses were observed. From the rhizosphere soil, second-stage juveniles (J2) were extracted, and population density was 105/500 g soil. The species was determined to be Meloidogyne enterolobii based on morphological characteristics, including female perineal pattern, and genetic analyses. Female (n = 10) perineal patterns showed oval shape, with coarse and smooth striae, dorsal arch rounded to square, and lateral lines not distinct. The male head cap was high and rounded, with the head region only slightly set off from the body, knobs large, ovoid to rounded. The measurements of males (n = 10) included body length, 1,230.7 ± 244.94 (997 to 1,569) µm; a, 38.58 ± 7.8 (33.45 to 47.05) µm; c, 113.03 ± 26.22 (80.82 to 144.23) µm; stylet, 15.68 ± 1.1 (14.5 to 17.4) µm; spicules, 31.83 ± 2.84 (28.69 to 36.1) µm; tail, 11.09 ± 1.72 (8.02 to 13.38) µm; and gubernaculum length, 8.34 ± 0.28 (8.11 to 8.98) µm. Measurements of J2 (n = 20) included body length, 455.75 ± 44.94 (381 to 512) µm; a, 26.32 ± 3.89 (18.18 to 32.70) µm; c, 8.56 ± 1.2 (6.36 to 10.80) µm; stylet, 12.44 ± 0.76 (11.2 to 13.8) µm; DGO, 3.65 ± 0.54 (2.84 to 4.68) µm; tail, 53.89 ± 6.36 (39.8 to 62.2) µm; and hyaline tail terminus, 11.77 ± 2.83 (7.14 to 16.2) µm. These morphological characteristics are similar to those reported in the original description of M. enterolobii (Yang and Eisenback 1983). The sequences of the partial ITS region was amplified with V5367 (5'-TTGATTACGTCCCTGCCCTTT-3') and 26S (5'-TTTCACTCGCCGTTACTAAGG-3') primers (Vrain et al. 1992). The region between cytochrome oxidase subunit II (COII) and the 16S rRNA mitochondrial DNA (mtDNA COII) was also amplified with the primers C2F3 (5'-GGTCAATGTTCAGAAATTTGTGG-3') (Powers and Harris 1993) and MRH106 (5'-AATTTCTAAAGACTTTTCTTAGT-3') (Stanton et al. 1997). The ITS region yielded a fragment of 757 bp (OR072957) and mtDNA COII of 706 bp (OR078415). A BLAST search indicated the sequences were 100% identical to several sequences of M. enterolobii (MT406250, MH756127 and AY831967, MN269940, respectively). To confirm pathogenicity, 20 passion fruit (P. edulis Sim. f. flavicarpa) 30-day-old seedlings were transplanted into pots with an autoclaved mixture of sand and field soil (3:1) and maintained in the glasshouse at 25 ± 2°C with 65 ± 5% relative humidity. After eight weeks, fifteen plants were inoculated with 500 J2/pot (nematode culture collected from the original field), and another five uninoculated plants served as a control. Two months later, aboveground symptoms were similar to those observed in the field. Nematode reproduction occurred and root galls were observed. The reproduction factor (nematode final population density/initial population density) was 4.8. The disease caused by M. enterolobii was severe in Yulin city of Guangxi. Guangxi is an important area for passion fruit culture, with about 2000 ha, which is responsible for two-thirds of China production (Xing et al. 2020). This is the first record of P. edulis natural infection with M. enterolobii in the Yulin City of Guangxi, China.

[Effects of remimazolam versus propofol on postoperative recovery quality in elderly patients undergoing thoracoscopic laparoscopic radical esophagectomy]

Objective: To investigate the effects of remimazolam versus propofol on postoperative recovery quality in elderly patients undergoing thoracoscopic laparoscopic radical esophagectomy. Methods: A total of 108 elderly patients undergoing thoracoscopic laparoscopic radical esophagectomy under general anesthesia in the Affiliated Cancer Hospital of Zhengzhou University from May to October 2022 were prospectively included. The participants were divided into two groups by the random number table method: remimazolam group (R group, n=54) and propofol group (P group, n=54). There were 54 cases in the R group, with 35males and 19 females, and aged (65.4±3.1) years. Meanwhile, there were 54 cases in the P group, with 33males and 21 females, and aged (64.5±3.0) years. Anesthesia was induced as follows: remimazolam 0.2-0.3 mg/kg and remifentanil 0.5-1.0 μg/kg were intravenously injected in R group, while propofol 1-2 mg/kg and remifentanil 0.5-1.0 μg/kg were intravenously injected in P group. Subsequently, anesthesia was maintained as follows: remimazolam 0.4-1.0 mg·kg^-1·h^-1 and remifentanil 0.05-0.2 μg·kg^-1·min^-1 were intravenously infused in group R, while propofol 4-10 mg·kg^-1·h^-1 and remifentanil 0.05-0.2 μg·kg^-1·min^-1 were intravenously infused in group P. Bispectral index (BIS) was maintained at 45-60 during operation. The main outcome measures were the 15-item quality of recovery (QoR-15) scores 1 day before surgery, 1 day and 3 days after surgery. Secondary outcome measures included mean arterial pressure (MAP), heart rate and pulse oxygen saturation (SpO₂) recorded 5 min before anesthesia induction (T₀), 1 min after induction (T₁), 1 min after endotracheal intubation (T₂), immediately after skin incision (T₃) and tracheal extubation (T₄). The incidence of bradycardia and hypotension and the frequency of application of vasoactive drugs during anesthesia were recorded. Restlessness score (RS) and Ramsay sedation scale during the awakening period were recorded. Emergence time, tracheal extubation time, duration of postanesthesia care unit (PACU) stay and postoperative length of hospital stay were recorded. The incidence of postoperative pulmonary infection and other complications were also recorded. Results: The QoR-15 scale scores [M (Q₁, Q₃)] of R group 1 day and 3 days after surgery were 114.0 (109.0, 118.3) and 131.0 (127.8, 133.0), which were higher than those of P group [106.0 (101.0, 112.0) and 127.0 (125.0, 129.3)] (both P<0.001). The incidence of bradycardia, hypotension and the frequency of application of vasoactive drugs of R group during anesthesia were 5.6% (3/54), 35.2% (19/54) and 27.8% (15/54), which were lower than those in P group [33.3% (18/54), 63.0% (34/54) and 55.6% (30/54), respectively] (all P<0.05). RS score during the awakening period in R group was 0.9±0.5, which was lower than that of P group (1.1±0.6) (P=0.046). Emergence time, tracheal extubation time and postoperative length of hospital stay of R group were (15.4±4.9) min, (16.6±4.7) min and (11.6±1.4) d, which were shorter than those of P group [(26.2±6.4) min, (27.8±5.8) min and (12.6±1.3) d] (all P<0.05). There were no statistically significant differences in Ramsay scores during the awakening period, duration of PACU stay and the incidence of postoperative complications (all P>0.05). Conclusions: Both remimazolam and propofol can achieve satisfactory postoperative recovery quality in elderly patients undergoing thoracoscopic laparoscopic radical esophagectomy. Remimazolam has more stable hemodynamics and lower incidence of adverse reactions.

First Report of Root-Knot Nematode Meloidogyne enterolobii on Antirrhinum majus in China

Antirrhinum majus L. is a medicinal and ornamental herb commonly grown in China. In October 2022, A. majus plants were observed stunted in growth with yellowish leaves and containing a large number of galls on roots in a field in Nanning, Guangxi, China (N22°47'23.35″, E108°23'4.26). Ten samples were collected randomly from rhizosphere soil and roots of A. majus. Second-stage juveniles (J2) were isolated from fresh soil with a Baermann funnel, and a mean of 36 ± 2.9 per 500 cm3 of soil was recorded. Gall roots were dissected using a microscope, where 2+ 0.42 males per sample were recovered. The species was determined to be Meloidogyne enterolobii based on morphological characteristics, including the female perineal pattern, and DNA studies. Female perineal patterns and morphometric data were similar to the original description of M. enterolobii Yang and Eisenback 1983 from Enterolobium contortisilquum (Vell.) Morong in China (Yang and Eisenback 1983). The measurements of males (n = 10) included body length, 1600.7 ± 55.32 (1421.3 to 1924.3) µm; body diameter = 41.3 ± 0.80 (37.8 to 45.4) µm, stylt length = 20.5 ± 0.40 (19.1 to 22.2) µm, spicules length = 30.0 ± 0.47 (28.2 to 32.0) µm and DGO = 4.5 ± 0.3 (3.8 to 5.2) µm. Measurements of J2 (n = 20) included body length, 441.9 ± 5.42 (403.2 to 493.3) µm; body diameter = 16.6 ± 0.30 (14.4 to 8.7) µm, a = 26.8 ± 0.54 (21.9 to 31.2), c = 8.7 ± 0.27 (6.4 to 10.8), stylet length = 12.6 ± 0.17 (11.2 to 14.3) µm, DGO = 3.8 ± 0.10 (2.9 to 4.8) µm, tail length = 51.6 ± 1.27 (42.3 to 63.1) µm and hyaline tail terminus length = 11.7 ± 0.15 (10.2 to 13.1) µm. These morphological characteristics are similar to the original description of M. enterolobii (Yang and Eisenback 1983). Pathogenicity tests were conducted on A. majus 'Taxiti' plants directly germinated from seeds in a 10.5-cm-diameter pot filled with 600 ml of sterilized peat moss/sand (1:1, v/v) soil in the glasshouse. After 1 week, fifteen plants were inoculated with 500 J2/pot (nematode culture collected from the original field) and five uninoculated plants served as a control. After 45 days, aboveground parts of all inoculated plants showed symptoms similar to those observed in the field. No symptoms were observed on control plants. The RF value of the inoculated plants was determined by the method of Belair and Benoit (1996) 60 days after inoculation, and the average was 14.65. J2 were used in this test and sequenced on 28S rRNA-D2/D3, ITS, COII -16SrRNA 3 region and confirmed to be M. enterolobii. Species identification was confirmed by using polymerase chain reaction primers D2A/D3B (De Ley et al. 1999), F194/5368r (Ferris et al. 1993), C2F3/1108 (Powers and Harris, 1993). The sequences obtained GenBank accession numbers OP897743 (COII), OP876758 (rRNA) and OP876759 (ITS) were 100% similar to other M. enterolobii populations from China (MN269947), (MN648519) and (MT406251). M. enterolobii is a highly pathogenic species and has been reported in vegetables, ornamental plants, guava (Psidium guajava L.), and weeds in China, Africa and America (Brito et al. 2004; Xu et al. 2004; Yang and Eisenback 1983). The medicinal plant Gardenia jasminoides J. Ellis was also infected by M. enterolobii in China (Lu et al. 2019). Of concern is its ability to develop on crop genotypes carrying RKN resistance genes in tobacco (Nicotiana tabacum L.), tomato (Solanum lycopersicum L.), soybean (Glycine max (L.) Merr.), potato (Solanum tuberosum L.), cowpea (Vigna unguiculata (L.) Walp.), sweetpotato (Ipomoea batatas (L.) Lam.), and cotton (Gossypium hirsutum L.). Consequently, this species was added to the European and Mediterranean Plant Protection Organization A2 Alert List in 2010. This is the first natural infection report of M. enterolobii in Guangxi, China on the medicinal and ornamental herb A. majus. Acknowledgments This research was funded by the National Natural Science Foundation of China (31860492), Natural Science Foundation of Guangxi (2020GXNSFAA297076), and Guangxi Academy of Agricultural Sciences Fund, China (2021YT062, 2021JM14, 2021ZX24). References: Azevedo de Oliveira, S., et al. 2018. PLoS One 13:e0192397. Belair, G., and Benoit, D. L. 1996. J. Nematol. 28:643. Brito, J. A., et al. 2004. J. Nematol. 36:324. De Ley, P., et al. 1999. Nematol. 1:591-612. Ferris, V. R., et al. 1993. Fundam. Appl. Nematol. 16:177-184. Lu, X. H., et al. 2019. Plant Dis. 103:1434. Powers, T. O. and Harris, T. S. 1993. J. Nematol. 25:1-6 Vrain, T. C., et al. 1992. Fundam. Appl. Nematol. 15:563. Yang, B. and Eisenback, J. D. 1983. J. Nematol. 15:381.

[A case of microsporidial keratitis]

A case of keratitis caused by microsporidia infection was reported. A 57-year-old female patient, without any obvious predisposing cause, presented with eye redness, eye abrasion and vision loss for one year in the left eye. The patient was diagnosed with viral keratitis based on laboratory examinations and clinical symptoms two months ago in our hospital. He was given outpatient treatment for antivirus. Two months later, he was admitted to our hospital with worsened condition that presented with corneal ulcer. After admission, corneal scraping examination was performed for the detection of microsporidia with calcofluor white (CFW) and Ziehl-Neelsen staining, the smear revealed multiple oval spore-like structures, with acid-fast positive and showed blue fluorescence on potassium hydroxide with CFW stain, confirming a diagnosis of microsporidial keratitis in the left eye. Treatment: topical use of ofloxacin eye ointment and voriconazole eye drops was not effective, and then penetrating keratoplasty was performed, and the patient's condition was stable after surgery. At present, they are still in treatment and follow-up.

Suppressive effect erythropoietin on oxidative stress by targeting AMPK/Nox4/ROS pathway in renal ischemia reperfusion injury

OBJECTIVE

To explore the effect of erythropoietin (EPO) on the AMP-activated protein kinase (AMPK)/nicotinamide adenine dinucleotide phosphatase oxidase 4 (NOX4) signaling pathway during renal ischemia reperfusion injury (RIRI) in rats.

METHODS

A rat model of RIRI was established by clamping the left renal pedicle and removing the right kidney. The rats in the sham group did not have their left renal pedicle clamped. Rats with a model of RIRI were randomly divided into RIRI alone (control), erythropoietin treatment (EPO/RIRI), and Compound C treatment (CPC/RIRI) groups. Hematoxylin-eosin (H&E) staining was used to examine pathological kidney damage. Serum creatinine and urea nitrogen levels were measured to evaluate renal function. Western blotting was performed to detect the expression levels of phosphorylated p-AMPK and total AMPK protein in the kidneys. RT-PCR was used to evaluate the mRNA levels of Nox4 and p22 in the kidneys. Oxidative stress-related indices (ROS, CAT, GSH, SOD, and MDA) were also measured.

RESULTS

EPO treatment improved kidney function by preventing kidney damage induced by the RIRI model. Preventing ischemia/reperfusion injury in the RIRI model was correlated with an increased p-AMPK/AMPK ratio and elevated activity of CAT, GSH, and SOD, which ameliorated the expression of NOX4, p22, ROS, and MDA. Moreover, treatment with CPC (an AMPK inhibitor) reduced the effects of EPO in the RIRI model.

CONCLUSION

EPO treatment protected rats against RIRI in the RIRI model by alleviating oxidative stress by triggering the AMPK/NOX4/ROS pathway.

[Effects of S(+)-ketamine combined with sufentanil for patient-controlled intravenous analgesia on the early recovery in elderly patients undergoing laparoscopic radical resection of rectal cancer]

Objective: To observe the efficacy and safety of S(+)-ketamine combined with sufentanil for patient-controlled intravenous analgesia (PCIA) in elderly patients undergoing laparoscopic radical resection of rectal cancer and explore its impact on patients' early recovery. Methods: One hundred and ten patients undergoing laparoscopic radical resection of rectal cancer in Affiliated Cancer Hospital of Zhengzhou University from December 2020 to March 2021, were divided into two groups (n=55) using a random number table: group S received PCIA, with continuous infusion of S(+)-ketamine combined with sufentanil, while group C received PCIA, with continuous infusion of sufentanil. PCIA was initiated at the end of the surgery, and the formulations were as follows: group S, S(+)-ketamine (1.44 mg/kg), sufentanil (1.05 μg/kg), ketorolac tromethamine (2.0 mg/kg) and tropisetron (5 mg), in 100 ml of normal saline; group C: sufentanil (1.50 μg/kg), ketorolac tromethamine (2.0 mg/kg) and tropisetron (5 mg), in 100 ml of normal saline. Postoperative visual analogue scale (VAS) and Ramsay sedation scale were recorded at 6, 12, 24, 36, 48 h after the surgery. The incidence of remedial analgesia, the effective compressions number of PCI during 48 h after the operation. Time to first ambulation, time to first anal exhaust, time to resume oral feeding were recorded. The occurrence of adverse effects was compared between the two groups. Results: A total of 10 patients were excluded during the study, including 4 cases of conversion to laparotomy, 3 cases of dropping out of the study, and 3 cases with operation time more than 4 hours. Finally, 50 cases in group S and 50 cases in group C completed the study. There were no significant differences in VAS scores and Ramsay sedation sores at all time points between two groups (all P>0.05). Likewise, there were also no significant differences in the number of remedial analgesia and effective compressions of PCIA during 48 h after the operation between the two groups (both P>0.05). The total dosage of sufentanil consumption in group S [(64±9) μg] was lower than that in group C [(95±12) μg] within 48 h of PCIA, with a statistically significant difference (P<0.001). Time to first ambulation in group S was (1.1±0.2) d, which was shorter than that in group C [(1.6±0.5) d], and the difference was statistically significant (P<0.001). Likewise, time to first anal exhaust in group S [(1.3±0.4) d] was shorter than that in group C [(1.8±0.6) d], with a statistically significant difference (P<0.001). Additionally, time to resume oral feeding in group S was (2.5±0.6) d, which was shorter than that in group C [(3.1±0.7) d], and there was a statistically significant difference (P<0.001). The incidence of nausea, vomiting and pruritus in group S were 4.0%, 2.0% and 0, which were lower than that in group C (16.0%, 10% and 8.0%, respectively), with statistically significant differences (all P<0.05). No case with psychiatric symptoms was found in both groups. Conclusion: When used for postoperative intravenous analgesia in elderly patients undergoing laparoscopic radical resection of rectal cancer, S(+)-ketamine combined with sufentanil can provide satisfactory analgesic effects, decrease total consumption of sufentanil and the incidence of adverse effects, and thus facilitate patients' early recovery.

[Efficacy of two-lung ventilation with different tidal volume assisted by CO2 pneumothorax for airway management in patients undergoing radical resection of esophageal cancer using combined laparoscopic and thoracoscopic approach]

Objective: To evaluate the efficacy of two-lung ventilation with different tidal volume assisted by CO₂ pneumothorax for airway management in patients undergoing radical esophagectomy using combined thoracoscopic and laparoscopic approach. Methods: One hundred and eighty patients undergoing radical esophagectomy using combined thoracoscopy and laparoscopy under general anesthesia from the Affiliated Cancer Hospital of Zhengzhou University between February and September 2019 were randomly divided into three groups (group V₁, V₂, V₃, n=60) according to the tidal volume (TV) used. The TVs of group V₁-V₃ were 4, 5, 7 ml/kg during thoracoscopic surgery, respectively. All the patients were intubated with a single-lumen endotracheal tube and underwent two-lung ventilation assisted by continuous positive pressure CO₂ pneumothorax in group V₁, V₂ and V₃, with the CO₂ pressure of 10 mmHg (1 mmHg=0.133 kPa) and the frequency of 20 times/min. Mean arterial pressure (MAP) and heart rate (HR) were recorded before thoracoscopic surgery (T₁), 30 minutes after thoracoscopic surgery (T₂), at the end of thoracoscopic surgery (T₃), after thoracoscopic surgery and 30 minutes after two-lung intermittent positive pressure ventilation, respectively. The results of arterial blood gas were collected at T₁, T₂, T₃ and T₄. Recovery time from anesthesia, consciousness recovery time, and lung collapse condition were recorded. Results: At T₂, the value of MAP in group V₁ was (81±10) mmHg, which was higher than those of group V₂ [(69±7) mmHg] and group V₃ [(71±8) mmHg], with a statistically significant difference (F=9.270, P<0.05). Meanwhile, at T₂, the value of HR in group V₁ was (83±7) times/min, which was higher than those of group V₂ [(68±6) times/min] and group V₃ [(71±7) times/min], and there was a statistically significant difference (F=23.460, P<0.05). However, at T₂, the values of arterial partial pressure of oxygen (PaO₂) in three groups were (262±16), (249±16) and (241±20) mmHg, respectively, with no statistically significant difference (F=1.929, P>0.05). At T₃, the value of arterial partial pressure of carbon dioxide (PaCO₂) in group V₃ was (46±5) mmHg, which was lower than those of group V₁ [(63±9) mmHg] and V₂ [(62±10) mmHg], with a statistically significant difference (F=20.890, P<0.05). Moreover, at T₃, the value of pH in group V₃ was (7.35±0.04), which was higher than those of group V₁ (7.28±0.04) and V₂ (7.32±0.04), and there was a statistically significant difference (F=9.309, P<0.05). Additionally, the satisfaction rates of lung collapse in group V₃ was 57.1%, which was lower than those of group V₁ (94.7%) and group V₂ (96.3%), with a statistically significant difference (χ²=7.601, P<0.05). There was no statistical significance in the time of awakening and consciousness recovery among three groups (F=1.020 and 1.110, both P>0.05). Conclusion: The two-lung ventilation with 5 ml/kg tidal volume assisted by CO₂ pneumothorax has advantages in terms of hemodynamics and surgical field exposure, and is more suitable as the appropriate dose for respiratory management in patients undergoing radical resection of esophageal cancer using combined thoracoscopic and laparoscopic approach.

[Clinical features and treatment prognoses of Pythium keratitis]

Objective: To analyze the clinical features and evaluate the prognoses of Pythium keratitis. Methods: It was a retrospective study. The clinical characteristics, confocal microscopic image characteristics, treatment and curative effect of 6 cases of Pythium keratitis identified by DNA sequencing from June 2017 to June 2019 were reviewed retrospectively. Results: Among the 6 patients, there were 4 males and 2 females. All cases were monocular. The age was (58.7±11.3) years (range, 52 to 72 years). Keratopathy under a slit lamp was characterized by a dry ulcer surface, burr signs, satellite foci and pseudopodia around the ulcer. An elevated lesion was observed in 2 patients, and no obvious immune ring structure was observed in all patients. Confocal microscopy did not reveal any specific characteristics of Pythium infection. All patients did not respond well to antifungal drugs and received keratoplasty. Three patients had postoperative recurrence. The recurrence time was 4-6 days after the first operation and 2-3 days after the second operation. Two patients underwent two and three corneal transplants, respectively, after recurrence, but evisceration was required finally. Conclusions: Pythium keratitis is rare and can hardly be distinguished from common fungal infections in clinical manifestations and auxiliary examinations. The disease progresses rapidly, the rates of recurrence and evisceration after keratoplasty are both high, and DNA sequencing is the key to identifying the etiology, which should be paid more attention. (Chin J Ophthalmol, 2021, 57: 589-594).

HMGB1-TLR4-IL-23-IL-17A axis accelerates renal ischemia-reperfusion injury via the recruitment and migration of neutrophils

Renal ischemia-reperfusion injury (IRI) is an important cause of setting off acute kidney injury. Neutrophil-mediated immunomodulation has a pivotal role in the evolving of IRI. The HMGB1-TLR4-IL-23-IL-17A axis gives rise to neutrophil activation. Therefore, in the study, the role of the HMGB1-TLR4-IL-23-IL-17A axis in IRI was evaluated. Cell viability, inflammation, apoptosis, oxidative stress, survival, renal function and pathology, and the activation of macrophages and neutrophils were measured. Moreover, we evaluated the acetylation, translocation, and secretion of HMGB1 as well as levels of TLR-4, IL-23, IL-17A, and neutrophil chemokines (KC, LIX, and MIP-2). In vivo, anti-HMGB1 antibody decreased the acetylation, translocation, and secretion of HMGB1, reduced the expression of TLR-4, IL-23, IL-17A, KC, LIX, and MIP-2, alleviated the activation of macrophages and neutrophils, improved the survival rate and renal dysfunction, and decreased inflammation, apoptosis, oxidative stress, and pathological injury of the kidney. However, the intervention with recombinant HMGB1(R-HMGB1) significantly abolish the above effect of anti-HMGB1 in IRI. Neutralization IL-23 or IL-17A can alleviated the neutrophils mediated renal dysfunction by suppressing inflammation, apoptosis, and oxidative stress in IRI. In vitro, we confirmed that hypoxic/deoxygenation (H/R) induces the secretion of HMGB1 though acetylation on HK-2 and HMGB1 promotes the secretion of IL-23 in a HMGB1/TLR-4-dependent manner on macrophages. Together, these results implied that the HMGB1-TLR4-IL-23-IL-17A axis regulates inflammation, oxidative stress, apoptosis, and renal injury in IRI by promoting the recruitment and migration of neutrophils.

[Application of different kinds of endotracheal intubation in the combined thoracoscopic and laparoscopic esophagectomy]

Objective: To observe the application of three different kinds of endotracheal intubation in the combined thoracoscopic and laparoscopic esophagectomy. Methods: one hundred and eighty patients undergoing combined thoracoscopic and laparoscopic esophagectomy under general anesthesia from the Affiliated Cancer Hospital of Zhengzhou University from February to September 2019 were randomly divided into three groups which include: double-lumen endotracheal intubation group (group S,n=60),single-lumen endotracheal intubation group (group D,n=60) and Coopdech occlusion of bronchial catheter combined with a single-lumen endotracheal intubation group (group C,n=60). The arterial blood samples were collected immediately after endotracheal intubation (T₀), 30 min after artificial pneumothorax (single lung ventilation) (T₁), 30 min after artificial pneumothorax (double lung ventilation) (T₂), and 30 min after extubation (T₃) to detect arterial blood gas. Patients' heart rate (HR), blood oxygen partial pressure (PaO₂), blood carbon dioxide partial pressure (PaCO₂) and airway pressure(Paw) were recorded at T₀-T₃.Completion time of endotracheal intubation, carbon dioxide intrathoracic inflation pressure, degree of lung collapse and incidence of postoperative 3-day pneumonia in three groups were recorded. The bronchoalveolar lavage fluid (BALF) of patients at T₀, T₂ and the end of the operation (T₄) were collected to detect the levels of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8) in BALF by enzyme-linked immunosorbent assay (ELISA). Results: A total of 14 patients were excluded during the operation, of which 9 cases lasted longer than 6 hours, 3 cases had arrhythmia during the operation and 2 cases lasted less than 1 hour. Finally, 56 cases in group S, 54 cases in group D and 56 cases in group C completed the experiment. The satisfaction rates of lung collapse in group S, group D and group C were 85.7% (48/56), 100.0% (54/54), 89.2% (50/56), respectively, with no statistically significant difference (χ²=1.308, P>0.05). The intrathoracic inflation pressure of carbon dioxide in group D was (10.2±2.2) mmHg (1 mmHg=0.133 kPa), which was higher than (5.1±3.4) mmHg in group S and (5.6±3.1) mmHg in group C, the difference was statistically significant (F=-9.303, P<0.05). The incidence of postoperative 3-day pneumonia in group D was 14.8%, which was lower than 39.3% in group S and 17.8% in group C, the difference was statistically significant (χ²=8.300, P<0.05). At T₄, the value of TNF-α in group D was (122.4±4.4) ng/L, which was lower than that in group S and group C, (257.9±6.3) and (185.8±5.6) ng/L, with statistically significant difference (F=69.020, P<0.05). At T₄, the value of IL-6 in group D was (175.4±4.9) ng/L, which was lower than that of patients in group S and group C, (289.6±6.8) and (226.2±4.4) ng/L, with statistically significant difference (F=59.750, P<0.05). At T₄, the value of IL-8 in group D was (303.1±7.2) ng/L, which was lower than in group S and group C, (595.4±22.1) and (436.8±10.9) ng/L, with statistically significant difference (F=55.359, P<0.05). Conclusion: All the three endotracheal intubations can produce satisfactory ventilation effect in the combined thoracoscopic and laparoscopic esophagectomy, however, single-lumen endotracheal intubation has less effect on lung injury.

LncRNA XIST regulates cell proliferation, migration and invasion of glioblastoma via regulating miR-448 and ROCK1

Long non-coding ribonucleic acids (lncRNAs) have been recognized as markers in several cancers and play important roles in glioblastoma (GBM). But the role of lncRNA X inactive-specific transcript (XIST) in GBM and its possible mechanisms are rarely studied in depth. This study was conducted to explore the detailed roles of XIST in cell proliferation, migration, and invasion of GBM. Expressions of XIST, miR-448, and ρ associated coiled coil containing protein kinase 1 (ROCK1) were detected by qRT-PCR or Western blot in A172 and U251 cells. The interactions among XIST, miR-448 and ROCK1 were verified through luciferase reporter assay and RNA immunoprecipitation (RIP) assay. Cell Counting Kit-8 (CCK-8) assay and Transwell assay were introduced to detect how XIST knockdown, miR-448 overexpression, or along with ROCK1 overexpression affect cellular malignancy of GBM cells. XIST and ROCK1 were up-regulated while miR-448 expression was decreased in GBM cells. XIST knockdown or miR-448 overexpression could dramatically inhibit GBM cell proliferation, migration, and invasion. Moreover, XIST negatively regulated miR-448 expression through the function as competing endogenous RNA (ceRNA), thus leading to the up-regulation of ROCK1, one miR-448 target gene. Moreover, ROCK1 overexpression could reverse the suppression of XIST knockdown or miR-448 upregulation on cellular malignancy. In brief, the effects of XIST may promote cellular malignancy of GBM through miR-448/ROCK1 axis, which will provide new understanding of GBM pathogenesis and progression.

[Effects of desflurane and sevoflurane anesthesia on postoperative recovery after long-term tumor surgery]

Objective: To analyze the effects of desflurane and sevoflurane anesthesia on postoperative recovery after long lasting tumor surgery. Methods: One hundred and sixty patients undergoing endoscopic radical esophagectomy and gastrectomy (80 cases of each surgical type) from November 2019 to March 2020 at Henan Cancer Hospital, were randomized into 4 groups(n=40): group CS (esophageal cancer+sevoflurane anesthesia), group DS (esophageal cancer+desflurane anesthesia),group CW (stomach cancer+sevoflurane anesthesia) and group DW (gastric cancer+desflurane anesthesia). General anesthesia was induced by intravenous agents in all four groups, which were maintained by inhaled anesthetic during the operation. The mean arterial pressure (MAP), heart rate (HR), and surplus pulse O(2) (SpO(2)) immediately before induction (T(1)), the moment of operation begin (T(2)), operation end (T(3)) and extubation (T(4)) were recorded. Also, the duration required for inhalation anesthetic alveolar concentration reaching 0.5 minimum alveolar concentration (MAC) during induction, the alveolar anesthetic concentration at the beginning of the operation, the duration required for XMAC (patients specific alveolar concentration) declining to 0.5 MAC on recovery period, and the duration of alveolar concentration of 0.5 MAC declining to 0.2 MAC were determined. Additionally, the durations of spontaneous breathing recovery, eyes opening, extubation and recovery of consciousness were recorded. Finally, restlessness score (RS) during recovery period was used to evaluate postoperative agitation. Results: Compared with group CS and group CW, no significant differences in MAP, HR, SpO(2) in group DS and group DW at T(1) to T(4) were found (all P>0.05). The durations required for inhalation anesthetic alveolar concentration reaching 0.5 MAC were (5.6±1.3), (5.8±2.1), (3.5±1.5) and (3.8±1.0) min in group CS, group CW, group DS and group DW, where the durations in group DS and group DW were significantly shorter than those in group CS and group CW (F=32.538, P<0.05). The durations of alveolar concentration of 0.5 MAC declining to 0.2 MAC were (6.4±2.2), (7.0±1.5), (4.2±2.2) and (4.1±1.5) min in group CS, group CW, group DS and group DW, and the durations in group DS and group DW were significantly shortened as compared with group CS and group CW (F=42.113, P<0.05). Compared with group CS and group CW, group DS and group DW required significantly shorter time for spontaneous breathing recovery, eye opening,extubation, and directional force recovery after operation (all P<0.05). Conclusions: Both desflurane and sevoflurane anesthesia can achieve satisfactory anesthesia depth during long lasting tumor surgery. Desflurane can shorten the recovery time and early extubation, and improve the quality of recovery.

[The predictive value of serum alkaline phosphatase combined with parathyroid hormone in all-cause and cardiovascular mortality in maintenance hemodialysis patients]

To analyze the predictive value of serum intact parathyroid hormone (iPTH) and alkaline phosphatase (ALP) on all-cause and cardiovascular mortality in maintaining hemodialysis (MHD) patients. A total of 224 MHD patients were prospectively investigated and followed up for 2 years. Serum iPTH levels were not associated with all-cause death and cardiovascular death (HR=1.001, 95%CI 1.000-1.004, P=0.048) . The level of serum ALP was associated with cardiovascular death (HR=1.002, 95%CI 1.000-1.004, P=0.033) . ALP≥106 IU/L was an independent risk factor for cardiovascular death in MHD patients (P<0.05) . The joint variable was correlated with mortality in MHD patients (HR=1.002, 95%CI 1.000~1.004, P=0.033) , that equal or over 37.28 was an independent risk factor for mortality (P<0.05).

[Effect of Dexmedetomidine Combined with Propofol or Sevoflurane General Anesthesia on Stress and Postoperative Quality of Recovery(QoR-40) in Patients Undergoing Laparoscopic Surgery]

Objective: To explore the effects of dexmedetomidine combined with propofol or sevoflurane general anesthesia on stress and postoperative quality of recovery (QoR-40) in patients undergoing laparoscopic surgery. Methods: Two hundreds patients with laparoscopic gastrointestinal tumor resection (100 cases of gastric tumor and 100 cases of colon tumor) from March 2016 to January 2018 at Henan Cancer Hospital,were randomly divided into 4 groups(n=50): group SP (gastric neoplasm + propofol anaesthesia), group SS (gastric tumor + sevoflurane anaesthesia), group CP (colon tumor+ propofol anaesthesia), and group CS (colon tumor + sevoflurane anaesthesia). The four groups were all induced by dexmedetomidine, etomidate, sufentanil and cisatracurium. The patients in group SP and group CP were administered with propofol, and the patients in group SS and group CS were given general anesthesia with sevoflurane. The results of the operation and the quality of recovery were compared. The heart rate, mean arterial pressure change, norepinephrine, epinephrine and cortisol were measured in T0 (before anesthesia started), T1 (30 min after surgery), T2 (10 min after tracheal catheter extraction), T3 (24 h after surgery), T4 (postoperative 48 h), respectively. The postoperative recovery quality after operation was evaluated by QoR-40. Results: There were no significant differences in operation time, bleeding volume and other operation conditions between each group (all P>0.05), and also no significant differences in heart rate and mean arterial pressure from T0 to T4 time points (all P>0.05). There were significant differences in the levels of norepinephrine and cortisol among the four groups at T1 and T2 time points (F=54.135,140.733,12.037, 21.644,all P<0.05). The levels of norepinephrine and cortisol in SP group at T1 and T2 time points were less than SS group (all P<0.05). Similar, those in CP group were less than CS group (P<0.05). However, there was no significant difference among the 4 groups at other time points (all P>0.05). The scores of VAS and RS in SP group were (0.9±0.4) and (0.8±0.4), which were lower than that of SS group(1.4±0.5,1.4±0.5,all P<0.05).At the same time, the time of regain consciousness was (9.3±1.4) min, which was also lower than SS group [(10.1±1.4)min,P<0.05]. The scores of VAS and RS in CP group were (0.8±0.5) and (0.8±0.4), which were lower than that of CS group(1.4±0.5,1.4±0.4,all P<0.05).At the same time, the time of regain consciousness was (9.2±1.2)min,which was also lower than CS group [(10.1±1.2)min,P<0.05]. The recovery quality scores of the SP and CP group were (164±11) and (168±11) after 24 hours, which were greater than that of the SS and CS group(146±10, 143±12, all P<0.05). Conclusion: Dexmedetomidine combined with propofol in laparoscopic surgery can effectively suppress intraoperative stress, reduce postoperative pain and agitation, and improve the quality of postoperative recovery.

[Effect of single lumen endobronchial tube and double lumen endobronchial tube on ventilation and lung injury in patients with esophageal cancer undergoing combined thoracoscopic and laparoscopic esophagectomy]

Objective: To investigate the effect of the single lumen endobronchial tube and the double lumen endobronchial tube on ventilation and lung injury in patients with esophageal cancer undergoing combined thoracoscopic and laparoscopic esophagectomy. Methods: Sixty patients with esophageal cancer undergoing combined thoracoscopic and laparoscopic esophagectomy were divided into single lumen endobronchial tube group (D group, n=30) and double lumen endobronchial tube group (S, n=30) according to the random number table. Blood samples were harvested at the moment of tracheal intubation (T(0)), after artificial pneumothorax (one lung ventilation) 30 min (T(1)), after artificial pneumothorax (one lung ventilation) 90 min (T(2)), artificial pneumothorax over (double lung ventilation) 30 min (T(3)) and after extubation 30 min (T(4)) for arterial blood gas analysis. Heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO(2)), oxygen tension (PaO(2)), carbon dioxide partial pressure (PaCO(2)) and airway pressure (PAW) were recorded at T(0)-T(4). The incidences of pneumonia of two groups were record at 3 days after operation. Results: There were no obvious differences in HR, MAP, SpO(2), PaO(2), PaCO(2) between two groups at T(0)-T(4) (P>0.05). Compared with T(0), the levels of HR and PaO(2) were increased remarkably at T(1)-T(3) (P<0.05), the levels of PaCO(2) were increased remarkably at T(1)-T(4) (P<0.01), and the levels of Paw were increased remarkably at T(1)-T(3) (P<0.01). Compared with S group, the levels of Paw were decreased remarkably at T(1)-T(2) (29.5±3.7 vs 21.3±2.1, P=0.001; 30.7±4.8 vs 20.3±2.3, P=0.001). There were no obvious differences in the levels of TNF-α, IL-6, IL-8 in Bronchoalveolar Lavage Fluid (BALF) between two groups at T(0) (P>0.05). Compared with T(0), the levels of TNF-α, IL-6, IL-8 in BALF were increased remarkably at T(3), T(5) (P<0.05). Compared with S group, the levels of TNF-α, IL-6, IL-8 in D group in BALF were decreased remarkably at T(3), T(5) (P<0.05). Compared with S group, the incidence of pneumonia in D group were decreased remarkably at 3 days after operation (4(13.3%) vs 11(36.7%), P=0.017). Conclusion: The ventilation effect of the single lumen endobronchial tube on lung injury for patients with esophageal cancer undergoing combined thoracoscopic and laparoscopic esophagectomy is the same as that of the double lumen endobronchial tube, however the single lumen endobronchial tube has less injury on the lung.

[Effect of dexmedetomidine on perioperative stress and postoperative pain in patients with radical resection of esophageal cancer under combined thoracoscope and laparoscope]

Objective: To investigate the effects of dexmedetomidine on perioperative stress and postoperative pain in patients with radical resection of esophageal cancer under combined thoracoscope and laparoscope. Methods: In this prospective study, one hundred patients undergoing radical resection of esophageal cancer in Affiliated Cancer Hospital of Zhengzhou University from January 2016 to October 2017, were randomly divided into control group (group C) and dexmedetomidine group (group D), n=50. All patients were anaesthetized (induced and maintained) with intravenous target-controlled infusion(TCl) of propofol and remifentanil, and intermittent intravenous injection of cisatracuriumbesylate. Bispectral index(BIS) was used to monitor the depth of anesthesia and maintained between 45-60 during operation.All patients received sufentanil (0.3 μg/kg) 30 min before the end of the operation and then received intravenous analgesia pump for postoperative patient controlled analgesia(PCA). Patients in group D received intravenous infusion of dexmedetomidine(1 μg/kg) 20 min before anesthesia induction, followed by intravenous pumping of dexmedetomidine(0.2 μg·kg(-1)·h(-1)) intraoperatively.Postoperative intravenous patient-controlled analgesia(PCA) was performed in all patients, with background doses of sufentanil 0.04 μg· kg(-1)·h(-1) for patients in group C, and sufentanil 0.025 μg·kg(-1)·h(-1) plus dexmedetomidine 0.1 μg· kg(-1)·h(-1) for patients in group D. The operation time, liquid input and output during operation, the number of PCA pressings after operation were recorded. At these time points: T(0)(the day before operation), T(1)(immediate before anesthesia induction), T(2)(1 h after emergence), T(3)(24 h after operation), T(4)(3 d after operation), T(5)(7 d after operation), T(6)(one month after operation), T(7)(3 months after operation) and T(8)(6 month after operation) , venous blood samples of patients were collected for detection of epinephrine, norepinephrine and corticosterone. The pain visual analogue scale(VSA) was used to assess pain levels in patients at T(2), T(3), T(4), T(5), T(6), T(7), T(8). Results: The age, sex ratio, body mass index (BMI) and ASA grading ratio in two groups were not significantly different(all P>0.05). There were no Significant differences in operation time, liquid input and blood output between group C and group D(all P>0.05). Within 24 h after operation, the sufentanil consumption in group D[(35.86±8.65)μg]was significantly less than that in group C[(59.53±15.26) μg, t=7.061, P<0.05], and the number of PCA pressing in group D(2.15±1.38) was obviously less than that in group C(5.85±2.16, t=4.971, P<0.05). Compared with group C, serum norepinephrines in group D was significantly less (t=13.276, 16.027, 14.319, 12.771, 12.296, respectively; all P<0.05) at T(1), T(2), T(3), T(4), T(5).And there were no difference between these two groups at T(0), T(6), T(7), T(8)(all P>0.05). Serum epinephrine in group D were significantly lower than them in group C at T(2), T(3), T(4), T(5) (t=6.153, 8.774, 9.127, 8.409, respectively; all P<0.05), but there were no difference between these two groups at T(0), T(1), T(6), T(7), T(8)(all P>0.05). Serum corticosterone in group D were sharply less than them in group C at T(2), T(3), T(4), T(5) (t=16.364, 15.306, 12.153, 12.592, respectively; all P<0.05), but at T(0), T(1), T(6), T(7), T(8), there were no difference between these two groups (all P>0.05). Compared with group C, the number of patients with postoperative pain(VAS score≥4) in group D was obviously less at T(6), T(7), T(8)(10 vs 20, 4 vs 12, 3 vs 10; χ(2)=4.762, 4.762, 4.332, respectively; all P<0.05). Conclusion: Perioperative application of dexmedetomidine can effectively decrease the perioperative stress response, obviously cut down the perioperative opioid consumption, and prevent the transition from postoperative acute pain to chronic pain in patients with radical resection of esophageal cancer under combined thoracoscope and laparoscope.

First Report of Ilyonectria robusta Causing Rusty Root of Asian Ginseng in China

Asian ginseng (Panax ginseng) is an economically important perennial herb, mainly cultivated in Jilin Province, China. In September 2013, Asian ginseng plants in Jilin showed rusty root symptoms. Typical symptoms included rusty superficial lesions of irregular shapes and margins. Ten symptomatic roots were collected from each of five fields for investigation. To isolate the pathogen, root epidermal tissues with typical lesions were excised, surface-sterilized, and placed on potato dextrose agar (PDA) amended with 50 μg/ml tetracycline. After incubation at 20 ± 1°C in the dark for a week, 18 single-spore isolates out of 50 samples were obtained and identified as Ilyonectria robusta (A.A. Hildebr.) A. Cabral & Crous based on morphological characters and DNA sequence analysis (1). After incubating 7 days on PDA in the dark at 20°C, colonies were cottony to felty in texture and orange white to brownish grey in color with average diameters of 60 ± 3 mm. Isolates were cultured on synthetic nutrient-poor agar for conidial measurements. Macroconidia formed on simple conidiophores predominately, with mostly one and occasionally up to three septa, and were cylindrical with both ends broadly rounded. Macroconidia varied in size depending on the number of cells as follows: one-septate, 7.0 ± 0.6 × 27.7 ± 2.7 μm; two-septate, 7.3 ± 0.7 × 33.3 ± 2.1 μm; three-septate, 7.4 ± 0.6 × 33.4 ± 2.2 μm. Microconidia that formed on complex conidiophores were ellipsoid to ovoid and ranged in size from aseptate 3.7 ± 0.5 × 8.7 ± 1.1 μm to one-septate 5.0 ± 0.6 × 13.1 ± 1.6 μm. Brown chlamydospores were abundantly produced on PDA, globose to subglobose in shape, and in size of 10.9 ± 1.3 × 11.8 ± 1.5 μm (n ≥ 30 observations per structure for each measurement). The isolates were further classified by amplifying and sequencing the ITS1-5.8S rRNA-ITS2 region and histone H3 gene with primer pairs ITS5 and ITS4 (4), and H3-1a and H3-1b (3), respectively. Sequences of the two loci (GenBank Accession Nos. KM015300 and KM015299) showed 100% identity among the three examined isolates and the published I. robusta isolates (JF735268 and JF735517). To confirm the pathogenicity, bare roots of 3-year-old Asian ginseng were inoculated with mycelial plugs of three isolates of I. robusta selected randomly. Four roots were inoculated as replicates for each isolate with pathogen-free agar plugs as a control. One week post-inoculation in the dark at 20 ± 1°C, all the inoculated ginseng roots showed light-brown to dark-brown lesions. I. robusta was recovered from symptomatic roots and confirmed by analyzing the DNA sequence of the histone H3 gene. The inoculation experiment was repeated, and both trials showed the same results. The ginseng tissue under the control agar plugs remained symptomless, and no fungi were isolated. To our knowledge, this is the first report of I. robusta causing rusty root of P. ginseng in China (1,2,5). References: (1) A. Cabral et al. Mycol. Prog. 11:655, 2012. (2) I. Erper et al. Eur. J. Plant Pathol. 136:291, 2013. (3) N. L. Glass et al. Appl. Environ. Microbiol. 61:1323, 1995. (4) T. J. White et al. PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, 1990. (5) X. Lu et al. Plant Dis. 98:1580, 2014.

First Report of Rhexocercosporidium panacis Causing Rusty Root of Panax ginseng in Northeastern China

In northeastern China, Asian ginseng (Panax ginseng) roots exhibited reddish brown lesions of various sizes, irregular shapes, and diffuse margins, typical of rusty root disease. The lesions remain superficial, smooth, and limited to the epidermal and peridermal tissues. In September 2013, 10 symptomatic roots were collected from each of three fields in Jilin and Heilongjiang provinces. One piece of symptomatic skin tissue from each root was excised, surface-disinfested in 1% NaClO for 3 min, rinsed three times with sterile water, and then placed on tetracycline-amended (50 μg/ml) potato dextrose agar. After incubation at 22 ± 1°C in the dark for a week, small olivaceous black colonies developed from the symptomatic tissue from five of the 30 samples. No spores were observed. A single hyphal tip of each colony was transferred to a fresh V8 agar plate to purify the culture. Two-week-old colonies on V8 agar were olivaceous gray, and 42 to 46 mm in diameter with an outer white margin (3 to 5 mm wide). Conidia produced in V8 broth after 3 weeks with a 12-h photoperiod were straight and hyaline, cylindrical or subcylindrical with no or one septum. Mature conidia were 12.8 to 21.8 × 2.2 to 4.5 μm (mean 18.2 × 3.0 μm, n = 100 conidia for each of three isolates). Three isolates selected randomly were further identified by analyzing the partial sequences of the ITS region of rDNA with primers ITS4 and ITS5 (5), and partial sequences of β-tubulin with the primers tub2F and tub2R (1). Sequences of the three isolates (GenBank Accession Nos. KJ149287, KJ149288, and KJ149290 to 93) showed 99% to 100% homology with previously identified and deposited Rhexocercosporidium panacis isolates (DQ2499992 and DQ457119) for both loci (3). Therefore, the three isolates were identified as R. panacis and deposited in China General Microbiological Culture Collection Center (CGMCC3.17259 to 61). Pathogenicity of R. panacis in Asian ginseng was investigated using these three isolates as described previously with slight modifications (4). Bare roots of 3-year-old Asian ginseng were surface-disinfested as described above, and inoculated with mycelial plugs (4 mm diameter) cut from the margin of actively growing colonies of the isolates on V8 agar. Three mycelial plugs were placed on each root at 3-cm intervals and four roots (replicates) were inoculated for each isolate. Four additional roots were inoculated with non-colonized agar plugs as control. The treated roots were placed on moist filter paper in an enamel tray. The plates were sealed with plastic wrap to prevent desiccation and incubated in the dark at 18 ± 1°C. Four weeks post inoculation, all the inoculated ginseng roots showed red-brown lesions, which turned to dark red or black over time. R. panacis was recovered from symptomatic roots for all isolates and confirmed by ITS sequence analysis. The mock-inoculated control roots remained symptomless and no R. panacis was isolated. The inoculation experiment was repeated and showed the same results. R. panacis was reported in 2006 to infect roots of Panax quinquefolius (2,3,4). To our knowledge, this is the first report of R. panacis causing rusty root of P. ginseng. References: (1) P. R. Hirsch et al. Mycol. Res. 104:435, 2000. (2) Z. K. Punja et al. Can. J. Plant Pathol. 35:503, 2013. (3) R. D. Reeleder. Mycologia. 99:91, 2007. (4) R. D. Reeleder et al. Phytopathology 96:1243, 2006. (5) T. J. White et al. PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, 1990.

The effects of recombinant human epithelialgrowth factor and protein-free calf blood extract for recovery of corneal mechanical epithelial defects healing and neovascularization

OBJECTIVE

This study was undertaken to investigate the effects of recombinant human epidermal growth factor (rhEGF) and protein-free calf blood extract on corneal wound healing and neovascularization.

MATERIALS AND METHODS

An rabbit central corneal wound and neovascularization model was established in rabbits. One eye of each group was chosen randomly for topical administration of protein-free calf blood extract, rhEGF, or NS (physiological saline), and variability in the area of corneal epithelial wound healing and neovascularization was observed.

RESULTS

On days 1 and 2, the healing rate of corneal epithelium was various among the protein-free calf blood extract group, rhEGF group and NS group (F=6.475, p=0.012). The healing rate of corneal epithelium in the rhEGF group was better than the protein-free calf blood extract group (p=0.004) and NS group (p=0.041) on day 1. The corneal neovascularization area in the protein-free calf blood extract group was less than that of rhEGF group (p=0.04) and NS group (p=0.008) on day 18.

CONCLUSIONS

rhEGF had better promotive effect on corneal epithelial wound healing than the protein-free calf blood extract in the advanced phase (within 2 days). Both rhEGF and protein-free calf blood extract were not found to promote.

Origin of shape resonance in second-harmonic generation from metallic nanohole arrays

Second-harmonic generation (SHG) from periodic arrays of subwavelength rectangular air hole with various aspect ratios perforated in gold thin films can get resonantly enhanced for some specific geometric shapes. Here we clarify the physical origin of this shape resonance effect. A nonlinear coupled-mode theory is set up to solve energy conversion from fundamental wave (FW) mode to second-harmonic wave (SHW) mode within the nanoscale air hole. It reveals that several physical mechanisms, including the FW mode excitation amplitude, FW-SHW modal spatial overlap, FW-SHW mode phase mismatch, and SHW mode attenuation, are all geometric shape sensitive and altogether act to induce the SHG shape resonance effect. The theory agrees well with experimental observations and provides an accurate and complete explanation for the long-emphasized but elusive shape effect. The study may stimulate deeper insights to visualize general nonlinear nanophotonic processes and pave the way to engineering high-efficiency nonlinear nanophotonic devices.

Amorphous cobalt hydroxide with superior pseudocapacitive performance

Cobalt hydroxide (Co(OH)2) has received extensive attention for its exceptional splendid electrical properties as a promising supercapacitor electrode material. Co(OH)2 study so far prefers to crystal instead of amorphous, in spite of amorphous impressive electrochemical properties including the ability to improve the electrochemical efficiency based on the disorder structure. The amorphous Co(OH)2 nanostructures with excellent electrochemical behaviors were successfully synthesized by a simple and green electrochemistry. Our as-prepared Co(OH)2 electrode exhibited ultrahigh capacitance of 1094 F g(-1) and super long cycle life of 95% retention over 8000 cycle numbers at a nominal 100 mV s(-1) scan rate. The united pseudo-capacitive performances of the amorphous Co(OH)2 nanostructures in electrochemical capacitors are totally comparable to those of the crystalline Co(OH)2 nanomaterials. These findings actually open a door to applications of amorphous nanomaterials in the field of energy storage as superior electrochemical pseudocapacitors materials.

First Report of Pythium recalcitrans Causing Cavity Spot of Carrot in Michigan

During a survey of carrot (Daucus carota L.) cavity spot in Michigan in September 2010, carrot roots with typical cavity spot symptoms were collected from production fields in Fremont Co. The lesions were excised from infected roots, surface-disinfested with 0.62% NaClO for 3 min, rinsed in sterilized, distilled water three times, cut into 0.5 cm long pieces, and then plated on water agar (WA) amended with carbendazim (10 μg/ml), ampicillin (50 μg/ml), rifampicin (50 μg/ml), and pentachloronitrobenzene (10 μg/ml) (cumulatively referred to as CARP). Plates were incubated at 22 ± 1°C in the dark for 3 days. Pure cultures of the isolates were obtained by transferring a single hyphal tip of each colony to potato dextrose agar (PDA) amended with CARP. Among the 33 isolates obtained, M2-05 was identified as a Pythium sp. that differed from the known cavity spot pathogens of carrot. The isolate has spherical hyphal swellings but no other distinguishing morphological characteristics. M2-05 was further classified by analyzing the partial sequences of four genes: the internal transcribed spacer (ITS) region of ribosomal DNA, beta-tubulin (β-tub), cytochrome c oxidase subunit 2 (cox 2), and NADH dehydrogenase subunit 1 (nadh 1) (1,3). A BLAST search of these sequences for M2-05 was conducted using the nucleotide database of GenBank, resulting in 100% similarity to all four sequenced genes of P. recalcitrans (2). The DNA sequences of M2-05 were deposited in GenBank (JQ734349, JQ734229, JQ734289, and JQ734409 for ITS, β-tub, cox 2, and nadh 1, respectively). Koch's postulates were conducted by inoculating mature carrot roots (cv. Nantindo) with mycelial plugs (4 mm in diameter) cut from the margin of actively growing colonies of M2-05 on PDA plates. Two mycelial plugs were placed on each carrot root at 3-cm intervals, with the mycelial side facing the root; and two non-colonized agar plugs were placed similarly for the non-inoculated control treatment. In comparison, carrot roots also were inoculated with an isolate of each of P. sulcatum and P. violae using the same method. There were four replicate carrot roots inoculated for each isolate and each of the control treatments. The inoculated roots were placed on a plastic grid (7 mm in height) in a closed plastic container, with moist paper towels underneath the grids. The container was incubated in the dark at 22 ± 1°C, and the roots were sprayed gently daily with sterilized, distilled water to maintain high humidity. Brown lesions were observed on all inoculated carrot roots 5 days after inoculation. The lesions measured 0.68 ± 0.48, 1.20 ± 0.71, and 0.56 ± 0.31 mm² averaged over all eight lesions for the isolates of P. recalcitrans, P. sulcatum, and P. violae, respectively. Symptomatic tissues from the inoculated roots were excised and incubated on WA-CARP plates, and the culture from each lesion confirmed as the isolates inoculated using the same molecular methods described above. The carrot tissue under the control agar plugs remained symptomless, and no Pythium was recovered from the control roots. P. recalcitrans was described in 2008 as infecting roots of Beta vulgaris and Vitis vinifera (2). To our knowledge, this is the first published report of P. recalcitrans naturally infecting carrot roots, not only in Michigan, but anywhere in the world. References: (1) L. Kroon et al. Fungal. Genet. Biol. 41:766, 2004. (2) E. Moralejo et al. Mycologia 100:310, 2008. (3) N. O. Villa et al. Mycologia 98:410, 2006.

Generating ultrabroadband terahertz radiation based on the under-compression mode of velocity bunching

We propose and analyze a scheme to generate enhanced ultrabroadband terahertz (THz) radiation through coherent transition radiation emitted by ultrashort electron beams based on a 10.5 m beamline at Tsinghua University. The proposed scheme involves the initial compression of the electron beam with a few hundred pC charges using a velocity bunching scheme (i.e., RF compression) in an under-compression mode instead of the usual critical-compression mode in order to maintain a positive energy chirp at the exit of the traveling wave accelerator. After a long drift segment, the particles in the tail catch up with the bunch head. More than 80% of the particles are distributed in a spike with an rms length less than 20 fs. Such beams correspond to an ultrabroadband coherent transition radiation (CTR) spectrum of 0.1 THz to 25 THz, with the single-pulse THz radiation energy of up to 50 μJ. The principle of CTR and under-compression mode of velocity bunching are introduced in this paper. And the ASTRA simulation parameters and the stability of the system are also discussed.

Degradation of nicosulfuron by Bacillus subtilis YB1 and Aspergillus niger YF1

The optimal degrading conditions for the nicosulfuron degradation by Bacillus subtilis YB1 and Aspergillus niger YF1, and site of their action on nicosulfuron were studied. The results showed that the degradation efficiency of free cells of B. subtilis YB1 and A. niger YF1 was respectively 87.9 and 98.8% in basic medium III containing 2 mg/l of nicosulfuron after inoculation with 1 ml of culture containing 2.3 x 10(7) CFU ml(-1) and incubation for 5 days at 35 degrees C. Moreover, the degradation rate of nicosulfuron by the mixture of microorganisms was much higher than for every of them taken separately in the same conditions. The mass spectrometric analysis of the products degraded by B. subtilis YB1 revealed that the sulfonylurea bridge in nicosulfuron molecule had been broken. Extracellular (EXF) and endocellular (ENF) fractions obtained from bacterium and fungus were tested for the ability to degrade nicosulfuron. The degradation efficiency of fractions extracted from B. subtilis YBI was 66.8% by EXF and 15.8% by ENF, but neither EXF nor ENF extracted from A. niger YFI had the activity of degrading nicosulfuron.

Natural occurrence of fumonisins b1 and b2 in corn from three main production provinces in China

A total of 255 corn samples collected in 2010 from three main corn production provinces of China (Liaoning, Shandong, and Henan) were analyzed for contamination with fumonisins (FB(1) and FB(2)). The incidence of contamination was significantly higher in samples from Liaoning than in samples from the other two provinces. Approximately 80.0% of the samples from Liaoning were contaminated with fumonisins, with a mean total fumonisin concentration of 3,990 ng/g. In contrast, the mean total fumonisin concentrations were 845 and 665 ng/g in samples from Shandong and Henan, respectively. The probable daily intake of fumonisins (0.3 μg/kg of body weight) is within the provisional maximum tolerable daily intake of 2.0 μg/kg of body weight set by the Joint Food and Agriculture Organization and World Health Organization Expert Committee on Food Additives.

In vivo study of four preparative extracts of Clematis terniflora DC. for antinociceptive activity and anti-inflammatory activity in rat model of carrageenan-induced chronic non-bacterial prostatitis

AIM OF THE STUDY

The present study was conducted to evaluate the anti-inflammatory and antinociceptive activities of Clematis terniflora DC. extracts and fractions and to further support its traditional use as Chinese folk medicine in treatment of urinary infections, especially the disease of prostatitis.

MATERIALS AND METHODS

The antinociceptive activity of its water extract (WE), 70% ethanol extract (EE), water eluted part of EE from AB-8 macroporous resin (WEPMR) and 70% ethanol eluted part of EE from AB-8 macroporous resin (EEPMR) was conducted using mice writhing test with different doses. Then the anti-inflammatory activity of the four parts was evaluated on rat models of carrageenan-induced chronic non-bacterial prostatitis (CNP). Preliminary study was taken to determine the phytochemical compositions of the four preparative extracts.

RESULTS

Significant writhing inhibitory effect was found with EE at small (7.5 g/kg body wt.), moderate (15 g/kg body wt.) and large (30 g/kg body wt.) doses (doses here are presented as crude herbs) as well as EEPMR at moderate and large doses by oral administration (OA) (p≤0.01). Data from prostatic index, lecithin microsome density and white blood cell level showed that moderate dose of EE and EEPMR both had significant (p≤0.05 or p≤0.01) inhibition effect on carrageenan-induced inflammation in rat prostate. The HPLC analytical results showed that flavonoids were the main active compounds in WE, EE and EEPMR. And most flavonoids were accumulated into the part of EEPMR by AB-8 macroporous resin leaving only few compounds in WEPMR. No acute toxicity was identified in oral administration of the four parts at a dose of 100g/kg body wt.

CONCLUSIONS

The results described here suggest that extracts of the aerial part of Clematis terniflora DC. might be of therapeutic interest in the treatment of prostatitis.

Immunohistochemical analysis and biological behaviour of gastric glomus tumours: a case report and review of the literature

Gastric glomus tumours are rare and clinically recognized as benign. Nevertheless, some show biological behaviour similar to that of malignant lesions. During the last 40 years, we have encountered only one gastric glomus tumour. Analysis of frozen sections of this tumour suggested a mesenchymal tumour with malignant potential. Three mitoses per 50 high-power fields, with no cytological abnormalities, were observed. Tumour cells were positive for α-smooth muscle actin, vimentin and actin but negative for CD117, S-100 protein, creatine kinase, desmin, CD68, collagen type IV, CD34 and p53. The post-operative period was uneventful. During 37 months' follow-up, no recurrence or metastasis was detected and a benign course was considered likely. Literature on the immunohistochemistry and biological behaviour of gastric glomus tumours was also reviewed. Immunohistochemical studies are helpful in the differential diagnosis of gastric glomus tumours: although most are benign, malignancy cannot be excluded. Thus, long-term follow-up of the patient is necessary.

Characterization of an influenza A H5N2 reassortant as a candidate for live-attenuated and inactivated vaccines against highly pathogenic H5N1 viruses with pandemic potential

We generated a high-growth 7:1 reassortant (Len17/H5) that contained the hemagglutinin (HA) gene from non-pathogenic A/Duck/Potsdam/1402-6/86 (H5N2) virus and other genes from the cold-adapted (ca) attenuated A/Leningrad/134/17/57 (H2H2) strain. Len17/H5 demonstrated an attenuated phenotype in mice and did not infect chickens. Mice administered Len17/H5 either as a live-attenuated intranasal vaccine or as an inactivated intramuscular vaccine were substantially protected from lethal challenge with highly pathogenic A/Hong Kong/483/97 (H5N1) virus and were protected from pulmonary infection with antigenically distinct A/Hong Kong/213/2003 (H5N1) virus. The cross-protective effect correlated with the levels of virus-specific mucosal IgA and/or serum IgG antibodies. Our results suggest a new strategy of using classical genetic reassortment between a high-growth ca H2N2 strain and antigenically related non-pathogenic avian viruses to prepare live-attenuated and inactivated vaccines for influenza pandemic.

QSAR study on the Ah receptor-binding affinities of polyhalogenated dibenzo-p-dioxins using net atomic-charge descriptors and a radial basis neural network

A radial basis function neural network (RBFN) has been used to correlate Ah receptor-binding affinities of polychlorinated, polybrominated, and polychlorinated-brominated dibenzo-p-dioxins with molecular weight and eight net atomic charge descriptors. Support vector machine (SVM) and partial least square (PLS) regression models based on the same data set have also been built. Leave-one-out cross-validation was used to train the RBFN, SVM, and PLS models. For predicting Ah receptor-binding affinities, the RBFN model with a squared cross-validation correlation coefficient (q2) of 0.8818 outperforms the SVM and PLS models and also compares favorably with any other reported quantitative structure-activity relationship model based on the same activity data set. The significance of the RBFN model with net atomic charges as descriptors suggests that electrostatic and dispersion-type interactions play important roles in governing the Ah receptor binding of polychlorinated, polybrominated, and polychlorinated-brominated dibenzo-p-dioxins.

Pathogenesis of and immunity to a new influenza A (H5N1) virus isolated from duck meat

The outbreak of avian influenza H5N1 in Hong Kong in 1997 raised concerns about the potential for the H5 subtype to cause a human pandemic. In 2001 a new H5N1 virus, A/Duck Meat/Anyang/AVL-1/2001 (A/Dkmt), was isolated from imported duck meat in Korea. The pathogenesis of this virus was investigated in mice. A/Dkmt virus had low infectivity but was lethal for mice at high doses, and at lethal doses, the virus replicated in the brains of infected mice. A/Dkmt virus cross-reacted poorly with ferret antisera raised against human H5N1 viruses, but prior infection with A/Dkmt virus protected mice from death after secondary infection with human H5N1 virus.

Prediction of n-octanol/water partition coefficients for polychlorinated dibenzo-p-dioxins using a general regression neural network

A general regression neural network was used for the first time to study quantitative structure and property relationships of organic pollutants to correlate and predict n-octanol/water partition coefficients of polychlorinated dibenzo- p -dioxins from their topological molecular descriptors. In total, 42 polychlorinated dibenzo- p -dioxins and dibenzo- p -dioxins were available for this study-42 polychlorinated dibenzo- p -dioxins and dibenzo- p -dioxins in the training data set and 41 polychlorinated dibenzo- p -dioxins in the test data set. Partial least squares regression, back propagation network and general regression neural network models were trained using the training data set, and the accuracy of the models obtained were examined by the use of leave-one-out cross-validation. For prediction of the n-octanol/water partition coefficient, the best method is the general regression neural network. With the test data set, the correlation coefficient, root mean square error and mean absolute relative error for the general regression neural network model are 0.9276, 0.22 and 2.79%, respectively. For describing the structure of polychlorinated dibenzo- p -dioxins, the topological molecular descriptors outperform the mobile order and disorder thermodynamic method.

One-week regimens containing ranitidine bismuth citrate, furazolidone and either amoxicillin or tetracycline effectively eradicate Helicobacter pylori: a multicentre, randomized, double-blind study

BACKGROUND

The metronidazole resistance of Helicobacter pylori strains has increased rapidly.

AIM

To evaluate the efficacy and safety of new 1-week regimens containing ranitidine bismuth citrate, furazolidone and either amoxicillin or tetracycline.

METHODS

One hundred and twenty patients with H. pylori-positive inactive duodenal ulcer or non-ulcer dyspepsia diagnosed by endoscopy were recruited randomly to receive one of two regimens for 7 days: ranitidine bismuth citrate, 350 mg b.d., furazolidone, 100 mg b.d., and either amoxicillin, 1000 mg b.d. (n=60), or tetracycline, 500 mg b.d. (n=60). H. pylori infection was identified by rapid urease testing and histology. 13C-Urea breath test was performed to evaluate the cure of H. pylori infection at least 4 weeks after completion of triple therapy.

RESULTS

The eradication rates of H. pylori by ranitidine bismuth citrate-furazolidone-amoxicillin and ranitidine bismuth citrate-furazolidone-tetracycline regimens were 82% and 85% (P > 0.05), respectively, by intention-to-treat analysis, and 85% and 91% (P > 0.05), respectively, by per protocol analysis. Adverse effects were mild in both ranitidine bismuth citrate-furazolidone-amoxicillin and ranitidine bismuth citrate-furazolidone-tetracycline groups.

CONCLUSIONS

One-week regimens containing ranitidine bismuth citrate, furazolidone and amoxicillin or tetracycline are well tolerated and effective for the eradication of H. pylori.

[Potential anxiolytic role of c-fos antisense oligonucleotide in social-defeated rats]

OBJECTIVES

This study was to explore the therapeutic potential of c-fos antisense phosphorothioate oligonucleotide and the possible molecular mechanism.

METHODS

On the basis of the sequence of c-fos mRNA, two 15-mer phosphorothioated oligodeoxynucleotide(ODN) were synthesized. Antisense ODN was corresponded to the initiation codon of c-fos mRNA. The complementary sense and vehicle(saline) served as controls. Anxiety was induced in rats by a social-defeated paradigm and then rats were given a 5-minute exposure to the plus maze and open field test. Rats were injected c-fos antisense, sense ODNs and vehicles into the lateral ventricle through stainless-steel guide cannulate implanted unilaterally from the beginning of the experiment. The expression of the protein product of the immediate early gene c-fos was analyzed with immunochemistry in different brain regions, such as the amygdala and paraventricularis hypothalami nucleus. Computer assisted image analysis was performed to quantify the results of immuno-cytochemistry.

RESULTS

Socially defeated c-fos antisense-treated rats displayed obviously reduced anxiety-related behavior, as they spent significantly more time in the open arms of the plus maze compared to sense ODN- and vehicle-treated rats. The behavioral effects were similar to those of established anti-anxiety drugs(diazepam). Antisense oligodeoxynucleotide significantly decreased Fos positive nucleus in paraventricularis hypothalami nucleus. The inhibitory efficiency was 57.03%.

CONCLUSION

Our data provide further evidence that c-fos is involved in acute stress elicited anxiety related behavior.

[The change of soft tissue profile before and after treatment with Begg technique]

OBJECTIVE:This study was to determine the facial soft tissue profile changes Begg technique after treatment. METHODS: 32 patients presented with Angle Class II divide I malocclusion. Lateral cephalograms were taken before treatment and after each treatment stage.Each experimental subject served as its own control by means of cephalometric analysis. RESULTS: Significant soft tissue profile improvement could be expected from first stage to second stage.But third stage of orthodontic treatment had little effective for the profile changes.The soft tissue profile changes which occured during treatment were (1) a retraction of lips and a reduction in the prominence of the lips.(2) an increase of nose prominence. (3) vertical opening at the chin. CONCLUSION: Begg technique was more close to clinical requirement in improvement of soft tissue profile.Achieved a harmony of soft tissue profile must be emphasized as an orthodontic treatment goal during second stage,then establishment of a proper occlusion would be finished.

[The detection of Legionella pneumophila DNA with polymerase chain reaction in water samples]

Legionella pneumophila has been known as an important pathogen causing Legionnaires Disease (LD), responsible for more than 80 per cent of clinical LD cases and majority of the LD outbreaks. In order to detect the existence of Legionella pneumophila strains in water samples, we have developed a ploymerase chain reaction method, using two primers synthesized according to the reported Legionella pneumophila mip gene nucleotide sequence. This method was proved to be highly sensitive (18 cfu/ml) and specific. Two water samples were detected positive. This newly developed method provided a quick, accurate way not only to detect Legionella pneumophila in the diagnosis of LD but also in the capture of suspected pathogen during epidemiologic investgation when LD outbreaks.

Structure/function relationship study of Tyr14 and Arg22 in trichosanthin, a ribosome-inactivating protein

Amino acids Tyr14 and Arg22 in trichosanthin are residues on helix A1 close to the active-site cleft. They are invariant in various type-I and type-II ribosome-inactivating proteins. In this study, Tyr14 was changed to Phe and Arg22 to Lys and Leu. Modified proteins were purified, and activities compared by assaying their median inhibitory concentration (ID50) on a rabbit-reticulocyte-lysate protein-synthesis system. While the ID50 of wild-type trichosanthin was 0.02 nM, those for [Phe14], [Lys22], [Leu22] and [Phe14, Leu22]trichosanthin were 0.10, 0.03, 0.25 and 0.15 nM, respectively. Therefore, compared with Tyr14, Arg22 appears to play a more important role in trichosanthin. Structural studies on [Leu22]trichosanthin showed that two water molecules occupy the space left by the side chain of Arg22, and hydrogen bonds exist between these water molecules and nearby residues to retain the conformation. The use of intermolecular rather than intramolecular hydrogen bonds may have an adverse effect on stability or folding of the protein and results in a mild decrease in activity.

[Circadian rhythm in susceptibility of mice to the anti-tumor drug carboplatin]

The platinum-containing compounds has become a major chemical agent in the treatment of cancer. A circadian rhythm in the susceptibility of rodents and human being to cisplatin has been demonstrated, the maximal tolerance being found in the animal's active phase. Carboplatin is a second generation analog. Two studies were performed on mice with carboplatin under 12:12 light dark cycle to study its chronotoxicity and chronoeffectiveness. In study I, single intraperitoneal injection of 192mg/kg (LD50) carboplatin was given to four groups of mice at four different circadian stage. It was found that at 50% the overall mortality of mice, there was a mortality difference of 28% for mice receiving the drug at 9 a.m. to 71% for mice receiving drug at 9 p.m. It demonstrated that carboplatin was better tolerated in the animal's early sleep phase. In study II, S180 tumor-bearing mice were treated with 50mg/kg of carboplatin. The longest mean survival time and the lowest marrow toxicity occurred in the group which received the drug at the beginning of the sleep phase. It showed that the susceptibility of mice to carboplatin is circadian stage dependent. These data clearly demonstrate that, by timing the administration of drugs according to body rhythms, such as the host susceptibility-resistance rhythm to a drug, one can gain a therapeutic advantage over an approach which ignores such rhythms.

[Relation between cesarean section rate and perinatal mortality rate]

In order to evaluate the effect of cesarean section on reduction of perinatal mortality rate (PMR). All cases delivered in Beijing Obstetrics and Gynecology Hospital from Jan. 1, 1980 to Dec. 31, 1992 were analysed. The total number of delivery in study period was 74,199. Number of cesarean section delivery was 18,557. The cesarean section rate was 25.0%. The total number of perinatal baby was 74,914. The number of perinatal death was 1,140. PMR was 15.2%. The 13 years were divided into three periods to compare the cesarean section rate and PMR. The 1st period was from 1980 to 1984. The 2nd period was from 1985 to 1988. Years from 1989 to 1992 were 3rd period. The cesarean section rate was increasing year by year. It was significant since 1985. On the other hand, the PMR was marked decreasing since 1983. But there was no continually decrease in 2nd period. In 3rd period trend of decreasing PMR was shown. There was no significant difference in PMR especially in neonatal mortality rate (NMR) between cesarean section group and vaginal delivery group in 1st period. In 2nd period the PMR and NMR of cesarean section group was higher than that of vaginal delivery group (P < 0.01). In 3rd period it was lower in cesarean section group (P < 0.05). Main causes of neonatal deaths in cesarean section group were congenital abnormalities and respiratory diseases. In 2nd period pulmonary hemorrhage, hyaline membrane disease were marked higher in cesarean section group. It was related to more premature and low birth weight babies in this group.(ABSTRACT TRUNCATED AT 250 WORDS)

[Factors influencing the prognosis of gastric cancer patients: a study using international gastric cancer staging classification]

In the 18-year period from 1973 to 1991, 502 cases with gastric cancer were treated surgically at the Peking Union Medical College Hospital. A unified international classification for staging of gastric cancer had been applied to these patients in this study. The pathologic staging classification is based on the extent of the disease at the time of surgical exploration of the abdomen and/or histopathologic study of the excised surgical specimens. According to the new TNM staging classification, the 5-year cumulative survival rates of all surgically treated patients Ia, Ib, II, IIIa, IIIb and IV were 96.25%, 87.34%, 66.11%, 43.70%, 30.33% and 9.36% respectively. It was showed that there is a decreasing tendency in the 5-year survival rates for the depth of invasion of the gastric cancer. The histological types of the gastric cancer had the same prognostic significance as depth of invasion. The 5-year cumulative survival rate of patients with curative surgery was better in the group with chemotherapy (55.6%) than in that without chemotherapy (43%).

[Evaluation of endoscopic retrograde cholangiopancreatography in diagnosis of chronic pancreatitis]

155 cases of chronic pancreatitis in PUMC hospital from 1952 to 1990 were investigated. Because endoscopic retrograde cholangiopancreatography (ERCP) and exocrine pancreatic function tests have been used since 1974, the diagnostic rate of chronic pancreatitis during 1974-1990 is 6.6 fold as that during 1952-1974. The pancreatic duct in 97 cases among 105 cases with chronic pancreatitis examined by ERCP was compared with CT and ultrasonography in diagnosis of chronic pancreatitis. The accuracy of diagnosis for ERCP is 84.8%, and is significantly higher than that for CT (56.0%, P < 0.01) and ultrasonography (37.8%, P < 0.001). The detective rate of abnormal pancreatic duct for ERCP is 91.4%, and is also significantly higher than that for CT (80.0%) and ultrasonography (79.7%, P < 0.05). These data indicated that the clinical features of chronic pancreatitis in China is more related to biliary diseases, rather than alcoholism. BT-PABA test and ultrasonography are valuable screen examinations, and ERCP is credible important examination in diagnosis of chronic pancreatitis.

[The common causes and differential diagnosis of malignant jaundice]

To investigate the common causes and differential diagnosis of malignant jaundice, we reviewed 903 cases with obstructive jaundice in PUMC hospital in recent 16 years. 383 of them were malignant jaundice (42.4%). The most common origin of malignant jaundice was carcinoma of the pancreatic head with 198 patients (51.7%), and carcinoma of the ampulla Vater with 94 cases (24.5%) and carcinoma of the extrahepatic bile duct with 71 cases (5.2%). The clinical symptoms and signs were not much helpful to the differentiation of malignant jaundice. No specific early signs were found to the malignant jaundice, but most of the patients felt epigastric distension and distress, anorexia, loss of body weight and fatigue before jaundice appeared. More than one third patients had discontinuous fever. The imaging investigation had decisive roles in the diagnosis and differential diagnosis of the malignant jaundice. The positive rate of diagnosis in sonography was 95.5%, but the correct rate only 85.0% (P < 0.05). We regard that sonography might be the first imaging examination for the malignant jaundice and clue for further investigation. ERCP can clearly reveal the papilla, biliary and pancreatic ducts with high positive rate (97.7%) and correct rate (95.1%). PTC was only used in those patients who had the contraindications to ERCP or the cannulation of ERCP was not successful. The positive rate of PTC was 95.8% in the cases with extrahepatic cholangiocarcinoma. The combination of ERCP and PTC could determine the position and extent of extrahepatic cholangiocarcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effect of drugs on endoscopic manometry of the sphincter of Oddi]

We used a catheter passing through the papilla duodeni under the view of endoscope, with persistent perfusion system and transducer, to measure the pressure and contraction frequency of sphincter of Oddi (SO) in 10 healthy persons and 20 patients. Meanwhile, we compared the effect of Buscopan, Nitrostat and Vitamin K3 on the pressure and contraction frequency (CF). SO basal pressure (BP) in healthy group was 5.21 +/- 1.61 kPa (mean +/- s), SO peak pressure (PP) 8.21 +/- 1.34 kPa and CF 6.14 waves/min. In the group of peripapillary fistula, SO pressure decreased significantly and CF slowed down greatly. In comparison with the healthy group, SO pressure and CF in the group of gallbladder stone, choledocholithiasis and pancreatic diseases did not show any change of statistic significance. Intravenous injection of Buscopan could decrease SO peak pressure and BP remarkably. Sublingual administration of Nitrostat and intramuscular injection of Vit K3 could reduce SO PP markedly, SO BP didn't change statistically. It was also showed that spheric and semi-spheric papillae had higher pressure than the flat ones (P less than 0.001).

Determination of nickel in water by chemiluminescence

The acetone chemiluminescence determination of nickel in water was investigated. Optimization data for the determination of Ni2+ and interference data for over 20 species are provided. The limit of detection for Ni2+ by this method is 2.5 ng ml-1, and the linear dynamic range is from 10 ng ml-1 to 1 microgram ml-1. The application of the method to the determination of Ni2+ in river and waste waters is discussed.

[Effect of sclerotherapy in patients with bleeding due to portal hypertension]

The author reports the preliminary results of an unrandomized trial comparing the effect of endoscopic variceal sclerosis, shunt surgery and medical therapy in the management of cirrhotic patients with variceal bleeding, sixty-six patients were studied, among them 23 received sclerosis, 25 shunt surgery and 18 medical therapy. Survival was significantly (P less than 0.001) improved in the group with sclerotherapy, with 85% one year survival rate as compared with 45% in the group with shunt surgery and 21% in the group with medical therapy.

[Primary gastric lymphoma: a clinical and pathologic analysis of 25 cases]

25 cases of primary gastric lymphoma diagnosed in our hospital from 1973 to 1987 were analysed. Primary gastric lymphoma comprised 1.55% of the stomach malignancies. There were 25 gastric lymphomas among 198 patients with lymphomas (12.6%). The diagnostic accuracy with X-ray was 30.4%. However, with modern fiberoptic endoscopy and directed biopsy technique, a correct diagnosis was made in 72% of the cases. Of the 24 follow-up cases, the overall 5 years survival rate was 54.28%. Surgery combined with radiotherapy or chemotherapy has yield a 5-year survival rate of 72%. Therefore, both correct and early diagnosis may contribute to improved prognosis.