[Thoughts and suggestions on digital services to enhance the level of vaccination management]

With the development of information technology and the increasing demand for vaccination services among the people, it is a definite trend to enhance the quality of vaccination services through digitization. This article starts with a clear concept of digital services for vaccination, introduces the current development status in China and abroad, analyzes the advantages and disadvantages of existing models in leading regions, takes a glean from the summation, and proposes targeted solutions. This study suggests establishing a departmental coordination mechanism for data interconnection and sharing, formulating data standards and functional specifications, enhancing the functionalities of the immunization planning information system, strengthening data collection and analytical usage, and intensifying appointment management and science and health education to provide expert guidance for the construction of digital vaccination services across the country in the future.

Inhibition mechanism of cordycepin and ergosterol from Cordyceps militaris Link. against xanthine oxidase and cyclooxygenase-2

Cordyceps militaris Link. (C. militaris) is an entomopathogenic fungus that parasitizes the pupa or cocoon of lepidopteran insect larvae, with various bioactive compounds. Cordycepin and ergosterol are the two active components in C. militaris. This study aimed to evaluate the inhibitory activity of cordycepin and ergosterol against xanthine oxidase (XO) and cyclooxygenase-2 (COX-2), as well as investigate the inhibition mechanism. Cordycepin could better inhibit XO (IC50 = 0.014 mg/mL) and COX-2 (IC50 = 0.055 mg/mL) than ergosterol. Additionally, surface hydrophobicity and circular dichroism (CD) spectra results confirmed the conformational changes in enzymes induced by cordycepin and ergosterol. Finally, cordycepin and ergosterol significantly decreased uric acid (UA) and inflammatory factors to normal level in mice with gouty nephropathy (GN). This study could provide theoretical evidence for utilization of C. militaris in hyperuricemia-management functional foods.

[Expression and Clinical Significance of Exosome Component 4 in Newly Diagnosed Patients with Diffuse Large B-Cell Lymphoma]

OBJECTIVE

To explore the expression of Exosome Component 4（EXOSC4） in the tissues of newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL) and its clinical significance.

METHODS

The expression of EXOSC4 protein in the tissues of 181 newly diagnosed DLBCL patients was analyzed by immunohistochemical staining. Clinical data were collected. The correlation between EXOSC4 protein expression in the tissues of newly diagnosed DLBCL patients and clinical features were analyzed and its prognostic significance.

RESULTS

The positive rate of EXOSC4 protein expression was 68.51% in the tissues of 181 newly diagnosed DLBCL patients. These patients were divided into two groups, with 44 cases in high expression group and 137 cases in low expression group. There were no significant differences in age, gender, B symptoms, serum lactate dehydrogenase (LDH) level, Eastern Cooperative Oncology Group (ECOG) score, Ann Arbor stage, extranodal disease, International Prognostic Index (IPI) score, National Comprehensive Cancer Network IPI (NCCN-IPI) score, and cell origin between the two groups (P>0.05). Cox multivariate regression analysis showed that high EXOSC4 protein expression in tissues was an independent poor prognostic factor for OS and PFS in newly diagnosed DLBCL patients (all P<0.05). K-M survival analysis showed that newly diagnosed DLBCL patients with high EXOSC4 protein expression had significantly shorter overall survival (OS) and progression free survival (PFS) than those patients with low EXOSC4 protein expression (all P<0.05).

CONCLUSION

High EXOSC4 protein expression in tissues of newly diagnosed DLBCL patients is an independent poor prognostic factor for survival.

Induced Abortion and the Risk of Rh Sensitization

Importance

While population-level data suggest Rh immunoglobulin is unnecessary before 12 weeks' gestation, clinical evidence is limited. Thus, guidelines vary, creating confusion surrounding risks and benefits of Rh testing and treatment. As abortion care in traditional clinical settings becomes harder to access, many people are choosing to self-manage and need to know if ancillary blood type testing is necessary.

Objective

To determine how frequently maternal exposure to fetal red blood cells (fRBCs) exceeds the most conservative published threshold for Rh sensitization in induced first-trimester abortion.

Design, Setting, and Participants

Multicenter, observational, prospective cohort study using high-throughput flow cytometry to detect circulating fRBCs in paired maternal blood samples before and after induced first-trimester abortion (medication or procedural). Individuals undergoing induced first-trimester abortion before 12 weeks 0 days' gestation were included. Paired blood samples were available from 506 participants who underwent either medical (n = 319 [63.0%]) or procedural (n = 187 [37.0%]) abortion.

Exposure

Induced first-trimester abortion.

Main Outcomes and Measures

The primary outcome was the proportion of participants with fRBC counts above the sensitization threshold (125 fRBCs/5 million total RBCs) after induced first-trimester abortion.

Results

Among the 506 participants, the mean (SD) age was 27.4 (5.5) years, 313 (61.9%) were Black, and 123 (24.3%) were White. Three of the 506 participants had elevated fRBC counts at baseline; 1 of these patients had an elevated fRBC count following the abortion (0.2% [95% CI, 0%-0.93%]). No other participants had elevated fRBC counts above the sensitization threshold after induced first-trimester abortion. The median change from baseline was 0 fRBCs, with upper 95th and 99th percentiles of 24 and 35.6 fRBCs, respectively. Although there was a strong association between the preabortion and postabortion fRBC counts, no other baseline characteristic was significantly associated with postabortion fRBC count.

Conclusions and Relevance

Induced first-trimester abortion is not a risk factor for Rh sensitization, indicating that Rh testing and treatment are unnecessary before 12 weeks' gestation. This evidence may be used to inform international guidelines for Rh immunoglobulin administration following first-trimester induced abortion.

Noncovalent composites of meso-substituted A2B2-porphyrins and carbon nanotubes for enhanced electrocatalytic oxygen reduction

Exploring highly active oxygen reduction electrocatalysts with low precious metals content is imperative but remains a considerable challenge. Herein, a series of heterobimetallic multi-walled carbon nanotubes (MWCNTs) electrocatalysts based on metal complexes are presented. These electrocatalysts feature diverse transition metals (M=Mn, Fe, Co, Ni) 5,15-bromophenyl-10, 20-methoxyphenyl porphyrin (MBMP) and tetrakis(triphenylphosphine)palladium (0) (Pd[P(Ph3)4]) anchored non-covalently on its surface. The resulting NiBMP-based MWCNTs with Pd[P(Ph3)4] (PdNiN4/MWCNTs) display outstanding electrocatalytic oxygen reduction activity (onset potential, 0.941 V; half wave potential, 0.830 V) and robust long-term durability in alkaline electrolyte. While in neutral condition, the MnBMP-based MWCNTs with Pd[P(Ph3)4] (PdMnN4/MWCNTs) are the most active heterobimetallic ORR catalyst and produce ultra-low concentration hydrogen peroxide (H2O2yield, 1.2%-1.3%). Synergistically tuning the ORR electrocatalytic activity and electron transfer pathway is achieved by the formation of NiBMP/MnBMP-Pd[P(Ph3)4] active sites. This work indicates such metalloporphyrin-Pd[P(Ph3)4] active sites on MWCNTs have significantly positive influence on electrocatalytic ORR systems and provides facile and mild strategy for designing highly efficient ORR electrocatalysts with ultra-low loading precious metal.

[One case of myocardial damage caused by carbamate pesticide poisoning]

The data of a patient with carbamate pesticide poisoning were analyzed. Cardiac arrest, oliguria, acute renal injury and pulmonary infection occurred during treatment. After cardiopulmonary resuscitation, tracheal intubation, CRRT, anti-infection and other symptomatic support treatment, the patient recovered and discharged. The myocardial damage caused by carbamate pesticide poisoning is easy to be ignored, and it often causes cardiac manifestations such as arrhythmia and cardiac insufficiency, and the related markers of cardiac injury, electrocardiogram and echocardiogram are also changed. Therefore, the awareness of cardiac damage caused by carbamate pesticide poisoning should be improved.

Variation in pollinator visitation among garden cultivars of marigold, portulaca, and bidens

Due to declines in pollinator populations, many people are now interested in learning about which annual flowers they can plant in their garden to better support pollinators. However, reports of experimental evaluation of cultivars of annual flowers for attraction to pollinators are scarce. We sampled pollinators visiting six cultivars of marigold (Tagetes erecta and T. patula), ten cultivars of bidens (Bidens ferulifolia and B. aurea), and eight cultivars of portulaca (Portulaca oleracea and P. grandiflora) for two years to compare pollinator visitation rates among cultivars within each flower type. Pollinators collected on flowers in research plots were categorized into four groups, honey bees (Apis mellifera), common eastern bumble bees (Bombus impatiens), wild bees, and syrphids, to show the proportion of different pollinator visitors to each cultivar. Pollinator visitation rates varied significantly among cultivars of marigold, bidens, and portulaca, with some cultivars having as much as 10-fold the visitation rate of other cultivars of the same flower type. In the second year we also evaluated nectar production and nectar quality of the most and least visited cultivars of portulaca and bidens. Our results show that pollinators have a strong preference for cultivars that produce the most nectar or nectar with the highest sugar content. This research will better inform entomologists, growers, educators, and plant breeders, about which cultivars of marigold, portulaca, and bidens are visited the most by pollinators, and how to accurately determine this at the cultivar level.

[Analysis of the direct economic burden of measles cases and its influencing factors in Shanghai from 2017 to 2019]

Objective: To analyze the direct economic burden caused by measles cases in Shanghai from 2017 to 2019 and its influencing factors. Methods: A total of 161 laboratory-confirmed measles cases reported from January 1, 2017, to December 31, 2019, in Shanghai were included in the study through the "Measles Surveillance Information Reporting and Management System" of the "China Disease Surveillance Information Reporting and Management System". Through telephone follow-up and consulting hospital data, the basic information of population, medical treatment situation, medical treatment costs and other information were collected, and the direct economic burden of cases was calculated, including registration fees, examination fees, hospitalization fees, medical fees and other disease treatment expenses, as well as transportation and other expenses of cases. The multiple linear regression model was used to analyze the main influencing factors of the direct economic burden. Results: The age of 161 measles cases M (Q₁, Q₃) was 28.21 (13.33, 37.00) years. Male cases (56.52%) were more than female cases (43.48%). The largest number of cases was≥18 years old (70.81%). The total direct economic burden of 161 measles cases was 540 851.14 yuan, and the per capita direct economic burden was 3 359.32 yuan. The direct economic burden M (Q₁, Q₃) was 873.00 (245.01, 4 014.79) yuan per person. The results of multiple linear regression model analysis showed that compared with other and unknown occupations, central areas and non-hospitalized cases, the direct economic burden of measles cases was higher in scattered children, childcare children, students, and cadre staff in the occupational distribution, suburban areas and hospitalized, with the coefficient of β (95%CI) values of 0.388 (0.150-0.627), 0.297 (0.025-0.569), 0.327 (0.148-0.506) and 1.031 (0.853-1.209), respectively (all P values<0.05). Conclusion: The direct economic burden of some measles cases in Shanghai is relatively high. Occupation, area of residence and hospitalization are the main factors influencing the direct economic burden of measles cases.

[Mid-term outcome of deep layer repair with the long head of the biceps autograft bridging for Kim classification type Ⅰ A delaminiated rotator cuff tear]

Objective: To investigate the mid-term clinical outcome of deep layer repair with the long head of the biceps autograft bridging for Kim classification type ⅠA delaminated rotator cuff tear. Methods: A follow-up study. The clinical data of 42 consecutive patients with Kim classification type ⅠA delaminated rotator cuff tear admitted to the First Affiliated Hospital of Jinan University from January 2018 to June 2019 were retrospectively included. All patients underwent shoulder arthroscopic surgery. During the operation, the autogenous long head of the biceps tendon was transferred to repair the deep layer of delaminated rotator cuff tear. The preoperative and postoperative (last follow-up) visual analogue scale (VAS) for pain, University of California Los Angeles (UCLA) score, Constant-Murley shoulder score, range of motion (ROM) of the shoulder and radiographic results were statistically analyzed. Results: A total of 42 patients were included in this study. There were 18 males and 24 females, with an average age of (64.5±15.2) years and a mean follow-up of (43.9±7.1) months. At the last follow-up, ROM of abduction increased from 80.8°±26.5° to 154.2°±14.3°, and ROM of external rotation increased from 18.2°±13.6° to 31.8°±7.8°; the VAS score of pain decreased from (5.5±1.3) points to (0.7±0.7) points, the UCLA score increased from (21.3±3.7) points to (29.9±2.1) points, and the Constant-Murley score increased from (45.4±10.0) points to (87.2±4.8) points; the differences were all statistically significant (all P<0.001). The X-ray films showed that there were no upward of the humeral head in all the patients. MRI results indicated that rotator cuff re-teared in one case (Sugaya classification type Ⅲ), and healed in other cases (Sugaya classification type Ⅰ-Ⅱ). No complications such as upper limb nerve injury was found in all cases. Conclusion: Deep layer repair with the long head of the biceps autograft bridging can significantly alleviate the pain and improve the function of patients with Kim classification type ⅠA delaminated rotator cuff tear, and the incidence of retear is low.

Blood brain barrier permeability and immune function of brain in rainbow trout responding to IHNV infection

Viral infection of the central nervous system (CNS) is often associated with blood-brain barrier (BBB) disruption. Mammals have developed complicated and efficient immune strategies to protect the BBB. However, the immune defense of brain and BBB permeability changes are not well-understood in teleost during virus invading. In this study, we constructed an infectious hematopoietic necrosis virus (IHNV) immersion infected rainbow trout model. After IHNV infection, pathological changes occurred in the brain, and MPO and ROS activities were significantly increased. In addition, the expression levels of BBB permeability-related genes were also changed. Transcriptome analysis showed that immune-related genes and signaling pathways in the brain were activated after IHNV infection. These results showed that the permeability of BBB increased significantly after IHNV infection, thus activating immune related factors and cells to enter the CNS through blood circulation to resist pathogenic infection.

[Comparative analysis on prevalence of tobacco and e-cigarettes uses in junior middle school students in Shanghai, 2013 and 2019]

Objective: To examine the prevalence and trend of tobacco and e-cigarettes uses and identify the influencing factors for smoking behavior in junior middle school students in Shanghai, and provide data support and scientific basis for the development of tobacco control intervention strategy in adolescents. Methods: Multi-stage stratified random sampling method was used to select junior middle school students in 8 districts and 10 districts in Shanghai in 2013 and in 2019 respectively. Information about tobacco and e-cigarettes uses in the students were collected by using self-administrated questionnaire. The prevalence of tobacco and e-cigarettes uses were calculated, the difference between two years was compared with χ² test. The influencing factors were identified by multivariate logistic regression analysis. Results: In 2019, the current smoking rate was 0.6% in junior middle school students in Shanghai, and the smoking attempt rate was 2.9%, both were lower than the levels in 2013 (0.7% and 6.9%). The current use rate of e-cigarettes was 0.6% in 2019,with no significant change compared with 2013 (0.6%). The proportion of the students who had heard of e-cigarettes in 2019 (78.4%) was higher than that in 2013 (47.2%). In 2019, the second-hand smoke (SHS) exposure rate at home, in both indoor and outdoor public places and on public transportations was 72.5%, which was slightly lower than the level in 2013 (73.0%), the differences were all significant (P<0.05). In 2019, the students seeing close friend smoking (OR=27.381, 95%CI: 12.037-62.287), seeing someone smoking in school (OR=2.477, 95%CI: 1.155-5.312), believing that SHS may not be harmful (OR=8.471, 95%CI: 1.464-49.005) had higher possibility of smoking. Being aged ≥15 years (compared with being aged ≤12 years, OR=8.688, 95%CI: 1.922-39.266), exposure to SHS in outdoor public place (OR=8.608, 95%CI: 1.048-70.692), close friend smoking (OR=8.115, 95%CI: 1.754-37.545) were positively associated with e-cigarettes use, and believing that smoking results in uncomfortable social contact [compared with believing that smoking results in comfortable social contact (OR=0.105,95%CI: 0.018-0.615)] were negatively associated with e-cigarettes use, the difference was significant (P<0.05). Conclusion: The prevalence of tobacco and e-cigarette uses in junior middle school students in Shanghai remained at a low level in recent years. The SHS exposure rate in junior middle school students is high. Smoking behavior of junior middle school students is closely related to personal attitude and awareness of tobacco, exposure to SHS, peer smoking and the situation of tobacco control in schools. Prevention and intervention should be carried out from multi-dimensions to effectively protect teenagers from tobacco hazards.

[Consideration on implementation of co-administration of Seasonal Influenza and COVID-19 vaccines during pandemic in China]

Influenza is an infectious respiratory disease caused by the influenza viruses. Older people, infants and people with underlying medical conditions could have a higher risk of severe influenza symptoms and complications. The co-infection of Coronavirus Diseases 2019 (COVID-19) with influenza viruses could lead to the complication of prevention, diagnosis, control, treatment, and recovery of COVID-19. Influenza vaccine and COVID-19 vaccine overlapped in target populations, vaccination time, and inoculation units. Although there was insufficient evidence on the immunogenicity and safety of co-administration of influenza vaccine and COVID-19 vaccine, World Health Organization and some countries recommended co-administration of inactivated influenza vaccine and COVID-19 vaccine. This review summarized domestic and international vaccination policies and research progress, and put forward corresponding suggestions in order to provide scientific support for the formulation of vaccination strategy on seasonal influenza vaccine and COVID-19 vaccine.

[Proportion and rate: connotation and understanding route]

Proportion and rate have multiple and overlapping meanings, which blur their concepts. Based on the existence of the states and the occurrence of the events and their measuring process, we first put forward the concept of "cumulative number of states in point time". Considering the general meaning of "rate" in mathematics and the units of the elements in indexes, this paper puts forward the concept of "the change of cumulative number of states in point time", which is equal to the commonly acknowledged concept "number of incident event within observation period" or "absolute rate", and further constructs relative rate and proportion. Proportions can be classified into three types: time-point (or rate-type) constitutional proportion, time-period incidence proportion and their synthesis, time-period constitutional proportion. The essential difference between relative rate and time-period proportions is whether the observation period is regarded as a one-unit-length fixed period which would be further moved to the description of the indexes. Furthermore, the sources populations of relative rate and proportions are exclusively those at the beginning of the observation period. Thus, we established a unified identification route about ratios, proportions, and rates, the basic indicators of categorical data in populations. These are applicable to both fixed and dynamic populations. The paper aims to clarify the connotation of the indexes and the feasible understanding route and provide some reference for the population researchers.

[Enlightment of routine vaccination under the prevention and control of COVID-19 based on the circulating event of type Ⅲ vaccine-derived poliovirus in Shanghai]

Since the Global Polio Eradication Initiative was launched by the World Health Assembly in 1988, significant progress has been made in global polio prevention and control. But the occurrence of vaccine-associated paralytic poliomyelitis cases and vaccine-derived poliovirus related cases have become a major challenge during the post-polio era. While coronavirus disease 2019(COVID-19) has brought serious disease burden and economic burden to all countries in the world, prevention and control of vaccine-preventable infectious diseases such as polio should not be neglected under the background of the global common fight against COVID-19. Taking the type Ⅲ VDPV cycle event in Shanghai as an example, the paper discussed how to do a good job of routine inoculation under the prevention and control of COVID-19 to strictly prevent the outbreak of vaccine-preventable infectious diseases.

The Effects of Negative Online Reviews on Consumer Perception, Attitude and Purchase Intention: Experimental Investigation of the Amount, Quality, and Presentation Order of eWOM

The quick growth and fast spread of electronic word-of-mouth (eWOM) have created a new threat to Internet merchants and marketers through paid online reviewers flooding sites with product and service reviews that could confuse and deter customers. This study examined the effects of the posts by paid reviewers—specifically, the negative reviews—on consumers’ risk perception, product attitude, and purchase intention. While extant research examined negative eWOM as an information source, little attention has been paid to the role of a hired reviewer's post aimed at destroying the reputation of certain targets (Internet Water Army Attack [IWAA]). To gain a better understanding of this phenomenon, three experiments were conducted to investigate the effects of the amount, quality, and presentation order of negative eWOM on consumers’ perception change and decision making. We tested the hypothesis using a test environment that mimicked a PTT online forum ( https://www.ptt.cc/ ) in Taiwan. Three simulation cases (smartphone, digital camera, and tablet) based on real-world events were used. A total of 193 participants completed all three experiments and provided valid responses. The results of this study are mostly consistent with previous research findings that online marketing is greatly threatened by negative eWOM. Nevertheless, it was also found that the effects of the amount, quality, and presentation order of negative eWOM are more complicated than we have anticipated. The findings revealed that IWAA can effectively increase customers’ risk perception toward a product and change their attitude and purchase intention.

Prevailing Role of Mucosal Igs and B Cells in Teleost Skin Immune Responses to Bacterial Infection

The skin of vertebrates is the outermost organ of the body and serves as the first line of defense against external aggressions. In contrast to mammalian skin, that of teleost fish lacks keratinization and has evolved to operate as a mucosal surface containing a skin-associated lymphoid tissue (SALT). Thus far, IgT representing the prevalent Ig in SALT have only been reported upon infection with a parasite. However, very little is known about the types of B cells and Igs responding to bacterial infection in the teleost skin mucosa, as well as the inductive or effector role of the SALT in such responses. To address these questions, in this study, we analyzed the immune response of trout skin upon infection with one of the most widespread fish skin bacterial pathogens, Flavobacterium columnare This pathogen induced strong skin innate immune and inflammatory responses at the initial phases of infection. More critically, we found that the skin mucus of fish having survived the infection contained significant IgT- but not IgM- or IgD-specific titers against the bacteria. Moreover, we demonstrate the local proliferation and production of IgT⁺ B cells and specific IgT titers, respectively, within the SALT upon bacterial infection. Thus, our findings represent the first demonstration that IgT is the main Ig isotype induced by the skin mucosa upon bacterial infection and that, because of the large surface of the skin, its SALT probably represents a prominent IgT-inductive site in fish.

[Efficacy evaluation after 5 years of inoculation of 23 valent pneumococcal polysaccharide vaccine for the elderly aged 60 years old and above in Shanghai during 2013-2018]

Objective: To evaluate the efficacy of 23 valent pneumococcal polysaccharide vaccine (PPV23) inoculation against community-acquired pneumonia (CAP) among the elderly aged 60 years old and above in Shanghai. Methods: A prospective cohort study was conducted using a stratified random sampling from October 2013, in which 1 214 and 2 387 elderly people aged 60 and above were selected as the inoculation group and control group, respectively. And a unified questionnaire was used to investigate the basic information of the subjects in the inoculation group and the control group. From October 2013 to December 2018, the subjects were followed up at home or by telephone for a total of 20 times, mainly for whether they had CAP during the observation period. Multivariate logistic regression model was used to calculate RR and 95%CI of CAP incidence between inoculation group and control group for comparing. Results: There were 556 males (45.8%) in the inoculation group and 1 012 males (42.4%) in the control group. And the incidence density of CAP in the inoculation group was lower than that of the control group (0.848/100 person-years vs. 1.452/100 person-years), and the vaccine protection rate was 41.6%, with a statistically significant difference ［RR (95%CI)= 0.584 (0.428-0.790), P<0.001］. After adjusting for age, RR (95%CI) was 0.699 (0.507-0.956), and the difference was still statistically significant (P=0.025).Further stratified analysis showed that the vaccine protective rates of PPV23 in the 60-69 year-old group, the 70-79 year-old group and the ≥80 year-old group were 36.7%, 21.6% and 26.0%, respectively, but only in the 60-69 year-old group showed statistical difference (RR=0.633, 95%CI=0.399-0.990, P=0.045). Conclusion: To a certain extent, the incidence of CAP can be reduced by inoculation of PPV23 in elderly population aged 60 and above in Shanghai, and it should be further recommended in elderly population of low age.

Single-scan, dual-functional interferometer for fast spatio-temporal characterization of few-cycle pulses

Accurate and fast characterization of spatio-temporal information of high-intensity, ultrashort pulses is crucial in the field of strong-field laser science and technology. While conventional self-referenced interferometers were widely used to retrieve the spatial profile of the relative spectral phase of pulses, additional measurements of temporal and spectral information at a particular position of the laser beam, however, were necessary to remove the indeterminacy, which increases the system complexity. Here we report an advanced, dual-functional interferometer that is able to reconstruct the complete spatio-temporal information of ultrashort pulses with a single scan of the interferometer arm. The setup integrates an interferometric frequency-resolved optical gating (FROG) with a radial shearing Michelson interferometer. Through scanning one arm of the interferometer, both the cross-correlated FROG trace at the central part of the laser beam and the delay-dependent interferograms of the entire laser profile are simultaneously obtained, allowing a fast three-dimensional reconstruction of few-cycle laser pulses.

The concentration of fetal red blood cells in first-trimester pregnant women undergoing uterine aspiration is below the calculated threshold for Rh sensitization

OBJECTIVES

To calculate the minimum fetal red blood cell concentration required to cause maternal Rh sensitization; validate the use of a flow cytometry protocol below that concentration; preliminarily assess the concentrations of fetal red blood cells in pregnant women before and after uterine aspiration.

STUDY DESIGN

Using pre-existing literature, we calculated the lowest concentration of fetal red blood cells found to cause sensitization within adult female circulation. We validated a two-color flow cytometry protocol using fluorescently labeled antibodies to Hemoglobin F (expressed by fetal red blood cells and adult F cells) and Carbonic Anhydrase (expressed in red blood cells during the third trimester and postnatally) by titrating second trimester cord blood into non-pregnant adult blood. We applied this flow cytometry protocol in a prospective cohort study of 42 pregnant women at 5-12 weeks gestational age undergoing uterine aspiration for induced or spontaneous abortion.

RESULTS

The calculated threshold for causing Rh sensitization was 250 fetal red blood cells per 10 million total red blood cells. We showed a linear relationship between observed and expected fetal red blood cell fractions in titrated samples. Fetal red blood cell counts were more reliable when samples acquired by flow cytometry contained at least 1 million red blood cells. All 37 subjects with evaluable paired samples demonstrated fetal red blood cell concentrations below the calculated threshold for Rh sensitization both pre- and post-procedure. The fetal RBC concentrations increased from a mean of 4.5 (median 0, range 0-57) fetal RBCS pre- to a mean of 8.6 (median 2, range 0-32) fetal RBCs post- per 10 million total RBCs (p < 0.001).

CONCLUSIONS

Flow cytometry was capable of separately quantifying fetal red blood cells and maternal F cells to very dilute concentrations. Fetal red blood cell exposure in the first trimester was well below the calculated threshold for maternal Rh sensitization in our cohort. Larger studies are warranted to confirm our pilot study findings, fill this evidence gap and inform universal guidelines for administering Rh immunoglobulin after first trimester uterine aspiration.

IMPLICATIONS

Fetal red blood cell exposure following first trimester uterine aspiration is well below the calculated threshold for maternal Rh sensitization in our cohort.

Air pollution and temperature are associated with increased COVID-19 incidence: A time series study

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Air quality is tightly associated with COVID-19 transmission.

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PM_2.5 and NO₂ strongly promote COVID-19 transmission.

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Temperature is inversely associated with COVID-19 transmission.

Objectives

Although COVID-19 is known to be caused by human-to-human transmission, it remains largely unclear whether ambient air pollutants and meteorological parameters could promote its transmission.

Methods

A retrospective study was conducted to study whether air quality index (AQI), four ambient air pollutants (PM_2.5, PM₁₀, NO₂ and CO) and five meteorological variables (daily temperature, highest temperature, lowest temperature, temperature difference and sunshine duration) could increase COVID-19 incidence in Wuhan and XiaoGan between Jan 26th to Feb 29th in 2020.

Results

First, a significant correlation was found between COVID-19 incidence and AQI in both Wuhan (R² = 0.13, p < 0.05) and XiaoGan (R² = 0.223, p < 0.01). Specifically, among four pollutants, COVID-19 incidence was prominently correlated with PM_2.5 and NO₂ in both cities. In Wuhan, the tightest correlation was observed between NO₂ and COVID-19 incidence (R² = 0.329, p < 0.01). In XiaoGan, in addition to the PM_2.5 (R² = 0.117, p < 0.01) and NO₂ (R² = 0.015, p < 0.05), a notable correlation was also observed between the PM₁₀ and COVID-19 incidence (R² = 0.105, p < 0.05). Moreover, temperature is the only meteorological parameter that constantly correlated well with COVID-19 incidence in both Wuhan and XiaoGan, but in an inverse correlation (p < 0.05).

Conclusions

AQI, PM_2.5, NO₂, and temperature are four variables that could promote the sustained transmission of COVID-19.

Ferroelectric P(VDF-TrFE)/POSS nanocomposite films: compatibility, piezoelectricity, energy harvesting performance, and mechanical and atomic oxygen erosion

Poly(vinylidene difluoride) (PVDF) and its copolymers as the polymers with the highest piezoelectric coefficient have been widely used as sensors and generators. However, their relatively low performances limit their applications in some harsh environments. In this work, piezoelectric poly(vinylidene-trifluoroethylene) P(VDF-TrFE) matrices with different amounts of polyhedral oligomeric silsesquioxane (POSS) were prepared by a low temperature solvent evaporation method and thermal poling. The morphology, surface performance, crystalline phase, and piezoelectric and ferroelectric properties of the nanocomposites were investigated and the influence of POSS on these performances was studied. POSS had good compatibility with P(VDF-TrFE) and did not affect the crystalline phase formation of the matrix. The composites presented good piezoelectric properties. Piezo- and triboelectric nanogenerators were designed and fabricated. The voltage and current outputs were analyzed and the polarization effect was evaluated. The average output voltage and the current density of the matrix were 3 V and 0.5 μA cm⁻² when subjected to a force of 38 N on an area of 1 cm². The mechanical properties of P(VDF-TrFE)/POSS nanocomposites were also studied by the nanoindentation test. The hardness and modulus of samples increased 20% and 17% with a low addition of POSS. Atomic oxygen erosion properties of the composites were numerically simulated by the Monte Carlo method. The erosion cavity shape and depth were compared and studied. The influence of POSS addition on the P(VDF-TrFE) matrix and the associated reinforcing mechanism were analyzed.

Poly(vinylidene difluoride) (PVDF) and its copolymers as the polymers with the highest piezoelectric coefficient have been widely used as sensors and generators.

A persistent outbreak of varicella in a primary school in Dongguan City, Guangdong Province, China

Objectives

To describe the epidemiological features of a school varicella outbreak in Dongguan City, China, to identify the reasons underlying persistent spread, and to assess the effectiveness of the varicella vaccine.

Methods

We identified all cases during the outbreak. We described the outbreak epidemic course and examined the influence of the following variables on the outbreak: sleeping in the dormitory, eating in school, taking school transportation, hand-washing habits, morning examinations, and effectiveness of case isolation. Logistic regression was used to estimate the odds ratio and 95% confidence interval (CI) of contracting varicella.

Results

A total of 92 varicella cases were reported, accounting for 5.53% (92/1663) of all students. Among cases, 64.13% (59/92) were vaccinated. The outbreak lasted for 93 days and occurred in six generations. Vaccination coverage was between 78.05% and 85.67%. The varicella vaccine was effective in 56.63% of recipients (95% CI: 35.49–70.84%). Vaccine effectiveness significantly decreased after 4–6 years.

Conclusions

The varicella vaccine was unable to prevent virus spread even with high vaccination coverage. Delayed and inefficient isolation of cases was the primary cause of the persistent outbreak.

[Optimization of mulched drip irrigation amount for peanut based on AHC model in northwestern Liaoning, China]

To evaluate the applicability of AHC (agro-hydrological chemical and crop systems simulator) model and explore the suitable irrigation amount for peanut (Arachis hypogaea) under mulched drip irrigation in the semi-arid areas of northwestern Liaoning Province, based on the two-year field experimental data of peanut in 2016 and 2017, the model parameters were firstly chosen for global sensitivity analysis. Then, module parameters of soil moisture and crop growth were calibrated and validated. Finally, AHC model was used to analyze the responses of peanut yield and water use efficiency (WUE) to different irrigation amounts. The results showed that the two extremely sensitive parameters of the model were saturated hydraulic conductivity in the first and second layers of soil. Root mean square error (RMSE) and mean relative error (MRE) between simulated and measured values of soil water content ranged from 0.02 to 0.03 cm³·cm^-3 and 1.5% to 2.3%, respectively. The RMSE and MRE of leaf area index and plant height were 0.3-0.6, 4.2-4.5 cm, and 5.0%-8.9%, 5.2%-6.8%, respectively. The MRE of peanut yield and water consumption were both within 5%, indicating that the model was suitable for simulating soil moisture and peanut growth in the northwest Liaoning Province. With the increases of irrigation amounts, peanut yield increased and water use efficiency decreased. Considering both peanut yield and WUE, we recommend that the optimal mulched drip irrigation amounts for peanut in the semi-arid areas of Northwestern Liaoning in test year (normal year) was 80-97 mm.

Ionization-induced adiabatic soliton compression in gas-filled hollow-core photonic crystal fibers

We investigate in the experiments the ionization-induced adiabatic soliton compression process in a short length of He-filled single-ring photonic crystal fiber. We observe that the plasma-driven blueshifting solitons show little residual light near the pump wavelength in a certain pulse energy region, leading to a high-efficiency frequency upconversion process. In contrast, at high pulse energy levels, we observe that the quality of the frequency upshifting process is impaired due to the existence of a dynamical loss channel induced by the coupling of the soliton to linear modes near the pump wavelength. In addition, through adjusting the input pulse energy, the central wavelength of blueshifting solitons can be continuously tuned over 300 nm. These experimental results, confirmed by numerical simulations, not only offer a deep insight into ionization-induced soliton-plasma dynamics in gas-filled hollow-core photonic crystal fibers, but also develop highly tunable ultrafast light sources at visible wavelengths, which may have many applications in ultrafast spectroscopy.

Pharyngeal Immunity in Early Vertebrates Provides Functional and Evolutionary Insight into Mucosal Homeostasis

The pharyngeal organ is located at the crossroad of the respiratory and digestive tracts in vertebrate, and it is continuously challenged by varying Ags during breathing and feeding. In mammals, the pharyngeal mucosa (PM) is a critical first line of defense. However, the evolutionary origins and ancient roles of immune defense and microbiota homeostasis of PM are still unknown. In this study, to our knowledge, we are the first to find that diffuse MALT is present in PM of rainbow trout, an early vertebrate. Importantly, following parasitic infection, we detect that strong parasite-specific mucosal IgT and dominant proliferation of IgT⁺ B cell immune responses occurs in trout PM, providing, to our knowledge, the first demonstration of local mucosal Ig responses against pathogens in pharyngeal organ of a nonmammal species. Moreover, we show that the trout PM microbiota is prevalently coated with secretory IgT and, to a much lesser degree, by IgM and IgD, suggesting the key role of mucosal Igs in the immune exclusion of teleost pharyngeal bacteria. Overall, to our knowledge, our findings provide the first evidence that pharyngeal mucosal immunity appear earlier than tetrapods.

P5379Modification with CREKA improves cell retention of myocardial ischemia reperfusion

Background

Poor cell homing limits efficacy of cardiac cellular therapy. The cysteine–arginine–glutamic acid–lysine–alanine (CREKA) homing peptide binds with high specificity to fibrin which is involved in repair of tissue injury.

Purpose

We assessed if CREKA-modified stem cells had enhanced fibrin-mediated homing ability resulting in better functional recovery and structural preservation in a rat myocardial injury model.

Methods

CREKA-modified mesenchymal stem cells (CREKA-MSCs) were obtained via membrane fusion with CREKA-modified liposomes. The fibrin targeting ability of CREKA-MSCs was examined both in vitro and in vivo.

Results

Under both static and flow conditions in vitro, CREKA significantly enhanced MSCs binding ability to fibrin clots. CREKA-MSCs showed much more higher accumulation than unmodified MSCs in injured rat myocardium, colocalizing with fibrin and resulting in better cardiac function.

Stem cell-CREKA-fibrin targeting system

Conclusions

Modification of MSCs with the homing peptide CREKA favored their migration and retention in the infarcted area, resulting in better structural preservation and functional recovery. Fibrin is therefore a novel target for enhancing homing of transplanted cells to injured myocardium and the fibrin-targeting delivery system represents a generalizable platform technology for regenerative medicine.

Convergent Evolution of Mucosal Immune Responses at the Buccal Cavity of Teleost Fish

The buccal mucosa (BM) is a critical first line of defense in terrestrial animals. To gain further insights into the evolutionary origins and primordial roles of BM in teleosts here we show that rainbow trout, a teleost fish, contains a diffuse mucosal associated lymphoid tissue (MALT) within its buccal cavity. Upon parasite infection, a fish immunoglobulin specialized in mucosal immunity (sIgT) was induced to a high degree, and parasite-specific sIgT responses were mainly detected in the buccal mucus. Moreover, we show that the trout buccal microbiota is prevalently coated with sIgT. Overall our findings revealed that the MALT is present in the BM of a non-tetrapod species. As fish IgT and mucus-producing cells are evolutionarily unrelated to mammalian IgA and salivary glands, respectively, our findings indicate that mucosal immune responses in the BM of teleost fish and tetrapods evolved through a process of convergent evolution.

[Clinical analysis of five cases of autism spectrum disorder complicated with epilepsy with chromosome copy number variation]

Objective: To explore the clinical features and genetic causes of autism spectrum disorder (ASD) patients with epilepsy. Methods: The clinical data of five patients with ASD and epilepsy admitted to Xuanwu Hospital between September 2017 and September 2018 were collected, including medical history, intelligence level, developmental level, physical examination, neuroimaging and electroencephalogram. High-throughput whole-genome sequencing was applied to five patients and their parents. Results: Of five patients, four were male and one was female. All five patients had mild mental retardation, and one patient had significant growth retardation and craniofacial deformity. The average epilepsy onset age was 6.3 years old (7 months to 16 years). The main epileptic type was tonic-clonic seizure with abnormal EEG results. All patients have a favorable response to anti-epileptic drugs. Whole-exome sequencing (WES) revealed copy number variation in all 5 patients. Among them, 3 cases were reported to be pathogenic, and 2 cases were not reported (chromosome 16p13.3 duplication and chromosome 21q22.3 deletion). Conclusions: The results of current study support that autism spectrum disorders with seizures is often associated with copy number variations, such as Williams-Beuren region duplication syndrome, chromosome 15q11.2 duplication syndrome and chromosome 15q11.2 deletion syndrome. We reported two novel copy number variations (chromosome 16p13.3 duplication and chromosome 21q22.3 deletion) in two autism spectrum disorder patients with epileptic seizures.

[Staging the severity of liver cirrhosis and decision of surgical treatment for hepatocellular carcinoma: Tongji experience]

Liver resection is the mainstay of treatment for patients with hepatocellular carcinoma (HCC). Most of HCC patients are associated with varied degrees of liver cirrhosis.Severity of liver cirrhosis adversely affects the outcomes of liver resection, and also plays a vital role in making an appropriate surgical strategy for HCC.In current surgical practice for HCC, liver function and functional reserve are the focus of preoperative evaluation. Liver cirrhosis is still widely regarded as an one-stage entity. The pathological severity of liver cirrhosis is largely ignored. As neither liver function nor functional reserve can reflect the pathological severity of liver cirrhosis when liver function is at the stage of compensation. Preoperative evaluation on the severity of cirrhosis has not been established in a surgical setting.Thus, there is an urgent need to stage the severity of cirrhosis in surgical practice in order to make more precise surgical modalities for individual patients.This article mainly introduces the ongoing research progress in staging the severity of liver cirrhosis while treating HCC at Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, and emphasizes the importance of staging the severity of cirrhosis in surgical treatment of HCC.

[Observation on safety of sequential vaccination schedule of different strain inactivated poliovirus vaccines]

Objective: To evaluate the safety of population based sequential vaccination schedule of inactivated poliovirus vaccines prepared with different strains. Methods: This randomized, parallel-group controlled trial was conducted from March, 2017 to May, 2018, in Shanghai. Adverse reaction data of Sabin strain inactivated polio vaccine (sIPV), wild strains inactivated polio vaccines (wIPV) and bivalent types Ⅰ and Ⅲ oral poliomyelitis vaccine (bOPV) were systematically collected through active observation in 1 917 infants in Shanghai after the vaccination at 2, 3, 4 months old. The eligible infants aged 2 months were divided into 4 groups: ①sIPV+sIPV+bOPV group; ②sIPV+wIPV+bOPV group; ③wIPV+sIPV+bOPV group; ④wIPV+wIPV+bOPV group. Results: The incidence of adverse reaction 30 days later after 3 basic dose vaccinations was 16.79% (946/5 633). No serious adverse reaction was reported. Local and systemic reactions were mainly mild. Common local reactions were pain, erythema, cutaneous nodule, etc.; and common systemic reactions were abnormal crying, drowsiness, diarrhea and appetite lost, etc.. The incidence of local reactions 30 days later after 3 basic dose vaccinations was 1.65% (93/5 633), and the incidence rates of grade 1-3 reactions were1.26% (71/5 633), 0.21% (12/5 633) and 0.20% (11/5 633) respectively. The incidence rate of systemic reactions 30 days later after 3 basic vaccinations was 15.14% (853/5 633), and the incidence rates of grade 1-3 reactions were 11.33% (638/5 633), 3.18% (179/5 633) and 0.64% (36/5 633) respectively. There were no significant differences in the rate of grade 3 reaction among different groups (χ(2)=4.17, P=0.24). Conclusions: No severe adverse reactions related to sequential vaccination of different strain inactivated polio vaccines were observed, most of reactions were mild and all of them were cured. It is safe to use sIPV and wIPV simultaneously or alternately for childhood sequential vaccination.

Continuously wavelength-tunable blueshifting soliton generated in gas-filled photonic crystal fibers

We experimentally report the generation of wavelength-tunable blueshifting soliton in the visible spectral region through a gas-filled single-ring photonic crystal fiber (SR-PCF). In particular, in a He-filled SR-PCF, we observed a sharp narrow-band spectral peak at the first resonant spectral region of the SR-PCF, which results from phase-matched nonlinear processes. To the best of our knowledge, this is the first time investigating the influence of the core-cladding resonance on the blueshifting soliton. In addition, when Ar gas was filled into the SR-PCF, some interference fringes on the blueshifting soliton were observed at high pulse-energy levels due to plasma-induced pulse fission. These two experimental observations are confirmed by numerical simulations. Furthermore, through properly adjusting input pulse energy, we found that the blueshifting soliton can obtain a high conversion efficiency (∼84%) and its wavelength can be tuned over hundreds of nanometers (∼240  nm).

Prevalence of stress and its determinants among residents enrolled in China Standardized Training Program for Resident Doctor (C-STRD) program: A cross-sectional study

BACKGROUND

It has been widely understood that well-trained doctors are crucial for a high-quality public health system and safe patient care. Thus, in 2011, China initiated its first national residency training program, called the China Standardized Training for Resident Doctor (C-STRD), for medical graduates to prepare qualified doctors for the medical care system with increasing demands. So far, no studies have specifically address the prevalence of stress and its determinants among residents enrolled in the C-STRD.

PARTICIPANTS AND METHODS

The research is performed in two stages. In stage I, the authors conducted a pilot study and met 112 C-STRD residents in person. Based on the preliminary data, a revised questionnaire was adopted in stage II, during which the authors conducted a multi-institutional, cross-sectional survey of 340 participants from 11 hospitals in Shanghai in a self-administered manner.

RESULTS

The results showed that C-STRD residents were overall under severe stress as their mean PSS score was 27.5 ± 4.9, which was higher than the threshold of high stress (PSS = 20). Specifically, the PSS score for the residents with Bachelor (MB), Master (MM) and Doctoral of Medicine (MD) educational degree were 26.6 ± 4.1, 27.8 ± 3.5 and 27.1 ± 5.2, respectively (P>0.05). Their stress was mainly associated with their financial income status and workload, as these two factors caused more severe burden than other listed stressors (P<0.05). Specially, the residents indicated that their montly payroll amout were as low as $590.2 ± 127 while no benefit package and allowance were given. Surprisingly, wage arrears up to 5.3 month were reported by 36 (10%) participants. Workload survey showed the residents has high work intensity and inadequate rest. Since no stress management program was provided, the majority of residents tended to cope their stress with unhealthy strategies, such as mesmerizing in TV/computer (88.2%) and overeating (59.7%).

CONCLUSION

The C-STRD residents are at high risk of perceived stress. Although there was a difference in perception of stress for workload and career future among different educational degree owners, low financial income is the major stressor among all C-STRD residents. Unhealthy stress management strategies were adopted by all residents due to lack of appropriate stress-relieving intervention.

Hyaluronidase Pretreatment Improves the Cryopreservation of Human Ovarian Tissue

BACKGROUND

Slow freezing has been widely applied to preserve human ovarian tissue.

OBJECTIVE

The aim of this study is to determine whether human ovarian cortex pretreated with hyaluronidase can improve the protective effect of cryopreservation.

MATERIALS AND METHODS

Human ovarian biopsies from seven patients were cryopreserved using slow freezing. The samples in the experimental group were incubated in culture medium with hyaluronidase for a short time before cryopreservation. The histology of the thawed ovarian tissue was investigated; the levels of steroid hormone in the culture media were then used to evaluate the development and function of thawed ovarian tissue.

RESULTS

The result showed that the percentage of morphologically abnormal primordial follicles was higher in the freezing control than in the experimental group (P<0.05). 17β-estradiol (E₂) and progesterone (P₄) concentrations were significantly higher in the experimental group than in the freezing control group (P<0.05).

CONCLUSION

Our study showed that human ovarian cortex pretreatment with hyaluronidase can improve the protective effect of cryopreservation by improving the penetration of cryoprotectant.

Mucosal immunoglobulins protect the olfactory organ of teleost fish against parasitic infection

The olfactory organ of vertebrates receives chemical cues present in the air or water and, at the same time, they are exposed to invading pathogens. Nasal-associated lymphoid tissue (NALT), which serves as a mucosal inductive site for humoral immune responses against antigen stimulation in mammals, is present also in teleosts. IgT in teleosts is responsible for similar functions to those carried out by IgA in mammals. Moreover, teleost NALT is known to contain B-cells and teleost nasal mucus contains immunoglobulins (Igs). Yet, whether nasal B cells and Igs respond to infection remains unknown. We hypothesized that water-borne parasites can invade the nasal cavity of fish and elicit local specific immune responses. To address this hypothesis, we developed a model of bath infection with the Ichthyophthirius multifiliis (Ich) parasite in rainbow trout, Oncorhynchus mykiss, an ancient bony fish, and investigated the nasal adaptive immune response against this parasite. Critically, we found that Ich parasites in water could reach the nasal cavity and successfully invade the nasal mucosa. Moreover, strong parasite-specific IgT responses were detected in the nasal mucus, and the accumulation of IgT⁺ B-cells was noted in the nasal epidermis after Ich infection. Strikingly, local IgT⁺ B-cell proliferation and parasite-specific IgT generation were found in the trout olfactory organ, providing new evidence that nasal-specific immune responses were induced locally by a parasitic challenge. Overall, our findings suggest that nasal mucosal adaptive immune responses are similar to those reported in other fish mucosal sites and that an antibody system with a dedicated mucosal Ig performs evolutionary conserved functions across vertebrate mucosal surfaces.

The olfactory organ is a vitally important chemosensory organ in vertebrates but it is also continuously stimulated by pathogenic microorganisms in the external environment. In mammals and birds, nasopharynx-associated lymphoid tissue (NALT) is considered one of the first lines of immune defense against inhaled antigens and in bony fish, protecting against water-borne infections. However, although B-cells and immunoglobulins (Igs) have been found in teleost NALT, the defensive mechanisms of parasite-specific immune responses after pathogen challenge in the olfactory organ of teleost fish remain poorly understood. Considering that the NALT of all vertebrates has been subjected to similar evolutionary forces, we hypothesize that mucosal Igs play a critical role in the defense of olfactory systems against parasites. To confirm this hypothesis, we show the local proliferation of IgT⁺ B-cells and production of pathogen-specific IgT within the nasal mucosa upon parasite infection, indicating that parasite-specific IgT is the main Ig isotype specialized for nasal-adaptive immune responses. From an evolutionary perspective, our findings contribute to expanding our view of nasal immune systems and determining the fate of the host–pathogen interaction.

Influence of inhibitors on the adhesion of SRB to the stainless steel in circulating cooling water

Influence of the surface characteristics of three stainless steels (SS304, 316L and 317) and presence of scale inhibitors on adhesion kinetics of sulfate reducing bacteria (SRB) in circulating cooling water, were investigated by evaluating surface free energy, adhesion kinetic constants in a parallel plate flow chamber. Results show that the surface free energy values of SS317, SS316L and SS304 are -31.69, -24.18 and -13.92 mJ m^-2, respectively. SS317 surface had higher surface hydrophobicity than SS316L and SS304. In the process of bacteria cells adhesion onto SS surfaces, electrostatic interaction for SS is slightly more than hydrophobic interaction. The number of adhering bacteria and the adhesion kinetic constants are different on the three types of stainless steel. The adhesion kinetic constants for SS317 and 316L are greater than that for SS304, which are 0.0354, 0.0282 and 0.0190 min^-1, respectively. Scale inhibitors of hydrosy ethyl fork phosphonic acid (HEDP) and phosphono butane-1, 2, 4-tricarboxylic acid (PBTCA) have a certain influence on the initial adhesion of bacteria cell and adhesion kinetics constants are reduced in the presence of HEDP and PBTCA.

[Nanos2 in the male reproductive system: Progress in studies]

Nanos2, a member of the Nanos2 gene family, is a specific gene in male germ cells and encodes an evolutionarily conserved RNA binding protein expressed in male primordial germ cells (PGCs) during the embryonic period as well as in the spermatogonial stem cells (SSCs) of the testis. In the embryonic period, Nanos2 promotes the development of male PGCs and inhibits them from meiosis. In the process of spermatogenesis, Nanos2 suppresses the differentiation of SSCs in the testis and maintains the stability of the SSC pool. The knockout of Nanos2 may cause the disappearance of germ cells and sterility in male mice while its overexpression in the testis may lead to accumulation of SSCs in seminiferous tubules. Besides, Nanos2 is involved in the degradation of specific RNAs and possibly associated with some diseases of the male reproductive system. This review focuses on the recent progress in the studies of Nanos2 in the male reproductive system.

Online measurement of conductivity/permittivity of fluid by a new contactless impedance sensor

By expanding the contactless conductivity detection (CCD) technique to contactless impedance detection technique, a new contactless impedance sensor is designed to implement the online measurement for both the conductivity of a conductive fluid and the permittivity of a non-conductive fluid. In the new contactless impedance sensor, a new simulated inductor is developed to overcome the unfavorable influences of the coupling capacitances by impedance elimination principle, and the digital phase-sensitive demodulation (DPSD) technique is adopted to realize the impedance measurement. To verify the effectiveness of the new contactless impedance sensor, simulation experiments (using different resistors, capacitors, and their combinations) and practical fluid experiments (using KCl solutions with different concentrations, eight organic solvents, and pure water) are carried out. The experimental results show that the development of the new contactless impedance sensor is successful and the conductivity/permittivity measurement performance of the new sensor is satisfactory. The maximum relative error of conductivity measurement is 3.1% and the maximum relative error of permittivity measurement is 5.5%. Compared with the conventional conductivity/permittivity sensors, the new sensor can implement the contactless online measurement of both the two electrical parameters of fluid. Meanwhile, the new contactless impedance sensor is suitable for industrial applications and has the advantages of simple construction and low cost.

Meta-analysis of the IL-10 promoter polymorphisms and pediatric asthma susceptibility

The results of previous epidemiological studies exploring the relationship between interleukin-10 (IL-10) promoter polymorphisms and susceptibility to pediatric asthma are not consistent. Therefore, we have performed a systematic review and meta-analysis to provide a more convincing conclusion. Odds ratios (OR) with their 95% confidence intervals (CIs) were used to evaluate the strength of association between the IL-10 promoter polymorphisms and susceptibility to pediatric asthma. Publication bias was examined by Begg's funnel plots and the Egger test. A detailed literature search based on stringent parameters yielded sixteen relevant studies, comprising 2494 cases and 2160 controls. The overall population showed no significant association between the IL-10 -1082G/A polymorphism and pediatric asthma risk in any of the genetic models (dominant model: OR = 1.583, 95%CI = 0.614-4.076, P = 0.342; allelic model: OR = 1.214, 95%CI = 0.748-1.971, P = 0.433; additive model: OR = 2.240, 95%CI = 0.950-5.277, P = 0.065; recessive model: OR = 1.435, 95%CI = 0.659-3.128, P = 0.363). Subgroup analyses revealed a significant association between different ethnicity and atopic status subgroups. However, there was no evidence of a significant association between the other two polymorphisms (-819C/ T and -592C/A) and pediatric asthma in our study. No significant publication bias was observed in this meta-analysis. The results of this study indicate that the IL-10 -1082G/A polymorphism might be a risk factor for asthma in children. However, because of the small sample size included in the subgroup analyses, the results should be interpreted with caution.

[Massive hemorrhage caused by fungal infections after donation-after-cardiac-death kidney transplantation: clinical features, prevention and treatment experience]

OBJECTIVE

To study the characteristics and prevention and treatment strategies of massive hemorrhage caused by fungal infections after donation-after-cardiac-death (DCD) kidney transplantation.

METHODS

A total of 91 cases of DCD kidney transplantation between August 25, 2013 and June 30, 2015 in Third Affiliated Hospital of Sun Yat-sen Univservity were retrospectively analyzed. The characteristics of and prevention and treatments strategies for postoperative massive hemorrhage caused by fungal infections were summarized.

RESULTS

Ninety-one cases of DCD kidney transplantation were divided into 2 groups based on regimens for preventing postoperative fungal infections: fluconazole prophylaxis group: a total of 26 cases of renal transplant before June 11, 2014 received fluconazole regimen, from postoperative day 0 to 2 weeks; micafungin prophylaxis group: a total of 65 cases of renal transplant after June 11, 2014 received micafungin regimen, also for 2 weeks from postoperative day 0. Two cases in fluconazole group developed postoperative massive hemorrhage. In case 1, the hemorrhage occurred at 2 weeks after transplantation. Graft nephrectomy was performed during surgical exploration for hemostasis, yet the massive hemorrhage relapsed 2 weeks later. Endoluminal exclusion of external iliac artery using endovascular covered stent-graft at the anastomosis site was performed and the massive bleeding was successfully stopped. The patient was restored to hemodialysis and waited for second kidney transplantation. Candia albicans was detected in the culture of blood and drainage liquid from incision. The other case of hemorrhage occurred at 3 weeks after transplantation. Graft nephrectomy plus endovascular exclusion using covered stent-graft were also performed to stop the massive bleeding. Massive fungal hyphae and spores were observed at the stump of renal graft artery under microscope. The patient received second kidney transplantation after 6 months successfully. No massive hemorrhage caused by fungal infections occurred in micafungin prophylaxis group.

CONCLUSIONS

Massive hemorrhage cased by fungal infections after DCD kidney transplantation is usually characterized by delayed and recurrent course, and may result in graft nephrectomy or even death of patients. Endovascular exclusion using covered stent can successfully stop bleeding and rescue life of patients. Two-week preemptive prophylaxis of fungal infections using micafungin can effectively prevent delayed fungal massive hemorrhage in DCD kidney transplantation.

Varroa destructor changes its cuticular hydrocarbons to mimic new hosts

Varroa destructor (Vd) is a honeybee ectoparasite. Its original host is the Asian honeybee, Apis cerana, but it has also become a severe, global threat to the European honeybee, Apis mellifera. Previous studies have shown that Varroa can mimic a host's cuticular hydrocarbons (HC), enabling the parasite to escape the hygienic behaviour of the host honeybees. By transferring mites between the two honeybee species, we further demonstrate that Vd is able to mimic the cuticular HC of a novel host species when artificially transferred to this new host. Mites originally from A. cerana are more efficient than mites from A. mellifera in mimicking HC of both A. cerana and A. mellifera. This remarkable adaptability may explain their relatively recent host-shift from A. cerana to A. mellifera.

Association of the IL-4R Q576R polymorphism and asthma in the Chinese Han population: a meta-analysis

The IL-4R Q576R polymorphism has been reported to increase susceptibility to asthma, but the results are controversial. Thus, we performed a meta-analysis to evaluate the association of the IL-4R Q576R polymorphism and asthma risk in the Chinese Han population. A total of sixteen eligible case-control studies that evaluated the relationship between the IL-4R Q576R polymorphism and asthma in the Chinese Han population were obtained by comprehensive literature search incorporating electronic databases, and included 2077 asthma cases and 1589 controls. Our analysis detected a significant association between the IL-4R Q576R polymorphism and the risk of asthma in the Chinese Han population (Allelic model: OR = 1.481, 95%CI = 1.134-1.935, P = 0.004; Dominant model: OR = 1.542, 95%CI = 1.194-1.990, P = 0.001; Recessive model: OR = 1.695, 95%CI = 1.170-2.456, P = 0.005, Additive model: OR = 1.897, 95%CI = 1.299-2.771, P = 0.005). The year of publication and size of total sample might be sources of between-study heterogeneity. Upon subgroup analysis by size of total sample of each study, the significant association only remained in a subgroup with a small sample size. In summary, our meta-analysis suggested that the IL-4R Q576R polymorphism is associated with asthma in the Chinese Han population.

Gefitinib maintenance therapy in Chinese advanced-stage lung adenocarcinoma patients with EGFR mutations treated with prior chemotherapy

The aim of this study was to determine the response of advanced-stage non-small cell lung cancer (NSCLC) patients with or without EGFR mutations to platinum-based chemotherapy with or without gefitinib maintenance. Patients were treated with four cycles of platinum-based chemotherapy. Patients with wild-type EGFR were observed (group 1; n=15). EGFR mutation-positive patients were randomly assigned to observation (group 2; n=7) or gefitinib maintenance (group 3; n=7). The median patient age was 59 years. The 1-year progression-free survival rates in groups 1, 2, and 3 were 6.7%, 28.6%, and 57.1%, respectively (p = 0.049); the 1-year overall survival rates were 53.3%, 57.1 %, and 100%, respectively (p = 0.111). The results indicate that patients with advanced-stage NSCLC with EGFR mutations have a better response to chemotherapy followed by gefitinib than chemotherapy alone and a better response to chemotherapy than wild-type patients.

KEYWORDS

chemotherapy, gefitinib, NSCLC, tyrosine kinase inhibitors.

Gene polymorphisms associated with susceptibility to coronary artery disease in Han Chinese people

This study investigated 5 single nucleotide polymorphism (SNP) haplotypes in susceptibility genes for coronary artery disease (CAD) and the putative involvement of these SNPs in CAD in the Chi-nese Han population. From March 2008 to June 2009, we selected 119 CAD patients and 115 subjects not related to the CAD of Chinese Han or-igin as controls. The SNP genotypes were performed by multiplex SNaP-shot technology. The HNRPUL1 gene rs11881940T and GATA2 gene rs3803T loci were highly correlated with CAD (P < 0.05). rs10757278G increased the risk of CAD in patients indicated by an odds ratio (OR) = 1.242 [95% confidence interval (CI) = 1.04-1.49]; rs11881940T and rs3803T were protective factors for CAD with ORs = 0.767 (95%CI = 0.61-0.97) and 0.53 (95%CI = 0.40-0.72), respectively. Analysis of the rs10757278, rs11881940 and rs3803 loci showed that haplotypes ATC (OR = 4.26; 95%CI = 2.85-6.40, P < 0.01), GAC (OR = 1.50; 95%CI = 1.25-1.81, P < 0.01) and GAT (OR = 1.53; 95%CI = 1.12-2.09, P < 0.01) were CAD risk factors, whereas GTC was protective (OR = 0.48; 95%CI = 0.32-0.72, P < 0.01). ATC and glucose were positively correlated (OR = 1.91; 95%CI = 1.01-3.61, P < 0.05). GAT was a risk factor for hyper-tension (OR = 2.86; 95%CI = 1.40-5.83, P < 0.01). In conclusion, poly-morphisms and haplotype analysis of susceptibility genes for CAD can improve predicting this disease and will enable early diagnosis of CAD.

Molecular cloning and immune response analysis of putative variable lipoproteins from Mycoplasma mycoides subsp capri

Mycoplasma mycoides subsp capri is the cause of goat "MAKePS" (Mastitis, Arthritis, Keratoconjunctivitis, Pneumonia, Septicemia) syndrome. We identified three genes (GL_ 000459; 000461; 000462) as variable lipoprotein genes in the M. mycoides subsp capri str. PG3 genome by genomic information and comparative genomic analyses. To study the role of variable lipoproteins in M. mycoides subsp capri pathogenesis and evaluate the immunogenic and protective potentials of those proteins, we constructed the expression systems and expressed the mature peptide portion of the three proteins in E. coli. We also determined the titers and opsonophagocytosis activity of total IgG antibodies and the levels of Th1 and Th2 cytokines in sera, and we ran a lymphocyte proliferation assay in mice immunized with recombinant proteins His-tag-GL000459, His-tag-GL000461, and His-tag-GL000462. These three lipoproteins induced humoral and cellular immune responses in the immunized mice. Additionally, the whole blood opsonophagocitic in vitro assay demonstrated that the antibodies produced by the immunized groups can neutralize strain PG3; consequently, these three variable lipoproteins could be the major surface antigens in M. mycoides subsp capri str. PG3.