[Forensic Pathological Examination on 73 Medical Malpractice Cases of Pediatrics]

OBJECTIVES

To analyse 73 medical malpractice cases of pediatrics for discussing the importance of forensic pathology in solving the issues such as medical malpractice of pediatrics.

METHODS

From January 2002 to August 2016, 73 medical malpractice cases of pediatrics with age of death between 28 days old and 10 years old were collected from Institute of Judical Expertise of Nanjing Medical University. The relationship between causes of death and related medical institutions was retrospectively analysed.

RESULTS

In 73 cases, the male to female ratio was 1.70∶1, and ages of 28 days old to 1 year old were common （26 cases, 35.62%）, followed by ages between 1 year old and 3 years old （21 cases, 28.77%）. In 71 cases which had been determined the cause of death by postmortem examination, the main cause of death was disease, especially respiratory diseases （33 cases, 46.48%）, followed by cardiovascular diseases （12 cases, 16.90%）. In 75 medical institutes which involved with these medical malpractices, most were tertiary medical institutes （32, 42.67%）, followed by the sub-secondary （excluding the secondary） medical institutions （23, 30.67%）. The clinical diagnosis of 38 cases （52.05%） completely or mostly corresponded with the pathological findings. There were 35 cases （47.95%） undefined or misdiagnosed cases.

CONCLUSIONS

Autopsy and forensic pathological examination contribute to determine causes of death, which not only provide scientific evidence for medical malpractice of pediatrics, but also enrich and develop clinical medical knowledge, and thus improve diagnosis and treatment level in a certain extent.

[The volume and mass growth of persisted pulmonary nodules detected in low-dose CT screening and its influence factors]

Objective: To evaluate the changes of volume and mass of pulmonary nodules which were detected in low-dose computed tomography (LDCT) screening, and to analyze the influencing factors. Methods: This retrospective study analyzed the CT images of the participants who underwent at least two chest LDCT scanning from March 2009 to December 2015 in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. The inclusion criteria was the nodule diameter ≥6 mm; the volume growth was defined as ≥20%. Fifty-one pulmonary nodules (PNs) were selected among 51 enrolled participants (26 men and 25 women). According to characteristic of nodule and risk stratification of participant, the nodules were classified into different groups (10 non-solid nodules, 17 part-solid nodules and 24 solid nodules; 14 PNs in high-risk group, 12 PNs in moderate-risk group and 25 PNs in low-risk group). The Lung-VCAR software was used to measure the diameter and volume of the PNs, and all nodules were calculated for the volume doubling time (VDT) and mass doubling time (MDT). Results: Among the 51 PNs, the diameter of 33 nodules increased more than 1.5 mm while 18 nodules increased less than 1.5 mm. The median VDT of part-solid nodules was 364 days, which was shorter than that of non-solid nodules and solid nodules (761 and 819 days, respectively), the differences were statistically significant (both P<0.05). The median MDT of part-solid nodules was 351 days, which was lower than that of non-solid nodules and solid nodules (772 days and 840 days, respectively). The difference was statistically significant (P<0.05). The median VDT and MDT of the pulmonary nodules in the high-risk group were 181 days and 256 days, respectively, which were lower than those in the low risk group (1 037 days and 1 035 days, respectively). VDT has good correlation with MDT (r=0.909, P<0.001). Conclusions: Both the characteristic of PNs and the risk status of the participants could affect the growth of nodules in LDCT screening. The part-solid nodules and high-risk group nodules grew relatively faster, which should be closely focused on. Compared with the two-dimensional diameter, the three-dimensional quantitative indicators (VDT and MDT) were more sensitive for nodule growth. The mass changes of part-solid nodules were earlier than that of volume.

Enhancements to AERMOD's Building Downwash Algorithms based on Wind-Tunnel and Embedded-LES Modeling

Knowing the fate of effluent from an industrial stack is important for assessing its impact on human health. AERMOD is one of several Gaussian plume models containing algorithms to evaluate the effect of buildings on the movement of the effluent from a stack. The goal of this study is to improve AERMOD's ability to accurately model important and complex building downwash scenarios by incorporating knowledge gained from a recently completed series of wind tunnel studies and complementary large eddy simulations of flow and dispersion around simple structures for a variety of building dimensions, stack locations, stack heights, and wind angles. This study presents three modifications to the building downwash algorithm in AERMOD that improve the physical basis and internal consistency of the model, and one modification to AERMOD's building pre-processor to better represent elongated buildings in oblique winds. These modifications are demonstrated to improve the ability of AERMOD to model observed ground-level concentrations in the vicinity of a building for the variety of conditions examined in the wind tunnel and numerical studies.

Intravoxel Incoherent Motion MR Imaging in the Differentiation of Benign and Malignant Sinonasal Lesions: Comparison with Conventional Diffusion-Weighted MR Imaging

BACKGROUND AND PURPOSE

Intravoxel incoherent motion is a promising method for the differentiation of sinonasal lesions. This study aimed to evaluate the value of intravoxel incoherent motion in the differentiation of benign and malignant sinonasal lesions and to compare the diagnostic performance of intravoxel incoherent motion with that of conventional DWI.

MATERIALS AND METHODS

One hundred thirty-one patients with histologically proved solid sinonasal lesions (56 benign and 75 malignant) who underwent conventional DWI and intravoxel incoherent motion were recruited in this study. The diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) values derived from intravoxel incoherent motion and ADC values derived from conventional DWI were measured and compared between the 2 groups using the Student t test. Receiver operating characteristic curve analysis, logistic regression analysis, and 10-fold cross-validation were performed to evaluate the diagnostic performance of single-parametric and multiparametric models.

RESULTS

The mean ADC and D values were significantly lower in malignant sinonasal lesions than in benign sinonasal lesions (both P < .001). The mean f value was higher in malignant lesions than in benign lesions (P = .003). Multiparametric models can significantly improve the cross-validated areas under the curve for the differentiation of sinonasal lesions compared with single-parametric models (all corrected P < .05 except the D value). The model of D+f provided a better diagnostic performance than the ADC value (corrected P < .001).

CONCLUSIONS

Intravoxel incoherent motion appears to be a more effective MR imaging technique than conventional DWI in the differentiation of benign and malignant sinonasal lesions.

The morphological changes of bronchovascular bundles within subsolid nodules on HRCT correlate with the new IASLC classification of adenocarcinoma

AIM

To observe the morphological changes of bronchovascular bundles within subsolid nodules on high-resolution (HR) computed tomography (CT) and analyse the correlation with the new adenocarcinoma classification.

MATERIALS AND METHODS

Two hundred and sixteen lesions (absent consolidation on mediastinal window) were reviewed retrospectively. CT features including dimensions, contour, morphological changes of the blood vessels, and bronchi/bronchioles, vacuole signs, and their correlation with histopathology were evaluated.

RESULTS

Excluding nine non-cancerous lesions, 34 pre-invasive lesions (PILs) including 15 atypical adenomatous hyperplasias (AAHs) and 19 adenocarcinomas in situ (AISs), 21 minimally invasive adenocarcinomas (MIAs), and 152 invasive adenocarcinomas (IACs) were analysed. Lepidic, acinar, and papillary patterns were identified in this cohort of adenocarcinomas. IACs were grouped into three types: type I (lepidic pattern ≥80%, n=47), type II (lepidic pattern ≥50%, <80%, n=67), and type III (lepidic pattern <50%, n=38). The contour of lesions, and morphological changes in vessels and bronchi/bronchioles significantly correlated with the classification of PIL, MIA, and IACs (p=0.000, p=0.000, and p=0.017, respectively). In IACs, the prevalence of vascular abnormalities on HRCT significantly correlated with (p=0.000) the proportion of non-lepidic pattern (23.40% in type I, 58.21% in type II, and 76.32% in type III); the prevalence of bronchial/bronchiolar abnormalities was higher (p=0.008) in type II/III (20.95%) compared with type I (6.38%).

CONCLUSIONS

The morphological changes of vessels and bronchi/bronchioles within the subsolid nodules on HRCT help to differentiate IAC from PIL and MIA, and are more common in non-lepidic predominant adenocarcinomas.

A highly sensitive glucose sensor based on a gold nanoparticles/polyaniline/multi-walled carbon nanotubes composite modified glassy carbon electrode

The PTFE/GOx/AuNPs/PANI/MWCNTs/GCE glucose sensor possesses wide linear range, low detection limit, high sensitivity, which can measure the glucose in human serum and holds application potential.

Interactions between salicylic acid and antioxidant enzymes tilting the balance of H2O2 from photorespiration in non-target crops under halosulfuron-methyl stress

Halosulfuron-methyl (HSM) is a safe, selective and effective sulfonylurea herbicide (SU) for the control of sedge and broadleaf weeds in sugarcane, corn, tomato, and other crops. The primary site of action is acetolactate synthase (ALS), a key enzyme of branched chain amino acids (BCAAs) synthesis. In addition to ALS inhibition, BCAAs deficiencies and oxidative damage may be involved in toxic effects of SUs. However, secondary targets of HSM relevant to plant physiological responses are unclear. In the present study, comparative growth inhibition and peroxidization injury between sensitive and tolerance crops were observed at biochemical and physiological levels suggesting involvement of H2O2, ethylene, salicylic acid (SA) in the oxidative stress responses to HSM. HSM caused accumulation of H2O2, stimulated photorespiration and consequent accumulation of SA that worsened the peroxidization injury to the sensitive C3 plant soybean (Glycine max). The growth inhibition at low concentrations of HSM could be lessened by supplementary BCAAs, reactive oxygen species scavengers or ethylene inducers, whereas the oxidation damage at high concentrations of HSM could not be reversed and ultimately lead to plant death. H2O2 at a low level stimulated the antioxidase system including glutathione S-transferase activities in the HSM-tolerant C4 maize (Zea mays), which contributes to HSM tolerance. H2O2 plays an important role on HSM stress responses in both HSM-sensitive and HSM-tolerant soybean and maize.

Assessment of serum Golgi protein 73 as a biomarker for the diagnosis of significant fibrosis in patients with chronic HBV infection

Transient elastography (TE) is accurate in staging fibrosis noninvasively. However, a reliable serum biomarker with comparable accuracy is also important, especially when TE is unreliable/unavailable. Therefore, we aimed to evaluate the diagnostic performance of serum Golgi protein 73 (GP73) for significant fibrosis in patients with chronic HBV infection. A total of 801 patients with chronic liver disease (CLD; 492 chronic HBV infection and 309 non-HBV liver disease) with liver biopsy performance were enrolled. Healthy controls (n = 180) and hepatocellular carcinoma (HCC) patients (n = 85) were included for comparisons. Liver biopsy was used as the reference method for fibrosis staging. Serum GP73 level was measured in duplicate in double-blind fashion. Serum GP73 was highest in HCC but also significantly higher in chronic hepatitis B than in healthy controls. The elevation of serum GP73 in non-HCC patients was significantly associated with the presence of significant fibrosis independently of ALT level, liver stiffness (LS) value, inflammation grade and other confounding factors. The diagnostic performance of serum GP73 was accurate in antiviral-naïve HBV patients (area under the receiver operating curve [AUROC], 0.76 95% CI: 0.72-0.81) but not in patients with ongoing antiviral treatment (AUROC, 0.60). The utility of serum GP73 was also confirmed in non-HBV CLD (AUROC, 0.80 95% CI: 0.75-0.85). Serum GP73 was comparable to LS (AUROC, 0.78 95% CI: 0.73-0.82) and significantly better than AST to platelet ratio index (APRI) (AUROC, 0.67 95% CI: 0.62-0.72) and FIB-4 (AUROC, 0.68 95% CI: 0.63-0.73). In conclusion, serum GP73 is an accurate serum marker for significant fibrosis in chronic HBV infection, with higher accuracy than APRI and FIB-4. Serum GP73 is potentially a complementary tool for TE when evaluating the necessity of antiviral treatment, particularly in patients without definite antiviral indication.

Untangle the Structural and Random Zeros in Statistical Modelings

Count data with structural zeros are common in public health applications. There are considerable researches focusing on zero-inflated models such as zero-inflated Poisson (ZIP) and zero-inflated Negative Binomial (ZINB) models for such zero-inflated count data when used as response variable. However, when such variables are used as predictors, the difference between structural and random zeros is often ignored and may result in biased estimates. One remedy is to include an indicator of the structural zero in the model as a predictor if observed. However, structural zeros are often not observed in practice, in which case no statistical method is available to address the bias issue. This paper is aimed to fill this methodological gap by developing parametric methods to model zero-inflated count data when used as predictors based on the maximum likelihood approach. The response variable can be any type of data including continuous, binary, count or even zero-inflated count responses. Simulation studies are performed to assess the numerical performance of this new approach when sample size is small to moderate. A real data example is also used to demonstrate the application of this method.

[The relationship between smoking status and epidermiology of asthma in people aged over 14 years in China]

Objective: To study the relationship between bronchial asthma and smoking status in Chinese people. Methods: Asthma epidemiological survey and stratified-cluster-random method survey were performed in residents over 14 years in 8 provinces (cities) of China from February 2010 to August 2012. Asthma was diagnosed based upon case history, clinical signs and lung function test. Smoking status was investigated by questionnaire. Results: Sampling population was 180 099 and 164 215 were valid. A total of 2 034 subjects were diagnosed as asthma including 79 692 men and 84 523 women. The overall prevalence rate of asthma was 1.24% (2 034/164 215). Smokers were 23.8% (39 137/164 215) in the whole population. Smokers were 34.5% (702/2 034) in asthmatic patients, compared with 23.7% (38 435/162 181) in no-asthmatic population. The incidence of asthma was 1.79% and 1.06% in smokers and non-smokers respectively (P<0.001), suggesting that OR of smoking was 1.70 (95% CI 1.55-1.86, P<0.001). According to asthma control test (ACT) score, the level of asthma control in non smoking group was higher than that in smoking group(43.2% vs 35.3%). The times of hospitalization due to acute exacerbations(0.51 vs 0.41 events/person/year), total hospitalization rate(27.35% vs 20.12%), annual emergency room visits (0.80 vs 0.60 events/person/year) and emergency room visit rate (31.77% vs 24.47%) were all much higher in smoking asthmatic patients than those in non smoking asthmatic patients, indicating that the level of asthma control in smoking patients was significantly worse than in non smoking patients. Conclusions: The smoking rate in Chinese people over 14 years is still high. The prevalence rate of asthma in smokers is significantly higher than that of non-smokers. The level of asthma control in smokers is significantly worse than that in non smokers.

Antifungal activities and active ingredients of Melodinus suaveolens Champ. ex Benth

Four Melodinus species with antifungal activity were found in survey of the floral resources, in Shiwan Mountain Natural Reserve, Guangxi Province, China. Crude methanolic extracts of the twigs and leaves of Melodinus suaveolens exhibited potent antifungal activities against the plant pathogenic fungi Colletotrichum musae, Colletotrichum graminicola, Colletotrichum gloeosporioides and Alternaria musae, and the ethyl acetate fraction inhibited these pathogens at rates of 85.37, 91.47, 72.77 and 89.87%, respectively (5 mg/mL). A new compound, (2R, 3S, 5S, 6R)-1-O-methyl- chiro-inositol was isolated from the ethyl acetate fraction, along with 15 known compounds. The antifungal activities of compounds (1-16) were evaluated for the first time. Compound (4) had potent antifungal activity against C. gloeosporioides, C. graminicola and A. musae.

Taller height as a risk factor for venous thromboembolism: a Mendelian randomization meta-analysis

Essentials Observational data suggest taller people have a higher risk of venous thromboembolism (VTE). We used Mendelian randomization techniques to further explore this association in three studies. Risk of VTE increased by 30-40% for each 10 cm increment in height. Height was more strongly associated with deep vein thrombosis than with pulmonary embolism.

SUMMARY

Background Taller height is associated with a greater risk of venous thromboembolism (VTE). Objectives To use instrumental variable (IV) techniques (Mendelian randomization) to further explore this relationship. Methods Participants of European ancestry were included from two cohort studies (Atherosclerosis Risk in Communities [ARIC] study and Cardiovascular Health Study [CHS]) and one case-control study (Mayo Clinic VTE Study [Mayo]). We created two weighted genetic risk scores (GRSs) for height; the full GRS included 668 single-nucleotide polymorphisms (SNPs) from a previously published meta-analysis, and the restricted GRS included a subset of 362 SNPs not associated with weight independently of height. Standard logistic regression and IV models were used to estimate odds ratios (ORs) for VTE per 10-cm increment in height. ORs were pooled across the three studies by the use of inverse variance-weighted random effects meta-analysis. Results Among 9143 ARIC and 3180 CHS participants free of VTE at baseline, there were 367 and 109 incident VTE events. There were 1143 VTE cases and 1292 controls included from Mayo. The pooled ORs from non-IV models and models using the full and restricted GRSs as IVs were 1.27 (95% confidence interval [CI] 1.11-1.46), 1.34 (95% CI 1.04-1.73) and 1.45 (95% CI 1.04-2.01) per 10-cm greater height, respectively. Conclusions Taller height is associated with an increased risk of VTE in adults of European ancestry. Possible explanations for this association, including taller people having a greater venous surface area, a higher number of venous valves, or greater hydrostatic pressure, need to be explored further.

Evolving safety practices in the setting of modern complex operating room: role of nurses

Operating room (OR) nursing previously referred to patient care provided during the intra-operative phase and the service provided within the OR itself. With the expansion of responsibilities of nurses, OR nursing now includes pre-operative and post-operative periods, therefore peri-operative nursing is accepted as a nursing process in OR in the contemporary medical literature. Peri-operative nurses provide care to the surgical patients during the entire process of surgery. They have several roles including those of manager or a director, clinical practitioner (scrub nurse, circulating nurse and nurse anesthetist), educator as well as researcher. Although, utmost priority is placed on insuring patient safety and well-being, they are also expected to participate in professional organization, continuing medical education programs and participating in research activities. A Surgical Patient Safety Checklist formulated by the World Health Organization serves as a major guideline to all activities in OR, and peri-operative nurses are key personnel in its implementation. Communication among the various players of a procedure in OR is key to successful patient outcome, and peri-operative nurses have a central role in making it happen. Setting up of OR in military conflict zones or places that suffering a widespread natural disaster poses a unique challenge to nursing. This review discusses all aspects of peri-operative nursing and suggests points of improvement in patient care.

[A cross-section study of severe asthma in eight provinces of China]

Objective: To analyze the prevalence of severe asthmain China. Methods: The epidemiological data was collected from 2 034 asthmatics who were diagnosed in the last epidemiological survey from 2009 to 2010 in 8 provinces. Results: According to the questionnaire survey, among the 2 034 patients, the previously diagnosed patients accounted for 72.47% (1 474/2 034) and the percentage of newly-diagnosed patients was 27.53% (560/2 034). In those 1 474 previously diagnosed asthmatics, 122 (8.28%) were classified into severe asthma, while 6.00% (122/2 034) of all asthmatics and 0.07% (122/164 215) of total respondents presented as severe cases. Statistically, there was no difference in the prevalence of severe patients between men and women. The morbidity rate of severe asthma was the lowest in the 21-30 year old group and the highest in 61-70 year old group (0.85% and 8.31% respectively). The difference among ages was statistically significant (χ²=18.791, P=0.005). In addition, the prevalence rates of severe asthma were also significantly diverged among patients with different education background(χ²=24.639, P<0.000 1). A negative relation was found between education level and the proportion of severe cases. Moreover, the morbidity of severe asthma in smoking patients and non-smoking patients were significantly different as well (χ²=7.447, P<0.05). Compared with asthma patients who do not smoke, smokers were more likely to suffer severe asthma (OR=1.663, 95% CI 1.150-2.404). Conclusions: The prevalence rate of severe asthma in China is similar to that in other countries.Elderly patients have higher risk of severe asthma. Smoking is considered as a risk factor for severe asthma.

Evolution of the Reactor Antineutrino Flux and Spectrum at Daya Bay

The Daya Bay experiment has observed correlations between reactor core fuel evolution and changes in the reactor antineutrino flux and energy spectrum. Four antineutrino detectors in two experimental halls were used to identify 2.2 million inverse beta decays (IBDs) over 1230 days spanning multiple fuel cycles for each of six 2.9 GW_{th} reactor cores at the Daya Bay and Ling Ao nuclear power plants. Using detector data spanning effective ^{239}Pu fission fractions F_{239} from 0.25 to 0.35, Daya Bay measures an average IBD yield σ[over ¯]_{f} of (5.90±0.13)×10^{-43}  cm^{2}/fission and a fuel-dependent variation in the IBD yield, dσ_{f}/dF_{239}, of (-1.86±0.18)×10^{-43}  cm^{2}/fission. This observation rejects the hypothesis of a constant antineutrino flux as a function of the ^{239}Pu fission fraction at 10 standard deviations. The variation in IBD yield is found to be energy dependent, rejecting the hypothesis of a constant antineutrino energy spectrum at 5.1 standard deviations. While measurements of the evolution in the IBD spectrum show general agreement with predictions from recent reactor models, the measured evolution in total IBD yield disagrees with recent predictions at 3.1σ. This discrepancy indicates that an overall deficit in the measured flux with respect to predictions does not result from equal fractional deficits from the primary fission isotopes ^{235}U, ^{239}Pu, ^{238}U, and ^{241}Pu. Based on measured IBD yield variations, yields of (6.17±0.17) and (4.27±0.26)×10^{-43}  cm^{2}/fission have been determined for the two dominant fission parent isotopes ^{235}U and ^{239}Pu. A 7.8% discrepancy between the observed and predicted ^{235}U yields suggests that this isotope may be the primary contributor to the reactor antineutrino anomaly.

Pretransplantation Risk Factors Associated With New-onset Diabetes After Living-donor Kidney Transplantation

Mid-term date of kidney recipients with new-onset diabetes mellitus after transplantation (NODAT) was poor. We made a retrospective study of 397 patients who had living-donor kidney transplantation between January 2007 and May 2010 in our center. Pretransplantation risk factors for NODAT were identified by univariate and multivariate analyses. The mean follow-up was 53.5 ± 10.4 months. The prevalence of NODAT was 9.3%. Univariate analyses found the mean recipient age ≥40 years, body mass index (BMI) ≥24 kg/m², family history of diabetes, fasting blood glucose (FBG) ≥5.6 mmol/L, 2-hour plasma glucose ≥7.8 mmol/L, and tacrolimus were risk factors for NODAT. In logistic regression, BMI ≥24 kg/m² (odds ratio [OR]: 4.14, confidence interval [CI]: 2.02 ∼ 8.49, P < .001), family history of diabetes (OR: 2.62, CI: 1.09 ∼ 6.34, P = .032), and FBG ≥5.6 mmol/L (OR: 3.21, CI: 1.52 ∼ 6.79, P = .002) were independent risk factors. In conclusion, the mid-term prevalence of NODAT in Chinese renal recipients was low (9.3%). Pretransplantation independent risk factors were BMI ≥24 kg/m², family history of diabetes, and FBG ≥5.6 mmol/L; thus identifying which factors might help to prevent NODAT.

Validation of daily increment deposition and early growth of mud carp Cirrhinus molitorella

In this study, laboratory reared Cirrhinus molitorella from hatching through to the juvenile stage were used to validate daily increment deposition. Lapilli were suitable for ageing C. molitorella. The slope of the linear relationships between increment counts and age was not significantly different from 1 (n = 258, P > 0·05), indicating that growth increments are deposited daily. The first increment following the first-feeding check formed 3 days post hatch (dph). One hundred and twenty-three juveniles, ranging from 36·4 to 84·7 mm in body length (L_B ), were collected in the Pear River estuary from July to January in both 2014 and 2015 and used to estimate growth rate. The core in the lapillus, consisting of a single primordium, a diffuse area and the first-feeding band, was followed by 20 narrow and poorly contrasted daily increments. Thereafter, increments were wide and well-defined, and, finally became less distinct, but still homogenous after c. 53 dph. The mean increment width increased to the 29th increment and stayed relatively constant up to the 35th increment and then, gradually declined to the edge of the otolith. Wild juveniles were aged from 69 to 178 dph and hatched from the 15 February to 2 September. Growth rate was estimated from the adjusted linear regression of L_B on age: L_B = 4·37 + 0·44A (r² = 0·60), where A = age. The radius of the core and the regularity and resolution of the increments showed some differences between reared and wild fish. These results are of value for the further study of early life traits and recruitment of C. molitorella.

Identification of lipopeptides produced by Bacillus subtilis Czk1 isolated from the aerial roots of rubber trees

We obtained a strain of Bacillus subtilis, which we named Czk1, from the aerial roots of rubber trees. This bacterial isolate exhibits strong antagonistic activity against Ganoderma pseudoferreum, Phellinus noxius, Helicobasidium compactum, Rigidoporus lignosus, Sphaerostilbe repens, and Colletotrichum gloeosporioides. Our earlier research has shown that the antagonistic activity of a fermentation supernatant Czk1 isolate produces a complex mixture of lipopeptides. In this study, we used methanol to extract crude lipopeptides, purified them using a Sephadex G-25 column, cloned the lipopeptide genes, and analyzed purified fractions by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS) to identify the lipopeptides from B. subtilis strain Czk1. The cloned lipopeptide genes included those that encode the enzymes lpa, ituD, sfp, and fenB. The crude lipopeptides were purified and found in five fractions. Further analysis revealed that five fractions of the purified composition contained members of the surfactin, iturin, fengycin, and bacillomycin families of antibiotics. This suggests that these lipopeptides from strain Czk1 have potential as plant disease biocontrol agents.

eNOS/iNOS and endoplasmic reticulum stress-induced apoptosis in the placentas of patients with preeclampsia

Disruption of nitric oxide pathway and endoplasmic reticulum (ER) stress had been observed in preeclampsia (PE). However, the correlation and overall detailed expression profiles of ER stress-related markers and endothelial nitric oxide synthase/inducible nitric oxide synthase (eNOS/iNOS) in patients with PE were poorly understood. In this study, placental protein expression of ER stress-related markers as well as eNOS/iNOS in normotensive control (n=32) and PE pregnancies (n=32) was examined by western blot. In addition, apoptosis was detected by terminal deoxynucleotidyl transferase-mediated nick-end labelling (TUNEL) staining in placentas. Compared with control, we found elevated ER stress response was agreeable with iNOS upregulation in placenta tissue of PE patients. Placental protein expression of ER stress-related markers, including GRP78, GRP94, p-PERK, eIF2a, p-eIF2a, XBP1, CHOP, Ire1, p-Ire1 and iNOS, was higher, and eNOS expression was lower in PE (P<0.05 for all); however, the expression of ATF6 and PERK was similar in the PE and control groups. Upregulation of CHOP and iNOS was consistent of apoptosis increasing indicated by TUNEL staining and caspase 4 expression upregulation in PE placenta. Our datas suggest that the exaggerated ER stress response and upregulated iNOS are probably associated with increased apoptosis in placenta of PE patients and may contribute to the pathophysiology of PE.

Molecular mechanism of the protective effect of monomer polyvinylpyrrolidone on antioxidants - experimental and computational studies

We previously developed a lutein-polyvinylpyrrolidone (PVP) complex with improved aqueous saturation solubility and stability, though the conjugation mechanism is still unclear. In this paper, experiments with astaxanthin-PVP complex and curcumin-PVP complex were carried out, which indicated that PVP could improve the solubility and stability of astaxanthin and curcumin. We aimed to construct a computational model capable of understanding the protective effect in complexes formed between PVP and antioxidants, through which the binding mode of PVP and antioxidants was investigated with molecular modelling in order to obtain the interactions, binding energy, binding site and surface area between PVP and antioxidants. Solubility enhancement was attributed to the H-bonds between PVP and antioxidants, and the saturation solubility was curcumin > lutein > astaxanthin. Binding energy, binding site and surface area were beneficial for the stability of complex, and the stability enhancement was lutein > astaxanthin > curcumin. The experimental results were in agreement with the computational results. Furthermore, we established a method for the exploration of a similar system with other polymer complexes. Additionally, the proposed PVP model could predict the interactions between PVP and various ligands, such as antioxidants and drugs.

DGGE diversity of manganese mine samples and isolation of a Lysinibacillus sp. efficient in removal of high Mn (II) concentrations

Manganese contamination has become a serious environmental problem in the world and bacterial removal plays an important role in global cycling of manganese. In this study, microorganism distribution within samples from a manganese mine was analyzed with PCR-DGGE technology. The results suggested that Manganese oxidizing bacteria (such as Bacillus, Hyphomicrobiaceae and Erythrobacter) were dominant in the soil. In addition, a Lysinibacillus sp. Isolate, strain MK-1, revealed robust growth at high Mn(II) concentrations up to 1 mM. At that concentration, 55.94% of added Mn(II) was oxidized and 36.23% of the Mn(II) was adsorbed by MK-1(total manganese removal reached 94.67%) after 7 days of culturing. By measuring its metabolic process, the great role of biological adsorption was found. Additionally, the spectroscopic result demonstrated that Mn(III) was an intermediate during the biological oxidation process. These findings increase the knowledge of biological manganese removal mechanisms and show some potentials to the operation of manganese treatment.

FOXK1 interaction with FHL2 promotes proliferation, invasion and metastasis in colorectal cancer

The transcriptional factor Forkhead box k1 (FOXK1) is a member of the FOX family. The abnormal expression of FOXK1 may have an important role in tumour development. Our previous studies showed that four-and-a-half LIM protein 2 (FHL2) is a critical inducer of the epithelial-to-mesenchymal transition (EMT) and invasion. However, the molecular mechanism by which FOXK1 synergizes with FHL2 tumour proliferation, EMT and metastasis is not well defined. We evaluated that messenger RNA (mRNA) and protein expression levels by quantitative RT–PCR, western blot, immunofluorescence and immunohistochemistry (IHC) assays. The migration and invasive abilities of colorectal cancer (CRC) cells were evaluated using short hairpin RNA (shRNA)-mediated inhibition in vitro and in vivo. We showed that FOXK1 expression was upregulated in CRC compared with matched normal tissues. FOXK1 physically interacts with FHL2 in CRC. Moreover, higher expression levels of the two proteins were significantly associated with differentiation, lymph node metastasis, AJCC stage and poorer prognosis. Furthermore, the overexpression of FOXK1 in CRC cells is associated with EMT, invasion and metastasis. However, the siRNA-mediated repression of FHL2 in FOXK1-overexpressing cells reversed EMT and both the proliferative and metastatic phenotypes in vitro and in vivo. These data identified that the co-expression of FOXK1 and FHL2 enhances cell proliferation and metastasis through the induction of EMT. Thus, FOXK1 and FHL2 may serve as putative targets in the combined therapy of CRC.

[Clinical observation on human alpha glucosidase in treatment of five patients with glycogen storage disease Ⅱ]

Objective: To evaluate the effect of enzyme replacement therapy (ERT) on glycogen storage disease typeⅡ(GSDⅡ). Method: The clinical data of three juvenile onset and two infant onset GSDⅡpatients were collected from First Affiliated Hospital of Sun Yat-sen University in October 2015 to July 2016.Patient 1 was female, the age of onset was 15 months. Patient 2 was male, the age of onset was 20 months. Patient 3 was female, the sister of patient 2, the age of onset was 47 months. Patient 4 was male, the age of onset was 5 months. Patient 5 was male, the age of onset was 1 month.The age at the start of ERT of the 5 patients was 32, 31, 56, 34, and 3 months respectively and the duration of ERT was 19, 9, 4, 5, 5 doses respectively.ERT was administered at 20 mg/kg every 2 weeks.Dexamethasone was regularly given before each infusion. Result: ERT was well tolerated, only one time, Patient 1 developed tachycardia and hypertension without using dexamethasone.Patient 2 underwent successfully ventilator weaning.Patient 1 underwent a tracheotomy, also needed mechanical ventilation treatment.Patient 4 noninvasive ventilation was tried. Conclusion: Recombinant human alpha-glucosidase treatment was effective and well tolerated in patients with GSDⅡ.

1D NiO-SnO2 Heterojunction Nanofibers as Acetone Sensor

<p>1D NiO-SnO₂ nanofibers with p-n heterostructure were synthesized by electrospinning with post-synthetic heat treatment. The morphology and composition were characterized by scanning electron microscope, X-ray diffraction, and energy dispersive X-ray spectrometry. A possible growth model was proposed to describe the formation of hierarchical NiO-SnO₂. The gas sensors based on NiO-SnO₂ exhibited p-type response to acetone. The excellent acetone sensing properties may be attributed to numerous p-n junctions between NiO and SnO₂ nanograins as well as the unique architecture. The changes of energy level and space charge layer of NiO-SnO₂ heterojunction nanofibers when exposed to acetone are described in detail.</p>

Limits on Active to Sterile Neutrino Oscillations from Disappearance Searches in the MINOS, Daya Bay, and Bugey-3 Experiments

Searches for a light sterile neutrino have been performed independently by the MINOS and the Daya Bay experiments using the muon (anti)neutrino and electron antineutrino disappearance channels, respectively. In this Letter, results from both experiments are combined with those from the Bugey-3 reactor neutrino experiment to constrain oscillations into light sterile neutrinos. The three experiments are sensitive to complementary regions of parameter space, enabling the combined analysis to probe regions allowed by the Liquid Scintillator Neutrino Detector (LSND) and MiniBooNE experiments in a minimally extended four-neutrino flavor framework. Stringent limits on sin^{2}2θ_{μe} are set over 6 orders of magnitude in the sterile mass-squared splitting Δm_{41}^{2}. The sterile-neutrino mixing phase space allowed by the LSND and MiniBooNE experiments is excluded for Δm_{41}^{2}<0.8  eV^{2} at 95%  CL_{s}.

Improved Search for a Light Sterile Neutrino with the Full Configuration of the Daya Bay Experiment

This Letter reports an improved search for light sterile neutrino mixing in the electron antineutrino disappearance channel with the full configuration of the Daya Bay Reactor Neutrino Experiment. With an additional 404 days of data collected in eight antineutrino detectors, this search benefits from 3.6 times the statistics available to the previous publication, as well as from improvements in energy calibration and background reduction. A relative comparison of the rate and energy spectrum of reactor antineutrinos in the three experimental halls yields no evidence of sterile neutrino mixing in the 2×10^{-4}≲|Δm_{41}^{2}|≲0.3  eV^{2} mass range. The resulting limits on sin^{2}2θ_{14} are improved by approx imately a factor of 2 over previous results and constitute the most stringent constraints to date in the |Δm_{41}^{2}|≲0.2  eV^{2} region.

Acceptability and feasibility of a social entrepreneurship testing model to promote HIV self-testing and linkage to care among men who have sex with men

OBJECTIVES

HIV self-testing (HIVST) offers an opportunity to increase HIV testing among people not reached by facility-based services. However, the promotion of HIVST is limited as a consequence of insufficient community engagement. We built a social entrepreneurship testing (SET) model to promote HIVST linkage to care among Chinese men who have sex with men (MSM) in Guangzhou.

METHODS

The SET model includes a few key steps. Each participant first completed an online survey, and paid a US$23 (refundable) deposit to receive an HIVST kit and a syphilis self-testing (SST) kit. After the testing, the results were sent to the platform by the participants and interpreted by Center for Disease Control and Prevention (CDC) staff. Meanwhile, the deposit was returned to each participant. Finally, the Community based organizations (CBO) contacted the participants to provide counselling services, confirmation testing and linkage to care.

RESULTS

During April-June 2015, a total of 198 MSM completed a preliminary survey and purchased self-testing kits. The majority were aged < 34 years (84.4%) and met partners online (93.1%). In addition, 68.9% of participants had ever been tested for HIV, and 19.5% had ever performed HIVST. Overall, feedback was received from 192 participants (97.0%). Of these participants, 14 people did not use the kits; among those who did use the kits, the HIV and syphilis prevalences were 4.5% (eight of 178) and 3.7% (six of 178), respectively. All of the screened HIV-positive individuals sought further confirmation testing and were linked to care.

CONCLUSIONS

Using an online SET model to promote HIV and syphilis self-testing among Chinese MSM is acceptable and feasible, and this model adds a new testing platform to the current testing service system.