[The ventilation efficacy and safety of new nasopharyngeal airway applied in left atrial appendage occlusion]

Objective: The present retrospective study aimed to analyses the ventilation efficacy and safety of new nasopharyngeal airway applied in left atrial appendage occlusion. Methods: A total of 37 advanced aged patients diagnosed with atrial fibrillation(>65 years)who underwent left atrial appendage occlusion (LAAO) in Xuanwu Hospital of Capital Medical University from March 2021 to March 2022 were enrolled in this study. All patients received supplemental oxygen by a new nasopharyngeal airway to ensure intraoperative ventilation. The primary outcome was the occurrence of hypoxemia. The secondary outcomes included the incidence of hypotension after anesthesia, the incidence of body movement during surgery, significant fluctuations of the vital signs such as mean arterial pressure (MAP), heart rate (HR), saturation of pulse oxygen (SpO2) and respiratory rate (RR) at different time points (T1: pre-operation; T2: at the time of placing nasopharyngeal airway; T3: at the time of placing transesophageal echocardiography(TEE); T4: at the time of TEE intraoperative exploration; T5: end of the surgery; T6: at the time of patient woke up), and the incidence of postoperative adverse events. Results: There were 24 males and 13 females with a mean age of (73.8±7.7) years. The incidence of hypoxemia was 16.2% (6/37), which could return to normal after simple treatment. The incidence of hypotension was 27.0% (10/37), occurred after anesthesia induction mainly.32.4% (12/37) of the patients experienced movements, but no adverse events led to surgical termination. MAP at different time points was significantly different (P=0.001), but other vital signs of HR, SpO2 and RR were not significantly different(all P>0.05), without serious hemodynamic fluctuations. The incidence of postoperative adverse cardiovascular events was 10.8% (4/37), and delirium was 2.7% (1/37). All patients successfully completed the surgery and were safely discharged from the hospital. Conclusion: The new nasopharyngeal airway can meet the requirements of airway management during left atrial appendage occlusion under intravenous anesthesia without serious adverse events.

[Application of transbronchial cryobiopsy in the diagnosis of postoperative complications after lung transplantation: a report of 6 cases]

Objective: To investigate the efficacy and safety of transbronchial cryobiopsy (TBCB) after lung transplantation. Methods: The clinical characteristics, TBCB procedure, diagnosis and treatment, and outcomes of lung transplant recipients of 6 patients (all male, aged 33-67 years) with TBCB in China-Japan Friendship Hospital from May to November 2021 were retrospectively analyzed. Results: Among the 6 patients diagnosed by TBCB, there were 2 cases of organizing pneumonia, 1 acute cellular rejection, 1 antibody-mediated rejection, and 1 bronchiolitis obliterans, and 1 diffuse alveolar damage. After the clinical diagnosis was confirmed, the condition improved after adjustment of the treatments followed. There were no serious complications related to the TBCB procedure. Conclusion: TBCB is valuable and relatively safe in the diagnosis of complications after lung transplantation, but the indications need to be strictly controlled.

[Diversity of root canal morphology in mandibular first premolars and its clinical strategies]

It is a basic prerequisite for the successful completion of endodontic treatment to thoroughly understand the root canal space anatomy. With the development of dental devices in dentistry, the root canal morphology of the mandibular first premolars can be presented in more detail. Before conducting root canal therapy on the mandibular first premolar with complex root canal morphology, it should be necessary to evaluate the potential difficulties and risks for making an appropriate treatment plan. The present paper reviews the research progress on the diversities of root canal morphology in mandibular first premolars in recent years, and then makes technologic recommendations based on the morphology diversities.

[Pneumatosis cystoides intestinalis in lung transplant recipients: three cases report and literature review]

Objective: To report the clinical characteristics and treatment courses of pneumatosis cystoides intestinalis(PCI) after lung transplantation(LT). Methods: We included all cases of PCI after LT from March 2017 to June 2021 in China-Japan Friendship Hospital. In addition to our cases, we searched literatures published in Chinese and English languages using China National Knowledge Infrastructure (CNKI), Wanfang Data and PubMed/MEDLINE with the search terms"pneumatosis intestinalis"and"lung transplantation". The clinical characteristics and treatment courses of all cases were summarized and analyzed. Results: Three cases of PCI occurred after LT in this study, with an incidence of 0.804% (3/373). Thirteen related literatures were retrieved, with 51 cases enrolled. The median age of the 54 patients was 55.4 years (22-79 years), with 33 males and 21 females. 64.81% (35/54) of the 54 patients underwent LT for interstitial lung disease and 90.74% (49/54) underwent bilateral LT. Twenty-two cases(40.7%) were asymptomatic when PCI occurred. Thirty-eight cases (38/54,70.37%)had involvement of ascending colon, and 35 cases(35/54,64.81%)had involvement of transverse colon. Forty-three cases(43/54, 79.63%) were treated conservatively. The average interval between transplantation and PCI was 210 (5-2 495) days. Conclusion: PCI is a rare complication after lung transplantation, most often occurring in the colon. Most patients were asymptomatic and could improve by conservative treatments.

[Survival analysis of unexpected small cell lung cancer following surgery]

Objective: To investigate the survival and influencing factors of unexpected small cell lung cancer following surgery. Methods: We respectively reviewed the clinical characters of 104 patients who underwent surgical treatment and be proved as small cell lung cancer by pathology between January 2000 to October 2020 in Chinese PLA General Hospital. Overall survival (OS) of patients was evaluated using Kaplan-Meier and Cox proportional hazards analysis. Results: Of 104 patients, 27 cases showed central lesions, and other 77 showed peripheral nodules. The margin of nodules was smooth in 42 cases on CT imaging. The median OS was 34.3 months and 5-year OS rate was 45.8%. Postoperative 5-year OS rates for patients were 52.1%, 45.4%, and 27.8% for clinical stages Ⅰ, Ⅱ, and Ⅲ, respectively. Univariate analyses identified the age, surgical access, surgical approach, N stage, TNM stage and vascular cancer emboli were associated with OS (P<0.05). The N stage was an independent factor for the OS of patients (P<0.05). Conclusions: Patients with unexpected SCLC, including Ⅰ, Ⅱ and part ⅢA stage have favorable outcome and can benefit from surgery and systemic postoperative treatment. Standard lobectomy plus systemic lymph node dissection is commended.

[Pulmonary mucormycosis after lung transplantation:3 cases report with literature review]

Objective: To report the risk factors, clinical characteristics and treatment courses of pulmonary mucormycosis after lung transplantation(LT). Methods: We included 3 cases with pulmonary mucormycosis after LT from March 2017 to July 2020 in the centre for lung transplantation of China-Japan Friendship Hospital. Twelve cases from Chinese and English literature from China National Knowledge Infrastructure (CNKI), China Biomedical Literature Service System and Pubmed Database from March 1980 to July 2020 were added. The risk factors, clinical characteristics and treatment courses of all cases were summarized and analyzed. Results: Pulmonary mucormycosis occurred in 1.06% (3/284) in our centre. A total of 15 cases with 12 cases from literature included 10 males and 5 females with a mean age of(47±20)years. Thirteen cases occurred after LT, and 2 cases occurred after heart-lung transplantation (HLT). Nine probable cases were diagnosed by positive isolation of the pathogen from bronchoalveolar lavage fluid or sputum. Three proven cases were diagnosed by transbronchial lung biopsy. Meanwhile, the other 3 proven cases diagnosed by CT-guided percutaneous lung biopsy, autopsy and surgical operation respectively. Ten cases (66.7%) were diagnosed with pulmonary mucormycosis within 90 days after lung transplantation. The mortality was as high as 46.67% (7/15), but if it occurred within 90 days, the mortality reached 70% (7/10). The average interval between transplantation and positive isolation of the pathogen was 112.3 (5-378) days. Conclusions: The clinical and radiographic features of pulmonary mucormycosis after LT were nonspecific. It had a high mortality, especially in those occurred within 90 days after LT. The combination of antifungal therapy and surgical resection may contribute to a better outcome of the disease.

[Analysis on characteristics of HIV-1 molecular network in injected drug users in Guangzhou, 2008-2017]

Objective: To understand the characteristics of the HIV-1 molecular networks in injected drug users (IDUs) in Guangzhou from 2008 to 2017, and provide reference for the prevention and control of AIDS in this population. Methods: The serum samples of newly diagnosed HIV-1 positive IDUs in Guangzhou from 2008 to 2017 were collected, HIV-1 RNA was extracted for pol gene amplification and sequencing. The molecular cluster in the phylogenetic tree was identified by Cluster Picker 1.2.3 for cluster analysis. TN93 model in HyPhy2.2.4 was used to calculate the gene distance between the cluster sequences. Software Cytoscape3.8.2 was used to visualize the molecular network, and χ² test or exact probability method was used for cluster analysis and centrality analysis. Results: A total of 586 sequences were successfully amplified (73.9%, 586/793), and 80 molecular clusters were produced, with a clustering rate of 46.6% (273/586). In molecular clusters, the proportions of the strains from IDUs in Han ethnic group (48.4%, 260/537), IDUs who were local residents in Guangdong (52.7%, 146/277) and IDUs whose strain sequence subtype was CRF55_01B (93.3%, 14/15) were higher. In the molecular network, the degree range was 1-7, and nodes with degree ≥3 accounted for 12.8% (24/187), which was associated with another 81 nodes in the molecular network (43.3%, 81/187). The centrality analysis showed that the proportions of housework/unemployed with high degree centrality (19.0%, 19/100), high intermediary (22.0%, 22/100), and high proximity centrality (32.0%, 32/100) were higher in IDUs infected with HIV-1. Conclusion: The risk of HIV-1 clustering in IDUs in Guangzhou was high, suggesting that IDUs who were from both Guangdong and Guangxi and were house workers or unemployed should be viewed as the key targets, and precise intervention should be implemented to reduce the HIV-1 infection rate in this population.

Risk of post-contrast acute kidney injury in emergency department patients with sepsis

INTRODUCTION

Although computed tomography (CT) is a useful tool for exploring occult infection in patients with sepsis in the emergency department, the potential nephrotoxicity of contrast media is a major concern. Our study aimed to investigate the association between use of contrast-enhanced CT and the risks of acute kidney injury and other adverse outcomes in patients with sepsis.

METHODS

In total, 587 patients with sepsis who underwent CT scan (enhanced CT group: 105, non-enhanced CT group: 482) from January 2012 to December 2016 at a tertiary referral centre were enrolled in this retrospective analysis, and propensity score matching was performed to minimise the selection bias. The length of stay, incidences of acute kidney injury and emergent dialysis, and short-term mortality were compared between the two groups.

RESULTS

Compared with patients in the non-enhanced CT group, patients in the contrast-enhanced CT group did not have increased risks of acute kidney injury (odds ratio [OR]=1.38, 95% confidence interval [CI]=0.55-3.43; P=0.489), emergent dialysis (OR=1.31, 95% CI=0.47-3.68; P=0.602), or short-term mortality (OR=0.90, 95% CI=0.48-1.69; P=0.751). In addition, there was no significant difference in the median length of hospital stay between survivors in the two groups (20 vs 19 days, P=0.742).

CONCLUSIONS

Intravenous contrast administration during CT scanning was not associated with prolonged length of hospital stay in patients with sepsis in an emergency setting. Moreover, the use of contrast-enhanced CT was not associated with increased risks of acute kidney injury, emergent dialysis, or short-term mortality.

[A single-center experience of venous thromboembolism after adult lung transplantation]

Objective: To investigate the incidence of venous thromboembolism (VTE) in lung transplant (LT) recipients. Methods: The clinical data on 124 consecutive patients who underwent lung transplant at Lung Transplantation Center of China-Japan Friendship Hospital from March 2017 to September 2018 were retrospectively collected. Deep venous thrombosis (DVT) was ascertained by vascular ultrasound. Pulmonary embolism (PE) was diagnosed by either chest computed tomography pulmonary angiogram or ventilation/perfusion scan. The risk factors in those patients with postoperative VTE were studied. Results: A total of 124 lung transplant recipients including 78 single lung transplant recipients (62.9%) and 46 bilateral lung transplant recipients(37.1%) were enrolled. Preoperative and postoperative prophylactic anticoagulant was used in 52 patients(52/124, 41.9%) and 69 patients(69/124, 55.6%) respectively. Thirty-two patients developed postoperative VTE among 124 consecutive patients. The overall incidence rate of VTE among 124 LT recipients was 25.8%. The median time to VTE episode following lung transplant was 22.5 days (range 4-295 days). The percentage of DVT in VTE was 93.8%(30/32), involving 1-8 (2.83±1.86) veins. And 60.0% of DVT was from lower extremities and 56.7% located in upper extremities (P>0.05). Four patients (4/32,12.5%) had PE episodes, and half of them suffered from only PE without DVT. The use of extracorporeal membrane oxygenation (ECMO) in 32 patients with VTE was 90.6% (29/32), which was significantly higher than that without VTE (64/92,69.6%, P=0.033). However, there was no difference in the use of peripherally inserted central catheter (PICC) between two groups (96.9% vs 81.5%, P=0.067). Resolution of VTE was successfully accomplished by anticoagulant therapy with long-term use of low molecular weight heparin in 30 patients (93.7%) and followed by oral warfarin in 2 patients (6.3%). Three months follow-up data after anticoagulant therapy showed that total and partial vascular recanalization rate was 65.6%(21/32) and 34.4%(11/32), respectively. Despite anticoagulation-related bleeding complications in three patients, no serious consequences occurred. Conclusions: VTE was frequent in LT recipients. It was speculated that ECMO utilization may be a major risk factor for high incidence of VTE in LT recipients. Aggressive VTE screening/treatment protocols were suggested to be implemented in LT recipients.

Traumatic Dissections of Bilateral Internal carotid Artery with Aneurysms Formation

Carotid artery dissection is an unusual complication of blunt neck trauma with high mortality and severe neurological deficits. Traumatic bilateral dissections and dissecting aneurysms are extremely rare. A 17-year-old male presented to our emergency department with sudden onset of right hemiparesis and aphasia. Initial computed tomography scan of head and neck showed no remarkable finding. On the second day, a magnetic resonance angiography of head and neck demonstrated bilateral extracranial internal carotid artery dissections. The diagnosis of traumatic carotid artery dissection for emergency physicians is difficult because of the absence or delayed onset in symptomatology. Magnetic resonance angiography is currently considered as an appropriate initial diagnostic tool for carotid artery injury. In clinical practice, early diagnosis by keeping a high index of suspicions is required by emergency physicians.

[Distribution of HIV-1 subtypes among foreign patients, in Guangzhou, between 2008 and 2010, and in 2015]

Objective: To understand the characteristic of subtype distribution among foreigners who were living with HIV-1, in Guangzhou. Methods: HIV-1 RNAs were extracted from 114 serum specimens in foreigners diagnosed with HIV-1 infections between 2008 and 2010, and in 2015. Partial pol gene of HIV-1 genome from these RNA samples were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) with nucleotide sequenced. Subsequently, phylogenetic tree was reconstructed using the pol sequences of samples and references. Results: Among all the 114 samples, 57.9% were from males and 42.1% from females, with an average age as 35.21 years old and the standard deviation as 9.63 years. A total of 6.8% of the samples were from Africans. The top three subtypes were identified as CRF02_AG, subtype G and subtype C, accounted for 30.7%, 14.9% and 12.3% respectively. Compared with samples gathered from 2008 to 2010, the proportions of subtype A1 and CRF01_AE significantly increased, while the other subtypes significantly decreased in 2015 (χ(2)=37.570; P=0.013, 99% CI: 0.010-0.016). Proportions of CRF01_AE and subtype G among males outnumbered the females but the proportions of subtype A1, CRF02_AG and URF among females appeared the other way round (χ(2)=15.528; P=0.029, 99%CI: 0.024-0.033). Proportions of CRF02_AG and subtype G among HIV-1 positive Africans were larger than those from other Southeast Asian countries or areas, However, the proportion of CRF01_AE among HIV-1 positive patients from Southeast Asian countries was higher than those patients from other areas (χ(2)=39.399; P=0.009, 99% CI: 0.006-0.011). The rates of resistance to any drug of protease inhibitors (PIs), reverse transcriptase inhibitors (RTIs), as well as to PIs, NRTIs, and NNRTIs alone, were 21.9%, 12.3%, 6.1% and 7.0%, respectively. One of nine CRF01_AEs from the HIV-1 positive patients were found closely clustered in those phylogenetic tree (bootstrap=0.855) samples, collected from local patients in Guangzhou. Conclusions: Our findings showed that these foreign subtypes had been spread to the natives, more from the Africans than from the other areas, in Guangzhou. These types of viruses were different from the strains identified locally, suggesting that they might have been brought in by foreigners living with HIV-1, in Guangzhou. Programs related to care, support and behavioral intervention for HIV positive foreigners living in Guangzhou, should be strengthened.

[Application of " Internet Plus" AIDS prevention services among men who have sex with men in Guangzhou, China: results from 2010 to 2015]

Objective: To introduce the development strategy of " Internet Plus" AIDS prevention services and its implementation results from 2010 to 2015 in Guangzhou, China. Methods: A gay men's health column was created for an active website aimed at men who have sex with men(MSM), in collaboration with local community organizations and the Guangzhou CDC. We designed intervention tools(including scenario-based applications and HIV risk self-assessment systems)and an online HIV testing service platform, integrated with applied psychology and behavioral theory as well as the " Internet Plus" concept, to intervene in HIV infection risk factors among MSM. Data of clients who accessed the " Internet Plus" AIDS services from 2010 to 2015 were used to evaluate service operation. Six-year consecutive surveys, conducted between April and July of each service year, were collected using a national AIDS sentinel surveillance questionnaire. For each year of surveillance, information on HIV prevalence, HIV interventions received during the past year, unprotected anal intercourse in the past 6 months, and HIV testing in the past year were compared using the chi-squared(χ²)test, to roughly reflect the effect of"Internet Plus" AIDS prevention services. Results: As of 31 December 2015, a total of 34 395 MSM had received " Internet Plus" services and HIV testing. The number of MSM tested increased from 2 338 in 2010 to 8 054 in 2015. From 2010 to 2015, newly identified HIV cases in each year were 59, 166, 312, 283, 291, and 270, which accounted for 25.0%, 32.8%, 38.8%, 35.1%, 30.5%, and 23.2% of MSM HIV cases of Guangzhou, respectively. Sentinel surveillance data showed that during the study period, 3 047 MSM were investigated, with 405, 400, 401, 633, 608, and 600 each year, respectively. The proportion of participants who had received any HIV intervention during the past year was 74.3%(301), 70.8%(283), 83.3%(334), 85.0%(538), 69.1%(420), and 83.8%(503)each year, respectively(trend χ²=6.53, P=0.011). HIV testing done during the past year accounted for 44.0%(178), 44.3%(177), 49.4%(198), 53.4%(338), 56.1%(341), and 60.2%(361)each year, respectively(trend χ²=40.83, P<0.001). Unprotected anal intercourse in the past 6 months accounted for 59.3%(240), 62.0%(248), 56.6%(227), 57.0%(361), 48.4%(294), and 43.7%(262)each year, respectively(trend χ²=42.21, P<0.001). Conclusion: The"Internet Plus"AIDS prevention services in this study represent a manner to enhance traditional HIV prevention strategies. We found these services to be effective in implementation of the national AIDS control and prevention strategy, especially for the expansion of intervention, testing, and case identification among high-risk populations.

Strain-tuned optoelectronic properties of hollow gallium sulphide microspheres

Sulfide semiconductors have attracted considerable attention. The main challenge is to prepare materials with a designable morphology, a controllable band structure and optoelectronic properties. Herein, we report a facile chemical transportation reaction for the synthesis of Ga2S3 microspheres with novel hollow morphologies and partially filled volumes. Even without any extrinsic dopant, photoluminescence (PL) emission wavelength could be facilely tuned from 635 to 665 nm, depending on its intrinsic inhomogeneous strain distribution. Geometric phase analysis (GPA) based on high-resolution transmission electron microscopy (HRTEM) imaging reveals that the strain distribution and the associated PL properties can be accurately controlled by changing the growth temperature gradient, which depends on the distance between the boats used for raw material evaporation and microsphere deposition. The stacking-fault density, lattice distortion degree and strain distribution at the shell interfacial region of the Ga2S3 microspheres could be readily adjusted. Ab initio first-principles calculations confirm that the lowest conductive band (LCB) is dominated by S-3s and Ga-4p states, which shift to the low-energy band as a result of the introduction of tensile strain, well in accordance with the observed PL evolution. Therefore, based on our strain driving strategy, novel guidelines toward the reasonable design of sulfide semiconductors with tunable photoluminescence properties are proposed.

Expression of Ras-related protein 25 predicts chemotherapy resistance and prognosis in advanced non-small cell lung cancer

Ras-related protein 25 (Rab25) is involved in many human malignancies. However, its role in chemotherapy response and prognosis in advanced non-small cell lung cancer (NSCLC) remains unknown. Therefore, we investigated the relationship between Rab25 and chemotherapy sensitivity and prognosis in NSCLC. Rab25 expression was assessed using immunohistochemistry in 324 advanced NSCLC patients. Its correlations with clinical features were analyzed. Sensitivity to cisplatin (DDP) was compared between DDP-sensitive A549 and DDP-resistant A549/DDP cells. Furthermore, small interfering RNA (siRNA) targeting Rab25 was used for in vitro experiments. Patients with positive Rab25 expression had a significantly lower chemotherapy response rate (P = 0.004) and poorer overall survival (OS, P = 0.0012) than those with negative Rab25 expression. Multivariate analysis indicated that Rab25 expression was an independent prognostic factor for OS (P = 0.016). Moreover, Rab25 expression was significantly higher in A549/DDP cells than in A549 cells. Knockdown of Rab25 by siRNA suppressed cell migration and invasion. Cisplatin resistance in A549/DDP cells was also partially reversed by Rab25 silencing. Rab25 expression is a potential prognostic index for advanced NSCLC patients and its inhibition may improve chemosensitization in NSCLC treatment.

Aberrant brain activation of error processing among adults with attention deficit and hyperactivity disorder

Individuals with adult attention deficit/hyperactivity disorder (ADHD) have a deficit in their cognitive control. The aim of this study was to reveal the brain correlates of the deficits in response inhibition or error processing in adult ADHD. A total of 29 adults with ADHD and 25 control individuals were recruited. They completed an event-related-design Go/No-go task under functional magnetic resonance imaging scanning. Both the ADHD group and the control group exhibited activation of the frontostriatal network when processing response inhibition. They also exhibited activation of the frontoinsula cortex and anterior cingulate in error processing. Adults with ADHD have a lower brain activation of error processing over the right inferior frontal lobe adjacent to the insula than control individuals. The altered frontoinsula cortex activation may represent the mechanism of error processing deficit among adults with ADHD.

The contribution of antibiotic resistance mechanisms in clinical Burkholderia cepacia complex isolates: an emphasis on efflux pump activity

Due to the limited information of the contribution of various antibiotic resistance mechanisms in clinical Burkholderia cepacia complex isolates, Antibiotic resistance mechanisms, including integron analysis, identification of quinolone resistance-determining region mutations, measurement of efflux pump activity, and sequence analysis of efflux pump regulators, were investigated in 66 clinical B. cepacia complex isolates. Species were identified via recA-RFLP and MALDI-TOF. Four genomovars were identified by recA-RFLP. B. cenocepacia (genomovar III) was the most prevalent genomovar (90.1%). Most isolates (60/66, 90.9%) were correctly identified by MALDI-TOF analysis. Clonal relatedness determined by PFGE analysis revealed 30 pulsotypes, including two major pulsotypes that comprised 22.7% and 18.2% of the isolates, respectively. Seventeen (25.8%) isolates harboured class 1 integron with various combinations of resistance genes. Among six levofloxacin-resistant isolates, five had single-base substitutions in the gyrA gene and three demonstrated efflux pump activities. Among the 42 isolates exhibiting resistance to at least one antimicrobial agent, 94.4% ceftazidime-resistant isolates (17/18) and 72.7% chloramphenicol-resistant isolates (16/22) demonstrated efflux pump activity. Quantitation of efflux pump RNA level and sequence analysis revealed that over-expression of the RND-3 efflux pump was attributable to specific mutations in the RND-3 efflux pump regulator gene. In conclusion, high-level expression of efflux pumps is prevalent in B. cepacia complex isolates. Mutations in the RND-3 efflux pump regulator gene are the major cause of efflux pump activity, resulting in the resistance to antibiotics in clinical B. cepacia complex isolates.

Predictors of health-care needs in discharged burn patients

Patients' health-care needs are an important issue, but have not been studied in the burn field. The aims of this study were to explore discharged burn patients' health-care needs and related factors. This cross-sectional study used convenience sampling and four questionnaires, including basic information, Mental Status Inventory, Burn Patients' Social Support and Burn Patients' Healthcare Needs for data collection. There were 93 adults, injured on average 45% of total body surface area, who completed the study. Results indicated that the level of psychosocial care needs were higher than physiological needs. The level of physiological care needs changed over time, but psychosocial needs did not change. Self-reported psychosocial needs and physiological care needs correlated with each other. The multiple regressions showed that the most important predictors of overall health-care needs were numbers of visible scarred areas, time since discharge and previous psychiatric history. The findings revealed the burn patients provided clinically useful information and supported further evaluation in the area of care needs for burn patients.

Synthesis and structural characterizations of multi-crystalline La0.5Ba0.5MnO3 nanowires: a "multi-nuclei" growth mode

Multi-crystalline La0.5Ba0.5MnO3 Nanowires have been synthesized with cationic surfactant at 220 degrees C. The structure, composition and physical property of the as-prepared nanowires have been characterized by a series of techniques including XRD, SEM, HRTEM, electron energy-loss spectroscopy (EELS) and magnetic measurements. It is found that the La0.5Ba0.5MnO3 nanowire has the typical cubic perovskite structure, each nanowire is composed of many small crystalline grains with different orientations. Valance state of manganese ion in La0.5Ba0.5MnO3 nanowires is determined by EELS technique. A "multi-nuclei" growth mode is proposed based on the microstructure analysis. The temperature dependence of magnetization has been briefly discussed.

Characterization of the RNA-binding domain in the Dendrolimus punctatus cytoplasmic polyhedrosis virus nonstructural protein p44

Dendrolimus punctatus cytoplasmic polyhedrosis virus (DpCPV-1) belongs to the Cypovirus genus in the Reoviridae family. The ORF of genome segment 8 (S8) of DpCPV-1 was cloned into vector pMAL-c2X and used to express a 44kDa protein (p44) in E. coli, which was detected by Western blotting. The gel mobility shift assays showed that p44 had ssRNA-binding activity. Competitive assay indicated that this protein only bind to ssRNA and could not interact with DNA and dsRNA. The binding of p44 to ssRNA is sequence non-specific. To identify the domain(s) important for RNA binding of the protein, a number of deletions were made. These truncated proteins were expressed in E. coli and purified. The affinity of each truncated protein towards ssRNA was then assayed by electrophoretic mobility shift assays and northwestern blot. The results indicated that glutamic acid-rich domain in the central region of p44 from residues 104 to 201 was the ssRNA-binding domain.

Mapping the RNA-binding domain on the DpCPV VP4

The RNA-binding properties of VP4 protein of Dendrolimus punctatus cytoplasmic polyhedrosis virus (DpCPV) VP4 were analyzed. VP4 was expressed in E. coli and assayed for RNA binding activity by gel mobility shift assay. VP4 was found to bind RNA (ssRNA and dsRNA) in a sequence-independent manner, but did not interact with DNA. To identify the domain(s) of the protein important for RNA binding, a number of deletions were made and tested by gel mobility shift assays and northwestern blot. The central region of VP4 from amino acid residues 77 to 155 was found to contain the RNA binding domain.

Genetic analysis, molecular tagging and mapping of the thermo-sensitive genic male-sterile gene (wtms1) in wheat

A thermo-sensitive genic male-sterile (TGMS) wheat line ( Triticum aestivum L.) BNY-S was obtained from the spontaneous mutant of BNY-F. Its fertility was decided by the temperature during the differentiation stage of the spikelets. BNY-S was completely sterile when the temperature was lower than 10 degrees C during the differentiation stage of the spikelets, but fertile when the temperature was higher than 10 degrees C. Genetic analysis indicated that the sterility of BNY-S was controlled by a single recessive gene, which was named as wtms1. An F(2) population, consisting of 3,000 individuals from the cross between BNY-S and Lankao 52-24, was used for genetic analysis and statistical analysis of the TGMS and, out of them, 158 sterile and 93 fertile extremes were present for molecular tagging and mapping of the wtms1 gene. SSR (simple sequence repeat) and AFLP (amplified fragment length polymorphism) techniques combined with BSA (bulked segregant analysis) were used to screen markers linked to the target gene. As a result, wtms1 was preliminarily mapped on chromosome 2B according to SSR analysis. In AFLP analysis, 14 polymorphic AFLP loci were identified with a linkage relation to the wtms1 gene. Then linkage analysis using the F(2) population showed that three of them, E: AAG/M: CTA(163), E: AGG/M: CTC(220) and E: ACA/M: CTA(160), were linked to the wtms1 gene relatively close to a genetic distance of 6.9 cM, 6.9 cM and 13.9 cM, respectively. Finally, the wtms1 gene was mapped between the SSR marker Xgwm 374 and the AFLP marker E: AAG/M: CTA(163) with the distance of 4.8 cM and 6.9 cM, respectively. A partial linkage map was constructed according the SSR and AFLP data.

Genomic sequence analyses of segments 1 to 6 of Dendrolimus punctatus cytoplasmic polyhedrosis virus

The complete nucleotide sequences of genomic segments S1 to S6 from Dendrolimus punctatus cypovirus 1 (DpCPV-1) have been determined. Each segment of S1 to S6 possess a single open reading frame. Conserved motifs 5' (AGUAA) and 3'(GUUAGCC) were found at the ends of each segment. Comparison of the proteins of DpCPV with those of other members in the family Reoviridae lead us to suggest that S1, S3, S4 and S6 encode the viral structural protein VP1, VP2, VP3 and VP4, respectively. S5 encoded viral non-structural protein p100 and S2 encodes an RNA-dependent RNA polymerase (RdRp). Motif analysis shows that VP3 is similar to the methyltransferase of Methanosarcina mazei Goe1, VP4 has motifs for leucine zipper and ATP/GTP-binding sites, and p100 is remarkably similar to foot-and-mouth disease virus 2A protease (FMDV 2Apro). Phylogenetic analysis of RdRps from nine viruses of the family Reoviridae indicates that DpCPV is a type 1 cypovirus, more related to Bombyx mori cypovirus (BmCPV) than to other cypovirus species. DpCPV is more related to Rice ragged stunt virus (RRSV) than to other members of different genera of the family Reoviridae, which seems to confirm the previous hypothesis that plant reoviruses originated from insect reoviruses.

Molecular characterization of segments 7-10 of Dendrolimus punctatus cytoplasmic polyhedrosis virus provides the complete genome

The nucleotide sequences of genomic segments S7-S10 from Dendrolimus punctatus cypovirus strain Hunan (DpCPV-Hn) have been determined. This provides the complete genome sequences of DpCPV-Hn. Each segment of S7-S10 possess a single segment each. Homology searches showed that the nucleotide sequences and the deduced amino acid sequences of DpCPV S7-10 had high level of identities with those of Bombyx mori cypovirus (BmCPV) S7-10, respectively. While the amino acid sequences of the proteins encoded by DpCPV S7 and S8 have low identities with those of the proteins encoded by type 14 Lymantria dispar cypovirus S7 and S8, respectively. DpCPV S7 encodes viral structural protein VP5, S8 and S9 encode viral non-structural proteins, and S10 encodes polyhedrin gene, according to the function of the genome segments of BmCPV. There are glutamic-acid-rich and proline-rich domains in the central region of DpCPV S8 encoded protein. A nuclear localization signal was found in the protein encoded by DpCPV S9. Phylogenetic analysis of RNA-dependent RNA polymerases from nine viruses of the family Reoviridae and polyhedrin from eight viruses of the genus Cypovirus indicate that DpCPV is a type 1 cypovirus, more closely related to BmCPV than to other cypovirus species. These results also support the classification of CPV groups based on the electrophoretic migration of genomic dsRNA.

A novel locus for autosomal dominant non-syndromic deafness (DFNA41) maps to chromosome 12q24-qter

We have studied 36 subjects in a large multigenerational Chinese family that is segregating for an autosomal dominant adult onset form of progressive non-syndromic hearing loss. All affected subjects had bilateral sensorineural hearing loss involving all frequencies with some significant gender differences in initial presentation. After excluding linkage to known loci for non-syndromic deafness, we used the Center for Inherited Disease Research (CIDR) to test for 351 polymorphic markers distributed at approximately 10 cM intervals throughout the genome. Analysis of the resulting data provided evidence that the locus designated DFNA41 maps to a 15 cM region on chromosome 12q24.32-qter, proximal to the marker D12S1609. A maximum two point lod score of 6.56 at theta=0.0 was obtained for D12S343. This gene is distal to DFNA25, a previously identified locus for dominant adult onset hearing loss that maps to 12q21-24. Positional/functional candidate genes in this region include frizzled 10, epimorphin, RAN, and ZFOC1.

Spindle cell lipoma of the female genital tract. A report of two cases

BACKGROUND

Lipomas presenting in the female genital tract are most commonly seen in the vulva or myometrium as a component of a leiomyoma. These lesions have the gross appearance of a typical lipoma.

CASES

Two cases of spindle cell lipoma occurred, one incidentally encountered in the cervix and the other presenting as a vulvar mass. Both lesions demonstrated histologic features characteristic of spindle cell lipomas normally found elsewhere, and the diagnosis was supported by immunohistochemical staining patterns.

CONCLUSION

This is the first report of spindle cell lipomas diagnosed in the female genital tract.

[Factors influence on transformation by particle bombardment in Indica rice]

Four factors influence on transformation of indica rice, which were high osmotic treatment; different explant as the target tissue; pressure of rupture disk and quantity of plasmid DNA, were investigated in this experiment. High osmotic treatment of target tissue prior to and after bombardment increased 3.2-fold for Gus transient expression than control. The best treatment of high osmotic was that the target tissues were kept in the target-bed medium which contained 0.4-0.6 mol/L sorbitol and manitol each for 4 h prior to bombardment and for 16 h after bombardment. Four explants: scutellum from mature seed, young panicle, embryogenic callus and suspension cells of indica rice were tested as target explant by particle bombardment. The results of Gus transient showed that the highest expression was scutellum and for other three explants, the order from high to low was young panicle, embryogenic callus and suspension cell. Transgenic plants were obtained from all of the explants except young panicle. For the pressure of rupture disk on transformation, 1100 psi or 1300 psi of the pressure of rupture disk were best one for the transformation and higher than 1300 psi could damage the target tissue which become black and died in the following culture duration. For the quantity of plasmid DNA, the results showed that 0.83 microgram of plasmid DNA per bombardment was preferred for the transformation of indica rice.

Mutations in connexin31 underlie recessive as well as dominant non-syndromic hearing loss

Mutations in the GJB3 gene encoding connexin31 (Cx31) can cause a dominant non-syndromic form of hearing loss (DFNA2). To determine whether mutations at this locus can also cause recessive non-syndromic deafness, we screened 25 Chinese families with recessive deafness and identified in two families affected individuals who were compound heterozygotes for Cx31 mutations. The three affected individuals in the two families were born to non-consanguineous parents and had an early onset bilateral sensorineural hearing loss. In both families, differing SSCP patterns were observed in affected and unaffected individuals. Sequence analysis in both families demonstrated an in-frame 3 bp deletion (423-425delATT) in one allele, which leads to the loss of an isoleucine residue at codon 141, and a 423A-->G transversion in the other allele, which creates an Ile-->Val substitution at codon 141 (I141V). Neither of these two mutations was detected in DNA from 100 unrelated control subjects. The altered isoleucine residue lies within the third conserved alpha-helical transmembrane domain (M3), which is critical for the formation of the wall of the gap junction pore. Both the deletion of the isoleucine residue 141 and its substitution to valine in the two families could alter the structure of M3, and impair the function of the gap junction. The present data demonstrate that, like mutations in connexin26, mutations in Cx31 can lead to both recessive and dominant forms of non-syndromic deafness.

[Study on factors influencing Agrobacterium-mediated cassava transformation]

Factors influencing agrobacterium-mediated cassava transformation were investigated. Among the four Agrobacterium strains tested, LBA 4404 (pTOK 233) and LBA 4404 (pBin9GusInt) gave higher transient expression than C 58 C1 (pIG121Hm) and EHA 105 (pBin9Husint). Pretreatment of explants by bombardment or vaccum had no significant effect on transient expression while preinduction of Agrobacterium with acetosyringone showed better effects, and preculture of explants showed worse effects. All the cultivars tested were susceptible to Agrobacterium infection, while the types of explants and the physiological state of the explants had a strong influence on the transient expression efficiency. The 15-day-old somatic cotyledons and the fully expanded leaves from in vitro plantlets were the most susceptible to Agrobacterium infection. The results also showed that all the four selective reagents (hygromycin, geneticin, PPT, and kanamycin) synchronously suppressed the growth of callus, shoot organogenesis and shoot rooting in a dose dependent manner.

Extraskeletal osteochondroma of the foot

A case of pathologically proven extraskeletal osteochondroma is presented with magnetic resonance imaging (MRI), computed tomography (CT), bone scan and radiographic findings. The diagnosis of extraskeletal osteochondroma should be considered when a discrete, ossified mass is localized in the soft tissues of the distal extremities. Nomenclature surrounding this entity is controversial and is discussed.

Primary colon cancer without gross mucosal tumor: unusual presentation of a common malignancy

Colon cancer typically arises in the colonic lumen, allowing for endoscopic detection of cancerous and premalignant lesions. In the case presented, a 73-year-old man with iron deficiency anemia had two colonoscopies showing only diverticula and internal hemorrhoids. Three years later, when the patient complained of dull, intermittent lower abdominal pain, a third colonoscopy identified diverticula, three adenomatous polyps, and no other abnormality. Computed tomography (CT) of the abdomen revealed a 5 cm x 6 cm pericolic fluid collection, which was later found to communicate with the sigmoid colon. The surgical specimen from a partial colectomy contained a distal sigmoid perforation with a 2.5 cm moderately differentiated adenocarcinoma in the underlying submucosal tissue. There was no gross intraluminal tumor. Histopathology, including immunohistochemistry, was consistent with colonic adenocarcinoma. Primary colon cancer grossly sparing the mucosa is an unusual presentation for this common malignancy.

Ischemic fasciitis. Report of a case with fine needle aspiration findings

BACKGROUND

Ischemic fasciitis, also called atypical decubital fibroplasia, was recently described as a distinctive fibroblastic proliferation occurring predominantly in elderly, bed-ridden individuals. This entity can easily be misdiagnosed as a malignant process.

CASE

A 70-year-old, white male presented with an enlarging right hip mass. Fine needle aspiration yielded spindled and ovoid cells with ample cytoplasm and occasional nuclear atypia. The histologic features of a subsequent biopsy and resection specimen included a zonal pattern of fibrinoid necrosis with surrounding reactive fibroblasts, histiocytes and vascular proliferation, which are characteristic of ischemic fasciitis.

CONCLUSION

Ischemic fasciitis can be mistaken clinically, cytologically and histologically for sarcoma. The cytologic findings seen in this case, when combined with the clinical history, were sufficient to avoid misdiagnosis of malignancy in a benign, proliferative lesion.

Goblet cell carcinoid arising in a mature teratoma of the mediastinum

Goblet cell carcinoid (GCC) is a rare but distinctive neoplasm with features of both adenocarcinoma and carcinoid tumor. Most cases described in the literature have occurred in the appendix. An additional well-defined location is the ovary, and these tumors have been associated with a mature teratoma of the ovary. GCC arising within a mature teratoma of the mediastinum has not been described in the English-language literature. We report a case of this previously undescribed entity and provide a review of the literature on mediastinal teratomas with malignant transformation. The histologic findings included uniform, smooth-bordered glandular nests lined by goblet cells and admixed endocrine and Paneth cells. Occasional tubular glands were present, as were transitional type glands with both goblet cell and tubular features. Cytologic atypia was minimal, and mitotic activity was rare. Immunohistochemical studies showed positive staining of GCC tumor cells with chromogranin, cytokeratin, neuron-specific enolase, serotonin (focal), and Leu-7 (focal). The GCC component was entirely contained within the mature teratoma.

Isolation and characterization of two major degradation products of dyclonine hydrochloride

Dyclonine hydrochloride, a local anesthetic, is known to degrade in aqueous media. In this paper, the isolation and characterization of two major degradation products, formed by heating of an aqueous solution of dyclonine hydrochloride for 2 weeks at 50 degrees C, are presented. The proton and carbon-13 nuclear magnetic resonance, infrared, and mass spectral data reported conclusively show the two products to be 1-(4-butoxyphenyl)-2-propen-1-one and 1-(4-butoxyphenyl)-3-hydroxy-1-propanone. The proton and carbon-13 nuclear magnetic resonance spectral data of the free dyclonine base are also included.

[Stimulative effect of electro-blunt-tip needle on the points of human skin and its analgesia in rats]

The stimulative effect of electro-blunt-tip needle (a kind of electroacupuncture stimulating on the surface of skin point) on the 120 points of human skin was observed in 12 healthy volunteers. It was shown that the substitute typical electro-blunt-tip needle stimulator and its special pen-like electrode by a general electroacupuncture stimulator and a tape-like adjustable electrode and similar therapeutic effects. It was found in animal experiment that the pain threshold determined with rat tail flick analgesia method was raised by electroacupuncture and electro-blunt-tip needle, the optimal stimulating time being 10-20 minutes for both, the percentages of the maximal changing pain threshold being 206.6% and 175.4%, and the corresponding voltage being 2v and 7v respectively.

Ossifying fibromyxoid tumor of soft parts. A clinicopathological analysis of 59 cases

We describe 59 cases of a microscopically unique neoplasm that has not been previously reported. The tumor almost exclusively affected adults (range 14-79 years) and had a male predominance (38 men and 21 women). It presented in most cases as a small, painless, well-circumscribed mass (median, 4 cm) in subcutis or muscle. It occurred chiefly in the upper and lower extremities (40 cases) and less frequently in the trunk (11 cases) and the head and neck region (eight cases). Microscopically, the tumor was partly lobulated and composed of small, round cells that had vesicular nuclei and indistinct cytoplasm. Typically, the cells were arranged in a cord- or nestlike pattern within a myxoid matrix that frequently showed transitions toward hyaline fibrosis and focal osteoid formation. In about two-thirds of the cases, the cells contained immunoreactive S-100 protein. An additional typical feature, seen in 48 (81%) of the 59 cases, was the presence of an incomplete shell of mature bone in the capsular region of the tumor. Follow-up information, available in 41 cases, revealed that 11 patients (27%) experienced one or more recurrences. One patient with three recurrences developed a second tumor in the opposite thigh, presumably a metastasis. None of the patients died of the tumor, but three died of causes unrelated to the disease. Although the histogenesis is uncertain, cartilaginous or neural origin seem to be most likely. Until this issue is resolved, we prefer the descriptive and less committal designation of "ossifying fibromyxoid tumor of soft parts."

Image-shearing camera for direct measurement of surface strains

This paper describes a new image-shearing camera which focuses two laterally sheared images at the film plane. With coherent illumination, this camera becomes a shearing interferometer, which directly measures the derivatives of the surface displacements. This strain measuring tool enjoys several advantages over the conventional, holographic, and speckle interferometry, namely, (1) better fringe quality (than speckle interferometry); (2) does not require special vibration isolation; (3) very simple optical setup; (4) direct determination of strains; and (5) extended controllable range of sensitivity.

Time-averaged shadow-moiré method for studying vibrations

A time-averaged shadow-moiré method is presented which permits the determination of the amplitude distribution of the deflection of a plate in steady state vibration. No stroboscope is required, and the recording is done statically. The method is less sensitive than holographic methods and is therefore suitable for studying relatively large amplitudes.