[Mechanism and application prospects of microbial fertilizers in regulating quality formation of medicinal plants]

With the promotion of chemical fertilizer and pesticide reduction and green production of traditional Chinese medicines, microbial fertilizers have become a hot way to achieve the zero-growth of chemical fertilizers and pesticides, improve the yield and qua-lity of medicinal plants, maintain soil health, and promote the sustainable development of the planting industry of Chinese herbal medicines. Soil conditions and microenvironments are crucial to the growth, development, and quality formation of medicinal plants. Microbial fertilizers, as environmentally friendly fertilizers acting on the soil, can improve soil quality by replenishing organic matter and promoting the metabolism of beneficial microorganisms to improve the yield and quality of medicinal plants. In this regard, understanding the mechanism of microbial fertilizer in regulating the quality formation of medicinal plants is crucial for the development of herbal eco-agriculture. This study introduces the processes of microbial fertilizers in improving soil properties, participating in soil nutrient cycling, enhancing the resistance of medicinal plants, and promoting the accumulation of medicinal components to summarize the mechanisms and roles of bacterial fertilizers in regulating the quality formation of medicinal plants. Furthermore, this paper introduces the application of bacterial fertilizers in medicinal plants and makes an outlook on their development, with a view to providing a scientific basis for using microbial fertilizers to improve the quality of Chinese herbal medicines, improve the soil environment, promote the sustainable development of eco-agriculture of traditional Chinese medicine, and popularize the application of microbial fertilizers.

Clinical use of venoarterial extracorporeal membrane oxygenation

With advances in mechanical circulation, venoarterial extracorporeal membrane oxygenation has become an established technique to provide cardiopulmonary support for patients with cardiovascular collapse. This article reviews the physiological principles of such extracorporeal technique and its interaction with the native heart. Practical aspects including equipment, patient selection, and common complications with their prevention and specific management are summarised. The strategy for weaning from venoarterial extracorporeal membrane oxygenation is also discussed.

Clinical use of venovenous extracorporeal membrane oxygenation

Extracorporeal membrane oxygenation has been used clinically for more than 40 years. The technique provides respiratory and/or circulatory support via venovenous and veno-arterial configurations, respectively. We review the basic physiological principles of extracorporeal membrane oxygenation systems in venovenous extracorporeal membrane oxygenation. Clinical aspects including patient selection, equipment, setup, and specific patient management are outlined. Pros and cons of the use of extracorporeal membrane oxygenation in respiratory failure are discussed.

Acquired factor V inhibitor in a patient receiving venous-venous extracorporeal membrane oxygenation for Legionella pneumonia

We report a rare complication of factor V deficiency in a patient having Legionella pneumonia. This patient also had other complications like severe acute respiratory distress syndrome, acute kidney injury, and septic shock that required venous-venous extracorporeal membrane oxygenation support. This is the first reported case of acquired factor V deficiency in a patient receiving extracorporeal membrane oxygenation for Legionella pneumonia. With the combined use of intravenous immunoglobulin, rituximab and plasma exchange, we achieved rapid clearance of the factor V inhibitor within 1 week so as to allow safe decannulation of extracorporeal membrane oxygenation.

Efficiency dip observed with InGaN-based multiple quantum well solar cells

The dip of external quantum efficiency (EQE) is observed on In(0.15)Ga(0.85)N/GaN multiple quantum well (MQW) solar cells upon the increase of incident optical power density. With indium composition increased to 25%, the EQE dip becomes much less noticeable. The composition dependence of EQE dip is ascribed to the competition between radiative recombination and photocurrent generation in the active region, which are dictated by quantum-confined Stark effect (QCSE) and composition fluctuation in the MQWs.

Changes in the Attitude and Practice Toward End-of-Life Care: Perspective of Chinese Physicians in Medical Department

INTRODUCTION

End-of-life care is affected by the attitude and cultural influence of doctors.

METHODS

To investigate the attitudes and practices of doctors on end-of-life care by questionnaire survey in 2004 and 2008.

RESULTS

In 2004, 31.7% of the respondents agreed that they "do not attempt resuscitation" (DNAR) form was useful and it rose to 54.4% in 2008. A higher proportion of respondents in 2008 claimed that they signed the DNAR form for documentation and accepted withholding noninvasive life-sustaining treatment compared to 2004. In 2004, 50% of the respondents regarded their training and education on handling DNAR issue as inadequate.

CONCLUSION

Documentation by DNAR form is gaining wider acceptance. Many doctors are expected to have more training and coaching on communication for handling such sensitive issues.

High-voltage thin-film GaN LEDs fabricated on ceramic substrates: the alleviated droop effect at 670 W/cm(2)

High-voltage thin-film GaN LEDs with the emission wavelength of 455 nm were fabricated on ceramic substrates (230 W/m · K). The high-voltage operation was achieved by three cascaded sub-LEDs with dielectric passivation and metal bridges conformally deposited on the side walls. Under the driving power of 670 W/cm(2), the high-voltage LEDs exhibit much alleviated efficiency droop and the operative temperature below 80 °C. The excellent performances were attributed to the improved current spreading within each sub-LED and the superior heat sinking of the ceramic substrate.

A rare neurological complication due to lithium poisoning

Lithium salts have been used in treatment of depression and bipolar disorder for more than 50 years. Neurotoxic side-effects such as nystagmus, ataxia, tremor, fasciculation, clonus, seizure and even coma have been well described in the literature. We present a case of generalised peripheral neuropathy following lithium intoxication. It is a rare presentation with delayed onset and characterised by a rapid downhill course. Diagnosis was confirmed by nerve conduction tests, which showed axonal neuropathy. Despite the profound neurological effects of this toxicity, it is readily reversible with supportive care and the prognosis is good.

Familial aggregation and heritability of insomnia in a community-based study

BACKGROUND

Emerging data suggested a significant familial aggregation of insomnia. We aimed to clarify the familial aggregation and heritability of insomnia disorder by using structural clinical interviews for the ascertainment of insomnia and psychiatric disorders in a community-based sample.

METHODS

Seventy-five adolescents with insomnia and their 180 first degree relatives, together with 141 age- and sex-matched non-insomnia controls and their 382 first degree relatives, were recruited. Each subject underwent a structured clinical interview and completed a series of psychometric inventories. The rates of insomnia disorder among the first degree relatives were employed to analyze familial aggregation. Heritability of insomnia was analyzed by SOLAR program as based on father-mother-offspring trios.

RESULTS

Our study confirmed a significant familial aggregation of insomnia with a first degree relatives' recurrence risk of 2.33 for current insomnia and 2.82 for lifetime insomnia, respectively. The heritability±SE of current and lifetime insomnia disorder was 0.48±0.13 and 0.61±0.11 (p<0.001), respectively, which were higher than insomnia symptoms as estimated by the Insomnia Severity Inventory (h(2)±SE=0.27±0.09) and the Pittsburgh Sleep Quality Index (h(2)±SE=0.30±0.11). After exclusion of comorbid psychiatric disorders, the heritability for current and lifetime primary insomnia was 0.45±0.17 (p=0.007) and 0.58±0.21 (p=0.004), respectively.

CONCLUSIONS

Our study demonstrates a significant familial aggregation with a high heritability of insomnia disorder. The strong heritability of insomnia persists despite the exclusion of psychiatric disorders. Further molecular genetic investigation of insomnia is indicated.

Solar energy harvesting scheme using syringe-like ZnO nanorod arrays for InGaN/GaN multiple quantum well solar cells

Syringe-like ZnO nanorod arrays (NRAs) synthesized by a hydrothermal method were applied as the light-harvesting layer on InGaN-based multiple quantum well (MQW) solar cells. Theoretical calculations show that the NRAs with an abrupt shrinkage of tip diameter can further suppress surface reflectance in comparison with the flat NRAs. InGaN-based MQW solar cells with the syringe-like NRAs exhibit greatly improved conversion efficiencies by 36%. These results are attributed to the improved flatness of the refractive index profile at the air/device interface, which results in enhanced light trapping effect on the device surface.

Slope-tunable Si nanorod arrays with enhanced antireflection and self-cleaning properties

Slope-tunable Si nanorod arrays (NRAs) were fabricated with colloidal lithography and reactive ion etching (RIE). Sharpened NRAs fabricated by increasing the SF6/O2 flow ratio during RIE exhibit enhanced antireflection (AR) and hydrophobic properties, which are attributed to the smooth gradient in the effective refractive index of NRAs, and the enlarged water/air interface of the water drops in the NRA layers, respectively. Enhanced AR characteristics via modifying the slope of NRAs are accompanied by broad-band working ranges, omnidirectionality, and polarization insensitivity. Detailed experimental and theoretical analysis of slope-tunable NRAs should benefit the development of various self-cleaning optoelectronic devices with efficient light management.

Characterization of a novel rat cytomegalovirus (RCMV) infecting placenta-uterus of Rattus rattus diardii

A new rat cytomegalovirus (RCMV) isolated from the placenta/uterus of a house rat (Rattus rattus diardii) was found to productively infect rat embryo fibroblast (REF) cells. The virus produced typical herpesvirus-like cytopathic effects characterized by a lytic infection. The well-known herpesvirus morphology was confirmed by electron microscopy. Its slow growth in cell culture indicated that the virus is belonging to subfamily Betaherpesvirinae. Electron microscopy techniques and immunohistochemistry confirmed the presence of herpesviral inclusion bodies and virus related particles in the cytoplasm and nucleus of infected cells. Hyperimmune serum against the Maastricht strain of RCMV revealed the virus identity in neutralization test, immunoperoxidase and immunofluorescence techniques. Despite typical characteristics of CMV, the viral genome is significantly different from that of Maastricht, English, UPM/Sg and UPM/Kn strains. The dissimilarities, which have not been reported before, had been confirmed by mean of restriction endonuclease analysis. The new RCMV strain, a virus that infects placenta and uterus of rats, has been named as ALL-03.

Anorexia nervosa in Chinese adolescents-does culture make a difference?

The clinical and psychosocial characteristics of 16 Chinese adolescents from Hong Kong with anorexia nervosa are reported. In contrast to previous local reports of adult patients, over 80 per cent of these younger patients reported a fear of fatness. It appears that, against the background of increasing Westernization, the illness is taking on a Western pattern, in line with the suggestion that significant concern about weight in anorexia nervosa is a pathoplastic effect of Westernization. There was also a marked increase in the referral rate of patients in the younger age group, reflecting both an increase in the incidence and general awareness of the illness.

Trinucleotide CGG repeat in the FMR1 gene in Chinese mentally retarded patients

The fragile X syndrome of mental retardation is related to the number of trinucleotide CGG repeats at the 5'-untranslated region of the FMR1 gene located on the X-chromosome. We have studied X-chromosomes from 649 unaffected Chinese subjects and 324 patients with mild mental retardation. All study subjects were unrelated. The CGG repeat number was analysed by electrophoresis of a polymerase chain reaction followed by gel transfer and hybridisation with a 32P-labeled (CCG)5 probe. The DNA samples having detectable CGG expansion were further analysed by Southern blot analysis with probe StB12.3 after restriction digestion by EcoR I and Eag I. For the unaffected Chinese subjects, a different distribution pattern of CGG allele size from Caucasians was observed. It was a bimodal pattern and the CGG repeat number ranged from 19 to 54. The most common CGG repeat allele was 29 compared with 30 in Caucasians. The second mode appeared at 36 repeats. There was mild statistical difference in the repeat patterns between the mentally retarded patients and unaffected subjects, although the essential features were similar. Among the mentally retarded patients, one male had an unmethylated full mutation and one female had a full mutation. The fragile X prevalence was 0.6%, which is lower than two previous studies in Chinese mentally retarded patients utilising cytogenetic analysis. Our results indicate that a large-scale screening program would be worthwhile to determine the prevalence of the fragile X syndrome in the Chinese population.

FRAXAC1 and DXS548 polymorphisms in the Chinese population

The fragile X syndrome is the most common inherited form of mental retardation. Haplotype studies using FRAXAC1 and DXS548 polymorphic markers flanking the fragile site have demonstrated linkage disequilibrium at the FMR1 locus. We investigated the association of the FRAXAC1, DXS548 and CGG alleles between normal subjects and mentally retarded (MR) patients of unspecified cause who do have fragile X syndrome. We have evaluated the FRAXAC1 site in 390 normal subjects and 321 MR patients and the DXS548 site in 146 normal and 319 MR subjects. Both FRAXAC1 and DXS548 alleles were determined by application of the polymerase chain reaction. When compared with Caucasians, the normal Chinese population has a different FRAXAC1 allele distribution. There are more AC18 repeat alleles and fewer AC19 repeat alleles. The DXS548 allele distributions were similar between Chinese and Caucasians. The same distribution pattern of FRAXAC1 alleles was found in both normal subjects and MR patients, but there were significant differences in the distribution patterns of DXS548 alleles. The FMR1 CGG-DXS548 and FRAXAC1-DXS548 haplotype distribution between normal subjects and MR patients also differed significantly. Our results suggest a possible association between DXS548 alleles and non-FRAXA mental retardation.

CGG repeat interruptions in the FMR1 gene in patients with infantile autism

We determined the CGG repeat length and AGG interruptions in the FMR1 gene in normal Chinese subjects and patients with infantile autism and mild mental retardation. Genomic DNA was investigated by PCR and Southern hybridisation for CGG repeat number and PCR with Mnl I restriction analysis for AGG interruption. Both the normal subjects and the patients with autism have 53 CGG repeats in FMR1, and the majority have two interspersed AGG. Our normal Chinese subjects have a similar number of interspersed AGG as other populations. When compared with the normal subjects, the autism patients have less AGG interruptions and a different pattern of AGG distribution. There was a significant difference in the CGG configurations between normal subjects and patients with autism. The latter had less interspersed AGG, as in fragile X patients, but they did not have fragile X. A study on mentally retarded patients with no infantile autism should also be carried out to ascertain whether mental retardation alone may have contributed to such AGG pattern.

Characteristics of dropouts from a child psychiatry clinic in Hong Kong

There is, to date, no study on the pattern of dropping out from child and adolescent psychiatry clinics in a non-western setting. This study aims to investigate this phenomenon in Hong Kong. The database and medical charts of 235 new cases were reviewed 1 year after the initial assessments. The clinical, demographic and family data of the dropout and non-dropout groups were compared. An overall dropout rate of 27.2% was found. Boys and children with attention deficit hyperkinetic disorder and infantile autism were less likely to drop out. No interaction with gender was found. Compared with western literature, there are some important differences in the factors associated with dropping out of treatment. Our study highlights the importance of socio-cultural influences on the characteristics of clinic drop-outs.

Dropping out from child psychiatric treatment: reasons and outcome

This study explores the reasons underlying dropping out from a child psychiatric clinic in Hong Kong, and the outcome of these children. A reluctance to accept psychiatric help, or the possibility of being labelled as psychiatrically ill, and differences between the families and doctors in their perception of the presenting problems are common reasons given for dropping out. A substantial number of children who dropped out continued to have some degree of psychiatric morbidity two years later. These results highlight the need to increase the community's awareness of the nature of child psychiatry, and for doctors to be sensitive to the families' perception of the presenting problems so as to minimise the likelihood of dropping out.

Attention deficit hyperactivity disorder in a young adult

A case of attention deficit hyperactivity disorder in a young adult is reported. The essential features of this probably under-recognised psychiatric syndrome are briefly summarised.

Aggressive pleomorphic CD2+, CD3-, CD56+ lymphoma with t(5;9)(q31;q34) abnormality

CD56-positive lymphoma is a recently described entity which is characterized by predominantly extranodal involvement and an aggressive clinical course. We report one such case with involvement of the bone marrow and spinal cord at presentation, and associated with reactive hemophagocytic syndrome. The lymphoma cells had a highly pleomorphic appearance which is uncommon in CD56-positive lymphoma. Cytogenetic studies revealed a t(5;9)(q31;q34) abnormality. Analysis of more cases is required to determine if this is a recurring chromosomal translocation characteristic of the group of aggressive CD56-positive lymphoma.

Case study: early-onset anorexia nervosa in a Chinese boy

In this case study of early-onset anorexia nervosa in a male patient from Hong Kong, clinical features are outlined and compared with those of their Western counterparts. Implications of being the only son in a traditional Chinese family and the process of acculturation and cultural conflicts of growing up in a Western-oriented society are put forward as significant psychodynamic factors in the etiology of his illness.

Profile of opportunistic infections among HIV-1 infected people in Hong Kong

BACKGROUND

To determine the spectrum of opportunistic infections in patients with human immunodeficiency virus (HIV-1) infection in Hong Kong.

METHODS

A retrospective study of 214 HIV-1-infected patients, seen between December 1984 and December 1993 in a specialist clinic for HIV/AIDS:

RESULTS

A majority (94%) of the patients in the cohort were male; 84% had acquired HIV via sexual contacts. Two-thirds were ethnic Chinese. Ninety-two (43%) had developed AIDS, and 54(25%) had presented with other non AIDS-defining opportunistic infections during the study period. The primary AIDS defining illnesses of 80 patients were infections: Pneumocystis carinii pneumonia (50%), extrapulmonary tuberculosis (10%) and cytomegalovirus (CMV) disease (8%). Opportunistic infections among Chinese and non-Chinese were similar in spectrum, though higher frequencies of infection with CMV, Mycobacterium avium intracellulare and tuberculosis were seen among Chinese, whereas the opposite was true for Pneumocystis carinii pneumonia, toxoplasmosis and cryptosporidiosis. Disseminated Penicillium marneffei infection was another significant disease for HIV-positive patients. Common non AIDS-defining opportunistic infections included herpes zoster, oral candidiasis, herpes simplex infection and genital/anal wart. The median CD4 count at HIV diagnosis for AIDS patients was much lower than non-AIDS patients (147 vs 546/ul). Survival of deceased AIDS patients was poor, with a median of only five months. Survival has however, apparently, improved over the recent years.

CONCLUSIONS

In Hong Kong, Pneumocystis carinii pneumonia remained the most common primary AIDS event, while Penicillium marneffei was emerging as another significant cause of major infection. Herpes zoster and oral candidiasis were the two most frequently encountered minor opportunistic infections.

Cognitive abilities associated with the Silver-Russell syndrome

There is no consensus opinion on whether or not cognitive impairments are found in the Silver-Russell syndrome. An investigation of a substantial sample was undertaken, using standardised assessments, in 20 boys and five girls aged 6.0 years to 11.8 years. Mean (SD) birth weights were -2.65 (0.95) SD scores, corrected for gestation. At evaluation the children had a mean (SD) age of 8.8 (1.8) years and a mean height of -2.26 (1.5) SD scores. Tests of cognitive abilities included assessments of general intelligence, reading and arithmetic attainments, and a cognitive processing task. Most had some degree of developmental delay: mean (SD) full scale IQ was 86 (24); 32% scored within the learning disability range (that is, IQ < 70); 40% were reading at least 24 months below their chronological age. Current head circumference correlated highly with full scale IQ. Assessments of special educational needs had been completed on 36%; 48% were receiving speech therapy. Approximately half of children with the Silver-Russell syndrome have significant impairment of their cognitive abilities.

Use of pelvic ultrasound to monitor ovarian and uterine maturity in childhood onset anorexia nervosa

This study reports the use of pelvic ultrasound scanning in childhood onset anorexia nervosa. The aim was to determine the weight and weight for height ratio (wt/ht) that would correspond with ovarian and uterine maturity and therefore offer the optimal opportunity for the start or resumption of menstruation. On initial assessment, all children had mean weight, wt/ht, ovarian and uterine volumes significantly below expected. At follow up, half the children had started or resumed menstruation. When compared with those who had persisting amenorrhoea, the recovered children had a significantly higher mean weight (48.4 kg v 43.8 kg), mean wt/ht (96.5% v 87.5%), mean ovarian volume (6.2 ml v 4.9 ml), and mean uterine volume (14.6 ml v 10.8 ml). The study indicates that conventional target weight and wt/ht in anorexia nervosa may be too low to ensure ovarian and uterine maturity, and that pelvic ultrasound, which is well tolerated by this group of children, is a useful addition to their management.

Patterns of referral to child psychiatry in Hong Kong

The referral pattern by three major sources to the Child and Adolescent Psychiatric Unit of a university teaching hospital in Hong Kong is reviewed. In a health care system where primary health care is not properly developed, referral of children with psychiatric problems relies heavily on secondary health care professionals. Over a three year period, 37.8% of the new cases were referred by the other departments of the same hospital, while the Education Department and general practitioners each referred 17.4%. Overall, up to 80% of these children had definite psychiatric problems. Because the morbidities of these children often traverse physical, psychological, social, and educational dimensions, a close liaison with all the different professionals involved is vital.