Wolfberry genome database: integrated genomic datasets for studying molecular biology

Wolfberry, also known as goji berry or Lycium barbarum, is a highly valued fruit with significant health benefits and nutritional value. For more efficient and comprehensive usage of published L. barbarum genomic data, we established the Wolfberry database. The utility of the Wolfberry Genome Database (WGDB) is highlighted through the Genome browser, which enables the user to explore the L. barbarum genome, browse specific chromosomes, and access gene sequences. Gene annotation features provide comprehensive information about gene functions, locations, expression profiles, pathway involvement, protein domains, and regulatory transcription factors. The transcriptome feature allows the user to explore gene expression patterns using transcripts per kilobase million (TPM) and fragments per kilobase per million mapped reads (FPKM) metrics. The Metabolism pathway page provides insights into metabolic pathways and the involvement of the selected genes. In addition to the database content, we also introduce six analysis tools developed for the WGDB. These tools offer functionalities for gene function prediction, nucleotide and amino acid BLAST analysis, protein domain analysis, GO annotation, and gene expression pattern analysis. The WGDB is freely accessible at https://cosbi7.ee.ncku.edu.tw/Wolfberry/. Overall, WGDB serves as a valuable resource for researchers interested in the genomics and transcriptomics of L. barbarum. Its user-friendly web interface and comprehensive data facilitate the exploration of gene functions, regulatory mechanisms, and metabolic pathways, ultimately contributing to a deeper understanding of wolfberry and its potential applications in agronomy and nutrition.

[The application value of Gd-EOB-DTPA enhanced MRI based radiomics in the differential diagnosis of iso-or hyperintensity HCC and focal nodular hyperplasia in hepatobiliary phase]

Objective: To investigate the application value of Gd-EOB-DTPA enhanced MRI based radiomics model in the differential diagnosis of iso-or hyperintensity HCC and focal nodular hyperplasia (FNH) in hepatobiliary phase. Methods: A total of 88 patients with HCC or FNH confirmed by surgical or puncture pathology who underwent preoperative Gd-EOB-DTPA enhanced MRI (all lesions showed iso-or hyperintensity in hepatobiliary phase) between January 2015 and February 2023 in The First Affiliated Hospital of Soochow University and Nantong No.3 People's Hospital were retrospectively evaluated, which including 58 males and 30 females, aged [M(Q1, Q3)]56 (40, 67) years, including 61 patients with HCC and 27 patients with FNH. The included cases were divided into training (43 cases of HCC, 19 cases of FNH) and validation cohort (18 cases of HCC, 8 cases of FNH) in the ratio of 7∶3 using the random seeding method. A total of 1 781 radiomics features were extracted from Gd-EOB-DTPA enhanced MRI in the arterial, portal and hepatobiliary phases, respectively. The independent three phase models, combined three phases model and combined clinical-radiomics model was established using Auto-Encoder (AE) and Native Bayes (NB) classifier, respectively. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of these models. DeLong test was used to compare the areas under curve (AUC). Results: In the validation cohort, the combined clinical-radiomics model had the highest AUC (AUC=0.938, 95%CI: 0.828-1.000). The AUC, accuracy, sensitivity, specificity of the clinical-radiomics combined model using AE classifier in the validation cohort were 0.896 (95%CI: 0.760-1.000), 88.5%, 88.9%, 87.5%. The AUC of the clinical-radiomics combined model using NB classifier in the validation cohort were 0.938 (95%CI: 0.828-1.000), 92.3%, 88.9%, 100.0%. Conclusion: Gd-EOB-DTPA enhanced MRI combined clinical-radiomics model has certain value in preoperative differentiation of iso-or hyperintensity in the hepatobiliary phase HCC and FNH, with a high accuracy, sensitivity and specificity.

[Study of the urban-impact on microbial communities and their virulence factors and antibiotic resistance genomes in the Nandu River, Haikou]

Objective: To explore the changes in bacterial community structure, antibiotic resistance genome, and pathogen virulence genome in river water before and after the river flowing through Haikou City and their transmission and dispersal patterns and to reveal anthropogenic disturbance's effects on microorganisms and resistance genes in the aquatic environment. Methods: The Nandu River was divided into three study areas: the front, middle and rear sections from the upstream before it flowed through Haikou City to the estuary. Three sampling sites were selected in each area, and six copies of the sample were collected in parallel at each site and mixed for 3 L per sample. Microbial community structure, antibiotic resistance, virulence factors, and mobile genetic elements were analyzed through bioinformatic data obtained by metagenomic sequencing and full-length sequencing of 16S rRNA genes. Variations in the distribution of bacterial communities between samples and correlation of transmission patterns were analyzed by principal co-ordinates analysis, procrustes analysis, and Mantel test. Results: As the river flowed through Haikou City, microbes' alpha diversity gradually decreased. Among them, Proteobacteria dominates in the bacterial community in the front, middle, and rear sections, and the relative abundance of Proteobacteria in the middle and rear sections was higher than that in the front segment. The diversity and abundance of antibiotic resistance genes, virulence factors, and mobile genetic elements were all at low levels in the front section and all increased significantly after flow through Haikou City. At the same time, horizontal transmission mediated by mobile genetic elements played a more significant role in the spread of antibiotic-resistance genes and virulence factors. Conclusions: Urbanization significantly impacts river bacteria and the resistance genes, virulence factors, and mobile genetic elements they carry. The Nandu River in Haikou flows through the city, receiving antibiotic-resistant and pathogen-associated bacteria excreted by the population. In contrast, antibiotic-resistant genes and virulence factors are enriched in bacteria, which indicates a threat to environmental health and public health. Comparison of river microbiomes and antibiotic resistance genomes before and after flow through cities is a valuable early warning indicator for monitoring the spread of antibiotic resistance.

A new method for molecular sex identification in the emu (Dromaius novaehollandiae)

1. Sex chromosomes of emus are largely homomorphic. Therefore, the standard methodology for molecular sexing is based on screening intron length variations in sex-linked genes is not applicable. However, emu sexing requires costly and time-consuming PCR-RFLP or multiplex PCR methods.2. This experiment used a directed PCR amplification and capillary electrophoresis sexing protocol. Two distinct peaks were observed in females (ZW), while only one peak was observed in males (ZZ).3. This sexing technique proved to be rapid, non-invasive, and highly sensitive and may be useful for verifying the sex ratio and breeding management of emus.

[The prediction value of enhanced magnetic resonance imaging nomogram model for dual phenotype hepatocellular carcinoma]

Objective: To explore the value of enhanced magnetic resonance imaging nomogram model in the prediction of dual-phenotype hepatocellular carcinoma(DPHCC). Methods: Data of 116 patients of hepatocellular carcinoma (HCC) confirmed by postoperative pathology, who underwent preoperative enhanced MRI between January 2016 and March 2021 in the First Affiliated Hospital of Soochow University were retrospectively evaluated, of these, there are 87 males and 28 females, aged 30-79 (59±10) years, including 31 patients with DPHCC and 85 patients with non-DPHCC. The patients were randomly divided into training set(51 cases of non-DPHCC,19 cases of DPHCC)and validation set(34 cases of non-DPHCC, 12 cases of DPHCC) in a ratio of 6∶4, according to random number table,clinical and imaging characteristics of the two groups were compared. The statistically significant parameters were included in multivariate logistic regression to identify the independent predictors and for the establishment of the nomogram model. The receiver operating characteristic curves were used to evaluate the prediction ability of the models, the corrected curve was used to validate the model. Results: In the training group, the proportions of rim arterial phase hyperenhancement in the DPHCC was significantly higher than that of the non-DPHCC [47.4%(9/19)vs 7.8%(4/51),P<0.001]. Rim arterial phase hyper-enhancement and enhanced capsule were significant predictors for DPHCC[OR=10.17(1.70-60.80),0.17(0.03-0.93),all P<0.05]. In the training group, the area under curve (AUC), sensitivity and specificity of the nomogram were 0.888 (95%CI: 0.806-0.969), 78.9% and 86.3%. In the validation group, the above three indicators were 0.811(95%CI: 0.655-0.968), 75.0% and 82.4%. Conclusion: Enhanced MRI nomogram model has certain value in prediction of DPHCC, with high sensitivity and specificity.

[Value of the application of enhanced CT radiomics and machine learning in preoperative prediction of microvascular invasion in hepatocellular carcinoma]

Objective: To explore the value of machine learning models in preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) based on dual-phase contrast-enhanced CT radiomics features. Methods: The data of 148 patients [106 males and 42 females, with an average age of (58±11) years] with HCC confirmed by pathology in the First Affiliated Hospital of Soochow University from January 2015 to May 2020 were retrospectively analyzed, including 88 cases of positive MVI and 60 cases of negative MVI. According to the ratio of 7∶3, the patients were randomly divided into the training and validation sets, respectively. The three-dimensional (3D) radiomics features of HCC in arterial phase (AP) and portal venous phase (PP) were extracted by MaZda software, and the optimal feature subset was obtained by combining three feature selection methods (FPM method) and Lasso regression. Then, six machine learning methods were used to build the prediction models. Receiver operating characteristic (ROC) curves were drawn to evaluate the prediction ability of the aforementioned models, and the area under the curve (AUC), accuracy, sensitivity and specificity were calculated. Results: Radiomics features of HCC in AP and PP were extracted by MaZda software, with 239 in each phase. There were 7 optimal features in AP and 14 optimal features in PP selected by FPM method and Lasso regression, respectively. The AUCs of decision tree, extreme gradient boosting, random forest, support vector machine (SVM), generalized linear model, and neural network based on the 7 optimal features in AP in the validation set were 0.736, 0.910, 0.913, 0.915, 0.897, 0.648, respectively. The SVM had the highest AUC in the validation set, with the accuracy, sensitivity and specificity of 95.35%, 95.83% and 94.74%, respectively. Likewise, the AUCs of machine learning models in prediction of MVI in HCC based on the 14 optimal features in PP in the validation set were 0.873, 0.876, 0.913, 0.859, 0.877, 0.834, respectively, and there were no significant differences (all P>0.05). The random forest had the highest AUC in the validation set, with the accuracy, sensitivity and specificity of 90.70%, 87.50% and 94.74%, respectively. Conclusion: Machine learning models based on dual-phase enhanced CT radiomics features can be used in preoperative prediction of MVI in HCC, particularly the SVM and random forest models have high prediction efficiency.

[The predictive value of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced MRI imaging features combined with quantitative parameters for the pathologic grading of hepatocellular carcinoma]

Objective: To investigate the predictive value of gadolinium-ethoxybenzyl- diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI imaging features combined with quantitative parameters for the pathologic grading of hepatocellular carcinoma (HCC). Methods: Eighty patients (65 males, 15 females; range 30-74 years,average age (59±11) years old) with HCC who underwent curative resection or biopsy from June 2016 to June 2019 in the First Affiliated Hospital of Soochow University after Gd-EOB-DTPA-enhanced MRI were evaluated retrospectively.According to the pathological results of the postoperative pathology, eighty patients were divided into poorly differentiated group (26 cases, 22 males, 4 females) and moderately-well differentiated group (54 cases, 43 males, 11 females). In Gd-EOB-DTPA-enhanced MRI, qualitative parameters were assessed. Quantitative parameters including tumor size, tumor-to-liver signal intensity ratio(SIR) of arterial phase (AP), portal vein phase (PP), equilibrium phase (EP) and hepatobiliary phase (HBP), contrast enhancement ration AP (CER-AP)were measured and calculated. Clinical data and qualitative parameters between poorly differentiated group and moderately-well differentiated group were analyzed by using χ(2) test.Quantitative parameters were analyzed by using independent sample t test. Statistically significant qualitative parameters, quantitative parameters, qualitative combined with quantitative parameters and AFP combined with qualitative and quantitative parameters were included in binary logistic regression model. The receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of the four prediction model for the pathologic grading of HCC. Results: There was a statistical difference between poorly differentiated group and moderately-well differentiated group in AFP, arterial peritumoral enhancement, arterial rim enhancement, peritumoral hypointensity on HBP and tumor signal (all P<0.05). In two groups, tumor size, SIR-AP and SIR-PP were (7.0±3.7) vs (3.9±2.4)cm,1.11±0.29 vs 1.31±0.32 and 0.89±0.21 vs 1.03±0.27 (all P<0.05). AUC of qualitative parameters, quantitative parameters, qualitative combined with quantitative parameters and AFP combined with qualitative and quantitative parameters were 0.805, 0.804, 0.855, 0.892.There was a statistical difference between qualitative parameters and qualitative combined with quantitative parameters in sensitivity(80.8% vs 92.3%, P<0.05). Conclusion: Gd-EOB-DTPA-enhanced MRI imaging features combined with quantitative parameters can be used to predict the pathologic grading of HCC preoperatively, which has a great applicative value.

[Epidemiological investigation of 511 adult inpatients with gas burns]

Objective: To analyze the epidemiological characteristics of adult inpatients with gas burns in the Department of Burns of Hwa Mei Hospital of University of Chinese Academy of Sciences (hereinafter referred to as the author's unit) , so as to provide evidence for the prevention of gas burn. Methods: Medical records of all inpatients with flame burns admitted to the author's unit from January 2011 to December 2017 were collected. The percentage of adult inpatients with gas burns in total inpatients with flame burns in the same period, and their gender, age, injury season, accident place, burn severity, common compound injury, complication, population caliber, education, industry, as well as the pre-injury disease and prognosis of elderly inpatients with gas burns were retrospectively analyzed. In addition, the age, accident place, education, and industry of the floating population in the adult inpatients with gas burns were analyzed separately and compared with the total population of adult inpatients with gas burns in 7 years. Data were processed with chi-square test or Fisher's exact probability test (Monte Carlo algorithm). Results: During the 7 years, 1 490 inpatients with flame burns were admitted to the author's unit, among which 511 were adult inpatients with gas burns, accounting for 34.30%. The number of adult inpatients with gas burns increased gradually during the 7 years, but its percentage in the total inpatients with flame burns during the same period showed no significant difference (χ(2)=7.087, P>0.05). Among the 511 adult inpatients with gas burns (hereinafter referred to as the patients in this group), there were 315 males and 196 females, with a male/female ratio of 1.61 to 1.00, and the middle-aged patients were the most, up to 270 cases, accounting for 52.84%. The distribution of adult inpatients with gas burns during the 7 years was significantly different in gender and age (χ(2)=54.810, 27.832, P<0.01). Among the patients in this group, most were injured in summer, totally 251 cases, accounting for 49.12%, and the accident place was mainly at home, totally 388 cases, accounting for 75.93%. The distribution of adult inpatients with gas burns during the 7 years was significantly different in injury season (χ(2)=42.254, P<0.01), but not in accident place (χ(2)=6.782, P>0.05). The patients in this group were mainly with moderate burns (237 cases, accounting for 46.38%), and the distribution trend of burn severity of adult inpatients with gas burns was basically the same during the 7 years (χ(2)=19.680, P>0.05); 176 patients (34.44%) were accompanied by inhalation injury, and 30 patients (5.87%) were accompanied by blast injury of lung; post injury complications occurred in 20 patients (3.91%). In the elderly inpatients with gas burns, 44.44% (32/72) were accompanied by pre-injury basic diseases, and the proportion of death or unhealed reached 18.06% (13/72). Most of the patients in this group were permanent residents (358 cases, accounting for 70.06%) and received secondary education (304 cases, accounting for 59.49%), and the majority of them were engaged in manufacturing/construction (138 cases, accounting for 27.01%), self-employed business (90 cases, accounting for 17.61%), and catering (90 cases, accounting for 17.61%) industries. The distribution of adult inpatients with gas burns during the 7 years was significantly different in population caliber, education, and occupation (χ(2)=17.496, 29.898, 88.896, P<0.05 or P<0.01). Among the patients of this group, the floating population were mainly young (90 cases, accounting for 58.82%) and middle-aged (62 cases, accounting for 40.52%), with main accident place at home (97 cases, accounting for 63.40%), generally received secondary education (101 cases, accounting for 66.01%), and were mainly engaged in manufacturing/construction (71 cases, accounting for 46.41%), self-employed business (26 cases, accounting for 16.99%), and catering (20 cases, accounting for 13.07%) industries. Compared with the total adult inpatients with gas burns in 7 years, the floating population were younger, more injured in the workplace, and more concentrated in industry (χ(2)=42.924, 9.390, 27.819, P<0.01). Conclusions: Gas burn was the leading injury cause of inpatients with flame burns in the author's unit, which mainly occurred in summer and at home; the patients were mainly male, young and middle-aged, and permanent residents, most of which were with moderate burn, often accompanied by inhalation injury. Most of the patients were of secondary education, engaged in manufacturing/construction, self-employed business, and catering industries, among which the floating population were younger, more injured in the workplace, and more concentrated in industry. In order to prevent gas burn, we should pay more attention to the propaganda and education of gas safety among young and middle-aged men, floating population, retired old people and housewives, especially in summer, we should do a good job in gas safety inspection at home. In addition, we should urge enterprises to further strengthen the supervision of production safety.

P4696Short- and long-term follow-up of 1024 Children with transcatheter closure of ventricular septal defects: A Single center Study

Objective

To investigate the safety, efficacy and long-term prognosis of pediatric patients after percutaneous ventricular septal defect (VSD) closure.

Method

A total of 1024 children with VSD in were enrolled. All children underwent transthoracic echocardiography (TTE), electrocardiogram (ECG) and chest roentgenogram before and after the treatment. Follow-up evaluation was done at 1, 3, 6, 12 months.

Results

1. 40 of 1024 patients gave up TC after angiography. Successful closure of VSD was achieved in 94.9% (934/984).

2. The defect were successfully occluded in 934 children. 939 VSD devices were implanted, 5 patients received 2 occluders. The average diameter of occluder was 6.40±2.13mm (3.00–18.00mm), and the mean operation time was 86.81±41.85min (30.00–360.00min).

3. Short postoperative complications were as follows: diffuse subarachnoid hemorrhage (1/934, 0.11%), high or complete atrioventricular block (1/934, 0.32%), mechanical hemolysis occurred (18/934, 1.93%). Moreover, the conduction disturbances included complete left bundle branch block (15/934, 1.61%), incomplete right bundle branch block (144/934, 15.42%), borderline rhythm (48/93, 45.14%), and complete right bundle branch block (44/934, 4.71%), left anterior branch block (27/934, 2.89%), premature contraction (21/934, 2.36%), ST-T segment changes (12/934, 1.28%).

4. The follow-up time ranged from1 to 192 months with the median time 36 months (12, 60) and the follow-up rate was 84.1% (795/934). There was no difference of mean left ventricular size between normal outpatients and patients accepted TC for more than 10 years (4.50±0.30cm V.S. 4.57±0.35cm, t=1.171, P=0.251).

5. New complications included III°AVB (1 case), CLBBB (1 case), ARs (27 cases) and residual shunt (12 cases). The operation age, the distance from defect to valve, the occluder diameter, the asymmetrical occluder and follow-up duration were associated risk factors of AR (OR= 4.107, 5.30, 3.824, 6.750, 9.625, P=0.033, 0.015, 0.045, 0.020, 0.000, respectively). The difference of occluder diameter, defect size and follow-up time were related risk factors of residual shunt (OR=7.000, 5.417, 11.333, 29.250, P=0.012, 0.037, 0.031, 0.000, respectively).

6. The patients were divided into 4 groups (∼3 years group, 3 ∼ 4 years group, 4∼ 6 years group, and 6∼ 18 years group. No significant differences of the success rate, defect size, operation time, incidence rate of short- and long-term complications rate. There was significantly difference of short complications incidence rate in 4 groups (c2=23.431 P=0.000).

Conclusions

The TC has a high successful rate in the pediatric patients with VSD. Patients with CLBBB or III°AVB can return to normal in the early stage after operation, but may recur during follow-up period. There is no significant difference in the successful rate and the incidence rate of long-term complications between patients <3 years and children ≥3 years old.

Acknowledgement/Funding

Taishan scholars (no. ts201511099)

[Application of augmented-reality surgical navigation technology combined with ICG molecular fluorescence imaging in laparoscopic hepatectomy]

Objective: To study the application value of augmented-reality (AR) surgical navigation technology combined with indocyanine green (ICG) molecular fluorescence imaging in three-dimensional (3D) laparoscopic hepatectomy. Methods: The clinical data of forty-eight patients who had undergone 3D laparoscopic hepatectomy for hepatocellular carcinoma at First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University from January 2018 to April 2019 were retrospectively analyzed.The patients were divided into two groups: the group of 3D laparoscopic hepatectomy navigated by augment reality technology combined with ICG molecular fluorescence imaging (Group A) , and group of conventional 3D laparoscopic hepatectomy (Group B) . Patients in Group A (n=23) underwent 3D laparoscopic hepatectomy using augmented-reality technology combined with ICG molecular fluorescence imaging. In this group, the self-developed three-dimensional laparoscopic augmented-reality surgical navigation system (No. 2018SR840555) was operated to project the preoperative three-dimensional model to the surgical field, and the use of this system in combination with ICG molecular fluorescence imaging navigated laparoscopic hepatectomy. No surgical navigation technology was applied in Group B (n=25) . All patients signed the informed consent, which were in accordance with the requirements of medical ethics (Ethics No.: 2018-GDYK-003) . The preoperative data, surgical indicators and postoperative complications between the two groups were compared and analyzed. Results: The median amount of intraoperative blood loss of Group A was 250 (200) ml (M (Q(R)) ) , which was significantly lower than that of Group B (300 (150) ml) (Z=-2.307, P=0.021) .The transfusion rate of Group A was 13.0% (3/23) , which was significantly lower than that of Group B (40.0%, 10/25) (χ(2)=4.408, P=0.036) .The median postoperative hospitalization time of Group A was 8 (2) d, which was significantly shorter than that of Group B (11 (6.5) d) (Z=-2.694, P=0.007) . There were no serious complications and perioperative death in both groups.The incidence of postoperative complications in Group A was 17.4% (4/23) , which was not significantly different from that in group B (28%, 7/25) (χ(2)=0.763, P=0.382) . Conclusion: Augmented-reality surgical navigation technology combined with ICG molecular fluorescence imaging has better effect in 3D laparoscopic hepatectomy.

[Five patients with severe burns complicated by fungal infection]

From June to November 2016, 5 patients with severe burns were admitted to our unit. Broad-spectrum antibiotic and fluconazole were used on patients as earlier empirical anti-infection therapy of bacteria and fungi. Seven to twenty-one days after injury, 5 patients developed fungal infection. Antifungal agents of caspofungin, voriconazole, and amphotericin B liposomewere were used according to the results of fungal culture, and the infected wounds were also treated with repeated debridement and dressing change. Multiple autologous skin grafts were performed after infection control of wounds. With the above antifungal infection treatment for 5 to 11 days, 2 patients' condition tended to be stable, and no fungus was found in wound secretion after cultured for many times. The patients were discharged with wounds healed after 52 to 54 days' hospital stay. Due to severe burns degree and or elder age, fungal infection aggravated and expanded to the trunk in the other 3 patients, then developed into burn sepsis, resulting in patients died of multiple organ failure secondary to sepsis.

[Investigation of acquired drug-resistant genes and strains relationship in Pseudomonas aeruginosa isolated from burn patients]

Objective: To investigate the acquired drug-resistant genes and strains relationship in 40 strains of Pseudomonas aeruginosa isolated from burn patients. Methods: Forty strains of Pseudomonas aeruginosa isolated from burn patients hospitalized in our burn department from January 2014 to December 2015 were selected, with 20 strains from each year. Kirby-Bauer paper disk diffusion method was used to detect sensitivity of the isolated Pseudomonas aeruginosa to 9 kinds of antibiotics of cefotaxime, ceftazidime, cefepime, imipenem, meropenem, gentamicin, amikacin, ciprofloxacin, and levofloxacin. Polymerase chain reaction was applied to detect 9 kinds of acquired β-lactamase antibiotics-resistant genes, outer membrane porin protein oprD2 genes, 12 kinds of acquired aminoglycosides antibiotics-resistant genes, and 6 kinds of acquired disinfectant-resistant genes and genetic marker genes of mobile genetic elements. Among the above genes, positive expression genes were verified by DNA sequencing and comparison. Sequences of twenty-eight acquired drug-resistant genes of the above 40 Pseudomonas aeruginosa strains were analyzed by unweighted pair-group method with arithmetic means cluster analysis. Results: Forty strains of Pseudomonas aeruginosa were resistant to the above 9 kinds of antibiotics. Two kinds of acquired β-lactamase antibiotics-resistant genes of bla(TEM), bla(CARB), 5 kinds of acquired aminoglycosides antibiotics-resistant genes of aac(6')-Ⅰb, aac(6')-Ⅱ, ant(2″)-Ⅰ, ant(3″)-Ⅰ, and rmtB, and 3 kinds of acquired disinfectant-resistant genes and genetic marker genes of mobile genetic elements of qacE△1-sul1, merA, and intⅠ1were detected in 40 strains of Pseudomonas aeruginosa with oprD2 gene deficiency. Forty strains aggregated obviously, with a total of 7 gene modes and 3 clones. Drug-resistant gene sequences of strains of number 2 to 4, 6 to 9, 11, 14, and 17 to 39 were similar and with close relationship. Drug-resistant gene sequences of number 12 and 13 strains were similar and with close relationship. Drug-resistant sequences of number 10 and 16 strains were similar and with close relationship. Conclusions: Genes of bla(TEM), bla(CARB), aac(6')-Ⅰb, aac(6')-Ⅱ, ant(2″)-Ⅰ, rmtB, qacE△1-sul1, merA, and intⅠ1 were prevalent in these strains of Pseudomonas aeruginosa with oprD2 gene deficiency isolated from burn patients, which may play key roles in resistance of Pseudomonas aeruginosa to β-lactamase, aminoglycoside, and quinolone antibiotics, and the drug-resistant phenotypes were in good coincidence with genotypes. Pseudomonas aeruginosa strains isolated from burn patients were with similar acquired drug-resistant genes and close relationship.

Genetic diversity of Jiangsu native chicken breeds assessed with the mitochondrial DNA D-loop region

1. The objective of this study was to determine the origin and evolution of chickens from 5 native breeds that are traditionally raised in Jiangsu Province. 2. To address this question, the complete mitochondrial DNA D-loop sequence of 149 chickens from 5 native breeds of Jiangsu Province was analysed. 3. Sequence read lengths of the native breeds were 1231 to 1232 bp, with a single-base deletion from the 859 bp site in the 1231 bp haplotype. A total of 33 variable sites that defined 19 haplotypes were identified. The average haplotype diversity and nucleotide diversity were 0.862 ± 0.017 and 0.00591 ± 0.00135. 4. Phylogenetic analysis showed that genetic structure of the mtDNA haplotypes of Jiangsu chickens are distributed across 5 clades (haplogroups): Clades A, B, C, D, and E. However, most of the individuals characterised in this study belonged to clades A and B. 5. The results of this study indicate that Jiangsu chicken populations have relatively low nucleotide and haplotype diversity and likely share 5 common maternal lineages.

[The construction of three-dimensional visualization platform and its application in diagnosis and treatment for hilar cholangiocarcinoma]

OBJECTIVE

To explore the construction and clinical efficacy of three-dimensional(3D) visualization platform about diagnosis and treatment of hilar cholangiocarcinoma.

METHODS

From January 2009 to December 2015, a total of 32 patients with hilarcholangiocarcinoma treated in Zhujiang Hospital of Southern Medical University were analyzed.There were 20 male and 12 female patients aged from 40 to 85 years. Bismuth-Corlette 3D visualization type: 2 cases with type Ⅰ, 5 cases with type Ⅱ, 10 cases with type Ⅲa, 11 cases with type Ⅲb, 4 cases with type Ⅳ.Among 32 cases, there were 5 cases who were established liver 3D printing models to guide intraoperative real-time navigation.The clinical effect of this platform was evaluated by the operation time, intraoperative blood loss, laboratory test and postoperative complications.The 3D visualization platform consists of the preoperative surgical planning with the aid of virtual 3D reconstruction technology and intraoperative real-time navigation with 3D printing models.

RESULTS

The liver 3D models for all patients were constructed successfully, they could clearly show intrahepatic pipeline, size and location of tumors, relationship between tumor and intrahepatic pipeline.The 3D printing models could accomplish real-time intraoperative navigation surgery with strong stereoscopic sense.According to Bismuth classification 3D visualization type, 2 patients with type Ⅰ received local excision of tumor and choledochojejunostomy; 5 patients with type Ⅱ received resection of segment Ⅰ, Ⅳb and partial Ⅴ combined with choledochojejunostomy; 10 patients with type Ⅲa received right semi-hepatectomy combined with resection of segment Ⅰ and choledochojejunostomy; 11 cases with type Ⅲb received left semi-hepatectomy combined with resection of segment Ⅰ and choledochojejunostomy; 4 cases with type Ⅳ received resection of segment Ⅳb and Ⅴ combined with choledochojejunostomy.The operation time was 270-660 minutes; the mean intraoperative blood loss was 588 ml; the mean postoperative hospital stay was 25 days.The bilirubin level three day after operation was 233 μmol/L.There was 1 case presented biliary fistula and cured by conservative treatment; there was no incision infection, no liver failure and no perioperative deaths occurred.

CONCLUSION

The 3D visualization is valuable for optimizing the operation scheme preoperatively and navigating surgery accurately intraoperatively in real-time which may improve the precision of the operation and achieve better the recovery.

Available energy content, nutrients digestibility of chili meal and effects on performance of growing pigs

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Chili meal is classified as a roughage due to its high dietary fiber content.

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Chili meal has moderate DE, ME and nutrients digestibility for growing pigs.

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Addition of chili meal have adverse effect on ADG and ATTD of nutrients.

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The combination of 50 g/kg chili meal and proper soybean has no significant negative effects for growing pigs.

The objective of this study was to evaluate the digestible energy (DE), metabolizable energy (ME) content, apparent total tract digestibility (ATTD) of nutrients in chili meal (CM), and to determine the effects of CM on the performance of growing pigs. In Exp. 1, 12 barrows (Duroc x Landrace x Yorkshire) with an initial body weight (BW) of 50.9 ± 1.8 kg were allocated to one of two treatments, corn-soybean meal basal diet or diet containing 194.2 g/kg CM, which replaced corn and soybean meal in the basal diet. Pigs were placed in metabolism crates for a 7-d adaptation period followed by a 5-d total collection of feces and urine to detect DE, ME and ATTD of nutrients in CM. Exp. 2 was conducted for 4 wk. to evaluate the effect of CM on performance of growing pigs. 150 growing pigs (58.4 ± 1.2 kg BW) were allocated to 1 of 5 treatments. Treatment 1 was a corn-soybean meal basal diet met the DE requirement for growing pigs recommended by NRC (2012). Treatment 2 or 3 were diets containing 50 g/kg or 100 g/kg CM respectively. Treatment: 4 or 5 were based on treatment 2 or 3, while soybean oil (SBO) was added to improve the DE content to that in treatment 1. In Exp. 1, the DE and ME content of CM were 9.08 and 8.48 MJ/kg. The ATTD of dry matter (DM), gross energy (GE), organic matter (OM) and neutral detergent fiber (NDF) were 0.60, 0.54, 0.66 and 0.38, respectively. In Exp. 2, addition of CM linearly decreased (P < 0.05) average daily gain (ADG) and the ATTD of DM, GE and OM while ATTD of crude protein (CP) had a quadratic (P < 0.05) change. When SBO was supplemented in diets containing CM, greater values (P < 0.05) of ATTD of most nutrients were observed. With the dietary inclusion of CM, the albumin/globulin ratio in serum had a quadratic change (P < 0.05), and the level of low-density cholesterol linearly (P < 0.05) increased. In treatments with 50 g/kg CM, a significant reduction (P < 0.05) of total antioxidant capacity was found in diet formulated with SBO. In treatments with 100 g/kg CM, the level of total cholesterol was lower (P < 0.05) in the diet with SBO. In conclusion, CM had moderate energy density and nutrients digestibility in pig diets. 50 g/kg CM with SBO in diets could be fed to growing pigs with no significant negative effects.

[The regulative effcets of A2a adenosine receptor on expression of SOCS-3 in rats of hypoxic pulmonary hypertension]

OBJECTIVE

To study the regulative effects and mechanism of A2aAR on expression of suppressor of cytokinesignaling-3(SOCS-3) in hypoxic pulmonary hypertension rats.

METHODS

Sprague-Daeley rats were randomly divided into 3 groups: a normal control group, a hypoxia group, and a hypoxia with selective agonists of A2aAR group. Animals in the hypoxia groups were housed in a chamber with 8%- 11% O2 and 1%-3% CO2 for 8 hours (8: 00 AM to 4: 00 PM) daily for 28 days. They were treated intraperitoneally with either 4 ml/kg weight of normal saline or 0.2 mg/kg weight of CGS-21680 30 minutes before exposure to hypoxia. Four weeks later, mean pulmonary artery pressure (mPAP), mean carotid arterial pressure (mCAP) and right ventricular rate [RV/(LV+ S)] were measured. The expression of A2aAR and SOCS-3 in pulmonary arterioles was measured by immunohistochemistry. The expression of A2aAR mRNA and SOCS-3 mRNA in lung tissues were measured by real time RT-PCR. The expression of A2aAR protein and SOCS-3 protein in lung tissues were measured by Western blot.

RESULTS

The mPAP in the hypoxia group was [(20.9±3.9)mmHg, 1 mmHg=0.133 kPa], significantly higher than the normal control group [(12.6±6.6)mmHg](P<0.01). The mPAP in CGS-21680 group was [ (14.8±3.8)mmHg], significantly lower than the hypoxia group(P<0.01). RV/(LV+ S) in the hypoxia group was [(35.2±2.0)%] , significantly higher than the normal control group [(29.6±2.7)%] (P<0.01). RV/(LV+ S) in the CGS-21680 group was [(28.3±8.8)%], significantly lower than the hypoxia group(P<0.01). WA/TA in the hypoxia group was (73±5, P<0.01), significantly higher than the normal control group. WA/TA in CGS21680 group was (54±3, P<0.01), significantly lower than the hypoxia group. A2aAR and SOCS-3 expressions on pulmonary arterioles in the hypoxia group were (0.134±0.034) and (0.119±0.011), both significantly higher than the normal group(P<0.01); and CGS-21680 treatment further increased their expressions. The mRNA expression of both molecules showed a 1.5-fold increase after 28-day hypoxia exposure. A2aAR activation by CGS-21680 treatment in hypoxia-exposed rats further increased the expression levels of A2aAR and SOCS-3 to about 2-fold higher than the normal controls. Furthermore, protein levels of A2aAR and SOCS-3 in the lung tissue were determined using Western blot. A similar increase was observed in hypoxia-induced pulmonary hypertension, and CGS-21680 treatment group showed the highest levels of these 2 proteins.

CONCLUSION

A2aAR activation prevents hypoxia-induced pulmonary hypertension, and its mechanisms are related to the activation of A2aAR SOCS-3 signaling pathway.

Effects of exogenous phytase and xylanase, individually or in combination, and pelleting on nutrient digestibility, available energy content of wheat and performance of growing pigs fed wheat-based diets

OBJECTIVE

Two experiments were conducted to determine the effects of adding exogenous phytase and xylanase, individually or in combination, as well as pelleting on nutrient digestibility, available energy content of wheat and the performance of growing pigs fed wheat-based diets.

METHODS

In Experiment 1, forty-eight barrows with an initial body weight of 35.9±0.6 kg were randomly assigned to a 2×4 factorial experiment with the main effects being feed form (pellet vs meal) and enzyme supplementation (none, 10,000 U/kg phytase, 4,000 U/kg xylanase or 10,000 U/kg phytase plus 4,000 U/kg xylanase). The basal diet contained 97.8% wheat. Pigs were placed in metabolic cages for a 7-d adaptation period followed by a 5-d total collection of feces and urine. Nutrient digestibility and available energy content were determined. Experiment 2 was conducted to evaluate the effects of pelleting and enzymes on performance of wheat for growing pigs. In this experiment, 180 growing pigs (35.2±9.0 kg BW) were allocated to 1 of 6 treatments according to a 2×3 factorial treatment arrangement with the main effects being feed form (meal vs pellet) and enzyme supplementation (0, 2,500 or 5,000 U/kg xylanase).

RESULTS

In Experiment 1, there were no interactions between feed form and enzyme supplementation. Pelleting reduced the digestibility of acid detergent fiber (ADF) by 6.4 percentage units (p<0.01), increased the digestibility of energy by 0.6 percentage units (p<0.05), and tended to improve the digestibility of crude protein by 0.5 percentage units (p = 0.07) compared with diets in mash form. The addition of phytase improved the digestibility of phosphorus (p<0.01) and calcium (p<0.01) by 6.9 and 7.6 percentage units respectively compared with control group. Adding xylanase tended to increase the digestibility of crude protein by 1.0 percentage units (p = 0.09) and increased the digestibility of neutral detergent fiber (NDF) (p<0.01) compared with control group. Supplementation of the xylanase-phytase combination improved the digestibility of phosphorus (p<0.01) but impaired NDF digestibility (p<0.05) compared with adding xylanase alone. In Experiment 2, adding xylanase increased average daily gain (p<0.01) and linearly improved the feed:gain ratio (p<0.01) compared with control group.

CONCLUSION

Pelleting improved energy digestibility but decreased ADF digestibility. Adding xylanase increased crude protein digestibility and pig performance. Phytase increased the apparent total tract digestibility of phosphorus and calcium. The combination of phytase-xylanase supplementation impaired the effects of xylanase on NDF digestibility.

Non-monotonic changes in critical solidification rates for stability of liquid-solid interfaces with static magnetic fields

We report the magnetic field dependence of the critical solidification rate for the stability of liquid-solid interfaces. For a certain temperature gradient, the critical solidification rate first increases, then decreases, and subsequently increases with increasing magnetic field. The effect of the magnetic field on the critical solidification rate is more pronounced at low than at high temperature gradients. The numerical simulations show that the magnetic-field dependent changes of convection velocity and contour at the interface agree with the experimental results. The convection velocity first increases, then decreases, and finally increases again with increasing the magnetic field intensity. The variation of the convection contour at the interface first decreases, then increases slightly, and finally increases remarkably with increasing the magnetic field intensity. Thermoelectromagnetic convection (TEMC) plays the role of micro-stirring the melt and is responsible for the increase of interface stability within the initially increasing range of magnetic field intensity. The weak and significant extents of the magneto-hydrodynamic damping (MHD)-dependent solute build-up at the interface front result, respectively, in the gradual decrease and increase of interfacial stability with increasing the magnetic field intensity. The variation of the liquid-side concentration at the liquid-solid interface with the magnetic field supports the proposed mechanism.

Analysis of MS2Bnap genomic DNA homologous to MS2 gene from Arabidopsis thaliana in two dominant digenic male sterile accessions of oilseed rape (Brassica napus L.)

PCR technique was employed to isolate gene homologous to the MS2Bnap (X99922.1) from two rapeseed (Brassica napus L.) dominant digenic male sterile lines, namely 220A (male sterile) and 220B (male fertile), 6A (male sterile) and 6C (male fertile). The isolated 2,581 bp sequences from 220A (named 220A-gDNA, GenBank accession number AY288778), 220B (220B-gDNA, AY257490), 6A (6A-gDNA, DQ060318) and 6C (6C-gDNA, DQ060319) all contained six introns. Forty-one single nucleotide polymorphism (SNP) sites were detected by alignment of these four sequences, seven of them dispersed in the exon regions. Two SNPs (1247, 1656) were detected between 220A-gDNA and 220B-gDNA, and the one at nucleotide 1247 of 220A-gDNA with A replaced by C was a missense mutation, which may be the putative male sterility site in 220A. All eight SNPs identified between 6A-gDNA and 6C-gDNA were located in the third intron, so the proteins encoded by them are the same. The one SNP between 6A-/6C-gDNA and 220A-/220B-gDNA at nucleotide 2474 of 220A-/220B-gDNA with C replaced by G was a missense mutation. Mutation site of BNMS2PROT (CAA68190.1) encoded by MS2Bnap in 220A(254) and 6A/6C(584) is different, which indicated dominant digenic male sterile line 220AB and 6CA have some difference in the molecular level. Comparison of structure of MS2Bnap in B. napus with that of MS2 in Arabidopsis thaliana revealed that the similarity of exons between these two genes is higher than that of introns.

Preparation of insulin nanoparticles and their encapsulation with biodegradable polyelectrolytes via the layer-by-layer adsorption

To develop a new polypeptide delivery system, insulin nano-aggregates with sizes of 100-230nm were prepared by the salting out method with NaCl and encapsulated via the layer-by-layer (LbL) adsorption to provide the insulin nanoparticles shelled with two oppositely charged polyelectrolytes. Poly(alpha,beta-l-malic acid) (PMA) and water-soluble chitosan (WSC) as the weak polyelectrolytes with good biodegradability and biocompatibility in vivo were chosen to be the encapsulating materials of the LbL adsorption. In the preparation of the insulin nano-aggregates, the NaCl concentration and pH in the medium obviously affected yield and particle size of the insulin nano-aggregates. After eight adsorption cycles of the polyelectrolytes on the insulin nano-aggregates, the insulin-polyelectrolyte nanoparticles with the sizes of 100-250nm were obtained with about 20% insulin loss. The insulin release from the nanoparticles was mostly pH-dependent owing to sensitivity of the weak polyelectrolytes to pH. Insulin was hardly released from the nanoparticles in a medium at pH 4-5 while it could be released at pH 7.4, corresponding to the pH of the human blood and the body fluid. A burst effect was also observed although it could be reduced via increasing the polyelectrolyte layers of PMA and WSC assembled on insulin nano-aggregates.

Temporal lobe changes following radiation therapy: imaging and proton MR spectroscopic findings

Radiation therapy for nasopharyngeal carcinoma affects the temporal lobes. This paper characterizes proton MR spectroscopic findings of the temporal lobes and correlates them with imaging changes. Single-voxel proton MR spectroscopic examinations were acquired from 13 healthy adult volunteers (25 spectra) and 18 patients (28 spectra). All patients had biopsy-confirmed nasopharyngeal carcinoma and were previously treated with radiation therapy. Six patients (33%) had a single treatment and 12 (67%) patients had two treatments. Point resolved spectroscopy (PRESS) method was used (TR = 3,000 ms, TE = 135 ms) and data processed automatically using the LCModel software package for metabolite quantification. Voxel size and geometry were adapted to the lesion to reduce skull-base lipid contamination. The metabolites were quantitated relative to water signal. For each location, an additional non-water-suppressed reference scan in fully relaxed conditions was performed. The imaging findings were divided into four categories: I, normal; II, edema only; III, contrast-enhancing lesions; and IV, cystic encephalomalacia. The N-acetyl-aspartate levels were reduced in 27 (96%) spectra. Choline was increased in 3 (11%), normal in 4 (14%), and reduced in 21 (75%) spectra. The creatine level was normal in 8 (29%) spectra and reduced in 20 (71%) spectra. Imaging showed 4 (14%) spectra with category-I imaging findings; 5 (18%) spectra with category-II findings; 15 (54%) spectra with category-III findings; and 4 (14%) spectra with category-IV findings. Magnetic resonance spectroscopy showed reduced N-acetyl-aspartate in radiation-induced temporal lobe changes. Creatine levels were relatively more stable. Choline levels may be increased, normal, or reduced. Imaging findings ranged from normal to contrast-enhancing lesions and cystic encephalomalacia.

Selective separation and simultaneous determination of trace levels of five types of fluorinated quinolone drugs by thin-layer chromatography/fluorescence densitometry

This paper reports the determination of trace levels of 5 types of fluorinated quinolone drugs, i.e., ciprofloxacin, norfloxacin, enoxacin, pefloxacin, and ofloxacin, by thin-layer chromatography (TLC)/fluorescence densitometry. The new analytical method uses 2-step TLC development, selective separation, and simultaneous determination of the 5 drugs. The method was also applied to the determination of recoveries of standards of the 5 drugs in plasma and urine samples. The results show that the method has a wide linear range, high repeatability, and good stability.

Prevalence and significance of hepatitis B virus (HBV) pre-S mutants in serum and liver at different replicative stages of chronic HBV infection

Several types of naturally occurring pre-S mutants in sera or liver tissues in patients with chronic hepatitis B virus (HBV) infection have been identified. To clarify the prevalence and significance of emergence of pre-S mutants, 140 sera and 18 resected livers from patients with HBV were studied. Replicative status was designated as high, intermediate, and low based on the HBV-DNA levels in serum or the expression of HBV antigens in liver. In vitro transfection and Western blot analysis were performed to characterize expression and secretion of HBsAg by the mutant constructs. Five major types (I to V) of pre-S deletion mutants in serum and liver and 2 types (VI and VII) in liver were identified. Pre-S mutant was 6.4% at high replicative phase, 13% at intermediate, and 37.5% at low or nonreplicative phases in serum. In livers, the same tendency existed: pre-S2 deletion mutants emerged and prevailed at a low replicative phase in hepatocytes that expressed a novel marginal pattern of HBsAg and usually clustered in groups. The deletion sequence of pre-S2 region coincides with human leukocyte antigen-restricted T- and B-cell epitopes. In vitro HBsAg was retained in the hepatocytes and synthesis and secretion of major surface antigen decreased for most of the pre-S mutants. Pre-S mutants prevailed with evolution of chronic HBV, probably under immune pressure. Emergence of pre-S mutants may account for the life-long persistence and discrepancy of HBsAg in serum and liver in HBV and may confer growth advantage in view of the clustering proliferation of hepatocytes harboring pre-S2 mutant.

Radiology of the retropharyngeal space

The retropharyngeal space extends from the skull base to the T4 vertebral level and contains the retropharyngeal nodes superiorly and fatty tissue elsewhere. This space is important as it is a potential route for the spread of infection and malignancy. This pictorial essay outlines the anatomy of the retropharyngeal space and illustrates the various disease processes that may be seen in region.Chong, V. F. H., Fan, Y. F. (2000). Clinical Radiology55, 740-748.

Radiation-induced temporal lobe changes: CT and MR imaging characteristics

OBJECTIVE

This article documents the CT and MR imaging characteristics of patients with temporal lobe changes after radiation therapy for nasopharyngeal carcinoma. These characteristics may serve to differentiate radiation-induced changes from intracranial tumor recurrence.

MATERIALS AND METHODS

We reviewed the imaging records of 1916 patients with nasopharyngeal carcinoma examined over a 5-year period. Forty-seven patients (2.5%) had temporal lobe changes. Thirty-four patients underwent CT (55 examinations), and 26 patients underwent MR imaging (32 examinations). Thirteen patients underwent CT and MR imaging. These studies were independently analyzed according to imaging technique and were categorized as follows: location of lesions, characteristics of gray or white matter changes, and patterns of late changes.

RESULTS

On CT, 12 patients (35%) had unilateral temporal lobe changes, and 22 patients (65%) had bilateral temporal lobe changes. The following patterns were noted: ill-defined contrast enhancement in 27 patients (79%); solid enhancement in six patients (18%); and ring enhancement in one patient (3%). On MR imaging, 11 patients (42%) had unilateral lesions, and 15 patients (58%) had bilateral lesions. Simultaneous gray and white matter lesions were noted in 17 patients (65%), and nine patients (35%) had lesions localized to the gray matter. Three patients (6%) had cerebral atrophy, and two patients (4%) had encephalomalacia.

CONCLUSION

The temporal lobes show characteristic CT and MR imaging features after radiation injury. Familiarity with these changes may assist in differentiating temporal lobe changes from progressive nasopharyngeal carcinoma.

Facial lymphadenopathy in nasopharyngeal carcinoma

AIMS

This paper reports the findings of facial nodal metastasis in nasopharyngeal carcinoma (NPC).

MATERIALS AND METHODS

The film records of 1916 patients with histologically confirmed NPC seen over a 5-year period were reviewed.

RESULTS

Eight facial nodes were demonstrated in three (0.2%) patients. There were three buccinator, two malar, two infraorbital and one mandibular nodes.

CONCLUSION

Facial nodal metastasis in NPC is unusual, but may be seen at presentation or during recurrence.

Imaging the sphenoid sinus: pictorial essay

This paper focuses on the spectrum of sphenoid sinus lesions that may be seen radiologically and the mapping of disease extent. Imaging plays a central role in the assessment of sphenoid sinus disease. Although primary sphenoid sinus disease is uncommon, this sinus is nevertheless affected secondarily by a variety of pathological processes.

Identification of a pre-S2 mutant in hepatocytes expressing a novel marginal pattern of surface antigen in advanced diseases of chronic hepatitis B virus infection

BACKGROUND AND AIMS

The expression of hepatitis B viral (HBV) antigens in liver tissue reflects the replicative status of chronic HBV infection. We have previously recognized a novel marginal pattern of hepatitis B surface antigen (HBsAg) in hepatocytes, which usually clusters in groups and emerges at the late non-replicative phase. This study was designed to investigate whether the marginal-type HBsAg represented the gene product of a specific HBV-surface mutant.

METHODS

Microdissection of cirrhotic nodules homogeneously expressing marginal HBsAg was performed on two of 12 resected livers from HBsAg-seropositive patients with hepatocellular carcinoma. The gene presumably encoding marginal HBsAg was polymerase chain reaction (PCR)-cloned, sequenced and analysed. In vitro transfection and expression of the cloned surface mutant plasmids were performed on the Huh7 cell line to illustrate intrahepatic HBsAg expression.

RESULTS

Immunohistochemical staining revealed that the marginal HBsAg was positive for pre-S1 and thus contained large surface proteins. The PCR cloning and sequencing of the genes presumably encoding marginal-type HBsAg in both cases revealed the same deletion at the 5' terminus (nt 2-55) of pre-S2. A point mutation on the small-surface (S) antigen was also found in one case. The pre-S2 deletion sequence and the mutation sites of the S gene coincide with human lymphocyte antigen-restricted T- and/or B-cell epitopes. In vitro transfection of the mutant plasmid revealed a blot-like retention or accumulation of HBsAg in the cytoplasm or at the periphery of hepatocytes, accompanied by a decreased secretion of HBsAg in the culture supernatant, mimicking intrahepatic expression.

CONCLUSION

A natural pre-S2 deletion mutant was identified in hepatocytes expressing a novel marginal pattern of HBsAg, which probably contains mutant, large, surface proteins. The biological significance of the pre-S2 deletion mutant should be interesting in view of the clustering proliferation of hepatocytes expressing marginal HBsAg.

Radiology of the nasopharynx: pictorial essay

The nasopharynx, located just below the central skull base, is a difficult area to evaluate clinically. Endoscopic examination provides useful information but cannot delineate submucosal disease. Benign lesions of the nasopharynx are relatively uncommon. They include Thornwaldt cyst, juvenile angiofibroma, haemangioma, haemangiopericytoma, Kimura's disease, branchial cleft cyst, oncocytoma, amyloidoma, and non-ossifying fibromyxoid tumours. The most common malignant lesions are carcinomas and lymphomas. Other malignant neoplasms such as adenocystic carcinomas are rarely seen. The purpose of the present pictorial review is to highlight the salient normal anatomy of the nasopharynx and the spectrum of pathological anatomy.

Meningeal infiltration in recurrent nasopharyngeal carcinoma

Permeative infiltration of the meninges appears to be a distinct form of recurrent nasopharyngeal carcinoma (NPC). The present report of eight patients with recurrent NPC illustrates meningeal infiltration following basal foramina extension. Seven of the eight patients (88%) showed jugular foramen involvement. Three patients had concomitant infiltration of the foramen magnum. There was one patient showing spread through the foramen lacerum. Only four (50%) of these patients had clinically detectable tumour in the nasopharynx, while the other half showed deep submucosal recurrence with endoscopically unremarkable findings. Permeative meningeal infiltration appears to be a distinct form of NPC recurrence. It is important to recognize this phenomenon so as to optimize the treatment options.

Temporal lobe necrosis following radiation therapy for nasopharyngeal carcinoma: 1H MR spectroscopic findings

PURPOSE

To observe the patterns of radiation-induced temporal lobe necrosis (TLN) following radiation therapy for nasopharyngeal carcinoma (NPC).

METHODS AND MATERIALS

Twenty-five proton magnetic resonance spectroscopic (1H MRS) examinations were acquired from 13 healthy adult volunteers for comparison with data from the patient population. There were 18 patients (28 spectra) with radiologic evidence of TLN and all patients were confirmed cases of NPC treated with radiation therapy. Six patients (33%) had a single treatment while 12 (67%) patients had two treatments. All 1H MRS examinations were performed on a 2-T whole body system (Bruker) using the point-resolved spectroscopy (PRESS) method with TE = 135 ms, TR = 3000 ms, and data processed automatically using the LCModel software package for metabolite quantification.

RESULTS

The N-acetyl-aspartate (NAA) levels were reduced in all except one spectrum (96%). Choline (Cho) was increased in 3 (11%), normal in 4 (14%), and reduced in 21 (75%) spectra. The creatine (Cr) level was normal in 8 (29%) spectra and reduced in 20 (71%) spectra. In four patients with normal imaging findings 1H MRS was abnormal.

CONCLUSION

1H MRS can characterize radiation-induced TLN. Spectra with increased Cho can be mistaken for neoplasm. Spectroscopy can also identify metabolic derangement before imaging.

Radiology of the orbital apex

The orbital apex, formed by the superior orbital fissure and optic canal, is the cross-road between the orbit and the intracranial structures. Pathological processes may extend intracranially via the superior orbital fissure and vice versa. In addition to intrinsic soft tissue lesions, various pathological processes may involve the surrounding osseous anatomy. Malignant lesions arising from adjacent structures or from haematogeneous metastasis may also infiltrate this region.

Parotid gland involvement in nasopharyngeal carcinoma

PURPOSE

This study documents the imaging findings of parotid gland involvement in nasopharyngeal carcinoma (NPC).

METHOD

This study reviewed the film records of 1,916 patients with NPC seen over a 5 year period. There were 27 (1.4%) patients with parotid involvement. There were 27 CT and 4 MR studies, and the pattern of involvement was categorized into the following groups: (1) parotid nodal involvement; (2) parotid invasion from extracapsular cervical nodal spread; (3) direct invasion by NPC; and (4) diffusely infiltrated gland not related to (2) or (3).

RESULTS

In the subset of 27 patients, parotid nodal involvement was seen in 11 (41%) patients. Ten (37%) patients had cervical extranodal spread into the parotid gland. Three patients (11%) showed direct invasion by NPC, and another three patients (11%) showed an isolated and diffusely infiltrated parotid gland.

CONCLUSION

Metastatic NPC may involve parotid nodes. The parotid gland may also be involved by extracapsular spread from enlarged cervical nodes or infiltrated directly by the primary lesion in the nasopharynx.

Pictorial review: radiology of the sphenoid bone

The sphenoid bone is located in the central skull base and forms part of the floor of the anterior and middle cranial fossae. The optic foramen, superior orbital fissure, foramen rotundum, foramen ovale and foramen spinosum are found within this complex bone. These foramina form important transition zones between intracranial and extracranial structures. Imaging plays a central role in delineating lesions within the sphenoid bone and the associated fissures and neural foramina. The purpose of this pictorial review is to highlight the pertinent normal and pathological anatomy of the sphenoid bone.

Carcinoma of the nasopharynx

Nasopharyngeal carcinoma (NPC) is an intriguing disease that shows a distinct geographical distribution with well-defined, high-risk ethnic groups. This neoplasm exhibits strong associations with the Epstein-Barr virus, dietary and genetic factors. Radiation therapy is the mainstay of treatment and imaging plays a central role in tumor mapping and radiation therapy planning. NPC provides an excellent model for the study of normal and pathological anatomy of the skull base. It also provides an excellent model in the study of consequences of radiation therapy.

Computed tomographic and magnetic resonance imaging findings in paranasal sinus involvement in nasopharyngeal carcinoma

Nasopharyngeal carcinoma (NPC) may spread to the paranasal sinuses. This retrospective study describes the features of paranasal sinus involvement in NPC on computed tomography (CT) and magnetic resonance imaging (MRI). One hundred and fourteen patients with histologically proven NPC underwent staging with both CT and MRI. Maxillary sinus infiltration was demonstrated on MRI in 10 patients; sphenoid sinus infiltration in 24 patients; and, ethmoid sinus involvement in 4 patients. CT could separate inflammatory changes from tumour in all maxillary sinuses but is less helpful in the sphenoid and ethmoid sinuses. Contrast-enhanced MRI could differentiate tumour from inflammatory changes in all sinuses. Using MRI as the standard, the rates of CT separating tumour from inflammation are: maxillary sinus (100%), sphenoid sinus (43%) and ethmoid sinus (25%). Histological confirmation of tumour involvement in the paranasal sinuses is not available. It is important to separate sinusitis from tumour infiltration as prognosis and treatment planning may be affected.

Comparison of CT and MRI features in sinusitis

OBJECTIVE

To correlate the features of inflammatory changes in the paranasal sinuses on magnetic resonance imaging (MRI) with computed tomography (CT).

METHODS AND PATIENTS

One hundred and fourteen patients with histologically proven nasopharyngeal carcinoma (NPC) were staged with both CT and MRI. All CT and MRI images of patients with mucosal thickening but no tumour involvement of the sinuses were retrospectively analysed.

RESULTS

There were inflammatory changes in 36 maxillary, 21 sphenoid and 16 ethmoid sinuses. These changes include mucosal thickening, retention cysts, retained secretions, inspissated secretions and dystrophic calcification. MRI is superior to CT in separating thickened mucosa, retained secretions and retentions cysts.

CONCLUSION

It is important to appreciate CT changes of sinusitis and the corresponding spectrum of MRI features.

Functional endoscopic sinus surgery (FESS): what radiologists need to know

The place of coronal computed tomography (CT) in the assessment of patients prior to functional endoscopic sinus surgery (FESS) is well established. The ability to accurately correlate radiological and surgical anatomy enhances precision and safety during FESS. This pictorial essay reviews the conceptual anatomical framework that forms the basis of FESS.

Radiology of the parapharyngeal space

The parapharyngeal space (PPS) is a central space in the deep neck. Intrinsic lesions within this space are limited. Other spaces in the neck are closely related to the PPS and the direction of displacement of this space often suggests the origin of a lesion. The morphology of a lesion, together with the site of origin, helps in narrowing the diagnostic possibilities. The behaviour of the PPS often helps to determine whether a lesion is an intrinsic abnormality or whether it arises from a neighbouring space. Such information is crucial in the planning of surgical approach and the placement of drains.

Hypoglossal nerve palsy in nasopharyngeal carcinoma

The carotid space and the last four cranial nerves are at risk when nasopharyngeal carcinoma (NPC) recurs or spreads posterolaterally. The objective of this study is to document the features of hypoglossal nerve infiltration and the appearance of the paralysed tongue. We reviewed hypoglossal nerve palsy in 16 patients with NPC. The following features were analysed: tumour morphology (submucosal spread), hypoglossal canal erosion, perineural infiltration or intracranial spread, other lower cranial nerve palsies, and appearance of the tongue. These findings were correlated with clinical records. All 16 patients had tumour recurrence following radiation therapy. In 7 patients (44 %), recurrence was submucosal. Hypoglossal canal involvement was seen in 12 patients (75 %). Isolated hypoglossal nerve palsy was noted in 5 patients (31 %) and 7 patients (44 %) had posterior cranial fossa tumour spread. Posterior displacement of the tongue was consistently well seen. In conclusion, tumour recurrence should be suspected in the presence of hypoglossal nerve palsy even when endoscopic findings are negative. Posterior displacement of the tongue, which has not been emphasised in the literature, is an easily recognisable sign and may indicate early hypoglossal nerve palsy.

Radiology of the jugular foramen

The jugular foramen, a complex bony canal, transmits vessels and nerves from the posterior cranial fossa through the skull base into the carotid space. It is inaccessible to clinical examination and radiology plays a central role in evaluating this region. Familiarity with the normal anatomy of this area will help in the formulation of differential diagnosis and the assessment of disease extent. Both intracranial and extracranial lesions may affect the jugular foramen in addition to intrinsic abnormalities. Normal variants and artefacts seen on magnetic resonance imaging (MRI) should not be mistaken for pathological processes.

The retropharyngeal space: route of tumour spread

The retropharyngeal space is a potential route for the spread of infection and malignancy. We present patients with squamous cell carcinoma of the larynx and tongue with superior contiguous spread along the retropharyngeal space resulting in skull base erosion. The fascia defining the retropharyngeal space is attached to the skull base and pathological processes can extend superiorly to destroy the skull base.

Temporal lobe necrosis in nasopharyngeal carcinoma: pictorial essay

Nasopharyngeal carcinoma (NPC) shows a high frequency of skull base erosion and intracranial spread. This tumour is usually treated with radiation therapy. The medial and inferior portions of both temporal lobes are included within the radiation portals. These areas are therefore potential sites of radiation-induced necrosis. It is important to recognize this complication and separate it from intracranial tumour recurrence because the treatments of these entities are different.

Pathogenesis of middle-ear effusion in nasopharyngeal carcinoma: a new perspective

The theory that middle-ear effusion (MEE) associated with nasopharyngeal carcinoma (NPC) is merely the result of tensor veli palatinus destruction is deficient because recent studies have shown that many patients with NPC have MEE but no tensor veli palatinus dysfunction. The present study evaluates the relationship between MEE and Eustachian cartilage erosion by NPC and examines the pathogenesis of NPC-associated MEE from a new perspective. Thirty-five patients with NPC were studied by magnetic resonance scans taken along the lengths of the Eustachian tubes. Twenty-four patients had tumour involvement of both sides of the nasopharynx so that 59 ears were available for study. Eighteen ears had MEE of which 12 had Eustachian cartilage erosion (p < 0.00001), Fischer's Exact Test). In ears with MEE, Eustachian cartilage erosion was frequently but not necessarily associated with tensor veli palatinus destruction. We postulate that altered Eustachian tubal compliance as a result of cartilage erosion by tumour is an important reason why middle-ear effusions develop in patients with NPC.

Pterygopalatine fossa and maxillary nerve infiltration in nasopharyngeal carcinoma

BACKGROUND

Nasopharyngeal carcinoma (NPC) may infiltrate the pterygopalatine fossa (PPF) and the maxillary nerve. This study illustrates involvement of the maxillary nerve in the PPF with perineural spread to the cavernous sinus.

METHODS

One hundred and fourteen patients with proven NPC were studied using magnetic resonance imaging (MRI) and computed tomography (CT). The images were retrospectively reviewed for PPF infiltration and maxillary nerve involvement.

RESULTS

Seventeen (15%) patients showed infiltration of the PPF. Four patients had maxillary nerve involvement and a perineural spread to the cavernous sinus. Of the 17 patients with PPF infiltration, 8 (47%) patients showed hypoesthesia in the distribution of the infraorbital nerve. All 4 patients with contrast-enhancement of the maxillary nerve exhibited infraorbital neuropathy.

CONCLUSION

Infiltration of the maxillary nerve in the PPF with intracranial spread is uncommon but should be suspected in patients with infraorbital neuropathy. This is important as it affects both prognosis and radiation treatment planning.

Sequence analysis of the small cryptic Xanthomonas campestris pv. vesicatoria plasmid pXV64 encoding a Rep protein similar to gene II protein of phage 12-2

The complete nucleotide sequence (1,851 bp) was determined for the Xanthomonas campestris pv. vesicatoria plasmid pXV64. Sequence analysis revealed an intergenic region (IG) of 355 bp and two oppositely running open reading frames, ORF1 and ORF2, encoding polypeptides of 39 and 16 kDa, respectively. While the function of ORF2 is not known, ORF1 is suggested to be the gene encoding Rep protein based on (i) similarity in amino acid sequence to that of the gene II protein (gIIP) of filamentous phage 12-2, (ii) presence of a sequence in the ori-containing region which is similar to the sequence around the Rep nicking site in some rolling circle-replicating replicons, and (iii) ability to support replication in trans of the region containing pXV64 ori (392 bp) which is located within the region including IG and a short stretch in the N-terminus of ORF2.

Detection of recurrent nasopharyngeal carcinoma: MR imaging versus CT

PURPOSE

To compare the use of magnetic resonance (MR) imaging and computed tomography (CT) in detection of recurrent nasopharyngeal carcinoma.

MATERIALS AND METHODS

Forty-five sets of CT and MR images were obtained in 34 patients. The images were placed in three categories: (a) clinically or radiologically abnormal findings in patients who underwent biopsy (n = 16), (b) clinically normal and radiologically borderline findings in patients who were followed up clinically and radiologically (n = 10), and (c) clinically and radiologically normal findings in patients who were monitored only clinically (n = 19). All images were read by two observers independently.

RESULTS

There were nine positive and seven negative biopsy results. All patients in the latter two categories had normal findings at followup. CT had a sensitivity of 45% and 67% and a specificity of 64% and 70% for each of the two observers. MR imaging had a sensitivity of 56% (for both observers) and a specificity of 78% and 83%. The kappa test for interobserver concordance was 0.53 for CT and 0.66 for MR imaging.

CONCLUSION

Both modalities have relatively low sensitivity and moderate specificity in detection of tumor recurrence and in distinguishing recurrence from post-radiation therapy changes.