[Analysis on the characteristics of natural foci of hemorrhagic fever with renal syndrome in Gansu Province, 2012-2022]

Objective: To explore the characteristics of natural foci of hemorrhagic fever with renal syndrome (HFRS) in Gansu Province. Methods: The information of HFRS case data and rodent density monitoring data from 2012 to 2022 in Gansu Province were collected and epidemiological methods were used to analyze and investigate the characteristics of the epidemic focus. Results: A total of 869 cases of HFRS were reported, and four patients died from 2012 to 2022. The annual incidence rate is between 0.05 per 100 000 and 1.21 per 100 000. The cases were mainly distributed in the eastern, southeast, southern, and south of the central region of Gansu Province. Most cases were distributed between age 20-60, and the sex ratio was 1.85∶1 (564∶305). Most cases were farmers (61.80%, 537/869), herdsmen (19.79%,172/869) and students (6.33%, 55/869). In a wild rat-type epidemic focus,the incidence peak was from November to January of the following year. The natural rodent hosts of HFRS were Rattus norvegicus, Apodemus agrarius, and Mus musculus. The hantaan virus carriage rates were 2.79% (21/754), 0.42% (5/1 179) and 0.31% (2/643),respectively. Three epidemic foci were defined: two derived from the Pingliang and Gannan prefecture new outbreaks epidemic foci, respectively, while the other was the residue of the Dingxi epidemic focus. Conclusions: The southern, south of the central region and eastern part of Gansu Province are current key HFRS epidemic foci dominated by Rattus norvegicus, Apodemus agrarius, and Mus musculus, respectively. The virus genotype is hantaan virus. Case reporting areas should strengthen epidemic monitoring; the key epidemic areas should strengthen and implement various prevention and control measures to reduce the harm caused by HFRS.

[Application of bridging study design in preventive vaccine clinical trials]

Bridging study in vaccine clinical trials means a series of small-scale additional tests on the basis that the original safety and effectiveness of a vaccine have been confirmed in clinical trials, to prove that the characteristics of safety, immunogenicity and effectiveness of a vaccine are similar or consistent after component, population and immunization procedure change to other types which can extrapolate data from existing clinical trials. Compared with traditional vaccine clinical trials, bridging trials can promote the approval of vaccines to the market, accelerate the expansion of vaccine application, and promote the use of vaccines across regions and populations. In recent years, the application of bridge study design in vaccine clinical research has become more and more common. In order to better guide and promote the application of bridging trial design in the field of vaccine clinical research, we reviewed the design characteristics and application examples of bridging study design in vaccine clinical trials, and systematically elaborated the design ideas, key points and statistical evaluation methods of bridging study.

[Research and discovery of "inner GPS" of brain]

Since the 20th century, with the progress of brain science research, scientists have discovered the brain GPS, revealing the mechanism of brain spatial cognition. The discovery process of brain GPS has gone through three stages. In 1971, John O'Keefe discovered the position cells in the hippocampus of the brain, which was the beginning of the research on the GPS in the brain; In 1900, James Rank discovered the head direction cells in the medial entorhinal cortex of the brain, and the research on the GPS in the brain made a breakthrough; In 2005, Edvard I. Moser and his wife discovered grid cells, marking the maturity of the research on GPS in the brain. The discovery of intracerebral GPS not only reveals the spatial cognitive function of the brain at the cellular level, but also provides a theoretical basis for the study of diseases related to the nervous system.

[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.

[Drug resistance and genomic characteristics of a strain of O139 Vibrio cholerae isolated from human bloodstream infection]

Objective: To analyze the drug resistance and genomic characteristics of a strain of serogroup O139 Vibrio cholerae producing cholera toxin isolated from the bloodstream of a person with bacteremia. Methods: The broth dilution method and automatic drug sensitivity analyzer were used to determine the antibiotic sensitivity of the strain. The complete genome sequence of the strain was obtained by using second-generation gene sequencing and nanopore sequencing. BLAST software was used for comparison and analysis with CARD, Resfinder, ISfinder, VFDB, and other databases. The drug-resistant genes, insertion sequences and virulence genes carried by the strain were identified. MEGA 5.1 software was used to construct a genetic phylogenetic tree based on the core genomic single nucleotide polymorphisms. Results: V. cholerae SH400, as the toxigenic strain, carried multiple virulence-related genes and four virulence islands. The strain was resistant to streptomycin, tetracycline and cotrimoxazole, carrying corresponding drug-resistant genes. The strain also carried IncA/C plasmid with the size of 172914 bp and contained 10 drug-resistant genes. Combined with the genomic evolutionary relationship, this study found that the drug-resistant genes and drug-resistant plasmids carried among strains showed certain aggregation. The traditional ST type of strain SH400 was ST69, and the cgMLST type was a new type highly similar to cgST-252. Conclusion: This strain of serogroup O139 V. cholerae carries the ctxAB gene, multiple drug-resistant genes and IncA/C plasmid, and there are multiple drug-resistant islands.

[Family-based association tests for rare variants]

Next-generation sequencing has revolutionized family-based association tests for rare variants. As the lower power of genome wide association study for detecting casual rare variants, methods aggregating effects of multiple variants have been proposed, such as burden tests and variance component tests. This paper summarizes the methods of rare variants association test that can be applied for family data, introduces their principles, characteristics and applicable conditions and discusses the shortcomings and the improvement of the present methods.

[Advances in clinical research of virus vector-based COVID-19 vaccines]

The COVID-19 outbreak at the end of 2019 has accelerated the development and research for COVID-19 vaccines worldwide. Among the COVID-19 vaccines in clinical trials developed via different platforms, recombinant virus vector-based vaccines have shown excellent immunogenicity and efficacy. However, at the same time, there are serious issues such as vaccine safety and pre-existing antibodies against vectors. This article summarizes the design concept and development history of recombinant virus vector-based vaccines, and focuses on the progress in the clinical studies of vector-based COVID-19 vaccines as well as the challenges, in order to provide reference for the research of recombinant vector-based vaccines.

[Early German research on virology and establishment of the specialised research institution]

Aftosa spread rapidly in Europe at the end of the 19th century.The German imperial government was concerned about it and appointed some scientists, such as Friedrich Loeffler and Paul Frosch, to do the research on it and they identified the virus of Aftosa in 1897. An experimental study was planned to be conducted by Friedrich Loeffler at the Greifswald Institute of Hygiene at a farm outside the city in 1899, but cancelled by the Government concerned about potential safety hazards in the research sites. After three years of preparation, the first virology research institution in the world was established by Friedrich Loeffler and others on Riems Island in Germany on October 10, 1910. This old virology research institution has now become the Federal Animal Health Research Center, making significant contributions to human research on zoonotic diseases.

[ALPK3 gene-related pediatric cardiomyopathy with craniofacial-skeletal features: a report and literature review]

Objective: To explore the clinical characteristics and mutation spectrum of ALPK3-related pediatric cardiomyopathy and craniofacial-skeletal abnormalities in children. Methods: The clinical data during a follow-up of 11 years including clinical features, echocardiogram, electrocardiogram, cardiac magnetic resonance, genetic testing, and other data of a child firstly diagnosed with ALPK3 gene-related cardiomyopathy and craniofacial-skeletal abnormalities in China were collected retrospectively. The literatures containing the keyword of "ALPK3 gene" published in the China National Knowledge Infrastructure, Wanfang database and PubMed were collected up to November 2020. Then, the clinical features and gene mutations of ALPK3 gene-related pediatric cardiomyopathy with craniofacial-skeletal features were summarized. Results: A female patient aged 10 months who presented with an enlarged heart for 2 months, was admitted to the hospital and initially diagnosed with endocardial elastic fibrosis. The echocardiography showed features of dilated left ventricle (LV) and LV systolic dysfunction. Low-set ears, webbed neck, a grade 2/6 systolic murmur at lower left sternal area and bilateral absent flexion creases of dig were observed. After treatment, the size and function of the heart recovered to normal at age 13 months. However, the ventricular septum and LV wall were thicker than normal values. Then, the diagnosis was revised to hypertrophic cardiomyopathy(HCM) and suspected congenital malformation syndrome. LV hypertrophy (LVH) progressed slowly before the age of 8 years and then progressed rapidly. At age 9 years, compound heterozygous ALPK3 mutations (c.721dup, p.Y241Lfs*42(exon 1) and c.4840C>T, p.R1614*(exon 10)) were detected in the proband and the mutations had not been reported previously. Then, the final diagnosis of ALPK3 gene-related pediatric cardiomyopathy with craniofacial-skeletal features was made. During the follow up of 11 years, regular follow-up echocardiographic images showed progressive LVH. At age 11 years, electrocardiogram showed LVH, ST-T changes in multiple-lead, T wave inversion, and prolonged QT intervals. Cardiac magnetic resonance showed biventricular hypertrophy and late gadolinium enhancement showed non-uniform enhancement of left and right ventricular myocardium. A total of 7 articles published in English were retrieved, and no Chinese literature was found. Twenty-eight cases were reported in the articles plus the patient in this study. Twenty-four mutations were reported worldwide, 18 patients carried homozygous mutations and 10 patients compound heterozygous mutations. Eleven patients showed dilated cardiomyopathy (DCM) at early stage of disease, and 10 of them transitioned to HCM at the disease progression stage. Eight patients presented with HCM at early stage of disease. Nine patients initially exhibited a mixed phenotype of DCM and HCM, and 6 of them eventually progressed to HCM. Electrocardiogram showed prolonged QT interval. Extracardiac features included short stature, special face, cleft palate, webbed neck, joint contracture, and scoliosis, etc. Conclusions: Progressive myocardial hypertrophy is a major feature of ALPK3 gene-related cardiomyopathy with craniofacial-skeletal malformations. Precise diagnosis depends on molecular genetic techniques. More cases should be accumulated for further analysis on the genotype-phenotype correlation and prognosis assessment.

[The development history of oral contraceptives]

The creation of oral contraceptives goes back 60 years. It has gone through a long and complex process from the discovery of sex hormones to their development into drugs to market. A correct understanding of the developmental history of oral contraceptives is of great importance for human reproduction. Gregory G Pincus successfully synthesized the first oral contraceptive Enovid based on research by Carl Djerassi, this was approved for marketing by the US Federal Drug Administration (FDA) in May 1960. However, due to the severe side effects of Enovid, the safer and more effective second generation oral contraceptives - Levonorgestrel and the third generation oral contraceptives - Pregnene are widely used and continue to be used to this day. The introduction of oral contraceptives not only dampened the explosive growth of the world's population, but also improved the social status of women, and catalyzed the sexual liberation movement.

[A multicenter survey of the accessibility of essential medicines for children in China]

Objective: To investigate the availability, prices and affordability of essential medicines in pediatric population across China, in the hope of improving rational use of medicines. Methods: A multicenter cross-sectional survey of medicine prices, availability and affordability was conducted in 17 provinces, municipalities and autonomous region across east, south-central part, west and north of China. Data on 42 medicines used in pediatric population, both original and generic, were collected in 55 public hospitals from May 26 to June 2, 2017. Availability was expressed as the percentage of hospitals with stock of the target medicine on the day of data collection,and median price ratio (MPR) was the ratio of price upon investigation to international reference. Based on national minimum daily wage, affordability represents the number of working days needed to earn the expense which covers a standard course using the target medicine. Statistical software SPSS 13.0 was applied for descriptive analysis of availability, MPR and affordability. Results: Mean Availability of original and generic medicine was 33% and 32%, with median MPR being 5.43 and 1.55. Among the 19 medicines with price information for both original and generic product, the median MPR was 7.73 and 2.04 respectively. Regarding the five medicines used to treat four common pediatric diseases (pneumonia,peptic ulcer, congenital hypothyroidism, refractory nephrotic syndrome), the affordability was 0.63 (0.16-6.17) d for generic medicine, and 1.03 (0.16-11.53) d for its original counterpart. Conclusions: The availability to both original and generic products of the 42 medicines used in pediatric population was low in China. The prices of generic medicines seem to be lower and affordability higher than those of original medicines. There is an urgent need to improve the availability and affordability of pediatric medicines.

[Genomic recombination of the vibrio cholerae serogroup O1 El Tor pandemic strains]

Objective: To analyze the genomic recombination of the vibrio cholerae serogroup O1 El Tor pandemic strains. Methods: A total of 292 complete or draft genome sequences of Vibrio cholerae O1 serogroup El Tor strains isolated from 1937 to 2015 were selected from National Biotechnology Information Center database. The genome alignment of strains was computed by snippy software by using N16961 as reference sequence. Then ClonalFrameML software was used to do the recombinant analysis. The wilcox.test function in agricolae package was used to compare the number recombinant segments and the total length of recombinant regions between small and large chromosomes. The kruskal function was used to compare the number recombinant segments and the total length of recombinant regions among different isolation continents. The KOBAS tool was used to do the gene ontology enrichment analysis of recombinant hotspot genes. Results: Of all 292 strains of Vibrio cholerae, 163 strains (55.8%) were recombined. The median of normalized recombinant segment number of small chromosome was 4.7×10(-6) (9.3×10(-7), 2.0×10(-5)), which was significantly larger than that of large chromosome [2.4×10(-6) (3.4×10(-7), 5.7×10(-6))] (P<0.001). The median (P(25),P(75)) of recombinant segment number of strains isolated from Africa, Asia, Europe, North America and South America were 23(1.0,33.0), 1.0(0.0,34.0), 6.0(2.0,13.0), 0.0(0.0,1.0) and 29.5(6.8,56.8), respectively, and the difference was statistically significant (P<0.001). The median (P(25),P(75)) of total length of recombinant regions of strains isolated from Africa, Asia, Europe, North America and South America were 233.0(4.0, 461.0), 11.0(0.0, 695.5), 56.0(4.0,111.0), 0.0(0.0,9.0) and 347.5(132.8,1 323.5) bp, respectively, and the difference was statistically significant (P<0.001). Gene ontology Enrichment analysis showed that the functions of 62 recombinant hotspot genes were mainly enrichment in chemotaxis, taxis, response to external stimulus, receptor activity and molecular transducer activity. Conclustion: In this study, we found that there were significant differences in the number of recombinant fragments and the length of recombinant regions between large and small chromosomes of Vibrio cholerae El Tor. We also found significant differences in the number of recombinant fragments and the total length of recombinant regions among different continents.

[Gas Disease Special in Chinese Medical Journal and Lester Institute of Medical Research]

In the September of 1937, there was a special issue named Military Gas Disease Prevention and Simple Therapy published in Chinese Medical Journal. The special issue included chemical composition of gas, gas classification, vesiculation gas, other poisons, treatment of victims, emergency services, etc. The special issue was published at the time when Japan began its full-scale invasion of China, and during that time, Japan sent some of its chemical forces to Shanghai to cooperate with the Japanese army in using chemical weapons during the Battle of Shanghai. The author of this special issue was the Department of Pathology of the Lester Institute of Medical Research. Under the auspices of the heritage of the British Christian and architectural engineer Lester-Lester Trust, the Lester Institute of Medical Research was established in 1932. The gas disease special and related rescue work done by Lester Institute of Medical Research made an important contribution to the medicine, military medicine and national defense medicine of China during the wartime and even when and after the People's Republic of China was found.

[Jean-Martin Charcot, discovery and nomenclature of amyotrophic lateral sclerosis]

In the 19th century, neurologists discovered a series of diseases characterized by limb weakness and muscle atrophy, but it was not certain whether they were variants of the same disease or completely different diseases. In 1869, Jean-Martin Charcot first diagnosed the disease, and began to use the term "amyotrophic lateral sclerosis" in 1874. The disease is also known as "Lou Gehrig's disease" in the United States, "Charcot's disease" in France, and "Motor Neuron Disease (MND)" in UK. In China, it is commonly known as "Jian-Dong Ren disease" .

[Vertigo in children：composition and clinical characteristics]

Objective: To explore composition and characteristics of vertigo in children. Method:The diagnosis, medical history and examinations of 46 patients (≤17 years old) with vertigo were studied retrospectively. Result:Of the 46 children patients with vertigo enrolled in this study, 19 patients were with BPVC(41.3%), 11 patients with VM(23.9%),4 patients with BPPV(8.7%), 3 patients with unclassifiable vestibular syndrome(6.5%), 2 patients with Meniere's disease (4.3%), 1 patient with sudden deafness with vertigo, 1 patient with labyrinthitis, 1 patient with vestibular paroxysmal, 1 patient with vestibular neuritis, 1 patient with head trauma, 1 patient with light cupula, 1 patient with benign paroxysmal torticollis (2.2%, respectively). The statistical analysis was conducted among 4 kinds of the most common causes of vertigo in children. There was no significant differences in sex composition among different groups(P>0.05). The mean age and mean age of onset in patients with BPVC were the youngest(P<0.05). Headache was complained more often in patients with VM(P<0.05) and there was no difference in other accompanying symptoms (such as nausea, vomiting and tinnitus) among each groups(P>0.05).Most patients with VM had family history of vertigo or migraine, but not in patients with VM and patients with BPVC(P>0.05). Conclusion:The most common vertigo in children were BPVC, VM and BPPV. The medical history, physical examinations and vestibular function tests can help doctors to diagnose more correctly.

[The beginning of modern nursing education: the first hospital nursing school in the United States at New England Hospital for Women and Children]

In 1872, New England Hospital for Women and Children was established as the first hospital nursing school in the United States, which became the beginning of modern nursing education in the United States. Its establishment and development were influenced by Nightingale's nursing educational thought, and were also closely related to the work of two American female doctors. The establishment of New England Hospital for Women and Children nursing school made it possible to train professional nurses through formal nursing education, and laid the foundation for the development of nursing education in the United States.

[Effect of microRNA-27a-3p on proliferation, apoptosis and cell cycle of hepatoma cells]

Objective: To investigate the effect of miR-27a-3p on proliferation, apoptosis and cell cycle of hepatoma cells. Methods: A quantitative real-time polymerase chain reaction (qPCR) was used to detect differential expression of miR-27a-3p in normal hepatic epithelial cells (L02) and hepatoma cells (HepG2 and PLC). Cell experiment was divided into four groups: HepG2 overexpression cells, Mi-27a-3p overexpression group (Mi-27a) and negative control group (Mi-Con); PLC knockdown cells, Mi-27a-3p knockdown group (Mi-inhibitor-27a) and negative control group (Mi-inhibitor-Con). The expression of microRNA-27a-3p in each group after transfection was detected by qPCR analysis. MTT assay was used to detect the cell proliferation. Flow cytometry was used to detect the apoptosis and cell cycle. One-way ANOVA was used for multiple comparisons, and t-test was used to compare two groups. Results: qPCR results showed that the expression levels of miR-27a-3p in L02, HepG2 and PLC increased sequentially, and the relative expression levels were 1.07 ± 0.04, 4.81 ± 0.64 and 11.31 ± 0.92, respectively (P < 0.05). MTT assay showed that the cell viability of HepG2 cells transfected with miR-27a-3p overexpression plasmid was significantly decreased compared with the negative control group (P < 0.05). The apoptosis assay showed that the apoptosis rate of miR-27a-3p overexpression group was higher than the negative control group (P < 0.05). The cell cycle results showed that the proportion of S phase cells in the miR-27a-3p overexpression cell group was significantly lower than the negative control group (P < 0.05). Furthermore, microRNA-27a-3p knockdown validation in PLC cells showed that MTT, apoptosis and cell cycle tests results were opposite to the results of HepG2 overexpression cells, and the differences were statistically significant (P < 0.05). Conclusion: miR-27a-3p can significantly inhibit the proliferation of hepatoma cells, promote cell apoptosis, alter the cell cycle distribution, and may become a potential target in hepatocellular carcinoma therapy.

Alterations of intestinal flora and the effects of probiotics in children with recurrent respiratory tract infection

BACKGROUND

Recurrent respiratory tract infection (RRTI) is a disease occurred frequently in preschool children.

METHODS

A total of 120 RRTI children were randomly divided into active group, remission group, intervention group and control group, meanwhile 30 healthy children were selected as the healthy group. Children in the intervention group were given oral Bifidobaeterium tetravaccine tablets (Live) for 2 months, while the control group received routine treatment. Stool sample were detected to analyze the bacterial strains. The occurrence of respiratory tract infection (RTI) was compared between different groups during 1 year follow-up.

RESULTS

Compared with the healthy group, the number of Bifidobacteria and Lactobacilli in the active group, remission group, intervention group and control group was significantly decreased (P < 0.05). The number of Bifidobacteria and Lactobacilli in the intervention group was significantly higher compared to other RRTI groups (P < 0.05). During the follow-up period, the average annual frequency of different acute RTI and use of antibiotics were significantly reduced (P < 0.05), the average duration of cough, fever and use of antibiotics at each episode were also significantly shortened (P < 0.05) in the intervention group compared to the control group.

CONCLUSIONS

Children with RRTI are susceptible to intestinal flora imbalance. Oral probiotics can effectively improve the RRTI intestinal microecological balance in children and reduce the frequency of RTI.

[Multicenter investigation of extracorporeal membrane oxygenation application in pediatric intensive care unit in China]

Objective: To survey the conduction and evaluate the effectiveness of extracorporeal membrane oxygenation (ECMO) therapy in pediatric intensive care unit (PICU) in China mainland. Methods: In a questionnaire-based survey, we retrospectively reviewed the application of ECMO in children's hospital and general hospital in China mainland to summarize and analyze the categories of diseases and prognosis of children treated with ECMO therapy. Results: By December 31, 2017, a total of 23 hospitals using ECMO, including 22 tertiary referral hospitals and 1 secondary hospital, among which 16 were children's hospitals and 7 were general hospitals. Thirty-seven ECMO equipment was available. A total of 518 patients treated with ECMO, within whom 323 (62.4%) successfully weaned from ECMO and 262 (50.6%) survived to discharge. Among 375 pediatric patients, 233 (62.1%) were successfully weaned from ECMO and 186 (49.6%) survived to discharge. Among 143 newborn patients, 90 (62.9%) successfully weaned from ECMO, 76 (53.1%) survived to discharge. ECMO was applied in veno-arterial (VA) mode to 501 (96.7%) patients, veno-venous (VV) mode to 14 (2.7%) patients, and VV-VA conversion mode to 3 (0.6%) patients. Sixty-nine patients required extracorporeal cardiopulmonary resuscitation (ECPR), including 20 newborn patients (29.0%) and 38 pediatric patients (71.0%), who were all with cardiovascular disease. Neonatal respiratory distress syndrome (26/61), persistent pulmonary hypertension of the newborn (PPHN) (12/61), and meconium aspiration syndrome (MAS) (11/61) are the most common pulmonary diseases in newborn patients; among whom, infants with PPHN had highest survival rate (10/12), followed by MAS (9/11). Among newborn patients with cardiovascular diseases, those who admitted were after surgery for congenital cardiac disease were the most common (54/82), while those with septic shock had the highest survival rate (2/3). In pediatric pulmonary diseases, acute respiratory distress syndrome was the most common (42/93), while plastic bronchitis was with the highest survival rate (4/4), followed by viral pneumonia (13/16). Among pediatric cardiovascular diseases, congenital cardiac defect was the most common (124/282), while fulminant myocarditis had the highest survival rate (54/77). Conclusion: The application of ECMO as a rescue therapy for children with severe cardiopulmonary failure has dramatically developed in China mainland.

[Clinical features of children with Epstein-Barr virus-related acute liver failure: an analysis of four cases]

A retrospective analysis was performed for the clinical data of four children with Epstein-Barr virus (EBV)-related acute liver failure. There were two boys and two girls with a median age of 10 months (range 8.5-44 months). Of the four children, three were diagnosed with infectious mononucleosis (IM), among whom two met the diagnostic criteria of hemophagocytic lymphohistiocytosis (HLH), and one was diagnosed with past EBV infection. All the children had positive EBV DNA in blood and all had pyrexia, hepatomegaly, and jaundice on admission. Three children had the symptom of splenomegaly, ascites, or vomiting. Two children had enlargement of cervical lymph nodes, skin rash, or pleural effusion. One child had gastrointestinal bleeding or stage 2 hepatic encephalopathy. All the children had an abnormal lymphocyte count of <10%, and only one child had leukocytosis and thrombocytopenia. Among the four children, alanine aminotransferase level increased by 10-100 times; total bilirubin level increased by 3-5 times; lactate dehydrogenase level increased by many 10 times; prothrombin time prolonged significantly. All the children were given antiviral therapy with intravenously injected acyclovir or ganciclovir, as well as hepatocyte growth factor to promote hepatocyte growth and hormone to alleviate inflammatory response. Two children were given plasma exchange in addition, among whom one was given the combination of continuous venovenous hemodiafiltration. Two children with HLH were given chemotherapy according to the HLH-2004 regimen. Three children survived, and one child with HLH died of multiple organ failure. It is concluded that EBV infection can cause acute liver failure and that early use of multimodality therapy including blood purification may be beneficial for prognosis in these children.

[Application of superselective lingual artery embolization in treatment of severe hemorrhange in patients with carcinoma of tongue]

To explore the clinical value of superselective lingual artery embolization in treating the severe hemorrhage in patients with advanced carcinoma of tongue. Four patients with advanced tongue cancer hemorrhage from March 2014 to February 2016 were enrolled in this study. T3N2M0 (2 cases) and T4N1M0 (2 cases) were diagnosed preoperatively. Two cases of advanced tongue carcinoma tumors had severe bleeding and the other 2 cases of hemorrhage were after radiotherapy. All cases including 3 squamous cell carcinoma and 1 adenocarcinoma were firstly demonstrated by arterigraphy under seldinger technique with digtial subtraction angiogarphy to ensure the rupture site and then all cases were followed by superselective artery embolization. The efficacy and complications of interventional embolizationg were observed. There was no serious complication of central nervous system injury such as hemorrhage and hemiplegia during follow-up. Superselective lingual artery embolization can accurately locate the responsibility of blood vessels, and the injury is small, significant effect, fewer complications.

[Brief history of the First Hospital of Harbin City (1913-2013)]

In 1913, after the Russian Prostitutes Sanatorium of Harbin Eastern Railway was received by the board of directors, they established the "Harbin City Board Hospital" and funded its expansion. In March 1926, the provisional Committee of the Harbin autonomous renamed the "City Board of First Hospital" to "The Public Hospital" . In November 1926, "The Public Hospital" was renamed as "Harbin Special Municipal Hospital" by the Harbin City Council and further funds were invested in its construction. In 1931, the Japanese invaded Northeast China, and controlled the "City Hospital" . In 1946, when Harbin was liberated, after the Communist's take-over of the Hospital, it developed sustainedly since then. From 1946-1949, The First Hospital of Harbin City dispatched manpower, material resources, and financial resources to support the people's Liberation Army, establishedthe medical service team, received and treated the wounded. From the 1930s, the Hospital was involved in the treatment of cholera, plague, scarlet fever, typhus and other infectious diseases, and participated in the medical rescue in Wenchuan of Sichuan and Xinjiang Aletai area. From 1928, the Hospital took over from Binjiang Hospital as the Teaching Hospital of Harbin Medical School, and later became the Harbin Medical University Teaching Hospital. It made contribution to the training of medical students.

[Value of European Organisation for Research and Treatment of Cancer score system for predication of immediate postoperative intravesical instillation of pirarubicin after transurethral resection of non-muscle invasive bladder cancer]

Objective: To assess value of immediate postoperative intravesical instillation of pirarubicin after transurethral resection (TURBT)of non-muscle invasive bladder cancer. Methods: 484 patients diagnosed with non-muscle-invasive bladder cancer admitted to the Second Affiliated Hospital of Kunming Medical University were divided into two groups after transurethral resection of bladder tumor. 285 patients received postoperative intravesical instillation of pirarubicin within 6 hours after the surgery, 199 patients received first instillation of pirarubicin at 10 days after the surgery, after that, all the patients received routine bladder perfusion chemotherapy. Patients who received intravesical instillation of pirarubicin within 6 hours were defined as immediate intravesical instillation group and the other patients as the control group. Based on the European Organisation for Research and Treatment of Cancer risk tables, scores of recurrence and progression of patients were calculated and then stratified into risk groups accordingly. Recurrence and progression rates of the immediate intravesical instillation group were analyzed and then compared with the corresponding reference of the risk tables. Results: The 1-year and 5-year recurrence rate of patients with EORTC table scoring 0 in the immediate intravesical instillation group were significantly lower than that of the EORTC reference group (5.3% and 14.0% vs 15.0% and 31.0%, P<0.05). 1-year recurrence free rate between the immediate intravesical instillation group and the control group in patients scoring 1-4 was significantly different (81.3% vs 76.7%, P=0.014). However, 1-year recurrence free rate of the immediate intravesical instillation group was comparable with that of the control group in patients scoring 5-9, 10-17(P>0.05), which is quite close to the EORTC reference. The probability rates of 1-year and 5-year progression of the 285 patients who received immediate intravesical instillation group did not show significant difference with the EORTC reference. On multivariate analysis, previous recurrence, tumor grade G2-3, tumor multiplicity, delay of immediate intravesical instillation were independent risk factors of recurrence(P<0.05). Conclusions: With the help of EORTC recurrence risk table stratifying the patients into different risk groups, our study showed that delay of immediate postoperative intravesical instillation of chemotherapy after TURBT was an independent risk factor of post-surgery recurrence of tumor. Moreover, patients with EORTC scoring 1-4 might obtain greatest benefits.

Comparison of nitrogen utilization and urea kinetics between yaks (Bos grunniens) and indigenous cattle (Bos taurus)

Under traditional management on the Qinghai-Tibetan Plateau, yaks () graze only on natural pasture without supplements and are forced to cope with sparse forage of low N content, especially in winter. In contrast, indigenous Tibetan yellow cattle () require supplements during the cold season. We hypothesized that, in response to harsh conditions, yaks cope with low N intakes better than cattle. To test this hypothesis, a study of whole-body N retention and urea kinetics was conducted in 2 concurrent 4 × 4 Latin squares, with 1 square using yaks and 1 square using cattle. Four isocaloric forage-concentrate diets differing in N concentrations (10.3, 19.5, 28.5, and 37.6 g N/kg DM) were formulated, and by design, DMI were similar between species and across diets. Urea kinetics were determined with continuous intravenous infusion of NN urea for 104 h, and total urine and feces were concomitantly collected. Urea production, urea recycling to the gut, and ruminal microbial protein synthesis all linearly increased ( < 0.001) with increasing dietary N in both yaks and cattle. Urinary N excretion was less ( = 0.04) and N retention was greater ( = 0.01) in yaks than in cattle. Urea production was greater in yaks than in cattle at the 3 lowest N diets but greater in cattle than in yaks at the highest N diet (species × diet, < 0.02). Urea N recycled to the gut ( < 0.001), recycled urea N captured by ruminal bacteria ( < 0.001), and ruminal microbial protein production ( = 0.05) were greater in yaks than in cattle. No more than 12% of urea recycling was through saliva, with no difference between species ( = 0.61). Glomerular filtration rate was lower ( = 0.05) in yaks than in cattle. The higher urea recycling and greater capture of recycled urea by ruminal microbes in yaks than in cattle suggest that yaks use mechanisms to utilize dietary N more efficiently than cattle, which may partially explain the better survival of yaks than cattle when fed low-N diets.

[Association between S100B gene polymorphisms and hand, foot and mouth disease caused by enterovirus 71 infection]

OBJECTIVE

To investigate the association between rs9722 polymorphisms in the S100B gene and hand, foot and mouth disease (HFMD) caused by enterovirus 71.

METHODS

A total of 124 HFMD children with enterovirus 71 infection were enrolled as subjects, and 56 healthy children were enrolled as control group. The rs9722 polymorphisms in the S100B gene were detected for both groups, and the serum level of S100B protein was measured for 74 HFMD children.

RESULTS

The rs9722 locus of the S100B gene had three genotypes, CC, CT, and TT, and the genotype frequencies were in accordance with Hardy-Weinberg equilibrium. Compared with the control group, the HFMD group had significant increases in the frequencies of TT genotype and T allele (P<0.01). Children with severe HFMD caused by enterovirus 71 infection had significantly higher frequencies of TT genotype and T allele than those with moderate or mild HFMD (P<0.05). Compared with the cured patients, the patients with poor prognosis had significant increases in the frequencies of TT genotype and T allele in the rs9722 locus of the S100B gene (P<0.05). Among the 74 children with HFMD, the children with TT genotype had the highest serum level of S100B protein, and those with CC genotype had the lowest level (P<0.01).

CONCLUSIONS

T allele in the rs9722 locus of the S100B gene might be a risk factor for severe HFMD caused by enterovirus 71 infection.

[Impact of blood pressure control on coronary flow reserve in hypertensive patients]

OBJECTIVE

To investigate the impacts of blood pressure control on coronary flow reserve (CFR) in hypertensive patients.

METHODS

A total of 236 patients without significant coronary stenosis (defined as <50% luminal narrowing which was confirmed by coronary angiography or coronary artery CT scan) between January 2011 to July 2015 were retrospectively enrolled in this study. CFR was measured in the left anterior descending coronary artery (LAD) during adenosine triphosphate-induced hyperemia by transthoracic Doppler echocardiography. Patients were divided into hypertension group (n=173) and non-hypertension group (n=63). The hypertension patients were further divided into ideally controlled (n=31, defined as SBP <120 mmHg (1 mmHg=0.133 kPa) and DBP <80 mmHg), controlled (n=82, defined as SBP 120 to 139 mmHg and DBP <90 mmHg) and uncontrolled groups (n=60, defined as SBP≥140 mmHg and/or diastolic DBP≥90 mmHg) based on their blood pressure after systematic antihypertensive therapy and CFR values were compared among the 4 groups. Multivariate regression analyses were performed to identify the independent determinants of CFR in patients with hypertension.

RESULTS

Compared with non-hypertension group, the CFR was significantly lower in controlled (3.27±0.71 vs. 2.87±0.56, P<0.001) and uncontrolled groups (3.27±0.71 vs. 2.61±0.71, P<0.001), but was similar in ideally controlled group (3.27±0.71 vs. 3.21±0.85, P=0.68). Furthermore, the CFR was significantly lower in uncontrolled group than that of the other two hypertension groups and was significantly lower in controlled group than that of ideally controlled group. Higher blood pressure (β=-0.17, P=0.03) and age(β=-0.02, P=0.03) were independent predictors of lower CFR in patients with hypertension.

CONCLUSIONS

Higher blood pressure is an independent predictor of decreased CFR in patients with hypertension. Hypertensive patients with ideally controlled blood pressure have similar CFR level as patients without hypertension.

Fabrication of nanopore and nanoparticle arrays with high aspect ratio AAO masks

How to use high aspect ratio anodic aluminum oxide (AAO) membranes as an etching and evaporation mask is one of the unsolved problems in the application of nanostructured arrays. Here we describe the versatile utilizations of the highly ordered AAO membranes with a high aspect ratio of more than 20 used as universal masks for the formation of various nanostructure arrays on various substrates. The result shows that the fabricated nanopore and nanoparticle arrays of substrates inherit the regularity of the AAO membranes completely. The flat AAO substrates and uneven AAO frontages were attached to the Si substrates respectively as an etching mask, which demonstrates that the two kinds of replication, positive and negative, represent the replication of the mirroring of Si substrates relative to the flat AAO substrates and uneven AAO frontages. Our work is a breakthrough for the broad research field of surface nano-masking.

[Early stage western hospitals in Harbin]

From 1900 to 1932, China Eastern Railway Central Hospital, Harbin Board First Hospital, Harbin Special City Second Hospital, Binjiang Hospital, Jewish Hospital, Kong's Hospital, Mingming Ophthalmic Hospital and other western medicine hospitals were established in Harbin. These Hospitals had different sources of funds and talents, different consumers, including general hospitals and specialized hospitals with integration of clinic, education and academic research, which encouraged the dissemination of western medicine in Harbin at the beginning of the 20th century.

Hybrid metamaterial switching for manipulating chirality based on VO2 phase transition

Polarization manipulations of electromagnetic waves can be obtained by chiral and anisotropic metamaterials routinely, but the dynamic and high-efficiency modulations of chiral properties still remain challenging at the terahertz range. Here, we theoretically demonstrate a new scheme for realizing thermal-controlled chirality using a hybrid terahertz metamaterial with embedded vanadium dioxide (VO₂) films. The phase transition of VO₂ films in 90° twisted E-shaped resonators enables high-efficiency thermal modulation of linear polarization conversion. The asymmetric transmission of linearly polarized wave and circular dichroism simultaneously exhibit a pronounced switching effect dictated by temperature-controlled conductivity of VO₂ inclusions. The proposed hybrid metamaterial design opens exciting possibilities to achieve dynamic modulation of terahertz waves and further develop tunable terahertz polarization devices.

A comparison of nitrogen utilization and urea metabolism between Tibetan and fine-wool sheep

To study metabolic adaptation to harsh foraging conditions, an experiment was conducted to characterize and quantify N utilization efficiency and urea metabolism in Tibetan and fine-wool sheep fed 4 levels of dietary N (11.0, 16.7, 23.1, and 29.2 g N/kg DM) in 2 concurrent 4 × 4 Latin square designs. Urea kinetics were determined using continuous intrajugular infusions of 15N15N-urea. Urinary excretions of total N and urea N increased linearly (P < 0.001) with dietary N and were not different between breeds (P ≥ 0.37). Fecal N excretion increased with dietary N for Tibetan sheep but not for fine-wool sheep (linear dietary N × breed; P < 0.05). Nitrogen retention (both amount per day and percentage of N intake) increased with increasing dietary N concentration (P < 0.001), and the rates of increase were greater in fine-wool than in Tibetan sheep (linear dietary N × breed and cubic dietary N × breed; P < 0.05). In Tibetan sheep, N retention as a percentage of intake was greatest for diets containing 16.7 g N/kg DM, whereas it was maximal for fine-wool sheep when the diet contained 23.1 g N/kg DM. Urea N entry rate, urea N recycled to the gastrointestinal tract (GIT), and urea N returned to the ornithine cycle all increased with dietary N (P < 0.05), and all were greater in Tibetan than fine-wool sheep for the 11.0 g N/kg DM diet but were greater in fine-wool than Tibetan sheep for the diet with 29.2 g N/kg DM (linear dietary N × breed; P < 0.05). Urea N excreted in feces, both amount and fraction of GIT entry rate, was less in Tibetan than fine-wool sheep for the 11.0 and 16.7 g N/kg DM diets but similar for diets with 23.1 or 29.2 g N/kg DM (linear dietary N × breed; P < 0.01). For the lowest-protein diet, the fraction of urea N production recycled to the GIT was greater in the Tibetan than fine-wool sheep (88% vs. 82%), but for the diet with 29.2 g N/kg DM it was greater for fine-wool than Tibetan sheep (46% vs. 39%; linear dietary N × breed; P < 0.05). Plasma urea N increased more rapidly in response to increasing dietary N concentration for fine-wool sheep than for Tibetan sheep (linear dietary N × breed; P < 0.05). Urea tubular load and the amount and percentage of urea reabsorbed by the kidney were greater in Tibetan than fine-wool sheep (P < 0.05). These results suggest that Tibetan sheep have mechanisms that allow them to utilize N more efficiently than the fine-wool sheep when dietary N is inadequate.

Silver nanoparticle film induced photoluminescence enhancement of near-infrared emitting PbS and PbS/CdS core/shell quantum dots: observation of different enhancement mechanisms

The photoluminescence (PL) enhancement of a Ag nanoparticle and near-infrared quantum dots (QD) plasmon/fluorophore system was investigated. Different enhancement mechanisms were obtained by tuning surface plasmon resonance of the Ag film and PL of the QDs. A maximum enhancement factor of 2.8 was achieved.

[Early history of medicine and health career in Harbin]

Harbin, located in the northeast of China, was still an agricultural region dominated by traditional natural economy in the late 19th century. Harbin became the"Eurasia land bridge"and the transportation junction of the northeast railway network, along with the building of Mid-east railway in 1898, which sped up the development of the city. With the influx of foreign workers and capital, in the 1930s, Harbin has become a city with 19 countries' consulates and nearly 100, 000 people from more than 20 foreign countries. In this international multicultural city, the rapid introduction and spread of western medicine showed the great effect for the development of medicine and health career, ranking the top in China.

[Practice and inspiration: Schweitzer's road to medicine and his view of life ethics]

Albert Schweitzer established the hospital in the African jungle and practiced medicine for over a half of century. He proposed"reverence for life"and became a thought and practice unifier. The Schweitzer's Hospital was not only a medical institution, but also a social institution for education. Later, the school, consulting office and medical institute were also set up in Africa. For over a century, the Schweitzer's Hospital always insisted on the ethics of respecting individual and reverence for life, which enlightened modern medical practice and medical education. The introduction of the ethics of"reverence for life"to clinical practice would exert very important effect for establishing the harmony and equality of doctor-patient relationship.

Purification, characterization, and heterologous expression of an antifungal protein from the endophytic Bacillus subtilis strain Em7 and its activity against Sclerotinia sclerotiorum

An antifungal protein exhibiting a high activity against Sclerotinia sclerotiorum in vivo was purified by ammonium sulfate precipitation, hydrophobic chromatography, and gel filtration chromatography from the culture filtrate of the endophytic Bacillus subtilis strain Em7. The protein was characterized as a β-1,3-1,4-glucanase according to amino acid analysis, and showed excellent properties in thermal stability and acid resistance. At the same time, the antifungal protein was cloned and heterologously expressed in Escherichia coli BL21. The recombinant protein was purified and showed similar enzymatic properties to the native protein, exhibiting strong inhibitory activity against S. sclerotiorum. This shows that the β-1,3-1,4-glucanase may play a very important role in B. subtilis Em7 biocontrol function. In addition, many physiochemical properties of the native and purified recombinant protein were compared, including the effect of pH, temperature, metal cations, substrate specificity, and kinetic parameters. All parameters were similar between the native and recombinant purified protein, indicating that the purified recombinant protein has potential for industrial applications.

[Effects of myocardial performance index on assessing left ventricular function in patients with primary hypertension]

OBJECTIVE

To investigate the value of myocardial performance index (MPI) in assessing LV function in patients with primary hypertension (HP).

METHODS

We studied 130 patients with HP (mean age 54.9±13.3 years)and 155 healthy control subjects (mean age 52.4±11.6 years). MPI was determined by tissue doppler imaging using the following formula: MPI=(isovolumic contraction time + isovolumic relaxation time)/ ejection time. The HP group was divided into hypertrophy subgroup( LVMI≥115 g/m(2) in males, or ≥95 g/m(2) in females) and normal mass subgroup(LVMI <115 g/m(2) in males, or<95 g/m(2) in females).

RESULTS

MPI was significantly different in control group, normal mass subgroup and hypertrophy subgroup(0.72±0.23 vs. 0.54± 0.17 vs. 0.45±0.11, P<0.001). Hypertrophy subgroup had significant higher MPI than normal mass subgroup(P =0.046), and both the groups had significant higher MPI than control group(all P<0.001). MPI was positively associated with age(r=0.369,P<0.001), Left ventricular end diastolic diameter(r=0.169, P<0.05), Sm(r=-0.211, P<0.001) and Em(r=-0.383, P<0.001) in control group. In multiple linear regression analysis, MPI was independently related to age (β=0.492, t=7.222,P<0.001) in control group. Among the HP patients, MPI was positively associated with left atrial area (r=0.293, P<0.001),intra ventricular septum(IVS) diameter (r=0.453, P<0.001), LVMI (r=0.453, P<0.001), relative wall thickness(r=0.458, P<0.001), and negatively associated with Sm(r=-0.414, P<0.001), Em(r=-0.508, P<0.001), left ventricular ejection fraction (r=-0.305, P<0.001) in bivariate analysis. In the multiple linear regression analysis, MPI was independently related to Em (β=0.401, t=4.256,P<0.001) and IVS diameter (β=-0.365, t=-3.878,P<0.001) in the HP patients.

CONCLUSION

The HP patients had elevated MPI, especially in the ones with LV hypertrophy. Tissue doppler imaging (TDI) derived MPI could be a useful index to evaluate the overall cardiac function in HP patients.

[Correlation between epicardial adipose tissue and coronary flow reserve in coronary heart disease patients with no chest pain]

OBJECTIVE

To assess whether epicardial adipose tissue (EAT) thickness is associated with coronary flow reserve (CFR) and could be used to detect coronary microvascular dysfunction.

METHODS

We enrolled 62 nondiabetic patients who underwent computed tomography angiography or invasive coronary angiography and had no obstructive coronary artery disease. CFR and EAT thickness were measured by transthoracic Doppler echocardiography (TTDE).

RESULTS

In the study, a total of 62 patients were enrolled, echocardiographic coronary flow reserve were obtained in 61 of the patients with a mean age of (59±10) years. 34 patients (56%) had reduced CFR (CFR<3, 2.52±0.32) suggesting microvascular dysfunction and 27 patients (44%) had normal CFR (CFR≥3, 3.56±0.52). EAT thickness was significantly increased in the patients with microvascular dysfunction as compared with those without [(3.4±0.8) mm vs. (2.3±0.6) mm, P<0.001]. EAT thickness was strongly related to CFR (r=-0.668, P<0.001). By Logistic regression analysis, EAT thickness was the independent predictor of coronary microvascular dysfunction (OR=7.78, 95%CI: 2.44-24.79). EAT thickness>2.9 mm had 82.4% sensitivity and 92.3% specificity to detect CFR<3 (area under ROC curve 0.860, P<0.001).

CONCLUSION

EAT thickness was significantly increased in patients with coronary microvascular dysfunction. EAT thickness was independently associated with impaired CFR. EAT>2.9 mm had high sensitivity and specificity to detect coronary microvascular dysfunction.

[Long-term effect of different right ventricular apex pacing ratio on heart structure and function of patients with dual chamber pacemaker]

OBJECTIVE

To evaluate Long-term effect of different right ventricular apex pacing ratio for heart structure and function of patients with dual chamber pacemakers.

METHODS

Patients who were implanted with dual chamber pacemakers at Department of Cardiology, Peking University Third Hospital were collected. The electrodes were put in right ventricular apex. All the patients, last pacemaker programming control and echocardiography results were followed up and collected.Patients with 10%-40% pacing ratio were rejected.

RESULTS

The total of 83 patients were enrolled in this study. The mean duration of the follow-up was (38±23) months. The morbility rates of moderate-severe mitral regurgitation (MR) and tricuspid regurgitation (TR) all significantly increased after implantation compared with those before implantation (6.2% vs. 2.6%, 11.1% vs. 4.9%, all P<0.01). There were 9 patients with moderate-severe TR after pacemaker implantation. They had higher pulmonary artery systolic pressure (PASP) and mitral diastolic early flow peak velocity/lateral mitral annulus diastolic early velocity (E/Em) [(49.6±10.5) mmHg vs. (33.8±12.0) mmHg, P<0.01, 1 mmHg=0.133 kPa; and 11±5 vs.9±3, P<0.05]. And 52 patients had less than 10% pacing ratio (group A) and 31 patients had more than 40% pacing ratio (group B). The right atrium area and right ventricular diastolic diameter were bigger after implantation than those before implantation in group B [(17.7±4.0) cm(2) vs. (15.6±3.2) cm(2), (21.5±4.4) mm vs. (19.9±3.4) mm, all P<0.05]. The morbility of pulmonary artery systolic pressure (PASP) ≥50 mmHg was higher after implantation than that before implantation in group B (9.7% vs. 3.2%, P<0.05). The left atrium area and right atrium area were bigger in group B than those in group A [(21.8±5.5) cm(2) vs. (20.2±4.6) cm(2), (17.7±4.0) cm(2) vs. (16.1±3.8) cm(2), all the P<0.05] after implantation, and lower left ventricular ejection fraction (LVEF) in group B than that in group A (68%±6% vs. 70%±6%, P<0.05).

CONCLUSION

Patients with higher right ventricular apex pacing ratio have bigger left atrium, right atrium and right ventricular, higher PASP and lower LVEF in the long term.

IMM-H004, a novel coumarin derivative compound, protects against amyloid beta-induced neurotoxicity through a mitochondrial-dependent pathway

We have investigated the effect of IMM-H004 (7-hydroxy-5-methoxy-4-methyl-3-(4-methylpiperazin-1-yl)-2H-chromen-2-one), a coumarin derivative, on the amyloid beta (Aβ)-induced neurotoxicity in primary culture cortical neurons and pheochromocytoma (PC12) cells. Our results showed that treatment with IMM-H004 markedly reduced the number of apoptotic cells after exposure to Aβ25-35 or Aβ1-42, determined by MTT, TUNEL staining and Flow cytometry. Further study indicated that IMM-H004 significantly inhibited Aβ-induced cytotoxicity and apoptosis by reversing Aβ-induced mitochondrial dysfunction, including MMP (mitochondrial membrane potential) decrease, reactive oxygen species production, and mitochondrial release of cytochrome c. IMM-H004 can regulate the interaction between Bax and Bcl-2, decreased levels of p53 and active caspase-3 protein induced by Aβ25-35. Furthermore, IMM-H004 also reduced translocation of AIF (apoptosis-inducing factor) induced by Aβ25-35. These results demonstrated that IMM-H004 was capable of protecting neuronal cells from Aβ-induced degeneration through a mitochondrial-dependent apoptotic pathway. The results of this study lend further credence to the notion that IMM-H004 is a 'multipotent therapeutic agrent' that reduces toxic levels of brain Aβ, and holds the potential to protect neuronal mitochondrial function in Alzheimer's disease.

High-resolution diffusion-weighted MR imaging of the human lumbosacral plexus and its branches based on a steady-state free precession imaging technique at 3T

3D diffusion-weighted steady-state free precession imaging (3D DW-SSFP) with isotropic resolution was performed to delineate structures of the human lumbosacral plexus (LSP). 3D DW-SSFP clearly revealed detailed anatomy of the LSP and its branches. Our data suggest that the sequence based on 3D DW-SSFP can be used for high-resolution MR imaging of the peripheral nervous system.

Effects of astragaloside IV on myocardial calcium transport and cardiac function in ischemic rats

AIM

To explore the effects of astragaloside IV (XGA) on myocardial calcium transport and cardiac function in ischemic rats.

METHODS

Eighty-four Wistar rats were divided into three groups: control group (n=12); ischemic group (n=12) was given isoprenaline injection sc at a dose of 30 mg/kg; and XGA group (n=60) was given XGA after isoprenaline administration. The changes of the parameters of hemodynamics, cardiac function, and intra- and extracellular calcium concentration of the myocardial cells were determined. The dose- and time-effect relationship of XGA on myocardial calcium transport and cardiac function were observed.

RESULTS

After XGA administration, there was significant improvement in cardiac function and hemodynamics in ischemic rats. The cardiac output, heart rate, stroke volume, mean aortic pressure, systolic aortic pressure, the stroke work of left ventricule, the right and left ventricle systolic pressure, and +dp/dt of the right ventricle of ischemic rats gradually recovered to the level of the control group with increasing the dose of XGA and prolongation of the action of XGA. The ionized calcium of the myocardium and the total amount of calcium of the myocardial tissue decreased markedly compared to those in ischemic group, and the activity of calcium pump of erythrocyte membrane increased significantly in comparison to that of ischemic group, but their changes had no trend of increase with increasing dose of the XGA. However, there was a gradual decrease of the ionized calcium of the myocardium with the prolongation of acting time of XGA.

CONCLUSION

XGA improves the cardiac function in ischemic rats, and the reduction of excessive accumulation of intracellular calcium within myocardial cells plays an important role.

Reduced length of stay by implementation of a clinical pathway for bariatric surgery in an academic health care center

Bariatric surgery is being performed in increasing numbers in an era when reimbursements are being reduced. Academic health centers bear the responsibility for training surgeons to perform these operations yet must keep costs to a minimum and retain high quality. The UCLA Bariatric Surgery Program developed a clinical pathway for the pre- and postoperative management for gastric bypass patients to achieve these goals. Medical records for 182 consecutive gastric bypass patients were retrospectively reviewed before implementation of the pathway (Group I) during the fiscal year of 1998/1999. Data on average length of stay, average intensive care unit length of stay, average standard variable cost, percentage readmission rate, and percentage return to the operating room were collected. This information was compared with the data collected prospectively from 182 patients after implementation of the pathway in July of 1999 (Group II) during the fiscal year of 1999/2000. Hospital cost per admission was reduced by 40 per cent in Group II compared with Group I (P < 0.02). The average length of stay was reduced from 4.05 days in Group I to 3.17 days in Group II (P < 0.033). Overall readmission rate was decreased from 4.2 per cent in Group I to 3.2 per cent in Group II (P < 0.05). There were no differences in morbidities between both groups. The pathway reduced costs by reducing the hospital length of stay, intensive care unit utilization, and readmission rates. Quality was maintained as evidenced by a similar pattern of postoperative morbidities yet readmission rates were reduced. Our results indicate that implementation of a clinical pathway for bariatric surgery reduces cost and improves quality of care in an academic institution.

Redistribution index and relative binding intensity of heavy metals in salt-amended soils

Redistribution processes of heavy metals and their binding intensity in salt-amended arid-zone soils were analyzed under saturated, field capacity and wetting-drying cycle moisture regimes. Two newly developed parameters, redistribution index and reduced partitioning parameter, were used to depict the removal/attainment of metal-amended soils from/to the fractional distribution pattern in the native soils and the relative binding intensity of metals in the amended soils, respectively. Metal-amended soils, in forms of salts approached the fractional distribution pattern in the non-amended soils with time. The rates at which the metal-amended arid-zone soils approached the fractional distribution pattern characteristic of the native soil were affected by the nature and loading levels of the metals, soil properties and time. Metals in amended soils at low loading levels approach the fractional distribution pattern characteristic of non-amended soil more rapidly than at high loading levels. The sequences of approach by various metals to the fractional distribution pattern in the native soil are as follows: Cd > Cu > Ni, Zn > Cr. Moisture regime, however, did not considerably affect the metal-amended soils' overall rates of approach to the fractional distribution pattern prevailing in the non-amended soils. The binding intensity of metals in soils was affected by the nature of metal, loading level, soil properties and time. In both non-amended and amended soils, Cr had highest binding intensity, Cd lowest and Cu, Ni and Zn intermediate. The binding intensity decreased with the loading level of the metals and increased with time. The redistribution index and reduced partitioning index can quantitatively and effectively depict the kinetics of redistribution processes of metals and their relatively binding intensity in waste-amended soils.

[Studies on chemical constituents from the flower of Albizzia julibrissin Durazz]

OBJECTIVE

To study the chemical constituents in the flower of Albizzia julibrissin.

METHOD

Chromatographic and spectroscopic analyses were used to isolate and elucidate the chemical constituents in the plant.

RESULT

Two compounds were isolated from the petroleum ether and ethyl acetate fractions of the flower and identified as tetracosanoic acid and quercitrin.

CONCLUSION

These two compounds were obtained from the plant for the first time.

Imaging diagnosis of abdominal and pelvic sarcomas

Sarcomas of the abdomen and pelvis are rare malignant mesenchymal neoplasms that often remain undiagnosed until they attain large size. Complete tumour resection is associated with improved patient survival. Detection and delineation of the tumour, its extent and its relationship with surrounding tissues are important for surgical planning. Radiography, barium studies, and intravenous urography are of limited value in the imaging diagnosis of abdominal and pelvic sarcomas. Ultrasound is sensitive for detecting neoplasms larger than 6 cm. Computed tomography is useful for detection, defining extent, and predicting resectability of the primary tumour, evaluation of response to treatment, and detecting recurrence and metastasis. Sarcomas are predominantly large, poorly demarcated, heterogeneous masses of muscle density with haemorrhage or necrosis.

Diversity of cDNAs encoding phospholipase A2 from Agkistrodon halys pallas venom, and its expression in E. coli

As a step toward understanding the structure and function of phospholipase A2(PLA2), we isolated several novel cDNAs encoding Agkistrodon halys Pallas PLA2 isoenzymes including B-PLA2, Asn49-PLA2, A-PLA2, A'-PLA2 and BA1-PLA2 by polymerase chain reaction with oligonucleotide primers corresponding to the N- and C-terminus of these enzymes. The amino acid sequences of A-PLA2 deduced from cDNA are consistent with that isolated from venom except for four residues. Asn49-PLA2 and B-PLA2 are highly similar (> 95%), but the critical residue Asp49 in the active centre of B-PLA2 is replaced by Asn49 in Asn49-PLA2. The N-terminal residues (1-24) of BA1-PLA2 shows high similarity to that of B-PLA2 which has strong ability to hemolyze erythrocytes, while its C-terminal residues (72-125) are the same as that of A-PLA2 which can inhibit platelet aggregation. The successful cloning of these isoenzymes not only provide excellent native material to study the structure-function relationship of PLA2s, but also to disclose the genesis of structural diversity of PLA2s, namely DNA modification and gene rearrangement. The cloned cDNA for A-PLA2 has been expressed in E. coli. By Q-Sepharose column chromatography, denaturation-renaturation and FPLC, we obtained the active recombinant protein with the initiator Met. This is the first report of the production of an active recombinant PLA2 with the initiator Met.

Computed tomography of abdominal neurogenic tumours

Abdominal and pelvic neurogenic tumours are uncommon neoplasms in adults apart from those tumours found in patients with neurofibromatosis. Malignant degeneration occurs in 2.4-29% of neurofibromatosis. Biopsy of neurofibromas can be complicated by sensorimotor nerve deficit. Distinction of malignancy by imaging may circumvent biopsies of asymptomatic benign neurogenic tumours. Benign neurogenic neoplasm is suspected on CT scan if the tumour is in the region of known nerve ganglia or pathway, and is well demarcated, solid, homogeneous, hypodense relative to muscle, and enhances with contrast material. Malignant neurogenic tumours are often large, irregular, infiltrative, and necrotic with heterogeneous contrast enhancement. Computed tomography is valuable in distinguishing malignant from benign neurogenic neoplasms, predicting resectability, detecting distant metastases, and evaluating response to treatment.