Association between trajectories of systolic blood pressure and frailty outcome in middle-aged and older adults

OBJECTIVES

The association between blood pressure and frailty outcome in the middle-aged and older population remains controversial. This study aimed to examine the relationship between trajectories of systolic blood pressure (SBP) and new-onset frailty.

DESIGN

Cohort study with a 7-year follow-up.

SETTING AND PARTICIPANTS

Data were derived from 4 waves (2011, 2013, 2015 and 2018) of the China Health and Retirement Longitudinal Study and 6168 participants aged ≥45 years were included in the study.

METHODS

The frailty index (FI) was constructed based on 40 scored items, with FI ≥ 0.25 defined as frailty. We identified the 5-year trajectory of SBP by latent class trajectory modeling. The association between SBP trajectories and frailty was explored based on hazard ratios (HR) by four Cox proportional hazards models. Furthermore, we also investigated the relationship between mean SBP and systolic blood pressure variability (SBPV) and frailty.

RESULTS

6168 participants were included in this study with a mean age of 59 years. We identified five trajectories based on SBP, which are maintained low-stable SBP (T0), moderate-stable SBP (T1), remitting then increasing SBP (T2), increasing then remitting SBP (T3), and remaining stable at high SBP levels (T4). During the 7-year follow-up period, frailty outcome occurred in 1415 participants. After adjusting for other confounders, the two trajectories labeled "T2" and "T4" were associated with a higher risk of frailty compared with T0. In addition, elevated SBP and increased SBPV were associated with risk of frailty.

CONCLUSIONS

Higher risk of frailty occurred in two trajectories, remitting then increasing and remaining stable at high SBP levels, were associated with a relatively higher risk of frailty.

[Bioinformatics analysis in metagenomic next-generation sequencing of pathogenic microorganisms: current status and challenges]

The clinical application of metagenomic next-generation sequencing (mNGS) in the diagnosis of unknown pathogenic infections and critical infections has become increasingly valuable. Due to the huge volume of mNGS data and the complexity of clinical diagnosis and treatment, mNGS has difficulties in data analysis and interpretation in practical application. Therefore, in the process of clinical practice, it is crucial to grasp the key points of bioinformatics analysis and establish a standardized bioinformatics analysis process, which is an important step in the transformation of mNGS from laboratory to clinic. At present, bioinformatics analysis of mNGS has made great progress, but with the high requirements of clinical standardization of bioinformatics analysis and the development of computer technology, bioinformatics analysis of mNGS is also facing new challenges. This article mainly elaborates on quality control, and identification and visualization of pathogenic bacteria.

[The value of CXorf67 and H3K27me3 for diagnosing germ cell tumors in central nervous system]

Objective: To investigate immunohistochemical patterns of CXorf67 and H3K27me3 proteins in central nervous system germ cell tumors (GCTs) and to assess their values in both diagnosis and differential diagnosis. Methods: A total of 370 cases of central nervous system GCTs were collected from 2013 to 2020 at Huashan Hospital of Fudan University, Shanghai, China. The expression of CXorf67, H3K27me3 and commonly-used GCT markers including OCT4, PLAP, CD117, D2-40, and CD30 by immunohistochemistry (EnVision method) was examined in different subtypes of central nervous system GCTs. The sensitivity and specificity of each marker were compared by contingency table and area under receiver operating characteristic (ROC) curve. Results: Of the 370 cases there were 282 males and 88 females with a mean age of 19 years and a median age of 17 years (range, 2-57 years). Among the GCTs with germinoma, the proportions of male patients and the patients with GCT located in sellar region were both higher than those of GCTs without germinoma (P<0.05), respectively. CXorf67 was present in the nuclei of germinoma and normal germ cells, but not in other subtypes of GCT. H3K27me3 was negative in germinoma, but positive in the nuclei of surrounding normal cells and GCTs other than germinoma. In the 283 GCTs with germinoma components, the expression rate of CXorf67 was 90.5% (256/283), but no cases were positive for H3K27me3. There was also an inverse correlation between them (r²=-0.831, P<0.01). The expression rates of PLAP, OCT4, CD117 and D2-40 were 81.2% (231/283), 89.4% (253/283), 73.9% (209/283) and 88.3% (250/283), respectively. In 63 mixed GCTs with germinoma components, the expression rate of CXorf67 was 84.1% (53/63), while all cases were negative for H3K27me3. The expression rates of PLAP, OCT4, CD117 and D2-40 were 79.4% (50/63), 79.4% (50/63), 66.7% (42/63) and 87.3% (55/63), respectively. The 6 markers with largest area under ROC curve in ranking order were H3K27me3, CXorf67, D2-40, OCT4, PLAP and CD117 (P<0.05). Conclusions: CXorf67 and H3K27me3 have high sensitivity and high specificity in diagnosing germinoma. There is a significant inverse correlation between them. Therefore, they can both be used as new specific immunohistochemical markers for the diagnosis of GCTs.

[A longitudinal study on the progression and influencing factors of myopia in primary school students from grade one to grade three in Hubei Province]

Objective: To investigate the longitudinal epidemiological characteristics of myopia in primary school students from grade one to grade three in Hubei province, and to analyze the main factors affecting the occurrence and development of myopia, so as to provide the direction and theoretical basis for the prevention and control of myopia in children and adolescents. Methods: Longitudinal study. A total of 13, 244 primary school students from grade one to grade three in 17 prefectures and forest districts of Hubei province were included in the study by means of random stratified cluster sampling. Among them, there were 7, 331 boys and 5, 913 girls with an age of (7.7±1.0) years. The same group of students were followed up for two years from October 2017 to October 2019 to complete three data collections. All included subjects underwent visual acuity examination, which required further automatic computer optometry after using cyclopentolate hydrochloride eye drops if the visual acuity was less than 1.0. In the questionnaire, the general situation and eye behavior of the included subjects were collected. The Chi-square test was used to compare the prevalence of myopia among different genders,different reproductive history and grades. The Kruskal-Wallis H test was used to compare the difference in the mean spherical equivalent refraction, and logistic regression was used to analyze the influencing factors of myopia. Results: The prevalence of myopia was 23.10% at baseline in 2017, 28.67% after one year's follow-up and 33.26% after two years' follow-up among primary school students in grade one to grade three in Hubei province. The overall prevalence of myopia increased with time (χ²=307.47, P<0.05). It also increased with the increase of grades. After two years of follow-up, the myopia rate of students in grades one through three was 25.62%, 35.07% and 41.05%, respectively (χ²=200.98, P<0.05). In 2017, the prevalence of myopia was 21.62% in boys and 24.93% in girls, and it increased to 31.20% and 35.69% after 2 years of follow-up, respectively. Both the prevalence of myopia and the spherical equivalent refraction were higher in girls than in boys. Moreover, myopia was associated with parents' myopia (OR=1.17), less time for outdoor activities (OR=1.06), no rest after half an hour's study (OR=1.18), more time for daily exposure to electronic products (OR=1.07), longer time for extracurricular study (OR=1.09), and higher grades (OR=1.78). Children whose parents were more myopic and who ate sweets and fizzy drinks more often had greater levels of myopia. Conclusions: Myopia occurs early in primary school students of grade one to grade three in Hubei province and increases rapidly. More attention should be paid to good habits for eyes, regular screening, outdoor activities and girls. (Chin J Ophthalmol, 2021, 57: 749-756).

[Protective effect and mechanism of mild hypothermia on liver injury after cardiopulmonary resuscitation in pigs]

Objective: To investigate the effect of mild hypothermia therapy on liver after cardiopulmonary resuscitation. Methods: Thirty-three inbred Chinese Wuzhishan (WZS) minipigs, weighted (28±2) kg, were used to establish a ventricular fibrillation model. And 30 animals survived after cardiopulmonary resuscitation reached basic life support. The surviving animals were randomly divided into two groups: mild hypothermia group (group M, n=15) and conventional treatment group (group C, n=15). All the animals were observed for 24 hours. Blood samples were extracted at baseline, 0.5, 1, 2, 4, 6, 12 and 24 h after successful resuscitation. The concentrations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected at the time points. The enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α). The data were compared between the two groups, LSD test was used when the variance was homogeneous, and Tamhane T2 test was used when the variance was uneven. Results: Eleven pigs (73.3%) in the group M and 8(53.3%) in the group C survived at 24 h after successful resuscitation, with no statistically significant difference between the two groups (χ(2)=1.229, P=0.225). After successful resuscitation, the AST, ALT increased in both group but less in M group (all P<0.05). After successful resuscitation, the concentrations of TFN-α and IL-6 in the blood increased in both groups, reached the peak at 4h, and then decreased gradually. The concentrations of TFN-α in group M were lower than those in group C at 0.5, 2, 4 and 6 h after successful resuscitation (t=0.01, 0.01, 0.87, 0.86, all P<0.05). The concentrations of IL-6 in the group M were lower than those in group C at 0.5, 1, 2 and 4 h after successful resuscitation (t=0.23, 0.78, 0.11, 0.80, all P<0.05). Conclusions: After successful resuscitation, the release of inflammatory mediators, such as TNF-α and IL-6, and cell apoptosis may involve in liver ischemia reperfusion injury. After successful resuscitation, the liver undergoes ischemia-reperfusion injury, which may be related to the release of inflammatory mediators such as TNF-α and IL-6. Mild hypothermia therapy can prevent the release of TNF-α, IL-6 to reduce the degree of liver damage after resuscitation.

[The Role of Soluble HLA-G in the Vertical Transmission of Toxoplasma gondii]

Soluble human leukocyte antigen G (sHLA-G) plays a key role in pregnancy through interaction with decidual natural killer (dNK) cell inhibitory receptors at the maternal-fetal interface. To demonstrate the possible role of sHLA-G during the pregnancy with Toxoplasma gondii infection, we compared the concentration of a murine functional homolog of sHLA-G, Qa-2, in T. gondii infected and non-infected pregnant C57BL/6 mice, and that of sHLA-G in BeWo culture supernatant. In addition, the levels of KIR2DL4 expressed on human dNK cells and NKG2A in pregnant mice were evaluated. We showed that T. gondii infection result in significant increase in the level of Qa-2 and NKG2A in pregnant mice. sHLA-G and KIR2DL4 in human samples were also significantly upregulated under the condition of T. gondii infection. The further treatment with sHLA-G antibody could reduce the expression level of KIR2DL4 which was upregulated by T. gondii infection. In summary, sHLA-G could upregulate the expression level of KIR2DL4 which lead to excessive immunological tolerance, and further contributed to T. gondii immunity escaping and affecting fetus via vertical transmission which may lead to adverse outcomes.

[Study on the relationship between preoperative evaluation, operation and prognosis of microvascular decompression for the treatment of hemifacial spasm]

Objective: To investigate the relationship between preoperative evaluation, surgery and prognosis of microvascular decompression (MVD) for the treatment of hemifacial spasm (HFS). Methods: The clinical data of 128 HFS patients treated with MVD in the department of neurosurgery of Taizhou Hospital of Zhejiang Province were retrospectively analyzed. According to the SMC grading system, the patients were divided into general spasm group and severe spasm group, and the clinical characteristics, offending vessel, prognosis and surgical complications of the two groups were compared. Results: In the general spasm group,the age at MVD was (48.6±10.6) years, the disease duration was (4.2±3.3) years;while in the severe spasm group,the age at MVD was (51.8±9.9) years, the disease duration was (8.1±4.5) years;the differences of age and disease duration between the two groups were statistically significant (P<0.05).In the general spasm group, there were 41 cases in which the offending vessel were AICA, 21 cases were PICA, 1 case was VA, 63 cases were single offending vessel, and 7 cases were multiple offending vessels. In the severe spasm group, there were 29 cases in which the offending vessel were AICA, 13 cases were PICA, 2 cases were VA, the total of 44 cases were single offending vessel and 14 cases were multiple offending vessels.There was a significant difference in the proportion of multiple offending vessels in the two groups, and the difference was statistically significant (P<0.05).Patients in the two groups were followed up for 12 to 32 months after surgery, and the difference in effective rate and recurrence rate was not statistically significant (P>0.05).Some kinds of postoperative complications were different between the two groups, the incidence of postoperative delayed facial paralysis was statistically significant (P<0.05), and the other complications were not statistically significant (P>0.05). Conclusion: Compared with the general spasm group, the patients in the severe spasm group were older, with longer disease duration, higher probability of multiple offending vessels and higher incidence of postoperative delayed facial paralysis. Therefore, preoperative SMC grading is helpful for the evaluation and prediction of intraoperative and postoperative conditions, which is worthy of wide clinical application.

[Clinical efficacy of different vascular reconstruction on adult moyamoya disease]

Objective: To investigate the clinical efficacy of superficial temporal artery -middle cerebral artery combined with encephalo-duro-arterio-myo-synangiosis (STA-MCA+EDAMS) and encephalo-duro-arterio-myo-synangiosis (EDAMS) in the treatment of adult moyamoya disease. Methods: The clinical data of 47 adult patients with moyamoya disease who received vascular reconstruction in the Department of Neurosurgery of Taizhou Hospital of Zhejiang Province from January 2014 to January 2018 were retrospectively analyzed. Among them, 21 patients received EDAMS alone (EDAMS group, 14 patients with hemorrhagic moyamoya disease, 7 patients with ischemic moyamoya disease), 26 patients received STA-MCA combined with EDAMS (STA-MCA+EDAMS group, 17 patients with hemorrhagic moyamoya disease, 9 patients with ischemic moyamoya disease). Cerebral hemodynamics at 1 day before surgery and 3 and 6 months after surgery were compared. The clinical efficacy and postoperative complications of the two methods were compared at 3 and 6 months postoperatively in hemorrhagic and ischemic types. Results: For hemorrhagic moyamoya disease, the remission rate (94.1%) at 6 months after surgery in the STA-MCA + EDAMS group was higher than that in the EDAMS group (57.1%), and the difference was statistically significant (P<0.05). The CBF and CBV in the STA-MCA+EDAMS group were higher than those in the EDAMS group at 3 and 6 months after operation, and the MTT and TPP were lower than those in the EDAMS group, but there was no significant difference between the two groups (all P>0.05). For hemorrhagic moyamoya disease and ischemic moyamoya disease, the total incidence of postoperative complications of the two surgical methods was different, but the difference was not statistically significant (both P>0.05). Conclusion: Superficial temporal artery -middle cerebral artery combined with encephalo-duro- arterio-myo-synangiosis (STA-MCA+EDAMS) and encephalo-duro-arterio-myo-synangiosis (EDAMS) can significantly improve neurological function and cerebral hemodynamics in adult moyamoya disease patients with high safety.

[Safety of resuscitation with hydroxyethyl starch 130/0.4 in hemorrhagic shock rats]

Objective: To evaluate the safety of resuscitation with hydroxyethyl starch 130/0.4 during the early stage of hemorrhagic shock. Methods: Total of 120 healthy male SD rats of 2 to 3 months of age were selected as the study sample (weighed from 250 to 290 g), all the rats were numbered by staining.After that, the rats were divided into 12 groups by using random number table method: sham group (S group), no liquid resuscitation group (NF group), lactated Ringer's resuscitation group (LR group), HES resuscitation group (HES group). At the same time, the LR and HES resuscitation groups were divided into five subgroups with a concentration of 7.5, 15, 30, 60 and 90 ml·kg(-1)·h(-1,) respectively.The model of uncontrollable hemorrhagic shock was created by the method of exsanguination plus tail-cuffing.Fluid resuscitation was started 30 minutes after the exsanguination and continued for 60 min after transfusion for 15 min.The observation was continued for 330 min.At the end of observation, all rats were sacrificed and blood was collected from the rats to determine the thromboelastograms and the maximum amplitude and related parameters, as well as platelet counts, blood urea nitrogen, creatinine, urinary and renal injury molecules, and neutrophil gelatinase-associated apolipoprotein levels.Rat lung tissue specimens were collected and wet weights of the right lung and dry weights after drying were measured.The data were compared by using one-way analysis of variance (ANOVA), LSD-t test or Dunnett-t test. Results: ANOVA analysis showed that there was no significant difference in mean artery pressure (MAP) values between groups at the beginning of fluid resuscitation (F=0.934, P=0.245). At the end of fluid resuscitation, the MAP of HES90 group was (40±9) mmHg, which was lower than that in other groups.Compared with other groups, the HES90 group had higher blood loss and blood transfusion rate.There was no significant differences in platelet counts between the HES group and the LR group at 330 min (t=0.987, P>0.05), but the maximal amplitude (MA) of the thrombelastogram (TEG) was lower in the HES90 group than that in the S group (t=2.354, P<0.05). No significant difference was detected in blood urea nitrogen and serum creatinine levels between the HES, LR group and the S group (t=1.098, 0.895, both P>0.05). The total amount of urinary kidney injury molecule 1 (Kim-1) in the HES90 and NF groups increased, neutrophil gelatinase-associated apolipoprotein (NGAL) concentration and urinary NGAL levels were significantly higher than those in other groups, and the difference were statistically significant (t=3.532-11.209, all P<0.05). Conclusion: Small to moderate doses of HES130/0.4 during hemorrhagic shock is more effective and safer than the same dose of LR.

Down-regulation of telomerase reverse transcriptase-related anti-apoptotic function in a rat model of acrylamide induced neurobehavioral deficits

Although the precise mechanism is unknown, neuron apoptosis is believed to participate in neuropathy caused by acrylamide (ACR). Telomerase reverse transcriptase (TERT) exhibits an anti-apoptotic function, but its contribution to the pathogenesis of ACR neurotoxicity is unclear. We investigated adult male rats that were given 30, 40 and 50 mg/kg ACR three times/week for 4 weeks. We found that ACR treatment caused significant deficits in sensory/motor function as measured by gait score, landing foot spread distance, movement initiation test and tail immersion test. Histological examination showed that the cerebral cortex in all ACR treated animals exhibited fewer neurons and more condensed nuclei than normal cortex. A significant increase in apoptosis was found in the cerebral cortex of rat brains subjected to ACR treatment in a dose-dependent manner. The expression of TERT in the brain was significantly reduced by ACR treatment. The pro-apoptotic cleaved caspase-3 protein level was increased, while the anti-apoptotic Bcl-2 protein level was decreased by 30 - 50 mg/kg ACR. Our findings indicate that TERT and its downstream regulators of neuron apoptosis, including Bcl-2 and cleaved caspase-3, were involved in ACR neurotoxicity.

[Effect of the ischemic post-conditioning on the prevention of the cardio-renal damage in patients with acute ST-segment elevation myocardial infarction after primary percutaneous coronary intervention]

Objective: To evaluate the effect of the ischemic post-conditioning (IPC) on the prevention of the cardio-renal damage in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PPCI). Methods: A total of 251 consecutive STEMI patients underwent PPCI in the heart center of Tianjin Third Central Hospital from January 2012 to June 2014 were enrolled in this prospective, randomized, control, single-blinded, clinical registry study. Patients were randomly divided into IPC group (123 cases) and control group (128 cases) with random number table. Patients in IPC group underwent three times of inflation/deflation with low inflation pressure using a balloon catheter within one minute after culprit vessel blood recovery, and then treated by PPCI. Patients in control group received PPCI procedure directly. The basic clinical characteristics, incidence of reperfusion arrhythmia during the procedure, the rate of electrocardiogram ST-segment decline, peak value of myocardial necrosis markers, incidence of contrast induced acute kidney injury(CI-AKI), and one-year major adverse cardiovascular events(MACE) which including myocardial infarction again, malignant arrhythmia, rehospitalization for heart failure, repeat revascularization, stroke, and death after the procedure were analyzed between the two groups. Results: The age of IPC group and control group were comparable((61.2±12.6) vs. (64.2±12.1) years old, P=0.768). The incidence of reperfusion arrhythmia during the procedure was significantly lower in the IPC group than in the control group(42.28% (52/123) vs. 57.03% (73/128), P=0.023). The rate of electrocardiogram ST-segment decline immediately after the procedure was significantly higher in the IPC group than in the control group (77.24% (95/123) vs. 64.84% (83/128), P=0.037). The peak value of myocardial necrosis markers after the procedure were significantly lower in the IPC group than in the control group(creatine kinase: 1 257 (682, 2 202) U/L vs. 1 737(794, 2 816)U/L, P=0.029; creatine kinase-MB: 123(75, 218)U/L vs.165(95, 288)U/L, P=0.010). The rate of CI-AKI after the procedure was significantly lower in the IPC group than in the control group(5.69%(7/123) vs. 14.06%(18/128), P=0.034). The rate of the one-year MACE was significantly lower in the IPC group than in the control group(7.32%(9/123) vs. 15.63% (20/128), P=0.040). Conclusion: The IPC strategy performed eight before PPCI can reduce myocardial ischemia- reperfusion injury, decline the rates of CI-AKI and one-year MACE significantly in STEMI patients, thus has a significant protective effect on heart and kidney in STEMI patients. Clinical Trial Registration Chinese Clinical Trials Registry, ChiCTR-ICR-15006590.

[Clinical features and prognostic analysis of neuromyelitisoptica spectrum disease with sjogrensyndrome]

Objective: To explore the clinical features and conduct prognostic analysis about visual recovery and relapse of neuromyelitisoptica (NMO) spectrum disease (NMOSD) with sjogren syndrome (SS). Methods: A retrospective and prospective observational study was conducted.Between July 2013 and June 2016, 172 patients with NMOSD (NMOSD-non SS: 116/172, 67.4%; NMOSD-SS: 56/172, 32.6%) were assessed at Beijing Tongren Hospital, Capital Medical University, Beijing, China.The prognostic factors of NMOSD-SS patients were also analyzed. Results: As compared with NMOSD-non SS patients, NMOSD-SS patients had worse visual impairment (percentage of patients with visual acuity less than 0.1, 83.9% vs 69.8%, P<0.05), higher positive rate of SSA (92.9% vs 0.0%, P<0.05), higher proportion of dryness of mouth and eye (66.1% vs 5.2%, P<0.05) as well as higher percentage of reduced visual evoked potential (VEP) amplitude (60.7% vs 43.1%, P<0.05). NMOSD-SS patients had a significantly higher average year recurrent frequency (0.58 vs 0.53) and significantly shorter mean recurrence time (6.7 months vs 12.4 months, P<0.05). The results showed that recurrent eyes, the worst visual acuities of onset less than 0.1 were independent risk factors of visual impairment (visual activity <0.1), according to at least six months' follow-up of all NMOSD-SS patients (OR=6.410 and 9.434, respectively, P<0.05). Meanwhile, immunosuppressive drugs were protective factors of relapse in NMOSD-SS patients (OR=0.107, P<0.05). Conclusions: NMOSD-SS patients have worse visual impairment, and they are more vulnerable to relapse than NMOSD-non SS patients, and the vision is lack of recovery for NMOSD-SS with recurrent eyes or the worst vision of onset less than 0.1.Immunosuppressive drugs can reduce the recurrence of NMOSD-SS relapse.

[Resuscitation efficacy of extracorporeal membrane oxygenation in non-postcardiotomy adult patients with cardiac arrest]

Objective: To evaluate the resuscitation efficacy of extracorporeal membrane oxygenation (ECMO) for non-postcardiotomy cardiac arrest adult patients post failed conventional cardiopulmonary resuscitation (CCPR). Methods: We retrospectively analyzed the clinical data of a total of 25 consecutive adults who suffered from non-postcardiotomy cardiac arrest and were treated with ECMO post failed CCPR in our hospital between January 2010 and January 2015. Inclusion criteria included: 18 to 75 years old; the duration from cardiac arrest to CCPR initiation<5 minutes; no recovery of spontaneous circulation within 10 min after implementation of standard CCPR, and the length of CCPR <90 minutes. Patients were divided into non-survival group (18 cases) and survival group (7 cases) based on their in-hospital outcome and the clinical characteristics were compared. Related factors of survival to discharge were analyzed by Spearman correlation analysis. Results: Majority of patients (84.0%(21/25)) developed cardiac arrest in our hospital, mostly due to acute myocardial infarction (80.0%(20/25)). The mean duration of CCPR prior to ECMO support was 40.0 (27.5, 72.0) minutes. The mean duration of ECMO support was 72.0 (47.5, 128.3) hours and 9 patients (36.0%) were successfully weaned. Intensive care unit stay was significantly shorter (3.0(1.8-7.8)days vs.16.0(11.0-37.0) days, P<0.01), mean blood pressure at 24 and 48 hours after ECMO initiation was significantly lower ((73.2±20.1)mmHg(1 mmHg=0.133 kPa) vs. (91.1±20.4)mmHg, P<0.05; (63.0±16.7)mmHg vs. (86.6±18.0 mmHg), P<0.05, respectively) and platelet count at 72 hours after extracorporeal support was significantly lower ((57.0±30.1)×10⁹/L vs. (97.3±31.5)×10⁹/L, P<0.05) in the non-survivor group than in survival group. Spearman correlation analysis demonstrated that mean arterial pressure at 24 hours (r=0.427, P<0.05) and 48 hours(r=0.558, P<0.05), and platelet count at 72 hours after extracorporeal support (r=0.577, P<0.05) were significantly correlated with survival to discharge. Conclusion: ECMO can be used as an effective alternative for refractory cardiac arrest in non-postcardiotomy adult patients.

Association between the XPG gene Asp1104His polymorphism and lung cancer risk

It has been suggested that the xeroderma pigmentosum complementation group G (XPG) gene Asp1104His polymorphism is linked to susceptibility to lung cancer. However, the results from the published studies are contradictory rather than conclusive. With this meta-analysis, we aimed to achieve a better understanding of the effects of the XPG gene Asp1104His polymorphism on lung cancer risk. We identified six eligible studies from five publications that included a total of 2293 lung cancer patients and 2586 controls. There was a significant association between the XPG gene Asp1104His polymorphism and lung cancer (His/His vs Asp/Asp: OR = 1.24, 95%CI = 1.04-1.48; Asp/His vs Asp/Asp: OR = 1.17, 95%CI = 1.03-1.34; the dominant model: OR = 1.18, 95%CI = 1.04-1.33; the recessive model: OR = 1.10, 95%CI = 0.94-1.28). In a subgroup analysis by nationality, we found a significant association between the XPG gene Asp1104His polymorphism and lung cancer risk in Asians. No publication bias was found in this study. The results from this meta-analysis indicate that the XPG gene Asp1104His polymorphism is associated with lung cancer risk, especially in Asians.

High NH(4)(+)-N concentration wastewater treatment by shortcut nitrification-denitrification using a system of A/O inner loop fluidized bed biofilm reactors

In this experiment, a rapid mass-transfer inner loop fluidized bed biofilm reactor (ILFBBR) was employed to treat synthetic high ammonia nitrogen-containing (NH(4)(+)-N) wastewater by shortcut nitrification-denitrification. The reactor operation was stable after a short start-up period. Ammonia oxidizing bacteria (AOB) were predominant and 65% nitrite (NO(2)(-)-N/NO(x)(-)-N) levels were achieved. During the nitrification-denitrification period, the removal rates of NH(4)(+)-N and total nitrogen (TN) reached 94 and 82%, respectively. From the material balance, it was indicated that 87% of NH(4)(+)-N was removed by shortcut nitrification. The features of ILFBBR and the benefits of shortcut nitrification were combined in this experiment, and showed an excellent removal of NH(4)(+)-N from high-concentration NH(4)(+)-N wastewater.

Lipid peroxidation and antioxidant status in vagina microenvironment of patients with several common vaginitis

OBJECTIVE

Oxidative stress has been suggested to play an important role in many diseases, including vaginitis. To evaluate oxidative biomarkers in the secretion of cervix samples of vaginitis, this study will illustrate the status of lipid peroxidation and antioxidant status in vaginal microenvironment.

MATERIALS AND METHODS

A total of 257 patients with vaginitis, including candida vaginitis, bacterial vaginosis, and trichomonas vaginitis were involved in this study. Cervico-vaginal fluid was collected from these patients before and after treatment, and the malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), hydrogen peroxide (H2O2), and vitamin C levels were measured by enzyme-linked immunosorbent assay (ELISA).

RESULTS

The results revealed that the MDA and H2O2 levels were increased in the vaginitis patients, while there was no significant difference in MDA level among different kinds of vaginitis before treatment. The CAT and vitamin C levels in vaginitis were decreased before treatment. Moreover, the data also showed that the MDA and H2O2 levels were decreased, while the CAT, SOD, and vitamin C levels were increased after received treatment, respectively, and there was no significant difference between controls and vaginitis.

CONCLUSION

This study indicated that oxidative stress played an important role in vaginitis.

Separation of oil from oily wastewater by modified resin

A new type of packing material, polystyrene resin modified by cetyltrimethyl-ammonium bromide (R-CTAB), was developed for separation of emulsified oil wastewater. The unique separation mechanism of the modified resin is due to the hydrogen bond formation between hydrocarbon molecules and the free hydrophilic part of the fixed surfactant. It changed the zeta potential of oil droplets and made them coalescing easier, which provide an optional choice without any chemicals added into the wastewater. A column of R-CTAB was investigated for its performance in separating emulsified oil droplets in oily wastewater. The effects of liquid space velocity and influent oil concentration were studied in particular. The results showed that R-CTAB column was more efficient than the un-modified resin column. Under the optimum experimental conditions, more than 85% of oil was removed by using R-CTAB column that at least 10% higher than the un-modified resin column.

Kinetics of plasmid transfer among Bacillus cereus group strains within lepidopteran larvae

The cry toxin encoding plasmid pHT73 was transferred from Bacillus thuringiensis subspecies kurstaki KT0 to six B. cereus group strains in three lepidopteran (Spodoptera exigua, Plutella xyllostella and Helicoverpa armigera) larvae by conjugation. The conjugation kinetics of the plasmid was precisely studied during the larval infection using a new protocol. The infections were performed with both vegetative and sporulated strains. However, larval death only occurred when infections were made with spore and toxin preparations. Likewise, spore germinations of both donor and recipient strains were only observed in killed larvae, 44-56 h post-infection. Accordingly, kinetics showed that gene transfer between B. thuringiensis strain KT0 and other B. cereus strains only took place in dead larvae among vegetatively growing bacteria. The conjugational transfer ratios varied among different strain combinations and different larvae. The highest transfer ratio reached 5.83 x 10(-6) CFU/donor between the KT0 and the AW05R recipient in Helicoverpa armigera, and all transconjugants gained the ability to produce the insecticidal crystal. These results indicated that horizontal gene transfer among B. cereus group strains might play a key role for the acquisition of extra plasmids and evolution of these strains in toxin susceptible insect larvae.

[Clonning and identification of the gene encoding specific IgE antibody-related antigen of Schistosoma japonicum]

OBJECTIVE

To obtain the gene encoding specific IgE-related antigen of Schistosoma japonicum from the cDNA library of adult Schistosoma japonicum.

METHODS

The pooled sera from 15 individuals with high levels of specific IgE antibody against SWAP were absorbed with Protein-G and used for screening of IgE-related antigen from the adult worm cDNA library of Schistosoma japonicum. The inserted cDNA was amplified by PCR and sequenced. According to the first reading frame of the sequence, a pair of new probes, in which EcoR I and Not I sites were incorporated respectively, were designed and used to amplify the target gene. Then, the gene was cloned into vector pGEM-T and subcloned into expression vector pGEX-6p-1. The fusion protein was expressed, analysed by SDS-PAGE and identified by Western blotting with the specific IgE antibody, respectively.

RESULTS

The inserted cDNA fragment from the positive clone was about 1,200 bp, with the ORF of 507 bp which encoded 169 amino acids. The deduced molecular weight of the recombinant protein was 19.3 kDa. The homology between the target gene (Sj43B) and other known DNA sequences was less than 40%. The fusion protein expressed by the recombinant vector pGEX-6p-1/Sj43B could be recognized by schistosome specific IgE antibody.

CONCLUSION

Sj43B may encode the specific IgE-related antigen of Schistosoma japonicum. The successful construction of recombinant plasmid pGEX-6p-1/Sj43B lay the groundwork for further studies on immunological characteristics and protection immunity of the recombinant protein.

[Analysis of the mitochondria-related protein of Schistosoma japonicum and its antigen epitopes]

OBJECTIVE

To sequence the cloned gene Sj338 and to identify the encoded protein and its antigen epitopes.

METHODS

The Sj338 gene fragment obtained from adult S. japonicum cDNA library amplified by PCR method was subcloned into pGEM-T vector for sequencing. The sequence of nucleotides and the characteristics of the encoded protein were analyzed by DNASIS Program and Goldkey DNA and Protein Analytical Program, and then the homology of the amino acid sequence was searched on the BLAST net.

RESULTS

The cloned rSj338 gene was demonstrated to be 487 bp containing one 459 bp ORF, encoding a protein consisted of 153 amino acids with a molecular weight of 17.6 kDa. The amino acid sequence of the recombinant protein rSj338 shared 46% identity with that of the corresponding part of human mitochondrial import receptor and 44% identity with that of the Rattus sp. mitochondrial precursor receptor. The possible antigen epitopes were predicted within the peptide fragments of 26-32 aa, 37-46 aa and 147-151 aa.

CONCLUSION

The protein encoded by rSj338 gene fragment might be the mitochondria-related protein of Schistosoma japonicum.

[Gene cloning and characterization of mitochondria-related protein of Schistosoma japonicum]

OBJECTIVE

To subclone and characterize a cDNA clone coding for Schistosoma japonicum (S.j.) mitochondria-related protein.

METHODS

The open reading frame of the fragment(Sj338/24) obtained from an adult worm cDNA library of S.j. was analysed, at the upstream and downstream of the open reading frame(ORF) the primers A and B were designed, respectively, and the cDNA fragment was used as PCR template. The Sj338 gene fragment obtained was amplified by PCR method and then subcloned into pGEM-T vector for sequencing. The gene sequence was analyzed and the target fragment was restrictedly digested and subcloned into expression vector pGEX-6P-1. The expressed recombinant protein was purified and characterized.

RESULTS

The cloned Sj338 gene was demonstrated to be 487 bp long containing one 459 bp ORF, encoding a protein with a molecular weight of 17 kDa. The nucleotide sequence of the cloned gene Sj338 had higher homology with those genes coding for mitochondrial outer membrane protein of Homo sapiens and Rattus norvegicus. The recombinant construct of pGEX-6P-1/Sj338 could be expressed efficiently and the antigenicity of its product rSj338 has been demonstrated by Western blotting.

CONCLUSION

Sj338 may be the gene coding for S.j. mitochondria-related protein and the recombinant protein may be used as a new vaccine candidate.

Characteristics of a bioflocculant produced by Bacillus mucilaginosus and its use in starch wastewater treatment

A bioflocculant, MBFA9, was produced from a strain of bioflocculant-producing bacteria isolated from a soil sample and identified as Bacillus mucilaginosus. MBFA9 had a good flocculating capability and could achieve a flocculating rate of 99.6% for kaolin suspension at a dosage of only 0.1 ml/l. The major component of MBFA9 was found to be polysaccharide composed mainly of uronic acid (19.1%), neutral sugar (47.4%) and amino sugar (2.7%). Infrared spectrum analysis showed the presence of carboxyl and hydroxyl groups in the bioflocculant. MBFA9 is nontoxic and can be used in food industries for suspended solids (SS) recovery. When applied to starch wastewater treatment, MBFA9 greatly accelerated the formation of flocs and the settling of organic particles in the presence of Ca(2+) salt. After 5 min of settling, the removal rate of SS and chemical oxygen demand were up to 85.5% and 68.5%, respectively, which is better than traditional chemical flocculants.

[The calculation-improving of stress amplification coefficient and the checking of its trouble-shooting model]

Through mechanical analysis, it is discovered that the twined structure decides the amplification coefficient of the catgut tension. Many troubles of production can be explained with this mechanics model, and it could be used as a reference for medical sutures. The paper gives an accurate calculating formula for catgut design and its direct tensile strength through improving mechanics model. It can raise the material strength from 10 to over 31% depending on its twined structure.

[Stability of liensinine injection]

The stability of liensinine injection was studied by accelarating test with classical isothermal method. Results of the study showed that the decomposition of the injection was found to be a first-order reaction. The activation energy was 75030 J.mol-1. The shelf life at 10 degrees C and 25 degrees C was predicted to be about 15 months and 3 months respectively. This experiment provides a reference for the storage of the injection.

[Quantitative determination of liensinine in the embryo Nelumbinis (Nelumbo nucifera Gaertn.) by TLC-scanning]

The content of liensinine in the green seed embryo of Nelumbo nucifera was determined by dual-wavelength TLC-scanning. The crude drug was extracted with two different method of impregnating and refluxing. The content of liensinine was determined to be 0.853% and 0.939% and the average recovery was 97.9% and 100.9% respectively.

Immunization of neonates with trivalent oral poliomyelitis vaccine (Sabin)

A study was carried out between November 1981 and April 1982 on the immunological effect of administering trivalent live, oral polio vaccine to 200 mature healthy neonates from Henan Province, China. The initial dose of vaccine was given at 3 days of age, and 2 months thereafter antibodies to poliovirus types 1, 2, and 3, respectively, were detected in 46.7%, 60.7% and 48.6% of the neonates; after the second dose, the levels were 86.9%, 95.3%, and 97.2%, with geometric mean titres of 1:106.2, 1:349.8, and 1:232.5. Almost 100% of neonates exhibited antibodies after the fourth dose of vaccine. Eighty-two percent of the neonates excreted poliovirus for at least a week after the initial dose of vaccine, and this increased to 99% after the second dose. Seroconversion at 4 months of age was similar to that of a group of controls who received their initial dose of vaccine at 2 months of age; however, immunization of neonates induced immunity to poliovirus at the earliest possible age.