A 5-year follow up analysis of cases in a high school tuberculosis outbreak / 中国学校卫生

Objective@#To explore the effectiveness of preventive treatment for latent tuberculosis infection (LTBI) patients, so as to provide reference for the management and preventive treatment of clustered epidemic in schools.@*Methods@#Data came from the school tuberculosis outbreak of a boarding high school in Kaizhou District, Chongqing, which occurred between June 2017 and March 2018 among 2016 grade high school teachers and students for investigation and analysis. The total incidence, LTBI patients, and the incidence after preventive treatment for 5 years were followed up.@*Results@#A total of 34 cases of pulmonary tuberculosis from June 2017 to March 2018. A total of 1 357 individuals were screened for 6 concentrated contact screenings, with a confirmed tuberculosis rate of 2.43%, a tuberculosis skin test (TST) positive rate of 27.41%, and a strong TST positive rate of 7.39%. Among them, the confirmed tuberculosis rate and TST positive rate in the first case class were much higher than those in other classes, with statistically significant differences ( χ 2=286.30, 98.59, P ＜0.01). 88 cases of LTBI were found, with 31 cases receiving preventive treatment (35.23%), of which 28 completed preventive treatment (90.32%). After five years of follow-up, 73 cases of pulmonary tuberculosis were diagnosed in 2016 by the school senior high school, with a incidence rate of 0.98/10 2 (person/person years). Fifteen of the 88 LTBI patients were diagnosed with pulmonary tuberculosis, and the incidence rate was 3.33/10 2 (person/person years). The incidence rate of the preventive treatment group was 0.7/10 2 (person/person years)lower than that of the medical observation group 4.5/10 2 (person/person years), with a statistically significant difference ( χ 2=4.31, P ＜0.05).@*Conclusion@#The classes with higher TST positive rate and strong positive rate have higher incidence rate. Improving the preventive treatment rate of LTBI patients can effectively reduce the incidence rate of tuberculosis.

Minimally invasive laminar lift and posterior cervical laminoplasty via the intermuscular approach: a canine model study

Purpose: This study aimed to develop a minimally invasive surgical procedure for laminar lift and posterior cervical laminoplasty via the intermuscular approach using a canine model. Methods: Six Alaskan dogs were used for developing the surgical approach. The bilateral laminae of C3-7 were cut with an ultrasonic osteotome and fixed with bilateral plates to maintain the lamina lifting and reshape a wider spinal canal. The important structures, such as ligaments, supraspinous ligaments, interspinous ligaments, and ligamentum flavum were preserved. The therapeutic effect was evaluated by preoperative and postoperative imaging results and neck mobility. Results: The surgical procedures were all successfully performed in the 6 animals. All the dogs survived well within 1 year of postoperative follow-up. The postoperative neck mobility was as good as the preoperative one. Computed tomography results showed that the anteroposterior diameter of the spinal canal was successfully enlarged and maintained well. Conclusions: The minimally invasive surgical procedure for laminar lift and posterior cervical laminoplasty via the intermuscular approach was feasible in a canine model, which might be applied in clinical practice.

The expression of ITGB2 in renal cell carcinoma and its effect on malignant biological behaviors of ACHN cells / 中国肿瘤生物治疗杂志

@#[Abstract] Objective：To investigate the expression of ITGB2 (integrinβ2) in renal cell carcinoma (RCC) tissues and cells (ACHN cells) and its effects on the proliferation, migration, invasion and cell cycle of ACHN cells. Methods: The expression level of ITGB2 in RCC tissues and para-cancerous tissues was analyzed by GEPIA database. The tissue samples of 66 RCC patients retained in the biological specimen bank of the Fourth Hospital of Hebei Medical University from 2016 to 2020 were selected for this study. The expression level of ITGB2 in 66 cases of RCC tissues and para-cancerous tissues was detected by immunohistochemical SP and qPCR, and the relationship between ITGB2 and clinical parameters was analyzed. The shRNA with ITGB2 knockdown was constructed and transfected into ACHN cells for functional experiments to detect its effect on the malignant biological behaviors of ACHN cells, and its effect on the cell cycle was detected by flow cytometry. WB was used to detect the effect of ITGB2 knockdown on ITGB2 protein expression in ACHN cells. Results: The relative expression of ITGB2 in RCC tissues was significantly higher than that in para-cancerous tissue (P<0.01), and the expression was related to the clinical stage of RCC (P<0.05). Transfection of shITGB2 into ACHN cells could knock down the gene and protein expression of ITGB2 (all P<0.01). Knockdown of ITGB2 could significantly inhibit the proliferation (P<0.05), migration(P<0.01) and invasion (P<0.05) of ACHN cells but had no significant effect on cell cycle (P>0.05). Conclusion: ITGB2 is highly expressed in RCC tissues and cells and is associated with the clinical stage of RCC. Knockdown of ITGB2 can inhibit the malignant biological behaviors of ACHN cells.

CircRNA RSF1 regulated ox-LDL induced vascular endothelial cells proliferation, apoptosis and inflammation through modulating miR-135b-5p/HDAC1 axis in atherosclerosis

BACKGROUND: Atherosclerosis (AS) is the most common type in cardiovascular disease. Due to its complex pathogenesis, the exact etiology of AS is unclear. circRNA has been shown to play an essential role in most diseases. However, the underlying mechanism of circRNA in AS has been not understood clearly. METHODS: Quantitative Real-Time PCR assay was used to detect the expression of circRSF1, miR-135b-5p and histone deacetylase 1 (HDAC1). Western blot was applied to the measure of protein expression of HDAC1, B-cell lymphoma-2 (Bcl-2), BCL2-associated X (Bax), cleaved-caspase-3, vascular cell adhesion molecule 1 (VCAM1), intercellular cell adhesion molecule-1 (ICAM1) and E-selectin. MTT assay and flow cytometry were used to detect cell proliferation and apoptosis, respectively. Dual luciferase reporter assay and RIP assay was used to determine the relationship among circRSF1, miR-135b-5p and HDAC1. Besides, an ELISA assay was performed to measure the levels of IL-1ß, IL-6, TNF-α and IL-8. RESULTS: In this study, ox-LDL inhibited circRSF1 and HDAC1 expression while upregulated miR-135b-5p expression in Human umbilical vein endothelial cells (HUVECs). Importantly, ox-LDL could inhibit HUVECs growth. Moreover, promotion of circRSF1 or inhibition of miR-135b-5p induced cell proliferation while inhibited apoptosis and inflammation of ox-LDL-treated HUVECs, which was reversed by upregulating miR-135b-5p or downregulating HDCA1 in oxLDL-treated HUVECs. More than that, we verified that circRSF1 directly targeted miR-135b-5p and HDAC1 was a target mRNA of miR-135b-5p in HUVECs. CONCLUSION: CircRSF1 regulated ox-LDL-induced vascular endothelial cell proliferation, apoptosis and inflammation through modulating miR-135b-5p/HDAC1 axis in AS, providing new perspectives and methods for the treatment and diagnosis of AS.

Gout of feet and ankles in different disease durations: diagnostic value of single-source DECT and evaluation of urate deposition with a novel semi-quantitative DECT scoring system

Abstract Objectives: To investigate the diagnostic performance of single-source dual-energy computed tomography (DECT) based on gemstone spectral imaging technology (including Discovery CT750HD and Revolution CT) in patients with suspected feet/ankles gouty arthritis, and evaluate the urate deposition with a novel semi-quantitative DECT scoring system. Methods: A total of 196 patients were consecutively included. Feet and ankles were evaluated in all patients by single-source DECT scan. The 2015 EULAR/ACR criteria were used as the reference for the diagnosis of gout. The sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of DECT for the diagnosis of gout in the early (≤1 year), middle (1-3 years), and late (> 3 years) disease durations were calculated. Besides, a novel semi-quantitative DECT scoring system was assessed for the measurement of urate deposition, and the correlation between the scores and the clinical and serological data were also evaluated. Moreover, the influences of artifacts on the diagnostic performance of DECT were also determined. Results: The sensitivity, specificity, and AUC of DECT in 196 patients were 38.10, 96.43%, and 0.673 in the early-stage group; 62.96, 100.00%, and 0.815 in the middle-stage group; and 77.55, 87.50%, and 0.825 in the late-stage group, respectively. The overall diagnostic accuracies in the AUC of DECT (Discovery CT750HD and Revolution CT) in the middle and late stages of gout were higher than that in the early stage of gout. Besides, the monosodium urate crystals were deposited on the first metatarsophalangeal joints and ankles/midfeet. Age, the presence of tophus, bone erosion, and disease duration considerably affected the total urate score. No statistical difference in the positive detection of nail artifact, skin artifact, vascular calcification, and noise artifact was found between the case and control groups. Conclusion: DECT (Discovery CT750HD and Revolution CT) showed promising diagnostic accuracy for the detection of urate crystal deposition in gout but had limited diagnostic sensitivity for short-stage gout. Longer disease duration, the presence of tophus, and bone erosion were associated with the urate crystal score system. The artifacts do not remarkably affect the diagnostic performance of DECT in gout.

Image smoothing using regularized entropy minimization and self-similarity for the quantitative analysis of drug diffusion

Background: Targetable drug delivery is an important method for the treatment of liver tumors. For the quantitative analysis of drug diffusion, the establishment of a method for information collection and characterization of extracellular space is developed by imaging analysis of magnetic resonance imaging (MRI) sequences. In this paper, we smoothed out interferential part in scanned digital MRI images. Materials and Methods: Making full use of priors of low rank, nonlocal self-similarity, and regularized sparsity-promoting entropy, a block-matching regularized entropy minimization algorithm is proposed. Sparsity-promoting entropy function produces much sparser representation of grouped nonlocal similar blocks of image by solving a nonconvex minimization problem. Moreover, an alternating direction method of multipliers algorithm is proposed to iteratively solve the problem above. Results and Conclusions: Experiments on simulated and real images reveal that the proposed method obtains better image restorations compared with some state-of-the-art methods, where most information is recovered and few artifacts are produced

Insufficient radiofrequency ablation promotes epithelial–mesenchymal transition mediated by interleukin-6/signal transducer and activator of transcription 3/Snail pathway in the H22 cells

Context: Radiofrequency ablation (RFA), an established and minimally invasive therapy for hepatocellular carcinoma, has become an important treatment strategy. However, tumor aggressiveness remains a common problem. The epithelial–mesenchymal transition (EMT) is thought to play an important role in this process. Design and Aims: Due to limited sample volumes harvested from patients, we established a heat-treated cell line and a mouse model to investigate the mechanisms of incomplete ablation in EMT. Materials and Methods: We heat-treated H22 and HepG2 cells using a water bath to determine a suitable temperature for incomplete RFA. Male BALB/c mice were orthotopically transplanted with H22 cells and then subjected to incomplete ablation. Changes in the EMT biomarkers were detected by real-time polymerase chain reaction, western blotting, and immunofluorescence. Statistical Analysis: The experimental results are expressed as means ± standard deviations. Results: Incomplete RFA promoted EMT, downregulated E-cadherin, upregulated vimentin and Snail, and enhanced the phosphorylation of signal transducer and activator of transcription 3 (STAT3) both in vivo and in vitro. Moreover, interleukin (IL)-6 secretion increased after heat treatment in the H22 cells. AG490, an IL-6 inhibitor, inhibited the occurrence of EMT. Conclusions: Insufficient ablation performed at low temperature successfully induces EMT and promotes tumor aggressiveness, which is mediated by the IL-6/STAT3/Snail pathway in both cell and mouse models.

Association of circulating long non-coding RNA MALAT1 in diagnosis, disease surveillance, and prognosis of acute ischemic stroke

We aimed to investigate the association of long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 (lnc-MALAT1) with acute ischemic stroke (AIS), and its association with disease severity, inflammation, and recurrence-free survival (RFS) in AIS patients. One hundred and twenty AIS patients and 120 controls were recruited. Venous blood samples from AIS patients (within 24 h after symptoms onset) and controls (at entry to study) were collected to detect plasma lnc-MALAT1 expression by real-time quantitative polymerase chain reaction. AIS severity was assessed by the National Institutes of Health Stroke Scale (NIHSS) score. Plasma concentrations of inflammation factors (including C-reactive protein (CRP), tumor necrosis factor α (TNF-α), interleukin (IL)-6, IL-8, IL-10, IL-17, and IL-22) were measured and RFS was calculated. lnc-MALAT1 expression was decreased in AIS patients compared to controls, and it had a close correlation with AIS (AUC=0.791, 95% CI: 0.735-0.846). For disease condition, lnc-MALAT1 expression negatively correlated with NIHSS score and pro-inflammatory factor expression (including CRP, TNF-α, IL-6, IL-8, and IL-22), while it positively correlated with anti-inflammatory factor IL-10 expression. Furthermore, lnc-MALAT1 expression was elevated in AIS patients with diabetes. For prognosis, no statistical correlation of lnc-MALAT1 expression with RFS was found, while a trend for longer RFS was observed in patients with lnc-MALAT1 high expression compared to those with lnc-MALAT1 low expression.

Epidemiological characteristics of coronavirus disease 2019 in Huzhou / 预防医学

Objective@#To learn the epidemiological characteristics of coronavirus disease 2019（COVID-19）in Huzhou,so as to provide reference for prevention and control of COVID-19.@*Methods@#All the confirmed cases of COVID-19 in Huzhou,diagnosed according to the COVID-19 Diagnosis and Treatment Plan（Sixth Version Trial）and reported from January 25 to February 7,2020,were recruited. The process of diagnosis and treatment,clinical manifestation,exposure history and close contacts were collected to analyze the epidemiological characteristics. @*Results@#On January 25,the first confirmed cases of COVID-19 in Huzhou was reported. By February 7,totally 10 confirmed cases were reported and no asymptomatic infection was found. They were all imported,including three Wuhan residents,two with a trip to Wuhan,three with a trip to Suizhou,one with a trip to Hangzhou and one with a trip to Thailand（two Wuhan passengers on the same flight）. The ratio of male to female cases was 1∶1. The median age was 32 years old. Seven cases were found when they went to a doctor by themselves,and three cases were found during the quarantine. The main clinical manifestations were fever,dry cough and fatigue. The median time from onset to diagnosis was 3 days. By March 3,all the cases were discharged,with median course of 24 days. There were 312 close contacts,and all of them were released after 14 days of quarantine. @*Conclusions @#To prevent imported cases from outside and stop spread inside taken by Huzhou government was proved to be effective. All the COVID-19 cases in Huzhou were imported,mostly from Wuhan. No local cases were reported.

Levosimendan confers perioperative renoprotection in severe patients undergoing cardiac surgery: A systematic review and meta-analysis / 中国胸心血管外科临床杂志

@#Objective    To evaluate the effect of levosimendan on acute kidney injury (AKI) in patients with left ventricular dysfunction (preoperative left ventricular ejection fraction≤40.0%) undergoing cardiac surgery. Methods    A systematic review and meta-analysis was conducted based on a comprehensive search of the randomized controlled trial (RCT) from PubMed, EMbase and The Cochrane Library (up to Jan 2018). The clinical endpoints included the incidence of AKI and need for renal replacement therapy (RRT), mortality, mechanic ventilation (MV) duration and intensive care unit (ICU) stay. Random-effect model was used for the potential clinical inconsistency. All analyses were performed by RevMan 5.3 and Stata 12.0. Results    Thirteen trials with a total of 2 046 patients were selected. Compared with controls, levosimendan significantly reduced the incidence of postoperative AKI (OR=0.44, P=0.000 1, I2=0%), the risk of RRT (OR=0.63, P=0.02, I2=0%) and the mortality (OR=0.49, P<0.000 1, I2=0%). Levosimendan also shortened the postoperative MV duration (WMD=–5.62, P=0.07, I2=93%) and ICU stay (WMD=–1.50, P=0.005, I2=98%). Conclusion    The present meta-analysis suggests that perioperative levosimendan for patients with left ventricular ejection fraction≤40.0%undergoing cardiac surgery reduces the incidence of AKI, RRT and death, as well as shortens MV duration and ICU stay.

Research progress of HHLA2/TMIGD2 in solid tumors / 中国肿瘤生物治疗杂志

@#以程序性死亡因子 1（PD-1）及其配体 1（PD-L1）为代表的B7/CD28家族在肿瘤免疫治疗中显示出极大的应用潜力，但仍 有很多PD-L1检测阴性患者无法从中受益。作为B7家族成员，人内源性逆转录病毒-H长末端重复关联蛋白2 (HHLA2)分子结 构与PD-L1等其他B7家族成员有一定的同源性和相似性， 对T细胞有共刺激和共抑制作用，在多数实体肿瘤中呈高表达，且在某 些实体肿瘤中表达比PD-L1更广泛；其通过与受体穿膜和免疫球蛋白结构域2(TMIGD2)结合可促进肿瘤免疫逃逸，导致肿瘤的 进展和转移。基于此，HHLA2/TMIGD2有望成为肿瘤免疫治疗新的通路和靶点之一。本文就HHLA2及其受体TMIGD2的分子 结构、生物学功能及其在实体肿瘤中作用的研究进展作一综述。

Research progress of PARP1 in colorectal cancer / 中国肿瘤生物治疗杂志

@#近年来 DNA修复途径成为癌症治疗的热门靶点， 聚ADP核糖聚合酶［poly（ADP）-ribosepolymerase，PARP]作为DNA修 复的关键酶得到了广泛研究，目前上市的PARP抑制剂（PARP inhibitor，PARPi）药物，在乳腺及卵巢等肿瘤中取得了革命性的突 破。结直肠癌（CRC）具有异质性，其发生与发展是一个多途径、多基因参与及多步骤的过程，其发病率与病死率在中国逐年上 升。研究发现，PARP1与CRC的发生、发展及治疗密切相关，本文从PARP1的分子结构及生物学功能、PARPi的作用机制、PARP1 在CRC组织中的表达情况、PARP1与结直肠癌干细胞的关系、PARPi与CRC治疗的关系等5个方面对PARPi在CRC中作用的研 究进展作一系统综述，为临床治疗CRC寻找新的治疗策略。

Roles of the ERK1/2 and PI3K/PKB signaling pathways in regulating the expression of extracellular matrix genes in rat pulmonary artery smooth muscle cells

Abstract Purpose: To investigate the mechanisms by which PD98059 and LY294002 interfere with the abnormal deposition of extracellular matrix regulated by connective tissue growth factor (CTGF) of rat pulmonary artery smooth muscle cells (PASMCs). Methods: Rat PASMCs were cultured and separated into a control group. Real-time fluorescence quantitative PCR was performed to detect the expression of collagen III and fibronectin mRNA. Immunohistochemistry and western blot analyses were performed to detect the expression of collagen III protein. Results: The expression of collagen III and fibronectin mRNA was greater in PASMCs stimulated with CTGF for 48 h, than in the control group. After 72h of stimulation, the expression of collagen III protein in the PASMCs was greater than in the control. The equivalent gene and protein expression of the CPL group were much more significant. Conclusions: CTGF can stimulate the gene expression of collagen III and fibronectin in PASMCs, which may be one of the factors that promote pulmonary vascular remodeling (PVR) under the conditions of pulmonary arterial hypertension (PAH). PD98059 and LY294002 can inhibit the ERK1/2 and PI3K/PKB signaling pathways, respectively, thus interfering with the biological effects of CTGF. This may be a new way to reduce PAH-PVR.

Value of non-real-time radial probe endobronchial ultrasound guided transbronchial lung biopsy in the diagnosis of peripheral lung cancer and analysis of false negative results / 中国内镜杂志

Objective To explore the diagnostic value of non-real-time radial probe endobronchial ultrasound (RP-EBUS) guided transbronchial lung biopsy (TBLB) for peripheral lung cancer and analysis of false negative results. Methods A retrospective analysis of the clinical and imaging data of 256 patients with peripheral lung cancer between March 2013 and December 2016, all the cases underwent non-real-time RP-EBUS guided TBLB, then evaluate its significance in the diagnosis of peripheral lung cancer and analyze the reasons of false negative results. Result In 256 patients who received non-real-time RP-EBUS examinations, 73.83% (189/256) of peripheral lung cancer were detected by RP-EBUS and the positive rate of RP-EBUS guided TBLB was 61.33% (157/256). The positive rate of non-real-time RP-EBUS guided TBLB was correlated with lesions >2 cm in diameter, lesions close to visceral pleura, ultrasonic image characteristics and the RP-EBUS probe surrounding by lesion (P < 0.05). The positive rate of non-real-time RP-EBUS guided TBLB was not correlated with RP-EBUS probe passed through lesions and times of biopsy (P > 0.05). Complications including bleeding, chest pain and pneumothorax recovered spontaneously. Conclusion Non-real-time RP-EBUS guided TBLB was a practical technology for diagnosis of peripheral lung cancer with high diagnostic rate and good safety. Lesion size, connection to visceral pleura, ultrasonic image characteristics and the RP-EBUS probe surrounding by lesion influenced the diagnostic yield. Improvement of operative skills can reduce false negative results.

Chemical constituents from roots of Actinidia rufa and their cytotoxicity / 中国中药杂志

To investigate the chemical compounds from the roots of Actinidia rufa, nine compounds were isolated by various column chromatography on silica gel and Sephadex LH-20, and high performance liquid chromatography (HPLC). Their structures were elucidated as 2α, 3β, 19α, 23, 24-pentahydroxyurs-12-en-28-oic acid-28-O-β-D-glucopyranoside (1), 2α, 3α, 19α, 24-tetrahydroxyurs-12-en-28-oic acid-28-O-β-D-glucopyranoside (2), 2α, 3α, 24-trihydroxyurs-12-en-28-oic acid (3), 2α, 3α, 24-trihydroxyolean-12-en-28-oic acid (4), 2α, 3α, 23, 24-tetrahydroxyurs -12-en-28-oic acid (5), 2α, 3β, 23, 24-tetrah-ydroxyurs-12-en-28-oic acid (6), 2α, 3β, 23-trihydroxy-12-en-28-oic acid (7), 2α, 3β, 23-trihydroxyurs-12, 20(30)-dien-28-oic acid (8), and 2α, 3α, 23-trihydroxyurs-12, 20(30)-dien-28-oic acid (9). Compounds 1 and 2 were isolated from the Actinidia genus for the first time. Compounds 2, 3, and 4 showed cytotoxic activity against human SKVO3 and TPC-1 cancer cell lines with IC₅₀ values ranging from 10.99 to 16.41 μmol•L⁻¹, compounds 3 and 4 have cytotoxic activity against human HeLa cancer cell line with IC₅₀ values of 15.53 and 13.07 μmol•L⁻¹, respectively.

The antioxidative defense system is involved in the premature senescence in transgenic tobacco (Nicotiana tabacum NC89)

BACKGROUND: α-Farnesene is a volatile sesquiterpene synthesized by the plant mevalonate (MVA) pathway through the action of α-farnesene synthase. The α-farnesene synthase 1 (MdAFS1) gene was isolated from apple peel (var. white winterpearmain), and transformed into tobacco (Nicotiana tabacum NC89). The transgenic plants had faster stem elongation during vegetative growth and earlier flowering than wild type (WT). Our studies focused on the transgenic tobacco phenotype. RESULTS: The levels of chlorophyll and soluble protein decreased and a lower seed biomass and reduced net photosynthetic rate (Pn) in transgenic plants. Reactive oxygen species (ROS) such as hydrogen peroxide (H2O2) and superoxide radicals (O2._) had higher levels in transgenics compared to controls. Transgenic plants also had enhanced sensitivity to oxidative stress. The transcriptome of 8-week-old plants was studied to detect molecular changes. Differentially expressed unigene analysis showed that ubiquitin-mediated proteolysis, cell growth, and death unigenes were upregulated. Unigenes related to photosynthesis, antioxidant activity, and nitrogen metabolism were downregulated. Combined with the expression analysis of senescence marker genes, these results indicate that senescence started in the leaves of the transgenic plants at the vegetative growth stage. CONCLUSIONS: The antioxidative defense system was compromised and the accumulation of reactive oxygen species (ROS) played an important role in the premature aging of transgenic plants.

A meta-analysis of metronidazole and vancomycin for the treatment of Clostridium difficile infection, stratified by disease severity

The aim of this meta-analysis was to compare the efficacy of metronidazole and vancomycin for the treatment of Clostridium difficileinfection, especially to investigate which agent was superior for treating either mild or severe C. difficileinfection. A meta-analysis of randomized controlled trials and cohort studies identified in Pubmed, Embase, and the Cochrane Library was conducted. Four randomized controlled trials and two cohort studies involving 1218 patients were included in this meta-analysis. Metronidazole was inferior to vancomycin for treating C. difficileinfection in terms of both initial clinical cure rates (risk ratio, RR = 0.91, 95% confidence interval, CI = 0.84-0.98, p= 0.02) and sustained cure rates (RR = 0.88, 95% CI = 0.82-0.96, p= 0.003). For mild C. difficileinfection, the efficacy of metronidazole and vancomycin resulted in similar clinical cure rates (RR = 0.94, 95% CI = 0.84-1.04, p= 0.21) and sustained cure rates (RR = 0.93, 95% CI = 0.83-1.05, p= 0.26). For severe C. difficileinfection the efficacy of vancomycin was superior to metronidazole in terms of clinical cure rates (RR = 0.81, 95% CI = 0.69-0.95, p= 0.009), whereas sustained cure rates were similar (RR = 0.86, 95% CI = 0.72-1.02, p= 0.08). Regarding microbiological cure metronidazole therapy was as effective as vancomycin therapy (RR = 0.88, 95% CI = 0.64-1.21, p= 0.43). Recurrence rates with metronidazole and vancomycin for both mild C. difficileinfection (RR = 0.95, 95% CI = 0.56-1.60, p= 0.85) and severe C. difficileinfection (RR = 1.27, 95% CI = 0.85-1.91, p= 0.25) were not different. Likewise, no difference in all-cause mortality was found as well (RR = 0.87, 95% CI = 0.56-1.35, p= 0.53). In conclusion, vancomycin provides improved initial clinical and sustained cure rates in patients with C. difficileinfection compared with metronidazole, especially in patients with severe C. difficileinfection. In view of these data, vancomycin may be considered first line therapy for severe C. difficileinfection.

Study of novel coating strategy for coronary stents: simutaneous coating of VEGF and anti- CD34 antibody / Estudo da nova estratégia de revestimento para stents coronários: revestimento simultâneo de VEGF e anticorpo anti-CD34

Abstract Introduction: Intravascular coronary stenting has been used in the treatment of coronary artery disease (CAD), with a major limitation of in-stent restenosis (ISR). The 316 stainless steel has been widely used for coronary stents. In this study, we developed a novel coating method to reduce ISR by simultaneously coating vascular endothelial growth factor (VEGF) and anti-CD34 antibody on 316L stainless steel. Methods: Round 316L stainless steel sheets in the D-H group were polymerized with compounds generated from condensation reaction of dopamine and heparin using N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide (EDC) and N-hydroxysuccinimide (NHS). Sixteen sheets from the D-H group were further immersed into 1ug/ml VEGF165 and 3mg/ml heparin sodium one after another for 10 times, and named as the D-(H-V)10 group. Eight sheets from the D-(H-V)10 group were coated with anti-CD34 antibody and termed as the D-(H-V)10-A group. Immunofluorescence assay and ELISA were used to evaluate whether the 316L stainless steel disks were successfully coated with VEGF and anti-CD34 antibody. Results: The results of immunofluorescence assay and ELISA showed that VEGF could be detected in the D-(H-V)10 and D-(H-V)10-A group, suggesting the steel sheets were successfully covered with VEGF. Anti-CD34 antibody could only be observed in the D-(H-V)10-A group, which was the only group coated with CD34 antibody. Both results suggested that the 316L stainless steel sheets were successfully coated with VEGF and anti-CD34 antibody. Conclusion: Our study developed a method to simultaneously coat VEGF and anti-CD34 antibody to stainless metal steel. This research serves as a fundamental role for a novel coating strategy. .

Resumo Introdução: O stent coronário intravascular tem sido utilizado no tratamento de doença arterial coronária, com uma maior limitação de restenose intra-stent (RIS). O aço inoxidável 316 tem sido amplamente utilizado para stents. Neste estudo, foi desenvolvido um novo método de revestimento para reduzir a RIS para revestir simultaneamente o fator de crescimento endotelial vascular (VEGF) e anti-CD34 em aço inoxidável 316L. Métodos: Placas de aço inoxidável 316L redondas no grupo DH foram polimerizadas com compostos gerados a partir da reacção de condensação de dopamina e heparina utilizando N- (3-dimetilaminopropil) -N'-etilcarbodiimida (EDC) e N-hidroxissuccinimida (NHS). Dezesseis folhas a partir do grupo DH foram ainda imersas em 1 ug/ml de VEGF 165 e 3 mg/ml de heparina sódica, um após outro por 10 vezes, sendo denominado como o grupo D-(HV)10. Oito folhas de D-(HV)10 foram revestidas com anticorpo anti-CD34 e denominado como grupo D-(HV)10-A. Testes de imunofluorescência e ELISA foram usados para avaliar se os discos de aço inoxidável 316L foram revestidos com sucesso com VEGF e anticorpo anti-CD34. Resultados: Os resultados dos testes de imunofluorescência e ELISA mostraram que o VEGF pôde ser detectado nos grupos D-(HV)10 e D-(HV)10-A, evidenciando que as chapas de aço foram cobertas com VEGF com sucesso. O anticorpo anti-CD34 podia apenas ser observado no grupo D-(HV)10-A, o único grupo revestido com anticorpo CD34. Ambos os resultados sugerem que as chapas de aço inoxidável 316L foram revestidas com sucesso com VEGF e anticorpo anti-CD34. Conclusão: Nosso estudo desenvolveu um método para revestir simultaneamente VEGF e anti-CD34 de aço inoxidável. Esta pesquisa tem um papel fundamental para a nova estratégia de revestimento. .

Curcumin inhibited rat colorectal carcinogenesis by activating PPAR-γ: an experimental study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the chemopreventive effect of curcumin on DMH induced colorectal carcinogenesis and the underlining mechanism.</p><p><b>METHODS</b>Totally 40 Wistar rats were divided into the model group and the curcumin group by random digit table, 20 in each group. Meanwhile, a normal control group was set up (n =10). A colorectal cancer model was induced by subcutaneously injecting 20 mg/kg DMH. The tumor incidence and the inhibition rate were calculated. The effect of curcumin on the expression of peroxisome proliferator-activated receptor gamma (PPARγ) in rat colon mucosal tissues was observed using immunohistochemistry and Western blot. HT 29 cell line were cultured and divided into a control group, the curcumin + GW9662 (2-chloro-5-nitro-N-4-phenylbenzamide) intervention group, and the curcumin group. The inhibition of different concentrations curcumin on HT29 cell line was detected using MTT. The expression of curcumin on PPARy was also detected using Western blot.</p><p><b>RESULTS</b>The tumor incidence was 80. 00% (12/15 cases) in the model group, obviously higher than that of the curcumin group (58. 82%, 10/17 cases, P <0. 05). The inhibition rate of curcumin on DMH induced colorected carcinoma reached 26. 46%. Compared with the normal control group, the expression of PPARγ protein was significantly increased in the curcumin group and the model group (P <0. 01). Compared with the model group at the same time point, the expression of PPARy protein was significantly enhanced in the curcumin group (P <0. 05). MTT analysis showed that curcumin could inhibit the proliferation of in vitro HT 29 cells in dose and time dependent manners. The expression of PPARy protein was significantly increased in the GW9662 group and the curcumin group, showing statistical difference when compared with the normal control group (P <0. 01). Compared with the GW9662 group, the expression of PPARγ protein was significantly increased in the curcumin group (P <0. 01).</p><p><b>CONCLUSION</b>Curcumin could inhibit DMH-induced rat colorectal carcinogenesis and the growth of in vitro cultured HT 29 cell line, which might be achieved by activating PPARy signal transduction pathway.</p>

Colistin and anti-Gram-positive bacterial agents against Acinetobacter baumannii

Introduction Acinetobacter baumannii has attained an alarming level of resistance to antibacterial drugs. Clinicians are now considering the use of older agents or unorthodox combinations of licensed drugs against multidrug-resistant strains to bridge the current treatment gap. We investigated the in vitro activities of combination treatments that included colistin with vancomycin, norvancomycin or linezolid against multidrug-resistant Acinetobacter baumannii. Methods The fractional inhibitory concentration index and time-kill assays were used to explore the combined effects of colistin with vancomycin, norvancomycin or linezolid against 40 clinical isolates of multidrug-resistant Acinetobacter baumannii. Transmission electron microscopy was performed to evaluate the interactions in response to the combination of colistin and vancomycin. Results The minimum inhibitory concentrations (MICs) of vancomycin and norvancomycin for half of the isolates decreased below the susceptibility break point, and the MIC of linezolid for one isolate was decreased to the blood and epithelial lining fluid concentration using the current dosing regimen. When vancomycin or norvancomycin was combined with subinhibitory doses of colistin, the multidrug-resistant Acinetobacter baumannii test samples were eradicated. Transmission electron microscopy revealed that subinhibitory doses of colistin were able to disrupt the outer membrane, facilitating a disruption of the cell wall and leading to cell lysis. Conclusions Subinhibitory doses of colistin significantly enhanced the antibacterial activity of vancomycin, norvancomycin, and linezolid against multidrug-resistant Acinetobacter baumannii. .