A Case Report of Brucellosis and the Differential Diagnosis of Lymphoma and Tuberculosis

ABSTRACT In this paper, we present a male patient from Xinjiang with fever of unknown origin and significant weight loss for more than 1 month. He was admitted to hospital with negative Rose Bengal test (RBT) and decreased leucocyte count. Ultrasound revealed splenomegaly and abdominal computed tomography, which showed multiple hypodense splenic nodules. The patient was suspected of lymphoma or tuberculosis. Pathological biopsy suggested brucellosis infection following splenectomy. Anti-Brucella treatment was effective and his temperature gradually returned to normal. During the follow-up, the patient's RBT result turned to positive and he was instructed to continue the anti-Brucella drug regimen. His temperature, weight, white blood cell count, other laboratory examinations, and imaging findings all returned to normal during the 6-month follow-up after the treatment.

Protective effects of sodium ferulate on flap transplantation via anti-inflammatory modulation and oxidative stress inhibition

Ischemia-reperfusion injury (IRI) has brought attention to flap failure in reconstructive surgery. To improve the prognosis of skin transplantation, we performed experimental IRI by surgical obstruction of blood flow and used sodium ferulate (SF) to prevent IRI in rats. After SF treatment, the morphological and histological changes of the skin flaps were observed by H&E and Masson's trichrome staining. We also detected the expression levels of COX-1, HO-1, and Ki67 by immunohistochemical and western blot analysis. Moreover, enzyme-linked immunosorbent assay was used to identify the content of tumor necrosis factor (TNF)-α, myeloperoxidase (MPO), malondialdehyde (MDA), and nitric oxide (NO) in peripheral blood and skin tissue. Compared with the model group, SF treatment significantly improved the recovered flap area (%) and promoted collagen synthesis. Cyclooxygenase-2 (COX-2) expression was significantly inhibited by heme oxygenase-1 (HO-1) induction after SF treatment. Furthermore, SF significantly inhibited the levels of TNF-α in peripheral blood, MPO and MDA in the skin tissue, and the increased synthesis of NO. Our results showed the protective effects of SF on IRI after flap transplantation and we believe that the protective effects of SF was closely related to the alleviation of the inflammatory response and the inhibition of the oxidative stress injury.

Re-evaluation of the diagnostic value of fractional exhaled nitric oxide & its impact in patients with asthma

Background & objectives: The diagnostic value of fractional exhaled nitric oxide (FeNO) in patients with asthma remains controversial. This study was aimed to re-evaluate the diagnostic value of FeNO in specific groups with asthma and identify potential factors associated with FeNO. Methods: FeNO measurement and bronchial provocation test (BPT) or bronchodilator test (BDT) were performed in patients with suggestive symptoms for asthma. Correlation analysis was performed, and receiver-operating characteristic (ROC) curves and area under the curve (AUC) were calculated to evaluate the accuracy of FeNO in diagnosis. Results: A total of 265 (66.3%) patients with asthma were identified in 400 individuals suspected to have asthma from October 2014 to June 2015. Positive correlations of gender (r=0.138, P=0.005), atopy (r=0.598, P <0.001) and rhinitis (r=0.485, P <0.001) but negative correlations of age (r=?0.220, P <0.001) and the cumulative methacholine dosage with a 20 per cent decrease in forced expiratory volume in one second (r=?0.197, P <0.001) with FeNO were found. AUC of FeNO in whole population and patients with atopy and rhinitis was 0.728 [95% confidence interval (CI) 0.675-0.781, P <0.001] and 0.752 (95% CI 0.640-0.865, P <0.001), while the cut-offs were 23.5 and 44.5 parts per billion (ppb), respectively, rendering sensitivities, specificities, positive predictive value and negative predictive value of 79.9, 54.7, 77.9, 58.1 and 78.7, 67.9, 89.2 and 48.7 per cent, respectively. The cut-off of FeNO with specificity of 90 per cent (FeNO90) for all patients and a sub-group of patients with atopy and rhinitis was 59.5 and 90.5 ppb, respectively, while FeNO90decreased by 12 ppb with every 10 years. Interpretation & conclusions: Our findings show that the diagnostic value of FeNO varies in different groups of patients with asthma, thus, the cut-off point should be adjusted in different asthmatic sub-populations. A cut-off point of FeNO with a specificity >90 per cent could decrease the false-positive rate.

Mechanism of hif-1α mediated hypoxia-induced permeability changes in bladder endothelial cells

This study aimed to investigate the mechanism of hypoxia-inducible factor-1 alpha (HIF-1α) mediated hypoxia-induced permeability changes in bladder endothelial cells. Models of in vitro hypoxic cell culture of bladder cancer, bladder cancer cells with low HIF-1α expression and HIF-1α RNA interference (RNAi) expression vector were established. Western blot and reverse transcription polymerase chain reaction (RT-PCR) were used to detect the expression of HIF-1α and vascular endothelial growth factor (VEGF) in each group. Bladder cell permeability was determined. Results showed that protein and mRNA expression of HIF-1α and VEGF at 3 and 12 h of hypoxia were significantly higher than normal control (P<0.05), and peaked at 12 h. HIF-1α and VEGF expression in the hypoxic group and hypoxic+3-(5′-hydroxymethyl-2′-furyl)-1-benzyl indazole (YC-1) group were significantly higher than normal control (P<0.05), while expression in the hypoxic+YC-1 group was significantly lower than the hypoxic group (P<0.05). Bladder cell permeability in the hypoxic and hypoxic+YC-1 group were significantly increased compared to normal control (P<0.05), while in the hypoxic+YC-1 group was significantly decreased compared to the hypoxic group (P<0.05). Most of the cells in the stably transfected HIF-1α RNAi expression vector pcDNA6.2-GW/EmGFP-miR-siHIF-1α expressed green fluorescence protein (GFP) under fluorescence microscope. pcDNA6.2-GW/EmGFP-miR-siHIF-1α could significantly inhibit HIF-1α gene expression (P<0.05). HIF-1α and VEGF expression in the hypoxic group and siHIF-1α hypoxic group were significantly higher than normal group (P<0.05), while expression in the siHIF-1α hypoxic group was significantly lower than the hypoxic group (P<0.05). Findings suggest that HIF-1α is an important factor in the increase of bladder cancer cell permeability.

Circular RNA hsa_circ_0000523 regulates the proliferation and apoptosis of colorectal cancer cells as miRNA sponge

Among the novel class of endogenous long non-coding RNAs, circular RNA (circRNA) is known as a key regulator in the development and progression of different cancers. Its function and mechanism in the tumorigenesis of colorectal cancer, however, has not been well studied. This study thus aimed to investigate potential regulation of colorectal cancer by circRNAs and the corresponding regulatory mechanism. We demonstrated that the expression of circRNA hsa_circ_0000523 (also known as circ_006229) was down-regulated in different colorectal cancer cell lines. It was also found that interference of hsa_circ_0000523 induced proliferation and suppressed apoptosis of colorectal cancer cells, the proliferation rate of which was reduced by the overexpression of hsa_circ_0000523. In addition, we found that miR-31 could recognize hsa_circ_0000523 sequence and that it acted as a "sponge" of miR-31, indirectly regulating Wnt/β-catenin signaling pathway, which was involved in the progression of colorectal cancer. The results suggested that the expression of hsa_circ_0000523 correlated to the tumorigenesis of colorectal cancer cells. In addition, as a sponge of miR-31, the low level of hsa_circ_0000523 led to activation of Wnt/β-catenin signaling pathway, inducing the subsequent progress of colorectal cancer.

Balance and postural control in basketball players / Equilíbrio e controle postural em atletas de basquetebol

Abstract Introduction: Basketball is one of the most popular sports involving gestures and movements that require single-leg based support. Dorsiflexion range of motion (DROM), balance and postural control may influence the performance of this sport. Objective: To compare and correlate measures of balance, postural control and ankle DROM between amateur basketball athletes and non-athletes. Methods: Cross-sectional study, composed by 122 subjects allocated into one control group (CG = 61) and one basketball group (BG = 61). These groups were subdivided into two other groups by age: 12-14 years and 15-18 years. The participants were all tested for postural balance with the Star Excursion Balance Test (SEBT), postural control with the Step-down test and DROM with the Weight-bearing lunge test (WBLT). Between-groups differences were compared using repeated-measures multivariate analysis of variance. Normalized reaching distances were analyzed and correlated with the WBLT and Step-down test. Results: There was no difference in the scores of WBLT (P = .488) and Step-down test (P =. 916) between the groups. Scores for the anterior reach (P = .001) and total score of SEBT (P = .030) were higher in BG. The values for the posterolateral (P = .001) and posteromedial reach (P = .001) of SEBT were higher in BG at the age of 15-18. The correlation between the anterior reach of the SEBT and WBLT was significant in BG between 12-14 years (r = 0.578, P = .008), and in the CG between 15-18 years (r = 0.608, P=.001). Conclusion: The balance was better in the BG, although adolescents between 15-18 years have better balance control for the posteromedial and posterolateral reaches of the SEBT.

Resumo Introdução: O basquetebol é um dos esportes mais praticados na atualidade, o qual envolve gestos e movimentos que exigem apoio unipodal. Amplitude de movimento de dorsiflexão (ADMD), equilíbrio e controle postural podem influenciar o desempenho deste esporte. Objetivo: Comparar e correlacionar medidas de equilíbrio, controle postural e ADMD de tornozelo entre atletas de basquetebol amadores e não-atletas. Métodos: Trata-se de um estudo transversal, composto por 122 participantes. Estes foram distribuídos em grupo controle (GC = 61) e grupo basquete (GB = 61). Cada grupo foi subdivido em outros dois, de acordo com a idade: 12-14 e 15-18 anos. Todos foram avaliados para equilíbrio postural com Star Excursion Balance Test (SEBT), controle postural com Step-down teste e ADMD foi testada com Weight-bearing lunge test (WBLT). As diferenças entre os grupos foram comparadas pelo teste de medidas repetidas e análise de variância multivariada. Distâncias normalizadas dos alcances no SEBT foram analisadas e correlacionados com o WBLT e Step-down test. Resultados: Não houve diferença entre os grupos nos escores do WBLT (P = .488) e Step-down test (P = .916). A pontuação para alcance anterior (P = .001) e escore total de SEBT (P = .030) foram maiores no GB. Os valores para alcance posterolateral (P = .001) e posteromedial (P = .001) do SEBT foram maiores no GB de 15-18 anos. A correlação entre distância anterior do SEBT e WBLT foi significativa no GB de 12-14 anos (r = 0.578, P = .008) e no GC de 15-18 anos (r = 0.608, P = .001). Conclusão: O equilíbrio foi melhor no GB, embora adolescentes de 15-18 anos possuam melhor controle de equilíbrio para alcances posteromedial e posterolateral do SEBT.

Efficacy of minimally invasive tonsil surgery for treatment of obstructive sleep apnea-hypopnea syndrome in children

This study aimed to investigate the efficacy of minimally invasive tonsil surgery for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS) in children. Tonsil ablation or turbinate reduction was performed on 49 pediatric patients with OSAHS by minimally invasive tonsil surgery. In order to evaluate the efficacy of surgery, a comparison was conducted between pre-operation and post-operation data in terms of the symptoms, signs and polysomnography test. Total effectiveness rate of the surgery was 83.7%. Subgroup analysis was also performed based on the severity of their conditions: mild, moderate, and severe groups had an effectiveness rate of 90.0, 88.9, and 66.7%, respectively (Hc=6.665, P<0.05). Postoperatively, the apnea-hypopnea index, the minimum oxygen saturation (SaO2), and corresponding symptoms improved compared to pre-operation conditions (P<0.05). Minimally invasive tonsil surgery was a safe and effective method for treating OSAHS in children.

Meta-analysis of the efficacy of proton pump inhibitors for the symptoms of laryngopharyngeal reflux

The objective of this study was to perform a systematic review and meta-analysis to assess the effectiveness of proton pump inhibitors (PPI) for reflux disease in adult patients with laryngopharyngeal symptoms. A comprehensive search of Cochrane Library, EMBASE, Ovid EBM Reviews, and PubMed was performed for English-language literature about laryngopharyngeal reflux (LPR), in September 2014. The papers were filtered using pre-defined inclusion and exclusion criteria. Eight papers were identified and included in this meta-analysis. The sample comprised a pooled total of 370 patients, of which 210 and 160 patients took PPIs and placebo, respectively. The difference between PPIs and placebo groups in overall improvement of symptoms in adult patients with LPR was not statistically significant (RR=1.22; 95%CI=0.93-1.58; P=0.149). The difference in cough improvement was also not significant between PPIs and placebo groups (RR=0.65; 95%CI=0.30-1.41; P=0.279).

Role of mitochondrial ATP-sensitive potassium channel-mediated PKC-ε in delayed protection against myocardial ischemia/reperfusion injury in isolated hearts of sevoflurane-preconditioned rats

This study aimed to determine the role of mitochondrial adenosine triphosphate-sensitive potassium (mitoKATP) channels and protein kinase C (PKC)-ε in the delayed protective effects of sevoflurane preconditioning using Langendorff isolated heart perfusion models. Fifty-four isolated perfused rat hearts were randomly divided into 6 groups (n=9). The rats were exposed for 60 min to 2.5% sevoflurane (the second window of protection group, SWOP group) or 33% oxygen inhalation (I/R group) 24 h before coronary occlusion. The control group (CON) and the sevoflurane group (SEVO) group were exposed to 33% oxygen and 2.5% sevoflurane for 60 min, respectively, without coronary occlusion. The mitoKATP channel inhibitor 5-hydroxydecanoate (5-HD) was given 30 min before sevoflurane preconditioning (5-HD+SWOP group). Cardiac function indices, infarct sizes, serum cardiac troponin I (cTnI) concentrations, and the expression levels of phosphorylated PKC-ε (p-PKC-ε) and caspase-8 were measured. Cardiac function was unchanged, p-PKC-ε expression was upregulated, caspase-8 expression was downregulated, cTnI concentrations were decreased, and the infarcts were significantly smaller (P<0.05) in the SWOP group compared with the I/R group. Cardiac function was worse, p-PKC-ε expression was downregulated, caspase-8 expression was upregulated, cTnI concentration was increased and infarcts were larger in the 5-HD+SWOP group (P<0.05) compared with the SWOP group. The results suggest that mitoKATP channels are involved in the myocardial protective effects of sevoflurane in preconditioning against I/R injury, by regulating PKC-ε phosphorylation before ischemia, and by downregulating caspase-8 during reperfusion.

SIRT1 negatively regulates amyloid-beta-induced inflammation via the NF-B pathway

Chronic inflammation induced by amyloid-beta (Aβ) plays a key role in the development of age-related macular degeneration (AMD), and matrix metalloproteinase-9 (MMP-9), interleukin (IL)-6, and IL-8 may be associated with chronic inflammation in AMD. Sirtuin 1 (SIRT1) regulates inflammation via inhibition of nuclear factor-kappa B (NF-κB) signaling, and resveratrol has been reported to prevent Aβ-induced retinal degeneration; therefore, we investigated whether this action was mediated via activation of SIRT1 signaling. Human adult retinal pigment epithelial (RPE) cells were exposed to Aβ, and overactivation and knockdown of SIRT1 were performed to investigate whether SIRT1 is required for abrogating Aβ-induced inflammation. We found that Aβ-induced RPE barrier disruption and expression of IL-6, IL-8, and MMP-9 were abrogated by the SIRT1 activator SRT1720, whereas alterations induced by Aβ in SIRT1-silenced RPE cells were not attenuated by SRT1720. In addition, SRT1720 inhibited Aβ-mediated NF-κB activation and decrease of the NF-κB inhibitor, IκBα. Our findings suggest a protective role for SIRT1 signaling in Aβ-dependent retinal degeneration and inflammation in AMD.

Prevalence and factors associated with thoracic alterations in infants born prematurely / Prevalência e fatores associados às alterações torácicas em lactentes nascidos prematuros

OBJECTIVE: To determine the prevalence of thoracic musculoskeletal alterations and associated factors in infants born prematurely. METHODS: This was a cross sectional study with infants in the first year of age, born prematurely with birth weight < 2,000 g, who were followed up at the Premature Clinic from February, 2007 to December, 2008. Exclusion criteria were: maj or congenital malformations as defined by the Centers for Disease Control and Prevention (CDC), grade III/IV intraventricular hemorrhage, or periventricular leucomalacia. Physical examinations performed independently by two physiotherapists were used to assess shoulder elevation and thoracic retractions. Comparisons between groups were performed using the chi-squared test or Fisher's exact test for categorical variables, and Mann-Whitney's test or Student's t-test were used for continuous variables. Interobserver reliability between the two physiotherapists was assessed by the kappa coefficient. Variables associated with these thoracic musculoskeletal alterations were studied by univariate and multiple logistic analyses. Statistical differences were considered significant when p < 0.05. This study was approved by the ethical committee of the institution, and parents/guardians signed an informed consent. RESULTS: 121 infants with a gestational age of 31.1 ± 2.8 weeks and birth weight of 1,400 ± 338 g were included. Thoracic alterations were detected by Physiotherapist 1 in 81 (66.9%) infants, and in 83 (68.6%) by Physiotherapist 2 (kappa coefficient = 0.77). By multivariate logistic regression analysis, factors associated with thoracic musculoskeletal alterations were: respiratory distress syndrome (odds ratio [OR] = 3.246, 95% confidence interval [CI]: 1.237-8.732), bronchopulmonary dysplasia (OR = 11.138, 95% CI: 1.339-92.621), and low length/age ratio (OR = 4.571, 95% CI: 1.371-15.242). CONCLUSION: The prevalence of thoracic alterations was high in infants born prematurely, and was associated with pulmonary disease and low length/age ratio.

OBJETIVO: Determinar a prevalência e os fatores associados às alterações torácicas musculoesqueléticas em lactentes nascidos prematuros. MÉTODOS: Estudo transversal com lactentes no primeiro ano de vida, nascidos prematuros com peso < 2000 g e acompanhados em um ambulatório de seguimento de prematuros, de fevereiro/2007 a dezembro/2008. Foram excluídas crianças com malformações maiores definidas pelo CDC ou com hemorragia peri-intraventricular grau III/IV ou leucomalácia periventricular. Duas fisioterapeutas realizaram o exame físico, avaliando, de modo independente, a elevação de ombros e as retracões da caixa torácica. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Instituição, sendo solicitada assinatura do Termo de Consentimento pelos pais. As variáveis numéricas foram comparadas pelo teste t ou Mann-Whitney. O grau de concordância entre as avaliações das fisioterapeutas foi obtido pelo coeficiente kappa e as variáveis associadas às alterações torácicas foram estudadas por regressão logística univariada e múltipla. Considerou-se significante p < 0,05. RESULTADOS: Foram estudados 121 lactentes com idade gestacional de 31,1 ± 2,8 semanas e peso ao nascer de 1400 ± 338 g. A fisioterapeuta 1 detectou alterações torácicas em 81 (66,9%) lactentes e a fisioterapeuta 2 em 83 (68,6%) (coeficiente kappa = 0,77). Os fatores associados às alterações musculoesqueléticas foram: síndrome do desconforto respiratório no período neonatal (OR=3,246; IC 95%: 1,237-8,732), ter apresentado displasia broncopulmonar (OR=11,138; IC 95%: 1,339-92,621) e relação comprimento para a idade alterada (OR=4,571; IC 95%: 1,371-15,242). CONCLUSÃO: A prevalência de alterações torácicas foi alta em lactentes nascidos prematuros e associou-se a doença pulmonar no período neonatal e baixa relação comprimento/idade.

Clinical evaluation of fleroxacin in the treatment of bone and joint infections.

The objective of this open label, non-comparative study was to evaluate the efficacy and safety of fleroxacin 400mg administered orally once daily to patients with acute osteomyelitis and/or acute septic arthritis. Nineteen patients (10 males and 9 females) were evaluable for the analysis of clinical efficacy and safety. Of these, 7 (36.8%) had osteomyelitis and 12 (63.2%) had septic arthritis. Bacteriological cures were reported in 6 of 7 patients (85.7%) with osteomyelitis and in 8 of 11 patients (72.7%) with septic arthritis. The median duration of treatment for the clinical cures in osteomyelitis and septic arthritis were 29.5 days and 46 days respectively. The eradication rate for the most common pathogens, Salmonella enteritidis and Staphylococcus aureus were 77.7% and 80.0%, respectively. The clinical response was cure in 4 of 7 patients (57.1%) evaluable for osteomyelitis, and in 9 of 12 patients (75.0%) evaluable for septic arthritis at the three-month follow-up after treatment. Adverse reactions were minimal. It is concluded that fleroxacin appears to be an effective and safe in the treatment of acute osteomyelitis and acute septic arthritis.

Estudio comparativo de dos esquemas de tratamiento con Albendazol en himenolepiasis / Comparative study of two schemes of treatment with Albendazole in hymenolepiasis

El presente trabajo, se realizó en una población de 206 escolares pertenecientes al C.E. de menores 40473, colegio nacional mixto, cuyas edades variaban de 6 a 15 años. De los 206 escolares se recolectaron muestras fecales que fueron conservadas en formol salino, hasta el momento de su procesamiento, que se realizó mediante el método de Teleman modificado, utilizando el MIF como colorante. Se encontró 42 casos de HYMENOLEPSIS NANA (20.4%), a los cuales se les dividió en dos sub grupos. El grupo A recibió Albendazol, durante 3 días consecutivos, a la misma dosis diaria, en éste grupo luego de 10 días de la última dosis, se repitió el tratamiento. En ambos grupos luego de 21 días de concluido el tratamiento, se realizó un examen de heces seriado, por el método de recolección de 3 en 1 y procesadas con la misma técnica. En ambos grupos se obtuvo un porcentaje de éxito de 66.7% de curación de himenolepiasis. Albendazol en ambos grupos fue bien tolerado