Clinical significance of methyl-CpG binding protein 2 in postherpetic neuralgia: an observational study / Importancia clínica de la proteína 2 de unión a metil-CpG (MECP2) en la neuralgia posherpética: un estudio observacional

Abstract The present study was aimed to investigate the clinical significance of methyl-CpG binding protein 2 (MECP2) in patients with postherpetic neuralgia (PHN). This prospective case control study enrolled 319 cases of PHN patients from April 2017~December 2019. The patients' sleep quality and quality of life were evaluated using the Pittsburgh sleep quality score and the SF- 36 scale, respectively. The serum levels of MECP2, CRP, IL -6 and TNF-α were tested using enzyme linked immunosorbent assay (ELISA). The pain condition of the patients was evaluated using the visual analogue scale (VAS). The levels of MECP2 were significantly increased in PHN patients compared with the patients without PHN. Serum MECP2 levels were the highest in patients with severe pain, and were the lowest in patients with mild pain. Similarly, the frequency of severe pain in patients with low expression of MECP2 was significantly lower than the patients with higher MECP2 expression. Besides, serum levels of inflammatory factors CRP, IL -6 and TNF-α were markedly increased in PHN patients, which were also increased with the increase of the severity of pain. CRP, IL -6 and TNF-α were positively correlated with serum levels of MECP2 in PHN patients. Before the study, patients with lower MECP2 levels showed a significantly higher SF-36 score and lower Pittsburgh and VAS scores than patients with higher levels of MECP2. However, after one month, no significant difference was found between the patients. ROC curve showed MECP2 had the potential as a diagnostic biomarker for PHN. In conclusion, higher serum MECP2 levels are associated with a more severe pain condition and increased release of inflammatory factors.

Resumen El objetivo de este estudio fue investigar la importancia clínica de la MECP2 en pacientes con neuralgia posherpética (NPH). Este estudio observacional prospectivo incluyó 319 pacientes con NPH entre abril de 2017 y diciembre de 2019. La calidad del sueño y la calidad de vida de los pacientes se evaluaron con la escala de calidad del sueño de Pittsburgh y la escala SF - 36, respectivamente. Los niveles séricos de MECP2, PCR, IL -6 y TNF-α fueron determinados por ELISA. Se utilizó la escala visual analógica (EVA) para evaluar la intensidad del dolor. Los niveles de MECP2 en pacientes con NPH aumentaron significativamente en comparación con los pacientes sin NPH. El nivel sérico de MECP2 fue más alto en pacientes con dolor grave y el más bajo en pacientes con dolor leve. Además, la incidencia de dolor grave en pacientes con baja expresión de MECP2 fue significativamente menor que en pacientes con alta expresión de MECP2. Además, los niveles séricos de PCR, IL -6 y TNF-α aumentaron significativamente en pacientes con NPH, y se incrementaron con el aumento del grado de dolor. Los niveles séricos de PCR, IL -6 y TNF-α en pacientes con NPH se correlacionaron positivamente con los niveles séricos de MECP2. Antes del estudio, los pacientes con niveles más bajos de MECP2 tenían puntuaciones significativamente más altas de SF - 36, y puntuaciones más bajas de Pittsburgh y EVA que los pacientes con niveles más altos de MECP2. Sin embargo, no se encontraron diferencias significativas entre los pacientes un mes después. Las curvas ROC mostraron que la MECP2 podría ser un biomarcador de diagnóstico para la NPH. En general, los niveles séricos más altos de la MECP2 se asociaron con condiciones de dolor más graves y un aumento de la liberación de factores inflamatorios.

Survival analysis of 36 patients with malignant mesothelioma / 预防医学

Objective @#To analyze the survival of patients with malignant mesothelioma, so as to provide insights into the management of malignant mesothelioma.@*Methods @#Totally 36 patients with malignant mesothelioma admitted to Cixi Third People’s Hospital from October 2012 to January 2021 were enrolled, and the demographic features, exposure to asbestos, and diagnosis and treatment were retrospectively reviewed. The survival rate and median survival time were calculated with the life-table method, and the factors affecting the survival rate of malignant mesothelioma were identified using the Kaplan-Meier estimate and log-rank test.@*Results @#The 36 patients with malignant mesothelioma included 6 men ( 16.67% ) and 30 women ( 83.33% ), and had a median age of 61 ( interquartile range, 14 ) years. There were 30 cases with pleural malignant mesothelioma ( 83.33% ) and 6 cases with peritoneal malignant mesothelioma ( 16.67% ), 32 cases ( 88.89% ) with a history of occupational exposure to asbestos, and 26 cases ( 72.22% ) receiving palliative treatment. The 1-, 2- and 3-year cumulative survival rates were 30%, 15% and 3%, respectively, and the median survival time was 0.71 years. In addition, there were no significant differences in the survival period among patients with malignant mesothelioma in terms of gender, age, route of asbestos exposure, duration of asbestos exposure, pathogenic site and treatment regimens ( P>0.05 ).@*Conclusion @#The 36 patients with malignant mesothelioma had a median survival period of 0.71 years, and no association was found between the survival period and asbestos exposure or pathogenic site.

Physical exercise in the promotion of gene therapy auxiliary effect / O exercício físico na promoção de efeitos auxiliares da terapia genética / El ejercicio físico en la promoción de efectos auxiliares de la terapia genética

ABSTRACT Introduction: In recent years, genetic engineering has made outstanding contributions to sports, and it has played a huge role in promoting the development of sports-related fields. Objective: We analyze the tissue source of bone growth and healing by studying the role of bone morphogenetic protein and transforming growth factors in fracture injuries caused by sports. Methods: We established a human fracture model to express the shape and content of bone morphogenetic protein and transforming growth factor during fracture healing. Results: In the fracture healing stage caused by different sports, the expression levels of the two genes are different. Bone morphogenetic protein has a high content in the osteogenesis stage of the membrane, while transforming growth factor is high in the cartilage ossification stage. Conclusion: Gene therapy for fractures caused by physical exercise has certain advantages. Osteoblasts and chondrocytes are involved in the synthesis of transforming growth factors. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: Nos últimos anos, a engenharia genética tem contribuído de forma notável para os esportes, além de ter uma função importante na promoção do desenvolvimento de áreas relacionadas ao esporte. Objetivo: Analisamos a origem de tecidos do crescimento ósseo e sua regeneração através do estudo da proteína morfogenética óssea e fatores de transformação do crescimento em fraturas causadas pela prática do esporte. Métodos: Criamos um modelo de fratura humana para expressar a forma e o conteúdo da proteína morfogenética óssea e de fatores de transformação do crescimento durante a recuperação de fraturas. Resultados: Na fase de recuperação da fratura causada por diversos esportes, os níveis de expressão dos dois genes são diferentes. A proteína morfogenética óssea se apresenta em alta quantidade na fase osteogenetica da membrana, e o fator de transformação de crescimento apresenta alta quantidade na fase de ossificação da cartilagem. Conclusão: A terapia genética para fraturas causadas por exercícios físicos apresenta diversas vantagens. Osteoblastos e condrócitos tem um papel na síntese dos fatores de transformação do crescimento. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Introducción: En los últimos años, la ingeniería genética ha contribuido de forma notable para los deportes, además de tener una función importante en la promoción del desarrollo de áreas relacionadas al deporte. Objetivo: Analizamos el origen de tejidos del crecimiento óseo y su regeneración a través del estudio de la proteína morfogenética ósea y factores de crecimiento transformante en fracturas causadas por la práctica del deporte. Métodos: Creamos un modelo de fractura humana para expresar la forma y el contenido de la proteína morfogenética ósea y de factores de crecimiento transformante durante la recuperación de fracturas. Resultados: En la fase de recuperación de la fractura causada por diversos deportes, los niveles de expresión de los dos genes son diferentes. La proteína morfogenética ósea se presenta en alta cantidad en la fase osteogénica de la membrana, y el factor de crecimiento transformante presenta alta cantidad en la fase de osificación del cartílago. Conclusión: La terapia genética para fracturas causadas por ejercicios físicos presenta diversas ventajas. Osteoblastos y condrocitos tienen un papel en la síntesis de los factores de crecimiento transformante. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

Necrosis tisular local y trombocitopenia después de una intoxicación por mordedura de Bungarus multicinctusen una niña / Local tissue necrosis and thrombocytopenia following Bungarus multicinctus envenomation in a child

La intoxicación por mordedura de serpiente es un problema de salud pública global. En la población pediátrica, la intoxicación por mordedura de serpiente presenta características diferentes que en los pacientes adultos. La Bungarus multicinctus es una especie de elápido sumamente venenoso. Las presentaciones clínicas documentadas después de la intoxicación por mordedura de Bungarus multicinctus son reacciones locales mínimas, insuficiencia respiratoria, dolor generalizado e hiponatremia potencialmente mortal. Presentamos el caso de una intoxicación por mordedura de Bungarus multicinctus en una niña con manifestaciones clínicas atípicas, incluidas necrosis tisular grave y trombocitopenia con coagulopatía.

Snakebite envenoming is a global public health problem. The pediatric population poisoned by snakebite envenoming has different features than adult patients. Bungarus multicinctus is a highly venomous species of the elapid snake. The documented clinical presentations following Bungarus multicinctus envenoming are minimal local reactions, respiratory failure, general pain, and life-threatening hyponatremia. We present an uncommon case of Bungarus multicinctus envenomation in a girl with unusual clinical findings, including severe tissue necrosis and thrombocytopenia with coagulopathy.

Establishment of a deep learning-based visual model for intelligent recognition of Oncomelania hupensis / 中国血吸虫病防治杂志

Objective To establish a deep learning-based visual model for intelligent recognition of Oncomelania hupensis, the intermediate host of Schistosoma japonicum, and evaluate the effects of different training strategies for O. hupensis image recognition. Methods A total of 2 614 datasets of O. hupensis snails and 4 similar snails were generated through field sampling and internet capture, and were divided into training sets and test sets. An intelligent recognition model was created based on deep learning, and was trained and tested. The precision, sensitivity, specificity, accuracy, F1 score and Youden index were calculated. In addition, the receiver operating characteristic (ROC) curve of the model for snail recognition was plotted to evaluate the effects of “new learning”, “transfer learning” and “transfer learning + data enhancement” training strategies on the accuracy of the model for snail recognition. Results Under the “transfer learning + data enhancement” strategy, the precision, sensitivity, specificity, accuracy, Youden index and F1 score of the model were 90.10%, 91.00%, 97.50%, 96.20%, 88.50% and 90.51% for snail recognition, which were all higher than those under both “new learning” and “transfer learning” strategies. There were significant differences in the sensitivity, specificity and accuracy of the model for snail recognition under “new learning”, “transfer learning” and “transfer learning + data enhancement” training strategies (all P values < 0.001). In addition, the area under the ROC curve of the model was highest (0.94) under the “transfer learning + dataenhancement” training strategy. Conclusions This is the first visual model for intelligent recognition of O. hupensis based on deep learning, which shows a high accuracy for snail image recognition. The “transfer learning + data enhancement” training strategy is helpful to improve the accuracy of the model for snail recognition.

Apendicolito: factor explícito que ocasiona apendicitis complicada en la niñez / Appendicolith: an explicit factor leading to complicated appendicitis in childhood

Objetivos. El objetivo de este estudio fue evaluar el riesgo clínico de la apendicitis con apendicolito y su importancia al elegir las estrategias terapéuticas.Métodos. Se analizó retrospectivamente a niños con diagnóstico de apendicitis aguda entre junio de 2011 y enero de 2017. Se dividió en un grupo con apendicolito(GA) y un grupo sin apendicolito (GSA) según la presencia o no de apendicolito durante la cirugía abierta. Se revisaron y compararon la presentación clínica, de laboratorios, los resultados de la tomografía computada y los cambios patológicos.Resultados. De 163 pacientes, se incluyó a 23 (media de edad: 6,1 años) en el GA y a 140 (media de edad: 8,1 años) en el GSA. Los pacientes en el GA tuvieron una hospitalización más extensa, mayor temperatura corporal, mayor frecuencia de diarrea, signo de Blumberg, aumento del porcentaje de neutrófilos, proteína C-reactiva y mayor riesgo de perforación. La puntuación en las escalas de Alvarado (8,3 ± 1,2 frente a 7,0 ± 1,3; P < 0,05) y de respuesta inflamatoria a apendicitis (10,7 ± 1,6 frente a 7,7 ± 1,9; P < 0,05) fue mayor en el GA que en el GSA; la presencia de fiebre y apendicolito se asoció con una mayor tasa de apendicitis perforada.Conclusiones. La apendicitis pediátrica con apendicolito representa un mayor riesgo clínico y tiende a causar apendicitis complicada

Objectives. This study aims to assess the clinical risk of pediatric appendicitis with appendicolith and its guiding significance in therapeutic strategies' selection.Methods. Children diagnosed with acute appendicitis from June 2011-January 2017 were analyzed retrospectively. Patient cohort was divided to appendicolith group (AG) and non- appendicolith group (NAG) based on whether the appendicolith presents or not in the open surgery. Clinical presentations, laboratory parameters, computed tomography findings, and pathological changes were reviewed and compared between two groups. Results. Among 163 patients, 23 (meanage,6.1yearsold)weredefinedin AG and 140; mean age, 8.1 years old) in NAG. The patients in AG demonstrated prolonged length of stay (12.4 ± 5.6d vs. 8.7 ± 5.0d, P <0.05), higher body temperature (38.2 ± 0.8 °C vs. 37.3 ± 0.8 °C, P <0.05), higher frequency of diarrhea (17 % vs. 3%, P <0.05), rebound tenderness (100 % vs. 87 %, P <0.05), increased neutrophil percentage (81.4 ± 8.0 % vs. 65.3 ± 22.8 %, P <0.05), C-reactive protein (33.13 ± 10.3 mg/L vs. 23.7 ± 13.7 mg/L, P <0.05), and great risk of perforation (78 % vs. 29 %, P <0.05). Alvarado score (8.3 ± 1.2 vs. 7.0 ± 1.3, P <0.05) and AIR score (10.7 ± 1.6 vs. 7.7 ± 1.9, P <0.05) of AG, were higher than NAG he presence of fever and appendicolith was associated with a high rate of perforated appendicitis.Conclusions. Pediatric appendicitis with appendicolith has greater clinical risk and tends to causing complicated appendicitis

The temporal stability of recurrence quantification analysis attributes from chronic atrial fibrillation electrograms

Abstract Introduction The temporal behavior of atrial electrograms (AEGs) collected during persistent atrial fibrillation (persAF) directly affects ablative treatment outcomes. We investigated different durations of AEGs collected during persAF using recurrence quantification analysis (RQA). Methods 797 bipolar AEGs with different durations (from 0.5 s to 8 s) from 18 patients were investigated. Four RQA-based attributes were evaluated based on AEG durations: determinism (DET); recurrence rate (RR); laminarity (LAM); and diagonal lines' entropy (ENTR). The Spearman correlation (ρ) between each duration versus 8 s was calculated. AEG classification was performed following the CARTO criteria (Biosense Webster) and receiving operating characteristic (ROC) curves were created for the RQA variables. Results The RQA variables successfully discriminated the AEGs: the area under the ROC curves were as high as 0.70 for AEGs with 3.5 s or greater. Three types of AEGs were found using these variables: normal, fractionated and temporally unstable. The number of unstable AEGs decreased with longer AEG segments. Different AEG durations significantly affected the RQA variables (P<0.0001), with no statistical difference between the durations 6 s, 7 s and 8 s for DET, LAM and ENTR, and no difference between 7 s and 8 s for RR (P<0.0001). AEGs with 3 s or longer have shown ρ ≥ 80% for all variables. Conclusion The RQA variables have been shown effective in the characterization of AEGs collected during persAF with a shorter duration than current recommendations, which motivates their use for the characterization of atrial substrate during persAF ablation.

Confluent and reticulated papillomatosis: Case series of 3 patients from Kedah, Malaysia and literature review

@#Confluent and reticulated papillomatosis (CRP) was first described in 1927 by Gougerot and further characterised by Carteud.1 It is relatively rare, and the exact pathophysiology was not well known. Over the years, multiple treatment modalities were proposed. We report our experience with three cases of CRP which showed complete clearance with tetracycline group of antibiotics

Case Series of Acrodermatitis Enteropathica in Langkawi Hospital

Acrodermatitis enteropathica (AE) is a rare genetic autosomal recessive disorder characterised byperiorificial inflammatory rash, diarrhoea and hair loss. Hereby, we report 3 cases of acrodermatitisenteropathica.

Necrotising pneumonia: A pneumonia that may need surgical intervention

Pneumonia is primarily a disease that is usually managedmedically with antibiotics. However, in rare cases it mayprogress to necrotising pneumonia, which is an uncommonbut severe complication of bacterial pneumonia. This caseillustrates a typical case of necrotising pneumoniacomplicated with parenchymal and pleural complicationsuch as empyema, pneumothorax with possiblebronchopleural fistula. Early consultation with thoracicsurgeon can be life-saving.

The clinical significance on changes of plasma fibrinogen,plasminogen and D-dimmer before and after thrombolytic therapy in patients with acute myocardial infarction / 国际检验医学杂志

Objective To explore the changes of plasma fibrinogen ,plasminogen and D-dimmer before and after thrombolytic therapy in patients with acute myocardial infarction (AMI) ,to provide the evidence for treatment and prognosis AMI .Methods 93 cases of patients with AMI were divided into twe groups ,reperfusion group of 77 cases ,obstract group of 16 cases .At the same pe-riod ,30 cases myocardial infarction of patients with non thrombolytic therapy were selected as control group .The levels of plasma Fib ,Plg and D-dimer in each group were detected at different times .Results The levels of Fib and D-D in AMI patients were higher than those in the control group before thrombolysis therapy (P<0 .05) .Compared with before thrombolysis therapy ,the Fib and Plg levels of AMI patients were decreased significantly after thrombolytic therapy 6 h(P<0 .01) ,and returned to the normal level after 48 h .The D-dimmer level of AMI patients was increased significantly after thrombolytic therapy 6 h(P<0 .01) ,and returned to the normal level after 7 d .After thrombolytic therapy 6 h ,the levels of Fib and Plg of reperfusion group were decreased signifi-cantly(P<0 .05) ,the level of D-dimmer was increased significantly (P<0 .05) .Conclusion The levels of plasma fibrinogen ,plas-minogen and D-dimmer have important reference value for monitor the thrombolytic therapy effect in patients with AMI .

Changes of mean platelet volume, fibrinogen content and blood rheology in peripheral blood of youth patients with cerebral infarction / 中国实验血液学杂志

This study was aimed to explore the correlation of mean platelet volume (MPV), fibrinogen (FIB) and blood rheology with the youth patients with cerebral infarction, so as to provide the basis for the clinical early diagnosis and treatment. The 109 patients with cerebral infarction aged between 18 - 45 were divided into three group: the large (> 10 cm(3)), middle (4 - 10 cm(3)) and small (< 4 cm(3)) area infarction; 30 healthy persons were served as control group. All the four groups were subjected to 16 examinations, such as MPV, FIB, and rheology (Lηb, Mηb, Hηb, ηp, Lηr, Mηr, Hηr, KVE, EAI, ERI, EDI, EEI, HCT, ESR). The results showed that all the MPV, FIB and rheology indexes of the different infarction groups were higher than those of healthy control group (P < 0.05). The MPV, FIB and rheology indexes in the large area infarction group were all higher than those in the small area infarction group (P < 0.05). The indexes of MPV, FIB and rheology in the various cerebral infarction area groups obviously decreased, but those did not reach to the level in the healthy control group (P < 0.05). The MPV, FIB content and rheology level correlated with infarction areas (r = 0.36, 0.29 and 0.48, respectively). It is concluded that the serious intensity of youth patients with cerebral infarction positively correlated with the levels of MPV, FIB and rheology indexes. Regular examination of above mentioned index may be useful to prevent youth patients from cerebral infraction.

O conceito da reconstrução anatômica do LCA dupla banda / The concept of anatomic anterior cruciate ligament reconstruction

Um interesse cada vez maior na reconstrução dupla banda do LCA tem estimulado um grande avanço nesta área de pesquisa e levado a um aumento no nosso conhecimento de anatomia, cinemática e função do joelho. Estudos recentes têm melhor definido o tamanho e orientação das inserções femorais e tibiais das bandas ântero-medial e póstero-lateral do LCA. O objetivo da reconstrução anatômica do LCA é utilizar esses novos conceitos para melhorar a técnica cirúrgica e mimetizar a anatomia original do LCA. Acreditamos que a reconstrução anatômica do LCA irá resultar em uma melhora na biomecânica e, consequentemente, uma melhora no quadro funcional de cada paciente.

Detection of recent HIV-1 infections among men who have sex with men in Beijing during 2005 - 2006 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Men who have sex with men (MSM) have become one of the most risky populations for HIV infection in China. Though several cross-sectional sero-prevalence studies have been conducted, the annual HIV incidence remains unknown in this population.</p><p><b>METHODS</b>We applied IgG-capture BED-enzyme immunoassay (BED-CEIA) to define the recent HIV-1 infections among MSM in Beijing in the years 2005 and 2006 and the annual HIV incidence was estimated.</p><p><b>RESULTS</b>Overall, 1067 MSM samples were collected, including 526 samples in the year 2005 and 541 in 2006. In 2005, of 17 HIV seropositive samples, 7 were identified as recent HIV-1 infections and the estimated HIV infection incidence was 2.9% per year (95% CI, 0.8% - 5.0%). In 2006, of 26 HIV seropositive samples, 9 were identified as recent HIV-1 infections and the estimated annual incidence was 3.6% (95% CI, 1.3% - 5.9%), which was 0.7% higher than that in 2005. Individuals engaging in male group sexual intercourse (5.17% vs 0.87%, P = 0.019) and having receptive anal sexual intercourse more than five times (2.79% vs 0.33%, P = 0.047) in the past 6 months significantly increase the risk of being infected by HIV-1.</p><p><b>CONCLUSIONS</b>A high level of annual HIV-1 infection incidence was observed among MSM in Beijing for the consecutive years 2005 and 2006 with a continuous increasing trend. The rising incidence and related high risk behavior among MSM alarmed the health authorities and calls for more effective intervention strategies among this population.</p>

HIV-specific T cell immunity across the entire HIV genome in Chinese men who have sex with men / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Man who has sex with man (MSM) is one of the high risk groups for spreading HIV/AIDS. It was reported that the most prevalent human immunodeficiency virus type 1 (HIV-1) strain among MSM is subtype B; however, T cell immunity remains unknown across the HIV-1 B genome in this population.</p><p><b>METHODS</b>Using Elispot assay with synthetic peptides spanning the sequence of HIV-1 consensus B, HIV-1-specific cytotoxic T-cell lymphocyte responses were quantified among 3 treated and 19 untreated HIV-1 infected MSM from Beijing, China. Cross-sectional association between viral loads and cellular immune responses were analyzed.</p><p><b>RESULTS</b>Peptide pools corresponding to each HIV-1 protein were used for Env, Gag, Pol, Nef, Tat/Rev, Vpr/Vpu and Vif. The results showed that the magnitude of T cell responses in the 3 treated HIV(+) MSM group [median, 770 spot forming cells (SFCs) per 10(6) peripheral blood mononuclear cells (PBMCs)] might be significantly lower than that in the 19 untreated HIV(+) MSM group (median, 6175 SFCs per 10(6) PBMCs). Nef, Gag and Pol are the most frequently targeted HIV-1 antigens; and 16 subjects (73%) were identified with vigorous T cell immunity against each of these three proteins. The overall magnitude of T cell immunity closely related to its breadth (r = 0.72, P < 0.05) and was inversely but weakly associated with viral loads (r = -0.15). Further analysis showed that both Gag (r = -0.24) and Pol specific T cells (r = -0.12) contributed to this inverse association whereas Nef specific T cells showed no association with viral loads.</p><p><b>CONCLUSIONS</b>The magnitude of HIV-1 specific T cells is inversely but weakly associated with viral loads among MSM; HIV-specific T cell responses against conservative sequences (Gag and Pol) are the main contributors to this association among Chinese HIV(+) MSM. These findings have important implications for vaccine design.</p>