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Objective: This study aimed to investigate the association between epicardial fat volume (EFV) and obstructive coronary artery disease (CAD) with myocardial ischemia, and evaluate the incremental value of EFV on top of traditional risk factors and coronary artery calcium (CAC) in predicting obstructive CAD with myocardial ischemia. Methods: This study was a retrospective cross-sectional study. Patients with suspected CAD who underwent coronary angiography (CAG) and single photon emission computerized tomography-myocardial perfusion imaging (SPECT-MPI) at the Third Affiliated Hospital of Soochow University from March 2018 to November 2019 were consecutively enrolled. EFV and CAC were measured by non-contrast chest computed tomography (CT) scan. Obstructive CAD was defined as coronary artery stenosis≥50% in at least one of the major epicardial coronary arteries, and myocardial ischemia was defined as reversible perfusion defects in stress and rest MPI. Obstructive CAD with myocardial ischemia was defined in patients with coronary stenosis severity≥50% and reversible perfusion defects in the corresponding areas of SPECT-MPI. Patients with myocardial ischemia bot without obstructive CAD were defined as none-obstructive CAD with myocardial ischemia group. We collected and compared the general clinical data, CAC and EFV between the two groups. Multivariable logistic regression analysis was performed to identify the relationship between EFV and obstructive CAD with myocardial ischemia. ROC curves were performed to determine whether addition of EFV improved predictive value beyond traditional risk factors and CAC for obstructive CAD with myocardial ischemia. Results: Among the 164 patients with suspected CAD, 111 patients were males, and average age was (61.4±9.9) years old. 62 (37.8%) patients were included into the obstructive CAD with myocardial ischemia group. 102 (62.2%) patients were included into the none-obstructive CAD with myocardial ischemia group. EFV was significantly higher in obstructive CAD with myocardial ischemia group than in none-obstructive CAD with myocardial ischemia group ((135.63±33.29)cm3 and (105.18±31.16)cm3, P<0.01). Univariate regression analysis showed the risk of obstructive CAD with myocardial ischemia increased by 1.96 times for each SD increase in EFV(OR 2.96; 95%CI, 1.89-4.62; P<0.01). After adjustment for traditional risk factors and CAC, EFV remained as an independent predictor for obstructive CAD with myocardial ischemia (OR, 4.48, 95%CI, 2.17-9.23; P<0.01). Addition of EFV to CAC and traditional risk factors was related to larger AUC for predicting obstructive CAD with myocardial ischemia (0.90 vs. 0.85, P=0.04, 95%CI: 0.85-0.95) and the global chi-square increased by 21.81 (P<0.05). Conclusions: EFV is an independent predictor for obstructive CAD with myocardial ischemia. Addition of EFV to traditional risk factors and CAC has incremental value for predicting obstructive CAD with myocardial ischemia in this patient cohort.
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Male , Humans , Middle Aged , Aged , Female , Coronary Artery Disease/diagnostic imaging , Cross-Sectional Studies , Retrospective Studies , Myocardial Ischemia/diagnostic imaging , Coronary Stenosis , CalciumABSTRACT
Objective:To evaluate the clinical significance of molecular detection testing multiple pathogens in children with viral central nervous system infections.Methods:We retrospectively included 176 children who were suspected with central nervous system infection at Shanghai Children′s Medical Center from January 2017 to May 2021.Film Array Meningitis/Encephalitis Panel(FA-M/E) was used to test cerebrospinal fluid samples of these children.The results were analyzed compared with clinical symptoms and cerebrospinal fluid indices.Results:There were 34 samples with positive FA-M/E virus detection(19.32%, 34/176). Among the 34 samples, enterovirus was the most common pathogen(27 cases, 79.41%). In different combinations, the sensitivity and positive predictive value were all less than 90%.The median time for antiviral drugs used in FA-M/E virus-positive and negative children was 4.5(0, 8.5)d and 2.6(0, 2.0)d, respectively.The difference was statistically significant( P<0.05). Conclusion:Molecular tests of multiple pathogens can quickly and sensitively detect pathogens.It can improve the efficacy of clinical diagnosis of viral central nervous system infection.
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It was found that intestinal flora could directly regulate mitochondria of intestinal epithelial cells or indirectly through the nucleus. This effect is associated with the flora metabolites such as short-chain fatty acids (SCFAs), hydrogen sulfide (H2S) and nitric oxide (NO). These metabolites are involved in mitochondria-related energy metabolic processes and the production of mitochondrial reactive oxygen species (mtROS), and even in the immune response of the whole organism. Numerous studies have also shown that intestinal flora metabolites and mitochondria have become a hot spot for research on the mechanism of action of traditional Chinese medicine, but the research on the mechanism of association between them is not yet in-depth. In this review, we summarize the mechanism of mitochondrial regulation of intestinal epithelial cells by intestinal flora metabolites and herbal interventions to provide a theoretical basis for targeting intestinal microbes and mitochondria to regulate body metabolism and health.
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Objective:To evaluatte the high risk factors of stent occlusion in patients with acute iliofemoral vein thrombosis and Cockett syndrome.Methods:The clinical data of 178 patients of Cockett syndrome and acute lower extremity deep vein thrombosis from Jan 2014 to Dec 2016 was analyzed retrospectively. All patients underwent catheter directed thrombolysis or percutaneous mechanical thrombectomy combined with stent placement. The patency rate of stent was followed up by color Doppler ultrasound. Patients were divided into study group (stent occlusion) and control group (stent patency).Results:The stent patency rate at 6 months was 83.7%, body mass index ( OR=1.245, 95% CI: 1.097-1.413), time of thrombosis more than 2 weeks ( OR=3.899, 95% CI: 1.147-13.257), low thrombus clearance ( OR=0.238, 95% CI: 0.117-0.486) was the high risk factor of short-term stent occlusion. Stent patency rate at 3 years was 75.3%, body mass index( OR=1.225, 95% CI: 1.076-1.394), thrombosis history more than 2 weeks( OR=11.777, 95% CI: 2.576-53.832), malignant tumor( OR=4.444, 95% CI: 1.153-17.127) , compression therapy( OR=0.332, 95% CI: 0.113-0.977), low thrombus clearance( OR=0.184, 95% CI: 0.089-0.381), long stents( OR=8.427, 95% CI: 2.329-30.488) was the high risk factor for mid-term stent occlusion. Conclusions:Obesity, the duration of thrombus longer than 2 weeks and low thrombus clearance are the high risk factors of early stent occlusion, while malignant tumor, irregular compression therapy and long stents may lead to lower medium and long term patency rate of the stent.
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Objective:To explore the value of FilmArray meningitis/encephalitis(ME)Panel in etiological diagnosis of infection in central nervous system(CNS) in Chinese children.Methods:Cerebrospinal fluid(CSF)obtained through lumbar puncture was collected from 145 patients with suspected CNS infection at Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine from March 2019 to November 2019.All specimens were cultured simultaneously, which were detected by FilmArray ME Panel, and the results of cerebrospinal fluid culture and FilmArray ME Panel were compared.Results:Among 145 patients with suspected CNS infection, three samples were found to be positive after cerebrospinal fluid culture, and the positive rate was 2.1%(3/145). For the FilmArray ME Panel, 30 specimens were found to be positive, with a positive rate of 20.7%(30/145), and the difference of positive rate between the two methods was statistically significant( χ2=24.927, P<0.05). Among the samples FilmArray ME Panel tested positive with pathogen, 26 specimens were positive with virus making up 17.9%(26/145)and enterovirus(15.2%)was the primary pathogen.In addition, of the 142 specimens cerebrospinal fluid culture negative, 28 samples were tested positive by the FilmArray ME Panel, accounting for 19.7%(28/142). Conclusion:FilmArray ME Panel has the characteristics with high positive rate and could be time-saving.Meanwhile, FilmArray ME Panel has significant advantage in the detection of virus and improves the positive detection rate of virus.
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Objective: To explore the association between inflammation activity of left atrial epicardial adipose tissue (LA-EAT) measured by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and atrial fibrillation (AF). Methods: A total of 78 patients with AF, who underwent 18F-FDG PET/CT in the Nuclear Medicine Department of the Third Affiliated Hospital of Soochow University due to abnormally elevated levels of tumor indicators or malignant tumors from March 2018 to December 2019, were enrolled in this retrospective study. According to the examination date of PET/CT and basic characteristics of AF patients (gender, age), a 1∶1 propensity score matching was used to enroll a non-AF control group (78 patients). The maximum standard uptake value of left atrial epicardial tissue (LA-EAT FDG SUVmax) and total EAT volume (V-EAT) were measured by 18F-FDG PET/CT. Left ventricular ejection fraction (LVEF) and left atrial diameter (LAD) were obtained by echocardiography. Blood lipids and biomarkers of inflammation were measured. The differences of clinical data and EAT-related indicators were compared between the AF group and control group. Logistic multivariate regression analysis was used to determine the related factors of AF. Then the receiver operating characteristic (ROC) curve was used to determine the cutoff value of LA-EAT FDG SUVmax on the diagnosis of AF. Univariate and multivariate logistic regression analysis were used to analyze the relationship between the increase of LA-EAT FDG SUVmax and AF. Results: The age was (66.9±10.2) years and there were 55 males (70.5%) in the AF group. The age was (66.9±8.0) years, and there were 52 males (66.7%) in the control group (both P>0.05). The LAD ((44.2±5.8) mm vs. (35.4±4.4) mm), V-EAT ((122.1±42.0) cm3 vs. (91.6±34.5) cm3), and LA-EAT FDG SUVmax ((1.6±0.3) vs. (1.4±0.2)) values were significantly higher, while LVEF ((60.1±4.7)% vs. (63.9±2.9)%) was lower in the AF group than in the control group (P all<0.001). Multivariate logistic regression analysis showed that LAD (OR=1.340, 95%CI 1.195-1.502), V-EAT (OR=1.016, 95%CI 1.001-1.031), and LA-EAT FDG SUVmax (OR=1.375, 95%CI 1.095-1.723) were positively correlated with AF, LVEF (OR=0.781, 95%CI 0.659-0.926) was negatively correlated with AF(P all<0.05). The area under the ROC curve of LA-EAT FDG SUVmax for diagnosis of AF was 0.680 (95%CI 0.597-0.764, P<0.001), and the best cut-off value was 1.415 with a sensitivity of 65.4% and specificity of 61.5%. After adjusting for high-density lipoprotein cholesterol, LVEF, LAD and V-EAT, LA-EAT FDG SUVmax≥1.415 was independently associated with AF (OR=2.982, 95%CI 1.122-7.926, P=0.010). Conclusions: The inflammatory activity of LA-EAT measured by 18F-FDG PET/CT is an independent risk factor of AF, and the increased inflammatory activity of LA-EAT is positively correlated with AF.
Subject(s)
Aged , Humans , Male , Middle Aged , Adipose Tissue/diagnostic imaging , Atrial Fibrillation/diagnostic imaging , Fluorodeoxyglucose F18 , Inflammation/diagnostic imaging , Positron Emission Tomography Computed Tomography , Retrospective Studies , Stroke Volume , Ventricular Function, LeftABSTRACT
The quality of Astragali Radix (AR) was closely related to the growth period. However, the current commodity grades of AR were only divided by diameter but not directly related to the growth period, which leads to the contradiction between the grade standard and the quality evaluation index. Therefore, solving this problem will be the key for the quality evaluation of AR. The present study established a potential quality evaluation approach for the absolute growth years' wild Astragali Radix (WAR) and transplanted Astragali Radix (TAR) based on the chemical components and anti-heart failure efficacy through adopting a bare-handed sections approach to rapidly identify the growth years of WAR. In this study, the absolute growth years of WAR were obtained by identifying the growth rings of 1-6 growth years root through the methods. The contents of flavonoids and saponins in 2-6 growth years' WAR were determined by HPLC-UV-ELSD. The contents of 12 chemical components and the anti-fatigue failure effects of WAR (4-year-old) and TAR were compared on rat models of heart failure induced by doxorubicin. Meanwhile, NMR-based untargeted metabolomics studies were performed to investigate the regulative effects of WAR and TAR. The result shows that the numbers of growth rings were consistent with the actual growth periods of AR. The HPLC-UV-ELSD determination indicated that the content of total flavonoids in WAR was significantly higher than that in TAR. Pharmacodynamics analysis revealed that the effects of WAR on cardiac function parameters (EF, FS and LVIDs), contents of serum CK and BNP were superior to those of TAR. 13 metabolites of heart were identified that had a higher rate of change in WAR group than TAR. Overall, a rapid identification method for the growth years of WAR was established, and the fact that WAR were significantly better than TAR in the heart failure rats was first proved in the paper. This study provided a scientific basis for establishing a novel commodity specification and grade of AR for clinical rational drug use.
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Objective:To explore the clinical characteristics of influenza A virus infection in children, and provide evidence for early identification of severe patients.Methods:A total of 114 patients with influenza like symptoms admitted to Shanghai Children′s Medical Center from October 2017 to May 2019 were enrolled in our study.All the patients were confirmed influenza A infection by Xpert-Xpress influenza/respiratory syncytial virus detection platform.The patients were divided into mild influenza A group (47 cases) and severe influenza A group (67 cases with pneumonia). The clinical data of these patients were analyzed and compared.Results:The male to female ratio of 114 cases was 1.28∶1.The age of included patients ranged from 1 month 12 days to 12 years old, and the median age was 3.00 (4.27) years old.The most common clinical manifestations were fever, cough and wheezing, accounting for 79.82%, 68.42%, and 43.00%, respectively.The rate of mixed infection was 24.56%, and adenovirus(5.26%), respiratory syncytial virus(4.39%) as well as mycoplasma(3.51%) accounted for the top three, and the rate of mixed bacterial infection was 12.28%.The median age of the patients in the severe influenza A group was 1.00 (3.58) years, and that in the mild influenza A group was 4.00 (5.00) years, with statistical difference ( Z=-3.81, P<0.001). The mixed infection rate was 38.80% (26/67) in severe influenza A group and 4.26% (2/47) in mild influenza A group, with statistical difference ( χ2= 17.8, P<0.001). The neutrophil/lymphocyte ratio in peripheral blood was 2.64 (3.37) in severe influenza A group and 1.17 (2.02) in mild influenza A group, with statistical difference ( χ2=-2.46, P=0.01). Conclusion:Children with smaller age, mixed infection and higher neutrophil/lymphocyte ratio are easy to develop into severe cases.The detection system of Xpert-Xpress influenza / respiratory syncytial virus is a simple, rapid and accurate method for influenza detection, which provides a good basis for diagnosis and treatment.
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Objective:To investigate the clinical features of Herpes simplex virus encephalitis(HSE) with cerebral hematoma as the prominent manifestation and the significanc of metagenomic next-generation sequencing (mNGS) in the diagnosis of HSE.Methods:The clinical manifestations, diagnostic process, clinical treatment and prognosis of a case of HSE with cerebral hematoma as the prominent manifestation at Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine in June 2019 were retrospectively analyzed.The relevant literatures were also searched and reviewed.Results:A 4-year-old boy presented with slight fever, headache, convulsion and vomiting was considered to have intracranial space-occupying lesions and possible intratumoral hemorrhage after undergoing imaging examination at a local hospital.The patient was checked by head CT in Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, which showed that there were many bleeding foci in the brain, indicating the possibility of complications of blood system diseases.Therefor the child was given the examination of blood routine and coagulation routine, but the results were normal, the bone marrow cytology was negative, the cerebrospinal fluid(CSF) of lumbar puncture was biochemically normal, and mNGS were 8×10 6/L.Besides, CSF smear, culture and next-generation sequencing were negative, the autoimmune encephalitis CSF testing was negative, and brain biopsy suggested inflammation.The mNGS brain tissue showed herpes simplex virus 1 was positive in two specimens, confirming the diagnosis of HSE.After 3 weeks of antiviral treatment with Aciclovir, the child′s condition improved.After a 5-month follow-up, the patient had quadriplegia and only had activities such as blinking and swallowing. Conclusions:When the intracerebral hemorrhage such as hematoma caused by encephalitis clinically can not be ruled out, the possibility of HSE should be considered, and mNGS is helpful for identifying the central ner-vous system pathogen.
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Objective: To compare the incidence of coronary microvascular disease (CMVD) between patients with non-obstructive and obstructive coronary arteries. Methods: We retrospectively analyzed 97 patients with angina pectoris, who underwent the absolute quantitative PET examination of myocardial perfusion and coronary anatomy examination within 90 days. All patients were divided into two groups: non-obstructive group (72 cases, no stenosis ≥50% in all three coronary arteries) and obstructive group (25 cases, at least one coronary stenosis ≥50%; and at least one coronary stenosis<50%). Quantitative parameters derived from PET including rest myocardial blood flow (RMBF), stress myocardial blood flow (SMBF), coronary flow reserve (CFR) and cardiovascular risk factors were compared between the two groups. CMVD was defined as CFR<2.90 and SMBF<2.17 ml·min(-1)·g(-1). Results: Incidence of CMVD was significant higher in the non-obstructive coronary arteries of the obstructive group than in the non-obstructive coronary arteries of non-obstructive group (47.1% (16/34) vs. 25.5% (55/216), χ(2)=6.738, P=0.009) while incidence of CMVD was similar between non-obstructive and obstructive patients ((44% (11/25) vs. 33.3% (24/72), χ(2)=0.915, P=0.339). RMBF ((0.83±0.14) ml·min(-1)·g(-1) vs. (0.82±0.17) ml·min(-1)·g(-1)), SMBF ((2.13±0.60) ml·min(-1)·g(-1) vs. (1.91±0.50) ml·min(-1)·g(-1)) and CFR (2.59±0.66 vs. 2.36±0.47) were similar between the two groups (all P>0.05). Conclusions: CMVD can occur in non-obstructive coronary arteries in both patients with non-occlusive coronary arteries and patients with obstructive coronary arteries. Prevalence of CMVD is significantly higher in patients with obstructive coronary arteries than in patients with non-obstructive coronary arteries. The CMVD severity is similar between the two groups.
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Humans , Coronary Angiography , Coronary Artery Disease , Coronary Circulation , Coronary Stenosis , Myocardial Perfusion Imaging , Positron-Emission Tomography , Retrospective StudiesABSTRACT
As one of the two methods for 2019 novel coronavirus (2019-nCoV), gene sequencing is different from quantitative real-time PCR (RT-PCR) in detection principles. Therefore, gene sequencing has its own pros and cons in clinical application. Currently, metagenomic next-generation sequencing (mNGS) is the most commonly used technology in clinical application.Due to its broad coverage of all types of pathogens, mNGS demonstrates incomparable advantage in rapid identification of novel pathogens such as 2019-nCoV. In addition, it can simultaneously identify other pathogens except 2019-nCoV and mixed infections. On the other hand, however, due to the complexity of mNGS and long detection time, it is unlikely to achieve the purpose of wide-range and rapid diagnosis of 2019 n-CoV. Therefore, mNGS can complement RT-PCR to achieve best clinical application.
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As one of the two methods for 2019 novel coronavirus (2019-nCoV), gene sequencing is different from quantitative real-time PCR (RT-PCR) in detection principles. Therefore, gene sequencing has its own pros and cons in clinical application. Currently, metagenomic next-generation sequencing (mNGS) is the most commonly used technology in clinical application. Due to its broad coverage of all types of pathogens, mNGS demonstrates incomparable advantage in rapid identification of novel pathogens such as 2019-nCoV. In addition, it can simultaneously identify other pathogens except 2019-nCoV and mixed infections. On the other hand, however, due to the complexity of mNGS and long detection time, it is unlikely to achieve the purpose of wide-range and rapid diagnosis of 2019 n-CoV. Therefore, mNGS can complement RT-PCR to achieve best clinical application.
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Objective: To explore the receiuer operating characteristic(ROC) curve mathematical statistics method to establish the content limit of isoflavones glucoside contents in Astragali Radix,in order to distinguish the difference in isoflavones glucoside content between Hengshan wild-simulated Astragali Radix in Shanxi and cultivated Astragali Radix in Gansu. Method: A total of 225 samples of 45 batches of wild-simulated Astragali Radix in Hengshan and 210 samples of 42 batches of cultivated Astragali Radix in Gansu were selected as research objects,and isoflavones glucoside contents of these samples were determined by using the method in the edition 2015 Chinese Pharmacopoeia. Data was statistically analyzed, and the ROC curve was used to determine the critical value of wild-simulated Astragali Radix in Hengshan and transplanted Astragali Radix in Gansu. Result: The average contents of isoflavones glucoside in imitative wild Astragali Radix in Henshan and cultivated Astragali Radix in Gansu were 0.107%and 0.039%respectively,with statistically significant differences(PConclusion: ROC curve can be used to distinguish the critical value of the wild-simulated Astragali Radix in Hengshan and cultivated Astragali Radix in Gansu. The results reflected the regularity of "high quality and good price" in the market. The research provided a theoretical basis for the establishment of standard of high-quality Chinese herbal medicines.
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Objective@#To investigate the interaction between the gut microbiota and the sepsis in children by comparing the difference of gut microbiota between septic children and healthy children.@*Methods@#Genome was extracted from excrements of 18 cases of sepsis and 6 cases of healthy children.After genomic extraction, the hypervariable region of 16S rDNA gene were amplified and a small fragment library was constructed, and high-throughput sequencing was carried out, then the data of the lower machine was effectively sequenced by biological information processing.We could seek for the species that had changed significantly due to sepsis by comparing the diversity and the differences in the composition of intestinal flora between the two groups.@*Results@#The gut microbiome of the sepsis group was distinct from that of the health group.The operational taxonomic units in the sepsis group were significantly reduced compared with healthy group(P=0.001). The gut microbiome of children with sepsis had significantly lower diversity and richness compared with healthy group(P<0.05). A total of 7 species were shown to be differentially abundant between septic patients and healthy controls.The genus Pseudomonadales, Carnobacteriaceae and Granulicatella_elegans were significantly more abundant in the sepsis group; meanwhile the genus Pasteurellaceae, Ruminococcus, Lactobacillus_rogosae and Anaerostipes_butyratucus were less abundant in the sepsis group.In addition, the Granulicatella_elegans was characteristically present in the intestine of children with sepsis(P<0.001).@*Conclusion@#The microbial diversity and structure of the gut microbiome in children with sepsis are significantly different from those of healthy children.Our data suggest biomarkers identified in this study might participate in the pathogenesis or development process of sepsis.
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Objective To compare the growth and reproduction of the promastigotes of Leishmania isolates from various endemic areas of visceral leishmaniasis in China in various culture media, so as to provide experimental evidence for selecting an appropriate medium for the culture of Leishmania. Methods A total of 3 × 105 promastigotes of KS-2, Cy and JIASHI-5 Leishmania isolates were inoculated into 1 mL NNN medium, 1 mL M199 medium supplemented with 20% fetal bovine serum medium, 1 mL M199 medium supplemented with 20% horse serum medium, and 1 mL brain heart infusion medium containing heme, respectively. All media were placed at 22 ℃ under a sterile condition, and the number of promastigotes was counted continuously for 8 days under a microscope. The growth curve was plotted for the three Leishmania isolates. Results The promastigotes of KS-2, Cy and JIASHI-5 Leishmania isolates all grew and reproduced in the NNN medium, the M199 medium supplemented with 20% fetal bovine serum medium, and the M199 medium supplemented with 20% horse serum medium. The number of promastigotes of KS-2, Cy and JIASHI-5 Leishmania isolates was all significantly higher in the NNN medium than in the M199 medium supplemented with 20% fetal bovine serum medium, and the M199 medium supplemented with 20% horse serum medium at various time points of culture (all P values < 0.05), and the number of promastigotes of the KS-2 isolate was all significantly greater than that of the Cy and JIASHI-5 isolates in the NNN medium, the M199 medium supplemented with 20% fetal bovine serum medium, and the M199 medium supplemented with 20% horse serum medium at various time points of culture (all P values < 0.05). In ad dition, the promastigotes of KS-2, Cy and JIASHI-5 Leishmania isolates failed to grow and reproduce in the brain heart infusion medium. Conclusions The growth and reproduction of the promastigotes of various Leishmania isolates from various endemic areas of visceral leishmaniasis in China vary in the same culture medium, and the growth and reproduction of a Leishmania isolate vary in different culture media. The NNN medium best fits for the culture of Leishmania isolates in the endemic areas of visceral leishmaniasis in China.
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Objective To analyze the protein abundance differences between two Leishmania infantum strains isolated from different epidemiological types of visceral leishmaniasis in China by comparative proteomics method. Methods Tryptic digests of total proteins were analyzed by using liquid chromatography-tandem mass spectrometry (LC-MS/MS), followed by label-free quantitative differential expression analysis. The MS data were analyzed with MaxQuant software (ver 1.3.0.5) against data base. Results This study resulted in the identification of 4 274 proteins across two strains (JIASHI-5 and SC6) . Of these, 1 219 differentially expressed proteins (ratio ＞ 2.0 or ＜ 0.5, P < 0.05) were identified. Considering the proteins differentially or uniquely expressed in the strains, 550 proteins were only found in the JIASHI-5 strain, and 174 proteins were only found in the SC6 strain. Totally 495 differentially proteins were expressed in the two groups, among which 328 proteins were down-regulated and 167 proteins were up-regulated in SC6 strain. Some of the identified differentially expressed proteins were demonstrated and they involved in energy metabolism, stress response, prolonging the lifetime of the infected host cell and survival and proliferation in virulent strains. Conclusion This study reveals a group of differentially expressed proteins and the related biologic function that may lay the foundation for screening and identification of the key Leishmania molecules relative to pathogenicity.
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Objective To compare the growth and reproduction of the promastigotes of Leishmania isolates from various endemic areas of visceral leishmaniasis in China in various culture media, so as to provide experimental evidence for selecting an appropriate medium for the culture of Leishmania. Methods A total of 3 × 105 promastigotes of KS-2, Cy and JIASHI-5 Leishmania isolates were inoculated into 1 mL NNN medium, 1 mL M199 medium supplemented with 20% fetal bovine serum medium, 1 mL M199 medium supplemented with 20% horse serum medium, and 1 mL brain heart infusion medium containing heme, respectively. All media were placed at 22 ℃ under a sterile condition, and the number of promastigotes was counted continuously for 8 days under a microscope. The growth curve was plotted for the three Leishmania isolates. Results The promastigotes of KS-2, Cy and JIASHI-5 Leishmania isolates all grew and reproduced in the NNN medium, the M199 medium supplemented with 20% fetal bovine serum medium, and the M199 medium supplemented with 20% horse serum medium. The number of promastigotes of KS-2, Cy and JIASHI-5 Leishmania isolates was all significantly higher in the NNN medium than in the M199 medium supplemented with 20% fetal bovine serum medium, and the M199 medium supplemented with 20% horse serum medium at various time points of culture (all P values < 0.05), and the number of promastigotes of the KS-2 isolate was all significantly greater than that of the Cy and JIASHI-5 isolates in the NNN medium, the M199 medium supplemented with 20% fetal bovine serum medium, and the M199 medium supplemented with 20% horse serum medium at various time points of culture (all P values < 0.05). In ad dition, the promastigotes of KS-2, Cy and JIASHI-5 Leishmania isolates failed to grow and reproduce in the brain heart infusion medium. Conclusions The growth and reproduction of the promastigotes of various Leishmania isolates from various endemic areas of visceral leishmaniasis in China vary in the same culture medium, and the growth and reproduction of a Leishmania isolate vary in different culture media. The NNN medium best fits for the culture of Leishmania isolates in the endemic areas of visceral leishmaniasis in China.
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Objective To investigate the interaction between the gut microbiota and the sepsis in children by comparing the difference of gut microbiota between septic children and healthy children. Methods Genome was extracted from excrements of 18 cases of sepsis and 6 cases of healthy children. After genom-ic extraction,the hypervariable region of 16S rDNA gene were amplified and a small fragment library was constructed,and high-throughput sequencing was carried out,then the data of the lower machine was effec-tively sequenced by biological information processing. We could seek for the species that had changed signifi-cantly due to sepsis by comparing the diversity and the differences in the composition of intestinal flora between the two groups. Results The gut microbiome of the sepsis group was distinct from that of the health group. The operational taxonomic units in the sepsis group were significantly reduced compared with healthy group(P＝0. 001). The gut microbiome of children with sepsis had significantly lower diversity and richness compared with healthy group(P<0. 05). A total of 7 species were shown to be differentially abundant be-tween septic patients and healthy controls. The genus Pseudomonadales,Carnobacteriaceae and Granulicatella elegans were significantly more abundant in the sepsis group; meanwhile the genus Pasteurellaceae, Ruminococcus,Lactobacillus rogosae and Anaerostipes butyratucus were less abundant in the sepsis group. In addition,the Granulicatella elegans was characteristically present in the intestine of children with sepsis(P<0. 001). Conclusion The microbial diversity and structure of the gut microbiome in children with sepsis are significantly different from those of healthy children. Our data suggest biomarkers identified in this study might participate in the pathogenesis or development process of sepsis.
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@#AIM: To explore the clinical effect of micro-pulse laser at 577nm threshold in treatment of diabetic macular edema(DME).<p>METHODS: The clinical data of 48 patients with DME(64 eyes)were retrospectively analyzed. The patients with micro-pulse laser at 577nm threshold were included in observation group(26 cases, 35 eyes), and the patients who underwent conventional grid-like laser were included in control group(22 cases, 29 eyes). The best corrected visual acuity(BCVA)(LogMAR visual acuity chart), central macular foveal thickness(CFT), mean tetinal sensitive(MS)and mean visual deviation(MD)were compared before surgery and at 1, 3 and 6mo after surgery. And duration of fundus hard exudate and the occurrence of complications after surgery were analyzed in the two groups.<p>RESULTS: At 1, 3 and 6mo after surgery, the LogMAR visual acuity test results and CFT levels in the two groups were significantly decreased compared with those before surgery, and the indexes in observation group were significantly lower than those in control group at the same time(0.30±0.09 <i>vs</i> 0.35±0.10, 0.19±0.07 <i>vs</i> 0.26±0.09, 0.13±0.04 <i>vs</i> 0.18±0.05; 349.26±21.80 μm <i>vs</i> 364.37±23.91μm, 314.46±20.49μm <i>vs</i> 335.07±22.68μm, 328.35±21.74μm <i>vs</i> 352.43±23.60μm)(all <i>P</i><0.05). Compared with preoperative, the MS and MD levels in observation group were significantly increased, and significantly higher than that in control group at the same time(5.83±1.16dB <i>vs</i> 4.22±1.04dB, 6.38±1.29dB <i>vs</i> 4.49±1.17dB, 6.75±1.22dB <i>vs</i> 4.68±1.20dB, -5.53±1.41dB <i>vs</i> -7.66±1.52dB, -5.09±1.30dB <i>vs</i> -7.26±1.39dB, -4.68±1.14dB <i>vs</i> -7.05±1.26dB)(all <i>P</i><0.05). The duration of fundus hard exudate in observation group was significantly lower than that in control group(3.39±0.80mo <i>vs</i> 4.25±1.14mo)(<i>P</i><0.05). Within 6mo after surgery, the incidence rate of eyeball pain in observation group was significantly lower than that in control group \〖3%(1/35)<i>vs</i> 24%(7/29)\〗(<i>P</i><0.05), but there were no statistically significant differences in the incidence rates of anterior chamber inflammatory response, visual field defect, intraocular hypertension and corneal edema.<p>CONCLUSION: Micro-pulse laser at 577nm threshold is safe and effective for DME.
ABSTRACT
Objective To explore the clinical characteristics of acute lower respiratory tract infection in children after influenza,and to provide evidence-based basis for timely diagnosis and accurate treatment of acute lower respiratory tract infection in children after influenza. Methods Eighty- two patients with acute lower respiratory tract infection admitted to Shanghai Children′ s Medical Center from October 2016 to November 2017 were enrolled in our study. The clinical data of these patients were analyzed and influenza A or influenza B were confirmed by Filmarray platform. The clinical characteristics of patients with influenza A and influenza B,severe pneumonia and non-severe pneumonia,mechanical ventilation and non-mechanical ventilation were compared. Results The age distribution of the children ranged from 0. 13 to 15 years old, with 73 cases (89. 0％ ) being younger than 5 years old. There were 47 cases of influenza A (57. 3％ ) and 35 cases of influenza B (42. 7％ ). The proportions of cases in spring,summer,autumn and winter were 35. 3％ ,15. 9％ ,15. 9％ and 32. 9％ ,respectively. Congenital heart disease was the most common underlying disease (28 cases,34. 1％ ). Twenty-five(30. 5％ ) patients were diagnosed as severe pneumonia. Oseltamivir was added on the first to eighth days of the course with median time ( IQR) 2. 0 (3. 0) days. Thirteen (15. 9％ ) patients needed ventilator-assisted ventilation. There were significant differences in the incidence of influenza A and influenza B in summer (12 / 47 vs. 1 / 35,χ2 = 7. 7,P < 0. 01). Compared to non-severe pneu-monia,severe pneumonia was positively correlated with underlying diseases(17 / 25 vs. 18 / 57,χ2 = 9. 4,P <0. 01),digestive tract symptoms(10 / 25 vs. 6 / 57,χ2 = 9. 6,P < 0. 01) and high PCT level(8 / 23 vs. 8 / 56,χ2 = 3. 1,P < 0. 01),but negatively correlated with oseltamivir application[M(IQR)] [5. 0(2. 5) d vs. 2. 0 (1. 5)d,Z = - 6. 1,P < 0. 01]. There was significant difference in the proportion of influenza A/ B between ventilator group and non-ventilator group (11 / 2 vs. 36 / 33,χ2 = 4. 7,P < 0. 01). Conclusion Filmarray re-spiratory tract detection system can detect influenza virus infection quickly and accurately,providing a good basis for early diagnosis and treatment. Children under 5 years old are susceptible to influenza. Influenza in children mainly occurs in winter and spring. Influenza A mainly occurs in summer. Patients with influenza A infection,underlying diseases,digestive tract symptoms during the course of illness and elevated PCT are more likely to progress to severe illness or even use ventilator treatment. Early use of oseltamivir can improve the prognosis of the disease.