A case report on CREST syndrome with acrodermatitis

Acrodermatitis enteropathica (AE) is an autosomal recessive disorder, which is characterized by mutation affecting intestinal zinc absorption, subsequently leading to hypozincemia. In 20% of the cases, occurs the triad comprising dermatitis, alopecia and intractable diarrhoea as its diagnostic hallmark. The major manifestations include dermatitis, diarrhoea, alopecia, mood changes, anorexia, neurological disturbances, growth retardation, weight loss and recurrent infections. It is caused by mutations in the gene that encodes a membrane protein that binds zinc. Zinc is an essential coenzyme in metal enzymes (like ALP), which is important structural component of gene regulatory proteins and gene expression. Calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia (CREST) syndrome is a variant systemic sclerosis characterized by the presence of calcinosis, Raynaud抯 phenomenon, oesophageal motility abnormalities, sclerodactyly and telangiectasia antinuclear antibodies recognizing chromosomal centromere proteins are characteristic of CREST syndrome and are present in more than 50% cases. Circulating antibodies against anti-nucleolar antigens are present in most patients with systemic scleroderma. Alterations of the blood vessels and induction of fibroblasts by potent mediators plays an important role in the early phase of scleroderma. Here, we present a case of 12-year-old girl child with insidious onset gradually progressive symptoms of dryness in both lower limbs, bluish discoloration of the fingers on exposure to cold, skin tightening over the face and hands, whitish pigmentation over the scalp and neck, whitish nodules progressing to ulceration over the posterior aspects of both elbows and difficulty in eating- both solids and liquids for 1-year duration.

Phytochemical Investigation and in Vitro Antioxidant Activity of Panchavalkala Bark Extracts

Natural antioxidants have an important role in the prevention of many age-related diseases and promotion of health. Among natural antioxidants from plants, flavonoids and other phenolic compounds are potent antioxidants and chelating agents. Panchavalkala the barks of five trees i.e. Nyagrodha (Ficus benghalensis L.), Udumbara (Ficus racemosa L.), Ashwatha (Ficus religiosa L.), Plaksha (Ficus virens Aiton) and Parisha (Thespesia populnea (L.)Sol.ex Correa) are also known as Pancha Ksheeri Vrikshas in use since Vedic period. Barks of these trees are dried in shade and are used for different formulations (Pancha Kashaya Kalpanas), in different pathological conditions, especially as wound healing, gynecological disorders and etc. The plant samples were extracted using ethanol and water, and subjected for the phytochemical analysis. It was confirmed that samples contain many biologically active compounds like flavonoids, polyphenols, tannins, alkaloids, glycosides and terpinoids etc. The marker compound of each trial drug and the quantitative analysis has been carried out by high performance liquid chromatography. The antioxidant study was done by using in vitro method 1, 1­-diphenyl-2-picryl-hydrazyl (DPPH) radical scavenging assay. The marker compounds caffeic acid and gallic acid were quantified in each extract for their quality and efficacy. PVK barks showed high free radical scavenging activity as evidenced by the low IC50 values in DPPH (EE PVK- 20.46µg/ml, AE PVK-37.79µg/ml, EE T.poulenea-22µg/ml, AE T. poulenia- 23.31µg/ml AE F. benghalensis- 25.53µg/ml, EE F. benghalensis- 26.23µg/ml, EE F. religiosa - 34µg/ml). Quercetin- IC50 value 4.026µg/ml is used as standard. The results of the study demonstrated that PVK barks possess phyto-constituent’s viz. tannins, flavonoids, polyphenols etc. and has potential antioxidant activity. Thus these barks have good therapeutic potential as natural antioxidant and might be used in life style related conditions like hyperlipidemia, diabetes, obesity, cardiovascular disorders and etc.

Characteristics of HIV-1 CRF01_AE molecular network in Yunnan Province / 中华微生物学和免疫学杂志

Objective:To investigate the molecular network of HIV-1 CRF01_AE in Yunnan Province and the factors influencing it.Methods:Demographic data and plasma samples of HIV/AIDS patients in Yunnan drug resistance monitoring database from 2018 to 2021 were collected. HIV-1 pol gene fragments (protease and reverse transcriptase region) were amplified using RT-PCR and then sequenced. The optimal gene distance was selected and a molecular network was constructed based on the sequences of CRF01_AE genotype. Results:In this study, a total of 967 sequences of CRF01_AE genotype were obtained by sequencing. At the optimal gene distance threshold of 1.75%, a total of 320 sequences were involved in the network with a rate of 33.1%, and 84 clusters were identified. In the regional distribution, one cluster dominated by multiple regions, one cluster dominated by Zhaotong, one cluster dominated by Honghe and five clusters dominated by Wenshan were formed in the network. In the network, 75.8% of heterosexual men were connected with other heterosexual men and 54.1% were connected with heterosexual women. There was potential transmission among 66.7% of men who have sex with men (MSM). HIV/AIDS patients in Chuxiong, Dali, Dehong, Honghe, Lincang, Pu′er, Wenshan, Yuxi and Zhaotong were more likely to be involved in the network that those in Kunming. People who were 50 years old and above were more likely to be involved in the network than those less than 25 years old. Factors influencing HIV/AIDS patients with HIV-1 CRF01_AE infection to become high-risk transmitters in Yunnan were not found and further study on this subject was needed.Conclusions:HIV-1 CRF01_AE strains had spread actively in different regions of Yunnan Province and the transmission network was complex. Dynamic monitoring of CRF01_AE strains should be strengthened and a precise intervention for high-risk transmitters should be performed to reduce new infections.

Safety of human papilloma virus vaccine based on Vaccine Adverse Event Reporting System from 2006 to 2021 / 中国生物制品学杂志

@#Objective To investigate the characteristics of distribution of adverse event(AE)associated with human papillomavirus(HPV)vaccine by analysis of data on AE collected from the Vaccine Adverse Event Reporting System(VAERS).Methods The data on AE reported in VAERS from January 1st,2006 to December 31st,2021 were analyzed and compared by using Pearson Chi-square test and Mann-Whitney U test.Results A total of 53 571 cases of AE were included in the study,in which the ratio of male to female was 0. 25∶1,and the median age of vaccinees was 15 years. A portion of 36. 1%of AE occurred after the first dose,while 90. 7% occurred within 3 d after vaccination. Both the gender ratios(χ~2=72. 570,P < 0. 001) and the median ages(Z = 4. 255,P < 0. 001)of vaccinees in non-serious and serious adverse event(SAE)showed significant difference. In terms of classification of SAE,hospitalization,prolonged hospitalization and disability were more common in females than in males,of which the percentages decreased with the increasing age. Among the AE,syncope was the most common clinical symptom. In the SAE,the highest proportion of deaths was caused by HPV2 vaccine,which was 19. 0%. The proportion of prolonged hospitalization caused by HPV4 vaccine was higher than that by HPV9vaccine. In general,HPV4 vaccine was more prone to cause SAE than HPV9 vaccine(χ~2=183. 267,P < 0. 001).Conclusion In all the AE,the largest proportion occurred in the age group of 9 ～ 17 years,followed by those in the groups of 18 ～ 26 and 27 ～ 45 years. Most of the AE occurred after the first dose. The clinical symptoms of AE caused by three vaccines were different. The analysis of distribution characteristics of AE may provide a reference for the study on clinical safety of HPV vaccine and optimization of vaccination.

A real-time and modular approach for quick detection and mechanism exploration of DPIs with different carrier particle sizes

Dry powder inhalers (DPIs) had been widely used in lung diseases on account of direct pulmonary delivery, good drug stability and satisfactory patient compliance. However, an indistinct understanding of pulmonary delivery processes (PDPs) hindered the development of DPIs. Most current evaluation methods explored the PDPs with over-simplified models, leading to uncompleted investigations of the whole or partial PDPs. In the present research, an innovative modular process analysis platform (MPAP) was applied to investigate the detailed mechanisms of each PDP of DPIs with different carrier particle sizes (CPS). The MPAP was composed of a laser particle size analyzer, an inhaler device, an artificial throat and a pre-separator, to investigate the fluidization and dispersion, transportation, detachment and deposition process of DPIs. The release profiles of drug, drug aggregation and carrier were monitored in real-time. The influence of CPS on PDPs and corresponding mechanisms were explored. The powder properties of the carriers were investigated by the optical profiler and Freeman Technology four powder rheometer. The next generation impactor was employed to explore the aerosolization performance of DPIs. The novel MPAP was successfully applied in exploring the comprehensive mechanism of PDPs, which had enormous potential to be used to investigate and develop DPIs.

Distribution modelling of Aedes aegypti in three dengue-endemic areas in Sumatera, Indonesia

@#Ae. aegypti is a dengue virus vector and a public health threat in Indonesia. Furthermore, the Dengue Haemoragic Fever (DHF) has spread to all cities in the country, including Bandar Lampung. A species distribution model, Maximum Entropy (MaxEnt), was used to predict the geographic distribution of this vector in three dengue-endemic areas, namely Sukarame, Kemiling, and Tanjung Seneng. Previously, surveillance was conducted to determine the presence of Ae. aegypti. Therefore, this study suggested that environmental variables such as rainfall, temperature, land cover, and population density have influenced the widespread of Ae. aegypti and facilitate its proliferation in the study areas. The influence of the environmental variables was analyzed using a response curve. The model performance was measured by percent contribution, the importance of permutations, and the jackknife test. This study’s evaluation indicates that the certainty models for the presence of Ae. aegypti in Sukarame, Kemiling, and Tanjung Seneng were developed extremely well, with respective values of 0.989, 0.993, and 0.969. The results showed that Ae. aegypti is widespread in the three endemic areas. The high population density and land conversion into settlements are influential environmental variables essential in determining the distribution of the vector in three areas of Bandar Lampung. Climatic factors such as rainfall and temperature are supporting aspects in maintaining the habitat of Ae. aegypti in the area. Mapping areas at risk of this dengue vector can aid in planning disease management strategies and identifying priority locations for entomological surveys to control epidemics.

Late effects of Beauveria bassiana on larval stages of Aedes aegypti Linneo, 1762 (Diptera: Culicidae) / Efeitos tardios de Beauveria bassiana nos estágios larvais de Aedes aegypti Linneo, 1762 (Diptera: Culicidae)

Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104, 1.5× 105, 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107, while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.

Late effects of Beauveria bassiana on larval stages of Aedes aegypti Linneo, 1762 (Diptera: Culicidae)

Abstract Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104, 1.5× 105, 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107, while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

Resumo O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.

Late effects of Beauveria bassiana on larval stages of Aedes aegypti Linneo , 1762 (Diptera: Culicidae) / Efeitos tardios de Beauveria bassiana nos estágios larvais de Aedes aegypti Linneo, 1762 (Diptera: Culicidae)

Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104 , 1.5× 105 , 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107 , while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.

Hepatotoxicity reports in the FDA adverse event reporting system database: A comparison of drugs that cause injury

Drug-induced liver injury (DILI) is a leading reason for preclinical safety attrition and post-market drug withdrawals. Drug-induced mitochondrial toxicity has been shown to play an essential role in various forms of DILI, especially in idiosyncratic liver injury. This study examined liver injury reports submitted to the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) for drugs associated with hepatotoxicity

ADR/AE early warning analysis of Shujin Jianyao Pills based on spontaneous reporting system / 中国中药杂志

To explore the general characteristics of adverse drug reactions/adverse events(ADR/AE) in patients after using Shujin Jianyao Pills, and explore risk warning signals, this study analyzed 166 cases of ADR/AE reports of Shujin Jianyao Pills collected from 2005 to 2017 based on the National Center for ADR Monitoring spontaneous reporting system(SRS). And the descriptive statistical method was used to analyze general characteristics. The results showed that among the 166 ADR/AE cases, 106 cases were female patients, accounting for 63.86%. Middle-aged and elderly people aged 45 to 64 accounted for the largest proportion(82 cases, 49.40%), which were followed by elderly aged 65 and over(48 cases, 28.91%). ADR/AE involved a wide range of systems and organs, of which skin and its accessories were the most damaged(30 cases, 12.93%), which were followed by systemic damage(27 cases, 11.64%). The top 10 ADR/AE manifestations were rash(15 cases, 6.33%), nausea(14 cases, 5.91%), dizziness(14 cases, 5.91%), abdominal pain(12 cases, 5.06%), pruritus(11 cases, 4.64%), low back pain(11 cases, 4.64%), vomiting(10 cases, 4.22%), hepatocyte damage(9 cases, 3.80%), headache(9 cases, 3.80%), and diarrhea(7 cases, 2.95%). Bayesian confidence propagation neural network(BCPNN) was used to mine the ADR/AE risk early warning signal of Shujin Jianyao Pills, and the propensity score method was used to control the balance of confounding factors. The results suggested warning signs for nausea, diarrhea, rash, and dizziness, vomiting, abdominal pain, headache, liver cell damage. This study provides a basis for the post-marke-ting safety evaluation of Shujin Jianyao Pills, and can provide guidance for its rational clinical use and risk management.

Transmission cluster and network of HIV-1 CRF01_AE strain in China, 1996-2014 / 中华流行病学杂志

Objective: To understand the transmission patterns and risk factors of HIV-1 strain CRF01_AE subtypes in China, and to provide guidance for the implementation of precise intervention. Methods: A total of 2 094 CRF01_AE pol sequences were collected in 19 provinces in China between 1996 and 2014. Phylogenetic tree was constructed by PhyML 3.0 software to select the transmission clusters. Transmission network was constructed by Cytoscape 3.6.0, which was further used for exploring of the major risk factors. Results: Of the 2 094 sequences, 12.18% (255/2 094) were in clusters. A total of 82 transmission clusters were identified. The numbers of clusters and contained sequences in intra-provincial transmission (61, 173) were significantly more than those in inter-provincial transmission (21, 82). The ratio of transmission clustering in MSM increased over time from 2.41% (2/83) during 1996-2008 to 23.61% (72/305) during 2013-2014, showing a significant upward trend (χ(2)=27.800, df=1, P=0.000). The proportion of MSM with inter-provincial transmission clusters were higher than those with intra-provincial transmission clusters, which increased from 0.67% (2/297) during 1996-2008 to 6.36%(30/472) during 2013-2014, showing a significant upward trend (χ(2)=20.276, df=1, P=0.000). The transmission rate in homosexuals of the inter-transmission clusters (86.59%, 71/82) was higher than that of intra-provincial transmission clusters (56.65%, 98/173), and the difference was statistically significant (χ(2)=22.792, P=0.000). The proportion of inter-provincial transmission clusters with more than 2 transmission routes (33.33%, 7/21) was higher than that of intra-provincial clusters (13.11%, 8/61), and the difference was statistically significant (χ(2)=4.273, P=0.039). Results from the transmission network analysis indicated that the proportion of high risk population (degree≥4) with inter-provincial transmission clusters (51.22%, 42/82) was significantly higher than that with intra-provincial transmission clusters (26.59%, 46/173), and the difference was statistically significant (χ(2)=14.932, P=0.000). Inter-provincial clusters were mainly detected in and and MSM. Conclusions: Complex transmission networks were found for HIV-1 CRF01_AE strains in the mainland of China. Inter-provincial transmission clusters increased rapidly, MSM played an important role in the wide spread of the strain. More researches in transmission networks are needed to guide the precision intervention.

Transmission cluster and network of HIV-1 CRF01_AE strain in China, 1996-2014 / 中华流行病学杂志

Objective To understand the transmission patterns and risk factors of HIV-1 strain CRF01_AE subtypes in China,and to provide guidance for the implementation of precise intervention.Methods A total of 2 094 CRF01_AE pol sequences were collected in 19 provinces in China between 1996 and 2014.Phylogenetic tree was constructed by PhyML 3.0 software to select the transmission clusters.Transmission network was constructed by Cytoscape 3.6.0,which was further used for exploring of the major risk factors.Results Of the 2 094 sequences,12.18％ (255/2 094) were in clusters.A total of 82 transmission clusters were identified.The numbers of clusters and contained sequences in intra-provincial transmission (61,173) were significantly more than those in inter-provincial transmission (21,82).The ratio of transmission clustering in MSM increased over time from 2.41％ (2/83) during 1996-2008 to 23.61％ (72/305) during 2013-2014,showing a significant upward trend (x2 =27.800,df=1,P =0.000).The proportion of MSM with inter-provincial transmission clusters were higher than those with intra-provincial transmission clusters,which increased from 0.67％ (2/297) during 1996-2008 to 6.36％(30/472) during 2013-2014,showing a significant upward trend (x2=20.276,df=1,P=0.000).The transmission rate in homosexuals of the inter-transmission clusters (86.59％,71/82) was higher than that of intra-provincial transmission clusters (56.65％,98/173),and the difference was statistically significant (x2=22.792,P=0.000).The proportion of inter-provincial transmission clusters with more than 2 transmission routes (33.33％,7/21) was higher than that of intra-provincial clusters (13.11％,8/61),and the difference was statistically significant (x2=4.273,P=0.039).Results from the transmission network analysis indicated that the proportion of high risk population (degree≥4) with inter-provincial transmission clusters (51.22％,42/82) was significantly higher than that with intra-provincial transmission clusters (26.59％,46/173),and the difference was statistically significant (x2=14.932,P=0.000).Inter-provincial clusters were mainly detected in and and MSM.Conclusions Complex transmission networks were found for HIV-1 CRF01_AE strains in the mainland of China.Inter-provincial transmission clusters increased rapidly,MSM played an important role in the wide spread of the strain.More researches in transmission networks are needed to guide the precision intervention.

Expression of mitofusin 2 in IgA1-induced glomerular mesangial cell proliferation and association with a valsartan-induced inhibitory effect on hyperplasia / 中国医师杂志

Objective To observe glomerular mesangial cells (GMCs) proliferation induced by IgA1 and the association with the expression of apoptosis-related proteins-B cell lymphoma-2 (Bcl-2),cysteine aspartic acid protease-3 (Caspase-3),cysteine aspartic acid protease-9 (Caspase-9) and with mitofusin 2 (Mfn2) in rat GMCs,to study the possible mechanism of valsartan inhibiting rat GMCs proliferation,and to provide a new direction for the mechanism of GMCs proliferation and intervention research in IgA nephrology (IgAN).Methods GMCs stimulated with IgA1 were cultured in vitro to detect cellproliferation with the cell counting kit-8 cell activity assay (CCK8).GMCs were divided into three groups:CG,TG and VG.The GMCs proliferation level was detected by the CCK8,using real-time PCR to detect Mfn2 expression and Western blotting to detect protein levels of Mfn2,Bcl-2,Caspase-3,and Caspase-9.Results Rat GMCs proliferated significantly after stimulation with IgA1,and IgA1 could obviously stimulate high expression of Bcl-2 in GMCs and down regulate the expression of Mfn2,Caspase-3,and Caspase-9.Valsartan could inhibit the proliferation of GMCs induced by IgA1 significantly,downregulate the expression of Bcl-2,and upregulate the expression of Mfn2,Caspase-3,and Caspase-9.Conclusions These results showed that the mechanism of action of valsartan in the treatment of lgAN is inhibiting the proliferation of GMCs.This mechanism may be associated with the regulation of apoptosis-related proteins,such as Mfn2,Bcl-2,Caspase-3,and Caspase-9.These findings may provide a new direction for the mechanism of GMCs proliferation and intervention research in IgAN.

Study on the complications of radical vaginal hysterectomy for locally bulky cervical cancer patients / 中国医师杂志

Objective To analyze the complications of radical vaginal hysterectomy in patients with locally bulky cervical cancer.Methods All 258 patients of early cervical cancer (stage Ⅰ A2-Ⅱ A) selected in our hospital during the period of June 2011 to June 2016 undergoing radical vaginal hysterectomy and laparoscopic pelvic lymph node dissection were analyzed.All cases were divided into observation (locally bulky) and control (conventional) groups.Comparison analysis was performed for complications of the two groups and the influence of neoadjuvant chemotherapy on the complications of local bulky patients.Results The incidence of complications in the observation group was 26 cases (27.9％),higher than that in the control group of 28 cases (17.0％),the difference was statistically significant (P ＜ 0.05).The incidence of bladder injury (5 cases vs 2 cases) in observation group was significantly higher than that in control group (P ＜ 0.05).For patients with locally bulky early cervical cancer,the incidence rate of complications of the neoadjuvant chemotherapy group (15.8％) was significantly lower than the simple operation group (36.4％) (P ＜ 0.05).The incidence rate of ureteral injury in neoadjuvant chemotherapy group (0 cases vs 6 cases) was significantly lower than that in simple operation group (P ＜ 0.05).Conclusions Early cervical cancer patients with locally bulky (stage Ⅰ B2/ 1Ⅱ A2) had higher incidence of complications of radical vaginal hysterectomy,and neoadjuvant chemotherapy can reduce the incidence of surgical complications.

Examination of the expressions of miR-221 in the human pulmonary fibrosis tissues and in A549 cells treated with TGFβ1 / 中国医师杂志

Objective To investigate the expressions of microRNA-221 (miR-221) in the human pulmonary fibrosis tissues and in adenocarcinoma(A549) cells treated with transforming growth factor beta 1 (TGFβ1).Methods Real time-PCR was used to detect the expressions of miR-221 in pathologically diag nosed as pulmonary fibrosis tissue and in A549 cells treated with TGFβ1.Results miR-221 in pulmonary fibrosis tissue was downregulated compared to normal tissues (P ＜ 0.05).The morphology of cells was changed from long spindle type to short, the number of cells was increased, and the adjacent cells were not connected closely.TGFβ1, N-cadherin, vimentin, α-smooth muscle actin (α-SMA), collagen Ⅰ, and collagen Ⅲ levels were higher, whereas E-cadherin level was lower in TGFβ1-treated group compared to the control group.miR-221 expression was downregulated in cells after TGFβ1 treatment (P ＜ 0.05).Conclusions miR-221 was downregulated in pulmonary fibrosis tissues and in A549 cells, which indicates that miR-221 may play an important role in the formation of pulmonary fibrosis.

Establishment of a rat caudal disc degeneration model by percutaneous fine-needle aspiration of the fibrous ring / 中国医师杂志

Objective To compare the effect of different size needle gauges to the degenerative response in rat caudal discs.Methods A total of 40 Sprague Dawley (SD) rats,level 5/6,7/8 and 9/10 interverbral discs of rat caudal spine were punctured with 18 or 21 or 25-gauge needles respectively.Radiographs and magnetic resonance imaging (MRI) were obtained at 1,2,4 and 6 weeks postsurgery.At each time point,ten rats from each group were sacrificed for histological analysis.Real-time fluorescent quantitative polymerase chain reaction (qPCR) was used to examine mRNA expression level.Results Significant differences were identified in the disc height index (DHI ％) and MRI grade between 18 G and normal group,MRI grade,histological score between 21 G and normal group at 2,4,and 6 weeks postsurgery.Significant differences were also identified in the histological score and mRNA expression levels between 18 G and normal group,alcian blue stain and hypoxia inducible factor-1α (HIF-1 α) mRNA expression level between 21G and normal group at all time point postsurgery.Significant differences existed in DHI％,type Ⅱ collagen and aggrecan mRNA expression levels between 21 G and normal group,all type mRNA expression levels between 25 G and normal group at 4,6 weeks.There were significant differences in MRI grade and histological score between 25 G and normal group at 6 weeks.Significant differences existed in almost all parameters compared between 18 G and 25 G at all time point.There were significant differences in DHI％,MRI grade,histological score and HIF-1α mRNA expression levels between 18 G and 21 G at 4,6 weeks.There were significant differences in type Ⅱ collagen and aggrecan mRNA expression levels between 18 G and 21 G at all time point.Significant differences exist in DHI％ and HIF-1α mRNA expression level between 21 G and 25 G at 6 weeks.Compared with the 25 G group,the DHI％ and Pfirrmann scores and the pathological score of each time at 2,4 and 6 weeks after operation in 18 G group have significant difference (P ＜ 0.05).Conclusions The middle size needle (21G) is better to induce disc degeneration.The 2-week time point may be the better time frame to further experimental treatments.

Research progress on the protective effects of polyphenols against doxorubicin-induced cardiotoxicity / 中国医师杂志

Doxorubicin is a major culprit in chemotherapy-induced cardiotoxicity,which is the chief limiting factor in delivering optimal chemotherapy to cancer patients.Although extensive efforts have been devoted,no chemical synthesized drugs or natural compounds are available to prevent the harmful action of doxorubicin without reducing its anti-cancer efficacy.Accumulative experimental evidence has shown that polyphenols can prevent doxorubicin-induced cardiotoxicity largely due to their anti-cancer and cardio protective properties.We elaborated on the potential mechanisms associated with doxorubicin-induced cardiotoxicity and reviewed published literatures about the protective effects of polyphenols on doxorubicin-induced cardiotoxicity to provide novel strategies for the study of cardioprotective drugs.

Effects of intravenous anesthesia with sufentanil combined with propofol on hemodynamics and oxygen metabolism in patients with esophageal cancer under high altitude / 中国医师杂志

Objective To investigate the effect of intravenous anesthesia with sufentanil combined with propofol on hemodynamics and oxygen metabolism in patients with esophageal cancer under high altitude.Methods 60 patients with esophageal cancer radical surgery was selected from March 2015 to March 2017 in our hospital and were divided into two groups according to the random number table,30 patients in each group.Patients in the control group were given with fentanyl and propofol intravenous anesthesia,and patients in the observation group were given sufentanil combined with propofol anesthesia.The occurrence of restlessness during the recovery of anesthesia in the two groups were observed,the spontaneous breathing recovery time,extubation time and postoperative Mini-mental State Examination (MMSE) score were recorded,and the indexes of hemodynamics and oxygen metabolism were measured at the time of before induction of anesthesia (T0),tracheal intubation (T1),skin incision (T2),thoracotomy (T3),free esophagus (T4),esophageal catheter removal time (T5).Results The spontaneous respiration recovery time and extubation time of the observation group were significantly shorter than those of the control group (P ＜ 0.05).The degree of restlessness in the observation group was weaker than that in the control group (P ＜ 0.05).Mean arterial pressure (MAP) in the control group at T2-T4 were significantly higher than those in T0 (P ＜ 0.05),but MAP and heart rate (HR) in the observation group at T1-T5 were significantly lower than those of T0 (P ＜ 0.05).Compared with T0 group,oxygen saturation (SpO2),oxygen saturation of mixed venose blood (SvO2) and oxygen delivery (DO2) at T1-T5 were significantly decreased (P ＜ 0.05),oxygen consumption (VO2) at T2-T4 was significantly increased (P ＜ 0.05),especially in the control group (P ＜ 0.05).The MMSE scores of the two groups were significantly lower than those before the operation (P ＜ 0.05),and the scores in observation group was significantly higher than the control group (P ＜ 0.05).Conclusions The intravenous anesthesia with sufentanil combined with propofol is more helpful in maintaining hemodynamic stability and oxygen metabolism balance than intravenous anesthesia with fentanyl combined with propofol and has little effect on postoperative anesthesia recovery and cognitive function.

Effects of different anesthesia modes on POCD occurrence, serum S-100β and Aβ1-42 proteins in TURP patients after elderly patients / 中国医师杂志

Objective To investigate the effects of general anesthesia and hard epidural anesthesia on the incidence of postoperative cognitive dysfunction (POCD),serum S-100β and Aβ1-42 protein in elderly patients with transurethral resection of the prostate (TURP).Methods 120 cases of elderly male patients who wanted to implement TURP were enrolled in this study.From March 2014 to August 2016,60 patients underwent general anesthesia (general anesthesia group) and 60 patients underwent epidural anesthesia (hard epidural Group).The effects of two anesthesia methods on the cognitive function,serum S-100 β and Aβ1-42 protein were compared.Results There was no significant difference in mini-mental state examination (MMSE) score in preoperative,postoperative 12 h,postoperative 24 h,postoperative 72 h,and postoperative 1 week between hard epidural group and general anesthesia group (P ＞ 0.05).The MMSE scores at 12 h,24 h and 72 h after operation in both groups were significantly lower than those before operation in both groups (P ＜0.05).There was no significant difference in clock drawing task (CDT) score in preoperative,24 h after operation,72 h after operation and one week after operation (P ＞ 0.05).The CDT scores of both groups at 12 h,24 h,72 h after operation were significantly lower than those before operation (P ＜0.05).There was no significant difference in serum S-100β levels between the two groups at preoperative and 12 h,72 h after operation (P ＞0.05).Serum S-100β levels at 12 h and 72 h after surgery in both groups were significantly higher than those before surgery (P ＜ 0.05).There was no significant difference in preoperative and postoperative 12 h,postoperative between hard epidural group and general anesthesia group (P ＞ 0.05).Serum Aβ1-42 levels at preoperative,12 h and 72 h after operation in both groups were significantly lower than those before operation (P ＜ 0.05).There was not statistically significant in the incidence of POCD between hard epidural group [28.33 ％ (17/60)] and general anesthesia group [35％ (21/ 60)] (P ＞ 0.05).Conclusions There was no significant difference in the incidence of POCD between general anesthesia and hard epidural anesthesia group in elderly patients with TURP.The incidence of POCD in elderly patients was related to the decrease of serum S-100β and the decrease of Aβ1-42.