Fatal Balamuthia mandrillaris infection with red plaques on the nasal dorsum as the first presentation

Abstract Balamuthia mandrillaris infection is a rare infectious disease around the world, with high rates of morbidity and mortality. Its early and correct diagnosis is a big challenge for us, and without it the delay in starting effective treatment can lead to the development of encephalitis. This is a report of a case of Balamuthia mandrillaris infection in a Chinese boy, with red plaques on the nasal dorsum as the first presentation, who finally developed into fatal encephalitis. The authors have reviewed the related literature and share the special skin features in order to favor the early diagnosis of the disease and increase the chances of survival.

Adiponectin is protective against endoplasmic reticulum stress-induced apoptosis of endothelial cells in sepsis

Endoplasmic reticulum (ER) stress is a critical molecular mechanism involved in the pathogenesis of sepsis. Hence, strategies for alleviating this stress may be essential for preventing cardiovascular injuries under sepsis. Adiponectin is secreted by adipocytes and its levels are decreased in sepsis. The purpose of this study was to investigate the protective effects of adiponectin treatment on endothelial cells and its mechanism. Male Wistar rats underwent cecal ligation and puncture (CLP) before being treated with adiponectin (72 and 120 μg/kg). The levels of malondialdehyde (MDA) in plasma, histological structure, and apoptosis of endothelial cells were evaluated. In vitro, human umbilical vein endothelial cells (HUVECs) were treated with adiponectin at 10 and 20 μg/mL for 24 h after stimulation by lipopolysaccharide (LPS). The levels of reactive oxygen species (ROS), ultrastructure, rate of apoptosis, the expression of inositol-requiring enzyme 1α (IRE1α) protein, and its downstream molecules (78 kDa glucose-regulated protein (GRP78), C/EBP homologous protein (CHOP), and caspase-12) were detected. The results showed that the levels of MDA and ROS induced by CLP or LPS stimulation were increased. Furthermore, endothelial cell apoptosis was increased under sepsis. The IRE1α pathway was initiated, as evidenced by activated IRE1α, increased GRP78, and up-regulated CHOP and caspase-12 in HUVECs. Following treatment with adiponectin, the number of apoptotic endothelial cells was markedly decreased. These findings demonstrated that treatment with adiponectin decreased apoptosis of endothelial cells caused by sepsis by attenuating the ER stress IRE1α pathway activated by oxidative stress.

Disruption of reproductive development in male rat offspring following gestational and lactational exposure to di-(2-ethylhexyl) phthalate and genistein

Studies of developmental effects of mixtures of endocrine disrupters on the male reproductive system are of great concern. In this study, the reproductive effects of the co-administration of di-2-(ethylhexyl) phthalate (DEHP) and genistein (GEN) during pregnancy and lactation were studied in male rat offspring. Pregnant Sprague-Dawley rats were gavaged from gestation day 3 to postnatal day 21 with vehicle control, DEHP 250 mg/kg body weight (bwyday, GEN 50 mg/kg bwday, GEN 400 mg/kg bwday, and two combinations of the two compounds (DEHP 250 mg/kg bwday + GEN 50 mg/kg bwday, DEHP 250 mg/kg bwday + GEN 400 mg/kg bwday). The outcomes studied were general morphometry (weight, AGD), testicular histology, testosterone levels, and expression at the mRNA level of genes involved in steroidogenesis. Organ coefficient, AGD / body weight1/3 י, serum testosterone concentration and genes involved in steroidogenic pathway expression when exposed to DEHP (250mg/kg bwday), GEN(50mg/kg bwday) or GEN(400mg/kg bwday) alone were not significantly different from the control group. When exposed to (DEHP 250mg/kg bwday +GEN 50mg/kg bwday) together during pregnancy and lactation, serum testosterone concentration, epididymis coefficient and Cypal17a1,Scarb1 m RNA expression significantly decreased compared to the control and GEN(50mg/kg bwday). When exposed to (DEHP 250mg/kg bwday +GEN 400mg/kg bwday) together during pregnancy and lactation, AGD / body weight1/3 י, serum testosterone concentration, testis and epididymis coefficient and Star, Cypal17a1 mRNA expression appeared significantly decreased compared to the control and DEHP/GEN single exposure, together with developmental impairment of seminiferous tubules and seminiferous epithelium. Overall, co-administration of DEHP and GEN during gestation and lactation seem to acts in a cumulative manner to induce the most significant alterations in the neonate, especially with GEN at high dose, although the effect of the DEHP-GEN mixture on adult offspring should be observed further.

Therapeutic effect of acupoint catgut embedding on irritable bowel syndrome of diarrhea type / 中国针灸

<p><b>OBJECTIVE</b>To observe the therapeutic effects of irritable bowel syndrome of diarrhea type (deficiency of spleen and stomach) treated with acupoint catgut embedding therapy.</p><p><b>METHODS</b>Sixty cases of irritable bowel syndrome of diarrhea type were randomly divided into an acupoint catgut embedding group and a medication group. In acupoint catgut embedding group, acupoint catgut embedding therapy was given at Tianshu (ST 25), Dachang shu (BL 25) and Zusanli (ST 36), etc., once treatment every 10 days and 3 treatments in all. In medication group, Pinaverium Bromide was orally taken for 50 mg, 3 times a day and 30 days in all. The therapeutic effects were compared after 3Q days treatment and the recurrence rates were observed after 3 months in both groups.</p><p><b>RESULTS</b>The total effective rate was 86.7% (26/30) in acupoint catgut embedding group, superior to that of 56.7% (11/30) in medication group (P < 0.05). The recurrence rate was 15.4% (4/26) in acupoint catgut embedding group, which was lower than that of 64. 7% (11/17) in medication group after 3 months (P < 0.05).</p><p><b>CONCLUSION</b>The curative effect of irritable bowel syndrome of diarrhea type (deficiency of spleen and stomach) treated by acupoint catgut embedding is superior to that by Pinaverium Bromide, with low recurrence rate.</p>

Identifi cation of binding peptides of the ADAM15 disintegrin domain using phage display.

ADAM15 plays an important role in tumour development by interacting with integrins. In this study, we investigated the target peptides of the ADAM15 disintegrin domain. First, we successfully produced the recombinant human ADAM15 disintegrin domain (RADD) that could inhibit melanoma cell adhesion by using Escherichia coli. Second, four specifi c binding peptides (peptides A, B, C, and D) were selected using a phage display 12-mer peptide library. The screening protocol involved 4 rounds of positive panning on RADD and 2 rounds of subtractive selection with streptavidin. By using the BLAST software and a relevant protein database, integrin α v β 3 was found to be homologous to peptide A. Synthetic peptide A had a highly inhibitory effect on RADD–integrin α v β 3 binding. The results demonstrate the potential application of short peptides for disrupting high-affi nity ADAM–integrin interactions.

Damage control surgery for severe thoracic and abdominal injuries / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the application of damage control surgery in treatment of patients with severe thoracic and abdominal injuries.</p><p><b>METHODS</b>A retrospective study was done on 37 patients with severe thoracic and abdominal injuries who underwent damage control surgery from January 2000 to October 2006 in our department. There were 8 cases of polytrauma (with thoracic injury most commonly seen), 21 of polytrauma (with abdominal injury most commonly seen) and 8 of single abdominal trauma. Main organ damage included smashed hepatic injuries in 17 cases, posterior hepatic veins injuries in 8,pancreaticoduodenal injuries in 7, epidural or subdural hemorrhage in 4, contusion and laceration of brain in 5, severe lung and bronchus injuries in 4, pelvis and one smashed lower limb wound in 3 and pelvic fractures and retroperitoneal hemorrhage in 6. Injury severity score (ISS) was 28-45 scores (38.4 scores on average), abbreviated injury scale (AIS) > or = 4.13. The patients underwent arteriography and arterial embolization including arteria hepatica embolization in 4 patients, arteria renalis embolization in 2 and pelvic arteria retroperitoneal embolization in 7. Once abbreviated operation finished, the patients were sent to ICU for resuscitation. Twenty-four cases underwent definitive operation within 48 hours after initial operation, 5 underwent definitive operation within 72 hours after initial operation, 2 cases underwent definitive operation postponed to 96 hours after initial operation for secondary operation to control bleeding because of abdominal cavity hemorrhea. Two cases underwent urgent laparotomy and decompression because of abdominal compartment syndrome and 2 cases underwent secondary operation because of intestinal fistulae (1 case of small intestinal fistula and 1 colon fistula) and gangrene of gallbladder.</p><p><b>RESULTS</b>A total of 28 patients survived, with a survival rate of 75.68%, and 9 died (4 died within 24 hours and 5 died 3-9 days after injury). The trauma deaths at the early stage were caused by severe primary injuries resulting in failure of respiration and circulation, while mortality at the later stage was caused by multiple organ failure.</p><p><b>CONCLUSIONS</b>Damage control surgery is important for the treatment against severe thoracic and abdominal injuries. It is suggested that the surgeon should select the reasonable auxiliary examination before operation, and take the proper time to perform damage control and definitive surgery.</p>

Observation on the transient analgesic effect of abdominal acupuncture TENS on pain of neck, shoulder, loin and legs / 中国针灸

<p><b>OBJECTIVE</b>To observe on the transient analgesic effect of abdominal points transcutaneous electrical nerve stimulation (TENS) combined with abdominal acupuncture according to the holographic theory on pain of neck, shoulder, loin and legs.</p><p><b>METHODS</b>One hundred and twenty cases of pain of neck, shoulder, loin and legs were randomly divided into 4 groups: abdominal acupuncture TENS group, acupoints TENS group, electroacupuneture (EA) group, non-abdominal acupuncture TENS group, 30 cases in each group. All the cases were treated by the same stimulation parameters, but different stimulation points. The VAS scores were recorded before and after treatment.</p><p><b>RESULTS</b>The VAS scores were significantly different before and after treatment in abdominal acupuncture TENS group (P < 0.01); the total effective rate of the transient analgesic effec t was 96.7% in the abdominal acupuncture TENS group, 93.3% in the acupoints TENS group, 96.7% in the EA group with no significant difference among the 3 groups, but with a very significant difference between the abdominal acupuncture TENS group and the non-abdominal acupunctureTENS group (10.0%), P < 0.01.</p><p><b>CONCLUSION</b>Abdominal acupuncture TENS has a better transient analgesic effect and can use less stimulation points to increase the analgesic effect.</p>

Experimental treatment of chronic pelvic inflammatory disease in rats with acupoint injection of Astragalus parenteral solution / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To observe the effect of acupoint injection with astragalus parenteral solution in rat chronic pelvic inflammatory disease (CPID).</p><p><b>METHODS</b>Fifty female Wistar rats were randomly divided into 6 groups: CPID model was induced in 4 groups, in addition to control group and false surgery group. The rats were given acupoint (Guanyuan and Zusanli) injection with astragalus parenteral solution and saline. The drug group was fed with Qianjinpian solutions. The histopathologic changes of uterus were observed and serum IL-2 and TNF-alpha levels detected.</p><p><b>RESULT</b>The rats in the model group showed chronic inflammatory changes, the animals in astragalus parenteral injection group and Qianjinpian group showed little histopathological changes. The serum TNF-alpha levels in the model group were significantly higher than those in the normal group and the astragalus parenteral injection group; while the IL-2 levels in model group were significantly lower than those of other 5 groups. The TNF-alpha and IL-2 levels in astragalus parenteral injection group were similar to those of normal group.</p><p><b>CONCLUSION</b>The treatment of chronic pelvic inflammatory disease with acupoint injection of astragalus parenteral solution might be effective.</p>

Effect of acupoint injection by Astragalus injection on local SIgA and pathomorphology changes in rats with chronic pelvic inflammatory disease / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the effect of acupoint injection by astragalus injection on local SIgA and pathomorphologial changes in rats with chronic pelvic inflammatory disease (CPID).</p><p><b>METHOD</b>50 female Wistar rats were randomly devided into 6 groups, in which CPID model was made except the normal group and sham operation group. The astragalus injection group and the 0.9% NaCl injection group were treated by acupoint injection in Guanyuan (RN4) and Zusanli (ST36). The group was fed Qianjinpian solution into stomach. The histopathologic changes of rats' uterus of each group were observed and SIgA in vagina flushing was detected.</p><p><b>RESULT</b>The model group showed inflammatory changes, and astragalus injection group and Qianjinpian group showed little histopathologic changes. The levels of SIgA in astragalus injection group were significantly higher than those in other groups, but that in the model group was the lowest.</p><p><b>CONCLUSION</b>The deficiency of local SIgA lead to repeatedly attack of CPID. The treatment of acupoint injection by astragalus injection can improve the excretion of SIgA, reinforce the local immunity, and prevent the repeatedly attack.</p>

Safety and immunogenicity of split vaccines of influenza viruses / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and immunogenicity of influenza split vaccine.</p><p><b>METHODS</b>According to the criteria of No.2002SL0043, instruction of application for new drug in clinical trial issued by the State Food and Drug Administration, 876 healthy persons were divided at random into vaccine group and control group. The trial was performed with the double blind method. Local and systemic adverse reactions were observed within 3 days after the vaccine group subjects were vaccinated. The antibody response to vaccines was detected with hemagglutination inhibition (HI) test. Numbers of seroconversions and HI titers greater than or equal to 40, as well as the mean geometric titer increase in HI were analyzed.</p><p><b>RESULTS</b>There was no significant difference in local and systemic adverse reaction between vaccine and control groups. Meanwhile there was also no significant difference in seroconversions and protective level between two groups. However, there was obvious difference in mean geometric titer increase of antibody against H1N1 virus, while there was no significant difference in that of antibodies to H3N2 and type B viruses.</p><p><b>CONCLUSIONS</b>The safety and immunogenicity of both vaccines are excellent.</p>