Diagnosis and Treatment to a Post-Craniotomy Intracranial Infection Caused by Corynebacterium.

Objective: To explore the perioperative prophylactic medication, identification of Causative pathogen and the treatment strategy of post-craniotomy intracranial infection (PCII) caused by Corynebacterium. Patients and Methods: A 47-year-old overweight male patient with hypertension, diabetes, cerebral hemorrhage and recalcitrant syphilis was clinically diagnosed with PCII based on cerebrospinal fluid (CSF) routine examination (RT), biochemical test (BT), neuroimaging CT and MRI scans, bacterial culture and identification of CSF and clinical manifestations. The risk factors of PCII and perioperative antibiotic prophylaxis were analyzed based on some reviews. The identification of the Corynebacterium Jeikeium (C. Jeikeium) and Corynebacterium simulans (C. simulans) was confirmed by CSF bacterial culture, antibiotics sensitivity in vitro and Metagenomic next-generation sequencing (mNGS) of pathogenic microorganisms, respectively. In addition, individualized therapy schemes were modified according to antimicrobial susceptibility of pathogens and mNGS of pathogenic microorganisms combined with the pathologic and physiological conditions of patients. The efficacy was evaluated depending on the changes in patients' body temperature, clinical manifestation, CSF RT, BT, and other infection-related indicators. Results: The patient recovered after 5 weeks of individualized comprehensive treatment and was discharged home, no recurrence had been observed for three months. Conclusion: This is likely the first reported case of chronic PCII caused by two species of Corynebacterium simultaneously in high risk patient. The PCII can not be prevented by the perioperative antibiotic prophylaxis recommended by the guidelines, prophylaxis need to be individualized based on the risk of infection and the colonization status of the patient. Causative pathogens can be identified by CSF culture and mNGS of pathogenic microorganisms. A judicious antimicrobial therapy plan should take into account not only the in vitro antimicrobial susceptibility, but also the penetration of the antimicrobial agent into the cerebrospinal fluid. It was an excellent choice to combine intrathecal vancomycin with intravenous linezolid to treat PCII resulted from Corynebacterium.

Improved feeding and forages at a crossroads: Farming systems approaches for sustainable livestock development in East Africa.

Dairy development provides substantial potential economic opportunities for smallholder farmers in East Africa, but productivity is constrained by the scarcity of quantity and quality feed. Ruminant livestock production is also associated with negative environmental impacts, including greenhouse gas (GHG) emissions, air pollution, high water consumption, land-use change, and loss of biodiversity. Improved livestock feeding and forages have been highlighted as key entry point to sustainable intensification, increasing food security, and decreasing environmental trade-offs including GHG emission intensities. In this perspective article, we argue that farming systems approaches are essential to understand the multiple roles and impacts of forages in smallholder livelihoods. First, we outline the unique position of forages in crop-livestock systems and systemic obstacles to adoption that call for multidisciplinary thinking. Second, we discuss the importance of matching forage technologies with agroecological and socioeconomic contexts and niches, and systems agronomy that is required. Third, we demonstrate the usefulness of farming systems modeling to estimate multidimensional impacts of forages and for reducing agro-environmental trade-offs. We conclude that improved forages in East Africa are at a crossroads: if adopted by farmers at scale, they can be a cornerstone of pathways toward sustainable livestock systems in East Africa.

A robust semi-supervised NMF model for single cell RNA-seq data.

BACKGROUND: Single-cell RNA-sequencing (scRNA-seq) technology is a powerful tool to study organism from a single cell perspective and explore the heterogeneity between cells. Clustering is a fundamental step in scRNA-seq data analysis and it is the key to understand cell function and constitutes the basis of other advanced analysis. Nonnegative Matrix Factorization (NMF) has been widely used in clustering analysis of transcriptome data and achieved good performance. However, the existing NMF model is unsupervised and ignores known gene functions in the process of clustering. Knowledges of cell markers genes (genes that only express in specific cells) in human and model organisms have been accumulated a lot, such as the Molecular Signatures Database (MSigDB), which can be used as prior information in the clustering analysis of scRNA-seq data. Because the same kind of cells is likely to have similar biological functions and specific gene expression patterns, the marker genes of cells can be utilized as prior knowledge in the clustering analysis. METHODS: We propose a robust and semi-supervised NMF (rssNMF) model, which introduces a new variable to absorb noises of data and incorporates marker genes as prior information into a graph regularization term. We use rssNMF to solve the clustering problem of scRNA-seq data. RESULTS: Twelve scRNA-seq datasets with true labels are used to test the model performance and the results illustrate that our model outperforms original NMF and other common methods such as KMeans and Hierarchical Clustering. Biological significance analysis shows that rssNMF can identify key subclasses and latent biological processes. To our knowledge, this study is the first method that incorporates prior knowledge into the clustering analysis of scRNA-seq data.

Prevalence difference of Helicobacter pylori infection between Tibetan and Han ethnics: The protocol of a meta-analysis on epidemiologic studies.

OBJECTIVES: Helicobacter pylori (Hp) is an identified carcinogenic pathogen of human gastric cancer. China is not only one of the countries with high incidence and mortality of gastric cancer, but also a high infection area of Hp. As a multi-ethnic country, China may have a diverse prevalence of Hp infection among ethnics. This meta-analysis tends to compare the prevalence of Hp infection between Tibetan and Han ethnics, the results may provide evidence for targeted screening and eradication of Hp in China. METHODS: The following databases will be searched: PubMed, Web of Science, Technology Periodical Database (VIP), China National Knowledge infrastructure (CNKI), and WanFang databases. Studies which reported the prevalence of Hp infection between Tibetans and Hans in China are eligible. Two reviewers will independently screen studies, extract data and assess the risk of bias of included studies. The prevalence of Hp infection between Tibetan and Han ethnics will be compared by meta-analysis. Heterogeneity tests and meta-analyses will be conducted using RevMan 5.3 and Stata 12.0 softwares. Meanwhile, subgroup analysis, publication bias and sensitivity analysis evaluation will be performed where applicable. RESULTS: This study will be reported in compliance with the PRISMA statement.This systematic review will not be submitted for any ethical approval since no privacy health information will be included. The findings will be published through peer-reviewed publications or conference presentations. PROSPERO REGISTRATION NUMBER: CRD42019121192. CONCLUSIONS: Our study will provide us evidence for tailored strategy and robustness of Hp screening and eradication among Tibetans.

Clinical effect of platelet-rich plasma combined with flap transplantation in treatment of refractory wounds / 局解手术学杂志

Objective To investigate the clinical effect of platelet-rich plasma combined with flap transplantation in treatment of refractory wounds.Methods Sixty patients of refractory wounds who were admitted into our hospital from April 2016 to February 2017 were enrolled in the observation group,and another sixty patients with refractory wounds who had been discharged from the hospital before April 2016 were trea-ted as the control group.All the patients accepted debridement and disinfection.Then the observation group were managed with PRP and flap transplantation,while the control group were treated with flap transplantation directly without PRP.Observed the frequency of dressing changes, rate of wound infection,healing time and recovering rate of the two groups.Measurement data were analyzed with t inspection and analysis of va-riance,and count data were compared by χ2test,and repeat data was analyzed with repeat data variance analysis.Results After one weeks' treatment,the number of wet gauze layers were(20.5 ±1.6)in the observation group,which was less than(23.3 ±6.1)in the control group with statistically significant difference(t=-3.439,P=0.001).The healing time of the observation group was(25 ±2)d,which was shorter than(43 ±5)d in the control group(t=-25.891,P=0.000).The frequency of dressing changes was(7.1 ±1.0)times in observation group, which was less than(9.3 ±1.4)times in the control group(t=-9.905,P=0.000).There were 5 cases of inflammation reaction in the obser-vation group,which was less than 18 cases in the control group(χ2=9.090,P=0.003).The cases of the skin flap survival in the observation group was 55,which was more than 41 cases in the control group,and the difference of the two groups was statistically significant(χ2=10.208, P=0.001).The average healing rate of the two groups both increased at different time points.And the average healing rate of the observation group was higher than that in the control group at different time points,and the difference was statistically significant(P<0.05).Conclusion Platelet-rich plasma can remarkably shorten the healing time,improve healing rate,reduce frequency of dressing change and promote wound healing for refractory wound.

Effect of platelet-rich plasma combined with negative pressure wound therapy on orthopedic refractory wound / 新乡医学院学报

Objective To investigate the effect of platelet-rich plasma (PRP) combined with negative pressure wound therapy (NPWT) on orthopedic refractory wound.Methods A total of 84 patients with chronic refractory wound were selected from January 2014 to December 2016 in Department of Osteology,Jizhong Energy Xingtai Mining Group General Hospital.The patients were divided into control group and observation group according to the admission time,42 cases in each group.The patients in the control group were treated with NPWT,and the patients in the observation group were treated with PRP and NPWT.The power of hydrogen (pH) of wound exudate,wound temperature and wound pressure ulcer scale for healing (PUSH) were compared between the two groups before and after treatment.The bacterial cuhure result was compared between the two groups after two weeks of treatment.The change of serum erythropoietin (EPO) level were observed before and four weeks after treatment,and the suitable skingrafting time,wound healing time and cure rate were observed in the two groups.Results After two weeks of treatment,the positive rate of bacterial culture in the observation group was significantly lower than that in the control group (x2 =4.850,P ＜ 0.05).The pH value of wound exudate and the wound PUSH score in the observation group were significantly lower than those in the control group(P ＜0.05),but the wound temperature in the observation group was higher than that in the control group after two weeks of treatment (P ＜ 0.05).The results of intra group comparison showed that the serum EPO level showed an upward trend within four weeks of treatment,and the difference was statistically significant at different time points in the two groups (F =7.356,8.264;P ＜ 0.05).The level of serum EPO in the observation group was significantly higher than that in the control group at the treatment of 1,2,3 and 4 weeks (P ＜ 0.05).Compared with the control group,the suitable skingrafting time was early (P ＜ 0.05),the wound healing was fast (P ＜ 0.05),and the cure rate was high in the observation group (x2 =4.720,P ＜ 0.05).Conclusion The combination of PRP and NPWT has good antibacterial effect,and can promote the EPO level and wound healing.

Incidence of Thymoma in Myasthenia Gravis: A Systematic Review

BACKGROUND AND PURPOSE: Myasthenia gravis (MG) is usually comorbid with thymoma. More accurate estimates of the incidence thymoma in MG will help inform patients and their physicians, facilitate health policy discussions, provide etiologic clues, and optimize the management of MG. METHODS: We conducted a systematic review search of relevant English-language studies published between 1960 and 2012 using MEDLINE and Embase. We identified additional studies by reviewing the bibliographies of the retrieved articles and hand searched the main neurology journals. Only incidence studies and case series of unselected MG patients in which information about thymoma were included. RESULTS: Out of 2206 potentially relevant studies, 49 met the inclusion criteria. Although there was a considerable degree of heterogeneity, the pooled estimate of the incidence of thymoma in MG was 21% (95% confidence interval, 20-22%). The pooled incidence was significantly higher for surgery-based studies than for population- and hospital-based studies. A large proportion of the reported thymomas were noninvasive. Furthermore, thymoma appears to occur significantly more frequently among male MG patients and those older than 40 years at the onset of MG. CONCLUSIONS: Thymoma is common in MG patients, but appears to be found more often in male MG patients and those older than 40 years at the onset of MG. Further research is needed to expand our understanding of these association conditions.

Variations of brain magnetic resonance imaging among manganese-exposed workers / 中华预防医学杂志

<p><b>OBJECTIVE</b>Variations of the signal intensities in the magnetic resonance (MR) T(1)-weighted image (T(1)WI) of globus pallidus among manganese(Mn)-exposed workers were explored to provide a scientific basis for exposed biomarker of manganese-injured central nervous system (CNS).</p><p><b>METHODS</b>The brain MR T(1) and T(2) WI in eighteen male asymptomatic Mn-exposed, eight manganism and nine healthy control workers were examined routinely by adopting a 1.5 Tesla signal superconducting system. The SIGP and the signal intensity in frontal white matter (SIFWM) in the same side were determined, then pallidal index (PI) was calculated. Concentration of MnO(2) in workplaces and content of manganese in red blood cell (MnRBC) among workers were respectively determined by flame atomic absorption spectrometer (AAS) and inductively coupled plasma-atomic emission spectrophotometry (ICP-AES). The follow-up investigation in the eight high Mn-exposed workers was made one year later.</p><p><b>RESULTS</b>The results showed that the median of air MnO(2) in smelting workplace was 0.64 mg/m(3)(0.07 - 5.40 mg/m(3)), which were respective 0.56 mg/m(3)(0.09 - 1.71 mg/m(3)) in power distribution room (low Mn-exposure) and 0.89 mg/m(3) (0.07 - 5.40 mg/m(3)) in furnace (high Mn-exposure). PI in the Mn-exposed and high Mn-exposed workers were both higher than those of the manganism and control workers(116.4 +/- 8.2, 119.0 +/- 7.9, 105.3 +/- 8.4 and 102.2 +/- 1.5, respectively. Mn vs control, t' = 7.146, P = 0.000; Mn vs manganism, t = 3.181, P = 0.004. High Mn-exposure vs control, t' = 7.446, P = 0.000; high Mn-exposure vs manganism, t = 3.763, P = 0.001). The increased signal in T(1)WI of globus pallidus was observed in Mn-exposed workers, especially in high Mn-exposed workers. The content of manganese in red blood cell of Mn-exposed and control workers was significantly higher than those of the manganism workers [(151.6 +/- 40.5) ng/ml, (149.2 +/- 21.3) ng/ml, (154.5 +/- 46.6) ng/ml, (144.4 +/- 14.2) ng/ml, (20.8 +/- 7.4) ng/ml respectively. The difference was significant in statistics. Manganism vs control, t = 20.206, P = 0.000; manganism vs Mn, t' = 13.144, P = 0.000; manganism vs low and high Mn, t' = 12.964, 9.957, respectively, P = 0.000]. Only a decreased median of air MnO(2) in furnace was found one year later (0.89, 0.31 mg/m(3), Z = -2.142, P = 0.032). The difference was significant in statistics.</p><p><b>CONCLUSION</b>Our data suggests that SIGP of MR T(1)WI among workers was obviously increased by manganese-exposure. PI may be taken as the signal of CNS injury which was induced by manganese-exposure.</p>