[Analysis of factors related to recanalization of intramural hematoma-type carotid artery dissection].

Objective: To investigate the factors related to recanalization of intramural hematoma-type carotid artery dissection (CAD). Methods: Retrospective analysis was performed on 56 patients (61 CADs) with intramural-hematoma type CAD confirmed by multimodal imaging examination based on cervical vascular ultrasound (CDU) in the Stroke Center of the First Affiliated Hospital of Suzhou University from August 2015 to May 2019. The clinical and imaging data were collected, and the time from onset to visit is bounded by 14 days. CDU follow-up was performed at 3, 6, and 12 months after the onset. According to the results of the 12-month follow-up, patients were divided into complete recanalization group and incomplete recanalization group. The clinical data, ultrasonic manifestations and drug treatment of patients between the two groups were compared. Multivariate logistic regression analysis was used to analyze the related factors affecting vascular recanalization. Results: Vascular recanalization: the rates of complete recanalization at 3, 6 and 12 months were 42.6% (26/61), 55.7% (34/61) and 59.0% (36/61), respectively. While among the 25 vessels in the incomplete recanalization group, 26.2% (16/61) showed residual stenosis and 14.8% (9/61) showed persistent occlusion. Comparison between the complete recanalization group and the incomplete recanalization group: the differences in the proportion of time from onset to visit ≤ 14 days, the echo type of intramural hematoma, and the proportion of vascular occlusion were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that the time from onset to visit ≤14 days (OR=5.625, 95%CI: 1.302-24.293, P=0.021), and the hypoechoic intramural hematoma (OR=4.888, 95%CI: 1.304-18.320, P=0.019) were positively correlated with complete recanalization, while the dissection vascular occlusion (OR=0.234, 95%CI: 0.059-0.932, P=0.039) was negatively correlated with complete recanalization. Conclusions: CDU showed that hypoechoic intramural hematoma-type CAD treated with standard medications in the acute phase had a higher complete recanalization rate, while the recanalization rate of patients with dissecting vessel occlusion decreased. Early evaluation can provide a basis for clinical individualized treatment.

[Clinical characteristics and economic burden of influenza among children under 5 years old, in Suzhou, 2011-2017].

Objective: To understand the clinical characteristics and economic burden of influenza-like illness (ILI) children aged 0-59 months in the outpatient settings in Suzhou, China, 2011-2017. Methods: From March 2011 to February 2017, we conducted a prospective surveillance program on ILI for children aged less than 5 years at Soochow University Affiliated Children's Hospital. Through standard questionnaires and follow-up survey via telephone, we collected information regarding the demographic characteristics, medical history, clinical symptoms and both direct and indirect costs associated with influenza, of the patients. We then compared clinical characteristics and economic burden of influenza A/H1N1, A/H3N2, and B infections among children with ILI. Results: We enrolled 6 310 patients with ILI from March 2011 to February 2017 and collected all their throat swabs. 791 (12.9%) of the swabs showed positive for influenza virus, including 88 (11.1%) subtype influenza A/H1N1, 288 (36.4%) subtype influenza A/H3N2, and 415(52.5%) type influenza B. The proportions of cough, rhinorrhea, wheezing, vomiting and convulsion in influenza-positive children were higher than those influenza-negative children. Except for the prevalence rates of cough (χ(2)=9.227, P=0.010), wheezing (χ(2)=7.273, P=0.026) and vomiting (χ(2)=8.163, P=0.017), other clinical symptoms appeared similar between the three viral subtypes. Among all the ILI children, the average total cost per episode of influenza was 688.4 Yuan (95%CI: 630.1-746.7) for influenza-negative children; 768.0 Yuan (95%CI: 686.8-849.3) for influenza-positive children and 738.3 Yuan (95%CI: 655.5-821.1) for influenza B. Children with influenza A/H1N1 spent much more than those with influenza A/H3N2 or influenza B in the total cost (χ(2)=7.237, P=0.028). Conclusion: Children infected influenza showed higher prevalence rates of cough, rhinorrhea, wheezing, vomiting and convulsion than those without influenza. Influenza A/H1N1 subtype caused heavier economic burden than the other two influenza subtypes.

[Clinical analysis of therapeutic bronchoscopy for tracheal neoplasm].

Objective: To analyze the clinical features in adults with tracheal neoplasm and to evaluate the efficacy of interventional bronchoscopic treatment. Methods: We retrospectively analyzed the clinical features of 43 adults undergoing therapeutic bronchoscopy for tracheal neoplasm diagnosed in Changhai Hospital affiliated to the Second Military Medical University from January 2004 to July 2014.The degree of stenosis, the grade of dyspnea, and Karnofsky performance status scale were evaluated before and after the last procedure. All cases were followed up for 2 years. Results: The 43 cases took (4.6±3.9) months on average to be diagnosed since initial symptom. The initial misdiagnosis rate was 41.9%(18/43), and 11 cases were mistaken for asthma (11/43). Malignant tumors were more common than benign tumors for tracheal neoplasm in adults. Squamous cell carcinoma and adenoid cystic carcinoma were the top 2 histological types. Central airway obstruction was completely or partially alleviated with significant relief of dyspnea after the procedures, and all 6 cases of tracheal benign tumors got complete alleviation (the overall response rate was 100%). The grade of dyspnea was 3.2±0.7 before and 1.5±0.8 after the procedures(t=6.63, P<0.05). The value of KPS was 63±12 before and 83±11 after the procedures(t=5.78, P<0.05). The 2-year survival rate of 6 cases of tracheal benign tumors was 100.0%, and 1 case of papillomatosis had a relapse. The 1-year survival rate and 2-year survival rate of 37 cases of tracheal malignant tumors were 59.5% and 43.2% respectively with a median survival of 13.6 months. Conclusion: Therapeutic bronchoscopic interventions provide significantly alleviation of central airway obstruction and result in improvement in shortness of breath and quality of life for tracheal neoplasm.

Reduced Penetrance of PRRT2 Mutation in a Chinese Family With Infantile Convulsion and Choreoathetosis Syndrome.

Paroxysmal kinesigenic dyskinesia is a rare episodic movement disorder that can be isolated or associated with benign infantile seizures as part of choreoathetosis syndrome. Mutations in the PRRT2 gene have been recently identified as a cause of paroxysmal kinesigenic dyskinesia and infantile convulsion and choreoathetosis (ICCA). We reported a PRRT2 heterozygous mutation (c.604-607delTCAC, p.S202Hfs*25) in a 3-generation Chinese family with infantile convulsion and choreoathetosis and paroxysmal kinesigenic dyskinesia. The mutation was present in 5 family members, of which 4 were clinically affected and 1 was an obligate carrier with reduced penetrance of PRRT2. The affected carriers of this mutation presented with a similar type of infantile convulsion during early childhood and developed additional paroxysmal kinesigenic dyskinesia symptoms later in life. In addition, they all had a dramatic clinical response to oxcarbazepine/phenytoin therapy. Reduced penetrance of the PRRT2 mutation in this family could warrant genetic counseling.

NiW/Ru underlayer for CoPt-SiO2 granular perpendicular recording media.

This paper presented the usage of the NiW/Ru underlayer to replace the single Ru underlayer for promoting CoPt hcp (0002) texture. Fcc (111) textured NiW film was used to induce the Ru hcp (0002) texture. It was found that the utilization of the (111) textured NiW alloying layer promoted the formation of Ru(0002) texture, enhanced the magnetic grain isolation and generated the uniform grains with gain size less than 10 nm in CoPt-SiO2 recording layer. The out-of-plane coercivity was also enhanced with the growth of 10 nm NiW underlayer below the Ru layer.

Intratympanic injection with dexamethasone for sudden sensorineural hearing loss.

OBJECTIVE: To investigate the efficacy of intratympanic steroid therapy in adults with sudden sensorineural hearing loss, and to analyse the factors associated with treatment outcome. DESIGN: Retrospective study of patients undergoing intratympanic steroid injection for sudden sensorineural hearing loss between 1 January 2006 and 30 June 2007 at a teaching hospital in Taipei, Taiwan. RESULTS: Patients who received intratympanic steroid therapy within seven days of disease onset achieved a significantly better response rate (76.1 per cent), compared with the delayed treatment group (50 per cent). The total response rate, after four steroid injections, was 68.9 per cent. Patients with low and mid-frequency hearing loss were more responsive to steroid treatment. Vertigo was a negative prognostic factor for recovery. There were no long-term sequelae of intratympanic steroid treatment. CONCLUSION: Intratympanic steroid injection may be a simple and effective treatment for patients with sudden sensorineural hearing loss.

Association between renin-angiotensin system gene polymorphism and recurrent wheezing in Chinese children: a 4-year follow-up study.

This study aimed to clarify the association between angiotensin-converting enzyme (ACE) gene polymorphisms and infant wheezing, and to determine whether an association may contribute to early prediction of persistent wheezing and asthma. The study cohort comprised 149 patients with asthma, 169 patients with wheezing but no clinical diagnosis of asthma and 165 healthy control subjects. The insertion/deletion (I/D) polymorphism of the ACE gene was determined by polymerase chain reaction. Total serum immunoglobulin E was determined for the wheezy group and a 4-year follow-up study was carried out to observe wheezing relapse. Significant differences were found between patients and controls in allele frequency and genotype distribution. The DD genotype was more frequent in patients in the wheezing and asthma groups than in the control subjects. Patients with the DD genotype had a higher frequency of relapse than patients expressing the ID or II genotypes. It is concluded that the DD genotype of ACE is a risk factor for recurrent wheezing in early childhood.

[NADPH-diaphorase activity and Fos expression in brainstem nuclei involved in cardiovascular regulation following intracarotid injection of capsaicin].

The present study was undertaken to define whether intracarotid injection of capsaicin induces Fos expression associated with the activation of NOS-containing neurons in brainstem nuclei by combining the immunocytochemical method for Fos with NADPH-d histochemical technique for NOS. The results obtained are as follows: (1) Intracarotid injection of capsaicin caused a significant increase of Fos-like immunoreactive neurons in area postrema (AP), nucleus tractus solitarius (NTS), paragigantocellularis lateralis (PGL) and locus coeruleus (LC), without influence upon the neurons of raphe nuclei (RN) and periaqueductal gray (PAG). (2) NO-containing neurons in PGL and NTS and the double-labeled neurons in PGL were also increased significantly following intracarotid injection of capsaicin. Small numbers of NO-containing neurons were found in LC, but there was no change in the number of NO-containing neurons in RN and PAG. No NADPH-d histochemical activity could be found in AP. (3) The above responses to capsaicin were significantly inhibited by pretreatment with either a capsaicin receptor antagonist ruthenium red or a NMDA receptor antagonist MK-801. The above results indicate that intracarotid injection of capsaicin may activate the neurons in brainstem nuclei involved in cardiovascular regulation, and that NO only plays an indirect role in the modulation of the responses of brainstem nuclei to capsaicin. These effects of capsaicin are mediated by capsaicin receptors with involvement of glutamate.

Role of renal nerve in cardioprotection provided by renal ischemic preconditioning in anesthetized rabbits.

The effects of renal ischemic preconditioning (RIP) on ischemia-reperfused myocardium were examined in the urethane-anesthetized rabbit to determine whether RIP may provide cardioprotection and to observe the role of the renal nerve in such condition. The results obtained are as follows: (1) During 45 min myocardial ischemia and subsequent 180 min reperfusion, blood pressure, heart rate and myocardial oxygen consumption decreased progressively. Epicardial electrographic ST-segment was elevated significantly in the period of ischemia and returned to the baseline gradually in the course of reperfusion. The myocardial infarct size occupied 55.80 +/- 1.25% of the area at risk. (2) RIP significantly reduced the myocardial infarct size to 36.51 +/- 2.80% (P < 0.01), indicating the cardioprotective effect of such an intervention. (3) Renal nerve section (RNS) completely abolished the cardioprotection afforded by RIP, though RNS per se did not affect the myocardial infarct size produced by ischemia-reperfusion. (4) During 10 min renal ischemia, the averaged multi-unit discharge rate of the renal afferent was increased from 0.14 +/- 0.08 to 0.65 +/- 0.12 imp/s (P < 0.01). (5) Pretreatment with an adenosine receptor antagonist 8-phenyltheophylline (10 mg/kg) markedly attenuated the discharge rate of the renal afferent induced by transient renal ischemia, implying that adenosine released in ischemic kidney activated the renal afferent. It is suggested that activation of renal afferents by transient renal ischemia-reperfusion plays an important role in the cardioprotection afforded by RIP.

Renal ischemia-induced Fos expression in catecholaminergic neurons of rats.

The present study was undertaken to define whether the renal artery occlusion (RAO) would activate the catecholaminergic neurons in the brainstem nuclei by double immunohistochemical method for detecting Fos and tyrosine hydroxylase. The results are as follows: (1) while the basal expression of Fos was relatively low in the brainstem, RAO was capable of inducing a robust Fos-like immunoreactive neurons in the nucleus tractus solitarius (NTS), area postrema (AP), nucleus paragigantocellularis lateralis (PGL) and locus coeruleus (LC); (2) numerous catecholaminergic neurons in NTS, AP, PGL and LC could be activated by RAO as shown by Fos expression; and (3) these responses to RAO were significantly attenuated by pretreatment with an adenosine receptor antagonist 8-phenyltheophylline. The results suggest that RAO can activate a large number of neurons including some catecholaminergic neurons in the brainstem nuclei. Such effects of renal ischemia may be attributed to RAO-induced adenosine release from the kidney which subsequently activates renal afferents.

Renal ischemia enhances electrical activity and Fos protein expression of the rostral ventrolateral medullary neurons in rats.

The effects of renal ischemia on spontaneous electrical activity and Fos protein expression of nucleus paragigantocellularis lateralis (PGL) in rostral ventrolateral medulla (RVLM) were observed in 67 anesthetized Sprague-Dawley rats with sinoaortic denervation by using extracellular recording and immunohistochemical techniques. The results obtained are as follows. (1) Renal ischemia increased the discharge rate from 11.40 +/- 1.08 to 21.1 +/- 1.74 spikes/s (P < 0.001) in 28 out of 30 PGL neurons, while blood pressure and heart rate had no significant change (P > 0.05). (2) Administration of 8-phenyltheophylline (8-PT), an adenosine receptor antagonist, did not affect the discharge rate of PGL neurons, but could partially inhibit the effects of renal ischemia in 17 units (P < 0.05). (3) Renal ischemia resulted in a remarkable increase in the number of Fos-like protein immunoreactive PGL neurons in the RVLM (P < 0.01). (4) Fos protein expression induced by renal ischemia was significantly inhibited by pretreatment with 8-PT (P < 0.05). Taken together, it is concluded that renal ischemia induces an increase in spontaneous electrical activity and Fos protein expression in PGL neurons of RVLM, and that adenosine released within ischemic kidney may be involved in such effects.

[Effect of progesterone on cerebral cortex edema in rats exposed to focal ischemia/reperfusion].

AIM: To explore the effects of progesterone (PROG) on brain edema in rats. METHODS: Forty eight rats were randomly divided into 6 groups that were ischemia/reperfusion (I/R), dimethylsulfoxide (DMSO), and pretreatment, pre + posttreatment, posttreatment with PROG, and dexamethasone (DEXA) groups. The model of focal cerebral ischemia was established in rats by reversible inserting a nylon thread into the anterior cerebral artery. All rats were decapitated at 24 hours after the left middle cerebral artery occlusion (MCAO) respectively, and then brain H2O, Na+, K+, Ca2+ contents were determined. RESULTS: Compared with the result in DMSO group, the content of water (P < 0.01), Na+ (P < 0.01), Ca2+ (P < 0.01) was significantly reduced, but K+ (P < 0.01) was obviously elevated in ischemia cortex in pretreatment group or pre + posttreatment group with PROG. There was also significant reduction in water (P < 0.05) and Na+ (P < 0.01), but was not significantly changed in Ca2+ (P > 0.05) and K+ (P > 0.05) in posttreatment group with PROG. The changes occurring in DEXA group were similar to those found in pretreatment group or pre + posttreatment group with PROG. CONCLUSION: Pretreatment or pretreatment plus posttreatment with progesterone can significantly reduce brain edema in I/R.

[Ischemic preconditioning reduces cardiomyocytic apoptosis in rabbit heart in vivo].

The effects of ischemia-reperfusion (IR) and ischemic preconditioning (IP) on hemodynamics, epicardial electrography, myocardial infarct size, cardiomyocytic apoptosis and gene proteins involving apoptosis (Fas, Bcl-2 and Bax) were observed in aneasthetized rabbit myocardium. The results are as follows. (1) During ischemia-reperfusion, heart rate, arterial blood pressure and myocardial oxygen consumption were reduced progressively. The epicardial electrographic ST-segment was elevated significantly during ischemia (P<0.001)and recovered to the baseline during reperfusion. (2) The infarct size occupied 57.7+/-2.0% of the ischemic myocardium in IR group while IP reduced the infarct size to 27.7+/-1.5% (P<0.01). (3) DNA ladder pattern of ischemic myocardium was revealed by agrose gel electrophoresis in IR group while it was not found in IP group. Apoptotic cardiomyocytes were sparse within the ischemic myocardium at risk in IP as compared with those in IR heart. Apoptosis rate of the ischemic myocardium from IR and IP groups detected by flow cytometry was 11.2+/-0.4% and 6.35+/-0.2% (P<0.01), respectively. (4) Fas and Bax protein expression in the ischemic myocardium of IR and IP groups was elevated as compared with those in non-ischemic myocardium group (P<0.05). The Fas protein expression of IR group was higher than that of IP group (P<0.05). Bcl-2/Bax ratio of IR group was lower than that in non-ischemic myocardium (P<0.01). From the results, it is suggested that IP decreases cardiomyocytic apoptosis induced by IR and this action is mediated by the reduction of Fas protein expression.

[Role of KATP channels in the cardioprotection provided by ischemic preconditioning in anesthetized rabbits].

The effects of KATP channel opener cromaklim (Cro) and ischemic preconditioning (IP) on hemodynamics and myocardial infarct size were examined in both urethane and sodium pentobarbital anesthetized rabbit models of myocardial ischemia-reperfusion to determine whether the KATP channel was involved in the cardioprotection provided by IP. The results were as follows: (1) All hemodynamic parameters and myocardial oxygen consumption were decreased progressively during the course of ischemia (30 min)-reperfusion (180 min). (2) In the urethane anesthetized model, the myocardial infarct size of the left ventricle induced by ischemia-reperfusion was (32.3 +/- 0.8)%. Pretreatment with Cro reduced the myocardial infarct size to (23.3 +/- 2.2)%, while IP significantly reduced the infarct size to (21.6 +/- 1.8)%, which was abolished by a potent KATP channel blocker glibenclamide. (3) In the sodium pentobarbital anesthetized model, myocardial infarct size was (32.7 +/- 1.0)%. IP also reduced the myocardial infarct size to (19.7 +/- 1.5)%, which could not be blocked by cardioprotection of IP by glibenclamide. Cro failed to decrease infarct size. Such results indicated that activation of KATP channels exerted a beneficial action on ischemia-reperfused myocardium only in the urethane anesthetized rabbit.

[Ischemic preconditioning and exogenous L-arginine reduce infarct size in rabbit heart].

The effects of NO donor--L-arginine (L-arg) and ischemic preconditioning (IP) on the hemodynamics and myocardial infarct size were examined in the anesthetized rabbit subjected to myocardial ischemia-repefusion to define whether exogenous L-arg could exert a beneficial effect in this pathological model, and whether the L-arg-NO pathway was involved in the cardioprotection provided by IP. The results obtained were as follows: (1) During the course of ischemia (30 min)-reperfusion (180 min), blood pressure, heart rate and myocardial oxygen consumption decreased progressively, and the myocardial infarct size occupied 33.9 +/- 2.4% of the whole left ventricle. (2) The myocardial infarct size could be reduced to 20.1 +/- 2.2% (P < 0.01) by pretreatment with L-arg (300 mg/kg). This myocardial protective effect of L-arg was abolished by NO synthesis inhibitor--Nitro-L-arginine (L-NNA), thereby indicating the involvement of L-arg-NO pathway. (3) IP significantly reduced the infarct size to 21.9 +/- 2.1% (P < 0.01), indicating the prominent cardioprotective effect of such an intervention. Since L-NNA showed no effect on the cardioprotection afforded by IP, it was implied that the L-arg-NO pathway was not involved in the cardioprotective mechanism of IP. (4) Exogenous L-arg might markedly augment cardioprotection provided by IP. The above results strongly suggested that the cardioprotective effect of L-arg on ischemia-reperfused myocardium was mediated by L-arg-NO pathway, which, however, was not involved in the cardioprotection provided by IP.

[Experimental study of the heat and cold constitutional types (II). A comparative observation on the heat and cold constitutional type rats on the DNA replication capacity after ultraviolet damage].

The cold-constitutional and the heat-constitutional type had selected in Wistar rats as the object of study. Using peripheral blood and spleen as materials by means of ultraviolet injury, isotope incorporation, cells incubation in vitro and liquid scintillation counting, the capacity of peripheral lymphocytes DNA replication after damage with ultraviolet radiation and the capacity of the spleen lymphocytes proliferation in vitro was observed. The results showed that the both capacities mentioned above were higher in the heat constitutional type rat than that in the cold type. It is suggested that the following conclusion in the Lingshu Jing is correct: "the capacity of tissue repair is higher in the heat constitutional type than in the cold."

Two cellulolytic Clostridium species: Clostridium cellulosi sp. nov. and Clostridium cellulofermentans sp. nov.

Two cellulolytic clostridia, one thermophilic and the other mesophilic, were isolated and characterized. Cells of the thermophile are gram-negative rods that are motile with lophotrichous flagella and spherical terminal endospores which swell the cells. The optimum growth temperature is 55 to 60 degrees C, with a range of 40 to 65 degrees C. The deoxyribonucleic acid composition is 35 mol% G + C. The name Clostridium cellulosi sp. nov. is proposed. The type strain is AS 1.1777. Cells of the mesophile are gram negative and motile with peritrichous flagella and terminal oval or spherical spores which swell the cells. The deoxyribonucleic acid composition is 34 mol% G + C. The name Clostridium cellulofermentans sp. nov. is proposed. The type strain is AS 1.1775. Both C. cellulosi AS 1.1777 and C. cellulofermentans AS 1.1775 are deposited in the China Committee for Culture Collection of Microorganisms, Institute of Microbiology, Academia Sinica, Beijing, People's Republic of China.