Clinical characteristics and related factors analysis of adrenal crisis occurred in children with primary nephrotic syndrome / 中华儿科杂志

Objective: To investigate the clinical characteristics and related factors of corticosteroid induced adrenal crisis (AC) in children with primary nephrotic syndrome (NS). Methods: Case control study. The case group included 7 children aged 1 to 18 years with NS combined with AC hospitalized in Peking University First Hospital from January 2016 to May 2021 (AC group). According to the ratio of case group: control group 1: 4, 28 children aged 1 to 18 years who were diagnosed with NS without AC during the same period were matched as controls (non-AC group). Clinical data were collected. The clinical characteristics of AC were described. The clinical parameters were compared between the 2 groups by t test, Mann-Whitney U test or Fisher's test. Receiver operating characteristic (ROC) curve was used to analyze the cutoff values of clinical parameters for prediction of AC. Results: The AC group included 4 boys and 3 girls aged 6.9 (4.6, 10.8) years. The non-AC group included 20 boys and 8 girls aged 5.2 (3.3, 8.4) years. All AC events occurred during the relapse of NS with infection. Seven children had gastrointestinal symptoms such as nausea, vomiting and abdominal pain. Six children had poor mental state or impaired consciousness. No significant differences in NS course, corticosteroid treatment course, corticosteroid type, steroid dosage, steroid medication interval, the proportion of gastroenteritis and fever existed between the two groups (all P>0.05). Compared with the non-AC group, the duration from the onset of the relapse of NS until hospitalization in the AC group was significantly shorter (0.2 (0.1, 0.6) vs. 1.0 (0.4, 5.0) month,U=25.50, P=0.005). The 24 h urinary total protein (UTP) level was significantly higher in the AC group (193 (135, 429) vs. 81 (17, 200) mg/kg, U=27.00,P=0.036) than the non-AC group. The serum albumin level in the AC group was significantly lower((13.1±2.1) vs. (24.5±8.7) g/L,t=-6.22,P<0.001) than the non-AC group. There were significantly higher total white blood cell counts ((26±9)×109 vs. (11±5)×109/L,t=4.26,P=0.004), percentage of neutrophils (0.71±0.08 vs. 0.60±0.19,t=2.56,P=0.017) and the proportion of children with C reactive protein level≥8 mg/L (3/7 vs. 0,P=0.005) in the AC group than in the non-AC group. ROC curve analysis showed that the cutoff value of 24 h UTP was 122 mg/(kg·d) with a sensitivity of 100.0% and specificity of 70.4%. The cutoff value of serum albumin was 17.0 g/L with a sensitivity of 100.0% and specificity of 82.1%. Conclusions: Gastrointestinal symptoms and poor mental state were prominent manifestations of AC in children with NS. High 24 h UTP level, low serum albumin level, high peripheral white blood cell counts, high neutrophils percentage, and high C-reactive protein level during the early stage of NS relapse may be related to the occurrence of AC in children with NS.

Outcome of Thoracic Column Antedisplacement and Fusion in Treatment of Thoracic Myelopathy Caused by Ossification of Posterior Longitudinal Ligament: A Case Series Study.

BACKGROUND: Up to date, surgical outcome of multilevel thoracic ossification of posterior longitudinal ligament (T-OPLL) with high canal occupation ratio is less satisfactory. OBJECTIVE: To explore the result of thoracic column antedisplacement and fusion (TCAF) in treatment of multilevel T-OPLL with high canal occupation ratio. METHODS: A total of 5 patients who underwent TCAF procedure for T-OPLL were retrospectively reviewed. Parameters including extent of OPLL, thickness of the maximal OPLL (max-OPLL), maximal canal occupying ratio (max-COR) of OPLL, effective canal diameter (ECD) at the max-OPLL level, antedisplacement distance of thoracic columns, ASIA grades, Japanese Orthopedic Association (JOA) scores, and complications were collected and analyzed at preoperation and the last follow-up. RESULTS: All patients (5 F, mean age 61.0 yr, mean follow-up 18.0 months) underwent TCAF successfully and no spinal cord injury or cerebrospinal fluid leakage occurred. The mean extent of OPLL was 2.8 vertebral bodies. The mean preoperative thickness of the max-OPLL was 5.9 mm. The average antedisplacement distance of thoracic columns was 5.6 mm. The mean ECD was improved from 6.5 mm to 10.9 mm, and the max-COR was improved from 50.7% to 7.1% at last follow-up. Two patients showed improvement in ASIA grades and JOA scores were significantly improved from 5.6 points to 10.4 points at final follow-up. The overall therapeutic results of 1 patient were classified into good and 4 into fair at last follow-up. CONCLUSION: TCAF may be a safe and effective procedure in treatment of multilevel T-OPLL with high canal occupation ratio.

Development of an indirect ELISA to specifically detect antibodies against African swine fever virus: bioinformatics approaches.

BACKGROUND: African swine fever (ASF), characterized by acute, severe, and fast-spreading, is a highly lethal swine infectious disease caused by the African swine fever virus (ASFV), which has caused substantial economic losses to the pig industry worldwide in the past 100 years. METHODS: This study started with bioinformatics methods and verified the epitope fusion protein method's reliability that does not rely on traditional epitope identification. Meanwhile, it will also express and purify the constructed genes through prokaryotic expression and establish antibody detection methods. RESULTS: The results indicated that the protein had good reactivity and did not cross-react with other swine diseases. The receiver-operating characteristic analysis was performed to verify the determination. The area under the receiver-operating characteristic curve was 0.9991 (95% confidence interval 0.9973 to 1.001). CONCLUSIONS: It was proved that the recombinant protein is feasible as a diagnostic antigen to distinguish ASFV and provides a new idea for ASFV antibody detection.

Morphological Evaluation of the Subaxial Cervical Spine in Patients with Basilar Invagination: A CT-based Study.

STUDY DESIGN: Retrospective study. OBJECTIVE: To evaluate the morphologic features of the subaixal cervical spine in patients with basilar invagination (BI) and provide information for the accurate screw placement in this region. SUMMARY OF BACKGROUND DATA: BI is a congenital anomaly, comprising a wide range of abnormal structures. The screw fixation can be required in situation that BI is combined with subaxial cervical spine pathologies. However, there are no literatures specifically addressed the subaxial cervical morphology of BI. METHOD: A total of 42 BI patients were included in this retrospective study. Forty-two patients without head or cervical disease were matched for sexes and ages. Information on radiographic features of the subaxial cervical spine was collected and compared systematically. RESULTS: There were no differences in the age and sex between the BI and control group. The BI group manifested a wider pedicle and laminar than the control group at all cervical levels, except for the pedicle of C6 and C7, and the laminar of C3 and C6. In addition, the BI group had a wider lateral mass from C3 to C5 than the control group. There were no differences in most measurements of the length of pedicle, laminar, and lateral mass. CONCLUSION: BI patients have a wider pedicle and laminar than the general population in the subaxial cervical spine, but the same size in length of pedicle, laminar, and lateral mass.Level of Evidence: 4.

Surgical treatment for basilar invagination with irreducible atlantoaxial dislocation: transoral atlantoaxial reduction plate fixation vs occipitocervical fixation.

BACKGROUND: Transoral atlantoaxial reduction plate (TARP) fixation or occipitocervical fixation (OF) is an effective treatment for basilar invagination (BI) with irreducible atlantoaxial dislocation (IAAD). But, all current clinical studies involved a single surgical procedure. The clinical effects of TARP and OF operation for BI with IAAD have yet to be compared. We therefore present this report to compare the treatment of TARP and OF procedure for BI with IAAD. METHODS: Fifty-six patients with BI with IAAD who underwent TARP or OF operation from June 2011 to June 2017 were retrospectively analyzed. Among these, 35 patients underwent TARP operation (TARP group), and 21 patients underwent OF operation (OF group). We compared the difference of clinical, radiological, and surgical outcomes between the TARP and OF groups postoperatively. RESULTS: Compared with OF group, the operative time and blood loss in TARP group were lower. There was no statistical difference in the atlantodental interval (ADI), clivus canal angle (CCA), cervicomedullary angle (CMA), distance between the top of the odontoid process and the Chamberlain line (CL) and Japanese Orthopaedic Association (JOA) score between the TARP and OF groups preoperatively, but the improvements of these parameters in the TARP group were superior to those in the OF group postoperatively. The fusion rates were higher in the TARP group than those in the OF group at the early stage postoperatively. CONCLUSIONS: TARP and OF operations are effective surgical treatment for BI with IAAD, but the performance of reduction and decompression and earlier bone fusion rates of TARP procedure are superior to those of OF.

Transoral intraarticular cage distraction and C-JAWS fixation for revision of basilar invagination with irreducible atlantoaxial dislocation.

BACKGROUND: The revision surgery of basilar invagination (BI) with irreducible atlantoaxial dislocation (IAAD) after a previous occipitocervical fusion (OCF) is challenging. Transoral revision surgery has more advantages than a combined anterior and posterior approach in addressing this pathology. The C-JAWS is a cervical compressive staple that has been used in the lower cervical spine with many advantages. Up to now, there is no report on the application of C-JAWS in the atlantoaxial joint. We therefore present this report to investigate the clinical outcomes of transoral intraarticular cage distraction and C-JAWS fixation for revision of BI with IAAD. METHODS: From June 2011 to June 2015, 9 patients with BI and IAAD were revised by this technique after previous posterior OCF in our department. Plain cervical radiographs, computed tomographic scans and magnetic resonance imaging were obtained pre- and postoperatively to assess the degree of atlantoaxial dislocation and compression of the cervical cord. The Japanese Orthopedic Association (JOA) score was used to evaluate the neurological function. RESULTS: The revision surgeries were successfully performed in all patients. The average follow-up duration was 18.9 ± 7.3 months (range 9-30 months). The postoperative atlas-dens interval (ADI), cervicomedullary angle (CMA), distance between the top of the odontoid process and the Chamberlain line (CL) and JOA score were significantly improved in all patients (P < 0.05). Bony fusion was achieved after 3-9 months in all cases. No patients developed recurrent atlantoaxial instability. CONCLUSIONS: Transoral revision surgery by intraarticular cage distraction and C-JAWS fixation could provide a satisfactory outcome for BI with IAAD after a previous unsuccessful posterior operation.

Motion-preserving treatment of unstable atlas fracture: transoral anterior C1-ring osteosynthesis using a laminoplasty plate.

BACKGROUND: C1-ring osteosynthesis is a valid alternative to posterior C1-C2 or C0-C2 fusion to preserve important C1-C2 motion in the treatment of unstable atlas fractures. Nevertheless, the fixation instruments used in current studies for transoral anterior C1-ring osteosynthesis were not suitable for anterior anatomy of the atlas or did not have reduction mechanism. We therefore present this report to investigate preliminary clinical effects of transoral anterior C1-ring osteosynthesis using a laminoplasty plate in unstable atlas fractures. METHODS: From January 2014 to December 2017, 13 patients with unstable atlas fractures were retrospectively reviewed. All patients were treated with transoral anterior C1-ring osteosynthesis using a laminoplasty plate. Pre- and postoperative images were obtained to assess reduction of the fracture, internal fixation placement, and bone union. Neurological function, range of motion, and pain levels were evaluated clinically on follow-up. RESULTS: The surgeries were successfully performed in all cases. The average follow-up duration was 16.6 ± 4.4 months (range 12-24 months). One patient suffered screw loosening after operation and underwent replacement operation subsequently. Satisfactory clinical outcomes were achieved in all patients with ideal fracture reduction, reliable plate placement, well-preserved range of motion, and neck pain alleviation. All patients achieved bone union of fractures without loss of reduction or implant failure or C1-C2 instability during the follow-up. No vascular or neurological complication was noted during the operation and follow-up. CONCLUSIONS: Transoral anterior C1-ring osteosynthesis using a laminoplasty plate is a effective surgical treatment for unstable atlas fractures. This technique has a ingenious reduction mechanism, and can provide satisfactory bone union and preservation of C1-C2 motion.

[Progress in treatment of unstable atlas fracture].

OBJECTIVE: To summarize the progress in treatment of unstable atlas fracture, the existing problems, and the research direction. METHODS: Related literature at home and abroad was reviewed. The stability evaluation of atlas fracture and treatment methods were introduced, and the selection of surgical approach and fixation instruments in treatment of unstable atlas fracture were summarized and analyzed. RESULTS: At present, atlas fractures are considered as unstable fractures except single anterior arch fractures with complete transverse ligament or simple posterior arch fractures. The treatment of unstable atlas fracture has been developed from nonsurgical treatment and traditional fusion surgery to single-segment fixation. Nonsurgical treatment is less effective, while traditional fusion surgery has a disadvantage of limited the motion of the upper cervical spine. Single-segment fixation can not only restore and fix the fracture, but also preserve the upper cervical motion function. Single-segment fixation approaches include posterior and transoral approaches, and the fixation instruments are being constantly improved, mainly including screw-rod system, screw-plate system, and plate system. CONCLUSION: For unstable atlas fracture, single-segment fixation is an ideal surgical method, and has more advantages when compared with nonsurgical treatment and traditional fusion surgery. Single-segment fixation via transoral approach is more direct for atlas anterior arch fracture reduction, but there is a high risk of infection; and single-segment fixation via posterior approach is less effective for the reduction of atlas anterior arch fracture. Therefore, a better reduction method should be explored.

Antitumor activity of ginsenoside Rd in gastric cancer via up-regulation of Caspase-3 and Caspase-9.

Ginsenoside Rd (GS-Rd), isolated from the Chinese traditional herbal medicine Panax ginseng, is used for the treatment of cardiovascular diseases, inflammation, different body pains, and trauma. Caspase-3 and Caspase-9 belong to cysteine aspartic acid specific protease (Caspase) family that plays an important role in apoptosis progression of cancers. In the present study, we investigated the anti-tumor effect of GS-Rd by MTT assay, colony formation assessment, flow cytometry, and Western blotting. Our results revealed that ginsenoside Rd significantly inhibits human gastric cancer (GC) growth and cell proliferation. Flow cytometer analysis showed that the GS-Rd could significantly induce apoptosis and arrest the G0/G1 phase in GC cells. Further, GS-Rd was found to increase the ratio of Bax/Bcl-2 and the expression of Caspase-3 and Caspase-9, respectively, and to decrease the expression of Cyclin D1. Taken together, our study suggests that GS-Rd significantly inhibits GC cell proliferation, induces cell apoptosis through increase the expression of Caspase-3, Caspase-9, and the ratio of Bax/Bcl-2. GS-Rd also induces cell cycle arrest at G0/G1 phase by down-regulation Cyclin D1. Thus, GS-Rd could serve as a lead to develop novel therapeutic agents to against human gastric cancer.

Relationship between the laminectomy extension and spinal cord injury caused by acute spinal shortening: goat in vivo experiment.

OBJECTIVE: To investigate the relationship between different types of laminectomy extension and spinal cord injury subsequent to acute spinal shorting after 3-column osteotomy in living goat model. METHODS: A total of 18 healthy goats were selected, and a procedure of bivertebral column resections and total laminectomy of T13 and L1 was completed followed by different laminectomy extensions under the somatosensory evoked potential (SSEP) monitoring. The samples were divided into three groups according to types of subsequent laminectomy extension. In the first group (enlarged resection of upper lamina group), laminectomy extension was performed on 10 mm caudal to T12; in the second group (equidistant enlarged resection of upper and lower lamina group), laminectomy extension was performed on 5 mm caudal to T12 and 5 mm cranial to L2 simultaneously; and in the third group (enlarged resection of lower lamina group), laminectomy extension was performed on 10 mm cranial to L2. The SSEP measured after vertebral resection was set as the baseline, and the SSEP decreased by 50% from the baseline amplitude and/or delayed by 10% relative to the baseline peak latency was set as positive results, which indicated spinal cord injury. Spinal column was gradually shortened until the SSEP monitoring just did not show a positive result. The shortened distance (ΔH) and the changed angle of the spinal cord buckling (Δα) were measured in each group. Neurologic function was recorded by the Tarlov scores at 2 days after the surgery. RESULTS: The safe shortening distances of three groups were 38.6 ± 1.2 mm, 41.5 ± 0.7 mm, 43.7 ± 0.8 mm, respectively; the corresponding changed angles of the spinal cord buckling were 62.8 ± 6.9°, 82.8 ± 7.5°, and 98.5 ± 7.0°. Significant differences of ΔH and Δα were found among the three groups by LSD multiple comparison test (P < 0.05). Strong correlation between ΔH and Δα was shown in each group by Pearson's correlation test. CONCLUSIONS: Different laminectomy extensions after 3-column osteotomy have different effects on the prevention of SCI caused by acute spinal shortening. The enlarged resection of lower lamina is superior to equidistant enlarged resection of upper and lower laminas which is superior to enlarged resection of upper lamina in preventing SCI. These slides can be retrieved under Electronic Supplementary Material.

Anterior Transoral Débridement Combined with Posterior Fixation and Fusion for Atlantoaxial Tuberculosis.

BACKGROUND: Atlantoaxial tuberculosis (TB) is rare in clinical practice, accounting for only about 0.3%-1% of spinal TB. An anterior-only surgical approach cannot provide strong fixation, whereas a posterior approach cannot achieve complete removal of lesions. A method combining anterior and posterior approaches to treat atlantoaxial TB is advisable. The aim of this study was to evaluate the effectiveness of anterior transoral débridement combined with posterior fixation and fusion for atlantoaxial TB. METHODS: Clinical data of 20 patients with atlantoaxial TB who underwent anterior transoral débridement combined with posterior fixation and fusion in our hospital were retrospectively analyzed. Antituberculosis drugs were administered for 18 months after surgery. Neurologic status, clinical symptoms, fusion, reduction, and complications were evaluated. RESULTS: Surgeries were performed successfully in all 20 cases with no injuries to spinal cord, nerves, or blood vessels. Clinical symptoms were relieved in all 20 patients (100%). Postoperative Japanese Orthopaedic Association score, occipitocervical visual analog scale score, and atlantodental interval were significantly improved (P < 0.05). Average follow-up duration was 33 months (range, 24-48 months). Bony fusion was achieved in all 20 cases. No serious complications were documented during follow-up. CONCLUSIONS: Anterior transoral débridement combined with posterior fixation and fusion is an effective treatment for atlantoaxial TB, achieving removal of lesions and stability.

Anatomical analysis of the occipital bone in patients with basilar invagination: a computed tomography-based study.

BACKGROUND CONTEXT: The occipital bone is often involved in the surgical treatment of basilar invagination (BI). However, the anatomy of the occipital bone associated with BI patients has yet to be investigated. PURPOSE: To present a morphological map of the occipital bone in BI patients and help guide screw placement for occipitocervical fusion. STUDY DESIGN: A retrospective case-control study. METHODS: Radiological measurements of the occipital bone were performed on computed tomography images based on a matrix of 99 points centered around the external occipital protuberance (EOP) in a cohort of 50 BI patients and 50 cases with no head and cervical disease. The comparison between the BI group and the control group was assessed using Student t analysis and p<.05 was considered statistically significant. RESULTS: All thicknesses measured from points of the matrix in the BI group were thinner than those in the control group (p<.05). The maximum thicknesses in both groups were located at the center of the EOP, which were 15.11±2.84 mm in the BI group and 17.56±3.03 mm in the control group, respectively. Additionally, thickness decreased with the distance away from the center of EOP. CONCLUSIONS: The occipital bone in BI patients is thinner than that in the general population. A limited safe zone in BI patients is available for surgeons to place screws, which may need to be fully evaluated before operation.

Fabrication and release behavior of nitrapyrin Microcapsules: Using modified melamine-formaldehyde resin as shell material.

As a commonly used nitrification inhibitor, nitrapyrin can significantly improve the utilization of nitrogen in soils. However, the effectiveness of the traditional dosage form of nitrapyrin is reduced by soil adsorption. In this study, nitrapyrin was encapsulated into a melamine-formaldehyde resin microcapsule with good dispersion and release behavior using an in situ polymerization method. The nitrapyrin microcapsules were characterized using Fourier transform infrared spectroscopy, thermogravimetric analysis, scanning electron microscopy, transmission electron microscopy, and particle-size analysis. The results indicated that the microcapsules had a spherical-shell structure, a uniform morphology with nanoscale micropores on the surface, and a decent nitrapyrin loading content (67.19%). Tests revealed that the release behavior of the nitrapyrin microcapsules was outstanding and conformed to the double-release kinetic model. These results of this study indicate that the nitrapyrin microcapsules can be applied as nitrification inhibitors with beneficial environmental effects and high efficacy.

Safe Limit of Shortening of the Spinal Cord in Thoracolumbar Bivertebral Column Resections: An Experimental Study in Goats.

OBJECTIVE: To clarify the safe limit of shortening of the spinal cord in thoracolumbar bivertebral column resection in a goat model. METHODS: Ten healthy goats were selected for the experiment. Radiographs were taken before surgery to measure the height of T13, L1, and the initial osteotomy segment (distance from the lower end plate of T12 to the upper end plate of L2). A procedure of thoracolumbar bivertebral column resection (T13 and L1) was completed under the monitoring of somatosensory evoked potential (SSEP) monitoring. The SSEP measured after vertebral resection was set as the baseline. SSEPs decreased by 50% from the baseline amplitude and/or delayed by 10% relative to the baseline peak latency were set as positive results, indicating spinal cord injury. The initial height of the osteotomy gap was measured first and the spinal column was gradually shortened until the SSEP monitoring did not show a positive result. Then the height of the osteotomy gap was recorded again. The safe limit of shortening was measured and recorded when any morphologic change of the spinal cord was observed. Hindlimb function was evaluated by the Tarlov scores on day 2 postoperatively. RESULTS: The safe limit of shortening of the spinal cord in thoracolumbar bivertebral columns resection was 35.2 ± 2.6 mm, which was roughly equal to 127.6% of the mean osteotomy vertebral height and 57.1% of the initial osteotomy gap height. Pearson correlation test showed that the safe limit of shortening of the spinal cord was correlated with the height of T13, the height of L1, the mean height of T13 and L1, and the height of the initial osteotomy gap. CONCLUSIONS: The safe limit of shortening distance of the bivertebral column resection was roughly equal to 127.6% of the mean osteotomy vertebral height and 57.1% of the initial osteotomy gap height with good correlation. Moreover, the safe limit of shortening distance of the bivertebral column resection was longer than that in single vertebral column resection. Increasing the number of vertebrae resected may prevent spinal cord injury because of excessive shortening.

Propranolol induces hemangioma endothelial cell apoptosis via a p53­BAX mediated pathway.

The use of propranolol for the treatment of infantile hemangioma (IH) has been widely investigated in recent years. However, the underlying therapeutic mechanism of propranolol for the treatment of IH remains poorly understood. The aim of the present study was to investigate the expression of proteins regulated by cellular tumor antigen p53 (p53) in associated apoptosis pathways in IH endothelial cells (HemECs) treated with propranolol. Furthermore, the present study aimed to investigate the exact apoptotic pathway underlying the therapeutic effect of propranolol against IH. In the present study, HemECs were subcultured and investigated using an inverted phase contrast microscope, immunocytochemical staining and a scanning electron microscope (SEM). Experimental groups and blank control groups were prepared. All groups were subjected to drug treatment. A high p53 expression model of HemECs was successfully established via transfection, and a low p53 expression model of HemECs was established using pifithrin­α. The apoptosis rate of each group was determined using Annexin V­fluorescein isothiocyanate/propidium iodide double staining and flow cytometry. The expression levels of downstream proteins regulated by p53 [tumour necrosis factor receptor superfamily member 6 (FAS), p53­induced death domain­containing protein (PIDD), death receptor 5 (DR5), BH3­interacting domain death agonist (BID), apoptosis regulator BAX (BAX), p53 unregulated modulator of apoptosis (PUMA), phosphatidylinositol­glycan biosynthesis class S protein (PIGS), and insulin­like growth factor­binding protein 3 (IGF­BP3)] were revealed in the experimental and control groups via western blotting. Microscopic observation revealed the growth of an adherent monolayer of cells, which were closely packed and exhibited contact inhibition. Immunocytochemical staining demonstrated increased expression of clotting factor VIII. SEM analysis revealed presence of Weibel­Palade bodies. The results of the analyses verified that the cultured cells were HemECs. The staining of the samples resulted in a significantly increased rate of apoptosis in experimental groups compared with the blank control group. This result suggested that there is an association between p53 expression and the rate of apoptosis of propranolol­treated HemECs. The results of the western blot analysis demonstrated an upregulation of BAX expression and a downregulation of IGF­BP3 expression in the HemECs treated with propranolol. There were no significant differences in the expression levels of FAS, DR5, PIDD, BID, PUMA and PIGS between experimental and control groups. This result suggests that p53 has an important role in HemEC apoptosis. The results of the present study additionally suggest that the propranolol­induced HemEC apoptosis pathway is a mitochondrial apoptosis pathway and is regulated by p53­BAX signaling.

[Significance of Morphological Examination, Cytochemical Staining Combined with Bone Marrow Biopsy in Differential Diagnosis of Myelodysplastic Syndrome with Low Blasts and Hemolytic Anemia].

OBJECTIVE: To explore the value of morphological examination, cytochemical staining combined with bone marrow biopsy in the differential diagnosis between myelodysplastic syndrome (MDS) with low blasts and hemolytic anemia (HA). METHODS: The clinical data of 85 cases of myelodysplastic syndrome with low blasts (< 5%) and 61 patients with hemolytic anemia in Chinese PLA's Gerneral hospital from September 2009 to March 2015 were retrospectively analysed. The clinical characteristics, cytogenetic and molecular features, bone marrow cell count and morphology features, cytochemical staining results and bone marrow biopsy features of above-methioned patients were compared. RESULTS: There was no significant difference (P > 0.05) in clinical data between MDS group and HA group. Megakaryocytic dysplasia-positive rate, and ring sideroblasts positive rate, and PAS positive rate were significantly higher in MDS group than those that in HA group (P < 0.05). Abnormal localization of immature precursors (ALIP) and megakaryocytic dysplasia positive rate in bone marrow biopsy were significantly higher in MDS group than those that in HA group (P < 0.05), 90.6% of MDS with low blasts patients were identifiable by combined detections. CONCLUSION: Combining detection of morphology, cytochemistry staining and bone marrow biopsy has been confirmed to be more useful for differential diagnosis between MDS with low blasts and HA.

Semi-coke briquettes: towards reducing emissions of primary PM2.5, particulate carbon, and carbon monoxide from household coal combustion in China.

Direct household use of unprocessed raw coals for cooking and heating without any air pollution control device has caused serious indoor and outdoor environment problems by emitting particulate matter (PM) and gaseous pollutants. This study examined household emission reduction by switching from unprocessed bituminous and anthracite coals to processed semi-coke briquettes. Two typical stoves were used to test emission characteristics when burning 20 raw coal samples commonly used in residential heating activities and 15 semi-coke briquette samples which were made from bituminous coals by industrial carbonization treatment. The carbonization treatment removes volatile compounds from raw coals which are the major precursors for PM formation and carbon emission. The average emission factors of primary PM2.5, elemental carbon, organic carbon, and carbon monoxide for the tested semi-coke briquettes are much lower than those of the tested raw coals. Based on the current coal consumption data in China, switching to semi-coke briquettes can reduce average emission factors of these species by about 92%, 98%, 91%, and 34%, respectively. Additionally, semi-coke briquette has relatively lower price and higher burnout ratio. The replacement of raw coals with semi-coke briquettes is a feasible path to reduce pollution emissions from household activities.

Pneumonia relevant to lung transplantation and pathogen distribution.

BACKGROUND: Pneumonia is the most common cause of morbidity and mortality in lung transplant (LT) recipients. The aim of the present study was to evaluate the incidence, etiology, risk factors and prognosis of pneumonia in LT recipients. METHODS: The LT cohort consisted of 28 recipients receiving LT in Beijing Chao-Yang Hospital from August 2005 to April 2011. Data collected included demographic data, underlying disorders, time and type of transplant, follow-up information, date of last follow-up, and patient status. A retrospective analysis was made of observational data that were prospectively collected. RESULTS: Twenty-two patients of 28 LT recipients had 47 episodes of pneumonia throughout the study period. Thirtyeight episodes of pneumonia in 19 recipients occurred post-LT with a median follow-up of 257.5 days (1-2104 days), the incidence of pneumonia was 192.4 episodes per 100 LT/year and its median time of onset was 100.5 days (0-946 days) post-transplantation. Bacteria, virus and fungi accounted for 62%, 16% and 15% of the microbial pathogens, respectively. The most frequent were Pseudomonas aeruginosa (20%), cytomegalovirus (CMV) (15%), and Aspergillus fumigatus (10%). A total of 29% (11/38) of pneumonias occurred in the first month post-LT, and then the incidence decreased gradually. The incidence of CMV pneumonia was 25% (7/28) with a median time of 97 days (10-971 days). More than one bacterial infection and CMV infection were independent risk factors for aspergillus infection. The incidence of pulmonary tuberculosis (TB) was 18% (5/28), and the history of TB was a risk factor for TB relapse. There were 58% (7/12) of recipients who died of infection, and 71% (5/7) of these died in the first year after LT. CONCLUSIONS: Pneumonia is still a major cause of morbidity and mortality in LT recipients. The most frequent microorganisms were Pseudomonas aeruginosa, CMV, and Aspergillus fumigates. The incidence of CMV pneumonia decreases with a delayed median time of onset. More than one incidence of bacterial infection and CMV infection are independent risk factors for aspergillus infection. LT recipients are at high risk for TB, and the history of TB is a risk factor for TB relapse.

A green luminescent 1-D helical tubular dipyrazol-bridged cadmium(II) complex: a coordination tube included in a supramolecular tube.

A 1-D helical tubular cadmium coordination polymer, [Cd(H2Me4bpz)(H2bidc)2]n (1, H2Me4bpz = 3,3',5,5'-tetramethyl-4,4'-bipyrazole; H3bidc = benzimidazole-5,6-dicarboxylic acid) was hydrothermally synthesized and characterized by means of elemental analyses, PXRD, IR, 2D IR correlation spectra, solid UV, TG analysis, luminescence spectroscopy and single crystal X-ray diffraction. The crystal structure of 1 is a unique example of a 1D helical tube-in-tube structure. Interestingly, the [Cd(H2Me4bpz)] coordination helical tube is included in the [Cd(H2bidc)] supramolecular helical tube with the same handness. The compound displays a green luminescence upon excitation at 397 nm.

Two novel 2D lanthanide-cadmium heterometal-organic frameworks based on nanosized heart-like Ln6Cd6O12 wheel-clusters exhibiting luminescence sensing to the polarization and concentration of cations.

Two novel 2D Ln-Cd HMOFs [Ln2Cd3(EDTA)3(H2O)11](H2O)14 (Ln = Sm 1; Eu 2; H4EDTA = ethylene diamine tetraacetic acid) based on nanosized heart-like Ln6Cd6O12 wheel-clusters were hydrothermally synthesized and characterized. The luminescence sensing of 2 to the polarization and concentration of cations was discussed.