Evaluation of right heart function changes in patients with pulmonary hypertension via two-dimensional speckle tracking imaging: a retrospective study.

Objective: To realize the changes in pulmonary hypertension (PH) patients' right ventricular function.Methods: A total number of 74 patients with PH were included, and the parameters of standard echocardiographic were measured as well as the strain of peak longitudinal of each segment during the systole of the right ventricle to calculate the global longitudinal strain (LS) during systole of the right ventricular free wall.Results: ① As pulmonary arterial pressure increased, the right ventricular area gradually increased, and the case group showed the decreased right ventricular fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), and tricuspid annular peak systolic velocity (S') (p < 0.05). They, RVFAC, and TAPSE depicted significant differences that were statistical (p < 0.05) from the other groups. ② With increasing pulmonary arterial pressure, the right ventricular free wall's LS gradually reduced (p < 0.05).Conclusion: ① LS right ventricular free wall is useful in detecting changes in right ventricular systolic function early on with greater sensitivity than RVFAC, TAPSE, and S'. In addition, increased right ventricular pressure loading can result in a subsequent impairment of right ventricular myocardial mechanics. ② As right ventricular pressure loading increases, right ventricular strain decreases. ③ In mild PH, the right ventricular free wall's. LS is more sensitive than standard measures in spotting early alterations in myocardial mechanics.

Radiomics model based on contrast-enhanced computed tomography to predict early recurrence in patients with hepatocellular carcinoma after radical resection.

BACKGROUND: Radical resection remains an effective strategy for patients with hepatocellular carcinoma (HCC). Unfortunately, the postoperative early recurrence (recurrence within 2 years) rate is still high. AIM: To develop a radiomics model based on preoperative contrast-enhanced computed tomography (CECT) to evaluate early recurrence in HCC patients with a single tumour. METHODS: We enrolled a total of 402 HCC patients from two centres who were diagnosed with a single tumour and underwent radical resection. First, the features from the portal venous and arterial phases of CECT were extracted based on the region of interest, and the early recurrence-related radiomics features were selected via the least absolute shrinkage and selection operator proportional hazards model (LASSO Cox) to determine radiomics scores for each patient. Then, the clinicopathologic data were combined to develop a model to predict early recurrence by Cox regression. Finally, we evaluated the prediction performance of this model by multiple methods. RESULTS: A total of 1915 radiomics features were extracted from CECT images, and 31 of them were used to determine the radiomics scores, which showed a significant difference between the early recurrence and nonearly recurrence groups. Univariate and multivariate Cox regression analyses showed that radiomics scores and serum alpha-fetoprotein were independent indicators, and they were used to develop a combined model to predict early recurrence. The area under the receiver operating characteristic curve values for the training and validation cohorts were 0.77 and 0.74, respectively, while the C-indices were 0.712 and 0.674, respectively. The calibration curves and decision curve analysis showed satisfactory accuracy and clinical utilities. Kaplan-Meier curves based on recurrence-free survival and overall survival showed significant differences. CONCLUSION: The preoperative radiomics model was shown to be effective for predicting early recurrence among HCC patients with a single tumour.

miR-126-5p Targets SP1 to Inhibit the Progression of Parkinson's Disease.

BACKGROUND: At present, symptomatic treatment may improve the life quality of Parkinson's disease (PD) patients to a certain extent but cannot completely cure PD. Therefore, it is urgent medical problem to be solved for improving the efficacy and safety of PD treatment. METHODS: SH-SY5Y and SK-N-SH cells were treated with 1-methyl-4-phenylpyridinium (MPP+) to establish PD model cells. miR-126-5p and specific protein-1 (SP1) expression levels were detected by quantitative Real-Time PCR (qRT-PCR). Western blot was applied to measure protein levels of SP1, Bax, and Bcl-2. The viabilities and apoptosis rates of treated cells were measured using cell counting kit-8 assay and flow cytometry analysis. Enzyme-linked immunosorbent assay was performed to measure TNF-α and IL-1ß releases. Interaction between miR-126-5p and SP1 was examined by dual-luciferase reporter assay. RESULTS: MPP+ treatment greatly downregulated miR-126-5p expression while upregulated SP1 expression in SH-SY5Y and SK-N-SH cells in a time- and does-dependent manner. Overexpression of miR-126-5p facilitated cell viability, while reduced cell apoptosis and inflammatory responses induced by MPP+ treatment. Moreover, SP1 was a target of miR-126-5p and could be negatively regulated by miR-126-5p. Overexpression of SP1 could reverse the effects of miR-126-5p on MPP+-administrated cells. CONCLUSION: Our results suggested that miR-126-5p attenuated the neurotoxicity induced by MPP+ in vitro through targeting SP1 (Graphical abstract), which further enhanced our understanding of the pathological mechanism of PD.

Use of PD-1 inhibitor tislelizumab in the treatment of advanced pulmonary sarcomatoid carcinoma: A case report.

Pulmonary sarcomatoid carcinoma (PSC), characterized by poor differentiation, aggressive progression, and early metastasis, is a rare type of non-small cell lung carcinoma (NSCLC), which shows a low response rate to conventional antitumor therapies and has a poor prognosis. With the achievements in gene sequencing, targeted therapy, and immunotherapy, several new approaches have recently been explored in PSC treatment. A small case series of PSC patients were found to have programmed death-ligand 1 (PD-L1) overexpression, a prerequisite for PD-1 inhibiting therapy, which made immunotherapy possible. However, anti-PD-1 treatment for PSCs was still at a preliminary stage. Here, we report the successful outcome of tislelizumab monotherapy in a patient with advanced PSC with pleural invasion, thus providing a novel promising approach for PSC patients with PD-L1 overexpression.

Genus-Wide Comparative Genomics Analysis of Neisseria to Identify New Genes Associated with Pathogenicity and Niche Adaptation of Neisseria Pathogens.

N. gonorrhoeae and N. meningitidis, the only two human pathogens of Neisseria, are closely related species. But the niches they survived in and their pathogenic characteristics are distinctly different. However, the genetic basis of these differences has not yet been fully elucidated. In this study, comparative genomics analysis was performed based on 15 N. gonorrhoeae, 75 N. meningitidis, and 7 nonpathogenic Neisseria genomes. Core-pangenome analysis found 1111 conserved gene families among them, and each of these species groups had opening pangenome. We found that 452, 78, and 319 gene families were unique in N. gonorrhoeae, N. meningitidis, and both of them, respectively. Those unique gene families were regarded as candidates that related to their pathogenicity and niche adaptation. The relationships among them have been partly verified by functional annotation analysis. But at least one-third genes for each gene set have not found the certain functional information. Simple sequence repeat (SSR), the basis of gene phase variation, was found abundant in the membrane or related genes of each unique gene set, which may facilitate their adaptation to variable host environments. Protein-protein interaction (PPI) analysis found at least five distinct PPI clusters in N. gonorrhoeae and four in N. meningitides, and 167 and 52 proteins with unknown function were contained within them, respectively.

Dual enzyme-assisted one-step isothermal real-time amplification assay for ultrasensitive detection of polynucleotide kinase activity.

A novel, simple, one-step and one-tube detection method was developed for ultrasensitive detection of polynucleotide kinase (PNK) activity on the basis of dual enzyme-synergistic signal amplification. This method was also demonstrated to work well for PNK inhibitor screening and endogenous PNK detection in cell lysates at a single-cell level.

[Research in technical regulations for production of pollution-free Chinese herbal medicines].

Aimed to solve the issues of pesticide residue, heavy metal contents and harmful elements in the productive process of Chinese herbal medicines, the research team built the technical regulations for production of pollution-free Chinese herbal medicines. This regulation included the environment of production area, the process of production, quality of products etc., which were the key steps controlled the quality of Chinese herbal medicines. The environment of production area was selected according to the ecological factors which were stipulated by Ecological Suitability Regionalization of Chinese herbal medicines (second edition). The quality of air should be attain the one or two levels of GB/T3095-2012 standard values. The cultivation soils should reach to the one or two levels of GB15618 and NY/T391 standard values. The quality of irrigation water should accord with the stipulation of GB5084-2005. Aimed to the production of Chinese herbal medicines, disease-resistant and superior varieties which were suitable to the local stations should be selected, and the breeding of superior seeds and seedlings should be strengthened. Additionally, rational fertilizer application of pollution-free Chinese herbal medicines should be conformed to the principles, requirements, and the kinds of fertilizers allowed or limited for use, which were stipulated by the standard of DB13/T454. Furthermore, the plant protection policy of priority to prevention and synthetical prevention should be followed; improving ecological environment and strengthening cultivation management should be served as the basics. Agricultural measures, and biological and physical control strategies should be preferred to use; and high toxicity, residue pesticide and its mixture should be inhibited; the use of chemical pesticides should be minimized and then to decrease contamination and residue. Additionally, the quality of products should be reached to the standard of pollution-free Chinese herbal medicines; high toxicity and detection rate of pesticide residues and the contents of heavy metal and harmful elements (e.g. plumbum, cadmium, mercury, arsenic and cuprum) should accord with the common criteria of pollution-free Chinese herbal medicines. Application of technical regulations for production of pollution-free Chinese herbal medicines guarantees significantly social, economic and ecological benefits.

[Effects of elevated O3 on leaf litter decomposition and nutrient release of Quercus mongolica in city].

The leaf litters of 10-year-old Quercus mongolica were put in nylon bags and exposed to elevated 03 level (120 nmol . mol-1) with the control of 40 nmol . mol-1 in open top chambers (OTCs) for 150 days to test the effect of high O3 on the litter decomposition. The results showed that no significant difference was observed in residual mass between elevated O3 treatment and the control. Elevated 03 inhibited the release of C and K during the decomposition, the residual rate of K under elevated O3 treatment (23.9%) was significantly higher than that of the control (17.1%) after 150-day decomposition. Compared with the control, N mineralization and lignin degradation in elevated O3 treatment were inhibited during early period of decomposition (0-60 d), but were promoted in later period (90-150 d). The changes of lignin/N showed no significant difference between elevated O3 treatment and the control during the decomposition. Elevated O3 generally promoted the release of P in leaf litter of Q. mongolica during the decomposition. C/P ratio was higher under elevated 03 than that under control. Significant positive correlation was shown between residual dry mass of leaf litters and the residual rate of C, N, K, C/N ratio during decomposition. Elevated 03 might play an important role in the nutrient cycle of forest ecosystem in high-O3 pollution area.

[Effects of different tillage methods on photosynthetic characteristics, dry matter production and economic benefit of double cropping soybean].

In order to explore suitable mode of high yield cultivation of double cropping soybean after wheat under drip irrigation in northern Xinjiang, field trials were set in 2013-2014 to investigate physiological indices and agronomic traits of double cropping soybean under different tillage methods under drip irrigation. The results showed that leaf area index (LAI), chlorophyll content (SPAD), leaf net photosynthetic rate (Pn), transpiration rate (Tr) and stomatal conductance (g(s)) during the determination period under different tillage methods were in the order of tillage plus film covering (TP)> tillage (T)> rotary tillage (RT) > no-tillage (NT) , and the concentration of intercellular CO2(Ci) was the opposite. LAI, SPAD, Pn, Tr, and g(s) of TP were higher than that with NT by 55.0%, 9.1%, 41.8%, 37.5% and 56.4%, respectively, and Ci was decreased by 22.1%. TP enhanced the photosynthetic efficiency of soybean and improved the ability of CO2assimilation, consequently leading to the increase of soybean yield under TP compared to NT. The plant dry matter accumulation of TP treatment was improved greatly, with the pod number and seeds number per plant, 100-seed mass and yield of quadric sowing soybean being increased by 50.3%, 48.1%, 11.8% and 20.8% compared with that under NT, and the differences were significant. Therefore, the plastic film mulching combined with tillage under drip irrigation technology was suitable for double cropping soybean after wheat in northern Xinjiang under this experimental condition.

[Response of cotton seeding date to climate warming in Northern Slope Economic Zone of Tianshan Mountain, China].

Based on the meteorological date acquired from 11 meteorological stations in Northern Slope Economic Zone of Tianshan Mountain during 1971-2010 and by using the methods of linear regression, t-test technique and IDW interpolation, this paper analyzed the spatial distribution of each ten-day average temperature from late March to late April and beginning date of ≥ 12 °C to understand the effect of climate change on the cotton seeding date. Results showed that each ten-day average temperature from late March to late April increased by 0. 8, 0. 5, 0. 1 and 0. 5 °C . (10 a)-1, but the beginning date of ≥12 °C advanced by 0.5 d . (10 a)-1 during 1971-2010. All meteorological elements in this research ascended abruptly in the 1990s. The abrupt climate change made each ten-day average temperature increasing by 2.5, 1.9, 1.1 and 1.5 °C, to 7.2, 10.0, 13.2 and 15.6 °C, respectively from late March to late April. The high values of each ten-day average temperature from late March to late April expanded the scope of main cotton producing areas in Northern Slope Economic Zone of Tianshan Mountain, such as Wusu, Sawan and Manasi, and the low values were observed in Urmuqi. The spatial distribution of the beginning day of ≥12 °C was significant different in different regions. During this study period, the early beginning dates of ≥ 12 °C expanded the scope of Jinghe and Manasi as cotton producing areas, and the late beginning dates of ≥ 12 °C narrowed to areas around Urumqi. With the advance of the beginning day of ≥ 12 °C, the seeding date of cotton could start from 22nd to 28th April in most of the counties, and mulch cover could bring forward the suitable sowing date to 15th through 21st April.

Identification of Gene Biomarkers for Distinguishing Small-Cell Lung Cancer from Non-Small-Cell Lung Cancer Using a Network-Based Approach.

Lung cancer consists of two main subtypes: small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC) that are classified according to their physiological phenotypes. In this study, we have developed a network-based approach to identify molecular biomarkers that can distinguish SCLC from NSCLC. By identifying positive and negative coexpression gene pairs in normal lung tissues, SCLC, or NSCLC samples and using functional association information from the STRING network, we first construct a lung cancer-specific gene association network. From the network, we obtain gene modules in which genes are highly functionally associated with each other and are either positively or negatively coexpressed in the three conditions. Then, we identify gene modules that not only are differentially expressed between cancer and normal samples, but also show distinctive expression patterns between SCLC and NSCLC. Finally, we select genes inside those modules with discriminating coexpression patterns between the two lung cancer subtypes and predict them as candidate biomarkers that are of diagnostic use.

[The diagnostic value of medical thoracoscopy for unexplained pleural effusion].

OBJECTIVE: To explore the endoscopic features of patients with unexplained pleural effusion, and to evaluate the diagnostic value of medical thoracoscopy. METHODS: A retrospective analysis of 2380 patients with unexplained pleural effusion (1320 males and 1060 females; age 15-94 years) in Shandong Provincial Hospital from 1992 to 2011 were performed .The diagnosis was confirmed by medical thoracoscopy. RESULTS: The endoscopic findings of malignant pleural effusion mostly showed nodules of varying sizes. The nodules could be grape-like, cauliflower-like, fused into masses, or diffused small nodules . The appearance of cancerous nodules was more diversified compared to tuberculous nodules. Tuberculous pleurisy was manifested as diffuse pleural congestion and miliary changes, multiple small gray-white nodules, fibrin deposition and adhesion in the pleural cavity, pleural thickening and loculation . The pathological diagnosis was as follows: pleural metastases in 899 (37.8%), primary pleural mesothelioma in 439 (18.4%), tuberculous pleurisy in 514 (21.6%), non-specific inflammation in 226 (9.5%), empyema in 190 (8.0%), hepatic pleural effusion in 36 (1.5%) and pleural effusion of unknown causes in 76 (3.2%) cases. The diagnostic positive rate of medical thoracoscopy was 96.8%. No serious complications were observed. CONCLUSION: Medical thoracoscopy is a relatively safe procedure and has an important application value in the diagnosis of unexplained pleural effusion.

Expression of Yes-associated protein in non-small cell lung cancer and its relationship with clinical pathological factors.

BACKGROUND: Yes-associated protein (YAP) plays an important role in signal transduction and gene transcription regulation in normal cells, with elevated and over-expressed YAP levels observed in various malignant tumors. The aim of this study was to investigate the expression of YAP in non-small cell lung cancer (NSCLC), and to study the possible relationship of YAP expression with the occurrence and development of NSCLC. METHODS: YAP expression was assessed in 40 cases of NSCLC tumor tissues by immunohistochemistry, and their protein and mRNA levels were evaluated through Western blotting and reverse transcription-polymerase chain reaction (PCR), respectively. Normal lung tissues obtained from the same patient were used as control. Statistical analysis was performed to correlate the YAP expression to clinical pathological factors, such as tumor type, stage and grade. RESULTS: YAP-positive expression was found in 28 (70%) of the 40 cases of NSCLC, which included 10 cases of squamous cell carcinoma (25%), 17 cases of adenocarcinoma (42.5%) and 1 case of squamous adenocarcinoma (2.5%). In the 28 YAP-positive cases, 19 cases showed lymph node metastasis and were classified in TNM stage II + III (47.5%); the other nine cases showed no lymph node metastasis (22.5%) and were classified in the TNM stage I. There was no relationship between YAP expression and patients' age, gender or tumor histological grades. However, YAP showed significant over expression in late period of T stage (P = 0.012), TNM stage (P = 0.039), and lymph node metastasis (P = 0.013), respectively. Notably, YAP-positive expression was significantly higher in adenocarcinoma than that in squamous cell carcinoma (P = 0.041). CONCLUSIONS: Over-expression of YAP was associated with NSCLC, especially lung adenocarcinoma. The high YAP expression in late period of tumor stage and lymph node metastasis may indicate that YAP expression could be an early marker for NSCLC tumorigenesis.

Secretion and action of insulin among Han and Uygur subjects with impaired fasting glucose and impaired glucose tolerance,from Xinjiang / 中华流行病学杂志

Objective To compare insulin secretion and action with impaired fasting glucosc (IFG),impaircd glucose tolerance (IGT) and combined glucose intolerance (CGI,IFG and IGT) between Han and Uygur populations living in Xinjiang.Methods A multicenter cross-section survey (The Third Diabetes Epidemiological Survey in China) was conductcd in Xinjiang from 2007 to 2008 including 2203 subjects (Han 1118,Uygur 1085) underwent an oral glucosc test (OGTT).Homeostasis model assessment on insulin resistance (HOMA-IR) and β cell function (HOMA-β)were calculated.The ratio of incrcmcntal insulin(Δ130 ) and glucose (ΔG30)response was used to evaluate the early insulin secretion.ΔI30/ΔG30/HOMA-IR was used to evaluate the glucosc disposition index (DI).Results There were differences noticed regarding the waist circumstances (WC),body mass index (BMI),lipids,0 and 120 min insulin lcvcls in different glucose tolerance status between the Hans and Uygurs.Data related to NGT,IFG,CGI,WC from the Uygurs was significantly diffcrcnt from that of the Hans (P＜0.01),while the NGT,IFG,IGT and 120-minute plasna insulin levels of the Hans were significantly different from that of the Uygurs (P＜0.01).HOMA-IR and HOMA-β in Hans were significantly different from those of the Uygurs (P＜0.01).There were significant differences noticed on data reoated to Δ130/ΔG30,and DI among the two populations with different ethnicities.Conclusion Regarding the regulation of impaired glucose,the insulin resistance among the Hans was significantly different from that of the Uygurs,while there seemed to be a compensatory secretion of pancreatic β cells which played the role of maintaining blood glucose homeostasis.

[Prevalence of asymptomatic intracranial artery stenosis in middle-aged and elderly population in the community of Foshan city, Guangdong province: a cross-sectional study].

OBJECTIVE: To investigate the prevalence and risk factors of asymptomatic intracranial artery stenosis in middle-aged and elderly population in the community of Foshan city, Guangdong province. METHODS: Subjects from residential communities were chosen through Cluster sampling method. Physical data and history were collected. Serum fasting glucose, total cholesterol and triglycerides concentrations were tested with venous blood samples. Intracranial artery stenosis was diagnosed by transcranial Doppler (TCD). Data was analyzed by the software SPSS 18.0. RESULTS: 1405 subjects met the inclusive criteria, among which 163 (11.6%) were found one (7.4%) or more (4.2%) stenotic arteries, and the standardized rate was 10.3%. 9.89% of the SICA, and 3.05%, 2.29%, 1.59%, 1.38%, 0.89% of basilar artery, middle cerebral artery, anterior cerebral artery, vertebral artery, posterior cerebral artery were found stenotic respectively. Data from the age-stratified analysis showed that the prevalence in these above 70 (27.8%) was significantly higher than that under age 70 (7.5%) (P = 0.000). Single factor and logistic regression analysis demonstrated the history of diabetes mellitus and elevated systolic pressure present were significantly different between stenotic group and the non-stenotic group (P = 0.000, P = 0.000), which were the independent risk factors of asymptomatic stenosis of intracranial arteries (OR = 2.362, 95%CI: 1.194 - 4.674;OR = 1.024, 95%CI: 1.016 - 1.031). CONCLUSION: Comparatively high prevalence of asymptomatic intracranial artery stenosis in middle-aged and aged community population was found in the Southern part of China, especially among the age group above 70. History of diabetes and elevated systolic pressure seemed to be the independent risk factors of asymptomatic stenosis of intracranial arteries.

Mutation of thyroid peroxidase gene in 35 patients with congenital hypothyroidism / 中华儿科杂志

<p><b>OBJECTIVE</b>To identify thyroid peroxidase (TPO) gene mutations in 35 patients with congenital hypothyroidism.</p><p><b>METHOD</b>Genomic DNA was isolated from peripheral blood samples of 35 patients with congenital hypothyroidism. All of the 17 exons and flanking introns of TPO gene were amplified by PCR, then the PCR products were sequenced bi-directionally and were analyzed by restriction endonucleases.</p><p><b>RESULT</b>One patient had compound heterozygous mutations c.961A>G/c.2422delT, one was c.2268insT/c.1477G>A, and three was homozygous mutation c.2268insT. The TPO gene mutation c.961A>G [p. Thr321Ala] was one novel mutation.</p><p><b>CONCLUSION</b>High frequency mutation in TPO gene was detected in patients with congenital hypothyroidism.</p>

[Role of abdominal obesity in asymptomatic intracranial arterial stenosis: a community-based study].

OBJECTIVE: To investigate the relationship between abdominal obesity and intracranial artery stenosis and the underlying mechanism. METHODS: By cluster sampling, 1405 adult Han people were selected from the residential communities. Among them, 1035 people conformed to the inclusion criteria. Medical history was documented and body height, body weight, waist circumference, hip circumference and blood pressure were measured. Venous blood samples were collected to detect the serum concentrations of fasting glucose, total cholesterol and triglycerides. Serum nitric oxide (NO) level was determined by cadmium reduction method. Middle cerebral artery stenosis (MCAS) was diagnosed by transcranial Doppler. The SPSS 11.0 software package was used for data analysis. RESULTS: MCA stenosis was found in 66 subjects (6.4%). Univariate analysis showed history of hypertension, history of ischemic heart disease, systolic blood pressure and diastolic blood pressure were the risk factors for MCAS and waist-to-hip ratio (WHR) was a risk factor only in males. Logistic regression demonstrated history of hypertension was an independent risk factor for MCAS both in males and females (P = 0.011, P = 0.009) and WHR for MCAS only in males (P = 0.030). Among males and females over 55 years old, the NO levels were higher in people with a higher WHR and the difference was statistically significant (P = 0.042, P = 0.016); however the NO levels for people with a varying WHR showed statistically insignificant difference among females under 55 years old (P = 0.228). CONCLUSION: Hypertension and abdominal obesity are important risk factors for MCAS. Endothelial cell dysfunction and an elevated level of oxidative stress may be involved in the atherogenetic mechanism of abdominal obesity while estrogen may play a protective role in it.

Patient with pontine warning syndrome and bilateral posterior internuclear ophthalmoplegia: case report.

BACKGROUND: Capsular warning syndrome was first described in 1993, featured with repetitive episodes of motor and/or sensory dysfunction without cortical signs. Recently, it has been demonstrated that clinically typical capsular warning syndrome can be associated with pontine infarct and the term oepontine warning syndrome was coined. CASE PRESENTATION: A 54-year-old woman with a history of hypertension was seen with profound left-sided hemiplegia. She had had 3 episodes of left-sided weakness before complete hemiplegia. Her speech was slurred. Left central facial palsy and hemiglossoplegia were presented. Her left plantar response was extensor and bilateral posterior internuclear ophthalmoplegia was seen on neurologic examination. Biochemical tests revealed hyperglycemia and dyslipidemia on the next day. MRI demonstrated an acute right paramedian pontine infarct. The patient was commenced on oral clopidogrel, atorvastatin and acarbose. After 23 days of hospitalization, she was discharged with severe left hemiplegia. CONCLUSIONS: 1) Pontine warning syndrome may be underestimated and understudied. 2) Posterior internuclear ophthalmoplegia is a rare clinical sign in cerebrovascular diseases, while it can help to locate a brainstem lesion rather than an internal capsular one. 3) Blood pressure lowering administration may be improper for patients with pontine warning syndrome.

Identification of six type III effector genes with the PIP box in Xanthomonas campestris pv. campestris and five of them contribute individually to full pathogenicity.

Xanthomonas campestris pv. campestris is the pathogen of black rot of cruciferous plants. The pathogenicity of the pathogen depends on the type III secretion system (T3SS) that translocates directly effector proteins into plant cells, where they play important roles in the molecular interaction between the pathogen and its hosts. The T3SS of Xanthomonas spp. is encoded by a cluster of hypersensitive response and pathogenicity (hrp) genes. It has been demonstrated that the expression of hrp genes and some type III secreted (T3S)-effector genes is coactivated by the key hrp regulatory protein HrpX. The regulation by HrpX can be mediated by the binding of HrpX protein to a cis-regulatory element named the plant-inducible promoter (PIP) box present in the promoter region of HrpX-regulated genes. A genome screen revealed that X. campestris pv. campestris 8004 possesses 56 predicted genes with the PIP box. Nine of these genes have been shown to encode T3S effectors, Hrp, and Hrp-associated proteins. In this study, we employed an established T3S effector translocation assay with the hypersensitive-reaction-inducing domain of X. campestris pv. campestris AvrBs1 as a reporter to characterize the remaining 47 genes with the PIP box and showed that 6 of them, designated as XopXccE1, XopXccP, XopXccQ, XopXccR1, XopXccLR, and AvrXccB, harbor a functional translocation signal in their N-terminal regions, indicating that they are T3S effectors of X. campestris pv. campestris. We provided evidence to demonstrate that all these effectors are expressed in an HrpX-dependent manner and their translocation into plant cells relies on the translocon protein HrpF and the chaperone HpaB. Mutational analyses demonstrated that all these effectors, except AvrXccB, are individually required for full virulence and growth of X. campestris pv. campestris in the host plant Chinese radish.