Cytokine Storm Related to CD4+TCells in Influenza Virus-Associated Acute Necrotizing Encephalopathy

Acute necrotizing encephalopathy (ANE) is a rare but deadly complication with an unclear pathogenesis. We aimed to elucidate the immune characteristics of H1N1 influenza virusassociated ANE (IANE) and provide a potential therapeutic approach for IANE. Seven pediatric cases from a concentrated outbreak of H1N1 influenza were included in this study. The patients’ CD4+T cells from peripheral blood decreased sharply in number but highly expressed Eomesodermin (Eomes), CD69 and PD-1, companied with extremely high levels of IL-6, IL-8 in the cerebrospinal fluid and plasma. Patient 2, who showed high fever and seizures and was admitted to the hospital very early in the disease course, received intravenous tocilizumab and subsequently showed a reduction in temperature and a stable conscious state 24 h later. In conclusion, a proinflammatory cytokine storm associated with activated CD4+T cells may cause severe brain pathology in IANE. Tocilizumab may be helpful in treating IANE.

Surfactin inhibits Fusarium graminearum by accumulating intracellular ROS and inducing apoptosis mechanisms.

Fusarium graminearum, a devastating fungal pathogen, is the main pathogen of Fusarium head blight (FHB) in wheat globally; it results in significant yield loss and mycotoxin contamination that severely threatens global wheat production and food safety. However, despite ongoing efforts, controlling this pathogen still remains a major challenge. Surfactin, primarily synthesized by Bacillus sp. via non-ribosomal peptide synthetases, exhibits potent surfactant and antibacterial properties, but its antifungal mechanism has yet to be fully elucidated. We found that the EC50 of surfactin against hyphal growth of F. graminearum was 102.1 µg/mL, and control efficacy against wheat FHB under field conditions achieved 86.38% in wheat cultivar Huaimai 40 and 81.60% in wheat cultivar Zhoumai 36, indicating that surfactin has potential antifungal activity against F. graminearum. Accumulated intracellular ROS, decreased mitochondrial membrane potential (MMP), activated metacaspase activity and condensed chromatin, were induced by surfactin in F. graminearum hyphae, suggesting that growth inhibition of fungus is mainly caused by apoptosis-like cell death. Furthermore, accumulated intracellular ROS was evidenced to act as a key mediator of surfactin-induced apoptosis. Broad-spectrum caspase inhibitor Z-VAD-FMK treatment indicated that surfactin induces caspase-independent apoptosis in F. graminearum. Collectively, this study provides evidence that surfactin induces a ROS-mediated mitochondrial apoptosis in F. graminearum hyphae, and may exert its antifungal activity against F. graminearum by activating apoptosis. This study demonstrates the potential of surfactin as an antifungal agent for FHB biocontrol, provides a new perspective on the antifungal mechanism of surfactin against filamentous fungi, and contributes to the application of surfactin-producing microbes in the biocontrol of plant diseases.

Electroacupuncture at acupoints of yangming meridians for sarcopenia: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of electroacupuncture at acupoints of yangming meridians for sarcopenia.@*METHODS@#A total of 60 patients with sarcopenia were randomized into an observation group and a control group, 30 cases in each group. In the control group, conventional nutrition intervention for sarcopenia was adopted. In the observation group, on the basis of the treatment in the control group, acupuncture was applied at bilateral Binao (LI 14), Quchi (LI 11), Zusanli (ST 36), Yanglingquan (GB 34), etc.,ipsilateral Quchi (LI 11) and Zusanli (ST 36) were connected to electroacupuncture, with discontinuous wave, 2 Hz in frequency, 1-10 mA in intensity, 2 times a week, with a interval of 3 days. A total of 12-week treatment was required in the two groups. Before and after treatment, the appendicular skeletal muscle mass index (ASMI), grip strength, 6 m-walking time, body fat percentage and body moisture percentage were observed in the two groups.@*RESULTS@#Compared with those before treatment, after treatment, ASMI and grip strength were increased while 6 m-walking time was shortened in the two groups (P<0.05); body fat percentage was decreased while body moisture percentage was increased in the observation group (P<0.05). After treatment, in the observation group, ASMI, grip strength and body moisture percentage were increased (P<0.05), 6 m-walking time was shortened and body fat percentage was decreased (P<0.05) compared with those in the control group.@*CONCLUSION@#Electroacupuncture at acupoints of yangming meridians can effectively improve the skeletal muscle mass, muscle function, body fat percentage and body moisture percentage in patients with sarcopenia, and make the distribution of muscle and fat more reasonable.

Association between PPP2CA expression and colorectal cancer prognosis tumor marker prognostic study.

BACKGROUND: Colorectal cancer (CRC) is one of the most common cancers worldwide. The aim of this study is to identify candidate genes by bioinformatics and investigate its clinical pathological characters and prognostic significance. METHOD: First, we identify differentially expressed genes (DEGs) in CRC by analyzing gene expression datasets from Gene Expression Omnibus (GEO). Then we performed a bioinformatics analysis by using Oncomine, STRING and Oncolnc databases. Gene Set Enrichment Analysis (GSEA) was performed using TCGA data set. Then, the protein expression level of PPP2CA was detected by immunohistochemistry in 196 pairs of primary colorectal cancer and corresponding non-tumor tissues. RESULT: Total 81 differential expressed genes were identified in the overlap of datasets. PPI network show the hub genes were CCND1, PPP2CA and YAP1. We investigated Oncomine databases and found that PPP2CA mRNA expression was lower in CRC tissues compared with normal tissues. Bioinformatics analysis indicated that PPP2CA expression was associated with epithelial-mesenchymal transition signaling pathway. Low expression of PPP2CA was associated with T stage, N stage, and M stage. Low expression of PPP2CA was associated with worse overall survival for CRC, and retained significance as an independent prognostic factor for CRC. CONCLUSION: PPP2CA may act as an oncogene in the progression of colorectal cancer. Moreover, PPP2CA has potential to be used as prognostic markers or therapeutic targets in CRC.

Bioinformatic analysis of differentially expressed genes involved in the hepatitis B virus-associated acute liver failure.

BACKGROUND: The rarity of acute liver failure, along with its severity and heterogeneity, has resulted in a very limited evidence to understand of the molecular mechanism. To analyze the differentially expressed genes (DEGs) in the Hepatitis B Virus -Associated Acute Liver Failure and elucidate the biological significance of the DEGs. METHODS: Firstly, differentially expressed genes (DEGs) between seventeen HBV-associated acute liver failure liver samples and ten control normal liver samples were identified by R package. Then, the enriched GO terms and KEGG pathways of those DEGs were obtained using the Database for Annotation, Visualization and Integrated Discovery (DAVID). Finally, protein-protein interactions (PPI) network of those DEGs were constructed using STRING database and visualized by Cytoscape software. RESULTS: A total of 328 DEGs were identified in Hepatitis B Virus-Associated Acute Liver Failure group compared with the control group. Several novel biomarkers that might play important roles in HBV-associated acute liver failure were identified through the analysis of gene microarray in GEO. Furthermore, DEGs with high connectivity degrees, such as KNG1, PLG, F2 and pathways such as complement and coagulation cascades were noticed. CONCLUSION: DEGs with high connectivity degrees, such as KNG1, PLG and their relative pathway complement and coagulation cascades may be important for further understanding of the molecular mechanism of HBV-associated acute liver failure.

Intraperitoneal ropivacaine instillation versus no intraperitoneal ropivacaine instillation for laparoscopic cholecystectomy: A systematic review and meta-analysis.

BACKGROUND: Pain is one of the important reasons for delayed discharge and Enhanced Recovery After Surgery (ERAS) after laparoscopic cholecystectomy. To assess the benefits and disadvantage of intraperitoneal instillation of ropivacaine in people undergoing laparoscopic cholecystectomy. METHODS: We searched the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Science Citation Index Expanded to December 2016 to identify randomised clinical trials of relevance to this review. We analysed the data with Review Manager 5 analysis. MAIN RESULTS: We identified 12 suitable studies. A total of 853 participants were randomised to intraperitoneal ropivacaine instillation (442 participants) versus "no intraperitoneal ropivacaine instillation" (411 participants). The pain scores as measured by the visual analogue scale (VAS) were significantly lower in the ropivacaine instillation group than the control group at 4-8 h (10 trials; 751 participants; MD -0.64 cm; 95% CI -0.86 to -0.43; p < 0.00001) and at 9-24 h (9 trials; 582 participants; MD -0.47 cm; 95% CI -0.66 to -0.28; p < 0.00001).The proportion of people who developed the adverse events were less in the ropivacaine instillation group than the control group(RR 0.60; 95% CI 0.45 to 0.79; p = 0.0002). There was no significant difference in the Post-anesthesia care unit (PACU) stay time between the two groups (3 trials; 197 participants; MD -3.77 min; 95% CI -10.24 to 2.69). The overall quality of evidence was very low. Further trials are necessary.

Control effects of different optical correction methods on adolescent myopia / 眼科新进展

Objective To compare the changes of diopter and axial length(AL) m 2 years after wearing orthokeratology lens,rigid gas permeable contact lens (RGPCL) and spectacles in adolescent myopia,and evaluate the control effects of different methods on adolescent myopia.Methods Prospective clinical study.The date of 99 eyes of 50 adolescent myopia cases wearing orthokeratology,95 eyes of 48 adolescent myopia cases wearing RGPCL,and 100 eyes of 50 adolescent myopia cases wearing full correction single vision spectacles were collected from June 2012 to June 2014.The follow-up time was 2 years.The status of diopter and AL before and wore mirror after 2 years and the uncorrected visual acuity (UCVA) in group of orthokeratology were recorded.The examinations were repeated after 2 years without wearing orthokeratology and RGPCL at least 30 days.Results There was no statistical difference in age,refractive status and AL among three groups before wearing the mirror.After wearing for 2 years,AL and spherical equivalent in three groups were increased (F =278.43,140.12;all P ＜ 0.01).The increase of AL and SE was as follows:orthokeratology group (0.30 ± 0.39) mm,(0.83 ±0.97) D;RGPCL group (0.55 ± 0.41) mm,(1.55 ± 0.63) D;spectacles group (0.59 ± 0.34)mm,(1.73 ± 0.62)D.The increase of orthokeratology group was the least,and there was no statistical difference between the other two groups.UCVA was significantly improved at each time point after wearing orthokeratology(F =486.38,P ＜0.01).Conclusion In the three optical correction methods of orthokeratology,RGP and spectacles,the ortho-keratology is the best on controlling adolescent myopia,and no difference between the other two.At the same time,wearing orthokeratology can also significantly improve UCVA in myooia cases.

Risk factors of anterior ischemic optic neuropathy after phacoemulsification / 眼科新进展

Objective To select the risk factors and focus on the pathogenesis of anterior ischemic optic neuropathy (AION) after cataract surgery.Methods A retrospective review of all patients with phacoemulsification surgery referred to the Ophthalmology Divisions,the First Affiliated Hospital,Zhengzhou University,from September 1,2010 to September 1,2016 was performed.Eligible patients were 11 206 cases(13 320 eyes),30 cases (30 eyes) were complicated with AION after cataract surgery (AION group),and 90 cases (90 eyes) were selected as control group according to the ratio of 1 ∶ 3 by random sequence.Factors of small cup disc ratios,previous surgery history,cardiac disease,diabetes,hypertension,hyperlipemia,smoking,carotid disease and intraocular pressure (IOP) were collected,x2 test,Logistic regression and t test were performed to analyze risk factors for AION.Results Small cup-disc ratios,diabetes,hypertension,hyperlipemia,carotid disease were influencing factors of AION after cataract surgery.Hyperlipemia and carotid disease were risk factors of AION after cataract surgery.There was no significant difference in preoperative intraocular pressure between two groups(all P ＞ 0.05).The intraocular pressure at postoperative 1 day and 7 days in AION group were higher than those in control group (all P ＜ 0.05).Conclusion Hyperlipemia and carotid artery disease are risk factors for AION after cataract surgery,and high intraocular pressure may be the inductive factor of AION.

Clinical characteristics of congenital cataract in 476 children / 眼科新进展

Objective To analyze the operative methods,intraocular lens (IOL) implantation and postoperative complications in children with congenital cataract,and give the references for treating of congenital cataract.Methods From January 2008 to January 2016,children under the age of 13 years with congenital cataract were enrolled.Preoperative and posterior slit lamp microscope,fundus,intraocular pressure were examined.Children under 2 years old were treated with phacoemulsification (PHACO),posterior continuous curvilinear capsulorrhexis (PCCC),anterior-vitrectomy (AV),and ＞ 2-4 years old with PHACO + PCCC + AV + IOL implantation,＞ 4-7 years old children with PHACO + PCCC + IOL implantation,children ＞ 7 years with PHACO + IOL implantation.Results A total of 476 patients (740 eyes) were enrolled in the study,the average age were (33.59 ± 37.14) months,of which 0 ～ 6 months were 166 cases (282 eyes,38.11％).260 eyes were implanted with IOL,aged (5.59 ±2.43) years,480eyes were implanted in the second surgery,aged (4.06 ± 2.12) years.Refaction diopter (equivalent spherical) after IOL implantation in children aged ＞ 2-4 years old was (3.53 ± 0.56) D,＞ 4-6 years old was (2.36 ± 0.32) D,＞ 6-8 years old was (1.65 ±0.52)D,＞8-13 years old was (-0.25 ±0.32) D.The postoperative complications occurred in 326 eyes,of which 115 eyes (35.28％) with iridotic adhesions,97 eyes (29.75％) with posterior cataract on the visual axis,and 54 eyes (16.56％) with glaucoma.At the last follow-up,the best corrected visual acuity were (0.56 ± 0.41) LogMAR for monocular cataract surgery and (0.42 ± 0.27) LogMAR for binocular cataract surgery,the difference was statistically significant (P =0.04).Conclusion One-third of children with congenital cataract are treated with surgical treatment under 6 months old,about half of the children undergo IOL implantation at 2 ～ 3 years of age.The postoperative visual acuity in children with binocular cataract is better than children with monocular cataract.The complications in children are more complicated than adults,which should be paid more attention.

Abdominal drainage versus no abdominal drainage for laparoscopic cholecystectomy: A systematic review with meta-analysis and trial sequential analysis.

The aim is to assess the benefits and harms of routine abdominal drainage in laparoscopic cholecystectomy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until August 2016. We included all randomised clinical trials comparing drainage versus no drainage after laparoscopic cholecystectomy irrespective of language and publication status. We used standard methodological procedures in accordance with the PRISMA guidelines. A total of 2398 participants were randomised to drain (1197 participants) versus 'no drain' (1201 participants) in 16 trials included in this article. Pain 24 h after surgery was less severe in the no drain group (MD1.31; 95% CI, 0.96 to 1.65; p < 0.00001). Abdominal drainage prolonged operative time (MD 5.77 min; 95% CI 4.98 min-6.57 min; p < 0.00001) but not the length of hospital stay (MD 0.21 days; 95% CI -0.00 days to 0.42 days; p = 0.05). No significant difference was present with respect to the intra-abdominal fluid, wound infection, nausea or vomit, mortality after operation. There is no significant advantage of drain placement after laparoscopic cholecystectomy. Further well designed randomized clinical trials should be carefully re-considered.