Potential Impact of SOD2 (rs4880; p.Val16Ala) Variant with the Susceptibility for Childhood Bronchial Asthma.

Oxidative stress is a sophisticated situation that orignates from the accumulation of reactive free radicals within cellular compartments. The antioxidant mechanism of the MnSOD enzyme facilitates the removal of these lethal oxygen species from cellular components. The main goal of this pertained work is to study the contribution of the SOD2 (rs4880; p.Val16Ala) variant to the development of bronchial asthma among children. The study's design was carried out based on a total of 254 participants including 127 asthmatic children (91 atopic and 36 non-atopic) along with 127 unrelated healthy controls. Allelic discrimination analysis was executed using the T-ARMS-PCR protocol. This potential variant conferred a significant association with decreased risk of bronchial asthmatic children under allelic (OR = 0.56, P-value = 0.002), recessive (OR = 0.32, P-value = 0.011), and dominant (OR = 0.51, P-value = 0.040) models. Additionally, atopic and non-atopic asthmatic children indicated a protection against bronchial asthma development under allelic, and dominant models (p-value < 0.05). Our findings suggested that the SOD2*rs4880 variant was correlated with decreased risk of childhood bronchial asthma.

Video of Totally Laparoscopic Modified Esophagogastrostomy Using a Spade Shaped Anastomosis Following Proximal Gastrectomy (SPADE Operation)

Proximal gastrectomy (PG) has been tried as a function-preserving surgery for management of early upper gastric cancer. However, Reflux symptoms and stricture limit its applicability. We designed an anastomosis between the distal part of the posterior esophageal wall and the proximal part of the anterior wall of the stomach to make an anti-reflux mechanism. We named it the SPADE operation owing to its spade-like shape and because it is an acronym for a spade-shaped esophagogastrostomy after PG, which creates a partially duplicated esophagogastric wall. This video illustrates the case of a 74-year-old man diagnosed with early gastric cancer in the high body of the stomach along the greater curvature. We performed a totally laparoscopic proximal gastrectomy and a SPADE operation. He was discharged on the 7th postoperative day with an uneventful postoperative course and resumption of diet without reflux symptoms.

Changes of lung AT1R and Mas receptor protein expression in lung tissue of mice with lung injury after limb ischemia-reperfusion / 中国病理生理杂志

AIM: To explore the role of imbalance of local renin-angiotensin system (RAS) in lung injury by observing the changes of angiotensin Ⅱ type 1 receptor (AT1R) and Mas receptor protein expression in the lung and the degree of lung injury subject to limb ischemia-reperfusion (LIR) in the mice.METHODS: Male ICR mice (n=42, 8 weeks old) were randomly assigned into 7 groups (6 in each group), including control group and 6 model groups with LIR of 0.5 h, 1 h, 2 h, 4 h, 6 h and 12 h reperfusion.Tourniquets were used to block the blood flow of the hind limbs of the ICR mice and were released after 2 h ischemia to initiate reperfusion.The mice were sacrificed by eyeball blood withdrawal at different time points after reperfusion.The organ coefficient and wet/dry weight ratio (W/D) of the lung tissue were calculated.Bronchoalveolar lavage fluid (BALF) was taken for cell counting and protein concentration measurement.The histopathological changes of the lung tissues was observed, and the pathological score was calculated.The protein expression of AT1R and Mas receptor in the lung tissues was determined by Western blot.RESULTS: The organ coefficient, W/D of lung tissue, and cell number and protein concentration in BALF of model groups were significantly higher than those in control group after LIR.The pathological changes were found in the lung tissue of model mice, including alveolar capillary dilation and congestion, edema, inflammatory cell infiltration in peripheral vascular, alveolar and bronchial walls, alveolar septal thickening and inflammatory cell infiltration.The lung injury score was elevated gradually along with the extension of reperfusion time.The protein expression of AT1R began to increase at reperfusion time points of 0.5 h and 1 h.With the extension of reperfusion time, the protein expression of AT1R decreased gradually.Conversely, the protein expression of Mas receptor increased gradually with prolonged reperfusion.CONCLUSION: LIR induces acute lung injury gradually.The imbalance of AT1R and Mas receptor expression may be involved in the damage process.

Diagnostic value of repeated enzyme immunoassays in Clostridium difficile infection.

OBJECTIVES: There has been a significant increase in the prevalence, severity, and mortality of Clostridium difficile infection (CDI), with an estimated three million new cases per year in the United States. Yet diagnosing CDI remains problematic. The most commonly used test is stool enzyme immunoassay (EIA) detecting toxin A and/or B, but there are no clear guidelines specifying the optimal number of tests to be ordered in the diagnostic workup, although multiple tests are frequently ordered. Thus, we designed a study with the primary objective of evaluating the diagnostic utility of repeat second and third tests of stool EIA detecting both toxins A and B (EIA (A&B)) in cases with negative initial samples, and sought to describe the physicians' patterns of ordering this test in the workup of suspected CDI. METHODS: A retrospective study was carried out using a database of all stool EIA (A&B) tests ordered for a presumptive diagnosis of CDI. All patients were adults admitted to a major teaching hospital over a three-and-a-half-year period (tests completed within 5 days of ordering the first test were grouped into a single episode, and only the first three samples per episode were analyzed). Age, gender, and results of stool EIA were tabulated. In addition, physicians' ordering patterns and proportion of positive stools relative to the number of tests ordered were also analyzed. A single positive EIA result was interpreted as evidence for the clinical presence of CDI. RESULTS: A total of 3,712 patients contributed to 5,865 separate diarrhea episodes (total stool EIA (A&B)=9,178), and 1,165 (19.9%) of these episodes were positive for CDI. Of the positive patients, 73.2% were over the age of 65 years and 54.2% of them were females. The most frequent ordering pattern for presumptive CDI was a single stool test (60.1%), followed by two more tests (23.2%). Three tests were still ordered in 16.6% of the cases. Of the 1,165 positive cases, 1,046 (89.8%) were diagnosed in the very first test, 95 (8.2%) in the second, and only 24 (2.0%) in the third test. In 1,934 instances, a second test was ordered after an initial negative result, of which 95 (4.91%) became positive. In 793 episodes, a third test was ordered after two negative samples, of which only 24 (3.03%) became positive. CONCLUSIONS: This study highlights the low diagnostic yield of repeat stool EIA (A&B) testing. Findings strongly support the utility of limiting the workup of suspected CDI to a single stool test with only one repeat test in cases of high clinical suspicion, and avoiding the routine ordering of multiple stool samples. As Clostridium difficile is becoming an endemic health-care problem resulting in major financial burdens for the US health-care system, clear guidelines specifying the optimal number of stool EIA (A&B) tests to be ordered in the diagnostic workup of suspected CDI must be established to assist physicians in the practice of evidence-based medicine.