Effects of Three Different Heating Devices on Patients Undergoing Surgery: A Network Meta-Analysis.

PURPOSE: Perioperative hypothermia is a common anesthesia-related complication that can result in negative outcomes. Intraoperative active heating can positively impact these outcomes. Therefore this study aimed to investigate the effectiveness of three common heating devices for controlling hypothermia, improving thermal comfort, and reducing anesthesia recovery time. DESIGN: Systematic review and meta-analysis. METHODS: Seven electronic literature databases were searched from the inception date of the databases to March 18, 2022. RevMan 5.4 and Stata 15.1 were used to perform meta-analyses on the obtained data, and the Cochrane Evaluation Manual was used for quality risk assessment of the included studies. FINDINGS: A total of 18 studies involving 1,511 patients undergoing surgery using heating devices were included. In this meta-analysis, a ranking method known as the Surface Under the Cumulative Ranking Curve (SUCRA) was used. SUCRA provides a numerical measure of the effectiveness of treatments, with higher values indicating superior efficacy. Findings demonstrated that the concurrent use of three heating devices led to an elevation in core body temperatures (SUCRA = 69.2%) and enhanced delayed recovery (SUCRA = 88.6%) as compared to the application of a single device. Furthermore, for thermal comfort, the employment of heating blankets proved to be the most effective (SUCRA = 87.8%). CONCLUSIONS: This study showed the core body temperatures and reductions in delayed recovery were greater when three heating devices were used together as compared to use one of them alone. Heating blankets was the most effective option for improving the thermal comfort of patients. Thus, clinicians should opt for appropriate heating equipment according to the type of surgery and the characteristics and needs of patients. The choice of appropriate heating equipment will ensure surgical safety, improve patient comfort, and reduce surgical risks.

[Current status and challenges of immunotherapy for multiple myeloma].

Multiple myeloma (MM) is the second most common hematologic malignancy and the incidence of MM in mainland China in 2016 was 1.15/100 000.With the development of China's aging society, the incidence of MM is expected to increase year by year. Immunotherapy for MM has become the fourth pillar of therapy after autologous hematopoietic stem cell transplantation, immunomodulators, and proteasome inhibitors, and is the most active area of MM treatment. Nine new drugs have been approved for multiple myeloma treatment in China, and three are expected to be approved in 2024, which will focus on immunotherapy. There are many ambiguities about the current status of research and utilization in this emerging field in China. Determining the optimal integration of these therapies into the treatment regimen for Chinese MM patients constitutes a critical challenge for clinicians. Immunotherapy for MM primarily encompasses two major categories: antibody-based drug therapy and cellular immunotherapy. Antibody-based medications primarily include monoclonal antibodies, T-cell engagers, IgG-like bispecific antibodies, and trispecific antibodies. Cellular immunotherapy mainly consists of chimeric antigen receptor T (CAR-T) cells, as well as other immune cells such as chimeric antigen receptor natural killer (CAR-NK) cells, dendritic cells, T cell receptor-engineered T cells, and peptide vaccines.This article mainly focuses on the current research status and existing issues of the aforementioned immunotherapy methods, with the aim of providing references for the treatment of MM.

[The interpretation of the updated American Urological Association guideline of interstitial cystitis/bladder pain syndrome in 2022].

In 2022, American Urological Association updated the guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS). A significant change has been made in treatment recommendations. The updated guideline no longer divided treatments into first-line through sixth-line tiers. Instead, treatment is categorized into behavioral/non-pharmacologic, oral medicines, bladder instillations, procedures, and major surgery. This change emphasizes the heterogeneity of IC/BPS patients and the importance of individualized treatment, overturns traditional unreasonable ideas about hierarchical and progressive treatment, and encourages patients and physicians to make treatment decisions together. At the same time, the panel emphasized the importance of early implementation of cystoscopy in patients suspected of Hunner lesions and warned against the possibility of pentosan polysulfate causing a unique retinal pigmentary maculopathy. Urinary reconstruction surgery was considered to only be used as a last resort for the treatment of IC/BPS, and there is uncertainty about the overall balance between benefits and risks/burdens. The updated guideline provides a new understanding and decision-making basis for the diagnosis and treatment of IC/BPS. However, it should be noted that the clinical characteristics of Chinese patients should be considered in practice and the application of the guideline should be localized.

[A single-center retrospective analysis of 100 consecutive cases treated with lenalidomide/bortezomib/dexamethasone in newly diagnosed multiple myeloma].

Objective: To investigate the efficacy and safety of lenalidomide combined with bortezomib and dexamethasone (RVD) in patients with newly diagnosed multiple myeloma (NDMM). Methods: A total of 100 consecutive NDMM patients treated with RVD from August 2016 to September 2020 at Peking University People's Hospital were retrospectively analyzed, including response, drug toxicity, follow-up and survival, and subgroup analysis. Results: The median follow-up time was 19.5 (2.0-57.0) months. For patients undergoing autologous stem cell transplantation (ASCT) after RVD regimen, the objective response rate (ORR)/complete response+stringent complete response (CR+sCR)/≥very good partial response (VGPR) rates were 100%, 73.3% (33/45), 95.6% (43/45) respectively. For 54 patients not receiving transplantation, the ORR/CR+sCR/≥VGPR rates were 79.6% (43/54), 18.5% (10/54), 51.9% (28/54) respectively. As to the survival analysis, 2-year progression free survival (PFS) rates were 84.5% and 70.9% in transplant and non-transplant patients respectively (P=0.102). Two-year overall survival (OS) rates were 100% and 80.8% in transplant and non-transplant patients respectively (P=0.003). The common hematologic adverse events (AEs) were thrombocytopenia (33%) and neutropenia (25%). Abnormal liver function (43%) and peripheral neuropathy (24%) were recognized more as non-hematologic AEs. Conclusion: RVD as front-line regimen has high efficient response rate and acceptable safety in Chinese NDMM patients.

[Statistical methods for relative risk estimation and applications in case-cohort study].

Objective: To systematically introduce the design of case-cohort study and the statistical methods of relative risk estimation and their application in the design. Methods: First, we introduced the basic principles of case-cohort study design. Secondly, Prentice's method, Self-Prentice method and Barlow method were described in the weighted Cox proportional hazard regression models in detail, finally, the data from the Shanghai Women's Health Study were used as an example to analyze the association between obesity and liver cancer incidence in the full cohort and case-cohort sample, and the results of parameters from each method were compared. Results: Significant association was observed between obesity and risk for liver cancer incidence in women in both the full cohort and the case-cohort sample. In the Cox proportional hazard regression model, the partial regression coefficients of the full cohort and the case-cohort sample fluctuated with the adjustment of confounding factors, but the hazard ratio estimates of them were close. There was a difference in the standard error of the partial regression coefficient between the full cohort and the case-cohort sample. The standard error of the partial regression coefficient of the case-cohort sample was larger than that of the full cohort, resulting in a wider 95% confidence interval of the relative risk. In the weighted Cox proportional hazard regression model, the standard error of the partial regression coefficient of Prentice's method was closer to the parameter estimates from full cohort than Self-Prentice method and Barlow method, and the 95% confidence interval of hazard ratio was closer to that of the full cohort. Conclusions: Case-cohort design could yield parameter results closer to the full cohort by collecting and analyzing data from sub-cohort members and patients with the disease, and reduce sample size and improve research efficiency. The results suggested that Prentice's method would be preferred in case-cohort design.

Bone marrow mesenchymal stem cell-derived exosomal MiR-338-3p represses progression of hepatocellular carcinoma by targeting ETS1.

The present study aims to explore the function of human bone marrow mesenchymal stem cell (BMSC)-derived exosomal micro ribonucleic acid (miR)-338-3p in hepatocellular carcinoma (HCC) and further investigate its effect on HCC cell functions. Firstly, BMSCs were co-cultured with HCC cells, and BMSC-derived exosomes were identified. Next, Transwell assay and methyl thiazolyl tetrazolium (MTT) experiments were carried out to detect the effects of miR-338-3p and E26 transformation specific-1 (ETS1) on the viability, invasion, migration, and apoptosis of HCC cells through the exosomes derived from BMSCs. Furthermore, the targeting relationship between miR-338-3p and EST1 was verified via bioinformatics study and dual-luciferase reporter gene analysis. Additionally, Western blotting (WB) was carried out to measure the expression levels of EST1 and other proteins in HCC cells. It was found that BMSCs inhibited HCC cell proliferation, invasion and migration, and induced cell apoptosis, while the inhibitors of exosomes played the opposite roles. In addition, the up-regulation of exosomal miR-338-3p or the silencing of EST1 restrained HCC cell proliferation, invasion and migration, and induced cell apoptosis. In conclusion, BMSC-derived exosomal miR-338-3p delays the development of HCC by down-regulating EST1, providing a new promising treatment target for HCC.

[Analysis of the short-term results of pre fenestration and external branched thoracic endovascular aortic repair for aortic lesions].

Objective: To evaluate the short-term effect of left subclavian artery (LSA) reconstruction with pre fenestration and external branch thoracic endovascular aortic repair (TEVAR) in the treatment of aortic arch descending lesions. Methods: The clinical data of 79 patients with aortic diseases who received LSA reconstruction in Tianjin Medical University General Hospital from November 2015 to October 2019 were analyzed retrospectively. According to different LSA reconstruction methods, they were divided into the fenestrated group (group f) 50 cases and the external branched group (group b) 29 cases. The surgical success rate, intraoperative and postoperative complication rate, re-intervention rate, mortality rate, and the change of the true and false lumen area of the dissection were compared and analyzed. Results: There were no significant differences in the perioperative and recent total complication rate, secondary intervention rate and mortality between the two groups (χ²=0, 1.246, 0.156, all P>0.05). The operation time of group f [(123.0±40.7 min)] was significantly longer than that of group b ((84.2±16.3) min, t=2.173, P=0.034). The degree of false lumen thrombosis of the stent segment was better than that of the non-stent segment (χ²=7.213, 14.359, both P<0.05) in the two groups after surgery, but no significant difference between the two groups (χ²=1.510, 0.886, both P>0.05). There was no significant difference in the change rate of the true and false lumen on each plane of the dissection between the two groups (all P>0.05). Conclusions: Both fenestrated and external branched TEVAR reconstruction LSA have good safety and effectiveness in treating aortic arch descending lesions. The external branched TEVAR takes less time, has higher effectiveness for lesions with shorter landing zone, and has better aortic remodeling effect in the stent segment soon; and the fenestrated TEVAR has better economy.

Functions of a C-type lectin with a single carbohydrate-recognition domain in the innate immunity and movement of the red flour beetle, Tribolium castaneum.

C-type lectins (CTLs) are a superfamily of proteins found in almost all vertebrates and invertebrates. They play an important role in innate immune defences, development and epidermal structure. Here, a CTL with one carbohydrate-recognition domain containing a highly conserved Gln-Pro-Asp (QPD) motif was identified in Tribolium castaneum and given the name TcCTL5. Spatiotemporal analyses showed that Tcctl5 was highly expressed in the late pupa stage and mainly existed in the central nervous system and haemolymph. The transcript level of Tcctl5 was prominently induced after bacterial infection. Recombinant TcCTL5 proteins (rTcCTL5) were found to bind to lipopolysaccharide, peptidoglycan and tested bacteria and induce microbial agglutination in the presence of Ca2+ . Interestingly, when Tcctl5 was knocked down, the transcript level of antimicrobial peptides (AMPs) (attacin1, defensins3, coleoptericin1 and cecropins3) was prominently downregulated after induction with Gram-negative Escherichia coli. More interestingly, Tcctl5 was knocked down, leading to increased mortality and loss of locomotor activity, which exhibited less travel distances among early adults. These results demonstrate that Tcctl5 plays an important role in the innate immune reaction and the movement of T. castaneum. Thus, it may represent an alternative molecular target for pest control and thus reduce the use of pesticides in agricultural production.

[Progress in diagnosis and treatment of rectal neuroendocrine neoplasms].

Neuroendocrine neoplasms (NENs) are relatively rare heterogeneous tumors that originate from peptidergic neurons and neuroendocrine cells and have been referred to as "carcinoids" in the past. Although this type of tumor had been previously considered to be indolent tumor with a low degree of malignancy, with the development of medicine and clinical study, researchers found that NENs had the potential to metastasize. They can occur in any part of the body where neuroendocrine cells are distributed and gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) are the most common type of NENs.Due to the improvement of techniques such as endoscopy and imaging, the incidence of rectal neuroendocrine tumors(R-NENs) and the number of related clinical researches have both increased significantly in recent years. Although researches in Chinese and foreign medical centers are mostly retrospective studies of small samples and the efficacies of different treatment methods are still under debating and lack of sufficient medical evidence to support, the diagnosis and treatment of this disease is gradually becoming standardized according to the proposal of corresponding guidelines. The recent advances in the epidemiology, diagnosis and treatment of rectal neuroendocrine neoplasms are reviewed in this paper.

Cell migration and osteo/odontogenesis stimulation of iRoot FS as a potential apical barrier material in apexification.

AIM: To investigate the in vitro biological effects of a nanoparticle bioceramic material, iRoot Fast Set root repair material (iRoot FS), on the proliferation, migration and osteo/odontogenic differentiation of human stem cells from the apical papilla (hSCAP), and to further explore the mechanism involved in osteo/odontogenic induction of iRoot FS. METHODOLOGY: hSCAP were isolated and characterized in vitro. iRoot FS conditioned medium were prepared and used to treat hSCAP, while using mineral trioxide aggregate (MTA) conditioned medium as the positive control and regular medium as the negative control. MTT assay and BrdU labelling assay were performed to determine cell proliferation. Wound healing assay and transwell assay were conducted to evaluate cell migration. The osteo/odontogenic differentiation of hSCAP was evaluated by qPCR, Western blot and Alizarin red S staining. Wnt inhibitor was used for downregulating the expression level of ß-catenin of hSCAP. RESULTS: The cell proliferation of hSACP in the iRoot FS group was not significantly different compared with the control groups. The cell migration of hSCAP in the iRoot FS group was significantly increased than the MTA and negative control groups (P < 0.01). The expression levels of osteo/odontogenic markers and mineralization nodule formation of hSCAP in the iRoot FS group were significantly elevated (P < 0.01). Furthermore, iRoot FS enhanced the osteo/odontogenic differentiation of hSCAP by activating Wnt/ß-catenin signalling. CONCLUSIONS: iRoot FS promoted the cell migration of hSCAP and enhanced their oseto/odontogenesis potential via the Wnt/ß-catenin pathway without cytotoxicity. iRoot FS had satisfactory biological properties and has potential to be used as an apical barrier in apexification or as a coronal sealing material in regenerative endodontic treatment.

[Correlation research between imaging performance and pulmonary function of pneumoconiosis patients at stage three].

Objective: To study the imaging performance and pulmonary function of pneumoconiosis patients at stage three. Methods: 89 cases of pneumoconiosis patients at stage three for high thousand volt back chest, chest CT, pulmonary function, analysis the relationship of high thousand volt back chest, chest CT manifestations and pulmonary function. Results: In patients with chest X-ray progressive massive fibrosis range of 2.31-102.95 cm(2), divide patients according to the X-ray performance into three groups, the difference of each group pulmonary function index FVC、FEV(1)、PEF、MEF(75%)、MEF(50%)、MEF(25%)、MVV is statistically significant (P<0.01) , the difference of FEV(1)/FVC%、RV/TLC、DLCO is no statistical significance (P>0.05) . Checked by related, in pneumoconiosis patients at stage three, the X-ray manifestations and pulmonary function index FVC、FEV(1)、FEV(1)/FVC%、PEF、MEF(75%)、MEF(50%)、MEF(25%)、MVV、DLCO showed a negative correlation (r=-0.326, -0.438, -0.251, -0.344, -0.317, -0.337, -0.425, -0.347, -0.230) . With the deterioration of the X-ray imaging findings, pulmonary function index FVC、FEV(1)、FEV(1)/FVC%、PEF、MEF(75%)、MEF(50%)、MEF(25%)、MVV、DLCO is a trend of decrease (P<0.05) . The X-ray changes is not associated with RV/TLC. By linear regression analysis, FVC、FEV(1)、FEV(1)/FVC%、PEF、MEF(75%)、MEF(50%)、MEF(25%)、MVV、DLCO regression equation are meaningful. The RV/TLC regression equations is meaningless. The volume of the patients with chest CT progressive massive fibrosis range of 4.86~179.74 cm(3), divide patients according to the chest CT performance into three groups, the difference of each group pulmonary function index FVC、FEV(1)、PEF、MEF(75%)、MEF(50%)、MEF(25%)、MVV、RV/TLC is statistically (P<0.05) , the difference of FEV(1)/FVC%、DLCO is no statistical significance (P>0.05) . Checked by related, in pneumoconiosis patients at stage three, chest CT manifestations and pulmonary function index FVC、FEV(1)、FEV(1)/FVC%、PEF、MEF(75%)、MEF(50%)、MEF(25%)、MVV showed a negative correlation (r=-0.360, -0.419, -0.256, -0.432, -0.366, -0.326, -0.254, -0.405, ) , It is not associated with the RV/TLC、DLCO. With the deterioration of the chest CT imaging findings, pulmonary function index FVC、FEV(1)、FEV(1)/FVC%、PEF、MEF(75%)、MEF(50%)、MEF(25%)、MVV is a trend of decrease (P<0.05) . By linear regression analysis, FVC、FEV(1)、FEV(1)/FVC%、PEF、MEF(75%)、MEF(50%)、MEF(25%)、MVV regression equations are meaningful. The RV/TLC、DLCO regression equations are meaningless. Conclusion: It is correlated with chest X-ray, chest CT manifestations and pulmonary function in pneumoconiosis patients at stage three, that could help guide clinicians comprehensive evaluation in patients with pulmonary function status.

Protective effects of melatonin on mitochondrial biogenesis and mitochondrial structure and function in the HEK293-APPswe cell model of Alzheimer's disease.

OBJECTIVE: The effects and mechanisms of melatonin on Alzheimer's disease (AD) are still not researched thoroughly. 20E2 cells (HEK293-APPswe cells) are a cellular model of AD. The modulation effects of melatonin on the structure and function of mitochondria in 20E2 cells need to be studied. MATERIALS AND METHODS: The Alzheimer's disease (AD) cell model was assessed for cell viability, expression levels of mitochondrial biogenesis factors (peroxisome proliferator-activated receptor gamma coactivator 1-alpha [PGC-1α], nuclear respiratory factor 1 [NRF1], nuclear respiratory factor 2 [NRF2], mitochondrial transcription factor A [TFAM]), mitochondrial membrane potential, Na+-K+-adenosine triphosphatase (ATPase) and cytochrome C oxidase activity, adenosine triphosphate (ATP) level, mitochondrial DNA/nuclear DNA (mtDNA/nDNA) ratio, and mitochondrial structure with and without melatonin. RESULTS: Melatonin improved 20E2 cell viability, expression of mitochondrial biogenesis factors (PGC-1α, NRF1, NRF2, TFAM), mitochondrial membrane potential, Na+-K+-ATPase, and cytochrome C oxidase activity, ATP level, mtDNA/nDNA ratio, mitochondrial structure, and decreased amyloidogenic amyloid precursor protein processing. CONCLUSIONS: Mitochondrial biogenesis disorder is associated with the pathogenesis of AD through PGC-1α-NRF-TFAM pathway, and melatonin improves the mitochondrial structure and function by enhancing mitochondrial biogenesis and decreasing amyloidogenic APP processing in Alzheimer's disease.

Gut microbiota and obesity-associated osteoarthritis.

Obesity is a well-known primary risk factor for osteoarthritis (OA). In recent decades, the biomechanics-based theoretical paradigm for the pathogenesis of obesity-associated OA has been gradually but fundamentally modified. This modification is a result of accumulating evidence that biological factors also contribute to the etiology of the disease. The gut microbiota is a complicated ecosystem that profoundly influences the health of the host and can be modulated by the combined effects of environmental stimuli and genetic factors. Recently, enteric dysbacteriosis has been identified as a causal factor in the initiation and propagation of obesity-associated OA in animal models. Gut microbes and their components, microbe-associated lipid metabolites, and OA interact at both systemic and local levels through mechanisms that involve interplay with the innate immune system. However, the demonstration of causality in humans will require further studies. Nonetheless, probiotics, prebiotics, dietary habits and exercise, which aid the restoration of a healthy microbial community, are potential therapeutic approaches in the treatment of obesity-associated OA.

[Rapid screening questionnaire based on clinical symptoms of patientswith benign paroxysmal positional vertigo].

Objective:To fomulate a rapid screening questionnaire for benign paroxysmal positional vertigo (BPPV) according to the symptoms of patients with BPPV. Method:A total of 276 patients with dizziness participated in this study, and 219 cases were included in the questionnaire validity evaluation except for 48 patients who participated in the revision of the questionnaire and 9 patients with inconsistent diagnosis. Subjects were divided into BPPV group and non-BPPV group according to the diagnostic criteria. ①All patients completed questionnaires based on positional dizziness, and the differences between the two groups were compared. ②Reliability test adopted test-retest reliability and Cronbach's α coefficient; content validity adopted expert judgment method, and structural validity adopted factor analysis. Result:①Reliability test: test-retest reliability was 0.945, Cronbach's α coefficient was 0.649. Validity test: KMO value was 0.720. Two factors were used with a characteristic root of higher than 0.9. The total cumulative contribution rate was 61.2%. ②Results of the questionnaire: The patients who developed dizziness when getting up/down or turning over in bed, accounted for 78(94.0%) in the BPPV group and 57(41.9%) in the non-BPPV group, with a statistical difference (P<0.01). In the cases of vertigo, there were 82 cases (98.8%) in the BPPV group and 96 cases (70.6%) in the non-BPPV group, with a statistical difference (P<0.01). There were 65 cases (78.3%) in the BPPV group and 53 cases (39.0%) in the non-BPPV group with dizziness/vertigo attack time less than 1 minute, with a statistical difference (P<0.01). Patients who had hearing loss or tinnitus during the dizziness episode accounted for 8(9.6%) in the BPPV group and 31 (22.8%) in the non-BPPV group, with a statistically difference (P<0.05). The patients with consciousness during dizziness episode were in 79 patients (95.2%) in the BPPV group and 128 patients (94.1%) in the non-BPPV group, with no statistical difference (P>0.05). Conclusion:This questionnaire has clinical applicability and can be used for rapid differential screening of BPPV in patients with dizziness.

[An analysis of biochemical markers of bone metabolism in patients with idiopathic benign paroxysmal positional vertigo].

Objective:To analyze the biochemical markers of bone metabolism in patients with idiopathic benign paroxysmal positional vertigo（iBPPV）. Method:The study included 38 patients with iBPPV. Thirty-two healthy persons were collected as control group. Routine history collection, physical examination, and diagnosis were recorded in case group. Both the case group and control group were assessed for the status of bone biochemical markers. Result:①Among the 38 patients with iBPPV, posterior semicircular canal BPPV in right ear（R-PC-BPPV）presented in 23 cases , left ear（L-PC-BPPV）in 9 cases, horizontal semicircular canal BPPV in right ear in 2 cases, and in left ear in 2 cases, horizontal semicircular canal cupulolithiasis in 2 cases. ②The value of osteocalcin(OC), 25 hydroxyvitamin D3ï¼»25(OH)D3ï¼½, amino terminal propeptide of type I procollagen (PINP) in case group were lower than the normal reference value, and also significantly lower than that in the control group,OC: t=-2.013, P=0.048; 25(OH)D3: t=-2.133，P=0.037; PINP: t=-2.615,P=0.011. There was no significant difference of ß-isomerized carboxy-terminal telopeptide of type I collagen (ß-CTx) between the case group and control group. ③The value of OC(t=-2.187，P=0.035), 25(OH)D3(t=-2.190，P=0.035) and PINP(t=-2.322，P=0.026) in patients lower than 50 years old were significantly lower than that in the control group. The difference of these biochemical markers between the case and control group was not significant when subjects were ≥50 years old. Conclusion:The biochemical markers of bone metabolism in patients with iBPPV are declined, especially in patients lower than 50 years old. There may be abnormal bone metabolism in iBPPV patients.

A C-type lectin with a single carbohydrate-recognition domain involved in the innate immune response of Tribolium castaneum.

C-type lectins are one of the pattern-recognition proteins involved in innate immunity in invertebrates. Although there are 16 C-type lectin genes that have been identified in the genome of Tribolium castaneum, their functions and mechanisms in innate immunity remain unknown. Here, we identified one C-type lectin orthologue, TcCTL6 (TC003708), by sequencing random clones from the cDNA library of the coleopteran beetle, T. castaneum. TcCTL6 contains a 654 bp open reading frame encoding a protein of 217 amino acids that includes a single carbohydrate-recognition domain. The expression of TcCTL6 was significantly induced by Escherichia coli, Staphylococcus aureus and stimulation with carbohydrates, including lipopolysaccharide and peptidoglycan. A binding assay suggested that the recombinant TcCTL6 not only bound to lipopolysaccharide and peptidoglycan but also bound to Gram-positive (S. aureus, Bacillus subtilis and Bacillus thuringiensis) and Gram-negative bacteria (E. coli and Pseudomonas aeruginosa) in the presence of calcium ions. Furthermore, when TcCTL6 was knocked down by RNA interference, four antimicrobial peptides (attacin1, attacin2, coleoptericin1 and coleoptericin2) were significantly decreased. These results demonstrate that TcCTL6 plays a vital role in the immune response towards pathogen infection by influencing the expression of antimicrobial peptides and the agglutination of bacteria in the presence of calcium ions in T. castaneum.

[A multicenter clinical study on 1 138 cases of invasive pneumococcal disease in children from 2012 to 2017].

Objective: To explore the clinical features, the serotype distribution and drug resistance of the isolates in patient with invasive pneumococcal disease (IPD). Methods: By retrieving the laboratory information system in 18 children's hospitals from 2012 to 2017, the children with IPD were enrolled. Streptococcus pneumoniae (Spn) must be isolated from the sterile sites (blood, cerebrospinal fluid, hydrothorax and joint effusion etc.). The clinical characteristics, serotype, drug resistance, treatment and prognosis were reviewed and analyzed. According to the telephone follow up results, the patients were divided into death group and recovered group. The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis. Results: There were 1 138 children with IPD, including 684 male and 454 female. The proportion of male to female was 1.5∶1. The age ranged from one day to 16 years. The median age was 1 year 3 month. The majority was under 5 years of age (89.3%, n= 1 016), especially under 2 years of age (61.9%, n=704). In all cases, 88.2% (n=1 004) were community acquired infection. The infections included meningitis (n=446, 39.2%), pneumonia with bacteremia (n=339, 29.8%), and bacteremia without focus (n=232, 20.4%). Underlying diseases were found in 242 cases (21.3%). Co-infections were determined in 62 cases (5.4%) with mycoplasma, 27 cases (2.4%) with adenovirus and 34 cases with influenza virus (3.0%). The penicillin insensitivity (PNSP) rates in meningitis and non-meningitis isolates were 69.5% (276/397) and 35.9% (221/615), respectively. There were 81 strains serotyped, in which 93.8% (76/81) were covered by 13-valent protein-polysaccharide conjugate vaccine (PCV13). In the 965 patients who were followed up by phone call, 156 cases (16.2%) were confirmed dead. The independent risk factors for the death were under 2 years of age (OR=2.143, 95%CI 1.284-3.577, P=0.004), meningitis (OR=3.066, 95%CI 1.852-5.074, P<0.01), underlying disease (OR=4.801, 95%CI 2.953-7.804, P<0.01), septic shock(OR=3.542, 95%CI 1.829-6.859, P<0.01), disseminated intravascular coagulation (DIC) (OR=4.150, 95%CI 1.468-11.733, P=0.007), multiple organ failure (OR=12.693, 95%CI 6.623-24.325, P<0.01) and complications of central nervous system (OR=1.975, 95%CI 1.144-3.410, P=0.015). Conclusions: Most children with IPD were under 5 years of age, having underlying diseases and acquired the infection in community. The independent risk factors for death were under two years old, meningitis, underlying diseases and multiple organ failure. The problem of drug resistance was severe. The universal immunization of PCV13 would be effective to prevent IPD in Chinese children.

Detection and Analysis of 12 Suspected Amelogenin Allelic Loss Cases.

OBJECTIVES: To observe and analyse the Amelogenin allelic loss in parent-child identification cases, and to explore the type and mechanism of Amelogenin allelic loss as well as its influence on gender identification and solutions. METHODS: After the detection by SiFaSTR™ 23plex DNA identification system, samples had the characteristics of the peak area of Amelogenin X was the same as the one of adjacent heterozygote or lower than one half of adjacent homozygote in females while Amelogenin X loss was observed in males were selected. X chromosome STR （X-STR） typing and Amelogenin X sequencing were performed. The samples with Amelogenin Y loss in males were confirmed by the detection of Y chromosome STR typing and sex-determining region of Y （SRY）. The type and rate of Amelogenin allelic loss were confirmed and calculated, and the mechanism and influence of this variation were also analysed. RESULTS: Amelogenin X allelic loss was observed in one male sample, the mutation in primer-binding region was confirmed by sequencing. The suspected Amelogenin X allelic loss was observed in four female samples, but the mutation in primer-binding region was confirmed by sequencing in only one sample. Amelogenin Y allelic loss was observed in seven male samples, SRY positive cases was detected in five of them, and two were SRY negative. Y-STR type was detected in four cases of the five SRY positive cases, which was not detected in the two SRY negative cases. The rate of Amelogenin allelic loss was about 0.029%. CONCLUSIONS: Amelogenin X allelic loss does not affect the gender identification, but Amelogenin Y allelic loss may cause wrong gender identification. Thus, Y-STR or SRY should be detected for gender confirmation. When Y-STR genotypes are not detected in a "male" whose SRY detection is also negative, then the chromosome karyotype analysis and sex differentiation related genes test should be taken to further confirm the gender.