Clinical analysis of relapsing polychondritis with airway involvement.

OBJECTIVE: To identify the clinical characteristics, treatment, and prognosis of relapsing polychondritis patients with airway involvement. METHODS: Twenty-eight patients with relapsing polychondritis, hospitalised in the First Hospital of Shanxi Medical University between April 2011 and April 2021, were retrospectively analysed. RESULTS: Fifty per cent of relapsing polychondritis patients with airway involvement had a lower risk of ear and ocular involvement. Relapsing polychondritis patients with airway involvement had a longer time-to-diagnosis (p < 0.001), a poorer outcome following glucocorticoid combined with immunosuppressant treatment (p = 0.004), and a higher recurrence rate than those without airway involvement (p = 0.004). The rates of positive findings on chest computed tomography and bronchoscopy in relapsing polychondritis patients with airway involvement were 88.9 per cent and 85.7 per cent, respectively. Laryngoscopy analysis showed that 66.7 per cent of relapsing polychondritis patients had varying degrees of mucosal lesions. CONCLUSION: For relapsing polychondritis patients with airway involvement, drug treatment should be combined with local airway management.

[The clinical effect and imaging features of accordion maneuver in promoting bone healing at the docking site after tibial transport under ultrasonic monitoring].

Objective: To explore the imaging features and clinical effect of accordion maneuver in promoting the bone healing at the docking site after tibial transport under ultrasonic monitoring. Methods: Retrospective analysis was conducted on the clinical data of 16 patients with tibial bone transport who were admitted to the Department of Orthopedics, the second Hospital of Shanxi Medical University from May 2018 to October 2019. All the patients were treated with accordion maneuver to promote bone healing at the docking site under ultrasound monitoring. There were 14 males and 2 females, aged (45.3±14.3) years (range: 6 to 61 years). Before tibial bone transport, the length of the tibial defect of 16 patients was (6.0±2.6) cm (range: 2.0 to 12.1 cm). The operation steps of accordion maneuver were as follows: pressurization for 2 weeks, suspension for 12 days, distraction for 2 weeks, retraction for 2 weeks, and then stop the operation to consolidate the bone mineralization. During accordion treatment, ultrasound was used to monitor the size of hematoma, Adler grade of blood flow signal and the changes of new callus in and around the docking site. X-ray was performed to monitor bone healing at the docking site. Pearson correlation coefficient was used to analyze the correlation between the size of hematoma, the resistance index of blood flow signal and the bone healing time of the docking site. Paley healing criterion was used to evaluate the bone healing and functional recovery of the patients. Results: During accordion maneuver, ultrasound examination showed that the Adler grade of blood flow signals around the docking site increased gradually before retraction and then decreased gradually, but the degree of callus mineralization continued to increase gradually. After 2 weeks of pressure on the docking site, hematoma was observed in 14 patients by ultrasound examination. X-ray showed that all docking sites had bony healing, with the healing time of (30.8±4.9) weeks (range: 23 to 40 weeks).The size of the hematoma was negatively correlated with the healing time of the docking site (r=-0.819,P<0.01). No hematoma was found in 2 patients, and after continuous observation for 20 weeks, there was still no obvious callus connection at the docking site. After bone cortical removal, ultrasound examination showed hematoma formed at the docking site. Accordion maneuver was continued, and the docking site healed at 30 and 32 weeks after surgery, respectively. There was a negative linear correlation between hematoma size at 2 weeks of compression and the blood flow resistance index at 2 weeks of retraction in 16 patients (r=-0.801, P<0.01). The patients were followed-up for (14.5±3.2) months (range: 10.6 to 20.2 months). At the last follow-up, 12 patients were evaluated as excellent and 4 were evaluated as good by Paley healing criteria. Conclusion: The distraction and compression stress applied in accordion maneuver can promote bone healing at the docking site, and ultrasound can monitor early signs of bone healing at the docking site to help determine the tendency of bone healing.

[Advances in the research of protective effect of curcumin on intestinal mucosal barrier function].

As a natural extract from turmeric, curcumin has extensive pharmacological effects, such as anti-tumor, anti-inflammation, anti-oxidative stress, anti-microbial, immunoregulation and so on. In recent years, an increasing number of basic and clinical researches have shown that curcumin takes therapeutic effects on various diseases, such as gastrointestinal diseases, cardiovascular diseases, autoimmune diseases, neuropsychiatric diseases and so on. Many of the pharmacological effects and mechanisms of curcumin are associated with protective effects of intestinal mucosal barrier. It can protect intestinal mucosal barrier through mutiple pathways, including anti-inflammation, anti-oxidative stress, anti-bacterial, anti-apoptosis, regulating intestinal microecology and intestinal immune response and so on. This paper summarizes the protective effects of curcumin on intestinal barrier function and the mechanism, in order to provide new ideas for diagnosis and treatment of intestinal dysfunction.

[Advances in exosomes derived from the mesenchymal stem cells in the treatment of sepsis].

Exosomes derived from mesenchymal stem cells (MSCs) are small membrane vesicles with diameters in 30-150 nm, which are secreted into extracellular matrix by MSCs in resting or activated state. Recent studies have found that exosomes secreted by MSCs can be used as important signal transduction mediator, which can transport bioactive substances such as mRNA, microRNA, and proteins effectively to target cells, and play important roles in regulating tissue regeneration and immunomodulation. Here we give an overview of biological properties, mechanisms, and the roles in treating sepsis of exosome derived from MSCs, in order to provide some basises to highlight the MSCs-exosomes therapy in sepsis.

[Analysis of electrocardiogram and blood related indicators in workers occupationally exposed to mercury in Jiangsu Province from 2016 to 2018].

Objective: To investigate the health status of occupational mercury workers and reveal the effects of mercury exposure on the cardiovascular system. Methods: In June 2019, a total of 2651 mercury workers participated in the occupational health examination between 2016-2018 from a thermometer manufacturing plant and a fluorescent lamp manufacturing plant were included in this study. Then, they were divided into a high-level mercury exposure group (425 workers whose urine mercury concentration >35 µg/g creatinine) and a low-mercury mercury exposure group (2226 workers whose urinary mercury concentration <35 µg/g creatinine) . Mercury concentration in the workplace was also detected. Finally, the results of electrocardiogram (ECG) , blood routine, blood biochemistry and other physical examinations were analyzed. The measurement data of age and exposure years were analyzed by test. Urinary mercury and blood parameters were analyzed by Mann-Whitney nonparametric test. Chi-square test was used for the analyses of gender, ECG abnormality rate and other categorical data. Results: The 8-hour weighted average allowable concentration (CTWA) of mercury in the workplace of high-exposure group was 0.002 2-0.152 mg/m(3). The abnormal rate of ECG in the high-exposed group (29.6%) was higher than that in the low-exposure group (10.1%) in 2018 (P<0.01) . Compared with the low-exposure group, the WBC of the high-exposure group from 2016 to 2018 was increased, with statistically significance (P<0.05) ; the RBC of the high-exposure group in 2016 and 2017 was decreased, with statistically significance (P<0.01) ; the total bilirubin concentration in the high-exposure group was decreased from 2016 to 2018, with statistically significance (P<0.05) . Conclusion: Long-term exposure to high concentration of mercury in the workplace may influence cardiovascular system. Therefore, engineering protection and individual protection should be implemented well.

[Characteristics and drug resistance of non-O157 Shiga toxin-producing E. coli in animal feces, from Shandong Province].

Objective: To understand the infection status, characteristics and drug resistance of non-O157 Shiga toxin-producing E. coli (STEC) in animal feces in Shandong Province. Methods: From 2015 to 2016, convient sampling method was used to collect 1 022 fresh feces of animals in Weishan county and Laizhou city, and 24 non-O157 STEC were isolated. The serotypes of non-O157 STEC strains were confirmed through serum agglutination test. The susceptibility was explored through the antimicrobial sensitivity experiments. ESBLs activity was confirmed by double-disc diffusion. PCR method was used to detect the resistance genes. PFGE typing was operated to assess the relatedness and variability of the strains. The multi-locus sequence typing (MLST) was adopted to get the allelic profile and ST sequence of strains. Analysis was made on the evolutionary relationship between different ST groups was made through CLC Sequence Viewer and Counting Express. Results: A total of 24 non-O157 STEC were isolated from animal feces. 23 strains were from pig feces, and 1 strain was from cow feces, and the serotypes were more dispersed. All of the 24 strains carried stx2 genes. The highest resistance rate was sulfamethoxazole(22 strains), the mount of cotrimoxazole and nalidixic acid was 18 strains, chloramphenicol was 13 strains, tetracycline was 19, and there was a phenomenon of multiple drug resistance. The drug resistance spectrum was sulfamethoxazole tetracycline-compound novammin-naphthidine-chloramphenicol. All strains were sensitive to cefepime and imipenem. The ESBLs confirmatory test showed that 4 strains of non O157 STEC produced beta lactamase. PCR detected 7 resistance genes, and 4 tetracycline resistance genes (Tet A, Tet B, tetC and tetD) were detected. The beta lactamase resistance genes (blaSHV-1, bla CTX-M, bla TEM) were all negative. 24 strains were divided into 15 PFGE types, and their clustering results were more dispersed and no dominant PFGE type. There were 11 kinds of MLST types, most of them are ST540 and ST5133 types, each of which was 4 strains, and clustered into 1 MLST genomes. Conclusion: The serotypes of non-O157 STEC in animal feces O157 STEC were dispersed, and the resistant rate to common antibiotic was high. MLST typing results presents obvious polymorphism. Surveillance and manage ment of these strains should be strengthened.

Neutrophil Gelatinase-Associated Lipocalin in Cats with Naturally Occurring Chronic Kidney Disease.

BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker for the early prediction of renal damage and the progression of chronic kidney disease (CKD) in humans and dogs. HYPOTHESIS: Neutrophil gelatinase-associated lipocalin also may play a role in the progression of CKD in cats. ANIMALS: Eighty CKD and 18 control cats. METHODS: Cats were categorized into different stages according to the International Renal Interest Society (IRIS) staging system. Urine and plasma samples were collected and tested for NGAL concentrations using an in-house sandwich ELISA system and urinary NGAL (uNGAL)-to-creatinine ratio (UNCR) was determined. Cats in which serum creatinine concentration increased by >0.5 mg/dL from baseline within 30 days were defined as exhibiting progression. RESULTS: The urinary NGAL and UNCR of CKD cats were significantly higher than those of healthy cats (P < .05) and were highly correlated with serum creatinine concentration. The area under the receiver operating characteristic curve (AUROC) for uNGAL, when predicting the progression of CKD, was 0.71 and the best cutoff value was 2.06 ng/mL with a sensitivity of 76.9% and a specificity of 75%. The AUROC for UNCR when predicting the progression of CKD was 0.79 and the best cutoff value was 4.08 × 10-6 with a sensitivity of 76.9% and specificity of 79.2%. Cats with UNCR values higher than their cutoffs experienced significantly faster deterioration with a median of 19 days. CONCLUSIONS: Both urinary NGAL and UNCR are useful markers for the prediction of CKD progression in cats.

Combined multiplex loop-mediated isothermal amplification with lateral flow assay to detect sea and seb genes of enterotoxic Staphylococcus aureus.

UNLABELLED: Staphylococcal enterotoxins (SEs) are the most common cause of food poisoning worldwide and can induce symptoms, such as diarrhoea, vomiting and abdominal cramping. Thus, the aim of this study is to develop a multiplex loop-mediated isothermal amplification combined with a lateral flow assay (m-LAMP/LFA) to simultaneously detect the sea and seb genes of Staphylococcus aureus. The amplicons of the sea gene were labelled with digoxigenin (Dig) and biotin while those of seb gene were labelled with fluorescein isothiocyanate (FITC) and biotin. These amplicons were detected using a multiplex LFA with NeutrAvidin-tagged gold nanoparticles as the detection reagent. After optimization, the detection limit of this assay was 10(2)  CFU ml(-1) Staph. aureus, which was one tenth that of a multiplex PCR. This assay did not exhibit any cross-reactivity in detecting other enterotoxic Staph. aureus strains or other food pathogens. After 6 h of enrichment, this developed assay detected 1 CFU ml(-1) of Staph. aureus in milk, apple juice, cheese and rice. The developed m-LAMP/LFA method does not require expensive equipment and can be completely implemented within an 8-h workday. Therefore, this method can provide an effective means of quickly screening staphylococcal enterotoxin A- and/or staphylococcal enterotoxin B-producing Staph. aureus in food samples. SIGNIFICANCE AND IMPACT OF THE STUDY: Staphylococcus aureus is one of the major foodborne pathogens worldwide, and its staphylococcal enterotoxin A and B are strongly associated with food poisoning. This work developed a multiplex loop-mediated isothermal amplification combined with a lateral flow assay (m-LAMP/LFA) to simultaneously detect the sea and seb genes of Staph. aureus in food samples. The assay has good specificity and sensitivity with ease-of-use features, making it ideal for on-site detection.

[Advances in the research of sepsis-related stress response].

In recent years, the levels of anti-infection and organ function support of sepsis have been improved, but the mortality rate remains high, which brings about challenges for critical care clinicians. Sources of sepsis-related stress response include severe infection, frequent therapeutic procedures, routine nursing measures, and physical constraints, etc. Although sepsis-related stress response has obtained a lot of concern, its understanding is still in the stage of research and the treatment method is nonspecific. This article summarizes the pathogenesis, evaluation methods, and treatment of sepsis-related stress response, with a hope to provide reference for its clinical treatment.

[Observation on treatment of mailuoning injection for 46 pregnancy induced hypertension patients].

In order to observe the effect of treatment of Mailuoning Injection (MI) for pregnancy induced hypertension (PIH), 46 PIH patients in treated group were treated with intravenous dripping of MI and 40 patients in control group were treated with intravenous dripping of 25% magnesium sulfas. The result showed: The headache and edema ameliorated significantly in treated group in comparison with control (P < 0.05). Both methods could decrease the levels of mean arterial pressure, but the former's lowering arterial pressure was better than that of latter's (P < 0.05-0.01). The improvements of hemorheology in both groups after treatment were found, but the decrease of hematocrit was more significant in treated group (P < 0.05). No difference was found in albuminuria, delivery pattern, postpartum bleeding and neonatal Apgar Score between the two groups. The result suggested that the MI could prevent the progress of pathological process of the PIH, and relieve the systemic arteriolospasm, improve the microcirculation, change the hypercoagulability of the patients' blood and increase the blood flow in the patient of PIH.