Investigations of two poisoning incidents caused by Omphalotus guepiniformis from Nanping, Fujian Province, China / 中华急诊医学杂志

Objective:To describe a systematic approach on identification of poisonous mushroom by investigating two cases of Omphalotus guepiniformis poisoning in Jianyang district, Nanping, Fujian province. Methods:Two incidents of food poisoning on 10 migrant workers were investigated. The remaining suspected mushroom samples were collected and the same fresh mushroom specimens were also collected in the following field investigations from the same dead tree and fallen trunk. These mushroom specimens were identified based on morphological and phylogenetic analyses.Results:On November 24 and 26, 2018, 8 and 2 migrant workers from Jianyang District, Nanping ate wild mushrooms and developed acute nausea, vomiting, abdominal pain and other symptoms within 10 to 90 min after consumption. They were diagnosed as mushroom poisoning, with gastroenteritis as the main manifestation. Further analysis showed that the more poisonous mushroom were consumed, the shorter latency and longer duration of nausea and vomiting were resulted. After admission, gastric lavage, catharsis, acid preparation, gastric protection, fluid replenishment and other symptomatic support treatments were given in time, all patients were discharged in 1-3 d. Based on morphological and phylogenetic analyses, the samples were identified as O. guepiniformis. Conclusions:The two incidents were caused by accidental consumption of O. guepiniformis. Awareness education about poisonous mushroom should be provided to migrant workers to prevent more such poisoning incidents in the future.

Transcriptome of congenital talipes equinovarus based on RNA sequencing / 国际儿科学杂志

Objective:To sequence the whole transcriptomics of congenital talipes equinovarus(CTEV)by RNA sequencing(RNA-Seq)and to compare the differential expression of mRNA, long non-coding RNA(lncRNA), circular RNA(circRNA)and microRNA(miRNA)between CTEV and normal children.Methods:RNA was extracted from plasma samples of 3 CTEV children(experimental group)and 3 normal children(control group). After RNA-Seq, the differentially expressed genes(DEG)and transcripts of CTEV and normal children were screened out.Gene ontology analysis and Kyoto encyclopedia of genes and genomes pathway enrichment analysis were carried out for the DEG.Results:The gene expression profile was successfully constructed.There were 181 DGE in the experimental group and control group, including 58 up-regulated genes and 123 down-regulated genes.A total of 23 lncRNA, 12 up-regulated and 11 down-regulated, were differentially expressed in the present study.There were 23 miRNA differentially expressed, including 11 up-regulated and 12 down-regulated miRNA.No differential expression of circRNA was found in the present study.The expression of secreted phosphoprotein 1(SPP1)and ribosomal protein S27(RPS27)was significantly different in the experimental group and the control group with the fold change being 82.24 and 0.01, respectively.Conclusion:DGE in the plasma samples of CTEV and normal children were analysed by full transcriptome sequencing.SPP1 and RPS27 may be the candidate genes of CTEV.

Cytokine Networks and Survivin Peptide-Specific Cellular Immune Responses Predict Improved Survival in Patients With Glioblastoma Multiforme.

PURPOSE: We investigated serum cytokine and T-cell responses directed against tumour-associated antigens (TAAs) in association with survival of patients with glioblastoma multiforme (GBM). PATIENTS AND METHODS: Peripheral blood from 205 treatment-naïve patients with glioma (GBM = 145; non-GBM = 60) was obtained on the day of surgery to measure (i) circulating T-cells reacting to viral antigens and TAAs, in the presence or absence of cytokine conditioning with IL-2/IL-15/IL-21 or IL-2/IL-7, and (ii) serum cytokine levels (IL-4, IL-5, IL-6, TNF-α, IFN-γ and IL-17A). Patients were followed-up for at least 1000 days post-surgery. Survivin protein and gene expression in resected GBM tumour tissue were confirmed by immunohistochemistry and real-time polymerase chain reaction, respectively. Antigen-specific T-cell responses were gauged by ICS (intracellular cytokine production). Associations between patient survival and immunological reactivity patterns were analysed using univariate and multivariate statistics. RESULTS: Approximately 2% of patients with GBM and 18% of patients with non-GBM glioma, were alive beyond 1000 days of surgery. Univariate analysis indicated that the combination of three cytokines (IL-4/IL-5/IL-6, p = .0022; IFN-γ/TNF-α/IL-17A, p = .0083) but not a 'partial' combination of these cytokines, the IFN-γ immune response to EBV-EBNA-1 (p < .0001) as well as T-cell responses to the survivin97-111 peptide (p = .0152) correlated with longer survival among patients with GBM. Multivariate analysis identified survivin97-111-directed IFN-γ production with IL-2/IL-15/IL-21 conditioning (p = .024), and the combined presence of serum IFN-γ/TNF-α/IL-17a (p = .003) as independent predictors of survival. CONCLUSION: Serum cytokine patterns and lymphocyte reactivity to survivin97-111, particularly with IL-2, IL-15 and IL-21 conditioning may be instrumental in predicting survival among patients with GBM. This has implications for clinical follow-up of patients with GBM and the targeted development of immunotherapy for patients with CNS tumours.

Quick separation and enzymatic performance improvement of lipase by ionic liquid-modified Fe3O4 carrier immobilization.

To promote the activity and stability of immobilized porcine pancreatic lipase (PPL), novel carrier was combined with special immobilization method. Enzymatic activity was enhanced after immobilized onto ionic liquid modified magnetic Fe3O4 by electrostatic adsorption. Activity of immobilized enzyme (PPL-IM/BF4-Fe3O4@CA) reached 596 U/g PPL. Through the combination of electrostatic adsorption and embedding immobilization methods, we improve binding force between the carrier and enzyme, and further enhance the efficiency and stability of immobilized enzyme. The activity of PPL-IM/BF4-Fe3O4@CA after repeated third use was 78%. After storage at room temperature for 5 days, the residual activity was 89%. Enzymatic properties and catalytic kinetics of immobilized enzymes were studied, and the effect mechanism of ionic liquid modified Fe3O4 on PPL was revealed. The effect of ionic liquid on the carrier structure was investigated by characterization of XRD, FT-IR, SEM and TG. The mechanism and enzymatic properties of immobilized PPL via electrostatic adsorption and embedding were analyzed. A novel and efficient immobilized PPL was developed.

Mesothelin-specific Immune Responses Predict Survival of Patients With Brain Metastasis.

BACKGROUND: Patients with advanced malignancies, e.g. lung cancer, ovarian cancer or melanoma, frequently present with brain metastases. Clinical presentation and disease progression of cancer is in part shaped by the interaction of the immune system with malignant cells. Antigen-targeted immune responses have been implicated in the prolonged survival of patients with cancer. This includes the tumor-associated antigen (TAA) mature mesothelin, a 40kDa cell surface-bound antigen that is overexpressed in several malignancies including lung ovarian and pancreatic cancer. We examined in an observational, prospective study the survival of patients with brain metastases in association with clinical parameters and cellular immune responses to molecularly defined TAAs or viral (control) target antigens. METHODS: Immune cells in peripheral blood obtained from thirty-six patients with brain metastases were tested for cytokine production in response to a broad panel of defined viral and TAA target antigens, including full-length mesothelin. Incubation of immune cells with antigenic targets was carried out in i) medium alone, (ii) in a cytokine cocktail of interleukin (IL)-2/IL-15/IL-21, or (iii) IL-2/IL-7. Supernatants were tested for interferon gamma (IFN-γ) production, after which univariate and multivariate analyses (Cox stepwise regression model) were performed to identify independent clinical and immunological factors associated with patient survival. Patients were followed-up for at least 500days after surgery or until death. FINDINGS: Univariate analysis identified age, gender, radiotherapy and mutational load as clinical parameters affecting survival of patients with brain metastases. Cox multivariate analysis showed that radiotherapy (P=0·004), age (P=0·029) and IFN-γ responses to mature mesothelin, conditioned by IL-2/IL-7 (P=0·045) were independent predictors of the survival of patients from surgery up to follow-up or death. INTERPRETATION: This is the first evidence that immune responses to mesothelin serve as a marker of increased overall survival in patients with brain metastases, regardless of the primary tumor origin. Analyses of immunological markers could potentially serve as prognostic markers in patients with brain metastases and help to select patients in need for adjunct, immunological, treatment strategies.

A Preliminary Report: Radical Surgery and Stem Cell Transplantation for the Treatment of Patients With Pancreatic Cancer.

We examined the immunologic effects of allogeneic hematopoietic stem cell transplantation (HSCT) in the treatment of pancreatic ductal adenocarcinoma, a deadly disease with a median survival of 24 months for resected tumors and a 5-year survival rate of 6%. After adjuvant chemotherapy, 2 patients with resected pancreatic ductal adenocarcinoma underwent HSCT with HLA-identical sibling donors. Comparable patients who underwent radical surgery, but did not have a donor, served as controls (n=6). Both patients developed humoral and cellular (ie, HLA-A*01:01-restricted) immune responses directed against 2 novel tumor-associated antigens (TAAs), INO80E and UCLH3 after HSCT. Both TAAs were highly expressed in the original tumor tissue suggesting that HSCT promoted a clinically relevant, long-lasting cellular immune response. In contrast to untreated controls, who succumbed to progressive disease, both patients are tumor-free 9 years after diagnosis. Radical surgery combined with HSCT may cure pancreatic adenocarcinoma and change the cellular immune repertoire capable of responding to clinically and biologically relevant TAAs.

Measurement of reference value of maximum epiphyseal width lateral to Klein's line and modification of Klein's line in 2 800 hips of 1 400 normal children / 国际儿科学杂志

Objective To investigate the maximum epiphyseal width lateral to Klein' s line (MEWLKL) and modification of Klein's Line (namely difference value of bilateral MEWLKL) on hip plain radiographs of normal children, and to investigate the relationship between MEWLKL and modification of Klein's Line and gender and body side, respectively.Methods Anteroposterior (AP) view pelvic plain radiographs of fourteen thousand eight hundred and thirty-seven cases aged from zero to fourteen years old in Shengjing Hospital of China Medical University from 2005 January to 2014 December were reviewed.Seven thousand one hundred and forty-seven normal AP pelvic plain radiographs were included in the present study.Fourteen groups based on the age from one years old to fourteen years old were divided.One hundred cases in each age group, including fifty males and fifty females, were randomly selected.Fourteen hundred AP view pelvic plain radiographs including twenty eight hundred hips were measured.The reference value of MEWLKL and modification of Klein's line were measured using AutoCAD2007 software.the Normal distribution test were performed using Excel and SPSS19.0 software.The relationship curve between MEWLKL and modification of Klein's Line and age were drawed.The intra-group difference between MEWLKL and gender and body side were performed using t-test in normal children.The inter-group difference between modification of Klein's line and average MEWLKL were performed using one-way analysis of variance in normal children.Results The reference value of MEWLKL and modification of Klein's Line were both normal distribution.Average reference value of MEWLKL were (5.20 ± 1.92) mm, (5.04 ± 1.88) mm in male, and (5.36 ± 1.94) mm in female (P =0.000), (5.06 ± 1.87) mm on the left side, and (5.33 ± 1.96) mm on the right side (P =0.000).The curve of reference value of MEWLKL in fourteen general groups were similar to those of fourteen male groups and fourteen female groups, and reference value of MEWLKL increased with age.It was in the trough at the age of five [general groups: (3.77 ± 1.00) mm;male groups: (3.53 ± 1.00) mm;female groups: (4.01 ±0.94) mm], and it was at the peak at the age of thirteen [general groups: (7.49 ± 1.43)mm;female group: (7.84 ± 1.42) mm].It was at the peak at the age of fourteen in male groups, and the value was (7.24 ± 1.46) mm.The reference value of MEWLKL in fourteen groups and in female groups both fell slightly after the age of fourteen.There were second trough, (6.44 ± 1.86) mm to (6.38 ± 1.15) mm,at age eleven to twelve in female groups.The curves of reference value of MEWLKL on bilateral sides was very similar, and they increased with age.They were in the trough at the age of five [(3.54 ± 0.84) mm in left side and (4.00 ± 1.10) mm in right side], and they were at the peak at the age of thirteen [(7.25 ± 1.57)mm in left side and (7.72 ± 1.24) mm in right side].The curves both fell slightly after the age of fourteen.The general reference value of modification of Klein's line was (0.93 ±0.82) mm.The average value of each age group waved in the level of 1.0 mm.Statistical significance were found in comparison of two intergroups, age eight versus age seven (P =0.011), and age eleven versus age ten (P =0.04).The maximum value of modification of Klein's line in four of fourteen groups were greater than 2.0 mm, including 2.02 mm in age ten, 2.05 mm in age eleven, 2.3 mm in age thirteen, and 2.17 mm in age fourteen, respectively.Conclusion The value of modification of Klein's line in normal children can be more than 2.0 mm, and the average value waved in the level of 1.0 mm.It is not reliable to determine slipped capital femoral epiphysis using modification of Klein's line.

Proteins of neural tube defects / 国际儿科学杂志

Neural tube defects(NTD)are a common congenital malformations in humans leading to in-fant mortality or severe disability.The etiology of NTD is complicated,with both environmentaland genetic con-tributions.It has been found that the protein markers associated with NTD are mainly maternal serum alpha feto-protein,amniotic fluid alpha fetoprotein and amniotic fluid glial fibrillary acidic protein.This article reviews the protein biomarks related with NTD.

T-Cell Therapy: Options for Infectious Diseases.

The emergence of drug-resistant tuberculosis is challenging tuberculosis control worldwide. In the absence of an effective vaccine to prevent primary infection with Mycobacterium tuberculosis and tuberculosis disease, host-directed therapies may offer therapeutic options, particularly for patients with multidrug-resistant and extensively drug-resistant tuberculosis where prognosis is often limited. CD8(+) and CD4(+) T cells mediate antigen-specific adaptive cellular immune responses. Their use in precision immunotherapy in clinical conditions, especially in treating cancer as well as for prevention of life-threatening viral infections in allogeneic transplant recipients, demonstrated safety and clinical efficacy. We review key achievements in T-cell therapy, including the use of recombinant immune recognition molecules (eg, T-cell receptors and CD19 chimeric antigen receptors), and discuss its potential in the clinical management of patients with drug-resistant and refractory tuberculosis failing conventional therapy.

Preliminary study of vacuum phenomenon in pediatric hip joint / 国际儿科学杂志

Objective To find the accurate incidence of vacuum phenomenon in the hip and the best projection position produced the vacuum phenomenon on plain radiograph of hip in children.Methods All pediatric anteroposterior view and frog-leg position plain radiographs of hip joints were retrieved in our hospital between January 2003 and March 2013.All subjects was between 0 and 14 years old (mean age,4.2 years old).All the plain radiographs showing the crescent,linear,and irregular lucency between the femoral head and acetabulum were included in the present study.Results A total of 16 749 cases,including 12 422 cases (5 912 boys and 6 510 girls) only taken AP view plain radiographs and 4 327 cases (1 537 boys and 2 790 girls) taken both AP view and frog-leg position plain radiographs,were taken in our hospital between January 2003 and March 2013.None of AP view plain radiographs of hips could find the vacuum phenomenon.Two hundred and fifty-eight cases (321 hips) with vacuum phenomenon of the hips were found only in the frog-leg position plain radiographs of 4 327 cases,and the constituent ratio of vacuum phenomenon in the hip joint is 5.96％ in frog-leg position plain radiographs.One thousand seven hundred and thirty-eight normal children were included in 4 327 frog-leg position radiographs,and 150 cases of vacuum phenomenon were included in 1 738 normal children,and incidence of vacuum phenomenon in normal children is 8.63％.Two thousand three hundred and sixty children with developmental dysplasia of the hip (DDH) were included in 4 327 frog-leg position radiographs,and 98 cases of vacuum phenomenon were included in 2 360 children with DDH,and incidence of vacuum phenomenon in children with DDH is 4.15％.258 cases with vacuum phenomenon included 150 cases of normal hips (58.14％),98 cases of developmental dysplasia of the hip (37.98％),5 cases of Legg-Calvé-Perthes disease (1.94％),and 1 each in solitary eosinophilic granuloma of ischium,polyostotic fibrous dysplasia of the bilateral proximal femur,hereditary multiple exostoses,congenital coxa vara and fracture of femoral neck after surgery.Three hundred and twenty-one hips in 258 cases were classified into complete type (121 hips,37.69％) and partial type (200 hips,62.31％) according to the proportion of lucency area in the hip joints and linear (159 hips,49.53％),crescent (151 hips,47.04％) and irregular (11 hips,3.43％) lucency according to the shape of lucency area in the hips.Conclusion Vacuum phenomenon of the hip in children is not very rare in frog-leg position plain radiograph.It is easier to find the vacuum phenomenon in normal hip compared to that of developmental dysplasia of the hip.The frog-leg position plain radiograph is a better projection position to obtain the vacuum phenomenon of the hip in children compared to the anteroposterior view plain radiograph.

Relationship between serum levels of galectin-3 and prognosis of patients with chronic heart failure:A Meta-analysis / 吉林大学学报(医学版)

Objective To evaluate the relationship between the newly recominended chronic heart failue (CHF) marker-serum galection-3 (Gal-3)level and the prognosis of CHF by Meta-analysis.Methods The Chinese and English literatures about the relationship between Gal-3 and CHF prognosis were searched in PubMed,EMbase, Chinese Biomedical Literature Databases. All literatures were assessed by the inclusion and exclusion criteria. Hazard ratio (HR)and 95% confidence interval (CI)in each literature were extracted for Meta-analysis using STATA 12.1 software.The stability and reliability were evaluated by sensitivity analysis and publication bias analysis.Results Ten literatures complying with the requirements were included.The results of heterogeneity test were as follows:① When the influence of other factors were not excluded,heterogeneity test showed that P =0.000,I 2 =89.2%,heterogeneity existed in different studies,so statistics were combined using a random effects model.The combined HR of univariate analysis was 1.36 and 95% CI was 1.23-1.50.2.When the influence of other factors were excluded,heterogeneity test showed that P < 0.001,I 2 = 68.4%,heterogeneity existed in different studies,so statistics were combined using a random effects model.The combined HR of multivariate analysis was 1.17 and 95% CI was 1.07-1.26.3.Sensitivity analysis showed that when the study with the largest samples was excluded,the combined HR of univariate analysis was 1.54 and 95% CI was 1.32 - 1.77;the combined HR of multivariate analysis was 1.26 and 95% CI was 1.09 - 1.42.When the study with the smallest samples was excluded,the combined HR of univariate analysis was 1.34 and 95% CI was 1.20 - 1.47;the combined HR of multivariate analysis was 1.15 and 95% CI was 1.06-1.24.Conclusion The serum level of Gal-3 is increased significantly in the patients with CHF and it may be an independent risk factor for poor prognosis of the CHF patients.

Stent-delayed implantation strategy of acute myocardial infarction with high thrombus burden in primary percutaneous coronary intervention / 中南大学学报(医学版)

OBJECTIVE@#To retrospectively evaluate the efficacy of stent-delayed implantation in patients with acute myocardial infarction (AMI) with high thrombus burden after thrombus extraction was performed.@*METHODS@#Of 186 consecutive AMI patients, 56 were included according to thrombus score(TS)>or=2, and then were divided into 2 groups based on the thrombus score after thrombus extraction was executed: the stent-direct implantation group (TS=0 or 1)and the stent-delayed implantation group (TS>or=2) even if 3 times thrombus extraction were given. Thrombolysis in myocardial infarction(TIMI)flow grade and TIMI myocardial perfusion (TMP) were used to assess the coronary artery flow and myocardial perfusion,respectively.@*RESULTS@#TIMI score in the stent-direct implantation group was lower than that in the stent-delayed implantation group. There was no significant difference(P=0.07). TMP score in the stent-direct implantation group was significantly lower than that in the stent-delayed implantation group (P<0.05).@*CONCLUSION@#Stent-delayed implantation can remarkably improve myocardial perfusion in AMI patients with high thrombus burden after thrombus extraction and intensive anti-thrombosis therapy is administrated.