Abnormal interaction between cortical regions of obstructive sleep apnea hypopnea syndrome children.

Obstructive sleep apnea hypopnea syndrome negatively affects the cognitive function of children. This study aims to find potential biomarkers for obstructive sleep apnea hypopnea syndrome in children by investigating the patterns of sleep electroencephalography networks. The participants included 16 mild obstructive sleep apnea hypopnea syndrome children, 12 severe obstructive sleep apnea hypopnea syndrome children, and 13 healthy controls. Effective brain networks were constructed using symbolic transfer entropy to assess cortical information interaction. The information flow pattern in the participants was evaluated using the parameters cross-within variation and the ratio of posterior-anterior information flow. Obstructive sleep apnea hypopnea syndrome children had a considerably higher symbolic transfer entropy in the full frequency band of N1, N2, and rapid eye movement (REM) stages (P < 0.05), and a significantly lower symbolic transfer entropy in full frequency band of N3 stage (P < 0.005), in comparison with the healthy controls. In addition, the cross-within variation of the ß frequency band across all sleep stages were significantly lower in the obstructive sleep apnea hypopnea syndrome group than in the healthy controls (P < 0.05). What is more, the posterior-anterior information flowin the ß frequency band of REM stage was significantly higher in mild obstructive sleep apnea hypopnea syndrome children than in the healthy controls (P < 0.05). These findings may serve as potential biomarkers for obstructive sleep apnea hypopnea syndrome in children and provide new insights into the pathophysiological mechanisms.

The expression level of fibroblast growth factor gene in serum samples of lung cancer patients.

Lung cancer, one of the most deadly and dangerous types of cancer in the world, kills many men and women every year. Activation of fibroblast growth factor signals plays a role in the pathogenesis of several cancers, including lung cancer. Also, this factor may indicate prognosis and is related to the survival rate in patients with NSCLC. Therefore, this research investigated the level of fibroblast growth factor gene expression in the serum of people with lung cancer. In this research, 60 serum samples of healthy people and 60 serum samples of people with NSCLC were prepared, and personal and clinicopathological information of the studied people were collected by questionnaires. Then, plasma isolation, RNA extraction, cDNA synthesis, primers design, implementation, and changes in fibroblast growth factor gene expression in the serum of healthy and lung cancer patients were evaluated by the Real-time PCR method. REST software was used to analyze the results. The findings showed no significant difference in the expression of the fibroblast growth factor gene in the serum of people with the first to third stages of metastasis. However, in the serum of patients with the fourth stage of metastasis, the expression level of this gene was significantly decreased by 3.92 times compared to normal samples (P<0.05). According to the results of this study, it is possible to use the expression level of the fibroblast growth factor gene in people's serum to predict the metastasis stage of lung cancer.

Recent advances in diagnostic approaches for orf virus.

Orf virus (ORFV), the prototype species of the Parapoxvirus genus, is an important zoonotic virus, causing great economic losses in livestock production. At present, there are no effective drugs for orf treatment. Therefore, it is crucial to develop accurate and rapid diagnostic approaches for ORFV. Over decades, various diagnostic methods have been established, including conventional methods such as virus isolation and electron microscopy; serological methods such as virus neutralization test (VNT), immunohistochemistry (IHC) assay, immunofluorescence assay (IFA), and enzyme-linked immunosorbent assay (ELISA); and molecular methods such as polymerase chain reaction (PCR), real-time PCR, loop-mediated isothermal amplification (LAMP), recombinase polymerase amplification (RPA), and recombinase-aided amplification (RAA) assay. This review provides an overview of currently available diagnostic approaches for ORFV and discusses their advantages and limitations and future perspectives, which would be significantly helpful for ORFV early diagnosis and surveillance to prevent outbreak of orf. KEY POINTS: • Orf virus emerged and reemerged in past years • Rapid and efficient diagnostic approaches are needed and critical for ORFV detection • Novel and sensitive diagnostic methods are required for ORFV detection.

Understanding college students' continuous usage intention of asynchronous online courses through extended technology acceptance model.

Asynchronous online learning has gained great popularity in higher education, especially due to the recent COVID-19 pandemic. However, few studies have investigated how to maintain students' continuous usage intention of asynchronous online courses in the context of higher education. This study incorporated four key factors (intrinsic motivation, extrinsic motivation, perception of multiple sources, and cognitive engagement) associated with students' continuous usage intention of asynchronous online courses into technology acceptance model (TAM) to identify the influencing factors on students' continuous usage intention. A survey with 325 college students was conducted to explore their continuous usage intention of asynchronous online courses and structural equation modeling analysis was carried out to analyze the relationships between the key influencing factors and students' continuous usage intention. The results showed that cognitive engagement was the only factor that directly related to continuous usage intention. Intrinsic motivation, extrinsic motivation, and perception of multiple sources indirectly correlated with students' continuous usage intention through different pathways. The results of the study have several theoretical and practical implications. Theoretically, the study verified what key learning factors incorporated into TAM and in what way they relate to the continuous usage intention of asynchronous online courses. Practically, the present study indicated that it is required to take intrinsic motivation, extrinsic motivation, perception of multiple sources, cognitive engagement and TAM into consideration when designing and conducting asynchronous online learning courses to ensure college students' continuous usage intention of asynchronous online courses.

Qin's seven steps for endoscopic selective lateral neck dissection via the chest approach in patients with papillary thyroid cancer: experience of 35 cases.

BACKGROUND: Endoscopic thyroidectomy is widely performed as it does not result in neck scar. However, there is a paucity of reports pertaining to completely endoscopic lateral neck dissection (LND). In this study, we introduce our step-wise approach for performing endoscopic selective LND via the chest-breast approach. We refer to this approach as Qin's seven steps. METHODS: The Qin's seven steps are: (1) establishment of working space range; (2) dissection of lymph nodes between the SCM and the sternohyoid muscle (level IV) and exposure of omohyoid; (3) dissection of lymph nodes at level IV; (4) dissection of lymph nodes at level III; (5) dissection of lymph nodes at carotid triangle (level III); (6) exposure of accessory nerve and dissection of lymph nodes at level II a; (7) dissection of lymph nodes at level II b. We reviewed the clinical data of 35 patients with papillary thyroid cancer (PTC) who were operated using the Qin's seven steps. RESULTS: All 35 patients successfully underwent LND; bilateral LND was performed in 5 patients. The mean tumor size was 1.8 ± 1.0 cm; seven patients had multiple lesions. The mean number of retrieved lymph nodes in level II, III and IV were 8.8 ± 5.6, 6.1 ± 4.0 and 9.3 ± 5.1, respectively. As for complications, there were 3 cases of accessory nerve injury and 1 case of hypoglossal nerve injury. Internal jugular vein injury, cervical plexus injury and lymphatic leakage occurred in 2, 7, and 1 patients, respectively. CONCLUSION: The Qin's seven steps for performing endoscopic selective LND could be safely used in PTC patients with lateral lymph node metastasis. Satisfactory results were achieved in the short-term follow-up period. We recommend the use of Qin's seven steps for PTC patients who are not desirous of neck scar.

Endoscopic thyroidectomy via the combined trans-oral and chest approach for cT1-2N1bM0 papillary thyroid carcinoma.

BACKGROUND: Recent years there have been witnessed considerable advances in endoscopic selective lateral neck dissection (LND). However, dissection of lymph nodes at level IV and level VI via the chest approach is inherently challenging. In this study, we used combined trans-oral and chest approach for endoscopic thyroidectomy in patients with cT1-2N1bM0 papillary thyroid carcinoma (PTC). METHODS: Clinical characteristics and surgical outcomes of ten patients with cT1-2N1bM0 PTC who underwent endoscopic thyroidectomy via combination of trans-oral and chest approach between September 2020 and September 2021 were retrospectively reviewed. RESULTS: All 10 patients successfully underwent total thyroidectomy and selective LND via chest approach, while central neck dissection (CND) and supplementary dissection of lymph nodes at level IV were performed via the trans-oral approach. The mean number of positive/retrieved level II, III-IV, and VI lymph nodes were 0.6 ± 1.0/9.8 ± 5.0, 4.6 ± 2.8/23.1 ± 4.7, and 4.9 ± 3.4/10.3 ± 4.6, respectively. Four patients developed transient hypoparathyroidism which spontaneously resolved within 1 month. Five patients developed numbness of lateral neck and ear and one patient experienced limb lift restriction. No other complications or tumor recurrence occurred during follow-up. CONCLUSION: It is feasible to perform total thyroidectomy, CND, and selective LND via combined trans-oral and chest approach, and satisfactory short-term outcomes were observed in this cohort. This approach may offer one more option for cT1-2N1bM0 PTC patients, especially those in whom metastatic lymph nodes at level IV or level VI are detected by preoperative examination.

Interactions of central and autonomic nervous systems in patients with sleep apnea-hypopnea syndrome during sleep.

PURPOSE: Sleep apnea-hypopnea syndrome (SAHS) is an independent risk factor for various cardiovascular and cerebrovascular diseases, but the underlying relationship of its physiological subsystems remains unclear. Thus, we aimed to investigate the effect of SAHS on central and autonomic nervous system (CNS-ANS) interactions during sleep. METHODS: Thirty-five patients with SAHS and 19 healthy age-matched controls underwent overnight polysomnography. The absolute spectral powers of five frequency bands from six EEG channels and ECG morphological features (HR, PR interval, QT interval) were calculated. Multivariable transfer entropy was applied to analyze the differences of the CNS-ANS network interactions between patients with SAHS of different severities and healthy controls during deep, light, and rapid eye movement sleep. RESULTS: The CNS-ANS network interacted bidirectionally in all researched groups, with the cardiac information modulating the brain activity. The information strength from QT to most EEG components and PR to some EEG components was significantly affected by SAHS severity during light sleep, which indicates the coupling features of QT-brain nodes are important indicators. The driver effects from the ß-band significantly increased in patients with SAHS. CONCLUSIONS: Respiratory events may be the main reason for the CNS-ANS interaction changes in SAHS. These findings help explain the physiological regulation process of SAHS and provide valuable information for analysis of the development of SAHS-related cardiovascular and chronic diseases.

Tumor size rather than the thyroid invasion affects the prognosis of parathyroid carcinoma without lymph node or distant metastasis.

PURPOSE: This study aimed to explore the prognostic value of thyroid invasion of parathyroid carcinoma without lymph node or distant metastasis. METHODS: Two hundred and nine cases of parathyroid carcinoma from the SEER (1989-2014) were eligible for this study. A Chi-squared test, t test, X-tile, Kaplan-Meier curves, and multivariate Cox proportional hazard regression were used for analysis. RESULTS: Thyroid invasion, sex, race, age, radiation, and surgery were not significantly associated with cancer-specific survival by multivariate analysis. However, tumor size ≥ 4 cm was significantly associated with worse cancer-specific survival (P < 0.001). CONCLUSION: Thyroid invasion, which was the criterion for T1 and T2 staging criteria of parathyroid carcinoma according to the AJCC, did not affect the prognosis of patients with parathyroid carcinoma without local lymph node or distant metastasis. Our study indicates that a tumor size ≥ 4 cm may be an appropriate indicator of T1 and T2 cancer staging.

Safety and feasibility of the transoral endoscopic thyroidectomy vestibular approach with neuroprotection techniques for papillary thyroid carcinoma.

BACKGROUND: This study aimed to evaluate the feasibility and safety of the trans-oral endoscopic thyroidectomy vestibular approach (TOETVA) with neuroprotection techniques for the surgical management of papillary thyroid carcinoma (PTC). METHODS: Patients with PTC who underwent TOETVA between December 2016 and July 2020 were included in this study, and their relevant clinical characteristics, operational details, and surgical outcomes were reviewed and extracted from their medical records for further analysis. RESULTS: A total of 75 patients successfully underwent TOETVA with zero conversions. Unilateral lobectomy with isthmectomy and total thyroidectomy were completed for 58 and 17 patients, respectively, all using our unique neuroprotective procedure and ipsilateral central neck dissection (CND). The mean number of retrieved lymph nodes versus positive lymph nodes was 6.8 ± 3.7 vs. 1.5 ± 2.3. Postoperative complications included three cases of transient superior laryngeal nerve (SLN) palsy (4.0%), five cases of transient recurrent laryngeal nerve (RLN) palsy (6.7%), 14 cases of transient hypoparathyroidism (18.7%), two cases of numb chin (2.7%) and two cases of flap perforation (2.7%). The follow-up period for patients with PTC lasted for 15.6 ± 10.9 months, during which no other complications or tumor recurrence were observed. CONCLUSION: TOETVA can be safely performed for patients with PTC with satisfactory results during the short-term follow-up period. Our neuroprotection techniques can be integrated into TOETVA, which is worth recommending for PTC patients who desire better cosmetic surgical outcomes.

Detection of aerobe-anaerobe mixed infection by metagenomic next-generation sequencing in an adult suffering from descending necrotizing mediastinitis.

BACKGROUND: Descending necrotizing mediastinitis (DNM) is one of the most virulent forms of mediastinitis. The main causes of high mortality in DNM are believed to stem from difficulty and delay in the diagnosis. Fast and accurate identification of pathogens is important for the treatment of these patients. Metagenomics next-generation sequencing (mNGS) is a powerful tool to identify all kinds of pathogens, especially for rare and complex infections. CASE PRESENTATION: A 64-year-old male patient was admitted to the intensive care unit (ICU) with unconsciousness, dyspnea, and swelling in the mandible and neck. Computed tomography (CT) scan results combined with clinical laboratory examination indicated DNM. Vancomycin and imipenem were used, and vacuum sealing drainage was applied for debridement and drainage of the infected area. The positive mNGS results of drainage fluid confirmed the presence of mixed infection caused by Streptococcus anginosus, Prevotella oris, and several other anaerobes. The antibiotics were adjusted to piperacillin/tazobactam and tinidazole according to the mNGS results and antimicrobial susceptibility testing of cultured pathogens. After 11 days of antibiotic therapy, the infection symptoms of the neck and mediastinum improved, and the patient was transferred out of the ICU on the 26th day after negative result of drainage fluid culture. CONCLUSION: This case suggested that mNGS is a promising technology for precise and fast pathogens identification with high sensitivity, which may guide the diagnosis of infectious diseases in the future trend.

Research about the optimal strategies for prevention and control of varicella outbreak in a school in a central city of China: based on an SEIR dynamic model.

Varicella is an acute respiratory infectious diseases, with high transmissibility and quick dissemination. In this study, an SEIR (susceptible-exposed-infected-recovered) dynamic model was established to explore the optimal prevention and control measures according to the epidemiological characteristics about varicella outbreak in a school in a central city of China. Berkeley Madonna 8.3.18 and Microsoft Office Excel 2010 software were employed for the model simulation and data management, respectively. The result showed that the simulated result of SEIR model agreed well with the reported data when ß (infected rate) equal to 0.067. Models showed that the cumulative number of cases was only 13 when isolation adopted when the infected individuals were identified (assuming isolation rate was up to 100%); the cumulative number of cases was only two and the TAR (total attack rate) was 0.56% when the vaccination coefficient reached 50%. The cumulative number of cases did not change significantly with the change of efficiency of ventilation and disinfection, but the peak time was delayed; when δ (vaccination coefficient) = 0.1, m (ventilation efficiency) = 0.7 or δ = 0.2, m = 0.5 or δ = 0.3, m = 0.1 or δ = 0.4 and above, the cumulative number of cases would reduce to one case and TAR would reduce to 0.28% with combined interventions. Varicella outbreak in school could be controlled through strict isolation or vaccination singly; combined interventions have been adopted when the vaccination coefficient was low.

Integrative analyses identify a DNA damage repair gene signature for prognosis prediction in lower grade gliomas.

Background: The DNA damage repair (DDR) pathways play important roles for regulating cancer progression and therapeutic response. IDH mutations, well-known prognosis biomarkers for glioma, lead to hypermethylation of tumor cells and affect genes' expression. Whether IDH mutations affect glioma prognosis through influencing the expression of DDR genes remains unclear. Methods: A total of 272 DDR genes were selected for differential expression and survival analysis. The identified genes were then utilized to construct the prognosis predicting model. Results: PARPBP, PLK3, POLL and WEE1 were found differential expressed between IDH mutations carriers and wild-type carriers, and were associated with survival of low grade glioma (LGG) patients. The predicting algorithm can predicts the prognosis of LGG patients. Conclusion: IDH mutations may affect LGG prognosis through regulation of DDR pathways.

The study on the early warning period of varicella outbreaks based on logistic differential equation model.

Chickenpox is a common acute and highly contagious disease in childhood; moreover, there is currently no targeted treatment. Carrying out an early warning on chickenpox plays an important role in taking targeted measures in advance as well as preventing the outbreak of the disease. In recent years, the infectious disease dynamic model has been widely used in the research of various infectious diseases. The logistic differential equation model can well demonstrate the epidemic characteristics of epidemic outbreaks, gives the point at which the early epidemic rate changes from slow to fast. Therefore, our study aims to use the logistic differential equation model to explore the epidemic characteristics and early-warning time of varicella. Meanwhile, the data of varicella cases were collected from first week of 2008 to 52nd week of 2017 in Changsha. Finally, our study found that the logistic model can be well fitted with varicella data, besides the model illustrated that there are two peaks of varicella at each year in Changsha City. One is the peak in summer-autumn corresponding to the 8th-38th week; the other is in winter-spring corresponding to the time from the 38th to the seventh week next year. The 'epidemic acceleration week' average value of summer-autumn and winter-spring are about the 16th week (ranging from the 15th to 17th week) and 45th week (ranging from the 44th to 47th week), respectively. What is more, taking warning measures during the acceleration week, the preventive effect will be delayed; thus, we recommend intervene during recommended warning weeks which are the 15th and 44th weeks instead.

Rare Shewanella spp. associated with pulmonary and bloodstream infections of cancer patients, China: a case report.

BACKGROUND: Members of Shewanella species are opportunistic pathogens that are found in marine environments. Currently more than sixty species have been identified, whereas the most commonly clinical cases associated with Shewanella species have involved only two species, i.e., S. algae and S. putrefaciens. We present two cases of pulmonary and bloodstream infections caused by two rare Shewanella spp. strains from patients of gastrointestinal cancer. CASE PRESENTATION: Two male patients with a history of gastrointestinal cancer presented to hospital with pulmonary and bloodstream infections, respectively. The infective pathogens of both cases were primarily isolated and identified as Shewanella algae (case I) and Shewanella putrefaciens (case II) by phenotypic features and VITEK 2 system, but they were further confirmed as Shewanella haliotis and Shewanella upenei by 16S rRNA gene sequence analysis. The major bacterial composition of the bronchoalveolar lavage in case I was also identified as Shewanella by 16S rRNA amplicon sequencing analysis. Antimicrobial susceptibility testing showed that the two strains had broad susceptibility, but S. haliotis in the case I was resistant to ciprofloxacin and levofloxacin and S. upenei in the case II was intermediate to imipenem, piperacillin/tazobactam and ciprofloxacin. CONCLUSIONS: To the best of our knowledge, this is the first cases of the pulmonary and bloodstream infections caused by Shewanella spp. from clinical patients in mainland China. Shewanella as a potential pathogen in China should not be ignored.

Overexpression of Fn14 in gliomas: tumor progression and poor prognosis.

AIM: To confirm whether the expression level of Fn14 could affect progression or prognosis of glioma patients. METHODS: Glioma cohorts in The Cancer Genome Atlas, Gene Expression Omnibus and Chinese Glioma Genome Atlas databases were comprehensively analyzed. RESULTS: Low-grade patients had lower expression level of Fn14, while patients with higher expression of Fn14 tended to harbor shorter overall survival and disease-free survival. The expression level of Fn14 was downregulated by IDH1/IDH2 mutations while its gene body methylation was upregulated. After adjusting age, the expression level of Fn14 was still significantly associated with overall survival and disease-free survival in low-grade gliomas. In a cell line data analysis, Fn14 expression was positively correlated with temozolomide dosage. CONCLUSION: Fn14 was an independent predictive biomarker for the progression and prognosis in low-grade gliomas.

Factors associated to prevalence and treatment of carbapenem-resistant Enterobacteriaceae infections: a seven years retrospective study in three tertiary care hospitals.

BACKGROUND: The increasing incidence of carbapenem-resistant Enterobacteriaceae (CRE), has resulted in a difficult problem in the current clinical anti-infective treatment. We performed a retrospective analysis of prevalence and treatment for CRE infections patients. METHODS: This study was conducted in three tertiary care hospitals from January 1, 2010 to December 30, 2016. Baseline data, treatment, and outcomes were collected in patients with ventilator-associated bacterial pneumonia (VABP), bacteremia, complicated urinary tract infection (cUTI)/acute pyelonephritis (AP), hospital-acquired bacterial pneumonia (HABP), superficial wound infection (SWI), biliary tract infection (BTI), deep wound infection (DWI) and sterile body fluids infection (SBFI) due to CRE. RESULTS: One hundred twenty-four cases of CRE infection were identified: 31 VABP, 22 bacteremia, 18 cUTI/AP, 16 HABP, 16 SWI, 9 BTI, 7 DWI and 5 SBFI. The patient population had significant immunocompromised (33 of 124, 26.6%) and severe sepsis (43 of 124, 34.7%). The most common CRE pathogens were Klebsiella pneumoniae (84 of 124, 67.7%) and Enterobacter cloacae (24 of 124, 19.4%). And the production of IMP-type carbapenemase was the main antibiotic resistance mechanism. The majority of patients to take monotherapy for empiric therapy and dual therapy for direct treatment. Outcomes were universally poor (28-day mortality was 22.6%, 28 of 124) across all sites of infection. CONCLUSIONS: We identified a large number of cases of CRE infection in 7 years from different parts, most of these pathogens have been confirmed to produce IMP-type carbapenemases. The retrospective analysis of cases of such bacterial infections will help to control future infections of these pathogens. Despite the high mortality rate, we still found that the selection of quinolone antibiotics can be effective in the treatment of CRE producing IMP type enzymes.

Essential genes of the macrophage response to Staphylococcus aureus exposure.

BACKGROUND: Although significant advances have been made in understanding the mechanisms of macrophage response to Staphylococcus aureus infection, the molecular details are still elusive. Identification of the essential genes and biological processes of macrophages that are specifically changed at different durations of S. aureus exposure is of great clinical significance. METHODS: We aimed to identify the significantly changed genes and biological processes of S. aureus-exposed macrophages. We systematically analyzed the macrophage gene expression profile GSE 13670 database with 8 h, 24 h or 48 h S. aureus infection. The results were further confirmed by western blot and quantitative polymerase chain reaction (qPCR) analyses. RESULTS: After 8 h of S. aureus infection, the expression of 624 genes was significantly changed. Six hundred thirteen differentially expressed genes (DEGs) were identified after 24 h of S. aureus infection. Two hundred fifty-three genes were significantly changed after 48 h of S. aureus infection. STAT1 was consistently up-regulated in these three treatments. TP53, JAK2, CEBPA, STAT3, MYC, CTNNB1 and PRKCA were only identified in the 8 h or 24 h S. aureus infection groups. CTNNB1 and PRKCA were for the first time identified as potential essential genes in S. aureus infection of macrophages. In the Gene Ontology (GO) term analysis, the defense response was shown to be the most significantly changed biological process among all processes; KEGG pathway analysis identified the JAK-STAT signaling pathway involved in early infection. CONCLUSIONS: Our systematic analysis identified unique gene expression profiles and specifically changed biological processes of the macrophage response to different S. aureus exposure times.

[Study on genotype and clinical characteristics of infection of carbapenemase-producing Enterobacter cloacae].

OBJECTIVE: To study the genotypes and clinical characteristics of carbapenemase-producing Enterobacter cloacae (E.cloacae), and lay the foundation for active control of nosocomial infection. METHODS: E.cloacae isolates were collected from January 2007 to December 2014. Strains which showed decreased sensitivity to carbapenem were screened out by the modified Hodge test (MHT) and EDTA-disk synergy test. The genotype of blaKPC, blaIMP, blaVIM, blaOXA-48 and blaNDM-1 were detected by PCR amplication, the product of PCR was sequenced and conducted by Blast (http://blast.ncbi.nlm.nih.gov/Blast.cgi). Conjugal transfer experiment was conducted to prove horizontal transmit of carbapenemase gene produced by E.cloacae. Meanwhile, the clinical epidemiological data of patients infected by selected strains were also analyzed. RESULTS: Sixty-four carbapenemase producing E.cloacae were detected by MHT, EDTA-disk synergy test and PCR amplification. Forty-five strains (70.3%) out of 64 strains infection came from nosocomial infection, while 19 strains (29.7%) from the community infection. The strains were mainly isolated from secretions samples and sputum samples, which accounted for 65.6% (42/64) and 23.4% (15/64) separately. The mainly clinical departments were orthopaedics (43.8%), department of burn (21.9%), ICU (18.8%) and pediatrics (14.1%). Bed changing, invasive operation and indwelling catheter were risk factors for the transmission of carbapenemase producing E.cloacae, and infected patients had longer time of staying in hospital, lower cure rate and higher frequency of cephalosporins enzyme inhibitor compound or carbapenem agents administration (all P<0.05). Sixty-four strains showed increased MIC to most of the antibiotics except for polymyxin and tigecycline. Among the 64 strains, 29 strains were genotype blaIMP-4 and 35 strains were genotype blaIMP-8 by Blast alignment, no genotype blaVIM, blaOXA-48 and blaNDM-1 were detected. Result of conjugal transfer experiment showed that receptor strain obtained carbapenem resistance, and the sequence of resistance gene of receptor strain was the same to the donator strain. CONCLUSIONS: The drug resistance of E.cloacae are growing, IMP-4 and IMP-8 carbapenemase are the main enzymes produced by strains. As the resistance gene can horizontal transmit between strains through conjugal transfer system, the strains have been locally spread in hospital departments, thus it is important to control risk factors of transmission timely.

Natural selection and functional diversification of the epidermal growth factor receptor EGFR family in vertebrates.

BACKGROUND: Genes that have been subject to adaptive evolution can produce varying degrees of pathology or differing symptomatology. ErbB family receptor activation will initiate a number of downstream signaling pathways, such as mitogen-activated protein kinase (MAPK), activator of transcription (STAT), the modulation of calcium channels, and so on, all of which lead to aggressive tumor behavior. However, the evolutionary mechanisms operating in the retention of ErbB family genes and the changes in selection pressures are not clear. RESULTS: Sixty-two full-length cDNA sequences from 27 vertebrate species were extracted from the UniProt protein database, NCBI's GenBank and the Ensembl database. The result of phylogenetic analysis showed that the four ErbB family members in vertebrates might be formed by gene duplication. In order to determine the mode of evolution in vertebrates, selection analysis and functional divergence analysis were combined to explain the relationship of the site-specific evolution and functional divergence in the vertebrate ErbB family. Our results indicate that the acceleration of asymmetric evolutionary rates and purifying selection together were the main force for the production of ErbBs, and positive selections were detected in the ErbB family. CONCLUSION: An evolutional phylogeny of 27 vertebrates was presented in our study; the tree showed that the genes have evolved through duplications followed by purifying selection, except for seven sites, which evolved by positive selection. There was one common site with positive selection and functional divergence. In the process of functional differentiation evolving through gene duplication, relaxed selection may play an important part.

Diagnosis of bovine viral diarrhea virus: an overview of currently available methods.

Bovine viral diarrhea virus (BVDV) is the causative agent of bovine viral diarrhea (BVD), which results in significant economic losses in the global cattle industry. Fortunately, various diagnostic methods available for BVDV have been established. They include etiological methods, such as virus isolation (VI); serological methods, such as enzyme-linked immunosorbent assay (ELISA), immunofluorescence assay (IFA), and immunohistochemistry (IHC); molecular methods, such as reverse transcription-polymerase chain reaction (RT-PCR), real-time PCR, digital droplet PCR (ddPCR), loop-mediated isothermal amplification (LAMP), recombinase polymerase amplification (RPA), and CRISPR-Cas system; and biosensors. This review summarizes the current diagnostic methods for BVDV, discussing their advantages and disadvantages, and proposes future perspectives for the diagnosis of BVDV, with the intention of providing valuable guidance for effective diagnosis and control of BVD disease.