Erdheim­Chester disease of multisystem involvement with delayed diagnosis: A case report and literature review.

Erdheim-Chester disease (ECD) is a rare tumor of histiocytic origin, characterized by foamy or lipid-laden histiocytes mixed or surrounded by fibrosis that infiltrate multiple organs. Misdiagnosis is common due to the diversity of clinical presentations. The present study reported a case of ECD with the involvements of bone, cardiac, aorta and retroperitoneum. The patient had no obvious clinical symptoms and no noteworthy foamy histiocytes or Touton giant cells were found on pathological examination, delaying the diagnosis. The patient was a young male found to have pericardial effusion on physical examination, and computed tomography (CT) revealed soft tissue infiltrates in the retroperitoneum and around the aorta. A mediastinal biopsy revealed fibrous connective tissue with small-vessel hyperplasia and acute-chronic inflammatory cell infiltration. The initial diagnosis was retroperitoneal fibrosis (RPF), and hormonal and tamoxifen treatments were administered. The patient presented with oliguria, eyelid edema and fever four years later. A repeat CT revealed an increase in the extent of tissue infiltration and pericardial effusion compared with the previous CT. Subsequent cardiac magnetic resonance imaging revealed massive thickening in the form of fibrotic tissue infiltrating the heart and surrounding thoracic and abdominal aorta. Single photon emission CT revealed multiple areas of increased bone metabolism, particularly symmetrical involvement of the long bones of both lower extremities. A biopsy of the perirenal tissue revealed fibrous tissue and a small number of lymphocytes and macrophages [typical foamy histiocytes observed via x200 magnification and hematoxylin-eosin (HE) staining, no presence of xanthogranuloma or Touton giant cells]. After a comprehensive evaluation and ruling out other diseases, the diagnosis of ECD was determined. The prognosis of this disease is poor; early diagnosis is critical and requires accurate judgment by clinicians. Biopsies of all involved sites and refinement of genetic tests to guide treatment, if possible, are both necessary.

Comparison of characteristics and anti-MDA5 antibody distribution and effect between clinically amyopathic dermatomyositis and classic dermatomyositis: a retrospective case-control study.

Background: Clinically amyopathic dermatomyositis (CADM) is a distinct subtype of dermatomyositis (DM) characterized by typical DM cutaneous findings but with minimal or no evidence of myositis. It possesses unique features different from classic DM (CDM). Anti-melanoma differentiation-associated gene 5 (MDA5) antibodies were found in CADM and are thought to increase the risk of rapidly progressive interstitial lung disease (RP-ILD) and are present in both CADM and CDM patients, affecting their condition and prognosis. Nevertheless, no large-sample studies have compared all aspects concerning patients with CADM and those with CDM. This study aimed to investigate differences in clinical characteristics and risk factors for mortality between CADM and CDM and to clarify the distribution and impact of anti-MDA5 antibodies in patients with these conditions. Methods: A retrospective case-control study included 330 patients and collected and analyzed their clinical data from The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Hospital of Traditional Chinese Medicine between January 2015 and July 2022; all patients were followed up to evaluate changes in their condition and prognosis. Several new cohorts were designed around anti-MDA5 antibodies to explore their distribution and impact in CADM and CDM. Results: We found CADM to be associated with higher rates of mortality, 1-year mortality, interstitial lung disease (ILD), and RP-ILD than CDM. In CADM, RP-ILD, anti-MDA5 antibodies, and high ferritin and lactate dehydrogenase (LDH) levels were identified as independent risk factors for death. In CDM, the neutrophil-to-lymphocyte ratio, anti-MDA5 antibodies, and high ferritin levels were shown to be independent risk factors for death, whereas mechanic's hand was considered a protective factor against it. Anti-MDA5 antibody-positive patients did not exhibit any significant difference based on whether they belonged to the CADM or CDM groups. When no anti-MDA5 antibody-positive patients participated, the ferritin levels and rates of RP-ILD and ILD were still higher in CADM than in CDM; however, such differences decreased, whereas the LDH levels, rates of mortality, and 1-year mortality did not differ. Anti-MDA5 antibody-positive patients consistently showed higher LDH and ferritin levels, lower lymphocyte levels, higher probability of RP-ILD and ILD, and worse prognosis than anti-MDA5 antibody-negative patients, irrespective of whether the patients had DM, CADM, or CDM. Conclusion: Patients with CADM exhibit relatively worse symptoms, serological findings, and prognosis than those with CDM. Furthermore, patients with CADM and those with CDM have commonalities and differences in risk factors for death. Moreover, CADM may necessitate earlier and more aggressive treatment strategies than CDM. Anti-MDA5 antibodies occur at a high level in patients with CADM, not only affecting the symptoms and prognosis of DM but also having a non-negligible impact on the differences between CADM and CDM. Hence, screening for anti-MDA5 antibodies in patients with CADM and CDM is extremely essential.

Bifunctional defect mediated direct Z-scheme g-C3N4-x/Bi2O3-y heterostructures with enhanced piezo-photocatalytic properties for efficient tooth whitening and biofilm eradication.

Biofilm-associated dental diseases and tooth discoloration have recently become the major barriers to achieve healthy teeth. However, there are few effective strategies to address these issues. Herein, the piezo-photocatalytic process is first proposed to be applied for biofilm eradication and tooth whitening with well-designed direct Z scheme g-C3N4-x/Bi2O3-y heterostructures. DFT calculation and XPS results verify the formation of direct Z scheme g-C3N4/Bi2O3 heterostructures theoretically and experimentally. Using the direct Z scheme g-C3N4-x/Bi2O3-y heterostructure, excellent piezo-photocatalytic effects for tooth whitening and biofilm removal are achieved. For piezo-photocatalytic degradation of the typical food colorant of indigo carmine the degradation rate constant is about quadruple that of piezocatalytic and 2.6 times of photocatalytic treatment. Tooth whitening experiments indicate that g-C3N4-x/Bi2O3-y could whiten the stained teeth through the synergistic piezo-photocatalysis. In addition, excellent antibacterial performances can be obtained on the g-C3N4-x/Bi2O3-y heterostructure through piezo-photocatalytic treatment. Not only the planktonic S. mutans but also those bacteria embedded in biofilms can be effectively killed. The analyses of the piezo-photocatalytic mechanism indicates that the enhanced piezo-photocatalytic performance of the g-C3N4-x/Bi2O3-y heterostructure could be attributed to the much higher separation efficiency of photoexcited charge carriers, increased production amounts of ROS and superior adsorption ability for bacteria than those with bare semiconductors of g-C3N4-x and Bi2O3-y and those treated only with ultrasonic vibration or irradiation. Biosafety results show that the g-C3N4-x/Bi2O3-y heterostructure is biologically safe and piezo-photocatalytic treatment has no harm the tooth structure, demonstrating the great potential of piezo-photocatalytic effect based new tooth whitening and antibacterial technology in future dental care fields.

Excessive intake of sugar: An accomplice of inflammation.

High sugar intake has long been recognized as a potential environmental risk factor for increased incidence of many non-communicable diseases, including obesity, cardiovascular disease, metabolic syndrome, and type 2 diabetes (T2D). Dietary sugars are mainly hexoses, including glucose, fructose, sucrose and High Fructose Corn Syrup (HFCS). These sugars are primarily absorbed in the gut as fructose and glucose. The consumption of high sugar beverages and processed foods has increased significantly over the past 30 years. Here, we summarize the effects of consuming high levels of dietary hexose on rheumatoid arthritis (RA), multiple sclerosis (MS), psoriasis, inflammatory bowel disease (IBD) and low-grade chronic inflammation. Based on these reported findings, we emphasize that dietary sugars and mixed processed foods may be a key factor leading to the occurrence and aggravation of inflammation. We concluded that by revealing the roles that excessive intake of hexose has on the regulation of human inflammatory diseases are fundamental questions that need to be solved urgently. Moreover, close attention should also be paid to the combination of high glucose-mediated immune imbalance and tumor development, and strive to make substantial contributions to reverse tumor immune escape.

Exceptional response of skin symptoms to secukinumab treatment in a patient with SAPHO syndrome: Case report and literature review.

RATIONALE: SAPHO syndrome is a rare clinical entity characterized by a wide range of dermatological and musculoskeletal manifestations. Treatment strategies are not standardized. Palmoplantar pustulosis (PPP) is the most common rash in patients with SAPHO syndrome. PATIENT CONCERNS: A 24-year-old Chinese woman with no relevant medical or familial history had a 1-year history of cutaneous lesions with PPP and pain in the sternoclavicular joint. DIAGNOSIS: Based on the diagnostic criteria for SAPHO syndrome proposed by Nguyen et al in 2012, we diagnosed SAPHO syndrome with severe PPP as the predominant manifestation. INTERVENTIONS: Due to the limited therapeutic efficacy of methotrexate and cyclosporin, we started therapy with subcutaneous secukinumab 150 mg weekly for the first month, then 150 mg monthly thereafter. OUTCOMES: After 4 weeks of secukinumab administration, the patient showed significant remission of pustular skin lesions, with almost no joint pain and no adverse reaction. Complete remission of skin symptoms was achieved after 3 months. Joint pain and adverse events have not reoccurred in follow-up thus far. CONCLUSIONS: In patients with SAPHO syndrome, we recommend personalized treatment, which may have excellent therapeutic efficacy in those with PPP or severe skin symptoms. Although data related to the use of IL-17 blockers for SAPHO syndrome are very limited, secukinumab provides a novel therapeutic option, especially for patients with PPP and severe skin lesions. Further prospective studies are needed to support our findings.

Observational studies: Ambient air pollution and hospitalization for RA-ILD in a heavily polluted city in China.

ABSTRACT: Little is known within the medical community about the impact of air pollution on hospital admissions due to rheumatoid arthritis associated with interstitial lung disease (RA-ILD). Our research aimed to explore whether there is a correlation and to estimate how the association was distributed across various lags in Jinan, China.The relationships between ambient air pollutant concentrations, including PM2.5, PM10, sulfur dioxide (SO2), ozone (O3), and nitrogen dioxide (NO2), and monthly hospitalizations for RA-ILD were studied by employing a general linear model with a Poisson distribution. This time-series study was performed from January 1st, 2015 to December 31st, 2019.In the 5-year study, there were 221 hospitalizations for RA-ILD in Jinan city. The levels of PM2.5, PM10, SO2, and NO2 were significantly related to the number of admissions for RA-ILD. PM2.5, PM10, and SO2 showed the most significant effect on the month (lag 0), and NO2 was most related to RA-ILD at a lag of two months (lag 2). The monthly admissions of RA-ILD increased by 0.875% (95% CI: 0.375-1.377%), 0.548% (95% CI: 0.148-0.949%), 1.968% (95% CI: 0.869-3.080%), and 1.534% (95% CI: 0.305-2.778%) for each 10 µg/m3 increase in PM2.5, PM10, SO2 and NO2, respectively.This study might add more detailed evidence that higher levels of PM2.5, PM10, SO2 and NO2 increase the risk of hospitalizations for RA-ILD. Further study of the role of air pollution in the pathogenesis of RA-ILD is warranted.

Stable isotopes reveal intensive pig husbandry practices in the middle Yellow River region by the Yangshao period (7000-5000 BP).

It is well-known that pigs (Sus scrofa) were domesticated very early in Neolithic China, but far less is known about the processes by which pig husbandry intensified so that pork became the most important animal protein for humans are less clear. Here, we explore pig feeding practices using the carbon and nitrogen isotope composition of bone collagen, focusing on developments in pig husbandry during the Yangshao period (7000-5000 BP) in the middle Yellow River region of China, and at the site of Xipo (5800-5000 BP) in particular. The results show that the diets of domestic pigs at Xipo were dominated by millet foods. Comparisons with other Yangshao sites in the region show a trend of increasing millet foddering for pigs throughout the Yangshao period. These results, and comparisons of the isotopic data for pigs against those for humans from the Xipo cemetery (5300-5000 BP), suggest that pigs were closely managed by humans. The evidence points to an intensification of Neolithic pig husbandry in the middle Yellow River region from this period.

MMP-16 as a New Biomarker for Predicting Prognosis and Chemosensitivity of Serous Ovarian Cancer: A Study Based on Bioinformatics Analysis.

OBJECTIVE: To explore the prognostic value of MMP-16 expression in patients with serous ovarian cancer and the usefulness of MMP-16 expression to predict sensitivity to chemoradiotherapy. METHODS: The relationship between MMP-16 expression and clinicopathological parameters of serous ovarian cancer was evaluated in The Cancer Genome Atlas (TCGA) database. Cox proportional hazard regression analysis was performed to measure the prognostic significance of MMP-16 in serous ovarian cancer. Dataset GSE51373 was applied to estimate the difference of MMP-16 expression between chemotherapy-sensitive group and resistant group of serous ovarian cancer. Receiver operating characteristic (ROC) curve was also drawn. In addition, the online tool Kaplan-Meier Plotter was used to assess the prognostic value of MMP-16 in patients with serous ovarian cancer. RESULTS: A total of 235 patients with serous ovarian cancer were included in the TCGA database. Cox regression univariate analysis showed that high expression of MMP-16 was not conducive to the overall survival of patients with serous ovarian cancer (hazard ratio [HR] = 1.47, 95% CI: 1.03~2.08; P < 0.05). The results of Cox regression multivariate analysis also demonstrated that there was a statistically significant difference. The results of the online database Kaplan-Meier Plotter analysis showed that the high expression of MMP-16 was not conducive to the progression-free survival (PFS) of patients with serous ovarian cancer (HR = 1.26, 95% CI: 1.06~1.29; P < 0.05). The expression of MMP-16 in the chemotherapy-sensitive group was notably lower than that in the chemotherapy-resistant group, which had a moderate predictive value in predicting the chemosensitivity of serous ovarian cancer (AUC = 0.7187). CONCLUSION: High expression of MMP-16 is not conducive to chemotherapy sensitivity and survival of patients with serous ovarian cancer, and has predictive value for chemotherapy resistance and prognosis.

Fibrodysplasia ossificans progressiva in a young adult with genetic mutation: Case report.

RATIONALE: Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal dominant disorder characterized by congenital skeletal deformities and soft tissue masses that progress into heterotopic ossification. Deformities of the great toes are distinctive and heterotrophic ossification usually begins in the first decade of the patient's life. Any invasive procedure could potentially trigger a flare and heterotopic calcification. The diagnosis is difficult and there is no effective treatment for FOP and the approximate life expectancy is 4 decades. PATIENT CONCERNS: A 22-year-old male patient who had suffered from pain and movement limitations for 14 years. At the early stage of disease, the child underwent an operation on both thighs with a diagnosis of myophagism. He had serious stiffness and multiple bony masses with the characteristic bilateral hallux valgus deformity and microdactyly. DIAGNOSES: The patient was diagnosed with FOP by the help of characteristic great toe malformations and widespread heterotopic ossification throughout the body. Deoxyribonucleic acid sequencing demonstrated that the patient had a de novo heterozygous mutation (c.617G>A; p.R206H) in activin A receptor/activin-like kinase 2. INTERVENTIONS: We administered a co-therapy of glucocorticoids, NSAIDs to relieve pain, and montelukast for 2 months. Bisphosphonate (5 mg, intravenous) was used once. OUTCOMES: At the follow-up 12 months later, the patient still felt low back pain sometimes and need take NSAIDs three times a week. LESSONS: Clinicians and radiologists should realize the characteristic features of FOP and early diagnosis can prevent additional invasive harm to the patient.

Development and validation of a novel diagnostic model for assessing lung cancer metastasis in a Chinese population based on multicenter real-world data.

BACKGROUND: Accurate disease staging plays an important role in lung cancer's clinical management. However, due to the limitation of the CT scan, it is still an unmet medical need in practice. In the present study, we attempted to develop diagnostic models based on biomarkers and clinical parameters for assessing lung cancer metastasis. METHODS: This study consisted of 799 patients with pulmonary lesions from three regional centers in China. It included 274 benign lesions patients, 326 primary lung cancer patients without metastasis, and 199 advanced lung cancer patients with lymph node or organ metastasis. The patients were divided into nodules group and masses group according to tumor size. RESULTS: Four nomogram models based on patient characteristics and tumor biomarkers were developed and evaluated for patients with nodules and masses, respectively. In patients with pulmonary nodules, the AUC to identify metastatic lung cancer from unidentified nodules (including benign nodules and lung cancer, model 1) reached 0.859 (0.827-0.887, 95% CI). Model 2 was used to predict metastasis in patients with lung cancer with AUC of 0.838 (0.795-0.876, 95% CI). In patients with pulmonary masses, the AUC to identify metastatic lung cancer from unidentified masses (model 3) reached 0.773 (0.717-0.823, 95% CI). Model 4 was used to predict metastasis in patients with lung cancer and AUC reached 0.731 (0.771-0.793, 95% CI). Decision curve analysis corroborated good clinical applicability of the nomograms in predicting metastasis. CONCLUSION: All new models demonstrated promising discrimination, allowing for estimating the risk of lymph node or organ metastasis of lung cancer. Such integration of blood biomarker testing with CT imaging results will be an efficient and effective approach to benefit the accurate staging and treatment of lung cancer.

Development and validation of a novel diagnostic nomogram model based on tumor markers for assessing cancer risk of pulmonary lesions: A multicenter study in Chinese population.

PURPOSE: This study aimed to build a valid diagnostic nomogram for assessing the cancer risk of the pulmonary lesions identified by chest CT. PATIENTS AND METHODS: A total of 691 patients with pulmonary lesions were recruited from three centers in China. The cut-off value for each tumor marker was confirmed by minimum P value method with 1000 bootstrap replications. The nomogram was based on the predictive factors identified by univariate and multivariate analysis. The predictive performance of the nomogram was measured by concordance index and calibrated with 1000 bootstrap samples to decrease the overfit bias. We also evaluated the net benefit of the nomogram via decision curve analysis. Finally, the nomogram was validated externally using a separate cohort of 305 patients enrolled from two additional institutions. RESULTS: The cut-off for CEA, SCC, CYFRA21-1, pro-GRP, and HE4 was 4.8 ng/mL, 1.66 ng/mL, 1.83 ng/mL, 56.55 pg/mL, and 63.24Lpmol/L, respectively. Multivariate logistic regression model (LRM) identified tumor size, CEA, SCC, CYFRA21-1, pro-GRP, and HE4 as independent risk factors for lung cancer. The nomogram based on LRM coefficients showed concordance index of 0.901 (95% CI: 0.842-0.960; P < 0.001) for lung cancer in the training set and 0.713 (95% CI: 0.599-0.827; P < 0.001) in the validation set. Decision curve analysis reported a net benefit of 87.6% at 80% threshold probability superior to the baseline model. CONCLUSION: Our diagnostic nomogram provides a useful tool for assessing the cancer risk of pulmonary lesions identified in CT screening test.

Adoptive Induced Antigen-Specific Treg Cells Reverse Inflammation in Collagen-Induced Arthritis Mouse Model.

Rheumatoid arthritis (RA) is a systemic autoimmune disease that may cause bone damage and worsening disability. Manipulating antigen-specific Treg cells is a promising approach to treat autoimmune disease since the immune suppressive function of Treg cells has the feature of antigen specificity which could avoid overall immune suppression. It has been known that the function of Treg cells is impaired in RA, and adoptive transfer of Treg cells is effective in suppressing RA. Here, we designed a new approach to generate antigen-specific Treg cells by culturing CD4+ T cells from mice with RA onset, and we also proved that the adoptive transfer of these antigen-specific Treg cells reversed the collagen-induced arthritis (CIA) progression by suppressing the key inflammatory cytokine TNF-α. Further analysis showed that the transferred Treg cells were stable in vivo. These findings suggest this novel approach may have clinical applications for treatment of autoimmunity, including RA and other autoimmune disorders.

KILLER CELL IMMUNOGLOBULIN-LIKE RECEPTOR GENES AND THEIR HLA-C LIGANDS IN HASHIMOTO THYROIDITIS IN A CHINESE POPULATION.

OBJECTIVE: Natural killer (NK) cells serve as primary immune surveillance and are partially regulated by combinations of killer immunoglobulin-like receptors (KIR) and their human leukocyte antigen-C (HLA-C) ligands. Alterations in NK cell activity have been associated with Hashimoto thyroiditis (HT). The aim of this study was to determine whether certain KIR/HLA-C genotype combinations play a role in HT pathogenesis. METHODS: The present study enrolled 107 unrelated HT patients and 108 random healthy individuals in a case-control study. Blood was collected for DNA extraction; typing of KIR genes and HLA-C alleles was performed by polymerase chain reaction with sequence specific primers (PCR-SSP), followed by electrophoresis on agarose gels. RESULTS: Among a panel of KIR2D/HLA-C genotype combinations, the frequency of KIR2DS2/HLA-C1 was significantly increased in HT patients compared to controls (33.64% vs. 12.96%, P<.001). To further analyze the precise genotype, we investigated inhibitory or activating KIR/HLA-C gene pairs when their corresponding activating or inhibitory KIR genes were absent in the 2 groups. Only the frequency of KIR2DS2(-)2DL2/3(+)HLA-C1(+) was significantly decreased in HT patients compared to controls (48.60% vs. 70.37%, P = .001). CONCLUSION: Our data suggest that KIR2DS2/HLA-C1 may correlate with HT pathogenesis. On the contrary, the predominance of KIR2DL2/3/HLA-C1 in the absence of KIR2DS2 suggests a potential inhibitory role in HT pathogenesis. In conclusion, our findings may further elucidate the mechanisms underlying the pathogenesis of HT and other autoimmune diseases. ABBREVIATIONS: HLA-C = human leukocyte antigen-C HT = Hashimoto thyroiditis KIR = killer immunoglobulin-like receptor NK = natural killer PCR = polymerase chain reaction.

The aberrant expression of stimulatory and inhibitory killer immunoglobulin-like receptors in NK- and NKT-cells contributes to lupus.

BACKGROUND: Killer cell immunoglobulin-like receptors (KIR) contribute to the pathogenesis of multiple auto-immune diseases via the modulation of NK-, NKT- and T-cells. Thus, we want to know whether the expression pattern of KIR is associated with systemic lupus erythematosus (SLE) susceptibility. METHODS: Here, real-time quantitative PCR and fluorescence-activated cell sorting (FACS) were used to measure the stimulatory KIR (sKIR) and inhibitory KIR (iKIR) mRAN and protein levels on NK-, NKT- and T-cells in both SLE patients and healthy controls. RESULTS: In SLE patients, CD158a/h (KIR2DL1/S1) was highly expressed while CD158b/i/j (KIR2DL2/L3/S2, iKIR/iKIR/sKIR) was lowly expressed in NK- and NKT-cells in patients. The expression levels of KIR2DL1 and KIR2DL2 (iKIRs) were decreased while the expression levels of KIR2DS1 (sKIR) were increased in NK- and NKT-cells in the patients. CONCLUSIONS: We found that SLE patients represent aberrant expression of stimulatory and inhibitory KIRs in NK- and NKT-cells. Consequently, these different expression levels of KIRs may contribute to the abnormal function of these cells, which lead to the risk of SLE.

Diagnostic value of anti-Sa and anticitrullinated protein antibodies in rheumatoid arthritis.

OBJECTIVE: To determine the diagnostic value of anticitrullinated protein antibodies, second generation (ACPA2), by electrochemiluminescent immunoassay (ECLIA) and anti-Sa by ELISA in a large cohort of Chinese patients with early rheumatoid arthritis (RA). METHODS: One hundred ninety-eight patients with early RA (< 1 yr duration), 112 with other rheumatic diseases, and 60 healthy individuals were studied. RESULTS: The combination of anti-Sa and ACPA2 positivity had the highest specificity (99.42%), but it had a rather low sensitivity (50.0%). The combination of anti-rheumatoid factor (RF) and ACPA2 showed the highest sensitivity (80.30%), with specificity of 95.93%. The mean titer of ACPA2 and RF was significantly higher in the anti-Sa-positive group compared to the negative group (ACPA2, p <0.001; RF, p = 0.007). The 28-joint Disease Activity Scores of the anti-Sa-positive patients were significantly higher than those of the negative group (p = 0.01). The anti-Sa had no significant correlation with age, sex, antinuclear antibody, SSA, SSB, erythrocyte sedimentation rate, C-reactive protein, immunoglobulin A (IgA), IgG, IgM, C3, and C4. CONCLUSION: Our results come from a newly developed ECLIA for detection of ACPA2 and the anti-Sa-antibody-based ELISA system. The combined application of ACPA2 and anti-Sa tests can improve the laboratory diagnosis of early RA.

Prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis in Chinese women with genital infectious diseases.

BACKGROUND: Previous studies have confirmed that the presence of Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) increases the risks of various diseases including genital infections in women. Hence, the surveillance policies for the prevalence and antimicrobial susceptibility of UU and MH are important for both the prevention and the treatment of the diseases associated with genital mycoplasmas. AIM: The objective of this study is to investigate the characteristics of UU and MH prevalence and its antimicrobial susceptibility in Chinese women with genital infection. METHODS: By using commercial mycoplasma strips, we investigated the incidence and antimicrobial resistance of UU and MH in 3306 Chinese women with genital infection between January 2005 and December 2009 in Changzhou China. RESULTS: (1) The overall positive incidence of genital mycoplasmas was 62.16%. The most common pattern was UU monoinfection (46.52%), the UU-MH coinfection pattern ranked second (13.91%) and MH monoinfection was lowest (1.71%). According to annual analysis, MH infection revealed an increasing trend between 2005 and 2009. However, a significantly higher infection rate by genital mycoplasmas was found in young women (age range: 16-35 years). (2) Overall, MH susceptibility rates remained high only to doxycycline (DOX), minocycline (MIN) and josamycin (JOS), while UU had high susceptibility rates only to DOX, MIN and clarithromycin (CLA). The resistance rates of UU-MH-mixed isolates to most of drugs were significantly higher than those of UU- or MH-single isolates. CONCLUSIONS: High infection rates and severe drug resistances of genital mycoplasmas were found in Chinese women with genital infections. The laboratory screening and antimicrobial susceptibility testing for genital mycoplasmas is vital to treat the infection.

Estimation of the dynamic spinal forces using a recurrent fuzzy neural network.

Estimation of the dynamic spinal forces from kinematics data is very complicated because it involves the handling of the relationship between kinematic variables and electromyography (EMG) signals, as well as the relationship between EMG signals and the forces. A recurrent fuzzy neural network (RFNN) model is proposed to establish the kinematics-EMG-force relationship and model the dynamics of muscular activities. The EMG signals are used as an intermediate output and are fed back to the input layer. Since EMG is a direct reflection of muscular activities, the feedback of this model has a physical meaning. It expresses the dynamics of muscular activities in a straightforward way and takes advantage from the recurrent property. The trained model can then have the forces predicted directly from kinematic variables while bypassing the costly procedure of measuring EMG signals and avoiding the use of a biomechanics model. A learning algorithm is derived for the RFNN model.

[Evaluation of estrogenic activity for nonylphenol using quantitative real-time RT-PCR method].

It has been demonstrated that nonylphenol (NP) exerts estrogenic activity. Quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) was used to study the VTG-I , VTG-II , CHG-H and CHG-L genes expression in the liver of juvenile medaka exposed to NP at 1, 10, 50, 100 microg/I. for 60 days. The results show that the VTG-I , VTG-II, CHG-H and CHG-L genes expression in the liver of juvenile medaka are induced even at 1 microg/L, significantly. It should be noted that the lowest-observed-effect concentration (LOECs) based on the hepatic vitellogenin (VTG) induction is about 1 microg/L, suggesting that quantitative real-time RT-PCR can detect the estrogenic activity of NP at relatively low concentration, and there is a potential application in evaluating the estrogenic activity of NP in aquatic environment.