[Research progress on detection techniques for effective albumin concentration].

Hypoalbuminemia is one of the important clinical features of decompensated cirrhosis. As the disease progresses, not only does the total albumin concentration decrease, but so does the proportion of albumin that remains structurally and functionally intact. The structural and functional integrity of albumin is essential for its normal physiological role in the body. This led to the concept of "effective albumin concentration," which may be much lower than the total albumin concentration routinely measured clinically in patients with advanced cirrhosis. Liquid chromatography-tandem mass spectrometry, and electron paramagnetic resonance (EMR) are emerging technologies for effective albumin concentration detection, showing promising clinical application prospects, but research in patients with cirrhosis is still in the preliminary stage. Therefore, this article will comprehensively summarize the latest research on the aspects of effective albumin detection methods, liquid chromatography-tandem mass spectrometry, and electron paramagnetic resonance, as well as their applications.

[Genetic variants, circulating levels of monocyte chemoattractant protein-1 with risk of breast cancer: a case-control study and Mendelian randomization analysis].

Objective: To assess the association of genetic polymorphisms and circulating levels of chemokine monocyte chemoattractant protein-1 (MCP1) with risk of breast cancer. Methods: A total of 820 patients with pathologically confirmed breast cancer and 900 age-and area-of-residence-matched healthy controls who visited the hospital for routine health screening during the same period were included in this case-control study. Mendelian randomization analysis was performed using three widely followed functional single nucleotide polymorphisms (SNPs) of the MCP1 gene rs1024611, rs2857656 and rs4586 to construct instrumental variables. Results: MCP1 rs1024611 (OR=1.26, P=0.002), rs2857656 (OR=1.23, P=0.006) and rs4586 (OR=1.23, P=0.003) were significantly associated with increased risk of breast cancer. SNP rs1024611 (ß=1.194, P<0.001), rs2857656 (ß=1.221, P<0.001) and rs4586 (ß=1.137, P<0.001) were positively correlated with higher circulating level of MCP1. The case-control study showed that an increase of 23.7 pg/ml of circulating levels of MCP1 was associated with a 0.25-fold increased risk of breast cancer. MR analysis confirmed that the genetic predicted circulating levels of MCP1 were associated with an increased risk of breast cancer, and the risk of breast cancer increased by 0.20 times with an increase of 23.7 pg/ml in MCP1. Conclusion: Genetic variants and circulating levels of MCP1 are significantly associated with the risk of breast cancer and can be used as a biomarker for early prediction of breast cancer.

[Phenotypes and genotypes of 78 patients with propionic acidemia].

Objective: Propionic acidemia is a rare inherited metabolic disorder caused by propionyl CoA carboxylase (PCC) deficiency. This study aims to analyze the clinical characteristics and gene variations of Chinese patients with propionic acidemia, and to explore the correlation between clinical phenotypes and genotypes. Methods: Single-center, retrospective and observational study. Seventy-eight patients of propionic acidemia (46 males and 32 females) from 20 provinces and autonomous regions were admitted from January 2007 to April 2022. Their age of initial diagnosis ranged from 7 days to 15 years. The clinical manifestations, biochemical and metabolic abnormalities, genetic variations, diagnosis, treatment and outcome were studied. Chi-Square test or Mann-Whitney U test were used for statistical analysis. Results: Among 78 cases, 6 (7.7%) were identified by newborn screening; 72 (92.3%) were clinically diagnosed after onset, and the age of onset was 2 hours after birth to 15 years old; 32 cases had early-onset disease and 40 cases had late-onset disease. The initial manifestations included lethargy, hypotonia, vomiting, feeding difficulties, developmental delay, epilepsy, and coma. Among the 74 cases who accepted gene analysis, 35 (47.3%) had PCCA variants and 39 (52.7%) had PCCB variants. A total of 39 PCCA variants and 32 PCCB variants were detected, among which c.2002G>A and c.229C>T in PCCA and c.838dupC and c.1087T>C in PCCB were the most common variants in this cohort. The variants c.1228C>T and c.1283C>T in PCCB may be related to early-onset type. The variants c.838dupC, c.1127G>T and c.1316A>G in PCCB, and c.2002G>A in PCCA may be related to late-onset disease. Six patients detected by newborn screening and treated at asymptomatic stage developed normal. The clinically diagnosed 72 cases had varied complications. 10 (12.8%) cases of them died. 62 patients improved after metabolic therapy by L-carnitine and diet. Six patients received liver transplantation because of recurrent metabolic crisis. Their clinical symptoms were markedly improved. Conclusion: The clinical manifestations of propionic acidemia are complex and lack of specificity. Newborn screening and high-risk screening are keys for early treatment and better outcome. The correlation between the genotype and phenotype of propionic acidemia is unclear, but certain variants may be associated with early-onset or late-onset propionic acidemia.

[Analysis of respiratory syncytial virus detection outcomes of 973 cases with severe respiratory infection during 2016-2019, Yuhang district of Hangzhou].

This study collected nasopharyngeal swab specimens from severe respiratory infection cases in First People's Hospital of Yuhang District during 2016-2019. Real-time PCR was used to detect respiratory syncytial virus (RSV). Rate of RSV positive detection were analysised in different age groups and different months. A total of 973 nasopharyngeal swab specimens of severe respiratory infection cases were collected, and the total positive rate of nucleic acid test of RSV was 6.47%; The detection rate of nucleic acid in male is higher than that in female, with no statistical differences (P=0.023). The positive rate of nucleic acid test was negatively correlated with age. The positive rate was 15.2% in the group aged 0-1 years and 12% in the group aged 1-2 years. There are obvious seasonal differences in the prevalence of RSV, human are easier to infect RSV in spring and winter.

Emergency management in fever clinic during the outbreak of COVID-19: an experience from Zhuhai.

Coronavirus disease 2019 (COVID-19) is a global health threat. A hospital in Zhuhai adopted several measures in Fever Clinic Management (FCM) to respond to the outbreak of COVID-19. FCM has been proved to be effective in preventing nosocomial cross infection. Faced with the emergency, the hospital undertook creative operational steps in relation to the control and spread of COVID-19, with special focuses on physical and administrative layout of buildings, staff training and preventative procedures. The first operational step was to set up triaging stations at all entrances and then complete a standard and qualified fever clinic, which was isolated from the other buildings within our hospital complex. Secondly, the hospital established its human resource reservation for emergency response and the allocation of human resources to ensure strict and standardised training methods through the hospital for all medical staff and ancillary employees. Thirdly, the hospital divided the fever clinic into partitioned areas and adapted a three-level triaging system. The experiences shared in this paper would be of practical help for the facilities that are encountering or will encounter the challenges of COVID-19, i.e. to prevent nosocomial cross infection among patients and physicians.

[Jiangsu Province Coronary Artery Bypass Grafting Registry study: a report of 4 661 patients in 13 centers].

Objective: To examine the overall status of the Jiangsu Province Coronary Artery Bypass Grafting Registry database. Methods: The patients date of Jiangsu Province Coronary Artery Bypass Grafting Registry database from October 2017 to December 2019 was collected retrospectively.Risk factors, history, cardiac function (New York Heart Association class), extent of coronary artery lesion, European system for cardiac operative risk evaluation Ⅱ (EuroSCORE Ⅱ), cardiopulmonary bypss, arterial grafts, the numbers and flow of grafts and postoperative major adverse cardiac and cerebrovascular event(MACCE) information were analyzed. The clinical data of patients underwent on-pump CABG(ONCABG) or off-pump CABG (OPCAB) were compared by t test or χ(2) test. Results: Up till December 2019, the database enrolled 7 138 patients, in which 4 661 patients receiving primary isolated CABG. There were 3 486 males and 1 175 females with the age of (64.6±8.1) years (range:31 to 87 years). There were coronary left main disease in 960 patients, triple vessel disease in 3 934 patients, both left main and triple vessel disease in 837 patients, ejection fraction>50% in 3 841 patients, cardiac function class Ⅲ to Ⅳ in 1 664 patients. EuroSCORE Ⅱ was (2.3±0.7)% (range: 0.5% to 35.8%). There were 2 731 patients (58.59%) underwent ONCABG and 1 930 patients (41.41%) underwent OPCAB. There were 4 144 patients (88.91%) for whom the left internal thoracic artery was harvested. Seven centers (2 centers routinely) used left radial artery, 5 centers (3 centers routinely) used the transit time flow meter. The graft was 3.4±0.7 (range:1 to 7), the aortic crossclamp time was (65.0±20.4) minutes (range: 21 to 196 minutes), the cardiopulmonary bypass time was (90.0±24.2) minutes (range: 33 to 227 minutes). In-hospital death ocurred in 84 patients(1.80%), while re-operation in 93 patients (2.00%), myocardial infarction in 71 patients (1.52%), cerebral infarction in 33 patients (0.71%) and dialysis in 56 patients (1.20%). There were 2 936 patients prescribed with secondary prevention drugs(62.99%).Comparing with OPCAB group, ONCABG group had younger age, more female, more diabetes mellitus, more history of myocardial infarction and percutaneous transluminal coronary angioplasty, poorer cardiac function and coronary lesions, higher EuroSCORE Ⅱ, preoperatively (all P<0.05), and was associated with higher MACCE (135/2 731 vs. 71/1 930, χ(2)=4.280, P=0.039), and of more grafts, transfusion and intra-aortic balloon counterpulsation application (all P<0.05). Conclusions: Jiangsu Province Coronary Artery Bypass Grafting Registry database is generally in good operation, and some parameters still need to be improved. Comparing with OPCAB group, ONCABG has more severe preoperative general conditions, while the outcomes is acceptable.

Remote sensing image segmentation based on a robust fuzzy C-means algorithm improved by a parallel Lévy grey wolf algorithm.

Due to the insufficient use of local information, the traditional fuzzy C-means (FCM) algorithm and its extension algorithm combined with spatial information show poor robustness and low segmentation accuracy. In addition, in the process of image segmentation based on the FCM algorithm, the initial center estimation is regarded as the process of searching the appropriate value in the gray range. To solve these problems, a new robust algorithm is proposed in this paper. The algorithm searches the optimal initial center by introducing an improved parallel Lévy grey wolf optimization algorithm, which is an improved fuzzy C-means segmentation algorithm that combines local information and adaptive gray weighting. Experimental results infer that both the precision and efficiency of the proposed method are superior to those of the state-of-arts.

MicroRNA-421 inhibits caspase-10 expression and promotes breast cancer progression.

Breast cancer is one of the most prevalent and fatal diseases around the world. The mechanism of tumorigenesis in breast cancer remains to be clarified. miR-421 plays an oncogenic role in many cancers. Although, the clinical significance of miR-421 in patients with breast cancer is still to be investigated. Caspase-10 is one of the initiator of apoptosis. But the relationship between miR-421 and caspase-10 has not been investigated. In the present study, we found that miR-421 was expressed much higher in breast cancer tissues compared to those in adjacent non-tumor tissues. Furthermore, miR-421 promotes cell proliferation and colony formation in vitro. miR-421 inhibits cell apoptosis probably through restraining caspase-10 expression. Thus, miR-421 might be a potential diagnostic maker and therapeutic target for breast cancer.

[The impact of male circumcision on the natural history of genital HPV infection: a prospective cohort study].

Objective: To analyze the correlation between circumcision and incidence and clearance of male genital HPV infection. Methods: From May to July 2014, 18-55 year old men who had sexual behavior history were recruited from the general population in Liuzhou, Guangxi to set up a cohort. Totally, 113 circumcised and 560 uncircumcised men were enrolled and interviewed using a questionnaire (including information on demographic characteristics and sexual behaviors), then they were followed-up with 6-month interval for 2 times. On each visit, specimens of male external genitalia were collected and genotyped for HPV DNA. The differences of incidence and clearance of genital HPV infections between circumcised and uncircumcised men were analyzed by Log-rank test. Cox regression was used to analyze the relationship between circumcision and incidence and clearance of HPV infection. Results: The median age (P(25), P(75)) of circumcised and uncircumcised men were 28 (24, 35) and 32 (24, 31), respectively. The incidences of any HPV infections were 9.1 (95%CI: 2.4-15.7) and 8.4 (95% CI: 5.6-11.2) per 1 000 person-months (χ(2)=0.10, P=0.758), respectively. The clearance of circumcised men [136.3 (95%CI: 70.0-202.7) per 1 000 person-months] was higher than that in uncircumcised men [89.6 (95%CI: 65.9-113.3) per 1 000 person-months] (χ(2)=8.19, P=0.004). In multivariate COX regression analysis, compared with uncircumcised men, circumcised men had higher possibility to clear any HPV infections (HR: 2.41, 95%CI: 1.30-4.46). Compared with men having one sexual partner, people having more than 4 sexual partners had lower possibility to clear any HPV infections (HR: 0.49, 95%CI: 0.25-0.96). Compared with 18-25 years old men, men aged 26-35 years old had higher possibility to clear high-risk HPV infections (HR: 2.14, 95%CI: 1.08-4.23). Conclusion: Circumcised and uncircumcised men had similar incidence of genital HPV infection, whereas, men conducted circumcision and having fewer sexual partners could increase the clearance of genital HPV infections.

A new family of insect muscarinic acetylcholine receptors.

Most currently used insecticides are neurotoxic chemicals that target a limited number of sites and insect cholinergic neurotransmission is the major target. A potential target for insecticide development is the muscarinic acetylcholine receptor (mAChR), which is a metabotropic G-protein-coupled receptor. Insects have A- and B-type mAChRs and the five mammalian mAChRs are close to the A-type. We isolated a cDNA (CG12796) from the fruit fly, Drosophila melanogaster. After heterologous expression in Chinese hamster ovary K1 cells, CG12796 could be activated by acetylcholine [EC50 (half maximal effective concentration), 73 nM] and the mAChR agonist oxotremorine M (EC50 , 48.2 nM) to increase intracellular Ca(2+) levels. Thus, the new mAChR is coupled to Gq/11 but not Gs and Gi/o . The classical mAChR antagonists atropine and scopolamine N-butylbromide at 100 µM completely blocked the acetylcholine-induced responses. The orthologues of CG12796 can also be found in the genomes of other insects, but not in the genomes of the honeybee or parasitoid wasps. Knockdown of CG12796 in the central nervous system had no effect on male courtship behaviours. We suggest that CG12796 represents the first recognized member of a novel mAChR class.

Development of polymorphic SSR markers in the razor clam (Sinonovacula constricta) and cross-species amplification.

Next-generation sequencing provides large-scale sequencing data with relative ease and at a reasonable cost, making it possible to identify a large amount of SSR markers in a timely and cost-effective manner. On the basis of the transcriptome database of Sinonovacula constricta obtained by Illumina/Solexa pyrosequencing, 60 polymorphic SSR markers were developed and characterized in 30 individuals. The number of alleles per polymorphic locus ranged from 2 to 7 with an average of 3.75 alleles. The observed and expected heterozygosities varied from 0.050 to 1.000 and from 0.050 to 0.836, respectively. Nineteen loci significantly deviated from Hardy-Weinberg equilibrium (P < 0.01) after Bonferroni's correction for multiple tests. In addition, interspecific transferability revealed that 20 polymorphic loci in Solen linearis were first characterized in this study. To the best of our knowledge, this is the highest number of SSRs in S. constricta and the first report of cross-species amplification. These novel polymorphic SSR markers will be particularly useful for conservation genetics, evolutionary studies, genetic trait mapping, and marker assisted selection in the species.

Hydroxycamptothecin shows antitumor efficacy on HeLa cells via autophagy activation mediated apoptosis in cervical cancer.

OBJECTIVES: To investigate the effect and the mechanism of anti-tumor agent hydroxycamptothecin (HCPT) on HeLa cells in cervical cancer. MATERIALS AND METHODS: Autophagy and apoptosis were detected by western blotting and the transfection of GFP-LC3 shRNA as well as Hoechst staining. RESULTS: The authors found that the expression of the regulators of Beclin-1, p62, and microtubule-associated protein 1 light chain 3 (LC3) upregulated and then triggered the occurrence of cell autophagy. On the other hand, HCPT could induce to the formation of autophagy and resulted in cell apoptosis after autophagy. CONCLUSION: HCPT can alter cell autophagy and then trigger cell apoptosis to achieve antitumor effects.

[Effect of lumbar dorsal muscle injuries on lumbar vertebral bone quality of rat].

Objective: To explored the effects of lumbar dorsal muscle damage on local lumbar vertebral bone quality. Methods: Thirty SD female rats, at age of 20 weeks, were randomly divided into three groups: control group, or say pseudo surgery group, an incision in the back were performed as CNT; bilateral erector spinal muscle group in which group bilateral lumbar erector spinal muscle were removed as RESM; castration group in which bilateral ovaries were resected as OVX.After three months, bone mineral density, microscopic CT and vertebral compression test were taken in lumbar vertebral (L4-6) in turn. Results: After three months bone mineral density in RESM group was obviously lower than the control group [(0.211±0.028) g/cm2 vs(0.253±0.021) g/cm2, P<0.01], however, there was no significant difference between OVX and RESM[(0.197±0.015) g/cm2 vs(0.211±0.028) g/cm2, P>0.05]. In microscopic CT three-dimensional reconstruction and bone histomorphometry analysis, compared with control group CNT , in the experimental groups OVX and RESM, bone trabecula of vertebral bodies were more sparse, the overall number and interconnection of trabecula were less.Especially in the OVX, osteoporotic trend of trabecular network trend is more obvious.In vertebral compression test, the maximum load, energy absorption, the maximum stress and elastic modulus in both OVX and RESM were significantly reduced (P<0.01). In the RESM the above four biomechanical parameters were significantly higher than those of OVX (P<0.05). Conclusion: Integrity and vigor of paravertebral muscles would be of great significance to maintain adjacent vertebral bone quality.Resection of lumbar dorsal muscles could lead to a significant decrease of local vertebral bone quality.Damage and atrophy of lumbar dorsal muscle could cause osteoporosis of vertebral bodies.

[Stereotactic brain biopsy guided by iMRI co-registration combined with PET/CT].

OBJECTIVE: To explore the clinical value of intraoperative magnetic resonance imaging (iMRI) coregistration combined with position emission tomography/computed tomography (PET/CT) in stereotactic brain biopsy. METHODS: Forty nine patients with intracranial lesions were operated by stereotactic biopsy from June 2010 to June 2015 in Tianjin Medical University General Hospital. Seventeen patient's operation was guided by iMRI only (group A), thirty two patients' operation was guided by iMRI and PET/CT (group B). The diagnosis success rate and operation related complications were compared between the two groups. RESULTS: PET/CT and iMRI were integrated successfully in all cases of group B. Fourteen patients (82.4%) of group A and all 32 patients (100%) of group B had final diagnosis confirmed by histopathological and immunohistochemical observation. The diagnosis success rate of group B was higher than group A (P<0.05). There were 5 patients in total who had postoperative complication, 2 (11.8%) in group A and 3 (9.3%) in group B, but the difference was not statistically significant. CONCLUSIONS: PET/CT based metabolic imaging can be automatically integrated with standard MRI guided stereotactic biopsy. Compared with iMRI only, the combined treatment improves diagnosis success rate without increasing complications; it's safe, and has high clinical efficacy.

[Analysis for protection rate and antibody levels of epidemic cerebrospinal meningitis among children aged between 3-23 months in Liuzhou, in 2012].

Objective: To understand the level of bactericidal antibodies against Neisseria meningitidis and their rate of protection in children aged between 3 and 23 months, in Liuzhou, in 2012. Methods: Convenience sampling was performed in Liujiang, Rong'an and Sanjiang Counties from May through August, 2012. The inclusion criteria for 603 subjects were: Children aged between 3 and 23 months; no history of meningococcal meningitis; no vaccination against Neisseria meningitidis serogroup C; more than 30 days from the last vaccination against Neisseria meningitidis serogroup A. Demographic information and immunization history of the subjects were obtained using questionnaires. Venous blood samples (2.0 ml each) were collected and levels of Neisseria meningitides antibodies determined using a Serum Bactericidal Assay (SBA). The geometric mean titer (GMT) of serum bacterial antibodies was positive when it was greater than or equal to 1∶2 and protective when greater than 1∶8. Chi-square and Fisher's exact tests were used to compare differences in the positive and protective rates of serum antibodies of Neisseria meningitidis serogroup A and Neisseria meningitidis serogroup C, among children with different demographic characteristics. Kruskal-Wallis H test was used to compare differences in the GMT of serum antibodies of Neisseria meningitidis serogroup A and Neisseria meningitidis serogroup C, among children with different demographic characteristics. Results: Of 603 subjects, 325 (53.9%) were female and 278 (46.1%) were male; 276 (45.8%), 143 (23.7%) and 184 (30.5%) subjects were administered, respectively, no treatment, 1 dose vaccine and 2 doses vaccine. The GMT of serum antibodies against group A Neisseria meningitidis was 1∶1.11, the positive rate was 7.6% (46) and the protective rate was 2.0% (12). The GMT of antibodies in children receiving 1 vaccine dose was 1∶1.16 and the protective rate was 3.5% (5), both values higher than those in children receiving 2 vaccine doses (GMT: 1∶1.2, protective rate: 3.5% (5)). However, these differences were not statistically significant (GMT: H=0.64, P=0.728; protective rate: Fisher's exact test, P= 0.080). The GMT of antibodies in children receiving 1 and 2 doses of meningococcal polysaccharide vaccines were 1∶1.12 and 1∶2.30, respectively (≤180 d). The GMT of serum antibodies for group C meningococcal vaccine was 1∶1.18 and its positive and protective rates were 14.6% (88) and 2.2% (13), respectively. Conclusion: Children aged between 3 and 23 months are susceptible to Neisseria meningitidis groups A and C. The immune effectiveness of group A meningococcal polysaccharide vaccine is relatively poor in this age group and their antibody levels decreased rapidly.

[Clinic analysis of femtosecond laser-assisted cataract surgery].

OBJECTIVE: To evaluate the safety and effectiveness of femtosecond laser-assisted cataract surgery. METHODS: The interventional case series enrolled 314 eyes undergoing cataract surgery in Xiamen Ophthalmic Center between April and December 2013, patients were randomized to femtosecond laser-assisted cataract surgery(153 eyes) and conventional phacoemulsification cataract surgery(161 eyes). The clincic parameters of preoperation, during operation and postoperation were compared and statistically studied. Quantitative data were analyzed using the analysis of variance, independent t tests. Qualitative datawere analyzed using the crosstabs analysis chi-square test or the Fisher's exact test. RESULTS: The patient's demographics parameters(age, gender, IOP, axial length, mean keratometry, AC depth, Cataract grade) did not differ significantly between groups (P>0.05) . The CDE showing 4.78% (3.18%-8.88%) and EPT showing 14.05 s (10.07-20.85 s) in the laser group were significantly lower than the CDE showing 8.82% (6.01%-19.16%) and EPT showing 23.65 s (18.36-46.96 s) in the conventional group (z=2.30, 2.91; P<0.05) . The relative diameter and circularity in laser-assisted capusulotomies were significantly more accurate (t=2.58, 3.92; P<0.05). The corneal endothelial cell loss showing 73.50 (-69.51-111.03)/mm(2) was significantly lower in the laser group than the loss of 118.06 (53.55-299.03)/mm(2) in the conventional group 1 month postoperatively (z=2.44; P<0.05). Postoperative anterial chamber flare was significantly greater in the conventional group at 1 day of 18.81 (13.32-20.23) ph/ms in laser group, 24.51(16.38-32.18)ph/m in conventional group and at 1 month of 13.01(9.23-16.28) ph/ms in laser group, 18.05(12.37-24.97) ph/ms in conventional group than the laser group (z=2.40, 2.31; P<0.05). There were no severe surgical complications for both groups. CONCLUSIONS: The femtosecond laser-assisted cataract surgery was effective and safe. It reduced EPT and CDE during operation, therefore decreased endothelial damage and postoperative anterior chamber inflammation. It also provided more precise and reproducible capsulotomies.

Effect of siRNA targeting HER2/neu on the proliferation and viability of prostate cancer PC-3M cells.

The aim of this study was to investigate the effect of a small interfering RNA (siRNA) targeting human epidermal growth factor receptor 2 (HER2/neu) on the proliferation and viability of prostate cancer PC-3M cells. Chemically synthesized siRNA targeting HER2/neu was transfected into PC-3M cells by using liposomes, and cells transfected with empty liposomes, a negative siRNA sequence, or nothing (untransfected) were used as controls. mRNA and protein levels of HER2/neu were detected using reverse transcription-polymerase chain reaction and western blot, respectively. The inhibitory action of HER2/neu siRNA on the in vitro growth of PC-3M cells was assessed by the cholecystokinin 8 assay and apoptosis was detected using flow cytometry. Cells transfected with HER2/neu siRNA showed decreased mRNA and protein levels of HER2/neu compared to control groups (P < 0.05). The survival rate of PC-3M cells decreased significantly after transfection with HER2/neu siRNA compared to that of untransfected cells (55.39 ± 1.60 and 81.42 ± 0.80%, respectively; P < 0.05). The apoptosis rate in cells transfected with HER2/neu siRNA was quite high (45.60 ± 0.70%) compared to that of blank control, empty liposome, and negative siRNA sequence groups (P < 0.05). In conclusion, siRNA targeting HER2/neu inhibits HER2/neu expression in PC-3M cells, resulting in an inhibition in proliferation and an induction of apoptosis.

Effect of Repeated Recruitment Manoeuvres on Patients with Severe Acute Respiratory Distress Syndrome.

OBJECTIVE: The study aimed to evaluate the influence of repeated recruitment manoeuvres (RRMs) on lung injury in patients with acute respiratory distress syndrome (ARDS). METHODS: Forty-one ventilated patients with severe ARDS were selected for this study. Recruitment manoeuvres (RMs) were conducted with continuous positive airway pressure (CPAP; 30 cm H2O for 40 seconds). Recruitment manoeuvres were repeated every two hours for all three groups. Changes in haemodynamics, pulmonary compliance, gas exchange and extravascular lung water index (EVLWI) were monitored before RM (pre-RM), 10 minutes after each RM, and four hours after RM3 (4 hours post-RRM). Pulmonary inflammatory factors (tumour necrosis factor-alpha [TNF-α] and interleukin [IL]-6 and -10) were also analysed. RESULTS: Compared with those in pre-RM, pulmonary compliance, oxygenation index (ratio of partial pressure of arterial oxygen to fraction of inspired oxygen [PaO2/FiO2]) and EVLWI remarkably improved in RM1, RM2, RM3 and 4 hours post-RRM (p < 0.05). The PaO2/FiO2 ratio increased significantly in RM1 and RM3 (p < 0.05). Extravascular lung water index decreased significantly in RM1 compared with that in RM3 and 4 hours post-RRM (p < 0.05). There was no significant difference in cytokines. CONCLUSION: Repeated recruitment manoeuvres during lung-protected ventilation can improve pulmonary compliance and oxygenation and significantly decrease extravascular lung water in ARDS patients. Lung injury was not worsened by RRMs in patients with severe ARDS.

[Analysis of 9 patients with adolescence-onset methylenetetrahydrofolate reductase deficiency].

Objective: To explore the diagnosis and treatment of adolescence-onset methylenetetrahydrofolate reductase (MTHFR) deficiency. Methods: This was a retrospective case study. Nine patients with adolescence-onset MTHFR deficiency were diagnosed at Peking University First Hospital from January 2016 to December 2022, and followed up for more than 1 year. Their general information, clinical manifestations, laboratory tests, cranial images, MTHFR gene variants, diagnosis, treatment, and outcome were analyzed retrospectively. Results: The 9 patients came from 8 families. They had symptoms at age of 8.0 years to 17.0 years and diagnosed at 9.0 years to 17.5 years. Eight were male and 1 was female. Two patients were brothers, the elder brother developed abnormal gait at 17.0 years; and the younger brother was then diagnosed at 15.0 years of age and treated at the asymptomatic stage, who was 18.0 years old with normal condition during this study. The main manifestations of the 8 symptomatic patients included progressive dyskinesia and spastic paralysis of the lower limbs, with or without intellectual decline, cognitive impairment and behavioral abnormalities. Totally, 15 variants of MTHFR gene were identified in the 9 patients, including 8 novel variants. Five patients had brain image abnormalities. Increased plasma total homocysteine level (65-221 µmol/L) was found in all patients, and decreased to 20-70 µmol/L after treatment with betaine and calcium folinate. Besides, the 8 symptomatic patients had their behavior and cognitive problems significantly improved, with a legacy of lower limb motor disorders. Conclusions: Late-onset MTHFR deficiency can occur in adolescence. The diagnosis is usually delayed because of non-specific clinical symptoms. The test of blood total homocysteine could be used as a selective screening test. Eight novel varients of MTHFR gene were identified. Timely treatment can improve clinical condition significantly, and pre-symptomatic treatment may prevent brain damage.