Protective efficacy of Toxoplasma gondii GRA12 or GRA7 recombinant proteins encapsulated in PLGA nanoparticles against acute Toxoplasma gondii infection in mice.

Background: Toxoplasma gondii is an apicomplexan parasite that affects the health of humans and livestock, and an effective vaccine is urgently required. Nanoparticles can modulate and improve cellular and humoral immune responses. Methods: In the current study, poly (D, L-lactic-co-glycolic acid) (PLGA) nanoparticles were used as a delivery system for the T. gondii dense granule antigens GRA12 and GRA7. BALB/c mice were injected with the vaccines and protective efficacy was evaluated. Results: Mice immunized with PLGA+GRA12 exhibited significantly higher IgG, and a noticeable predominance of IgG2a over IgG1 was also observed. There was a 1.5-fold higher level of lymphocyte proliferation in PLGA+GRA12-injected mice compared to Alum+GRA12-immunized mice. Higher levels of IFN-g and IL-10 and a lower level of IL-4 were detected, indicating that Th1 and Th2 immune responses were induced but the predominant response was Th1. There were no significant differences between Alum+GRA7-immunized and PLGA+GRA7-immunized groups. Immunization with these four vaccines resulted in significantly reduced parasite loads, but they were lowest in PLGA+GRA12-immunized mice. The survival times of mice immunized with PLGA+GRA12 were also significantly longer than those of mice in the other vaccinated groups. Conclusion: The current study indicated that T. gondii GRA12 recombinant protein encapsulated in PLGA nanoparticles is a promising vaccine against acute toxoplasmosis, but PLGA is almost useless for enhancing the immune response induced by T. gondii GRA7 recombinant protein.

Dominant infection of Cryptosporidium baileyi in broiler chickens in Zhejiang Province, China.

Cryptosporidium is a common enteric parasite in chickens. A total of 812 fecal specimens were collected from 11 broiler farms in Zhejiang Province, China, and analyzed by nested PCR amplification based on the small subunit ribosomal RNA (SSU rRNA) gene. The overall infection rate of Cryptosporidium was 6.3% (51/812), and five of 11 farms were Cryptosporidium positive. Broilers aged > 90 days accounted for the highest infection rate of 16.1% (6/56), followed by those aged 30-60 days (10.6%, 38/358) and 60-90 days (4/378, 1.1%). Two Cryptosporidium species were identified by sequence analysis, with the predominant species being C. baileyi (96.1%, 49/51) and the minor infection being C. meleagridis (3.9%, 2/51). Based on the 60-kDa glycoprotein (gp60) gene, two C. meleagridis-positive isolates were identified as one known subtype, IIIbA24G1R1. This study indicated the common occurrence of C. baileyi in broiler chickens in this region and low zoonotic transmission potential of Cryptosporidium to humans.

Genetic characterization of Cryptosporidium spp. in Hotan Black Chickens in China reveals two novel subtypes of Cryptosporidium meleagridis.

A total of 617 fecal specimens were collected on 18 Hotan Black chicken farms in Southern Xinjiang, China, and tested for the presence of Cryptosporidium spp. by PCR of the small subunit ribosomal RNA (SSU rRNA) gene. The overall infection rate by Cryptosporidium spp. was 11.5% (71/617), and ten of the 18 farms were positive. The infection rate by Cryptosporidium spp. was 14.5% (48/331) in the 30-60 d group, higher than chickens in the <30 d (12.0%, 15/125), 60-90 d (6.9%, 5/72), and >90 d (3.4%, 3/89) groups. Cryptosporidium meleagridis (n = 38) and C. baileyi (n = 33) were confirmed by sequencing analysis. A total of 25 of the 38 C. meleagridis-positive specimens were subtyped successfully at the gp60 gene, including one known subtype (IIIbA23G1R1, n = 1) and two novel subtypes, named IIIbA25G1R1 (n = 20) and IIIbA31G1R1 (n = 4). The results showed that infection by Cryptosporidium spp. in Hotan Black Chickens was common in this area and the distribution of C. meleagridis subtypes had regional characteristics.

Title: La caractérisation génétique de Cryptosporidium spp. chez les poulets noirs du Hotan en Chine révèle deux nouveaux sous-types de Cryptosporidium meleagridis. Abstract: Un total de 617 échantillons fécaux ont été prélevés dans 18 élevages de poulets noirs du Hotan dans le sud du Xinjiang, en Chine, et testés pour la présence de Cryptosporidium spp. par PCR du gène de la petite sous-unité de l'ARN ribosomique (ARNr SSU). Le taux d'infection global par Cryptosporidium spp. était de 11,5 % (71/617) et dix des 18 élevages étaient positifs. Le taux d'infection de Cryptosporidium spp. était de 14,5 % (48/331) dans le groupe 30­60 jours, supérieur à celui des poulets dans les groupes <30 jours (12,0 %, 15/125), 60­90 jours (6,9 %, 5/72) et >90 jours (3,4 %, 3/89). Cryptosporidium meleagridis (n = 38) et C. baileyi (n = 33) ont été confirmés par analyse de séquençage. Vingt-cinq des 38 spécimens positifs pour C. meleagridis ont été sous-typés avec succès au niveau du gène gp60, dont un sous-type connu (IIIbA23G1R1, n = 1) et deux nouveaux sous-types, nommés IIIbA25G1R1 (n = 20) et IIIbA31G1R1 (n = 4). Les résultats ont montré que l'infection par Cryptosporidium spp. chez les poulets noirs du Hotan était commune dans cette zone et que la distribution des sous-types de C. meleagridis avait des caractéristiques régionales.

Selective reduction of nitrite to nitrogen by polyaniline-carbon nanotubes composite at neutral pH.

The selective reduction of nitrite (NO2-) to nitrogen by chemical reductant is a desirable strategy to remove NO2- from polluted water and wastewater. However, the residue and reuse of chemical reductant are two main issues to be addressed. Herein, a novel polyaniline-carbon nanotubes composite (PANI-CNTs) was developed by in-situ polymerization to selectively reduce NO2- to nitrogen gas (N2). The used PANI-CNTs could be reused after regeneration with NaBH4. The PANI-CNTs could reduce NO2- with 93.9% N2 selectivity at initial pH of 6.8. The NO2- removal efficiency only decreased by 12.08% after five cycles of reduction/regeneration. The interconversion between imine nitrogen (-N) and amine nitrogen (-NH-) groups induced the chemical reduction of NO2- and regeneration of PANI-CNTs. PANI-CNTs exhibited an excellent performance for the removal of NO2- in the presence of competitive ions and in actual water and wastewater samples. This new PANI-CNTs composite may have great potential for water purification and wastewater denitrification.

Molecular characterization of Cryptosporidium spp. and Giardia duodenalis in pet dogs in Xinjiang, China.

Cryptosporidium spp. and Giardia duodenalis are opportunistic zoonotic protozoa transmitted through several routes. In this study, a total of 604 fecal samples were collected from pet dogs in Xinjiang, China to detect the presence of Cryptosporidium spp. and G. duodenalis by PCR amplification of the small subunit (SSU) rRNA gene. The incidence rate of Cryptosporidium spp. or G. duodenalis was 5.3% (32/604). Among the collection sites, a higher number of Cryptosporidium spp. or G. duodenalis positive dogs were detected in Hotan (9.9%, 21/213) and Shihezi (9.8%, 4/41) were higher than those in Aksu (4.5%, 1/22), Urumqi (2.1%, 4/191), and Korla (1.5%, 2/137). Among the sources, dogs in pet shops (7.4%, 19/256) showed a significantly higher incidence rate than those in pet hospitals (3.0%, 4/134) and pet kennels (2.3%, 5/214). When the data were examined by age, dogs < 1 year of age (6.1%, 28/459) were more likely to be infected by Cryptosporidium spp. or G. duodenalis than older (≥ 1 year) dogs (2.8%, 4/145). No significant differences were observed when animals were grouped by sex (5.0%, 14/278 for males; 5.5%, 18/326 for females). Sequence analysis revealed that the Cryptosporidium spp. (n = 10) in dogs were identified as C. canis. The G. duodenalis detected belonged to assemblages A (n = 1), C (n = 14), and D (n = 7). Among the identified 22 G. duodenalis isolates, eight samples were subtyped according to ß-giardin (bg) and the results were consistent with the identified assemblages. To our knowledge, this is the first report of Cryptosporidium spp. and G. duodenalis infections in domesticated canines in Xinjiang, China. The C. canis and G. duodenalis assemblage A identified in pet dogs in the present study were previously associated with infections in humans, indicating the potential for zoonotic transmission.

Selective reduction of nitrate to nitrogen by Fe0-Cu0-CuFe2O4 composite coupled with carbon dioxide anion radical under UV irradiation.

Zero-valent iron (Fe0) has been widely used for the reduction of nitrate, but the end reduction product is mainly ammonium. Here, a novel strategy for selective reduction of nitrate (NO3-) to nitrogen gas (N2) with high efficiency and N2 selectivity was investigated using Fe-based material (Fe0-Cu0-CuFe2O4) combined with citric acid (CA) and ultraviolet (UV) irradiation. In this strategy, the nitrate was firstly reduced to nitrite (NO2-) by Fe0-Cu0-CuFe2O4/UV process, and then the produced NO2- could be further reduced to N2 by carbon dioxide anion radicals (CO2•-) which was generated from CA that was added later. In this process, the selective reduction of NO3- to NO2- was a key step. For this purpose, we synthesized Fe0-Cu0-CuFe2O4 composite by simple chemical replacement and in-situ growth process, which made it have a delicate structure with good contact between Cu and Fe and CuFe2O4. The selective reduction of NO3- to NO2- in Fe0-Cu0-CuFe2O4/UV process was due to that the Cu0 was the electron enrichment center and the photo-generated hole could suppress the NO3- reduction to NH4+ by Fe2+. In this proposed strategy, 100% NO3- removal efficiency and 96.3% N2 selectivity were achieved when the initial NO3- concentration was 30 mg N/L and the reduction time was 60 min. The denitrification mechanism of the Fe0-Cu0-CuFe2O4/UV/CA system was proposed.

Selective reduction of nitrite to nitrogen gas by CO2 anion radical from the activation of oxalate.

Nitrite (NO2-) reduction by carbon dioxide anion radical (CO2•-) from the activation of small molecule carboxylic acid was investigated to selectively reduce nitrite to nitrogen gas (N2). However, the CO2•- generation efficiency from the activation of small molecule carboxylic acid needs to be enhanced to increase the NO2- reduction efficiency. In this study, a novel and promising process for selective NO2- reduction was proposed based on activation of oxalic acid (OA) by UV radiation coupled with Fe3+. In Fe(III)/OA/UV system, the activation of OA by photo-induced electron transfer process of Fe(III)-oxalate complex and by •OH radical from the photolysis of Fe3+ or NO2- could promote the generation of CO2•- radical, which enhanced the NO2- reduction. The 100% removal efficiency of NO2-, 94.72% of total nitrogen (TN) and 94.72% of selectivity for N2 were achieved in Fe(III)/OA/UV/NO2- system, at the Fe3+ dosage of 8 mmol/L, initial pH of 1.70, OA dosage of 16 mmol/L, initial NO2- concentration of 30 mg N/L, and reaction time of 180 min. CO2•- radical played a significant role in the reduction of NO2- by Fe(III)/OA/UV system based on the inhibition experiments in which methyl violet was used as a quenching agent of CO2•- radical. Based on the results from batch experiments and FTIR analysis, the activation mechanism of OA and selective reduction mechanism of NO2- in Fe(III)/OA/UV system was proposed.

A novel CNTs-Fe3O4 synthetized via a ball-milling strategy as efficient fenton-like catalyst for degradation of sulfonamides.

A novel composite (CNTs-Fe3O4) was synthesized by a ball-milling strategy and characterized by BET, SEM, FTIR, XRD and VSM. The as-fabricated CNTs-Fe3O4 was used to remove six sulfonamides by a Fenton degradation process, including sulfanilamide (SAM), sulfamerazine (SMR), sulfadimethoxine (SMX), sulfadiazine (SDZ), sulfamethazine (SMT) and sulfametoxydiazine (SMD). The degradation behaviors of six sulfonamides in CNTs-Fe3O4/H2O2 system and the relationship between molecular structure of sulfonamides and their degradation behaviors were investigated systematically. Batch experimental results showed that the as-fabricated CNTs-Fe3O4 had excellent Fenton catalytic activity for the degradation of sulfonamides due to its unique porous structure and the good combination mode of CNTs with Fe3O4 particles. The first-order kinetic mode could better describe the degradation behaviors of six sulfonamides in CNTs-Fe3O4/H2O2 system, and the degradation rate constant could be ordered as: SAM < SMT < SDZ < SMR < SMD < SMX. The quantitative relationship between the Mulliken charge of sulfonamides (x) and their degradation rate constant (y) in CNTs-Fe3O4/H2O2 system could be described as: y = - 28.719x + 15.67 (R2 = 0.957). Finally, the possible synthesis mechanisms of CNTs-Fe3O4 and the degradation mechanisms of sulfonamides in CNTs-Fe3O4/H2O2 system was proposed.

R-wave peak time at lead II in Chinese healthy adults.

BACKGROUND: Wide QRS complex tachycardia (WCT) is a common arrhythmia. How to differentiate between WCTs is a challenge in clinical practice. Recently R-wave peak time (RWPT) at lead II was reported to be a helpful and simple tool for differentiating WCTs. However, it has remained unknown about the reference range of RWPT at lead II. In present study, we aimed to investigate the reference range of RWPT at lead II in Chinese healthy adults. METHODS: A retrospective study was conducted in the First Affiliated Hospital of Shantou University Medical College in Southern China. Two thousand four hundred healthy adults aged 21-80 years with no history of structural heart diseases were included. RWPT at lead II was determined. RESULTS: Of 2400 healthy adults, 1200 men and 1200 women were included. The differences of age, mean heart rate and mean QRS duration at lead II between male and female were not significant. RWPT ranged from 16 to 42 ms in male while from 16 to 44 ms in female. The 95 % reference range of RWPT in normal male and female are 19.91 ~ 39.55 ms and 21.75 ~ 37.67 ms, respectively. Compared with the female, the male had a significantly longer RWPT at lead II (29.73 ± 5.01 ms vs 29.71 ± 4.06 ms in female, P = 0.000). CONCLUSION: Our study showed that RWPT at lead II is different between male and female. The male had a significantly longer RWPT at lead II than the female.

[Five-case report for transvenous epicardial pacemaker implantation via coronary sinus in patients after prosthetic tricuspid valve replacement].

Five patients after prosthetic tricuspid valve, who received pacemaker implantation via coronary sinus during Oct, 2011 and Jul, 2014, were enrolled. Pacemakers were implanted via coronary vein in 5 patients without complications. The stimulation thresholds keep stable and symptoms (such as short breath and fatigue) were disappeared during the follow-up. For patients after tricuspid valve replacement, implantation of pacemaker via coronary sinus provides a safe and invasive approach and avoids opening the chest again.

Rice stripe virus affects the viability of its vector offspring by changing developmental gene expression in embryos.

Plant viruses may affect the viability and development process of their herbivore vectors. Small brown planthopper (SBPH) is main vector of Rice stripe virus (RSV), which causes serious rice stripe disease. Here, we reported the effects of RSV on SBPH offspring by crossing experiments between viruliferous and non-viruliferous strains. The life parameters of offspring from different cross combinations were compared. The hatchability of F1 progeny from viruliferous parents decreased significantly, and viruliferous rate was completely controlled by viruliferous maternal parent. To better elucidate the underlying biological mechanisms, the morphology of eggs, viral propagation and distribution in the eggs and expression profile of embryonic development genes were investigated. The results indicated that RSV replicated and accumulated in SBPH eggs resulting in developmental stunt or delay of partial eggs; in addition, RSV was only able to infect ovum but not sperm. According to the expression profile, expression of 13 developmental genes was regulated in the eggs from viruliferous parents, in which two important regulatory genes (Ls-Dorsal and Ls-CPO) were most significantly down-regulated. In general, RSV exerts an adverse effect on SBPH, which is unfavourable for the expansion of viruliferous populations. The viewpoint is also supported by systematic monitoring of SBPH viruliferous rate.

Comparative proteomics analysis of superior and inferior spikelets in hybrid rice during grain filling and response of inferior spikelets to drought stress using isobaric tags for relative and absolute quantification.

The biological functions of the differentially abundant proteins between superior and inferior spikelet grains were investigated based on the isobaric tags for relative and absolute quantification to further clarify the mechanism of rice grain filling at the proteomic level, as well as the response of inferior spikelets to drought dress (-20kPa or -40kPa). Compared with superior spikelets, inferior ones had lower sink strength due to the lower sink activities (lower abundances of ADP-glucose pyrophosphorylase, granule-bound starch synthase, starch branching enzyme and pullulanase) and smaller sink sizes (lower abundances of structural proteins). The slower and later grain filling resulted from the weaker decomposition and conversion of photoassimilate and the slower cell division. Moderate drought stress (-20kPa) promoted the grain filling of inferior spikelets through regulating the proteins associated with photoassimilate supply and conversion. These proteins may be important targets for rice breeding programs that raise the rice yield under drought condition. The findings offer new insights into rice grain-filling and provide theoretical evidences for better quality control and scientific improvement of super rice in practice. BIOLOGICAL SIGNIFICANCE: Rice cultivars with large panicles do not always guarantee high yield and grain quality probably due to the slow grain filling and many unfilled grains of inferior spikelets. In general, earlier-flowering superior spikelets, which are usually located on apical primary branches, fill faster and produce larger and heavier grains. In contrast, later-flowering inferior spikelets located on proximal secondary branches are either sterile or fill slowly and poorly, and the differences are more significant in large panicle rice or super rice. The increase of rice yield has been limited by the unsatisfactory grain filling of inferior spikelets, and the inferior spikelets are more prone to environmental factors during grain filling. Thus, we herein investigated the biological functions of differently abundant proteins between superior and inferior spikelet grains by using iTRAQ to unravel the mechanism of rice grain filling and the response of inferior spikelets to drought stress at proteomic level. This study offers new insights into rice grain-filling and provides valuable evidences for better quality control and scientific improvement of super rice in practice.

Data in support of comparative proteomics analysis of superior and inferior spikelets in hybrid rice during grain filling and response of inferior spikelets to drought stress using isobaric tags for relative and absolute quantification.

We provide the raw data for protein and peptide identification and quantization of superior and inferior spikelets in hybrid rice during grain filling. The mass spectrometry proteomics data have been deposited to the Proteome Xchange Consortium via the PRIDE partner repository with the dataset identifier PXD001046. Our data presented here is also related to the article "Comparative proteomics analysis of superior and inferior spikelets in hybrid rice during grain filling and response of inferior spikelets to drought stress using isobaric tags for relative and absolute quantification "in the Journal of Proteomics [1].

Investigation on subcellular localization of Rice stripe virus in its vector small brown planthopper by electron microscopy.

BACKGROUND: Rice stripe virus (RSV), which is transmitted by small brown planthopper (Laodelphax striatellus Fallén, SBPH), has been reported to be epidemic and cause severe rice stripe disease in rice fields in many East Asian countries, including China. Investigation on viral localization in the vector is very important for elucidating transmission mechanisms of RSV by SBPH. In this study, transmission electron microscopy and immuno-gold labeling technique were used to investigate the subcellular localization of the ribonucleoproteins (RNPs) of RSV in the digestive tract, muscles, ovary and testes of SBPH. RESULTS: A lot of amorphous RSV inclusion bodies with high electron density were observed in the cytoplasmic matrix and vacuoles of follicular cells of ovarioles in viruliferous SBPH, which were very similar to viral inclusions formed in rice cells. After magnified, it was found that sand-like or parallel filamentary structures were constructed inside the electron-dense inclusions. A large numbers of RSV RNPs distributed diffusely throughout the eggshell surface and interior of ovum, midgut lumen and epithelial cells, while the amount of the virus in muscles was far less than that in the ovary and midgut tissues. Besides RSV, numerous endogenous microorganisms were also observed in SBPH body, including yeast-like endosymbiotes (YLES), endosymbiotic bacteria and insect virus. CONCLUSIONS: According to the results of the virus localization, a potential mechanism of RSV transovarial transmission was proposed that RSV might replicate and accumulate initially in the inclusions of follicular cells, then exploit the pathway of the nutrition transportation to pass through the eggshell and spread into the oocytes along with the nutrition. Moreover, RSV might exploit muscles for its spread in vector body with a lower efficiency.

[Distribution of pathogenic bacteria in patients of injuries combined with infection after May 12 Wenchuan Earthquake and drug resistance thereof].

OBJECTIVE: To investigate the distribution of pathogenic bacteria in the patients of injuries combined with infection after May 12 Wenchuan Earthquake and the drug resistance thereof. METHODS: Bacterial culture and identification were conducted on 139 clinical specimens from 108 patients with open injuries combined with infection. Drug-sensitive test was carried out by Kirby-Bauer method on the isolated strains. RESULTS: Ninety-six stains were isolated, 79.86% of them were from the infected wound secretion and 58.33% were from three department of orthopedics. The bacteria with high isolation rates included Acinetobacter spp. (20 strains), Enterobacter cloacae (20 strains), Escherichia coli (17 strains), and Staphylococcus spp. (13 strains). The isolated Gram negative bacteria showed lower resistance to imipenem, amikacin, and cefoperazone/sulbactam. CONCLUSION: The Gram negative bacteria isolated from the wounds caused by earthquake show lower resistance to imipenem, amikacin, and cefoperazone/sulbactam. No Staphylococcus spp. is found resistant to glycopeptides.

[Transthoracic echocardiography in transcatheter closure of atrial septal aneurysm combined with secoundum-type atrial septal defect].

OBJECTIVE: To explore the value of transthoracic echocardiography (TTE) in transcatheter closure of atrial septal aneurysm (ASA) combined with secoundum-type atrial septal defect (ASD). METHODS: Fourteen patients (3 males and 11 females) who had ASA combined with secoundum-type ASD were diagnosed by TTE or transesophageal echocardiography. The ASA projected to the right atrium in all patients. The width of basilar part was 13 approximately 24 (18.5+/-3.9) mm, and the vertical extent was 7 approximately 11(9.7+/-1.8) mm. Ten patients combined with single hole ASD and 4 patients with multiple hole ASD. Blood shifting from the left atrium to the right atrium was displayed in color Doppler in all patients. All patients were treated by transcatheter closure under the guiding of X fluoroscopy and TTE, and examined with TTE during the follow-up. RESULTS: Transcatheter closure was successfully performed by 14 occluders in all patients. No residual shunt was detected immediately by TTE after the procedure in all patients. During the 6 approximately 12 month follow-up, no residual shunt or occluder shifting was found, the dimensions of the heart became normal in 11 patients (79%) and were significantly decreased in 4. CONCLUSION: Transcatheter closure is feasible in patients with ASA combined with secoundum-type ASD, and extra attention must be paid to the specialty. TTE is very important in case selection before transcatheter closure, and it may be used to monitor and guide the procedure during transcatheter closure.

[Short and mid-term effects of percutaneous transcatheter closure of ventricular septal defects on the cardiac remodeling].

OBJECTIVE: To evaluate the short and mid-term changes of the cardiac morphology after percutaneous transcatheter closure of ventricular septal defects (VSD) with transthoracic echocardiography (TTE). METHODS: The left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic volume (LVEDV), left atrial diameter (LAd), and right ventricular diameter (RVd) in 30 VSD patients were measured before the VSD closure,and on the 3rd day, 3rd month, and 6th month after the VSD closure by TTE. RESULTS: LVEDD and LVEDV significantly decreased on the 3rd day after the VSD closure compared with pre-VSD closure. LVEDD and LVEDV continuously decreased on the 3rd month and 6th month after the VSD closure. LAd was smaller on the 3rd month and 6th month after the VSD closure, but there was not significant difference between the 3rd and 6th month. RVd increased on the 3rd day after the VSD closure, while no significant difference was found among the 3rd month and 6th month before and after VSD closure. CONCLUSION: Percutaneous transcatheter VSD closure may effectively improve the cardiac remodeling in VSD patients in the short and mid-term follow-up.

[Serum level of homocysteine and the development of collateral circulation in patients with severe coronary artery stenosis].

OBJECTIVE: To investigate the relationship between serum level of homocysteine and the development of collaterals in patients with severe coronary artery stenosis (SCAS). METHODS: Eighty patients with at least one vessel stenosis over 90% among the 3 main vessels of coronary artery were consecutively enrolled into the study according to angiographic estimation. The development of collaterals was classified by Rentrop's method. RESULTS: The serum levels of homocysteine among the single-vessel, bi-vessel and tri-vessel coronary artery disease groups had no significant difference; there was no linear correlation between the serum level of homocysteine and Gensini's score. The level of homocysteine in the poorly developed collaterals was significantly higher than that in the well-developed collaterals in the SCAS patients (P<0.001). Multiple stepwise logistic analysis revealed that homocysteine negatively correlated with the development of collaterals (P<0.001, odds ratio=0.353; 95% confidence interval=0.201 - 0.620), whereas it positively correlated with the number of stenosis vessels. CONCLUSION: The serum level of homocysteine is independently and negatively associated with the development of collateral circulation in severe SCAs patients.

Improving the management of anemia in hemodialysis patients by implementing the continuous quality improvement program.

BACKGROUND: Anemia is common in hemodialysis patients, and improvement in anemia management is possible with the implementation of continuous quality improvement (CQI) programs. The aim of this study is to improve anemia management in chronic hemodialysis patients using CQI. METHODS: Ninety hemodialysis patients in our single center were enrolled in the study. The patients were followed up from January 2004 to October 2005. The CQI team-oriented approach was driven by a process called the 'FOCUS-PDCA cycle plan' (find, organize, clarify, uncover, start, plan, do, check and act). Hemoglobin (Hb), serum ferritin and transferrin saturation were monitored periodically. RESULTS: By implementation of the CQI program, the proportion of patients with Hb >or=110 g/l increased from 42.2 to 60.0% (p < 0.05), and the Hb level increased from 101.2 +/- 18.05 to 110.4 +/- 14.23 g/l (p < 0.0001). The proportion of patients with an adequate iron status increased from 28.0 to 53.3% (p < 0.05). CONCLUSION: The CQI program is a useful method in the management of anemia in hemodialysis patients.

[The misdiagnosis of testicular torsion (a report of 113 cases)].

OBJECTIVE: To improve the diagnosis and treatment of testicular torsion (or spermatic cord torsion), and reduce its misdiagnosis and mistreatment. METHODS: One hundred and thirteen misdiagnosed clinical cases of testicular torsion from 1994 to 2004 were reviewed and analysed. RESULTS: The error rate of initial diagnosis was 84.3%, among which 81 cases (71.7%) were misdiagnosed as acute epididymitis or testis, 10 (8.8%) as hydrocele of the tunica vaginalis, and 7 (6.2%) as acute enteritis. The lengths of time between the income and diagnosis of the disease varied from 2 hours to 2 months, averaging 6.3 days. Hand replacement succeeded in 3 cases, surgical examination was carried out in 92, resection of the testis or epididymis was performed in 64, testis atrophy occurred in 26, and the total testis impairment rate was 79.6%. CONCLUSION: The key to the reduction of misdiagnosis is to improve the diagnostic methods, which can be achieved by the combined use of case history, physical signs and color ultrasonography. Surgical examination of the scrotum is the best option for both the diagnosis and the treatment of testicular torsion.