Mortality and Related Risk Factors of Fragile Hip Fracture.

OBJECTIVE: To explore the mortality of patients with fragile hip fractures and assess the death-associated risk factors. METHODS: A total of 690 patients with osteoporotic hip fractures (age, 50-103 years) that were treated from January 2010 to December 2015 were enrolled and followed-up in this study and the clinical data were retrospectively collected. Three months, 1 year, and the total mortality were measured. Mortality-related risk factors were assessed including age, gender, surgery, the duration from injury to operation, pulmonary infection, and the number and type of complications. The mortality of each group was compared by chi-square test or corrected chi-square test for univariate analysis, and the factors with statistically significant mortality difference confirmed by univariate analysis were analyzed by binary logistic multivariate analysis. RESULTS: The 3-month mortality was 7.69%, the 1-year mortality was 15.60%, and the total mortality of the follow-up time was 24.06%. The 1-year and total mortality during the follow-up of the patients were higher in the >75-year-old group than those in the ≤75-year-old group (p = 0.000, respectively); were higher in the male patients than that in the female patients (p = 0.042; p = 0.017, respectively); were significantly lower in the operation group than that in the non-operation group (p = 0.000, respectively); were significantly lower in the patients that underwent the operation in ≤5 days than the patients that underwent the operation within >5 days (p = 0.008; p = 0.000, respectively); were significantly lower in patients with >2 kinds of combined medical diseases than those with ≥2 kinds of chronic diseases (p = 0.000, respectively); were significantly lower in patients receiving anti-osteoporosis treatment than in patients not receiving anti-osteoporosis treatment (p = 0.000, p = 0.002, respectively). Binary logistic regression analysis showed that the independent risk factors affecting mortality included advanced age >75-years-old (OR = 5.653, p = 0.000), male (OR = 1.998, p = 0.001), non-surgical treatment (OR = 9.909, p = 0.000), the number of combined medical diseases ≥2 (OR = 1.522, p = 0.042), and non-anti-osteoporosis treatment (OR = 1.796, p = 0.002). CONCLUSION: Age, whether or not surgical treatment was performed, the number of medical diseases, and whether or not anti-osteoporosis treatment was performed were independent risk factors for 3-month and 1-year mortality in patients with fragile hip fractures.

Acute pancreatitis-induced thrombotic thrombocytopenic purpura: A case report.

BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a life-threatening but treatable disorder. Acute pancreatitis is a well-described consequence of TTP, but TTP as a consequence of acute pancreatitis is rare. CASE SUMMARY: A 32-year-old male developed acute pancreatitis due to a fatty diet and suffered splenectomy 3 years ago due to trauma. From day 4 of his onset of pain the blood examination showed the platelet extremely reduced, bilirubin elevated and creatinine increased. High clinical suspicion of TTP was made and prompt initiation of plasma exchange was given followed intravenous drip methylprednisolone. After 7 sessions of plasm exchange and the laboratory parameters were back to normal and the patient was discharged from the hospital on the 13th day of admission. CONCLUSION: Patients develop acute pancreatitis with no apparent causes for hemolytic anemia and thrombocytopenia, the possibility of TTP should be considered. Treatments for TTP including plasm exchange should be evaluated as soon as a diagnosis is made.

[Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom].

OBJECTIVE: To analyze the efficacy of percutaneous vertebroplasty for osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom. METHODS: A retrospective analysis was performed on 37 patients with osteoporotic vertebral compression fractures treated from January 2015 to January 2021, all of whom had spin-derived abdominal pain as the main symptom, and were divided into surgery group(21 cases) and conservative group (16 cases) according to different treatment methods. Patients in the surgery group were treated with percutaneous vertebroplasty, including 7 males and 14 females, with an average age of (75.95±6.84) years old and an average course of disease of (5.26±3.79) days. The conservative group received non-surgical treatment, including 5 males and 11 females, with an average age of (75.50±8.07) years old and an average course of disease of (4.28±3.42) days. Two groups of patients with preoperative mainly characterized by abdominal pain, abdominal distension and constipation, have no obvious chest waist back pain symptoms, the thoracolumbar MRI diagnosed as fresh osteoporotic vertebral compression fractures, record its postoperative abdominal pain visual analogue scale (VAS), medical outcomes study short form-36 (SF-36) score, defecation interval after treatment, etc. RESULTS: Thirty-seven patients were followed up for (14.90±14.11) months in surgery group and( 21.42±17.53) months in conservative group. Compared with before treatment, the VAS of surgery group at each time period after treatment, VAS of conservative group at 1 month after treatment and SF-36 score between two groups at 3 months after treatment were all improved(P<0.05), while VAS of conservative group at 3 days after treatment showed no statistically significant difference(P>0.05). Compared between two groups, there were no significant differences in VAS and SF-36 scores at 1 day before treatment(P>0.05), but VAS at 3 days after treatment in surgery group, life vitality and social function score at 3 months after treatment, and defecation time after treatment in surgery group were better than those in conservative group(P<0.05). There were no significant differences in other indexes(P>0.05). The incision healing of patients in surgery group was good, and no serious complications occurred in both groups. CONCLUSION: Percutaneous vertebroplasty is an effective method for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom. Compared with conservative treatment, percutaneous vertebroplasty has more advantages in early relief of abdominal pain and constipation, recovery of vitality and social function.

Resveratrol Promotes Osteogenic Differentiation of Bone Marrow-Derived Mesenchymal Stem Cells Through miR-193a/SIRT7 Axis.

Resveratrol (RES) is a novel dietary phenol compound derived from plants and has been studied extensively for its health benefit and medical potential including osteoporosis. The purpose of this study is to investigate the role of resveratrol in osteoporosis in vivo and in vitro and explore the mechanism of osteogenic differentiation of BMSCs. RT-qPCR, ELISA, and Western blot were used to measure the expression level of miR-193a, SIRT7, and osteogenic markers proteins. The interaction between miR-193a and SIRT7 was validated by dual-luciferase reporter assay. Moreover, MTT assay was conducted to detect cell viability. Alizarin red s staining was used to examine bone formation and calcium deposits. The ovariectomized rat model was set up successfully and HE staining was used to examine femoral trabeculae tissue. Our results showed that miR-193a was overexpressed, while SIRT7 was downregulated in osteoporosis. RES suppressed miR-193a to promote osteogenic differentiation. Mechanically, miR-193a targeted and negative regulated SIRT7. Additionally, it was confirmed that SIRT7 promoted osteogenic differentiation of BMSCs through NF-κB signaling pathway. Further study indicated that RES exerted its beneficial function through miR-193a/SIRT7-mediated NF-κB signaling to alleviate osteoporosis in vivo. Our research suggested that the RES-modulated miR-193a inhibition is responsible for the activation of SIRT7/NF-κB signaling pathway in the process of osteogenic differentiation, providing a novel insight into diagnosis and treatment of osteoporosis.

The Role of Type II Fatty Acid Synthesis Enzymes FabZ, ODSCI, and ODSCII in the Pathogenesis of Toxoplasma gondii Infection.

Toxoplasma gondii is an obligate intracellular protozoan parasite, which has a worldwide distribution and can infect a large number of warm-blooded animals and humans. T. gondii must colonize and proliferate inside the host cells in order to maintain its own survival by securing essential nutrients for the development of the newly generated tachyzoites. The type II fatty acid biosynthesis pathway (FASII) in the apicoplast is essential for the growth and survival of T. gondii. We investigated whether deletion of genes in the FASII pathway influences the in vitro growth and in vivo virulence of T. gondii. We focused on beta-hydroxyacyl-acyl carrier protein dehydratase (FabZ) and oxidoreductase, short chain dehydrogenase/reductase family proteins ODSCI and ODSCII. We constructed T. gondii strains deficient in FabZ, ODSCI, and ODSCII using CRISPR-Cas9 gene editing technology. The results of immunofluorescence assay, plaque assay, proliferation assay and egress assay showed that in RHΔFabZ strain the apicoplast was partly lost and the growth ability of the parasite in vitro was significantly inhibited, while for RHΔODSCI and RHΔODSCII mutant strains no similar changes were detected. RHΔFabZ exhibited reduced virulence for mice compared with RHΔODSCI and RHΔODSCII, as shown by the improved survival rate. Deletion of FabZ in the PRU strain significantly decreased the brain cyst burden in mice compared with PRUΔODSCI and PRUΔODSCII. Collectively, these findings suggest that FabZ contributes to the growth and virulence of T. gondii, while ODSCI and ODSCII do not contribute to these traits.

[Distribution and drug resistance of pathogens causing periprosthetic infections after hip and knee arthroplasty].

OBJECTIVE: To study the distribution and drug resistance of pathogens causing periprosthetic infections after hip and knee arthroplasty, and to formulate prevention and treatment strategies for drug-resistant bacteria. METHODS: The data of 146 cases of periprosthetic infection after primary hip and knee arthroplasty from 2010 to 2015 were collected, including 111 cases of periprosthetic infection after hip arthroplasty and 35 cases of periprosthetic infection after knee arthroplasty. The culture positive rate, pathogenic bacteria composition and drug resistance rate were counted over the years, and the change trend of pathogen distribution and drug resistance was analyzed. RESULTS: One hundredand eight strains of pathogenic bacteria were detected in 146 cases, and the positive rate of culture was 73.97%. Gram positive bacteria accounted for 55.48%, Staphylococcus epidermidis and Staphylococcus aureus accounted for 25.34% and 15.07% respectively. Gram negative bacteria accounted for 13.01%, including Enterobacter cloacae, Pseudomonas aeruginosa and Escherichia coli. There were 4 cases of Mycobacterium tuberculosis infection and mixed infection. The results of culture over the years showed that the constituent ratio of Gram positive bacteria had an increasing trend, fluctuating from 39.13% to 76.47%. The results of drug sensitivity showed that the pathogens were highly resistant to ß-lactams, quinolones, clindamycin and gentamicin, and the drug resistance rate was increasing, but it was still sensitive to rifampicin, nitrofurantoin, tigecycline, linezolid and vancomycin. CONCLUSION: Gram positive bacteria are the main pathogens of periprosthetic infection, and the proportion is increasing gradually.The pathogens have high resistance to many kinds of antibiotics, and the resistance rate is still increasing. To strengthen the monitoring of the distribution and drug resistance of pathogenic bacteria is helpful to grasp its change trend and formulate targeted prevention and control strategies.

A Novel miRNA-hlo-miR-2-Serves as a Regulatory Factor That Controls Molting Events by Targeting CPR1 in Haemaphysalis longicornis Nymphs.

Successful completion of the molting process requires new epidermal growth and ecdysis of the old cuticle in Haemaphysalis longicornis (H. longicornis). MicroRNAs (miRNAs) participate in the development of organisms by inhibiting the expression of their target mRNAs. In this study, a novel tick-specific miRNA was identified and denoted hlo-miR-2 that serves as a novel regulator of molting events in H. longicornis nymphs by targeting a cuticular protein. The full length of this cuticular protein was first obtained and named it CPR1. A qRT-PCR analysis showed that hlo-miR-2 and CPR1 exhibit significant tissue and temporal specificity and that their transcription levels are negatively correlated during the molting process. CPR1, as a direct target of hlo-miR-2, was identified by a luciferase reporter assay in vitro. Agomir treatment indicated that the overexpression of hlo-miR-2 significantly reduced the protein expression level of CPR1, decreased the molting rate and delayed the molting time point in H. longicornis nymphs. RNA interference (RNAi) experiments demonstrated that CPR1 was significantly associated with the molting process in H. longicornis nymphs. Phenotypic rescue experiments convincingly showed that hlo-miR-2 participated in molting events by targeting CPR1 in H. longicornis nymphs. In summary, we present evidence demonstrating that miRNAs constitute a novel important regulator of molting events in addition to hormones. The described functional evidence implicating CPR1 in molting events contributes to an improved understanding of the distinct functions of the CPR family in ticks and will aid the development of a promising application of cuticular protein RNAi in tick control.

[Uremic Toxins in Cognitive Impairment].

Patients with uremia can suffer from decreased renal function and endocrine and metabolism disorders,which can lead to the accumulation of toxins in the body.Accumulation of uremic toxins is a major cause of cognitive dysfunction in uremic patients.This article summarizes some of the cognitive dysfunction-related uremic toxins and their possible mechanisms.

Evaluation of immune protection against Toxoplasma gondii infection in mice induced by a multi-antigenic DNA vaccine containing TgGRA24, TgGRA25 and TgMIC6.

Toxoplasma gondii infection is prevalent in humans and animals worldwide. In this study, recombinant eukaryotic expression plasmids (pVAX-GRA24, pVAX-GRA25 and pVAX-MIC6) were constructed, and then injected into Kunming mice intramuscularly, as cocktailed plasmids or as single-gene plasmids. We evaluated immune protective responses by detecting the titer of antibodies and cytokine production of IFN-γ, IL-2, IL-4, IL-10, IL-12 and IL-23, the percentages of the subclasses of T lymphocytes, as well as the records of the survival time and cyst decrement in the brain of the mouse model after challenge with the T. gondii RH and Pru strains, respectively. Compared with the control groups, antibody and cytokine production were significantly increased, while the survival times of mice in all immunized groups were also prolonged, and the number of T. gondii cysts in their brains were decreased significantly (29.03% for pVAX-GRA24; 40.88% for pVAX-GRA25; 37.70% for pVAX-MIC6; 48.06% for pVAX-GRA24 + pVAX-GRA25; and 55.37% for pVAX-GRA24 + pVAX-GRA25 + pVAX-MIC6). The mouse group immunized with the three-gene cocktail (TgGRA24 + TgGRA25 + TgMIC6) had better performance in each detection index than the mouse groups immunized with the two-gene cocktail of TgGRA24 + TgGRA25, which was better than that in the group immunized with the single gene vaccine of TgGRA24, TgMIC6 or TgGRA25. In conclusion, TgGRA24 or TgGRA25 may be good vaccine candidates against T. gondii infection, but the three-gene cocktail of TgGRA24, TgMIC6 and TgGRA25 may induce the strongest protective immunity. Further studies of multi-antigenic DNA vaccines or cocktailed vaccines against T. gondii infection are necessary.

TITLE: Évaluation de la protection immunitaire contre l'infection par Toxoplasma gondii chez la souris, induite par un vaccin à ADN multi-antigénique contenant TgGRA24, TgGRA25 et TgMIC6. ABSTRACT: L'infection à Toxoplasma gondii est répandue chez les humains et les animaux dans le monde entier. Dans cette étude, des plasmides d'expression eucaryotes recombinants (pVAX-GRA24, pVAX-GRA25 et pVAX-MIC6) ont été construits, puis injectés à des souris Kunming par voie intramusculaire, comme cocktails de plasmides ou comme plasmides à un seul gène. Nous avons évalué les réponses de protection immunitaire en détectant le titre des anticorps et la production de cytokines IFN-γ, IL-2, IL-4, IL-10, IL-12 et IL-23, les pourcentages des sous-classes des lymphocytes T, ainsi qu'en mesurant les temps de survie et de décrément des kystes dans le cerveau du modèle souris après challenge par les souches RH et Pru de T. gondii, respectivement. Comparativement aux groupes témoins, la production d'anticorps et de cytokines était significativement accrue, tandis que le temps de survie des souris de tous les groupes immunisés était également prolongé et que le nombre de kystes de T. gondii dans leur cerveau diminuait de manière significative (29,03 % pour pVAX-GRA24 ; 40,88 % pour pVAX-GRA25 ; 37,70 % pour pVAX-MIC6 ; 48,06 % pour pVAX-GRA24 + pVAX-GRA25 ; 55,37 % pour pVAX-GRA24 + pVAX-GRA25 + pVAX-MIC6). Le groupe de souris immunisées avec les cocktails à trois gènes (TgGRA24 + TgGRA25 + TgMIC6) présentait la meilleure performance dans chaque indice de détection par rapport aux groupes de souris immunisées avec des cocktails à deux gènes de TgGRA24 + TgGRA25, qui était supérieur à ceux immunisés avec les vaccins monogéniques TgGRA24, TgMIC6 ou TgGRA25. En conclusion, TgGRA24 ou TgGRA25 peuvent être de bons candidats au vaccin contre l'infection à T. gondii, mais un cocktail à trois gènes de TgGRA24, TgMIC6 et TgGRA25 peut induire la plus forte immunité protectrice. Des études supplémentaires sur les vaccins à ADN multi-antigéniques ou les vaccins en cocktail contre l'infection à T. gondii sont nécessaires.

[Progress on salt resistance in autopolyploid plants].

Polyploidization is a key driving force that plays a vital role in the evolution of higher plants. Autopolyploid plants often demonstrate altered physiology phenomena due to the different genome composition and gene expression patterns. For example, autopolyploid plants are more resistant to stresses than their homologous diploid ancestors. Soil salinity and secondary salinization are two vital factors affecting crop production which severely limit the sustainable development of agriculture in China. Polyploid plants are important germplasm resources in crop genetic improvement due to their higher salt tolerance. Revealing the mechanism of salt tolerance in homologous plants will provide a foundation for breeding new plants with improved salt resistance. In this review, we describe the existing and ongoing characterization of the mechanism of salt tolerance in autopolyploid plants, including the salt tolerance evolution, physiology, biochemistry, cell structure and molecular level researches. Finally, we also discuss the prospects in this field by using polyploid watermelon as an example, which will be helpful in polyploid research and plant breeding.

[Epidemiology characteristics of crawfish related rhabdomyolysis in Nanjing, 2016: a multicenter retrospective investigation].

OBJECTIVE: To investigate the epidemiology characteristics of crawfish related rhabdomyolysis (RM) in Nanjing, 2016. METHODS: Outpatient and inpatient electronic medical system of 21 hospitals in Nanjing during 2016 were retrospectively searched, and all the patients diagnosed with RM were selected. The patients with none crayfish-related RM was excluded. The epidemiology characteristics were depicted. The geographic information system (GIS) was used to collect, manage and analyze the spatial data, to visualize it, to analyze the spatial distribution features of the disease, and to explore the cause of disease prediction. GeoDa 1.8 software was used to analyze the global and local spatial auto-correlation. RESULTS: A total of 1 183 patients with crawfish related RM were initially screened, excluding 59 patients with RM caused by trauma, severe exercise, heat stroke, myositis, poisoning, drugs, and genetic diseases, and 1 124 patients were enrolled. The proportion of men was 36.48% (410/1 124) with an incidence of 12.54/100 thousands; while of women was 63.52% (714/1 124) with an incidence of 21.86/100 thousands. The median age at onset was 34 (28, 43) years. From July to August, the incidence of crawfish related RM was the highest, accounting for 96.53% of the total number of cases. The top four incidence areas were Pukou (41.54/100 thousands), Jianye (25.94/100 thousands), Qixia (25.73/100 thousands), Gulou (25.04/100 thousands), all of which were adjacent to the Yangtze River. Global spatial autocorrelation analysis showed: Moran I = 0.427, Z = 2.646, P = 0.003, suggesting that the crawfish related RM had positive spatial autocorrelation. The results showed that the spatial structure of crawfish related RM existed in Nanjing in 2016. Local spatial autocorrelation analysis showed that the "high-high" concentration areas were Pukou, Jianye and Liuhe. The incidences of above three areas which were the Nanjing section of the lower reaches of the Yangtze River flowed through the region and surrounding areas were higher than the overall incidence of Nanjing. CONCLUSIONS: The prevalence of crawfish related RM in Nanjing during 2016 had an obvious region-concentrated character and global spatial autocorrelation with the high prevalent regions mainly concentrated in the urban areas adjacent to the Yangtze River.

MIC16 gene represents a potential novel genetic marker for population genetic studies of Toxoplasma gondii.

BACKGROUND: The zoonotic agent Toxoplasma gondii is distributed world-wide, and can infect a broad range of hosts including humans. Microneme protein 16 of T. gondii (TgMIC16) is responsible for binding to aldolase, and is associated with rhomboid cleavage and presence of trafficking signals during invasion. However, little is known of the TgMIC16 sequence diversity among T. gondii isolates from different hosts and geographical locations. RESULTS: In this study, we examined sequence variation in MIC16 gene among T. gondii isolates from different hosts and geographical regions. The entire genomic region of the MIC16 gene was amplified and sequenced, and phylogenetic relationship was reconstructed using Bayesian inference (BI) and maximum parsimony (MP) based on the MIC16 gene sequences. The results of sequence alignments showed two lengths of the sequence of MIC16 gene among all the examined 12 T. gondii strains: 4391 bp for strains TgCatBr5 and MAS, and 4394 bp for strains RH, TgPLH, GT1, PRU, QHO, PTG, PYS, GJS, CTG and TgToucan. Their A+T content ranged from 50.30 to 50.59 %. A total of 107 variable nucleotide positions (0.1-0.9 %) were identified, including 29 variations in 10 exons and 78 variations in 9 introns. Phylogenetic analysis of MIC16 sequences showed that typical genotypes (Type I, II and III) were able to be grouped into their respective genotypes. Moreover, the three major clonal lineages (Type I, II and III) can be differentiated by PCR-RFLP using restriction enzyme Pst I. CONCLUSIONS: Phylogenetic analysis and PCR-RFLP of the MIC16 locus among T. gondii isolates from different hosts and geographical regions allowed the differentiation of three major clonal lineages (Type I, II and III) into their respective genotypes, suggesting that MIC16 gene may provide a novel potential genetic marker for population genetic studies of T. gondii isolates.

Co-administration of interleukins 7 and 15 with DNA vaccine improves protective immunity against Toxoplasma gondii.

Toxoplasma gondii is an obligatory intracellular parasite, which can infect all warm-blooded animals including humans. Cytokines, including IL-15 and IL-7, play a critical role in the regulation of the homeostasis of naive and memory T cells. Co-administration the DNA vaccine with cytokines may improve its efficacy. IL-7 and IL-15 from splenic tissues of Kunming mice were cloned, and eukaryotic plasmid pVAX-IL-7-IL-15 was constructed. Kunming mice were administrated with DNA vaccine expressing T. gondii calcium-dependent protein kinase 1 (TgCDPK1), pVAX-CDPK1, in the presence or absence of IL-7 and IL-15 plasmids (pVAX-IL-7-IL-15), immune responses were analyzed including lymphoproliferative assay, cytokine and serum antibody measurements, flow cytometric surface markers on lymphocytes, and thus protective immunity against acute and chronic T. gondii infection was estimated. Mice injected with pVAX-CDPK1 supplemented with pVAX-IL-7-IL-15 showed higher Toxoplasma-specific IgG2a titers, Th1 responses associated with the production of IFN-γ, IL-2 as well as cell-mediated cytotoxic activity where stronger frequencies of IFN-γ secreting CD8+ and CD4+ T cells (CD8+/CD4+ IFN-γ+ T cells) compared to controls. Co-administration of pVAX-IL-7-IL-15 and pVAX-CDPK1 significantly (P < 0.05) increased survival time (18.07 ± 5.43 days) compared with pVAX-CDPK1 (14.13 ± 3.85 days) or pVAX-IL-7-IL-15 (11.73 ± 1.83 days) alone, and pVAX-IL-7-IL-15 + pVAX-CDPK1 significantly reduced the number of brain cysts (73.5%) in contrast to pVAX-CDPK1 (46.0%) or pVAX-IL-7-IL-15 alone (45.0%). Our results indicate that supplementation of DNA vaccine with IL-7 and IL-15 would facilitate specific humoral and cellular immune responses elicited by DNA vaccine against acute and chronic T. gondii infection in mice.

[Morphological Characteristics and Molecular Identification of Trichuris sp. from Giraffe].

Objective: To investigate the morphological characteristics of Trichuris sp. from giraffe in Hefei wild zoo and identify its species using molecular techniques. Methods: Morphological characteristics of Trichuris collected from giraffe were analyzed. The internal transcribed spacer 1（ITS-1） was amplified by PCR and the PCR product was sequenced. The resulting sequence was homology analysis in GenBank and its heredity evolution tree was constructed by MEGA 4.0 software. Results: The male worms had a body length of 35.89-58.56 mm, an esophagus to body length ration of 0.29-0.40, and a spicule length of 1.96-3.89 mm. The thick and thin proportions of body were 7.02-23.45 mm and 28.05-40.05 mm respectively. These data showed different degrees of variation with previous reports. The PCR resulted in a product of 491 bp, comprising part of 18S rRNA and full length ITS-1. Sequence alignment showed that the identified Trichuris was most homologous（98.6%） with T. bos taurus HE608848, T. capreolus JX218218, and T. japanese AB367795, but it was only 46.0% homologous with T. discolor AB367794. In the heredity evolution tree, it was not located on the same branch as T. discolor, T. ovis and T. bos taurus. Conclusions: The Trichuris sp. collected from giraffe is different from previous reports in morphology and ITS-1 sequence. Further research is needed to determine if it is a new species.

Endoscopic retrograde appendicitis therapy (ERAT) : a multicenter retrospective study in China.

BACKGROUND: Endoscopic retrograde appendicitis therapy (ERAT) is a new procedure for the treatment of acute uncomplicated appendicitis. The aim of the study was to review the clinical outcomes of ERAT and further examine its effectiveness and safety. METHODS: The study was performed on patients who underwent ERAT for acute uncomplicated appendicitis at three tertiary hospitals in China from December 2009 to May 2013. Patient demographics, technique aspects of the ERAT procedures, clinical success (resolution of symptoms and normalization of laboratory tests), time until resumption of diet, and hospital stay were analyzed, and complications and recurrence were followed up. RESULTS: Forty-one patients were entered, among which 34 patients were definitely diagnosed as having acute uncomplicated appendicitis; in 7 patients, acute appendicitis was excluded by endoscopic retrograde appendicography. Thirty-three patients completed ERAT except one patient who failed appendiceal cannulation. Abdominal pain resolved immediately in 32 patients, and clinical success rate was 97 %. There was one failure case (3 %) that complicated perforation after 48 h received emergency appendectomy. The median follow-up period was 12 months (IQR = 9-23 months). During follow-up, there were no long-term complication; 2 patients (6.2 %) had recurrent abdominal pain and received appendectomy (one had a histologically normal appendix). CONCLUSIONS: ERAT is an effective method to diagnose and treat acute uncomplicated appendicitis. Multicenter prospective clinical trials are needed to confirm its utility and place in the management of suspected acute appendicitis.

Neuroprotective effects of autophagy induced by rapamycin in rat acute spinal cord injury model.

BACKGROUND/AIMS: To explore the effects of rapamycin-induced autophagy on apoptosis in a rat model of acute spinal cord injury (SCI), and to explore the effect of rapamycin on apoptosis in primary spinal cord cell culture. METHODS: SCI was induced at T10 in female adult Sprague-Dawley rats. After injury was induced, the rats were injected with rapamycin and/or methylprednisolone and were sacrificed at various days after injury. Apoptosis and autophagy were examined with TUNEL staining and electron microscopy. Hind limb function was assessed by the Gale scale. RESULTS: The expression of the apoptosis-related protein caspase-3 did not significantly increase until 21 days following injury, while increases in LC3II and LC3I began 10 days after injury, but then declined. TUNEL staining and electron microscopy confirmed that following injury autophagy occurred before apoptosis, but by 14 days after the injury, the level of autophagy had decreased significantly while the level of apoptosis showed a continued increase. Following treatment with rapamycin, apoptosis was significantly higher than in the vehicle control group, but significantly lower than in the sham-operated group, showing a protective effect of rapamycin. Gale scale grades in rats treated with rapamycin were significantly higher compared with the vehicle control group, suggesting a functional effect of rapamycin-induced inhibition of apoptosis. CONCLUSIONS: The results indicate that rapamycin significantly improved the prognosis of acute SCI in rats by inhibiting cell apoptosis. Rapamycin might be useful as a therapeutic agent for acute SCI.

Beclin-1-mediated autophagy protects spinal cord neurons against mechanical injury-induced apoptosis.

Apoptosis has been widely reported to be involved in the pathogenesis associated with spinal cord injury (SCI). Recently, autophagy has also been implicated in various neuronal damage models. However, the role of autophagy in SCI is still controversial and its interrelationship with apoptosis remains unclear. Here, we used an in vitro SCI model to observe a time-dependent induction of autophagy and apoptosis. Mechanical injury induced autophagy markers such as LC3 lipidation, LC3II/LC3I conversion, and Beclin-1 expression. Injured neurons showed decreased cell viability and increased apoptosis. To elucidate the effect of autophagy on apoptosis, the mechanically-injured neurons were treated with the mTOR inhibitor rapamycin and 3-methyl adenine (3-MA), which are known to regulate autophagy positively and negatively, respectively. Rapamycin-treated neurons showed the highest level of cell viability and lowest level of apoptosis among the injured neurons and those treated with 3-MA showed the reciprocal effect. Notably, rapamycin-treated neurons exhibited slightly reduced Bax expression and significantly increased Bcl-2 expression. Furthermore, by plasmid transfection, we showed that Beclin-1-overexpressing neuronal cells responded to mechanical injury with greater LC3II/LC3I conversion and cell viability, lower levels of apoptosis, higher Bcl-2 expression, and unaltered Bax expression as compared to vector control cells. Beclin-1-knockdown neurons showed almost the opposite effects. Taken together, our results suggest that autophagy may serve as a protection against apoptosis in mechanically-injured spinal cord neurons. Targeting mTOR and/or enhancing Beclin-1 expression might be alternative therapeutic strategies for SCI.

Bone marrow-derived mesenchymal stem cells expressing the bFGF transgene promote axon regeneration and functional recovery after spinal cord injury in rats.

OBJECTIVE: To investigate neurological effects of transplanting bone marrow-derived mesenchymal stem cells (BMSCs) transfected with the basic fibroblast growth factor (bFGF) gene in spinal cord-injured rats. METHODS: Ninety-six male adult Sprague-Dawley rats were randomized into four groups: (1) pcDNA3.1-bFGF group; (2) pcDNA3.1 group; (3) BMSCs group; and (4) vehicle control (DMEM) group. After the rat model of acute spinal cord injury (SCI) was established, 1×10(6) BMSCs or cells transfected with pcDNA3.1-bFGF or pcDNA3.1 were injected into rats of groups 1-3. At days 1, 7, 14, and 21 after injection, the Basso-Beattie-Bresnahan (BBB) locomotor rating scale was used to evaluate recovery of motor function. Expression changes of bFGF, myelin basic protein (MBP), and NF200 were examined by immunohistochemistry. RESULTS: The BBB score of DMEM group was significantly lower than those of groups 1-3 (P<0.05), but the score of pcDNA3.1-bFGF group was significantly higher than that of BMSCs group or pcDNA3.1 group at day 14 or 21 after injection (P<0.01). The number of bFGF-positive neurons in rats of pcDNA3.1-bFGF group was significantly higher than those of groups 1-3 at any time point (P<0.05). The optical density values of NF200-positive neurons and MBP-positive MBP axons in rats of pcDNA3.1-bFGF group were significantly higher than those of groups 1-3 at day 7 or 14 after injection (P<0.05). CONCLUSIONS: bFGF gene-modified BMSCs not only effectively promoted axonal outgrowth but also enhanced recovery of neurological function after SCI in rats, and may be a good candidate to evaluate gene therapy of SCI in man.

The effect of strontium incorporation in hydroxyapatite on osteoblasts in vitro.

The purpose of this study was to test the effects of a series of strontium-substituted HA (Sr-HA) ceramics (0, 1, 5, and 10 mol% Sr substitution) on osteoblasts, thereby demonstrating whether strontium incorporation with HA would favor osteoblast metabolism. Rat primary osteoblasts were cultured with culture media containing ions released from the Sr-HA ceramics as they dissolved. MTT test, alkaline phosphatase activity, osteoblast transcription factor gene (cbfa1) expression and Alizarin Red staining were conducted at different time-points. There is no significant difference in cell proliferation between groups. However, compared with HA group, Sr-HA groups presented significant enhancement with regard to ALP activity, cbfa1 mRNA expression, and mineralization nodules. Among Sr-HA groups, 5 and 10% groups showed much better performances in ALP activity, cbfa1 mRNA expression, and mineralization nodules than 1% group, however, no significant difference was found between 5 and 10% groups. This study has demonstrated that Sr incorporation in HA ceramic enhanced osteoblastic cell differentiation and mineralization. However, further detailed studies are needed to understand the mechanistic effects of this Sr incorporation on osteoblastic cells and the optimal percentage of calcium should be substituted with strontium in HA.

[Clinical features in 65 patients with acute myocardial infarction underwent successful thrombolytic therapy post cardiopulmonary resuscitation].

OBJECTIVE: To analyze the clinical features of patients with acute myocardial infarction underwent successful thrombolytic therapy post cardiopulmonary resuscitation. METHODS: This retrospective analysis included 65 patients with acute myocardial infarction underwent successful intravenous thrombolysis post cardiopulmonary resuscitation. The cases were collected from Chinese Journal Full-text Database from 1996 to 2006, only patients met the recanalization criteria of coronary artery were included. RESULTS: Most of the patients were male (93.8%, 61/65) and aged less than 65 years (81.5%, 53/65). Cardiopulmonary resuscitation was performed within 5 min after cardiac arrest in 63 patients (96.9%). Defibrillation was performed 3.2 times per patient, chest compression in 52 patients (80.0%) and tracheal intubation in 21 patients (32.3%). The restoration time of spontaneous circulation were achieved within 10 min in 36 cases (55.4%), between 11 - 30 min in 19 cases (29.2%)and between 31 - 107 min in 10 cases (15.4%). Thrombolysis agents (urokinase, recombinant streptokinase or recombinant tissue-type plasminogen activator) were given intravenously at 172 +/- 92 min after acute myocardial infarction. Mild hemorrhage was seen in 12 cases (18.5%) and there was no report on severe hemorrhage event. The hemorrhage incidence tended to be higher than that of reported large Chinese thrombolysis trials (11.1% - 15.1%, P > 0.05). CONCLUSION: Thrombolytic therapy was relatively safe and effective for those middle-aged male AMI patients received rapid cardiopulmonary resuscitation (< 5 min after cardiac arrest) and with shorter spontaneous circulation restoration time (<30 min).