Apelin/APJ-Manipulated CaMKK/AMPK/GSK3ß Signaling Works as an Endogenous Counterinjury Mechanism in Promoting the Vitality of Random-Pattern Skin Flaps.

A random-pattern skin flap plays an important role in the field of wound repair; the mechanisms that influence the survival of random-pattern skin flaps have been extensively studied but little attention has been paid to endogenous counterinjury substances and mechanism. Previous reports reveal that the apelin-APJ axis is an endogenous counterinjury mechanism that has considerable function in protecting against infection, inflammation, oxidative stress, necrosis, and apoptosis in various organs. As an in vivo study, our study proved that the apelin/APJ axis protected the skin flap by alleviating vascular oxidative stress and the apelin/APJ axis works as an antioxidant stress factor dependent on CaMKK/AMPK/GSK3ß signaling. In addition, the apelin/APJ-manipulated CaMKK/AMPK/GSK3ß-dependent mechanism improves HUVECs' resistance to oxygen and glucose deprivation/reperfusion (OGD/R), reduces ROS production and accumulation, maintained the normal mitochondrial membrane potential, and suppresses oxidative stress in vitro. Besides, activation of the apelin/APJ axis promotes vascular migration and angiogenesis under relative hypoxia condition through CaMKK/AMPK/GSK3ß signaling. In a word, we provide new evidence that the apelin/APJ axis is an effective antioxidant and can significantly improve the vitality of random flaps, so it has potential be a promising clinical treatment.

Evaluation of Real-Time PCR Coupled With Multiplex Probe Melting Curve Analysis for Pathogen Detection in Patients With Suspected Bloodstream Infections.

Background: This study aimed to evaluate real-time polymerase chain reaction coupled with multiplex probe melting curve analysis (PCR-MCA) for pathogen detection in patients with suspected bloodstream infections (BSIs). Methods: A PCR-MCA assay was developed for simultaneous identification of 28 kinds of the most common pathogens and two resistance genes within a few hours. The diagnostic performance of the PCR-MCA assay was determined and compared to the results of blood culture. Results: A total of 2,844 consecutive new episodes of suspected BSIs in 2,763 patients were included in this study. There were 269 episodes of pathogens identified by blood culture. For all the pathogens tested, the PCR-MCA assay exhibited a sensitivity of 88.8% (239/269), specificity of 100% (2,575/2,575), and agreement of 98.9% (2,814/2,844). For the pathogens on the PCR-MCA list, the PCR-MCA results had a sensitivity of 99.2% (239/241), specificity of 100% (2,575/2,575), and agreement of 99.9% (2,814/2,816) compared with the results of blood culture. For seven samples with multiple pathogens identified simultaneously during one blood culture investigation, the PCR-MCA assay verified the results of the blood culture, with an agreement rate of 100% for each. Conclusion: The PCR-MCA assay could discover 88.8% of the pathogens in clinical practice, showing excellent diagnostic performance vs. that of blood culture for pathogen detection in patients with suspected BSIs, and would contribute to rapid diagnosis and correct antibiotic administration.

Correlation between polymorphisms in toll-like receptor genes and the activity of hepatitis B virus among treatment-naïve patients: a case-control study in a Han Chinese population.

BACKGROUND: Because of the high prevalence and absence of cure for infection, chronic hepatitis B virus (HBV) infection has been acknowledged as a pressing public health issue. Toll-like receptors (TLRs) activate the human innate immune system and the polymorphisms in TLRs may alter their function. The present study aimed to investigate the association between TLR polymorphisms and disease progression of chronic HBV infection. METHODS: During the study period, 211 treatment-naïve patients with chronic HBV infection were recruited, and blood samples were collected from each individual. Matrix-assisted laser desorption/ionization time of flight mass spectrometry was employed to genotype the selected TLR polymorphisms after human genome extraction. In addition, HbsAg, TNF-α, and IL-6 levels were quantified using enzyme linked immunosorbent assay (ELISA). Statistical analyses were conducted to investigate the association between TLR polymorphisms and hepatitis activity, liver function parameters, HbsAg level, and cytokine level. RESULTS: We did not observe any mutations in rs4986790, rs4986791, and rs5743708 among all study subjects. A logistic regression revealed that mutations in rs3804099 and rs4696480 were associated with milder hepatitis activity. Consistent with the logistic regression, improved liver function parameters and reduced level of both HbsAg and cytokines were also correlated with the mutant carriers of rs3804099 and rs4696480. CONCLUSIONS: TLR mutations were significantly associated with milder hepatitis activity among patients with chronic HBV infection. Therefore, we conclude that the activation of TLR pathways may further intensify the inflammation of hepatocytes, and leads to progression of disease.

Risk factors and molecular epidemiology of extended-spectrum ß-lactamase-producing Klebsiella pneumoniae in Xiamen, China.

OBJECTIVES: The aim of this study was to evaluate the risk factors for pneumonia due to extended-spectrum ß-lactamase-producing Klebsiella pneumoniae (ESBL-KP) and to analyse the molecular epidemiology of ESBL-KP in Xiamen, China. METHODS: A case-control study was conducted at Zhongshan Hospital from January 2014 to August 2015. Medical records of patients with nosocomial pneumonia caused by K. pneumoniae were collected. A total of 40 cases with ESBL-KP infection and 90 controls with non-ESBL-KP infection were included. The sequence types (STs) of the 40 ESBL-KP strains were determined by multilocus sequence typing (MLST). RESULTS: Univariate analysis primarily revealed an association between the following seven risk factors and ESBL-KP infection (P<0.10): length of hospitalisation; use of cephalosporins; use of quinolones; presence of a nasogastric tube; presence of an intravenous catheter; mechanical ventilation; and cerebrospinal fluid drainage. Furthermore, multivariate analysis revealed that use of cephalosporins and presence of a nasogastric tube were independent risk factors for ESBL-KP infection (P<0.05), with adjusted odds ratios of 3.473 [95% confidence interval (CI) 1.105-10.911; P=0.033] and 2.488 (95% CI 1.083-5.715; P=0.032), respectively. MLST identified 28 STs. The main STs were ST23 (10.0%) and ST37 (10.0%); three novel STs were identified. CONCLUSIONS: Use of cephalosporins and presence of a nasogastric tube are independent risk factors for ESBL-KP infection. In addition, the discovery of three novel STs serves as a reminder to continuously monitor outbreaks of ESBL-KP infection.

Treatment of persistent congenital chylothorax with intrapleural injection of sapylin in infants.

Test the therapeutic efficacy of Sapylin in resolving persistent Congenital Chylothorax (CC) in four infants who failed to respond to conservative medical therapy including Erythromycin and/or Octreotide management. All cases were cured and have no adverse reactions during follow-up. The result shows Sapylin is effective in reducing chylous production.

[Effects of lipoxinA4 on endoplasmic reticulum stress during myocardial ischemia reperfusion injury in rats].

OBJECTIVE: To explore the protective effect of lipoxin (LX)A4 during myocardial ischemia reperfusion injury (MIRI) and discuss the molecular mechanism of excessive endoplasmic reticulum stress (ERS) in rats. METHODS: Seventy-two male SD rats were divided into 6 groups, according to random number table, 12 in each group: sham operation group (group sham)1, 2: injected with normal saline (NS) 2 ml/kg before and after coronary artery threading. MIRI group (group I/R)1, 2: injected with NS 2 ml/kg before and after MIRI. Group LX1, LX2: injected with LXA4 100 µg/kg in 2 ml/kg NS before and after MIRI treatment. After the rat MIRI model was established, the serum concentrations of troponin I (cTnI) were measured in each group before open-chest operation (T1) and at the end of the experiment (T2). Besides, expressions of GRP-78, caspase-12 protein and mRNA were test. At the same time, myocardial cell apoptosis, the myeloperoxidase (MPO), superoxide dismutase (SOD) activation and malondialdehyde (MDA) content were detected while the HE and ultrastructural changes of cardiac muscle were observed. RESULTS: The expression levels of GRP-78, caspase-12 protein and mRNA, apoptotic index, serum cTnI concentrations (T2) and MPO, SOD activation, MDA content were all significantly higher in groups I/R and LX than those in group sham 1 and sham 2 (all P < 0.05). The expression levels of GRP-78, caspase-12 protein in group LX1 (compared with group I/R1) and in group LX2 (compared with group I/R2) were all significantly lower (all P < 0.05). Besides, the expression of GRP-78, caspase-12 mRNA in group LX1 were significantly less than those in group I/R1 ((0.86 ± 0.06)×10(5) vs (1.95 ± 0.65)×10(5), (12.35 ± 4.15)×10(5) vs (23.76 ± 6.57) ×10(5), both P < 0.05), so were those in groups LX2 and I/R2 ((0.64 ± 0.05)×10(5) vs (2.36 ± 0.57)×10(5), (7.04 ± 0.81)×10(5) vs (26.49 ± 6.82)×10(5), both P < 0.05). The apoptotic index, the serum concentrations of cTnI (T2), MPO activation and MDA content were all significantly lower in group LX1 than those in group I/R1 (34.6% ± 5.7% vs 52.5% ± 6.4%, (293 ± 22) vs (581 ± 44) ng/L, (176 ± 47) vs (331 ± 94) U/g tissue, (1549 ± 238) vs (2403 ± 439) nmol/g protein, both P < 0.05), so were those in groups LX2 and I/R2(26.5% ± 4.6% vs 54.8% ± 6.3%, (207 ± 29) vs (593 ± 61) ng/L, (99 ± 24) vs (329 ± 92) U/g tissue, (1055 ± 237) vs (2422 ± 518) nmol/g protein, all P < 0.05). In addition, the activity of SOD in groups LX1 and LX2 were both significantly higher respectively than those in groups I/R1 and I/R2 (both P < 0.05). Moreover, compared with groups I/R1 and I/R2, the neutrophils infiltration were significantly less than those in groups LX1 and LX2 respectively, and the ultrastructure damage were also much milder. CONCLUSIONS: Before and after MIRI, application of LXA4 may significantly inhibit neutrophil infiltration and attenuate myocardial oxidative injury. LXA4 play its role in myocardial protection via down-regulating the expression of GRP-78, caspase-12 and the inhibition of excessive ERS.

[Study on the automatic parameters identification of water pipe network model].

Based on the problems analysis on development and application of water pipe network model, the model parameters automatic identification is regarded as a kernel bottleneck of model's application in water supply enterprise. The methodology of water pipe network model parameters automatic identification based on GIS and SCADA database is proposed. Then the kernel algorithm of model parameters automatic identification is studied, RSA (Regionalized Sensitivity Analysis) is used for automatic recognition of sensitive parameters, and MCS (Monte-Carlo Sampling) is used for automatic identification of parameters, the detail technical route based on RSA and MCS is presented. The module of water pipe network model parameters automatic identification is developed. At last, selected a typical water pipe network as a case, the case study on water pipe network model parameters automatic identification is conducted and the satisfied results are achieved.