Plague in China 2014-All sporadic case report of pneumonic plague.

BACKGROUND: Yersinia pestis is the pathogen of the plague and caused three pandemics worldwide. Pneumonic plague is rarer than bubonic and septicemic plague. We report detailed clinical and pathogenic data for all the three sporadic cases of pneumonic plagues in China in 2014. CASE PRESENTATION: All the three patients are herders in Gansu province of China. They were all infected by Yersinia pestis and displayed in the form of pneumonic plague respectively without related. We tested patient specimens from the upper (nasopharyngeal swabs) or the lower (sputum) respiratory tract and whole blood, plasma, and serum specimens for Yersinia pestis. All patients had fever, cough and dyspnea, and for patient 2 and 3, unconscious. Respiratory symptoms were predominant with acute respiratory failure. The chest X-ray showed signs consistent with necrotizing inflammation with multiple lobar involvements. Despite emergency treatment, all patients died of refractory multiple organ failure within 24 h after admission to hospital. All the contacts were quarantined immediately and there were no secondary cases. CONCLUSIONS: Nowadays, the plague is epidemic in animals and can infect people who contact with the infected animals which may cause an epidemic in human. We think dogs maybe an intermediate vector for plague and as a source of risk for humans who are exposed to pet animals or who work professionally with canines. If a patient has been exposed to a risk factor and has fever and dyspnea, plague should be considered. People who had contact with a confirmed case should be isolated and investigated for F1 antigen analysis and receive post-exposure preventive treatment. A vaccination strategy might be useful for individuals who are occupationally exposed in areas where endemically infected reservoirs of plague-infected small mammals co-exist.

[Impact of the hCG on epidermal growth factor in the phallic tissues of hypospadiac mice].

OBJECTIVE: To investigate the impact of hCG on the epidermal growth factor (EGF) in the phallic tissues of hypospadiac mice. METHODS: The Kunming mouse model of congenital hypospadias was established. As controls, 10 three-week-old normal male mice and 10 3-week-old congenital hypospadiac mice were injected with isometric sodium chloride intraperitoneally. Another 40 mice with hypospadias were divided into 4 groups and injected intraperitoneally with 50 IU, 100 IU, 150 IU and 200 IU of hCG respectively per day for 7 days. Then the concentration of ECG in the phallus and in the serum were assayed by ELISA. RESULTS: The EGF level in the phallus of the hypospadiac mice was much lower than that of the controls statistically (P < 0. 05). After the injection of exogenous hCG, the concentration of ECG increased with the dose of hCG, 50 IU (59.57 +/- 22.16) pg/ml, 100 IU (57.97 +/- 9.59) pg/ml, 150 IU (73.02 +/- 31.35) pg/ml and 200 IU (92.45 +/- 35.74) pg/ml. The concentration of ECG showed no significant difference between the control group and the 150 IU and 2000 IU groups (P > 0.05). CONCLUSION: Decreased concentration of EGF in the mouse phallus may be associated with the pathogeny of hypospadias. A proper dose of exogenous hCG may increase the concentration of EGF in the mouse phallus.

Coronary artery plaque imaging: Comparison of black-blood MRI and 64-multidetector computed tomography.

OBJECTIVE: To comparatively evaluate black-blood coronary arterial wall MRI and 64-multidetector computed tomography (64-MDCT) for detection and classification of coronary artery plaques. METHODS: We included 15 patients with confirmed coronary artery plaques in the proximal or middle segments of coronary arteries by 64-MDCT, who underwent black-blood coronary wall MRI at 1.5 T within 10 days. Cross-sectional coronary wall images were acquired using a 2D double-inversion-recovery, electrocardiograph-triggered, navigator-gated, fat-suppressed, turbo-spin-echo sequence on the coronary arteries with lesions from the ostium to the middle segment continuously without gap. The vessel cross-sectional area (CSA), luminal CSA, maximal wall thickness, plaque burden, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were measured in each slice and subsequently compared with computed tomography angiography (CTA) images. CTA images were divided into 5-mm segments for side-by-side comparison with MRI. RESULTS: Of the 15 patients, 12 were enrolled in the study. Coronary plaques were found in 46 slices on both CTA and MRI. Plaques were classified to 3 groups based on CTA: calcified plaques (n = 11), soft plaques (n = 23), and mixed plaques (n = 12). In MRI, the plaque burden, maximal wall thickness, SNR, and CNR in the coronary walls containing plaques were greater than in the normal coronary walls (0.83 ± 0.08 vs. 0.73 ± 0.08, 1.88 ± 0.51 vs. 1.51 ± 0.26 mm, 12.95 ± 2.78 vs. 9.93 ± 2.31, and 6.76 ± 2.52 vs. 3.89 ± 1.54, respectively; P < 0.05). The luminal CSA at the plaque was smaller than in normal coronary walls (2.50 ± 1.50 vs. 4.72 ± 2.28 mm2; P < 0.05). The SNR in the soft plaque was significantly greater than in calcified and mixed plaques (P < 0.05). CONCLUSIONS: Coronary wall MRI can identify coronary plaques in the proximal and middle segments and has the potential to differentiate plaque types based on signal intensity.