Impact of HbA1c control and type 2 diabetes mellitus exposure on the oral microbiome profile in the elderly population.

Objective: To investigate the associations of the oral microbiome status with diabetes characteristics in elderly patients with type 2 diabetes mellitus. Methods: A questionnaire was used to assess age, sex, smoking status, drinking status, flossing frequency, T2DM duration and complications, and a blood test was used to determine the glycated haemoglobin (HbA1c) level. Sequencing of the V3-V4 region of the 16S rRNA gene from saliva samples was used to analyze the oral microbiome. Results: Differential analysis revealed that Streptococcus and Weissella were significantly enriched in the late-stage group, and Capnocytophaga was significantly enriched in the early-stage group. Correlation analysis revealed that diabetes duration was positively correlated with the abundance of Streptococcus (r= 0.369, p= 0.007) and negatively correlated with the abundance of Cardiobacterium (r= -0.337, p= 0.014), and the level of HbA1c was not significantly correlated with the oral microbiome. Network analysis suggested that the poor control group had a more complex microbial network than the control group, a pattern that was similar for diabetes duration. In addition, Streptococcus has a low correlation with other microorganisms. Conclusion: In elderly individuals, Streptococcus emerges as a potential biomarker linked to diabetes, exhibiting elevated abundance in diabetic patients influenced by disease exposure and limited bacterial interactions.

Hemodynamic-based virtual surgery design of double-patch repair for pulmonary arterioplasty in tetralogy of Fallot.

BACKGROUND AND OBJECTIVE: Surgical correction of pulmonary artery stenosis (PAS) is essential to the prognosis of patients with tetralogy of Fallot (TOF). The double-patch method of pulmonary arterioplasty is usually applied in case of multiple stenosis in TOF patients' pulmonary artery (PA) and when PAS cannot be relieved by the single-patch method. The surgical planning for the double-patch design remains challenging. The purpose of this study is to investigate the double-patch design with different angulations between the left pulmonary artery (LPA) and the right pulmonary artery (RPA), and to understand postoperative hemodynamic alterations by the application of computer-aided design (CAD) and computational fluid dynamics (CFD) techniques. METHODS: The three-dimensional model of the PA was reconstructed based on preoperative computed tomography imaging data obtained from the patient with TOF. Three postoperative models with different designs of double-patch were created by "virtual surgery" using the CAD technique. Double-Patch 120 Model was created with double patches implanted in the main pulmonary artery (MPA) and the PA bifurcation and without changing the spatial position of PA. The angulation between the LPA and the RPA was defined as θ, which equaled to 120° in Pre-Operative Model and Double-Patch 120 Model. Based on Double-Patch 120 Model, Double-Patch 110 Model and Double-Patch 130 Model were generated with θ equaled to 110° and 130°, respectively. Combined with CFD, the differences of velocity streamlines, wall shear stress (WSS), flow distribution ratio (FDR), and energy loss (EL) were compared to analyze postoperative pulmonary flow characteristics. RESULTS: The values of velocity and WSS decreased significantly after virtual surgery. Obvious vortices and swirling flows were observed downstream of the stenosis of RPA and LPA in Pre-Operative Model, while fewer vortices developed along the anterior wall of the expanded lumens of RPA, especially in Double-Patch 110 Model. With the relief of PAS, two relatively higher WSS regions were observed at the posterior walls of RPA and LPA. The maximum WSS values in these regions of Double-Patch 110 Model were lower than those in Double-Patch 120 Model and Double-Patch 130 Model. Furthermore, the FDRs were elevated and the ELs were greatly reduced. It was found that Double-Patch 110 Model with the angulation between the LPA and the RPA equaled to 110° showed relatively better properties of hemodynamics than other models. CONCLUSIONS: The angulation between the LPA and the RPA is an important factor that should be integrated in the double-patch design for TOF repair. Virtual surgery based on patient-specific vascular model and computational hemodynamics can be used to provide assistance for individualized surgical planning of double-patch arterioplasty.

Computed tomography-based radiomics to assess risk stratification in pediatric malignant peripheral neuroblastic tumors.

This study aimed to develop and validate an analysis system based on preoperative computed tomography (CT) to predict the risk stratification in pediatric malignant peripheral neuroblastic tumors (PNTs). A total of 405 patients with malignant PNTs (184 girls and 221 boys; mean age, 33.8 ±â€…29.1 months) were retrospectively evaluated between January 2010 and June 2018. Radiomic features were extracted from manually segmented tumors on preoperative CT images. Spearman's rank correlation coefficient and the least absolute shrinkage and selection operator (LASSO) were used to eliminate redundancy and select features. A risk model was built to stratify low-, intermediate-, and high-risk groups. An image-defined risk factor (IDRFs) model was developed to classify 266 patients with malignant PNTs and one or more IDRFs into high-risk and non-high-risk groups. The performance of the predictive models was evaluated with respect to accuracy (Acc) and receiver operating characteristic (ROC) curve, including the area under the ROC curve (AUC). The risk model demonstrated good discrimination capability, with an area under the curve (AUC) of 0.903 to distinguish high-risk from non-high-risk groups, and 0.747 to classify intermediate- and low-risk groups. In the IDRF-based risk model with the number of IDRFs, the AUC was 0.876 for classifying the high-risk and non-high-risk groups. Radiomic analysis based on preoperative CT images has the potential to stratify the risk of pediatric malignant PNTs. It had outstanding efficiency in distinguishing patients in the high-risk group, and this predictive model of risk stratification could assist in selecting optimal aggressive treatment options.

Suprapatellar pouch effusion is associated with an increased risk of neglected osteochondral fractures in primary acute traumatic patellar dislocation: a consecutive series of 113 children.

BACKGROUND: The aim of this study was to investigate the risk factors of neglected osteochondral fractures in primary acute traumatic patellar dislocation in the pediatric population. METHODS: A total of 113 patients with primary acute traumatic patellar dislocation for whom coincident osteochondral fractures could not be confirmed by X-ray examination at initial diagnosis between January 2010 and February 2022 were retrospectively analyzed. Medical history, physical examination, and radiographic images were recorded in detail. The greatest dimension of the suprapatellar pouch (SP) effusion on radiograph was measured. Computed tomography and magnetic resonance imaging were used to confirm the presence of neglected osteochondral fractures and measure the fragment size. Potential risk factors were calculated and correlated with reference to the neglected osteochondral fractures and fragment size using multivariate linear regression analysis. RESULTS: Weight, walking ability, effusion grade, and SP measurement had a significant correlation with neglected osteochondral fractures in primary acute traumatic patellar dislocation (p = 0.046; p < 0.001; p = 0.048; p < 0.001). The cutoff point was 53.5 kg for weight and 18.45 mm for SP measurement. In the neglected fractures group, SP measurement was statistically significant with larger fragment size (beta value = 0.457; p < 0.001), and the cutoff point was 26.2 mm. CONCLUSIONS: SP effusion is not only associated with an increased risk of neglected osteochondral fractures in primary acute traumatic patellar dislocation but also with larger fragment size. Knee radiograph, medical history, and physical examination can predict the need for further imaging examination and even surgery in primary acute traumatic patellar dislocation.

Analysis of differences in tobacco leaf microbial communities after redrying in Chinese provinces and from abroad.

Microorganisms play an important role in the tobacco aging process. Before the aging process, raw tobacco leaves must be threshed and redried. In order to explore the differences of microbial community structure of threshed and redried tobacco leaves from different origins at home and abroad, 14 groups of tobacco leaves from 8 different countries were tested by high-throughput DNA sequencing and microbiology analysis. Then, through amplicon sequence variants (ASV) cluster analysis, Venn diagram and species labeling and other microbial diversity analysis, the dominant bacteria and fungi on the surface of threshed and redried tobacco leaves were obtained. The results showed that there were significant differences in the composition of tobacco bacteria and fungi after threshing and redrying from different geographical areas. The relative abundance of Microbacterium and Sphingomonas in domestic tobacco leaves was significantly higher than that of foreign tobacco leaves. The relative abundance of Pseudomonas in foreign tobacco bacterial colonies was significantly higher than that of domestic tobacco leaves. In terms of fungi, the relative abundance of Aspergillus and Alternaria in domestic tobacco leaves was significantly higher than that of foreign tobacco leaves. Septoria, Sampaiozyma, Cladosporium and Phoma account for significantly higher proportions of foreign tobacco leaves. These microorganisms may be indispensable in aging process to form different flavors of tobacco leaves. It provides an important theoretical basis for the further use of microorganisms to promote tobacco leaf aging.

Characterization of bacterial community in tobacco leaves at flue-curing and redrying processing stages.

During the processing of tobacco leaves, flue-curing and redrying can affect the structure of bacterial community, having an effect on the aging quality of tobacco leaves. In order to characterize the effects of flue-curing and redrying on the bacterial community of tobacco leaves, the bacterial community of samples at different processing stages (before flue-curing, after flue-curing, before redrying and after redrying) was analyzed using Illumina sequencing. A total of 33 phyla, 79 classes, 195 orders, 344 families, 826 genera and 7922 ASVs were obtained from 36 samples. There was no significant difference in the core bacterial groups of tobacco leaf at four processing stages. Proteobacteria dominated at the phylum level. Sphingomonas, Pseudomonas and Methylobacterium were the main genera shared by all samples. The functional prediction by PICRUSt showed an increase in the relative abundance of pathway related to metabolism after flue-curing and pathway related to environmental information processing after redrying. This study, we analyzed the changes of bacterial community and structural composition of tobacco leaves from flue-curing to redrying, and found that flue-curing had a greater effect on the microbial community than redrying. This is conducive for the exploration of microbial resources and improvement of tobacco leaf quality.

A novel victorivirus isolated from the tobacco spot blight fungus Stagonosporopsis cucurbitacearum in China.

Stagonosporopsis cucurbitacearum is an important plant-pathogenic fungus that causes stem and leaf blight diseases in a variety of crops. Here, we report the characterization of a novel victorivirus, tentatively named "Stagonosporopsis cucurbitacearum victorivirus 1" (ScVV-1), isolated from the S. cucurbitacearum isolate M-7. The ScVV-1 genome is 5,165 bp in length with a predicted GC content of 60.1% and contains two large open reading frames (ORF 1 and ORF2) encoding putative proteins that share significant sequence similarity with coat proteins (CPs) and RNA-dependent RNA polymerases (RdRps) of mycoviruses of the family Totiviridae. The ScVV-1 RdRp appears to be translated using a stop-initiation pentanucleotide UAAUG sequence. Phylogenetic analysis based on CP and RdRp amino acid (aa) sequences both indicated that ScVV-1 belongs to the genus Victorivirus in the family Totiviridae. To our knowledge, this is the first full-length genome sequence of a victorivirus infecting S. cucurbitacearum.

Identification and Expression Profiles of Putative Soluble Chemoreception Proteins from Lasioderma serricorne (Coleoptera: Anobiidae) Antennal Transcriptome.

The cigarette beetle, Lasioderma serricorne (Fabricius) (Coleoptera: Anobiidae), is a destructive stored product pest worldwide. Adult cigarette beetles are known to rely on host volatiles and pheromones to locate suitable habitats for oviposition and mating, respectively. However, little is known about the chemosensory mechanisms of these pests. Soluble chemoreception proteins are believed to initiate olfactory signal transduction in insects, which play important roles in host searching and mating behaviors. In this study, we sequenced the antennal transcriptome of L. serricorne and identified 14 odorant-binding proteins (OBPs), 5 chemosensory proteins (CSPs), and 2 Niemann-Pick C2 proteins (NPC2). Quantitative realtime PCR (qPCR) results revealed that several genes (LserOBP2, 3, 6, and 14) were predominantly expressed in females, which might be involved in specific functions in this gender. The five LserOBPs (LserOBP1, 4, 8, 10, and 12) that were highly expressed in the male antennae might encode proteins involved in specific functions in males. These findings will contribute to a better understanding of the olfactory system in this stored product pest and will assist in the development of efficient and environmentally friendly strategies for controlling L. serricorne.

Highly sensitive time-resolved fluoroimmunoassay for the quantitative onsite detection of Alternaria longipes in tobacco.

AIMS: Alternaria longipes is a causal agent of brown spot of tobacco, which remains a serious threat to tobacco production. Herein, we established a detection method for A. longipes in tobacco samples based on the principle of time-resolved fluoroimmunoassay, in order to fulfil the requirement of rapid, sensitive and accurate detection in situ. METHODS AND RESULTS: A monoclonal antibody against A. longipes was generated, and its purity and titration were assessed using western blot and ELISA. The size of europium (III) nanospheres was measured to confirm successful antibody conjugation. The method described here can detect A. longipes protein lysates as low as 0.78 ng ml-1 , with recovery rates ranging from 85.96% to 99.67% in spiked tobacco. The specificity was also confirmed using a panel of microorganisms. CONCLUSIONS: The fluorescent strips allow rapid and sensitive onsite detection of A. longipes in tobacco samples, with high accuracy, specificity, and repeatability. SIGNIFICANCE AND IMPACT OF THE STUDY: This novel detection method provides convenience of using crude samples without complex procedures, and therefore allows rapid onsite detection by end users and quick responses towards A. longipes, which is critical for disease control and elimination of phytopathogens.

Diagnosis of Infantile Hip Dysplasia With B-Mode Ultrasound via Two-Stage Meta-Learning Based Deep Exclusivity Regularized Machine.

The B-mode ultrasound (BUS) based computer-aided diagnosis (CAD) has shown its effectiveness for developmental dysplasia of the hip (DDH) in infants. In this work, a two-stage meta-learning based deep exclusivity regularized machine (TML-DERM) is proposed for the BUS-based CAD of DDH. TML-DERM integrates deep neural network (DNN) and exclusivity regularized machine into a unified framework to simultaneously improve the feature representation and classification performance. Moreover, the first-stage meta-learning is mainly conducted on the DNN module to alleviate the overfitting issue caused by the significantly increased parameters in DNN, and a random sampling strategy is adopted to self-generate the meta-tasks; while the second-stage meta-learning mainly learns the combination of multiple weak classifiers by a weight vector to improve the classification performance, and also optimizes the unified framework again. The experimental results on a DDH ultrasound dataset show the proposed TML-DERM algorithm achieves the superior classification performance with the mean accuracy of 85.89%, sensitivity of 86.54%, and specificity of 85.23%.

Construction of a TRFIC strip for rapid and sensitive detection of Ralstoniasolanacearum.

The development of a sensitive and rapid screening method for Ralstonia solanacearum is critical for the control of tobacco wilt. In the present study, tissue homogenates of three tobacco varieties (Honda, Yunnan 87 and K326) with different resistance to R. solanacearum, were individually used as additives to the bacteria culture medium. The changes in R. solanacearum secretome were investigated and one of the most abundant secretary proteins with increased expression, polygalacturonase (PG), was selected as a marker for R. solanacearum identification. Then PG gene was cloned into E. coli, and the expressed protein was used as the immunogen to develop monoclonal antibodies. Subsequently, the monoclonal antibody against PG was coupled with synthesized polystyrene microspheres, and a rapid test strip system was developed for the detection of R. solanacearum based on time-resolved fluorescent immunochromatographic (TRFIC) method. Under optimal conditions, the detection limit of the strips could reach 72 cells/mL; while it was 422 cells/mL with a linear range from 4 × 102 to 5.12 × 104 cells/mL when testing tobacco samples, which is 1000 times lower than that of colloidal gold-labeled strips. Notably, no cross-reactivity was observed with nine tobacco-related pathogens. Finally, this TRFIC strips was applied to detect R. solanacearum existed in the tobacco and soils of fields with or without bacterial wilt. The results demonstrated that this TRFIC strips could distinguish the difference in bacterial concentration existed in tobacco and soil between the two fields. In summary, this test strip is suitable for sensitive, quick screening of R. solanacearum in tobacco.

Effects of Patent Ductus Arteriosus on the Hemodynamics of Modified Blalock-Taussig Shunt Based on Patient-Specific Simulation.

The question of preserving the patent ductus arteriosus (PDA) during the modified Blalock-Taussig shunt (MBTS) procedure remains controversial. The goal of this study was to investigate the effects of the PDA on the flow features of the MBTS to help with preoperative surgery design and postoperative prediction. In this study, a patient with pulmonary atresia and PDA was included. A patient-specific three-dimensional model was reconstructed, and virtual surgeries of shunt insertion and ductus ligation were performed using computer-aided design. Computational fluid dynamics was utilized to analyze the hemodynamic parameters of varied models based on the patient-specific anatomy and physiological data. The preservation of the PDA competitively reduced the shunt flow but increased total pulmonary perfusion. The shunt flow and ductal flow collided, causing significant and complicated turbulence in the pulmonary artery where low wall shear stress, high oscillatory shear index, and high relative residence time were distributed. The highest energy loss was found when the PDA was preserved. The preservation of PDA is not recommended during MBTS procedures because it negatively influences hemodynamics. This may lead to pulmonary overperfusion, inadequate systemic perfusion, and a heavier cardiac burden, thus increasing the risk of heart failure. Also, it seems to bring no benefit in terms of reducing the risk for thrombosis.

Preoperative Morphological Prediction of Early Reoperation Risk After Primary Repair in Tetralogy of Fallot: A Contemporary Analysis of 83 Cases.

This study was conducted to investigate the pulmonary artery (PA) variations in tetralogy of Fallot (TOF) and preoperative morphological predictors for early reoperation. Eighty-three TOF patients and 20 children with normal PA were included. The TOF group was divided into two subsets according to whether or not reoperation was performed within 3 years postoperatively. Clinical information was obtained, along with computed tomography (CT)-based three-dimensional geometry of the PA. Morphological measurements of the length of the main PA branches, the angles between them, and the cross-sectional area of each segment of the PAs were acquired using computer software. Logistic regression and receiver operating characteristic curves were applied to analysis. The TOF group showed a significantly smaller PA size and irregular PA shape, with lower Nakata and McGoon indices, than the control group. The median bifurcation angle (angle-γ) was greater than 100° in the TOF group, as compared to 66.70° in the control group (P < 0.000). Residual obstruction of the infundibulum or PAs was the main reason for early reoperation in this series. The development of the main PA and left PA was poorer in the reoperation subset than in the non-reoperation subset (P ≤ 0.01). The preoperative angle-γ in the reoperation subset was larger than that in the non-reoperation subset (median, 117.8° vs. 112.0°, P = 0.026). Higher weight (OR = 0.372) and McGoon index (OR = 0.122) were protective factors, while larger angle-γ (> 114.8°, OR = 5.040) and angle-γ normalized by body surface area (BSA) (γ/BSA > 297.9, OR = 18.860) were risk factors. This study provides an intuitive perspective of PA anatomical variations in TOF. Larger preoperative PA bifurcation angle and γ/BSA were morphological risk predictors of postoperative reoperation in patients with TOF.

Feasibility of using a non-sedation protocol for evaluation of neonatal congenital heart disease by using a 16-cm wide-detector computed tomography with a low radiation dose: preliminary experience from a single pediatric medical center.

The aim of this study is to explore the feasibility of using a non-sedation protocol for the evaluation of neonatal congenital heart disease by using 16-cm wide-detector CT with a low radiation dose. Thirty-four neonates (group 1) were enrolled to undergo cardiac CT without sedation between August 2018 and March 2019. The control group (group 2) comprising 20 inpatient neonates was sedated. Cardiac CT was performed using 16-cm area detector 320-row CT with free breathing and prospective ECG-triggering scan mode. The examination completion time, radiation dose, and image quality were compared between the groups. The results of cardiac CT for patients in group 1 who underwent surgery were compared with surgical findings. Intergroup differences in body weight, age, examination completion time, radiation dose, and image quality evaluation were not significant. There was no significant difference in oxygen saturation before and after the examination in group 1. In all, 98 separate cardiovascular abnormalities in 27 group 1 patients were confirmed using surgical reports. The overall sensitivity, specificity, positive predictive value, and negative predictive value of cardiac CT were 94.90%, 100.0%, 100.0%, and 98.53%. The non-sedation protocol can be applied in neonates with congenital heart disease by using 16-cm wide-detector CT with a low radiation dose. Based on the image quality obtained, non-sedative examination did not extend the examination completion time and helped avoid the possible side effects of sedative drugs.

Pulmonary artery hemodynamic assessment of blood flow characteristics in repaired tetralogy of Fallot patients versus healthy child volunteers.

BACKGROUND: This study aimed to assess the severity of helix and vortex flow in pulmonary artery hemodynamic using 4-dimensional flow cardiac magnetic resonance (4D flow CMR) in patients with repaired tetralogy of Fallot (rTOF) and healthy child volunteers and to explore the relationship between pulmonary hemodynamic changes and right heart function. METHODS: CMR studies were performed in 25 rTOF patients (15 M/10 F; 8.44±4.52 years) and 10 normal child volunteers (7 M/3 F; 8.2±1.22 years) on 3.0T MR scanners. Cardiac function was calculated in the patient and control groups. Systolic diameter, peak velocity, net flow, and regurgitation was quantified in the main pulmonary artery (MPA) plane, left pulmonary artery (LPA) plane, and right pulmonary artery (RPA) plane. The relationship between the hemodynamic parameters and quantitative flow indices and right ventricular (RV) function were analyzed through simple linear regression analysis using Pearson R-values. We analyzed differences in flow patterns between the 2 groups for the same slice. According to the severity of the helix and vortex flow in the 4D flow CMR, we categorized rTOF patients into the following groups: group 1, severe flow grading; group 2, mild flow grading; group 3, no flow grading; the control cases with no flow grade were included in group 4. We compared RV cardiac function, wall shear stress (WSS), and viscous energy loss (EL) between group 1+2 and group 3+4 using unpaired t-test analysis for normally distributed data and the Mann-Whitney test for non-normally distributed continuous variables. RESULTS: RV end-diastolic volume index (EDVi) (127.8±36.13 vs. 83.11±6.18, respectively; P<0.001), RV end-systolic volume index (ESVi) (65.14±27.02 vs. 36.13±5.95, respectively; P<0.001), and ejection fraction (EF) (49.97±6.39 vs. 56.71±4.56, respectively; P=0.006,) were significantly different between the groups. The rTOF diameters of the MPA and RPA were significantly larger than those of the control group (19.74±4.01 vs. 14.97±2.37 for MPA, P=0.001; 12.04±3.28 vs. 8.99±1.23 for RPA, P=0.004, respectively). There were correlations between peak WSS and pulmonary regurgitation (PR) in the MPA (R=0.48, P=0.014), correlations between peak systolic EL and RVEDV (R=0.51, P=0.008), and between peak systolic EL and RVESV (R=0.51, P=0.009). The peak systole and diastole WSS of group 1+2 were significantly different compared to group 3+4 in the MPA (P<0.05). The peak systole and diastole EL of group 1+2 was significantly different from group 3+4 in the MPA (P<0.05). The peak systole EL of group 1+2 was significantly different from group 3+4 in the RPA (P<0.01). CONCLUSIONS: Increased peak WSS and EL were associated with pulmonary hemodynamic changes in the MPA and RPA. There might be an earlier marker of evolving hemodynamic inefficiency than that in traditional parameters. The better understanding of pulmonary artery hemodynamic assessment in rTOF may lead to a greater insight into pulmonary artery (PA)-RV interactions and how they ultimately impact RV function.

Hip morphology in mucopolysaccharidosis type IVA through radiograph, magnetic resonance imaging and arthrogram assessment.

PURPOSE: This study examined the hip morphology of paediatric patients with mucopolysaccharidosis (MPS) type IVA (MPS IVA). METHODS: This was a retrospective chart review of 42 hips in 21 children with MPS IVA. Pelvic radiographs and magnetic resonance imaging (MRI) scans of 42 hips and arthrograms of 13 hips were analysed. The bony, cartilaginous and labral coverage of the acetabulum was determined by acetabular index (AI), centre edge angle (CEA) and femoral head coverage (FHC). RESULTS: The mean age at the time of radiography was 66.3 ± 21.7 months. The bony, cartilaginous and labral AI in the MRI assessment were 36.3 ± 5.3, 18.3 ± 4.7 and 12.1 ± 4.6 degrees, respectively. The inter-class correlation coefficients (ICCs) for the bony AI, CEA and FHC measurements on radiographs and MRI were 0.936, 0.879 and 0.810, respectively. In the MRI assessment, labrum in 12 of 42 hips appeared as a regular triangle, and it was flat on 30/42 hips. The average arthrographic AI (AAI) was 11.1 ± 2.7 degrees. The ICCs value of AAI versus cartilaginous and labral AI on MRI indicates good agreement but higher in labral AI. CONCLUSION: Hips in MPS IVA exhibited obvious cartilage and labrum compensation in response to abnormal ossification of bony acetabulum. Cartilage in MPS IVA hip increases the thickness in the longitudinal direction, while the labrum becomes flatten in the horizontal direction. The AAI may represent intraoperative labrum coverage. The femora-acetabular harmony is difficult to determine using radiography only, and pre-operative MRI and an intraoperative arthrogram are very important in a hip assessment in MPS IVA.

Early open reduction of dislocated hips using a modified Smith-Petersen approach in arthrogyposis multiplex congenita.

BACKGROUND: Arthrogryposis multiplex congenita (AMC) is a rare syndrome with multiple joint contractures. Within the medical community, there is controversy surrounding AMC in terms of the ideal surgical approach and age for performing a reduction of dislocated hips. The purpose of this retrospective study was to evaluate the clinical outcomes of early open reduction of infant hip dislocation with arthrogryposis multiplex congenita following a modified Smith-Petersen approach that preserves the rectus femoris. METHODS: From 2010 to 2017, we performed this procedure on 28 dislocated hips in 20 infants under 12 months of age with AMC. The clinical and radiology data were reviewed retrospectively. The mean age at surgery was 6.9 ± 5.1 months, with a mean follow-up of 42.4 ± 41.1 months. RESULTS: After open reduction, the average hip acetabular index (AI), the international hip dysplasia institute classification (IHDI), and the hip range of motion significantly improved (all P < 0.001). After the surgery, 16 patients were community walkers, and four patients were home walkers. Three hips in two patients required secondary revision surgery for residual acetabular dysplasia with combined pelvic osteotomy and femoral osteotomy. Seven of the hips that had been operated on showed signs of avascular necrosis (AVN). Among them, four were degree II, two were degree III, and one was degree IV. Multiple linear regression analysis demonstrated that greater age (in months) heightened the risk for secondary revision surgery (P = 0.032). CONCLUSIONS: The modified Smith-Petersen approach preserving the rectus femoris is an encouraging and safe option for treating hip dislocation in young AMC patients (before 12 months). If surgery takes place at less than 12 months of age for patients with AMC, this earlier open reduction for hip dislocation may reduce the chances of secondary revision surgery. LEVEL OF EVIDENCE: IV, retrospective non-randomized study.

Systemic ventricular strain and torsion are predictive of elevated serum NT-proBNP in Fontan patients: a magnetic resonance study.

BACKGROUND: This study aimed to investigate the associations between cardiac strain, cardiac torsion, ventricular volumes, and ventricular ejection fraction, with N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in Fontan patients who were age- and gender-matched with healthy control subjects. METHODS: Cardiovascular magnetic resonance (CMR) studies performed in 22 (15 male, 7 female) patients with single-ventricle physiology (all morphological left ventricles) palliated with Fontan and 17 (10 male, 7 female) age- and gender-matched healthy children volunteers were retrospectively analyzed. Serum NT-proBNP levels were obtained in Fontan subjects. Standard post-processing of CMR images included systemic ventricular end-diastolic and end-systolic volumes, stroke volume, cardiac mass, atrioventricular regurgitation, and ejection fraction. CMR tissue tracking (TT) software was used to quantify global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) and torsion of the systemic ventricle. Pearson and Spearman correlation coefficients were used in comparisons of correlations between NT-proBNP and functional parameters in repair Fontan patients. Intra-observer and inter-observer variability of CMR strain and torsion values were determined from 10 randomly selected Fontan subjects and 10 randomly selected control subjects. RESULTS: GLS was significantly lower in Fontan patients than in control subjects (-15.19±2.94 vs. -19.97±1.70; P<0.001). GLS was not significantly different between normal NT-proBNP levels and high NT-proBNP levels in Fontan patients (-15.59±2.72 vs. -14.62±3.32; P=0.462). The GCS of repair Fontan patients was not significantly lower than that of the control group (-16.76±3.27 vs. -17.88±2.26; P=0.235). GCS was significantly different between normal and high NT-proBNP levels group in Fontan patients (-17.95±2.43 vs. -15.04±3.67; P=0.036). The peak systolic torsion and peak systolic torsion rates were significantly lower in Fontan patients than in control subjects (0.81±0.41 vs. 1.07±0.36, P=0.044; 7.36±3.41 vs. 9.85±2.61, P=0.017). Peak systolic torsion was significantly lower in Fontan patients with normal NT-proBNP levels than in high NT-proBNP subjects (0.67±0.43 vs. 1.01±0.29; P=0.036). GCS and torsion were more strongly correlated with NT-proBNP in the patient group (r=0.541 for GCS; r=0.588 for torsion, P<0.01). The parameters of strain and torsion could be reproduced with sufficient accuracy by intra-observer agreement(biases =0.04 for GLS; biases =0.66 for GCS; biases =1.03 for GRS; biases =0.04 for torsion) and inter-observer agreement (biases =0.32 for GLS; biases =0.85 for GCS; biases =1.52 for GRS; biases =0.18 for torsion). CONCLUSIONS: GLS is an earlier marker of contractile dysfunction in repair Fontan patients. Peak systolic torsion may be a biomarker for determining subclinical dysfunction, as it is more strongly correlated with serum biomarkers of ventricular function than ventricular size or ejection fraction.

High concentrations of serum interleukin-6 and interleukin-8 in patients with bipolar disorder.

Immune system dysregulation plays a key role in the physiopathology of bipolar disorder (BD) and major depressive disorder (MDD). However, whether interleukins might be biomarkers to distinguish these 2 affective disorders is unclear. Here, we assessed the differences in serum levels of interleukin 6 (IL-6) and interleukin 8 (IL-8) as well as C-reactive protein (CRP) in patients with MDD and BD. In total, we enrolled 21 MDD patients, 26 BD patients, and 20 healthy controls. We collected a total of 35 samples from BD patients in 3 different phases, depression phase, manic phase, and remission stage, and 27 samples from MDD patients in acute and remission phases. Serum IL-6 and IL-8 levels were assessed with solid phase sandwich ELISA-based quantitative arrays, and CRP levels were determined with an automatic analyzer. Both serum IL-6 and IL-8 levels were elevated in BD patients but not MDD patients. Subgroup analysis indicated elevated serum IL-6 in both the depression and manic phases in BD patients. The serum CRP levels did not change in either BD or MDD patients. However, sex differences in CRP concentrations were observed in healthy controls. Furthermore, there were linear correlations between the CRP levels and Bech-Rafaelsen Mania Rating Scale (BRMS) scores in BD patients. IL-6 and IL-8 levels may serve as biomarkers to differentiate between MDD and BD patients, even when the clinical manifestations are atypical. IL-6 may be used for the differential diagnosis of MDD and depressive episodes in BD.

Carbon Monoxide Potentiates High Temperature-Induced Nicotine Biosynthesis in Tobacco.

Carbon monoxide (CO) acts as an important signal in many physiological responses in plants, but its role in plant secondary metabolism is still unknown. Nicotine is the main alkaloid generated in tobacco and the plant hormone jasmonic acid (JA) has previously been reported to efficiently induce its biosynthesis. Whether and how CO interacts with JA to regulate nicotine biosynthesis in tobacco remains elusive. In this study, we demonstrate that high temperature (HT) induces quick accumulation of nicotine in tobacco roots, combined with an increase in CO and JA concentration. Suppressing CO generation reduced both JA and nicotine biosynthesis, whereas exogenous application of CO increased JA and nicotine content. CO causes an increased expression of NtPMT1 (a key nicotine biosynthesis enzyme), via promoting NtMYC2a binding to the G-box region of its promoter, leading to heightened nicotine levels under HT conditions. These data suggest a novel function for CO in stimulating nicotine biosynthesis in tobacco under HT stress, through a JA signal.