[The ineffective or short-term recurrence of trigeminal neuralgia after microballoon compression:different causes and management strategies].

Objectives: To explore the causes of ineffective or short-term recurrence (within 3 months)of trigeminal neuralgia treated by percutaneous microballoon compression(PBC), and to examine the reoperative strategies and clincal outcomes of modified PBC. Methods: The clinical data of 21 patients with ineffective or short-term recurrence after PBC treatment (5.7% of 369 patient received PBC) admitted to the Department of Neurosurgery,Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University from June 2018 to June 2020 were retrospectively analyzed.There were 8 males and 13 females, mean aged 66.6 years (range:51 to 79 years).Among them,2 patients was ineffective after PBC and 19 patients relapsed within 3 months.The distribution of pain was along V2 branches in 2 cases,V3 branches in 3 cases,V1+V2 branches in 1 case,and V2+V3 branches in 15 cases.The mean time of recurrence was 46.8 days (range:23 to 76 days) among the 19 patients with short-term recurrence.The patients were divided into 4 types based on the causes of postoperative ineffectiveness or short-term recurrence.TypeⅠ:extracapsular false pear (1 case);Type Ⅱ:invalid true pear(2 cases);Type Ⅲ:capsular rupture (6 cases);Type Ⅳ:compression blind area (12 cases).The individualized modified PBC operation plans were used according to the types of the patients and the clinical effect and complications of the patients were observed. Results: The pain symptoms of the patients disappeared after the second operation with immediate effective rate of 100%. All patients had mild facial numbness after surgery.Five patients(23.8%,5/21) had masseter muscle weakness, 3 (14.3%,3/21) had peristomatous herpes, 1(4.8%, 1/21) had diplopia.No bleeding or other complications occurred.All patients were followed up for at least 12 months (range:13 to 28 months). One patient (4.8%,1/21) (compression blind area type) had pain recurrence 9 months after surgery, and cured by receiving the original modified PBC surgery again with no recurrence after another 13 months' follow-up. None of the other patients relapsed during the follow-up period.Up to the last follow-up,19 cases(90.5%,19/21) were cured,and 2 cases (9.5%,2/21) were relieved. Conclusions: The main reason for ineffective or short-term recurrence of PBC in trigeminal neuralgia patients is the ineffectively compressed of trigeminal ganglion.According to the different types of patients,the use of individualized modified surgical scheme can improve the efficacy of PBC surgery.

Signal transduction pathways in Synechocystis sp. PCC 6803 and biotechnological implications under abiotic stress.

Cyanobacteria have developed various response mechanisms in long evolution to sense and adapt to external or internal changes under abiotic stresses. The signal transduction system of a model cyanobacterium Synechocystis sp. PCC 6803 includes mainly two-component signal transduction systems of eukaryotic-type serine/threonine kinases (STKs), on which most have been investigated at present. These two-component systems play a major role in regulating cell activities in cyanobacteria. More and more co-regulation and crosstalk regulations among signal transduction systems had been discovered due to increasing experimental data, and they are of great importance in corresponding to abiotic stresses. However, mechanisms of their functions remain unknown. Nevertheless, the two signal transduction systems function as an integral network for adaption in different abiotic stresses. This review summarizes available knowledge on the signal transduction network in Synechocystis sp. PCC 6803 and biotechnological implications under various stresses, with focuses on the co-regulation and crosstalk regulations among various stress-responding signal transduction systems.

The evolutionary history of hepaciviruses.

In the search for natural reservoirs of hepatitis C virus (HCV), a broad diversity of non-human viruses within the Hepacivirus genus has been uncovered. However, the evolutionary dynamics that shaped the diversity and timescale of hepaciviruses evolution remain elusive. To gain further insights into the origins and evolution of this genus, we screened a large dataset of wild mammal samples (n = 1,672) from Africa and Asia, and generated 34 full-length hepacivirus genomes. Phylogenetic analysis of these data together with publicly available genomes emphasizes the importance of rodents as hepacivirus hosts and we identify 13 rodent species and 3 rodent genera (in Cricetidae and Muridae families) as novel hosts of hepaciviruses. Through co-phylogenetic analyses, we demonstrate that hepacivirus diversity has been affected by cross-species transmission events against the backdrop of detectable signal of virus-host co-divergence in the deep evolutionary history. Using a Bayesian phylogenetic multidimensional scaling approach, we explore the extent to which host relatedness and geographic distances have structured present-day hepacivirus diversity. Our results provide evidence for a substantial structuring of mammalian hepacivirus diversity by host as well as geography, with a somewhat more irregular diffusion process in geographic space. Finally, using a mechanistic model that accounts for substitution saturation, we provide the first formal estimates of the timescale of hepacivirus evolution and estimate the origin of the genus to be about 22 million years ago. Our results offer a comprehensive overview of the micro- and macroevolutionary processes that have shaped hepacivirus diversity and enhance our understanding of the long-term evolution of the Hepacivirus genus.

Lentinula edodes (Shiitake) mushroom extract protects against hydrogen peroxide induced cytotoxicity in peripheral blood mononuclear cells.

Lentinula edodes (Berk) Pegler, commonly known as Shiitake mushroom has been used as medicinal food in Asian countries, especially in China and Japan and is believed to possess strong immunomodulatory property. In the present study, the methanolic extract of the fruit bodies of L. edodes was investigated for cytoprotective effect against H2O2-induced cytotoxicity in human peripheral blood mononuclear cells (PBMCs) by measuring the activities of xanthine oxidase (XO) and glutathione peroxidase (GPx) . H2O2 at a concentration of 5 microM caused 50% inhibition of PBMCs viability. The extract improved the PBMC viability and exerted a dose-dependent protection against H2O2-induced cytotoxicity. At 100 microg/ml of extract concentration, the cell viability increased by 60% compared with the PBMCs incubated with H2O2 alone. The extract also inhibited XO activity in PBMC, while showing moderate stimulatory effect on GPx. However, in the presence of H2O2 alone, both the enzyme activities were increased significantly. The GPx activity increased, possibly in response to the increased availability of H2O2 in the cell. When the cells were pretreated with the extract and washed (to remove the extract) prior to the addition of H2O2, the GPx and XO activities as well as the cell viability were comparable to those when incubated with the extract alone. Thus, it is suggested that one of the possible mechanisms via which L. edodes methanolic extract confers protection against H2O2-induced oxidative stress in PBMC is by inhibiting the superoxide-producing XO and increasing GPx activity which could rapidly inactivate H2O2.

Occurrence of gastrointestinal nematodes in captive nonhuman primates at Matang Wildlife Centre, Sarawak.

Gastrointestinal nematodes can cause assorted health problems to human and other primates. The status of gastrointestinal nematodes in non-human primates remained less documented in Malaysia. This study aimed to determine the occurrence of gastrointestinal nematodes recovered from the fecal samples of captive non-human primates at the Matang Wildlife Centre (MWC), Sarawak. Fresh fecal samples were collected from 60 non-human primates of six species (i.e. Orangutan, Bornean gibbon, Silvered Leaf monkey, Slow loris, Pig-tailed macaque, and Long-tailed macaque) and processed using simple fecal floatation method and fecal sedimentation method. This study shows high prevalence of nematode infection (>=50%) and co-infection (22 from 45 infected individuals) in all species of captive non-human primates found in MWC, except one individual of young Silvered Leaf monkey was negative for nematode. From these, eight genera of 11 species and one unknown nematode larvae were recovered and among them Oesophagostomum sp., Ascaris sp., and Strongyloides sp. were the most common nematodes infecting the non-human primates. All the Bornean gibbon (n=7) were found to be infected with nematodes. Moreover, Long-tailed macaques at the centre were heavily infected by Ascaris sp. (number of total count, nt = 2132; total mean abundance, MA=113.70). This is the first report of high prevalence nematode infection on multiple species of captive non-human primates in a wildlife centre located in Sarawak. Some of the nematodes are of zoonotic potential. This information is important for health care management, both in-situ and ex-situ conservations of captive and free-ranging nonhuman primates.

Co-infections of ectoparasite species in synanthropic rodents of western Sarawak, Malaysian Borneo.

Little is known regarding infestation of ectoparasites in synanthropic rodents in Sarawak, Malaysia. A total of 44 rodents from three species (Rattus rattus, Rattus tiomanicus and Sundamys muelleri) were trapped from four residential areas in western Sarawak, Malaysia, for ectoparasites screening. A total of 117 ectoparasites from three hard tick species (Ixodes granulatus, Haemaphysalis sp. 1, Haemaphysalis sp. 2), three mesostigmatid mite species (Laelaps echidninus, Laelaps sedlaceki, and Laelaps nuttalli), one trombiculid mite (chigger species), and one louse species (Hoplopleura sp.), were recovered from 32 infected rodents (72.73% infestation). Infestations by multiple ectoparasite species on the same rodent individuals were recorded in R. rattus and R. tiomanicus (28.1%, n=9) in this study, while Sundamys muelleri was only infested with L. echidninus. One R. rattus individual was co-infected with ticks, louse, and mesostigmatid mite. L. echidninus was the generalist ectoparasite species that infected all three rodent species in three of the residential areas studied. Ectoparasite species diversity was significantly different among four residential areas based on Shannon index and diversity t-test (p-value <0.05). This study provides the first record of the association of synanthropic rodents with multiple ectoparasite infections in residential areas of western Sarawak, Malaysia.

Clinics in diagnostic imaging (109). Nocardial adrenal abscess.

A 34-year-old man presented with a two-month history of intermittent fever and left loin pain. A large left suprarenal mass was detected on computed tomography and magnetic resonance imaging. Blood pressure, serum electrolytes, serum cortisol and urinary catecholamines were normal. Laparoscopic adrenalectomy was planned but the mass was found to be an isolated adrenal abscess due to Nocardiosis. He was later found to have AIDS. The clinical utility of various imaging modalities and management of adrenal cysts are reviewed.

Giant mixed-type perinephric liposarcoma.

Retroperitoneal fatty tumours are uncommon occurrences in current urologic practice, the differentials being lipomas, liposarcomas and extra-renal angiomyolipomas (AML). We report an unusual case of a 48-year-old Chinese female who presented with a 6.2 kg giant mixed-type liposarcoma in the left perinephric space, invading into the renal cortex and parenchyma. Extirpative surgery with left radical nephrectomy was performed, and histology confirmed liposarcoma with both myxoid and well-differentiated elements. The patient remains well and disease-free at 6-month follow-up. We review the literature on the diagnosis and management of these perinephric lipomatous lesions. We also discuss the diagnostic dilemma in differentiating such malignancies from benign angiomyolipomas in the perinephric area on conventional radiological imaging, and its direct implications with respect to extent of surgery and renal preservation.

Two cases of intraperitoneal bladder rupture following vaginal delivery.

We report two rare cases of isolated spontaneous intraperitoneal bladder rupture following normal vaginal delivery without concomitant uterine rupture. Two primigravidas, aged 32 years and 34 years, presented following vaginal delivery with abdominal distension and acute renal failure. The initial diagnosis in both cases was severe urosepsis. Definitive diagnosis was achieved after 48 hours. Comparison was made with two of the cases found in the literature and all four cases were reviewed. Laparotomy and bladder repair were performed in all patients with no adverse outcome reported. Two of them were diagnosed only during laparotomy. Key diagnostic clinical features were acute renal failure, new-onset ascites and bowel ileus with sepsis. This rare but life-threatening condition is often diagnosed late. Prompt laparotomy and bladder repair are necessary to prevent an adverse outcome.

Clear cell sarcoma of the rectus sheath.

We report a 35-year-old Chinese woman with clear cell sarcoma of the rectus sheath aponeurosis presenting as a tender anterior abdominal mass. She was treated with wide local excision. Local recurrence and distant metastasis occurred within two months of the onset of the complaint. Clear cell sarcoma is a rare cancer with a propensity for slow progressive invasion. They occur most commonly in the extremities, and the majority of patients are young adults. This case report demonstrates an unusual site of occurrence for clear cell sarcoma.