[Progress of metagenomics next-generation sequencing in the detection of drug-resistant phenotypes of Gram-negative bacteria].

The ongoing spread of drug-resistant bacterial infections poses a significant threat to public health, and early diagnosis and targeted treatment are the keys to successful treatment. Traditional bacterial culture and drug susceptibility testing is time-consuming and insensitive, and cannot meet the needs of clinical diagnosis and treatment, so molecular detection technologies, such as metagenomics next-generation sequencing, have become a new research direction. This article reviewed recent advances in high-throughput sequencing for the diagnosis and treatment of drug resistance in Gram-negative bacteria.

Properties of

Mass-separated ^{187}Ta_{114} in a high-spin isomeric state has been produced for the first time by multinucleon transfer reactions, employing an argon gas-stopping cell and laser ionization. Internal γ rays revealed a T_{1/2}=7.3±0.9 s isomer at 1778±1 keV, which decays through a rotational band with perturbations associated with the approach to a prolate-oblate shape transition. Model calculations show less influence from triaxiality compared to heavier elements in the same mass region. The isomer-decay reduced E2 hindrance factor f_{ν}=27±1 supports the interpretation that axial symmetry is approximately conserved.

[Analysis of pregnancy outcome after fertility-preserving treatment among women with atypical endometrial hyperplasia or endometrial carcinoma].

Objective: To analyze the pregnancy outcome, influencing factors and recurrence of fertility-preserving therapy for women with atypical endometrial hyperplasia (AEH) or endometrial carcinoma (EC). Methods: The multi-center retrospective study included 107 women with AEH or EC for fertility-preserving therapy in 10 hospitals from January 1st, 2009 to December 31st, 2018. The clinical pregnancy rate, live birth rate and recurrence of 66 patients with urgent child-bearing requirements after fertility-preserving treatment were analyzed. Results: (1) Among the 66 AEH and EC women with urgent child bearing requirements, 24 women chose spontaneous pregnancy, the clinical pregnancy rate was 54.2% (13/24) and the live birth rate was 41.7% (10/24), the median time from fertility-preserving therapy withdrawal to clinical pregnancy was 5.5 months. Forty-two women chose assisted reproductive technology (ART), the clinical pregnancy rate was 59.5% (25/42) and the live birth rate was 35.7% (15/42), the median time from fertility-preserving therapy withdrawal to clinical pregnancy was 19.5 months. The time from fertility-preserving therapy withdrawal to pregnancy in women receiving ART was significantly longer than that in women with spontaneous pregnancy (P=0.048). (2) Age and intrauterine adhesions were independent factors affecting the clinical pregnancy rate (P<0.05). (3) Among 107 patients with AEH or EC, the recurrence rate was 27.1% (29/107). Among the 42 cases who chose ART, 9 of them recurred before ART treatment, who received the fertility-preserving therapy again and then ART treatment, 8 women got clinical pregnancy,5 of them delivered at least a live birth. Conclusions: Women with AEH or EC could achieved satisfactory clinical pregnancy rate and live birth rate after fertility-preserving therapy. Age and intrauterine adhesions are independent factors affecting clinical pregnancy rate. The women with recurrent AEH or EC could be treated with fertility-preserving therapy again and get a satisfactory pregnancy outcome.

[Research Status and Limitations of Sadomasochism].

ABSTRACT: Sadomasochism is the sexual interest, psychosexual deviance or sexual crimes that are sexually aroused by suffering or causing others to suffer. This study summarizes the concept, assessment and diagnosis, categories and symptoms, psychological and biological mechanisms, judicial disposition and clinical intervention strategies of sadomasochism from the perspectives of clinical medicine, law, criminology and psychology, suggests that further research should take local people with sadomasochism preference and local patients as research objects, pay attention to different types of sadomasochists, conduct bottom-up research, explore the core elements and manifestations of sadomasochism, and accurately define and classify sadomasochism, construct an effective scale, a erectile measurement sexual stimulation system and a diagnostic criteria; discuss evaluation methods combined with crime scene data; discuss the validity of masochists' consent combined with diagnosis; establish targeted criminal correction programs and a treatment and rehabilitation system to provide reference for the improvement of medical, judicial and mental health services.

Serum uric acid level and left ventricular hypertrophy in elderly male patients with nonvalvular atrial fibrillation.

BACKGROUND AND AIMS: Recent studies have suggested that serum uric acid (SUA) induces oxidative stress and inflammation, which are involved in the mechanism of cardiac hypertrophy. In patients with atrial fibrillation (AF), comorbidity of left ventricular hypertrophy (LVH) exacerbates cardiac function. In this study, we investigated the association between SUA and cardiac hypertrophy in AF patients. METHODS AND RESULTS: Initially, 1296 consecutive elderly patients (age >60) with nonvalvular AF were retrospectively selected from the inpatient clinic between January 2012 and April 2015. Demographic, clinical, and echocardiographic characteristics were carefully recorded. The final study population was 577 patients. The mean SUA level was significantly higher in patients with LVH than those without LVH. Compared with the non-LVH group, the LVH group was older, had a higher percentage of female patients, and had lower hemoglobin levels and estimated glomerular filtration rates. Patients in the LVH group also had a higher rate of coronary heart disease and fewer had history of radiofrequency ablation compared with the non-LVH group. In the hyperuricemia group, B-type natriuretic peptide levels, left atrial diameter, left ventricular mass index, and percentage of NYHA (New York Heart Association) class III/IV were significantly higher than the SUA normal group. Multivariate logistic regression analysis indicated the independent risk factors for LVH in elderly AF patients included SUA, age, male sex, the presence of coronary heart disease, and diuretic therapy. Subgroup analysis identified SUA as a significant risk factor associated with LVH in men. CONCLUSIONS: SUA was independently associated with LVH in elderly male patients with nonvalvular AF.

Effect of atmospheric fine particles on epidermal growth factor receptor mRNA expression in mouse skin tissue.

We investigated the effect of atmospheric fine particles on epidermal growth factor receptor (Egfr) mRNA expression in mouse skin tissue and explored the effect of atmospheric fine particles on skin aging. Forty female BALB/c mice were randomly divided into four groups (each comprising 10 mice) as follows: a saline control group and low-, medium-, and high-dose atmospheric fine particle groups (1.6, 8.0, and 40.0 mg/kg, respectively) (fine particles were defined as those with a diameter of £2.5 mm, i.e., PM2.5). Each dose group was exposed to intratracheal instillation for 3 days. Twenty-four hours after the last exposure, real-time quantitative polymerase chain reaction was used to detect the expression of Egfr mRNA in the skin tissue of each mouse. The expression levels of Egfr mRNA in the medium- and high-dose PM2.5 groups were significantly higher (P < 0.05) than that in the control group, and were positively correlated with the dose. Medium and high concentrations of PM2.5 can induce the expression of Egfr mRNA and promote skin aging.

Uric acid promotes chemokine and adhesion molecule production in vascular endothelium via nuclear factor-kappa B signaling.

BACKGROUND AND AIMS: Hyperuricemia is an important risk factor for atherosclerosis, yet the potential mechanisms are not well understood. Migration and adhesion of leukocytes to endothelial cells play key roles in initiation and development of atherosclerosis. We investigated monocyte-endothelial cell interactions and potential signaling pathways under uric acid (UA)-stimulated conditions. METHODS AND RESULTS: Primary human umbilical vein endothelial cells (HUVECs) were cultured and exposed to different concentrations of UA for various periods. Experimental hyperuricemia rat models were established. Expression of chemoattractant protein-1 (MCP-1), interleukin 8 (IL-8), vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) were evaluated. Monocyte-endothelial cell interactions were elucidated by chemotaxis and adhesion assays, and nuclear factor-kappa B (NF-κB) pathway was studied using fluorescent microscopy and electrophoretic mobility shift assay. Results showed that high concentration of UA stimulated generation of chemokines and adhesion molecules in ex vivo and in vivo experiments. Migration and adhesion of human monocytic leukemia cell line THP-1 cells to HUVECs were promoted and activated NF-κB was significantly increased. UA-induced responses were ameliorated by organic anion transporter inhibitor probenecid and NF-κB inhibitor BAY11-7082. It was also observed that human endothelial cells expressed urate transporter-1, which was not regulated by UA. CONCLUSION: High concentration of UA exerts unfavorable effects directly on vascular endothelium via the NF-κB signaling pathway, the process of which requires intracellular uptake of UA.

Effect of low-dose aspirin on serum uric acid levels in Chinese individuals over 60: subanalysis of a multicentre randomized clinical trial.

OBJECTIVE: Uric acid is considered a biomarker for cardiovascular risk. Only a few studies have investigated the effect of aspirin on serum uric acid (SUA) levels with contradictory results. The present study evaluated the effect of aspirin on SUA levels in Chinese individuals over 60 years of age. PATIENTS AND METHODS: Subjects over 60 with coronary artery disease or multiple cardiovascular risk factors were enrolled in a multicentre randomized clinical trial. Eligible subjects were randomized to receive 50 mg or 100 mg aspirin daily. Levels of arachidonic acid-induced platelet aggregation performed by light transmission aggregometry (LTA-AA) and SUA were measured at randomization and two weeks thereafter. In this subanalysis, subjects without aspirin use prior to enrolment were chosen. RESULTS: A total of 446 subjects were analysed, of which 151 subjects took 50 mg aspirin, and 295 took 100 mg aspirin. Hyperuricaemia was present in 23.3% (104/446) of subjects at baseline. LTA-AA levels were significantly reduced in subjects after taking aspirin for two weeks (both 50 mg and 100 mg, p < 0.001). SUA levels were decreased after aspirin administration (311 µmol/L vs. 302 µmol/L, p < 0.001). Further analysis showed SUA levels were unchanged in normouricaemic subjects (284 µmol/L vs. 280 µmol/L, p > 0.05), while slightly decreased in hyperuricaemic subjects (429 µmol/L vs. 392 µmol/L, p < 0.001). CONCLUSIONS: Our study showed that both 50 mg and 100 mg aspirin significantly inhibited platelet aggregation. Aspirin treatment for two weeks showed no hyperuricaemic effect in people over 60. SUA levels were unchanged after taking aspirin in normouricaemic subjects but decreased in hyperuricaemic subjects. This trial was registered at www. chictr.org.cn as ChiCTR1800018517.

Autofluorescence reveals menstrual phase in the endometrium.

OBJECTIVE: Tissue contains fluorophores that autofluoresce without additional dye or photosensitizer with the appropriate light excitation. This technique has been widely applied for discrimination between normal and precancerous tissue. The aim of this study was to explore the capability and reliability of autofluorescence phase determination in samples of human endometrium. METHODS: A total of 70 measurement sites from 31 endometrial tissue samples from hysterectomy were enrolled. Xenon light (330 nm) was directed at the endometrial tissue and the resultant autofluorescence intensity recorded. Spectra were then grouped according to the proliferative and secretory phase, with multivariant analysis, partial least square (PLS) and analysis of variance (ANOVA) used for evaluation of the statistical significance of phase determination. RESULTS: Both proliferative and secretory autofluorescence spectra showed a similar characteristic triple-peak curve shape pattern, however, each of the intensities at the three peaks between the two phases varied markedly (p < 0.01). PLS analysis confirmed that collagen, NADH and FAD autofluorescence were the principle determinants of endometrial spectrum; the sensitivity and specificity of phase determination by autofluorescent was 100% and 97%, respectively. CONCLUSION: Autofluorescence measurement provides real-time information on endometrial phase status and, based on our results, it appears reasonable to suggest that it may be promising as a clinical tool for prompt phase interpretation.

[Functional modified periauricular incision in parotidectomya].

Objective:The purpose of this study was to present the usefulness of modified periauricular incision in parotid surgical procedures. Method:Sixteen consecutive partial superfacial parotidectomies were performed using modified periauricular incision. Clinical evaluation of cosmetic satisfaction, incidence of complications such as Frey's syndrome, facial nerve palsy, earlobe numbness and salivary fistula were observed. Result:The parotid tumors were removed in all cases with need for any further skin procedures, as the incisions produced a good aesthetic result. The average scale of cosmetic satisfaction are 9.2. Temporary paralysis of the facial nerve were found in two patients, and six patients felt numbness around earlobe after operation. Hey all recovered in 1 to 3 months after surgery. All patient healed without salivary fistula and Frey's syndrome. No recurrence was happened during follow-up in 6 to 30 months (median follow-up period was 22 months). Conclusion:The results of the present study indicate that modified periauricular incision have a high-quality and highly aesthetic option for surgical procedures concerning benign conditions of the parotid gland.

Predictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease.

OBJECTIVES: Previous studies have illustrated the link between high on-aspirin platelet reactivity (HAPR) with increasing thrombotic risks. The aim of our study was to investigate relative risk factors of HAPR in elderly patients with coronary artery disease. METHODS: Elderly, hospitalized coronary artery disease patients on regular aspirin treatment were enrolled from January 2014 to September 2016. Medical records of each patient were collected, including demographic information, cardiovascular risk factors, concomitant drugs and routine biological parameters. Arachidonic acid (AA, 0.5 mg/mL) and adenosine diphosphate (ADP, 5 µmol/L) induced platelet aggregation were measured via light transmission assay (LTA) to evaluate antiplatelet responses, referred as LTA-AA and LTA-ADP. RESULTS: A total of 275 elderly patients were included, with mean age of 77.2±8.1 years, and males accounted for 81.8%. HAPR was defined as LTA-AA in the upper quartile of the enrolled population. HAPR patients tended to have lower renal function (P=0.052). Higher serum uric acid (SUA) level, as well as lower platelet count, hemoglobin and hematocrit were observed in HAPR patients, with a higher proportion of diuretics use (P<0.05). Multivariate analysis revealed that SUA (OR: 1.004, 95% CI: 1.000-1.007, P=0.048), platelet count (OR: 0.994, 95% CI: 0.989-1.000, P=0.045), hematocrit (OR: 0.921, 95% CI: 0.864-0.981, P=0.011) and concomitant P2Y12 receptor inhibitors use (OR: 1.965, 95% CI: 1.075-3.592, P=0.028) were correlated with HAPR. Spearman's correlation analysis demonstrated an inverse association of LTA-AA with hematocrit (r=-0.234, P<0.001), hemoglobin (r=-0.209, P<0.001) and estimated glomerular filtration rate (r=-0.132, P=0.031). CONCLUSION: SUA, platelet count, hematocrit and P2Y12 receptor inhibitors use were independently correlated with HAPR. These parameters might provide novel therapeutic targets for optimizing antiplatelet therapy.

Validation of aspirin response-related transcripts in patients with coronary artery disease and preliminary investigation on CMTM5 function.

Aspirin is widely used in the prevention of cardiovascular diseases, but the antiplatelet responses vary from one patient to another. To validate aspirin response related transcripts and illustrate their roles in predicting cardiovascular events, we have quantified the relative expression of 14 transcripts previously identified as related to high on-aspirin platelet reactivity (HAPR) in 223 patients with coronary artery disease (CAD) on regular aspirin treatment. All patients were followed up regularly for cardiovascular events (CVE). The mean age of our enrolled population was 75.80±8.57years. HAPR patients showed no significant differences in terms of co-morbidities and combined drugs. Besides, the relative expression of HLA-DQA1 was significantly lower in low on-aspirin platelet reactivity (LAPR) patients, when compared with HAPR and high normal (HN) group (p=0.028). What's more, the number of arteries involved, HAPR status and the relative expression of CLU, CMTM5 and SPARC were independent risk factors for CVE during follow up (p<0.05). In addition, overexpression of CMTM5 attenuated endothelial cells (ECs) migration and proliferation, with significantly decreased phosphorylated-Akt levels, while its inhibition promoted these processes in vitro (p<0.05).Our study provides evidence that circulating transcripts might be potential biomarkers in predicting cardiovascular events. CMTM5 might exert anti-atherosclerotic effects via suppressing migration and proliferation in the vessel wall. Nevertheless, larger-scale and long-term studies are still needed.

[Application of functional parotidectomy via retroauricular hairline incision in the excising superficial parotid tumor].

Objective: To evaluate the usefulness of retroauricular hairline incision (RAHI) in partial superficial parotidectomy (PSP) by comparison with modified Blair incision (MBI). Methods: A retrospective analysis of 64 medical records for patients with benign parotid tumors who underwent partial superficial parotidectomy was undertaken (28 were in MBI group, 36 in RAHI group). Size and location of tumors, operative time, occurrence of facial nerve paralysis and Frey's syndrome, and cosmetic outcomes were compared between RAHI and MBI groups. Results: Compared with MBI group, RAHI group showed better cosmetic results for benign parotid tumors in mean satisfaction score(P<0.001). There were no significant differences in size and location of tumors, operative time, incidence of transient or permanent facial nerve paralysis and Frey's syndrome between two groups (P>0.05). Conclusions: Partial superficial parotidectomy can be performed safely via RAHI in most cases of benign parotid tumors. Compared with MBI, RAHI for benign parotid tumorscan improve the cosmetic outcome, without increasing the operative time or operative morbidity.

Desmoplastic small round cell tumor--report of 3 cases and review of the literature.

Desmoplastic small round cell tumor (DSRCT) is a rare neoplasm with distinctive histological features, characterized by extensive stromal tissue around islands of small and undifferentiated cells revealing the desmoplastic appearance. It was first described by Gerald and Rosai. It mainly the peritoneum and is found predominently in adolescents and young adults, and it is much more common in males than in females. The histological and immunhistochemical features are very distinct but may be misdiagnosed as other undifferentiated neoplasm if the pathologist has no idea of this entity. We report the experience of three cases here. The first case was diagnosed as malignant neuroendocrine neoplasm orginally and revised to DSRCT later. Case 2 had been diagnosed as Atypical carcinoid and received surgery and chemotherapy. It was revised as DSRCT 5 years later by an other pathologist. Case 3 carried the characteristic feature whereby diagnosis could be made even in frozen section.

Real-time dynamic telepathology through the Internet: evaluation of a new and economic technology at Taipei Veterans General Hospital.

BACKGROUND: Computer-aided, digitalized telepathology was introduced about 10 years ago and is gaining acceptance as a mode of providing pathology to remote site. The usefulness of telepathology for remote diagnosis of histology, cytology and frozen section has been evaluated in USA, Europe and Japan. In Taiwan, the use of telepathology for pathological diagnosis is still rare. In order to evaluate the potential use of this technique, we undertook the study using commercialized and low-cost microscopy, personal computer and software on routine biopsy material. METHODS: Sixty prostatic sextant transrectal needle biopsies, including 30 cases of adenocarcinoma and 30 cases of benign lesions, were retrieved retrospectively. The real-time dynamic images were transmitted to the remote site via internet and reviewed by a senior uropathologist who was unaware of the diagnosis. The diagnoses made at the remote site were correlated to the final diagnoses of the cases. RESULTS: All malignant specimens (30/30) were correctly diagnosed by this method. Only one benign case (1/31) of nonspecific granulomatous prostatitis was misdiagnosed as poorly differentiated carcinoma. CONCLUSIONS: Our results show that this method is a good way for teleconsultation. Further studies on other types of specimen worth encouragement for both intra- and inter-institutional consultation.

Lorenz number in high T(c) superconductors: evidence for bipolarons.

The strong electron-phonon interaction in cuprates has gathered support over the last decade in a number of experiments. While phonons remain almost unrenormalized, electrons are transformed into itinerant bipolarons and thermally excited polarons when the electron-phonon interaction is strong. We calculate the Lorenz number of the system to show that the Wiedemann-Franz law breaks down because of the interference of polaron and bipolaron contributions in the heat flow. The model fits numerically the experimental Hall Lorenz number, which provides direct evidence for bipolarons in the cuprates.