Clinical Characteristics and Diagnostic Methods of Pulmonary Mucormycosis / 中山大学学报(医学科学版)

ObjectiveTo summarize the clinical features and prognosis of pulmonary mucormycosis （PM） in southern China， and to explore the diagnostic value of metagenomic next generation sequencing （mNGS） in PM. MethodsThe clinical manifestations， diagnosis， treatment and prognosis of patients diagnosed with PM in The First Affiliated Hospital of Sun Yat-sen University from January 1， 2019 to January 31， 2022 who had undergone mNGS detection in lung tissue or alveolar lavage fluid were collected retrospectively. A total of 14 patients with PM were included， including 4 patients with confirmed diagnosis and 10 patients with clinical diagnosis. ResultsAll patients had underlying medical conditions， with hematological malignancies and diabetes being the most common. The most common symptoms were fever （n = 10）， cough （n = 9） and shortness of breath （n = 9）. Consolidation was the most common sign of chest CT， followed by mass， mostly with cavity. On laboratory tests， decreased CD4+T lymphocytes， elevated CD8+T lymphocytes， and decreased CD4+/CD8+ ratio， and presentation with pleural effusion indicate poor prognosis. The positive rate of mNGS diagnosis was 78.5%， which was significantly higher than that of histopathology （50%）， fungus rapid fluorescence staining （61.5%） and fungal culture （23.1%） of bronchoalveolar lavage fluid. ConclusionsPulmonary mucormycosis is more likely to occur in patients with underlying diseases or who are immunocompromised. The clinical manifestations lack specificity. The low CD4/CD8 ratio and presentation of pleural effusion on CT imaging indicate poor prognosis of patients. mNGS is a rapid， convenient and sensitive method for the diagnosis of PM， which has advantages in the diagnosis of pulmonary mucormycosis.

Associations between indoor volatile organic compounds and nocturnal heart rate variability of young female adults: A panel study / 北京大学学报(医学版)

OBJECTIVE@#To investigate the association between short-term exposure to indoor total volatile organic compounds (TVOC) and nocturnal heart rate variability (HRV) among young female adults.@*METHODS@#This panel study recruited 50 young females from one university in Beijing, China from December 2021 to April 2022. All the participants underwent two sequential visits. During each visit, real time indoor TVOC concentration was monitored using an indoor air quality detector. The real time levels of indoor temperature, relative humidity, noise, carbon dioxide and fine particulate matter were monitored using a temperature and humidity meter, a noise meter, a carbon dioxide meter and a particulate counter, respectively. HRV parameters were measured using a 12-lead Holter. Mixed-effects models were used to evaluate the association between the TVOC and HRV parameters and establish the exposure-response relationships, and two-pollutant models were applied to examine the robustness of the results.@*RESULTS@#The mean age of the 50 female subjects was (22.5±2.3) years, and the mean body mass index was (20.4±1.9) kg/m2. During this study, the median (interquartile range) of indoor TVOC concentrations was 0.069 (0.046) mg/m3, the median (interquartile range) of indoor temperature, relative humidity, carbon dioxide concentration, noise level and fine particulate matter concentration were 24.3 (2.7) ℃, 38.5% (15.0%), 0.1% (0.1%), 52.7 (5.8) dB(A) and 10.3 (21.5) μg/m3, respectively. Short-term exposure to indoor TVOC was associated with significant changes in time-domain and frequency-domain HRV parameters, and the exposure metric for most HRV parameters with the most significant changes was 1 h-moving average. Along with a 0.01 mg/m3 increment in 1 h-moving average concentration of indoor TVOC, this study observed decreases of 1.89% (95%CI: -2.28%, -1.50%) in standard deviation of all normal to normal intervals (SDNN), 1.92% (95%CI: -2.32%, -1.51%) in standard deviation of average normal to normal intervals (SDANN), 0.64% (95%CI: -1.13%, -0.14%) in percentage of adjacent NN intervals differing by more than 50 ms (pNN50), 3.52% (95%CI: -4.30%, -2.74%) in total power (TP), 5.01% (95%CI: -6.21%, -3.79%) in very low frequency (VLF) power, and 4.36% (95%CI: -5.16%, -3.55%) in low frequency (LF) power. The exposure-response curves showed that indoor TVOC was negatively correlated with SDNN, SDANN, TP, and VLF when the concentration exceeded 0.1 mg/m3. The two-pollutant models indicated that the results were generally robust after controlling indoor noise and fine particulate matter.@*CONCLUSION@#Short-term exposure to indoor TVOC was associated with significant negative changes in nocturnal HRV of young women. This study provides an important scientific basis for relevant prevention and control measures.

Association of ambient fine particulate air pollution with hospitalization costs and stays for depression in China: a multicity analysis / 中华预防医学杂志

Objective: To explore the effect of fine particulate matter (PM2.5) pollution on depression hospitalization cost and length of stay in 57 cities of China. Methods: A total of 84 207 patients with depression in 57 cities of China from January 2013 to December 2017 were selected as the subjects. The demographic characteristics and hospitalization status of the patients were obtained from the database of basic medical insurance for urban workers and urban residents in China. The environmental exposure data of the same period were obtained from the national air quality real-time release platform of China Environmental Monitoring Station. A generalized additive model based on quasi-Poisson distribution was used to analyze PM2.5 exposure effect in each city, and the nonlinear mixing of moving average temperature, relative humidity and date was controlled by natural smooth spline function. Results: Among the included cities, southern cities accounted for 50.88% (29), and the number of female inpatients, hospitalization costs and hospitalization days accounted for 62.65%, 63.50% and 60.85% (42 735 cases, 567.78 million yuan and 1.14 million days, respectively). The proportion of hospitalized cases, hospitalization cost and length of stay in the age group of 40 to 64 years old were 59.15% (40 346 cases), 53.92% (482.15 million yuan) and 52.07% (0.98 million days), respectively. PM2.5 level was positively correlated with the number of hospitalized cases with depression, hospitalization cost and length of stay. When the 3-day moving average of PM2.5 exposure level increased by 10 μg/m3, the number of hospitalization cases increased by 0.64%. The attributed percentage (95%CI) of hospitalized cases, hospitalization costs and length of stay were 3.35% (0.57%-6.04%), 3.04% (0.52%-5.48%) and 3.07% (0.49%-5.56%), respectively. Subgroup analysis showed that the attributed percentage of hospitalization cases, hospitalization cost and length of stay to PM2.5 exposure ranged from 3.97% to 4.68%, 4.04% to 4.33% and 4.13% to 4.30% in northern China, male and cold season, respectively. Conclusion: PM2.5 exposure is associated with the increase of hospitalization cost and length of stay among Chinese urban population with depression.

Effects of length and chemical modification on the activation of vascular endothelial cells induced by multi walled carbon nanotubes / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effects of multi-walled carbon nanotubes (MWCNTs) with different length or chemical modification on endothelial cell activation and to explore the role of nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) inflammasome.@*METHODS@#MWCNTs were characterized by dynamic light scattering (DLS) after being suspended in culture medium. The immortalized mouse cerebral microvascular endothelial cell line b.End3 was treated with short MWCNTs (S-MWCNT, 0.5 to 2 μm), long MWCNTs (L-MWCNT, 10 to 30 μm) and the above long MWCNTs functionalized by carboxyl-(L-MWCNT-COOH), amino-(L-MWCNT-NH2) or hydroxyl-(L-MWCNT-OH) modification. Cytotoxicity of MWCNTs in b.End3 cells was determined by cell counting kit-8 (CCK-8) assay and lactate dehydrogenase (LDH) release assay, and non-toxic low dose was selected for subsequent experiments. Effects of all types of MWCNTs on the endothelial activation of b.End3 were determined by the measurement of vascular cell adhesion molecule-1 (VCAM-1) concentration in cell supernatant and adhesion assay of human monocytic cell line THP-1 to b.End3.To further elucidate the mechanism involved, the protein expressions of nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3(NLRP3) in cells treated with S-MWCNT, L-MWCNT and L-MWCNT-COOH were measured by Western blot.@*RESULTS@#At a higher concentration (125 μg/cm2) and treated for 24 h, all types of MWCNTs significantly inhibited viability of b.End3 cells. At a sub-toxic concentration (6.25 μg/cm2), all types of MWCNTs treated for 12 h significantly induced the activation of b.End3 cells, as evidenced by the elevated VCAM-1 release and THP-1 adhesion. Compared with S-MWCNT, L-MWCNT significantly promoted endothelial cell activation. L-MWCNT and L-MWCNT-COOH activated b.End3 cells to a similar extent. Furthermore, treatment with S-MWCNT, L-MWCNT and L-MWCNT-COOH increased NLRP3 expression in a time-dependent manner at 6.25 μg/cm2. Compared with S-MWCNT, cells treated with L-MWCNT for 4 h and 12 h exhibited significantly increased protein expressions of NLRP3. However, no significant differences were detected in the level of NLRP3 protein in cells treated with L-MWCNT and L-MWCNT-COOH.@*CONCLUSION@#Compared with the surface chemical modification, length changes of MWCNTs exerted more influence on endothelial cell activation, which may be related to the activation of NLRP3 inflammasome. Our study contributes further understanding of the impact of MWCNTs on endothelial cells, which may have implications for the improvement of safety evaluation of MWCNTs.

Monitoring metrics for short-term exposure to ambient ozone and pulmonary function and airway inflammation in healthy young adults / 北京大学学报(医学版)

OBJECTIVE@#To assess the associations of different monitoring metrics for short-term exposure to ambient ozone (O3) with pulmonary function and airway inflammation in healthy young adults.@*METHODS@#A total of 97 healthy young college students were recruited and followed in a panel study conducted from December 2017 to June 2018. Each participant underwent 3 follow-up visits, and lung function and fractional exhaled nitric oxide (FeNO) were measured at each visit. Ambient air pollutant concentrations were obtained from the environment monitoring station of Beijing closest to the participant residences, and meteorological data were collected from China Meteorological Data Service Center. Linear mixed-effect models were applied to assess the associations between different monitoring metrics for ambient O3 short-term exposure with pulmonary function or airway inflammation in the healthy young adults.@*RESULTS@#During the study period, the P50 (P25, P75) values for ambient O3 concentration expressed as daily 1-hour maximum (O3-1 h max), daily maximum 8-hour average (O3-8 h max) and 24-hour average (O3-24 h avg) were 102.5 (76.8, 163.0) μg/m3, 91.1 (68.3, 154.3) μg/m3 and 61.6 (36.9, 81.7) μg/m3, respectively. The different monitoring metrics for short-term exposure to ambient O3 were significantly associated with reduced forced expiratory volume in the first second (FEV1) and increased FeNO. An interquartile range (IQR) increase in 6-d moving average of O3-1 h max (IQR=71.5 μg/m3) was associated with a 6.2% (95%CI: －11.8%, －0.5%) decrease in FEV1 and a 63.3% (95%CI: 13.8%, 134.3%) increase in FeNO. An IQR increase in 7-d moving average of O3-8 h max (IQR=62.0 μg/m3) was associated with a 6.2% (95%CI: －11.6%, －0.7%) decrease in FEV1and a 75.5% (95%CI: 19.3%, 158.0%) increase in FeNO. An IQR increase in 5-d moving average of O3-24 h avg (IQR=32.9 μg/m3) was associated with a 3.7% (95%CI: －7.1%, －0.2%) decrease in FEV1and a 25.3% (95%CI: 3.6%, 51.6%) increase in FeNO. There was no significant association between the three monitoring metrics for O3 exposure and peak expiratory flow (PEF).@*CONCLUSION@#Short-term exposure to ambient O3 was associated with decreased lung function and increased airway inflammation among the healthy young adults, and daily 1-hour maximum was more sensitively to the respiratory effects of O3.

Morphological change analysis based on cone beam CT of the upper airway for obstructive sleep apnea syndrome patients treated with oral appliance in skeletal class Ⅱ malocclusion with different vertical patterns / 华西口腔医学杂志

OBJECTIVE@#To analyze the morphological changes in the upper airway of obstructive sleep apnea syndrome (OSAS) patients treated with oral appliance in skeletal class Ⅱ malocclusion with different vertical features by using cone beam CT (CBCT).@*METHODS@#Thirty-six patients diagnosed with OSAS by polysomnography and daytime sleepiness scale and skeletal class Ⅱ malocclusion were treated with oral appliance for 4 months. The changes based on CBCT in the morphology of glossopharyngeal and palatopharyngeal before and after treatment in OSAS patients with different vertical features were compared.@*RESULTS@#After treatment with oral appliance, the glossopharyngeal and palatopharyngeal morphologies of patients with mild OSAS showed significant changes. After treatment with oral appliance, the glossopharyngeal morphology of all patients showed significant changes (P<0.05). The palatopharyngeal morphology of patients in the lower and average groups also exhibited significant changes (P<0.05). Sagittal changes in the glossopharyngeal measurements of high-angle patients demonstrated significant difference, whereas the other measured values showed no significant difference.@*CONCLUSIONS@#The morphological changes in the upper airway were significant in OSAS patients with lower and average vertical patterns when treated with oral appliance, but the changes in high vertical patterns were not significant.

Effect and Mechanism of Curdione on Migration and Invasion of Breast Cancer HCC1937 Cells / 中国实验方剂学杂志

Objective: To investigate effect of curdione on the migration and invasion of human breast cancer HCC1937 cells and its mechanism.Method: HCC1937 cells were cultured in vitro and treated with curdione at various doses (0, 12.5, 25, 50, 100, 200, 400 μmol·L-1) for 24, 48 h, the cell viability was detected by cell counting kit-8 method. curdione groups (12.5, 25, 50 μmol·L-1) and blank group were established. The effect of curdione on the adhesion of HCC1937 cells was detected by the cell adhesion assay. The effect of curdione on migration of HCC1937 cells was detected by wound healing assay. The effect of curdione on the migration and invasion of HCC1937 cells were detected by transwell chamber assay. The effect of curdione on regulation of mitogen-activated protein kinase(MAPK)and protein kinase B(Akt)signaling pathways and the protein expressions of matrix metalloproteinases-2 (MMP-2) and matrix metalloproteinases-9 (MMP-9) of HCC1937 cells were detected by the Western blot analysis. Effect of curdione on mRNA expressions of MMP-2 and MMP-9 of HCC1937 cells were detected by Real-time PCR.Result: Compared with the blank group, curdione (12.5, 25, 50 μmol·L-1) groups had no significant effect on cell viability, but a remarkable effect on cell viability HCC1937 cells, and cell viability was gradually decreased with the increase of the concentration of curdione (PP-1) had a significant effect on cell adhesion rate, migration rate and invasion rate of HCC1937 cells (PP-1) could down-regulate phosphorylation levels of key proteins extracellular regulated protein kinases(ERK), c-Jun N-terminal kinase(JNK), Akt on MAPK and Akt signaling pathways (PConclusion: curdione can inhibit the migration and invasion of human breast cancer HCC1937 cells, and the mechanism may be related to down-regulation of phosphorylation levels of key proteins ERK, JNK, Akt on MAPK and Akt signaling pathways, so as to reduce the expressions of MMP2 and MMP-9.

Clinical Analysis of Arthroscopic Repairing of Ellman Grade Ⅲ Bursal-side Partial-thickness Rotator Cuff Tears / 中国运动医学杂志

Objective To investigate the clinical outcome of Ellman grade Ⅲ bursal-side partial-thickness rotator cuff tears(b-PT-RCT)treated by the arthroscopic single-row technique with articular tendon fibers reservation.Methods A retrospective study was conducted on 31 patients with Ellman grade Ⅲ (b-PT-RCT) who underwent arthroscopic rotator cuff repair (RCR) with the single-row technique in our hospital between January 2014 and October 2016.The intact articular side tissue of the rotator cuff was reserved in 17 patients of group A,and was resected to convert to a full-thickness cuff tear in 14 patients of group B.The visual analog pain scale(VAS)score,Constant-Murley score and shoulder active range of motion(ROM),and magnetic resonance imaging(MRI)results were compared between the two groups during the last follow-up.Results Among the 31 patients,25 were followed,with 14 in group A followed for an average of 16.29(12～25)months and 11 of group B followed for an average of 15.37(12～27)months.There were no significant differences between the two groups in all measurements before the intervention and at the last follow-up.After the operation,significant improvement was observed in all planes of the active ROM for both groups(P＜0.05).The VAS score of group A and B decreased significantly from 6.50 ± 1.16 and 6.63 ± 1.80 before the operation to 0.86 ± 0.57 and 0.91 ± 0.63 at the last follow-up(P＜0.05 for both).However,the average Constant-Murley score improved significantly from 55.21 ± 6.40 to 86.85 ± 4.85 in Group A(P＜0.05),while from 54.37 ± 6.30 to 85.73 ± 5.36 in group B(P＜0.05).During the last follow-up,no retear occurred in both groups according to the MRI examination.Conclusion The outcome of single-row repair for grade Ⅲ bursal-sided partial-thickness rotator cuff tears with either articular tendon preservation or converting of the lesion to a full-thickness tear is satisfying.No significant differences were found in their clinical outcomes.

Muscarinic receptor 3 agonist promotes epithelial-meschymal transition in human lung cancer A549 cells by activating PI3K/AKT signaling pathway / 中国病理生理杂志

AIM: To investigate the possible signaling pathway that promotes epithelial-mesenchymal transi-tion(EMT)of the lung cancer A549 cells stimulated with muscarinic receptor 3(M3R)agonist carbachol.METHODS:The lung cancer cells A549 were treated with 400 μmol/L carbachol.The morphological changes of the cells were observed under inverted phase contrast microscope.The migration and invasion abilites were measured by Wound healing and Tran-swell assays.qPCR was used to detect the mRNA level of vimentin and E-cadherin.The protein levels of p-AKT,vimentin and E-cadherin were determined by Western blot.RESULTS:After treatment with carbachol,the A549 cells showed loss of the close connection and the cell morphology was transformed from irregular polygon to spindle -like cells.The results of Wound healing and Transwell assays showed that the migration and invasion abilites of the A 549 cells were enhanced.Car-bachol increased the vimentin expression and decreased the E-cadherin expression at mRNA and protein level(P<0.05). The phosphorylation of AKT in the A549 cells was up-regulated(P<0.05).These changes was inhibited by M3R antago-nist 4-DAMP.CONCLUSION:Carbachol promotes EMT in the human lung cancer A 549 cells by activating PI3K/AKT signaling pathway.

Effects of high-efficiency particulate air purifiers on indoor fine particulate matter and its constituents in a district of Beijing during winter / 北京大学学报(医学版)

OBJECTIVE@#To analyze the effect of domestic high-efficiency particulate air (HEPA) purifiers on the concentrations of indoor fine particulate matter (PM2.5) and its elementary constituents in 20 residences in a district of Beijing during winter.@*METHODS@#From November 2015 to January 2016, 20 residences in a district of Beijing were selected, where indoor and outdoor PM2.5 data were collected simultaneously in three time periods according to the operating of air purifiers (Group 0 h: 24 hours before operating; Group 24 h: 24 hours after operating; Group 48 h: 24 to 48 hours after operating). The content of 21 elements in PM2.5 samples were determined by inductively coupled plasma mass spectrometry (ICP-MS) and inductively coupled plasma optical emission spectrometry (ICP-OES). Indoor/outdoor particle concentration ratio (I/O ratios) and ΔI/O ratios were used to describe the pollution levels and the variation range of PM2.5 and its 21 elementary constituents. One-way analysis of variance (ANOVA) for repeated measurement data was applied to compare the I/O ratios of PM2.5 and its elementary constituents among the different groups, and Bonferroni method was used for comparison in pairs. Wilcoxon signed rank test for paired-samples was used to compare ΔI/O ratios of 21 elementary constituents with that of PM2.5.@*RESULTS@#The median I/O ratios of PM2.5 in the three groups were 1.27 (P25-P75: 0.50-2.68), 0.45 (P25-P75: 0.27-1.03) and 0.36 (P25-P75: 0.28-2.48), respectively. Compared with Group 0 h, the I/O ratios of PM2.5 in Group 24 h (P=0.042) and Group 48 h (P=0.006) decreased significantly. However, there was no significant difference between Group 24 h and Group 48 h. Significant differences were found comparing ΔI/O ratios of aluminium, ferrum and titanium to that of PM2.5, in both Group 24 h and Group 48 h (P<0.05). No significant change was found in the I/O ratios of these three elements among the three groups before and after air purifier operating (P>0.05). Distances from residences to traffic arteries could affect I/O ratios of some elements from traffic-related source (P<0.05).@*CONCLUSION@#Domestic HEPA air purifiers could effectively reduce indoor PM2.5 concentration, and the pollution level of PM2.5 tend to be stable after the purifier operating for a time. The purifiers had different effects on different elements, among which most showed statistical significances.

Complications associated with stent-assisted coil embolization of wide-neck intracranial aneurysms / 中国组织工程研究

BACKGROUND: Stent-assisted coil embolization has become an important technique for the treatment of intracranial complex aneurysms. However, there is no systematic analysis of complications and prevention strategies related to this technique. OBJECTIVE: To systematically analyze the complications related to stent-assisted coil embolization of intracranial aneurysms during perioperative and follow-up periods and to assess the safety of this method. METHODS: A retrospective study of 232 consecutive patients with 239 wide-necked aneurysms who underwent stent-assisted coil embolization at the Department of Neurosurgery, General Hospital of Shenyang Military Command from July 2003 to December 2009 was performed. Angiographic results and clinical outcomes were evaluated. A variety of complications were analyzed. The technical feasibility of the procedure, procedure-related complications, angiographic results, clinical outcomes and follow-up angiography were evaluated. RESULTS AND CONCLUSION: Stenting was successful in the 236 of 239 aneurysms. Procedure-related complications included thomboembolism (n=13), intraprocedural rupture (n=8), coil protrusions (n=5), new mass effect (n=3), vessel injury (n=3), and stent dislodgement (n=2). Procedure-related morbidity and mortality was 4.3% (10/232) and 1.3% (3/232), respectively. Nonprocedural complications attributable to subarachnoid hemorrhage in 129 patients with acute ruptured aneurysms were symptomatic vasospasm (18.6%, 24/129) and shunt-dependent hydrocephalus (7.0%, 9/129). Favorable clinical outcomes (mRS 0-2) were observed in 88.3% (205/232) of the patients, and no rehemorrhage of treated aneurysms occurred. Follow-up angiography was obtained in 155 patients (159 treated aneurysms). The overall recanalization rate was 14.5% (23/159). No stenting or coiling displacement occurred during the follow-up. Delayed complications included in-stent stenosis (n=2) and penetrating artery occlusion (n=2). In conclusion, our study indicates that stent-assisted coil embolization of intracranial aneurysm is a safe technique with low morbidity and mortality rates. Thromboembolism is the main cause of procedure-related disability and death. Nevertheless, further long-term follow-up is necessary to determine the durability of these promising results.

Epidemiological survey of Haemophilus influenzae-positive hospitalized children: a retrospective analysis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the basic clinical characteristics and drug resistance of Haemophilus influenzae (Hi) infection in hospitalized children in the past two years.</p><p><b>METHODS</b>A retrospective cross-sectional study was conducted to analyze Hi strains isolated from the sputum and pharyngeal swabs of children aged 0-17 years who were hospitalized in the Third People's Hospital of Chengdu between June 2011 and May 2013.</p><p><b>RESULTS</b>A total of 117 strains were isolated from 111 hospitalized children. There were 102 cases (91.9%) of respiratory infection and 9 cases (8.1%) of other diseases. The positive rates of Hi in children with bronchopneumonia or pneumonia (50.8%, 30/59) and in children with acute laryngotracheobronchitis (50.0%, 2/4) were relatively high, followed by in children with capillary bronchitis (34.6%, 9/26), in children with acute bronchitis (24.2%, 32/132), in children with herpangina (19.0%, 4/21), in children with asthmatoid bronchitis (17.9%, 5/28), in children with acute upper respiratory tract infection (11.8%, 9/76), in children with acute tonsillitis (8.2%, 7/85), and in children with neonatal pneumonia (5.6%, 3/54). There were significant differences in the rates of resistance to amoxicillin-clavulanate (15% vs 23%; P=0.010) and chloramphenicol (25% vs 8%; P=0.015) between the two survey years. The frequencice of β-lactamase-nonproducing-ampicillin-resistant (BLNAR) strains and β-lactamase-producing-amoxicilli/clavulanate-resistant (BLPACR) strains increased from 12% to 21% and from 13% to 19% respectively during the two survey years (P>0.05).</p><p><b>CONCLUSIONS</b>Hi plays an important role in the respiratory tract infection of children aged 0-17 years. The increasing trend of BLNAR and BLPACR rates makes it harder for antibiotic selection in clinical practice.</p>

Traditional Chinese medicinal herbs combined with epidermal growth factor receptor tyrosine kinase inhibitor for advanced non-small cell lung cancer: a systematic review and meta-analysis / 中西医结合学报

<p><b>BACKGROUND</b>Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) targeted treatment has been a standard therapy for advanced non-small cell lung cancer (NSCLC), but it is not tolerated well by all patients. In China, some studies have reported that traditional Chinese medicinal herbs (TCMHs) may increase efficacy and reduce toxicity when combined with EGFR-TKI, but outside of China few studies of this kind have been attempted.</p><p><b>OBJECTIVE</b>This study is intended to systematically review the existing clinical evidence on TCMHs combined with EGFR-TKI for treatment of advanced NSCLC.</p><p><b>SEARCH STRATEGY</b>PubMed, the Cochrane Library, the Excerpta Medica Database (EMBASE), the China BioMedical Literature (CBM), and the China National Knowledge Infrastructure (CNKI) and web site of the American Society of Clinical Oncology (ASCO), the European Society for Medical Oncology (ESMO), the World Conference of Lung Cancer (WCLC) were searched; the search included all documents published in English or Chinese before October 2013.</p><p><b>INCLUSION CRITERIA</b>We selected randomized controlled trials based on specific criteria, the most important of which was that a TCMH plus EGFR-TKI treatment group was compared with an EGFR-TKI control group in patients with advanced NSCLC.</p><p><b>DATA EXTRACTION AND ANALYSIS</b>The modified Jadad scale was used to assess the quality of studies. For each included study, patient characteristics, treatment details, therapeutic approach and clinical outcomes were collected on a standardized form. When disagreements on study inclusion or data extracted from a study emerged, the consensus of all coauthors provided the resolution. The clinical outcome metrics consisted of objective response rate (ORR; complete response + partial response divided by the total number of patients), disease control rate (DCR; complete response + partial response + no change divided by the total number of patients), survival rate, improved or stabilized Karnofsky performance status (KPS), and severe toxicity. RevMan 5.0 software was used for data syntheses and analyses. Risk ratio (RR) and 95% confidence interval (CI) were calculated; if the hypothesis of homogeneity was not rejected (P>0.1, I(2)<50%), the fixed-effect model was used to calculate the summary RR and the 95% CI. Otherwise, a random-effect model was used.</p><p><b>RESULTS</b>In this review, 19 studies were included based on the selection criteria. Of them, 13 studies were of high quality and 6 studies were of low quality, according to the modified Jadad scale. When the TCMH plus EGFR-TKI treatment groups were compared with the EGFR-TKI control groups the meta-analysis demonstrated a statistically significant higher ORR (RR 1.34; 95% CI 1.15 to 1.57; P=0.000 2), DCR (RR 1.18; 95% CI 1.09 to 1.27; P<0.000 1), one-year survival rate (RR 1.21; 95% CI 1.01 to 1.44; P=0.04), 2-year survival rate (RR 1.91; 95% CI 1.26 to 2.89; P=0.002) and improved or stable KPS (RR 1.38; 95% CI 1.26 to 1.51; P<0.000 01). Severe toxicity for rash was decreased (RR 0.55; 95% CI 0.32 to 0.94; P=0.03), as were nausea and vomiting (RR 0.17; 95% CI 0.04 to 0.72; P=0.02) and diarrhea (RR 0.46; 95% CI 0.24 to 0.89; P=0.02). Sensitivity analysis indicated that findings of the meta-analysis were robust to study quality. In the funnel plot analysis, asymmetry was observed, and publication bias was indicated by Egger's test (P=0.03).</p><p><b>CONCLUSION</b>TCMH intervention can increase efficacy and reduce toxicity when combined with EGFR-TKI for advanced NSCLC, although this result requires further verification by more well designed studies.</p>

Use of rich BHI medium instead of synthetic TMH medium for gene regulation study in Yersinia pestis / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study is to verify the use of rich BHI medium to substitute synthetic media for gene regulation studies in Yersinia pestis.</p><p><b>METHODS</b>The transcriptional regulation of rovA by PhoP or via temperature upshift, and that of pla by CRP were investigated when Y. pestis was cultured in BHI. After cultivation under 26 °C, and with temperature shifting from 26 to 37 °C, the wild-type (WT) strain or its phoP or crp null mutant (ΔphoP or Δcrp, respectively) was subject to RNA isolation, and then the promoter activity of rovA or pla in the above strains was detected by the primer extension assay. The rovA promoter-proximal region was cloned into the pRW50 containing a promoterless lacZ gene. The recombinant LacZ reporter plasmid was transformed into WT and ΔphoP to measure the promoter activity of rovA in these two strains with the β-Galactosidase enzyme assay system.</p><p><b>RESULTS</b>When Y. pestis was cultured in BHI, the transcription of rovA was inhibited by PhoP and upon temperature upshift while that of pla was stimulated by CRP.</p><p><b>CONCLUSION</b>The rich BHI medium without the need for modification to be introduced into the relevant stimulating conditions (which are essential to triggering relevant gene regulatory cascades), can be used in lieu of synthetic TMH media to cultivate Y. pestis for gene regulation studies.</p>

Cellular fatty acids as chemical markers for differentiation of Acinetobacter baumannii and Acinetobacter calcoaceticus / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Gas chromatography (GC) was used to investigate the cellular fatty acid (CFA) composition of 141 Acinetobacter baumannii and 32 A. calcoaceticus isolates from different locations in China and to find chemical markers to differentiate these two closely related bacteria.</p><p><b>METHODS</b>Whole cell fatty acid methyl esters (FAMEs) were obtained by saponification, methylation, and extraction for GC analysis, followed by a standardized Microbial Identification System (MIS) analysis.</p><p><b>RESULTS</b>All A. baumannii and A. calcoaceticus strains contained some major fatty acids, namely, 18:1 ω9c, 16:0, Sum In Feature 3, 12:0, 17:1ω8c, 3-OH-12:0, 17:0, Sum In Feature 2, 2-OH-12:0, and 18:0 compounds. Although most of the total CFAs are similar between A. baumannii and A. calcoaceticus strains, the ratios of two pairs of CFAs, i.e., Sum In Feature 3/18:1 ω9c versus 16:0/18:1 ω9c and Sum In Feature 3/18:1 ω9c versus unknown 12.484/18:1 ω9c fatty acids, could differentiate these two closely related bacteria. A. baumannii could be easily classified into two subgroups by plotting some ratios such as Sum In Feature 3/16:0 versus 17:0 and Sum In Feature 3/2-OH-12:0 versus 17:0 fatty acids.</p><p><b>CONCLUSION</b>The ratios of some CFAs could be used as chemical markers to distinguish A. baumannii from A. calcoaceticus.</p>

Efficacy of endoscopic sinus surgery-based on multidisciplinary treatment for chronic rhinosinusitis with asthma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of endoscopic sinus surgery (ESS)-based on multidisciplinary treatment for patients with chronic rhinosinusitis (CRS) and asthma.</p><p><b>METHODS</b>The study included 25 CRS patients with asthma who received ESS from September 2006 to March 2009, besides surgery, who also used corticosteroid nasal spray, oral macrolide antibiotics and nasal irrigation perioperatively. Evaluation was performed before ESS, 1 year and 3 years post-ESS. Evaluation index included visual analogue scale (VAS) and endoscopy Lund-Kennedy assessment for CRS, and asthma control test (ACT) and pulmonary function tests for asthma.</p><p><b>RESULTS</b>Twenty-three (92%) patients were followed up for 12 months. Twelve (48%) of them were followed up for 36 months. CRS efficacy: VAS of general symptom significantly improved after ESS compared to pre-ESS (8.12 ± 0.60, x(-) ± s), after 1 year (3.20 ± 2.19) and 3 year (3.79 ± 2.32) follow up (both P = 0.000). There was no statistic difference between 1 year and 3 year follow up (P = 0.851). Endoscopy Lund-Kennedy score significantly improved in post-ESS after 1 year (4.35 ± 3.21) and 3 year (5.50 ± 2.64) follow up compared to pre-ESS (9.80 ± 2.10, both P = 0.000), and there was no difference between 1 year and 3 year follow up (P = 0.606). Asthma efficacy: ACT pre-ESS, 1 year and 3 year were 21.96 ± 2.16, 23.61 ± 1.94 and 22.33 ± 3.47, without statistic difference (F = 2.871, P = 0.065). Pulmonary function showed no significant change after surgery (Pre-ESS 74.68 ± 11.09, 1 year 73.27 ± 12.27, 3 year 73.50 ± 7.87, F = 0.076, P > 0.05).</p><p><b>CONCLUSIONS</b>ESS improves CRS with asthma significantly and persistently. Asthma control level, anti-asthma drug dose and pulmonary function remain stable after ESS.</p>

Different strategies for preparation of non-tagged rV270 protein and its efficacy against Yersinia pestis challenge / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>LcrV is an important component for the development of a subunit vaccine against plague. To reduce immunosuppressive activity of LcrV, a recombinant LcrV variant lacking amino acids 271 to 326 (rV270) was prepared by different methods in this study.</p><p><b>METHODS</b>A new strategy that produced non-tagged or authentic rV270 protein was designed by insertion of rV270-thrombin-hexahistidine fusion gene into the vector pET24a, or by insertion of hexahistidine-enterokinase-rV270 or hexahistitine-factor Xa-rV270 fusion gene into the vector pET32a. After Co(2+) affinity chromatography, a purification strategy was developed by cleavage of His tag on column, following Sephacryl S-200HR column filtration chromatography.</p><p><b>RESULTS</b>Removal of His tag by thrombin, enterokinase and factor Xa displayed a yield of 99.5%, 32.4% and 15.3%, respectively. Following Sephacryl S-200HR column filtration chromatography, above 97% purity of rV270 protein was obtained. Purified rV270 that was adsorbed to 25% (v/v) Al(OH)₃ adjuvant in phosphate-buffered saline (PBS) induced very high titers of antibody to rV270 in BALB/c mice and protected them (100% survival) against subcutaneous challenge with 10⁶ CFU of Y. pestis virulent strain 141.</p><p><b>CONCLUSION</b>The completely authentic rV270 protein can be prepared by using enterokinase or factor Xa, but they exhibited extremely low cleavage activity to the corresponding recognition site. Thrombin cleavage is an efficient strategy to prepare non-tagged rV270 protein and can be easily operated in a large scale due to its relatively low cost and high cleavage efficacy. The recombinant rV270 can be used as a key component to develop a subunit vaccine of plague.</p>

The comparison of the indoor environmental factors associated with asthma and related allergies among school-child between urban and suburban areas in Beijing / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the indoor environmental factors associated with the prevalence of asthma and related allergies among school children.</p><p><b>METHODS</b>A cluster sampling method was used and the ISAAC questionnaire was conducted. A total of 4612 elementary students under Grade Five of 7 schools were enrolled in the survey for the impact of indoor environmental factors on the prevalence of asthma and related allergies in several urban and suburban schools of Beijing.</p><p><b>RESULTS</b>A total of 4060 sample were finally analyzed including 1992 urban and 2068 suburban. The prevalence of wheeze, allergic rhinoconjunctivitis and atopic eczema in the past 12 months was 3.1% (61/1992), 5.3% (106/1992), 1.1% (22/1992) among urban children while 1.3% (27/2068), 3.1% (65/2068), 1.0% (22/2068) among suburban children respectively. The prevalence of wheeze and allergic rhinoconjunctivitis of the past 12 months in urban were both significantly higher than that in suburban (χ(2) = 14.77, 11.93, P < 0.01). The incidences of having asthma and eczema ever among urban children (5.3% (105/1992), 29.4% (586/1992)) were significantly (χ(2) = 39.03, 147.22, P < 0.01) higher than that among suburban (1.7% (35/2068), 13.8% (285/2068)). Although the distributions of indoor environmental factors were similar in both areas, passive smoking and interior decoration had different influence on the prevalence of asthma and related allergies among school children in the two areas. The significant impact of passive smoking on having asthma ever among suburban children was observed (OR = 2.70, 95%CI = 1.17 - 6.23) while no significant result in urban (OR = 1.06, 95%CI = 0.71 - 1.58); the percentage of interior decoration was 84.0% (1673/1992) among urban children and 80.0% (1655/2068) among suburban children, there was significant impact of interior decoration on the prevalence of having eczema ever among urban children (OR = 1.57, 95%CI = 1.17 - 2.10) but no significant results were found in suburban sample (OR = 1.06, 95%CI = 0.76 - 1.48).</p><p><b>CONCLUSION</b>The prevalence of asthma and related allergies among school children is much higher in urban areas than that in suburban areas and the indoor environmental factors such as passive smoking and interior decoration may differently explain the prevalence of asthma and related allergies in the two areas.</p>

Pollutions of indoor fine particles in four types of public places and the influencing factors / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the levels of pollutions caused by fine particulate matter (PM(2.5)) in the public places and investigate the possible influencing factors.</p><p><b>METHODS</b>A total of 20 public places in four types such as rest room in bath center, restaurant, karaoke bars and cyber cafe in Tongzhou district in Beijing were chosen in this study; indoor and outdoor PM(2.5) was monitored by TSI sidepak AM510. Data under varying conditions were collected and analyzed, such as doors or windows or mechanical ventilation devices being opened, rooms cramped with people and smoking.</p><p><b>RESULTS</b>The average concentration of indoor PM(2.5) in 20 public places was (334.6 +/- 386.3) microg/m(3), ranging from 6 microg/m(3) to 1956 microg/m(3); while in bath center, restaurant, karaoke bars and cyber cafe were (116.9 +/- 100.1)microg/m(3), (317.9 +/- 235.3) microg/m(3), (750.6 +/- 521.6)microg/m(3) and (157.5 +/- 98.5) microg/m(3) respectively. The concentrations of PM(2.5) in restaurant (compared with bath center: Z = -10.785, P < 0.01; compared with karaoke bars: Z = -10.488, P < 0.01; compared with cyber cafe: Z = -7.547, P < 0.01) and karaoke bars (compared with bath center: Z = -16.670, P < 0.01; compared with cyber cafe: Z = -15.682, P < 0.01) were much higher than those in other two places. Single-factor analysis revealed that the average concentration of indoor PM(2.5) in 20 public places was associated with the number of smokers per cube meters(9.13 x 10(-3); r = 0.772, F = 26.579, P < 0.01) and ventilation score [(2.5 +/- 1.5) points; r = 0.667, F = 14.442, P < 0.01], and there were significant correlation between the average indoor and outdoor levels in restaurant [(317.9 +/- 235.3) microg/m(3), (67.8 +/- 78.9) microg/m(3); r = 0.918, F = 16.013, P = 0.028] and cyber cafe [(157.5 +/- 98.5) microg/m(3), (67.7 +/- 43.7) microg/m(3); r = 0.955, F = 30.785, P = 0.012]. Furthermore, significant correlation was observed between the average concentration of indoor PM(2.5) [(157.5 +/- 98.5) microg/m(3)]and the number of people per cube meters (288.7 x 10(-3)) in cyber cafe (r = 0.891, F = 11.615, P = 0.042). Multiple regression analysis showed that smoking (b' = 0.581, t = 3.542, P = 0.003) and ventilation (b' = -0.348, t = -2.122, P = 0.049) were the major factors that may influence the concentration of indoor PM(2.5) in four public places. With cluster analysis, the results showed that the major factors that influence the concentration of indoor PM(2.5) was the outdoor PM(2.5) levels [(49.6 +/- 39.5) microg/m(3); b = 1.556, t = 3.760, P = 0.007] when ventilation (score > 2) was relatively good. The number of smokers per cube meters (14.7 x 10(-3)) became the major influence factor when the ventilation score </= 2 (b = 140.957, t = 3.108, P = 0.013) and 51.8% increases of indoor PM(2.5) was attributed to smoking.</p><p><b>CONCLUSION</b>This study indicated that smoking was the main source of indoor PM(2.5) in public places. Outdoor PM(2.5) should be correlated with indoor PM(2.5) concentration under drafty situation.</p>

Evaluation of immunization protection efficacy of plague subunit vaccine / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the protective efficacy of plague subunit vaccine, BALB/c mice, guinea pigs and rabbits were used in this study.</p><p><b>METHODS</b>Groups of mice (10 per group), guinea pigs (14 per group) and rabbits (6 per group) were immunized with F1 + rV270 vaccine, EV76 vaccine and alum adjuvant by intramuscular route, respectively. Serum antibody titres of mice, guinea pigs and rabbits were determined by ELISA and the immunized animals were challenged with 10(6) CFU of Y. pestis strain 141 at the 8th week after the primary immunization.</p><p><b>RESULTS</b>The immunized mice, guinea pigs or rabbits with subunit vaccine developed anti-F1 IgG titre of 41 587.3 +/- 2.1, 11 543.7 +/- 2.1 or 522.4 +/- 22.4 and elicited statistical anti-F1 IgG titre difference among them (F = 17.58, P < 0.01). The immunized mice, guinea pigs or rabbits with subunit vaccine had anti-rV270 IgG titre of 15 748.7 +/- 1.6, 12.6 +/- 1.4 or 1648.0 +/- 5.0 and induced statistical anti-rV270 IgG titre difference among them (F value was 16.34, P < 0.01). There was significant anti-F1 IgG titre difference among mice, guinea pigs and rabbits immunized with EV76 vaccine that developed anti-F1 IgG titre of 913.4 +/- 4.5, 937.0 +/- 2.0 or 342.0 +/- 12.0 (F = 23.67, P < 0.01), whereas the immunized mice, guinea pigs and rabbits with EV76 vaccine developed anti-rV270 IgG titre of 12.0 +/- 1.0, 447.0 +/- 10.0, 40.0 +/- 11.0 and there was no anti-rV270 IgG titre difference between them (F = 2.20, P = 0.1314). The immunized mice with subunit vaccine developed significantly higher anti-F1 IgG titres than immunized guinea pigs and rabbits (q value was 30.57 and 19.04, respectively, P < 0.01), and there were no anti-F1 IgG titre differences between the immunized guinea pigs and rabbits (q = 0.04, P = 0.8485). The immunized mice with subunit vaccine developed significantly higher anti-rV270 IgG titres than immunized guinea pigs and rabbits (q value was 27.10 and 19.49, respectively, P < 0.01), and there were no anti-rV270 IgG titre differences between the immunized guinea pigs and rabbits with the subunit vaccine (q = 0.25, P = 0.6187). The immunized mice with EV76 elicited higher anti-F1 IgG titres than immunized guinea pigs and rabbits (q value was 40.67 and 29.10, respectively, P < 0.01), whereas there was no difference of F1 IgG titer between immunized guinea pigs and rabbits (q = 0.06, P = 0.8098). The immunized mice, guinea pigs and rabbits with subunit vaccine provided 100% (10/10), 86% (12/14) and 100% (5/5) protection against 10(6) CFU Y. pestis of challenge, respectively. The immunized mice, guinea pigs and rabbits with EV76 vaccine gave 100% (6/6), 93% (13/14) and 100% (6/6) protection against 10(6) CFU Y. pestis of challenge respectively.</p><p><b>CONCLUSION</b>BALB/c mice is the best small animal model for valuation of protective efficacy of plague subunit vaccine. The guinea pigs showed a high individual variation for this purpose. The rabbits can be used as an alternative model for evaluating plague subunit vaccine.</p>