Analysis of Osmotic Tolerance, Physiological Characteristics, and Gene Expression of Salmonella enterica subsp. enterica Serotype Derby.

Salmonella is an important foodborne pathogen, and recent epidemiological studies have shown high infection rates of Salmonella enterica subsp. enterica serotype Derby (S.Derby) in poultry in western China and other regions. S.Derby presents increasing concerns with the development of resistance to hypertonic environments; however, there are few reports investigating the mechanism of resistance. Therefore, in this study, we examined hypertonic adaptation in S.Derby at the physiological and molecular levels. The K-B paper method, wiping glass bead method, crystal violet staining, and RT-PCR combined with comparative genomics analysis were employed to characterize virulence, drug resistance, biofilm formation, and changes in gene expression of genes related to hypertonic adaptation in S.Derby. Hypertonic-adapted S.Derby exhibited resistance to OXA, AMP, PEN, and CEP antibiotics, and biofilm-forming ability was 1.25 times that of nonadapted S.Derby. RT-PCR results showed that compared with nonadapted S.Derby, the expression of virulence-related genes in hypertonic-adapted S.Derby increased by 2-3 times, that of biofilm-related genes increased by 2-4 times, and that of OXA, AMP, PEN, and CEP-related drug resistance genes was relatively high. Four hypertonic tolerance-related genes (otsA, proV, proW, omsV) were preliminarily identified in S.Derby. The expression of proW was always relatively high in hypertonic-adapted S.Derby, the expression of otsA gradually became higher than that of proW with increasing time of osmotic stress, and the expression of proV and omsV was only high in non-hypertonic-adapted S.Derby.

Comparisons of Cytokines, Growth Factors and Clinical Efficacy between Platelet-Rich Plasma and Autologous Conditioned Serum for Knee Osteoarthritis Management.

This study aimed to directly compare the contents and the clinical efficacy of the two autologous blood-derived products, platelet-rich plasma (PRP) and autologous conditioned serum (ACS) for osteoarthritis (OA) treatment. The contents of standard-prepared PRP and ACS prepared at 37 °C for 1 h, 3 h, 6 h, and 24 h from healthy volunteers were compared. The clinical efficacy of pain relief in patients with Stage III knee OA was evaluated by a patient-reported visual analog scale (VAS) pain rating. PDGF-BB levels in ACS 1 h were significantly higher than those in PRP, and the levels in ACS preparations remained stable. IGF-1 level of ACS 24 h showed a significant increase compared to those of other ACS preparations and PRP. ACS 3 h showed a turning of IL-1Ra level and revealed a time-dependent increase up to 24 h. ACS 6 h showed a turning increase in TNF-α levels. ACS 3 h was chosen for clinical comparison with PRP. The reduction in pain VAS in the ACS group was significantly more compared to those of the PRP group (p = 0.028). However, PRP showed significant earlier improvement (p < 0.001). Conclusion: ACS contained higher levels of PDGF-BB and IL-1Ra and provided better improvement in pain relief compared to PRP.

Posteromedial dislocation of the elbow with lateral condyle fracture in children.

Posteromedial dislocation of the elbow with lateral condyle fracture is a rare injury, and only a few cases have been reported in the literature. We report 3 children who had posteromedial dislocation of the elbow with Milch type II lateral condylar fracture of the distal humerus. Major complications included malunion, nonunion of the fracture, heterotophic calcification and elbow subluxation. From our experience and a review of the literature, open anatomical reduction and internal fixation of the lateral condyle fracture is the mainstay of treatment for these children. Poor reduction of the lateral condyle fracture results in incongruity of the joint surface and leads to poor results.

[The manifestations and clinical significance of chest CT in paragonimiasis at different clinical phases].

OBJECTIVE: To investigate the chest CT manifestations of paragonimiasis at different clinical phases. METHODS: Forty-eight cases of paragonimiasis confirmed by laboratory studies were retrospectively analyzed. There were 30 males and e18 females ageing 9 - 66 years (average, 31.4 years). Conventional chest CT was performed in all cases and contrast enhanced CT in some cases. RESULTS: The chest CT findings of paragonimiasis included: (1) peribronchial inflammation (n = 9); (2) infiltration (n = 13), manifested as unilateral or bilateral patchy infiltrates with hazy borders. The location and shape were variable. The typical "canal gas-path" sign was seen in a few patients; (3) nodular and masses (n = 11); (4) cysts and cavity (n = 6); (5) pleural effusion (n = 9). The CT appearances of paragonimiasis were different at different clinical phases. Peribronchial inflammation, infiltration and pleural effusion were early presentations, not distinguishable from other common infections. The appearance of nodules, masses, cysts and cavities was more common in the clinical course. At the stabilization phase, nodular cavity or pleura thickening and calcification were revealed. CONCLUSION: There are various abnormalities on chest CT at different phases of paragonimiasis. Combination of clinical manifestations with chest CT characteristics is important in the diagnosis of paragonimiasis.

Case report: lateral capsular release for acute extension deficit in a child with congenital radioulnar synostosis.

Acute elbow extension deficit is an unusual phenomenon that has been observed in patients with congenital radioulnar synostosis. We report the case of an 11-year-old girl with congenital radioulnar synostosis who developed acute extension deficit of the right elbow and whose elbow range of motion was restored following lateral capsular release.

Traumatic Separation of the Distal Ulnar Physis in Children: A New Classification for Displaced Volar-Flexion Injuries.

OBJECTIVES: To propose a new fracture classification according to the direction of epiphysis displacement and to compare clinical findings and surgical outcomes between these subtypes. DESIGN: Retrospective study. SETTING: A tertiary referral hospital. PATIENTS: Twelve adolescents (mean age, 13.4 ± 1.3 years) who experienced separation of the distal ulnar physis were identified from the pediatric trauma database. INTERVENTION: Closed reduction was attempted for all injuries. If a satisfactory alignment could not be achieved, an open reduction was performed. MAIN OUTCOME MEASUREMENTS: The clinical outcome was evaluated with Mikic's criteria (union, alignment, length, distal radioulnar joint subluxation, limitations of elbow/wrist function, and degree of supination/pronation). The impacts of fracture patterns and locations of wrist abrasions on treatment decisions and clinical outcomes were tested with Fisher exact tests (unadjusted) and logistic regression analyses (adjusted for age and gender) with the bootstrap method. Five orthopedic surgeons used the new classification, and the reproducibility was tested with multirater kappa. RESULTS: The injury patterns included 6 dorsally-tilted distal ulnas (type 1) and 6 volarly-tilted distal ulnas [type 2-A (n = 1), type 2-B (n = 3), and type 2-C (n = 2)]. All type 1 fractures were successfully treated with closed reduction. Five of 6 cases with type 2 injuries failed closed reduction because of entrapment of the extensor carpi ulnaris tendon in the fracture site. Eleven of the patients' outcomes were excellent. One patient with a type 2-C injury experienced ulnar growth arrest. The multirater kappa for the new classification equals to 0.94, and P < 0.001. CONCLUSIONS: A majority of volar-flexion injuries require surgery to reduce the entrapped soft tissue. This new classification is easy to understand with a good interrater reproducibility. It is useful in identifying the injury mechanism and correlated with the likelihood of open reduction. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Temporal processing impairment in children with attention-deficit-hyperactivity disorder.

The current study aimed to investigate temporal processing in Chinese children with Attention-Deficit-Hyperactivity Disorder(ADHD) using time production, time reproduction paradigm and duration discrimination tasks. A battery of tests specifically designed to measure temporal processing was administered to 94 children with ADHD and 100 demographically matched healthy children. A multivariate analysis of variance (MANOVA) and a repeated measure MANOVA indicated that children with ADHD were impaired in time processing functions. The results of pairwise comparisons showed that the probands with a family history of ADHD performed significantly worse than those without family history in the time production tasks and the time reproduction task. Logistic regression analysis showed duration discrimination had a significant role in predicting whether the children were suffering from ADHD or not, while temporal processing had a significant role in predicting whether the ADHD children had a family history or not. This study provides further support for the existence of a generic temporal processing impairment in ADHD children and suggests that abnormalities in time processing and ADHD share some common genetic factors.

Gastrocnemius tightness on joint angle and work of lower extremity during gait.

BACKGROUND: Muscular tightness is a common clinical musculoskeletal disorder and is regarded as a predisposing factor for muscle injuries. In this study, a two-way mixed design ANOVA was applied to investigate the effects of the gastrocnemius tightness on the joint angle and joint work during walking. METHODS: Twenty-two patients with muscular tightness of gastrocnemius muscle (<12 degrees of ankle dorsiflexion with knee extended) and 22 age- and gender-matched subjects with normal gastrocnemius flexibility (>15 degrees of ankle dorsiflexion with knee extended) participated in this study. The joint angle and work at hip, knee, and ankle joints during the stance phase were analyzed at two preset cadences of 100 steps/min and 140 steps/min. FINDINGS: Significantly greater flexion angles at hip (P=0.025) and knee (P=0.001) were found in the tightness group at the time of maximal ankle dorsiflexion. Significantly less work generation at knee (P=0.034) and greater work absorption at ankle (P=0.024) were detected in the tightness group. INTERPRETATION: The subjects with gastrocnemius tightness revealed a compensatory gait pattern, which included the changes in the joint angles and associated work productions. The potential disturbance of the knee control and strain injuries of plantar flexors might be crucial in the clinical considerations for subjects with gastrocnemius tightness.