[A case of high-pressure injection injury of hand complicated with deep chemical burn caused by industrial cement].

This article reports a patient with extensive high-pressure injection injury of the hand combined with deep chemical burn caused by high-pressure injection of industrial cement materials was diagnosed and treated in the Department of Hand Surgery, Xiaolan Hospital Affiliated to Southern Medical University in 2022. The nerves, tendons and blood vessels of the left hand were involved, and the ulnar skin of the left thumb was extensively necrosis, and a large number of extensive cement foreign bodies remained under the skin. Part of the cement was inserted into the joint capsule of the interphalangeal joint. After emergency surgical treatment, the patient was saved successfully, and the wound healed well without chemical poisoning and other related complications, which created conditions for the second stage of flap repair.

[Xiongcan Yishen Formula up-regulates the clock gene expressions in the testis tissue of the rats with late-onset hypogonadism].

OBJECTIVE: To investigate the effect of Xiongcan Yishen Formula (XYF) on the expressions of the clock genes in the testis tissue of the rats with late-onset hypogonadism (LOH). METHODS: Forty-eight 8-week-old male SD rats were randomly divided into 6 groups, normal control, model control, testosterone propionate (TP), and low-, medium- and high-dose XYF. The LOH model was made in the later 5 groups of rats by intraperitoneal injection of D-galactose at 480 mg/kg/d for 56 successive days, while the normal controls were injected with the same volume of normal saline. After modeling, the rats in the low-, medium- and high-dose XYF groups were treated intragastrically with XYF at 10.4, 20.8 and 41.6 g/kg/d, bid, respectively, those in the normal and model control groups with the same volume of distilled water, and those in the TP group intramuscularly with TP at 5.21 mg/kg/d, qd alt, all for 28 days. After treatment, the supernatant was obtained for measurement of the serum T level by ELISA, and the testis tissue collected for determination of the mRNA and protein expressions of BMAL1, NR1D1, PER2, CRY1, StAR and CYP11A1 by RT-qPCR and Western blot. RESULTS: Compared with the normal controls, the rats in the LOH model control group showed significantly decreased serum T and mRNA and protein expressions of BMAL1, NR1D1, PER2, CRY1, StAR and CYP11A1 (P < 0.05). In comparison with the findings in the model controls, the T level was remarkably increased in the TP and XYF groups (P < 0.05), the expressions of StAR mRNA and CYP11A1 mRNA and protein markedly up-regulated in the high-dose XYF group (P < 0.05), and so was the expression of the StAR protein in the XYF and TP groups (P < 0.05), those of BMAL1 and NR1D1 proteins and PER2 mRNA and protein in the high-dose XYF group (P < 0.05), those of BMAL1 mRNA and CRY1 protein in the medium- and high-dose XYF groups (P < 0.05), that of NR1D1 mRNA in the XYF and TP groups (P < 0.05), and that of CRY1 mRNA in the medium- and high-dose XYF and TP groups (P < 0.05). CONCLUSION: Xiongcan Yishen Formula could up-regulate the expressions of the clock genes in the testis tissue of the LOH rats and increase the serum T level as well, which may underlie the mechanisms of Xiongcan Yishen Formula acting on LOH.

Comparison of bacteria isolated from open fractures following debridement and subsequent infection.

BACKGROUND: One of the major objectives for the management of open fractures is to prevent bone and soft tissue infection. Here, we identified species and drug sensitivities of bacterial isolates recovered during open fracture debridement and after infection and compared the results between the two time points. METHODS: A total of 61 hospitalized patients with open fractures who developed post-operative wound infection between October 2016 and December 2017 were included in this study. The cohort included 43 males and 18 females aged between 4 and 72 years. Patients were admitted to hospital 1-14 h after injury. Samples were collected after debridement and after infection and submitted for bacterial culture. Resulting isolates were identified using a VITEK 2 Bacterial Identification System and tested for drug sensitivity using the disc diffusion method. Results from the two time points were then compared. RESULTS: The positive bacterial culture rate following debridement was relatively low (14/61, 22.9%). In addition, bacteria cultured after debridement were generally inconsistent with those cultured after wound infection, with a concordance rate of only 3.3% (2/61). Gram-negative bacteria accounted for 91.3% (63/69) of isolates recovered from wound infections following surgery, among which Acinetobacter baumannii was baumannii was the predominant pathogen, accounting for 49.3% (42/69) of all isolates. Overall, 60.8% (42/69) of postoperative infections were caused by multi-drug resistant bacteria, with A. baumannii isolates accounting for 80.9% (34/42) of these cases. Rates of cefoperazone/sulbactam resistance were relatively low among the isolates (15/34, 44.1%), and most isolates showed a sensitive or intermediate resistance phenotype. CONCLUSIONS: Results of bacterial culture after debridement could not predict pathogenic bacteria causing postoperative infection. Therefore, we propose that open fracture infections are predominantly nosocomial and are mainly caused by multidrug-resistant Gram-negative bacteria. Further attention should be paid to the control of these pathogens in clinical settings.

Analysis of medial tibial plateau fracture injury patterns using quantitative 3D measurements.

BACKGROUND: The Wahlquist system classifies tibial medial plateau fractures into three types based on the sagittal fracture line location, with type C at highest risk of complications. However, the injury mechanism of tibial medial plateau fractures, especially tibial rotation movement, remains unclear. The purpose of the present study was to determine the injury patterns of medial tibial plateau fractures using 3D model simulation and quantitative 3D measurements. METHODS: Seventy-eight consecutive AO/OTA type 41-B tibial plateau fractures were retrospectively analyzed using CT-based 3D models and quantitative 3D measurements. The knee posture at the moment of fracture occurrence was simulated, and various knee angles in the sagittal, coronal, and axial planes were measured to evaluate the mechanism of medial tibial plateau fracture. The mean valgus-varus, hyperextension-flexion, and internal-external rotation angles were determined, and the chi-square test was used for comparisons of categorical varus and valgus force data to determine the main force direction in Wahlquist type C fractures. RESULTS: Angle measurements in the coronal planes showed that 28 (35.9%) medial tibial plateau fractures resulted from a varus injury pattern, while 50 fractures (64.1%) resulted from a valgus pattern. Valgus force produced significantly more Wahlquist type C fractures (37 of 50 fractures) than varus force (2 of 28 fractures) (p < 0.05). There was no significant difference in the cases of patients with type C fractures between the tibial internal and external rotation injury patterns(P > 0.05). CONCLUSIONS: Valgus force was the cause of 64.1% of the medial tibia plateau fractures in the present cohort. Furthermore, valgus force produced more Wahlquist type C fractures than varus force. The present findings will help orthopedists understand the injury mechanism of the Wahlquist classification system, and will facilitate the identification of the common features of medial tibial plateau fractures induced by specific injury patterns.

Thiamine ameliorates inflammation of the ruminal epithelium of Saanen goats suffering from subacute ruminal acidosis.

This study aimed to examine the role of thiamine in the local inflammation of ruminal epithelium caused by high-concentrate diets. Eighteen mid-lactating (148 ± 3 d in milk; milk yield = 0.71 ± 0.0300 kg/d) Saanen goats (body weight = 36.5 ± 1.99 kg; body condition score = 2.73 ± 0.16, where 0 = emaciated and 5 = obese) in parity 1 or 2 were selected. The goats were randomly divided into 3 groups (n = 6/group): (1) control diet (concentrate:forage 30:70), (2) high-concentrate diet (HC; concentrate:forage 70:30), and (3) high-concentrate diet with 200 mg of thiamine/kg of dry matter intake (THC; concentrate:forage 70:30). Goats remained on experimental diets for 8 wk. On the last day of 8 wk, ruminal and blood samples were collected to determine ruminal parameters, endotoxin lipopolysaccharide, and blood inflammatory cytokines. Goats were slaughtered to collect ruminal tissue to determine gene and protein expression of toll-like receptor 4 (TLR4) signaling pathways. Thiamine supplementation increased ruminal pH (6.03 vs. 5.42) compared with the HC group. Propionate (21.08 vs. 31.61 mM), butyrate (12.08 vs. 19.39 mM), lactate (0.52 vs. 0.71 mM), and free lipopolysaccharide (42.16 vs. 55.87 × 103 endotoxin units/mL) concentrations in ruminal fluid were lower in THC goats compared with HC goats. Similar to plasma interleukin 1ß (IL-1ß) concentration (209.31 vs. 257.23 pg/mL), blood CD8+ percentage (27.57 vs. 34.07%) also decreased in response to thiamine. Compared with HC goats, THC goats had lower ruminal epithelium activity of the enzymes myeloperoxidase and matrix metalloproteinase (MMP) 2 and 9. In contrast to HC, THC had downregulated mRNA expression of nuclear factor-κB (NFKB), TLR4, IL1B, MMP2, and MMP9 in ruminal epithelium. Thiamine supplementation led to lower relative protein expression of IL-1ß, NF-κB unit p65, and phosphorylated NF-κB unit p65 in ruminal epithelium. Taken together, these results suggest that thiamine supplementation mitigates HC-induced local inflammation and ruminal epithelial disruption.

The kidney allocation system does not appropriately stratify risk of pediatric donor kidneys: Implications for pediatric recipients.

Kidney Allocation System (KAS) was enacted in 2014 to improve graft utility, while facilitating transplantation of highly-sensitized patients and preserving pediatric access to high-quality kidneys. Central to this system is the Kidney Donor Profile Index (KDPI), a metric intended to predict transplant outcomes based on donor characteristics but derived using only adult donors. We posited that KAS had inadvertently altered the profile and quantity of kidneys made available to pediatric recipients. This question arose from our observation that most pediatric donors carry a KDPI over 35 and have therefore been rendered relatively inaccessible to pediatric recipients under KAS. Here we explore early trends in pediatric transplantation following KAS, including: (i) use of pediatric donors, (ii) use of Public Health System (PHS) high infectious risk donors, (iii) wait time, and (iv) living donor transplantation. We note some concerning preliminary changes following KAS implementation, including the allocation of fewer deceased donor pediatric kidneys to children and stagnation in pediatric wait times. Moreover, the poor predictive power of the KDPI for adult donors appears to be even worse when applied to pediatric donors. These early trends warrant further observation and consideration of changes in pediatric kidney allocation if they persist.

Assessment of Tocilizumab (Anti-Interleukin-6 Receptor Monoclonal) as a Potential Treatment for Chronic Antibody-Mediated Rejection and Transplant Glomerulopathy in HLA-Sensitized Renal Allograft Recipients.

Extending the functional integrity of renal allografts is the primary goal of transplant medicine. The development of donor-specific antibodies (DSAs) posttransplantation leads to chronic active antibody-mediated rejection (cAMR) and transplant glomerulopathy (TG), resulting in the majority of graft losses that occur in the United States. This reduces the quality and length of life for patients and increases cost. There are no approved treatments for cAMR. Evidence suggests the proinflammatory cytokine interleukin 6 (IL-6) may play an important role in DSA generation and cAMR. We identified 36 renal transplant patients with cAMR plus DSAs and TG who failed standard of care treatment with IVIg plus rituximab with or without plasma exchange. Patients were offered rescue therapy with the anti-IL-6 receptor monoclonal tocilizumab with monthly infusions and monitored for DSAs and long-term outcomes. Tocilizumab-treated patients demonstrated graft survival and patient survival rates of 80% and 91% at 6 years, respectively. Significant reductions in DSAs and stabilization of renal function were seen at 2 years. No significant adverse events or severe adverse events were seen. Tocilizumab provides good long-term outcomes for patients with cAMR and TG, especially compared with historical published treatments. Inhibition of the IL-6-IL-6 receptor pathway may represent a novel approach to stabilize allograft function and extend patient lives.

Rise Time Reduction of Thermal Actuators Operated in Air and Water through Optimized Pre-Shaped Open-Loop Driving.

Electrothermal actuators have many advantages compared to other actuators used in Micro-Electro-Mechanical Systems (MEMS). They are simple to design, easy to fabricate and provide large displacements at low voltages. Low voltages enable less stringent passivation requirements for operation in liquid. Despite these advantages, thermal actuation is typically limited to a few kHz bandwidth when using step inputs due to its intrinsic thermal time constant. However, the use of pre-shaped input signals offers a route for reducing the rise time of these actuators by orders of magnitude. We started with an electrothermally actuated cantilever having an initial 10-90% rise time of 85 µs in air and 234 µs in water for a standard open-loop step input. We experimentally characterized the linearity and frequency response of the cantilever when operated in air and water, allowing us to obtain transfer functions for the two cases. We used these transfer functions, along with functions describing desired reduced rise-time system responses, to numerically simulate the required input signals. Using these pre-shaped input signals, we improved the open-loop 10-90% rise time from 85 µs to 3 µs in air and from 234 µs to 5 µs in water, an improvement by a factor of 28 and 47, respectively. Using this simple control strategy for MEMS electrothermal actuators makes them an attractive alternative to other high speed micromechanical actuators such as piezoelectric stacks or electrostatic comb structures which are more complex to design, fabricate, or operate.

Effect of tibial slope changes on femorotibial contact kinematics after cruciate-retaining total knee arthroplasty.

PURPOSE: The present study was undertaken to evaluate the effect of tibial slope (TS) changes on the femorotibial articular contact kinematics in subjects undergoing posterior cruciate-retaining total knee arthroplasty (CRTKA). METHODS: Eighteen knees in nine patients with medial osteoarthritis who underwent CRTKA using the same size prosthesis were analysed preoperatively and 2 years after TKA. TS changes were calculated on lateral radiographs taken before and after TKA. Knees were classified into two groups according to the change in TS obtained by subtracting the post-operative value from the preoperative value: group 1 (>3°) and group 2 (<3°). The femorotibial articular contact kinematics of knees during weight-bearing flexion were compared between the two groups by two-dimensional/three-dimensional registration. RESULTS: Group 1 showed a continuous posterior translation of the medial femoral condyle during the process of knee flexion, whereas in group 2 the medial femoral condyle experienced paradoxical anterior motion from 20° to 90° of knee flexion. The lateral femoral condyle continuously moved posteriorly in both groups. CONCLUSION: A greater reduction in TS after TKA compared with preoperative TS reduces paradoxical medial femoral condylar movement. This may contribute to improved patient satisfaction after CR TKA. LEVEL OF EVIDENCE: III.

[Domestic external fixator application in the treatment of limb deformities: 7 289 cases application report].

Objective: To discuss the clinical application and effects of domestic external fixator in the treatment of patients with malformations of limbs. Methods: A total of 7 289 patients with malformation of limbs who had been operated in Qin Sihe orthopedic surgery team from January 1989 to June 2016 were retrospective analyzed. The patients were treated with domestic external fixator, including 4 033 males and 3 256 females, aging from 2 to 82 years with a mean age of 23.4 years. There were 2 732 patients using Ilizarov external fixator, 4 713 patients using hybrid external fixator, 57 patients using monobrachial external fixator, 232 patients using Ilizarov external fixator and hybrid external fixator. The Ilizarov, hybrid and monobrachial external fixator were used in 67, 65 and 0 patients on the upper limbs and in 2 665, 4 616 and 57 patients on the lower limbs. There were 3 028 patients operated on the left limbs, 3 260 patients operated on the right limbs and 1 001 patients operated on the bilateral limbs. The top three types of diseases were sequelae of poliomyelitis, cerebral palsy and post-traumatic stress disorder peromely. Deformity types inclued talipes equinovarus, knee flexion deformity, cavus foot and so on. Results: All the patients were followed up for a period of 2.5 months to 22.4 years, with an average follow-up time of 5.4 years. All of the external fixators were used for single once, and there was no substitute for external fixator quality problem. All the patients were completed surgery goal until removing external fixation except 1 patient gave up treatment and 1 removed the fixator because of metal allergy. The common complications included wire or pin infection and joint movement limitation and so on. Conclusions: The domestic external fixator developed and produced based on the characteristics of Chinese limb deformity disability. The domestic external fixator can be used to treat kinds of limb deformities with the advantages of practical, economical, adjustable, universal and portable. The domestic external fixator could meet the clinical demand for fixation of the osteotomy end of the limbs, the correction of the deformity, the repair of the defects and the limb lengthening.

Lack of association between IL-6 -174G>C polymorphism and lung cancer: a meta-analysis.

The results of previous case-control studies examining the relationship between the interleukin (IL)-6 gene -174G>C polymorphism and lung cancer are controversial. In this study, we evaluated the relationship between the IL-6 gene -174G>C polymorphism and lung cancer. We selected 5 case-control studies related to the IL-6 gene -174G>C polymorphism and lung cancer by searching the PubMed, EMBase, Chinese Biomedical Literature Database, and Wanfang database. We utilized the Q-test and I2 test to determine heterogeneity between each study. To merge the odds ratios (OR) and 95% confidence intervals (CI), we utilized the fixed effects model and random effect model for analyses. The present study included 2801 patients with lung cancer and 3234 cancer-free control subjects. The meta-analysis revealed no association between the IL-6 gene -174G>C polymorphism and lung cancer in either genotype or allele distribution [CC+GC vs GG: OR = 1.04, 95%CI (0.86-1.26), P = 0.70; GG+GC vs CC: OR = 0.93, 95%CI (0.82-1.05), P = 0. 23; CC vs GG: OR = 1.08, 95%CI (0.95-1.23), P = 0.23; C allele vs D allele: OR = 1.03, 95%CI (0.96-1.11), P = 0.44]. We concluded that the IL-6 gene -174G>C polymorphism was not associated with lung cancer.

Survival of Cochlear Spiral Ganglion Neurons Improved In vivo by Anti-miR204 via TMPRSS3.

OBJECTIVE: Sensorineural hearing loss (SNHL) is caused by damage to hair cells followed by degeneration of the spiral ganglion neurons (SGNs), and cochlear implanting is an effective treatment. Unfortunately, the progressive hearing loss is still found due to ongoing degeneration of cochlear SGNs. The aim of this study was to investigate the neuroprotective effect of anti-miR204 on SGNs in vivo. METHODS: Our recent in vitro work suggested that anti-miR204 could be a potential therapeutic strategy in SNHL via rescue cochlear SGNs. In order to further our knowledge of miR204 on SGNs in vivo, we made a kanamycin ototoxicity model and then virus containing the anti-miR204 gene (AAV1-anti-miR204) was microinjected into the cochlear of the model to monitor the effect. RESULTS: The SGNs were rescued by anti-miR204 in the kanamycin ototoxicity mouse group compared to the sham group. Moreover, expression of TMPRSS3 in SGNs was saved by anti-miR204 treatment. CONCLUSION: Anti-miR204 might be an alternate way to alleviate the degeneration of cochlear SGNs of kanamycin ototoxicity mice.

Immune response of γδT cells in Schistosome japonicum-infected C57BL/6 mouse liver.

Systematic evaluation of the role of γδT cells during the Schistosoma japonicum infection has not been reported, despite the fact that γδT cells contribute to many infectious diseases in innate immunity. Therefore, the aim of this study was to observe the properties of γδT cells in the liver of C57BL/6 mice infected by S. japonicum. In this report, using immuno-fluorescent histological analysis, γδT cells were found around hepatic granulomatous. Moreover, the flow cytometry results revealed that the percentage of hepatic γδT cells increased significantly after S. japonicum infection. More interestingly, a subset of CD3(-)γδTCR(+) cells were found and markedly increased after infection. Furthermore, expression of activation markers (CD25 and CD69) and cytokine profiles were detected in these hepatic CD3(+)γδTCR(+) and CD3(-)γδTCR(+) cells. The significantly higher level of CD69, IL-4 and IL-17 were observed in CD3(+)γδTCR(+) cells after infection, suggesting that CD3(+)γδTCR(+) cells instead of CD3(-)γδTCR(+) cells might play a predominant role during the infection. Finally, our results indicated that the expression of NKG2D on CD3(+)γδTCR(+) cells was higher than that on CD3(-)γδTCR(+) cells. Collectively, γδT cells could play an important role in the liver of C57BL/6 mouse during japonicum infection.

Asymmetric bi-layer PFSA membranes as model systems for the study of water management in the PEMFC.

New bi-layer PFSA membranes made of Nafion® NRE212 and Aquivion™ E79-05s with different equivalent weights are prepared with the aim of managing water repartition in the PEMFC. The membrane water transport properties, i.e. back-diffusion and electroosmosis, as well as the electrochemical performances, are compared to those of state-of-art materials. The actual water content (the inner water concentration profile across the membrane thickness) is measured under operation in the fuel cell by in situ Raman microspectroscopy. The orientation of the equivalent weight gradient with respect to the water external gradient and to the proton flow direction affects the membrane water content, the water transport ability and, thus, the fuel cell performances. Higher power outputs, related to lower ohmic losses, are observed when the membrane is assembled with the lower equivalent weight layer (Aquivion™) at the anode side. This orientation, corresponding to enhanced water transport by back-flow while electroosmosis remains unaffected, results in the higher hydration of the membrane and of the anode active layer during operation. Also, polarization data suggest a different water repartition in the fuel cell along the on-plane direction. Even if the interest in multi-layer PFSA membranes as perspective electrolytes for PEMFCs is not definitively attested, these materials appear to be excellent model systems to establish relationships between the membrane transport properties, the water distribution in the fuel cell and the electrochemical performances. Thanks to the micrometric resolution, in situ Raman microspectroscopy proves to be a unique tool to measure the actual hydration of the membrane at the surface swept by the hydrated feed gases during operation, so that it can be used as a local probe of the water concentration evolution along the gas distribution channels according to changing working conditions.

A rare disorder mimics otitis media: Langerhans cell histiocytosis of the temporal bone in a child with interstitial pulmonary fibrosis.

Langerhans cell histiocytosis (LCH) is a rare disease ranging from a benign to a rapidly fatal condition affecting young children predominantly, and is characterized by an abnormal clonal proliferation of Langerhans cells. We report a case of a 3-year-old child presenting with a 1-year history of otorrhea and otorrhagia followed by a 6-month history of postauricular swelling in the right ear. Imaging demonstrated a large mass of organized tissue. A biopsy was conducted, and the diagnosis of LCH was confirmed by histopathological and immunohistochemical examination. The child was treated with a 12-month course of vinblastine chemotherapy with prednisolone. No clinical evidence of recurrence was noticed after 3 years of follow-up. This rare case highlights the importance for otolaryngologists to keep LCH in mind for differential diagnosis in very young patients with symptoms and signs suggestive of acute mastoiditis or chronic otitis media.

First Report of Leaf and Fruit Spot of Citrus reticulata Blanco cv. Nian Ju Caused by Colletotrichum truncatum in China.

In the spring of 2011, leaf and fruit spot symptoms were observed in three orchards planted with Citrus reticulata Blanco cv. Nian Ju in Longmen City, Guangdong Province. The incidence of fruit and leaf spot ranged from of 5 to 25% across all three orchards. Similar symptoms were not observed on the fruit of C. reticulata cv. Shiyue Ju planted at the same orchards. Lesions on the diseased leaves and fruit first emerged on the lower portions of the trees and were initially small, circular, and diffuse in distribution over the leaf surface. Within 2 weeks, the small circular spots on the leaves and fruit enlarged to brown sunken necrotic lesions ranging from 5 to 30 mm in diameter. To isolate the causal organism, symptomatic leaves and fruit peels (from different trees) adjacent to the lesions as well as the lesions themselves were surface-disinfested with 1% sodium hypochlorite for 1 min and rinsed three times with sterile water. The tissues were then plated on potato dextrose agar (PDA) under alternating light and dark conditions at 28°C for 4 days. Sixteen fungal isolates with nearly identical fungal colonies were recovered from all samples. After 7 days of incubation, isolates with grayish white to dark gray mycelium and salmon pink conidia masses were observed. The conidia were hyaline, smooth-walled, aseptate, one-celled, and falcate, with oil droplets in the cytoplasm. The conidia were 19.7 to 22.5 (mean = 21.5) × 2.8 to 3.9 (mean = 3.4) µm. The fungal colonies also produced acervuli, setae, and sclerotia in the culture. The cultural and morphological characteristics of these isolates were consistent with the description of Colletotrichum truncatum (2). The ACT, TUB2, CHS I, GAPDH, and ITS regions of four representative isolates (GenBank Accession Nos. KF591214, KF591213, KF591211, KF591212, and KF011205) were sequenced and identical to those of the type specimen of C. truncatum CBS 151.35. To determine pathogenicity, leaves of three 3-year-old potted plants and ten 8-month-old fruit of C. reticulata Blanco cv. Nian Ju were each wound-inoculated with 20 µl of a suspension of conidia (1 × 105 conidia/ml). Leaves of an additional two potted plants and 10 similarly-aged fruit were wound-inoculated with 20 µl of sterile water as control. The citrus plants and fruit were then maintained at 90% relative humidity at 28°C with a 12-h photoperiod. Symptoms identical to those observed in the orchards in Longmen City developed on all of the inoculated citrus leaves and fruit after 14 days. The controls remained healthy throughout this period. The inoculation experiment was performed a second time with identical results. Isolates of C. truncatum identical to that of the isolate used for inoculation were obtained from all the inoculated symptomatic citrus leaves and fruit. C. truncatum has a broad host range and is known to be pathogenic on several crops including Medicago sativa L., Phaseolus lunatus, and Arachis hypogea (1,2,3,4). To our knowledge, this is the first report of leaf and fruit rot of C. reticulata Blanco cv. Nian Ju caused by C. truncatum in China. The golden-yellow fruit of C. reticulata Blanco cv. Nian Ju are commonly displayed during the Spring Festival of the Chinese New Year, and future epidemics of fruit spot may affect sustainability of this important cultural practice. References: (1) P. A. Backman et al. Plant Dis. 66:1032, 1982. (2) U. Damm et al. Fungal Divers. 39:45, 2009. (3) C. Eken and E. Demirci. Plant Dis. 84:100, 2000. (4) F. Huang et al. Fungal Divers. 61:61, 2013.

First Report of Foliar Blight Caused by Phytophthora capsici on Citrus reticulata Blanco cv. Nian Ju in Guangdong, China.

Citrus reticulata Blanco cv. Nian Ju, an important ornamental plant, is traditionally displayed during the Chinese Spring Festival because its golden fruits are a symbol of auspiciousness. In the spring of 2012, foliar blight was observed on 10 to 30% of the Nian Ju plants at four nurseries in Yangjiang, Guangdong Province, China. Initial symptoms appeared as brown to black foliar lesions, followed by expansion of spots into blight. Some young branches also had necrosis. During frequent rainfall and prolonged wet periods at 22°C to 30°C, white and dense mycelia and sporangia were observed on the infected seedlings. To isolate the causal organism, leaves and stems were cut into sections. Each section included some partial lesion and adjacent asymptomatic tissues. They were surface-disinfested in 1% sodium hypochlorite for 60 s, rinsed three times with sterile water, and placed on V8 juice agar (V8A) at 25°C. After 3 days, 10 isolates were obtained and purified by single-zoospore method. These isolates were identified to species level by sequencing the rRNA internal transcribed spacer (ITS) region. Four representative isolates had an identical ITS sequence (GenBank Accession No. KF750568), which had 99% homology with Phytophthora capsici sequences in GenBank. In addition, all recovered isolates were identical in morphological characteristics. They produced caducous, papillate, and ovoid to ellipsoid sporangia (Length × width = 46.2 ± 7.7 × 23.6 ± 11.3 µm), often with a tapered base. The average length of pedicels was 33.3 ± 4.5 µm. All isolates are A2 mating type. They produced gametangia when paired with an A1 tester of P. capsici isolated from pepper on V8A. Plerotic oospores were 25.3 ± 2.1 µm in diameter. Amphigynous antheridia were 13.6 ± 2.8 µm long and 11.2 ± 0.9 µm wide. Oogonia were 27.4 ± 3.2 µm in diameter. To determine the pathogenicity, three 3-year-old potted C. reticulata cv. Nian Ju plants were sprayed with 20 ml of zoospore suspension from one representative isolate at 105 per ml. Two control plants were sprayed with 20 ml distilled water. All plants were then maintained at 90% relative humidity at 25°C with a 12-h photoperiod. Symptoms similar to those observed in the nurseries developed on all inoculated plants but not on any control plants after 10 days. The pathogenicity test was repeated once and similar results were obtained. P. capsici was recovered from all inoculated plants and resultant isolates had identical morphology to that of the isolates used for inoculation. P. capsici has a relatively broad host range including pumpkins, cucumbers, peppers, beans, squashes, and spinach (1,2). To our knowledge, this is the first report of foliar blight of C. reticulata cv. Nian Ju caused by P. capsici. This study indicates that P. capsici is potentially an important pathogen of C. reticulata cv. Nian Ju plants and further investigations into its epidemiology and development of site-specific integrated management programs for this new disease are warranted. References: (1) D. C. Erwin and O. K. Ribeiro. Phytophthora Diseases Worldwide. American Phytopathological Society, St. Paul, MN, 1996. (2) D. Tian and M. Babadoost. Plant Dis. 88:485. 2004.

Assessment of iron overload in very young children with limited thalassemia care resources in South China.

Southern China has one of the world's largest population of patients needing transfusions. Transfusion and chelation are not uniformly available and no magnetic resonance imaging (MRI) assessment data exists to date. A total of 153 young ß-thalassemia major (ß-TM) patients were assessed using a validated 1.5T scanner in Hong Kong, People's Republic of China (PRC). Their median age was 13 (range 7 to 30), and most patients were young (22.0% age <10, 73.0% age <15, 88.0% age <18). Erratic health care made estimation of total transfusion and chelation exposure impossible. Despite their early age, 24.0% had severe cardiac hemosiderosis [T2*<10 milliseconds (ms)], at ages as early as 8 years old. Median heart iron was 1.68 mg/g dry weight (range 0.19-7.66) and increased with age (p = 0.017), while liver iron was 22.2 mg/g dry weight (range 3.15 to 39.2). Serum ferritin levels were poor predictors of heart and liver, or pancreatic R* and pituitary R* values. Magnetic resonance imaging scans are needed to screen very young ß-TM patients with immediate risk of premature cardiac death in developing nations and triage them to more intensive treatment. This is particularly important in countries with a large number of patients and limited resources. Our data suggests that in developing countries, there is no lower limit for thalassemia MRI scanning programs.

First Report of Colletotrichum siamense Causing Leaf Drop and Fruit Spot of Citrus reticulata Blanco cv. Shiyue Ju in China.

Citrus reticulata Blanco cv. Shiyue Ju, which produces one of China's most popular tropical fruits, is widely planted throughout southern China. In 2008, a new citrus disease was found in Zhaoqing City in Guangdong Province on about 20,000 ha. Yield losses averaged 15% on a wide range of different aged trees of C. reticulata cv. Shiyue Ju. No yield losses were observed on C. reticulata cv. Gong gan. Symptoms first appeared on young leaves as leaf lesions, which were reddish-brown, elliptical, and 2 to 5 mm in diameter. After several weeks, 20 to 70% of leaves dropped and 10 to 50% of fruits on the trees showed brown spots (5 to 40 mm in diameter). Leaves and fruit peels adjacent to and including lesions from different trees were surface disinfested with 1% sodium hypochlorite for 1 min and rinsed three times in sterile water. Then the tissues were plated on potato dextrose agar (PDA) in alternating light and dark at 28°C for 3 days. Twenty-three similar isolates of a fast-growing fungus were recovered from all samples. For identification, single-spore cultures were grown on potato dextrose agar (PDA) at 28°C. Initially, the colonies were white, but after 5 days, they became pale gray with concentric zones and greenish black beneath. No setae, acervuli, or ascocarp were observed in the PDA culture. Conidia formed in pink conidial masses, were hyaline, fusiform, straight, obtuse at the ends, sometimes slightly curved, and 14 to 20 × 4.5 to 6 µm (x¯ = 16.2 ± 1.5 × 4.9 ± 0.5, n = 100). The cultural and morphological characteristics of these isolates matched the description of Colletotrichum siamense (3), but not that of C. gloeosporioides or C. acutatum, which cause anthracnose on citrus plants (1,2). The actin, ß-tubulin, CHS I, CAL, GPDH, and ITS regions of four representative isolates (GenBank KC524462, KC524463, KC524464, KC524465, KC524466, and KC524467) were identical and with almost 100% identity to those of the type specimen of C. hymenocallidis isolate CSSN3 (C. hymenocallidis is synonymous with C. siamense) (4), except for two inconsistent nucleotide bases in the GPDH gene. Four potted plants of C. reticulata cv. Shiyue Ju were used for pathogenicity tests. On each plant, 10 randomly selected leaves and four 6-month-old fruits were wound-inoculated with 20 µl of sterile water or conidial suspensions (1 × 105 conidia per ml). Plants were then maintained at 90% relative humidity with a 12-h photoperiod at 28°C. Symptoms resembling those in the field were observed on three inoculated plants after 14 days. In another similar experiment without wounding, three of 20 inoculated plants exhibited the symptoms after 14 days. Controls remained healthy throughout this period. The tests were performed three times. C. siamense was reisolated from all diseased inoculated plants, and the culture and fungus characteristics were the same as the original isolate. Thus, C. siamense was determined to be the pathogen causing leaf drop and fruit spot on C. reticulata cv. Shiyue Ju. To our knowledge, this is the first report of leaf drop and fruit spot on C. reticulata cv. Shiyue Ju caused by C. siamense. References: (1) H. Benyahia et al. Plant Pathol. 52:798, 2003. (2) N. A. Peres et al. Plant Dis. 89:784, 2005. (3) H. Prihastuti, et al. Fungal Diversity 39:89, 2009. (4) B. Weir et al. Stud Mycol. 73:115, 2012.