Reference values for six-minute walk distance and six-minute walk work in Caucasian adults.

RATIONALE: The six-minute walk test (6MWT) is a practical and simple field-based test to assess physical capacity. Several reference equations for six-minute walking distance (6MWD, m) exist, but have a number of limitations that decrease their clinical utility. In addition, no reference equations exist for the 6MWT-derived outcome six-minute walk work (6MWORK, kg.m). OBJECTIVES: To establish new reference equations for 6MWD and 6MWORK on a 20 m course using data from the population-based Canadian Cohort Obstructive Lung Disease study. METHODS AND MEASUREMENTS: A total of 335 participants without obstructive or restrictive pulmonary function, with normal self-reported health status, normal exercise capacity, and <30 pack years cigarette smoking history were selected to create a representative sample of Canadian adults aged ≥40 years. All participants performed two 6MWTs. Reference equations were derived using multiple regression analyses. MAIN RESULTS: On average, 6MWD and 6MWORK were 541±98 m and 41.3 ± 11.2 kg.m, respectively. All outcomes were significantly greater in males than females. Sex-specific reference equations were derived from the results of 6MWD and 6MWORK with an explained variance of 24 to 35%. CONCLUSIONS: This study established reference equations for 6MWD and 6MWORK on a 20 m course in Caucasian males and females aged ≥40 years with normal pulmonary function, self-reported health status and exercise capacity. These newly derived reference equations add value to the assessment of functional capacity in clinical practice.

[Meta-analysis on efficacy of PCI treatment or conservative treatment among patients with chronic total occlusions].

Objective: To compare the efficacy between percutaneous coronary intervention (PCI) and conservative medication treatment in chronic total occlusions (CTO) patients. Methods: It was a meta-analysis.Articles on drug therapy and PCI for complete coronary artery occlusion were retrieved from Pubmed, Embase and Web of Science databases. The search time was from the database construction to May 10, 2020, and the following search criteria were used for the search "chronic total occlusion" "percutaneous coronary intervention" and "medical therapy". References from searched literatures were also searched to identify more eligible studies. Randomized controlled trials (RCT) and cohort studies comparing efficacy of PCI versus oral medication as well as medication as initial therapy option for CTO patients with single or multiple lesions were included. The primary endpoints included all-cause death, cardiac death, recurrent myocardial infarction, re-revascularization, major adverse cardiac events (MACE) and stroke. Data were analyzed with ReviewManager5.3.0 software. Pooled effect size RR and 95%CI were calculated by randomization effect model. Heterogeneity was evaluated by I2. Bege test was used to evaluate publication bias. Subgroup analyses were performed for RCT and cohort studies. Results: A total of 1 079 articles were retrieved and 16 studies (RCT=4, cohort study=12) were included with 12 223 patients. Fourteen publications (RCT=4, cohort study=10) reported all-cause death post PCI and/or drug therapy. Results showed that risk of all-cause death was significantly lower in PCI group than in drug therapy group (RR=0.45,95%CI 0.39-0.53,P<0.001);subgroup analysis showed that risk of all-cause death was significantly lower in PCI group than in drug therapy group from cohort studies (RR=0.44,95%CI 0.38-0.52,P<0.001),but comparable in RCT (P=0.27). Thirteen studies (RCT=3, cohort study=10) reported cardiac death post PCI and/or drug therapy. Results showed that risk of cardiac death was significantly lower in PCI group than in drug therapy group (RR=0.44,95%CI 0.35-0.55,P<0.001);subgroup analysis showed that risk of cardiac death was significantly lower in PCI group than in drug therapy group in cohort studies (RR=0.43,95%CI 0.34-0.54,P<0.001),but not in RCT (P=0.25). Fourteen publications (RCT=4, cohort study=10) reported recurrent myocardial infarction post PCI and/or drug therapy. Results showed that risk of recurrent myocardial infarction was significantly lower in PCI group than in drug therapy group (RR=0.62,95%CI 0.44-0.88,P=0.007);subgroup analysis showed that risk of recurrent myocardial infarction was significantly lower in PCI group than in drug therapy group from cohort studies (RR=0.56,95%CI 0.40-0.78,P=0.000 5),but comparable in RCT (P=0.17). Fourteen publications (RCT=4, cohort study=10) reported re-revascularization post PCI and/or drug therapy. Results showed that risk of re-revascularization was comparable between PCI group and drug therapy group (P=0.91);subgroup analysis showed that risk of re-revascularization was comparable between PCI group and drug therapy group both in cohort study and RCT (P=0.60 and 0.41, respectively). Eleven publications (RCT=3, cohort study=8) reported MACE post PCI and/or drug therapy. Results showed that risk of MACE was significantly lower in PCI group than in drug therapy group (RR=0.74,95%CI 0.59-0.93,P=0.03);subgroup analysis showed that risk of MACE was significantly lower in PCI group than in drug therapy group in cohort studies (RR=0.72,95%CI 0.56-0.93,P=0.01), but not in RCT (P=0.8). Six publications (RCT=2, cohort study=4) reported stroke post PCI and/or drug therapy. Results showed that risk of stroke was comparable between PCI and drug therapy groups (RR=0.62,95%CI 0.32-1.20, P=0.15);subgroup analysis showed that risk of stroke was comparable between PCI and drug therapy groups both in cohort studies and RCT (P=0.48 and 0.32, respectively). Conclusion: Compared with oral drug therapy, PCI may have better efficacy for CTO patients based on results from this cohort study.

Value of three biopsy methods in prostate cancer detection: a meta-analysis and systematic review.

OBJECTIVE: The study aimed at investigating the value of systemic biopsy (sysPbx), magnetic resonance imaging/ultrasound fusion targeted biopsy (fusPbx) and fusPbx combined with sysPbx (comPbx) for prostate cancer (PCa) detection. MATERIALS AND METHODS: Data from the PubMed, Cochrane, and Embase databases were searched from inception until March 23, 2020. Prospective studies comparing the detection rates of sysPbx, fusPbx and comPbx were identified. We pooled the detection rates for all PCa, clinically significant prostate cancer (csPCa), and clinically insignificant prostate cancer (cinsPCa) of fusPbx, sysPbx, and comPbx. Risk ratios (RRs) were calculated for the meta-analysis. Then, analyses were performed to identify the possible sources of heterogeneity. RESULTS: Seventeen studies, including 18 cohorts with 3035 men, were included. No patients had previous evidence of PCa. Each patient had one or more suspicious lesions found on multiparametric magnetic resonance imaging (mpMRI) and received both fusPbx and sysPbx. The results showed that fusPbx and sysPbx did not differ significantly in detecting all PCa (RR=1.00, 95% CI: 0.95-1.05, p>0.05). However, fusPbx provided a higher detection rate for csPCa (RR=1.24, 95% CI: 1.14-1.34, p<0.05) and a lower detection rate for cinsPCa (RR=0.68, 95% CI: 0.61-0.76, p<0.05) than sysPbx. In addition, comPbx detected more PCa (RR=1.22, 95% CI: 1.16-1.29, p<0.05) and csPCa cases (RR=1.13, 95% CI: 1.05-1.21, p<0.05) than fusPbx. CONCLUSIONS: In men with positive mpMRI findings, compared to sysPbx, fusPbx had significantly increased the detection rates for csPCa and decreased those for cinsPCa. The combination of fusPbx with sysPbx outperformed fusPbx in detecting both overall PCa and csPCa.

[Radioanatomic study on the role of Hadad-Bassagasteguy flap in skull base reconstruction in endoscopic endonasal approach].

Objective: To evaluate the value of Hadad-Bassagasteguy flap (HBF) in endoscopic endonasal approaches (EEA) skull base reconstruction by radioanatomic measurements on CT of the skull base of Chinese adults. The following data in terms of anterior skull base defect and reconstruction, sphenoid platform area and middle skull base defect and reconstruction including sphenoid platform and sella area, clivus area defect and reconstruction, and HBF were collected and assessed. Methods: CT image data of 42 Chinese adults were selected to obtain radioanatomic measurement data related to HBF, anterior skull base defect and reconstruction, middle skull base defect and reconstruction, and defect and reconstruction of clivus area. SPSS 26.0 software was used to analyze the data. Results: The radioanatomic measurement data about HBF and skull base of 42 Chinese adults were obtained. The width of the leading edge of HBF [(37.49±2.86) mm] was 6 mm more than the anterior skull base width at the level of the anterior ethmoidal artery [(30.87±8.61) mm], and the width of the trailing edge of HBF [(42.61±3.95) mm] was also 6 mm more than the anterior skull base width at the level of the sphenoethmoidal junction [(26.79±2.79) mm]. The total length of HBF including the pedicle [(79.68±4.96) mm] was 6 mm more than the length of the anterior skull base reconstruction [(54.06±8.67) mm], and the length of HBF without pedicle [(46.27±3.14)] mm was 6 mm more than the length of anterior skull base defect [(30.87±8.61) mm]. The trailing edge width was 6 mm more than the planum sphenoidal width at the level of the optic strut [(30.87±8.61) mm]. The total length of HBF including the pedicle was 6 mm more than the length of the planum sphenoidal, and the sella reconstruction [(64.44±10.25) mm], also was 6 mm more than the length of the planum sphenoidal reconstruction [(73.61±8.28) mm]. The length of HBF without pedicle was 6 mm more than the length of the planum sphenoidal, and the sella defect [(27.88±3.74) mm], also was 6 mm more than the length of the planum sphenoidal defect [(15.50±3.38) mm]. The width of the leading edge of HBF and the width of the trailing edge were both 6 mm more than the width of clivus reconstruction at the level of the foramen lacerum [(21.68±2.30) mm]. The total length of HBF including pedicles was 6 mm more than the clivus reconstruction length [(67.09±5.44) mm], while the length of HBF without pedicles was also 6 mm more than the clivus defect length [(37.19±3.80) mm]. Conclusions: In this study, the radiosanatomic measurements ensured that HBF could provide sufficient tissue flap for the reconstruction of the anterior skull base and sphenoid plateau and extend the reconstruction area to sella and clivus. Preoperative radiosanatomic measurement can be used to predict the size of HBF required for skull base reconstruction, which provides important guidance for flap harvest.

Genetic effects of vascular endothelial growth factor and its receptor 2 on feather maturity in three chicken breeds.

1. The goal of the current study was to evaluate the genetic effects of the vascular endothelial growth factor (VEGF) and its receptor (VEGFR-2) on feather maturity in the Qingyuan partridge chicken, Guangxi sanhuang chicken and Princess chicken. 2. Both SSCP-PCR and qPCR were employed to detect the polymorphism and gene expression of the VEGF and VEGFR-2 genes. 3. Four SNPs were identified in the VEGFR-2 gene. Exon10-A69G was associated with feather maturity (P < 0.01). Princess chickens with the genotype EF had higher feather maturity scores (P < 0.01). Higher expression levels of VEGF and VEGFR-2 were detected in the immature feather group of Qingyuan partridge chickens, especially in the skin. 4. The VEGF and VEGFR-2 genes play critical roles in feather maturity. In addition, exon10-A69G and genotype EF in the Princess chicken could potentially be utilised as genetic markers to improve efficiency in breeding.

[Correlation analysis of eosinophils in peripheral blood and polyp tissues of patients with chronicrhinosinusitis with nasal polyps].

Objective:To explore the correlation between peripheral blood eosinophils and tissue eosinophils in patients with chronic rhinosinusitis with nasal polyps(CRSwNP) in different periods.Method:This trial was a prospective study involved 342 patients with CRSwNP who were treated by endoscopic sinus surgery in the Huai'an First People's Hospital, Nanjing Medical University in 2008, 2012 and 2016. Nasal polyp resection specimens were stained by HE.Tissue eosinophils were counted per high-power field, and peripheral blood eosinophils were collected from blood routine examination before operation.The relationship between peripheral blood eosinophils and tissue eosinophils were evaluated.Result:The correlation between peripheral blood eosinophils and tissue eosinophils was positive in nasal polyps in 2008,2012 and 2016(r= 0.275,0.435,0.505, respectively). AUC values were all greater than 0.7. Conclusion:There is a positive correlation between peripheral blood eosinophils and tissue eosinophils infiltration in patients with CRSwNP. Although the cutoff value is changing, peripheral blood eosinophils can be used as an indicator for predicting eosinophilic CRSwNP.

[Effects of sleep body posture on subjective sleepiness in patients with OSAHS].

Objective:To observe the effects of sleep body posture on subjective sleepiness in patients with OSAHS.Method: We assessed the sleeping body position, the sleep structure, position specific AHI and the Epworth Sleepiness Scale (ESS) in a total of 90 patients with OSAHS. The patients were grouped according to AHI: mild OSAHS (5≤AHI<15), moderate (15≤AHI<30) and severe (AHI≥30). The polysomnography data and clinical characteristics were compared between each group.Result: There was statistically significant difference in arousal index，MinSpO2，REM% and NREM% among three groups (F value was 12.10,43.67,15.81,13.17，respectively，P<0.05). Compared with supine，the severe OSAHS group had significantly bigger changes in MinSpO2， REM% and NREM%（t value was 3.02,2.41,2.90，respectively，P<0.05）. For mild-to-moderate groups，there was no correlation between the ESS and the AHI at any position（P>0.05）. For severe group，the ESS was significantly correlated with L-AHI（r=0.454，P<0.01)；the REM L-AHI and NREM L-AHI was also significantly correlated with ESS of severe group (r=0.522 and 0.425，P<0.01). Conclusion:The sleep body posture had significant effects on sleep structure and respiratory events in severe OSAHS group. The L-AHI was found to have a closer association with daytime sleepiness in severe OSAHS than other groups.

Outcomes and predictors of failure of non-invasive ventilation in patients with community acquired pneumonia in the ED.

OBJECTIVE: We set out to describe the use and analyze the predictors of non-invasive ventilation failure in patients with community-acquired pneumonia who receive non-invasive ventilation as first line ventilatory therapy in the emergency department. METHODS: A retrospective cohort study was conducted among consecutive patients with community acquired pneumonia requiring ventilator support presenting to two tertiary care university-affiliated emergency departments. Multivariable logistic regression analysis was used to determine predictors of non-invasive ventilation failure at initiation of non-invasive ventilation and at two hours of non-invasive ventilation use; RESULT: After excluding patients with a do not resuscitate order status, 163 (74.8%) patients with community acquired pneumonia were initially treated with non-invasive ventilation on initial presentation to the emergency department. Non-invasive ventilation failure occurred in 50% of patients and was found to be associated with the absence of chronic obstructive airway disease, APACHE II score, the need for hemodynamic support and the number of CXR quadrants involved. Two-hour physiological parameters associated with non-invasive ventilation failure included higher respiratory rate, lower serum pH and the ongoing need of hemodynamic support. CONCLUSION: In conclusion, the use of non-invasive ventilation to support patients presenting to the emergency department with respiratory failure and community acquired pneumonia is common and is associated with a significant failure rate. Hemodynamic support is a strong predictor of failure. The selection of the appropriate patient and monitoring of physiological parameters while on NIV is crucial to ensure successful treatment.

MicroRNA-124 inhibits cell invasion and epithelial-mesenchymal transition by directly repressing Snail2 in gastric cancer.

OBJECTIVE: MicroRNAs (miRNAs) act as critical regulators of genes expression involved in tumor biological processes. The study aimed to investigate the clinical significance and biological role of miR-124 in gastric cancer (GC). PATIENTS AND METHODS: MiR-124 expression was analyzed from 88 GC tissues and adjacent normal tissues by quantitative Real-time PCR (qRT-PCR). Kaplan-Meier curves and log-rank test was used to evaluate the association between miR-124 and the over survival (OS) time of GC patients. MTT assays and transwell invasion assays were performed to assess cell proliferation and invasion. The relationship between miR-124 and Snail2 expression was analyzed by dual luciferase reporter assay. Western blot analyses were performed to detect the relative protein expression. RESULTS: We found that miR-124 expression was significantly reduced in GC tissue samples when compared to the adjacent normal tissues (p<0.05). Lower miR-124 was found to be associated with tumor size (p=0.001), lymphatic metastasis (p=0.008) and TNM stage (p=0.015). Furthermore, patients who have lower miR-124 predicted poor OS time (p<0.05). Function studies suggested that cell proliferation and invasion ability of GC cells were inhibited by up-regulation of miR-124 expression. Moreover, we demonstrated that Snail2 was a direct target of miR-124. Meanwhile, miR-124 inhibited Epithelial-Mesenchymal Transition (EMT) process by repressing the Snail2 expression in GC cells. CONCLUSIONS: MiR-124 acted as a tumor suppressor in GC and may be a useful target for GC treatment.

[Clinical effects assessment of nasal cellulose powder on allergic rhinitis].

Objective:To evaluate the role of nasal cellulose powder locally applied in allergic rhinitis patients.Method:Fifty patients with allergic rhinitis were divided randomly into two groups: the study group and the control group. The study group were treated with nasal cellulose powder while the control group were treated with physiological sea water.Objective and subjective examinations (nasal airway resistance, nasal syndrome score, rhinoconjunctivitis qualityof life questionnaire and olfactory function,nasal mucus cilia clearance ) were performed before and 3 months after treatment.Result:After treatment, partial parameters in nasal syndrome store ( nasal itching, nasal discharge,sneezing and total store) and rhinoconjunctivitis qualityof life questionnaire (sleep, nasal symptom, non-hay-fever symptom, emotional function and total score) in the study group were significantly improved than those in the control group (P< 0.05). However, no significant difference was found in olfactory function, Nasal airway resistance, nasal mucus cilia clearance and the eye symptom in rhinoconjunctivitis qualityof life questionnaire between the two groups after treatment (P> 0.05). No adverse reaction was found in both groups.Conclusion:Nasal cellulose powder can help alleviate clinical symptoms and improve the quality of life in allergic rhinitis patients with no significant side effect.

[Comparison of PedsQL™4.0 and RQLQ scales in the assessment of the quality of life in children with allergic rhinitis].

Objective:To explore the value of PedsQL™4.0 and RQLQ scales in assessment of quality of life(QOL) in children with allergic rhinitis(AR). Method:A prospective trial was conducted to survey the QOL status of 71 AR clinical patients, 68 chronic pharyngitis(CP) clinical patients and 62 healthy individuals by generic questionnaire PedsQL™4.0 and disease specific questionnaire rhinoconjunetivitis quality of life questionnaire(RQLQ) respectively. The correlation between PedsQL™4.0 and RQLQ were analyzed．All the results were analyzed statistically. Result:①By the assessment of PedsQL™4.0 the scores of Social functioning and School functioning domains in AR clinical patients(the same as follow. the scores were 82.8±19.7，64.0±24.6 respectively) were less than those(86.2±18.58, 4.9±18.7) in healthy individuals(P<0.05);while the scores of Physical health and Emotional functioning domains in AR clinical patients(88.3±20.3，75.4±22.4 respectively) were similar with those(89.1±17.7，75.9±22.0) in CP clinical patients(P>0.05)．②By the assessment of RQLQ in AR patients, the nasal symptom and practical problem domains got the highest scores(2.54±1.37,2.70±1.29 respectively).③According to the assessment of the correlation between PedsQL™4.0 and RQLQ, the correlation was weak(r=-0.199--0.468，P<0.05)． Conclusion:Both PedsQL™4.0 and RQLQ were suitable for assessing the health status of AR clinical patients.PedsQL™4.0 and RQLQ each covers different aspects of the QOL of AR clinical patients, and the combination of the two questionnaires could improve the QOL assessment．.

[The clinical study of olfactory dysfunction in IgG4-related disease].

Objective:IgG4-related disease is a newly recognized systemic disease, and its elucidation is progressing. However, little is known about its sinonasal manifestations.The aim of this study was to assess the olfaction of patients with IgG4-related disease.Method:Twenty-two patients with IgG4-related disease underwent the odor stick identification test to measure olfactory function.We analyzed the clinical features, including serum IgG4 levels, involved organs, and sinonasal computed tomography scores to explore the etiology of olfactory dysfunction.Result:Eleven patients with IgG4-related disease were found to have olfactory dysfunction. There were no differences in the clinical features between the olfactory dysfunction group and the normal group.Conclusion:There were no correlation between olfactory function and serum IgG4 level, involved organs or sinonasal computed tomography scores.We found that the prevalence of olfactory dysfunction was high in patients with IgG4-related disease and that it could be reversed.Olfactory dysfunction appears to be a novel important manifestation of IgG4-related disease.

[The application of tragal cartilage-perichondrium in open method tympanoplasty].

Objective:To investigate the efficacy of the application of tragus cartilage-perichondrium in open method tympanoplasty.Method:Thirty patients with middle ear cholesteatoma were treated with open method tympanoplasty and titanium ossicular prosthesis replacement surgery utilized the tragus cartilage-perichondrium, the air-bone gap and the recovery of tympanic membrane were observed before and after operation.Result:Thirty ears achieved primary healing. After a follow-up of 12 months, no prosthesis extrusion and atticus lateral wall collapse were observed. The average air-bone gaps reduced by 13 dB in average.Conclusion:The tragus cartilage-perichondrium is an appropriate material in open method tympanoplasty.

Occupational and environmental risk factors for chronic rhinosinusitis in China: a multicentre cross-sectional study.

BACKGROUND: Chronic rhinosinusitis (CRS) is defined as a condition of inflammation in the paranasal sinus mucosa persisting for more than 12 weeks. We previously reported that the prevalence of CRS was about 8 % in China. Here, we aim to investigate the occupational and environmental risk factors associated with CRS. METHODS: Data were collected from seven Chinese cities: Urumqi, Changchun, Beijing, Wuhan, Chengdu, Huaian and Guangzhou. CRS was diagnosed according to the European Position Paper on Rhinosinusitis and Nasal Polyps (EP(3)OS) document. Participants were asked to complete a standardized questionnaire, which was developed by the Global Allergy and Asthma European Network (GA(2)LEN) project and covered sociodemographic characteristics, CRS-related symptoms and occupational and environmental exposures. We evaluated the association between CRS and various occupational and environmental factors using odds ratios (ORs) and 95 % confidence intervals (95 % CIs). RESULTS: The total study population consisted of 10,633 subjects, 850 (7.99 %) of whom were defined as having CRS according to the EP(3)OS criteria. We found that there were significant associations between occupational and environmental factors and CRS. Specifically, having a clearance-related job, occupational exposure to dust, occupational exposure to poisonous gas, a pet at home or carpet at home or at the workplace were risk factors for CRS. Additionally, the method used to keep warm in winter, the duration of time spent using air conditioning in summer and the frequency of exposure to mouldy or damp environments were significantly different in subjects with and without CRS. CONCLUSIONS: Our data showed that some occupational and environmental exposures are strongly associated with CRS, which aids in understanding the epidemiology of CRS.

Karyotype analysis and ribosomal gene localization of spotted knifejaw Oplegnathus punctatus.

The spotted knifejaw, Oplegnathus punctatus, is an important aquaculture fish species in China. To better understand the chromosomal microstructure and the karyotypic origin of this species, cytogenetic analysis was performed using Giemsa staining to identify metaphase chromosomes, C-banding to detect C-positive heterochromatin, silver staining to identify the nucleolus organizer regions (Ag-NORs), and fluorescence in situ hybridization (FISH) for physical mapping of the major (18S rDNA) and minor (5S rDNA) ribosomal genes. The species showed a karyotype of 2n = 48 for females, composed of 2 submetacentric and 46 telocentric chromosomes, with a fundamental number (FN) = 50, while the karyotype of males was 2n = 47, composed of 1 exclusive large metacentric, 2 submetacentric, and 44 telocentric chromosomes, with FN = 50. These karyotype results suggest that O. punctatus might have an X1X1X2X2/X1X2Y multiple sex chromosome system. C-positive heterochromatin was distributed in the centromeres of all chromosomal pairs and in the terminal portions of some chromosomes. A single pair of Ag-positive NORs was found to be localized at the terminal regions of the short arms of the subtelocentric chromosome pair, which was supported by FISH of 18S rDNA. After FISH, 5S rDNA were located on the interstitial regions of the smallest telocentric chromosome pair. This study was the first to identify the karyotype of this species and will facilitate further research on karyotype evolution in the order Perciformes.

[Tryptase and ECP are related to olfactory dysfunction in allergic rhinitis].

Objective:Olfactory dysfunction is one of the common symptoms in patients with allergic rhinitis(AR),but the underlying mechanisms are not yet known.The purpose of this study was to explore the underlying mechanisms which tryptase and eosinophilic cationic protein(ECP) lead to olfactory dysfunction in patients with AR.Method:We have compared the results between tryptase,ECP,nasal airway resistance and olfactory function of the patients with AR and analyzed the correlations between them.Result:Patients with AR showed impaired olfactory functions compaired to the control group,but there was no differences in the nasal airway resistance between the two groups.Nasal secretion analysis in the patients with AR showed that the level of tryptase and ECP was increased in comparison with the controls.Conclusion:The increase of tryptase and ECP in the olfactory cleft can lead to olfactory dysfunction in patients with AR.

Identification of transgenic cloned dairy goats harboring human lactoferrin and methylation status of the imprinted gene IGF2R in their lungs.

Dairy goat is a good model for production of transgenic proteins in milk using somatic cell nuclear transfer (SCNT). However, animals produced from SCNT are often associated with lung deficiencies. We recently produced six transgenic cloned dairy goats harboring the human lactoferrin gene, including three live transgenic clones and three deceased transgenic clones that died from respiratory failure during the perinatal period. Imprinted genes are important regulators of lung growth, and may be subjected to faulty reprogramming. In the present study, first, microsatellite analysis, PCR, and DNA sequence identification were conducted to confirm that these three dead kids were genetically identical to the transgenic donor cells. Second, the CpG island methylation profile of the imprinted insulin-like growth factor receptor (IGF2R) gene was assessed in the lungs of the three dead transgenic kids and the normally produced kids using bisulfite sequencing PCR. In addition, the relative mRNA level of IGF2R was also determined by real-time PCR. Results showed that the IGF2R gene in the lungs of the dead cloned kids showed abnormal hypermethylation and higher mRNA expression levels than the control, indicating that aberrant DNA methylation reprogramming is one of the important factors in the death of transgenic cloned animals.

Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities.

BACKGROUND: Chronic sinusitis (CRS) is a common otorhinolaryngologic disease that is frequently encountered in everyday practice, but there is a lack of precise data regarding the prevalence of CRS in developing countries. We performed a national investigation in China to determine the prevalence and associated factors of CRS. METHODS: We conducted a cross-sectional investigation in 2012. A stratified four-stage sampling method was used to select participants randomly from seven cities in mainland China. All participants were interviewed face-to-face via a standardized questionnaire. Unconditional logistic regression analyses were conducted to examine the association between smoking and sinusitis after adjusting for socio-demographic factors. RESULTS: This study included a total of 10 636 respondents from seven cities. The overall prevalence of CRS was 8.0% and ranged from 4.8% to 9.7% in seven centres. Chronic sinusitis affected approximately 107 million people in mainland China. Chronic sinusitis was particularly prevalent among people with specific medical conditions, including allergic rhinitis, asthma, chronic obstructive pulmonary disease and gout. The prevalence was slightly higher among males (8.79%) than females (7.28%) (P = 0.004), and the prevalence varied by age group, ethnicity and marital status and education (P < 0.05), but not by household per capita income or living space (P > 0.05). Both second-hand tobacco smoke and active smoking were independent risk factors for CRS (P = 0.001). CONCLUSIONS: Chronic sinusitis is an important public health problem in China. Our study provides important information for the assessment of the economic burden of CRS and the development and promotion of public health policies associated with CRS particularly in developing countries.

The role of noninvasive positive pressure ventilation in community-acquired pneumonia.

BACKGROUND: Despite the increasing use of noninvasive positive pressure ventilation (NIV) in the treatment of critically ill patients with respiratory failure, its role in the treatment of severe community-acquired pneumonia (CAP) is controversial. The aim of this study was to assess the use of NIV in patients with CAP requiring ventilation who are admitted an intensive care unit. METHODS: A retrospective cohort study of all consecutive patients admitted to 3 tertiary care, university-affiliated, intensive care units from January 2007 to January 2012 with the principal diagnosis of CAP and requiring positive pressure ventilation was carried out. The primary outcome was acute hospital mortality. Univariable and multivariable analysis were performed to assess the association between mode of ventilation and death as well as factors associated with failure of NIV. RESULTS: A total of 229 patients were admitted, with 20 patients excluded from the analysis because of do-not-resuscitate orders. Fifty-six percent of patients were initially treated with NIV. Of those, 76% failed NIV and required intubation and invasive ventilation. After adjusting for confounders, no difference in mortality was seen between patients who received NIV as first-line therapy in comparison with patients who received invasive ventilation (odds ratio [OR], 1.63; 95% confidence interval [CI], 0.81-3.28; P = .17). Multivariable analysis demonstrated a trend toward increased NIV failure for the patients who had higher Acute Physiology and Chronic Health Evaluation II scores (P = .07) and vasopressor use at 2 hours after initiation of positive pressure ventilation (OR, 7.5; 95% CI, 1.8-31.3, P = .006). In an adjusted analysis, patients who failed NIV had an increased odds of death when compared with patients who were treated with invasive ventilation (OR, 2.2; 95% CI, 1.0-4.8; P = .03). CONCLUSION: Noninvasive pressure ventilation is frequently used in CAP but is associated with high failure rates. Mortality was not improved in the group of patients who received NIV as first-line therapy despite clinical characteristics that might have suggested a more favorable prognosis. Given the high rates of NIV use, high failure rates, and the hypothesis generating nature of the data in this study, further randomized studies are needed to better delineate the role of NIV in CAP.