[Epidemiology of chronic cough in China: current status and future perspective].

Chronic cough is one of the most common major complaints in medical outpatient. Chronic cough not only seriously affects quality of personal life, but also burdens public health. Large-scale and high-quality epidemiological study on chronic cough has not been carried out in China, and relevant reviews are also lacking. Therefore, based on the studies concerning epidemiology of chronic cough in China, we reviewed the prevalence, risk factors, etiology, quality of life and economic burden. In addition, future perspectives and reasonable suggestions for the development of epidemiology of chronic cough were also proposed.

The identification of up-regulated ebv-miR-BHRF1-2-5p targeting MALT1 and ebv-miR-BHRF1-3 in the circulation of patients with multiple sclerosis.

Epstein-Barr virus (EBV) is a well-documented aetiological factor for multiple sclerosis (MS). EBV encodes at least 44 microRNAs (miRNAs) that are readily detectable in the circulation of human. Previous studies have demonstrated that EBV-encoded miRNAs regulate host immune response and may serve as biomarkers for EBV-associated diseases. However, the roles of EBV miRNAs in MS are still unknown. To fill the gap, we conducted a comprehensive profiling of 44 mature EBV miRNAs in 30 relapsing-remitting MS (RRMS) patients at relapse and 30 matched healthy controls. Expression levels of ebv-miR-BHRF1-2-5p and ebv-miR-BHRF1-3 were elevated significantly in the circulation and correlated positively with the expanded disability status scale (EDSS) scores of MS patients. Receiver operating characteristic (ROC) analyses confirmed that the expression of these two miRNAs distinguished MS patients clearly from healthy controls. Luciferase assays revealed that ebv-miR-BHRF1-2-5p may directly target MALT1 (mucosa-associated lymphoid tissue lymphoma transport protein 1), a key regulator of immune homeostasis. In conclusion, we described the expression of EBV miRNAs in MS and preliminarily validated the potential target genes of significantly altered EBV miRNAs. The findings may pave the way for prospective study about the pathogenesis of MS.

Transfer and expression of the rabbit defensin NP-1 gene in lettuce (Lactuca sativa).

Lettuce (Lactuca sativa L.) is an annual plant of the daisy family, Asteraceae, with high food and medicinal value. However, the crop is susceptible to several viruses that are transmitted by aphids and is highly vulnerable to post-harvest diseases, as well as insect and mammal pests and fungal and bacterial diseases. Here, the rabbit defensin gene NP-1 was transferred into lettuce by Agrobacterium-mediated transformation to obtain a broad-spectrum disease-resistant lettuce. Transgenic lettuce plants were selected and regenerated on selective media. The presence of the NP-1 gene in these plants was confirmed by western blot analyses. Resistance tests revealed native defensin NP-1 expression conferred partial resistance to Bacillus subtilis and Pseudomonas aeruginosa, which suggests new possibilities for lettuce disease resistance.

Large-scale tissue-specific and temporal gene expression profiles in Pengze crucian carp.

In the present study, the tissue-specific and temporal gene expression profiles of four catalogues of gonadal development-related genes (sex differentiation-related, steroid receptor, steroidogenic, and structural genes) were detected in nine tissues and during 11 successive developmental stages in the Pengze crucian carp (Pcc) (a triploid mono-female gynogenic fish). The results showed that these target genes exhibited overlapping distributions in various tissues, with the exception of Pcc-vasa and Pcc-cyp17a1. Gene expression profiling of the developmental stages showed that all of the target genes simultaneously reached peak expression levels at 40 and 48 days post hatching (dph). Both 40 and 48 dph appeared to be two key time points associated with the process of Pcc gonadal development. These data will provide a clear understanding of gene expression patterns associated with the gonadal development-related genes of this gynogenic teleost.

Delayed diagnosis of vertebral osteomyelitis in a paraplegic patient.

STUDY DESIGN: Case report. OBJECTIVE: Vertebral osteomyelitis, usually presented with back pain and local tenderness, can pose a great challenge of early diagnosis among spinal cord injury (SCI) patients who lost sensation below the injured level. We reported a paraplegic patient who had recurrent febrile episodes after being treated as urinary tract infection initially and was discovered later to have vertebral osteomyelitis. CASE REPORT: A 41-year-old man, completely paralyzed at the T11 level and with Foley catheterization for 9 years, was re-admitted within 2 weeks for recurrent fever, turbid urine, bacteriuria and bacteremia with Escherichia coli. Spine X-ray and renal, cardiac and abdominal ultrasonography showed no definite lesions related to infection in a previous admission. Intermittently febrile episodes continued despite treatment with antibiotics for 1 week. He had no pressure sores or other wounds. Computerized tomography and magnetic resonance imaging showed lumbosacral osteomyelitis and bilateral paravertebral abscess. The patient underwent debridement of paravertebral tissue. Fever subsided soon after surgery and the patient continued antibiotics and remained free of fever at a 1-year follow-up. CONCLUSION: It can be challenging to diagnose vertebral osteomyelitis below injury levels in SCI patients. Vertebral osteomyelitis should be considered in febrile SCI patients even with known infectious foci, as classic symptoms of osteomyelitis are lacking in this population.

[Indication of radical surgery (R2, R3) based upon the pattern of lymph node metastasis from gastric cancer].

From Jan. 1980 to June. 1984, radical operation was performed in 156 patients with gastric cancer according to the "protocol" introduced by the Gastric Cancer Research Society of Japan. There were 24 early and 132 advanced gastric cancers. Seventy patients were treated by type R2, 86 by R+2 and R3. Radical distal subtotal gastrectomy was done in 116, proximal subtotal gastrectomy in 7, simple total gastrectomy in 13 and subtotal or total gastrectomy combined with neighbouring organ resection in 20. According to TNM staging, 24 (15.4%) lesions were stage I, 9 (5.8%) stage II, 100 (64.1%) stage III and 23 (14.7%) stage IV. Twenty four lesions were within the mucosa or submucosal layer, 11 in proprius muscle layer, 18 to subserosa, 15 to serosa, 46 beyond serosa, 42 involving the surrounding organs. Lymph node metastatic rate was 66% (103 cases), metastatic degree was 21.5% (558/2593). The metastatic degree of lymph node line I, II and III was 24.7%, 20% and 8.3%, respectively. Basing on lymph node metastatic rate and degree as well as the line degree, it is proposed that, in the early stage of gastric cancer, type R1 be performed for cancer limited to the mucosa, especially the minute type, R2 for cancer invading the submucosa, in which, R+2 be indicated for some isolated patients. In the advanced gastric cancer, type R+2 be performed in the majority of patients and R3 in a few. R3 or total gastrectomy combined with neighbouring organ resection be carried out only in a part of cases with the limited type infiltrating beyond the serosa or invading the neighbouring organs.

Impact of age on the injury pattern and survival of people with cervical cord injuries.

STUDY DESIGN: A retrospective, follow-up study. OBJECTIVES: To differentiate the injury pattern and survival of people with cervical cord injuries with onset at different ages. SETTING: Rehabilitation wards of a university hospital that is a tertiary referral center in Taipei, Taiwan. METHODS: The records of acute and traumatic cervical cord injury patients hospitalized from 1989 to 1997 were reviewed. All subjects received comprehensive rehabilitation programs during hospitalization. Their survival status at the end of follow-up was studied. RESULTS: Forty-seven of 109 (43.1%) people with cervical cord injuries were 50 years or older at onset. Older patients were more frequently injured by minor falls, resulting in more incomplete quadriplegia. They also showed fewer spinal fractures, and more demonstrated associated spondylosis and ossification of the posterior longitudinal ligament. Eleven (10.2%) subjects were deceased, found by a linkage to a death registration database at the end of follow-up. The significant predictor of survival status at follow-up was older age at injury using Cox proportional hazards model. CONCLUSION: Spinal cord injured patients had different injury patterns, demanding different preventative strategies. Those injured at older ages were at higher risk of mortality according to our study. SPONSORSHIP: This study was supported in part by grants from the National Taiwan University Hospital (89S2005), Taipei, Taiwan.

Clinical experience in rehabilitation of spinal cord injury associated with schizophrenia.

OBJECTIVE: To identify the clinical features and rehabilitation outcomes in spinal cord injury (SCI) patients with preexisting schizophrenia. DESIGN: A retrospective study conducted by reviewing the charts of all patients diagnosed with both SCI and schizophrenia hospitalized from 1987 throughout 1994 in 2 rehabilitation units. SETTING: Rehabilitation wards of two hospitals in Taiwan. PATIENTS: Seventeen traumatic SCI patients with schizophrenia, including 7 men and 10 women. Patients without neurological deficits were excluded. INTERVENTION: All subjects received psychiatric intervention and intensive rehabilitation programs during hospitalization. MAIN OUTCOME MEASURES: The injury pattern and psychiatric condition were described. Abilities of locomotion, management of activities of daily living, and bladder control were measured. RESULTS: Fifteen injuries caused by a voluntary fall subsequently resulted in thoracolumbar insult. Ten incomplete paraplegics were able to ambulate with or without a device on discharge. Four subjects had poor bladder control. The outcome of self-care skills was worse in those with high level injury. Psychiatric symptoms were one of the main obstacles during rehabilitation. CONCLUSION: Voluntary fall that caused thoracolumbar injuries was the main cause of injuries in these patients. Psychiatric symptoms were present in the majority and might hinder the prognosis of treatment. Nevertheless rehabilitation programs were found to benefit subjects after their psychiatric problems were under control.