[Analysis of the clinical characteristics and misdiagnosis of area postrema syndrome manifesting as intractable nausea, vomiting, and hiccups in neuromyelitis optica spectrum disorders].

Objective: To investigate the misdiagnosis of area postrema syndrome (APS) manifesting as intractable nausea, vomiting and hiccups in neuromyelitis optic spectrum disease (NMOSD) and reduce the risk of misdiagnosis. Methods: We retrospectively analyzed data from NMOSD patients attending the Department of Neurology at the First Medical Center of PLA General Hospital between January 2019 and July 2021. SPSS25.0 was then used to analyze the manifestations, misdiagnosis, and mistreatment of APS. Results: A total of 207 patients with NMOSD were included, including 21 males and 186 females. The mean age of onset was 39±15 years (range: 5-72 years). The proportion of patients who were positive for serum aquaporin 4 antibody was 82.6% (171/207). In total, 35.7% (74/207) of the NMOSD patients experienced APS during the disease course; of these patients, 70.3% (52/74) had APS as the first symptom and 29.7% (22/74) had APS as a secondary symptom. The misdiagnosis rates for these conditions were 90.4% (47/52) and 50.0% (11/22), respectively. As the first symptom, 19.2% (10/52) of patients during APS presented only with intractable nausea, vomiting and hiccups; 80.8% (42/52) of patients experienced other neurological symptoms. The Departments of Gastroenterology and General Medicine were the departments that most frequently made the first diagnosis of APS, accounting for 54.1% and 17.6% of patients, respectively. The most common misdiagnoses related to diseases of the digestive system and the median duration of misdiagnosis was 37 days. Conclusions: APS is a common symptom of NMOSD and is associated with a high rate of misdiagnosis. Other concomitant symptoms often occur with APS. Gaining an increased awareness of this disease/syndrome, obtaining a detailed patient history, and performing physical examinations are essential if we are to reduce and avoid misdiagnosis.

[Research progress of airway microbiome and airway immune response in asthma].

Bronchial asthma (asthma) is one of the most common chronic airway diseases, with more than 300 million people worldwide suffering from this disease. In recent years, studies have shown that compared with healthy people, the airway microecological structure and relative abundance of various flora of asthmatic patients have changed, and are related to the airway inflammatory phenotype of asthma. Airway microecology can affect the occurrence and development of asthma through immune response. The mechanism of interaction between airway microecology and asthma can provide new ideas for the accurate treatment of asthma. This article mainly reviewed the current research on airway microecology in asthma, and puts forward prospects for the accurate treatment of asthma in the future.

[Clinicopathological significance of Golgi phosphoprotein 3 expression in papillary thyroid carcinoma].

Objective: To investigate the expression of Golgi phosphoprotein 3 (GOLPH3) in papillary thyroid carcinoma (PTC) and its relationship with clinicopathological characteristics of PTC and American Thyroid Association (ATA) risk of recurrence stratification. Methods: The mRNA expression level of GOLPH3 in PTC tissues and the matched adjacent noncancerous tissues from 30 cases of PTC undergoing surgical operation in Fujian Provincial Hospital between March 2017 and April 2018 was detected by reverse transcription-quantitative PCR (RT-qPCR). The protein expression of GOLPH3 in PTC tissues and the matched adjacent noncancerous tissues of 135 cases of PTC between January 2013 and April 2018 was measured by immunohistochemistry. The correlation between the expression of GOLPH3 in PTC and clinicopathologic characteristics and ATA risk of recurrence stratification was analyzed. Results: The mRNA level of GOLPH3 in PTC tissues was significantly higher than that in adjacent noncancerous tissues (7.53±1.32 vs 3.64±1.44, P<0.001). The protein expression level of GOLPH3 in PTC tissues was significantly higher than that in adjacent noncancerous tissues [66(30, 95) vs 34(20, 72), P<0.001]. The expression of GOLPH3 was significantly correlated to the tumor size (P=0.026), extrathyroid invasion (P=0.016), lymph node metastasis (P=0.001) and TNM stage (P=0.027) in PTC. Multivariate logistic regression analysis showed that GOLPH3 expression was independently correlated to tumor size (OR=3.58, 95%CI: 1.19-15.46, P=0.017) and lymph node metastasis (OR=7.28, 95%CI: 2.43-10.08, P=0.002). The expression of GOLPH3 was positively correlated to ATA risk of recurrence stratification (P=0.041). Conclusions: Overexpression of GOLPH3 is associated with the development of PTC and poor prognosis in patients with PTC. Detection of GOLPH3 expression can help evaluate proliferative and metastatic potential of PTC, as well as the risk of postoperative recurrence in patients with PTC.

Treatment gaps of epilepsy and retention rates of sodium valproate in rural Guangxi, China.

This study aimed to investigate the prevalence and treatment gaps of epilepsy, as well as the clinical effects, drug safety, and retention rates of sodium valproate (VPA) for treating epilepsy. Physicians received supervised training to use the survey form recommended by the Chinese Association Against Epilepsy while screening for suspected or confirmed epilepsy cases. These cases were ultimately enrolled in the study by neurologists. Enrolled patients were given a year of free VPA treatment so that its efficacy and adverse effects during the follow-up period could be evaluated. In total, 302 patients were enrolled in this study, which included 189 males and 113 females. Among these cases, 179 (59.27%) were confirmed to have generalized seizures, 162 (53.6%) had tonic-clonic seizures, 10 (3.3%) had absence seizures, and 123 (40.72%) had partial seizures. Only 63 patients had received regular treatments 1 week before enrollment, with a treatment gap of 79.1%. The retention rates during the 6th, 12th, 18th, and 24th months were 100, 93.56, 89.05, and 77.06%, respectively. During the 1-year follow-up period, 30 cases encountered mild adverse effects, but no severe adverse reactions were reported. A large treatment gap for epilepsy still existed in the rural areas of southern China, with few adverse effects and high retention rates. VPA showed satisfactory effects in the treatment of epileptic patients.

Enhanced metabolic function of human hepatocytes cryopreserved with low concentration me2so and polyol additives at -80C.

The metabolic function of cryopreserved cells, in addition to cell viability after thawing, is an important parameter in any successful cryopreservation protocol. Dimethyl sulfoxide (Me2SO) is known to affect the differentiation of recovered cells. In this study, we report that sugars and sugar alcohols increases cell recovery, and also improves the metabolic function of human hepatocytes that are cryopreserved using low concentration Me2SO (5%). Three sugars (glucose, sucrose, and trehalose) and three sugar alcohols (xylitol, maltol, and sorbitol) have been tested. Cell viability after thaw and 24-h post-thaw attachment rate of cryopreserved human hepatocytes were assessed. Post-thaw metabolic activities (albumin, glucose, urea content) were measured, and cell proliferation was observed with inverted microscope. Cell viability, post-thaw attachment rate and metabolic activity of cryopreserved hepatocytes are enhanced by the addition of 0.4M sorbitol into 5% Me2SO solution. The study concludes that 5% Me2SO + 0.4M sorbitol can replace the 10% Me2SO method for cryopreservation of human hepatocytes at -80C freezer. The new solution may reduce the side effects on the patients and improve the safety of using cryopreserved hepatocytes.

[Two cases report of laryngeal malignant melanoma and a review of literatures].

Summary Two patients both complained of one year history of hoarseness and the clinical manifestations and imageology among 2 patients were lack of specificity. The pathological tissue was successfully eradicated by surgical removal. Histopathology established laryngeal malignant melanoma as the diagnosis. The clinical manifestations and imageology were lack specificity between laryngeal malignant melanoma, laryngeal cancer and other malignant tumor, the diagnosis is difficult, often confirmed by postoperative pathology, the treatment is often by surgery and have a poor prognosis.

Delineation of DNA sequences that are important for in vitro transcription from the adenovirus EIIa late promoter.

Late in infection, transcription of the EIIa gene is initiated primarily at map unit 72 of the adenovirus genome. A cell-free nuclear extract system was used to determine sequence elements important for the function of this late promoter. In such a system, the transcriptional activity of a circular template was found to be much higher (5- to 10-fold) than that of a linear template. The effect of template topology appeared to be dependent on two distal upstream elements with 5' boundaries located near -265 to -223 and -147 to -133 (in relation to the initiation site), since deletions of these regions reduced transcription of the circular template, in a stepwise fashion, to a level similar to that observed with the linear template. Further deletions revealed an element in the -116 region that appeared to be more important for transcription of the circular template (10-fold reduction) than for transcription of the linear template (3-fold reduction). Lastly, deletion of the TACAAA sequence in the -29 region resulted in further reduction in transcription, indicating that this element functions as a promoter in vitro.

Functional reconstruction of trans regulation of the Ultrabithorax promoter by the products of two antagonistic genes, trithorax and Polycomb.

Maintenance of the "on-off" state of Drosophila homeotic genes in Antennapedia and bithorax complexes requires activities of the trithorax and Polycomb groups of genes. To identify cis-acting sequences for functional reconstruction of regulation by both trithorax and Polycomb, we examined the expression patterns of several Ubx-lacZ transgenes that carry upstream fragments corresponding to a region of approximately 50 kb. A 14.5-kb fragment from the postbithorax/bithoraxoid region of Ultrabithorax exhibited proper regulation by both trithorax and Polycomb in the embryonic central nervous system. Using a Drosophila haploid cell line for transient expression, we found that trithorax or Polycomb can function independently through this upstream fragment to activate or repress the Ultrabithorax promoter, respectively. Studies of deletion mutants of trithorax and Polycomb demonstrated that trithorax-dependent activation requires the central zinc-binding domain, while Polycomb-dependent repression requires the intact chromodomain. In addition, trithorax-dependent activity can be abrogated by increasing the amount of Polycomb, suggesting a competitive interaction between the products of trithorax and Polycomb. Deletion analysis of this fragment demonstrated that a 440-bp fragment contains response elements for both trithorax and Polycomb. Furthermore, we showed that the integrity of the proximal promoter region is essential for trithorax-dependent activation, implicating a long-range interaction for promoter activation.

A cyclophosphamide/DNA phosphoester adduct formed in vitro and in vivo.

The antitumor activity of cyclophosphamide is thought to be due to the alkylating activity of phosphoramide mustard, a metabolite of cyclophosphamide. Reaction of 2'-deoxyguanosine 3'-monophosphate and phosphoramide mustard resulted in the formation of several adducts that could be detected by high performance liquid chromatography (HPLC). One of these adducts, isolated and purified by HPLC, could be detected by 32P postlabeling. This product was identified by UV, nuclear magnetic resonance, and mass spectrometry and by acid, base, and enzymatic hydrolysis to be 2'-deoxyguanosine 3'-monophosphate 2-(2-hydroxyethyl)aminoethyl ester. A combination of HPLC fractionation of digested DNA and 32P postlabeling was used to detect this adduct in calf thymus DNA incubated in vitro with metabolically activated cyclophosphamide and in DNA from the liver of mice treated with cyclophosphamide. In these DNA samples the adduct occurred at a level of 1/10(5) and 1/3 x 10(7) nucleotides, respectively.

Breaking the low barrier hydrogen bond in a serine protease.

The serine protease subtilisin BPN' is a useful catalyst for peptide synthesis when dissolved in high concentrations of a water-miscible organic co-solvent such as N,N-dimethylformamide (DMF). However, in 50% DMF, the k(cat) for amide hydrolysis is two orders of magnitude lower than in aqueous solution. Surprisingly, the k(cat) for ester hydrolysis is unchanged in 50% DMF. To explain this alteration in activity, the structure of subtilisin 8397+1 was determined in 20, 35, and 50% (v/v) DMF to 1.8 A resolution. In 50% DMF, the imidazole ring of His64, the central residue of the catalytic triad, has rotated approximately 180 degrees around the Cbeta-Cgamma bond. Two new water molecules in the active site stabilize the rotated conformation. This rotation places His64 in an unfavorable geometry to interact with the other members of the catalytic triad, Ser221 and Asp32. NMR experiments confirm that the characteristic resonance due to the low barrier hydrogen bond between the His64 and Asp32 is absent in 50% DMF. These experiments provide a clear structural basis for the change in activity of serine proteases in organic co-solvents.

Proton NMR and optical spectroscopic studies on the DNA triplex formed by d-A-(G-A)7-G and d-C-(T-C)7-T.

Triplex and duplex formation of two deoxyribohexadecamers d-A-(G-A)-G (a) and d-C-(T-C)-T (b) have been studied by UV, CD, fluorescence, and proton NMR spectroscopy. Optical studies of a and b at dilute concentrations (microM range) yielded results similar to those seen for polymers of the same sequence, indicating that these hexadecamers have properties similar to the polymers in regard to triplex formation. The CD spectra of concentrated NMR samples (mM range) are similar to those observed at optical concentrations at both low and high pH, making possible a correlation between CD and NMR studies. In NMR spectra, two imido NH-N hydrogen bonded resonance envelopes at 12.6 and 13.7 ppm indicate that only the duplex conformation is present at pH greater than 7.7. Four new NH-N hydrogen-bonded resonance envelopes at 12.7, 13.5, 14.2, and 14.9 ppm are observed under acidic conditions (pH 5.6) and the two original NH-N resonances gradually disappear as the pH is lowered. Assignment of these four peaks to Watson-Crick G.C. Hoogsteen T.A Watson-Crick A.T, and Hoogsteen C+.G hydrogen-bonded imidos, respectively, confirm the formation of triple-stranded DNA NMR results also show that triplex is more stable than duplex at the same salt condition and that triplex melts to single strands directly without going through a duplex intermediate. However, in the melting studies, a structural change within the triple-stranded complex is evident at temperatures significantly below the major helix-to-coil transition. These studies demonstrate the feasibility of using NMR spectroscopy and oligonucleotide model compounds a and b for the study of DNA triplex formation.

13C-N.M.R. study of the conformation of helical complexes of amylodextrin and of amylose in solution.

Amylose (average d.p. 1000) and amylodextrin (average d.p. 25) have identical 13C-n.m.r. spectra, except for some minor signals from the small amount of alpha-1----6 branch linkages present in amylodextrin. Amylodextrin can be obtained as stable solutions in much higher concentrations than amylose and so requires only 1/100th as many scans to obtain a spectrum comparable to that of amylose. 13C-N.m.r. spectroscopy has been used to study the formation of amylodextrin complexes with organic complexing agents in aqueous solution. A control study using dextran, which does not form helical complexes, showed that, when complexing agents are added, the signals from all of the carbons show a slight downfield shift due to a general solvent effect. In the case of amylodextrin, the addition of increasing concentrations of complexing agent also produced a downfield shift of the signals of all the carbons, but there was a greater shift of the signals for carbons 1 and 4 than for carbons 2, 3, and 6, indicating that something more than a solvent effect was occurring. The cycloamyloses (cyclic alpha-1----4 linked D-glucose oligosaccharides which may be considered as model for an amylose helix) in water have chemical shifts for carbons 1 and 4 that are comparable to those shown by the amylodextrin complexes. It is thus proposed that the formation of a helical complex with amylodextrin results in a change in the conformation of the glycosidic linkage, which is reflected by greater downfield shifts of the signals for carbons 1 and 4, relative to those for carbons 2, 3, and 6. It was observed that differences in the ratio of the downfield shifts of C-1 and C-4 of the different amylodextrin complexes indicate differences in the degree of compactness of the helical structures. A comparison of the 13C chemical shifts of methyl alpha-D-glucoside and methyl alpha-maltoside showed that, for a molecule as small as a disaccharide, there is a conformational change about the glycosidic linkage when complexing agents are added.

Structure of the group G streptococcal polysaccharide.

The structure of the group-specific polysaccharide of group G Streptococcus was determined by means of methylation analysis and selective chemical degradations. The anomeric configurations and conformations of the sugar residues were studied by 1H- and 13C-n.m.r. spectroscopy. The tetrasaccharide repeating unit, ----3)-alpha-D-Galp-(1----2)-[alpha-L-Rhap-(1----3)-beta-D-GalpNAc - (1----4)]-alpha-L-Rhap-(1----, was determined.

Structure of the type-specific polysaccharide antigen of Streptococcus rattus.

The structure of the type-specific polysaccharide antigen of Streptococcus rattus was determined by methylation analysis, periodate oxidation, and by 2D-1H- and 13C-n.m.r.-spectroscopy. The polysaccharide was found to possess the trisaccharide repeating unit----3)-alpha-L-Rhap-(1----2)-[alpha-D-Galp-(1----3)]-alpha-L-+ ++Rhap- (1----.

The crystal and molecular structure of trichosanthin at 2.6 A resolution.

The crystallographic refinement of trichosanthin has been performed at 2.6 A resolution. The crystal and molecular structure of trichosanthin is described in detail in this paper. On summarizing the regularity of the amino acid sequences of eight kinds of ribosome inactivating proteins and combining with the crystal and molecular structure of trichosanthin, fifteen most conservative amino acid residues are analyzed. It is found that four most conservative polar amino acid residues Gln156, Glu160, Arg163 and Glu189 gather on the molecular surface on the boundary of the large and small domains, thus forming the active center of the protein molecule.