[Effect of donor and recipient HLA mismatched locus on the prognosis of childhood with leukemia after umbilical cord blood transplantation].

Objective: The aim of the study was to investigate the impact of the sites of high-resolution human leukocyte antigen (HLA) mismatch on the prognosis of children with leukemia undergoing umbilical cord blood transplantation (UCBT). Methods: Clinical data and high-resolution HLA-A, HLA-B, HLA-C, HLA-DRB1 and HLA-DQB1 locus gene information were collected in the children who underwent the UCBT for the first time at Children's Hospital of Soochow University between January 2016 and June 2023. In each locus, according to whether the two genes were compatible, they were divided into a compatible group (two genes were perfectly matched) and a non-compatible group (one gene was not matched). In different loci, the differences in occurrence, recurrence, non-recurrence death and survival of acute graft versus host disease (aGVHD) were compared between the two groups. Multivariate Cox regression was employed to analyzed the influencing factors for overall survival rate, and Fine-Gray proportional hazards model was employed to analyze the influencing factors of other outcome events. Results: A total of 100 patients were enrolled (55 males and 45 females), whose age [M (Q1, Q3)] at the time of transplantation was 3.9 (2.0, 6.5) years. There were 55 cases in the HLA-A matched group and 45 cases in the mismatched group. The 5-year non-recurrence mortality (NRM) in the HLA-A matched group was lower than that in the mismatched group (P=0.024). The cumulative incidence of aGVHD within 100 days after transplantation in the HLA-A matched group was lower than that in the mismatched group (P=0.017), and there were no statistically significant differences in other outcome events between the groups (all P>0.05). There were 70 cases in the HLA-B matched group and 30 cases in the mismatched group. The 5-year cumulative recurrence rate in the HLA-B matched group was higher than that in the mismatched group (P=0.027). There were 79 cases in the HLA-C matched group and 21 cases in the mismatched group, and there were no statistically difference in the outcome events between the groups (P>0.05). There were 73 cases in HLA-DRB1 matched group and 27 cases in mismatched group. The 5-year overall survival rate in HLA-DRB1 matched group was higher than that in mismatched group (P=0.036), the 5-year cumulative recurrence rate in HLA-DRB1 matched group was higher than that in mismatched group (P=0.028), and the 5-year NRM in HLA-DRB1 matched group was lower than that in mismatched group (P=0.008). The cumulative incidence of aGVHD within 100 days after transplantation in the matched group was lower than that in the mismatched group (P=0.010), and and there were no statistically significant difference in other outcome events between the groups (P>0.05). There were 68 cases in HLA-DQB1 matched group and 32 cases in mismatched group. There was no statistical difference in outcome events between the two groups (all P>0.05). The risk of aGVHD in HLA-A mismatched group was higher than that in HLA-A matched group (HR=1.25, 95%CI: 1.12-1.38). The risk of recurrence in HLA-B mismatched group was lower than that in HLA-B matched group (HR=0.77, 95%CI: 0.63-0.91). Mismatched group at HLA-DRB1 compared with matched group at HLA-DRB1, had a higher risk of aGVHD (HR=1.37, 95%CI: 1.26-1.48), a higher risk of non-recurrence death (HR=1.39, 95%CI: 1.28-1.50), and a higher risk of death (HR=1.27, 95%CI: 1.18-1.36). No association was found between HLA-C and HLA-DQB1 locus with the risk of aGVHD, recurrence, non-recurrence death, and survival (all P>0.05). Conclusions: In UCBT, the risk of aGVHD in children with matching HLA-A sites of donor and recipient is lower than that in children with incompatible HLA-A sites. Compared with children with incompatible HLA-DRB1 sites, children with HLA-DRB1 matched sites has a lower risk of acute GVHD, a lower 5-year NRM, and a higher risk of death. The recurrence rate of children with matching HLA-B loci is higher than that of children without matching HLA-B loci.

[Predictive value of plasma exosomal miR-124-3p for the risk of chronic cerebral hypoperfusion].

Objective: To investigate the predictive value of plasma exosomal microRNA (miR)-124-3p in the risk of chronic cerebral hypoperfusion (CCH). Methods: A case-control study. Thirty patients who were diagnosed with CCH (CCH group) based on cranial artery spin labeling (ASL) in the neurology outpatient clinic of Sichuan Provincial People's Hospital from March 2022 to June 2022 and 30 healthy volunteers (control group) were included. Age, gender, smoking history, alcohol consumption history, diabetes history, hypertension, hyperlipidemia history, uric acid, fasting blood glucose, homocysteine and plasma exosomal miR-124-3p expression level were compared between the two groups. Comparisons of categorical variables were analyzed by either χ2 test or Fisher's exact test. If the data of continuous variables followed a normal distribution, they were expressed as mean±standard deviation (SD) and compared by t-test for two independent samples; otherwise, the data were expressed as M(Q1, Q3), and analyzed by Mann-Whitney U test for comparison between two groups. The correlation between cerebral blood flow and exosomal miR-124-3p levels was analyzed by Pearson's correlation. Binary multifactorial logistic regression analysis was used to determine the risk factors associated with CCH, and corresponding odds ratios (OR) and 95% confidence intervals (CI) were calculated. P<0.05 was considered significant. Results: There was no significant difference in age (64±8 vs. 60±8 years old), gender (33.3% vs. 30.0%), history of smoking (20.0% vs. 3.3%), alcohol consumption (20.0% vs. 6.7%), diabetes mellitus (13.3% vs. 13.3%), hypertension (53.3% vs. 30.0%), history of hyperlipidemia (46.7% vs. 36.7%), uric acid (288±60 vs.319±67 µmol/L), and fasting glucose [4.99(4.63, 5.91) vs. 5.28(5.09, 6.05) mmol/L] and homocysteine [11.35(10.18, 13.08) vs.11.00(9.78, 13.03) µmol/L] between the CCH and control groups (P>0.05). Plasma exosomal miR-124-3p expression was significantly higher in the CCH group than in the control group [13.08 (8.59, 21.55) vs. 2.85 (1.44, 5.10), respectively; U=169.50, P<0.001]. Pearson's correlation test showed that the level of exosomal miR-124-3p was negatively correlated with cerebral blood flow in the hypoperfused region in patients with CCH (r=-0.932, P<0.001). Multi-factor logistic regression analysis showed that plasma exosomal miR-124-3p was independently associated with the risk of CCH (OR=1.169,95%CI 1.063-1.286,P=0.001). Conclusions: The expression of plasma exosomal miR-124-3p is negatively correlated with cerebral blood flow in areas of low perfusion and is an independent risk factor for CCH. Plasma exosomal miR-124-3p may thus serve as a valid biomarker for CCH risk prediction.

[A dry-reagent assay to rapidly detect Mycobacterium tuberculosis using loop-mediated isothermal amplification].

A molecular diagnostic assay which could be stored at room temperature was developed to rapidly detect Mycobacterium tuberculosis (MTB) based on loop-mediated isothermal amplification (LAMP) technology and dry-reagent process. LAMP uses 4 or 6 primers and Bst DNA polymerase to amplify DNA at a constant temperature. The results showed that the LAMP assay could detect the amplification of IS6110 target gene within 20 min using real-time fluorescence signal detection. The sensitive of LAMP assay was similar to the PCR technology while the precision of PCR was better than LAMP (coefficient of variation, LAMP 18.9%, PCR 3.4%), meaning LAMP was more suitable for qualitative detection. The LAMP assay did not amplify DNA of other 10 types of pathogens, including Neisseria meningitidis, Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae, Rubivirus, mumps virus, adenovirus (type 3), adenovirus (type 7), respiratory syncytial virus B and parainfluenza virus type 2, indicating a good specificity. Furthermore, a dry-reagent assay was developed using air-drying and freeze-drying process. The performance of dried reagents did not change after 10 days storage at 50 ℃, meaning the dried reagents could be stored at room temperature (25 ℃) for more than six months. The dry-reagent LAMP assay also successfully amplified MTB DNA from several clinical samples within 20 min. In conclusion, the developed LAMP assay together with isothermal amplifier could rapidly detection MTB.

[Application of augmented reality navigation combined with indocyanine green fluorescence imaging technology in the accurate guidance of laparoscopic anatomical segment 8 liver resection].

Objective: To investigate the application value of augmented reality navigation combined with indocyanine green(ICG) fluorescence imaging technology in laparoscopic anatomical segment 8 liver resection. Methods: Clinical and pathological data from 8 patients with hepatocellular carcinoma located in segment 8 of the liver admitted to the First Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University from October 2021 to October 2022 were collected restrospectively. Among them,there were 5 males and 3 females,aged between 40 and 72 years. During the operation,the self-developed laparoscopic augmented reality surgical navigation system was used to integrate the three-dimensional liver model with the laparoscopic scene,and ICG fluorescence imaging technology was used to guide the anatomical liver resection of segment 8. The predicted liver resection volume and actual liver resection volume,related surgical indicators and postoperative complications were analyzed. Results: Among the 8 patients, 4 underwent laparoscopic anatomical segment 8 liver resection,1 underwent laparoscopic anatomical ventral subsegment of segment 8 liver resection,2 underwent laparoscopic anatomical ventral subsegment combined with medial subsegment of segment 8 liver resection, and 1 underwent laparoscopic anatomical dorsal subsegment of segment 8 liver resection. All operations were completed under the guidance of augmented reality navigation combined with ICG fluorescence imaging,without conversion to open surgery. The operation time was (276.3±54.8)minutes(range:200 to 360 minutes). Intraoperative blood loss was (75.0±35.4)ml(range:50 to 150 ml). No blood transfusion was performed during the operation. The length of postoperative hospital stay was (7.6±0.8)days(range:7 to 9 days). There were no deaths or postoperative complications such as bleeding or biliary fistula during the perioperative period. Conclusion: Augmented reality navigation combined with ICG fluorescence imaging technology can guide the implementation of laparoscopic anatomical segment 8 liver resection.

[Preoperative serum creatinine as an independent prognostic biomarker in patients with early-stage cervical adenocarcinoma].

Objective: To investigate the effect of preoperative serum creatinine (Scr) level on the prognosis of patients with early cervical adenocarcinoma (ADC) and its predictive value. Methods: A retrospective review was performed on 199 patients with the International Federation of Gynecology and Obstetrics (FIGO) stage ⅠA1-ⅡA1 and pathology-proven invasive ADC from January 2005 to December 2015. Patients were followed up by phone and outpatient, with a median follow-up time 77.5 (57.0, 114.0) months, 11 cases (5.5%) were missing, 19 cases (10.1%) recurred, and 17 cases (9.0%) died. Multivariate analysis was performed by Cox regression model to analyze the related factors of the prognosis of ADC patients. The optimal cut-off point was determined by the analysis of receiver operating characteristics (ROC), and the predictive value of related factors for prognosis was evaluated by the area under the curve (AUC). Results: The median age of 199 patients was 44.0 (39.0-50.0) years. Overall, 16 patients (8.0%) were stage ⅠA1; 4 patients (2.0%) were stage ⅠA2; 147 patients (74.0%) were stage ⅠB1; 13 patients (6.5%) were stage ⅠB2; 19 patients (9.5%) were stage ⅡA1. The multivariate analysis showed that FIGO stage [4.570 (1.625-12.854)] and elevated Scr [1.065 (1.006-1.128)] were correlated with DFS in patients with early ADC, as well as correlated with OS [4.412 (1.458-13.350) and 1.076 (1.012-1.144), respectively (all P<0.05)]. The optimal cut-off point of Scr level was 75.2 µmoI/L. The AUC showed that the Scr level was a predictor of DFS (AUC=0.677, 95%CI: 0.608-0.742, P=0.006) and OS (AUC=0.677, 95%CI: 0.607-0.741, P=0.012). Conclusions: The preoperative Scr level independently predicts the prognosis of early-stage ADC; patients with Scr levels>75.2 µmoL/L might require more follow-up and adjuvant treatment, as they might have a poorer prognosis.

[Expression and significance of chemokine CXCL12 and receptor CXCR4 in adenomyosis].

Objective: To observe the expression, correlation and significance of chemokine (C-X-C motif) ligand 12 (CXCL12) and chemokine (C-X-C motif) receptor 4 (CXCR4) in endometrium and myometrium of adenomyosis. Methods: Totally 38 patients were selected in this study, who underwent hysterectomy for adenomyosis at Beijing Obstetrics and Gynecology Hospital from October 2017 to December 2018 as the adenomyosis group, and, in the same period, selected 31 patients with cervical intraepithelial neoplasia Ⅲ or cervical cancer undergoing hysterectomy served as control group. The expression levels of mRNA and protein for CXCL12, CXCR4 in the endometrium and myometrium of the two groups were detected by immunohistochemistry and real-time PCR. Results: (1) The protein levels of CXCL12 and CXCR4 in endometrium in uterus with adenomyosis (0.229±0.025 and 0.226±0.016) were significantly higher than those in endometrium in uterus without adenomyosis (0.153±0.018 and 0.178±0.026); compared with each other, the differences were statistically significant (all P<0.05). And the expressions of CXCL12 and CXCR4 proteins in uterine myometrium of adenomyosis were 0.222±0.045 and 0.126±0.058, respectively, which were higher than those in the control group (0.091±0.029 and 0.099±0.020); compared with each other, the differences were statistically significant (all P<0.05). (2) The expression levels of CXCL12 and CXCR4 mRNA in endometrium of patients with adenomyosis were 6.31±0.12 and 8.49±0.21, respectively, which were higher than those in the control group (1.23±0.10 and 1.36±0.13); compared with each other, the differences were statistically significant (all P<0.05). Moreover, the expression levels of CXCL12 and CXCR4 mRNA in myometrium of patients with adenomyosis were 9.11±0.12 and 8.45±0.16, respectively, which were higher than those in the control group (1.18±0.08 and 1.46±0.13); compared with each other, the differences were statistically significant (all P<0.05). (3) In endometrium and myometrium of uterus with adenomyosis, CXCL12 and CXCR4 mRNA expression levels were positively associated (r=0.478, 0.542, all P<0.05). Conclusions: The levels of CXCL12 and CXCR4 in the endometrium and myometrium of adenomyosis are increased and positively correlated. The two chemokine may be involved in the development of adenomyosis.

Analysis of Consistency between Forensic Psychiatry Identification Diagnosis and Clinical Diagnosis of 1 369 Cases.

ABSTRACT: Objective To explore the consistency between identification diagnosis and pre-identification clinical diagnosis of patients with mental disorder undergoing forensic psychiatry identification. Methods The identification data of 1 369 appraised individuals who underwent criminal responsibility identification carried out by the Forensic Institute of Second Affiliated Hospital of Jining Medical University from 2014 to 2017 were collected retrospectively using self-designed investigation data sorting table. A comparative analysis of the mental disorder diagnosis results of expert opinion and past clinical diagnosis results was made. Results Among 1 369 appraised individuals, 964 cases （70.4%） were identified and diagnosed with mental disorder and 405 cases （29.6%） without mental disorder. Among the former, 63.3% （610 cases） were clinically diagnosed, which was higher than 43.2% （175 cases, P<0.05） in the latter. Among the various mental disorders that had been identified and diagnosed, patients with hysteria, stress, and neurosis had the highest proportion of clinical diagnoses （86.7%）, while patients with mental retardation had the lowest proportion of clinical diagnoses （9.6%）. Schizophrenia had the highest overall consistency rate of identification diagnosis and clinical diagnosis （98.4%）, while personality and behavior disorder had the lowest （33.3%）. The overall consistency rate between clinical diagnosis and identification diagnosis of the mental disorder group was 84.1%, and the Kappa value was 0.759. Compared with clinical diagnosis, the consistency rate between inpatient diagnosis and identification diagnosis was higher （85.9%, P<0.05）. Conclusion In forensic psychiatry identification that provides data of past clinical diagnosis and treatment, a high consistency between identification diagnosis and clinical diagnosis of the appraised individual who is identified and diagnosed with mental disorder exists. Clinical diagnosis （especially the inpatient diagnosis） has a relatively good reference value for forensic psychiatry identification.

Chronic hyponatremia and association with osteoporosis among a large racially/ethnically diverse population.

Chronic hyponatremia may contribute to decreased bone density. We studied 341,003 men and women who underwent DXA testing and observed that individuals with chronic hyponatremia (sodium < 135 mEq/L) had an 11% greater likelihood of having osteoporosis. There was a dose-dependent effect with lower sodium and stronger association with osteoporosis. INTRODUCTION: Chronic hyponatremia has been associated with both neurologic deficits and increased risk of gait abnormalities leading to falls and resultant bone fractures. Whether chronic hyponatremia contributes to decreased bone density is uncertain. We evaluated whether chronic, mild hyponatremia based on serial sodium measurements was associated with increased risk of osteoporosis within a large, ethnically diverse population. METHODS: This is a retrospective cohort study between January 1, 1998 and December 31, 2014 within Kaiser Permanente Southern California, an integrated healthcare delivery system. Men and women were aged ≥ 55 years with ≥ 2 serum sodium measurements prior to dual-energy X-ray absorptiometry (DXA) testing. Time-weighted (TW) mean sodium values were calculated by using the proportion of time (weight) elapsed between sodium measurements and defined as < 135 mEq/L. Osteoporosis defined as any T-score value ≤ - 2.5 of lumbar spine, femoral neck, or hip. RESULTS: Among 341,003 individuals with 3,330,903 sodium measurements, 11,539 (3.4%) had chronic hyponatremia and 151,505 (44.4%) had osteoporosis. Chronic hyponatremic individuals had an osteoporosis RR (95% CI) of 1.11 (1.09, 1.13) compared to those with normonatremia. A TW mean sodium increase of 3 mEq/L was associated with a lower risk of osteoporosis [adjusted RR (95% CI) 0.95 (0.93, 0.96)]. A similar association was observed when the arithmetic mean sodium value was used for comparison. CONCLUSIONS: We observed a modest increase in risk for osteoporosis in people with chronic hyponatremia. There was also a graded association between higher TW mean sodium values and lower risk of osteoporosis. Our findings underscore the premise that chronic hyponatremia may lead to adverse physiological effects and responses which deserves better understanding.

[Development and Optimization of Therapeutic Analogues of Anti-TNFα Antibody Infliximab].

Previously, we have reported the crystal structures of Fab fragment of Infliximab in complex with TNFα. The structurally identified epitope on TNFα revealed the mechanism of TNFα inhibition by partially overlapping with the TNFα-receptor interface and the possibility to optimize the binding affinity. In this study, we launched a screen of a phage display library to isolate novel anti-TNFα antibodies based on the infliximab epitope. To develop novel anti-TNFα antibodies, structural analysis, the phage display antibody isolation, step by step antibody optimization, CDR residues random mutagenesis, and binding affinity characterization were performed. One of the novel antibodies generated on the backbone of infliximab, Inf3D6, has the superior binding affinity to TNFα, thus, demonstrating the potential for structure guided optimization for improvement of existing antibody-based therapeutics.

[Sample size for the estimation of F-wave parameters in healthy volunteers and amyotrophic lateral sclerosis patients].

Objective: The study aimed to investigate whether sample sizes of F-wave study differed according to different nerves, different F-wave parameters, and amyotrophic lateral sclerosis(ALS) patients or healthy subjects. Methods: The F-waves in the median, ulnar, tibial, and deep peroneal nerves of 55 amyotrophic lateral sclerosis (ALS) patients and 52 healthy subjects were studied to assess the effect of sample size on the accuracy of measurements of the following F-wave parameters: F-wave minimum latency, maximum latency, mean latency, F-wave persistence, F-wave chronodispersion, mean and maximum F-wave amplitude. A hundred stimuli were used in F-wave study. The values obtained from 100 stimuli were considered "true" values and were compared with the corresponding values from smaller samples of 20, 40, 60 and 80 stimuli. F-wave parameters obtained from different sample sizes were compared between the ALS patients and the normal controls. Results: Significant differences were not detected with samples above 60 stimuli for chronodispersion in all four nerves in normal participants. Significant differences were not detected with samples above 40 stimuli for maximum F-wave amplitude in median, ulnar and tibial nerves in normal participants. When comparing ALS patients and normal controls, significant differences were detected in the maximum (median nerve, Z=-3.560, P<0.01; ulnar nerve, t=5.019, P<0.01; tibial nerve, Z=-2.475, P<0.05; peroneal nerve, Z=-2.088, P<0.05)and mean F-wave latency (median nerve, Z=-3.243, P<0.01; ulnar nerve, t=3.876, P<0.01; tibial nerve, Z=-2.206, P<0.05; peroneal nerve, Z=-2.205, P<0.05)in all four nerves, F-wave chronodispersion (Z=-3.152, P<0.01)in the ulnar nerve, F-wave persistence in the median (Z=6.139, P<0.01)and ulnar nerves(Z=5.350, P<0.01), mean F-wave amplitude in the tibial nerve(t=2.981, P<0.01), maximum F-wave amplitude in the ulnar (Z=-2.134, P<0.05)and tibial nerves (t=2.746, P<0.01)with 20 stimuli; for chronodispersion in tibial nerve (t=2.551, P<0.05)100 stimuli, for chronodispersion in peroneal nerve (Z=-2.086, P<0.05)80 stimuli, for F-wave persistence in tibial nerve (Z=2.119, P<0.05) 60 stimuli, for mean F-wave amplitude in ulnar (Z=-2.552, P<0.05)and peroneal nerve (Z=-2.228, P<0.05)40 stimuli, for maximum F-wave amplitude in peroneal nerve (t=2.693, P<0.01)60 stimuli were necessary to detect differences. Conclusions: Sample sizes of F-wave study differed according to different nerves, different F-wave parameters , and ALS patients or healthy subjects.

[Modified Prolift procedure without trachelectomy or hysterectomy for the treatment of advanced pelvic organ prolapse complicated with cervical elongation].

OBJECTIVE: To evaluate the effect and safety of a modified Prolift procedure, without preceding partial trachelectomy or hysterectomy for pelvic organ prolapse (POP) with coexistent cervical elongation. METHODS: Clinical data of 72 patients that underwent a modified Prolift procedure for POP with coexistent cervical elongation, between December 2008 and June 2012 in Fuzhou General Hospital of Nanjing Military Command was retrospectively analysed. A comparison was carried out between preoperative and postoperative parameters of pelvic organ prolapse quantitation system (POP-Q), and an objective evaluation was made according to the overall cure rate and recurrence rate. Pelvic floor distress inventory-short form 20 (PFDI-20) was used to investigate the subjective cure rate and improvement of symptoms. RESULTS: Patients were followed up at median 52 months (36-78 months). One bladder perforation and one rectum perforation occurred during the procedure. Four patients (6%, 4/72) had uterine prolapse at 9-19 months after the opertaion and had transvaginal hysterectomy laterly. The overall anatomical correction rate was 94% (68/72). Six patients (8%, 6/72) had mesh exposures at 3-9 months after the opertaion. Scores of PFDI-20 decreased sifnificantly after the procedure (118.2±25.2 vs 12.1±8.0 vs 12.5±9.5 vs 13.0±9.9, P< 0.05). The patients' satisfaction rate was 92% (66/72). CONCLUSION: This modified Prolift procedure, without preceding partial trachelectomy or hysterectomy, could effectively and safely correct POP with coexistent cervical elongation.

p-type doping of MgZnO films and their applications in optoelectronic devices.

A lithium and nitrogen codoping method has been employed to prepare p-type MgZnO films, and p-MgZnO/i-ZnO/n-ZnO structured light-emitting devices (LEDs) and photodetectors have been fabricated. The LEDs can work continuously for about 97 h under the injection of a 20 mA continuous current, which is the best value ever reported for ZnO-based LEDs. The performance of the photodetectors degrades little after several running cycles. The above results reveal the applicability of the p-MgZnO films in optoelectronic devices.

Acremonium Brown Spot, a New Disease Caused by Acremonium sclerotigenum on Bagged Apple Fruit in China.

In China, covering developing apple (Malus × domestica) fruit with paper bags is a standard production practice. The fruit are usually covered from May to October to exclude pests and rain-dispersed pathogens and reduce pesticide residue at harvest. From 2010 to 2012, a fruit spot disease was observed on bagged fruit and caused 1 to 30% annual yield losses in most orchards in Shandong Province. Affected fruit were covered with red-brown, sunken, circular lesions 2 to 20 mm in diameter with dark violet edges often surrounded by a red halo. In many cases, the lesion cracked and pinkish mycelium was observed within the cracks. Isolations were made from bagged fruit from 12 orchards in October 2010 to 2012. Fungal isolations were made onto potato dextrose agar (PDA) medium. Two strains were consistently obtained from isolates. Strain 1 produced conidia assembled in head. Conidia were ellipsoidal to ovoid and 2.1 to 7.5 × 1.1 to 3.0 µm. Colonies were whitish with some pink and powdery on PDA. String 2 produced conidia in a long chain. Conidia were spindle-shaped with apiculate at both ends and 2.1 to 6.6 × 1.3 to 3.8 µm. Colonies were whitish at the beginning and grayish later and powdery on PDA. To further confirm the identity of the isolated fungus, the large subunit (LSU), the small subunit (SSU), and the internal transcribed spacer (ITS) sequences of ribosomal DNA, and the ß-tubulin gene (ß-tubulin), were amplified and sequenced with the primers V9G/LR5, NS1/NS24, ITS1/ITS4, and Bt1a/Bt1b, respectively. LSU (GenBank Accession Nos. KJ194115 and KJ194116), SSU (KJ194117 and KJ194118), ITS (KF225143 and KF225144), and ß-tubulin (KF225145 and KF225146) sequences didn't have any variation between the two strains sequenced. Phylogenetic analyses of each of the examined genes indicated a high similarity (>99%) with Acremonium sclerotigenum (CBS 384.65 HQ232129). Based on the sequence data and the morphology, we identified the fungus as A. sclerotigenum (1,2). To confirm pathogenicity, a spore suspension (1 × 104 conidia per ml) was made from each of the strains isolated. Strains were subsequently inoculated on to 10 mature apple fruit by wounding them to a depth of 2 mm with an acupuncture needle. Inoculation with sterile distilled water was included as a control. Prior to inoculation, all fruit were surface-sterilized with 75% alcohol. Lesions developed on fruit inoculated with the putative pathogen 10 days after incubation in >90% humidity chamber at 25°C. The fungi that were isolated from the infected fruit were identical to the inoculated strains. No lesions developed on the control fruit. This is the first report of brown spot disease caused by A. sclerotigenum in apple and in bagged fruit production. Given that brown spot disease symptoms were usually observed in September after long periods of rain, management efforts need to focus on protecting bagged fruit before harvest. References: (1) H. Perdomo et al. J. Clin. Microbiol. 49:243, 2011. (2) R. C. Summerell et al. Stud. Mycol. 68:139, 2011.

An association between genetic variation in the roundabout, axon guidance receptor, homolog 2 gene and immunity traits in chickens.

The roundabout, axon guidance receptor, homolog 2 (ROBO2) gene is one member of the roundabout (ROBO) family, which belongs to the immunoglobulin superfamily. The ROBO molecules are known to function in axon guidance and cell migration and are involved in SLIT/ROBO signaling. In this study, we obtained the full-length cDNA sequence of the chicken ROBO2 gene. Sequence analysis indicated that 3 SNP (1418G > A, 1421C > A and 2462T > C) exist in exons 5 and 12 of the ROBO2 gene. Genotyping results revealed that the allele frequency of SNP 1421C > A was similar in all tested breeds, but the allele frequencies of the other 2 SNP were different between White Leghorn and Chinese indigenous chickens. Allele G of 1418G > A and allele T of 2462T > C predominated in the Chinese indigenous breed, whereas alleles A and C predominated in the White Leghorn breed. Association analyses revealed that birds with the GG genotype of SNP 1418G > A or the TT genotype of SNP 2462T > C had significantly higher antibody responses to Newcastle disease virus (NDV_S/P; P < 0.01) than carriers of the A allele (GA and AA) or the C allele (TC), respectively. Real-time PCR further revealed that ROBO2 expression in the spleens of the birds with higher antibody responses (GG and TT genotypes at SNP 1418 and 2462, respectively) was significantly higher than in the spleens of birds with the AA and AG genotypes at SNP 1418 or the TC genotype at SNP 2462 (P < 0.01). The results demonstrated that genetic variation at the ROBO2 gene plays a key role in the immune response to Newcastle disease virus, and SNP 1418G > A and 2462T > C can be used as genetic markers for the selection of chickens with stronger immune responses to Newcastle disease virus.

Air dispersal of multi-drug-resistant organisms including meticillin-resistant Staphylococcus aureus, carbapenem-resistant Acinetobacter baumannii and carbapenemase-producing Enterobacterales in general wards: surveillance culture of air grilles.

BACKGROUND: The environmental surveillance of air grilles in clinical areas has not been systematically analysed. METHODS: Samples were collected from frequently touched items (N = 529), air supply (N = 295) and exhaust (N = 184) grilles in six medical and 11 surgical wards for the cultures of multi-drug-resistant organisms (MDROs): meticillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenemase-producing Enterobacterales (CPE), and isolates were selected for whole-genome sequencing (WGS). The contamination rates were correlated with the colonization pressures of the respective MDROs. RESULTS: From 3rd October to 21st November 2023, 9.8% (99/1008) of the samples tested positive, with MRSA (24.2%, 24/99), CRAB (59.6%, 59/99) and CPE (2.0%, 2/99), being the only detected MDROs. The contamination rate in air exhaust grilles (26.6%, 49/184) was significantly higher than in air supply grilles (5.8%, 17/295; P<0.001). The contamination rate of air exhaust grilles with any MDRO in acute medical wards (73.7%, 14/19) was significantly higher than in surgical wards (12.5%, 4/32; P<0.001). However, there was no difference in the contamination rate of air exhaust grilles between those located inside and outside the cohort cubicles for MDROs (27.1%, 13/48 vs 28.8%, 30/104; P=0.823). Nevertheless, the weekly CRAB colonization pressure showed a significant correlation with the overall environmental contamination rate (r = 0.878; 95% confidence interval (CI): 0.136-0.986; P=0.004), as well as with the contamination rate in air supply grilles (r = 0.960; 95% CI: 0.375-0.999; P<0.001) and air exhaust grilles (r = 0.850; 95% CI: 0.401-0.980; P=0.008). WGS demonstrated clonal relatedness of isolates collected from patients and air exhaust grilles. CONCLUSIONS: Air grilles may serve as MDRO reservoirs. Cohort nursing in open cubicles may not completely prevent MDRO transmission through air dispersal, prompting the consideration of future hospital design.

Therapeutic effect of micropump intravenous infusion of ambroxol hydrochloride on respiratory distress syndrome in premature infants.

OBJECTIVE: This work aimed to explore the therapeutic effect of micropump intravenous infusion of ambroxol hydrochloride (AH) on respiratory distress syndrome (RDS) in premature infants. PATIENTS AND METHODS: 56 premature infants from 28 to 34 weeks were recruited for analysis in this work. According to the treatment methods, they were randomly divided into two groups, with 28 patients in each group. Patients in the experimental group were given intravenous AH by micropump, while those in the control group inhaled atomized AH. The therapeutic effects were evaluated by comparing the data after treatment. RESULTS: The results showed that the serum 8-iso-PGP2α level in the experimental group was 166.32 ± 49.52, which was substantially inferior to that in the control group (183.32 ± 52.54), p < 0.05. In the experimental group, PaO2, SaO2, and PaO2/FiO2 were 95.88 ± 12.82 mmHg, 95.86 ± 2.27%, and 346.81 ± 51.93 mmHg, respectively, after 7 days of treatment. Compared with the control group (88.21 ± 12.82 mmHg, 93.18 ± 3.13%, and 266.83 ± 48.09 mmHg), the difference was statistically significant, p < 0.05. The oxygen duration, respiratory distress relief time, and length of stay were 95.12 ± 12.53 h, 4.4 ± 0.6 d, and 19.84 ± 2.8 d, respectively, in the experimental group, while they were 145.92 ± 13.85 h, 6.9 ± 0.9 d, and 28.42 ± 3.7 d, respectively, in the control group, showing great differences (p < 0.05). CONCLUSIONS: Micropump infusion of AH in the treatment of premature RDS patients was more conducive to efficacy. It can alleviate the clinical symptoms of children with RDS, improve their blood gas indicators, relieve and repair the damage to alveolar epithelial cell lipids in children with RDS, and ultimately improve the therapeutic effect, which can be used for the clinical treatment of premature RDS.

Ultraviolet emissions excited by accelerated electrons.

By employing an insulating zinc oxide (i-ZnO) as an electron accelerating layer, and an n-type ZnO as an active layer, ultraviolet (UV) emissions at 385 nm caused by the excitation of the n-ZnO layer by the accelerated electrons from the i-ZnO layer have been realized. By replacing the active layer with larger bandgap Mg0.39Zn0.61O and properly optimizing the structure, shorter wavelength emissions at around 328 nm have been obtained. Considering that the p-type doping of wide bandgap semiconductors is still a challenging issue, the results reported in this Letter may provide a promising alternative route to UV emissions.

Tunable magnetic properties by interfacial manipulation of L1(0)-FePt perpendicular ultrathin film with island-like structures.

Based on interfacial manipulation of the MgO single crystal substrate and non-magnetic AIN compound, a L1(0)-FePt perpendicular ultrathin film with the structure of MgO/FePt-AIN/Ta was designed, prepared, and investigated. The film is comprised of L1(0)-FePt "magnetic islands," which exhibits a perpendicular magnetic anisotropy (PMA), tunable coercivity (Hc), and interparticle exchange coupling (IEC). The MgO substrate promotes PMA of the film because of interfacial control of the FePt lattice orientation. The AIN compound is doped to increase the difference of surface energy between FePt layer and MgO substrate and to suppress the growth of FePt grains, which takes control of island growth mode of FePt atoms. The AIN compound also acts as isolator of L1(0)-FePt islands to pin the sites of FePt domains, resulting in the tunability of Hc and IEC of the films.

First Report of Glomerella Leaf Spot of Apple Caused by Glomerella cingulata in China.

A new destructive apple disease, causing black spots and necrotic lesions on leaves and defoliation on cvs. Gala and Golden Delicious (Malus × domestica Borkh.), was observed in August 2011 in Fengxian, Jiangsu Province, China. More than 90% of trees of those cultivars in the area were defoliated by the disease and almost no leaves were left on trees before harvest. The disease was similar to Glomerella leaf spot reported first in Brazil in 1988 (2) and in the United States in 1998 (1) on cvs. Gala and Golden Delicious. The initial symptom was small black lesions on leaves. Above 30°C, the lesions developed quickly and grew to 2 to 3 cm, with a blurred edge. Diseased leaves became dark and were shed. At lower temperatures, the black lesions stopped enlarging after 5 to 6 days and formed large necrotic spots with clear edges; these leaves gradually grew yellow and were shed. When incubated at 30°C and 100% relative humidity for 1 to 2 days, the black lesions produced a mass of saffron-yellow conidia. On fruit, the pathogen only caused circular, necrotic, sunken, red-bordered lesions 2 to 3 mm in diameter, which was different from bitter rot. Three monospored cultures were isolated from diseased leaves and new conidia were obtained from isolates. The colony, with abundant mycelium, was white but turned gray to black. Conidia were 12 to 17 × 5 to 7 µm, and were cylindrical with rounded ends. After germination, conidia formed appressoria, oval, or circular cells with black thick walls 7 to 12 × 5 to 7 um. Based on morphological characteristics, the pathogen was putatively identified as Glomerella cingulata. The conidia were inoculated in vitro on leaves of cvs. Gala and Fuji by dripping a suspension of about 104 conidia/ml of water onto upper leaf surfaces. Dark necrotic lesions were observed on all inoculated Gala leaves, which were similar to those observed in orchards, after 4 days incubation in a chamber at 30°C with 100% humidity. Only small black lesions, about 1 to 2 mm in diameter, were observed on Fuji leaves. No symptoms developed on leaves inoculated with distilled water. The internal transcribed spacer (ITS) region of ribosomal DNA and part of the 18S and 28S ribosomal RNA of the three isolates were amplified with the universal primers ITS1 (5'-TCCGTAGGTGAACCTGCGG-3') and ITS4 (5'-CCTCCGCTTATTGATATGC-3'). The amplified ITS sequences confirmed that the three isolates belonged to the same species, with only one base pair variation among sequences. The nucleotide sequence of isolate 1 and 2 was deposited in GenBank (JN714400 and JN714401). BLAST analysis showed that the sequence had 99% homology with the sequence of G. cingulata (EU008836), the causal agent of Glomerella leaf spot. However, the sequence of isolate 1 had 100% homology with that of G. cingulata (HQ845103.1) isolated from walnut in Shandong, China, while the sequence of isolate 2 had 100% homology with that of G. cingulata (HM015004.1) isolated from sweet pepper in Taiwan. Results suggested the disease is Glomerella leaf spot and the causal agent is G. cingulata. The disease will eliminate sensitive apple cultivars, such as Gala, from wet, warm production areas if effective control measures are not developed within a few years. To our knowledge, this was the first finding of the disease in China and will provide useful information for developing effective control strategies. References: (1) E. González and T. B. Sutton. Plant Dis. 83:1074, 1999. (2) T. B. Sutton and R. M. Sanhueza. Plant Dis. 82:267, 1998.

Racial and ethnic disparities in diabetes risk after gestational diabetes mellitus.

AIMS/HYPOTHESIS: To investigate racial/ethnic disparities in diabetes risk after gestational diabetes mellitus (GDM). METHODS: This is a retrospective cohort study of women enrolled in the Kaiser Permanente Southern California health plan from 1995 to 2009. GDM status was identified on the basis of plasma glucose levels during pregnancy. The incidence of diabetes after the first delivery complicated by GDM before 31 December 2009 (n = 12,998) was compared with the experience for women without GDM (n = 64,668) matched on maternal age at delivery, race/ethnicity and year of delivery (1:5 ratio). Matched Cox regression was used to compare the RRs of diabetes associated with GDM within and across racial/ethnic groups. RESULTS: Compared with the women without GDM, the HRs (95% CI) of diabetes for women after GDM were 6.5 (5.2, 8.0) in non-Hispanic white, 7.7 (6.8, 8.7) in Hispanic, 9.9 (7.5, 13.1) in black and 6.3 (5.0, 7.9) in Asian/Pacific Islanders after adjustment for parity, maternal education, comorbidity and number of outpatient visits before the index pregnancy. The HR of diabetes for black women was significantly higher than that for non-Hispanic white women (p = 0.032). Further adjustment for prepregnancy BMI reduced the diabetes risk association with GDM for each racial/ethnic group, but did not explain the risk differences across groups. CONCLUSIONS/INTERPRETATIONS: Racial/ethnic disparities exist in risk of diabetes after GDM. Black women with GDM had the highest risk of developing diabetes. This highlights the importance of developing an effective diabetes screening and prevention programme in women with GDM, particularly black women with GDM.