Multisensory Conflict Impairs Cortico-Muscular Network Connectivity and Postural Stability: Insights from Partial Directed Coherence Analysis / 神经科学通报·英文版

Sensory conflict impacts postural control, yet its effect on cortico-muscular interaction remains underexplored. We aimed to investigate sensory conflict's influence on the cortico-muscular network and postural stability. We used a rotating platform and virtual reality to present subjects with congruent and incongruent sensory input, recorded EEG (electroencephalogram) and EMG (electromyogram) data, and constructed a directed connectivity network. The results suggest that, compared to sensory congruence, during sensory conflict: (1) connectivity among the sensorimotor, visual, and posterior parietal cortex generally decreases, (2) cortical control over the muscles is weakened, (3) feedback from muscles to the cortex is strengthened, and (4) the range of body sway increases and its complexity decreases. These results underline the intricate effects of sensory conflict on cortico-muscular networks. During the sensory conflict, the brain adaptively decreases the integration of conflicting information. Without this integrated information, cortical control over muscles may be lessened, whereas the muscle feedback may be enhanced in compensation.

Development and external validation of a prognostic multivariable model on admission for hospitalized patients with COVID-19

BackgroundCOVID-19 pandemic has developed rapidly and the ability to stratify the most vulnerable patients is vital. However, routinely used severity scoring systems are often low on diagnosis, even in non-survivors. Therefore, clinical prediction models for mortality are urgently required. MethodsWe developed and internally validated a multivariable logistic regression model to predict inpatient mortality in COVID-19 positive patients using data collected retrospectively from Tongji Hospital, Wuhan (299 patients). External validation was conducted using a retrospective cohort from Jinyintan Hospital, Wuhan (145 patients). Nine variables commonly measured in these acute settings were considered for model development, including age, biomarkers and comorbidities. Backwards stepwise selection and bootstrap resampling were used for model development and internal validation. We assessed discrimination via the C statistic, and calibration using calibration-in-the-large, calibration slopes and plots. FindingsThe final model included age, lymphocyte count, lactate dehydrogenase and SpO2 as independent predictors of mortality. Discrimination of the model was excellent in both internal (c=0{middle dot}89) and external (c=0{middle dot}98) validation. Internal calibration was excellent (calibration slope=1). External validation showed some over-prediction of risk in low-risk individuals and under-prediction of risk in high-risk individuals prior to recalibration. Recalibration of the intercept and slope led to excellent performance of the model in independent data. InterpretationCOVID-19 is a new disease and behaves differently from common critical illnesses. This study provides a new prediction model to identify patients with lethal COVID-19. Its practical reliance on commonly available parameters should improve usage of limited healthcare resources and patient survival rate. FundingThis study was supported by following funding: Key Research and Development Plan of Jiangsu Province (BE2018743 and BE2019749), National Institute for Health Research (NIHR) (PDF-2018-11-ST2-006), British Heart Foundation (BHF) (PG/16/65/32313) and Liverpool University Hospitals NHS Foundation Trust in UK. Research in contextO_ST_ABSEvidence before this studyC_ST_ABSSince the outbreak of COVID-19, there has been a pressing need for development of a prognostic tool that is easy for clinicians to use. Recently, a Lancet publication showed that in a cohort of 191 patients with COVID-19, age, SOFA score and D-dimer measurements were associated with mortality. No other publication involving prognostic factors or models has been identified to date. Added value of this studyIn our cohorts of 444 patients from two hospitals, SOFA scores were low in the majority of patients on admission. The relevance of D-dimer could not be verified, as it is not included in routine laboratory tests. In this study, we have established a multivariable clinical prediction model using a development cohort of 299 patients from one hospital. After backwards selection, four variables, including age, lymphocyte count, lactate dehydrogenase and SpO2 remained in the model to predict mortality. This has been validated internally and externally with a cohort of 145 patients from a different hospital. Discrimination of the model was excellent in both internal (c=0{middle dot}89) and external (c=0{middle dot}98) validation. Calibration plots showed excellent agreement between predicted and observed probabilities of mortality after recalibration of the model to account for underlying differences in the risk profile of the datasets. This demonstrated that the model is able to make reliable predictions in patients from different hospitals. In addition, these variables agree with pathological mechanisms and the model is easy to use in all types of clinical settings. Implication of all the available evidenceAfter further external validation in different countries the model will enable better risk stratification and more targeted management of patients with COVID-19. With the nomogram, this model that is based on readily available parameters can help clinicians to stratify COVID-19 patients on diagnosis to use limited healthcare resources effectively and improve patient outcome.

Construction of a murine model of chronic graft-versus-host disease by haplo-identical spleen cell infusion / 中华器官移植杂志

Objective For providing experimental platform of chronic graft-versus-host disease (cGVHD),to establish a mouse model by haplo-identical spleen cell infusion.Methods The donor male mice (Balb/cH-2d) and the recipient (Balb/c C57BL/6) F1 H2-d/b (CB6F1) female mice were randomly divided into four groups:3 experimental groups injected with 3 107,6 107 and 9 107 spleen cells,respectively,while the control group received RPMI 1640 solution.H-2d and H-2b were checked to analyze the chimerism in bone marrow cells.Body mass,figure,cutaneous manifestation and survival of recipient mice were observed and scored every 3 days.Pathologic changes of target organs were observed and scored.Results Injection of 6 107 and 6 107 splenocytes in the recipient mice resulted in a chronic disease with a low level of parental cell engraftment steadily.As compared with 3 107 group,the incidence of cGVHD in 6 107 and 9 107 groups were significantly increased (P ＜0.01).But there was no significant difference between 6 107 and 9 107 groups (P＞0.05).Conclusion A murine model of cGVHD after haplo-identical spleen cell infusion of donor is successfully established by injection of 6 107 and 9 107 spleen cells.

Clinical significance of anti-HBc-IgG only positivity of HBV markers in serum / 国际检验医学杂志

Objective To discuss the clinical significance of anti-HBc-IgG(anti-HBc) only positivity of HBV markers in serum.Methods The total and the isolated anti-HBc positive rate were calculated retrospectively from 5 213 and 594 inpatients′ serum samples determined for five HBV markers including HBsAg,anti-HBs,HBeAg,anti-HBe and anti-HBc by microparticle enzyme immunoassay(MEIA),enzyme-linked immunosorbent assay(ELISA),respectively.The levels of anti-HBs were analysed in 167 five-HBV-marker negative and 124 anti-HBc-only positive subjects determined for five HBV markers by MEIA.Making a dilution with range from 2- to 30-fold with the phosphate buffer system containing 10% bovine calf serum to 97 serum samples with epidemiological anti-HBc only positivity screened from 594 inpatients determined for five HBV markers by ELISA,and anti-HBc of the dilute serum samples were determined by ELISA and MEIA,respectively.Results The total and the isolated anti-HBc positive rate with epidemiological and clinical significance by ELISA were 72.1%, 16.3 % and 62.6%,7.6%,respectively.The total and the isolated anti-HBc positive rate by MEIA were 78.1% and 13.2%,respectively.The difference of anti-HBs levels between five-HBV-marker negative and anti-HBc-only positive subjects determined for anti-HBs by MEIA was significant(?~2= 86.9 ,P

Effect of K_(ATP) Channel Regulators on the Expression of K_(ATP) Subunits on the Cerebral Ischemia Reperfusion Injury in Gerbil / 航天医学与医学工程

Objective To investigate the effect of KATP channel regulator on the expression of KATP subunits on the cerebral ischemia reperfusion injury(I-R) in gerbil.Methods The I-R models of gerbil were performed by occlusion common carotid artery for 10 min and reperfusion for 60 min.Forty eight gerbils were randomly divided into 8 groups: sham-operated group,I-R group,I-R+diazoxide pretreatment group,I-R+5-Hydroxydecanoate(5-HD) pretreatment group,I-R+diazoxide+5-HD pretreatment group,I-R+ pinacidil pretreatment group,I-R+glibenclamide pretreatment group,I-R+pinacidil+glibenclamide pretreatment group.Pre I-R,the gerbil of each group was injected with KATP openers or blockers correspondingly,and the expressions of Kir6.1,SUR1,SUR2 mRNA in brain tissue were detected by reverse transcriptase-polymerase chain reaction(RT-PCR).Results Compared with sham-operated group,the expression of Kir6.1 mRNA in I-R group was increased significantly.Compared with I-R group,the expression of Kir6.1 mRNA in diazoxide pretreatment group was increased significantly,whereas that in glibenclamide treatment group was decreased significantly.Compared with sham-operated group,the expression of SUR2 mRNA was increased significantly both in I-R groups and pharmacologic pretreatment groups.However,there was no difference among KATP opener and blocker groups.And the expression of SUR1 mRNA was no difference in sham-operated group,I-R group and pharmacologic pretreatment groups.Conclusion Kir6.1 mRNA is increased significantly with diazoxide pretreatment.Kir6.1 subunit plays an important role in protection of cerebral ischemia reperfusion injury.However,SUR1 mRNA and SUR2 mRNA are not influenced by the KATP regulators.

Effect of aging on the endothelial function of the penile corpus cavernosum in rats / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of aging on the endothelial function of the penile corpus cavernosum in rats.</p><p><b>METHODS</b>The intracavernosal pressure (ICP) was compared in response to acetylcholine (Ach, endothelium-dependent vasodilator), sodium nitroprusside (SNP, an NO donor) and A23187 (a calcium ionophore)in the young (5 months old) and aged (20 months old) rats. In addition, the activity of nitric oxide synthase (NOS)in penile cavernosal tissues was examined.</p><p><b>RESULTS</b>Ach-mediated ICP was significantly attenuated from the maximum of (54.8 +/- 4.2) in the young rats to (40.3 +/- 2.8) mm Hg in the aged ones (Ach = 0.1 mmol/L), P < 0.01. The ICP to SNP (0.1 mmol/L) was (58.9 +/- 4.7) mm Hg in the young rats and (51.7 +/- 5.3) mm Hg in the aged. No statistically significant difference was noted between the two groups, P > 0.05. The Ach-mediated ICP in the young rats was not significantly augmented from the maximum of (54.8 +/- 4.2) to (55.8 +/- 4.7) mm Hg in the presence of the calcium ionophore A23187 (10 micromol/L), P > 0.05. However, A23187 significantly augmented Ach-mediated ICP in the aged from the maximum of (40.3 +/- 2.8) to (56.2 +/- 4.1) mm Hg, P < 0.01. Finally the activity of nitric oxide synthase was not significantly attenuated in either the aged or the young, P > 0.05.</p><p><b>CONCLUSION</b>The endothelial function of the penile cavernosum declines with the advance of age. And endothelial dysfunction may play some role in the mechanisms of age-related erectile dysfunction.</p>

Apoptosis and the expression of Bax and Bcl-2 in the penis of diabetic rats / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between apoptosis and the expression of Bcl-2 and Bax in the penis cavernosal tissues of diabetic rats.</p><p><b>METHODS</b>Fifty male adult Wistar rats were divided into two groups: 10 as normal control and 40 used to induce diabetes by intravenous injection of alloxan (AXN) (50 mg/kg). After 8 weeks, their penises were harvested. Apoptosis was evaluated by means of terminal deoxynucleotidyl transferase mediated d-UTP nick end labeling (TUNEL). Immunohistochemistry was employed to detect the protein of Bcl-2 and Bax.</p><p><b>RESULTS</b>Compared with those in the control group, apoptotic cells were more in number (P<0.01) and the expression of Bcl-2 was absent in the penis cavernosal tissues of the diabetic rats. However, there was upregulation of Bax and decrease in Bcl-2/Bax ratio in the diabetic group.</p><p><b>CONCLUSION</b>The high rate of apoptosis in diabetic rats may play a role in the pathophysiology of erectile dysfunction. The change in Bcl-2 and Bax activities may be responsible for apoptosis in diabetic penis erectile tissues.</p>

Extended Spectrum ?-Lactamases Producing Enterobacter cloacae:Its Clinical Distribution and Drug Resistance / 中华医院感染学杂志

OBJECTIVE To explore the clinical distribution and drug resistance of extended-spectrum ?-lactamases(ESBLs) producing Enterobacter cloacae.METHODS The clinical distribution and drug resistance of 73 strains of E.cloacae and ESBLs producing E.cloacae identified in our hospital from Jan 2002 to Jan 2004 were analyzed.RESULTS Among them,the highest detectable rate was in respiratory department and from phlegm specimen.No ESBLs producing E.cloacae and non-(ESBLs) were resistant to imipenem;no non-ESBLs were resistant to cefepime,but some ESBLs producing E.cloacae was resistant to it;all ESBLs producing E.cloacae and non-(ESBLs) were resistant to ceftriaxone and amoxicillin/clavulanic acid.CONCLUSIONS E.cloacae is one of the(commonest) pathogens in nosocomial infection,and ESBLs producing E.cloacae has a high detectable rate,its drug resistance has increased;the clinic should choose antimicrobial agents rationally according to drug sensitive tests in vitro.