Achromobacter species (sp.) outbreak caused by hospital equipment containing contaminated water: risk factors for infection.

BACKGROUND: Nosocomial outbreaks of urinary tract infections caused by Achromobacter spp. have been rare in recent decades. AIM: To identify the origin of an Achromobacter sp. outbreak, conduct multi-modal infection control measures, and finally to stop the outbreak. To this end, an epidemiological outbreak investigation and risk factor analysis were performed. METHODS: Achromobacter sp. was detected in 22 patients in our urology wards and six environmental cultures of specimens obtained from the operating rooms. Strains isolated were submitted for antimicrobial susceptibility testing. An on-site epidemiological investigation, evaluation of patient medical records, and environmental sampling were performed to identify the source of the outbreak, and implementation of infection control intervention. A case-control study was performed to analyse the potential risk factors. FINDINGS: Environmental sampling showed that the source of the infection for 22 patients was an ISA-IIIA-type medical pressurizer containing contaminated water. A case-control analysis showed that the risk factors for infection were: diagnosis of kidney/ureteral stones, surgery, placement of a double-J stent, and history of hospitalization in the past three months. CONCLUSION: It was concluded that the outbreak occurred in patients who underwent internal lithotripsy and double-J stent placement, due to contact transmission with the contaminated sensor and connecting tubes of the ISA-IIIA-type medical pressurizer.

Proopiomelanocortin and its potential functions in the pathological synovium of patients with osteoarthritis.

OBJECTIVE: Osteoarthritis (OA) is a chronic degenerative disease of the joints, adversely affecting the quality of life for the patients. To better understand the mechanisms underlying the pathological changes in osteoarthritis and identify the key genes associated with osteoarthritis pathogenesis, we utilized a comprehensive bioinformatics approach to analyze the transcriptome between osteoarthritis synovial and control samples with public microarray datasets. MATERIALS AND METHODS: First, the GSE82107 microarray dataset containing ten osteoarthritis synovial and seven control samples were selected from the Gene Expression Omnibus (GEO) database. RESULTS: A total of 52 overlapped differentially expressed genes (DEGs) in GSE82107 and OA-associated genes in the Comparative Toxicogenomics Database were identified. These OA-associated DEGs were further incorporated into a protein-protein interaction (PPI) network. Gene proopiomelanocortin (POMC) was identified in the largest cluster of PPI network with Cytoscape. GO and KEGG analyses suggested that these genes were associated with multiple functions. Other GEO datasets of osteoarthritis synovial tissues, including GSE55235 and GSE55457, were used to validate the expression level of POMC. Quantitative polymerase chain reaction and western blot analyses were also used to test the expression levels of POMC in our osteoarthritis samples. We found POMC was positively associated with transporter complex, ion channel activity, and G protein-coupled receptor signaling pathway. CONCLUSIONS: This study highlighted the OA-associated gene POMC, and its related biological pathways, suggesting it served as a potential treatment target in osteoarthritis.

Logistic regression analysis of risk factors for intra-abdominal hypertension after giant ventral hernia repair: a retrospective cohort study.

BACKGROUND: Intra-abdominal hypertension (IAH) is a classical complication after giant ventral hernia surgery and may lead to abdominal compartment syndrome (ACS). Assessment of risk factors and prevention of IAH/ACS are essential for hernia surgeons. METHODS: We performed a retrospective study including 58 giant ventral hernia patients in our center between Jan 1, 2017, and Mar 1, 2022, we recorded age, gender, chronic obstructive pulmonary disease (COPD), coronary heart disease (CHD), hypertension, type 2 diabetes mellitus (T2DM), hypoproteinemia, body mass index (BMI), the ratio of hernia sac volume to abdominal cavity volume (HSV/ACV), defect width, tension reduction procedure (TRP), positive fluid balance (PFB) and IAH of these patients and analyzed the data using univariate and multivariate logistic regression to screen the risk factors for IAH after surgery. RESULTS: The multivariate analysis showed that HSV/ACV ≥ 25%, hypoproteinemia, and PFB were independent risk factors for the occurrence of IAH after giant ventral hernia repair (P = 0.025, 0.016, 0.017, respectively). We did not find any correlation between postoperative IAH and the patient's age, gender, COPD, CHD, hypertension, T2DM, BMI, defect width, TRP, and PFB. CONCLUSION: Identifying risk factors is of great significance for the early identification and prevention of IAH/ACS. We found that HSV/ACV ≥ 25%, hypoproteinemia, and PFB were independent risk factors for IAH after giant ventral hernia repair.

[Single center experience of transcatheter aortic valve replacement with a simplified operative protocol].

Objective: To summarize the single center experience of transcatheter aortic valve replacement (TAVR) with a simplified operative protocol. Methods: Consecutive patients who underwent transfemoral TAVR (TF-TAVR) from July 2020 to December 2020 in Fuwai Hospital were retrospectively analyzed. We compared the baseline characteristic, procedure information, 30-day follow-up outcomes of the patients who underwent TF-TAVR without the simplified operative protocol (routine group) or with the simplified operative protocol (simplified protocol group). Results: 93 patients were collected, 42 patients belonging to routine group, 51 patients belonging to simplified protocol group. In simplified protocol group, there were 51 patients planned to use ultrasound-guided femoral access puncture, procedure was successful in all 51 patients (100%). There were 49 patients planned to use the radial artery as the secondary access, procedure was successful in 45 patients (92%). There were 48 patients planned to use the strategy of avoidance of urinary catheter, this strategy was achieved in 35 patients (73%). There were 12 patients planned to use the left ventricular guidewire to pace, procedure was successful in 11 patients (92%). There were no differences in baseline characteristics, major clinical endpoints and 30-day follow-up outcomes between the two groups. Meanwhile, the procedure time ((62.5±17.9)min vs. (78.3±16.7)min, P<0.001), operation room time ((133.7±25.1)min vs. (159.2±42.6)min, P<0.001), X-ray exposure time ((17.2±6.5)min vs. (20.2±7.7)min, P=0.027) were significantly shorten in simplified protocol group compared with the routine group. Conclusion: Our study results indicate that the simplified operative protocol of TF-TAVR is as effective and safe as the routine operative protocol, meanwhile using the simplified operative protocol can significantly increase the operative efficiency of TF-TAVR.

[Clinical features and spinal lesions in patients with chronic prostatitis/chronic pelvic pain syndrome].

Objective: To analyze the clinical features and spinal lesions related to micturitionin of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) patients. Methods: Patients with CP/CPPS were enrolled to this study at the outpatient department of Tongji Hospital between January and June 2019. The data of clinical features was collected and analyzed, including lower urinary tract symptoms(LUTS), bowel syndrome and pain over different parts of body, as well as lower urinary tract dysfunction, spinal lesions and pelvic organ morphological changes demonstrated by MRI. The potential role of spinal lesions in the development of CP/CPPS syndrome was investigated. Results: A total of 126 CP/CPPS patients were included, with an age［M（Q1，Q3）］of 41(31,53) years and a course of disease of 2(1,20) years. Among them, 126 (100.0%) were complicated with LUTS, 72(57.1%) with bowel dysfunction and 88(69.8%) with pain. MRI showed the cervical central disc herniation(126 cases, 100.0%), the ischemic changing in the cervical area of visceral efferant pathway(82 cases, 65.1%), the lumbar central disc herniation(65 cases, 51.6%), and the sacral nerve cysts(97 cases, 77.0%) are commonly seen. In addition, the morphological changes in the visceral organs containing smooth muscle were demonstrated, including thickened bladder wall(91 cases, 72.2%), distended seminal vesicles(70 cases, 55.6%) and distended sigmoid colon/rectum(59 cases, 46.8%). Conclusions: CP/CPPS patients were characterized by the co-existence of LUTS, bowel dysfunction and somatic pain in one individual. The presence of multi-organ symptoms, combined with the high prevalence of spinal lesions associated with micturition reflex, suggesting the potential role of the spinal lesions in the development of CP/CPPS.

Directed evolution of AAV accounting for long-term and enhanced transduction of cardiovascular endothelial cells in vivo.

Cardiac endothelial cells (ECs) are important targets for cardiovascular gene therapy. However, the approach of stably transducing ECs in vivo using different vectors, including adeno-associated virus (AAV), remains unexamined. Regarding this unmet need, two AAV libraries from DNA shuffling and random peptide display were simultaneously screened in a transgenic mouse model. Cardiac ECs were isolated by cell sorting for salvage of EC-targeting AAV. Two AAV variants, i.e., EC71 and EC73, enriched in cardiac EC, were further characterized for their tissue tropism. Both of them demonstrated remarkably enhanced transduction of cardiac ECs and reduced infection of liver ECs in comparison to natural AAVs after intravenous injection. Significantly, persistent transgene expression was maintained in mouse cardiac ECs in vivo for at least 4 months. The EC71 vector was selected for delivery of the endothelial nitric oxide synthase (eNOS) gene into cardiac ECs in a mouse model of myocardial infarction. Enhanced eNOS activity was observed in the mouse heart and lung, which was correlated with partially improved cardiac function. Taken together, two AAV capsids were evolved with more efficient transduction in cardiovascular endothelium in vivo, but their endothelial tropism might need to be further optimized for practical application to cardiac gene therapy.

Irreducible Traumatic Radial Head Dislocation Due to Annular Ligament Interposition in a Child with Ulnar Plastic Deformation: A Case Report.

BACKGROUND: The traumatic dislocation of the radial head in children is commonly treated by closed reduction. Sometimes, however, this strategy of treatment may not be effective due to the location of soft tissues in the radio-shoulder joint. The literature presents a few cases of the irreducible radial head dislocation with ulnar plastic deformation. Because it is a relatively rare condition, such a traumatic dislocation can be easily missed. Neglected injuries can lead to unwanted complications and unpredictable surgical outcomes. CASE PRESENTATION: This study presents a relatively rare case of traumatic radial head dislocation with ulnar plastic deformation in a 3-year-old child, which was successfully treated by open reduction. The examined case did not require osteotomy and ligamentous reconstruction. The initial attempt of closed reduction failed due to annular ligament interposition, which has been detected on MRI. After 3 months of treatment, the range of motion of the operated arm gradually improved. At the 6-month follow-up, the Mayo elbow-performance score indicated an excellent treatment outcome. CONCLUSIONS: The delayed treatment of radial head dislocation with ulnar plastic deformation can hinder the supination and pronation of the forearm, resulting in elbow/forearm deformity. The earlier this condition is detected, the easier it will be to treat it and the better the treatment outcome will be. The examined case of irreversible traumatic dislocation, successfully treated by open reduction, may help to treat radial head dislocation better.

[Expression of SQSTM1 in papillary thyroid carcinoma and its influence on invasion, migration and proliferation of papillary thyroid cancer cells].

Objective: To investigate the expression of SQSTM1 in thyroid papillary carcinoma and its influence on the invasion and migration of thyroid papillary carcinoma cells TPC-1. Methods: From April to June 2019, cancer tissues and adjacent tissues of 21 cases with thyroid papillary carcinoma in the First Affiliated Hospital of Zhengzhou University were collected, and the expression of SQSTM1 was detected by RT-qPCR. SQSTM1 knockdown cell line SQSTM1-KD-TPC-1 was constructed in TPC-1 cells by lentivirus transfection. RT-qPCR was used to detect SQSTM1 expression in TPC-1 cells and SQSTM1-KD-TPC-1 cells. The changes of invasion and migration before and after SQSTM1 knockdown in TPC-1 cells were detected by transwell test. The proliferation of TPC-1 and SQSTM1-KD-TPC-1 cells were detected by MTT and clone formation test. RT-qPCR was used to detect the gene expression of proliferation related proteins. Results: The expression of SQSTM1 in papillary thyroid carcinoma tissues was significantly higher than that in normal adjacent tissues, and 76.2%(16/21) of the petients showed high mRNA expression. Knock down SQSTM1 significantly inhibited the ability of tumor proliferation, invasion and migration, and the expression of proliferation-related proteins were significantly decreased (P<0.01), indicating that SQSTM1 was involved in the regulation of proliferation related pathway mechanism. Conclusion: SQSTM1 significantly promotes invasion, migration and proliferation in thyroid papillary cancer cells TPC-1 and may be a potential gene therapy target.

Threshold for lateral meniscal body extrusion on MRI in middle-aged and elderly patients with symptomatic knee osteoarthritis.

PURPOSE: To determine the MRI-based threshold of lateral meniscal body extrusion (LMBE) that are associated with meniscal damage, cartilage damage and radiological knee osteoarthritis (OA). MATERIALS AND METHODS: A total of 142 patients (59 men and 83 women) with a mean age of 57.2±7.9 (SD) years (range: 41-77 years) with symptomatic knee OA were included. Radiological assessment was performed using the Kellgren-Lawrence scoring system. Meniscus and cartilage damage were assessed using the whole-organ magnetic resonance imaging score. Meniscal extrusion was quantified on coronal sections of intermediate-weighted MRI sequences. Differences between medial and lateral compartments in meniscal extrusion and incidence of tibiofemoral OA-related structural changes were assessed using Wilcoxon signed rank test and Bowker test. Receiver operating characteristic curves and Youden index were used for determining thresholds for meniscal extrusion. RESULTS: A total of 142 knees were assessed. Meniscal body extrusion distances between medial and lateral compartments were significantly different in the entire sample, and in subjects with and without radiological knee OA (P<0.05 for all). The incidence of structural changes between medial and lateral compartments were significantly different (P=0.003 for meniscal damage; P=0.001 for femoral cartilage damage). Three mm and 2mm were determined to be the optimal thresholds for medial and lateral meniscal body extrusion, respectively. CONCLUSION: Medial and lateral meniscal body extrusion were associated with the incidence of OA-related knee structural changes in symptomatic patients with knee OA. A threshold of 2mm for LMBE with respect to meniscal damage, cartilage damage and radiological knee OA was determined.

[The inhibitory effect of CtBP-interacting protein on the oxidative damage of cerebral endothelia cells].

Objective: To explore the effect of CtBP-Interacting protein (CtIP) on oxidative damage of cerebral endothelia cells and its mechanism. Method: Cerebral endothelia cells were stimulated by TBHP to induce oxidative damage. The cell line of CtIP gene were prepared by over-expression and interfering lentivirus technology. Cell damage was detected by immunofluorescence assay of cysteinyl aspartate specific proteinase-3 (Caspase-3). The expression of CtIP and Caspase-3 protein was detected by Western blotting, and the related genes of CtIP signaling pathway were detected by Realtime RT-PCR. Result: The results of immunofluorescence and Western blotting showed that overexpression of CtIP inhibited the Caspase-3 expression reducing to 1/3 level compared with normal cultured cerebral endothelia cells. Interfering with CtIP expression resulted in the Caspase-3 expression increased significantly to 4/5 level compared with normal cultured cerebral endothelia cells and cerebral endothelia cells were damaged more severely. Realtime RT-PCR data showed that expression of CtIP significantly increased the expression of BRCA1 and ZBRK1 genes, but inhibited the expression of p21 gene. Conclusion: It is confirmed that CtIP gene has the significantly inhibitory effect on injured cerebral endothelia cells, and the regulatory relationship between CtIP gene and BRCA1, ZBRK1 and p21 genes in the process of injury are determined.

Diphtheria toxoid dissolving microneedle vaccination: Adjuvant screening and effect of repeated-fractional dose administration.

In this study the effect of repeated-fractional intradermal administration of diphtheria toxoid (DT) compared to a single administration in the presence or absence of adjuvants formulated in dissolving microneedles (dMNs) was investigated. Based on an adjuvant screening with a hollow microneedle (hMN) system, poly(I:C) and gibbsite, a nanoparticulate aluminum salt, were selected for further studies: they were co-encapsulated with DT in dMNs with either a full or fractional DT-adjuvant dose. Sharp dMNs were prepared regardless the composition and were capable to penetrate the skin, dissolve within 20 min and deposit the intended antigen-adjuvant dose, which remained in the skin for at least 5 h. Dermal immunization with hMN in repeated-fractional dosing (RFrD) resulted in a higher immune response than a single-full dose (SFD) administration. Vaccination by dMNs led overall to higher responses than hMN but did not show an enhanced response after RFrD compared to a SFD administration. Co-encapsulation of the adjuvant in dMNs did not increase the immune response further. Immunization by dMNs without adjuvant gave a comparable response to subcutaneously injected DT-AlPO4 in a 15 times higher dose of DT, as well as subcutaneous injected DT-poly(I:C) in a similar DT dose. Summarizing, adjuvant-free dMNs showed to be a promising delivery tool for vaccination performed in SFD administration.

Structural Characterization and Immune Activity Screening of Polysaccharides With Different Molecular Weights From Astragali Radix.

Saccharides are the most abundant substance with the strongest immunological activity in Astragali Radix (AR). However, systematic structure study and immunoactivity screening of polysaccharides with different molecular weights (Mw) in AR have yet to be conducted. In this study, Astragalus polysaccharides (APSs) were divided into three fragments of different Mw values, >2,000 kDa (APS-Ⅰ), about 10 kDa (APS-Ⅱ), and about 300 Da (APS-Ⅲ), by using ultrafiltration for the first time. The structural differences of the three products were determined on the basis of monosaccharide composition, FT-IR spectrum, linkage analysis, and nuclear magnetic resonance analysis. Cellular immune activity experiments in vitro and cyclophosphamide immunosuppression animal model experiments in vivo for nonspecific and specific immunoactivity screening were applied to identify the most immunogenic fragment in APSs. Linkage analysis results showed that APS-Ⅰ, APS-Ⅱ, and APS-Ⅲ have different attachment sites of monosaccharide residues. Immune screening experiments indicated that the Mw of the APSs influenced their activity, and APS-Ⅱ had the strongest immunoenhancing activity among the products. This research may serve as a reference for further study on APSs with different structures and immune activities, and as a guidance for the quality control of APSs and the development of new APS products.

[Effectiveness of snail control by immersion of molluscicides through tide diversion in marshlands: a field evaluation].

OBJECTIVE: To compare the effectiveness of snail control between immersion of molluscicides through tide diversion and mollusciciding by spraying in marshland areas. METHODS: Immersion of 26% suspension concentrate of metaldehyde and niclosamide through tide diversion and spraying 26% suspension concentrate of metaldehyde and niclosamide alone were employed for snail control in two neighboring snail-breeding marshlands, and snails were surveyed before and after mollusciciding. The mortality of snails and the density of living snails were estimated. RESULTS: The density of living snails reduced by 72.19% and 100.00% 1 and 2 years after immersion of 26% suspension concentrate of metaldehyde and niclosamide through tide diversion, and 5.93% and 18.15% 1 and 2 years after spraying 26% suspension concentrate of metaldehyde and niclosamide alone. CONCLUSIONS: Immersion of 26% suspension concentrate of metaldehyde and niclosamide through tide diversion is significantly superior to spraying 26% suspension concentrate of metaldehyde and niclosamide along for snail control, and implementation of immersion of 26% suspension concentrate of metaldehyde and niclosamide through tide diversion for more than 2 successive years may achieve a higher snail control efficiency.

Efficient nitrogen-vacancy centers' fluorescence excitation and collection from micrometer-sized diamond by a tapered optical fiber in endoscope-type configuration.

Using an optical fiber to both excite the nitrogen-vacancy (NV) center in diamond and collect its fluorescence is essential to build NV-based endoscope-type sensor. Such endoscope-type sensor can reach inaccessible fields for traditional NV-based sensors built by bulky optical components and extend the application areas. Since single NV's fluorescence is weak and can easily be buried in fluorescence from optical fiber core's oxide defects excited by the green laser, fixing a micrometer size diamond containing high-density NVs rather than a nanodiamond containing single NV or several NVs on the apex of an optical fiber to build an endoscope-type sensor is more implementable. Unfortunately, due to small numerical aperture (NA), most of the optical fibers have a low fluorescence collection efficiency, which limits the sensitivity and spatial resolution of the NV-based endoscope-type sensor. Here, using a tapered optical fiber (TOF) tip, we significantly improve the efficiency of the laser excitation and fluorescence collection of the NV ensembles in diamond. This could potentially enhance the sensitivity and spatial resolution of the NV-based endoscope-type sensor. Numerical calculations show that the TOF tip delivers a high NA and has a high NV excitation and fluorescence collection efficiency. Experiments demonstrate that such TOF tip can obtain up to over 7-fold excitation efficiency and over 15-fold fluorescence collection efficiency of that from a flat-ended fiber (non-TOF) tip.

Individualized medication of voriconazole: a practice guideline of the division of therapeutic drug monitoring, chinese pharmacological society

BACKGROUND: Voriconazole (VRZ) is a second-generation triazole antifungal agent with broad-spectrum activity. It is available in both intravenous and oral formulations, and is primarily indicated for treating invasive aspergillosis. The most commonly used dose for adults is 4 mg/kg or 200 mg twice daily. VRZ presents nonlinear pharmacokinetics in adults, whereas drug-drug interactions and cytochrome P450 2C19 (CYP2C19) polymorphism are of great concern for VRZ. Because the liquid chromatography method has been widely used for measuring VRZ blood concentration, and target VRZ blood concentration has been recommended in some guidelines regarding efficacy and safety, therapeutic drug monitoring is considered as a useful tool for VRZ-individualized medication. Also, the CYP2C19 genotype test is available for guiding relevant drugs use in some health care facilities. Our objective was to develop an evidence-based practice guideline for VRZ-individualized medication. METHODS: We followed the latest guideline definition from the Institute of Medicine and referred to the World Health Organization handbook for guideline development. The guideline was initially registered in the International Practice Guidelines Registry Platform (IPGRP-2015CN001). The guideline is, in principle, targeted at all Chinese health care providers. The quality of evidence and strength of the recommendations were assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. RESULTS: Twenty-six recommendations were formulated regarding therapeutic drug monitoring, special groups of patients, drug safety, off-indication use, and drug-drug interactions. Of them, 12 were strong recommendations. Most quality of evidence was low, very low, or expert opinions. CONCLUSIONS: We developed an evidence-based practice guideline for VRZ-individualized medication, which provided comprehensive and practical recommendations for health care providers. The development of the guideline exposed several research gaps to improve VRZ use.

Properties of oscillatory neuronal activity in the basal ganglia and thalamus in patients with Parkinson's disease.

BACKGROUND: The cardinal features of Parkinson's disease (PD) are bradykinesia, rigidity and rest tremor. Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms. This study aims to characterize properties of oscillatory activity in the basal ganglia and motor thalamus in patients with PD. METHODS: Twenty-nine patients with PD who underwent bilateral or unilateral electrode implantation for subthalamic nucleus (STN) DBS (n = 11), unilateral pallidotomy (n = 9) and unilateral thalamotomy (n = 9) were studied. Microelectrode recordings in the STN, globus pallidus internus (GPi) and ventral oral posterior/ventral intermediate of thalamus (Vop/Vim) were performed. Electromyography of the contralateral limbs was recorded. Single unit characteristics including interspike intervals were analyzed. Spectral and coherence analyses were assessed. Mean spontaneous firing rate (MSFR) of neurons was calculated. Analysis of variance and X2 test were performed. RESULTS: Of 76 STN neurons, 39.5% were 4-6 Hz band oscillatory neurons and 28.9% were ß frequency band (ßFB) oscillatory neurons. The MSFR was 44.2 ± 7.6 Hz. Of 62 GPi neurons, 37.1% were 4-6 Hz band oscillatory neurons and 27.4% were ßFB neurons. The MSFR was 80.9 ± 9.6 Hz. Of 44 Vop neurons, 65.9% were 4-6 Hz band oscillatory neurons and 9% were ßFB neurons. The MSFR was 24.4 ± 4.2 Hz. Of 30 Vim oscillatory neurons, 70% were 4-6 Hz band oscillatory neurons and 13.3% were ßFB neurons. The MSFR was 30.3 ± 3.6 Hz. Further analysis indicated that proportion of ßFB oscillatory neurons in STN and GPi was higher than that of similar neurons in the Vop and Vim (P < 0.05). Conversely, the proportion of 4-6 Hz band oscillatory neurons and tremor related neurons in the Vim and Vop was higher than that of STN and GPi (P < 0.05). The highest MSFR was for GPi oscillatory neurons whereas the lowest MSFR was for Vop oscillatory neurons (P < 0.005). CONCLUSION: The alterations in neuronal activity in basal ganglia play a critical role in generation of parkinsonism. ß oscillatory activity is more prominent in basal ganglia than in thalamus suggesting that the activity likely results from dopaminergic depletion. While both basal ganglia and thalamus have tremor activity, the thalamus appears to play a more important role in tremor production, and basal ganglia ß oscillatory activity might be the trigger.

The study on pathological mechanism and solution method for spinal cord ischemia reperfusion injury.

OBJECTIVE: We aimed at investigating the pathological mechanism changing of injury during reperfusion injury, reperfusion time correlation and compliance, finding the blood supply and improving the secondary damage. MATERIALS AND METHODS: A total of 180 patients who underwent a surgical procedure and that received normal saline intraperitoneally immediately after the patients' aortic occlusions were investigated. Patients were divided in three groups. Experimental conditions and programs were designed for various approaches. RESULTS: Thirty min after the onset of ischemia, we found a decrease in the local blood flow in the lumbar spinal cord, almost -77.48% of the baseline, which was reversed partially by initial reperfusion, even exceeding the baseline level. However, 1 hour after reperfusion, the blood flow was again decreased to the level below the baseline, followed by a decline to 207.13% ± 38.25 PU for 3 h without any recovery. Attenuating this secondary damage with neuroprotective strategies requires an understanding of these pathophysiologic processes. CONCLUSIONS: This study showed the pathological mechanism changes during reperfusion injury and reperfusion time correlation and compliance, and analyzed some of the important pathophysiologic processes involved in secondary damage after spinal cord injury. Moreover, our research discusses a number of pharmacologic therapies that have either been studied or have future potential for this devastating injury.

Linking seed germination and plant height: a case study of a wetland community on the eastern Tibet Plateau.

Seed germination is the earliest trait expressed in a plant's life history, and it can directly affect the expression of post-germination traits. Plant height is central to plant ecological strategies, because it is a major determinant of the ability of a species to compete for light. Thus, linking seed germination and plant height at the community level is very important to understanding plant fitness and community structure. Here, we tested storage condition and temperature requirements for germination of 31 species from a wetland plant community on the eastern Tibet Plateau and analysed correlation of germination traits with plant height in relation to storage condition. Germination percentage was positively related to plant height, and this relationship disappeared when seeds were incubated at a low temperature (i.e. 5 °C) or after they were stored under wet-cold conditions. The response of seeds to dry+wet-cold storage was negatively related to plant height. Based on the scores of each species on the first two principal components derived from PCA, species were classified into two categories by hierarchical clustering, and there was a significant difference between germination and plant height of species in these two categories. These results suggest that the requirements for seed germination together with seasonal change in environmental conditions determine the window for germination and, in turn, plant growth season and resource utilisation and ultimately plant height.

Observation and analysis of clinical efficacy of melatonin on AOPP-induced delirium patients.

OBJECTIVE: To observe the clinical efficacy of melatonin on acute organophosphorus pesticide poisoning (AOPP). PATIENTS AND METHODS: In this randomized control trial, a total of 59 AOPP patients with subsequent delirium were randomly divided into two groups, the melatonin group (n=29) and the placebo-controlled group (n=30). Patients in the melatonin group (n=29) underwent oral administration of melatonin in addition to the symptomatic treatment, while those in the placebo-controlled group took a placebo in addition to the symptomatic treatment. Before and 12 weeks after treatment, adverse events of participants in both groups were classified according to their scores in the assessment of the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression-Severity of Illness (CGI-SI) scale, and Treatment Emergent Symptom Scale (TESS). RESULTS: The excellence rates of patients in the melatonin group and the placebo-controlled group were 82.75% and 30.00%, respectively (χ2 = 17.054, p < 0 .01). No adverse events were identified in all participants. CONCLUSIONS: Melatonin may serve as an effective drug in the treatment of AOPP-induced deliration.