[Analysis of disease progression rate and related factors in amyotrophic lateral sclerosis patients at initial visit].

Objective: To find out the relationship of the progression rate of amyotrophic lateral sclerosis (ALS) patients with relevant clinical indicators at initial visit so as to enrich the knowledge of ALS at its early stage. Methods: The clinical data of 282 patients diagnosed with ALS at Neurology Department of the First Medical Center, Chinese PLA General Hospital from June 2016 to March 2021 were collected in order to make a retrospective analysis of the dynamic change of the progression rate (ΔFS) and influencing factors, and thus a classification of the progression rate will be summarized. Results: Among 282 patients, 164 were males and 118 were females. The age of onset was (53±11) years old. The ΔFS had a negative exponential relationship with delay time of diagnosis no matter what kinds of onset the patients experienced (upper limb onset, lower limb onset or bulbar onset). The ΔFS for the limb function sub-group had a similar functional relationship with diagnostic delay in patients with either upper limb onset or lower limb onset. The statistical model indicated that the disease progression rate of ALS at initial visit can be classified into three types (high speed type: ΔFS≥1.0 score/month; moderate speed type: 0.5≤ΔFS<1.0 score/month; low speed type: ΔFS<0.5 score/month). The critical values of the three types in patients with upper limb onset were 8 and 20 months, while 9 and 24 months for lower limb onset patients, and 9 and 36 months for bulbar onset patients. At initial visit, there were significant statistical differences among these three types in age at onset (P=0.008), diagnostic delay (P<0.001), ALS functional rating scale-revised (ALSFRS-R) score (P<0.001) and onset site (P=0.006). The age at onset in moderate speed type was significantly greater than that of the slow speed type [(54.9±10.4) years vs (50.2±9.6) years, P=0.002]. The diagnostic delay in high speed type [6 (4, 10) months] was significantly shorter than that in moderate speed type [12 (8, 19) months, P<0.001] and low speed type [22 (14, 36) months, P<0.001], and the moderate speed type was shorter in comparison with low speed type (P<0.001). As for the ALSFRS-R score, the high speed type [36(32, 39)] was significantly lower than the moderate speed type [39 (36, 42), P<0.001] and low speed type [42 (39, 44), P<0.001], and the moderate speed type was lower in comparison with low speed type (P=0.002). The proportion of cases with upper limb onset in high speed type (20.3%) was significantly lower than that in low speed type (42.2%, P<0.001) and moderate speed type (37.5%, P=0.014). By contrast, the proportion of cases with lower limb onset in high speed type (39.2%) was significantly higher than that in low speed type (28.9%, P=0.023), however no difference was shown between the fast speed type and moderate speed type (32.0%, P=0.061). There was no difference among these three progression types in patients with bulbar onset. Conclusions: The disease progression rate of ALS at initial visit can be classified into three types including high speed, moderate speed and low speed. At early stage of ALS, ΔFS is affected by onset age, onset site, diagnostic delay and ALSFRS-R score.

An outbreak of hepatitis A in recently vaccinated students from ice snacks made from contaminated well water.

On 30 May 2006, township S in Sichuan Province, China, reported an outbreak of hepatitis A (HA) in students who had recently received HA vaccine. The concern was raised that the vaccine had caused the outbreak. We attempted to identify the source of infection and mode of transmission. A HA case was defined as onset of jaundice or anorexia since 1 April 2006 with a twofold elevation of alanine aminotransferase (ALT) and anti-HA virus-IgM in a resident of or visitor to the township. Exposures to vaccine and snacks of 90 case-students to those of 107 control-students were compared. Thirty-four per cent of cases ate ice slush compared to 4.7% of controls (OR 4.1), and 51% of cases ate snow cones compared to 17% of controls (OR 8.3). The ice snacks were made with well water. HA virus RNA was detected by reverse transcription-polymerase chain reaction from patients' blood and well water. Untreated well water poses important dangers to the public in areas where piped, potable water is available.

Atomic packing and short-to-medium-range order in metallic glasses.

Unlike the well-defined long-range order that characterizes crystalline metals, the atomic arrangements in amorphous alloys remain mysterious at present. Despite intense research activity on metallic glasses and relentless pursuit of their structural description, the details of how the atoms are packed in amorphous metals are generally far less understood than for the case of network-forming glasses. Here we use a combination of state-of-the-art experimental and computational techniques to resolve the atomic-level structure of amorphous alloys. By analysing a range of model binary systems that involve different chemistry and atomic size ratios, we elucidate the different types of short-range order as well as the nature of the medium-range order. Our findings provide a reality check for the atomic structural models proposed over the years, and have implications for understanding the nature, forming ability and properties of metallic glasses.

Icosahedral short-range order in amorphous alloys.

We have characterized the icosahedral short-range order in amorphous solids using local environment probes. Such topological local order is pronounced even in an amorphous alloy that does not form quasicrystalline phases upon crystallization, as demonstrated by the extended x-ray absorption fine structure and x-ray absorption near-edge structure of a Ni-Ag amorphous alloy analyzed through reverse Monte Carlo simulations.

Sensitivity to citrus red mite and the development of asthma.

BACKGROUND AND OBJECTIVE: The citrus red mite (Panonychus citri, CRM) is an important allergen in the development of asthma and/or rhinitis in citrus farmers and a common sensitizing allergen among exposed children. The aim of this study was to evaluate CRM-induced skin responses and serum-specific IgE, IgG4, and IgG1 responses, and their role in the development of asthmatic symptoms among exposed adolescents. METHODS: A total of 100 adolescents between the ages of 15 and 16 years (59 males and 41 females) were randomly recruited. All of the subjects responded to the ISAAC questionnaire themselves. Skin prick tests to CRM were carried out and serum-specific IgE, IgG4, and IgG1 levels were measured using ELISA. RESULTS: Fourteen subjects (14%) had experienced wheezing during last 12 months. The wheal size formed by CRM was larger than 3 mm in 23 subjects (23%). Serum-specific IgE levels were elevated in 21 subjects (21%), IgG4 levels were elevated in 32 subjects (32%), and IgG1 levels were elevated in five subjects (5%). The prevalence of wheezing during last 12 months was significantly higher in subjects with positive skin responses and serum-specific IgE responses induced by CRM than in those with negative skin responses and low serum IgE responses (30.4% versus 9.0%, P < .05; 33.3% versus 8.7%, P < .05). The prevalence of wheezing, however, did not differ according to serum-specific IgG4 levels (9.4% versus 16.2%, P > .05). Skin responses to CRM showed a significant correlation with serum-specific IgE levels, but not with IgG1 and IgG4 levels. Serum CRM-specific IgE levels correlated with specific IgG1 and IgG4 levels, but no significant correlation was found between serum IgG1 and IgG4 levels. CONCLUSION: The specific IgE responses induced by CRM were prevalent among adolescents living near citrus farms, and may be important in the development of asthma. The specific IgG4 and IgG responses induced by CRM play a minimal role in the development of asthma symptoms.