Diagnostic status and epidemiological characteristics of community-acquired bacterial meningitis in children from 2019 to 2020: a multicenter retrospective study.

Community-acquired bacterial meningitis (CABM) is the main cause of morbidity and mortality in children. The epidemiology of CABM is regional and highly dynamic. To clarify the diagnostic status and epidemiological characteristics of children with CABM in this region, and pay attention to the disease burden, so as to provide evidence for the prevention and treatment of CABM. By retrospective case analysis, the clinical data of 918 CABM cases in children aged 0-14 years in Zhejiang Province from January, 2019 to December, 2020 were collected. The etiological diagnosis rate of CABM in children was 23.1%, the annual incidence rate 4.42-6.15/100,000, the annual mortality rate 0.06-0.09/100,000,the cure and improvement rate 94.4%, and the case fatality rate 1.4%. The total incidence of neuroimaging abnormalities was 20.6%. The median length of stay for CABM children was 20(16) days, with an average cost of 21,531(24,835) yuan. In addition, the incidence rate was decreased with age. Escherichia coli(E.coli) and group B Streptococcus agalactiae(GBS) were the principal pathogens in CABM infant<3 months(43.3%, 34.1%), and Streptococcus pneumoniae(S. pneumoniae) was the most common pathogen in children ≥ 3 months(33.9%). In conclusion, the annual incidence and mortality of CABM in children aged 0-14 years in Zhejiang Province are at intermediate and low level. The distribution of CABM incidence and pathogen spectrum are different in age; the incidence of abnormal neuroimaging is high; and the economic burden is heavy.

Wnt/b-Catenin Promotes the Osteoblastic Potential of BMP9 Through Down-Regulating Cyp26b1 in Mesenchymal Stem Cells

BACKGROUND@#All-trans retinoic acid (ATRA) promotes the osteogenic differentiation induced by bone morphogenetic protein 9 (BMP9), but the intrinsic relationship between BMP9 and ATRA keeps unknown. Herein, we investigated the effect of Cyp26b1, a critical enzyme of ATRA degradation, on the BMP9-induced osteogenic differentiation in mesenchymal stem cells (MSCs), and unveiled possible mechanism through which BMP9 regulates the expression of Cyp26b1. @*METHODS@#ATRA content was detected with ELISA and HPLC–MS/MS. PCR, Western blot, and histochemical staining were used to assay the osteogenic markers. Fetal limbs culture, cranial defect repair model, and micro–computed tomographic were used to evaluate the quality of bone formation. IP and ChIP assay were used to explore possible mechanism. @*RESULTS@#We found that the protein level of Cyp26b1 was increased with age, whereas the ATRA content decreased. The osteogenic markers induced by BMP9 were increased by inhibiting or silencing Cyp26b1 but reduced by exogenous Cyp26b1. The BMP9-induced bone formation was enhanced by inhibiting Cyp26b1. The cranial defect repair was promoted by BMP9, which was strengthened by silencing Cyp26b1 and reduced by exogenous Cyp26b1. Mechanically, Cyp26b1 was reduced by BMP9, which was enhanced by activating Wnt/b-catenin, and reduced by inhibiting this pathway. b-catenin interacts with Smad1/5/9, and both were recruited at the promoter of Cyp26b1. @*CONCLUSIONS@#Our findings suggested the BMP9-induced osteoblastic differentiation was mediated by activating retinoic acid signalling, viadown-regulating Cyp26b1. Meanwhile, Cyp26b1 may be a novel potential therapeutic target for the treatment of bone-related diseases or accelerating bone-tissue engineering.

Effects of Embryonic Inflammation and Adolescent Psychosocial Environment on Cognition and Hippocampal Staufen in Middle-Aged Mice.

Accumulating evidence has indicated that embryonic inflammation could accelerate age-associated cognitive impairment, which can be attributed to dysregulation of synaptic plasticity-associated proteins, such as RNA-binding proteins (RBPs). Staufen is a double-stranded RBP that plays a critical role in the modulation of synaptic plasticity and memory. However, relatively few studies have investigated how embryonic inflammation affects cognition and neurobiology during aging, or how the adolescent psychosocial environment affects inflammation-induced remote cognitive impairment. Consequently, the aim of this study was to investigate whether these adverse factors can induce changes in Staufen expression, and whether these changes are correlated with cognitive impairment. In our study, CD-1 mice were administered lipopolysaccharides (LPS, 50 µg/kg) or an equal amount of saline (control) intraperitoneally during days 15-17 of gestation. At 2 months of age, male offspring were randomly exposed to stress (S), an enriched environment (E), or not treated (CON) and then assigned to five groups: LPS, LPS+S, LPS+E, CON, and CON+S. Mice were evaluated at 3-month-old (young) and 15-month-old (middle-aged). Cognitive function was assessed using the Morris water maze test, while Staufen expression was examined at both the protein and mRNA level using immunohistochemistry/western blotting and RNAscope technology, respectively. The results showed that the middle-aged mice had worse cognitive performance and higher Staufen expression than young mice. Embryonic inflammation induced cognitive impairment and increased Staufen expression in the middle-aged mice, whereas adolescent stress/an enriched environment would accelerated/mitigated these effects. Meanwhile, Staufen expression was closely correlated with cognitive performance. Our findings suggested embryonic inflammation can accelerate age-associated learning and memory impairments, and these effects may be related to the Staufen expression.

Effects of Prenatal Exposure to Inflammation Coupled With Stress Exposure During Adolescence on Cognition and Synaptic Protein Levels in Aged CD-1 Mice.

Age-associated impairment of spatial learning and memory (AISLM) presents substantial challenges to our health and society. Increasing evidence has indicated that embryonic exposure to inflammation accelerates the AISLM, and this can be attributable, at least partly, to changed synaptic plasticity associated with the activities of various proteins. However, it is still uncertain whether social psychological factors affect this AISLM and/or the expression of synaptic protein-associated genes. Synaptotagmin-1 (Syt1) and activity-regulated cytoskeleton-associated protein (Arc) are two synaptic proteins closely related to cognitive functions. In this study, pregnant CD-1 mice received daily intraperitoneal injections of lipopolysaccharide (LPS) (50 µg/kg) or normal saline at days 15-17 of gestation, and half of the offspring of each group were then subjected to stress for 28 days in adolescence. The Morris water maze (MWM) test was used to separately evaluate spatial learning and memory at 3 and 15 months of age, while western blotting and RNAscope assays were used to measure the protein and mRNA levels of Arc and Syt1 in the hippocampus. The results showed that, at 15 months of age, control mice had worse cognitive ability and higher protein and mRNA levels of Arc and Syt1 than their younger counterparts. Embryonic exposure to inflammation or exposure to stress in adolescence aggravated the AISLM, as well as the age-related increase in Arc and Syt1 expression. Moreover, the hippocampal protein and mRNA levels of Arc and Syt1 were significantly correlated with the performance in the learning and memory periods of the MWM test, especially in the mice that had suffered adverse insults in early life. Our findings indicated that prenatal exposure to inflammation or stress exposure in adolescence exacerbated the AISLM and age-related upregulation of Arc and Syt1 expression, and these effects were linked to cognitive impairments in CD-1 mice exposed to adverse factors in early life.

A Long-Term Enriched Environment Ameliorates the Accelerated Age-Related Memory Impairment Induced by Gestational Administration of Lipopolysaccharide: Role of Plastic Mitochondrial Quality Control.

Studies have shown that gestational inflammation accelerates age-related memory impairment in mother mice. An enriched environment (EE) can improve age-related memory impairment, whereas mitochondrial dysfunction has been implicated in the pathogenesis of brain aging. However, it is unclear whether an EE can counteract the accelerated age-related memory impairment induced by gestational inflammation and whether this process is associated with the disruption of mitochondrial quality control (MQC) processes. In this study, CD-1 mice received daily intraperitoneal injections of lipopolysaccharide (LPS, 50 µg/kg) or normal saline (CON group) during gestational days 15-17 and were separated from their offspring at the end of normal lactation. The mothers that received LPS were divided into LPS group and LPS plus EE (LPS-E) treatment groups based on whether the mice were exposed to an EE until the end of the experiment. At 6 and 18 months of age, the Morris water maze test was used to evaluate spatial learning and memory abilities. Quantitative reverse transcription polymerase chain reaction and Western blot were used to measure the messenber RNA (mRNA) and protein levels of MQC-related genes in the hippocampus, respectively. The results showed that all the aged (18 months old) mice underwent a striking decline in spatial learning and memory performances and decreased mRNA/protein levels related to mitochondrial dynamics (Mfn1/Mfn2, OPA1, and Drp1), biogenesis (PGC-1α), and mitophagy (PINK1/parkin) in the hippocampi compared with the young (6 months old) mice. LPS treatment exacerbated the decline in age-related spatial learning and memory and enhanced the reduction in the mRNA and protein levels of MQC-related genes but increased the levels of PGC-1α in young mice. Exposure to an EE could alleviate the accelerated decline in age-related spatial learning and memory abilities and the accelerated changes in MQC-related mRNA or protein levels resulting from LPS treatment, especially in aged mice. In conclusion, long-term exposure to an EE can counteract the accelerated age-related spatial cognition impairment modulated by MQC in CD-1 mother mice that experience inflammation during pregnancy.

Synthesis of Graphene Oxide Modified Magnetic Chitosan Having Skin-Like Morphology for Methylene Blue Adsorption.

In this work, a novel magnetic biomass adsorbent was synthesized by a simple method. The adsorbent prepared from chitosan, graphene oxide and CoFe2O4 with a 'skin-like' morphology had a strong adsorption capacity for methylene blue adsorption and was easily separated from the liquid. The synthesized samples were characterized by scanning electron microscope, energy dispersive spectroscopy, fourier transform infrared spectroscopy and X-ray diffractomer. The adsorption capacity of the adsorbent was evaluated. The various factors affecting the adsorption performance were explored. Meanwhile, the adsorption process was simulated by five kinetic models and four isotherm models. The adsorption process was well described by the Pseudo-second-order kinetic model and the Freundlich isotherm model. ΔG < 0, ΔH < 0 and ΔS < 0 indicate that the adsorption process was a spontaneous, exothermic and randomness decrease process. The adsorbents loaded with methylene blue could be desorbed by soaking in dilute hydrochloric acid. The adsorption-desorption cycle experimental results showed that the adsorbent had good reusability performance.

Radiology on Board the PLA(N) Peace Ark Hospital Ship During a Humanitarian Medical Relief Mission to the Philippines.

OBJECTIVE: From November 24 to December 10, 2013, the Chinese People's Liberation Army Navy [PLA(N)] hospital ship Peace Ark was deployed to the Leyte Gulf in the Philippines to provide humanitarian medical relief in Tacloban after Typhoon Haiyan. The purpose of this study was to assess the radiological services aboard the ship to provide guidance for future missions. METHODS: A retrospective review was performed on a cohort of 109 patients who underwent digital radiography (DR) and 59 patients who underwent computed tomography (CT) scans during a 16-day period during a humanitarian medical relief mission to the Philippines. Patient demographics, DR findings, and CT findings were analyzed. RESULTS: The mean age of the 109 DR patients was 39.7 years for the 64 males and 43.7 years for the 45 females. A total of 148 DR examinations were performed of the chest (n=109), extremities (n=35), and spine (n=4). The mean age of the 59 CT patients was 43.8 years for the 32 males and 49.1 years for the 27 females. A total of 72 CT scans were performed of the head and neck (n=36), thorax (n=24), abdomen (n=5), spine (n=4), and extremities (n=3). The imaging findings mainly included disaster-related and non-disaster-related fractures, pulmonary tuberculosis, pulmonary infection, acute brain infarction, intracranial hematoma, and occupying lesions. CONCLUSION: Analysis of radiological services during a humanitarian medical relief mission to the Philippines provided meaningful information for future humanitarian medical relief missions.

Prevalence of open-angle glaucoma in southwestern China: the Yongchuan Glaucoma Study / 华中科技大学学报（医学）（英德文版）

This study examined the prevalence of primary open-angle glaucoma (POAG) among residents aged ≥50 years living in Yongchuan district of Chongqing. Stratified cluster sampling was employed in random selection to estimate the prevalence of glaucoma from April to June, 2005. Twenty-nine villages or neighborhood communities were randomly selected in urban area (Zhongshan Road), suburban area (Shanjiao Town) and exurban area (Zhutuo Town) of this district. All the respondents underwent detailed ophthalmic examinations. The examinations included questionnaire investigation, visual acuity test, naked-eye examination, measurement of peripheral anterior chamber depth (Van Herrick's technique), detection of intraocluar pressure (IOP) with a Perkins hand-held applanation tonometer (HA-2) and examination of the optic disc by using a 78 diopters (D) lens (including the cup-disc ratio, cup/disc ratio asymmetries, horizontal and vertical diameter, notching and optic disc hemorrhages). A total of 5938 residents were actually examined, and the response rate was 85.19%. The crude prevalence of POAG was 0.86% (n=51/5938, 95% CI 0.64%-1.11%). There were 24 males and 27 females in the glaucoma group. The glaucoma prevalence was not significant different in case number between the male and female subjects (P=0.4900). Furthermore, no association between age or schooling and POAG was noted (P=0.8030, 0.0734). Out of 51 subjects with POAG, unilateral glaucoma-related blindness occurred in 38 subjects (74.5%) and bilateral glaucoma-related blindness was found in 7 subjects (13.7%). This study exhibited that the prevalence of POAG was 0.86% among residents aged ≥50 years living in Yongchuan District of Chongqing. The vision loss caused by POAG in this population was obviously higher than that previously reported in other studies. Glaucoma management, detection of affected persons and handling of the burden of glaucoma should be the priorities of the agenda of local health authorities of Western China.

Prevalence of open-angle glaucoma in southwestern China: the Yongchuan Glaucoma study / 华中科技大学学报（医学）（英德文版）

This study examined the prevalence of primary open-angle glaucoma (POAG) among residents aged ≥50 years living in Yongchuan district of Chongqing. Stratified cluster sampling was employed in random selection to estimate the prevalence of glaucoma from April to June, 2005. Twenty-nine villages or neighborhood communities were randomly selected in urban area (Zhongshan Road), suburban area (Shanjiao Town) and exurban area (Zhutuo Town) of this district. All the respondents underwent detailed ophthalmic examinations. The examinations included questionnaire investigation, visual acuity test, naked-eye examination, measurement of peripheral anterior chamber depth (Van Herrick's technique), detection of intraocluar pressure (IOP) with a Perkins hand-held applanation tonometer (HA-2) and examination of the optic disc by using a 78 diopters (D) lens (including the cup-disc ratio, cup/disc ratio asymmetries, horizontal and vertical diameter, notching and optic disc hemorrhages). A total of 5938 residents were actually examined, and the response rate was 85.19%. The crude prevalence of POAG was 0.86% (n=51/5938, 95% CI 0.64%-1.11%). There were 24 males and 27 females in the glaucoma group. The glaucoma prevalence was not significant different in case number between the male and female subjects (P=0.4900). Furthermore, no association between age or schooling and POAG was noted (P=0.8030, 0.0734). Out of 51 subjects with POAG, unilateral glaucoma-related blindness occurred in 38 subjects (74.5%) and bilateral glaucoma-related blindness was found in 7 subjects (13.7%). This study exhibited that the prevalence of POAG was 0.86% among residents aged ≥50 years living in Yongchuan District of Chongqing. The vision loss caused by POAG in this population was obviously higher than that previously reported in other studies. Glaucoma management, detection of affected persons and handling of the burden of glaucoma should be the priorities of the agenda of local health authorities of Western China.

Induction of interleukin 2 expression in the liver for the treatment of H22 hepatoma in mice.

BACKGROUND AND AIMS: We designed this study to evaluate the ability of a plasmid carrying an RU486 regulatory system to induce expression of interleukin-2 (IL-2) gene and to examine the antitumour efficacy of the induced IL-2 gene. METHODS: The plasmid pRS-mIL-2,which contains an RU486 inducible system and IL-2 gene was injected into mice. Sera and tissues from liver, spleen, lungs and kidneys were taken to test the properties of the plasmid. To examine the antitumour efficacy of pRS-mIL-2, tumours were established in the liver by direct inoculation of H22 hepatoma cells. RESULTS: The IL-2 levels in serum correlated with the dose of plasmid and RU486. High and sustained IL-2 levels could be achieved by administration of RU486 every day. The mRNA of transgene IL-2 was found only in the liver. Treatment of mice with pRS-mIL-2 plus RU486 resulted in the significant reduction in tumour volume compared with control groups. CONCLUSIONS: Tight temporal and spatial control of transgene IL-2 expression can be achieved by a plasmid containing an RU486 inducible system driven by liver specific promoter. pRS-mIL-2 exhibited strong antitumour efficacy following consecutive induction with RU486.

[Expressions of survivin and GRIM-19 in prostate cancer].

OBJECTIVE: To investigate the expressions of survivin and GRIM-19 in prostatic cancer tissue and their clinical implications. METHODS: We detected the expressions of survivin and GRIM-19 in the tissues of normal prostate (NP), benign prostate hyperplasia (BPH) and prostate cancer (PCa) using immunohistochemical staining, RT-PCR and Western blot, and processed the data by SPSS12. RESULTS: The positive rates of survivin expression were 6.25% , 18.18% and 90.62% in NP, BPH and PCa (P < 0.01), while those of GRIM-19 were 87.50%, 81.82% and 9.37% , respectively (P < 0.01). Semiquantitative RT-PCR and immunohistochemical staining showed that both survivin mRNA and survivin expressions were highly positive in PCa but negative in NP and BPH. Western blot exhibited that the survivin protein was expressed strongly in PCa but weakly in NP and BPH, while the GRIM-19 protein was expressed just contrariwise (P < 0.01). CONCLUSION: The expressions of survivin and GRIM-19 may be closely correlated with the pathogenesis of prostate cancer.

[Value of multiplanar reconstruction of lumbar nerve roots on the same level by high resolution computed tomography in diagnosis of lumbar disc herniation and/or bulge].

OBJECTIVE: To explore value of multiplanar reconstruction of lumbar nerve roots on the same level by high resolution computed tomography (HRCT) in diagnosis of lumbar disc herniation and/or bulge (LDHB). METHODS: Thirty-one patients with manifestations of typical nerve root compression, such as lumbago and tenderness of percussion pain at the corresponding sites were scanned with 16-slice spiral CT and multiplanar reconstruction of lumbar nerve roots on the same level with the workshop ADW4.150, and were diagnosed as with LDHB with 50 segments. The diagnoses were confirmed by operation later. RESULTS: This technique showed not only the existence of LDHB but also the signs of nerve root compression, including the touch of nerve roots with the LDHB (100%), translocation of nerve roots (96%), morphological change (94%), changes of diameter (92%), changes of direction (88%), changes of density (80%), increase of the angle between the dural sac and nerve root (76%), etc. Along with the prolonging of time, the nerve roots became thinner in all segments. CONCLUSION: Multiplanar reconstruction of lumbar nerve roots on the same level by high resolution computed tomography is valuable in the diagnosis of lumbar disc herniation and/or bulge.

[Features of obturator nerve by high-resolution CT at the same slice with multiplanar planar reconstruction techniques and clinic value thereof].

OBJECTIVE: To explore the features of obturator nerve (ON) by high-resolution CT (HRCT) at the same slice with multiplanar planar reconstruction techniques and clinic value thereof. METHODS: The normal lumbar vertebral bodies of 60 healthy adults and the abnormal lumbar vertebral bodies of 31 patients with ON disorders were scanned with 16-slice spiral CT, multiplanar reconstruction was conducted in the Workstation ADW4. 1, with UNIX system and DICOM form. The images at the same slice were studied. RESULTS: The shapes, thickness, direction, length, adjourning relationship, and tension could be shown at the same slice of oblique and coronal section or oblique and sagittal plane with rotation in external sides on the way from the starting point of dural sac to foramen obturatum in pelvis, meanwhile the manifestations of abnormal ON also could be shown. CONCLUSION: The anatomical features and abnormal manifestation of ON at the same slice with 16-slice spiral CT using the multiplanar reconstruction techniques can be fully shown from the starting point of dural sac to the foramen obturatum in pelvis. This technique is very important in diagnosis and treatment of diseases of obturator nerve.

A prediction model of MF radiation in environmental assessment.

OBJECTIVE: To predict the impact of MF radiation on human health. METHODS: The vertical distribution of field intensity was estimated by analogism on the basis of measured values from simulation measurement. RESULTS: A kind of analogism on the basis of geometric proportion decay pattern is put forward in the essay. It showed that with increasing of height the field intensity increased according to geometric proportion law. CONCLUSION: This geometric proportion prediction model can be used to estimate the impact of MF radiation on inhabited environment, and can act as a reference pattern in predicting the environmental impact level of MF radiation.

Therapeutic effect of phacoemulsification for complicated cataract seco ndary to uveitis / 第三军医大学学报

Objective　To evaluate the therapeutic effect of phacoemulsification for complicated cataract secondary to uveitis. Metho ds　Twenty-one eyes of 19 patients with complicated cataract secondary to uveitis were emulsified in situ frature technique after blunt separation of iris posterior synechiae, excision of organized membrane with scissors and st retching pupil. Results　The visual acuities with correction on e week after operation was≥ 0.5 in 16 eyes (76.2%), and ≥0.2 in 18 eyes (85.7% ). The major complications were iris damage and corneal edema. No rupture of pos terior capsule and corneal decompensation were found. After operation, a round p upil was obtained in 19 eyes (90.5%) and an irregular pupil in 2 eyes (9.5%).Conclusion　This operation is suitable for complicated cataract se condary to uveitis, and worth to popularize due to the minimization of iris dam age and postoperative inflammation in the anterior chamber, good visual acuity r ehabilitation earlier.

Therapeutic effect of phacoemulsification for complicated cataract seco ndary to uveitis / 第三军医大学学报

Objective　To evaluate the therapeutic effect of phacoemulsification for complicated cataract secondary to uveitis. Metho ds　Twenty-one eyes of 19 patients with complicated cataract secondary to uveitis were emulsified in situ frature technique after blunt separation of iris posterior synechiae, excision of organized membrane with scissors and st retching pupil. Results　The visual acuities with correction on e week after operation was≥ 0.5 in 16 eyes (76.2%), and ≥0.2 in 18 eyes (85.7% ). The major complications were iris damage and corneal edema. No rupture of pos terior capsule and corneal decompensation were found. After operation, a round p upil was obtained in 19 eyes (90.5%) and an irregular pupil in 2 eyes (9.5%).Conclusion　This operation is suitable for complicated cataract se condary to uveitis, and worth to popularize due to the minimization of iris dam age and postoperative inflammation in the anterior chamber, good visual acuity r ehabilitation earlier.