Development of a novel monoclonal antibody-based competitive ELISA for antibody detection against bovine leukemia virus.

Infection with bovine leukemia virus (BLV) leads to enzootic bovine leukosis, the most prevalent neoplastic disease in cattle. Due to the lack of commercially available vaccines, reliable eradication of the disease can be achieved through the testing and elimination of BLV antibody-positive animals. In this study, we developed a novel competitive ELISA (cELISA) to detect antibodies against BLV capsid protein p24. Recombinant p24 protein expressed by Escherichia coli, in combination with the monoclonal antibody 2G11 exhibiting exceptional performance, was used for the establishment of the cELISA. Receiver-operating characteristic curve analysis showed that the sensitivity and specificity of the assay were 98.85 % and 98.13 %, respectively. Furthermore, the established cELISA was specific for detecting BLV-specific antibodies, without cross-reactivity to antisera for six other bovine viruses. Significantly, experimental infection of cattle and sheep with BLV revealed that the cELISA accurately monitors seroconversion. In a performance evaluation, the established cELISA displayed a high agreement with Western blotting and the commercial BLV gp51 cELISA kit in the detection of 242 clinical samples, respectively. In conclusion, the novel p24 cELISA exhibited the potential to be a reliable and efficient diagnostic tool for BLV serological detection with a broad application prospect.

Photocatalytic Unsymmetrical Diamination of Styrenes, Indoles, and Benzofurans Facilitated by Benzotriazolyl and Iminyl Radicals.

Utilizing energy transfer catalysis, this research employed the bifunctional reagents benzotriazole carboxylic acid oxime esters to simultaneously generate benzotriazole and imine radicals. The synthesis of two distinct C-N bonds in a single conversion is showcased through radical addition and radical-radical cross-coupling processes between benzotriazole carboxylic acid oxime ester and olefins. This process facilitates the intermolecular two-component unsymmetrical diamination reaction of olefins. Using this approach, more than 40 benzotriazole-containing molecules were successfully synthesized using styrene, indole, and benzofuran as acceptors, with yields ranging from moderate to excellent.

Trends in phytoremediation of heavy metals-contaminated soils: A Web of science and CiteSpace bibliometric analysis.

Heavy metals pollution in soils is an urgent environmental issue worldwide. Phytoremediation is a green and eco-friendly way of remediating heavy metals. However, a systematic overview of this field is limited, and little is known about future development trends. Therefore, we used CiteSpace software to conduct bibliometric and visual analyses of published literature in the field of phytoremediation of heavy metals in soils from the Web of Science core collection and identified research hotspots and development trends in this field. Researchers are paying increased attention to phytoremediation of heavy metals in soils, especially environmental researchers. A total of 121 countries or regions, 3790 institutions, 4091 funded organisations and 15,482 authors have participated in research in this area. China, India, and Pakistan are the largest contributors. There has been extensive cooperation between countries, institutions, and authors worldwide, but there is a lack of cooperation among top authors. 'Calcareous soil', 'Co-contaminated soil' and 'Metal availability' are the most intensively investigated topics. 'EDTA', 'Plant growth-promoting Rhizobacteria', 'Photosynthesis', 'Biochar' and 'Phytoextraction' are research hotspots in this field. In addition, more and more researchers are beginning to pay attention to research on co-contaminated soil, metal availability, chelating agents, and microbial-assisted phytoremediation. In summary, bibliometric, and visual analyses in the field of phytoremediation of heavy metals in soils identifies probable directions for future research and provides a resource through which to better understand this rapidly advancing subject.

Efficacy of lumbar decompression under large-channel spinal endoscope in elderly patients with segmental lumbar spinal stenosis.

OBJECTIVE: The present study was conducted with an attempt to explore the overall efficacy of large-channel spinal endoscopy technology in elderly patients with segmental lumbar spinal stenosis. METHODS: We included a total of 68 elderly patients with segmental lumbar spinal stenosis in our hospital from February 2021 to March 2023. The participants were randomly and equally distributed into the study group and the control group using a random number table method. The control group received the open lumbar decompression surgery, and the study group received the lumbar decompression under large-channel spinal endoscopy technology. We compared the surgical conditions of the two groups, including pain level, Oswestry Disability Index (ODI) score, and Japanese Orthopedic Association (JOA) score before surgery, 1 week after surgery, 3 months after surgery, and 1 year after surgery. In addition, we compared the efficacy and adverse reactions 1 year after surgery between the two groups. RESULTS: Our findings revealed that the operation time, intraoperative blood loss, postoperative drainage volume, and hospital stay in the study group were significantly lower than those in the control group (p < 0.05). There was no statistically significant difference in the degree of pain between the two groups before surgery (p > 0.05), and the pain intensity of the study group was significantly lower than that of the control group at 1 week, 3 months, and 1 year after surgery (p < 0.05). Similarly, preoperative ODI and JOA scores were not significantly different between the two groups (p > 0.05), while they were significantly lower in the study group than those in the control group at 1 week, 3 months, and 1 year after surgery (p < 0.05). Before surgery, no significant difference was seen in therapeutic efficacy between the two groups (p > 0.05), whereas the efficacy was remarkably improved in the study group comparing to the control group at 1 week, 3 months, and 1 year after surgery (p < 0.05). All patients in this study were followed up for 10 to 16 months, with an average of 13.29 ± 1.28 months. The incidence of adverse reactions in the study group was significantly lower than that in the control group (p < 0.05). CONCLUSIONS: Large-channel spinal endoscopy technology exerted promising results in elderly patients with segmental lumbar spinal stenosis, in terms of reducing the surgical time, intraoperative bleeding, postoperative drainage volume, and hospital stay. The approach also alleviated pain, reduced ODI and JOA scores, and restored lumbar function, with decreased incidence of adverse reactions, thereby promoting patient recovery. It is considered valid for wide clinical application.

The prevalence and treatment rate trends of osteoporosis in postmenopausal women.

BACKGROUND: To evaluate the prevalence and treatment of postmenopausal women with osteoporosis in recent years, analyze differences between the prevalence diagnosed by physicians and the prevalence detected by bone mineral density (BMD), and observe the trends of prevalence and treatment rate of osteoporosis in postmenopausal women over time are of great value for the management of osteoporosis. METHODS: This cross-sectional study collected the data of 4012 postmenopausal women from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2010, 2013 to 2014 and 2017 to 2018. The prevalence of osteoporosis and osteopenia as well as the treatment rate of osteoporosis were analyzed using Mann-Kendall trend test. Subgroup analysis was conducted in different age, race, body mass index (BMI), diabetes, hypertension, or glucocorticoid use groups. RESULTS: The overall prevalence of physician diagnosed of osteoporosis was 17.4% and was fluctuated in a small range and remained relatively stable within a certain range (Mann-Kendall trend test: Z = 2.20, P = 0.027) during 2005-2018. The prevalence of osteoporosis in postmenopausal women determined by bone mineral density (BMD) examination reached 9.2% during the five cycles. From 2005 to 2018, the prevalence of physician diagnosed osteoporosis fluctuated in a small range. For osteopenia measured by BMD, the prevalence was 59.6% and a gradual increasing trend was found between 2005 and 2018 (Mann-Kendall trend test: Z = 2.20, P = 0.027). Among patients with physician diagnosed osteoporosis, the treatment rate reached 70.49%. The treatment rate of physician diagnosed osteoporosis was decreased from 2005 to 2008, and further decreased from 2009 to 2018 (Mann-Kendall trend test: Z = -2.20, P = 0.027). The actual treatment rate of osteoporosis patients was 55.53%. During 2005-2018, the actual treatment rate of osteoporosis showed a continuous decline (Mann-Kendall trend test: Z = -2.20, P = 0.027). CONCLUSION: Osteoporosis management might be insufficient and more efforts are needed to improve the diagnosis and treatment rates of osteoporosis in postmenopausal women.

Diagnostic performance of texture analysis in the differential diagnosis of perianal fistulising Crohn's disease and glandular anal fistula.

BACKGROUND: Perianal fistulising Crohn's disease (PFCD) and glandular anal fistula have many similarities on conventional magnetic resonance imaging. However, many patients with PFCD show concomitant active proctitis, but only few patients with glandular anal fistula have active proctitis. AIM: To explore the value of differential diagnosis of PFCD and glandular anal fistula by comparing the textural feature parameters of the rectum and anal canal in fat suppression T2-weighted imaging (FS-T2WI). METHODS: Patients with rectal water sac implantation were screened from the first part of this study (48 patients with PFCD and 22 patients with glandular anal fistula). Open-source software ITK-SNAP (Version 3.6.0, http://www.itksnap.org/) was used to delineate the region of interest (ROI) of the entire rectum and anal canal wall on every axial section, and then the ROIs were input in the Analysis Kit software (version V3.0.0.R, GE Healthcare) to calculate the textural feature parameters. Textural feature parameter differences of the rectum and anal canal wall between the PFCD group vs the glandular anal fistula group were analyzed using Mann-Whitney U test. The redundant textural parameters were screened by bivariate Spearman correlation analysis, and binary logistic regression analysis was used to establish the model of textural feature parameters. Finally, diagnostic accuracy was assessed by receiver operating characteristic-area under the curve (AUC) analysis. RESULTS: In all, 385 textural parameters were obtained, including 37 parameters with statistically significant differences between the PFCD and glandular anal fistula groups. Then, 16 texture feature parameters remained after bivariate Spearman correlation analysis, including one histogram parameter (Histogram energy); four grey level co-occurrence matrix (GLCM) parameters (GLCM energy_all direction_offset1_SD, GLCM entropy_all direction_ offset4_SD, GLCM entropy_all direction_offset7_SD, and Haralick correlation_all direction_ offset7_SD); four texture parameters (Correlation_all direction_offset1_SD, cluster prominence _angle 90_offset4, Inertia_all direction_offset7_SD, and cluster shade_angle 45_offset7); five grey level run-length matrix parameters (grey level nonuniformity_angle 90_offset1, grey level nonuniformity_all direction_offset4_SD, long run high grey level emphasis_all direction_offset1_SD, long run emphasis_all direction_ offset4_ SD, and long run high grey level emphasis_all direction_offset4_SD); and two form factor parameters (surface area and maximum 3D diameter). The AUC, sensitivity, and specificity of the model of textural feature parameters were 0.917, 85.42%, and 86.36%, respectively. CONCLUSION: The model of textural feature parameters showed good diagnostic performance for PFCD. The texture feature parameters of the rectum and anal canal in FS-T2WI are helpful to distinguish PFCD from glandular anal fistula.

The TGEV Membrane Protein Interacts with HSC70 To Direct Virus Internalization through Clathrin-Mediated Endocytosis.

Coronavirus membrane protein is a major component of the viral envelope and plays a central role in the viral life cycle. Studies of the coronavirus membrane protein (M) have mainly focused on its role in viral assembly and budding, but whether M protein is involved in the initial stage of viral replication remains unclear. In this study, eight proteins in transmissible gastroenteritis virus (TGEV)-infected cells coimmunoprecipitated with monoclonal antibodies (MAb) against M protein in PK-15 cells, heat shock cognate protein 70 (HSC70), and clathrin were identified by matrix-assisted laser desorption ionization-tandem time of flight mass spectrometry (MALDI-TOF MS). Further studies demonstrated that HSC70 and TGEV M colocalized on the cell surface in early stages of TGEV infection; specifically, HSC70 bound M protein through its substrate-binding domain (SBD) and preincubation of TGEV with anti-M serum to block the interaction of M and HSC70 reduced the internalization of TGEV, thus demonstrating that the M-HSC70 interaction mediates the internalization of TGEV. Remarkably, the process of internalization was dependent on clathrin-mediated endocytosis (CME) in PK-15 cells. Furthermore, inhibition of the ATPase activity of HSC70 reduced the efficiency of CME. Collectively, our results indicated that HSC70 is a newly identified host factor involved in TGEV infection. Taken together, our findings clearly illustrate a novel role for TGEV M protein in the viral life cycle and present a unique strategy used by HSC70 to promote TGEV infection in which the interaction with M protein directs viral internalization. These studies provide new insights into the life cycle of coronaviruses. IMPORTANCE TGEV is the causative agent of porcine diarrhea, a viral disease that economically affects the pig industry in many countries. However, the molecular mechanisms underlying viral replication remain incompletely understood. Here, we provide evidence of a previously undescribed role of M protein in viral replication during early stages. We also identified HSC70 as a new host factor affecting TGEV infection. We demonstrate that the interaction between M and HSC70 directs TGEV internalization in a manner dependent on CME, thus revealing a novel mechanism for TGEV replication. We believe that this study may change our understanding of the first steps of infection of cells with coronavirus. This study should facilitate the development of anti-TGEV therapeutic agents by targeting the host factors and may provide a new strategy for the control of porcine diarrhea.

Effects of aerobactin-encoding gene iucB and regulator of mucoid phenotype rmpA on the virulence of Klebsiella pneumoniae causing liver abscess.

This study aimed to analyze the influence of the main aerobactin-encoding gene iucB and the regulator of mucoid phenotype rmpA on the virulence of Klebsiella pneumoniae causing liver abscess. In addition, the possible regulatory effects of the main encoding gene iucB on the regulator of mucoid phenotype rmpA were explored, thus providing novel strategies for the prevention and control of hypervirulent K. pneumoniae (hvKp) causing liver abscess. The virulence-related genes iucB and rmpA of K. pneumoniae were detected by PCR. iucB and rmpA were cloned into K. pneumoniae strain by using plasmid pET28b as vector. Quantitative real-time PCR (RT-qPCR) was employed to detect the relative expression of rmpA gene in K. pneumoniae. We investigated the potential effects of aerobactin coding gene iucB and regulator of mucoid phenotype rmpA on the virulence of K. pneumoniae by establishing the Galleria mellonella infection model. Capsule quantitative experiment was conducted to investigate the impact of aerobactin-encoding gene iucB on the modulation of regulator of mucoid phenotype rmpA. The results of the G. mellonella infection model indicated that iucB gene could significantly enhance the virulence of K. pneumoniae, but the presence of rmpA gene did not markedly affect the virulence of K. pneumoniae. RT-qPCR showed that iucB inhibited the expression of rmpA gene. Quantitative capsulation experiments showed that the presence of rmpA gene could not increase the capsulation production of K. pneumoniae. The main encoding gene of aerobactin, namely iucB, could substantially enhance the virulence of K. pneumoniae. The gene iucB might be involved in the biosynthesis of the capsular polysaccharide through an unknown mechanism instead of the gene rmpA. Overall, these findings provide important theoretical support for the treatment of infections caused by hvKp.

Cluster Differences in Antibiotic Resistance, Biofilm Formation, Mobility, and Virulence of Clinical Enterobacter cloacae Complex.

Due to the lack of research on the characteristics of different clusters of Enterobacter cloacae complex (ECC), this study aimed to characterize and explore the differences among species of the ECC. An analysis based on hsp60 showed that Enterobacter hormaechei was predominant in ECC. Interestingly, the antibiotic resistance rates of clusters were different, among which E. hormaechei subsp. steigerwaltii (cluster VIII) and Enterobacter cloacae IX (cluster IX) possessed high resistant rates to ciprofloxacin and levofloxacin, but cluster II (Enterobacter kobei) had low resistant rates. Cluster II exhibited a strong biofilm formation ability. Different motility and protease production ability were shown for distinct clusters. A PCR analysis showed that clusters I, III, VI, VIII, and IX carried more virulence genes, while cluster II had fewer. Clusters I, VIII, and IX with high pathogenicity were evaluated using the Galleria mellonella infection model. Thus, the characteristics of resistance, biofilm-forming ability, mobility, and virulence differed among the clusters. The strains were divided into 12 subgroups based on hsp60. The main clusters of ECC clinical strains were I, II, III, VI, VIII, and IX, among which IX, VIII, and I were predominant with high resistance and pathogenicity, and cluster II (E. kobei) was a special taxon with a strong biofilm formation ability under nutrient deficiency, but was associated with low resistance, virulence, and pathogenicity. Hence, clinical classification methods to identify ECC subgroups are an urgent requirement to guide the treatment of clinical infections.

How to Achieve Swift Resilience: the Role of Digital Innovation Enabled Mindfulness.

Contributed to by the prevalence of digital technology, various cases of new ventures achieve resilience quickly despite experiencing hardship. Growing attention has been devoted to mindfulness-being alert and acting swiftly-to explain recovery. Scholars have primarily focused on mindful resource preparation pre-crisis. Nevertheless, how to mindfully organize resources as a crisis occurs remains under-explored. Based on an inductive study of a ride-sharing vehicle venture, which rapidly became an open service platform during the COVID-19 pandemic in China, we develop a framework termed "swift resilience" to understand how new ventures mindfully organize resources, driven by digital innovation. In particular, we critically trace three mechanisms-"data-driven stretching," "collective sharing," and "rapid pivoting"-and develop a process model to understand how new ventures build swift resilience. Our emerging findings shed light on the scholarship of organizational resilience, mindfulness, and digital entrepreneurship, and provide guidance to managers on achieving resilience quickly.

Quercetin Rejuvenates Sensitization of Colistin-Resistant Escherichia coli and Klebsiella Pneumoniae Clinical Isolates to Colistin.

Colistin is being considered as "the last ditch" treatment in many infections caused by Gram-negative stains. However, colistin is becoming increasingly invalid in treating patients who are infected with colistin-resistant Escherichia coli (E. coli) and Klebsiella Pneumoniae (K. pneumoniae). To cope with the continuous emergence of colistin resistance, the development of new drugs and therapies is highly imminent. Herein, in this work, we surprisingly found that the combination of quercetin with colistin could efficiently and synergistically eradicate the colistin-resistant E. coli and K. pneumoniae, as confirmed by the synergy checkboard and time-kill assay. Mechanismly, the treatment of quercetin combined with colistin could significantly downregulate the expression of mcr-1 and mgrB that are responsible for colistin-resistance, synergistically enhancing the bacterial cell membrane damage efficacy of colistin. The colistin/quercetin combination was notably efficient in eradicating the colistin-resistant E. coli and K. pneumoniae both in vitro and in vivo. Therefore, our results may provide an efficient alternative pathway against colistin-resistant E. coli and K. pneumoniae infections.

Incidence and risk factors for decreased range of motion of the knee joint after surgery for closed tibial plateau fracture in adults.

PURPOSE: The aim of this study was to quantify the incidence of and identify independent risk factors for decreased range of motion (ROM) of the knee joint after surgery for closed tibial plateau fractures in adults. METHODS: This retrospective study was performed at the trauma centre in our hospital from January 2018 to December 2019. Data from adult patients with tibial plateau fractures treated by surgery were extracted from the electronic medical records. A total of 220 tibial plateau fracture patients were enrolled. We extracted the patients' demographic characteristics, fracture characteristics, and surgery-related variables. Univariate and multivariate logistic regression models were used to investigate the potential independent risk factors. RESULTS: Fifty-seven patients developed decreased ROM of the knee joint at the 1-year follow-up in this study. The overall incidence was 25.9%. The independent predictors of decreased ROM after surgery, as identified in the multivariate analysis, were orthopedic polytrauma (odds ratio = 3.23; 95% CI = 1.68-6.20; p = 0.000), fracture type (Schatzker V-VI) (odds ratio = 2.52; 95% CI = 1.16-5.47; p = 0.019), and an open reduction and internal fixation approach (odds ratio = 2.10; 95% CI = 1.07-4.12; p = 0.031). CONCLUSIONS: The study confirmed that patients with orthopaedic polytrauma, more complex fractures and those treated with open reduction and internal fixation (ORIF) surgery were more likely to suffer decreased ROM of the knee joint 1 year after surgery.

Calculus-related functional protein expression in ureteral calculus-adhered polyp: A preliminary study.

ABSTRACT: To explore the expressions of calculus-related functional proteins in the ureteral calculus-adhered polyp tissues and investigate the role of these proteins in the formation of adhesions between the calculus and polyp.Patients with ureteral calculi and polyps who underwent ureteroscopic lithotripsy for the excision of polyps between January 2019 and June 2019 were enrolled. Polyps obtained from each patient were divided into 2 groups using a matched pairs design: observation group (polyps adhered to calculus) and control group (polyps not adhered to calculus). Histopathological examination of polyps was performed using hematoxylin and eosin staining. Polyp tissues were immunohistochemically stained to assess the expressions of calculus-related functional proteins, that is, annexin A1, calcium-binding protein S100A9 (S100A9), uromodulin, and osteopontin. Furthermore, quantitative analysis was performed using the H-score of tissue staining; Pearson correlation analysis was performed for proteins with high expression.Overall, 40 polyp specimens were collected from 20 patients with ureteral calculi combined with polyps (observation group, 20 specimens; control group, 20 specimens). Hematoxylin and eosin staining revealed obvious epithelial cell proliferation in polyps of both groups; crystals were observed in the epithelial cells of the polyp tissue in the observation group. The expression levels of annexin A1 and S100A9 in the observation group were significantly greater than those in the control group (P < .05). However, no obvious expression of osteopontin or uromodulin was observed in the polyp tissues of both groups. There was a strong correlation between the increased expressions of annexin A1 and S100A9 in the observation group (R = 0.741, P = .022).We documented increased expressions of annexin A1 and S100A9 in the ureteral calculus-adhered polyp tissues. Annexin A1 and S100A9 may play an essential role in the adhesion of calculus and polyp and the growth of calculi.

Incidence and risk factors for deep venous thrombosis of lower extremity after surgical treatment of isolated patella fractures.

BACKGROUND: Limited information exists on the incidence of postoperative deep venous thromboembolism (DVT) in patients with isolated patella fractures. The objective of this study was to investigate the postoperative incidence and locations of deep venous thrombosis (DVT) of the lower extremity in patients who underwent isolated patella fractures and identify the associated risk factors. METHODS: Medical data of 716 hospitalized patients was collected. The patients had acute isolated patella fractures and were admitted at the 3rd Hospital of Hebei Medical University between January 1, 2016, and February 31, 2019. All patients met the inclusion criteria. Medical data was collected using the inpatient record system, which included the patient demographics, patient's bad hobbies, comorbidities, past medical history, fracture and surgery-related factors, hematological biomarkers, total hospital stay, and preoperative stay. Doppler examination was conducted for the diagnosis of DVT. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors. RESULTS: Among the 716 patients, DVT was confirmed in 29 cases, indicating an incidence of 4.1%. DVT involved bilateral limbs (injured and uninjured) in one patient (3.4%). DVT involved superficial femoral common vein in 1 case (3.4%), popliteal vein in 6 cases (20.7%), posterior tibial vein in 11 cases (37.9%), and peroneal vein in 11 cases (37.9%). The median of the interval between surgery and diagnosis of DVT was 4.0 days (range, 1.0-8.0 days). Six variables were identified to be independent risk factors for DVT which included age category (> 65 years old), OR, 4.44 (1.34-14.71); arrhythmia, OR, 4.41 (1.20-16.15); intra-operative blood loss, OR, 1.01 (1.00-1.02); preoperative stay (delay of each day), OR, 1.43 (1.15-1.78); surgical duration, OR, 1.04 (1.03-1.06); LDL-C (> 3.37 mmol/L), OR, 2.98 (1.14-7.76). CONCLUSION: Incidence of postoperative DVT in patients with isolated patella fractures is substantial. More attentions should be paid on postoperative DVT prophylaxis in patients with isolated patella fractures. Identification of associated risk factors can help clinicians recognize the risk population, assess the risk of DVT, and develop personalized prophylaxis strategies.

A porcine epidemic diarrhea virus strain with distinct characteristics of four amino acid insertion in the COE region of spike protein.

In recent years, a novel, highly virulent variant of porcine epidemic diarrhea virus (PEDV) has emerged, causing substantial economic losses to the pork industry worldwide. In this study, a PEDV strain named LNsy was successfully isolated in China. Phylogenetic analysis based on the whole genome revealed that PEDV LNsy belonged to the G2 subtype. For the first time, a unique four amino acids (4-aa) insertion was identified in the COE region of the spike (S) protein (residues 499-640), resulting in an extra alpha helix in the spatial structure of the COE region. To determine changes in virus-neutralization (VN) antibody reactivity of the virus, polyclonal antibodies (PAbs) against the S protein of different subtypes were used in a VN test. Both PAbs against the S protein of the G1 and G2 subtype showed reduced VN reactivity to PEDV LNsy. Further, recombination analyses revealed that PEDV LNsy was the result of recombination between PEDV GDS13 and GDS46 strains at the genomic breakpoints (nt 17,959-20,594 in the alignment) in the ORF1b gene of the genomes. Pathological examination showed gross morphological pathological changes in the gut, including significant villus atrophy and shedding of the infected piglets. These results indicated that a 4-aa insertion in the COE region of the S protein may have partly altered the profiles of VN antibodies and thus it will be important to develop vaccine candidates to resist wild virus infection and to monitor the genetic diversity of PEDV.

Incidence and locations of deep venous thrombosis of the lower extremity following surgeries of tibial plateau fractures: a prospective cohort study.

OBJECTIVE: To investigate the incidence of deep venous thrombosis (DVT) of the lower extremities following surgeries of tibial plateau fractures. METHODS: Retrospective analysis of the prospectively collected data on patients undergoing surgeries of tibial plateau fractures between October 2014 and December 2018 was conducted. Duplex ultrasonography (DUS) was used to screen for postoperative DVT of the bilateral lower extremities. Data on demographics, comorbidities, injury, surgery, and laboratory biomarkers at admission were collected. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors associated with DVT. RESULTS: Among 987 patients included, 46 (4.7%) had postoperative DVT, with incidence rate of 1.0% for proximal and 3.7% for distal DVT. The average interval between operation and DVT was 8.3 days (median, 5.8 days), ranging from 2 to 42 days. DVT involved the injured extremity in 39 (84.8%) patients, both the injured and uninjured extremity in 2 patients (4.3%) and only the uninjured extremity in 5 patients (10.9%). Five risk factors were identified to be associated with postoperative DVT, including age (≥ 41 vs < 41 years) (OR 3.08; 95% CI 1.43-6.61; p = 0.004), anesthesia (general vs regional) (OR 2.08; 95% CI 1.12-3.85; p = 0.021), hyponatremia (OR 2.21; 95% CI 1.21-4.06; p = 0.010), prolonged surgical time (OR 1.04; 95% CI 1.01-1.07; p = 0.017) and elevated D-dimer level (OR 2.79; 95% CI 1.34-4.83; p = 0.004). CONCLUSION: These epidemiologic data may be helpful in individualized assessment, risk stratification, and development of targeted prevention programs.

Magnetic resonance imaging findings of carcinoma arising from anal fistula: A retrospective study in a single institution.

BACKGROUND: Magnetic resonance imaging (MRI) is currently the standard investigation for suspected perianal diseases. Carcinoma arising from anal fistula is very rare, and early diagnosis is often difficult. AIM: To describe and summarize the MRI findings of carcinoma arising from anal fistula. METHODS: In this retrospective study, records of ten patients diagnosed with carcinoma arising from anal fistula and confirmed by surgery (n = 7) or biopsy (n = 3) between June 2006 and August 2018 were analyzed. All patients underwent preoperative pelvic MRI. Morphologic features, signal characteristics, fistula between the mass and the anus, contrast enhancement of mass, signal and enhancement of peritumoral areas, and regional lymphadenopathy were assessed. RESULTS: All ten tumors were solitary (8 mucinous adenocarcinomas and 2 adenocarcinomas). The maximum diameter of the tumors ranged from 3.4 cm to 12.4 cm (median: 4.15 cm; mean: 5.68 cm). Eight patients had a fistula between the mass and the anus. Contrast enhancement of the peritumoral areas was noted in three (3/5) patients. Perirectal or inguinal lymphadenopathy was noted in seven patients. Most lesions of mucinous adenocarcinoma were multiloculated and cauliflower-like, with a thin capsule and focally unclear boundary. They were markedly hyperintense on fat-suppressed T2WI, slightly hyperintense with focal hyperintensity on diffusion-weighted imaging (DWI), and hyperintense with focal hypointensity on apparent diffusion coefficient (ADC) map, with progressive mesh-like contrast enhancement. Adenocarcinomas had an infiltrative margin without a capsule and appeared heterogeneously hyperintense or slightly hyperintense on fat-suppressed T2WI, hyperintense on DWI, and hypointense on ADC map, with persistent heterogeneous enhancement. CONCLUSION: Our study highlighted several characteristic and potentially helpful MRI findings to diagnose carcinomas arising from anal fistula.

Molecular characterization of an emerging reassortant mammalian orthoreovirus in China.

Mammalian orthoreoviruses (MRVs) infect almost all mammals, and there are some reports on MRVs in China. In this study, a novel strain was identified, which was designated as HLJYC2017. The results of genetic analysis showed that MRV HLJYC2017 is a reassortant strain. According to biological information analysis, different serotypes of MRV contain specific amino acid insertions and deletions in the σ1 protein. Neutralizing antibody epitope analysis revealed partial cross-protection among MRV1, MRV2, and MRV3 isolates from China. L3 gene recombination in MRV was identified for the first time in this study. The results of this study provide valuable information on MRV reassortment and evolution.

Cathepsin C promotes the progression of periapical periodontitis.

Although the role of cathepsin C (Cat C) in inflammation is gradually being elucidated, its function in periapical periodontitis, which is one of the most common infectious diseases worldwide, has not been studied. This study evaluated a surgically-induced model of periapical periodontitis in cathepsin C (Cat C) knock-down (KD) mice, which was constructed with a tetracycline operator, to evaluate the role of Cat C in the pathogenesis and progression of periapical periodontitis. Our results showed, for the first time, that there was a statistically significant increase in the expression of Cat C as periapical periodontitis progressed; this increase started from 1 week after surgery and reached a peak at 3 weeks after surgery, before gradually decreasing. The volume of periapical bone resorption in Cat C KD mice was significantly smaller than that in wild-type mice at 3 and 4 weeks after surgery (P<0.05). Inflammatory cell infiltration into the apical tissues of wild-type mice was also significantly higher than that of Cat C KD mice. The expression of receptor activator of nuclear factor-κB ligand (RANKL) in wild-type mice was also higher than that in Cat C KD mice. The difference in the number of osteoclasts in the apical area between the two groups was statistically significant after 2 weeks. Correlation analysis showed that there was a significant correlation between Cat C and RANKL expression (r= 0.835). Therefore, our data indicated that Cat C promoted the apical inflammation and bone destruction in mice.

Imaging findings of intraductal tubulopapillary neoplasm (ITPN) of the pancreas: Two case reports and literature review.

RATIONALE: Intraductal tubulopapillary neoplasm (ITPN) is a rare type of pancreatic epithelial neoplasm. We report 2 cases of ITPN and detail the imaging findings. PATIENT CONCERNS: The 1st case was a 36-year-old woman who complained of jaundice, yellow urine and diarrhea. She accepted ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) examination before surgery, which all revealed a mass in the pancreatic head. The 2nd case was a 62-year-old woman who was admitted to our hospital for the treatment of a pancreatic tumor. The MRI showed a mass filled the mian pancreatic duct in the head and neck. DIAGNOSIS: The ITPN is an intraductal, grossly visible, tubule-forming epithelial neoplasm with high-grade dysplasia and ductal differentiation without overt mucin production. INTERVENTIONS: The 1st patient received percutaneous transhepatic cholangial drainage procedure, endoscopic ultrasound guided fine needle aspiration, pancreatoduodenectomy, cholecystectomy, and lymphadenectomy successively. The 2nd patient received pancreaticoduodenectomy, cholecystectomy, and partial gastrectomy. OUTCOMES: Two months after surgery, the follow-up MRI revealed hepatic metastasis of the 1st patient. She is still alive now. The 2nd patient was lost to follow-up. LESSONS: The ITPN is a rare pancreatic neoplasm and its clinical symptoms are atypical. It is difficult to make accurate diagnosis of ITPN before surgery even though various imaging modalities are used in combination. When a solid mass growing in the lumen of the pancreatic duct, ITPN should be taken into consideration.