Risk factors and prediction score model for unplanned readmission among neonates with NRDS under one year of age: A retrospective cohort study.

Objective: This study aimed to analyze the risk factors and establish a prediction score model for unplanned readmission among neonates with neonatal respiratory distress syndrome (NRDS) for respiratory problems under one year of age. Methods: This retrospective cohort study enrolled 230 neonates with NRDS who were admitted between January 2020 and December 2020. The infants were classified into two subgroups based on whether they were readmitted for respiratory problems under one year of age: readmit group and non-readmit group. Readmission risk factors for NRDS were analyzed by logistic regression and a prediction score model was generated. Results: Among the 230 enrolled infants, 51 (22%) were readmitted, and 179 (78%) were not readmitted. In univariate analysis, compared with non-readmit group infants, readmit group infants had a significantly younger birth gestational age (31.9 ± 2.3 vs. 32.8 ± 2.5 weeks, p = 0.012), lower birth weight (1,713.7 ± 501.3 g vs. 1,946.8 ± 634.4 g, p = 0.007), older age at discharge (41.7 vs. 31.7 days, p = 0.012), higher proportion of necrotizing enterocolitis (NEC) (31% vs. 16%, p = 0.016), higher rate of blood transfusion (39% vs. 25%, p = 0.049), higher rate of postnatal dexamethasone (DEX) administration (28% vs. 9.5%, p = 0.001), and higher rate of home oxygen therapy (HOT) (57% vs. 34%, p = 0.003). Moreover, readmit group infants had significantly longer antibiotic days usage (12.0 vs. 10.0 days, p = 0.026) and a longer duration of hospital stay (41.0 vs. 31.0 days, p = 0.012) than non-readmit group infants. The multivariate logistic regression analysis showed that taking readmission as a target variable, postnatal DEX administration (OR: 2.689, 95% CI: 1.168-6.189, p = 0.020), HOT (OR: 2.071, 95% CI: 1.060-4.046, p = 0.033), and NEC (OR: 2.088, 95% CI: 0.995-4.380, p = 0.051) could be regarded as risk factors for readmission. A scoring model predicting readmission was administered with a positive predictive value of 0.651 (95% CI: 0.557-0.745, p = 0.002), with a sensitivity of 0.412 and a specificity of 0.888 at a cut-off of 3.5 points, which were evaluated on the receiver operating characteristic curve. Conclusions: Postnatal DEX administration, HOT, and NEC were risk factors for readmission of NRDS. NRDS infants with a predictive score of 3.5 points or more were at high risk for unplanned readmission.

Identification of Novel Mutations in Chinese Infants With Citrullinemia.

Citrullinemia is a rare autosomal recessive disorder characterized by elevated concentrations of citrulline in the blood resulting from malfunction of the urea cycle. It is categorized into two types, types I and II, which are caused by argininosuccinate synthase 1 (ASS1), and citrin (SLC25A13) gene mutations, respectively. In this study, we performed genetic analysis on nine Chinese infants with citrullinemia using next-generation sequencing, which identified a novel mutation (p.Leu313Met) and a rare mutation (p.Thr323Ile, rs1250895424) of ASS1. We also found a novel splicing mutation of SLC25A13: c.1311 + 4_+7del. Functional analysis of the ASS1 missense mutations showed that both significantly impaired the enzyme activity of ASS1, with the p. Thr323Ile mutation clearly affecting the interaction between ASS1 and protein arginine methyltransferase 7 (PRMT7). These findings expand the mutational spectrum of ASS1 and SLC25A13, and further our understanding of the molecular genetic mechanism of citrullinemia in the Chinese population.

Impact of the COVID-19 pandemic on neonatal admissions in a tertiary children's hospital in southwest China: An interrupted time-series study.

BACKGROUND: The unprecedented coronavirus disease 2019 (COVID-19) pandemic has caused millions of infections worldwide and represents a significant challenge facing modern health care systems. This study was conducted to investigate the impact of lockdown measures in a tertiary Children's Hospital in southwest China, which might be used to predict long-term effects related to health-seeking behavior of parents/caregivers. METHODS: This study included newborns enrolled over a span of 86 weeks between January 4, 2019, and August 27, 2020. We designated two time periods for analysis purposes: a stable pre-COVID period(55 weeks between January 4, 2019, and January 23, 2020) and a COVID-impacted period (31 weeks between January 24, 2020, and August 27, 2020). An interrupted time-series analysis was employed to compare changes and trends in hospital admissions and disease spectra before and after the period of nonpharmaceutical interventions (NPIs). Furthermore, this study was conducted to evaluate whether the health-seeking behavior of parents/caregivers was influenced by pandemic factors. RESULTS: Overall, 16,640 infants were admitted to the neonatology department during the pre-COVID period (n = 12,082) and the COVID-impacted period (n = 4,558). The per week neonatal admissions consistently decreased following the first days of NPIs (January 24, 2020). The average weekly admission rates of 220/week pre-COVID period and 147/week COVID-impacted period. There was an evident decrease in the volume of admissions for all disease spectra after the intervention, whereas the decrease of patients complaining about pathological jaundice-related conditions was statistically significant (p<0.05). In the COVID-impacted period, the percentage of patients who suffered from respiratory system diseases, neonatal encephalopathy, and infectious diseases decreased, while the percentage of pathological jaundice-related conditions and gastrointestinal system diseases increased. The neonatal mortality rates (NMRs) increased by 8.7% during the COVID-impacted period compared with the pre-COVID period. CONCLUSIONS: In summary, there was a significant decline in neonatal admissions in a tertiary care hospital during the COVID-19 Pandemic and the associated NPIs. Additionally, this situation had a remarkable impact on disease spectra and health-seeking behavior of parents/caregivers. We, therefore, advise continuing follow-ups and monitoring the main health indicators in vulnerable populations affected by this Pandemic over time.

Serum troponin I: a potential biomarker of hypoxic-ischemic encephalopathy in term newborns.

OBJECTIVE: This study was intended to evaluate the predictive values of serum procalcitonin (PCT), lactate, creatine kinase (CK-MB), and troponin I on the diagnosis and staging of neonatal hypoxic-ischemic encephalopathy (HIE). MATERIALS AND METHODS: We retrospectively retrieved data from electronic medical records at our children's hospital, and we included all term newborns admitted between December 2018 and June 2020 with features of perinatal asphyxia. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to measure and evaluate the predictive values of biomarkers. p values < 0.05 were set as statistical significance. RESULTS: A total of 201 neonates were included. They were grouped as control (n = 40), mild HIE (n = 105), moderate HIE (n = 36), and severe HIE (n = 20). Serum lactate, PCT, CK-MB, and troponin I levels in severe hypoxic-ischemic brain injury group were significantly higher than those in mild to moderate hypoxic-ischemic brain injury group and control group (p < 0.05). Based on ROC and AUC analysis, troponin I showed highest predictive ability with AUC of 0.904, and sensitivity and specificity of 95.00% and 87.50% respectively. CONCLUSION: Serum troponin I has a good predictive value for neonatal hypoxic-ischemic encephalopathy after perinatal asphyxia.

Comparative efficacy of anti-epileptic drugs for neonatal seizures: A network meta-analysis.

BACKGROUND: Anti-epileptic drugs have different effects on neonatal seizures, and new agents have been widely used in recent years. Meanwhile, significant differences still exist in the treatment for neonatal seizures, whether in choice of drug or in duration of treatment. And with the increase in options for treatment, the best choice of second-line treatment has not been recommended. METHODS: The MEDLINE, the Cochrane Library, Web of Science, Embase and clinicaltrials.gov databases were searched (January 1, 1960 to October 20, 2020). Randomized controlled trials (RCTs) or observational investigations studying anti-epileptic drugs for neonatal seizures were selected. And then we conducted a network meta-analysis and examined comparative efficacy of the first-line and second-line anti-epileptic drugs for neonatal seizures. RESULTS: Data were extracted from 11 included studies by 2 independent investigators. Random effects models were used to estimate odds ratios (ORs). We performed direct meta-analyses with a random effects model and network meta-analyses for first-line and second-line drugs. Five published RCTs and 6 observational investigations with 1333 patients and 6 interventions contributed to the analysis. CONCLUSION: We recommend phenobarbital as the first-line drug for neonatal seizures. In addition, there is a tendency for levetiracetam to be an effective second-line treatment for neonatal seizures after failure of first-line drugs.

An ethyl thioglycolate-based chemosensor: Spectrophotometric detection of Fe3+ and fluorometric detection of Hg2+ with high selectivity.

A novel symmetric bianthracene derivative (D2) containing one benzene ring and two ethyl thioglycolates connecting to the benzene ring on both sides of the bianthracene unit was designed and synthesized. D2 can detect Fe3+ and Hg2+ in acetonitrile/water (6:4, v/v) solution via different changes of absorbance and fluorescence in the pH range from 3 to 10. D2 exhibits high colorimetric sensitivity for Fe3+ with low detection limit (1.87 × 10-5 mol/L). The absorbance intensity of D2 in acetonitrile/water solution show a linear response to Fe3+ in the wide concentration range of 0 -1000 µM, which is beneficial for quantitative analysis. D2 also displays highly selective fluorescent sensing for Hg2+ with a low detection limit of 1.07 µM over other metal ions and can accurately detect the existence of Hg2+ in water samples.

D-π-A-π-D type solvatochromic fluorescence probes based on triphenylamine: Synthesis, photophysical properties and application.

Two D-π-A-π-D type solvatochromic fluorescence probes (JT1 and JT2) based on triphenylamine have been synthesized. The photophysical and electrochemical properties of these probes as well as their solvatochromic behavior were studied. The Stokes shifts of JT1 and JT2 reach 175 nm (6417.0 cm-1) and 218.6 nm (9916.7 cm-1) in the acetonitrile solution, respectively. There is an excellent linear correlation between the Stokes shifts and the ET (30) solvent polarity values in different solvents. The high responsiveness of JT1 and JT2 to solvent polarity makes them promising candidates for solvatochromic fluorescence probes, especially for the detection of the polarity of non-proton solvents or the content of water in tetrahydrofuran.

A simple indolo[2,3-a]carbazole based colorimetric chemosensor for simultaneous detection of Cu2+ and Fe3+ ions.

A new indolo[2,3-a]carbazole based colorimetric chemosensor C1 was designed and synthesized. The optical properties of C1 were investigated by UV-vis spectroscopy, UV-vis titrations, and fluorescence spectroscopy. The HOMO and LUMO values of C1 were obtained using density functional theory (DFT) calculations. The results indicate that C1 has specific selectivity and high sensitivity for detection of Cu2+ and Fe3+ ions compared with metal ions (K+, Na+, Mg2+, Zn2+, Cd2+, Pb2+, Hg2+, Ag+, Co2+, Cr2+, Ni2+, Mn2+, Ba2+). The presence of Cu2+ ions leads to visible color change from yellow to colorless in an aqueous-acetonitrile solution, especially. Moreover, the detection limit for the analysis of Cu2+ and Fe3+ ions is found to be as low as 2.93 × 10-7 M and 4.10 × 10-7 M, respectively. Therefore, C1 should have potential applications as a practical colorimetric chemosensor for simultaneous detection of Cu2+ and Fe3+ in the environment and biological systems.

Biosynthetic Mycotoxin Conjugate Mimetics-Mediated Green Strategy for Multiplex Mycotoxin Immunochromatographic Assay.

Various mycotoxins widely co-exist in agro-products, and their combined effects cause toxicity and potential carcinogenicity to humans and animals. In this work, we developed an economical and sensitive quantum dots (QDs)/QD microbead (QDs/QB)-based multiplex immunochromatographic assay (mICA) for the rapid detection of fumonisin B1 (FB1), zearalenone (ZEN), and ochratoxin A (OTA) without the building-up process of mycotoxin conjugates. QDs and QBs were selected as fluorescent reporters and conjugated with antimycotoxin monoclonal antibodies for improving sensitivity. Furthermore, phage-displayed FB1, ZEN, and OTA mimotope peptide-based soluble and monovalent fusions to maltose-binding protein (MBP) were applied onto the test line of the mICA as the mimetic coating antigen. Under the optimized conditions, the visual detection limits (vLODs) of peptide-MBP-based mICA could be obtained as 0.25 ng/mL for FB1, 3.0 ng/mL for ZEN, and 0.5 ng/mL for OTA within 10 min. The results for spiked real sample detection indicate good accuracy, reproducibility, and practicability. In addition, the proposed mICA was comparable with ultraperformance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS) in terms of reliability in detecting FB1, ZEN, and OTA using natural samples. From the point of promoting commercial production, these time-saving and low-cost peptide-MBP antigens applied in ICA might provide promising potential for promoting productivity and decreasing the cost of production.

Argon plasma coagulation tonsillectomy versus coblation tonsillectomy: a comparison of efficacy and safety.

BACKGROUND: Tonsillectomy is one of the most common otolaryngological procedures. Nonetheless, there is still no universally approved 'gold standard' technique. OBJECTIVE: To compare the safety and efficacy of argon plasma coagulation and coblation techniques in tonsillectomy. METHODS: A multi-institutional, retrospective cohort study was conducted, comprising 283 patients who underwent bilateral tonsillectomies performed by a single surgeon between 2014 and 2017. The outcome measures included: operative time, intra-operative blood loss, post-operative pain and post-operative haemorrhage. RESULTS: In the argon plasma coagulation group, mean operative time and post-operative haemorrhage rate were significantly reduced, p = 0.0006 and p = 0.003 respectively. There was no statistically significant difference between the two groups in terms of post-operative pain and intra-operative blood loss. CONCLUSION: The argon plasma coagulation technique is easy, safe and efficacious. Argon plasma coagulation tonsillectomy seems cost-effective compared to coblation tonsillectomy: the single-use disposable electrode tip and wand used in this study cost AUD$76.50 and AUD$380 respectively. Argon plasma coagulation appears to be a favourable alternative to current modalities such as coblation.

A new thiosemicarbazone fluorescent probe based on 9,9'-bianthracene for Hg2+ and Ag.

A new 9,9'-bianthracene-based thiosemicarbazone (D1) has been successfully synthesized and utilized for chemosensors. The properties of D1 were systematically investigated by UV-Vis, fluorescence titration and theoretical calculations. As a result, D1 exhibits a characteristic fluorescence quenching phenomenon in the presence of Hg2+ or Ag+ compared to other metal cations (Na+, K+, Mg2+, Ba2+, Al3+, Zn2+, Fe2+, Pb2+, Cu2+, Co2+, Cd2+, Ni2+ and Mn2+). The detection limits of Hg2+ and Ag+ reach 6.62×10-7M and 1.99×10-5M, respectively. This is mainly attributed to the Hg2+ (or Ag+) forms a stable five-membered ring with the N atom in Schiff base CN and the S atom in thiourea. The results suggest that the probe D1 is a promising candidate for chemosensors in aqueous media due to its highly selectivity for Hg2+ and Ag+.

Ultrasensitive and green electrochemical immunosensor for mycotoxin ochratoxin A based on phage displayed mimotope peptide.

Here, we demonstrated a new approach for development of an ultrasensitive and green electrochemical immunosensor for Ochratoxin A (OTA). Phage displayed mimotope peptide of OTA was used as mimics of conventional competing antigen, which is chemical synthesized with toxic mycotoxins OTA as raw material, in a competitive sensing platform. The working electrode was modified by polyethylene glycol (PEG) for the purpose of immobilizing antibody effectively. Under the optimized test condition, the limit of detection (LOD) of the established immunosensor was 2.04 fg/mL, and the linear range was 7.17-548.76 fg/mL. Specific measurement of this established method was conducted by testing cross-reactivity of other common mycotoxins, the result showed that mimotope peptide-based immunosensor has negligible cross-reactivity with other mycotoxins. Furthermore, the novel concept of phage displayed mimotope peptide-based immunosensor may provide a potential application in general method for the ultrasensitive detection of various toxic small molecules in food.

An ultrasensitive electrochemical immunosensor for Cry1Ab based on phage displayed peptides.

The rapid and widespread adoption of Bacillus thuringiensis (Bt) proteins in genetically modified (GM) crops has raised concerns about the impact of GM crops on environment and food safety. A sensitive and specific method for detecting Bt proteins in GM crops is of great significance for environment and food risk assessment. In this study, using Cry1Ab as a model Bt protein, an ultrasensitive electrochemical immunosensor for Cry1Ab protein has been developed based on phage displayed peptide. Phage displayed peptides against Cry1Ab protein were obtained from a phage displayed peptide library without animal immunization process through biopanning-elution strategy. After modification of electrode with gold nanoparticles, selected phage displayed peptide was applied to electrochemical immunosensor for Cry1Ab. Under the optimized conditions, the peptide-based immunosensor showed a dynamic range of 0.01-100ng/mL and a limit detection of 7pg/mL. Specific measurement of this established method was conducted by testing cross-reactivity of Cry1Ac (88% amino acid sequence homology to Cry1Ab protein), and the result showed that peptide-based immunosensor has negligible cross-reactivity with analogue. In addition, the accuracy and reproducibility of this established immunosensor was evaluated by testing the recovery of spiked samples and assay coefficients of variation, respectively. The results showed that the average recovery of corn and wheat sample was 90-120% and 86.7-120%, respectively; the intra-assay coefficient of variation was 7.4% (n = 6), and the inter-assay coefficient of variation was 6.9% (n = 6) at 1ng/mL Cry1Ab solution. Furthermore, the novel concept of peptide-based immunosensor may provide a potential application in general method for the ultrasensitive detection of various Bt proteins.

A formalin-inactivated vaccine provides good protection against Vibrio harveyi infection in orange-spotted grouper (Epinephelus coioides).

Vibrio harveyi is one of the most common threats to farmed grouper, so considerable efforts are in practice to control the pathogen. This study presents a highly effective vaccine against V. harveyi in the orange-spotted grouper with the help of a single intraperitoneal immunization. The vaccine candidate was in form of whole, formalin-inactivated V. harveyi cells combined with a metabolizable ISA763 AVG adjuvant. Our results indicated that the vaccine triggered a remarkably higher expression level of interleukin (IL)-1ß, IL-6, IL-8, and IL-10 in the groupers' kidneys and spleens, as recorded after 1 and 3 days of immunization. Antibody titers were significantly elevated in the vaccinated fish. A pivotal observation was that the vaccine highly protected the grouper from a homologous V. harveyi strain challenge with relative percentage survival values of 100% and 91.7% at 6 and 12 weeks post-immunization, respectively. Vaccinated fish also demonstrated strong cross-protection against a heterologous bacterial isolate challenge. Therefore, the inactivated V. harveyi vaccine is a promising candidate that could stimulate good immune responses and confer remarkable protection in farmed groupers.

[Brief discourse on development of psychology of modern traditional Chinese medicine].

In 1980, Wang Miqu proposed the concept of "The Psychology of Traditional Chinese Medicine (TCM Psychology)". In 1985, "The First National Symposium on Psychology of Traditional Chinese Medicine" was held, and the concept of TCM Psychology was put forward in the symposium, thus declaring the establishment of TCM Psychology, a new disciplinary branch. Since then, 12 national or international academic symposia of TCM Psychology were convened nationwide. Based on inheriting the original TCM, by means of exploring, sorting out and improving, and by combining and integrating with psychology and medical psychology, the theory of TCM Psychology was thus gradually innovated, and a systematic knowledge of TCM Psychology was set up and utilized in the clinical practice extensively.

Molecular characterization and expression analysis of the autophagic gene beclin 1 from the purse red common carp (Cyprinus carpio) exposed to cadmium.

Beclin 1, the mammalian orthologue of yeast Atg6, has a central role in autophagy, which has been linked to diverse biological processes including immunity, development, tumor suppression, lifespan extension, etc. However, the relevant study about Beclin 1 is rare in fish compared with mammals. In this study, we isolated Beclin 1 gene from the kidney tissue of common carp (Cyprinus carpio) using rapid amplification of cDNA ends (RACE). The deduced amino acid sequence of cloned Beclin 1 comprised 447 amino acids, which showed approximately 80.7% identity and 88.9% similarity to human Beclin 1. It possessed a typical Bcl-2 homology domain 3 (BH3) and an evolutionarily conserved domain (ECD). Phylogenetic analysis demonstrated that common carp Beclin 1 formed a clade with zebrafish Beclin 1. To explore the relationship between Beclin 1 and cadmium (Cd)-induced injury, a Cd exposure experiment was conducted. The result showed that Cd content was significantly increased in a dose-dependent manner in kidney after Cd exposure. Swelling and vacuolation of renal tubular epithelial cells, and glomerular hyalinization were observed. Renal leukocyte infiltration was diffusely distributed in the interstitial tissue. Real-time quantitative RT-PCR analysis revealed that the mRNA transcript level of Beclin 1 was markedly up-regulated in a dose-dependent and time-dependent manner after exposure to Cd. Similarly, Western blot analysis indicated that its protein level was significantly elevated in a dose-dependent manner after Cd treatment. All the results indicate that the common carp Beclin 1 gene may play a regulatory role against Cd toxicity.

Impact of reclaimed water irrigation on antibiotic resistance in public parks, Beijing, China.

The abundance and distribution of antibiotics and antibiotic resistance genes (ARGs) in soils from six parks using reclaimed water in Beijing, China, were characterized. Three classes of commonly used antibiotics (tetracycles, quinolones, and sulfonamides) were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The highest concentrations of tetracyclines and quinolones were 145.2 µg kg(-1) and 79.2 µg kg(-1), respectively. Detected tetG, tetW, sulI, and sulII genes were quantified by quantitative PCR. ARGs exhibited various abundances for different park soils. The integrase gene (intI1) as an indicator of horizontal gene transfer potential was also detected in high abundance, and had significant positive correlation with tetG, sulI, and sulII genes, suggesting that intI1 may be involved in ARGs dissemination. Both sulII and intI1 clones had high homology with some classes of pathogenic bacteria, such as Klebsiella oxytoca, Acinetobacter baumannii, Shigella flexneri, which could trigger potential public health concern.

Cadmium induces liver cell apoptosis through caspase-3A activation in purse red common carp (Cyprinus carpio).

Caspase-3, the essential effector caspase, plays a pivotal role during caspase-dependent apoptosis. In this study, we isolated and characterized caspase-3A gene from common carp. The common carp caspase-3A comprising 273 amino acids showed 71.8% sequence similarity and 59.3% sequence identity to human caspase-3. It exhibited an evolutionarily conserved structure of mammalian caspase-3 genes, including a pro-domain, a large subunit, a small subunit and other motifs such as the pentapeptide active-site motif (QACRG) and the putative cleavage sites at the aspartic acids. Phylogenetic analysis demonstrated that common carp caspase-3A formed a clade with cyprinid fish caspase-3. To assess whether caspase-3A is involved in cadmium (Cd)-induced cell apoptosis in common carp, a Cd exposure experiment was performed. TUNEL analysis showed that Cd triggered liver cell apoptosis; caspase-3A activity was markedly increased; its proenzyme level was significantly decreased, and the levels of its cleaved forms were markedly increased. However, real-time quantitative PCR analysis revealed that the mRNA transcript level of caspase-3A was not significantly elevated. Immunoreactivities were observed in the cytoplasm of hepatocytes by immunohistochemical detection. The findings indicates that Cd can trigger liver cell apoptosis through the activation of caspase-3A. Caspase-3A may play an essential role in Cd-induced apoptosis.

[A historical retrospect of Pre-hospital emergency treatment].

In 1240, the first organization of first aid medical service for rescuing and transferring the wounded in the world was established at Florence, Italy. The stations of Air Ambulances were set up in most of the developed countries at the end of the 1960s. In the middle of the 1970s, the International Red Cross put forward the principles of internationalization, international cooperation and its standardization, thus, promoting the development of pre-hospital emergency treatment. In 1972, the first Emergency Medical Service Center was established and in 1973, Congress of the United States passed the Emergency Medical Services Act (EMSS). In 1976, the legislative procedure was finished and the National Emergency Network was formed, afterwards, pre-hospital emergency treatment, on-site rescue and transfer care, patient monitoring system of ICU-CCU were set up successively. Since the first rescue group of "three failure" (heart failure, lung failure and renal failure) was first formed at Tianjin First Center Hospital in August 1974, the pre-hospital emergency of China had been developing gradually.

Molecular cloning, immunohistochemical localization, characterization and expression analysis of caspase-9 from the purse red common carp (Cyprinus carpio) exposed to cadmium.

Caspase-9, the essential initiator caspase is believed to play a central role in mitochondria-mediated apoptosis signaling. In this study, we isolated the caspase-9 gene from common carp, one of the most important industrial aquatic animals in China using rapid amplification of cDNA ends (RACE). The deduced amino acid sequence of caspase-9, composed of 436 amino acids, showed approximately 47.6% identity and 64.7% similarity to human caspase-9. It also possessed a conserved caspase-associated recruitment domain (CARD), a large subunit and a small subunit. Phylogenetic analysis clearly demonstrated that caspase-9 formed a clade with cyprinid fish caspase-9. Real-time quantitative PCR analysis revealed that caspase-9 transcripts were not significantly increased in kidney after exposure to cadmium (Cd). Whereas caspase-9 cleaved fragments were detected using Western blot analysis with the same Cd treatment condition. Furthermore, the result of immunohistochemical detection showed immunoreactivities were predominantly limited to the cytoplasm of renal tubular epithelial cells and no remarkable changes of immunopositive staining were observed after Cd treatment. Accordingly, the results signify that caspase-9 may play an essential role in Cd induced apoptosis.