[Age distribution characteristics of intestinal segmented filamentous bacteria and their relationship with intestinal mucosal immunity in children].

OBJECTIVE: To investigate the age distribution characteristics of intestinal segmented filamentous bacteria (SFB) in children and their relationship with intestinal mucosal immunity. METHODS: The fresh feces of 177 children and the ileocecal fluid of 47 children during colonoscopy were collected. The SFB was determined by real-time PCR. The concentration of secretory immunoglobulin A (sIgA) was determined by enzyme-linked immunosorbent assay. The numbers of interleukin 17A (IL-17A) cells and intraepithelial lymphocytes in the terminal ileum mucosa and the expression of transcription factors associated with the differentiation of T helper (Th) cells, T-box transcription factor (T-bet), forkhead box P3 (FOXP3), and retinoid-related orphan receptor gamma t (ROR-γt), were determined by immunohistochemistry. RESULTS: The positive rate of intestinal SFB in these children was 19.2% (34/177). Trend analysis showed that the positive rate of SFB was correlated with age: the rates for children aged 0-, 1-, 2-, 3-, 4-, 5-, 6-, and 7-15 years were 40%, 47%, 32%, 15%, 12%, 13%, 15% and 4% respectively (P<0.001). The concentration of sIgA in intestinal fluid was significantly higher in SFB-positive children (n=24) than in SFB-negative children (n=23) (P<0.01). The number of intraepithelial lymphocytes in the terminal ileum mucosa and the expression of T-bet, FOXP3, and ROR-γt were not significantly different between the SFB-positive group (n=12) and the SFB-negative group (n=11), but the number of IL-17A cells in the terminal ileum mucosa was significantly lower in the SFB-positive group than in the SFB-negative group (P<0.05). CONCLUSIONS: Intestinal SFB colonization in children is age-related, and the colonization rate is relatively high in children under 3 years old. In SFB-positive children, the secretion of intestinal sIgA is increased, while the number of IL-17A cells in the terminal ileum is reduced.

CHA2DS2-Vasc score and CHA2DS2-Vasc-HS score are poor predictors of in-stent restenosis among patients with coronary drug-eluting stents.

OBJECTIVE: To evaluate the ability of two scoring systems (CHA2DS2-VASc score and CHA2DS2-VASc+hyperlipidaemia+smoking [CHA2DS2-VASc-HS score]) to predict in-stent restenosis (ISR) among patients undergoing drug-eluting stent (DES) implantation. METHODS: This retrospective study enrolled patients who underwent coronary angiography to assess coronary artery disease severity secondary to a diagnosis of stable angina or acute coronary syndrome that subsequently underwent DES implantations. Demographic, clinical, angiographic and biochemical parameters were compared between those patients that experienced ISR and those that did not during the study follow-up period. Univariate and multivariate logistic regression analyses were used to evaluate associations between the baseline parameters, the two scoring systems and ISR risk. RESULTS: A total of 358 patients (non-ISR group n = 316; ISR group n = 42) participated in the study. Compared with the non-ISR group, more patients in the ISR group had diabetes mellitus and received stents with smaller diameters but longer lengths. There were no significant differences with regard the predictive ability for ISR of either the CHA2DS2-Vasc or the CHA2DS2-Vasc-HS scores. Multivariate logistic regression analyses demonstrated that stent diameter, follow-up duration and glycosylated haemoglobin were independent risk factors for ISR. CONCLUSIONS: The CHA2DS2-Vasc and CHA2DS2-Vasc-HS scores did not predict ISR in patients after coronary DES placement.

Ileal perforation caused by a fish bone shortly after drug-eluting stent implantation for acute myocardial infarction.

During the past century, the incidence of myocardial infarction has markedly increased worldwide. Percutaneous coronary intervention with stent implantation is often considered as the first-choice treatment, especially in emergency cases. Current guidelines recommend delayed elective noncardiac surgery for such vulnerable patients. However, few suggestions are available regarding the exact treatment strategy for patients who have already undergone percutaneous coronary intervention but suddenly need emergent noncardiac surgery for an unrelated reason. We herein present a case involving a patient with acute myocardial infarction who had undergone implantation of a drug-eluting stent and developed an ileal perforation due to fish bone ingestion 3 days postoperatively. After carefully balancing the risks of stent thrombosis and uncontrollable bleeding, dual antiplatelet therapy and low-molecular-weight heparin were given with close monitoring. Emergency laparotomy and partial small bowel resection surgery were then performed, after which the patient eventually recovered. This case indicates a possible management strategy for patients with acute myocardial infarction complicated by emergency noncardiac surgery.

Dronedarone and Amiodarone Induce Dyslipidemia and Thyroid Dysfunction in Rats.

BACKGROUND/AIMS: Amiodarone, a thyroid hormone-like molecule, can induce dyslipidemia and thyroid dysfunction. However, the effects of dronedarone on lipid metabolism and of both dronedarone and amiodarone on thyroid function and lipid metabolism remain unknown. METHODS: Fifty male Sprague-Dawley rats were randomly divided into 5 groups (10 in each group): normal control (NC), amiodarone-treated (AMT), dronedarone-treated (DRT), rats treated with amiodarone combined with polyene phosphatidylcholine (AC), and rats treated with dronedarone combined with polyene phosphatidylcholine (DC). Rats were given amiodarone (120 mg/kg/d), dronedarone (120 mg/kg/d), and polyene phosphatidylcholine (200 mg/kg/d) for 13 weeks. At the end of weeks 4, 8, 12, and 13, plasma-free triiodothyronine (FT3), free thyroxine (FT4), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) were determined. At the end of this protocol, rats were sacrificed and the thyroid glands were isolated, weighed, and examined histopathologically. The protein expression of Bcl-2 was measured by immunochemical staining. The mRNA expression of thyroglobulin (Tg), type-1 deiodinase (D1), and thyroid peroxidase (TPO) were detected by polymerase chain reaction (PCR). RESULTS: Compared with the NC group, FT3 and FT4 levels in the DRT and DC groups significantly increased at week 4 but declined thereafter. The AMT and AC groups had lower FT3 levels but comparable FT4 levels. The levels of TG, LDL-c, and HDL-c in the NC group were lower than those in the other groups whereas the LDL-c/HDL-c ratio was lowest in the AMT group. Bcl-2 expression significantly increased in the DRT group. The mRNA expression of Tg increased whereas the mRNA expression of D1 decreased. Dronedarone induced hyperthyroidism at the early stage and hypothyroidism at the late stage whereas amiodarone only caused hypothyroidism. CONCLUSION: Both dronedarone and amiodarone can induce dyslipidemia and increase the levels of TC, LDL-c, and HDL-c, and these effects may be associated with thyroid dysfunction.

[Timing of nasojejunal feeding tube placement and enteral nutrition in children with acute pancreatitis].

OBJECTIVE: To investigate the impact of timing of nasojejunal feeding tube placement and enteral nutrition on clinical outcomes in children with acute pancreatitis. METHODS: A retrospective analysis was performed on the clinical data of 31 children with acute pancreatitis, who received nasojejunal feeding between January 2008 and July 2013, to investigate the relationship of abdominal symptoms/signs and serum amylase level with the tolerability of catheterization and success rate of enteral nutrition. The treatment outcome and incidence of adverse reactions and complications were compared between the early enteral nutrition group ( ≤7 days from the onset of the disease) and late enteral nutrition group (>7 days from the onset of the disease). RESULTS: Abdominal symptoms/signs and serum amylase level were independent of the tolerable rate of catheterization and success rate of enteral nutrition. Compared with the late enteral nutrition group, the early enteral nutrition group had a shortened time to normal serum amylase level, significantly reduced incidence of systemic complications, length of hospital stay, and hospitalization expenses, and less weight gain. The tolerable rate of catheterization and success rate of enteral nutrition showed no significant difference between the two groups. Similarly, no significant differences were found in the increase in albumin level after enteral nutrition, duration of enteral nutrition, incidence of adverse reactions, and incidence of local complications. CONCLUSIONS: Abdominal symptoms/signs and serum amylase level cannot be used as a measure of whether nasojejunal feeding tube placement and enteral nutrition can be performed. Early enteral nutrition can better improve clinical outcomes in children with acute pancreatitis, and it is feasible.

Highly enantioselective trapping of zwitterionic intermediates by imines.

Reactions with the unstable and highly reactive zwitterionic intermediates generated in processes catalysed by transition metals are providing new opportunities for molecular constructions. Insertion reactions involve the collapse of zwitterionic intermediates, but trapping them would allow structural elaborations that are not currently available. To synthesize complex molecules in this manner, reactive electrophiles can be used to trap the zwitterionic intermediates. Here, we describe the use of imines, activated by chiral organocatalysts, and a highly efficient integrated rhodium and chiral Brønsted acid co-catalysed process to trap zwitterionic intermediates that have been proposed previously to undergo a formal C-H insertion reaction, allowing us to obtain polyfunctionalized indole and oxindole derivatives in a single step with excellent diastereoselectivity and enantioselectivity.

Effects of mid-myocardial pacing on transmural dispersion of repolarization and arrhythmogenesis.

INTRODUCTION: Epicardial (Epi) activation of the left ventricular (LV) wall increases transmural dispersion of repolarization (TDR), which creates a substrate for the development of ventricular arrhythmia. We hypothesize that pacing from the LV mid-myocardium may decrease the TDR and occurrence of arrhythmias. METHODS AND RESULTS: A transmural electrocardiogram and transmembrane action potentials were simultaneously recorded from Epi, mid-myocardial (M), and endocardial (Endo) layers of the arterially perfused canine LV wedge preparations (n= 8). Transmural dispersion of repolarization varied when the preparations were paced at each layer, respectively (Endo pacing, 35.6 ± 6.6 ms; M pacing, 34.9 ± 7.3 ms; Epi pacing, 72.4 ± 4.9 ms; P< 0.001). A significant difference was noted in TDR between M pacing and Epi pacing (P< 0.001), but not between M pacing and Endo pacing (P= 0.831). This result was reproducible in the presence of ischaemia-reperfusion experiments (n= 8). Transmural dispersion of repolarization was amplified as compared with non-ischaemic experiments and differed when preparations were paced at each layer (Endo pacing, 62.8 ± 13.8 ms; M pacing, 63.3 ± 13.3 ms; Epi pacing, 111.1 ± 17.7 ms; P< 0.001). There was again no significant difference between Endo pacing and M pacing (P= 0.948). However, as pacing was shifted from M to Epi, there was a significant increase in TDR (P< 0.001). Ventricular arrhythmias were induced in two of eight ischaemic preparations during Epi pacing, but did not occur in either M or Endo pacing. CONCLUSION: Mid-myocardial pacing can significantly decrease the TDR and prevent the occurrence of ventricular arrhythmias as compared with Epi pacing.

Diastereoselectively switchable enantioselective trapping of carbamate ammonium ylides with imines.

The diastereoselectively switchable enantioselective trapping of protic carbamate ammonium ylides with imines is reported. The intriguing Rh(2)(OAc)(4) and chiral Brønsted acid cocatalyzed three-component Mannich-type reaction of a diazo compound, a carbamate, and an imine provides rapid and efficient access to both syn- and anti-α-substituted α,ß-diamino acid derivatives with a high level control of chemo-, diastereo-, and enantioselectivity.

[Refractive and biometric changes in adolescent guinea pig eyes in development and recover stages of form-deprivation myopia].

OBJECTIVE: To investigate changes in refraction and vitreous length during form-deprivation and visual re-exposure in guinea pig eyes. METHODS: It was an experimental study. Ninety-six guinea pigs with age of three weeks were randomly divided into form-deprivation and normal control groups (n = 48 in each group). The form-deprivation group was further divided into 4 subgroups (n = 12 in each subgroup) which underwent monocular form-deprivation for 1, 2, 4, and 6 weeks, respectively. At the end of each time point, the form-deprived eyes in all animals were visually re-exposed and followed for 3 (n = 6) and 7 days (n = 6). The control group was also divided into four subgroups (n = 12 in each subgroup) to match the time-points of the form-deprivation group. During form-deprivation and recovery, vitreous length and refraction in each group was measured and compared. RESULTS: There was significant difference in vitreous length (F = 6.108, 28.222, 19.195) and refraction (F = 12.504, 15.003, 6.829) when compared deprived eyes with contralateral eyes 2, 4, or 6 weeks after form-deprivation (P < 0.05). Difference in refraction between deprived eyes and contralateral eyes was -2.36 D, -3.64 D and -3.68 D at 2, 4, 6 week, respectively. Difference in vitreous length was 0.08 mm, 0.19 mm and 0.22 mm. During visual re-exposure, form-deprived eyes changed into hyperopia as compared with contralateral eyes. At day 3 point, there was no significant difference in refraction and vitreous length between form deprived eyes and contralateral eyes in 1 week and 2 weeks groups (F = 0.032, 0.280; P > 0.05). After 7 days recovery, vitreous length and refraction in deprived eyes almost backed to level of contralateral eyes in 1 and 2 weeks groups. At day 3 point, there was significant difference of refraction and vitreous length between form-deprived eyes and contralateral eyes in 4 weeks group and 6 weeks group. After 7 days recovery, there was significant difference in vitreous length for 4 weeks group and there was significant difference in both refraction and vitreous length for 6 weeks group (F = 4.108, 6.317; P < 0.05). CONCLUSION: Form-deprivation causes myopic changes in deprived eyes, during visual re-exposure the refraction recovers and the extent depends on the length of form-deprivation. The recovery rate is faster during the first 3 days and then slower after 3 days. The mechanism of form-deprivation myopia in guinea pig eyes is similar to that of myopia in juvenile human beings.

[Susceptibility of guinea pig eyes to form deprivation myopia and its age-related recovery].

OBJECTIVE: Young guinea pigs are susceptible to become myopic during form deprivation. They can also quickly recover from the myopia after removal of the form deprivation. This study investigated whether mature guinea pigs are sensitive to form deprivation and its refractive recovery from deprivation myopia. METHODS: It was an experimental study. Thirty-nine guinea pigs were arranged to 3 groups according to age. Group 1: 9-week old (n = 18). Group 2: 12-week old (n = 10). Group 3: 15-week old (n = 11). All the animals were performed refraction measurement prior to the experiment, then wore a facemask that covered one randomly assigned eye for three weeks. The masks were then removed and refraction was measured in both eyes immediately, 2 and 7 days after. RESULTS: After form deprivation, the refraction of the MFD (monocular form deprivation) eyes shifted to myopia, which had significant difference compared to the unmasked eye in all the groups (t = -5.691, -2.203, -2.760; P < 0.05), the relative myopia compared to the unmasked eye in 9 weeks old animals were (-2.53 ± 1.89) D, 12 weeks old (-1.43 ± 1.57) D, 15 weeks old (-0.60 ± 1.48) D. There was significant difference between 9 weeks old animals and 15 weeks old animal in the refractive error right after the form deprivation (F = 2.823, P < 0.05). And the distribution of refractive error tended to lower degree of myopia as the guinea pigs grew older. None of the three groups showed significant reduction in relative refractive error during the recovery, but a trend of recovery was found in 9 weeks old animals. CONCLUSIONS: The guinea pigs are sensitive to the form deprivation even when they are sexual mature, but both the susceptibility and the ability of recovery decrease as they grow older but in different patterns. The ability of recovery in short term (7 days) diminishes when guinea pig is older than 12 weeks while the sensitivity to form deprivation last until 15 w.

[Measurement of grating acuity in guinea pigs by a customized automated optomotor device].

OBJECTIVE: The guinea pig becomes an important model for studies on myopia, but little is known about its visual performance. In this study, grating acuity was measured using a custom-built automated device to track optomotor responses. METHODS: To record head nystagmus, guinea pigs were individually placed in the center of a rotating drum of 130 cm diameter. The drum was covered inside with square wave gratings of adjustable fundamental spatial frequencies and contrast. The turning movements of the head were tracked using custom-written video software that detected two little white spots painted on a small black piece of cardboard that was attached to the guinea pig's head. Angular head speed was determined from the positions of the two white spots with respect to each other over time, and the ratio of angular head speed to drum speed was determined (the "gain"). In 11 guinea pigs of the same age, but with different refractive states (+9.7 to -15.0 D), responses to spatial frequencies of 0.6 and 2.4 cyc/deg were tested. Furthermore, 17 guinea pigs were tested which had similar refractive states but were different in age (1 to 3 months old). Finally, the effects of different grating contrasts were studied (25%, 50% and 100% contrast respectively) and the effects of different stripe luminances (10, 30, and 350 cd/m(2) respectively). RESULTS: The optomotor response could be used to measure vision in one eye only even if both eyes opened. The optomotor gain was affected by refractive error. Younger animals (one month old) had lower optomotor gain than older ones (0.61 ± 0.2 in one-month, 0.77 ± 0.13 in two-month and 0.80 ± 0.11 in three-month old). For a spatial frequency of 0.6 cyc/deg, the effects of stripe contrast were tested in two months old guinea pigs. At an average stripe luminance of 30 cd/m(2), the optomotor gain dropped from 0.95 ± 0.20 at maximal contrast, to 0.94 ± 0.16 at 50% contrast, and 0.70 ± 0.10 at 25% contrast. At three different luminances, gains were 0.81 ± 0.25 (10 cd/m(2)), 0.95 ± 0.20 (30 cd/m(2)), and 0.80 ± 0.09 (350 cd/m(2)), measured with gratings of 100% contrast, respectively. CONCLUSIONS: Myopic guinea pigs have reduced grating acuity compared to hyperopic ones. The optomotor gain increases with age. For a given grating contrast, the highest optomotor gains are obtained at the highest luminance of 30 cd/m(2). In summary, spatial vision in guinea pig declines with the magnitude of myopia, and increases with luminance and age.

[Therapeutic effects of traditional Chinese herbal formula with Smilax glabra on mice's lead poisoning].

OBJECTIVE: To investigate the influence of traditional Chinese herbal formula with Smilax glabra on lead expelling and oxidative damage in lead-poisoned mice. METHODS: Mice were received intraperitoneal injections of lead acetate to establish lead-poisoned models. The concentration of lead, zinc and copper in blood, brain, liver, kidney and bone were determined. The lipid peroxidation of liver was systematically evaluated. RESULTS: The traditional Chinese herbal formula had no influence on body weight and organ weight/body weight ratio of lead-poisoned mice. The traditional Chinese herbal formula might significantly reduce the concentration of lead in blood, rain, liver, kidney and bone, and the rate were 74%, 48%, 56%, 51% and 44%, but had no influence on zinc's and copper' s concentration. The decreasing rate of MDA levels in liver by the traditional Chinese herbal formula was 31%. In addition, the increase rate of GSH levels and the activities of GSH-Px and SOD in liver by traditional Chinese herbal formula were 63% ,76% and 66%, respectively. CONCLUSIONS: The traditional Chinese herbal formula with Smilax glabra can significantly advance the excretion of lead and protect liver against oxidative damage induced by lead.

[Form deprivation myopia in C57BL/6 mice].

OBJECTIVE: To investigate the changes of refraction and ocular biometric parameters in form deprived myopia, and try to find the effective duration to induce significant myopic shift in C57BL/6 mice. METHODS: It was an experimental study. Seventy-four C57BL/6 mice, approximately 23 days old, were divided into three groups randomly: FD (Form-deprivation), Recovery and Normal control groups. FD group was treated with diffuser worn on one eye for 2 weeks (n = 12), 3 weeks (n = 20) and 4 weeks (n = 18), respectively. In Recovery group, diffusers were removed after 4 weeks form deprivation, and vertical meridian refraction and other biometric parameters were performed immediately on 4(th) and 7(th) day. The same measurements were performed in the normal control group at the same time-points. Refraction was measured by photoretinoscopy and corneal radius of curvature (CRC) was measured by a modified keratometry. Corneal thickness (CT), anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD), and axial length (AL) were measured by optical coherence tomography (OCT) with focal plane advancement. RESULTS: The FD eyes were approximately -0.85 D more myopic compared to the fellow and the normal control eyes after 2 weeks form deprivation (P > 0.05). After 3 weeks form deprivation, treated eye had a obvious myopic shift (about -4.27 D) compared to fellow eye, with increased vitreous chamber depth and axial length, however, there was no statistic difference among FD eye, fellow eye and control eye. And after 4 weeks form deprivation, treated eyes were induced significant myopic shift (about -5.22 D) compared with the fellow eye. The difference in refraction of form-deprived and fellow eyes was significantly correlated with the difference in vitreous chamber depth and axial length, which indicate that the induced myopia was mainly axial. The relative myopia shifted rapidly diminished in 4 days after removing the diffuser, followed by a slower recovery. A complete refraction recovery occurred by 7 days after removal of the diffuser compared to the fellow and normal control eyes (P > 0.05). CONCLUSION: Form deprivation myopia can be induced in C57BL/6 mice, but it required longer period than other animals; A complete recovery occurred by 7 days after removal of the diffuser.Optical Coherence Tomography is a useful instrument to measure mouse eye dimension.

First record of Bursaphelenchus rainulfi on pine trees from eastern China and its phylogenetic relationship with intro-genus species.

Bursaphelenchus rainulfi isolated from dead pine trees in Zhejiang, China, is described and illustrated. It also provided some molecular characters of the Chinese population, including the PCR-RFLP and sequences of ITS region and D2-D3 expansion region of the large subunit (LSU) rRNA gene. Both the morphological characters and ITS-RFLP patterns match with the original description. The phylogenetic trees based on the 13 sequences of D2-D3 expansion region of the LSU rRNA gene and ITS region of Bursaphelenchus species were constructed, respectively, with the results showing the similar clades. The phylogenetic relationship based on the molecular data is similar to that with morphological characters. This is the first report of the species on pine wood in eastern China.

[The grating acuity of children in preschool age].

OBJECTIVE: To study the developmental trend of the binocular grating acuity of preschool children. METHODS: Binocular grating acuities in 599 children from 2 months to 72 months old (18 groups) were measured using the closed-circuit operant preferential looking system (COPLs). The children included in the investigation were required to be a normal term birth, development and normal eyes, and cycloplegic refraction error within specific limits. The system's reliabilities and measurable rates were also evaluated. RESULTS: The difference of the vision acuities obtained by the same tester on different days has no statistic significance. The measurable rates reached 90% in most age groups. The grating acuity of the children included in the study developed rapidly during first year, and then it reached to a slower development period from 30 to 36-months, the grating acuity stabilized after 3 years old. CONCLUSION: The COPL system is a practical devise to assess the grating visual acuity of infants and preschool children and it can be used to investigate the vision developmental trend including speed, age of its maturation and the top-acuity of the development.