[Four cases of acute renal injury caused by acute dimethyl oxalate poisoning].

Objective: To investigate the clinical features, non-dialysis treatment and prognosis of acute renal injury caused by acute dimethyl oxalate (DMO) poisoning. Methods: Retrospective analysis was performed on the occupational data, clinical manifestation, laboratory examination, treatment methods and prognosis of 4 patients with acute DMO poisoning in July 2020. Results: A large number of white DMO crystals were observed in the workplace. Four patients had acute onset, presenting symptoms such as fatigue, abdominal distension, abdominal cramps and nocturia to varying degrees. Laboratory tests all showed acute kidney injury. Serum creatinine of patients at the onset were 119-835 µmol/L. Patients were given early treatment including rest, protection of renal function, hydration and alkalization of urine, Bailing capsule. Renal function of 4 patients returned to normal, and clinical prognosis was good. Conclusion: Acute DMO poisoning leads to acute renal injury, mainly with renal tubulointerstitial lesions such as hypogravity uria and aseptic leucuria. Active treatment in the early stage has a good short-term clinical prognosis.

[Clinical analysis of surgical treatment of post-infarction left ventricular aneurysm: a series of 254 patients].

Objective: To examine the efficacy of two surgical procedures on post-infarction left ventricular aneurysm. Methods: The clinic data of 254 patients with post-infarction left ventricular aneurysm, who underwent surgical ventricular reconstruction between January 1997 and December 2019 in Department of Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University was analyzed retrospectively. There were 183 males and 71 females aged from 31 to 81 years, with a median age of 64.6 years. Based on the size of the ventricular aneurysm, there were 73 patient received linear reconstruction (linear group) and 181 patients received endoventricular patch plasty technique (patch plasty group). Ejection fraction, left ventricular systolic and end diastolic volume and left ventricular systolic and end diastolic volume index were recorded preoperatively, 2-week, 3-month, 1-year and 5-year after operation. The survival curves were plotted with Kaplan-Meier method and the survival rates were compared by Log-rank test. Results: All patients underwent surgery with a mean cardiopulmonay bypass duration of (92±32) minutes (44 to 196 minutes) and aortic cross clamp duration of (67±22) minutes (33 to 152 minutes).There were 9 perioperative deaths with a mortality rate of 3.5%. Angina pectoris of other cases are relief and heart function improved greatly. Five years after operation, the percentage of cardiac function (New Yord Heart Association) class Ⅲ to Ⅳ patients decreased from 96.1%(244/254) to 9.9%(16/161). There was no significant difference in survival rate between linear group and patch plasty group at 1-, 3-, 5-years postoperatively (96%, 91%, 77% vs. 96%, 90%, 79%, P=0.562). Ejection fraction increased from (39±10)% (range: 22% to 50%) preoperatively to (46±6)% (range: 39% to 54%) 1-year postoperatively in the linear group, while increased from (38±13)% (range: 26% to 51%) preoperatively to (50±6)% (range: 39% to 55%) in the patch plasty group. Conclusions: Left ventricular reconstruction is quite effective for patients with post-infarction left ventricular aneurysm. The choice of operative approaches is determined by the size and range of ventricular aneurysm. Both linear reconstruction and endoventricular patch plasty technique can got similarly surgical outcomes with near and late curative effect.

MiR-135a regulates renal fibrosis in rats with diabetic kidney disease through the Notch pathway.

OBJECTIVE: To explore the influence of micro ribonucleic acid (miR)-135a on the renal fibrosis in rats with diabetic kidney disease (DKD) through the Notch signaling pathway. MATERIALS AND METHODS: A total of 30 male Wistar rats weighing 200-220 g were selected and randomly divided into Control group (n=10), diabetes mellitus (DM) group (n=10), and miR-13a inhibitor group (n=10). Streptozotocin (STZ) was intraperitoneally injected daily to establish the DM model in rats of both DM group and miR-135a group, while normal saline was given daily through intraperitoneal injection in rats of Control group. After 4 weeks, the rats in miR-135a inhibitor group were intraperitoneally injected with miR-135a inhibitor, and those in Control and DM groups were administrated with an equal amount of normal saline. Changes in the blood glucose (BG), glycated hemoglobin (GHb), serum creatinine (Scr), triglyceride (TG), and total cholesterol (TC) of rats were evaluated, and the pathological changes in the renal tissues of DM rats were observed via hematoxylin-eosin (HE) staining. Sirius red staining was performed to observe the changes in collagen fibers in the kidney of all groups of rats. The expressions of Notch and Hes1 in the renal tissues of rats in each group were detected using immunohistochemistry. Immunofluorescence assay was employed to detect the positive expression of Notch in the renal tissues of rats. The mRNA expressions of Notch and miR-135a were detected via quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR). Finally, Western blotting was conducted to detect the protein expressions of Notch, Notch intracellular domain (NICD) and Hes1. RESULTS: Compared with Control group, rats in DM group had substantially raised levels of BG, GHb, Scr, TG, and TC (p<0.05). HE staining showed that the rats in Control group had renal tubular cells with normal morphology and well-defined structure, while those in DM group exhibited evident cavitation in the renal tubular epithelium. Sirius red staining results manifested that the red collagen fibers were evenly distributed with light staining in the glomeruli and renal tubules of rats in Control group. In contrast, the collagen fibers of the glomeruli and renal tubules of rats in DM group exhibited deep and evident red staining. Moreover, compared with DM group, rats in miR-135a inhibitor group had notably faded red staining in the glomeruli and renal tubules of rats, evenly distributed collagen and remarkably decreased fibrotic nodules. According to immunohistochemistry detection results, the protein levels of Notch and Hes1 in the renal tubulointerstitial cells and renal tubular epithelial cells of rats in DM group were markedly higher than those in Control group. Compared with those in DM group, their protein levels were remarkably lowered in miR-135a inhibitor group (p<0.05). Immunofluorescence assay results revealed that the protein level of Notch in the renal tissues of rats in DM group was considerably higher than that in Control group (p<0.05), while its protein level in miR-135a inhibitor group was significantly lower than that in DM group. According to qRT-PCR results, compared with those in Control group, mRNA expressions of Notch mRNA and miR-135a in the rat kidney tissues were substantially raised in DM group (p<0.05), and they were notably lowered in miR-13a inhibitor group compared with those in DM group (p<0.05). Finally, Western blotting results manifested that the protein levels of Notch, NIC, and Hes1 in the renal tissues of rats in DM group were considerably higher than those in Control group (p<0.05), and that their protein expression levels in miR-135a inhibitor group were markedly lower than those in DM group (p<0.05). CONCLUSIONS: Inhibition of miR-135a can reduce the renal fibrosis in DKD rats through the Notch pathway.

Development of a chemiluminescence immunoassay using recombinant non-structural epitope-based proteins to accurately differentiate foot-and-mouth disease virus-infected and vaccinated bovines.

The contamination of inactivated vaccine with non-structural proteins (NSPs) leads to a high false-positive rate, which is a substantial barrier to accurately differentiate foot-and-mouth disease virus (FMDV)-infected animals from vaccinated animals. To address this problem, a new chemiluminescence immunoassay (CLIA) method was developed to detect antibodies targeting the two recombinant epitope-based proteins located in 3A and 3B. The 3Aepitp-3Bepitp CLIA exhibited a diagnostic sensitivity of 94.0% and a diagnostic specificity of 97.5% for the detection of serum samples (naïve bovines, n = 52, vaccinated bovines, n = 422, infected bovines, n = 116) from animals with known status. The CLIA method also had a concordance rate of 88.1% with the PrioCHECK FMDV NSP ELISA based on the detection of 270 serum samples from the field. Importantly, the 3Aepitp-3Bepitp CLIA produced no false-positives when used to detect FMDV in samples from bovines that had been vaccinated up to five times, and it was demonstrated a low false-positive rate when the bovines had been vaccinated up to ten (2.15%) and fifteen times (5.93%). Therefore, the 3Aepitp-3Bepitp CLIA detects FMDV in samples from frequently vaccinated bovines with high accuracy and represents an alternative method to differentiate FMDV-infected and vaccinated bovines.

[Efficacy of mitral valve repair versus replacement in severe ischemic mitral regurgitation].

Objective: To compare the mortality, survival rate and the therapeutic efficacy between mitral valve repair and replacement as treatment for severe ischemic mitral regurgitation (IMR), and explore the middle- and long-term outcomes. Methods: Between January 2000 and January 2016, 378 patients with severe IMR underwent coronary artery bypass grafting (CABG) combined with mitral valve repair (n=162) or mitral valve replacement (n=216) in the Department of Cardiovascular Surgery of Nanjing First Hospital. Clinical data, in-hospital morbidity and mortality of patients were retrospectively reviewed. The patients were followed up for the long term survival rate, heart function and re-admission. Results: No statistically significant differences of baseline data and operation details were found between the two groups except for left ventricular end-diastolic diameter[(61.3±10.2)mm in replacement group vs (56.2±9.0)mm in repair group, P<0.001]. Seven patients died during the perioperative period, with a total operation mortality of 1.9%.No significant difference of mortality was found between the two groups (5 cases in the replacement group and 2 cases in the repair group). The early outcome after the surgery showed that the rate of low cardiac output and ventricular arrhythmia of patients were significantly higher in the replacement group compared with the repair group (both P<0.05). The mortality of patients received mitral valve replacement was better than who received mitral valve repair when left ventricular end-diastolic diameter was over 65 mm (5.9% vs 10.0%, P=0.036). No significant differences were observed between the two groups in the middle- and -long term survival rate (87% for replacement group vs 85% for repair group, P=0.568). The follow-up time was 1-85 (52.8±21.5) months and the follow-up rate was 93%. The rate of valve-related complications was significantly higher in the repair group compared with the replacement group (8.82% vs 3.82%, P=0.003). Conclusions: We should choose the surgical methods carefully (replacement or repair) for severe IMR patients according to degree of left ventricular remodeling and pathological changes of mitral valve. Mitral valve replacement with preservation of the subvalvular apparatus is a safe and effective surgical alternative for mitral valve repair, especially for patients with complications or complex reflux.

Genome sequence compression based on optimized context weighting.

Context weighting is an important technology for genome compression. In this study, we discuss the relationship between the weighting of context models and the weighting of the description lengths corresponding to their respective context models. It indicates that weighting of context models is equivalent to the weighting of their description lengths. With these discussions, we present the weights optimization algorithm based on the minimum description length, and suggest implementing the least-square algorithm for the optimization of the weights. The proposed optimization algorithm is used in the compression of bacterial genome sequences. The experiment results indicate that by using the proposed weights optimization method, our context weighting-based genome compression algorithm can achieve better performance than context weighting-based algorithms reported in the literature.

Staged reimplantation for the treatment of fungal peri-prosthetic joint infection following primary total knee arthroplasty.

BACKGROUND: Fungal peri-prosthetic joint infections (PJI) are rare complication following total knee arthroplasty (TKA). There exists no established guidelines in the treatment of these infections and controversies are focused on the usefulness of antifungal-loaded cement spacers, the duration of systemic antifungal treatment and the ideal interval between implant removal and reimplantation. Therefore we ask if: (1) adding antifungal in cement space is a viable solution to manage fungal PJI; (2) there is no adverse effect adding antifungal medication in cement? HYPOTHESIS: We hypothesized that fungal PJI following TKA could be managed successfully by 2-stage reimplantation strategy using antifungal-loaded cement spacer. PATIENTS AND METHODS: Five cases of fungal PJI following total knee arthroplasty were treated in our institution between 2007 and 2013 using a 2-stage reimplantation strategy. The median elapsed time from primary arthroplasty to the diagnosis of infection was 7.4 months (range, 5-10 months). The infection was caused by Candida species in 4 cases and Pichia anomala in 1 case. Antibiotic- and antifungal-loaded articulating cement spacer was implanted during the interval between stages. Systemic antifungal agents were administered for at least 6 weeks after removal of prosthesis in all cases. The mean interval between removal and reimplantation was 6 months (range, 3-9 months). RESULTS: At a mean follow-up of 41.6 months (range, 24-65 months) after reimplantation, no patient had recurrent infection or revision due to any other reasons. The mean global IKS score improved from 58.4 (range, 37-96 points) preoperatively to 152.4 (range, 136-169 points) at final follow-up. The average range of motion of the knee for flexion improved from 63° (range, 10-110°) preoperatively to 98° (range, 80-120°) at final follow-up. CONCLUSIONS: Fungal PJI following TKA can be successfully treated by a staged reimplantation strategy. Antibiotic- and antifungal-loaded cement spacer implanted during interval period between stages may be an effective adjunct to therapy. Effective antifungal therapy is crucial to a successful result without adverse effect. LEVEL OF EVIDENCE: IV: retrospective or historical series.

Resurfacing arthroplasty for hip dysplasia: a prospective randomised study.

In this prospective study a total of 80 consecutive Chinese patients with Crowe type I or II developmental dysplasia of the hip were randomly assigned for hip resurfacing arthroplasty (HRA) or total hip replacement (THR). Three patients assigned to HRA were converted to THR, and three HRA patients and two THR patients were lost to follow-up. This left a total of 34 patients (37 hips) who underwent HRA and 38 (39 hips) who underwent THR. The mean follow-up was 59.4 months (52 to 70) in the HRA group and 60.6 months (50 to 72) in the THR group. There was no failure of the prosthesis in either group. Flexion of the hip was significantly better after HRA, but there was no difference in the mean post-operative Harris hip scores between the groups. The mean size of the acetabular component in the HRA group was significantly larger than in the THR group (49.5 mm vs 46.1 mm, p = 0.001). There was no difference in the mean abduction angle of the acetabular component between the two groups. Although the patients in this series had risk factors for failure after HRA, such as low body weight, small femoral heads and dysplasia, the clinical results of resurfacing in those with Crowe type I or II hip dysplasia were satisfactory. Patients in the HRA group had a better range of movement, although neck-cup impingement was observed. However, more acetabular bone was sacrificed in HRA patients, and it is unclear whether this will have an adverse effect in the long term.

[Analysis of the nucleotide sequence for C and NS5 regions and the genotype of HCV isolate in Shandong Province].

OBJECTIVE: To study the genotype of HCV epidemic strains in Shandong Province. METHODS: HCV fragments of C(432 bp) and NS5(319 bp) regions were amplified by RT nested PCR. The fragments were cloned to T vector and sequenced by dideoxynucleotide chain termination reaction. RESULTS: Three of all 4 strains in C region were 1b genotype, and 1 was 2a. All of 10 strains of NS5 region were 1b genotype. No other genotype was found in this region. The homology of nucleotide sequence was over 90% compared with that of more than 50 strains in Gen Bank. CONCLUSIONS: The major genotype of HCV epidemic strains in Shandong Province is 1b. The 2a genotype is also found in this area.

[Determination of residues of 20 kinds of organochlorinated pesticides in oils, fruits and vegetables by wide-bore capillary gas chromatographic column].

A rapid and high performance gas chromatographic method for the determination of 20 organchlorinated pesticides in oils, fruits and vegetables has been developed. The samples of fruits and vegetables were extracted with petroleum ether-acetone, while those of oils were extracted with acetonitrile-hexane. The extract was purified by Florisil column with ethyl ether-hexane(15:85, V/V) or ethyl ether-petroleum ether(15:85, V/V) as eluent. Chromatographic analysis was performed on wide-bore capillary column with ECD detector. Satisfactory separation and detection of these organchlorinated pesticides are presented with the proposed method. The detection limits of this method were 1.0 ng/g-20.0 ng/g(S/N = 5), the recoveries 83.2%-106.8% and the relative standard deviations 2.0%-9.5%.

[Genetic subtyping of HIV-1 strains by heteroduplex mobility assay].

DNA fragments of HIV-1 env gene were amplified by nested PCR from uncultured peripheral blood mononuclear cells (PBMCs) obtained from 24 HIV-1 infected individuals. The PCR products were separated by melting and annealing with denatured PCR product prepared from reference plasimd of representative subtypes. Heteroduplex were then formed between the single-stranded DNA from the two sources and were analysed on polyacrylamide gels. The results from heteroduplex mobility assay (HMA) were compared with HIV-1 subtype results determined by DNA sequencing. With advantages of high speed, low cost and high specificity, HMA is a reliable screening method for HIV-1 subtyping.

[Clinical anti-caries effect of dentifrice containing two fluorides]

Anti-caries effect of dentifrice containing sodium monofluorophophate and sodium fluoride was studied among 2-3 years OLD nursery children.After one year,both mean dft and dfs were very significantly lower than those of control groups.

[Detection of specific antibodies to cytomegalovirus in the blood donors in Qingdao].

The detection of cytomegalovirus (CMV) infection in the blood donors in China has not been reported the literature available at hands. 344 serum samples from healthy blood donors in Qingdao were examined for the presence of CMV-IgG by IFA and CMV-IgM, CMV-IgA by ELISA. The frequency of positive donors was 99,45%, 4,65%, and 3,20%, respectively. The result showed CMV infection was rather common in the donors, the rate of active CMV infection was also higher than that abroad. We suggest that when blood is transfused to high risk patients, CMV-IgM and CMV-IgA should be examined regularly on donors to exclude or reduce the incidence of transfusion-associated CMV infection. At present it is not practical for CMV-IgG as a screening marker in our country.