DNA methylation of promoter region inhibits galectin-1 expression in BMSCs of aged mice.

Senile osteoporosis increases fracture risks. Bone marrow stromal cells (BMSCs) are sensitive to aging. Deep insights into BMSCs aging are vital to elucidate the mechanisms underlying age-related bone loss. Recent advances showed that osteoporosis is associated with aberrant DNA methylation of many susceptible genes. Galectin-1 (Gal-1) has been proposed as a mediator of BMSCs functions. In our previous study, we showed that Gal-1 was downregulated in aged BMSCs and global deletion of Gal-1 in mice caused bone loss via impaired osteogenesis potential of BMSCs. Gal-1 promoter is featured by CpG islands. However, there are no reports concerning the DNA methylation status in Gal-1 promoter during osteoporosis. In the current study, we sought to investigate the role of DNA methylation in Gal-1 downregulation in aged BMSCs. The potential for anti-bone loss therapy based on modulating DNA methylation is explored. Our results showed that Dnmt3b-mediated Gal-1 promoter DNA hypermethylation plays an important role in Gal-1 downregulation in aged BMSCs, which inhibited ß-catenin binding on Gal-1 promoter. Bone loss of aged mice was alleviated in response to in vivo deletion of Dnmt3b from BMSCs. Finally, when bone marrow of young wild-type (WT) mice or young Dnmt3bPrx1-Cre mice was transplanted into aged WT mice, Gal-1 level in serum and trabecular bone mass were elevated in recipient aged WT mice. Our study will benefit for deeper insights into the regulation mechanisms of Gal-1 expression in BMSCs during osteoporosis development, and for the discovery of new therapeutic targets for osteoporosis via modulating DNA methylation status.NEW & NOTEWORTHY There is Dnmt3b-mediated DNA methylation in Gal-1 promoter in aged bone marrow stromal cell (BMSC). DNA methylation causes Gal-1 downregulation and osteogenesis attenuation of aged BMSC. DNA methylation blocks ß-catenin binding on Gal-1 promoter. Bone loss of aged mice is alleviated by in vivo deletion of Dnmt3b from BMSC.

Effect of Psychological Intervention on Differentiated Thyroid Cancer Patients in the Treatment with Radioactive Iodine.

Objective: This study aimed to design a standard method of psychological intervention and evaluate the effect of such psychological intervention against the psychological distress of differentiated thyroid cancer (DTC) patients in the treatment with radioactive iodine. Methods: The enrolled patients were randomly divided into the intervention group and the control group. Both the patients in the 2 groups received the routine nursing care, while the patients in the intervention group also received the additional standard psychological interventions. The questionnaires including patient health questionnaire-9 (PHQ-9), generalized anxiety disorder 7-item (GAD-7), cancer fatigue scale (CFS) and positive and negative affect schedule (PANAS) were used to assess psychological status. These questionnaires were performed at week 0 (T0), week 8 (T1, immediately after the last time of intervention) and week 24 (T2, 16 weeks after the intervention). Results: PHQ-9, GAD-7, CFS and Negative Affect (NA) scores measured at T1 and T2 in the intervention group were significantly lower than those in the control group (P < 0.001). And intervention group also had higher positive affect (PA) scores at T1 and T2 (P < 0.001). Furthermore, the changes of PHQ-9, GAD-7, CFS, PA and NA scores from T0 to T1 and T0 to T2 were more evident in the intervention group than in the control group. Conclusion: Psychological intervention could significantly improve psychological distress of DTC patients in the treatment with radioactive iodine.

Association of Obstructive Sleep Apnea With the Risk of Repeat Adverse Cardiovascular Events in Patients With Newly Diagnosed Acute Coronary Syndrome: A Systematic Review and Meta-Analysis.

BACKGROUND: The impact of obstructive sleep apnea (OSA) on subsequent cardiovascular events in patients with acute coronary syndrome (ACS) remains inconclusive. AIM: Our aim was to systematically assess the relationship between preexisting OSA and adverse cardiovascular events in patients with newly diagnosed ACS by conducting a systematic review and meta-analysis. METHODS: We systematically searched PubMed, EMBASE, and Cochrane library for studies published up to May 1, 2020, that reported any association between OSA and cardiovascular events in patients with newly diagnosed ACS. The main outcomes were a composite of all-cause or cardiovascular death, recurrent myocardial infarction, stroke, repeat revascularization, or heart failure. We conducted a pooled analysis using the random-effects model. We also performed subgroup, sensitivity, heterogeneity analysis, and the assessment of publication bias. RESULTS: We identified 10 studies encompassing 3350 participants. The presence of OSA was associated with increased risk of adverse cardiovascular events in newly prognosed ACS (risk ratio [RR] 2.18, 95% confidence interval [CI]: 1.45-3.26, P < .001, I2 = 64%). Between-study heterogeneity was partially explained by a multicenter study (9 single-center studies, RR 2.33 95% CI 1.69-3.19, I2 =18%), and I2 remarkably decreased from 64% to 18%. Moreover, OSA significantly increased the incidence of repeat revascularization (8 studies) and heart failure (6 studies) in patients with newly diagnosed ACS. CONCLUSION: Patients with preexisting OSA are at greater risk of subsequent cardiovascular events after onset of ACS. Further studies should investigate the treatment of OSA in patient with ACS.

[Pathogen Diagnosis of a Febrile HIV Case by the Metagenomic Next-generation Sequencing].

This study is aimed to explore the value of metagenomic next-generation sequencing (mNGS) in diagnosing pathogen in fever patients. It is often a challenge to identify the pathogen that caused the infection in the HIV patients with fever. How could the mNGS be helpful for pathogen diagnosis is unclear. Here we reported a case of human immunodeficiency virus (HIV) patient with 2-month period of fever. After routine clinical laboratory tests including the conventional smear, culture, serological tests and pathological examinations, the causal pathogen still remained undiagnosed. Then the lymph node biopsy tissue was subjected to broad-range polymerase chain reaction (PCR) and the peripheral blood was subjected to mNGS. At the same time, peripheral blood culture was carried out with an extension of culture time to acquire the pathogen. Results from both broad-range PCR and mNGS revealed the pathogen was Talaromyces marneffei. The isolate recovered from the peripheral blood culture was subjected to the whole-genome sequencing. Whole genome sequencing revealed that the antimicrobial resistance gene FLU1 existed in this pathogen's genome, but mNGS did not detect the FLU1 gene. Phylogenetic analysis based on whole genome sequence revealed that this isolate was far from other clones published in NCBI database. Here we reported a case of Talaromyces marneffei infection diagnosed by mNGS, showing that mNGS is helpful in etiological diagnosis for HIV patients with unexplained fever. However, application of mNGS in antimicrobial resistant genes detection and pathogen tracing need to be well-studied in the future.

Proteomic Analysis of Vesicle-Producing Pseudomonas aeruginosa PAO1 Exposed to X-Ray Irradiation.

Ionizing irradiation kills pathogens by destroying nucleic acids without protein structure destruction. However, how pathogens respond to irradiation stress has not yet been fully elucidated. Here, we observed that Pseudomonas aeruginosa PAO1 could release nucleic acids into the extracellular environment under X-ray irradiation. Using scanning electron microscopy (SEM) and transmission electron microscopy (TEM), X-ray irradiation was observed to induce outer membrane vesicle (OMV) formation in P. aeruginosa PAO1. The size distribution of the OMVs of the irradiated PAO1 was similar to that of the OMVs of the non-irradiated PAO1 according to nanoparticle tracking analysis (NTA). The pyocin-related proteins are involved in OMV production in P. aeruginosa PAO1 under X-ray irradiation conditions, and that this is regulated by the key SOS gene recA. The OMV production was significantly impaired in the irradiated PAO1 Δlys mutant, suggesting that Lys endolysin is associated with OMV production in P. aeruginosa PAO1 upon irradiation stress. Meanwhile, no significant difference in OMV production was observed between PAO1 lacking the pqsR, lasR, or rhlR genes and the parent strain, demonstrating that the irradiation-induced OMV biosynthesis of P. aeruginosa was independent of the Pseudomonas quinolone signal (PQS).

Volume Navigation with Fusion of Real-Time Ultrasound and CT Images to Guide Posterolateral Transforaminal Puncture in Percutaneous Endoscopic Lumbar Discectomy.

BACKGROUND: The use of percutaneous endoscopic lumbar discectomy (PELD) is increasing in the treatment of lumbar disc herniations (LDH). Nerve and vessel injury may happen during the establishment of the transforaminal working channel. Also, there is usually exposure to intraop radiation when the C-arm is used to help establish the location of the transforaminal working channel. OBJECTIVE: To evaluate the accuracy and safety of the volume navigation technique for guiding transforaminal puncture in cadaver and clinical patient treatment. STUDY DESIGN: Cadaver experiment and comparative clinical research. SETTING: Changhai Hospital, the Second Military Medical University. METHOD: Volume navigation guided transforaminal puncture was performed in 15 cadavers. The registration error, time of overall puncture, ultrasound (US) observed distance between needle tip and target (DNT), and puncture error were recorded. Clinical research was performed in 63 patients who had undergone PELD. Comparative research was done between 2 groups: Those who had transforaminal puncture carried out under C-arm guidance (n = 30), and those patients whose transforaminal puncture was carried out under volume navigation guidance (n = 33). Puncture times and frequency of fluoroscopy were recorded. Both groups were evaluated with Oswestry Disability Index (ODI), and visual analog scale (VAS) before surgery at 1, 3, and 6 months, and 1 year post-surgery. RESULTS: In the cadaver experiment, mean registration error was 2.66 ± 1.10 mm; DNT 20.08 ± 1.32 mm; puncture error 2.91 ± 1.29 mm; overall time of puncture 22.10 ± 5.20 min. In the clinical patient research, puncture times and frequency of fluoroscopy were significantly lower in the volume navigation group compared with the C-arm group (P < 0.001). There were no significant differences between the 2 groups in ODI and VAS scores (P > 0.05) at different time points. LIMITATIONS: The correlation between the registration errors and the puncture errors requires further analysis. Also, due to the relatively small number of cases studied, additional cases need to be collected to obtain reliable results. CONCLUSION: The volume navigation technique can be used for PELD because it helps to guide percutaneous posterolateral transforaminal puncture accurately with reduced puncture times and intraop radiation. KEY WORDS: Lumbar disc herniation (LDH), ultrasound volume navigation (US VNav), percutaneous endoscopic lumbar discectomy (PELD), foramen, puncture.

Preoperative deep vein thrombosis in patients with cervical spondylotic myelopathy scheduled for spinal surgery.

INTRODUCTION: The prevalence of deep vein thrombosis (DVT) and its risk factors in patients with cervical spondylotic myelopathy (CSM) before spinal surgery are poorly understood. We investigated this association with a retrospective cross-sectional study. PATIENTS CONCERNS: The study cohort consisted of all consecutive patients with CSM who were scheduled for spinal surgery at our institution from 2013 to 2015. DVT was defined as an intraluminal filling defect in a lower extremity vein identified by Doppler ultrasonography. OUTCOMES: Of the 396 patients with CSM, 16 (4%) had DVT. Compared with patients without preoperative DVT, patients with preoperative DVT were older (62.75 ±â€Š8.79 vs 53.03 ±â€Š10.95 years, P = 0.001), had higher D-dimer concentrations (2.23 ±â€Š4.15 vs 0.43 ±â€Š0.90 mg/L, P = 0.04), had experienced longer duration of CSM (7.56 ±â€Š7.08 vs 4.01 ±â€Š6.37 months, P = 0.03), had lower Japanese Orthopaedic Association lower limb motor dysfunction scores (1.68 ±â€Š1.25 vs 2.54 ±â€Š0.91, P = 0.01), and had a history of ischemic cardiovascular events (33.3% vs 2.1%, P = 0.02). The area under the curve for the ability of D-dimer levels to predict DVT was 0.858 (95% confidence interval: 0.764-0.951; P < 0.0001). A D-dimer level of 0.54 mg/L detected DVT with a sensitivity and specificity of 87.5% and 83.2%, respectively. Abnormal D-dimer levels and ischemic cardiovascular events history were independent predictors of DVT. CONCLUSION: Patients with CSM who were scheduled for surgery often presented with preoperative DVT. Preoperative vascular screening should be considered for patients with CSM, especially for those who are older, have had longer duration of CSM, have poor lower limb mobility, and have a heart disease history. Inferior vena cava filter insertion and anticoagulation treatments should be considered for CSM patients with preoperative DVT.

Renal and perinephric abscesses in West China Hospital: 10-year retrospective-descriptive study.

AIM: To elucidate the clinical, radiological and laboratory profiles of renal abscess (RA) and perinephric abscess (PNA), along with related treatment and outcome. METHODS: Ninety-eight patients diagnosed with RA or PNA using the primary discharge diagnoses identified from the International Statistical Classification of Diseases and Related Health Problems Tenth Edition (ICD-10) codes (RA: N15.101, PNA: N15.102) between September 2004 and December 2014 in West China Hospital were selected. Medical records including patients' characteristics, symptoms and signs, high-risk factors, radiological features, causative microorganisms and antibiotic-resistance profiles, treatment approaches, and clinical outcomes were collected and analyzed. RESULTS: The mean age of the patients was 46.49 years with a male to female ratio of 41:57. Lumbar pain (76.5%) and fever (53.1%) were the most common symptoms. Other symptoms and signs included chills (28.6%), anorexia and vomiting (25.5%), lethargy (10.2%), abdominal pain (11.2%), flank mass (12.2%), flank fistula (2.0%), gross hematuria (7.1%), frequency (14.3%), dysuria (9.2%), pyuria (5.1%) and weight loss (1.0%). Painful percussion of the costovertebral angle (87.8%) was the most common physical finding. The main predisposing factors were lithiasis (48.0%), diabetes mellitus (33.7%) followed by history of urological surgery (16.3%), urinary tract infections (14.3%), renal function impairment (13.3%), liver cirrhosis (2.0%), neurogenic bladder (1.0%), renal cyst (1.0%), hydronephrosis (1.0%), chronic hepatitis B (1.0%), post-discectomy (1.0%) and post-colectomy (1.0%). Ultrasound (US) and computed tomography were the most valuable diagnostic tools and US was recommended as the initial diagnostic imaging choice. Escherichia coli (51.4%), Staphylococcus aureus (10.0%) and Klebsiella pneumoniae (8.6%) were the main causative microorganisms. Intravenous antibiotic therapy was necessary while intervention including surgical and nonsurgical approaches were reserved for larger abscesses, multiple abscesses, PNAs and non-responders. CONCLUSION: Heightened alertness, prompt diagnosis, and especially proper antibiotics in conjunction with interventional approaches allow a promising clinical outcome of renal and perinephric abscesses.

CD30+ extranodal natural killer/T-cell lymphoma mimicking phlegmonous myositis: A case report.

The current study presents a case of a 23-year-old male with CD30+ nasal-type extranodal natural killer/T-cell lymphoma (NKTL), with unusual clinical features mimicking phlegmonous myositis. The patient initially presented with swelling and tenderness of the left lower limb, particularly around the left ankle. One month later, pharyngalgia and fever developed and the patient was treated with antibiotics for the phlegmonous inflammation, however, the symptoms were not relieved. A muscle biopsy was performed on the lesion and revealed diffuse infiltration of atypical lymphoid cells with irregular nuclei. Immunohistochemistry showed staining for CD3ɛ(-), CD20(-), CD45(+), CD30(+) and CD56(+) presented with positive staining for certain tumor cells, granzyme B(+), activin receptor-like kinase 1(-), Ki-67(+) and Epstein-Barr virus-encoded small RNA(+), which indicated nasal-type extranodal NKTL. The present case emphasized that extranodal NKTL may be a rare cause of phlegmonous inflammation and fever of undetermined origin.

[Clinical analysis of 137 patients with visceral leishmaniasis].

OBJECTIVE: To analyze the clinical and epidemiological characteristics of visceral leishmaniasis cases in Sichuan. METHODS: The medical records of 137 patients with visceral leishmaniasis were reviewed between January 2000 and April 2012 in West China Hospital. The epidemiological data, clinical manifestations, laboratory features, diagnosis, therapeutic procedures and outcome of the patients were retrospectively analyzed. RESULTS: Eighty-eight (64.2%) out of 137 cases were the residents in the endemic area of Sichuan Province and adjacent areas, and 49 (35.8%) were non-endemic area residents with a history of visiting endemic area. Patients living in rural areas accounted for 84.7% (116/137), in town for 15.3% (21/137). Visceral leishmaniasis should be strongly suspected in a patient with prolonged fever, marked hepatosplenomegaly, lymphadenectasis, cytopenia and hypergammaglobulinemia. All patients showed positive in rk39 dipstick test, and were treated with antimony sodium gluconate. Among these patients, 86.1% (118/137) were cured by drug, 2.9% (4/137) received splenectomy, and 6.6% (9/137) relapsed. The misdiagnosis rate was 23.4% (32/137). CONCLUSION: Bone marrow smear staining and biopsy, combined with rk39 antibody detection and epidemiological history are crucial for early diagnosis and treatment of visceral leishmaniasis. Antimonials is still an effective therapeutic choice.

Magnetic resonance imaging analysis of surgical trans-sacral axial L5/S1 interbody fusion.

BACKGROUND: Trans-sacral axial L5/S1 interbody fusion (AxiaLIF), a novel surgical procedure, recently adopted in clinical practice, has excellent clinical outcomes. However, there is inadequate data on the feasibility of the approach in all adult patients and the optimal surgical approach is currently unclear; therefore, further studies are required. In order to enhance the surgical approach for AxiaLIF, prospective anatomical imaging optimization is necessary. The objective of this study was to investigate the ability of magnetic resonance imaging (MRI) to achieve an optimal procedural setting. METHODS: The subjects (n=40) underwent lumbosacral MRI examination. The median sagittal MRI images were analyzed and four measurement markers were defined as follows: the center of the L5/S1 disc (A), the anterior margin of the S1/2 disc space (B), the sacrococcygeal junction (C), and the coccygeal tip (D). The measurement markers were connected to each other to produce five lines (AB, AC, AD, BC, and BD), as reference lines for surgical approaches. The distance between each reference line and the anterior and posterior margins of the L5 and S1 vertebral bodies was measured to determine the safety of the respective approaches. RESULTS: In all patients, Lines AB and AC satisfied the imaging safety criteria. Line AB would result in a significant deviation from the median and was determined to be unsuitable for AxiaLIF. Line AD satisfied the imaging safety criteria in 39 patients. However, the anal proximity of the puncture point proved to be limiting. For lines BC and BD, the imaging safety criteria were satisfied in 70% and 45% of patients, respectively. CONCLUSIONS: The AxiaLIF procedure is a safe technique for insertion of fusion implants in all subjects. Line AC is a favorable reference line for surgical approach and safe for all subjects, while line BC is not suitable for all subjects.

PCR versus serology for diagnosing Mycoplasma pneumoniae infection: a systematic review & meta-analysis.

BACKGROUND & OBJECTIVES: Diagnosis for Mycoplasma pneumoniae usually relies on serological tests. PCR technology has some advantages but also limitations. The optimal selection for these tests still needs discussion. This paper reviews the overall diagnostic accuracy of PCR versus serological assays for diagnosis of M. pneumoniae infections and to identify factors associated with heterogeneity of results. METHODS: MEDLINE and Embase databases were searched. Articles meeting the selection criteria were retrieved for data collection and analysis. Studies were assessed for methodological quality using QUADAS. Hierarchial summary receiver operating characteristic (HSROC) model was used to estimate summary ROC curve. RESULTS: Initial meta-analysis showed a summary estimate of sensitivity (SEN) 0.62 (95% CI, 0.45-0.76), and specificity (SPE) 0.96 (95% CI, 0.93-0.98). Subgroup analyses were performed to identify factors associated with heterogeneity. For different gene targets, reference standards, subjects (children or adults) and different PCR types, these aspects can generate results of heterogeneity. The 16s rDNA target and adult subjects and real-time PCR may have better test results for PCR. INTERPRETATION & CONCLUSIONS: Commercial PCR tests generated consistent results with high specificity but a lower and more variable sensitivity. The findings suggest commercial PCR tests having superiorities in diagnosing M. pneumoniae infections but still cannot replace serology. PCR plus serology could be good screening tests for reliable and accurate diagnosis of M. pneumoniae.

Is the transsacral axial interbody fusion a candidate surgical approach for fusing both L5/S1 and L4/5?

BACKGROUND: Previous clinical and basic research of axial lumbar interbody fusion (AxiaLIF) all focused on the L5/S1. However, there is no data on the feasibility of this approach for the fusion of both L4/5 and L5/S1. This study aimed to explore whether transsacral axial interbody fusion is a candidate for the fusion of both L4/5 and L5/S1. METHODS: The subjects (n = 40) underwent lumbosacral magnetic resonance imaging (MRI). The median sagittal MRI images were analyzed and five measurement markers were defined as follows: the center of the L4/5 disc (A), the center of the L5/S1 disc (B), the anterior margin of the S1/2 space (C), the sacrococcygeal junction (D), and the coccygeal tip (E). The measurement markers were connected each other to produce nine lines (AB, AC, AD, AE, BC, BD, BE, CD and CE) as the reference lines for surgical approaches. The distance between each reference line and the anterior and posterior margins of the L4, L5 and S1 vertebral bodies were measured to determine the safety of the respective approaches. RESULTS: Twenty subjects were capable of finding one reference line to fuse both L4/5 and L5/S1 via transsacral axial interbody fusion approach. The surgical approach reference line was AE or CE line. In the other 20 subjects, it was failed to find a reference line which met the safety criteria for fusing both L4/5 and L5/S1. CONCLUSIONS: About half of subjects were capable of finding a suitable AxiaLIF reference line to fuse both L4/5 and L5/S1. In some subjects, it was difficult to find a suitable AxiaLIF reference line to fuse both L4/5 and L5/S1.

An MRI study of psoas major and abdominal large vessels with respect to the X/DLIF approach.

Extreme/direct lateral interbody fusion (X/DLIF) has been used to treat various lumbar diseases. However, it involves risks to injure the lumbar plexus and abdominal large vessels when it gains access to the lumbar spine via lateral approach that passes through the retroperitoneal fat and psoas major muscle. This study was aimed to determine the distribution of psoas major and abdominal large vessels at lumbar intervertebral spaces in order to select an appropriate X/DLIF approach to avoid nerve and large vessels injury. Magnetic resonance imaging scanning on lumbar intervertebral spaces was performed in 48 patients (24 males, 24 females, 54.2 years on average). According to Moro's method, lumbar intervertebral space was divided into six zones A, I, II, III, IV and P. Thickness of psoas major was measured and distribution of abdominal large vessels was surveyed at each zone. The results show vena cava migrate from the right of zone A to the right of zone I at L1/2-L4/5; abdominal aorta was located mostly to the left of zone A at L1/2-L3/4 and divided into bilateral iliac arteries at L4/5; Psoas major was tenuous and dorsal at L1/2 and L2/3, large and ventral at L3/4 and L4/5. Combined with the distribution of nerve roots reported by Moro, X/DLIF approach is safe via zones II-III at L1/2 and L2/3, and via zone II at L3/4. At L4/5, it is safe via zones I-II in left and via zone II in right side, respectively.

Population pharmacokinetics of oral levofloxacin 500 mg once-daily dosage in community-acquired lower respiratory tract infections: results of a prospective multicenter study in China.

This study aimed to explore the pharmacokinetic features of levofloxacin (LVFX) in Chinese patients with infections and to confirm oral LVFX 500 mg once daily as an optimal treatment regimen based on pharmacokinetic-pharmacodynamic (PK-PD) analysis. A total of 1052 plasma samples from 164 Chinese adult patients with community acquired lower respiratory tract infections (CALRTIs) and 18 healthy volunteers were used for population PK analysis. LVFX 500-mg tablets were given once daily. A nonlinear mixed effects model (NONMEM) program was used for population PK model-building and a two-compartment model with first-order absorption process was established. Creatinine clearance (CL(cr)) and body weight were identified as intrinsic factors which significantly affected oral clearance (CL(t)/F) and the apparent volume of distribution of the central compartment (V1/F), respectively. The final model is described as follows: CL(t)/F (l/h) = (8.97 + 0.917 x (CL(cr) (ml/min)-100.92) x 60/1000) x exp (eta(CLt/F)). V1/F (l) = (85.3 + 1.22 x (weight (kg)-60.75)) x exp (eta(V1/F)). Q/F (l/h) = 0.351. V2/F (l) = 6.81. k(a) (h(-1)) = 1.44 x exp(eta(ka)). Based on the population PK model, mean C(max) and AUC(0-24h) in CALRTI patients were estimated as 5.13 microg/ml and 58.98 microg.h/ml, respectively. A subgroup analysis showed that patients with mild renal dysfunction (50 ml/min < or = CL(cr) < 80 ml/min) had 34% higher AUC(0-24h) values compared to patients with normal renal function (CL(cr) > or = 80 ml/min). Postmodeling simulation using final population PK estimates also showed that C(max) and AUC(0-24h) increased markedly in patients with severe renal dysfunction. The results indicate that LVFX dosage adjustment should be individualized on the basis of the CL(cr), especially in those with CL(cr) less than 50 ml/min. None of the PK parameters had any correlation with the occurrence of adverse events. PK-PD analysis indicated that, in patients treated with LVFX 500 mg once daily, the AUC(0-24h)/MIC ratio exceeded the target for those major CALRTI pathogens isolated. In addition, the C(max)/MIC ratio reached 5 for Streptococcus pneumoniae, indicating that the emergence of LVFX-resistant S. pneumoniae could be prevented during the therapy with this dosage regimen. These results demonstrate that oral LVFX 500 mg once daily has favorable PK parameters and PK-PD features in patients with CALRTIs, and the results strongly support this dosage regimen for the treatment of CALRTI.

Infantile hemangioma is originated from placental trophoblast, fact or fiction?

Infantile hemangiomas are common, benign tumors, distinctive for their perinatal presentation, rapid growth and subsequent involution. Hemangiomas can pose serious concerns to the cosmetic and psychosocial development of the afflicted child, but none of the current therapeutic modalities is ideal to date, partly because the origin of the pathogenic ECs in infantile hemangioma is unknown. Many clues and evidences suggest a link between infantile hemangiomas and the maternal placental trophoblasts. Shared expression of distinct endothelial markers in hemangioma and placental tissues raises a possibility that infantile hemangioma is originated from placental trophoblast. Moreover, the findings of a very high similarity between the transcriptomes of placenta and hemangioma provide strong support for this theory. Furthermore, epidemiologic and clinical evidences accumulated in recent years also suggest the placental trophoblast as the cell of origin for infantile hemangioma. These findings imply a unique relationship between hemangioma and the placental trophoblast and suggest a hypothesis that infantile hemangioma is originated from placental trophoblast. The hypothesis could provide new understanding of these vascular tumors of childhood and may become the most promising research fields for the etiology of infantile hemangiomas. Further study of the precise mechanisms for the placental trophoblast originated hemangiomas will produce new preventive strategies and therapeutic avenues, possibly immunologic treatment, to the very difficult problem.

[Survey of studies on tissue structures and biological characteristics of channel lines].

In order to comprehensively understand current situation about studies on channels and to open train of thought for the study, the relative literatures are analyzed and summarized from morphology, biophysics, biochemistry and so on. Probe into existing models of channel lines from nerves, blood vessels and nerves, gap junction, connective tissue; summarize biophysical characte-ristics of channels from temperature, loose connective tissue, biopressure effect, coherence electromagnetic field, etc.; and summarize biochemical characteristics of channels from ion concentration, exhalant of CO2, extracellular matrix and enzymology on the channel lines. Although the studies have not revealed essence of channel lines, these results reflect survey of studies on tissue structures and biological characteristics of channel lines at present.

[Application of rDNA-ITS sequence in entomology].

As an important complement of the information obtained from mtDNA, the internal transcribed spacer (ITS) of nuclear ribosomal DNA is being increasingly applied in entomological study. This paper introduced the structure and characters of ITS, and summarized its applications in identifying insect species and in studying their relative relationships and phylogenesis, evolution and spread, and relations with environment. ITS was mainly applied in identifying the species whose morphological differences were subtle. The research of relative relationships and phylogenesis was aimed to understand the species origin and evolution, while the study on the relations with environment was mainly focused on sociological and parasitic insects. The problems and their possible causes in ITS application were discussed.