[Effect of endoscopic vidian neurectomy in patients with coexisting allergic rhinitis and bronchial asthma].

Objective: To evaluate the clinical significance of endoscopic vidian neurectomy (EVN) on outcomes in patients with coexisting refractory allergic rhinitis (AR) and bronchial asthma, and to analyze its influence factor. Methods: Clinical data of 109 patients with moderate to severe persistent intractable AR and bronchial asthma who were allocated to the bilateral EVN group (surgery group, 70 cases) or conservative medication group (drug group, 39 cases) from 1 May 2008 to 30 April 2013 in Department of Otorhinolaryngology Head and Neck Surgery, Third Xiangya Hospital, Central South University were retrospectively analyzed, including 47 cases of male and 62 cases of female aged (32.7±6.8) years.Ninety-five patients were followed up for at least 3 years. The Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), Visual Analog Scale (VAS), Asthma Quality of Life Questionnaire (AQLQ), Total Asthma Symptom Score (TASS), forced expiratory volume in 1 second of predicted (FEV1) and medication scores were evaluated at 6 months, 1 year and 3 years after undergoing the initial treatments in the two groups. Multiple factor analysis was used to determine the factors influencing the improvement after EVN. Results: Postoperative scores of RQLQ were significantly lower than preoperative scores during follow-up in surgery group (the preoperative score and postoperative score at 6 months, 1 year, 3 years after operation was 2.39±0.61 (x±s), 0.81±0.43, 0.89±0.32, 1.06±0.24, respectively, all P<0.001). Postoperative scores of VAS were significantly lower than preoperative scores during follow-up in surgery group (the preoperative score and postoperative score at 6 months, 1 year,3 years after operation was 7.13±1.04, 2.52±1.47, 2.70±1.42, 2.85±1.64, respectively, all P<0.05). Scores of RQLQ and VAS in surgery group were significantly lower than those of drug group. Postoperative scores of AQLQ were significantly higher than preoperative scores during follow-up in surgery group (the preoperative score and postoperative score at 6 months, 1 year, 3 years after operation was 3.78±0.81, 4.99±0.45, 4.75±0.71, 4.62±0.64, respectively, all P<0.05), and were significantly higher than those of drug group. The TASS and FEV1 were not significantly changed in surgery group. The postoperative medication scores for AR were gradually reduced after surgery (the preoperative score and postoperative score at 6 months, 1 year, 3 years after operation was 0.99±0.21, 0.37±0.12, 0.39±0.26, 0.45±0.11, respectively, all P<0.05), and the postoperative medication scores for Asthma were gradually reduced after surgery too (the preoperative score and postoperative score at 6 months, 1 year, 3 years after operation was 1.27±0.31, 0.82±0.29, 0.85±0.23, 0.96±0.19, respectively, all P<0.05), and all the postoperative medication scores were significantly lower than those of drug group. At the end of the follow-up, the improvement rates for AR and asthma were 90.6% (58/64) and 45.3% (29/64), respectively. Asthma outcomes were significantly improved by controlling rhinitis symptoms in patients whose asthma attacks were induced by "rhinitis onset" or "climate change" . Conclusion: For patients with AR and bronchial asthma, EVN can significantly control AR symptoms, and improve asthma outcomes in patients whose asthma attacks are induced by rhinitis onset and/or climate change.

Clone, expression and plasminogen binding property of three fructose-1,6-bisphosphate aldolases from Clonorchis sinensis.

Fructose-1,6-bisphosphate aldolase (FbA), a well characterized glycometabolism enzyme, has been found to participate in other important processes besides the classic catalysis. To understand the important functions of three fructose-1,6-bisphosphate aldolases from Clonorchis sinensis (CsFbAs, CsFbA-1/2/3) in host-parasite interplay, the open reading frames of CsFbAs were cloned into pET30a (+) vector and the resulting recombinant plasmids were transformed into Escherichia coli BL21 (DE3) for expression of the proteins. Purified recombinant CsFbAs proteins (rCsFbAs) were approximately 45.0 kDa on 12% SDS-PAGE and could be probed with each rat anti-rCsFbAs sera by western blotting analysis. ELISA and ligand blot overlay indicated that rCsFbAs of 45.0 kDa as well as native CsFbAs of 39.5 kDa from total worm extracts and excretory-secretory products of Clonorchis sinensis (CsESPs) could bind to human plasminogen, and the binding could be efficiently inhibited by lysine analog ε-aminocaproic acid. Our results suggested that as both the components of CsESPs and the plasminogen binding proteins, three CsFbAs might be involved in preventing the formation of the blood clot so that Clonorchis sinensis could acquire enough nutrients from host tissue for their successful survival and colonization in the host. Our work will provide us with new information about the biological function of three CsFbAs and their roles in hostparasite interplay.

Clone, expression and plasminogen binding property of three fructose-1,6-bisphosphate aldolases from Clonorchis sinensis

@# Fructose-1,6-bisphosphate aldolase (FbA), a well characterized glycometabolism enzyme, has been found to participate in other important processes besides the classic catalysis. To understand the important functions of three fructose-1,6-bisphosphate aldolases from Clonorchis sinensis (CsFbAs, CsFbA-1/2/3) in host-parasite interplay, the open reading frames of CsFbAs were cloned into pET30a (+) vector and the resulting recombinant plasmids were transformed into Escherichia coli BL21 (DE3) for expression of the proteins. Purified recombinant CsFbAs proteins (rCsFbAs) were approximately 45.0 kDa on 12% SDS-PAGE and could be probed with each rat anti-rCsFbAs sera by western blotting analysis. ELISA and ligand blot overlay indicated that rCsFbAs of 45.0 kDa as well as native CsFbAs of 39.5 kDa from total worm extracts and excretory-secretory products of Clonorchis sinensis (CsESPs) could bind to human plasminogen, and the binding could be efficiently inhibited by lysine analog ε-aminocaproic acid. Our results suggested that as both the components of CsESPs and the plasminogen binding proteins, three CsFbAs might be involved in preventing the formation of the blood clot so that Clonorchis sinensis could acquire enough nutrients from host tissue for their successful survival and colonization in the host. Our work will provide us with new information about the biological function of three CsFbAs and their roles in hostparasite interplay

[Impact of antimicrobial stewardship program on antimicrobial usage and detection rate of multidrug-resistant gram-negative bacteria].

Objective: Analyze the changes of indicator of antimicrobial usage and detection rate of multidrug-resistant gram-negative bacteria (MDR-GNB), in order to evaluate the impact of antimicrobial stewardship program (ASP). Methods: The antimicrobial stewardship program was implemented since December 2011 at the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University. Intensified effort was made from 2014 to 2017. We divided the program into four stages, one before ASP (2010-2011) and three after ASP (2012-2013 as the first, 2014-2015 as the second and 2016-2017 as the third post-ASP stages). The usage rates in outpatient,emergency department and inpatient, along with the antibiotic use density (AUD, defined as daily doses/per 100 patient-days), the AUD of the third-generation cephalosporins and carbapenems in inpatient were reviewed retrospectively. The detection rates of extended-spectrum ß-lactamases (ESBLs)-producing Escherichia coli, ESBLs-producing Klebsiella pneumonia, carbapenem-resistant E. coli, carbapenem-resistant Klebsiella pneumonia, carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Pseudomonas aeruginosa were also analyzed at the same time. The correlation analysis between the detection rate of MDR-GNB and the indicator of antimicrobial usage was made. Result: Among four stages, the usage rates were 55.2% (560 578/1 015 540) , 38.1% (493 554/1 296 336) , 26.8% (378 602/1 411 595) and 23.1% (347 817/1 502 817) in outpatient, 75.6% (429 582/568 230) , 61.4% (382 558/623 138) , 43.6% (265 102/608 071) and 35.1% (218 484/622 397) in emergency department, and 76.0% (30 568/40 221) , 53.7% (30 437/56 636) , 49.9% (37 395/74 895) and 50.3% (35 493/70 544) in inpatient, respectively. All indicators decreased significantly (χ(2)=297 811.798, 3 155 704.783, 5 592.037, P<0.01). The AUD in inpatient was 38.4,31.8,21.7 and 19.41,and the AUD of the third-generation cephalosporins were 13.83, 11.21, 6.20 and 6.84, respectively, which decreased significantly after ASP (r=-0.878, -0.781, P<0.05). The AUD of carbapenems were 1.94,1.77,1.87 and 1.93, respectively (r=0.123, P>0.05). A total of 11 289 strains of bacteria were collected, including 5 589 strains of E. coli, 2 823 strains of K.pneumoniae, 1 637 strains of A. baumandii, and 1 240 strains of P. aeruginosa.The detection rates of ESBLs-producing E.coli and ESBLs -producing K. pneumoniae in four stages were 75.4% (1 034/1 371) , 66.6% (893/1 341) , 57.8% (834/1 443) , 46.7% (670/1 434) and 78.7% (547/695) , 67.5% (455/674) , 49.3% (421/854) , 32.5% (195/600) , respectively,both decreased significantly (χ(2)=266.204; 328.805, P<0.01). The detection rates of Carbapenem-resistant A. baumannii were 28.2% (115/408) , 26.7% (126/472) , 24.3% (125/515) and 12.0% (29/242) respectively,and showed significant decreasing trend after ASP (χ(2)=18.112, P<0.01). The detection rates of carbapenem-resistant P. aeruginosa were 11.3% (40/355) , 18.5% (58/313) , 13.4% (46/343) and 7.0% (16/229) , respectively,with the most obvious decrease in the third stage after ASP. The detection rates of carbapenem-resistant E. coli and carbapenem-resistant K. pneumonia were continuously lower (<5%). There were positive correlations between the detection rates of ESBLs-producing E. coli and K. pneumoniae and all usage indicators (r(1)=0.930, 0.974, 0.746, 0.958, 0.842; r(2)=0.910, 0.960, 0.765, 0.963, 0.898, P<0.05). Conclusion: The antimicrobial stewardship program can effectively reduce both the usage of antimicrobial and the production of MDR-GNB, which has great value to promote rational clinical use of antimicrobials and reduce bacterial resistance.

Long non-coding RNA Dleu2 affects proliferation, migration and invasion ability of laryngeal carcinoma cells through triggering miR-16-1 pathway.

OBJECTIVE: Laryngeal cancer is a common malignant tumor in the head and neck, which affects swallowing, breathing, and pronunciation function. In recent years, many long non-coding RNAs (lncRNAs) have been shown to be involved in the progression of cancer with the development of gene sequencing, transcriptomics, and bioinformatics. LncRNA Dleu2 is a cancer-related lncRNA that down-regulates tumor progression in a variety of cancers. However, its possible effects and related signaling pathway in the development of laryngeal cancer are not clear. PATIENTS AND METHODS: Real-time PCR was applied to test lncRNA Dleu2 and microRNA-16-1 (miR-16-1) expressions in laryngeal carcinoma tissues. LncRNA Dleu2 and miR-16-1 levels were over-expressed by transfection. Cell proliferation was assessed by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. Cell migration was evaluated by using wound-healing assay. Cell invasion was determined by using transwell assay. RESULTS: LncRNA Dleu2 and miR-16-1 levels were significantly declined in the laryngeal carcinoma tissue compared to para-carcinoma tissue (p < 0.05). LncRNA Dleu2 and miR-16-1 up-regulation significantly reduced cell proliferation, migration, and invasion compared to the control group (p < 0.05). Ago-miR16-1 transfection significantly enhanced the luciferase activity of wild-type Dleu2 compared to control group (p < 0.05), suggesting their interaction with each other. CONCLUSIONS: LncRNA Dleu2 influences the proliferation, migration, and invasion of laryngeal cancer cells through miR-16-1. Therefore, lncRNA Dleu2 and miR-16-1 may serve as potential biomarkers and targets for laryngeal cancer diagnosis and treatment.

Isolation and characterization of novel polymorphic microsatellite markers for Epinephelus akaara.

In the present study, ten novel microsatellite markers were developed from an enriched-(CA)13 genomic library of Epinephelus akaara. The mean number of alleles per locus was 21.6, with a range of 12 to 33. Observed heterozygosity ranged from 0.767 to 0.967, and expected heterozygosity ranged from 0.831 to 0.975, with mean values of 0.877 and 0.923, respectively. Among the ten loci, three loci deviated from Hardy-Weinberg equilibrium after sequential Bonferroni's correction. These polymorphic microsatellite markers may be useful for studies on the population genetics of E. akaara.

Nineteen polymorphic microsatellite markers developed for Trachinotus ovatus.

To evaluate the population genetic diversity of the ovate pompano, we isolated and characterized 19 microsatellite markers using a (CA)13-enriched genomic library. Polymorphism was assessed in 30 individuals from a single population collected from the Daya Bay Aquaculture Center, Guangdong, China. The number of alleles per locus ranged from 2 to 18 with an average of 7.8. The observed and expected heterozygosities varied from 0.2667 to 1.000 and from 0.3960 to 0.9435, respectively. Sixteen of 19 loci conformed to Hardy-Weinberg equilibrium, and no significant linkage disequilibrium was detected between any locus pairs. Our study supplies candidate microsatellite markers that can be useful for studying the population genetic structure of ovate pompano.

Detection of anti-Trichinella antibodies in serum of experimentally-infected swine by immunochromatographic strip.

An immunochromatographic strip method, developed with the excretory-secretory antigens from muscle larvae (ML) of Trichinella spiralis labeled with colloidal gold, was used for the detection of anti-Trichinella antibodies in serum of experimentally-infected swine. Sera from swine infected with 200, 2000 and 20,000 infective ML were collected at different days post infection (dpi) and used to evaluate the method. The strip method was shown able to detect anti-Trichinella antibodies by 35 dpi, 28 dpi and 21 dpi for the three different infection doses, respectively, and closely correlated with the results of an ELISA test. The strip method is rapid and easy to perform and is suggested as an acceptable alternative for clinical laboratories lacking specialized equipment, and for field diagnosis of trichinellosis.

Identification and molecular characterisation of HMW glutenin subunit 1By16* in wild emmer.

In this study, a novel y-type high molecular weight glutenin subunit (HMW-GS) in wild emmer wheat Triticum turgidum L. var. dicoccoides (Körn.) accession KU1952 was identified by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE), capillary electrophoresis (CE) and matrix-assisted laser desorption ionisation/time-of-flight/mass spectrometry (MALDI-TOF-MS). Its electrophoretic mobility and molecular weight were similar to those of 1By16 and was designated as 1By16*. The complete coding sequence of the 1By16* gene isolated by allelic-specific polymerase chain reaction (AS-PCR) consists of 2,157 bp, encoding 729 amino acid residues. The real presence and authenticity of the 1By16* gene in KU1952 were further confirmed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), heterologous expression and Western blotting. The molecular structure as well as phylogenetic analysis revealed that 1By16* had 21 single-nucleotide polymorphism (SNP) variations and possessed greater similarity with superior quality subunits 1By15 and 1By16 of common wheat. Secondary structure prediction displayed higher α-helix and ß-strand contents in the 1By16* subunit, which could form a superior gluten structure and, consequently, might have positive effects on dough quality. Our results suggest that 1By16* is expected to be a new potential gene for wheat quality improvement.

Molecular characterization of HMW-GS 1Dx3(t) and 1Dx4(t) genes from Aegilops tauschii and their potential value for wheat quality improvement.

Two x-type high molecular weight glutenin subunits (HMW-GS) in Aegilops tauschii, 1Dx3(t) and 1Dx4(t) were identified by SDS-PAGE and MALDI-TOF-MS. Their complete coding sequences were isolated by AS-PCR. 1Dx3(t) and 1Dx4(t) genes consist of 2535 bp and 2508 bp and encode 845 and 836 amino acid residues, respectively. The deduced molecular masses of 1Dx3(t) and 1Dx4(t) gene products are 87655.26 Da and 86664.24 Da, respectively, well corresponding to the molecular masses measured by MALDI-TOF-MS. A total of 18 SNPs were identified between 1Dx3(t) and 1Dx4(t). Comparing with 1Dx5 subunit, 1Dx3(t) had a six amino acid insertion at 146-151 while the 1Dx4(t) had a nine amino acid deletion when compared with 1Dx3(t) subunit. The authenticity of the cloned 1Dx3(t) and 1Dx4(t) genes were confirmed by successful expression of their ORFs in E. coli. Comparison and phylogenetic tree based on the amino acid and nucleotide sequences confirmed that 1Dx3(t) was most closely related to 1Dx5 subunit that is widely accepted as a superior subunit for bread-making property. The secondary structure prediction demonstrated that 1Dx3(t) subunit has significantly high α-helix and ß-strand contents, suggesting it might have positive effects on dough quality.

An interactive multimedia training system for advanced cardiac life support.

This paper describes an Advanced cardiac life support (ACLS) training system (ACLSYS) with multimedia and hypertext features for training medical personnel and evaluating their performance during ACLS events. ACLSYS runs in a Windows 95 environment and is written in Visual Basic 4.0 Enterprise Edition and Access 7.0. The system consists of two primary modules: a multimedia training module and a simulation/evaluation module. The training module provides the knowledge and skills required for the appropriate early treatment of cardiopulmonary arrest. The simulation/evaluation module generates randomly an unlimited number of ACLS cases. These cases become part of the training case database and are available for retraining. ACLS certified personnel were included in the validation of the system.

Effects of vitamin C on myocardial mitochondrial function and ATP content in hypoxic rats.

AIM: To observe the effects of large dose of vitamin C (Vc) on myocardial mitochondrial function, ATP content, and myocardial structure in acute and chronic hypoxic rats. METHODS: Rats were exposed to a simulated altitude 4000 m (barometric pressure = 43 kPa) for 3 and 30 d. Vc (0.75 g.kg-1.d-1) was injected i.p. The heart mitochondrial respiratory function were determined by Clark-type O2 electrode; mitochondrial membrane fluidity (MMF) were assayed through fluorescence polarizative method; the contents of ATP, ADP, and AMP in myocardial tissue were measured with HPLC. RESULTS: After administration of Vc, the ATP content was increased from 35 +/- 3 mg.g-1 to 53 +/- 3 mg.g-1 in acute hypoxic rats (P < 0.01), from 42 +/- 4 mg.g-1 to 48 +/- 3 mg.g-1 in chronic hypoxic rats (P < 0.01); Pa, O2 was increased from 7.2 +/- 1.4 kPa to 9.5 +/- 1.2 kPa in acute hypoxic rats (P < 0.01); mitochondrial respiratory control rate (RCR) was increased from 2.1 +/- 0.6 to 4.7 +/- 0.5 in acute hypoxic rats (P < 0.01), and from 3.3 +/- 0.7 to 4.5 +/- 0.6 in chronic hypoxic rats (P < 0.01); MMF was increased in acute and chronic hypoxic rats (P < 0.05); the degree of myocardial necrosis in vitamin C preventive rats was attenuated as compared with those of acute hypoxic rats. CONCLUSION: Vc is effective on improving myocardial energy metabolism and protecting against myocardial structural injury in hypoxic rats.

Protective effects of Ginkgo biloba extract against lysophosphatidylcholine-induced vascular endothelial cell damage.

AIM: To study the protective effects of Ginkgo biloba extract (GbE) against endothelial cell damage induced by lysophosphatidylcholine (LPC). METHODS: The vasorelaxation response to acetylcholine (ACh) were investigated in the isolated rabbit thoracic aorta. Lipid peroxidation products were determined by measuring thiobarbituric acid reactive substance. RESULTS: GbE attenuated the inhibition of vasorelaxation response to ACh and prevented the LPC-induced increase of malondialdehyde (MDA) content both in thoracic aortae. GbE prevented the leakage of LDH and the increase of MDA content in cultured endothelial cells in a concentration-dependent manner. GbE also markedly increased epoprostenol level in cultured endothelial cells treated with LPC. CONCLUSION: GbE protected endothelial cells against LPC-induced damage due to reduction in lipid peroxidation and facilitation of synthesis and/or release of epoprostenol.

Preventive and therapeutic effects of nitrendipine on hypoxic right ventricular hypertrophy.

AIM: To assess whether nitrendipine (Nit) can be used to prevent and treat the hypoxic right ventricular hypertrophy (RVH). METHODS: Rats were exposed to a simulated altitude of 5000 m (barometric pressure = 54 kPa) for 30-60 d. Nit (10-20 mg.kg-1.d-1) was administered via gavage. The therapeutic efficacy was evaluated with right ventricular weight index (RVWI), right ventricular systolic pressure (RVSP), and myocardial ultrastructure. RESULTS: Chronic intermittent hypoxia for 30 d (8 h.d-1) resulted in an increase of RVSP and RVWI as well as in the changes of RV myocardial ultrastructure. As the hypoxic time was prolonged to 60 d, RVWI and RVSP were not further augmented. Nit (20 mg.kg-1.d-1, i.g.), when administered from the beginning of hypoxia, reduced RVSP (8.1 +/- 1.1 vs 6.0 +/- 1.0 kPa, P < 0.05) and RVWI (1.014 +/- 0.012 vs 0.915 +/- 0.049 mg/g body weight, P < 0.05). After development of hypoxic RVH, Nit (20 mg.kg-1) also decreased RVSP (7.9 +/- 1.0 vs 6.2 +/- 0.8 kPa, P < 0.05) and RVWI (1.02 +/- 0.13 vs 0.88 +/- 0.12 g/kg body weight, P < 0.05). Myocardial blood flow was increased and myocardial ultrastructure became nearly normal in rats treated with Nit. CONCLUSION: Nit prevented and lessened the hypoxic right ventricular hypertrophy.

[The role of polycythemia in the pathogenesis of hypoxic myocardial hypertrophy].

Either chronic hypoxia or polycythemia induced by CoCl2 injection resulted in an increase of RBC, Hb, Hct and blood viscosity at different shear rate. There was an increase of right ventricular systolic and end diastolic pressure, +/- dp/dtmax, Vmax and right weight index, as compared with the control rats. Chronic hypoxia combined with polycythemia induced by CoCl2 injection further augmented the above parameters except Vmax of RV, and caused an increase of left ventricular weight index. The positive correlation was seen between the RV weight index and Hct. The above results prove that polycythemia might play important role in pathogenesis of hypoxic myocardial hypertrophy.