CmDOF18 positively regulates salinity tolerance in Chrysanthemum morifolium by activating the oxidoreductase system.

BACKGROUND: Chrysanthemum, one of the four major cut flowers all over the world, is very sensitive to salinity during cultivation. DNA binding with one finger (DOF) transcription factors play important roles in biological processes in plants. The response mechanism of CmDOF18 from chrysanthemum to salt stress remains unclear. RESULTS: In this study, CmDOF18 was cloned from Chrysanthemum morifolium, and its expression was induced by salinity stress. The gene encodes a 291-amino acid protein with a typical DOF domain. CmDOF18 was localized to the nucleus in onion epidermal cells and showed transcriptional activation in yeast. CmDOF18 transgenic plants were generated to identify the role of this gene in resistance to salinity treatment. Chrysanthemum plants overexpressing CmDOF18 were more resistant to salinity stress than wild-type plants. Under salinity stress, the malondialdehyde content and leaf electrolyte conductivity in CmDOF18-overexpressing transgenic plants were lower than those in wild-type plants, while the proline content, chlorophyll content, superoxide dismutase activity and peroxidase activity were higher than those in wild-type plants. The opposite findings were observed in gene-silenced plants compared with wild-type plants. The gene expression levels of oxidoreductase increased in CmDOF18-overexpressing transgenic plants but decreased in CmDOF18-SRDX gene-silenced transgenic plants. CONCLUSION: In summary, we analyzed the function of CmDOF18 from chrysanthemum, which may regulate salinity stress in plants, possibly due to its role in the regulation of oxidoreductase.

The complete chloroplast genome of Dianella ensifolia (Asphodelaceae).

Dianella ensifolia (L.) Redouté 1802 is a plant known for its significant medicinal values. In this study, we presented its chloroplast genome. The length of the chloroplast genome was found to be 156,571 bp, with a GC content of 37.86%. It consisted of a large single-copy (LSC) of 85,318 bp and a small single-copy (SSC) of 18,307 bp, a pair of inverted repeats (IRs) of 26,473 bp each that separated the LSC and SSC regions. The chloroplast genome of D. ensifolia consisted of 114 unique genes, including 80 protein-coding genes, four rRNA genes, and 30 tRNA genes. Through phylogenetic analysis, we identified a close relationship between D. ensifolia and D. nigra. This newly sequenced chloroplast genome not only enhances our understanding of the genome of Dianella, but also provides valuable insights for the evolutionary study of the family Asphodelaceae.

The complete chloroplast genome sequence of a warm season ornamental grass, Cenchrus alopecuroides Thunb. 1794 (Poaceae).

Cenchrus alopecuroides Thunb. 1794 is a warm-season ornamental grass with glossy foliage and showy inflorescence, which is widely distributed from eastern Asia to Australia. Although this species is of great economic importance, little genomic sequence data are available. Here, we report the complete chloroplast genome sequence of C. alopecuroides, which provides valuable plastid genomic resources for further studies on this ornamental grass. The chloroplast genome of C. alopecuroides was 138,053 bp in length and exhibited a typical quadripartite structure, which comprised a pair of inverted repeat regions (22,331 bp) separated by a large (81,177 bp) and a small single copy (12,214 bp) region. In total, 110 unique genes were annotated in the chloroplast genome, containing 76 protein-coding genes, 30 transfer RNAs and four ribosomal RNAs. The overall GC content of the chloroplast genome was 38.6%. Phylogenetic analysis based on 11 whole-chloroplast genome sequences of Cenchrus species suggested that C. alopecuroides and C. compressus were sisters to each other and joint sisters to C. clandestinus.

The complete chloroplast genome and phylogenetic analysis of Acalypha hispida Burm. f. (Euphorbiaceae), an ornamental and medicinal plant.

Acalypha hispida Burm. f. (1768) is an evergreen shrub native to New Guinea and the Bismarck Archipelago. Currently, it is widely cultivated as an ornamental and medicinal plant in tropical and subtropical areas worldwide. This study characterized the complete chloroplast genome of A. hispida, which is 172,122 bp in length and consists of large single-copy (LSC) and small single-copy (SSC) regions of 97,025 bp and 19,787 bp, respectively, that are separated by a pair of 27,655 bp inverted repeat (IR) regions. The overall GC content of the genome is 34.22%. The genome contains 131 genes, including 86 protein-coding, 37 tRNA, and eight rRNA genes. Phylogenetic analysis indicates that A. hispida is closely related to Ricinus communis and Cleidiocarpon cavaleriei in the Euphorbiaceae family. The complete chloroplast genome of A. hispida provides genomic resources and potential markers suitable for future species identification and speciation studies of the genus Acalypheae and will also provide important information on the phylogenetic relationships of the Euphorbiaceae family.

The complete chloroplast genome of Angelonia angustifolia Benth. (Plantaginaceae), an ornamental and medicinal plant.

In this study, we assembled and characterized the complete chloroplast (cp) genome of Angelonia angustifolia Benth., 1846, a herbaceous and perennial plant, native to Latin America. It is an ornamental and medicinal plant that showed bright prospects for application. The cp genome of A. angustifolia has a typical conserved quadripartite structure of 154,316 bp in total length. The genome includes a large single-copy (LSC) region (84,110 bp), a small single-copy (SSC) region (15,950 bp), and a pair of inverted repeat (IR) regions (27,128 bp). The cp genome contains 130 genes comprising 85 protein-coding, 37 tRNA, and 8 rRNA genes. Phylogenetic analysis indicates that A. angustifolia is closely related to Bacopa monnieri, Scoparia dulcis, and Limnophila sessiliflora in the Plantaginaceae. Taken together, the complete cp genomes of A. angustifolia provided significant insights and important information for molecular biology, evolution, and taxonomy in the genus Angelonia.

The complete chloroplast genome of Osteospermum ecklonis (DC.) Norl. (Asteraceae: Asterodae: Calenduleae), an ornamental plant.

Osteospermum ecklonis (DC.) Norl. 1838 is a herbaceous and perennial plant native to South Africa. It is an ornamental plant that shows great commercial potential. In the present study, the complete chloroplast (cp) genome was 151,295 bp in total length, and 127 genes were identified, including 85 protein-coding, 34 tRNA, and eight rRNA genes. The cp genome includes a large single-copy (LSC) region of 83,293 bp, a small single-copy (SSC) region of 18,012 bp, and a pair of inverted repeats (IRs) regions of 24,995 bp. The phylogenetic relationship of O. ecklonis revealed by cp genome provides a foundation for future studies of the phylogeny in the Asteraceae.

Integrated Proteomic and Metabolomic Analyses Provide Insights Into Acquisition of Embryogenic Ability in Agapanthus praecox.

Somatic embryogenesis (SE) is an ideal model for plant cell totipotency. Transition from somatic cells to embryogenic cells is the key to SE. The poor frequency of embryogenic callus (EC) induction has limited the application of SE in many plants, such as Agapanthus praecox. We performed large-scale, quantitative proteomic and metabolomic analyses with different callus differentiation directions (SE and organogenesis) and stages (initial SE and repetitive SE) to better understand the morphological, physiological, and molecular characteristics of the acquisition of embryogenic ability in A. praecox. Integrated proteomic and metabolomic analyses suggested that callus differentiation direction was potentially regulated by pathways related to carbohydrate and energy metabolism (fatty acid metabolism, pyruvate metabolism, glycolysis/gluconeogenesis, pentose and glucuronate interconversions, starch and sucrose metabolism, galactose metabolism, carbon fixation pathways in prokaryotes, carbohydrate digestion and absorption, and fructose and mannose metabolism), chromatin accessibility and DNA methylation, reactive oxygen species responses and resistance (ascorbate and aldarate metabolism), and plant hormonal signaling. As a validation, we found that carbon source combination and plant hormone regulation in the culture medium significantly affected the acquisition of embryogenic ability, thereby inducing EC. Interestingly, plant hormonal signaling-related genes showed different expression patterns significantly when callus cultured with different carbon sources. Thus, our results suggested that energy supply and hormone signal transduction seemed to cooperatively contribute to the activation of embryogenic ability. Altogether, this study revealed valuable information regarding the molecular and biochemical changes that occurred during EC induction and provided valuable foundation for comprehensive understanding of the mechanisms associated with SE and organogenesis in A. praecox.

The complete chloroplast genome of Clematis florida Thunb. (Ranunculaceae), an ornamental and medicinal plant from Henan province, China.

Clematis florida Thunb. is a herbaceous and perennial plant native to East Asia. The plant is resistant to cold but sensitive to heat. It is an ornamental and medicinal plant that has great commercial potential. Here, we assembled and characterized the complete chloroplast (cp) genome of C. florida. The cp genome of C. florida was characterized by Illumina pair-end sequencing and is 159,606 bp in total length. The genome includes a large single-copy (LSC) region of 79,467 bp, a small single-copy (SSC) region of 18,057 bp, and a pair of inverted repeats (IR) regions of 31,041 bp. The genome contains 135 genes including 91 protein-coding, 36 tRNA, and eight rRNA genes. Phylogenetic analysis based on 18 Clematis species indicates that C. florida is closely related to C. fusca in the Ranunculaceae. The phylogenetic relationships and taxonomic status of C. florida revealed by cp genome were consistent with the previous molecular studies, and can serve as a reference for future studies on molecular biology, evolution, and taxonomy in the genus Clematis.

The complete chloroplast genome of Agapanthus praecox (Agapanthaceae), an ornamental and medicinal plant.

Agapanthus praecox is a monocotyledonous, herbaceous, and perennial plant, which has been used as an ornamental and medicinal plant. Here, we assembled and characterized the complete chloroplast (cp) genome of A. praecox by de novo high throughput sequencing. The results revealed that the cp genome of A. praecox was 157,038 bp in total length, including a large single-copy (LSC) region of 85,195 bp, a small single-copy (SSC) region of 18,113 bp, and two invert repeats (IR) regions of 26,865 bp. The total plastid genome of A. praecox included 132 genes comprising 86 protein-coding genes, 38 tRNA genes, and eight rRNA genes. The phylogenetic analysis was conducted based on the complete cp genomes of 17 species and it indicated that A. praecox is closely related to A. coddi in Agapanthaceae family.

Cathepsin B-like cysteine protease ApCathB negatively regulates cryo-injury tolerance in transgenic Arabidopsis and Agapanthus praecox.

Cell death is an inevitably cryo-injury in cell and tissue cryopreservation. The research on programmed cell death (PCD) in plant cryopreservation is still in its infancy. In this study, the survival rate of Agapanthus praecox embryogenic callus was significantly improved when the vitrification solution was added with 20 µM E-64, which is an inhibitor of cathepsin B. For further investigating the relation between cathepsin B and cryo-injury, the coding gene of cathepsin B, ApCathB was isolated and characterized. A subcellular localization assay showed that ApCathB was located in cytomembrane. Heterologous overexpression of ApCathB reduced the recovery rate during Arabidopsis seedlings cryopreservation from 29.56 % to 16.46 %. Transgenic seedlings lost most of cell viability in hypocotyl after dehydration and lead to aggravated cryo-injury. The reduced survival rate of ApCathB-overexpressing embryogenic callus of A. praecox further confirmed its negatively function in cryo-injury tolerance. In addition, the survival of ApCathB-overexpressing lines was almost rescued by E-64. TUNEL detection showed intensified signal and ROS was burst, especially for H2O2. Furthermore, VPE, Metacaspase 1, Cyp15a and AIF genes related to cell death regulation were remarkably up-regulated in ApCathB-overexpressing embryogenic callus during cryopreservation. Additionally, the expression level of genes regulating cell degradation was also elevated, indicating accelerated cell death caused by ApCathB-overexpressing. Taken together, this work verified that ApCathB negatively regulated the cryo-injury tolerance and cell viability through mediating the PCD event in plant cryopreservation. Significantly, cathepsin B has potential to be a target to improve survival rate after cryopreservation.

RNA-Seq-based transcriptome analysis of stem development and dwarfing regulation in Agapanthus praecox ssp. orientalis (Leighton) Leighton.

Agapanthus praecox is a monocotyledonous ornamental bulb plant. Generally, the scape (inflorescence stem) length can develop more than 1m, however application 400 mg·L(-1) paclobutrazol can shorten the length beyond 70%. To get a deeper insight into its dwarfism mechanism, de novo RNA-Seq technology has been employed, for the first time, to describe the scape transcriptome of A. praecox. We got 71,258 assembled unigenes, and 45,597 unigenes obtained protein functional annotation. Take the above sequencing results as a reference gene set, using RNA-seq (quantification) technology analyzed gene expression profiles between the control and paclobutrazol-treated samples, and screened 2838 differentially expressed genes. GO, KEGG and MapMan pathway analyses indicated that these differentially expressed genes were significantly enriched in response to stimulus, hormonal signaling, carbohydrate metabolism, cell wall, cell size, and cell cycle related biological process. To validate the expression profiles obtained by RNA-Seq, real-time qPCR was performed on 24 genes selected from key significantly enriched pathways. Comprehensive analysis suggested that paclobutrazol blocks GA signal that can effectively inhibit scape elongation; the GA signal interact with other hormonal signals including auxin, ethylene, brassinosteroid and cytokinins, and trigger downstream signaling cascades leading to metabolism, cell wall biosynthesis, cell division and the cycle decreased obviously, and finally induced dwarfism trait. Furthermore, AP2/EREBP, bHLH, C2H2, ARR, WRKY and ARF family's transcription factors were involved in the regulation of scape development in A. praecox. This transcriptome dataset will serve as an important public information platform to accelerate research on the gene expression and functional genomics of Agapanthus.

GA4 and IAA were involved in the morphogenesis and development of flowers in Agapanthus praecox ssp. orientalis.

The transition from vegetative to reproductive growth represents a major phase change in angiosperms. Hormones play important roles in this process. In this study, gibberellic acid (GA), cytokinins (CKs), indoleacetic acid (IAA), and abscisic acid (ABA) were analyzed during the flowering in Agapanthus praecox ssp. orientalis. Eleven types of endogenous gibberellins in addition to GA1 were detected in various organs. GA9 was detected with the highest concentrations, followed by GA5, GA8, and GA19. However, GA4 was the main bioactive GA that was involved in the regulation of flowering. Eight types of endogenous cytokinins were detected in A. praecox ssp. orientalis, and zeatin, zeatin riboside, zeatin-O-glucoside, and N(6)-isopentenyladenosine-5-monophosphate were present at higher levels throughout the study, of which zeatin plays an important role in the development of various organs. IAA increased by 581% in the shoot tips from the vegetative to inflorescence bud stages and had the most significant changes during flowering. Phytohormone immunolocalization analysis suggested that IAA involved in differentiation and development of each floral organs, GA and zeatin play important roles in floret primordia differentiation and ovule development. Using exogenous plant growth regulators proved that GA signaling regulate the scape elongation and stimulate early-flowering, and IAA signaling is involved in the pedicel and corolla elongation and delay flowering slightly.

A comprehensive analysis of flowering transition in Agapanthus praecox ssp. orientalis (Leighton) Leighton by using transcriptomic and proteomic techniques.

Comprehensive transcriptomic and proteomic analyses were performed to gain further understanding of the molecular mechanisms of floral initiation in Agapanthus praecox ssp. orientalis. Samples of stem apexes were collected at three different time points including the vegetative, induced, and reproductive period. A total of 374 transcript-derived fragments and 72 proteins showed significant differential expression between the samples. The largest proportion of the identified genes and proteins are involved in metabolism, followed by signal transduction, protein fate, cellular transport, and biogenesis of cellular components. A large number of these genes and proteins were upregulated during the induced and reproductive stages. Their expression profiles demonstrate that carbohydrate metabolism provides nutrients foundation for floral initiation in Agapanthus. Furthermore, a transcription factors GAI (GA insensitive protein) that negatively regulates gibberellin signaling, auxin receptor protein TIR1 (Transport inhibitor response 1), a key enzyme of ethylene biosynthesis SAMS (S-adenosylmethionine synthase), and ethylene receptor protein ETR were isolated and identified. Expression patterns of these proteins, in combination with the results of quantitative phytohormone and immunolocalization analyses, indicated that GA, indole-acetic acid (IAA), and ethylene regulate floral morphogenesis and flowering. In conclusion, these data provide novel insight into the early regulatory steps of flowering in Agapanthus.

[Characterization and reconstruction of aerosol light scattering coefficient at Chengdu during biomass burning and dust storm period in spring].

Aerosol samples for PM2.5 were collected from 19 April to 17 May in 2009 at Chengdu. The concentrations of organic carbon, element carbon, water-solubility ions, crustal elements and levoglucosan of all particle samples were determined by thermal/ optical carbon analyzer,ion chromatography, X-ray fluorescence spectrometer and high performance anion exchange chromatography, respectively. In-situ scattering coefficients (b(sp)) and meteorological parameters for this period were also conducted. Ambient scattering coefficients were reconstructed by IMPROVE formula and compared with measured scattering coefficients. The results showed that the average mass concentration of PM2.5 and measured b(sp) were 133.2 microg x m(-3) and 530 Mm(-1), respectively. Levoglucosan and crustal elements were good traces for biomass burning and dust storm events, respectively. The calculated b'sp was 504 Mm(-1) during campaigning period. The major contributors to scattering coefficients included: (NH4)2SO4 (26%), NH4NO3 (15%), OM (53%), FS (4%) and CM (2%), respectively. The calculated b'sp was 575 Mm(-1) and the dominant species were FS (17%) and CM (21%) during dust storm period (DS). The calculated b'sp was 635 Mm(-1) and OM contributed 62% during biomass burning (BB) period.

Low-dose-rate californium-252 neutron intracavitary afterloading radiotherapy combined with conformal radiotherapy for treatment of cervical cancer.

PURPOSE: To study the efficacy of low-dose-rate californium-252 ((252)Cf) neutron intracavitary afterloading radiotherapy (RT) combined with external pelvic RT for treatment of cervical cancer. METHODS AND MATERIALS: The records of 96 patients treated for cervical cancer from 2006 to 2010 were retrospectively reviewed. For patients with tumors ≤4 cm in diameter, external beam radiation was performed (1.8 Gy/day, five times/week) until the dose reached 20 Gy, and then (252)Cf neutron intracavitary afterloading RT (once/week) was begun, and the frequency of external beam radiation was changed to four times/week. For patients with tumors >4 cm, (252)Cf RT was performed one to two times before whole-pelvis external beam radiation. The tumor-eliminating dose was determined by using the depth limit of 5 mm below the mucosa as the reference point. In all patients, the total dose of the external beam radiation ranged from 46.8 to 50 Gy. For (252)Cf RT, the dose delivered to point A was 6 Gy/fraction, once per week, for a total of seven times, and the total dose was 42 Gy. RESULTS: The mean ± SD patient age was 54.7 ± 13.7 years. Six patients had disease assessed at stage IB, 13 patients had stage IIA, 49 patients had stage IIB, 3 patients had stage IIIA, 24 patients had stage IIIB, and 1 patient had stage IVA. All patients obtained complete tumor regression (CR). The mean ± SD time to CR was 23.5 ± 3.4 days. Vaginal bleeding was fully controlled in 80 patients within 1 to 8 days. The mean ± SD follow-up period was 27.6 ± 12.7 months (range, 6-48 months). Five patients died due to recurrence or metastasis. The 3-year survival and disease-free recurrence rates were 89.6% and 87.5 %, respectively. Nine patients experienced mild radiation proctitis, and 4 patients developed radiocystitis. CONCLUSIONS: Low-dose-rate (252)Cf neutron RT combined with external pelvic RT is effective for treating cervical cancer, with a low incidence of complications.

[Clinical study on toxicity-attenuation effect of Yiguan Decoction in treatment of non-small cell lung cancer with NP protocol of chemotherapy].

OBJECTIVE: To observe the toxicity-attenuation effect of Yiguan Decoction (YGD) in treatment of non-small cell lung cancer (NSCLC) with NP protocol of chemotherapy. METHODS: Ninety-two NSCLC patients were randomly assigned to two groups equally, the control group given only NP protocol of chemotherapy and the treated group given the same protocol of chemotherapy plus YGD. Hepatic function, T-cell subgroup and NK cell were examined, and quality of life (QOL) was evaluated with scoring by Karnofsky performance status (KPS), Quality of Life Questionnaire-Core30 (EORTC QLQ-C30) and Special Scale for lung cancer (EORTC LC13) issued by European Organization for Research and Treatment of Cancer. RESULTS: The effects on all the above-mentioned indexes in the treated group were better than those in the control group after 42 days of treatment (P <0.05). CONCLUSION: YGD could not only reduce the side and toxic effects caused by NP protocol of chemotherapy in NSCLC patients but also improve their QOL.

[Clinical observation on treatment of radiation pneumonia by Qingjin Runfei Decoction combined with hormone and antibiotic].

OBJECTIVE: To observe the curative effect of Qingjin Runfei Decoction (QRD) combined with hormone and antibiotic in treating radiation pneumonia (RP). METHODS: Patients were randomly assigned to two groups, the control group (51 cases) treated with hormone and antibiotic and the treated group (53 cases) with the above therapy plus QRD. The curative effects on RP, quality of life (QOL), chest radiography and TCM symptoms were observed. RESULTS: The curative effects on the above items in the treated group were all significantly better than those in the control group (P < 0.05). CONCLUSION: QRD could enhance the effects of hormone and antibiotic in treating RP, as well as improve QOL of the patients.

Efficacy and tolerability of oxycodone hydrochloride controlled-release tablets in moderate to severe cancer pain.

BACKGROUND AND OBJECTIVE: Oxycodone is a semisynthetic opioid analgesic drug classed as a strong opioid. The controlled-release oxycodone tablet formulation (OCRT) was approved in China in 2004 for management of moderate to severe cancer pain. Few data about the efficacy of OCRT and clinical outcomes in Chinese patients taking this drug are available. The purpose of this study was to evaluate the efficacy and tolerability of this drug for relief of moderate to severe cancer pain in Chinese patients. METHODS: This was a prospective, open-label, multicentre clinical trial carried out in ten hospitals in Zhejiang Province, China. Patients with cancer pain with a score > or =4 (numerical rating scale) were enrolled. They received oral OCRT at an initial dosage of 5mg every 12 hours for patients scoring 4-6 and 10mg every 12 hours for patients scoring > or =7. Doses were then titrated on an individual basis. Onset of analgesic action, pain score and quality-of-life (QOL) scores - including items measuring family understanding and support, sleep, mental state, appetite, fatigue, and activities of daily life - were evaluated. Adverse effects were also documented. RESULTS: 216 patients (126 males and 90 females) aged 22-84 years were enrolled. The total mean OCRT dosage was 445.2 +/- 361.6mg (range 130-2320mg). The daily dosages of the vast majority of cases (89%) were between 10mg and 30mg. Onset of analgesic action occurred within 1 hour in 198 cases (91.7%) following administration of OCRT. 82.4% of cases were titrated to a steady dosage level within 2 days following administration of the first dose of medication. Pain score decreased significantly (p < 0.01) from 7.1 +/- 1.2 at baseline to 2.3 +/- 1.2 one week after starting medication and 1.8 +/- 0.9 four weeks after starting medication. Scores on all six QOL items increased significantly (p < 0.01) compared with baseline but showed varying rates of improvement. Adverse events included constipation, nausea, vomiting, drowsiness and dysuria. These were noted most frequently in the first week (25.5% of patients) and lessened over time. No severe adverse events were noted. CONCLUSION: We conclude that OCRT is well tolerated and effective in controlling moderate to severe cancer pain in Chinese patients.

Streptococcal toxic shock syndrome caused by Streptococcus suis serotype 2.

BACKGROUND: Streptococcus suis serotype 2 (S. suis 2, SS2) is a major zoonotic pathogen that causes only sporadic cases of meningitis and sepsis in humans. Most if not all cases of Streptococcal toxic shock syndrome (STSS) that have been well-documented to date were associated with the non-SS2 group A streptococcus (GAS). However, a recent large-scale outbreak of SS2 in Sichuan Province, China, appeared to be caused by more invasive deep-tissue infection with STSS, characterized by acute high fever, vascular collapse, hypotension, shock, and multiple organ failure. METHODS AND FINDINGS: We investigated this outbreak of SS2 infections in both human and pigs, which took place from July to August, 2005, through clinical observation and laboratory experiments. Clinical and pathological characterization of the human patients revealed the hallmarks of typical STSS, which to date had only been associated with GAS infection. Retrospectively, we found that this outbreak was very similar to an earlier outbreak in Jiangsu Province, China, in 1998. We isolated and analyzed 37 bacterial strains from human specimens and eight from pig specimens of the recent outbreak, as well as three human isolates and two pig isolates from the 1998 outbreak we had kept in our laboratory. The bacterial isolates were examined using light microscopy observation, pig infection experiments, multiplex-PCR assay, as well as restriction fragment length polymorphisms (RFLP) and multiple sequence alignment analyses. Multiple lines of evidence confirmed that highly virulent strains of SS2 were the causative agents of both outbreaks. CONCLUSIONS: We report, to our knowledge for the first time, two outbreaks of STSS caused by SS2, a non-GAS streptococcus. The 2005 outbreak was associated with 38 deaths out of 204 documented human cases; the 1998 outbreak with 14 deaths out of 25 reported human cases. Most of the fatal cases were characterized by STSS; some of them by meningitis or severe septicemia. The molecular mechanisms underlying these human STSS outbreaks in human beings remain unclear and an objective for further study.