Combined multiplex loop-mediated isothermal amplification with lateral flow assay to detect sea and seb genes of enterotoxic Staphylococcus aureus.

UNLABELLED: Staphylococcal enterotoxins (SEs) are the most common cause of food poisoning worldwide and can induce symptoms, such as diarrhoea, vomiting and abdominal cramping. Thus, the aim of this study is to develop a multiplex loop-mediated isothermal amplification combined with a lateral flow assay (m-LAMP/LFA) to simultaneously detect the sea and seb genes of Staphylococcus aureus. The amplicons of the sea gene were labelled with digoxigenin (Dig) and biotin while those of seb gene were labelled with fluorescein isothiocyanate (FITC) and biotin. These amplicons were detected using a multiplex LFA with NeutrAvidin-tagged gold nanoparticles as the detection reagent. After optimization, the detection limit of this assay was 10(2)  CFU ml(-1) Staph. aureus, which was one tenth that of a multiplex PCR. This assay did not exhibit any cross-reactivity in detecting other enterotoxic Staph. aureus strains or other food pathogens. After 6 h of enrichment, this developed assay detected 1 CFU ml(-1) of Staph. aureus in milk, apple juice, cheese and rice. The developed m-LAMP/LFA method does not require expensive equipment and can be completely implemented within an 8-h workday. Therefore, this method can provide an effective means of quickly screening staphylococcal enterotoxin A- and/or staphylococcal enterotoxin B-producing Staph. aureus in food samples. SIGNIFICANCE AND IMPACT OF THE STUDY: Staphylococcus aureus is one of the major foodborne pathogens worldwide, and its staphylococcal enterotoxin A and B are strongly associated with food poisoning. This work developed a multiplex loop-mediated isothermal amplification combined with a lateral flow assay (m-LAMP/LFA) to simultaneously detect the sea and seb genes of Staph. aureus in food samples. The assay has good specificity and sensitivity with ease-of-use features, making it ideal for on-site detection.

[Perioperational management of gynecological cancer patients with severe internal medical complications: a serial of 37 clinical cases].

Objective: To evaluate the effectiveness and safety of perioperational management of gynecological cancer patients with severe internal medical complications. Methods: We collected 37 cases of gynecological cancer patients with severe internal medical complications who were hospitalized in Peking University First Hospital from Jan. 2010 to Nov. 2014. All of the cases were planned to move to ICU right after operation based on the preoperational assessment of anesthetist and physician. The median age was 69.4 years, and 25 cases (68%,25/37) of them were over 70 years old. The pathological types, preoperational complications, preoperational preparation, process of anesthesia and surgery, post-operational short-term morbidity were retrospectively analyzed. Results: (1) Pathological type: among 37 cases of gynecological cancer patients, 16 cases of endometrial cancer, 12 cases of ovarian cancer, 5 cases of vulvar cancer, 3 cases of uterine sarcoma and 1 case of fallopian cancer. (2) Preoperational complication: all the patients had more than 2 types of internal complications, 34 cases (92%, 34/37)of them had no less than 3 types of internal complications. The preoperational complications mainly included 25 cases of hypertension, 13 cases of coronary heart disease and 5 cases of arrhythmia, 5 cases of history of cerebral infarction or hemorrhage, 19 cases of diabetes and 1 case of obesity, 6 cases of allergic asthma and history of pulmonary embolism. (3) Preoperational preparation: medication were taken according to internal physicians to make blood pressure lower than 140/90 mmHg(1 mmHg=0.133 kPa), fasting blood glucose lower than 8.0 mmol/L, postprandial blood glucose lower than 10.0 mmol/L and cardiac function return to a generally normal status. (4) Process of anesthesia and surgery: 37 cases completed operation successfully after preoperational anesthetic assessment and internal medication. No perioperational death was observed. (5) Post-operational morbidity: 17 cases of post-operational short-term morbidity were observed before discharge, including 9 cases of poor wound healing, 5 cases of gastro-intestinal dysfunction and 3 cases of pulmonary infection. All of them were improved or cured. Conclusion: Surgery is safe and applicable to gynecological cancer patients with severe internal medical complications on the compressive management of anesthesia assessment, perioperational internal adjustment and post-operational multi-discipline treatment.

The feasibility of QR-code prescription in Taiwan.

WHAT IS KNOWN AND OBJECTIVE: An ideal Health Care Service is a service system that focuses on patients. Patients in Taiwan have the freedom to fill their prescriptions at any pharmacies contracted with National Health Insurance. Each of these pharmacies uses its own computer system. So far, there are at least ten different systems on the market in Taiwan. To transmit the prescription information from the hospital to the pharmacy accurately and efficiently presents a great issue. METHODS: This study consisted of two-dimensional applications using a QR-code to capture Patient's identification and prescription information from the hospitals as well as using a webcam to read the QR-code and transfer all data to the pharmacy computer system. Two hospitals and 85 community pharmacies participated in the study. RESULTS AND DISCUSSION: During the trial, all participant pharmacies appraised highly of the accurate transmission of the prescription information. The contents in QR-code prescriptions from Taipei area were picked up efficiently and accurately in pharmacies at Taichung area (middle Taiwan) without software system limit and area limitation. The QR-code device received a patent (No. M376844, March 2010) from Intellectual Property Office Ministry of Economic Affair, China. WHAT IS NEW AND CONCLUSION: Our trial has proven that QR-code prescription can provide community pharmacists an efficient, accurate and inexpensive device to digitalize the prescription contents. Consequently, pharmacists can offer better quality of pharmacy service to patients.

Assessment of the combined effect of plasma exchange and plasma perfusion on patients with severe hepatitis awaiting orthotopic liver transplantation.

To determine if plasma exchange combined with plasma perfusion is a reliable and effective temporary liver support treatment for patients on the waiting list for OLT, we tested this method in 5 patients with end-stage and 3 patients with middle-stage severe hepatitis. Four patients were successfully controlled until a donor liver was available 4 to 13 days later. In contrast, the remaining 4 patients were not adequately controlled by this treatment and experienced aggravated disease progression, dying 3 to 8 days after treatment while still awaiting OLT. Of those 4 patients who received OLT, 2 patients died from multi-organ failure caused by hepatic failure, while the other 2 survived. These findings show that plasma exchange combined with plasma perfusion provides temporary support for some patients on the waiting list for OLT. The ability of patients to successfully bridge to OLT is closely associated with the degree of liver failure, complications, multi-organ failure, and the length of the waiting period for a donor liver.

[Prognostic factors in patients with stage I epithelial ovarian cancer].

From 1962 to 1989, 67 patients with stage I epithelial ovarian cancer were treated in our hospital. They were divided into three groups according to the time period of treatment. Thirteen patients treated in the 1960s were in group 1, 23 in the 1970s in group 2, and 31 in 1980s in group 3. There were no other significant differences other than the adjuvant chemotherapy in the three groups. In this study, the 5-year survival rate was 46% in group 1 (1962-1969), 82% in group 2 (1970-1979), and 97% in group 3 (1980-1989). The prognosis was improved significantly from 1960s to 1970s (P < 0.005), as well as from 1970s to 1980s (P < 0.05). Multivariate analysis indicated adjuvant chemotherapy (P < 0.01), stage (P < 0.01), and histological grade (P < 0.05) as having independent prognostic effects. Patients with more than 4 courses of combination chemotherapy, stage Ia, grade I and grade II had a better survival rate. The chemotherapy, complete surgical staging and preservation of fertility in surgical treatment of stage I epithelial ovarian cancer were also discussed.

Unequal coupling between locomotor pacemakers of the German cockroach, Blattella germanica (L.).

Male adult German cockroaches, Blattella germanica (L.), expressed robust locomotor circadian rhythmicity under 28 degrees C and constant darkness (DD) conditions. By surgically severing the connections between the optic lobes and midbrain and their subsequent regeneration, we demonstrated that the locomotor circadian pacemaker was located in the optic lobes and that it controlled the locomotor circadian rhythm through neural pathways. From the results that unilaterally optic tract severed males still showed locomotor circadian rhythmicity (93.1%, n=29) without significantly changing the circadian period (tau) or level of motor activity, we concluded that the right and left optic lobes each contain a circadian pacemaker competent to drive the locomotor circadian rhythm. These two pacemakers were strongly coupled since only one rhythm was expressed when the pacemakers were independently exposed to opposite lighting conditions (DD or LL) at the same time. However, an unequal contribution of each pacemaker in determining the overt circadian period was found under constant dim light (10 lux) conditions, revealing a major-minor coupling relationship between these two pacemakers, so that the unilaterally blinded male expressed either a LL-rhythm with a circadian period of 24.27+/-0.21 h (41.7%, n=24) or a DD-rhythm with a circadian period of 23.43+/-0.19 h (58.3%, n=24). However, higher intensity of photic information (200-300 lux) could overpower this relationship and cause the minor pacemaker to lead the rhythm.