ABSTRACT Background: Clostridiodes difficile infection (CDI) is one of the most common causes of antibiotic-associated diarrhea in children. Conventional antibiotics and emerging fecal micro-biota transplantation (FMT) are used to treat CDI. Methods: Children with CDI admitted to the Shanghai Children’s Hospital, from September 2014 to September 2020, were retrospectively included to this observational study. Pediatric patients were assigned as initial CDI and recurrent CDI (RCDI), and symptoms, comorbid-ities, imaging findings, laboratory tests, and treatments were systematically recorded and analyzed. Results: Of 109 pediatric patients with CDI, 58 were boys (53.2%), and the median age was 5 years (range, 2-9 years). The main clinical symptoms of CDI children were diarrhea (109/109, 100%), hematochezia (55/109, 50.46%), abdominal pain (40/109, 36.70%); fever, pseudomembrane, vomit, and bloating were observed in 39 (35.78%), 33 (30.28%), and 24 (22.02%) patients, respectively. For the primary therapy with conventional antibiotics, 68 patients received metronidazole, and 41 patients received vancomycin. RCDI occurred in 48.53% (33/68) of those initially treated with metronidazole compared with 46.33% (19/41) of those initially treated with vancomycin (p=0.825). The total resolution rate of FMT for RCDI children was significantly higher than with vancomycin treatment (28/29, 96.55% vs 11/23, 47.83%, p < 0.001). There were no serious adverse events (SAEs) reported after two months of FMT. Conclusions: The major manifestations of children with CDI were diarrhea, hematochezia, and abdominal pain. The cure rate of FMT for pediatric RCDI is superior to vancomycin treatment.

SUMMARY OBJECTIVE: This study aims to compare the efficacy and safety of endoscopic transsphenoidal pituitary surgery and microscopic transseptal pituitary surgery in the treatment of Cushing's disease (CD). METHODS: A total of 46 patients with CD were randomized into endoscopic group and microscopic group, with 23 cases in each group. The endoscopic group received the endoscopic transsphenoidal pituitary surgery, and the microscopic group received the microscopic transseptal pituitary surgery. The retrospective data, surgical outcomes, surgical cure rates, and complications in two groups were compared. RESULTS: Compared with microscopic group, the operative time was significantly shorter (p<0.05), the estimated blood loss was significantly less (p<0.05), and the hospital stay was significantly shorter (p<0.05) in endoscopic group. The surgical cure rate in endoscopic and microscopic groups was 69.56% and 60.86%, respectively, with no significant difference between the two groups (p>0.05). The incidence of complications in endoscopic group was significantly lower than that in microscopic group (p<0.01). CONCLUSIONS: For the treatment of CD, the efficacy of endoscopic transsphenoidal pituitary surgery is basically the same as that of traditional microscopic transseptal pituitary surgery. However, the endoscopic surgery can further shorten the operative time, reduce the estimated blood loss, shorten the hospital stay, and reduce the complications.

Resumo Introdução: Evidências emergentes indicam que as condições fisiológicas e patológicas do nariz são reguladas pós-transcripcionalmente por microRNAs, uma classe de pequenos RNAs não codificantes. Recentemente, o microRNA-223-3p tem sido cada vez mais implicado na modulação da rinite alérgica. Objetivo: Avaliar o papel e o mecanismo do microRNA-223-3p em um modelo de rinite alérgica em camundongos. Método: O nível de expressão do microRNA-223-3p foi medido no soro de 41 pacientes com rinite alérgica e 39 controles saudáveis com polimerase chain reaction quantitativo em tempo real. Camundongos BALB/c foram usados para estabelecer um modelo de rinite alérgica através de sensibilização intraperitoneal e teste de provocação nasal com ovalbumina. O microRNA-223-3p agomir/antagomir foi então administrado por via intranasal a camundongos após provocação com ovabulmina por mais uma semana. Os sintomas de prurido nasal e espirros foram registrados. A concentração sérica de imunoglobulina E específica para ovalbumina, expressão de microRNA-223-3p e níveis de citocinas pró-inflamatórias (IL-4, IL-5, IFN-γ) na mucosa nasal foram medidos por ELISA e polimerase chain reaction quantitativo, respectivamente. As alterações histopatológicas foram avaliadas com coloração com hematoxilina e eosina. Resultados: Os níveis de microRNA-223-3p aumentaram significativamente em ambos os pacientes e camundongos com rinite alérgica. Além disso, a suprarregulação dos níveis de microRNA-223-3p através da administração nasal de microRNA-223-3p agomir também aumentou significativamente a concentração de IgE específica para ovalbumina, as frequências de prurido nasal e espirros, os níveis de citocinas pró-inflamatórias (IL-4, IL-5, IFN-γ) e infiltração de eosinófilos na mucosa nasal de camundongos com rinite alérgica. Além disso, o microRNA-223-3p antagomir pareceu melhorar significativamente os sintomas e a doença da mucosa nasal. Posteriormente, demonstramos pela primeira vez que o microRNA-223-3p regulou negativamente a expressão de INPP4A ao se ligar à região 3’ não traduzida 3'UTR) do gene INPP4A. Conclusões: Esses achados indicam que o microRNA-223-3p desempenha um papel importante na regulação da doença e dos sintomas da rinite alérgica, tem como alvo o gene INPP4A.

Abstract Introduction: Emerging evidence indicates that physiological and pathological conditions of the nose are posttranscriptionally regulated by microRNAs, a class of small noncoding RNAs. Recently, microRNA-223-3p has been increasingly implicated in the modulation of allergic rhinitis Objective: This study aimed to assess the role and mechanism of microRNA-223-3p in a mouse model of allergic rhinitis. Methods: The expression level of miR-223-3p was measured in the serum of 41 allergic rhinitis patients and 39 healthy controls using quantitative real time polymerase chain reaction. BALB/c mice were used to establish an allergic rhinitis model by intraperitoneal sensitization and intranasal challenge with ovalbumin. MicroRNA-223-3p agomir/antagomir was then intranasally administered to mice after ovalbumin challenge for another week. The symptoms of nasal rubbing and sneezing were recorded. Serum ovalbumin-specific immunoglobulin E concentration, microRNA-223-3p expression and proinflammatory cytokine (IL-4, IL-5, IFN-γ) levels in nasal mucosa were measured by ELISA and quantitative real time polymerase chain reaction, respectively. Histopathologic changes were evaluated using hematoxylin and eosin staining. Results: MicroRNA-223-3p levels increased significantly in both allergic rhinitis patients and allergic rhinitis mice. In addition, upregulation of microRNA-223-3p levels by nasal administration of microRNA-223-3p agomir also markedly increased the concentration of ovalbumin -specific IgE, the frequencies of nasal rubbing and sneezing, the levels of proinflammatory cytokines (IL-4, IL-5, IFN-γ) and eosinophil infiltration in the nasal mucosa of allergic rhinitis mice. Moreover, microRNA-223-3p antagomir appeared to strongly ameliorate the symptoms and pathology in nasal mucosa. Subsequently, we demonstrated for the first time that microRNA-2233p negatively regulated INPP4A expression by binding with the 3 untranslated region 3'UTR) of INPP4A. Conclusions: These findings indicate that microRNA-223-3p plays an important role in regulating the pathology and symptoms of allergic rhinitis by targeting INPP4A.

Resumo Fundamento: As plaquetas são importantes no início da trombose e suas alterações morfológicas e funcionais estão intimamente relacionadas com a ocorrência e o desenvolvimento de trombose da artéria coronária. Os parâmetros plaquetários podem ser valiosos na distinção entre infarto agudo do miocárdio (IAM) e doença arterial coronariana estável (DACE). Objetivo: O objetivo desse estudo foi detectar e comparar alterações nos parâmetros plaquetários, como o volume plaquetário médio (VPM) em pacientes com infarto agudo do miocárdio (IAM) e doença arterial coronariana estável (DACE) e investigar seu papel nessas doenças. Métodos: Coleta de amostras: Entre janeiro de 2011 e dezembro de 2013, foram retirados 2 mL de sangue da veia do antebraço de cada um dos 31 pacientes diagnosticados principalmente com IAM, 34 pacientes com DACE e 50 indivíduos saudáveis; e colocado em tubos com anticoagulante EDTA-K2. As contagens de plaquetas (PQT), VPM, massa total de plaquetas (MTP), Amplitude de Distribuição de Plaquetas (PDW, do inglês platelet distribution width), contagem de glóbulos brancos (WBC, do inglês white blood cells) e neutrófilos (NEU) foram determinadas utilizando-se um analisador de hematologia automatizado STKS (Beckman Courter). Resultados: Comparado com o grupo controle, os níveis de VPM foram significativamente maiores nos grupos IAM e DACE (p < 0,05), enquanto os níveis de PQT foram significativamente menores (p < 0,05). Conclusão: Esses resultados sugerem que o VPM e outros parâmetros associados têm um certo valor no diagnóstico de DACE e IAM.

Abstract Background: Platelets are important in the initiation of thrombosis, and their morphological and functional changes are closely related with the occurrence and development of coronary artery thrombosis. Platelet parameters might be valuable in distinguishing between acute myocardial infarction (AMI) and stable coronary artery disease (SCAD). Objective: This study was designed to detect and compare changes in platelet parameters, such as mean platelet volume (MPV) in patients with acute myocardial infarction (AMI) and stable coronary artery disease (SCAD) and to investigate their roles in these diseases. Methods: Specimen collection: Between January 2011 and December 2013, 2 mL of elbow vein blood was drawn from each of 31 patients primarily diagnosed with AMI, 34 SCAD patients and 50 healthy subjects; and placed in EDTA-K2 anticoagulant tubes. Platelet count (PLT), MPV, plateletcrit (PCT), platelet distribution width (PDW), white blood cell (WBC) and neutrophil (NEU) counts were determined using an STKS automated hematology analyzer (Beckman Courter). Results: Compared with the control group, MPV levels were significantly higher in the AMI and SCAD groups (p < 0.05), while PLT was significantly lower (p < 0.05). Conclusion: These results suggest that MPV and other related parameters have a certain value in the diagnosis of SCAD and AMI.

This study aimed to compare the ability of narrow-band imaging to detect early and invasive lung cancer with that of conventional pathological analysis and white-light bronchoscopy. We searched the PubMed, EMBASE, Sinomed, and China National Knowledge Infrastructure databases for relevant studies. Meta-disc software was used to perform data analysis, meta-regression analysis, sensitivity analysis, and heterogeneity testing, and STATA software was used to determine if publication bias was present, as well as to calculate the relative risks for the sensitivity and specificity of narrow-band imaging vs those of white-light bronchoscopy for the detection of early and invasive lung cancer. A random-effects model was used to assess the diagnostic efficacy of the above modalities in cases in which a high degree of between-study heterogeneity was noted with respect to their diagnostic efficacies. The database search identified six studies including 578 patients. The pooled sensitivity and specificity of narrow-band imaging were 86% (95% confidence interval: 83-88%) and 81% (95% confidence interval: 77-84%), respectively, and the pooled sensitivity and specificity of white-light bronchoscopy were 70% (95% confidence interval: 66-74%) and 66% (95% confidence interval: 62-70%), respectively. The pooled relative risks for the sensitivity and specificity of narrow-band imaging vs the sensitivity and specificity of white-light bronchoscopy for the detection of early and invasive lung cancer were 1.33 (95% confidence interval: 1.07-1.67) and 1.09 (95% confidence interval: 0.84-1.42), respectively, and sensitivity analysis showed that narrow-band imaging exhibited good diagnostic efficacy with respect to detecting early and invasive lung cancer and that the results of the study were stable. Narrow-band imaging was superior to white light bronchoscopy with respect to detecting early and invasive lung cancer; however, the specificities of the two modalities did not differ significantly.

ABSTRACT PURPOSE: To investigate the severity of pancreatitis in lipoprotein lipase (LPL)-deficient hypertriglyceridaemic (HTG) heterozygous mice and to establish an experimental animal model for HTG pancreatitis study. METHODS: LPL-deficient HTG heterozygous mice were rescued by somatic gene transfer and mated with wild-type mice. The plasma amylase, triglyceride, and pathologic changes in the pancreas of the LPL-deficient HTG heterozygous mice were compared with those of wild-type mice to assess the severity of pancreatitis. In addition, acute pancreatitis (AP) was induced by caerulein (50 µg/kg) for further assessment. RESULTS: The levels of plasma amylase and triglyceride were significantly higher in the LPL-deficient HTG heterozygous mice. According to the pancreatic histopathologic scores, the LPL-deficient HTG heterozygous mice showed more severe pathologic damage than the wild-type mice. CONCLUSIONS: Lipoprotein lipase deficient heterozygous mice developed severe caerulein-induced pancreatitis. In addition, their high triglyceride levels were stable. Therefore, LPL-deficient HTG heterozygous mice are a useful experimental model for studying HTG pancreatitis.

Objective: to evaluate the association between serum uric acid and obesity among university students who participated in routine health screening in 2013. Methods: in this cross-sectional study, 3529 subjects were analyzed. Obesity categories were classified by BMI levels references in China. And serum uric acid levels were classified by serum uric acid quartiles. Two-sample T-test and Wilcoxon Rank sum test were used to compare age, biochemical and anthropometric parameters of subjects of two genders. Rank correlation used to analyze relationship between serum uric acid and obesity. Results: there were 1285 males (mean age, 19.8 ± 1.3 years) and 2244 females (mean age, 19.9 ± 1.3 years) in this study. Association between 2nd serum uric acid quartile and normal in male are significant and coefficient was 0.519. The 3rd serum uric acid quartile and normal in female was associated significantly(r = 0.173, p = 0.010). And associations between overweight and 3rd and 4th serum uric acid quartiles in female were significant( r = 0.128, p = 0.038 in 1st quartile and r = 0.282, p = 0.004 in 4th quartile). The 4th serum uric acid quartile and Obesity in two gender groups were significantly associated(r = 0.291, p = 0.000 in male and r = 0.484, p = 0.001 in female). Conclusion: high serum uric acid was positively associated with obesity in overweight and obesity group. However, the association was weak between two variables because serum uric acid.

Objetivo: evaluar la asociación entre el ácido úrico en suero y la obesidad entre los estudiantes universitarios que participaron en los exámenes de salud de rutina en 2013. Métodos: en este estudio transversal, 3.529 sujetos fueron analizados. La obesidad categorías fueron clasificados por el IMC niveles referencias en China.Y los niveles de ácido úrico en suero fueron clasificados por el ácido úrico en suero cuartiles. Dos Sample T - test y Wilcoxon Rank sum test se utiliza para comparar los parámetros antropométricos, bioquímicos y de los sujetos de ambos sexos. Rango correlación utilizado para analizar la relación entre el ácido úrico en suero y la obesidad. Resultado: hay 1.285 hombres (edad media, 19,8 ± 1,3 años) y 2.244 mujeres (edad media, 19,9 ± 1,3 años) en este estudio. Asociación entre el segundo cuartil de ácido úrico en suero y normal en el macho son significativos y se 0,519 coeficiente. El tercer cuartil de ácido úrico en suero y normal en mujeres se asoció significativamente (R = 0,173, p = 0,010). Y asociaciones entre sobrepeso y 3º y 4º de ácido úrico sérico cuartiles en mujeres fueron significativa (R = 0,128, p = 0,038 en 1er cuartil y R = 0,317, p = 0,004 en cuarto cuartil). El cuarto cuartil de ácido úrico en suero y la obesidad en dos grupos de género fueron asociados significativamente (R = 0,286, p = 0,000 en macho y R = 0,484, p = 0,001 en mujeres). Conclusión: alta de ácido úrico en suero fue asociado positivamente con la obesidad en el sobrepeso y la obesidad. Sin embargo, la asociación entre dos variables es débil porque el ácido úrico en suero influenciado la obesidad con otros factores conexos.

Many phylogenetic questions in the Ciconiiformes remain unresolved and complete mitogenome data are urgently needed for further molecular investigation. In this work, we determined the complete mitogenome sequence of the little egret (Egretta garzetta). The genome was 17,361 bp in length and the gene organization was typical of other avian mtDNA. In protein-coding genes (PCGs), a C insertion was found in ND3, and CO III and ND4 terminated with incomplete stop codons (T). tRNA-Val and tRNA-Ser (AGY) were unable to fold into canonical cloverleaf secondary structures because they had lost the DHU arms. Long repetitive sequences consisting of five types of tandem repeats were found at the 3′ end of Domain III in the control region. A phylogenetic analysis of 11 species of Ciconiiformes was done using complete mitogenome data and 12 PCGs. The tree topologies obtained with these two strategies were identical, which strongly confirmed the monophyly of Ardeidae, Threskiorothidae and Ciconiidae. The phylogenetic analysis also revealed that Egretta was more closely related to Ardea than to Nycticorax in the Ardeidae, and Platalea was more closely related to Threskiornis than to Nipponia in the Threskiornithidae. These findings contribute to our understanding of the phylogenetic relationships of Ciconiiformes based on complete mitogenome data.

OBJECTIVE:We examined the demographic and clinical profiles of Parkinson's disease in Shanghai, China, to assist in disease management and provide comparative data on Parkinson's disease prevalence, phenotype, and progression among different regions and ethnic groups.METHODS:A door-to-door survey and follow-up clinical examinations identified 180 community-dwelling Han-Chinese Parkinson's disease patients (104 males, 76 females).RESULTS:The average age at onset was 65.16±9.60 years. The most common initial symptom was tremor (112 patients, 62.22%), followed by rigidity (38, 21.11%), bradykinesia (28, 15.56%) and tremor plus rigidity (2, 1.11%). Tremor as the initial symptom usually began in a single limb (83.04% of patients). The average duration from onset to mild Parkinson's disease (Hoehn-Yahr phase 1-2) was 52.74±45.64 months. Progression from mild to moderate/severe Parkinson's disease (phase≥3) was significantly slower (87.07±58.72 months; p<0.001), except for patients presenting initially with bradykinesia (53.83±24.49 months). Most patients (149/180, 82.78%) took levodopa with or without other drugs. The Hamilton Anxiety Scale revealed symptoms of clinical anxiety in 35 patients, and the Hamilton Depression Scale revealed depressive symptoms in 88 patients. The depressed or anxious subgroup (123 patients) demonstrated a significantly younger age at onset (55.54±7.68 years) compared with the overall mean (p<0.05).CONCLUSION:Unilateral limb tremor was the most common initial symptom, and motor function deteriorated slowly over ≅4−9 years. Earlier-onset patients experience greater psychiatric dysfunction.

The objective of the present study was to investigate the effects of 3-n-butylphthalide (NBP) on a 1-methyl-4-phenylpyridinium (MPP+)-induced cellular model of Parkinson’s disease (PD) and to illustrate the potential mechanism of autophagy in this process. For this purpose, rat PC12 pheochromocytoma cells were treated with MPP+ (1 mM) for 24 h following pretreatment with NBP (0.1 mM). Cell metabolic viability was determined by the MTT assay and cell ultrastructure was examined by transmission electron microscopy. The intracellular distribution and expression of α-synuclein and microtubule-associated protein light chain 3 (LC3) were detected by immunocytochemistry and Western blotting. Our results demonstrated that: 1) NBP prevented MPP+-induced cytotoxicity in PC12 cells by promoting metabolic viability. 2) NBP induced the accumulation of autophagosomes in MPP+-treated PC12 cells. 3) Further study of the molecular mechanism demonstrated that NBP enhanced the colocalization of α-synuclein and LC3 and up-regulated the protein level of LC3-II. These results demonstrate that NBP protects PC12 cells against MPP+-induced neurotoxicity by activating autophagy-mediated α-synuclein degradation, implying that it may be a potential effective therapeutic agent for the treatment of PD.

Background: Based on the conserved sequences of a known NBS resistance gene, a pair of degenerate primers was designed to amplify the NBS-LRR resistance gene from peanut using PCR and RACE methods. Results: Analyzing the amino acid sequence by BLAST on NCBI, which was deduced from the 1088bp-long gene named PnAG1-2, showed that it had a certain homology with some resistance proteins, among which Arachis cardenasii resistance protein gene had the highest homology (66%). Relative quantification PCR analysis indicated that PnAG1-2 gene expresses more in J11 (an A. flavus-resistant variety) than in JH1012 (an A. flavus-susceptible variety) when the harvest time was coming. Conclusions: In this study, the NBS-LRR resistance sequence was successfully cloned from peanut and prokaryotic expression was done on the gene, which provided a foundation for cultivating anti-A. flavus peanut varieties.