Objective To discuss the risk in duo paternity testing. Methods 22 fictitious duo families formed by 22 pairs of unrelated individuals having one or zero inconsistent locus were selected after detected by GoldeneyeTM 20A Kit. The 22 fictitious duo families were further tested with STRtyper-10G kit and/or AGCU 21+1 STR kit until there were more than 3 inconsistent loci and the cumulative paternity index(CPI) value was less than 0.0001. According to the three excluding rules, ① number of inconsistent loci>3; ② CPI ≤ 0.0001; ③ accord with both ① and ② , using multiple STR systems, such as 19 STR loci, 26 STR loci, 39 STR loci and 46 STR loci to test and discuss whether there is difference among the excluding result of unrelated individual. Results Among those 22 fictitious duo families, using three excluding rules, None was excluded by 19 STR loci, and all was excluded by 39 STR loci. Conclusion Duo paternity tests may get a wrong result using only 19 loci system. To reduce the error risk 39 STR-loci systems would be suggested.

China ; Electrophoresis, Gel, Pulsed-Field ; Escherichia coli O157 ; classification ; genetics ; Genes, Bacterial ; Humans ; Molecular Typing ; Virulence

Objective To compare the diuretic efficacy of torasemide as a 2-hour continuous infusion and as a bolus injection of equal dose in patients with nephrotic syndrome,and to investigate a preferable administration mode of torasemide for these patients.Methods Twenty-three hospitalized patients were randomized to receive torasemide 20 mg or 40 mg per day by either 2-hour intravenous infusion or bolus injection,and interchanged after 48 hours of washout.Results Patients received torasemide by 2-hour intravenous infusion exhibited significantly higher daily urinary volume,chloride excretion,sodium excretion and fractional excretion of sodium (FENa) within 24 hours than those by bolus injection (P ＜ 0.05).Significantly lower bound-state torasemide excretion,higher ratio of urinary volume to torasemide excretion and a markedly larger area under the curve in the plasma concentrationtime profiles were also observed in the infusion group (P ＜ 0.05).Conclusion 2-hour continuous infusion delivers a better diuretic effect compared with a bolus injection of equal dose of torasemide in patients with nephrotic syndrome.

Objective:To investigate the clinical characteristics of congenital esophageal atresia with gastric perforation, and to improve pediatricians′ understanding of this disease.Methods:The clinical data of five neonates with congenital esophageal atresia and gastric perforation treated in the neonatal intensive care unit of the Affiliated Hospital of Qingdao University from 2012 to 2022 were analyzed retrospectively.Results:Among the five neonates, four were boys and one was girl.The gestational age was 28 + 5 to 37 + 6 weeks, the birth weight was 1 100~2 350 g. All of them had dyspnea and feeding difficulties after birth.Gastric perforation occurred in three cases during invasive mechanical ventilation, one case during non-invasive ventilation, and one case during nasal catheter oxygen inhalation.Emergency primary gastric repair was performed, followed by secondary esophageal anastomosis.All the patients were cured and discharged from hospital. Conclusion:Gastric perforation is a rare complication of congenital esophageal atresia, which is more common in premature infants and low birth weight infants.Mechanical ventilation may promote the occurrence of gastric perforation.If gastric perforation is complicated, repair should be performed as soon as possible, and esophageal anastomosis surgery should be performed early after stability to improve the final outcome.

OBJECTIVETo investigate the expression of BATF, a member of the activator protein-1 family, in the renal tissues of mice with lupus nephritis.

METHODSThe renal tissues from 24-week-old female MRL/lpr mice and age- and sex-matched C57BL/6 mice were examined for BATF protein expressions using Western blotting and for expressions of BATF, RORγt and IL-17A mRNA using quantitative real-time PCR. The results of laboratory examinations were analyzed in relation with the histopathology of the mice.

RESULTSThe urinary protein and ds-DNA levels were significantly higher in MRL/lpr mice than in the control mice (P<0.05). Compared to normal control mice, MRL/lpr mice showed obvious glomerular fibrosis and inflammatory cell infiltrating with significantly increased BATF protein and mRNA expressions (P<0.05) and RORγt and IL-17 mRNA expressions in the renal tissues (P<0.05). In MRL/lpr mice, the expression of BATF mRNA was positively correlated with the RORγt and IL-17A mRNA expressions in the renal tissues.

CONCLUSIONThe renal expressions of BATF protein and mRNA is increased in MRL/lpr mice. BATF may participate in the immunopathogenesis of lupus nephritis by enhancing Thl7 cell response.

Animals ; Basic-Leucine Zipper Transcription Factors ; metabolism ; Blotting, Western ; Female ; Interleukin-17 ; metabolism ; Kidney ; metabolism ; Kidney Glomerulus ; pathology ; Lupus Nephritis ; metabolism ; Mice ; Mice, Inbred C57BL ; Mice, Inbred MRL lpr ; Nuclear Receptor Subfamily 1, Group F, Member 3 ; metabolism ; RNA, Messenger ; Real-Time Polymerase Chain Reaction

Objective:To investigate the effect of Mini-Clinical Evaluation Exercise (Mini-CEX) combined with direct observation of procedural skills (DOPS) in ophthalmology practice training in the integrated teaching of sensory system diseases.Methods:The medical students in the five-year program who entered the stage of ophthalmology practice in the integrated teaching of sensory system diseases in The Second Clinical College of Chongqing Medical University, were selected as research group, and the medical students in the five-year program who received training from October 2020 to July 2021 were selected as control group. The two groups were compared in terms of department examination score, progressive evaluation of the research group, and the degree of satisfaction with practice. SPSS 23.0 was used for the t-test. Results:Compared with the control group, the research group had significantly better scores of medical history inquiry, medical record writing, and operational skills ( t=2.47, P=0.016; t=5.26, P<0.001; t=2.20, P=0.031). In progressive training, the Mini-CEX and DOPS scores in the second progressive formative assessment were better than those in the first assessment ( t=-21.06, P<0.001; t=-15.09, P<0.001). The degree of satisfaction with performance among the interns and the degree of satisfaction with interns among the examiners in the second assessment were better than those in the first assessment ( t=-5.53, P<0.001; t=-8.19, P<0.001). Conclusion:Mini-CEX combined with DOPS has a good effect in ophthalmology practice training in the integrated teaching of sensory system diseases and thus holds promise for application.

Objective:To explore the changes and their clinical significance of plasma d-dimer (D-D) and fibrinogen (Fib) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with hypoxemia.Methods:150 patients with AECOPD admitted to our hospital from September 2017 to October 2018 were selected and divided into simple AECOPD group (75 cases) and AECOPD combined with hypoxemia group (75 cases) according to the arterial blood gas analysis results. In addition, 75 healthy people in the same period were selected as the control group. The D-D, Fib and C-reactive protein (CRP) level were detected in venous blood, and the differences and correlation of these indexes among the groups were statistically analyzed.Results:The D-D and Fib of AECOPD combined with hypoxemia group were significantly higher than those of AECOPD group and healthy control group, and the AECOPD group was higher than the healthy control group ( P<0.001). In AECOPD group, the plasma Fib and D-D were positively correlated with CRP ( r=0.617, P<0.001; r=0.300, P=0.009), but not with platelets (PLT) and white blood cell (WBC) ( P>0.05); in AECOPD combined with hypoxemia group, the plasma Fib was positively correlated with CRP, WBC and PLT ( r=0.854, P<0.001; r=0.345, P=0.002; r=0.272, P=0.018), but there was no correlation between D-D and CRP, WBC and PLT ( P>0.05). Conclusions:The plasma level of D-D and Fib increase with the aggravation of chronic obstructive pulmonary disease (COPD). They could be considered as potential inflammatory markers for the assessment of inflammation in the progression of COPD.

Objective: To explore the role of ROCK1 in oxidized low-density lipoprotein (ox-LDL) induced podocyte injury and its possible mechanism. Methods: The conditionally immortalized mouse podocyte cells were cultured in vitro and exposed to 20 μg/ml ox-LDL for 24 h. Western blotting was used to analyze the expression level of p-MYPT, nephrin, LC3-Ⅱ, p62, p-ULK1 in groups of control, ox-LDL, ROCK1 siRNA with ox-LDL, wtROCK1 with ox-LDL. Podocytes were incubated with DiI labeled ox-LDL for 4 h and fluorescence microscope was used to analyze lipid distribution. Results: Compared with control group, ox-LDL increased cell cholesterol accumulation, activated ROCK along with decreased nephrin, LC3-Ⅱ(P<0.05), and increased p62, and p-ULK1 expression (P<0.05). Over-expression of ROCK1 significantly decreased the expression of nephrin and LC3-Ⅱ, but up-regulated the levels of p62, p-ULK1 and cell cholesterol accumulation in ox-LDL stimulated podocytes (P<0.05). In contrast, Inhibition of ROCK1 protected podocyte by improved lipophagy. Conclusion ROCK1 mediated disfunction of lipophagy contributes to the ox-LDL induced podocyte injury.

Objective To investigate the spatial correlation and spatial cluster pattern of hemorrhagic fever with renal syndrome (HFRS) in Jingzhou City,Hubei Province from 2013 to 2017.Methods The HFRS surveillance data during 2013-2017 were collected from China Disease Prevention and Control Information System.Software ArcGIS 10.3 was used to analyze the spatial distribution,and global autocorrelation analysis (Moran'sI) and hot spot analysis (Getis-Ord Gi) were used to analyze the spatial autocorrelation.Spatial cluster pattern was explored by trend surface analysis and directional distribution.Results In 2013-2017,the global Moran's I was 0.117 6 (P ＞ 0.05),0.349 8 (P ＜ 0.05),0.102 1 (P ＞ 0.05),0.276 3 (P ＜ 0.05),and 0.394 8 (P ＜ 0.05),respectively.The Getis-Ord Gi analysis showed that there were 7,8,8,8,15 hot areas with high incidence of HFRS during this period,respectively,which were part of townships in Jiangling County,Shashi District,Jianli County,and Honghu City.The cold spot area with low incidence of HFRS was only detected in 2015,and it was part of the township in Shashi District and Jingzhou District.The trend surface analysis showed that the inverted-U type curve could reflect the HFRS distribution from northern to southern,and it was also from eastern to western.The directional distribution showed that the HFRS cases were distributed in the north-central part of Jingzhou in 2013-2017,and they were inconsistent with the distribution of the Yangtze River system.Conclusions The incidence of HFRS has an obvious spatial clustering characteristic,and the areas at high risk are mainly in the north-central part of Jingzhou City.The spatial cluster pattern of HFRS has nothing to do with the Yangtze River system.

Objective:To explore the serotype distribution and drug resistance of Shigella in stool samples of children under five years old with diarrhea from 2008 to 2017 in Sui County, Henan Province. Methods:A total of 4 721 stool samples of children under five years old with diarrhea were collected from Doufuyuan Clinic of Sui County during 2008 to 2017, and Shigella strains were isolated through bacterial culture. The slide agglutination test was used for serotyping of Shigella strains. Two hundred of seventy-one Shigella strains were selected in proportion, and multiple gradient polymerase chain reaction was used to detect virulence genes and Kirby-Bauer agar method was used for drug sensitivity. Trend chi square test was used to analyze the annual trend of drug resistance. Results:The detection rate of Shigella strains in 4 721 fecal samples was 20.69% (977/4 721). A total of 977 Shigella strains were divided into 13 serotypes in two groups, including 77.79%(760/977) Shigella flexneri strains and 22.21%(217/977) Shigella sonnei strains.The top three serotypes detected alternately every year.The dominant gene pattern of Shigella flexneri was Shigella enterotoxin ( shET)-1+ , shET-2+ , invasion plasmid antigen H ( ipaH)+ , invasion-associated locus ( ial)+ , accounted for 84.04%(179/213) and that of Shigella sonnei was shET-1-, shET-2+ , ipaH+ , ial+ , accounted for 46.55%(27/58). The drug resistance rates of 271 Shigella strains to ampicillin, nalidixic acid and tetracycline were more than 90% and the strains were more sensitive to cefepime and ceftazidime.The drug resistance rates to cefotaxime, cefepime, ciprofloxacin, chloramphenicol and sulfamethoxazole/trimethoprim increased year by year, and all had statistically significant differences ( χ2=24.027, 7.232, 6.039, 4.764 and 6.809, respectively, all P< 0.05). There were 98.52%(267/271) strains resistant to more than three kinds of drugs. The resistance rates of Shigella flexneri to ciprofloxacin, norfloxacin, and chloramphenicol were higher than those of Shigella sonnei, and the resistance rates to gentamicin and sulfamethoxazole/trimethoprim were lower than those of Shigella sonnei. The differences were statistically significant ( χ2=31.866, 14.868, 83.036, 68.534 and 14.738, respectively, all P<0.01). Conclusions:The major serotypes of Shigella in children under five years old in Sui County are constantly changing from 2008 to 2017. The dominant gene patterns of different serotypes are different. Most isolated strains have multiple drug resistances, and different serotypes have different resistance profiles.