Hematopoietic Stem Cell Transplantation ; Humans ; Multiple Myeloma ; pathology ; therapy ; Neoplasm Staging ; Transplantation, Autologous

Objective To explore and analyze genetic mutations of phospholipase C (PLC)-encoding genes plcABCD among clinical isolates of Mycobacterium tuberculosis and to provide scientific basis for understanding virulence and pathogenesis of Mycobacterium tuberculosis. Methods A total of 102 isolates from patients with active tuberculosis were identified. Bacterial DNA was extracted. All plcABCD genes were amplified by polymerase chain reaction (PCR) and checked for deletions or mutations by agarose gel electrophoresis. Results According to presence or absence of plcABCD genes, 102 isolates were divided into 13 genotypes. Thirty-one (30.39%) isolates were plc wild genotype with all plcABCD genes; 71(69. 61%) isolates were plc mutant type with different plc gene deletions. Of 71 plc mutant isolates, 48 missed only one of four plc genes, 14 had deletions of 2 plc genes, 8 were triple mutants and 1 was quadruple mutant. There were 61 (59. 80%) isolates with plcD gene mutation, while the mutation rates of plcA, plcB and plcC genes were lower, which were 15. 69%(16/102), 9. 80%(10/102) and 16. 67%(17/ 102), respectively. Conclusion This study shows great diversity in plcABCD genes among clinical isolates of Mycobacterium tuberculosis, with the most common of plcD.

To investigate the chlorogenic acids resources in Eucommia ulmoides Olive leaves, Lonicera japonica Thunb. leaves and Houttuynla cordata Thunb. leaves, methanolic extracts of these three materials have been analysed qualitatively for chlorogenic acids and their derivatives by structure-diagnostic LC-MSn. Three monocaffeoylquinic acids (3-CQA, 4-CQA, 5-CQA) were detected. 5-CQA dominated this subgroup in Eucommia ulmoides Olive and Lonicera japonica Thunb. leaves, but 3-CQA and 4-CQA dominated this subgroup of chlorogenic acids in the leaves of Houttuynla cordata Thunb. Caffeoylquinic acid-glycosides were detected for the first time from Eucommia ulmoides leaves. 5-FQA was found in Lonicera japonica Thunb. leaves, and 3-FQA and 4-pCoQA have been identified in Houttuynla cordata Thunb. This is the first report of the chlorogenic acid profile in Houttuynla cordata Thunb. The comparatively unusual profile of caffeoylquinic acids in Houttuynla cordata Thunb. makes it a convenient source of 3-CQA and 4-CQA that are not commercially available.

Aged ; Diagnosis, Differential ; Drug Therapy, Combination ; Female ; Humans ; Liver ; blood supply ; pathology ; Multiple Myeloma ; diagnostic imaging ; drug therapy ; pathology ; Neovascularization, Pathologic ; diagnosis ; pathology ; Tomography, X-Ray Computed

Ebola virus infection causes severe hemorrhagic fever in human and non-human primates with high mortality.Viral entry/infection is initiated by binding of glycoprotein GP protein on Ebola virion to host cells,followed by fusion of virus-cell membrane also mediated by GP.Using an human immunodeficiency virus (HIV)-based pseudotyping system,the roles of 41 Ebola GP1 residues in the receptor-binding domain in viral entry were studied by alanine scanning substitutions.We identified that four residues appear to be involved in protein folding/structure and four residues are important for viral entry.An improved entry interference assay was developed and used to study the role of these residues that are important for viral entry.It was found that R64 and K95 are involved in receptor binding.In contrast,some residues such as I170 are important for viral entry,but do not play a major role in receptor binding as indicated by entry interference assay and/or protein binding data,suggesting that these residues are involved in post-binding steps of viral entry.Furthermore,our results also suggested that Ebola and Marburg viruses share a common cellular molecule for entry.

The glycoprotein (GP) of Ebola is the sole structural protein that forms the spikes on the viral envelope. The GP contains two subunits, GP1 and GP2, linked by a disulfide bond, which are responsible for receptor binding and membrane fusion, respectively. In this study, the full length of GP gene of Ebola Zaire species, 2028 base pairs in length, was synthesized using 38 overlapping oligonucleotides by multiple rounds of polymerase chain reaction (PCR). The synthesized GP gene was shown to be efficiently expressed in mammalian cells. Furthermore, an efficient HIV-based pseudotyping system was developed using the synthetic GP gene, providing a safe approach to dissecting the entry mechanism of Ebola viruses. Using this pseudotyping system and mutational analysis, the role of the charged residues in the GP2 helical regions was examined. It was found that substitutions of the most charged residues in the regions did not adversely affect GP expression, processing, or viral incorporation, however, most of the mutations greatly impaired the ability of GP to mediate efficient viral infection. These results demonstrate that these charged residues of GP2 play an important role in GP-mediated Ebola entry into its host cells. We propose that these charged residues are involved in forming the intermediate conformation(s) of GP in membrane fusion and Ebola entry.

Objective Background Pulmonary endarterectomy (PEA) is a safe and effective surgical treatment for chronic thromboembolic pulmonary hypertension. University of California at San Diego Medical Center is widely recognized as the world's leading referral center for PEA surgery with extensive surgical experience, which has surgically treated about 2400 patients till 2009, which account for more than 50% of the total cases in the world. Methods During visiting in UCSD, 32 pulmonary endarterectomy operations were performed by Prof. Stuart W Jamieson and Mechel M Madani. In these patients, 17 were males (53%), the average age was (47.56 ± 16.04 ) years, 47% with prior history of pulmonary embolism and/or deep vein thrombosis. Obvious pulmonary hypertension and hypoxemia were observed in all patients. Bilateral pulmonary endarterectomy was performed under cardiopulmonary bypass with profound hypothermic circulatory arrest. Results According to the classification of surgical specimens, 21.8% are type Ⅰ , 28.1% are type Ⅱ and 37.5% are type Ⅲ. The average time of cardiopulmonary bypass (CPB) was (236.32 ± 37.27) mins. The aortic cross clamp time was ( 111.69 ± 28.14) mins. The circulatory arrest time was (38.00±13.58 ) mins [ right side (21.39 ± 9.57 ) mins and left side ( 16.61 ± 6.83) mins]. Postoperatively the average mechanical ventilation time was ( 66.23 ± 99.24) hours, and the ICU stay was (4.62 ± 4.50 ) days.There was no postoperative moorality. All cases had significant decrease in systolic pulmonary artery pressure [(81.03 ± 16.92)mm Hg vs. (51.20±12.16) mm Hg] and pulmonary vascular resistance [(88.91 ±42.32) kPa · s · L-1 vs. (34.38 ±15.68 ) kPa · s · L-1 ], great improvement in cardiac output [(3.65 ±1.08 ) L/min vs. ( 5.85 ± 1.21 ) L/min ] and central venous pressure [(13.07 ± 2.11) cmH2O vs. ( 9.86 ± 3.02 ) cmH2O] postoperatively compared to preoperative data. Shortterm follow-up showed that the cardiac function of all cases returned to NYHA class Ⅰ or Ⅱ, with great improvement in CTPA.Conclusion PEA is definitive treatment of chronic thromboembolic pulmonary hypertension. According the successful experience of UCSD PEA team, first and foremost pulmonary endarterectomy is a bilateral procedure, because chronic thromboembolic pulmonary hypertension is mostly a bilateral disease. Second, cardiopulmonary bypass with the aid of deep hypothermia and circulatory arrest are essential to operator in recognizing the true endarterectomy plane of the media and in following the specimen to its feathered tail end in each branch, using these approaches can effectively reduce pulmonary hypertension and provide good hemodynamic and symptomatic results. Third, PEA remains an uncommon procedure in China. Only a few centers can perform high qualified PEA surgery. In most of inexperienced centers, type Ⅰ and type Ⅱ disease should be choose to operation.Patients with sPAP ≥100 mm Hg, PVR ≥ 100 kPa · s · L-1 or type Ⅲ disease will face more dangers peri-operation.

Objective Describe the prevalence of depressive disorders (mood disorders with current depressive episode) among individuals treated in general hospitals in Beijing. Methods 2877 outpatients and 2925 inpatients ≥15 years of age from 50 general hospitals (selected by stratified random sampling) were screened by trained psychiatric nurses using a depression screening instrument and then the gold standard diagnosis of all subjects screened positive and 10% of those screened negative was determined by a trained psychiatrist who used a semi-structured interview schedule based on American psychiatric diagnostic criteria (DSM-IV). Results The adjusted point prevalence, one-year prevalence, and lifetime prevalence of any type of depressive disorder were 5.23%, 5.72% and 8.22%, respectively; corresponding prevalences of major depressive disorder were 2.94%, 3.46%, and 5.32%, respectively. Conclusions The prevalence of depressive disorders among patients in general hospitals in Beijing is not significantly higher than in the general population in China.

With the development of information technology,the concept of smart healthcare has gradually come to the fore.Smart healthcare uses a new generation of information technologies,such as the internet of things (IoT),big data,cloud computing,and artificial intelligence,to transform the traditional medical system in an all-round way,making healthcare more efficient,more convenient,and more personalized.With the aim of introducing the concept of smart healthcare,in this review,we first list the key technologies that support smart healthcare and introduce the current status of smart healthcare in several important fields.Then we expound the existing problems with smart healthcare and try to propose solutions to them.Finally,we look ahead and evaluate the future prospects of smart healthcare.

The objective of the current study is to discuss the problems related to how data is used to calculate Years Lost with Disability (YLD) with the method recommended by the World Bank. The study includes collecting useful data, estimating disease duration and average age of disease onset,adjusting incidence and prevalence data by means of a software programme, DISMOD ( Harvard University Incidence & Prevalence Model), and assessing the importance of YLD calculation for different diseases.Remission and fatality rates of 3 diseases were estimated by experts at 2 round consultations.Incidence rates, disease duration and average age of disease onset were calculated and adjusted by DISMOD. YLD due to schizophrenia is the highest among 4 diseases in two regions. YLD is18.88% in disability adjusted life year for 4 diseases in Xiacheng District, and 19.97% in Fuyang County.Available data can be used for the calculation of YLD after being adjusted. DISMOD is a useful instrument to test the internal consistency of incidence, prevalence, remission and fatality rate. The adjusted data are acceptable to experts and DISMOD. To get rational remission and fatality rates, we can use a cohort method through expert consultations. To reflect overall burden of disease, YLD calculation should be used.