Objective To analyze clinical manifestation and identify prognostic factors in patients with acute respiratory distress syndrome (ARDS) caused by cytomegalovirus (CMV) pneumonia after kidney transplantation.Methods Fifty five kidney transplant recipients' data were analyzed in a case-control study of patients with a primary discharge diagnosis of ARDS caused by CMV pneumonia.Results The mortality of ARDS after kidney transplantation was 56.4%;when association with mechanical ventilation,it was 72.5%.In multivariate Logistic regression analysis,numbers of complications (odds ratioOR2.60,95% confidence intervalCI1.00~6.76),severity of diffuse infiltrates in chest X-ray (OR 11.83,CI 1.14~123.07),mechanical ventilation (OR 11.83,CI 1.14~123.07) were independent risk factors to death.Conclusion Even in modern era,kidney transplant recipients with ARDS after kidney transplantation are still at high risk for death.Numbers of complications,severity of diffuse infiltrates in chest X-ray,mechanical ventilation are associated with poor outcomes.

BACKGROUND:Alogeneic tendon has been frequently used to reconstruct the anterior cruciate ligament. However, there is a lack of middle- and long-term clinical evaluation. OBJECTIVE:To evaluate the middle- and long-term curative effect of alogeneic tendon reconstruction of the anterior cruciate ligament under arthroscopy. METHODS:Twenty-five patients with anterior cruciate ligament injury under alogeneic tendon transplantation were reviewed retrospectively. They were al folowed up for 3 years or more. The clinical outcomes were evaluated and compared using Lyshlom score scale, IKDC2000 and Tegner score scale. RESULTS AND CONCLUSION:Al the patients were folowed up. Lysholm scale scores on the knee function, Tegner scores and IKDC scores were significantly increased after transplantation (P < 0.05). No complications of infection and compartment syndrome occurred. Symptoms were relieved and the function of knee joint was improved. There was one case weakly positive for anterior drawer test. Both Lachman test and pivot shift test showed negative signs. Overal, the reconstruction of anterior cruciate ligament with alogeneic tendon has less trauma and complications, with good middle-term efficacy.

BACKGROUND:Autologous hamstring tendon reconstruction of the medial patel ofemoral ligament is now more popular surgical procedure.
OBJECTIVE:To study the clinical mid-term outcomes of isolated medial patel ofemoral ligament reconstruction for recurrent lateral patel ar dislocation.
METHODS:The clinical data of 24 patients (25 knees) undergoing medial patel ofemoral ligament reconstruction for recurrent patel ar dislocation from September 2006 to September 2009 were retrospectively studied. Clinical, functional, and CT outcomes were assessed at an average of 3.1 years after surgery (range, 2-5 years), using recurrent instability as the primary end point.
RESULTS AND CONCLUSION:The success rate of medial patel ofemoral ligament reconstruction for preventing recurrent dislocations was 92%. Two patients (8%) experienced a recurrent lateral patel ar dislocation, and required a reoperation. At final fol ow-up, the mean IKDC, Tenger and Lycholm scores were significantly higher than those before operation (P<0.01). Reconstruction of the medial patel ofemoral ligament for recurrent patel ar instability is a minimal y invasive operation and has a number of benefits. The mid-term clinical outcome was satisfactory.

BACKGROUND:The treatment method of tibial avulsion fractures of anterior cruciate ligament is varied;each has its advantages. OBJECTIVE:To investigate the methods and clinical effects of the treatment of avulsion fractures of tibial insertion of anterior cruciate ligament by the means of making two decussate lines and four strands of non-absorbable Arthrex sutures passing through two bone tunnels combined with pushlock free knotting anchor under arthroscopy. METHODS:From December 2014 to November 2015, 23 cases of avulsion fractures of tibial insertion of anterior cruciate ligament were treated in the Second Hospital of Inner Mongolia Medical University. Under the arthroscopy, avulsed fracture was fixed in tibial intercondylar eminence by the means of making two decussate lines of Arthrex sutures passing through. At the same time, pushlock free knotting anchor beside tibial tubercle provided a tightening of tension for Arthrex sutures, which could strengthen the fixation of avulsion fracture blocks. Knee joint Lysholm and Tegner scores were fol owed up. Knee stability was evaluated by anterior drawer test and Lachman test. Postoperative reset and healing were evaluated with X-ray films. RESULTS AND CONCLUSION:(1) Al 23 patients were fol owed up for 6 months to 1 year. (2) Lysholm scale of the knee function was (47.31±6.16) preoperatively and (94.69±1.28) postoperatively (P<0.05). Tegner score was (3.14±1.58) preoperatively and (7.74±1.69) postoperatively (P<0.05). (3) Lachman test of al cases was negative. X-ray films demonstrated that fracture healing was good. There was no repeated swel ing or cross locking of the joint. The knee was not limited by flexion or extension. No infection or deep venous thrombosis of lower extremity occurred. (4) The method of Arthrex sutures passing through two bone tunnels combined with pushlock free knotting anchor under arthroscopy has the advantages of minimal y invasive, simple operation, reliable fixation, no metal implants and satisfactory result to treat the tibial intercondylar eminence fracture of anterior cruciate ligament.

AIM: To study the protective effects of basic fibroblast growth factor (bFGF) on myocardial ischemia in rats and their underlying mechanism. METHODS: A rat myocardial ischemic injury model was established by left coronary artery ligation. The rats were killed at 2 h, 4 h, 8 h after coronary artery occlusion. The samples of blood and myocardium were collected for observing the expression of Bcl-2 and Bax in myocardial cells and the changes of superoxide dismutase (SOD) or myocardial enzymes. RESULTS: The amount of Bcl-2 protein expression of myocardial cells in ischemia + bFGF group was significantly higher than that in ischemia+saline group (P

Objective:To identify the pathogenic gene and inheritance pattern in a pedigree of congenital iris coloboma with congenital cataract.Methods:The method of pedigree investigation was adopted.A pedigree of congenital iris coloboma with congenital cataract was collected by Yunnan Disabled Rehabilitation Center and the 2nd Afliated Hospital of Kunming Medical University in February 2020.Ophthalmic examinations were carried out on the female proband, her parents, her children and her husband, and the clinical diagnosis was made.Genomic DNA was extracted from peripheral blood samples collected from the family members.The suspected pathogenic gene in the proband and her husband was screened by whole exome sequencing and was identified by bioinformatics analysis.The amino acid conservation was analyzed by UGENE software.The impact of the mutation on protein translation was predicted using MutationTaster software.The pathogenicity of the mutation was assessed according to the American College of Medical Genetics (ACMG) Standards and Guidelines.Pathogenic gene and mutations were verified by Sanger sequencing.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the 2nd Afliated Hospital of Kunming Medical University (No.PJ-2020-61).Written informed consent was obtained from each subject or custodian.Results:The proband showed large iris defects in both eyes with only a small amount of observable iris tissue in the periphery, lens cortical opacity and posterior capsule opacification, accompanied by nystagmus.A novel heterozygous frameshift variation c. 415dupA (p.R139fs) was located in exon 8 of PAX6 gene, and the variation was conservative across multiple species.The variation was in the highly conserved region of PAX6 gene and caused the dysfunction of PAX6 protein.The variation was graded as PVS1+ PM2+ PP1, a pathogenic variation, based on ACMG guidelines.The pedigree was consistent with co-segregation, indicating that the novel variation was pathogenic.The proband and her children were diagnosed, but her parents were phenotypically normal, in accordance with autosomal dominant inheritance. Conclusions:The novel frameshift variation c.415dupA (p.R139fs) on the exon 8 of PAX6 gene is responsible for congenital iris coloboma with congenital cataract in the pedigree.This is the first report of this novel variation in PAX6 gene.

Objective The objective of this study was to investigate the relationship between CYP2D6 gene polymorphisms and the concentrations of tamoxifen metabolites in breast cancer patients. Methods Peripheral blood samples from breast cancer pa-tients were collected to detect the single nucleotide polymorphism(SNP)of s16947,rs1065852 and rs28371725 gene sites on CYP2D6 gene from January 2010 to December 2012. Genotypes of the three SNPs of CYP2D6 and the concentrations of tamoxifen metabolites were detected in breast cancer patients. Statistical analysis was performed using an independent sample Kruskal-Wallis test in a non-parametric test. Results There was a statistical difference in the concentrations of tamoxifen metabolites 4-OH-N-D-TAM and 4′OH-N -D -TAM in the blood in different CYP2D6 gene genotype carriers at rs16947 site ( P =0. 049), indicating that the rs16947 site of CYP2D6 gene affected the metabolism of tamoxifen drug in breast cancer patients. Conclusion The genotype of CYP2D6 gene at rs16947 site is related to the blood concentration of tamoxifen metabolites in breast cancer patients.

BACKGROUND:The clinical application of Mongolian Medicine Erdun-uril in the treatment of osteoarthritis is effective,but its therapeutic effect and related mechanism are still unclear. OBJECTIVE:To observe the repairing process of osteoarthritis in rats by Mongolian Medicine Erdun-uril and analyze its mechanism. METHODS:Thirty male Sprague-Dawley rats(8 weeks of age)were selected to establsih an osteoarthritis model using intraarticular injection of sodium iodoacetate solution into the unilateral knee joint.Two weeks after modeling,the model rats were randomly divided into three groups:control group(n=6)was given normal saline by gavage,and low and high dose groups(n=12 per group)were given Erdun-uril 1.4 and 2 g,respectively,3 times per day.After 2 and 4 weeks of continuous administration,blood samples,articular cartilage and periarticular bone tissue were taken from rats to detect changes in cartilage metabolic markers(cartilage oligomeric matrix protein,proteoglycan),bone metabolic markers(bone alkaline phosphatase,keratan sulfate),inflammatory markers(interleukin 6,tumor necrosis factor α),lipid metabolic markers(total cholesterol,triacylglycerol).Histopathological changes were also observed. RESULTS AND CONCLUSION:qRT-PCR results showed that after 2 and 4 weeks of administration,the mRNA expression of cartilage oligomeric matrix protein,proteoglycan and bone alkaline phosphatase and keratan sulfate in knee cartilage of rats were significantly reduced in the low and high dose groups compared with the control group(P<0.05,P<0.01,P<0.001),with the reduction being more significant in the high dose group.After 2 and 4 weeks of administration,compared with the control group,serum tumor necrosis factor α and interleukin 6 levels were decreased(P<0.01,P<0.001)and total cholesterol and triacylglycerol levels were increased(P<0.05,P<0.01,P<0.001)in the low and high dose groups,with the improvement being more significant in the high dose group.Hematoxylin-eosin staining results showed that in the control group,there were large defective areas on the surface of the knee cartilage with unknown structure and severe inflammatory cell infiltration;in the low dose group,the surface of the knee cartilage was rough with disordered cell arrangement and the cartilage structure did not improve significantly after 2 weeks of administration,while the number of inflammatory cells in the knee cartilage was reduced and the cartilage structure was restored to some extent after 4 weeks of administration;in the high dose group,the structure of the knee cartilage become clear after 2 weeks of administration and even clearer after 4 weeks of administration,and the inflammation was significantly reduced after 2 weeks of administration.To conclude,Mongolian Medicine Erdun-uril with better anti-inflammatory properties can improve cartilage metabolism and obviously alleviate osteoarthritis in rats.

Variety of accessibility to edible species in different regions has climatic and historical roots. In the present study, we try to systematically analyze 28,064 records of relationships between 11,752 edible species and 228 geographic zones by hierarchical clustering. The 228 geographic regions were classified into 11 super groups named as A to K, which were further divided into 39 clusters (CLs). Of them, at least one member of each of 28 CLs is associated to 20 or more edible species according to present information of KNApSAcK DB (http://kanaya.naist.jp/KNApSAcK_World/top.jsp). We examined those 28 CLs and found that majority of the members of each of the 27 CLs (96%) have specific type of climate. Diversity of accessibility to edible species makes it possible to separate 8 geographic regions on continental landmasses namely Mediterraneum, Baltic Sea, Western Europe, Yucatan Peninsula, South America, Africa and Arabian Peninsula, Southeast Asia, and Arctic Ocean; and three archipelagos namely, Caribbean Islands, Southeast Asian Islands and Pacific Islands. In addition, we also examined clusters based on cultural exchanges by colonization and migration and mass movement of people and material by modern transportation and trades as well as biogeographic factors. The era of big data science or data intensive science make it possible to systematically understand the content in huge data and how to acquire suitable data for specific purposes. Human healthcare should be considered on the basis of culture, climate, accessibility of edible foods and preferences, and based on molecular level information of genome and digestive systems.