Objective To explore the correlation between Alzheimer's disease (AD), vascular dementia (VD) and carotid artery atherosclerosis. Methods This case-control study was conducted among 64 AD and 42 VD in-patients and out-patient admitted in Guangzhou Brain Hospital between July 2005 and July 2007, involving also 69 age- and gender-matched control subjects. Color Doppler ultrasound was performed to examine the artery shape, intima-media thickness (IMT), shape and size of the arteriosclerotic plaques, and diameter of the common carotid artery at 2 cm from the bifurcation and of the distal internal carotid artery 1.0-1.5 cm from the enlargement of the initial segment. Results Compared with those in the control group, the IMT, vascular diameter and arteriosclerotic plaques in the carotid artery were significantly increased in the dementia patients (P<0.05), but no obvious differences were found between the AD and VD patients. The degree of carotid artery atherosclerosis, represented by the number of plaques, was inversely correlated to the Mini-Mental State Examination scores (r=-0.389, P=0.000). Conclusion Carotid artery atherosclerosis is closely associated with the development of AD and VD, and the degree of atherosclerosis is positively correlated to the severity of dementia.

BACKGROUNDOnabotulinumtoxinA is widely used in treating neurogenic detrusor overactivity (NDO). We carried out a systematic review and meta-analysis to assess the efficacy and safety of the drug for treating NDO.

METHODSWe searched the following databases: Medline, EMBASE, and the Cochrane Controlled Trials Register. All published randomized double-blind, placebo-controlled trials of onabotulinumtoxinA for the treatment of NDO were identified in the analysis. The reference lists of the retrieved studies were also investigated.

RESULTSFour publications involving a total of 807 patients were identified in the analysis, which compared onabotulinumtoxinA with placebo. The changes of the mean number of urinary incontinence per week (the standardized mean difference [SMD] = -10.91, 95% confidence intervals [CIs] = -14.18--7.63, P < 0.0001); maximum cystometric capacity (SMD = 146.09, 95% CI = 126.19-165.99, P < 0.0001) and maximum detrusor pressure (SMD = -32.65, 95% CI = -37.83--27.48, P < 0.0001) indicated that onabotulinumtoxinA was more effective than the placebo, despite the doses of onabotulinumtoxinA. Safety assessments primarily localized to the urinary tract indicated onabotulinumtoxinA were often associated with more complications. Urinary tract infections (relative risk [RR] =1.48, 95% CI = 1.20-1.81, P = 0.0002); hematuria (RR = 1.81, 95% CI = 1.00-3.24, P = 0.05) and urinary retention (RR = 5.87, 95% CI = 3.61-9.56, P < 0.0001).

CONCLUSIONSThis meta-analysis indicates that onabotulinumtoxinA to be an effective treatment for NDO with side effects primarily localized to urinary tract.

Botulinum Toxins, Type A ; adverse effects ; therapeutic use ; Humans ; Urinary Bladder, Overactive ; drug therapy

Global Health ; History, 20th Century ; Humans ; Influenza A Virus, H1N1 Subtype ; genetics ; isolation & purification ; Influenza A Virus, H3N2 Subtype ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; therapy ; virology ; Russia ; epidemiology

OBJECTIVETo analyze the clinical features and genotype in a 8-year-old boy with dyskeratosis congenita (DC).

METHODSWe reviewed the clinical data of the case and amplified 7 DC-related genes (including DKC1,TERT,TERC,TINF2,NOP10, NHP2 and WRAP53) using polymerase chain reaction for DNA sequence analysis to identify the abnormal exons.

RESULTSDNA sequence analysis showed a c.85-15T>C mutation in DKC1 gene of the patient. His mother was a carrier of the mutated gene and presented with partial clinical features such as abnormal nails.

CONCLUSIONThe mutation of c.85-15T>C in DKC1 gene was reported for the first time in China. The diagnosis of DC should be considered if a young patient presents with mucocutaneous abnormalities, bone marrow failure, cancer susceptibility and a family history of cancer. Early genetic tests can improve the diagnosis rates and reduce misdiagnosis and missed diagnosis.

Cell Cycle Proteins ; genetics ; Child ; China ; Dyskeratosis Congenita ; genetics ; pathology ; Exons ; Genotype ; Humans ; Male ; Mutation ; Nuclear Proteins ; genetics ; Polymerase Chain Reaction ; Sequence Analysis, DNA

Objective To investigate the prenatal ultrasonographic features of fetal total anomalous pulmonary venous connection (TAPVC).Methods Forty-one cases who received prenatal ultrasound examination and then were diagnosed with TAPVC by postnatal surgery at the Third Affiliated Hospital of Zhengzhou University from June 2013 to June 2018 were enrolled.Echocardiography findings of all cases were analyzed retrospectively,and the prenatal imaging features were summarized.Results Among all cases,21 were confirmed as supracardiac type,14 as intracardiac type,four as infracardiac type and two as mixed type after surgery.The echocardiographic features of TAPVC were as follows:all 41 cases showed smooth posterior wall of left atrium without visible part of pulmonary venous connected to the left atrium in the-four chamber view;in 33 cases,the space between left atrium and descending aorta was widened and the pulmonary venous confluence was observed in the four-chamber view;ten cases showed a dilated coronary sinus in the four-chamber view and 27 cases showed vertical vein in the three vessels and trachea or the upper abdomen view.None of the 41 cases was complicated by other structural intracardiac abnormalities.However,seven cases were complicated by obstruction of blood flow,and the blood flow velocity measured by Doppler ultrasound was 0.76 m/s to 1.25 m/s.Conclusions Blood flow in pulmonary veins should be carefully observed in prenatal ultrasonography,and anomalous pulmonary venous connection should be considered when pulmonary veins do not connect to the left atrium.

Objective:To compare percutaneous cannulated screw (PCS) fixation and plating via a minimally invasive longitudinal approach (MILA) after closed reduction for the treatment of intra-articular tongue-type calcaneal fractures.Methods:A retrospective analysis was conducted of the 67 patients with intra-articular tongue-type calcaneal fracture who had been treated at Department of Orthopedics, The Third Hospital of Peking University from May 2017 to May 2020. They were 56 males and 11 females, 19 to 58 years of age (average, 34.5 years). Of them, 32 were treated by the PCS fixation after closed reduction (PCS group) and 35 by the MILA plating after closed reduction (MILA group). The operation time, preoperative time, post-operative hospital stay, blood loss and postoperative complications were recorded and compared between the 2 groups. The calcaneal length, width and height, Gissane angle, B?hler angle, varus angle, valgus angle and visual analog scale (VAS) were compared between the 2 groups at preoperation, immediate postoperation, 3 months postoperation, and the last follow-up. The American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was used at 3 months postoperation and the last follow-up to evaluate the function of the injured hindfoot.Results:There was no significant difference in the preoperative general data between the PCS group and the MILA group, showing they were comparable ( P>0.05). All patients were followed up for an average of 18.5 months (from 15 to 25 months). For the PCS group and the MILA group, respectively, the operation time was 60.5 (51.5, 68.0) min and 86.0 (78.0, 96.0) min, the blood loss 10 (5.0, 20.0) mL and 20 (15, 25) mL, the postoperative hospital stay 1 (1.0, 1.8) d and 2 (2, 3) d, the calcaneal width at immediate postoperation (43.8±4.4) mm and (40.6±2.8) mm, the calcaneal width at 3 months postoperation 43.8 (39.6, 48.3) mm and 41.5 (38.8, 44.5) mm, the calcaneal width at the last follow-up 44.2 (40.2, 48.0) mm and 41.3 (39.0, 44.3) mm, the VAS at the last follow-up 5.0 (5.0, 5.0) and 6.0 (5.0, 6.0). The comparisons of the above items showed significant differences between the 2 groups (all P<0.05). No significant differences were observed between the 2 groups in the calcaneal length or height, Gissane or B?hler angle, AOFAS hindfoot score, or complication rate (all P>0.05). Conclusions:In the treatment of tongue-type calcaneal fractures, after closed reduction, the PCS fixation can shorten operation time and postoperative hospital stay, and reduce intraoperative blood loss and postoperative pain, but the MILA plating is more advantageous in restoring the calcaneal width.

To compare the discriminatory ability of multilocus sequence typing and serotype of animal-derived Salmonella and find its distribution in Shandong Province,78 chicken-origin,56 duck-origin and 20 swine-origin Salmonella were separated from some regions of Shandong Province.Seven conserve sequences of Salmonella were PCR-amplified for MLST and slide agglutination test for serotyping.Results showed that by serotyping,6 serotypes were identified from chicken-origin Salmonella,including 88.5％0 S.enteritidis,5.1％ S.indiana,2.6％ S.thompson,1.3％ S.typhimurium,1.3％ S.senftenberg,1.3％ S.agama.Two serotypes were identified from duck-origin Salmonella,including 67.9％ S.enteritidis,32.1％ S.ty phimurium.Three serotypes were identified from swine-origin Salmonella,including 65％ S.typhimurium,20％ S.derby,and 15％ S.enteritidis.By MLST typing,seven ST types were identified from chicken-origin Salmonella:ST11,ST19,ST26,ST128,ST14,ST17 and Newl.Three ST types were identified form duck-origin Salmonella:ST11,ST19 and New2.Three ST types were identified from swine-origin Salmonella:ST34,ST40 and ST3007.Overall,the types identified with two methods were closed,so MLST and serotype have similar discriminatory ability.

Autophagy, a conserved intracellular degradation system, is a specific life phenomenon in eukaryocytes. Autophagy is widely accepted as a pathway that double-membrane autophagosomes envelop and sequester intracellular cytoplasmic components and then fuse with lysosomes to form autolysosomes, which degrade their contents to regenerate nutrients. Autophagy may be triggered by starvation and a diverse range of pathogens, including parasites. Following infection with intracellular parasites, host cells may eliminate parasites by autophagy. However, parasites may develop self-defense mechanisms, and promote the self-growth and -development by host cell autophagy. This review describes the advances in the interplay between parasitic infections and host cell autophagy. Understanding autophagy is of great significance for the management of parasitic infections and the development of antiparasitic drugs.

Objective To describe the epidemiological and clinical features of hospitalized people less than 18 years old with influenza A (H1N1)-associated pneumonia and associated risk factors.Methods Through Chinese Reporting System of Influenza A (H 1 N1 ),children aged under 18 years who were hospitalized with laboratory confirmed influenza A (H1N1),case report forms and related information on pneumonia were collected between 1 September 2009 and 4 July 2010.Epidemiological and clinical characteristics including demographics,underlying chronic diseases,treatment,complications and clinical outcome etc.were described.Hospitalized children with pneumonia were compared with those without the above mentioned features,through the univariate and multivariate analysis.Results There were 4240 influenza A (H1N1)-associated hospitalized children with case report forms identified.Of the 4107 influenza A (H1N1) -associated hospitalized children with related information on pneumonia shown in the case report forms,2289 (55.7％) of them had pneumonia.Hospitalized children with influenza A (H1N 1 ) -associated pneumonia had a younger median age (4.9year old),when compared with those without pneumonia (13.1 year old,P＜ 0.0001 ).When compared with the hospitalized children without pneumonia,those hospitalized children with pneumonia were more likely to require intensive care unit care,using mechanical ventilation epuipmentto develop ARDS,respiratory failure or leading to death.Data from multivariate analysis showed that children aged ＜6months(OR=7.08,95％CI:4.15-12.06) between 6 and 23 months(aOR=8.26,95％CI:6.10-11.20) or between 2 to 4 year old (aOR=9.53,95％CI:7.39-12.29) were more likely to develop pneumonia than children aged 5 to 17.Factors as having asthma (OR=12.19,95％ CI:5.18-28.72),cardiovascular disease (OR=5.19,95％ CI:1.94-13.90),chronic renal diseases (OR=2.14,95％ CI:1.02-4.53),chronic hepatic diseases ( OR =5.26,95％ CI:1.40-19.81 ) and allergy (OR=2.54,95％ CI:1.64-3.93 )were significantly associated with influenza A (H1N1) -associated pneumonia.Risk of complication with pneumonia had an increase when oseltamivir treatment was initiated ＞2 days after the onset of illness.Conclusion Pneumonia was a common complication among children hospitalized with influenza A (H1N1).Hospitalized children with influenza A (H1N1)-associated pneumonia were more likely to develop either severe clinical courses or outcomes than those without pneumonia.

OBJECTIVEGastrointestinal stromal tumors (GISTs) have a broad spectrum of biological behaviors ranging from benign, borderline and malignant. This study aimed to screen differentially expressed microRNAs (miRNAs) between malignant and borderline GISTs and to investigate the potential role of miRNAs in the malignant transformation of GISTs.

METHODSSix GIST samples including borderline tumors (n = 3) and malignant tumors (n = 3) were collected based on the clinical and pathological characteristics. Total RNA was extracted, followed by miRNA microarray analysis to screen the differentially expressed miRNAs. The most significantly expressed 4 miRNAs were then chosen for further validation by real-time PCR in 22 additional GIST samples.

RESULTSDirect comparison of malignant group versus borderline group revealed 14 significantly and differentially expressed miRNAs (P < 0.05, with a fold change of < 0.5 or > 2). Five miRNAs were up-regulated and nine were down-regulated in the malignant group. Four miRNAs (miR-221, miR-135b, miR-675(*) and miR-218) were most significantly and differentially expressed between the two groups. The differential expression of 2 miRNAs (miR-221 and miR-675(*)) were subsequently confirmed with good concordance by real-time PCR.

CONCLUSIONSThe differential miRNA expression profiles between two groups are revealed by miRNA microarray assay, and confirmed by real-time PCR. Among differentially expressed miRNAs, miR-221 and miR-675(*) might be related to the malignant transformation of GISTs, and have a potential value in predicting biological behavior of GISTs.

Adult ; Aged ; Aged, 80 and over ; Cell Transformation, Neoplastic ; Down-Regulation ; Female ; Gastrointestinal Neoplasms ; genetics ; pathology ; Gastrointestinal Stromal Tumors ; genetics ; pathology ; Gene Expression Profiling ; Humans ; Male ; MicroRNAs ; genetics ; metabolism ; Microarray Analysis ; Middle Aged ; Real-Time Polymerase Chain Reaction ; Up-Regulation