BACKGROUND: The new emerging avian influenza A H7N9 virus, causing severe human infection with a mortality rate of around 41%. This study aims to provide a novel treatment option for the prevention and control of H7N9. METHODS: H7 hemagglutinin (HA)-specific B cells were isolated from peripheral blood plasma cells of the patients previously infected by H7N9 in Jiangsu Province, China. The human monoclonal antibodies (mAbs) were generated by amplification and cloning of these HA-specific B cells. First, all human mAbs were screened for binding activity by enzyme-linked immunosorbent assay. Then, those mAbs, exhibiting potent affinity to recognize H7 HAs were further evaluated by hemagglutination-inhibiting (HAI) and microneutralization in vitro assays. Finally, the lead mAb candidate was selected and tested against the lethal challenge of the H7N9 virus using murine models. RESULTS: The mAb 6-137 was able to recognize a panel of H7 HAs with high affinity but not HA of other subtypes, including H1N1 and H3N2. The mAb 6-137 can efficiently inhibit the HA activity in the inactivated H7N9 virus and neutralize 100 tissue culture infectious dose 50 (TCID50) of H7N9 virus (influenza A/Nanjing/1/2013) in vitro, with neutralizing activity as low as 78 ng/mL. In addition, the mAb 6-137 protected the mice against the lethal challenge of H7N9 prophylactically and therapeutically. CONCLUSION The mAb 6-137 could be an effective antibody as a prophylactic or therapeutic biological treatment for the H7N9 exposure or infection.
Animals ; Antibodies, Monoclonal/therapeutic use* ; Antibodies, Neutralizing/therapeutic use* ; Antibodies, Viral ; Hemagglutinins ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza A Virus, H3N2 Subtype ; Influenza A Virus, H7N9 Subtype ; Influenza Vaccines ; Influenza in Birds ; Influenza, Human/prevention & control* ; Mice

Objective:To explore the clinical effect of de-stretching suture combined with electronic irradiation after resection of recurrent keloid.Methods:From May 2016 to August 2019, the patients with postoperative recurrent keloid were selected for the Department of Plastic Surgery, Yuncheng Central Hospital. The keloid lesions were resected, and the subcutaneous skin on both sides of the incision was extensively elevated to reduce the tension for direct suture. Local flap transfer was used when the direct suture is impossible due to too much tension. The PDS Ⅱ suture of 2-0 to 4-0 was used subcutaneously to reduce the suture tension with the "heart" suture technology, and the skin was intermittently sutured with the Prolene suture of 6-0 or 7-0 and 3M tensile tape was applied on the wound to reduce tension. Besides, electronic irradiation was performed within 6 hours and 1 week after the operation, with 8 Gy for each time, a total dose of 16 Gy. After the suture was removed, tension glue and elastic sleeve were used for external compression, and regular follow-up was conducted to observe the width and degree of scar hyperplasia of the patients. The therapeutic effect was evaluated according to the scar beauty evaluation and rating scale.Results:A total of 36 patients with postoperative recurrent of keloids were included in this group, including 28 males and 8 females, aged 17-68 years, with an average of 42.5 years old. The incisions healed in all patients after the operation, and no recurrence of keloids was found in the follow-up period of 18 to 36 months. The highest score of scar cosmetic evaluation and rating scale was 4, and the lowest was 0.Conclusions:Surgical resection combining with electronic irradiation is an effective method for the treatment of recurrent keloid.

Objective:To explore the clinical effect of de-stretching suture combined with electronic irradiation after resection of recurrent keloid.Methods:From May 2016 to August 2019, the patients with postoperative recurrent keloid were selected for the Department of Plastic Surgery, Yuncheng Central Hospital. The keloid lesions were resected, and the subcutaneous skin on both sides of the incision was extensively elevated to reduce the tension for direct suture. Local flap transfer was used when the direct suture is impossible due to too much tension. The PDS Ⅱ suture of 2-0 to 4-0 was used subcutaneously to reduce the suture tension with the "heart" suture technology, and the skin was intermittently sutured with the Prolene suture of 6-0 or 7-0 and 3M tensile tape was applied on the wound to reduce tension. Besides, electronic irradiation was performed within 6 hours and 1 week after the operation, with 8 Gy for each time, a total dose of 16 Gy. After the suture was removed, tension glue and elastic sleeve were used for external compression, and regular follow-up was conducted to observe the width and degree of scar hyperplasia of the patients. The therapeutic effect was evaluated according to the scar beauty evaluation and rating scale.Results:A total of 36 patients with postoperative recurrent of keloids were included in this group, including 28 males and 8 females, aged 17-68 years, with an average of 42.5 years old. The incisions healed in all patients after the operation, and no recurrence of keloids was found in the follow-up period of 18 to 36 months. The highest score of scar cosmetic evaluation and rating scale was 4, and the lowest was 0.Conclusions:Surgical resection combining with electronic irradiation is an effective method for the treatment of recurrent keloid.

OBJECTIVE: To investigate the persistent damage of learning and memory ability after the cessation of sub-chronic manganese(Mn)-exposure in rats. METHODS: Specific pathogen free weaning male SD rats were randomly divided into control group and low-, medium-and high-dose groups based on body weight, with 6 rats in each group. Rats were intraperitoneally injected with Mn chloride(MnCl_2·4 H_2O) at the concentrations of 0, 5, 10, or 20 mg/kg body weight, 5 days per week for 6 weeks and continued to be observed for 12 weeks after the cessation of Mn-exposure. During the experiment, the body mass of the rats was weighed. Learning and memory ability was evaluated by a Morris water-maze task at the 6 th weeks of Mn-exposure(cessation of Mn-exposure of week 0), the 6 th and 12 th week of the cessation of Mn-exposure. The organ coefficients of heart, liver, spleen, kidney and testicles were evaluated after the cessation of Mn-exposure on week 12. RESULTS: The body mass of the high-dose group was lower than that of the other 3 groups(P<0.05) at the 4 th and 6 th week of Mn-exposure and the 2 nd week of the cessation of Mn-exposure. There was no significant difference in body mass between the groups(P>0.05) on the 12 th week of the cessation of Mn-exposure. The escape latency of high-dose group was higher than that of the control group(P<0.05), and the number of platform crossings in the low-, medium-and high-dose groups were fewer than that in the control group(P<0.05) after the cessation of Mn-exposure. The escape latency was shorter and the numbers of platform crossings were higher on the 6 th and 12 th week of the cessation of Mn-exposure(P<0.05) when compared with that of the 6 th week of Mn-exposure rats. There was no statistical significance in the organ coefficients of heart, liver, spleen, kidney and testicles among the 4 groups at the 12 th week of the cessation of Mn-exposure in rats(P>0.05).CONCLUSION: Sub-chronic Mn exposure can impair learning and memory ability of rats, and the damage persists after the cessation of Mn-exposure.

OBJECTIVE: To study the influence of maternal sex chromosomal abnormalities on the prediction of fetal sex chromosome abnormalities (SCAs) by non-invasive prenatal testing (NIPT). METHODS: Thirty-six pregnant women with a prediction for fetal SCAs by NIPT were verified as false positive after prenatal diagnosis using amniotic fluid samples. With informed consent, these women were subjected to chromosomal karyotyping or copy number variations (CNVs) analysis through high-throughput sequencing. RESULTS: Sex chromosomal abnormalities were found in 8 women, which yielded an abnormal rate of 22.22% (8/36). Among these, 3 had sex chromosome aneuploidies (47, XXX), 4 had sex chromosome mosaicisms, and 1 carried structural chromosomal abnormalities. Reanalysis of the results of NIPT were consistent with the maternal CNVs by large. With the ratio of cffDNA (ChrX)/cffDNA was more than 2, 6 of the eight women were found to harbor sex chromosome abnormalities, and the fetal karyotype was normal. However, with a ratio of less than 2, only 2 of the 38 pregnant women had sex chromosome abnormalities, and 10 of the fetuses were confirmed as positive. CONCLUSION The presence of maternal sex chromosomal abnormalities can greatly influence the result of NIPT, which may also be an important reason for false prediction for fetal SCAs by NIPT. When NIPT indicates abnormal SCAs, it is necessary to analyze maternal sex chromosomes. The ratio of cffDNA(ChrX)/cffDNA may help to determine the source of abnormal signals.

Objective To investigate the predictive value of quick sequential organ failure assessment (qSOFA) score on the prognosis of adult patients with infection in intensive care unit (ICU). Methods A retrospective analysis was conducted on the clinical data of the infected patients in the ICU of the 401st Hospital of the People's Liberation Army from August 1st, 2000 to December 31st, 2017. The clinical data included patients' gender, age, basic diseases, etc.; the worst values of vital signs and laboratory test results within 24 hours of admission were recorded, the scores of the qSOFA, sequential organ failure assessment (SOFA), acute physiology and chronic health evaluationⅡ(APACHEⅡ) were calculated separately; the outcome of ICU was recorded. The predictive values of three scoring systems were evaluated by receiver operating characteristic curve (ROC). Results Excluding patients with incomplete clinical data, cancer and immunosuppressive patients, a total number of 1 059 patients were enrolled in this study, with 679 males and 380 females, the average age was 72.57±16.06, the ICU mortality was 35.32% (374/1 059). The ROC curve analysis showed that the areas under ROC curve (AUC) of APACHE Ⅱ, SOFA, qSOFA scores to predict the prognosis of infected patients were 0.713, 0.744 and 0.662, respectively. Although the AUC of qSOFA in predicting prognosis was significantly lower than that of other two scoring systems (both P < 0.05), but it still had some predictive ability. According to the Youden index, the best cut-off point for qSOFA was 2 to evaluate the prognosis of the infection, and the sensitivity was 71.65%, the specificity was 53.87%, the positive likelihood ratio was 1.55, the negative likelihood ratio was 0.53, the positive predictive value was 0.426, the negative predictive value was 0.799, and the accuracy was 59.62%. The mortality of the infected patients was increased with qSOFA score, and the mortality difference among patients with different qSOFA scores was statistically significant (χ2= 84.605, P = 0.000). The patients were divided into two groups according to the cut-off value of qSOFA, and the mortality in qSOFA score ≥2 group was higher than that in qSOFA score < 2 group [odds ratio (OR) = 2.767, 95% confidence interval (95%CI) = 2.116-3.617, P = 0.000]. Conclusions qSOFA, SOFA and APACHE Ⅱscores have the capability of predicting the outcome for the infected patients. qSOFA score is expected to be a quick and simple tool to judge the prognosis of ICU infection patients because of its advantages of quick acquisition.

Objective To investigate the structural changes of gut microbiota in patients with Parkinson's disease ( PD).Methods Twenty-four PD patients and 14 healthy controls from Beijing Hospital in 2015 were recruited in this cross-sectional study.The general clinical information was collected and all subjects were assessed with Parkinson's disease related scales.The gut microbiota status between two groups was analyzed after extracting feces'DNA and carrying out high-throughput sequencing of bacterial 16S rRNA.Results At the phylum level, actinobacteria (0.76%(0.13%, 1.85%) vs 0.14%(0.07%, 0.30%), Z＝2.784, P＜0.01) were significantly increased and bacteroidetes (57.28%(48.75%, 64.95%) vs 63.78%(56.72%, 68.21%), Z＝-4.963, P＜0.01) were significantly decreased in PD patients compared to healthy controls.At the class level, bacilli (0.52%(0.11%, 2.10%) vs 0.13%(0.05%, 0.16%), Z＝2.693, P＜0.01), negativicutes (5.04%(2.93%, 14.02%) vs 2.87%(1.46%, 4.43%), Z＝2.360, P＝0.018), actinobacteria (0.60%(0.10%, 1.59%) vs 0.12%(0.04%, 0.20%), Z＝2.512, P＝0.011 ), gammaproteobacteria ( 1.72%( 0.58%, 5.46%) vs 0.43%(0.24%, 2.19%), Z＝2.179, P＝0.029) were significantly increased in PD patients compared to healthy controls.At the family level, veillonellaceae (3.78%(0.53%, 13.82%) vs 0.49%(0.08%, 3.14%), Z＝2.754, P＜0.01), streptococcaceae (0.33%(0.09%, 0.69%) vs 0.19%(0.14%, 0.24%), Z＝1.770, P＝0.004), enterobacteriaceae (1.04%(0.40%, 4.95%) vs 0.20%(0.10%, 0.45%), Z＝2.784, P＜0.01 ), lactobacillaceae ( 0.079%( 0.014%, 0.575%) vs 0.003%(0.002%, 0.028%), Z＝3.119, P＜0.01), bifidobacteriaceae (0.60%(0.09%, 1.57%) vs 0.11%(0.03%, 0.19%), Z＝2.481, P＝0.012) were significantly increased and pasteurellaceae (0.009%(0.002%, 0.047%) vs 0.110%(0.022%, 0.898%), Z＝-2.545, P＝0.010) were significantly decreased in PD patients compared to healthy controls.Conclusions The structures of gut microbiota in PD patients and healthy controls were significantly different at the levels of phylum , class, and family.All these changes are potentially associated with the development of PD pathology.

Dementia is a clinical syndrome characterized by cognitive impairment and decreased daily activity.In recent years, more and more studies have shown that there are neuropsychiatric syndromes in people with normal cognitive function , thus increasing the risk of dementia.This population has been defined as mild behavioral impairment (MBI).MBI is now considered to be one of the prodromal symptoms of dementia, and there have been some researches and consensus on the definition , diagnosis and screening scale of MBI, but there are still a lot of controversies.For this reason, we systematically reviewed the research progress of MBI , to clarify the evidence on the definition , diagnostic criteria and screening methods of MBI, and to summarize the consensus and controversy of the research on the correlation between MBI and dementia, aiming to draw attention to the applicability and necessity of MBI diagnostic criteria in clinical practice.