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Chronic obstructive pulmonary disease (COPD) is becoming a leading cause of morbidity and mortality in China. In the IMPACT trial, fluticasone furoate[FF]/umeclidinium[UMEC]/vilanterol[VI] single-inhaler triple therapy demonstrated lower rates of moderate/severe exacerbations than dual therapy with FF/VI or UMEC/VI in patients with symptomatic COPD and a history of exacerbations. This analysis investigates the China cohort and its consistency with the overall ITT population. 10,355 patients were randomized 2:2:1 to once-daily FF/UMEC/VI 100/62.5/25 µg, FF/VI 100/25 µg, or UMEC/VI 62.5/25 µg for 52 weeks. Endpoints included: annual rates of exacerbations, time-to-first on-treatment moderate/severe exacerbation and change from baseline in trough forced expiratory volume in 1 s (FEV1) at Week-52. Clinical trial registration is NCT02164513 (CTT116855). 535 patients (5.2%) were from China. Annual on-treatment moderate/severe exacerbation rate was 0.81 with FF/UMEC/VI versus 0.96 with FF/VI (rate ratio: 0.84; 95% confidence interval [CI]: 0.64, 1.11; p = .227) and 0.80 with UMEC/VI (rate ratio: 1.02; 95% CI: 0.72, 1.44; p = .929). Hazard ratio for time-to-first moderate/severe exacerbation was 0.84 (95% CI: 0.63, 1.11; p = .218) for FF/UMEC/VI versus FF/VI and 0.89 (95% CI: 0.62, 1.27; p = .516) versus UMEC/VI. Significant improvements in mean change from baseline in trough FEV1 were observed for FF/UMEC/VI versus FF/VI (treatment difference 137 mL; 95% CI: 86, 188; p p = .050). Health status was improved with FF/UMEC/VI versus both dual therapies. Results were similar to the overall ITT population. No new safety signals were identified. Single-inhaler triple therapy with FF/UMEC/VI versus FF/VI or UMEC/VI reduced the rate and risk of exacerbations, and improved lung function and health status in the China cohort similar to the overall ITT population. No new safety signals were identified.

Few large-scale studies have demonstrated the efficacy of tobramycin nebulization in bronchiectasis. We evaluated the efficacy and safety of nebulized tobramycin inhalation solution (TIS) in adults with bronchiectasis with Pseudomonas aeruginosa infection.Can TIS effectively reduce sputum P aeruginosa density and improve the bronchiectasis-specific quality of life in patients with bronchiectasis with P aeruginosa infection?This was a phase 3, 16-week, multicenter, randomized, double-blind, placebo-controlled trial. Eligible adults with bronchiectasis were recruited from October 2018 to July 2021. On the basis of usual care, patients nebulized TIS (300 mg/5 mL twice daily) or normal saline (5 mL twice daily) via vibrating-mesh nebulizer. Treatment consisted of two cycles, each consisting of 28 days on-treatment and 28 days off-treatment. The coprimary end points included changes from baseline in P aeruginosa density and Quality-of-Life Bronchiectasis Respiratory Symptoms score on day 29.The modified intention-to-treat population consisted of 167 patients in the tobramycin group and 172 patients in the placebo group. Compared with placebo, TIS resulted in a significantly greater reduction in P aeruginosa density (adjusted mean difference, 1.74 logTIS is an effective treatment option and has an acceptable safety profile in patients with bronchiectasis with P aeruginosa infection.ClinicalTrials.gov; No. NCT03715322; URL: www.gov.

Standardized mechanical planting of single-bud seedcane sett can improve planting efficiency and reduce costs in sugarcane production and is a research focus at present. Small RNA (miRNA) is an important regulator of life activities, which regulates many plant physiological processes such as gene expression, growth, development and metabolism. In this study, miRNAs in six germinating bud samples (S, bud of single-bud sett; D1, upper bud of double-bud sett; D2, lower bud of double-bud sett; T1, upper bud of three-bud sett; T2, median bud of three-bud sett; T3, lower bud of three-bud sett) derived from sugarcane variety GT42 were analyzed. As a result, 8,055,449, 19,172,991, 8,163,579, 11,748,126, 13,547,550 and 12,861,743 clean tags were obtained respectively, and their length was ranged from 16 to 35 nt. For different bud samples, S, D1, D2, T1, T2 and T3, 174, 600, 318, 425, 466, and 317 novel miRNAs were identified respectively, and a total of 1797 miRNAs, 28,042 target genes and 53,141 target sites were obtained from them. As compared with D1, D2, T1, T2 and T3, it was found the sample S showed 219, 157, 108, 44 and 41 up-regulated miRNAs, respectively. Plant hormone signal transduction pathway was the unique pathway enriched by KEGG analysis, and the enriched gene number was 67, 48, 54, 44 and 40 in S_VS_D1, S_VS_D2, S_VS_T1, S_VS_T2 and S_VS_T3, respectively. Furthermore, a total of 19 allelic genes were co-enriched. Among them, the most abundant allelic gene was found to be IAA gene, with a total of 32 gene sequences. All the up-regulated genes were involved in eight aspects metabolic regulation in plant hormone information transduction. The results showed that plant hormone information transduction played a dominant role in the single-bud sett germinating process, which might be the main reason for promoting the early germination and growth. These results can be referred for popularization and application of standardized mechanical planting of single-bud sett in sugarcane.

Postpartum cerebral arterial dissections are rare, and the clinical features, diagnosis, and treatment approaches are not clear to many physicians. This study was to investigate the clinical features, diagnosis, and treatment of postpartum cerebral arterial dissections.One patient with postpartum cerebral arterial dissections enrolled in our hospital was analyzed. All patients with postpartum cerebral arterial dissections retrieved from the PubMed were also included in this study and analyzed.A total of 45 patients with postpartum cerebral arterial dissections were retrieved including our case, with an age range of 24 to 44 years (mean 34). Thirty-six (80%) patients were older than 30 years of age (mean 35). There were 17 cases of cesarean section, 14 cases of natural labor, and 14 cases whose delivery modes were not reported. The clinical symptoms included headache in 35 cases (78%) and neck pain in 14 (31%). The symptoms occurred at a mean time of 11 days (range 0-53 days) following delivery. Among 45 patients, arterial dissections involved unilateral carotid or vertebral artery in 29 cases (64%), bilateral carotid or vertebral arteries in 8 (18%), 3 arteries in 3 (7%), and all bilateral carotid and vertebral arteries in 5 (11%). Fourteen (31%) patients were treated with antiplatelet agents, 27 (60%) with anticoagulation, 7 (16%) with both antiplatelet and anticoagulation medications, and only 2 (4%) with stent angioplasty. The prognosis was complete recovery in 30 (86%) patients and mild focal neurological symptoms in 5 (14%).Postpartum cerebral arterial dissections are rare, and correct diagnosis relies on imaging examination. Prognosis is usually favorable in patients with early diagnosis and prompt treatment.

Background In the Phase III InforMing the PAthway of COPD Treatment (IMPACT) trial, fluticasone furoate [FF]/umeclidinium [UMEC]/vilanterol [VI] single-inhaler triple therapy resulted in lower rates of moderate/severe exacerbations than dual therapy with FF/VI or UMEC/VI in patients with symptomatic chronic obstructive pulmonary disease (COPD) and a history of exacerbations. Here we present the result in the subpopulation of patients enrolled in China. Methods The IMPACT trial was a 52-week, randomized, double-blind, parallel-group, multicenter trial. Patients (≥40 years of age) with COPD and ≥1 moderate/severe exacerbations in the prior year were randomized 2:2:1 to once-daily FF/UMEC/VI 100/62.5/25 µg, FF/VI 100/25 µg, or UMEC/VI 62.5/25 µg administered via the Ellipta inhaler. Endpoints, assessed in the overall intent-to-treat (ITT) population and in patients from China, included annual rates of exacerbations, time-to-first on-treatment moderate/severe exacerbation, and change from baseline in trough forced expiratory volume in 1 second (FEV1) at Week 52. Results Of the 10,355 patients randomized, 535 (5.2%) were from China. In the China cohort, the rate of on-treatment moderate/severe exacerbations was 0.81 per year with FF/UMEC/VI versus 0.96 with FF/VI (rate ratio [RR]: 0.84; 95% confidence interval [CI]: 0.64, 1.11; p=0.227) and 0.80 with UMEC/VI (RR: 1.02; 95% CI: 0.72, 1.44; p=0.929). Hazard ratio for time-to-first moderate/severe exacerbation was 0.84 (95% CI: 0.63, 1.11; p=0.218) for FF/UMEC/VI versus FF/VI, and 0.89 (95% CI: 0.62, 1.27; p=0.516) for FF/UMEC/VI versus UMEC/VI. Improvements in mean change from baseline in trough FEV1 were observed for FF/UMEC/VI versus FF/VI (treatment difference 137 mL; 95% CI: 86, 188; p

Saccharum spontaneum is the most important and widely used wild germplasm in sugarcane resistance breeding, which can improve sugarcane resistance and ratoon capacity. In order to further exploit and utilize the resistance genes in S. spontaneum, we used a new generation of sequencing technology Illumina HiSeq high-throughput platform to analyze the expression profile of transcriptome genes in S. spontaneum GX83-10 leaves under normal watering (SS_CK) and drought stress (SS_T). The sequencing data were assembled by de novo, and functional annotation, differential gene screening and enrichment analysis were done. The results showed that 54499640 and 56440692 clean reads were obtained from the drought stress group and the control group, respectively. A total of 88941 unigenes and 1325 significantly differentially expressed genes (DEGs) were obtained in this study. The 125 functional gene groups were enriched by GO enrichment analysis. Five metabolic pathways were obtained by KEGG enrichment analysis, namely ascorbate and aldarate metabolism, plant hormone signal transduction, carotenoid biosynthesis, starch and sucrose metabolism, and phenylpropanoid biosynthesis. Seven significantly up-regulated genes were selected to conduct qRT-PCR analysis, and the results confirmed that all the seven genes were significantly up-regulated at varying degrees under drought stress. This study revealed the molecular mechanism of S. spontaneum leaf in response to drought stress and provided a reference for researches on related key genes which would be beneficial to breed new drought-resistant sugarcane varieties.

Hepatic ischemia and reperfusion (I/R) injury plays an active role in hepatic resection and transplantation. While the effects of protein kinase C (PKC)-βII activation and the role of PKC-β inhibitors are well understood in myocardial I/R in diabetes, they remain unclear in liver I/R. The aim of this study was to explore the effect of PKC-β inhibition and the potential mechanism by which PKC-β inhibitor treatment protects against hepatic I/R injury in diabetic rats. Diabetic rats were established and randomized into two groups. These were an untreated group (n=10), which did not receive any treatment, and a treatment group (n=10), orally treated with ruboxistaurin at a dose of 5 mg/kg/day for 2 weeks. The rats from the two groups were subjected to hepatic I/R. Aspartate transaminase (AST) and lactate dehydrogenase (LDH) levels were measured by enzymatic methods at 1, 3 and 5 h after I/R. Tumor necrosis factor-α (TNF-α) and intercellular adhesion molecule 1 (ICAM-1) were examined by enzyme-linked immunosorbent assay at the same time-points. Nuclear factor-κB (NF-κB) p65 expression was analyzed by immunofluorescence and western blotting. Apoptosis of hepatic cells was examined by the western blot analysis of caspase 3 expression and by DNA ladder analysis. Pathological changes were examined using light and electron microscopy. Serum AST and LDH levels in the PKC-β inhibitor treatment group were diminished compared with those in the untreated group (P

Oxidative stress increases serum thioredoxin (TRX), a redox-regulating protein with antioxidant activity recognized as an oxidative stress marker. The aim of this study was to assess the clinical significance of serum TRX levels in Chinese patients with acute ischemic stroke (AIS). From January 1, 2012, to December 31, 2013, all patients with first-ever acute ischemic stroke were recruited to participate in the study. Serum levels of TRX were assayed with solid-phase sandwich enzyme-linked immunosorbent assay (ELISA), and the severity of stroke was evaluated with the National Institutes of Health Stroke Scale (NIHSS) score on admission. The results indicated that the median serum TRX levels were significantly (P

With the extensive research and application of SOI nano-optical ring resonators, the problem of high integration becomes the bottleneck restricting its development. To research the effect of deposited SiO2 insulating layer on the resonance characteristic of SOI nano-waveguid ring cavity while integrating, a rib waveguide ring resonator with 500nm SiO2 insulating layer deposited was designed and fabricated in this paper. By testing the resonance transmission spectrum power of this structure, it is found that SiO2 insulating layer deposited has no effect on the grating vertical coupling efficiency while improves the quality factor to 14.000±1.000.

Identification of Pneumocysis pneumonia (PCP) after renal transplantation has a great impact on early diagnosis and therapy, which could decrease its mortality. Due to a lack of characteristic clinical symptoms, imaging modalities became very important in the diagnosing PCP. Thirteen PCP patients after renal transplantation were reviewed. They underwent a series of chest radiographs and chest high-resolution CT scans. The common radiological presentations were bilateral diffuse symmetrical ground-glass and consolidation opacities, followed by pneumoceles or air-filled cysts or linear or reticular shadows. Ground-glass attenuations were showed clearly on HRCT in 13 patients, while only 6 on CXR. Pneumoceles or cysts (n = 8) were seen only on HRCT. Air-filled cysts or pneumoceles within bilateral diffuse symmetrical ground-glass and consolidation opacities may be the characteristic of this disease. If combined with clinical data, the diagnosis of PCP could be established.

Two nitrogen fixing sugarcane varieties of Brazil RB72/454 and RB86/7575 were employed as the plant materials. They were cultured in nutrient solution containing different levels of Mo i.e. 0mg/L, 0.01mg/L, 0.02mg/L and 0.04mg/L, respectively, in pot trial with sand in greenhouse. The activities of nitrate reductase (NR) and glutamine synthetase (GS), and the contents of NO3 −-N and NH4 +-N were measured at different stages. The results showed that under nitrogenous conditions in the greenhouse, all the Mo treatments increased the activity of NR and decreased the NO3 −-N content compared with the control for both the test varieties. As a result, the treatment with 0.01mg/L Mo increased the activity of GS in RB72/454 after initial elongation stages and that in RB86/7575 at young seedling stage, and it also decreased the NH4 −-N content to improve the nitrogen metabolism. Under non-nitrogenous conditions, after initial elongation stage, the activity of NR was increased and the NO3 −-N content was decreased in both sugarcane varieties treated with different levels of Mo. Furthermore, the activity of GS was higher than the control of RB72/454 and the NH4 +-N content was lower in leaves of RB86/7575 at tillering stage. The effect of different Mo treatment on the process of nitrogen metabolism and ammonia assimilation at different stages of growth was different under nitrogenous or non-nitrogenous condition. The lower concentration of Mo could increase the activities of NR and GS absolutely, decrease the contents of NO3 −-N and NH4 +-N in leaf of the two sugarcane varieties as well as improve the nitrogen metabolism and ammonia assimilation.

Background The Solitaire AB stent is one of many assistant stents used for treating wide-necked cerebral aneurysm, and has been used since 2003. However, large sample studies on its safety and effectiveness are lacking. The objective of this study was to evaluate the effectiveness and safety of the Solitaire AB stent in the coil embolization of wide-necked cerebral aneurysms. Methods Retrospective review of the clinical and image data of 116 patients with wide-necked cerebral aneurysms who had been enrolled at six interventional neuroradiology centers from February 2010 to February 2014 and had been treated by coil embolization; in total, 120 Solitaire AB stents were used. The degree of aneurysm occlusion was examined using digital subtraction angiography (DSA) immediately after the procedure and during follow-up, and was graded using the modified Raymond classification. We also observed complications to evaluate the safety and effectiveness of this therapy. Results The 120 Solitaire AB stents (4 mm × 15 mm, four stents; 4 mm × 20 mm, 16 stents; 6 mm × 20 mm, 36 stents; 6 mm × 30 mm, 64 stents) were inserted to treat 120 wide-necked cerebral aneurysms. All stents were inserted successfully. DSA immediately post-surgery revealed 55 cases of complete occlusion, 59 cases of neck remnant, and six cases of aneurysm remnant. Perioperatively, there were four cases of hemorrhage and four cases of stent thrombosis. The follow-up spanned 3–37 months; of 92 patients examined by DSA at the 6-month follow up, 12 had disease recurrence. Conclusions The Solitaire AB stent is effective with a good technical success rate and short-term effect for assisting coil embolization of wide-necked cerebral aneurysms.

Calcium ions are the most ubiquitous and pluripotent cellular signaling molecules that control a wide variety of cellular processes. The calcium signaling system is represented by a relatively limited number of highly conserved transporters and channels, which execute Ca2+ movements across biological membranes and by many thousands of Ca2+-sensitive effectors. Molecular cascades, responsible for the generation of calcium signals, are tightly controlled by Ca2+ ions themselves and by genetic factors, which tune the expression of different Ca2+-handling molecules according to adaptational requirements. Ca2+ ions determine normal physiological reactions and the development of many pathological processes.

Background Attention-deficit/hyperactivity disorder (ADHD) is a common chronic neurodevelopmental disorder with a high heritability. Much evidence of hemisphere asymmetry has been found for ADHD probands from behavioral level, electrophysiological level and brain morphology. One previous research has reported possible association between BAIAP2, which is asymmetrically expressed in the two cerebral hemispheres, with ADHD in European population. The present study aimed to investigate the association between BAIAP2 and ADHD in Chinese Han subjects. Methods A total of 1,397 ADHD trios comprised of one ADHD proband and their parents were included for family-based association tests. Independent 569 ADHD cases and 957 normal controls were included for case-control studies. Diagnosis was performed according to the DSM-IV criteria. Nine single nucleotide polymorphisms (SNPs) of BAIAP2 were chosen and performed genotyping for both family-based and case-control association studies. Results Transmission disequilibrium tests (TDTs) for family-based association studies showed significant association between the CA haplotype comprised by rs3934492 and rs9901648 with predominantly inattentive type (ADHD-I). For case-control study, chi-square tests provided evidence for the contribution of SNP rs4969239, rs3934492 and rs4969385 to ADHD and its two clinical subtypes, ADHD-I and ADHD-C. However, only the associations for ADHD and ADHD-I retained significant after corrections for multiplicity or logistic regression analyses adjusting the potential confounding effect of gender and age. Conclusions These above results indicated the possible involvement of BAIAP2 in the etiology of ADHD, especially ADHD-I.

Using the technique of radioactive 51Cr-labeled biological microspheres, this study evaluated arterial blood flow following small vessel anastomosis by CO2 laser welding and a dissolvable stent in the lumen. A total of 30 Sprague-Dawley rats were divided into two groups. Group A: 11 rats had their femoral arteries ligated on one side. The contralateral side served as a control, with the artery transected and repaired using conventional microsuturing. Group B: 19 rats had their femoral arteries transected and repaired using CO2 laser welding and an intraluminal dissolvable stent technique. The contralateral side was again used as a control using conventional microsuturing. At 1 hr postoperatively, 51Cr-labeled biological microspheres were injected centripetally into the left common carotid artery and the legs and thighs immediately harvested for measurement of radioactivity. All repaired arteries were patent (30/30 in the microsuturing group and 19/19 in the stented welding group), with no detectable stenosis or dilation at the repaired site. Statistical analysis showed that tissue radioactivity (cpm/g) in the ligated group (3,972 +/- 384 in thighs and 3,142 +/- 742 in legs) was significantly lower than in the microsuturing group (7,132 +/- 1,723 in thighs and 6,557 +/- 1,469 in legs) (P 0.05) and legs (6,386 +/- 1,703 and 6,288 +/- 1,757, respectively; P > 0.05). This study provided evidence that the dissolvable stent placed intraluminally does not impair blood circulation and that when coupled with CO2 laser welding offers a high-quality alternative to conventional small vessel anastomosis.

Streptococcus pneumoniae (S. pneumoniae) is a major causative agent of severe infections, including sepsis, pneumonia, meningitis, and otitis media, and has become a major public health concern. We report the pneumococcal serotype and sequence type (ST) distribution, and antimicrobial resistance of 39 S. pneumoniae strains from seven hospitals in China.Blood/cerebrospinal fluid (CSF) and sputum isolates from patients were analyzed to determine S. pneumoniae serotypes by polymerase chain reaction (PCR) and the Neufeld Quellung reaction, the multilocus sequence types (MLST) by PCR and sequencing, and susceptibility to antimicrobial agents by the VITEK Gram Positive Susceptibility Card.A total of 39 isolates were collected including 21 blood/CSF and 18 sputum isolates. Conventional serotyping by the Quellung reaction required 749 reactions. In contrast, PCR based typing needed only 106 PCR reactions. The most frequent serotypes from the blood/CSF isolates were 14 (38.1%), 19A (14.3%), 23F (9.5%), and 18C (9.5%). In the sputum isolates the most frequent serotypes were 19F (33.3%), 23F (16.7%), 19A (11.1%), and 3 (11.1%). The incidence of penicillin resistance in the blood/CSF and sputum isolates was 66.7% and 55.6%, respectively. Statistical analysis showed that patients = 5 years old had a higher resistance to penicillin when they compared with the patients = 65 years old (P = 0.011). Serotypes 14, 19A and 19F were significantly associated with penicillin resistance (P0.001). ST320, ST271, and ST876 isolates showed high resistant rates to several antibiotics including penicillin (P = 0.006). All of the isolates of serotype 19A were resistant to both penicillin and erythromycin, and they were all multi-drug resistant (MDR) isolates.The specificity and sensitivity of multiplex-PCR are good, and this method represents a substantial savings of time and money, and can be widely used in the laboratory and clinical practice. Data from this research showed an extremely high prevalence of penicillin resistance and an increasing prevalence of multi-drug resistant (MDR) rate in S. pneumoniae. A distinctive emergence of serotype 19A was observed which was also associated with the increasing prevalence of antimicrobial resistance. Therefore, nationwide surveillance of pneumococcal resistance and serotypes is strongly warranted.

Etiologic diagnoses of lower respiratory tract infections (LRTI) have been relying primarily on bacterial cultures that often fail to return useful results in time. Although DNA-based assays are more sensitive than bacterial cultures in detecting pathogens, the molecular results are often inconsistent and challenged by doubts on false positives, such as those due to system- and environment-derived contaminations. Here we report a nationwide cohort study on 2986 suspected LRTI patients across P. R. China. We compared the performance of a DNA-based assay qLAMP (quantitative Loop-mediated isothermal AMPlification) with that of standard bacterial cultures in detecting a panel of eight common respiratory bacterial pathogens from sputum samples. Our qLAMP assay detects the panel of pathogens in 1047(69.28%) patients from 1533 qualified patients at the end. We found that the bacterial titer quantified based on qLAMP is a predictor of probability that the bacterium in the sample can be detected in culture assay. The relatedness of the two assays fits a logistic regression curve. We used a piecewise linear function to define breakpoints where latent pathogen abruptly change its competitive relationship with others in the panel. These breakpoints, where pathogens start to propagate abnormally, are used as cutoffs to eliminate the influence of contaminations from normal flora. With help of the cutoffs derived from statistical analysis, we are able to identify causative pathogens in 750 (48.92%) patients from qualified patients. In conclusion, qLAMP is a reliable method in quantifying bacterial titer. Despite the fact that there are always latent bacteria contaminated in sputum samples, we can identify causative pathogens based on cutoffs derived from statistical analysis of competitive relationship. Trial Registration ClinicalTrials.gov NCT00567827

In resent years, a number of studies have been done on physiological effect of polysaccharides. Polysaccharides is a species of compounds take on some very important biological activity and pharmacological activity; And because our country is the origin of traditional Chinese medicine, in which saccharide is a common component, the exploitation of plant polysaccharides come to a new period that more and more people take part in it. The focus of this article is to make a summary on the functions of plant polysaccharides, such as antioxidant, scavenging free radical , anti-tumor, immunity, decline blood glucose, et al. At the last we bring forward the direction of the development in future.

Diabetes mellitus (DM) is a serious endocrine disorder disease affecting the metabolism of carbohydrates, fats and protein. In recent years, the incidence of DM has increased worldwide, especially in developed countries. Two main classes of medicines, oral hypoglycemic drugs (OHD) and hypoglycemic active elements from plants (HAEPs), are used to treat DM by reducing blood sugar levels. OHDs can be classed based on their chemical structures as sulfonylurea compounds, biguanide compounds, α-glucosidase inhibitors, thiazolinediones and repaglindes. HAEPs can also be classed based on their chemical structure as polysaccharides, saponins, flavonoids, alkaloids, terpenoids, peptides, sulfuryl containing compounds, steroids and unsaturated fatty acids. This paper reviews the uses of OHDs and HAEPs for the treatment of DM.

Plenty of experiments have demonstrated that polysaccharides have effect of hyperglycemic. We review the possible mechanisms that polysaccharide reduce blood sugar and the therapeutic potential in this paper. The mechanisms include improve islet morphology and function, stimulate insulin secretion, enhance the insulin sensitivity, improve glycometabolism, modulate autoimmunity, improve the activities of glycometabolism related enzymes, suppress insulin metabolism, ameliorate the lipid metabolism and inhibit alpha-glucosidase. Polysaccharides not only reduce the blood sugar but also improvement the complications of diabetes mellitus such as dyslipidemia, diabetic nephropathy et al. Suggest polysaccharides possess the possibility of being developed from a new anti-diabetic agent.

To investigate the current status of atypical pathogen associated infections in community-acquired pneumonia (CAP) in adults, and their clinical attributes.Clinical data, sputum specimens from acute phase, and paired sera from acute- and convalescent-phases of CAP in 153 adult patients were collected from May 2005 to May 2008 in multiple medical centers. Chlamydia pneumoniae (Cpn) IgG antibody, and Legionella pneumophila (LP) mixed IgG, IgA and IgM antibodies were determined by indirect immuno-fluorescent assay. Mycoplasma pneumoniae (Mpn) mixed IgG, IgA and IgM antibodies were determined by passive agglutination assay. All the sputum specimens were routinely cultured for bacterial isolation.Fifty-two (34%) out of the 153 cases were diagnosed as atypical CAP per the paired serum-antibody assay. Forty-seven of the 52 atypical CAP cases were infected by one atypical pathogen, 38 with Cpn, 4 with Mpn, and 5 with LP, while 5 out of the 52 atypical CAP cases were infected by 2 pathogens, Cpn and Mpnin 2, Cpn and LP in 3 cases. Eleven cases (21.2%) out of the 52 patients with atypical pneumonia were complicated with bacterial infection. Except peripheral white blood count was significant increased in the group of typical (bacterial only) pneumonia (WBC10 × 10⁹)/L, P = 0.03), all the other clinical parameters did not show statistically significant difference between the typical and the atypical pneumonia groups.Our data suggest that Chlamydia pneumoniae, Mycoplasma pneumoniae and Legionella pneumophila are common pathogens of adult CAP. Chlamydia pneumoniae might be the most frequent atypical pathogen associated with atypical CAP.

Acinetobacter baumanii (A. baumanii ) remains an important microbial pathogen resulting in nosocomial acquired infections with significant morbidity and mortality. The mechanism by which nosocomial bacteria, like A. baumanii, attain multidrug resistance to antibiotics is of considerable interest. The aim in this study was to investigate the spread status of antibiotic resistance genes, such as multiple β-lactamase genes and aminoglycoside-modifying enzyme genes, from A. baumanii strains isolated from patients with lower respiratory tract infections (LRTIs).Two thousand six hundred and ninety-eight sputum or the bronchoalveolar lavage samples from inpatients with LRTIs were collected in 21 hospitals in the mainland of China from November 2007 to February 2009. All samples were routinely inoculated. The isolated bacterial strains and their susceptibility were analyzed via VITEK-2 expert system. Several kinds of antibiotic resistant genes were further differentiated via polymerase chain reaction and sequencing methods.Totally, 39 A. baumanii strains were isolated from 2698 sputum or bronchoalveolar lavage samples. There was not only a high resistant rate of the isolated A. baumanii strains to ampicillin and first- and second-generation cephalosporins (94.87%, 100% and 97.44%, respectively), but also to the third-generation cephalosporins (ceftriaxone at 92.31%, ceftazidine at 51.28%) and imipenem (43.59%) as well. The lowest antibiotic resistance rate of 20.51% was found to amikacin. The OXA-23 gene was identified in 17 strains of A. baumanii, and the AmpC gene in 23 strains. The TEM-1 gene was carried in 15 strains. PER-1 and SHV-2 genes were detected in two different strains. Aminoglycoside-modifying enzyme gene aac-3-Ia was found in 23 strains, and the aac-6'-Ib gene in 19 strains. aac-3-Ia and aac-6'-Ib genes hibernated in three A. baumanii strains that showed no drug-resistant phenotype.A. baumanii can carry multiple drug-resistant genes at the same time and result in multi-drug resistance. Aminoglycoside-modifying enzyme genes could be hibernating in aminoglycoside sensitive strains without expressing their phenotype.

To investigate the relationship between clinical features of patients with A/H5N1 infection and their prognosis in mainland China.This study included 28 human cases with A/H5N1 infection in mainland China from October 2005 to May 2008. Data were collected and reviewed from hospital medical records and publishied papers. A database was built by EPIDATA 3.02 and statistical analyses were performed with SPSS 13.0.The median age of the 28 cases was 29 years (range 6-62), and 15 were females. Ten patients survived, and 18 died. The typically clinical manifestations of human influenza A/H5N1 infection included fever and lower respiratory infection. The numbers of peripheral white blood cells, lymphocytes and platelets in the survival and non-survival groups were (4.01 +/- 1.86) x 10(9)/L vs (5.1 +/- 2.9) x 10(9)/L, (1.09 +/- 0.49) x 10(9)/L vs (0.98 +/- 0.44) x 10(9)/L, and (116 +/- 39) x 10(9)/L vs (101 +/- 40) x 10(9)/L, respectively; the differences were not statistically significant between the 2 groups (P0.05). There was also no statistically significant difference in the increased serum enzymes, such as aspartate aminotransferase [(173 +/- 246) U/L vs (272 +/- 263) U/L], lactate dehydrogenase [(1016 +/- 568) U/L vs (1512 +/- 1052) U/L], creatine kinase [(1099 +/- 1590) U/L vs (2534 +/- 4281) U/L] and MB isoenzyme of creatine kinase [(28 +/- 30) U/L vs (125 +/- 197) U/L] (P0.05) between the survival and the non-survival groups. However, there was a statistically significant difference in the number of patients with an initial LDH level more than 8 fold of the normal value between the survival and the non-survival groups (none vs 6, P0.05). All of the 28 cases developed bilateral multiple infiltrates and consolidation in chest radiographs. Acute respiratory distress syndrome occurred in 22 cases, 17 of them died. All the 9 patients with acute kidney injury died. Ten patients received antiviral treatment with oseltamivir, and 6 of them survived. There was a statistical difference in the time of initiating oseltamivir treatment between the survival and the non-survival cases [(6.5 +/- 3.0) d vs (11.8 +/- 3.3) d, Z = 3.70, P0.05]. Broad spectrum antibiotics and corticosteroids were administered in all of the 28 cases. There was no statistical difference between the survival and the non-survival groups regarding to the corticosteroid treatment (P0.05).Initial LDH level reaching more than 8 fold of the normal value suggests a poor prognosis for human H5N1 infection. Patients complicated with either ARDS or acute kidney injury had a higher risk of death. Early administration of effective antiviral agents might improve the prognosis and decrease case fatality.

In this paper, by combining the Rough Sets theory and Intuitionistic Fuzzy Special Sets theory, the model of the rough interval-valued intuitionistic fuzzy sets is defined, some basic operations of the model are given, and the properties of the model are discussed. The discussion is the emphasis in the properties of complement. By discussing, Co-normality, Normality, Duality are established in Rough Interval-valued Intuitionistic Fuzzy Sets, Multiplication and Addition are not.

To investigate the antagonism of LY333531 on the increased permeability of cardiac microvascular endothelial cells (CMECs) induced by high glucose.The cultured CMECs from rats were randomly divided into four groups: normal group, high glucose group (25 mmol/L), high glucose+LY333531 (10 micromol/L) group and high glucose+saline group. The permeability of cell monolayer was detected using in vitro vascular permeability assay kit. Cell apoptosis was determined by TUNEL and the expression of PKCbeta II was analyzed by immunofluorescence and Western blot in each group.Compared with normal group, the permeability (400.0+/-20.00 vs 223.3+/-25.17; P0.01) of cell monolayer cultured in high glucose medium was increased at a higher apoptosis rate (55.00%+/-5.000% vs 2.333%+/-1.155%; P0.01) and PKCbeta II expression (0.4767+/-0.0751 vs 0.1733+/-0.0208; P0.01). However, the high glucose+LY333531 group showed noticeable attenuation on both permeability (360+/-17.32 vs 400.0+/-20.00; P0.05) and apoptosis (25.00%+/-5.000% vs 55.00%+/-5.000%; P0.01) with reduced PKCbeta II expression (0.2800+/-0.0700 vs 0.4767+/-0.0751; P0.01). No significant effects of saline on the cell permeability, apoptosis and PKCbeta II expression were observed.The antagonism of LY333531 has shown obvious effects on the impairment of high glucose to the permeability of CMECs.

Considering a user's actual demand, this paper analyzed the functional requirments which can be brought forward by a user of a clustering system and proposed a fuzzy c-means clustering algorithm based on Euclidean distance. In this algorithm, weights are directly appointed by a user or a domanial expert. Different weights show the distinction of the userpsilas recognition of different character criterion. Compared with the traditional fuzzy c-means clustering method, this algorithm can improve the clusteringpsilas flexibility and produce a more satisfactory clustering result.

BACKGROUND: While human cases of highly pathogenic avian influenza A (H5N1) virus infection continue to increase globally, available clinical data on H5N1 cases are limited. We conducted a retrospective study of 26 confirmed human H5N1 cases identified through surveillance in China from October 2005 through April 2008. METHODOLOGY/PRINCIPAL FINDINGS: Data were collected from hospital medical records of H5N1 cases and analyzed. The median age was 29 years (range 6-62) and 58% were female. Many H5N1 cases reported fever (92%) and cough (58%) at illness onset, and had lower respiratory findings of tachypnea and dyspnea at admission. All cases progressed rapidly to bilateral pneumonia. Clinical complications included acute respiratory distress syndrome (ARDS, 81%), cardiac failure (50%), elevated aminotransaminases (43%), and renal dysfunction (17%). Fatal cases had a lower median nadir platelet count (64.5 x 10(9) cells/L vs 93.0 x 10(9) cells/L, p = 0.02), higher median peak lactic dehydrogenase (LDH) level (1982.5 U/L vs 1230.0 U/L, p = 0.001), higher percentage of ARDS (94% [n = 16] vs 56% [n = 5], p = 0.034) and more frequent cardiac failure (71% [n = 12] vs 11% [n = 1], p = 0.011) than nonfatal cases. A higher proportion of patients who received antiviral drugs survived compared to untreated (67% [8/12] vs 7% [1/14], p = 0.003). CONCLUSIONS/SIGNIFICANCE: The clinical course of Chinese H5N1 cases is characterized by fever and cough initially, with rapid progression to lower respiratory disease. Decreased platelet count, elevated LDH level, ARDS and cardiac failure were associated with fatal outcomes. Clinical management of H5N1 cases should be standardized in China to include early antiviral treatment for suspected H5N1 cases.

To introduce a practical, economical, and time-saving method to stain (with osmic acid) the myelin sheath in normal and regenerated peripheral nerves.A total of 12 Sprague Dawley rats, weighing 250-320 g (mean equal to 276 g+/-38 g), were divided into two groups: a normal nerve group (n equal to 6) and a regenerated nerve group (n equal to 6). In the normal nerve group, the ventral and dorsal roots of L(4) to L(6) and their sciatic nerves were harvested for histological analysis. While in the regenerated nerve group, the right sciatic nerves were severed and then repaired with an epineurial microsuture method. The repaired nerves were harvested 12 weeks postoperatively. All the specimens were fixed in 4% paraformaldehyde and transferred to 2% osmic acid for 3-5 days. Then the specimens were kept in 75% alcohol before being embedded in paraffin. The tissues were cut into sections of 3 micromolar in thickness with a conventional microtome.Under a light microscope, myelin sheaths were clearly visible at all magnifications in both groups. They were stained in clear dark colour with a light yellow or colorless background, which provided high contrast images to allow reliable morphometric measurements. Morphological assessment was made in both normal and regenerated sciatic nerves. The ratios of the myelin area to the fibre area were 60.28%+/-7.66% in the normal nerve group and 51.67%+/-6.85% in the regenerated nerve group, respectively (P less than 0.01).Osmic acid staining is easy to perform and a very clear image for morphometrical assessment is easy to obtain. Therefore, it is a reliable technique for quantitative evaluation of nerve morphology.

A high performance liquid chromatographic method was established for the determination of cinnabar in Zijinhong capsules using diethyldithiocarbamate (DEDTC) chelate. A Waters X-Terra C18 column was used with a mixture of methanol-0.01 mol/L Na2HPO4 (pH 7.5) (containing 0.01% DEDTC) (73:27, V/V) as the mobile phase and a detector set at 270 nm. The calibration curve was linear (r = 0. 999 6) in the range of 10.1 mg/L - 100.9 mg/L of Hg2+. The recoveries were 97.0% - 100.8% with RSDs of 1.8% - 2.3%.

To evaluate the effect of polyethylene glycol/montmorillonite (PEG/MMT) nanocomposite material in adsorption of triglyceride (TG), cholesterin and low-density lipoprotein-cholesterol (LDL-C).The structure of PEG/MMT nanocomposite was analyzed by means of X ray diffraction and its effect of blood lipid and albumin adsorption was evaluated in comparison with Na-MMT.The interval distance was larger when the PEG of greater molecular weight was used for preparing the nanocomposite, and PEG/MMT nanocomposite had greater adsorption rate of TG, cholesterin and LDL-C in serum than that of serum albumin. MMT material had poor adsorption effect.PEG/MMT nanocomposite possesses the potential as a novel adsorbent of blood lipid for clinical use.

To evaluate the effect of silicon and latex urinary catheters on urinary mucosa.A randomized, controlled prospective clinical trial was carried out in 60 patients admitted in the Department of Neurosurgery, who required long-term use of an indwelling urinary catheter. The patients were divided into 2 equal groups with placement of silicon or latex urinary catheter, and routine laboratory urine test was performed on a regular basis and the patients feelings during catheter retention were recorded.Patients with placement of indwelling silicone catheters reported no obvious discomfort in relation to the catheter placement and had significantly lower incidence of hematuria identified microscopically than those with common latex catheters.Compared with latex catheters, silicone catheters cause less injuries and reduce substantially irritation of the urinary mucosa, and we suggest the use of silicone catheter in patients requiring long-term indwelling urinary catheters.