MRI在喉癌术前分期中的临床应用价值

目的:探讨MRI在喉癌术前诊断、分期中的临床应用价值。方法:对114例行电子喉镜检查并经病理学证实为喉癌的患者行术前MRI扫描,根据图像资料判断肿瘤侵及范围及判断有无淋巴结转移;同时进行术前分期、分型,并与术后病理分期、分型对照研究。结果:术前MRI T1期27例,其中25例经病理证实为T1期,2例为T2期,准确率为92.6%;术前MRI T2期39例,其中经病理证实35例为T2期,3例T1期,1例T3期,准确率为89.7%;术前MRI T3期29例,其中经病理证实25例为T3期,4例T2期,准确率为86.2%;术前MRI T4期17例,其中经病理证实15例为T4期,2例T3期,准确率为88.2%;MRI术前T分期总准确率为87.7%。N1期准确率为81.8%,N2期准确率为94.1%。结论:MRI图像能很好地显示喉癌肿块的侵及范围及淋巴结转移等,对喉癌的术前分期、分型及制定合理的手术方案具有指导意义。     

High Rates of Hepatitis C Virus Reinfection and Spontaneous Clearance of Reinfection in People Who Inject Drugs: A Prospective Cohort Study

Hepatitis C virus reinfection and spontaneous clearance of reinfection were examined in a highly characterised cohort of 188 people who inject drugs over a five-year period. Nine confirmed reinfections and 17 possible reinfections were identified (confirmed reinfections were those genetically distinct from the previous infection and possible reinfections were used to define instances where genetic differences between infections could not be assessed due to lack of availability of hepatitis C virus sequence data). The incidence of confirmed reinfection was 28.8 per 100 person-years (PY), 95%CI: 15.0-55.4; the combined incidence of confirmed and possible reinfection was 24.6 per 100 PY (95%CI: 16.8-36.1). The hazard of hepatitis C reinfection was approximately double that of primary hepatitis C infection; it did not reach statistical significance in confirmed reinfections alone (hazard ratio [HR]: 2.45, 95%CI: 0.87-6.86, p=0.089), but did in confirmed and possible hepatitis C reinfections combined (HR: 1.93, 95%CI: 1.01-3.69, p=0.047) and after adjustment for the number of recent injecting partners and duration of injecting. In multivariable analysis, shorter duration of injection (HR: 0.91; 95%CI: 0.83-0.98; p=0.019) and multiple recent injecting partners (HR: 3.12; 95%CI: 1.08-9.00, p=0.035) were independent predictors of possible and confirmed reinfection. Time to spontaneous clearance was shorter in confirmed reinfection (HR: 5.34, 95%CI: 1.67-17.03, p=0.005) and confirmed and possible reinfection (HR: 3.10, 95%CI: 1.10-8.76, p-value=0.033) than primary infection. Nonetheless, 50% of confirmed reinfections and 41% of confirmed or possible reinfections did not spontaneously clear. Conclusions: Hepatitis C reinfection and spontaneous clearance of hepatitis C reinfection were observed at high rates, suggesting partial acquired natural immunity to hepatitis C virus. Public health campaigns about the risks of hepatitis C reinfection are required.     

Spread of chloroquine resistance in Plasmodium falciparum

Malaria resistant to chloroquine has now been confirmed in more than 40 countries. The drug was introduced in 1934, but was not in large-scale use until the early 1950s. Anecdotal reports suggest that resistance emerged as early as 1957 both in Colombia and along the then Cambodia-Thailand border area. But by 1960, resistance in these areas was confirmed - and may represent two separate events. Resistance spread rapidly, with a new focus of resistance confirmed in East Africa by 1977. Chloroquine resistance represents a severe problem both for prophylaxis and treatment of malaria. In this aricle, David Payne traces the spread of resistance and discusses some of its implications.     

Polymorphism in rice amylases at an early stage of seed germination

A polymorphism in rice amylases at an early stage of seed germination is analyzed by zymogram. In non-glutinous cultivars of rice, alpha-amylase isozymes are mainly confirmed in germinating seeds. However, in glutinous cultivars, beta-amylase isozymes, which are not confirmed in nonglutinous cultivars, make up the major part of the total amylase activity and the expression of alpha-amylases are repressed.     

City-wide screening for urinary abnormalities in schoolboys

Screening for urinary tract infection was carried out in 27,722 schoolboys aged 5 to 14 using Uricult to perform urine cultures and Hema-combistix to detect hematuria, proteinuria and glycosuria. Cultures of 10⁵ colonies per ml or more on two occasions were found in 40 cases (0.14%), but no case was confirmed by the family physician using standard culture techniques.Proteinuria was found in 136 cases (0.49%) and confirmed in 47 (37%) of the 126 children who were seen by their family physician. In this group 8.8% had evidence of pyelonephritic scarring on intravenous pyelograms without a positive urine culture.Hematuria was found in 19 children and confirmed in 10 (59%) of the 17 children who were seen by their family physician. No abnormalities were detected on intravenous pyelography in any case.Glycosuria was found in 12 cases and confirmed in five. Three of these children had renal glycosuria and two had previously undetected diabetes.     

Etiology of intestinal Enterobacteriaceae infections in young children

Enterobacteria, potentially capable of causing infections, were isolated from the feces of 88.7% of young children in the intestinal department of an infectious disease hospital. Opportunistic bacteria were considered to be the causative agents of infections only in cases of their high concentration in the material under test. In about a half of the cases the etiological role of the suspected microorganisms was confirmed by the detection of antibodies in low titers. The presence of maternal antibodies did not interfere with diagnostic procedures. The detection of antibodies to autocultures, even in a single case, is of diagnostic importance in the examination of young children. Autoserologically confirmed mixed infection was found to take a more prolonged course than autoserologically confirmed monoinfection.     

SENSORY DIFFERENCE TESTS: THURSTONIAN AND SSA PREDICTIONS FOR VANILLA FLAVORED YOGURTS

The Thurstonian prediction that judges will get a higher proportion of correct 3-AFC tests than triangle tests was confirmed using a yogurt system. As predicted, d' values for the triangle and 3-AFC tests corresponded. Sequential Sensitivity Analysis predictions for the sensitivity of various tasting sequences were confirmed for the 3-AFC test but not the triangle test. Further predictions that the 2-AFC is more sensitive than the 3-AFC were confirmed. This increase in sensitivity more than offset the greater statistical power of the 3-AFC. Difficulties of specifying the nature of the difference for the 2-AFC and 3-AFC tests were overcome using a warm-up procedure.     

Genetic transformation of green bean callus via Agrobacterium mediated DNA transfer

Summary Kanamycin resistant callus was produced from leaf disc or hypocotyl expiants of green bean (Phaseolus vulgaris L.) when cultured on a defined medium containing 50 mg/l kanamycin after 4 days of co-cultivation with Agrobacterium tumefaciens strain EHA101 containing the binary vector pKYLX71GUS. The presence of neomycin phosphotransferase II (NPT-II) in crude cellular extracts from the kanamycin resistant callus was confirmed by ELISA. The expression of the ß-glucuronidase (GUS) reporter gene was confirmed by histochemical and fluorimetric analyses. Southern blot border analysis confirmed the integration of the foreign DNA. In addition to the evidence obtained from Southern analysis, the absence of Agrobacterium in the transformed callus cultures was confirmed by microscopic observation and through test cultures. Using the above protocol, bean callus cultures were also transformed with a bean chalcone synthase promoter-GUS fusion. These cultures, when treated with the elicitor glutathione, showed higher levels of GUS expression than the unelicited callus clumps.     

Isolation and characterization of hydrogen peroxide producing Aerococcus sp. from soil samples

Genes involved in 4-methyl-o-phthalate and 4-hydroxy-iso-phthalate catabolism reside on a 226-232 kbp catabolic plasmid termed MOP. This was confirmed by transformation and conjugation into an isogenic heat-cured (MOP-) derivative of the wild-type isolate, identified and termed Pseudomonas cepacia Pc701. Transformation confirmed the presence of Tn1 in MOP derived from Pc704, a mutant deficient in 4-methyl-o-phthalate catabolism. pCS1, a recombinant plasmid bearing MOP DNA, complemented MOP::Tn1 restoring the ability of Pc704 to grow on 4-methyl-o-phthalate. DNA-DNA hybridization using pCS1 as probe confirmed that loss of 4-methyl-o-phthalate catabolism by Pc704 was the result of Tn1 insertion into a 2.1 kbp HindIII fragment of MOP.     

Polymorphism in Rice Amylases at an Early Stage of Seed Germination

A polymorphism in rice amylases at an early stage of seed germination is analyzed by zymogram. In nonglutinous cultivars of rice, α-amylase isozymes are mainly confirmed in germinating seeds. However, in glutinous cultivars, β-amylase isozymes, which are not confirmed in nonglutinous cultivars, make up the major part of the total amylase activity and the expression of α-amylases are repressed.     

Multi-locus test conditional on confirmed effects leads to increased power in genome-wide association studies

Complex diseases or phenotypes may involve multiple genetic variants and interactions between genetic, environmental and other factors. Current genome-wide association studies (GWAS) mostly used single-locus analysis and had identified genetic effects with multiple confirmations. Such confirmed single-nucleotide polymorphism (SNP) effects were likely to be true genetic effects and ignoring this information in testing new effects of the same phenotype results in decreased statistical power due to increased residual variance that has a component of the omitted effects. In this study, a multi-locus association test (MLT) was proposed for GWAS analysis conditional on SNPs with confirmed effects to improve statistical power. Analytical formulae for statistical power were derived and were verified by simulation for MLT accounting for confirmed SNPs and for single-locus test (SLT) without accounting for confirmed SNPs. Statistical power of the two methods was compared by case studies with simulated and the Framingham Heart Study (FHS) GWAS data. Results showed that the MLT method had increased statistical power over SLT. In the GWAS case study on four cholesterol phenotypes and serum metabolites, the MLT method improved statistical power by 5% to 38% depending on the number and effect sizes of the conditional SNPs. For the analysis of HDL cholesterol (HDL-C) and total cholesterol (TC) of the FHS data, the MLT method conditional on confirmed SNPs from GWAS catalog and NCBI had considerably more significant results than SLT.     

Late failure of vasectomy after two documented analyses showing azoospermic semen.

From April 1970 to December 1980, 14 047 men underwent vasectomy for sterilisation under local anaesthetic at this clinic. In each man sterility was confirmed by two analyses of semen showing azoospermia. Allowing for a minimum follow up of three years, the wives of six of these men subsequently became pregnant between 16 months and three years after vasectomy. Analyses of semen confirmed recanalisation of the vasa deferentia in all six men. Only five similar cases initially fulfilling the same criteria for sterility have previously been reported. Full account of the rare possibility of recanalisation should be taken both when couples are counselled preoperatively and when pregnancy occurs after the male partner has been confirmed to be sterile.     

Polymerase chain reaction for verification of fluorescent colonies of Erwinia chrysanthemi and Pseudomonas putida WCS358 in immunofluorescence colony staining

The potential of polymerase chain reaction (PCR) for verifying the identity of colonies stained by the immunofluorescence colony-staining (IFC) procedure was investigated. Using primers directed against conserved sequences of the pectate lyase-genes coding for isozymes PLa, PLd and PLe of Erwinia chrysanthemi , the authors confirmed the identity of 96% of 20 fluorescent target colonies, punched from IFC-stained samples with pure cultures. In pour plates with mixtures of Erw. chrysanthemi and non-target colonies from potato peel extracts, the identity of 90% of 113 target colonies was confirmed.
Using primers directed against sequences of the ferric-pseudobactin receptor gene pupA of Pseudomonas putida WCS358, the identity of 96% of 22 target colonies was confirmed in IFC-stained samples with pure cultures. In pour plates with mixtures of Ps. putida WCS358 and non-target bacteria from compost extracts, the identity of 59% of 108 fluorescent colonies was confirmed by PCR. It was shown that components from non-target bacteria lowered the threshold level of PCR for Ps. putida WCS358     

非结核分枝杆菌肺病临床分离株的菌种鉴定及临床特征分析

为探究非结核分枝杆菌（nontuberculous mycobacterium,NTM）肺病临床分离株的菌种分布及临床特征, 对2017年5月―2018年10月就诊于复旦大学附属中山医院的90例NTM肺病患者的样本进行分析。采用快速全自动分枝杆菌培养和药物敏感检测系统（BACTEC MGIT960 System）或改良罗氏培养法对90例患者的采集样本进行培养,利用基质辅助激光解析/电离飞行时间质谱（matrix assisted laser desorption/ionization time of flight mass spectrometry,MALDI-TOF MS）进行菌种鉴定,并对回顾性分析收集的90例患者的临床资料进行分析。结果NTM菌种鉴定为9种,其中慢速生长分枝杆菌65例,以胞内分枝杆菌（54.4%,49/90）占多数;快速生长分枝杆菌25例,以脓肿分枝杆菌（22.2%,20/90）占多数。90例患者中确诊67例、疑似23例。确诊患者中少见菌种所占比例较低（6.0% vs 26.1%,P = 0.016）。确诊与疑似患者在临床表现方面未见显著差异,但确诊患者有抗NTM治疗史的比例显著高于疑似患者（85.1% vs 4.3%,P < 0.001）。确诊患者中,快速生长NTM肺病患者既往抗结核治疗史的比例显著高于慢速生长组（52.9% vs 24.0%,P = 0.036）。本研究结果为NTM肺病的临床诊治提供了数据参考。     

中国内地首例确诊甲型H1N1流感病例的实验室检测

本实验室针对中国四川省一例输入性疑似甲型H1N1流感病例的临床咽拭子标本进行Real-time PCR和RT-PCR检测,并随后对部分基因片段进行测序,结果表明临床咽拭子标本为甲型H1N1流感病毒阳性,因此该疑似甲型H1N1流感病例成为中国内地首例确诊的甲型H1N1流感病例。     

Short report: The potential of PCR on skin flakes from bed linens for diagnosis of scabies in an outbreak

BackgroundScabies outbreaks are common in nursing homes in the Netherlands. In October 2018, a local public health service (PHS) in The Hague was notified of a new scabies outbreak in a nursing home in that region. The PHS initiated an outbreak investigation. Cases were defined as: possible (reported symptoms), probable (scabies-like lesions) and confirmed (PCR or microscopy in skin flakes). Head-to-toe examinations were performed of all residents and those staff members who reported symptoms suggestive of scabies. Skin scrapings of lesions were tested either with microscopy or by PCR. Experimentally for case finding, skin flakes from bed linens of residents who reported symptoms of itchiness but did not have primary lesions were sent for PCR testing.Principal findingsAll residents (41) and 37/44 staff were included in this outbreak investigation. We identified 30 possible, four probable and six confirmed cases. The overall attack rate for probable/confirmed cases was 10/78 (13%). Of the six confirmed cases, two were confirmed by PCR, three by microscopy, and one showed positive findings with both techniques. Two out of the three bed-linen specimens were PCR-positive.ConclusionsIn this outbreak of scabies in a nursing home, PCR was used on skin flakes from bed linens, which led to the detection of two additional cases. This illustrates the potential of PCR during the investigation of scabies outbreaks.     

Clinical and laboratory aspects of a trichinellosis outbreak in Izmir, Turkey

Epidemiological, clinical and laboratory data were collected during an outbreak of trichinellosis, which occurred in Izmir, Turkey, between January and March 2004. The source of the infection was raw meatballs made with a mixture of uncooked beef and pork. Of 474 persons who were admitted at the Ataturk Training and Research Hospital during this period with a history of raw meatball consumption, the diagnosis of trichinellosis was confirmed for 154 (32.5%, 87 males and 67 females; mean age 31 years, range 6-67 years). Among persons with a confirmed diagnosis, 79% had myalgia, 77% weakness and malaise, 63% arthralgia, 40% jaw pain, 68% fever, 63% periorbital and/or facial oedema, 49% oedema at the trunk and limb, 42% abdominal pain, 40% nausea and vomiting, 28% diarrhoea, 23% subconjunctival haemorrhage, 25% macular or petechial rash, 4% subungual haemorrhage, 15% cardiac complaints and 0.2% neurological complaints. Nine patients (5.8%) were hospitalised due to severe myalgia (n = 2), high fever (n = 3), neurological manifestations (n = 1), thrombophlebitis (n = 2) and palmar erythema (n = 1). Eosinophilia was present in 88% of the confirmed cases at the admission. Elevated levels of serum creatine phosphokinase, lactic dehydrogenase and aspartate aminotransferase were detected in 72%, 70% and 16% of the confirmed cases, respectively. The seroconversion occurred in most of the infected people between the 4th and 6th weeks after the infection. All of the confirmed cases were treated with mebendazole. People with severe symptoms were treated also with prednisolone (60 mg/day for three days) and those with a moderately severe clinical pattern received a non-steroid anti-inflammatory drug (naproxen sodium, 550 mg/day). All confirmed cases recovered without any clinical sequela.     

Phylogeny and lipid composition of Thermonema lapsum, a thermophilic gliding bacterium

Abstract 1490 nucleotides of the 16S rRNA gene of a Gram-negative, thermophilic and gliding bacterium, Thermonema lapsum , have been sequenced. Phylogenetic analysis indicates that T. lapsum is related to cytophaga-flavobacteria-bacteriodes (CFB) and is confirmed by the identification signature nucleotides that define this group. Further phylogenetic analysis indicates that T. lapsum forms the deepest branch in the CFB group; this observation was confirmed by the identification of unique nucleotide and nucleotide pairs which separate T. lapsum from all other members of this group. The phospholipid fatty acid (PLFA) profile also confirmed that T. lapsum is related to the cytophaga-flavobacteria-bacteroides group and also to selected members of the genus Flexibacter ; the PLFA profile is unique to T. lapsum .     

A Lentiviral Gene Therapy Strategy for the In Vitro Production of Feline Erythropoietin

Nonregenerative anemia due to chronic renal failure is a common problem in domestic cats. Unfortunately, administration of recombinant human erythropoietin often only improves anemia temporarily due to antibody development. In this in vitro study, feline erythropoietin cDNA was cloned from feline renal tissue and utilized in the construction of a replication-defective lentiviral vector. The native recombinant feline erythropoietin (rfEPO) sequence was confirmed by sequencing. Upon viral vector infection of human 293H cells, Crandall Renal Feline Kidney cell line and primary feline peripheral blood mononuclear cells, bioactive rfEPO protein was produced. The presence of cellular rfEPO cDNA was confirmed by standard PCR, production of abundant rfEPO mRNA was confirmed by real-time PCR, and secretion of rfEPO protein was demonstrated by Western blot analyses, while rfEPO protein bioactivity was confirmed via an MTT proliferation bioassay. This in vitro study demonstrates the feasibility of a replication-defective lentiviral vector delivery system for the in vitro production of biologically active feline erythropoietin. Anemic cats with chronic renal failure represent a potential in vivo application of a lentiviral gene therapy system.