teins in colon tissue decreased significantly in the moxibustion group (

<0.01).

Moxibustion ST25 and ST37 can improve diarrhea symptom and visceral hypersensitivity in IBS-D rats, which may be related with its effects in inhibiting TLR4/MyD88/NF-κB signaling pathway and reducing the expression of inflammatory factors.

Moxibustion ST25 and ST37 can improve diarrhea symptom and visceral hypersensitivity in IBS-D rats, which may be related with its effects in inhibiting TLR4/MyD88/NF-κB signaling pathway and reducing the expression of inflammatory factors.

To observe the effect of electroacupuncture (EA) on liver surface blood perfusion and related indexes of oxidative stress in mice with acute alcoholic liver injury （AALI）, so as to explore its mechanism underlying improving of AALI.

Twenty-four Kunming mice were randomly divided into control, model and EA groups (8 mice/group). AALI model was established by intragastric administration of 50% ethanol at 6 g/kg. EA (4-6 V, 50 Hz) was applied to bilateral”Zusanli”(ST36) and”Taichong”(LR3) for 30 min. The liver surface blood perfusion was dynamically observed by moorFLPI laser speckle imager for 30 min. The morphological changes of the liver tissue were determined by H.E. staining. Levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in the liver were measured by ELISA.

Compared with the control group, the model group had markedly pathological changes of the hepatic cords, hepatic sinuses and hepatocytes shown by H.E. staining, a significant reduction in liver surface blood perfusion and the content of SOD in liver tissue (

<0.01,

<0.05), and a significant increase in the content of MDA in liver tissue (

<0.05). Compared with the model group, H.E. staining showed reduced pathological changes of the liver tissue, meanwhile the liver surface blood perfusion significant increased (

<0.05) and the content of MDA in liver tissue significantly decreased (

<0.01) in the EA group.

EA can improve the liver surface circulation of AALI mice, and regulate the oxidative stress response, and thus help to repair the damage of liver tissue.

EA can improve the liver surface circulation of AALI mice, and regulate the oxidative stress response, and thus help to repair the damage of liver tissue.

To observe the effect of wrist-ankle acupuncture (WA) stimulation at „R

„- „R

” – „R

” on the expression of glutamate (Glu) and phosphorylated protein NMDAR1(p-NMDAR1) of the spinal dorsal horn in spared nerve injury (SNI) rats, so as to explore its mechanism underlying improvement of SNI.

A total of 36 SD rats were randomly divi-ded into sham operation, model and WA groups, with 12 rats in each group. The SNI procedure comprised an axotomy and ligation of the tibial and common peroneal nerves leaving the sural nerve intact. Rats of the WA group were treated by acupuncture at „R

„-„R

„-„R

” points from the 5

day to the 14

day after modeling. The mechanical pain thresholds were measured before and 5, 10 and 14 d after SNI, respectively. The cold allodynia was dectected by Acetone solution dropped onto the lateral plantar surface of the paw. Glu content and p-NMDAR1 expression of spinal dorsal horn were detected by

H-MRS, ELISA and immunohistochemistry Methods.

Compared with the sham operation group, the mechanical pain threshold of the model group was significantly decreased (

<0.01), the duration of cold stimulation foot contraction was increased (

<0.01), and the Glu content and p-NMDAR1 expression in the spinal dorsal horn were significantly increased (

<0.05,

<0.01). After WA intervention, the mechanical pain threshold was significantly increased (

<0.01), the duration of cold stimulation was significantly shortened (

<0.01), and Glu content and p-NMDAR1 protein expression of spinal dorsal horn were decreased significantly (

<0.05,

<0.01) in the WA group compared with the model group.

WA can reduce pain sensitivity in rats with neuropathic pain, possibly by inhibiting the expression of Glu and p-NMDAR1 in the spinal dorsal horn.

WA can reduce pain sensitivity in rats with neuropathic pain, possibly by inhibiting the expression of Glu and p-NMDAR1 in the spinal dorsal horn.

To compare the effect of electroacupuncture (EA) of acupoint group for „reinforcing the kidney and regulating Governor Vessel” and acopoint group for „reinforcing the kidney and lung and regulating Governor Vessel” on lear-ning-memory ability and expression of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) proteins in the hippocampus and prefrontal cortex (PFC) in Alzheimer’s disease （AD） rats, so as to explore the efficacy of the two acupoint groups and mechanisms underlying improvement of AD.

Forty male SD rats were randomly divided into control, sham operation, model, „Baihui” + „Shenshu” (GV20+BL23, for „reinforcing the kidney and regulating Governor Vessel”) EA and GV20+BL23+ „Feishu” (BL13, GV20+BL23+BL13, for „reinforcing the kidney and lung and regulating Governor Vessel”) EA groups (

=8 rats in each group). The AD model was established by bilateral injection of amyloid β peptide （Aβ

，10 μL) into bilateral hippocampus, and rats of the sham operation group received injection of normal both GV20+BL23 EA and GV20+BL23+BL13 EA groups (

<0.05,

<0.01). No significant differences were found between the GV20+BL23 and GV20+BL23+BL13 EA groups in the above mentioned indexes (

>0.05).

EA of both GV20+BL23 and GV20+BL23+BL13 acupoint can improve learning-memory ability of AD rats, which is associated with their effects in down-regulating the expression of IL-1β and TNF-α in the PFC and hippocampus to reduce inflammatory reaction. There were no significant differences between the two acupoint groups in the therapeutic effects.

EA of both GV20+BL23 and GV20+BL23+BL13 acupoint can improve learning-memory ability of AD rats, which is associated with their effects in down-regulating the expression of IL-1β and TNF-α in the PFC and hippocampus to reduce inflammatory reaction. There were no significant differences between the two acupoint groups in the therapeutic effects.

To investigate the effect of electroacupuncture (EA) at „Baihui”(GV20), „Fengfu”(GV16) and bilateral „Shenshu”(BL23) on learning-memory ability, apoptosis in the hippocampus and expression of Aβ, Caspase 3, Bax and Bcl-2 proteins in the hippocampus and cerebral cortex in immature mice with Alzheimer’s disease (AD), so as to explore its mechanism underlying improvement of AD.

Forty APP/PS1 transgenic male young mice were equally randomized into model and EA groups and 20 C57BL/6J male young mice were used as the normal control. EA (10 Hz, about 2 mA) was applied to GV20-BL23 and GV16-BL23 for 20 min, once daily, 6 days a week for 16 weeks. The Morris water maze swimming test was used to evaluate the animals’ learning-memory ability. Congo red staining and immunohistochemical staining were used to detect senile plaques in the hippocampus (dentate gyrus) and cerebral cortex tissues. Terminal deoxynucleotidyl transferase-mediated dUTP Nick-end Labeling (TUNEL) was used to detect the cellular apoptosis of hipp neuronal apoptosis in the hippocampus and down-regulating the expression levels of Aβ, Caspase 3 and Bax proteins in both hippocampus and cerebral cortex.

To investigate the effect of electroacupuncture (EA) on the p38 mitogen-activated protein kinase (p38 MAPK) and signal transducer and activator of transcription 3 (STAT3) pathway in hippocampus and frontal cortex of diabetic rats with cognitive impairment (CI), as well as the mechanism of EA in protection against CI in diabetic rats.

Thirty SD rats were divided into normal, model and EA groups (

=10 rats/group). The diabetic model was established by i.p.injection of Streptozotocin solution(25 mg/kg), followed by high-fat diet raising for 1 month, and the CI rats was confirmed by Morris water maze tasks. The rats in the EA group were given acupuncture at „Zusanli” (ST36) „Neiting” (ST44) and „Yishu” (EX-B3) 20 min/d, among which ST36 and ST44 were treated with EA. The treatment was conducted 6 times a week for 4 weeks. The fasting blood glucose (FBG) contents were assayed by glucometer before and after treatment. The rats’ learning-memory ability was detected by Morris water maze tasks. The expression levα, p38 MAPK, p-p38 MAPK, STAT3 and p-STAT3, and the mean fluorescence intensity of p38 MAPK and STAT3 in hippocampus and frontal cortex were down-regulated(

<0.001,

<0.05).

EA can inhibit the over production of pro-inflammatory cytokines in diabetic rats with CI, possibly by regulating the expression of p38 MAPK and STAT3 pathway.

EA can inhibit the over production of pro-inflammatory cytokines in diabetic rats with CI, possibly by regulating the expression of p38 MAPK and STAT3 pathway.

Extremity injury represents the leading cause of trauma hospitalizations among adults under the age of 65 years, and long-term impairments are often substantial. Restoring function depends, in large part, on bone and soft tissue healing. Thus, decisions around treatment strategy are based on assessment of the healing potential of injured bone and/or soft tissue. However, at the present, this assessment is based on subjective clinical clues and/or cadaveric studies without any objective measure. Optical imaging is an ideal method to solve several of these issues.

The aim is to highlight the current challenges in assessing bone and tissue perfusion/viability and the potentially high impact applications for optical imaging in orthopaedic surgery.

The prospective will review the current challenges faced by the orthopaedic surgeon and briefly discuss optical imaging tools that have been published. With this in mind, it will suggest key research areas that could be evolved to help make surgical assessments moith how these conditions are managed.

While there are several optical measurements to directly measure bone function, the choice of tools can determine also the signal strength and depth of sampling. For orthopaedic surgery, real-time data regarding bone and tissue perfusion should lead to more effective patient-specific management of common orthopaedic conditions, requiring deeper penetrance commonly seen with indocyanine green imaging. This will lower morbidity and result in decreased variability associated with how these conditions are managed.

To confirm feasibility of recording pressure along the length of the urethra using a multi-sensor fibre-optic pressure catheter; to identify the spatial and temporal features of changes in pressure along the urethra at sites related to specific striated pelvic floor muscles; and to investigate the relationship between urethral pressures and activation of individual pelvic floor muscles estimated from ultrasound imaging.

Proof-of-concept study including one male (47 years old) and one female (33 years old). A multi-sensor fibre optic pressure catheter (10 mm sensor separation) was inserted into the urethra. Pressure data were recorded simultaneously with trans-perineal ultrasound imaging measures of pelvic floor muscle activity during sub-maximal and maximal voluntary contractions and evoked coughs.

Pressure changes along the urethra were recorded in all tasks in both participants. Face validity of interpretation of pressure measures with respect to individual muscles was supported by correlation with ultrasound-measured displacements induced by the relevant muscles. Onset of pressure increase occurred in a distal to proximal sequence in the urethra of the male but not the female during voluntary contraction. Peak urethral pressures varied in location, timing and amplitude between tasks. Evoked cough induced in the greatest urethral pressure increase across all tasks for both participants.

The high spatial resolution pressure catheter provide viable and valid recordings of urethral pressure in a male and female. Data provide preliminary evidence of sex differences in spatial and temporal distribution of urethral pressure changes.

The high spatial resolution pressure catheter provide viable and valid recordings of urethral pressure in a male and female. Data provide preliminary evidence of sex differences in spatial and temporal distribution of urethral pressure changes.

Poor awakening in patients with enuresis has been assumed to be an adaptation to the chronic influence of arousal stimuli like lower urinary tract dysfunction (LUTD). This study aimed to examine the effect of controlling LUTD on improvement of awakening and cure of enuresis.

Data for 119 enuretic patients with overactive bladder were retrospectively analyzed. The patients received urotherapy, laxatives, and anticholinergic agents. LUTD symptoms and enuresis were regularly monitored every 3 months. History of waking up because of bedwetting (ability to awaken, AA) was used as a surrogate marker of arousal and was graded at baseline and every 3 months of treatment. Changing distribution of each grade of AA was associated with other LUTD symptoms. Multivariate analysis was applied to understand whether the lack of improvement in AA might harbor any prognostic implications regarding cure of enuresis.

Decreasing number of LUTD with treatment corresponded to increasing number of better AA. Enuresis was resolved completely in 88 patients in a median time of 7 months. Failure to show even single episode of awakening before bedwetting within 6 months of treatment and persistent daytime incontinence were identified as risk factors for treatment resistance until 18 months of treatment.

Controlling LUTD symptoms in the management of nonmonosymptomatic enuresis was crucial for not only the treatment of enuresis but also for allowing the patients to obtain better arousal. AA tended to improve subsequent to bladder control and may contribute to the cure of enuresis.

Controlling LUTD symptoms in the management of nonmonosymptomatic enuresis was crucial for not only the treatment of enuresis but also for allowing the patients to obtain better arousal. AA tended to improve subsequent to bladder control and may contribute to the cure of enuresis.

The Acute Cystitis Symptom Score (ACSS) used in a clinical trial comparing the phytodrug Canephron®N (BNO 1045) with an antibacterial agent (fosfomycin trometamol [FT]) in the treatment of acute uncomplicated cystitis (AC) in women was evaluated as a patient-reported outcome measure in a

analysis.

This double-blind, randomized, multicenter, phase III noninferiority trial was performed in 51 centers in Europe. The ACSS questionnaire was used to assess severity and course of symptoms.

The

analysis included 325 patients treated with BNO 1045 and 332 patients treated with FT (total of 657 patients). The mean sum-scores of the ACSS-typical domain were comparable between groups on day 1 (BNO 1045 10.2; FT 10.1), and then decreased on day 4 (BNO 1045 5.1; FT 4.5), at end of treatment on day 8 (BNO 1045 2.1; FT 2.1), and at late follow-up on day 38 (BNO 1045 0.8; FT 0.9). Predefined thresholds using the scoring system of the ACSS could be established and validated to define „clinical cure.”

Evaluating n outcomes in well-designed, international, clinical studies investigating different treatment modalities of uncomplicated urinary tract infections.

This study aimed to determine the effectiveness and safety of partial nephrectomy (PN) without ischemia compared with PN with warm ischemia for reducing the deterioration in renal function in patients with cT1 renal tumors.

We conducted a systematic review that included patients over 18 years of age who underwent PN with or without warm ischemia for cT1 renal tumors. The primary outcome was impaired renal function. A search strategy was performed in MEDLINE, EMBASE, LILACS, CENTRAL, the article reference lists, and the unpublished literature to reach saturation of the information. We assessed the risk of bias with the methodological index for nonrandomized studies (MINORS) tool, and we performed a meta-analysis according to the type of variable.

We found a total of 5,682 articles, of which 14 met the inclusion criteria. Seven studies evaluated renal function, identifying a difference in means (MD) of 3.50 (95% confidence interval [CI], 1.16 to 5.83), favoring no ischemia. We did not find any significant differences regarding intraoperative bleeding or operative time (MD, 55 mL; 95% CI, -33.16 to 144.08; and MD, 1.87; 95% CI, -20.47 to 24.21; respectively).

In this study, PN without ischemia showed a decrease in deterioration of the estimated glomerular filtration rate compared with warm ischemia.

In this study, PN without ischemia showed a decrease in deterioration of the estimated glomerular filtration rate compared with warm ischemia.The use of ureteral access sheaths (UAS) is common practice during routine flexible ureteroscopy procedures. However, debates and concerns continue amongst endourologists on routine UAS placement. UAS placement allows for multiple passages of the ureteroscope, decreases intrarenal pressure, and may improve stone-free rates. However, concerns for the UAS’s effectiveness in these claimed benefits and complications related to UAS placement has been documented and investigated by many. In this review, we will discuss the controversies surrounding the placement of UAS during ureteroscopy.Acinetobacter baumannii is one of the most important etiologies of nosocomial infections in recent years mainly because of increasing in frequency of multidrug and pan-resistant pathogens. Meningitis caused by this organism is a dilemma; because polymyxins are the only effective antibiotics against pan-resistant serotypes, but have poor penetration via blood brain barrier; however, it has still remained uncertain whether the intravenous therapy with these agents is an effective treatment with the sufficient concentration of the drug in the cerebrospinal fluid. Herein, we report a neonate who suffered from pan-resistant A. baumannii nosocomial meningitis successfully treated with intravenous colistin combined with meropenem and rifampin. It seems that intravenous colistin at least in combination with rifampin and meropenem might be considered as an option to try in patients in whom daily intrathecal injection or insertion of intraventricular device is not possible.Coronavirus disease 2019 (COVID-19) has spread widely across the world since January 2020. There are many challenges when caring for patients with COVID-19, one of which is infection prevention and control. In particular, in cases where surgery must absolutely be performed, special infection control may be required in order to perform surgery without spreading infection within the hospital. We aim to present potentially useful recommendations for non-deferrable surgery for COVID-19 patients based on in vivo and in vitro research and clinical experiences from many countries.Vivax malaria which had been highly prevalent in Korea disappeared rapidly from the 1960s to 1984 when domestic occurrence of cases stopped. However, malaria reemerged in 1993 near the demilitarized zone (DMZ) bordering with North Korea. The number of patients thereafter increased exponentially year after year totaling 35,526 cases by the end of 2015. A small number of cases (1 – 53 patients annually) also occurred among the United States military personnel camping in Korea. However, after the 2010s the number of annual malaria cases has been decreasing slowly in Korea. Several reports on malaria situation in North Korea described high malaria prevalence after 1997 which peaked during 1999 – 2002 and has been decreasing thereafter. At the beginning of the reemergence, the majority of cases (60 – 90%) were soldiers aged 20 – 25 years camping around the northern parts of Gyeonggi-do and Gangwon-do (Province), Korea just facing the DMZ. However, as the outbreak continued more civilians were infected. The course of illness was relatively mild, and chemotherapy with chloroquine in combination with primaquine was successful in most of the patients. Mass chemoprophylaxis combined with mosquito control activities greatly contributed to the decline of malaria situation among Korean military soldiers.Coronaviruses have caused serious Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and Coronavirus Disease 2019 (COVID-19) outbreaks, and only remdesivir has been recently indicated for the treatment of COVID-19. In the line of therapeutic options for SARS and MERS, this study aims to summarize the current clinical evidence of treatment options for COVID-19. In general, the combination of antibiotics, ribavirin, and corticosteroids was considered as a standard treatment for patients with SARS. The addition of this conventional treatment with lopinavir/ritonavir, interferon, and convalescent plasma showed potential clinical improvement. For patients with MERS, ribavirin, lopinavir/ritonavir, interferon, and convalescent plasma were continuously recommended. However, a high-dose of corticosteroid was suggested for severe cases only. The use of lopinavir/ritonavir and convalescent plasma was commonly reported. There was limited evidence for the effect of corticosteroids, other antiviral drugs like ribavirin, and favipiravir. Monoclonal antibody of tocilizumab and antimalarial agents of chloroquine and hydroxychloroquine were also introduced. Among antibiotics for infection therapy, azithromycin was suggested. In conclusion, this study showed the up-to-date evidence of treatment options for COVID-19 that is helpful for the therapy selection and the development of further guidelines and recommendations. Updates of on-going clinical trials and observational studies may confirm the current findings.Korea had been one of hyperendemic countries of human parasitic infections until 1970s. In 1966, the Law for the Prevention of Parasitic Diseases was enacted, and the nationwide anti-parasitic control program began in 1969. The initiation of the national program was supported financially by Japan. The program included screening of whole students in Korea and treatment of all egg positive cases twice a year, and ended in 1995. In addition to student program, deworming campaign was run in the community, and 8 national status surveys were implemented from 1971 to 2012. Whole helminth egg positive rate was 84.3% in 1971 and decreased to 2.6% in 2012. Ascaris and other intestinal nematodes, Paragonimus, Taenia, and intestinal protozoa had decreased significantly throughout the country, but Clonorchis sinensis and intestinal trematodes are still prevalent locally in endemic areas. Lymphatic filariasis had been endemic in Jeju-do and other southern islands but elimination was endorsed in 2008. The control of parasitic infection in Korea was successful with statistical prevalence data, which can be a benchmarking model. In conclusion, the successful control in Korea could be achieved by social agreement of the priority, professional guidelines and systematic approach with good anthelminthics supply, and simultaneous economic growth.

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection is not differentiated clinically from other respiratory infections, and intensive care units (ICUs) are vulnerable to in-hospital transmission due to interventions inducing respiratory aerosols. This study evaluated the effectiveness of universal SARS-CoV-2 screening in ICUs in terms of screened-out cases and reduction in anxiety of healthcare personnel (HCP).

This prospective single-armed observational study was conducted in 2 ICUs of a single hospital. The number of patients diagnosed with SARS-CoV-2 infection by the screening program and healthcare workers in ICUs that visited the SARS-CoV-2 screening clinic or infection clinic were investigated.

During the 7-week study period, no positive screening case was reported among a total of 142 patients. Among 86 HCP in the ICUs, only 2 HCP sought medical consultation for SARS-CoV-2 infection during the initial 2 weeks.

A universal screening program for SARS-CoV-2 infection in ICUs with the coordination of other countermeasures in the hospital was reasonably effective in preventing in-hospital transmission in a pandemic situation and making clinical practices and HCP stable.

A universal screening program for SARS-CoV-2 infection in ICUs with the coordination of other countermeasures in the hospital was reasonably effective in preventing in-hospital transmission in a pandemic situation and making clinical practices and HCP stable.Vibrio cholerae is a pathogen known to cause the waterborne epidemic disease cholera. Overall, V. cholerae O1 or O139 strains produce the cholera toxin that cause gastroenteritis, resulting in watery diarrhea. Most of the enterocolitis caused by V. cholerae can be easily treated with fluid therapy and conservative care. However, V. cholerae non-O1/O139 strains can cause extraintestinal infections, such as wound infection or sepsis, in immunocompromised patients. The clinical course of these infections is very similar to that of V. vulnificus infection. We report about a 52-year-old man without previous underlying disease who was diagnosed with V. cholerae non-O1/O139 infection and died within 72 hours after admission to the intensive care unit.Scrub typhus present with a variety clinical manifestations caused by Orientia tsutsugamushi, it is sometimes accompanied by severe complications. The clinical course of this complication is not well clear. Herein, we first report a case with acute cholangitis and acalculous cholecystitis caused by the Boryong genotype of O. tsutsugamushi. A 82-year-old woman presented with fever and acute abdominal pain on the right upper quadrant. Initially, the patient showed an abnormality of liver enzymes of cholestatic pattern. An acute cholangitis and cholecystitis were suspected on the enhanced computed tomography (CT), and emergent endoscopic retrograde cholangiopancreatography (ERCP) performed. However, neither ERCP nor CT detected common bile duct stones or sludge. The patient’s illness progressed despite bile drainage and antibiotic therapy. On the fifth day in hospital, an immunofluorescence IgG assay for O. tsutsugamushi was positive, and the patient newly developed a skin rash and an eschar lesion on the right abdomen. The polymerase chain reaction amplification of Orientia genes from blood and bile was positive, genotype of both samples was identified the Boryong type. The presentation of scrub typhus as an acute cholangitis is not reported till now. In endemic areas, scrub typhus would be considered a rare etiology of acute cholangitis.Cytomegalovirus (CMV) causes severe infection in immunocompromised patients, especially those with acquired immunodeficiency syndrome (AIDS), those who have undergone organ transplantation, and/or those who are being treated with steroids. In patients with AIDS, CMV is the most common pathogen that causes opportunistic infections. Here, we present a case of liver abscess due to CMV in a 58-year-old man diagnosed with AIDS. At the time of the study, his CD4 T lymphocyte count was 39 cells/mm³, and his human immunodeficiency virus (HIV) ribonucleic acid (RNA) level was 411,000 copies/mL. Upon presentation, he complained of upper abdominal pain. Ultrasonography-guided percutaneous drainage of the liver abscess was performed, and polymerase chain reaction PCR analysis of the drained pus was positive for CMV. He was treated with intravenous ganciclovir, after which he recovered fully. In conclusion, our patient represents, to our knowledge, the first described case of liver abscess caused by CMV in an AIDS patient, which was probably facilitated by severe immunodeficiency.Cushing’s syndrome is characterized by excessive cortisol and immuno-suppression. We experienced a case of Cushing’s syndrome caused by adrenocortical carcinoma that was complicated by multiple opportunistic infections. A 37-year-old woman with adrenocortical carcinoma (ACC) presented with decreased mental ability and high fever one week after undergoing chemotherapy. Her initial blood culture revealed methicillin-resistant Staphylococcus aureus bacteremia accompanied by septic pneumonia. We admitted her to the intensive care unit and treated her for invasive pulmonary aspergillosis (IPA), Pneumocystis jirovecii pneumonia (PJP), candidemia, and Stenotrophomonas maltophilia pneumonia with broad-spectrum antibiotics and antifungal agents. Nevertheless, her clinical course worsened and she died. Herein, we report a case of Cushing’s syndrome associated with cortisol-secreting ACC that presented with multiple opportunistic infections, including MRSA bacteremia, septic pneumonia, candidemia, PJP, and IPA, illuminating a relationship between hypercortisolemia and opportunistic infections.Disseminated adenovirus infections (d-ADV) after hematopoietic cell transplant (HCT) are often fatal with limited treatment options. Brincidofovir (BCV) a lipid ester of cidofovir is developed for this indication. We report four pediatric HCT recipients with d-ADV treated successfully with BCV.Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be detected via a nasopharyngeal swab and in sputum, blood, urine, and feces. However, there is only limited data on the real-time reverse transcriptase polymerase chain reaction (RT-PCR) results of coronavirus disease 2019 (COVID-19) patients with pleural fluid. We report a case of COVID-19 with SARS-CoV-2 detected in both sputum and pleural fluid. A 68-year-old male patient came to the hospital with a chief complaint of dyspnea. He was diagnosed with lung cancer. A biopsy was performed, and a pneumothorax was found. As a result, a chest tube was placed into the right pleural space. During his hospital stay, the patient was confirmed as COVID-19 positive. We identified the presence of SARS-CoV-2 through real-time RT-PCR assay from the pleural fluid. Although pleural effusion is an uncommon finding in the COVID-19, care should be taken to avoid exposure when handling the pleural fluid sample.

Rapid diagnostic test (RDT) of norovirus and rotavirus is commonly used for outbreak screening and patient management. Varying accuracy of the test and cross-reactivity has been reported and could affect the outcome of management. The primary purpose of this study is to provide the accuracy of norovirus and rotavirus rapid diagnostic tests and to analyze the cross-reactivity of both tests.

Stool samples collected from every acute diarrhea patient aged <15 years old who was admitted at Bhumibol Adulyadej Hospital, Bangkok, Thailand, from November 2014 to September 2016 underwent the following test QuickNaviTM – Norovirus2 for norovirus, VIKIA® Rota-Adeno for rotavirus, and aerobic bacterial culture. Real-time reverse transcription polymerase chain reaction was used as a gold standard for virus detection. False-positive results determined cross-reactivity.

From 358 stool specimens, the sensitivity of RDTs for norovirus and rotavirus was 27.5% and 44.8%, respectively. The specificity of RDTs for norovirus and rotavirus was 97.7% and 91.6%, respectively. False positive results of RDT for norovirus occurred in 6 samples (1.7%) and 22 samples (6.1%) in RDT for rotavirus. Rotavirus RDT was found to have cross-reactivity with 11 norovirus infection and 3 bacterial infected stools.

We found that the RDTs for both rotavirus and norovirus have high specificity but low sensitivity. Cross-reactivity was observed in positive rotavirus RDT with half of it being norovirus.

We found that the RDTs for both rotavirus and norovirus have high specificity but low sensitivity. Cross-reactivity was observed in positive rotavirus RDT with half of it being norovirus.

Adolescence and young adulthood are considered the peak age for the emergence of many psychiatric disorders, in particular major depressive disorder (MDD). Previous research has shown substantial heritability for MDD. In addition, the brain-derived neurotrophic factor (BDNF) gene is known to be associated with MDD. However, there has been no study conducting targeted sequencing of the BDNF gene in young MDD patients so far.

To examine whether the BDNF gene is associated with the occurrence of MDD in young patients, we used targeted sequencing to detect the BDNF gene variants in 259 young Chinese Han people (105 MDD patients and 154 healthy subjects).

The BDNF variant rs4030470 was associated with MDD in young Chinese Han people (uncorrected p=0.046), but this was no longer significant after applying FDR correction (p=0.552, after FDR correction). We did not find any significant differences in genotype or haplotype frequencies between the case and control groups, and furthermore discovered no rare mutation variants any of the 259 subjects.

Our results do not support an association of the BDNF gene variants with MDD in young people in the Chinese Han population.

Our results do not support an association of the BDNF gene variants with MDD in young people in the Chinese Han population.

Genetics is best dedicated to interpreting pathogenesis and revealing gene functions. The past decade has witnessed unprecedented progress in genetics, particularly in genome-wide identification of disorder variants through Genome-Wide Association Studies (GWAS) and Phenome-Wide Association Studies (PheWAS). However, it is still a great challenge to use GWAS/PheWAS-derived data to elucidate pathogenesis.

In this study, we used HotNet2, a heat diffusion-based systems genetics algorithm, to calculate the networks for disease genes obtained from GWAS and PheWAS, with an attempt to get deeper insights into disease pathogenesis at a molecular level.

Through HotNet2 calculation, significant networks for 202 (for GWAS) and 167 (for PheWAS) types of diseases were identified and evaluated, respectively. The GWAS-derived disease networks exhibit a stronger biomedical relevance than PheWAS counterparts. Therefore, the GWAS-derived networks were used for pathogenesis interpretation by integrating the accumulated biared with original GWAS/PheWAS results, HotNet2-calculated disease-gene associations have stronger biomedical significance, hence provide better interpretations for the pathogenesis of genome-wide variants, and offer new insights into gene functions as well. These results are also helpful in drug development.

This cohort study assessed the risk for bodyweight gain and development of glucose intolerance based on the frequency of consumption of balanced meals including grain, fish or meat and vegetables.

The participants (8,573 men, 3,327 women) were employees of a company in Japan. A self-administered questionnaire was used to evaluate the frequency of balanced meal consumption. Bodyweight changes and the incidence of glucose intolerance (glycated hemoglobin >6.0%) during the 3-year follow-up period were determined through annual health examinations.

The mean bodyweight change over a period of 3years was 0.78kg for men and 0.84kg for women. A lower frequency of balanced meals was associated with a higher bodyweight gain for men (P for trend=0.004), but not for women. During the study, 464 men and 115 women developed glucose intolerance. Overall, the frequency of balanced meals was not associated with the risk of glucose intolerance in either sex. However, the interaction between the frequency of balanced meals and degree of obesity had a significant effect on the incidence of glucose intolerance in men (P=0.005), with less frequent consumption of balanced meals being associated with a higher risk for glucose intolerance among men with a BMI ≥25.0kg/m

(P for trend=0.007).

A higher frequency of balanced meals, including grain, fish or meat and vegetable dishes – important components of healthy Japanese food – was associated with a lower risk of glucose intolerance in obese men, but not in non-obese men and women.

A higher frequency of balanced meals, including grain, fish or meat and vegetable dishes – important components of healthy Japanese food – was associated with a lower risk of glucose intolerance in obese men, but not in non-obese men and women.

Efficacy of immune checkpoint inhibitors (ICIs) in metastatic gastric/gastroesophageal junction (GEJ) adenocarcinoma is inconsistent. Whether the efficacy of ICIs is comparable across different subgroups remains unknown.

We identified randomized controlled trials (RCTs) that compared standard treatment for metastatic gastric/GEJ adenocarcinoma to ICIs. Hazard ratios (HRs) and 95% confidence intervals (CI) for overall survival (OS) were extracted and pooled in a meta-analysis. Prespecified subgroups were included as follows age at randomization (</≤65 vs ≥/>65years), gender (female vs male), ethnicity (Asians vs non-Asians), performance-status (0 vs 1), tumor location (gastric vs GEJ), and histological subtype (diffuse vs others). OS in patients with programmed death ligand (PD-L1) positive and with microsatellite instability-high (MSI-H) were also extracted and pooled in a meta-analysis.

Five RCTs comprising 2,264 patients were analyzed. Compared to standard therapy, ICIs did not improve OS (HR=0.86, 95% CI 0.71-1.03, P=.10) and the effect of ICIs on OS was similar in all subgroups. Nonsignificantly greater effect sizes were seen in older patients (HR=0.85 vs 0.88, P=.81), male (HR=0.82 vs 0.99, P=.16), Asians (HR=0.86 vs 0.96, P=.55), performance-status 0 (HR=0.84 vs 0.88, P=.81), GEJ tumors (HR=0.78 vs 0.90, P=.37), and nondiffuse subtype (HR=0.71 vs 0.79, P=.62). ICIs were associated with significantly improved OS in patients with MSI-H (HR=0.33, P=.001), but not in PD-L1 positive disease (HR=0.86, P=.06).

Compared to standard treatment, ICIs in metastatic gastric/GEJ adenocarcinoma did not improve OS. None of the evaluated subgroups has shown increased magnitude of effect to ICIs, aside of the small group with MSI-H tumors.

Compared to standard treatment, ICIs in metastatic gastric/GEJ adenocarcinoma did not improve OS. None of the evaluated subgroups has shown increased magnitude of effect to ICIs, aside of the small group with MSI-H tumors.

There is a growing interest in adolescent motherhood and HIV among policymakers and programme implementers. To better shape services and health outcomes, we need evidence on reproductive aspirations and contraception use in this high-risk group, including the effect of motherhood and HIV status. We report data from a large survey of adolescent girls and young women conducted in a mixed rural-urban district in South Africa.

Quantitative interviews were conducted with 1712 adolescent girls and young women (ages 10 to 24) 336 adolescent mothers living with HIV (AMLHIV), 454 nulliparous adolescent girls living with HIV (ALHIV), 744 HIV-negative adolescent mothers (control adolescent mothers) and 178 HIV-negative nulliparous adolescent girls (nulliparous controls) in 2018 to 2019. Standardized questionnaires included socio-demographic measures, reproductive health and contraception experiences. Reproductive aspirations were measured as the number of children participants wanted to have. Dual protection was comraceptive method 29.0% among control mothers and 23.5% among AMLHIV.

Among adolescent girls and young women in HIV-endemic communities, reproductive aspirations and contraceptive practices affect HIV risk and infection. Tailored adolescent-responsive health services could help young women plan their pregnancies for when they are healthy and well-supported, and help interrupt the cycle of HIV transmission by supporting them to practice dual protection.

Among adolescent girls and young women in HIV-endemic communities, reproductive aspirations and contraceptive practices affect HIV risk and infection. Tailored adolescent-responsive health services could help young women plan their pregnancies for when they are healthy and well-supported, and help interrupt the cycle of HIV transmission by supporting them to practice dual protection.

Esophageal cancer (EC) is the leading cause of cancer-related mortality worldwide. The underlying genetic risk factors remain unclear. The association between gene growth hormone receptor (GHR) and phospholipase C epsilon 1 (PLCE1) polymorphisms and the EC risk were identified in this study.

A total of 506 EC cases and 507 controls were included in this research. Two SNPs (rs6898743 of GHR and rs2274223 of PLCE1) were selected and genotyped. The associations between gene polymorphisms and the EC risk were assessed by logistic regression analysis. The databases RegulomeDB, GTEx, and UALCAN were used for functional annotations.

In the allelic frequencies analysis, the rs6898743 of GHR was associated with decreased susceptibility of EC (OR=0.83, 95% CI 0.70-1.00, p=0.049), while rs2274223 of PLCE1 was associated with increased 0.25-fold EC risk (OR=1.25, 95% CI 1.02-1.53, p=0.037). The „GC” genotype of rs6898743 was associated with a 0.24-fold decreased risk of EC under co-dominant model (OR=0.76, 95% CI 0.58-0.99, p=0.046), and the „GA” genotype of rs2274223 was associated with increased EC risk under co-dominant model (OR=1.36, 95% CI 1.04-1.77, p=0.023). Using GTEx database, rs2274223 was found to be significant associated with increased PLCE1 expression (p=4.1 × 10

) in esophagus muscularis. The UALCAN database demonstrated that the GHR gene was under-expressed in esophageal cancer tissues (p=0.017).

The gene GHR and PLCE1 polymorphisms are associated with EC in the general population and the results need to be verified in future.

The gene GHR and PLCE1 polymorphisms are associated with EC in the general population and the results need to be verified in future.

As a result of the pandemic of COVID-19, the public have been experiencing psychological distress. However, the prevalence of psychological distress during the COVID-19 pandemic remains unknown. Our objective was to evaluate the prevalence of psychological distress during COVID-19 outbreak and their risk factors, especially their internal paths and causality.

A nationwide cross-sectional survey of the prevalence of mental disorders was conducted. We used Hospital Anxiety and Depression Scale (HADS) to estimate the prevalence of anxiety and depression. The internal paths and the causality of the psychological health were analyzed using a structural equation modeling (SEM) approach.

A total of 24,789 respondents completed the survey. We found that the overall prevalence of anxiety, depression, combination of anxiety, and depression were 51.6% (95% CI 51.0-52.2), 47.5% (95% CI 46.9-48.1), and 24.5% (95% CI 24.0-25.0), respectively. The risk of psychological disorders in men was higher than that in women. The status of psychological health was different across different age groups, education levels, occupations, and income levels. The SEM analysis revealed that inadequate material supplies, low income, low education, lack of knowledge or confidence of the epidemic, and lack of exercise are major risk factors for psychological distress.

The evidence from this survey poses serious challenges related to the high prevalence of psychological distress, but also offers strategies to deal with the mental health problems caused by the COVID-19 pandemic.

The evidence from this survey poses serious challenges related to the high prevalence of psychological distress, but also offers strategies to deal with the mental health problems caused by the COVID-19 pandemic.

Bladder cancer (BCa) is the most common urinary malignancy. The standard surgical treatment for patients with muscle-invasive BCa is cystectomy plus urinary diversion. Ileal conduit (IC) or orthotopic neobladder (ON), which have different indications, are the most commonly performed urinary diversions.

We sampled 5480 BCa patients from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015. Kaplan-Meier method with the log-rank test was used to assess cancer-specific survival (CSS) and overall survival (OS). Univariate and multivariate Cox’s proportional hazard model was conducted to evaluate the hazard ratio of cancer-specific mortality and all-cause mortality before and after propensity score matching (PSM).

We identified 5480 patients who received radical cystectomy (RC) plus IC (n=5071) or ON (n=409) with a median follow-up period of 33months (interquartile range, 13-78months). Patients in the ON group tended to be male and younger, with a higher percentage of married individuals, early pathological T stage, lymphadenectomy, and non-radiotherapy (all P<.05). After 11 PSM, 409 matched pairs were selected. Univariate and multivariate analysis showed that the ON group had better CSS and OS probabilities than the IC group in the overall cohort [hazard ratio (HR) 0.692, 95% confidence intervals (CI) 0.576-0.831, P<.001; HR 0.677, 95% CI 0.579-0.793, P<.001 respectively]. However, subgroup analysis revealed that only patients with pathological T2 stage benefited from ON diversion after PSM in the context of CSS (P=.016) and OS (P<.001).

Young, married, and male patients with early pathological T stage, especially T2 stage, were more suitable to receive RC plus ON surgery, which could improve their probability of survival.

Young, married, and male patients with early pathological T stage, especially T2 stage, were more suitable to receive RC plus ON surgery, which could improve their probability of survival.

Few investigations have been conducted to identify genetic determinants of common, polygenetic forms of heart failure (HF), and only a limited number of these genetic associations have been validated by multiple groups.

We performed a case-control study to further investigate the potential impact of 14 previously reported candidate genes on the risk of HF and specific HF sub-types. We also performed an exploratory genome-wide study. We included 799 patients with HF and 1529 controls. After adjusting for age, sex, and genetic ancestry, we found that the C allele of rs2234962 in BAG3 was associated with a decreased risk of idiopathic dilated cardiomyopathy (odds ratio 0.42, 95% confidence interval 0.25-0.68, P=0.0005), consistent with a previous report. No association for the other primary variants or exploratory genome-wide study was found.

Our findings provide independent replication for the association between a common coding variant (rs2234962) in BAG3 and the risk of idiopathic dilated cardiomyopathy.

Our findings provide independent replication for the association between a common coding variant (rs2234962) in BAG3 and the risk of idiopathic dilated cardiomyopathy.

Maternal feeding style has been associated with childhood obesity and has been the target of numerous interventions, but few studies included fathers.

We assessed correlations and associations between maternal and paternal feeding style.

We examined 202 mothers, fathers, and infants in Nurture, a racially diverse US cohort (2013-2017). Mothers and fathers completed the Infant Feeding Style Questionnaire when infants were 6 and 12 months. We examined unadjusted correlations using Spearman’s Rho and adjusted associations using linear regressions.

All feeding styles were significantly correlated. After adjustment, maternal feeding style was associated with paternal feeding style at 6 and 12 months for responsive (ß 0.31; CI 0.18, 0.45; P ≤ 0.0001 and ß 0.67; CI 0.50, 0.84; P ≤ 0.0001), restrictive (ß 0.24; CI 0.09, 0.38; P = 0.001 and ß 0.44; CI 0.29, 0.59; P ≤ 0.0001), pressuring (ß 0.46; CI 0.34, 0.58; P ≤ 0.0001 and ß 0.51; CI 0.38, 065; P ≤ 0.0001), indulgent (ß 0.36; CI 0.20, 0.52; P ≤ 0.0001 and ß 0.57; CI 0.40, 0.73; P ≤ 0.0001), and laissez-faire (ß 0.39; CI 0.24, 0.55; P ≤ 0.0001 and ß 0.55; CI 0.37, 0.72; P ≤ 0.0001).

Maternal and paternal feeding styles were correlated. Associations held after adjustment, suggesting that mothers and fathers are in relative agreement in their reporting.

Maternal and paternal feeding styles were correlated. Associations held after adjustment, suggesting that mothers and fathers are in relative agreement in their reporting.

The process indicators of ending the HIV epidemic include 90% of people living with HIV receiving antiretroviral therapy (ART). The population of youth, however, has less access to healthcare. We assessed ART initiation and attrition outcomes of the HIV continuum from HIV diagnosis to ART initiation in youth living with HIV (YLHIV) and factors associated with ART initiation.

We studied YLHIV aged 15 to 24years who were registered on the National AIDS Program (NAP) from January 2008 to May 2019. The study period was divided into 2008 to 2013 (initiated ART by CD4-guided criteria) and 2014 to 2018 (initiate ART at any CD4). Date of registration was used as a surrogate for the diagnosis date and defined as the baseline. The database included ART prescription and laboratory results, and the vital status was linked daily with the National Death Registry. Competing risk methods were used to assess factors associated with accessing ART, with loss to follow-up (LTFU) and death considered as competing events. Logi4 level, 83% of YLHIV registered on the Thai National AIDS Program initiated ART. The majority initiated within one month of registration.

In the era of universal treatment of all at any CD4 level, 83% of YLHIV registered on the Thai National AIDS Program initiated ART. The majority initiated within one month of registration.

RasGTPases are master regulators of multiple intracellular signaling cascades. Perturbation of this pathway has been implicated in the pathogenesis of rheumatoid arthritis (RA). In this study we aimed to define the therapeutic potential of a novel RasGTPases inhibitor, farnesylthiosalicylate (FTS), in the preclinical mouse model of collagen-induced arthritis (CIA) and better delineate its immunomodulatory effects both ex vivo and in the mouse.

We analyzed in vitro the immunomodulatory effects of FTS on various CD4

T-cell functions such as activation, proliferation, T-helper polarization, and production of proinflammatory cytokines. Using the CIA model, we further determined the efficacy of FTS to inhibit clinical, histopathologic, and diverse immunological outcomes of arthritis.

FTS treatment of CD4

T cells in vitro effectively targeted distinct kinases (extracellular signal-regulated kinase 1/2, p38, protein kinase B/AKT, and mammalian target of rapamycin), the production of interleukin (IL)-17A, I cells and is a potent immunomodulatory compound in the CIA model, primarily targeting the generation of autoreactive Th17 cells and the production of autoantibodies and their subsequent pathogenic hyposialylation.Rhabdomyosarcoma of the extremities present with two main challenges correct evaluation of initial regional nodal involvement and define adequate local treatment.

Pediatric patients with localized rhabdomyosarcoma of the extremity included in the EpSSG-RMS2005 study between 2005 and 2014 were evaluated for staging, treatment, and survival. The outcome was compared to the preceding European SIOP-MMT studies.

Of the 162 patients included, histology was unfavorable in 113 (70%), 124 (77%) were younger than 10years, 128 (79%) were IRS III, and 47 (29%) were node-positive. A regional node biopsy was performed in 97 patients (60%) and modified the lymph node stage in 15/97 (16%). Primary and delayed surgery was performed in 155 (96%) and radiotherapy delivered in 118 (73%) patients. Relapse occurred in 61 cases (38%), local in 14 (23%), regional in 13 (21%), distant in 22 (36%), and combined relapse in 12 (20%) with five progressive diseases (8%) and four secondary tumors (7%). Five-year event free (EFS) and overall survival (OS) were 58.