Professional Steps: The Certification Path

Obtaining certification is a critical step on the road to professionalism. There are many questions to consider in this decision. Included among these are cost, preparation, and return on the investment. Important answers to these questions are discussed.     

New approaches to moderate CRISPR-Cas9 activity: Addressing issues of cellular uptake and endosomal escape

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A candidate multi-epitope vaccine against porcine reproductive and respiratory syndrome virus and Mycoplasma hyopneumoniae induces robust humoral and cellular response in mice

Porcine reproductive and respiratory syndrome virus (PRRSV) and Mycoplasma hyopneumoniae (M. hyopneumoniae, Mhp) are two of the most common pathogens involved in the porcine respiratory disease complex (PRDC) resulting in significant economic losses worldwide. Vaccination is the most effective approach to disease prevention. Since PRRSV and Mhp co-infections are very common, an efficient dual vaccine against these pathogens is required for the global swine industry. Compared with traditional vaccines, multi-epitope vaccines have several advantages, they are comparatively easy to produce and construct, are chemically stable, and do not have an infectious potential. In this study, to develop a safe and effective vaccine, B cell and T cell epitopes of PRRSV-GP5, PRRSV-M, Mhp-P46, and Mhp-P65 protein had been screened to construct a recombinant epitope protein rEP-PM that has good hydrophilicity, strong antigenicity, and high surface accessibility, and each epitope is independent and complete. After immunization in mice, rEP-PM could induce the production of high levels of antibodies, and it had good immunoreactivity with anti-rEP-PM, anti-PRRSV, and anti-Mhp antibodies. The anti-rEP-PM antibody specifically recognizes proteins from PRRSV and Mhp. Moreover, rEP-PM induced a Th1-dominant cellular immune response in mice. Our results showed that the rEP-PM protein could be a potential candidate for the development of a safe and effective multi-epitope peptide combined vaccine to control PRRSV and Mhp infections.     

Comparison of quantitative susceptibility mapping methods on evaluating radiation-induced cerebral microbleeds and basal ganglia at 3T and 7T

Quantitative susceptibility mapping (QSM) has the potential for being a biomarker for various diseases because of its ability to measure tissue susceptibility related to iron deposition, myelin, and hemorrhage from the phase signal of a T₂*-weighted MRI. Despite its promise as a quantitative marker, QSM is faced with many challenges, including its dependence on preprocessing of the raw phase data, the relatively weak tissue signal, and the inherently ill posed relationship between the magnetic dipole and measured phase. The goal of this study was to evaluate the effects of background field removal and dipole inversion algorithms on noise characteristics, image uniformity, and structural contrast for cerebral microbleed (CMB) quantification at both 3T and 7T. We selected four widely used background phase removal and five dipole field inversion algorithms for QSM and applied them to volunteers and patients with CMBs, who were scanned at two different field strengths, with ground truth QSM reference calculated using multiple orientation scans. 7T MRI provided QSM images with lower noise than did 3T MRI. QSIP and VSHARP + iLSQR achieved the highest white matter homogeneity and vein contrast, with QSIP also providing the highest CMB contrast. Compared with ground truth COSMOS QSM images, overall good correlations between susceptibility values of dipole inversion algorithms and the COSMOS reference were observed in basal ganglia regions, with VSHARP + iLSQR achieving the susceptibility values most similar to COSMOS across all regions. This study can provide guidance for selecting the most appropriate QSM processing pipeline based on the application of interest and scanner field strength.     

心源性脑卒中患者血栓弹力图检测与抗凝因子蛋白S、蛋白C的相关性研究

目的:探讨心源性脑卒中(CES)患者血栓弹力图检测与抗凝因子蛋白S、蛋白C的相关性。方法:选取2018年9月~2020年6月入院治疗的CES患者86例纳入CES组,同时选取同期健康体检者40例纳入健康组。检测两组TEG及抗凝因子蛋白S、蛋白C水平,对不同神经功能损伤严重程度及不同预后患者上述参数进行比较,分析TEG与蛋白S、蛋白C的相关性。结果:与健康组相比,CES组R值、K值、蛋白S、蛋白C水平明显降低,α值、MA值明显增高(P<0.05);随着病情严重程度升高,患者R值、K值、蛋白S、蛋白C水平明显降低,α值、MA值明显升高(P<0.05)。预后良好组R值、K值、蛋白S、蛋白C水平明显高于预后不良组,α值、MA值明显低于预后不良组(P<0.05);CES患者蛋白S及蛋白C水平与R值、K值呈正相关,与MA值呈负相关(P<0.05)。结论:CES患者TEG部分参数与抗凝因子蛋白S、蛋白C存在相关性,临床可以两种指标相互补充,增强患者凝血功能功能监测效果。     

Method’s corner: Allergist’s guide to network meta-analysis

Network meta-analyses (NMAs) simultaneously estimate the effects of multiple possible treatment options for a given clinical presentation. For allergists to benefit optimally from NMAs, they must understand the process and be able to interpret the results. Through a worked example published in Pediatric Allergy and Immunology, we summarize how to identify credible NMAs and interpret them with a focus on recent innovations in the GRADE approach (Grading of Recommendations Assessment, Development, and Evaluation). NMAs build on traditional systematic reviews and meta-analyses that consider only direct paired comparisons by including indirect evidence, thus allowing the simultaneous assessment of the relative effect of all pairs of competing alternatives. Our framework informs clinicians of how to identify credible NMAs and address the certainty of the evidence. Trustworthy NMAs fill a critical gap in providing key inferences using direct and indirect evidence to inform clinical decision making when faced with more than two competing courses of treatment options. This document will help allergists to identify trustworthy NMAs to enhance patient care.     

3D打印骨折模型在复杂骨盆骨折手术中的治疗方法及效果探讨

目的:探讨复杂骨盆骨折手术治疗中3D打印骨折模型的应用方法及效果。方法:选取医院收治的60例复杂骨盆骨折患者,按照随机数表法将其分为对照组和观察组,每组30例。对照组行传统CT指导下手术治疗,观察组行3D打印仿真骨盆模型体外模拟术后,应用腹直肌旁切口钢板内固定术治疗。比较两组手术时间、住院时间和骨折愈合时间,以及术中出血量、并发症发生率和骨盆功能恢复优良率。结果:观察组手术时间、住院时间及骨折愈合时间短于对照组,术中出血量少于对照组,差异有统计学意义(t=2.721,t=2.458,t=2.791,t=4.450;P<0.05);观察组和对照组并发症发生率分别为3.33%和10.00%,差异无统计学意义(x²=0.267,P>0.05);观察组和对照组骨盆功能恢复优良率分别为96.67%和73.33%,观察组明显高于对照组,差异有统计学意义(x²=4.705,P<0.05)。结论:复杂骨盆骨折手术中应用3D打印骨折模型可缩短手术时间、住院时间,减少出血量,促进骨折愈合,可改善骨盆功能且并发症少。     

基于网络药理学研究黄连解毒汤抗幽门螺杆菌感染作用机制

目的运用网络药理学方法预测黄连解毒汤抗Hp感染的主要有效成分、靶点及信号通路,挖掘其潜在作用机制,为后续实验研究提供依据。方法应用TCMSP筛选黄连解毒汤中黄连、黄芩、黄柏、栀子4味中药的主要有效成分及其潜在作用靶点。通过GeneCards数据库和人类孟德尔遗传数据库(OMIM)筛选Hp感染相关靶点,并取药物和疾病的交集靶点。将交集靶点导入Cytoscape 3.7.2构建有效成分和Hp感染相关靶点网络,并进行拓扑学分析。应用STRING在线分析平台构建靶蛋白相互作用(PPI)网络并进行分析。运用R语言在线检索Bioconductor平台对靶点进行GO功能富集;通过DAVID数据库对靶点进行KEGG通路富集分析。结果黄连解毒汤中共筛选出85个有效成分,主要包括槲皮素、小檗碱、山柰酚、汉黄芩素、黄芩素等。对应靶点112个,疾病相关靶点1960个,药物疾病共同靶点71个。网络中度值最高的有效成分为槲皮素,度值最高的靶点为环加氧酶1(PTGS1)。PPI网络中69个节点中度值较高的靶蛋白包括半胱氨酸蛋白酶3(CASP3)、IL6、MAPK8、原癌基因(MYC)、VEGFA、表皮生长因子受体(EGFR)等。GO功能富集分析共获得89个条目,KEGG通路富集分析共筛选12条存在显著差异的信号通路,其中发挥主要作用的有癌症通路、ErbB信号通路、p53信号通路、凋亡、黏附斑等。结论黄连解毒汤可通过多成分、多靶点、多通路发挥对Hp的治疗作用,可通过抗肿瘤机制调控胃癌进程,本研究可为其有效成分研究和抗Hp机制研究提供依据。     

儿童腹型过敏性紫癜不同中医证候临床及尿液蛋白质组学差异比较＊

目的 探讨儿童腹型过敏性紫癜（AHSP）不同中医证候的临床及尿液蛋白特征。方法 按照诊断及纳入、排除标准，收集AHSP不同中医证候患儿的临床信息及尿样进行分析，并通过尿液蛋白质组质谱分析，筛选及比较AHSP不同证候的尿液差异蛋白。结果 AHSP不同证候临床特征显示，皮肤紫癜首发者风热伤络证最多，湿毒内蕴证次之；皮肤紫癜伴腹痛症状首发者仅在脾虚不摄证中出现。不同证候间实验室指标未出现统计学差异。通过DDA及DIA定量方法，在不同证候间筛选出21个证候差异蛋白，其中风热伤络、湿毒内蕴证间2个，风热伤络、脾虚不摄证间3个，湿毒内蕴、脾虚不摄证间16个；经OPLS-DA分析筛选出10个差异蛋白，包括ALDOB、Glyc、GSTA2、GPDA、GAPDH、CRYL1、AK1A1、VMO1、Cat S、DHPR。结论 AHSP不同证候间临床及尿液蛋白存在差异，这些差异可为腹型过敏性紫癜的证候诊断提供一定的帮助。