Finger dexterity in well-functioning cohort of office workers in Macau

AimThe study aimed to describe the finger dexterity in office workers of an Asian population.MethodsOne hundred twenty-seven right-handed office workers, aged 21–50 with a similar split of male and female, were recruited with finger dexterity measured by the O’Connor Finger Dexterity Test. The grip strength, tip and lateral pinch strength of both hands were also measured.ResultsThis study provided the percentile score of the O’Connor Finger Dexterity Test of both males and females in the Asian population. Raw scores of below 218 and 213 seconds in male and female participants respectively reach the 90th percentile, and above 237 and 235 seconds in male and female below the 10th percentile. Results showed no significant difference in local mean scores across different age groups, between male and female and with varying hours of working in typing, filing, and writing. A significant difference was only found in finger dexterity and years of working as office workers. No significant correlation was found between the finger dexterity with grip strength, tip and lateral pinch of the dominant right hand. The results were similar to the original normative score with similar work skills and demands.ConclusionThe mean scores could be used as a valid reference for local occupational therapists to evaluate the finger dexterity of office workers. However, caution has to be taken that conclusions drawn can be biased because of the relatively small sample size, and the results cannot be generalized to represent a wider Asian population.     

Detection of New H5N1 High Pathogenicity Avian Influenza Viruses in Winter 2021–2022 in the Far East,Which Are Genetically Close to Those in Europe

Many high pathogenicity avian influenza (HPAI) cases in wild birds due to H5N1 HPAI virus (HPAIV) infection were reported in northern Japan in the winter of 2021–2022. To investigate the epidemiology of HPAIVs brought to Japan from surrounding areas, a genetic analysis of H5 HPAIVs isolated in northern Japan was performed, and the pathogenicity of the HPAIV in chickens was assessed by experimental infection. Based on the genetic analysis of the hemagglutinin gene, pathogenic viruses detected in northern Japan as well as one in Sakhalin, the eastern part of Russia, were classified into the same subgroup as viruses prevalent in Europe in the same season but distinct from those circulating in Asia in winter 2020–2021. High identities of all eight segment sequences of A/crow/Hokkaido/0103B065/2022 (H5N1) (Crow/Hok), the representative isolates in northern Japan in 2022, to European isolates in the same season could also certify the unlikeliness of causing gene reassortment between H5 HPAIVs and viruses locally circulating in Asia. According to intranasal challenge results in six-week-old chickens, 50% of the chicken-lethal dose of Crow/Hok was calculated as 10^4.5 times of the 50% egg-infectious dose. These results demonstrated that the currently prevalent H5 HPAIVs could spread widely from certain origins throughout the Eurasian continent, including Europe and the Far East, and implied a possibility that contagious viruses are gathered in lakes in the northern territory via bird migration. Active monitoring of wild birds at the global level is essential to estimate the geographical source and spread dynamics of HPAIVs.     

Targeting EGFR with photodynamic therapy in combination with Erbitux enhances in vivo bladder tumor response

Background

Renal cell carcinoma (RCC) is histopathologically heterogeneous with clear cell and papillary the most common subtypes. The most frequent molecular abnormality in clear cell RCC is VHL inactivation but promoter methylation of tumour suppressor genes is common in both subtypes of RCC. To investigate whether RCC CpG methylation status was influenced by histopathology and VHL status we performed high-throughput epigenetic profiling using the Illumina Goldengate Methylation Array in 62 RCC (29 RCC from von Hippel-Lindau (VHL) disease patients, 20 sporadic clear cell RCC with wild type VHL and 13 sporadic papillary RCC).

Results

43 genes were methylated in >20% of primary RCC (range 20–45%) and most (37/43) of these had not been reported previously to be methylated in RCC. The distribution of the number of methylated CpGs in individual tumours differed from the expected Poisson distribution (p < 0.00001; log-likelihood G test) suggesting that a subset of RCC displayed a CpG Island Methylator Phenotype. Comparison of RCC subtypes revealed that, on average, tumour specific CpG methylation was most prevalent in papillary RCC and least in VHL RCC. Many of the genes preferentially methylated in pRCC were linked to TGFβ or ERK/Akt signalling.

Conclusion

These findings demonstrate differing patterns of tumour-specific CpG methylation in VHL and non VHL clear cell RCC and papillary RCC, and identify multiple novel potential CpG methylation biomarkers for RCC.     

Does the MONARC transobturator suburethral sling cause post-operative voiding dysfunction? A prospective study

The aim of this study was to compare pre-operative and post-operative voiding parameters following insertion of the MONARC transobturator tape (TOT), for treating women with urodynamic stress incontinence. This prospective observational study was conducted at a tertiary referral urogynaecology unit, in North Queensland, involving 83 women who were prospectively assessed pre-operatively and at 6–8 weeks following the procedure. Information collected included patient demographics, concomitant surgery, pre-operative and post-operative symptomatology (using validated questionnaires), and pre-operative and post-operative urodynamic parameters. Parameters used to assess voiding function included symptoms of voiding difficulty (incomplete emptying and irritative symptoms) as well as objective parameters including maximum flow rate (Q_max), adjusted maximum flow rate (Q_maxadj) using the Liverpool nomogram (LN), maximal urethral pressure, and post-void residual (PVR). Pre-operative average Q_max was 23.7 ml/s compared to 21.1 ml/s post-operatively (p=0.064). When the Q_max was adjusted for voided volume using the LN, Q_maxadj was seen to decrease significantly from 26 ml/s to 18 ml/s (p<0.05). Women with PVR>50 ml did not differ significantly pre-operatively and post-operatively, 5/83(6%) vs 7/83 (8.4%) (p=0.75). The number of women with a flow rate <10th centile on LN was 22 (26.5%) pre-operatively vs 29 (34.9%) post-operatively (p=0.21). One (1.2%) post-operatively had voiding dysfunction diagnosed by an abnormal voiding pattern (p=0.728), which was not statistically significant. Objective voiding dysfunction as determined by adjusted flow rates <10th centile LN and >50 ml PVR was seen in four women (4.8%). Adjusted free flow rates are significantly reduced following insertion of the MONARC TOT, as are some symptoms related to voiding dysfunction. Despite this, satisfaction rates remain high with observed voiding dysfunction or objective measures of voiding dysfunction showing no statistical change in the short term. Long-term follow-up is planned at 1 year.     

升麻酰胺及其类似物的合成

升麻酰胺是从兴安升麻(Cimicifuga dahurica)根茎中分到的新天然产物,本文经7步反应完成了该化合物的全合成,总收率为31%,三氟乙酰氧基用作C-1的离去基团,其结构经光谱分析和元素分析证实与天然物相一致。此外,还报道其7个类似物的合成及初步的抗肿瘤活性实验结果。     

Effets tardifs de la radiothérapie chez l'enfant

Although most pediatrie tumors can be cured with lower doses of radiation than their adult counterparts, long-term radiation-induced complications and sequelae remain a major concern both in terms of frequency and intensity. Most of them have been extensively documented in the pre-chemotherapeutic era like those affecting bone, cartilage and soft tissue growth or CMS and endocrine glands. More recently the emphasis has been put on the apparent increasing incidence of reported second malignancies. This could have been favored by the chemo-radiation combinations used in most children but also has been made possible mainly by the extensive follow-up of the increasing cohort of cured children.     

Typhoid in Kenya Is Associated with a Dominant Multidrug-Resistant Salmonella enterica Serovar Typhi Haplotype That Is Also Widespread in Southeast Asia

In sub-Saharan Africa, the burden of typhoid fever, caused by Salmonella enterica serovar Typhi, remains largely unknown, in part because of a lack of blood or bone marrow culture facilities. We characterized a total of 323 S. Typhi isolates from outbreaks in Kenya over the period 1988 to 2008 for antimicrobial susceptibilities and phylogenetic relationships using single-nucleotide polymorphism (SNP) analysis. There was a dramatic increase in the number and percentage of multidrug-resistant (MDR) S. Typhi isolates over the study period. Overall, only 54 (16.7%) S. Typhi isolates were fully sensitive, while the majority, 195 (60.4%), were multiply resistant to most commonly available drugs—ampicillin, chloramphenicol, tetracycline, and cotrimoxazole; 74 (22.9%) isolates were resistant to a single antimicrobial, usually ampicillin, cotrimoxazole, or tetracycline. Resistance to these antibiotics was encoded on self-transferrable IncHI1 plasmids of the ST6 sequence type. Of the 94 representative S. Typhi isolates selected for genome-wide haplotype analysis, sensitive isolates fell into several phylogenetically different groups, whereas MDR isolates all belonged to a single haplotype, H58, associated with MDR and decreased ciprofloxacin susceptibility, which is also dominant in many parts of Southeast Asia. Derivatives of the same S. Typhi lineage, H58, are responsible for multidrug resistance in Kenya and parts of Southeast Asia, suggesting intercontinental spread of a single MDR clone. Given the emergence of this aggressive MDR haplotype, careful selection and monitoring of antibiotic usage will be required in Kenya, and potentially other regions of sub-Saharan Africa.Typhoid fever, caused by Salmonella enterica serovar Typhi, is an important disease in many developing countries. It is estimated that there are approximately 22 million typhoid cases and ∼200,000 deaths per year worldwide (10). However, the true global distribution of typhoid fever is not well documented. For example, in Africa the overall burden of typhoid fever remains largely unknown, mainly because facilities capable of performing the blood culture tests essential for diagnosis are absent from many regions. Some local estimates of typhoid incidences in different African regions have been made. Typhoid incidence rates of 39/100,000 and 59/100,000 have been reported for Kenya/East Africa and Egypt, respectively (10, 28), but these figures may be underestimates due to underreporting, as only severely ill patients seek treatment in hospitals. In other studies, Weeramanthri et al. (30) observed that over a 5-year period typhoid remained a common cause of septicemic illness in The Gambia, while in Nigeria (2) and Ghana (5), cases of ileal perforation due to typhoid were documented.Problems are also emerging with the clinical treatment of typhoid in resource-poor settings. For many years, the antibiotics chloramphenicol, ampicillin, and cotrimoxazole formed the mainstays of typhoid treatment. However, outbreaks of multidrug-resistant (MDR) S. Typhi (20, 24, 25) prompted the widespread use of fluoroquinolones, such as ciprofloxacin and ofloxacin. Fluoroquinolone usage was followed by the emergence of nalidixic acid-resistant S. Typhi exhibiting reduced susceptibility to fluoroquinolones in the early 1990s (18, 22), and it has since become widespread (1, 12, 16, 19, 25). Thus, the spread of MDR and fluoroquinolone resistance in S. Typhi presents significant clinical challenges.Better methods for monitoring the emergence and spread of MDR S. Typhi would facilitate disease control and treatment. However, this monophyletic (clonal) pathogen presents particular challenges in this regard. Studies on the population structure of S. Typhi have shown that this human-adapted pathogen exhibits extremely limited genetic variation, challenging our ability to develop discriminatory tools of value in the field (3, 11, 25, 27). However, the application of novel deep-sequencing and bioinformatics approaches has succeeded in stratifying the S. Typhi population into distinct phylogenetic lineages based on over 1,000 single-nucleotide polymorphisms (SNPs) distributed throughout the chromosome. Typing of these chromosomal SNPs allows isolates from typhoid patients to be mapped to specific points on the phylogenetic tree of S. Typhi (11, 27). This provides an unequivocal test of the genetic relatedness of multiple S. Typhi isolates, which can be inferred from their relative positions in the phylogenetic tree. In particular, isolates sharing identical haplotypes, mapping to the leaf nodes of the S. Typhi phylogenetic tree, are deemed to be very closely related even if they are isolated in widely different geographical locations.In Kenya, MDR S. Typhi isolates from adults and school age children associated with sporadic outbreaks in resource-poor settings, especially in slum areas, have been reported (13, 15). Here, we analyzed a collection of 323 S. Typhi isolates from three hospitals in Nairobi, Kenya, between 1988 and 2008 for their population structure. We used a novel SNP-typing method capable of simultaneously interrogating ∼1,500 points of potential variation on the S. Typhi genome in a single DNA sample. Using this powerful high-throughput approach, we show that a particular MDR-associated haplotype, H58, previously shown to be widespread in several countries in Asia, has become dominant in Kenya, replacing more divergent antimicrobial-susceptible S. Typhi strains.     

微波和磁疗治疗膝关节骨性关节炎300例

1临床资料①对象:本组骨性关节炎患者300(男130,女170)例,年龄36～78(56±1.0)岁,病程1 mo～10 a,其中左膝120例,右膝112例,双膝68例.临床表现为关节疼痛、僵直、活动受限,偶尔会关节肿胀、关节腔积液.X线表现为关节间隙变窄,关节软骨下骨质致密,骨密度增高,骨小梁有断裂,髁间嵴变尖及髌骨后缘和外侧缘增生形成骨刺[1].