BACKGROUND & AIMS: :Extensive laboratory testing is often performed in the emergency department evaluation of the new-onset seizure patient. To determine the utility of such testing, a prospective study of patients with a new-onset seizure presenting to the ED of an inner-city, university-affiliated teaching hospital was done. One hundred thirty-six patients were entered into the study between October 1984 and January 1988. All patients had uniform data collection performed. Pertinent historical information and physical examination findings were recorded on a standardized form before laboratory abnormality was a sole or contributory cause of the seizure disorder. These included four patients with hypoglycemia, four with hyperglycemia, two with hypocalcemia, and one with hypomagnesemia. Only two cases (hypoglycemia) were not suspected on the basis of findings on the history or physical examination. In ED patients, the incidence of a new-onset seizure due to a correctable metabolic disturbance is low. We conclude that, with the exception of the serum glucose, the extensive ED laboratory workup often done for the evaluation of a new-onset seizure is unnecessary. Further test ordering should be directed by the medical history and physical examination.

背景与目标： ：急诊科通常会对新发作的癫痫患者进行广泛的实验室检查。为了确定此类测试的实用性，对在市内大学附属教学医院急诊室就诊的新发癫痫患者进行了一项前瞻性研究。在1984年10月至1988年1月之间，共有136例患者进入研究。所有患者均进行了统一的数据收集。在实验室异常是癫痫发作的唯一或共同原因之前，以标准化的形式记录相关的历史信息和体格检查结果。这些患者包括四名低血糖患者，四名高血糖患者，两名低钙血症患者和一名低镁血症患者。根据病史或体格检查的结果，仅怀疑2例（低血糖）。在ED患者中，由于可纠正的代谢紊乱引起的新发作癫痫发作的发生率较低。我们得出的结论是，除血清葡萄糖外，不必要进行广泛的ED实验室检查以评估新发癫痫发作。进一步的测试顺序应由病史和体格检查指示。

BACKGROUND & AIMS: BACKGROUND AND OBJECTIVES:Spine surgery frequently needs allogeneic blood transfusions to compensate for great blood loss. Autologous blood donations often are indicated to reduce homologous transfusions. In last decades interbody spinal fusion has gained popularity, being frequently performed in many spine procedures. Nevertheless, there are few studies evaluating the risk factors of additional blood transfusions in the postoperative course of degenerative spine surgery and no one concerning patients who underwent interbody fusion. MATERIALS AND METHODS:In 15 consecutive months, in the same Department of Spine Surgery 40 different elective spine surgeries were performed, divided into four groups: laminectomy alone, laminectomy with an instrumented posterolateral fusion, laminectomy with an instrumented posterolateral and interbody fusion, extensive instrumented fusion. All patients surgery-related data were respectively recorded: patient age, gender, diagnosis, preoperative hemoglobin rate, autologous blood availability, number of spinal level decompressed and fused, duration of surgery, type of surgical procedure, duration of hospital stay. These data were statistically analysed to determine whether variables could determine higher risk of blood transfusion. RESULTS:In an univariate analysis of factors influencing the need of blood transfusion, significantly greater risk of blood transfusions was observed in the female, in case of low preoperative Hb rate, longer surgical times, multiple spinal level decompressed or fused and longer duration of hospital stay. Our linear multiple regression modeling showed that patients gender and increased number of levels decompressed and levels surgically fused were significant determinants of need of blood transfusion. CONCLUSIONS:The practical value of this work can be particularly appreciated by those who are used to consider blood predonation. According to our findings blood predonation should preferably be proposed to women supposed to undergo spine instrumented fusion or a more than three levels spine decompression.

背景与目标： 背景与目的：脊柱外科手术经常需要进行同种异体输血，以弥补大量失血。自体献血通常被指示为减少同源输血。在最近的几十年中，椎间融合术已经普及，在许多脊柱手术中经常进行。然而，很少有研究评估变性脊柱手术术后额外输血的危险因素，并且没有人涉及接受椎间融合的患者。
材料与方法：连续15个月，在同一脊柱外科进行了40次不同的选择性脊柱外科手术，分为四组：单独的椎板切除术，经器械后外侧融合的椎板切除术，经器械后外侧和椎间融合的椎板切除术，广泛的器械融合。记录所有患者与手术有关的数据：患者年龄，性别，诊断，术前血红蛋白率，自体血液可用性，脊柱减压和融合术的次数，手术时间，手术程序类型，住院时间。对这些数据进行统计分析，以确定变量是否可以确定较高的输血风险。
结果：对影响输血需求的因素进行单因素分析，发现女性术前血红蛋白率低，手术时间较长，多处脊柱减压或融合以及住院时间较长的情况下，女性输血的风险明显增加。停留。我们的线性多元回归模型显示，患者的性别和减压水平的增加数量以及手术融合的水平是需要输血的重要决定因素。
结论：那些习惯于考虑血液捐赠的人特别赞赏这项工作的实用价值。根据我们的发现，应该对应该进行脊柱器械融合术或三级以上脊柱减压的女性建议进行血液捐血。

BACKGROUND & AIMS: Objective:To estimate the cumulative incidence of persistent arthralgia at 6 months from acute Chikungunya virus (CHIKV) infection and to evaluate the association of clinical markers with the risk of long-term arthralgia. Methods:This multicenter retrospective cohort study was conducted in the Mexican state of Colima. A total of 136 individuals aged 15 years and older with serologically confirmed CHIKV infection were enrolled. Participants were interviewed at 6 months from the onset of symptoms, and self-reported persistent arthralgia (PA) was the main binary outcome. A self-report numeric rating scale (NRS) ranging from 0 to 10 was used to estimate the severity of articular pain. Results:The cumulative incidence of PA was 41.9%. Severe pain (NRS ≥ 7) presented in 36.8% of participants with PA. In multiple analysis, individuals aged 40 years and older (risk ratio (RR) = 1.60; 95% confidence interval (CI), 1.03-2.48) and those with articular pain at 3 months post-infection (RR = 3.95; 95% CI, 1.95-8.01) had a significantly increased risk of PA at 6 months from CHIKV infection. Conclusions:To the best of our knowledge, this is first report of a CHIKV-associated long-term outcome in Mexico, where the incidence of the infection has been high. This is also the first study in Latin America evaluating several factors associated with the risk of PA. Our findings may be useful in health care settings to stratify the risk of chronic arthralgia secondary to CHIKV infection and to identify patients who would benefit clinically from early medical intervention.

背景与目标： 目的：评估急性基孔肯雅病毒（CHIKV）感染六个月后持续性关节痛的累积发生率，并评估临床标志物与长期关节痛风险之间的关系。
方法：这项多中心回顾性队列研究在墨西哥科利马州进行。共有136位年龄在15岁及以上且经血清学证实为CHIKV感染的患者入组。从出现症状开始的六个月就对参与者进行了采访，自我报告的持续性关节痛（PA）是主要的二元结局指标。使用自我报告的数字评分量表（NRS），范围从0到10，以评估关节痛的严重程度。
结果：PA的累积发生率为41.9％。严重疼痛（NRS≥7）在PA参与者中占36.8％。在多重分析中，年龄在40岁以上（风险比（RR）= 1.60； 95％置信区间（CI），1.03-2.48）以及感染后3个月时出现关节痛的患者（RR = 3.95； 95％CI） ，1.95-8.01）在CHIKV感染后6个月时患PA的风险显着增加。
结论：据我们所知，这是墨西哥CHIKV相关的长期结局的首次报道，该国的感染发生率很高。这也是拉丁美洲首次评估与PA风险相关的几个因素的研究。我们的发现可能在医疗机构中有用，以对继发于CHIKV感染的慢性关节痛的风险进行分层，并确定可从早期医疗干预中受益的患者。

BACKGROUND & AIMS: BACKGROUND:Laboratory animal workers are at high risk of developing occupational allergy. Little is known about the relationship between levels of exposure and the risk of developing laboratory animal allergy. Since laboratory animal work comprises a large number of different-often short lasting-tasks, it is of interest to assess which activities are associated with high, low or intermediate levels of allergen exposure. OBJECTIVE:To develop and evaluate highly sensitive immunoassays in order to quantify rat and mouse urinary allergens in airborne dust sampled during short-lasting tasks. METHODS:Personal air dust samples were taken during full-shift periods as well as during specific tasks in seven laboratory animal facilities. Two sandwich enzyme immunoassays were developed, using rabbit antisera against rat and mouse urinary proteins. The rabbit antibodies were analysed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting and compared with IgE antibodies from sensitized laboratory animal workers. RESULTS:The rabbit antibodies were highly specific for rat and mouse urinary proteins and reacted with all IgE-binding allergens in either urinary protein preparation. The assays for rat and mouse urine were very sensitive, with detection limits of 0.075 ng/mL. The coefficient of variation of the analysis was 12.9% for both assays. Animal caretakers appeared to experience the highest exposure to aeroallergens. A large variation in exposure within jobs was found, due to differences between tasks performed during the sampling day and the facility worked at. The highest exposure levels were found during removal of contaminated bedding from the cages. However, rat and mouse allergen exposure levels during this task varied enormously between facilities, 1.1-158 ng eq/m3 and 0.63-2000 ng eq/m3, respectively. CONCLUSION:Both sandwich immunoassays are highly specific and sensitive and are able to identity tasks of relatively short duration with high, medium and low exposure to airborne rat and mouse urinary allergens.

背景与目标： 背景：实验室动物工作者有发展职业过敏的高风险。关于暴露水平与发生实验动物过敏的风险之间的关系知之甚少。由于实验室动物工作包括大量不同的，通常是短期的任务，因此评估哪些活动与高，低或中等水平的过敏原暴露相关是很有意义的。
目的：开发和评估高度敏感的免疫分析方法，以定量在短期任务中采样的空气中粉尘中的大鼠和小鼠尿液过敏原。
方法：在全班工作期间以及在特定任务期间，在七个实验室动物设施中采集了个人空气尘埃样本。使用针对大鼠和小鼠尿蛋白的兔抗血清，开发了两种夹心酶免疫测定法。通过十二烷基硫酸钠-聚丙烯酰胺凝胶电泳（SDS-PAGE）和免疫印迹分析兔抗体，并将其与来自敏化实验动物工作者的IgE抗体进行比较。
结果：兔抗体对大鼠和小鼠的尿蛋白具有高度特异性，并与两种尿蛋白制剂中的所有IgE结合过敏原反应。大鼠和小鼠尿液的测定非常敏感，检出限为0.075 ng / mL。两种测定的分析变异系数均为12.9％。动物看护者似乎经历了最高的空气过敏原暴露。由于在采样日执行的任务与所使用的设施之间存在差异，因此发现工作中的暴露程度存在很大差异。从笼子中取出受污染的被褥时发现了最高暴露水平。但是，在此任务期间，大鼠和小鼠的过敏原暴露水平在设施之间的差异很大，分别为1.1-158 ng eq / m3和0.63-2000 ng eq / m3。
结论：这两种夹心免疫测定法都具有高度特异性和敏感性，能够识别持续时间相对较短，高，中和低暴露于机载大鼠和小鼠尿液变应原的任务。

BACKGROUND & AIMS: :One-hundred and two patients with hemophilia A, hemophilia B, or acquired antibody to factor VIII who had undergone invasive procedures were cross referenced with patients participating in an ongoing prospective natural history study of HIV-1 infection in hemophiliacs. Matching revealed that HIV-1 status was known for 83 patients (83%) who had undergone 169 procedures between July 1979 and April 1988. Invasive procedures were classified as clean in 108 patients (63.9%), clean-contaminated in 45 (26.6%), contaminated in 2 (1.2%), and infected in 14 (8.3%). Wound infection rates by HIV-1 status were as follows (95% confidence intervals): HIV+ 1.4% (0% to 5%), HIV- 0% (0% to 9%), and procedure before testing HIV+ 1.5% (0% to 6%). There were no significant differences between the wound infection rates of HIV-positive and HIV-negative hemophiliacs nor in the wound infection rate among all three subgroups of patients (p greater than 0.5, Fisher's Exact Test). We conclude that surgery in HIV-1-infected patients who have not progressed to AIDS does not entail an increased risk of postoperative wound infections.

背景与目标： ：将一百零二名接受了侵入性治疗的血友病A，血友病B或获得性VIII因子抗体的患者与参与正在进行的对血友病患者HIV-1感染的自然史研究的患者进行交叉参考。匹配显示，在1979年7月至1988年4月之间进行了169例手术的83例患者（83％）已知HIV-1状况。在108例患者（63.9％）中，侵入性程序被分类为纯净，在45例中，有26例被干净污染。 ），其中2个（1.2％）被污染，14个（8.3％）被感染。按HIV-1状况分类的伤口感染率如下（95％置信区间）：HIV 1.4％（0％至5％），HIV-0％（0％至9％）以及测试HIV 1.5％之前的程序（0 ％至6％）。 HIV阳性和HIV阴性血友病患者的伤口感染率以及所有三个亚组的伤口感染率均无显着差异（p大于0.5，Fisher精确检验）。我们得出的结论是，在尚未发展为AIDS的HIV-1感染患者中进行手术不会增加术后伤口感染的风险。

BACKGROUND & AIMS: STUDY OBJECTIVES:To determine the total number of active sleep laboratories in the United States and the number of polysomnograms conducted on a yearly basis in these laboratories. METHODS:All members of the AASM and all AASM accredited sleep laboratory directors received a questionnaire addressing their laboratory and its volume. In three states, multiple telephone calls to AASM members were used to correctly identify the absolute number of labs and their PSG volume in those states. Extrapolating from the number of labs studies identified per questionnaire relative to the correct number (per calls) in those states and, then applying this ratio to the entire US, the total number of labs and studies was determined. RESULTS:Our data suggests that there are, in the year 2001, 1,292 sleep laboratories conducting 1,165,135 polysomnograms per year. This comes to 427 PSG's/year per 100,000 population in the United States. CONCLUSIONS:These data suggest that there are a relatively large number of sleep laboratories in the US conducting a substantial number of PSG's. However, there was considerable variability in this volume between states that did not relate to known markers of healthcare utilization. These numbers have likely increased since 2001.

背景与目标： 研究目的：确定美国活跃睡眠实验室的总数以及这些实验室每年进行的多导睡眠图的数量。
方法：所有AASM成员和所有AASM认可的睡眠实验室主任均收到了一份有关其实验室及其数量的问卷。在三个州中，使用多次致电AASM成员的电话来正确标识实验室的绝对数量及其在这些州中的PSG量。从每个调查表中确定的实验室研究数量相对于这些州的正确数量（每次呼叫）进行推断，然后将该比率应用于整个美国，即可确定实验室和研究的总数。
结果：我们的数据表明，在2001年，有1,292个睡眠实验室每年进行1,165,135项睡眠监测。在美国，每10万人中有427个PSG /年。
结论：这些数据表明，美国有相对大量的睡眠实验室在进行大量的PSG。但是，与已知的医疗保健利用指标无关，各州之间的容积存在很大差异。自2001年以来，这些数字可能有所增加。

BACKGROUND & AIMS: :Various factors, including the phylogenetic distance between laboratory animals and humans, the discrepancy between current in vitro systems and the human body, and the restrictions of in silico modelling, have generated the need for new solutions to the ever-increasing worldwide dilemma of substance testing. This review provides a historical sketch on the accentuation of this dilemma, and highlights fundamental limitations to the countermeasures taken so far. It describes the potential of recently-introduced microsystems to emulate human organs in 'organ-on-a-chip' devices. Finally, it focuses on an in-depth analysis of the first devices that aimed to mimic human systemic organ interactions in 'human-on-a-chip' systems. Their potential to replace acute systemic toxicity testing in animals, and their inability to provide alternatives to repeated dose long-term testing, are discussed. Inspired by the latest discoveries in human biology, tissue engineering and micro-systems technology, this review proposes a paradigm shift to overcome the apparent challenges. A roadmap is outlined to create a new homeostatic level of biology in 'human-on-a-chip' systems in order to, in the long run, replace systemic repeated dose safety evaluation and disease modelling in animals.

背景与目标： ：各种因素，包括实验室动物与人类之间的系统发育距离，当前体外系统与人体之间的差异以及计算机模拟的局限性，都导致需要新的解决方案来应对全球范围内日益加剧的物质困境测试。这次审查提供了关于这一困境加深的历史速写，并着重指出了迄今为止采取的对策的基本局限性。它描述了最近引入的微系统在“片上器官”设备中模拟人体器官的潜力。最后，它着重于对旨在模仿“芯片上人”系统中人体系统器官相互作用的首批设备的深入分析。讨论了其替代动物急性全身毒性试验的潜力，以及它们无法提供重复剂量长期试验的替代方法。受到人类生物学，组织工程和微系统技术的最新发现的启发，本综述提出了一种范式转变，以克服这些明显的挑战。概述了一个路线图，以在“单芯片人”系统中创建新的体内稳态生物学水平，以便从长远来看取代动物的系统性重复剂量安全性评估和疾病建模。

BACKGROUND & AIMS: :Fungi produce a variety of secondary metabolites (SMs), low-molecular weight compounds associated with many potentially useful biologic activities. The examples of biotechnologically relevant fungal metabolites include penicillin, a β-lactam antibiotic, and lovastatin, a cholesterol-lowering drug. The discovery of pharmaceutical lead compounds within the microbial metabolic pools relies on the selection and biochemical characterization of promising strains. Not all SMs are produced under standard cultivation conditions, hence the uncovering of chemical potential of investigated strains often requires the use of induction strategies to awake the associated biosynthetic genes. Triggering the secondary metabolic pathways can be achieved through the variation of cultivation conditions and growth media composition. The alternative strategy is to use genetic engineering to activate the respective genomic segments, e.g. by the manipulation of regulators or chromatin-modifying enzymes. Recently, whole-genome sequencing of several fungi isolated from the Chernobyl accident area was reported by Singh et al. (Genome Announc 2017; 5:e01602-16). These strains were selected for exposure to microgravity at the International Space Station. Biochemical characterization of fungi cultivated under extreme conditions is likely to provide valuable insights into the adaptation mechanism associated with metabolism and, possibly, a catalog of novel molecules of potential pharmaceutical importance.

背景与目标： ：真菌产生多种次级代谢产物（SMs），低分子量化合物，与许多潜在有用的生物活性有关。与生物技术相关的真菌代谢物的例子包括青霉素（一种β-内酰胺抗生素）和洛伐他汀（一种降低胆固醇的药物）。在微生物代谢池中发现药物先导化合物依赖于有前途的菌株的选择和生化特性。并非所有SM都是在标准培养条件下生产的，因此要揭示被调查菌株的化学潜能，通常需要使用诱导策略来唤醒相关的生物合成基因。触发次级代谢途径可以通过改变培养条件和生长培养基组成来实现。另一种策略是使用基因工程来激活各自的基因组片段，例如通过调节剂或染色质修饰酶的操作。最近，Singh等报道了从切尔诺贝利事故地区分离出的几种真菌的全基因组测序。 （Genome Announc 2017; 5：e01602-16）。这些菌株被选择在国际空间站暴露于微重力中。在极端条件下培养的真菌的生化特性可能会提供与代谢相关的适应机制的有价值的见解，并可能提供具有潜在药物重要性的新型分子的目录。

BACKGROUND & AIMS: :Many investigators have reported that persistent low back pain may occur after posterior surgical intervention, and studies have investigated the histologic and histochemical changes in back muscle after posterior lumbar spine surgery. The purpose of the current study is to compare the pre- and postoperative cross-sectional area of the back musculature among 5 surgical groups including anterior lumbar interbody fusion, which has no direct invasion of the back musculature, using magnetic resonance imaging, and to correlate the clinical results with the degree of atrophy. The cross-sectional area of the back musculature was measured before and after surgery in T2-weighted axial magnetic resonance images using a computer-linked digitizer. The degree of atrophy (atrophy ratio) was calculated as a ratio of the postoperative cross-sectional area to the preoperative cross-sectional area. Clinical results were evaluated using the Japanese Orthopaedic Association's scores for the management of low back pain. Atrophy of the back musculature was confirmed in each group. However, no significant difference was seen in the atrophy ratio between the groups. Back musculature atrophy occurred even in anterior lumbar interbody fusion, which does not involve any direct surgery of the back muscle. A positive correlation was noted between the atrophy ratio and operation time only in posterior surgery, especially in nonfusion surgery. In conclusion, the current study suggests that a shorter operation time may minimize back muscle injury, and shows that factors inducing back musculature atrophy include not only direct invasion of the back muscle via a posterior approach, but also postoperative external fixation.

背景与目标： ：许多研究人员报告说，后路手术干预可能会导致持续的下背部疼痛，并且研究调查了后路腰椎手术后背部肌肉的组织学和组织化学变化。本研究的目的是使用磁共振成像技术比较包括前腰椎椎间融合术在内的5个手术组的前，后肌肉截面积，其中前腰椎椎间融合术不直接侵犯后肌，并进行相关分析。临床结果与萎缩程度有关。使用计算机链接的数字化仪，在T2加权的轴向磁共振图像中，在手术前后测量背部肌肉的横截面积。萎缩度（萎缩率）以术后截面积与术前截面积之比计算。使用日本骨科协会的腰背痛管理评分对临床结果进行评估。在每个组中都证实了背部肌肉的萎缩。但是，两组之间的萎缩率没有显着差异。甚至在前腰椎椎间融合术中也发生了背部肌肉萎缩，这不涉及对背部肌肉的任何直接手术。仅在后路手术中，尤其是在非融合手术中，发现萎缩率与手术时间之间存在正相关。总而言之，当前的研究表明，较短的手术时间可以最大程度地减少背部肌肉的损伤，并表明引起背部肌肉萎缩的因素不仅包括通过后路直接侵入背部肌肉，还包括术后外固定。

BACKGROUND & AIMS: :Brucella species are pathogenic agents that cause brucellosis, a debilitating zoonotic disease that affects a large variety of domesticated animals and humans. Brucella melitensis and Brucella abortus are considered major health threats because of their highly infectious nature and worldwide occurrence. The availability of the annotated genomes for these two species has allowed a comparative proteomics study of laboratory grown B. melitensis 16M and B. abortus 2308 by two-dimensional (2-D) gel electrophoresis and peptide mass fingerprinting. Computer-assisted analysis of the different 2-D gel images of strains 16M and 2308 revealed significant quantitative and qualitative differences in their protein expression patterns. Proteins involved in membrane transport, particularly the high affinity amino acids binding proteins, and those involved in Sec-dependent secretion systems related to type IV and type V secretion systems, were differentially expressed. Differential expression of these proteins may be responsible for conferring specific host preference in the two strains 2308 and 16M.

背景与目标： 布鲁氏菌属是引起布鲁氏菌病的病原体，布鲁氏菌病是一种使人畜共患的令人衰弱的人畜共患疾病，影响多种驯养的动物和人类。布鲁氏菌和流产布鲁氏菌被认为是主要的健康威胁，因为它们具有高度的传染性和在世界范围内广泛存在。这两个物种的注释基因组的可获得性允许通过二维（2-D）凝胶电泳和肽质量指纹图谱对实验室生长的B. melitensis 16M和B.abortus 2308进行蛋白质组学比较研究。对菌株16M和2308的不同2-D凝胶图像的计算机辅助分析显示，它们的蛋白质表达模式存在明显的定量和定性差异。差异表达了膜运输中涉及的蛋白质，特别是高亲和力氨基酸结合蛋白，以及涉及与IV型和V型分泌系统有关的Sec依赖性分泌系统的蛋白质。这些蛋白质的差异表达可能是在两个菌株2308和16M中赋予特定宿主偏好的原因。

BACKGROUND & AIMS: :We compared serotype distributions of Streptococcus pneumoniae isolates from patients aged <5 and o5 years with invasive pneumococcal disease in New South Wales, Australia, and antibiotic susceptibilities of isolates from the <5 years age group only, before (2002–2004) and after(2005–2009) introduction of the 7-valent pneumococcal conjugate vaccine (PCV7). Overall, there were significant decreases in the mean annual number of referred isolates (770 vs. 515) and the proportion belonging to PCV7 serotypes (74% vs. 38%), but non-PCV7 serotypes, particularly 19A, increased (5% vs. 18%). All changes were more marked in the <5 years age group.Susceptibility testing of isolates from the <5 years age group showed variation in resistance between serotypes, but significant overall increases in penicillin non-susceptibility (23% vs. 31%),ceftriaxone resistance (2% vs. 12%) and multidrug resistance (4% vs. 7%) rates ; erythromycin resistance fell (32% vs. 25%). Continued surveillance is needed to monitor changes following the introduction of 13-valent PCV in 2012.

背景与目标： ：我们比较了澳大利亚新南威尔士州<5和o5岁患有侵袭性肺炎球菌疾病的患者的肺炎链球菌分离株的血清型分布和仅<5岁年龄组的分离株的抗生素敏感性（2002-2004年之前和之后） （2005-2009）引入了7价肺炎球菌结合疫苗（PCV7）。总体而言，转介的分离株的年均数量显着减少（770比515）和属于PCV7血清型的比例（74％比38％），但非PCV7血清型，特别是19A血清型增加（5％vs。 18％）。在<5岁年龄组中所有变化均更为明显。<5岁年龄组的分离株的药敏试验显示，血清型之间的耐药性存在差异，但青霉素的非药敏性总体显着增加（23％vs. 31％），头孢曲松耐药率（2％vs. 12％）和多药耐药性（4％vs. 7％）比率；红霉素耐药性下降（32％对25％）。在2012年推出13价PCV之后，需要持续进行监测以监测变化。

BACKGROUND & AIMS: :During the production of clinical-grade retroviral vector supernatant, we noted significant differences in the lactate production and glucose consumption of various producer cell lines submitted to the National Gene Vector Laboratory (NGVL). Since differences in growth characteristics could be important in determining the optimal culture conditions for maximizing titer, we studied the growth characteristics of three commonly used packaging cell lines: PA317, PG13 and GP+envAM12. A transformed phenotype, assessed by the ability to form colonies in semisolid media, was evident in all three packaging cell lines tested. In confluent cultures, the rates of glucose consumption and lactate production (per cell per hour) were similar for the three lines tested, but the growth rate and culture density varied. PA317 and PG13 continued to expand after reaching confluence, resulting in higher cell densities and subsequent rapid depletion of glucose within the 24-hr observation period. When the cell lines were evaluated for titer optimization, the slower growing packaging cell line GP+envAM12 generally provided the highest titer after 8 hr of culture in confluent roller bottles, while most vectors introduced into PA317 and PG13 cells yielded optimal titers after 24 hr of culture. We also found that the improved titers obtained by culturing cells at 32 degrees C previously reported for PA317 cells do not apply to other packaging cell lines. In particular, PG13 rapidly lost titer when grown at the lower temperature. Our findings suggest that optimization of titer requires careful consideration of the culture conditions, which should be individualized for the vector producer cell line.

背景与目标： 在临床级逆转录病毒载体上清液的生产过程中，我们注意到提交给国家基因载体实验室（NGVL）的各种生产细胞系的乳酸生产和葡萄糖消耗存在显着差异。由于生长特性的差异对于确定最大滴度的最佳培养条件可能很重要，因此我们研究了三种常用包装细胞系的生长特性：PA317，PG13和GP envAM12。通过在半固体培养基中形成菌落的能力评估的转化表型在所有测试的三种包装细胞系中均很明显。在融合培养物中，三个试验品系的葡萄糖消耗速率和乳酸产生速率（每细胞每小时）相似，但是生长速率和培养密度不同。达到汇合后，PA317和PG13继续扩增，导致更高的细胞密度，随后在24小时观察期内葡萄糖迅速耗竭。当评估细胞系的滴度优化时，生长缓慢的包装细胞系GP envAM12通常在融合滚瓶中培养8小时后提供最高滴度，而导入PA317和PG13细胞的大多数载体在培养24小时后产生最佳滴度。我们还发现先前报道的PA317细胞通过在32摄氏度下培养细胞获得的改进的滴度不适用于其他包装细胞系。特别是，PG13在较低温度下生长时会迅速失去效价。我们的发现表明效价的优化需要仔细考虑培养条件，应针对载体生产细胞株进行个性化。

BACKGROUND & AIMS: Background:Research focused on extreme environments is often associated with difficulties in obtaining fresh plant material. Herbaria may provide great support as they house large collections of specimens from different parts of the world. Accordingly, there is also a growing interest in methods using herbarium specimens in molecular studies. Much of the literature on herbarium DNA is aimed to improve extraction and PCR amplification and is focused mostly on vascular plants. Here, I provide a brief study of DNA extraction efficiency from moss herbarium specimens, emphasizing the importance of herbaria as an invaluable source of material from hard-to-access geographical areas, such as the Antarctic region. Methods:The presented study is based on herbarium collections of 25 moss species collected in the austral polar regions between 1979 and 2013. The majority of samples were obtained using the DNeasy Plant Mini Kit (Qiagen, Hilden, Germany). The remaining, smaller part was extracted using an adapted CTAB-based approach. The performance of DNA extraction methods in terms of PCR amplification success was measured by testing several DNA fragments of various size. Furthermore, in order to estimate of DNA fragmentation level, an automated on-chip electrophoresis system was used. Results:Results reveal that DNA purity and the length of the target genetic region are the fundamental agents which drive the successful PCR reaction. Conversely, the DNA yield and specimen age seem to be less relevant. With this study, I present also an optimized CTAB-based approach which may effectively suppress inhibitors in the herbarium DNA. This method can be considered a cheaper alternative to column-based technology, particularly useful for dealing with a large number of samples. Results of this study confirmed previous reports and contribute to filling the existing gap in molecular analyses which involve the use of herbarium collections of mosses.

背景与目标： 背景：针对极端环境的研究通常与获取新鲜植物材料有关。草本植物可能会提供很大的支持，因为它们会收集来自世界各地的大量标本。因此，在分子研究中使用植物标本室标本的方法也越来越引起人们的兴趣。关于植物标本室DNA的许多文献旨在改善提取和PCR扩增，并且主要集中在维管植物上。在这里，我对从苔藓植物标本室标本中提取DNA的效率进行了简要研究，强调了草as作为难以接近的地理区域（如南极地区）的宝贵材料来源的重要性。
方法：本研究基于1979年至2013年在南极地区收集的25种苔藓植物标本室的收集。大部分样品是使用DNeasy Plant Mini Kit（Qiagen，Hilden，德国）获得的。使用基于CTAB的方法提取剩余的较小部分。通过测试几种大小不同的DNA片段，可以测量DNA提取方法在PCR扩增成功率方面的性能。此外，为了估计DNA片段化水平，使用了自动芯片上电泳系统。
结果：结果表明，DNA纯度和靶基因区域的长度是驱动成功PCR反应的基本因素。相反，DNA产量和标本年龄似乎不太相关。通过这项研究，我还提出了一种基于CTAB的优化方法，该方法可以有效抑制植物标本室DNA中的抑制剂。可以认为该方法是基于列的技术的更便宜的替代方法，对处理大量样品特别有用。这项研究的结果证实了以前的报道，并有助于填补分子分析中现有的空白，其中涉及使用植物标本室收集的苔藓。

BACKGROUND & AIMS: OBJECTIVE:To evaluate the clinical characteristics and laboratory test results in pregnant women with coronavirus disease 2019 (COVID-19). METHODS:A retrospective study to review and compare clinical data including electronic medical records and laboratory tests from pregnant and nonpregnant patients admitted the Central Hospital of Wuhan, China from December 8, 2019 to April 1, 2020. RESULTS:A total of 72 women (30 pregnant and 42 nonpregnant) with COVID-19 were included. No patients developed severe pneumonia during the study. Compared with the nonpregnant group, pregnant patients were admitted to hospital earlier (0.25 vs 11.00 days; P<0.001), presented milder symptoms, had a higher rate of asymptomatic infection (26.7% vs 0%), and shorter length of hospital stay (14.5 vs 17.0 days; P<0.01). Laboratory test results showed that levels of inflammation markers such as white blood cell count, neutrophil count and percentage, C-reactive protein, procalcitonin, and D-dimer were significantly higher in pregnant women, whereas mean lymphocyte percentage was significantly lower compared with nonpregnant women. CONCLUSION:In some respects, the clinical characteristics and laboratory test results of COVID-19 in pregnant patients seems to be distinctive from their nonpregnant counterparts. Appropriate advice and positive treatment might be critical to the prognosis when dealing with these pregnant patients. Pregnant patients with COVID-19 had their own positive clinical characteristics and special laboratory test results. Responsive medical advice and active treatment for those patients are critical to recovery.

背景与目标： 目的：评估2019年冠状病毒病孕妇的临床特征和实验室检查结果（COVID-19）。
方法：一项回顾性研究，旨在回顾和比较2019年12月8日至2020年4月1日收治于中国武汉市中心医院的孕妇和非孕妇的临床数据，包括电子病历和实验室检查结果。
结果：总共包括72例COVID-19的妇女（30例孕妇和42例未妊娠）。在研究期间，没有患者出现严重的肺炎。与未怀孕组相比，怀孕患者较早入院（0.25 vs 11.00天; P <0.001），症状较轻，无症状感染率较高（26.7％vs 0％），住院时间较短（ 14.5天与17.0天； P <0.01）。实验室测试结果显示，孕妇的炎症标志物（如白细胞计数，中性粒细胞计数和百分比，C反应蛋白，降钙素和D-二聚体）的水平显着较高，而平均淋巴细胞百分比与未怀孕的女性相比明显较低。 。
结论：在某些方面，COVID-19在孕妇中的临床特征和实验室检查结果似乎与非孕妇有区别。当与这些怀孕的患者打交道时，适当的建议和积极的治疗可能对预后至关重要。孕妇的COVID-19患者具有自己的阳性临床特征和特殊的实验室检查结果。对这些患者的响应性医疗建议和积极治疗对于康复至关重要。

BACKGROUND & AIMS: :The use of aspirin is considered the "gold standard" for the decrease of major adverse cardiovascular events in patients with atherosclerosis, including peripheral arterial disease (PAD), whereas a dual-antiplatelet regimen with aspirin and clopidogrel is usually indicated for such patients after angioplasty and stent deployment. However, a substantial number of subsequent adverse events still occur, even in patients who receive double-antiplatelet therapy. The "high on-treatment platelet reactivity" (HTPR) phenomenon has been lately recognized and plays a major role in the management of patients with PAD. Greater and more rapid inhibition of platelet aggregation has become the goal for new antiplatelet agents with the expectation of further improving outcomes for percutaneous intervention for PAD. The purpose of this review article is to highlight current evidence regarding the prevalence, aetiology, and clinical implications of HTPR in PAD as well as to discuss the possibilities of novel alternative antiplatelet regiments.

背景与目标： ：阿司匹林的使用被认为是减少动脉粥样硬化患者包括周围动脉疾病（PAD）的主要不良心血管事件的“黄金标准”，而此类患者通常在接受阿司匹林和氯吡格雷双重抗血小板治疗后使用血管成形术和支架的部署。但是，即使在接受双重抗血小板治疗的患者中，仍会发生大量后续不良事件。最近已经认识到“治疗中血小板反应性高”（HTPR）现象，并且在治疗PAD患者中起主要作用。对血小板聚集的更大和更快速的抑制已成为新型抗血小板药物的目标，期望进一步改善PAD的经皮介入治疗的效果。本文的目的是强调有关HTPR在PAD中的流行，病因和临床意义的最新证据，并讨论新型抗血小板疗法的可能性。