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We investigated a case of cutaneous infection in an immunocompromised patient in China that was caused by a novel species within the Mycobacterium gordonae complex. Results of whole-genome sequencing indicated that some strains considered to be M. gordonae complex are actually polyphyletic and should be designated as closely related species. [ABSTRACT FROM AUTHOR]

Background The abuse and deficiency of nutritional support coexist in China, and clinical pharmacists have responsibilities to promote the rational use of drugs. Objective Apply the Screening Tool Risk on Nutritional Status and Growth to observe the influence of parenteral nutrition on children with an incarcerated hernia and educate physicians to promote the rational use of parenteral nutrition. Setting Department of General Surgery of Nanjing children's hospital. Method Patients were grouped according to the sores of Screening Tool Risk on Nutritional Status and Growth, and each group was then divided into subgroups according to receiving parenteral nutrition only (subgroup A) or no extra nutritional support (subgroup B). The clinical results were compared to ascertain whether parenteral nutrition was necessary, and the clinical pharmacists educated the physicians according to the results. One year later, the clinical results before and after education were compared. Main outcome measure Nutritional indicators (body weight, albumin, prealbumin, retinol binding protein), length of hospital stay after operation, hospitalization cost and incidence of adverse reactions. Results There were no significant differences in changes of nutritional indicators between the A and B subgroups of the score 1 and 2 groups. In the score 3 group, decreases of nutritional indicators were more pronounced in subgroup B than in subgroup A, and the length of hospital stay after operation was significantly shorter in subgroup A. The incidence of adverse reactions was significantly higher for those who received parenteral nutrition. One year after the clinical pharmacists educated the staff, the use of parenteral nutrition, hospitalization cost and incidence of adverse reactions significantly decreased. Conclusions Clinical pharmacists played an important role in improving the rational use of parenteral nutrition. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the motives of clinical nurses for experiencing empathy with patients and their families based on a self-determination theory framework. Methods: Semi-structured face-to-face interviews with twenty-one nurses at four tertiary hospitals in Anhui, China, were conducted, recorded and transcribed. A content analysis with a directed approach was performed. Results: An analysis of the interview transcripts revealed three categories of empathy motivation: autonomous motivation, controlled motivation and a lack of empathy motivation. Autonomous motivation included personal interests, enjoyment and a sense of value, pure altruism, assimilation, and recognition of the importance of empathy. Controlled motivation highlighted pressures from oneself and others, the possibility of tangible or intangible rewards, and avoidance of adverse effects. Finally, a lack of empathy motivation referred to a lack of intention for empathy and denial of the value of empathy. Conclusion: This study provides a deep understanding of the motives underlying empathy in nurses. The results reveal the reasons for empathy and may support the development of effective strategies to foster and promote empathy in nurses. [ABSTRACT FROM AUTHOR]

Background: To evaluate the distribution of biometric parameters and corneal astigmatism using the IOLMaster device before phacoemulsification in cataract patients in Central China.Methods: Consecutive cataract patients were recruited at the Central Hospital of Wuhan between January 2015 and June 2016. Ocular axial length (AL), keratometry values, anterior chamber depth (ACD) and horizontal corneal diameter (white to white [WTW]) of each cataract-affected eye were measured with the IOLMaster device.Results: The study evaluated 3209 eyes of 2821 cataract patients. The mean AL, ACD, and WTW were 24.38 ± 2.47 mm, 3.15 ± 0.48 mm, and 11.63 ± 0.43 mm, respectively. Corneal astigmatism of 0.51-1.00 diopters (D) was the most common range of values (34.96%). A total of 10.56% patients exhibited a corneal astigmatism greater than 2.0 D. The flat and steep keratometry values gradually increased with age. The mean ACD and WTW showed increasing trends as the AL increased (P < 0.001). When the AL was shorter than 26.0 mm, the keratometry decreased as AL increased. The against-the-rule (ATR) astigmatism proportion increased with age and the with-the-rule (WTR) astigmatism proportion decreased with age.Conclusions: The profile of ocular biometric data and corneal astigmatism may help ophthalmologists improve their surgical procedures and make an appropriate IOL choice to gain a high quality of postoperative vision. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate the pregnancy complications, perinatal outcomes, and congenital abnormalities (CAs) that occurred in Beijing, China, when pregnant women became infected with the 2009 pandemic influenza A (H1N1) (H1N1pdm). Methods: Pregnancy complications, perinatal outcomes, and CAs were compared among 3 groups of pregnant women. The 23 women in group 1 were confirmed to harbor viral RNA; the 23 in group 2 had serum levels of virus-specific antibodies against H1N1pdm, meaning that they were suspected of being infected with the virus; and the 93 in group 3 had no detectable virus-specific antibodies. Results: Perinatal outcomes and pregnancy complications were not significantly different in groups 1 and 3. Higher percentages of stillbirths (12.0%) and placental disorders (13.0%) were observed in group 2 than in group 3. Many women in group 2 (62.5%) experienced symptoms of having a cold during pregnancy and most took no medication. Two cases of CA occurred in group 1, in the offspring of women infected in the second trimester. Conclusion: When left untreated, infection with the 2009 H1N1pdm virus during pregnancy appears to have increased fetal mortality and morbidity. Because CAs are traumatic for all concerned, their possible association with the virus should be further evaluated. [Copyright &y& Elsevier]

A new species of permineralized ovule is reported from a previously undocumented diverse fossil plant assemblage preserved in volcaniclastic tuff from the Late Permian Xuanwei Formation at the Huopu coal mine in Guizhou Province, China. The ovule is large and platyspermic, with 180° rotational symmetry. It has a pronounced commissure that distally divides the integument into two valves. The integument comprises a two-part sarcotesta, a sclerotesta also divided into two parts, and an endotesta that is unusually thick in the central part of the ovule and at the apex. Fusion of the nucellus to the integument occurs only at the chalaza, and the nucellar apex is small, consisting of a proximal pollen chamber and a distally extending tubular projection. A single vascular bundle enters the base of the ovule and divides in the major plane at the boundary of the inner and outer sarcotesta to form two integumentary bundles, one to each side of the ovule, with the nucellar bundle continuing to the base of the nucellus, where it forms a small vascular cup. The gross morphology and the pattern of vascularization of the ovule fit the circumscription of the morphogenus Cardiocarpus Brongniart, to which the ovule is here assigned, but are distinct from previously recognized morphospecies leading to the erection of Cardiocarpus huopuensis sp. nov. In C. huopuensis sp. nov., tissues of the outer sarcotesta are rarely preserved and where present occur external to a zone of poorly preserved cells that suggests exfoliation of the outer sarcotesta through ontogeny. Although the identity and, hence, affinity of the parent plant for C. huopuensis sp. nov. are unknown, previous evidence shows ovules of this kind to be produced by either a coniferophyte or a seed fern (pteridosperm). [ABSTRACT FROM AUTHOR]

The Miocene Shanwang biota from eastern China contains exceptionally well-preserved plant fossils with abundant leaf fossils and palynomorphs co-occurring at several levels in the sedimentary succession. This has provided an ideal opportunity to undertake detailed comparative quantitative palaeoclimate reconstruction, based on both mega- and microfloral assemblages, using various approaches, namely the coexistence approach (CoA), leaf margin analysis (LMA) and Climate Leaf Analysis Multivariate Programme (CLAMP). By applying these approaches to the same dataset and using multiple fossil assemblages from different levels we are able to compare results from the different methods of climate prediction. CLAMP and LMA give consistently lower temperature (mean annual temperature, MAT) predictions than the CoA. Taking errors into account all methods indicate no overall climate change through the sequence studied. Results from CoA show overall agreement in the palaeoclimate parameters obtained using both pollen and leaf datasets indicating a high degree of internal consistency with this method. [Copyright &y& Elsevier]

Objective: To study the prevalence, genotypes and molecular characteristics of norovirus (NoV) in acute gastroenteritis., Methods: RT-PCR was used to determine the molecular epidemiology of NoV., Results: Out of 685 samples, 66 positive specimens were identified and the prevalence was 9.6% (66/685), 9.9% in males and 9.4% in females, respectively, with no significant difference. The prevalence rates showed no differences between age groups or between inpatients and outpatients. NoV gastroenteritis did not present any seasonal distribution. 43 out of the 66 specimens were classified, with 10 (22.7%) belonged to GI including 2 GI.3, 1 GI.4, 4 GI.5 and 3 GI.7. Other 33 (77.3%) belonged to GII genogroup, including GII.4 accounted for 60.6% (20/33) and followed by 7 GII.12, 2 GII.6, 1 GII.2, 1 GII.3, 1 GII.5. Six specimens mixed with GI and GII and 3 specimens were classified as GI.3/GII.7, GI.5/GII.5 and GI.4/GII.4., Conclusion: The main symptoms of acute gastroenteritis were abdominal pain, nausea, vomit and fever. There were many genotypes identified in our study and the main genotypes were GII.4/2006a and 2006b. GI and GII could be coinfected with each other.

The aim of the present study was to evaluate the clinical usefulness of applying RT-nested PCR along with RFLP as a method for diagnosis and genotypic differentiation of Hantavirus in the acute-stage sera of HFRS patients as compared to the ELISA technique. A prospective study of patients with suspected HFRS patients was carried out. Sera were collected for serological evaluation by ELISA and RT-nested PCR testing. Primers were selected from the published sequence of the S segment of HTNV strain 76-118 and SEOV strain SR-11, which made it possible to obtain an amplicon of 403 bp by RT-nested PCR. The genotypic differentiations of the RT-nested PCR amplicons were carried out by RFLP. Sequence analyses of the amplicons were used to confirm the accuracy of the results obtained by RFLP. Of the 48 acute-stage sera from suspected HFRS patients, 35 were ELISA-positive while 41 were positive by RT-nested PCR. With Hind III and Hinf I, RFLP profiles of the RT-nested PCR amplicons of the 41 positive sera exhibited two patterns. 33 had RFLP profiles similar to the reference strain R22, and thus belonged to the SEOV type. The other 8 samples which were collected during October-December had RFLP profiles similar to the reference strain 76-118, and thus belonged to the HTNV type. Sequence phylogenetic analysis of RT-nested PCR amplicons revealed sdp1, sdp2 YXL-2008, and sdp3 as close relatives of HTNV strain 76-118, while sdp22 and sdp37 as close relatives of SEOV strain Z37 and strain R22 located in two separate clusters in the phylogenetic tree. These results were identical to those acquired by RFLP. RT-nested PCR integrated with RFLP was a rapid, simple, accurate method for detecting and differentiating the genotypes of Hantavirus in the acute-stage sera of suspected HFRS patients. In Shandong province, the main genotypes of Hantavirus belonged to the SEOV types, while the HTNV types were observed during the autumn-winter season.

Scrub typhus is one of the most common infectious diseases of rural south and southeastern Asia and the western Pacific. It emerged in Shandong Province in northern China from autumn to winter of 1986. Since then, the "autumn-winter type scrub typhus" has been found in many areas of northern China. However, the principle genotypes of Orientia tsutsugamushi still remain unknown. This study was undertaken to identify the genotypes of O. tsutsugamushi obtained from scrub typhus patients, chigger mites and rodents from the focal point of the problem in Shandong Province. Forty-four isolates from patients, rodents, and chiggers, 47 blood clots from patients during the acute phase, 10 eschars from patients during the convalescence phase and 16 pools of larval chiggers were tested for the scrub typhus antigen 56-kD protein (Sta56) gene by nested PCR methodology and additional sequence analysis including DNA sequence alignment and phylogenetic analysis. Based on nested PCR, ninety-five initial PCR-positive samples produced amplicons using Kawasaki strain-specific primers, while the other two (the FXS4 and LHGM2 strains) produced amplicons using Karp strain-specific primers. The partial Sta56 gene sequence analysis indicated that the sequence homologies of 3 selected isolates (the B16, FXS2, and XDM2 strains) and 7 eschars out of the 95 samples, which were nested PCR-positive using Kawasaki strain-specific primers, were 94-98% to that of Kawasaki strain. The sequence homology of the FXS4 and LHGM2 strains to that of the Karp strain was respectively 83 and 96%. These findings implied that the key genotypes of O. tsutsugamushi in patients, rodents, and chiggers in Shandong Province were identical and similar to Kawasaki strains.

Five new 1,3-diarylpropan-1-ols, combretol A-E (1- 5), together with one known coumarin (6) and ten known triterpenes (7-16), were isolated from Combretum yunnanense. Their structures were determined by spectroscopic investigation, including ¹H and ¹³C NMR, NOESY, HSQC, HMBC, and HRESIMS analyses. This is the first report on the occurrence of 1,3-diarylpropan-1-ols and coumarin in the Combretum genus including C. yunnanense. Also, to the best of our knowledge, 1,3-diarylpropan-1-ols are rare in nature., (© Georg Thieme Verlag KG Stuttgart · New York.)