Sputum matrix metalloproteinase-8 and -9 and tissue inhibitor of metalloproteinase-1 in bronchiectasis: clinical correlates and prognostic implications.

BACKGROUND AND OBJECTIVE: The triplet of airway infection, inflammation and bronchial wall destruction associated with excessive matrix metalloproteinases (MMP) release and imbalance of tissue inhibitor metalloproteinase-1 (TIMP-1) is implicated in bronchiectasis. We sought to determine the associations between sputum MMP (MMP-8, MMP-9) and TIMP-1 and the severity of bronchiectasis; the utility of MMP in predicting risks of future bronchiectasis exacerbations (BE); and the changes in MMP levels during BE. METHODS: We recruited 102 patients with stable bronchiectasis and 22 healthy subjects. For bronchiectasis patients, baseline measurements consisted of sputum inflammation and MMP measurements, bacterial culture, spirometry and chest high-resolution computed tomography (HRCT). Bronchiectasis patients were followed up for 1 year to determine the frequency of BE. Changes in MMP levels during BE were assessed in 36 bronchiectasis patients. RESULTS: Sputum MMP-8, MMP-9 and MMP-9/TIMP-1 ratio in bronchiectasis patients were significantly increased compared with healthy subjects. MMP-8 and MMP-9 levels, but not TIMP-1, were positively correlated with clinical measures, including HRCT scores, spirometry and Bronchiectasis Severity Index. Seventy-nine bronchiectasis patients were included in survival analyses of BE. Lower levels of baseline MMP-9 were associated with reduced risks of and a longer time to the first BE during follow-up. MMP-8 and MMP-9, but not TIMP-1 or MMP-9/TIMP-1 ratio, were significantly heightened during BE. CONCLUSIONS: Sputum MMP might be useful biomarkers for the assessment of bronchiectasis severity and the prediction of future risks of BE. Our results provide the rationales for the future clinical application of MMP inhibitors.

[Bronchoesophageal fistula secondary to mediastinal lymph node tuberculosis: a case report and review of the literature].

OBJECTIVE: To analyze the clinical features of 1 case of bronchoesophageal fistula (BEF) secondary to mediastinal lymph node tuberculosis. METHODS: The clinical, auxiliary examinational and pathological data of 1 case with BEF were presented, and the literatures were reviewed. RESULTS: The patient was a 19 year old female, who was admitted to hospital because of fever and cough associated with liquid intake. It was diagnosed by chest CT scan, endobronchial ultrasound biopsy of mediastinal lymph nodes, and clinical testing (methylene blue). The BEF was closed after anti-tuberculosis therapy and preventing contamination of the fistula by indwelling stomach tube. CONCLUSIONS: Bronchoesophageal fistula secondary to mediastinal lymph node tuberculosis is rare. Chest CT scan, fiberoptic bronchoscopy, and clinical testing (methylene blue) are useful diagnostic tools for BEF.

Efficient Fenton-like degradation of tetracycline by stalactite-like CuCo-LDO/CN catalysts: The overlooked contribution of dissolved oxygen.

In the Fenton-like processes, the resources that exist in the system itself (e.g., dissolved oxygen, electron-rich pollutants) are often overlooked. Herein, a novel CuCo-LDO/CN composite catalyst with a strong "metal-π" effect was fabricated by in situ calcination which could activate dissolved oxygen to generate active oxygen species and degrade the electron-rich pollutants directly. The CuCo-LDO/CN (1:10) with the largest specific surface aera, most C-O-M bonds and least oxygen vacancies exhibited the best catalytic performance for tetracycline (TC)degradation (TC removal efficiency 93.2% and mineralization efficiency 40%, respectively, after 40 min at neutral pH) compared to CuCo-LDO and other CuCo-LDO/CN composite catalysts. In the absence of H2O2, dissolved oxygen could be activated by the catalyst to generate O2·-and ·OH, which contributed to approximately 20.7% of TC degradation, providing a faster and cost-effective way for TC removal from wastewater. While in the presence of H2O2, it was activated by CuCo-LDO/CN to generate·OH as the dominant reactive oxygen species and meanwhile TC transferred electrons to H2O2 through C-O-M bonds, accelerating the Cu+/Cu2+ and Co2+/Co3+ redox cycles. The possible degradation pathways of TC were proposed, and the environmental hazard of TC is greatly mitigated according to toxicity prediction.

Defect-rich MoS2/NiS2 nanosheets loaded on SiNWs for efficient and stable photoelectrochemical hydrogen production.

Photoelectrochemical (PEC) reaction with efficient, stable, and cost-effective photocathodes using non-precious metals will be one of the most environmentally friendly technologies for hydrogen (H2) generation under the worldwide pressure for carbon neutrality. Herein, a new 3-dimentional (3D) SiNWs@MoS2/NiS2 photocathode was designed and synthesized. Defect-rich MoS2/NiS2 nanosheets on silicon nanowires (SiNWs) provide more active sites to promote charge transfer and photo-generated electron-hole separation. Meanwhile, the 3D structure of the photocathode provides an effective charge transfer mode and an open channel for rapid H2 release. The SiNWs@MoS2/NiS2 photocathode exhibits the maximum photocurrent density (21.4 mA·cm-2 at 0.9 V vs. RHE), highest H2 production rate (183 µmol·h-1), smallest diffusion resistance (34.7 Ω), and excellent catalytic stability for more than 10 h at pH = 7. Based on density function theory calculation, the MoS2/NiS2 nanosheets are conducive to chemical adsorption of H2 intermediates, which are crucial for the maintenance of the composite photocathode in PEC H2 production.

Carbon Nitride-Based siRNA Vectors with Self-Produced O2 Effects for Targeting Combination Therapy of Liver Fibrosis via HIF-1α-Mediated TGF-ß1/Smad Pathway.

Hypoxia is an important feature, which can upregulate the hypoxia-inducible factor-1α (HIF-1α) expression and promote the activation of hepatic stellate cells (HSCs), leading to liver fibrosis. Currently, effective treatment for liver fibrosis is extremely lacking. Herein, a safe and effective method is established to downregulate the expression of HIF-1α in HSCs via targeted delivery of VA-PEG-modified CNs-based nanosheets-encapsulated (VA-PEG-CN@GQDs) HIF-1α small interfering RNA (HIF-1α-siRNA). Due to the presence of lipase in the liver, the reversible release of siRNA can be promoted to complete the transfection process. Simultaneously, VA-PEG-CN@GQD nanosheets enable trigger the water splitting process to produce O2 under near-infrared (NIR) irradiation, thereby improving the hypoxic environment of the liver fibrosis site and maximizing the downregulation of HIF-1α expression to improve the therapeutic effect, as demonstrated in liver fibrosis mice. Such combination therapy can inhibit the activation of HSCs via HIF-1α-mediated TGF-ß1/Smad pathway, achieving outstanding therapeutic effects in liver fibrosis mice. In conclusion, this study proposes a novel strategy for the treatment of liver fibrosis by regulating the hypoxic environment and the expression of HIF-1α at lesion site.

Classification and research progress of implant surface antimicrobial techniques.

Due to the good biocompatibility and ideal mechanical property, titanium implants have been widely used in dental clinic and orthopedic surgery. However, bacteria induced infection can cause per-implant inflammation and decrease the success rate of implant surgery. Therefore, developing antimicrobial techniques is essential to successful application of titanium implants. Many surface antimicrobial techniques, including antimicrobial coating and surface modifications, have been explored and they always exert antimicrobial effect by reducing bacterial adhesion, inhibiting their metabolism, or destructing cell structure. In this paper, different surface antimicrobial techniques and their recent research progress are reviewed to provide a brief insight on this area.

CuCo and sulfur doped carbon nitride composite as an effective Fenton-like catalyst in a wide pH range.

The heterogeneous Fenton-like reaction, as an advanced oxidation process, is widely recognized attributed to its recyclability, wide pH response range, easy solid-liquid separation, and non-production of iron sludge. Recently, the bimetallic catalysts have attracted intense attention due to their high catalytic performance and excellent stability over a wide pH range. In this article, CuCo/SCN bimetallic catalyst was prepared by pyrolysis method with sulfur doped carbon nitride (SCN) as the carrier. Under the conditions of pH = 7, catalyst dosage of 0.8 g/L, and concentration of H2O2 of 15 mM, 20 mg/L of methyl orange (MO) can be completely removed within 1 h. With the synergistic action between bimetals and sulfur doped carbon nitride, the CuCO/SCN involved Fenton-like system exhibited excellent catalytic degradation efficiency and strong stability for MO in neutral and weak alkaline conditions. The EPR characterization proved that OH and O2 - were the main active components. Furthermore, CuCo/SCN involved Fenton-like system has good adaptability. Bimetallic CuCo/SCN catalyst has great application potential in the degradation of environmental pollutants.

A 12-Year-Old Girl Presenting With Recurrent Dyspnea and Pulmonary Ground-Glass Opacities.

CASE PRESENTATION: A 12-year-old girl presented with shortness of breath with exercise for 2 weeks. Her oxygen saturation was 85% during exercise. Birth and family histories were unremarkable. The girl was healthy until 7.1 years of age, when she suffered a "pneumonia" with fever, dyspnea, and hypoxemia, which diminished after a 19-day treatment with antibiotics and methylprednisolone. These symptoms relapsed 8 months later, and she was diagnosed with rapidly progressive interstitial lung disease (ILD) and a Mycoplasma pneumoniae infection. At that time, her symptoms failed to respond to a course of antibiotic therapy but resolved with IV methylprednisolone at 2.7 mg/kg/day. She remained on a tapering dose of methylprednisolone plus methotrexate for the next 18 months until withdrawal of these medications because of return of almost normal lung imaging. She had never had myalgia, muscle weakness, arthritis, rashes, mechanic's hands, Raynaud's phenomenon, dry mouth, or dry eyes.

Direct Z-scheme SiNWs@Co3O4 photocathode with a cocatalyst of sludge-derived carbon quantum dots for efficient photoelectrochemical hydrogen production.

Solar driven photoelectrochemical (PEC) hydrogen production has attracted considerable attention, but the design of highly efficient, robust and low-cost photocathode still remains a significant challenge. Herein, we report a novel SiNWs@Co3O4Z-scheme heterojunction photocathode with carbon quantum dots eco-friendly derived from sludge (SCQDs) as the co-catalyst. The photocathode not only leads to effective separation of electron-hole pair, lower transmission resistance, and longer lifetime of charge carriers, but also elevates the stability by preventing direct contact between the SiNWs and the electrolyte as well as the self-oxidation. Simultaneously, the excellent electron transport properties of the SCQDs further improved the PEC performance. Correspondingly, a maximum current density of 14.88 mA·cm-2 was obtained at -0.67 V with the applied bias photon-to-current efficiency (ABPE) achieving 8.4% under visible light irradiations at pH = 7. This work provides a promising scheme for Si-based photocathodes for PEC hydrogen production with a high performance, reliable stability, and low-cost.

Effects of several tea extracts on nonalcoholic fatty liver disease in mice fed with a high-fat diet.

Nonalcoholic fatty liver disease (NAFLD) is considered as a severe threat to human health. It has been reported that tea has abundant bioactive compounds and beneficial effects. In our study, the effects of 12 tea extracts on NAFLD were assessed and compared at the dose of 200 mg/kg body weight in mice fed with a high-fat diet (HFD) for 15 weeks. Enshi Yulu Tea, Fenghuang Narcissus Tea, and Yihong Tea showed strong effects in suppressing the accumulation of epididymal and perirenal adipose tissue as well as the increases of body weight and liver weight. The histopathological analysis revealed that hepatic steatosis and adipocyte hypertrophy induced by a HFD could be ameliorated by tea supplementation. In addition, Enshi Yulu Tea and Qing Brick Tea exerted more remarkable functions on decreasing the level of serum triglyceride and preventing hepatic fat accumulation, respectively. Furthermore, Fenghuang Narcissus Tea, Enshi Yulu Tea, and Qing Brick Tea could reverse the abnormal change in the levels of glutathione and superoxide dismutase. Moreover, 13 phytoconstituents were detected and quantified in these teas with high-performance liquid chromatography (HPLC) method. The correlation analysis demonstrated that gallic acid might decrease MDA level, and the reduction of liver weight might be attributed to ellagic acid. However, it should be paid attention to some teas that showed hepatotoxicity with elevated levels of aspartate transaminase and alanine aminotransferase. Several teas showed strong effects in the prevention of NAFLD, which could be developed into functional foods against NAFLD.

Clinical features, treatment, and survival outcome of primary pulmonary NUT midline carcinoma.

OBJECTIVE: NUT midline carcinoma (NMC), a rare type of squamous cell carcinoma, is genetically characterised by NUT midline carcinoma family member 1 (NUTM1) gene rearrangement. NMC can arise from the lungs; however, there is no standard for the management of primary pulmonary NMC. This study aimed to confirm the clinical features and report the treatments, especially with immune checkpoint inhibitors (ICIs), and outcomes of patients with primary pulmonary NMC. METHODS: A retrospective review of patients with primary pulmonary NMC was performed in the First Affiliated Hospital of Guangzhou Medical University between January 2015 and December 2018. Clinical manifestations as well as radiographic and pathological findings were recorded. Whole-exome sequencing (WES), a predictor for ICI response, was used to determine the tumour mutational burden (TMB). Treatments, especially by immune checkpoint blockade, and patient survival were analysed. RESULTS: Seven patients with primary pulmonary mass (four men and three women) with a mean age of 42 years (range, 23-74) who were diagnosed with NMC according to NUT immunohistochemistry staining were included for analysis. One patient had a rare fusion of CHRM5-NUTM1 by tumour sequencing. A wide range of TMB (1.75-73.81 mutations/Mbp) was observed. The initial treatments included chemotherapy (5/7, 71.4%), surgery (1/7, 14.3%), and radiotherapy (1/7, 14.3%). Five patients (5/7, 71.4%) received ICIs (programmed cell death protein 1 [PD1]/programmed cell death ligand 1 [PDL1] monoclonal antibody) as second- or higher-line treatments. The median overall survival (OS) was 4.1 months (range, 1.5-26.7 months). CONCLUSIONS: Patients with primary pulmonary NMC have a poor prognosis and chemotherapy is often preferred. Checkpoint immunotherapy is a good option as the second- or higher-line treatment. TMB seems to be not associated with OS.

Construction of highly pure nanocrystalline heteropoly acid inside the channels of mesoporous material with the imprisoned hydrolyzation reaction of heteropoly acid etherate.

A novel technique was developed to prepare highly pure heteropoly acid (HPA) nanocrystals inside mesoporous SBA-15 by the imprisoned reaction of HPA etherate and water, which was utilized as a main driving force for the transportation of building-blocks. The transmission electron microscopy, X-ray diffraction, FT-IR spectrum and NMR characterizations unambiguously demonstrate that this method allows the highly pure heteropoly acid nanocrystals with intact Keggin-type structure controlled directionally self-assembly within mesopores of silica SBA-15. Such method may open up a new entry to the highly pure multicomponent nanocrystalline particles inside the cavity of the porous materials.

The enhancement of synthesized wastewater on non-uniform electrokinetic remediation of a Cd-spiked natural clayey soil.

It is usually very difficult to achieve satisfactory extraction efficiencies in electrokinetic remediation of heavy metal-contaminated soils of high acid/base buffer capacity. Enhancement agent is often required. In this study, synthesized citric acid industrial wastewater (CAIW) is used as the enhancement agent to remediate cadmium-spiked natural clayey soil from Shanghai, China. Four electrokinetic extraction experiments were carried out to evaluate the enhancement effects of CAIW on the remediation of metal-spiked clayed soil of high buffer capacity and the effects of treatment time and initial cadmium concentration on the migration of cadmium in the specimen. The results of electrokinetic experiments indicated that CAIW can efficiently enhance the transport of cadmium in comparison with HNO3 of the same pH. Cadmium mobilization was enhanced with prolonged treatment time from 104 to 261.2 h, but the average cadmium removal efficiency was not significantly enhanced. A non-uniform cadmium distribution in the specimen was observed after the enhanced electrokinetic experiments due to the localized electrical gradients with an electrical gradient of approximately 1 V/cm and a ratio of the distance between electrodes of the same polarity to the outer diameter of electrode of 2.8 (50:18 mm).

A case report of acute fibrinous and organizing pneumonia with pneumothorax and avian exposure history.

Acute fibrinous and organizing pneumonia (AFOP) is an uncommon variant of acute lung injury. Here, we report a patient with AFOP and a previously unreported condition, pneumothorax. After our experience with this case, we suggest that exposure to birds may be associated with AFOP; pneumothorax can develop in patients with AFOP; and glucocorticoids are very effective for treating AFOP.

[Enhanced Electrokinetic Remediation of Heavy Metals Contaminated Soils by Stainless Steel Electrodes as well as the Phenomenon and Mechanism of Electrode Corrosion and Crystallization].

Electrode corrosion and salt crystallization are important challenges that restrict the engineering application of electrokinetic technology. In the present study, using stainless steel as an electrode, and deionized water (DW), citric acid (CA) and polyaspartic acid (PASP) as electrolytes, Pb/Cu-contaminated soil was remediated by electrokinetic. All of the EK experiments were conducted in a 2 L soil cell reactor with a moisture level of about 35% blended with 1000 mg·g-1 of Pb and 778 mg·g-1 of Cu under a constant voltage gradient (1 V·cm-1, 2 V·cm-1) for 150 h. The removal efficiency of heavy metals and influencing factors, as well as the phenomenon and mechanism of electrode corrosion and salt crystallization were explored. The experimental results showed under the action of electric field, the Ca in the test soil would move to the cathode, and the crystal was formed in the alkaline condition. Additionally, the conductivity of the electrode was reduced. During the EK process, water at the anode was primarily oxidized, undergoing a reduction reaction at the cathode. Because H+ and OH- were transported through the soil by electromigration and electro-osmotic flow (EOF), changes in soil pH could occur. The concentrations distribution of Pb-Cu appeared to be related to the distribution of soil pH in the cell, which might be associated with the desorption and hydroxide precipitation of Pb-Cu. PASP resulted in obvious inhibitory effect on the corrosion of stainless steel electrode, CA and PASP could clearly destroy the formation of CaCO3 crystal, while barely effectively disrupted the formation of Ca (OH)2 crystal. Both CA and PASP could promote the removal of Pb, but the influence of PASP on the removal of Cu was not obvious, and the effect of CA was very significant. Combined with different corrosion inhibitor and reinforcing agent, stainless steel can be chosen as the engineering application electrode in electrokinetic remediation.

Case report: dermatomyositis associated with lung cancer with heterogeneous morphology.

Dermatomyositis (DM) complicated with non-small cell lung cancer (NSCLC) is not rare, and could rapidly develop into severe lung cancer [performance-status score (PS) between 2 and 4]. Moreover, tumor has remarkable heterogeneity, and it is not possible to properly target treatments in cases of relapse without knowing pathological diagnosis. We retrospectively analyzed the diagnosis and treatment of a patient with DM complicated with NSCLC, which developed into severe lung cancer with heterogeneity of the tumor during chemotherapy. In this report, we addressed that in patients with severe lung cancer, both the cancer and factors associated with exacerbation should be simultaneously managed to reduce the PS score and avoid unnecessary delay. A second biopsy is important for proper management of the tumor with heterogeneity.

[Expression and significance of severe acute respiratory syndrome associated coronavirus (SARS-CoV)-X4 protein in lungs of SARS patients].

OBJECTIVE: To investigate the significance of severe acute respiratory syndrome associated coronavirus (SARS-CoV)-X4 protein expression in lungs of patients with SARS. METHODS: Pathological features of the lungs from 4 SARS patients were examined and the expression of SARS-CoV-X4 protein in the lungs was evaluated with immunohistochemical staining using specific antibodies against protein X4. RESULTS: Microscopically, all lungs from 4 cases showed edema, erythrocyte and fibrin exudates in the alveoli, hyperplasia of alveolar epithelium, necrosis, hyaline membrane formation and fibroblast foci. Immunohistochemical stains showed a strong positivity of X4 protein in denudation cells, vascular endothelial cells and also erythrocytes and neutrophils in the alveoli of the lung tissues from the 4 cases. CONCLUSIONS: Expression of SARS-CoV-X4 protein in the lungs may be involved in the pathogenesis and progression of SARS.

Validation of human small airway measurements using endobronchial optical coherence tomography.

BACKGROUND: Small airway remodeling is the cardinal feature underlying chronic airway diseases. There is no modality which identifies small airway pathological changes, which is crucial for early diagnosis, efficacy and prognostic assessment. OBJECTIVE: To evaluate the usefulness of endobronchial optical coherence tomography (EB-OCT) in assessing small airways morphology in vivo. METHODS: Twelve patients with pulmonary nodules scheduled for lung resection underwent spirometry, multi-detector computed tomography (MDCT) and EB-OCT. We measured D(mean) (mean luminal diameter), Ai (inner luminal area), Aw (airway wall area) and Aw% [Aw/(Ai + Aw) × 100%] from the 3rd to 5th generation bronchi of RB9 segment by MDCT. D(mean), Ai, Aw and Aw% from the 3rd to 9th generation bronchi of RB9 segment were measured by EB-OCT and histology. Correlations of these parameters, measured by three different methods, were evaluated. We recruited 4 COPD patients to determine if EB-OCT could identify peripheral airway remodeling. RESULTS: The 4 parameters, measured by CT and EB-OCT, correlated significantly [D(mean) (r = 0.991), Ai (r = 0.997), Aw (r = 0.997), Aw% (r = 0.991), all P < 0.01]. Significant correlation were found for these parameters, measured by histology and EB-OCT, from the 3rd to 5th generation bronchi [D(mean) (r = 0.989), Ai (r = 0.997), Aw (r = 0.999), Aw% (r = 0.988), all P < 0.01], and from the 6th to 9th generation bronchi [D(mean) (r = 0.979), Ai (r = 0.997), Aw (r = 0.994) and Aw% (r = 0.988), all P < 0.01]. Significant small airways morphological abnormalities were observed in COPD patients. CONCLUSIONS: EB-OCT, a minimally invasive imaging modality with high-resolution, is useful and clinically practical for assessing proximal and distal airways of human compared with CT and histology.

[Pathological changes of lungs in patients with severity acute respiratory syndrome].

OBJECTIVE: To evaluate the progression in morphologic changes of lungs in SARS patients. METHODS: Four cases of SARS with lung tissue samples available (including one for ultrastructural examination) were enrolled into the study. Histochemical study for VG, Masson, reticulin, orcein, PAS, sirius red stains and immunohistochemical study for vimentin, desmin, smooth muscle actin, HHF-35, CD34, F8, collagen types I and III were also performed. RESULTS: According to the morphologic changes, lung lesions in SARS were subcategorized into 3 phases: acute exudative inflammation, fibrous proliferation and the final fibrotic stage. Two cases belonged to the acute exudative phase, in which the course was less than 20 days. The principal lesions consisted of acute alveolar exudative inflammation, hyperplasia of alveolar epithelium, necrosis, alveolar hyaline membrane formation, alveolar desquamation and focal fibroplasia. The acute exudative protein was PAS-positive. There was an increase in reticulin fiber formation. The reactive fibroblasts were highlighted by desmin and vimentin. One case belonged to the fibroproliferative stage, in which the course was around 25 days. Major lesions included proliferative interstitial pneumonia with early pulmonary fibrosis. There was also evidence of organizing pneumonia, with an increase in reticulin fiber formation, which had a glomeruloid appearance on special stain. The mesenchymal cells showed either myofibroblastic (which expressed desmin, HHF-35, smooth muscle actin and vimentin) or fibroblastic (which expressed vimentin only) differentiation. Fibroelastosis and fibroplasia was also noted. The remaining case belonged to the fibrotic stage, in which the course was around 75 days. The main features included diffuse fibrosis and honeycomb change, which were highlighted by sirius red stain. Immunohistochemistry showed mainly types I and IV collagen fibers. In all lesions, there was also an increase of number of CD68-positive macrophages. CONCLUSIONS: The morphologic progression in lungs of SARS patients is characterized by the development of increased fibrosis. The primitive mesenchymal cells, hyperplastic alveolar epithelial cells and macrophages play an important role in the pathogenesis.