Comparison of the gut microbiota of short-term and long-term medical workers and non-medical controls: a cross-sectional analysis.

OBJECTIVES: The hospital environment has been implicated in the enrichment and exchange of pathogens and antibiotic resistance, but its potential in shaping the symbiotic microbial community of hospital staff is unclear. This study was designed to evaluate the alteration of the gut microbiome in medical workers compared to non-medical controls. METHODS: A prospective cross-sectional cohort study was conducted in the intensive care unit (ICU) and other departments of a centre in north-eastern China. Faecal samples of 175 healthy medical workers-short-term (1-3 months) workers (n = 80) and long-term (>1 year) workers (n = 95)-and 80 healthy non-medical controls were analysed using 16S rRNA amplicon sequencing. The hospital environmental samples (n = 9) were also analysed. RESULTS: The gut microbiomes of medical workers exhibited marked deviations in diversity and alteration in microbial composition and function. Short-term workers showed significantly higher abundances of taxa such as Lactobacillus, Butyrivibrio, Clostridiaceae, Clostridium, Ruminococcus, Dialister, Bifidobacterium, Odoribacter, and Desulfovibrio and lower abundances of Bacteroides and Blautia than the controls. Long-term workers showed higher abundances of taxa such as Dialister, Veillonella, Clostridiaceae, Clostridium, Bilophila, Desulfovibrio, Pseudomonas, and Akkermansia and lower abundances of Bacteroides and Coprococcus than the controls. The medical workers' department (ICU versus non-ICU) and position (resident doctor versus nursing staff) also impacted their gut microbiome. Compared with the non-ICU workers, workers in the ICU showed a significant increase in the abundances of Dialister, Enterobacteriaceae, Phascolarctobacterium, Pseudomonas, Veillonella, and Streptococcus and a marked depletion of Faecalibacterium, Blautia, and Coprococcus. In contrast with the nursing staff, the resident doctors showed a significant increase in Erysipelotrichaceae and Clostridium and a decrease in Bacteroides, Blautia, and Ruminococcus in the gut microbiome. Moreover, we found that the microbiota of hospital environments potentially correlated with the workers' gut microbiota. CONCLUSIONS: Our findings demonstrated structural changes in the gut microbial community of medical workers.

Environmental remodeling of human gut microbiota and antibiotic resistome in livestock farms.

Anthropogenic environments have been implicated in enrichment and exchange of antibiotic resistance genes and bacteria. Here we study the impact of confined and controlled swine farm environments on temporal changes in the gut microbiome and resistome of veterinary students with occupational exposure for 3 months. By analyzing 16S rRNA and whole metagenome shotgun sequencing data in tandem with culture-based methods, we show that farm exposure shapes the gut microbiome of students, resulting in enrichment of potentially pathogenic taxa and antimicrobial resistance genes. Comparison of students' gut microbiomes and resistomes to farm workers' and environmental samples revealed extensive sharing of resistance genes and bacteria following exposure and after three months of their visit. Notably, antibiotic resistance genes were found in similar genetic contexts in student samples and farm environmental samples. Dynamic Bayesian network modeling predicted that the observed changes partially reverse over a 4-6 month period. Our results indicate that acute changes in a human's living environment can persistently shape their gut microbiota and antibiotic resistome.

Recombinant Adenovirus-p53 Gene Therapy for Advanced Unresectable Soft-Tissue Sarcomas.

Patients with unresectable advanced soft-tissue sarcomas (STS) receiving radiotherapy or/and chemotherapy still have a poor prognosis. This study aimed to evaluate retrospectively the efficacy and safety of recombinant adenovirus-p53 (rAd-p53) gene therapy combined with radiotherapy and hyperthermia for advanced STS. A total of 71 patients with advanced unresectable STS treated at the authors' center from April 2007 to November 2014 were included. Of these 71 patients, 36 cases received rAd-p53 therapy combined with radiotherapy and hyperthermia (p53 group), while 35 cases received radiotherapy and hyperthermia alone (control group). Short-term therapeutic efficacies, long-term survival outcomes, and adverse events were evaluated and compared between groups. Compared to the control group, the p53 group had a significantly higher disease control rate (83.33% vs. 54.29%; p = 0.008) and a lower progressive disease rate (16.67% vs. 45.71%; p = 0.018). In addition, rAd-p53 treatment significantly improved the progression-free survival and overall survival of STS patients. Cox regression indicated that rAd-p53 treatment significantly reduced the risks for disease progression or death event for STS patients. Furthermore, there was no significant difference in all adverse events, except for transient fever, which occurred in 89% of patients with rAd-p53 therapy. rAd-p53 combined with radiotherapy and hyperthermia can effectively improve the therapeutic efficacy and survival outcomes in patients with advanced unresectable STS, providing a new therapeutic strategy.

Research Advances in Chemokine-like Factor Super Family Member 8.

Chemokine-like factor super family member (CMTM) is a novel generic family firstly reported by Peking University Center for Human Disease Genomics. CMTM8 is one member of this family and has exhibited tumor-inhibiting activities. It can encode proteins approaching to the transmembrane 4 superfamily. CMTM8 is down-regulated in most carcinoma cell lines and tissues. Over-expression of CMTM8 may inhibit the proliferation,migration,and invasion of carcinoma cells. However,the exact mechanism of its anti-tumor activity remains unclear. CMTM8 may be involved in various signaling pathways governing the occurrence and development of tumors. CMTM8 may be a new target in the gene therapies for tumors,while further studies on CMTM8 and its anti-tumor mechanisms are warranted.

[Expression of brainderived neurotrophic factor in urine of patients with benign prostatic hyperplasia complicated overactive bladder symptoms].

OBJECTIVE: To investigate the expression of urinary brainderived neurotrophic factor (BDNF) in benign prostatic hyperplasia patients with overactive bladder (OAB) symptoms and its correlation with the severity of OAB symptoms. METHODS: According to the inclusion and exclusion criteria, a total of 178 patients with benign prostatic hyperplasia who were to undergo transurethral resection of prostate (TURP) were enrolled in this study. All the patients had accepted basic preoperative evaluations, as well as an assessment of their International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS). The patients who had been scheduled for surgery had to take the urodynamic assessment. Urinary BDNF levels were measured by the enzyme-linked immunosorbent assay (ELISA) and the results were further normalized to the concentration of urinary creatinine (BDNF/Cr, mg/mol). RESULTS: The urinary BDNF/Cr levels of the patients with moderate and severe lower urinary tract symptoms were (1.189 ± 0.753) mg/mol and (1.817 ± 1.110) mg/mol (P < 0.001). The urinary BDNF/Cr levels of the patients with grades III-VI obstruction were (1.382 ± 0.945) mg/mol, (1.435 ± 0.938) mg/mol, (1.640 ± 1.104) mg/mol, and (1.653 ± 1.019) mg/mol, respectively (P > 0.05). There was no correlation between the urinary BDNF/Cr levels and the severity of obstruction (r = 0.103, P = 0.173). The urinary BDNF/Cr levels in the patients with and without OAB symptoms were (1.913 ± 0.843) mg/mol and (0.297 ± 0.183) mg/mol (P < 0.001). The urinary BDNF/Cr levels in the patients with mild, moderate and severe OAB symptoms were (1.501 ± 0.543) mg/mol, (1.806 ± 0.703) mg/mol and (2.560 ± 0.979) mg/mol, respectively (P < 0.05). There was a correlation between the urinary BDNF/Cr levels and the severity of OAB symptoms (r = 0.743, P < 0.001). The urinary BDNF/Cr levels in the patients with urodynamic detrusor overativity were significantly higher than those without detrusor overativity [(1.917 ± 0.866) mg/mol and (1.194 ± 1.013) mg/mol, P < 0.001]. CONCLUSION: There is no correlation between urinary BDNF and severity of obstruction in benign prostatic hyperplasia patients with moderate and severe lower urinary tract symptoms. The urinary BDNF levels in patients with OAB symptoms are elevated compared with patients without OAB symptoms, and are correlated with the severity of OAB symptoms.

[Influence of tension-free midurethral sling surgery on sexual function in women with stress urinary incontinence].

OBJECTIVE: To investigate the change of the female patients' sexual function after tension free vaginal tape (TVT) or transobturator suburethral tape (TVT-O) surgery for stress urinary incontinence (SUI). METHODS: Female sexual function index (FSFI) was sent to 66 female patients who underwent a TVT/TVT-O surgery at least 3 months after the operation, to a maximum of 5 years. All The patients were divided into two groups according to different surgical methods, different follow-up intervals (more than or less than 1 year) and whether there was concomitant coital incontinence (CCI) before the operation. The changes of FSFI scores before and after the operation were compared between the two groups by multiple covariances analysis. The total score was higher, and the sexual function was better. RESULTS: In the study, 60 patients answered the questionnaire, and 51 questionnaires were available. Before surgery, there were no significant difference between TVT and TVT-O groups in FSFI, age, body mass index (BMI). As to patients who had TVT/TVT-O surgery, when the influence of the postoperative period and symptoms accompanying intercourse were corrected, the two groups had no significant difference in difference of FSFI (dFSFI) scores after operation (F = 2.52, P = 0.119), and they had similar sexual function improvement ratio (40.0% vs. 44.4%, P > 0.05). But to the patients who had concomitant coital incontinence before the operations, the dFSFI scores was higher than patients who did not have concomitant coital incontinence (1.86 ± 1.95 vs. -0.09 ± 2.24, P < 0.05). CONCLUSION: TVT and TVT-O surgery have no significant difference in influence on sexual function in women between each other, but the patients who suffer from CCI before the surgery will have a better sexual function improvement.

[Diagnostic value of ultrasound-guided core needle biopsy for soft tissue tumors].

OBJECTIVE: To study the diagnostic value and pitfalls of ultrasound-guided core needle biopsy (CNB) of soft tissue tumors. METHODS: One hundred and six cases of CNB specimens encountered during the period from 2007 to 2012 were enrolled into the study. The pathologic diagnosis using CNB was compared with that using surgical specimens. Diagnostic accuracy was analyzed using Chi-square test, with respect to the histologic pattern (such as spindle cell and myxoid), biologic behavior (benign versus malignant) and immunohistochemical results. The 59 cases of sarcoma were subdivided into three grades according to FNCLCC grading system. RESULTS: Histologic diagnosis could be made in 84.0% (89/106) cases. Thirteen cases were non-diagnostic on CNB. There were 4 cases on CNB showing diagnostic discrepancy with surgical specimens. Four cases of "benign lesions" on CNB found to be myxoid liposarcoma and lipoma-like liposarcoma upon resection. In general, myxoid pattern (9/17) seen on CNB showed less diagnostic correlation with surgical specimens, as compared to spindle cell and other histologic patterns (P < 0.01). The rate of diagnostic correlation was 79.7% (49/59) for the 59 cases of sarcoma studied, with grade 2 and grade 3 sarcoma showing better correlation (in contrast to 7/17 for grade 1 sarcoma) (P < 0.01). Comparative analysis showed no significant difference between benign/borderline tumors and sarcomas. The application of immunohistochemical study did not result in significant improvement in diagnostic accuracy on CNB. CONCLUSIONS: Ultrasound-guided CNB is a reliable tool in pathologic diagnosis of soft tissue tumors and shows a high accuracy rate especially for high-grade sarcoma. Tumors with myxoid pattern, lipomatous tumors and grade 1 sarcomas are associated with lower diagnostic accuracy on CNB. Correlation with clinicoradiologic findings would also be helpful in diagnostic evaluation and surgical planning.

Analysis of soft tissue sarcomas in 1118 cases.

BACKGROUND: It is important to analyze and compare soft tissue sarcomas periodically so as to update the incidence, the clinical diagnosis, the treatment, and the ongoing research. The present study was conducted to determine the relative frequency of each type of soft tissue sarcoma. METHODS: A total of 1118 cases of primary soft tissue sarcomas treated between January 1993 and December 2006 were evaluated in a retrospective analysis. RESULTS: According to the pathologic grouping, the diseases with the highest proportion were malignant fibrous histiocytomas (35.24%), synovial sarcomas (17.08%), liposarcomas (16.28%), and rhabdomyosarcomas (12.61%). Soft tissue sarcomas were detected in every age group and occurred in all parts of the body. The number of cases increased gradually over the years. CONCLUSIONS: Malignant fibrous histiocytomas had the highest frequency among the soft tissue sarcomas. The number of cases increased gradually over the years.

[Roles of immunohistochemistry and detection of SYT-SSX fusion gene in diagnosis of synovial sarcoma].

OBJECTIVE: To assess the diagnostic values of immunohistochemistry and SYT-SSX fusion gene detection for synovial sarcoma. METHODS: Based on clinical features, histological and immunohistochemical profiles, 195 cases of tumors were divided into three diagnostic categories: definitive synovial sarcoma, probable synovial sarcoma and possible synovial sarcoma. RT-PCR Detection of the SYT-SSX fusion gene was performed using paraffin embedded tissue samples. Comparison between RT-PCR and immunohistochemistry results was carried out and their diagnostic value was evaluated. RESULTS: There were 62 (31.8%) definite synovial sarcomas, 49 (25.1%) probable synovial sarcomas and 84 cases (43.1%) possible synovial sarcomas. SYT-SSX fusion gene was detected in 140 (78.2%) cases overall, including 94.7% (54/57) definite synovial sarcomas, 86.0% (37/43) probable synovial sarcomas and 62.0% (49/79) possible synovial sarcomas. In tumors in the certain and probable synovial sarcoma categories, the positive rates of epithelial membrane antigen (EMA) were significantly higher in the SYT-SSX positive cases than SYT-SSX-negative cases (P = 0.022, P = 0.010, respectively). EMA was positively correlated with the presence of SYT-SSX (r(s) = 0.431, P = 0.001, r(s) = 0.463, P = 0.002, respectively). However, such a correlation was not seen in cytokeratin (CK), vimentin or S-100 protein immunostains (P > 0.05). In tumors of possible synovial sarcoma category, there were no significant differences of CK, EMA, vimentin or S-100 protein between SYT-SSX-positive and SYT-SSX-negative tumors. CONCLUSIONS: SYT-SSX fusion gene detection is not needed when the conventional approaches are diagnostic. EMA positivity has a similar diagnostic value to that of SYT-SSX by RT-PCR for tumors in the probable synovial sarcoma category. However, detection of SYT-SSX is very important for diagnosis of the tumors in the category of possible synovial sarcoma.