Insight into the role of Streptococcus suis zinc metalloprotease C from the new serotype causing meningitis in piglets.

Streptococcus suis (S. suis) is an important gram-positive pathogen and an emerging zoonotic pathogen that causes meningitis in swine and humans. Although several virulence factors have been characterized in S. suis, the underlying mechanisms of pathogenesis are not fully understood. In this study, we identified Zinc metalloproteinase C (ZmpC) probably as a critical virulence factor widely distributed in S. suis strains. ZmpC was identified as a critical facilitator in the development of bacterial meningitis, as evidenced by the detection of increased expression of TNF-α, IL-8, and matrix metalloprotease 9 (MMP-9). Subcellular localization analysis further revealed that ZmpC was localized to the cell wall surface and gelatin zymography analysis showed that ZmpC could cleave human MMP-9. Mice challenge demonstrated that ZmpC provided protection against S. suis CZ130302 (serotype Chz) and ZY05719 (serotype 2) infection. In conclusion, these results reveal that ZmpC plays an important role in promoting CZ130302 to cause mouse meningitis and may be a potential candidate for a S. suis CZ130302 vaccine.

Impact of evidence-based nursing on postoperative psychological state, quality of life, and function of affected limbs in breast cancer patients: An observational study.

To analyze the effect of evidence-based nursing on postoperative psychological state, quality of life, and function of affected limbs in breast cancer (BC) patients. This study is a retrospective analysis. The clinical data of 122 BC patients in our hospital were selected and divided into evidence-based group and routine group according to different nursing programs. Patients in evidence-based group received evidence-based nursing, and patients in the conventional group received routine nursing intervention. The acceptance level of BC diagnosis in evidence-based group was significantly higher than that in the conventional group, showing statistical significance (P < .05). After intervention, Self-rating Anxiety Scale and Self-rating Depression Scale scores of both groups were significantly reduced, and the Self-rating Anxiety Scale and Self-rating Depression Scale scores in evidence-based group were significantly lower than those in conventional group, showing statistically significant difference (P < .05); Self-Esteem Scale scores were significantly increased in both groups after intervention, and the scores in evidence-based group were significantly higher than those in conventional group, showing statistically significant difference (P < .05). After intervention, in evidence-based group, the proportion of patients without edema was significantly increased, while the proportion of patients with mild, moderate and severe edema was significantly decreased, exhibiting statistically significant difference (P < .05). After intervention, the circumference difference of the healthy side and the affected side decreased significantly, which was much lower in evidence-based group, showing statistically significant difference (P < .05). After intervention, range of motion of the upper limbs increased significantly between the 2 groups, which was much higher in evidence-based group, exhibiting statistical significance (P < .05). The scores of quality of life (role, emotion, body, cognition and society dimension) in evidence-based group were higher than those in conventional group, exhibiting statistically significant difference (P < .05). Evidence-based nursing can develop more targeted nursing measures according to patients' problems, thus effectively promoting the recovery of upper limb function of BC patients after surgery.

SssP1, a Fimbria-like component of Streptococcus suis, binds to the vimentin of host cells and contributes to bacterial meningitis.

Streptococcus suis (S. suis) is one of the important pathogens that cause bacterial meningitis in pigs and humans. Evading host immune defences and penetrating the blood-brain barrier (BBB) are the preconditions for S. suis to cause meningitis, while the underlying mechanisms during these pathogenic processes are not fully understood. By detecting the red blood and white blood cells counts, IL-8 expression, and the pathological injury of brain in a mouse infection model, a serine-rich repeat (SRR) glycoprotein, designated as SssP1, was identified as a critical facilitator in the process of causing meningitis in this study. SssP1 was exported to assemble a fimbria-like component, thus contributed to the bacterial adhesion to and invasion into human brain microvascular endothelial cells (HBMECs), and activates the host inflammatory response during meningitis but is not involved in the actin cytoskeleton rearrangement and the disruption of tight junctions. Furthermore, the deletion of sssP1 significantly attenuates the ability of S. suis to traverse the BBB in vivo and in vitro. A pull-down analysis identified vimentin as the potential receptors of SssP1 during meningitis and following Far-Western blot results confirmed this ligand-receptor binding mediated by the NR2 (the second nonrepeat region) region of SssP1. The co-localisation of vimentin and S. suis observed by laser scanning confocal microscopy with multiplex fluorescence indicated that vimentin significantly enhances the interaction between SssP1 and BBB. Further study identified that the NR216-781 and NR1711-2214 fragments of SssP1 play critical roles to bind to the BBB depending on the sialylation of vimentin, and this binding is significantly attenuated when the antiserum of NR216-781 or NR1711-2214 blocked the bacterial cells, or the vimentin antibody blocked the BBB. Similar binding attenuations are observed when the bacterial cells were preincubated with the vimentin, or the BBB was preincubated with the recombinant protein NR216-781, NR1711-2214 or sialidase. In conclusion, these results reveal a novel receptor-ligand interaction that enhances adhesion to and penetration of the BBB to cause bacterial meningitis in the S. suis infection and highlight the importance of vimentin in host-pathogen interactions.

Effects of Out-of-Hospital Continuous Nursing on Postoperative Breast Cancer Patients by Medical Big Data.

This study aimed to explore the application value of the intelligent medical communication system based on the Apriori algorithm and cloud follow-up platform in out-of-hospital continuous nursing of breast cancer patients. In this study, the Apriori algorithm is optimized by Amazon Web Services (AWS) and graphics processing unit (GPU) to improve its data mining speed. At the same time, a cloud follow-up platform-based intelligent mobile medical communication system is established, which includes the log-in, my workstation, patient records, follow-up center, satisfaction management, propaganda and education center, SMS platform, and appointment management module. The subjects are divided into the control group (routine telephone follow-up, 163) and the intervention group (continuous nursing intervention, 216) according to different nursing methods. The cloud follow-up platform-based intelligent medical communication system is used to analyze patients' compliance, quality of life before and after nursing, function limitation of affected limb, and nursing satisfaction under different nursing methods. The running time of Apriori algorithm is proportional to the data amount and inversely proportional to the number of nodes in the cluster. Compared with the control group, there are statistical differences in the proportion of complete compliance data, the proportion of poor compliance data, and the proportion of total compliance in the intervention group (P < 0.05). After the intervention, the scores of the quality of life in the two groups are statistically different from those before treatment (P < 0.05), and the scores of the quality of life in the intervention group were higher than those in the control group (P < 0.05). The proportion of patients with limited and severely limited functional activity of the affected limb in the intervention group is significantly lower than that in the control group (P < 0.05). The satisfaction rate of postoperative nursing in the intervention group is significantly higher than that in the control group (P < 0.001), and the proportion of basically satisfied and dissatisfied patients in the control group was higher than that in the intervention group (P < 0.05).

An Auto-Regulating Type II Toxin-Antitoxin System Modulates Drug Resistance and Virulence in Streptococcus suis.

Toxin-antitoxin (TA) systems are ubiquitous genetic elements that play an essential role in multidrug tolerance and virulence of bacteria. So far, little is known about the TA systems in Streptococcus suis. In this study, the Xress-MNTss TA system, composed of the MNTss toxin in the periplasmic space and its interacting Xress antitoxin, was identified in S. suis. ß-galactosidase activity and electrophoretic mobility shift assay (EMSA) revealed that Xress and the Xress-MNTss complex could bind directly to the Xress-MNTss promoter as well as downregulate streptomycin adenylyltransferase ZY05719_RS04610. Interestingly, the Xress deletion mutant was less pathogenic in vivo following a challenge in mice. Transmission electron microscopy and adhesion assays pointed to a significantly thinner capsule but greater biofilm-formation capacity in ΔXress than in the wild-type strain. These results indicate that Xress-MNTss, a new type II TA system, plays an important role in antibiotic resistance and pathogenicity in S. suis.

Lumbar drainage for the treatment of refractory intracranial hypertension in HIV-negative cryptococcal meningitis.

Aim: This study aims to evaluate lumbar drainage (LD) for controlling refractory intracranial hypertension among non-HIV cryptococcal meningitis patients. Patients & methods: A case-control study was designed to compare LD (case) with repeated lumbar puncture (control). Results: Both LD and repeated lumbar puncture can efficiently control refractory intracranial hypertension. LD group showed better clinical symptom remission, such as lower rate of headache, vision disorders, signs of meningeal irritation and conscious disturbance, than control group. LD group was reported with higher intracranial pressure reduction (173.75 ± 17.72 mmH2O) than those among control group (113.50 ± 14.94 mmH2O; p < 0.05). Conclusion: LD is an effective and safe alternative to control refractory intracranial hypertension in HIV-negative cryptococcal meningitis patients.