[Effect of Chelated Iron on Nitrogen Removal Efficiency and Microbial Community Structure in the Anaerobic Ferric Ammonium Oxidation].

In order to understand the characteristics and interactions of the microbial community during the anaerobic ferric ammonium oxidation (FEAMMOX) process, this study investigated the effects of various forms of chelated iron on nitrogen removal efficiency and microbial community structure. After 77 days of reactor operation, the removal efficiency of total nitrogen was 83.32% for the ferric humate group, 43.67% for the ferric citrate group, 55.07% for the ferric sodium ethylene diamine tetraacetate group, and 12.65% for the ferric ammonium triacetate group. After the experiment, the abundance of denitrifying bacteria Comamonadaceae in ferric humate group was 17.57%, the abundance of Clostridium in ferric citrate group was 47.70%; and the abundance of denitrifying bacteria Thermomonas in the ferric sodium ethylene diamine tetraacetate group was 20.11%. This indicates that ferric humate is a more effective electron acceptor for the FEAMMOX process. The result of function prediction shows that the iron, sulfur, and nitrogen cycles are all closely related, with iron and sulfur metabolism playing an important role in nitrogen removal. In the humate group, iron respiration and the nitrogen cycle are more strongly correlated than other groups. Co-occurrence network analysis showed that the keystone species in the FEAMMOX process is Tessaracoccus.

Concomitant systemic lupus erythematosus and HIV infection: A rare case report and literature review.

RATIONALE: Coexisting systemic lupus erythematosus (SLE) and human immunodeficiency virus (HIV) infection cases are rare worldwide. Great challenges are posed on the diagnosis and treatment of such concurrent cases. PATIENT CONCERN: We report the case of a 44-year-old Chinese man with edema, hematuria, and fever who presented at West China Hospital, Sichuan University, Chengdu, Sichuan, China, in 2013. DIAGNOSES: An initial diagnosis of SLE was made from the clinical manifestations and laboratory findings based on the Systemic Lupus International Collaborating Clinics classification criteria. Immunosuppressant therapy relieved him of the edema and hematuria, but he regained the symptoms after a cold. Workup, including electrochemiluminescence immunoassay, western blot, and polymerase chain reaction analysis, revealed that he was concurrently infected with HIV after hospitalization. INTERVENTIONS: The treatment plan included methylprednisolone and cyclophosphamide, with gastroprotective and hepatoprotective agents, simultaneously aiming to reduce urinary protein. After HIV infection confirmed, cyclophosphamide was stopped. He was referred to the local Centers for Disease Control and Prevention for combination antiretroviral therapy (ART). He was suggested to continue monitoring CD4 T-cell count for an appropriate dose of immunosuppressive drugs. OUTCOMES: In the last follow-up in May 2017, he had been stable in terms of both SLE and HIV infection. LESSONS: The case highlights the presence of concurrent SLE and HIV infection. Laboratory technicians and clinicians should be cautious on diagnosis, especially in eliminating the false-positive results. Attention should be paid to the dose of immunosuppressants and the ART procedure.