Management of a Complex Peristomal Fistula: A Case Study.

BACKGROUND: We describe our experiences caring for a patient with a peristomal fistula (PF), characterized by suppuration from a peristomal abscess. The challenges associated with this case included management of a complex fistula and prevention of abdominal necrotizing fasciitis and peritonitis. CASE: A 63-year-old man presented with severe peristomal swelling and pain resulting from an abscess adjacent to his ileostomy. He was malnourished and depressed. He underwent a low anterior resection (Dixon procedure) for rectal cancer 2 years ago and an abdominoperineal resection (Miles procedure) for the recurrence of rectal carcinoma 1 year later. In addition, he underwent bowel resection with the creation of an ileostomy due to intestinal obstruction caused by a second recurrence approximately 1 month prior to this admission. Following evaluation of the fistula anatomy, incision and drainage of the abscess was performed. Diversion of the effluent was used to control infection and promote fistula closure. A registered dietitian and a psychologist were consulted to optimize nutrition and treat his depression. After 20 days of treatment, the patient recovered and was safely discharged. CONCLUSION: Peristomal fistula management should include anatomical assessment, incision and drainage of the abscess, diversion to control effluent, and skin protection. For complex cases, the coordinated efforts of the interdisciplinary team are imperative.

Ultra-processed food consumption and metabolic disease risk: an umbrella review of systematic reviews with meta-analyses of observational studies.

Background and aims: There is an ongoing debate on whether to advocate reducing ultra-processed food (UPF) in dietary guidelines to control metabolic disease (such as obesity and type 2 diabetes mellitus [T2DM]). We aimed to summarize the evidence from systematic reviews with meta-analyses between UPF consumption and metabolic diseases risk, assess the credibility, and verify the robustness of these associations. Methods: We systematically searched PubMed, Web of Science, Embase, and Cochrane Library databases from their inception to July 15, 2023, to identify relevant systematic reviews with meta-analyses. We used the random-effects model to evaluate the summary effect size, along with 95% confidence interval and prediction interval. We also assessed heterogeneity, evidence of small-study effects and excess significance bias, and categorized the credibility of each association based on quantitative umbrella review criteria. Additionally, we conducted subgroup and sensitivity analyses to assess the robustness of associations based on continents, study design, dietary assessment methods, definition methods of UPF, population, and units of UPF consumption. Results: Overall, 6 systematic reviews with 13 meta-analyses were included. Three (23.08%) meta-analyses were classified as highly suggestive evidence for meeting the criteria that associations were significant at p < 10-6, had more than 1,000 cases, and presented the largest study with significance at p < 0.05. Among them, the highest UPF consumption quantile was associated with an increased risk of obesity (OR = 1.55, 95% CI: 1.36-1.77) when compared with the lowest UPF consumption quantile. The highest UPF consumption quantile was associated with an increased risk of T2DM (RR = 1.40, 95% CI: 1.23-1.59) when compared with the lowest UPF consumption quantile, and a 10% increase in UPF consumption (% g/d) was associated with an increased risk of T2DM (RR = 1.12, 95% CI: 1.10-1.13). Meanwhile, the robustness of these associations was verified by a series of subgroup and sensitivity analyses. Conclusion: UPF consumption may be a risk factor for several metabolic diseases. However, well-designed studies are still needed to verify our findings in the future.

Per- and polyfluoroalkyl substances and human health outcomes: An umbrella review of systematic reviews with meta-analyses of observational studies.

BACKGROUND: Although evidence on the association between per- and polyfluoroalkyl substances (PFASs) and human health outcomes has grown exponentially, specific health outcomes and their potential associations with PFASs have not been conclusively evaluated. METHODS: We conducted a comprehensive search through the databases of PubMed, Embase, and Web of Science from inception to February 29, 2024, to identify systematic reviews with meta-analyses of observational studies examining the associations between the PFASs and multiple health outcomes. The quality of included studies was evaluated using the A Measurement Tool to Assess Systematic Reviews (AMSTAR) tool, and credibility of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria. The protocol of this umbrella review (UR) had been registered in PROSPERO (CRD 42023480817). RESULTS: The UR identified 157 meta-analyses from 29 articles. Using the AMSTAR measurement tool, all articles were categorized as of moderate-to-high quality. Based on the GRADE assessment, significant associations between specific types of PFASs and low birth weight, tetanus vaccine response, and triglyceride levels showed high certainty of evidence. Moreover, moderate certainty of evidence with statistical significance was observed between PFASs and health outcomes including lower BMI z-score in infancy, poor sperm progressive motility, and decreased risk of preterm birth as well as preeclampsia. Fifty-two (33%) associations (e.g., PFASs and gestational hypertension, cardiovascular disease, etc) presented low certainty evidence. Additionally, eighty-five (55%) associations (e.g., PFASs with infertility, lipid metabolism, etc) presented very low certainty evidence. CONCLUSION: High certainty of evidence supported that certain PFASs were associated with the incidence of low birth weight, low efficiency of the tetanus vaccine, and low triglyceride levels.

Engineering probiotic-derived outer membrane vesicles as functional vaccine carriers to enhance immunity against SARS-CoV-2.

Because of the continued emergence of SARS-CoV-2 variants, there has been considerable interest in how to display multivalent antigens efficiently. Bacterial outer membrane vesicles (OMVs) can serve as an attractive vaccine delivery system because of their self-adjuvant properties and the ability to be decorated with antigens. Here we set up a bivalent antigen display platform based on engineered OMVs using mCherry and GFP and demonstrated that two different antigens of SARS-CoV-2 could be presented simultaneously in the lumen and on the surface of OMVs. Comparing immunogenicity, ClyA-NG06 fusion and the receptor-binding domain (RBD) of the spike protein in the OMV lumen elicited a stronger humoral response in mice than OMVs presenting either the ClyA-NG06 fusion or RBD alone. Taken together, we provided an efficient approach to display SARS-CoV-2 antigens in the lumen and on the surface of the same OMV and highlighted the potential of OMVs as general multi-antigen carriers.

Recent advances in metal catalyst- and oxidant-free electrochemical C-H bond functionalization of nitrogen-containing heterocycles.

The C-H functionalization of nitrogen-containing heterocycles has emerged as a powerful strategy for the construction of carbon-carbon (C-C) and carbon-heteroatom (C-X) bonds. In order to achieve efficient and selective C-H functionalization, electrochemical synthesis has attracted increasing attention. Because electrochemical anodic oxidation is ideal for replacing chemical reagents in C-H functionalization reactions. This mini-review summarizes the current knowledge and recent advances since 2017 in the synthetic utility of electrochemical transformations for the C-H functionalization of nitrogen-containing heterocycles.

Characterisation of copal resin and amber by negative-ion electrospray ionisation Fourier transform ion cyclotron resonance mass spectrometry.

Copal resin and amber from Columbia were analysed by negative-ion electrospray ionisation (ESI) Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS), with particular focus on polar compounds with relatively high molecular weights. A total of 4038 and 2755 compounds were identified between m/z 150 and 1,000 in the spectra of the copal resin and amber DCM extracts, respectively. The CHO classes were the most abundant species in the detected polar compounds. The petrochemical process of converting copal resin to amber is accompanied by evaporation and dispersion of volatile molecules and polymerisation of relatively smaller molecules. Thus, the most abundant compounds in copal resin comprised more than one C5 basic unit compared to amber, and the relative abundances of compounds with a high number of carbon and oxygen atoms in amber were higher than those in copal resin. There were strong positive correlations between the double-bond equivalence (DBEav ) values and the number of oxygen atoms in both samples. The slopes and y-intercepts of the linear relationship indicated that the C5 pentadienoic acid is the basic structure of heteroatom compound molecules in copal resin and amber. FT-ICR MS analysis focuses on the characterisation of heteroatom compounds with relatively high molecular weight and is helpful to provide supplementary information on the origin and evolution of complex organic mixtures such as copal resin and amber at the molecular level in a fast and convenient way.

Circular RNA circ_0011385 promotes cervical cancer progression through competitively binding to miR-149-5p and up-regulating SOX4 expression.

Circular RNAs (circRNAs), emerging as a new type of non-coding RNAs, play important roles in cancers. Instead, the functions and mechanisms of circ_0011385 in cervical cancer (CC) are still inconclusive. Microarray data GSE102686 was downloaded from Gene Expression Omnibus (GEO) database, and were utilized to screen out circRNAs differently expressed in CC tissues. Circ_0011385, miR-149-5p, SRY-box transcription factor 4 (SOX4) mRNA expressions in CC tissues and cells were probed by quantitative real-time PCR (qRT-PCR). CC cell lines with circ_0011385 knockdown were constructed, and he multiplication, migration, invasion, and apoptosis of CC cells were evaluated by cell counting kit-8 (CCK-8) method, transwell assay, and flow cytometry. In addition, the targeting relationships between miR-149-5p and circ_0011385 or SOX4 mRNA 3'UTR were probed by dual-luciferase reporter gene assay and RNA pull-down assay. The regulatory function of circ_0011385 and miR-149-5p on SOX4 expression was studied with western blot. Expressions of circ_0011385 and SOX4 mRNA were raised in CC tissues and cells, while miR-149-5p expression was decreased. Knocking down circ_0011385 restrained the multiplication, migration, and invasion of CC cells and induced the apoptosis. Circ_0011385 directly targeted miR-149-5p, and SOX4 was the target of miR-149-5p, which could be positively regulated by circ_0011385. Circ_0011385 elevates SOX4 expression by targeting miR-149-5p, thus participating in promoting the malignant biological behaviors of CC cells.

Geochemically Distinct Oil Families in the Gudong Oilfield, Zhanhua Depression, Bohai Bay Basin, China.

Twenty crude oil samples were obtained from the Gudong Oilfield and their organic geochemical characteristics were analyzed. The oil samples were classified into three families by hierarchical cluster analysis and principal component analysis based on 13 source-related and depositional environment-related biomarker parameters. Oils in family I have low ratios of C19/C23 tricyclic terpanes and C24 tetracyclic terpane/C26 tricyclic terpanes, and relatively high ratios of steranes/hopanes and C30 4-methylsteranes/ααα20R C29 sterane, thus indicating that microalgae were the dominant organic matter input for the source rocks of family I. The gammacerane/C30 hopane ratios are higher than that of family II and family III, whereas the C35/C34 homohopane ratios are lower, thus indicating a suboxic, brackish water environment for the source rocks. The inferred source rock is the first member of the Shahejie Formation in the Huanghekou Sag. Family II is characterized by high ratios of C19/C23 tricyclic terpanes and C24 tetracyclic terpane/C26 tricyclic terpanes but relatively low ratios of steranes/hopanes and C27/C29 αααR steranes. These findings suggest that the original organic matter of the source rocks had a greater contribution from terrigenous higher plants than from microalgal. The relatively low ratios of gammacerane/C30 hopane and C35/C34 homohopane suggest that the source rocks were deposited in an oxic environment with a low salinity, thus corresponding to the Dongying Formation in the Huanghekou Sag. Family III oils have high C27/C29 ααααR steranes ratios and low C30 4-methylsteranes/ααα20R C29 ratios, which indicate the contribution of microalgae (especially zooplankton algae) to the source rocks. The relatively high abundance of C35 homohopane and low gammacerane/C30 hopane ratios suggest a weakly reducing condition with low salinity, which is in accordance with the third member of the Shahejie Formation in the Gunan Sag. The C31S/(S + R) homohopane ratios imply that oil samples in this study are in the mature stage, although the ratios of C2920S/(20S + 20R) and C29ßß/(αα + ßß) steranes suggest that the maturity of family II is higher than that of family I and family III.

Involvement of a velvet protein ClVelB in the regulation of vegetative differentiation, oxidative stress response, secondary metabolism, and virulence in Curvularia lunata.

The ortholog of Aspergillus nidulans VelB, which is known as ClVelB, was studied to gain a broader insight into the functions of a velvet protein in Curvularia lunata. With the expected common and specific functions of ClVelB, the deletion of clvelB results in similar though not identical phenotypes. The pathogenicity assays revealed that ΔClVelB was impaired in colonizing the host tissue, which corresponds to the finding that ClVelB controls the production of conidia and the methyl 5-(hydroxymethyl) furan-2-carboxylate toxin in C. lunata. However, the deletion of clvelB led to the increase in aerial hyphae and melanin formation. In addition, ΔClVelB showed a decreased sensitivity to iprodione and fludioxonil fungicides and a decreased resistance to cell wall-damaging agents and osmotic stress and tolerance to H2O2. The ultrastructural analysis indicated that the cell wall of ΔClVelB became thinner, which agrees with the finding that the accumulated level of glycerol in ΔClVelB is lower than the wild-type. Furthermore, the interaction of ClVelB with ClVeA and ClVosA was identified in the present research through the yeast two-hybrid and bimolecular fluorescence complementation assays. Results indicate that ClVelB plays a vital role in the regulation of various cellular processes in C. lunata.

[Effects of light intensity on the phenotypic plasticity of invasive species Ambrosia trifida].

Through artificial shading, this paper studied the phenotypic plasticity of invasive species Ambrosia trifida in its morphology, biomass allocation, and photosynthesis characteristics in response to different light intensities. As compared with the control, shading increased the stem height, crown width, leaf area, specific leaf area, and the proportion of leaf biomass in total biomass of A. trifida significantly, but decreased the total biomass, biomass per unit leaf area, and root to shoot ratio. Under natural light condition, the crown width and leaf area were smaller and the root to shoot ratio was larger, which benefited the decrease of water loss under high temperature and high light intensity and manifested the stronger phenotypic plasticity of A. trifida in its morphology and biomass allocation in response to different light intensities. Under shading, the mean daily net photosynthetic rate, transpiration rate, and stomatal conductance decreased, while the stomatal CO2 concentration increased. At noon when the light intensity was the highest, the photosynthetic rate, transpiration rate, and stomatal conductance under low shading reached the maximum. Under moderate shading and high shading, the chlorophyll content increased significantly, and the chlorophyll a/b had a significant decrease, which could improve the utilization of light energy by A. trifida under shading environment.