Preliminary Investigation and Imaging Analysis of Early Lung Cancer Screening Among Petroleum Workers in North China.

BACKGROUND: The detection rate of lung nodules has increased significantly among petroleum workers in North China since the low-dose CT (LDCT) screening has been widely carried out. What's more, the number of confirmed early lung cancers is increasing continuously. Therefore, a great deal of concern for the high risk of lung cancer has been shown among petroleum workers. PURPOSE: To improve the screening efficiency and maximize the benefits of the subjects, the current situation of LDCT lung cancer screening should be understood and the imaging characteristics of early lung cancer should be analyzed for petroleum workers in North China. MATERIALS AND METHODS: Firstly, the dynamic changes of LDCT early lung cancer screening for petroleum workers in North China were analyzed in recent years. Then, the survey data of 3121 petroleum workers was compared with that of 1868 non-petroleum workers, which was analyzed. Finally, 91 patients (129 nodular lung cancer) confirmed by pathology were retrospectively analyzed, and the data of which was compared with the clinical features obtained from survey data above. The imaging characteristics and related factors of different subtypes of lung adenocarcinoma were discussed and analyzed. RESULTS: Lung nodules were found in 810 cases (25.95%) out of 3121 petroleum workers; and the surgery was chosen by 42 patients, 38 of whom were confirmed as lung cancer. Compared with the data of screened petroleum workers, there were more older people and more females as well as a higher proportion of people with family malignancy history, and a lower proportion of smoking people in 91 patients with lung cancer. As the pathological grade of tumor nodules increased, the volume and diameter of nodules gradually increased, and the mean density, maximum density and standard deviation of density also increased (p < 0.001). The volume and diameter of nodules were positively correlated with ages (p < 0.05). CONCLUSION: The occurrence of lung adenocarcinoma is closely related to the family history of malignant tumors, and the constituent ratio of young women without a history of smoking increased significantly. At the same time, the quantitative information obtained by using CT images has important value in predicting its pathological subtypes.

Noncoding RNAs involved in DNA methylation and histone methylation, and acetylation in diabetic vascular complications.

Diabetes is a metabolic disorder and its incidence is still increasing. Diabetic vascular complications cause major diabetic mobility and include accelerated atherosclerosis, nephropathy, retinopathy, and neuropathy. Hyperglycemia contributes to the pathogenesis of diabetic vascular complications via numerous mechanisms including the induction of oxidative stress, inflammation, metabolic alterations, and abnormal proliferation of EC and angiogenesis. In the past decade, epigenetic modifications have attracted more attention as they participate in the progression of diabetic vascular complications despite controlled glucose levels and regulate gene expression without altering the genomic sequence. DNA methylation and histone methylation, and acetylation are vital epigenetic modifications and their underlying mechanisms in diabetic vascular complication are still urgently needed to be investigated. Non-coding RNAs (nc RNAs) such as micro RNAs (miRNAs), long non-coding RNA (lncRNAs), and circular RNAs (circ RNAs) were found to exert transcriptional regulation in diabetic vascular complication. Although nc RNAs are not considered as epigenetic components, they are involved in epigenetic modifications. In this review, we summarized the investigations of non-coding RNAs involved in DNA methylation and histone methylation and acetylation. Their cross-talks might offer novel insights into the pathology of diabetic vascular complications.

CircRNA RSF1 regulated ox-LDL induced vascular endothelial cells proliferation, apoptosis and inflammation through modulating miR-135b-5p/HDAC1 axis in atherosclerosis.

BACKGROUND: Atherosclerosis (AS) is the most common type in cardiovascular disease. Due to its complex pathogenesis, the exact etiology of AS is unclear. circRNA has been shown to play an essential role in most diseases. However, the underlying mechanism of circRNA in AS has been not understood clearly. METHODS: Quantitative Real-Time PCR assay was used to detect the expression of circRSF1, miR-135b-5p and histone deacetylase 1 (HDAC1). Western blot was applied to the measure of protein expression of HDAC1, B-cell lymphoma-2 (Bcl-2), BCL2-associated X (Bax), cleaved-caspase-3, vascular cell adhesion molecule 1 (VCAM1), intercellular cell adhesion molecule-1 (ICAM1) and E-selectin. MTT assay and flow cytometry were used to detect cell proliferation and apoptosis, respectively. Dual luciferase reporter assay and RIP assay was used to determine the relationship among circRSF1, miR-135b-5p and HDAC1. Besides, an ELISA assay was performed to measure the levels of IL-1ß, IL-6, TNF-α and IL-8. RESULTS: In this study, ox-LDL inhibited circRSF1 and HDAC1 expression while upregulated miR-135b-5p expression in Human umbilical vein endothelial cells (HUVECs). Importantly, ox-LDL could inhibit HUVECs growth. Moreover, promotion of circRSF1 or inhibition of miR-135b-5p induced cell proliferation while inhibited apoptosis and inflammation of ox-LDL-treated HUVECs, which was reversed by upregulating miR-135b-5p or downregulating HDCA1 in ox-LDL-treated HUVECs. More than that, we verified that circRSF1 directly targeted miR-135b-5p and HDAC1 was a target mRNA of miR-135b-5p in HUVECs. CONCLUSION: CircRSF1 regulated ox-LDL-induced vascular endothelial cell proliferation, apoptosis and inflammation through modulating miR-135b-5p/HDAC1 axis in AS, providing new perspectives and methods for the treatment and diagnosis of AS.

The function role of ubiquitin proteasome pathway in the ER stress-induced AECII apoptosis during hyperoxia exposure.

BACKGROUND: Bronchopulmonary dysplasia (BPD) is a major cause of mortality and morbidity in premature infants, characterized by alveolar dysplasia and pulmonary microvascular remodeling. In the present study, we have investigated the functional roles of ubiquitin proteasome pathway (UPP) in BPD, and its relationship with endoplasmic reticulum stress (ERS) mediated type II alveolar epithelial cell (AECII) apoptosis. METHODS: A hyperoxia-induced BPD rat model was constructed and the pathologic changes of lung tissues were evaluated by hematoxylin-eosin staining. Cell apoptosis and protein expression were determined by TUNEL assay and Western blotting, respectively. Further reagent kit with specific fluorescent substrate was utilized to measure the activity of 20 s proteasome. Meanwhile, AECII were cultured in vitro and exposed to hyperoxia. AECII apoptosis were measured by flow cytometry. In contrast, MG132 treatment was induced to explore UPP during hyperoxia exposure on AECII apoptosis and ERS sensors expression. RESULTS: A significant increase in apoptosis and total ubiquitinated proteins expression were observed in BPD rats and AECII culture, and the change of UPP was associated with ERS. In order to confirm the role of UPP in AECII apoptosis of BPD, AECII cells were treated by MG132 with the concentration of 10 µmol/L under hyperoxia exposure. We found that the proteins expression of glucose-regulated protein 78 (GRP-78), PKR-like ER kinase (PERK), activating transcription factor 4 (ATF4), activating transcription factor 6 (ATF6) and C/EBP homologous protein (CHOP), as well as AECII apoptosis were increased following MG132 treatment. Furthermore, the relatively up-regulated in the levels of total ubiquitinated proteins expression and 20 s proteasome activity were correlated with increased ERS sensors expression. CONCLUSIONS: Our findings indicate that UPP may participate in the ERS-induced AECII apoptosis under hyperoxia condition.

Pro-inflammatory role of cell-free mitochondrial DNA in cardiovascular diseases.

Cardiovascular disease (CVD) is a major cause of morbidity and mortality. Inflammation contributes to the pathogenesis and progression of CVD. Circulating cell-free mitochondrial DNA (ccf-mtDNA) is that mtDNA fragments are released outside the cell and into the circulation by cell necrosis and secretion. The levels of ccf-mtDNA are increased in CVD and associated risk conditions, including hypercholesterolemia, diabetes mellitus, and arterial hypertension. MtDNA containing unmethylated CpG dinucleotides and can trigger inflammation that aggravates tissue injury by activating toll-like receptor 9, inflammasomes, and the stimulator of interferon genes pathway. Here, we review the expanding field of ccf-mtDNA-mediated inflammation and its role in the progression of CVD.

Columbianadin Suppresses Lipopolysaccharide (LPS)-Induced Inflammation and Apoptosis through the NOD1 Pathway.

Columbianadin (CBN) is one of the main bioactive constituents isolated from the root of Angelica pubescens. Although the anti-inflammatory activity of CBN has been reported, the underpinning mechanism of this remains unclear. In this study, we investigated the anti-inflammatory effect of CBN on lipopolysaccharide (LPS)-stimulated THP-1 cells and explored the possible underlying molecular mechanisms. The results showed that CBN suppressed LPS-mediated inflammatory response mainly through the inactivation of the NOD1 and NF- κ B p65 signaling pathways. Knockdown of NOD1 reduced the degree to which inflammatory cytokines decreased following CBN treatment, whereas forced expression of NOD1 and CBN treatment reduced NF- κ B p65 activation and the secretion of inflammatory cytokines. Furthermore, CBN significantly reduced cellular apoptosis by inhibiting the NOD1 pathway. Collectively, our results indicate that CBN suppressed the LPS-mediated inflammatory response by inhibiting NOD1/NF- κ B activation. Further investigations are required to determine the mechanisms of action of CBN in the inhibition of NOD signaling: However, CBN may be employed as a therapeutic agent for multiple inflammatory diseases.

The Role of Regulatory T Cell in Nontypeable Haemophilus influenzae-Induced Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

Chronic obstructive pulmonary disease (COPD) is associated with irreversible persistent airflow limitation and enhanced inflammation. The episodes of acute exacerbation (AECOPD) largely depend on the colonized pathogens such as nontypeable Haemophilus influenzae (NTHi), one of the most commonly isolated bacteria. Regulatory T cells (Tregs) are critical in controlling inflammatory immune responses and maintaining tolerance; however, their role in AECOPD is poorly understood. In this study, we hypothesized a regulatory role of Tregs, as NTHi participated in the progress of COPD. Immunological pathogenesis was investigated in a murine COPD model induced by cigarette smoke (CS). NTHi was administrated through intratracheal instillation for an acute exacerbation. Weight loss and lung function decline were observed in smoke-exposed mice. Mice in experimental groups exhibited serious inflammatory responses via histological and cytokine assessment. Expression levels of Tregs and Th17 cells with specific cytokines TGF-ß1 and IL-17 were detected to assess the balance of pro-/anti-inflammatory influence partially. Our findings suggested an anti-inflammatory activity of Tregs in CS-induced model. But this activity was suppressed after NTHi administration. Collectively, these data suggested that NTHi might play a necessary role in downregulating Foxp3 to impair the function of Tregs, helping development into AECOPD.

Anti-Inflammatory Effect of Columbianetin on Lipopolysaccharide-Stimulated Human Peripheral Blood Mononuclear Cells.

Dysregulated inflammation is increasingly considered as the main cause of many diseases on which NOD1/NF-κB pathway plays an important role. Columbianetin (CBT) is derived from the root of the Chinese herb Radix Angelicae Pubescentis for treating inflammatory diseases. Although the anti-inflammatory effect of CBT has been reported, its anti-inflammatory mechanism was poorly studied. In this study, we explored the anti-inflammatory pathway of CBT in lipopolysaccharide- (LPS-) stimulated human peripheral blood mononuclear cell (PBMC) model. Inflammatory cytokine production in culture supernatant was assessed using ELISA assay, and the possible anti-inflammatory pathway of CBT was screened using qPCR array and enrichment analysis with DAVID6.8. To further confirm the targeted pathway of CBT, we pretreated PBMC with the selective NOD1 inhibitor ML130 and then measured the protein levels of the pathway by Western blotting. The result showed that CBT effectively suppressed the expressions of TNF-α, IL-6, MCP-1, and IL-1ß in a dose-dependent manner and significantly downregulated 19 out of 32 differentially expressed genes, most of which were involved in the NOD1/NF-κB pathway, and also showed that CBT remarkably inhibited LPS-induced NOD1, RIP2, and NF-κB activation. Furthermore, the inhibitory effects of CBT on NOD1/NF-κB pathways were blocked by ML130. These findings indicated that CBT inhibits the production of inflammatory cytokines induced by LPS involved in the downregulation of NOD1/NF-κB pathways.

The Role of Lower Airway Dysbiosis in Asthma: Dysbiosis and Asthma.

With the development of culture-independent techniques, numerous studies have demonstrated that the lower airway is not sterile in health and harbors diverse microbial communities. Furthermore, new evidence suggests that there is a distinct lower airway microbiome in those with chronic respiratory disease. To understand the role of lower airway dysbiosis in the pathogenesis of asthma, in this article, we review the published reports about the lung microbiome of healthy controls, provide an outlook on the contribution of lower airway dysbiosis to asthma, especially steroid-resistant asthma, and discuss the potential therapies targeted for lower airway dysbiosis.

Correlation of computed tomography angiography parameters and shock index to assess the transportation risk in aortic dissection patients.

BACKGROUND: Aortic dissection (AD) is a serious, life-threatening disease. It is currently crucial for AD patients to be transferred to a specialised hospital in a safe and timely manner. For this reason, the search for clinical and imaging changes related to transportation risk is becoming increasingly important. PURPOSE: The transportation risks of AD patients were assessed by studying the correlation between computed tomography angiography (CTA) parameters and shock index. MATERIALS AND METHODS: Thirty-six cases of AD confirmed with 64-slice volumetric CT (VCT) (18 cases of Stanford type A and 18 cases of type B) were divided into a high-risk group (14 cases, six Stanford type A and eight type B) and a low-risk group (22 cases, 12 Stanford type A and 10 type B) according to the modified Early Warning Score. The shock index (ratio of heart rate to systolic blood pressure) and measured CTA parameters were compared between the high-risk group and the low-risk group, and the correlation between the measured CTA parameters and shock index was analysed. RESULTS: The shock index and ratio of false/true lumen were compared between Stanford type A and type B, and no statistically significant differences were found. The shock index and ratio of false/true lumen were compared between the high-risk group and low-risk group, revealing a statistically significant difference (p < 0.05). Moreover, a significant linear correlation was found between the ratio of false/true lumen and the shock index (r = 0.691; p = 0.001). CONCLUSION: The higher the shock index and the ratio of false/true lumen are, the greater the transportation risk for AD patients. The shock index and the ratio of false/true lumen proved to be essential clinical and radiological indices for assessing the transportation risk of AD patients.

[Relationship between placental inflammation and fetal inflammatory response syndrome and brain injury in preterm infants].

OBJECTIVE: To explore the relationship between histological chorioamnionitis (HCA) and fetal inflammatory response syndrome (FIRS) and brain injury in preterm infants. METHODS: One hundred and three singleton infants with premature rupture of membranes (PROM) (gestation ages of less than 34 weeks) were enrolled. All the placentas were submitted for pathological evaluation. Umbilical cord blood interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor alpha (TNF-α) and granulocyte-colony stimulating factor (G-CSF) levels were measured with liquid chip. All preterm infants accepted brain imaging examinations. Based on the placental pathological examination and umbilical cord blood level of IL-6, the 103 infants were classified into HCA⁻ FIRS⁻, HCA⁺ FIRS⁻, and HCA⁺ FIRS⁺ groups. RESULTS: The incidences of HCA, FIRS, and brain injury were 53.4%, 20.4% and 38.8% respectively. The prevalence of brain injury in HCA⁻ FIRS⁻, HCA⁺ FIRS⁻, and HCA⁺ FIRS⁺ cases was 21%, 41%, and 76% respectively (P<0.01). The grade 2 and grade 3 of placental inflammation and the inflammation at stage 2 and stage 3 increased the risk of brain injury. The cord blood levels of IL-8, TNF-α, and G-CSF in the HCA⁺ FIRS⁺ group were significantly higher than in the other two groups, and the levels of the above parameters in the HCA⁺ FIRS⁻ were higher than in the HCA⁻ FIRS⁻ group (P<0.05). CONCLUSIONS: Placental inflammation and FIRS are associated with brain injury in preterm infants. Preterm infants exposed to severe placental inflammation have an increased risk of brain injury. Cord blood IL-8, TNF-α and G-CSF may be involved in the process of brain injury in preterm infants with placental inflammation and FIRS.

The preliminary exploration of 64-slice volume computed tomography in the accurate measurement of pleural effusion.

BACKGROUND: Using computed tomography (CT) to rapidly and accurately quantify pleural effusion volume benefits medical and scientific research. However, the precise volume of pleural effusions still involves many challenges and currently does not have a recognized accurate measuring. PURPOSE: To explore the feasibility of using 64-slice CT volume-rendering technology to accurately measure pleural fluid volume and to then analyze the correlation between the volume of the free pleural effusion and the different diameters of the pleural effusion. MATERIAL AND METHODS: The 64-slice CT volume-rendering technique was used to measure and analyze three parts. First, the fluid volume of a self-made thoracic model was measured and compared with the actual injected volume. Second, the pleural effusion volume was measured before and after pleural fluid drainage in 25 patients, and the volume reduction was compared with the actual volume of the liquid extract. Finally, the free pleural effusion volume was measured in 26 patients to analyze the correlation between it and the diameter of the effusion, which was then used to calculate the regression equation. RESULTS: After using the 64-slice CT volume-rendering technique to measure the fluid volume of the self-made thoracic model, the results were compared with the actual injection volume. No significant differences were found, P = 0.836. For the 25 patients with drained pleural effusions, the comparison of the reduction volume with the actual volume of the liquid extract revealed no significant differences, P = 0.989. The following linear regression equation was used to compare the pleural effusion volume (V) (measured by the CT volume-rendering technique) with the pleural effusion greatest depth (d): V = 158.16 × d - 116.01 (r = 0.91, P = 0.000). The following linear regression was used to compare the volume with the product of the pleural effusion diameters (l × h × d): V = 0.56 × (l × h × d) + 39.44 (r = 0.92, P = 0.000). CONCLUSION: The 64-slice CT volume-rendering technique can accurately measure the volume in pleural effusion patients, and a linear regression equation can be used to estimate the volume of the free pleural effusion.

Construction and evaluation of normalized cDNA libraries enriched with full-length sequences for rapid discovery of new genes from Sisal (Agave sisalana Perr.) different developmental stages.

To provide a resource of sisal-specific expressed sequence data and facilitate this powerful approach in new gene research, the preparation of normalized cDNA libraries enriched with full-length sequences is necessary. Four libraries were produced with RNA pooled from Agave sisalana multiple tissues to increase efficiency of normalization and maximize the number of independent genes by SMART™ method and the duplex-specific nuclease (DSN). This procedure kept the proportion of full-length cDNAs in the subtracted/normalized libraries and dramatically enhanced the discovery of new genes. Sequencing of 3875 cDNA clones of libraries revealed 3320 unigenes with an average insert length about 1.2 kb, indicating that the non-redundancy of libraries was about 85.7%. These unigene functions were predicted by comparing their sequences to functional domain databases and extensively annotated with Gene Ontology (GO) terms. Comparative analysis of sisal unigenes and other plant genomes revealed that four putative MADS-box genes and knotted-like homeobox (knox) gene were obtained from a total of 1162 full-length transcripts. Furthermore, real-time PCR showed that the characteristics of their transcripts mainly depended on the tight expression regulation of a number of genes during the leaf and flower development. Analysis of individual library sequence data indicated that the pooled-tissue approach was highly effective in discovering new genes and preparing libraries for efficient deep sequencing.

Pulmonary nodules detection assistant platform: An effective computer aided system for early pulmonary nodules detection in physical examination.

BACKGROUND AND OBJECTIVE: Early detection of the pulmonary nodule from physical examination low-dose computer tomography (LDCT) images is an effective measure to reduce the mortality rate of lung cancer. Although there are many computer aided diagnosis (CAD) methods used for detecting pulmonary nodules, there are few CAD systems for small pulmonary nodule detection with a large amount of physical examination LDCT images. METHODS: In this work, we designed a CAD system called Pulmonary Nodules Detection Assistant Platform for early pulmonary nodules detection and classification based on the physical examination LDCT images. Based on the preprocessed physical examination CT images, the three-dimensional (3D) CNN-based model is presented to detect candidate pulmonary nodules and output detection results with quantitative parameters, the 3D ResNet is used to classify the detected nodules into intrapulmonary nodules and pleural nodules to reduce the physician workloads, and the Fully Connected Neural Network (FCNN) is used to classify ground-glass opacity (GGO) nodules and non-GGO nodules to help doctor pay more attention to those suspected early lung cancer nodules. RESULTS: Experiments are performed on our 1000 samples of physical examinations (LNPE1000) with an average diameter of 5.3 mm and LUNA16 dataset with an average diameter of 8.31 mm, which show that the designed CAD system is automatic and efficient for detecting smaller and larger nodules from different datasets, especially for the detection of smaller nodules with diameter between 3 mm and 6 mm in physical examinations. The accuracy of pulmonary nodule detection reaches 0.879 with an average of 1 false positive per CT in LNPE1000 dataset, which is comparable to the experienced physicians. The classification accuracy reaches 0.911 between intrapulmonary and pleural nodules, and 0.950 between GGO and non-GGO nodules, respectively. CONCLUSION: Experimental results show that the proposed pulmonary nodule detection model is robust for different datasets, which can successfully detect smaller and larger nodules in CT images obtained by physical examination. The interactive platform of the designed CAD system has been on trial in a hospital by combining with manual reading, which helps doctors analyze clinical data dynamically and improves the nodule detection efficiency in physical examination applications.

CT virtual endoscopy of the ampulla of Vater: preliminary report.

AIM: To explore multi-slice spiral CT (MSCT) virtual endoscopy (CTVE) in the detection of Vater's ampulla lesions. METHODS: In addition to 30 healthy volunteers, 18 cases of common bile duct stones, and 7 cases of ampullary carcinoma were scanned with MSCT including virtual endoscopy (VE) reconstruction. Patterns of the duodenal papilla were then observed, and its size was measured. RESULTS: Reconstructed images of CTVE in the volunteers showed that the normal type of the duodenal papilla was nodular in 16 cases, V-shaped in 8 cases, and Y-shaped in 6 cases. Its mean diameter was 0.84 ± 0.17 cm in the healthy volunteers; in patients with common bile duct stones of nodular type, mean diameter was 1.72 ± 0.32 cm. In ampullary cancer patients with an irregular protruded type, its diameter was 2.30 ± 0.85 cm, Overall the mean differences between the groups were statistically significant (P < 0.001). CONCLUSION: CTVE is a convenience, no-wound, and precise clinical examination mode utilizing which the shape of duodenal papilla can be observed, and size of the latter can be measured.

[Effect of modified huopo xialing decoction in treating pi-wei dampness-heat syndrome and its impact on the tongue epithelial cell apoptosis].

OBJECTIVE: To study the effects of modified Huopo Xialing Decoction (HXD) in treating patients of Pi-Wei dampness-heat syndrome (PWDHS) and its impact on epithelial cell apoptosis of tongue. METHODS: Fifty patients with PWDHD were randomized depending on their visiting sequence into two groups, the 30 patients in the treatment group treated with HXD and the 20 in the control group treated with Domperidone. The therapeutic course for both groups was 2 weeks. Besides, a normal control group consisting of 30 healthy volunteers was set up. The changes of tongue fur, grade of major syndromes in different groups were observed and scored before and after treatment to evaluate the therapeutic effectiveness, and the apoptotic index (AI) was estimated using TUNEL technique. RESULTS: AI in the two patient groups before treatment was obviously lower than that in the normal group (P < 0.01 or P < 0.05); after treatment, AI in the treatment group increased significantly (P < 0.01), with no difference from that in the normal group (P > 0.05), while in the control group, it only showed a slight trend of increasing. Similar outcome of tongue fur grades was seen in the two groups, it was improved significantly (P < 0.01) in the treatment group but insignificantly in the control group (P > 0.05). After treatment, syndrome scores were both lower in the two groups (P < 0.01), but the decrement in the treatment group was more significant than that in the control group (P < 0.01). Comparison between groups showed that the total effective rate in the treatment group was significantly superior to that in the control group (90% vs 65%, P < 0.01). CONCLUSION: HXD has good clinical efficacy in treating PWDHS, and has good effect in alleviating the greasy yellow tongue fur in patients with PWDHS by accelerating the tongue epithelial cell apoptosis.

Removal efficacy of opportunistic pathogen gene markers in drinking water supply systems: an in situ and large-scale molecular investigation.

The prevalence and interactions with biofilm and disinfectant of opportunistic pathogens in drinking water supply systems (DWSSs) have been extensively interpreted. In contrast, the large geographical distribution and in situ removal of opportunistic pathogens are overlooked aspects. Here, paired source and tap water samples of 36 parallel DWSSs across China were collected, with five common waterborne pathogens characterized by qPCR. From source to tap, the removal of bacterial biomass (16S rRNA gene copy number) was 1.10 log, and gene marker removal of five opportunistic pathogens ranged from 0.66 log to 2.27 log, with the order of Escherichia coli > Mycobacterium spp. > Clostridium perfringens > Bacillus cereus > Aeromonas hydrophila. Different with bacterial community, geographical location and source water types (river or reservoir) were not key contributor to variation of opportunistic pathogens. Gene marker removal efficacies of E. coli, Mycobacterium spp., and C. perfringens from source to tap were restricted to removal efficacy of overall bacterial biomass, while abundance of B. cereus in tap water linked to the input of B. cereus from source water. Although culture-dependent approach is important for pathogen enumeration in drinking water, qPCR-based molecular survey shows advantages of quantifiable high-throughput and easy operation, providing abundant and timely information on pathogen occurrence in water. This study provides the in situ, molecular-level evidence toward differential propagation features of multiple opportunistic pathogens in DWSSs and suggests the source protection and early warning of treatment-resistant pathogens.

Association between nutrition support and acute gastrointestinal injury in critically ill patients during the first 72 hours.

BACKGROUND & AIMS: The impact of nutrition support on patients with acute gastrointestinal injury (AGI) has not been fully determined. This study aimed to 1) investigate the relationship between nutrition support and AGI, as well as nutrition support and prognosis in critically ill AGI patients and 2) evaluate the prognostic benefits of nutrition support in different severity categories of AGI patients. METHODS: This prospective study included 379 patients in whom AGI occurred in the first 72 h after admission from 12 teaching hospitals in China. Clinical characteristics including demographics, APACHE II score, modified NUTRIC score, SOFA score, calories of nutrition, and 7 and 28-day mortality were recorded. Multiple logistic regression analysis was applied to identify the risk factors for mortality. The survival benefit of nutrition support as reflected by calories of nutrition in 72 h was evaluated for patients categorized according to their APACHE II, modified NUTRIC, and SOFA scores. RESULTS: Patients were classified into Grades I (n = 141), II (n = 173), III (n = 48), and IV (n = 17). Significant differences were observed among different AGI grade cohorts (I-IV) in terms of APACHE II, SOFA, and modified NUTRIC scores and calories of enteral nutrition (EN), parenteral nutrition (PN), and EN + PN. Ordinal logistic regression analysis showed that only SOFA score was an independent risk factor for AGI grades (P < 0.001). APACHE II score, mechanical ventilation (MV), AGI grades, and calories of EN + PN intake were independent risk factors for 28-d mortality. Increased nutritional intake was associated with reduced mortality in severely ill patients with APACHE II scores ≥15 (P = 0.007). CONCLUSIONS: AGI grade affected the intake of calories and was one of the risk factors for 28-d mortality. The nutrition intake of patients with AGI grade III to IV was almost only PN. The positive association between nutrition support and prognosis was more apparent in AGI patients with higher APACHE II scores.

Antibiotic resistomes in drinking water sources across a large geographical scale: Multiple drivers and co-occurrence with opportunistic bacterial pathogens.

Antibiotic resistance genes (ARGs) can survive the water treatment process. However, the prevalence patterns, key drivers, and relationships with opportunistic pathogens of the antibiotic resistome harbored in drinking water sources remain unclear. Herein, 53 drinking water samples collected across a large geographical scale in China were characterized based on ARGs, mobile genetic elements (MGEs), bacterial communities, antibiotics, and opportunistic bacterial pathogens. A total of 265 unique ARGs and MGEs were detected by high-throughput quantitative polymerase chain reaction (HT-qPCR), and 101 genes were shared among over 50% of samples. ARG abundance was higher in rivers than in reservoirs or groundwater, and ARG similarity showed a distance-decay relationship at the >4 000 km scale. Four out of the five detected opportunistic pathogens (i.e., Escherichia coli, Mycobacterium spp., Clostridium perfringens, and Bacillus cereus group) were potential hosts of ARGs. Based on multivariate statistics, our results demonstrated that the factors influencing the antibiotic resistome in drinking water sources were multiple and interactive. The bacterial community greatly contributed to ARG structure, and antibiotic concentrations and MGEs also affected ARG proliferation. The structural equation model indicated that geographical location and sample types (i.e., river, reservoir, and groundwater) had indirect effects on ARGs by changing the bacterial community and antibiotic concentration. Holistic consideration of natural and anthropogenic factors is recommended to understand antibiotic resistome variation in drinking water sources at a large geographical scale. Furthermore, large-scale diverse samples are suggested to minimize the potential influence of accident or stochasticity. Our findings provide insight into water quality risks induced by drinking water antibiotic resistomes.