Distribution of nontuberculous mycobacteria in patients with and without HIV/AIDS in Chongqing.

INTRODUCTION: In this study, the distribution of nontuberculous mycobacteria (NTM) strains in patients with and without HIV/AIDS in Chongqing, China was evaluated. METHODS: A retrospective study was performed in January-December 2020 at Chongqing Public Health Medical Center. NTM strains were assessed by a multi locus phylogenetic analysis. The distribution of NTM strains in HIV/AIDS and non-HIV/AIDS groups was compared. CD4+ cell counts, imaging changes, and characteristics of mycobacterial species were determined. RESULTS: In total, 324 patients with NTM infection (50 patients with HIV/AIDS and 274 patients without HIV/AIDS) were included. The most common etiological agent was M. abscessus (29%), followed by M. paraintracellulare (12%) and M. colombiense (11%). Predominant NTM species were M. avium (26%), M. colombiense (24%), and M. kansasii (18%) in patients with HIV/AIDS and were M. abscessus (32%), M. paraintracellulare (13%), M. fortuitum (10%), and M. intracellulare (10%) in patients without HIV/AIDS. For a CD4+ cell count of <200/µl, the predominant species were M. aviumin the HIV/AIDS group and M. abscessus in the non-HIV/AIDS group. With respect to radiologic characteristics, different NTM strains were associated with distinct imaging manifestations; for example, M. marseillense, M. kansasii, and M. parasenchytosis were more likely to induce cavities. Imaging cavities, bronchiectasis, and acinar-like changes were more common in the non-HIV/AIDS groups. CONCLUSIONS: The infection rates of HIV and NTM in Chongqing are high, while M. abscessus, M. paraintracellulare, and M. colombiense are the main pathogens causing NTM diseases in Chongqing, and NTM strains differed significantly between patients with and without HIV/AIDS. Monitoring these indicators can help develop prevention strategies.

Distribution of Nosocomial Pathogens and Antimicrobial Resistance among Patients with Burn Injuries in China: A Comprehensive Research Synopsis and Meta-Analysis.

INTRODUCTION: Over the past decade, numerous studies have described the types of pathogens and their antibiotic resistance patterns in patients with burn injuries in China; however, the findings have generally been inconsistent. We conducted a literature search and meta-analysis to summarize the infection spectra and antimicrobial resistance patterns in patients with burn injuries. METHODS: We searched the PubMed, Embase, Web of Science, China National Knowledge Infrastructure, China Biomedical Literature, Wanfang, and Weipu databases for relevant articles published between January 2010 and December 2023. The DerSimonian-Laird random-effects model was used to estimate the proportions and 95% confidence intervals (CIs) of pathogens among Chinese patients with burn injuries. Meta-regression analyses were performed to explore differences in the proportions of pathogens among different subgroups and their resistance patterns. This study was registered with PROSPERO (CRD42024514386). RESULTS: The database searches yielded 2017 records; after removing duplicates and conducting initial screening, 219 articles underwent full-text screening. Ultimately, 60 studies comprising a total of 62,819 isolated strains reported the proportions of pathogens in patients with burn injuries and were included in this meta-analysis. Meta-analyses were conducted on 18 types of pathogens. The most common pathogens causing infections in Chinese patients with burn injuries were Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus epidermidis. Similar results were observed in the subgroup analysis focusing on wound infections. Since 2015, there has been a significant decrease in the proportion of Pseudomonas aeruginosa (R2 = 4.89%) and a significant increase in the proportion of Klebsiella pneumoniae (R2 = 9.60%). In terms of antibiotic resistance, there has been a significant decrease in the resistance of Staphylococcus aureus to multiple antibiotics and an increasing trend in the resistance of Klebsiella pneumoniae. CONCLUSIONS: We systematically summarized the epidemiological characteristics and antibiotic resistance patterns of pathogens among individuals suffering from burns in China, thus providing guidance for controlling wound infections and promoting optimal empirical antimicrobial therapy. The observed high levels of antibiotic resistance underscore the need for ongoing monitoring of antibiotic usage trends.

Sludge Retention Time as a Suitable Operational Parameter to Remove Both Estrogen and Nutrients in an Anaerobic-Anoxic-Aerobic Activated Sludge System.

Estrogen in wastewater are responsible for a significant part of the endocrine-disrupting effects observed in the aquatic environment. The effect of sludge retention time (SRT) on the removal and fate of 17ß-estradiol (E2) and 17α-ethinylestradiol (EE2) in an anaerobic-anoxic-oxic activated sludge system designed for nutrient removal was investigated by laboratory-scale experiments using synthetic wastewater. With a hydraulic retention time of 8 h, when SRT ranged 10-25 days, E2 was almost completely removed from water, and EE2 removal efficiency was 65%-81%. Both estrogens were easily sorbed onto activated sludge. Distribution coefficients (Kd) of estrogens on anaerobic sludge were greater than those on anoxic and aerobic sludges. Mass balance calculation indicated that 99% of influent E2 was degraded by the activated sludge process, and 1% remained in excess sludge; of influent EE2, 62.0%-80.1% was biodegraded; 18.9%-34.7% was released in effluent; and 0.88%-3.31% remained in excess sludge. Optimal SRT was 20 days for both estrogen and nutrient removal. E2 was almost completely degraded, and EE2 was only partly degraded in the activated sludge process. Residual estrogen on excess sludge must be considered in the sludge treatment and disposal processes. The originality of the work is that removal of nutrients and estrogens were linked, and optimal SRT for both estrogen and nutrient removal in an enhanced biological phosphorus removal system was determined. This has an important implication for the design and operation of full-scale wastewater treatment plants.

Risk Factors for CSF/Plasma HIV-1 RNA Discordance in HIV-Infected Patients.

BACKGROUND: Few large investigations have evaluated the association of cerebrospinal fluid/plasma (CSF/plasma) discordance with opportunistic neurological infections. We aimed to determine risk factors for CSF/plasma discordance to further assess whether CSF/plasma discordance is associated with antiretroviral therapy (ART) and opportunistic neurological infections. METHODS: A retrospective study was conducted based on HIV RNA viral load and associated risk factors in plasma and CSF samples from 491 HIV-infected patients. HIV RNA levels higher in CSF compared with plasma was defined as CSF/plasma discordance. RESULTS: In this study, the rate of CSF/plasma discordance was 18.3%. We observed that headache, cryptococcal antigen, CSF cell count, Treponema pallidum particle assay positivity, and ART use were significantly associated with CSF/plasma discordance in the multivariate logistic regression model. The CSF RNA/plasma RNA ratio was significantly higher in HIV-infected patients with neurological infections than in HIV-infected cases without neurological infections (P < 0.001). CSF/plasma discordance was significantly different between HIV-infected patients without central nervous system (CNS) infection and those with CNS infection, tuberculous meningitis, cryptococcal meningitis, and neurosyphilis (P < 0.05). CONCLUSIONS: ART and CNS inflammation may influence CSF/plasma discordance.

Higher plasma NT-proBNP levels correlate with syndrome of inappropriate antidiuretic hormone and poor prognosis in neurological patients.

BACKGROUND: Hyponatremia induced by syndrome of inappropriate antidiuretic hormone secretion (SIADH) was common electrolyte disturbance encountered in critically ill neurological diseases, which has normal or increased fluid volume. Brain natriuretic peptide (BNP), which is released in equal proportion to N-terminal pro-brain natriuretic peptide (NT-proBNP), plays vital roles in regulation of volume status. The relationship between SIADH and NT-proBNP levels in neurological diseases has rarely been reported. METHODS: A retrospective cross-sectional study was conducted to analyze plasma NT-proBNP levels in 33 patients with SIADH and 23 controlled eunatremic patients with neurological diseases. RESULTS: Baseline NT-proBNP levels were compared between two groups [SIADH group: median 311 pg/mL, interquartile range (IQR) 110-768 pg/mL] vs. eunatremic group: median 46 pg/mL, IQR, 12-96 pg/mL) (P<0.05). Plasma NT-proBNP levels were markedly increased in hyponatremic patients who had two or more complications than those who had less complication (P<0.05). In SIADH patients, NT-proBNP levels in remission phase were lower to levels at baseline. Furthermore, no death was seen in eunatremic patients, while five SIADH patients died from complications. CONCLUSIONS: SIADH had higher plasma NT-proBNP levels and poorer prognosis compared to eunatremic neurological patients. NT-proBNP serves as a biomarker of disease severity while not extracellular volume (ECV) status in critically ill neurological patients.

Blockade of tumor necrosis factor (TNF) receptor type 1-mediated TNF-alpha signaling protected Wistar rats from diet-induced obesity and insulin resistance.

TNF-alpha plays an important role in the pathogenesis of obesity and insulin resistance in which the effect of TNF-alpha signaling via TNF receptor type 1 (TNFR1) largely remains controversial. To delineate the role of TNFR1-mediated TNF-alpha signaling in the pathogenesis of this disorder, a TNFR1 blocking peptide-Fc fusion protein (TNFR1BP-Fc) was used for the present study. Wistar rats were fed a high-fat/high-sucrose (HFS) diet for 16 wk until obesity and insulin resistance developed. In comparison with increased body weight and fat weight, enlarged adipocytes, and hypertriglyceridemia in the obese state, the subsequent 4-wk treatment with TNFR1BP-Fc resulted in significant weight loss characterized by decreased fat pad weight and adipocyte size and reduced plasma triglycerides. Furthermore, obesity-induced insulin resistance, including hyperinsulinemia, elevated C-peptide, higher degree of hyperglycemia after glucose challenge, and less hypoglycemic response to insulin, was markedly improved, and the compensatory hyperplasia and hypertrophy of pancreatic islets were reduced. Interestingly, treatment with TNFR1BP-Fc markedly suppressed systemic TNF-alpha release and its local expression in pancreatic islets and muscle and adipose tissues. In addition, blockage of TNFR1-mediated TNF-alpha signaling in obese rats significantly enhanced tyrosine phosphorylation of insulin receptor substrate 1 (IRS-1) in the muscle and fat tissues. Our results strongly suggest a pivotal role for TNFR1-mediated TNF-alpha signaling in the pathogenesis of obesity and insulin resistance. Thus, TNFR1BP-Fc may be a good candidate for the treatment of this disease.

Sorption and degradation of bisphenol A by aerobic activated sludge.

Laboratory-scale batch experiments were conducted to investigate the sorption and degradation of bisphenol A (BPA) at microg/L range in an aerobic activated sludge system. The sorption isotherms and thermodynamics indicated that the sorption of BPA on sludge was mainly a physical process in which partitioning played a dominating role. The values of sorption coefficient Koc were between 621 and 736 L/kg in the temperature range of 10-30 degrees C. Both mixed liquor suspended solid (MLSS) and temperature influenced BPA sorption on sludge. The degradation of BPA by acclimated activated sludge could be described by first-order reaction equation with the first-order degradation rate constant of 0.80 h(-1) at 20 degrees C. The decrease of initial COD concentration and the increase of MLSS concentration and temperature enhanced BPA degradation rate. The removal of BPA in the activated sludge system was characterized by a quick sorption on the activated sludge and subsequent biodegradation.

The impact of prophylaxis of healthcare workers on influenza pandemic burden.

Several models have rationalized the use of antiviral drugs as an early control measure for delaying the progression and limiting the size of outbreaks during an influenza pandemic. However, the strategy for use of these drugs is still under debate. We evaluated the impact of prophylaxis of healthcare workers (HCWs) through a mathematical model that considers attack rates in a range of 25-35% in the general population and 25-50% among HCWs. Simulations and uncertainty analysis using the demographics of the province of Ontario, Canada show that increasing prophylaxis coverage of HCWs has little impact on reducing the reproduction number of disease transmission and may not prevent the occurrence of an outbreak if expected. However, it does enable a high level of treatment, which substantially reduces morbidity and mortality in the population as a whole. Therefore, prophylaxis of HCWs should be considered an important part of public health efforts for minimizing influenza pandemic burden and its socio-economic disruption.

Transmembrane tumor necrosis factor-alpha sensitizes adipocytes to insulin.

Transmembrane TNF-α (tmTNF-α) acts both as a ligand, delivering 'forward signaling' via TNFR, and as a receptor, transducing 'reverse signaling'. The contradiction of available data regarding the effect of tmTNF-α on insulin resistance may be due to imbalance in both signals. Here, we demonstrated that high glucose-induced impairment of insulin-stimulated glucose uptake by 3T3-L1 adipocytes was concomitant with decreased tmTNF-α expression and increased soluble TNF-α (sTNF-α) secretion. However, when TACE was inhibited, preventing the conversion of tmTNF-α to sTNF-α, this insulin resistance was partially reversed, indicating a salutary role of tmTNF-α. Treatment of 3T3-L1 adipocytes with exogenous tmTNF-α promoted insulin-induced phosphorylation of IRS-1 and Akt, facilitated GLUT4 expression and membrane translocation, and increased glucose uptake while addition of sTNF-α resulted in the opposite effect. Furthermore, tmTNF-α downregulated the production of IL-6 and MCP-1 via NF-κB inactivation, as silencing of A20, an inhibitor for NF-κB, by siRNA, abolished this effect of tmTNF-α. However, tmTNF-α upregulated adiponectin expression through the PPAR-γ pathway, as inhibition of PPAR-γ by GW9662 abrogated both tmTNF-α-induced adiponectin transcription and glucose uptake. Our data suggest that tmTNF-α functions as an insulin sensitizer via forward signaling.

Decreased expression levels of Nurr1 are associated with chronic inflammation in patients with type 2 diabetes.

Chronic inflammation is associated with insulin resistance, a characteristic of type 2 diabetes (T2D). Nuclear receptor­related protein 1 (Nurr1) can regulate inflammation, dependent on the nature of individual diseases. However, whether Nurr1 regulates chronic inflammation during the pathogenic process of T2D in humans remains to be fully elucidated. The present study aimed to investigate the potential association between the expression of Nurr1 in peripheral blood mononuclear cells (PBMCs) and inflammation in patients with T2D. The levels of plasma tumor necrosis factor (TNF)α and interleukin (IL)­6, the relative expression levels of Nurr1, and glycogen synthase kinase (GSK)­3ß phosphorylation in PBMCs from 40 patients with T2D and 40 healthy controls (HC group) were examined, and their potential association with clinical measures were analyzed. The expression levels of Nurr1, induced by high glucose and palmitic acid, were assessed in the PBMCs from the HC group. Compared with the HC group, significantly higher levels of plasma TNFα and IL­6 were correlated positively with the degree of insulin resistance in the T2D patients. However, significantly lower expression levels of Nurr1 and GSK­3ß phosphorylation in the PBMCs were correlated negatively with the levels of TNFα, IL­6, fasting insulin and insulin resistance in the T2D patients. Treatment of the PBMCs with high glucose or palmitic acid inhibited the expression of Nurr1 in a dose­ and time­dependent manner. Therefore, decreased expression levels of Nurr1 were associated with chronic inflammation and insulin resistance in patients with T2D.

Immunohistochemistry analysis of micrometastasis in pretreatment lymph nodes from patients with esophageal cancer.

BACKGROUND: With recent advances in neoadjuvant therapy in esophageal cancer, pretreatment lymph node staging has become increasingly important in stratifying patients to appropriate treatment regimens and for prognostication. Immunohistochemical analysis (IHC) using epithelial markers has been shown to identify micrometastases in histologically negative lymph nodes. We performed this study to evaluate if IHC analysis in thoracoscopic/laparoscopic (Ts/Ls) pretreatment staging lymph nodes can reveal additional diagnostic information to routine histopathology. METHODS: Specimens of 106 patients with esophageal cancer who had pretreatment Ts/Ls staging were retrospectively studied. Lymph node biopsies were obtained for IHC staining using cytokeratin (CK) of AE1/AE3. IHC staining for p53, an apoptosis protein associated with poor prognosis in esophageal cancer, was also performed. RESULTS: 331 Ts/Ls staging lymph node biopsies were collected from 106 patients. A total of 15.4% (51/331) of the lymph nodes or 34.9% (37/106) of patients were found to have metastatic deposits by routine histology. All the histologically positive lymph nodes were CK positive. Among the remaining 280 histologically negative lymph nodes, 11(3.9%) were found to have micrometastasis by CK staining. Three patients (4.3%, 3/69) were upstaged from N0 to N1. They died of early recurrences after treatment. A total of 67.6% (25/37) of the patients with histologically positive lymph node were p53 positive. No histologically negative lymph node was found to be p53 positive in this series. CONCLUSIONS: Immunohistochemical analysis for CK can detect micrometastatic involvement of lymph nodes that are missed on routine pathologic examination, and, therefore, can improve lymph node staging. Its clinical significance in esophageal cancer warrants further study.

[Reponses of sugar metabolism in seed germination of three various acid-fast plants to acid rain].

Responses of sugar metabolism during germination of rice (O. sativa ), wheat (T. aestivum) and rape (B. chinensis var. oleifera) seeds to simulated acid rain (pH 2.0, pH 2.5, pH 3.0, pH 3.5, pH 4.0, pH 4.5, pH 5.0) were investigated. The purpose was to clarify the mechanism of acid rain affecting seed germination. The results show that the alpha-amylase activity, contents of soluble sugar and reducing sugar of the rice, wheat and rape seeds decrease with increased stress level (pH 5.0 - 2.0), and are lower than CK. The response order of three indexes to stress level of acid rain is that rice (pH 3.5 - 4.0/53.88% - 77.7%) is smaller than wheat (pH 3.5 - 4.5/58.60% - 89.41%), and rape (pH 4.0 - 5.0/60.14% - 100%) is the smallest, alpha-amylase activity, contents of soluble sugar and reducing sugar of rice increase with prolonged stress time, but the three indexes of wheat and rape increase at first, and then decrease. In the same stress time (3 - 7 d), the three indexes of the three species for all treatment groups are lower than CK, and decrease with increased stress level. The stress time when the maximum damage of a-amylase activity, contents of soluble sugar and reducing sugar appeared is that rice (7 d, 7 d, 7 d) > wheat (7 d, 6 d, 5 d) > rape (3 d, 7 d, 5 d). Responses of three indexes to stress level and stress time of acid rain show that the ability of sugar metabolism resisting acid rain is that rice is stronger than wheat and rape is the worst, and the difference in sugar metabolism of 3 species is one of the internal reasons why the germination indexes behave differently.

[Sorption and degradation of 17beta-estradiol to anoxic activated sludge].

Batch experiments were conducted to investigate the sorption isotherms and degradation kinetics of 17beta-estradiol (E2) at a low levels (microg/L) by anoxic activated sludge. The effects of temperatures and the concentrations of electron acceptor on the sorption and degradation were also investigated. Results showed that, when the initial concentrations of E2 were 5-15 microg/L, E2 was completely degraded after 2 h under anoxic conditions. Anoxic degradation of E2 in the activated sludge can be described by first-order reaction kinetics. During degradation, E2 sorption was well correlated by both Freundlich and linear adsorption isothermal model at different temperatures. The biodegradation behavior was inside the sludge phase. The transfer of the compound between the water phase and the sludge phase followed a linear adsorption isotherm. Temperature exerted significant effects on both the sorption and degradation of E2. The increase of temperature enhanced the E2 biodegradation rate but decreased E2 adsorption capacity on the sludge. The first-order reaction constants for E2 anoxic degradation at the temperatures of 10, 20 and 30 degrees C were 2.411, 3.045, and 3.527 h(-1), respectively. The distribution coefficients (k(d)) were 540.9, 460.4, 396.9 L/kg for 10, 20, 30 degrees C, respectively. To some extent, the first-order rate constant of E2 anoxic degradation was infected by NO3-; -N concentration (10-30 mg/L).

[Sorption behavior of bisphenol A on anaerobic sludge].

Batch experiments were conducted to investigate the sorption behavior of bisphenol A (BPA) with low concentration on anaerobic sludge. The autoclaved inactivated sludge was used to minimize the influence of degradation of activated sludge. The results showed that the sorption of BPA on anaerobic sludge was a quick process. Anaerobic sludge had achieved 89.1% of the maximum sorption capacity at 15 min. The sorption isotherms of BPA were fitted well by Freundlich and linear sorption models. The sorption coefficients normalized by organic carbon contents were in the range of 665-878 at 10-30 degrees C. MLSS had significant effect on the sorption behavior. With the increase in MLSS, the sorption removal efficiency increased. Through the determination of thermodynamics parameters of BPA, it can be concluded that the sorption of BPA on the anaerobic sludge was mainly a physical process and partitioning between the water and sludge phases played a dominant role. Desorption tests showed that BPA sorption on anaerobic sludge was partially reversible.

The utility of preemptive mass influenza vaccination in controlling a sars outbreak during flu season.

During flu season, respiratory infections can cause non-specific influenza-like-illnesses (ILIs) in up to one-half of the general population. If a future SARS outbreak were to coincide with flu season, it would become exceptionally difficult to distinguish SARS rapidly and accurately from other ILIs, given the non-specific clinical presentation of SARS and the current lack of a widely available, rapid, diagnostic test. We construct a deterministic compartmental model to examine the potential impact of preemptive mass influenza vaccination on SARS containment during a hypothetical SARS outbreak coinciding with a peak flu season. Our model was developed based upon the events of the 2003 SARS outbreak in Toronto, Canada. The relationship of different vaccination rates for influenza and the corresponding required quarantine rates for individuals who are exposed to SARS was analyzed and simulated under different assumptions. The study revealed that a campaign of mass influenza vaccination prior to the onset of flu season could aid the containment of a future SARS outbreak by decreasing the total number of persons with ILIs presenting to the health-care system, and consequently decreasing nosocomial transmission of SARS in persons under investigation for the disease.

[Adsorption characteristics of 17beta-estradiol to anaerobic and anoxic sludge].

Adsorption tests were performed to measure the adsorption capacity of anaerobic and anoxic inactivated sludge for 17beta-estradiol. The effects of pH and temperature were also investigated. The adsorption equilibrium was established in 30 min; no significant pH effect was observed in the pH range of 6-9 at 20 degrees C; when pH >9, the adsorptive capacities decreased with increasing pH value; the adsorptive capacities decreased with increasing temperature. The experimental data of equilibrium concentrations were well correlated by both Freundlich and linear adsorption isothermal models. Distribution coefficients (Kd) decreased with increasing temperature. The distribution coefficients (Kd) of anaerobic inactivated sludge were 629.2 (10 degrees C) > 534.9 (20 degrees C) > 405.6 (30 degrees C), and those of anoxic inactivated sludge were 601.2 (10 degrees C ) > 491.3 (20 degrees C) > 360.1 (30 degrees C). Comparatively, Freundlich parameters K(F), 1/n and Kd of the anaerobic and anoxic activated sludge were measured at 20 degrees C; Distribution coefficient of anoxic activated sludge was lower than that of anaerobic activated sludge. No significant differences were observed between activated and inactivated sludge. The adsorption abilities of anaerobic activated/inactivated sludge were greater than those of anoxic activated/inactivated sludge.

[Effect of acid rain on seed germination of rice, wheat and rape].

Rice, wheat and rape seeds were treated with simulated acid rain at pH 2.0, 2.5, 3.0, 3.5, 4.0 and 5.0 levels for 7 days in order to understand the effects of acid rain on seed germination of various acid-fast plant. The germination test showed that seed germination was absolutely inhibited at pH 2.0 for three species. Rice and wheat seeds germinated abnormally at pH 2.5. WhenpH values above 3.0, percentage germination, germination energy, germination index, vigor index of rice, wheat and rape seeds increased in relation with decreased acidity levels. In contrast, the percentage of abnormal germination of rice and wheat decreased. The experiment data about physiological aspect demonstrated that water absorption rate, respiratory rate and storage reserve transformation rate of rice, wheat and rape seeds also increased with increased pH values. The storage loss of rice and wheat increased with increased pH values but that of rape decreased. Inhibition index of shoot and root length of three kinds of seeds decreased in relation with increased pH values. The amplitude difference of index of rice was lower than that of wheat, and wheat was lower than that of rape. The experiment data showed that rice had stronger fastness than wheat and rape, wheat had stronger fastness than rape under acid rain stress.