Organic Intercalation Induced Kinetic Enhancement of Vanadium Oxide Cathodes for Ultrahigh-Loading Aqueous Zinc-Ion Batteries.

Vanadium-based oxides have attracted much attention because of their rich valences and adjustable structures. The high theoretical specific capacity contributed by the two-electron-transfer process (V5+ /V3+ ) makes it an ideal cathode material for aqueous zinc-ion batteries. However, slow diffusion kinetics and poor structural stability limit the application of vanadium-based oxides. Herein, a strategy for intercalating organic matter between vanadium-based oxide layers is proposed to attain high rate performance and long cycling life. The V3 O7 ·H2 O is synthesized in situ on the carbon cloth to form an open porous structure, which provides sufficient contact areas with electrolyte and facilitates zinc ion transport. On the molecular level, the added organic matter p-aminophenol (pAP) not only plays a supporting role in the V3 O7 ·H2 O layer, but also shows a regulatory effect on the V5+ /V4+ redox process due to the reducing functional group on pAP. The novel composite electrode with porous structure exhibits outstanding reversible specific capacity (386.7 mAh g-1 , 0.1 A g-1 ) at a high load of 6.5 mg cm-2 , and superior capacity retention of 80% at 3 A g-1 for 2100 cycles.

Toward Simultaneous Dense Zinc Deposition and Broken Side-Reaction Loops in the Zn//V2 O5 System.

The Zn//V2 O5 system not only faces the incontrollable growth of zinc (Zn) dendrites, but also withstands the cross-talk effect of by-products produced from the cathode side to the Zn anode, inducing interelectrode talk and aggravating battery failure. To tackle these issues, we construct a rapid Zn2+ -conducting hydrogel electrolyte (R-ZSO) to achieve Zn deposition modulation and side reaction inhibition in Zn//V2 O5 full cells. The polymer matrix and BN exhibit a robust anchoring effect on SO4 2- , accelerating Zn2+ migration and enabling dense Zn deposition behavior. Therefore, the Zn//Zn symmetric cells based on the R-ZSO electrolyte can operate stably for more than 1500 h, which is six times higher than that of cells employing the blank electrolyte. More importantly, the R-ZSO hydrogel electrolyte effectively decouples the cross-talk effects, thus breaking the infinite loop of side reactions. As a result, the Zn//V2 O5 cells using this modified hydrogel electrolyte demonstrate stable operation over 1,000 cycles, with a capacity loss rate of only 0.028 % per cycle. Our study provides a promising gel chemistry, which offers a valuable guide for the construction of high-performance and multifunctional aqueous Zn-ion batteries.

Activation of the CD200/CD200R1 axis attenuates neuroinflammation and improves postoperative cognitive dysfunction via the PI3K/Akt/NF-κB signaling pathway in aged mice.

BACKGROUND: Postoperative cognitive dysfunction (POCD) is a neurological complication occurring after anesthesia and surgery. Neuroinflammation plays a critical role in the pathogenesis of POCD, and the activation of the cluster of differentiation 200 (CD200)/CD200R1 axis improves neurological recovery in various neurological disorders by modulating inflammation. The aim of this study was to investigate the impact and underlying mechanism of CD200/CD200R1 axis on POCD in aged mice. METHODS: The model of POCD was established in aged mice. To assess the learning and memory abilities of model mice, the Morris water maze test was implemented. CD200Fc (CD200 fusion protein), CD200R1 Ab (anti-CD200R1 antibody), and 740Y-P (a specific PI3K activator) were used to evaluate the effects of the CD200/CD200R1/PI3K/Akt/NF-κB signaling pathway on hippocampal microglial polarization, neuroinflammation, synaptic activity, and cognition in mice. RESULTS: It was observed that anesthesia/surgery induced cognitive decline in aged mice, increased the levels of tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, IL-1 ß and decreased the levels of postsynaptic density protein 95 (PSD-95), synaptophysin (SYN) in the hippocampus. Moreover, CD200Fc and 740Y-P attenuated neuroinflammation and synaptic deficits and reversed cognitive impairment via the phosphatidylinositol 3-kinase (PI3K)/ protein kinase B (Akt)/nuclear factor-kappa B (NF-κB) signaling pathway, whereas CD200R1 Ab administration exerted the opposite effects. Our results further show that the CD200/CD200R1 axis modulates M1/M2 polarization in hippocampal microglia via the PI3K/Akt/NF-κB signaling pathway. CONCLUSIONS: Our findings indicate that the activation of the CD200/CD200R1 axis reduces neuroinflammation, synaptic deficits, and cognitive impairment in the hippocampus of aged mice by regulating microglial M1/M2 polarization via the PI3K/Akt/NF-κB signaling pathway.

Large Interlayer Distance and Heteroatom-Doping of Graphite Provide New Insights into the Dual-Ion Storage Mechanism in Dual-Carbon Batteries.

Dual-ion batteries (DIBs) is a promising technology for large-scale energy storage. However, it is still questionable how material structures affect the anion storage behavior. In this paper, we synthesis graphite with an ultra-large interlayer distance and heteroatomic doping to systematically investigate the combined effects on DIBs. The large interlayer distance of 0.51 nm provides more space for anion storage, while the doping of the heteroatoms reduces the energy barriers for anion intercalation and migration and enhances rapid ionic storage at interfaces simultaneously. Based on the synergistic effects, the DIBs composed of carbon cathode and lithium anode afford ultra-high capacity of 240 mAh g-1 at current density of 100 mA g-1 . Dual-carbon batteries (DCBs) using the graphite as both of cathode and anode steadily cycle 2400 times at current density of 1 A g-1 . Hence, this work provides a reference to the strategy of material designs of DIBs and DCBs.

An Unprecedented Fireproof, Anion-Immobilized Composite Electrolyte Obtained via Solidifying Carbonate Electrolyte for Safe and High-Power Solid-State Lithium-Ion Batteries.

The update of electrolytes from a liquid state to a solid state is considered effective in improving the safety and energy density of lithium-ion batteries (LIBs). Although numerous efforts have been made, solid-state electrolytes' (SSEs) insufficient charge transfer capability remains a significant obstruction to practical applications. Herein, a fireproof and anion-immobilized composite electrolyte is designed by solidifying carbonate electrolyte, exhibiting superior Li-ion conductivity (11.5 mS cm-1 at 30 °C) and Li-ion transference number (0.90), which endows LIBs excellent rate capability and cycling stability. Elaborate characteristics and theoretical calculations demonstrate the presence of robust anion-molecule coordination (composed of lithium bond and Coulomb force) enables a more efficient ion transport, where the mobility of Li+ ion is enhanced meanwhile the anions are immobilized. This work highlights how the strong interactions between electrolyte components can be used to simultaneously regulate the migration of Li+ ion and anion, and realize a one-step conversion of inflammable liquid-state electrolyte to nonflammable solid-state electrolyte.

Stabilization of Lithium Metal Interfaces by Constructing Composite Artificial Solid Electrolyte Interface with Mesoporous TiO2 and Perfluoropolymers.

The next generation of high-energy-density storage devices is expected to be rechargeable lithium metal batteries. However, unstable metal-electrolyte interfaces, dendrite growth, and volume expansion will compromise lithium metal batteries (LMB) safety and life. A simple drop-casting method is used to create a double-layer functional interface composed of inorganic mesoporous TiO2 and F-rich organics PFDMA. For high-quality lithium deposition, TiO2 can provide uniform mechanical pressure, abundant mesoporous channels, and increased ionic conductivity, while PFDMA provides enough F to form LiF in the first cycle and improves Li-electrolyte compatibility. Experiments and simulations are combined to investigate the optimized mechanism of the LiF-rich solid electrolyte interface (SEI). The high binding energy of organic matter and Li demonstrates that Li+ preferentially binds with the F atom in organic matter. As a result, the tightly bound double-layer structure can inhibit lithium dendrite growth and slow electrolyte decomposition. Consequently, the symmetric Li||Li cell has a high stability performance of over 800 h. The assembled LiFePO4 ||Li cell can sustain 300 cycles at a 1 C rate and has a reversible capacity of 136.7 mAh g-1 .

Sustainable Recycling Technology for Li-Ion Batteries and Beyond: Challenges and Future Prospects.

Tremendous efforts are being made to develop electrode materials, electrolytes, and separators for energy storage devices to meet the needs of emerging technologies such as electric vehicles, decarbonized electricity, and electrochemical energy storage. However, the sustainability concerns of lithium-ion batteries (LIBs) and next-generation rechargeable batteries have received little attention. Recycling plays an important role in the overall sustainability of future batteries and is affected by battery attributes including environmental hazards and the value of their constituent resources. Therefore, recycling should be considered when developing battery systems. Herein, we provide a systematic overview of rechargeable battery sustainability. With a particular focus on electric vehicles, we analyze the market competitiveness of batteries in terms of economy, environment, and policy. Considering the large volumes of batteries soon to be retired, we comprehensively evaluate battery utilization and recycling from the perspectives of economic feasibility, environmental impact, technology, and safety. Battery sustainability is discussed with respect to life-cycle assessment and analyzed from the perspectives of strategic resources and economic demand. Finally, we propose a 4H strategy for battery recycling with the aims of high efficiency, high economic return, high environmental benefit, and high safety. New challenges and future prospects for battery sustainability are also highlighted.

Chloride application weakens cadmium immobilization by lime in paddy rice soil.

Contamination of agricultural products by cadmium (Cd) is a global health problem, causing chronic abnormalities. The consumption of rice, the most-consumed foods, is an important exposure route of Cd to human body. Chloride (Cl-) is reported to increase Cd uptake by rice; however, the effect on Cd uptake and accumulation by rice in the presence of lime is not clear. Therefore, a pot culture experiment was performed to explore the influence of Cl- on the absorption and accumulation of Cd in rice plants under lime remediation and its possible mechanisms. The results showed that Cl- promoted Cd accumulation in rice grains, mainly because of increased Cd bioavailability in the soil and by impeding the formation of iron plaques on rice roots, which reduced chelating and precipitation of Cd. Moreover, increased overexpression of the main transporters of Cd in rice roots, including OsNramp5, OsNramp1, OsIRTs and OsHMA2, favored the upward translocation of Cd from the root to shoot and increased the transfer factors (TFs) from soil to root, root-stem, leaf to grain, and soil to grain. Therefore, the application of Cl-rich materials to Cd-contaminated rice fields should be avoided during liming of the soil for Cd immobilization.

Overexpression of lncRNAs with endogenous lengths and functions using a lncRNA delivery system based on transposon.

BACKGROUND: Long noncoding RNAs (lncRNAs) play important roles in many physiological and pathological processes, this indicates that lncRNAs can serve as potential targets for gene therapy. Stable expression is a fundamental technology in the study of lncRNAs. The lentivirus is one of the most widely used delivery systems for stable expression. However, it was initially designed for mRNAs, and the applicability of lentiviral vectors for lncRNAs is largely unknown. RESULTS: We found that the lentiviral vector produces lncRNAs with improper termination, appending an extra fragment of ~ 2 kb to the 3'-end. Consequently, the secondary structures were changed, the RNA-protein interactions were blocked, and the functions were impaired in certain lncRNAs, which indicated that lentiviral vectors are not ideal delivery systems of lncRNAs. Here, we developed a novel lncRNA delivery method called the Expression of LncRNAs with Endogenous Characteristics using the Transposon System (ELECTS). By inserting a termination signal after the lncRNA sequence, ELECTS produces transcripts without 3'-flanking sequences and retains the native features and function of lncRNAs, which cannot be achieved by lentiviral vectors. Moreover, ELECTS presents no potential risk of infection for the operators and it takes much less time. ELECTS provides a reliable, convenient, safe, and efficient delivery method for stable expression of lncRNAs. CONCLUSIONS: Our study demonstrated that improper transcriptional termination from lentiviral vectors have fundamental effects on molecular action and cellular function of lncRNAs. The ELECTS system developed in this study will provide a convenient and reliable method for the lncRNA study.

Vestibular migraine: the chameleon in vestibular disease.

Vestibular migraine (VM) has been recently receiving increasing attention as an independent disease concept. It is a common cause of dizziness or headache; however, it was not clearly defined until 2018. Its diagnosis mainly relies on clinical history, including vertigo and migraine, as indicated by the appendix of the 3rd edition of the International Classification Diagnostic Criteria for Headache Diseases. There is often an overlap of vertigo and migraine across vestibular diseases; therefore, VM often imitates various vestibular diseases. Additionally, VM lacks specific laboratory biomarkers; therefore, it has high misdiagnosis and missed diagnosis rates. Therefore, numerous clinical patients could have inaccurate diagnoses and improper treatment. Therefore, there is a need for further basic research to further clarify the pathogenesis. Moreover, there is a need for clinical trials focusing on specific laboratory biomarkers, including serological, radiological, and electrophysiological examinations, to develop more detailed and complete diagnostic criteria.

Effects and mechanisms of Cd remediation with zeolite in brown rice (Oryza sativa).

The effects of zeolite amendment on the Cd absorption and accumulation of two varieties of rice, ZY-18 (Zheyou 18, hybrid indica) and DL-5 (Donglian 5, conventional indica), planted in a slightly Cd-contaminated paddy soil, and the associated mechanisms were studied based on a pot experiment. The results showed that zeolite addition significantly reduced the Cd availability in the soil by the increasing of soil pH and the Cd sorption capacity of soil, as well as the reduction of Eh, dissolved organic carbon (DOC) and the water-soluble Fe/Mn in the soil. The decrease in the amount of Fe and Cd in iron plaques on rice roots treated with zeolite resulted in the reduction of Cd uptake by rice roots. Zeolite application decreased the Cd contents in the roots, stems and leaves, and finally the brown rice through the inhibition of uptake and translocation of Cd by rice plant. The Cd concentration in rice grains of ZY-18 was more decreased than that of DL-5, which was attributed to its higher pH and lower Eh, DOC, and Cd availability in the soil, higher mounts of iron plaque and Cd in plaques on rice roots, and lower root-to-grain transfer factor (TFroot-grain) of ZY-18.

Gut dysbiosis induces the development of pre-eclampsia through bacterial translocation.

OBJECTIVE: Pre-eclampsia (PE) is one of the malignant metabolic diseases that complicate pregnancy. Gut dysbiosis has been identified for causing metabolic diseases, but the role of gut microbiome in the pathogenesis of PE remains unknown. DESIGN: We performed a case-control study to compare the faecal microbiome of PE and normotensive pregnant women by 16S ribosomal RNA (rRNA) sequencing. To address the causative relationship between gut dysbiosis and PE, we used faecal microbiota transplantation (FMT) in an antibiotic-treated mouse model. Finally, we determined the microbiome translocation and immune responses in human and mouse placental samples by 16S rRNA sequencing, quantitative PCR and in situ hybridisation. RESULTS: Patients with PE showed reduced bacterial diversity with obvious dysbiosis. Opportunistic pathogens, particularly Fusobacterium and Veillonella, were enriched, whereas beneficial bacteria, including Faecalibacterium and Akkermansia, were markedly depleted in the PE group. The abundances of these discriminative bacteria were correlated with blood pressure (BP), proteinuria, aminotransferase and creatinine levels. On successful colonisation, the gut microbiome from patients with PE triggered a dramatic, increased pregestational BP of recipient mice, which further increased after gestation. In addition, the PE-transplanted group showed increased proteinuria, embryonic resorption and lower fetal and placental weights. Their T regulatory/helper-17 balance in the small intestine and spleen was disturbed with more severe intestinal leakage. In the placenta of both patients with PE and PE-FMT mice, the total bacteria, Fusobacterium, and inflammatory cytokine levels were significantly increased. CONCLUSIONS: This study suggests that the gut microbiome of patients with PE is dysbiotic and contributes to disease pathogenesis.

Cationic liposome-triggered luminol chemiluminescence reaction and its applications.

Liposomes are spherical phospholipid bilayer vesicles. In the present study, we found that cationic liposomes made by (2,3-dioleoyloxy-propyl)-trimethylammonium (DOTAP) could enhance the luminol-H2O2 chemiluminescence (CL) reaction. Mechanism studies showed that the positive charge on the surface of liposomes plays an important role in the CL process. We speculated that the cationic liposomes with quaternary ammonium groups on the surface may be capable of catalyzing the decomposition of H2O2 leading to the formation of oxygen-related free radicals including ˙OH, 1O2, and O2˙-. The luminol anions tend to move close to the surface of the cationic liposomes and then to be oxidized by the oxidizing radical species which may be around the surface of cationic liposomes forming excited-state 3-aminophthalate* (3-APA*). When the 3-APA* returns to the ground state, an enhanced CL is observed. In addition, the single-strand DNA (ssDNA) showed a significant inhibition effect on the proposed CL reaction. The CL intensity decreased linearly with an increasing amount of DNA from 0.05 to 2 pmol. We assumed that the binding of ssDNA with cationic liposomes would neutralize the positive charge on the surface of liposomes and inhibit the catalytic activity of DOTAP cationic liposomes. Based on the ssDNA-inhibited luminol-H2O2-cationic liposome CL reaction, simple label-free CL sensing platforms were developed for the detection of sequence-specific DNA related to the hepatitis B virus (HBV) gene and for the detection of ATP (as a model analyte) using an anti-ATP aptamer as the recognition element.

Determining the susceptibility of carbapenem resistant Klebsiella pneumoniae and Escherichia coli strains against common disinfectants at a tertiary hospital in China.

BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) infections have become a global health threat. Controlling CRE transmission in hospitals is increasingly dependent on the use of disinfectants to restrict the risk of infection. Here, the susceptibility of patient-derived carbapenem resistant Klebsiella pneumoniae (CRKP) and Escherichia coli (CREC) strains against three common disinfectants and the determinants of resistance to disinfectants were investigated. METHODS: The minimum inhibitory concentrations (MICs) and the minimum bactericidal concentrations (MBCs) of three common chemical disinfectants: chlorhexidine, trichloroisocyanuric (TCCA) acid and Povidone iodine (PVP-I) against 50 CRE strains were measured. The drug-resistance genes -qacEΔ1, qacA/B and cepA-were determined using polymerase chain reaction. RESULTS: A total of 36 CRKP and 14 CREC strains were collected in our hospital from 2016 to 2018. The MIC ranges of 36 CRKP strains against chlorhexidine, TCCA and PVP-I were 8~512 mg/L, 64~128 mg/L and 8~128 mg/L, respectively. For 14 CREC strains, the MIC ranges against chlorhexidine, TCCA and PVP-I were 4~128 mg/L, 64~128 mg/L and 4~128 mg/L, respectively. Moreover, against chlorhexidine and PVP-I, the MIC90 of 36 CRKP strains was higher than that of 50 CSKP strains. The qacE△1 gene was detected in 15 isolates among 36 CRKP strains (41.7%), and 8 isolates among 14 CREC strains (57.1%); while the qacA/B gene was not detected. Specifically, the cepA gene was much more prevalent than the qacEΔ1; it reached over 80% among CRKP strains. Compared to the CSKP strains, the presence of the qacEΔ1 and cepA genes was significantly higher among the CRKP strains (p < 0.05). CONCLUSION: CRE strains collected from patients in our hospital exhibit various degree of resistance to the commonly used chemical disinfectants. It is of great help to keep monitoring the tendency of the reduced susceptibility of the pan-resistant strains against disinfectants, in order to effectively control and prevent the spread of the super resistant bacteria.

In Situ Generation of Prussian Blue with Potassium Ferrocyanide to Improve the Sensitivity of Chemiluminescence Immunoassay Using Magnetic Nanoparticles as Label.

Using magnetic nanoparticles (MNPs) as a label in immunoassay (IA) possesses advantages such as high specific surface area, simple modification process. However, the catalytic activity of MNPs is low, which limits their applications in IA. The present study found it interesting that potassium ferrocyanide reacts with MNPs, leading to the in situ generation of Prussian blue. The produced Prussian blue shows high catalytic activity on a luminol chemiluminescent (CL) reaction. Therefore, a simple and sensitive immunoassay for rabbit IgG (rIgG) as model analyte using MNPs as label was developed. The CL intensity had a linear increase with the concentration of rIgG that ranged from 0.625 to 20 ng mL-1. The limit of detection was calculated to be 0.59 ng mL-1. In addition, the applicability of this method was evaluated using the standard addition method. The recovery ranged from 80.0% to 115.0%. What's more, the proposed CLIA method based on in situ generation of Prussian blue with MNPs was also applied to the detection of carcinoembryonic antigen (CEA) and hepatitis B virus (HBV)-related sequence-specific DNA. The LOD for the detection of CEA and sequence-specific DNA was estimated to be 0.28 ng mL-1 and 0.044 pmol, respectively.

A Chemical Precipitation Method Preparing Hollow-Core-Shell Heterostructures Based on the Prussian Blue Analogs as Cathode for Sodium-Ion Batteries.

Prussian blue and its analogs are regarded as the promising cathodes for sodium-ion batteries (SIBs). Recently, various special structures are constructed to improve the electrochemical properties of these materials. In this study, a novel architecture of Prussian blue analogs with large cavity and multilayer shells is investigated as cathode material for SIBs. Because the hollow structure can relieve volume expansion and core-shell heterostructure can optimize interfacial properties, the complex structure materials exhibited a highly initial capacity of 123 mA h g-1 and a long cycle life. After 600 cycles, the reversible capacity of the electrode still maintains at 102 mA h g-1 without significant voltage decay, indicating a superior structure stability and sodium storage kinetics. Even at high current density of 3200 mA g-1 , the electrode still delivers a considerable capacity above 52 mA h g-1 . According to the electrochemical analysis and ex-situ measurements, it can be inferred that the enhanced apparent diffusion coefficient and improved insertion/extraction performance of electrode have been obtained by building this new morphology.

[Simultaneous determination of quercitrin, phloridzin and 3-hydroxyl phloridzin in leaves of Malus halliana by ultrasound-assisted ionic liquid-reversed phase liquid chromatography].

To establish a method for the simultaneous determination of phloridzin, 3-hydroxy phloridzin and quercitrin in leaves of Malus halliana by ultrasonic-assisted ionic liquid coupled with RP-HPLC. An Agilent TC-C18 (4.6 mm×250 mm, 5 µm) column was used, with the mobile phase of acetonitrile and 1% phosphoric acid-water (20∶80) by gradient elution at the detection wavelength of 270 nm. The flow rate was 0.8 mL•min⁻¹, and chromatographic column temperature was controlled at the room temperature. Under the optimized conditions, the linear ranges for phloridzin, 3-hydroxy phloridzin and quercitrin were 0.9-112.5 µg (r = 0.999 6), 0.093 2-11.65 µg (r = 0.999 1) and 0.097 2-12.15 µg (r = 0.999 8), respectively. The average recoveries of the three constituents were 99.35%, 98.80% and 98.19%, respectively. The method was environmental friendly, rapid, accurate and highly reproducible, and so suitable for the quantitative analysis of phloridzin, 3-hydroxy phloridzin and quercitrin in leaves of M. halliana.

[Spectrum-effect relationship in antioxidant activity of Ligustri Lucidi Fructus based on DPPH, ABTS and FRAP assays].

Characteristic chromatogram of Ligustri Lucidi Fructus which were processed by heat treatment with different temperatures and times was developed by HPLC. DPPH, ABTS and FRAP assays were performed to determine the antioxidant activity. The spectrum-effect correlation was studied using Partial Least Squares(PLS)to explore the active ingredients of Ligustri Lucidi Fructus by investigating the relationship between HPLC spectrum and antioxidant activity. S1, S2, S15, S24, S27, S29, S32, S33 and S35 were characteristic compounds in 35 matching characteristic chromatograms which were positive relationship with scavenging DPPH free radical activity. S1, S2, S5, S8, S16, S27 and S33 were significantly positively related to scavenge ABTS free radical activity. S12, S20, S22, S28, S30, S31, S32 and S34 were significantly positively related to restore Fe³âº activity. Among the chromatographic peaks, S1, S2, S27 and S33were positively related to scavenge DPPH free radical and ABTS free radical activity, and S32 was positively related to scavenge DPPH free radical and restore Fe³âº activity. S3, S19, S21, S22, S23, S33 and S34 were determined as salidroside, luteolin-7-O-glucoside, specnuezhenide, oleuropein, ligustroflavone, luteolin andapigenin, respectively. The results showed that although specnuezhenide and salidroside were stipulated index compounds to evaluate the quality of Ligustri Lucidi Fructus, the Ligustri Lucidi Fructus pharmcodynamic effect did not depend on the contents of those index components. The quality of traditional Chinese medicines(TCMs)should be determined by the compound groups associated with pharmcodynamic effect.

USA's expanded overseas tuberculosis screening program: a retrospective study in China.

BACKGROUND: To address increasing tuberculosis (TB) incidence in foreign-born populations, immigrant TB screening programs have been implemented in the USA. These programs are modified periodically, the effectiveness of which have been disputed. The aim of this retrospective study was to assess the value of the 2009 Technical Instructions for Tuberculosis Screening and Treatment Using Cultures and Directly Observed Therapy (CDOT TB TI) in a cohort of the USA permanent-resident applicants from China. METHODS: Standardized forms were used to collect demographic, clinical, and laboratory data of Chinese individuals screened at the Guangdong International Travel Healthcare Center for permanent residence in the USA between October 08, 2009 and December 31, 2012. Applicants' data were further retrospectively evaluated by three experienced panel physicians and radiologists according to the 1991 Technical Instructions for Tuberculosis Screening and Treatment (TI). TB cases and characteristics identified by the 1991 and expanded 2009 programs were compared. RESULTS: The CDOT TB TI identified more than twice as many TB cases that required treatment completion before clearance for travel than the 1991 TI (270 vs. 131). In addition, the expanded screening program identified more cases of negative sputum smear but positive culture (181 vs. 44), and more cases of radiography suggestive of inactive (22 vs. 3) and active (248 vs. 128) TB. Specifically, the 1991 TI screening program failed to identify 25/38 (65.79%) cases carrying drug-resistant isolates, and 13/131 (9.92%) would have been inappropriately treated. Moreover, 220/270 (81.48%) of the cases were asymptomatic, which were identified by screening and subsequently treated. Improved chest radiograph and sputum negative conversion occurred in all treated cases. CONCLUSION: CDOT TB TI, a screening program that includes sputum culture and drug susceptibility tests, identifies a greater number of TB cases, likely contributing to the overall decrease in TB prevalence in host (USA) and origin (China) countries.