Status of fungal sepsis among preterm infants in 25 neonatal intensive care units of tertiary hospitals in China / 中华儿科杂志

Objective: To analyze the prevalence and the risk factors of fungal sepsis in 25 neonatal intensive care units (NICU) among preterm infants in China, and to provide a basis for preventive strategies of fungal sepsis. Methods: This was a second-analysis of the data from the "reduction of infection in neonatal intensive care units using the evidence-based practice for improving quality" study. The current status of fungal sepsis of the 24 731 preterm infants with the gestational age of <34+0 weeks, who were admitted to 25 participating NICU within 7 days of birth between May 2015 and April 2018 were retrospectively analyzed. These preterm infants were divided into the fungal sepsis group and the without fungal sepsis group according to whether they developed fungal sepsis to analyze the incidences and the microbiology of fungal sepsis. Chi-square test was used to compare the incidences of fungal sepsis in preterm infants with different gestational ages and birth weights and in different NICU. Multivariate Logistic regression analysis was used to study the outcomes of preterm infants with fungal sepsis, which were further compared with those of preterm infants without fungal sepsis. The 144 preterm infants in the fungal sepsis group were matched with 288 preterm infants in the non-fungal sepsis group by propensity score-matched method. Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of fungal sepsis. Results: In all, 166 (0.7%) of the 24 731 preterm infants developed fungal sepsis, with the gestational age of (29.7±2.0) weeks and the birth weight of (1 300±293) g. The incidence of fungal sepsis increased with decreasing gestational age and birth weight (both P<0.001). The preterm infants with gestational age of <32 weeks accounted for 87.3% (145/166). The incidence of fungal sepsis was 1.0% (117/11 438) in very preterm infants and 2.0% (28/1 401) in extremely preterm infants, and was 1.3% (103/8 060) in very low birth weight infants and 1.7% (21/1 211) in extremely low birth weight infants, respectively. There was no fungal sepsis in 3 NICU, and the incidences in the other 22 NICU ranged from 0.7% (10/1 397) to 2.9% (21/724), with significant statistical difference (P<0.001). The pathogens were mainly Candida (150/166, 90.4%), including 59 cases of Candida albicans and 91 cases of non-Candida albicans, of which Candida parapsilosis was the most common (41 cases). Fungal sepsis was independently associated with increased risk of moderate to severe bronchopulmonary dysplasia (BPD) (adjusted OR 1.52, 95%CI 1.04-2.22, P=0.030) and severe retinopathy of prematurity (ROP) (adjusted OR 2.55, 95%CI 1.12-5.80, P=0.025). Previous broad spectrum antibiotics exposure (adjusted OR=2.50, 95%CI 1.50-4.17, P<0.001), prolonged use of central line (adjusted OR=1.05, 95%CI 1.03-1.08, P<0.001) and previous total parenteral nutrition (TPN) duration (adjusted OR=1.04, 95%CI 1.02-1.06, P<0.001) were all independently associated with increasing risk of fungal sepsis. Conclusions: Candida albicans and Candida parapsilosis are the main pathogens of fungal sepsis among preterm infants in Chinese NICU. Preterm infants with fungal sepsis are at increased risk of moderate to severe BPD and severe ROP. Previous broad spectrum antibiotics exposure, prolonged use of central line and prolonged duration of TPN will increase the risk of fungal sepsis. Ongoing initiatives are needed to reduce fungal sepsis based on these risk factors.

Inhibition of glutaminolysis alleviates myocardial fibrosis induced by angiotensin II / 生理学报

The present study was aimed to investigate the role and mechanism of glutaminolysis of cardiac fibroblasts (CFs) in hypertension-induced myocardial fibrosis. C57BL/6J mice were administered with a chronic infusion of angiotensin II (Ang II, 1.6 mg/kg per d) with a micro-osmotic pump to induce myocardial fibrosis. Masson staining was used to evaluate myocardial fibrosis. The mice were intraperitoneally injected with BPTES (12.5 mg/kg), a glutaminase 1 (GLS1)-specific inhibitor, to inhibit glutaminolysis simultaneously. Immunohistochemistry and Western blot were used to detect protein expression levels of GLS1, Collagen I and Collagen III in cardiac tissue. Neonatal Sprague-Dawley (SD) rat CFs were treated with 4 mmol/L glutamine (Gln) or BPTES (5 μmol/L) with or without Ang II (0.4 μmol/L) stimulation. The CFs were also treated with 2 mmol/L α-ketoglutarate (α-KG) under the stimulation of Ang II and BPTES. Wound healing test and CCK-8 were used to detect CFs migration and proliferation respectively. RT-qPCR and Western blot were used to detect mRNA and protein expression levels of GLS1, Collagen I and Collagen III. The results showed that blood pressure, heart weight and myocardial fibrosis were increased in Ang II-treated mice, and GLS1 expression in cardiac tissue was also significantly up-regulated. Gln significantly promoted the proliferation, migration, mRNA and protein expression of GLS1, Collagen I and Collagen III in the CFs with or without Ang II stimulation, whereas BPTES significantly decreased the above indices in the CFs. α-KG supplementation reversed the inhibitory effect of BPTES on the CFs under Ang II stimulation. Furthermore, in vivo intraperitoneal injection of BPTES alleviated cardiac fibrosis of Ang II-treated mice. In conclusion, glutaminolysis plays an important role in the process of cardiac fibrosis induced by Ang II. Targeted inhibition of glutaminolysis may be a new strategy for the treatment of myocardial fibrosis.

Investigation and risk assessment for water quality hygiene in self-supply well water in four northern provinces of China / 中华疾病控制杂志

Objective To understand the water quality of self-supply wells in four provinces of northern China (Heilongjiang, Beijing, Inner Mongolia and Tibet), so as to provide a reference for supervision and management of self-supply wells. Methods Water were sampled from 233 self-supply wells in four northern provinces of China according to standard examination methods for drinking water (GB/T 5750-2006). In total, The samples were tested for 27 kinds of water quality parameters involving sensory properties, chemistry, bacteriology and toxicology, and then evaluated. Results The total unqualified rate of water quality in self-supply well water in four northern provinces of China was 52.36%. The water quality varied greatly among provinces. As for Heilongjiang, the main unqualified indicators of self-supply wells water involved turbidity, visible to the naked eye, manganese, arsenic and nitrate. In relation to Beijing, these referred to the nitrate and microorganism. In case of Inner Mongolia province, these included sulfate and fluoride. With reference to Tibet, these were zinc and chloride. Conclusions To ensure the safety of drinking water for residents, the management, disinfection and purifying measures of self-supply wells should be strengthened basing on their regional differences and water quality characteristics.

An overview of the removal of algal toxins by water treatment process / 军事医学

The environmental and health problems caused by the frequent occurrence of cyanobacteria blooming and its secondary metabolites,algal toxins, have become a hot spot in environmental science research.This article reviews the production and contamination status of algal toxins, and the removal effects of microcystins(MCs), anatoxin-a(ANTX) and other algal toxins by different water treatment processes, including coagulation and sedimentation, ozone oxidation, activated carbon adsorption,membrane treatment, chlorination and UV irradiation.Furthermore, the factors affecting the removal effect are analyzed,and the advantages and limitations of each water treatment process are summarized.Finally, some feasible proposals are presented regarding the future research of removing algal toxins.

Safety evaluation of drinking water along the border of Inner Mongolia / 军事医学

Objective To find out about the sanitary conditions of drinking water along the border line of Inner Mongolia via safety evaluation of drinking water along the border line of Inner Mongolia.Methods 108 samples of drinking water along the border line of Inner Mongolia(70 samples of self-supply source water,21 ones of self-supply tap water and 17 ones of municipal tap water)were collected.Hygienic evaluation of sensory indexes, normal chemical indexes, toxicological indexes and microbiology indexes of water quality was performed according to hygienic standards for drinking water(GB 5749—2006).Results 58 samples were qualified with a total qualified rate of 53.7%.The unqualified rate of the total number of coliforms was the highest(20.4%),followed by fluoride(19.4%).As for deep wells, shallow wells and surface water,there was no statistically significant difference.Compared with municipal tap water,the unqualified rate of self-supply water(28.6%)was higher(17.7%).Conclusion The qualified rate along the border line of Inner Mongolia of drinking water is low.Treatment and disinfection facilities for drinking water,detection devices of water quality are needed.The cleaning and disinfection of storage tanks should be performed periodically in oder to prevent waterborne infectious diseases.