Single Atom Engineered Antibiotics Overcome Bacterial Resistance.

The outbreak of antibiotic-resistant bacteria, or "superbugs", poses a global public health hazard due to their resilience against the most effective last-line antibiotics. Identifying potent antibacterial agents capable of evading bacterial resistance mechanisms represents the ultimate defense strategy. This study shows that -the otherwise essential micronutrient- manganese turns into a broad-spectrum potent antibiotic when coordinated with a carboxylated nitrogen-doped graphene. This antibiotic material (termed NGA-Mn) not only inhibits the growth of a wide spectrum of multidrug-resistant bacteria but also heals wounds infected by bacteria in vivo and, most importantly, effectively evades bacterial resistance development. NGA-Mn exhibits up to 25-fold higher cytocompatibility to human cells than its minimum bacterial inhibitory concentration, demonstrating its potential as a next-generation antibacterial agent. Experimental findings suggest that NGA-Mn acts on the outer side of the bacterial cell membrane via a multimolecular collective binding, blocking vital functions in both Gram-positive and Gram-negative bacteria. The results underscore the potential of single-atom engineering toward potent antibiotics, offering simultaneously a long-sought solution for evading drug resistance development while being cytocompatible to human cells.

Development and validation of a risk prognostic model based on the H. pylori infection phenotype for stomach adenocarcinoma.

Background: Stomach adenocarcinoma (STAD) is one of the most common malignancies. Infection of helicobacter pylori (H. pylori) is a major risk factor that leads to the development of STAD. This study constructed a risk model based on the H. pylori-related macrophages for predicting STAD prognosis. Methods: The single-cell RNA sequencing (scRNA-seq) dataset and the clinic information and RNA-seq datasets of STAD patients were collected for establishing a prognostic model and for validation. The "Seurat" and "harmony" packages were used to process the scRNA-seq data. Key gene modules were sectioned using the "limma" package and the "WGCNA" package. Kaplan-Meier (KM) and Receiver Operating Characteristic Curve (ROC) analyses were performed with "survminer" package. The "GSVA" package was employed for single sample gene set enrichment analysis (ssGSEA). Cell migration and invasion were measured by carrying out wound healing and trans-well assays. Results: A total of 17397 were screened and classified into 8 cell type clusters, among which the macrophage cluster was closely associated with the H. pylori infection. Macrophages were further categorized into four subtypes (including C1, C2, C3, and C4), and highly variable genes of macrophage subtype C4 could serve as an indicator of the prognosis of STAD. Subsequently, we developed a RiskScore model based on six H. pylori -associated genes (TNFRSF1B, CTLA4, ABCA1, IKBIP, AKAP5, and NPC2) and observed that the high-risk patients exhibited poor prognosis, higher suppressive immune infiltration, and were closely associated with cancer activation-related pathways. Furthermore, a nomogram combining the RiskScore was developed to accurately predict the survival of STAD patients. AB CA 1 in the RiskScore model significantly affected the migration and invasion of tumor cells. Conclusion: The gene expression profile served as an indicator of the survival for patients with STAD and addressed the clinical significance of using H. pylori-associated genes to treat STAD. The current findings provided novel understandings for the clinical evaluation and management of STAD.

Thermally-stable single-site Pd on CeO2 catalyst for selective amination of phenols to aromatic amines without external hydrogen.

Developing a new route to produce aromatic amines as key chemicals from renewable phenols is a benign alternative to current fossil-based routes like nitroaromatic hydrogenation, but is challenging because of the high dissociation energy of the Ar-OH bond and difficulty in controlling side reactions. Herein, an aerosolizing-pyrolysis strategy was developed to prepare high-density single-site cationic Pd species immobilized on CeO2 (Pd1/CeO2) with excellent sintering resistance. The obtained Pd1/CeO2 catalysts achieved remarkable selectivity of important aromatic amines (yield up to 76.2%) in the phenols amination with amines without external hydrogen sources, while Pd nano-catalysts mainly afforded phenyl-ring-saturation products. The excellent catalytic properties of the Pd1/CeO2 are closely related to high-loading Pd single-site catalysts with abundant surface defect sites and suitable acid-base properties. This report provides a sustainable route for producing aromatic amines from renewable feedstocks.

Evaluation of phage-based decontamination in respiratory intensive care unit environments using ddPCR and 16S rRNA targeted sequencing techniques.

Background: Klebsiella pneumoniae is a major cause of hospital-acquired infections (HAIs), primarily spread through environmental contamination in hospitals. The effectiveness of current chemical disinfectants is waning due to emerging resistance, which poses environmental hazards and fosters new resistance in pathogens. Developing environmentally friendly and effective disinfectants against multidrug-resistant organisms is increasingly important. Methods: This study developed a bacteriophage cocktail targeting two common carbapenem-resistant Klebsiella pneumoniae (CRKP) strains, ST11 KL47 and ST11 KL64. The cocktail was used as an adjunctive disinfectant in a hospital's respiratory intensive care unit (RICU) via ultrasonic nebulization. Digital PCR was used to quantify CRKP levels post-intervention. The microbial community composition was analyzed via 16S rRNA sequencing to assess the intervention's impact on overall diversity. Results: The phage cocktail significantly reduced CRKP levels within the first 24 hours post-treatment. While a slight increase in pathogen levels was observed after 24 hours, they remained significantly lower than those treated with conventional disinfectants. 16S rRNA sequencing showed a decrease in the target pathogens' relative abundance, while overall species diversity remained stable, confirming that phages selectively target CRKP without disrupting ecological balance. Discussion: The findings highlight the efficacy and safety of phage-based biocleaners as a sustainable alternative to conventional disinfectants. Phages selectively reduce multidrug-resistant pathogens while preserving microbial diversity, making them a promising tool for infection control.

Alternative splicing regulation and its therapeutic potential in bladder cancer.

Bladder cancer is one of the leading causes of mortality globally. The development of bladder cancer is closely associated with alternative splicing, which regulates human gene expression and enhances the diversity of functional proteins. Alternative splicing is a distinctive feature of bladder cancer, and as such, it may hold promise as a therapeutic target. This review aims to comprehensively discuss the current knowledge of alternative splicing in the context of bladder cancer. We review the process of alternative splicing and its regulation in bladder cancer. Moreover, we emphasize the significance of abnormal alternative splicing and splicing factor irregularities during bladder cancer progression. Finally, we explore the impact of alternative splicing on bladder cancer drug resistance and the potential of alternative splicing as a therapeutic target.

Rational design of amorphous vanadium pentoxide and hollow porous carbon spheres hybrid for superior zinc-ion battery.

Aqueous zinc-ion batteries (AZIBs) are expected to be a promising large-scale energy storage system owing to their intrinsic safety and low cost. Nevertheless, the development of AZIBs is still plagued by the design and fabrication of advanced cathode materials. Herein, the amorphous vanadium pentoxide and hollow porous carbon spheres (AVO-HPCS) hybrid is elaborately designed as AZIBs cathode material by integrating vacuum drying and annealing strategy. Amorphous vanadium pentoxide provides abundant active sites and isotropic ion diffusion channels. Meanwhile, the hollow porous carbon sphere not only provides a stable conductive network, but also enhances the stability during charging/discharging process. Consequently, the AVO-HPCS exhibits a capacity of 474 mAh/g at 0.5 A/g and long-term cycle stability. Moreover, the corresponding reversible insertion/extraction mechanism is elucidated by ex-situ X-ray diffraction, X-ray photoelectron spectroscopy and transmission electron microscopy. Furthermore, the flexible pouch battery with AVO-HPCS cathode shows high comprehensive performance. Hence, this work provides insights into the development of advanced amorphous cathode materials for AZIBs.

Randomized Control Trial on Internet-Based Self-Management of Arteriovenous Fistula in Hemodialysis Patients.

PURPOSE: To assess the impact of incorporating internet-based resources and popular science workshops on self-care management among hemodialysis patients with arteriovenous fistula. DESIGN: A randomized controlled trial involving 110 hemodialysis patients with arteriovenous fistula, randomly assigned to either the experimental or control group. METHODS: The experimental group received self-management training utilizing internet resources and interactive workshops, while the control group received conventional health education methods. After the intervention, the self-management proficiency of both groups was assessed, including comprehension of arteriovenous fistula-related information, satisfaction levels, self-care abilities, engagement in functional exercises, quality of life, and other relevant factors. FINDINGS: Patients in the experimental group exhibited significantly greater proficiency in arteriovenous fistula self-management knowledge, higher levels of patient satisfaction, enhanced self-management abilities, improved functional exercise performance, and better overall quality of life compared to those in the control group (p < 0.05). CONCLUSIONS: The combination of internet resources and popular science workshops presents a novel and promising approach for educating and promoting self-care management among hemodialysis patients with arteriovenous fistula. This method holds potential for widespread dissemination and implementation in science education. CLINICAL EVIDENCE: The study demonstrates the tangible benefits of integrating internet-based resources and popular science workshops into self-management training for arteriovenous fistula among hemodialysis patients, as evidenced by improved knowledge, satisfaction, abilities, exercise performance, and quality of life in the experimental group compared to the control group.

Resolve the species-specific effects of iron (hydr)oxides on the performance of underlying zerovalent iron for metalloid removal: Identification of their key properties.

Despite the importance of surface iron (hydr)oxides (Fe-(hydr)oxides) for the decontamination performance of zerovalent iron (ZVI) -based technologies has been well recognized, controversial understandings of their exact roles still exist due to the complex species distribution of Fe-(hydr)oxides. Herein, we re-structured the surface of ZVI using eight distinct Fe-(hydr)oxides and analyzed their species-specific effects on the performance of ZVI for Se(IV) under well-controlled conditions. The kinetics-relevant performance indicators (Se(IV) removal rates, Fe2+ release rates, and the utilization ratio of ZVI) under the effect of each Fe-(hydr)oxide roughly followed the order: δ-FeOOH > Fe5HO8·4H2O > α-FeOOH > ß-FeOOH > Î³-FeOOH > Î³-Fe2O3 > Fe3O4 > α-Fe2O3. Multiple linear regression analysis shows that the large pore volume and size (instead of specific surface area), low open-circuit potential, and low electrochemical impedance are key positive properties for kinetics-relevant performance. Besides, for electron efficiency of ZVI, only Fe3O4 increased the value to 50.0%, due to the contribution of its ferrous components, while others did not change it (∼20%). Additional experiments with commercial ZVI covered by individual Fe-(hydr)oxides confirmed the observed species-specific trends. All these results not only provide new basis for mechanism explanation but also have practical implications for the production or modification of ZVI.

Four years of natural progressive course: A rare case report of juvenile Xp11.2 translocations renal cell carcinoma with TFE3 gene fusion.

Background: Renal cell carcinoma (RCC) with TFE3 gene fusion caused by Xp11.2 translocations is a rare RCC subtype. This tumor is typically seen in children, comprising 20‒40% of overall RCC cases compared to 1‒1.6% observed in adults. Xp11.2 RCC is associated with a poor prognosis due to both the progression of local lesions and early distant and lymphatic metastasis. Case presentation: A case of RCC with Xp11.2 RCC translocations and TFE3 gene fusion was found in a pediatric patient, illustrating the catastrophic effects of ignoring the condition. The tumor developed from a local lesion to lymph metastasis (3.2-12 cm) within 4 years. Despite ongoing controversy, surgical resection remains the most common and productive approach. In this patient, renal retroperitoneal lymph node dissection and radical nephrectomy of the left kidney were performed via laparoscopic surgery. The RCC-associated Xp11.2 translocation/TFE3 gene fusions were identified by postoperative pathology. Microscopic analysis showed the presence of intravascular cancer thrombus, renal sinus invasion, and cancer necrosis. The pathological stages were confirmed as PT3aN1M0 with a negative margin. Follow-up at 5 months showed that the patient recovered without the use of any adjuvant treatments. Conclusion: Our study highlights the natural course, diagnosis, and treatment of RCC-associated Xp11.2 translocation/TFE3 gene fusions, especially the necessity of early surgery. This case may be a helpful reference for urologists in the treatment of similar cases. It also serves as a precautionary signal for patients who neglect the renal neoplasm.

Unraveling distinct effects between CuOx and PtCu alloy sites in Pt-Cu bimetallic catalysts for CO oxidation at different temperatures.

In situ exploration of the dynamic structure evolution of catalysts plays a key role in revealing reaction mechanisms and designing efficient catalysts. In this work, PtCu/MgO catalysts, synthesized via the co-impregnation method, outperforms monometallic Pt/MgO and Cu/MgO. Utilizing quasi/in-situ characterization techniques, it is discovered that there is an obvious structural evolution over PtCu/MgO from PtxCuyOz oxide cluster to PtCu alloy with surface CuOx species under different redox and CO oxidation reaction conditions. The synergistic effect between PtCu alloy and CuOx species enables good CO oxidation activity through the regulation of CO adsorption and O2 dissociation. At low temperatures, CO oxidation is predominantly catalyzed by surface CuOx species via the Mars-van Krevelen mechanism, in which CuOx can provide abundant active oxygen species. As the reaction temperature increases, both surface CuOx species and PtCu alloy collaborate to activate gaseous oxygen, facilitating CO oxidation mainly through the Langmuir-Hinshelwood mechanism.

The relationship between boredom proneness, the behavioral inhibition system, and anxiety in college students: variable-centered and person-centered analytic approaches.

Objective: To explore the relationship among boredom proneness, the behavioral inhibition system, and anxiety among college students based on variable-centered and person-centered analytic approaches. Methods: A questionnaire survey was conducted on 1,102 college students from a university in Hebei Province using the Boredom Proneness Questionnaire (BPQ) for College Students, the Behavioral Inhibition System Scale (BIS), and the General Anxiety Disorder-7 scale (GAD-7). Results: The results reveal that boredom proneness was negatively correlated with scores on the behavioral inhibition system (r = -0.100, p < 0.01), and positively correlated with anxiety (r = 0.457, p < 0.001), while the behavioral inhibition system was positively correlated with anxiety (r = 0.086, p < 0.01). In the variable-centered analyses study, it was found that the behavioral inhibition system partially mediated the association between boredom proneness and anxiety. In the person-centered analyses study, three subtypes were identified: the high boredom-low inhibition group (9.35%), the moderate boredom-inhibition group (66.70%), and the low boredom-high inhibition group (23.95%). Individuals in these subtypes showed significant differences in anxiety scores (F = 4.538, p < 0.05), with the low boredom-high inhibition group scoring the highest. Conclusion: The results showed that the behavioral inhibition system partially mediates the relationship between boredom proneness and anxiety in college students; boredom proneness and the behavioral inhibition system exhibit group heterogeneity, with distinct classification features closely related to anxiety.

Synchrotron Radiation-Based In Situ GIWAXS for Metal Halide Perovskite Solution Spin-Coating Fabrication.

Solution-processable perovskite-based devices are potentially very interesting because of their relatively cheap fabrication cost but outstanding optoelectronic performance. However, the solution spin-coating process involves complicated processes, including perovskite solution droplets, nucleation of perovskite, and formation of intermediate perovskite films, resulting in complicated crystallization pathways for perovskite films under annealing. Understanding and therefore controlling the fabrication process of perovskites is difficult. Recently, synchrotron radiation-based in situ grazing-incidence wide-angle X-ray scattering (GIWAXS) techniques, which possess the advantages of high collimation, high resolution, and high brightness, have enabled to bridge complicated perovskite structure information with device performance by revealing the real-time crystallization pathways of perovskites during the spin-coating process. Herein, the developments of synchrotron radiation-based in situ GIWAXS are discussed in the study of the crystallization process of perovskites, especially revealing the important crystallization mechanisms of state-of-the-art perovskite optoelectronic devices with high performance. At the end, several potential applications and challenges associated with in situ GIWAXS techniques for perovskite-based devices are highlighted.

Myocardial work by pressure-strain loop is associated with molecular imaging of fibroblast activation in hypertensive hearts using 99mTc-HFAPI SPECT.

99mTc-HFAPI can visualize fibroblast activation in hypertensive hearts. Myocardial work (MW) reflects the cardiac mechanical properties after accounting for the afterload in hypertensive patients. We investigated whether MW was associated with increased uptake of 99mTc-HFAPI. A total of 97 hypertensive patients and 41 healthy volunteers were prospectively recruited. Global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) were analyzed. According to whether myocardial uptake of FAPI was higher than the adjacent blood pool, hypertensive patients were divided into two groups, namely: FAPI + and FAPI- group, respectively. GWI, GCW and GWE of the FAPI + group were lower than the FAPI- group. The value of GWW in the FAPI + group was higher than in the FAPI- group. Multiple regression analyses revealed GWI, GWW and GWE were independently associated with early myocardial fibrosis. According to receiver operating characteristics (ROC) analysis, the best cutoff points for FAPI + of GWI, GWW and GWE were 1968.50 mmHg% (AUC: 0.687, 95% CI: 0.581-0.793, P = 0.002), 133.00 mmHg% (AUC: 0.778, 95% CI: 0.688-0.869, P < 0.001) and 95.07% (AUC: 0.813, 95% CI: 0.730-0.896, P < 0.001), respectively. GWI, GWW and GWE were impaired in hypertensive patients with cardiac 99mTc-HFAPI uptake and were associated with fibroblast activation in hypertensive hearts.

Embedding Single Pd Atoms on NiGa Intermetallic Surfaces for Efficient and Selective Alkyne Hydrogenation.

Catalytic removal of alkynes is essential in industry for producing polymer-grade alkenes from steam cracking processes. Non-noble Ni-based catalysts hold promise as effective alternatives to industrial Pd-based catalysts but suffer from low activity. Here we report embedding of single-atom Pd onto the NiGa intermetallic surface with replacing Ga atoms via a well-defined synthesis strategy to design Pd1-NiGa catalyst for alkyne semi-hydrogenation. The fabricated Pd1Ni2Ga1 ensemble sites deliver remarkably higher specific mass activity under superb alkene selectivity of >96 % than the state-of-the-art catalysts under industry-relevant conditions. Integrated experimental and computational studies reveal that the single-atom Pd synergizes with the neighbouring Ni sites to facilitate the σ-adsorption of alkyne and dissociation of hydrogen while suppress the alkene adsorption. Such synergistic effects confer the single-atom Pd on the NiGa intermetallic with a Midas touch for alkyne semi-hydrogenation, providing an effective strategy for stimulating low active Ni-based catalysts for other selective hydrogenations in industry.

The impact of negative urgency on implicit mobile phone addiction tendency among college freshmen in the context of social exclusion.

Purpose: The purpose of this study is to investigate the impact of negative urgency on implicit mobile phone addiction tendency among college freshmen, and to observe whether social exclusion situations affect the relationship between negative urgency and implicit mobile phone addiction tendency. Methods: The UPPS-P Impulsive Behavior Scale was used to screen 575 freshmen from a certain university. The experiment utilized a GO/NO-GO paradigm. Experiment 1 employed a 2 (negative urgency group: high negative urgency group, low negative urgency group) × 2 (word type: phone related words, phone non-related words) two-factor mixed experimental design. Experiment 2 employed a 2 (negative urgency group: high negative urgency group, low negative urgency group) × 2 (social exclusion type: priming group, non-priming group) × 2 (word type: phone related words, phone non-related words) three-factor mixed experimental design. Results: Experiment 1 results showed a significant main effect of negative urgency group and a significant interaction effect between negative urgency group and word type. Experiment 2 results demonstrated a significant main effect of negative urgency group and a significant main effect of social exclusion type. There was a significant interaction effect between word type and social exclusion type, as well as between word type and negative urgency group. The three-way interaction effect among negative urgency group, word type, and social exclusion type was significant. Conclusion: College freshmen with high negative urgency exhibit a higher tendency toward implicit mobile phone addiction. In social exclusion situations, college freshmen show a higher tendency toward implicit smartphone addiction. Social exclusion situations and negative urgency jointly influence the implicit mobile phone addiction tendency of college freshmen.

Intron Retention of DDX39A Driven by SNRPD2 is a Crucial Splicing Axis for Oncogenic MYC/Spliceosome Program in Hepatocellular Carcinoma.

RNA splicing is a dynamic molecular process in response to environmental stimuli and is strictly regulated by the spliceosome. Sm proteins, constituents of the spliceosome, are key components that mediate splicing reactions; however, their potential role in hepatocellular carcinoma (HCC) is poorly understood. In the study, SNRPD2 (PD2) is found to be the most highly upregulated Sm protein in HCC and to act as an oncogene. PD2 modulates DDX39A intron retention together with HNRNPL to sustain the DDX39A short variant (39A_S) expression. Mechanistically, 39A_S can mediate MYC mRNA nuclear export to maintain high MYC protein expression, while MYC in turn potentiates PD2 transcription. Importantly, digitoxin can directly interact with PD2 and has a notable cancer-suppressive effect on HCC. The study reveals a novel mechanism by which DDX39A senses oncogenic MYC signaling and undergoes splicing via PD2 to form a positive feedback loop in HCC, which can be targeted by digitoxin.

Fluorine Incorporation for Enhanced Gas Separation Performance in Porous Organic Polymers: Investigating Reaction Pathways and Pore Structure Control.

The precise control of pore structures in porous organic polymer (POP) materials is of paramount importance in addressing a wide range of challenges associated with gas separation processes. In this study, we present a novel approach to optimize the gas separation performance of POPs through the introduction of fluorine groups and figure out an important factor of reaction decision that whether the AlCl3-catalyzed polymerization is Scholl reaction or Friedel-Crafts alkylation. In the chloroform system, the steric hindrance of function groups could make direct coupling between the benzene rings difficult, which would lead to part solvent knitting (Friedel-Crafts alkylation) instead. The fluorinated polymers show enhanced surface area and pore size characteristics. Notably, the fluorinated polymers exhibited significantly improved adsorption and separation performance for SF6, as evidenced by an ideal adsorbed solution theory selectivity (SF6/N2, v: v = 50:50, 273 K) increase of 75.0, 668.8, and 502.8% compared to the nonfluorinated POPs. These findings highlight the potential of fluorination as a strategy for tailoring the properties of POP materials for advanced gas separation applications.

CFZA camera: a high-resolution lensless imaging technique based on compound Fresnel zone aperture.

In lensless imaging using a Fresnel zone aperture (FZA), it is generally believed that the resolution is limited by the outermost ring breadth of the FZA. The limitation has the potential to be broken according to the multi-order property of binary FZAs. In this Letter, we propose to use a high-order component of the FZA as the point spread function (PSF) to develop a high-order transfer function backpropagation (HBP) algorithm to enhance the resolution. The proportion of high-order diffraction energy is low, leading to severe defocus noise in the reconstructed image. To address this issue, we propose a Compound FZA (CFZA), which merges two partial FZAs operating at different orders as the mask to strike a balance between the noise and resolution. Experimental results verify that the CFZA-based camera has a resolution that is double that of a traditional FZA-based camera with an identical outer ring breadth and can be reconstructed with high quality by a single HBP without calibration. Our method offers a cost-effective solution for achieving high-resolution imaging, expanding the potential applications of FZA-based lensless imaging in a variety of areas.

Analysis of microbial community composition and diversity in the rhizosphere of Salvia miltiorrhiza at different growth stages.

Salvia miltiorrhiza is a kind of medicinal plant with various pharmacological activities. Few studies on the composition and diversity of rhizosphere microbial communities at different growth stages have been conducted on Salvia miltiorrhiz; in particular, salviorrhiza grows in soil that has been continuously planted for 3 years. The purpose of this study was to understand the changes of soil physicochemical properties of Salvia miltiorrhiza at different growth stages, and to study the composition and diversity of rhizosphere microbial community at different growth stages. Illumina NovaSeq sequencing technology was used to analyze the bacterial 16S rRNA gene and the fungal ITS region in the rhizosphere soil of Salvia miltiorrhiza at different growth stages. The results showed that the dominant bacterial phyla in the Salvia miltiorrhiza rhizosphere were Proteobacteria, Bacteroidetes, Acidobacteria, Firmicutes, Actinobacteria, and Chloroflexi. The dominant fungal phyla were Ascomycota, Mortierellomycota, Basidiomycota, and Rozellomycota. During the growth of Salvia miltiorrhiza, the physical and chemical properties of soil changed. As the Salvia miltiorrhiza grew, the content of available phosphorus, available potassium, pH, nitrate nitrogen, and ammonium nitrogen significantly decreased. Ammonium nitrogen and nitrate nitrogen had a greater impact on the bacterial community structure in the rhizosphere than on the fungal community structure. The work was to reveal differences in the rhizosphere bacterial and fungal community structure during different growth stages of Salvia miltiorrhiza, further understand the changes of rhizosphere microbial ecological characteristics and soil physicochemical properties during the cultivation of Salvia miltiorrhiza.

Disasters pile up on the rubbing heel: Sporothrix globosa as secondary infection to Mycobacterium chelonae infection.

Mycobacterium chelonae and Sporothrix globosa, both of which are opportunistic pathogens, have been proved to be possible multidrug resistant. However, are all recurring symptoms in chronic infections related to decreasing susceptibility? Here we report a case of sporotrichosis secondary to M. chelonae infection. In addition, we find that the blackish-red spots under the dermoscopic view can be employed as a signal for the early identification and regression of subcutaneous fungal infection.