Sulfur-doped activated carbon for the efficient degradation of tetracycline with persulfate: Insight into the effect of pore structure on catalytic performance.

Sulfur-doped activated carbon has proved to be a promising metal-free catalyst for persulfate (PDS) catalytic activation for the oxidation of aqueous refractory organics. Herein, sulfur-doped porous carbon (ACS) catalysts with different pore structures and doped-S contents were prepared via a template method using d(+)-glucose as the carbon source, sulfur as the sulfur source, and nano-MgO with different particle sizes as templates. Characterization results showed that the particle size of MgO significantly affects the pore structure and doped-S content of ACSs catalysts: a sample synthesized with 20 nm MgO as template (ACS-20) presented the highest content of doped-S and a mesoporous structure, which endowed it with superior adsorption and catalytic performance toward tetracycline (TC) removal. The effect of catalyst dosage, TC concentration, PDS concentration and solution pH on TC removal efficiency were evaluated. The reaction mechanism, investigated by combination of EPR, quenching experiments and LC-MS, indicated that the reactive species included HO·, SO4˙-, and 1O2, but that 1O2 played the dominant role in TC oxidation through a non-radical oxidation pathway. In addition, the reusability and regeneration properties of the ACS-20 catalyst were also studied. This work provides a promising strategy and some theoretical basis for the design and preparation of activated carbon catalysts for advanced oxidation reactions from the viewpoint of pore structure design and S-doping.

Loss of KLF15 impairs endometrial receptivity by inhibiting EMT in endometriosis.

The impaired endometrial receptivity is a major factor contributing to infertility in patients with endometriosis (EM), but the underlying mechanism remains unclear. Our study aimed to investigate the role of Kruppel-like factor 15 (KLF15) in endometrial receptivity and its regulation in EM. We observed a significant decrease in KLF15 expression in the mid-secretory epithelial endometrial cells of EM patients compared to normal females without EM. To confirm the role of KLF15 in endometrial receptivity, we found a significantly reduced KLF15 expression and a significant decrease in embryo implantation number in the rat model via uterine horn infection with siRNA. This highlights the importance of KLF15 as a regulator receptivity. Furthermore, through ChIP-qPCR, we discovered that the progesterone receptor (PR) directly binds to KLF15 promoter regions, indicating that progesterone resistance may mediate the decrease in KLF15 expression in EM patients. Additionally, we found that the mid-secretory endometrium of EM patients exhibited impaired epithelial-mesenchymal transition (EMT). Knockdown of KLF15 upregulated E-cadherin and downregulated vimentin expression, leading to inhibited invasiveness and migration of Ishikawa cells. Overexpression KLF15 promotes EMT, invasiveness, and migration ability, and increases the attachment rate of JAR cells to Ishikawa cells. Through RNA-seq analysis, we identified TWIST2 as a downstream gene of KLF15. We confirmed that KLF15 directly binds to the promoter region of TWIST2 via ChIP-qPCR, promoting epithelial cell EMT during the establishment of endometrial receptivity. Our study reveals the involvement of KLF15 in the regulation of endometrial receptivity and its downstream effects on EMT. These findings provide valuable insights into potential therapeutic approaches for treating non-receptive endometrium in patients with EM.

Effect of activator/precursor mass ratio on sulfur-doped porous carbon for catalytic oxidation of aqueous organics with persulfate.

Sulfur-doped porous carbon has emerged as promising metal-free catalysts toward persulfate (PS) for catalytic oxidation of aqueous organics. Wherein, thermal pyrolysis with activator activation is very common for the preparation of activated carbon. However, the relationship between the mass ratio of activator/precursor and catalytic efficiency has been rarely reported. Herein, a series of sulfur-doped porous carbons (S-AC) were synthesized by one-step chemical activation of (Poly(phenylene sulphide) (PPS)) with K2CO3 as activator at K2CO3/PPS mass ratio ranging from 0 to 3. The effects of K2CO3/PPS mass ratio on its physicochemical properties and its catalytic performance for p-chlorophenol (PCP) degradation with PS were comprehensively investigated. Experiment results show that sulfur doping enhanced its catalytic activity and the sample synthesized with K2CO3/PPS mass ratio of 2 (S-AC-2) exhibited the best adsorption and catalytic performance toward PS for PCP removal. More importantly, S-AC-2 with PS could efficiently degrade various aqueous toxic organics other than PCP, and S-AC-2 showed superior catalytic activity to many recently reported advanced materials. In addition, the effects of several operate parameters, including reaction temperature, PS concentration, pH, humic acid, and inorganic ions on PCP oxidation were evaluated. By combining with the results of quenching experiments and EPR, the PS activation mechanism over S-AC-2 was revealed. Moreover, the reusability and regenerability of S-AC-2 was also studied. It indicates that S-AC-2 showed inferior reusability, but the catalytic activity of which could be fully recovered through thermal treatment at 600 °C for 2 h in N2.

Epidemiology and Clinical Outcomes of HIV Infection in South-Central China: A Retrospective Study From 2003 to 2018.

Objective: HIV epidemiology in South-Central China is rarely reported. This study aims to characterize epidemiological and clinical features of HIV-infected patients in Hunan Province, located in South-Central China, for better management of HIV infections. Methods: This retrospective study retrieved multi-center records of laboratory-confirmed HIV-infected patients in Hunan province. Information on HIV-associated mortality and antiretroviral therapies was also collected. Results: Among 34,297 patients diagnosed with HIV infections from 2003 to 2018, 73.9% were males, 41.3% were older adults (≥50 years), and 71.2% were infected by heterosexual transmission. Despite a slow growth of new HIV infections in the overall population, annual percentages of HIV infections increased in older males (85.3% through heterosexual transmission) and young patients <30 years (39.9% through homosexual transmission). At baseline, serum levels of CD4+ T-cell counts were lower in older adults (191.0 cells/µl) than in young patients (294.6 cells/µl, p-value < 0.0001). A large proportion (47.2%, N = 16,165) of HIV-infected patients had advanced HIV disease (CD4+ T-cell counts < 200 cells/µl) from 2003 to 2018. All-cause mortality (57.0% due to AIDS-related illnesses) was reported among 4411 HIV-infected patients, including 2619 older adults. The 10-year survival rate was significantly lower in elderly males than in other patients (59.0 vs. 78.4%, p-value < 0.05). Conclusions: Elderly males are prone to HIV infections with a high risk of HIV-associated fatality. Our findings support early prevention and critical care for elderly populations to control HIV infections.

Dynamic Changes in the Immune Response Correlate with Disease Severity and Outcomes During Infection with SARS-CoV-2.

INTRODUCTION: The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout China and worldwide. Little is known about the dynamic changes in the patient immune responses to SARS-CoV-2 and how different responses are correlated with disease severity and outcomes. METHODS: Seventy-four patients with confirmed COVID-19 were enrolled in this prospective research. The demographic information, medical history, symptoms, signs and laboratory results were analyzed and compared between severe and non-severe patients. The leukocytes, lymphocyte subsets and inflammatory cytokines were longitudinally collected. RESULTS: Of the 74 patients included, 17 suffered from severe disease. The severe patients tended be older (65.29 ± 12.33 years vs. 45.37 ± 18.66 years) and had a greater degree of underlying disease (41.18% vs. 24.56%), lower baseline lymphocyte counts [0.64 (0.46-0.95) × 109 vs. 1.27 (0.95-1.70) × 109], higher neutrophil-lymphocyte ratios [NLRs; 3.76 (3.15-5.51) vs. 2.07 (1.48-2.93)] and lower baseline eosinophil counts [0 (0-0.01) × 109 vs. 0.03 (0.01-0.06) × 109] than those in non-severe patients. The baseline helper T (Th) cells (335.47 vs. 666.46/µl), suppressor T(Ts) cells (158 vs. 334/µl), B cells (95 vs. 210/µl) and natural killer (NK) cells (52 vs. 122/µl) were significantly decreased in severe cases compared to that in non-severe cases. In addition, the baseline neutrophils were positively correlated with the severity of COVID-19, and the baseline lymphocytes were negatively correlated with the severity of COVID-19. The dynamic change of T cells, Th cells and IFN-γ in the severe cases were parallel to the amelioration of the disease. CONCLUSIONS: Collectively, our study provides novel information on the kinetics of the immune responses in a cohort of COVID-19 patients with different disease severities. Furthermore, our study indicates that both innate and adaptive immune responses correlate with better clinical outcomes.

Increasing Age, the Existence of Comorbidities, and Corticosteroid Treatment in Combination With Antiviral Therapy Prolongs the Recovery of SARS-COV-2-Infected Patients, Measured as the Conversion From Positive to Negative rtPCR: A 239 Patients' Retrospective Study.

Background: Severe acute respiratory syndrome (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), has become a global pandemic in the past months. An overall defined treatment has not yet been established. Therefore, it is important to summarize and report treatment experiences and identify patient groups that have a significantly higher risk of an adverse clinical outcome. Methods: Two hundred thirty-nine COVID-19 patients were recruited from January 25 to February 15, 2020. Demographic, clinical, laboratory, treatment management, and outcome data obtained from patients' medical records were evaluated. Results: Patients who recovered from PCR positive to negative within 2 weeks had significantly lower erythrocyte sedimentation rate (ESR) and higher C-reactive protein (CRP) levels than those recovered post 2 weeks. During antiviral treatment, COVID-19 patients with older age, comorbidities, and corticosteroid treatment required a significantly longer time to turn from PCR positive to negative COVID-19 result. Conclusion: PCR tests are of great importance to evaluate the recovery of COVID-19-positive patients, and ESR could be an indirect indicator to monitor SARS-COV-2 activity. Furthermore, our data suggest that older age, the existence of comorbidities, and corticosteroid treatment of COVID-19 patients during antiviral treatment could prolong the duration of conversion from SARS-COV-2 positive to negative.

SARS-CoV-2 clearance in COVID-19 patients with Novaferon treatment: A randomized, open-label, parallel-group trial.

BACKGROUND: The antiviral effects of Novaferon, a potent antiviral protein drug, on COVID-19 was evaluated in the laboratory, and in a randomized, open-label, parallel-group trial. METHODS: In the laboratory, Novaferon's inhibition of viral replication in cells infected with SARS-CoV-2, and prevention of SARS-CoV-2 entry into healthy cells was determined. Antiviral effects of Novaferon in COVID-19 patients with treatment of Novaferon, Novaferon plus Lopinavir/Ritonavir, or Lopinavir/Ritonavir were evaluated. The primary endpoint was the SARS-CoV-2 clearance rates on day six of treatment, and the secondary endpoint was the time to SARS-CoV-2 clearance. RESULTS: Novaferon inhibited viral replication (EC50=1.02ng/ml), and prevented viral infection (EC50=0.10ng/ml). Results from the 89 enrolled COVID-19 patients showed that both Novaferon and Novaferon plus Lopinavir/Ritonavir groups had significantly higher viral clearance rates on day six than Lopinavir/Ritonavir group (50.0% vs. 24.1%, p=0.0400, and 60.0% vs. 24.1%, p=0.0053). The median time to viral clearance was six days, six days, and nine days for three groups, respectively, a 3-day reduction in both the Novaferon and Novaferon plus Lopinavir/Ritonavir groups compared with the Lopinavir/Ritonavir group. CONCLUSIONS: Novaferon exhibited anti-SARS-CoV-2 effects in vitro and in COVID-19 patients. These data justify further evaluation of Novaferon. TRIAL REGISTRATION NUMBER: Number ChiCTR2000029496 at the Chinese Clinical Trial Registry (http://www.chictr.org.cn/).

Clinical characteristics of older and younger patients infected with SARS-CoV-2.

BACKGROUND: SARS-CoV-2 causes high mortality risk in older patients. This study aims to characterize the clinical features of older and younger SARS-CoV-2 infected patients. RESULTS: A total of 239 patients were divided into the younger group (<60 years; n=181) and the older group (≥60 years; n=58). In both groups, fever and cough were common symptoms. However, dyspnea was more frequent in older patients than younger patients (20.7% versus 9.9%, p=0.032). Compared with younger patients, older patients harbored more severe cases (37.9% versus 17.1%, p=0.001) and comorbidities (58.6% versus 21.0%, p<0.001) such as hypertension and diabetes. The baseline values of eosinophils and C-reactive protein were abnormal in older and younger groups. From baseline to day 14, significant decreases of three biomarkers (C-reactive protein, hemoglobin, albumin) and dramatic increases of three biomarkers (lymphocytes, platelets, blood urea nitrogen) were observed in older patients. CONCLUSION: Older and younger patients exhibited differences in dyspnea, comorbidities, and proportions of severe cases. Moreover, the disease progression of SARS-CoV-2 in older patients is observed with the dynamics of laboratory biomarkers, supporting their potential use in disease monitoring. METHODS: We retrieved clinical symptoms, laboratory findings, comorbidities, and hospitalization information of SARS-CoV-2 cases in Changsha.

Treatment strategies of hospitalized patients with coronavirus disease-19.

With the outbreak of coronavirus disease-19 (COVID-19), Changsha faced an increasing burden of treating the Wuhan migrants and their infected patients. This study is a retrospective, single-center case series of the 238 consecutive hospitalized patients with confirmed COVID-19 at the First Hospital of Changsha city, China, from 01/21 to 02/14, 2020; the final date of follow-up was 02/27, 2020. Of 238 patients 43.7% visited Wuhan, 58.4% got in touch with Wuhan people, and 47.5% had contacted with diagnosed patients. 37.8% patients had family members infected. 190 cases had mild / general disease, and 48 cases had severe / critical disease. Compared to mild or general patients, more severe or critical patients visited Wuhan (59.6% vs 40.2%; P=0.02) and contacted with Wuhan people (74.5% vs 55.0%; P=0.02). All patients received antiviral treatment, including Lopinavir / Ritonavir (29.3%), Interferon (14.6%) and their combination (40.6%), Arbidol (6.7%), Xuebijing (7.1%) and Chloroquine phosphate (1.3%). Severe and critical patients received glucocorticoid, Gamma-globulin and oxygen inhalation. Some received mechanic ventilation support. As of 02/27, 161 patients discharged. The median length of hospital stay was 13 days. The 10-, 14-, 20- and 28-day discharge rate was 19.1%, 42.8%, 65.0% and 76.4%, respectively. No hospital-related transmission was observed.

Mortality risk of COVID-19 in elderly males with comorbidities: a multi-country study.

The COVID-19 pandemic causes severe morbidity and mortality. This multi-country study aimed to explore risk factors that drive mortality in COVID-19 patients who received neither dexamethasone nor remdesivir. We analyzed a cohort of 568 survivors and 507 non-survivors from China, European regions, and North America. Elderly males ≥70 years accounted for only 25% of survivors, but this rate was significantly higher in non-survivors from China (55%), European regions (63%), and North America (47%). Compared with survivors, non-survivors had more incidences of comorbidities such as cerebrovascular disease and chronic obstructive pulmonary disease (COPD, p-values<0.05). Survival analyses revealed age, male gender, shortness of breath, cerebrovascular disease, and COPD as mortality-associated factors. Survival time from symptom onset was significantly shorter in elderly versus young patients (median: 29 versus 62 days), males versus females (median: 46 versus 59 days), and patients with versus without comorbidities (mean: 41 versus 61 days). Mortality risk was higher in elderly males with comorbidities than in young females without comorbidities (p-value<0.01). Elderly male survivors with comorbidities also had longer hospital stays than other survivors (25 versus 18.5 days, p-value<0.01). Overall, the high mortality risk in elderly males with COVID-19-associated comorbidities supports early prevention and critical care for elderly populations.

Clinical characteristics and cerebro-spinal fluid cytokine changes in patients with acquired immunodeficiency syndrome and central nervous system infection.

Clinical characteristics and the cerebro-spinal fluid (CSF) cytokine changes in acquired immunodeficiency syndrome (AIDS) patients with tuberculous meningitis and cryptococcal meningitis in central nervous system (CNS) infections before and after treatment were investigated. The clinical records of 80 AIDS patients with CNS infections and 40 non-CNS infection patients hospitalized in the Infection Department of the First Hospital of Changsha from February 2013 to March 2016 were retrospectively analyzed. Forty-one cases of AIDS complicated with tuberculous meningitis were enrolled as group A, 39 cases of AIDS complicated with cryptococcal meningitis as group B, and 40 cases of non-CNS infection with lumbar puncture indication as group C. The general data, clinical symptoms, CSF examination and prognosis of the three groups of patients were collected. Of the 80 patients, 56 patients were discharged from hospital (improvement group) and 24 died (death group) after treatment. The concentrations of interferon-γ (IFN-γ), interleukin-6 (IL-6), interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) in CSF were detected by enzyme-linked immunosorbent assay. There were significant differences in clinical manifestations, CSF pressure, CSF leucocyte count, CSF glucose, CSF chloride and CSF protein between group A, group B and group C (P<0.05). The concentrations of IFN-γ, IL-6, IL-10 and TNF-α in CSF of group A and group B increased significantly compared with group C (P<0.001). The IL-6, IL-10 and TNF-α levels in CSF in the improvement group were significantly lower than those in the death group (P<0.001), while the concentration of IFN-γ increased significantly (P<0.001). CSF biochemistry is characterized by increased pressure, leucocyte count and protein, and decreased chloride and glucose. IFN-γ, IL-6, IL-10 and TNF-α in CSF have certain predictive value for poor prognosis of AIDS patients with CNS infection.