Relationship between Coronary Artery Calcium Score and Coronary Stenosis.

Background: The coronary artery calcium score (CACS) is commonly employed to quantify the degree of calcification in coronary atherosclerosis. Indeed, increased coronary stenosis severity is associated with a progressive increase in CACS. Objectives: This study sought to explore the association between CACS and coronary stenosis of ≥50% and ≥70%. Methods: We conducted a retrospective analysis of patient data collected between July 1, 2017, and March 3, 2022, at Jiangmen Central Hospital. A total of 208 patients, presenting with both symptomatic and asymptomatic manifestations and suspected coronary artery disease (CAD), were included. Statistical analyses included ROC curve assessments, subgroup analyses based on age, and comparisons of CACS values against the presence of coronary stenosis ≥50% and ≥70%. Results: Ultimately, 208 patients were included, with a median age of 65.0 years and a median CACS of 115.7 (interquartile range: 13.7-369.4). A CACS threshold of ≥1300 demonstrated a specificity of 100% for coronary stenosis of ≥50%. Notably, the percentage of patients with obstructive CAD showing CACS = 0 was significantly higher in those under 65 years (15.1%) compared to patients over 65 years (3.8%) (P=0.005). The inflection point, at which the risk probability for coronary stenosis of ≥50% shifted from being a protective factor to a risk factor, was observed when CACS fell within the range of 63.3 to 66.0. Conclusion: CACS demonstrates good performance for the detection of coronary artery stenosis.

Toxic effects of long-term dual or single exposure to oxytetracycline and arsenic on Xenopus tropicalis living in duck wastewater.

Direct discharge of aquaculture wastewater may have toxic effects, due to the presence of heavy metals, antibiotics, and even resistant pathogens, but little attention has been given. Here, tanks simulating a wild ecosystem were built to study the effects of long-term exposure to duck wastewater containing oxytetracycline (OTC) and/or arsenic (As) on the growth, physiological function, and gut microbiota evolution of Xenopus tropicalis. The results showed that duck wastewater had no apparent impact on X. tropicalis, but the impact increased significantly (P < 0.05) with exposure to OTC and/or As, especially the impact on body weight and growth rate. Biochemical indicators revealed varying degrees of oxidative stress damage, hepatotoxicity (inflammation, necrosis, and sinusoids), and collagen fibrosis of X. tropicalis in all treated groups after 72 days of exposure, which indirectly inhibited X. tropicalis growth. Moreover, 16S rDNA amplicon sequencing results showed that the gut microbiota structure and metabolic function were perturbed after chronic exposure, which might be the leading cause of growth inhibition. Interestingly, the abundance of intestinal resistance genes (RGs) increased with exposure time owing to the combined direct and indirect effects of stress factors in duck wastewater. Moreover, once the RGs were expressed, the resistance persisted for at least 24 days, especially that conferred by tetA. These results provide evidence of the toxic effects of DW containing OTC (0.1-4.0 mg/L) and/or As (0.3-3.5 µg/L) on amphibians and indicate that it is vital to limit the usage of heavy metals and antibiotics on farms to control the biotoxicity of wastewater.

Intestinal toxicity and resistance gene threat assessment of multidrug-resistant Shigella: A novel biotype pollutant.

Multidrug-resistant bacteria, especially pathogens, pose a serious threat to disease treatment and recovery, but their potential toxicity to animal development is not entirely clear. As the most important site for nutrient absorption, we studied the intestinal microbiome of Xenopus tropicalis by analyzing the effect of multidrug-resistant Shigella on its intestinal health. Unlike in the control, Shigella intake promoted the secretion of neutral mucus and inhibited intestinal development and weight gain. Following 60 days of exposure, intestinal crypt atrophy, intestinal villus shortening, internal cavity enlargement, and external mucosal muscle disintegration were observed. The circular and longitudinal intestinal muscles became thinner with increasing pathogen exposure. In addition, the presence of Shigella altered the expression of multiple cytokines and classic antioxidant enzyme activities in the gut, which may have caused the intestinal lesions that we observed. 16 S rDNA sequencing analysis of intestinal samples showed that exposure to Shigella destroyed the normal gut microbial abundance and diversity and increased the functional bacterial ratio. Notably, the increased abundance of intestinal antibiotic resistance genes (ARGs) may imply that the resistance genes carried by Shigella easily migrate and transmit within the intestine. Our results expand existing knowledge concerning multidrug-resistant Shigella-induced intestinal toxicity in X. tropicalis and provide new insights for the threat assessment of resistance genes carried by drug-resistant pathogens.

Acute stress of the typical disinfectant glutaraldehyde-didecyldimethylammonium bromide (GD) on sludge microecology in livestock wastewater treatment plants: Effect and its mechanisms.

Glutaraldehyde and didecyldimethylammonium bromide (GD) is a disinfectant widely used to prevent African swine fever (ASF) in livestock farms. However, the effect of residual GD on the activated sludge microbial ecology of receiving wastewater treatment plants (WWTPs) remains largely unknown. In this study, seven simulated systems were established to research the effects of GD on WWTPs and reveal the underlying mechanisms of microecological responses to GD at different concentrations. Both the nitrogen and carbon removal rates decreased with increasing GD concentrations, and nitrogen metabolism was inhibited more obviously, but the inhibition weakened with increasing stress duration. Microorganisms activated their SoxRS systems to promote ATP synthesis and electron transfer to support the hydrolysis and efflux of GD by producing a small number of ROS when exposed to GD at less than 1 mg/L. The overproduction of ROS led to a decrease of antioxidant and nitrogen removal enzyme activities, and upregulation of the porin gene increased the risk of GD entering the intracellular space upon exposure to GD at concentrations higher than 1 mg/L. Some denitrifiers survived via resistance and their basic capabilities of sugar metabolism and nitrogen assimilation. Notably, low concentrations of disinfectants could promote vertical and horizontal transfer of multiple resistance genes, especially aminoglycosides, among microorganisms, which might increase not only the adaptation capability of denitrifiers but also the risk to ecological systems. Therefore, the risks of disinfectants targeting ASF on ecology and health as well as the effects of disinfectant residuals from the COVID-19 epidemic should receive more attention.

Effects of Shigella flexneri exposure on development of Xenopus Tropicals embryo and its immune response.

Shigella sp. is a highly infectious intestinal pathogen worthy of serious attention that is widely present in aquaculture water and some other polluted water types and might inhibit embryonic development as a biological pollutant. In this study, acute toxicity tests in which Xenopus tropical embryos were exposed to Shigella flexneri at subpathogenic concentrations (106, 107, and 108 CFU·mL-1) for 96 h were carried out to evaluate toxicity indicators such as mortality, hatching rate, malformation rate and enzyme activity. Meanwhile, the expression of related genes was also studied to reveal the toxicity and mechanism of S. flexneri involved in embryonic development. Under S. flexneri exposure, embryo mortality, heart rate and malformation rate increased, but the hatching rate decreased and even led to embryonic gene misexpression, oxidative stress and immune responses. The results showed that S. flexneri might affect the growth and development of embryos by causing differences in the expression of genes related to embryonic development, oxidative stress and immune disorders. Its target organs are the intestine and heart, whose toxic effects are positively correlated with exposure concentration. This result provides a certain theoretical reference for rational evaluation of the influence of Shigella on the early embryos of amphibians.

Reversal of alopecia areata, osteoporosis follow treatment with activation of Tgr5 in mice.

BACKGROUND: Alopecia areata is an autoimmune hair loss disease with infiltration of pro-inflammatory cells into hair follicles. The role of Tgr5 in dermatitis has attracted considerable attention. The present study aimed to investigate the effect of Tgr5 in the development of Alopecia areata. METHODS: The study utilized a comparison control group design with four groups of wild-type group, wild-type+INT777 group, Tgr5-/- group, and Tgr5-/-+INT777 group. The mice were treated with INT777 (30 mg/kg/day) or the carrier solution (DMSO) intraperitoneally for 7 weeks, and the back skin was collected and analyzed by histology and immunohistochemistry staining. The lumbar vertebrae 4 has also been analyzed by DXA and Micro-CT. RESULTS: Tgr5-/- mice displayed the decreasingly significant in hair area and length, skin thickness, and the ratio of anagen and telogen, collagen, and mast cell number and loss the bone mass than WT group. After treating with INT777, the appearance of alopecia areata and bone microstructure has improved. Immunohistochemistry and qPCR analysis showed that activation of Tgr5 can down-regulate the express of JAK1, STAT3, IL-6, TNF-α, and VEGF. CONCLUSION: These findings indicate that activation of Tgr5 mediated amelioration of alopecia areata and osteoporosis by down-regulated JAK1-STAT3 signaling pathway.

Potential reproductive toxicity of multi-walled carbon nanotubes and their chronic exposure effects on the growth and development of Xenopus tropicalis.

The increasing production and use of multi-walled carbon nanotubes (MWCNTs) will inevitably lead to discharge into the environment and exert negative effects on organisms. Many studies have focused on the toxicity of MWCNTs to aquatic animals, but little is known about their possible potential reproductive toxicity. In this study, 6 sexually mature Xenopus tropicalis were exposed to 0.5 and 2.5 mg/L MWCNTs suspensions for 56 days, and the toxicity of MWCNTs to the growth and reproduction of X. tropicalis were studied. The results showed that MWCNTs could inhibit the growth of body, including the testis, ovaries and fat of X. tropicalis. Histopathological section analysis showed that MWCNTs affected the formation of spermatogonia and oocytes, while had no notable effect on the heart or liver. MWCNTs would be accumulated in lungs of X. tropicalis inducing lung cannons. In addition, MWCNTs changed the microbial community structure and diversity of gut microbiota but did not change its abundance significantly. Moreover, MWCNTs could even decrease the fertilized and survival rate of X. tropicalis embryos. These results indicated that chronic exposure to MWCNTs would not only affect the growth and development of X. tropicalis, but also pose a potential risk on their reproduction.

Comparison of the elimination effectiveness of tetracycline and AmpC ß-lactamase resistance genes in a municipal wastewater treatment plant using four parallel processes.

Municipal wastewater treatment plants (mWWTPs), considered reservoirs of antibiotic resistance genes (ARGs), are selected to compare the contributions of technology and process to ARG removal. Fifteen ARGs (tetA, tetB, tetC, tetE, tetG, tetL, tetM, tetO, tetQ, tetS, tetX, MOX, CIT, EBC, and FOX) and two integron genes (intI1, intI2) were tracked and detected in wastewater samples from a large-scale mWWTP with four parallel processes, including three biological technologies of AAO (anaerobic-anoxic-oxic), AB (adsorption-biodegradation), and UNITANK, two different disinfection technologies, and two primary sedimentation steps. The results showed that ARGs were widely detected, among which tetA and tetM had the highest detection rate at 100%. AAO was the most effective process in removing ARGs, followed by the AB and UNITANK processes, where the separation step was critical: 37.5% AmpC ß-lactamase genes were reduced by the secondary clarifier. UV disinfection was more efficient than chlorination disinfection by 47.0% in ARG removal. Both disinfection and primary sedimentation processes could effectively remove integrons, and the swirling flow grit chamber was a more effective primary settling facility in total ARG removal than the aerated grit chamber. The tet genes and AmpC ß-lactamase genes were significantly correlated with the water quality indexes of BOD5, CODCr, SS, TP, TOC, pH and NH4+-N (p < 0.05). In addition, the correlation between efflux pump genes and AmpC ß-lactamase genes was strongly significant (r2 = 0.717, p < 0.01). This study provides a more powerful guide for selecting and designing treatment processes in mWWTPs with additional consideration of ARG removal.

Impact of contrast-induced acute kidney injury on the association between renin-angiotensin system inhibitors and long-term mortality in heart failure patients.

INTRODUCTION: Renin-angiotensin system inhibitors (RASi) reduce mortality among heart failure (HF) patients, but their effect among those complicating contrast-induced acute kidney injury (CI-AKI) remains unexplored. We aimed to investigate whether the relationship between RASi prescription at discharge and mortality differs between HF patients with or without CI-AKI following coronary angiography (CAG). METHODS: About 596 HF patients from an observational cohort were divided into a CI-AKI group (n = 104) and a non-CI-AKI group (n = 492) based on whether they had CI-AKI following CAG. The endpoint was all-cause mortality. Multivariable Cox regression was performed in each group to explore the associations between RASi at discharge and mortality. RESULTS: During the median follow-up time of 2.26 (1.70; 3.24) years, higher mortality rate was observed in the CI-AKI group compared to the non-CI-AKI group (18.3% vs 8.9%, p = 0.002). Among HF patients with CI-AKI, after adjusting for confounding factors, the association was not significant between RASi prescription at discharge and mortality (HR: 0.39, 95%CI: 0.12-1.31, p = 0.128), while it was among those without CI-AKI (HR: 0.39, 95%CI: 0.18-0.84, p = 0.016). CONCLUSION: RASi prescription at discharge for HF patients complicating CI-AKI tended to be ineffective, while it benefited those without CI-AKI. Further randomized evidence is needed to confirm this trend.

Accumulation and toxicity of multi-walled carbon nanotubes in Xenopus tropicalis tadpoles.

Multi-walled carbon nanotubes (MWCNTs), a common nanomaterial widely used and discharged in environment, might exert toxic effects on aquatic animals. In this paper, filter-feeding tadpole of Xenopus tropicalis was selected as bioindicator to study the exposure effects of MWCNTs suspensions of 0.5, 1, 2, 4 and 8 mg/L for 72 h. The results showed that the tadpoles could remain high survival rate of over 96.7% after 24 h's exposure to MWCNTs, but then decrease considerably, showing a significant time-dependent relationship. The LC50 was 2.53 mg/L for tadpoles exposed to MWCNTs for 72 h, when MWCNTs accumulated in their gills and digestive tracts. Moreover, the enrichment degree of MWCNTs in tadpole was related to exposure density than time. When MWCNTs suspension concentration was not over 1 mg/L, the heart rates increased significantly and then decreased continuously. The survivors from the toxicity test were transferred to fresh filtered water for recovery, but MWCNTs accumulated in the tadpoles' body didn't decrease obviously after 4 days. Although the maximum tadpoles survival rate of 80% was recorded in the exposure group of 0.5 mg/L MWCNTs, only 43.3% of the survivors could recover. Therefore, the final survival rate was negative related to the exposure densities of MWCNTs but positive related to the accumulating degree in tadpoles' body. The results demonstrated that MWCNTs exposure posed potential health risks to filter-feeding organisms by intake and accumulation in organs, which could provide useful information for the reasonable evaluation and scientific management of nanomaterials.

Association between prophylactic hydration volume and risk of contrast-induced nephropathy after emergent percutaneous coronary intervention.

BACKGROUND: Intravenous hydration during percutaneous coronary intervention (PCI) significantly reduces the risk of contrast-induced nephropathy (CIN), but there are no well-defined protocols regard¬ing the optimal hydration volume (HV) required to prevent CIN following emergent PCI. Therefore, this study investigates the association between the intravenous HV and CIN after emergent PCI. METHODS: 711 patients were prospectively recruited who had underwent emergent PCI with hydration at routine speed and the relationship was investigated between HV or HV to weight ratio (HV/W) and the CIN risk, which was defined as a ≥ 25% or ≥ 0.5 mg/dL increase in serum creatinine levels from baseline within 48-72 h of exposure to the contrast. RESULTS: The overall CIN incidence was 24.7%. Patients in the higher HV quartiles had elevated CIN rates. Multivariate analysis showed that higher HV/W ratios were not associated with a decreased risk (using the HV) of CIN, but they were associated with an increased risk (using the HV/W) of CIN (Q4 vs. Q1: adjusted odds ratio 1.99; 95% confidence interval 1.05-3.74; p = 0.034). A higher HV/W ratio was not significantly associated with a reduced risk of long-term death (all p > 0.05). CONCLUSIONS: The data suggests that a higher total HV is not associated with a decreased CIN risk or beneficial long-term prognoses, and that excessive HV may increase the risk of CIN after emergent PCI.

Contrast Volume to Cystatin C-Based Glomerular Filtration Ratio Predicts the Risk of Contrast-Induced Nephropathy After Cardiac Catheterization.

Cystatin C is considered to be a better alternative to creatinine for estimating glomerular filtration rate (GFR). The aim of this study was to investigate whether a contrast volume to estimated GFR based on cystatin C (V/eGFRcys) is a better predictor of contrast-induced nephropathy (CIN). We enrolled 1195 consecutive patients undergoing elective cardiac catheterization. Receiver-operating characteristic (ROC) curves were used to identify the optimal cutoff value of V/eGFRcys for detecting CIN. Multivariate regression models were used to evaluate whether V/eGFRcys is an independent risk factor for CIN. A total of 19 (1.6%) patients developed CIN. There was a significant association between a higher V/eGFRcys ratio and CIN risk ( P = .008). A ROC curve analysis indicated that a V/eGFRcys ratio of 2.29 was a fair discriminator for CIN. After adjusting for other known CIN risk factors, V/eGFRcys ratios >2.29 remained significantly associated with CIN (odds ratio = 2.93, 95% confidence interval: 1.02-8.44, P = .047). In conclusion, a V/eGFRcys >2.29 was a significant and independent predictor of CIN after cardiac catheterization.

Equilibrium of Treg/Th17 cells of peripheral blood in syphilitic patients with sero-resistance.

The aim of the present study was to examine changes of cellular homeostasis in regulatory T (Treg) and T helper 17 (Th17) cells by detecting the proportion of Treg and Th17 cells of peripheral blood, as well as the expression of specific transcription factors in these two types of cells, in syphilitic patients with sero-resistance. A total of 49 subjects were enrolled in the study and divided into two groups, comprising 26 cases of sero-resistant syphilitic patients in the experimental group, and 23 cases of healthy donors in the normal control group. Flow cytometry was applied to examine the proportion of Treg and Th17 cells, as well as the quantitative expression of relevant specific transcription factors [forkhead box P3 (Foxp3) and retinoic acid-related orphan receptor γt (ROR-γt)] in the two groups. A correlation analysis was subsequently performed. The results showed that in syphilitic patients with sero-resistance, the proportion of peripheral blood Treg cells was obviously higher than that of the normal control group (p<0.01) and the proportion of Th17 cells was significantly lower than that of the normal control group (p<0.01). In addition, the expression of transcription factor Foxp3 in CD4+ T cells was higher than that of the normal control group, while the expression of ROR-γt was lower than that of the normal control (p<0.05). The expression of Foxp3 and ROR-γt in peripheral blood CD4+ T cells had a negative correlation (r=-0.481, p<0.01). In conclusion, the peripheral blood of syphilitic patients with sero-resistance may have abnormalities in Treg/Th17 cellular balance.

Relationship Between the Urine Flow Rate and Risk of Contrast-Induced Nephropathy After Emergent Percutaneous Coronary Intervention.

A low urine flow rate is a marker of acute kidney injury. However, it is unclear whether a high urine flow rate is associated with a reduced risk of contrast-induced nephropathy (CIN) in high-risk patients. We conducted this study to evaluate the predictive value of the urine flow rate for the risk of CIN following emergent percutaneous coronary intervention (PCI). We prospectively examined 308 patients undergoing emergent PCI who provided consent. The predictive value of the 24-hour postprocedural urine flow rate, adjusted by weight (UR/W, mL/kg/h) and divided into quartiles, for the risk of CIN was assessed using multivariate logistic regression analysis. The cumulative incidence of CIN was 24.4%. In particular, CIN was observed in 29.5%, 19.5%, 16.7%, and 32.0% of cases in the UR/W quartile (Q)-1 (≤0.94  mL/kg/h), Q2 (0.94-1.30  mL/kg/h), Q3 (1.30-1.71  mL/kg/h), and Q4 (≥1.71  mL/kg/h), respectively. Moreover, in-hospital death was noted in 7.7%, 3.9%, 5.1%, and 5.3% of patients in Q1, Q2, Q3, and Q4, respectively. After adjusting for potential confounding predictors, multivariate analysis indicated that compared with the moderate urine flow rate quartiles (Q2 + Q3), a high urine flow rate (Q4) (odds ratio [OR], 2.69; 95% confidence interval [CI], 1.27-5.68; P = 0.010) and low urine flow rate (Q1) (OR, 2.23; 95% CI, 1.03-4.82; P = 0.041) were significantly associated with an increased risk of CIN. Moreover, a moderate urine flow rate (0.94-1.71  mL/kg/h) was significantly associated with a decreased risk of mortality. Our data suggest that higher and lower urine flow rates were significantly associated with an increased risk of CIN after emergent PCI, and a moderate urine flow rate (0.94-1.71  mL/kg/h) may be associated with a decreased risk of CIN with a good long-term prognosis after emergent PCI.

Clinical Application of Confocal Laser Scanning Microscopy for Atypical Dermatoses.

Confocal laser scanning microscopy (CLSM) is a novel non-invasive imaging technique for in vivo evaluation of cutaneous lesions at near-histologic resolution. The applicability of CLSM for various neoplastic and inflammatory skin diseases has been shown. The objective of the study is to utilize the CLSM for the differential diagnosis of atypical dermatoses. Six patients with atypical clinical manifestation were detected by CLSM. In spite of non-typical clinical manifestations, CLSM can still detect their characteristic pathological changes and help differentiate them from other diseases that are liable to be confused in clinical practice. CLSM deserves wide application in clinical practice as it boasts of easy and convenient operation, broad application, no pains or traumas for patients, rapid examination reports, as well as it can relieve patient's distress by avoiding the traumas resulting from histopathological biopsy.

[Synthesis of polyrotaxane-camptothecin conjugates and evaluation of its anti-tumor effect].

To prepare polyrotaxane-camptothecin conjugates and evaluate its anti-tumor effect, polyrotaxane-camptothecin conjugates were successfully synthesized, and the release behavior was performed; MTT assay and cell morphology were used to examine the inhibition of cells' proliferation effect in vitro. The experimental study of the antitumor effect on S180 mice in vivo was also performed to further evaluate the anti-tumor effect of conjugate. The result showed polyrotaxane-camptothecin conjugates can effectively inhibit the proliferation in a dose dependent effect. In vivo study and cell morphology observation of S180 mice showed significant decrease in growth of tumor, degree of tumor infiltration and blood vessel number. The result indicated anti-tumor mechanism may be through affect the angiogenesis and reduced blood supply to tumor cells and then leading to necrosis.

[Preparation of Ginkgo biloba extract 50-phospholipid complex and study on its physicochemical properties].

OBJECTIVE: To optimize the preparation technology of GBE 50-phospholipid complex and study its physicochemical properties. METHODS: The preparation conditions for GBE 50-phospholipid complex were optimized by means of single factor study and orthogonal design, and taking the complexing rate of total flavonoids as assessment criteria, the complex was analyzed by DSC, IR and determined apparent oil-water distribution coefficients in different pH aqueous solution. RESULTS: The optimized preparation conditions for GBE 50-phospholipid complex were obtained as follows: the solvent was Tetrahydrofuran, the temperature was 30 degrees C, the concentration of GBE 50 was 20 mg/mL, the ratio of GBE 50 to phospholipids was 1 to 1, and the complexing rate was 98%. The complex significantly improved GBE 50 on the solubility in octanol, also on the oil-water apparent partition coefficient. CONCLUSION: GBE 50-phospholipid complex is very different from GBE 50 on the physicochemical properties.

In vitro effects of spectinomycin and ceftriaxone alone or in combination with other antibiotics against Chlamydia trachomatis.

The in vitro effects of spectinomycin and ceftriaxone, alone or in combination with erythromycin, ofloxacin, and doxycycline, against Chlamydia trachomatis were investigated by the checkerboard method and compared by Ridit (reference identical unit) analysis. A combination of spectinomycin with erythromycin or doxycycline was found to be more effective than that of ceftriaxone.