Clinical and EEG characteristics analysis of autoimmune encephalitis in children with positive and negative anti-N-methyl- D-aspartate receptor antibodies.

BACKGROUND: Autoimmune encephalitis is complex and varied, but it is a curable disease. However, the diagnosis and treatment of children with Autoimmune encephalitis remains challenging. Therefore, we conducted this study to analyze the clinical features, electroencephalogram (EEG) characteristics, treatment and prognosis of autoimmune encephalitis in children with negative and positive anti-N-methyl-D-aspartate receptor (NMDAR) antibody. METHODS: From January 2015 to January 2017, 28 child patients with autoimmune encephalitis were hospitalized in the Neural Ward of the Children's Medical Center, Qilu Hospital of Shandong University. Inclusion criteria were based on the diagnostic criteria for autoimmune encephalitis published in Lancet Neurology in 2016. The clinical, EEG and imaging data were summarized. The clinical features, treatment regimen, follow-up and prognosis were also analyzed. RESULTS: Among these 28 child patients, 10 patients had positive anti-NMDAR antibody, while 18 patients had negative anti-NMDAR antibody. The clinical manifestations, EEG findings and seizures were similar (P>0.05) between these two groups. All 28 child patients were treated with methylprednisolone shock and human immunoglobulin. The response to immunotherapy was similar between these two groups (P>0.05). CONCLUSIONS: The clinical manifestation of autoimmune encephalitis is complex and varied, but it is a curable disease. Immunotherapy should be considered as soon as possible, with or without autoantibodies. Most of the child patients had a good prognosis, while some of them had the sequelae of epilepsy, mild mental symptoms, and dyskinesia. It is necessary to improve the understanding of autoimmune encephalitis with/without positive antibodies, and make diagnosis and treatment as soon as possible, in order to improve the prognosis.

Distribution of perfluoroalkyl substances (PFASs) in aquatic plant-based systems: From soil adsorption and plant uptake to effects on microbial community.

This study systematically explored the distribution of perfluoroalkyl substances (PFASs) through soil adsorption and plant bioaccumulation in aquatic plant-based systems, derived from a surface flow constructed wetland (CW) planted with Typha angustifolia. The water-soil-plant systems were fortified with eight perfluoroalkyl subsntances (PFASs) at different concentrations. The potential for individual PFAS adsorption onto soil substrate and bioaccumulation in the plants increased with the increasing PFAS initial concentrations. Longer-chain PFASs exhibited higher affinity to soil substrate compared to shorter-chain PFASs. The highest concentration in the soil was observed for PFOS (51.3 ng g-1), followed by PFHxS (9.39 ng g-1), and PFOA (5.53 ng g-1) at low PFAS level. The perfluoroalkyl chain length dependent trend was also seen in the roots with the highest individual PFAS concentration for PFOS (68.9 ng g-1), followed by PFOA (18.5 ng g-1) and PFHxS (13.4 ng g-1). By contrast, shorter-chain PFASs were preferentially translocated from roots to shoots in Typha angustifolia. A significant (p < 0.05) positive correlation between bioaccumulation factor (BAFplant/water) (whole plant) and perfluoroalkyl chain length was observed. PFASs content in the plant compartments increased with increasing PFAS concentrations in the soil. Mass balance analysis indicates that approximately 40.7-99.6% of PFAS mass added to the system was adsorbed onto the soil and bioaccumulated in the plant tissues of T. angustifolia. Soil adsorption played a vital role in PFAS mass distribution. The results of Illumina high-throughput sequencing show that the bacterial diversity decreased upon PFAS exposure. The most predominant phyla retrieved were Proteobacteria (24.7-39.3%), followed by Actinobacteria (4.2-41.1%), Verrucomicrobia (7.9-25.1%), Bacteroidetes (10.2-20.4%), Cyanobacteria (0.4-16.5%), and Firmicutes (1.1-6.4%). The PFAS enrichment caused the changes (p > 0.05) in the structure and composition of bacterial community. This study helps to gain insight into a better understanding of the potential for PFASs distribution in an aquatic plant-based system and the impact on dynamic of microbial community exposed to PFASs.

Regulatory effect of anti-gp130 functional mAb on IL-6 mediated RANKL and Wnt5a expression through JAK-STAT3 signaling pathway in FLS.

We investigated the effect on rheumatoid arthritis (RA) of an anti-gp130 monoclonal antibody (mAb) and its mechanism using RA fibroblast-like synoviocytes (FLS) and a collagen antibody-induced arthritis (CAIA) mouse model. We determined the interleukin 6 (IL-6), IL-6 receptor α (IL-6Rα), gp130, receptor activator of nuclear factor κB ligand (RANKL), matrix metalloproteinase 3 (MMP3), TIMP metallopeptidase inhibitor 1 (TIMP1), and Bcl-2 levels in RA and osteoarthritis (OA) serum and synovial fluid. RA FLS were cultured with or without IL-6/IL-6Rα; WNT5A and RANKL levels were detected. We generated an anti-gp130 mAb (M10) with higher affinity and specificity, blocked IL-6 signaling with it, and assessed its effects on the CAIA model, WNT5A and RANKL expression, and signal transducer and activator of transcription 3 (STAT3) phosphorylation. The IL-6 signaling system in patients with RA was increased; RANKL, MMP3, TIMP1, and Bcl-2 in RA bone were elevated. IL-6/IL-6Rα increased RA FLS WNT5A and RANKL expression. M10 ameliorated arthritis in the CAIA model, and inhibited RANKL, WNT5A, and Bcl-2 expression in RA FLS by blocking IL-6 signaling, likely via Janus kinase-STAT3 pathway downregulation. The IL-6-soluble IL-6Rα-gp130 complex is hyperactive in RA and OA. M10 may be the basis for a novel RA treatment drug.

Identification of hub genes and pathways associated with bladder cancer based on co-expression network analysis.

The aim of the present study was to identify hub genes and signaling pathways associated with bladder cancer (BC) utilizing centrality analysis and pathway enrichment analysis. The differentially expressed genes (DEGs) were screened from the ArrayExpress database between normal subjects and BC patients. Co-expression networks of BC were constructed using differentially co-expressed genes and links, and hub genes were investigated by degree centrality analysis of co-expression networks in BC. The enriched signaling pathways were investigated by Kyoto Encyclopedia of Genes and Genomes database analysis based on the DEGs. The hub gene expression in BC tissues was validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blotting. A total of 329 DEGs were screened, including 147 upregulated and 182 downregulated genes. The co-expression network constructed between BC and normal controls consisted of 182 nodes and 434 edges, and the two genes in each gene pair were differentially co-expressed genes. Centrality analysis of co-expression networks suggested that the top 5 hub genes with high degree included lectin, galactoside-binding, soluble, 4 (LGALS4), protein tyrosine phosphatase, receptor type N2 (PTPRN2), transmembrane protease, serine 11E (TMPRSS11E), tripartite motif containing 31 (TRIM31) and potassium voltage-gated channel subfamily D member 3 (KCND3). Pathway analysis revealed that the 329 DEGs were significantly enriched in 5 terms (cell cycle, DNA replication, oocyte meiosis, p53 signaling pathway and peroxisome proliferator-activated receptor signaling pathway). According to RT-qPCR and western blot analysis, 4/5 hub genes were significantly expressed, including LGALS4, PTPRN2, TMPRSS11E, TRIM31; however, KCND3 was not significantly expressed. In the present study, 5 hub genes were successfully identified (LGALS4, PTPRN2, TMPRSS11E, TRIM31 and KCND3) and 5 biological pathways that may be underlying biomarkers for early diagnosis and treatment associated with bladder cancer were revealed.

Constructed wetlands for wastewater treatment in cold climate - A review.

Constructed wetlands (CWs) have been successfully used for treating various wastewaters for decades and have been identified as a sustainable wastewater management option worldwide. However, the application of CW for wastewater treatment in frigid climate presents special challenges. Wetland treatment of wastewater relies largely on biological processes, and reliable treatment is often a function of climate conditions. To date, the rate of adoption of wetland technology for wastewater treatment in cold regions has been slow and there are relatively few published reports on CW applications in cold climate. This paper therefore highlights the practice and applications of treatment wetlands in cold climate. A comprehensive review of the effectiveness of contaminant removal in different wetland systems including: (1) free water surface (FWS) CWs; (2) subsurface flow (SSF) CWs; and (3) hybrid wetland systems, is presented. The emphasis of this review is also placed on the influence of cold weather conditions on the removal efficacies of different contaminants. The strategies of wetland design and operation for performance intensification, such as the presence of plant, operational mode, effluent recirculation, artificial aeration and in-series design, which are crucial to achieve the sustainable treatment performance in cold climate, are also discussed. This study is conducive to further research for the understanding of CW design and treatment performance in cold climate.

Effects of ZnO nanoparticle exposure on wastewater treatment and soluble microbial products (SMPs) in an anoxic-aerobic membrane bioreactor.

The effect of zinc oxide nanoparticles (ZnO NPs) on the performance of an anoxic-aerobic submerged membrane bioreactor (MBR), and the characterization of the soluble microbial products (SMPs) produced in the presence of ZnO NPs was evaluated. Continuous operation over 144 days showed that ZnO NPs at concentrations of 10 and 50 mg/L exerted a negative impact on chemical oxygen demand (COD) and nitrogen removal, although ZnO NPs were efficiently removed in the MBR (>92%). 10 and 50 mg/L ZnO NPs decreased COD removal substantially from 93.1± 0.6% to 90.1± 0.8% (<0.05) and 86.3± 2.3% (<0.05), respectively. Similarly, with 10 and 50 mg L ZnO NPs, the decreased in NH4N removal was 8.1% and 21.1%, respectively. Exposure to 1, 10 and 50 mg/L ZnO NPs increased SMP concentrations by 12.8%, 42.4% and 51.5%, respecti. High performance size exclusion chromatograph (HP-SEC) analysis revealed that the presence of ZnO NPs caused a significant increase in high-molecular weight (MW) (583 kDa) SMPs at 1 and 10 mg/L ZnO NP concentration. A substantial decrease in the concentration of high-MW compounds in the MBR effluent was observed at the end of the experiment. Excitation emission matrix (EEM) fluorescence contours revealed that SMPs were dominated by amino acid-, tryptophan protein-, polyaromatic-, and polycarboxylate-type substances. The presence of ZnO NPs enhanced the production of amino acid-like (7.5-25.1%) and tryptophan protein-like compounds (31.7-38.1%), compared to the control (6.0-20.2% for amino acid-like compounds; and 28.5-36.7% for tryptophan protein-like compounds). In contrast, the fulvic and humic acid-like compounds decreased with exposure to ZnO NPs. This work may help better understanding the effect of nanoparticle exposure on wastewater treatment performance and SMP characteristics.

Characterization and biodegradability of sludge from a high rate A-stage contact tank and B-stage membrane bioreactor of a pilot-scale AB system treating municipal wastewaters.

In light of global warming mitigation efforts, increasing sludge disposal costs, and need for reduction in the carbon footprint of wastewater treatment plants, innovation in treatment technology has been tailored towards energy self-sufficiency. The AB process is a promising technology for achieving maximal energy recovery from wastewaters with minimum energy expenditure and therefore inherently reducing excess sludge production. Characterization of this novel sludge and its comparison with the more conventional B-stage sludge are necessary for a deeper understanding of AB treatment process design. This paper presents a case study of a pilot-scale AB system treating municipal wastewaters as well as a bio- (biochemical methane potential and adenosine tri-phosphate analysis) and physico-chemical properties (chemical oxygen demand, sludge volume index, dewaterability, calorific value, zeta potential and particle size distribution) comparison of the organic-rich A-stage against the B-stage activated sludge. Compared to the B-sludge, the A-sludge yielded 1.4 to 4.9 times more methane throughout the 62-week operation.

Application of constructed wetlands for wastewater treatment in tropical and subtropical regions (2000-2013).

Constructed wetlands (CWs) have been successfully used for treating various wastewaters for decades and have been identified as a sustainable wastewater management option for developing countries. With the goal of promoting sustainable engineered systems that support human well-being but are also compatible with sustaining natural (environmental) systems, the application of CWs has become more relevant. Such application is especially significant for developing countries with tropical climates, which are very conducive to higher biological activity and productivity, resulting in higher treatment efficiencies compared to those in temperate climates. This paper therefore highlights the practice, applications, and research of treatment wetlands under tropical and subtropical conditions since 2000. In the present review, removal of biochemical oxygen demand (BOD) and total suspended solid (TSS) was shown to be very efficient and consistent across all types of treatment wetlands. Hybrid systems appeared more efficient in the removal of total suspended solid (TSS) (91.3%), chemical oxygen demand (COD) (84.3%), and nitrogen (i.e., 80.7% for ammonium (NH)4-N, 80.8% for nitrate (NO)3-N, and 75.4% for total nitrogen (TN)) as compared to other wetland systems. Vertical subsurface flow (VSSF) CWs removed TSS (84.9%), BOD (87.6%), and nitrogen (i.e., 66.2% for NH4-N, 73.3% for NO3-N, and 53.3% for TN) more efficiently than horizontal subsurface flow (HSSF) CWs, while HSSF CWs (69.8%) showed better total phosphorus (TP) removal compared to VSSF CWs (60.1%). Floating treatment wetlands (FTWs) showed comparable removal efficiencies for BOD (70.7%), NH4-N (63.6%), and TP (44.8%) to free water surface (FWS) CW systems.

[Research achievements on biological activities of calycosin].

Calycosin, which is a kind of typical phytoestrogen, can bind with estrogen receptor and produce estrogen-like effects. Calycosin were reported to have antioxidant, anti-osteoporosis, anti-tumor and immunomodulating activities. This review covers biological activities and its mechanism of calycosin. It will provide a useful reference for clinical research and rational utilization of monomericompound.

Exogenous IFN-beta regulates the RANKL-c-Fos-IFN-beta signaling pathway in the collagen antibody-induced arthritis model.

BACKGROUND: Although a variety of drugs have been used to treat the symptoms of rheumatoid arthritis (RA), none of them are able to cure the disease. Interferon ß (IFN-ß) has pleiotropic effects on RA, but whether it can be used to treat RA remains globally controversial. Thus, in this study we tested the effects of IFN-ß on RA patients and on collagen antibody-induced arthritis (CAIA) model mice. METHODS: The cytokine and auto-antibody expression profiles in the serum and synovial fluid (SF) from RA patients were assessed using enzyme-linked immunosorbent assay (ELISA) and compared with the results from osteoarthritis (OA) patients. Exogenous IFN-ß was administered to RA patients and CAIA model mice, and the therapeutic effects were evaluated. Endogenous IFN-ß expression in the joint bones of CAIA model mice was evaluated by quantitative real-time PCR (qRT-PCR). The effects of exogenous IFN-ß on CAIA model mice were assessed using a clinical scoring system, hematoxylin eosin and safranin-O with fast green counterstain histology, molybdenum target X-ray, and tartrate-resistant acid phosphatase (TRAP) staining. The RANKL-RANK signaling pathway was analyzed using qRT-PCR. The RAW 264.7 cell line was differentiated into osteoclasts with RANKL stimulation and then treated with exogenous IFN-ß. RESULTS: The expression of inflammatory cytokines (IFN-γ, IL-17, MMP-3, and RANKL) and auto-antibodies (CII antibodies, RF-IgM, and anti-CCP/GPI) were significantly higher in RA compared with OA patients. After IFN-ß intervention, some clinical symptoms in RA patients were partially alleviated, and the expression of IFN-γ, IL-17, MMP-3, and OPG) returned to normal levels. In the CAIA model, the expression of endogenous IFN-ß in the joint bones was decreased. After IFN-ß administration, the arthritis scores were decreased; synovial inflammation, cartilage, and bone destruction were clearly attenuated; and the expression of c-Fos and NFATc1 were reduced, while RANKL and TRAF6 expression was unchanged. In addition, exogenous IFN-ß directly inhibited RANKL-induced osteoclastogenesis. CONCLUSIONS: Exogenous IFN-ß administration immunomodulates CAIA, may reduce joint inflammation and, perhaps more importantly, bone destruction by inhibiting the RANKL-c-Fos signaling pathway. Exogenous IFN-ß intervention should be selectively used on RA patients because it may only be useful for RA patients with low endogenous IFN-ß expression.

Increased expression of miR-222 is associated with poor prognosis in bladder cancer.

BACKGROUND: MicroRNA-222 (miR-222) has been shown to play a potential oncogenic role in bladder cancer. The aim of this study was to evaluate the expression of miR-222 in bladder cancer and its potential relevance to clinicopathological characteristics and patient survival. METHODS: Surgical specimens of cancer tissue and adjacent normal tissue were obtained from 97 patients with bladder cancer. The relative expression levels of miR-222 in the cancer and the normal adjacent tissue were measured by quantitative reverse-transcriptase PCR. We analyzed their correlation with clinicopathological parameters and prognostic value. RESULTS: The expression level of miR-222 was significantly higher in tumor tissues than in corresponding non-cancerous tissues (5.46 ± 1.45 versus 1.92 ± 0.65, P < 0.0001), and a high expression of miR-222 was found to be significantly associated with tumor grade (P = 0.003) and tumor stage (P = 0.005). The miR-222 expression level was classified as high or low in relation to the median value (cutoff value = 5.15). Kaplan-Meier analysis showed that patients with higher levels of miR-222 had significantly poorer survival than those with lower expression of this miRNA in patients, with a 5-year overall survival of 29.53% and 52.75%, respectively (P = 0.0034). In the multivariate Cox proportional hazards analysis, which included miR-222 level, tumor grade, tumor stage, and tumor number, high miR-222 expression was independently associated with poor survival (P < 0.001; hazard ratio 6.17; 95% CI 2.33 to 10.39). CONCLUSION: miR-222 overexpression is involved in the poor prognosis of bladder cancer and can be used as a biomarker for selection of cases requiring special attention.

Application of constructed wetlands for wastewater treatment in developing countries--a review of recent developments (2000-2013).

Inadequate access to clean water and sanitation has become one of the most pervasive problems afflicting people throughout the developing world. Replication of centralized water-, energy- and cost-intensive technologies has proved ineffective in resolving the complex water-related problems resulting from rapid urbanization in the developing countries. Instead constructed wetlands (CWs) have emerged and become a viable option for wastewater treatment, and are currently being recognized as attractive alternatives to conventional wastewater treatment methods. The primary objective of this review is to present a comprehensive overview of the diverse range of practice, applications and researches of CW systems for removing various contaminants from wastewater in developing countries, placing them in the overall context of the need for low-cost and sustainable wastewater treatment systems. Emphasis of this review is placed on the treatment performance of various types of CWs including: (i) free water surface flow CW; (ii) subsurface flow CW; (iii) hybrid systems; and, (iv) floating treatment wetland. The impacts of different wetland design and pertinent operational variables (e.g., hydraulic loading rate, vegetation species, physical configurations, and seasonal variation) on contaminant removal in CW systems are also summarized and highlighted. Finally, the cost and land requirements for CW systems are critically evaluated.

ABCG5/8 variants are associated with susceptibility to coronary heart disease.

ATP-binding cassette sub-family G member 5 (ABCG5) and ABCG8 are members of an ATP-binding cassette transporter superfamily. ABCG5 and ABCG8 variants affected serum levels of cholesterol and were considered as risk factors for coronary heart disease (CHD). The present control study analyzed ABCG5 and ABCG8 variants in a population for association with the risk of CHD. A total of 417 CHD patients and 267 controls were recruited for genotyping of four single nucleotide polymorphisms (SNPs; i.e. i7892T>C in ABCG5 and Tyr54CysA>G, Thr400LysC>A and 5U145A>C in ABCG8) using quantitative PCR high-resolution melting (qPCR-HRM). Serum lipid levels were measured using an automatic biochemical analyzer. The association of ABCG5/8 variants with lipid levels was analyzed using a Chi-square test. The impact of candidate ABCG5/8 SNPs on CHD was evaluated in a dominant genetic model with stepwise multiple regression analysis. Subgroup analyses were performed with regard to these SNPs, tobacco smoking status, alcohol consumption and gender. Genotypic and allelic frequencies of ABCG8 Thr400LysC>A were significantly different (P<0.05) between CHD patients and controls. CC homozygotes of the ABCG8 Thr400LysC>A SNP had greater triglyceride levels than CA/AA carriers with CHD. Logistic analysis revealed CHD risk was significantly higher in CC homozygotes of ABCG8 Thr400LysC>A than in carriers of the A allele (adjusted P=0.048; OR=2.034; 95% CI=0.983-4.207). Furthermore, there was a significant gene-tobacco smoking interaction. CC homozygotes of ABCG8 Thr400LysC>A SNP had significantly higher triglyceride concentrations (P=0.012) and an increased risk of CHD than tobacco smoking carriers of the A allele. The data from the current study suggested that ABCG8 Thr400LysC>A SNP genetic variants modulated plasma triglyceride levels and thereby affected CHD risk in the population studied. The genetic variant of ABCG8 also contributed to CHD risk through interaction with tobacco smoking.

Novel KIF6 polymorphism increases susceptibility to type 2 diabetes mellitus and coronary heart disease in Han Chinese men.

OBJECTIVES: The effect of the KIF6 polymorphism Trp719Arg on the risk of T2DM and T2DM with CHD remains unclear. METHODS: 946 unrelated subjects of Han Chinese origin were recruited, comprising 346 controls, 312 T2DM, and 288 T2DM + CHD patients. Genotyping was performed by high-resolution melting curve analysis using real-time qPCR. The impact of the variant on T2DM/T2DM + CHD and gene-sex interaction were evaluated by stepwise multiple regression analysis. RESULTS: The frequencies of the Trp719 allele in T2DM and T2DM + CHD patients were similar to the control group, whereas significantly increased 719Arg allele frequencies were observed in male T2DM and T2DM + CHD patients compared with the corresponding control group. Further sex partition analysis revealed that only male 719Arg allele carriers had approximately 3-fold and 5-fold higher risk of T2DM and T2DM + CHD, respectively, than noncarriers. There was also a significant association between carriers and higher TG and lower HDL-C levels. CONCLUSION: The KIF6 719Arg allele may increase the risk of T2DM and T2DM + CHD only in Han Chinese men by modulating lipid metabolism, especially with regard to TG and HDL.

Clinical observations on attention-deficit hyperactivity disorder (ADHD) in children with frontal lobe epilepsy.

The objective was to investigate the prevalence of attention-deficit hyperactivity disorder (ADHD) in children with frontal lobe epilepsy and related factors. The medical records of 190 children diagnosed with frontal lobe epilepsy at Qilu Hospital of Shandong University between 2006 and 2011 were retrospectively collected, and a follow-up analysis of the prevalence of ADHD in these children was conducted. Of the 161 children with an effective follow-up, 59.0% (95/161) with frontal lobe epilepsy suffered from ADHD as well. Analysis of epilepsy and ADHD-related factors indicated that the incidence of ADHD was 89.4% (76/85) in children with abnormal electroencephalogram (EEG) discharges on the most recent EEG, which was significantly higher than the ADHD incidence of 25% (19/76) in children with normal readings on the most recent EEG (P < .01). Children with frontal lobe epilepsy have a high incidence of ADHD. Sustained abnormal discharge on the electroencephalogram is associated with increased comorbidity of ADHD with frontal lobe epilepsy.

[Risk factors of hepatorenal syndrome in patients with acute on chronic liver failure].

OBJECTIVE: To identify the risk factors of hepatorenal syndrome in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure(ACLF). METHODS: A total of 726 hospitalized patients with HBV-ACLF were retrospectively analyzed. Data of demographic and clinical parameters (sex, age, family history, and presence of liver cirrhosis and diabetes), common complications (spontaneous bacterial peritonitis, pulmonary infection, hepatic encephalopathy, and upper gastrointestinal hemorrhage), and baseline biochemical parameters (albumin, globulin, total bilirubin, direct bilirubin, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, cholesterol, cholinesterase, K+, Na+, plasma thromboplastin antecedent, alpha-fetoprotein, HBV DNA, white blood cell count, hemoglobin, and platelet count) were collected from the medical records database. Univariate and multiple regression analyses were performed to determine the risk factors of hepatorenal syndrome. RESULTS: Multiple logistic regression analysis indicated that upper gastrointestinal hemorrhage [risk (R) = 1.313, relative hazard (RH) = 3.716, 95% confidence interval (CI): 2.156-6.404], hepatic encephalopathy (R = 1.120, RH = 3.065, 95% CI: 1.900-4.945), spontaneous bacterial peritonitis (R = 1.005, RH = 2.733, 95% CI: 1.379-5.417), pulmonary infection (R = 1.051, RH = 2.862, 95% CI: 1.783-4.592), and white blood cell count (R = 0.056, RH = 1.058, 95% CI: 1.010-1.107) were independent risk factors for hepatorenal syndrome development in patients with HBV-ACLF. CONCLUSION: Several risk factors were significantly associated with the development of hepatorenal syndrome in HBV-ACLF, including upper gastrointestinal hemorrhage, hepatic encephalopathy, spontaneous bacterial peritonitis, pulmonary infection, and elevated white blood cell count.

[Clinical characteristics of and factors related to relapse in chronic hepatitis B patients after nucleoside analogues withdrawal].

OBJECTIVE: To investigate the clinical characteristics of and factors related to relapse in chronic hepatitis B (CHB) patients who had previously achieved cessation criteria and had been withdrawn from nucleoside analogues treatment. METHODS: Sixty CHB patients who experienced relapse after nucleoside analogues withdrawal based on cessation criteria were enrolled in the study retrospectively. Each patient's data on biochemical, serological and viral characteristics corresponding to baseline (treatment initiation), withdrawal and relapse were collected. COX proportional hazard modeling was used to evaluate the factors related to relapse. RESULTS: The hepatitis B e antigen (HBeAg)-positive and -negative patients had similar median antiviral treatment times (38 months (range: 24 - 80) vs. 35 months (30 - 60); Z = -1.313, P more than 0.05). For all patients, the median follow-up time was 12 months (2 - 72), during which 49 (81.7%) patients developed virological breakthrough and 17 (28.3%) developed HBeAg recurrence. The patients who experienced virological breakthrough or HBeAg recurrence had significantly higher baseline levels of HBV DNA than those patients who remained disease-free (t = 2.15 and -2.54 respectively; P less than 0.05). The median relapse time of the HBeAg-positive patients was significantly longer than that of the HBeAg-negative patients (14 months (3 - 72) vs. 6 months (3 - 36); Chi-square test = 7.045, P less than 0.01). HBeAg status at baseline was identified as an independent factor associated with relapse (relative risk = 1.937, 95% confidence interval = 1.14-3.28, P less than 0.05). CONCLUSION: HBeAg-positive and-negative patients showed distinct clinical characteristics of relapse, with the latter being more prone to relapse soon after nucleoside analogues withdrawal. Prolonging the treatment course may be beneficial to HBeAg-negative patients, even if cessation criteria are achieved.

Fate of pharmaceutical compounds in hydroponic mesocosms planted with Scirpus validus.

A systematic approach to assess the fate of selected pharmaceuticals (carbamazepine, naproxen, diclofenac, clofibric acid and caffeine) in hydroponic mesocosms is described. The overall objective was to determine the kinetics of depletion (from solution) and plant uptake for these compounds in mesocosms planted with S. validus growing hydroponically. The potential for translocation of these pharmaceuticals from the roots to the shoots was also assessed. After 21 days of incubation, nearly all of the caffeine, naproxen and diclofenac were eliminated from solution, whereas carbamazepine and clofibric acid were recalcitrant to both photodegradation and biodegradation. The fact that the BAFs for roots for carbamazepine and clofibric acid were greater than 5, while the BAFs for naproxen, diclofenac and caffeine were less than 5, implied that the latter two compounds although recalcitrant to biodegradation, still had relatively high potential for plant uptake. Naproxen was sensitive to both photodegradation (30-42%) and biodegradation (>50%), while diclofenac was particularly sensitive (>70%) to photodegradation alone. No significant correlations (p > 0.05) were found between the rate constants of depletion or plant tissue levels of the pharmaceuticals and either log Kow or log Dow.

[Effects of perioperative blood transfusion on the severity of postoperative infection].

This study was purposed to explore whether the blood transfusion of surgical patients can increase the severity of postoperative infection by a retrospective analysis of patients with postoperative infection in Chinese PLA General Hospital. By using a software "clinical transfusion database" developed by our department, 150 infected surgical cases were retrieved and divided into deep infection group and superficial infection group according to the infected location. These two groups were compared in term of the patient's age, duration of hospitalization, red blood cell transfusion volume, none-red cell transfusion volume, transfusion frequency and average transfusion volume. The results showed that red blood cell transfusion volume or none-red cells transfusion volume of patients with superficial infection was 4.50 (0 - 59) U or 2.95 (0 - 119.6) U, and that of deep infection was 9.00 (0 - 153) U and 8.05 (0 - 136.6) U, the differences was significant (P < 0.05). Between two groups, the transfusion frequency showed the most significant difference, median in the patients with superficial infection was about 2 (1 - 31) times, less than the deep infection group about 4 (1 - 49) times (P < 0.001). There was no significant difference between two groups in the average transfusion volume. It is concluded that perioperative blood transfusion volume and frequency of surgical patients seems to display a positive correlation with the degree of postoperative infection.

Assessment of plant-driven uptake and translocation of clofibric acid by Scirpus validus.

Pharmaceutical compounds are now considered as emerging contaminants of environmental concern. The overall objective of this study was to evaluate the uptake and translocation of clofibric acid (CA) by the macrophyte Scirpus validus growing hydroponically. A set of the three replicates was established for each exposure time and for each CA concentration. Plants were grown in 4 L vessels (four plants per vessel corresponding to the three exposure period studies, i.e., 7, 14, 18, and 21 days) which contained an aerated modified Hoagland nutrient solution that was spiked with CA at concentrations of 0.5, 1.0, and 2.0 mg L(-1). At each exposure period, CA concentration was measured in the nutrient solutions. A sea sand disruption method was employed for the extraction of CA from plant tissues. The determination of the pharmaceutical concentration was carried out using solid phase extraction (SPE) followed by chromatographic analysis. The quantification of CA concentrations in both nutrient solutions (after SPE) and plant tissues (after extraction) was conducted by chromatographic analysis. CA concentrations of 5.4-26.8 µg g(-1) (fresh weight) were detected in the roots and 7.2-34.6 µg g(-1) (fresh weight) in the shoots after 21 days. Mass balance calculations showed that S. validus uptake alone accounted for a significant contribution (6-13% for the roots and 22-49% for the shoots) of the total loss of CA. The bioaccumulation factors (BAFs) based on fresh weight for the roots ranged from 6.6 to 23.2, while values for the shoots ranged from 9.5 to 32.1. All the BAFs for the shoots were greater than those in the roots, implying that CA has greater tendency to be translocated to the shoots, rather than the roots of S. validus. All the shoot-to-root concentration ratios were more than 1, denoting that the shoots of S. validus do preferentially accumulate CA. We demonstrated that CA can be actively taken up, subsequently translocated and accumulated by aboveground tissues of S. validus. Since S. validus could account for the removal of 28-62% of the total mass loss of CA from the system, such phytoremediation technology has great potential for the removal of pharmaceuticals such as CA from inflowing waters.