[Clinical Characteristics of Obstructive Sleep Apnea and Comorbid Primary Aldosteronism].

Objective: To explore the characteristics of patients with obstructive sleep apnea (OSA) and comorbid primary aldosteronism (PA) and to explore the relevant factors affecting plasma aldosterone concentration. Methods: A total of 105 patients diagnosed with PA and admitted at West China Hospital, Sichuan University between January 2016 and December 2021 were retrospectively analyzed. The subjects were divided into a PA with comorbid snoring group (n=20) and a PA with comorbid OSA group (n=85) based on the results of polysomnography (PSG). The PA with comorbid OSA group was further divided into mild, moderate, and severe subgroups according to the apnea-hypopnea index (AHI). A total of 85 outpatients diagnosed with OSA were included as the control group. Demographic, clinical, biochemical, and PSG data were compared between the groups. Results: Compared with patients with only OSA, a significantly higher proportion of patients with OSA and comorbid PA had hypertension and elevated levels of systolic and diastolic blood pressure (P<0.05). In addition, patients with OSA and comorbid PA had significantly increased AHI and significantly decreased mean oxygen saturation and sleep efficiency (P<0.05). The more severe the OSA was, the higher levels of BMI, cholesterol, low-density lipoprotein, and uric acid the PA patients had. Linear regression analysis showed that the lowest oxygen saturation (ß=－0.222, P=0.045) was negatively correlated with plasma aldosterone concentration. Conclusion: Comorbidity with PA can aggravate the clinical manifestations of OSA, while OSA further disrupted the metabolism of lipids and uric acid in PA patients. Plasma aldosterone concentrations in patients with comorbid OSA and PA were affected by the lowest oxygen saturation level.

How anammox process resists the multi-antibiotic stress: Resistance gene accumulation and microbial community evolution.

The effects of multiple antibiotics on the anaerobic ammonia oxidation (anammox) process were investigated. The resistance of the anammox system to high-concentration antibiotics was also demonstrated through gradual acclimation experiments. Inhibition of the anammox process (R1) occurred when the concentrations of erythromycin (ERY), sulfamethoxazole (SMX) and tetracycline (TC) were 0.1, 5.0 and 0.1 mg L-1, respectively. The nitrogen removal efficiency (NRE) of R1 was reduced from 97.2% to 60.7% within 12 days and then recovered to 88.9 ± 9.5% when the nitrogen loading declined from 4.52 ± 0.69 to 2.11 ± 0.58 kg N m-3 d-1. Even when the concentrations of ERY, SMX and TC were as high as 1.0, 15.0 and 1.0 mg L-1, respectively, R1 maintained stable operation. The increases in the abundance of antibiotic resistance genes (ARGs) and in extracellular polymeric substances (EPS) content showed that the anammox process alleviated stress from multiple antibiotics mainly by producing ARGs and secreting EPS. The molecular docking simulation results illustrated the potential binding sites between ammonium transporter and different antibiotics. The upregulation of functional gene expression and the stable abundance of Candidatus Kuenenia in R1 compared with that in the control suggested that the R1 reactor generally maintained more stable long-term operation. This work provides a new understanding of the application of the anammox process to treat wastewater containing multiple antibiotics.

Deciphering the toxic effects of antibiotics on denitrification: Process performance, microbial community and antibiotic resistance genes.

The extensive application of antibiotics, and the occurrence and spread of antibiotic resistance genes (ARGs) shade health risks to human and animal. The long-term effects of sulfamethoxazole (SMX) and tetracycline (TC) on denitrification process were evaluated in this study, with the focus on nitrogen removal performance, microbial community and ARGs. Results showed that low-concentration SMX and TC (<0.2 mg L-1) initially caused a deterioration in nitrogen removal performance, while higher concentrations (0.4-20 mg L-1) of both antibiotics had no further inhibitory influences. The abundances of ARGs in both systems generally increased during the whole period, and most of them had significant correlations with intI1, especially efflux-pump genes. Castellaniella, which was the dominant genus under antibiotic pressure, might be potential resistant bacteria. These findings provide an insight into the toxic effects of different antibiotics on denitrification process, and guides future efforts to control antibiotics pollution in ecosystems.

Evaluating the effects of metal oxide nanoparticles (TiO2, Al2O3, SiO2 and CeO2) on anammox process: Performance, microflora and sludge properties.

The increasing use of engineered metal oxide nanoparticles (MONPs) in consumer products raises great concerns about their environmental impacts, but their potential impacts on anaerobic ammonium oxidation (anammox) process in wastewater treatment remain unclear. In this study, the presence of MONPs (1, 50, 200 mg L-1) exhibited no visible effects on the nitrogen removal performance of anammox reactors, but high levels (200 mg L-1) of SiO2NPs, Al2O3NPs and CeO2NPs had a distinct effect on shaping the anammox community. Long-term exposure of MONPs caused different responses in the relative abundance of Ca. Kuenenia, the level of functional gene HzsA and the activities of three key enzymes involved in anammox metabolism, but no significant inhibition effects on specific anammox activity were detected. Overall, the effects of MONPs on anammox community structure and sludge properties depended on their types and levels and followed the order SiO2 > CeO2 > Al2O3 > TiO2.

Susceptibility, resistance and resilience of anammox biomass to nanoscale copper stress.

The increasing use of engineered nanoparticles (NPs) poses an emerging challenge to biological wastewater treatment. The long-term impact of CuNPs on anaerobic ammonium oxidation (anammox) process was firstly investigated in this study. The nitrogen removal capacity of anammox reactor was nearly deprived within 30days under the stress of 5.0mgL-1 CuNPs and the relative abundance of anammox bacteria (Ca. Kuenenia) was decreased from 29.59% to 17.53%. Meanwhile, copper resistance genes associated with the Cus, Cop and Pco systems were enriched to eliminate excess intracellular copper. After the withdrawal of CuNPs from the influent, the nitrogen removal capacity of anammox biomass recovered completely within 70days. Overall, anammox biomass showed susceptibility, resistance and resilience to the stress of CuNPs. Therefore, the potential impacts of ENPs on anammox-based processes should be of great concern.

Fluorouracil implants caused a diaphragmatic tumor to be misdiagnosed as liver metastasis: a case report.

BACKGROUND: Fluorouracil implants are widely used in peritoneal interstitial chemotherapy. Curative effects have been obtained, but implants have also caused some complications. CASE PRESENTATION: We performed an analysis of a 66-year-old male patient's case history, as well as conventional pathological analysis and Raman spectroscopic detection of the diaphragmatic tumor. We also analyzed the underlying causes of this condition to prevent complications and reduce misdiagnoses in future cases. The patient had a history of peritoneal fluorouracil implantation. Pathological analysis of the diaphragmatic mass revealed foreign particles, and Raman detection showed that the mass contained fluorouracil. CONCLUSION: Fluorouracil implants may persist due to the high concentrations of this drug used in peritoneal chemotherapy. This finding should provide guidance and improve the application of peritoneal implants. In clinical trials, and the diagnosis of liver metastasis should be based on pathological results.

Screening analysis of candidate gene mutations in a kindred with polycystic liver disease.

AIM: To find potential mutable sites by detecting mutations of the candidate gene in a kindred with polycystic liver disease (PCLD). METHODS: First, we chose a kindred with PCLD and obtained five venous blood samples of this kindred after the family members signed the informed consent form. In the kindred two cases were diagnosed with PCLD, and the left three cases were normal individuals. All the blood samples were preserved at -85 °C. Second, we extracted the genomic DNA from the venous blood samples of the kindred using a QIAamp DNA Mini Kit and then performed long-range polymerase chain reaction (PCR) with different primers. The exons of PKD1 were all sequenced with the forward and reverse primers to ensure the accuracy of the results. Next, we purified the PCR products and directly sequenced them using Big Dye Terminator Chemistry version 3.1. The sequencing reaction was conducted with BiomekFX (Beckman). Finally, we analyzed the results. RESULTS: A total of 42 normal exons were identified in detecting mutations of the PKD1 gene. A synonymous mutation occurred in exon 5. The mutation was a homozygous T in the proband and was C in the reference sequence. This mutation was located in the third codon and did not change the amino acid encoded by the codon. Missense mutations occurred in exons 11 and 35. These mutations were located in the second codon; they changed the amino acid sequence and existed in the dbSNP library. A nonsense mutation occurred in exon 15. The mutation was a heterozygous CT in the proband and was C in the reference sequence. This mutation was located in the first codon and resulted in a termination codon. This mutation had an obvious influence on the encoded protein and changed the length of the protein from 4303 to 2246 amino acids. This was a new mutation that was not present in the dbSNP library. CONCLUSION: The nonsense mutation of exon 15 existed in the proband and in the third individual. Additionally, the proband was heterozygous for this mutation, so the mutable site was a pathogenic mutation.

[AOX Pollution in Wastewater Treatment Process of Dyeing and Dyestuff Chemical Industries].

Selecting six large-scale dyeing factories and four large-scale dyestuff chemical factories in the well-developed Yangtze River Delta region, this study aimed to investigate the AOX pollution status in the raw wastewater as well as in the activated sludge treatment system. The components of AOX were characterized by GC-MS. Results showed that AOX concentration was low in wastewater from the six dyeing enterprises, ranging 0. 15-1. 62 mg.L-1 in the raw wastewater and 0. 06-1. 30 mg.L-1 in the biologically treated effluent. All the biologically treated effluent met the emission limits of 8 mg.L-1 in the Discharge Standard of Water Pollutants for Dyeing and Finishing of Textile Industry. Sludge in five factories with AOX was below 621 mg.kg-1, only one factory was with high AOX concentration of 3 280 mg.kg-1. By comparison, AOX concentration greatly varied between the wastewater from dyestuff chemical factories, was 1. 70 mg.L-1 to 78. 72 mg.L-1 in the raw wastewater and was 1. 88 mg.L-1 to 33. 11 mg.L-1 in the biologically treated effluent. AOX concentration in the activated sludge was as high as 960-2,297 mg.kg-1. Chlorobenzenes, chloronitrobenzenes, chloroanilines, chlorine nitroanilines and halophenols were typical TOX components detectable in the dyestuff chemical wastewater. Halophenols and chlorine nitroanilines could be efficiently removed. Single chloroanilines and single chloronitrobenzenes seemed to be easier removable than polychlorinated anilines and polychlorinated nitrobenzenes. Polychlorinated benzenes were also easily removal but the products chlorobenzene was hard to remove.