Ancient Clostridium DNA and variants of tetanus neurotoxins associated with human archaeological remains.

The analysis of microbial genomes from human archaeological samples offers a historic snapshot of ancient pathogens and provides insights into the origins of modern infectious diseases. Here, we analyze metagenomic datasets from 38 human archaeological samples and identify bacterial genomic sequences related to modern-day Clostridium tetani, which produces the tetanus neurotoxin (TeNT) and causes the disease tetanus. These genomic assemblies had varying levels of completeness, and a subset of them displayed hallmarks of ancient DNA damage. Phylogenetic analyses revealed known C. tetani clades as well as potentially new Clostridium lineages closely related to C. tetani. The genomic assemblies encode 13 TeNT variants with unique substitution profiles, including a subgroup of TeNT variants found exclusively in ancient samples from South America. We experimentally tested a TeNT variant selected from an ancient Chilean mummy sample and found that it induced tetanus muscle paralysis in mice, with potency comparable to modern TeNT. Thus, our ancient DNA analysis identifies DNA from neurotoxigenic C. tetani in archaeological human samples, and a novel variant of TeNT that can cause disease in mammals.

Characteristic of decreased bacterial diversity in psoriasis / [Característica da diminuição da diversidade bacteriana na psoríase]

Disturbance of commensal intestinal microbiota is related to chronic inflammatory dermatosis. We analyzed the diversity of the gut microbiota to characterize the biological variation of psoriasis (Ps). Significant differences of gut microbiome profiles were revealed in murine model with psoriasis by sequencing 16S rRNA V3-V4 variable region. Group comparisons included the imiquimod cream (IMQ group, n=8), the imiquimod cream and antibiotics (ATB) (PC+IMQ group, n=8) and the healthy control (CTRL group, n=8). The gut microbiota existed in Ps groups including IMQ group and PC+IMQ group encompassed less diversity than controls, which were attributed to decreased presence of several taxa. The two Ps groups were characterized by significant reduction in firmicutes. In this study, microbiota of psoriasis was defined by an increase presence of Bacteroides. After treated with ATB, we found substantial increase of Lactobacillales but significant decrease of Clostridiales and Coriobacteriales. Relative lower abundance of multiple intestinal bacteria was observed in Ps groups. Although part of genera were concomitantly reduced in both IMQ and PC+IMQ conditions, we discovered the specialty of PC+IMQ group samples was that contained lower abundance of beneficial taxa. Characteristics of gut microbiota profiles in Ps mice were comparable to profiles in patients with Ps, which were related to alteration of specific inflammatory proteins in disease groups but were significantly different from control group. Thus, this study emphasizes the role of intestinal microbiota in the pathogenesis of Ps and provides new insight for investigating association between intestinal microbes and immune inflammation.

A perturbação da microbiota intestinal comensal está relacionada à dermatose inflamatória crônica. Analisamos a diversidade da microbiota intestinal para caracterizar a variação biológica da psoríase (Ps). Diferenças significativas do perfil microbiológico intestinal foram reveladas no modelo murino com psoríase pelo sequenciamento da região variável 16S rRNA V3-V4. As comparações de grupo incluíram o creme imiquimod (grupo IMQ, n=8), o creme imiquimod e antibióticos (ATB) (grupo PC+IMQ, n=8) e o controle saudável (grupo CTRL, n=8). A microbiota intestinal existia nos grupos Ps, incluindo o grupo IMQ e o grupo PC+IMQ englobava menos diversidade do que os controles, que foram atribuídos à diminuição da presença de vários taxa. Os dois grupos de Ps caracterizavam-se por uma redução significativa nos firicutes. Neste estudo, a microbiota da psoríase foi definida por um aumento da presença de bacteroides. Após o tratamento com ATB, encontramos um aumento substancial de Lactobacillales mas uma diminuição significativa de Clostridiales e Coriobacteriales. Uma menor abundância relativa de bactérias intestinais múltiplas foi observada nos grupos de Ps. Embora parte dos gêneros tenha sido concomitantemente reduzida tanto em condições IMQ como PC+IMQ, descobrimos que a especialidade das amostras do grupo PC+IMQ era que continham menor abundância de taxas benéficas. As características dos perfis de microbiota intestinal em ratos de Ps eram comparáveis aos perfis em pacientes com Ps, que estavam relacionados à alteração de proteínas inflamatórias específicas em grupos de doenças, mas eram significativamente diferentes do grupo controle. Assim, este estudo enfatiza o papel da microbiota intestinal na patogênese do Ps e fornece novos conhecimentos para investigar a associação entre micróbios intestinais e inflamação imunológica.

Comparison and trend of perioperative outcomes between robot-assisted radical prostatectomy and open radical prostatectomy: nationwide inpatient sample 2009-2014

ABSTRACT Purpose: To make a further evaluation of perioperative outcomes between the robot-assisted radical prostatectomy (RARP) and open radical prostatectomy (ORP), we conducted a comparison and trend analysis by using the Nationwide Inpatient Sample (NIS) from 2009 to 2014. Materials and Methods: Adult prostate cancer patients with radical prostatectomy were abstracted from the NIS. RARP and ORP were identified according to the International Classification of Diseases, 9th Revision, Clinical Modification procedure codes. The perioperative outcomes included blood transfusion, intraoperative and postoperative complications, prolonged length of stay (pLOS), and in-hospital mortality. Propensity score matching method and multivariable logistic regression model were performed to adjust for the pre-defined covariates. The annual percent change (APC) was used to detect the change trend of rates for outcomes. Results: A total of 77.054 patients were included in our study. According to the results of propensity score matching analyses, RARP outperformed ORP in blood transfusion (1.96% vs. 9.40%), intraoperative complication (0.73% vs. 1.25%), overall postoperative complications (8.87% vs. 11.97%), and pLOS (13.39% vs. 36.70%). We also found that there was a significant decreasing tendency of incidence in blood transfusion (APC=-9.81), intraoperative complication (APC=-12.84), and miscellaneous surgical complications (APC=-14.09) for the RARP group. The results of multivariable analyses were almost consistent with those of propensity score matching analyses. Conclusions: The RARP approach has lower incidence rates of perioperative complications than the ORP approach, and there is a potential decreasing tendency of complication incidence rates for the RARP.

Comparison and trend of perioperative outcomes between robot-assisted radical prostatectomy and open radical prostatectomy: nationwide inpatient sample 2009-2014.

PURPOSE: To make a further evaluation of perioperative outcomes between the robot-assisted radical prostatectomy (RARP) and open radical prostatectomy (ORP), we conducted a comparison and trend analysis by using the Nationwide Inpatient Sample (NIS) from 2009 to 2014. MATERIALS AND METHODS: Adult prostate cancer patients with radical prostatectomy were abstracted from the NIS. RARP and ORP were identified according to the International Classification of Diseases, 9th Revision, Clinical Modification procedure codes. The perioperative outcomes included blood transfusion, intraoperative and postoperative complications, prolonged length of stay (pLOS), and in-hospital mortality. Propensity score matching method and multivariable logistic regression model were performed to adjust for the pre-defined covariates. The annual percent change (APC) was used to detect the change trend of rates for outcomes. RESULTS: A total of 77.054 patients were included in our study. According to the results of propensity score matching analyses, RARP outperformed ORP in blood transfusion (1.96% vs. 9.40%), intraoperative complication (0.73% vs. 1.25%), overall postoperative complications (8.87% vs. 11.97%), and pLOS (13.39% vs. 36.70%). We also found that there was a significant decreasing tendency of incidence in blood transfusion (APC=-9.81), intraoperative complication (APC=-12.84), and miscellaneous surgical complications (APC=-14.09) for the RARP group. The results of multivariable analyses were almost consistent with those of propensity score matching analyses. CONCLUSIONS: The RARP approach has lower incidence rates of perioperative complications than the ORP approach, and there is a potential decreasing tendency of complication incidence rates for the RARP.

Development of a new protocol for freeze-drying preservation of Pseudoalteromonas nigrifaciens and its protective effect on other marine bacteria

Background: Freeze-drying is known as one of the best methods to preserve bacterial strains. Protectant is the key factor affecting the survival rate of freeze-dried strains. In addition, salinity, bacterial suspension concentration, drying time, and other factors can also affect the survival rate of strains to varying degrees. At present, there are relatively few studies on freeze-drying preservation of marine bacteria. In the present study, we performed the freeze-drying protectant screening and optimized the preservation conditions for Pseudoalteromonas nigrifaciens, which is widely distributed in marine environment. The protective effects of the screened protectants were verified by 18 other marine bacterial strains. Results: The results indicated that the combination of 5.0% (w/v) lactose, 5.0% (w/v) mannitol, 5.0% (w/v) trehalose, 10.0% (w/v) skim milk powder, 0.5% (w/v) ascorbic acid and 0.5% (w/v) gelatin was the best choice for the preservation of P. nigrifaciens. The suggested salinity and concentration of initial cell suspension were 10 g/L NaCl and 1.0 × 109 CFU/mL, respectively. Furthermore, stationary-phase cells were the best choice for the freeze-drying process. The highest survival rate of P. nigrifaciens reached 52.8% when using 5­10% (w/v) skim milk as rehydration medium. Moreover, the other 18 marine strains belonging to Pseudoalteromonas, Vibrio, Photobacterium, Planomicrobium, Edwardsiella, Enterococcus, Bacillus, and Saccharomyces were freezedried under the abovementioned conditions. Their survival rates were 2.3­95.1%. Conclusion: Collectively, our results supported that the protectant mixture and parameters were beneficial for lyophilization of marine bacteria

Optimal Entry Point and Trajectory for Anterior C1 Lateral Mass Screw.

STUDY DESIGN: A radiographic analysis of the anatomy of the C1 lateral mass using computed tomography (CT) scans and Mimics software. OBJECTIVE: To define the anatomy of the C1 lateral mass and make recommendations for optimal entry point and trajectory for anterior C1 lateral mass screws. SUMMARY OF BACKGROUND DATA: Although various posterior insertion angles and entry points for screw insertion have been proposed for posterior C1 lateral mass screws, no large series have been performed to assess the ideal entry point and optimal trajectory for anterior C1 lateral mass screw placement. MATERIALS AND METHODS: The C1 lateral mass was evaluated using CT scans and a 3-dimensional imaging application (Mimics software). Measuring the space available for the anterior C1 lateral mass screw (SAS) at different camber angles from 0 to 30 degrees (5-degree intervals) was performed to identify the ideal camber angle of insertion. Measuring the range of sagittal angles was performed to calculate the ideal sagittal angle. Other measurements involving the height of the C1 lateral mass were also made. RESULTS: The optimal screw entry point was found to be located on the anterior surface of the atlas 12.88 mm (±1.10 mm) lateral to the center of the anterior tubercle. This optimal entry point was found to be 6.81 mm (±0.59 mm) superior to the anterior edge of the atlas inferior articulating process. The mean ideal camber angle was 20.92 degrees laterally and the mean ideal sagittal angle was 5.80 degrees downward. CONCLUSIONS: These measurements define the optimal entry point and trajectory for anterior C1 lateral mass screws and facilitate anterior C1 lateral mass screw placement. A thorough understanding of the local anatomy may decrease the risk of injury to the spinal cord, vertebral artery, and internal carotid artery. Delineating the anatomy in each case with preoperative 3D CT evaluation is recommended.

Conservative and Operative Treatment in Extension Teardrop Fractures of the Axis.

STUDY DESIGN: A retrospective case series describing teardrop fracture of the axis. OBJECT: The purpose of the study was to clarify the clinical features, the mechanism of injury, and the potential instability of extension teardrop fractures of the axis, so as to emphasize the importance of recognizing this injury as a separate entity. SUMMARY OF BACKGROUND DATA: Teardrop fractures of the axis are rare spinal fractures, comprising only a small percentage of all injuries of the cervical spine. The stability of this fracture pattern has been a matter of debate leading to controversy regarding treatment strategies and the need for stabilization. METHODS: We retrospectively reviewed data collected from 16 patients to document the mechanism of injury, neurological deficit, treatment and clinical outcome, and imaging findings. RESULTS: Extension teardrop fractures accounted for approximately 8.9% of the upper cervical spinal injuries and 12.7% of axis fractures at the authors' institution over the same period. Six patients (4 males and 2 females) underwent surgery (4 by an anterior approach, 2 by a posterior approach). Ten cases underwent Halo-vest immobilization for a period between 6 and 12 weeks. At final follow-up, 14 cases achieved excellent results, whereas 2 patients complained of mild residual neck pain. Maximum cranial-caudal dimensions of the fragments were between 5 and 24 mm (average, 12.9 mm), and the transverse dimensions were between 5 and 22 mm (average, 11.1 mm). Fragment displacement ranged from 1 to 9 mm (average, 3.5 mm), whereas fragment rotation ranged from 10 to 52 degrees (average, 24.4 degrees) in the sagittal plane. CONCLUSIONS: Most patients with an extension teardrop fracture of the axis can be treated conservatively. On the basis of this case series, the authors suggest that large fragment size, displacement or angulation, intervertebral disk injury, neurologic deficit, or signs of instability are reasonable indications for surgical treatment.

An anatomic study to determine the optimal entry point, medial angles, and effective length for safe fixation using posterior C1 lateral mass screws.

STUDY DESIGN: Anatomic study of the C1 lateral mass using fine-cut computed tomographic scans and Mimics software. OBJECTIVE: To investigate the optimal entry point, medial angles, and effective length for safe fixation using posterior C1 lateral mass screws. SUMMARY OF BACKGROUND DATA: Placing posterior C1 lateral mass screws is technically demanding, and a misplaced screw can result in injury to the vertebral artery, spinal cord, or internal carotid artery. Although various insertion angles have been proposed for posterior C1 lateral mass screw, no clear consensus has been reached on the ideal medial angle of the C1 lateral mass. METHODS: The C1 lateral masses were evaluated using computed tomographic scans and Mimics software in 70 patients. The effective width and effective screw length of posterior C1 lateral mass screws were measured at different medial angulations relative to the midline sagittal plane. The height (H) for screw entry point on the posterior surface of C1 lateral mass and the distance (D) between screw entry point and the intersection of the midline sagittal plane and the posterior arch of the atlas were also measured. RESULTS: The mean height (H) for screw entry on the posterior surface of the lateral mass was 4.25 mm, the mean distance (D) between screw entry point and the intersection of the midsagittal plane and the posterior arch of the atlas was 27.62 mm. The optimal medial angle was 20.86° with a corresponding effective width of 10.56 mm and effective screw length of 21.87 mm. CONCLUSION: This study helps to define the specific anatomy related to C1 posterior lateral mass screw placement in an effort to facilitate instrumentation. However, variation is seen in lateral mass anatomy, and this study must be combined with customized surgical planning that includes advanced imaging for safe and effective instrumentation. LEVEL OF EVIDENCE: 1.

A Microtus fortis protein, serum albumin, is a novel inhibitor of Schistosoma japonicum schistosomula.

Schistosomiasis is an endemic parasite disease and praziquantel is the only drug currently in use to control this disease. Experimental and epidemiological evidence strongly suggests that Microtus fortis ( Mf ) is a naturally resistant vertebrate host of Schistosoma japonicum . In the present study, we found that Mf serum albumin ( Mf -albumin) and the conditioned medium of pcDNA3.1- Mf -albumin caused 46.2% and 38.7% schistosomula death rates in 96 h, respectively, which were significantly higher than that of the negative control (p < 0.05). We also found that mice injected with Mf -albumin had a 43.5% reduction in worm burden and a 48.1% reduction in liver eggs per gram (p < 0.05) in comparison to the control animals. To characterise the mechanisms involved in clearance, schistosomula were incubated with fluorescein isothiocyanate-labelled Mf -albumin and fluorescent enrichment effects were found in the gut lumen of schistosomula after 48 h of incubation. Next, digestive tract excretions from schistosomula were collected and the sensitivity of Mf -albumin to digestive tract excretions was evaluated. The results indicated that schistosomula digestive tract excretions showed indigestibility of Mf -albumin. The death of schistosomula could be partially attributed to the lack of digestion of Mf -albumin by digestive tract excretions during the development of the schistosomula stage. Therefore, these data indicate the potential of Mf -albumin as one of the major selective forces for schistosomiasis.

A Microtus fortis protein, serum albumin, is a novel inhibitor of Schistosoma japonicum schistosomula

Schistosomiasis is an endemic parasite disease and praziquantel is the only drug currently in use to control this disease. Experimental and epidemiological evidence strongly suggests that Microtus fortis ( Mf ) is a naturally resistant vertebrate host of Schistosoma japonicum . In the present study, we found that Mf serum albumin ( Mf -albumin) and the conditioned medium of pcDNA3.1- Mf -albumin caused 46.2% and 38.7% schistosomula death rates in 96 h, respectively, which were significantly higher than that of the negative control (p < 0.05). We also found that mice injected with Mf -albumin had a 43.5% reduction in worm burden and a 48.1% reduction in liver eggs per gram (p < 0.05) in comparison to the control animals. To characterise the mechanisms involved in clearance, schistosomula were incubated with fluorescein isothiocyanate-labelled Mf -albumin and fluorescent enrichment effects were found in the gut lumen of schistosomula after 48 h of incubation. Next, digestive tract excretions from schistosomula were collected and the sensitivity of Mf -albumin to digestive tract excretions was evaluated. The results indicated that schistosomula digestive tract excretions showed indigestibility of Mf -albumin. The death of schistosomula could be partially attributed to the lack of digestion of Mf -albumin by digestive tract excretions during the development of the schistosomula stage. Therefore, these data indicate the potential of Mf -albumin as one of the major selective forces for schistosomiasis.