BACTERIAL IDENTIFICATION AND ANTIBIOTIC SENSITIVITY FROM THE ABSCESSES OF CAPTIVE TORTOISES-CLINICAL ANTIBIOTIC RECOMMENDATIONS.

Bacterial abscesses are commonly seen in tortoises. The morbidity and the resultant mortality are high. Multifactorial problems, antibiotics misapplication. and antibiotic-resistant bacteria make abscess treatment complicated and ineffective. This study identifies the etiological bacterial species and determines the best antibiotics for abscess treatment in captive tortoises. Sterile swab specimens from 40 tortoises with abscesses were analyzed using the Analytical Profile Index (API) system. Sixty-five bacteria species were identified covering facultative anaerobic gram-negative (n = 30, 46.2%), facultative anaerobic gram-positive (n = 19, 29.2%), and aerobic gram-negative bacteria (n = 16, 24.6%). The antibiotic sensitivity of these bacteria to 30 antibiotics was assessed using the Kirby-Bauer disk-diffusion method. Greater than 80% anaerobic gram-negative bacterial species showed sensitivity to amikacin and ceftazidime. Greater than 80% anaerobic gram-positive bacterial species were sensitive to amoxicillin, ampicillin, carbenicillin, and penicillin. In addition, more than 80% aerobic gram-negative bacterial species were sensitive to ceftazidime, colistin sulphate, amikacin, gentamicin, kanamycin, polymyxin B, and tobramycin. This study provides clinicians significant information for initial antibiotic options, which could elevate the abscess therapy success rate and improve the life quality of tortoises.

[Experience Caring for a Severe COVID-19 Patient With ARDS in the Intensive Care Unit].

The author's experience caring for a patient with COVID-19 whose condition deteriorated rapidly into a critical illness in the negative pressure room of the intensive care unit is described in this article. The onset of severe acute respiratory distress syndrome led this patient to receive endotracheal intubation with mechanical ventilation and subsequent extracorporeal membrane oxygenation for life support. He was isolated in the negative air pressure room in the intensive care unit for infection control for this emerging respiratory infectious disease. This patient was also confronted with emotional pressures arising from the general uncertainty regarding the progress of this novel disease and from being isolated from the outside world. The care period was from April 5th to May 12th, 2020. The data was collected through direct care, written conversations, physical communication, observation, medical record reviews, diagnosis reports, and nursing assessments of physical, psychological, social, and spiritual distress. The health problems of this patient were identified as gas exchange disorder, infection, anxiety, and other problems. Our chest physiotherapy team comprised nurses, physicians, and respiratory therapists. After administering individualized treatments, including monitoring vital signs and installing an external life support system, the lung consolidation and lung collapse problems of the patient improved, allowing the ventilator to be removed. To address the patient's psychological problems, we used a humanoid diagram and whiteboard drawing as communication tools to explain to the patient the reasons for and functions of the different tubes on his body to reduce his anxiety and maintain the safe use of these tubes. Moreover, bedside care was replaced by mobile phone video and phone calls, allowing the patient to communicate with family members, which reduced his isolation-related anxiety and enhanced his compliance with treatment and care protocols. This experience supports the benefit of installing two-way video devices and viewing monitors in negative pressure rooms in the ICU to facilitate effective communications between patients, patient family members, and the medical team to reduce patient-perceived anxiety and social isolation. This case report provides a reference demonstrating a patient-centered caring model for treating COVID-19 patients in the ICU.

A Minimally Invasive Approach to Lobectomy After Induction Therapy Does Not Compromise Survival.

BACKGROUND: The objective of this study was to evaluate the impact of a video-assisted thoracoscopic (VATS) approach on outcomes in patients who underwent lobectomy after induction therapy. METHODS: Outcomes of patients with T2-T4, N0, M0 and T1-T4, N1-N2, M0 non-small-cell lung cancer who received induction chemotherapy or chemoradiation followed by lobectomy in the National Cancer Data Base (2010-2014) were assessed using Kaplan-Meier, propensity score-matched, multivariable logistic regression and Cox proportional hazards analyses. RESULTS: In the National Cancer Data Base, 2887 lobectomy patients met inclusion criteria (VATS 676 [23%]; thoracotomy 2211 [77%]). Of the VATS cases, patients who underwent induction chemoradiation were more likely to undergo conversion (adjusted odds ratio 1.70, P = .05). Compared with an open approach, VATS was associated with decreased length of stay (median: 5 days vs 6 days, P < .01) and no significant differences in 30-day mortality (VATS [1.5% (n = 10)] vs open [2.6% (n = 58)]; P = .13) and 90-day mortality (VATS [3.7% (n = 25)] vs open [5.6% (n = 124)]; P = .14). There were no significant differences in 5-year survival between the VATS and open groups in both the entire cohort (VATS [50.3%] vs open [52.3%]; P = .83) and in a propensity score-matched analysis of 876 patients; furthermore, a VATS approach was not associated with worse survival in multivariable analysis (hazard ratio 1.02; 95% confidence interval 0.86-1.20; P = .83). CONCLUSIONS: In this national analysis, a VATS approach for lobectomy in patients who received induction therapy for locally advanced non-small-cell lung cancer was not associated with worse short-term or long-term outcomes when compared with an open approach.

High Strength Concrete Columns under Axial Compression Load: Hybrid Confinement Efficiency of High Strength Transverse Reinforcement and Steel Fibers.

Addition of steel fibers to high strength concrete (HSC) improves its post-peak behavior and energy absorbing capability, which can be described well in term of toughness. This paper attempts to obtain both analytically and experimentally the efficiency of steel fibers in HSC columns with hybrid confinement of transverse reinforcement and steel fibers. Toughness ratio (TR) to quantify the confinement efficiency of HSC columns with hybrid confinement is proposed through a regression analysis by involving sixty-nine TRs of HSC without steel fibers and twenty-seven TRs of HSC with hybrid of transverse reinforcement and steel fibers. The proposed TR equation was further verified by compression tests of seventeen HSC columns conducted in this study, where twelve specimens were reinforced by high strength rebars in longitudinal and transverse directions. The results show that the efficiency of steel fibers in concrete depends on transverse reinforcement spacing, where the steel fibers are more effective if the spacing transverse reinforcement becomes larger in the range of 0.25-1 effective depth of the section column. Furthermore, the axial load-strain curves were developed by employing finite element software (OpenSees) for simulating the response of the structural system. Comparisons between numerical and experimental axial load-strain curves were carried out.

Genetic diversity analysis of eight indigenous goat breeds (groups) in China using AFLP markers.

Eight goat breeds from Chengdu, Lezhi, Jintang, Baiyu, Yingshan, Hejiang, Jiangan, and Jialing in Sichuan, China were analyzed for genetic diversity using AFLP markers. A total of 261 individuals were analyzed using eight selective AFLP primer combinations which generated 174 discernible fragments, of which 80 were polymorphic with an average of 27.15 bands per primer pair. Shannon's gene diversity index among breeds ranged from 0.0888 to 0.2289, and the highest and the lowest gene diversity index among breeds were the Yingshan Black goat (0.2289) and the Baiyu Black goat (0.0888) respectively. The genetic distance (DR) among eight goat breeds were calculated by Rogers' genetic distance. Based on the analytical results, systematic trees were constructed by using the unweighted pair-group method with arithmetic average (UPGMA) and the neighbor joining (NJ) methods. Eight breeds were divided into two main clusters by using cluster analysis, one of which including two subclusters. The clustering results agreed well with the origin of the goats and geographic distribution. The results implied that AFLP markers were informative and could provide significant insights for genetic diversity research and genetic resource conservation of indigenous goats.

IL-20: biological functions and clinical implications.

IL-20 belongs to the IL-10 family and plays a role in skin inflammation and the development of hematopoietic cells. Little is known about its other biological functions and clinical implications, however. Updated information about IL-20, such as its identification, expression, receptors, signaling, biological activities, and potential clinical implications, is illustrated in this review based on our research and on data available in the literature. Our studies of IL-20 show that it is a pleiotropic cytokine with potent inflammatory, angiogenic, and chemoattractive characteristics. Inflammation and angiogenesis are essential for the pathogenesis of rheumatoid arthritis and atherosclerosis. Based on in vitro data and clinical samples, we demonstrated that IL-20 is involved in the diseases of rheumatoid arthritis and atherosclerosis. In addition, we found in our studies that IL-20 signaled through different molecules in several cells. The present review presents the clinical implications of IL-20 in rheumatoid arthritis and atherosclerosis. It may provide new therapeutic options in the future.

Detection of IL-20 and its receptors on psoriatic skin.

The aim of this study was to investigate the expression of interleukin-20 (IL-20) and its receptors on psoriatic skin by immunohistochemical analysis and to evaluate the correlation of CD8-positive T lymphocytes with epidermal proliferation. Overexpression of IL-20 and its receptors was detected in the keratinocytes of the lesional skin of psoriasis and spongiotic dermatitis. The expression pattern of IL-20 spreads throughout the whole layer of epidermis, while IL-19 was expressed in up to three or four layers suprabasally. The serum level of IL-20 in psoriatic patients was significantly lower than that in healthy controls. IL-20 upregulated KGF transcripts on CD8-positive T cells. We hypothesize that overexpression of IL-20 is correlated with keratinocyte proliferation that acts through their receptor complex expressed by keratinocytes themselves. Furthermore, IL-20 can stimulate CD8-positive lymphocytes to produce KGF, which may contribute to sustaining the hyperproliferative status of the keratinocytes.

IL-19 induced Th2 cytokines and was up-regulated in asthma patients.

IL-19 belongs to the IL-10 family, which includes IL-10, IL-19, IL-20, IL-22, melanoma differentiation-associated gene-7 (IL-24), and AK155 (IL-26). IL-10 has been shown to inhibit allergen-induced airway hyperreactivity and inflammation. To determine whether IL-19 was also associated with asthma, we used ELISA to analyze the serum level of IL-19 in patients with asthma and found that their serum IL-19 levels were twice those of healthy controls. Patients with a high level of IL-19 also had high levels of IL-4 and IL-13. In a dust mite-induced murine model of asthma, we found that IL-19 level in asthmatic BALB/cJ mice was also twice that of healthy control mice. IL-19 transcript was also induced in the lungs of asthmatic mice. Electroporation i.m. of the IL-19 gene into healthy mice up-regulated IL-4 and IL-5, but not IL-13. However, IL-19 up-regulated IL-13 in asthmatic mice. In vitro, IL-19 induced IL-4, IL-5, IL-10, and IL-13 production by activated T cells. Activation of T cells was required for induction of IL-13 because IL-19 did not induce IL-13 production on nonstimulated T cells. Taken together, these results demonstrated that IL-19 up-regulates Th2 cytokines on activated T cells and might play an important role in the pathogenesis of asthma.

Facilitation of cell adhesion by immobilized dengue viral nonstructural protein 1 (NS1): arginine-glycine-aspartic acid structural mimicry within the dengue viral NS1 antigen.

Dengue virus infection causes life-threatening hemorrhagic fever. Increasing evidence implies that dengue viral nonstructural protein 1 (NS1) exhibits a tendency to elicit potentially hazardous autoantibodies, which show a wide spectrum of specificity against extracellular matrix and platelet antigens. How NS1 elicits autoantibodies remains unclear. To address the hypothesis that NS1 and matrix proteins may have structural and functional similarity, cell-matrix and cell-NS1 interactions were evaluated using a cell-adhesion assay. The present study showed that dengue NS1 immobilized on coverslips resulted in more cell adhesion than did the control proteins. This cell adhesion was inhibited by peptides containing arginine-glycine-aspartic acid (RGD), a motif important for integrin-mediated cell adhesion. In addition, anti-NS1 antibodies blocked RGD-mediated cell adhesion. Although there is no RGD motif in the NS1 protein sequence, these data indicate that RGD structural mimicry exists within the NS1 antigen.