Combined effect of time in target range and variability of systolic blood pressure on cardiovascular outcomes and mortality in patients with hypertension: A prospective cohort study.

Time in target range (TTR) and blood pressure variability (BPV) of systolic blood pressure (SBP) are independent risk factors for major adverse cardiovascular events (MACE) and all-cause mortality in hypertensive patients. However, the association of the combination of low TTR and high BPV of SBP with the risk of MACE and all-cause mortality is unclear. This study sought to investigate the combined effect of the TTR and BPV on the risk of MACE and all-cause mortality in patients with hypertension. A total of 11 496 hypertensive patients from the Kailuan cohort study were included in our study. All participants were divided into four groups according to their TTR and BPV levels. Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) and 95% confidence interval (CI) for incident MACE and all-cause mortality. During a median follow-up of 5.64 years, 839 MACEs (included 99 cases of myocardial infarction, 591 cases of stroke, and 191 cases of heart failure) and 621 deaths occurred. Compared with the high-TTR and low-BPV group, the HRs (95% CI) of MACE and all-cause mortality were 1.309 (1.025-1.671) and 1.842 (1.373-2.473) for the high-TTR and high-BPV group, 1.692 (1.347-2.125) and 1.731 (1.298-2.309) for the low-TTR & low-BPV group, 2.132 (1.728-2.629) and 2.247 (1.722-2.932) for the low-TTR & high-BPV group. Our study suggests that the combination of low TTR and high BPV of SBP was associated with a higher risk of MACE and all-cause mortality in patients with hypertension.

Premature coronary heart disease complicated with hypertension in hospitalized patients: Incidence, risk factors, cardiovascular-related comorbidities and prognosis, 2008-2018.

Background: The clinical characteristics and risk factors of all-cause mortality in young hospitalized patients with comorbid coronary heart disease and hypertension (CAD + HT) are not well-characterized. Method: A total of 2288 hospitalized CAD patients (age<45 years) with or without hypertension in the Chinese PLA General Hospital from August 5, 2008 to June 22, 2018 were conducted. The risk factors of all-cause mortality were estimated in young CAD + HT patients by COX models. Results: The overall prevalence of hypertension in young CAD patients was 50.83% (n = 1163). CAD + HT patients had older age, higher heart rate, BMI, uric acid, triglyceride and lower level of eGFR and HDL-C than CAD patients (P < 0.05). The proportion of cardiovascular-related comorbidities (including obesity, diabetes mellitus, hyperuricemia and chronic kidney disease [CKD]) in the CAD + HT group was significantly higher than that in CAD group (P < 0.0001). The risk of all-cause mortality was higher in CAD + HT patients, although after adjusting for all covariates, there was no significant difference between the two groups. Furthermore, CKD (HR, 3.662; 95% CI, 1.545-8.682) and heart failure (HF) (HR, 3.136; 95%CI, 1.276-7.703) were associated with an increased risk of all-cause mortality and RAASi (HR, 0.378; 95%CI, 0.174-0.819) had a beneficial impact in CAD + HT patients. Conclusions: Hypertension was highly prevalent in young CAD patients. Young CAD + HT patients had more cardiovascular metabolic risk factors, more cardiovascular-related comorbidities and higher risk of all-cause mortality. CKD and HF were the risk factors, while RAASi was a protective factor, of all-cause mortality in CAD + HT patients.

Tracing the transfer characteristics of antibiotic resistance genes from swine manure to biogas residue and then to soil.

Based on laboratory simulation experiments and metagenomic analysis, this study tracked the transmission of antibiotic resistance genes (ARGs) from swine manure (SM) to biogas residue and then to soil (biogas residue as organic fertilizer (OF) application). ARGs were abundant in SM and they were assigned to 11 categories of antibiotics. Among the 383 ARG subtypes in SM, 43 % ARG subtypes were absent after anaerobic digestion (AD), which avoided the transfer of these ARGs from SM to soil. Furthermore, 9 % of the ARG subtypes in SM were introduced into soil after amendment with OF. Moreover, 43 % of the ARG subtypes in SM were present in OF and soil, and their abundances increased slightly in the soil amended with OF. The bacterial community in the soil treated with OF was restored to its original state within 60 to 90 days, probably because the abundances of ARGs were elevated but not significantly in the soil. Network analysis identified 31 potential co-host bacteria of ARGs based on the relationships between the bacteria community members, where they mainly belonged to Firmicutes, followed by Bacteroidetes, Actinobacteria, and Proteobacteria. This study provides a basis for objectively evaluating pollution by ARGs in livestock manure for agricultural use.

Investigation of reduction in risk from antibiotic resistance genes in laboratory wastewater by using O3 , ultrasound, and autoclaving.

Biological laboratory wastewater containing both antibiotic-resistant bacteria (ARB) and antibiotics is a potential source of antibiotic resistance genes (ARGs). Thus, we determined the efficacy of autoclaving, a common disinfection method, in eliminating 5 ARGs (sul1, sul2, tetW, tetM, amp) and the integrase-encoding gene intI1 from laboratory wastewater. Autoclaving (15 min, 121°C) inactivated all bacteria including ARB, whereas ARGs persisted in the wastewater with limited reduction even after 60 min of treatment. Ozonation (O3 ), ultrasound (US), O3 /US, and autoclaving followed by O3 were investigated for their ability to reduce ARGs in laboratory wastewater. With O3 and O3 /US, the reduction rate ranged from 5.44 to 7.13 log for all ARGs investigated. Wastewater treatment with US alone did not reduce ARGs under the present experimental conditions (150 W, 53 kHz). Among the four treatments, autoclaving followed by O3 treatment showed the highest reduction rates in the shortest time; however, further optimization and investigation are needed for the advanced treatment of bio-laboratory wastewater. Overall, this study provides novel insights into ARG sources and demonstrates that advanced oxidation methods can be useful to optimize laboratory wastewater treatment for ARG inactivation. PRACTITIONER POINTS: Bio-laboratory wastewater is potential reservoir of ARGs. Conventional autoclaving was not able to reduce ARGs to a low level. Autoclaving-O3 completely eliminate all the bacteria. Autoclaving-O3 reduced ARGs efficiently (6.12-7.86 logs removal in 60 min).

Interaction between 17ß-estradiol degradation and nitrification in mariculture wastewater by Nitrosomonas europaea and MBBR.

This study investigated the relation between 17ß-estradiol (E2) degradation and nitrification in synthetic mariculture wastewater by ammonia oxidizing bacterium Nitrosomonas europaea and moving bed biofilm reactor (MBBR). Batch experiments showed that E2 degradation by N. europaea in wastewater followed zero-order reaction kinetics (r2 = 0.944, 4.07 µg/ L h-1) when ammonia presented. Nitrite yield in N. europaea inoculation decreased by 77.8% exposed to 1 mg/L E2. The inhibitory impact on ammonia oxidation was enhanced with increasing E2 dosage from 50 ng/L to 1 mg/L. Notably, E2 as low as 50 ng/L still had significant interference with nitrite production, bacterial density and ammonia monooxygenase (AMO) activity of N. europaea. Still, the following continuous 68-day degradation test revealed that 84.5%-98.7% E2 could be removed by a bench-scale MBBR. Whereas, ammonia removal remarkably decreased from 94.7% ± 2.1% to 85.6% ± 2.1% (p < .05) along with the enhanced E2 removal (from 84.5% ± 2.0% to 98.7% ± 0.4%, p < .05) when inlet E2 increased from 10 µg/L to 1 mg/L, indicating the great role of heterotrophs in E2 degradation. In contrast, nitrite oxidation was not affected upon E2 exposure irrespective of E2 concentrations. In summary, nitrification was effective in removing E2, while E2 interfered with ammoxidation process, but this interference was negligible at the reactor level given the low level of E2 in practical field conditions.

Effects of carbon sources on 17 beta-estradiol degradation by Sphingomonas sp. and the analysis of the involved intracellular metabolomics.

17ß-estradiol (E2) ubiquitously exists in various water bodies with long-term endocrine-disrupting and carcinogenic impacts on wildlife even at the trace level of ng L-1. However, it remains unclear how easy-to-degrade carbon sources alter E2 biodegradation patterns. In this study, E2 biodegradation by Sphingomonas sp. MCCC 1A06484 was investigated with regard to alternative carbon sources. Results showed that the bacterium preferentially utilized glucose, sodium succinate and sodium acetate over E2. Interestingly, the presence of these preferred nutrients increased the E2 removal efficiency by 20.1%. Furthermore, a positive relation (p < 0.05) between the utilization of total organic carbon (TOC) and E2 was found. Using intracellular metabolomics by UHPLC-QTOF-MS, 11 up-regulated and 35 down-regulated metabolites (variable importance > 1, p < 0.05) were identified in the bacterium when cultivated with E2 under various carbon and nitrogen backgrounds. The E2 exposure contributed to metabolism changes of lipid, nucleotide, carbohydrate, amino acid and membrane transport, which were considered to play roles in the E2 metabolism. The up-regulated phosphatidylcholine might act as an indicator during the bacterial degradation of E2. Generally, this study contributes to an in-depth understanding of E2 biodegradation in complex environments with multiple carbon and nitrogen sources.

Fast start-up strategies of MBBR for mariculture wastewater treatment.

Moving bed biofilm reactor (MBBR) is widely used for ammonia removal in saline recirculating aquaculture systems but often faces a slow start-up problem. The aim of this study was to develop a strategy for the rapid start-up of MBBR treating synthetic mariculture wastewater. Changes in nitrification performance, biofilm characteristics and bacterial community were assessed in response to various start-up strategies: R1 as the control; R2 with step-decrease of inlet NH4+-N; R3 with step-increase of inlet salinity; R4 added with particulate organic matter (POM) and R5 inoculated with nitrifying bacteria. Results show that nitrification was completed on day 63 for R3, 16-18 days faster than the other strategies. The highest protein (28.2 ±â€¯5.1 mg/g·VS) and polysaccharide (59.4 ±â€¯0.4 mg/g·VS) contents were observed in R3, likely linked to the faster biofilm formation. Fourier Transform infrared spectroscopy (FTIR) analysis confirmed the typical constituents of carbohydrates, proteins, lipids and DNA in biofilms. Moreover, along with the biofilm development in R3, the intensity of the peak at 1400 cm-1 (assigned to specific amides) decreased. Pyrosequencing of 16s rRNA revealed that Gammaproteobacteria was the predominating microbial community at class level (35.6%) in R3. qPCR analysis further verified the significantly higher gene copies of amoA (1.57 × 104 copies/µL) and nxrB (5.51 × 103 copies/µL) in R3. Results obtained make the elevated salinity strategy a promising alternative for the rapid nitrification start-up of saline wastewater.

Bruceine D induces apoptosis in human non-small cell lung cancer cells through regulating JNK pathway.

Bruceine D (BD) is the quassinoids isolated from the traditional Chinese herbal medicine Brucea javanica's fruit, which exhibits anti-cancer activity. Here, we demonstrated that BD inhibited human non-small cell lung cancer (NSCLC) cell lines in vitro that were attributed to the induction of cell apoptosis. Human NSCLC H460 and A549 cell lines were treated with BD, and cell viability was conducted with CCK-8 assay. Cell clone formation was observed by clone formation assay. Cell apoptosis was measured using DAPI staining and flow cytometry. Protein levels was analyzed by western blot. The results showed BD inhibited the cell viability of H460 and A549 cells in a dose-dependent manner with IC50 values of 0.5 and 0.6 µmol/L, respectively, at 48 h of treatment. Treatment with BD (0.125-1.0 µmol/L) dose-dependently promoted chromatin condensation, Annexin V-positive cell population and caspase-dependent apoptosis in H460 and A549 cells. Mechanistically, BD stimulated the phosphorylation of JNK. Furthermore, the anti-cancer effects of BD were alleviated effectively by a specific JNK inhibitor SP600125 in NSCLC cells. In conclusion, the results demonstrated that BD exerted anti-cancer activity against NSCLC cells through JNK activation, which suggests its potent usefulness for prevention and treatment of NSCLC.

Start-up evaluations and biocarriers transfer from a trickling filter to a moving bed bioreactor for synthetic mariculture wastewater treatment.

Mariculture wastewater treatment by nitrification requires a long start-up time due to high salinity stress. This study aimed to verify the faster start-up of a trickling filter (TF) compared to a moving bed bioreactor (MBBR) treating synthetic mariculture wastewater, and to investigate the feasibility of transferring mature biocarriers from the TF to a new MBBR (TF-MBBR). The nitrogen removal performance, biofilm physicochemical properties and microbial communities were investigated. The results obtained showed that, the TF started up 41 days faster than the MBBR, despite the richer microbial diversity in the latter. Lower biofilm roughness and protein content as well as higher adhesive force and polysaccharide content in the TF were obtained compared to the MBBR. Adhesive force was found to be negatively correlated with roughness (r = -0.630, p = 0.069). Transmittance assigned to amide II (1538 cm-1) and amid III (1243 cm-1) through Fourier transform infrared spectroscopy (FTIR) determination was only obtained in the TF, which was likely related to the faster start-up. Nitrosomonas and Nitrospira were detected as the predominant nitrifiers in both reactors. In addition, the new MBBR, incubated with the mature biocarriers transferred from the TF, had a satisfactory nitrification performance with no lag time. Interestingly, the transfer action increased the microbial diversity and made the biofilm physicochemical characteristics shift toward those of the MBBR. Taken together, the study confirmed that MBBR nitrification start-up can be accelerated via TF and biocarrier transfer.

High removal efficiency of antibiotic resistance genes in swine wastewater via nanofiltration and reverse osmosis processes.

Swine wastewater treatment plant has become one of the main sources of antibiotic resistance genes (ARGs). Membrane treatment processes are promising solutions for removal of the emerging contaminants. However, limited studies have investigated the effects of nanofiltration and reverse osmosis treatment in removing ARGs in swine wastewater. In this study, the presence and the fate of common ARGs including sul1, sul2, tetA, tetM and tetW, as well as intI1 and 16S rRNA gene, were investigated in a medium-sized (6500) pig farm wastewater treatment plant (WWTP) equipped with conventional biological treatment and advanced membrane processing system. All of the genes were detected with highly abundance in the raw sewage. The biological treatments of the swine wastewater treatment plant did not reduce the quantity of the ARGs. As expected, nanofiltration and reverse osmosis treatment reduced the absolute gene copy number of ARGs efficiently (4.98-9.52 logs removal compared to raw sewage). Compared to the reverse osmosis effluent, however, the absolute abundance of ARGs in the artificial wetland increased by 1.00-2.06 logs. Meanwhile, the relative abundance of sulfonamide resistant genes were basically unchanged, while tetracycline resistance genes (tetA, tetM and tetW) decreased by 0.88, 3.47, 2.51 log, respectively. The results demonstrated that advanced membrane treatments are capable of removing various kinds of ARGs efficiently, as well as some common nitrogen and phosphorus contaminants. This study suggested a mature alternative method for the removal of ARGs from livestock wastewater.