[A long-term follow-up study of noninvasive positive pressure ventilation on all-cause mortality in patients with chronic obstructive pulmonary disease-obstructive sleep apnea overlap syndrome].

Objective: To investigate the effect of noninvasive positive pressure ventilation(NIPPV) on all-cause mortality in patients with chronic obstructive pulmonary disease-obstructive sleep apnea overlap syndrome(OVS) through long-term follow-up. Methods: A total of 187 OVS patients were divided into the NIPPV group(n=92) and the non-NIPPV group(n=95). Of these, 85 males and 7 females were in the NIPPV group with an average age of (66.5±8.5) years(range 47-80 years); 89 males and 6 females were in the non-NIPPV group with an average age of (67.4±7.8) years(range 44-79 years). Follow-up was performed from enrolment with an average duration of 39(20, 51) months. The all-cause mortality was compared between the two groups. Result: There were no significant differences in their baseline clinical characteristics(all P>0.05), indicating that the data from the two groups were comparable. The Kaplan-Meier curve showed no difference in all-cause mortality between the two groups(log rank P=0.229). However, deaths from cardio-cerebrovascular diseases were higher in the non-NIPPV than in the NIPPV group(15.8% vs. 6.5%,P=0.045). Age, BMI, neck circumference, PaCO2, FEV1, FEV1%, moderate to severe OSA(AHI>15 events/h), mMRC, CAT, number of acute exacerbations of COPD and number of hospitalizations were associated with all-cause death in OVS patients; among which, age(HR 1.067, 95%CI 1.017-1.119, P=0.008), FEV1(HR 0.378, 95%CI 0.176-0.811, P=0.013), and number of COPD exacerbations(HR 1.298, 95%CI 1.102-1.530, P=0.002) were independent risk factors for all-cause mortality in OVS patients. Conclusions: The combination of NIPPV and conventional treatment may reduce cardio-cerebrovascular disease-related mortality in OVS patients. The deceased OVS patients had severe airflow limitation and mild to moderate OSA. Old age, low FEV1 and COPD exacerbations were independent risk factors for all-cause mortality in OVS patients.

[Value of immunocytochemistry in differential diagnosis of gastric adenocarcinoma, reactive mesothelial cells and malignant epithelial mesothelioma in metastatic effusion fluid].

Objective: To investigate the diagnostic value of some antibodies in peritoneal fluid of patients with gastric cancer and malignant epithelioid mesothelioma in serous effusion. Methods: One hundred and eighty-two cases of serous effusion were collected at Jilin Cancer Hospital, from July 2012 to July 2016. The expression of GLUT1, CDX2, Villin, calretinin and WT1 was evaluated using SP immunocytochemical technique in peritoneal fluid samples collected from 98 patients with gastric cancer and 74 patients with reactive mesothelial cells. The expression of GLUT1, calretinin and WT1 was also evaluated in serous effusion from 10 patients with mesothelioma. Results: The sensitivity of GLUT1, CDX2 and Villin in adenocarcinoma cells was 91.8%(90/98), 68.4% (67/98) and 88.8%(87/98), respectively. The specificity was 95.9% (71/74), 100.0%(74/74) and 100.0% (74/74), respectively. The sensitivity of calretinin and WT1 for reactive mesothelium was 93.2% (69/74) and 79.7% (59/74), respectively. The specificity was 96.9% (95/98) and 100.0% (98/98), respectively. The sensitivity of GLUT1, calretinin and WT1 for mesothelioma was 9/10, 9/10 and 7/10. The reactivity of GLUT1, CDX2, Villin, calretinin and WT1 showed a significant difference (P<0.01) between adenocarcinoma cells and reactive mesothelium. The reactivity of GLUT1 showed a significant difference (P<0.01) between mesothelioma and reactive mesothelium. Conclusions: The optimal combination is a panel of GLUT1, CDX2, Villin, calretinin and WT1 for differential diagnosis between adenocarcinoma cells and reactive mesothelium in peritoneal fluid of patients with gastric cancer. Whereas GLUT1, calretinin and WT1 is the best for differential diagnosis between reactive mesothelium and mesothelioma in serous effusions.

Effects of iodine methionine on boar sperm quality during liquid storage at 17°C.

Microbial environment is one of the important factors that affect the quality of preserved semen. Iodine methionine (IM), participating in the production and activation of metabolic enzymes, is a new type of amino acid chelate. To date, there has been no report to evaluate the effects of IM on boar semen preservation at 17°C. This study was designed to investigate the effects of IM on boar sperm quality and reproductive performance during liquid storage at 17°C and its antibacterial effect. Semen samples collected from six Yorkshire boars were diluted with basic liquid containing different concentrations of IM (0, 20, 40, 80, 160 and 320 µM). Subsequently, sperm motility, plasma membrane integrity and acrosome integrity were determined. After 6 days of preservation, the difference in microbial composition between control group and 80 µM IM group was compared using 16S rDNA sequencing, and the effects of IM on reproductive performance were also compared and analysed between the two groups. The results demonstrated that 20, 40 and 80 µM IM improved boar sperm motility, plasma membrane integrity and acrosome integrity. 80 µM IM was the optimum concentration. Conversely, 160 and 320 µM IM resulted in deleterious consequences to boar sperm quality compared to the control group and other treatment groups (p < .05). After 6 days of preservation, sperm motility, plasma membrane integrity and acrosome integrity were 56.0%, 51.8% and 59.4%, respectively. There was no significant difference in non-return rate between the two groups (p > .05). But the litter size of 80 µM IM group was significantly higher than that of control group (p < .05). 80 µM IM inhibited proliferation of the phylum Proteobacteria and the genus Staphylococcus as well as Pseudomonas (p < .05). Further studies are required to understand the antibacterial mechanism of IM in liquid-preserved boar semen.

Implementation and Effectiveness of Early Chest Tube Removal during an Enhanced Recovery Programme after Oesophago-gastrectomy.

INTRODUCTION: Oesophageal resection were notoriously complicated and produces a cohort of patients prone to postoperative complications and here we would like to focus on the implementation and effectiveness of early chest tube removal in ERAS after oesophago-gastrectomy considering the various aspect like pleural effusion and reducing the length of hospital stay which ultimately lead to reducing the economic burden on patient. METHODS: An ERAS programme was devised and implemented with the support of a dedicated in-hospital task-force. The patients underwent esophago-gastrectomy were randomly divided into two groups: the ERAS group and the control group (non-ERAS). The ERAS group was treated with early removal of the chest tube after surgery, and the control group was treated with traditional way and outcomes were compared between them. RESULTS: The length of hospital stay and the cost of hospitalization in the ERAS group were significantly lower than those in the control group（p<0.05. However, there was no statistical significant difference in the incidences of pleural effusion between the two groups（p＞0.05). CONCLUSIONS: The introduction of early chest tube removal as an ERAS programme after oesophago-gastrectomy would not increase the risk of pleural effusion and would not increase the total length of stay and cost of hospitalisation without jeopardising patient safety or clinical outcomes.

Effect of dehydrated storage on the survival of Francisella tularensis in infant formula.

Francisella tularensis is a Gram-negative bacterium that can cause gastrointestinal or oropharyngeal tularemia in humans from ingestion of contaminated food or water. Despite the potential for accidental or intentional contamination of foods with F. tularensis, there are few studies on the long-term survivability of this organism in food matrices. Infant formula has previously been implicated as a vehicle for the transmission of a variety of bacterial pathogens in infants. In this study, we investigated the survival of F. tularensis in dehydrated infant formula under various storage conditions. F. tularensis was stored for up to 12 weeks in dehydrated infant formula in an ambient air, dry or nitrogen atmosphere. Viable counts of fresh F. tularensis at 12 weeks in infant formula revealed a 4.15, 3.37 and 3.72-log decrease in ambient air, dry and nitrogen atmosphere, respectively. D-values were calculated (in weeks) as 3.99, 4.68 and 4.47 in air, dry and nitrogen atmosphere, respectively.

Thermal resistance of Francisella tularensis in infant formula and fruit juices.

Francisella tularensis is a gram-negative bacterium that can cause gastrointestinal or oropharyngeal tularemia from ingestion of contaminated food or water. Despite the potential for accidental or intentional contamination of foods with F. tularensis, little information exists on the thermal stability of this organism in food matrices. In the present study, the thermal resistance of the live vaccine strain of F. tularensis in four food products (liquid infant formula, apple juice, mango juice, and orange juice) was investigated. D-values ranged from 12 s (57.5 degrees C) to 580 s (50 degrees C) in infant formula with a z-value of 4.37 degrees C. D-values in apple juice ranged from 8 s (57.5 degrees C) to 59 s (50 degrees C) with a z-value of 9.17 degrees C. The live vaccine strain did not survive at temperatures above 55 degrees C in mango juice and orange juice (>6-log inactivation). D-values at 55 to 47.5 degrees C were 15 to 59 s in mango juice and 16 to 105 s in orange juice with z-values of 9.28 and 12.30 degrees C, respectively. These results indicate that current pasteurization parameters used for destroying common foodborne bacterial pathogens are adequate for eliminating F. tularensis in the four foods tested. This study is the first to determine thermal inactivation of F. tularensis in specific foods and will permit comparisons with the thermal inactivation data of other more traditional foodborne pathogens.

Microbiological quality and production of botulinal toxin in film-packaged broccoli, carrots, and green beans.

The production of toxin by a 10-strain mixture of proteolytic Clostridium botulinum in fresh produce packaged in polyethylene films with different oxygen permeability was determined. Broccoli florets, shredded carrots, and green beans inoculated with approximately 10(2) C. botulinum spores per g were placed in bags (1.4 kg per bag) composed of four films with different oxygen transmission rates (OTRs). Broccoli was packaged in bags with OTRs of 3 (7,000 cm3/m2/24 h) and 4 (16,000 cm3/m2/24 h), and green beans were packaged in bags with OTRs of 2 (6,000 cm3/m2/24 h) and 4. Broccoli and green beans in bags were compressed and heat-sealed. Shredded carrots were packaged in bags with OTRs of 1 (3,000 cm3/m2/24 h) and 3 and vacuum-sealed. Produce was stored at 4, 13, and 21 degrees C for up to 27 (broccoli) or 28 (carrots and green bean) days and analyzed periodically. At each sampling time, gas composition within the bags, pH of the produce microbial population (total aerobic and anaerobic microorganisms, lactic acid bacteria, psychrotrophic bacteria, yeasts, and molds), and the presence or absence of botulinal toxin were determined. Packaging material affected the quality of vegetables, especially broccoli stored at 4 and 13 degrees C. For example, broccoli was scored as "good" after 22 days at 4 degrees C when it was packaged in film with higher gas permeability (OTR of 4), whereas broccoli appeared to be in "poor" condition when packaged in film with lower gas permeability (OTR of 3). With the exception of lactic acid bacteria, packaging material did not noticeably influence the growth of microorganisms. Lactic acid bacteria grew better in broccoli packaged in bags with an OTR of 3 than in those with an OTR of 4 at all temperatures. Botulinal toxin was detected in broccoli packaged in bags with an OTR of 3 and stored at 13 degrees C for 21 days and in those with an OTR of 4 and 3 and stored at 21 degrees C for 10 days. All toxic samples were visibly spoiled. Toxin was not detected in produce packaged under any other test conditions.

Cheesecake: a potential vehicle for salmonellosis?

This study was conducted to investigate the potential hazard of Salmonella Enteritidis surviving during the preparation and baking of cheesecake. Batters prepared with standard- and reduced-fat ingredients were inoculated with a 5-strain cocktail of S. Enteritidis (10 and 10(6) CFU/g) and were then baked according to a typical cheesecake recipe. After baking, the cheesecakes were refrigerated overnight before the survival of S. Enteritidis was determined either by direct plating or after enrichment. Samples (approximately 25 g each) were aseptically cut from the center, mid (6.35 cm from edge), and side (2.54 cm from edge) area of each cake for microbiological analysis. Proximate compositions (fat, moisture, protein, ash, pH, and water activity) of both raw batter and final baked cheesecakes were also determined. S. Enteritidis was able to survive baking of cheesecake when batter was inoculated with a high population (10(6) CFU/g) of S. Enteritidis regardless of whether standard-or reduced-fat ingredients were used. Three of nine standard- and four of nine reduced-fat cheesecake samples contained viable S. Enteritidis. In addition, one sample contained viable S. Enteritidis population detectable by direct plating (approximately 10 CFU per g of cake). This sample was taken from the center of a standard-fat cheesecake that was inoculated with a high population (10(6) CFU/g) of S. Enteritidis. Results of this study suggest that cheesecake prepared with eggs of low microbiological quality or cheesecake improperly handled or stored could serve as a vehicle for salmonellosis.

Microbiological quality and the inability of proteolytic Clostridium botulinum to produce toxin in film-packaged fresh-cut cabbage and lettuce.

The production of toxin by a 10-strain mixture of proteolytic Clostridium botulinum in fresh produce packaged in polyethylene films having high (7,000 cc/m2/24 h; HOTR) and low (3,000 cc/m2/24 h; LOTR) relative oxygen permeability was determined. Shredded cabbage and lettuce inoculated with approximately 10(2) spores/g were placed in bags composed of the two films (1.4 kg/bag), and the bags were then vacuum sealed. Produce was stored at 4, 13, and 21 degrees C for up to 21 (cabbage) or 28 (lettuce) days and analyzed periodically. At each sampling time, the gas composition within the bags, pH of the produce, and microbial populations (total aerobic and anaerobic microorganisms, lactic acid bacteria, psychrotrophic bacteria, and yeasts and molds) were determined. In addition, the presence of botulinal toxin was determined using the standard U.S. Food and Drug Administration mouse bioassay protocol. Bags made of HOTR film prolonged sensory quality of cabbage and lettuce, especially at 13 and 4 degrees C. Packaging material had an effect on the growth of various groups of microorganisms; however, there was not a general trend. For example, lettuce packaged in HOTR bags had higher aerobic microbial populations than that packed in LOTR, but no significant difference (P < or = 0.05) was observed with cabbage. Growth of psychrotrophic bacteria was greater in vegetables packaged in HOTR film while growth of yeasts and molds was not affected by either packaging film. Most differences in microbial populations in produce packaged in LOTR and HOTR films were less than 1 log10 CFU/g. Botulinal toxin was not detected in cabbage or lettuce packaged in either film or stored under any test condition.

Inhibition of Listeria monocytogenes and Aeromonas hydrophila by plant extracts in refrigerated cooked beef.

Refrigerated ready-to-eat foods are becoming increasingly popular but are often vulnerable to contamination and subsequent growth by psychrotrophic foodborne pathogens. Consequently, there is a need for additional methods to assure the safety of these foods. Beef slices prepared from roasted whole sirloin tips were used in the study. Nine plant extracts were evaluated for ability to inhibit the growth of two psychrotrophic pathogens (Aeromonas hydrophila and Listeria monocytogenes) in refrigerated cooked beef. Results indicated that only eugenol (clove extract) and pimento extract significantly inhibited the growth of A. hydrophila and L. monocytogenes. However, L. monocytogenes was not as sensitive as was A. hydrophila to both treatments, especially to pimento extracts. These results suggest that plant extracts might be useful as an antimicrobial in cooked ready-to-eat meat.

Ineffectiveness of Hot Acid Sprays to Decontaminate Escherichia coli O157:H7 on Beef.

The efficacy of warm (20°C) and hot (55°C) acetic, citric and lactic acid sprays on survival of Escherichia coli O157:H7 on raw beef was determined. Fresh, raw beef sirloin tips were sliced into ca. 1-cm slices with a sanitized slicer. Discs (5-cm diameter, ca. 25-g) were then taken from internal areas of each slice and inoculated with a 5-strain mixture of E. coli O157:H7 such that final populations on beef samples were 103 or 106 CFU/g. After standing for 15 min, each inoculated disc was sprayed with 1 mi of 0, 0.5, 1.0 and 1.5% of each acid at 20 or 55°C using an atomizer. Acid-treated meat samples were allowed to dry for 15 min and held at 5°C for up to 13 days in sterile plastic pouches. Escherichia coli O157:H7 was acid tolerant, and acids did not differ appreciably in their lack of antimicrobial activity on E. coli O157:H7. For example, reductions in populations differed by <0.3 logl0 CFU/g immediately after treatment and < 0.5 logl0 CFU/g after 13 days incubation, compared to untreated Controls. None of the acid treatments appreciably reduced E. coli O157:H7 on beef samples nor were any of the acid treatments judged effective for practical uses.

Influence of Modified Atmosphere on Growth of Vegetable Spoilage Bacteria in Media.

Six gas mixtures (CO2/O2/N2: 0/5/95, 0/10/90, 5/10/85, 5/20/75, 10/5/85, and 10/20/70) and air were used to investigate the effect of modified atmosphere (MA) on growth of four vegetable spoilage bacteria. In addition, we determined the ability of the MA which most inhibited spoilage bacteria to reduce spoilage in bell peppers inoculated with the respective bacteria. In general, MA did not significantly affect growth of the bacteria tested. Growth of Erwinia , Pseudomonas , Xanthomonas , and Pepper #15 (a pectinolytic Pseudomonas ) at 10 and 20°C was not significantly affected regardless of gas mixtures. At 5°C, growth of Erwinia , Xanthomonas , and Pepper #15 was slightly reduced by some gas mixtures (CO2/O2/N2: 0/5/95, 0/10/90, and 10/5/85; 10/5/85; 0/5/95 and 10/5/85, respectively). Modified atmosphere containing 10% CO2, 5% O2, and 85% N2 did not reduce the ability of bacteria tested to grow at elevated concentrations of sodium chloride. In addition, this MA composition did not change the percentage of bell peppers spoiled by test bacteria inoculated. However, overall visual quality was enhanced by MA.

Growth of Escherichia coli O157:H7 in Modified Atmosphere.

This study was conducted to determine the influence of temperature and modified atmosphere appropriate for use with fresh produce on growth of Escherichia coli O157:H7. None of the gas mixtures tested (CO2/O2/N2: 0/5/95, 0/10/90, 5/10/85, 5/20/75, 10/5/85, and 10/20/70) significantly affected growth of this bacterium at 5, 10, and 20°C. Similarly, modified atmosphere did not significantly affect the tolerance of E. coli O157:H7 to 3% NaCl. E. coli grew at 10 and 20°C and survived at 5°C.