[Establishment of a nomogram model for the early diagnosis of childhood sepsis]. / 基于列线图的儿童脓毒症早期诊断模型的建立.

OBJECTIVES: To establish a nomogram model for the early diagnosis of sepsis in children. METHODS: A total of 76 children with sepsis who were admitted to Sichuan Maternal and Child Health Hospital from January 2018 to June 2021 were retrospectively selected as the sepsis group. After matching for sex and age (±2 years) at a ratio of 1:1:1, 76 children with local infection who were hospitalized during the same period were enrolled as the local infection group, and 76 children with non-infectious diseases were enrolled as the control group. The three groups were compared in terms of laboratory markers and the results of quick Sequential Organ Failure Assessment (qSOFA) and Pediatric Critical Illness Score (PCIS). A multivariate logistic regression analysis was used to investigate the association between the above indicators and sepsis. R4.1.3 software was used to establish and validate the nomogram model for the early diagnosis of sepsis based on the results of the multivariate analysis. A receiver operating characteristic (ROC) curve analysis was used to evaluate the value of the nomogram model, and the Bootstrap method was used to perform the internal validation of the model. RESULTS: The multivariate logistic regression analysis showed that soluble triggering receptor expressed on myeloid cells-1, qSOFA score, PCIS score, C-reactive protein, interleukin-6, and interleukin-10 were independently associated with childhood sepsis (P<0.05). The above indicators were used to establish a nomogram for the early diagnosis of sepsis, with an area under the ROC curve of 0.837 (95%CI: 0.760-0.914), and the calibration curve results showed a mean absolute error of 0.024, suggesting that the performance of this model was basically consistent with that of the ideal model. CONCLUSIONS: The indicators soluble triggering receptor expressed on myeloid cells-1, qSOFA score, PCIS score, C-reactive protein, interleukin-6, and interleukin-10 are independently associated with childhood sepsis, and the nomogram model established based on these indicators has high discriminatory ability and accuracy in the early diagnosis of sepsis in children.

CXCL14 facilitates the growth and metastasis of ovarian carcinoma cells via activation of the Wnt/ß-catenin signaling pathway.

BACKGROUND: There is an urgent need to identify potential targets in anticancer therapy to improve the survival and prognosis of patients with ovarian cancer (OC). Herein, we investigated the functional significance of chemokine (C-X-C motif) ligand 14 (CXCL14) in OC cell growth and epithelial-mesenchymal transition (EMT). METHODS: qRT PCR and western blotting was used to detect CXCL14 mRNA level and protein expression, respectively. The functional mechanism of CXCL14 in OC was investigated by CCK-8, colony formation and transwell assays. The migration ability of OC cell was determined using wound healing. The protein expressions of CXCL14 and ß-catenin in OC tissues were determined by immumohistochemical staining. RESULTS: We demonstrated that high levels of CXCL14 were associated with a worse prognosis in patients with OC. CXCL14 knockdown considerably restrained the growth, migration and invasion of OC cell in vitro. In contrast, ectopic CXCL14 overexpression yielded the opposite results. Investigations to determine the underlying molecular mechanisms revealed that the Wnt/ß-catenin signaling pathway is involved in CXCL14-facilitated OC cell invasiveness. CONCLUSION: These data collectively demonstrate that CXCL14 contributes to OC cell growth and metastatic potential by regulating the Wnt/ß-catenin signaling pathway.

Drug-Resistant Tuberculosis among Children, China, 2006-2015.

Microbial drug resistance has become a major public health concern worldwide. To acquire epidemiologic data on drug-resistant tuberculosis (DR TB) among children, a major cause of illness and death for this population, we conducted a retrospective study of 2006-2015 data from 36 TB prevention and control institutions in Shandong Province, China. A total of 14,223 new TB cases, among which children (<18 years of age) accounted for only 5.5%, were caused by culture-confirmed Mycobacterium tuberculosis. Among children with TB, 18.9% had DR TB and 6.9% had multidrug-resistant TB. Over the past decade, the percentage of DR TB; multidrug-resistant TB; and overall first-line drug resistance for isoniazid, rifampin, ethambutol, and streptomycin among children increased significantly (at least 12%). Understanding the long-term trends of DR TB among children can shed light on the performance of TB control programs, thereby contributing to global TB control.

Trends and characteristics of drug-resistant tuberculosis in rural Shandong, China.

OBJECTIVES: The aim of this study was to describe the secular trends in drug-resistant tuberculosis (DR-TB) and to identify unique characteristics of multidrug-resistant tuberculosis (MDR-TB) in rural China. METHODS: A retrospective study was conducted using TB data collected from 36 TB prevention and control institutions serving rural populations in Shandong Province, China, for the period 2006-2015. RESULTS: Approximately 8.3% of patients suffered from MDR-TB, among whom 70% were newly treated patients; this rate increased by 1.3% annually during the 10-year study period. An increase in the percentage of overall first-line drug resistance against isoniazid, rifampicin, ethambutol, and streptomycin was confirmed (p<0.05). The percentage of MDR-TB in new and previously treated cases increased at yearly rates of 9.9% and 11.1%, respectively. MDR-TB patients were more likely to be female (odds ratio (OR) 1.58, 95% confidence interval (CI) 1.32-1.89), smokers (OR 1.75, 95% CI 1.47-2.07), to have had recent TB contact (OR 1.58, 95% CI 1.04-2.42), or to have been retreated (OR 2.89, 95% CI 2.46-3.41). CONCLUSIONS: Increasing MDR-TB and rates of primary MDR-TB characterize DR-TB cases in rural China. Persistent efforts need to be made among MDR-TB patients in future TB control strategies.

Epidemiological trends and outcomes of extensively drug-resistant tuberculosis in Shandong, China.

BACKGROUND: Extensively Drug-Resistant (XDR) Tuberculosis (TB) has posed a great threat to global health and finance systems, especially for developing countries with high TB and Multidrug-Resistant (MDR) TB burden. METHODS: We retrospectively analyzed HIV-uninfected TB case confirmed and treated in Shandong Provincial Chest Hospital (SPCH) between January 2008 and December 2015. Unique characteristics of XDR-TB were identified; its longitudinal changes and survival were analyzed. RESULTS: Between January 2008 and December 2015, a total of 144 cases were confirmed to be XDR-TB (2.5% of 5663 culture-confirmed TB cases; 27.9% of 516 MDR-TB cases). The proportion of XDR TB cases among MDR-TB cases has increased from 26.5% in 2008 to 44.5% in 2014 (Chi-Square test for trends: P < 0.01). Among the 144 XDR-TB cases, 21 patients (14.6%) had treatment success, 123 (85.1%) had poor treatment outcomes. Mortality was higher among XDR-TB cases than among MDR TB cases (8.3% vs. 3.8%, P = 0.033) and drug-susceptible TB cases (8.3% vs. 2.1%, P < 0.01). CONCLUSIONS: XDR-TB cases comprise a substantial and increasing fraction of MDR-TB cases, causing poor treatment outcomes and high mortalities. Early drug susceptibility testing, adequate TB treatment and efficient infection control must be in place in future TB control strategies.

Epidemiological Trends of Drug-Resistant Tuberculosis in China From 2007 to 2014: A Retrospective Study.

The emergence and spread of drug-resistant tuberculosis (DR-TB) has become the major concern in global TB control nowadays due to its limited therapy options and high mortality. A comprehensive evaluation for the epidemiological trends of DR-TB in mainland China, of which TB incidences remain high, is essential but lacking. This study aimed to describe the trends of DR-TB overtime, especially multidrug-resistant TB (MDR-TB); and to identify unique characteristics of MDR-TB cases compared with drug-susceptible TB cases in Mainland China. We retrospectively analyzed surveillance data collected from 36 TB prevention and control institutions in Shandong Province, China over an 8-year period. Unique characteristics of MDR-TB were identified; Chi-square test for trends and linear regression were used to assess the changes in proportions of different resistance patterns overtime. The overall MDR rate was 6.2% in our sample population. There were no statistically significant changes in the percentage of drug-susceptible, isoniazid (INH) resistance, ethambutol (EMB) resistance, streptomycin (SM) resistance, and MDR TB during our study period except that the overall rifampin (RFP) resistance and rifampin monoresistance (RMR) increased at a yearly rate of 0.2% and 0.1%, respectively. Among those with known treatment histories, a higher MDR rate of 8.7% was observed, in which 53.9% were primary MDR-TB patients, and this rate was increasing at a yearly rate of 4.1% over our study period. MDR-TB patients were more likely to be female (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.05-1.34), aged 25 to 44 years (OR, 1.67; 95%CI, 1.45-1.93), retreated (OR, 11.95; 95%CI, 9.68-14.76), having prior TB contact (OR, 1.89; 95%CI, 1.19-2.78) and having cavity (OR, 1.57; 95%CI 1.36-1.81), or bilateral disease (OR, 1.45; 95%CI 1.19-1.76) on chest radiology. Persistent high levels of MDR-TB, increasing rates of primary MDR-TB and RMR characterize DR-TB cases in mainland China; community-acquired drug resistance may be one of the most modifiable factors in future TB control strategies.

[Comparation of Toxic Effect of Silicious Mineral Dusts on Lung Epithelial A549 Cells].

Considering the high contents of minerals and the potential health risk of mineral dusts to human and the environment, this paper was aimed to figure out the toxic effect and mechanism of four common mineral particles (quartz, albite, sericite, and montmorillonite). Cytotoxicity assays for cell viability (MTT assay), membrane integrity (LDH assay), oxidative stress (H2O2 assay) and inflammatory cytokines (TNF-α and IL-6 assay) were applied. The results showed the influence of these mineral particles on A549 cell viability followed the order of momtmorillonite > cericite≥quartz > albite. There was no obvious relation between cell viability and the content of SiO2, however, good linear correlation with the content of iron, and the cytotoxicity of mineral dusts was strengthened with increasing iron content. Mineral dusts generated H2O2 in cell or cell-free systems. In particular, H2O2 exhibited a linear correlation with the iron content, which meant that iron in the mineral dusts played an important role in the generation of reactive radical. Among those samples, oxidative stress induced by montmorillonite was distinctly stronger, while there was negligible influence induced by quartz and albite. Besides, all the tested samples induced damage to A549 cell membrane, and triggered the release of TNF-α or IL-6, but differed by the kinds of mineral dusts. In conclusion, composition and structure directly affected, but were not the only factors that contributed to the biological activity of mineral dusts, the evaluation of cell viability, membrane damage, free radicals and inflammatory reaction induced by mineral dusts should take the external morphology, surface active groups, solubility, adsorption and ion exchange properties into consideration.

Multidrug-Resistant Tuberculosis in Patients with Chronic Obstructive Pulmonary Disease in China.

BACKGROUND: Relatively little is known about the specific relationship and impact from chronic obstructive pulmonary disease (COPD) on multidrug-resistant tuberculsosis (MDR-TB). METHODS: We conducted a retrospective study included patients aged ≥40 years with a confirmed pulmonary TB at three tertiary hospitals (Shandong, China) between January 2011 and October 2014. Univariable and multivariable analyses were performed to identify the relationship of MDR-TB and COPD. RESULTS: A total of 2164 patients aged ≥ 40 years with available results of drug susceptibility test (DST) and medical records were screened for this study: 268 patients with discharge diagnosis of COPD and 1896 patients without COPD. Overall, 14.2% of patients with COPD and 8.5% patients without COPD were MDR-TB. The rate of MDR-TB were significantly higher in patients with COPD (P<0.05). Migrant (odds ratios (OR) 1.32, 95% confidence interval (CI) 1.02-1.72), previous anti-TB treatment (OR 4.58, 95% CI 1.69-12.42), cavity (OR 2.33, 95% CI 1.14-4.75), and GOLD stage (OR 1.86, 95% CI 1.01-2.93) were the independent predictors for MDR-TB among patients with COPD. CONCLUSIONS: MDR-TB occurs more frequently in patients with underlying COPD, especially those with being migrant, previous anti-TB therapy, cavity and severe airway obstruction.

The Relationship between Extensively Drug-Resistant Tuberculosis and Multidrug-Resistant Gram-Negative Bacilli.

OBJECTIVE: The relationship between extensively drug-resistant tuberculosis (XDR-TB) and multidrug-resistant Gram-negative bacilli (MDR-GNB) is unclear. Identification of the relationship between XDR-TB and MDR-GNB would have important implications for patient care. METHODS: We conducted a retrospective study reviewing the records of patients admitted with a confirmed pulmonary TB from 2011 to 2014. To identify the relationship between XDR-TB and MDR-GNB, univariable comparison and multivariable logistic regression were performed. RESULTS: Among 2962 pulmonary TB patients, 45(1.5%) patients had a diagnosis of XDR-TB. A total of 165 MDR-GNB strains were detected in 143 (4.8%) pulmonary TB patients. XDR-TB patients had a significantly higher occurrence of MDR-GNB than non-XDR-TB patients (24.4% vs. 4.5%; P<0.001). Age (OR 1.02, 95% CI 1.01-1.03), hypoalbuminemia (OR 1.48, 95% CI 1.18-1.85), chronic renal failure (OR 6.67, 95% CI 1.42-31.47), chronic hepatic insufficiency (OR 1.99, 95% CI 1.15-3.43), presence of XDR-TB (OR 6.56, 95% CI 1.61-26.69), and duration of TB diagnostic delay (OR 1.01, 95% CI 1.00-1.02) were the independent risk factors for MDR-GNB infection. CONCLUSIONS: Patients with XDR-TB have a significantly higher risk of being affected by MDR-GNB pathogen. The underlying mechanism association warrant further studies.

[Quantitative detection of hydroxyl radical generated in quartz powder/phosphate buffer solution system by fluorescence spectrophotometry].

Quartz powder would release radical hydroxyl in phosphate buffer solution. In order to detect the quantity of radical hydroxyl with a quite low concentration, the present paper established a fluorescence method. According to the relationship between the concentration of 2-hydroxyl of terephthalic acid (HOTP) and fluorescence intensity at the wavelength of EX(max)/EM(max) = 316 nm/422 nm, a working standard curve was constructed. Then through the filtrated fluorescence intensity obtained from the powder and solution system, cumulative concentration of * OH can be measured indirectly. By repeating tests and analysis of five different experimental conditions of * OH cumulative concentration, the minimum detection limit of the method reached 1.59 x 10(-10) mol x L(-1), with a relative deviation of 1.20%-7.89%, standard deviation was 1.09 x 10(-9)-2.17 x 10(-9) mol x L(-1) and the relative standard deviation was 3.5%-5.8%. The method features high accuracy and good repeatability performance. Compared to other quantitative studies, this method might be applied to test radical hydroxy produced in pH neutral solution systems. In addition, it has apparent advantages such as low detection limit, low cost, higher sensitivity, and better stability and reproducibility. That provides the means for the quantitative study of mixed systems consisting of quartz powder and phosphate buffered solution.

Integration of RAFT polymerization and click chemistry to fabricate PAMPS modified macroporous polypropylene membrane for protein fouling mitigation.

A copper (I)-catalyzed azide-alkyne cycloaddition (CuAAC) grafting-to method was used to tether alkyne-terminated poly(2-acrylamido-2-methyl propane sulfonic acid) (alkyne-PAMPS) to the azide functionalized macroporous polypropylene membrane (MPPM-N3). Alkyne-PAMPS was synthesized by the reversible addition-fragmentation chain transfer polymerization (RAFT) of AMPS with an alkyne-terminated trithiocarbonate served as a chain transfer agent. The combination of RAFT polymerization with click chemistry to graft polymer to the surface of polypropylene membrane produced relatively high grafting density and controllable grafting chain length. The structure and composition of the modified and unmodified MPPM surfaces were analyzed by attenuated total reflection-Fourier transform infrared spectroscopy (ATR/FT-IR), X-ray photoelectron spectroscopy (XPS); field emission scanning electron microscopy (FE-SEM) was employed to observe the morphological changes on the membrane surface. The permeation performances were tested by the filtration of protein dispersion. The experimental results show that with the grafting degree going up, the relative flux reduction decreases, while the relative flux recovery ratio increases, and the protein fouling is obviously mitigated by tethering PAMPS to the membrane surface. The modified membranes can be potentially applied for fouling reduction during the filtration of proteins.

Surface modification of polypropylene microporous membrane to improve its antifouling characteristics in an SMBR: N2 plasma treatment.

Fouling is the major obstacle in membrane processes applied in water and wastewater treatment. The polypropylene hollow fiber microporous membranes (PPHFMMs) were surface modified by N(2) low-temperature plasma treatment to improve the antifouling characteristics. Morphological changes on the membrane surface were characterized by field emission scanning electron microscopy (FE-SEM). The change of surface wettability was monitored by contact angle measurements. The static water contact angle of the modified membrane reduced obviously; the relative pure water flux of the modified membranes increased with the increase of plasma treatment time. To assess the relation between plasma treatment and membrane fouling in a submerged membrane bioreactor (SMBR), filtration of activated sludge was carried out by using synthetic wastewater. After continuous operation in the SMBR for about 90 h, flux recoveries for the N(2) plasma-treated PPHFMM for 8 min were 62.9% and 67.8% higher than those of the virgin membrane after water and NaOH cleaning. The irreversible fouling resistance decreased after plasma treatment.