Resting-state fMRI network efficiency as a mediator in the relationship between the glymphatic system and cognitive function in obstructive sleep apnea hypopnea syndrome: Insights from a DTI-ALPS investigation.

INTRODUCTION: Obstructive sleep apnea hypopnea syndrome (OSAHS) is associated with cognitive impairment and physiological complications, necessitating further understanding of its mechanisms. This study investigates the relationship between glymphatic system function, brain network efficiency, and cognitive impairment in OSAHS patients using diffusion tensor image analysis along the perivascular space (DTI-ALPS) and resting-state fMRI. MATERIALS AND METHODS: This study included 31 OSAHS patients and 34 age- and gender-matched healthy controls (HC). All participants underwent GE 3.0T magnetic resonance imaging (MRI) with diffusion tensor image (DTI) and resting-state fMRI scans. The DTI-ALPS index and brain functional networks were assessed. Differences between groups and correlations with clinical characteristics were analyzed. Additionally, the mediating role of brain network efficiency was explored. Finally, receiver operating characteristics (ROC) analysis assessed diagnostic performance. RESULTS: OSAHS patients had significantly lower ALPS-index (1.268 vs. 1.431, p < 0.0001) and moderate negative correlation with Apnea Hypopnea Index (AHI) (r = -0.389, p = 0.031), as well as moderate positive correlation with Montreal Cognitive Assessment (MoCA) (r = 0.525, p = 0.002). Moreover, global efficiency (Eg) of the brain network was positively correlated with the ALPS-index and MoCA scores in OSAHS patients (r = 0.405, p = 0.024; r = 0.56, p = 0.001, respectively). Furthermore, mediation analysis showed that global efficiency partially mediated the impact of glymphatic system dysfunction on cognitive impairment in OSAHS patients (indirect effect = 4.58, mediation effect = 26.9 %). The AUROC for identifying OSAHS and HC was 0.80 (95 % CI 0.69 to 0.91) using an ALPS-index cut-off of 1.35. CONCLUSIONS: OSAHS patients exhibit decreased ALPS-index, indicating impaired glymphatic system function. Dysfunction of the glymphatic system can affect cognitive function in OSAHS by disrupting brain functional network, suggesting a potential underlying pathological mechanism. Additionally, preliminary findings suggest that the ALPS-index may offer promise as a potential indicator for OSAHS.

Abrasive Wear Properties of Wear-Resistant Coating on Bucket Teeth Assessed Using a Dry Sand Rubber Wheel Tester.

Ni60-WC coatings with different WC contents on the bucket tooth substrates were pre- pared using laser cladding technology. Their abrasive wear properties were assessed using the dry sand rubber wheel test system. The substrate and the hard-facing layer were tested for comparison. The results showed that the hardness of the Ni60-WC coatings increased with the increase in WC content. The wear resistance of the bucket tooth substrate was greatly improved by hard-facing and laser cladding Ni60-WC coatings. The wear rate of the hard-facing layer was reduced to 1/6 of that of the tooth substrate. The wear rate of the laser cladding coatings with 20-40 wt.% WC was similar to that of the hard-facing layer. It is worth mentioning that the wear rate of the coatings with 60-80 wt.% WC was only 1/4 of that of the hard-facing layer. Micro-cutting with surface plastic deformation was the main wear mechanism of the substrate to form narrow and deep furrows. The wear mechanism of the hard-facing layer was mainly plastic deformation with a wide groove, and the surface cracks promoted the removal of the material. The removal of the binder phase caused by micro-cutting was the main wear mechanism of the laser cladding Ni60-WC coatings. However, the hard phase of WC hinders micro-cutting and plastic deformation, which improves the wear resistance of the coating.

Ancient Mitogenomes Reveal the Maternal Genetic History of East Asian Dogs.

Recent studies have suggested that dogs were domesticated during the Last Glacial Maximum (LGM) in Siberia, which contrasts with previous proposed domestication centers (e.g. Europe, the Middle East, and East Asia). Ancient DNA provides a powerful resource for the study of mammalian evolution and has been widely used to understand the genetic history of domestic animals. To understand the maternal genetic history of East Asian dogs, we have made a complete mitogenome dataset of 120 East Asian canids from 38 archaeological sites, including 102 newly sequenced from 12.9 to 1 ka BP (1,000 years before present). The majority (112/119, 94.12%) belonged to haplogroup A, and half of these (55/112, 49.11%) belonged to sub-haplogroup A1b. Most existing mitochondrial haplogroups were present in ancient East Asian dogs. However, mitochondrial lineages in ancient northern dogs (northeastern Eurasia and northern East Asia) were deeper and older than those in southern East Asian dogs. Results suggests that East Asian dogs originated from northeastern Eurasian populations after the LGM, dispersing in two possible directions after domestication. Western Eurasian (Europe and the Middle East) dog maternal ancestries genetically influenced East Asian dogs from approximately 4 ka BP, dramatically increasing after 3 ka BP, and afterwards largely replaced most primary maternal lineages in northern East Asia. Additionally, at least three major mitogenome sub-haplogroups of haplogroup A (A1a, A1b, and A3) reveal at least two major dispersal waves onto the Qinghai-Tibet Plateau in ancient times, indicating eastern (A1b and A3) and western (A1a) Eurasian origins.

Experimental studies on the characteristics of chisel picks in coal cutting for bucket wheel excavators.

Chisel pick is a basic and important rock cutting tool, and the performance of chisel pick directly affects rock mining. In this paper, a rock cutting device was developed for chisel picks cutting experiments. The influence of the depth of cutting, width of chisel pick, rake angle, back clearance angle and tip fillet radius on the cutting performance such as cutting force, normal force, and specific energy has been comprehensively studied. In addition to the general conclusions, the experimental results show that the back clearance angle has an influence range on the cutting, and the ratio of the normal force to the cutting force decreases with the increase of the rake angle; the tip fillet radius greatly improve the mean cutting force and specific energy. The experimental results will provide data support for the design of chisel picks on rock excavation machinery and a more reasonable chisel pick cutting rock mechanics model.

A finite-time path following scheme of unmanned surface vessels with an optimization strategy.

The path-following problem of unmanned surface vessels (USVs) is solved in this paper, considering unknown interference, energy-saving strategy, input constraints, and input rate of change constraints. Firstly, the USV model considering lumped interference is given, while an interference observer based on finite-time theory is used for interference estimation where the convergence time is specified. Then, to accelerate the USV convergence to a given path, a novel improved adaptive finite-time line-of-sight (IAFTLOS) scheme is developed. The proposed IAFTLOS scheme makes the cross-path error with finite-time convergence. At the same time, an adaptive time-varying looking distance law is designed to improve the convergence performance further. Next, nonlinear model predictive control is introduced to deal with rates of change and input constraints. In addition, an energy-saving strategy is incorporated into the design of the controller. Finally, stable control of the whole cascade system is achieved, and comparative simulation cases verify the feasibility and robustness of the entire system.

Infection pattern and immunological characteristics of Epstein-Barr virus latent infection in cervical squamous cell carcinoma.

Previous studies reported the association between Epstein-Barr virus (EBV) and cervical squamous cell carcinoma (CSCC), but its infection pattern and clinical significance unclear. This study aimed to comprehensively investigate the infection pattern, clinicopathology, outcomes, and immunology of this entity in central China. We evaluated a total of 104 untreated CSCC tumor tissue specimens using in situ hybridization for EBV-encoded small RNAs (EBERs), and by employing flowcytometry fluorescence hybridization for human papillomavirus (HPV) genotyping. The expression of EBV latency proteins and immune biomarkers was evaluated and quantified by immunohistochemistry. EBERs transcripts were detected in 21 (20.2%) cases overall (in malignant epithelial cells of 13 cases and in lymphocytes of 8 cases). EBV belonged to latency type I infection in CSCC. The high-risk (HR)-HPV was detected in all of EBV-positive CSCC, and the difference of detection rate of HR-HPV was significant when compared with EBV-negative CSCC (p = 0.001). The specific clinicopathology with increased frequency of advanced clinical stages, tumor-positive lymph nodes, neural invasion, and increased infiltration depth (all p value < 0.05) were observed in cases with EBV. However, EBV infection was found to have no impact on prognosis of patients with CSCC. Increased densities of forkhead box P3 (FoxP3)+-tumor infiltrating lymphocytes (TILs) (p = 0.005) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4)+-TILs (p = 0.017) and higher expression of programmed cell death-1 (PD-1) (p = 0.002) and programmed cell death-1 ligand 1 (PD-L1) (p = 0.040) were associated with EBV latent infection in CSCC, and these immunological changes were more likely to be associated with the infection in lymphocytes rather than tumor cells. Moreover, in patients with HPV-positive CSCC, similar significant differences were still found. In conclusions, EBV-positive CSCC may have specific infection pattern and clinicopathology and can exhibit an immunosuppressive microenvironment dominated by Treg cells aggregation and immune checkpoint activation.

Pulmonary infection in patients with severe fever with thrombocytopenia syndrome: A multicentre observational study.

Co-infection in patients with severe fever with thrombocytopenia syndrome (SFTS) has been reported, posing a serious threat to survival and treatment. We aimed to systematically investigate the SFTS associated pulmonary infection, particularly invasive pulmonary fungal infection (IPFI). During April 2019 to October 2021, we conducted a multicentre observational study on adult hospitalized patients confirmed with SFTS from three tertiary hospital in central China. Demographic, clinical and laboratory data of patients were collected and re-assessed. A total of 443 patients (51.7% were male sex) were included for analysis with median age of 65-year-old. Among them, 190 (42.9%) patients met the criteria for pulmonary infection. Pulmonary infection was associated with shorter survival time (p < 0.0001 by log-rank test), and adjusted hazard ratio was 1.729 [95% confidence interval, 1.076-2.780] (p = 0.024). Age (odds ratio (OR) 1.040 [1.019-1.062], p < 0.001), time from onset to admission (OR 1.163 [1.070-1.264], p < 0.001), having severe status (OR 3.166 [2.020-4.962], p < 0.001) and symptoms of skin change (OR 2.361 [1.049-5.316], p < 0.001) at admission and receiving intravenous immunoglobin (OR 2.185 [1.337-3.569], p = 0.002) were independent risk factors for the occurrence of pulmonary infection. A total of 70 (15.8%) patients were defined as IPFI. Multivariate analysis showed that time from onset to admission (OR 1.117 [1.016-1.229], p = 0.022), severe status (OR 5.737 [3.054-10.779], p < 0.001), having smoking history (OR 3.178 [1.251-8.070], p = 0.015) and autoimmunity disease (OR 7.855 [1.632-37.796], p = 0.010), receiving intravenous immunoglobin (OR 3.270 [1.424-7.508], p = 0.005) were independent risk factors for the occurrence of IPFI. In SFTS patients with pulmonary infection, white blood count <2.09 × 109 per L (OR 11.064 [3.708-33.012], p < 0.001) and CD3+ CD4+ T cell count <104.0 per µL (OR 10.429 [3.395-32.038], p < 0.001) could independently predict IPFI. This study showed the high prevalence and poor outcomes of pulmonary infection and IPFI in patients with SFTS. These findings highlighted the need for active surveillance of fungal pathogens and early antifungal treatment in patients with SFTS.

Protective effects of ZIP8 on Toxoplasma gondii-induced acute hepatocyte injury in mice.

Toxoplasma gondii (T. gondii), as an intracellular protozoan parasite, has the potential to disturb the homeostasis of trace metal elements in host cells. Zinc (Zn) is one of those essential metals that is required for combating infection. Zinc cellular homeostasis is controlled by zinc membrane transporters, including efflux and influx transporters. One of the Zrt-Irt-like protein (ZIP) transporters, ZIP8, facilitates zinc influx into the cytosol. It was recently reported to play significant roles in facilitating Zn uptakes during infection. Here, we investigated the function of ZIP8 in host defense against T. gondii infection in cultured alpha mouse liver 12 (AML12) hepatocytes and mice, with loss of ZIP8 function. Herein, C57BL/6 J female wild-type (WT) and ZIP8-KD mice (Slc39a8 knockdown mice), that were infected with tachyzoites of ToxoDB#9(TgCtwh3), were used as a model of acute toxoplasmosis. AML12 hepatocytes were transfected with lentivirus (LV), with silenced ZIP8 expression. Finally, we observed the function of hepatocytes pretreated with ZnCl2 before TgCtwh3 infection in vivo and in vitro. In vivo, the levels of zinc ions and ZIP8 protein were upregulated after TgCtwh3 infection. ZIP8 knockdown exacerbated liver damage, further decreased antioxidant enzyme activity, promoted inflammatory mediator expression, and upregulated the rate of apoptosis. ZnCl2 pretreatment before TgCtwh3 infection improved liver injury, increased antioxidant enzyme activity, restrained the expression of inflammatory mediators, and decreased the rate of apoptosis. The results in vitro were almost the same as those in vivo. This study defines the function of ZIP8-dependent zinc in hepatocyte damage during intracellular pathogen infection. Reagents that regulate ZIP8 activity might be developed as therapeutics to protect the liver function of toxoplasmosis.

First Study of Bacteremia Caused by Herbaspirillum huttiense in China: A Brief Research Report and Literature Review.

Bacteremia caused by Herbaspirillum huttiense (H. huttiense) is relatively rare in positive blood cultures. H. huttiense is an opportunistic bacterium in patients with cancer and cirrhosis and has also been described in immunocompromised hosts. In this study, H. huttiense was isolated from a patient with repeated chest tightness and chest pain. Smears were prepared, stained, and examined by microscopy. Single colonies were analyzed by Gram staining, matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS), 16S rRNA sequencing and Next-Generation Sequencing (NGS). Antibiotic sensitivity was assessed by agar dilution. Almost all publications on H. huttiense infections in the PubMed/ScienceDirect/EBSCO databases were reviewed and summarized. Blood sample culturing yielded white, gelatinous, and slightly raised colonies without hemolytic rings. The bacilli were found to be Gram-negative, and MS results showed 99.2% homology with H. huttiense. This was confirmed by 16S rRNA gene sequencing, phylogenetic tree analysis and NGS all of which were homologous with H. huttiense in GenBank. Antibiotic susceptibility tests were performed to determine the minimum inhibitory concentrations (MICs) of imipenem, meropenem, piperacillin-tazobactam, and levofloxacin. A comprehensive literature review revealed that H. huttiense was an emergent pathogen. After medical treatment, the patient's body temperature returned to normal. This is the first report of bacteremia caused by H. huttiense in China. The findings could improve the awareness and attention of the rare pathogenic microorganisms in China.

Predictors of Occurrence and 30-Day Mortality for Co-Infection of Carbapenem-Resistant Klebsiella pneumoniae and Carbapenem-Resistant Acinetobacter baumannii.

Background: The phenomenon of co-infection with multiple carbapenem-resistant bacteria is growing, which pose a great challenge for infection control and treatment. This study aimed to analyze predictors of occurrence and 30-day mortality for carbapenem-resistant Klebsiella pneumoniae and carbapenem-resistant Acinetobacter baumannii co-infection. Methods: From June 2018 to June 2021, clinical data of 103 patients co-infected with carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Klebsiella pneumoniae (CRKP) were collected from a tertiary teaching hospital in Anhui Province, China. The clinical characteristics and predictors of mortality were analyzed. Meanwhile, the bacterial isolates were characterized for drug susceptibility, multi-locus sequence typing, and drug resistance genes. Results: The multivariate analysis revealed that fiberoptic bronchoscopy (p = 0.005, OR=2.72), repeat transfusions (p = 0.008, OR= 2.23) and exposure to tigecycline (p = 0.002, OR = 6.58) were independent risk factors for CRKP and CRAB co-infection. Neutrophil ≥11.9*109 (p = 0.035, adjusted HR = 3.12) and C-reactive protein ≥ 149 mg/L (p = 0.009, adjusted HR = 4.41) were found associated with 30-day mortality. Combined neutrophil with C-reactive protein could predict 30-day mortality, of which AUC value was 0.791 (95%CI: 0.661-0.921). KPC (46/51, 90.2%) was the most common carbapenemase in CRKP. 33 isolates of CRKP belong to ST11 (33/51, 64.7%), and three new ST types ST5882, ST5883, ST5885 were detected. Conclusions: Invasive operations and antibiotics exposure can lead to CRKP and CRAB co-infection. Combined neutrophil with C-reactive protein could predict 30-day mortality.

Rapid Detection of Carbapenem-Resistant Klebsiella pneumoniae Using Machine Learning and MALDI-TOF MS Platform.

Background: Rapid detection of carbapenem-resistant Klebsiella pneumoniae (CRKP) is essential for specific antimicrobial therapy. Machine learning techniques combined with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) can be used as a rapid, reliable, sensitive, and low-cost species identification method. Methods: Clinically collected K. pneumoniae were subjected to MALDI-TOF MS analysis. A random forest (RF) algorithm and non-linear support vector machine (SVM) were used to construct the RF, SVM, and dimension reduction (SVM-K) models, and their performance was assessed for accuracy, sensitivity, specificity, and area under the subject worker curve (AUC). Results: The RF, SVM and SVM-K models showed good classification performance with 0.88, 0.88, and 0.91 accuracy, 0.82, 0.85, and 0.89 sensitivity, 0.93, 0.92, and 0.94 specificity with an AUC of 0.9013, 0.9298, and 0.9356, respectively. For the SVM-K model, the optimal dimension reduction was 105 to 153, and the average accuracy was >0.9. The top 10 peak features of significance according to the RF algorithm with 6515 Da appeared in 56.8% of CRKP isolates and 5.3% of CSKP isolates, which indicated the best classification performance. Conclusion: The three RF, SVM, and SVM-K models showed excellent classification performance differentiating the CRKP from CSKP; the SVM-K model was the best. Data analysis with machine learning combined with MALDI-TOF MS can be employed as a rapid and inexpensive alternative to existing detection methods.

Immunosuppressed Patients with Clinically Diagnosed Invasive Fungal Infections: The Fungal Species Distribution, Antifungal Sensitivity and Associated Risk Factors in a Tertiary Hospital of Anhui Province.

OBJECTIVE: Since the nosocomial fungal infections increasingly emerge, we extensively investigated the fungal species stratification and antifungal sensitivity profiles, clinical characteristics and associated risk factors of immunosuppressed patients with clinically diagnosed invasive fungal infections (IFIs) in a tertiary hospital of Anhui province. METHODS: In total, 112 subjects with immunosuppressive state were enrolled from a comprehensive tertiary hospital in Central China between July 2019 and December 2021. Eight-one fungal isolates were clinically recovered by fungus-culturing approaches. The identifications were conducted through a mass spectrometry detecting platform. The susceptibilities to antifungals were tested using the broth micro-dilution method, and the possible antifungal azole-resistance mechanism in specific Candida species was availably explored by sequencing. Patient medical profiles were accessed via the digitized retrieval system of hospital, from which clinical outcomes and multiple risk factors for immunosuppressed patients with clinically diagnosed IFIs were explicitly documented for evaluation. RESULTS: Candida species predominated in clinically diagnosed IFIs of immunosuppressed patients (accounting for 88.88%), followed by Trichosporon and Aspergillus species (6.17% and 4.94%, respectively). The source types of specimen were primarily comprised of urine (41.98%), respiratory samples (33.33%) and peripheral blood (9.88%). Frequently isolated Candida and Trichosporon species exhibited a high level of in vitro sensitivity for amphotericin B and 5-fluorocytosine, whereas a substantial portion of Candida species including C. glabrata, C. parapsilosis complex and C. tropicalis, and Trichosporon species showed lowered sensitivity patterns toward itraconazole, fluconazole and voriconazole at different levels. Specifically, gene mutations of ERG11 were identified in azole-resistant C. tropicalis. Distinct risk factors were analyzed to be highly associated with the clinically diagnosed IFI incidence, mainly including hospitalization duration, surgical procedures, immunosuppressive treatments, underlying diseases and other conditions. CONCLUSION: Candida, Trichosporon and Aspergillus species were the top three pathogenic fungal agents causing clinically diagnosed IFIs in immunosuppressed patients. The attenuated sensitivity to azoles in Candida and Trichosporon species needs close surveillance, and ERG11 polymorphism might contribute to azole resistance in specific Candida species. Multiple featured risk factors for immunosuppressed patients developing clinically diagnosed IFIs require further consideration during clinical practice.

Applying a Psychological Nursing Care Quality Evaluation Index in hospitalized patients: A pilot study.

Psychological problems have become a significant public health problem. Appropriate mental health care is crucial in promoting patient care quality. This study aimed to test the feasibility of a Psychological Nursing Quality Evaluation Index in hospitalized patients. This is a pilot study with patients hospitalized with myocardial infarction from July to September 2020 in China. The researchers used an observational approach to examine nurses' psychological health care performance based on the Psychological Nursing Quality Evaluation Index. The results indicated high compliance rates of nurses' psychological care performance, which provides references for evaluating and monitoring inpatient psychological nursing care.

Evaluating the Clinical Performance of a Dual-Target Stool DNA Test for Colorectal Cancer Detection.

The dual-target stool DNA test, iColocomf, has potential utility for colorectal cancer (CRC) detection, but its clinical accuracy has not been validated on larger groups. We therefore evaluated the performance of iColocomf in a multicenter clinical trial. In this double-blinded case-control study, 1164 participants from three independent hospitals, including 320 CRC patients, 148 adenomas, 396 interfering diseases, and 300 healthy controls were enrolled. The primary indicators of sensitivity, specificity, and accuracy were estimated. Stool samples of participants were collected and tested by the assay. The test results were then verified by Sanger sequencing and retesting of resected participants. The sensitivity and specificity for CRC detection were 95.31% and 96.67%, respectively, with an accuracy of 90.29%. When combining the interfering diseases, the specificity was 88.39%. No statistically significant variations of positive detection rates were observed for the test in different patients' clinical features. For advanced adenomas (n = 38) and nonadvanced adenomas (n = 110), the sensitivities were 63.16% and 33.64%, respectively. The average accuracy was 99.62% for the methylation status of 375 samples verified by Sanger sequencing, and 94.12% for 34 participants who received the test after surgical resection. The iColocomf test showed robust performance for the early detection of colorectal cancer and potential monitoring ability in clinical practice.

Study on the Effect and Application Value of Heat-Inactivated Serum on the Detection of Thyroid Function, Tumor Markers, and Cytokines During the SARS-CoV-2 Pandemic.

Purpose: The current explored the impact of heat inactivation of blood samples on the results of a particular clinical test and its potential application value during the SARS-CoV-2 pandemic. We have aimed at providing a reference for clinical testing methods during the pandemic. Methods: Blood samples were selected from our department's routine clinical examination between January 2021 and June 2021. The levels of these samples for quantitative detection of these indicators in each group (n = 90 cases/group) covered normal reference ranges and medically determined levels. For qualitative testing of the indicators, the specimens were additionally classified as negative, weakly positive, and positive (n = 20 cases/group). The specimens were then inactivated, and the differences in relevant indicators before and after inactivation were evaluated. Results: A statistically significant difference was evident between the levels of TSH, T3, FT4, FT3, AFP, NSE, CYFRA211, IRI, IL-1ß, IL-6, IL-8, IL-10, IL-2R, and TNF-α in the non-inactivated group 1 and the inactivated group 1 (P < 0.05). Among them, there was a strong correlation between TSH, T3, FT4, FT3, CYFRA211, IRI, IL-1ß, IL-6, IL-8, and IL-2R levels in the two groups (P < 0.05), however, there was no correlation between AFP (P = 0.256) and NSE (P = 0.352) levels between the two groups (P > 0.05). The detected values of low-level AFP (<4 ng/mL), IL-10, and TNF-α after inactivation were all lower than the detection limit. There was not any statistically significant difference in the levels of tumor markers, such as CEA, CA125, CA724, CA199, CA153, and the quantitative levels of T4, Vit. D, HCG, CPS, and five items of hepatitis B virus (P > 0.05). The positive rate of anti-nuclear antibodies after inactivation was not statistically different from the ones observed before inactivation (P > 0.05). Upon correction by the regression equation, the observed levels of TSH, T3, FT4, FT3, CYFRA211, IRI, IL-1ß, IL-6, IL-8, and IL-2R were not significantly different from those before inactivation (P > 0.05). Conclusion: The heat inactivation of blood samples had different various effects on different test indicators, and some indicators could be corrected by employing regression equations. This detection method could potentially be employed during the SARS-CoV-2 pandemic, thereby effectively preventing iatrogenic infections.

A Preliminary Study on the Promotion of Canine Adipose-Derived Stem Cell Differentiation by Perfusion-Decellularized Ureter Matrix.

BACKGROUND: This study was to assess the possibility of the perfusing decellularized ureters (DUs) promoting the differentiation of the canine adipose stem cell (cASCs). METHODS: cASCs were isolated and cultured in different induction media to determine their multidirectional differentiation potential. The perfusion system was used to prepare the DUs, and the prepared DUs were systematically evaluated. The DU coating was prepared by enzymatic digestion for cell culture. The cASCs were seeded on the coverslips covered with DU coating and samples were collected on days 3, 7, and 10. Immunofluorescence staining and molecular biology testing were used to examine the differentiation of cASCs seeded on the DU coating. RESULTS: The cASCs were isolated and identified by flow cytometry. The prepared DUs removed the nuclear materials, and the 3-dimensional structure and biological compositions of the ureter were well preserved. Immunofluorescence staining showed the expression of anti-alpha smooth muscle actin (α-SMA). Western blot results suggested that the content of α-SMA in the experimental group was significantly higher than that in the control group at 3 different time points, and the mRNA expressions of α-SMA in the experimental group gradually increased with extended the culture time, whereas there was no significant change in the control group. CONCLUSION: The cASCs seeded on the coverslips of DU coating could differentiate into smooth muscle cells, and the number of differentiated cASCs increased significantly with extended incubation time.

Immunization with Pneumocystis carinii A121-85 antigen activates immune function against P. carinii.

BACKGROUND: Pneumocystis pneumonia (PcP), which is caused by Pneumocystis carinii, is a life-threatening infection that affects immunocompromised individuals. Unfortunately, chemoprophylaxis and dapsone are only effective for half of the patients with PcP, indicating that additional preventive methods are needed. We predicated the pneumocystis surface protein A12 sequence 1-85 by DNAStar software and BepiPred, and identified it as a potential vaccine candidate by bioresearch. METHODS: We used recombinant A121-85 as antigen to immunized mice and detected serum titer of IgG, expression of inflammatory factors by EILSA, qRT-PCR and flow cytometry. RESULTS: Our results showed that immunization with recombinant A121-85 increased the serum titer of IgG, promoted the secretion of T lymphocytes, increased the expression of inflammatory factors, and elevated lung inflammatory injury in mice. CONCLUSIONS: Our findings suggest that A121-85 is a potential vaccine target for preventing Pneumocystis carinii. The evaluation of A121-85-elicited antibodies in the prevention of PcP in humans deserves further investigation.

Robot-assisted radical cystectomy with intracorporeal Mainz â ¡ rectosigmoid pouch for muscle-invasive bladder cancer.

BACKGROUND: To report the surgical techniques and results of robot-assisted radical cystectomy (RARC) with intracorporeal Mainz Ⅱ rectosigmoid pouch at our centre. METHODS: Two female patients were treated with this procedure. Construction of the pouch was divided into four main steps: incision of the rectum and sigmoid colon, closure of the posterior wall of the pouch, reimplantation of the ureters at the bottom of pouch in an anti-reflux manner, and closure of the anterior wall. Surgical results and perioperative complications were assessed. RESULTS: The operations were performed completely intracorporeally. No perioperative complications were observed. Postoperatively, high-grade invasive urothelial carcinoma was detected. On postoperative day 60, no bilateral ureteral dilation was detected. Two patients demonstrated total continence. Clinical recurrence was not observed during the follow-up period. CONCLUSIONS: With careful patient selection, robot-assisted intracorporeal Mainz Ⅱ rectosigmoid pouch might be a simple minimally invasive surgical technique to be evaluated in repeated applications.

Risk Factors, Molecular Epidemiology, and Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Infection for Hospital-Acquired Pneumonia: A Matched Case-Control Study in Eastern China During 2015-2017.

This study was conducted to acknowledge microbiological and clinical characteristics of hospital-acquired pneumonia (HAP) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). A retrospective, 1:1 matched (age, gender, specimen source, and ward) case-control study was conducted during 2015-2017 in a tertiary teaching hospital in Anhui, China. Multivariate logistic regression analysis demonstrated that prior central venous catheter use, sputum suction, continuous renal replacement therapy, and exposure to fluroquinolones were independent risk factors for the morbidity of CRKP infection for HAP. Treatment failure for infection was an independent risk factor for crude in-hospital mortality, while the use of fluroquinolones may improve the effective treatment for infection (p = 0.040). Among 74 CRKP strains, 85.1% of them were positive for the production of KPC-2, and one of them was detected for co-harboring blaKPC-2 and blaIMP-38-like. Separately, sequence type (ST) 11 (81.1%) was the predominant ST in this study, and ST11 CRKP isolates were related with higher detection rate of blaKPC-2 and lower resistance rate to trimethoprim/sulfamethoxazole when compared with non-ST11 ones. Moreover, resistance to carbapenem was associated with higher mortality (35.1%) and hospitalization costs for HAP patients with K. pneumoniae infection. Invasive procedures may increase the morbidity of CRKP infection for HAP. Prior exposure to fluroquinolones is associated with the development of resistance, but as a targeted treatment it may be effective.