Rapid Detection of Bacterial Pathogens Causing Lower Respiratory Tract Infections via Microfluidic-Chip-Based Loop-Mediated Isothermal Amplification.

Respiratory tract infections (RTIs) are among the most common problems in clinical settings. Rapid and accurate identification of bacterial pathogens will provide practical guidelines for managing and treating RTIs. This study describes a method for rapidly detecting bacterial pathogens that cause respiratory tract infections via multi-channel loop-mediated isothermal amplification (LAMP). LAMP is a sensitive and specific diagnostic tool that rapidly detects bacterial nucleic acids with high accuracy and reliability. The proposed method offers a significant advantage over traditional bacterial culturing methods, which are time-consuming and often require greater sensitivity for detecting low levels of bacterial nucleic acids. This article presents representative results of K. pneumoniae infection and its multiple co-infections using LAMP to detect samples (sputum, bronchial lavage fluid, and alveolar lavage fluid) from the lower respiratory tract. In summary, the multi-channel LAMP method provides a rapid and efficient means of identifying single and multiple bacterial pathogens in clinical samples, which can help prevent the spread of bacterial pathogens and aid in the appropriate treatment of RTIs.

Rapid discrimination of four Salmonella enterica serovars: A performance comparison between benchtop and handheld Raman spectrometers.

Foodborne illnesses, particularly those caused by Salmonella enterica with its extensive array of over 2600 serovars, present a significant public health challenge. Therefore, prompt and precise identification of S. enterica serovars is essential for clinical relevance, which facilitates the understanding of S. enterica transmission routes and the determination of outbreak sources. Classical serotyping methods via molecular subtyping and genomic markers currently suffer from various limitations, such as labour intensiveness, time consumption, etc. Therefore, there is a pressing need to develop new diagnostic techniques. Surface-enhanced Raman spectroscopy (SERS) is a non-invasive diagnostic technique that can generate Raman spectra, based on which rapid and accurate discrimination of bacterial pathogens could be achieved. To generate SERS spectra, a Raman spectrometer is needed to detect and collect signals, which are divided into two types: the expensive benchtop spectrometer and the inexpensive handheld spectrometer. In this study, we compared the performance of two Raman spectrometers to discriminate four closely associated S. enterica serovars, that is, S. enterica subsp. enterica serovar dublin, enteritidis, typhi and typhimurium. Six machine learning algorithms were applied to analyse these SERS spectra. The support vector machine (SVM) model showed the highest accuracy for both handheld (99.97%) and benchtop (99.38%) Raman spectrometers. This study demonstrated that handheld Raman spectrometers achieved similar prediction accuracy as benchtop spectrometers when combined with machine learning models, providing an effective solution for rapid, accurate and cost-effective identification of closely associated S. enterica serovars.

Resolvins protect against diabetes-induced colonic oxidative stress, barrier dysfunction, and associated diarrhea via the HO-1 pathway.

Diabetes is associated with increased oxidative stress, leading to altered tight junction formation and increased apoptosis in colonic epithelial cells. These changes may lead to intestinal barrier dysfunction and corresponding gastrointestinal symptoms in patients with diabetes, including diarrhea. The aim of this study was to characterize the effect and mechanism of Resolvin D1 (RvD1) on diabetes-induced oxidative stress and barrier disruption in the colon. Mice with streptozotocin-induced diabetes were treated with RvD1 for 2 weeks, then evaluated for stool frequency, stool water content, gut permeability, and colonic transepithelial electrical resistance as well as production of reactive oxygen species (ROS), apoptosis, and expression of tight junction proteins Zonula Occludens 1 (ZO-1) and occludin. The same parameters were assessed in human colonoid cultures subjected to elevated glucose. We found that RvD1 treatment did not affect blood glucose, but normalized stool water content and prevented intestinal barrier dysfunction, epithelial oxidative stress, and apoptosis. RvD1 also restored ZO-1 and occludin expression in diabetic mice. RvD1 treatment increased phosphorylation of Akt and was accompanied by a 3.5-fold increase in heme oxygenase-1 (HO-1) expression in the epithelial cells. The protective effects of RvD1 were blocked by ZnPP, a competitive inhibitor of HO-1. Similar findings were observed in RvD1-treated human colonoid cultures subjected to elevated glucose. In conclusion, Oxidative stress in diabetes results in mucosal barrier dysfunction, contributing to the development of diabetic diarrhea. Resolvins prevent ROS-mediated mucosal injury and protect gut barrier function by intracellular PI3K/Akt activation and subsequent HO-1 upregulation in intestinal epithelial cells. These actions result in normalizing stool frequency and stool water content in diabetic mice, suggesting that resolvins may be useful in the treatment of diabetic diarrhea.

Association between fecal short-chain fatty acid levels and constipation severity in subjects with slow transit constipation.

OBJECTIVE: We measured the fecal levels of short-chain fatty acids (SCFAs) in subjects with slow transit constipation (STC) and assessed the correlation between SCFA levels and disease severity as well as quality of life. METHODS: We isolated the supernatant from fecal samples of healthy and STC subjects and measured the SCFA levels. To assess the correlation between fecal SCFA levels and disease severity as well as quality of life, we used the Constipation Scoring System, Patient Assessment of Constipation Symptoms, and Patient Assessment of Constipation Quality of Life questionnaires. RESULTS: 16 STC subjects and 16 healthy controls were enrolled. STC subjects had lower SCFA levels, but the difference was not statistically significant (475.85 ±â€…251.68 vs. 639.77 ±â€…213.97 µg/ml, P = 0.056). Additionally, STC subjects had lower acetic and propionic acid levels (149.06 ±â€…88.54 vs. 261.33 ±â€…109.75 µg/ml and 100.60 ±â€…60.62 vs. 157.34 ±â€…66.37 µg/ml, respectively, P < 0.05) and higher isobutyric and isovaleric acid levels (27.21 ±â€…15.06 vs. 18.16 ±â€…8.65 µg/ml and 31.78 ±â€…18.81 vs. 16.90 ±â€…10.05 µg/ml, respectively, P < 0.05). At 252.21 µg/ml acetic acid, the specificity and sensitivity to distinguish healthy from STC subjects were 93.7% and 56.3%, respectively. In STC subjects, there were significant negative correlations between acetic and propionic acid levels and Constipation Scoring System scores. CONCLUSION: Fecal SCFA, acetic acid, and propionic acid levels decreased in STC subjects. There were significant negative correlations between the levels of the two acids and constipation severity.

A Case of Invasive Fungal Infection Due to Scedosporium apiospermum in a Patient with Psoriasis.

Scedosporium apiospermum (S. apiospermum) is typically reported to be involved in superficial and subcutaneous fungal infections but overlooked in invasive infections, which is associated with a high mortality rate. It poses a diagnostic challenge due to its confusable characteristics to other hyaline hyphomycetes. Here, we reported a psoriasis patient with an invasive S. apiospermum infection. The patient presents an abscess at the intermuscular space of the left hip and an increased C-reactive protein level. Pus culture showed white-greyish, cottonlike colonies with aerial mycelium and terminal oval conidia, suggesting S. apiospermum. This rare fungus was rapidly confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and RNA sequencing. The patient was successfully treated with voriconazole with no recurrence of the abscesses despite delayed treatment. This is the first such case infection report from China that described an unusual case of intermuscular space abscesses due to S. apiospermum. This report highlights the possibility of fungal infections in deeper tissue, as well as the necessity of thorough evaluation and microbiological diagnosis for invasive infections, particularly in immunocompromised patients.

Estrogen increases the expression of BKCa and impairs the contraction of colon smooth muscle via upregulation of sphingosine kinase 1.

Estrogen (E2) may impair the contraction of colonic smooth muscle (SM) leading to constipation. Large conductance Ca2+ -activated K+ channels (BKCa ) are widely expressed in the smooth muscle cells (SMCs) contributing to hyperpolarization and relaxation of SMCs. Sphingosine kinase 1 (SphK1) is known to influence the expression of BKCa . We aimed to elucidate the potential underlying molecular mechanism of BKCa and SphK1 that may influence E2-induced colonic dysmotility. In ovariectomized rats, SM contraction and expression of BKCa , SphK1, sphingosine-1-phosphate receptor (S1PR) were analyzed after the treatment with vehicle, BSA-E2, E2, and E2 receptor antagonist. The role of BKCa , SphK1, and S1PR in E2-induced SM dysmotility was investigated in rat colonic SMCs. The effect of SphK1 on SM contraction as well as on the expression of BKCa and S1PR was analyzed in SphK1 knock-out mutant mice and wild-type (WT) mice treated with or without E2. The E2-treated group exhibited a weak contraction of colonic SM and a delayed colonic transit. The treatment with E2 significantly upregulated the expression of BKCa , SphK1, S1PR1, and S1PR2, but not S1PR3, in colon SM and SMCs. Inhibition of BKCa , SphK1, S1PR1, and S1PR2 expression attenuated the effect of E2 on Ca2+ mobilization in rat colon SMCs. WT mice treated with E2 showed impaired gastrointestinal motility and enhanced expression of BKCa , S1PR1, and S1PR2 compared with those without E2 treatment. Conversely, in SphK1 knock-out mice treated with E2, these effects were partially reversed. E2 increased the release of S1P which in turn could have activated S1PR1 and S1PR2. Loss of SphK1 attenuated the effect of E2 on the upregulation of S1PR1 and S1PR2 expression. These findings indicated that E2 impaired the contraction of colon SM through activation of BKCa via the upregulation of SphK1 and the release of S1P. In the E2-induced BKCa upregulation, S1PR1 and S1PR2 might also be involved. These results may provide further insights into a therapeutic target and optional treatment approaches for patients with constipation.

Esophagogastric Junction Outflow Obstruction Is Likely to Be a Local Manifestation of Other Primary Diseases: Analysis of Single-Center 4-Year Follow-Up Data.

BACKGROUND: Whether esophagogastric junction outflow obstruction (EGJOO) is a variant of achalasia cardia (AC) or an esophageal motility state of certain organic or systemic diseases remains controversial. We aimed to investigate the differences between EGJOO and AC in clinical characteristics and outcomes through a 4-year follow-up. METHODS: Patients diagnosed with primary EGJOO or AC were included. Based on the presence of concomitant disease, EGJOO patients were divided into a functional and an anatomical EGJOO group; similarly, patients with AC were divided into an AC with organic disease group and a true AC group. Disease characteristics and high-resolution manometry (HRM) parameters were retrospectively compared between the groups, and the development of organic diseases that could affect esophageal motility disorders and responses to treatment were examined during the follow-up. Symptom relief was defined as an Eckardt score of ≤3 after the treatment. RESULTS: The study included 79 AC patients and 70 EGJOO patients. Compared with patients with AC, EGJOO patients were older, had shorter disease duration, a lower Eckardt score, and were more likely to have concurrent adenocarcinoma of the esophagogastric junction (AEG) and autoimmune disease (p < 0.05 for all). The severity of dysphagia and Eckardt scores were higher in the anatomical EGJOO group than in the functional EGJOO group. Significant differences were seen in HRM parameters (UES residual pressure, LES basal pressure, and LES residual pressure) between AC and EGJOO patients. However, no significant differences in HRM parameters were observed between the functional EGJOO and anatomical EGJOO groups. Sixty-seven (95.71%) patients with EGJOO and sixty-nine (87.34%) patients with AC experienced symptom relief (p = 0.071). Among patients achieving symptom relief, a relatively large proportion of patients with EGJOO had symptom relief after medications (37/67, 55.22%), the resolution of potential reasons (7/67, 10.45%), and spontaneous relief (15/67, 22.39%), while more patients with AC had symptom relief after POEM (66/69, 95.65%). Among EGJOO patients achieving symptom relief, more patients (7/20, 35%) with anatomical EGJOO had symptom relief after the resolution of potential reasons for EGJOO, while more patients (32/47, 68.09%) with functional EGJOO had symptom relief with medications. CONCLUSIONS: Concurrent AEG and autoimmune diseases are more likely in EGJOO than in AC. A considerable part of EGJOO may be the early manifestation of an organic disease. Anatomical EGJOO patients experience symptom improvement with the resolution of primary diseases, while most functional EGJOO patients experience symptom relief with pharmacotherapy alone or even without any treatment.

Heterogeneous Metallaphotocatalytic C(sp2)-C(sp3) Cross-Coupling Reactions with Integrated Bipyridyl-Ni(II)-Carbon Nitride.

A fully heterogeneous metallaphotocatalytic C-C cross-coupling of aryl/vinyl halides with alkyl/allyltrifluoroborates has been developed by employing integrated bipyridyl-Ni(II)-carbon nitride as a stable and recyclable bifunctional catalyst. This visible-light-mediated heterogeneous protocol allows for the sustainable synthesis of diverse valuable diarylmethanes and allylarenes in high efficiency.

Case Report: Double trouble: a rare case of successfully treated Mycoplasma hominis and Pseudomonas aeruginosa co-infection.

Background: Extra-urogenital infections due to Mycoplasma hominis (M. hominis) are rare, particularly co-infection with Pseudomonas aeruginosa (P. aeruginosa). Herein, we report on a patient who was co-infected and successfully treated despite delayed treatment. Case presentation: We reported the case of a 43-year-old man with M. hominis and P. aeruginosa co-infection after a traffic accident. The patient developed a fever and severe infection despite postoperative antimicrobial therapies. The blood culture of wound tissues was positive for P. aeruginosa. Meanwhile, culturing of blood and wound samples showed pinpoint-sized colonies on blood agar plates and fried-egg-type colonies on mycoplasma medium, which were identified as M. hominis by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16S rRNA sequencing. Based on antibiotic susceptibility and symptoms, ceftazidime-avibactam and moxifloxacin were administered for P. aeruginosa infection. Meanwhile, after the failure of a series of anti-infective agents, M. hominis and P. aeruginosa co-infection was successfully treated with a minocycline-based regimen and polymyxin B. Conclusion: The co-infection with M. hominis and P. aeruginosa was successfully treated with anti-infective agents despite delayed treatment, providing information for the management of double infection.

Poly(heptazine imide) ligand exchange enables remarkable low catalyst loadings in heterogeneous metallaphotocatalysis.

The development of heterogeneous metallaphotocatalysis is of great interest for sustainable organic synthesis. The rational design and controllable preparation of well-defined (site-isolated) metal/photo bifunctional solid catalysts to meet such goal remains a critical challenge. Herein, we demonstrate the incorporation of privileged homogeneous bipyridyl-based Ni-catalysts into highly ordered and crystalline potassium poly(heptazine imide) (K-PHI). A variety of PHI-supported cationic bipyridyl-based Ni-catalysts (LnNi-PHI) have been prepared and fully characterized by various techniques including NMR, ICP-OES, XPS, HAADF-STEM and XAS. The LnNi-PHI catalysts exhibit exceptional chemical stability and recyclability in diverse C-P, C-S, C-O and C-N cross-coupling reactions. The proximity and cooperativity effects in LnNi-PHI significantly enhances the photo/Ni dual catalytic activity, thus resulting in low catalyst loadings and high turnover numbers.

Characteristics of fecal microbiota in different constipation subtypes and association with colon physiology, lifestyle factors, and psychological status.

Background: Patients with chronic constipation (CC) show altered gut microbial composition. Objectives: To compare the fecal microbiota with different constipation subtypes and to identify potential influencing factors. Design: This is a prospective cohort study. Methods: The stool samples of 53 individuals with CC and 31 healthy individuals were analyzed using 16S rRNA sequencing. The associations between microbiota composition and colorectal physiology, lifestyle factors, and psychological distress were analyzed. Results: In all, 31 patients with CC were classified as having slow-transit constipation, and 22 were classified under normal-transit constipation. The relative abundance of Bacteroidaceae was lower, and the relative abundance of Peptostreptococcaceae, Christensenellaceae, and Clostridiaceae was higher in slow-transit than in normal-transit group. In all, 28 and 25 patients with CC had dyssynergic defecation (DD) and non-DD, respectively. The relative abundance of Bacteroidaceae and Ruminococcaceae was higher in DD than in non-DD. Rectal defecation pressure was negatively correlated with the relative abundance of Prevotellaceae and Ruminococcaceae but positively correlated with that of Bifidobacteriaceae in CC patients. Multiple linear regression analysis suggested that depression was a positive predictor of Lachnospiraceae relative abundance, and sleep quality was an independent predictor of decreased relative abundance of Prevotellaceae. Conclusion: Patients with different CC subtypes showed different characteristics of dysbiosis. Depression and poor sleep were the main factors that affected the intestinal microbiota of patients with CC. Plain language summary: Characteristics of fecal microbiota in different constipation subtypes and association with colon physiology, lifestyle factors, and psychological status Patients with chronic constipation (CC) show altered gut microbial composition. Previous studies in CC are limited by lacking of subtype stratification, which is reflected in the lack of agreement in findings across the large number of microbiome studies. We analyzed stool microbiome of 53 CC patients and 31 healthy individuals using 16S rRNA sequencing. We found that the relative abundance of Bacteroidaceae was lower, and the relative abundance of Peptostreptococcaceae, Christensenellaceae, and Clostridiaceae was higher in slow-transit than in normal-transit CC patients. The relative abundance of Bacteroidaceae and Ruminococcaceae was higher in dyssynergic defecation (DD) than in non-DD patients with CC. In addition, depression was a positive predictor of Lachnospiraceae relative abundance, and sleep quality was an independent predictor of decreased relative abundance of Prevotellaceae in all CC patients. This study emphasizes patients with different CC subtypes have different characteristics of dysbiosis. Depression and poor sleep may be the main factors that affect the intestinal microbiota of patients with CC.

Delay in seeking health care from community residents during a time with low prevalence of COVID-19: A cross-sectional national survey in China.

Background: The pandemic of COVID-19 has significant implications on health resources allocation and health care delivery. Patients with non-COVID illness may have to change their care seeking behaviors to mitigate the risk of infections. The research aimed to investigate potential delay of community residents in seeking health care at a time with an overall low prevalence of COVID-19 in China. Methods: An online survey was conducted in March 2021 on a random sample drawn from the registered survey participants of the survey platform Wenjuanxing. The respondents who reported a need for health care over the past month (n = 1,317) were asked to report their health care experiences and concerns. Logistic regression models were established to identify predictors of the delay in seeking health care. The selection of independent variables was guided by the Andersen's service utilization model. All data analyses were performed using SPSS 23.0. A two-sided p value of <0.05 was considered as statistically significant. Key results: About 31.4% of respondents reported delay in seeking health care, with fear of infection (53.5%) as a top reason. Middle (31-59 years) age (AOR = 1.535; 95% CI, 1.132 to 2.246), lower levels of perceived controllability of COVID-19 (AOR = 1.591; 95% CI 1.187 to 2.131), living with chronic conditions (AOR = 2.008; 95% CI 1.544 to 2.611), pregnancy or co-habiting with a pregnant woman (AOR = 2.115; 95% CI 1.154 to 3.874), access to Internet-based medical care (AOR = 2.529; 95% CI 1.960 to 3.265), and higher risk level of the region (AOR = 1.736; 95% CI 1.307 to 2.334) were significant predictors of the delay in seeking health care after adjustment for variations of other variables. Medical consultations (38.7%), emergency treatment (18.2%), and obtainment of medicines (16.5%) were the top three types of delayed care, while eye, nose, and throat diseases (23.2%) and cardiovascular and cerebrovascular diseases (20.8%) were the top two conditions relating to the delayed care. Self-treatment at home was the most likely coping strategy (34.9%), followed by Internet-based medical care (29.2%) and family/friend help (24.0%). Conclusions: Delay in seeking health care remained at a relatively high level when the number of new COVID-19 cases was low, which may present a serious health risk to the patients, in particular those living with chronic conditions who need continuous medical care. Fear of infection is the top reason for the delay. The delay is also associated with access to Internet-based medical care, living in a high risk region, and perceived low controllability of COVID-19.

Clinical significance and related factors of rectal hyposensitivity in patients with functional defecation disorder.

Background: Rectal hyposensitivity (RH) is not uncommon in patients with functional defecation disorder (FDD). FDD patients with RH are usually unsatisfied with their treatment. Aims: The aim of this study was to find the significance of RH in patients with FDD and the related factors of RH. Methods: Patients with FDD first completed clinical questionnaires regarding constipation symptoms, mental state, and quality of life. Then anorectal physiologic tests (anorectal manometry and balloon expulsion test) were performed. Rectal sensory testing (assessing rectal response to balloon distension using anorectal manometry) was applied to obtain three sensory thresholds. Patients were separated into three groups (non-RH, borderline RH, and RH) based on the London Classification. The associations between RH and clinical symptoms, mental state, quality of life, and rectal/anal motility were investigated. Results: Of 331 included patients with FDD, 87 patients (26.3%) had at least one abnormally elevated rectal sensory threshold and 50 patients (15.1%) were diagnosed with RH. Patients with RH were older and mostly men. Defecation symptoms were more severe (p = 0.013), and hard stool (p < 0.001) and manual maneuver (p = 0.003) were more frequently seen in the RH group. No difference in rectal/anal pressure was found among the three groups. Elevated defecatory desire volume (DDV) existed in all patients with RH. With the number of elevated sensory thresholds increasing, defecation symptoms got more severe (r = 0.35, p = 0.001). Gender (male) (6.78 [3.07-15.00], p < 0.001) and hard stool (5.92 [2.28-15.33], p < 0.001) were main related factors of RH. Conclusion: Rectal hyposensitivity plays an important role in the occurrence of FDD and is associated with defecation symptom severity. Older male FDD patients with hard stool are prone to suffer from RH and need more care.

Technological parameter optimization for walnut shell-kernel winnowing device based on neural network.

The detection method for technological parameter is outdates as the traditional test cycle is long as well as the measurement error and the test amount are huge. Moreover, it is difficult to disclose the operation mechanism of devices as the operation is time-consuming and laborious. Therefore, numerical simulation was used in this study to reveal the mechanism of the walnut shell-kernel winnowing device. Moreover, the influence of baffle opening combinations, inlet wind velocity and inlet angle on cleaning rate and loss rate was predicted by the neural network model. The results demonstrated that inlet wind velocity was the primary influencing factor of cleaning rate, followed by baffle opening and inlet angle. Besides, inlet wind velocity was the primary influencing factor of loss rate, followed by inlet angle and baffle opening. The winnowing device performed best (79.91% cleaning rate, 14.37% loss rate) when the baffle opening, inlet wind velocity and inlet angle were 7.01 cm, 24.36 m/s, and 9.47°. In addition, 1/8 walnut shells and 1/4 walnut kernels were incorrectly classified due to the increase in inlet wind velocity. The inlet wind velocity was considered the major cause behind the deteriorating winnowing performance of the device. Finally, the bench test and simulation optimization results were compared. The cleaning rate and loss rate relative error during the simulation test was lower than 1.06%, which ascertained the feasibility and validity of the neural network as well as the combined numerical simulation method. This study could be useful for future research and development of shell-kernel winnowing devices for hard nuts.

Clinical Characteristics of Adult Functional Constipation Patients with Rectoanal Areflexia and Their Response to Biofeedback Therapy.

Background: The London Classification for anorectal physiological dysfunction specifically proposes rectoanal areflexia (RA), which means the absence of a rectoanal inhibitory reflex (RAIR) based on a manometric diagnosis. Although RA is not observed in healthy people, it can be found in adult patients with functional constipation (FC). This study describes the clinical manifestations of adult patients with FC and RA and their response to biofeedback therapy (BFT). Methods: This retrospective study reviewed the reports of high-resolution anorectal manometry (HR-ARM) and the efficacy of BFT in adult patients with FC. In addition, the Constipation Scoring System (CSS) scale, Patient Assessment of Constipation Symptoms (PAC-SYM) scale, Patient Assessment of Constipation Quality of Life (PAC-QOL) scale, Zung's Self-Rating Anxiety Scale (SAS), Zung's Self-Rating Depression Scale (SDS), balloon expulsion test (BET), and the use of laxatives were assessed. Results: A total of 257 adult patients diagnosed with FC were divided into the RA group (n = 89) and the RAIR group (n = 168). In the RA and RAIR groups, 60 (67.4%) and 117 (69.6%) patients, respectively, had dyssynergic defecation (DD) during simulated defecation. Type II pattern of dyssynergia was most frequently observed in both groups. Compared with the RA group, the RAIR group showed a higher CSS score, physical discomfort score, and prevalence of inadequate relaxation of the anal sphincter (p < 0.001, p = 0.036, and p = 0.017, respectively). The anxiety and depression scores were not different between the two groups. The proportion of patients using volumetric and stimulant laxatives and their combination was significantly higher in FC patients with RA, whereas the efficacy of BFT was significantly lower (p = 0.005, p < 0.001, p = 0.045, and p = 0.010, respectively). Conclusion: Adult FC patients with RA may suffer more severe constipation and have a lower efficacy of BFT compared with those with RAIR.

Cu(I)/Chiral Vanadium Complex Cooperatively Catalyzed Asymmetric Sulfonation/Rearrangement of Alkenylfurans.

The asymmetric three-component rearrangement of alkenylfurans with various sulfonyl chlorides and anilines is developed via copper(I) and chiral vanadium cooperative catalysis, providing a facile access to a broad spectrum of sulfonyl-functionalized 4-aminocyclopentenones in high yields with excellent enantio- and diastereoselectivities.

Asymmetric Ketoalkylation/Rearrangement of Alkyenlfurans via Synergistic Photoredox/Brønsted Acid Catalysis.

An enantioselective three-component rearrangement of alkenylfurans with various cycloalkyl silyl peroxides and anilines has been developed by merging photoredox catalysis with chiral Brønsted acid catalysis. This protocol provides expedient access to a broad spectrum of ketoalkyl-functionalized 4-aminocyclopentenones in high yields with excellent enantio- and diastereoselectivities. Diverse functional groups can be introduced via facile product derivations.

Organocatalytic Asymmetric Synthesis of Bridged Tetrahydrobenzo[b]azepines/oxepines.

The asymmetric synthesis of bridged tetrahydrobenzo[b]azepine and oxepine derivatives through chiral Brønsted acid catalyzed asymmetric aza-Piancatelli rearrangement/Michael addition sequence has been developed. The reaction proceeds under mild reaction conditions to afford the final bridged cyclic products in good yields with excellent enantio- and diastereoselectivities.

Catheter-related infections caused by Mycobacterium abscessus in a patient with motor neurone disease: A case report.

BACKGROUND: Mycobacterium abscessus (M. abscessus) is a rapidly growing mycobacterium and ubiquitous in the environment, which infrequently causes disease in humans. However, it can cause cutaneous or respiratory infections among immunocompromised hosts. Due to the resistance to most antibiotics, the pathogen is formidable and difficult-to-treat. CASE SUMMARY: Here, we present a case of catheter-related M. abscessus infections in a patient with motor neurone disease. Catheter and peripheral blood cultures of the patient showed positive results during Gram staining and acid-fast staining. The alarm time of catheter blood culture was 10.6 h earlier than that of peripheral blood. After removal of the peripherally inserted central catheter, secretion and catheter blood culture were positive. M. abscessus was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry and 16S rDNA sequencing. CONCLUSION: For catheter-related M. abscessus infection, rapid diagnosis and timely and adequate antimicrobial therapy are crucial.

Effect of visfatin on KATP channel upregulation in colonic smooth muscle cells in diabetic colon dysmotility.

The mechanisms of diabetes-related gastrointestinal dysmotility remains unclear. This study aimed to investigate the effect and mechanisms of proinflammatory adipokine visfatin (VF) in the contractile dysfunction of diabetic rat colonic smooth muscle. Twenty Sprague-Dawley rats were randomly divided into control and type 2 diabetes mellitus groups. VF levels in the serum and colonic muscle tissues were tested, the time of the bead ejection and contractility of colonic smooth muscle strips were measured, and the expression of ATP-sensitive potassium (KATP) channels in the colonic muscle tissues was analyzed. In vitro, we tested VF's effects on intracellular reactive oxygen species (ROS) levels, NF-κB's nuclear transcription, KATP channel expression, intracellular Ca2+ concentrations, and myosin light chain (MLC) phosphorylation in colonic smooth muscle cells (CSMCs). The effects of NAC (ROS inhibitor) and BAY 11-7082 (NF-κB inhibitor) on KATP expression were also tested. Diabetic rats showed elevated VF levels in serum and colonic muscle tissues, a delayed distal colon ejection response time, weakened contractility of colonic smooth muscle strips, and increased KATP channel expression in colonic muscle tissues. VF significantly inhibited the contractility of colonic smooth muscle strips from normal rats. In cultured CSMCs, VF caused ROS overload, increased NF-κB nuclear transcription activity and increased expression of Kir6.1, eventually reducing intracellular Ca2+ levels and MLC phosphorylation. NAC and BAY 11-7082 inhibited the VF-induced Kir6.1 upregulation. In conclusion, VF may cause contractile dysfunction of CSMCs by upregulating the expression of the Kir6.1 subunit of KATP channels via the ROS/NF-κB pathway and interfering with Ca2+ signaling.