Shotgun metagenomics reveals significant gut microbiome features in different grades of acute pancreatitis.

BACKGROUND: Acute pancreatitis (AP) has a broad spectrum of severity and is associated with considerable morbidity and mortality. Dysbiosis of gut microbiota may be associated with AP severity. AIMS: We aimed to evaluate the composition and functional effects of gut microbiota in different grades of AP severity. METHODS: We carried out shotgun metagenomic sequencing on rectal swab samples from three patients with mild acute pancreatitis (MAP), three with moderately severe acute pancreatitis (MSAP), three with severe acute pancreatitis (SAP) and three normal control persons (NOR). Differences analysis in gut microbiota composition and functional enrichment was performed. RESULTS: Gut microbiota in AP patients was characterized by decreased species richness. The most representative gut microbiota in mild acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP) was Streptococcus, Escherichia-coli, and Enterococcus, respectively. Each of the three AP-associated genera could differentiate AP from healthy control population. Representative pathways associated with the glutathione metabolism, lipopolysaccharide biosynthesis, and amino acid metabolism (valine, leucine and isoleucine degradation) were enriched in MAP, MSAP, and SAP, respectively. CONCLUSIONS: The study shows a potential association of gut microbiome composition and function to the progression of AP severity.

The impact of mating competitiveness and incomplete cytoplasmic incompatibility on Wolbachia-driven mosquito population suppressio.

To control mosquito-borne diseases such as dengue, malaria, and Zika, {\it Wolbachia}-infected male mosquitoes have been released in open areas to suppress wild mosquito population driven by cytoplasmic incompatibility (CI). In this work, we initiate a preliminary assessment on how the CI intensity $\xi$, and the mating competitiveness $\mu$ of released males relative to wild males, impact the suppression efficacy by a delay differential equation model. Our analysis identifies a threshold CI intensity $\xi_0\in (0, 1)$ as an increasing function of the natural reproduction rate of the wild mosquitoes, and a threshold value $r^*$ for the ratio $r(t)$ between the numbers of released males and wild males. The population suppression fails when $\xi\le \xi_0$, and succeeds when $\xi>\xi_0$ and $r(t)\ge r^*$. Our analyses indicate that $\xi$ plays a more important role than $\mu$ in the population suppression. For instance, a slight decrease of $\xi$ from 1 to 0.92 is more devastating than halving $\mu$ from 1 to 0.5. In our estimation of the optimal starting date for infected male release to target a more than $95\%$ wild population reduction during the peak season of dengue in Guangzhou, we find that the optimal date is almost independent of $\mu$ but is sensitive to $\xi$. If CI is complete, then starting about two months ahead can be an optimal option for less financial and labor costs. A slight reduction in the CI intensity requires a considerably earlier starting date.

[Effects of combination of midazolam and propofol on anterograde amnesia in critical patients].

OBJECTIVE: To observe the effects of sedation with midazolam and propofol on anterograde amnesia in critical patients. METHODS: Sixty selected patients on mechanical ventilation in intensive care unit (ICU) were randomly divided into three subgroups (propofol, midazolam, and midazolam and propofol combination group), with 20 cases in each group. Patients who were awakened from sedation were showed with a card depicted with different colors, figures and numbers. When patients were totally conscious after weaning from mechanical ventilation,the influence of the different methods of sedation on anterograde amnesia of these critically ill patients was assessed. RESULTS: (1) 70%, 95% and 90% of patients manifested amnesia in propofol, midazolam and the combination group, respectively. All the patients recovered their memory immediately in 30 minutes after withdrawal of the sedatives. (2) When midazolam was compared with propofol and combination group, time of onset was obviously prolonged after an intravenous injection of a load dose in midazolam group [(2.7+/-1.1) minutes and (3.1+/-1.3) minutes vs. (5.1+/-2.8) minutes], also was time of extubation after regaining of consciousness [(0.7+/-0.2) hour and (1.2+/-0.6) hours vs. (2.7+/-0.3) hours, all P<0.01]. There was no significant difference between propofol group and the combination group in time of onset and extubation (both P>0.05). (3) Cost of propofol [(2,100+/-125) yuan] was 75% higher than that of midazolam [(1,200+/-112) yuan, P<0.01], but cost of sedatives in the combination group [(1,300+/-132) yuan] was similar to that in midazolam group (P>0.05). CONCLUSION: Combination of midazolam and propofol can not only ensure anterograde amnesia in critical patients, reduce drug dosage and adverse reactions, but also can help reduce the hospital expenses. This method may be a better sedation program in ICU.

Effect of the Shenfu Injection Combined with Early Goal-Directed Therapy on Organ Functions and Outcomes of Septic Shock Patients.

Shenfu injection (SFI) derived from traditional Chinese medicine has been widely used in cardiovascular diseases. The objective of this study was to determine the effect of SFI and conventional early goal-directed therapy (EGDT) on organ functions and outcomes of septic shock patients. For this purpose, a total of 45 septic shock patients were randomly divided into control group A (24 patients on EGDT) and experimental group B (21 patients on SFI + EGDT). SFI was administered (100@20 mL/h) twice daily. Hemodynamic status, lactic acid, and vasoactive drug use were observed before and after treatment. Other indicators included ventilator weaning time, ICU stay time, free of organ failure time, and 28-day hospital mortality. Regarding experimental group, compared with controls, BUN/creatinine decreased significantly at 3, 5, and 7 days while PaO2/FiO2 increased at 1 and 3 days (P < 0.05). APACHE-II and SOFA scores decreased in both groups at 3, 5, and 7 days (P < 0.05), whereas SOFA scores improved more in experimental group as compared with controls. Ventilator weaning time and ICU stay were significantly shorter in experimental group as compared with controls. In both groups, mean arterial pressure/systemic vascular resistance index post-treatment levels increased and lactic acid decreased at 6, 12, 24, 48, and 72 h (P < 0.05). Heart rate decreased at 24, 48, and 72 h (P < 0.05); while gamma-glutamyl transpeptidase and glutamate oxaloacetate transaminase levels increased at 1 day and 1 and 3 days, respectively (P < 0.05). Combined use of SFI and EGDT can improve hemodynamics, reduce the damage to vital organs, and shorten ventilation and ICU stay times in septic shock patients.

[Optimization of application parameters of soil seed bank in vegetation recovery via response surface methodology].

The thickness of surface soil, the covering thickness and the number of adding arbor seeds are all important factors to be considered in the application of soil seed bank (SSB) for vegetation recovery. To determine the optimal conditions, the Box-Behnken central composite design with three parameters and three levels was conducted and Design-Expert was used for response surface optimization. Finally, the optimal model and optimal level of each parameter were selected. The quadratic model was more suitable for response surface optimization (P < 0.0001), indicating the model had good statistical significance which could express ideal relations between all the independent variable and dependent variable. For the optimum condition, the thickness of surface soil was 4.3 cm, the covering thickness was 2 cm, and the number of adding arbor seeds was 224 ind x m(-2), under which the number of germinated seedlings could be reached up to 6222 plants x m(-2). During the process of seed germination, significant interactions between the thickness of surface soil and the covering thickness, as well as the thickness of surface soil and the number of adding arbor seeds were found, but the relationship between the covering thickness and the number of adding arbor seeds was relatively unremarkable. Among all the parameters, the thickness of surface soil was the most important one, which had the steepest curve and the largest standardized coefficient.

Hemodiafiltration combined with resin-mediated absorption as a therapy for hyperlipidemic acute pancreatitis.

The aim of this study is to investigate whether hemodiafiltration combined with resin-mediated absorption is a better therapy for hyperlipidemic acute pancreatitis. Patients (n = 67) with acute pancreatitis treated in ICU from January 2009 to December 2012 were included in this study. Seven of these 67 cases were diagnosed hyperlipidemic acute pancreatitis (HLAP). All the 7 HLAP patients went through fast, gastrointestinal decompression, anti-shock treatment, inhibition of pancreatic secretion, antiseptic treatments, and hemoperfusion (HP) combined with continuous veno venous hemodiafiltration (CVVHDF). After one round of treatment by resin adsorption, there was a significant decrease in serum triglycerides (TG) (29.78 %) and total cholesterol (TC) (24.02 %) levels (p < 0.01). TG and TC levels dropped by 49.02 and 37.66 %, respectively, after 1-day treatment of HP + CVVHDF; by 62.81 and 47.37 % on day 2 post-treatment; and by 69.57 and 49.47 % on day 3 post-treatment. All the 7 patients survived. The average time spent in the ICU was 7 ± 3.8 days, and the average duration of hospitalization was 19 ± 15.1 days. Our results show that hemoperfusion combined with hemodiafiltration is an efficient treatment as this approach can reduce plasma lipid levels effectively and reduce the risk of acute pancreatitis due to hyperlipidemia.

Efficacy of various combined blood purification techniques for treating patients with non-viral acute liver failure.

We sought to study the clinical efficacy of various combined blood purification techniques in patients with non-viral acute liver failure complicated by multiple organ dysfunction syndrome (MODS). For this purpose, 19 patients diagnosed of mid- or late-stage liver failure with MODS score-4 were randomly divided into 3 treatment groups of PE+HP+CVVHDF, PE+CVVHDF, and HP+CVVHDF, respectively. Pre- and post-treatment heart rate (HR), mean arterial pressure (MAP), arterial blood gases (pH, PaO2, and PaCO2), hepatic function, platelet count, and blood coagulation were determined. The data show significant improvement in HR, MAP, PaO2/FiO2, total bilirubin (TBIL), and alanine aminotransferase (ALT) levels after treatment (P < 0.05). TBIL decreased more significantly after treatment in PE+CVVHDF and PE+HP+CVVHDF groups (P < 0.01). Significant improvement in prothrombin time and albumin was observed only in PE+CVVHDF and PE+HP+CVVHDF groups (P < 0.05). The decrease of TBIL and improvement of PaO2/FiO2 ratio were more pronounced in PE+HP+CVVHDF than in HP+CVVHDF group (P < 0.05). To conclude, liver function was relatively improved by all the three combined blood purification techniques used; however, PE+HP+CVVHDF approach was found more efficient in the removal of toxic metabolites, especially bilirubin. The data suggest that the combined blood purification techniques used were effective and involved minor side effects.

[Topsoil application in vegetation restoration in Japan].

Soil seed bank has the unique regional species composition and genetic characteristics, and plays important roles in maintaining species diversity and population density. Topsoil, as a kind of revegetation materials, has the potential in vegetation restoration. Based on the Japanese literatures, this paper introduced the characteristics and contents of revegetation with topsoil, and discussed the revegetation modes from the aspects of topsoil mixing ratio, slope surface condition, and topsoil collection depth. The application cases of topsoil in various habitat types such as forests, roads, wetlands, and abandoned lands were also introduced. Some suggestions to the further researches on topsoil application in vegetation restoration were proposed, e.g., to strengthen the practical research of topsoil, to determine the appropriate techniques and targets of topsoil application as well as the survey methods and applicability standards, and to develop the low cost and high-efficient new application ways of topsoil.