The effect of COVID-19 infection on patients with rheumatic diseases in China.

OBJECTIVES: At the end of 2022, the COVID-19 outbreak erupted in China, and BA.5.2 or BF.7 subtypes of Omicron novel variations were implicated in more than 90% of the cases. We created a real-world questionnaire survey to better understand how this new variant pandemic was affecting rheumatic patients in China. METHODS: During the COVID-19 outbreak in China, the subjects of this study were rheumatic patients and non-rheumatic individuals (control group), who were matched for sex and age. Professional physicians carefully questioned the participants before administering a questionnaire as part of the study. This study focused on the general baseline characteristics, clinical symptoms and treatment after COVID-19 infection, and the target populations' awareness of COVID-19. RESULTS: The study included 1130 participants, of whom 572 were assigned to the rheumatic group and 558 to the control group. The percentage of vaccinated controls was significantly higher than that of rheumatic patients (90.1% vs. 62.8%, p < 0.001), while the rate of COVID-19 infection was not significantly different between the two groups (82.3% vs. 86.6%, p = 0.051). Patients with rheumatic disease experienced substantially more days of fever following infection (2.87 ± 3.42 vs. 2.18 ± 1.65, p = 0.002) compared to individuals in the control group. The rheumatic patients had a greater prevalence of cough (67.1% vs. 54.0%, p < 0.001), somnipathy (13.8% vs. 6.0%, p < 0.001), and conjunctivitis/ophthalmodynia (5.3% vs. 2.1%, p = 0.008), while dry throat/throat pain/weakness (49.9% vs. 59.4%, p = 0.003), myalgia/osteodynia (33.3% vs. 41.8%, p = 0.003), and dyspnea (14.0% vs. 25.3%, p < 0.001) were more likely to occur in non-rheumatic group after infection. Human immunoglobulin (2.1% vs. 0.2%, p = 0.006), glucocorticoids (19.5% vs. 1.6%, p < 0.001), oxygen support (6.8% vs. 2.1%, p < 0.001), and traditional Chinese medicine (21.9% vs. 16.6%, p = 0.037) were all more frequently used by rheumatic patients with COVID-19 infection. People in the control group were more confused about whether to use masks in following social activities after contracting COVID-19 (14.7% vs. 7.6%, p = 0.001). In the control group, more individuals than patients with rheumatic disease (25.1% vs. 13.4%, p < 0.001) expressed an interest to receive the vaccine again. After being exposed to COVID-19, the majority of rheumatic patients (66.9%) reported no discernible change, only 29.1% reported a worsening of their symptoms, and the remaining 4% indicated an improvement. CONCLUSIONS: After the COVID-19 outbreak in China, the proportion of patients with rheumatic diseases infected with the virus was similar to that of normal individuals. But the clinical symptoms, follow-up treatment requirements, and awareness of the COVID-19 among rheumatic patients were distinct from those among non-rheumatic patients, necessitating the use of individualized diagnosis and treatment plans as well as health advice by medical professionals in clinical work. Key Points • Despite there were different comorbidities and vaccination rates, the rate of COVID-19 infection in patients with rheumatic disease was similar to that of normal individuals. • After COVID-19 infection, rheumatic patients and normal controls had different clinical symptoms and drug usage. • After being exposed to COVID-19, the majority of rheumatic patients felt no significant change in the primary disease, while the normal controls was more likely to accept a new vaccine injection and confused about whether to use masks in following social activities.

Effect of traditional therapeutics on prevalence and clinical outcomes of coronavirus disease 2019 in Chinese patients with autoimmune diseases.

The impact of the Coronavirus disease 2019 (COVID-19) pandemic on autoimmune diseases (AID) patients has been an important focus. This study was undertaken to characterize the incidence, clinical manifestations and hospitalization among AID affected by COVID-19 and to analyze the association between immunomodulatory medication and these outcomes. Clinical, demographic, maintenance treatment, symptoms and disease course data and outcomes of AID patients with COVID-19 infection were assessed via an online survey tool and printed copy from 1 January till February 28, 2023. A total of 432 patients with AID were enrolled in the study. The results showed the most common conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) was hydroxychloroquine (HCQ). The usage of csDMARDs didn't increase the risk of COVID-19 infection. Patients who warranted hospitalization were significantly older. ILD was associated with higher hospitalization rate. No csDMARDs other than calcineurin inhibitor (CNI) was associated with increased risk of hospitalization. HCQ intake was associated with cough. Compared with no glucocorticoids (GCs) group, high doses of GCs were accompanied with higher proportion of gastrointestinal symptoms and tachycardia, lower proportion of sore throat and ageusia. GCs didn't provoke the COVID-19 infection in patients with AID, but chronic use of oral GCs was significantly more common in those requiring hospitalization, and higher dose of GCs were correlated with higher risk of hospitalization. 97 patients discontinued csDMARDs after infection, which resulted in an elevated risk of hospitalization. Meanwhile, withdrawal of csDMARDs was associated with higher odds of disease flare and lower proportion of remission than maintenance groups. Collectively, our analysis provides the evidence that maintenance treatment of csDMARDs may be more prudent for AID patients during COVID-19 pandemic.

Study on the effect of magnesium on leaf metabolites, growth and quality of tea tree.

Magnesium (Mg) is one of the essential elements for the growth of tea trees. In this study, we investigated changes in metabolites, photosynthetic fluorescence parameters and quality indexes of tea leaves under different concentrations of magnesium treatment, and the results showed that there were no significant differences in the quantity and total content of metabolites in tea leaves under different Mg concentrations. The results of volcano map analysis showed that the content of 235 metabolites in tea leaves showed an increasing trend and the content of 243 metabolites showed a decreasing trend with the increase of Mg concentration. The results of the combined analysis of the OPLS-DA model and bubble map showed that 45 characteristic metabolites were screened at different concentrations of Mg. Among these, the content of 24 characteristic metabolites showed an increasing trend and 21 characteristic metabolites showed a decreasing trend with the increase of Mg concentrations. The results of KEEG pathway enrichment showed that 24 characteristic metabolites with a upward trend were significantly enriched in saccharides metabolism, nucleic acid metabolism and vitamin metabolism, while the 21 characteristic metabolites with a downward trend were enriched in the synthesis of plant secondary metabolites, phenylpropanoid biosynthesis, biosynthesis of terpenoids, synthesis and metabolism of alkaloids, and synthesis and metabolism of amino acids. It can be inferred that Mg regulation was beneficial to enhance the photosynthetic capacity of tea trees, improve the accumulation and metabolism of carbohydrate substances in tea trees, and thus promoted the growth of tea trees, but was not conducive to the synthesis of secondary metabolites and amino acids related to tea quality. The results of photosynthetic fluorescence parameters and quality indexes of the tea tree confirmed the conclusion predicted by metabolomics. This study provided a reference for regulating of the growth and quality of tea trees with Mg fertilizer in tea plantations.

Reasonable deep application of sheep manure fertilizer to alleviate soil acidification to improve tea yield and quality.

Soil acidification in Chinese tea plantations is widespread, and it has significantly affected the growth of tea trees; it was important to explore soil remediation of acidified tea plantations in depth for the sustainable development of tea industry. In this study, the effects of sheep manure fertilizer with different application depths on soil acidification, tea yield and quality, and soil nitrogen transformation in tea plantations were analyzed for five consecutive years from 2018 to 2022. The results showed that long-term use of sheep manure fertilizer significantly reduced soil acidification (P< 0.05) in tea plantations, improved soil pH and soil ammonium nitrogen content, enhanced root activity and root nitrogen uptake capacity of tea trees, and thus improved tea yield and quality. The effect of different application depths of sheep manure fertilizer on tea yield and quality was mainly reflected in the transformation ability of soil ammonium nitrogen and nitrate nitrogen, which showed that high transformation ability of soil ammonium nitrogen and high ammonium nitrogen content were beneficial to high tea yield and vice versa, and the best effect was achieved when sheep manure was applied at a depth of 50 cm and 70 cm. The topsis analysis confirmed that sheep manure fertilization had a greater effect on root activity, ammonium nitrogen, ammonia intensity, and nifH gene. This study provided an important practical basis for the restoration of acidified tea plantation soil through sheep manure fertilizer management.

Contribution of traditional deep fermentation to volatile metabolites and odor characteristics of Wuyi rock tea.

Fermentation is extremely important for the formation of the special flavor of Wuyi rock tea. This study determined volatile metabolite contents using GC-MS technique and futher analyzed their odor characteristics during the traditional deep fermentation technology of Wuyi rock tea. The results showed that 17 characteristic compounds significantly changed during the first stage of the preliminary processing, namely fresh leaves, withering and fermentation. The key to the formation of floral aroma lied in dihydromyrcenol, and the woody aroma derived from six terpenoids, and their synthesis depended on dihydromyrcenol content. The fruity aroma was dominated by six esters, and the fruity aroma mainly came from (Z) -3-hexen-1-yl butyrate, (E) -3-hexen-1-yl butyrate and 5-Hexenyl butyrate. This study provided an important theoretical and practical basis for improving the preliminary processing of Wuyi rock tea.

Comparative analysis of helium and air surface micro-discharge plasma treatment on the microbial reduction and quality attributes of beef slices.

This work aimed to compare the effects of helium and air surface micro-discharge (SMD) plasma on the microbial safety and quality of beef tissues. For the beef tissue model, the concentration and diffusion depth of hydroxyl radical and ozone have different change patterns over plasma treatment time and distance in helium and air SMD plasma. The inactivation efficiency of helium plasma depended on the plasma treatment time and distance, while the inactivation efficiency of air plasma only depended on the treatment time. For the fresh beef slices, air SMD plasma treatment exhibited a higher antimicrobial activity against S. aureus and E. coli than helium SMD plasma treatment (1.5 versus 0.9; 0.9 versus 0.28 log CFU/g at 10 min). However, air SMD plasma treatment caused more adverse effects on beef quality, leading to a smooth surface, extensive lipid oxidation, protein structure damage, low pH and discoloration compared to helium SMD plasma treatment. This work provides valuable guidelines for the working gas choice in the practical application of plasma to meat decontamination.

Effects of Magnesium on Transcriptome and Physicochemical Index of Tea Leaves.

Magnesium (Mg) is one of the essential elements for the growth of tea tree and is extremely important for its development. In this study, we investigated the effect of Mg on the transcriptome and physicochemical indexes of tea leaves, and the results showed that Mg could significantly affect the gene expression of tea leaves. The results of Orthogonal Partial Least-Squares Discriminant Analysis (OPLS-DA) model analysis showed that a total of 300 key genes (Variable Importance for the Projection, VIP > 1) were screened under different concentrations of Mg treatment, among which 140 genes were up-regulated and 160 genes were down-regulated. The bubble map was used to screen the characteristic genes from the above key genes, and a total of 121 representative characteristic genes were obtained, mainly involving 9 metabolic pathways. Among them, gene expression of three metabolic pathways, including porphyrin metabolism, alpha-linolenic acid metabolism and photosynthesis, showed an increasing trend with the increase of Mg concentration, while gene expression of four metabolic pathways, including biosynthesis of secondary metabolites, anthocyanin biosynthesis, ABC transporters, pentose and glucuronate interconversions, showed a decreasing trend. The results of physiological index analysis showed that with the increase of Mg concentration, the photosynthetic physiological index, theanine and soluble sugar content of tea leaves showed an increasing trend, while the content of tea polyphenol, flavone and caffeine showed a decreasing trend. The results of TOPSIS analysis showed that the physiological indexes of tea trees most affected by Mg were chlorophyll, tea polyphenols and flavonoids, while the metabolic pathways most affected by Mg on gene expression were the metabolic pathways and biosynthesis of secondary metabolites. It can be seen that the effects of Mg on tea tree were mainly related to photosynthesis and synthesis of secondary metabolites, and Mg was beneficial for improving the photosynthetic capacity of tea tree, enhancing the accumulation of primary metabolites, and thus increasing tea yield. However, Mg was not conducive to the synthesis of secondary metabolites of tea tree and the accumulation of main quality indexes of tea leaves.

Clinicopathological features and long-term prognosis of glomerular diseases associated with mercury-containing cosmetics.

OBJECTIVE: The pathological types and long-term prognosis of glomerular diseases related to mercury exposure are unclear. This study retrospectively examined 41 cases of glomerulonephropathy caused by mercury-containing cosmetics. METHODOLOGY: Forty-one subjects with glomerular diseases presumably caused by mercury-containing cosmetics were selected. Clinical features, kidney biopsy, treatment, and follow-up data were collected. RESULTS: All patients were female with an average age of 39.4 ± 6.6 years at diagnosis. Median time of exposure to mercury-containing cosmetics was six months, and average urine mercury level was 66.80 ± 38.55ug/(g·Cr). Most patients presented with nephrotic syndrome. Renal histopathology showed membranous nephropathy in 22 patients (53.65%), minimal change disease in 13 patients (31.71%), IgA nephropathy with minimal change disease in 5 patients (12.20%), and focal segmental glomerulosclerosis in 1 patient. Median time of exposure to mercury was longer and the proportion of patients with autoantibodies (mainly antinuclear antibodies) was higher in patients with membranous nephropathy. Both blood phospholipase A2 receptor -Ab and kidney tissue phospholipase A2 receptor were negative. Thirty-six patients received glucocorticosteroids and/or immunosuppressants. Five patients were treated with an angiotensin receptor blocker, and nine patients were treated with chelation therapy. The median follow-up time was 40 months (range 27-94). All patients achieved complete remission, and the median time to complete remission was one month. They all successfully discontinued the drugs without relapsing; withdrawal time was 26 months. CONCLUSION: Membranous nephropathy was the most common pathological type in mercury-induced glomerular disease. Patients were sensitive to glucocorticosteroids and immunosuppressants and achieved complete remission quickly. Contrary to primary glomerulonephritides, patients with mercury-induced glomerular diseases had no relapses after withdrawal of the mercury containing cosmetics.

Visible-light-driven photocatalytic inactivation of S. aureus in aqueous environment by hydrophilic zinc oxide (ZnO) nanoparticles based on the interfacial electron transfer in S. aureus/ZnO composites.

Waterborne diseases caused by pathogenic microorganisms pose severe threats to human health. ZnO nanoparticles (NPs) hold great potentials as an effective, economical and eco-friendly method for water disinfection, but the exact antimicrobial mechanism of ZnO NPs under visible-light illumination is still not clear. Herein, we investigate the visible-light-driven photocatalytic inactivation mechanism of amino-functionalized hydrophilic ZnO (AH-ZnO) NPs against Staphylococcus aureus (S. aureus) in aqueous environment from the perspective of electron transfer theory. The results show that the antibacterial effects of AH-ZnO NPs are dependent on the AH-ZnO NPs concentration and treatment time. The bulk ORP value and released Zn2+ concentration in AH-ZnO NPs solutions increase with AH-ZnO NPs concentration. The SEM and intracellular protein leakage results indicate that AH-ZnO NPs can adhere to S. aureus surface without causing obvious cell membrane disruption. The photoluminescence (PL) intensity and fluorescence lifetime of AH-ZnO NPs are remarkedly decreased after adding S. aureus, which confirms the electron transfer from S. aureus to AH-ZnO NPs. Moreover, the ΔPL intensity is closely correlated with the inactivation efficiency, demonstrating that the interfacial electron transfer in S. aureus/AH-ZnO NPs composites contributes to the antibacterial activity, which is speculated to disrupt the normal respiratory electron transfer chain of S. aureus, thereby causing intracellular ROS generation, cell membrane depolarization and eventually apoptosis-like death.

Clinical Characteristics and Controllable Risk Factors of Osteoporosis in Elderly Men with Diabetes Mellitus.

OBJECTIVE: To analyze the clinical characteristics and controllable risk factors of osteoporosis in elderly men with type-2 diabetes mellitus (T2DM). METHODS: A total of 250 elderly OP patients with T2DM were included in the present study. Patients with one or more common chronic diseases (including hypertension, coronary heart disease, heart failure, chronic bronchitis, chronic nephrosis, and cirrhosis), and a course of more than 3 years were defined as complicated with chronic diseases. Blood glucose, cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, calcium, phosphorus, glycosylated hemoglobin, urea nitrogen, creatinine, fasting insulin, liver function, and 25-hydroxy vitamin D3 levels were measured. Bone mineral density was also measured. RESULTS: A total of 16 patients (6.4%) had severe osteoporosis. Furthermore, 66 patients (26.4%) had blood glucose control that reached the standard, while 176 patients (70.4%) used more than two anti-diabetic drugs. The serum testosterone level was lower than the median in 87 patients (34.8%) and in 56 smokers (22.4%). Furthermore, 138 patients (55.2%) were overweight and obese, six patients (2.4%) were underweight, 197 patients (78.8%) had chronic diseases, 88 patients (35.2%) were sticking to exercise, and 117 patients (46.8%) had less exercise. In addition, 92 patients (36.8%) were treated with osteotrophy-protective agents, and 24 patients (9.6%) received anti-osteoporosis therapy. Smoking, poor glycemic control, low testosterone levels, less exercise, and complications with chronic diseases were the most relevant controllable risk factors. CONCLUSION: For elderly male osteoporosis patients with type-2 diabetes, smoking cessation, blood sugar control up to the standard, regular exercise, active prevention and treatment of complications, and appropriate testosterone supplementation are necessary for preventing and curing osteoporosis.

Subcellular mechanism of microbial inactivation during water disinfection by cold atmospheric-pressure plasma.

Although the identification of effective reactive oxygen species (ROS) generated by plasma has been extensively studied, yet the subcellular mechanism of microbial inactivation has never been clearly elucidated in plasma disinfection processes. In this study, subcellular mechanism of yeast cell inactivation during plasma-liquid interaction was revealed in terms of comprehensive factors including cell morphology, membrane permeability, lipid peroxidation, membrane potential, intracellular redox homeostasis (intracellular ROS and H2O2, and antioxidant system (SOD, CAT and GSH)), intracellular ionic equilibrium (intracellular H+ and K+) and energy metabolism (mitochondrial membrane potential, intracellular Ca2+ and ATP level). The ROS analysis show that ·OH, 1O2, ·O2-and H2O2 were generated in this plasma-liquid interaction system and ·O2-served as the precursor of 1O2. Additionally, the solution pH was reduced. Plasma can effectively inactivate yeast cells mainly via apoptosis by damaging cell membrane, intracellular redox and ion homeostasis and energy metabolism as well as causing DNA fragmentation. ROS scavengers (l-His, d-Man and SOD) and pH buffer (phosphate buffer solution, PBS) were employed to investigate the role of five antimicrobial factors (·OH, 1O2, ·O2-, H2O2 and low pH) in plasma sterilization. Results show that they have different influences on the aforementioned cell physiological activities. The ·OH and 1O2 contributed most to the yeast inactivation. The ·OH mainly attacked cell membrane and increased cell membrane permeability. The disturb of cell energy metabolism was mainly attributed to 1O2. The damage of cell membrane as well as extracellular low pH could break the intracellular ionic equilibrium and further reduce cell membrane potential. The remarkable increase of intracellular H2O2 was mainly due to the influx of extracellular H2O2 via destroyed cell membrane, which played a little role in yeast inactivation during 10-min plasma treatment. These findings provide comprehensive insights into the antimicrobial mechanism of plasma, which can promote the development of plasma as an alternative water disinfection strategy.

Hydrophilic ZnO Nanoparticles@Calcium Alginate Composite for Water Purification.

Herein, hydrophilic ZnO nanoparticles@calcium alginate composite has been prepared by embedding hydrophilic ZnO nanoparticles (NPs) into calcium alginate. The hydrophilic ZnO NPs within the composites can act as a killer of bacteria, while calcium alginate can remove the organic impurities due to its adsorption capacity, thus realizing the purification of water via sterilization and removal of organics. A water purifier based on the composite has been demonstrated, the aerobic bacterial counts of the contaminated water can be decreased from 2240 to 9 cfu mL-1, and the turbidity of the water is decreased to 0.51 NTU, which is below the maximum permissible of Guidelines for Drinking-water Quality designed by the World Health Organization. Sterilization mechanism studies show that the ZnO NPs can cause excessive oxidative stress in cells, inducing bacteria to produce large amounts of intracellular reactive oxygen species (ROS), which leads to the apoptosis of the bacteria.

A systematic study of the antimicrobial mechanisms of cold atmospheric-pressure plasma for water disinfection.

Waterborne diseases caused by pathogenic microorganisms pose a severe threat to human health. Cold atmospheric-pressure plasma (CAP) has recently gained much interest as a promising fast, effective, economical and eco-friendly method for water disinfection. However, the antimicrobial mechanism of CAP in aqueous environments is still not clearly understood. Herein, we investigate the role of several short-lived reactive oxygen species (ROS) and cellular responses in the CAP inactivation of yeast cells in water. The results show that singlet oxygen (1O2), hydroxyl radical (OH) and superoxide anion (O2-) are generated in this plasma-water system, and O2- served as the precursor of OH. The 5-min plasma treatment resulted in the effective inactivation (more than 2-log reduction) of yeast cells in water. The ROS scavengers significantly increased the survival ratio in the following order: water < D-Man (scavenging OH) < SOD (scavenging O2-) < L-His (scavenging 1O2), indicating that 1O2 contributes the most to the yeast inactivation. In addition, the acidic pH had a synergetic antimicrobial effect with ROS against the yeast cells. During the CAP inactivation process, yeast cells underwent apoptosis in the first 3 min due to the accumulation of intracellular ROS, mitochondrial dysfunction and intracellular acidification, later followed by necrosis under longer exposure times, attributed to the destruction of the cell membrane. Additionally, L-His could switch the cell fate from necrosis to apoptosis through mitigating plasma-induced oxidative stress, indicating that the level of oxidative stress is a critical factor for cell death fate determination. These findings provide comprehensive insights into the antimicrobial mechanism of CAP, which can promote the development of CAP as an alternative water disinfection strategy.