Enterococcus gallinarum meningitis: a case report and literature review.

BACKGROUND: As an opportunistic pathogen, E. gallinarum mainly leads to nosocomial infections, and it's multi-drug resistance has gained more and more attention. Central nervous system infections caused by E. gallinarum are rare, but have been reported more often in recent years. The previous cases were generally secondary to neurosurgery, especially ventriculoperitoneal shunts. In recent years, the cases largely occurred in patients with impaired immune function. The patient in our report may have had dual risk factors (immune impairment and an invasive surgical procedure). CASE PRESENTATION: The patient, a 35-year-old female, was admitted to our hospital for headaches of 3 days duration accompanied by nausea and vomiting for 2 days. The patient had fevers and chills for 3 days before admission; the peak body temperature was 38.5 °C. The patient had a splenectomy in our hospital 2 years earlier for thrombocytopenia and was thought to be immunocompromised. The abnormal findings on physical examination and laboratory testing were as follows: neck stiffness, present; lumbar puncture: pressure, 300 mmH2O; Pandy's test, positive; white blood cell (WBC) count, 1536 × 106/L; monocyte count, 602 × 106/L; monocyte percentage, 39.2%; multinucleate cell count, 934 × 106/L; multinucleate cell percentage, 60.8%; protein, 1.08 g/L; WBC count, 21.1 × 109/ L; neutrophil percentage, 85.3%; neutrophil count, 20.55 × 109/L; C reactive protein (CRP): 136.4 mg/L; procalcitonin, 6.70 ng/mL. The patient was given meropenem (2.0 g, intravenous infusion, every 8 h) for anti-infection supplemented with other symptomatic support treatments. The patient's fever and headache had no significant relief. CONCLUSIONS: Central nervous system infections caused by E. gallinarum are rare, but should be suspected, particularly inpatients with impaired immune function or ineffective treatment. Avoiding long-term invasive treatment and improving immunity are helpful to reduce the occurrence of E. gallinarum infections. Early detection and diagnosis, as well as rational antibiotic use, are the keys to achieve satisfactory efficacy.

[Extracts from Testudinis Carapacis et Plastri Regulates Expression of ID1 in Mscs].

OBJECTIVE: To explore BMP4 affecting the Extracts from Testudinis Carapacis et Plastri (PTE) stimulating proliferation of MSCs and the mechanism. METHODS: Cotransfected PGL3-IDI and pEGFP-BMP4 of 0, 0. 1,0. 3, 0. 5 and 1 µg/mL respectively using the calcium phosphate co-precipitation method in rat MSCs. One of transfected cells were divided into control group and PTE group. PTE group was stimulated by PTE of 30 µ/L for 36 h, while control group was not. Collected cells using lucifease activity measurement to detect the activity of ID. Then 0. 3 µg/mL pEGFP-BMP4 was chose to cotransfect. MSCs was divided into control group, PTE group, BMP4 group, BMP4 + PTE group. BMP4 and BMP4 + PTE group were cotransfected with PGL3-ID1 and pEGFP-BMP4 but control or PTE groups were not. PTE and BMP4 + PTE groups were stimulated by PTE of 30 µg/mL for 36 h but the either two groups were not. The activities of ID1, BMP4 and RARα were detected using RT-PCR. RESULTS: The expressions of ID1, BMP4 and RARa rose in PTE group. The expression of BMP4 and RARα rose while IDI decreased in BMP4 groups. BMP4, ID1 and RARα decreased remarkable in BMP4 + PTE group comparing with BMP4 group. CONCLUSION: PTE promotes the proliferation of MSCs, it also regulates the expression of BMP4 to prevent excessive proliferation of MSCs.

[Preparation and characterization of polyvinyl alcohol microsphere pre-coated dynamic membranes].

To alleviate membrane fouling and reduce the price of membrane module, polyvinyl alcohol microsphere pre-coated dynamic membranes (PVA-MS/PCDMs) were investigated detailedly. It was prepared when the polyvinyl alcohol microsphere of the pre-coated reagent deposited on the surface and entered the pores of porous substrate common filter cloth which was low-cost by means of circulatory filtration. The morphology and structure of PVA-MS/PCDMs were examined using scanning electron microscope (SEM), and approximate maximal separated aperture, water contact angle, pure water permeation resistance and relative Zeta potential of the membrance surface were also determined. The results showed that pure water permeation resistance of PVA-MS/PCDMs was between 0.64 x 10(10) m(-1) and 3.84 x 10(10) m(-1) and the approximate maximal separated aperture reached microfiltration level. The hydrophilicity of PVA-MS/PCDMs increased with increasing PVA-MS pre-coated mass. The relative Zeta potential of the PVA-MS/PCDMs, which were measured using 0.01 mol x L(-1) KCl solution, pH 8.0 +/- 0.2 and at 20 degrees C, reached a peak value of -36.4 mV with pre-coated mass of 15.7 g x m(-2) PVA-MS on the membrance surface. In addition, evolutions of PVA-MS/PCDMs flux versus time were investigated using a 4 hours short-term filtration experiment at 9.5 kPa in an SMBR and the permeability coefficient of PVA-MS/PCDMs were measured by the extracellular polymeric substances (EPS) diffusion experiments. Results indicated that the PVA-MS/PCDMs presented dramatically high anti-fouling characteristics when the pre-coated mass of PVA-MS was 23.9-61.9 g x m(-2).

[Preparation and characterization of cross-linked polyvinyl alcohol microspheres as a novel precoating reagent in dynamic membrane].

In order to modify the membrane surface by adsorbing a precoated layer, cross-linked polyvinyl alcohol microspheres were prepared via an emulsion polymerization that PVA cross linked with glutaraldehyde which was extracted by anhydrous aether. Effects of concentration of PVA solution, the volume ratio of aqueous phase to oil phase, the selection of surface active agent (SAA) and its concentration on the stabilization of emulsion were studied. When the concentration of PVA solution was 2.7%, the volume ratio of PVA solution/n-heptane was 40:60 and the concentration of span-80 was 1.30 g/dL, the prepared microspheres contented our needs. The size of microspheres diminished with the stirring speed increasing under the condition of enough span-80. It became smaller with the accretion of an aimed cross-linking degree which has little affection on surface charge. The contact angle of PVA microspheres with distilled water showed that these microspheres were hydrophilic. Morphology of PVA microspheres were observed by SEM. The FTIR results suggested that functional groups varied with the change of aimed cross-linking degrees.

[Anti-fouling characteristics of the novel precoating reagent in dynamic membrane bioreactor].

Further research was made on precoating reagents in dynamic membrane process, in which novel precoating reagent-polyvinyl alcohol microsphere (PVA-MS) was prepared through emulsive polymerization of PVA and glutaraldehyde (GA). Furthermore, polymerization mechanism and anti-fouling characteristics through adsorption of membrane major fouling substances EPS upon PVA-MS were studied. The results showed that hemiacetals reaction played a major role in emulsive polymerization process, as the quantity of hydroxyl on PVA was decreased a little, PVA-MS surface behaved good hydrophilic, and the adsorption of protein and amylose upon PVA microsphere was stable and low, which was 0.543 mg x g(-1) and 0.694 mg x g(-1) respectively. In addition, PVA-MS surface behaved electronic negativity, which acted electrostatic repulsion to active sludge floc. Upon this characteristics and data, it was concluded that membrane fouling was delayed in microscopy structure. Diameter of PVA-MS in precoating liquid was about 1.14 microm, and Zeta-potential of precoating liquid with different precoating reagent concentration was less than - 39 mV, which made PVA microsphere diffused and stable from each other, then sedimentate rapidly on porous support membrane surface and internal wall of hole path. Besides, the morphology of PVA-MS and dynamic membrane formed from PVA-MS on support membrane were observed through SEM.

[Experimental study on application of the boundary layer theory for determining steady aeration intensity of precoated dynamic membrane bioreactor].

The rheological behaviour of the low sludge concentration liquor in MBR was investigated and made a conclusion that this liquor approximated to the Newtonian fluid while the concentration of the sludge was less than 8000 mg x L(-1). Furthermore, when the laminar flow boundary layer thickness on the surface of flat membrane came up to the thickness of precoated dynamic membrane (PDM), the steady aeration intensity was calculated by using the boundary layer theory in the Newtonian hydrodynamics. In order to ensure the stability of the pre-coated dynamic membrane bioreactor (PDMBR), oxygen supply aeration intensity was chosen to supply the best dissolved oxygen (3-5 mg x L(-1) in the initial stages and gradually increased to the steady aeration intensity. The results indicated that this mode could enhance the stability of PDM. In the experiment period (31 d), effluent COD was less than 12.48 mg x L(-1) and its average removal rate was 97.49%, NH4+ -N was less than 5.27 mg x L(-1) and its average removal rate was 76.13%, while the operational pressure just increased to 27 kPa. During the last period of the experiment, the stability of the PDMBR was studied when the aeration intensity was more than the steady aeration intensity and it was found that the precoated layer had been brushed off from the surface of common filter cloth, so this phenomenon proved that using the boundary layer theory could determine steady aeration intensity of PDMBR.