Clinical analysis and methodological evaluation of syphilis infection in patients in a first-class tertiary hospital in Suzhou, China.

OBJECTIVE: To explore the distribution and epidemiological characteristics of patients with syphilis in a first-class tertiary hospital and to evaluate the coincidence rate between chemiluminescence immunoassay (CLIA) and Treponema pallidum particle agglutination assay (TPPA). METHODS: The medical records of 247,501 outpatients and inpatients were retrospectively analyzed. TPPA was used to verify positive and suspected cases, and the coincidence rate between CLIA and TPPA was evaluated. Receiver operating characteristic (ROC) curve was used to determine optimal diagnostic thresholds. RESULTS: Of the 247,501 serum samples, 5,173 were detected positive for syphilis using CLIA, with a detection rate of 2.09% and a men-to-women ratio of 1.39. The chi-square test showed that sex and age were both factors that affected the detection rate (χ2=229.51, P < 0.0001). In addition, urology, orthopedics, cardiology, general surgery, gastroenterology, and gynecology represented the top six departments with the highest numbers of positive cases. Comparative analysis showed that the overall coincidence rate between CLIA and TPPA was 80.24%. Analysis of the ROC curve showed that the area under the curve (AUC) was 0.936 (95% confidence interval [CI]: 0.929-0.942, P < 0.0001) using sample/cut-off value (S/CO) as a diagnostic indicator. The results showed that an S/CO value of 3.945 was the best diagnostic value for the CLIA method, with a diagnostic specificity of 93.64% and a sensitivity of 81.90%. CONCLUSIONS: Syphilis is widely distributed in various hospital departments and primarily affects middle-aged and older individuals. For cases that have been initially screened as positive or suspicious, TPPA and other tests should be used for verification to avoid misdiagnosis and missed diagnosis.

The Effect of Elevated Alanine Transaminase on Non-invasive Prenatal Screening Failures.

Objective: To determine the effects of alanine transaminase (ALT) levels on the screening failure rates or "no calls" due to low fetal fraction (FF) to obtain a result in non-invasive prenatal screening (NIPS). Methods: NIPS by sequencing and liver enzyme measurements were performed in 7,910 pregnancies at 12-26 weeks of gestation. Univariate and multivariable regression models were used to evaluate the significant predictors of screening failure rates among maternal characteristics and relevant laboratory parameters. Results: Of the 7,910 pregnancies that met the inclusion criteria, 134 (1.69%) had "no calls." Multiple logistic regression analysis demonstrated that increased body mass index, ALT, prealbumin, albumin levels, and in vitro fertilization (IVF) conception rates were independently associated with screening failures. The test failure rate was higher (4.34 vs. 1.41%; P < 0.001) in IVF pregnancies relative to those with spontaneous conceptions. Meanwhile, the screening failure rates increased with increasing ALT levels from 1.05% at ≤10 U/L to 3.73% at >40 U/L. In particular, IVF pregnancies with an ALT level of >40 U/L had a higher test failure rate (9.52%). Compared with that for an ALT level of ≤10 U/L, the adjusted odds ratio of "no calls" for ALT levels of 10-20, 21-40, and >40 U/L was 1.204 [95% confidence interval (CI), 0.709-2.045], 1.529 (95% CI, 0.865-2.702), and 2.764 (95% CI, 1.500-5.093) (P trend < 0.001), respectively. Conclusions: Increased ALT and IVF conceptions were associated with a higher screening failure rates in NIPS. Therefore, a feasible strategy to adjust these factors to reduce the probability of "no calls" due to low FF would be of great clinical significance.

Comparison of acute respiratory distress syndrome in patients with COVID-19 and influenza A (H7N9) virus infection.

OBJECTIVES: We aimed to compared the clinical features of acute respiratory distress syndrome (ARDS) induced by COVID-19 and H7N9 virus infections. METHODS: Clinical data of 100 patients with COVID-19 and 46 patients with H7N9 were retrospectively analyzed. RESULTS: Elevated inflammatory indices and coagulation disorders were more common in COVID-19-ARDS group than in the H7N9-ARDS group. The median interval from illness onset to ARDS development was shorter in H7N9-ARDS. The PaO2/FiO2 level was lower in H7N9-ARDS, whereas the Sepsis-related Organ Failure Assessment score was higher in COVID-19-ARDS. The proportion of patients with disseminated intravascular coagulation and liver injury in COVID-19-ARDS and H7N9-ARDS was 45.5% versus 3.1% and 28.8% versus 50%, respectively (P <0.05). The mean interval from illness onset to death was shorter in H7N9-ARDS. A total of 59.1% patients with H7N9-ARDS died of refractory hypoxemia compared with 28.9% with COVID-19-ARDS (P = 0.014). Patients with COVID-19-ARDS were more likely to die of septic shock and multiple organ dysfunction compared with H7N9-ARDS (71.2% vs 36.4%, P = 0.005). CONCLUSION: Patients with H7N9 were more susceptible to develop severe ARDS and showed a more acute disease course. COVID-19-ARDS was associated with severe inflammatory response and coagulation dysfunction, whereas liver injury was more common in H7N9-ARDS. The main causes of death between patients with the two diseases were different.

Analysis of Serum IgG1 to Predict Progression and Therapeutic Effect in Patients with Multiple Myeloma.

Objective: The correlation between laboratory indicators and clinical treatment effects and the prognosis of multiple myeloma remains poorly understood. Therefore, our study investigated whether serum IgG subclasses could be employed as potential indicators contributed to evaluate the therapeutic effect and prognosis of patients with multiple myeloma. Patients and Methods. Records of patients with multiple myeloma were initially diagnosed at the First Affiliated Hospital of Soochow University, China, from August 1, 2017, to February 28, 2020. The assessment abilities of serological indicators for therapeutic effect were evaluated in patients compared with healthy controls. Results: In 560 study patients with multiple myeloma, serum IgA, IgG, IgM, κ-LC, and λ-LC increased by15%, 33.04%, 1.96%, 27.50%, and 26.43%, respectively. Further analysis found that IgG1, IgG2, IgG3, and IgG4 were over the upper limit of the reference range with 26.38%, 6.09%, 8.12%, and 4.64%, respectively. κ-LC and λ-LC were found in the urine in 65.13% and 29.70%, respectively. In peripheral blood, the proportion of CD3+CD4+, CD3-CD19+ cells, and CD4+/CD8+ decreased, whereas CD3+CD8+ cells and CD16+/CD56+ increased, and the associated cytokines IL-2, IL-4, IL-6, TNF-α, and IFN-γ were upregulated in patients when compared with healthy controls. Furthermore, the serum levels of IgA, IgG, IgG1, IgG2, IgG3, and IgG4 gradually decreased in patients before, during, and after treatment. Similar results were found in serum and urine κ-LC and λ-LC. Conclusion: Serum IgG1 level could serve as the potential indicator for evaluating the therapeutic effect for patients with multiple myeloma. κ-LC and λ-LC also have the potential to be prognostic indicators. More studies are warranted to explore these serological indicators for personalized therapy in the future.

Research Advances of Prevention and Control of Hydrogen Sulfide in Coal Mines.

Sudden emission and casualty accidents caused by abnormal enrichment of hydrogen sulfide (H2S) in coal mines are becoming frequent increasingly, causing major casualties and environmental pollution. Scholars in various countries have developed various measuring devices for hydrogen sulfide content in coal and rock formations and their calculation methods. The existing prevention and control technologies of H2S in coal mines were summarized in various countries. According to the distribution characteristics, occurrence modes, and emission forms of H2S in coal mines, the prevention and control technologies of H2S in coal-bearing strata, airflow in tunnel, and underground water body are mainly introduced. Analyzed the effects of different ventilation systems on prevention and control of H2S, which include conventional ventilation system, partial homotropal ventilation system, and full homotropal ventilation system. The methods used mainly include neutralization by injecting alkalizer through drilling in coal seams with high pressure, spraying alkalizer in tunnel, attenuation by increasing wind amount, changing the ventilation method, pumping, dredging, and blocking the water that contains H2S as well as comprehensive prevention and control method. The basic agents adopted mainly include sodium carbonate (the mass percentage concentration is about 0.5% ~ 3.0%) and sodium bicarbonate solution, and some basic solution is added by an additive, such as surfactant, Fenton reagent, sodium dodecyl benzene sulfonate, sodium hypochlorite, or chloramine-T. The treatment effect and the main problems of each prevention and control technology are analyzed, and a comprehensive method of prevention and control techniques of H2S in coal mines is proposed. According to current technological level as well as the cost, the effective prevention and control techniques of H2S should take the occurrence, distribution, and emission forms of H2S in coal mines as well as the content into consideration.

Dye-Incorporated Polynaphthalenediimide Acceptor for Additive-Free High-Performance All-Polymer Solar Cells.

All-polymer solar cells (all-PSCs) can offer unique advantages for applications in flexible devices, and naphthalene diimide (NDI)-based polymer acceptors are the widely used polymer acceptors. However, their power conversion efficiency (PCE) still lags behind that of state-of-the-art polymer solar cells, due to low light absorption, suboptimal energy levels and the strong aggregation of the NDI-based polymer acceptor. Herein, a rhodanine-based dye molecule was introduced into the NDI-based polymer acceptor by simple random copolymerization and showed an improved light absorption coefficient, an up-shifted lowest unoccupied molecular orbital level and reduced crystallization. Consequently, additive-free all-PSCs demonstrated a high PCE of 8.13 %, which is one of the highest performance characteristics reported for all-PSCs to date. These results indicate that incorporating a dye into the n-type polymer gives insight into the precise design of high-performance polymer acceptors for all-PSCs.

Roll-To-Roll Printing of Meter-Scale Composite Transparent Electrodes with Optimized Mechanical and Optical Properties for Photoelectronics.

Flexible transparent electrodes are an indispensable component for flexible optoelectronic devices. In this work, the meter-scale composite transparent electrodes (CTEs) composed of poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) and Ag grid/polyethylene terephthalate (PET) with optimized mechanical and optical properties are demonstrated by slot-die roll-to-roll technique with solution printing method under a low cost ($15-20 per square meter), via control of the viscosity and surface energy of PEDOT:PSS ink as well as the printing parameters. The CTEs show excellent flexibility remaining 98% of the pristine value after bending 2000 times under various bending situations, and the square resistance ( Rs) of CTEs can be reduced to 4.5-5.0 Ω/sq with an appropriate transmittance. Moreover, the optical performances, such as haze, extinction coefficient, and refractive index, are investigated, as compared with indium tin oxide/PET, which are potential for the inexpensive optoelectronic flexible devices. The CTEs could be successfully employed in polymer solar cells with different areas, showing a maximal power conversion efficiency of 8.08%.

Improved Glass Transition Temperature towards Thermal Stability via Thiols Solvent Additive versus DIO in Polymer Solar Cells.

The halogen-free solvent additive, 1,4-butanedithiol (BT) has been incorporated into PTB7-Th:PC71 BM, leading to higher power conversion efficiency (PCE) value as well as substantially enhanced thermal stability, as compared with the traditional 1,8-diiodooctane (DIO) additive. More importantly, the improved thermal stability after processing with BT contributes to a higher glass transition temperature (Tg ) of PTB7-Th, as determined by dynamic mechanical analysis. After thermal annealing at 130 °C in nitrogen atmosphere for 30 min, the PCE of the specimen processed with BT reduces from 9.3% to 7.1%, approaching to 80% of its original value. In contrast, the PCE of specimens processed with DIO seriously depresses from 8.3% to 3.8%. These findings demonstrate that smart utilization of low-boiling-point solvent additive is an effective and practical strategy to overcome thermal instability of organic solar cells via enhancing the Tg of donor polymer.

Butanedithiol Solvent Additive Extracting Fullerenes from Donor Phase To Improve Performance and Photostability in Polymer Solar Cells.

In this work, we demonstrated that the excited poly[4,8-bis(5-(2-ethylhexyl)thiophen-2-yl)benzo[1,2-b;4,5-b']dithiophene-2,6-diyl-alt-(4-(2-ethylhexyl)-3-fluorothieno[3,4-b]thiophene-)-2-carboxylate-2,6-diyl)] (PTB7-Th) will be degraded by [6,6]-phenyl-C71-butyric acid methyl ester (PC71BM) or photolysis fragment of 1,8-diiodooctane (DIO) in the presence of oxygen and under irradiation of red light. From the previous reports, the fragment of DIO may be involved in the reaction directly. Our work indicates the PC71BM is not directly involved in the reaction, but is acting as a catalyst to promote the reaction of excited donors with oxygen. Thus, PTB7-Th urgently needs a kind of nonresidual iodine-free additive to replace DIO and remove the fullerene from the donor phase at the same time. Taking into consideration PC71BM solubility and boiling point difference between solvent additives and host solvents, 1,4-butanedithiol solvent was selected to fabricate PTB7-Th:PC71BM-based solar cells achieving a best power conversion efficiency (PCE) of 10.2% (8.5% for PTB7:PC71BM). Iodine-free butanedithiol can not only avoid excited polymer reacting with the photolysis fragment of DIO but also suppress the degradation of the excited PTB7-Th caused by synergistic effect between the fullerene and oxygen via extracting the free/trapped PC71BM from the donor phase. Eventually, the film prepared with 1,4-butanedithiol shows higher stability than the film prepared without any additives and much better than the film with DIO in macro-/micromorphology, light absorption, and device performance.

Up-regulated HMGB1 in EAM directly led to collagen deposition by a PKCß/Erk1/2-dependent pathway: cardiac fibroblast/myofibroblast might be another source of HMGB1.

High mobility group box 1 (HMGB1), an important inflammatory mediator, is actively secreted by immune cells and some non-immune cells or passively released by necrotic cells. HMGB1 has been implicated in many inflammatory diseases. Our previous published data demonstrated that HMGB1 was up-regulated in heart tissue or serum in experimental autoimmune myocarditis (EAM); HMGB1 blockade could ameliorate cardiac fibrosis at the last stage of EAM. And yet, until now, no data directly showed that HMGB1 was associated with cardiac fibrosis. Therefore, the aims of the present work were to assess whether (1) up-regulated HMGB1 could directly lead to cardiac fibrosis in EAM; (2) cardiac fibroblast/myofibroblasts could secrete HMGB1 as another source of high-level HMGB1 in EAM; and (3) HMGB1 blockade could effectively prevent cardiac fibrosis at the last stage of EAM. Our results clearly demonstrated that HMGB1 could directly lead to cardiac collagen deposition, which was associated with PKCß/Erk1/2 signalling pathway; furthermore, cardiac fibroblast/myofibroblasts could actively secrete HMGB1 under external stress; and HMGB1 secreted by cardiac fibroblasts/myofibroblasts led to cardiac fibrosis via PKCß activation by autocrine means; HMGB1 blockade could efficiently ameliorate cardiac fibrosis in EAM mice.

[Release of HMGB1 by LPS-treated cardiac fibroblasts and its contribution to the production of collagen type I and III].

AIM: To investigate whether cardiac fibroblasts (CFs) treated by LPS can actively secrete high-mobility group box protein 1 (HMGB1) and to analyze the correlation between HMGB1 releasing and the accumulation of collagen type I , III . METHODS: CFs were isolated from the heart of 7-14-day-old BALB/c mice and cultured in DMEM with 10% fetal bovine serum (FBS). We collected the CFs and cell supernatants after treated by LPS for 0, 6, 12, 24, 36, 48 h, respectively. The mRNA and protein expression levels of HMGB1, collagen 1a1 (col1a1) and collagen 3a1 (col3a1) in CFs after LPS stimulation were detected by RT-PCR and Western blotting, respectively. The intracellular localization of HMGB1 in treated CFs was investigated by immunofluorescence. RESULTS: After 0-6 h of LPS stimulation, the mRNA levels of HMGB1, col1a1, col3a1 had no significant changes; but increased obviously at 12, 24, 36, 48 h. HMGB1 was found in the cell supernatant by Western blotting after 24 h LPS stimulation, and its expression decreased following the first rise in CFs. Meanwhile, immunofluorescence showed HMGB1 translocation from nucleus to cytoplasm. The levels of col1a1 and col3a1 were up-regulated in CFs after stimulation. CONCLUSION: LPS can induce HMGB1 translocation from nucleus to cytoplasm and across cellular membrane to the outside of CFs at a time-dependent manner. Col1a1 and Col3a1, which are closely associated with myocardial fibrosis, were obviously up-regulated by LPS stimulation, which indicates that actively released HMGB1 might contribute to myocardial fibrosis following the endotoxin induced-sepsis.

IL-17 contributes to cardiac fibrosis following experimental autoimmune myocarditis by a PKCß/Erk1/2/NF-κB-dependent signaling pathway.

Myocarditis is a common clinical cardiovascular disease, and some patients progress to dilated cardiomyopathy (DCM) with chronic heart failure. Common viral infections are the most frequent cause of myocarditis, but other pathogens and autoimmune diseases have also been implicated. T(h)17 cells are novel IL-17-producing effector T helper cells that play an important role in the development of autoimmune myocarditis. Furthermore, IL-17 is also important in post-myocarditis cardiac remodeling and progression to DCM. However, the mechanisms whereby IL-17 and IL-17-producing cells promote the progression of cardiac fibrosis remain unclear. We therefore investigated whether IL-17 directly induced cardiac fibrosis in experimental autoimmune myocarditis (EAM) and explored the possible molecular mechanisms. The EAM model was induced and serum IL-17 level was detected by ELISA; western blot, immunofluorescence and sirius red staining were used to analyze the collagen expression. PCR was used to assay the IL-17RA and IL-17RC. The results indicated that IL-17 induced cardiac fibrosis both in vitro and in vivo. The protein kinase C (PKC)ß/Erk1/2/NF-κB (Nuclear Factor κappa B) pathway was involved in the development of myocardial fibrosis and IL-17 contributed to cardiac fibrosis following EAM via this pathway. These results provide the first direct evidence for the involvement of the PKCß/Erk1/2/NF-κB signaling pathway in IL-17-induced myocardial fibrosis.

Complex class 1 integron containing bla ( CTX-M-1 ) genes isolated from Escherichia coli: a potentially novel resistant gene-capturing tool kit.

For this study, ten complex class 1 integron was characterized in Escherichia coli (E. coli) isolates from Zhenjiang. Among the ten isolates, five included the bla ( CTX-M-1 ) gene between orf513 and the IS 3000. Analysis the five isolates by PFGE showed that zj102 and zj562 had same patterns profiles, which suggested that the spread of a specific clone contributed to a wide dissemination of a particular type of integron; the results also indicated that the complex class 1 integron might be a potentially novel resistant gene-capturing tool kit.

Role of positive selection in functional divergence of mammalian neuronal apoptosis inhibitor proteins during evolution.

Neuronal apoptosis inhibitor proteins (NAIPs) are members of Nod-like receptor (NLR) protein family. Recent research demostrated that some NAIP genes were strongly associated with both innate immunity and many inflammatory diseases in humans. However, no similar phenomena have been reported in other mammals. Furthermore, some NAIP genes have undergone pseudogenization or have been lost during the evolution of some higher mammals. We therefore aimed to determine if functional divergence had occurred, and if natural selection had played an important role in the evolution of these genes. The results showed that NAIP genes have undergone pseudogenization and functional divergence, driven by positive selection. Positive selection has also influenced NAIP protein structure, resulting in further functional divergence.