Malignant phyllodes tumor of the breast with predominant osteosarcoma and chondrosarcomatous differentiation: a rare case report and review of literature.

Background: Phyllodes tumors (PTs), which account for less than 1% of mammary gland tumors, composed of both epithelial and stromal components. If a malignant heterologous component is encountered, PT is considered malignant. Malignant phyllodes tumors (MPTs) only account for 8% to 20% of PTs. We report a case of MPT with osteosarcoma and chondrosarcoma differentiation and review the literature to discuss the differential diagnosis and therapy. Case presentation: A 59-year-old Chinese woman come to our hospital because of a palpable mass she had had for 1 months in the left breast. Preoperative core needle biopsy (CNB) was performed on the left breast mass on January 11, 2023. Pathological diagnosis was malignant tumor, the specific type was not clear. Mastectomy and sentinel lymph node biopsy of the left breast was performed. No metastasis was found in 3 sentinel lymph nodes identified by carbon nanoparticles and methylene blue double staining. Heterologous osteosarcoma and chondrosarcomatous differentiation of phyllodes tumor were observed. Immunohistochemistry: spindle tumor cells ER(-), PR(-), HER-2(-), CK-pan(-), CK7(-), CK8(-), SOX10(-), S100(-), and MDM2(-), CK5/6(-), P63(-), P40(-) were all negative. CD34:(+), SATB2(+), P53(90% strong), CD68 (+), Ki-67(LI: about 60%). No ductal carcinoma in situ was found in the breast. Fluorescence in situ hybridization (FISH) indicated USP6 was negatively expressed on formalin-fixed, paraffin-embedded (FFPE) tissue sections. Conclusion: MPTs are rare, and heterologous differentiation in MPTs is exceedingly rare. It could be diagnosed by pathology when metaplastic carcinoma, primary osteosarcoma, or myositis ossificans were excluded. This case could help clinicians to improve the prognosis and treatment of this disease.

Appearance of Recalcitrant Dissolved Black Carbon and Dissolved Organic Sulfur in River Waters Following Wildfire Events.

Increasing wildfire frequency, a consequence of global climate change, releases incomplete combustion byproducts such as aquatic pyrogenic dissolved organic matter (DOM) and black carbon (DBC) into waters, posing a threat to water security. In August 2022, a series of severe wildfires occurred in Chongqing, China. Samples from seven locations along the Yangtze and Jialing Rivers revealed DBC, quantified by the benzene poly(carboxylic acid) (BPCA) method, comprising 9.5-19.2% of dissolved organic carbon (DOC). High concentrations of BPCA-DBC with significant polycondensation were detected near wildfire areas, likely due to atmospheric deposition driven by wind. Furthermore, Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR-MS) revealed that wildfires were associated with an increase in condensed aromatics, proteins, and unsaturated hydrocarbons, along with a decrease in lignins. The condensed aromatics primarily consisted of dissolved black nitrogen (DBN), contributing to abundant high-nitrogen-containing compounds in locations highly affected by wildfires. Meanwhile, wildfires potentially induced the input of recalcitrant sulfur-containing protein-like compounds, characterized by high oxidation, aliphatic nature, saturation, and low aromaticity. Overall, this study revealed the appearance of recalcitrant DBC and dissolved organic sulfur in river waters following wildfire events, offering novel insights into the potential impacts of wildfires on water quality and environmental biogeochemistry.

Jianpi Jiedu decoction reverses 5-fluorouracil resistance in colorectal cancer by suppressing the xCT/GSH/GPX4 axis to induce ferroptosis.

Introduction: Innate and acquired chemoresistance in colorectal cancer (CRC) often results in 5-fluorouracil (5-FU) treatment failure. This study aimed to investigate the potential of Jianpi Jiedu (JPJD) decoction to reverse 5-FU resistance in CRC and clarify its potential mechanism of action. Methods: The CCK-8 assay was employed to assess cell activity. Flow cytometry was employed to assess various parameters including cell apoptosis, cell cycle distribution, P-glycoprotein (P-gp) activity, reactive oxygen species levels, and lipid peroxidation. Metabolomics analysis was conducted to identify differentially expressed metabolites. Western blotting was utilized for protein expression analysis. Results: In this study, we demonstrated that the combined JPJD and 5-FU treatment reversed 5-FU resistance in HCT8/5-FU cells, inducing cell apoptosis, causing G2/M-phase cell cycle arrest, and reducing P-gp protein expression and activity. Metabolomics analysis revealed ferroptosis as a key pathway in the development of 5-FU resistance. Furthermore, the combination treatment reversed drug resistance primarily by impacting ferroptosis and triggering critical ferroptosis events through the suppression of the cystine/glutamate transporter (xCT)/glutathione (GSH)/glutathione peroxidase (GPX4) axis. Conclusion: JPJD decoction primarily suppressed the xCT/GSH/GPX4 axis to trigger ferroptosis, thereby effectively reversing 5-FU resistance in colorectal cancer (CRC).

Mapping the intellectual structure and landscape of colorectal cancer immunotherapy: A bibliometric analysis.

Immunotherapy, particularly immune checkpoint inhibitor (ICIs) therapy, stands as an innovative therapeutic approach currently garnering substantial attention in cancer treatment. It has become a focal point of numerous studies, showcasing significant potential in treating malignancies, including lung cancer and melanoma. The objective of this research is to analyze publications regarding immunotherapy for colorectal cancer (CRC), investigating their attributes and identifying the current areas of interest and cutting-edge advancements. We took into account the publications from 2002 to 2022 included in the Web of Science Core Collection. Bibliometric analysis and visualization were conducted using CiteSpace, VOSviewer, R-bibliometrix, and Microsoft Excel. The quantity of publications associated with this domain has been steadily rising over the years, encompassing 3753 articles and 1498 reviews originating from 573 countries and regions, involving 19,166 institutions, 1011 journals, and 32,301 authors. In this field, China, the United States, and Italy are the main countries that come forward for publishing. The journal with the greatest impact factor is CA-A Cancer Journal for Clinicians. Romain Cohen leads in the number of publications, while Le Dt stands out as the most influential author. The immune microenvironment and immune infiltration are emerging as key hotspots and future research directions in this domain. This research carries out an extensive bibliometric examination of immunotherapy for colorectal cancer, aiding researchers in understanding current focal points, investigating possible avenues for research, and recognizing forthcoming development trends.

Photo-oxidation of Micro- and Nanoplastics: Physical, Chemical, and Biological Effects in Environments.

Micro- and nanoplastics (MNPs) are attracting increasing attention due to their persistence and potential ecological risks. This review critically summarizes the effects of photo-oxidation on the physical, chemical, and biological behaviors of MNPs in aquatic and terrestrial environments. The core of this paper explores how photo-oxidation-induced surface property changes in MNPs affect their adsorption toward contaminants, the stability and mobility of MNPs in water and porous media, as well as the transport of pollutants such as organic pollutants (OPs) and heavy metals (HMs). It then reviews the photochemical processes of MNPs with coexisting constituents, highlighting critical factors affecting the photo-oxidation of MNPs, and the contribution of MNPs to the phototransformation of other contaminants. The distinct biological effects and mechanism of aged MNPs are pointed out, in terms of the toxicity to aquatic organisms, biofilm formation, planktonic microbial growth, and soil and sediment microbial community and function. Furthermore, the research gaps and perspectives are put forward, regarding the underlying interaction mechanisms of MNPs with coexisting natural constituents and pollutants under photo-oxidation conditions, the combined effects of photo-oxidation and natural constituents on the fate of MNPs, and the microbiological effect of photoaged MNPs, especially the biotransformation of pollutants.

Adsorption characteristics and mechanisms of water-soluble polymers (PVP and PEG) on kaolin and montmorillonite minerals.

The excessive use and accumulation of water-soluble polymers (WSPs, known as "liquid plastics") in the environment can pose potential risks to both ecosystems and human health, but the environmental fate of WSPs remains unclear. Here, the adsorption behavior of WSPs with different molecular weight on kaolinite (Kaol) and montmorillonite (Mt) were examined. The results showed that the adsorption of PEG and PVP on minerals were controlled by hydrogen bond and van der Waals force. The Fourier transform infrared (FTIR) spectra and two-dimensional correlation spectroscopy (2D-COS) analysis revealed that there were interactions between the Al-O and Si-O groups of the minerals and the polar O- or N-containing functional groups as well as the alkyl groups of PEG and PVP. The adsorption characteristics of WSPs were closely related to their molecular weight and the pore size of minerals. Due to the relatively large mesopore size of Kaol, both PEG and PVP were absorbed into inner spaces, for which the adsorption capacity increased with molecular weight of the polymers. For Mt, all types of PEG could enter its micropores, while PVP with larger molecular weights appeared to be confined externally, leading to a decrease in the adsorption capacity of PVP with increasing molecular weight. The findings of this study provide a theoretical basis for scientific evaluation of environmental processes of WSPs.

Assessing the Mass Concentration of Microplastics and Nanoplastics in Wastewater Treatment Plants by Pyrolysis Gas Chromatography-Mass Spectrometry.

The level of microplastics (MPs) in wastewater treatment plants (WWTPs) has been well evaluated by the particle number, while the mass concentration of MPs and especially nanoplastics (NPs) remains unclear. In this study, pyrolysis gas chromatography-mass spectrometry was used to determine the mass concentrations of MPs and NPs with different size ranges (0.01-1, 1-50, and 50-1000 µm) across the whole treatment schemes in two WWTPs. The mass concentrations of total MPs and NPs decreased from 26.23 and 11.28 µg/L in the influent to 1.75 and 0.71 µg/L in the effluent, with removal rates of 93.3 and 93.7% in plants A and B, respectively. The proportions of NPs (0.01-1 µm) were 12.0-17.9 and 5.6-19.5% in plants A and B, respectively, and the removal efficiency of NPs was lower than that of MPs (>1 µm). Based on annual wastewater effluent discharge, it is estimated that about 0.321 and 0.052 tons of MPs and NPs were released into the river each year. Overall, this study investigated the mass concentration of MPs and NPs with a wide size range of 0.01-1000 µm in wastewater, which provided valuable information regarding the pollution level and distribution characteristics of MPs, especially NPs, in WWTPs.

Multicenter analysis on the non-suicidal self-injury behaviors and related influencing factors-A case study of left-behind children in northeastern Sichuan.

BACKGROUND: Few studies have been conducted focusing on the non-suicidal self-injury (NSSI) incidence rate and influencing factors among left-behind children in northeastern Sichuan, China. In this study, we investigated the incidence rate of the NSSI behaviors, levels of anxiety and depression in left-behind children in northeastern Sichuan, and relevant sociodemographic factors. METHODS: The NSSI behaviors were identified using the Ottawa Self-injury Inventory (Chinese version). Its incidence rate and related influencing factors were evaluated by Cluster sampling; the Depression Anxiety Stress Scale-21 Items (DASS-21) was adopted to assess the levels of anxiety, depression, and stress. RESULTS: A total of 9450 adolescents met the inclusion criteria, including 543 with NSSI behaviors, and the prevalence of NSSI was 5.7 %. There were 3596 left-behind children, and 243 of them had NSSI behaviors, the NSSI incidence in left-behind children was 6.8 %. There were 5854 non-left-behind children, and the NSSI incidence in non-left-behind children was 5.1 %. Left-behind children's NSSI behaviors were remarkably correlated with five risk factors: being female (OR = 2.411, 95%CI = 1.773-3.279), parents' divorce (OR = 1.742, 95%CI = 1.262-2.404), elder age (OR = 1.120, 95%CI = 1.028-1.219), severe depression (OR = 1.212, 95%CI = 1.148-1.281), and high anxiety (OR = 1.170, 95%CI = 1.093-1.251). LIMITATIONS: This is a cross-sectional study, we cannot probe into the causality between NSSI behaviors and corresponding risk factors. Reporting and recalling biases may be unavoidable as questionnaires are performed by self-rating scales and retrospective reports. CONCLUSION: The NSSI behaviors are common in left-behind children in northeastern Sichuan. This study proposes that prevention and intervention measures are necessary for the healthy growth of such children.

Combined effects of photoaging and natural organic matter on the colloidal stability of nanoplastics in aquatic environments.

The transport and fate of nanoplastics (NPs) in aquatic environments are closely associated with their colloidal stability, which is affected by aging and natural organic matter (NOM) adsorption. This study systematically investigated the combined effects of photoaging and NOM (e.g. humic acids, HA; and a model protein, bovine serum albumin, BSA) on the aggregation kinetics of NPs (polystyrene, PS) in NaCl and CaCl2 solutions. Our results showed that photoaged NPs adsorbed less HA than pristine NPs due to weaker hydrophobic and π-π interactions. In return, HA showed weaker impacts on NPs' stability after photoaging. Differently, photoaged NPs absorbed more BSA than pristine NPs due to stronger hydrogen bonding and electrostatic attraction. Thus, the inhibitory effects of BSA on the aggregation kinetics of NPs were enhanced after photoaging. Regarding the effects of NOM on the aging of NPs, our results showed that HA competed with NPs for photons and underwent photo-degradation. Subsequently, the destruction/reconstruction of adsorbed HA increased (in NaCl) or decreased (in CaCl2) the stability of NPs. Notably, light radiation-induced flocculation of BSA molecules, which wrapped and integrated NPs and lead to their destabilization. Overall, this study provided new insights into the aggregation behavior of NPs in aquatic systems, which have significant implications for predicting the transport and fate of NPs in complex real-world environments.

A Very rare case report of male invasive micropapillary breast carcinoma in China and review of literature.

INTRODUCTION: To report a rare case of male breast micropapillary carcinoma (MBMC) with early metastasis of axillary lymph nodes, the molecular characteristics were further studied in both primary and metastatic foci. In addition, we have reviewed similar published cases in the literature and tried to outline the molecular characteristics of this disease. PRESENTATION OF CASE: A 63-year-old male patient presented with a painless mass on the medial side of left breast and was pathologically diagnosed with MBMC. Postoperative examination revealed 80 % invasive ductal carcinoma (IDC) and 20 % invasive micropapillary carcinoma (IMPC) in the mass, with a histological grade WHO III. There were 25 axillary lymph nodes, 11 of which were metastatic, including 5 macrometastasis and 1 micrometastasis, with a lymph node metastasis rate of 44 % (11/25). Pathological TNM stage: pT2N2M0. Immunohistochemical results in primary foci: AR (90 %, +), HER- 2 (1 +) and ER (90 %, +), PR (60 %, +), E - cadherin (+), EGFR (-), GATA - 3 (90 %, 3 +), Ki - 67 (50 %). Lymph node metastasis: AR (40 %, strong +), HER-2 (2+), ER (90 %, strong +), PR (40 %, strong +), Ki-67 (50 %). AR and Ki-67 were obviously expressed in both primary and metastatic foci. A mixture of IDC and IMPC was found in lymph node metastases, both of which expressed varying degrees of AR and Ki-67. CLINICAL DISCUSSION: MBMC is easy to early metastasized to lymph node. In this case, there was no significant difference between primary and metastatic cancer in molecular results. It is positive for ER and PR, but negative for HER-2 in this patient. There is few data on male HER-2 expression, HER-2 expression is deficient in this case. AR is found to be positive in 50 % of MBMC cases, although their clinical relevance has not been established yet. The significance of EGFR in the prognosis of MBMC remains unclear, however, EGFR positive expression is not found in this patient. CONCLUSIONS: MBMC is a rare disease characterized by early lymph node metastasis, high histological grade, positive ER and PR, and generally negative HER-2. The molecular biological characteristics and prognostic significance of MBMC need to be further studied in order to develop the optimal treatment strategy.

Identification and Quantification of Nanoplastics in Surface Water and Groundwater by Pyrolysis Gas Chromatography-Mass Spectrometry.

Nanoplastics (NPs) are currently considered an environmental pollutant of concern, but the actual extent of NP pollution in environmental water bodies remains unclear and there is not enough quantitative data to conduct proper risk assessments. In this study, a pretreatment method combining ultrafiltration (UF, 100 kDa) with hydrogen peroxide digestion and subsequent detection with pyrolysis gas chromatography-mass spectrometry (Py-GC/MS) was developed and used to identify and quantify six selected NPs in surface water (SW) and groundwater (GW), including poly(vinylchloride) (PVC), poly(methyl methacrylate) (PMMA), polypropylene (PP), polystyrene (PS), polyethylene (PE), and poly(ethylene terephthalate) (PET). The results show that the proposed method could detect NPs in environmental water samples. Nearly all selected NPs could be detected in the surface water at all locations, while PVC, PMMA, PS, and PET NPs were frequently below the detection limit in the groundwater. PP (32.9-69.9%) and PE (21.3-44.3%) NPs were the dominant components in both surface water and groundwater, although there were significant differences in the pollution levels attributed to the filtration efficiency of riverbank, with total mass concentrations of 0.283-0.793 µg/L (SW) and 0.021-0.203 µg/L (GW). Overall, this study quantified the NPs in complex aquatic environments for the first time, filling in gaps in our knowledge about NP pollution levels and providing a useful methodology and important reference data for future research.

Influence of dissolved black carbon on the aggregation and deposition of polystyrene nanoplastics: Comparison with dissolved humic acid.

Dissolved black carbon (DBC), widely found in soil and water environments is likely to affect the transport of nanoplastics in aquatic environments. The aggregation and deposition behaviors of fresh and aged polystyrene nanoplastics (PSs) with and without DBC in NaCl solution were investigated by time-resolved dynamic light scattering (DLS) and quartz crystal microbalance with dissipation monitoring equipment (QCM-D) techniques. The results suggest that DBC can screen the surface charges of PSs by interacting with PSs through hydrogen bonding, hydrophobic interactions and π-π interactions, although they were negatively charged. DBC promoted the aggregation of PSs under relatively low ionic strengths, and it minimally affected the stability of PSs under high ionic strength. Deposition experiments showed that both DBC in salt solution and DBC adsorption on silica surface facilitated the deposition of fresh PSs while HA inhibited both deposition processes. After aging, PSs were more stable, and the effects of DBC and HA were weakened. This study investigated the influence mechanism of DBC on the aggregation and deposition behaviors, which provides new insights into the stability and transport of PSs in complex aquatic environments.

Interactions between activated sludge extracellular polymeric substances and model carrier surfaces in WWTPs: A combination of QCM-D, AFM and XDLVO prediction.

To understand the biofilm formation of biofilm-based processes in wastewater treatment plants (WWTPs), the interaction mechanisms between extracted extracellular polymeric substances (EPS) and three model carrier surfaces (i.e., negatively charged hydrophilic silica, positively charged hydrophilic alumina, and neutral charged hydrophobic polystyrene) were investigated employing a laboratory quartz crystal microbalance with dissipation monitoring equipment (QCM-D) and an atomic force microscope (AFM). The data suggested that surface charge and hydrophobicity of both EPS and carriers played significant roles in the interaction behaviors. Moreover, increases in ionic strength could lead to the increasing zeta potential and hydrophobicity of EPS. It is worth noting that long-range DLVO forces dominated the EPS deposition on carriers in lower ionic strength while short-range Lewis acid-base (AB) interaction controlled the adhesion behaviors in higher ionic strength. Besides, the presence of calcium ions contributed to the adhesion behaviors because of strong charge neutralization and hydrophobic effect. Bound EPS (BEPS) showed higher affinity to model carriers than dissolved EPS (DEPS), which conformed to XDLVO prediction rather than classical DLVO model. Overall, these results provide insights into the influence mechanisms of carrier characteristics, ionic strength, calcium ion and EPS components on the interaction between EPS and representative carriers, contributing to predict and regulate biofilm formation in biofilm-based processes.

Impacts of carrier properties, environmental conditions and extracellular polymeric substances on biofilm formation of sieved fine particles from activated sludge.

To investigate the effect of properties of carriers, environmental conditions and extracellular polymeric substances (EPS) on the initial adhesion of biofilm formation in biofilm-based reactors, a quartz crystal microbalance with dissipation (QCM-D) was applied to monitor the deposition rates and viscoelastic properties of sieved sludge particles on model biocarriers. The results suggested that surface charge, hydrophobicity and surface coating of five representative carriers influenced deposition rates and viscoelastic properties of biofilm, whose variation with NaCl concentrations was controlled by not only the Derjaguin-Landau-Verwey-Overbeek (DLVO) interaction but also non-DLVO forces. On hydrophobic surface, the addition of cationic substances enhanced the deposition rates and the compaction of deposited layer due to strong "hydrophobizing effect". For examples, 10 mM Ca2+, 10 mM Mg2+ and 10 mg/L poly-l-lysine enhanced the deposition rates to nearly 3, 2 and 4 times, as well as reduced the softness of deposited layer to almost 35%, 60% and 35%. Conversely, 10 mg/L negatively charged alginate might cause water retainment and steric shielding, thereby reducing the deposition rates to 40% and increasing the softness of deposited film to 120%. The presence of EPS sub-fractions can modify surface properties of sludge particles, to distinct degrees, contributing to biofilm formation. Notably, compared to tightly bound EPS (TB-EPS), loosely bound EPS (LB-EPS) was more conducive to microbial attachment, but the presence of LB-EPS promoted the formation of a soft layer on a hydrophobic surface. Overall, these results provide insights into intrinsic mechanisms of the variation of deposition rates and viscoelastic properties responding to critical factors, which are meaningful to predict and regulate the initial adhesion process in biofilm-based reactors.

Serial anti-tuberculous immune responses during the follow-up of patients with tuberculous pleurisy.

Little is known about the decay kinetics of interferon (IFN)-γ response and its influencing factors in tuberculous pleurisy. We enrolled thirty-two patients with tuberculous pleurisy prospectively and followed up at month 0, 6, and 9, at which time peripheral venous blood was drawn for interferon gamma release assay (IGRA) by means of QuantiFERON-TB Gold In-Tube (QFT-GIT). Demographic and clinical data were captured. To identify significant predictive factors influencing the IFN-γ response, multiple linear regression analyses were performed. Percentage of CD4+, CD8+, Vγ2Vδ2 T cells and Treg cells were measured by flow cytometry. The percentage of QFT-GIT-positive patients at baseline, month 6 and month 9 were 96.9% (30/32), 90.6% (29/32) and 84.4% (27/32), respectively. Quantitative IFN-γ response at baseline were significantly correlated with symptom duration (P = .003, R = 0.261) and age (P = .041, R = 0.132). Besides, the decreases of the IFN-γ response at month 6 and month 9 were positively correlated with the IFN-γ level at baseline. The dynamic tendency of the percentages of Treg cells was similar to the IFN-γ responses at each time-point. Quantitative IFN-γ response could be influenced by host immune status, instead of disease burden and anti-tuberculosis treatment. IGRA is probably not a useful biomarker of treatment efficacy in tuberculous pleurisy.

High long non-coding RNA NORAD expression predicts poor prognosis and promotes breast cancer progression by regulating TGF-ß pathway.

BACKGROUND: To investigate the expression and significance of long noncoding RNA NORAD (lncRNA-NORAD) in breast cancer. METHODS: Q-PCR was adopted to detect the mRNA expression of lncRNA-NORAD in breast cancer and adjacent tissues, survival analysis to compare the low-expression groups with the Kaplan-Meier method. Knockout of lncRNA-NORAD was adopted to observe the effects on the cell proliferation, migration and invasion of breast cancer in vitro and in vivo. The TGF-ß/RUNX2 signaling pathway was observed by Western blot after the knockout of lncRNA-NORAD. RESULTS: Increased expression of lncRNA-NORAD in breast cancer tissues promotes proliferation, invasion and migration of breast cancer cells and correlated with worse prognosis. LncRNA-NORAD activated TGF-ß/RUNX2 signaling pathway in breast cancer cells. CONCLUSIONS: These results strongly suggested that lncRNA-NORAD might play an important role in breast cancer progression and potentially be a new therapeutic target.

Detection and quantification of Aeromonas schubertii in Channa maculata by TaqMan MGB probe fluorescence real-time quantitative PCR.

Aeromonas schubertii is a major epidemiological agent that threatens cultured snakeheads (Channidae) and has caused great economic losses in fish-farming industries in China in recent years. In present study, a specific TaqMan minor groove binder (MGB) probe fluorescence real-time quantitative PCR (qPCR) assay was developed to rapidly detect and quantify A. schubertii. A pair of qPCR primers and a TaqMan MGB probe were selected from the rpoD gene, which were shown to be specific for A. schubertii. A high correlation coefficient (R2  = 0.9998) in a standard curve with a 103% efficiency was obtained. Moreover, the qPCR method's detection limit was as low as 18 copies/µl, which was 100 times more sensitive than that of conventional PCR. The detection results for the A. schubertii in pond water and fish tissue were consistent with those of the viable counts. Bacterial load changes detected by qPCR in different tissues of snakeheads infected with A. schubertii showed that the gills and intestines may be the entry for A. schubertii, and the spleen and kidney are major sites for A. schubertii replication. The established method in present study should be a useful tool for the early surveillance and quantitation of A. schubertii.

Serum Macrophage Migration Inhibitory Factor as a Biomarker of Active Pulmonary Tuberculosis.

BACKGROUND: Macrophage migration inhibitory factor (MIF), a pro-inflammatory cytokine with chemokine-like functions, has been shown to play a central role in several acute and chronic inflammatory diseases. However, limited information is available regarding the use of MIF as an inflammatory pathway marker in patients with tuberculosis. This study aimed to investigate the association of MIF with IFN-γ and TNF-α in active pulmonary tuberculosis (APTB) following anti-tuberculosis treatment. METHODS: The MIF, TNF-α, and IFN-γ serum levels were determined in 47 patients with APTB by cytokine-specific ELISA at four phases: prior to anti-tuberculosis drug treatment (baseline), and following 2, 4, and 6 months of treatment. In addition, we measured the MIF, TNF-α, and IFN-γ serum levels in 50 health controls. RESULTS: MIF serum levels were significantly elevated (P<0.05) in patients with APTB prior to treatment compared with that in control subjects, and TNF-α ≥449.7 pg/mL was associated with high MIF levels (≥13.1 ng/mL). MIF levels were significantly reduced (P<0.01) following 2, 4, and 6 months of treatment, with variations in TNF-α and IFN-γ serum levels. MIF levels were positively correlated with the paired TNF-α level at baseline (r=0.1103, P=0.0316) and following 6 months of treatment (r=0.09569, P=0.0364). CONCLUSIONS: A reduction in the MIF serum levels in patients with APTB following anti-tuberculosis treatment may positively affect host immune protection against Mycobacterium tuberculosis infection. Thus, serum MIF levels may constitute a useful marker for assessing therapy effectiveness in patients with APTB.

Reflectance confocal microscopy features of irritant cutaneous reactions to sodium lauryl sulphate in healthy adults / 中华皮肤科杂志

Objective To investigate reflectance confocal microscopy (RCM) features of irritant cutaneous reactions to sodium lauryl sulphate (SLS) in healthy persons aged from 18 to 60 years,to analyze effects of age and gender on cutaneous reactions,and to estimate the value of RCM in objective evaluation of cutaneous reactions.Methods An occlusive patch test was performed on the back of 120 healthy testees with 0.1％ and 0.5％ SLS solution (0.1％ and 0.5％ SLS groups) and distilled water (negative control group) for 48 hours.At different time points after the patch removal,clinical evaluation and RCM were performed.Results RCM imaging in the 0.1％ and 0.5％ SLS groups showed parakeratosis,indistinct structure of the stratum corneum,spongiosis and infiltration of inflammatory cells in the epidermis,and telangiectasia in the papillary dermis.The incidence of RCM features reached the peak until 24 hours after the removal of 0.1％ and 0.5％ SLS patches,and the incidence of telangiectasia in the dermis was up to 66.7％ and 95.0％ in the 0.1％ and 0.5％ SLS groups respectively.At 24 hours after the removal of 0.5％ SLS patch,the incidence of spongiosis was significantly lower in the males than in the females (68.9％ [42/61] vs.84.7％ [50/59],x2 =4.24,P ＜ 0.05).However,the incidence of spongiosis was significantly higher in testees aged 18-40 years than in those aged 41-60 years at 24 hours after the removal of 0.1％ SLS patch (53.3％[32/60] vs.35.0％[21/60],x2 =4.09,P ＜ 0.05).For the other RCM features,there were no significant differences in their incidence between different genders or age groups after the removal of 0.1％ and 0.5％ SLS patches (all P ＞ 0.05).Clinical evaluation showed that after the removal of 0.1％ and 0.5％ SLS patches,no significant difference in the incidence of irritant cutaneous reactions was observed between the males and the females or between the testees aged 18-40 years and those aged 41-60 years (all P ＞ 0.05).There were good correlations between the clinical evaluation results and RCM features.At 24 hours after the removal of 0.1％ SLS patch,the correlation coefficient between spongiosis and clinical evaluation results was up to 0.77,so was that between telangiectasia in the dermis and clinical evaluation results (both P ＜ 0.001).However,at 0.5 hour after the removal of SLS patches,clinical evaluation showed that the positive reaction rates were 2.5％ (3/120) and 12.5％ (15/120) in the 0.1％ and 0.5％ SLS groups respectively.In the meantime,there were 17.5 ％ (21 / 120) and 51.7％ (62/120) of testees manifesting more than 2 RCM features in the 0.1％ and 0.5％ SLS groups respectively,which were more similar to the clinical evaluation results at 24 hours after the removal of SLS patches (34.2％ [41/120] and 85.0％ [102/120] in the 0.1％ and 0.5％ SLS groups respectively) compared with the clinical evaluation results at 0.5 hour after the removal of SLS patches.Conclusions Neither gender nor age affects irritant cutaneous reactions to 0.1％ and 0.5％ SLS.Compared with clinical evaluation,RCM can evaluate cutaneous reactions more objectively and accurately in the early stage of irritant reactions.

Prevalence of Carbapenem-Resistant Klebsiella Pneumoniae (CRKP) and the Distribution of Class 1 Integron in Their Strains Isolated from a Hospital in Central China.

Objective The aim of our study is to investigate the prevalence of Carbapenem-resistant Klebsiella pneumoniae (CRKP) and the genetic characteristics of the class 1 integron in CRKP on multi-drug resistance.Methods Clinical Klebsiella pneumoniae strains were collected from multiple departments of a hospital in central China. CRKP strains were identified among the isolates, and antibiotics susceptibility of CRKP strains was analyzed. The polymerase chain reaction (PCR) was adopted to amplify the class 1 integron variable area. The integron genetic structure was analyzed with enzyme digestion and DNA sequencing technology. The relation between class 1 integron and drug resistance was analyzed statistically.Results Totally 955 strains of Klebsiella pneumoniae were isolated from varied sites of the hospital, and 117(12.3%) of them were identified as CRKP, with a separation rate of 8.9% (26/292) in 2013, 11.3% (38/336) in 2014 and 16.2% (53/327) in 2015, which shows an increasing trend by year. 44.4% (52/117) of CRKP strains were separated from specimen of ICU, and 61.5% (72/117) were from sputum. Over 95% CRKP strains were resistant to ampicillin/sulbactam, aztreonam, imipenem, meropenem, ceftazidme, cefotaxime, cefepime,and piperacillin, while relatively low resistant rates were found in tigecycline (12.8%) and colistin (35.9%). The class 1 integron was detected in 77.8% (91/117) of CRKP strains. Class 1 integron of CRKP was significantly correlated with the antibiotic resistance to the tobramycin, gentamicin and amikacin (all P<0.01). The gene cassette analysis of variable area of class 1 integron showed that aadA2 accounts for 64.8% (59/91), aacA4-catB8-aadA1 23.1% (21/91), and aadA2-dfrA25 12.1% (11/91).Conclusions CRKP has an increasing trend in a clinical setting in China, and most of them were resistant to multiple antibiotics. Class 1 integron in CRKP has strong ability to capture the genes resistant to aminoglycosides antibiotics from environment, with the aadA2 gene as the most popular one.