Genome assembly of Ottelia alismoides, a multiple-carbon utilisation aquatic plant.

OBJECTIVES: Ottelia Pers. is in the Hydrocharitaceae family. Species in the genus are aquatic, and China is their centre of origin in Asia. Ottelia alismoides (L.) Pers., which is distributed worldwide, is a distinguishing element in China, while other species of this genus are endemic to China. However, O. alismoides is also considered endangered due to habitat loss and pollution in some Asian countries. Ottelia alismoides is the only submerged macrophyte that contains three carbon dioxide-concentrating mechanisms, i.e. bicarbonate (HCO3-) use, crassulacean acid metabolism and the C4 pathway. In this study, we present its first genome assembly to help illustrate the various carbon metabolism mechanisms and to enable genetic conservation in the future. DATA DESCRIPTION: Using DNA and RNA extracted from one O. alismoides leaf, this work produced ∼ 73.4 Gb HiFi reads, ∼ 126.4 Gb whole genome sequencing short reads and ∼ 21.9 Gb RNA-seq reads. The de novo genome assembly was 6,455,939,835 bp in length, with 11,923 scaffolds/contigs and an N50 of 790,733 bp. Genome assembly completeness assessment with Benchmarking Universal Single-Copy Orthologs revealed a score of 94.4%. The repetitive sequence in the assembly was 4,875,817,144 bp (75.5%). A total of 116,176 genes were predicted. The protein sequences were functionally annotated against multiple databases, facilitating comparative genomic analysis.

Analysis of Mechanical Characteristics of the Swing Angle Milling Head of a Heavy Computer Numerical Control Milling Machine and Research on the Light Weight of a Gimbal.

As the key component of a five-axis CNC planer-type milling machine, the integral mechanical property of the A/C swing angle milling head directly affects the machining accuracy and stability of the milling machine. Taking the mechanical A/C swing-angle milling head of a five-axis numerical-control gantry milling machine as the research object, the stress deformation characteristics and natural frequency of the swing-angle milling head under actual working conditions were studied using finite-element analysis. Based on the analytical results, it was determined that the cardan frame, with its large mass proportion and strong rigidity of the whole milling head, is the object to be optimized. The topological optimization of the cardan frame, in which achieving the minimum flexibility was the optimization objective, was carried out to determine the quality reduction area. By comparing the simulation results of the cardan frames of three different rib plate structures, it was shown that the cardan frame performance of the ten-type rib plate structure was optimal. The analytical results showed that, when the cardan frame met the design requirements for stiffness and strength, the mass after optimization was reduced by 13.67% compared with the mass before optimization, the first-order natural frequency was increased by 7.9%, and the maximum response amplitude was reduced in all directions to avoid resonance, which was beneficial to the improvement of the dynamic characteristics of the whole machine. At the same time, the rationality and effectiveness of the lightweight design method of the cardan frame were verified, which has strong engineering practicality. The research results provide an important theoretical basis for the optimization of other machine tool gimbals and have important practical significance and application value.

Detection and Recognition of Tilted Characters on Railroad Wagon Wheelsets Based on Deep Learning.

The quality of railroad wheelsets is an important guarantee for the safe operation of wagons, and mastering the production information of wheelsets plays a vital role in vehicle scheduling and railroad transportation safety. However, when using objection detection methods to detect the production information of wheelsets, there are situations that affect detection such as character tilting and unfixed position. Therefore, this paper proposes a deep learning-based method for accurately detecting and recognizing tilted character information on railroad wagon wheelsets. It covers three parts. Firstly, we construct a tilted character detection network based on Faster RCNN for generating a wheelset's character candidate regions. Secondly, we design a tilted character correction network to classify and correct the orientation of flipped characters. Finally, a character recognition network is constructed based on convolutional recurrent neural network (CRNN) to realize the task of recognizing a wheelset's characters. The result shows that the method can quickly and effectively detect and identify the information of tilted characters on wheelsets in images.

Celastrol Treatment Ameliorated Acute Ischemic Stroke-Induced Brain Injury by Microglial Injury Inhibition and Nrf2/HO-1 Pathway Activations.

Background: Stroke is the third main reason of mortality, which is the leading reason for adult disability in the globe. Poststroke inflammation is well known to cause acute ischemic stroke- (AIS-) induced brain injury (BI) exacerbation. Celastrol (CL) has exhibited anti-inflammatory activities in various inflammatory traits though underlying mechanisms remain unknown. So, the present investigation is aimed at studying CL protective mechanism against AIS-induced BI. Methods: A mouse model regarding middle cerebral artery occlusion and an oxygen-glucose deprivation (OGD) cell model with or not CL treatment were constructed to study CL protective effects. NF-E2-related factor 2 (Nrf2) was then silenced in BV2 microglia cells (BV2) to study Nrf2 role regarding CL-mediated neuroprotection. Results: The results showed that CL treatment suppressed AIS-induced BI by inhibiting NLRP3/caspase-1 pathway activations and induction of apoptosis and pyroptosis in vivo and in vitro. NLRP3/caspase-1 pathway blocking activation suppressed OGD-induced cell pyroptosis and apoptosis. Also, CL treatment reversed OGD-induced microglial injury by promoting Nrf2/heme oxygenase-1 (HO-1) pathway activations. Nrf2 downregulation reversed CL protective effects against OGD-induced microglial injury, pyroptosis, and apoptosis. Conclusion: The findings advise that CL treatment ameliorated AIS-induced BI by inhibiting microglial injury and activating the Nrf2/HO-1 pathway.

A Novel Method for Carbendazim High-Sensitivity Detection Based on the Combination of Metamaterial Sensor and Machine Learning.

Benzimidazole fungicide residue in food products poses a risk to consumer health. Due to its localized electric-field enhancement and high-quality factor value, the metamaterial sensor is appropriate for applications regarding food safety detection. However, the previous detection method based on the metamaterial sensor only considered the resonance dip shift. It neglected other information contained in the spectrum. In this study, we proposed a method for highly sensitive detection of benzimidazole fungicide using a combination of a metamaterial sensor and mean shift machine learning method. The unit cell of the metamaterial sensor contained a cut wire and two split-ring resonances. Mean shift, an unsupervised machine learning method, was employed to analyze the THz spectrum. The experiment results show that our proposed method could detect carbendazim concentrations as low as 0.5 mg/L. The detection sensitivity was enhanced 200 times compared to that achieved using the metamaterial sensor only. Our present work demonstrates a potential application of combining a metamaterial sensor and mean shift in benzimidazole fungicide residue detection.

Exosome circRNAs and ceRNA network profiles in different ANA sera.

Increasing evidences show that circRNAs are associated with some autoimmunity diseases either as a biomarker or therapeutic target. Exosomes containing nucleic acids and proteins are found in sera of series diseases and could serve as either diagnostic or therapeutic target. ANA serves as first common diagnostic test for autoimmunity disease, different ANA staining reflecting different types of autoimmunity disease. Till now, whether different ANA sera exosomes express different circRNAs and relevant ceRNA networks are still shortage of investigation. This study analyzed circRNAs, miRNAs, and their interaction networks in different ANA sera exosomes by high-throughput sequencing. It found no significant difference of total circRNAs and miRNAs amount across different ANA sera exosomes. However, significant differences were found of circRNAs, miRNA constituents, function analysis by KEGG and GO, and their ceRNA networks including miRNA-circRNA and miRNA-mRNA among different ANA sera exosomes, suggesting sera exosome circRNAs as either biomarker or mechanism of autoimmunity diseases.

Long noncoding RNA ADIRF antisense RNA 1 upregulates insulin receptor substrate 1 to decrease the aggressiveness of osteosarcoma by sponging microRNA-761.

An increasing number of studies have supported the critical regulatory actions of long noncoding RNAs (lncRNAs) in osteosarcoma (OS). However, the detailed roles of adipogenesis regulatory factor-antisense RNA 1 (ADIRF-AS1) in OS have not been comprehensively described. Hence, we first detected ADIRF-AS1 expression in OS and evaluated its clinical significance. Functional experiments were then performed to determine the modulatory role of ADIRF-AS1 in OS progression. ADIRF-AS1 was found to be overexpressed in OS, and the overall survival of patients with OS who had high ADIRF-AS1 levels was shorter than that of those with low levels. ADIRF-AS1 knockdown led to restricted proliferation, migration, and invasiveness of OS cells and increased apoptosis. Additionally, ADIRF-AS1 downregulation impeded tumor growth in vivo. Mechanistically, ADIRF-AS1 acted as a competitive endogenous RNA for microRNA-761 (miR-761) that siphoned miR-761 away from its target, namely insulin receptor substrate 1 (IRS1), leading to IRS1 overexpression. Rescue experiments showed that low levels of miR-761 or restoration of IRS1 could neutralize the effects of ADIRF-AS1 ablation in OS cells. In summary, ADIRF-AS1 exacerbates the oncogenicity of the OS cells by targeting the miR-761/IRS1 axis. Our findings may aid in the advancement of lncRNA-directed therapeutics for OS.

Long non­coding RNA LINC01748 exerts carcinogenic effects in non­small cell lung cancer cell lines by regulating the microRNA­520a­5p/HMGA1 axis.

The important functions of long non­coding RNAs in the malignancy of non­small cell lung cancer (NSCLC) has been increasingly highlighted. However, whether LINC01748 functions in a crucial regulatory role still requires further research. The aim of the present study was to investigate the biological roles of LINC01748 in NSCLC. Furthermore, different experiments were utilized to investigate the mechanism of action of LINC01748 in 2 NSCLC cell lines. Reverse transcription­quantitative PCR was used to measure mRNA expression levels. Cell Counting Kit­8 assay, flow cytometry analysis and Transwell and Matrigel assays were also used to analyze, cell viability, apoptosis, and migration and invasion, respectively. A tumor xenograft model was used for in vivo experiments. RNA immunoprecipitation experiments, luciferase reporter assays and rescue experiments were used to investigate the mechanisms involved. Data from The Cancer Genome Atlas dataset and patients recruited into the present study showed that LINC01748 was overexpressed in NSCLC. Patients with high LINC01748 mRNA expression level had shorter overall survival rate compared with that in patients with low LINC01748 mRNA expression level. Then, knockdown of LINC01748 mRNA expression level reduced cell proliferation, migration and invasion, but increased cell apoptosis in vitro. Knockdown of LINC01748 also reduced tumor growth in vivo. Mechanistically, LINC01748 could act as a competing endogenous (ce)RNA to sponge microRNA(miR)­520a­5p, to increase the expression level of the target gene, high mobility group AT­hook 1 (HMGA1) in the NSCLC cell lines. Furthermore, rescue experiments illustrated that the functions exerted by LINC01748 knockdown were negated by miR­520a­5p inhibition or HMGA1 overexpression. In summary, LINC01748 acted as a ceRNA by sponging miR­520a­5p, leading to HMGA1 overexpression, thus increasing the aggressiveness of the NSCLC cells. Accordingly, targeting the LINC01748/miR­520a­5p/HMGA1 pathway may benefit NSCLC therapy.

Study on the High-Speed Milling Performance of High-Volume Fraction SiCp/Al Composites.

Compared with other materials, high-volume fraction aluminum-based silicon carbide composites (hereinafter referred to as SiCp/Al) have many advantages, including high strength, small change in the expansion coefficient due to temperature, high wear resistance, high corrosion resistance, high fatigue resistance, low density, good dimensional stability, and thermal conductivity. SiCp/Al composites have been widely used in aerospace, ordnance, transportation service, precision instruments, and in many other fields. In this study, the ABAQUS/explicit large-scale finite element analysis platform was used to simulate the milling process of SiCp/Al composites. By changing the parameters of the tool angle, milling depth, and milling speed, the influence of these parameters on the cutting force, cutting temperature, cutting stress, and cutting chips was studied. Optimization of the parameters was based on the above change rules to obtain the best processing combination of parameters. Then, the causes of surface machining defects, such as deep pits, shallow pits, and bulges, were simulated and discussed. Finally, the best cutting parameters obtained through simulation analysis was the tool rake angle γ0 = 5°, tool clearance angle α0 = 5°, corner radius r = 0.4 mm, milling depth ap = 50 mm, and milling speed vc = 300 m/min. The optimal combination of milling parameters provides a theoretical basis for subsequent cutting.

The mediating role of resilience between work-family conflict and career development among Chinese nurses: A cross-sectional study.

AIM: To investigate the association between work-family conflicts and career development with resilience among nurses. BACKGROUND: Nurses tend to have high levels of work-family conflict. Resilience may affect their individual career development, the stability of the nursing team and the quality of nursing care. METHODS: A cross-sectional survey using correlational design was conducted in mainland China. Data were collected using demographic and career development questionnaire, work-family conflict and resilience scale. RESULTS: A total of 70,932 nurses were included. The total score for work-family conflict was relatively high (38.37 ± 12.82). Work-family conflict of nurses had a significant negative correlation with career development (r = -0.35, p < .001) and with resilience (r = -0.23, p < .001), while resilience had a significant positive correlation with career development (r = 0.62, p < .001). Resilience plays a mediating role between work-family conflict and career development. CONCLUSIONS: The work-family conflict had a significant negative correlation with career development among nurses. Resilience has a mediating role between work-family conflict and career development. Nursing managers could reduce the level of work-family conflict by enhancing nurses' resilience. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should prioritize the improvement of resilience through training and education, enhancing nurses' ability to address work-family conflicts.

Transcriptome Classification Reveals Molecular Subgroups in Patients with Hepatitis B Virus.

Hepatitis B virus (HBV) specifically infects hepatocytes, which can cause progressive liver fibrosis and a significantly increased risk of liver cancer. Multiple studies indicated host genetic, virological, and immunological factors could affect the HBV infection. However, the underlying mechanism involved in HBV infection remained unclear. Based on the analysis of gene expression data of 124 HBV patients (GEO accession: GSE84044), molecular subgroups of patients infected with hepatitis B virus were identified in this study, including C1, C2, and C3 groups. The age, fiber, degree of chemical and inflammation, and gene expression difference were also compared among the three sampling groups. Furthermore, the liver index was calculated using 93 liver-specific genes. The liver-specific gene expression in different molecular subgroups of HBV patients was thoroughly analyzed and then was compared with fibrosis and inflammation levels. Results showed that the C2 group was the youngest and the C3 group had the highest degree of fibrosis and inflammation. Enrichment analysis showed that metabolism-related pathways were mainly expressed in the C1 and C2 groups, and inflammation-related pathways and proteoglycans in cancer were highly expressed in the C1 and C3 groups. The liver index was higher in the C2 group than in the C1 and C3 groups, and it was the lowest in the C3 group. Macrophage M1/M2 and neutrophils were significantly different in the three groups. M1 was mainly abundant in the C3 group, and M2 and neutrophils were mainly abundant in the C2 group. This study provides novel information to understand the mechanisms of HBV infection in chronic hepatitis B (CHB) patients.

Homology and functions of inner staminodes in Anaxagorea javanica (Annonaceae).

Inner staminodes are widespread in Magnoliales and present in Anaxagorea and Xylopia, but were lost in the other genera of Annonaceae and have no counterparts in derived angiosperms. The coexistence of normal stamens, modified stamens and inner staminodes in Anaxagorea javanica is essential to understand the homology and pollination function of the inner staminodes. Anaxagorea javanica was subjected to an anatomical study by light and scanning electron microscopy, and the chemistry of secretions was evaluated by an amino acid analyser. Inner staminodes have a secretory apex, but do not have thecae. They bend towards either tepals or carpels at different floral stages, and function as a physical barrier preventing autogamy and promoting outcrossing. At the pistillate phase, the exudates from the inner staminodes have high concentration of amino acid, and provide attraction to pollinating insects; while abundant proline was only detected in stigmas exudates, and supply for pollen germination. Modified stamens have a secretory apex and one or two thecae, which are as long as or shorter than that of the normal stamens. As transitional structures, modified stamens imply a possible degeneration progress from normal stamens to inner staminodes: generating a secretory apex first, shortening of the thecae length next and then followed by the loss of thecae. The presence of modified stamens together with the floral vasculature and ontogeny imply that the inner staminodes are homologous with stamens.

Influenza A virus inhibits influenza virus replication by inducing IL-37.

BACKGROUNDS: The influenza virus is one of the major pathogens that seriously affect human health. It can cause a strong immune response and trigger a series of complications. Interleukin 37 (IL-37) is a newly discovered cytokine that plays an important regulatory role in infection and immunity. To date, there have been few studies on the correlation between influenza virus infection and IL-37. METHODS: Serum levels of IL-37 in 115 patients with influenza A virus (IAV) infection and 102 healthy subjects were measured by an enzyme-linked immunosorbent assay (ELISA). Real-time quantitative PCR (RT-qPCR) was used to detect differences in IL-37 expression in peripheral blood mononuclear cells (PBMCs) between IAV patients and healthy subjects. IL-37 expression was measured in A549 cells and PBMCs infected with IAV H3N2 using ELISA and RT-qPCR. After the H3N2-infected A549 cells were treated with human IL-37, the concentration of viral RNA was determined using RT-qPCR, and the titer of influenza virus was determined by a hemagglutination test. RESULTS: The IL-37 levels in the sera and PBMCs of patients infected with IAV were higher than those of healthy subjects. The expression of IL-37 mRNA and protein in IAV-infected A549 cells and PBMCs was upregulated, and IL-37 protein was able to inhibit the replication of IAV RNA. CONCLUSION: IAV-induced IL-37 expression inhibits IAV replication.

Formation pattern in five types of pollen tetrad in Pseuduvaria trimera (Annonaceae).

In basal angiosperms, there are several types of permanent tetrad but their formation pattern remains elusive. Pseuduvaria trimera has five types of tetrads and is the species with the most abundant tetrad types in Annonaceae. In order to interpret the formation pattern of different tetrad types, pollen development was investigated from the microspore mother cell stage to the bicellular pollen stage and the ultrastructure of pollen wall in the five tetrad types using light microscopy, transmission electron microscopy, and confocal laser scanning microscopy. Both successive and intermediate cytokinesis were observed within the same anther. The nucleus location of the microspores together with cytokinesis determine the number and the spatial arrangement of callose plates, and further have an effect on the tetrad types. The anthers with or without septation and the arrangement of microsporocytes might be also related to the tetrad type. The individual pollen grains within the tetrads are connected with each other by crosswall cohesion and cytoplasmic channels at localized points in the proximal walls. The various types of tetrads, cytokinesis, and cohesion in P. trimera reflect the high diversity in pollen development, which enhances the dramatic variety in pollen morphology in this family. Our observations of the development of tetrads provided some new insights for interpreting the factors influencing the types of tetrads, and reported the existence of a cytoplasmic channel in Annonaceae for the first time.

HBV Upregulates CtBP2 Expression via the X Gene.

BACKGROUND: Hepatitis B virus (HBV) infection causes acute and chronic liver diseases that can eventually develop into cirrhosis and hepatocellular carcinoma (HCC), but the carcinogenesis of HBV is not fully understood. Carboxyl-terminal-binding protein 2 (CtBP2) plays an important role in tumorigenesis and progression. The aim of this study was to investigate the effect of HBV on CtBP2 expression and to explore its mechanism. METHODS: Real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) and western blotting were used to evaluate the CtBP2 mRNA and protein expression levels in tissues and cells. The HBV infectious clone pHBV1.3 and plasmids expressing a single gene of the HBV genome were cotransfected with the CtBP2 gene promoter pGL3-CtBP2 into the human hepatoma cell line HepG2, and luciferase activity was determined using a luminometer. RESULTS: CtBP2 expression was higher in HBV-related HCC tissues than in paracancerous tissues. CtBP2 expression was higher in HepG2.2.15 cells integrated with the HBV genome than in HepG2 cells. pHBV1.3 upregulated CtBP2 mRNA and protein expression. The HBV X gene significantly activated CtBP2 gene promoter activity, and CtBP2 mRNA and protein expression were upregulated by the HBV X gene. This activation effect was enhanced by the increase in the dose of the X gene, showing metrological dependence. CONCLUSION: HBV may be involved in the occurrence and development of HCC by upregulating CtBP2 expression.

Hepatitis B virus inhibits the expression of complement C3 and C4, in vitro and in vivo.

The immune system serves an important function in Hepatitis B virus (HBV) infection, and the complement system is a major component of innate immunity. However, the regulatory effect of HBV on complement proteins has not yet been fully elucidated. The present study focused on investigating the impact of HBV on the expression of complement proteins C3 and C4. A total of 226 patients with a clinical diagnosis of HBV infection were enrolled in the study, including 153 with chronic hepatitis B (CHB) and 73 with hepatocellular carcinoma (HCC), whereas 116 healthy individuals were included as a control group. Immunoturbidimetric detection was performed to determine the levels of complement C3 and C4 in the serum of the patients with HBV and the control group. The results revealed that the mean ± standard deviation C3 and C4 content was 1.223±0.237 and 0.226±0.052 g/l for the control group, 0.687±0.150 and 0.145±0.070 g/l for the patients with CHB, and 0.829±0.332 and 0.174±0.088 g/l for the patients with HCC, respectively. The levels of complement C3 and C4 in the patients with CHB or HCC were significantly lower than the control group (P<0.05). The HBV infectious clone pHBV1.3 was used to transfect Huh7 cells; Huh7 cells transfected with the pBlue-ks empty vector were used as the blank control. The changes in mRNA and protein expression of complements C3 and C4 were detected by RT-PCR and western blotting. When compared with the control cells, the Huh7 cells transfected with pHBV1.3 exhibited reduced C3 and C4 mRNA and protein expression levels. It was concluded that HBV can inhibit the expression of complement C3 and C4 in vitro and in vivo, which may lay the foundation for revealing the pathogenesis of HBV.

Celastrol treatment protects against acute ischemic stroke-induced brain injury by promoting an IL-33/ST2 axis-mediated microglia/macrophage M2 polarization.

BACKGROUND: Acute ischemic stroke (AIS) is the most common type of cerebrovascular disease and is a leading cause of disability and death worldwide. Recently, a study suggested that transformation of microglia from the pro-inflammatory M1 state to the anti-inflammatory and tissue-reparative M2 phenotype may be an effective therapeutic strategy for ischemic stroke. Celastrol, a traditional oriental medicine, may have anti-inflammatory and neuroprotective effects. However, the underlying mechanisms remain unknown. METHODS: We first determined the expression levels of inflammatory factors in patients and rodent models associated with AIS; we then determined the anti-inflammatory effects of celastrol in AIS, both in vivo and in vitro, using animal models of middle cerebral artery occlusion (MCAO) and cell models of oxygen-glucose deprivation (OGD) treatment with or without celastrol, respectively. RESULTS: The results indicated that expression of both inflammatory (interleukin (IL)-1ß, IL-6, and tumor necrosis factor (TNF)-α) cytokines, as well as the anti-inflammatory cytokine, IL-33, and IL-10, were increased following AIS in patients and in animal models. Furthermore, in vitro experiments confirmed that celastrol treatment decreased inflammatory cytokine expression induced by OGD through an IL-33/ST2 axis-mediated M2 microglia/macrophage polarization. Finally, celastrol is protected against ischemic-induced nerve injury, both in vivo and in vitro. CONCLUSIONS: Taken together, these data suggest that celastrol post-treatment reduces ischemic stroke-induced brain damage, suggesting celastrol may represent a novel potent pharmacological therapy.

Early diagnosis of bacterial infection in patients with septicopyemia by laboratory analysis of PCT, CRP and IL-6.

The aim of the present study was to investigate the early diagnostic values of measuring procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (lL-6) levels in patients with bacterial infections and septicopyemia. Ninety-two patients with septicopyemia who were diagnosed and treated in the First Affiliated Hospital of Fujian Medical University between December 2012 and October 2013 were randomly selected. Based on results of hemoculture, the patients were divided into the Gram-negative bacterial infection group (n=47) and the Gram-positive bacterial infection group (n=45). Immune nephelometry was used for measuring serum CRP levels, electrochemiluminescence assay was used to measure serum PCT and IL-6. The levels of serum CRP, PCT, and IL-6 in the Gram-negative bacterial infection group were significantly higher than in the Gram-positive group. Analysis with Spearman's correlation coefficient showed that there were positive correlations between the levels of PCT and CRP, and between PCT and IL-6 (P<0.05). The diagnosis of Gram-negative bacterial infections was as follows: The area under the PCT curve was 0.974 (P<0.05) with sensitivity and specificity of 96.8 and 93.5%, respectively. The area under the CRP curve was 0.953 (P<0.05) with sensitivity and specificity of 94.2 and 91.7%, respectively. The area under the IL-6 curve was 0.925 (P<0.05) with sensitivity and specificity of 93.6 and 90.5%, respectively. The diagnosis of Gram-negative bacterial infections was as follows: The area under the PCT curve was 0.854 (P<0.05) with sensitivity and specificity of 92.7 and 91.8%, respectively. The area under the CRP curve was 0.832 (P<0.05) with sensitivity and specificity of 90.2 and 89.3%, respectively. The area under the IL-6 curve was 0.817 (P<0.05) with sensitivity and specificity of 89.4 and 81.5%, respectively. In conclusion, PCT, CRP, and lL-6 can act as early diagnostic markers for bacterial infections in patients with septicopyemia.

Prospective study on the overuse of blood test-guided antibiotics on patients with acute diarrhea in primary hospitals of China.

BACKGROUND: Overuse with antibiotics in the treatment of infectious diseases has become a central focus of public health over the years. The aim of this study was to provide an up-to-date evaluation of the blood test-guided antibiotic use on patients with acute diarrhea in primary hospitals of China. MATERIALS AND METHODS: A cross-sectional survey was conducted on 330 patients with acute diarrhea in Shanghai, People's Republic of China, from March 2013 to February 2016. These patients were treated with or without antibiotics based on the results of their blood tests, including examinations of C-reactive protein (CRP), white blood cells (WBC), and the percentage of neutrophils (Neu%). The infection types, which included bacterial, viral, and combination diarrhea, were determined by microbiological culture methods. Antibiotics used in non-bacterial diarrhea patients were considered misused and overused. RESULTS: There were significant overall differences in the clinical characteristics and blood tests between patients with diarrhea with a bacterial infection and patients with other types of infections. The patients were divided into four grading groups (0-3) according to the number of the positive results from three blood testes (CRP, WBC, and Neu%). The misuse rates of antibiotics in each group (0-3) were 81.3%, 71.1%, 72.4%, and 64.9%, respectively. CONCLUSION: In this prospective study, the current diagnostic criteria (CRP, WBC, and Neu%) based on blood tests are not reliable in diagnosing bacterial diarrhea or guiding antibiotics use. To limit antibiotic overuse, a rapid and accurate differentiation of bacterial diarrhea from other types of diarrhea is pivotal.