IGRA-based INH regimen for prevention of active tuberculosis after kidney transplantation: A single-centre retrospective study.

OBJECTIVES: To evaluate the effectiveness and safety of Interferon-gamma release Assay (IGRA)-based isoniazid (INH) prophylaxis strategy to prevent tuberculosis (TB) infection in kidney transplantation (KT) with a risk of TB occurrence. METHODS: Adult KT recipients (KTRs) between June 2014 and July 2021 were retrospectively enrolled. The development of active TB after KT was evaluated. RESULTS: Of 925 KTRs, 111 (12.0%) developed active TB. Among the 501 KTRs at a risk of TB occurrence, 70 (14.0%) patients developed active TB, while 41 (9.7%) of 424 patients without risk factors developed active TB (P = 0.05). Two hundred thirty-nine KTRs received IGRA test with 62 (25.9%) were positive. None of IGRA positive patients (0/40) receiving INH prophylaxis developed active TB, whereas 8 out of 22 patients who had positive IGRA results without INH prophylaxis developed active TB (0 vs. 36.4%, P < 0.01). Of note, for those in risk group but with negative IGRA result, no active TB was found even without INH prophylaxis. Although alanine aminotransferase and aspartate aminotransferase in INH prevention group were higher than those before treatment, they did not exceed three-fold of limit of reference range. CONCLUSIONS: IGRA-based INH treatment is an effective and safe protocol to prevent the development of active TB in KTRs.

Higher serum selenium concentration is associated with lower risk of all-cause and cardiovascular mortality among individuals with chronic kidney disease: A population-based cohort study of NHANES.

Background: Selenium is an essential nutrient and trace element required for human health and plays an important role in antioxidative and anti-inflammatory processes. However, the long-term impact of selenium levels on the health of patients with chronic kidney disease remains unclear. Method: Participants in this study were 3,063 CKD adults from the Third National Health and Nutrition Examination Survey (NHANES 1999-2000, 2003-2004, and 2011-2018). The mortality status and the cause of death of the study participants were obtained from the National Death Index records. For all-cause and cardiovascular disease (CVD) mortality, the models employed to estimate hazard ratios (HRs) and 95% CI were Cox proportional hazard models and competing risk models, respectively. Result: During the follow-up period, 884 deaths occurred, including 336 heart-disease-associated deaths. The median (IQR) concentration of serum selenium was 181.7 (156.1, 201.5) µg/L. After full adjustment, serum selenium levels were associated with a decreased risk of mortality in patients with CKD, including all-cause and CVD mortality (P < 0.001). The multivariate-adjusted HRs (95%CI) were 0.684 (0.549-0.852) for all-cause mortality (P trend < 0.001) and 0.513 (0.356-0.739) for CVD mortality (P trend < 0.001) when selenium concentrations were compared according to the extreme quartiles. Selenium levels are inversely associated with an increased risk of all-cause mortality and CVD mortality. Similar results were observed in subgroup and sensitivity analyses. Conclusion: Higher serum selenium concentration was independently associated with a decreased risk of all-cause and CVD mortality in patients with CKD.

Identification of an amino acid metabolism-associated gene signature predicting the prognosis and immune therapy response of clear cell renal cell carcinoma.

Background: The upregulation of amino acid metabolism is an essential form of metabolic reprogramming in cancer. Here, we developed an amino acid metabolism signature to predict prognosis and anti-PD-1 therapy response in clear cell renal cell carcinoma (ccRCC). Methods: According to the amino acid metabolism-associated gene sets contained in the Molecular Signature Database, consensus clustering was performed to divide patients into two clusters. An amino acid metabolism-associated signature was identified and verified. Immune cell infiltrates and their corresponding signature risk scores were investigated. Two independent cohorts of clinical trials were analyzed to explore the correspondence between the signature risk score and the immune therapy response. Results: Two clusters with different amino acid metabolic levels were identified by consensus clustering. The patients in the two clusters differed in overall survival, progression-free survival, amino acid metabolic status, and tumor microenvironment. We identified a signature containing eight amino acid metabolism-associated genes that could accurately predict the prognosis of patients with ccRCC. The signature risk score was positively correlated with infiltration of M1 macrophages, CD8+ T cells, and regulatory T cells, whereas it was negatively correlated with infiltration of neutrophils, NK cells, and CD4+ T cells. Patients with lower risk scores had better overall survival but worse responses to nivolumab. Conclusion: Amino acid metabolic status is closely correlated with tumor microenvironment, response to checkpoint blockade therapy, and prognosis in patients with ccRCC. The established amino acid metabolism-associated gene signature can predict both survival and anti-PD-1 therapy response in patients with ccRCC.

Transforaminal Percutaneous Endoscopic Decompression for Lower Thoracic Spinal Stenosis.

OBJECTIVE: To explore the effect and safety of transforaminal percutaneous endoscopic decompression for lower thoracic spinal stenosis. METHODS: We reviewed 6 patients receiving transforaminal percutaneous endoscopic thoracic decompression for sympathetic symptoms in the lower extremities. Pre- and postoperative Frankel grade and Japanese Orthopaedic Association scale (JOA) score, Oswestry Disability Index (ODI) score, and visual analog scale (VAS) scores of back and lower extremities were also evaluated and recorded. Wilcoxon signed-rank test was performed for statistical analysis. RESULTS: All 6 patients completed the follow-up. Mean follow-up was 12.6 months. Frankel grade in all patients improved to normal at the third month after operation. JOA scores significantly increased from 4.4 (range, 3.5-5.0) preoperatively to 5.5 (range, 5.0-6.5) postoperatively, to 6.5 (range, 6.0-7.0) at 3 months, to 6.6 (range, 6.2-7.0) at 6 months, and to 6.6 (range, 6.2-7.1) at 12 months (P < 0.05). ODI scores significantly decreased from 71.2 (range, 65-78) preoperatively to 50.2 (range, 45-60) postoperatively, to 30.3 (range, 25-40) at 3 months, to 12.2 (range, 0-20) at 6 months, and to 10.2 (range, 0-15) at 12 months (P < 0.05). VAS back scores decreased from 7.8 (range, 7.0-9.0) preoperatively to 6.9 (range, 6.0-7.5) postoperatively, to 3.3 (range, 3.0-4.0) at 3 months, to 2.3 (range, 2.0-3.0) at 6 months, and to 1.9 (range, 1.5-3.0) at 12 months (P < 0.05). VAS lower extremity scores decreased from 8.7 (range, 8.0-9.0) preoperatively to 3.0 (range, 2.5-3.6) postoperatively, to 1.1 (range, 0.5-1.3) at 3 months, to 0.9 (range, 0.2-1.2) at 6 months, and to 0.3 (range, 0.1-1.0) at 12 months (P < 0.05). Four patients reported excellent results and 2 reported good results at the last follow-up. CONCLUSIONS: Percutaneous endoscopic transforaminal thoracic decompression is effective and safe in settling lower thoracic spinal stenosis.

Heavy Metal Pollution and Ecological Risk Assessment of the Agriculture Soil in Xunyang Mining Area, Shaanxi Province, Northwestern China.

Mining is considered to be one of the most significant sources of environmental pollution with regard to heavy metals. Mineral mining causes large quantities of mercury, cadmium, and other elements to be released into the environment and naturally poses a serious threat to environment. This paper will analyze the pollution status of agricultural soil caused by the mining of heavy metals in various mining areas in the Xunyang County in the Shaanxi Province of China, an area in famous for its resource mining. Equally, it will look at the potential ecological risk assessment process that is used to analyze the ecological risks of mining heavy metals in agricultural soil located in the surrounding areas. Based on the soil investigation, As pose a moderate ecological risk on the Au mining area. In addition, the Hg metals pose a significantly high potential ecological risk and Cd metals pose a considerable potential ecological risk on the Hg mining area. In the Pb-Zn mining area, a significantly high potential ecological risk was mainly posed by Cd. These results suggest that many heavy metals pose a high potential ecological risk on the agricultural soil in these three mining areas in the Xunyang County, and may cause elevated heavy metal contents in crops, eventually jeopardizing the health of local residents who consume food grown in polluted soil.

Evaluation of nutrients and heavy metals in the sediments of the Heer River, Shenzhen, China.

The parameters of water contents, oxidation-reduction potential, organic matter, total phosphorus, total nitrogen and heavy metals concentrations of mercury (Hg), cadmium (Cd), lead (Pb), arsenic (As), chromium (Cr), copper (Cu) and zinc (Zn) in surface sediment and their vertical distribution incore sediments of the Heer river were investigated. Evaluation of nutrients and heavy metals in the Heer River sediments was done by pollution index and potential ecological risk index (PERI) method, respectively. Environmental dredging depth was calculated. The parameters pH, water content, total nitrogen (TN), and organic matter (OM) as well as heavy metals decline with the increased depth. Nutrients of TN, total phosphorus (TP), OM, and heavy metals Cd, Cu, and Pb were classified into the same group and there were significant positive correlations according to the principal component analysis and Pearson correlation, implying that they have a common origin. The results of high pollution index value of OM, TP, and TN of surface sediment obtained from this research showed that the Heer River was in serious nutrient pollution. The contributions of individual metals to the potential ecological risk were in the following order: Cd > Cu > Ni > Cr > Zn > As > Pb. Cd presented serious ecological risk and contributed most to the sediments of the Heer River. The ecological risk (RI) was at a considerable high risk level, and therefore, the environmental dredging depth of the Heer River is 94 cm for the purpose of reducing heavy metal contamination of the Heer River.

Potential bioavailability of mercury in humus-coated clay minerals.

It is well-known that both clay and organic matter in soils play a key role in mercury biogeochemistry, while their combined effect is less studied. In this study, kaolinite, vermiculite, and montmorillonite were coated or not with humus, and spiked with inorganic mercury (IHg) or methylmercury (MeHg). The potential bioavailability of mercury to plants or deposit-feeders was assessed by CaCl2 or bovine serum albumin (BSA) extraction. For uncoated clay, IHg or MeHg extraction was generally lower in montmorillonite, due to its greater number of functional groups. Humus coating increased partitioning of IHg (0.5%-13.7%) and MeHg (0.8%-52.9%) in clay, because clay-sorbed humus provided more strong binding sites for mercury. Furthermore, humus coating led to a decrease in IHg (3.0%-59.8% for CaCl2 and 2.1%-5.0% for BSA) and MeHg (8.9%-74.6% for CaCl2 and 0.5%-8.2% for BSA) extraction, due to strong binding between mercury and clay-sorbed humus. Among various humus-coated clay particles, mercury extraction by CaCl2 (mainly through cation exchange) was lowest in humus-coated vermiculite, explained by the strong binding between humus and vermiculite. The inhibitory effect of humus on mercury bioavailability was also evidenced by the negative relationship between mercury extraction by CaCl2 and mercury in the organo-complexed fraction. In contrast, extraction of mercury by BSA (principally through complexation) was lowest in humus-coated montmorillonite. This was because BSA itself could be extensively sorbed onto montmorillonite. Results suggested that humus-coated clay could substantially decrease the potential bioavailability of mercury in soils, which should be considered when assessing risk in mercury-contaminated soils.

Prediction of methylmercury accumulation in rice grains by chemical extraction methods.

To explore the possibility of using chemical extraction methods to predict phytoavailability/bioaccumulation of soil-bound MeHg, MeHg extractions by three widely-used extractants (CaCl2, DTPA, and (NH4)2S2O3) were compared with MeHg accumulation in rice grains. Despite of variations in characteristics of different soils, MeHg extracted by (NH4)2S2O3 (highly affinitive to MeHg) correlated well with grain MeHg levels. Thus (NH4)2S2O3 extraction, solubilizing not only weakly-bound and but also strongly-bound MeHg, may provide a measure of 'phytoavailable MeHg pool' for rice plants. Besides, a better prediction of grain MeHg levels was obtained when growing condition of rice plants was also considered. However, MeHg extracted by CaCl2 or DTPA, possibly quantifying 'exchangeable MeHg pool' or 'weakly-complexed MeHg pool' in soils, may not indicate phytoavailable MeHg or predict grain MeHg levels. Our results provided the possibility of predicting MeHg phytoavailability/bioaccumulation by (NH4)2S2O3 extraction, which could be useful in screening soils for rice cultivation in contaminated areas.