Transformation products of tetracyclines in three typical municipal wastewater treatment plants

Antibiotics in the environment could undergo various processes with formation of transformation products, but little has been known about their occurrence and (eco)toxicological consequences. Here we investigated the occurrence and fate of nine transformation products of four tetracyclines (tetracycline, oxytetracycline, chlortetracycline and doxycycline) in three municipal wastewater treatment plants (WWTPs) in Guangzhou, China. The results showed the detection of all the tetracyclines and their transformation products in the WWTPs, with mean concentrations ranging from 17.8 ng/L (anhydrotetracycline) to 49.1 ng/L (oxytetracycline) in influent, 3.03 ng/L (tetracycline) to 6.94 ng/L (4-epi-chlortetracycline) in effluent, and 19.8 ng/g (isochlortetracycline) to 503 ng/g (4-epi-tertracycline) in sludge, respectively. The transformation products of tetracycline, oxytetracycline, chlortetracycline and doxycycline accounted for 73%-83%, 26%-52%, 70%-73% and 69%-74% of total concentrations, respectively. The aqueous removal rates of tetracyclines and their transformation products in the three WWTPs ranged from 18.4% (demethyl-chlortetracycline) to 93.7% (oxytetracycline). Mass balance analysis based on both aqueous and solid phase showed that their removals were mainly attributed to the sludge adsorption. Residual tetracyclines and their transformation products in the effluents would pose no obvious ecological risks to three aquatic organisms (green algae, daphnia and fish). However, 43.5% of sludge samples had high risks from these tetracyclines and transformation products, especially the compounds with poor biodegradability. The results from this study suggest that transformation products should be included in future environmental monitoring and control.

PM2.5 induces pulmonary microvascular injury in COPD via METTL16-mediated m6A modification

Fine particulate matter (PM2.5) exposure is a significant cause of chronic obstructive pulmonary disease (COPD), but the detailed mechanisms involved in COPD remain unclear. In this study, we established PM2.5-induced COPD rat models and showed that PM2.5 induced pulmonary microvascular injury via accelerating vascular endothelial apoptosis, increasing vascular permeability, and reducing angiogenesis, thereby contributing to COPD development. Moreover, microvascular injury in COPD was validated by measurements of plasma endothelial microparticles (EMPs) and serum VEGF in COPD patients. We then performed m⁶A sequencing, which confirmed that altered N⁶-methyladenosine (m⁶A) modification was induced by PM2.5 exposure. The results of a series of experiments demonstrated that the expression of methyltransferase-like protein 16 (METTL16), an m⁶A regulator, was upregulated in PM2.5-induced COPD rats, while the expression of other regulators did not differ upon PM2.5-induction. To clarify the regulatory effect of METTL16-mediated m⁶A modification induced by PM2.5 on pulmonary microvascular injury, cell apoptosis, permeability, and tube formation, the m⁶A level in METTL16-knockdown pulmonary microvascular endothelial cells (PMVECs) was evaluated, and the target genes of METTL16 were identified from a set of the differentially expressed and m⁶A-methylated genes associated with vascular injury and containing predicted sites of METTL16 methylation. The results showed that Sulfatase 2 (Sulf2) and Cytohesin-1 (Cyth1) containing the predicted METTL16 methylation sites, exhibited higher m⁶A methylation and were downregulated after PM2.5 exposure. Further studies demonstrated that METTL16 may regulate Sulf2 expression via m⁶A modification and thereby contribute to PM2.5-induced microvascular injury. These findings not only provide a better understanding of the role played by m⁶A modification in PM2.5-induced microvascular injury, but also identify a new therapeutic target for COPD.

Hydrogen Sulfide Biology and Its Role in Cancer

Hydrogen sulfide (H2S) is an endogenous biologically active gas produced in mammalian tissues. It plays a very critical role in many pathophysiological processes in the body. It can be endogenously produced through many enzymes analogous to the cysteine family, while the exogenous source may involve inorganic sulfide salts. H2S has recently been well investigated with regard to the onset of various carcinogenic diseases such as lung, breast, ovaries, colon cancer, and neurodegenerative disorders. H2S is considered an oncogenic gas, and a potential therapeutic target for treating and diagnosing cancers, due to its role in mediating the development of tumorigenesis. Here in this review, an in-detail up-to-date explanation of the potential role of H2S in different malignancies has been reported. The study summarizes the synthesis of H2S, its roles, signaling routes, expressions, and H2S release in various malignancies. Considering the critical importance of this active biological molecule, we believe this review in this esteemed journal will highlight the oncogenic role of H2S in the scientific community.

Hypothetical scenarios estimating and simulating the fate of antibiotics: Implications for antibiotic environmental pollution caused by manure application

The application of animal manure containing antibiotic residues as an organic fertilizer to farmlands, poses a major threat to the health of river basin ecosystems. Waste treatment processes can help reduce antibiotic pollution levels in river basins following manure application, but the overall influence of these processes remains unclear. This study evaluates the impact of manure treatment methods on the emission and subsequent river pollution caused by 14 frequently detected antibiotics in a typical pig breeding area in China, by using hypothetical scenarios method. Three scenarios were constructed based on possible fate pathways of antibiotics, representing in 47.0, 55.3, and 81.6 ton·yr^-1 antibiotic emissions into the river basin. The soil and water assessment tool (SWAT) model successfully simulated the transport of antibiotics from farmland to surface water, with calibration and verification performed using hydrological station monthly data over 8 consecutive years. Field measured concentrations also verified the reliability of the model and were used to determine the most realistic scenario. In basins applied with manure, environmental antibiotic pollution is most affected by the wastewater treatment process and manure applied patterns, followed by changes in streamflow. The antibiotic pollution in manure applied areas showed significant spatial and temporal differences, resulting from the different manure application patterns. The simulated total outflow of antibiotics in the river basin accounted for 18.1% of the inflow, with the loss of target antibiotics by degradation, volatilization and sedimentation deposition in the river basin being 0.23, 0.01 and 33.2 ton·yr^-1, respectively. This study can help to clarify the environmental fate of antibiotics in the basin following manure application, provide guidance for policy makers and help to design the effective corrective interventions for reducing the environmental pollution.

Effects of individualized positive end-expiratory pressure combined with recruitment maneuver on intraoperative ventilation during abdominal surgery: a systematic review and network meta-analysis of randomized controlled trials

Low tidal volume ventilation strategy may lead to atelectasis without proper positive end-expiratory pressure (PEEP) and recruitment maneuver (RM) settings. RM followed by individualized PEEP was a new method to optimize the intraoperative pulmonary function. We conducted a systematic review and network meta-analysis of randomized clinical trials to compare the effects of individualized PEEP + RM on intraoperative pulmonary function and hemodynamic with other PEEP and RM settings. The primary outcomes were intraoperative oxygenation index and dynamic compliance, while the secondary outcomes were intraoperative heart rate and mean arterial pressure. In total, we identified 15 clinical trials containing 36 randomized groups with 3634 participants. Ventilation strategies were divided into eight groups by four PEEP (L: low, M: moderate, H: high, and I: individualized) and two RM (yes or no) settings. The main results showed that IPEEP + RM group was superior to all other groups regarding to both oxygenation index and dynamic compliance. LPEEP group was inferior to LPEEP + RM, MPEEP, MPEEP + RM, and IPEEP + RM in terms of oxygenation index and LPEEP + RM, MPEEP, MPEEP + RM, HPEEP + RM, IPEEP, and IPEEP + RM in terms of dynamic compliance. All comparisons were similar for secondary outcomes. Our analysis suggested that individualized PEEP and RM may be the optimal low tidal volume ventilation strategy at present, while low PEEP without RM is not suggested.

Transcranial Electrical Stimulation for Relief of Peripartum Mental Health Disorders in Women Undergoing Cesarean Section With Combined Spinal-Epidural Anesthesia: A Pilot Randomized Clinical Trial

OBJECTIVE

This study aimed to explore transcranial electrical stimulation (tES) to relieve peripartum anxiety and depressive symptoms in women undergoing cesarean section with combined spinal-epidural anesthesia.

METHODS

This double-blind, randomized, sham-controlled trial was conducted in the Affiliated Hospital of Xuzhou Medical University from March 2021 and May 2021. One hundred and forty-eight full-term parturients giving birth by elective cesarean section were selected, and 126 were included in the intent-to-treat analysis. Parturients were provided standardized anesthesia and randomized to the active-tES (a-tES) group and sham-tES group. Parturients and outcome assessors were blinded to treatment allocation. The primary outcome was the changes in peripartum mental health disorders, including anxiety, assessed by the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2). Secondary outcomes included peripartum depressive symptoms, assessed by the Edinburgh Postnatal Depression Scale (EPDS), maternal satisfaction, fatigue level, sleep quality index, and pain score during and after operation. Data were collected before entering the operating room (T0), between post-anesthesia and pre-surgery (T1), before leaving the operating room (T2), and at 24 h post-surgery (T3).

RESULTS

One hundred and twenty-six eligible parturients were enrolled in the two groups: a-tES group (N = 62) and sham-tES group (N = 64). Treatment with tES resulted in significantly lower scores of anxiety compared with sham-tES (T2: P < 0.001; T3: P = 0.001). Moreover, the a-tES groups showed a significant reduction in depression scores (T2: P = 0.003; T3: P = 0.032).

CONCLUSION

In this randomized pilot study, tES treatment is efficacious in alleviating peripartum anxiety and depressive symptoms in women undergoing cesarean section and has been demonstrated to be a novel strategy for improving peripartum mental health disorders.

CLINICAL TRIAL REGISTRATION

[www.chictr.org.cn], identifier [ChiCTR2000040963].

Prevalence of Insomnia Symptoms in Older Chinese Adults During the COVID-19 Pandemic: A Meta-Analysis

Background: The ongoing COVID-19 pandemic has disproportionately affected the sleep health of older adults, but the limited number of studies on insomnia symptoms of older Chinese adults differed in terms of screener of insomnia, sample size, and prevalence, making mental health planning for this population difficult. This meta-analysis estimated the prevalence of insomnia symptoms in older Chinese adults during the COVID-19 pandemic.

Methods: Both Chinese (CNKI, Wanfang, VIP) and English (PubMed, EmBase, PsycInfo) databases were systematically searched to identify cross-sectional studies containing data on the prevalence of insomnia symptoms in older Chinese adults during the pandemic. Risk of bias (RoB) of included studies was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.

Results: Nine studies with a total of 27,207 older Chinese adults were included. RoB scores of these studies ranged between zero and six. The pooled prevalence rates of insomnia symptoms and moderate and severe insomnia symptoms were 24.6% [95% confidence interval (CI): 19.5–30.5%] and 11.1% (95% CI: 7.2–16.9%), respectively. In subgroup analysis, significantly higher prevalence rates were observed in studies defining insomnia symptoms as “Insomnia Severity Index (ISI) ≥ 8” than in those defining them as “ISI ≥ 15” (32.6 vs. 15.6%, P < 0.001) and in older adults living in the COVID-19 epicenter than in those living in other places (35.2 vs. 23.3%, P = 0.006).

Conclusion: Nearly one out of every four older Chinese adults suffered from insomnia symptoms during the pandemic. Mental health services for this population during the pandemic should include supportive activities aimed at improving mental well-being, periodic assessment of insomnia symptoms, and psychiatric assessment and treatment when necessary.

Clinical manifestations and acid alpha-glucosidase mutation characterisation of a cohort of patients with late-onset Pompe disease in eastern China

Background

Pompe disease is a rare, progressive, and life-threatening autosomal recessive disorder. In its late-onset form, the disease is primarily characterised by mild progressive proximal limb and respiratory muscle weakness. Mutations in the acid alpha-glucosidase (GAA) gene cause lysosomal enzyme GAA to be significantly reduced or missing altogether, for which supplementation can be given through enzyme replacement therapy.

Methods

Fourteen patients diagnosed with late-onset Pompe disease (LOPD) in the First Affiliated Hospital of Nanjing Medical University from 2017 to 2021 were enrolled. GAA activity was measured based on enzymatic activity in dried blood spots, and next-generation sequencing was used to detect mutations in the GAA gene. The impacts of novel missense variants were determined by five different prediction algorithms. The structural figures of novel variants and their wide types were processed with PyMOL.

Results

The study included 14 patients with LOPD (male-to-female ratio, 1:1) from eastern China. The median age at symptom onset and diagnosis was 15.0 years (7–36 years) and 21.5 years (8–47 years), respectively. The median diagnostic delay from onset was 3.0 years (0–22 years). Proximal muscle weakness was the first prominent symptom in 8 patients, while the other 6 patients experienced respiratory failure, chest congestion and asthma, and scoliosis. The most frequent mutation of the GAA gene was c.2238G>C (p.W746C), which was observed at an allele frequency of 14.3% (4/28) and in 28.6% of patients (4/14). Four novel variants potentially related to the pathogenicity of LOPD were found: c.1299G>C (p.Q433H), c.1409A>G (p.N470S), c.2242delG (p.E748Rfs*16), and c.2832delA (p.E945Sfs*78).

Conclusions

The c.2238G>C (p.W746C) mutation was the most common mutation in 14 patients with LOPD from eastern China. This study has identified four novel variants in patients with LOPD. Predicting the pathogenicity of these novel variants may increase the understanding of the genetic mutation spectrum in LOPD. Our findings may also improve recognition of the characteristics of Chinese patients with LOPD.

Band-selective Holstein polaron in Luttinger liquid material A0.3MoO3 (A = K, Rb)

(Quasi-)one-dimensional systems exhibit various fascinating properties such as Luttinger liquid behavior, Peierls transition, novel topological phases, and the accommodation of unique quasiparticles (e.g., spinon, holon, and soliton, etc.). Here we study molybdenum blue bronze A_0.3MoO₃ (A = K, Rb), a canonical quasi-one-dimensional charge-density-wave material, using laser-based angle-resolved photoemission spectroscopy. Our experiment suggests that the normal phase of A_0.3MoO₃ is a prototypical Luttinger liquid, from which the charge-density-wave emerges with decreasing temperature. Prominently, we observe strong renormalizations of band dispersions, which are recognized as the spectral function of Holstein polaron derived from band-selective electron-phonon coupling in the system. We argue that the strong electron-phonon coupling plays an important role in electronic properties and the charge-density-wave transition in blue bronzes. Our results not only reconcile the long-standing heavy debates on the electronic properties of blue bronzes but also provide a rare platform to study interesting excitations in Luttinger liquid materials.

[The risk factors for regional lymph node metastasis of mismatch repair deficient colorectal cancer]

Objective: To explore the risk factors for regional lymph node (RLN) metastasis in colorectal cancer patients with mismatch repair deficiency (dMMR). Methods: The data of 357 dMMR colorectal cancer patients who underwent surgery in National Cancer Center from January 2012 to December 2016 was retrospectively analyzed. Univariate and multivariate analysis were used to identify the risk factors for RLN metastasis. Results: Among the 357 patients, 204 were male and 153 were female, 61.6% (220/357) lesion located in right half colon, while the other 16.2% (58/357) located in rectum. Univariate analysis showed that tumor size, differentiation, lymphovascular invasion, tumor deposit, postoperative pathologic T stage (pT), the number of negative lymph nodes and the expression of the MSH6 protein were significantly associated with RLN metastasis (P<0.05). All of the patients with well differentiation tumors (15 patients) or staged pT1 (13 patients) had no RLN metastasis. Multivariate analysis showed that tumor differentiation (OR=2.582, 95%CI=1.567-4.274, P<0.001), pT (OR=3.778, 95%CI=1.448-12.960, P=0.015) and the expression of MSH6 protein (OR=2.188, 95%CI=1.159-4.401, P=0.021) were independent risk factors for RLN metastasis. Conclusions: The postoperative pT stage, tumor differentiation and the expression of MSH6 protein are independent risk factors for RLN metastasis of dMMR colorectal cancer. Preoperative assessment of these factors may further improve the accuracy of predicting the risk of RLN metastasis.

[Analysis of curative efficacy of transjugular intrahepatic portosystemic shunt using viabahn stent in the treatment of Budd-Chiari syndrome with extensive hepatic vein occlusion]

Objective: To investigate the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) using viabahn stent in patients with Budd-Chiari syndrome (BCS) with extensive hepatic vein occlusion. Methods: Technical success rates, portal pressure gradient (PPG), complications and shunt patency rate of 25 cases with BCS with extensive hepatic vein occlusion treated by TIPS using viabahn stent were retrospectively analyzed. Color Doppler ultrasound was used for postoperative follow-up. Patency rates were evaluated by Kaplan-Meier curve. Results: The technical success rate of TIPS was 100%. Mean PPG decreased from (22.7 ± 6.2) mmHg preoperatively to (9.7 ± 2.6) mmHg postoperatively (t = 9.58, P < 0.05). Hepatic encephalopathy incidence was 8.0% (2/25), and there were no complications such as intra-abdominal hemorrhage. Twenty-five cases were followed up for 1 to 39 ( mean 19.0 ± 11.9) months, and one patient died of liver failure three months after interventional treatment. The primary patency rates at 1, 2, and 3 years after interventional treatment were 91.3%, 91.3%, and 78.2%, respectively, while the repatency rates were 100%, 92.9%, and 92.9%, respectively. Conclusion: TIPS using viabahn stent can bring better short-term and mid-term curative efficacy in treatment of BCS with extensive hepatic vein occlusion.

Selective diffusive gradients in thin-films with molecularly imprinted polymer for measuring fluoroquinolone antibiotics in waters

Fluoroquinolones (FQs) have raised significant concerns due to their ubiquitous occurrence and promoting of antimicrobial resistance (AMR). In this study, a molecularly imprinted polymer-diffusive gradient in thin-films (MIP-DGT) sampler is developed for selective measurement of FQs in waters by using a commercial available MIP material as the binding agent. The MIP-DGT shows selective adsorption of the FQs and linearly accumulates the FQs over the deployment time. MIP-DGT measurement is independent of pH (6-8) and ionic strength (IS) (0.01-0.5 M) but is affected by DOM at higher concentrations (~10 mg•L^-1), which is due to the altered diffusion coefficients and reduced adsorption on the MIP binding gel. Significant interaction effects of DOM with pH or IS indicate that this is the predominant influence on the MIP-DGT performance, which results in a lower measurement by the MIP-DGT but this is curtailed to some extend with increasing IS or pH. The MIP-DGT measurements, however, correlate well with those by grab sampling in a wastewater treatment plant, suggesting it is reliable for measuring FQs in waters. For the first time, we demonstrate that key water chemistry parameters do have interaction effects on the DGT measurements, which should be considered for the data interpretation. The MIP-DGT is a promising tool to understand the interaction effects of the environmental parameters on the fate, behaviours and bioavailability/toxicity of organic contaminants and improve environmental risk assessments in the environment and modelling.

Variations of antibiotic resistome in swine wastewater during full-scale anaerobic digestion treatment

Anaerobic digesters have been widely used to treat wastewaters in livestock farms. With the increasing risk of antibiotic resistance originated from livestock husbandry, removal of antibiotics and antibiotic resistance genes (ARGs) via anaerobic digesters deserved more attention. Here we investigated the removal of antibiotics and ARGs in swine wastewater by three on-farm full-scale anaerobic digesters, including buried biogas digester (BBD), up-flow anaerobic sludge blanket (UASB) and high density polyethylene covered biogas digester (HDPE-BD). Variations of antibiotic resistome in swine wastewater were further revealed by metagenomic sequencing. Results showed the removal efficiencies for antibiotics, ARGs and mobile genetic elements (MGEs) varied in the three digesters, ranging from 65.1% to 98.1%, 3.5%-71.0% and 26.9%-77.2%, respectively. In general, UASB and HDPE-BD showed better removal efficiencies than BBD. However, enrichment of metal resistance genes (MRGs) was noted in UASB. Pathogens could not be effectively removed by all of the three digesters. What's more, accumulation of pathogens was found in UASB (removal efficiencies: -8.5%-13.6%). Bacterial community succession, horizontal genetic transfer and biocide and metal resistance genes (BMRGs) profiles jointly structured the variation of antibiotic resistome during anaerobic digestion. A total of 334 high-quality bins were identified from swine wastewater, 96 of which belonged to phylum of Firmicutes, Bacteroidetes and Proteobacteria carried ARGs. Proteobacteria was the dominant multi-drug resistant flora. Meanwhile, ARG-carrying pathogens (Bacteroides and Mycolicibacter) were found in the swine wastewater, suggesting a potential threat to human and animal health. The findings from this study showed that HDPE-BD is the most eco-friendly and effective anaerobic digester in controlling risks from antibiotic resistance determinants in swine wastewater.

Agricultural Plastic Pollution in China: Generation of Plastic Debris and Emission of Phthalic Acid Esters from Agricultural Films

Agricultural plastic films have been proven highly advantageous, but they also cause pollution of plastic debris and associated chemicals. Phthalates (phthalic acid esters, PAEs), an important additive of agricultural films, can be released and contaminate the environment. Here, we analyzed the agricultural plastic usage and assessed plastic debris in China and developed a method to estimate PAE emissions from agricultural films. Additionally, the environmental fate of PAEs was evaluated using a fugacity-based multimedia model. The agricultural plastic film usage in China in 2017 was 2,528,600 tons. After agricultural film recycling and water erosion, the plastic debris amount was estimated as 465,016 tons. The water erosion process carried 4329 tons of plastic debris into the aquatic environment. During its lifetime, the agricultural film released a total of 91.5 tons of two typical types of PAEs. PAEs from the mulching film would mostly be removed through degradation, while those from the greenhouse film accumulate in vegetables. Populated regions exhibited more serious PAE pollution in vegetables but with no immediate health risks. The model was well evaluated using comparable measured concentrations and uncertainty analysis based on the Monte Carlo method. The findings from this study demonstrate the serious agricultural plastic pollution problem and associated PAE contamination in China.

[Susceptibility of Anopheles sinensis to insecticides in Puyang City, Henan Province]

OBJECTIVE

To investigate the susceptibility of Anopheles sinensis to malathion, deltamethrin and lambda-cyhalothrin in Puyang City, Henan Province, so as to provide the scientific basis for local malaria vector control.

METHODS

An. sinensis was captured from Puyang County, Puyang City of Henan Province in September 2018 and July 2020, and the susceptibility of field captured An. sinensis to malathion, deltamethrin and lambda-cyhalothrin was tested using the filter-paper bioassay recommended by WHO. The insecticide resistance level was assessed based on the WHO criteria.

RESULTS

In 2018 and 2010, the half knock-down times (KT₅₀) of malathion were 91.08 min and 40.95 min for An. sinensis, with knock-down rates of 37.50% and 60.87% 60 min post-exposure to malathion and 24-hour mortality rates of 90.91% and 100%, respectively, and the insecticide resistance levels were moderately resistant (M) and susceptible (S). The KT₅₀ of deltamethrin were 415.56 min and 341.19 min for An. sinensis in 2018 and 2020, with knock-down rates of 22.92% and 16.98% 60 min post-exposure to malathion and 24-hour mortality rates of 22.92% and 16.98%, and the insecticide resistance levels were all resistant (R). The KT₅₀ of lambda-cyhalothrin were 164.22 min and 236.22 min for An. sinensis in 2018 and 2020, with knock-down rates of 30.39% and 38.30% 60 min postexposure to malathion and 24 h mortality rates of 19.60% and 21.28%, respectively, and the insecticide resistance levels were all R.

CONCLUSIONS

An. sinensis is relatively susceptible to malathion but has developed high-level resistance to deltamethrin and lambda-cyhalothrin in Puyang City, Henan Province..

Urinary albumin creatinine ratio associated with postoperative delirium in elderly patients undergoing elective non-cardiac surgery: A prospective observational study

Introduction

The blood‐brain barrier (BBB) disruption contributes to postoperative delirium, but cost‐effective and non‐invasive assessment of its permeability is not practicable in the clinical settings. Urine albumin to creatinine ratio (UACR), reflecting systemic vascular endothelial dysfunction, may be a prognostic and predictive factor associated with postoperative delirium. The aim was to analyze the relationship between UACR and postoperative delirium in elderly patients undergoing elective non‐cardiac surgery.

Materials and methods

Through stratified random sampling, a cohort of 408 individuals aged 60 years and older scheduled for elective non‐cardiac surgery were included between February and August 2019 in the single‐center, prospective, observational study. The presence of delirium was assessed using the Confusion Assessment Method (CAM) or Confusion Assessment Method for the ICU (CAM‐ICU) on the day of surgery, at 2 h after the surgery ending time and on the first 3 consecutive days with repeated twice‐daily, with at least 6‐h intervals between assessments. Urine samples were collected on one day before surgery, and 1st day and 3rd day after surgery. The primary outcome was the presence of postoperative delirium, and association of the level of UACR with postoperative delirium was evaluated with unadjusted/adjusted analyses and multivariable logistic regression.

Results

Postoperative delirium was observed in 26.75% (107 of 400) of patients within 3 days post‐surgery. UACR‐Pre (OR, 1.30; 95% CI, 1.14–1.49, p < 0.001), UACR‐POD1 (OR, 1.20; 95% CI, 1.13–1.27, p < 0.001), and UACR‐POD3 (OR, 1.14; 95% CI, 1.08–1.20, p < 0.001) between the delirium and non‐delirium groups show a significant difference, even after adjusting for age, education levels, and other factors.

Conclusion

As the marker of endothelial dysfunction, the high perioperative UACR value may be linked to the postoperative delirium in elderly patients undergoing elective non‐cardiac surgery.

MicroRNA-93-5p participates in type 2 diabetic retinopathy through targeting Sirt1

OBJECTIVE

To investigate the role of miR-93-5p in rats with type 2 diabetic retinopathy (DR) through targeting Sirt1.

METHODS

The targeting correlation between miR-93-5p and Sirt1 was validated by dual-luciferase reporter gene assay. Type 2 diabetes mellitus (T2DM) rat models were received intravitreal injection of antagomir NC (negative control), miR-93-5p antagomir, miR-93-5p agomir and/or recombinant Sirt1, followed by observation of pathological changes in retina via HE staining. Besides, retinal vascular permeability was determined by fluorescein isothiocyanate-bovine serum albumin (FITC-BSA), while the retinal vasculature was observed through retinal trypsin digestion. Expression of miR-93-5p and Sirt1 was measured by qRT-PCR and Western blotting, while the levels of VEGF, proinflammatory cytokines and anti-oxidative indicators were determined using corresponding kits.

RESULTS

MiR-93-5p could target Sirt1 as analyzed by the luciferase reporter gene assay. Rats in the T2DM group presented the up-regulation of miR-93-5p and down-regulation of Sirt1 in the retina, and miR-93-5p inhibition could up-regulate Sirt1 expression in the T2DM rats. Recombinant Sirt1 decreased retinal vascular permeability and acellular capillaries with improved pathological changes in retina from T2DM rats, which was abolished by miR-93-5p agomir. Moreover, miR-93-5p inhibition or Sirt1 overexpression decreased the levels of VEGF and proinflammatory cytokines while enhancing the activity of anti-oxidative indicators. However, indicators above had no significant differences between T2DM group and T2DM + agomir + Sirt1 group.

CONCLUSION

MiR-93-5p, via targeting Sirt1, could affect the vascular permeability and acellular capillaries and mitigate the inflammation and oxidative stress in the retinas, which may play a critical role in DR.

[Construction of Continuous Dynamic Model for River Networks and Its Application in Simulation of Spatiotemporal Migration of Typical Biocides]

Biocides are widely added to personal care products and enter the environment through sewage treatment plant (STP) discharge, which affects ecological health. This paper evaluated the pollution characteristics of triclosan and triclocarban in a river network during the COVID-19 epidemic. Moreover, a continuous dynamic river network model coupling a one-dimensional hydrodynamic model and four-level fugacity model was established to address the temporal and spatial heterogeneity of pollutants in the river network migration process; then, this model was applied to evaluate two biocides in the Shima River Basin. The model passed calibration and in-field concentration verification tests and yielded satisfactory simulation results. The results of the study showed that the concentration of biocides in the river network during the new crown epidemic was twice that of the non-epidemic period. The concentration of triclosan and triclocarban in the river channel first increased and then decreased with the increase of the river migration distance after STP discharge. The time variation characteristics of the concentrations were affected by the river flow. The biocide concentration in the river network of the low flow upstream area first increased and then decreased, gradually stabilizing in about 20 h. The pollution concentration in the high flow downstream area was increased, and the concentration did not stabilize at 24 h. These results indicate the necessity of evaluating the temporal and spatial characteristics of migration of typical biocides in the river network by stages and time on the premise of distinguishing the flow.

Andrographolide Suppresses the Growth and Metastasis of Luminal-Like Breast Cancer by Inhibiting the NF-κB/miR-21-5p/PDCD4 Signaling Pathway

Tumor growth and metastasis are responsible for breast cancer-related mortality. Andrographolide (Andro) is a traditional anti-inflammatory drug used in the clinic that inhibits NF-κB activation. Recently, Andro has been found in the treatment of various cancers. Andro inhibits breast cell proliferation and invasion and induces apoptosis via activating various signaling pathways. Therefore, the underlying mechanisms with regard to the antitumor effects of Andro still need to be further confirmed. Herein, a MMTV-PyMT spontaneous luminal-like breast cancer lung metastatic transgenic tumor model was employed to estimate the antitumor effects of Andro on breast cancer in vivo. Andro significantly inhibited tumor growth and metastasis in MMTV-PyMT mice and suppressed the cell proliferation, migration, and invasion of MCF-7 breast cancer cells in vitro. Meanwhile, Andro significantly inhibited the expression of NF-κB, and the downregulated NF-κB reduced miR-21-5p expression. In addition, miR-21-5p dramatically inhibited the target gene expression of programmed cell death protein 4 (PDCD4). In the current study, we demonstrated the potential anticancer effects of Andro on luminal-like breast cancer and indicated that Andro inhibits the expression of miR-21-5p and further promotes PDCD4 via NF-κB suppression. Therefore, Andro could be an antitumor agent for the treatment of luminal-like breast cancer in the clinic.

How much do human and livestock actually contribute to steroids emission and surface water pollution from past to the future: A global research

A comprehensive global inventory of past, present, and future steroid emissions was firstly developed based on the global 5' × 5' grids relevant data available. From 1970 to 2070, the growth rate of the annual global steroid emission was relatively stable around 10%. At present (in 2015), the global steroid emissions was 18,270 t, with 17% contributed by humans. Almost one-third of total animal emissions have been occurring in India and Brazil. India also had the highest value of human steroid emissions. Regions with highest steroid emissions were concentrated between 10° ~ 35° N and 70° ~ 90° E. The increase of sewage treatment rates can effectively reduce the total quantity of steroids entering the environment, especially for some developing countries. But the "technology bonus" from sewage treatment process will be exhausted until to 2030. Meanwhile, global surface water pollution was predicted based on steroid emissions into water compartment and on the digital river network with annual river discharge. The modelling results show that steroids are widely distributed across the globe, with concentrations mostly below 100 ng/L. However, if no proper treatment measures for animal excretions, in another 100 years, the range of the surface water contaminated by steroids will increase by 1.2 times. The Nile River resulted as the most polluted among the eight world's longest and famous rivers during the whole period investigated. Various measured concentrations worldwide validated our modelling result. The global steroid emission inventory and surface water pollution from past to the future will stand as an important data and knowledge base for the management of pollution from different types of steroids at global and regional level.