The potential mechanism of the progression from latent to active tuberculosis based on the intestinal microbiota alterations

INTRODUCTION

Tuberculosis (TB) poses a serious challenge to global health systems. The altered intestinal microbiota is associated with the pathogenesis of TB, but the exact links remain unclear.

METHODS

16 S rDNA sequencing was performed to comprehensively detect the changes in the intestinal microbiota of feces from active TB (ATB), latent TB infection (LTBI) and healthy controls (HC).

RESULTS

The rarefaction curves demonstrated the sequencing results' validity. The alpha diversity was lowest in ATB, while highest in HC. Boxplot of beta diversity showed significant differences in every two groups. LDA Effect Size (LEfSe) Analysis revealed differences in probiotic bacteria like Romboutsia, Bifidobacterium and Lactobacillus in LTBI, and pro-inflammatory bacteria like R. gnavus, Streptococcus and Erysipelatoclostridium in ATB, corresponding to the cluster analysis. PICRUST2 analysis revealed the pentose phosphate pathway was active in ATB and LTBI (more active in ATB). The differences between the groups are statistically significant at the P<0.05 level.

CONCLUSION

Our study indicated that from LTBI to ATB, some intestinal microbiota inhibit the synthesis of interferon (INF)-γ and interleukin (IL)-17, promoting the survival and spread of Mycobacterium tuberculosis (M. tb). In addition, the metabolites secreted by intestinal microbiota and dysbiosis in intestine also have an effect on the development of LTBI to ATB.

Untargeted Metabolomics of Feces Reveals Diagnostic and Prognostic Biomarkers for Active Tuberculosis and Latent Tuberculosis Infection: Potential Application for Precise and Non-Invasive Identification

Purpose

Distinguishing latent tuberculosis infection (LTBI) from active tuberculosis (ATB) is important to control the prevalence of tuberculosis; however, there is currently no effective method. The aim of this study was to discover specific metabolites through fecal untargeted metabolomics to discriminate ATB, individuals with LTBI, and healthy controls (HC) and to probe the metabolic perturbation associated with the progression of tuberculosis.

Patients and Methods

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was performed to comprehensively detect compounds in fecal samples from HC, LTBI, and ATB patients. Differential metabolites between the two groups were screened, and their underlying biological functions were explored. Candidate metabolites were selected and enrolled in LASSO regression analysis to construct diagnostic signatures for discriminating between HC, LTBI, and ATB. A receiver operating characteristic (ROC) curve was applied to evaluate diagnostic value. A nomogram was constructed to predict the risk of progression of LTBI.

Results

A total of 35 metabolites were found to exist differentially in HC, LTBI, and ATB, and eight biomarkers were selected. Three diagnostic signatures based on the eight biomarkers were constructed to distinguish between HC, LTBI, and ATB, demonstrating excellent discrimination performance in ROC analysis. A nomogram was successfully constructed to evaluate the risk of progression of LTBI to ATB. Moreover, 3,4-dimethylbenzoic acid has been shown to distinguish ATB patients with different responses to etiological tests.

Conclusion

This study constructed diagnostic signatures based on fecal metabolic biomarkers that effectively discriminated HC, LTBI, and ATB, and established a predictive model to evaluate the risk of progression of LTBI to ATB. The results provide scientific evidence for establishing an accurate, sensitive, and noninvasive differential diagnosis scheme for tuberculosis.

Theoretical Prediction of Rhenium Separation from Ammonium Perrhenate by Phonon-Photon Resonance Absorption

Rhenium (Re) is an extremely rare and precious element that is mainly used in the construction of aerospace components and satellite stations. However, an efficient and simple method for preparing Re has yet to be devised. To this end, we investigated the vibrational spectrum of ammonium perrhenate (NH₄ReO₄) using the CASTEP code based on first-principles density functional theory. We assigned the infrared (IR) absorption and Raman scattering spectra for NH₄ReO₄ using a dynamic process analysis of optical branch normal modes. We examined the IR-active peaks of Re-related vibrational modes in detail and found that the typical IR peak at approximately 914 cm^-1 is due to the Re-O bond stretching. Thus, we posit that strong terahertz laser irradiation of NH₄ReO₄ at 914 cm^-1 will lead to sufficient resonance absorption to cleave its Re-O bonds. This method could potentially be used to efficiently separate Re from its oxides.

Comparative Analysis of the Hydrogen Bond Vibrations of Ice XII

It is difficult to theoretically study the vibrational spectrum of hydrogen-disordered ice XII compared with its hydrogen-ordered counterpart, ice XIV. We constructed a 24-molecule supercell of ice XII to mimic its real structure. We focused on hydrogen bond (HB) vibrational modes in the translation band using first-principles density functional theory (DFT). Our simulated results were in good agreement with inelastic neutron scattering experiments. We found that the optical vibrational modes of HBs are composed of three main components. These are cluster vibrations in the lowest-frequency region, four-bond HB vibrations in the highest-frequency region, and two-bond modes in between. Although the experimentally recorded curve of ice XII is smooth in the translation region, our results support the proposal that two types of intrinsic HB vibrational modes are common in the ice family.

Visualization of yellow fever virus infection in mice using a bioluminescent reporter virus

Yellow fever virus (YFV) is a re-emerging flavivirus, which can lead to severe clinical manifestations and high mortality, with no specific antiviral therapies available. The live-attenuated yellow fever vaccine 17D (YF17D) has been widely used for over eighty years. However, the emergence of yellow fever vaccine-associated viscerotropic disease (YFL-AVD) and yellow fever vaccine-associated neurotropic disease (YFL-AND) raised non-negligible concerns. Additionally, the attenuation mechanism of YF17D is still unclear. Thus, the development of convenient models is crucial to understand the mechanisms behind YF17D attenuation and its adverse effects. In this work, we generated a reporter YF17D expressing nano-luciferase (NLuc). In vitro and in vivo characterization demonstrated that the NLuc-YF17D shared similar biological properties with its parental strain and the NLuc activity can reflect viral infectivity reliably. Combined with in vivo bioluminescence imaging, a series of mice models of YF17D infection was established, which will be useful for the evaluation of antiviral medicines and novel vaccine candidates. Especially, we demonstrated that intraperitoneally (i.p.) infection of NLuc-YF17D in type I interferon receptor-deficient mice A129 resulted in outcomes resembling YEL-AVD and YEL-AND, evidenced by viral replication in multiple organs and invasion of the central neuronal system. Finally, in vitro and in vivo assays based on this reporter virus were established to evaluate the antiviral activities of validated antiviral agents. In conclusion, the bioluminescent reporter virus described herein provides a powerful platform to study YF17D attenuation and vaccine-associated diseases as well as to develop novel countermeasures against YFV.

Comparative Analysis of Hydrogen-Bonding Vibrations of Ice VI

It is difficult to investigate the hydrogen-bonding dynamics of hydrogen-disordered ice VI. Here, we present a comparative method based on our previous study of its counterpart hydrogen-ordered phase, ice XV. The primitive cell of ice XV is a 10 molecule unit, and the vibrational normal modes were analyzed individually. We constructed an 80 molecule supercell of ice VI to mimic the periodic unit and performed first-principles density functional theory calculations. As the two vibrational spectra show almost identical features, we compared the molecular translation vibrations. Inspired by the phonon analysis of ice XV, we found that the vibrational modes in the translation band of ice VI are classifiable into three groups. The lowest-strength vibration modes represent vibrations between two sublattices that lack hydrogen bonding. The highest-strength vibration modes represent the vibration of four hydrogen bonds of one molecule. The middle-strength vibration modes mainly represent the molecular vibrations of only two hydrogen bonds. Although there are many overlapping stronger and middle modes, there are only two main peaks in the inelastic neutron scattering (INS) spectra. This work explains the origin of the two main peaks in the far-infrared region of ice VI and illustrates how to analyze a hydrogen-disordered ice structure.

Co-administration of Wuzhi tablet (Schisandra sphenanthera extract) alters tacrolimus pharmacokinetics in a dose- and time-dependent manner in rats

ETHNOPHARMACOLOGY RELEVANCE

Tacrolimus is a well-known potent but expensive immunosuppressant. We previously clarified the herb-drug interaction between tacrolimus and Wuzhi tablet (WZ), a prescribed drug of ethanol extract of Schisandra sphenanthera, and showed the ideal effect of WZ on maintaining therapeutic level of tacrolimus and reducing the total drug expense. However, WZ possesses a biphasic effect on regulating CYP3A (the major metabolizing enzyme of tacrolimus), which could induce the mRNA and protein expression after long-term treatment while transiently inhibit the activity of CYP3A. In clinic, clinicians are confused about the relationship between the blood concentration of tacrolimus and the dose and the duration of pretreatment of WZ. Therefore, the effects of the pretreatment time and the dose of WZ on the pharmacokinetics of tacrolimus is urgently needed to be clarified to better combine the use of WZ and tacrolimus in clinic.

AIM OF THE STUDY AND METHOD

This study aimed to investigate the effects of the pretreatment time and the dose of WZ on the pharmacokinetics of tacrolimus in rats.

RESULTS AND CONCLUSIONS

After pretreated rats with WZ for 0, 0.5, 2, 6, 12 or 24 h, the area under the curve (AUC) of tacrolimus was 2.27 ± 0.59, 1.87 ± 1.14, 2.86 ± 0.64, 1.62 ± 0.70, 1.54 ± 1.06 and 1.12 ± 0.69-fold of that of the tacrolimus alone group, respectively. The ratio of AUC of tacrolimus to that of the co-administration group with 0, 62.5, 125, 250, 500 or 750 mg/kg of WZ was 1.00: 1.07: 1.44: 2.60: 2.32: 2.42, respectively. These findings suggested that WZ increased tacrolimus AUC in a pretreatment time- and dose-dependent manner. In line with the in vivo findings, WZ extract inhibited CYP3A activity in a pre-treatment time- and concentration-dependent manner in human liver microsomes. In conclusion, the pharmacokinetics of tacrolimus was significantly affected by the pretreatment time and the dose of WZ. Oral pretreatment with WZ for 0-2 h or co-dosing of 250 mg/kg of WZ most significantly increased the blood concentration of tacrolimus. These findings would be helpful for guiding the reasonable use of WZ and tacrolimus in clinic.

[Pelvic-sacral tendon-regulation needling technique of acupuncture combined with manipulative reduction in treatment of postpartum pelvic girdle pain: a randomized controlled trial]

OBJECTIVE

To observe the effect on postpartum pelvic girdle pain treated with the combined therapy of pelvic-sacral tendon-regulation needling technique of acupuncture and manipulative reduction and the simple manipulative therapy.

METHODS

A total of 80 patients with postpartum pelvic girdle pain were randomized into an observation group and a control group, 40 cases in each one. In the control group, the manipulative reduction was simply adopted. In the observation group, on the base of the treatment as the control group, the pelvic-sacral tendon-regulation needling technique of acupuncture was applied at Mingmen (GV 4), Dachangshu (BL 25), Yaoyangguan (GV 3), Ciliao (BL 32), Zhongliao (BL 33), Huantiao (GB 30) and Yanglingquan (GB 34). In either group, the treatment was given once every two days, three times a week and 3 treatments taken as one course. Totally, 3 courses of treatment were required. The clinical therapeutic effect was compared in the patients between the two groups. The changes in the scores of the pain visual analogue scale (VAS), Oswestry dysfunction index (ODI) and Japanese Orthopaedic Association (JOA), as well as the pelvic floor distress inventory-short form 20 (PFDI-20), the pelvic floor impact questionnaire (PFIQ-7) and the sex life index (the frequency of intercourse and orgasm) were recorded in the patients of the two groups before and after treatment.

RESULTS

The total effective rate was 95.0% (38/40) in the observation group, higher than 77.5% (31/40) in the control group (P<0.01). After treatment, the scores of VAS, ODI, PFDI-20 and PFIQ-7 were lower than those before treatment respectively in the patients of the two groups (P<0.01). JOA score and the sex life index were increased after treatment as compared with those before treatment in the two groups (P<0.01). The difference value of each of the above indexes in the observation group was higher than the control group (P<0.01).

CONCLUSION

The combined therapy of pelvic-sacral tendon-regulation needling technique of acupuncture and manipulative reduction effectively alleviates pain and improves the muscle strength of pelvic floor muscle fibers in the patients with postpartum pelvic girdle pain. Its therapeutic effect is better than that of the simple manipulative therapy.

Computing Investigations of Molecular and Atomic Vibrations of Ice IX

The normal modes of ice IX were investigated using the CASTEP code package, which is based on density functional theory. We found that the translational modes could be divided into three categories: four-bond vibrations, which possessed the highest energy; two-bond vibrations, which possessed the medium energy; and cluster vibrations with the lowest energy. The former two categories represent monomers vibrating against neighbors and present as two distinct peaks in many ice phases recorded in inelastic neutron-scattering experiments. It is typically difficult to assign the molecular vibration peaks in the far infrared region. The method we developed to analyze the normal modes, especially in the translation band of ice IX, provided physical insights into the vibrational spectrum of ice.

Computational Analysis of Exotic Molecular and Atomic Vibrations in Ice XV

It is always difficult to assign the peaks of a vibrational spectrum in the far-infrared region. The two distinct peaks seen in many ice phases are still a mystery to date. The normal modes of ice XV were calculated using the CASTEP code based on first-principles density functional theory. On the basis of vibrational modes analysis, we divided the translational modes into three categories: four-bond vibrations, which have the highest energy levels; two-bond vibrations, which have medium levels of energy; and relative vibrations between two sublattices, which have the lowest energy. Whale et al. found that some intramolecular stretching modes include the isolated vibration of only one O–H bond, whereas the others do not vibrate in ice XV. We verified this phenomenon in this study and attributed it to local tetrahedral deformation. Analysis of normal modes, especially in the translation and stretching band of ice XV, clarified the physical insights of the vibrational spectrum and can be used with other ice phases.

Association of Preexisting Neurocognitive Impairments and Perioperative Neurocognitive Disorders for Hip Joint Replacement Surgery: A Prospective Cohort Study

Background

The association of preexisting neurocognitive impairments with perioperative neurocognitive disorders is not well-established. The objective of this study was to record incidences of perioperative neurocognitive disorders, to record changes in perioperative neurocognition, and to analyze factors of perioperative neurocognitive changes after hip joint replacement surgeries.

Material/Methods

Patients scheduled for hip joint replacement surgery were included in the test group (n=499) and patients with osteoarthritis but who were not planned for any type of surgeries were included in the control group (n=499). The cognitive tests were evaluated at the time of enrollment and at 1 week, 3 months, 1 year, and 4 years after baseline. Neurocognitive disorders for the individual parameter was defined as more than 2 SD of mean below norms for that parameter. Neurocognitive disorders were defined as a significant worst condition in at least 2 parameters out of all parameters.

Results

Compared to baseline, after 3 months the numbers of patients with perioperative neurocognitive disorders were increased (55 vs. 81, p=0.021). After 4 years, there was a significant decline in numbers of patients with perioperative neurocognitive disorders in the test group (55 vs. 3, p<0.0001). At the end of the 3-month follow-up period, elderly patients (p=0.002) and patients with preexisting neurocognitive impairments (p=0.005) had a higher incidence of perioperative neurocognitive disorders.

Conclusions

Age and preexisting neurocognitive impairments are markers predicting the risk of perioperative neurocognitive disorders.

A population pharmacokinetic model of vancomycin for dose individualization based on serum cystatin C as a marker of renal function

OBJECTIVES

This study aimed to establish a vancomycin population pharmacokinetics (PPK) model based on serum cystatin C and to optimize dosing for achieving targeted steady-state trough concentrations (C_ss ) of 10-15 and 15-20 mg/l.

METHODS

Patients aged ≥18 years were prospectively enrolled. A vancomycin PPK model was built with glomerular filtration rate (GFR) as a renal covariate estimated by cystatin C. A new group of patients were used for external evaluation. PPK analysis and Monte Carlo simulations were performed using nonlinear mixed effect modelling programme.

KEY FINDINGS

Two hundreds of patients with 514 samples were included. The final model was CL (L/h) = (5.07 × (GFR/105.5)^0.524 × (AGE/48.5)^-0.309 × (WT/60)^0.491 ); V (l) = 46.3. Internal and external evaluations demonstrated good stability and predictability. The average probability of target attainment (PTA) of optimal dosing regimens for targeted C_ss achieving 10-15 and 15-20 mg/l were 51.2% and 40.6%, respectively. An average PTA ≥71% for targeted concentration of 10-20 mg/l was obtained.

CONCLUSIONS

A vancomycin PPK model with cystatin C as the renal marker has good stability and predictability. The new proposed dosing regimens were predicted to achieve a good PTA.

[Correlation between laryngopharyngeal reflux and otitis media with effusion in adults patients]

Objective:Using the pepsin A concentration to investigate the relationship among gastroesophageal Reflux/laryngopharyngeal reflux and otitis media with effusion in adults patients.Method: Adults with OME underwent myringotomy with tube placement or eardrum puncturing suction were collected in the study group and the patients with coclear implatation were collected as control group. A standard sandwich Enzyme-linked Immunosorbent Assay (ELISA) method was applied to measure pepsin A concentration in the middle ear fluid.RSI and GERD-Q were used for the patients in study group.Result: Pepsin A concentration was (23.72±26.64; 2.00-84.47 ng/ml) in study group.The positive rates of pepsin A in the patients and samples were 21.69%(18/83) and 17.27%(19/110) respectively.In the control group, no pepsin A was detected in 26 samples. In the study group, 5 (6.02%) were diagnozid with GERD and 19 out of 83 patients (22.89%,19/83) were diagnosed with LPRD.LPRD, 8 out of 18 patients (44.44%) in the pepsin A positive group, was much higher than that in the pepsin A negative group (16.92%)(P<0.01).Conclusion: Laryngopharyngeal reflux was an important pathogeny of OME in adults patients, although those patients maybe have no any symptoms of GERD. The fat maybe be one of a indirect risk factor of OME in adults.

[Outcomes of pregnancy among women with alpha-thalassemia minor: A retrospective study of Pingguo county in Guangxi Zhuang Autonomous Region]

Objective: To investigate the association between the value of α-thalassemia minor and the outcomes in pregnant women. Methods: A total of 445 pregnant women with α-thalassemia minor were selected as thalassemia group in the Pingguo County Maternal and Child Health Hospital of Guangxi from January 2011 to December 2015, with ratio of 1∶4 healthy pregnant women was randomly recruited as non-thalassemia group. Clinical characteristics and pregnancy outcomes of the two groups were retrospectively analyzed using methods including t test, χ(2) test, and logistic regression model and ROC curve. Results: There were no significant differences noticed in factors as age, BMI, gestational age and educational level of the two groups. Hemoglobin of the thalassemia group was significantly lower than that of the non-thalassemia group (P<0.001). Differences on parity, ethnicities or occupation were statistically significant. Results from univariate analysis showed that the proportions of low birth weight, small for date infant and 1 min Apgar score<7 were higher in the thalassemia group, but the ratio of adverse pregnancy outcomes was comparable on parameters as preterm birth, stillbirth, macrosomia. Findings from the unconditional logistic regression showed that pregnancy complicated with α-thalassemia minor appeared a risk for both newborns with low birth weight (aOR=2.29, 95%CI: 1.32-3.95) and small for date infant (aOR= 2.11, 95%CI: 1.16-3.84). The ROC curve showed that α-thalassemia minor combined with multiple indicators presented a certain predictive value on neonatal birth weight. Conclusion: Pregnancy complicated with α-thalassemia minor was likely to increase the risk of birth weight loss in newborns, suggesting that prenatal care for pregnant women with thalassemia be strengthened, in order to reduce the incidence of adverse pregnancy outcomes.

[Modified radical mastoidectomy on"drum sinus" type chronic suppurative otitis media:our experience]

Objective:To our experience of modified radical mastoidectomy on "drum sinus" type chronic suppurative otitis media.Method:We measured the size of tympanic sinus,the extent of meningeal plate lowering and the extent of sigmoid ante-displacement in 54 patients of chronic suppurative otitis media,and determined the criterion of "drum sinus".The patients who comply with the criterion received modified radical mastoidectomy and tympanoplasty via epitympanum approach.The patients were followed up for at least 3 months,The time of dry ear,growth of repaired tympanic membrane,and any complications such as dizziness,facial paralysis,cerebrospinal fluid leakage were recorded.Result:Twenty-nine out of the 54 CSOM patients complied with the criterion of drum sinus.Two cases were lost to follow-up.Therefore,27 cases were included in the study.Three months after the operation,the rate of dry ear was 81.5% Tympanic membrane was successfully repaired in 77.8% of the patients.Three cases had dizziness after operation.No facial paralysis or cerebrospinal fluid leakage was observed.Conclusion:For"drum sinus" type chronic suppurative otitis media,the modified radical mastoidectomy and tympanoplasty via epitympanum approach can be taken.

Effect of long-term co-administration of Wuzhi tablet (Schisandra sphenanthera extract) and prednisone on the pharmacokinetics of tacrolimus

Tacrolimus (TAC) is an immunosuppressant that has been widely used alone or in combination with prednisone (PRED) to prevent acute rejection after organ transplantation. Wuzhi tablet (WZ, Schisandra sphenanthera extract) is often prescribed with TAC to prevent drug-induced hepatitis. We recently reported that WZ could significantly increase TAC blood exposure by inhibiting P-gp-mediated efflux and CYP3A-mediated metabolism of TAC. PRED is also a substrate of P-gp and is a weak inducer of CYP3A, and drug-drug interactions within this combination therapy might occur. Therefore, the purpose of this study was to investigate the effect of long-term treatment of WZ and PRED on the pharmacokinetics of TAC in rats. After 14 days of co-administration of WZ and PRED, the AUC(0-24h) of oral TAC was increased (from 59.6±37.3 to 95.3±39.4 ng h/ml, p=0.18) and the clearance was decreased (from 38.4±28.4 to 17.7±6.4 l/h/kg, p=0.15). When only co-administered with WZ, AUC(0-24h) of TAC was demonstrated a significantly increase (from 59.6±37.3 to 135.9±34.8 ng h/ml, p<0.05). The concomitant administration of PRED resulted in a reduction in the systemic exposure of TAC and an increase in its clearance, though neither was statistically significant. Thus, our study suggested that the presence of WZ and PRED still could increase the systemic exposure of TAC in rats. The drug-drug interactions among this combination therapy should still be taken into consideration in clinical practice.

[Study on Camellia Sect. Chrysantha Chang species identification by FTIR technology]

FTIR spectra from 16 kinds of Camellia Sect. Chrysantha by Fourier transform infrared spectroscopy (FTIR) method combined with the system clustering and correlation coefficient method were used to analyze and compare these spectral data. The results, show that: Camellia Sect. Chrysantha of 16 kinds were divided into three groups, the first kind was: C. longzhouensis etc, in all eleven kinds; The second kind was: C. achrysantha, C. limonia, C. pingguoensis and C. chuongtsoensis; The third kind was C. microcarpa, which for a class alone. According to the difference in related anatomy and morphology, this study supported that C. longgangensis and C. ptilosperma should be incorporated into one kind; C. multipetala, C. longgangensis, C. parvipetala, C. tunghinensis and C. limonia, C. achrysantha, C. microcarpa, C. nitidissima, C. terminali and C. pingguoensis should be divided into separate species. FTIR-cluster analysis can be used as a possible means for the identification of Camellia Sect. Chrysantha.

[p27 protein expression and its significance in human laryngeal carcinoma]

OBJECTIVE

To determine clinical significance and expression of p27 protein in human laryngeal carcinoma tissue.

METHOD

To measure p27 protein expression in 50 cases laryngeal carcinoma tissue by immunohistochemical LSAB (labelled streptavidin biotin) method, 15 cases vocal cord polyps used as control.

RESULT

There was significant difference between p27 protein expression in laryngeal carcinoma and in vocal cord polyps, among pathological staging of laryngeal carcinoma (G1-G2 and G3), between the survived and the dead laryngeal carcinoma patients 3 years after operation, but no significant difference among clinical staging and between the patients with and without lymph node metastases. There was significant difference between the survival rate curves (Kaplan-meier curve) in p27 protein expression positive group and that in p27 protein expression negative group.

CONCLUSION

p27 Protein expression is related to malignant degree of laryngeal carcinoma, so it can be an important marker of identifying the malignancy and prognosis of laryngeal carcinoma.