Emerging trends of invasive yeast infections and azole resistance in Beijing intensive care units

BACKGROUND

Invasive fungal infections pose a substantial threat to patients in healthcare settings globally. Recent changes in the prevalence of fungal species and challenges in conducting reference antifungal susceptibility testing emphasize the importance of monitoring fungi and their antifungal resistance.

METHODS

A two-phase surveillance project was conducted in Beijing, China, involving 37 centres across 12 districts, from January 2012 to December 2013 and from January 2016 to December 2017.

FINDINGS

We found that the proportion of Candida albicans in intensive care units (ICUs) during 2016-2017 exhibited a significant decline compared with the 2012-2013 period, although it remained the most predominant pathogen. In contrast, the prevalence of Nakaseomyces glabratus (formerly Candida glabrata) and Candida tropicalis notably increased during the two-phase surveillance. The high prevalence of C. tropicalis and its resistance to azole drugs posed a serious threat to patients in ICUs. The pathogens causing invasive fungal infections in Beijing were relatively sensitive to echinocandins. While C. albicans continued to exhibit susceptibility to azoles, the resistance and growth rates of C. tropicalis towards azoles were particularly prominent. Concerns were raised due to the emergence of multiple, short-term isolates of Clavispora lusitaniae and Candida parapsilosis complex in neonatal ICUs, given their similarity in antifungal susceptibilities. Such occurrences point towards the potential for transmission and persisting presence of these pathogens within the ICU environment.

CONCLUSIONS

Our study complements existing data on the epidemiology of invasive fungal infections. It is imperative to exercise cautious medication management for ICU patients in Beijing, paying particular attention to azole resistance in C. tropicalis.

Application of dural puncture epidural technique combined with programmed intermittent epidural bolus mode in labor analgesia: A randomized clinical trial

BACKGROUND

This study aims to evaluate the onset, maintenance, side effects s and the effect on newborns of dural puncture epidural (DPE) technique combined with programmed intermittent epidural bolus (PIEB) mode for labor analgesia as compared to conventional epidural (EP) technique combined with continuous epidural infusion (CEI) mode.

METHODS

All patients were randomly assigned to receive EP + CEI (Group EC), EP + PIEB (Group EP), DPE + CEI (Group DC) and DPE + PIEB (Group DP). Record the time to reach Numerical Rating Scale (NRS) ≤ 1, ropivacaine consumption, the NRS when the uterine neck whole opened (NRS2), the incidence of bilateral sensory block level to S2, asymmetric block, incomplete analgesia, replacement of catheter, intrapartum fever, as well as the occurrence of neonatal Apgar score ≤ 7 at 1 minute and 5 minutes.

RESULTS

A total of 455 women were included (111 in Group EC, 116 in Group EP, 114 in Group DC and 114 in Group DP). The time to reach NRS ≤ 1 in Group DP and Group DC was shorter than that in Group EP and Group EC (P < .05); the consumption of ropivacaine in Group DP was less than that in 3 other groups (P < .05); the incidence of incomplete analgesia and intrapartum fever in Group DP was lower than that in other 3 groups (P < .05).

CONCLUSIONS

DPE technique can provide faster analgesia than conventional EP technique, combined with PIEB mode maybe superior to traditional methods as a labor analgesia regimen.

Coordinating the Edge Defects of Bismuth with Sulfur for Enhanced CO2 Electroreduction to Formate

Bismuth-based materials have been recognized as promising catalysts for the electrocatalytic CO2 reduction reaction (ECO2RR). However, they poor selectivity due to competing hydrogen evolution reaction (HER) remains challenging. In this study, we have developed an edge defect modulation strategy for Bi by coordinating the edge defects of bismuth (Bi) with sulfur, to promote ECO2RR selectivity and inhibit the competing HER. The prepared catalysts demonstrate excellent product selectivity, with a high HCOO- Faraday efficiency of ~95% and an HCOO- partial current of ~250 mA cm-2 under alkaline electrolytes. Density function theory calculations reveal that sulfur tends to bind to the Bi edge defects, reducing the coordination-unsaturated Bi sites (*H adsorption sites), and regulating the charge states of neighboring Bi sites to improve *OCHO adsorption. This work deepens our understanding of ECO2RR mechanism on bismuth-based catalysts, guiding for the design of advanced ECO2RR catalysts.

Network Pharmacology Combined with an Experimental Validation Study to Reveal the Effect and Mechanism of Eucommia ulmoides Leaf Polysaccharide against Immunomodulation

In the present study, the immuno-enhancing effect of Eucommia ulmoides leaf polysaccharide (ELP) was investigated in immunosuppressed mice induced by cyclophosphamide (CTX). To evaluate the immune enhancement mechanism of ELP, the immunoregulation effect of ELP was evaluated in vitro and in vivo. ELP is primarily composed of arabinose (26.61%), galacturonic acid (25.1%), galactose (19.35%), rhamnose (16.13%), and a small amount of glucose (12.9%). At 1000~5000 μg·mL^-1, ELP could significantly enhance the proliferation and the phagocytosis of macrophages in vitro. Additionally, ELP could protect immune organs, reduce pathological damage, and reverse the decrease in the hematological indices. Moreover, ELP significantly increased the phagocytic index, enhanced the ear swelling response, augmented the production of inflammatory cytokines, and markedly up-regulated the expression of IL-1β, IL-6, and TNF-α mRNA levels. Furthermore, ELP improved phosphorylated p38, ERK1/2, and JNK levels, suggesting that MAPKs might be involved in immunomodulatory effects. The results provide a theoretical foundation for exploring the immune modulation function of ELP as a functional food.

Dietary Supplementation With Acer truncatum Oil Promotes Remyelination in a Mouse Model of Multiple Sclerosis

Background

Multiple sclerosis is a chronic demyelinating disease of uncertain etiology. Traditional treatment methods produce more adverse effects. Epidemiological and clinical treatment findings showed that unknown environmental factors contribute to the etiology of MS and that diet is a commonly assumed factor. Despite the huge interest in diet expressed by people with MS and the potential role diet plays in MS, very little data is available on the role of diet in MS pathogenesis and MS course, in particular, studies on fats and MS. The oil of Acer truncatum is potential as a resource to be exploited in the treatment of some neurodegenerative diseases.

Objective

Here, we investigated the underlying influences of Acer truncatum oil on the stimulation of remyelination in a cuprizone mouse model of demyelination.

Methods

Cuprizone (0.2% in chow) was used to establish a mouse model of demyelination. Acer truncatum oil was administrated to mice during remyelination. Following techniques were used: behavioral test, histochemistry, fluorescent immunohistochemistry, transmission electron microscope.

Results

Mice exposed to cuprizone for 6 weeks showed schizophrenia-like behavioral changes, the increased exploration of the center in the open field test (OFT), increased entries into the open arms of the elevated plus-maze, as well as demyelination in the corpus callosum. After cuprizone withdrawal, the diet therapy was initiated with supplementation of Acer truncatum oil for 2 weeks. As expected, myelin repair was greatly enhanced in the demyelinated regions with increased mature oligodendrocytes (CC1) and myelin basic protein (MBP). More importantly, the supplementation with Acer truncatum oil in the diet reduced the schizophrenia-like behavior in the open field test (OFT) and the elevated plus-maze compared to the cuprizone recovery group. The results revealed that the diet supplementation with Acer truncatum oil improved behavioral abnormalities, oligodendrocyte maturation, and remyelination in the cuprizone model during recovery.

Conclusion

Diet supplementation with Acer truncatum oil attenuates demyelination induced by cuprizone, indicating that Acer truncatum oil is a novel therapeutic diet in demyelinating diseases.

Porcine deltacoronavirus and its prevalence in China: a review of epidemiology, evolution, and vaccine development

Porcine deltacoronavirus (PDCoV) is one of the most important enteropathogenic pathogens, and it causes enormous economic losses to the global commercial pork industry. PDCoV was initially reported in Hong Kong (China) in 2012 and subsequently emerged in swine herds with diarrhea in Ohio (USA) in 2014. Since then, it has spread to Canada, South Korea, mainland China, and several Southeast Asian countries. Information about the epidemiology, evolution, prevention, and control of PDCoV and its prevalence in China has not been comprehensively reported, especially in the last five years. This review is an update of current information on the general characteristics, epidemiology, geographical distribution, and evolutionary relationships, and the status of PDCoV vaccine development, focusing on the prevalence of PDCoV in China and vaccine research in particular. Together, this information will provide us with a greater understanding of PDCoV infection and will be helpful for establishing new strategies for controlling this virus worldwide.

Neuroinflammation Induction and Alteration of Hippocampal Neurogenesis in Mice Following Developmental Exposure to Gossypol

BACKGROUND

Neurogenesis in the neonatal period involves the proliferation and differentiation of neuronal stem/progenitor cells and the establishment of synaptic connections. This process plays a critical role in determining the normal development and maturation of the brain throughout life. Exposure to certain physical or chemical factors during the perinatal period can lead to many neuropathological defects that cause high cognitive dysfunction and are accompanied by abnormal hippocampal neurogenesis and plasticity. As an endocrine disruptor, gossypol is generally known to exert detrimental effects in animals exposed under experimental conditions. However, it is unclear whether gossypol affects neurogenesis in the hippocampal dentate gyrus during early developmental stages.

METHODS

Pregnant Institute of Cancer Research mice were treated with gossypol at a daily dose of 0, 20, and 50 mg/kg body weight from embryonic day 6.5 to postnatal day (P) 21. The changes of hippocampal neurogenesis as well as potential mechanisms were investigated by 5-bromo-2-deoxyuridine labeling, behavioral tests, immunofluorescence, quantitative reverse transcription-polymerase chain reaction, and western-blot analyses.

RESULTS

At P8, maternal gossypol exposure impaired neural stem cell proliferation in the dentate gyrus and decreased the number of newborn cells as a result of reduced proliferation of BLBP+ radial glial cells and Tbr2+ intermediate progenitor cells. At P21, the numbers of NeuN+ neurons and parvalbumin+ γ-aminobutyric acid-ergic interneurons were increased following 50 mg/kg gossypol exposure. In addition, gossypol induced hippocampal neuroinflammation, which may contribute to behavioral abnormalities and cognitive deficits and decrease synaptic plasticity.

CONCLUSIONS

Our findings suggest that developmental gossypol exposure affects hippocampal neurogenesis by targeting the proliferation and differentiation of neuronal stem/progenitor cells, cognitive functions, and neuroinflammation. The present data provide novel insights into the neurotoxic effects of gossypol on offspring.

Dexmedetomidine attenuates sevoflurane‑induced neurocognitive impairment through α2‑adrenoceptors

It has been reported that sevoflurane induces neurotoxicity in the developing brain. Dexmedetomidine is an α2 adrenoceptor agonist used for the prevention of sevoflurane‑induced agitation in children in clinical practice. The aim of the present study was to determine whether dexmedetomidine could prevent sevoflurane‑induced neuroapoptosis, neuroinflammation, oxidative stress and neurocognitive impairment. Additionally, the involvement of α2 adrenoceptors in the neuroprotective effect of dexmedetomidine was assessed. Postnatal day (P)6 C57BL/6 male mice were randomly divided into four groups (n=6 in each group). Mice were pretreated with dexmedetomidine, either alone or together with yohimbine, an α2 adrenoceptor inhibitor, then exposed to 3% sevoflurane in 25% oxygen. Control mice either received normal saline alone or with sevoflurane exposure. Following sevoflurane exposure, the expression of cleaved caspase‑3 was detected by immunohistochemistry in hippocampal tissue sections. In addition, the levels of tumor necrosis factor‑α (TNF‑α), interleukin (IL)‑1β, IL‑6 and malondialdehyde, as well as superoxide dismutase (SOD) activity in the hippocampus were measured. At P35, the learning and memory abilities were assessed in each mouse using a Morris water maze test. Dexmedetomidine significantly decreased the expression of activated caspase‑3 following sevoflurane exposure. Moreover, dexmedetomidine significantly decreased the levels of TNF‑α, IL‑1β and IL‑6 in the hippocampus. SOD activity also increased in a dose‑dependent manner in dexmedetomidine‑treated mice. MDA decreased in a dose‑dependent manner in dexmedetomidine‑treated mice. Lastly, sevoflurane‑induced learning and memory impairment was reversed by dexmedetomidine treatment. By contrast, co‑administration of yohimbine significantly attenuated the neuroprotective effects of dexmedetomidine. These findings suggested that dexmedetomidine exerted a neuroprotective effect against sevoflurane‑induced apoptosis, inflammation, oxidative stress and neurocognitive impairment, which was mediated, at least in part, by α2 adrenoceptors.

Usefulness of CT texture analysis in differentiating benign and malignant renal tumours

AIM

To elucidate visually imperceptible differences between benign and malignant renal tumours using computed tomography texture analysis (CTTA) using filtration histogram based parameters.

MATERIALS AND METHODS

A retrospective study was performed by texture analysis of pretreatment contrast-enhanced CT examinations in 354 histopathologically confirmed renal cell carcinomas (RCCs) and 147 benign renal tumours. A region-of-interest was drawn encompassing the largest cross-section of the tumour on venous phase axial CT. CTTA features of entropy, kurtosis, mean positive pixel density, and skewness at different spatial filters were calculated and compared in an attempt to differentiate benign lesions from malignancy.

RESULTS

Entropy with fine spatial filter was significantly higher in RCC than benign renal tumours (p=0.022). Entropy with fine and medium filters was higher in RCC than lipid-poor angiomyolipoma (p=0.050 and 0.052, respectively). Entropy >5.62 had high specificity of 85.7%, but low sensitivity of 31.3%, respectively, for predicting RCC.

CONCLUSIONS

Differences in entropy were helpful in differentiating RCC from lipid-poor angiomyolipoma, and chromophobe RCC from oncocytoma. This technique may be useful to differentiate lesions that appear equivocal on visual assessment or alter management in poor surgical candidates.

Targeting cyclophilin-D by compound 19 protects neuronal cells from oxygen glucose deprivation/re-oxygenation

Oxygen and glucose deprivation (OGD) with re-oxygenation (OGDR) is applied to neuronal cells to mimic ischemia-reperfusion injuries. Activation of cyclophilin D (Cyp-D)-dependent programmed necrosis pathway mediates OGDR-induced neuronal cell damages. Here, we tested the potential effect of Compound 19 (C19), a novel Cyp-D inhibitor, in this process. In both established neuronal cell lines (Neuro-2a and NB41A3 cells) and the primary murine CA1 hippocampal neurons, pretreatment with C19 largely attenuated OGDR-induced cell viability reduction and cell death. Significantly, C19 was ineffective in Cyp-D-silenced Neuro-2a cells. OGDR induced mitochondria-dependent programmed necrosis in neuronal cells. OGDR induced p53 translocation to mitochondria and association with Cyp-D, causing mitochondrial depolarization, cytochrome C release and reactive oxygen species production. Such effects were largely attenuated with pre-treatment of C19. Importantly, C19 was significantly more efficient than other known Cyp-D inhibitors in protecting neuronal cells from OGDR. These results suggest that targeting Cyp-D by C19 protects neuronal cells from OGDR.

Microemulsion can improve the immune-enhancing activity of propolis flavonoid on immunosuppression and immune response

The objective of the present study was to investigate whether the immune-enhancing activity of propolis flavone (PF) could be improved after PF was made into PF microemulsion (PFM). Two experiments were carried out. In immunosuppression experiment, the immune-enhancing effect of PFM in immunosuppressive chickens was performed. The results showed that PFM at high and medium doses was able to overcome the CTX-induced immunosuppression, significantly increases the immune organ indexes, enhances lymphocyte proliferation and improves the concentrations of IL-2 and IL-6 in serum when compared with PF. In immune response experiment, the adjuvant effect of PFM at three doses and PF were compared on chickens which were immunized intramuscularly with Avian Influenza Recombinant Newcastle Disease Virus bivalent Vaccine. The results showed that PFM at high and medium doses could significantly promote lymphocyte proliferation, enhances antibody titer and the concentrations of IgG and IgM, and its efficacy were significantly better than PF at most time points. These results indicated that PFM could significantly improve the immune-enhancing activity and adjuvanticity of PF, and its high and medium doses possessed the best efficacy. Therefore, the microemulsion could be used as an effective formulation for enhancing the bioavailability of PF.