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The emergence of novel plasmid-mediated high-level tigecycline resistance genes tet(X) in the Enterobacteriaceae has increased public health risk for treating severe bacterial infections. Despite growing reports of tet(X)-positive isolates detected in animal sources, the epidemiological association of animal- and environment-derived isolates with human-derived isolates remains unclear. Here, we performed a comprehensive analysis of tet(X4)-positive Escherichia coli isolates collected in a hospital in Guangdong province, China. A total of 48 tet(X4)-positive E. coli isolates were obtained from 1001 fecal samples. The tet(X4)-positive E. coli isolates were genetically diverse but certain strains that belonged to ST48, ST10, and ST877 etc. also have clonally transmitted. Most of the tet(X4) genes from these patient isolates were located on conjugative plasmids that were successfully transferred (64.6%) and generally coexisted with other antibiotic resistance genes including aadA, floR, bla TEM and qnrS. More importantly, we found the IncX1 type plasmid was a common vector for tet(X4) and was prevalent in these patient-derived strains (31.3%). This plasmid type has been detected in animal-derived strains from different species in different regions demonstrating its strong transmission ability and wide host range. Furthermore, phylogenetic analysis revealed that certain strains of patient and animal origin were closely related indicating that the tet(X4)-positive E. coli isolates were likely to have cross-sectorial clonal transmission between humans, animals, and farm environments. Our research greatly expands the limited epidemiological knowledge of tet(X4)-positive strains in clinical settings and provides definitive evidence for the epidemiological link between human-derived tet(X4)-positive isolates and animal-derived isolates., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021. Published by Elsevier B.V.)

Background and Aims: Supplementation of fish oil (FO) containing lipid emulsions has been associated with a reduction in the length of hospital stay, infections and liver dysfunction in patients undergoing major surgery. We carried out a meta-analysis and subgroup analysis to examine randomised clinical trial (RCT)-based evidence of the aforementioned effects., Methods: Four databases, reference lists and the WHO ICTRP were systematically searched for RCTs to access the clinical efficacy of fish oil-enriched total parenteral nutrition in post-surgery patients. Methodological quality assessment was based on the Cochrane Handbook and GRADE., Results: Twenty-one RCTs were enrolled for meta-analysis. FO was associated with a significant reduction in the length of hospital stay (mean = -2.14 d, 95% CI = -3.02 to -1.27), infections (OR = 0.53, 95% CI = 0.35-0.81), ALT (mean = -6.35 U/L, 95% CI = -11.75 to -0.94), GGT (mean = -11.01 U/L, 95% CI = -20.77 to -1.25) and total bilirubin (mean = -2.06 μmol/L, 95% CI = -3.6 to -0.52), as well as a non-significant change in mortality and postoperative medical cost. The quality of evidence of each clinical outcome was accessed as high., Conclusion: FO-enriched lipid emulsions are likely to reduce infections, the length of hospital stay and liver dysfunction without influencing mortality and may be a safe and preferable choice in post-surgery patients. Further well-designed trials should be performed to determine whether FO lipid emulsions reduce mortality in patients undergoing hepatic surgery, especially liver transplantation, and the cost effectiveness of such treatment., (Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Published data on the association between Cyclin D1 (CCND1) G870A gene polymorphism and digestive tract cancers (DTC) are inconclusive. We carried out a meta-analysis of published case-control studies to derive a more precise estimation of the association. Relevant studies were identified from PubMed, EMBASE, and China National Knowledge Infrastructure up to February 1st, 2011. Crude odds ratios (OR) and 95% confidence intervals (CI) were used to investigate the strength of the association. Data were available from a total of 33 case-control studies with 8534 cases and 11,737 controls. The combined results based on all studies showed that there was a statistically significant link between CCND1 G870A polymorphism and DTC risk (GG vs. AA: OR=0.83, 95%CI=0.71-0.96). In the analysis of ethnic groups, we found the A allele carriers had a significantly increased DTC susceptibility among Caucasians, but not among Asians. When stratified for tumor location, the results based on all studies only showed the variant allele 870A might have a significantly increased risk of colorectal cancer (CRC), especially of rectal cancer (GG vs. AA: OR=0.71, 95%CI=0.58-0.89). When stratifying by the stage and histological differentiation of CRC, we only observed that patients had a significantly higher frequency of CCND1 870 AA than non-cancer patients among Caucasians. The A allele carriers (hetero- or homozygotes) were significantly more common in cases with a family history of CRC than in controls. There was no evidence of publication bias for CCND1 G870A polymorphism with DTC risk. In summary, this meta-analysis demonstrates that the CCND1 G870A polymorphism may be an ethnicity-dependent risk factor for DTC. And this genetic variant may increase the risk of rectal cancer, but not colon cancer., (Copyright © 2011 Elsevier Ltd. All rights reserved.)