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Background Detection of hepatitis B virus (HBV) is vital for the diagnosis of hepatitis B infection. A novel test loop‐mediated isothermal amplification (LAMP) has been successfully applied to detect various pathogens. However, the accuracy of LAMP in diagnosing HBV remains unclear. Therefore, in the present study, the accuracy of LAMP for HBV detection was evaluated systematically. Methods Embase, Cochrane Library, and PubMed databases were searched for studies using LAMP to detect HBV. Then, two researchers extracted data and assessed the quality of literature using the QUADAS‐2 tool independently. I2 statistic and chi‐square test were analyzed to investigate the heterogeneity, and Deek's funnel plot assessed the publication bias. The pooled sensitivity (SEN), specificity (SPE), positive LR (PLR), negative LR (NLR), diagnostic odds ratio (DOR), and 95% confidence intervals were displayed in forest plots. We calculated the area under the curve (AUC) to assess the overall efficiency of LAMP for HBV detection. Results A total of nine studies with 1298 samples were finally included in this evaluation. The pooled sensitivity and specificity of HBV detection were 0.91 (95% CI: 0.89 ~ 0.92) and 0.97 (95% CI: 0.94 ~ 0.99), respectively. The PLR, NLR, and DOR were 16.93 (95% CI: 6.15 ~ 46.55), 0.08 (95% CI: 0.05 ~ 0.14), and 397.57 (95% CI: 145.41 ~ 1087.07). Besides, the AUC was 0.9872, and Deek's plot suggested that there existed publication bias in the studies. Conclusion Compared with PCR, LAMP is a simple, rapid, and effective assay to diagnose HBV. However, additional evidence is essential to confirm that LAMP can replace other methods in diagnosing HBV infection.

Background: At present, the infection and prevalence rates of tuberculosis (TB) are still high in worldwide. The Xpert MTB/RIF technology has improved the diagnosis speed of Mycobacterium tuberculosis (MTB) and facilitated the rapid treatment of TB patients. Methods: We searched experimental data derived from Xpert MTB/RIF for detecting MTB in gastric aspirates in PubMed, Embase, Web Of Science, and the Cochrane Library databases between January 2012 to April 2019. A summary receiver operating characteristic curve (SROC curve) was used to analyze the pooled sensitivity, pooled specificity, PLR, NLR, and DOR for determining the accuracy of the test. Results: Our database search resulted in 10 relevant articles. The pooled sensitivity of Xpert MTB/RIF for detecting TB in GA was 86% (95% CI, 83–89%), and I2 = 93.4%. The pooled specificity was 92% (95% CI, 90–93%) and I2 = 97.8%. In addition, the positive LR was 12.12 (95% CI, 5.60–26.21), negative LR was 0.20 (95% CI, 0.11–0.36), and the diagnostic odds ratio (DOR) was 147.04 (95% CI, 37.20–581.19). Using the SROC curve, the AUC was 0.9730 and Q* was 0.9248 (SE = 0.0261). The publication bias was P=0.517 (P>0.05). Conclusions: The Xpert MTB/RIF for detecting MTB in gastric aspirates was highly accurate. In addition, we observed that the publication bias in the present study was low. Hence, the Xpert MTB/RIF technology is highly accurate and has the advantage of rapid testing for MTB in clinical samples.

Background. Influenza virus mainly causes acute respiratory infections in humans. However, the diagnosis of influenza is not accurate based on clinical evidence, as the symptoms of flu are similar to other respiratory virus. The lateral-flow assay is a rapid method to detect influenza virus. But the effectiveness of the technique in detecting flu viruses is unclear. Hence, a meta-analysis would be performed to evaluate the accuracy of LFA in detecting influenza virus. Methods. Relevant literature was searched out in PubMed, Embase, Web of Science, and Cochrane Library databases with the keywords “lateral flow assay” and “flu virus”. By Meta-DiSc software, pooled sensitivity, pooled specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), summary receiver operating characteristic curve (SROC), and area under the curve (AUC) can be calculated. Results. This meta-analysis contains 13 studies and 24 data. The pooled sensitivity and specificity of the influenza virus detected by LFA were 0.84 (95% CI: 0.82-0.86) and 0.97 (95% CI: 0.97-0.98), respectively. The pooled values of PLR, NLR, DOR, and SROC were 32.68 (17.16-62.24), 0.17 (0.13-0.24), 334.07 (144.27-773.53), and 0.9877. No publication bias was found. Conclusions. LFA exhibited high sensitivity and specificity in diagnosing influenza virus. It is a valuable alternative method which can diagnose influenza virus quickly. However, more evidence is required to confirm whether LFA is comparable to traditional methods for detecting the virus.

Background. The World Health Organization approved the use of Xpert MTB/RIF for the detection of Mycobacterium tuberculosis DNA, which has significantly improved the diagnosis of tuberculosis. In this study, our main objective was to evaluate the diagnostic efficacy of Xpert MTB/RIF for lymphoid tuberculosis to determine whether Xpert MTB/RIF could be used as a routine detection method. Materials and Methods. We searched four databases for the relevant literature published from May 2007 to December 2019. The quality of the literature was evaluated with reference to the evaluation criteria. Data that were extracted from the literature on Xpert MTB/RIF diagnosis of lymphatic tuberculosis were used to plot the summary receiver operating characteristic (SROC) curve, after which the software was used to combine and analyze the accuracy of these data. Results. A total of 27 studies were included. The sensitivity of Xpert MTB/RIF for detecting lymphatic tuberculosis was 0.79 (95% CI (0.77, 0.81)), the specificity was 0.88 (95% CI (0.87, 0.90)), and the positive likelihood ratio (PLR) was 7.21 (95% CI (4.93, 10.55)). In addition, the negative likelihood ratio (NLR) was 0.25 (95% CI (0.19, 0.32)) and the diagnostic odds ratio (DOR) was 40.23 (95% CI (24.53, 65.98)). At the same time, we used the extracted data to make the SROC curve, obtaining the following parameters: area under the curve AUC=0.9144, Q=0.8470 (SE=0.0163). Conclusion. Xpert MTB/RIF has high accuracy in detecting lymphatic tuberculosis, and it can be used to quickly and easily diagnose lymphatic tuberculosis at an early stage as a general method.

OBJECTIVES/HYPOTHESIS Eosinophilic and noneosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP and NECRSwNP) show distinguished clinical pathology, but their underlying mechanism remains unclear. We aimed to investigate the clinical, hematological, and histopathological changes in chronic rhinosinusitis with nasal polyps (CRSwNP) endotypes and its association with microbiota. STUDY DESIGN A comparative cross-sectional study. METHODS A comparative study of 46 patients with CRSwNP (34.69 ± 16.39 years old) who underwent endoscopic sinus surgery were recruited and subdivided into ECRSwNP and NECRSwNP groups based on eosinophilic tissue inflammation; 12 healthy controls were also included. A structured histopathological analysis was conducted, and complete blood count was determined in patients. Endoscopic-guided middle meatus swabs and fecal samples were collected from the patients and controls and subsequently subjected to 16S rRNA gene sequencing on Illumina MiSeq. RESULTS Compared to NECRSwNP, ECRSwNP showed a statistically significant increase in the computed tomography score, endoscopic score, blood eosinophil percentage, tissue eosinophil count, inflammation degree, subepithelial edema, and eosinophil aggregation. Airway microbiota communities differed among the three groups. The abundance of Moraxella and Parvimonas was significantly higher in the ECRSwNP group. Distinct microbiota dysbiosis in CRSwNP endotypes was found to be correlated with different clinical pathologies. Moreover, the gut microbiota in ECRSwNP and NECRSwNP showed dysbiosis, that is, significant decrease in the abundance of Actinobacteria in the former and significant increase in the abundance of Enterobacterales and several genera in NECRSwNP. CONCLUSIONS Significant clinical pathology and microbiota changes were evident in patients with ECRSwNP and NECRSwNP. Distinct microbiota dysbiosis was correlated with different clinical pathologies. Understanding these differences may improve the prognosis and treatment of chronic rhinosinusitis. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E34-E44, 2021.

Background: Xpert Xpress Flu/RSV assay is a fast and automated real-time nucleic acid amplification method, recently approved by the USA, Europe and China for detection and differentiation of influenza (Flu) A, Flu B and RSV virus from nasopharyngeal swabs. Nevertheless, there are still no systematic reviews and meta-analysis on the accuracy of identification of influenza virus by The Xpert Xpress Flu/RSV assay. The aim of this meta-analysis was to verify the accuracy of Xpert Xpress Flu/RSV for detecting Flu and RSV.Materials and Methods: The PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched using the following keywords: Xpert Xpress Flu/RSV, Flu and RSV up to April 2019. Four researchers screened and extracted documents according to inclusion and exclusion criteria. The quality of original research was assessed using the QUADAS-2 guidelines. Meta-DiSc 1.4 software was used to analyze the sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic ratio (DOR), and Summary receiver operating characteristic curves (SROC). Deek’s funnel plot asymmetry test was used to evaluate the publication bias by Stata 12.0.Results: Nine studies with 22 fourfold tables were included in this meta-analysis. The sensitivity of Xpert Xpress Flu/RSV for detection of Flu A, Flu B, and RSV was 0.96, 0.98, 0.98; the specificity was 0.97, 0.99, 0.99; +LR was 80.65, 163.74, 237.35; -LR was 0.02 , 0.03, 0.05；DOR was 4806.90, 6266.78, 5254.41, respectively. AUC was all over 0.9. In addition, no publication bias for FluA, Flu B, and RSV was found. Conclusions: Compared to the traditional PCR approach, Xpert Xpress Flu/RSV resulted as a valuable method for Flu and RSV diagnosis in the clinic, offering high sensitivity and specificity. Nonetheless, further research is necessary to determine whether Xpert Xpress Flu/RSV can be used as a clinical diagnostic standard for the identification of Flu and RSV. Keywords: Xpert Xpress Flu/RSV; influenza virus; respiratory syncytial virus; PCR

Water-soluble nonconjugated fluorescent polymer nanoparticles (NFPNs) were prepared from branched polyethylenimine (PEI) and citric acid through an amide condensation reaction in the aqueous phase. The NFPNs were characterized using a transmission electron microscope, Fourier transform infrared (FTIR) spectroscopy, and X-ray photoelectron spectra (XPS). The NFPN fluorescence (with excitation/emission peaks at 360/450 nm) was quenched by 2,4,6-trinitrophenol (TNP) at trace concentrations through the inner filter effect and the formation of self-assembled non-fluorescent Meisenheimer complexes of TNP on the NFPN surfaces through acid–base interactions. The complexes effectively enriched TNP from the bulk solution on the NFPN surfaces through acid–base interactions, and the strong overlap between NFPN excitation and TNP absorption peaks contributed to NFPNs having good sensitivity and selectivity for TNP. The method was selective for TNP and was not sensitive to other interfering species. The calibration plot of log(F0/F) versus TNP concentration shows a linear relationship (R2 = 0.999) for TNP concentration in the range of 0.5–150 μM. The detection limit for TNP was 0.7 μM. The assay was successfully used to determine TNP in spiked lake water samples, and the recoveries were 96.6–102.7%.

Background: Candida is a fungus that causes various types of candidemia, which is the fourth major infectious disease of the blood system. MALDI-TOF-MS is a simple and rapid detection instrument. The aim of the present study was to verify the accuracy of MALDI-TOF-MS in detecting Candida. Method: A pooled analysis of articles on MALDI-TOF-MS for diagnosis of candidemia was performed. The quality of original research was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) guidelines. Stata 12.0 software was used to merge the correct identification rates of Candida and Candida subspecies and obtain pooled sensitivity and specificity of the diagnostic methods. Heterogeneity was found in the subgroup analysis of the included articles. Hence, we explored the factors causing the heterogeneity and its impact on the overall situation. Sensitivity analysis was used to examine the effect of Candida level on total response. Egger’s test was used to evaluate the publication bias of the included articles. Results: A total of 16 articles in Pubmed, 79 articles in Embase, 1 article in Cochrane Library, 30 articles in Web of Science and 3 from other sources were identified, of which 10 articles were included based on the inclusion and exclusion criteria. The overall identification accuracy was 100%. Conclusion: The accuracy of MALDI-TOF-MS for the identification of Candida was 100%. Further research is necessary to determine whether MALDI-TOF-MS can be used as a clinical diagnostic standard for the identification of Candida.

Streptococcus agalactiae is a major pathogenic bacterium causing perinatal infections in humans. In the present study, a novel real-time fluorescence loop-mediated isothermal amplification technology was successfully developed and evaluated for the detection of S. agalactiae in a single reaction. Six specific primers were designed to amplify the corresponding six regions of fbs B gene of S. agalactiae, using Bst DNA polymerase with DNA strand displacement activity at a constant temperature for 60 min. The presence of S. agalactiae was indicated by the fluorescence in real-time. Amplification of the targeted gene fragment was optimized with the primer 1 in the current setup. Positive result was only obtained for Sa by Real-LAMP among 10 tested relevant bacterial strains, with the detection sensitivity of 300 pg/µl. Real-LAMP was demonstrated to be a simple and rapid detection tool for S. agalactiae with high specificity and stability, which ensures its wide application and broad prospective utilization in clinical practice for the rapid detection of S. agalactiae.

Streptococcus agalactiae is a major pathogenic bacterium causing perinatal infections in humans. In the present study, a novel real-time fluorescence loop-mediated isothermal amplification technology was successfully developed and evaluated for the detection of S. agalactiae in a single reaction. Six specific primers were designed to amplify the corresponding six regions of fbs B gene of S. agalactiae, using Bst DNA polymerase with DNA strand displacement activity at a constant temperature for 60 min. The presence of S. agalactiae was indicated by the fluorescence in real-time. Amplification of the targeted gene fragment was optimized with the primer 1 in the current setup. Positive result was only obtained for Sa by Real-LAMP among 10 tested relevant bacterial strains, with the detection sensitivity of 300 pg/µl. Real-LAMP was demonstrated to be a simple and rapid detection tool for S. agalactiae with high specificity and stability, which ensures its wide application and broad prospective utilization in clinical practice for the rapid detection of S. agalactiae.

Kidney diseases are common and the incidence rate is increasing. Gut microbiota is involved in metabolic and immune regulation of the host. Genetic, alimentary and environmental disease factors may change gut flora and increase opportunistic and pathogenic bacteria, contributing to immune or non-immune mediated kidney diseases including IgA nephropathy and diabetic nephropathy. Additionally, bacterial metabolites may be a source of uremic toxins. Thus, identification of diversity, composition, and metabolic and immunologic features of gut bacteria in chronic kidney diseases may help understand pathogenetic mechanism and develop therapy for diseases.

Hierarchical porous Fe/N/S-doped carbon with a high content of graphitic nitrogen (FeNS/HPC) has been successfully synthesized by a facile dual-template method. FeNS/HPC shows not only macropores resulting from the dissolution of the SiO2 template, but abundant mesopores were also obtained after removing the in situ generated Fe2O3 nanoparticles on the ultrathin (∼4 nm) carbon shell of the macropores. Moreover, micropores are produced during the thermal pyrolysis of the carbon precursors. With respect to the electrochemical performance in the oxygen reduction reaction (ORR), FeNS/HPC not only exceeds other prepared porous carbon materials completely but also shows higher onset potential (0.97 vs 0.93 V), half-wave potentials (0.87 vs 0.83 V), and diffusion current density (5.5 vs 5.3 mA cm–2) than those of Pt/C. Furthermore, FeNS/HPC also exhibits outstanding stability and methanol tolerance, making it a competent candidate for ORR. The following aspects contribute to its excellent ORR performance. (1) Hi...

Microbial electrochemical cells (MECs) are devices in which anaerobic treatment of wastewater can occur in the anode chamber, where anode-respiring bacteria oxidize fatty acids produced from fermentation of waste organics to produce an electrical current. MECs are best suited for high-strength industrial wastewater streams, rather than dilute domestic wastewater streams. We have evaluated the possibility of using MECs for treatment of rendering wastewater, which contains high concentrations of fats (and often also proteins). We first conducted biochemical methane potential (BMP) tests to determine the anaerobic biodegradability of rendering wastewater (COD concentrations of ~7000 mg/L), and to determine optimum organic loading rate (relative to biomass concentration). Using the optimum conditions, we then conducted batch MEC studies to determine maximum current densities that could be produced, as well as the COD removal and conversion efficiencies. Maximum current densities of up to 2.5 A/m2 were produced, while COD conversion to electrical current ranged between 70-80%. Our studies indicate that MECs could become suitable for treatment of high fat content wastewater streams.

To investigate the effects of orally administrated Saccharomyces boulardii (S. boulardii) on the progress of carbon tetrachloride (CCl4)-induced liver fibrosis, 34 male Wistar rats were randomly divided into four experimental groups including the control group (n = 8), the cirrhotic group (n = 10), the preventive group (n = 8), and the treatment group (n = 8). Results showed that the liver expression levels of collagen, type I, alpha 1 (Col1A1), alpha smooth muscle actin (αSMA), transforming growth factor beta (TGF-β) and the serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and malondialdehyde (MDA) increased significantly in cirrhotic rats compared with control and decreased by S. boulardii administration. Treatment of S. boulardii also attenuated the increased endotoxin levels and pro-inflammatory cytokines in CCl4-treated rats. And, these were associated with the changes of intestinal permeability and fecal microbial composition. Our study suggested that oral administration of S. boulardii can promote the liver function of CCl4-treated rats, and the preventive treatment of this probiotic yeast may decelerate the progress of liver fibrosis.

Hyperuricemia is well known as the cause of gout. In recent years, it has also been recognized as a risk factor for arteriosclerosis, cerebrovascular and cardiovascular diseases, and nephropathy in diabetic patients. Foods high in purine compounds are more potent in exacerbating hyperuricemia. Therefore, the development of probiotics that efficiently degrade purine compounds is a promising potential therapy for the prevention of hyperuricemia. In this study, fifty-five lactic acid bacteria isolated from Chinese sauerkraut were evaluated for the ability to degrade inosine and guanosine, the two key intermediates in purine metabolism. After a preliminary screening based on HPLC, three candidate strains with the highest nucleoside degrading rates were selected for further characterization. The tested biological characteristics of candidate strains included acid tolerance, bile tolerance, anti-pathogenic bacteria activity, cell adhesion ability, resistance to antibiotics and the ability to produce hydrogen peroxide. Among the selected strains, DM9218 showed the best probiotic potential compared with other strains despite its poor bile resistance. Analysis of 16S rRNA sequences showed that DM9218 has the highest similarity (99%) to Lactobacillus plantarum WCFS1. The acclimated strain DM9218-A showed better resistance to 0.3% bile salt, and its survival in gastrointestinal tract of rats was proven by PCR-DGGE. Furthermore, the effects of DM9218-A in a hyperuricemia rat model were evaluated. The level of serum uric acid in hyperuricemic rat can be efficiently reduced by the intragastric administration of DM9218-A (P

Several characteristics of current infectious diseases show that most patients of infectious disease are immune tolerant hosts. Most infection-induced microorganisms come from patients themselves and people around them with normal indigenous microflora. The effectiveness of antibiotics are weakened with the emergence of multidrug resistant strains. The model of ‘infection→antibiotics→reinfection→reuse of antibiotics’ must not be followed in order to more effectively fight against infection from various critical points such as outbreaks and spreads. Infectious microecology provides theoretical and practical support to avoid and control infections. The introduction of mechanisms and applications of probiotics in prevention and control of infectious diseases will be introduced and discussed below in details.