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This article discusses the establishment of a novel severe asthma canine model for research on respiratory intervention therapies. The researchers aimed to create a large animal model of asthma that closely mimics the clinical signs and features of severe asthma in humans. They exposed adult beagles to Toluene diisocyanate (TDI) via aerosol inhalation and observed pronounced asthma clinical signs, airway inflammation, and remodeling. The model also demonstrated the efficacy of respiratory intervention therapy. This model provides a valuable tool for studying the mechanisms and effectiveness of interventional pulmonological therapies for severe asthma. [Extracted from the article]

Background: Accumulating evidence reveals mitochondrial dysfunction exacerbates intestinal barrier dysfunction and inflammation. Despite the growing knowledge of mitochondrial dysfunction and ulcerative colitis (UC), the mechanism of mitochondrial dysfunction in UC remains to be fully explored., Methods: We integrated 1137 UC colon mucosal samples from 12 multicenter cohorts worldwide to create a normalized compendium. Differentially expressed mitochondria-related genes (DE-MiRGs) in individuals with UC were identified using the "Limma" R package. Unsupervised consensus clustering was utilized to determine the intrinsic subtypes of UC driven by DE-MiRGs. Weighted gene co-expression network analysis was employed to investigate module genes related to UC. Four machine learning algorithms were utilized for screening DE-MiRGs in UC and construct MiRGs diagnostic models. The models were developed utilizing the over-sampled training cohort, followed by validation in both the internal test cohort and the external validation cohort. Immune cell infiltration was assessed using the Xcell and CIBERSORT algorithms, while potential biological mechanisms were explored through GSVA and GSEA algorithms. Hub genes were selected using the PPI network., Results: The study identified 108 DE-MiRGs in the colonic mucosa of patients with UC compared to healthy controls, showing significant enrichment in pathways associated with mitochondrial metabolism and inflammation. The MiRGs diagnostic models for UC were constructed based on 17 signature genes identified through various machine learning algorithms, demonstrated excellent predictive capabilities. Utilizing the identified DE-MiRGs from the normalized compendium, 941 patients with UC were stratified into three subtypes characterized by distinct cellular and molecular profiles. Specifically, the metabolic subtype demonstrated enrichment in epithelial cells, the immune-inflamed subtype displayed high enrichment in antigen-presenting cells and pathways related to pro-inflammatory activation, and the transitional subtype exhibited moderate activation across all signaling pathways. Importantly, the immune-inflamed subtype exhibited a stronger correlation with superior response to four biologics: infliximab, ustekinumab, vedolizumab, and golimumab compared to the metabolic subtype., Conclusion: This analysis unveils the interplay between mitochondrial dysfunction and the immune microenvironment in UC, thereby offering novel perspectives on the potential pathogenesis of UC and precision treatment of UC patients, and identifying new therapeutic targets., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhang, Fan, Bai, Zhao, Song, Wu, Lu, Liu, Wang, Li and Chen.)

Objectives: Screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) at both urogenital and extragenital sites has been recommended in many countries. Testing of the infections using pooled specimens from urogenital and extragenital sites offer the opportunity to shorten the testing time and reduce the testing cost. Ex-ante pooling is placing the original single-site specimens in a tube with transport media, while ex-post pooling is making a pool of the transport media from both anorectal and oropharyngeal specimens and the urine. This study aimed to conduct a multisite performance evaluation of two pool-specimen approaches (ex-ante and ex-post) in detection of CT and NG using the Cobas 4800 platform among men who have sex with men (MSM) in China., Design: Diagnostic accuracy study., Setting, Participants and Outcome Measures: Participants were recruited from MSM communities at six cities in China. Two oropharyngeal and anorectal swabs collected by clinical staff and 20 mL first-void urine collected by the participant himself were used for evaluating sensitivity and specificity., Results: A total of 1311 specimens were collected from 437 participants in six cities. The sensitivities of ex-ante pooling approach as compared with single-specimen approach (reference standard) were 98.7% (95% CI, 92.7% to 100.0%) for detection of CT and 89.7% (95% CI, 75.8% to 97.1%) for NG, and the specificities were 99.5% (95% CI, 98.0% to 99.9%) and 98.7% (95% CI, 97.1% to 99.6%), respectively. The sensitivities of ex-post pooling approach were 98.7% (95% CI, 92.7% to 100.0%) for CT and 100.0% (95% CI, 91.0% to 100.0%) for NG, and the specificities were 100.0% (95% CI, 99.0% to 100.0%) and 100.0% (95% CI, 99.1% to 100.0%), respectively., Conclusions: The ex-ante and ex-post pooling approaches show good sensitivity and specificity in detecting urogenital and extragenital CT and/or NG, indicating that these approaches can be used in epidemiological surveillance and clinical management of CT and NG infections, particularly among MSM population., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: Bladder cancer (BCa) is a common malignancy in the urinary system. This study aims to explore the role of miR-186 in BCa tumorigenesis., Methods: The expression of miR-186 and ADAMTS12 in clinical BCa tissues and cell lines was detected. BCa cell lines T24, 5637 and EJ were used to transfect miR-186 mimics or inhibitors. Luciferase reporter gene detection confirmed the correlation between miR-186 and ADAMTS12. MTT method and flow cytometry were used to detect cell viability and apoptosis. Cell migration and invasion ability was detected by transwell assay. The protein level of ADAMTS12, β-catenin, GSK-3β and p-GSK-3β was determined using western blot analysis., Results: MiR-186 was negatively correlated with the expression of ADAMTS12 in BCa tissues. Further research confirmed that ADAMTS12 is the direct target of miR-186. In addition, overexpression of miR-186 down-regulated the expression of ADAMTS12, inhibiting cell viability and apoptosis, while knockout of miR-186 led to the opposite result. miR-186 also inhibits the phosphorylation of GSK-3 β and β-catenin without changing the total GSK-3β level. Our study shows that miR-186 has a negative regulatory effect on the expression of ADAMTS12 in clinical specimens and in vitro. miR-186 can inhibit the proliferation and invasion of BCa cells., Conclusions: miR-186 has the potential to be used as a biomarker in the early detection of BCa., Competing Interests: All authors have no conflicts of interest or financial ties to disclose., (© 2022 Liang JF et al.)

Diffraction gratings with high upward diffraction efficiency and large effective length are required for chip-scale light detection and ranging. We propose a diffraction grating based on a multilayer silicon nitride waveguide, which theoretically achieves an upward diffraction efficiency of 92%, a near-field effective length of 376 µm, and a far-field divergence angle of 0.105° at a wavelength of 850 nm. The diffraction grating has a high tolerance to process variations based on Monte Carlo analysis. When the conditions are ±5 % layer thickness variation, ±50 n m lithographic variation, and ±20 n m wavelength drift, more than 71% of the grating samples have a diffraction efficiency higher than 80%, and 100% of the samples have an effective length larger than 200 µm (corresponding to a far-field divergence <0.2 ∘ ). Furthermore, the near-field effective length of the grating with an upward diffraction efficiency above 90% can be adjusted from hundreds of microns to centimeters by changing the etching layer thickness and the grating duty cycle. This diffraction grating has a potential application in optical sensing and imaging from visible to near-IR wavelengths.

Background: Triple negative breast cancer (TNBC) is a highly heterogeneous breast cancer subtype with a poor prognosis due to its extremely aggressive nature and lack of effective treatment options. This study aims to summarize the current hotspots of TNBC research and evaluate the TNBC research trends, both qualitatively and quantitatively., Methods: Scientific publications of TNBC-related studies from January 1, 2010 to October 17, 2020 were obtained from the Web of Science database. The BICOMB software was used to obtain the high-frequency keywords layout. The gCLUTO was used to produce a biclustering analysis on the binary matrix of word-paper. The co-occurrence and collaboration analysis between authors, countries, institutions, and keywords were performed by VOSviewer software. Keyword burst detection was performed by CiteSpace., Results: A total of 12,429 articles related to TNBC were identified. During 2010-2020, the most productive country/region and institution in TNBC field was the USA and The University of Texas MD Anderson Cancer Center, respectively. Cancer Research, Journal of Clinical Oncology, and Annals of Oncology were the first three periodicals with maximum publications in TNBC research. Eight research hotspots of TNBC were identified by co-word analysis. In the core hotspots, research on neoadjuvant chemotherapy, paclitaxel therapy, and molecular typing of TNBC is relatively mature. Research on immunotherapy and PARP inhibitor for TNBC is not yet mature but is the current focus of this field. Burst detection of keywords showed that studies on TNBC proteins and receptors, immunotherapy, target, and tumor cell migration showed bursts in recent three years., Conclusion: The current study revealed that TNBC studies are growing. Attention should be paid to the latest hotspots, such as immunotherapy, PARP inhibitors, target, and TNBC proteins and receptors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Hao, Jia, Dai, Huo, Zhang, Liu and Wang.)

In multiple types of cancer, decreased tumour cell apoptosis during chemotherapy is indicative of decreased chemosensitivity. Forkhead box K2 (FOXK2), which is essential for cell fate, regulates cancer cell apoptosis through several post-translational modifications. However, FOXK2 acetylation has not been extensively studied. Here, we evaluated the effects of sirtiun 1 (SIRT1) on FOXK2 deacetylation. Our findings demonstrated that SIRT1 inhibition increased FOXK2-induced chemosensitivity to cisplatin and that K223 in FOXK2 was acetylated. Furthermore, FOXK2 K223 deacetylation reduced chemosensitivity to cisplatin in vitro and in vivo. Mechanistically, FOXK2 was acetylated by the acetyltransferase cAMP response element binding protein and deacetylated by SIRT1. Furthermore, cisplatin attenuated the interaction between FOXK2 and SIRT1. Cisplatin or SIRT1 inhibition enhanced FOXK2 acetylation, thereby reducing the nuclear distribution of FOXK2. Additionally, FOXK2 K223 acetylation significantly affected the expression of cell cycle-related and apoptosis-related genes in cisplatin-stimulated cancer cells, and FOXK2 K223 hyperacetylation promoted mitotic catastrophe, which enhanced chemosensitivity to cisplatin. Overall, our results provided insights into the mechanisms of SIRT1-mediated FOXK2 deacetylation, which was involved in chemosensitivity to cisplatin., (© 2021 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.)

Purpose: Neisseria gonorrhoeae , resistant to the first-line treatment option ceftriaxone, is widespread in China from 2016. Nowadays, diverse reagents of disks and strips for rapid gonococcal antimicrobial susceptibility tests used in clinics are culture-based disks diffusion and gradient strips methods. This study aimed to evaluate the accuracy, quality, and availability of almost all disks and strips acquired in the Chinese market and serve as a reference for clinical selection., Methods: We tested the performance of 15 commercial disks and 9 commercial gradient strips acquired in China, compared with traditional agar dilution method. The overall performance was evaluated by the categorical agreement. The reagent accuracy of gradient strips was assessed by the essential agreement., Results: A total of 167 gonococcal isolates were used to evaluate antimicrobial disks from three brands. The overall categorical agreements were 71.7% to 81.8% for ceftriaxone, less than 58% for cefixime, 100% for spectinomycin, over 98% for ciprofloxacin, below 70.5% for penicillin, and 73.3% to 81.8% for tetracycline. A total of 81 isolates were tested for different gradient strips. Categorical agreements were over 96% for ceftriaxone, 86.2% for azithromycin, 62.3% to 67.1% for penicillin, 41.9% to 67.5% for tetracycline, and 95% for ciprofloxacin. Essential agreements were 57.7% to 87.3% for ceftriaxone, 70% for azithromycin, 64.9% to 68.4% for penicillin, 51.8% to 71.2% for tetracycline, and 91.3% for ciprofloxacin., Conclusion: Rapid test reagents of disks and strips based on gonococcal culture have suboptimal performance. Disk diffusion for spectinomycin or ciprofloxacin can be recommended for clinical individualized prescription. The gradient strips are of great value to identify ceftriaxone-resistant gonococcal strains. Furthermore, abundant improvements are required for many reagents to further optimize their accuracy till the fulfillment of molecular detection., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Xu et al.)

Background: Little is known about rectal Chlamydia trachomatis (CT) infection in outpatients attending sexually transmitted disease (STD) clinics in China. In this study, we aimed to explore the clinical and epidemiologic features of rectal CT infection in this population., Methods: A cross-sectional study was conducted among patients attending STD clinics in Tianjin and Guangxi provinces of China from June 2018 to August 2020. Bivariate and multivariate logistic regression analysis were developed to explore the association of different risk factors for urogenital and rectal CT infection., Results: The prevalence of urogenital and rectal CT was 11.2% (154/1374) and 4.9% (68/1377), respectively. The rectal CT prevalence among female and male patients was 7.8% (60/767) and 1.3% (8/610), respectively. The most common genotype in urogenital CT-positive samples was genotype E (29.9%), while the most common genotype among rectal CT-positive samples was genotype J (23.4%). More than 85% (52/60) of women infected with rectal CT were co-infected with urogenital CT. About 90.0% (36/40) of women shared similar genotypes between rectal and urogenital samples. Females and patients infected with urogenital CT were deemed to be at an increased risk for rectal CT infection. A high proportion of rectal CT infection had concurrent urogenital CT infection, especially in women, and most of the co-infections were shared among the same genotypes., Conclusions: It would be prudent to encourage awareness and introduce detection tests and treatment strategies for rectal CT infection particularly in female patients visiting STD clinics in China., (© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Purpose: This study aimed to determine the minimum inhibitory concentrations (MICs) of ertapenem on Neisseria gonorrhoeae collected from eight Chinese provinces in 2018., Methods: The MICs of ertapenem on 503 Neisseria gonorrhoeae isolates (415 isolates selected randomly and 88 isolates selected with preference) were measured using the agar dilution method. For comparison, the MICs of ceftriaxone and azithromycin were detected., Results: Among 415 randomly selected isolates, the MIC range for ertapenem was from ≤0.008 mg/L to 0.5 mg/L. The corresponding MIC 50 and MIC 90 were 0.06 and 0.125 mg/L, respectively. Twelve of 415 isolates (2.9%) exhibited MIC values ≥0.25 mg/L, and only one isolate (0.2%) had a MIC of 0.5 mg/L. By comparing all 503 tested isolates, a correlation of r = 0.487 ( P <0.001) between ertapenem and ceftriaxone MIC was observed, and the correlation between MICs of ertapenem and azithromycin was low ( r = -0.12, P = 0.007). In 24 ceftriaxone-decreased susceptibility isolates, four isolates (16.7%) showed a MIC ≥0.25 mg/L for ertapenem. In 85 azithromycin resistant isolates, three isolates (3.5%) showed a MIC ≥0.25 mg/L for ertapenem., Conclusion: The in vitro results suggest that ertapenem has satisfactory susceptibility in isolates collected from eight provinces in China; hence, it might be a promising treatment option for resistant gonococcal infections., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Xu et al.)

Background: Previous studies have investigated rectal Mycoplasma genitalium (MG) in men who have sex with men (MSM), while little is known about the prevalence of rectal MG infection in individuals attending sexually transmitted disease (STD) clinics in China. We aimed to estimate the prevalence of rectal MG infection in this population and identified the potential risk factors for rectal MG infection., Methods: A cross-sectional study was conducted among individuals attending STD clinics located in China from June 2018 to August 2020. Univariate and multivariate logistic regression analyses were conducted to explore the association of different risk factors for rectal MG infection., Results: A total of 1,382 patients were included in the final analyses. A total of 30 of 1377 rectal swabs (2.2%) and 77 of 1374 urogenital samples (5.6%) were positive for MG. In Guangxi, 18 of 47 patients (38.3%) infected with urogenital MG and 5 of 19 patients (26.3%) infected with rectal MG received the recommended treatment. Factors found to be significantly associated with rectal MG infection included: male (adjusted odds ratio (AOR) 0.232, [95% CI: 0.072-0.745]) compared to female, homosexual or bisexual (AOR 40.427, [95% CI: 3.880-421.196]) compared to heterosexual, and those infected with urogenital MG (AOR 7.215, [95% CI: 2.898-17.965]) compared to those who did not get infected with urogenital MG., Conclusion: Rectal MG infection should be thought of not only in MSM population but also in STD clinic patients, especially females who have urogenital MG infection. Appropriate strategy for rectal MG screening and treatment needs to be developed for these patients in China., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Han et al.)

Purpose: The study aimed to evaluate meropenem, fosfomycin, berberine hydrochloride, and doxycycline minimum inhibitory concentrations (MICs) of Neisseria gonorrhoeae collected from eight provinces in China in 2018., Methods: The MICs of 540 Neisseria gonorrhoeae isolates (451 isolates selected randomly and 89 isolates selected with preference) were determined to meropenem, fosfomycin, berberine hydrochloride, and doxycycline using the agar dilution method, and the MICs of ceftriaxone and azithromycin were detected for comparison., Results: Among 451 randomly selected isolates, the MIC 90 was 0.06 mg/L for meropenem, 64 mg/L for fosfomycin, 64 mg/L for berberine hydrochloride, and 16 mg/L for doxycycline. All isolates showed the MIC ≤ 0.125 mg/L to meropenem, 13 isolates (2.9%) showed MIC > 64 mg/L to fosfomycin, 8 isolates (1.8%) demonstrated MIC > 64 mg/L to berberine hydrochloride, and 271 isolates (60.1%) demonstrated MIC > 1 mg/L to doxycycline. Comparing all 540 tested isolates, a correlation of r = 0.50 ( P < 0.001) between meropenem and ceftriaxone MIC was observed. In 24 ceftriaxone-decreased susceptibility isolates, all isolates showed an MIC ≤ 0.125 mg/L for meropenem, 1 isolate (4.2%) showed an MIC > 64 mg/L for fosfomycin, 1 isolate (4.2%) showed an MIC > 64 mg/L for berberine hydrochloride, and 13 isolates (54.2%) showed an MIC > 1 mg/L for doxycycline. In 87 azithromycin resistant isolates, all isolates showed an MIC ≤ 0.125 mg/L for meropenem, 2 isolates (2.3%) showed an MIC > 64 mg/L for fosfomycin, 4 isolates (4.6%) showed an MIC > 64 mg/L for berberine hydrochloride, and 64 isolates (73.6%) showed an MIC > 1 mg/L for doxycycline., Conclusion: The in vitro results suggest that meropenem might be a promising treatment option for resistant gonococcal infections, while the effects of fosfomycin and berberine hydrochloride should be further evaluated as potential therapeutic agents. The effectiveness of these drugs in animal experiments and clinical use may need further study., Competing Interests: The authors report no conflicts of interest in this work., (© 2020 Zheng et al.)

Objectives: The development and emergence of antimicrobial resistance in Neisseria gonorrhoeae (NG) have become a major public-health problem worldwide. This study aimed to analyse the antimicrobial susceptibility and molecular characteristics of NG isolates in Shenzhen, China., Methods: A total of 1282 NG isolates were consecutively collected between 2010 and 2017. Patient demographic information was also collected. MICs of ceftriaxone, spectinomycin, ciprofloxacin, azithromycin and penicillin were determined by agar dilution. Isolates were genotyped using N. gonorrhoeae multi-antigen sequence typing (NG-MAST)., Results: Among the isolates, 97.4% were resistant to ciprofloxacin and 68.2% to penicillin. Moreover, 5.0% showed decreased susceptibility to ceftriaxone (CRO D ) and 17.3% were resistant to azithromycin (AZM-R); 1.3% were simultaneously CRO D and AZM-R. All isolates were susceptible to spectinomycin. Increasing ceftriaxone MICs were found from 2010 to 2017. A total of 427 sequence types (STs) and 68 genogroups were identified from 724 isolates. ST5061, ST3741 and ST1766 were observed across the study years. ST14638 (n = 3) was predominant among 32 CRO D isolates. Prevalent STs were ST5061 (n = 6), ST1866 (n = 5) and ST11133 (n = 5) among 96 AZM-R isolates., Conclusions: A high prevalence of isolates resistant to ciprofloxacin and penicillin was found in this study. Azithromycin, one antimicrobial of dual antimicrobial therapy recommended by the WHO, showed a high prevalence of resistance. The other, ceftriaxone, can be used continuously in this region owing to lower resistance levels. However, the emergence of CRO D and decreasing susceptibility to ceftriaxone indicate that continuous antimicrobial resistance surveillance is essential., (Copyright © 2020. Published by Elsevier Ltd.)

Introduction: Antimicrobial resistance (AMR) of Neisseria gonorrhoeae ( N. gonorrhoeae ) becomes a grave public health problem in the world. A strengthened Antimicrobial Resistance Surveillance Program is needed to track the trend of AMR development. However, the lack of a proper antimicrobial susceptibility test (AST) method is a barrier to expand the AMR surveillance in China. Traditional agar dilution (AD) method is laborious and E-test strips have no approval license for clinical use. Herein, a Chinese group modified the microdilution (MD) method for clinical ASTs. The objective of this study is to compare the MD method with the AD method for N. gonorrhoeae AST., Materials and Methods: A total of 166 clinical isolates were tested for antimicrobial susceptibility of ceftriaxone, spectinomycin, azithromycin, ciprofloxacin, tetracycline, and penicillin using MD and AD method simultaneously. Results of MD method were read manually or automatically. Rates of essential agreement (EA), category agreement (CA), minor error, and very major error were compared., Results: The total EAs (compared with results read manually) of penicillin, tetracycline, ciprofloxacin, spectinomycin, ceftriaxone, and azithromycin were 90.4%, 97.0%, 85.5%, 100.0%, 94%, and 72.3%; and CAs were 82.5%, 94.0%, 100%, 100%, 95.2%, and 94%, respectively., Conclusion: We conclude that the MD method might be an alternative for clinical AST of N. gonorrhoeae in China. In particular, MD method has the potency of accurate differentiation of isolates resistant to ceftriaxone or azithromycin, which were empirically recommended for gonococcal treatment, but its quality remained suboptimal, and further improvement is needed for clinical use., Competing Interests: The authors declare no conflicts of interest., (© 2020 Chen et al.)

Aims: We aimed to explore diagnostic efficiencies of long noncoding RNAs (lncRNAs) adjacent to PGC combining with sPGC and anti- Helicobacter pylori IgG in identifying GC (gastric cancer) and precancerous disease. Patients & methods : A total of 265 patients with different gastric diseases were collected. ELISA was to detect sPGC and anti- H. pylori IgG. LncRNAs was determined by qRT-PCR. Results : The area under receiver operating characteristic curve of lncRNAs in discriminating GC+AG (atrophic gastritis) and superficial gastritis (SG) were 79.0, 68.1 and 75.9%. The diagnostic performance of lncRNAs with sPGC had increasing trends in distinguishing GC from non-GC, SG from GC+AG comparing with lncRNAs, with no statistic difference. Diagnosis efficacies of lncRNAs with anti- H. pylori IgG improved dramatically. Conclusions : Serum lncRNAs could distinguish GC, AG and SG. Diagnosis efficiencies of lncRNAs with sPGC and anti- H. pylori -IgG could be improved.

Purpose: Gentamicin is a promising antimicrobial for the treatment of gonorrhea. The study aimed to evaluate gentamicin minimum inhibitory concentrations (MICs) of Neisseria gonorrhoeae isolates in China., Methods: In this study, the agar dilution method was used to determine the MICs of 470 isolates collected in 2016 to four effective antimicrobials (gentamicin, azithromycin, ceftriaxone, and spectinomycin)., Results: Gentamicin MICs ranged from 1 to 8 mg/L. No isolate was resistant to gentamicin. Of seven isolates simultaneously resistant to azithromycin and ceftriaxone, 6 isolates demonstrated MICs of 4 mg/L or less to gentamicin. No cross relationships were found between MICs of gentamicinand susceptibility profiles of azithromycin, ceftriaxone, and spectinomycin., Conclusion: The in vitro results suggest that gentamicin can be a promising treatment option for gonococcal infections in China. Clinical trials to evaluate the therapeutic efficacy of gentamicin are required., Competing Interests: The authors report no conflicts of interest in this work.

Background: Provider adherence to the national treatment guidelines for gonorrhea is critical to assuring effective treatment. It is also an important means of limiting antibiotic overuse, which can lead to development of resistant bacteria. The Chinese treatment guidelines recommend the monotherapy with ceftriaxone or spectinomycin in accordance with the World Health Organization guidelines for treatment of uncomplicated gonorrhea. We evaluated adherence to the guidelines among treatment providers in China., Methods: The study was a nationwide cross-sectional study. In each of the 6 geographic regions in China, at least 1 province was selected. In each selected province, cities with elevated incidence of reported gonorrhea were purposively selected. Using a questionnaire, 2121 physicians recruited from 512 different categories and levels of health sectors from July to September 2017 were investigated., Results: Of the participants, more than 99% diagnosed gonorrhea using one of the laboratory tests including Gram stain, culture, nucleic acid amplification test, or other tests. Culture was the predominant assay of the choice for the diagnosis. Of the 1890 physicians who provided information on prescription behaviors, 62.2% were not adherent to the regimens for treatment of uncomplicated gonorrhea recommended by the National Sexually Transmitted Disease (STD) Treatment Guidelines (National STD Guidelines). Physicians working in the areas located in Northern China (adjusted odds ratio [AOR], 3.06; 95% confidence intervals [CIs], 1.77-5.31), in general hospitals or departments of urology (AOR, 1.54; 95% CIs, 1.08-2.19), diagnosing more cases in the past 6 months (AOR, 1.82; 95% CIs, 1.25-2.67), or unfamiliar with the treatment regimens in the National STD Guidelines (AOR, 3.48; 95% CIs, 2.76-4.37) were significantly more likely to be nonadherent to the National STD Guidelines., Conclusions: It can be concluded from our study that nonadherence to the national guidelines and empirical treatment with high doses of ceftriaxone occurred frequently in China. Further studies on the impacts of the empirical treatment on antimicrobial resistance of gonorrhea are needed.

Background and Aims: The aim of the study was to identify methylated-differentially expressed genes (MDEGs) in gastric cancer and investigate their potential pathways., Methods: Expression profiling (GSE13911 and GSE29272) and methylation profiling (GSE25869 and GSE30601) data were obtained from GEO DataSets. Differentially expressed genes and differentially methylated genes were identified using GEO2R. Gene ontology and pathway enrichment analyses were performed for the MDEGs. Protein-protein interaction (PPI) networks were established by STRING and Cytoscape. Analysis of modules in the PPI networks was performed using MCODE. Further, the hub genes derived from the PPI networks were verified by The Cancer Genome Atlas (TCGA) database and human tissues, with methylation-specific PCR for genes methylation and real-time qPCR for genes expression., Results: A total of 445 genes were identified as hypermethylated, lowly expressed genes (Hyper-LGs), which were enriched in the regulation of system process and channel activity. A total of 129 genes were identified as hypomethylated, highly expressed genes (Hypo-HGs), which were involved in cell adhesion, cell proliferation, and protein binding. Pathway analysis showed that Hyper-LGs were associated with neuroactive ligand-receptor interaction and calcium signaling pathway, while Hypo-HGs were enriched in pathways in cancer. In the PPI networks, after verification by TCGA analysis and human tissue detection, CASR, CXCL12, and SST were identified as significantly different hub genes., Conclusions: MDEG analysis helps to understand the epigenetic regulation mechanisms involved in the development and progression of gastric cancer. The hub genes have predictive and prognostic value as methylation-based biomarkers for the precise diagnosis and treatment of gastric cancer.

The objective of this study was to compare the fee-for-service and set fee for diagnosis-related group systems with regard to quality of medical care and cost to appendectomy patients. We conducted a retrospective study of 208 inpatients (from 20 hospitals) who undergone appendectomy in Changsha, China during 2013. Data were obtained from databases of medical insurance information systems directly connected to the hospital information systems. We collected and compared patient ages, length of study, and total medical costs for impatient appendectomies between patients using fee-for-service and set fee for diagnosisrelated group systems. One hundred thirty-three patients used the fee for service system and 75 used the set fee diagnosis related group system. For those using the diagnosis-related group system, the mean length of hospitalization (6.2 days) and mean number of prescribed antimicrobials (2.4) per patient were significantly lower than those of the patients who used the fee-for-service system (7.3 days and 3.0, respectively; p = 0.018; p < 0.05) and were accompanied by lower medical costs and cost of antimicrobials (RMB 2,518 versus RMB 4,484 and RMB476 versus RMB1,108, respectively; p = 0.000, p = 0.000). There were no significant differences in post-surgical complications between the two systems. The diagnosis-related group system had significantly medical costs for appendectomy compared to the fee-for-service system, without sacrificing quality of medical care.

Single nucleotide polymorphisms (SNPs) in pri- or pre-microRNAs (miRNAs) were found to be associated with gastric cancer risk. The aim of this study was to systematically review with update meta-analysis for the association of miRNA SNPs with gastric cancer risk. We systematically reviewed a total of 31 SNPs in the precursor genes of 29 miRNAs associated with overall cancer risk. Meanwhile, 13 case-control studies with a total of 9044 gastric cancer cases and 11,762 controls were included in a meta-analysis of five highly studied pre-miRNA SNPs (miR-146a rs2910164, miR-196a2 rs11614913, miR-499 rs3746444, miR-149 rs2292832 and miR-27a rs895819). Our results show both the homozygous miR-27a rs895819 and the miR-149 rs2292832 heterozygote genotype were associated with a decreased risk of gastric cancer when compared with wild type. In the stratified analysis, in some subgroup, heterozygous miR-146a rs2910164 was associated with a decreased risk of gastric cancer; and the variant genotype of miR-196a-2 rs11614913 was associated with an increased risk. No association was found between miR-499 rs3746444 and gastric cancer risk. In summary, miR-27a rs895819 and miR-149 rs2292832 are of potential forewarning ability for gastric cancer risk., (Copyright © 2014 Elsevier B.V. All rights reserved.)

In the alternating anaerobic/aerobic SBR reactor,the nitrification and denitrification characteristics of simultaneous nitrogen and phosphorus removal by granular sludge were studied. The results of batch experiments indicated that the maximal nitrification rate, denitrification rate, anoxic phosphorus uptake and denitrification rate were 14.13 mg x (g x h))-1), 34.89 mg x (g x h)/(-1) and 13.11 mg x (g x h)(-1), respectively. In SBR, the maximal nitrification rate and denitrification rate were 4.60 mg x (g x h)(-1) and 1.43 mg x (g x h)(-1), respectively, which were lower than those in the batch test. The amount of nitrogen removal by the simultaneous nitrification and denitrification process was approximately 232.5 mg x d(-1), which was 54.3% of the total nitrogen removal. The removal efficiency of N and P was about 90% and 95%, respectively. The simultaneous nitrogen and phosphorus removal by granular sludge showed high efficiency in nitrogen and phosphorus removal.

Objective: To investigate the survival and prognostic factors in patients undergoing potentially curative resection of stage IIIA-N2 non-small cell lung cancer., Methods: Clinical data of eighty-nine patients, who underwent curative operation from January 2003 to April 2007 in the Peking University First Hospital and were pathologically diagnosed as stage IIIA-N2 NSCLC, were reviewed. The patients were followed up until death or the cut-off date. The overall 3-year and 5-year survival rates were calculated, and Cox proportional hazard model was used to determine the clinical and pathological risk factors and evaluate their influence on the survival., Results: The three-year and five-year survival rates were 51.7% and 31.5%, respectively. The univariate Cox regression analysis revealed five significant factors associated with prognosis: the arm of age < 55, T3 stage, lymphovascular invasion (LVI), multiple positive N2 station and the number of positive N2 nodes > 3 were found to be at increased risk of tumor-related death, and those risk factors were confirmed especially in the age ≥ 55 group. Multivariate Cox regression analysis indicated three independent prognostic factors: T3 stage, LVI and multiple positive N2 station., Conclusions: The results of this preliminary study show that T3 stage, lymphovascular invasion and N2 level (single or multiple station) are associated with the prognosis of stage IIIA-N2 NSCLC patients after potentially curative resection, and the characteristics of age < 55 and the number of positive N2 nodes > 3 may imply worse prognosis.

Objective: To explore the postoperative recurrence patterns in the patients undergoing potentially curative resection of stage IIIA-N2 non-small cell lung cancer (NSCLC)., Methods: A total of 63 patients underwent curative operation from September 2004 to December 2008 at Peking University First Hospital and were pathologically diagnosed as stage IIIA-N2 NSCLC. Their clinical data were retrospectively reviewed. The follow-ups were conducted to detect the recurrent lesions. The recurrence rates at Year 2-3 were calculated by the Kaplan-Meier method while the Cox proportional hazard model was used to assess the risk factors associated with recurrence., Results: The 2 and 3-year recurrence rate was 46.6% and 57.3% respectively. Only one patient experienced local failure. However, the predominant recurrence pattern was distant failure (27/28). As demonstrated by the univariate Cox regression analysis, 4 significant factors associated with recurrence and the arm of lymphatic or vascular invasion (LVI), number of positive N2 station > 1, number of positive node > 3 and involvement of subcarinal lymph nodes were found to increase the risks of failure (P < 0.05)., Conclusion: Distant failure is the predominant pattern of postoperative recurrence in the patients of stage IIIA-N2 NSCLC. In addition to LVI, the level of positive N2 station, the number of positive N2 node and the involvement of subcarinal lymph nodes are associated with the postoperative risk of recurrence.