Norovirus outbreaks in hospitals in China: a systematic review

BACKGROUND

Norovirus outbreaks in hospitals can potentially impair patient care and result in significant financial expenses. There is currently limited information on hospital norovirus outbreaks in the Chinese mainland.

AIM

To systematically review the published literature to describe the characteristics of norovirus outbreaks in Chinese mainland hospitals to facilitate prompt identification and control of outbreaks.

METHODS

A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis standards. Databases including PubMed, Web of Science, and Chinese Journals Online databases (China National Knowledge Infrastructure (CNKI), Chinese Wan Fang digital database (WANFANG) were searched from inception to July 18th, 2022.

FINDINGS

A total of 41 norovirus Chinese hospital outbreaks occurring before July 18th, 2022 were reported in 32 articles. Most reported outbreaks were from Shanghai and Beijing, and occurred in December and January. Cases were mainly adults. The male:female ratio was 1.22:1. The majority of cases in norovirus outbreaks were hospitalized patients (56.82%); medical staff were affected in 15 outbreaks. Norovirus outbreaks occurred in both private and public hospitals, and in secondary and tertiary care centres, and occurred mainly in internal medicine and geriatric departments. Person-to-person transmission was the primary transmission mode and GII was more prevalent.

CONCLUSION

Norovirus outbreaks in hospitals can affect both patients and healthcare workers, sometimes causing serious financial losses. In order to have a more complete understanding of the disease burden caused by norovirus outbreaks, surveillance needs to be established in hospitals.

[C2 pedicle screw insertion assisted by mobilization of the vertebral artery in cases with high-riding vertebral artery]

Objective: To examine the feasibility, safety, and efficacy of mobilization of the vertebral artery for C2 pedicle screws in cases with high-riding vertebral artery (HRVA). Methods: The clinical data of 12 patients with basilar invagination and atlantoaxial dislocation underwent atlantoaxial reduction and fixation in the Department of Neurosurgery, the First Affiliated Hospital of University of Science and Technology of China between January 2020 and November 2021 were retrospectively analyzed. All patients had high-riding vertebral artery on at least one side that prohibited the insertion of C2 pedicle screws. There were 2 males and 10 females aged (48.0±12.8) years (range: 17 to 67 years). After correction of vertical dislocation during the operation, the C2 pedicle screw insertion and occipitocervical fixation and fusion were performed using the vertebral artery mobilization technique. Neurological function was assessed using the Japanese Orthopedic Association (JOA) scale. The preoperative and postoperative JOA score and the main radiological measurements, including the anterior atlantodental interval (ADI), the distance of the odontoid tip above the Chamberlain line, the clivus-canal angle, were collected and compared by paired t-test. Results: Mobilization of the high-riding vertebral artery was successfully completed, and C2 pedicle screws were then fulfilled after the vertebral artery was protected. There was no injury to the vertebral artery during the operation. Meanwhile, no severe surgical complications such as cerebral infarction or aggravated neurological dysfunction occurred during the perioperative period. Satisfactory C2 pedicle screw placement and reduction were achieved in all 12 patients. All patients achieved bone fusion 6 months after surgery. No looseness and shift in internal fixation or reduction loss was observed during the follow-up period. Compared to the preoperative, the postoperative ADI decreased from (6.1±1.9) mm to (2.0±1.2) mm (t=6.73, P<0.01), the distance of the odontoid tip above the Chamberlain line decreased from (10.4±2.5) mm to (5.5±2.3) mm (t=7.12, P<0.01), the clivus-canal angle increased from (123.4±11.1) ° to (134.7±9.6) ° (t=2.50, P=0.032), the JOA score increased from 13.3±2.1 to 15.6±1.2 (t=6.99, P<0.01). Conclusion: The C2 pedicle screw insertion assisted by mobilization of the vertebral artery is safe and considerably effective, providing a choice for internal fixation in cases with high-riding vertebral arteries.

Light-noise suppression method for the single-beam optically-pumped magnetometer arrays

We propose a miniaturized single-beam optically pumped magnetometer (OPM) with a laser power differential structure, along with a dynamically-adjusted detection circuit. This design enables the suppression of optical fluctuation noise and the enhancement of magnetometer sensitivity. For a single-beam OPM, pump light fluctuation noise is a significant contributor to output noise. To address this, we propose an OPM with a laser differential structure that separates the pump light as a part of the reference signal before it enters the cell. The reference current and OPM output current are then subtracted to suppress the noise introduced by pump light fluctuations. To achieve optimal optical noise suppression, we implement balanced homodyne detection (BHD) with real-time current adjustment, which dynamically adjusts the reference ratio between the two currents according to their amplitude. Ultimately, we can reduce the noise introduced by pump light fluctuations by 47% of the original. The OPM with laser power differential achieves a sensitivity of 17.5 fT/Hz^1/2, with the optical fluctuation equivalent noise at 13 fT/Hz^1/2.

Ganoderma lucidum polysaccharides improve lipid metabolism against high-fat diet-induced dyslipidemia

ETHNOPHARMACOLOGICAL RELEVANCE

As a kind of traditional medicinal fungi, Ganoderma lucidum has been employed as folk medicine in China against multiple metabolic diseases on account of its superior bioactivities. Recently, accumulated reports have investigated the protective effects of G. lucidum polysaccharides (GLP) on ameliorating dyslipidemia. However, the specific mechanism by which GLP improves dyslipidemia is not completely clear.

AIMS OF THE STUDY

This study aimed to investigate the protective effects of GLP on high-fatdiet-induced hyperlipidemia and exploring its underlying mechanism.

MATERIALS AND METHODS

The GLP was successfully obtained from G. lucidum mycelium. The mice were conducted with high-fatdiet to establish the hyperlipidemia model. Biochemical determination, histological analysis, immunofluorescence, western blot and real-time qPCR were used to assess the alterations in high-fatdiet-treated mice after the GLP intervention.

RESULTS

It was found that GLP administration significantly decreased body weight gain and the excessive lipid levels, and partly alleviated tissue injury. Oxidative stress and inflammations were efficiently ameliorated after the treatment of GLP by activing Nrf2-Keap1 and inhibiting NF-κB signal pathways. GLP promoted cholesterol reverse transport by LXRα-ABCA1/ABCG1 signaling, increased the expressions of CYP7A1 and CYP27A1 responsible for bile acids production, accompanied by inhibition of intestinal FXR-FGF15 levels. Besides, multiple target proteins involved in lipid metabolism were also significantly modulated under the intervention of GLP.

CONCLUSION

Taken together, our results suggested that GLP showed potential lipid-lowering effects and its possible mechanism was involved in improving oxidative stress and inflammation response, modulating bile acids synthesis and lipid regulatory factors, and promoting reverse cholesterol transport, thereby suggesting that GLP may possibly used as a dietary supplement or medication for the adjuvant therapy for hyperlipidemia.

Structural characterization of Hericium erinaceus polysaccharides and the mechanism of anti-T2DM by modulating the gut microbiota and metabolites

A low molecular weight polysaccharides of HEP-1, with molecular weights of 1.67 × 10⁴ Da and composition of →6)-β-D-Glcp-(1→, →3)-β-D-Glcp-(1→, β-D-Glcp-(1→ and →3,6)-β-D-Glcp-(1→, was isolated and characterized from the fruiting body of Hericium erinaceus. The results indicated that HEP-1 showed potential effects against T2DM-induced imbalance of glucose and lipid metabolism by promoting the serum glucose uptake by hepatic glycogen synthesis via activating the IRS/PI3K/AKT signaling pathway, and inhibiting fatty acid synthesis and reducing hepatic lipid accumulation via activating the AMPK/SREBP-1c signaling pathways. Besides, HEP-1 promoted the production of beneficial bacteria in the gut, and increased the beneficial metabolites in liver through the gut-liver axis, consequently, resisting the occurrence of T2DM.

Polysaccharides from Oudemansiella radicata residues attenuate carbon tetrachloride-induced liver injury

In addition to fruiting bodies and mycelia, the mushroom residues have also been demonstrated to be rich in polysaccharides which have attracted academic attentions owing to their extensive bioactivities. Therefore, the present work aimed to investigate the potential hepatoprotective effects of Oudemansiella radicata residues polysaccharides (RPS). Our results demonstrated that RPS showed significantly protective effects against carbon tetrachloride (CCl₄)-induced liver injury, and the possible mechanisms may be related with the predominant bioactivities of RPS containing anti-oxidation by activating the Nrf2 signal pathways, anti-inflammation by inhibiting NF-κB signal pathways and reducing the release of inflammatory cytokines, anti-apoptosis by regulating Bcl-2/Bax pathway, and anti-fibrosis by inhibiting the expressions of TGF-β1, Hyp and α-SMA, respectively. These findings suggested that RPS, a typical β-type glycosidic pyranose-polysaccharides, could be used as promising diet supplement or medication for the adjunctive treatment of hepatic diseases, and also contributed to promoting the recyclable utilization of mushroom residues.

[Clinicopathological characteristics of gastric SMARCA4-deficient undifferentiated/rhabdoid carcinoma]

Objective: To investigate the clinicopathological features and immunohistochemical phenotypes of gastric SMARCA4-deficient undifferentiated carcinoma, and to discuss the daily diagnostics of this entity and analyze its prognosis. Methods: The cases of gastric SMARCA4-deficient undifferentiated carcinoma diagnosed at the Department of Pathology, Peking University Cancer Hospital, China from January 2010 to August 2022 were collected. The histological sections were reviewed, the immunohistochemical results and clinicopathological features were analyzed, and relevant literature was reviewed. Results: Pure foci of undifferentiated carcinoma were seen in 7 cases, and 1 case was accompanied by a moderately differentiated tubular adenocarcinoma component. Undifferentiated carcinoma foci showed similar sheet-like or solid diffuse growth pattern, medium-sized tumor cells characterized by 1-2 nucleoli, and abundant cytoplasm and rhabdoid appearance. The average patient age was 65±8 years. Six patients were male and 2 were female. Immunohistochemical staining showed that undifferentiated carcinoma of all 8 tumors were negative for SMARCA4 (BRG1). Among 7 patients who underwent SMARCA2 (BRM) and SMARCB1 (INI1) staining, 4 cases showed loss of BRM expression, 2 cases showed weakly positive staining, and 1 case was diffusely positive, but all 7 cases were diffusely strong positive for INI1. The neuroendocrine marker, synaptophysin, was weakly positive in 5 cases, while CgA and CD56 were negative in 8 cases. Ki-67 index was more than 70%. Two cases were mismatch repair deficient and showed the loss of MLH1/PMS2 expression, while 1 case showed only MSH2 loss. PD-L1 staining showed that combined positive score (CPS)≥1 in 4 cases (CPS ranging from 1 to 55) and CPS<1 in the other 3 cases. Four patients had clinical stage Ⅳ disease. Two of them died within 3 months after diagnosis. Conclusions: Gastric SMARCA4-deficient undifferentiated carcinoma/rhabdoid carcinoma is a rare group of highly malignant tumors with a poor prognosis. Loss of the core subunit of SWI/SNF complex may be associated with the development of dedifferentiated histological pattern and aggressive tumor progression, which may be more frequently accompanied with mismatch repair deficiency.

[Preparation and properties of a new artificial bone composite material]

Objective

To study the preparation and properties of the hyaluronic acid (HA)/α-calcium sulfate hemihydrate (α-CSH)/β-tricalcium phosphate (β-TCP) material (hereinafter referred to as composite material).

Methods

Firstly, the α-CSH was prepared from calcium sulfate dihydrate by hydrothermal method, and the β-TCP was prepared by wet reaction of soluble calcium salt and phosphate. Secondly, the α-CSH and β-TCP were mixed in different proportions (10∶0, 9∶1, 8∶2, 7∶3, 5∶5, and 3∶7), and then mixed with HA solutions with concentrations of 0.1%, 0.25%, 0.5%, 1.0%, and 2.0%, respectively, at a liquid-solid ratio of 0.30 and 0.35 respectively to prepare HA/α-CSH/ β-TCP composite material. The α-CSH/β-TCP composite material prepared with α-CSH, β-TCP, and deionized water was used as the control. The composite material was analyzed by scanning electron microscope, X-ray diffraction analysis, initial/final setting time, degradation, compressive strength, dispersion, injectability, and cytotoxicity.

Results

The HA/α-CSH/β-TCP composite material was prepared successfully. The composite material has rough surface, densely packed irregular block particles and strip particles, and microporous structures, with the pore size mainly between 5 and 15 μm. When the content of β-TCP increased, the initial/final setting time of composite material increased, the degradation rate decreased, and the compressive strength showed a trend of first increasing and then weakening; there were significant differences between the composite materials with different α-CSH/β-TCP proportion ( P<0.05). Adding HA improved the injectable property of the composite material, and it showed an increasing trend with the increase of concentration ( P<0.05), but it has no obvious effect on the setting time of composite material ( P>0.05). The cytotoxicity level of HA/α-CSH/β-TCP composite material ranged from 0 to 1, without cytotoxicity.

Conclusion

The HA/α-CSH/β-TCP composite materials have good biocompatibility. Theoretically, it can meet the clinical needs of bone defect repairing, and may be a new artificial bone material with potential clinical application prospect.

[Analysis on infection sources and transmission chains of three outbreaks caused by 2019-nCoV Omicron variant in Beijing, China]

Objective: To investigate the infection sources and the transmission chains of three outbreaks caused by 2019-nCoV Omicron variant possibly spread through cross-border logistics in Beijing. Methods: Epidemiological investigation and big data were used to identify the exposure points of the cases. Close contacts were traced from the exposure points, and the cases' and environmental samples were collected for nucleic acid tests. Positive samples were analyzed by gene sequencing. Results: The Omicron variant causing 3 outbreaks in Beijing from January to April, 2022 belonged to BA.1, BA.1.1 and BA.2. The outbreaks lasted for 8, 12 and 8 days respectively, and 6, 42 and 32 cases infected with 2019-nCoV were reported respectively. International mail might be the infection source for 1 outbreak, and imported clothes might be the infection sources for another 2 outbreaks. The interval between the shipment start time of the imported goods and the infection time of the index case was 3-4 days. The mean incubation period (Q₁, Q₃) was 3 (2,4) days and the mean serial interval (Q₁, Q₃) was 3 (2,4)days. Conclusions: The 3 outbreaks highlighted the risk of infection by Omicron variant from international logistics-related imported goods at normal temperature. Omicron variant has stronger transmissibility, indicating that rapid epidemiological investigation and strict management are needed.

[Investigation for pathological interpretation criteria and its prognostic value for P53 expression in Chinese diffuse large B-cell lymphoma]

Objective: To explore the feasibility of predicting TP53 mutation risk by immunohistochemical staining (IHC) pattern of P53 in Chinese diffuse large B-cell lymphoma (DLBCL) and its correlation with a prognostic difference. Methods: Between January 2021 and December 2021, 51 DLBCL cases at Beijing Boren Hospital were gathered. These cases had both IHC and next-generation sequencing (NGS) results. IHC classified the P53 protein expression pattern into a loss (<1% ) , diffuse (>80% ) , and heterogeneous (1% -80% ) . The sensitivity and specificity of the predicting TP53 mutation by IHC were assessed by comparing the results of the NGS, and the TP53 high mutation risk group included both loss and diffuse expression of P53. From June 2016 to September 2019, Peking University Cancer Hospital collected 131 DLBCL cases with thorough clinicopathological and follow-up data. From their tumor blocks, tissue microarray blocks were made for IHC evaluation of P53 expression pattern, and prognosis effect of P53 studies. Results: Among 51 cases with both IHC and NGS results, 23 cases were classified as TP53 high mutation risk (7 cases loss and 16 cases diffuse) , 22/23 cases were proved with mutated TP53 by NGS. Only 1 of the 28 cases classified as TP53 low mutation risk was proved with mutated TP53 by NGS. IHC had a sensitivity and specificity of 95.7% and 96.4% for predicting TP53 mutation. NGS identified a total of 26 TP53 mutations with a mutation frequency of 61.57% (13.41% -86.25% ) . In the diffuse group, 16 missense mutations and 2 splice mutations were detected; 6 truncating mutations and 1 splice mutation were detected in the loss group; 1 truncating mutation was detected in the heterogeneous group. Multivariate analysis demonstrated that TP53 cases with high mutation risk have impartial adverse significance for the 131 patients included in survival analysis (HR=2.612, 95% CI 1.145-5.956, P=0.022) . Conclusion: IHC of P53 exhibiting loss (<1% ) or diffuse (>80% ) pattern indicated TP53 high mutation risk, IHC can predict TP53 mutation with high specificity and sensitivity. TP53 high mutation risk is an independent predictor for adverse survival.

Correlation analysis between risk factors, BMD and serum osteocalcin, CatheK, PINP, β-crosslaps, TRAP, lipid metabolism and BMI in 128 patients with postmenopausal osteoporotic fractures

OBJECTIVE

Our aim is to investigate the correlation between risk factors of postmenopausal osteoporotic fracture, BMD and Bone turnover markers, lipid metabolism and BMI.

SUBJECTS AND METHODS

The Cox proportional hazard model was used to conduct univariate and multivariate analysis to screen the risk factors related to postmenopausal osteoporotic fractures. Blood samples were collected to detect biochemical markers of bone turnover, blood lipids content, and then measure the BMI of the survey subjects. BMD was measured and its correlation with biochemical markers of bone turnover, lipid metabolism and BMI was analyzed.

RESULTS

Cox univariate analysis indicated that average age, menopause, years since menopause, number of deliveries, and limb spasm are associated covariates of postmenopausal osteoporotic fractures. Where, BMD severity, history of hysterectomy or ovariectomy, and years since menopause are significant covariates for the incidence of postmenopausal osteoporotic fractures. The correlation study with lipid metabolism found that the smaller the BMI value, the greater the BMD loss; the smaller the TG value, the greater the BMD loss, exhibiting a downward trend. No difference was observed between HDL-C and LDL-C content, and the difference was not statistically significant (p>0.05). Femoral neck BMD was negatively correlated with CatheK, serum osteocalcin, PINP, β-crosslaps and TRAP, and lumbar spine BMD was also negatively correlated with CatheK, serum osteocalcin, PINP, β-crosslaps and TRAP.

CONCLUSIONS

Biochemical markers of bone turnover are highly expressed in postmenopausal women and increase with the decrease of bone density, which can be used as markers for disease prediction. Combined with BMI, triglyceride and other related indicators, and closely related factors such as the patient's age, the number of deliveries, it is possible to predict the incidence of PMOP fractures early.

Lentinus edodes Polysaccharides Alleviate Acute Lung Injury by Inhibiting Oxidative Stress and Inflammation

Acute lung injury (ALI) is a kind of lung disease with acute dyspnea, pulmonary inflammation, respiratory distress, and non-cardiogenic pulmonary edema, accompanied by the mid- and end-stage characteristics of COVID-19, clinically. It is imperative to find non-toxic natural substances on preventing ALI and its complications. The animal experiments demonstrated that Lentinus edodes polysaccharides (PLE) had a potential role in alleviating ALI by inhibiting oxidative stress and inflammation, which was manifested by reducing the levels of serum lung injury indicators (C3, hs-CRP, and GGT), reducing the levels of inflammatory factors (TNF-α, IL-1β, and IL-6), and increasing the activities of antioxidant enzymes (SOD and CAT) in the lung. Furthermore, PLE had the typical characteristics of pyran-type linked by β-type glycosidic linkages. The conclusions indicated that PLE could be used as functional foods and natural drugs in preventing ALI.

Stropharia rugoso-annulata acetylated polysaccharides alleviate NAFLD via Nrf2/JNK1/AMPK signaling pathways

The acetylated Stropharia rugoso-annulata polysaccharides (ASRP) was successfully characterized, and the effects and mechanism on alleviating NAFLD were investigated in HFD-induced mice models. The characterization showed that ASRP was successfully acetylated and rich in galactose. The animal studies demonstrated that ASRP at the dose of 400 mg/kg possessed hepatoprotective effects by potential antioxidation, anti-inflammation and improving hepatocellular histopathology, with the possible mechanisms on regulating the JNK1/AP-1 and activating the Nrf2 signaling pathways. Besides, ASRP could improve the fat metabolism by activating the AMPK/SREBP-1c signaling pathways. The results provided basal theories for the development of ASRP on treating the NAFLD and its complications.

[Survey on infection source of a cold-chain product associated COVID-19 epidemic caused by 2019-nCoV Delta variant in Beijing]

Objective: To investigate the source and the transmission chain of a cold-chain product associated COVID-19 epidemic caused by 2019-nCoV Delta variant in Beijing. Methods: Epidemiological investigation were used to verify the exposure points of the cases. Close contacts were traced from the exposure points, and human and environmental samples were collected for nucleic acid tests. Positive samples were analyzed by gene sequencing. Results: A total of 112 cases of COVID-19 were reported in the epidemic from January 18 to February 6, 2022 in Beijing. Except for 1 case was uncertain, there were epidemiological links among 111 cases. The source of infection was the packages of imported cold-chain products from Southeast Asia, which were harvested and stored in a local cold-storage in January 2021, and packaged and sent to the cold-storage A in A district in June 2021, and then sold in batches in cold-storage B in B district from January 2022. The first case was infected in the handling of positive frozen products, and then 77 cases occurred due to working, eating and living together with the index case in the cold-storage B, cold-storage C and restaurant D. Besides the cold-storage B, C and the restaurant D, there were 16 sub-transmission chains, resulting in additional 35 cases. Conclusion: The epidemic indicated that the risk of 2019-nCoV infection from imported cold-chain products contaminated by package and highlighted the importance to strengthen the management of cold-chain industry in future.

[Progress in epidemiological research of norovirus infection]

With characteristics of high infectivity, diverse transmission routes and high variation, norovirus is the main pathogen of sporadic cases and outbreaks of acute gastroenteritis, resulting in a serious disease burden. This paper summarizes the latest progress in epidemiological research of norovirus infection from aspects of disease burden caused by acute gastroenteritis, virus variation and predominant strains, prevention and control measures, and immunization and vaccine development.

[Benefits and risks of prolonged dual antiplatelet therapy after percutaneous coronary intervention with drug-eluting stent in patients with stable coronary artery disease and diabetes]

Objective: To compare the efficacy and safety of prolonged dual antiplatelet therapy (DAPT>1 year) in patients with stable coronary artery disease (CAD) and diabetes who were event-free at 1 year after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) in a large and contemporary PCI registry. Methods: A total of 1 661 eligible patients were selected from the Fuwai PCI Registry, of which 1 193 received DAPT>1 year and 468 received DAPT ≤1 year. The primary endpoint was major adverse cardiac and cerebrovascular event (MACCE) and Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding, MACCE was defined as a composite of all-cause death, myocardial infarction or stroke. Multivariate Cox regression analysis and inverse probability of treatment weighting (IPTW) Cox regression analysis were performed. Results: After a median follow-up of 2.5 years, patients who received DAPT>1 year were associated with lower risks of MACCE (1.4% vs. 3.2%; hazard ratio (HR) 0.412, 95% confidence interval (CI) 0.205-0.827) compared with DAPT ≤1 year, which was primarily caused by the lower all-cause mortality (0.1% vs. 2.6%; HR 0.031, 95%CI 0.004-0.236). Risks of cardiac death (0.1% vs. 1.5%; HR 0.051, 95%CI 0.006-0.416) and definite/probable ST (0.3% vs. 1.1%; HR 0.218, 95%CI 0.052-0.917) were also lower in patients received DAPT>1 year than those received DAPT ≤ 1 year. No difference was found between the two groups in terms of BARC type 2, 3, or 5 bleeding (5.3% vs. 4.1%; HR 1.088, 95%CI 0.650-1.821). Conclusions: In patients with stable CAD and diabetes who were event-free at 1 year after PCI with DES, prolonged DAPT (>1 year) provides a substantial reduction in ischemic cardiovascular events, including MACCE, all-cause mortality, cardiac mortality, and definite/probable ST, without increasing the clinically relevant bleeding risk compared with ≤ 1-year DAPT. Further well-designed, large-scale randomized trials are needed to verify the beneficial effect of prolonged DAPT in this population.

Mycelium polysaccharides of Macrolepiota procera alleviate reproductive impairments induced by nonylphenol

Nonylphenol (NP) exposure has become a crucial inducement of male reproductive disorders in the world. Therefore, it is urgent to seek solutions to alleviate the toxicity of NP. This study was oriented toward studying the protective effects of Macrolepiota procera mycelium polysaccharides (MMP) on NP-induced reproductive impairments. After NP administration, declined sperm amounts and testis index, increased the deformity rate of sperms, aberrant hormone secretion and testicular pathological injury were observed, corporately leading to reproductive capacity attenuation. Importantly, MMP significantly reversed the foregoing changes in NP-treated mice. Notably, it has been observed that the MMP therapy remarkably improved oxidative stress, apoptosis, autophagy and inflammatory responses, and suppressed the Akt/mTOR signaling pathway in testicular tissues. These results manifested that MMP might be a promising treatment strategy for ameliorating the biotoxicity of NP.

[Etiological and epidemiological characteristics of Vibrio cholerae in Beijing, 2015-2021]

Objective: To analyze the etiological and epidemiological characteristics of Vibrio cholerae in Beijing during 2015-2021 and provide evidence for the prevention and control of cholera. Methods: The V. cholerae strains isolated in Beijing during 2015-2021 were analyzed by serotyping and virulence genes detection. Pulsed field gel electrophoresis (PFGE) was performed for the molecular typing of the strains. Based on the collected epidemiological and clinical data of cholera cases,the epidemiological characteristics of cholera were analyzed by descriptive epidemiology method. Results: A total of 76 Vibrio cholerae O1 strains were isolated in Beijing during 2015-2021, including 61 strains from human, 10 strains from environment and 5 strains from seafood. The 76 strains consisted of 68 Ogawa strains and 8 Inaba strains. Six Ogawa strains isolated from sporadic cases carried ctxAB. After NotⅠ digestion, 76 strains were divided into 33 PFGE patterns. From 2015 to 2021, a total of 38 cholera epidemics were reported in Beijing, most of them were sporadic ones, accounting for 92.11% (35/38). A total of 45 cases were reported, and the cases occurred during June-September accounted for 97.78% (44/45). Cholera cases occurred in 9 districts of Beijing, and the cases reported in Chaoyang district accounted for 42.22% (19/45) and in Changping district accounted for 31.11% (14/45). The age of the cholera cases ranged from 19 to 63 years. Except for one case with unknown clinical symptoms, 44 cases had diarrhea symptoms with 84.09% (37/44) of the cases reporting diarrhea (3-9 times/day), followed by yellow watery stool (95.45%, 42/44), abdominal pain (68.18%, 30/44), nausea and vomiting (40.91%, 18/44) and fever (36.36%, 16/44). Conclusion: Vibrio cholerae strains isolated in Beijing during 2015-2021 were mainly O1 serotype Ogawa,most of which were non-toxigenic. The PFGE of the strains varied. Cholera epidemics occurred in 9 districts of Beijing, but most were sporadic ones with incidence peak during June-September.

Medication Non-adherence and Condomless Anal Intercourse Increased Substantially During the COVID-19 Pandemic Among MSM PrEP Users: A Retrospective Cohort Study in Four Chinese Metropolises

Background

The coronavirus disease (COVID-19) pandemic has impacted HIV prevention strategies globally. However, changes in pre-exposure prophylaxis (PrEP) adherence and HIV-related behaviors, and their associations with medication adherence among men who have sex with men (MSM) PrEP users remain unclear since the onset of the COVID-19 pandemic.

Methods

A Retrospective Cohort Study of HIV-negative MSM PrEP users was conducted in four Chinese metropolises from December 2018 to March 2020, assessing the changes in PrEP adherence and HIV-related behaviors before and during the COVID-19. The primary outcome was poor PrEP adherence determined from self-reported missing at least one PrEP dose in the previous month. We used multivariable logistic regression to determine factors correlated with poor adherence during COVID-19.

Results

We enrolled 791 eligible participants (418 [52.8%] in daily PrEP and 373 [47.2%] in event-driven PrEP). Compared with the data conducted before the COVID-19, the proportion of PrEP users decreased from 97.9 to 64.3%, and the proportion of poor PrEP adherence increased from 23.6 to 50.1% during the COVID-19 [odds ratio (OR) 3.24, 95% confidence interval (CI) 2.62-4.02]. While the percentage of condomless anal intercourse (CAI) with regular partners (11.8 vs. 25.7%) and with casual partners (4.4 vs. 9.0%) both significantly increased. The proportion of those who were tested for HIV decreased from 50.1 to 25.9%. Factors correlated with poor PrEP adherence during the COVID-19 included not being tested for HIV (adjusted odds ratio [aOR] = 1.38 [95% CI: 1.00, 1.91]), using condoms consistently with regular partners (vs. never, aOR = 2.19 [95% CI: 1.16, 4.13]), and being married or cohabitating with a woman (vs. not married, aOR = 3.08 [95% CI: 1.60, 5.95]).

Conclusions

Increased poor PrEP adherence and CAI along with the decrease in HIV testing can lead to an increase in HIV acquisition and drug resistance to PrEP. Targeted interventions are needed to improve PrEP adherence and HIV prevention strategies.

[Epidemiological characteristics of imported COVID-19 cases in Beijing]

Objective: To analyze the epidemiological characteristics of imported COVID-19 cases and the effect of vaccination on virus load and disease severity of the cases in Beijing. Methods: The data of the imported COVID-19 cases in Beijing were collected from the National Notifiable Infectious Disease Reporting System of China Information for Disease Control and Prevention and Epidemiology investigation. The data were processed and analyzed by Excel 2010 and SPSS 22.0. Results: From June 1 to September 30, 2021, a total of 171 imported COVID-19 cases were reported in Beijing, of which 66.67% (114/171) were asymptomatic. The cases were mainly from the Philippines, the United Arab Emirates, the United Kingdom and the Russian Federation, accounting for 67.84% (116/171). The male to female ratio of the cases was 2∶1 (114∶57). The median age M (Q₁, Q₃) of the cases was 28 (23, 36) years. The cases of Chinese accounted for 80.12% (137/171). The sequencing of the whole genome of the virus in 47 imported COVID-19 cases showed that the proportion of Delta variant was 76.60% (36/47). The COVID-19 vaccination coverage rate in the cases was 60.82% (104/171), but the full vaccination coverage rate was 53.80% (92/171). In the imported COVID-19 cases, 13.53% (23/170) were screened to be SARS-CoV-2 nucleic acid positive on the day when they arrived in Beijing, and all the cases were positive for 2019-nCoV nucleic acid within 28 days. The severity of the disease was higher in the unvaccinated group than in the partially vaccinated group and fully vaccinated group (P<0.001). In the unvaccinated group, there were 1 severe case and 1 critical case. The median Ct values M (Q₁, Q₃) of N gene and ORFlab gene in unvaccinated group were 32.51 (23.23, 36.06) and 32.78 (24.00, 36.38), respectively. There was no significant difference in the median of double-gene Ct value between the partially vaccinated group and the fully vaccinated group. Conclusions: During the study period, most of the imported COVID-19 cases in Beijing were asymptomatic. No matter vaccinated or not, the viral loads in the COVID-19 cases were similar, but the vaccination could reduce the severity of the disease.

Glucopyranose from Pleurotus geesteranus prevent alcoholic liver diseases by regulating Nrf2/HO-1-TLR4/NF-κB signalling pathways and gut microbiota

This study investigated the effects of PGPs (Pleurotus geesteranus polysaccharides), a glucopyranose isolated from the mycelium of Pleurotus geesteranus and characterized with the main chain of →4)-α-D-Glcp-(1→, on the prevention against alcohol liver diseases (ALD), with the aim of providing a theoretical basis for the application of P. geesteranus as prebiotic agents in preventing and treating gut dysbiosis and alcohol-related metabolic disorders in individuals with ALD. The results showed that PGP treatment reduced oxidative stress by up-regulating the Nrf2/HO-1 signalling pathways, and decreased the pro-inflammatory factors by down-regulating TLR4/NF-κB signalling pathways. Furthermore, we validated effects of PGPs on balancing the gut-liver axis by maintaining the integrity of the intestinal epithelial barrier of decreasing intestinal permeability, increasing intestinal tight-junction protein and mucin expression and elevating the abundance of short-chain fatty acids (SCFAs) producers in the intestine by regulating the microbiota composition.

[Epidemiological characteristics of hand, foot and mouth disease among people aged 6 and over in Beijing, 2011-2020]

Objective: To analyze the epidemiological characteristics of hand, foot and mouth disease (HFMD) among people ≥6 years old in Beijing from 2011 to 2020. Methods: The incidence data of HFMD cases from 2011 to 2020 were collected from the National Notifiable Infectious Disease Reporting System of China Information for Disease Control and Prevention and the etiological surveillance of HFMD in 29 sentinel hospitals from 16 districts of Beijing. Descriptive epidemiological methods were used to analyze the distributions, pathogen constituents, and changes of HFMD cases in Beijing people ≥6 years old. Results: From 2011 to 2020, a total of 38 183 cases of HFMD were reported among people ≥6 years old in Beijing, of which 46 (0.12%) cases were severe. The average annual reported incidence was 19.04/100 000. The ratio of males to females were 1.37∶1(22 064∶16 119). The proportion of HFMD in people ≥6 years old increased from 7.56%(2 606/34 488) in 2011 to 24.54% (546/2 225) in 2020. The average incidence of HFMD was higher in Shunyi district, Yanqing district, and Tongzhou district than in other districts in Beijing. The positive rate of enterovirus in sentinel surveillance was 66.78% (1 976/2 959), the proportion of enterovirus group A 71 (EV-A71) was 45.29% (101/223) in 2014, no EV-A71 positive was detected in 2020, and the proportion of Coxsackievirus A 6 (CV-A6) increased from 15.11% (34/225) in 2016 to 81.08% (60/74) in 2020. Conclusions: From 2011 to 2020, the proportion of cases with HFMD in people ≥6 years old in Beijing increased yearly, and the proportion of EV-A71 positive patients decreased basically. Since 2016, CV-A6 has gradually become the dominant pathogen. More attention should be paid to the epidemic situation and dynamic pathogen changes of hand foot mouth disease in people ≥6 years old.

Leptin Aggravates Periodontitis by Promoting M1 Polarization via NLRP3

Periodontitis is characterized by periodontal pocket formation, loss of attachment, and alveolar bone resorption. Both innate and adaptive immunity are involved in the pathogenesis of this oral chronic inflammatory disease. Accumulating evidence indicates a critical role of leptin in periodontal diseases. However, the mechanism by which leptin promotes periodontitis pathogenesis remains unclear. In the present study, we observed an elevated expression of leptin in the serum of periodontitis mice compared to that in healthy controls. There was a higher extent of M1 phenotype macrophage infiltration in mice periodontitis samples than in healthy controls. A positive correlation was observed between the serum leptin levels and M1 macrophages. Treatment with leptin increased M1 macrophage polarization and decreased M2 macrophage polarization in RAW 264.7 cells. Moreover, leptin facilitated lipopolysaccharide (LPS)-induced M1 phenotype macrophage polarization in RAW 264.7 cells. In bone marrow-derived macrophages (BMDMs) generated from leptin-deficient obese (ob/ob) mice, M1 macrophage polarization was significantly attenuated after LPS stimulation compared to the healthy controls. With regards to the molecular mechanism, we found that leptin activated the NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome and promoted M1 polarization via the NLRP3 inflammasome in vitro. In BMDMs generated from Nlrp3^-/- mice, M1 macrophage polarization was significantly attenuated after synchronous stimulation with leptin and LPS compared with BMDMs produced by healthy controls. The NLRP3 inhibitor MCC950 also prevented leptin-mediated M1 macrophage polarization in RAW 264.7 cells. Nlrp3^-/- periodontitis models indicated that leptin aggravates the periodontal response to the ligature by promoting M1 macrophage polarization via the NLRP3 inflammasome. Taken together, we show that leptin promotes the progression of periodontitis via proinflammatory M1 macrophage skewing, and targeting leptin/NLRP3 signaling may be a feasible approach for treating periodontitis.

Three-dimensional Quantification of Enamel Preservation in Tooth Preparation for Porcelain Laminate Veneers: A Fully Digital Workflow In Vitro Study

OBJECTIVE

This in vitro study aimed to evaluate the preservation of enamel after tooth preparation for porcelain laminate veneers (PLVs) at different preparation depths based on a fully digital workflow.

METHODS AND MATERIALS

Sixty extracted human maxillary anterior teeth, including 20 maxillary central incisors (MCIs), 20 maxillary lateral incisors (MLIs), and 20 maxillary canines (MCs) underwent microcomputed tomography (CT) scanning, and were reconstructed as three-dimensional (3D) enamel and dentin models. Subsequently, the three-dimensional (3D) enamel models were imported into Materialise, where each enamel model underwent seven types of virtual preparation for PLVs at preparation depths at 0.1-mm increments from 0.1-0.3-0.5 mm (D1) to 0.7-0.9-1.1 mm (D7). The enamel surface was depicted by merging the virtual preparation and, respective, dentin models. The enamel area and prepared surface were measured to calculate the percentage of enamel (R%). The data were statistically analyzed using one-way analysis of variance (ANOVA) (α=0.05).

RESULTS

The group-wise mean (standard deviation) R values for the MCIs were as follows: D1-D3: 100.00 (0) each, and D4-D7: 74.70 (2.45), 51.40 (5.12), 24.40 (3.06), and 0.00 (0), respectively. The group-wise mean R values for the MLIs were 100.00 (0), 73.70 (3.40), 53.50 (3.44), 25.20 (3.79), and 0.90 (0.99) for the D1-D5 groups, respectively; and 0.00 (0) each for the D6-D7 groups. The group-wise mean (standard deviations) R values for the MCs were as follows: D1-D3: 100.00 (0) each, and D4-D7: 99.00 (1.34), 77.10 (3.28), 74.20 (3.61), and 52.20 (4.09), respectively. The one-way ANOVA revealed significant differences between the seven groups in the MCIs, MLIs, and MCs (p<0.05).

CONCLUSIONS

Our results recommended preparation depths of up to 0.3-0.5-0.7 mm (MCIs), 0.1-0.3-0.5 mm (MLIs), and 0.4-0.6-0.8 mm (MCs) to facilitate complete intraenamel preparation. Moreover, 50% enamel was preserved at preparation depths of 0.5-0.7-0.9 mm (MCIs), 0.3-0.5-0.7 mm (MLIs), and 0.7-0.9-1.1 mm (MCs).

Coprinus comatus polysaccharides ameliorated carbon tetrachloride-induced liver fibrosis through modulating inflammatory and apoptosis

Liver fibrosis is a serious global public health problem, due to lack of effective treatment. Coprinus comatus polysaccharides (CP), isolated from C. comatus, possess multiple biological activities. In our work,...

[Effect of half-dose fluorescein sodium contrast agent on liver and kidney functions in patients with mild to moderate chronic kidney disease: a retrospective cohort study]

OBJECTIVE

To observe the effect of half-dose fluorescein sodium (FINa) contrast agent on liver and kidney functions in patients with mild to moderate (stage 1 to 3) chronic kidney disease (CKD) and the incidence of contrast-induced nephropathy (CIN).

METHODS

Seventy-seven patients (including 50 male and 27 female patients with an mean age of 53.5±9.6 years) with CKD with normal renal function or mild to moderate abnormalities underwent fundus fluorescein angiography (FFG) examination with half-dose FINa. Liver function, blood creatinine (Scr), blood urea nitrogen (BUN), urine β2 microglobulin (β2-MG), and glomerular filtration rate (eGFR) of the patients were measured within 3 days before intravenous injection of the contrast agent and at 1, 3, 7, and 30±1 days after the operation to analyze the effect of the contrast agent on renal function.

RESULTS

Among the 77 patients, CIN occurred only in one case with an incidence rate of 1.30%. BUN, urine β2- MG, or rapid microalbumin/creatinine did not vary significantly after FFA in these patients. Scr levels showed no significant increments at 1 day and 7 days after FFA, but increased significantly at 3 days (24.6±2.3; P < 0.01) and 30 days (16.0±21.7; P < 0.05). Urine NAG enzymes and urinary osmolality were significantly reduced at 1, 3, 7, and 30 days after FFA (P < 0.01). The eGFR decreased significantly to 10.23±0.62 at 3 days after FAG and became normal at 7 days. Urine albumin level decreased significantly at 1, 3, 7, and 30 days after FFA (P < 0.01). Blood β2-MGFAG level increased significantly at 3 days after FFA (0.314± 0.121; P < 0.01), but decreased to 0.134±0.143 at 7 days (P < 0.05). The level transaminase decreased significantly at 3 and 7 days after FFA (P < 0.01).

CONCLUSION

Half-dose of FINa has no significant effect on liver function and has only minimal effect on kidney function in patients with mild to moderate CKD, and FFA with half-dose FINa can therefore be safely performed in these patients.

Protective effects of sulfated polysaccharides from Lentinula edodes on the lung and liver of MODS mice

In this work, the effects of sulfated polysaccharides from Lentinula edodes (SPLE) on zymosan (ZYM)-induced multiple organ dysfunction syndrome (MODS) mice were investigated. Using the MODS mice model, biochemical works have already shown that in mice treated with SPLE, the lung parameters of GGT, C3 and hs-CRP were down-regulated and the hepatic parameters of TC, TG, ALT and AST, HDLC, LDL-C and VLDL-C were improved, the serum levels of CK, Cr and Amy were decreased, and the levels of inflammatory factors such as TNF-α, IL-1β, IL-6 and IL-10 were also reduced, the activity of antioxidant enzymes SOD and CAT enhanced, and the content of MDA was reduced. In addition, histopathology of the lung and liver confirmed the beneficial effects of SPLE on MODS mice, indicating that SPLE played a role in protecting the organ function of MODS mice. In addition, SPLE was characterized as a sulfated β-glucan linked by β-type glycosidic bonds. These conclusions indicated that SPLE had effective antioxidant and anti-inflammatory activities, and could be used as a functional food and medicine to prevent MODS.

[Analysis on epidemiological characteristics of multidrug-resistant Salmonella Kentucky in Beijing, 2010-2020]

Objective: To investigate the epidemiological, drug resistance and molecular characteristics of Salmonella (S.) Kentucky strains isolated from diarrheal patients in Beijing. Methods: The drug susceptibility of 22 S. Kentucky strains isolated in Beijing during 2010-2020 was tested by using the micro broth dilution method. The multilocus sequence typing (MLST), drug resistance genes and Salmonella genomic island (SGI) identifications of the strains were performed by whole-genome sequencing (WGS).The pulsed field gel electrophoresis (PFGE) was performed to analyze the molecular epidemiological characteristics of the isolates. Results: The 22 strains were highly resistant to 8-22 kinds of antibiotics, especially to ciprofloxacin, cephalosporins and azithromycin, etc., showing a super high level of multidrug resistance and 21 strains were positive for extended-spetrum beta-lactamase (ESBL). The WGS analysis revealed that all the isolates belonged to ST198, carrying SGI1-K. The drug resistance genes tetA, sul1 and qacE were identified in all strains and Quinolone resistance-determining regions (QRDRs) showed 2 mutations in gyrA (S83F, D87 N) and 3 mutations in the parC gene (T57S, S80I, T255S). The resistance genes associated with β-lactam antibiotics (blaCTX-M-55, blaCTX-M-14b, blaTEM-141, blaTEM-206, blaTEM-209, blaTEM-214, blaTEM-1B), resistance genes associated with aminoglycosides [aac(3)-Id, aac(3)-IId, aac(6')-Iaa, aadA7, aadA17, aph(3')-Ia, aph(3'')-Ib, aph(6)-Id,rmtB] as well as floR, dfrA14, mphA and qnrS1 had significant differences in the strains of different years, which were highly consistent with the drug-resistant phenotype. Furthermore, phylogenetic analysis showed that the similarity of the 22 strains was more than 85%, and the strains were highly homologous to CIP-resistant ST198-X1 circulating in the world. In the process of spread, the drug resistance and PFGE spectrums had changed, two clusters had formed. Conclusions: The S. Kentucky strains isolated in Beijing shared high homology with the multidrug-resistant strain ST198-X1-SGI-1K isolated in the world, which has maintained a low level of spread since 2016, causing sporadic infections and clusters of diarrhea, and has serious resistances to fluoroquinolones, ESBLs and azithromycin. The surveillance for multidrug-resistant S. Kentucky should be strengthened.

Expression of miR-182 in patients with fracture of tibial plateau and its regulative effects on the fracture healing

OBJECTIVE

To investigate the expression of miR-182 in patients with fracture of tibial plateau (FTP) and its effects on osteoblasts and fracture healing.

PATIENTS AND METHODS

The patients with fracture of tibial plateau treated in our hospital and healthy subjects who received physical examination from January 2017 to January 2018 were collected. The expression of miR-182 in the serum was detected. The osteoblasts from SD rats were cultured and transfected with miR-182, anti-miR-182, miR-NC or anti-miR-NC using transfection reagent LipofectamineTM 2000. The proliferation, alkaline phosphatase (ALP) activity, calcification and osteogenic gene expression of osteoblasts were detected. The rat models with fracture of tibial plateau were divided into control group, fracture group, fracture+miR-182 group, and fracture+anti-miR-182 group. The levels of vascular endothelial growth factor (VEGF), epidermal growth factor (EGF) and transforming growth factor β (TGFβ) in serum were detected by enzyme-linked immunosorbent assay (ELISA).

RESULTS

Compared with the controls, the expression of miR-182 in serum was significantly elevated in patients with fracture of tibial plateau. Overexpression of miR-182 inhibited the proliferation of osteoblasts, while the knockdown of miR-182 increased the proliferation. MiR-182 could decrease the ALP activity of osteoblasts, while anti-miR-182 increased the ALP activity. Osteoblast calcification ability was significantly decreased by overexpression of miR-182. Knockdown of miR-182 increased the calcification ability of osteoblasts and the expression of osteogenic genes. MiR-182 could inhibit the expression of osteogenic genes. The levels of VEGF, EGF and TGFβ in the fracture group were higher than those in the control group, while the levels in the fracture+miR-182 group were higher than those in the fracture group. The levels of VEGF, EGF and TGFβ in the anti-miR-182 group were lower than those in the fracture group.

CONCLUSIONS

MiR-182 is elevated in patients with fracture of tibial plateau, which can inhibit the proliferation and differentiation of osteoblasts and affect the fracture healing. The knockdown of miR-182 might be a new method for treating fracture healing.

A polysaccharide of PFP-1 from Pleurotus geesteranus attenuates alcoholic liver diseases via Nrf2 and NF-κB signaling pathways

A polysaccharide named PFP-1 was isolated from the Pleurotus geesteranus fruiting body, and potential investigations on ameliorating oxidative stress and liver injury against alcoholic liver disease (ALD) were performed in mice. The animal studies demonstrated that PFP-1 had hepatoprotective effects by improving hepatocellular histopathology, modulating alcohol metabolisms and restoring the serum lipid levels. Besides, PFP-1 could attenuate oxidative stress and inflammatory responses by activating the Nrf2-mediated signal pathways and regulating the TLR4-mediated NF-κB signal pathways. The characterization indicated that PFP-1 was a typical pyranose-polysaccharide in a triple-helical conformation, which was linked by t-β-Glcp, 1,6-α-Glcp and 1,2,6-α-Galp. And the characteristic properties of higher water solubility and appropriate molecular weights contributed to the superior bioactivities. The results demonstrated that PFP-1 could be used as a supplement for alleviating alcohol-induced liver damage.

Transformable Nanosensitizer with Tumor Microenvironment-Activated Sonodynamic Process and Calcium Release for Enhanced Cancer Immunotherapy

Despite the promise of sonodynamic processes in cancer therapy, existing sonosensitizers often fail to regulate the generation of reactive oxygen species (ROS) against tumors, potentially leading to off-target toxicity to normal tissues. We report a transformable core-shell nanosonosensitizer (TiO₂ @CaP) that reinvigorates ROS generation and dissolves its CaP shell to release Ca²⁺ in an acidic tumor microenvironment (TME) under ultrasound activation. Thus, TiO₂ @CaP acts as a smart nanosonosensitizer that specifically induces mitochondrial dysfunction via overloading intracellular Ca²⁺ ions to synergize with the sonodynamic process in the TME. TiO₂ @CaP substantially enhances immunogenic cell death, resulting in enhanced T-cell recruitment and infiltration into the immunogenic cold tumor (4T1). In conjunction with checkpoint blockade therapy (anti-PD 1), TiO₂ @CaP-mediated sonodynamic therapy elicits systemic antitumor immunity, leading to regression of non-treated distant tumors and inhibition of lung metastasis. This work paves the way to development of "smart" TME-activatable sonosensitizers with temporospatial control over antitumor responses.

Tumor Microenvironment-"AND" Near-Infrared Light-Activated Coordination Polymer Nanoprodrug for On-Demand CO-Sensitized Synergistic Cancer Therapy

Carbon monoxide (CO) as an emerging treatment holds great promise for inducing the apoptosis of cancer cells. Here coordination assembled strategy is first reported for synthesis of Cu(II)-flavone coordination polymer (NCu-FleCP) CO nanoprodrug that is stable in normal physiological conditions, and yet readily reduces to small size prodrug complex and releases CO on demand under glutathione (GSH) and near infrared (NIR) light. Specifically, after uptaking by cancer cells, local GSH attacked coordination bond within NCu-FleCP, resulting in the release of Cu(I) and free Fle. The CC bond of Fle is cleavage under NIR light to release CO for gas therapy, and Cu(I) reacts with local H₂ O₂ through Fenton like reaction to generate hydroxyl radicals (^• OH) for chemodynamic therapy. Detailed in vitro and in vivo experiments demonstrate that the CO prodrug system in generating a sufficient quantity of CO and ^• OH offers remarkable destructive effects against cancer cells without causing toxicity to surrounding normal tissues. The study provides a solid foundation to develop smart coordination polymer CO prodrugs with on-demand CO release, enhanced permeability and retention effect, and biodegradability for multimodal synergistic therapy.

Structural characterization and amelioration of sulfated polysaccharides from Ganoderma applanatum residue against CCl4-induced hepatotoxicity

Natural polysaccharides and their derivatives have attracted academic attention due to their extensive physiological activities. However, the hepatoprotective effects against carbon tetrachloride (CCl₄) toxicity have not been well elucidated. The objectives of this study were to characterize the structural properties of sulfated Ganoderma applanatum residue polysaccharides (SGRP) and to evaluate their inhibitory effects on liver fibrosis caused by oxidative stress and inflammation. Our in vivo study showed that SGRP was hepatoprotective in CCl₄-induced chronic liver injury mice. It reduced the histopathological damages, down-regulated CYP2E1 (cytochrome P450 2E1) expression, reduced serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, improved the anti-oxidative and anti-inflammatory properties, inhibited TLR4/NF-κB signaling pathway, and reduced the release of inflammatory cytokines. The structural studies indicated that SGRP is a heteropolysaccharide with 7.8% sulfur content and α-linked residue. Our study projects SGRP as a potential candidate in anti-fibrosis treatment by using it as a food supplement or in medicines produced by pharmaceutical industries.

[Epidemiological characteristics of COVID-19 cases in outbreak in Xinfadi market in Beijing]

Objective: To understand the epidemiological characteristics of COVID-19 cases, including asymptomatic cases and symptomatic cases, in the outbreak in Xinfadi market in Beijing. Methods: Data and epidemiological survey reports of COVID-19 cases in Xinfadi market in Beijing were extracted from China's Infectious Disease Information System. Epidemiological characteristics of symptomatic cases and asymptomatic cases were analyzed and compared by using software SPSS 19.0. Results: From June 11 to July 10, 2020, a total of 368 laboratory-confirmed COVID-19 cases reported in the outbreak in Xinfadi market, in which, 335 (91.03%) were symptomatic and 33 (8.97%) were asymptomatic. The cases were distributed in 11 districts, and most cases (252/368, 68.48%) were reported in Fengtai district. The incidence curve of the cases showed a typical outbreak pattern, the case number peaked on 13 June. The median age of the cases were 43 years (Q_R: 31-51). The asymptomatic cases (M=32, Q_R: 29-46) were younger than the symptomatic cases (M=43, Q_R: 31-52), the difference was significant (Z=2.416, P=0.016). The ratio of male to female was 1.26∶1. Most cases (236/368, 64.13%) were engaged in catering service and public place service. About 73.91% of the cases (272/368) had direct exposures in Xinfadi market. About 54.08%(199/368) of cases were detected through nucleic acid testing and screening. Mild and moderate cases accounted for 99.10% (332/335) of the total cases, and no death occurred. Conclusion: The COVID-19 cases in the outbreak in Xinfadi market were mainly engaged in catering service and public place service. The asymptomatic cases were younger than the symptomatic cases.

Renoprotective effects of enzyme-hydrolyzed polysaccharides from Auricularia polytricha on adenine-induced chronic kidney diseases in mice

The present work was aimed to investigate the protective effects of enzymatic-hydrolyzed Auricularia polytricha polysaccharides (EnAPS) on renal functions. The characterizations were analyzed by physicochemical methods, and the renoprotections were processed in adenine-induced chronic kidney diseases (CKD) models of mice. Animal experiments exhibited that EnAPS showed superior renal-protections contributing to its antioxidant effects of increasing the enzyme activities and decreasing the lipid contents, and anti-inflammatory effects of reducing proinflammatory cytokines than A. polytricha polysaccharides (APS). Besides, the anti-apoptosis effects of EnAPS was proved by down-regulating Bax and Caspase-3 expressions and up-regulating Bcl-2 expressions by molecular biotechnology, and the anti-fibrosis effects was confirmed by histopathological observations of staining. The characterizations indicated that lower molecular weights possibly contributed to the superior renoprotective effects. These results suggested that enzymatic hydrolysis had potential effects in enhancing the bioactivities, and the polysaccharides could be used in the development of functional foods supplement against CKD.

[Double internal fixations of clavicle and scapula and intraoperative reduction of glenopolar angle for treatment of floating shoulder injuries]

Objective

To investigate the effectiveness of double internal fixations of clavicle and scapula and intraoperative reduction of glenopolar angle in the treatment of floating shoulder injuries.

Methods

Between January 2010 and June 2019, 13 patients with floating shoulder injury were treated with double internal fixation of clavicle and scapula and intraoperative reduction of glenopolar angle. There were 11 males and 2 females with an average age of 48 years (range, 25-65 years). The causes of injury included falling from height in 2 cases, traffic accident injury in 3 cases, heavy object injury in 2 cases, and other injuries in 6 cases. There were 2 cases of Ⅰ-B-3 type, 1 case of Ⅰ-C-2 type, 1 case of Ⅰ-C-3 type, 3 cases of Ⅱ-B-2 type, 1 case of Ⅱ-B-3 type, 1 case of Ⅱ-B-4 type, 2 cases of Ⅱ-C-2 type, 1 case of Ⅱ-C-4 type, and 1 case of Ⅱ-D-3 type according to the classification of floating shoulder injury. All patients had unilateral clavicle fracture with scapular neck fracture, 1-4 superior shoulder suspensory complex (SSSC) injuries. The time from injury to operation was 7-17 days, with an average of 12 days. The glenopolar angle, subacromail space, anteroposterior inclination angle of scapular glenoid, scapular glenoid up and down angle were measured before and after operation; Constant-Murly score and Herscovici score were used to evaluate the recovery of shoulder joint function.

Results

All incisions healed by first intention, and there was no early postoperative complications such as infection. All 13 cases were followed up 12-48 months, with an average of 25.2 months. Both the clavicle and the scapula had bone union, and the average healing time was 6 months and 4 months respectively. There were no complications such as nonunion, shoulder deformity, plate fracture or failure of internal fixation, acromion impingement syndrome, and frozen shoulder. At last follow-up, the glenopolar angle, subacromail space, anteroposterior inclination angle of scapular glenoid, and scapular glenoid up and down angle were all corrected significantly ( P<0.05). The pain, function, activity, muscle strength scores, and total score in Constant-Murly score were significantly improved when compared with preoperative scores ( P<0.05). According to the Herscovici scoring standard, the shoulder joint function was evaluated as excellent in 8 cases, good in 3 cases, and fair in 2 cases. The excellent and good rate was 84.6%.

Conclusion

Double internal fixation of clavicle and scapula to stabilize SSSC and reduct glenopolar angle during operation is an effective method for treating the floating shoulder injury.

Antioxidation, anti-inflammation and anti-fibrosis effect of phosphorylated polysaccharides from Pleurotus djamor mycelia on adenine-induced chronic renal failure mice

The mycelia polysaccharides (MPS) from Pleurotus djamor were prepared and purified by anion exchange column chromatography, and the phosphate content of phosphorylated MPS (PMPS) was 15.22 ± 0.37%. FT-IR spectra, HPLC and ¹H and ¹³C-NMR results showed the PMPS contained α-pyranose structure and the peak area percentage composition of galacturonic acid and glucose were 13.01% and 85.82%, respectively. Animal experiment investigated the antioxidant, anti-inflammation, anti-fibrosis effects of PMPS on kidney in adenine-induced chronic renal failure (CRF) mice. All results including serum biochemical indices, histopathological observation, qRT-PCR, western blotting, immunohistochemical staining manifested the kidney injury could be remitted by PMPS interventions. This experiment suggested that PMPS could remit CRF and other kidney injury related diseases as one kind of dietary supplements and functional foods without toxic side effects.

Characterization and anti-diabetic nephropathic ability of mycelium polysaccharides from Coprinus comatus

It seems quite necessary for obtaining effective substances from natural products against the diabetic nephropathic (DN) with the presently clinical problems of accompanying side-effects and lowing life qualities. This work aimed to characterize the primary structure of Coprinus comatus mycelium polysaccharides (CMP) and investigate the abilities against DN in streptozotocin induced mice models. The results indicated that CMP could improve insulin resistance and energy metabolism, and significantly suppress dysfunction on kidney and relieve the renal oxidative stress and inflammation in DN mice. Besides, the western blot results suggested that CMP reversed renal injury by modulating the PTEN/PI3K/Akt and Wnt-1/β-catenin pathways. The structure analysis indicated the typical characterizations with the major monosaccharide-compositions of galactose, α-pyranose configuration and proper molecular weights of 495.8 kDa possibly contributed to the anti-diabetic nephropathic effects of CMP. The results suggested that polysaccharides form C. comatus could be used as functional foods/drugs on preventing diabetic nephropathy.

Liver and Brain Protective Effect of Sulfated Polysaccharides from Residue of Lion's Mane Medicinal Mushroom, Hericium erinaceus (Agaricomycetes), on D-Galactose-Induced Aging Mice

This work describes the preparation of sulfated Hericium erinaceus residue polysaccharides (SHRPs) and investigates their antioxidant and antiaging effects on D-galactose-induced aging mice. The results indicated that the degree of SO42- substitution was 0.47 ± 0.22 for SHRPs. In vitro analysis and in vivo animal experiments manifested that SHRPs could alleviate aging properties by scavenging radicals, elevating enzyme activities, and reducing malondialde-hyde content, thus improving serum biochemical indices and enhancing immunological activity. Liver and brain injuries of mice could be remitted by SHRP interventions. Structural characteristics of SHRPs in this work were elucidated by Fourier transform infrared spectroscopy and gas chromatography-mass spectrometry, and the results suggest that SHRPs could be used as an effective dietary supplement and functional food for prevention of aging and age-related diseases.