The anaerobic granular sludge from an Internal Circulation (IC) reactor of a paper mill wastewater treatment plant were seeded in an Anammox upflow anaerobic sludge blanket reactor. After 185 days operation, the reactor was finally started up by increasing the influent ammonium and nitrite concentrations to 224 mg/L and 255 mg/L, respectively, with volumetric nitrogen removal rate increasing to 3.76 kg/(m3·d). The physicochemical characteristics of the cultivated Anammox granules were observed by scanning electron microscope, transmission electron microscope and Fourier Transform infrared spectroscopy (FTIR). Results suggested that during the start-up course, the granular sludge initially disintegrated and then re-aggregated. FTIR spectra results revealed that the Anammox granular sludge contained abundant functional groups, indicating that it may also possess good adsorption properties. The ecological structure of the granular sludge, analyzed by the metagenomic sequencing methods, suggested that the relative abundance of the dominant bacterial community in the seeding sludge, i.e., Proteobacteria, Firmicutes, Bacteroidetes, significantly reduced, while Planctomycetes which contains anaerobic ammonium oxidation bacteria remarkably increased from 1.59% to 23.24% in the Anammox granules.
Ammonia ; chemistry ; Bacteria ; Bioreactors ; Nitrogen ; chemistry ; Sewage ; microbiology ; Waste Disposal, Fluid ; methods ; Waste Water ; chemistry

OBJECTIVE:To prepare Polygala fallax rapidly disintegrating oral tablets and investigate its in vitro dissolution. METHODS:The rapidly disintegrating tablets was prepared by direct powder compression method. Using disintegration time as in-dex,the ratio of stuffing bulking agent mannitol to disintegrating agent microcrystalline cellulose,the amount of drug extract,the amount of lubricant magnesium stearate and other influential factors were investigated by single factor test and orthogonal test. The drug dissolution effect of prepared tablet(using senegenin as substance control)was evaluated by in vitro dissolution test(using wa-ter as dissolution medium,paddle method). RESULTS:The optimal formulation was that the amount of drug extract was 15%;the ratio of mannitol to microcrystalline cellulose was 1.5:1;the amount of magnesium stearate was 1.0%. The disintegration time of prepared tablet was(31±4)s;tablet hardness was(3.4±0.2)kg;tablet friability was(0.23±0.07)%(RSD<0.11%,n=3). Ac-cumulative dissolution rate of total saponins was more than 90% within 5 min. The dissolution parameters T50 was equal to 0.84 min and Td was equal to 1.77 min. CONCLUSIONS:Polygala fallax rapidly disintegrating oral tablets will dissolve quickly and dis-integrate rapidly in aqueous solution.

BACKGROUND:Animal experiments have demonstrated that transplanted bone marrow stem cells (BMSCs)in the myocardial infarction region can directionally differentiate into myocardial cells with normal physiological function and promote neovascularization. Clinical studies have also showed that the cardiac function can be improved in myocardial infarction and cardiomyopathy patients after stem cell transplantation.OBJECTIVE: To observe the effect of autologous BMSCs transplantation on short-term cardiac function of patients with heart failure of ischemic cardiomyopathy.DESIGN: Self-control study.SETTING: Department of Cardiology, Xiangtan Central Hospital.PARTICIPANTS: Twenty-one patients with ischemic cardiomyopathy, including 13 males and 8 females, aged (64±6)years,who received treatment in the Department of Cardiology,Xiangtan Central Hospital of Hunan Province from March 2004 to January 2006 were retrieved. Inclusive criteria: with previous myocardial infarction at least once, B-mode ultrasonic cardiac examination showed that cardiac chamber was expanded, obvious cardiac inadequacy or stenocardia existed before stent implantation and hospitalized repeatedly, underwent percutaneous coronary artery intervention for restoring blood flow of infarcted vessel to TIMI3 degree over 3 months,but cardiac inadequacy existed to different degrees.Coronary arteriongraphy showed that no stenosis was found in the stent implanted in the coronary artery.Informed consents were obtained from all the patients.METHODS:After admission, all the patients received BMSCs transplantation based on routine drug treatment.Infarction-related arterial passage was established by percutaneous transluminal catheter technique and occluded by balloon.Isolated bone marrow stem cell suspension was injected into infarction-related arterial passage through the central cavity of catheter. ① Left ventricular ejection fractions (LVEF) and left ventricular end-diastolic diameter(LVDd)were measured before and 6 months after transplantation.② 24-hour dynamic electrocardiogram evaluation was conducted before and 6 months after transplantation under the precondition of not taking antiarrhythmic drugs. ③Clinical cardiac functional grading was conducted before and 6 months after transplantation by NYHA grading method: Grade Ⅰto Ⅳ: the higher grade, the severer symptom. ④ Adverse events and side effects were observed after operation.MAIN OUTCOME MEASURES:① LVEF and LVDd were measured before and 6 months after transplantation. ②24-hour dynamic electrocardiogram evaluation results. ③ Clinical cardiac functional grading evaluation results. ④ Post-operative adverse events and side effects.RESULTS:All the involved 21 patients participated in the result analysis.①The LVEF of patients 6 months after transplantation of BMSCs was more than that before transplantation [(54.4±6.2)％, (44.6±6.4)％,t = -5.946, P＜ 0.01], and LVDd of patients 6 months after transplantation was smaller than that before transplantation [(54.6±4.2), (60.2±4.4) mm,t = 5.306, P ＜ 0.01]. ② No new arrhythmic types appeared, and case of malignant serious cardiac arrhythmias were not increased. ③ Six months after transplantation of BMSCs, there were totally 9 patients with cardiac function of grade Ⅲ and Ⅳ, while there were 18 patients before transplantation. ④ The whole transplantation was safe.No patients were found to undergo re-examination of coronary arteriongraphy, which showed stent necrosis, due to chest pain, and no dead cases were either found.CONCLUSION:It is feasible to treat ischemic cardiomyopathy by percutaneous coronary transplantation of BMSCs,which can boost LVEF and improve cardiac function after transplantation.

With the in-depth study of heart development, many human cardiomyocytes (CMs) have been generated in a laboratory environment. CMs derived from pluripotent stem cells (PSCs) have been widely used for a series of applications such as laboratory studies, drug toxicology screening, cardiac disease models, and as an unlimited resource for cell-based cardiac regeneration therapy. However, the low maturity of the induced CMs significantly impedes their applicability. Scientists have been committed to improving the maturation of CMs to achieve the purpose of heart regeneration in the past decades. In this review, we take CMs maturation as the main object of discussion, describe the characteristics of CMs maturation, summarize the key regulatory mechanism of regulating maturation and address the approaches to promote CMs maturation. The maturation of CM is gradually improving due to the incorporation of advanced technologies and is expected to continue.

Objective:To analyze the clinical characteristics of patients with nocardiosis, so as to improve the diagnosis and treatment of nocardia infection in the future.Methods:From May 2016 to October 2020, 24 patients with nocardiosis in Xiangya Hospital, Central South University were enrolled, and their clinical data including clinical features, laboratory examinations, imaging findings, diagnosis and treatment process, and outcome were retrospectively analyzed.Results:Among the 24 patients with nocardiosis, 18 cases (75.0%) were males, and the median age was 54.5 years.Twenty-three patients had underlying diseases, of which the most common disease was antineutrophil cytoplasmic antibody-related vasculitis (16.7%(4/24)). Of nine species of Nocardia identified from the 24 patients, Nocardia farcinica was the most common species (seven cases). The lesion sites were mainly lungs (70.8%(17/24)), skin and soft tissues (42.0%(10/24)), brain (25.0%(6/24)) and blood system (17.0%(4/24)). There were 12 cases (50.0%) of patients with more than two lesion sites. The clinical manifestations, imaging examinations and laboratory tests of the 24 patients were not specific. The diagnosis depended on the etiology. Nineteen patients received trimethoprim-sulfamethoxazole-based combination therapy, and two were discontinued due to adverse reactions of sulfa drugs. After treatment, 19 cases (79.2%) were improved and five cases (20.8%) died. Conclusions:Patients with nocardiosis often have atypical clinical manifestations, and multiple organs are easily affected.Early and accurate identification and rapid and effective anti-biotic therapy are the keys to improve the overall prognosis of these patients.

Purpose: No consensus exists about the causal relationship between vitamin D (VD) and male factor infertility due to heterogeneity and confounding factors even in randomized controlled trials (RCTs). This study aimed to investigate the causal association between 25 hydroxyvitamin D (25OHD) levels and male factor infertility through Mendelian randomization (MR) and provide complementary information for optimization of future RCTs. Materials and Methods: Two-sample MR analyses with four steps were performed. Single-nucleotide polymorphisms (SNPs) for VD were extracted from 417,580 Europeans in the UK Biobank, and the summary-level data of male factor infertility (825 cases and 85,722 controls) were extracted from the FinnGen. Results: Totally 99 SNPs robustly associated with the 25OHD were included, and a 1-unit increase in genetically predicted natural-log transformed 25OHD levels was associated with decreased risk of male factor infertility (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.44–0.89; p=0.010), which was consistent in all three sensitivity analyses (MR-Egger, weighted median, and weighted mode methods). The conclusion still stands after removing SNPs which explained more variation in the male factor infertility than the 25OHD (OR, 0.61; 95% CI, 0.42–0.88; p=0.009; n=62), and which were associated with confounders (body mass index, type 2 diabetes, smoking, and coronary artery diseases) of male factor infertility (OR, 0.58; 95% CI, 0.39–0.85; p=0.005; n=55). Conclusions VD supplement to increase serum 25OHD levels may be clinically beneficial for male factor infertility in the general population. The well-designed RCTs should be performed in priority to address this question.

Objective:To translate Evidence-based Practice-knowledge, attitude, application, anticipated future use (EBP-KAPF) scale into Chinese, and evaluate its reliability and validity.Methods:The Chinese version of the EBP-KAPF scale was determined through translation, adaptation, recall, review and pre-investigation. From July to August 2022, 250 clinicians from 28 provinces (autonomous regions and municipalities directly under the Central Government) were selected by using the convenience sampling method. A self-made questionnaire was used to investigate the EBP-KAPF scale in Chinese to investigate the EBM ability of clinicians, including the basic information of the respondents, the learning and use of Evidence-based medicine courses and related software. The item analysis, validity and reliability evaluation of the Chinese version of the EBP-KAPF scale were performed.Results:The Chinese version of the EBP-KAPF scale included 26 items in four dimensions: knowledge mastery, attitude, personal application and future use. A total of 265 questionnaires were sent out (including self-made questionnaires and the Chinese version of the EBP-KAPF scale), and 250 effective questionnaires were obtained, with a total effective rate of 94.3%. The total score of the Chinese version of the EBP-KAPF scale was (102.85±17.48) points, and the scores of knowledge mastery, attitude, personal application and future use sub-scales were (27.22±4.47), (13.56±7.70), (20.07±6.78), and (42.00±9.00) points, respectively. Except for item 16, all items were correlated with the total score of the scale, and the correlation coefficient ranged from 0.456 to 0.828. After item 16 was deleted, the determination values of the remaining 25 items ranged from 4.287 to 18.262 ( P<0.001). After item was removed one by one, the Cronbach′s α coefficient of the scale ranged from 0.870 to 0.888. After item 16 was removed, the Chinese version of the 25-item EBP-KAPF scale had good content validity, structural validity and discriminant validity. The content validity index (I-CVI) at the item level ranged from 0.875 to 1.000, and the content validity index at the overall agreement scale level was 0.615. The average S-CVI values were 0.952, and the probability of correction ( K*) values were 0.87 to 1.00. The results of confirmatory factor analysis showed that the structure fit was good [comparative fit index (CFI)=0.962, Tucker-Lewis index (TLI)=0.957, root mean square error of approximation (RMSEA)=0.060, χ2/ df=1.889]. Discriminant validity analysis showed that there were statistically significant differences in the EBP-KAPF scores among clinicians of different ages, evidence-based medicine course learning and related software use ( P<0.05). After item 16 was removed, the Cronbach′s α coefficient of the Chinese version of the EBP-KAPF scale was 0.893, and the Guttman half coefficients of each dimension were 0.915, 0.901, 0.812 and 0.906, respectively. The correlation coefficients were 0.902-0.982, 0.507-0.953, 0.517-0.744 and 0.632-0.986, respectively. Conclusion:The Chinese version of the EBP-KAPF scale is simple, easy to understand, unambiguous, and has good validity and reliability.

Objective:To translate Evidence-based Practice-knowledge, attitude, application, anticipated future use (EBP-KAPF) scale into Chinese, and evaluate its reliability and validity.Methods:The Chinese version of the EBP-KAPF scale was determined through translation, adaptation, recall, review and pre-investigation. From July to August 2022, 250 clinicians from 28 provinces (autonomous regions and municipalities directly under the Central Government) were selected by using the convenience sampling method. A self-made questionnaire was used to investigate the EBP-KAPF scale in Chinese to investigate the EBM ability of clinicians, including the basic information of the respondents, the learning and use of Evidence-based medicine courses and related software. The item analysis, validity and reliability evaluation of the Chinese version of the EBP-KAPF scale were performed.Results:The Chinese version of the EBP-KAPF scale included 26 items in four dimensions: knowledge mastery, attitude, personal application and future use. A total of 265 questionnaires were sent out (including self-made questionnaires and the Chinese version of the EBP-KAPF scale), and 250 effective questionnaires were obtained, with a total effective rate of 94.3%. The total score of the Chinese version of the EBP-KAPF scale was (102.85±17.48) points, and the scores of knowledge mastery, attitude, personal application and future use sub-scales were (27.22±4.47), (13.56±7.70), (20.07±6.78), and (42.00±9.00) points, respectively. Except for item 16, all items were correlated with the total score of the scale, and the correlation coefficient ranged from 0.456 to 0.828. After item 16 was deleted, the determination values of the remaining 25 items ranged from 4.287 to 18.262 ( P<0.001). After item was removed one by one, the Cronbach′s α coefficient of the scale ranged from 0.870 to 0.888. After item 16 was removed, the Chinese version of the 25-item EBP-KAPF scale had good content validity, structural validity and discriminant validity. The content validity index (I-CVI) at the item level ranged from 0.875 to 1.000, and the content validity index at the overall agreement scale level was 0.615. The average S-CVI values were 0.952, and the probability of correction ( K*) values were 0.87 to 1.00. The results of confirmatory factor analysis showed that the structure fit was good [comparative fit index (CFI)=0.962, Tucker-Lewis index (TLI)=0.957, root mean square error of approximation (RMSEA)=0.060, χ2/ df=1.889]. Discriminant validity analysis showed that there were statistically significant differences in the EBP-KAPF scores among clinicians of different ages, evidence-based medicine course learning and related software use ( P<0.05). After item 16 was removed, the Cronbach′s α coefficient of the Chinese version of the EBP-KAPF scale was 0.893, and the Guttman half coefficients of each dimension were 0.915, 0.901, 0.812 and 0.906, respectively. The correlation coefficients were 0.902-0.982, 0.507-0.953, 0.517-0.744 and 0.632-0.986, respectively. Conclusion:The Chinese version of the EBP-KAPF scale is simple, easy to understand, unambiguous, and has good validity and reliability.

Objective To analyze the clinical characteristics and screen pathogens and prognosis of anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis in children and so as to improve the diagnosis and treatment of anti-NMDAR encephalitis in children.Methods A retrospective and follow-up analysis of 38 cases of pediatric anti-NMDAR encephalitis was performed,who were admitted to the West China Second University Hospital,Sichuan University from May 2012 to June 2016,and their clinical features,associated pathogen screening,treatment and progno-sis were reviewed.Results Those 38 cases included 14 males and 24 females.The age ranged from 1 year and 10 months to 17 years and 6 months.The most common symptoms were psychiatric symptoms(33 cases),and dyskinesias and movement disorders(33 cases),speech disturbances(31 cases).Twenty-four cases(63.2%)received positive pathogenic screening and only one case had right ovarian mature cystic teratoma.Among them,11 cases had positive mycoplasma pneumonia immunoglobulin M(IgM)antibodies,10 cases had positive virus screening,and 1 case had toxoplasma gondii IgM antibodies positive,and 2 cases had mix infection.Symptoms of one case were relieved after anti-toxoplasma treatment without immunosuppression treatment,and another case had partial symptom relief after mycoplas-ma pneumonia treatment.Thirty-seven cases received immunosuppressant therapy(4 cases were treated with glucocor-ticoid,12 cases were treated with glucocorticoid combined with immune globulin,2 cases were treated with glucocorti-coid combined with plasma exchange,still 19 cases were treated with glucocorticoid combined with immune globulin and plasma exchange).After follow-up for median 12 months,3 cases relapsed,29 cases were fully recovered,5 cases had mild language impairment,2 cases had mild memory impairment,and 2 cases had involuntary movement.Conclusions The most common symptoms of the patients were psychiatric symptoms,dyskinesias and movement disorders,and speech disturbances.Children with anti-NMDAR encephalitis had a low incidence of tumors,while various pathogen infections including mycoplasma pneumonia,virus and toxoplasma gondii,which may trigger abnormal immune response of anti-NMDAR encephalitis.Pathogen screening needs to be done for pediatric anti-NMDAR encephalitis and anti-patho-genic treatment may be helpful for disease remission.

Objective:To explore the use of near-infrared autofluorescence probe (NIRAF-P) and its application in identifying parathyroid glands during surgery.Methods:A total of 68 patients undergoing thyroid surgery at Peking Union Medical College Hospital and Beijing Longfu Hospital between Dec. 2023 and Jun. 2024 were selected. During the operation, the near-infrared parathyroid gland detector was used to identify the parathyroid gland tissue to be tested, and histopathological examination was performed. The positive predictive value and accuracy of the near-infrared parathyroid gland detector were analyzed.Results:A total of 111 parathyroid glands were identified in 68 patients, and the positive predictive value and accuracy of the NIRAF-P were 95.5% and 94.6%, respectively.Conclusions:The NIRAF-P has high accuracy in identifying parathyroid glands. The standardized application of the NIRAF-P can help improve the efficiency of identifying parathyroid glands during surgery.