Background Antibiotics are frequently detected in aquatic environments, posing potential threats to ecological systems and public health. Objective To characterize antibiotic contamination in source water in Wuhan, evaluate the removal efficiency of conventional drinking water treatment processes, identify potential pollution sources, and assess ecological risks, thereby providing evidence to support water safety management. Methods A total of 34 source water samples and paired finished water samples were collected. Twenty-seven target antibiotics were analyzed via solid-phase extraction coupled with high-performance liquid chromatography-tandem mass spectrometry. Total antibiotic concentrations and the relative contributions of individual antibiotics were calculated for each sampling site. Differences in removal performance across seasons and waterworks scales were further assessed. Antibiotic pairs with co-occurrence frequencies of ≥ 10 were included in Spearman’s rank correlation analysis to explore co-occurrence patterns. Potential sources were inferred according to their approved clinic and veterinary uses. For ecological risk assessment, predicted no-effect concentrations were derived from chronic toxicity values for fish, Daphnia, green algae, and mysid obtained from the ECOSAR database. Risk quotients (RQ) were calculated using both the median and the 95th percentile concentrations to characterize typical and high-end ecological toxicity. Results Seventeen antibiotics were detected in the source water. Lincosamides, macrolides, and sulfonamides were frequently detected, with detection frequencies exceeding 50%. Although quinolones were detected less frequently (2.94%-38.24%), they exhibited episodic high concentrations; the 95th percentile concentration of cinoxacin (CNX) reached 365.73 ng·L⁻¹. The mean total antibiotic concentration was 1.79 times higher in the wet season (105.97 ng·L⁻¹) than in the dry season (59.21 ng·L⁻¹). The contribution of quinolones increased markedly from 0.87% in the dry season to 43.10% in the wet season. Except for flumequine (FQ), ofloxacin (OFX), enoxacin (ENX), and clarithromycin (CLR), the median removal rates of the remaining antibiotics by conventional treatment processes all exceeded 80%. Ten antibiotics achieved complete removal (100%) in the wet season, compared with 4 antibiotics in the dry season. The median removal rate of CLR declined with decreasing waterworks scale, from 67.92% in large-scale plants to –1.96% in medium-scale plants and –71.25% in small-scale plants. Apparent negative removal was observed for sulfadiazine (SDZ), FQ, OFX, and CLR, with OFX exhibiting the highest frequency of negative removal events (n=14). Correlation analysis revealed significant positive correlations between sulfonamides and macrolides (ρ=0.52-0.83), indicating mixed influences from livestock farming and domestic wastewater. Lincomycin (LIN) was positively correlated with sulfamethoxazole (SMX), but negatively correlated with the aforementioned antibiotic network, suggesting a predominantly human medical source. Based on median concentrations, the ecological risk of individual antibiotics was negligible. However, the cumulative risk to Daphnia reached a low level (RQ > 0.01), with sulfonamides contributing more than 70% of this risk. Based on the 95th percentile concentrations, bost individual and cumulative risks of quinolones to fish and Daphnia increased to low levels, with quinolones contributing more than 55% of the total risk. Conclusion Antibiotics are commonly detected in source water in Wuhan, and conventional drinking water treatment dose not completely eliminate all target compounds. Quinolones, despite their relatively low detection frequencies, occur at episodically high concentrations and pose low risks to fish and Daphnia under high-end exposure scenarios, warranting priority control. The coexistence of human-use and veterinary-use antibiotics reflects diverse pollution sources and highlights the need for coordinated multi-source pollution control.

OBJECTIVE: Recombination events are common and serve as the primary driving force of diverse human adenovirus (HAdV), particularly in children with acute respiratory tract infections (ARIs). Therefore, continual monitoring of these events is essential for effective viral surveillance and control. METHODS: Respiratory specimens were collected from children with ARIs between January 2022 and December 2023. The penton base, hexon, and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type. In cases with inconsistent typing results, genes were cloned into the pGEM-T vector to detect recombination events. Metagenomic next-generation sequencing (mNGS) was performed to characterize the recombinant HAdV genomes. RESULTS: Among 6,771 specimens, 277 (4.09%, 277/6,771) were positvie for HAdV, of which 157 (56.68%, 157/277) were successfully typed, with HAdV-B3 being the dominant type (91.08%, 143/157), and 14 (5.05%, 14/277) exhibited inconsistent typing results, six of which belonged to species B. The penton base genes of these six specimens were classified as HAdV-B7, whereas their hexon and fiber genes were classified as HAdV-B3, resulting in a recombinant genotype designated P7H3F3, which closely resembled HAdV-B114. Additionally, a partial gene encoding L1 52/55 kD was identified, which originated from HAdV-B16. CONCLUSION A novel recombinant, P7H3F3, was identified, containing sequences derived from HAdV-B3 and HAdV-B7, which is similar to HAdV-B114, along with additional sequences from HAdV-B16.
Humans ; Adenoviruses, Human/isolation & purification* ; Respiratory Tract Infections/epidemiology* ; Child, Preschool ; Child ; Recombination, Genetic ; Male ; Beijing/epidemiology* ; Infant ; Female ; Phylogeny ; Adenovirus Infections, Human/epidemiology* ; Acute Disease ; Genome, Viral

OBJECTIVE: Coronavirus disease 2019 (COVID-19) can result in fatigue and post-exertional malaise; however, whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection exacerbates lower urinary tract symptoms (LUTS) is unclear. This study investigated the association between prenatal SARS-CoV-2 infection and postpartum LUTS. METHODS: A multicenter, retrospective cohort study was conducted at two tertiary hospitals in China from November 1, 2022, to November 1, 2023. Participants were classified into infected and uninfected groups based on SARS-CoV-2 antigen results. LUTS prevalence and severity were assessed using self-reported symptoms and the Incontinence Impact Questionnaire-Short Form (IIQ-7). Pelvic floor muscle activity was measured using electromyography following the Glazer protocol. Group comparisons were performed to evaluate the association of SARS-CoV-2 infection with LUTS and electromyography parameters, with stratified analyses conducted using SPSS version 26.0. RESULTS: Among 3,652 participants (681 infected, 2,971 uninfected), no significant differences in LUTS prevalence or IIQ-7 scores were observed. However, SARS-CoV-2 infection was an independent factor influencing the electromyographic activity of the pelvic floor muscles (mean tonic contraction amplitudes), regardless of delivery mode ( P = 0.001). CONCLUSION Prenatal SARS-CoV-2 infection was not significantly associated with an increased risk of postpartum LUTS but independently altered pelvic floor muscle electromyographic activity, suggesting potential neuromuscular effects.
Humans ; Female ; COVID-19/epidemiology* ; Retrospective Studies ; Adult ; Pregnancy ; Lower Urinary Tract Symptoms/virology* ; Postpartum Period ; Pregnancy Complications, Infectious/virology* ; China/epidemiology* ; Electromyography ; SARS-CoV-2/physiology* ; Pelvic Floor/physiopathology* ; Prevalence

Objective To investigate the risk factors of hemodynamic instability after carotid artery stenting by meta-analysis.Methods Ten databases were searched:PubMed,ProQuest,ScienceDirect,Embase,Cochrane Library,Web of Science,China Knowledge Network,Wanfang Data,VIP Information Database,and China Biomedical Database.The search date was from inception until 2 February 2024,and meta-analysis was performed using Stata 16.0 statistical software.Results A total of 27 studies with 4199 subjects and 22 influencing factors were included.The studies showed a 37.4％(95％CI 30.3％-44.8％)incidence of haemodynamic instability after carotid stenting,Meta-analysis determined that age＞60 years(P＜0.001),hypertension(P＜0.001),calcified plaque(P＜0.001),stenosis＞70％(P=0.008),eccentric plaque(P=0.002),distance from the largest stenosis to the carotid bifurcation≤ 10 mm(P＜0.001),stenosis involvement of the balloon or bifurcation(P＜0.001),balloon post-dilation(P=0.003),open-loop stenting(P＜0.001),dilated balloon diameter≥5 mm(P=0.002),repeat balloon dilation(P=0.011)and balloon dilation pressure≥8 atm(P＜0.001)are risk factors for intraoperative and postoperative haemodynamic instability in patients undergoing carotid artery stenting surgery.Statin use was a protective factor(P＜0.001).Conclusions Medical staff working in the clinic should assess the patient's condition preoperatively,identify risk factors that may lead to haemodynamic instability,and avoid unnecessary intraoperative stimulation of patients who are already in a high-risk state.Reduce postoperative clinical complications in patients with carotid artery stenosis and improve patient recovery.

Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute（CLSI）. Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus（ n=1 544，35.2%），coagulase-negative Staphylococci（ n=1 441，32.9%）， Enterococcus faecium（ n=574，13.1%）， Enterococcus faecalis（ n=385，8.8%），and α-hemolytic Streptococci（ n=187，4.3%）. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）was 26.2%（405/1 544）and 69.8%（1 006/1 441），respectively. Notably，all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility（>97.0%）to cephalobiol，rifampicin，trimethoprim-sulfamethoxazole，linezolid，minocycline，tigecycline，and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium（resistance to vancomycin and teicoplanin：both 1.7%）compared to Enterococcus faecalis（both 0.3%）. The detection rates of MRSA and MRCNS exhibited significant regional variations across the country（ χ2=17.674 and 148.650，respectively，both P<0.001）. No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA（ χ2=14.111， P<0.001）and MRCNS（ χ2=4.828， P=0.028）in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA（ χ2=18.986， P<0.001）and MRCNS（ χ2=4.477， P=0.034）in less developed regions（per capita GDP

Objective:To report the results of bacterial resistant investigation collaborative system（BRICS）on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023，and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 were used to analyze the data.Results:During the study period，11 492 strains of Gram-negative bacteria were collected from 60 hospitals，of which 10 098（87.9%）were Enterobacterales and 1 394（12.1%）were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli（50.0%）， Klebsiella pneumoniae（26.1%）， Pseudomonas aeruginosa（5.1%）， Acinetobacter baumannii complex（5.0%）and Enterobacter cloacae complex（4.1%）. The ESBL-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus mirablilis were 46.8%（2 685/5 741），18.3%（549/2 999）and 44.0%（77/175），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（76/5 741）and 15.0%（450/2 999）；32.9%（25/76）and 78.0%（351/450）of CREC and CRKP were sensitive to ceftazidime/avibactam combination，respectively. 94.7%（72/76）and 90.2%（406/450）of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore，57.9%（44/76）and 79.1%（356/450）were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 64.6%（370/573），while more than 80.0% of CRAB complex was sensitive to tigecycline，eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 17.0%（99/581）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China，with statistically significant differences in the prevalence of CREC，CRKP，CRPA and CRAB complex（ χ2=10.6，28.6，10.8 and 19.3， P<0.05）. The prevalence of ESBL-producing Escherichia coli， CREC，CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals（ χ2=12.5，9.8，12.7 and 57.8，all P<0.01）. Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China，and Escherichia coli is ranked in the top，while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend，CREC infecton maintains a low prevalence level，and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.

Objective To compare the application effect of single perfusion technique and temperature gradient perfusion technique in balloon dilatation percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures.Methods A total of 116 patients with osteoporotic vertebral compression fracture who underwent PKP in our hospital were selected and divided into the single perfusion group(n=57)and the temperature gradient perfusion group(n=59)according to different bone cement perfusion methods.The perioperative indicators,pain visual analogue scale(VAS)scores,Oswestry dysfunction index(ODI)scores,imaging indicators and incidence of bone cement leakage were compared between the two groups.Results The amount of bone cement injection of patients in the temperature gradient perfusion group was less than that in the single perfusion group(P<0.05).There was no significant difference in operation time,intraoperative blood loss or intraoperative fluoroscopy times of patients between the two groups(P>0.05).The VAS and ODI scores of patients in the temperature gradient perfusion group were lower than those in the single perfusion group 1 week after operation(P<0.05).At 1 week after operation and the last follow-up,the relative height of the anterior edge of the injured vertebrae in both groups were higher than those before operation(P<0.05),and the Cobb angle were smaller than those before operation(P<0.05).The incidence of bone cement leakage in the temperature gradient perfusion group was lower than that in the single perfusion group(P<0.05).Conclusion The application of temperature gradient perfusion technique in PKP for the treatment of osteoporotic vertebral compression fractures can achieve the same surgical treatment effect as single perfusion technique,and temperature gradient perfusion technique can reduce the amount of bone cement injection,reduce the incidence of bone cement leakage,and alleviate postoperative pain.

This study aims to investigate whether resistance exercise can effectively alleviate disuse skel-etal muscle atrophy by activating the skeletal muscle Piezo1/AMPK/PGC-1α signaling pathway,impro-ving mitochondrial function and promoting myogenesis.8-week-old male C57BL/6J mice were used.Dis-use muscle atrophy was simulated by hind limb plaster fixation,and the mice were divided into the con-trol group,the disuse muscle atrophy group,the disuse muscle atrophy+resistance exercise group,and the disuse muscle atrophy+resistance exercise+Piezo1 inhibitor group.The resistance exercise group underwent an 8-week resistance training program.Methods such as Western Blotting,immunofluores-cence staining,and mitochondrial mass and function detection were employed to evaluate skeletal muscle mass,function,mitochondrial status,and myogenesis.Resistance exercise significantly increased the cross-sectional area of skeletal muscle in mice with disuse muscle atrophy by 23％(P＜0.01)and the relative mass of skeletal muscle by 11％(P＜0.01).Resistance exercise led to an average increase of 206 m in the longest running distance of mice(P＜0.01),an average increase of 36.7 g in the maxi-mum bearing capacity(P＜0.01),and an average reduction of 1.5 s in the balance beam crawling time(P＜0.01).Meanwhile,it upregulated the expression of the protein levels of Piezo1,AMPK,and PGC-1α(P＜0.01).In addition,resistance exercise increased the activity or protein expression levels of MMP,TFAM,COX Ⅰ,CS,ATPB,ATPase,ATP,p-mTOR/mTOR,p-P70S6K/P70S6K,Pax7,and MyoD in skeletal muscle(P＜0.05,P＜0.01).However,inhibiting Piezo1 decreased the expres-sion of the above enzyme activities and protein levels(P＜0.05,P＜0.01).Resistance exercise allevi-ates disuse skeletal muscle atrophy effectively by activating the Piezo1/AMPK/PGC-1α pathway,impro-ving skeletal muscle mitochondrial quality and function,and promoting protein synthesis and myogenesis.

Aim To explore the mechanism of Gano-derma lucidum polysaccharides(GLPS)promoting my-elin repair and regeneration in mice with chronic demy-elination induced by cuprizone(CPZ).Methods A total of 40 C57BL/6 mice were randomly divided into four groups:Normal+NS,Normal+GLPS,CPZ+NS and CPZ+GLPS.A chronic demyelination model was established using 0.2％CPZ.Open field and elevated plus maze tests were performed to observe the behavior-al changes in the mice.Immunofluorescence staining and Western blot were used to detect changes in myelin basic protein expression in the corpus callosum.ELISA was performed to measure the levels of TNF-α,IL-6,IL-1β and IL-10 in brain homogenates.Immunofluo-rescence staining was also used to observe the expres-sion of ionized calcium binding adapter molecule 1(Iba1)and neural-glial antigen 2(NG2).RT-qPCR and Western blot were conducted to assess the mRNA and protein expression levels of MBP,iNOS,COX-2,JAK2 and STAT3.Results Mice in the CPZ+NS group showed a significant decrease in body weight,cognitive behavior abnormalities,and impaired myelin regeneration.The expression of pro-inflammatory fac-tors increased,while anti-inflammatory factors de-creased.Additionally,Iba1 and NG2 expression in-creased,and the JAK2/STAT3 signaling pathway was activated.After GLPS intervention,the mouse body weight increased,myelin regeneration occurred,cogni-tive behavior was improved,the expression of inflamma-tory factors decreased,anti-inflammatory factors in-creased,NG2 expression was further elevated,and the proliferation of microglia as well as the activation of the JAK2/STAT3 signaling pathway was inhibited.Conclu-sions GLPS can improve cognitive behavior abnormali-ties and inflammatory responses in chronic demyelinated mice by inhibiting the JAK2/STAT3 signaling pathway,thereby promoting myelin repair and regeneration.

Objective:To analyze the predictive role of WT1 expression levels pre-and early post-transplantation on relapse and overall survival(OS)in patients with acute myeloid leukemia(AML)undergoing allogeneic hematopoietic stem cell transplantation(allo-HSCT)during their first complete remission(CR1).Methods:A retrospective analysis was conducted on the clinical data of 107 adult AML patients who underwent allo-HSCT during their CR1 at our center between May 2012 and December 2021.The predictive role of bone marrow WT1 expression levels before transplantation and at 3 and 6 months post-transplantation on relapse and OS was explored in combination with relevant clinical factors.Results:The median follow-up time for the 107 patients was 70(range:11-117)months.Among the patients,15 cases died.Kaplan-Meier survial analysis showed that the 3-year overall survival(OS)rate was 85.0％.20 patients experienced relapse,with a median time to relapse of 8(range:0.5-44)months and a l-year cumulative relapse rate of 13.1％.The overall median value of WT1 before transplantation,3 months after transplantation,and 6 months after transplantation was 0.26％(range:0％-23.64％),with an upper quartile value of 0.74％.No statistically significant differences in WT1 expression levels were observed among the pre-transplantation,3-month post-transplantation,and 6-month post-transplantation time points(P=0.227).Univariate analysis showed that patients with WT1 levels＞0.74％at 3 months post-transplantation had a higher 1-year relapse rate(P=0.029)and lower 3-year OS rate(P＜0.001)compared to patients with WT1 levels ≤0.74％.Other significant factors affecting 1-year relapse included stem cell source(P=0.041)and chronic graft-versus-host disease(cGVHD)(P=0.013).For 3-year OS,additional influencing factors were genetic high risk(P=0.048)and stem cell source(P=0.016).Multivariate analysis revealed that WT1 level＞0.74％at 3 months post-transplantation had a trend to affect 1-year relapse rate(HR=3.309,95％CI:0.958-11.431,P=0.058),while the absence of cGVHD was an independent risk factor for 1-year relapse(HR=3.473,95％CI:0.749-16.100,P=0.037).Only WT1 level＞0.74％at 3 months post-transplantation was an independent risk factor for 3-year OS(HR=6.886,95％CI:2.402-19.738,P＜0.001).Conclusion:High WT1 expression level at 3 months post-transplantation in AML patients undergoing allo-HSCT during CR1 affects the 1-year relapse rate and 3-year OS,and is an independent risk factor affecting 3-year OS.These findings suggest that dynamic monitoring of WT1 expression levels has certain value in prognostic assessment of AML patients who received allo-HSCT during CR1.