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Introduction The incidence of invasive pulmonary aspergillosis (IPA) has increased significantly over the last two decades. Alveolar macrophages (AMs) represent the first line of pulmonary host response to Aspergillus conidia. Recognition of conidia by AMs involves Dectin-1 (CLEC7A), which is a conserved structure to combine [beta]-glucans. The deficiency of Dectin-1 results in impaired fungal killing and uncontrolled growth of Aspergillus fumigatus. Thus, we hypothesized that high expression of Dectin-1 would enhance the host recognition and fungal killing. Methods We set out to develop an adenoviral vector encoding full-length Dectin-1 (Ad-Dectin-1-EGFP) and then transfect it to MH-S cells. Transfect cell model was verified by using real-time RT-PCR, Western blot, flow cytometric, and confocal microscopic assays. And also, the function of Dectin-1 was explored by measuring cytokine release and killing ability during the course of A. fumigatus infection. Results We constructed a recombinant adenovirus which could upregulate the expression of Dectin-1 and verified that Dectin-1 was expressed on cell membrane. The function of Dectin-1 was also demonstrated by its ability in promoting the production of cytokines and increasing the killing ability during the course of A. fumigatus infection. Conclusions An adenoviral vector was successfully applied to the production of a recombinant adenovirus encoding full-length Dectin-1, and also, its function in Aspergillus-induced innate immune response was demonstrated., Author(s): Di Xia[sup.1] , Wen-Kui Sun[sup.1] , Ming-Ming Tan[sup.1] , Yuan Ding[sup.1] , Zhi-Cheng Liu[sup.2] , Pei Li[sup.1] , Qian Qian[sup.3] , Xin Su[sup.1] , Yi Shi[sup.1] Author Affiliations: (1) [...]

Multi-walled carbon nanotubes (MWCNTs) were treated with dopamine coating to obtain modified MWCNTs (PDA@MWCNTs). Fe3O4 was deposited on the surface of MWCNTs to prepare Fe3O4@PDA@MWCNTs. SR/Fe3O4@PDA@MWCNTs composites were prepared by mixing liquid silicone rubber (SR) with Fe3O4@PDA@MWCNTs. The results show that the content of Fe element on the surface of Fe3O4@PDA@MWCNTs reaches 1.11%. The average particle size of Fe3O4 on the surface of MWCNTs after loading is 27.28 nm. With the increasing of Fe3O4@PDA@MWCNTs content, the thermal conductivity of the composites increases and the thermal stability decreases. When the filler content is 100 phr, the initial decomposition temperature of the composite is 284 °C, and the thermal conductivity is 0.432 1 W/(m⋅K), which is 73.5% higher than that of pure SR. After 200 s heating, the surface temperature of the composite material reaches 42.3 °C, which has good thermal conductivity and meets the requirements of CPU heat dissipation components. [ABSTRACT FROM AUTHOR]

Introduction: With the growing number of immunocompromised patients, the incidence of invasive pulmonary aspergillosis increases. Innate immunity plays a significant role in defensing against fungal infection. Airway epithelial cells induce immune responses like the production of cytokine and chemokine via Dectin-1 signaling pathway in response to Aspergillus fumigatus. Thus, we hypothesized that up-regulation of Dectin-1 on airway epithelium cells would promote the defense against A. fumigatus., Methods: We designed an adenoviral vector encoding full-length Dectin-1, and then transfected it into mice airway epithelial cells via intratracheal injection before the invasion of A. fumigatus. Transfect mice model was verified by using real-time PCR and immunohistochemistry. And also, we studied the effects of up-regulation of Dectin-1 on the production of proinflammatory cytokines, histological changes, fungal burden and survival rate during A. fumigatus infection., Results: The expression level of Dectin-1 in lungs of mice with Dectin-1 recombinant adenoviral vector significantly increased. And also, the mice had higher production of TNF-α, GM-CSF and IL-1β, lower fungal burden, more recruitment of neutrophils into lungs and higher survival rate in response to A. fumigatus infection., Conclusions: The administration of Dectin-1 recombinant adenoviral vector through trachea can elevate the expression of Dectin-1 on airway epithelium, and also, its function during the course of A. fumigatus infection was demonstrated.

Objective: The effectiveness of the combination therapy of triazole and echinocandin in treatment of invasive aspergillosis (IA) remains controversial. The objective of this systematic review was to assess the efficacy of combination therapy of triazole and echinocandin in treatment of IA., Methods: Relevant articles on the combination therapy of triazole and echinocandin in IA, including the animal studies and clinical studies from January 1966 to October 2013, were searched on Web of Science, PubMed and Cochrane Library. The prolongation of survival of the combination therapy of triazole and echinocandin in IA was performed as risk ratio (RR) with 95% confidence interval (95% CI)., Results: Nine animal studies with a total of 1,582 animals and five clinical trials totaling 872 patients were included. The survival of the included animal studies with combination therapy was significantly prolonged compared with echinocandin alone [RR =2.26, (95% CI, 1.79-2.87; P<0.00001)], but no statistical difference compared with monotherapy of triazole [RR =1.19, (95% CI, 0.98-1.44; P=0.08)]. Of the four human cohort studies, two studies observed that the combination therapy of triazole and echinocandin was associated with a significant reduction in mortality compared with other treatments, and one study might be considered as a preferable therapy [HR =0.58, (95% CI, 0.3-1.14; P=0.117)]. While another study revealed that there was no significant difference among the combination therapy of triazole and echinocandin and either of the monotherapy. In the randomized clinical trial (RCT), of the 135 patients who received the combination therapy, 39 died, while 55 died out of 142 patients who received monotherapy (P=0.08, 95% CI, -21.4, 1.09) by week 12., Conclusions: The combination therapy of triazole and echinocandin in treating IA results in a trend towards improved overall survival in animals' studies and clinical studies. Well-designed RCTs and further improved clinical trials are necessary to study the effectiveness of the combination therapy.

Objective: To investigate the molecular subtypes of 73 strains of Yersinia enterocolitica biotype 1A isolated in Shandong province by PFGE, and thereby to analyze the relationship between PFGE typing and biological characteristics., Methods: Seventy-three strains of Yersinia enterocolitica biotype 1A were isolated from animal feces and meat products in Gaomi city and Wulian county in Shandong province from 2008 to 2009. Motility test, serum agglutination and virulent genes detection by PCR were used to learn the biological characteristics of the isolated strains. The molecular subtypes were determined by PFGE, whose relationships with motility, serotypes and virulent genotypes were also analyzed., Results: Out of the 73 strains of Yersinia enterocolitica, 5 showed medium-active motility while the other 68 showed well-active motility. The dominated serotypes were O:5(17/73) and O:8(14/73), followed by O:9(5/73) and O:7, 8(1/73), and there was no O:3 serotype found. Meanwhile, 36 strains couldn't be serotyped. All the strains were negative with the gene ail, ystA, yadA and virF, yet the positive rate of ystB gene was 72.6% (53/73). The 73 strains of Yersinia enterocolitica isolated could be subtyped into 54 PFGE patterns (K6GN11SD0001-K6GN11SD0054), most of which only had 1 or 2 isolated strains, and no pattern was dominant. The strains in the same or similar cluster were from different hosts; each serotype and toxic genotype scattered in the clustering trees, without specific correlation with PFGE subtypes. 4 out of 5 strains, which showed medium-active motility, belonged to one branch, with the similarity coefficient at 80.9% - 100.0%; while all the toxic genotype belonged to type B., Conclusion: Biotype 1A Yersinia enterocolitica has many clones, whose PFGE types had relations with motility, but no relations with virulent genotype and host.

Objective: To investigate the etiology and clinical characteristics of hospital-acquired pneumonia (HAP) in China and to provide evidence for appropriate therapy., Methods: We performed a prospective multicenter study in 13 Chinese urban tertiary hospitals. All HAP cases diagnosed at respiratory general ward and respiratory intensive care unit (RICU) from August 2008 to December 2010 were studied. Epidemiological data, etiology and clinical characteristics of enrolled patients were collected. Sputum or tracheal aspirate and blood cultures, Legionella antibodies and Streptococcus pneumoniae urinary antigen tests were performed. Bacteria to antimicrobial susceptibility test was performed., Results: A total of 610 cases of HAP were diagnosed during the study, with an overall incidence of 1.4% among 42 877 hospitalized patients, while the incidence was 0.9% (362/41 261) in respiratory general ward and 15.4% (248/1616) in RICU. 93.9% (573 cases) of patients had at least one underlying disease, and 91.0% (555 cases) had exposure to at least one antimicrobial agent within 90 days prior to HAP diagnosis. Pathogens were identified in 487 patients, with Acinetobacter baumannii [30.0% (183/610)], Pseudomonas aeruginosa [22.0% (134/610)], Staphylococcus aureus [13.4% (82/610)] and Klebsiella pneumonia [9.7% (59/610)] being the most common pathogens. Eighteen patients (3.0%) had infection with fastidious bacteria. A. baumannii and S. aureus were the more frequent pathogens in the ventilator-associated pneumonia (VAP) cases [50.5% (97/192) and 21.4% (41/192)] as compared to non-VAP cases [20.6% (86/418) and 9.8% (41/418), P < 0.01]. A. baumannii and S. aureus were also frequent pathogens in cases with a score of more than 20 by the acute physiology and chronic health evaluation II (APACHEII) scoring [45.7% (69/151) and 20.5% (31/151)], as compared to cases with a score of less than 20 of APACHE II [24.8% (114/459) and 11.1% (51/459), P < 0.01]. A. baumannii showed high resistance rates to carbapenems [more than 70% (109/142)], and the susceptibility to cefoperazone/sulbactam, polymyxin B and tigecycline were 40.8% (58/142), 99.3% (141/142) and 95.8% (136/142) respectively. Resistance rates of P. aeruginosa to meropenem and imipenem were 48.8% (40/82) and 70.7% (58/82) respectively. Methicillin-resistant S. aureus (MRSA) accounted for 87.8% (43/49) in all strains of S. aureus. Mortality rate of VAP cases was 34.5% (61/177), significantly more than that of HAP patients [22.3% (135/605), P < 0.05]. The average hospital stay of patients with HAP was (23.8 ± 20.5) days, significantly more than that of the average for inpatients [(13.2 ± 13.6) days, P < 0.01] during the study period. Mean costs of HAP were (108 950 ± 116 608) yuan, significantly higher than the average hospital costs of respiratory inpatients (17 999 ± 33 364) yuan., Conclusions: Among Chinese patients hospitalized in urban tertiary medical centers, HAP incidence and mortality rate were high, which increased the patients' hospital stay and the medical costs. Common pathogens were A. baumannii, P. aeruginosa, S. aureus and K. pneumonia. The common bacteria of HAP in China showed high resistance rates to antibiotics.

Objective: To observe the expressions of nerve growth factor (NGF) and its tyrosine kinase A (TrkA) receptor on alveolar macrophage in a rat model of chronic obstructive pulmonary disease (COPD)., Methods: Forty healthy male SD rats were randomly divided into a control group and a COPD group. The COPD model was established by exposing the rats to cigarette smoke for 6 months, and lung function changes were measured. Lung histopathological changes were detected by HE staining. The expression of NGF protein in the supernatant of alveolar macrophage (AM) culture medium was detected by ELISA. Confocal microscopy was used to identify the separation and purification of AM from bronchoalveolar lavage fluid, and to detect semi-quantitatively the expression of TrkA receptor on AM. NGF and its TrkA receptor at the mRNA level were evaluated by real-time PCR. The differences among groups were calculated by one way ANOVA, and comparison between groups was made by t test., Results: Significant decrease of pulmonary compliance [(0.15 ± 0.03) ml/cm H(2)O (1 cm H2O = 0.098 kPa)] and minute ventilation [(0.045 ± 0.004) L], and significant increase of airway resistance [(0.038 ± 0.004) cm H2O×L(-1)×s(-1)] were found in the COPD group compared with the control group [(0.42 ± 0.05) ml/cm H2O and (0.102 ± 0.010) L and (0.016 ± 0.002) cm H2O×L(-1)×s(-1), t = 9.46 - 12.99, respectively, all P < 0.01]. Alveolar wall thinning, alveolar septa breakdown, alveolar enlargement and emphysema were significant in the COPD rats. The expression of NGF protein in the supernatant of AM culture medium was enhanced in the COPD group [(3.79 ± 1.52) ng/L] compared with the controls [(0.94 ± 0.27) ng/L, t = 4.13, P < 0.05]. Mean fluorescence intensity of TrkA protein on AM in the COPD group (19.5 ± 1.5) was higher than that in the control group (11.2 ± 1.9, t = 7.95, P < 0.05). The expressions of NGF and TrkA at mRNA level in the COPD group (24.8 ± 6.0 and 9.0 ± 3.3) were increased compared with the control group (1.0 ± 0.2 and 1.0 ± 0.4, t = 8.48 and 5.16, all P < 0.05)., Conclusions: The expressions of NGF and its TrkA receptor on AM in COPD group were increased, indicating that NGF and its TrkA receptor might be involved in the pathogenesis of COPD mediated by AM.

This study aimed at assessing the role of monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in the control of pleural effusion (PE) and survival in patients with primary lung adenocarcinoma. The concentrations of the 3 cytokines were measured in PE from 79 lung adenocarcinoma patients with malignant pleural effusion (MPE) and 23 patients with tuberculosis. Data were correlated with the efficacy of MPE control and patient survival. The level of MCP-1 in PE was significantly higher in patients with lung adenocarcinoma than those with tuberculosis. By contrast, the levels of TNF-alpha and IL-6 were significantly lower in patients with lung adenocarcinoma than those with tuberculosis. An MCP-1 level greater than 3,187 pg/mL (which was used as a cutoff point) indicated failure to control MPE (odds ratio [OR]=2.82, 95% confidence interval [CI]=1.02-7.82, p=0.04). In multivariate analysis, MCP-1 was confirmed as an independent prognostic factor for progression-free survival (hazard ratio [HR]=2.02, 95% CI=1.24-3.30, p=0.01). The level of MCP-1 in PE appears to be a reliable surrogate marker for evaluating the therapeutic efficacy in the control of MPE and predicting survival in lung adenocarcinoma patients with MPE.

Objective: To assess the value of galactomannan (GM) double-direct sandwich enzyme-linked immunosorbent assay (ELISA) in the diagnosis of invasive aspergillosis (IA)., Methods: A search in MEDLINE, EMbase, OVID, CBMdisc and CHKD from Jan. 1991 to Dec. 2008 was conducted to collect all articles about diagnostic tests of serum GM detection. Then the methodological quality was assessed by QUADAS-items, sources of heterogeneity investigated, pooled effect quantities evaluated, and meta-analysis studies, SROC curves, and subgroup analysis performed., Results: Thirty-six articles with a population of 4959 patients were included. The average prevalence of IA was 10%(532/4959). Our meta-analysis reported a median heterogeneity (I(2) = 48.6%, P < 0.05), with a pooled DOR value of 19.10 (95%CI 12.67 - 28.79), a pooled sensitivity of 0.66 (95%CI 0.61 - 0.70), a pooled specificity of 0.90 (95%CI 0.89 - 0.90), a pooled positive likelihood ratio of 5.48 (95%CI 4.27 - 7.02), a pooled negative likelihood ratio of 0.38 (95%CI 0.29 - 0.50), and an area under curve of SROC 0.88. The rate of underdiagnosis of serum GM detection was 34% (168/490) and the rate of misdiagnosis was 10% (466/4469). With a rise in the cut-off value the sensitivity of GM test decreased and specificity increased. Two consecutive positive tests decreased the sensitivity but increased the specificity. Age had no significant effect on the diagnosis by GM test. Both antifungal prophylaxis and antifungal therapy had no significant effect on sensitivity and specificity of GM test for IA diagnosis., Conclusion: Serum GM detection is an effective diagnostic tool for invasive aspergillosis in high-risk populations.