Publications by authors named "Z F Xu"

24,406 Publications

Anti-Vibrio dibutyl phthalate from marine-derived Streptomyces sp. S073.

Res Vet Sci 2021 Sep 8;140:198-202. Epub 2021 Sep 8.

Department of Ecology, Institute of Hydrobiology, School of Life Science and Technology, Key Laboratory of Eutrophication and Red Tide Prevention of Guangdong Higher Education Institutes, Engineering Research Center of Tropical and Subtropical Aquatic Ecological Engineering, Ministry of Education, Jinan University, Guangzhou 510632, PR China. Electronic address:

Marine Streptomyces S073 was previously shown to have strong anti-Vibrio activity, and its antibacterial mechanism was proposed to be associated with siderophore-mediated iron competition and other antagonistic agents. In this study, anti-Vibrio compounds produced by S073 were isolated by bioassay-guided fractionation using column chromatography and HPLC, and the target compound in the most active fraction was identified as dibutyl phthalate (DBP) by various spectroscopic analyses, including EI-MS, H NMR and C NMR. The DBP-producing capacity of S073 was 2.39 mg/L in ISP1 culture media. Pure DBP was demonstrated to have strong inhibitory activity on Vibiro parahaemolyticus growth with an MIC of 31.25 mg/L. When standard DBP was supplemented into the S073 fermentation broth in a gradient method, an additive inhibitory effect on V. parahaemolyticus was observed, indicating the important role of DBP in driving anti-Vibrio activity in S073 metabolites pool. A synergistic additive effect between DBP and florfenicol was observed in the Vibrio inhibition. These results indicate that, to achieve Vibrio-inhibition, S073 exerted multifaceted strategies, which included DBP-mediated antagonism and siderophore-governed iron competition. The application potential of S073 as an aquaculture probiotic was evaluated, and the safety risks associated with the endocrine disruptor attributes of DBP were discussed.
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http://dx.doi.org/10.1016/j.rvsc.2021.09.001DOI Listing
September 2021

Evaluation of Epidural Analgesia Use During Labor and Infection in Full-term Neonates Delivered Vaginally.

JAMA Netw Open 2021 Sep 1;4(9):e2123757. Epub 2021 Sep 1.

Department of Anesthesia, the International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Importance: Quantification of potential consequences associated with the use of epidural analgesia during labor could help to improve the safety and quality of labor and delivery care for parturient women.

Objective: To evaluate the association between epidural analgesia use during labor and neonatal infection in a large cohort of parturient women.

Design, Setting, And Participants: This propensity score-matched cohort study was conducted at a university-affiliated hospital in Shanghai, China. Women at full-term pregnancy undergoing vaginal delivery between January 2013 and October 2018 were included in the study. Parturient women who were parous, experiencing premature delivery (gestational age <37 weeks), were pregnant with more than 1 fetus, or had experienced a stillbirth were excluded. Data were analyzed from October 2019 to June 2020.

Exposures: The use of epidural analgesia during labor.

Main Outcomes And Measures: The primary outcome was the incidence of neonatal infection, including neonatal sepsis, neonatal uncharacterized infection, neonatal pneumonia, and neonatal necrotizing enterocolitis reported in the medical record. Secondary outcomes included the incidence of maternal intrapartum fever and histologic chorioamnionitis.

Results: Among 37 786 parturient women included (mean [SD] age, 29.5 [3.0] years), 19 968 (52.8%) received epidural analgesia during labor. In the propensity score-matched cohort (including 15 401 parturient women in each group), use of epidural analgesia was associated with a higher incidence of neonatal infection (absolute risk difference, 2.6%, 95% CI, 2.2%-3.0%; relative risk [RR], 2.43; 95% CI, 2.11-2.78), including higher incidence of sepsis (absolute risk difference, 0.1%, 95% CI, 0.1%-0.2%; RR, 3.50; 95% CI, 1.73-7.07) and uncharacterized infection (absolute risk difference, 2.2%, 95% CI, 1.9% to 2.6%; RR, 2.69; 95% CI, 2.30-3.15), compared with no epidural analgesia use. Use of epidural analgesia was also associated with greater incidence of maternal intrapartum fever (RR, 4.12; 95% CI, 3.78-4.50) and histologic chorioamnionitis (RR, 4.08; 95% CI, 3.59-4.64) compared with no epidural analgesia use.

Conclusions And Relevance: This cohort study found that use of epidural analgesia in full-term nulliparous women undergoing vaginal delivery was associated with an increased risk of neonatal infection, pending further investigation. These findings support efforts to further improve safety and quality of labor and delivery care for parturient women.
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http://dx.doi.org/10.1001/jamanetworkopen.2021.23757DOI Listing
September 2021

Comparing the effect of a consult model versus an integrated palliative care and medical oncology co-rounding model on health care utilization in an acute hospital - an open-label stepped-wedge cluster-randomized trial.

Palliat Med 2021 Sep;35(8):1578-1589

Duke-NUS Medical School, Singapore.

Background: The benefit of specialist palliative care for cancer inpatients is established, but the best method to deliver specialist palliative care is unknown.

Aim: To compare a consult model versus a co-rounding model; both provide the same content of specialist palliative care to individual patients but differ in the level of integration between palliative care and oncology clinicians.

Design: An open-label, cluster-randomized trial with stepped-wedge design. The primary outcome was hospital length of stay; secondary outcomes were 30-day readmissions and access to specialist palliative care. ClinicalTrials.gov number NCT03330509.

Setting/participants: Cancer patients admitted to the oncology inpatient service of an acute hospital in Singapore.

Results: A total of 5681 admissions from December 2017 to July 2019 were included, of which 5295 involved stage 3-4 cancer and 1221 received specialist palliative care review. Admissions in the co-rounding model had a shorter hospital length of stay than those in the consult model by 0.70 days (95%CI -0.04 to 1.45,  = 0.065) for all admissions. In the sub-group of stage 3-4 cancer patients, the length of stay was 0.85 days shorter (95%CI 0.05-1.65,  = 0.038). In the sub-group of admissions that received specialist palliative care review, the length of stay was 2.62 days shorter (95%CI 0.63-4.61,  = 0.010). Hospital readmission within 30 days (OR1.03, 95%CI 0.79-1.35,  = 0.822) and access to specialist palliative care (OR1.19, 95%CI 0.90-1.58,  = 0.215) were similar between the consult and co-rounding models.

Conclusions: The co-rounding model was associated with a shorter hospital length of stay. Readmissions within 30 days and access to specialist palliative care were similar.
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http://dx.doi.org/10.1177/02692163211022957DOI Listing
September 2021

Comprehensive analysis of angiogenesis subtype of squamous cell carcinoma.

World J Surg Oncol 2021 Sep 14;19(1):275. Epub 2021 Sep 14.

Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, People's Republic of China.

Background: Squamous cell carcinoma (SCC) is a disease with distinct management complexities as it displays a remarkably heterogeneous molecular subtype. However, the landscape of angiogenesis for SCC is not fully investigated.

Method And Materials: The angiogenesis-related subtypes of SCC were established by using the ConsensusClusterPlus package based on angiogenesis-related genes and TCGA data. We analyzed the alteration of genes and miRNAs as well as pathways associated with angiogenesis subtypes. Next, the regulation network, the correlation with genomic characteristics, immune microenvironment, and clinical features of the angiogenesis subtypes were further investigated. Finally, the prognostic impact of the angiogenesis-related subtypes for SCC was also analyzed.

Results: A total of 1368 SCC samples were included in this study. Two angiogenesis subtypes were then identified based on the one hundred and sixty-three angiogenesis-related genes with subtype1 (angiogenesis subtype) of 951 SCC patients and subtype2 (non-angiogenesis subtype) of 417 SCC. GSEA revealed that angiogenesis and epithelial-mesenchymal transition, inflammatory response, and hypoxia were enriched in the angiogenesis subtype. Eight of the 15 immune checkpoints (ADORA2A, BTLA, CD276, CYBB, HAVCR2, SIGLEC7, SIGLEC9, and VTCN1) were significantly upregulated while C10orf54 were significantly downregulated in the angiogenesis subtype. The survival analysis revealed that the patients in the angiogenesis subtype have poorer survival outcomes than those in the non-angiogenesis subtype (P = 0.017 for disease-free interval and P = 0.00013 for overall survival).

Conclusion: Our analysis revealed a novel angiogenesis subtype classification in SCC and provides new insights into a hallmark of SCC progression.
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http://dx.doi.org/10.1186/s12957-021-02367-3DOI Listing
September 2021

Inflammation/coagulopathy/fibrinolysis: Dynamic indicators of COVID-19 progression in patients with moderate COVID-19 in Wenzhou, China.

Clin Immunol 2021 Sep 11:108852. Epub 2021 Sep 11.

School of Basic Medical Science, Wenzhou Medical University, Wenzhou, China. Electronic address:

Background: Majority of coronavirus disease 2019 (COVID-19) non-survivors meet the criteria for disseminated intravascular coagulation (DIC). Although timely monitoring of clotting hemorrhagic development during the natural course of COVID-19 is critical for understanding pathogenesis, diagnosis, and treatment of the disease, however, limited data are available on the dynamic processes of inflammation/coagulopathy/fibrinolysis (ICF).

Methods: We monitored the dynamic progression of ICF in patients with moderate COVID-19. Out of 694 COVID-19 inpatients from 10 hospitals in Wenzhou, China, we selected 293 adult patients without comorbidities. These patients were divided into different daily cohorts according to the COVID-19 onset-time. Retrospective data were extracted from electronic medical records.

Results: The virus-induced damages to pre-hospitalization patients triggered two ICF fluctuations during the 14-day course of the disease. C-reactive protein (CRP), fibrinogen, and D-dimer levels increased and peaked at day 5 (D5) and D9 during the 1st and 2nd fluctuations, respectively. The ICF activities were higher during the 2nd fluctuation. Although twelve-day medication returned high CRP concentration to normal and blocked fibrinogen increase, the D-dimer levels remained high on 17 ± 2 and 23 ± 2 days of COVID-19 course.

Conclusion: COVID-19 is linked with chronic DIC, which could be responsible for the progression of the disease. Understanding and monitoring ICF progression during COVID-19 can help clinicians in identifying the stage of the disease quickly and accurately, and administer suitable treatment.
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http://dx.doi.org/10.1016/j.clim.2021.108852DOI Listing
September 2021
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