Startseite Gemella morbillorum infective endocarditis: A case report and literature review
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Gemella morbillorum infective endocarditis: A case report and literature review

  • Xuejie Cao und Lichao Yuan EMAIL logo
Veröffentlicht/Copyright: 18. Mai 2023

Abstract

Infective endocarditis (IE) caused by Gemella morbillorum is rare. Consequently, little is known about the natural course of endocarditis caused by this pathogen. This report describes the case of a 37-year-old male patient with G. morbillorum endocarditis. The patient was hospitalized for a fever of unknown origin. He complained of intermittent fever of unknown origin for 2 months. He had also undergone root canal therapy for pulpitis a month ago. After admission, the infectious pathogen G. morbillorum was identified using metagenomic next-generation sequence technology. The anaerobic blood culture bottle showed only Gram-positive cocci. Transthoracic echocardiography showed 10 mm vegetation on the aorta, which met the IE diagnostic Duke’s criteria, and the patient was diagnosed with G. morbillorum IE. Because no bacterial colonies were formed on the culture, the drug sensitivity test could not be conducted. Ceftriaxone anti-infective drugs are based on careful consideration of the literature and patient. Six days after antibiotic treatment in our department, the patient was discharged from the hospital in stable condition and had no adverse reactions at 1 week of follow-up. To help clinicians better understand the disease of G. morbillorum IE, we also reviewed and discussed the relevant cases published after 2010 when presenting the report.

1 Background

Gemella morbillorum, a Gram-positive, catalase-negative, facultatively anaerobic coccus, was given by Tunnicliff in 1917 [1]. G. morbillorum often behaves as commensal bacteria of the mucous membranes of the oropharynx, gastrointestinal tract, and genitourinary tract [2]. G. morbillorum causes a variety of infections in men, including meningitis, spondylodiscitis, pneumonia, osteomyelitis, endocarditis, and peritonitis [3,4,5,6,7]. Compared with other pathogens, G. morbillorum has a lower virulence. Still, delayed antimicrobial treatment of G. morbillorum endocarditis carries an increased risk of embolism or immune events. In severe cases, the risk of death also increases [8,9].

Infective endocarditis (IE) is a life-threatening infectious disease. The current pathogen spectrum includes Staphylococcus aureus and Streptococci, which are most of the organisms involved [10]. IE caused by G. morbillorum is currently rare and it is also rare in China. We present a case of a 37-year-old male diagnosed with G. morbillorum IE, in whom G. morbillorum was accurately detected by metagenomic next-generation sequence (mNGS). The patient benefited from this, received timely targeted treatment, and recovered well.

2 Case presentation

A 37-year-old male with a fever (38°C) presented to the fever clinics with a 2-month history of intermittent low-grade fever, chills, hunger, and headache. About a month back, he underwent root canal therapy for pulpitis without receiving antibiotic prophylaxis. He developed a fever the night after the operation and was treated with tinidazole combined with cephalosporin for empirical anti-infection. After 1 week of treatment, the temperature returned to normal but the fever recurred 2 days after stopping the medication, which was not taken seriously. At this visit to our hospital, the white blood cell (WBC) counts were 9.67 × 109/L, neutrophil counts were 7.74 × 109/L, and the C-reactive protein (CRP) level was 51.01 mg/L. The value of the N-terminal B-type natriuretic peptide precursor (NT-proBNP) was as high as 159 pg/mL, so the patient was transferred to our department for further diagnosis and treatment.

He reported eating normally, regular bowel movements. He did not suffer from hypertension, diabetes, heart disease, cerebrovascular disease, hepatitis, history of tuberculosis, history of trauma, blood transfusion, intrathoracic, intracardiac procedures, or gastrointestinal tract pathology. He also did not have any history of intravenous drug use or smoking.

2.1 Investigations

On physical examination, the patient was afebrile and sane. His blood pressure was 150/45 mmHg, with a heart rate of 104 bpm. There was no bump in the precordial area, the cardiac boundary was not enlarged, the heart sound was strong, the rhythm was uniform, and the level 2 wind-blowing diastolic murmur could be understood in the precordial area without a pericardial murmur. His skin was normal without rashes or subcutaneous bleeding, and his ophthalmoscopic examination was negative. Hearing and smell were normal. Oral hygiene was good, and the oropharynx was very healthy. Auscultation of the chest revealed clear lung fields bilaterally without any adventitious sounds. Physical examination revealed no abnormality in the chest, lungs, abdomen, liver, spleen, limbs, or intestines. It may be due to the brief duration of the disease that there were no common endocarditis signs, such as Osler node, Janeway lesion, or Roth spot.

Laboratory workup was notable for a hemoglobin level of 123 g/L, hypersensitive C-reactive protein (HS-CRP) of 57.65 mg/L, and an erythrocyte sedimentation rate of 58 mm/h on the day of admission to our department. We followed the blood routine examinations and cardiac function indexes on the second and third days. The WBC counts were 9.65 × 109/L and 9.91 × 109/L, neutrophil counts were 7.81 × 109/L and 7.42 × 109/L, and CRP levels were 71.65 and 48 mg/L. The NT-proBNP levels reached as high as 2,173 pg/mL. Transthoracic echo was notable for the aortic valve bivalve malformation, abnormal echo, and severe regurgitation left atrial dilatation, moderate mitral regurgitation, and left ventricular ejection fraction (LVEF) of 66% (Figure 1). So, aortic valve vegetation was considered. The longest was about 10 cm, and IE was highly suspected. Chest computed tomography (CT) examination showed no obvious abnormality.

Figure 1 
                  Transthoracic echocardiography (including tissue Doppler) showing aortic valve bivalve malformation, abnormal echo, and severe regurgitation left atrial dilatation, and moderate mitral regurgitation, with LVEF of 66%.
Figure 1

Transthoracic echocardiography (including tissue Doppler) showing aortic valve bivalve malformation, abnormal echo, and severe regurgitation left atrial dilatation, and moderate mitral regurgitation, with LVEF of 66%.

On pathogen examination, we timely collected blood samples from patients for culture. To obtain etiologic results quickly, we performed mNGS detection with the patient’s consent. On the second day, the results of feedback on specific pathogen tests showed that the 1,3-β-D-glucan (G) and galactomannan (GM) tests were negative. The respiratory-tract inspection was negative, and the Coxsackie virus antibody was negative. EBV and CMV were identified by multiplex polymerase chain reaction (PCR), and the results were also negative. The serological tests were negative, and the rubella virus and Toxoplasma gondii serological tests were also negative. The mNGS results from feedback within 24 h showed that 63 reads of G. morbillorum were detected in the cfDNA of blood samples (Table 1). On the fourth day, the anaerobic blood culture bottle showed Gram-positive cocci, so the possibility of G. morbillorum was high. At this point, our patient met “diagnosed” endocarditis per Duke’s criteria, and the pathogen was confirmed as G. morbillorum.

Table 1

Results of mNGS

Types Species Genus
Name Reads Name Reads
Gram positive bacteria Gemella morbillorum 63 Gemella 69
  1. Informed consent: Informed consent has been obtained from all individuals included in this study.

  2. Ethical approval: The research related to human use has complied with all the relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

2.2 Methods of mNGS

According to the Illumina next-generation sequencing assay manual, blood samples were processed in a medical laboratory (Nextseq CN500). The general detection process was as follows:

  1. A total of 200 μL of plasma was used to extract the nucleic acid for cfDNA libraries.

  2. Nextseq CN500 was used to perform sequencing after the library was validated by the 2100 Bioanalyzer system (Agilent Technologies, Inc.) and RT-PCR.

  3. Sequence reads were classified according to their origin by a developed bioinformatics pipeline.

The bioinformatics process mainly included the following steps:

  1. Remove low-quality reads.

  2. Host reads were subtracted.

  3. The remaining reads were aligned to the reference database, composed of multiple public sequence resources of bacteria, viruses, and fungi.

2.3 Differential diagnosis

The patient showed fever, so we checked whether it was rheumatic fever, sepsis, systemic lupus erythematosus, and autoimmune diseases. The patient was excluded for rheumatic fever because there was no history of upper respiratory tract infection, joint pain, or rheumatic heart disease. Similarly, this patient did not meet the clinical symptoms of sepsis, i.e., high fever, chills, and obvious respiratory, digestive, urinary, and other infectious symptoms. In patients with systemic lupus erythematosus, pericarditis is the most common cardiac involvement; valve involvement is less, and most patients are female and excluded. Regarding autoimmune diseases, the anti-nuclear antibody spectrum of the patients was examined and all of them were negative. Then, we improved the results of echocardiography and etiological examination as soon as possible to ascertain whether it was IE.

2.4 Treatment

Once a transthoracic echo revealed suspected endocarditis, our patient was empirically treated with ceftriaxone (2 g every 24 h was initiated) and netilmicin (2 g every 24 h was initiated). This decision was supported when the mNGS resulted in G. morbillorum, and blood cultures grew Gram-positive cocci. Because the drug sensitivity information could not be obtained through culture, we continued to use ceftriaxone for anti-infection treatment in combination with the literature and the patient’s situation. Simultaneously with the anti-infection, as the patient showed rapid heart rate, enlarged left atrium, and elevated NT-proBNP, we considered that the IE might involve the valve to cause heart failure, and torasemide diuresis was given to correct heart failure. Due to the increased activity of aortic vegetation in patients, we should be vigilant against systemic embolism caused by the shedding of vegetation.

2.5 Outcome

After 6 days of treatment in our department, the patient’s condition appeared stable without any particular discomfort. The general situation worked well. The vital signs showed that the body temperature was 36.4°C, the blood pressure was 140/60 mmHg, the heart rate was 84 bpm, and the blood routine test results showed that the fluctuation range of various indicators was small. The CRP decreased to 21.83 mg/L. After only 1 week in the hospital, the patient firmly asked to be discharged. Blood was collected and cultured the day before discharge again, and sterile growth occurred 5 days later. No antibiotics were prescribed at discharge. We repeatedly explained the necessity of continued hospitalization and suggested that the patient receive cardiac surgical treatment as soon as possible. On the second day after discharge, the patient was sent to a top-grade hospital in Beijing for surgical treatment. At the follow-up, the patient was receiving preoperative intravenous antibiotic therapy. Unfortunately, we could not obtain the antibiotic information.

3 Discussion

G. morbillorum is one of the rare causative microorganisms of endocarditis. We herein report a case of IE in a patient with an aortic valve caused by G. morbillorum. Based on modified Duke’s criteria [11], the patient was diagnosed with IE. In addition to the case description, we reviewed 16 cases of G. morbillorum endocarditis that were published between 2010 and 2021 (Table 2) [8,9,12,13,14,15,16,17,18,19,20,21,22,23,24,25]. Integrating patient information and discussion were required to expect a more profound and systematic understanding of this rare case.

Table 2

Reported cases of IE caused by Gemella morbillorum from 2010 to 2021

References Country Age/gender Pathogen detection The duration of antimicrobial therapy Valve replacement Valve type Valves involved Risk factors Survival outcome
Desai et al., 2021 [12] USA 72/male MALDI-TOF After 2 weeks of vancomycin treatment, it was changed to cefazolin treatment for 4 weeks Mitral and aortic valve Natural valve Mitral, aorticn and pulmonary valves Not explained Alive
Tanveer et al., 2021 [13] USA 48/male Blood culture Ceftriaxone was initiated for a 6-week duration Mitral valve Natural valve Mitral valve This patient did not have known predisposing conditions Alive
Patel et al., 2021 [14] USA 56/female Blood culture Ceftriaxone was initiated for a 6-week duration No Prosthetic valve Aortic valve Poor dentition and underlying cardiac pathologies Alive
Dogan et al., 2020 [15] Turkey 37/male MALDI-TOF Ceftriaxone was initiated for a 6-week duration Mitral and aortic valve Natural valve Aortic valve Bicuspid aorta Alive
Spaeth et al., 2020 [16] USA 23/male MALDI-TOF Gentamicin and ampicillin for 31 days Mitral and aortic valve Natural valve Aortic and mitral valves Dental caries Alive
Lee et al., 2019 [17] USA 33/male Not explained Not explained Pulmonary and aortic valve Natural valve Aortic and pulmonary valves Congenital heart defect Not explained
Rehman et al., 2019 [18] USA 34/male Blood culture Not explained Pulmonary and aortic valve Natural valve Aortic and pulmonary valves This patient did not have known predisposing conditions Not explained
Li et al., 2017 [19] China 28/male Blood culture Ceftriaxone for 5 weeks and vancomycin for 1 week Pulmonary valve Natural valve Pulmonary valve Congenital ventricular septal defect, atrial septal defect, and double-chambered right ventricle Alive
Shinha, 2017 [20] USA 37/male Blood culture Not explained Not explained Natural valve Aortic valve A history of intravenous drug abuse Not explained
Rosa et al., 2015[8] Brazil 72/male Blood culture After 1 day of ceftriaxone with gentamicin, it was changed to penicillin G with gentamicin treatment for 27 days Mitral valve Natural valve Mitral valve Previous coronary artery bypass graft surgery Deceased
Constantinos et al., 2015 [21] Cyprus 80/female Blood culture Ceftriaxone for 6 weeks and gentamycin for 2 weeks No Prosthetic valve Tricuspid valve History of aortic valve replacement Alive
Ural et al., 2014 [22] Turkey 67/male Blood culture After 3 weeks of ampicillin/sulbactam with gentamicin, it was changed to meropenem and vancomycin treatment for 1 week Not explained Natural valve Not explained Not explained Alive
Shahani, 2014 [23] USA 73/male 16S rRNA Penicillin G with gentamicin for 6 weeks Aortic valve Prosthetic valve Aortic valve Poor dentition and underlying cardiac pathologies Alive
Kolhari et al., 2014 [24] India 34/female Blood culture Crystalline penicillin and levofloxacin for 2 weeks Mitral valve Natural valve Mitral valve Asymptomatic obstructive hypertrophic cardiomyopathy and had undergone dental extraction Alive
Taimur et al., 2010 [25] Pakistan 31/female Blood culture Ceftriaxone for 6 weeks and gentamycin for 2 weeks No Natural valve Aortic valve A congenitally bicuspid aortic valve and had undergone repair of a large aortic aneurysm Alive
Massoure et al., 2010 [9] Djibouti 22/male Blood culture Amoxicillin and gentamycin (no treatment time) No Natural valve Aortic valve Dental caries and periodontitis Deceased
This case China 37/male mNGS and blood culture Netilmycin with cefatriaxone for 1 week Not explained Natural valve Aortic valve Dental surgery Alive

Retrospective cases revealed that aortic valves were affected in many cases, followed by the mitral valve. In contrast, the tricuspid valve and pulmonary valve were rarely involved. Tricuspid IE caused by G. morbillorum is extremely rare, and we only retrieved one case. Compared with a prosthetic valve, natural valves are more vulnerable.

Current trends in G. morbillorum IE from retrieved case reports showed that congenital heart disease is the most common risk factor (5/16). Apart from this, underlying conditions such as poor dentition and dental surgery (5/16), cardiac valvular disease (2/16), history of intravenous medication (1/16), and history of cardiac surgery were associated with human infection by G. morbillorum. In our case, the patient had an intermittent fever before 2 months and had dental surgery a month back. Therefore, dental surgery may be one of the factors causing this infection. Gemella spp. can adhere to the oral cavity surfaces using adherent proteins [26]. Therefore, the oral cavity is an ideal medium for Gemella. Furthermore, Gemella shares the structural features of IgA proteases, which aid in human IgA destruction [27]. It also explains why dental surgery or oral health is a common risk factor for G. morbillorum IE. Our case report highlights the importance of recognizing oral health in diagnosing and treating endocarditis.

In addition, according to our review of case reports, 2/16 patients had a final clinical outcome of death. This fact underscores the potential virulence of G. morbillorum in the setting of IE. The ability of this bacterium to destroy the cardiac valve tissue contributes to the rapid deterioration of patients with endocarditis, culminating in cardiogenic shock and even death. For this reason, we recommend maintaining a high G. morbillorum infection index in difficult-to-identify cases to facilitate early detection and accurate identification at the etiological diagnosis level.

In our summary cases, in 11/16 patients, the pathogen of G. morbillorum was identified through a blood culture. The gold standard for the etiological detection of IE is blood culture. However, G. morbillorum is not always considered first by clinicians, limiting the use of culture in diagnosis. Unlike culture, mNGS, with a high sensitivity and good timeliness and specificity, can unbiasedly detect almost all organisms in the sample without an a priori hypothesis and has been extensively used for the clinical diagnosis of various infections with satisfactory performance. This case is also the first known patient where, with an mNGS-assisted diagnosis of G. morbillorum, IE was clinically confirmed. It shows rapid and accurate characteristics in etiology diagnosis. Our finding indicated that mNGS could be an alternative for early diagnosis of G. morbillorum.

The treatment of G. morbillorum is either medical therapy or surgical replacement of the valve. Most patients recovered with combined treatment of antibiotics and surgery. Most G. morbillorum IE cases were cured with ceftriaxone, with gentamicin and vancomycin added empirically in a few reports. Because the blood culture result of our case showed only Gram-positive cocci, no drug sensitivity test was conducted. The antibiotic protocol formulation resulted from carefully considering the literature and the patient’s situation.

4 Conclusions

Clinicians need to be conscious that G. morbillorum can occasionally cause IE. The organisms must be considered, especially if the patient has underlying or predisposing conditions. Metagenome sequencing technology is a good choice in assisting the rapid clinical identification of IE pathogens.


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Acknowledgements

Authors thank the patient for permitting us to use the data.

  1. Funding information: Authors state no funding was involved.

  2. Author contributions: X.C. analyzed and interpreted the patient data and wrote the manuscript. L.Y. was a significant contributor to Organizing medical records and revising the manuscript. All authors contributed to the article and approved the submitted version.

  3. Conflict of interest: Authors state no conflict of interest.

  4. Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Received: 2022-12-19
Revised: 2023-03-18
Accepted: 2023-03-21
Published Online: 2023-05-18

© 2023 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  53. Cloning, subcellular localization and expression of phosphate transporter gene HvPT6 of hulless barley
  54. Coptisine mitigates diabetic nephropathy via repressing the NRLP3 inflammasome
  55. Significant elevated CXCL14 and decreased IL-39 levels in patients with tuberculosis
  56. Whole-exome sequencing applications in prenatal diagnosis of fetal bowel dilatation
  57. Gemella morbillorum infective endocarditis: A case report and literature review
  58. An unusual ectopic thymoma clonal evolution analysis: A case report
  59. Severe cumulative skin toxicity during toripalimab combined with vemurafenib following toripalimab alone
  60. Detection of V. vulnificus septic shock with ARDS using mNGS
  61. Novel rare genetic variants of familial and sporadic pulmonary atresia identified by whole-exome sequencing
  62. The influence and mechanistic action of sperm DNA fragmentation index on the outcomes of assisted reproduction technology
  63. Novel compound heterozygous mutations in TELO2 in an infant with You-Hoover-Fong syndrome: A case report and literature review
  64. ctDNA as a prognostic biomarker in resectable CLM: Systematic review and meta-analysis
  65. Diagnosis of primary amoebic meningoencephalitis by metagenomic next-generation sequencing: A case report
  66. Phylogenetic analysis of promoter regions of human Dolichol kinase (DOLK) and orthologous genes using bioinformatics tools
  67. Collagen changes in rabbit conjunctiva after conjunctival crosslinking
  68. Effects of NM23 transfection of human gastric carcinoma cells in mice
  69. Oral nifedipine and phytosterol, intravenous nicardipine, and oral nifedipine only: Three-arm, retrospective, cohort study for management of severe preeclampsia
  70. Case report of hepatic retiform hemangioendothelioma: A rare tumor treated with ultrasound-guided microwave ablation
  71. Curcumin induces apoptosis in human hepatocellular carcinoma cells by decreasing the expression of STAT3/VEGF/HIF-1α signaling
  72. Rare presentation of double-clonal Waldenström macroglobulinemia with pulmonary embolism: A case report
  73. Giant duplication of the transverse colon in an adult: A case report and literature review
  74. Ectopic thyroid tissue in the breast: A case report
  75. SDR16C5 promotes proliferation and migration and inhibits apoptosis in pancreatic cancer
  76. Vaginal metastasis from breast cancer: A case report
  77. Screening of the best time window for MSC transplantation to treat acute myocardial infarction with SDF-1α antibody-loaded targeted ultrasonic microbubbles: An in vivo study in miniswine
  78. Inhibition of TAZ impairs the migration ability of melanoma cells
  79. Molecular complexity analysis of the diagnosis of Gitelman syndrome in China
  80. Effects of maternal calcium and protein intake on the development and bone metabolism of offspring mice
  81. Identification of winter wheat pests and diseases based on improved convolutional neural network
  82. Ultra-multiplex PCR technique to guide treatment of Aspergillus-infected aortic valve prostheses
  83. Virtual high-throughput screening: Potential inhibitors targeting aminopeptidase N (CD13) and PIKfyve for SARS-CoV-2
  84. Immune checkpoint inhibitors in cancer patients with COVID-19
  85. Utility of methylene blue mixed with autologous blood in preoperative localization of pulmonary nodules and masses
  86. Integrated analysis of the microbiome and transcriptome in stomach adenocarcinoma
  87. Berberine suppressed sarcopenia insulin resistance through SIRT1-mediated mitophagy
  88. DUSP2 inhibits the progression of lupus nephritis in mice by regulating the STAT3 pathway
  89. Lung abscess by Fusobacterium nucleatum and Streptococcus spp. co-infection by mNGS: A case series
  90. Genetic alterations of KRAS and TP53 in intrahepatic cholangiocarcinoma associated with poor prognosis
  91. Granulomatous polyangiitis involving the fourth ventricle: Report of a rare case and a literature review
  92. Studying infant mortality: A demographic analysis based on data mining models
  93. Metaplastic breast carcinoma with osseous differentiation: A report of a rare case and literature review
  94. Protein Z modulates the metastasis of lung adenocarcinoma cells
  95. Inhibition of pyroptosis and apoptosis by capsaicin protects against LPS-induced acute kidney injury through TRPV1/UCP2 axis in vitro
  96. TAK-242, a toll-like receptor 4 antagonist, against brain injury by alleviates autophagy and inflammation in rats
  97. Primary mediastinum Ewing’s sarcoma with pleural effusion: A case report and literature review
  98. Association of ADRB2 gene polymorphisms and intestinal microbiota in Chinese Han adolescents
  99. Tanshinone IIA alleviates chondrocyte apoptosis and extracellular matrix degeneration by inhibiting ferroptosis
  100. Study on the cytokines related to SARS-Cov-2 in testicular cells and the interaction network between cells based on scRNA-seq data
  101. Effect of periostin on bone metabolic and autophagy factors during tooth eruption in mice
  102. HP1 induces ferroptosis of renal tubular epithelial cells through NRF2 pathway in diabetic nephropathy
  103. Intravaginal estrogen management in postmenopausal patients with vaginal squamous intraepithelial lesions along with CO2 laser ablation: A retrospective study
  104. Hepatocellular carcinoma cell differentiation trajectory predicts immunotherapy, potential therapeutic drugs, and prognosis of patients
  105. Effects of physical exercise on biomarkers of oxidative stress in healthy subjects: A meta-analysis of randomized controlled trials
  106. Identification of lysosome-related genes in connection with prognosis and immune cell infiltration for drug candidates in head and neck cancer
  107. Development of an instrument-free and low-cost ELISA dot-blot test to detect antibodies against SARS-CoV-2
  108. Research progress on gas signal molecular therapy for Parkinson’s disease
  109. Adiponectin inhibits TGF-β1-induced skin fibroblast proliferation and phenotype transformation via the p38 MAPK signaling pathway
  110. The G protein-coupled receptor-related gene signatures for predicting prognosis and immunotherapy response in bladder urothelial carcinoma
  111. α-Fetoprotein contributes to the malignant biological properties of AFP-producing gastric cancer
  112. CXCL12/CXCR4/CXCR7 axis in placenta tissues of patients with placenta previa
  113. Association between thyroid stimulating hormone levels and papillary thyroid cancer risk: A meta-analysis
  114. Significance of sTREM-1 and sST2 combined diagnosis for sepsis detection and prognosis prediction
  115. Diagnostic value of serum neuroactive substances in the acute exacerbation of chronic obstructive pulmonary disease complicated with depression
  116. Research progress of AMP-activated protein kinase and cardiac aging
  117. TRIM29 knockdown prevented the colon cancer progression through decreasing the ubiquitination levels of KRT5
  118. Cross-talk between gut microbiota and liver steatosis: Complications and therapeutic target
  119. Metastasis from small cell lung cancer to ovary: A case report
  120. The early diagnosis and pathogenic mechanisms of sepsis-related acute kidney injury
  121. The effect of NK cell therapy on sepsis secondary to lung cancer: A case report
  122. Erianin alleviates collagen-induced arthritis in mice by inhibiting Th17 cell differentiation
  123. Loss of ACOX1 in clear cell renal cell carcinoma and its correlation with clinical features
  124. Signalling pathways in the osteogenic differentiation of periodontal ligament stem cells
  125. Crosstalk between lactic acid and immune regulation and its value in the diagnosis and treatment of liver failure
  126. Clinicopathological features and differential diagnosis of gastric pleomorphic giant cell carcinoma
  127. Traumatic brain injury and rTMS-ERPs: Case report and literature review
  128. Extracellular fibrin promotes non-small cell lung cancer progression through integrin β1/PTEN/AKT signaling
  129. Knockdown of DLK4 inhibits non-small cell lung cancer tumor growth by downregulating CKS2
  130. The co-expression pattern of VEGFR-2 with indicators related to proliferation, apoptosis, and differentiation of anagen hair follicles
  131. Inflammation-related signaling pathways in tendinopathy
  132. CD4+ T cell count in HIV/TB co-infection and co-occurrence with HL: Case report and literature review
  133. Clinical analysis of severe Chlamydia psittaci pneumonia: Case series study
  134. Bioinformatics analysis to identify potential biomarkers for the pulmonary artery hypertension associated with the basement membrane
  135. Influence of MTHFR polymorphism, alone or in combination with smoking and alcohol consumption, on cancer susceptibility
  136. Catharanthus roseus (L.) G. Don counteracts the ampicillin resistance in multiple antibiotic-resistant Staphylococcus aureus by downregulation of PBP2a synthesis
  137. Combination of a bronchogenic cyst in the thoracic spinal canal with chronic myelocytic leukemia
  138. Bacterial lipoprotein plays an important role in the macrophage autophagy and apoptosis induced by Salmonella typhimurium and Staphylococcus aureus
  139. TCL1A+ B cells predict prognosis in triple-negative breast cancer through integrative analysis of single-cell and bulk transcriptomic data
  140. Ezrin promotes esophageal squamous cell carcinoma progression via the Hippo signaling pathway
  141. Ferroptosis: A potential target of macrophages in plaque vulnerability
  142. Predicting pediatric Crohn's disease based on six mRNA-constructed risk signature using comprehensive bioinformatic approaches
  143. Applications of genetic code expansion and photosensitive UAAs in studying membrane proteins
  144. HK2 contributes to the proliferation, migration, and invasion of diffuse large B-cell lymphoma cells by enhancing the ERK1/2 signaling pathway
  145. IL-17 in osteoarthritis: A narrative review
  146. Circadian cycle and neuroinflammation
  147. Probiotic management and inflammatory factors as a novel treatment in cirrhosis: A systematic review and meta-analysis
  148. Hemorrhagic meningioma with pulmonary metastasis: Case report and literature review
  149. SPOP regulates the expression profiles and alternative splicing events in human hepatocytes
  150. Knockdown of SETD5 inhibited glycolysis and tumor growth in gastric cancer cells by down-regulating Akt signaling pathway
  151. PTX3 promotes IVIG resistance-induced endothelial injury in Kawasaki disease by regulating the NF-κB pathway
  152. Pancreatic ectopic thyroid tissue: A case report and analysis of literature
  153. The prognostic impact of body mass index on female breast cancer patients in underdeveloped regions of northern China differs by menopause status and tumor molecular subtype
  154. Report on a case of liver-originating malignant melanoma of unknown primary
  155. Case report: Herbal treatment of neutropenic enterocolitis after chemotherapy for breast cancer
  156. The fibroblast growth factor–Klotho axis at molecular level
  157. Characterization of amiodarone action on currents in hERG-T618 gain-of-function mutations
  158. A case report of diagnosis and dynamic monitoring of Listeria monocytogenes meningitis with NGS
  159. Effect of autologous platelet-rich plasma on new bone formation and viability of a Marburg bone graft
  160. Small breast epithelial mucin as a useful prognostic marker for breast cancer patients
  161. Continuous non-adherent culture promotes transdifferentiation of human adipose-derived stem cells into retinal lineage
  162. Nrf3 alleviates oxidative stress and promotes the survival of colon cancer cells by activating AKT/BCL-2 signal pathway
  163. Favorable response to surufatinib in a patient with necrolytic migratory erythema: A case report
  164. Case report of atypical undernutrition of hypoproteinemia type
  165. Down-regulation of COL1A1 inhibits tumor-associated fibroblast activation and mediates matrix remodeling in the tumor microenvironment of breast cancer
  166. Sarcoma protein kinase inhibition alleviates liver fibrosis by promoting hepatic stellate cells ferroptosis
  167. Research progress of serum eosinophil in chronic obstructive pulmonary disease and asthma
  168. Clinicopathological characteristics of co-existing or mixed colorectal cancer and neuroendocrine tumor: Report of five cases
  169. Role of menopausal hormone therapy in the prevention of postmenopausal osteoporosis
  170. Precisional detection of lymph node metastasis using tFCM in colorectal cancer
  171. Advances in diagnosis and treatment of perimenopausal syndrome
  172. A study of forensic genetics: ITO index distribution and kinship judgment between two individuals
  173. Acute lupus pneumonitis resembling miliary tuberculosis: A case-based review
  174. Plasma levels of CD36 and glutathione as biomarkers for ruptured intracranial aneurysm
  175. Fractalkine modulates pulmonary angiogenesis and tube formation by modulating CX3CR1 and growth factors in PVECs
  176. Novel risk prediction models for deep vein thrombosis after thoracotomy and thoracoscopic lung cancer resections, involving coagulation and immune function
  177. Exploring the diagnostic markers of essential tremor: A study based on machine learning algorithms
  178. Evaluation of effects of small-incision approach treatment on proximal tibia fracture by deep learning algorithm-based magnetic resonance imaging
  179. An online diagnosis method for cancer lesions based on intelligent imaging analysis
  180. Medical imaging in rheumatoid arthritis: A review on deep learning approach
  181. Predictive analytics in smart healthcare for child mortality prediction using a machine learning approach
  182. Utility of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio in predicting acute-on-chronic liver failure survival
  183. A biomedical decision support system for meta-analysis of bilateral upper-limb training in stroke patients with hemiplegia
  184. TNF-α and IL-8 levels are positively correlated with hypobaric hypoxic pulmonary hypertension and pulmonary vascular remodeling in rats
  185. Stochastic gradient descent optimisation for convolutional neural network for medical image segmentation
  186. Comparison of the prognostic value of four different critical illness scores in patients with sepsis-induced coagulopathy
  187. Application and teaching of computer molecular simulation embedded technology and artificial intelligence in drug research and development
  188. Hepatobiliary surgery based on intelligent image segmentation technology
  189. Value of brain injury-related indicators based on neural network in the diagnosis of neonatal hypoxic-ischemic encephalopathy
  190. Analysis of early diagnosis methods for asymmetric dementia in brain MR images based on genetic medical technology
  191. Early diagnosis for the onset of peri-implantitis based on artificial neural network
  192. Clinical significance of the detection of serum IgG4 and IgG4/IgG ratio in patients with thyroid-associated ophthalmopathy
  193. Forecast of pain degree of lumbar disc herniation based on back propagation neural network
  194. SPA-UNet: A liver tumor segmentation network based on fused multi-scale features
  195. Systematic evaluation of clinical efficacy of CYP1B1 gene polymorphism in EGFR mutant non-small cell lung cancer observed by medical image
  196. Rehabilitation effect of intelligent rehabilitation training system on hemiplegic limb spasms after stroke
  197. A novel approach for minimising anti-aliasing effects in EEG data acquisition
  198. ErbB4 promotes M2 activation of macrophages in idiopathic pulmonary fibrosis
  199. Clinical role of CYP1B1 gene polymorphism in prediction of postoperative chemotherapy efficacy in NSCLC based on individualized health model
  200. Lung nodule segmentation via semi-residual multi-resolution neural networks
  201. Evaluation of brain nerve function in ICU patients with Delirium by deep learning algorithm-based resting state MRI
  202. A data mining technique for detecting malignant mesothelioma cancer using multiple regression analysis
  203. Markov model combined with MR diffusion tensor imaging for predicting the onset of Alzheimer’s disease
  204. Effectiveness of the treatment of depression associated with cancer and neuroimaging changes in depression-related brain regions in patients treated with the mediator-deuterium acupuncture method
  205. Molecular mechanism of colorectal cancer and screening of molecular markers based on bioinformatics analysis
  206. Monitoring and evaluation of anesthesia depth status data based on neuroscience
  207. Exploring the conformational dynamics and thermodynamics of EGFR S768I and G719X + S768I mutations in non-small cell lung cancer: An in silico approaches
  208. Optimised feature selection-driven convolutional neural network using gray level co-occurrence matrix for detection of cervical cancer
  209. Incidence of different pressure patterns of spinal cerebellar ataxia and analysis of imaging and genetic diagnosis
  210. Pathogenic bacteria and treatment resistance in older cardiovascular disease patients with lung infection and risk prediction model
  211. Adoption value of support vector machine algorithm-based computed tomography imaging in the diagnosis of secondary pulmonary fungal infections in patients with malignant hematological disorders
  212. From slides to insights: Harnessing deep learning for prognostic survival prediction in human colorectal cancer histology
  213. Ecology and Environmental Science
  214. Monitoring of hourly carbon dioxide concentration under different land use types in arid ecosystem
  215. Comparing the differences of prokaryotic microbial community between pit walls and bottom from Chinese liquor revealed by 16S rRNA gene sequencing
  216. Effects of cadmium stress on fruits germination and growth of two herbage species
  217. Bamboo charcoal affects soil properties and bacterial community in tea plantations
  218. Optimization of biogas potential using kinetic models, response surface methodology, and instrumental evidence for biodegradation of tannery fleshings during anaerobic digestion
  219. Understory vegetation diversity patterns of Platycladus orientalis and Pinus elliottii communities in Central and Southern China
  220. Studies on macrofungi diversity and discovery of new species of Abortiporus from Baotianman World Biosphere Reserve
  221. Food Science
  222. Effect of berrycactus fruit (Myrtillocactus geometrizans) on glutamate, glutamine, and GABA levels in the frontal cortex of rats fed with a high-fat diet
  223. Guesstimate of thymoquinone diversity in Nigella sativa L. genotypes and elite varieties collected from Indian states using HPTLC technique
  224. Analysis of bacterial community structure of Fuzhuan tea with different processing techniques
  225. Untargeted metabolomics reveals sour jujube kernel benefiting the nutritional value and flavor of Morchella esculenta
  226. Mycobiota in Slovak wine grapes: A case study from the small Carpathians wine region
  227. Elemental analysis of Fadogia ancylantha leaves used as a nutraceutical in Mashonaland West Province, Zimbabwe
  228. Microbiological transglutaminase: Biotechnological application in the food industry
  229. Influence of solvent-free extraction of fish oil from catfish (Clarias magur) heads using a Taguchi orthogonal array design: A qualitative and quantitative approach
  230. Chromatographic analysis of the chemical composition and anticancer activities of Curcuma longa extract cultivated in Palestine
  231. The potential for the use of leghemoglobin and plant ferritin as sources of iron
  232. Investigating the association between dietary patterns and glycemic control among children and adolescents with T1DM
  233. Bioengineering and Biotechnology
  234. Biocompatibility and osteointegration capability of β-TCP manufactured by stereolithography 3D printing: In vitro study
  235. Clinical characteristics and the prognosis of diabetic foot in Tibet: A single center, retrospective study
  236. Agriculture
  237. Biofertilizer and NPSB fertilizer application effects on nodulation and productivity of common bean (Phaseolus vulgaris L.) at Sodo Zuria, Southern Ethiopia
  238. On correlation between canopy vegetation and growth indexes of maize varieties with different nitrogen efficiencies
  239. Exopolysaccharides from Pseudomonas tolaasii inhibit the growth of Pleurotus ostreatus mycelia
  240. A transcriptomic evaluation of the mechanism of programmed cell death of the replaceable bud in Chinese chestnut
  241. Melatonin enhances salt tolerance in sorghum by modulating photosynthetic performance, osmoregulation, antioxidant defense, and ion homeostasis
  242. Effects of plant density on alfalfa (Medicago sativa L.) seed yield in western Heilongjiang areas
  243. Identification of rice leaf diseases and deficiency disorders using a novel DeepBatch technique
  244. Artificial intelligence and internet of things oriented sustainable precision farming: Towards modern agriculture
  245. Animal Sciences
  246. Effect of ketogenic diet on exercise tolerance and transcriptome of gastrocnemius in mice
  247. Combined analysis of mRNA–miRNA from testis tissue in Tibetan sheep with different FecB genotypes
  248. Isolation, identification, and drug resistance of a partially isolated bacterium from the gill of Siniperca chuatsi
  249. Tracking behavioral changes of confined sows from the first mating to the third parity
  250. The sequencing of the key genes and end products in the TLR4 signaling pathway from the kidney of Rana dybowskii exposed to Aeromonas hydrophila
  251. Development of a new candidate vaccine against piglet diarrhea caused by Escherichia coli
  252. Plant Sciences
  253. Crown and diameter structure of pure Pinus massoniana Lamb. forest in Hunan province, China
  254. Genetic evaluation and germplasm identification analysis on ITS2, trnL-F, and psbA-trnH of alfalfa varieties germplasm resources
  255. Tissue culture and rapid propagation technology for Gentiana rhodantha
  256. Effects of cadmium on the synthesis of active ingredients in Salvia miltiorrhiza
  257. Cloning and expression analysis of VrNAC13 gene in mung bean
  258. Chlorate-induced molecular floral transition revealed by transcriptomes
  259. Effects of warming and drought on growth and development of soybean in Hailun region
  260. Effects of different light conditions on transient expression and biomass in Nicotiana benthamiana leaves
  261. Comparative analysis of the rhizosphere microbiome and medicinally active ingredients of Atractylodes lancea from different geographical origins
  262. Distinguish Dianthus species or varieties based on chloroplast genomes
  263. Comparative transcriptomes reveal molecular mechanisms of apple blossoms of different tolerance genotypes to chilling injury
  264. Study on fresh processing key technology and quality influence of Cut Ophiopogonis Radix based on multi-index evaluation
  265. An advanced approach for fig leaf disease detection and classification: Leveraging image processing and enhanced support vector machine methodology
  266. Erratum
  267. Erratum to “Protein Z modulates the metastasis of lung adenocarcinoma cells”
  268. Erratum to “BRCA1 subcellular localization regulated by PI3K signaling pathway in triple-negative breast cancer MDA-MB-231 cells and hormone-sensitive T47D cells”
  269. Retraction
  270. Retraction to “Protocatechuic acid attenuates cerebral aneurysm formation and progression by inhibiting TNF-alpha/Nrf-2/NF-kB-mediated inflammatory mechanisms in experimental rats”
Heruntergeladen am 6.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/biol-2022-0599/html?lang=de
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