The prevalence of undifferentiated <i>Ureaplasma</i> spp. in NGU in China and the world.

a<p><i>χ²</i> = 1.430, <i>P</i> = 0.232 between the NGU and control groups in the world.</p><p><i>χ²</i> = 2.145, <i>P</i> = 0.143 between the NGU and control groups in China.</p><p><i>χ²</i> = 18.57, <i>P</i><0.0001 for the NGU group between China and the world.</p><p><i>χ²</i> = 5.33, <i>P</i> = 0.021 for the control group between China and the world.</p><p>The prevalence of undifferentiated <i>Ureaplasma</i> spp. in NGU in China and the world.</p

Flow diagram of the literature search process.

<p>Flow diagram of the literature search process.</p

Forest plots for the meta-analysis of the association of differentiated <i>U. urealyticum</i> and <i>U. parvum</i> with NGU.

<p>(A) Comparison of the <i>U. urealyticum</i> infection rate between the NGU and control groups. (B) Comparison of the <i>U. parvum</i> infection rate between the NGU and control groups.</p

Funnel plot for the meta-analysis of the distribution of <i>U. urealyticum</i> and <i>U. parvum</i> within the NGU group.

<p>The horizontal line represents the natural log (ln) of the combined OR. The funnel lines represent the pseudo 95% confidence limit.</p

Are <i>Ureaplasma</i> spp. a Cause of Nongonococcal Urethritis? A Systematic Review and Meta-Analysis

<div><p>Background</p><p>Nongonococcal urethritis (NGU) is the most common male reproductive tract syndrome. <i>Ureaplasmas</i> spp. including <i>U. urealyticum</i> and <i>U. parvum</i>, have been increasingly reported to be implicated in NGU. However, there are still many contradictions about their pathogenic role in NGU.</p><p>Aims</p><p>The goals of this study were to evaluate the association of <i>Ureaplasmas</i> spp. with NGU, and to compare the prevalence of <i>Ureaplasmas</i> spp. infection in China relative to the world average.</p><p>Methods</p><p>A systematic review and meta-analysis was conducted following standard guidelines for meta-analysis. The quality of included studies was assessed by Newcastle-Ottawa scale.</p><p>Results</p><p>A total of seven studies involving 1,507 NGU patients and 1,223 controls were eligible for meta-analysis. There was no significant difference in the <i>Ureaplasma</i> spp. positive rate between the NGU and control groups. However, the <i>U. urealyticum</i> positive rate was significantly higher in NGU patients compared to controls; the <i>U. parvum</i> positive rate was significantly higher in controls compared to NGU patients. Furthermore, within the NGU patient group, the positive rate of <i>U. urealyticum</i> was significantly higher than that of <i>U. parvum</i>, whereas within the control group, the opposite trend was observed. Compared to the world average, a significantly higher positive rate of <i>Ureaplasma</i> spp. was observed in both the NGU and control groups in China.</p><p>Conclusions</p><p>Our analysis supports that <i>U. urealyticum</i>, but not <i>U. parvum</i>, is an etiological agent in NGU. More detailed studies of these two species in China and the world could contribute to a better understanding of the epidemiology and pathogenesis, and facilitate the development of better strategies for treatment and prevention of NGU.</p></div

The analysis of AgNPs Characterizations by TEM.

<p>A. The AgNPs show the regular nanoparticle shape with the diameter ranging from 5 to 10nm. B. The elemental silver was conformed by EDX spectrum during the TEM experiment.</p

The observation of the micrograph of <i>E</i>. <i>coli</i> cells by TEM.

<p>A. Control group with no AgNPs stimulated. The typical morphology of <i>E</i>. <i>coli</i> was observed with the integrity cell membrane. B. <i>E</i>. <i>coli</i> stimulated with 5 μg/ml AgNPs group. The integrity cell membrane with no significant obvious damage can be found. Besides that, several electron dense granules also can be observed (the red arrow). C. <i>E</i>. <i>coli</i> stimulated with 10 μg/ml AgNPs group. There are also electron dense granules in <i>E</i>. <i>coli</i> (the red arrow), and the cell membrane also show the integrity.</p

Determination of <i>E</i>. <i>Coli</i>. growth by taking the absorbance at 600 nm and counting CFU.

<p>A. The normal growth curve by analyzing the absorbance at 600 nm. B. The normal growth curve by counting the CFU. C. The assessment of toxicity of NP-Ag in <i>E</i>. <i>Coli</i>. growth by plotting the curve of absorbance. D. The toxicity of NP-Ag in <i>E</i>. <i>Coli</i>. growth by CFU counting.</p

The analysis of the apoptosis in the cells.

<p>A. Flow cytometric analysis for apoptosis bacterial percentage using Annexin V-PI staining (one experiment results). B, C and D. statistic analysis for apoptosis bacterial percentage by One-way ANOVA test, followed Tukey’s multiple comparison test (n = 3). B shows the total percentage of apoptosis bacteria. C shows the percentage of apoptosis bacteria in early stage, including the bacteria in the PI-negative Annexin V-positive quadrant. D shows the percentage of apoptosis bacteria in middle and late stage, including the bacteria in PI-positive Annexin V-positive quadrant.</p

The new DNA systhesis analysis by ELISA.

<p>A. growth inhibition results of different concentration of AgNPs at the same time. B. Growth inhibition for the same concentration of AgNPs at different times. All data was analyzed by One-way ANOVA test and Tukey’s multiple comparison test following (n = 3).</p