Long-term outcomes after nucleos(t)ide analogue discontinuation in HBeAg-positive chronic hepatitis B patients

Nucleos(t)ide analogue (NUC) resistance is an important clinical risk resulting from long-term therapy in chronic hepatitis B (CHB) management. Discontinuation of NUCs is a feasible strategy to reduce resistance. We aimed to observe the outcomes after NUC withdrawal in HBeAg-positive CHB patients. A total of 97 patients (11 patients with HBsAg loss and 86 patients with sustained HBeAg seroconversion) were enrolled. HBV DNA levels and alanine aminotransferase (ALT) levels were monitored regularly after discontinuation. Relapse was defined as HBV DNA levels >2000 IU/mL in at least two determinations more than 4 weeks apart. HBeAg seroconversion was achieved within 48 weeks (interquartile range (IQR), 24-72 weeks). The time on consolidation therapy was 96 weeks (IQR, 84-144 weeks). No relapses occurred for HBsAg loss patients. Evidence of relapse was observed in 9.3% of HBeAg seroconversion patients. All relapse cases occurred within 48 weeks after discontinuation. The time to relapse was 33 ± 15 weeks. Elevation of HBV DNA and ALT levels over baseline were only observed in 12.5% of relapse patients. There were no significant differences in baseline characteristics (sex, HBV genotype, age or ALT levels) or time on consolidation therapy between patients with relapse or sustained response. NUC discontinuation in HBeAg-positive CHB patients is feasible after achieving HBeAg seroconversion at a minimum of 24 weeks. There is further benefit to prolonging the time on consolidation therapy to reduce relapse. More than 48 weeks of sustained response is a predictive marker for long-term sustained response.

[Antibiotic resistance of Helicobacter pylori in children and macrolide-resistant genotypes in Helicobacter pylori]

OBJECTIVE

To explore the antibiotic resistance of Helicobacter pylori (H.pylori ) in children and identify 23 S rRNA gene mutations in macrolide-resistant strains.

METHODS

From December 2008 to December 2010, a total of 73 H.pylori strains were isolated from 120 gastric mucosa specimens obtained from children of gastrointestinal symptoms with a diagnosis of gastritis or peptic ulcer underwent gastroscopy. The antibiotic resistance to 9 antibiotics of 73 H.pylori strains isolated from gastric biopsies was detected by E-test method. Mutations in 23 S rRNA gene of macrolide-resistant of isolated H.pylori strains were examined by polymerase chain reaction (PCR).

RESULTS

Seventy-three H.pylori strains (60.8%) were isolated from gastric biopsies.Seventy were drug resistance strains and only 3 sensitive strains.No resistance to amoxicillin, gentamicin and tetracycline was observed. The resistance rate to azithromycin, clarithromycin, metronidazole, rifampicin, levofloxacin and moxifloxacin was 79.5% (58/73), 80.8% (59/73), 58.9% (43/73), 6.8% (5/73), 12.3% (9/73) and 13.7% (10/73) respectively. The dual, triple and quadruple antibacterial resistant percentage was 47.9% (35/73), 8.2% (6/73) and 1.4% (1/73) respectively. And the multi-drug resistance rate to clarithromycin, azithromycin and metronidazole was 43.8% (32/73). The gene mutation rate of A2142C,A2142G, and A2143G in 23 S rRNA gene was 1.6% (1/64), 6.3% (4/64) and 85.9% (55/64) respectively.

CONCLUSIONS

There is a high rate of multi-drug resistance to clarithromycin, azithromycin and metronidazole in H.pylori strains isolated from children at our hospital. Therefore amoxicillin and rifampicin sensitive to H.pylori strains should be considered for H.pylori eradication. A2143G is the most populated mutation in macrolide-resistant strains.

[Classification and grading of environments with Oncomelania hupensis snails inside embankment of marshland and lake areas]

OBJECTIVE

To classify and grade the environments with Oncomelania hupensis snails inside embankment in marshland and lake areas, so as to improve the work efficiency and realize the systematic management.

METHODS

The schistosomiasis endemic area Liaodi and Xiongdi villages in Jiangling County, Hubei Province were selected as the experiment villages, and the environments with snails in the two villages were divided into sections with a length of 500 m, then the snail situation were surveyed by the systematic sampling method with 10 m and 50 m a frame respectively. The environments were classified according to the discovery of infected snails and wild fecal contamination, and the numbers of sites with snails and their areas in different classes were recorded. Meanwhile, the data of sites with infected snails in Jingzhou City during the recent 5 years were collected and graded according to the average density of snails, so as to discuss the correlativity between the grades of environments with snails and the numbers of sites with infected snails and the occurrence rate of frames with snails.

RESULTS

There were 1 967 sites with infected snails in Jingzhou City during the recent 5 years, and there was a positive correlation between the grades of environments with snails and the occurrence rate of frames with snails (r(s) = 0.77, P < 0.01), when the grade was 5, the constituent ratio of numbers of sites with infected snails was 3.1%, and when the grade was 2-3, the ratio raised to 56.3%. There were 39 sites with snails in the two villages, the Class 1, 2 and 3 environments included 1, 18 and 20 sites, with the areas of 1080, 51,640 m2 and 41,220 m2, respectively. There were no statistically significant difference between the grades divided by snail survey with 10 m and 50 m a frame ( chi2 = 4.667, P > 0.05), but the time-consuming of the former was 3 times of the latter.

CONCLUSIONS

The classification and grading of the environments with snails inside embankment in marshland and lake areas can master the key point of the snail survey. The subsection and setting frames at a suitable distance can save time and manpower, improve work efficiency, as well as understand the distribution of snail status of the environment with snails, which can realize the sort management of the snail environments inside embankment.

CSMD1 exhibits antitumor activity in A375 melanoma cells through activation of the Smad pathway

In this work, we studied the effects of CUB and Sushi multiple domains 1 gene (CSMD1) expression in A375 melanoma cells in vivo and in vitro. CSDM1 expression decreased proliferation and migration, and increased apoptosis and G(1) arrest in A375 cells in vitro. Expression of CSDM1 in established xenografted tumors decreased tumor size and weight, and decreased the density of intratumor microvessels. The survival rate of mice with tumors expressing CSMD1 was significantly higher than mice with tumors that did not express CSDM1. These results confirm the role of CSDM1 as a tumor suppressor gene in melanoma cells. Furthermore, we found that CSMD1 can interact with Smad3, activate Smad1, Smad2, and Smad3, and increase the expression of Smad4. These results might prove helpful for the development of novel therapies for melanoma treatment.

Residential exposure to 50 Hz magnetic fields and the association with miscarriage risk: a 2-year prospective cohort study

Objective

The hypothesis of whether exposure to extremely low-frequency magnetic fields (ELF-MF) may increase miscarriage risk is controversial. A 2-year prospective cohort study was designed to study the association between exposure to 50 Hz magnetic fields (MF) and the miscarriage risk for women residing in the area of the Pearl-River Delta of China.

Method

Two towns with densely distributed power supply constructions were selected as the study sites. From 2010 to 2012, 552 women in the region who were at approximately 8 weeks of gestation or who planned to have a baby within 1 year were selected as candidate subjects. Exposure to MF was estimated by measurements at their front doors and in the alley in front of the subjects’ houses. The average exposure level was used as a cutoff point to define the exposed group. Clinical miscarriage was diagnosed by local obstetricians. Staffs from the local population and family planning service stations were responsible for the follow-up interviews every 2 months.

Results

Four hundred and thirteen pregnant women were selected for the cohort study. The average residential exposure to MF was 0.099 µT. No significantly increased risk of miscarriage was found to be associated with the average front-door exposure (p>0.05). However, miscarriage risk was found to be significantly associated with maximum alley exposure (p=0.001). The relative risk (RR) of miscarriage from maximum alley exposure was 2.35 (95% C.I.: 1.18-4.71). In addition, Cox regression analysis showed that the adjusted hazard ratio of maximum alley exposure for miscarriage was 1.72 (95% C.I.:1.10-2.69).

Conclusion

Although the miscarriage incidence was shown to be positively associated with the maximum alley MF exposure, the association between miscarriage risk and the exposure to MF was not confirmed in the study. The results of this study are of interest concerning MF exposure assessment and pregnancy outcomes.

Histone acetyltransferase p300 promotes MKL1-mediated transactivation of catechol-O-methyltransferase gene

Previous studies have revealed that histone acetyltransferase p300 is recruited to the promoters of certain cardiac and smooth muscle specific genes to enhance the transactivation activity of myocardin, which is a master regulator in cardiovascular differentiation and development. Here, we found that the gene encoding catechol-O-methyltransferase (COMT), an important metabolic enzyme catalyzing the conversion of estrogen, is also a target gene of myocardin-related transcription factors (MRTFs). Megakaryoblastic leukemia 1 (MKL1, also named MRTF-A) and p300 could synergistically augment the expression of COMT gene, increase the metabolic rate of estrogen, and thus reduce the proliferation of MCF-7 breast cancer cells stimulated by estrogen.

Myocardin-related transcription factor A is up-regulated by 17β-estradiol and promotes migration of MCF-7 breast cancer cells via transactivation of MYL9 and CYR61

Many lines of evidence have suggested that estrogen plays important roles not only in the initiation and proliferation of breast cancer, but also in cancer metastasis. However, the mechanistic basis of the latter events is poorly understood. In addition, recent studies have suggested that myocardin-related transcription factor A (MRTF-A) might be related to cancer metastasis. However, as reports are contradictory, certain of its roles still remain confusing. In the present study, we showed that excessive 17β-estradiol could promote the migration of MCF-7 breast cancer cells and up-regulate the expression of MRTF-A, myosin regulatory light chain 9 (MYL9), and cysteine-rich angiogenic inducer 61 (CYR61). Overexpression of MRTF-A significantly promoted the migration of MCF-7 cells through its transactivation effects on MYL9 and CYR61 genes, while RNA interference-mediated knockdown of MRTF-A strongly inhibited transcription and expression of the target genes and reduced the migration ability of MCF-7 cells. These results provided novel evidence supporting the metastasis-promoting functions of MRTF-A, and implied that MRTF-A might be a switch for the estrogen pathway to change its proliferation-promoting roles into migration-stimulating roles in breast cancer.

Histone methyltransferase SMYD3 promotes MRTF-A-mediated transactivation of MYL9 and migration of MCF-7 breast cancer cells

Myocardin-related transcription factor-A (MRTF-A) is a Rho signal-responsive transcriptional coactivator of serum response factor (SRF). Recent studies indicated that MRTF-A might be an important regulator of mammary gland and be involved in cancer metastasis. However, the roles of histone modification in the MRTF-A-dependent signal pathway and tumor migration are still not very clear. Here, we report that histone methylation is required for the MRTF-A-mediated upregulation of myosin regulatory light chain 9 (MYL9), an important cytoskeletal component which is implicated in cell migration. Furthermore, we demonstrate that SET and MYND domain containing protein 3 (SMYD3), a hitone methyltransferase (HMT) associated with carcinogenesis, might be the one which is responsible for the histone methylation occurred in the MRTF-A-mediated- transactivation of MYL9 and migration of breast cancer cells. Overexpression of SMYD3 promotes MRTF-A-mediated upregulation of MYL9 and migration of MCF-7 breast cancer cells, while contrary results were observed when the endogenous MRTF-A and SMYD3 were suppressed with specific siRNAs. In addition, the mutation analysis suggested that this cooperative transactivation is mainly mediated via the proximal binding element of MRTF-A in the promoter of MYL9, and the HMT activity of SMYD3 is required as well. Our findings reveal a new mechanism by which MRTF-A and SMYD3 functions in transcriptional regulation and cell migration, and provide a better understanding for metastasis of breast cancer.

Extraneuronal monoamine transporter mediates the permissive action of cortisol in the Guinea pig trachea: possible involvement of tracheal chondrocytes

Cortisol, a member of glucocorticoids, could potentiate the action of catecholamine by a non-genomic mechanism. Although this permissive effect has been well appreciated in the anti-asthmatic medication, the underlying signaling pathway has remained mysterious. Here, we show that extraneuronal monoamine transporter (EMT), a membraneous reuptake transporter for circulating catecholamine clearance, is the direct target of cortisol in its permissive effect. We found that BSA-conjugated cortisol, which functions as a cortisol but cannot penetrate cell membrane, enhanced the spasmolytic effect of β-adrenoceptor agonist (isoprenaline) in histamine-sensitized tracheal spirals of guinea pigs, and pharmacological inhibition of EMT with famotidine was powerful enough to imitate the permissive action of cortisol. To our surprise, EMT protein expression was high in the chondrocytes of tracheal cartilage, but was undetectable in tracheal smooth muscle cells. The functionality of EMT was further confirmed with measurement of catecholamine uptake by tracheal chondrocytes. Moreover, cortisol-initiated membrane signaling could activate protein kinase C (PKC), which phosphorylates EMT and induces its internalization via a lipid raft-dependent pathway. Both of the mechanisms slow down the reuptake process by chondrocytes, leading to extracellular catecholamine accumulation and results in a more profound adrenergic signaling activation in tracheal smooth muscle cells. Thus, an EMT-centered pathway was proposed to explain the permissive action of cortisol. Collectively, our results highlight the role of EMT in the crosstalk between glucocorticoid and catecholamine. EMT may represent a promising target for adrenergic signaling modulation.

Association between copy number variations of HLA-DQA1 and ankylosing spondylitis in the Chinese Han population

Ankylosing spondylitis (AS) is a chronic inflammatory disease with complex genetic traits. Multiple sequence variations have been associated with AS, but explained only a proportion of heritability. The studies herein aimed to explore potential associations between genomic copy number variation (CNV) and AS of Han Chinese. Five AS patients were examined with the high-density comparative genomic hybridization (CGH) microarrays in the first screen test for AS associated CNVs. A total of 533 AS patients and 792 unrelated controls were examined in confirmation studies with the AccuCopy assays. A significant association was observed between the CNV of the HLA-DQA1 and AS. Comparing with controls, AS patients showed an aberrant copy number (CN), and significantly increased number of patients had more than 2 copies of the HLA-DQA1. Therefore, CNV of the HLA-DQA1 may play an important role in susceptibility to AS in Han Chinese population.

A simply HPLC method for determination of cefpodoxime in Chinese volunteer and pharmacokinetic study

A sensitive HPLC method was developed for the determination of cefpodoxime in human plasma. After protein precipitation with acetonitrile, sample was injected into the HPLC system for analysis. The chromatographic separation was carried out on a Diamonsil C18 column with a mobile phase consisting of acetonitrile-water. The mobile phase composed of water (containing 20 mmol/L monoammonium phosphate) and acetonitrile (90: 10, v/v). The detection wavelength was set at 254 nm. The standard curve for cefpodoxime was linear over the concentration range of 0.05-8 μg/mL with a lower limit of quantification of 0.05 μg/mL. The intra- and inter-day RSD values were lower than 10%, and the RE values were within±5%. For the pharmacokinetic analysis of plasma, the mean (SD) values obtained for the formulation were: Cmax, 4.21 (0.62) µg/mL; Tmax, 2.47 (0.61) h; t1/2, 2.38 (0.46) h; AUC0-24 h, 21.13 (3.39) µg/mL/h; and AUC0-∞, 23.34 (3.87) µg/mL/h; MRT, 2.21 (0.41) h, respectively.

Anthropometric nasal analysis of Han Chinese young adults

BACKGROUND

There are varying degrees of racial differences in the size, shape, proportions of the facial structures.

METHODS

A total of 900 Han Chinese young adults (501 females and 399 males) were included in the analysis. Measurements taken of the soft tissue of the external nose included 12 items of linear distance and 5 angles. Six proportion indices of the soft tissue of the external nose were determined.

RESULTS

In the 12 parameters of linear measurement, females were found to have significantly smaller nasal base width, nasal ala length, nasal ala thickness, columella height, columella width, and nasal tip width in comparison to males (all, P < 0.01). In the five angular measurements, females were found to have a smaller nasal tip angle and nasolabial angle (both, P < 0.05) and a larger nostril tilt angle, nasofrontal angle, and nasal tip angle (all, P < 0.001). Nasal depth-nasal width and columella height-nasal depth were both significantly less in males than females (53.25 ± 8.2 vs. 54.56 ± 9.7 and 51.61 ± 11.92 vs. 53.37 ± 12.56, respectively); whereas nasal ala length-nasal height was significantly less in females than in males (29.41 ± 8.95 vs. 30.9 ± 7.02).

CONCLUSION

Significant differences are present in nasal indices of males and females of Han Chinese ancestry. These data may serve as a reference standard for nasal reconstructive and aesthetic surgery.

Distinct roles of different fragments of PDCD4 in regulating the metastatic behavior of B16 melanoma cells

Melanoma is an aggressive cutaneous malignancy. In this study, we demonstrated that the levels of the programmed cell death 4 (PDCD4) protein and mRNA were lower in tumor tissues compared with normal tissues. In order to further investigate the effects of PDCD4 and its fragments in B16 melanoma cells, we established B16 clones with expression of different PDCD4 fragments. Intact PDCD4, PDCD4∆164‑469 and PDCD4∆327-440 expression, respectively, decreased proliferation and migration and increased apoptosis in B16 cells in vitro. We found that intact PDCD4, PDCD4∆164-469 or PDCD4∆327-440 can inhibit the activity of MMP-2 and the expression of CXCR4. However, PDCD4∆164-275 showed no effects on B16 cells. These results may prove helpful for the development of novel therapies for melanoma treatment.

Measurement of the azimuthal anisotropy of neutral pions in Pb-Pb collisions at sqrt[s](NN)] = 2.76 TeV

First measurements of the azimuthal anisotropy of neutral pions produced in Pb-Pb collisions at a center-of-mass energy of sqrt[s(NN)] = 2.76 TeV are presented. The amplitudes of the second Fourier component (v(2)) of the π(0) azimuthal distributions are extracted using an event-plane technique. The values of v(2) are studied as a function of the neutral pion transverse momentum (p(T)) for different classes of collision centrality in the kinematic range 1.6<p(T) <8.0 GeV/c, within the pseudorapidity interval |η|<0.8. The CMS measurements of v(2) (p(T)) are similar to previously reported π(0) azimuthal anisotropy results from sqrt[s(NN)] = 200 GeV Au-Au collisions at RHIC, despite a factor of ∼ 14 increase in the center-of-mass energy. In the momentum range 2.5<p(T)<5.0 GeV/c, the neutral pion anisotropies are found to be smaller than those observed by CMS for inclusive charged particles.

CD44v6 expression in human skin keratinocytes as a possible mechanism for carcinogenesis associated with chronic arsenic exposure

Inorganic arsenic is a well-known human skin carcinogen. Chronic arsenic exposure results in various types of human skin lesions, including squamous cell carcinoma (SCC). To investigate whether mutant stem cells participate in arsenic-associated carcinogenesis, we repeatedly exposed the human spontaneously immortalized skin keratinocytes (HaCaT) cell line to an environmentally relevant level of arsenic (0.05 ppm) in vitrofor 18 weeks. Following sodium arsenite administration, cell cycle, colony-forming efficiency (CFE), cell tumorigenicity, and expression of CD44v6, NF-κB and p53, were analyzed at different time points (0, 5, 10, 15, 20, 25 and 30 passages). We found that a chronic exposure of HaCaT cells to a low level of arsenic induced a cancer stem-like phenotype. Furthermore, arsenictreated HaCaT cells also became tumorigenic in nude mice, their growth cycle was predominantly in G2/M and S phases. Relative to nontreated cells, they exhibited a higher growth rate and a significant increase in CFE. Western blot analysis found that arsenic was capable of increasing cell proliferation and sprouting of cancer stem-like phenotype. Additionally, immunohistochemical analysis demonstrated that CD44v6 expression was upregulated in HaCaT cells exposed to a low level of arsenic during early stages of induction. The expression of CD44v6 in arsenic-treated cells was positively correlated with their cloning efficiency in soft agar (r=0.949, P=0.01). Likewise, the expressions of activating transcription factor NF-κB and p53 genes in the arsenic-treated HaCaT cells were significantly higher than that in non-treated cells. Higher expressions of CD44v6, NF-κB and p53 were also observed in tumor tissues isolated from Balb/c nude mice. The present results suggest that CD44v6 may be a biomarker of arsenicinduced neoplastic transformation in human skin cells, and that arsenic promotes malignant transformation in human skin lesions through a NF-κB signaling pathway-stimulated expression of CD44v6.