Malnutrition and Risk of Mortality in Ischemic Stroke Patients Treated With Intravenous Thrombolysis

Background and Purpose

Malnutrition is highly prevalent in ischemic stroke patients. We aimed to investigate whether malnutrition indexes may be useful in predicting mortality at 90 days in ischemic stroke patients treated with intravenous thrombolysis.

Methods

We retrospectively analyzed consecutive patients who underwent thrombolytic therapy at three comprehensive stroke centers. Malnutrition was assessed using the controlling nutritional status (CONUT) score, geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI).

Results

Of 979 patients (mean age, 66.8 years; males, 63.6%) included in this study, 91 (9.3%; 95% confidence interval [CI]: 8.4–10.2%) died at 3-month follow up. According to the CONUT, GNRI, and PNI scores, 9.9, 33.7, and 7.0% of patients were moderately or severely malnourished, respectively; 64.0% were at least mildly malnourished by at least 1 malnutrition index. In the multivariate regression model after adjusting for potential confounders, malnutrition (severe risk versus normal nutritional status) was significantly associated with an increased risk of mortality for CONUT scores (adjusted odds ratio [OR] 16.16, 95%CI, 7.86-67.11; P < 0.001), GNRI scores (adjusted OR 9.82, 4.10-23.51; P < 0.001) and PNI scores (adjusted OR 12.74, 5.56-29.19; P < 0.001). Similar results were found when the malnutrition scores were analyzed as continuous variables. Adding the three malnutrition indexes to models containing conventional risk factors significantly improved risk reclassification for 3-month mortality.

Conclusion

Our study showed that malnutrition may be associated with a higher risk of mortality at 3 months in ischemic stroke after intravenous thrombolysis.

[Melatonin inhibits growth and metastasis of MDA-MB-231 breast cancer cells by activating autophagy]

OBJECTIVE

To investigate the effects of melatonin on the growth and metastasis of MDA-MB-231 breast cancer cells and explore the mechanism.

METHODS

MDA-MB-231 cells were treated with 1, 3 or 5 mmol/L melatonin, and the changes in cell proliferation were examined using CCK-8 assay. Colony-forming assay and wound healing assay were used to assess the effects of melatonin treatmnent on colony-forming ability and migration of the cells. Flow cytometry and immunofluoresnce assay were employed to examine apoptosis and positive staining for autophagy-related proteins in the cells treated with 3 mmol/L melatonin. The effects of melatonin treatment alone or in combination with 3-methyladenine (3-MA) on the expressions of the proteins associated with autophagy (LC3, P62 and Beclin1), apoptosis (Bcl2 and Bax) and epithelial-mesenchymal transition (E-cadherin and Snail) were examined with Western blotting.

RESULTS

Melatonin treatment significantly inhibited the proliferation of breast cancer cells in a concentration- and time-dependent manner (P < 0.05), suppressed colony-forming ability and migration (P < 0.01), and promoted apoptosis of the cells (P < 0.01). Melatonin treatment alone significantly increased the expressions of Bax (P < 0.05), E-cadherin, LC3-II/LC3-I, and Beclin1 and lowered the expressions of Bcl2 (P < 0.05), Snail, P62 (P < 0.05), and Bcl2/Bax ratio (P < 0.01) in the cells, and caused enhanced positive staining of Beclin1 protein and attenuated staining of P62 protein. Compared with melatonin treatment alone, melatonin treatment combined with 3-MA significantly decreased the expressions of Beclin1 (P < 0.001), LC3-II/LC3-I (P < 0.05), Bax (P < 0.01), and E-cadherin (P < 0.001) and increased the expressions of Bcl2 (P < 0.05), Snail, and Bcl2/Bax ratio (P < 0.01).

CONCLUSION

Melatonin can induce autophagy of MDA-MB-231 breast cancer cells to inhibit cell proliferation and metastasis and promote cell apoptosis, and suppressing autophagy can weaken the inhibitory effect of melatonin on the growth and metastasis of breast cancer cells.

Computational design of phosphoinositide 3-kinase gamma (PI3Kg) inhibitors as a newer therapy for rheumatoid arthritis

Purpose: To develop a potential therapy for rheumatoid arthritis (RA) by altering factors involved in the pathogenesis of the disease. Methods: Molecular docking simulation-based virtual screening was performed against phosphoinositide-3-kinase gamma (PI3Kg) to identify potential leads that may serve as anti-rheumatoid arthritic agents through their interactions and binding energies with the target receptor, followed by their optimization for improvement of their pharmacokinetics and toxicity profiles. Results: Molecular docking simulation-based virtual screening and computational toxicity profiling predicted that the lead compounds ZINC04376856, ZINC01729526, ZINC01045089, ZINC03954520, ZINC01738764, and ZINC01163259 were potent PI3Kg inhibitors. Conclusion: These lead compounds exert potent inhibitory effects on human PI3Kg receptor. Thus, they need to be experimentally validated for use in the development of novel drugs for treating RA in humans.

Effects of Atomoxetine Hydrochloride on Regulation of Lifespan in Drosophila Model

Nootropics (smart drugs) are used by students to enhance cognitive performance which have been reported times in recent years. However, some of the nootropics are central nervous system stimulants which are very likely to lead to addiction or complications such as vomiting and dizziness. Are there nootropics that can improve learning behavior while having potential positive effect on health? Here, we reported that Atomoxetine (ATX) has sex-specific effect on prolonging the life span of female Drosophila melanogaster. Further study indicated that ATX enhanced female resistance to heat stress and their vertical climbing ability, but it did decrease the number of eggs laid. ATX increased food-intake and sleep time both of females and males, and significantly reduced the 24h spontaneous activity of females and males. Our results present the sex dimorphic effect of ATX on life span regulation in Drosophila, and support further research on the beneficial role of ATX and the mechanisms in other animal models.

Capsular Genotype and Lipooligosaccharide Class Associated Genomic Characterizations of Campylobacter jejuni Isolates From Food Animals in China

Campylobacter jejuni (C. jejuni) is the leading causative agent of gastroenteritis and Guillain–Barré syndrome (GBS). Capsular polysaccharide (CPS) and lipooligosaccharide (LOS) contribute to the susceptibility of campylobacteriosis, which have been concern the major evaluation indicators of C. jejuni isolates from clinical patients. As a foodborne disease, food animal plays a primary role in the infection of campylobacteriosis. To assess the pathogenic characterizations of C. jejuni isolates from various ecological origins, 1609 isolates sampled from 2005 to 2019 in China were analyzed using capsular genotyping. Strains from cattle and poultry were further characterized by LOS classification and multilocus sequence typing (MLST), compared with the isolates from human patients worldwide with enteritis and GBS. Results showed that the disease associated capsular genotypes and LOS classes over-represented in human isolates were also dominant in animal isolates, especially cattle isolates. Based on the same disease associated capsular genotype, more LOS class types were represented by food animal isolates than human disease isolates. Importantly, high-risk lineages CC-22, CC-464, and CC-21 were found dominated in human isolates with GBS worldwide, which were also represented in the food animal isolates with disease associated capsular types, suggesting a possibility of clonal spread of isolates across different regions and hosts. This is the first study providing genetic evidence for food animal isolates of particular capsular genotypes harbor similar pathogenic characteristics to human clinical isolates. Collective efforts for campylobacteriosis hazard control need to be focused on the zoonotic pathogenicity of animal isolates, along the food chain “from farm to table.”

[Clinical significance and management strategies of low-level viremia during the treatment of chronic hepatitis B]

Chronic hepatitis B and its related complications seriously endanger the lives and health of our country people. Although the first-line nucleos(t)ide analogs such as entecavir, tenofovir disoproxil fumarate and tenofovir alafenamide fumarate can inhibit virus replication to a certain extent, delay or prevent disease progression, and reduce the incidence of hepatitis B-related liver cancer, but in clinical practice, HBV DNA positivity is still detected continuously or intermittently in the serum of some patients. Therefore, low-level viremia has received widespread attention and triggered discussion, and has become the difficulties and hotspot of antiviral treatment of chronic hepatitis B. This article summarizes and discusses the definition and incidence in line with the main guidelines and studies, impact of disease control and clinical prognosis, and the current treatment options in order to provide definite reference for the management of low-level viremia during antiviral therapy in patients with chronic hepatitis B.

Optofluidic Resonance of a Transparent Liquid Jet Excited by a Continuous Wave Laser

We report a new optofluidic resonating phenomenon that naturally links the optical radiation pressure, total internal reflection, capillary wave, and Rayleigh-Plateau instability together. When a transparent liquid jet is radiated by a focused continuous wave laser beam, the highly ordered periodic jet breakup is unexpectedly triggered and maintained. The capillary wave enables the liquid-gas interface to serve as a rotating mirror reflecting the laser beam in a wide range of angles, including the critical angle for total internal reflection. The liquid jet acts as an optical waveguide to periodically transmit the laser beam to the upstream of the jet. The periodic optical beam transmittance inside the liquid jet exerts time-dependent optical pressure to the jet that triggers the Rayleigh-Plateau instability. The jet breakup process locks in at the frequency corresponding to the peak growth rate of the Rayleigh-Plateau instability of the liquid jet, which agrees with the prediction from the dispersion relation of a traveling liquid jet.

Novel compound heterozygous mutations in the CYP4F22 gene in a patient with autosomal recessive congenital ichthyosis

Autosomal recessive congenital ichthyosis (ARCI) is a rare form of keratinization disorder of the skin, which can be caused by mutations in 14 ARCI genes. We present a rare case of ARCI that carried a novel null mutation and a novel splice site mutation in the CYP4F22 gene.

[Expression of hepatocyte nuclear factor 4γ in gastric carcinoma and its role in cell proliferation and stemness]

Objective: To explore the role and molecular mechanism of hepatocyte nuclear factor 4γ (HNF4γ) in proliferation and stemness of gastric cancer. Methods: A total of 102 cases of paraffin-embedded gastric cancer tissues and matched adjacent gastric tissues and 42 cases of fresh-frozen tissues derived from gastric patients who received radical gastrectomy were collected from the First Affiliated Hospital of Zhengzhou University between 2012 to 2015. The expression of HNF4γ was tested by immunohistochemical staining, quantitative real-time polymerase chain reaction (qRT-PCR). HNF4γ overexpressed (AGS-HNF4γ) and shRNA silenced (HGC27-shHNF4γ) gastric cell lines were established. The effects of HNF4γ on cell proliferation and stemness were verified by XTT, clone formation and sphere formation assay. The expression of CD44 was detected by western blot. Results: The mRNA expression level of HNF4γ in fresh-frozen gastric cancer tissue was (12.43±2.702), which was significantly higher than (3.639±1.109) in normal tissue (P<0.001). The high protein expression rate of HNF4γ in paraffin-embedded gastric cancer tissues was 41.2% (42/102), which was significantly higher than 8.8% (9/102) in normal gastric mucosa tissue (P< 0.001). The protein expression of HNF4γ was closely related to the tumor differentiation, infiltration depth, lymph node metastasis and tumor stage (P<0.05). The median survival interval of patients with HNF4γ high expression was 25 months, the 3-year survival rate was 4.8% (2/42), significantly lower than 38 months and 51.7% (31/60) of patients with normal HNF4γ expression (P<0.001). The proliferation and CD44 protein expression of AGS-HNF4γ cells were significantly higher than those of the AGS-Vector cells. The number of clone formation, sphere formation rate of AGS-HNF4γ cells were 243.5±24.5 and (83.5±3.9)%, significantly higher than 81.0±16.0 and (21.8±5.6)% of AGS-Vector cells (P=0.030 and P=0.010, respectively). The proliferation and CD44 protein expression of HGC27-shHNF4 cells were significantly lower than those of the HGC27-vector cells. The number of clone formation, sphere formation rate of HGC27-shHNF4 cells were 26.0±1.0 and (20.8±8.4)%, significantly higher than 83.5±4.5 and (72.5±4.8)% of HGC27-vector cells (P=0.006 and P=0.030, respectively). Conclusions: HNF4γ is upregulated in the gastric cancer tissues and related with the poor prognosis of patients with gastric cancer. Overexpression of HNF4γ promotes the proliferation and remains the stemness of gastric cancer cells by upregulating the expression of CD44.

Light assisted synthesis of poly-para-phenylene on Ag(001)

A detailed study of poly-para-phenylene (PPP) obtained by light-assisted on-surface-synthesis (OSS) on Ag(100) was carried out by scanning tunneling microscopy and spectroscopy together with density functional theory calculations. The use of light in combination with heat allows to lower by 50 K annealing temperature the each stage of the Ullmann coupling. Debromination of the 4,4″ dibromo-p-terphenyl precursors was thus realized at 300 K, the formation of the first oligomers from the organometallic intermediate by silver bridging atom release at 423 K and PPP by complete elimination of the silver at 473 K. This approach to lower the reaction temperature permits to enhance the Ag(100) surface reactivity to become comparable to that of Cu(111). The underlying mechanism of light effect was proposed to occur via surface mediated excitation, with the creation of photoexcited electrons known as hot electrons correlated with surface plasmon excitation. This original pathway combining both light and heat provides an additional parameter to control OSS by separating the precursor activation stage from the diffusion.

[Diagnosis and treatment of new-onset or uncontrolled hyperthyroidism-induced liver injury]

The thyroid gland is the largest endocrine gland in the human body, which mainly secretes thyroid hormones. Thyroid hormone acts on almost all tissues and cells at different level regulating growth and development, metabolism and other functional activities of the body. Therefore, abnormal thyroid function can affect the multiple organs throughout the body. Liver, as the largest biochemical plant in the whole body, is widely regulated by thyroid hormones, and is one of the important target organs of the thyroid gland. Hyperthyroidism (HT for short) is a common disease of the endocrine system, which can cause liver injury, such as hepatomegaly, abnormal liver function, jaundice, cirrhosis, and liver failure. This phenomenon is also known as hyperthyroidism-induced liver injury, and it is more common in new or untreated or improperly treated patients with hyperthyroidism. The basic liver function test at the beginning of antithyroid drugs (ATD) treatment can clarify the degree of liver injury caused by hyperthyroidism itself, and further predict the additional liver injury with ATD therapy initiation. The core of treating hyperthyroidism-induced liver injury is to rapidly control hyperthyroidism, and restore normal liver function. This review briefly summarizes the incidence rate, possible mechanisms, pathological changes, clinical manifestations, laboratory, imaging and pathologic findings, and the recent advances in diagnosis and treatment of the hyperthyroidism-induced liver injury.

[Studies of the norm of Karitane Parenting Confidence Scale(KPCS)among parents of infants in urban areas of China]

Objective: To establish the norm of the Chinese version of Karitane Parenting Confidence Scale (KPCS) in urban areas of China. Methods: From August to December 2017, the parents of 2 216 children (<36 months old) were selected from 15 cities (Beijing, Lianyungang, Hangzhou, Chengdu, Xi'an, Guangzhou, Changsha, Jinan, Guiyang, Ningbo, Dalian, Qinhuangdao, Maanshan, Chongqing and Wuhan) in 14 provinces by stratified random sampling. The general demographic characteristics and parents' parenting confidence were collected by a self-made questionnaire and KPCS Chinese version. The percentile norm was established. P₃, P₁₀ and P₂₅ were used as the criteria to define the degree of lack of parenting confidence. Results: The age of mothers was (30.67±4.29). The age of the father was (32.50±4.99) years old. There were 726 (32.76%), 759 (34.25%) and 731 (32.99%) infants in 6-12, 12-23 and 24-35 months old groups. The total scores of P₅₀, P₂₅, P₁₀ and P₃ of KPCS (Chinese version) of infant parents in urban areas in China were 41, 38, 33, and 29 respectively. When the scores of parents were 34-37, 30-33, and ≤ 29, they were judged as mild, moderate, and severe lack of parenting confidence. There was no significant difference in the Chinese version of KPCS between parents of different age groups and parents of different gender (χ²=3.53, P=0.171; χ²=1.41, P=0.236). Each factor score≤P₃ is defined as the boundary score, and the corresponding boundary scores of "parenting" "support" and "competence" were 13, 9, and 5 respectively. Conclusion: The Chinese version of KPCS can be used to assess the parenting confidence of infants in urban areas of China. It can used as one of the bases for scientific and objective evaluation of the parenting status of families.

[A prospectively randomized controlled study of the effects of intensive insulin therapy combined with glutamine on nutritional metabolism, inflammatory response, and hemodynamics in severe burn patients]

Objective: To observe the effects of intensive insulin therapy combined with glutamine on nutritional metabolism, inflammatory response, and hemodynamics in severe burn patients. Methods: Thirty-two severe burn patients who met the inclusion criteria and hospitalized in the Affiliated Huaihai Hospital of Xuzhou Medical University from June 2017 to January 2019 were recruited into a prospectively randomized controlled study. According to the random number table, the patients were divided into conventional insulin therapy alone group, conventional insulin therapy+glutamine group, intensive insulin therapy alone group, and intensive insulin therapy+glutamine group, with 8 patients in each group, with genders of 5 males and 3 females, 4 males and 4 females, 3 males and 5 females, 4 males and 4 females, and ages of (35±7), (36±9), (33±11), and (38±7) years, respectively. Patients in conventional insulin therapy alone group were treated with conventional insulin therapy on the basis of routine treatment to control the blood glucose. Patients in conventional insulin therapy+glutamine group were supplemented with alanyl-glutamine for more than 14 days in addition to the treatment in conventional insulin therapy alone group. Patients in intensive insulin therapy alone group were treated with intensive insulin therapy on the basis of routine treatment to control the blood glucose. Patients in intensive insulin therapy+glutamine group were supplemented with alanyl-glutamine in addition to the treatment in intensive insulin therapy alone group. On treatment day (TD) 1, 3, 7, and 14, the blood glucose, albumin, prealbumin, white blood cell count, procalcitonin (PCT), and C-reactive protein (CRP) of patients in the 4 groups were detected. The cardiac index (CI), stroke volume index (SVI), global end-diastolic volume index (GEDVI), systemic vascular resistance index (SVRI), extravascular lung water index (EVLWI), and pulmonary vascular permeability index (PVPI) of patients in the 4 groups on TD 1, 3, and 7 were measured. Data were statistically analyzed with Fisher's exact probability test, one-way analysis of variance, analysis of variance for repeated measurement, and Bonferroni method. Results: All patients in the 4 groups successfully completed the study, and there were no withdrawal cases. On TD 3, 7, and 14, the blood glucose of patients in intensive insulin therapy alone group ((5.9±1.3), (5.8±0.6), (5.5±0.5) mmol/L) and intensive insulin therapy+glutamine group ((5.9±1.1), (5.6±1.1), (5.2±0.8) mmol/L) were significantly lower than those in conventional insulin therapy alone group ((9.1±0.5), (8.4±0.9), (7.4±1.1) mmol/L, P<0.05). Compared with those in conventional insulin therapy alone group, the levels of albumin of patients in conventional insulin therapy+glutamine group, intensive insulin therapy alone group, and intensive insulin therapy+glutamine group were significantly increased on TD 7 and 14 (P<0.05). Compared with the level of albumin of patients in intensive insulin therapy+glutamine group, the levels of albumin of patients in conventional insulin therapy+glutamine group and intensive insulin therapy alone group were significantly decreased on TD 14 (P<0.05). Compared with those in conventional insulin therapy alone group, the levels of prealbumin of patients in conventional insulin therapy+glutamine group and intensive insulin therapy alone group were significantly increased on TD 7 and 14 (P<0.05). Compared with those in intensive insulin therapy+glutamine group, the levels of prealbumin of patients in intensive insulin therapy alone group and conventional insulin therapy+glutamine group were significantly decreased on TD 1, 7, and 14 (P<0.05). There were no statistically significant differences in the white blood cell count, PCT, and CRP of patients in the 4 groups in pairwise comparison between groups on TD 1, 3, 7, and 14 (P>0.05). On TD 3 and 7, the levels of cardiac index, SVI, GEDVI, and SVRI of patients in intensive insulin therapy+glutamine group were significantly higher than those in conventional insulin therapy alone group (P<0.05), while the levels of EVLWI and PVPI were significantly lower than those in conventional insulin therapy alone group (P<0.05). Conclusions: Glutamine combined with intensive insulin therapy can improve the hypermetabolism in patients after severe burns, reduce the decomposition and consumption of endogenous nutrient substrates, and at the same time help the recovery of cardiac function and maintenance of hemodynamic stability.

Percutaneous vertebral augmentation for osteoporotic vertebral compression fractures will increase the number of subsequent fractures at adjacent vertebral levels: a systematic review and meta-analysis

OBJECTIVE

This study aimed to investigate whether percutaneous vertebral augmentation (PVA) was associated with clinical and radiological subsequent adjacent fractures in patients with osteoporotic vertebral compression fractures.

MATERIALS AND METHODS

The systematic review was performed following PRISMA guidelines. Data were retrieved from PubMed, EMBASE, Cochrane Library, Google Scholar, Web of Science, and ClinicalTrial.gov, from database inception to March 2020. Eligible studies were those that assessed subsequent adjacent fractures after PVA in comparison with conservative treatment (CT). The number of patients with adjacent secondary vertebral fractures was calculated, and the pooled risk ratio (RR) with its 95% confidence intervals (95% CI) was used. Moreover, heterogeneity, sensitivity, and publication bias analyses were performed.

RESULTS

Twenty-four studies were included finally. Moreover, 20/421 (4.75%) patients from the PVA group and 25/359 (6.96%) patients from the CT group had clinical subsequent adjacent fractures, and 46/440 (10.45%) patients from the PVA group and 36/444 (8.10%) patients from the CT group had radiological subsequent adjacent fractures. Both had no significant difference between the two groups (RR = 0.67, 95% CI [0.38, 1.19], p = 0.17)/(RR = 1.13, 95% CI [0.75, 1.70], p = 0.576). However, the number of fractured vertebrae was higher in the PVA group than in the CT group (RR = 1.41, 95% CI [1.03, 1.93], p = 0.03). A sensitivity analysis did not identify specific trials that seriously deflected. No obvious publication bias was identified.

CONCLUSIONS

The systematic review revealed that PVA did not increase the incidence for subsequent adjacent fractures regardless of whether they were clinical or radiological fractures. However, PVA can increase the number of subsequent fractures at adjacent vertebral levels.

Analyses of the Tympanic Membrane Impulse Response Measured with High-Speed Holography

The Tympanic Membrane (TM) transforms acoustic energy to ossicular vibration. The shape and the displacement of the TM play an important role in this process. We developed a High-speed Digital Holography (HDH) system to measure the shape and transient displacements of the TM induced by acoustic clicks. The displacements were further normalized by the measured shape to derive surface normal displacements at over 100,000 points on the TM surface. Frequency and impulse response analyses were performed at each TM point, which enable us to describe 2D surface maps of four new TM mechanical parameters. From frequency domain analyses, we describe the (i) dominant frequencies of the displacement per sound pressure based on Frequency Response Function (FRF) at each surface point. From time domain analyses, we describe the (ii) rising time, (iii) exponential decay time, and the (iv) root-mean-square (rms) displacement of the TM based on Impulse Response Function (IRF) at each surface point. The resultant 2D maps show that a majority of the TM surface has a dominant frequency of around 1.5 kHz. The rising times suggest that much of the TM surface is set into motion within 50 µs of an impulsive stimulus. The maps of the exponential decay time of the IRF illustrate spatial variations in damping, the least known TM mechanical property. The damping ratios at locations with varied dominant frequencies are quantified and compared.

Molecular analysis of 53 Chinese families with Wilson's disease: Six novel mutations identified

Background

Wilson's disease (WD) is a rare autosomal recessive inherited disorder that is induced by defects of the ATP7B gene and characterized by damage to the liver and nervous system caused by aberrant copper metabolism. The identification of pathogenic mutations on two homologous chromosomes has become the gold standard for the diagnosis of WD.

Methods

Sanger sequencing and multiplex ligation‐dependent probe amplification (MLPA) were combined to establish a genetic diagnosis for patients from 53 unrelated Chinese WD families.

Results

Biallelic mutations were detected by Sanger sequencing in 50 of the probands, while single heterozygous mutations were detected in the remaining three probands. A total of 45 diverse pathogenic mutations were detected, and 6 previously unreported mutations were involved. Five asymptomatic patients were screened from 85 family members of 38 probands participating in the study.

Conclusion

This study contributes to the enlargement of the mutational spectrum of the ATP7B gene among the population of China and highlights the significance of genetic testing for asymptomatic patients.

Surface Lattice Oxygen Activation by Nitrogen-Doped Manganese Dioxide as an Effective and Longevous Catalyst for Indoor HCHO Decomposition

Oxygen vacancy plays an important role in catalytic oxidation of formaldehyde (HCHO), but the inherent drawback of its thermodynamic instability causes the deactivation of catalysts. Hence, improving the thermodynamic stability of oxygen vacancy is a crux during HCHO oxidation. Here, a novel and simple nitrogen doping of MnO₂/C catalyst is designed for HCHO oxidation at room temperature. The surface lattice oxygen of MnO₂ will be activated by nitrogen-doping, which acts as active sites for HCHO oxidation and solves the thermodynamic instability issue of oxygen vacancy. Furthermore, carbon is doped with nitrogen to promote electron transfer and accelerate the HCHO oxidation process. Therefore, the catalytic activity and stability of the catalyst can be significantly promoted, which can completely remove ∼1 ppm HCHO in the tank within 3 h, and remains highly active after 5 cycles at room temperature (RH = 55%). In addition, the excellent removal performance over the prepared catalyst is also attributed to abundant surface oxygen species, amorphous crystallinity, and low reduction temperature. In situ diffuse reflectance infrared Fourier transform spectrometry (DRIFTS) and density functional theory (DFT) calculations reveal the reaction mechanism of HCHO. This strategy provides crucial enlightenment for designing novel Mn-based catalysts for application in the HCHO oxidation field.

Improved oxygen activation over metal-organic-frameworks derived and zinc-modulated Co@NC catalyst for boosting indoor gaseous formaldehyde oxidation at room temperature

The indoor low-concentration formaldehyde (HCHO) removal in cobalt-based catalysts is still a "hot potato". In this work, metal-organic-frameworks (MOF)-derived and Zinc (Zn)-modulated new cobalt nanoparticles catalyst (CZ-Co@NC-800) was designed and prepared. The CZ-Co@NC-800 performed outstanding elimination activities for ~1 ppm HCHO at 25 °C. In the static test condition, it achieves complete HCHO removal in 3 h at a relative humidity (RH) of ~55%. Moreover, 90.18% HCHO removal ratio is held after five recycle tests. In the dynamic test condition, it remains the characteristic to eliminate around 95.89% of HCHO within 8 h under an RH of ~55% and a gas hourly space velocity (GHSV) of ~150,000 mL·h^-1g^-1. Such advanced results should be ascribed to large specific surface area bringing about more cobalt active sites; and it is also because residual Zn metal affects the electronic structure of CZ-Co@NC-800 and enhance the surface charge transfer rate, thus the activation and dissociation ability of oxygen is promoted. Besides, a short HCHO reaction path over CZ-Co@NC-800 which was clarified by the In situ DRIFTs is also a reason for excellent catalytic performance. This work represents a crucial addition to expand the family of cobalt-based catalysts for indoor HCHO elimination.

AB0221 CURRENT IMPLEMENTATION OF TREAT-TO-TARGET APPROACH IN RHEUMATOID ARTHRITIS TREATMENT: THE PERSPECTIVE OF CHINESE RHEUMATOLOGISTS

Background:

Treat-to-target (T2T) approach is recommended as a standard management strategy in rheumatoid arthritis (RA) treatment by Chinese guideline for diagnosis and treatment of RA[1]. However, there is little known about its current implementation in China.

Objectives:

This study aimed to evaluate the implementation and achievement of T2T approach and explore their associated factors in Chinese RA cohort.

Methods:

A comprehensive cross-sectional survey of rheumatologists and their RA patients was conducted in China. Data were collected during May-Aug 2019 via physician-completed patient record forms. 60 rheumatologists provided data on demographic, clinical characteristics, treatments, and T2T approach implementation for 600 RA patients. Two logistic regressions were used to evaluate factors associated with T2T approach implementation and T2T goal achievement, respectively. Patients with missing data were not included in the models.

Results:

600 patients were included in this study (48.8±11.7 years, 70.3% female). 39.0% (N=234) of 600 patients were being treated with T2T approach, and 64.9% (N=366) of 564 patients had achieved T2T goal. Patients with longer disease duration (>2 years diagnosis) (odds ratio (OR) [95%CI]=1.61 [1.05, 2.49], vs. diagnosis ≤2 years), higher pain score (OR [95%CI]=1.26 [1.04, 1.51]), or receiving advanced therapy (OR [95%CI]=6.91 [3.64, 13.13]) were more likely to use T2T. Patients with BMI >23.9kg/m2 (OR [95%CI]=2.83 [1.59, 5.04], vs. BMI≤23.9kg/m2), or who worked full-time (OR [95%CI]=2.12 [1.26, 3.57]) were more likely to achieve T2T goal, while patients with more pain (OR [95%CI]=0.77 [0.64, 0.92]) were less likely to achieve T2T goal.

Conclusion:

Low implementation of T2T approach is observed in Chinese RA treatment. Longer disease duration, more pain, and receiving advanced therapy are associated with higher probability of T2T use, while higher BMI, full-time work and less pain are associated with higher probability of T2T goal achievement. Standard diagnosis and treatment according to guidelines may improve T2T approach implementation.

References:

[1]Association, C.R., 2018 Chinese guideline for the diagnosis and treatment of rheumatoid arthritis. Zhonghua nei ke za zhi, 2018. 57(4): p. 242.

Disclosure of Interests:

Jiu-liang Zhao: None declared, Xin Liu Employee of: Eli Lilly and Company, Lujing Zhan Employee of: Eli Lilly and Company, Hongyu Tang Employee of: Eli Lilly and Company (Intern), Jinnan Li Employee of: Eli Lilly and Company, Mengru Liu Employee of: Eli Lilly and Company, Elizabeth Holdsworth Consultant of: Eli Lilly and Company, Employee of: Adelphi Real World, Yan Zhao: None declared

[Role of the liver-enriched transcription factor binding site mutation in the C promoter region of hepatitis B virus genome for HBx-enhanced hepatitis B virus replication]

Objective: To construct a recombinant HBV replication-type plasmid with liver-enriched transcription factor binding site mutation at proximal of HBV C promoter in order to elucidate the role of HBx-enhanced HBV replication. Methods: Site-directed mutagenesis technology was used to construct a recombinant plasmid with liver-enriched transcription factor binding site mutation at proximal of HBV C promoter on the basis of wild-type HBV replicating plasmid and HBV replicating plasmid lacking HBx expression. Subsequently, plasmid transfection was carried out in HBV liver cancer cell replication model and mouse replication model, and HBV replication intermediates of cells and mouse liver tissue were extracted for detection. Results: Based on the HBV replicating plasmid, the HBV replicating plasmid with liver-enriched transcription factor binding site mutation at proximal of HBV C promoter was successfully constructed. HBx-enhanced HBV replication were detected in both the HBV liver cancer replication model and the mouse replication model. After mutating liver-enriched transcription factor binding site mutation at proximal of HBV C promoter, the effect of HBx on the enhancement of HBV replication was not significantly affected. Conclusion: HBx may not enhance HBV replication through liver-enriched transcription factor binding site mutation at proximal of HBV C promoter. The role of other liver-enriched transcription factor binding sites in HBx-enhanced HBV replication needs further study.