[Study of endoplasmic reticulum stress role in hepatic failure induced by severe hepatitis B]

Objective: To investigate the endoplasmic reticulum stress (ERS) role in the course of liver failure induced by severe hepatitis B virus (HBV) infection and its related mechanism. Methods: Liver tissue samples and clinical data [chronic hepatitis B patients (12 cases, chronic hepatitis B group), hepatic failure induced by severe hepatitis B virus (12 cases, severe hepatitis B virus liver failure group), and normal subjects (8 cases, control group)] were collected from the Beijing You'an Hospital affiliated to Capital Medical University between 2009 to 2011. Statistical analysis was performed on the clinical indicators of each group. The structure of endoplasmic reticulum in liver tissue was observed by transmission electron microscopy. Western blot and qRT-PCR were used to detect the expression of endoplasmic reticulum stress and apoptosis-related factors, including glucose-regulated protein (Grp), and C/EBP homologous protein (CHOP). Frozen sections of liver tissues were prepared for immunofluorescence test. All data were expressed as mean ± standard deviation. LSD-t test was used to compare the results between groups. A p value < 0.05 was considered as statistically significant. Results: Transmission electron microscopy showed that the morphological structure of the endoplasmic reticulum was damaged in both groups (chronic hepatitis B and liver failure induced by severe hepatitis B virus), and liver failure induced by severe hepatitis B virus group was more critical. Western blot and qRT-PCR showed that Grp78, Grp94 and Caspase-4 were highly expressed in normal group and chronic hepatitis B group, and the relative protein expressions were 1.20 ± 0.13 and 0.78 ± 0.11, 0.90 ± 0.06 and 0.11 ± 0.01, 0.15 ± 0.02 and 0.22 ± 0.04, respectively. The expression of protein was weakened in liver failure induced by severe hepatitis B virus group (relative protein expression was 0.01 ± 0, 0.01 ± 0, and 0.11 ± 0.02, respectively).There was a statistically significant difference between the two groups (P < 0.05). The expression of CHOP was consistent with the results of immunofluorescence, and increased with the stressing of injury. Conclusion: During the course of severe hepatitis B infection, dysregulated endoplasmic reticulum stress activated mild stress in chronic hepatitis B group, while severe stress in hepatic failure induced by severe hepatitis B virus group. Therefore, endoplasmic reticulum stress plays an important and complex role in the pathogenesis of hepatic failure induced by severe hepatitis B virus.

[Research progress of single-cell sequencing technology in liver diseases]

Liver disease is one of the most burdensome diseases in the world. Therefore, new technologies are needed to study its pathogenesis in depth; however, because of its complex pathogenesis, there are relatively limited treatment options. Single-cell sequencing (SCS), as an emerging sequencing method, reflects the heterogeneity between cells by sequencing the genome, transcriptome, and epigenome of a single cell, thereby revealing the complex mechanisms of disease occurrence and development. The application of SCS in the study of liver diseases will enrich our understanding of the pathogenesis of liver diseases and provide a new direction for exploring the diagnosis and treatment. This article mainly reviews the research progress of SCS technology in liver diseases.

The Spherical Evolutionary Multi-Objective (SEMO) Algorithm for Identifying Disease Multi-Locus SNP Interactions

Single-nucleotide polymorphisms (SNPs), as disease-related biogenetic markers, are crucial in elucidating complex disease susceptibility and pathogenesis. Due to computational inefficiency, it is difficult to identify high-dimensional SNP interactions efficiently using combinatorial search methods, so the spherical evolutionary multi-objective (SEMO) algorithm for detecting multi-locus SNP interactions was proposed. The algorithm uses a spherical search factor and a feedback mechanism of excellent individual history memory to enhance the balance between search and acquisition. Moreover, a multi-objective fitness function based on the decomposition idea was used to evaluate the associations by combining two functions, K2-Score and LR-Score, as an objective function for the algorithm's evolutionary iterations. The performance evaluation of SEMO was compared with six state-of-the-art algorithms on a simulated dataset. The results showed that SEMO outperforms the comparative methods by detecting SNP interactions quickly and accurately with a shorter average run time. The SEMO algorithm was applied to the Wellcome Trust Case Control Consortium (WTCCC) breast cancer dataset and detected two- and three-point SNP interactions that were significantly associated with breast cancer, confirming the effectiveness of the algorithm. New combinations of SNPs associated with breast cancer were also identified, which will provide a new way to detect SNP interactions quickly and accurately.

[Relationship between change of erythrocyte membrane lipid composition and pregnancy induced hypertension]

OBJECTIVE

To study the cause of decreased erythrocyte deformability and its relation to pregnancy induced hypertension (PIH).

METHODS

The cholesterol and phospholipid content of erythrocyte membrane in 24 non-pregnant healthy women, 22 normotensive pregnant women and 36 cases with PIH were determined using automatic biochemical analysor, Gas chromatography and modified colorimetric method.

RESULTS

The cholesterol content and the cholesterol/phospholipid (C/P) ratio of the erythrocyte membrane were obviously higher in the group with moderate or severe PIH than that in the nonmotensive pregnancies (P < 0.01). There was no significant difference between mild PIH group and the normotensive pregnant group (P > 0.05).

CONCLUSION

The increase of cholesterol content and C/P ratio in the erythrocyte membrane might be involved in the pathophysiology of PIH. The alteration of cholesterol content in the erythrocyte membrane probaby reflected the disturbance of serum lipid metabolism.

Changes in rat retinal ganglion neuronotrophic factor and its mRNA during postnatal development

The monoclonal antibody specific to the retinal ganglion neuronotrophic factor (RGNTF) was used to localize and quantify the presence and amount of RGNTF during the postnatal development of the visual system in the rat. The results showed that in the 0-1-day age group, neurons at the superficial layers and deep part of superior colliculus, and as well as retinal ganglion cells were strongly stained with their RGNTF contents quantified to be 88%, 100% and 100%, respectively. In the 5-6-day age group, RGNTF contents were significantly reduced to merely 50%, 30% and 80%, respectively. The RGNTF contents reduced further to 0% as age increased to 2 years old. A 32P-DNA probe specific to the first 7 amino acid sequence of RGNTF at its N-terminal end was synthesized and used for in situ hybridization studies. The results revealed that strong hybridized signals (i.e. mRNA of RGNTF) were localized in the same neurons in the superficial layers and deep part of the superior colliculus only in the 0-1-day age group, and that no signals were found in retinae of all postnatal age groups. The significant reduction of RGNTF may be related to the RGC death during postnatal development. Neurons at the superficial layers and deep part of the superior colliculus are the sources of RGNTF for RGCs in the postnatal retina.

Therapeutic Effects of Small Incision Open Reduction and Internal Fixation and Arthroscopic High Strength Non-Absorbable Suture on Tibial Insertion Avulsion Fracture of the Anterior Cruciate Ligament

PURPOSE OF THE STUDY To evaluate the therapeutic effects of small incision open reduction and internal fixation and arthroscopic high strength non-absorbable suture on tibial insertion avulsion fracture of the anterior cruciate ligament (ACL). MATERIAL AND METHODS In this prospectively study, 72 patients with ACL tibial insertion avulsion fracture treated from December 2017 to June 2020 were enrolled and divided into group A (treated with small incision open reduction and cannulated screw internal fixation) and group B (treated with arthroscopic high strength non-absorbable suture) using a random number table (n=36). Their general data, surgical indices and incidence of postoperative adverse reactions were compared. Knee function indices were compared before and after treatment, and evaluated by random walk model. RESULTS No significant differences were found in the general data, intraoperative blood loss, preoperative Lysholm score, International Knee Documentation Committee (IKDC) score, Tegner score, knee range of motion and difference of bilateral tibial forward displacement distance, and total incidence rate of postoperative adverse reactions between the two groups (P>0.05). Group B had significantly longer operation time, and significantly shorter hospital stay, time of first ambulation after operation and bone healing time than group A (P<0.05). Both groups had improved Lysholm score, IKDC score, Tegner score and knee range of motion after treatment, especially in group B (P<0.05). The difference of bilateral tibial forward displacement distance significantly reduced in both groups after treatment, particularly in group B (P<0.05). The random walk model revealed that group B had better improvement of knee function than group A. CONCLUSIONS Arthroscopic high strength non-absorbable suture in the treatment of ACL tibial insertion avulsion fracture can dramatically improve the knee function indices of patients, with rapid recovery and high safety, so it has a broad prospect of clinical application. Key words: small incision open reduction and internal fixation, arthroscopic high strength non-absorbable suture, tibial insertion avulsion fracture, anterior cruciate ligament, random walk model.

Inference and prediction of courses of the diseases caused by pathologic viruses by estimating molecular evolution of within-host virus

A new approach for inferring the evolutionary process of within-host virus is presented in this study. This approach includes a sequential-linking algorithm developed by us that can deal with the sequential viral samples that are obtained at different time points from the same host, and reconstruct a longitudinal phylogenetic tree in which the evolutionary relations between viral variants can be shown. A codon-based model, which uses a Markov process to describe substitutions between codons, is also employed in this approach to calculate synonymous and non-synonymous substitution rates and to distinguish positive selection and neutral evolution. The approach is applied to a data set of the V3 region of the HIV-1 envelope genes sequenced in different years after infection of a single patient. The results suggest that this approach may provide a more realistic description of viral evolution than the traditional evolution models because it accounts for both neutral and adaptive evolution. Most important of all, since this approach make it possible to follow up the evolutionary process of within-host virus by analyzing the sequential viral samples, it could be used in inference and prediction of the course of the diseases caused by pathologic viruses and evaluation of the treatment.

[Preliminary study on the protective effect of glycosyltransferase Colgalt2 gene deletion on acetaminophen-induced liver injury]

Objective: To investigate the protective effect of Colgalt2 gene deletion on acute liver injury induced by acetaminophen (APAP) in mice. Methods: Colgalt2(+/+) wild-type control mice and Colgalt2(-/-) mice (all C57BL/6J strains) were selected as the research subject. APAP solution was injected intraperitoneally to establish a mouse model of acute liver injury. The mouse were divided into four groups: Colgalt2(+/+) wild-type control group, Colgalt2(+/+) wild-type drug group (APAP 500 mg/kg), Colgalt2(-/-) control group, and Colgalt2(-/-) drug group (APAP 500 mg/kg). The survival rate was measured to plot survival curve. Liver function was evaluated by detecting serum ALT and AST levels. Liver histopathological changes were observed by HE staining to evaluate the condition of liver injury. Western blot was used to detect protein c-Jun N-terminal kinase (JNK)-related liver injury. Results: Compared with Colgalt2(+/+) mice, the survival rate was significantly increased after giving APAP to Colgalt2(-/-) mice (86.7% vs. 40%), and liver cell necrosis and inflammatory cell infiltrates of Colgalt2(+/+) mice were milder. Serum ALT, and AST level was significantly decreased [ALT: (5 291.9 ± 1 016.34) U/L vs. (1 616.9 ± 330.65) U/L, P = 0.000; AST: (4 978.0 ± 1 028.43) U/L vs. (1 851.0 ± 437.55) U/L, P = 0.000]. The expression level of JNK was significantly decreased in liver tissue. Conclusion: Colgalt2 gene deletion has a protective effect on acute liver injury induced by acetaminophen (APAP) in mice. Therefore, Colgalt2 may be a potential therapeutic option for acetaminophen-induced hepatotoxicity.

Clinical application of flap or flapless buccal surgery on the extractions of mesially/horizontally impacted 3rd molar with high or medium position impact: A comparative study

PURPOSE

To investigate and compare the clinical application of flap or flapless buccal surgery on the extractions of mesially/horizontally impacted 3rd molar with high or medium position impact in terms of the average surgery duration, number of root fracture, postoperative pain degree and duration, postoperative swelling degree and duration, degree of limitation of mouth opening.

MATERIALS AND METHODS

The present study was conducted of 28 patients who were examined and underwent bilateral extraction of impacted mandibular 3rd molar. One molar was randomly extracted with flap buccal surgery (Control Group, CG) and the other one with flapless buccal surgery (Experimental Group, EG) in the same patient.

RESULTS

Gender distribution, average age, average surgery duration and number of root fracture between the two groups were not statistically significant (P>0.05). The postoperative pain degree, swelling degree and degree of limitation of mouth opening were all significantly greater in CG than EG. Moreover, the duration of postoperative pain and swelling were all were all significantly longer in CG than EG (0.01<P<0.05).

CONCLUSION

Compared with the flap buccal surgery on the extractions of mesially/horizontally impacted 3rd molar with high or medium position impact, the clinical use of the flapless buccal surgery is a safe and effective method with less swelling, pain and degree of limitation of mouth opening. However, we need further study based on the broader indications, a much larger number of patients included and a follow-up in the longer term to confirm our point.

[The role of circulating tumor DNA in the diagnosis and prognosis of hepatocellular carcinoma]

Hepatocellular carcinoma (HCC) is one of the common malignant tumors. However, the detection of biomarkers can't meet the clinical needs for the diagnosis and prognosis of HCC now. Circulating tumor DNA (ctDNA) is a highly tumor-specific DNA molecule that exists in the blood circulation. It is part of Circulating cell free DNA (cfDNA) and originates from the primary tumor or metastasis of cancer patients. Now, with the developing of next-generation sequencing technology and a full understanding of HCC genetics or epigenetic changes, we can analyze ctDNA mutations and methylation more comprehensively. Through continuous exploration of ctDNA mutations and methylation and continuous innovation of detection methods, HCC diagnosis and prognosis can be greatly improved in terms of specificity and sensitivity.

[Study of the effect of CHOP signaling molecule in PPARα activation and inhibition with response to inflammation in mice with acute liver failure]

Objective: To investigate the mechanism of action of peroxisome proliferator-activated receptor α (PPARα)-mediated CCAAT/enhancer binding protein homologous protein (CHOP) signaling molecule with response to inflammation in mice with acute liver failure. Methods: C57BL/6 mice were used as the research subjects, and D-galactose (D-GalN) combined with lipopolysaccharide (LPS) was injected intraperitoneally to establish a mouse model of acute liver failure. PPARα was activated by Wy-14643. CHOP expression was promoted by plasmids. Liver pathological changes and serum transaminases (ALT and AST) were detected in mice to evaluate liver function. The mRNA expression level of inflammatory factors in liver tissue was detected by real-time fluorescence quantitative PCR. LPS-stimulated macrophage was used to establish an inflammation model. PPARα and CHOP expression was inhibited by siRNA. The mRNA expression level of inflammatory factors in the cells was detected by real-time fluorescence quantitative PCR. Results: Promoted PPARα activation had inhibited liver hemorrhage and inflammation in mice with acute liver failure induced by D-GalN/LPS. In addition, the serum level of transaminases and genetic level of inflammatory factors in liver tissues were reduced (P < 0.01). CHOP accelerated expression had reversed the hepatoprotective effect of PPARα activation, aggravated liver injury, and increased inflammatory factors expression (P < 0.01). At the cellular level, the inhibition of PPARα activation had accelerated the increase of inflammatory factors (P < 0.01), while the inhibition of CHOP activation had all over again decreased the inflammatory factors (P < 0.01). Conclusion: PPARα and CHOP are important signaling molecules to regulate the inflammatory response in acute liver failure and liver injury. PPARα acceleration can down-regulate CHOP to inhibit inflammatory factors, which might play a protective role in mice with acute liver failure.

[Research progress of the regulatory role of autophagy in metabolic liver diseases]

Autophagy is one of several hepatic metabolic processes in which starved cells are supplied with glucose, free fatty acids, and amino acids to produce energy and synthesize new macromolecules. Moreover, it regulates the quantity and quality of mitochondria and other organelles. As the liver is a vital metabolic organ, specific forms of autophagy are necessary for maintaining liver homeostasis. Protein, fat, and sugar are the three primary nutrients that can be altered by different metabolic liver diseases. Drugs that have an effect on autophagy can either promote or inhibit autophagy, and as a result, it can either increase or inhibit the three major nutritional metabolisms that are affected by liver disease. Thus, this opens up a novel therapeutic option for liver disease.

[24-hour esophageal pH monitoring for suspected esophageal originated chest pain]

Thirty patients with suspected esophageal originated chest pain were studied by 24 h esophageal pH monitoring. All of them complained of chest pain, heart burn, acid reflux or dysphagia. The result showed abnormal pH in 26 patients (86.7%). Sixteen of them had pH abnormalities in both day and night, whereas 8 had only abnormal day pH, and 2 pH out of the normal limits at night. Chest pain episode was correlated with the abnormalities in 18 cases (60%). Four patients with coronary heart disease showed simultaneous gastro-esophageal reflux originated chest pain; the positive correlation was obtained. Their diagnosis of cardiac chest pain was doubtful. We suggested that 24h pH monitoring was a significant method to determine the cause of chest pain.

Identification of a 12.5-kD protein from caudate-putamen nucleus as a dopaminergic neuronotrophic factor

The effect of the extract from caudate-putamen nucleus of newborn rats (CPe) on the dopaminergic (DA) neurons has been studied. An MTT colorimetric microassay measuring optical densities for the growth of DA neuron cultures reveals a significant increase in growth for cultures with CPe as compared to those without CPe (p < 0.05). Rhodamine retrograde-prelabelled DA neurons were cultured on a Phastgel containing all the electrophoretically separated protein bands from CPe, and able to fish out from it their own trophic factor, a 12.5-kD protein band. The survived neurons at the 12.5-kD protein band were immunostained positive with anti-dopamine antibody. Co-culturing the 12.5 kD-containing gel strip with explants from substantia nigra at a close distance for a week revealed anti-dopamine immunopositive neurites outgrowing from the explants only towards the 12.5-kD gel strip. These results indicate that a 12.5-kD protein from the CPe is capable of maintaining the survival of DA neurons of the substantia nigra and promoting their neurite outgrowth.

Topology selection in unrooted molecular phylogenetic tree by minimum model-based complexity method

In reconstruction of phylogenetic trees from molecular data, it has been pointed out that multifurcate phylogenetic trees are difficult to be correctly reconstructed by the conventional methods like maximum likelihood method(ML). In order to resolve this problem, we have been engaged in developing a new phylogenetic tree reconstruction method, based on the minimum complexity principle widely used in the inductive inference. Our method, which we call "minimum model-based complexity (MBC) method", has been proved so far to be efficient in estimating multifurcate branching when the tree is described in the form of rooted one. In this study, we make further investigations about the efficiency of MBC method in estimating the multifurcation in unrooted phylogenetic trees. To do so, we conduct computer simulation in which the estimations by MBC method are compared with those by ML, AIC and statistical test approach. The results show that MBC method also provides good estimations even in the case of multifurcate unrooted trees and suggest that it could be generally used for reconstruction of phylogenetic tree having arbitrary multifurcations.

Willingness to receive and recommend hypothetical mpox vaccination and associated factors in Chinese adults: a community-based survey in Shenzhen, China

OBJECTIVES

China may face new threats to public health due to the increased risk of imported mpox (monkeypox) cases. However, research gaps exist in the acceptance of mpox vaccination and potential associated factors in the Chinese population.

STUDY DESIGN

We conducted a cross-sectional study targeting community residents in Shenzhen, China, from August 5 to September 7 2022.

METHODS

A self-administered questionnaire was used to collect information about demographic and health characteristics, mpox-related perceptions, and attitudes towards mpox vaccination. Multivariable logistic regression models were applied to detect the factors associated with willingness to receive and recommend mpox vaccination.

RESULTS

A total of 2293 community residents were included in the analyses (average age: 34.03, female: 72.6%). Among the participants, 76.9% were aware of mpox, 62.1% were aware of the global mpox outbreak, but only 53.6% had a high knowledge level of mpox. Males had a higher proportion of high knowledge (56.9% vs 52.3%, P＜0.05) and a lower proportion of high worry (30.2% vs 45.4%, P＜0.05) than females. Approximately 69.1% of the participants were willing to vaccinate against mpox, and 69.6% were willing to recommend mpox vaccination to people around them, in which no gender difference was found. The obstacle reported most among people hesitant to receive vaccination was concerning the safety and side-effects, whereas it changed to be concerning the suitability due to individual health differences among people hesitant to recommend mpox vaccines. Factors associated with the willingness to receive and recommend mpox vaccination included having a history of influenza vaccination, having a history of COVID-19 vaccination, being aware of the global mpox outbreak, having a high knowledge level of mpox, and having a high level of mpox-related worry.

CONCLUSIONS

This study identified a moderate willingness to receive and recommend mpox vaccination among Chinese adults. Without gender differences, willingness to receive and recommend mpox vaccination was significantly associated with mpox-related perceptions, such as awareness, knowledge, and worry. Authoritative and up-to-date information is needed to help the general population improve public confidence in mpox vaccines in China.

[Monoclonal antibody against human primary hepatocellular carcinoma and immunocytochemical localization of the corresponding antigen]

A monoclonal antibody HAB5 was raised against human hepatocellular carcinoma. The reactivity of HAB5 was determined immuno-histologically on paraffin sections by ABC technique. Positive reaction was seen in 88% of 50 cases of hepatoma examined, including 2 cases of spindle-cell hepatoma. Positive reaction was also seen in 16% squamous-cell carcinoma and 25% transitional cell carcinoma. The monoclonal antibody did not react with metastatic adenocarcinoma of liver in 7 cases. The antigen to which HAB5 directed was a membrane glycoprotein with a molecular weight of 68 KDa.

[Role of endoplasmic reticulum stress-mediated glycogen synthase kinase 3β activity in pathogenesis of acute liver failure in mice]

Objective: To study the role of endoplasmic reticulum (ER) stress-mediated glycogen synthase kinase 3β (GSK3β) activity in the pathological process of liver injury in acute liver failure (ALF) mice. Methods: ALF model was established by intraperitoneal injection of D-galactosamine/lipopolysaccharide (D-GalN/LPS) in C57BL/6 mice. The mice were divided into control group (n=10), ALF model group (n=18), 4-phenylbutyrate (4-PBA, an ER stress inhibitor) group (n=18) and SB216763 (a specific inhibitor of GSK3β) group (n=16). The serum alanine transaminase (ALT) and aspartate transaminase (AST) levels were measured to reflect the liver function, liver injury was assessed by observing pathological changes of liver tissue, the levels of proteins in liver tissue were analyzed by Western blotting, the activity of GSK3β in liver tissue was detected using GSK3β activity assay kit, and the survival rate of hepatocyte was measured by methyl thiazolyl tetrazolium (MTT) assay. Results: In in vivo experiment, the expression levels of ER stress markers, glucose-regulated protein 78 (GRP78) and CCAAT/enhancer-binding protein homologous protein (CHOP), were upregulated during the progression of D-GalN/LPS-induced ALF, indicating activation of severe ER stress and increased activity of GSK3β. Compared with the model group, inhibition of ER stress by 4-PBA improved liver function[ALT: (365.4±58.6) U/L vs (1 094.5±201.5) U/L, P<0.05; AST: (555.1±60.8) U/L vs (1 444.3±533.7) U/L, P<0.05)and pathological injury, also decreased the activity of GSK3β (2.6±0.3 vs 4.6±1.3, P<0.05). Inhibition of GSK3β activity was shown to alleviate liver injury in ALF by reducing the expression levels of GRP78 and CHOP. The in vitro experiment of tunicamycin-induced hepatocyte apoptosis showed that inhibition of GSK3β activity increased the cell survival rate. Conclusion: In ALF induced by D-GalN/LPS, severe ER stress may accelerate the development and progress of ALF by upregulating the activity of GSK3β.