[A cross-sectional survey on the types of antiviral treatment plans for patients with chronic hepatitis B]

Objective: To understand the current antiviral treatment status and various clinical types of treatment plans in Xiamen City so as to explore ways to improve and optimize the diagnosis and treatment standards for chronic hepatitis B. Methods: A cross-sectional survey method was used to study the antiviral treatment status and treatment plans for chronic hepatitis B patients who visited and were diagnosed in the Department of Infectious Diseases and Hepatology of all tertiary hospitals in Xiamen City at 0:00~23:59 on May 25, 2022. Results: A total of 665 cases were surveyed in this study, with an antiviral treatment rate of 81.2%(540/665). The antiviral treatment rate of patients who accorded with the current guidelines for antiviral treatment indications was 85.8%(507/591). The antiviral treatment rate for 362 outpatients was 72.9%(264/362). Among them, the antiviral treatment rates were 80.1%, 89.3%, and 25.0%(226/282, 25/28, 13/52), respectively, for patients diagnosed with chronic hepatitis B, hepatitis B cirrhosis, and hepatitis B surface antigen-carrying status. The treatment plan for all outpatient patients was mainly oral nucleos(t)ide analogues, accounting for 59.1%(214/362). The antiviral treatment rate for 303 inpatients was 91.1%(276/303). The various clinical types of antiviral therapy rates among all patients were 70%~95%. The antiviral treatment plan for inpatients was mainly based on pegylated interferon alpha treatment, accounting for 72.6%(220/303). Conclusion: Antiviral treatment for chronic hepatitis B in Xiamen City can still be strengthened to meet the current demand for expanding antiviral treatment indications. Antiviral treatment rates and various types of treatment plans differ between outpatients and inpatients; thus, further awareness and acceptance of the goal of improving antiviral therapy, especially in outpatients, and the possibility for a clinical cure based on pegylated interferon alpha treatment are needed to maximize the benefit to more patients.

Effectiveness of Fuling () and its extracts against spleen deficiency in rats tonifying spleen

OBJECTIVE

To observe and explore the effect of Fuling () in alleviating the spleen deficiency symptom pattern (SDSP).

METHODS

We established an animal model of SDS in Sprague-Dawley () rats by treating them with deficiency-inducing factors, including irregular feeding and tail clamping. Mice were administered Fuling () and its extracts (raw/cooked powder, aqueous/alcohol extract) by gavage once a day for 21 d. The body weight, rectal temperature, and spleen and thymus organ coefficients were calculated. The levels of motilin (MTL), gastrin (GAS), aquaporin 2 (AQP2), interleukin 2 (IL-2), IL-4, and 5-hydroxytryptamine (5-HT) in the serum and the level of AQP2 in the kidneys were evaluated by enzyme-linked immunosorbent assay.

RESULTS

Fuling () and its extracts did not change the body weight, rectal temperature, and organ coefficients of the spleen and thymus. However, it reduced the levels of MTL and GAS and increased the levels of IL-2 and AQP2. In addition, the levels of IL-4 and 5-HT showed no significant alteration.

CONCLUSIONS

These results suggested the crucial function of () in SDSP, especially promoting digestive function and water metabolism.

Ulinastatin ameliorates the malignant progression of prostate cancer cells by blocking the RhoA/ROCK/NLRP3 pathway

Prostate cancer is a male malignant tumor disease with high incidence and mortality. This study was designed to explore the effects of ulinastatin (UTI) on the malignant progression of prostate cancer and its relevant mechanism of action. Human prostate cancer cell line PC-3 was applied to investigate the anticancer activity of UTI. PC-3 cells were treated with increasing concentrations (400, 800, and 1600 U/ml) of UTI. Cell proliferation, migration, invasion, and apoptosis were determined by cell counting kit-8 (CCK-8), colony formation, wound-healing, Transwell assay, and flow cytometry analysis, respectively. The expression level of corresponding proteins was detected by western blot. In addition, PC-3 cells were pretreated with RhoA agonist CN03 (1 μg/ml) or NLRP3 agonist nigericin (10 μM) before UTI treatment, and the cellular behaviors above were detected again. It was demonstrated that UTI significantly suppressed cell proliferation, migration, and invasion but promoted apoptosis in PC-3 cells in a concentration-dependent manner. Meanwhile, UTI could block RhoA/ROCK/NLRP3 inflammasome pathway in PC-3 cells, and the activation of RhoA or NLRP3 inflammasome partly weakened the impacts of UTI on cell proliferation, migration, and apoptosis in PC-3 cells, respectively. In summary, our study demonstrated the antitumor activity of UTI against prostate cancer by regulating RhoA/NLRP3 inflammasome pathway, providing a promising candidate drug for the therapeutic treatment of prostate cancer.

Design, Synthesis and Biological Evaluations of Novel Farnesoid X Receptor (FXR) Agonists

As a member of the nuclear receptor superfamily, the farnesoid X receptor (FXR) is a bile acid activated transcription factor. FXR is involved in many important metabolic processes and serves as a promising therapeutic target for nonalcoholic steatohepatitis (NASH). Since discovered, the first non-steroidal FXR agonist GW4064 has been widely used to explore the biological functions of FXR, however, the low pharmacokinetic limited its further clinical application. In current study, we designed a series of substituted isothiazoles as new FXR agonists. Among them, five compounds exhibited better FXR agonistic activity than GW4064. Specially, the most potent compound S5 possessed better pharmacokinetic profile and in vivo potency than lead compound.

Visible Light-Driven Selective Reduction of CO2 by Acetylene-Bridged Cobalt Porphyrin Conjugated Polymers

Photocatalytic conversion of CO₂ into renewable fuels with high efficiency and selectivity is desirable for solar energy utilization, but remains a great challenge. Herein, cobalt(II)-porphyrin functionalized conjugated polymers with acetylene bridging units, assembled through the Sonogashira cross coupling reaction, as heterogeneous catalysts for CO₂ photoreduction were presented. Experimental investigations and density functional theory calculations demonstrated the crucial roles of Co centers in porphyrin units for CO₂ activation and conversion, while excessive acetylene group prompted the competing hydrogen evolution reaction and reduced the selectivity. Thus, the CoPor-DBBP afforded superior activity for the CO generation with a rate of 286.7 μmol g^-1  h^-1 and high selectivity of up to 90.4 %. This work presents a new insight for rationally designing of porphyrin-based conjugated polymers as energetic photocatalyst in CO₂ reduction.

Construction of a hierarchical ZnIn2S4/C3N4 heterojunction for the enhanced photocatalytic degradation of tetracycline

Efficient charge separation and sufficiently exposed active sites are both critical limiting factors for solar-driven organic contaminant degradation. Herein, we describe a hierarchical heterojunction photocatalyst fabricated by the in situ growth of ZnIn₂S₄ nanosheets on micro-tubular C₃N₄ (denoted as ZIS/TCN). This ZIS/TCN heterojunction photocatalyst can take advantage of the hollow structure with stronger light absorption capacity and more active sites, and its heterostructure can accelerate the separation and transfer of photogenerated charge carriers. The optimized ZIS/TCN-3 exhibits superb photocatalytic efficiency for the degradation of tetracycline (86.1%, 60 min), maintains excellent stability and recyclability, and provides a facile strategy for the synthesis of efficient heterojuction photocatalysts towards wastewater treatment. In addition, the plausible photocatalytic degradation pathway of tetracycline is proposed according to the intermediates identified by LC-mass analysis.

Remote ischemic post-conditioning protects against myocardial ischemia/reperfusion injury by inhibiting the Rho-kinase signaling pathway

The aim of the present study was to observe the effect of Rho-kinase on remote ischemic post-conditioning (RIPostC) and explore the underlying mechanisms. Male Sprague Dawley rats (n=32) were randomly distributed into four groups: Sham group, ischemia/reperfusion (I/R) group, RIPostC group and I/R with fasudil group (I/R+Fas). Infarction size was detected by triphenyltetrazolium chloride staining. The levels of creatine kinase (CK), lactate dehydrogenase (LDH), superoxide dismutase (SOD), malondialdehyde (MDA) and cardiac troponin I (cTnI) were measured using an ultraviolet spectrophotometer. The mRNA expression levels of Rho-associated coiled-coil containing protein kinase (ROCK)-1 and ROCK2, B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X protein (Bax) were detected via reverse transcription-PCR. The protein expression levels of phosphorylated-myosin phosphatase target subunit (p-MYPT1) and phosphorylated-myosin light chain (p-MLC) were assessed by western blotting. The results demonstrated that RIPostC could decrease the infarct size, the levels of CK, LDH, cTnI and MDA and increase the activity of SOD compared with the I/R group. In addition, the mRNA expression of ROCK1 and ROCK2 was downregulated, the protein expression of p-MYPT1 and p-MLC was decreased, and the ratio of Bcl-2/Bax was elevated in the RIPostC groups compared with the I/R group. Notably, the aforementioned index in I/R with Fas group was similar to the RIPostC group and no significant difference was observed between RIPostC and I/R+Fas. These results revealed that RIPostC could attenuate I/R injury and the underlying mechanisms might be associated with a reduction in myocardial apoptosis and the suppression of the Rho-kinase signaling pathway.

[Y-27632 protects H9c2 cardiomyocytes against hypoxia/reoxygenation injury by inhibiting autophagy pathway]

Objective To investigate the protective effect of preconditioning with Rho-kinase inhibitor Y-27632 on H9c2 cardiomyocytes against hypoxia/reoxygenation (H/R) injury, and explore its underlying mechanism. Methods H9c2 cardiomyocytes were divided into normal group, H/R group, Y-27632 group and Y-27632 plus 3-methyladenine (Y-27632/3-MA) group. The cells of the normal group were cultured with 950 mL/L air and 50 mL/L CO₂ at 37DegreesCelsius for 6 hours. The cells of the H/R group were pretreated with hypoxia (940 mL/L N₂, 10 mL/L O₂, 50 mL/L CO₂) for 3 hours, followed by 3-hour reoxygenation (950 mL/L air, 50 mL/L CO₂). The cells of the Y-27632 group were preconditioned with 10 μmol//L of Rho-kinase inhibitor Y-27632 for 1 hour followed by H/R treatment as the H/R group did. The cells in the Y-27632/3-MA group were preconditioned with 10 μmol//L of Y- 27632 and 5 mmol/L of autophagy inhibitor 3-MA for 1 hour before H/R treatment. After the treatments, CCK-8 assay was used to detect cell survival rate and chemical colorimetry was used to detect lactate dehydrogenase (LDH) activity. Cell apoptosis was measured by flow cytometry. The protein levels of phosphorylation myosin light chain (p-MLC) and beclin 1 were analyzed by Western blot analysis. Results After Y-27632 pretreatment, the survival rate of H9c2 cells were improved; the LDH activity, the apoptosis rate and the protein level of p-MLC were reduced; and the level of beclin 1 was raised. However, in the Y-27632/3-MA group, the anti-apoptotic effect on H9c2 cells was significantly attenuated, the protein level of p-MLC increased and the level of beclin 1 decreased. Conclusion Preconditioning with Y-27632 can alleviate H/R-induced myocardium injury through inhibiting Rho-kinase and promoting autophagy pathway.

The construction and application of a cell line resistant to novel subgroup avian leukosis virus (ALV-K) infection

A novel avian leukosis viruses (ALV) subgroup named ALV-K was recently isolated from Chinese indigenous chickens which is different from the subgroups (A to E and J) that have previously been reported to infect chickens. More and more ALV-K strains have recently been isolated from local breeds of Chinese chickens. However, there are no more effective diagnostic methods for ALV-K other than virus isolation followed by envelope gene sequencing and comparison. Viral infection can be blocked through expression of the viral receptor-binding protein. In this study, we have engineered a cell line, DF-1/K, that expresses ALV-K env protein and thereby confers resistance to ALV-K infection. DF-1/K can be used in combination with the ALV-K susceptible cell line DF-1 as a specific diagnostic tool for ALV-K and provides a good tool for further research into the molecular mechanisms of interaction between ALV-K env protein and the host cell receptor.

Retrospective Study to Determine Diagnostic Utility of 6 Commonly Used Lung Cancer Biomarkers Among Han and Uygur Population in Xinjiang Uygur Autonomous Region of People's Republic of China

Early diagnosis was the main way to improve the survival rate of lung cancer patients. At present, the methods to diagnose lung cancer were varied, but early diagnosis of lung cancer was still difficult. In experimental and clinical studies, lung cancer related tumor markers were helpful to the early diagnosis of lung cancer. So far, there were many studies about lung cancer related tumor markers in China, but the subjects in these studies were almost the Han population. There were few studies about the Uygur population. Xinjiang was a multi-ethnic region in China, the ratios of Han and Uygur population were 40% and 45%, respectively. Xinjiang also was a high incidence area of lung cancer in China. The purpose of this study was to research the application of 6 tumor markers in Uygur and Han lung cancer patients in XinJiang, China.The study collected 342 cases who were diagnosed as lung cancer in Tumor Hospital Affiliated to XinJiang Medical University from May 2012 to December 2012. Serum concentrations of squamous cell carcinoma (SCC), cytokeratin fragment 19 (CYFRA21-1), carcino-embryonic antigen (CEA), carbohydrate antigen 125 (CA125), precursor of gastrin-releasing peptide (Pro-GRP), and neuron-specific enolase (NSE) were tested for every patient before radiation, chemotherapy, or surgery. The serum concentrations of SCC, CYFRA21-1, CEA, CA125, and Pro-GRP were assayed using the micro-particle luminescence analysis testing by the Abbott ARHCITECT i2000SR immunoanalyzer. NSE was assayed by the electrochemical luminescence analysis testing using Roche Cobas E601 electrochemical luminescence analyzer.Serum levels of SCC were different between 2 ethnic populations, smoking should be the influence factor to create the difference. Cluster analysis showed that the NSE and Pro-GRP were helpful to identify small cell lung cancer (SCLC), and CEA, CA125, SCC, CYFRA21-1 were beneficial to diagnose non-small cell lung cancer (NSCLC). The compare of diagnosis value about serum tumor markers also proved the result of cluster analysis. No matter SCLC or NSCLC, the positives rate of all tumor markers were increasing as clinical stage advancing. Pro-GRP had higher positive rate than NSE in limited stage of SCLC. CA125 had the highest positive rate in I and II stage of NSCLC, and CYFRA21-1 had the highest positive rate in III and IV stage of NSCLC. CEA and CA125 were beneficial to diagnose adenocarcinoma, CYFRA21-1, and SCC identified squamous cell cancer better.Only SCC level was higher in Han population than Uygur population because of the differences of smoking constituent ratio between 2 populations. So, it could be unified to research the application value of the 6 indicators for the Han and Uygur population. Then, we suggested a primary diagnostic utility of 6 commonly by lung cancer biomarkers in both the Han and Uygur populations in Xinjiang Uygur Autonomous Region of People's Republic of China.

Leiomyosarcoma of cervical stump following subtotal hysterectomy: a case report and review of literature

BACKGROUND

Leiomyosarcoma that arises in the uterine cervix stump after subtotal hysterectomy is exceedingly rare. Only one case has been documented. The authors report an unusual case of leiomyosarcoma that arose in the cervix stump.

CASE PRESENTATION

A 46-year-old female presented with a one-month history of vaginal bleeding. Vaginal and ultrasonography examination revealed a mass in the cervix. The patient underwent radical resection of the cervix, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. Chemotherapy and radiotherapy was given after the operation. The patient suffered from severe menopausal symptoms and received hormone replacement therapy. She eventually committed suicide.

CONCLUSION

Given the rarity of cases of leiomyosarcoma of cervical stump, its proper treatment remains to be determined. In dealing with benign uterus diseases, we should pay adequate attention in retaining the cervix. If the cervix is retained, patients require appropriate follow-up. The authors hope that this work will benefit the fields of gynecology and oncology.

Biological characteristics of different epidemic enterovirus 71 strains and their pathogeneses in neonatal mice and rhesus monkeys

Hand, foot and mouth disease (HFMD) has been prevalent in China since 2008. Enterovirus 71 (EV71) is a common causative agent of HFMD, and various strains of EV71 are prevalent worldwide. The EV71C4 subgenotype is the most endemic strain in China. However, few studies investigating the biological characteristics and pathogeneses of different C4 strains have been reported. Therefore, the current study investigated 19 clinical EV71 strains in neonatal ICR mice and neonatal rhesus monkeys by comparing pathogenicity; the virulence of different viral passages, dosages, and routes of infection; and the effects produced by subject animal age. These 19 clinical EV71 strains, which were of the same subtype, displayed varying pathogenic effects. Three strains (HE31, 231 and 262) induced limb paralysis in neonatal ICR mice. In addition, the degree of virulence was largely dependent upon the dose, route of infection, and number of passages of the challenge virus, as well as the ages of the infected animals. The present study provides valuable basic data to enable further research into EV71 pathogenesis and to facilitate the development of new drugs and vaccines.

Liver stiffness measurement-based scoring system for significant inflammation related to chronic hepatitis B

OBJECTIVES

Liver biopsy is indispensable because liver stiffness measurement alone cannot provide information on intrahepatic inflammation. However, the presence of fibrosis highly correlates with inflammation. We constructed a noninvasive model to determine significant inflammation in chronic hepatitis B patients by using liver stiffness measurement and serum markers.

METHODS

The training set included chronic hepatitis B patients (n = 327), and the validation set included 106 patients; liver biopsies were performed, liver histology was scored, and serum markers were investigated. All patients underwent liver stiffness measurement.

RESULTS

An inflammation activity scoring system for significant inflammation was constructed. In the training set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.964, 91.9%, and 90.8% in the HBeAg(+) patients and 0.978, 85.0%, and 94.0% in the HBeAg(-) patients, respectively. In the validation set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.971, 90.5%, and 92.5% in the HBeAg(+) patients and 0.977, 95.2%, and 95.8% in the HBeAg(-) patients. The liver stiffness measurement-based activity score was comparable to that of the fibrosis-based activity score in both HBeAg(+) and HBeAg(-) patients for recognizing significant inflammation (G ≥3).

CONCLUSIONS

Significant inflammation can be accurately predicted by this novel method. The liver stiffness measurement-based scoring system can be used without the aid of computers and provides a noninvasive alternative for the prediction of chronic hepatitis B-related significant inflammation.

Recombinant globular adiponectin inhibits lipid deposition by p38 MAPK/ATF-2 and TOR/p70 S6 kinase pathways in chicken adipocytes

Adiponectin plays a fundamental role in lipid and carbohydrate metabolism. However, its role in adipocyte differentiation remains controversial. To investigate the effect of gAd on lipid deposition in chicken adipocytes and its related signaling pathways, 200 μg/mL recombinant globular adiponectin, isoproterenol, SB253580, leucine, and rapamycin were used to treat chicken adipocytes. Results demonstrated that gAd increased the expression of endogenous adiponectin and AdipoR1 (P < 0.01); gAd inhibited triglyceride (TG) accumulation in chicken adipocyte and increased the release of free fatty acids (FFA) in medium; gAd decreased the expression of adipogenic marker genes CCAAT/enhancer binding protein alpha (C/EBPα) and fatty acid synthase (FAS), while activating the expression of lipolytic marker gene adipose triglyceride lipase (ATGL) (P < 0.01). Meanwhile, gAd activated the phosphorylation levels of p38 mitogen-activated protein kinase (p38 MAPK) and activating transcription factor 2 (ATF-2), and suppressed the phosphorylation levels of rapamycin (TOR) and p70 S6 Kinase (P < 0.01). In conclusion, the results demonstrate that gAd has an ability to inhibit lipids deposition in chicken adipocyte, which depends on the p38 MAPK/ATF–2 and TOR/p70 S6 Kinase pathways.

Enhanced HBsAg synthesis correlates with increased severity of fibrosis in chronic hepatitis B patients

BACKGROUND AND AIMS

Little is known about whether low serum HBsAg levels result from impaired HBsAg synthesis or a reduced number of hepatocytes caused by advanced liver fibrosis. Therefore, we investigated the capacity for HBsAg synthesis in a cross-sectional cohort of treatment-naïve chronic hepatitis B patients.

METHODS

Chronic hepatitis B patients (n = 362) were enrolled; liver biopsies were performed and liver histology was scored, and serum HBsAg and HBV DNA levels were investigated. In the enrolled patients, 183 out of 362 have quantitative serum HBsAg levels. Tissue HBsAg was determined by immunohistochemistry.

RESULTS

A positive correlation between serum HBsAg and HBV DNA levels was revealed in HBeAg(+) patients (r = 0.2613, p = 0.0050). In HBeAg(+) patients, serum HBsAg and severity of fibrosis were inversely correlated (p = 0.0094), whereas tissue HBsAg levels correlated positively with the stage of fibrosis (p = 0.0280). After applying the mean aminopyrine breath test as a correction factor, adjusted serum HBsAg showed a strong positive correlation with fibrosis severity in HBeAg(+) patients (r = 0.5655, p<0.0001). The adjusted serum HBsAg values predicted 'moderate to severe' fibrosis with nearly perfect performance in both HBeAg(+) patients (area under the curve: 0.994, 95% CI: 0.983-1.000) and HBeAg(-) patients (area under the curve: 1.000, 95% CI: 1.000-1.000).

CONCLUSIONS

Although serum HBsAg levels were negatively correlated with fibrosis severity in HBeAg(+) patients, aminopyrine breath test-adjusted serum HBsAg and tissue HBsAg, two indices that are unaffected by the number of residual hepatocytes, were positively correlated with fibrosis severity. Furthermore, adjusted serum HBsAg has an accurate prediction capability.

Screening and further analyzing differentially expressed genes in acute idiopathic pulmonary fibrosis with DNA microarray

BACKGROUND

Acute idiopathic pulmonary fibrosis (IPF) is a serious and progressive form of lung disease, and millions of people suffer from this disease in the world. To provide clues for getting a better understanding of the mechanism of this disease, we identified and further analyzed the differential expressed genes in IPF.

METHOD

In this study, we downloaded the gene expression microarray (GSE10667) from Gene Expression Omnibus (GEO) database. The dataset contained a total of 23 samples, including 15 normal controls and 8 diseases samples (IPF). Then, we identified the differentially expressed genes between normal and disease samples with packages in R language. Consequently, the PPI network was also constructed for the products of these DEGs, and modules in the network were analyzed by Cytoscape's plug-in Mcode and Bingo. Furthermore, enrichment analysis was performed by DAVID to illustrate the altered pathways in IPF. The drug compounds for PLK1 were screened in DrugBank.

RESULTS

Atotal of 349 genes were identified as differentially expressed genes between normal and disease samples, and we constructed a protein-protein interaction network which included 200 pairs of proteins. Then three modules were identified in our network. Function of these modules were predicted to be related to protein kinase binding, extracellular matrix structural and structural constituent of cytoskeleton, respectively. Finally, we focused on module A including 18 DEGs.

CONCLUSIONS

PLK1 (Polo like kinge-1) in this module was predicted as a marker gene in IPF, which was related to cell cycle pathway. Several compounds were found which may be the potential drug for IPF.

Efficacy of 3 years of adefovir monotherapy in chronic hepatitis B patients with lamivudine resistance

AIM

To study the effect of rescue monotherapy with adefovir (ADV) in patients with chronic hepatitis B (CHB) who developed drug resistance to lamivudine (LAM).

METHODS

A total of 76 treated CHB patients with resistance to LAM were enrolled in the present study. The patients' baseline characteristics, such as age, gender, blood tests and hepatitis B virus (HBV) DNA were collected; therapy duration and the response of each patient were also recorded. ADV monotherapy was set as the observation group A. Twenty-four patients with LAM resistance, who were set as group B, accepted combined therapy with LAM + ADV. Patients were followed up at 0, 12, 24, 52, 104 and 156 wk. Hepatitis B surface antigen status, hepatitis B e antigen (HBeAg)/anti-HBe status, HBV DNA level and biochemical indexes were monitored. Sequencer of HBV polymerase gene was performed on the ABI 3730 automated sequencer. If no desired effects had been achieved during the course of treatment, patients' choices were also taken into account. The control group was tested at the same time.

RESULTS

In the two groups, 27 cases developed viral breakthrough after LAM treatment response. The remaining 49 cases underwent biochemical rebound accompanied by rtM204I/V or rtL180M mutation. In group A, 52 cases finished 156 wk of ADV monotherapy; of whom, 36 cases were HBeAg positive and 16 HBeAg negative. In patients whose baseline HBV DNAs were 10(3)-10(5) copies/mL, 88.8% of patients' HBV DNAs were lower than the lower test limit (10(3) copies/mL) after 12 to 156 wk of ADV treatment. In patients whose baseline HBV DNAs were ≥ 10(6) copies/mL, 41.1%-47.0% of patients' HBV DNAs were lower than the lower test limit after the same course of ADV therapy (χ(2) were 4.35-5.4, 41.1%-47.0% vs 88.8% group 10(3)-10(5) copies/mL, P < 0.01). In group A, seroconversion of HBeAg developed in 8 of 36 cases (22.2%). In group B, 24 cases finished 156 wk of LAM + ADV; of whom, 17 cases were HBeAg positive and 7 HBeAg negative. In patients whose baseline HBV DNAs were 10(3)-10(5) copies /mL, 81.8% of patients' HBV DNAs were lower than the lower test limit (10(3) copies/mL) after 12 to 156 wk of treatment. In the patients whose baseline HBV DNAs were ≥ 10(6) copies/mL, 46.1%-53.8% of patients' HBV DNAs were lower than the lower test limit after the same course of LAM + ADV therapy (χ(2) were 4.1-5.0, 46.1%-53.8% vs 81.8% group 10(3)-10(5) copies/mL, P < 0.05-0.01). In group B, 4 of 17 cases (23.5%) developed seroconversion of HBeAg. Treatment outcomes in groups A and B were comparable.

CONCLUSION

In both group A and B, the ratios of virological response have similar efficacy in patients with lower baseline HBV DNAs.

Micelle-like nanoparticles of star-branched PEO-PLA copolymers as chemotherapeutic carrier

Four-armed (star-branched) block copolymers of l-PLA and PEO were synthesized using ring opening polymerization with different LA/EO ratio. Micellar aggregates were prepared from these block copolymers and characterized. Some surface segregation of PEG was found : the extent depends on the state of the material (whether it is in film or particle form), as well as on molecular geometry. The degradation behavior of star-shaped copolymer was studied over a three week period and compared to its linear counterpart. Anti-cancer drugs 5-FU and paclitaxel were loaded into the micellar nanoparticles. The drug release profile showed that the release of paclitaxel from these polymers could be controlled over 2 weeks. The kinetics of drug release for star-branched, tri- and di-block copolymers were compared. The micelles from star-shaped branch showed more complete release of drug than the diblock copolymers; also, the lower hydrodynamic radius of star-shaped polymers may result in better clearance of the carrier polymer from the body.

Micelle-like nanoparticles of PLA–PEG–PLA triblock copolymer as chemotherapeutic carrier

Triblock copolymer PLA-PEG-PLA were synthesized using ring opening polymerization with different LA/EG ratio. Micellar aggregates were prepared from these block copolymers and characterized. The degradation characteristics of selected copolymers were assessed in both micellar and film forms. Surface segregation of PEG was also quantified as a function of copolymer composition. Anti-cancer drugs 5-FU and paclitaxel were loaded into the micellar nanospheres with good efficiency. The drug release profile showed good control over the release of paclitaxel from these polymers.

[Influence of plasma replacement on the hepatic failure with infection]

OBJECTIVE

To investigate the influence of artificial liver support system on severe hepatic failure with infection, 37 cases of severe hepatic failure and 80 cases times of plasma replacement were analyzed.

METHODS

The volume of plasma replacement was 2,000-2,600 ml/time. Japanese Plasauto-iQ Blood Purifying Device was used. Blood samples were observed before and after plasma replacement to determine liver function and prothrombin time. PBMCs were isolated and cultured, and the supernatants were collected to determine the levels of interleukin-10 (IL-10), IL-12 and gamma-interferon (gamma-IFN).

RESULTS

Before plasma replacement, 32 cases of 80 case times had infection, 5 cases of them had fever, the temperature was 37.5-38.0 centigrade. Four cases of them were fungus infection, 1 case was lung infection. After plasma replacement, liver function was improved, temperature was normal infection was controlled. The levels of IL-10, IL-12 and gamma-IFN in supernatants before and after plasma replacement were significantly higher than normal control, and the IL-10 level after plasma replacement was markedly higher than that before plasma replacement. The levels of IL-12 and gamma-IFN after plasma replacement were higher than plasma replacement, but they didn't reached statistic difference.

CONCLUSION

Plasma replacement might be helpful to control infection and therefore to stabilized the hepatic failure.

Hepatitis C virus infection of human hepatoma cell line 7721 in vitro

AIM: To establish a cell culture system with long-term replication of hepatitis C virus in vitro.

METHODS: Human hepatoma cell line 7721 was tested for its susceptibility to HCV by incubating with a serum from a patient with chronic hepatitis C. Cells and supernatant were harvested at various phases during the culturing periods. The presence of HCV RNA, the expression of HCV antigens in cells and/or supernatant were examined by RT-PCR, in situ hybridization and immunohisto-chemistry respectively.

RESULTS: The intracellular HCV RNA was first detected on d2 after infection and then could be intermittently detected in both cells and supernatant over a period of at least three months. The expression of HCV NS₃, CP₁₀ antigens could be observed in cells. The fresh cells could be infected by supernatant from cultured infected cells and the transmission of viral genome from HCV-infected 7721 cells to PBMCs was also observed.

CONCLUSION: The hepatoma line 7721 is not only susceptible to HCV but also supports its long-term replication in vitro.

Outcomes of a natural rubber latex control program in an Ontario teaching hospital

BACKGROUND

Allergy to natural rubber latex (NRL) has been frequently reported in health care workers. However, there is little published evidence of the outcome of hospital intervention programs to reduce exposure and detect cases of sensitization early.

OBJECTIVE

This study assesses the effects of intervention to reduce NRL allergy in an Ontario teaching hospital with approximately 8000 employees.

METHODS

A retrospective review assessed annual numbers of employees visiting the occupational health clinic, allergy clinic, or both for manifestations of NRL allergy compared with the timing of introduction of intervention strategies, such as worker education, voluntary medical surveillance, and hospital conversion to low-protein, powder-free NRL gloves.

RESULTS

The number of workers identified with NRL allergy rose annually, from 1 in 1988 to 6 in 1993. When worker education and voluntary medical surveillance were introduced in 1994, a further 25 workers were identified. Nonsterile gloves were changed to low-protein, powder-free NRL gloves in 1995: Diagnoses fell to 8 workers that year, and 2 of the 3 nurses who had been off work because of asthma-anaphylaxis were able to return to work with personal avoidance of NRL products. With a change to lower protein, powder-free NRL sterile gloves in 1997, allergy diagnoses fell to 3, and only 1 new case was identified subsequently up to May 1999. No increased glove costs were incurred as a result of consolidated glove purchases.

CONCLUSIONS

This program to reduce NRL allergy in employees was effectively achieved without additional glove costs while reducing expenses from time off work and workers' compensation claims.

[Reconstruction of hepatitis D virus ribozymes and their ability to trans-cleave hepatitis C virus RNA]

OBJECTIVE

To study whether reconstructed hepatitis D virus (HDV) ribozymes have the ability to trans-cleave hepatitis C virus (HCV) RNA.

METHODS

We reconstructed the stem IV and substrate-binding region of HDV genomic ribozymes, thus obtained three HDV ribozymes named RzC1, RzC2 and RzC3 expected to be able to trans-cleave HCV RNA at predicted sites. The substrate containing HCV RNA 5'-noncoding region (5'-NCR) and 5'-fragment of C region (HCV RNA 5'-NCR-C) was synthesized by transcription in vitro, then radiolabelled at its 5'-end. Under certain pH and appropriate concentration of Mg(2+) with or without deionized formamide, the ribozymes and their substrate were mixed at mol ratio of 100 : 1 and reacted for two hours. Trans-cleaved products were shown by denatured polyacrylamide gel electrophoresis and autoradiography, and the percentage of trans-cleaved substrate was calculated as the activity indicator of these ribozymes.

RESULTS

RzC1 and RzC2 were able to trans-cleave HCV RNA 5'-NCR-C site specifically, and their activity could be enhanced by certain concentration of deionized formamide. RzC3 could not trans-cleave the substrate.

CONCLUSIONS

Optimized HDV genomic ribozymes can trans-cleave HCV RNA.

Prevalence and causes of cough in chronic dialysis patients: a comparison between hemodialysis and peritoneal dialysis patients

Peritoneal dialysis (PD) and hemodialysis (HD) are both common forms of dialysis for patients with end-stage renal disease. A few case reports have suggested that cough is associated with PD. From 1991 to 1998, 17 patients being treated with PD at the Toronto Western Hospital demonstrated persistent cough severe enough for referral to a respirologist. Causes of cough, often more than one cause per patient, included asthma, post-nasal drip, gastroesophageal reflux disease (GERD), chronic obstructive pulmonary disease, congestive heart failure, allergic rhinitis, pleural effusion, and respiratory infection. The aim of this cross-sectional study was to establish the prevalence of cough among PD patients, to determine if PD patients more commonly have a dry persistent cough than do HD patients, and, if the latter case is true, the possible reasons for it. A detailed survey of 92 PD patients and 91 HD patients was conducted in 1998 and 1999 at the University Health Network. Survey questions inquired about patient respiratory symptoms since onset of dialysis. Charts were reviewed to obtain information on use of medications possibly relevant to cough. In the PD and HD groups, 52% and 23% were females (p = 0.001), and the mean ages were 59.1 and 60.1 years, respectively. Angiotensin converting enzyme (ACE) inhibitors had been taken by 65% (PD) and 55% (HD) of patients, and beta-blocking medications by 43% (PD) and 51% (HD). Since initiation of dialysis--mean 2.7 years (PD) and 3.7 years (HD)--22% of PD patients reported persistent cough versus 7% of HD patients (p = 0.003). Although no significant association was seen between cough and self-reported heartburn in HD patients (p = 0.439), a significant association between cough and self-reported heartburn was seen in PD patients: 67% of PD patients with persistent cough reported heartburn versus 29% of those without cough (p = 0.008). The findings suggest that GERD and associated cough are more common in PD patients than in HD patients, perhaps owing to increases in intra-abdominal pressure from the peritoneal dialysate.

[Significance of polypeptide antigen of HCVE2/NS1 relative conservation region in detection of anti-HCV]

OBJECTIVE

In order to study the significance of HCVE2/NS1 relative conservation region antigen.

METHODS

EIA was established with HCVE2/NS1 relative conservation polypeptide antigen, as well as serum HCV RNA and ALT in patients with HCV infection.

RESULTS

The positive rate of 96 cases patients who were infected by HCV is 41.67%, acute 13.55% and chronic 25.04%, and we found that there were 3 cases weak positive in 40 healths; Agreement rate is 62.5% in 40 cases of the positive of anti-E2/NS1 in sera with HCVRNA, and they have relation. In ALT level in sera, acute infection of HCV is higher than chronic (P < 0.05).

CONCLUSION

There are virus necleic acid in sera when anti-HCVE2/NS1 appearence positive; however, antibody of anti-E2/NS1 relative conservation region has the some neutralive actions, and this humor immunity may have the actions in clearing virus, but wether anti-body of anti-E2/NS1 relative conservation of HCV is or not neutralive antibody well be investigated further.

[Establishment of a method for detecting anti-HCV IgM using recombinated structural region antigens]

Presence of IgM antibody to viral structural protein can be taken as the marker of its replication, so the detection method for anti-HCV IgM was established using as HCV recombinated structural region antigens, including C, E1, E2, as the coated antigen and rabbit anti-human gamma chain sera for neutralization and sheep anti-rabbit IgG coated for the sorbence of the complex of RAH-gamma with human IgG. 76 serum specimens of the hepatitis C patients were detected by indirect ELISA for anti-HCV IgM and by RT-PCR for RNA. The results suggested that IgM antibodies to C, E1, E2 were closely related with RNA (P < 0.005). The components of the IgM antibody, too were identified by indirect ELISA with recombined antigens coated respectively. When whole-fragment C or C + E2 were used as the coated antigens, anti-HCV IgM in 96.6% or 100% of serum specimens can be respectively detected. Using recombined structural region antigens, detection of anti-HCV IgM by ELISA was high sensitivity and specificity.