[Effect of preemptive analgesia with ibuprofen on postoperative pain after mandibular third molar extraction: a randomized controlled trial]

Objective: To evaluate the impact of preemptive analgesia with ibuprofen on postoperative pain following the extraction of impacted mandibular third molars in a Chinese population, aiming to provide a clinical reference for its application. Methods: This multicenter, randomized, double-blind, placebo-controlled parallel-group trial was conducted from April 2022 to October 2023 at the Capital Medical University School of Stomatology (40 cases), Beijing TianTan Hospital, Capital Medical University (22 cases), and Beijing Chao-Yang Hospital, Capital Medical University (20 cases). It included 82 patients with impacted mandibular third molars, with 41 in the ibuprofen group and 41 in the control group. Participants in the ibuprofen group received 300 mg of sustained-release ibuprofen capsules orally 15 min before surgery, while the control group received a placebo. Both groups were instructed to take sustained-release ibuprofen capsules as planned for 3 days post-surgery. Pain intensity was measured using the numerical rating scale at 30 min, 4 h, 6 h, 8 h, 24 h, 48 h, and 72 h after surgery, and the use of additional analgesic medication was recorded during days 4 to 6 postoperatively. Results: All 82 patients completed the study according to the protocol. No adverse events such as nausea, vomiting, or allergies were reported in either group during the trial. The ibuprofen group exhibited significantly lower pain scores at 4 h [2.0 (1.0, 4.0) vs. 4.0 (3.0, 5.0)] (Z=-3.73, P<0.001), 6 h [2.0 (1.0, 4.0) vs. 5.0(2.5, 6.0)] (Z=-3.38, P<0.001), and 8 h [2.0 (1.0, 4.0) vs. 5.0 (2.0, 6.0)] (Z=-2.11, P=0.035) postoperatively compared to the control group. There were no statistically significant differences in pain scores between the groups at 30 min, 24 h, 48 h, and 72 h postoperatively (P>0.05). Additionally, 11 out of 41 patients (26.8%) in the ibuprofen group and 23 out of 41 patients (56.1%) in the control group required extra analgesic medication between days 4 and 6 post-surgery, with the ibuprofen group taking significantly fewer additional pills [0.0 (0.0, 1.0) vs. 1.0 (0.0, 3.0)] (Z=-2.81, P=0.005). Conclusions: A pain management regimen involving 300 mg of oral sustained-release ibuprofen capsules administered 15 minutes before surgery and continued for 3 d postoperatively effectively reduces pain levels and the total amount of analgesic medication used after the extraction of impacted mandibular third molars. Considering its efficacy, safety, and cost-effectiveness, ibuprofen is recommended as a first-line drug for perioperative pain management, enhancing patient comfort during diagnosis and treatment in a feasible manner.

Functional-Group-Directed Regiodivergent (3 + 2) Annulations of Electronically Distinct 1,3-Dienes and 2-Formyl Arylboronic Acids

Presented herein is a palladium-catalyzed asymmetric (3 + 2) annulation reaction between 1,3-dienes and 2-formylarylboronic acids, proceeding in a cascade vinylogous addition and Suzuki coupling process. Both electron-neutral and electron-deficient 1,3-dienes are compatible under similar catalytic conditions, and distinct regioselectivity is observed via functional-group control of 1,3-diene substrates. A collection of 1-indanols with dense functionalities is constructed stereoselectively.

Voltage-Controlled Magnon Transistor via Tuning Interfacial Exchange Coupling

Magnon transistors that can effectively regulate magnon transport by an electric field are desired for magnonics, which aims to provide a Joule-heating free alternative to the conventional electronics owing to the electric neutrality of magnons (the key carriers of spin-angular momenta in the magnonics). However, also due to their electric neutrality, magnons have no access to directly interact with an electric field and it is thus difficult to manipulate magnon transport by voltages straightforwardly. Here, we demonstrated a gate voltage (V_{g}) applied on a nonmagnetic metal and magnetic insulator (MI) interface that bent the energy band of the MI and then modulated the probability for conduction electrons in the nonmagnetic metal to tunnel into the MI, which can consequently enhance or weaken the spin-magnon conversion efficiency at the interface. A voltage-controlled magnon transistor based on the magnon-mediated electric current drag (MECD) effect in a Pt-Y_{3}Fe_{5}O_{12}-Pt sandwich was then experimentally realized with V_{g} modulating the magnitude of the MECD signal. The obtained efficiency (the change ratio between the MECD voltage at ±V_{g}) reached 10%/(MV/cm) at 300 K. This prototype of magnon transistor offers an effective scheme to control magnon transport by a gate voltage.

[Clinical characteristics and surgical outcomes in pediatric progressive restrictive strabismus]

Objective: To investigate the clinical features, imaging manifestations, histopathological characteristics, and surgical outcomes in pediatric progressive restrictive strabismus. Methods: A retrospective case series study was conducted, including data from 9 cases (9 eyes) of pediatric progressive restrictive strabismus treated at Tianjin Eye Hospital from June 2017 to October 2022. The study compared the degree of globe protrusion in both eyes, changes in eyelid fissure height during internal and external rotation in the primary gaze, summarized clinical characteristics, and analyzed intraoperative conditions, surgical outcomes and postoperative histopathological results of strabismus correction surgery. Statistical analysis was performed using Wilcoxon signed-rank test and Friedman two-way analysis of variance. Results: All 9 cases involved unilateral onset, with 4 males and 5 females. Three cases affected the right eye, and six affected the left eye. Onset age ranged from 2 to 40 months. The degree of globe protrusion in the affected eyes was 13.00 (12.00, 13.00) mm for the right eye and 12.00 (12.00, 13.50) mm for the left eye, with no statistically significant difference (Z=-1.00, P=0.317). There were no significant changes in eyelid fissure height during internal rotation [8.00 (7.25, 8.00) mm], primary gaze [7.50 (7.00, 8.00) mm], and external rotation [8.00 (7.75, 8.00) mm] in the affected eyes (χ²=1.00, P=0.607). No apparent abnormalities were observed in head CT or MRI scans, serum, or immunological tests. However, orbital CT or MRI scans indicated thickening of different extraocular muscle bellies. Six out of nine cases underwent strabismus correction surgery, and postoperative examination revealed restriction in eye movement despite achieving orthophoria in the primary gaze. Tissue pathology of three cases showed increased collagen fiber proliferation in one, scattered bundles of smooth muscle fibers amid diffuse collagen fiber proliferation in another, and abnormal proliferation of striated muscle fibers with varying diameters, increased paired box (PAX)7-positive satellite cells expressing slow muscle myosin in the third case. Conclusions: Pediatric progressive restrictive strabismus presents with restrictive changes, without significant alterations in globe protrusion and eyelid fissure height. Imaging examinations reveal thickening of the extraocular muscle bellies in the affected eye. Although strabismus correction surgery improves eye position, postoperative eye movement remains restricted. Histopathological findings in some cases show abnormal proliferation of skeletal muscle fibers or collagen fibers.

Palladium(0)-Catalyzed Enantioselective Construction of Multifunctional Piperidine Derivatives from 1,3-Dienes, N-Cyano Imines, and Beyond

An enantioselective (4 + 2) reaction between 1,3-dienes and N-cyano imines has been developed under Pd(0) catalysis, proceeding through a cascade vinylogous addition and intramolecular allylic amination sequence. 2,6-cis-Disubstituted-1,2,3,6-tetrahydropyridines were furnished as single diastereomers in moderate to good yields and enantiocontrol. Moreover, a more challenging three-component (2 + 2 + 2) annulation of 1,3-dienes, N-cyano imines, and activated alkenes was efficiently realized to afford piperidines with high structural complexity, albeit with moderate enantioselectivity.

[Update points for the 2022 edition of the European Association for the Study of Liver Diseases Clinical Practice Guidelines for the Management of Hepatic Encephalopathy and comparison with China's 2018 edition guidelines]

The European Association for the Study of Liver Diseases issued the "Clinical Practice Guidelines for the Management of Hepatic Encephalopathy" in 2022, which included recommendations for clinical diagnosis, assessment, treatment, management, and prevention. The Society's "Hepatic Encephalopathy Clinical Practice Guidelines in Chronic Liver Disease," which was last published in 2014, and the "Guidelines for the Diagnosis and Treatment of Hepatic Encephalopathy in Cirrhosis," which the Chinese Society of Hepatology, Chinese Medical Association, released in 2018, have certain differences and updates in terms of comparison to terminology, grading and classification, diagnosis, clinical evaluation and treatment, management, and prevention. Herein, the updated points of this guideline and the differences between it and our nation's guidelines are summarized in order to refine and understand the guiding role of the new version of the guideline for the clinical treatment of hepatic encephalopathy and provide aid for standardizing clinical diagnosis and treatment.

A SARS-CoV-2-specific CAR-T-cell model identifies felodipine, fasudil, imatinib, and caspofungin as potential treatments for lethal COVID-19

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced cytokine storm is closely associated with coronavirus disease 2019 (COVID-19) severity and lethality. However, drugs that are effective against inflammation to treat lethal COVID-19 are still urgently needed. Here, we constructed a SARS-CoV-2 spike protein-specific CAR, and human T cells infected with this CAR (SARS-CoV-2-S CAR-T) and stimulated with spike protein mimicked the T-cell responses seen in COVID-19 patients, causing cytokine storm and displaying a distinct memory, exhausted, and regulatory T-cell phenotype. THP1 remarkably augmented cytokine release in SARS-CoV-2-S CAR-T cells when they were in coculture. Based on this "two-cell" (CAR-T and THP1 cells) model, we screened an FDA-approved drug library and found that felodipine, fasudil, imatinib, and caspofungin were effective in suppressing the release of cytokines, which was likely due to their ability to suppress the NF-κB pathway in vitro. Felodipine, fasudil, imatinib, and caspofungin were further demonstrated, although to different extents, to attenuate lethal inflammation, ameliorate severe pneumonia, and prevent mortality in a SARS-CoV-2-infected Syrian hamster model, which were also linked to their suppressive role in inflammation. In summary, we established a SARS-CoV-2-specific CAR-T-cell model that can be utilized as a tool for anti-inflammatory drug screening in a fast and high-throughput manner. The drugs identified herein have great potential for early treatment to prevent COVID-19 patients from cytokine storm-induced lethality in the clinic because they are safe, inexpensive, and easily accessible for immediate use in most countries.

[A biography of infectious diseases: Hans Zinsser and his Rats, Lice and History]

Hans Zinsser, a well-known bacteriologist and immunologist in the United States in the early 20th century, made great advancement in the research of pathogen of typhus and its vaccine, with the epidemic typhus renamed after him. His masterpiece, Rats, Lice and History, teased out the co-evolutionary process of infectious diseases and their related organisms, focusing on specific cases and the development history of typhus. In this sense, he revealed the tremendous impact of infectious diseases on human history. He examined microorganisms and humans equally rather than simply from a human point of view. He analysed the pathological features of infectious diseases and provided professional insights into historical events of infectious diseases, such as the origin of syphilis and the plague of Athens, based on sufficient citations and references. He also advocated interpreting the history of infectious diseases with a holistic insight of history. His book, Rats, Lice and History, has been reprinted many times after its first publication, driving the following scholars to put the history of infectious diseases into a grand background of human development, enhancing the comprehension of ecology and politics and promoting the development of research in the history of diseases including life sciences, history and other disciplines.

[Using the external auditory canal skin graft of the healthy side to treat unilateral congenital aural atresia: preliminary results of clinical research]

Objective: To investigate whether the contralateral normal external auditory canal (EAC) skin graft can maintain the ear canal health after EAC reconstruction in unilateral congenital aural atresia (CAA) cases. Methods: A Zelen design randomized controlled study was used to collect unilateral CAA patients for EAC reconstruction prospectively (clinical trial registration number: ChiCTR2000032103). The patients were randomly divided into the control group and the trial group. The trial group used the contralateral normal EAC skin graft group (transplant part of the contralateral normal EAC skin to repair the atresia side for unilateral CAA patients), the control group all used scalp blade thick skin. We observed the EAC health and hearing results of the two groups after EAC reconstruction. Results: A total of 13 cases were enrolled from July 2020 to August 2021. There were eight patients in the trial group, including six males and two females, with an average age of 22.3 years (14-36 years). There were two patients with CAA on the left and six patients on the right. The average follow-up time was 8.8 months (4-14 months). There were five patients in the control group, all cases were male with an average age of 16.2 years (12-20 years). There were four patients with CAA on the left and one patient on the right. The average follow-up time was 7.0 months (2-14 months). In the trial group, eight cases of reconstructed EAC epithelium were healthy, one patient had cicatricial stenosis of EAC opening and lateralization of the tympanic membrane. The other patient had cicatricial stenosis of reconstructed EAC, this case also had scar hyperplasia of the contralateral EAC opening but recovered after soft packing and triamcinolone acetonide injection treatment. The healthy side EAC of the rest trial group had no scarring stenosis or local bone hyperplasia during long-term follow-up. In the control group, one patient was lost to follow-up and the other four patients had dry ears of reconstructed EAC, but easily to form crusts and needed to be cleaned repeatedly, one patient had lateralization of the tympanic membrane, the EAC epithelium was not healthy for long-term follow-up. The incidence of complications related to EAC reconstruction was lower than previous studies (χ²=5.55, P=0.018), and the average postoperative Air-Bone Gap increased (18.8±10.0)dB. Conclusion: By optimizing the EAC reconstruction technology, the health of the reconstructed EAC is improved compared with the previous study. After active intervention and treatment, there should be no scarring stenosis or local bone hyperplasia on the contralateral side EAC.

[Clinical study of selection of the upper instrumented vertebra at one level caudal to upper end vertebra in patients with Lenke 5C adolescent idiopathic scoliosis]

Objective: To investigate whether the upper instrumented vertebra (UIV) can be selected at one level caudal to upper end vertebra (UEV) in Lenke type 5C adolescent idiopathic scoliosis (AIS) patients. Methods: Total of 28 Lenke 5C AIS patients who underwent selective posterior fusion in Drum Tower Hospital of Nanjing University Medical School from September 2013 to September 2015 were included. There were 4 males and 24 females, with an age of (15.0±2.0) years, the Risser sign was graded 2-5. The following imaging parameters were measured on standing full spine X-ray before, immediately after the surgery and at the last follow-up: thoracolumbar/lumbar (TL/L) Cobb angle, coronal balance, UIV translation, lower instrumented vertebra (LIV) translation, UIV tilt, LIV tilt, and thoracic apical vertebral translation (T-AVT), lumbar apical vertebral translation (L-AVT). The patients were divided into two groups: decompensation group (n=6) and non-decompensation group (n=22). Radiographic parameters and Scoliosis Research Society (SRS)-22 scores were compared between the two groups. Results: Six cases (21.4%) had proximal decompensation at the last follow-up. There were no significant differences in Risser grade(3.8±1.0 vs 3.6±1.6), baseline thoracic Cobb angle(25.8°±2.2° vs 26.3°±6.4°) and TL/L Cobb angle(43.7°±3.4° vs 45.2°±6.5°) between the two groups (all P>0.05). However, the baseline lumbar/thoracic apical vertebra translation (L-T AVT ratio) was significantly higher in patients with proximal decompensation (6.3±1.3 vs 4.0±2.0, P=0.048). Conclusion: Selecting UIV at one level caudal to UEV, would not increase the incidence of proximal decompensation in Lenke 5C AIS patients with Risser higher than grade 2, the smaller baseline L-T AVT ratio, and with thoracic compensatory curve over 15°, and can obtain satisfactory clinical results.

Inflammation-related adverse reactions following vaccination potentially indicate a stronger immune response

Concerns about vaccine safety are an important reason for vaccine hesitancy, however, limited information is available on whether common adverse reactions following vaccination affect the immune response. Data from three clinical trials of recombinant vaccines were used in this post hoc analysis to assess the correlation between inflammation-related solicited adverse reactions (ISARs, including local pain, redness, swelling or induration and systematic fever) and immune responses after vaccination. In the phase III trial of the bivalent HPV-16/18 vaccine (Cecolin®), the geometric mean concentrations (GMCs) for IgG anti-HPV-16 and -18 (P<0.001) were significantly higher in participants with any ISAR following vaccination than in those without an ISAR. Local pain, induration, swelling and systemic fever were significantly correlated with higher GMCs for IgG anti-HPV-16 and/or anti-HPV-18, respectively. Furthermore, the analyses of the immunogenicity bridging study of Cecolin® and the phase III trial of a hepatitis E vaccine yielded similar results. Based on these results, we built a scoring model to quantify the inflammation reactions and found that the high score of ISAR indicates the strong vaccine-induced antibody level. In conclusion, this study suggests inflammation-related adverse reactions following vaccination potentially indicate a stronger immune response.

Specific determination of hepatitis B e antigen by antibodies targeting precore unique epitope facilitates clinical diagnosis and drug evaluation against hepatitis B virus infection

Hepatitis B e antigen (HBeAg) is a widely used marker both for chronic hepatitis B (CHB) clinical management and HBV-related basic research. However, due to its high amino acid sequence homology to hepatitis B core antigen (HBcAg), most of available anti-HBe antibodies are cross-reactive with HBcAg resulting in high interference against accurate measurement of the status and level of HBeAg. In the study, we generated several monoclonal antibodies (mAbs) targeting various epitopes on HBeAg and HBcAg. Among these mAbs, a novel mAb 16D9, which recognizes the SKLCLG (aa -10 to -5) motif on the N-terminal residues of HBeAg that is absent on HBcAg, exhibited excellent detection sensitivity and specificity in pairing with another 14A7 mAb targeting the HBeAg C-terminus (STLPETTVVRRRGR, aa141 to 154). Based on these two mAbs, we developed a novel chemiluminescent HBeAg immunoassay (NTR-HBeAg) which could detect HBeAg derived from various HBV genotypes. In contrast to widely used commercial assays, the NTR-HBeAg completely eliminated the cross-reactivity with secreted HBcAg from precore mutant (G1896A) virus in either cell culture or patient sera. The improved specificity of the NTR-HBeAg assay enables its applicability in cccDNA-targeting drug screening in cell culture systems and also provides an accurate tool for clinical HBeAg detection.

[Occurrence of rod fracture and salvage methods after primary surgery of the congenital lumbosacral deformity associated with sacral agenesis]

Objective: To analyze the occurrence of rod fracture after surgery for lumbosacral deformity associated sacral agenesis and discuss the relevant salvage methods. Methods: The clinical records of 19 patients who underwent surgical treatment for lumbosacral deformity associated sacral agenesis from January 2001 to January 2018 were retrospectively reviewed, including 11 boys and 8 girls. The average age was (9.6±5.2) years. The outcomes of surgical correction and internal fixation were evaluated by postoperative regular follow-up. We also recorded the time and position of rod fracture occurrence. The Cobb angle, coronal balance and sagittal balance were measured and compared to analyze the corresponding salvage methods and revision outcomes. Results: Three patients encountered rod fracture during follow-up, so the incidence of rod fracture after surgery for lumbosacral deformity associated sacral agenesis was 15.8%(3/19). Based on their own conditions, we formulated the individualized strategy and performed the revision surgery through the posterior-only approach. The most critical step was abundant bone-grafting and fusion in the defected sacroiliac joint. After revision, the scoliotic Cobb angle improved in two patients (91.5° vs 47.5°, 49.0° vs 28.0°) and coronal balance improved in one patient (40.3 mm vs 24.3 mm). No complication reoccurred during follow-up. Conclusion: The rod fracture after surgery for lumbosacral deformity associated sacral agenesis is quite common, which is probably correlated with its unique deformed structure and biomechanical characteristics. The individualized salvage methods and adequate bone-grafting and fusion for the defected sacroiliac joint will guarantee the reconstruction and maintenance of spine balance after revision.

[Correction of severe cup ears using postauricular tongue-shaped flap combined with deep fascial suspension]

Objective: To investigate the effect and satisfaction of using the postauricular tongue-shaped flap combined with deep fascia suspension in correcting severe cup ear malformation. Methods: Between August 2018 and November 2019, nine cases (10 ears) of Tanzer type Ⅲ severe cup ear malformation were treated with postauricular tongue-shaped flap combined with deep fascia suspension in this study. Results: Nine cases primary healed without hematoma, infection or skin necrosis, except one case with postoperative incision dehiscence. The cup ear deformity was significantly improved after the operation, the helix was intact, and the anti-helix was visible. The length, width, and circumference of the auricle were significantly enlarged three months following surgeries. There were no other complications except 1 patient recurrence 12 months after surgery. The patients were highly satisfied with the results of the surgery. Conclusions: Although the aesthctic of the reconstructed auricle is insufficient, this new technology makes full use of the autologous auricle tissue to correct severe cup ear malformation with good results.

Several FDA-Approved Drugs Effectively Inhibit SARS-CoV-2 Infection in vitro

To identify drugs that are potentially used for the treatment of COVID-19, the potency of 1403 FDA-approved drugs were evaluated using a robust pseudovirus assay and the candidates were further confirmed by authentic SARS-CoV-2 assay. Four compounds, Clomiphene (citrate), Vortioxetine, Vortioxetine (hydrobromide) and Asenapine (hydrochloride), showed potent inhibitory effects in both pseudovirus and authentic virus assay. The combination of Clomiphene (citrate), Vortioxetine and Asenapine (hydrochloride) is much more potent than used alone, with IC50 of 0.34 μM.

[Analysis of BK virus infection in kidney transplant recipients]

Objective: To compare the infection of BK virus in the recipients of living donor(LD) kidney transplant and deceased donor(DD) kidney transplant. Methods: A total of 911 recipients who underwent kidney transplantation in the Organ Transplantation Research Institute of the 8th Medical Center of the People's Liberation Army General Hospital from January 2015 to August 2019 were enrolled in this study. The DNA copies of BK virus in urine and peripheral blood of kidney transplant recipients were detected by real-time quantitative PCR. The patients were divided into LD group (n=255) and DD group (n=656). BK virus infection in recipients with DD kidney transplant were compared with that in recipients of LD kidney transplant. Results: The BK virus positive rate in the urine of all subjects was 13.06%(119/911), and that in blood was 2.96% (27/911). The positive rate of BK virus in urine after kidney transplantation was significantly higher than that in blood(P<0.000 1). The positive rate in urine was 9.02% (23/255) in LD group, which was significantly lower than that of 14.63% (96/656) in DD group in the same period (χ(2)=5.097, P=0.012); The positive rate of BK virus infection in relatives group was 0.78% (2/255), which was significantly lower than that of 3.81% (25/656) in DD group (χ(2)=5.849, P=0.007). Conclusions: There was a significant difference in the infection rate of BK virus between the LD and DD group. The incidence of BK virus infection in kidney transplant recipients from DD was higher than that of from LD kidney transplant recipients.

Robust neutralization assay based on SARS-CoV-2 S-protein-bearing vesicular stomatitis virus (VSV) pseudovirus and ACE2-overexpressing BHK21 cells

The global pandemic of coronavirus disease 2019 (COVID-19) is a disaster for human society. A convenient and reliable neutralization assay is very important for the development of vaccines and novel drugs. In this study, a G protein-deficient vesicular stomatitis virus (VSVdG) bearing a truncated spike protein (S with C-terminal 18 amino acid truncation) was compared to that bearing the full-length spike protein of SARS-CoV-2 and showed much higher efficiency. A neutralization assay was established based on VSV-SARS-CoV-2-Sdel18 pseudovirus and hACE2-overexpressing BHK21 cells (BHK21-hACE2 cells). The experimental results can be obtained by automatically counting the number of EGFP-positive cells at 12 h after infection, making the assay convenient and high-throughput. The serum neutralizing titer measured by the VSV-SARS-CoV-2-Sdel18 pseudovirus assay has a good correlation with that measured by the wild type SARS-CoV-2 assay. Seven neutralizing monoclonal antibodies targeting the receptor binding domain (RBD) of the SARS-CoV-2 S protein were obtained. This efficient and reliable pseudovirus assay model could facilitate the development of new drugs and vaccines.

A unique B cell epitope-based particulate vaccine shows effective suppression of hepatitis B surface antigen in mice

OBJECTIVE

This study aimed to develop a novel therapeutic vaccine based on a unique B cell epitope and investigate its therapeutic potential against chronic hepatitis B (CHB) in animal models.

METHODS

A series of peptides and carrier proteins were evaluated in HBV-tolerant mice to obtain an optimised therapeutic molecule. The immunogenicity, therapeutic efficacy and mechanism of the candidate were investigated systematically.

RESULTS

Among the HBsAg-aa119-125-containing peptides evaluated in this study, HBsAg-aa113-135 (SEQ13) exhibited the most striking therapeutic effects. A novel immunoenhanced virus-like particle carrier (CR-T3) derived from the roundleaf bat HBV core antigen (RBHBcAg) was created and used to display SEQ13, forming candidate molecule CR-T3-SEQ13. Multiple copies of SEQ13 displayed on the surface of this particulate antigen promote the induction of a potent anti-HBs antibody response in mice, rabbits and cynomolgus monkeys. Sera and purified polyclonal IgG from the immunised animals neutralised HBV infection in vitro and mediated efficient HBV/hepatitis B virus surface antigen (HBsAg) clearance in the mice. CR-T3-SEQ13-based vaccination induced long-term suppression of HBsAg and HBV DNA in HBV transgenic mice and eradicated the virus completely in hydrodynamic-based HBV carrier mice. The suppressive effects on HBsAg were strongly correlated with the anti-HBs level after vaccination, suggesting that the main mechanism of CR-T3-SEQ13 vaccination therapy was the induction of a SEQ13-specific antibody response that mediated HBV/HBsAg clearance.

CONCLUSIONS

The novel particulate protein CR-T3-SEQ13 suppressed HBsAg effectively through induction of a humoural immune response in HBV-tolerant mice. This B cell epitope-based therapeutic vaccine may provide a novel immunotherapeutic agent against chronic HBV infection in humans.

Research Progress and Forensic Identification of Alcoholic Cardiomyopathy

Abstract

With the rapid development of the social economy in China, the incidence of diseases caused by excessive drinking is gradually increasing as well. Alcoholic cardiomyopathy refers to long-term high intake of ethanol, and has typical dilated cardiomyopathy characteristics, such as, hemodynamic changes, symptoms, signs, and morphological features. It is a kind of cardiomyopathy that excludes other causes of dilated cardiomyopathy. Due to the lack of specific pathological changes, the forensic pathological identification of alcoholic cardiomyopathy can only be based on the patient's medical history and by ruling out other causes of cardiomyopathy. This paper reviews the pathogenesis and forensic identification of alcoholic cardiomyopathy in order to provide reference for forensic pathologists and clinicians.

Robust in vitro assay for analyzing the neutralization activity of serum specimens against hepatitis B virus

Anti-HBs is a well-known marker of protective capability against HBV. However, little is known about the association between the qAnti-HBs determined by immunoassays and the neutralization activity (NAT) derived from functional assays. We developed an in vitro assay for direct measurement of the NAT of human sera. The new assay was highly sensitive, with an analytical sensitivity of 9.6 ± 1.3 mIU/mL for the HBIG standard. For serum detection, the maximum fold dilution required to produce ≥50% inhibition (MDF₅₀) of HBV infection was used as the quantitative index. In vitro NAT evaluations were conducted for a cohort of 164 HBV-free healthy individuals. The results demonstrated that the NAT positively correlated with the qAnti-HBs (R² = 0.473, p < 0.001). ROC analysis indicated that the optimal cutoff value of the qAnti-HBs to discriminate significant NAT (MDF₅₀ ≥ 8) was 62.9 mIU/mL, with an AUROC of 0.920. Additionally, we found that the qAnti-HBc was another independent parameter positively associated with the NAT (R² = 0.300, p < 0.001), which suggested that antibodies against other HBV proteins generated by previous HBV exposure possibly also contribute to the NAT. In summary, the new cell-based assay provides a robust tool to analyse the anti-HBV NAT. Abbreviations: HBV: Hepatitis B virus; HBsAg: Hepatitis B surface antigen; Anti-HBs: Hepatitis B surface antibody; HBeAg: Hepatitis B e antigen; Anti-HBc: Hepatitis B core antibody; qAnti-HBs: quantitative hepatitis B surface antibody; qAnti-HBc: quantitative hepatitis B core antibody; qHBeAg: quantitative hepatitis B e antigen; NAT: neutralization activity; HBIG: hepatitis B immune globulin; NTCP: Na⁺-taurocholate cotransporting polypeptide; IRES: internal ribosome entry site; ccHBV: cell culture derived hepatitis B virus; GE/cell: genome equivalent per cell; MOI: multiplicity of infection; Dpi: day post infection; HepG2-TetOn: a HepG2-derived cell line that expresses the doxycycline-regulated transactivator; ROC: receiver operating characteristic curve; AUROC: area under receiver operating characteristic curve; LLOQ: the lower limits of quantification; MDF₅₀: the maximum fold dilution required to produce ≥50% inhibition; IC50: half maximal inhibitory concentration.

[Correlation study of peripheral blood inflammatory factors in patients with sudden deafness]

Objective:The aim of this study is to compare the difference of inflammatory factors in peripheral blood between sudden deafness patients and normal people, and to evaluate the predictive value of inflammatory factors in hearing recovery of sudden deafness patients. Method:Seventy-two inpatients with sudden deafness and 19 healthy persons were included. At the beginning of treatment in our hospital, audiometry was performed and peripheral blood was collected. The levels of IL-1β, IL-6, IL-17α, TGF-β1 and TNF-α in peripheral blood were detected by ELISA. The treatment was intravenous steroid（not applied if patients with contraindication of systemic steroid application）+ intratympanic steroid injection+ microcirculation improvement or neurotrophic therapy+ hyperbaric oxygen. At the end of the treatment, audiometry was performed again. A total of 26 patients were collected to test the levels of inflammatory factors in peripheral blood again at the end of the treatment. Result:The mean levels of inflammatory factors IL-1β, IL-6, IL-17α, TGF-β1 and TNF-α in peripheral blood of patients were （2.66±9.57） pg/ml, （4.71±6.91） pg/ml, （19.33±32.27） pg/ml, （50 018.37±14 660.72） pg/ml, （1.52±2.40） pg/ml, respectively. And the level of these five inflammatory factors in normal persons were （3.61±9.82） pg/ml, （3.58±4.49） pg/ml, （11.64±13.29） pg/ml, （45 199.98±11 956.09） pg/ml，（1.09±1.08） pg/ml respectively. Statistical analysis showed no significant difference between these two groups. A total of 45 cases were effective（hearing threshold increased ≥15 dB） and 27 cases were ineffective（hearing threshold increased<15 dB）. There was no significant difference in the levels of inflammatory factors between the two groups. Among 26 patients with blood samples before and after treatment, the level of TGF-β1 after treatment was significantly lower than that before treatment. Conclusion:The levels of these five inflammatory factors including IL-1β, IL-6, IL-17α, TGF-β1 and TNF-αin peripheral blood could not predict the recovery of sudden hearing loss. The role of inflammation in the development of sudden deafness needs further confirmation. TGF-β1 may be involved in the development of sudden deafness.

Structural and functional analyses of hepatitis B virus X protein BH3-like domain and Bcl-xL interaction

Hepatitis B virus (HBV) X protein, HBx, interacts with anti-apoptotic Bcl-2 and Bcl-xL proteins through its BH3-like motif to promote HBV replication and cytotoxicity. Here we report the crystal structure of HBx BH3-like motif in complex with Bcl-xL where the BH3-like motif adopts a short α-helix to snuggle into a hydrophobic pocket in Bcl-xL via its noncanonical Trp120 residue and conserved Leu123 residue. This binding pocket is ~2 Å away from the canonical BH3-only binding pocket in structures of Bcl-xL with proapoptotic BH3-only proteins. Mutations altering Trp120 and Leu123 in HBx impair its binding to Bcl-xL in vitro and HBV replication in vivo, confirming the importance of this motif to HBV. A HBx BH3-like peptide, HBx-aa113-135, restores HBV replication from a HBx-null HBV replicon, while a shorter peptide, HBx-aa118-127, inhibits HBV replication. These results provide crucial structural and functional insights into drug designs for inhibiting HBV replication and treating HBV patients.

[Screening of periodontal and salivary parameters in patients with frequent acute exacerbation of chronic obstructive pulmonary disease]

Objective: To screen the risk factors of patients with frequent acute exacerbation of chronic obstructive pulmonary disease (COPD) by detecting the clinical indicators of periodontitis and the level of bacterial and inflammatory markers in saliva. Methods: Thirty-eight COPD patients in their stable period were recruited and detected from Beijing Chao-Yang Hospital,Capital Medical University during December 2016 to May 2017. The periodontal index were recorded. The levels of inflammatory factors in saliva samples were examined by using enzyme linked immunosorbent assay (ELISA). The bacteria composition in the saliva samples were identified by using 16SrRNA gene pyrosequencing. All patients were followed up and monitored for acute exacerbation of COPD for 12 months. The patients were divided into frequent acute exacerbation group (≥2 times/year, n=10) and non frequent acute exacerbation group (<2 times/year, n=28). Results: In univariate analysis, the patients' average age of frequent acute exacerbation group (69.0±7.3) was significantly older than that of non-frequent acute exacerbation group (61.8±8.3) (P=0.02). The numbers of remaining teeth ≤26 [100% (10/10)] was significantly higher and plaque index ≤2.5 (2/10) in frequent acute exacerbation group was significantly lower compared with the remaining teeth ≤26 [43% (12/28)] and the plaque index ≤2.5 [71% (21/28)] in non-frequent acute exacerbation group (P=0.02, P=0.01). The proportions of salivary inflammatory factors interleukin-6 (IL-6) level ≤60 ng/L (10%),C-reactive protein (CRP) level ≤1 550 μg/L (30%), matrix metalloproteinase-8 (MMP-8) level ≤140 μg/L (30%) and fibrinogen level ≤90 mg/L (30%) in frequent acute exacerbation group were significantly lower compared with salivary inflammatory factors IL-6 level ≤60 ng/L (71%),CRP level ≤1 550 μg/L (71%), MMP-8 level ≤140 μg/L (86%) and fibrinogen level ≤90 mg/L (71%) in non-frequent acute exacerbation group (P<0.05). The differences of relative abundances of salivary bacteria,such as species of Chloroflexi, Anaerolineae, Anaeroales, Corynebacteriales, Anaerolineaceae, Tissierellaceae, Leptotrichiaceae, Corynebacteriaceae, Leptotrichia, Moryella, Lachnoanaerobaculum and Corynebacterium between frequent acute exacerbation group and non-frequent acute exacerbation group were significantly different (P<0.05). In multivariate logistics regression analysis,the level of IL-6 >60 ng/L and the relative abundance of Corynebacteriales >0.2 had significant difference (P<0.05). Conclusions: The level of IL-6 and the relative abundance of Corynebacteriales might be the markers of frequent acute exacerbation in COPD patients.

[Optical properties of computer aided design and computer aided manufactured materials for veneer restorations]

Objective: To investigate the translucency parameters (TP) and the color parameters of computer-aided design and computer-aided manufacturing (CAD/CAM) materials for veneer restorations in order to guide clinical practice. Methods: Eleven groups of CAD/CAM materials (A2 shade) were included in this study: IPS e.max CAD HT/LT, IPS Empress CAD HT/LT, Lava(TM) Ultimate HT/LT, VITA SUPRINITY HT/T, VITA ENAMIC HT/T, VITABLOCS Mark Ⅱ, and were named as Group A, B, C, D, E, F, G, H, I, J, K. Each material was designed and milled to disk-shaped specimens (10.0 mm×8.0 mm×0.7 mm) (n=6). The specimens were polished with silicon carbide paper and the thickness of specimens were adjusted into (0.60±0.03) mm. The color parameters of specimens were individually measured with the colorimeter against black and white ceramic tiles background to obtain the TP values. The color parameters of the specimens against the composite resin background were also measured and the color differences (ΔE values) between specimens and the A2 shade tab were calculated. Results: One-way ANOVA showed that the translucency parameters of the 11 groups of materials were statistically significant (F=253.69, P<0.05). The ΔE values of CAD/CAM material groups ranged from 1.78 to 4.12 (ΔE values<5.5). Conclusions: The microstructure of CAD/CAM materials and the types of material translucency influence the optical properties. The CAD/CAM materials in this experiment have achieved color matching with the A2 shade tab.

[The effects of postauricular injection of methylprednisolone on medium-high frequency sudden hearing loss]

Objective:To study the effects of postauricular injection of methylprednisolone on medium-high frequency sudden hearing loss.Method:The data of 45 patients with invalid treatment who were diagnosed as medium-high frequency sudden hearing loss were retrospectively studied. They were divided into postauricular injection group and non-postauricular injection group. The treatment efficiency and hearing improvement at each frequency were compared between the two groups.Result:The improvements of hearing threshold in the non-postauricular injection group were(6.30±5.00)dB HL,(3.80±5.52)dB HL,(5.35±5.50)dB HL,(15.60±11.84)dB HL,(19.60±13.46)dB HL,(15.40±12.90)dB HL at 250, 500, 1000, 2000, 4000 and 8000Hz, respectively. The hearing improvements of the postauricular injection group were (5.35±6.22)dB HL,(2.50±3.00)dB HL,(4.65±6.60)dB HL,(23.75±10.75)dB HL,(25.75±11.73)dB HL,(30.50±14.50)dB HL at 250, 500,1000,2000,4000 and 8000Hz, respectively. There were significant differences between the two groups in hearing improvements at 2000-8000Hz. The treatment effective rates were 44% and 80% for the non-postauricular injection group and postauricular injection group respectively, which showed a significant difference(χ²=8.385P<0.05).Conclusion:Postauricular injection of methylprednisolone as a remedy treatment is safe and effective for sudden hearing loss in middle and high frequency.

[Research Progress on Postmortem Interval Estimation by Vitreous Humor]

Postmortem interval （PMI） estimation is one of the most challenging problems in the field of forensic science. Vitreous humor is a hotspot which has been used for PMI estimation and postmortem chemical analysis in forensic pathology. In order to provide novel perspectives for the future research of PMI estimation using vitreous humor, the comparison between vitreous humor with other common body fluids, the effect of temperature on vitreous humor, vitreous humor detection method and data fitting method have been reviewed in this paper.

[Application of Mixed-effect Model in PMI Estimation by Vitreous Humor]

OBJECTIVES

To test the changes of the potassium （K⁺） and magnesium （Mg²⁺） concentrations in vitreous humor of rabbits along with postmortem interval （PMI） under different temperatures, and explore the feasibility of PMI estimation using mixed-effect model.

METHODS

After sacrifice, rabbit carcasses were preserved at 5 ℃, 15 ℃, 25 ℃ and 35 ℃, and 80-100 μL of vitreous humor was collected by the double-eye alternating micro-sampling method at every 12 h. The concentrations of K⁺ and Mg²⁺ in vitreous humor were measured by a biochemical-immune analyser. The mixed-effect model was used to perform analysis and fitting, and established the equations for PMI estimation. The data detected from the samples that were stoned at 10 ℃, 20 ℃ and 30 ℃ with 20, 40 and 65 h were used to validate the equations of PMI estimation.

RESULTS

The concentrations of K⁺ and Mg²⁺ [f（x,y）] in vitreous humor of rabbits under different temperature increased along with PMI （x）. The relative equations of K⁺ and Mg²⁺ concentration with PMI and temperature under 5 ℃~35 ℃ were f_K⁺（x,y）=3.413 0+0.309 2 x+0.337 6 y+0.010 83 xy-0.002 47 x² （P<0.000 1）, and f_Mg²⁺（x,y）=0.745 6+0.006 432 x+0.033 8 y （P<0.000 1）, respectively. It was proved that the time of deviation for PMI estimation by K⁺ and Mg²⁺ was in 10 h when PMI was between 0 to 40 h, and the time of deviation was in 21 h when PMI was between 40 to 65 h.

CONCLUSIONS

the ambient temperature range of 5 ℃-35 ℃, the mixed-effect model based on temperature and vitreous humor substance concentrations can provide a new method for the practical application of vitreous humor chemicals for PMI estimation.

Role of quantitative hepatitis B core antibody levels in predicting significant liver inflammation in chronic hepatitis B patients with normal or near-normal alanine aminotransferase levels

AIM

Chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) levels are not free from significant hepatic lesions. Recently, there has been an improved understanding of the clinical significance of quantitative hepatitis B core antibody levels (qAnti-HBc) during CHB management. In this cross-sectional study, we evaluated the utility of qAnti-HBc in identifying significant liver inflammation in CHB patients.

METHODS

A total of 469 patients (training set, n = 363; validation set, n = 106) who underwent liver biopsy (LB) were included. The qAnti-HBc levels were quantified and the relationship between histology and serum markers was systematically analyzed.

RESULTS

In the training set, qAnti-HBc levels were found to have significant diagnostic value for moderate to severe liver inflammation (≥G2) in all patients (area under the receiver operating characteristic curve [AUROC] = 0.768; 95% confidence interval [CI], 0.721-0.810; P < 0.001) and in patients with normal or near-normal ALT levels (AUROC = 0.767; 95% CI, 0.697-0.828; P < 0.001). Our novel index (AC index) for the identification of ≥G2 inflammation, which combined the qAnti-HBc and ALT levels, significantly improved diagnostic performance (AUROC = 0.813; 95% CI, 0.768-0.852) compared to the use of ALT alone (AUROC = 0.779; 95% CI, 0.732-0.821) in all patients. In the validation set, the AC index showed an improved AUROC of 0.890 (95% CI, 0.814-0.942) and 0.867 (95% CI, 0.749-0.943) in all patients and patients with normal ALT levels, respectively.

CONCLUSIONS

The qAnti-HBc level predicts significant liver inflammation well, even in patients with normal or near-normal ALT levels. Compared with the conventional ALT level, the AC index is a more reliable non-invasive biomarker for significant liver inflammation in CHB patients.

A cell-penetrating whole molecule antibody targeting intracellular HBx suppresses hepatitis B virus via TRIM21-dependent pathway

Rationale: Monoclonal antibodies (mAbs) mostly targeting extracellular or cell surface molecules have been widely used in the treatment of various diseases. However, mAbs cannot pass through the cell membrane as efficiently as small compounds, thus limiting their use against intracellular targets. Methods to shuttle antibodies into living cells may largely expand research and application in areas based on mAbs. Hepatitis B virus X protein (HBx) is an important intracellular multi-functional viral protein in the life cycle of hepatitis B virus (HBV). HBx plays essential roles in virus infection and replication and is strongly associated with HBV-related carcinogenesis.

Methods: In this study, we developed a cell-penetrating whole molecule antibody targeting HBx (9D11-Tat) by the fusion of a cell penetrating peptide (CPP) on the C-terminus of the heavy chain of a potent mAb specific to HBx (9D11). The anti-HBV effect and mechanism of 9D11-Tat were investigated in cell and mouse models mimicking chronic HBV infection.

Results: Our results demonstrated that the recombinant 9D11-Tat antibody could efficiently internalize into living cells and significantly suppress viral transcription, replication, and protein production both in vitro and in vivo. Further analyses suggested the internalized 9D11-Tat antibody could greatly reduce intracellular HBx via Fc binding receptor TRIM21-mediated protein degradation. This process simultaneously stimulated the activations of NF-κB, AP-1, and IFN-β, which promoted an antiviral state of the host cell.

Conclusion: In summary, our study offers a new approach to target intracellular pathogenesis-related protein by engineered cell-penetrating mAb expanding their potential for therapeutic applications. Moreover, the 9D11-Tat antibody may provide a novel therapeutic agent against human chronic HBV infection.

Antibody-mediated immunotherapy against chronic hepatitis B virus infection

The currently available drugs to treat hepatitis B virus (HBV) infection include interferons and nucleos(t)ide analogs, which can only induce disease remission and are inefficient for the functional cure of patients with chronic HBV infection (CHB). Since high titers of circulating hepatitis B surface antigen (HBsAg) may be essential to exhaust the host anti-HBV immune response and they cannot be significantly reduced by current drugs, new antiviral strategies aiming to suppress serum hepatitis B surface antigen (HBsAg) could help restore virus-specific immune responses and promote the eradication of the virus. As an alternative strategy, immunotherapy with HBsAg-specific antibodies has shown some direct HBsAg suppression effects in several preclinical and clinical trial studies. However, most described previously HBsAg-specific antibodies only had very short-term HBsAg suppression effects in CHB patients and animal models mimicking persistent HBV infection. More-potent antibodies with long-lasting HBsAg clearance effects are required for the development of the clinical application of antibody-mediated immunotherapy for CHB treatment. Our recent study described a novel mAb E6F6 that targets a unique epitope on HBsAg. It could durably suppress the levels of HBsAg and HBV DNA via Fcγ receptor-dependent phagocytosis in vivo. In this commentary, we summarize the current research progress, including the therapeutic roles and mechanisms of antibody-mediated HBV clearance as well as the epitope-determined therapeutic potency of the antibody. These insights may provide some clues and guidance to facilitate the development of therapeutic antibodies against persistent viral infection.

[The basic study and clinical progress of auditory implants treatment of conductive hearing loss]

In recent years, with the emergence and clinical application of a series of artificial auditory implantation technologies, surgically hard-treated conductive hearing loss treatment has made great progress and development. In this paper, research progress of bone conduction implant aids and middle ear implant devices treatment of conductive hearing loss are reviewed.

Sleeping Beauty transposon-based system for rapid generation of HBV-replicating stable cell lines

The stable HBV-replicating cell lines, which carry replication-competent HBV genome stably integrated into the genome of host cell, are widely used to evaluate the effects of antiviral agents. However, current methods to generate HBV-replicating cell lines, which are mostly dependent on random integration of foreign DNA via plasmid transfection, are less-efficient and time-consuming. To address this issue, we constructed an all-in-one Sleeping Beauty transposon system (denoted pTSMP-HBV vector) for robust generation of stable cell lines carrying replication-competent HBV genome of different genotype. This vector contains a Sleeping Beauty transposon containing HBV 1.3-copy genome with an expression cassette of the SV40 promoter driving red fluorescent protein (mCherry) and self-cleaving P2A peptide linked puromycin resistance gene (PuroR). In addition, a PGK promoter-driven SB100X hyperactive transposase cassette is placed in the outside of the transposon in the same plasmid.The HBV-replicating stable cells could be obtained from pTSMP-HBV transfected HepG2 cells by red fluorescence-activated cell sorting and puromycin resistant cell selection within 4-week. Using this system, we successfully constructed four cell lines carrying replication-competent HBV genome of genotypes A-D. The replication and viral protein expression profiles of these cells were systematically characterized. In conclusion, our study provides a high-efficiency strategy to generate HBV-replicating stable cell lines, which may facilitate HBV-related virological study.

Effects of Oridonin on growth performance and oxidative stress in broilers challenged with lipopolysaccharide

This study was conducted to investigate the effects of oridonin (ORI) on growth performance and antioxidant capacity in broiler chickens that were repeatedly challenged with lipopolysaccharide (LPS). A total of 384 one-day-old male Arbor Acre broiler chickens were randomly assigned to 8 treatments with 6 replicate cages per treatment and 8 birds per replicate. There were 4 dietary treatments: the control group (birds fed the basal diet), the ORI 50 group, the ORI 80 group, and the ORI 100 group (the basal diet supplemented with 50, 80, and 100 mg/kg oridonin, respectively). Broilers were intraperitoneally injected with either 250 μg/kg BW LPS or an equivalent amount of sterile saline at 16, 18, and 20 d of age. LPS decreased the average daily weight gain (ADG), the average daily feed intake (ADFI), and the feed conversion ratio (FCR) of broiler chickens (P < 0.05); oridonin supplementation had no effects on performance whether before or after LPS injection (P > 0.05). LPS stimulation increased the relative weight of the spleen and bursa (P < 0.05); oridonin inclusion markedly attenuated the increased spleen index (P < 0.05). Additionally, the LPS-induced increases in the concentrations of malondialdehyde (MDA) and decreases in activities of total superoxide dismutase (T-SOD), total antioxidant capacity (T-AOC) and catalase (CAT) were dramatically attenuated by oridonin in both the serum and liver (P < 0.05). Furthermore, LPS down-regulated the mRNA expressions of nuclear factor erythroid 2-related factor 2 (Nrf2), copper and zinc superoxide dismutase (Cu/Zn-SOD), manganese superoxide dismutase (Mn-SOD), glutathione peroxidase (GPx1), and CAT in the liver (P < 0.05), However, oridonin inclusion increased the liver mRNA expression levels of Nrf2, Cu/Zn-SOD, Mn-SOD, CAT, and GPx1 (P < 0.05). It was concluded that the dietary oridonin supplementation at an optimum dose of 100 mg/kg improves the antioxidant capacity in broilers, as evidenced by the decrease in MDA and the increase in total SOD activities and mRNA expression levels of the liver antioxidant genes, although the effects on growth performance was negligible.

Prolonged suppression of HBV in mice by a novel antibody that targets a unique epitope on hepatitis B surface antigen

OBJECTIVE

This study aimed to investigate the therapeutic potential of monoclonal antibody (mAb) against HBV as a novel treatment approach to chronic hepatitis B (CHB) in mouse models.

METHODS

Therapeutic effects of mAbs against various epitopes on viral surface protein were evaluated in mice mimicking persistent HBV infection. The immunological mechanisms of mAb-mediated viral clearance were systematically investigated.

RESULTS

Among 11 tested mAbs, a novel mAb E6F6 exhibited the most striking therapeutic effects in several HBV-persistent mice. Single-dose administration of E6F6 could profoundly suppress the levels of hepatitis B surface antigen (HBsAg) and HBV DNA for several weeks in HBV-transgenic mice. E6F6 regimen efficiently prevented initial HBV infection, and reduced viral dissemination from infected hepatocytes in human-liver-chimeric mice. E6F6-based immunotherapy facilitated the restoration of anti-HBV T-cell response in hydrodynamic injection (HDI)-based HBV carrier mice. Immunological analyses suggested that the Fcγ receptor-dependent phagocytosis plays a predominant role in E6F6-mediated viral suppression. Molecular analyses suggested that E6F6 recognises an evolutionarily conserved epitope (GPCK(R)TCT) and only forms a smaller antibody-viral particle immune complex with limited interparticle crosslinking when it binds to viral particles. This unique binding characteristic of E6F6 to HBV was possibly associated with its effective in vivo opsonophagocytosis for viral clearance.

CONCLUSIONS

These results provided new insight into understanding the therapeutic role and mechanism of antibody against persistent viral infection. The E6F6-like mAbs may provide a novel immunotherapeutic agent against human chronic HBV infection.

Effects of CYP3A5 and CYP2D6 genetic polymorphism on the pharmacokinetics of diltiazem and its metabolites in Chinese subjects

PURPOSE

To assess the possibility of using CYP2D6 10 +/- CYP3A5*3 as biomarkers to predict the pharmacokinetics of diltiazem and its two metabolites among healthy Chinese subjects. METHODS 41 healthy Chinese were genotyped for CYP3A5 3 and CYP2D6 10, and then received a single oral dose of diltiazem hydrochloride capsules (300 mg). Multiple blood samples were collected over 48 h, and the plasma concentrations of diltiazem, N-desmethyl diltiazem and desacetyl diltiazem were determined by HPLC-MS/MS. The relationships between the genotypes and pharmacokinetics were investigated.

RESULTS

The pharmacokinetics of diltiazem, N-desmethyl diltiazem were not significantly affected by both CYP3A5 3 and CYP2D6*10 alleles. However, the systemic exposure of the pharmacologyically active metabolites, desacetyl diltiazem, was 2-fold higher in CYP2D6 10/10 genotype carriers than in 1/10 or 1/1 ones (AUC(o-inf) of CYP2D6 1/1, 1/10 and 10/10 are 398.2 +/- 162.9, 371,0 69.2 and 726.2 +/- 468.1 respectively, p <0.05).

CONCLUSIONS

Two of the most frequent alleles, CYP3A5 3 and CYP2D6 10, among Chinese do not have major impacts on the disposition of diltiazem and N-desmethyl diltiazem. However, the desacetyl diltiazem showed 2-fold accumulation in individuals with CYP2D6 10/10 genotype. Despite this, the effect of genotype of CYP2D6 on clinical outcome of diltiazem treatment is expected to be limited.

Fatty acid composition in breast milk and serum phospholipids of healthy term Chinese infants during first 6 weeks of life

AIM

To compare the fatty acid (FA) pattern in early and mature breast milk with that in plasma phospholipids of cord blood and breast-fed infants.

METHODS

Forty-five mother-infant pairs from western Shanghai were studied. All infants, born at term with normal weight and length, were examined at birth and days 5 and 42. FA was analyzed by capillary gas-liquid chromatography.

RESULTS

Cord blood showed higher concentration of long-chain polyunsaturated FA (LCPUFA) but lower saturated (SFA) and monounsaturated (MUFA) FA than postnatal infants' plasma. SFA decreased with age in the infants, but MUFA and linoleic acid (LA, 18:2omega6) increased. LCPUFA were lower in the plasma of 5-day-old infants than in cord blood, but LA was 80%, alpha-linolenic acid (ALA, 18:3omega3) 33% and the ratio omega-6/omega-3 42% higher. At day 42, LA increased further, LCPUFA remained similar, and was in breast milk lower than at day 5, while ALA and gamma-linolenic acid (18:3omega6) were higher. The activity index of desaturases indicated high Delta9 activity in breast milk and high activity of Delta5 desaturase in the infants.

CONCLUSION

Breast milk FA composition changed markedly from day 5 to 42 with increasing correlation to infants' plasma. Calculation of desaturase activities suggested high capacity of LCPUFA synthesis.

Mechanical characterization of cellulosic thecal plates in dinoflagellates by nanoindentation

Dinoflagellates constitute an important group of microorganisms. Symbiotic dinoflagellates are responsible for the primary production of coral reef ecosystems and the phenomenon of their demise is known as "coral bleaching." Blooming of the planktonic dinoflagellates is the major cause of "red tides." Many dinoflagellates have prominent membrane-bound thecal plates at their cell cortices. These thecal plates have high cellulose content and are biologically fabricated into various shapes. However, the mechanical properties of theca have not previously been characterized; understanding these properties, including hardness and elastic modulus, will give insights into the ecological significance and biotechnological potential of bio-fabricated structures. A series of nanoindentation tests were performed on various locations of cellulosic thecal plates isolated from the dinoflagellates Alexandrium catenella and Lingulodinium polyedrum. Despite having transparent properties, thecal plates possess mechanical properties comparable to softwood cell walls, implicating their role as a protective cell covering. Consistent measurements were obtained when indentation was performed at various locations, which contrasts with the high variability of cellulose microfibers from plant sources. The present study demonstrated the novel properties of this potential new source of cellulose.

Constitutive expression of human angiostatin in Pichia pastoris by high-density cell culture

A high-density cell culture method to produce human angiostatin has been successfully established by constitutive expression of the protein in Pichia pastoris. The fermentation was carried out in a 20 l bioreactor with a 10 l working volume, using a high-density cell culture method by continuously feeding with 50% glycerol-0.8% PTM4 to the growing culture for 60 h at 30 degrees C. Dissolved oxygen level was maintained at 25-30% and pH was controlled at 5 by the addition of 7 M NH4OH. Angiostatin was constitutively expressed during the fermentation by linking its expression to the P. pastoris constitutive GAP promoter (pGAP). But after 36 h of fermentation, the peak biomass growth was 305 as measured by absorption of 600 nm, while the peak angiostatin expression was 176 mg/l. Similar to the product expressed from inducible system [24], angiostatin produced from constitutive system also inhibited the angiogenesis on the CAM and suppressed the growth of B16 melanoma in C57BL/6J mouse. The above results suggest that GAP promoter is more efficient than AOX1 promoter for the expression of angiostatin in P. pastoris by shake flask culture or high-density cell fermentation and is likely to be an alternative to AOX1 promoter in large-scale expression of angiostatin and other heterologous proteins.

Influence of naturally occurring variations in maternal care on prepulse inhibition of acoustic startle and the medial prefrontal cortical dopamine response to stress in adult rats

In rats, naturally occurring variations in maternal care contribute to the development of individual differences in the behavioral and neuroendocrine responses to stress during adulthood. The dopamine (DA) projection to the medial prefrontal cortex (mPFC) plays an important role in mediating stress responsivity and is thought to be involved also in regulating sensorimotor gating. In the present study, we compared prepulse inhibition (PPI) of acoustic startle as well as the left and right mPFC DA stress responses in the adult offspring of high- and low-licking/grooming (LG) dams. Our data indicate that the offspring of low-LG animals are impaired on measures of PPI compared with high-LG animals. We also observed in low-LG animals a significant blunting of the mPFC DA stress responses that was lateralized to the right hemisphere, whereas in high-LG animals, the left and right mPFC DA stress responses were equally attenuated. Although mPFC levels of DA transporter did not differ between the two groups of animals, mPFC levels of catechol-O-methyl transferase immunoreactivity of low-LG animals were significantly lower than those of high-LG animals. These data provide evidence that variations in maternal care can lead to lasting changes in mPFC DA responsivity to stress and suggest the possibility that such changes in mesocorticolimbic DA function can also lead to deficits in sensorimotor gating.

Effects of dextromethorphan on nocturnal behavior and brain c-Fos expression in adolescent rats

Dextromethorphan, an antitussive widely available over-the-counter, is abused, mostly by teenagers at high doses. In our previous report, a high dose of dextromethorphan activated the midbrain dopamine neurons of adolescent rats. In the present study, we performed c-Fos immunohistochemistry in the dopaminergic terminal regions of adolescent rat brain after the intraperitoneal administration of dextromethorphan at different doses (0, 10, 20, and 40 mg/kg), and also examined the effects on nocturnal behavior. The results showed that dextromethorphan increased c-Fos expression dose dependently in the anterior cingulate cortex, caudate putamen, nucleus accumbens, and central amygdala. Significant ataxia occurred and both locomotor and rearing activity decreased immediately after the dextromethorphan injection. We conclude that the neurons in the reward pathway of the adolescent rat brain appear to be activated by a single injection of dextromethorphan, and that activation of this pathway by dextromethorphan may correlate with the behavioral effects and abuse potential of the drug.

Versatile two-phase solvent system for alkaloid separation by high-speed counter-current chromatography

In order to find a versatile high speed counter-current chromatography solvent system that can be used as a general prefractionation system for most alkaloids, the crude extracts of five Chinese traditional medicinal herbs, Cortex phellodendri, Semen strychni, green tea, Sophora flavescens ait, and Datura mete L. were resolved. All separations were performed only with a two-phase system composed of CHCl3-CH3OH-water (4:3:2). The water had different acidities controlled by adding NaH2PO4 or HCl to each sample. The fractionated components were identified by thin-layer chromatography, which confirmed this solvent system was versatile and very useful for the separation of alkaloids.

Dextromethorphan increases tyrosine hydroxylase mRNA in the mesencephalon of adolescent rats

Dextromethorphan (DM), an antitussive widely available in over-the-counter, has been abused mostly in teenage groups at high doses. To examine effects of DM on the reward pathway, we injected a high dose of DM (40 mg/kg; intraperitoneally) into the adolescent rat and measured tyrosine hydroxylase (TH) mRNA by in situ hybridization in the ventral tegmental area (VTA) and the substantia nigra (SN). Remarkable increases in the level of TH mRNA were observed in the VTA and SN 2 h after DM injection. Stereotyped behavior and ataxia increased, and rearing decreased by DM administration. These results suggest that DM-induced increase in TH mRNA expression in mesencephalon contribute to the reinforcing property and the behavioral effects of DM.