TIMAHAC: Streamlined Tandem IMAC-HILIC Workflow for Simultaneous and High-Throughput Plant Phosphoproteomics and N-glycoproteomics

Protein post-translational modifications (PTMs) are crucial in plant cellular processes, particularly in protein folding and signal transduction. N-glycosylation and phosphorylation are notably significant PTMs, playing essential roles in regulating plant responses to environmental stimuli. However, current sequential enrichment methods for simultaneous analysis of phosphoproteome and N-glycoproteome are labor-intensive and time-consuming, limiting their throughput. Addressing this challenge, this study introduces a novel tandem S-Trap-IMAC-HILIC (S-Trap: suspension trapping; IMAC: immobilized metal ion affinity chromatography; HILIC: hydrophilic interaction chromatography) strategy, termed TIMAHAC, for simultaneous analysis of plant phosphoproteomics and N-glycoproteomics. This approach integrates IMAC and HILIC into a tandem tip format, streamlining the enrichment process of phosphopeptides and N-glycopeptides. The key innovation lies in the use of a unified buffer system and an optimized enrichment sequence to enhance efficiency and reproducibility. The applicability of TIMAHAC was demonstrated by analyzing the Arabidopsis phosphoproteome and N-glycoproteome in response to abscisic acid (ABA) treatment. Up to 1954 N-glycopeptides and 11,255 phosphopeptides were identified from Arabidopsis, indicating its scalability for plant tissues. Notably, distinct perturbation patterns were observed in the phosphoproteome and N-glycoproteome, suggesting their unique contributions to ABA response. Our results reveal that TIMAHAC offers a comprehensive approach to studying complex regulatory mechanisms and PTM interplay in plant biology, paving the way for in-depth investigations into plant signaling networks.

Simple bone cysts of the proximal humerus presented with limb length discrepancy: A case report

BACKGROUND

Simple bone cysts (SBC) are benign tumor-like bone lesions typically identified in children. While SBC may lead to growth disturbances or growth arrest, such cases are uncommon. The mechanisms behind these observations remain unclear. Additionally, research on the etiology of SBC remains inconclusive, and there has been no consensus on the appropriate timing and methodology for treatment.

CASE SUMMARY

Here, we present our experience in the successful surgical management of a 10-year-old girl with SBC, who presented with a pathological fracture complicated by malunion of the displaced fracture, varus deformity, and limb length discrepancy. We hypothesized two possible etiologies for the patient's growth arrest and subsequent humerus varus deformity: (1) Direct disruption of the physis by fluid from the cyst itself; and (2) damage to the epiphysis due to repetitive pathological fractures associated with SBC. In addressing this case, surgical intervention was undertaken to correct the proximal humerus varus deformity. This approach offered the advantages of simultaneously correcting angular abnormalities, achieving mild limb lengthening, providing definitive SBC treatment, and reducing the overall treatment duration.

CONCLUSION

As per current literature, acute correction of acute angular deformity in proximal humeral SBC is not well comprehended. However, in this specific case, acute correction was considered an optimal solution.

Synthesis of High-Value Bio-Based Polyamide 12,36 Microcellular Foams with Excellent Dimensional Stability and Shape Recovery Properties

The search for alternatives to petroleum-based thermoplastic polyamide elastomers (TPAEs) has recently drawn great interest. In this study, a bio-massed TPAE, PA12,36, was synthesized using 1,12-dodecanediamine (DDA) and fatty dimer acid (FDA, PripolTM1009) precursors via catalyst and solvent-free melt polycondensation. The molecular structure and molecular weight of the PA12,36 were characterized by 1H NMR, FTIR, and GPC. PA12,36 displayed a low melting temperature of 85.8 °C, an initial degradation temperature of 425 °C, and a glass-transition temperature of 30.4 °C, whereas it sustained satisfactory tensile strength (10.0 MPa) and superior strain at break (1378%). Furthermore, PA12,36 was foamed by supercritical CO2, and the cell size, cell density, and porosity were determined. The entangled long-chained FDA component generated a physically crosslinked network, which promoted the melt viscosity of PA12,36 against elongations of foam cell growth and increased foamability significantly. As a result, uniform structured cellular foams with a cell diameter of 15-24 µm and high cell density (1011 cells/cm3-1012 cells/cm3) were successfully achieved. The foaming window was widened from 76 to 81 °C, and the expansion ratio was increased from 4.8 to 9.6. Additionally, PA12,36 foam with a physically crosslinked structure presented a better creep shape recovery percentage (92-97.9%) and sturdier dimensional stability. This bio-based PA12,36 foam is a promising candidate to replace petroleum-based thermoplastic elastomer foams for engineering applications, particularly shoe soles.

Biobased polyester versus synthetic fiberglass casts for treating stable upper limb fractures in children: a randomized controlled trial

BACKGROUND

Stable upper limb fractures, such as radius, ulna, or distal humerus fractures, are common pediatric orthopedic traumas that are traditionally managed with cast immobilization. The commonly used synthetic fiberglass cast is light and water resistant but may promote skin itchiness during casting, which is a common complaint of patients. In addition, these diisocyanate-based casts have been proven to be toxic and may cause asthma. Herein, we introduce a novel biobased polyester cast to compare its clinical outcomes and patient satisfaction with conventional synthetic fiberglass casts.

METHODS

From Feb 2022 to Nov 2022, we undertook a single-center prospective randomized trial involving 100 children with cast-immobilized stable upper limb fractures. These patients were randomized into either biobased polyester or synthetic fiberglass groups. All patients were regularly followed up till the cast removal which occurred approximately 3-4 weeks after immobilizing. Objective clinical findings and subjective patient questionnaire were all collected and analyzed.

RESULTS

According to the radiographs taken on the day of cast removal, there was no loss of reduction in both groups. The incidence of skin problems was 3.4 times higher in the synthetic fiberglass group than in the biobased polyester group. For the subjective questionnaire, the biobased polyester cast was preferred in every sub-item.

CONCLUSIONS

Our study strongly suggested that the novel biobased polyester cast provides matching stability to conventional fiberglass casts and improves patient satisfaction in an eco-friendlier and safer way.

TRIAL REGISTRATION

ClinicalTrials.gov Protocol Registration and Results System ( https://www.

CLINICALTRIALS

gov/ ; ID: NCT06102603; Date: 26/10/2023).

Bio-Based PLA/PBS/PBAT Ternary Blends with Added Nanohydroxyapatite: A Thermal, Physical, and Mechanical Study

The physical and mechanical properties of novel bio-based polymer blends of polylactic acid (PLA), poly(butylene succinate) (PBS), and poly (butylene adipate-co-terephthalate) (PBAT) with various added amounts of nanohydroxyapatite (nHA) were investigated in this study. The formulations of PLA/PBS/PBAT/nHA blends were divided into two series, A and B, containing 70 or 80 wt% PLA, respectively. Samples of four specimens per series were prepared using a twin-screw extruder, and different amounts of nHA were added to meet the regeneration needs of bone graft materials. FTIR and XRD analyses were employed to identify the presence of each polymer and nHA in the various blends. The crystallization behavior of these blends was examined using DSC. Tensile and impact strength tests were performed on all samples to screen feasible formulations of polymer blends for bone graft material applications. Surface morphology analyses were conducted using SEM, and the dispersion of nHA particles in the blends was further tested using TEM. The added nHA also served as a nucleating agent aimed at improving the crystallinity and mechanical properties of the blends. Through the above analyses, the physical and mechanical properties of the polymer blends are reported and the most promising bone graft material formulations are suggested. All blends were tested for thermal degradation analysis using TGA and thermal stability was confirmed. The water absorption experiments carried out in this study showed that the addition of nHA could improve the hydrophilicity of the blends.

Sulfide Oxidation on Ladder-Type Heteroarenes to Construct All-Acceptor Copolymers for Visible-Light-Driven Hydrogen Evolution

Conjugated polymers (CPs) have recently gained increasing attention as photocatalysts for sunlight-driven hydrogen evolution. However, they suffer from insufficient electron output sites and poor solubility in organic solvents, severely limiting their photocatalytic performance and applicability. Herein, solution-processable all-acceptor (A1 -A2 )-type CPs based on sulfide-oxidized ladder-type heteroarene are synthesized. A1 -A2 -type CPs showed upsurging efficiency improvements by two to three orders of magnitude, compared to their donor-acceptor -type CP counterparts. Furthermore, by seawater splitting, PBDTTTSOS exhibited an apparent quantum yield of 18.9% to 14.8% at 500 to 550 nm. More importantly, PBDTTTSOS achieved an excellent hydrogen evolution rate of 35.7 mmol h-1  g-1 and 150.7 mmol h-1  m-2 in the thin-film state, which is among the highest efficiencies in thin film polymer photocatalysts to date. This work provides a novel strategy for designing polymer photocatalysts with high efficiency and broad applicability.

[Advances of hydrogel in early protection of exposed intra-abdominal organs after open abdomen]

The protection of open abdomen (OA) wound is a significant subject in the field of trauma surgery. The key technical challenge in the early stage of OA wound management involves promoting granulation tissue filling between intestinal segments, reducing intestinal wall abrasion, and preventing the development of enteroatmospheric fistulas (EAF). Hydrogels, characterized by their high water content and exceptional biocompatibility, serve as extracellular matrix-mimicking materials, and are extensively employed in various medical and healthcare applications. In this review, we discuss the application of hydrogel developed by natural biomaterials in OA wounds protection, taking into consideration the unique pathophysiological characteristics of the OA wounds. This review aims to provide valuable insights for the development of hydrogel materials for early-stage OA wound protection in future research.

Suspension Trapping-Based Sample Preparation Workflow for In-Depth Plant Phosphoproteomics

Plant phosphoproteomics provides a global view of phosphorylation-mediated signaling in plants; however, it demands high-throughput methods with sensitive detection and accurate quantification. Despite the widespread use of protein precipitation for removing contaminants and improving sample purity, it limits the sensitivity and throughput of plant phosphoproteomic analysis. The multiple handling steps involved in protein precipitation lead to sample loss and process variability. Herein, we developed an approach based on suspension trapping (S-Trap), termed tandem S-Trap-IMAC (immobilized metal ion affinity chromatography), by integrating an S-Trap micro-column with a Fe-IMAC tip. Compared with a precipitation-based workflow, the tandem S-Trap-IMAC method deepened the coverage of the Arabidopsis (Arabidopsis thaliana) phosphoproteome by more than 30%, with improved number of multiply phosphorylated peptides, quantification accuracy, and short sample processing time. We applied the tandem S-Trap-IMAC method for studying abscisic acid (ABA) signaling in Arabidopsis seedlings. We thus discovered that a significant proportion of the phosphopeptides induced by ABA are multiply phosphorylated peptides, indicating their importance in early ABA signaling and quantified several key phosphorylation sites on core ABA signaling components across four time points. Our results show that the optimized workflow aids high-throughput phosphoproteome profiling of low-input plant samples.

Tandem Mass Tag-Based Phosphoproteomics in Plants

Mass spectrometry-based proteomics provide a powerful tool for plant research, allowing global detection of steady-state levels of proteins under a given experimental setup. Here, we provide an optimized protocol for proteomic profiling using tandem mass tag (TMT) labeling followed by liquid chromatography-mass spectrometry (LC-MS/MS) to quantitate phosphopeptides and non-phosphopeptides from the same samples. The outlined protocol comprises a series of successive steps, namely, SDS (sodium dodecyl sulfate) protein extraction, protein precipitation, digestion, TMT labeling, phosphopeptide enrichment, high pH reversed-phase fractionation, LC-MS/MS analysis, protein identification, and data analysis. Our proteome-scale protocol requires 0.1 mg protein per sample and allows for the reliable and accurate quantification of more than 8000 proteins in Arabidopsis plant samples across multiple conditions, including low abundant peptides.

Bio-based poly(hexamethylene 2,5-furandicarboxylate-co-2,6-naphthalate) copolyesters: a study of thermal, mechanical, and gas-barrier properties

A series of poly(hexamethylene 2,5-furandicarboxylate-co-2,6-naphthalate) copolyesters were synthesized using various amounts of poly(hexylene 2,5-furandicarboxylate) (PHF) and poly(hexylene 2,6-naphthalate) (PHN) via melt polymerization. The effects of introducing 2,6-naphthalene dicarboxylic acid (NDCA) on the thermal, mechanical, and gas-barrier properties were investigated. When the NDCA content was less than 30 mol%, the temperatures of crystallization (T_c) and melting (T_m) decreased as the amount of NDCA was increased owing to disturbance of the polymer-chain regularity. When the NDCA content was above 50 mol%, the T_c and T_m of the materials increased as the NDCA content was increased, showing that the dominant crystallization behavior varied from 2,5-furandicarboxylic acid to NDCA. Hence, the glass transition temperature (T_g) increased as the NDCA content was increased, which was attributed to the incorporation of NDCA with a more rigid naphthalate structure compared with the furan ring. The gas-barrier properties of the samples were observed to improve with the introduction of NDCA; this tendency could be explained by the β-relaxation behavior and free volume values of the samples in the amorphous state. The activation energy (E_a) of β-relaxation increased with the NDCA content, indicating that higher amounts of energy were needed to trigger the onset of long-range molecular motions. Free-volume calculations of the polymer structure showed that the introduction of NDCA hindered the space for gas penetration. For these reasons, the gas-barrier properties were improved and evaluated.

Main-chain engineering of polymer photocatalysts with hydrophilic non-conjugated segments for visible-light-driven hydrogen evolution

Photocatalytic water splitting is attracting considerable interest because it enables the conversion of solar energy into hydrogen for use as a zero-emission fuel or chemical feedstock. Herein, we present a universal approach for inserting hydrophilic non-conjugated segments into the main-chain of conjugated polymers to produce a series of discontinuously conjugated polymer photocatalysts. Water can effectively be brought into the interior through these hydrophilic non-conjugated segments, resulting in effective water/polymer interfaces inside the bulk discontinuously conjugated polymers in both thin-film and solution. Discontinuously conjugated polymer with 10 mol% hexaethylene glycol-based hydrophilic segments achieves an apparent quantum yield of 17.82% under 460 nm monochromatic light irradiation in solution and a hydrogen evolution rate of 16.8 mmol m⁻² h⁻¹ in thin-film. Molecular dynamics simulations show a trend similar to that in experiments, corroborating that main-chain engineering increases the possibility of a water/polymer interaction. By introducing non-conjugated hydrophilic segments, the effective conjugation length is not altered, allowing discontinuously conjugated polymers to remain efficient photocatalysis.

The introduction of hydrophilic segments into the main-chain of polymer photocatalysts allows water to efficiently enter the interior through these hydrophilic segments, and results in effective water/polymer interfaces for hydrogen evolution.

Highly Stretchable Fully Biomass Autonomic Self-Healing Polyamide Elastomers and Their Foam for Selective Oil Absorption

Renewable polymers with self-healing ability, excellent elongation, hydrophobicity, and selective oil absorption attributes are of interest for an extensive range of applications, such as e-skin, soft robots, wearable devices, and cleaning up oil spills. Herein, two fully renewable eco-friendly polyamide (PA)-based self-healing elastomers (namely, PA36,IA, and PA36,36) were prepared by a facile and green one-pot melt polycondensation of itaconic acid (IA), PripolTM 1009, and PriamineTM 1075 monomers. The molecular structures of these PAs were analyzed by FITR, 1H NMR, and 13C NMR. The distinct structure of these PAs shows superior strain values (above 2300%) and high ambient temperature autonomous self-healing ability. Interestingly, the synthesized renewable PA36,36 showed zero water absorption values and hydrophobic properties with a contact angle of θ = 91° compared to the synthesized PA36,IA and other previously reported PAs. These excellent attributes are due to the low concentration of amide groups, the highly entangled main chains, the intermolecular diffusion, the manifold dangling chains, and the numerous reversible physical bonds within the renewable PAs. Furthermore, the hydrophobic properties may aid in the selective oil absorption of the PA36,36-based foam, for which PA36,36 foam is produced by the green supercritical carbon dioxide (scCO2) batch foaming process. The PA36,36 foam with a microporous cellular structure showed better absorption capacity and high stability in repeated use. Due to these advantages, these bio-based PAs have potential for the production of eco-friendly self-healing materials, superabsorbent foams, and other polymeric materials.

P–522 Cervical secretion methylation profile is associated with the success of frozen-thawed embryo transfer - a proof-of-concept study

Study question

Is cervical secretion gene methylation profile different between receptive and non-receptive endometrium and associated with implantation outcome in frozen-embryo transfer (FET) cycle?

Summary answer

The combination of candidate genes methylation profiles obtained from cervical secretion showed significant associations with pregnancy outcomes.

What is known already

Implantation failure remains a black box in reproductive medicine, and the exact mechanism of how endometrial receptivity is regulated is still unknown. Epigenetic modifications play a role in the gene expression pattern and may alter the endometrial receptivity in the human endometrium. Cervical secretion containing various implantation-related cytokines, and the gene methylation change can be used as a non-invasive molecular source that reflects the endometrium condition.

Study design, size, duration

In this retrospective case-control study, sixty-two women who entered the FET cycle (30 pregnant and 32 non-pregnant women) were enrolled.

Participants/materials, setting, methods

Cervical secretion was collected before embryo transfer from women enrolled in multicenter university-affiliated reproductive units. The DNA methylation status of six candidate genes was measured using quantitative methylation-specific PCR (qMSP). The correlation between methylation change and the pregnancy outcome was analyzed.

Main results and the role of chance

The candidate genes were selected from that associated with implantation with literature review and the original genome-wide DNA methylation data from NCBI GEO DataSets (GSE90060) which processed using bioinformatics analysis. Six candidate genes whose CpG-level methylation analysis with β-value statistically higher in receptive endometrium than in a pre-receptive endometrium were selected. All six candidate genes showed different degrees of correlation with the pregnancy outcomes. Among them, PRKAG2 methylation changes showed the highest correlation with the pregnancy outcome. A logistic regression model was used to evaluate the performance of a single gene or a combination of genes for implantation prediction. The results showed a statistically significant association between the methylation status of a combination of genes (PRKAG2, KRS1, HAND2) and the pregnancy outcome (p = 0.008), resulting in an optimal AUC of 0.7 (95% CI: 0.57 - 0.81) for implantation prediction.

Limitations, reasons for caution

The results obtained from a relatively small cohort size. A larger study and further comprehensive methylome investigations are warranted.

Wider implications of the findings: This study is the first proof-of-concept study that cervical secretion methylation profile is associated with implantation outcome in a FET cycle, and showed potential as a non-invasive method for implantation prediction.

Trial registration number

non applicable

[Clinical cure strategy for hepatitis B: immunomodulatory therapy]

Chronic hepatitis B virus (HBV) infection remains a major world public health problem. Current guidelines of chronic hepatitis B (CHB) suggest the clinical cure as the ideal thearapeutic goal. Although the optimization of the existing antiviral treatment can make some patients achieve clinical cure, but for most patients with chronic hepatitis B, it is difficult to achieve clinical cure according to the existing antiviral treatment plan. The medical community has begun to work together to seek new treatment strategies, especially the immune intervention measures aimed at restoring the immune response in the liver microenvironment. Notably, immune antiviral response plays a crucial role in HBV clearance, and the clinical cure of chronic hepatitis B is finally achieved through the optimized combination of antiviral and immunomodulatory drugs.

Synthesis of Bio-Based Poly(Butylene Adipate-co-Butylene Itaconate) Copolyesters with Pentaerythritol: A Thermal, Mechanical, Rheological, and Molecular Dynamics Simulation Study

Bio-based unsaturated poly(butylene adipate-co-butylene itaconate) (PBABI) aliphatic copolyesters were synthesized with pentaerythritol (PE) as a modifier, observing the melting point, crystallization, and glass transition temperatures were decreased from 59.5 to 19.5 °C and 28.2 to -9.1 °C as an increase of itaconate concentration, and T_g ranged from -54.6 to -48.1 °C. PBABI copolyesters tend to the amorphous state by the existence of the BI unit above 40 mol%. The yield strength, elongation, and Young's modulus at different BA/BI ratios were valued in a range of 13.2-13.8 MPa, 575.2-838.5%, and 65.1-83.8 MPa, respectively. Shear-thinning behavior was obtained in all BA/BI ratios of PBABI copolyesters around an angular frequency range of 20-30 rad s^-1. Furthermore, the thermal and mechanical properties of PBABI copolyesters can be well regulated via controlling the itaconic acid contents and adding the modifier. PBABI copolyesters can be coated on a 3D air mesh polyester fabric to reinforce the mechanical property for replacing traditional plaster applications.

Effect of Bis (2-Aminoethyl) Adipamide/Adipic Acid Segment on Polyamide 6: Crystallization Kinetics Study

The crystallization behavior of novel polyamide 6 (PA6) copolyamides with different amounts of bis (2-aminoethyl) adipamide/adipic acid (BAEA/AA) segment was investigated. The wide-angle X-ray diffraction (WAXD) results showed that as the amount of BAEA/AA segment increased to 10 mole%, the crystalline forms of all PA6 copolyamide were transferred from the stable α-form to the unstable γ-form because of the complex polymer structure. According to studies of crystallization kinetics, the Avrami exponent (n) values for all copolyamide samples ranged from 1.43 to 3.67 under isothermal conditions, implying that the crystallization is involved in the two- to three-dimensional growth at a high temperature of isothermal condition. The copolyamides provided a slower crystallization rate and higher crystallization activation energy (ΔE_a) than neat PA6. Polyamide containing 10 mole% of BEAE/AA content exhibited a unique crystallization behavior in the coexistence of the α and γ forms. These results deepen our understanding of the relationship between BAEA/AA content, crystal structure, and its crystallization behavior in low-melting PA6, and they make these types of copolyamides useful for their practical application.

Urban-rural disparity of preventive healthcare utilisation among children under the universal health insurance coverage in Taiwan: a national birth cohort analysis

OBJECTIVE

In the context of universal health insurance coverage, this study aimed to determine whether urban-rural inequality still exists in preventive health care (PHC) amongst children in Taiwan.

STUDY DESIGN

Prospective cohort study.

METHODS

A total of 184,117 mothers and their children born in 2009 were identified as the study cohort. The number of children born in urban, satellite and rural areas was 40,176, 57,565 and 86,805, respectively. All children were followed for 7 years, before which a total of seven times PHC were provided by Taiwan's National Health Insurance (NHI) programme. Ordinal logistic regression models were used to associate urbanisation level with the frequency of PHC utilisation. Stratified analyses were further performed in accordance with the children's birth weight and the mothers' birthplace.

RESULTS

Children from satellite areas had higher utilisation for the first four scheduled PHC visits. Children living in urban areas received more PHC for the fifth and sixth scheduled visits. Compared with those from rural areas, children in satellite areas exhibited a small but significant increase in odds in PHC utilisation, with a covariate-adjusted odds ratio (aOR) of 1.04 and 95% confidence interval (CI) of 1.02-1.06. By contrast, no significant difference was observed between rural and urban areas (aOR = 1.01). Further stratified analyses suggest more evident urban-rural difference in PHC utilisation amongst children with low birth weight and foreign-born mothers.

CONCLUSIONS

Given a universal health insurance coverage and embedded mechanisms in increasing the availability of healthcare resources in Taiwan, a slight urban-rural difference is observed in PHC utilisation amongst children. Hence, sociodemographic inequality in utilisation of PHC still exists. This issue should be addressed through policy intervention.

Conjugated Copolymers through Electrospinning Synthetic Strategies and Their Versatile Applications in Sensing Environmental Toxicants, pH, Temperature, and Humidity

Conjugated copolymers (CCPs) are a class of polymers with excellent optical luminescent and electrical conducting properties because of their extensive π conjugation. CCPs have several advantages such as facile synthesis, structural tailorability, processability, and ease of device fabrication by compatible solvents. Electrospinning (ES) is a versatile technique that produces continuous high throughput nanofibers or microfibers and its appropriate synchronization with CCPs can aid in harvesting an ideal sensory nanofiber. The ES-based nanofibrous membrane enables sensors to accomplish ultrahigh sensitivity and response time with the aid of a greater surface-to-volume ratio. This review covers the crucial aspects of designing highly responsive optical sensors that includes synthetic strategies, sensor fabrication, mechanistic aspects, sensing modes, and recent sensing trends in monitoring environmental toxicants, pH, temperature, and humidity. In particular, considerable attention is being paid on classifying the ES-based optical sensor fabrication to overcome remaining challenges such as sensitivity, selectivity, dye leaching, instability, and reversibility.

Isothermal Kinetics of Poly(butylene adipate-co-butylene itaconate) Copolyesters with Ethylenediaminetetraacetic Acid

A series of aliphatic copolyesters, poly(butylene adipate-co-butylene itaconate) (PBABI), have been synthesized using melt polycondensation of adipic acid (AA), itaconic acid (IA), 1,4-butanediol (1,4-BDO), and the tetra-functional group of ethylenediaminetetraacetic acid (EDTA, 0.1 mol %) to form partially cross-linking density as novel thermoplastic unsaturated copolyesters in our previous research. The crystal phase of PBABI copolyesters tended to prefer thermodynamics in the presence of a small amount of EDTA. The isothermal crystallization analysis revealed that the PBABI with EDTA exhibited a higher crystallization rate and a shorter half-time of crystallization than neat PBABI copolyesters. All of the sizes of spherulite/sheet crystals in the BA/BI = 9/1 are smaller than at BA/BI = 10/0 with or without a cross-linking agent, which demonstrated that the morphology behavior tended to form a small sheet crystal in the presence of 10 mol % IA, which played a dominant role in determining the average size of the crystal. These results deepen our understanding of the relationship among the cross-linking agent, the crystal form, and solidification time in PBABI copolyesters, making these kinds of polymers applicable to reinforce three-dimensional (3D) air-permeable polyester-based smart textiles.

[Several issues worthy of reference and discussion of 2019 edition of the European Association for the Study of the Liver guideline for drug-induced liver injury]

The 2019 European Association for the Study of the Liver (EASL) Clinical Practice Guidelines (hereinafter referred to as the EASL Guidelines) extracted the required evidence from detailed research materials, and rigorously graded and condensed the varying strengths of evidence into 32 recommendations and 14 statements (recommendations and reminders) for drug-induced Liver Injury (DILI). This guideline has important reference values for helping clinicians to further improve their understanding of DILI and the level of clinical diagnosis, treatment and prevention; however, there are still several issues worthy of further discussion.

Influence of asymmetric substituent group 2-methyl-1,3-propanediol on bio-based poly(propylene furandicarboxylate) copolyesters

A series of bio-based poly(propylene-co-2-methyl-1,3-propanediol 2,5-furandicarboxylate) (PPMF) copolyesters, with various compositions from poly(propylene 2,5-furandicarboxylate) (PPF) to poly(2-methyl-1,3-propylene 2,5-furandicarboxylate) (PMePF), were synthesized by conventional melt polymerization. The effects of the substituent group to PPF on the thermal properties, mechanical properties, and gas barrier properties were analyzed by differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), dynamic mechanical analysis (DMA), tensile testing, and the oxygen permeation test. The introduction of the methyl group with a hydrogen atom altered the thermal behavior and gas barrier properties of copolyesters, suggesting that the glass temperature (Tg) and the melting temperature (Tm) were decreased as the 2-methyl-1,3-propanediol (MPO) content increased. PPF exhibited the highest Tm and Tg of 175.9 °C and 83.0 °C with a melting enthalpy (ΔHm) of 38.6 J g-1, and poly(2-methyl-1,3-propylene 2,5-furandicarboxylate) formed as an amorphous polyester. Moreover, the effect of a substituent methyl group on the barrier properties was attributed to β relaxation and fraction free volume, which could be raised by replacing the methyl group with a hydrogen atom for PPF, weakening the barrier properties.

Expression and prognostic significance of melatonin receptor MT1 in patients with gastric adenocarcinoma

Melatonin receptor type 1 (MTNR1A or MT1) is known to play an important role in cancer progression; however, its prognostic value for resected gastric adenocarcinoma (RGA) is unknown. In this study, we examined the potential of MT1 as a prognostic biomarker for RGA. The expression of the MT1 was evaluated in 67 patients with RGA by immunohistochemistry, and the relationship between MT1 levels and RGA prognosis was analyzed by Chi-square test, multivariate Cox regression, Kaplan-Meier method, and log-rank test. High MT1 expression was associated with a poor survival rate (29.0%, p=0.002) and the occurrence of metastasis (62.9%, p=0.004). Kaplan-Meier survival analysis and log rank tests revealed that patients with high expression of the MT1 had significantly shorter median overall survival compared to those with low expression (33.0 vs. 65.0 months, respectively; p=0.02). Multivariate Cox analysis indicated that the calculated death risk (hazard ratio [HR]) in patients with high expression levels of the MT1 increased to 2.68 (95% confidence interval [CI] 1.21-5.94, p=0.015), which was higher compared to those with low levels. HR of death was also high in patients with advanced T stage (2.51; 95 % CI 1.00-6.26, p=0.049) and metastasis (5.02; 95% CI 1.94-13.03, p=0.001). Our results showed that high MT1 expression in primary gastric adenocarcinoma tissues was associated with the occurrence of metastasis and poor prognosis. It may have prognostic significance as a potential biomarker in patients with RGA.

Bio-based thermoplastic poly(butylene succinate-co-propylene succinate) copolyesters: effect of glycerol on thermal and mechanical properties

Poly(butylene succinate-co-propylene succinate) (PBSPS) was polymerized using succinic acid, 1,4-butanediol, 1,3-propanediol, and glycerol (GC). The PBSPS copolyester with a BS/PS ratio of 7/3 has a low melting point (Tm, 80 °C) and crystallization temperature (Tc, 20 °C) in addition to excellent thermal stability with a thermal degradation temperature (Td) above 300 °C. Isodimorphism was observed for 30-50 mol% PS, lowering Tm and Tc. The featured crystalline lattices (021) and (110) of PBS at 2θ = 21.5° and 22.5° gradually disappeared with PS content greater than 50 mol% and transformed into a PPS crystalline lattice at 2θ = 22.3°. Young's modulus decreased with increasing PS content due to crystallinity loss. Wide-angle X-ray diffraction demonstrated that the chain movement regularity was affected by the GC content, reducing the crystallinity. The PBSPS copolyesters were elastic with 0.001 mol% GC but became rigid with GC content greater than 0.01 mol%. The chain conformation was flexible for 0.001-0.01 mol% GC and exhibited an irregular steric architecture for 0.02-0.03 mol% GC due to more GC acting as nodes. Thus, the thermal and mechanical properties of the synthesized bio-based PBSPS copolyesters can be controlled by adjusting the GC content; therefore, such copolyesters are suitable for medical support, coating, and phase-change material applications.

[Investigation of treatment and analysis of prognostic risk on enterocutaneous fistula in China: a multicenter prospective study]

Objective: To investigate the diagnosis and treatment for enterocutaneous fistula (ECF) in China, and to explore the prognostic factors of ECF. Methods: A multi-center cross-sectional study was conducted based on the Registration System of Chinese Gastrointestinal Fistula and Intra-Abdominal Infections to collect the clinical data of ECF patients from 54 medical centers in 22 provinces/municipalities from January 1, 2018 to December 31, 2018. The clinical data included patient gender, age, length of hospital stay, intensive care unit (ICU) admission, underlying diseases, primary diseases, direct causes of ECF, location and type of ECF, complications, treatment and outcomes. All medical records were carefully filled in by the attending physicians, and then re-examined by more than two specialists. The diagnosis of ECF was based on the clinical manifestations, laboratory/imaging findings and intraoperative exploration. Results: A total of 1521 patients with ECF were enrolled, including 1099 males and 422 females, with a median age of 55 years. The top three primary diseases of ECF were malignant tumors in 626 cases (41.2%, including 540 gastrointestinal tumors, accounting for 86.3% of malignant tumors), gastrointestinal ulcers and perforations in 202 cases (13.3%), and trauma in 157 cases (10.3%). The direct causes of ECF were mainly surgical operation in 1194 cases (78.5%), followed by trauma in 156 (10.3%), spontaneous fistula due to Crohn's disease in 92 (6.0%), radiation intestinal injury in 41 (2.7%), severe pancreatitis in 20 (1.3%), endoscopic treatment in 13 (0.9%) and 5 cases (0.3%) of unknown reasons. All the patients were divided into three groups: 1350 cases (88.7%) with simple ECF, 150 (9.9%) with multiple ECF, and 21 (1.4%) with combined internal fistula. Among the patients with simple ECF, 438 cases (28.8%) were jejuno-ileal fistula, 313 (20.6%) colon fistula, 170 (11.2%) rectal fistula, 111 (7.3%) duodenal fistula, 76 (5.0%) ileocecal fistula, 65 (4.3%) ileocolic anastomotic fistula, 55 (3.6%) duodenal stump fistula, 36 (2.4%) gastrointestinal anastomotic fistula, 36 (2.4%) esophagogastric/esophagojejunal anastomotic fistula, 29 (1.9%) gastric fistula and 21 (1.4%) cholangiopancreatiointestinal. Among all the simple ECF patients, 991 were tubular fistula and 359 were labial fistula. A total of 1146 patients finished the treatment, of whom 1061 (92.6%) were healed (586 by surgery and 475 self-healing) and 85 (7.4%) died. A total of 1043 patients (91.0%) received nutritional support therapy, and 77 (6.7%) received fistuloclysis. Infectious source control procedures were applied to 1042 patients, including 711 (62.0%) with active lavage and drainage and 331 (28.9%) with passive drainage. Among them, 841 patients (73.4%) underwent minimally invasive procedures of infectious source control (replacement of drainage tube through sinus tract, puncture drainage, etc.), 201 (17.5%) underwent laparotomy drainage, while 104 (9.1%) did not undergo any drainage measures. A total of 610 patients (53.2%) received definitive operation, 24 patients died within postoperative 30-day with mortality of 3.9% (24/610), 69 (11.3%) developed surgical site infection (SSI), and 24 (3.9%) had a relapse of fistula. The highest cure rate was achieved in ileocecal fistula (100%), followed by rectal fistula (96.2%, 128/133) and duodenal stump fistula (95.7%,44/46). The highest mortality was found in combined internal fistula (3/12) and no death in ileocecal fistula. Univariate prognostic analysis showed that primary diseases as Crohn's disease (χ(2)=6.570, P=0.010) and appendicitis/appendiceal abscess (P=0.012), intestinal fistula combining with internal fistula (χ(2)=5.460, P=0.019), multiple ECF (χ(2)=7.135, P=0.008), esophagogastric / esophagojejunal anastomotic fistula (χ(2)=9.501, P=0.002), ECF at ileocecal junction (P=0.012), non-drainage/passive drainage before the diagnosis of intestinal fistula (χ(2)=9.688, P=0.008), non-drainage/passive drainage after the diagnosis of intestinal fistula (χ(2)=9.711, P=0.008), complicating with multiple organ dysfunction syndrome (MODS) (χ(2)=179.699, P<0.001), sepsis (χ(2)=211.851, P<0.001), hemorrhage (χ(2)=85.300, P<0.001), pulmonary infection (χ(2)=60.096, P<0.001), catheter-associated infection (χ(2)=10.617, P=0.001) and malnutrition (χ(2)=21.199, P<0.001) were associated with mortality. Multivariate prognostic analysis cofirmed that sepsis (OR=7.103, 95%CI:3.694-13.657, P<0.001), complicating with MODS (OR=5.018, 95%CI:2.170-11.604, P<0.001), and hemorrhage (OR=4.703, 95%CI: 2.300-9.618, P<0.001) were independent risk factors of the death for ECF patients. Meanwhile, active lavage and drainage after the definite ECF diagnosis was the protective factor (OR=0.223, 95%CI: 0.067-0.745, P=0.015). Conclusions: The overall mortality of ECF is still high. Surgical operation is the most common cause of ECF. Complications e.g. sepsis, MODS, hemorrhage, and catheter-associated infection, are the main causes of death. Active lavage and drainage is important to improve the prognosis of ECF.

Effect of Ethylenediaminetetraacetic Acid on Unsaturated Poly(Butylene Adipate-Co-Butylene Itaconate) Copolyester with Low-Melting Point and Controllable Hardness

A series of copolyesters, poly(butylene adipate-co-butylene itaconate) (PBABI), was synthesized using melt polycondensation from adipic acid (AA), itaconic acid (IA), 1,4-butanediol (1,4-BDO), and ethylenediaminetetraacetic acid (EDTA). ¹H-NMR, FT-IR, GPC, DSC, TGA, DMA, XRD, Shore D, and tensile test were used to systematically characterize the structural and composition/physical properties of the copolyesters. It was found that the melting point (T_m) and crystallization temperature (T_c) of the copolyesters were, respectively, between 21.1 to 57.5 °C and −6.7 to 29.5 °C. The glass transition (T_g) and the initial thermal decomposition (T_d-5%) temperatures of the PBABI copolyesters were observed to be between −53.6 to −55.8 °C and 313.6 and 342.1 °C at varying ratios of butylene adipate (BA) and butylene itaconate (IA), respectively. The XRD feature peak was identified at the 2θ values of 21.61°, 22.31°, and 23.96° for the crystal lattice of (110), (020), and (021), respectively. Interestingly, Shore D at various IA ratios had high values (between 51.3 to 62), which indicated that the PBABI had soft plastic properties. The Young’s modulus and elongation at break, at different IA concentrations, were measured to be at 0.77–128.65 MPa and 71.04–531.76%, respectively, which could be attributed to a close and compact three-dimensional network structure formed by EDTA as a crosslinking agent. There was a significant bell-shaped trend in a BA/BI ratio of 8/2, at different EDTA concentrations—the ∆H_m increased while the EDTA concentration increased from 0.001 to 0.05 mole% and then decreased at an EDTA ratio of 0.2 mole%. Since the PBABI copolymers have applications in the textile industry, these polymers have been adopted to reinforce 3D air-permeable polyester-based smart textile. This kind of composite not only possesses the advantage of lower weight and breathable properties for textiles, but also offers customizable, strong levels of hardness, after UV curing of the PBABI copolyesters, making its potential in vitro orthopedic support as the “plaster of the future”.

[Clinical effect and safety of pegylated interferon-α-2b injection (Y shape, 40 kD) in treatment of HBeAg-positive chronic hepatitis B patients]

Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion: In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.

[Experimental study of silybin-phospholipid complex intervention on amiodarone-induced fatty liver in mice]

Objective: To probe into the mechanism and interventional effects of silybin-phospholipid complex on amiodarone-induced steatosis in mice. Methods: Eight-week-old male C57BL/6 mice were divided into three groups (5 mice in each group): a control group (WT) with normal diet, a model group with amiodarone 150mg/kg/d by oral gavage (AM), and an intervention group on amiodarone 150mg/kg/d combined with silybin-phospholipid complex(AM+SILIPHOS. All mice were fed their assigned diet for one week. Then, one week later, serum alanine aminotransferase, aspartate aminotransferase, triglyceride, total cholesterol and high-density lipoprotein were detected of each group. A liver pathological change was observed by oil red O and H&E staining. Ultrastructural pathological changes of hepatocytes were observed to evaluate the intervention effect by transmission electron microscopy. RT-q PCR was used to detect the expression of peroxisome proliferator-activated receptor alpha and its regulated lipid metabolism genes CPTI, CPTII, Acot1, Acot2, ACOX, Cyp4a10 and Cyp4a14 in liver tissues. Intra-group comparison was done by paired t-test. One-way ANOVA was used for comparison between groups and semi-quantitative data were tested using Mann-Whitney U test. Results: Oil Red O and H&E staining results of liver tissue in the intervention group showed that intrahepatic steatosis was significantly reduced when compared to model group. Transmission electron microscopy showed that the model group had pyknotic nuclei, mitochondrial swelling, structural damage, and lysosomal degradation whereas the intervention group had hepatic nucleus without pyknosis, reduced mitochondrial swelling and slight structural damage than that of model group. RT-q PCR results showed that the expression of peroxisome proliferator-activated receptor alpha, CPTI, CPTII, Acot1, Acot2, ACOX, Cyp4a10 and Cyp4a14 were increased in the model group but the expression of CPTI, Cyp4a14, Acot1 and peroxisome proliferator-activated receptor alpha were decreased in the intervention group (P < 0.05). Conclusion: Silybin-phospholipid complex can alleviate amiodarone-induced steatosis, and its mechanism may play a role in protecting mitochondrial function and regulating fatty acid metabolism. Thus, silybin-phospholipid complex has potential intervention effect on amiodarone-induced fatty liver.

Removal of sulfonamides from wastewater in the UV/TiO2 system: effects of pH and salinity on photodegradation and mineralization

The effects of salinity on the photodegradation and mineralization of sulfonamides in the UV/TiO₂ system were investigated. The goals of this study were to analyze the effects of pH and salinity on the sulfonamide concentration and total organic carbon (TOC) during the removal of sulfonamides in a UV/TiO₂ system. Four sulfonamides - sulfadiazine (SDZ), sulfamethizole (SFZ), sulfamethoxazole (SMX) and sulfathiazole (STZ) - were selected as parent compounds. The photodegradation and mineralization rates of sulfonamides in the UV/TiO₂ system satisfy pseudo-first-order kinetics. Direct photolysis degraded sulfonamides but sulfonamides cannot be mineralized. The photodegradation and mineralization rate constants in all experiments followed the order pH 5 > pH 7 > pH 9. At pH 5, the mineralization rate constants of SMX, SFZ, SDZ and STZ were 0.015, 0.009, 0.012 and 0.011 min^-1, respectively. The addition of NaCl inhibited the mineralization of the four tested sulfonamides more than it inhibited their photodegradation. The inhibitory effect of chloride ions on the removal of sulfonamides in the UV/TiO₂ system was attributed to the scavenging by chloride ions of hydroxyl radicals (HO•) and holes and the much lower reactivity of chlorine radicals thus formed, even though the chlorine radicals were more abundant than HO•.

Novel stretchable thermochromic transparent heaters designed for smart window defroster applications by spray coating silver nanowire

A productive and novel method for fabricating stretchable transparent heaters with recognised thermochromic properties using commercially available thermochromic ink (TM-55-blue) and silver nanowire (AgNW)-coated polydimethylsiloxane (PDMS) is proposed. Lower resistance, elevated heat generation, and higher transparencies were the expected essential prerequisites for the fabrication of items such as smart windows and window defrosters. AgNW-coated PDMS (hereafter PH devices) satisfied the essential prerequisites but did not produce sufficient color change. In addition to the appreciable electrical and optical characteristics and mechanical robustness, observable color changes represent a critical factor in effortless temperature monitoring by the heating device. Blending TM-55-blue thermochromic ink with PDMS (PBH device) improves the heating rate and color transformation and promotes the ultralow response time appreciably. More notably, it produces a visible transformation from blue to colorless. Color changes visible to the naked eye, ultralow response time, and heating rate represent valuable features for deploying the PBH devices as window defrosters and in smart window applications.

The as-designed heaters proved to be excellent candidates for employment in window defrosters, as they satisfy the essential prerequisites such as lower sheet resistance, high transparency, mechanical robustness and good stability to tensile strain.

Source identification and ecological impact evaluation of PAHs in urban river sediments: A case study in Taiwan

The Love River and Ho-Jin River, two major urban rivers in Kaohsiung City, Taiwan, are moderately to heavily polluted because different types of improperly treated wastewaters are discharged into the rivers. In this study, sediment and river water samples were collected from two rivers to investigate the river water quality and accumulation of polycyclic aromatic hydrocarbons (PAHs) in sediments. The spatial distribution, composition, and source appointment of PAHs of the sediments were examined. The impacts of PAHs on ecological system were assessed using toxic equivalence quotient (TEQ) of potentially carcinogenic PAHs (TEQ^carc) and sediment quality guidelines. The average PAHs concentrations ranged from 2161 ng/g in Love River sediment to 160 ng/g in Ho-Jin River sediment. This could be due to the fact that Love River Basin had much higher population density and pyrolytic activities. High-ring PAHs (4-6 rings) contributed to 59-90% of the total PAHs concentrations. Benzo(a)pyrene (BaP) had the highest toxic equivalence quotient (up to 188 ng TEQ/g). Moreover, the downstream sediments contained higher TEQ of total TPHs than midstream and upstream sediment samples. The PAHs were adsorbed onto the fine particles with high organic content. Results from diagnostic ratio analyses indicate that the PAHs in two urban river sediments might originate from oil/coal combustion, traffic-related emissions, and waste combustion (pyrogenic activities). Future pollution prevention and management should target the various industries, incinerators, and transportation emission in this region to reduce the PAHs pollution.

NMR-based metabolomics for the environmental assessment of Kaohsiung Harbor sediments exemplified by a marine amphipod (Hyalella azteca)

Inflow of wastewater from upstream causes a large flux of pollutants to enter Kaohsiung Harbor in Taiwan daily. To reveal the ecological risk posed by Kaohsiung Harbor sediments, an ecological metabolomic approach was employed to investigate environmental factors pertinent to the physiological regulation of the marine amphipod Hyalella azteca. The amphipods were exposed to sediments collected from different stream inlets of the Love River (LR), Canon River (CR), Jen-Gen River (JR), and Salt River (SR). Harbor entrance 1 (E1) was selected as a reference site. After 10-day exposure, metabolomic analysis of the Hyalella azteca revealed differences between two groups: {E1, LR, CR} and {JR, SR}. The metabolic pathways identified in the two groups of amphipods were significantly different. The results demonstrated that NMR-based metabolomics can be effectively used to characterize metabolic response related to sediment from polluted areas.

[Efficacy and safety of pegylated interferon α-2b injection (Y shape, 40 kD) in treatment of patients with genotype 1/6 chronic hepatitis C]

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion: In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.

[Carefully reviewing the history of diagnostic scales and paying more attention to the diagnostic value of Roussel - Uclaf causality assessment method scale for drug - induced liver injury]

Currently, the diagnostic criteria for drug-induced liver injury (DILI) used in the clinical studies and related literature in China are very confusing, making it difficult to compare and extend the use of the results, conclusions, and experience of these studies. Therefore, it is necessary to carefully review the developmental history of diagnostic scales and unify the diagnostic criteria and related knowledge of DILI. Since its publication in 1993, Roussel Uclaf Causality Assessment Method (RUCAM) scale has been widely used to assess the causality between drugs and liver injury, both in DILI studies and decisions on the regulation of drugs which may cause liver injury, in order to provide a useful analytical framework for clinical physicians in the diagnosis of DILI. At present, RUCAM scale should still be used to assess causality and assist diagnosis, unless markers with diagnostic significance are found in future.

Improving Non-Destructive Concrete Strength Tests Using Support Vector Machines

Non-destructive testing (NDT) methods are important alternatives when destructive tests are not feasible to examine the in situ concrete properties without damaging the structure. The rebound hammer test and the ultrasonic pulse velocity test are two popular NDT methods to examine the properties of concrete. The rebound of the hammer depends on the hardness of the test specimen and ultrasonic pulse travelling speed is related to density, uniformity, and homogeneity of the specimen. Both of these two methods have been adopted to estimate the concrete compressive strength. Statistical analysis has been implemented to establish the relationship between hammer rebound values/ultrasonic pulse velocities and concrete compressive strength. However, the estimated results can be unreliable. As a result, this research proposes an Artificial Intelligence model using support vector machines (SVMs) for the estimation. Data from 95 cylinder concrete samples are collected to develop and validate the model. The results show that combined NDT methods (also known as SonReb method) yield better estimations than single NDT methods. The results also show that the SVM model is more accurate than the statistical regression model.

Tenofovir disoproxil fumarate vs adefovir dipivoxil in Chinese patients with chronic hepatitis B after 48 weeks: a randomized controlled trial

Tenofovir disoproxil fumarate (TDF) has demonstrated long-term efficacy and a high barrier to resistance in multiple chronic hepatitis B (CHB) populations outside of China. This study aimed to evaluate the efficacy and safety of TDF compared with adefovir dipivoxil (ADV) in Chinese patients with CHB during 48 weeks of treatment (ClinicalTrial.gov number, NCT01300234). A Phase 3, multicentred, randomized, double-blind, controlled trial compared the efficacy and safety of TDF with ADV in Chinese patients with CHB. The primary endpoint was the proportion of patients with HBV DNA <400 copies/mL in each treatment group at Week 48, using an unpooled Z-test for superiority. Secondary endpoints included viral suppression, serologic response, histological improvement, normalization of alanine aminotransferase (ALT) levels and the emergence of resistance mutations. A total of 509 patients, 202 hepatitis B e antigen (HBeAg)-positive and 307 HBeAg-negative, with HBV DNA ≥10(5) copies/mL received either TDF 300 mg od or ADV 10 mg od. At Week 48, TDF demonstrated superior viral suppression compared with ADV in both HBeAg-positive (76.7% vs 18.2%, P < 0.0001) and HBeAg-negative (96.8% vs 71.2%, P < 0.0001) patients. The majority of patients in both treatment arms achieved ALT normalization (>85%). No resistance to TDF was observed. The frequency of adverse events was comparable between treatment arms (TDF 3.9% vs ADV 4.8%). In this double-blind, randomized, clinical trial, TDF demonstrated superiority over ADV with respect to viral suppression in Chinese patients with CHB at 48 weeks of treatment and without the development of resistance.

Oral toxicity evaluation of kefir-isolated Lactobacillus kefiranofaciens M1 in Sprague-Dawley rats

Lactobacilli kefiranofaciens M1 has shown novel immunomodulation and anti-allergy probiotic attributes in cell and animal models. An acute oral toxicity assessment of L. kefiranofaciens M1 was evaluated in Sprague-Dawley rats. The rats were randomly assigned to four groups (12 rats/sex/group): the low dose group was orally gavaged with L. kefiranofaciens M1 at 3.0×10(8)cfu/kg bw while the medium dose and high dose groups received 9.0×10(9)cfu/kg bw and 1.8×10(10)cfu/kg bw, respectively, for 28days. The control group received phosphate buffer saline. The body weights were measured weekly while blood samples were collected for haematology and serum biochemistry tests. Histopathology of the organs (heart, liver, kidney, adrenal glands, spleen, ovary, testis), and urinalysis were conducted on study termination. The body weight gain of the L. kefiranofaciens M1 and control groups were comparable during the administration period. Overall, L. kefiranofaciens M1 did not induce adverse effects on haematology, serum biochemistry, and urinalysis parameters. Gross and microscopic histopathology of the organs revealed no toxicity effect of L. kefiranofaciens M1. In conclusion, 1.8×10(10)cfu/kg bw of L. kefiranofaciens M1 was considered as the no-observed-adverse-effect-level (NOAEL), which was the highest dose tested in the present study.

Homology Models and Molecular Dynamics Simulations of Main Proteinase from Coronavirus Associated with Severe Acute Respiratory Syndrome (SARS)

In this study, two structural models (denoted as M^proST and M^proSH) of the main proteinase (M^pro) from the novel coronavirus associated with severe acute respiratory syndrome (SARS‐CoV) were constructed based on the crystallographic structures of M^pro from transmissible gastroenteritis coronavirus (TGEV) (M^proT) and human coronavirus HcoV‐229E (M^proH), respectively. Various 200 ps molecular dynamics simulations were subsequently performed to investigate the dynamics behaviors of several structural features. Both M^proST and M^proSH exhibit similar folds as their respective template proteins. These structural models reveal three distinct functional domains as well as an intervening loop connecting domains II and III as found in both template proteins. In addition, domain III of these structures exhibits the least secondary structural conservation. A catalytic cleft containing the substrate binding subsites S1 and the S2 between domains I and II are also observed in these structural models. Although these structures share many common features, the most significant difference occurs at the S2 subsite, where the amino acid residues lining up this subsite are least conserved. It may be a critical challenge for designing anti‐SARS drugs by simply screening the known database of proteinase inhibitors.

Two years efficiency of lamivudine and adefovir dipivoxil combined therapy in chronic hepatitis B patients

BACKGROUND

Lamivudine (LAM) and adefovir (ADV) are widely used in most Asian countries, though monotherapy is associated with the occurrence of resistance.

AIM

To evaluate the efficiency of LAM and ADV combined treatment of chronic hepatitis B patients with compensated cirrhosis.

PATIENTS AND METHODS

206 eligible Chinese patients were randomly assigned in a 1:1 ratio to receive either LAM or ADV for the first 24 weeks. According to virologic response at 24 weeks, the patients either continued to monotherapy or switched to combined therapy for 48 weeks. After 48 weeks, all patients received LAM and ADV combined therapy for 96 weeks.

RESULTS

Serum HBV DNA levels significantly decreased in patients with ADV or LAM monotherapy and continuously reduced after the combined therapy. Serum ALT normalized rate were 88.24% and 81.37% at week 48, and 95.74% and 87.36% at week 96 in ADV and LAM group respectively, comparing to 60.78% and 56.73% in ADV and LAM groups at baseline. The accumulated virological breakthrough rate at week 48 and 96 was significantly higher in LAM group.

CONCLUSIONS

Both combination strategies were resulted in the long term virological, biochemical improvement in Chinese chronic hepatitis B patients with compensated cirrhosis.

Influence of different flow-triggering levels on the breathing effort of mechanically ventilated patients

BACKGROUND

Although a sensitive flow triggering (FT) level is supposed to be associated with reduced breathing effort, the incidence of autotriggering (AT) is likely to be increased. The actual effects of various FT levels on the work of breathing and occurrence of AT in mechanically ventilated patients are unknown. We investigated the effects of different FT levels (1-8 L/min) on breathing effort and incidence of AT in mechanically ventilated patients under pressure support ventilation using a Puritan-Bennett 840 ventilator.

METHODS

Eight FT levels were randomly studied in mechanically ventilated patients under pressure support ventilation. The triggering effort (pressure-time product of triggering, PTPtr) was assessed by quantitating a segment of the pressure-time product of the esophagus (PTPes). The total PTPes, inspiratory work of breathing (Wi) and P0.1 were determined.

RESULTS

Nine patients with appropriately recorded signals were included. The incidence of AT significantly decreased with increasing FT level (FT1, 1 L/min: 30.7%, FT8: 0.2%). PTPtr significantly increased with increasing FT level (0.020 ± 0.004 cmH2O • S in FT1 to 0.190 ± 0.017 cmH2O • S in FT8), but P0.1 remained similar. PTPtr accounted for only1-3% of total PTPes. Wi and PTPes were significantly lower only at FT1, but there was no significant difference in Wi and PTPes at different FT levels when AT breaths were excluded.

CONCLUSION

A higher FT level was associated with lower incidence of AT, but without a significant increase in breathing effort. A higher FT level may be more reasonable in mechanically ventilated patients with this particular ventilator.