Serum Essential Trace Element Status in Women and the Risk of Endometrial Diseases: a Case-Control Study : Serum Essential Trace Element Status in Women and the Risk of Endometrial Diseases: a Case-Control Study

Endometrial diseases, including uterine fibroids, polyps, intrauterine adhesion, endometritis, etc., are the major causes of infertility among women. However, the association between essential trace element status in women and the risk of endometrial disease is limited and unclear. This study aimed to investigate this association using a case-control study design; a total of 302 women patients with endometrial diseases and 302 healthy women were included. Compared to women in the control group, serum selenium (Se) (p = 0.024) and zinc (Zn) (p = 0.017) levels were significantly lower, while copper (Cu) (p = 0.004) and molybdenum (Mo) (p = 0.005) levels were significantly higher among women with endometrial diseases. In addition, compared to women in the first quartile of the copper/zinc (Cu/Zn) ratio value group, the adjusted ORs (95% CIs) of endometrial diseases were 1.50 (1.05, 2.14), 1.68 (1.18, 2.39), and 1.47 (1.02, 2.10), respectively, in the second, third, and fourth quartile of the Cu/Zn ratio value group (p trend = 0.047). In addition, the results from restricted cubic splines showed that the dose-response relationships of serum levels of these essential elements with the risk of endometrial diseases were nonlinear for Se, Cu, and Zn and relatively linear for Mo and Cu/Zn ratio. The present study showed serum levels of Zn and Se among women with endometrial diseases were significantly lower compared to that among healthy women, while serum levels of Cu and Mo were significantly higher, in addition, the serum Cu/Zn ratio value was also significantly and positively associated with the risk of endometrial diseases.

Carbon skeleton materials derived from rare earth phthalocyanines (MPcs) (M = Yb, La) used as high performance anode materials for lithium-ion batteries

In this work, novel carbon skeleton materials were prepared by high-temperature carbonization of rare earth phthalocyanines (MPcs) (M = Yb, La) under a nitrogen atmosphere. The resulting carbon materials of YbPc-900 (carbonisation temperature of 900 °C for 2 h) and LaPc-1000 (carbonization temperature of 1000 °C for 2 h) have a graphite-layered structure in predominantly ordered states, with a smaller particle size, a larger specific surface area and a higher degree of hard carbonization compared to those of the uncarbonized sample. As a result, the batteries using the YbPc-900 and LaPc-1000 carbon skeleton materials as electrodes display excellent energy storage behaviors. The initial capacities of the YbPc-900 and LaPc-1000 electrodes at 0.05 A g^-1 were 1100 and 850 mA h g^-1, respectively. After 245 cycles and 223 cycles, the capacities remain at 780 and 716 mA h g^-1 with retention ratios of 71% and 84%. At a high rate of 1.0 A g^-1, the initial capacities of the YbPc-900 and LaPc-1000 electrodes were 400 and 520 mA h g^-1, respectively, and after 300 cycles, the capacities can still remain at 526 and 587 mA h g^-1 with retention ratios of 131.5% and 112.8%, respectively, which were much higher than those of the pristine rare earth phthalocyanine (MPc) (M = Yb, La) electrodes. Moreover, better rate capabilities were also observed during the YbPc-900 and LaPc-1000 electrode tests. The capacities of the YbPc-900 electrode at 0.05, 0.1, 0.2, 0.5, 1 and 2C were 520, 450, 407, 350, 300 and 260 mA h g^-1 respectively, which were higher than those of the YbPc electrode (550, 450, 330, 150, 90 and 40 mA h g^-1). Similarly, the rate performance of the LaPc-1000 electrode at different rates was also significantly improved compared to that of the pristine LaPc electrode. In addition, the initial Coulomb efficiencies of the YbPc-900 and LaPc-1000 electrodes were also greatly improved compared to those of pristine YbPc and LaPc electrodes. After carbonization, the YbPc-900 and LaPc-1000 carbon skeleton materials derived from rare earth phthalocyanines (MPcs) (M = Yb, La) exhibit improved energy storage behaviors, which would provide new ideas for developing novel organic carbon skeleton negative materials for lithium ion batteries.

[Interpretation for indications of metabolic and bariatric surgery released by ASMBS and IFSO in 2022]

With the increasing number of obese patients worldwide, metabolic and bariatric surgery (MBS) has quickly become an effective way to treat obesity and related metabolic diseases such as type 2 diabetes, hypertension, lipid abnormalities, etc. Although MBS has become an important part of general surgery, there is still controversy regarding the indications for MBS. In 1991, the National Institutes of Health (NIH) issued a statement on the surgical treatment of severe obesity and other related issues, which continues to be the standard for insurance companies, health care systems, and hospital selection of patients. The standard no longer reflects the best practice data and lacks relevance to today's modern surgeries and patient populations. After 31 years, in October 2022, the American Society for Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), the world's leading authorities on weight loss and metabolic surgery, jointly released new guidelines for MBS indications, based on increasing awareness of obesity and its comorbidities and the accumulation of evidence of obesity metabolic diseases. In a series of recommendations, the eligibility of patients for bariatric surgery has been expanded. Specific key updates include the following: (1) MBS is recommended for individuals with BMI≥35 kg/m², regardless of the presence, absence, or severity of co-morbidities; (2) MBS should be considered for individuals with metabolic diseases and BMI 30.0-34.9 kg/m²; (3) the BMI threshold should be adjusted for the Asian population:: BMI≥25 kg/m² suggest clinical obesity, and BMI ≥ 27.5 kg/m² population should consider MBS; (4) Appropriately selected children and adolescents should be considered for MBS.

Development and validation of a risk score for predicting inconsistent condom use with women among men who have sex with men and women

BACKGROUND

Men who have sex with men and women (MSMW) are the most important bridge population for HIV transmission. Condom use plays an important role for HIV infection. However the predictors for condom ues with females are not well characterized.

METHODS

This was a cross-sectional study. Participants were enrolled by four community-based organizations (CBOs) by offline (bathrooms, bars), and online (gay applications, chat room) from April to December 2019. Electronic questionnare was fulfilled after a face-to-face training led by CBOs. We identified predictors of inconsistent condom use with females by creating a risk score based on regression coefficients. We externally validated this score via an independent cross-sectional survey conducted in Zhejiang Province in 2021. A total of 917, 615 MSMW were included in analysis in 2019 and 2021, seperately.

RESULTS

Among 917 MSMW, 73.2% reported heterosexual behavior in the prior 6 months and 38.3% reported inconsistent condom use with females (ICUF) over that time. Compared with heterosexual/unsure MSMW, bisexual MSMW reported more male and female sex partners, higher proportion of inconsistent condom use with males, less commercial sex with males (p < 0.05). Four risky predictors of ICUF were identified: Duration of local residence ≦6 months; more than one male partner in the prior 6 months; inconsistent condom use with males in the prior 6 months; and never heard post-exposure prophylaxis (PEP). The proportions of respondents indicating ICUF in the low- (0), medium- (2-4) and high-risk (6-20) groups (according to our risk scoring system) were 11.7% (14/120), 26.9% (96/357), and 78.1% (125/160), respectively (P_trend < 0.001). In the validation survey, the respective proportions of those reporting ICUF were 13.4% (15/112), 17.8% (24/185) and 87.3% (96/110) (P_trend < 0.001).

CONCLUSIONS

We developed and validated a predictive risk score for ICUF among MSMW; four factors were identified, of which inconsistent condom use with men was the most important. Risk reduction intervention programs should focus on MSM who report inconsistent condom use with males, never heard PEP, having multiple partners and living in local less than 6 months.

DNA-scaffolded multivalent vaccine against SARS-CoV-2

Short peptides are poor immunogens. One way to increase their immune responses is by arraying immunogens in multivalency. Simple and efficient scaffolds for spatial controlling the inter-antigen distance and enhancing immune activation are required. Here, we report a molecular vaccine design principle that maximally drives potent SARS-CoV-2 RBD subunit vaccine on DNA duplex to induce robust and efficacious immune responses in vivo. We expect that the DNA-peptide epitope platform represents a facile and generalizable strategy to enhance the immune response. STATEMENT OF SIGNIFICANCE: DNA scaffolds offer a biocompatible and convenient platform for arraying immunogens in multivalency antigenic peptides, and spatially control the inter-antigen distance. This can effectively enhance immune response. Peptide (instead of entire protein) vaccines are highly attractive. However, short peptides are poor immunogens. Our DNA scaffolded multivalent peptide immunogen system induced robust and efficacious immune response in vivo as demonstrated by the antigenic peptide against SAR-CoV-2. The present strategy could be readily generalized and adapted to prepare multivalent vaccines against other viruses or disease. Particularly, the different antigens could be integrated into one single vaccine and lead to super-vaccines that can protect the host from multiple different viruses or multiple variants of the same virus.

Abstract 3123: A method for quantifying circulating tumor DNA level and molecular response using methylome sequencing

Background: Circulating tumor DNA (ctDNA) level and the change in level at a subsequent time point (e.g. on-treatment change from baseline or postoperative changes through time) are promising tools for predicting patient prognosis and response to therapy. Existing methods use somatic variant allele frequencies to quantify circulating tumor fractions (cTF). Their performance can be limited by the number of detectable somatic alterations and the associated limit of detection (LoD), as well as interference from copy number variation and non-tumor alterations, such as clonal hematopoiesis. Here, we describe the LoD, precision and limit of quantitation (LoQ) of cTF level and change using GuardantINFINITY, a next generation sequencing panel covering over 800 genes with genome-wide methylation detection.

Method: The cTF of a single sample is estimated from methylation signals across targeted regions of the GuardantINFINITY methylation panel, calibrated using internal training data. cTF change compares two or more samples from the same patient to identify patient-specific methylated regions, and compare the methylation signals of the paired regions. LoQ of cTF level and change were assessed in experimental titrations of advanced colorectal, breast, and lung cancer patient samples and cell line samples into cancer-free backgrounds at different target levels between 0.1%-0.5% cTF. LoD is defined as the lowest cTF level where &gt;95% replicates were detected to have tumor-derived methylation signals. LoQ of cTF level or change is defined as the lowest cTF where the coefficient of variation (CV) across replicates is less than 30%. Accuracy of methylation based cTF compared to cTFs calculated from maximum VAF of somatic mutations was assessed on 1,400 clinical samples of colorectal and lung cancer patients (N=189, 372, 252 and 463 for stage I to IV).

Results: Experimental titrations of cancer samples demonstrated a single-sample LoD of 0.05% cTF (lowest dilution level) and quantitative precision down to a LoQ of below 0.1%, compared to the LoQ of 0.3% estimated by somatic mutations. In paired clinical titration samples, the LoQ of methylation ctDNA level change was also below 0.1%, compared to the LoQ of ctDNA level change estimated by somatic mutations at 0.3-0.5%. In the 1,400 clinical samples, 64% had at least one somatic mutation detected, 90% had ct-DNA detected with methylation and 96% of these ct-DNA detected samples had cTF above the defined methylation LoQ. Among patients with both methylation and genomic signals identified, the methylation method quantified a similar cTF to those that were calculated using maximum somatic driver mutations (Pearson r=0.83).

Conclusion: Methylome sequencing using GuardantINFINITY enables accurate and precise quantification of ctDNA level and change with a liquid-only approach, offering longitudinal ctDNA monitoring for more patients than previous methods.

Citation Format: Sai Chen, Katie Quinn, Che-Yu Lee, Jun Zhao, Kyle Chang, Tingting Jiang, Shile Zhang, Carin Espenschied, Sara Wienke, Thereasa Rich, Indira Wu, Yvonne Kim, Xianxian Liu, Nageswara Alla, Dustin Ma, Giao Tran, Han-Yu Chuang. A method for quantifying circulating tumor DNA level and molecular response using methylome sequencing [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3123.

Abstract 6601: Analytical validation of a robust integrated genomic and epigenomic liquid biopsy for biomarker discovery, therapy selection, and response monitoring

Background: Despite its revolutionary impact, cancer genomics alone provides little information on tumor phenotype or functional state, which are governed by epigenetic mechanisms, notably methylation of regulatory regions. Tumor and host epigenetic methylation signatures reflect not only tumor phenotype, such as histology, prognosis, protein expression, and functional sub-type, but also that of the tumor microenvironment and the patient, including immune status, therapy-related adverse events, comorbidities, and disease location. Epigenetic markers also provide more sensitive and precise measures of tumor burden, opening up applications for longitudinal therapy response and monitoring. Here we report the initial validation of GuardantINFINITY, a liquid biopsy assay combining genomic information from &gt;800 genes with characterization of the blood-quiet regulatory methylome, both at single-molecule sensitivity from a single tube of peripheral blood.

Methods: Analytical performance was assessed using 594 cancer patient cfDNA, cell line, and cancer-free donor samples at 5-30ng cfDNA input.

Results: Reportable ranges established for SNVs were ≥0.04% variant allele fraction (VAF), ≥0.04% for indels, ≥0.06% for fusions, ≥2.12 copies for amplifications (CNAs), &lt;1.7 copies for copy loss. Observed 95% limits of detection (LoD) were 0.282% for SNVs across all genes (0.2% for oncogenic hotspots), 0.397% for non-homopolymeric indels, 0.05% for fusions, 2.5 copies for CNAs, 16.3% VAF or 1.84 copies for gene deletions, 7.3 copies for viral (HPV, EBV) detection, and 0.06% for MSI-H. For promoter and sample-level methylation, LoDs were 0.06% and 0.05% tumor fraction, respectively. cfDNA cancer samples demonstrated 100% accuracy for SNVs and Indels above 0.5% VAF and 100% for CNAs and fusions across the reportable range. The analytical false positive rate per base was 6.84e-6 for SNVs, 3.42e-6 for indels, and 0 for CNAs and fusions, with positive predictive values of 97.5% for SNVs, 98% for indels, and 100% for CNAs above 2.5 copies and all tested fusions.

Conclusions: GuardantINFINITY is a patient-care-ready liquid biopsy capable of integrated genomic and epigenomic analysis of all solid tumors at single-molecule sensitivity. In addition to traditional genotyping compatible with Guardant360 for more content, the technology’s demonstrated LoD showed the potential for ultra-sensitive ctDNA detection for MRD and recurrence surveillance, tumor fraction quantitation for therapy monitoring, oncogenic virus detection, immunogenotyping, epigenotyping, and tumor phenotype characterization, representing a new standard in biomarker discovery.

Citation Format: Tingting Jiang, Indira Wu, Yvonne Kim, Nageswara Alla, Giao Tran, Dustin Ma, Forum Shah, Jun Zhao, Sai Chen, Sante Gnerre, Melis Hazar, Hao Wang, Catalin Barbacioru, Karen Ryall, Ankit Jambusaria, Anupam Chakravarthy, Anthony Zunino, Theresa Pham, Farsheed Ghadiri, Evan Diehl, Benjamin Morck, Arancha Sanchez, Rochelle Dayan, XianXian Liu, Jeffrey Werbin, Jill Lai, Brett Kennedy, Ross Eppler, Justin Odegaard, Han-Yu Chuang, Helmy Eltoukhy. Analytical validation of a robust integrated genomic and epigenomic liquid biopsy for biomarker discovery, therapy selection, and response monitoring [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6601.

Abstract 6603: BRCA1 promoter methylation in sporadic breast cancer patients detected by liquid biopsy

Background: BRCA1 promoter methylation (PM) is an early initiating event in cancer, occurring in 3 to 65.2% of all breast tumors, and 30 to 65% of triple negative tumors. BRCA1 PM has been associated with defective homologous recombination repair (HRR), early onset of breast and ovarian cancer, and improved clinical response to adjuvant chemotherapy. Historically, there has been no diagnostic assay that comprehensively evaluates both BRCA1 PM and genomic alterations in cell-free circulating tumor DNA (ctDNA). Here, we describe the novel detection of BRCA1 PM and genomic alterations in a cohort of patients with breast cancer using GuardantINFINITY, a liquid biopsy assay interrogating 800+ genes and genome-wide methylation detection.

Method: We assessed for BRCA1 PM in ctDNA from 274 patients with late-stage breast cancer. Genomic sequencing of 800+ genes and PM profiling of 398 genes was performed by GuardantINFINITY. The positive calling threshold for PM was established by comparing cell-free DNA derived from patients with cancer and cancer-free donors. The limit of detection (LoD) was determined through in silico and experimental titrations of ctDNA from clinical samples and cell lines with known gene PM into the plasma of cancer-free donors.

Results: Among the 274 patients with advanced breast cancer, 8 (2.9%) had germline pathogenic mutations in BRCA1, BRCA2, or ATM. BRCA1 PM was detected in 11/274 (4.0%) patients at the predefined threshold of &gt;99% specificity. BRCA1 PM detection in this cohort was 8.9% (8/90) when excluding samples with low tumor shedding (&lt;1% epigenomic tumor fraction in cfDNA). Among the 11 patients with BRCA1 PM detected in ctDNA, one had a co-occurring somatic BRCA1 nonsense variant (p.S361*); none of the remaining patients with BRCA1 PM had another HRR-related mutation detected in cfDNA. Among patients without BRCA1 PM detected, pathogenic somatic alterations were detected in BRCA2, ATM, and CHEK2 in 25 (9.4%) patients. In silico simulations using clinical samples with BRCA1 PM indicated an LoD of 0.0408%. BRCA1 PM was not detected in 3210 individual and mixed cancer-free clinical samples, indicating a high specificity for BRCA1 PM calls.

Conclusion: GuardantINFINITY, a plasma-based diagnostic assay, detected both BRCA1 PM and genomic alterations in this unspecified advanced breast cancer cohort. The BRCA1 PM

detection rates of 4.0-8.9% are consistent with values previously reported in the literature. As BRCA1 PM has important prognostic and therapeutic implications for the management of breast (as well as ovarian) cancers, additional studies are warranted to further describe the PM patterns across breast cancer subtypes and how these patterns both influence and are influenced by disease evolution and therapeutic response. Liquid biopsy thus serves as a suitable method to noninvasively identify and monitor changes in both genomics and epigenomics.

Citation Format: Jennifer Yen, Sai Chen, Colby Jenkins, Brooke Overstreet, Yu Fu, Jun Zhao, Tingting Jiang, Leylah Drusbosky, Stephen Pettitt, Michael Dorschner, Lauren Lawrence, Han-Yu Chuang, Andrew Tutt. BRCA1 promoter methylation in sporadic breast cancer patients detected by liquid biopsy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6603.

Abstract 3128: Using Kmerizer, a germline and somatic genotyper for immune associated complex alleles in GuardantINFINITY, for immunotherapy response prediction using cfDNA

Background: HLA germline genotypes and somatic mutations show great promise as emerging biomarkers for immune checkpoint inhibitors (ICIs) and understanding patient prognosis. Multiple studies have shown that HLA homozygosity or loss-of-function somatic mutations negatively correlates ICI response rate. Here we present additional data on the algorithm Kmerizer, designed to perform HLA germline typing and somatic mutation detection from cfDNA input material, and we show how we use these in neoantigen prioritization for patient outcome prediction.

Methods: Kmerizer first leverages the high depth coverage of targeted sequencing to rapidly identify germline alleles by matching k-mers from the input reads to the k-mers of known HLA alleles. Careful realignment of reads ontothe called germlines is followed by proprietary somatic variant calling. MHC class1 germline allele calls are combined with patient mutation data to generate in silico TCR binding affinity predictions using net MHC-4.0. These predictions are compared across cohorts to assess how cancer type, TMB, and ICI response vary with the predicted neoantigens and TCR binding affinity.

Results: Of nineteen cell lines, twelve plasma samples and eight gDNA samples with confirmed HLA typing information, Kmerizer delivered 100% sensitivity on both MHC-I and II genes, with 99.5% and 98.7% specificity, respectively, based on GuardantINFINITY cfDNA sequencing data. For homozygous/heterozygous status, accuracy of 99.1% on class I and 97.7% on class II genes is achieved. HLA allele prevalence among our development samples is consistent with reference cohorts of similar geographic origin in MHC class I genes. The HLA somatic caller achieves &gt;99.99% specificity per base as computed on 48 normal samples, while achieves &gt;91% sensitivity for somatic events with expected allele frequency (AF) ~ 0.15% (AF range[0.08%,0.26%] for detected events) as evaluated through simulations. Additionally, we generated a total of 2,767 immunogenic (ic50&lt;500nM) class-I somatic neoantigens predictions across 112 samples from cancer patients with germline HLA typing results. We found average patient neoantigen TCR binding affinity was significantly associated with cancer type (χ2=86.08,p&lt;0.0001). Top predicted neoantigen binding affinity across patient HLA types were strongly inversely correlated with patient bTMB(rhospearman=-0.25, p&lt;0.0001).

Conclusions: The integration of Kmerizer into GuardantINFINITY enables accurate HLA germline and somatic detection along with neoantigen prediction, offering an enhanced and comprehensive biomarker profiling for ICI outcome prediction.

Citation Format: Sante Gnerre, Jun Zhao, Adrian Bubie, Yvonne Kim, Dustin Ma, Indira Wu, Bojan Losic, Tingting Jiang, Han-Yu Chuang. Using Kmerizer, a germline and somatic genotyper for immune associated complex alleles in GuardantINFINITY, for immunotherapy response prediction using cfDNA [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3128.

Equilibrative nucleoside transporter 3 promotes the progression of hepatocellular carcinoma by regulating the AKT/mTOR signaling pathway

Equilibrative nucleoside transporter 3 (ENT3) belongs to the solute carrier family 29. Nucleoside transporters encoded by ENT3 play an important role in the uptake of nucleosides, nucleobases, and their nucleoside analogs, as well as participate in and regulate several physiological activities. However, no study has so far reported the role of ENT3 in hepatocellular carcinoma (HCC). We employed bioinformatics to analyze the expression, prognosis, and mechanism of ENT3 in HCC, as well as verified the same through biological experiments including cell proliferation, cell migration and invasion, and cell cycle and apoptosis, along with the detection of the AKT/mTOR protein expression in the pathway by Western blotting. ENT3 was widely and highly expressed in pan-cancer and upregulated in HCC. The upregulated ENT3 was related to the poor prognosis and clinical features in HCC patients. ENT3 knockdown inhibited cell proliferation, migration, and invasion and promoted cell apoptosis. ENT3 knockdown reduced the p-AKT and p-mTOR protein phosphorylation level, inhibited p-p70S6K1 and increased the p-4EBP1-the downstream effector of the AKT/mTOR pathway-protein phosphorylation level. Our study findings demonstrated that the expression of ENT3 was upregulated in HCC, which represents a poor prognosis. Thus, ENT3 promotes the progression of HCC through the AKT/mTOR signaling pathway.

Identification of stable reference genes for quantitative gene expression analysis in the duodenum of meat-type ducks

Quantitative polymerase chain reaction (qPCR) is an important method to detect gene expression at the molecular level. The selection of appropriate housekeeping genes is the key to accurately calculating the expression level of target genes and conducting gene function studies. In this study, the expression of eight candidate reference genes, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), beta-actin (β-actin), 18S ribosomal RNA (18S rRNA), hydroxymethylbilane synthase (HMBS), hypoxanthine phosphoribosyltransferase 1 (HPRT1), TATA box binding protein (TBP), ribosomal protein L13 (RPL13), and tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein (YWHAZ), in the duodenal epithelial tissue of 42-day-old meat-type ducks were detected using qPCR. Furthermore, their expression stability was analyzed using the geNorm, NormFinder, and BestKeeper programs. The results indicated that HMBS and YWHAZ were the most stably expressed genes. All three programs indicated that the expression of 18S rRNA was the least stable, making it unsuitable for the study of gene expression in meat-type duck tissues. This study provides stable reference genes for gene expression analysis and contributes to further studies on the gene function of meat-type ducks.

Surface-charge-switch triggered self assembly of vancomycin modified carbon nanodots for enhanced photothermal eradication of vancomycin-resistant Enterococci biofilms

A new type of vancomycin (Van)-modified carbon nanodots (CNDs@Van) with pH-responsive surface charge switchable activity was successfully developed by covalently cross-linking Van on the surface of carbon nanodots (CNDs). Polymeric Van was formed on the surface of CNDs by covalent modification, which enhanced the targeted binding of CNDs@Van to vancomycin-resistant enterococci (VRE) biofilms and effectively reduced the carboxyl groups on the surface of CNDs to achieve pH-responsive surface charge switching. Most importantly, CNDs@Van was free at pH 7.4, but assembled at pH 5.5 owing to surface charge switching from negative to zero, resulting in remarkably enhanced near-infrared (NIR) absorption and photothermal properties. CNDs@Van exhibited good biocompatibility, low cytotoxicity, and weak hemolytic effects under physiological conditions (pH 7.4). Regarding targeted binding to VRE bacteria, CNDs@Van self-assembled in a weakly acidic environment (pH 5.5) generated by VRE biofilms, giving enhanced photokilling effects in in vitro and in vivo assays. Therefore, potentially, CNDs@Van can be used as a novel antimicrobial agent against VRE bacterial infections and their biofilms.

A Novel LncRNA MSTRG.310246.1 Promotes Differentiation and Thermogenesis in Goat Brown Adipocytes

Brown adipose tissue (BAT) plays a critical role in maintaining the body temperature in newborn lamb due to its unique non-shivering thermogenesis. Previous studies have found that BAT thermogenesis is regulated by several long non-coding RNAs (lncRNAs). Here, we identified a novel lncRNA, MSTRG.310246.1, which was enriched in BAT. MSTRG.310246.1 was localized in both the nuclear and cytoplasmic compartments. In addition, MSTRG.310246.1 expression was upregulated during brown adipocyte differentiation. Overexpression of MSTRG.310246.1 increased the differentiation and thermogenesis of goat brown adipocytes. On the contrary, the knockdown of MSTRG.310246.1 inhibited the differentiation and thermogenesis of goat brown adipocytes. However, MSTRG.310246.1 had no effect on goat white adipocyte differentiation and thermogenesis. Our results show that MSTRG.310246.1 is a BAT-enriched LncRNA that improves the differentiation and thermogenesis of goat brown adipocytes.

Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) Is Associated with Cervical Stromal Involvement in Endometrial Cancer Patients: A Cross-Sectional Study in South China

BACKGROUND

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a significant health issue closely associated with multiple extrahepatic cancers. The association between MAFLD and clinical outcomes of endometrial cancer (EC) remains unknown.

METHODS

We retrospectively included 725 EC patients between January 2012 and December 2020. The odds ratios (ORs) were calculated using logistic regression analyses. Kaplan-Meier survival curves were used for survival analysis.

RESULTS

Among EC patients, the prevalence of MAFLD was 27.7% (201/725, 95% confidence interval (Cl) = 0.245-0.311). MAFLD was significantly associated with cervical stromal involvement (CSI) (OR = 1.974, 95% confidence interval (Cl) = 1.065-3.659, p = 0.031). There was a significant correlation between overall survival (OS) and CSI (HR = 0.31; 95%CI: 0.12-0.83; p = 0.020), while patients with MAFLD had a similar OS to those without MAFLD (p = 0.952). Moreover, MAFLD was significantly associated with CSI in the type I EC subgroup (OR = 2.092, 95% confidence interval (Cl) = 1.060-4.129, p = 0.033), but not in the type II EC subgroup (p = 0.838). Further logistic regression analysis suggested that the hepatic steatosis index (HSI) was significantly associated with CSI among type I EC patients without type 2 diabetes mellitus (T2DM) (OR = 1.079, 95% confidence interval (Cl) = 1.020-1.139, p = 0.012).

CONCLUSIONS

About one-quarter of our cohort had MAFLD. MAFLD was associated with the risk of CSI in EC patients, and this association existed in type I EC patients but not in type II EC patients. Furthermore, the HSI can help predict CSI in type I EC patients without T2DM.

Elimination of varying chromatic aberrations based on diffractive optics

In telescopic systems consisting of Alvarez lenses, chromatic aberrations vary with the magnifications and the fields of view. Computational imaging has developed rapidly in recent years, therefore we propose a method of optimizing the DOE and the post-processing neural network in 2 stages for achromatic aberrations. We apply the iterative algorithm and the gradient descent method to optimize the DOE, respectively, and then adopt U-Net to further optimize the results. The results show that the optimized DOEs improve the results, the gradient descent optimized DOE with U-Net performs the best and has a very robust and good performance in the case of simulated chromatic aberrations. The results also verify the validity of our algorithm.

Longitudinal Analysis of Ocular Manifestation and Interleukin during Intravitreal Treatment of Vitreoretinal Lymphoma with Methotrexate

PURPOSE

To explore the trend of ocular manifestations and interleukin (IL) during the treatment of vitreoretinal lymphoma (VRL), and to evaluate potential effects of different intravitreal administration schedules on the therapeutic response.

DESIGN

Interventional comparative non-randomized clinical study.

METHODS

Patients diagnosed with VRL from January 2011 to January 2022 were included. Intravitreal methotrexate (MTX) injections consisting induction, consolidation and maintenance were scheduled. At baseline and each visit, ocular manifestations and interleukin in aqueous humor were recorded. Effects of the variations (e.g. frequency and number) in the injection schedule on the therapeutic response were analyzed.

RESULTS

Fifty-eight eyes of 33 patients were treated with intravitreal MTX chemotherapy. A mean (±SD) of 9±3 injections were given; 52 eyes achieved complete remission (CR). IL-10, keratic precipitates and sub-retinal lesions correlated well with the course of treatment (all P <0.001). Initial injection given twice weekly was correlated with a higher rate of CR (36/36) than given once weekly or less frequently (16/22, P=0.011). Ocular progression occurred in 13 eyes of 8 patients. The completion of schedule was correlated with PFS (induction + consolidation + maintenance: 547[335-874] days, induction + consolidation: 355[322-831] days, induction only: 147[116-187.5] days, P<0.001). IL-10 over 50 pg/mL was a feasible threshold for the detection of ocular relapse (sensitivity 100.0%, specificity 95.1%).

CONCLUSION

Keratic precipitates, sub-retinal lesions and IL-10 could serve as indicators for therapeutic response. Intensive initial administration and adequate injection number would help to improve the response and prognosis. IL-10 over 50 pg/mL could help to detect ocular relapse.

Phenediamine bridging phthalocyanine-based covalent organic framework polymers used as anode materials for lithium-ion batteries

In this study, phenediamine bridging phthalocyanine-based covalent organic framework materials (CoTAPc-PDA, CoTAPc-BDA and CoTAPc-TDA) with increasingly-widening pore sizes are prepared by reacting cobalt octacarboxylate phthalocyanine with p-phenylenediamine (PDA), benzidine (BDA) and 4,4''-diamino-p-terphenyl (TDA), respectively. The effects of frame size on the morphology structure and its electrochemical properties were explored. X-ray diffraction (XRD), Brunauer-Emmett-Teller (BET) and transmission electron microscopy (TEM) images show that the pore sizes of the CoTAPc-PDA, CoTAPc-BDA and CoTAPc-TDA are about 1.7 nm, 2.0 nm and 2.3 nm, respectively, which are close to the simulated results after geometric conformation optimization using Material Studio software. In addition, the specific surface areas of CoTAPc-PDA, CoTAPc-BDA and CoTAPc-TDA are 62, 81 and 137 m² g^-1, respectively. With increase in the frame size, the specific surface area of the corresponding material increases, which is bound to produce different electrochemical behaviors. Consequently, the initial capacities of the CoTAPc-PDA, CoTAPc-BDA and CoTAPc-TDA electrodes in lithium-ion batteries (LIBs) are 204, 251 and 382 mA h g^-1, respectively. As the charge and discharge processes continue, the active points in the electrode material are continuously activated, leading to a continuous increase in charge and discharge capacities. After 300 cycles, the CoTAPc-PDA, CoTAPc-BDA and CoTAPc-TDA electrodes exhibit capacities of 519, 680 and 826 mA h g^-1, respectively, and after 600 cycles, the capacities are maintained at 602, 701 and 865 mA h g^-1, respectively, with a stable capacity retention rate at a current density of 100 mA g^-1. The results show that the large-size frame structure materials have a larger specific surface area and more favorable lithium ion transmission channels, which produce greater active point utilization and smaller charge transmission impedance, thus showing larger charge and discharge capacity and superior rate capability. This study fully confirms that frame size is a key factor affecting the properties of organic frame electrodes, providing design ideas for the development of high-performance organic frame electrode materials.

Volume-accumulated reflectivity of the outer retina (integral) on spectral domain optical coherence tomography as a predictor of cone cell density: a pilot study

BACKGROUND

The study aims to investigate the relationship between the volume-accumulated reflectivity (termed "integral") on spectral domain optical coherence tomography (SD-OCT) and cone density on adaptive optics (AO) imaging.

METHODS

In this cross-sectional study, both eyes of 32 healthy subjects and 5 patients with inherited retinal diseases (IRD) were studied. The parameter, integral, was defined as the volume-accumulated reflectivity values in a selected region on OCT images; integrals of the ellipsoid zone (EZ) and interdigitation zone (IZ) were measured at 2°, 3°, 4°, 5°and 6° eccentricity along the four meridians on fovea-centered OCT B-scans. Cone density in the same region was measured using a flood illumination adaptive optics camera RTX1.

RESULTS

Integrals of EZ, IZ and cone density shared similar distribution patterns. Integral of the IZ was better correlated with cone density in both healthy people (r = 0.968, p < 0.001) and those with IRD (r = 0.823, p < 0.001) than direct measurements of reflectivity on OCT images. A strong correlation was found between best corrected visual acuity (BCVA) and cone density at 2° eccentricity (r = -0.857, p = 0.002). BCVA was also correlated with the integral of the IZ at the foveola (r = -0.746, p = 0.013) and fovea (r = -0.822, p = 0.004).

CONCLUSIONS

The new parameter "integral" of the photoreceptor outer segment measured from SD-OCT was noted to correlate with cone density and visual function in this pilot study.

Inhibition of hepatic natural killer cell function via the TIGIT receptor in schistosomiasis-induced liver fibrosis

Schistosomiasis is a zoonotic parasitic disease. Schistosoma japonicum eggs deposited in the liver tissue induce egg granuloma formation and liver fibrosis, seriously threatening human health. Natural killer (NK) cells kill activated hepatic stellate cells (HSCs) or induce HSC apoptosis and inhibit the progression of liver fibrosis. However, the function of NK cells in liver fibrosis caused by S. japonicum infection is significantly inhibited. The mechanism of this inhibition remains unclear. Twenty mice were percutaneously infected with S. japonicum cercariae. Before infection and 2, 4, 6, and 8 weeks after infection, five mice were euthanized and dissected at each time point. Hepatic NK cells were isolated and transcriptome sequenced. The sequencing results showed that Tigit expression was high at 4-6 weeks post infection. This phenomenon was verified by reverse transcription quantitative PCR (RT-qPCR) and flow cytometry. NK cells derived from Tigit-/- and wild-type (WT) mice were co-cultured with HSCs. It was found that Tigit-/- NK cells induced apoptosis in a higher proportion of HSCs than WT NK cells. Schistosomiasis infection models of Tigit-/- and WT mice were established. The proportion and killing activity of hepatic NK cells were significantly higher in Tigit-/- mice than in WT mice. The degree of liver fibrosis in Tigit-/- mice was significantly lower than that in WT mice. NK cells were isolated from Tigit-/- and WT mice and injected via the tail vein into WT mice infected with S. japonicum. The degree of liver fibrosis in mice that received NK cell infusion reduced significantly, but there was no significant difference between mice that received NK cells from Tigit-/- and WT mice, respectively. Our findings indicate that Tigit knockout enhanced the function of NK cells and reduced the degree of liver fibrosis in schistosomiasis, thus providing a novel strategy for treating hepatic fibrosis induced by schistosomiasis.

Structural-Based Stability Enhancement of Antisense DNA Oligonucleotides

Antisense DNA oligonucleotide (AS) technology is a promising approach to regulate gene expression and cellular processes. For example, ASs can be used to capture the overexpressed, oncogenic miRNAs in tumors to suppress tumor growth. Among many challenges faced by AS approach is the degradation of ASs by nucleases under physiological conditions. Elongating the AS lifespan can substantially enhance the functions of AS. The paper reports a simple strategy to increase the stability of ASs. The authors discover that the ASs degrade quickly if their ends are in unpaired, single-stranded form, but much slower if their ends are in paired duplex form. It is conceivable to integrate this strategy with other strategies (such as chemical modification of ASs backbones) to maximally increase the ASs stabilities.

The environmental, economic, and social influences of government subsidies on express delivery packaging supply chain

The rapid development of e-commerce and the prosperity of express delivery has brought great convenience to people's life. However, the environmental and social problems caused by express delivery packaging (EDP) have not been well understood yet. It has become an important issue to coordinate the economic, environmental, and social development goals of the government for the sustainable development of the EDP. This paper adopted the system dynamics (SD) method to simulate three subsystems in the express delivery packaging supply chain (EDPSC), i.e., the manufacturer subsystem, the consumer subsystem, and the recycler subsystem. Particularly, the impact of government subsidies on the EDPSC from three dimensions of economy, environment, and society was discussed in this paper. The results showed that (1) CO₂ emissions in the end-of-life stage of EDPSC account for about 83.9-91.8%, and incineration as the main carbon emission source of end-of-life reduce by 10-19% compared with no government subsidy. (2) The profit of recyclers is most affected by government subsidies, and incineration power generation is one of the main economic sources for recyclers. As the recycling rate of EDP increased from 2 to 32%, the income from incineration power generation decreased from about 25-40% to 15-25% of the total income. (3) The implementation of government subsidies is beneficial to improve social welfare, which has the biggest impact on consumers' surplus. (4) The comprehensive scenario subsidy is better than the single scenario subsidy, but it will bring a serious cost burden to the government. In the single scenario, the target of government subsidy depends on the level of government subsidy, which is subsidized to consumers at low and medium levels and recyclers at high levels. Therefore, our results can be used to help governments make decisions and also serve as a methodological reference for supply chains in other industries.

“Endoscope-assisted Anterolateral Approach for a Craniovertebral Junction Chordoma”

Chordomas of craniovertebral junction represent a challenging pathology for neurosurgeons, due to their deep location, proximity with critical neurovascular structures and local aggressiveness. Several surgical options are available for these tumors: both endoscopic extended approaches and open approaches. We present the case of a 24 years old female with a craniovertebral junction chordoma with anterior and right lateral extension. For this case, an anterolateral approach with endoscopic assistance was chosen. Key surgical steps are presented. In the postoperative course the neurological symptoms improved and there were no complications. Unfortunately, she had an early recurrence of tumor two months later, prior the beginning of radiotherapy. After multidisciplinary consultation, we performed a second surgical removal and a posterior cervical spine arthrodesis. The anterolateral approach is a valuable option for craniovertebral junction chordomas with lateral extension and the endoscope assistance allowed to reach the narrowest and furthermost points. The patients must be referred to multidisciplinary skull base surgery centers and be addressed to early adjuvant radiation therapy.

The scaffold RhoGAP protein ARHGAP8/BPGAP1 synchronizes Rac and Rho signaling to facilitate cell migration

Rho GTPases regulate cell morphogenesis and motility under the tight control of guanine nucleotide exchange factors (GEFs) and GTPase-activating proteins (GAPs). However, the underlying mechanism(s) that coordinate their spatiotemporal activities, whether separately or together, remain unclear. We show that a prometastatic RhoGAP, ARHGAP8/BPGAP1, binds to inactive Rac1 and localizes to lamellipodia. BPGAP1 recruits the RacGEF Vav1 under epidermal growth factor (EGF) stimulation and activates Rac1, leading to polarized cell motility, spreading, invadopodium formation, and cell extravasation and promotes cancer cell migration. Importantly, BPGAP1 down-regulates local RhoA activity, which influences Rac1 binding to BPGAP1 and its subsequent activation by Vav1. Our results highlight the importance of BPGAP1 in recruiting Vav1 and Rac1 to promote Rac1 activation for cell motility. BPGAP1 also serves to control the timing of Rac1 activation with RhoA inactivation via its RhoGAP activity. BPGAP1, therefore, acts as a dual-function scaffold that recruits Vav1 to activate Rac1 while inactivating RhoA to synchronize both Rho and Rac signaling in cell motility. As epidermal growth factor receptor (EGFR), Vav1, RhoA, Rac1, and BPGAP1 are all associated with cancer metastasis, BPGAP1 could provide a crucial checkpoint for the EGFR-BPGAP1-Vav1-Rac1-RhoA signaling axis for cancer intervention.

CI-Net: Clinical-Inspired Network for Automated Skin Lesion Recognition

The lesion recognition of dermoscopy images is significant for automated skin cancer diagnosis. Most of the existing methods ignore the medical perspective, which is crucial since this task requires a large amount of medical knowledge. A few methods are designed according to medical knowledge, but they ignore to be fully in line with doctors' entire learning and diagnosis process, since certain strategies and steps of those are conducted in practice for doctors. Thus, we put forward Clinical-Inspired Network (CI-Net) to involve the learning strategy and diagnosis process of doctors, as for a better analysis. The diagnostic process contains three main steps: the zoom step, the observe step and the compare step. To simulate these, we introduce three corresponding modules: a lesion area attention module, a feature extraction module and a lesion feature attention module. To simulate the distinguish strategy, which is commonly used by doctors, we introduce a distinguish module. We evaluate our proposed CI-Net on six challenging datasets, including ISIC 2016, ISIC 2017, ISIC 2018, ISIC 2019, ISIC 2020 and PH2 datasets, and the results indicate that CI-Net outperforms existing work. The code is publicly available at https://github.com/lzh19961031/Dermoscopy_classification.

Science Popularization Interventions on Rational Medication in Patients with Hyperuricemia

Objective: This research aimed to explore the science of population intervention in the rational medication treatment of hyperuricemia patients in China. The research model was designed to determine interventions from three dimensions of science propylitization (empirical evidence, logical reasoning, and skeptical attitude). Methods: The data for this research was collected from hyperuricemia patients in China with a survey-based questionnaire. A partial least square-structural equation modeling statistical method was used for data evaluation. Results: The research investigated that science popularization can strongly influence hyperuricemia patients' rational medication with empirical evidence, logical reasoning, and a skeptical attitude. Furthermore, the research asserted that more focus on scientific knowledge of hyperuricemia patients can improve their health further. Conclusion: Theoretically, this research would have wider implications. First, the research model was based on science popularization interventions which is a novel contribution to the relationship with rational medication. Second, the practical implications of this study would lie in science population interventions improving the rational medications for hyperuricemia patients. Besides, this research asserted a few future directions for scholars to contribute and determine the impact of further variables to enhance the model of science popularization in relationship with rational medication.

Effects of transcutaneous electrical acupoint stimulation on gastrointestinal dysfunction after gastrointestinal surgery: A meta-analysis

BACKGROUND

Postoperative gastrointestinal dysfunction (PGD) is a common complication in patients undergoing gastrointestinal surgery. Several studies have evaluated the effect of transcutaneous electrical acupoint stimulation (TEAS) on PGD, so we conducted a systematic review and meta-analysis to better understand these studies methodologic limitations and summarize clinical effects.

METHODS

Articles (published from January 2010 to April 2022) were searched from the following databases: Wanfang Database, China National Knowledge Infrastructure (CNKI), Cochrane Library, PubMed, Web of Science and Embase. Two authors conducted literature selection, data extraction and statistical analysis independently. This meta-analysis used RevMan 5.4 software to implement statistical analysis and applied Cochrane bias risk tool to assess methodologic weaknesses of included articles. We assessed the effect of TEAS on time to first flatus, first defecation and bowel sound recovery through meta-analyses using a random-effects model.

RESULTS

The meta-analysis included 10 articles including 1497 patients. This study showed that TEAS could effectively promote postoperative gastrointestinal function recovery by analyzing the time to first flatus (MD-14.81 h, 95% CI -15.88 to -13.75 h), time to first defecation (MD-14.68 h, 95% CI -20.59 to -8.76 h), time to bowel sound recovery (MD-5.79 h, 95% CI -10.87 to -0.71 h), length of hospital stay (MD-1.48d, 95% CI -1.86 to -1.11d), and the incidence of postoperative nausea and vomiting (PONV) (OR 0.41, 95% CI 0.29-0.58). In addition, we assessed the quality of the articles and found small sample sizes and lower methodological quality in some articles.

CONCLUSION

Our meta-analysis revealed that TEAS could be a nonpharmacological treatment for PGD in patients after gastrointestinal surgery. However, positive findings should be treated carefully and future studies with high quality and large samples are needed to support this results.

[The role of sinusoidal endothelial cells in liver injury: a review]

Liver sinusoidal endothelial cells (LSECs) locate on the surface of hepatic sinusoids. As the first line of defense between the liver and blood, LSECs are the most abundant non-parenchymal cells in the liver. Under physiological conditions, LSECs may induce liver immune tolerance through participating in substance transport and metabolic waste removal, thereby maintaining liver homeostasis, and under pathological conditions, LSECs may promote liver immune response via antigen presentation. LSECs have been found to play a crucial regulatory role in maintaining the balance between liver regeneration and liver fibrosis. This article reviews the progress of researches on LSECs functions, LSECs changes in liver injury, signal pathways associated with regulation of LSECs functions, and the interaction between LSECs and other types of cells in the liver, aiming to elucidate the function of LSECs and their roles in liver diseases.

Pathological Changes in Hepatic Sinusoidal Endothelial Cells in Schistosoma japonicum-Infected Mice

Schistosomiasis japonica is a zoonotic parasitic disease causing liver fibrosis. Liver sinusoidal endothelial cells (LSECs) exhibit fenestrations, which promote hepatocyte regeneration and reverses the process of liver fibrosis. To investigate the pathological changes of LSECs in schistosomiasis, we established a Schistosomiasis model. The population, phenotype, and secretory function of LSECs were detected by flow cytometry at 20, 28, and 42 days post infection. The changes in LSEC fenestration and basement membrane were observed through scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Quantitative real-time PCR and Western blotting were used to detect the expression of molecules associated with epithelial-mesenchymal transition (EMT) and fibrosis of LSECs and the liver. The flow cytometry results showed that the total LSEC proportions, differentiated LSEC proportions, and nitric oxide (NO) secretion of LSECs were decreased, and the proportion of dedifferentiated LSECs increased significantly post infection. The electron microscopy results showed that the number of fenestrate was decreased and there was complete basement membrane formation in LSECs following infection. The qPCR and Western blot results showed that EMT, and fibrosis-related indicators of LSECs and the liver changed significantly during the early stages of infection and were aggravated in the middle and late stages. The pathological changes in LSECs may promote EMT and liver fibrosis induced by Schistosoma japonicum infection.

Paeonol Attenuates the Endothelial-to-Mesenchymal Transition Induced by TGF-β1 in Human Umbilical Vein Endothelial Cells through ALK5-Smad2/3 Signaling Pathway

Background： Paeonol (Pae)， the main active compound of the root of Paeonia albiflora, is efficacious in treating atherosclerosis (AS). Endothelial dysfunction is throughout the pathological progression of AS. It is expected that inhibition of Endothelial-to-mesenchymal transition (EndMT) will be a key target for AS treatment. Objective： In this study, we investigated the molecular mechanism of the regulatory effect of Pae on EndMT in human umbilical vein endothelial cells (HUVECs). Methods： Cell cytotoxicity, proliferation, and migration were detected by CCK-8, the wound healing assay, and EdU staining, respectively. The protein expressions were measured by Western blot or immunofluorescence staining. Immunofluorescence staining was performed to indicate endothelial cells undergoing EndMT in ApoE-/- mice. In vitro TGF-β1-induced EndMT assays were performed in HUVECs and the effect of Pae was explored. Results：We demonstrated that Pae could improve induced TGF-β1-EndMT in vivo and in vitro. Mechanism study revealed that Pae directly bonds to the activin-like kinase 5 (ALK5, also known as TGFβ type I receptor), inhibited downstream Smad2/3 phosphorylation, and thus alleviated EndMT. Notably, overexpression of ALK5 significantly reversed the inhibitory effect of Pae on EndMT in HUVECs. Conclusion：Our results indicate that ALK5 is a promising druggable target for AS, and pharmacological regulation of ALK5-Smad2/3 signaling pathway with small-molecule holds great potential to benefit AS patients.

Effects of antiviral therapy and drug withdrawal on postpartum hepatitis in pregnant women with chronic HBV infection

OBJECTIVE

To investigate the effect of antiviral therapy and drug withdrawal on the incidence of hepatitis B after delivery in pregnant women with chronic hepatitis B virus (CHB) infection who received tenofovir disoproxil fumarate (TDF) treatment.

METHODS

Eligible CHB pregnant women were enrolled, and received TDF at 32 weeks gestation. The drug was stopped immediately or at 6 weeks after delivery. The HBV biomarkers and clinical biochemical parameters were monitored during gestation and 24 weeks after delivery.

RESULTS

There were 264 women completed the observation, including 96 untreated subjects in control group. Among 168 treated subjects, 131 cases stopped drug immediately after delivery and 37 cases delayed the drug withdrawal at 6 weeks after delivery. The incidence of postpartum hepatitis in control, immediate drug withdrawal, and delayed drug withdrawal were 28.1% (27/96), 23.7% (31/131), and 24.3% (9/37), showing no significant difference (χ² = 0.607, p = 0.738). No factor was found to be associated with the occurrence of postpartum hepatitis. It's noteworthy that 96.3% of postpartum hepatitis in control group and 92.3% of postpartum hepatitis in immediate drug withdrawal group occurred within 12 weeks after delivery. While in delayed drug withdrawal group, the rate of postpartum hepatitis occurred within 12 weeks after delivery was 77.7%.

CONCLUSION

Withdrawing antiviral drug immediately or at 6 weeks after delivery did not affect the incidence of postpartum hepatitis in CHB women, but delaying drug withdrawal might delay the onset of postpartum hepatitis.

CLINICAL TRIAL REGISTRATION NUMBER

NCT03214302.

Pain as a risk factor for incident sarcopenia in community-dwelling older adults: A 1-year prospective cohort study

BACKGROUND

Pain-related muscle disuse and inflammatory reactions may increase the risk of sarcopenia among older adults with pain. Although several studies have examined the association between pain and sarcopenia, the findings are mixed. In the present study, we examined the association of pain as well as pain intensity and location with incident sarcopenia among community-dwelling older adults and explored whether this association differed between men and women.

METHODS

Pain characteristics, including the presence of pain, intensity (mild, moderate, and severe), and location (multisite, low back, joint, and chest), were self-reported at baseline. Sarcopenia was identified according to the consensus of the Asin Working Group for Sarcopenia 2019 at baseline and 1 year later. Multivariable Poisson regression was used to determine the association of pain status, intensity, and location with incident sarcopenia, respectively.

RESULTS

Eight hundred seventy-three participants (67.1 ± 4.9 years, 524 female) who were free of sarcopenia at baseline were included, of which 64 (7.3%) developed sarcopenia in the follow-up. The presence of pain was significantly associated with an increased risk of incident sarcopenia in older adults (adjusted RR = 1.83, 95% CI = 1.16-2.89), with a significant risk accumulation in incident sarcopenia upon higher pain intensity. Older adults with multisite pain, low back pain, or joint pain were more likely to develop sarcopenia. Although older men reported a lower prevalence and intensity of pain, their risk of sarcopenia during follow-up was generally more pronounced than older women.

CONCLUSIONS

Older adults with pain had a significantly higher risk of incident sarcopenia, with a significant risk accumulation in sarcopenia development upon higher pain intensity and specific pain location. Additional attention is needed to identify older adults with pain and to implement timely pain interventions to prevent sarcopenia. High-quality randomized controlled trials are warranted to verify the clinical significance of the present study.

Deciphering the antibiotic resistome and microbial community in municipal wastewater treatment plants at different elevations in eastern and western China

Antibiotic resistance genes (ARGs) as emerging environmental contaminants pose severe global risks to public health and ecosystems. Municipal wastewater treatment plants (WWTPs) are crucial transmitters for the dissemination and propagation of ARGs into receiving water bodies via mobile genetic elements (MGEs). However, the comprehensive and deep deciphering of the diversity, abundance, and potential hosts of ARGs in two distinct altitudinal WWTPs is scarce. In this work, we revealed the elevational distribution characteristics of the resistance genes and microbial community of six WWTPs from two distinct geographical zones: a low-elevation (LE) region (Shandong, 10-22 m above sea level) and a high-elevation (HE) region (Gansu, 1,520-1,708 m above sea level). Significant elevational variations in the diversity and relative abundance of resistance genes were observed. Wastewater treatment could significantly reduce the concentrations of ARGs and MGEs by about 1-2 and 2-3 orders of magnitude, respectively. However, above 69.95% of resistance genes were enriched in effluent. In particular, 24 ARG subtype, 3 MGE subtypes, and 59 bacterial genera were persistent in all samples. More potential hosts for ARGs in LE region and more abundant human gut microbiota in HE region were identified. This work provides helpful information for controlling the spread of ARGs for their management and assessment, thereby mitigating the risks of ARGs in WWTPs.

Changes of natural killer cells' phenotype in patients with chronic hepatitis B in intermittent interferon therapy

Background

To investigate the changes of natural killer (NK) cell phenotype in the interferon alpha (IFN-α) treatment of chronic hepatitis B (CHB) and its relationship with clinical indicators.

Methods

The CHB patients who did not receive any antiviral treatment were set as initial treatment group and used pegylated interferon alpha (PEG-IFN α). Peripheral blood samples were collected at baseline, 4 weeks, and 12-24 weeks. For IFN-treated patients who entered the plateau were set as plateau group, and PEG-IFN α was discontinued and resumed after an interval of 12-24 weeks. Besides, we also enrolled some patients who had received oral drug for more than 6 months as oral drug group without follow up. Peripheral blood was collected during the plateau period, which was set as baseline, and after 12-24 weeks of intermittent treatment, and after 12-24 weeks of additional treatment with PEG-IFN α. The aim of the collection was to detect hepatitis B virus (HBV) virology, serology and biochemical indicators, and the NK cell related phenotype was detected by flow cytometry.

Results

In the plateau group, subgroup of CD69⁺CD56^dim was higher with statistical significance when comparing with the initial treatment group and oral drug group [10.49 (5.27, 19.07) vs 5.03 (3.67, 8.58), Z = -3.11, P = 0.002; 10.49 (5.27, 19.07) vs 4.04 (1.90, 7.26), Z = -5.30, P < 0.001)]. CD57⁺CD56^dim was significantly lower than that in initial treatment group and oral drug group respectively [68.42±10.37 vs 55.85±12.87, t = 5.84, P < 0.001; 76.38±9.49 vs 55.85±12.87, t = -9.65, P < 0.001]. The CD56^brightCD16^- subgroup in the plateau group was higher with statistical significance compared with initial treatment group and oral drug group respectively [11.64 (6.05, 19.61) vs 3.58 (1.94, 5.60), Z = -6.35, P < 0.001; 11.64 (6.05, 19.61) vs 2.37 (1.70, 4.30), Z = -7.74, P < 0.001)]. CD57⁺CD56^dim in the plateau group had a significant higher percentage than that at baseline after IFN discontinuation for 12-24 weeks (55.85±12.87 vs 65.95±12.94, t = -2.78, P = 0.011).

Conclusion

During the long-term treatment of IFN, the killer subgroup of NK cells is continuously depleted, leading to the differentiation of the regulatory subgroup into the killer subgroup. In the killing subgroup, although the number is continuously depleted, the activity of the subgroup is continuously increased. In the plateau phase, after stopping IFN for a period of time, the number of NK cell subsets would gradually recover, but was still lower than that in the initial treatment group.

Dynamic changes of the proportion of HLA-DR and CD38 coexpression subsets on T lymphocytes during IFN-based chronic hepatitis B treatment

Background

To investigate the changes of human leukocyte antigen DR (HLA-DR) and CD38 coexpression subsets on T lymphocytes following interferon (IFN) therapy for those who have chronic hepatitis B (CHB).

Methods

A prospective cohort of CHB patients participated in this study. CHB patients without IFN treatment (including naïve and nucleoside [nucleotide] analogs [NAs]-treated patients) were given pegylated interferon alfa (Peg-IFNα) treatment. Peripheral blood samples were taken at baseline, 4 weeks and 12-24 weeks of Peg-IFNα treatment. For the patients who entered the Peg-IFNα plateau phase due to the stagnation of the decrease in HBsAg, and Peg-IFNα was discontinued and Peg-IFNα therapy was resumed after an interval of 12-24 weeks. During the interval, they received first-line NAs treatment. Peripheral blood samples were collected at the baseline of the plateau phase, 12-24 weeks of intermittent treatment, and 12-24 weeks of Peg-IFNα retreatment. The peripheral blood samples were taken to determine virological, serological and biochemical indices of hepatitis B virus (HBV), and T lymphocyte related phenotypes were detected using flow cytometry.

Results

In the process of long-term treatment of Peg-IFNα, the percentage of HLA-DR⁺CD38^dim subsets increased significantly at first, then decreased gradually, while the percentage of HLA-DR⁺CD38^hi subsets markedly increased. During long-term Peg-IFNα treatment, there was a considerable negative correlation between HBsAg and the HLA-DR⁺CD38^hi subset percentage. The persistent high proportion of HLA-DR⁺CD38^hi subsets was related to the occurrence of Peg-IFNα plateau phase. After Peg-IFNα intermittent treatment, the percentage of HLA-DR⁺CD38^hi subsets decreased significantly. After Peg-IFNα retreatment, the level of HBsAg began to decrease again. At the same time, the percentage of HLA-DR⁺CD38^hi subsets significantly increased, but it was still lower than that at the baseline level.

Conclusions

The spectrum of HLA-DR and CD38 coexpression subsets on T lymphocytes changed during the long-term treatment of IFN. The establishment of the IFN plateau phase was linked to the persistence of a considerable proportion of HLA-DR⁺CD38^hi subsets on T lymphocytes. IFN intermittent treatment could significantly reduce the proportion of HLA-DR⁺CD38^hi subsets, helping regain the antiviral efficacy of IFN during IFN retreatment.

Wetting and deposition characteristics of air-assisted spray droplet on large broad-leaved crop canopy

Precision and efficient pesticide spraying is an important part of precision agriculture, banana is a large broad-leaved plant, with pests and diseases, has a high demand for spraying and pest control. The purpose of this study was to clarify the wettability of different pesticides on the banana leaf surface, and the effects of nozzle type and working parameters on the deposition distribution performance under air-assisted spray conditions. The wettability test results of different pesticides on banana leaf surfaces showed that the wettability of the adaxial side was always stronger than that of the abaxial side, the smaller the surface tension of the droplets, the better the wettability on the surface. The spray experiment was carried out on the previously developed air-assisted sprayer with the latest developed intelligent variable spray control system. Three types of nozzles were used to spray with different combinations of working parameters. The deposition distribution performance on the banana leaf surface was obtained by image processing using a self-compiled program. The experimental results show that the nozzle type, wind speed, and spray pressure have significant effects on the deposition distribution performance. Through the study of the interaction and coupling effect of nozzle type and working parameters on the spray droplet deposition distribution on both sides of banana leaves, the results show that under the conditions of hollow cone nozzle, 0.5Mpa spray pressure and 3-5 m/s wind speed, the spray coverage and droplet density are in the optimal state. This is mainly due to the low spray pressure and/or wind speed is not enough to make the banana leaves vibrate and improve the performance of pesticide deposition. excessive spray pressure and/or wind speed will cause large deformation of banana leaves and make them airfoil stable, which reduces the surface deposition performance. It is of great significance for promoting sustainable and intelligent phytoprotection.

A nomogram based on HBeAg, AST, and age to predict non-minimal liver inflammation in CHB patients with ALT <80 U/L

Objective

Precise assessment of liver inflammation in untreated hepatitis B e antigen (HBeAg)-positive patients with chronic hepatitis B virus (HBV) infection can determine when to initiate antiviral therapy. The aim of this study was to develop and validate a nomogram model for the prediction of non-minimal liver inflammation based on liver pathological injuries combined with age and alanine aminotransferase (ALT), aspartate aminotransferase (AST), hepatitis B surface antigen (HBsAg), HBeAg, and HBV DNA quantification.

Methods

We retrospectively included 735 HBeAg-positive chronic hepatitis B (CHB) patients with ALT < 80 U/L as the primary cohort and prospectively enrolled 196 patients as the validation cohort. Multivariate logistic regression analysis identified independent impact factors. A nomogram to predict significant liver inflammation was developed and validated.

Results

Multivariate logistic regression analysis showed that HBeAg, AST, and age were independent risk factors for predicting non-minimal liver inflammation in untreated CHB patients. The final formula for predicting non-minimal liver inflammation was Logit(P) = -1.99 - 0.68 × Log₁₀HBeAg + 0.04 × Age + 0.06 × AST. A nomogram for the prediction of non-minimal liver inflammation was established based on the results from the multivariate analysis. The predicted probability of the model being consistent with the actual probability was validated by the calibration curves, showing the best agreement in both the primary and validation cohorts. The C-index was 0.767 (95%CI = 0.734-0.802) in the primary cohort and 0.749 (95%CI = 0.681-0.817) in the prospective validation cohort.

Conclusions

The nomogram based on HBeAg, AST, and age might help predict non-minimal liver inflammation in HBeAg-positive CHB patients with ALT < 80 U/L, which is practical and easy to use for clinicians.

Efficacy and Safety of Glycyrrhizic Acid in Treatment of Autoimmune Hepatitis

To compare the long-term efficacy and safety of glycyrrhizic acid preparation and hormone treatment in patients with autoimmune hepatitis, we enrolled 377 patients in a study that lasted from January 2009 to January 2020. After performing propensity score matching, we included 58 patients in the hormone group and 58 in the glycyrrhizic acid preparation group in statistical analysis. We then compared the ratio of sustained biochemical responses at 48 weeks after treatment. Adverse events, including some incidence of decompensated liver cirrhosis and liver cancer, were evaluated. The results showed that a total of 61.8% of treated patients achieved complete biochemical remission. The cumulative biochemical remission rate in the hormone group and glycyrrhizic acid preparation group showed no significant difference (62.3% vs. 60.7%, [Formula: see text], [Formula: see text]). At the end of follow-up, the total bile acid in the hormone group was significantly higher than that in the glycyrrhizic acid preparation group (8.9[Formula: see text][Formula: see text]mol/L vs. 5.6[Formula: see text][Formula: see text]mol/L, [Formula: see text], [Formula: see text]). The incidence of adverse reactions in the hormone group was significantly higher than that in the glycyrrhizic acid preparation group (31.03% vs. 15.52%, [Formula: see text], [Formula: see text]). In conclusion, compared with the hormone treatment, glycyrrhizic acid preparation might be a safe and effective treatment for autoimmune hepatitis.

Development and validation of LC-MS/MS method for quantification of protease inhibitor Pepstatin A to monitor its robust clearance in vaccine downstream process

Pepstatin A reversibly inhibits aspartic acid proteases and minimizes the impact of protease-induced degradation in recombinant protein manufacturing process. Pepstatin A is considered as a process-related impurity and must be characterized and controlled during manufacturing. Herein we describe the development and validation of an LC-MS/MS method for the quantitation of pepstatin A to monitor its robust clearance in vaccine purification process. Analyte extraction from process intermediates was carried out using 10% acetonitrile/water extraction method. Acetyl-pepstatin was used as internal standard (IS). Pepstatin A and IS were resolved on a C18 column using 10 mM ammonium acetate in water and methanol/acetonitrile mobile phase system. A triple quadrupole mass spectrometer operating in the positive electrospray ionization mode with multiple reaction monitoring was used to detect Pepstatin A and IS transitions of m/z 686.5 to 229.3 and 644.5 to 229.3, respectively. The method was validated for specificity, linearity, accuracy, repeatability (precision), intermediate precision, and assay robustness. The assay was linear over the range of calibration standards 0.5-100 ng/mL. The Lower-limit-of-quantification (LLOQ) of the method was 0.50 ng/mL.

[Epidemiological features of echinococcosis cases reported in the National Notifiable Disease Report System in Henan Province from 2010 to 2021]

OBJECTIVE

To analyze the epidemiological characteristics of echinococcosis cases reported in the National Notifiable Disease Report System in Henan Province from 2010 to 2011, so as to provide insights into for echinococcosis control and surveillance.

METHODS

The data pertaining to reported echinococcosis cases in Henan Province from 2010 to 2021 were retrieved from the National Notifiable Disease Report System, and a descriptive epidemiological analysis was performed using the software SPSS 22.0.

RESULTS

A total of 150 echinococcosis cases were reported in Henan Province from 2010 to 2021, including 88 confirmed cases (58.67%) and 62 clinically diagnosed cases (41.33%), 77 cases reported by Henan Province (51.33%) and 73 cases reported by other provinces (48.67%). Echinococcosis cases were reported in each month, with 8 to 21 cases reported in each month, and the number of reported echinococcosis cases appeared no remarkable temporal changes. The echinococcosis cases were reported across 18 cities of Henan Province, with the highest number of cases reported in Zhoukou (17.33%) and Nanyang cities (17.33%) and the lowest number reported in Sanmenxia City (0.67%). The reported echinococcosis cases had a male to female ratio of 1.17:1, and the cases were found at each age group, with the the highest number of cases seen at ages of 20 to 59 years (73.33%). Farmer was the predominant occupation (63.33%), followed by housekeepers and the unemployed (12.67%). Of all reported echinococcosis cases, there were 25 local cases (16.67%) and 125 imported cases (83.33%), 144 cases reported by medical institutions (96.00%) and 6 cases reported by centers for disease control and prevention (4.00%).

CONCLUSIONS

Although imported echinococcosis cases were the predominant source of echinococcosis cases reported in the National Notifiable Disease Report System in Henan Province from 2010 to 2021, there were still sporadic local cases, and the emergence of local sources of infection cannot be excluded. Further expanded field surveys and surveillance of echinococcosis are required.

The association between exposure to multiple toxic metals and the risk of endometriosis: Evidence from the results of blood and follicular fluid

BACKGROUND

Endometriosis affects up to 10 % of women of reproductive age and can lead to infertility. Research investigating whether combined exposure to arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg) is related to an increased risk of endometriosis, especially using different biological samples to validate the association, is very limited.

OBJECTIVE

This investigation aimed to evaluate the associations between the concentrations of As, Cd, Pb and Hg in blood and follicular fluid and the risk of endometriosis.

METHODS

A total of 609 endometriosis cases and controls seen at the reproductive center of the First Affiliated Hospital of Anhui Medical University in Hefei, China, between April 2020 and December 2021 were included in our study. Blood (217 cases and 234 controls) and follicular fluid (182 cases and 203 controls) samples were collected from these subjects. The concentrations of Cd, Hg, As and Pb in the blood and follicular fluid were determined by inductively coupled plasma-mass spectrometry (ICP-MS). Unconditional logistic regression models were used to assess the associations between Cd, Hg, As or Pb levels and the risk of endometriosis; Bayesian kernel machine regression (BKMR) was used to evaluate the combined effect of metals on the risk of endometriosis.

RESULTS

We found significant associations between blood concentrations of As (highest vs. lowest tertile: aOR = 5.53, 95 % CI: 2.97, 10.30), Cd (second vs. lowest tertile: aOR = 1.96, 95 % CI: 1.07, 3.58; highest vs. lowest tertile: aOR = 3.21, 95 % CI: 1.79, 5.77), Pb (highest vs. lowest tertile: aOR = 2.73, 95 % CI: 1.56, 4.78) and Hg (high-level group vs. low-level group: aOR = 13.10, 95 % CI: 6.74, 25.44; second vs. lowest tertile: aOR = 15.27, 95 % CI: 4.96, 46.97; highest vs. lowest tertile: aOR = 35.66, 95 % CI: 11.99, 106.08) and increased risk of endometriosis adjusting for confounders. Follicular fluid As (highest vs. lowest tertile: aOR = 2.42, 95 % CI: 1.35, 4.33), Hg (highest vs. lowest tertile: aOR = 1.86, 95 % CI: 1.05, 3.29), Cd (second vs. lowest tertile: aOR = 2.45, 95 % CI: 1.29, 4.65; highest vs. lowest tertile: aOR = 3.12, 95 % CI: 1.67, 5.83), and Pb (second vs. lowest tertile: aOR = 1.97, 95 % CI: 1.11, 3.52) concentrations were positively associated with endometriosis risk. The BKMR analyses showed linear associations between the metal mixtures and the risk of endometriosis. Both in blood and in follicular fluid, As exhibited the highest contribution.

CONCLUSION

The data from this study suggest that toxic metals, individually and as a mixture, play a role in the risk of endometriosis, thus providing a novel idea for endometriosis prevention.

Study on pathological and clinical characteristics of chronic HBV infected patients with HBsAg positive, HBV DNA negative, HBeAg negative

Aims

Study of clinical characteristics of hepatitis B virus deoxyribonucleic acid (HBV DNA)-negative, hepatitis B surface antigen (HBsAg)-positive, hepatitis B e antigen (HBeAg)-negative patients based on liver histopathology.

Methods

We retrospectively enrolled patients with chronic HBV infection diagnosis at Beijing Ditan Hospital from May 2008 to November 2020. To study the differences between patients with significant hepatic histopathology and those without significant hepatic histopathology. And to study the independent factors of significant hepatic histopathology.

Results

85 HBV DNA-negative and HBeAg-negative patients were 37.90 ± 10.30 years old, 23.50% of patients with grade of inflammation (G) >1, 35.30% of patients with liver fibrosis stage (S) >1, 44.70% patients were diagnosed with significant hepatic histopathology. Compared to the no significant hepatic histopathology group, another group had older age (41.70 ± 10.70 vs 34.80 ± 8.87 years, t=-3.28, P=0.002), higher total bilirubin (TBIL) [14.9(10.3, 22.4) vs 11(8.9, 14.4) μmol/L, z=-2.26, P=0.024], lower cholinesterase (CHE) (t=-2.86, P=0.005, 7388.00 ± 2156.00 vs 8988.00 ± 2823.00 U/L) and lower platelet (PLT) (t=2.75, P=0.007, 157.00 ± 61.40 vs 194.00 ± 61.00 10^9/L). Abnormal ALT patients are more likely to have significant hepatic histopathology (z=5.44, P=0.020, 66.70% vs 337.50%). G had significant correlation with CHE (P=0.008, r=-0.23), alanine aminotransferase (ALT) (P=0.041, r=0.18), aspartate aminotransferase (AST) (P=0.001, r=0.29). S had significant correlation with TBIL (P = 0.008, r = 0.23), age (P < 0.001, r = 0.32), international normalized ratio (INR) (P = 0.04, r = 0.23), CHE (P < 0.001, r = -0.30), PLT (P < 0.001, r = -0.40) and prothrombin time activity (PTA) (P = 0.046, r = -0.22). Multivariate logistic analysis indicated only age (95%CI=1.014~1.130, OR=1.069, P=0.013) was an impact factor for significant hepatic histopathology. The cutoff point of age was 34.30 years.

Conclusions

A large proportion of chronic HBV infection patients with HBeAg-negative and HBV DNA-negative still have chronic hepatitis. Age is an independent factor for significant hepatic histopathology.

Postpartum hepatitis and host immunity in pregnant women with chronic HBV infection

In order to develop immune tolerant to the fetal, maternal immune system will have some modification comparing to the time before pregnancy. Immune tolerance starts and develops at the maternal placental interface. In innate immunity, decidual natural killer (dNK) cells, macrophages and dendritic cells play a key role in immue tolerance. In adaptive immunity, a moderate increase of number and immune inhibition function of regulatory T cells (Treg) are essential for immune tolerance. The trophoblast cells and immune cells expressing indoleamine 2,3-dioxygenase (IDO), the trophoblast cells expressing HLA-G, and Th1/Th2 shifting to Th2 dominant and Th17/Treg shifting to Treg domiant are in favor of maternal fetal immune tolerance. Steroids (estrogen and progesterone) and human chorionic gonadotropin (HCG) also participate in immune tolerance by inducing Treg cells or upregulating immunosuppressive cytokines. Most of the patients with chronic HBV infection are in the "HBV immune tolerance period" before pregnancy, and the liver disease is relatively stable during pregnancy. In chronic HBV infection women, after delivery, the relative immunosuppression in vivo is reversed, and Th1 is dominant in Th1/Th2 and Th17 is dominant in Th17/Treg balance. After delivery, the number of Treg decrease and NK cells increase in quantity and cytotoxicity in peripheral blood. Liver NK cells may cause liver inflammation through a non-antigen specific mechanism. After delivery, the number of CD8⁺ T cells will increase and HBV specific T cell response recovers from the disfunction in pregnancy. Under the background of postpartum inflammation, the rapid decrease of cortisol after delivery, and especially the enhancement of HBV specific T cell response induced by HBV DNA and cytokines, are the main reasons for postpartum hepatitis. HBeAg positive, especially HBeAg<700 S/CO, and HBV DNA>3-5Log₁₀IU/ml are risk factors for postpartum hepatitis. Antiviral treatment in late pregnancy can reduce the incidence of mother to child transmission (MTCT) in chronic HBV infection women. Chronic HBV infection women have hepatitis both during pregnancy and more often in 12 weeks postpartum. It is generally agreed that postpartum hepatitis is mild symptoms and self-limited. Delaying drug withdrawal to 48 weeks can increase the seroconversion rate of HBeAg in delivery women with elevated alanine aminotransferase (ALT) in pregnancy.

Association between spontaneous intracranial epidural hematoma and craniofacial infections: A systematic literature review

Background

Spontaneous and nontraumatic epidural hematoma (SEDH) is a rare entity. Etiology is various, including vascular malformations of the dura mater, hemorrhagic tumors, and coagulation defects. The association between SEDH and craniofacial infections is rather unusual.

Methods

We performed a systematic review of the available literature using the PubMed, Cochrane Library, and Scopus research databases. Literature research was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We exclusively included studies reporting demographic and clinical data, published until October 31, 2022. We also report one case from our experience.

Results

A total of 18 scientific publications, corresponding to 19 patients, met the inclusion criteria for the qualitative and quantitative analysis. Patients were mostly adolescents, with a clear male predominance. SEDHs frequently occurred in the frontal area, usually near the site of the infection. Surgical evacuation was the treatment of choice with good postoperative outcomes. Endoscopy of the involved paranasal sinus should be achieved as soon as possible to remove the cause of the SEDH.

Conclusion

SEDH may occur as a rare and life-threatening complication of craniofacial infections; therefore, prompt recognition and treatment are mandatory.

Combined associations of vitamin D and cognitive function with all-cause mortality among older adults in Chinese longevity areas: A prospective cohort study

Objectives

While both vitamin D deficiency and cognitive impairment have individually been linked to a greater risk of all-cause mortality, the combined effects of these two different conditions have not previously been explored in this context. We aimed to investigate the combined impact of vitamin D concentration and cognitive impairment on all-cause mortality in older adults.

Methods

The analyzed data were collected from community-dwelling adults ≥65 years of age that were enrolled in the Chinese Longitudinal Healthy Longevity Survey (n = 1,673). The Mini-Mental Status Examination (MMSE) was used to assess cognitive function, while the plasma 25-hydroxyvitamin D [25(OH)D] test was used to assess vitamin D status. The associations between vitamin D concentration, cognitive function, and all-cause mortality were assessed with Cox proportional hazards models. We used restricted cubic splines to examine the dose-response relationship between vitamin D and the risk of all-cause mortality and used joint effect testing to explore interactions between vitamin D concentration and cognitive function.

Results

During a mean (SD) follow-up of 3.8 (1.9) years, 899 (53.7%) deaths occurred. A negative dose-response relationship was observed between 25(OH)D concentration and cognition impairment at baseline, as well as the odds of all-cause mortality during follow-up. Similarly, cognitive impairment was significantly related to all-cause mortality risk (HR 1.81, 95% CI: 1.54 to 2.12). The combined analyses showed positive associations, with the highest mortality risk observed in older adults with both low vitamin D and cognitive impairment (HR 3.04, 95% CI: 2.40 to 3.86). Moreover, the interaction between 25(OH)D concentration and cognitive function was found to be significant in relation to the risk of mortality (p for interaction <0.001).

Conclusion

Lower plasma 25(OH)D and cognitive impairment were, respectively, associated with increased all-cause mortality risks. The 25(OH)D concentration and cognitive impairment exhibited a combined additive effect on all-cause mortality among older Chinese adults.

Epigenetic reprogramming in pancreatic premalignancy and clinical implications

Pancreatic cancer (PC) is the most lethal human cancer, with less than 10% 5-year survival. Pancreatic premalignancy is a genetic and epigenomic disease and is linked to PC initiation. Pancreatic premalignant lesions include pancreatic intraepithelial neoplasia (PanIN), intraductal papillary mucinous neoplasm (IPMN), and mucinous cystic neoplasm (MCN), with pancreatic acinar-to-ductal metaplasia (ADM) as the major source of pancreatic premalignant lesions. Emerging evidence reveals that an epigenetic dysregulation is an early event in pancreatic tumorigenesis. The molecular mechanisms of epigenetic inheritance include chromatin remodeling; modifications in histone, DNA, and RNA; non-coding RNA expression; and alternative splicing of RNA. Changes in those epigenetic modifications contribute to the most notable alterations in chromatin structure and promoter accessibility, thus leading to the silence of tumor suppressor genes and/or activation of oncogenes. The expression profiles of various epigenetic molecules provide a promising opportunity for biomarker development for early diagnosis of PC and novel targeted treatment strategies. However, how the alterations in epigenetic regulatory machinery regulate epigenetic reprogramming in pancreatic premalignant lesions and the different stages of their initiation needs further investigation. This review will summarize the current knowledge of epigenetic reprogramming in pancreatic premalignant initiation and progression, and its clinical applications as detection and diagnostic biomarkers and therapeutic targets in PC.

Effects of hepatitis B virus infection and strategies for preventing mother-to-child transmission on maternal and fetal T-cell immunity

One of the most common routes of chronic hepatitis B virus (HBV) infection is mother-to-child transmission (MTCT). Approximately 6.4 million children under the age of five have chronic HBV infections worldwide. HBV DNA high level, HBeAg positivity, placental barrier failure, and immaturity of the fetal immune are the possible causes of chronic HBV infection. The passive-active immune program for children, which consists of the hepatitis B vaccine and hepatitis B immunoglobulin, and antiviral therapy for pregnant women who have a high HBV DNA load (greater than 2 × 10⁵ IU/ml), are currently two of the most important ways to prevent the transmission of HBV from mother to child. Unfortunately, some infants still have chronic HBV infections. Some studies have also found that some supplementation during pregnancy can increase cytokine levels and then affect the level of HBsAb in infants. For example, IL-4 can mediate the beneficial effect on infants' HBsAb levels when maternal folic acid supplementation. In addition, new research has indicated that HBV infection in the mother may also be linked to unfavorable outcomes such as gestational diabetes mellitus, intrahepatic cholestasis of pregnancy, and premature rupture of membranes. The changes in the immune environment during pregnancy and the hepatotropic nature of HBV may be the main reasons for the adverse maternal outcomes. It is interesting to note that after delivery, the women who had a chronic HBV infection may spontaneously achieve HBeAg seroconversion and HBsAg seroclearance. The maternal and fetal T-cell immunity in HBV infection is important because adaptive immune responses, especially virus-specific CD8 T-cell responses, are largely responsible for viral clearance and disease pathogenesis during HBV infection. Meanwhile, HBV humoral and T-cell responses are important for the durability of protection after fetal vaccination. This article reviews the literature on immunological characteristics of chronic HBV-infected patients during pregnancy and postpartum, blocking mother-to-child transmissions and related immune mechanisms, hoping to provide new insights for the prevention of HBV MTCT and antiviral intervention during pregnancy and postpartum.