Long non-coding RNA MALAT1 promotes angiogenesis and immunosuppressive properties of HCC cells by sponging miR-140

Hepatocellular carcinoma (HCC) is the most prevalent primary liver cancer in adults. Previous studies in our laboratory found that long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) was upregulated in HCC cells, which could affect the metastasis and invasion of HCC. However, the underlying mechanism remains unknown. Herein, we studied the interaction between MALAT1 and miR-140 on the regulation of angiogenesis and immunosuppressive properties. We revealed that the expression of MALAT1 and VEGF-A was significantly increased in HCC cells. Knockdown of MALAT1 in HCC cells suppressed the production of VEGF-A, impaired the angiogenesis of HUVECs, and facilitated the polarization of macrophage toward the M1 subset. Mechanistically, the interaction between MALAT1 and miR-140 or between miR-140 and VEGF-A was confirmed by multiple assays. Besides, a negative correlation between MALAT1 and miR-140 was found in HCC tissues. Furthermore, miR-140 inhibition significantly increased VEGF-A expression, promoted angiogenesis of HUVECs, and redirected the polarization of macrophages toward the M2 subset. In addition, in vivo studies also verified the regulatory network of the MALAT1/miR-140 axis on VEGF-A in HCC progression. In summary, this study revealed the mechanism that MALAT1 worked as a putative HCC promotor via inhibiting miR-140. Therefore, targeting MALAT1 or miR-140 might alleviate the progression of HCC in 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.

Early hepatitis B viral DNA clearance predicts treatment response at week 96

AIM

To investigate whether hepatitis viral DNA load at 24 wk of treatment predicts response at 96 wk in patients with chronic hepatitis B.

METHODS

A total of 172 hepatitis B envelope antigen (HBeAg)-positive chronic hepatitis B patients who received initial treatment at 16 tertiary hospitals in Hunan Province, China were enrolled in this study. All patients received conventional doses of lamivudine and adefovir dipivoxil, telbivudine, entecavir dispersible tablets, or entecavir tablets for 96 wk. Patients who used other antiviral drugs or antitumor and immune regulation therapy were excluded. Patients were stratified into three groups according to their viral DNA load at 24 wk: < 10 IU/mL (group 1), 10-10³ IU/mL (group 2), and > 10³ IU/mL (group 3). Correlations of 24-wk DNA load with HBeAg negative status and HBeAg seroconversion at 96 wk were analyzed. Receiver operating characteristic curve analysis was used to test the predictive value of the HBV DNA load at 24 wk for long-term response.

RESULTS

The rates of conversion to HBeAg negative status and HBeAg seroconversion rates were 53.7% and 51.9%, respectively, in group 1; 35.21% and 32.39% in group 2; and 6.38% and 6.38% in group 3. The receiver operating characteristic curves for the three subgroups revealed that the lowest DNA load (< 10 IU/mL) was better correlated with response at 96 wk than a higher DNA load (10-10³ IU/mL). Nested PCR was used for amplifying and sequencing viral DNA in patients with a viral DNA load > 200 IU/mL at 96 wk; resistance mutations involving different loci were present in 26 patients, and three of these patients had a viral DNA load 10-10³ IU/mL at 96 wk.

CONCLUSION

Hepatitis B viral DNA load at 24 wk of antiviral treatment in patients with chronic hepatitis B is a predictor of the viral load and response rate at 96 wk.

Novel HBV mutations and their value in predicting efficacy of conventional interferon

BACKGROUND

Accumulating studies assessing the impacts of hot spot mutations on conventional interferon (IFN) efficacy come to discrepant conclusions; studies regarding the mutations in S and RT regions are also unclear. The present study aimed to evaluate the impacts of HBV mutations on the efficacy of conventional IFN.

METHODS

A total of 126 patients who received conventional IFN treatment for 48 weeks were enrolled. Biochemical and serological parameters were routinely tested. The sequences of HBV from 78 serum samples were amplified by nested-PCR; mutations were identified with sequence scanner V1.0 after ABI 3730xl direct sequencing, HBV genotypes were determined according to RT gene sequences utilizing NCBI Genotyping Tool which was based on phylogenetic analysis.

RESULTS

The baseline DNA levels of virological response (VR) group were significantly lower than those of no VR group [7.13+/-0.76 vs 7.69+/-0.56 lg (copies/mL), P=0.001]. The baseline ALT levels were significantly higher in the HBeAg clearance group (204.72+/-88.65 vs 162.80+/-85.81 IU/L, P<0.05) and HBeAg seroconversion group (204.89+/-95.68 vs 166.75+/-84.43 IU/L, P<0.05). Females and lower BMI levels (20.01+/-2.33 vs 21.65+/-3.66 kg/m2, P<0.05) were prone to acquired biochemical response (BR). PC-W28STOP (ntG1896A) was significantly higher in the combined response (CR) group than that in the no CR group (91.7% vs 39.7%, P=0.001). Multivariate logistic regression analysis showed that baseline DNA, PC-P159T (ntC2288A), BCP-N118T (ntA1726C) and BCP-L134L (ntA1775C/G/T) influenced VR independently. PC-G182C (ntG2357T), PC-S64A/T (ntT2003G/A) and BMI were independent influence factors for HBeAg clearance, HBeAg seroconversion and BR, respectively. The new predicting model concluded that baseline DNA and new mutations for VR were established successfully, and ROC analysis showed that AUC was 0.842 (P<0.001) with a sensitivity of 0.652 and a specificity of 0.933.

CONCLUSIONS

PC-P159T (ntC2288A), BCP-N118T (ntA1726C), BCP-L134L (ntA1775C/G/T), PC-G182C (ntG2357T) and PC-S64A/T (ntT2003G/A) were novel identified mutations that impacted IFN therapeutic efficacy. These novel mutations could serve as important predictors before conventional IFN treatment.

Phase IIb trial of in vivo electroporation mediated dual-plasmid hepatitis B virus DNA vaccine in chronic hepatitis B patients under lamivudine therapy

AIM

To assess the efficacy and safety of in vivo electroporation (EP)-mediated dual-plasmid hepatitis B virus (HBV) DNA vaccine vs placebo for sequential combination therapy with lamivudine (LAM) in patients with chronic hepatitis B.

METHODS

Two hundred and twenty-five patients were randomized to receive either LAM + vaccine (vaccine group, n = 109) or LAM + placebo (control group, n = 116). LAM treatment lasted 72 wk. Patients received the DNA vaccine or placebo by intramuscular injection mediated by EP at weeks 12 (start of treatment with vaccine or placebo, SOT), 16, 24, and 36 (end of treatment with vaccine or placebo, EOT).

RESULTS

In the modified intent-to-treat population, more patients had a decrease in HBV DNA > 2 log₁₀ IU/mL in the vaccine group at week 12 after EOT compared with the control group. A trend toward a difference in the number of patients with undetectable HBV DNA at week 28 after EOT was obtained. Adverse events were similar. In the dynamic per-protocol set, which excluded adefovir (ADV) add-on cases at each time point instantly after ADV administration due to LAM antiviral failure, more patients had a decrease in HBV DNA > 2 log₁₀ IU/mL in the vaccine group at week 12 and 28 after EOT compared with the control group. More patients with undetectable HBV DNA at week 28 after EOT in the vaccine group were also observed. Among patients with a viral load < 1000 copies/mL at week 12, more patients achieved HBeAg seroconversion in the vaccine group than among controls at week 36 after EOT, as well as less virological breakthrough and YMDD mutations.

CONCLUSION

The primary endpoint was not achieved using the HBV DNA vaccine. The HBV DNA vaccine could only be beneficial in subjects that have achieved initial virological response under LAM chemotherapy.

A novel prognostic score for acute-on-chronic hepatitis B liver failure

Patients with acute-on-chronic hepatitis B liver failure (HBV-ACLF) show high morbidity and mortality. Independent prognostic predictors of short-term HBV-ACLF mortality include the Child-Turcotte-Pugh (CTP) score, the model for end-stage liver disease (MELD) score, other MELD-based indices and the dynamic changes in these indices. The aims of this study were to evaluate the existing prognostic scores in a large cohort of HBV-ACLF patients and create a new predictive model. We retrospectively reviewed 392 HBV-ACLF patients from December 2008 to November 2011 and evaluated their 3-month survival. The predictive accuracy of CTP, MELD and MELD-based indices and the dynamic changes in the MELD-related scores (Δ scoring systems) upon admission and after two weeks of treatment were compared using the area under the receiver operating characteristic (ROC) curve method. Life-threatening factors and a series of bio-clinical parameters were studied by univariate and multivariate analyses. Among the existing scores, MELD had the best predictive ability. However, our new regression model provided an area under the curve of 0.930 ± 0.0161 (95% CI: 0.869 to 0.943), which was significantly larger than that obtained with the MELD score at admission and after two weeks of treatment as well as with the dynamic changes of the MELD score (0.819, 0.921, and 0.826, respectively) (Z=3.542, P=0.0004). In a large cohort of patients retrospectively reviewed for this study, our prognostic model was superior to the MELD score and is, therefore, a promising predictor of short-term survival in patients with HBV-ACLF.

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.

Synthesis and characterization of a new mid-infrared transparent compound: acentric Ba5In4Te4S7

A new infrared nonlinear optical crystal with mixed anions: S–Te.

Randomized controlled study of plasma exchange combined with molecular adsorbent re-circulating system for the treatment of liver failure complicated with hepatic encephalopathy

BACKGROUND/AIMS

To evaluate the use of plasma exchange (PE) combined with the molecular adsorbent re-circulating system (MARS) for the treatment of liver failure complicated with hepatic encephalopathy.

METHODOLOGY

A prospective randomized controlled study was conducted to compare the therapeutic effect of MARS treatment (MARS group, n=60) with that of PE combined with MARS treatment (PE+MARS group, n=60) in patients with liver failure complicated with hepatic encephalopathy.

RESULTS

The serum total bilirubin and blood ammonia levels were significantly decreased compared with pretreatment levels after 3 days of both the MARS treatment (p=0.0001, p<0.001) and PE+MARS treatment (both p<0.0001) and the Glasgow coma scale score was significantly increased (both p<0.0001). The 30-day mortality rate was 10.0% (6/60) in the MARS group and 11.7% (7/60) in the PE + MARS group. The per capita cost of treatment was significantly lower in the PE + MARS group than in the MARS group (p=0.0003).

CONCLUSIONS

Both MARS and PE + MARS therapy can safely and effectively be used to treat liver failure complicated with hepatic encephalopathy, but PE + MARS therapy reduces serum total bilirubin level more effectively and is more cost-effective.

HFRS with Severe Heart Liver and Renal Failure: a Case Report

Hemorrhagic fever with renal syndrome (HFRS) is caused by hantavirus infection, which was characterized by abrupt high fever, systemic hemorrhage, hypotension and renal damage. Although multiple system organ damage was not uncommon, but multiple organ system failure were rare. Hereafter we report one case with simultaneous renal, heart and liver failure. In this case, we received some experience and lessons.

Shorter durations and lower doses of peginterferon alfa-2a are associated with inferior hepatitis B e antigen seroconversion rates in hepatitis B virus genotypes B or C

As there is currently a lack of consensus on the most appropriate dose and duration of peginterferon alfa-2a (PEG-IFNα-2a) therapy in hepatitis B e antigen (HBeAg)-positive patients, the efficacy and safety of either 24 or 48 weeks' duration and 90 μg/week or 180 μg/week doses were compared. HBeAg-positive patients (n = 544; 34% genotype B, 51% genotype C) were randomized to receive PEG-IFNα-2a (2 × 2 factorial design) for 24 or 48 weeks and at 90 μg/week or 180 μg/week and included in the per-protocol population. The primary efficacy endpoint of the noninferiority study was HBeAg seroconversion 6 months posttreatment. The prespecified odds ratio (OR) noninferiority margin was 1.88 with a one-sided significance level of 0.025. The highest rates of HBeAg seroconversion 6 months posttreatment were in the 180/48 arm (36.2% versus 14.1%-25.8% in the other arms). When the dose and duration arms were pooled, the OR for noninferiority of 24 weeks versus 48 weeks was 2.17 (95% confidence interval [CI] 1.43, 3.31; P = 0.749) and for 90 μg versus 180 μg was 1.79 (95% CI 1.18, 2.72; P = 0.410). As the upper limit of the 95% CI of the ORs were >1.88, 24 weeks were inferior to 48 weeks and 90 μg/week was inferior to 180 μg/week. The highest rates of response in the 180/48 arm were achieved by patients with HBsAg <1,500 IU/mL at Week 12 (58%) or Week 24 (57%), whereas patients with HBsAg >20,000 IU/mL did not respond. Adverse events were typical of those associated with PEG-IFNα-2a.

CONCLUSION

Compared with lower doses and shorter durations, the licensed PEG-IFNα-2a treatment regimen (180 μg/48 weeks) was the most efficacious and beneficial for HBeAg-positive patients predominantly infected with hepatitis B virus genotypes B or C.

HBx gene deletion mutant (HBx-d382) enhances the proliferation and anchorage-independent growth of L02 cells

AIM: To establish a L02 cell line stably expressing HBx gene deletion mutant (HBx-d382) and to examine their proliferation changes.

METHODS: A recombinant plasmid encoding the HBx deletion mutant (pcDNA3.0/HBx-d382) was verified by PCR amplification, double restriction digestion and DNA sequencing, and then introduced into L02 cells by liposome-mediated transfection. Positive clones were selected in the present of G418. The genome integration of the HBx gene deletion mutant was confirmed by PCR amplification, and the expression of the deletion mutant was detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot. Cell proliferation changes were measured by methyl thiazol tetrazolium (MTT) assay and soft agar colony formation assay. The cell cycle distribution was tested by flow cytometry.

RESULTS: The recombinant plasmid pcDNA3.0/HBx-d382 was verified to contain HBx-d382 by PCR amplification, double digestion and DNA sequencing. Positive clones selected with G418 harbored chromosomally integrated HBx-d382 and could express HBx-d382. This cell line showed enhanced proliferation and anchorage-independent growth as revealed by MTT assay and soft agar colony formation assay. The percentage of cells in S and G₂ phases increased in transfected cell line.

CONCLUSION: L02 cell line stably expressing the HBx deletion mutant is established successfully. The proliferation ability of this cell line increases probably due to altered cell cycle.

Perceptual color image coding with JPEG2000

A perceptual color image coder (PCIC) is presented for the YC(b)C(r) color space within the framework of JPEG2000. This coder employs a vision model based perceptual distortion metric (PDM) to approximate perceived error for rate-distortion (R-D) optimization in order to maximize the visual quality of coded images. The vision model employed in the PCIC is structurally based on an existing monochromatic multichannel vision model, which is extended for color image coding. Subjective tests with 30 viewers show that the PCIC provides superior picture quality at low to intermediate bitrates in comparison with a JPEG2000 compliant coder employing the mean squared error (MSE) and the visual distortion metric (Cvis) as distortion measures, respectively.

Combined use of siRNAs specific for TGF-β1, TGF-β1 RI and TGF-β1 RII synergistically inhibits the TGF-β/Smad signaling pathway in rats with acute liver injury

AIM: To investigate the inhibitory effect of combined use of small interfering RNAs (siRNAs) specific for transforming growth factor beta 1 (TGF-β1) and transforming growth factor beta 1 receptors (TGF-β1 RI and TGF-β1 RII) on the TGF-β/Smad signaling pathway in rats with acute liver injury.

METHODS: Thirty rats were given two intraperitoneal injections of carbon tetrachloride (CCl4; 6 mL/kg) to induce acute liver injury and initiate the TGF-β/Smad signaling pathway. The rats were then divided into five groups: TGF-β1 siRNA intervention group (T), TGF-β1 siRNA plus TGF-β1 RI siRNA intervention group (T+R1), TGF-β1 siRNA plus TGF-β1 RII siRNA intervention group (T+R2), TGF-β1 siRNA plus TGF-β1 RI siRNA plus TGF-β1 RII siRNA intervention group (T+R1+R2) and model control group (M). Serum samples were taken to determine serum ALT, AST and HA. The pathological changes in the liver were evaluated by HE staining. Quantitative detection of α-SMA, collagen I and III, TGF-β1, Smad3, PCNA and TGF-α mRNAs was performed by RT-PCR. The expression of α-SMA, collagen I and III, TGF-β1, Smad3, PCNA and TGF-α in the liver was detected by immunohistochemistry.

RESULTS: After acute liver injury rats were transfected with plasmids harboring specific siRNA, serum ALT, AST and HA levels compared with that of model control group decreased significantly (ALT: 592.80 ± 98.4 IU/L, 440.80 ± 91.9 IU/L, 461.61 ± 120.0 IU/L, 284.00± 49.0 IU/L vs 949.5 ± 196.1 IU/L; AST: 686.80 ± 112.3 IU/L, 591.00 ± 99.87 IU/L, 607.50 ± 84.8 IU/L, 398.30 ± 61.9 IU/L vs 985.67 ± 274.8 IU/L and HA: 5682.80 ± 824.14 µg/L, 2871.26 ± 394.68 µg/L, 3004.29 ± 354.25 µg/L, 1982.12 ± 402.71 µg/L vs 8444.65 ± 812.15 µg/L, respectively; all P < 0.05). The best effect was achieved in the T+R1+R2 group. Compared with nonspecific siRNA transfection, siRNAs specific for TGF-β1, TGF-β1 RI and TGF-β1 RII could significantly inhibit the expression of TGF-β1, Smad3, α-SMA, collagen I and collagen III mRNAs in the liver (all P < 0.05). The best effect was achieved in the T+R1+R2 group. Similar results were observed for protein expression.

CONCLUSION: Combined use of siRNAs specific for TGF-β1, TGF-β1 RI and TGF-β1 RII can synergistically inhibit the TGF-β/Smad signaling pathway and reduce liver injury in rats with acute liver injury.

[Study on tumor formation of hepatocyte transformed by hepatitis B virus X gene in nude mice.]

OBJECTIVES

To investigate whether hepatitis B virus X gene alone is sufficient to transform the non-transformed immortalized human liver cell line QSG7701 and induce hepatocellular carcinoma in vivo.

METHODS

pCMVX/QSG7701 cells were transplanted into subcutaneous tissue of nude mice. pRcCMV2/QSG7701 and QSG7701 cells were used as control. Tumor formation was checked within 5 weeks after transplantation. The activity and food intake of the nude mice were recorded. The texture, volume and metastasis of transplantation tumor were observed grossly, and the HE stained transplantation tumor tissues were observed under optical microscope.

RESULTS

The transplantation tumor occurred in all of the six nude mice inoculated with pCMVX/QSG7701 cells at the second week after inoculation. No metastatic tumor was found in other organs. Transplant tumor was not formed in all of the negative control groups. The activity, eating and drinking of the nude mice transplanted with pCMVX/QSG7701 cells were normal, while their weights were increased gradually in the first 3 weeks. Since the 4th week after transplantation with pCMVX/QSG7701 cells, the activity of the mice was decreased and their body weight was no longer increased. It is interesting that the mental state and eating of those nude mice inoculated with pRcCMV2/QSG7701and QSG7701 cells were normal, and the weight was increasing all the time after inoculation. HE staining analysis confirmed that the transplanted tumor was hepatocellular carcinoma.

CONCLUSION

HBx alone is sufficient to transform the non-transformed immortalized human liver cell line QSG7701 and induce hepatocellular carcinoma in vivo.

Hepatitis B virus X protein promotes proliferation and upregulates TGF-beta1 and CTGF in human hepatic stellate cell line, LX-2

BACKGROUND

Chronic hepatitis B virus (HBV) infection is a major cause of liver fibrosis, but the mechanisms underlying HBV-related fibrogenesis are still unknown. Although the roles of HBV X protein (HBx) remain poorly understood, it is thought to play an important role in the regulation of cellular growth and hepatocarcinogenesis. The aim of this study was to determine the role of HBx in liver fibrogenesis by studying the effect of HBx on the proliferation and expression of fibrosis-related molecules in the human hepatic stellate cell line, LX-2.

METHODS

We established an in vitro co-culture system with LX-2 cells and a stable QSG7701-HBx cell line which had been transfected with the HBx gene. 3H-TdR incorporation and flow cytometry were used to determine the effects of HBx on the proliferation of LX-2 cells. Alpha-smooth muscle actin (alpha-SMA), transforming growth factor-beta1 (TGF-beta1), transforming growth factor-beta receptor II (TGF-betaRII), and connective tissue growth factor (CTGF) in LX-2 cells were analyzed by Western blotting. In addition, the expression levels of collagen type I (ColI) from the co-cultured media were measured by ELISA.

RESULTS

3H-TdR incorporation increased significantly in LX-2 cells co-cultured with QSG7701-HBx cells compared to those cultured with QSG7701-pcDNA3 and QSG7701 (non-tumorigenic human liver cell line). Cell cycle results revealed that HBx accelerated the progression of G1 to S in LX-2 cells. The expressions of alpha-SMA, TGF-beta1, TGF-betaRII, CTGF and ColI were significantly increased in the co-cultures of LX-2 cells with stable QSG7701-HBx cells.

CONCLUSION

These results suggest that HBx may facilitate liver fibrosis by promoting hepatic stellate cell proliferation and upregulating the expression of fibrosis-related molecules.

Mycophenolate mofetil prevents lethal acute liver failure in mice induced by bacille Calmette-Guérin and lipopolysaccharide

BACKGROUND/AIMS

To investigate the effect of mycophenolate mofetil (MMF) on acute liver injury induced by bacille Calmette-Guérin (BCG) and lipopolysaccharide (LPS).

METHODS

Acute liver failure was induced in male Kunming strain mice by injecting the animals with BCG 2.5 mg per mouse, and LPS 10 microg per mouse 10 days later. The mice in the treatment groups were given MMF 2 h before, simultaneous with, or 2 h after administration of LPS, and the mice in the control group were given the same dose of saline. The 24-h survival rate, serum alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were compared. Serum levels of tumor necrosis factor alpha (TNF-alpha), interferon gamma (IFN-gamma), and interleukin 6 (IL-6) were measured and the expressions of TNF-alpha, IFN-gamma, and IL-6 mRNA in the liver tissue were determined by reverse transcription-polymerase chain reaction (RT-PCR). Concanavalin A (Con A)-induced splenocyte proliferation were determined by methods of methyl thiazolyl tetrazolium.

RESULTS

Injecting a small dose of LPS into BCG-primed mice caused a lethal hepatic injury mimicking acute hepatitis, from which 16 of the 20 mice died within 24 h (20% survival rate). Massive necrosis of parenchymal hepatocytes with marked inflammatory cell infiltration was observed by histological examination. In parallel, serum ALT and TNF-alpha, IFN-gamma, and IL-6 levels were increased. Expression of TNF-alpha, IFN-gamma, and IL-6 mRNA in the liver were significantly increased also. Treatment with MMF markedly reduced the death rate in a dose-dependent manner. It reached its maximal effect at the dosage of 150 mg per kg of body weight when pretreated 2 h before LPS injection, with improvement of histological feather and survival rate (84.2%, 16/19). MMF significantly inhibited serum levels of TNF-alpha, IFN-gamma, and IL-6, and significantly reduced TNF-alpha, IFN-gamma, and IL-6 expression in the liver, which increased after BCG and LPS injection. Moreover, splenocyte proliferation response induced by Con A was also inhibited by MMF treatment.

CONCLUSIONS

Treatment with MMF has a protective effect on endotoxin-induced fatal liver failure by regulating the production of inflammatory cytokines and T-cell proliferation.

Cloning, prokaryotic expression and activity identification of human soluble tumor necrosis factor receptor 1 gene in Escherichia Coli JM109

AIM: To construct a prokaryotic expression plasmid of human soluble tumor necrosis factor receptor 1 (sTNFR1) gene, induce the expression of sTNFR1-maltose binding protein (MBP) fusion protein and investigate the bioactivity of expression products.

METHODS: The total RNA was extracted from HeLa cells and used as a template to amplify human sTNFR1 gene by reverse transcription-polymerase chain reaction (RT-PCR). The PCR products were cloned into T vector and sub-cloned into plasmid pMAL-c2x, a prokaryotic expression plasmid. The recombinant plasmid was transferred into Escherichia Coli JM109 and induced by isopropyl-β-D-thiogalactopyranoside (IPTG) to express fusion protein sTNFR1-MBP. sTNFR1-MBP was purified by amylose resin affinity chromatography and identified by sequencing and Western blot analysis. The bioactivity of sTNFR1-MBP was estimated by MTT assay.

RESULTS: A 558-bp fragment of human sTNFR1 gene had been amplified by RT-PCR and successfully cloned into vector pMAL-c2x as recombinant vector pMAL-c2x-sTNFR1, which was confirmed by DNA sequencing. sTNFR1-MBP was produced in Escherichia Coli with pMAL-c2x-sTNFR1 after IPTG inducement, and SDS-PAGE showed an extra protein band which was 66 kDa in size. The bioactivity of sTNFR1 was identified by Western blot. MTT assay revealed that sTNFR1 effectively blocked the TNF-α-mediated cytotoxicity on QSG7701 cells. The cytotoxicity was strengthened with the increase of sTNFR1 recombinant protein concentration (0.2, 2, 20, 40, 80 mg/L), and the rates of cell death were 69.98% ± 1.52%, 60.05% ± 2.18%, 46.27% ± 2.48%, 37.02% ± 3.17%, 1.83% ± 0.59% and 1.71% ± 0.61%.

CONCLUSION: The fusion protein sTNFR1-MBP with high bioactivity is obtained successfully, which lays a foundation for further study.

Incidence of bacterial meningitis in Asia using enhanced CSF testing: polymerase chain reaction, latex agglutination and culture

To enhance the detection of bacterial meningitis in an East Asian surveillance study, we employed cerebrospinal fluid (CSF) bacterial culture, latex agglutination (LA) and polymerase chain reaction-enzyme immunoassay (PCR-EIA) testing for Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (Sp). The sensitivity and specificity of CSF PCR-EIA testing was compared to LA and culture. A meningitis case was defined by one positive result for any of the three tests. The sensitivity of H. influenzae CSF PCR-EIA, LA, and culture was 100%, 40% and 57.5% respectively; and for Sp CSF PCR-EIA, LA and culture, the sensitivity was 100%, 58.3% and 66.7%, respectively. Hib and Sp specificity was 100% by each method. CSF PCR-EIA was more sensitive than culture or LA for the detection of Hib and Sp meningitis cases increasing their incidence by 74% and 50% compared to culture respectively. CSF PCR-EIA should be included for the detection of bacterial meningitis in surveillance studies.

Comparison of effect on hepatocellular apoptosis between core proteins of hepatitis B virus genotype B and C

AIM: To compare the proapoptosis effect of hepatitis B virus (HBV) genotype B and C core proteins on liver cells, and explore the pathogenesis of HBV infection with different genotypes.

METHODS: Four serum samples infected by HBV (2 for type B and C, respectively) were used to amplify HBV core fragment using polymerase chain reaction (PCR). After recombination, cloning, and subcloning, four eucaryotic plasmids with different genotypes and clinical phenotypes were obtained. Then the plasmids were transfected into hepatocellular carcinoma cell line HepG2, and MTT assay and flow cytometry were used to detect the proliferation and apoptosis of HepG2 cells.

RESULTS: All the four recombinant eucaryotic plasmids were constructed successfully, and HBV core protein expression was confirmed by internal reference for transfection. The proliferation of HepG2 cells was not significantly different between the four plasmids, but the apoptosis rate in C-type (C₂) group was markedly higher than that in B-type (B₁) group (8.8% ± 2.0%vs 6.4% ± 0.8%, P < 0.05).

CONCLUSION: C-type HBV can induce more severe cell apoptosis than B-genotype HBV.

[Effect of diazepam and modafinil on acute hepatic failure in mice]

OBJECTIVE

To investigate the effect of diazepam and modafinil on acute hepatic failure in mice.

METHODS

Acute liver failure was induced in male Kunming strain mice by enterocoelia injecting the mice with D-GalN and LPS . The mice in the treatment groups were given corresponding drug 2 h before the administration of D-GalN and LPS, and the mice in the control group were given the same dose of distilled water. The 24-hour survival rate, serum alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were compared. Serum levels of TNF-alpha and IL-1 and the levels of SOD, MDA, GR, GSH, NO and NOS in the liver were determined.

RESULTS

Treatment with diazepam increased the survival rate and improved liver histological feature. Diazepam inhibited the serum levels of ALT, AST, TNF-alpha and IL-1, and reduced levels of MDA, NO and NOS and increased levels of GR and SOD in the liver. Modafinil decreased liver histological feature, increased the serum levels of ALT, AST, TNF-alpha and IL-1, increased level of MDA, and inhabited levels of SOD and GR in the liver.

CONCLUSION

Treatment with diazepam may suppress the D-GalN/LPS-induced acute hepatic failure and modafinil may facilitate the acute hepatic failure.

Predictive value of HBV cccDNA in PBMC of response to lamivudine therapy in patients with chronic hepatitis B

AIM: To assess the value of hepatitis B virus (HBV) covalently closed circle DNA (cccDNA) in peripheral blood mononuclear cells (PBMC) for the prediction of the sustained response to lamivudine therapy in patients with chronic hepatitis B.

METHODS: Seventeen chronic hepatitis B patients with complete or partial response (serum HBV DNA turned negative, and ALT was normalized with or without HBeAg/anti-HBe seroconversion) were selected. HBV cccDNA in PBMC was detected at the end of lamivudine treatment, and 1 year after treatment.

RESULTS: Nine out of 17 patients were positive for HBV cccDNA in their PBMC at the end of lamivudine treatment. Virological relapse were found during 1-year follow-up in all of these 9 patients; whereas only 1 relapse was observed among the 8 patients without HBV cccDNA.

CONCLUSION: HBV cccDNA in PBMC at the end of treatment is of good predictive value for the sustained response to lamivudine treatment in chronic hepatitis B patients.

[Study on the influencing factors of thrombocytopenia in viral hepatitis]

OBJECTIVE

To explore the pathogenesis of thrombocytopenia in viral hepatitis.

METHODS

84 viral hepatitis patients and 20 healthy controls were divided into three groups: Group A: 48 viral hepatitis patients with thrombocytopenia; Group B: 36 viral hepatitis patients with normal platelet count; and Group C: 20 healthy controls. Serum thrombopoietin (TPO) levels were measured in all subjects by enzyme linked immunosorbent assay. The levels of PAIg, PAIgG, PAIgA, PAIgM were detected in all subjects by flow cytometry. Spleen size was assessed in all subjects by abdominal color ultrasound B Scan. Bone marrow cells were examined in 74 subjects with bone marrow punctures.

RESULTS

Serum thrombopoietin level was lower in group A than in group C and in group B. Serum TPO levels were correlated with platelet counts in the patients with advanced liver diseases. PAIg, PAIgG levels were significantly higher in group A than in group B and in group C. An inverse correlation was found between platelet counts and PAIg levels. An inverse correlation was also observed between platelet counts and PAIgG levels. The incidence of splenomegaly was significantly higher in group A (77.1%) than in group B (47.2%), while group C had no splenomegaly. An inverse correlation between spleen size and platelet count was observed (r = -0.581). There were 4 patients in group A with hypoplasia of bone marrow karyocytes, but there were no such cases in groups B and C.

CONCLUSIONS

TPO level decreasing in patients with severe liver function impairments correlates with thrombocytopenia in advanced liver diseases. Autoimmune mechanism mediated by PAIg may play an important role in thrombocytopenia associated with viral hepatitis. Splenomegaly is the influencing factor leading to thrombocytopenia in viral hepatitis. Patients with chronic liver diseases had bone marrow depression, which may be a factor inducing thrombocytopenia in patients with viral hepatitis.

[Establishment and the significance of a cell model of secreted alkaline phosphatase co-controlled by HCV 5'NCR and NS3 serine protease]

OBJECTIVE

To establish a cell model of secreted alkaline phosphatase (SEAP) co-controlled by HCV 5'NCR and NS3 serine protease in an effort to develop new antiviral agents.

METHODS

The fragments of HCV 5'NCR and NS3/4A-SEAP were amplified by PCR. They were fused into pBluescript SK+ to generate 5'NCR-NS3/4A-SEAP chimeric plasmid. The resulting chimeric gene was subcloned into HindIII/Bsu36 I site of pSEAP2-Control (a SEAP eukaryotic expression plasmid), to generate pNCR-NS3/4A-SEAP, in which the SEAP was fused in-frame to the downstream of NS4A/4B cleavage site. The SEAP activity in the culture media of transiently transfected cells was monitored quantitatively. The regulatory effect of HCV 5'NCR and NS3 serine protease on SEAP expression was measured by treatment of transfected cells with antisense oligodeoxynucleotide (ASODN) against HCV 5'NCR and TPCK, a irreversible serine protease inhibitor.

RESULTS

The SEAP activity in the culture media reached 80801+/-4794 RLU, and was significantly inhibited by 5 micromol/L, 10 micromol/L of ASODN (t=4.315, p<0.01; t=6.985, p<0.001) and 100 micromol/L of TPCK (t=6.949, P<0.001).

CONCLUSION

A cell model of SEAP co-controlled by HCV 5'NCR and NS3 serine protease has been successfully established. This might promote the screening of anti-viral drugs

Relationship between HBV infection and autoantibodies

AIM: To investigate the relationship between infection of hepatitis B virus (HBV) and development of autoantibodies.

METHODS: HBV-DNA and HBVM were tested in 160 serum samples by polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) respectively. Antinuclear antibodies (ANA) , an-double strain DNA antibodies.Ads-DNA anfibody, thyroglobulin antibody and thyroid microsome antibody (TGA/TMA) , rheumatoid factor (RF) were measured by using indirect immunofluorescent assay, radioimmunoassay, and immune emulsion agglutination respectively.

RESULTS: The positive rates of autoantibodies were significantly higher in patients with HBV infection compared to those in normal control (63.1% vs 20.8% x=15.28, P < 0.01). The antibodies such as ANA and RF appeared frequently. There was no remarkable differerence in the age and sex between autoantibodies positive and autoantibodies negative patients (P > 0.05). Compared to HBV infected patients without autoantibodies, ALT and TBIL and the positive rates of HBV-DNA and the time of HBV infection significantly increased in patients with autoantibodies (P < 0.05).

CONCLUSION: HBV infection can induce autoimmune reactions, resulting in production of autoantibodies. The autoimmune reaction has no connection with age and sex. It is in connection with the time of HBV infection, the positive rates of HBV-DNA and the liver dysfunction severity.

Detection for genotypes of hepatitis B virus in Hunan Province of China by nested PCR with multiplex pairs of primers

AIM: To determine the genotypes of hepatitis B virus (HBV) in Hunan Province of China by nested PCR with multiplex pairs of genotype-specific primers.

METHODS: Ten outer and inner primers were designed on the basis of the conserved nature of nuleotide sequences in regions of the Pre-S1 through S genes, in which 8 inner primers were devided into mix A and B to amplify HBV of genotype A, B, C and D, E, F respectively. The two different products from one sample in second-round PCR were separately electrophoresed on a 3% agarose gel. Genotypes of HBV were determined directly by the size of PCR products. To test its reliability and veracity, we compared new nested PCR with popular PCR-RFLP, followed by repeated experiments. This nested PCR was also used in the genotyping of HBVs in 220 Hunan patients with chronic hepatitis B to know the distribution of HBV genotype in Hunan Province of China.

RESULTS: The results showed complete concordence between the two assays and 100% recurrence in the repeated experiments. Of the 220 Hunan patients, 190 (86.4%) were genotype B and 30 (13.6%) were genotype C.

CONCLUSION: This new nested PCR can help to determine HBV genotypes clearly and directly with reliable and accurate results. With the application of this new method, the predominant HBV genotypes in Hunan are confirmed to be genotypes B and C.

[Effect of interleukin-12 on HBV pan-S gene vaccine]

OBJECTIVE

To investigate the effect of interleukin-12 (IL-12) on immune responses induced by pcDNA3 which expresses hepatitis B virus pan-S gene.

METHODS

BABL/c mice were immunized with pcDNA3 alone (control group), pcDNA3-PS alone, or co-immunized with pcDNA3-PS and pcDNA3-IL12. Six weeks after the immunization, sero anti-HBS antibody was examined, lymphocyte proliferation test and specific cytokine level were assayed. RESULTS The titer of anti-HBs antibody, the stimulation index of splenocytes, and cytokine level of IL-12 and IFN-gamma from the mice coimmunized with pcDNA3-PS and pcDNA3-IL12 were significantly higher than those of the mice immunized alone with pcDNA3-PS. Antibody level, SI, and cytokine level of the immunized mice were higher than those of the control group.

CONCLUSION

IL-12 expression plasmid can act as immunological adjuvants for HBV pan-S gene vaccine.

[Relation between genotype of HBV and its clinical manifestation by PCR with genotype-specific primers]

OBJECTIVE

To determine the relation between genotype of HBV and its clinical manifestation.

METHODS

Sera of 220 patients from Hunan Province of China, infected chronically with asymptomatic, mild, moderate, severe and fulminant hepatitis hepatitis B, were genotyped by PCR with genotype-specific primers. The results were statistically analyzed.

RESULTS

Only genotype B (86.4%) and C (13.6%) were found. With the aggravations of patients' condition, genotype C was found more often (P < 0.05). The levels of alanine aminotransferase (ALT), total bilirubin (TBIL) and HBV-DNA of genotype C was higher than those of genotype B, but there was no statistical difference. However, the ALT elevation rates of genotype C (96.7%) were significantly higher than those of genotype B (75.2%) (P < 0.05). There was no statistical difference in HBeAg rate between genotype B and C in general, but in patients with chronic fulminant hepatitis or aged 21 approximately 30, the HBeAg rates of genotype C (35.0% and 50.0%) were significantly higher than those of genotype B (14.4% and 24.5%) (P < 0.05).

CONCLUSION

The dominant genotype of HBV in Hunan Province of China is genotype B and C. Genotype of HBV correlates with its clinical manifestation and genotype C of HBV can lead to more severe hepatitis than genotype B of HBV.

Cloning and expression of tissue inhibitor of metalloproteinases-1 (TIMP-1) gene in Chinese

AIM

To clone the Chinese gene of TIMP-1 and express the fusion protein MBP-TIMP-1.

METHODS

The fragment of TIMP-1 gene from the liver tissue of indigenous Hunan residents was amplified by RT-nest-PCR and it was cloned, sequenced by gene recombinations techniques. Fusion protein MBP-TIMP-1 was expressed in E.coli, analysed by SDS-PAGE and Western blot and purified by affinity chromatography.

RESULTS

The sequence of cloned Chinese TIMP-1 gene was 624 bp. It is homologous with the reported other human TIMP-1 gene sequence. Fusion protein MBP-TIMP-1 was 66 kd and is of the antigenicity of TIMP-1. The MBP-TIMP-1 was purified by affinity chromatography.

CONCLUSION

The Chinese gene of TIMP-1 was cloned and MBP-TIMP-1 was expressed and purified successfully in vitro. It may be useful to the diagnosis of liver fibrosis.

[Study of the inhibiting effect of anti-NKG2D polyclonal antibody on cytotoxicities of NK and LAK cells]

AIM

To investigate the effect of anti NKG2D polyclonal antibody(pAb) on cytotoxicities of NK and LAK cells.

METHODS

Peripheral blood mononuclear cells(PBMCs) were separated by centrifugation on Ficoll-Hypaque gradients. LAK cells were induced from PBMCs by PHA (10 mg/L) and rhIL-2 (1x10(6)U/L). Then NK cells were sorted by flow cytometry(FCM). The cytotoxicities of NK and LAK cells were analyzed by MTT colorimetry after NKG2D molecule on NK and LAK cells were blocked with anti-NKG2D pAb.

RESULTS

FCM analysis proved that both purity and activity of obtained NK cells were high.The anti-NKG2D pAb could inhibit significantly cytotoxicities of NK and LAK cells to K562 and HepG2 cells, for NK cells,having decreased 82.9% and 75.6%, for LAK cells,having decreased 52.8% and 50.2%, respectively.The anti-NKG2D pAb had no effect on cytotoxicities of NK and LAK cells to CNE cells.

CONCLUSION

The anti-NKG2D pAb can inhibit cytotoxocities on tumor cells by NK and LAK cells through NKG2D molecule on two effector cells.

[Effect of artificial liver support system on the patients with severe hepatitis]

OBJECTIVE

To study the effective treatment for severe hepatitis.

METHODS

The severe hepatitis patients were treated by artificial liver support system on basis of the generalized treatment.

RESULTS

After treatment the level of serum total bilirubin was significant decreased (P < 0.01); the level of aminotransferase were significant decreased (P < 0.01); the prothrombin time was significantly shortened(P < 0.05). The survival rate of severe hepatitis was significantly increased(72%, 31/43)(P < 0.05).

CONCLUSION

The artificial liver support system can elevate the survival rate of severe hepatitis.

[Inhibitory effect of the combination of DHPAs and hyperbaric oxygen on Japanese B encephalitis virus infection in mice]

OBJECTIVE

To investigate the inhibitory effect of the combination of 2,3-dihydroxypropyl-adenine (DHPAs) and hyperbaric oxygen (HBO) on Japanese B encephalitis virus infection in mice.

METHODS

Mice infected P3-55 and P3-53 virus were used in the experiments. Virus was inoculated intraperitoneally to Kumming strain mice (8.5-9.5 g). Mice were divided into groups and treated in the incubation period of the infection. The duration of treatment was 5 days, and the experiments were terminated at the end of 2 weeks after treatment. The living and the dead were then counted finally.

RESULTS

The intergroup comparison showed marked difference between the control group and combination of DHPAs and hyperbaric oxygen group (P < 0.025 and P < 0.01), but there was no statistical difference between other groups and the control group (P > 0.05).

CONCLUSION

The combined treatment of (S) DHPA and/or (RS)-DHPA and HBO has inhibitory effect on Japanese encephalitis virus infection in experimental mice.

Polycolonization of Helicobacter pylori among Chinese subjects

OBJECTIVE

To investigate the situation among Chinese patients with regard to infection with multiple strains of Helicobacter pylori.

METHODS

Biopsy specimens for culture of H. pylori were obtained from gastric antrum, body and fundus of 20 patients during endoscopic investigation of upper gastrointestinal symptoms. H. pylori was identified by culture from one site in 16 and two or more sites in 10 of the 16 patients. Five isolated colonies of six strains of H. pylori from gastric antrum were subcultured and used for further analysis. Antibiotic susceptibility to metronidazole and clarithromycin was determined by disk diffusion test. Protein profiles of isolates were compared by sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE). DNA diversity of the isolates was determined by arbitrarily primed polymerase chain reaction (AP-PCR) fingerprinting.

RESULTS

Of the 10 patients with multiple isolates, 70% (7/10) exhibited variation in susceptibility to metronidazole and 20% (2/10) to clarithromycin between different sites. In 83% of (5/6) single colonies, no variability was seen in metronidazole and clarithromycin susceptibility; they were either susceptible or resistant. Protein profiles of all isolates by SDS-PAGE were similar. Isolates from different patients produced clearly different AP-PCR fingerprints. In 50% of H. pylori strains isolated from different sites of the stomach, genetic diversity was demonstrated by different AP-PCR fingerprints. In 67% (4/6) strains, five single-colony fingerprints were similar.

CONCLUSIONS

Genetic variability has been found in H. pylori strains. Individual patients are infected with a single predominant genotype at a single site but can be colonized by multiple strains, and they may show different antibiotic susceptibilities. Individual colonies of the H. pylori population from a single site may not always yield identical DNA fingerprints and antibiotic sensitivities.

[A study of the autoimmune pathogenesis of chronic HCV infection]

To explore the autoimmune pathogenesis of chronic hepatitis C virus(HCV) infection. Anti-GOR, antinuclear antibodies(ANA), thyroglobulin antibody(TGA), thyroid microsome antibody(TMA), serum levels of soluble Fas(sFas), and peripheral blood lymphocyte(PBMC) subsets and their apoptosis were measured in chronic HCV infection by using immunity assay and flow cytometry, respectively. The results showed that the positive rates of anti-GOR, ANA and TMA/TGA were significantly higher in chronic HCV-infected patients than those in normal controls(P < 0.01, respectively). In comparison with chronic HBV infected patients, anti-GOR and ANA were also significantly increased in chronic HCV infected patients(P < 0.01, P < 0.05, respectively). The serum levels of sFas were significantly higher in chronic HCV infection than those in healthy donors(P < 0.01). The apoptosis percentage of PBMCs and CD3+ cell was all increased in chronic HCV infection (vs normal controls P < 0.05). However, the apoptosis percentages of CD4+ T and CD19+ B cells in PBMCs were significantly decreased in patients with anti-GOR positive as compared with anti-GOR negative(P < 0.01, P < 0.05). The results indicate that autoimmune reactions and the imbalance of lymphocyte apoptosis exist during chronic HCV infection. Decreasing of the apoptosis of CD4+ T and CD19+ B lymphocytes may be the important reasons for the mechanism of autoimmune pathogenesis of chronic HCV infection. Increased serum levels of sFas may be responsible for the decrease of the apoptosis in a part of lymphocytes in chronic HCV infection.

Diversity of Helicobacter pylori among Chinese persons with H. pylori infection

To determine whether there is diversity among clinical isolates of Helicobacter pylori in Chinese patients with peptic ulcer disease, 40 strains of H. pylori were isolated from antral biopsy specimens obtained at the gastroenterology clinic of Xiangya Hospital from January 1996 to June 1998. Total protein profile by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and DNA diversity by polymerase chain reaction-random amplified polymorphic DNA (PCR-RAPD) fingerprinting were performed with these isolates. All the isolates from peptic ulcer disease were relatively homogeneous in protein profiles, but they showed a great DNA sequence diversity by PCR-RAPD fingerprinting. In Chinese patients H. pylori demonstrated an enormous diversity. The diversity among clinical isolates of H. pylori could be distinctly demonstrated and this observation will be helpful in the management of intrafamilial and recurrent H. pylori infection. PCR-RAPD fingerprinting is an efficient method of distinguishing between clinical isolates of H. pylori.

Circulating Th1 and Th2 cytokines in patients with hepatitis C virus infection

The imbalance of T-helper (Th) lymphocyte cytokine production may play an important role in immunopathogenesis of persistent hepatitis C virus (HCV) infection. To know whether an imbalance between Th1 and Th2 cytokines is present in chronic HCV infection, serum levels of Th1 cytokines, interferon gamma (IFN-gamma) and interleukin (IL)-2, and Th2 cytokines, IL-4 and IL-10, were measured using enzyme-linked immunosorbent assay in this study. Eighteen individuals with chronic HCV infection, 11 healthy subjects as normal controls and 10 chronic HBV infected patients as disease controls were observed. The results showed that the levels of Th2 cytokines (IL-4 and IL-10) were significantly increased in chronic HCV infected patients compared with normal controls (IL-4: 30.49+/-17.55 vs. 14.94+/-13.73, pg/ml, P<0.025; IL-10: 50.30+/-19.59 vs. 17.87+/-9.49, pg/ml, P<0.001). Similarly, the levels of Th1 cytokine, IL-2, was also elevated in individuals with chronic HCV infection when compared with normal controls (IL-2: 118.53+/-95.23 vs. 61.57+/-28.70, pg/ml, P<0.05). However, Th1 cytokine IFN-gamma level was not significantly changed during HCV infection (IFN-gamma: 28.09+/-15.65 vs. 24.10+/-15.61, pg/ml, P>0.05). Furthermore, the elevated levels of Th2 cytokines are greater than Th1 cytokines in HCV infection. Thus, the study indicates that an enhanced Th2 responses are present during chronic HCV infection, which may partly be responsible for the persistence of HCV infection.

Molecular cloning, sequencing and expression of core and NS3 fragments of HCV from patients with HCV infection

Fragments of core and NS3 of hepatitis C virus-Hunan (HCV-Hun) were cloned by RT-PCR and gene recombinant techniques from blood samples collected in Hunan Province, China. In comparison with sequences of our samples with those of HCV-US and HCV-J, the homologies of nucleotides and amino acids were about 90%, indicating that fragments of core and NS3 of HCV-Hun were in a relative conserved region of HCV. Two fusion proteins containing the peptides coded by HCV core (MBP-HCV core) and HCV. NS3 (MBP-HCV. NS3-Gal) were expressed by Escherichia Coli with recombinant plasmids. The specific HCV antigenicity of the two fusion proteins were identified by western blotting. Therefore, MBP-HCV. core and MBP-HCV.NS3-Gal were found useful for anti-HCV assay.

[Molecular cloning and sequencing of hepatitis C virus gene from human blood]

To clone and characterize hepatitis C virus strain in China, we extracted RNA from the pooled plasma of persons with HCV infection in Hunan, China. HCV gene was amplified and cloned by RT-PCR and gene recombinant techniques. A total of 2,307 nucleotides of the complementary DNA clones of HCV (HCV-Hun), including the clone of 5' noncoding region (311bp), core region (340bp), envelope region (397bp), NS1 region (634bp), NS3 region (245bp), and NS5 region (380bp) were isolated and identified. The homologies in nucleotide sequence between HCV-Hun and HCV-US or HCV-J were 98.1% and 98.7% respectively in 5' noncoding region; 92.6% and 97.4% in core region; 74.3% and 88.7% in envelope region; 83.5% and 91.0% in NS1 region; 82.9% and 94.7% in NS3 region; and 74.8% and 90.1% in NS5 region. The similar results were seen in deduced amino acid sequence homologies between above HCV stains. These findings indicate that HCV-Hun were more mimic to HCV-J than HCV-US, and there were considerable heterogeneity in hepatitis C virus genomes isolated from different areas of the world.

[Detection of serum antibody against hepatitis C virus in patients with hepatitis and liver diseases]

Antibody against hepatitis C virus (anti-HCV) was tested in 658 cases of hepatitis and liver diseases with ELISA, ninety of these cases were positive, with a total infection rate of 13.68% (90/658). The positive rate of anti-HCV was highest in patients with chronic severe hepatitis (33.78%) and CAH accompanied by cirrhosis of liver(31.58%). The infection rate in other types of hepatic diseases in order of frequency was as follows: fulminant hepatitis (18.18%), CAH without cirrhosis (15.13%), subacute severe hepatitis (13.43%), CPH (5.88%), primary hepatocellular carcinoma (3.85%), and acute hepatitis (2.42%). Serological markers of HBV infection were detectable concomitantly in 77 of the 90 cases who were anti-HCV positive, but there was no evidence of mutual inhibition of viral replication. There was neither appreciable difference in the level of hyperbilirubinemia in cases of hepatitis with or without anti-HCV, nor significant diversity in the number of death between cases of severe hepatitis with and without anti-HCV.

Effects of a minimally supervised exercise program for mentally retarded adults

Previous exercise studies that attempted to improve the cardiovascular fitness (CVF) of mentally retarded (MR) adults were flawed with methodological shortcomings that prevented conclusive results. At issue in these training studies were fitness test validity and reliability, exactness of duration and intensity of training, and an inordinate amount of supervision. Therefore, we sought to determine whether moderately MR adults (seven males, five females; IQ = 61 +/- 3, age = 25 +/- 3 yr) could improve their CVF through a minimally supervised 16-wk training program. Each subject repeated exercise tests twice on two different modes of exercise, the treadmill (TM) and Schwinn Air-Dyne ergometer (SAE), before training to ensure validity and reliability of initial CVF levels. Intensity and frequency of exercise were closely monitored. An observer was present during the training bouts, but, following initial instructions, no additional encouragement or instructions were given. Although the training program significantly increased peak VO2 (29.2 +/- 8 to 33.5 +/- 9 ml.kg-1.min-1) and peak ventilation (73 +/- 26 to 81 +/- 231.min-1) when assessed on the TM, significant changes in these same parameters were not seen when assessed on the SAE. The importance of these results was discussed.

Cardiorespiratory responses of mentally retarded adults to air-brake ergometry and treadmill exercise

The graded treadmill (TM) exercise test is considered the optimal mode of exercise for evaluating the cardiovascular fitness of mentally retarded (MR) individuals. A new mode of exercise, the Schwinn Air-Dyne ergometer (SAE), was evaluated and compared to the TM for determining the cardiovascular fitness of adults. Twelve MR adults performed maximal exercise tests to volitional exhaustion, on separate days, on the SAE and TM. Maximal heart rates, oxygen consumption, minute ventilation, and respiratory quotient were similar for both exercise tests. These results indicate that the SAE is comparable to TM exercise in assessing the cardiovascular capacity of MR adults.