[Effect of changes in posterior tibial slope on the mid-term clinical outcomes of Oxford unicompartmental knee arthroplasty]

Objective: To investigate the impact of changes in the posterior tibial slope (PTS) in Oxford unicompartmental knee arthroplasty (OUKA) on the mid-term clinical outcomes of postoperative patients. Methods: This study was a follow-up study. The data of 135 patients (150 knees) who underwent OUKA at the China-Japan Friendship Hospital from January 2012 to January 2013 were analyzed retrospectively. The patients were followed-up for at least ten years. According to the changes in PTS of the medial tibial plateau before and after surgery, patients were divided into three groups: group A (PTS decreased by more than 5°), group B (PTS changed by 5° or less), and group C (PTS increased by more than 5°). The Knee Society Clinical Score (KSS-C), Knee Society Functional Score (KSS-F), Oxford Knee Score (OKS), Forgotten Joint Score (FJS), and knee range of motion (ROM) among the three groups were compared at the last follow-up. Results: Prior to the final follow-up assessment, six patients expired, and an additional nine patients were lost to follow-up. A total of 120 patients (135 knees) were enrolled in this study (30 males and 90 females). The mean age was (66.29±8.62) years, and the follow-up time was (10.54±0.72) years. Group A consisted of 32 patients (34 knees), group B comprised 77 patients (90 knees), and group C included 11 patients (11 knees). One knee in group A suffered prosthesis loosening, and two knees in group C experienced postoperative bearing dislocation, one knee encountered bearing fragmentation. The incidence of postoperative complications differed significantly among the three groups (P<0.05). The preoperative OKS was (33.91±6.59) points, KSS-F was (43.46±8.99) points, KSS-C was (41.05±5.70) points and ROM was 115.23°±13.53°; after the surgery, they changed to (18.82±7.01) points, (81.51±7.34) points, (82.64±7.94) points, and 119.07°±8.62°, respectively, and all the differences were statistically significant (all P<0.001). In terms of postoperative outcomes, group A had an OKS of (21.44±8.46) points and a FJS of (63.83±11.40) points, group B had an OKS of (17.07±5.81) points and a FJS of (70.49±12.45) points, group C had an OKS of (25.09±5.07) points and a FJS score of (59.48±10.09) points; the differences among the three groups were all statistically significant (all P<0.05), but there were no significant differences in the postoperative KSS scores and ROM among the three groups (all P>0.05). Conclusions: After OUKA, better mid-term clinical outcomes are achieved when ΔPTS is<5°. Although the recommended central value for PTS in OUKA is 7° according to Oxford, it should be individualized, and it is recommended to consider the preoperative angle, with a change of less than 5° before and after surgery.

Facile Preparation of Cellulose Aerogels with Controllable Pore Structure

Cellulose aerogels are the latest generation of aerogels and have also received extensive attention due to their renewable and biocompatible properties. Herein, cellulose aerogel was facilely prepared by using NaOH/urea solution as solvent, raising the temperature to control gelation and drying wet gel sequentially. With NaOH/urea solution as solvent, the cellulose concentration has an important impact on the micromorphology of cellulose aerogels, while the aging time rarely affects the micromorphology. The appropriate solvent and drying method allow the formation of different cellulose crystalline structures. Different from the Cellulose Ⅰ crystalline structure of raw cellulose powder, the cellulose phase of as-prepared cellulose aerogels belongs to the Cellulose Ⅱ crystalline structure, and to some extent the pyrolysis temperature is also lower than that of raw cellulose powder. The resultant cellulose aerogel prepared by using NaOH/urea solution as solvent and freeze-drying has a uniform macroporous structure with a macropore size of 1~3 µm.

Modes and Mechanisms of Pacific Decadal-Scale Variability

The modes of Pacific decadal-scale variability (PDV), traditionally defined as statistical patterns of variance, reflect to first order the ocean's integration (i.e., reddening) of atmospheric forcing that arises from both a shift and a change in strength of the climatological (time-mean) atmospheric circulation. While these patterns concisely describe PDV, they do not distinguish among the key dynamical processes driving the evolution of PDV anomalies, including atmospheric and ocean teleconnections and coupled feedbacks with similar spatial structures that operate on different timescales. In this review, we synthesize past analysis using an empirical dynamical model constructed from monthly ocean surface anomalies drawn from several reanalysis products, showing that the PDV modes of variance result from two fundamental low-frequency dynamical eigenmodes: the North Pacific-central Pacific (NP-CP) and Kuroshio-Oyashio Extension (KOE) modes. Both eigenmodes highlight how two-way tropical-extratropical teleconnection dynamics are the primary mechanisms energizing and synchronizing the basin-scale footprint of PDV. While the NP-CP mode captures interannual- to decadal-scale variability, the KOE mode is linked to the basin-scale expression of PDV on decadal to multidecadal timescales, including contributions from the South Pacific.

The influence of CYP2R1 polymorphisms and gene-obesity interaction with hypertension risk in a Chinese rural population

BACKGROUND AND AIMS

Several studies have reported that variants in CYP2R1 have been linked with an increased risk of hypertension. However, the interaction between CYP2R1 variants and environmental factors on the susceptibility of hypertension remained unclear. Therefore, this study evaluated the influence of CYP2R1 polymorphisms on hypertension susceptibility, and explored the interaction effect of CYP2R1 variations and obesity on the disease.

METHODS AND RESULTS

We included 766 incident hypertension cases matched with non-hypertension controls in a 1:1 ratio by sex, age (within 3 years). Two loci in CYP2R1 gene (rs10766197 and rs12794714) were genotyped by TaqMan probe assays. The concentration of 25-hydroxyvitamin-D was determined by human enzyme-linked immunosorbent assay (ELISA) kits. The associations of CYP2R1 polymorphisms and risks of vitamin D deficiency (VDD) were analyzed by logistic regression. Multifactor dimensionality reduction (MDR) was used to analyze the gene-environment interaction. Multiple logistic regression was used to examine the effect of CYP2R1 gene variations, and the interaction between CYP2R1 variation and obesity on hypertension susceptibility. The results showed that rs10766197 (GG vs. AA) and rs12794714 (GG vs. AA) polymorphisms were both associated with an increased risk of VDD (OR = 1.49, 95% confidence interval (CI) = 1.08-2.05 and OR = 1.63, 95% CI = 1.19-2.25, respectively), after adjustment for potential risk factors. We also found that rs12794714 polymorphism was significantly associated with elevated risk of hypertension under the dominant model (OR = 1.26, 95% CI = 1.01-1.56). In addition, the interactions between rs12794714 with both general obesity (OR = 3.93, 95% CI = 2.72-5.68) and central obesity (OR = 3.22, 95% CI = 2.29-4.52) have significant effects on hypertension susceptibility.

CONCLUSIONS

The study provided further evidence that CYP2R1 variation was associated with a higher risk of hypertension in Chinese rural population. The interaction between CYP2R1 rs12794714 and obesity may increase the risk of hypertension.

Rapid and facile detection of HBV with CRISPR/Cas13a

Hepatitis B remains a major global public health challenge, with particularly high prevalence in resource-poor Western Pacific and African regions. The lack of specialized pathogen detection equipment, such as qPCR,...

Advances in Field Detection Based on CRISPR/Cas System

Rapid and accurate diagnostic methods are essential to interrupt outbreaks of infectious diseases such as COVID-19. However, the most commonly used nucleic acid detection method, qPCR or RT-qPCR, takes several hours to complete and requires highly sophisticated equipment. Recently, an emerging nucleic acid detection method based on the CRISPR/Cas system has reduced the reliance on qPCR. It has several important features that make it suitable for on-site POCT (point-of-care testing), including short detection cycles, low cost, high sensitivity, and the ability to be combined with different readout methods. This review briefly introduces the steps of CRISPR/Cas detection and then summarizes the current advances of CRISPR/Cas-based POCT from four steps: nucleic acid extraction, target amplification, CRISPR/Cas-based signal generation, and signal output. Finally, we discuss the advantages and challenges of CRISPR-based POCT and describe the future research perspectives for CRISPR.

Pathological Features of Enterovirus 71-Associated Brain and Lung Damage in Mice Based on Quantitative Proteomic Analysis

The outbreaks of enterovirus 71 (EV71)-associated hand, foot, and mouth disease (HFMD) have emerged as an emergency of global health due to its association with fatal encephalitis and subsequent neurogenic pulmonary edema; however, the molecular characteristics and pathological features underlying EV71-associated encephalitis and pulmonary edema remain largely unknown. In this study, we performed a proteomic analysis of fresh brain and lung tissues from EV71-infected mice at 7 days post infection. We detected a perturbed expression of 148 proteins in the brain and 78 proteins in the lung after EV71 expression. Further analysis showed that the dysregulated proteins in the brain are involved in a variety of fundamental biological pathways, including complement and coagulation cascades, innate and adaptive immune responses, platelet activation, and nitrogen metabolism, and those proteins in the lung participate in innate and adaptive immune responses, phagosome, arginine biosynthesis, and hypoxia-inducible factor 1 signaling pathway. Our results suggested that immune activation, complement and coagulation dysfunction, platelet activation, imbalance of nitrogen metabolism, and hypoxia could be involved in the pathogenesis of EV71, which explains the major clinical manifestation of hyperinflammatory status of severe HFMD cases. Our study provides further understanding of the molecular basis of EV71 pathogenesis.

Measurements of neutral particle energy spectrum on EAST using a time-of-flight low-energy neutral particle analyzer

The neutral particles generated by charge exchange reactions can play an important role in erosion of first wall materials in fusion devices. In order to measure the flux and energy of neutral particles to the first wall, a low-energy neutral particle analyzer (LENPA) based on the time-of-flight method has been developed and successfully applied on the Experimental Advanced Superconducting Tokamak (EAST)' to measure the neutrals with an energy of 20-3000 eV. The LENPA works in the counting mode, and the signal of photons is used as the reference for the flight time of neutrals. The energy spectrum of low-energy neutral particles on EAST has been obtained for the first time. The new diagnostics can help in understanding the neutral particle generation and deposition on the first wall materials in tokamaks under different plasma conditions.

A large-scale genome-wide association analysis reveals QTL and candidate genes for intramuscular fat content in Duroc pigs

This study aimed at identifying genomic regions and genes associated with intramuscular fat content (IMF) in Duroc pigs using a weighted single-step GWAS. Data from 3912 pigs, of which 3770 animals were genotyped with GeneSeek Porcine 50K Bead chip, were used for the association analysis. We identified 19 genomic regions that each explained >1% of the additive genetic variance associated with IMF. Notably, a consistent QTL on SSC7 (117.42-117.92 Mb) was confirmed, explaining 3.70% of the additive genetic variance, and two genes, BDKRB2 and ATG2B, were highlighted as promising candidates for IMF. Two QTL (SSC7, 94.19-94.64 Mb; SSC14, 123.25-123.75 Mb), which harbored MED6 and MAP3K9 genes and TCF7L2 gene respectively, were newly identified as associated with IMF. In conclusion, we identified a consistent QTL and additional genomic regions and genes that contributed to the genetic variance of IMF using a large-scale sample size of genotyped pigs and genealogical information.

CRISPR/Cas12-Based Ultra-Sensitive and Specific Point-of-Care Detection of HBV

Hepatitis B remains a major global public health challenge, with particularly high prevalence in medically disadvantaged western Pacific and African regions. Although clinically available technologies for the qPCR detection of HBV are well established, research on point-of-care testing has not progressed substantially. The development of a rapid, accurate point-of-care test is essential for the prevention and control of hepatitis B in medically disadvantaged rural areas. The development of the CRISPR/Cas system in nucleic acid detection has allowed for pathogen point-of-care detection. Here, we developed a rapid and accurate point-of-care assay for HBV based on LAMP-Cas12a. It innovatively solves the problem of point-of-care testing in 10 min, particularly the problem of sample nucleic acid extraction. Based on LAMP-Cas12a, visualization of the assay results is presented by both a fluorescent readout and by lateral flow test strips. The lateral flow test strip technology can achieve results visible to the naked eye, while fluorescence readout can achieve real-time high-sensitivity detection. The fluorescent readout-based Cas12a assay can achieve HBV detection with a limit of detection of 1 copy/μL within 13 min, while the lateral flow test strip technique only takes 20 min. In the evaluation of 73 clinical samples, the sensitivity and specificity of both the fluorescence readout and lateral flow test strip method were 100%, and the results of the assay were fully comparable to qPCR. The LAMP-Cas12a-based HBV assay relies on minimal equipment to provide rapid, accurate test results and low costs, providing significant practical value for point-of-care HBV detection.

CRISPR/Cas System: A Potential Technology for the Prevention and Control of COVID-19 and Emerging Infectious Diseases

The continued global pandemic of coronavirus disease 2019 (COVID-19) poses a serious threat to global public health and social stability and it has become a serious global public health problem. Unfortunately, existing diagnostic and therapeutic approaches for the prevention and control of COVID-19 have many shortcomings. In recent years, the emerging CRISPR/Cas technology can complement the problems of traditional methods. Biological tools based on CRISPR/Cas systems have been widely used in biomedicine. In particular, they are advantageous in pathogen detection, clinical antiviral therapy, drug, and vaccine development. Therefore, CRISPR/Cas technology may have great potential for application in the prevention and control of COVID-19 and emerging infectious diseases in the future. This article summarizes the existing applications of CRISPR/Cas technology in infectious diseases with the aim of providing effective strategies for the prevention and control of COVID-19 and other emerging infectious diseases in the future.

Development of machine learning models to predict response after cardiac resynchronization therapy

Background

There have been few practical and precise tools to predict response after cardiac resynchronisation therapy (CRT).

Purpose

We intend to develop predictive models using machine learning (ML) approaches and easily available features prior to implantation.

Methods

The baseline features of 596 patients receiving CRT were retrospectively collected. Nine predictive models were established, including logistic regression (LR), Elastic Net (EN), lasso regression, ridge regression (Ridge), neural network, support vector machine (SVM), random forest, XGBoost and k-nearest neighbor. Sensitivity, specificity, precision, accuracy, F1, area under receiver operating characteristic curve (AU-ROC) and average precision of each model were evaluated, and AU-ROC was compared between each pair of ML models and further between ML models and the latest guidelines.

Results

Sensitivity was highest with SVM by 0.69, and specificity was highest with LR by 0.81. The models EN and Ridge showed the highest overall predictive power with an average AU-ROC of 0.77. Specifically, the Ridge model provided significant higher AU-ROC than any other model (all P&lt;0.05). All ML models showed significant higher AU-ROC than those derived from the latest guidelines (all P&lt;0.05). Additionally, the effect size analysis identified LBBB, LVESD, and history of PCI as the most crucial predictive features.

Conclusion

ML algorithms produced efficient predictive models for evaluation of response after CRT with features prior to implantation. Tools developed accordingly might improve selection of CRT candidates and reduce rate of non-response in the future.

ROC and PR curves of predictive models

Funding Acknowledgement

Type of funding source: None

Association Between Human Papilloma Virus Infection and Malignant Sinonasal Inverted Papilloma

OBJECTIVE

This systematic review and meta-analysis aimed to evaluate the risk of malignant sinonasal inverted papilloma (SNIP) according to the type of human papilloma virus (HPV) infection.

METHODS

The databases of PubMed, EmBase, and Web of Science were searched for studies that reported the risk of malignant SNIP in patients infected by specific types of HPV. The quantitative analyses for pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

RESULTS

Twenty-six molecular epidemiological studies that recruited a total of 900 patients with SNIP were selected for the final meta-analysis. The summary ORs indicated that HPV-6 (OR: 2.02; 95% CI: 0.47-8.61; P = .343), HPV-11 (OR: 0.86; 95% CI: 0.26-2.89; P = .806), and HPV-6/11 (OR: 1.44; 95% CI: 0.59-3.53; P = .426) infections were not associated with the risk of malignant SNIP. However, the risk of malignant SNIP was increased in patients infected with HPV-16 (OR: 8.51; 95% CI: 3.36-21.59; P < .001), HPV-11/16 (OR: 7.95; 95% CI: 1.13-56.01; P = .038), HPV-18 (OR: 23.26; 95% CI: 5.27-102.73; P < .001), and HPV-16/18 (OR: 24.34; 95% CI: 5.74-103.18; P < .001).

CONCLUSIONS

This study found that patients infected with HPV types 16, 11/16, 18, and 16/18 were associated with an increased risk of malignant SNIP. However, patients infected with HPV types 6, 11, and 6/11 did not have a significant risk of malignant SNIP. Laryngoscope, 131:1200-1205, 2021.

Development of a quartz crystal microbalance diagnostic for measuring material erosion and deposition on the first wall in EAST

A quartz crystal microbalance (QMB) diagnostic system has been established in Experimental Advanced Superconducting Tokamak (EAST) for real-time and in situ measurements of erosion and deposition rates of plasma-facing materials at the first wall. A ∼70 nm aluminum (Al) film has been coated on the QMB crystal surface to measure the erosion rate by charge exchange neutral particles. Dual sensors of the QMB system have been used with a closed sensor for reference. The stability and light sensitivity of the QMB system have been tested in the lab, demonstrating its feasibility on the application of EAST experiments. The QMB system with cooling water has been successfully applied in the 2018 EAST campaign. The net erosion thickness measured by the QMB has been well validated by thickness measurements using the Rutherford backscattering spectrometry. The developed QMB systems can help us to understand the physics processes of material erosion and deposition at main chamber walls for long pulse operations in EAST.

Extended ORF8 Gene Region Is Valuable in the Epidemiological Investigation of Severe Acute Respiratory Syndrome-Similar Coronavirus

Severe acute respiratory syndrome coronavirus (SARS-CoV) was discovered as a novel pathogen in the 2002-2003 SARS epidemic. The emergence and disappearance of this pathogen have brought questions regarding its source and evolution. Within the genome sequences of 281 SARS-CoVs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and SARS-related CoVs (SARSr-CoVs), a ~430 bp genomic region (from 27 701 bp to 28 131 bp in AY390556.1) with regular variations was investigated. This ~430 bp region overlaps with the ORF8 gene and is prone to deletions and nucleotide substitutions. Its complexity suggested the need for a new genotyping method for coronaviruses related to SARS-similar coronaviruses (SARS-CoV, SARSr-CoV, and SARS-CoV-2). Bat SARSr-CoV presented 3 genotypes, of which type 0 is only seen in bat SARSr-CoV, type I is present in SARS in the early phase, and type II is found in all SARS-CoV-2. This genotyping also shows potential usage in distinguishing the SARS-similar coronaviruses from different hosts and geographic areas. This genomic region has important implications for predicting the epidemic trend and studying the evolution of coronavirus.

Semen quality pattern and age threshold: a retrospective cross-sectional study of 71,623 infertile men in China, between 2011 and 2017

BACKGROUND

The aim of this study was to provide information on the semen quality pattern of infertile men and age thresholds for semen parameters in China.

METHODS

This was a retrospective cross-sectional study investigating 71,623 infertile men from the Reproductive and Genetic Hospital of CITIC Xiangya in Hunan, China, from 2011 to 2017. The Kruskal-Wallis test, Mann-Kendall test, linear regression model and joinpoint regression were used.

RESULTS

Although erratic changes were observed in the median semen parameters (sperm concentration 40.1-52.1 × 10⁶/ml, total sperm count 117.8-153.1 × 10⁶, sperm progressive motility 33.4-38.1%) during the 7 years of observation, no significant decrease in semen quality was found, and 47.88% of infertile men showed normal semen parameters according to the World Health Organization (WHO) criteria. According to the joinpoint regression analysis, sperm progressive motility appeared to decrease earlier than the sperm concentration and total sperm count (at 28, 58, and 42 years of age, respectively).

CONCLUSIONS

There is no evidence of a deterioration in semen quality among infertile men in Hunan, China. Semen parameters decreased with increasing age, with turning points noted at different ages. Semen parameters are not absolute evidence for the assessment of male fertility potential. Therefore, we believe that, among semen parameters, the sperm concentration is the best predictor of fertility for ART, followed by motility. Decreased sperm motility may affect natural pregnancy, but it is not necessary for successful IVF.

Facile Synthesis of Methylsilsesquioxane Aerogels with Uniform Mesopores by Microwave Drying

Methylsilsesquioxane (MSQ) aerogels with uniform mesopores were facilely prepared via a sol⁻gel process followed by microwave drying with methyltrimethoxysilane (MTMS) as a precursor, hydrochloric acid (HCl) as a catalyst, water and methanol as solvents, hexadecyltrimethylammonium chloride (CTAC) as a surfactant and template, and propylene oxide (PO) as a gelation agent. The microstructure, chemical composition, and pore structures of the resultant MSQ aerogels were investigated in detail to achieve controllable preparation of MSQ aerogels, and the thermal stability of MSQ aerogels was also analyzed. The gelation agent, catalyst, solvent, and microwave power have important roles related to the pore structures of MSQ aerogels. Meanwhile, the microwave drying method was found to not only have a remarkable effect on improving production efficiency, but also to be conducive to avoiding the collapse of pore structure (especially micropores) during drying. The resulting MSQ aerogel microwave-dried at 500 W possessed a specific surface area up to 821 m²/g and a mesopore size of 20 nm, and displayed good thermal stability.

Effects of T cell subsets with different proportions on renal function and blood lipids in patients with preeclampsia

This study aimed to investigate the effect of T cell subsets with different proportions on renal function and blood lipids in patients with preeclampsia (PE). Ninety pregnant women were included in this experiment and classified into 3 groups: group A (30 with severe PE), group B (30 with mild PE) and group C (30 healthy pregnant women). Clinical characteristics were examined. The ratio of T cell subsets in the three groups was detected by flow cytometry. The relationship between PE and T cell subsets was determined. The results showed that no significant difference was found in age or gestational age (P>0.05). The number of CD4+ T cells (CD4 is mainly expressed in helper T cells, referred to as TH) in group A increased significantly compared with group B and group C (P less than 0.05), while the number of CD8+ T cells (CD8+ T cell, also known as cytotoxic T cell (CTL) in group A decreased noticeably in comparison to group C (P less than 0.05). The ratio of CD4+ cell number to CD8+ cell number (TH/CTL) in group A was elevated significantly compared with group B and group C (P less than 0.05). The uric acid (UA) concentration of group A was noticeably elevated compared to group C (P less than 0.05), which differed insignificantly between group B and C (P>0.05). Glomerular filtration rate (GFR) of group A was obviously impaired in comparison to group B and group C (P less than 0.05), which differed insignificantly between group B and C (P>0.05). Total cholesterol (TC) concentrations in group A, C and B were examined. TC concentrations in the former two groups were slightly higher compared to the latter (P less than 0.05), and those in the former two groups were also higher than the normal range (P less than 0.05). Mean triglyceride (TG) concentrations in all 3 groups were above the normal range, and those in group A and B were significantly higher compared to group C (P less than 0.05). TG concentrations differed insignificantly between group B and C (P>0.05). Serum TG, UA and TC in PE patients were positively related to TH/CTL (P less than 0.05). In conclusion, PE is related to T cell subsets, and T cell subsets are closely related to kidney injury and dyslipidemia.

Development of a time-of-flight low-energy neutral particle analyzer for EAST tokamak

To understand the erosion effect of neutral particles on the first wall, a low energy neutral particle analyzer (LENPA), based on the time-of-flight method, has been developed for the Experimental Advanced Superconducting Tokamak (EAST). The LENPA to be installed in the EAST mid-plane mainly consists of a chopper sub-system, a 3 m long flight tube, two sets of detector assemblies, and data acquisition and processing, vacuum, power supply, and control sub-systems. The neutral outflux is gated in bunches of 1 μs time scale by a slotted rotating disc which is driven by a vacuum compatible motor modified from a turbomolecular pump. A He-Ne laser beam is projected through the disc slit to record the instants of chopper slits opening with an avalanche photodiode module. An on-axis electron multiplier detects chopped neutrals, and a central perforated Cu-Be plate is employed to channel the emitted secondary electrons into an off-axis electron multiplier. The radiation peaks of on-axis electron multiplier caused by UV photons projected through the central hole of the Cu-Be plate provide an alternative way to record the chopper slits' opening time. With an additional 4 TB fast memory card, 1 GS/s sampling rate has been realized by using a GaGe acquisition card continuously. The LENPA data from the EAST together with neutral particle material erosion experiments will be used to benchmark the simulation results for better predictions on future fusion reactors, such as ITER and China Fusion Engineering Test Reactor (CFETR).

Gamma-glutamyl transpeptidase to cholinesterase and platelet ratio in predicting significant liver fibrosis and cirrhosis of chronic hepatitis B

OBJECTIVES

To evaluate the performance of a new mathematical model γ-glutamyl transpeptidase to cholinesterase and platelet ratio (GCPR) versus γ-glutamyl transpeptidase to platelet ratio (GPR) in predicting significant fibrosis and cirrhosis of chronic hepatitis B.

METHODS

A complete cohort of 2343 patients was divided into early and late cohort depending on the time of liver biopsy. With reference to the Scheuer standard, liver pathologic stage 2 or higher and stage 4 or higher were defined as significant fibrosis and cirrhosis, respectively. Receiver operating characteristic (ROC) curve was used to evaluate the performance of investigated models.

RESULTS

In the early cohort, the areas under ROC curves (AUROCs) of GCPR in predicting significant fibrosis of hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients (0.782 and 0.775) were both significantly greater than those of GPR (0.748 and 0.747) (Z = 8.198 and Z = 6.023, both p <0.0001); the AUROCs of GCPR in predicting cirrhosis of HBeAg-positive and HBeAg-negative patients (0.842 and 0.861) were both significantly greater than those of GPR (0.802 and 0.823) (Z = 6.686 and Z = 6.116, both p <0.0001). In early, late and complete cohorts, using a single cutoff of GCPR > 0.080, the specificities of GCPR in predicting significant fibrosis of HBeAg-positive patients were 83.3%, 88.2% and 85.0% and of HBeAg-negative patients were 87.6%, 87.4% and 87.6%, respectively; and the sensitivities of GCPR in predicting cirrhosis of HBeAg-positive patients were 81.9%, 88.7% and 84.2% and of HBeAg-negative patients were 83.1%, 82.1% and 82.7%, respectively.

CONCLUSIONS

GCPR has higher performance than GPR in predicting significant fibrosis and cirrhosis of chronic hepatitis B.

Facile Synthesis of Flexible Methylsilsesquioxane Aerogels with Surface Modifications for Sound- Absorbance, Fast Dye Adsorption and Oil/Water Separation

New flexible methylsilsesquioxane (MSQ) aerogels have been facilely prepared by a sol-gel process with methyltrimethoxysilane (MTMS) and dimethyldimethoxysilane (DMDMS) as co-precursors, followed by surface modification and ambient pressure drying. The microstructure, mechanical properties and hydrophobicity of these MSQ aerogels after surface modifications of hexamethyldisiloxane (HMDSO) and/or hexamethyldisilazane (HMDS) were investigated in detail, and the applications of surface-modified MSQ aerogels in sound-absorbance, fast dye adsorption and oil/water separation were evaluated, respectively. The MSQ aerogels surface-modified by HMDS possess flexibility, elasticity and superhydrophobicity, and demonstrate good performance in the mentioned applications. The resultant MSQ aerogel used in sound-absorbance has high frequency (about 6 kHz) acoustic absorptivity of up to 80%, benefiting from its macroporous structure and porosity of 94%, and it also possesses intermediate frequency acoustic absorptivity (about 1 kHz) up to 80% owing to its elasticity. This MSQ aerogel can selectively separate oil from oil/water mixtures with high efficiency due to its superhydrophobicity and superlipophilicity, resulting from a lot of methyl groups, density as low as 0.12 cm³·g-1 and a water contact angle as high as 157°. This MSQ aerogel can be assembled to be a monolithic column applied for fast dye adsorption, and shows selective adsorption for anionic dyes and removal efficiency of methyl orange of up to 95%.

[Association of Crohn's disease with aryl hydrocarbon receptor gene polymorphisms and haplotypes]

Objective: To explore the relationship of Crohn's disease (CD) susceptibility to aryl hydrocarbon receptor (AhR) polymorphisms and haplotypes in Han population in Wenzhou city, China. Methods: A total of 310 CD patients and 573 age- and sex-matched healthy controls were enrolled in our study. Three single nucleotide polymorphisms (SNPs) of AhR(rs10249788,rs2158041,rs2066853) were determined by the improved multiple ligase detection reaction technique. Unconditional logistic regression analyses was applied to analyze the allelic and genotypic differences of each SNP between CD patients and controls, as well as their influence on the clinicopathologic characteristics in CD patients. Analyses of linkage disequilibrium and haplotype were performed by Haploview 4.2 software in all study subjects. Results: Compared with the controls, the variant allele (T) and genotype (CT+TT) of (rs2158041) were evidently decreased among CD patients (19.52% vs. 25.04%, P=0.009; 34.19% vs. 44.68%, P=0.003). According to "the Montreal Classification Standards" , CD patients were divided into different subgroups. The variant allele (T) and genotype (CT+TT) of (rs2158041) were significantly lower in patients with terminal ileum CD than in controls (16.79% vs. 25.04%, P=0.005; 28.24% vs. 44.68%, P=0.001). Similar conclusions were also drawn in patients with constricting disease when compared with the controls (15.20% vs. 25.04%, P=0.003; 28.43% vs. 44.68%, P=0.003). The three SNPs above were shown to be in a linkage disequilibrium. Compared with the controls respectively, the frequency of haplotype (CCG) was increased in CD patients (44.73% vs. 39.60%, P=0.039), whereas that of haplotype (CTG) was decreased (18.02% vs. 22.78%, P=0.047). Conclusions: AhR (rs2158041) variation might influence the risk as well as the location and behavior of CD. The haplotype (CCG) possibly increase the risk of CD development, whereas haplotype (CTG) might decrease it.

[Association of ulcerative colitis with fork head/winged helix transcription factor-3 gene polymorphisms in Chinese patients]

Objective: To investigate the association of ulcerative colitis (UC) with fork head/winged helix transcription factor-3 (Foxp3) polymorphisms in Han population in Zhejiang province, China. Methods: A total of 381 UC patients and 490 healthy controls were enrolled in this study.The four single nucleotide polymorphisms (SNPs) of Foxp3 (rs3761547, rs2232365, rs2294021, rs3761548) were examined by SNaPshot.The analyses of linkage disequilibrium (LD) and haplotype were also performed in all study subjects. Results: When male and female UC patients were compared with their corresponding controls respectively, the alleles and genotypes of the four SNPs were not statistically different (all P>0.05). According to severity and location of the disease, the UC patients were divided into different subgroups. The alleles (C, G, A) of (rs2232365, rs2294021, rs3761548) were more frequent in male patients with severe UC than in the male controls (69.6% vs 34.3%, P=0.001; 69.6% vs 34.3%, P=0.001; 39.1% vs 14.4%, P=0.002, respectively). As compared with the female controls, the alleles (C, G, A) and genotypes (TC+ CC, AG+ GG, CA+ AA) of (rs2232365, rs2294021, rs3761548) were significantly increased in the female patients with severe UC (51.9% vs 38.0%, 63.5% vs 39.2%, 53.8% vs 21.4%, 80.8% vs 57.7%, 84.6% vs 58.4%, 76.9% vs 34.7%, all P<0.05). The four SNPs above were shown to be in a strong LD both in male and in female subjects.When male and female UC patients were compared with their corresponding controls respectively, nevertheless, each haplotype frequency was not statistically different (all P>0.05). Conclusions:Foxp3 (rs2232365, rs2294021, rs3761548) variations might engender the increased risk of severe UC in Chinese Han patients.

[Research advances in the role of interleukin-21 in chronic hepatitis B virus infection]

Interleukin-21 (IL-21) is a cytokine mainly secreted by activated CD4+ T cells and natural killer T cells and has multiple effects. It is involved in innate and adaptive immune responses. Recent studies have shown that IL-21 can promote functional activation of various immune cells in the process of hepatitis B virus (HBV) infection, and the gene polymorphisms of IL-21 is associated with the susceptibility to HBV. In addition, the expression of IL-21 is closely associated with HV genotype, HBV clearance, HBeAg seroconversion, HBV-related liver cirrhosis, liver failure, liver cancer, and autoimmune disease. This article reviews the research advances in clinical trials with reference to the aspects above.

The formation of H bubbles at small-angle tilt grain boundaries in W films

The accumulation of H at the small-angle tilt grain boundary (GB) in the W(001) surface is investigated, on the basis of the first-principles calculations. By exploring the solution and diffusion behaviors of H at the GB, we find that the small-angle GB can capture the H atoms nearby, serving as a nucleation site of H bubbles. With the increasing number of trapped H atoms, the GB expands gradually, and the GBs can be unripped with an areal density of H up to 5.0 × 10¹⁵ H atoms per cm², leading to the formation of H bubbles. Moreover, H₂ molecules are observed, when the areal density of H atoms in GB is over 6.6 × 10¹⁵ atoms per cm². According to our calculations, we propose a possible formation mechanism of H bubbles observed in the experiment, which is valuable for improving the service performance of W as a plasma-facing material in nuclear fusion reactors.

Effect of iguratimod and methotrexate on RANKL and OPG expression in serum and IL-1β-induced fibroblast-like synoviocytes from patients with rheumatoid arthritis

The receptor activator of nuclear factor κB ligand (RANKL)/receptor activator of nuclear factor κB (RANK)/osteoprotegerin (OPG) system plays a key role in rheumatoid arthritis (RA)-associated bone erosion. The upregulation of the RANKL/OPG ratio promotes bone erosion. The objective of this study is to explore the effects of iguratimod, a small-molecule disease-modifying antirheumatic drug (DMARD), alone or in combination with methotrexate (MTX), on RANKL and OPG expression in RA. We performed an enzyme-linked immunosorbent assay (ELISA) to investigate the modulatory effects of iguratimod, MTX, or their combination on serum RANKL and OPG levels of patients with RA before and after treatment for 12 and 24 weeks. Furthermore, fibroblast-like synoviocytes (FLS) from patients with RA were interleukin (IL)-1β-stimulated and then treated with different concentrations of iguratimod, MTX, or both, and RANKL and OPG expressions were investigated by using ELISA, quantitative real-time polymerase chain reaction (qPCR) and western blot analysis. We found that RANKL levels and the RANKL/OPG ratio significantly decreased in both serum and IL-1β-induced RA FLS after treatment. Moreover, combination therapy with iguratimod and MTX showed an even stronger inhibition than each drug alone did. Our results suggest that iguratimod and MTX, especially in combination, efficaciously protected against bone erosion by suppressing the production of RANKL.

[Association of Crohn's disease with transcobalamin Ⅱ gene polymorphisms and serum homocysteine, folate and vitamin B12 levels in Chinese patients]

OBJECTIVE

To investigate the association of Crohn's disease (CD) with transcobalamin Ⅱ (TCN2) gene polymorphisms and serum homocysteine (Hcy), folate, and vitamin B12 levels in Chinese patients.

METHODS

In a total of 307 CD patients (CD group) and 574 healthy controls (control group) of Han ethnicity selected at 4 hospitals in Wenzhou between January 2007 and August 2015, TCN2 gene polymorphisms (rs1801198, C/G; rs9606756, A/G) in peripheral blood were determined using improved multiple ligase detection reaction (iMLDR). The Simplified Crohn's Disease Activity Index (CDAI) was applied to evaluate activity of CD. Eighty-eight CD patients and 138 age- and sex-matched controls were randomly selected from all the study subjects using computer-generated random numbers, in whom serum Hcy level was tested by enzymatic cycling assay, folate and vitamin B12 levels were examined by chemiluminescence immunoassay.

RESULTS

(1) The mutant allele (G) and genotype (CG+ GG) of rs1801198 were not significantly different between the CD group and the control group (both P>0.05), but more prevalent in patients with stricturing CD than in controls (65.75% vs 56.10%, 93.15% vs 82.40%, both P<0.05). The frequencies of mutant allele (G) and heterozygous genotype (AG) of rs9606756 were higher in CD patients than in controls (2.44% vs 1.05%, 4.89% vs 2.09%, both P<0.05), also higher in patients with stricturing CD or ileocolonic CD compared with controls (stricturing CD: 4.79% vs 1.05%, 9.59% vs 2.09%; ileocolonic CD: 3.18% vs 1.05%, 6.36% vs 2.09%; all P<0.05). The two polymorphic loci (rs1801198 and rs9606756) were shown to be in a weak linkage disequilibrium. The frequency of haplotype (GG) was higher in the CD patients than in the controls (2.23% vs 0.81%, P<0.05). (2) When compared with the controls, the serum Hcy level was higher in the CD patients (P=0.023), whereas the folate and vitamin B12 levels were decreased in the CD patients (both P<0.001). The prevalence of hyperhomocysteinemia (Hcy >15 μmol/L), folate deficiency (folate <4 μg/L) and vitamin B12 deficiency (<203 ng/L) were higher in the CD patients than in the controls (18.18% vs 4.35%, 27.27% vs 5.07%, 31.82% vs 5.07%, all P<0.01). Compared to the patients at remission stage (CDAI<5), the serum Hcy level was increased in those at active stage (CDAI≥5) (P=0.005), while the folate and vitamin B12 levels were decreased in the patients ate active stage (both P<0.05). (3) According to the results of multivariate linear regression analysis, average Hcy level in the CD patients was negatively associated with folate level (β=-0.494, P<0.001), while positively correlated with percentage of neutrophils (β=0.294, P=0.004). Unconditional Logistic regression showed that both folate deficiency and vitamin B12 deficiency were independent risk factors for CD (OR=5.415, OR=7.112, both P<0.001).

CONCLUSIONS

TCN2 rs1801198 mutation might be associated with increased risk of stricturing CD. TCN2 rs9606756 mutation might be a potential functional locus to affect CD susceptibility. Individuals carrying the haplotype (GG) formed by TCN2 (rs1801198 and rs9606756) seem to be at higher risk of developing CD. Hyperhomocysteinemia, folate deficiency, and vitamin B12 deficiency are prevalent in this cohort of CD patients of Han ethnicity from Zhejiang province. Both folate deficiency and vitamin B12 deficiency are independent risk factors for CD.