Significance of high-sensitivity polymerase chain reaction in detecting hepatitis B virus in chronic hepatitis B patients with a very low viral load / 临床肝胆病杂志

ObjectiveTo investigate the significance of high-sensitive polymerase chain reaction （PCR） in detecting hepatitis B virus （HBV） among the population with a very low viral load （HBV DNA 10‍ — ‍99 IU/mL）. MethodsThis study was conducted among the chronic hepatitis B （CHB） patients who were treated with nucleos（t）ide analogues for ≥48 weeks in The Fifth Affiliated Hospital of Guangzhou Medical University from September 2019 to February 2022 and had an HBV DNA load below the lower limit of ordinary-sensitivity detection （100 IU/mL）. Then high-sensitivity HBV DNA detection was performed for all patients， and according to these results， the patients were divided into very low viral load group （VLVL group with an HBV DNA load of 10‍ — ‍99 IU/mL） and complete virologic response group （CVR group with an HBV DNA load of <10 IU/mL or without HBV DNA detected）. The two groups were compared in terms of general characteristics， serum virological indicators， biochemical parameters， and noninvasive fibrosis markers； the value of related serum virological indicators in predicting the results of high-sensitivity HBV DNA above the lower limit of detection were assessed； the influencing factors for failure to achieve CVR were analyzed. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The receiver operating characteristic （ROC） curve was used to investigate the value of related serum virological indicators in predicting the results of high-sensitivity HBV DNA above the lower limit of detection， and a binary logistic regression analysis was used to investigate the influencing factors for failure to achieve CVR. ResultsA total of 106 CHB patients were enrolled， with 24 in the VLVL group and 82 in the CVR group. Compared with the CVR group， the VLVL group had a significantly younger age （P=0.004） and significantly higher quantitative hepatitis B surface antigen （qHBsAg） level （P=0.002）， HBeAg positive rate （P=0.002）， pgRNA positive rate （P=0.010）， and alanine aminotransferase level （P=0.017）. The qHBsAg level had an area under the ROC curve of 0.717 （P=0.002） in predicting the results of high-sensitivity HBV DNA above the lower limit of detection （>10 IU/mL）， with an optimal cut-off value of 1 214.5 IU/mL， a sensitivity of 95.5%， and a specificity of 53.9%. Positive HBeAg （odds ratio ［OR］=3.654， 95% confidence interval ［CI］： 1.162‍ —‍ ‍11.489， P=0.027） and qHBsAg （OR=2.985， 95%CI： 1.058‍ — ‍8.422， P=0.039） were independent influencing factors for failure to achieve CVR. ConclusionSome CHB patients have an HBV DNA load of <100 IU/mL by ordinary-sensitivity detection， but with the presence of VLVL determined by high-sensitivity PCR. The VLVL group had significantly higher level of inflammatory damage and positive rates of pgRNA and HBeAg. Positive HBeAg and high qHBsAg level are independent influencing factors for failure to achieve CVR. Clinicians should not ignore the presence of VLVL in CHB patients， and high-sensitivity HBV DNA detection should be performed in a timely manner.

A close contact of coronavirus disease 2019 with severe imported malaria: a case report / 中国血吸虫病防治杂志

This article presents a severe cerebral malaria patient in shock with a close contact of COVID-19 that was successfully cured in a negative pressure ward during the global pandemic of COVID-19. The patient experienced a sudden onset of high fever and coma in a designated isolation hotel after returning from Africa, and was transferred to a designated hospital. Following antimalarial therapy, blood pressure elevation, increase of blood volume, bedside hemodialysis, mechanical ventilation, plasma and platelet transfusions, the case gradual recovered.

Dynein axonemal heavy chain 10 deficiency causes primary ciliary dyskinesia in humans and mice / 医学前沿

Primary ciliary dyskinesia (PCD) is a congenital, motile ciliopathy with pleiotropic symptoms. Although nearly 50 causative genes have been identified, they only account for approximately 70% of definitive PCD cases. Dynein axonemal heavy chain 10 (DNAH10) encodes a subunit of the inner arm dynein heavy chain in motile cilia and sperm flagella. Based on the common axoneme structure of motile cilia and sperm flagella, DNAH10 variants are likely to cause PCD. Using exome sequencing, we identified a novel DNAH10 homozygous variant (c.589C > T, p.R197W) in a patient with PCD from a consanguineous family. The patient manifested sinusitis, bronchiectasis, situs inversus, and asthenoteratozoospermia. Immunostaining analysis showed the absence of DNAH10 and DNALI1 in the respiratory cilia, and transmission electron microscopy revealed strikingly disordered axoneme 9+2 architecture and inner dynein arm defects in the respiratory cilia and sperm flagella. Subsequently, animal models of Dnah10-knockin mice harboring missense variants and Dnah10-knockout mice recapitulated the phenotypes of PCD, including chronic respiratory infection, male infertility, and hydrocephalus. To the best of our knowledge, this study is the first to report DNAH10 deficiency related to PCD in human and mouse models, which suggests that DNAH10 recessive mutation is causative of PCD.

Hepatic arterial transplantation of autologous bone marrow mesenchymal stem cells in treatment of decompensated liver cirrhosis / 中国组织工程研究

BACKGROUND:Autologous bone marrow mesenchymal stem cel s can treat decompensated liver cirrhosis, however, little evidence has addressed the control ed clinical research in hepatitis B patients with decompensated live cirrhosis. OBJECTIVE:To evaluate the clinical efficacy and safety of autologous bone marrow mesenchymal stem cel s in the treatment of hepatitis B with decompensated live cirrhosis. METHODS:A total of 67 hepatitis B patients with decompensated live cirrhosis were divided into two groups according to their wishes to receive stem cel transplantation. The control group (34 patients) only received oral administration of nucleoside analog antivirus and supportive treatment. The treatment group (33 patients) received autologous bone marrow mesenchymal stem cel s transplantation via hepatic artery plus antivirus and supportive treatment. The liver functional index, clinical signs and symptoms, adverse reactions were observed and compared at 4, 12, 24 weeks after treatment. RESULTS AND CONCLUSION:After treatment, al patients’ symptoms were improved to varying degrees. After 4 weeks of treatment, the liver functional indexes were al significantly improved compared with before treatment, the levels of alanme aminotransferase, cholinesterase and prothrombin activity in treatment group were significantly ameliorated compared with control group (P<0.05). At 12 and 24 weeks of treatment, the alanme aminotransferase, albumin, total bilirubin, cholinesterase and prothrombin activity in control group and treatment group showed statistical y significant differences compared with before treatment (P<0.05). At the same time point, al the indicators in the treatment group were significantly ameliorated compared with control group (P<0.05). The Child-pugh score and model for end-stage liver disease score declined at 4, 12, 24 weeks after treatment, showing significant differences compared with before treatment. The difference was also significant at the same time point between two groups. The treatment of nucleoside analogue antivirus combined with autologous bone marrow mesenchymal stem cel s transplantation on hepatitis B patients with decompensated liver cirrhosis is an effective method to improve liver function and blood coagulation function, with symptom improvement, safety and low risk.

The relationship of tension and blood flow of the expanded pedicled fasciocutaneous flap in pig / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of wound closure tension on the blood flow of the expanded pedicled fasciocutaneous flap, so as to find the best tension for the blood supply of the flap.</p><p><b>METHODS</b>8 piglets, aged 9-12 months, were used. On each side of pig back, a cephalic based expanded fasciocutaneous flap was designed. The size of the flaps was 5 cm x 20 cm. In the control group, the flaps were not elevated (0 g tension). In the experimental group, the flaps were treated at the end with the tension of 100, 200, 300, 400, 500, 600, 700, 800, and 900 g after elevation. The blood oxygen saturation (StO2) of the flaps was measured under different wound closure tension.</p><p><b>RESULTS</b>The flap StO2 raised along the increase of tension until the tension reached 200-300 g. Then the flap StO2 decreased when the tension continued to increase above 200-300 g.</p><p><b>CONCLUSIONS</b>The tension of 200-300 g is good for the blood flow of expanded pedicled fasciocutaneous flap. So the flap flexibility can be best used and the complication can be avoided.</p>

Effects of Saponin B from Anemarrhena asphodeloides Bunge on tau hyperphosphorylation induced by beta-amyloid peptide (25-35) in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the changes in the expressions of p53, DKK (the inhibitor of Wnt pathway) and phosphorylated tau in rat bilateral hippocampus after beta-amyloid peptide (beta-AP) (25-35) injection, and observe the effect of saponin B from Anemarrhena asphodeloides Bunge (SAaB) in this model.</p><p><b>METHODS</b>After bilateral injection of beta-AP (25-35) into the hippocampus of rats, RT-PCR was performed for observing the changes in p53 and DKK mRNA expressions and immunochemistry carried out to detect the changes in phosphorylated tau protein.</p><p><b>RESULTS</b>RT-PCR showed increased p53 and DKK mRNA expression and immunochemistry revealed increased phosphorylated tau-positive cells in rat hippocampus after beta-AP (25-35) injection, and administration of SAaB significantly ameliorated these changes.</p><p><b>CONCLUSION</b>SAaB can significantly ameliorate beta-AP-induced tau hyperphosphorylation by inhibiting increased p53 and DKK mRNA expressions in response to beta-AP injection.</p>