Identified OAS3 gene variants associated with coexistence of HBsAg and anti-HBs in chronic HBV infection.

The underlying mechanism of coexistence of hepatitis B surface antigen (HBsAg) and hepatitis B surface antigen antibody (anti-HBs) is still controversial. To identify the host genetic factors related to this unusual clinical phenomenon, a two-stage study was conducted in the Chinese Han population. In the first stage, we performed a case-control (1:1) age- and gender-matched study of 101 cases with concurrent HBsAg and anti-HBs and 102 controls with negative HBsAg and positive anti-HBs using whole exome sequencing. In the second validation stage, we directly sequence the 16 exons on the OAS3 gene in two dependent cohorts of 48 cases and 200 controls. Although, in the first stage, a genome-wide association study of 58,563 polymorphism variants in 101 cases and 102 controls found no significant loci (P-value ≤ .05/58563), and neither locus achieved a conservative genome-wide significance threshold (P-value ≤ 5e-08), gene-based burden analysis showed that OAS3 gene rare variants were associated with the coexistence of HBsAg and anti-HBs. (P-value = 4.127e-06 ≤ 0.05/6994). A total of 16 rare variants were screened out from 21 cases and 3 controls. In the second validation stage, one case with a stop-gained rare variant was identified. Fisher's exact test of all 149 cases and 302 controls showed that the rare coding sequence mutations were more frequent in cases vs controls (P-value = 7.299e-09, OR = 17.27, 95% CI [5.01-58.72]). Protein-coding rare variations on the OAS3 gene are associated with the coexistence of HBsAg and anti-HBs in patients with chronic HBV infection in Chinese Han population.

[Effect of nicorandil on ventricular arrhythmia in patients with acute ST-segment elevation myocardial infarction underwent emergent percutaneous coronary intervention treatment].

Objective: To investigate the effect of nicorandil on ventricular arrhythmia in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with emergent percutaneous coronary intervention (PCI). Methods: A total of 120 acute STEMI patients treated with emergent PCI in our hospital from January 2015 to June 2016 were randomly divided into control group and experiment group (n=60 each). Patients in both groups received conventional therapy.Patients in experiment group took 10 mg nicorandil orally before PCI and received oral nicorandil treatment (15 mg/d, three times daily) for 3 days.QT disperse(QTd), correct QTd(QTcd) and the occurrence rate of ventricular arrhythmia were compared between two groups. Results: QTd at 6, 24, 48 and 72 hours((70.6±4.4), (67.2±5.3), (55.7±8.5), (48.2±8.2) ms, respectively) after PCI was significantly lower in the experiment group than those of control group ((77.1±7.1), (71.3±6.5), (65.1±8.1), (57.2±5.4) ms, all P<0.05). The level of QTd was also significantly lower in the experiment group at 6, 24, 48 and 72 hours((77.5±7.7), (67.7±8.6), (61.2±7.5), (52.9±8.4) ms, respectively) after PCI comared to those of control group ((88.6±8.1), (79.2±7.8), (74.4±7.4), (69.6±8.6) ms, all P<0.05). There was no significant difference in the incidence of reperfusion arrhythmia during PCI procedure between the two groups.The prevalence of the ventricular premature beat in the experiment group (25/60, 41.7%) was significantly lower than in the control group(45/60, 75.0%) within 3 days after PCI(P<0.01), the prevalence of the no sustained ventricular tachycardia and ventricular fibrillation in the experiment group(6/60, 10.0%) was also significantly lower than in the control group (18/60, 30.0%, P<0.01) within 3 days after PCI. Conclusions: Nicorandil use prior and post PCI could decrease the occurrence rate of ventricular arrhythmia in STEMI patients undergoing emergent PCI, and this effect might be related with reduced QTd and QTcd post medication.

Analytical performance of the Abbott Architect i2000 tacrolimus assay in Chinese patients after renal transplantation.

BACKGROUND: Monitoring of tacrolimus concentrations has played a crucial role to control the efficacy versus adverse effects of treatment, because of the drug's narrow therapeutic range, inter- and intraindividual variabilities, and drug interactions mediated by hepatic cytochrome P450. Therefore, the stability of methods to monitor tacrolimus is of major importance. This study evaluated the analytical performance of the Abbott Architect i2000 tacrolimus assay, which was recently released in China to monitor tacrolimus therapy. We compared the results using the Abbott Architect i2000 Tacrolimus assay with the traditional Abbott IMx method. METHODS: We measured concentrations of tacrolimus in 100 samples from renal transplant patients by Architect i2000 and the commonly used Abbott IMx. RESULTS: We observed that the total %CV of the Architect i2000 assay was <10%, both at low and high concentration levels, with a functional sensitivity of <0.5 ng/mL. The Architect i2000 assay was linear over the reportable range with recoveries ranging from 90.6% to 106.7%. In addition, this assay was not affected by high concentrations of hemoglobin, lipids, or bilirubin in the samples. The 2 assays yielded similar results. The regression equation obtained from the Passing Bablok analysis was: y = 0.8788x - 0.3485 with a Spearman correlation coefficient (r) of 0.9922. The bias plot between the Architect i2000 and Abbott IMx assay yielded an average negative bias (-1.4 ng/mL). CONCLUSION: We concluded that, because of its high precision and sensitivity, low cross-reactivity, and acceptable accuracy, the Architect i2000 assay is a suitable alternative to monitor tacrolimus concentrations in renal transplant recipients.

Modified Wicomb's apparatus for preservation of heart for 24 hours.

To prolong the time of heart preservation, we modified the Wicomb's perfusion apparatus, in which oxygen flow acts as the source of power and provides oxygenation for the perfused myocardium. Ten adult porcine hearts which had been preserved for 24 hours were resuscitated successfully and continued to beat steadily for more than 1.5-3 hours after reperfusion. Myocardial ultrastructure was observed at the end of preservation and 15-120 minutes after reperfusion. The damages of the myocardial ultrastructure at the end of preservation were reversible.

[Endocarditis after extracorporeal circulation surgery].

Between January, 1976 and April 1988, 1279 patients underwent open-heart operation in Ren Ji Hospital. Thirty three patients were complicated by infective endocarditis postoperatively, an incidence of 2.58%. Medical treatment was carried out in 29 cases and thirteen were cured. In another three patients of valve prosthetic endocarditis, replacement of prosthetic valve was necessary for their cure. In our series, Gram negative bacilli had been proved by blood culture, autopsy and arterial thrombi in thirteen patients and candida in four, mixed infection in five and staphylococcus aureus in only one case. One should not rely on positive blood culture for the diagnosis. Echocardiographic studies are helpful to early diagnosis and proper treatment. The presence of vegetation or signs of prosthetic valve failure are strong indication for reoperation. In prevention, in addition to strict aseptic technic in the operating room, special emphasis should be focused on the preventive administration of sensitive antibiotics against hospital borne pathogens. All indwelling catheters in arteries and veins, tracheal tubes and urethral catheters should be removed after 72 hours. Efforts to prevent infection after reoperation are important measures for the prevention of infective endocarditis after open-heart operation.