[Non/hypo-response to hepatitis B vaccination and influencing factors in HIV-infected patients in the context of different immunization schedules].

Objective: To study the non/hypo-response to hepatitis B vaccination in HIV-infected patients, identify the influencing factors and provide evidence for the development of hepatitis B prevention and control strategies and measures for special population. Methods: On the basis of the randomized controlled trial of 20 µg hepatitis B vaccine immunization at 0-1-6 month, 0-1-2-6 month and 60 µg hepatitis B vaccine immunization at 0-1-2-6 month, the HIV-infected patients who completed one-month follow-up after the full course vaccination were selected as study subjects. Quantification of antibody to hepatitis B surface antigen (anti-HBs) in serum samples was performed by using chemiluminescent microparticle immunoassay (CMIA) and demographic characteristics, disease history, HIV infection and treatment status of the study subjects were collected. Statistical analysis was conducted by χ2 test, t test, unconditional logistic regression and interaction analyses. Results: The non/hypo-response rates to hepatitis B vaccination were 34.65% (35/101), 24.49% (24/98) and 10.99% (10/91) in 20 µg group at 0-1-6 month or 0-1-2-6 month and 60 µg group at 0-1-2-6 month (P<0.001), respectively. Logistic regression analysis showed that after controlling for confounding factors, the risk for non/hypo-response was 0.22 times higher in HIV-infected patients receiving 60 µg hepatitis B vaccine at 0-1-2-6 month than in patients receiving 20 µg hepatitis B vaccine at 0-1-6 month (95%CI: 0.10-0.50), the risk for non/hypo-response was higher in men than in women (OR=3.65, 95%CI: 1.88-7.07), and the risk for non/hypo-response was 2.64 times higher in those without hepatitis B vaccination history than in those with hepatitis B vaccination history (95%CI: 1.10-6.32). Moreover, there were multiplicative interactions between immunization schedule and gender (OR=2.49, 95%CI: 1.24-5.00). Conclusion: The non/hypo-response rate to hepatitis B vaccination was significantly lower in HIV-infected patients receiving 60 µg hepatitis B vaccine at 0-1-2-6 month than in those receiving 20 µg hepatitis B vaccine at 0-1-6 month and 0-1-2-6 month. Gender, vaccination schedule and history of hepatitis B vaccination were the influencing factors of the non/hypo-response to hepatitis B vaccination. There was a multiplicative interaction between vaccination schedule and gender, and men receiving 20 µg hepatitis B vaccines had a higher risk for non/hypo-response to hepatitis B vaccination.

[Totally endoscopic sublay repair (TES)--a novel approach to repair midline ventral hernia].

Objective: Investigating a novel approach to treat a midline ventral hernia--totally endoscopic sublay repair (TES). The procedure will be described in detail and the safety and efficacy evaluated. Methods: During July and December 2017, eleven consecutive cases of primary and secondary epigastric midline ventral hernias were repaired using the TES procedure. A large mesh should be placed in the retrorectus position using this minimally invasive procedure. The indications for this procedure include umbilical, epigastric and incisional hernia equal in length to the rectus diastasis. Results: All operations were successful without open conversion. The mean operation time was 120 mins(80-205 min), postoperative pain was mild and the mean VAS was 2.5 on first postoperative day. The average postoperative stay in hospital was 3.3 days (2-5 days). 2 cases experienced postoperative seroma but without adverse effect on the final outcome and no recurrences during the follow-up period of 1 to 6 months. Conclusions: TES procedure is safe, practical and minimally invasive requiring no specific device and highly reproducible. Besides there is no need for expensive anti-adhesion mesh and fixation tacker which make it more cost effective. TES is a good technique for the surgical treatment of midline ventral hernia.

Early diagnostic and prognostic utility of high-sensitive troponin assays in acute myocardial infarction: a meta-analysis.

BACKGROUND/AIM: To determine the diagnostic and prognostic utility of high-sensitive troponin assays in the very early phase of acute myocardial infarction (AMI) (less than 3 h since symptoms onset) by performing a meta-analysis of prospective studies. METHODS: Relevant studies were identified by searches of MEDLINE and Elsevier Sciencedirect until 31 January 2014 and by reviewing the reference lists from retrieved articles. Prospective studies that reported diagnostic utility in AMI using both high-sensitive troponin assays and conventional cardiac troponin, and reported the estimates of hazard ratio (HR) with 95% confidence intervals (CI) for prognostic utility were included. Data were extracted independently by two authors and summary estimates of association were obtained using a random effects model. RESULTS: Of the seven studies included, four studies reported the diagnostic utility of high-sensitive troponin assays (2863 patients) and three reported the prognostic utility in AMI (2329 patients). Within 12 h of symptoms onset, the pooled sensitivity and specificity of high-sensitive troponin assays were 0.89 (95% CI 0.85-0.91) and 0.89 (95% CI 0.85-0.92), respectively, and within 3 h, the pooled sensitivity and specificity of high-sensitive troponin assays were 0.79 (95% CI 0.71-0.85) and 0.92 (95% CI 0.88-0.96) respectively. Compared with conventional cardiac troponin assays, the high-sensitive troponin assays had higher sensitivity (0.89 vs 0.72) but lower specificity (0.89 vs 0.95) in diagnosing AMI within 12 h of symptoms onset. Within 3 h, the sensitivity of high-sensitive troponin assays was still higher (0.79 vs 0.59), but the specificity was almost the same (0.92 vs 0.95) as that of conventional troponin assays. The elevated high-sensitive troponin assays had an overall pooled HR of 2.66 (95% CI 1.31-5.44) and 2.14 (95% CI 1.15-3.98) for the end-points of death and non-fatal AMI respectively. CONCLUSIONS: These findings provide quantitative data supporting high-sensitive troponin assays having early diagnostic and prognostic utility in AMI.

Expression, Purification and Functional Identification of Extracellular Part of Discoidin Domain Receptor 2.

Discoidin domain receptor 2 (DDR2) is a new type of receptor tyrosine kinases, and was thought to be involved in the metastasis of some tumors. Its ligand is fibrillar collagen. The activation of DDR2 induced by collagen mediates the over-expression of matrix metalloproteinase 1 (MMP-1) in cells. A specific inhibitor of DDR2 was necessary for the study of DDR2 function. Theoretically, a soluble receptor could possibly be used as specific inhibitor for the native receptor on cell membrane. In this report, a fragment (DB) of extracellular part of DDR2 was cloned and expressed for the use as potential inhibitor. This DB fragment corresponded to the polypeptide from the 23rd amino acid residue to the 293rd amino acid residue of DDR2. The fragment was amplified by RT-PCR from human lung cancer tissue, and the product was cloned into pMD18-T vector. After identification by sequence analysis, the fragment was sub-cloned into pGEX-4T-1 vector. Fusion protein of GST-DB was expressed in JM109 E.coli cells as expected and the soluble part accounted for about 13% of the total fusion protein. The soluble fusion protein was then purified with glutathione affinity resin, and GST-DB with purity of 86.1% was obtained. Competitive combination inhibitory test showed that the purified GST-DB inhibited the interaction between collagen II and DDR2 on the surface of RA synovial fibroblasts. Zymography analysis showed that the level of MMP-1 of both NIH 3T3 cell and RA synovial fibroblasts with collagen II-stimulation decreased after adding GST-DB fusion protein. The results indicated that the fusion protein GST-DB could inhibit the function of DDR2 on cells, and DDR2 might mediate collagen II-induced over-expression of MMP-1 in these cells.

Fusion Expression and Purification of OSBP PH Domain and Preliminary Analysis of Its Second Structure.

Oxysterol binding protein (OSBP) is a regulator of oxysteroid metabolism. To investigate the function and the structure-function relationship of OSBP, the recombinant vector OSBP PH-pRSET-A was transformed into E.coli JM109(DE3), and the strain highly expressing soluble 6His-OSBP PH domain in minimal medium were obtained. The fusion protein was purified by Ni(2 )-NTA agarose beads. The secondary structure of the purified 6His-OSBP PH domain fusion protein was analysed by circular dichronism. The results indicated the PH domain was composed of alpha-helix 7.2%, beta-pleated sheets 71.1% and radom coil 21.7%.