A significant reduction in hepatitis B virus infection among the children of Shandong Province, China: the effect of 15 years of universal infant hepatitis B vaccination

AbstractObjectiveTo evaluate the effect of the universal infant hepatitis B vaccination program on hepatitis B infection in China.MethodsIn 2006, a survey was conducted in Shandong Province, China, among children aged 1–14 years, 15 years after the introduction of universal infant hepatitis B vaccination. The subjects were selected by stratified, multi-stage sampling. Vaccination history was obtained by immunization certificate (when available) or parent recall. Hepatitis B surface antigen (HBsAg) and antibodies to HBsAg (anti-HBs) and core antigen (anti-HBc) were detected by ELISA. Hepatitis B infection was defined as the presence of HBsAg and/or anti-HBc. The prevalence rates of HBsAg, anti-HBs and hepatitis B infection obtained in this survey were compared with the results of a survey conducted in 1992 (prior to universal vaccination).ResultsA total of 3738 children aged 1–14 years were included in the final analysis. A vaccination coverage rate of 93% was achieved in 2006. The prevalence rates of HBsAg and hepatitis B infection decreased from 8% and 46% in the 1992 survey to 1% and 4%, respectively, in the 2006 survey.ConclusionsUniversal hepatitis B vaccination in infants can result in a 90.47% reduction in hepatitis B infection in children aged 1–14 years

Atrial fibrillation of new onset during acute illness: prevalence of, and risk factors for, persistence after hospital discharge

Background Atrial fibrillation (AF) of new onset during acute illness (AFNOAI) has a variable incidence of 1%–44% in hospitalized patients. This study assesses the risk factors for persistence of AFNOAI in the 5 years after hospital discharge for critically ill patients. Methods This was a retrospective cohort study. All patients ≥18 years old admitted to the medical intensive care unit (MICU) of a tertiary care hospital from January 1, 2012, to October 31, 2015, were screened. Those designated with AF for the first time during the hospital admission were included. Risk factors for persistent AFNOAI were assessed using a Cox’s proportional hazards model. Results Two-hundred and fifty-one (1.8%) of 13,983 unique MICU admissions had AFNOAI. After exclusions, 108 patients remained. Forty-one patients (38%) had persistence of AFNOAI. Age (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.01–1.08), hyperlipidemia (HR, 2.27; 95% CI, 1.02–5.05) and immunosuppression (HR, 2.29; 95% CI, 1.02–5.16) were associated with AFNOAI persistence. Diastolic dysfunction (HR, 1.46; 95% CI, 0.71–3.00) and mitral regurgitation (HR, 2.00; 95% CI, 0.91–4.37) also showed a trend towards association with AFNOAI persistence. Conclusions Our study showed that AFNOAI has a high rate of persistence after discharge and that certain comorbid and cardiac factors may increase the risk of persistence. Anticoagulation should be considered, based on a patient’s individual AFNOAI persistence risk

Natural compounds from botanical drugs targeting mTOR signaling pathway as promising therapeutics for atherosclerosis: A review

Atherosclerosis (AS) is a chronic inflammatory disease that is a major cause of cardiovascular diseases (CVDs), including coronary artery disease, hypertension, myocardial infarction, and heart failure. Hence, the mechanisms of AS are still being explored. A growing compendium of evidence supports that the activity of the mechanistic/mammalian target of rapamycin (mTOR) is highly correlated with the risk of AS. The mTOR signaling pathway contributes to AS progression by regulating autophagy, cell senescence, immune response, and lipid metabolism. Various botanical drugs and their functional compounds have been found to exert anti- AS effects by modulating the activity of the mTOR signaling pathway. In this review, we summarize the pathogenesis of AS based on the mTOR signaling pathway from the aspects of immune response, autophagy, cell senescence, and lipid metabolism, and comb the recent advances in natural compounds from botanical drugs to inhibit the mTOR signaling pathway and delay AS development. This review will provide a new perspective on the mechanisms and precision treatments of AS

Stratifying chronic stroke patients based on the influence of contralesional motor cortices: an inter-hemispheric inhibition study

Objective: A recent “bimodal-balance recovery” model suggests that contralesional influence varies based on the amount of ipsilesional reserve: inhibitory when there is a large reserve, but supportive when there is a low reserve. Here, we investigated the relationships between contralesional influence (inter-hemispheric inhibition, IHI) and ipsilesional reserve (corticospinal damage/impairment), and also defined a criterion separating subgroups based on the relationships. Methods: Twenty-four patients underwent assessment of IHI using Transcranial Magnetic Stimulation (ipsilateral silent period method), motor impairment using Upper Extremity Fugl-Meyer (UEFM), and corticospinal damage using Diffusion Tensor Imaging and active motor threshold. Assessments of UEFM and IHI were repeated after 5 week-rehabilitation (n=21). Results: Relationship between IHI and baseline UEFM was quadratic with criterion at UEFM 43 (95%conference interval: 40-46). Patients less impaired than UEFM=43 showed stronger IHI with more impairment, whereas patients more impaired than UEFM=43 showed lower IHI with more impairment. Of those made clinically-meaningful functional gains in rehabilitation (n=14), more-impaired patients showed further IHI reduction. Conclusions: A criterion impairment-level can be derived to stratify patient-subgroups based on the bimodal influence of contralesional cortex. Contralesional influence also evolves differently across subgroups following rehabilitation. Significance: The criterion may be used to stratify patients to design targeted, precision treatments

Application of artificial intelligence-assisted compressed sensing combined with three types of fat-suppressed T₂WI techniques

Objective To explore the advantages of artificial intelligence-assisted compressed sensing （ACS） combined with three types of fat-suppressed T2WI techniques in image quality， scanning time and scheme selection. Methods In 30 patients with low back pain who underwent conventional lumbar magnetic resonance imaging （MRI） plain scan， ACS combined with 5 groups of sagittal （SAG） fat-suppressed T2WI sequences were added to original examination sequence. Frequency-selective fat saturation （FS）， water-fat separation （WFI） and short tau inversion recovery （STIR） techniques were employed. ACS-SAG-T2WI-FS （group A， n=30）， Acs-SAG-T2WI-WFI （group B， n=30）， ACS-SAG-STIR （group C n=30）， SAG-T2WI-FS （group D， n=30）， SAG-T2WI-WFI （group E， n=30） and SAG-STIR sequences （group F， n=30） were employed. Objective evaluation indicators of signal-to-noise ratio （SNR） and contrast-to-noise ratio （CNR） and subjective evaluation by two radiologists were carried out to assess the effect. Results The SNR and CNR of the fourth vertebra， the fourth and fifth intervertebral discs and the same spinal cord in group A were higher than those in group D. The SNR and CNR of the fourth vertebra， the fourth and fifth intervertebral discs， and the same spinal cord in group B were higher than those in group E. The SNR and CNR of the fourth vertebra， the fourth and fifth intervertebral discs， and the same spinal cord in group C were higher compared with those in group F （all P < 0.01）. The imaging time in group A was shortened by 13.2% compared with that in group D. The imaging time in group B was reduced by 8.9% compared with that in group E. The imaging time in group C was reduced by 12.4% compared with that in group F （all P < 0.01）. The subjective scores by two radiologists for groups A， B and C were significantly higher than those in groups D， E and F （all P < 0.01；The scores of the two physicians were consistent， Kappa=0.972， P <0.01）. Conclusions The combination of ACS and three types of fat-suppressed T2WI techniques （FS， WFI and STIR） is superior to use of fat-suppressed T2WI techniques alone. ACS-SAG-T2WI-FS sequence is recommended with the shortest imaging time and the highest image quality. ACS-SAG-T2WI-WFI sequence provides multiple groups of phase images， and the time advantage difference is the second choice. ACS-SAG-STIR sequence has the most stable fat-suppression capability， which can be used as the last option

Plasma levels of high density lipoprotein cholesterol and outcomes in chronic thromboembolic pulmonary hypertension.

BACKGROUND:High Density Lipoprotein Cholesterol (HDL-C) has various anti-inflammatory, anti-atherogenic, anti-oxidant and anti-coagulant properties that improve vascular function. The utility of HDL-C as a biomarker of severity and predictor of survival was described in patients with pulmonary arterial hypertension (PAH). No prior study has assessed the utility of HDL-C in patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH). OBJECTIVES:We aim to measure HDL-C levels in CTEPH patients and compare it to those in PAH patients and controls and determine HDL-C associations with markers of disease severity, hemodynamics and mortality in CTEPH. METHODS:We retrospectively included patients with CTEPH, identified from the Cleveland Clinic Pulmonary Hypertension Registry. All patients had right heart catheterization (RHC) and imaging studies consistent with CTEPH. We collected demographics, co-morbidities, baseline laboratory data including plasma HDL-C, six-minute walk test (6MWT), echocardiography and RHC. HDL-C levels were compared to a cohort of patients with cardiovascular risk factors and a previously published PAH cohort. RESULTS:HDL-C levels were available for 90 patients with CTEPH (age: 57.4±13.9 years; female 40%), 69 patients with PAH (age: 46.7±12.8 years; female 90%) and 254 control subjects (age: 56.7±13 years; female 48%). HDL-C levels in CTEPH patients were lower compared to controls and higher compared to PAH patients (median, IQR: CTEPH: 44, 34-57 mg/dl; PAH: 35.3, 29-39 mg/dl; Control: 49, 40-60 mg/dl; p < 0.01 for both pairwise comparisons). In CTEPH, higher HDL-C was associated with decreased prevalence of right ventricular dilation on echocardiography (p = 0.02). 57 patients with CTEPH underwent pulmonary thromboendarterectomy, higher HDL-C was associated with a larger decrement in postoperative pulmonary vascular resistance (PVR) (r = 0.37, p = 0.049). HDL-C was not associated with mortality or other markers of disease severity. CONCLUSIONS:HDL-C levels in CTEPH patients were lower compared to control subjects, but higher compared to PAH patients. Higher HDL-C in CTEPH was associated with less right ventricular dilation and greater decrement in postoperative PVR. These data suggest that HDL-C may be a useful marker of small vessel disease in CTEPH

A 2D Porous Zinc-Organic Framework Platform for Loading of 5-Fluorouracil

A hydrostable 2D Zn-based MOF, {[Zn(5-PIA)(imbm)]·2H2O}n (1) (5-H2PIA = 5-propoxy-isophthalic acid, imbm = 1,4-di(1H-imidazol-1-yl)benzene), was synthesized and structurally characterized. Complex 1 shows good water and thermal stability based on the TGA and PXRD analyses and displays a 2D framework with 1D channels of 4.8 × 13.8 and 10.0 × 8.3 Å2 along the a axis. The 5-fluorouracil (5-FU) payload in activated complex 1 (complex 1a) is 19.3 wt%, and the cumulative release value of 5-FU at 120 h was about 70.04% in PBS (pH 7.4) at 310 K. In vitro MTT assays did not reveal any cytotoxic effect of NIH-3T3 and HEK-293 cells when the concentration of 1 was below 500 μg/mL and 5 μg/mL, respectively. No morphological abnormalities were observed on zebrafish exposed to complex 1

Measurement error and reliability of TMS metrics collected from biceps and triceps in individuals with chronic incomplete tetraplegia

Transcranial magnetic stimulation (TMS) is used to investigate corticomotor neurophysiology associated with functional recovery in individuals with spinal cord injury (SCI). There is insufficient evidence about test–retest measurement properties of TMS in SCI. Therefore, we investigated test–retest agreement and reliability of TMS metrics representing corticomotor excitability, output, gain, map (representation), and inhibition in individuals with cervical SCI. We collected TMS metrics from biceps and triceps muscles because of the relevance of this proximal muscle pair to the cervical SCI population. Twelve individuals with chronic C3–C6 SCI participated in two TMS sessions separated by ≥ 2 weeks. Measurement agreement was evaluated using t tests, Bland–Altman limits of agreement and relative standard error of measurement (SEM%), while reliability was investigated using intra-class correlation coefficient (ICC) and concordance correlation coefficient (CCC). We calculated the smallest detectable change for all TMS metrics. All TMS metrics except antero-posterior map coordinates and corticomotor inhibition were in agreement upon repeated measurement though limits of agreement were generally large. Measures of corticomotor excitability, output and medio-lateral map coordinates had superior agreement (SEM% \u3c 10). Metrics representing corticomotor excitability, output, and inhibition had good-to-excellent reliability (ICC/CCC \u3e 0.75). The smallest detectable change for TMS metrics was generally high for a single individual, but this value reduced substantially with increase in sample size. We recommend use of corticomotor excitability and recruitment curve area owing to their superior measurement properties. A modest group size (20 or above) yields more stable measurements, which may favor use of TMS metrics in group level modulation after SCI