Circulating miR-122 Is a Predictor for Virological Response in CHB Patients With High Viral Load Treated With Nucleos(t)ide Analogs

Chronic hepatitis B (CHB) infection remains worldwide health problem. Antiviral treatment options for CHB patients include nucleos(t)ide analogs (NAs) and interferon. Most of the current biomarkers for predicting treatment response are virus-dependent. MicroRNA-122 is the most abundant liver-specific miRNA and has been identified involved in multiple liver physiology and pathology including hepatotropic virus infection. To identify the role of miR-122 in NA therapy, 80 CHB patients with high viral load (HVL) were enrolled and serum miR-122 levels at baseline, week 12 and week 24 were measured. Serum miR-122 levels were significantly lower in patients who developed virological response (VR), compared with non-VR group. Levels of miR-122 at week 12 and week 24 were determined to be independent prognostic indicators for a VR with satisfactory AUROC values at 0.812 and 0.800, respectively. During NA therapy, serum miR-122 level deceased steadily and an earlier reduction was observed in VR group, indicating early reduction of miR-122 level might increase the possibility of developing virological response. In conclusion, we identified the dynamic change of serum miR-122 level and miR-122 levels at week 12 and week 24 as independent predictors for VR in CHB patients with HVL treated with NAs

Impact of nucleos(t)ide analogues on quality of life in patients with chronic hepatitis B

ObjectiveTo investigate the impact of treatment with nucleos(t)ide analogues on quality of life (QoL) in patients with chronic hepatitis B (CHB), as well as proper nursing measures. MethodsA total of 102 CHB patients who were treated in Department of Infectious Diseases, Nanfang Hospital, Southern Medical University from March 2010 to July 2014 were enrolled and divided into continuous treatment group (54 patients) and drug withdrawal group (48 patients). The 36-item short-form health survey (SF-36) was used to measure QoL. The patients in the treatment group were evaluated before treatment and at 96 weeks of treatment, and those in the drug withdrawal group were evaluated at the time of drug withdrawal and at 48 weeks after drug withdrawal. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. The logistic regression analysis was performed for univariate and multivariate analyses. ResultsCompared with before treatment, the continuous treatment group had significant increases in the scores on the domains of physiological function, role physical, bodily pain, and general health after 96 weeks of antiviral therapy (physiological function: 94.91±7.11 vs 92.13±10.58, t=-2.924,P＜0.05; role physical: 81.94±24.96 vs 71.76±34.01, t=-2.623,P＜0.05; bodily pain: 87.72±8.64 vs 82.85±12.88, t=-3.576,P＜0.05; general health: 59.63±1459 vs 53.52±16.79, t=-3.786,P＜0.05). As for psychological quality, the continuous treatment group had a significant increase in the subscale of mental health (67.30±18.94 vs 75.56±15.53, t=-3.883,P＜0.001), while there were no significant improvements in other subscales. At 48 weeks after drug withdrawal, the drug withdrawal group had significant increases in role physical (84.20±18.97 vs 72.49±24.38, t=-2.768,P＜0.05), general health (69.28±22.94 vs 56.41±18.27, t=-3.206,P＜0.05), and mental health (75.02±16.03 vs 68.94±14.07, t=-2.078,P＜0.05). The multivariate analysis showed that marital status was associated with theimprovement in QoL after antiviral therapy (odds ratio=11.61, 95%CI:2.28-59.00,P=0.003); the unmarried patients had better improvements in QoL compared with the married ones, especially physiological function (t=-2.176,P=0.034), role physical (t=-2.173,P=0.034), and role emotional (t=-2.811,P=0.007). ConclusionAntiviral therapy can improve the QoL and mental health of CHB patients. Effective psychological intervention is necessary for CHB patients, especially married CHB patients

A noninvasive diagnostic model to assess nonalcoholic hepatic steatosis in patients with chronic hepatitis B

Objective: The objective of this study was to develop a noninvasive diagnostic test for nonalcoholic hepatic steatosis in patients with chronic hepatitis B (CHB) by using routinely available clinical markers. Methods: A retrospective study of patients with CHB, with or without hepatic steatosis (fatty change) who were diagnosed with controlled attenuation parameter (CAP) measured by transient elastography were included. Patient information was analyzed on lifestyle; laboratory tests, including serum lipid levels; blood pressure; blood uric acid; and medical history of type 2 diabetes mellitus (T2DM). Results: A total of 1312 patients were included in the study; 618 patients had confirmed hepatic steatosis. The CAP levels were significantly correlated with patient height ( p −0.425, the sensitivity, specificity, positive likelihood ratio (LR) and negative LR were 74.72%, 72.12%, 2.68, and 0.35 respectively. The average FL test result was −0.54 ± 1.26 in patients with CHB without hypertension, and 0.42 ± 1.35, 1.12 ± 1.65, and 1.98 ± 1.22 in patients with hypertension grade 1, 2, and 3, respectively ( p < 0.001). Conclusion: This study has demonstrated a noninvasive test for hepatic steatosis in patients with CHB

Association between hypertension and prognosis of patients with COVID-19: A systematic review and meta-analysis

Background To investigate the association between hypertension and clinical outcomes, including in-hospital mortality, intensive care unit (ICU) admission, and invasive ventilation in patients with coronavirus disease 2019 (COVID-19) pneumonia. Methods We implemented a systematic search of PubMed for articles that assessed clinical outcomes of hypertensive patients infected with SARS-CoV-2. The primary outcomes evaluated included: in-hospital mortality, ICU admission, and the use of invasive ventilation. Results A total of 18 studies were included, involving 13,293 patients and covering from January 25, 2020, to April 20, 2020. The relationship between hypertension and prognosis in COVID-19 patients was evaluated. Results showed that hypertension was a risk factor for in-hospital mortality in COVID-19 patients (RR: 2.20, 95% CI, 1.83–2.65, P < .001). Moreover, patients with hypertension were more likely to be admitted to ICU (RR: 1.86, 95% CI, 1.13–3.07, P = .001) and to use invasive ventilation (RR: 2.99, 95% CI, 1.73–5.17, P < .001). Conclusions Among COVID-19 patients, those combined with hypertension had a significantly higher risk of in-hospital deaths, admission to ICU, and need for invasive ventilation

Predictors of sustained virologic response after discontinuation of nucleos(t)ide analog treatment for chronic hepatitis B

Background/Aims: The aim of this study was to identify the predictors for relapse after discontinuation of oral nucleos(t)ide analog treatment for chronic hepatitis B (CHB). Patients and Methods: We evaluated patients who were receiving long-term, regular antiviral therapy with nucleos(t)ide analogs, and subsequently achieved the discontinuation criteria from the Asia-Pacific guideline. After they voluntarily discontinued the drug therapy, data were prospectively collected to observe the potential virologic relapse, and the parameters that predicted recurrence were analyzed. Results: Sixty-five patients met the inclusion criteria, and were included in this study. Twenty-eight patients relapsed, and the accumulative recurrence rates at the 3-month, 6-month, and 1-year follow-ups were 13.85%, 32.31%, and 49.23%, respectively. There was no difference in the accumulative recurrence rate 12 months after discontinuation among patients who were positive or negative for the hepatitis B e antigen (HBeAg) before they received the medication. Logistic regression analysis revealed that the time to complete response, age at discontinuation, and HBsAg levels at discontinuation affected the rate of relapse. Conclusions: Among patients who received orally administrated nucleos(t)ide analogs, serum levels of HBsAg, age at discontinuation, and the time to complete response might be used as a guide to discontinue treatment. Among younger patients, those with low serum HBsAg levels, and those with an earlier complete response, the risk of relapse is lower and discontinuation is much safer

Association between obesity and clinical prognosis in patients infected with SARS-CoV-2

BACKGROUND: It is well established that obesity is a disease of sustained low-grade inflammation. However, it is currently unknown if obesity plays a role in the clinical manifestations and prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients. In this study, we aimed to investigate whether obesity played a role in clinical manifestations and prognosis in patients infected with SARS-CoV-2. METHODS: This is a retrospective multicenter clinical study. A total of 96 patients hospitalized with SARS-CoV-2 infection were enrolled from Dongguan People’s Hospital, Nanfang hospital and the First Affiliated Hospital of Xiamen University between 23 January and 14 February 2020. Demographic and clinical data were extracted from medical records. Acute respiratory distress syndrome (ARDS) was defined as oxygenation index (PaO2/FiO2) ≤ 300 mmHg. We grouped patients through the body mass index (BMI). Associations were examined using the t test, χ2 test and multivariate logistic forward regression test. RESULTS: Patients with BMI &lt;  24 were significantly younger (P = 0.025) with lower creatine kinase (P = 0.013), lower diastolic pressure blood (P = 0.035), lower serum creatinine (P = 0.012), lower lactate dehydrogenase (P = 0.001) and higher platelet count (P = 0.002). The BMI level was 20.78 ± 3.15 in patients without pneumonia compared with the patients with pneumonia (23.81 ± 3.49, P = 0.001). For patients without ARDS, an average BMI level of 22.65 ± 3.53 was observed, significantly lower than patients with ARDS (24.57 ± 3.59, P = 0.022). The mean BMI was 22.35 ± 3.56 in patients experienced with relieving the clinical symptoms or stable condition by radiographic tests, lower than patients with disease exacerbation with 24.89 ± 3.17 (P = 0.001). In addition, lymphocyte count (r = − 0.23, P = 0.027) and platelet count (r = − 0.44, P &lt; 0.001) were negatively correlated with BMI. While hemoglobin (r = 0.267, P = 0.008), creatine kinase (r = 0.331, P = 0.001), serum creatinine (r = 0.424, P &lt; 0.001) and lactate dehydrogenase (r = 0.343, P = 0.001) were significantly positive correlated with BMI. Multivariate analysis showed that older age (OR = 1.046, P = 0.009) and BMI ≥ 24 (OR = 1.258, P = 0.005) were independent risk factors associated ICU admission while BMI ≥ 24 (OR = 4.219, P = 0.007) was independent risk factor associated with radiographic disease exacerbation. CONCLUSIONS: Our study found BMI was significantly associated with clinical manifestations and prognosis of patients with SARS-CoV-2 infection. For patients with increased risk, clinicians should intervene promptly to avoid disease progression

Data_Sheet_1_Prospective observational study of baloxavir marboxil in adults and adolescents with uncomplicated influenza from China.pdf

IntroductionThere are limited data on the efficacy of baloxavir marboxil (baloxavir) versus oseltamivir in Chinese patients with influenza A.MethodsThis study is an observational real-world investigation encompassing 246 patients (baloxavir, n = 147; oseltamivir, n = 99) confirmed positive for influenza A. The choice between baloxavir and oseltamivir antiviral treatments was determined collaboratively by the clinician and the patient. A thorough comparative analysis was undertaken between the two groups, examining parameters such as the duration of fever and symptoms, viral load dynamics, lymphocyte changes, and enhancements in health-related quality of life (QoL).ResultsNo significant differences were observed in demographic data between the two groups. The duration of fever was significantly shorter in the baloxavir group (P 0.05), positive rate of viral antigen on day 3 (P = 0.477) between the two groups. Remarkably, a mutation was observed in one case on the third-day after baloxavir treatment compared with first-day, from cysteine to serine at position 384 of the PA subunit.ConclusionIn the clinical setting, baloxavir demonstrated comparable clinical benefits to oseltamivir, establishing its efficacy as an effective antiviral therapy for Chinese patients with influenza.</p

Overcoming photovoltage deficit via natural amino acid passivation for efficient perovskite solar cells and modules

Electronic defects at grain boundaries and surfaces of perovskite crystals impair the photovoltaic performance and stability of solar devices. In this work, we report the compensation of photovoltage losses in blade-coated methylammonium lead triiodide (MAPbI3) devices via passivation with natural amino acid (NAA) molecules. We found that the optoelectronic properties of NAA-passivated perovskite films and the corresponding device performances are closely correlated with the molecular interaction strength. A side-by-side comparative study of four typical NAAs reveals that arginine (Arg) functionalized with a guanidine end group exhibits optimum passivation effects owing to the strongest coordinative bonding with the uncoordinated Pb2+, which markedly suppresses the detrimental antisite PbI deep level defects. As a result, nonradiative charge recombination is significantly reduced, resulting in a substantially increased open-circuit voltage (VOC) of 1.17 V and a high efficiency of 20.49%. A solar module with an active area of 10.08 cm2 is also fabricated, yielding an efficiency of 15.65% with negligible VOC losses. In parallel, the Arg-passivated solar devices exhibit enhanced operational stability due to the formation of a hydrophilic Arg protective layer which encapsulates the perovskite crystals