乙型肝炎病毒含量及感染方式与临床治愈率相关性研究

目的观察分析乙型肝炎病毒含量及感染方式与临床治愈率的相关性,提高临床对乙型肝炎病毒感染者的认识水平及治疗疗效。方法选取2010年3月-2013年3月收治的乙型肝炎病毒患者共170例,对其进行乙型肝炎病毒标志物及HBV-DNA的定量检测试验,研究数据采用SPSS16.0软件进行统计分析。结果入选患者中有70例为大三阳患者,其HBsAg、HBeAg和抗HBc同时为阳性结果,而有47例患者则属于小三阳,其中有33例患者的表面抗原阳性;表面抗原阳性患者的感染方式为急性、慢性或垂直感染,对比差异无统计学意义;而大三阳和小三阳的患者主要集中为慢性或垂直感染,急性感染中HBV-DNA含量>5.0×103的比率明显高于含量>5.0×103的比例,慢性垂直感染患者其体内的HBV-DNA有76.6%患者含量>5.0×103,急性感染患者的治愈率明显要高于慢性/垂直感染患者;而HBV-DNA含量<5.0×103的患者的治愈率也远远高于HBV-DNA含量<5.0×103患者。结论乙型肝炎病毒含量及感染方式与临床治愈率具有一定的相关性。     

IgD multiple myeloma: a cure at 21 years

A 52-year-old man with a plasmacytoma of the body of T-10 in February 1965 returned 6 months later with multiple myeloma characterized by bone pain, osteolytic lesions, and IgD lambda monoclonal protein in the serum, 6.1 g of Bence Jones protein in the urine, and 21% plasma cells in the bone marrow. The M-protein and bone pain disappeared within 6 weeks after therapy with melphalan and prednisone was started. Therapy was discontinued in December 1974. Immunoelectrophoreses and immunofixations of the serum and urine over the years revealed no monoclonal protein. A mediastinal tumor developed, and the patient died of respiratory insufficiency on October 23, 1986. Autopsy revealed a large bronchogenic carcinoma of the right lung extending to the mediastinum, trachea, and esophagus. There was no evidence of multiple myeloma. This patient had responded rapidly to chemotherapy and had no recurrence of myeloma during a 21-year follow-up.     

妊娠期口腔保健对妊娠期牙龈炎的临床防治效果

目的:探讨妊娠期口腔保健对妊娠期牙龈炎的临床防治效果。方法:选取某院产检中心2018年1~12月的160例妊娠期妇女,随机纳入常规组与保健组,各80例。常规组予以口腔疾病知识宣教,保健组加强口腔保健干预,对比两组妊娠期妇女的牙龈炎发病率以及妊娠期牙龈炎患者干预前后的牙周临床指标与总体疗效。结果:常规组的牙龈炎发病率为18.8%,保健组为7.5%,保健组低于常规组(P<0.05);保健组患者干预后的PLI、BOP、PD、AL均低于常规组(P<0.05);常规组的总有效率为66.7%,保健组为83.3%,保健组高于常规组(P<0.05)。结论:对妊娠期妇女实施口腔保健干预,可降低妊娠期牙龈炎的发病率,改善牙龈炎患者的牙周临床指标,提高总体疗效,值得推行。     

The efficacy of hepatitis B treatments in achieving HBsAg seroclearance: A systematic review and meta‐analysis

Current therapies for chronic hepatitis B (CHB) include nucleos(t)ide analogues (NAs) and interferon (IFN), but their relative efficacy as monotherapy or in combination has not been examined systematically for HBsAg loss (functional cure). Hence, we systematically reviewed the evidence for HBsAg loss in CHB patients treated with IFN, NA or the combination. We searched PubMed, EMBASE and abstracts from EASL, Asia Pacific Association for study of the Liver and American Association for the Study of Liver Disease for randomized controlled trials of CHB patients, comparing NA, IFN or the combination. The Cochrane Risk of Bias tool v2.0 and GRADE method were used. Analyses were stratified by NA genetic barrier, cirrhosis, type of combination therapy, HBeAg, treatment naivety, IFN dosage/duration and outcome duration. Sensitivity analysis was performed for selected strata, and HBsAg loss was measured at the end‐of‐study (EOS), end‐of‐treatment (EOT) or end‐of‐follow‐up (EOF). Effects were reported as risk differences (RD) with 95% confidence intervals (CI) using a random‐effects model. Forty‐five studies were included, all with low risk of bias. For HBsAg loss at EOS, when comparing combination vs IFN, RD = 1%, 95%CI‐1%, 2%; combination vs NA, RD = 5%, 95%CI 3%,7%; IFN vs NA, RD = 3%, 95%CI 2%,5%. Subgroup analysis showed a significant effect of standard IFN dose vs nonstandard; IFN duration ≥48 weeks vs <48 weeks, and loss of efficacy >2 years of follow‐up. Similar findings were seen in HBsAg seroconversion, but only three studies reported HBsAg seroreversion. In conclusion, IFN monotherapy/combination had a small but significant increase in HBsAg loss over NA, associated with standard dose of IFN and ≥48 weeks of therapy, although this effect faded over time.     

A ‘cure’ for Down syndrome: what do parents want?

Recent advancements in molecular genetics raise the possibility that therapeutics or a ‘cure’ for Down syndrome (DS) may become available. However, there are no data regarding how parents of children with DS perceive the possibility of mitigating specific manifestations such as the intellectual disability (ID) associated with DS, or curing the condition entirely. To explore these issues, we distributed a questionnaire to members of the Lower Mainland Down Syndrome Society in British Columbia, Canada. Questionnaires were completed by 101 parents (response rate = 41%). A majority (61%) viewed the possibility of reversing ID in DS positively, but only 41% said that they would ‘cure’ their child of DS if it were possible. Twenty‐seven percent of respondents said they would not ‘cure’ their child, and 32% were unsure if they would ‘cure’ their child. The most commonly cited motivation for opting for a ‘cure’ was to increase their child's independence. However, parental attitudes' towards a ‘cure’ for DS were complex, affected by ethical issues, perceived societal values, and pragmatic factors such as the age of the individual and long‐term care‐giving burden. These findings could be used by healthcare professionals supporting families who include a member with DS and to direct future research.     

Property evolution during vitrification of dimethacrylate photopolymer networks

Objectives

This study seeks to correlate the interrelated properties of conversion, shrinkage, modulus and stress as dimethacrylate networks transition from rubbery to glassy states during photopolymerization.

Methods

An unfilled BisGMA/TEGDMA resin was photocured for various irradiation intervals (7–600 s) to provide controlled levels of immediate conversion, which was monitored continuously for 10 min. Fiber optic near-infrared spectroscopy permitted coupling of real-time conversion measurement with dynamic polymerization shrinkage (linometer), modulus (dynamic mechanical analyzer) and stress (tensometer) development profiles.

Results

The varied irradiation conditions produced final conversion ranging from 6% to more than 60%. Post-irradiation conversion (dark cure) was quite limited when photopolymerization was interrupted either at very low or very high levels of conversion while significant dark cure contributions were possible for photocuring reactions suspended within the post-gel, rubbery regime. Analysis of conversion-based property evolution during and subsequent to photocuring demonstrated that the shrinkage rate increased significantly at about 40% conversion followed by late-stage suppression in the conversion-dependent shrinkage rate that begins at about 45–50% conversion. The gradual vitrification process over this conversion range is evident based on the broad but well-defined inflection in the modulus versus conversion data. As limiting conversion is approached, modulus and, to a somewhat lesser extent, stress rise precipitously as a result of vitrification with the stress profile showing little if any late-stage suppression as seen with shrinkage.

Significance

Near the limiting conversion for this model resin, the volumetric polymerization shrinkage rate slows while an exponential rise in modulus promotes the vitrification process that appears to largely dictate stress development.     

HIV cure: global overview of bNAbs’ patents and related scientific publications

Introduction: This article provides a global overview of patent deposits for broadly neutralizing antibodies (bNAbs), which have emerged as a key strategy for HIV cure and future HIV vaccines. Scientific and technological barriers to the discovery of an effective HIV vaccine in the last 40 years have raised concerns on the potential for relevant advances in this area. Nevertheless, recent breakthrough studies have identified novel immune pathways for new innovative HIV vaccine and HIV cure strategies.

Areas covered: In our patent study, we have identified in a global scale, in the last decade, a sharp increase in the number of bNAbs’ patent deposits related to HIV prevention and treatment strategies, reaching 90 bNAbs in 2017, protected by 184 different patent deposits. Refining our patent search to the different stages of bNAbs’ development has also allowed us to identify 12 of them already at clinical stage of research (VRC01, 10E8, 3BNC117, 10-1074, 2G12, 2F5, KD-247, 4E10, PG9, PGDM1400, PGT121, and VRC07). We describe these recent breakthroughs and discuss the prospects and limitations of these novel strategies.

Expert opinion: Our results indicate the intellectual property outcomes of a scientific revolution in this field, expressing innovative modifications in antibodies to increase their potency and half-life, which have resulted in extremely potent antibodies that could provide novel preventive and therapeutic HIV strategies.     

中西医结合介入治疗股骨头无菌性坏死临床分析

目的:探讨中西医结合放射介入治疗股骨头无菌性坏死的临床分析。方法:将54例患者,随机分为治疗组24例,采用Seldinger穿刺技术进行超选择股骨头供血动脉插管,动脉造影,推注复方丹参注射液、尿激酶等药物溶通治疗。对照组30例患者:口服中药苍术15g,羌活12g,升麻12g,防风12g,牛膝12g,蒿本12g一日一剂,十五天一个疗程。结果:24例患者治疗后髋部疼痛及关节功能障碍均有不同程度的减轻及改善;病变区血管分支增多、增粗;影像随访显示股骨头骨质不同程度修复,总有效率90·3%。结论:中西医结合介入治疗股骨头无菌性坏死疗效显著,值得临床运用。