Autophagy activated by GR/miR-421-3p/mTOR pathway as a compensatory mechanism participates in chondrodysplasia induced by prenatal caffeine exposure in male fetal rats.

Autophagy has been implicated in the developmental toxicity of multiple organs in offspring caused by adverse environmental conditions during pregnancy. We have previously found that prenatal caffeine exposure (PCE) can cause fetal overexposure to maternal glucocorticoids, leading to chondrodysplasia. However, whether autophagy is involved and what role it plays has not been reported. In this study, a PCE rat model was established by gavage of caffeine (120 mg/kg.d) on gestational day 9-20. The results showed that reduced cartilage matrix synthesis in male fetal rats in the PCE group was accompanied by increased autophagy compared to the control group. Furthermore, the expression of mTOR, miR-421-3p, and glucocorticoid receptor (GR) in male fetal rat cartilage of PCE group was increased. At the cellular level, we confirmed that corticosterone inhibited matrix synthesis in fetal chondrocytes while increasing autophagic flux. However, administration of autophagy enhancer (rapamycin) or inhibitor (bafilomycin A1 or 3-methyladenine) partially increased or further decreased aggrecan expression respectively. At the same time, we found that corticosterone could increase the expression of miR-421-3p through GR and target to inhibit the expression of mTOR, thereby enhancing autophagy. In conclusion, PCE can cause chondrodysplasia and autophagy enhancement in male fetal rats. Intrauterine high corticosterone activates GR/miR-421-3p signaling and down-regulates mTOR signaling in fetal chondrocytes, resulting in enhanced autophagy, which can partially compensate for corticosterone-induced fetal chondrodysplasia. This study confirmed the compensatory protective effect of autophagy on the developmental toxicity of fetal cartilage induced by PCE and its epigenetic mechanism, providing novel insights for exploring the early intervention and therapeutic target of fetal-originated osteoarthritis.

Exploring Appropriate Reference Intervals and Clinical Decision Limits for Glucose-6-Phosphate Dehydrogenase Activity in Individuals From Guangzhou, China.

Background: Quantitative detection of glucose-6-phosphate dehydrogenase (G6PD) is commonly done to screen for G6PD deficiency. However, current reference intervals (RIs) of G6PD are unsuitable for evaluating G6PD-activity levels with local populations or associating G6PD variants with hemolysis risk to aid clinical decision-making. We explored appropriate RIs and clinical decision limits (CDLs) for G6PD activity in individuals from Guangzhou, China. Methods: We enrolled 5,852 unrelated individuals between 2020 and 2022 and screened their samples in quantitative assays for G6PD activity. We conducted further investigations, including G6PD genotyping, thalassemia genotyping, follow-up analysis, and statistical analysis, for different groups. Results: In Guangzhou, the RIs for the G6PD activities were 11.20-20.04 U/g Hb in male and 12.29-23.16 U/g Hb in female. The adjusted male median and normal male median (NMM) values were 15.47 U/g Hb and 15.51 U/g Hb, respectively. A threshold of 45% of the NMM could be used as a CDL to estimate the probability of G6PD variants. Our results revealed high hemolysis-risk CDLs (male: <10% of the NMM, female: <30% of the NMM), medium hemolysis-risk CDLs (male: 10%-45% of the NMM, female: 30%-79% of the NMM), and low hemolysis-risk CDLs (male: ≥ 45% of the NMM, female: ≥ 79% of the NMM). Conclusions: Collectively, our findings contribute to a more accurate evaluation of G6PD-activity levels within the local population and provide valuable insights for clinical decision-making. Specifically, identifying threshold values for G6PD variants and hemolysis risk enables improved prediction and management of G6PD deficiency, ultimately enhancing patient care and treatment outcomes.

Remote teaching system for robotic surgery and its validation: results of a randomized controlled study.

BACKGROUND: Currently, only a limited number of remote assistance modalities are utilized in the basic phase of robotic surgery training to facilitate the rapid acquisition of robotic surgery skills by surgeons. This study aimed to investigate the benefits of real-time remote surgical robotic skill training based on a multi-channel video recording and playback system. METHODS: We randomly divided 40 medical students without prior expertise in the use of surgical robots into two groups to assess the performance of trainees on a robotic simulator (Mimic dV-Trainer). The remote group received remote training, while the control group received live one-on-one guidance. We compared the learning curves of the two groups based on simulator scores. Furthermore, the NASA task load index (NASA-TLX) scale was used to measure the fatigue load of the trainers. RESULTS: We observed no significant differences in the demographics or initial baseline skill levels between the two groups. Participants in the remote group achieved higher total scores in the Match Board 2 and Thread the Rings 1 exercises compared to the control group. In addition, trainers in the remote group reported lower subjective fatigue load than in the control group. CONCLUSIONS: The remote approach to surgical robotics skills training based on the Remote Teaching System for Robotic Surgery (ReTeRoS) is both feasible and has the potential for large-scale training.

Exploring the use of driving simulation to improve robotic surgery simulator training: an observational case-control study.

The correlation between driving skills and the ability to perform robotic surgery have not yet been discussed. Therefore, this study aimed to investigate the impact of driving skills on learning robotic surgery using a driving simulator and a robotic simulator. Sixty robot- and simulator-naïve participants were recruited: 30 with a driver's license and 30 without a driver's license. All participants completed a test on the driving simulator and learned four tasks using a robotic surgical simulator (dV-Trainer). On the driving simulator, the lap time in the driver's license group (D-Group) was significantly lower than that in the non-driver's license group (ND-Group) [217.93 ± 42.79 s vs. 271.24 ± 46.63 s, P < 0.001]. The average number of tires off track in the D-Group was lower than that in the ND-Group (0.13 ± 0.35 vs. 0.57 ± 0.63, P = 0.002). The baseline score of the D-Group on the robotic simulator was higher than that of the ND-Group (467.53 ± 107.62 vs. 385.53 ± 136.30, P = 0.022). In the Pick-and-Place-Clutching, Peg-Board-2, and Thread-the-Rings-1 tasks, the learning curve of the D-Group was steeper than that of the ND-Group. However, no significant difference was observed in the Match-Board-2 task. According to the lap time ranking, participants in the top tertile had a steeper learning curve than those in the bottom tertile, especially for the Pick-and-Place-Clutching and Peg-Board-2 tasks (P < 0.05). Significant differences were also found in the baseline and final stages of the Thread-the-Rings-1 task and in the initial stage of the Match-Board-2 task (P < 0.05). Students with a driver's license or better performance in racing games had more success in learning robotic surgery. Driving simulators may promote robotic surgery training.

A rationally designed ICAM1 antibody drug conjugate eradicates late-stage and refractory triple-negative breast tumors in vivo.

Triple-negative breast cancer (TNBC) remains the most lethal form of breast cancer, and effective targeted therapeutics are in urgent need to improve the poor prognosis of TNBC patients. Here, we report the development of a rationally designed antibody drug conjugate (ADC) for the treatment of late-stage and refractory TNBC. We determined that intercellular adhesion molecule-1 (ICAM1), a cell surface receptor overexpressed in TNBC, efficiently facilitates receptor-mediated antibody internalization. We next constructed a panel of four ICAM1 ADCs using different chemical linkers and warheads and compared their in vitro and in vivo efficacies against multiple human TNBC cell lines and a series of standard, late-stage, and refractory TNBC in vivo models. An ICAM1 antibody conjugated with monomethyl auristatin E (MMAE) via a protease-cleavable valine-citrulline linker was identified as the optimal ADC formulation owing to its outstanding efficacy and safety, representing an effective ADC candidate for TNBC therapy.

Genotypic and phenotypic characterization of glucose-6-phosphate dehydrogenase (G6PD) deficiency in Guangzhou, China.

BACKGROUND: G6PD deficiency is a common inherited disorder worldwide and has a higher incidence rate in southern China. Many variants of G6PD result from point mutations in the G6PD gene, leading to decreased enzyme activity. This study aimed to analyse the genotypic and phenotypic characteristics of G6PD deficiency in Guangzhou, China. METHODS: In this study, a total of 20,208 unrelated participants were screened from 2020 to 2022. G6PD deficiency was further analysed by quantitative enzymatic assay and G6PD mutation analysis. The unidentified genotype of the participants was further ascertained by direct DNA sequencing. RESULTS: A total of 12 G6PD mutations were identified. Canton (c.1376G>T) and Kaiping (c.1388G>A) were the most common variants, and different mutations led to varying levels of G6PD enzyme activity. Comparing the enzyme activities of the 6 missense mutations between the sexes, we found significant differences (P < 0.05) in the enzyme activities of both male hemizygotes and female heterozygotes. Two previously unreported mutations (c.1438A>T and c.946G>A) were identified. CONCLUSIONS: This study provided detailed genotypes of G6PD deficiency in Guangzhou, which could be valuable for diagnosing and researching G6PD deficiency in this area.

Proteome-Wide Profiling of the Covalent-Druggable Cysteines with a Structure-Based Deep Graph Learning Network.

Covalent ligands have attracted increasing attention due to their unique advantages, such as long residence time, high selectivity, and strong binding affinity. They also show promise for targets where previous efforts to identify noncovalent small molecule inhibitors have failed. However, our limited knowledge of covalent binding sites has hindered the discovery of novel ligands. Therefore, developing in silico methods to identify covalent binding sites is highly desirable. Here, we propose DeepCoSI, the first structure-based deep graph learning model to identify ligandable covalent sites in the protein. By integrating the characterization of the binding pocket and the interactions between each cysteine and the surrounding environment, DeepCoSI achieves state-of-the-art predictive performances. The validation on two external test sets which mimic the real application scenarios shows that DeepCoSI has strong ability to distinguish ligandable sites from the others. Finally, we profiled the entire set of protein structures in the RCSB Protein Data Bank (PDB) with DeepCoSI to evaluate the ligandability of each cysteine for covalent ligand design, and made the predicted data publicly available on website.

Spatial Differentiation and Influencing Factors of Poverty Alleviation Performance Under the Background of Sustainable Development: A Case Study of Contiguous Destitute Areas in Hunan Province, China.

Poverty eradication is a realistic requirement for the addressing of the urban-rural development imbalance. It consolidates the achievements of the poverty alleviation, and accelerates the realization of the United Nations Sustainable Development Goals. In research that deals with poverty, qualitative analysis is often used to study the connection between a single influencing factor and poverty reduction, and to solve regional poverty through government measures. However, these studies usually ignore the multidimensional nature of poverty, and the fact that poverty alleviation also needs to be approached from multiple perspectives. By constructing a theoretical framework of poverty alleviation performance from the perspective of sustainable development, this study selects contiguous poverty-stricken areas in the Hunan Province, China as the empirical study area, constructs an evaluation index system from the three dimensions of economic development, infrastructure and people's livelihood security, and selects influencing factors from three aspects of 'population', 'land' and 'industry'. The spatial differentiation characteristics and influencing factors of poverty alleviation performance in poverty-stricken areas were studied by using the methods of entropy weight method and geodetector. The results show: firstly, in the concentrated and contiguous poverty-stricken areas of the Hunan Province, the performance of poverty alleviation in the economic development makes little difference, showing a 'high-medium-low' cross-distribution pattern. The poverty alleviation performance of the infrastructure presents a distribution pattern of 'low in the middle and high on both sides. The poverty alleviation performance of people's livelihood security has significant spatial differentiation characteristics, which all present a reunion distribution. The overall poverty alleviation performance varies greatly, showing a funnel-shaped distribution in space. Secondly, the spatial differentiation of poverty alleviation performance in the concentrated and contiguous poverty-stricken areas of the Hunan Province is the result of the combined effects of multiple factors. 'Population' is the dominant factor affecting the performance of poverty alleviation, 'land' is the basic factor that causes the spatial differentiation of poverty alleviation performance, and 'industry' is the key factor for the improvement of the poverty alleviation ability.

The effect of preoperative hypoalbuminemia on complications after primary hip arthroplasty.

OBJECTIVES: To explore the risk factors of preoperative hypoalbuminemia and its' effects on complications in the elderly with primary hip arthroplasty. METHODS: A total of 211 elderly inpatients who underwent hip arthroplasty were collected. All patients were divided into the control group (preoperative serum albumin ≥35 g/L) and case group (preoperative serum albumin <35 g/L). The risk factors of preoperative hypoalbuminemia and the postoperative complications were analyzed. RESULTS: Compared to controls, hypoalbuminemia patients were older (P = 0.026), had lower BMI (P = 0.045), higher cardiac function score (P < 0.0001), higher ASA scores (P = 0.023), and longer hospital stay (P < 0.001). The intraoperative albumin loss in the case group was significantly higher than that of in control group (P < 0.001), but there was no significant difference in operation time and intraoperative blood loss between the two groups (P >0.05). Compared to controls, hypoalbuminemia patients had a higher risk for any complication (P = 0.014), such as delayed wound healing, pleural effusion, and pneumonia. The risk of postoperative complications increased by 6.9% with every 1 year old is increasing (age > 60). The risk of postoperative complications in the case group was 1.89 times higher than that in the control group. CONCLUSION: Patients with older age, poor nutritional status, and more than 2 concomitant diseases are more likely to develop preoperative hypoalbuminemia. Preoperative hypoalbuminemia is related to the increased incidence of postoperative complications. Perioperative albumin loss is not only due to perioperative blood loss, but also related to vascular permeability and abnormal albumin metabolism.

Development and Clinical Evaluation of a CRISPR-Based Diagnostic for Rapid Group B Streptococcus Screening.

Vertical transmission of group B Streptococcus (GBS) is among the leading causes of neonatal illness and death. Colonization with GBS usually is screened weeks before delivery during pregnancy, on the basis of which preventive measures, such as antibiotic prophylaxis, were taken. However, the accuracy of such an antenatal screening strategy has been questionable because of the intermittent nature of GBS carriage. We developed a simple-to-use, rapid, CRISPR-based assay for GBS detection. We conducted studies in a prospective cohort of 412 pregnant women and a retrospective validation cohort to evaluate its diagnostic performance. We demonstrated that CRISPR-GBS is highly sensitive and offered shorter turnaround times and lower instrument demands than PCR-based assays. This novel GBS test exhibited an overall improved diagnostic performance over culture and PCR-based assays and represents a novel diagnostic for potential rapid, point-of-care GBS screening.

Construction of a Live-Attenuated Vaccine Strain of Yersinia pestis EV76-B-SHUΔpla and Evaluation of Its Protection Efficacy in a Mouse Model by Aerosolized Intratracheal Inoculation.

Plague, which is caused by Yersinia pestis, is one of the most dangerous infectious diseases. No FDA-approved vaccine against plague is available for human use at present. To improve the immune safety of Y. pestis EV76 based live attenuated vaccine and to explore the feasibility of aerosolized intratracheal inoculation (i.t.) route for vaccine delivery, a plasminogen activator protease (pla) gene deletion mutant of the attenuated Y. pestis strain EV76-B-SHU was constructed, and its residual virulence and protective efficacy were evaluated in a mouse model via aerosolized intratracheal inoculation (i.t.) or via subcutaneous injection (s.c.). The residual virulence of EV76-B-SHUΔpla was significantly reduced compared to that of the parental strain EV76-B-SHU following i.t. and s.c. infection. The EV76-B-SHUΔpla induced higher levels of mucosal antibody sIgA in the bronchoalveolar lavage fluid of mice immunized by i.t. but not by s.c.. Moreover, after lethal challenge with Y. pestis biovar Microtus strain 201 (avirulent in humans), the protective efficacy and bacterial clearance ability of the EV76-B-SHUΔpla-i.t. group were comparable to those of the EV76-B-SHUΔpla-s.c. and EV76-B-SHU immunized groups. Thus, the EV76-B-SHUΔpla represents an excellent live-attenuated vaccine candidate against pneumonic plague and aerosolized i.t. represents a promising immunization route in mouse model.

Improved recombinant protein production by regulation of transcription and protein transport in Chinese hamster ovary cells.

OBJECTIVES: To identify genes that affected protein expression in Chinese hamster ovary (CHO) cells was significant, and we identified the changes in the transcriptome and the functional gene sets that would contribute to increase expression of recombinant protein. RESULTS: Here two sub-clones from a methotrexate-treated parental recombinant CHO cell line were selected. The two sub-clones, with different expression levels (qp were 42.8 pg/cell/day and 14.0 pg/cell/day), were analyzed through RNA-seq. More than 600 genes were identified as differently expressed, and we found that the differentially expressed genes were involved in processes such as RNA processing, transcription, protein catabolism, and protein transport. Among these, we cloned genes encoding proteins that were involved in transcription and protein transport to investigate their effect on protein production. CONCLUSIONS: We found that some genes involved in transcription and protein transport would improve recombinant protein production in CHO cells.

Sequencing and Genomic Diversity Analysis of IncHI5 Plasmids.

IncHI plasmids could be divided into five different subgroups IncHI1-5. In this study, the complete nucleotide sequences of seven bla IMP- or bla VIM-carrying IncHI5 plasmids from Klebsiella pneumoniae, K. quasipneumoniae, and K. variicola were determined and compared in detail with all the other four available sequenced IncHI5 plasmids. These plasmids carried conserved IncHI5 backbones composed of repHI5B and a repFIB-like gene (replication), parABC (partition), and tra1 (conjugal transfer). Integration of a number of accessory modules, through horizontal gene transfer, at various sites of IncHI5 backbones resulted in various deletions of surrounding backbone regions and thus considerable diversification of IncHI5 backbones. Among the accessory modules were three kinds of resistance accessory modules, namely Tn10 and two antibiotic resistance islands designated ARI-A and ARI-B. These two islands, inserted at two different fixed sites (one island was at one site and the other was at a different site) of IncHI5 backbones, were derived from the prototype Tn3-family transposons Tn1696 and Tn6535, respectively, and could be further discriminated as various intact transposons and transposon-like structures. The ARI-A or ARI-B islands from different IncHI5 plasmids carried distinct profiles of antimicrobial resistance markers and associated mobile elements, and complex events of transposition and homologous recombination accounted for assembly of these islands. The carbapenemase genes bla IMP-4, bla IMP-38 and bla VIM-1 were identified within various class 1 integrons from ARI-A or ARI-B of the seven plasmids sequenced in this study. Data presented here would provide a deeper insight into diversification and evolution history of IncHI5 plasmids.

Genetic analysis of heterogeneous sub-clones in recombinant Chinese hamster ovary cells.

Chinese hamster ovary (CHO) cells have been widely used for production of recombinant proteins and therapeutic antibodies. However, owing to the instability and heterogeneity of CHO cells, the development of stable and high-expression recombinant CHO cell lines is often time-consuming. To investigate the mechanisms associated with heterogeneity in protein productivity, we performed transcriptome analysis on the subclones derived from a stable parental CHO clone. Two high-expression subclones and one low-expression subclone were selected based on their similar genomic background and subjected to RNA-seq analysis. Over 100 differentially expressed genes were identified between the subclones with high and low productivity. The molecular functions of the differentially expressed genes were enriched for translational elongation, sterol biosynthetic process, and regulation of secretion. In addition, analyses of the two subclones with high protein expression levels identified over 300 differentially expressed genes involved in DNA metabolic processes, cellular macromolecule catabolic processes, cell cycle, protein catabolic processes, and RNA processing and transcription. A subset of the differentially expressed genes was overexpressed in CHO cells to identify their effects on protein production. Together, these results indicate that transcriptome variation can cause significant inter-cellular heterogeneity in CHO cells and a better understanding of the molecular mechanism underlying heterogeneity might help to improve the production of recombinant proteins by CHO cells.

Sequencing and comparative genomics analysis of the IncHI2 plasmids pT5282-mphA and p112298-catA and the IncHI5 plasmid pYNKP001-dfrA.

Incompatibility group IncHI plasmids are important vectors of antibiotic resistance in Enterobacteriaceae. In this study, a scheme for typing IncHI into five separately clustering subgroups, including previously designated IncHI1-3 as well as IncHI4-5, was proposed based on sequenced IncHI plasmids. The complete nucleotide sequences of the IncHI2 plasmids pT5282-mphA and p112298-catA and the IncHI5 plasmid pYNKP001-dfrA from clinical Enterobacter cloacae, Citrobacter freundii and Raoultella ornithinolytica isolates, respectively, were determined and were compared with IncHI2 and IncHI5 reference plasmids. Considerable genetic conservation was observed within the backbone sequences of each of the IncHI2 and IncHI5 subgroups, but the backbone sequences of the two subgroups were dramatically different from each other. However, the conjugal transfer regions tra1 and tra2 as well as the tellurium resistance gene cluster ter were present in all five plasmids. A number of accessory regions associated with integrons, transposons and insertion sequence-based mobile elements have been inserted at various sites of the plasmid backbones, among which were several large regions harbouring genes conferring resistance to multiple classes of antibiotics. Data generated from this study provide us with a deeper understanding of the diversification of IncHI-type resistance plasmids.

Procalcitonin levels in patients with positive blood culture, positive body fluid culture, sepsis, and severe sepsis: a cross-sectional study.

BACKGROUND: Numerous investigations on procalcitonin (PCT) have been carried out, although few with large sample size. To deal with the complexity of sepsis, an understanding of PCT in heterogeneous clinical conditions is required. METHODS: Hospitalized patients aged 10-79 years were included in this retrospective and cross-sectional study. PCT tests were assayed within 2 days of blood culture. RESULTS: A total of 2952 cases (from 2538 patients) were enrolled in this study, including 440 cases in the 'positive BC' group, 123 cases in the 'positive body fluid culture' group, and 2389 cases in the 'negative all culture' group. Median PCT values were 4.53 ng/ml, 2.95 ng/ml, and 0.49 ng/ml, respectively. Median PCT values in the gram-negative BC group and gram-positive BC group, respectively, were 6.99 ng/ml and 2.96 ng/ml. Median PCT values in the 'positive hydrothorax culture' group, 'positive ascites culture' group, 'positive bile culture' group, and 'positive cerebrospinal fluid culture' group, respectively, were 1.39 ng/ml, 8.32 ng/ml, 5.98 ng/ml, and 0.46 ng/ml. In all, 357 cases were classified into the 'sepsis' group, 150 of them were classified into the 'severe sepsis' group. Median PCT values were 5.63 ng/ml and 11.06 ng/ml, respectively. CONCLUSIONS: PCT could be used in clinical algorithms to diagnose positive infections and sepsis. Different PCT levels could be related to different kinds of microbemia, different infection sites, and differing severity of sepsis.

A comparison of Luminex xTAG® Gastrointestinal Pathogen Panel (xTAG GPP) and routine tests for the detection of enteropathogens circulating in Southern China.

To investigate whether Luminex xTAG® Gastrointestinal Pathogen Panel (xTAG GPP) is applicable for the diagnosis of diarrhea and surveillance of enteropathogens circulating in Southern China, 290 stool samples were tested for 15 kinds of enteropathogens using xTAG GPP and compared to the results from the routine tests, including culture; immunochromatography; real-time PCR; microscopy; and a third method, gene sequencing. One hundred fifty-nine samples were positive, yielding a total of 181 enteropathogens (69 bacteria and 112 viruses), with rotavirus being most prevalent (39.0%, 62/159). The overall sensitivity and specificity of xTAG GPP were 96.3% (93.3-98.2%) and 99.8% (99.6-99.9%), respectively, with a combination of the methods as the gold standard. The coinfection rates detected by the routine tests and xTAG GPP were 10.0% (25 double and 4 triple infections) and 12.1% (29 double, 4 triple and 2 quadruple infections), respectively. xTAG GPP is a powerful tool for the identification of multiple enteropathogens.

[Epidemiological investigation on autism spectrum disorders among preschool children in Shanghai].

OBJECTIVE: To investigate the prevalence of autism spectrum disorders (ASD) of children aged 4-6 years in public kindergartens in Shanghai. METHODS: Songjiang district and Xuhui district were selected randomly as the representative sample. By means of "Clancy Autism Behavior Scale", "Social Communication Questionnaire" and "high-functioning Autism Spectrum Screening Questionnaire", all of the 33 public kindergartens in chosen area, which contained 10 385 children aged 4-6 years, were surveyed. Those who were screened as suspected cases would be further diagnosed by "Autism Diagnostic Interview-Revised" and "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition". RESULTS: Among 9 665 valid questionnaires, 9 children were diagnosed with ASD. The ratio of male to female was 8:1, the point prevalence rate was 0.93‰. The results of ADI-R corresponded with that of DSM-5. There were two children who never had medical records. For others, "language" problem was the most likely reason for their parents to seek medical help, while "deficits in social communication" was the main symptom of patients. CONCLUSION: The prevalence of ASD was lower than those recorded in literature, home and abroad which might be related to some patients not going to public kindergartens.

[Analysis of hepatitis B surface antigen levels in patients with chronic hepatitis B in Guangzhou].

OBJECTIVE: To assess the value of quantitative analysis of hepatitis B surface antigen (HBsAg) levels in the diagnosis and therapeutic evaluations in patients with chronic hepatitis B (CHB). METHODS: According to the staging criteria defined by the American Association of Liver Diseases, 96 patients with CHB admitted in Zhujiang Hospital were classified in immune-tolerant (IT), HBeAg-positive hepatitis (EPH), inactive carrier (IC) and HBeAg-negative hepatitis (ENH) phases. Serum HBsAg, HBV-DNA and ALT levels were quantified and their correlations were evaluated in each phase of infection. RESULTS: The mean HBsAg titers (measured in log10U/L) differed significantly between the phases of CHB (4.12 in IT, 4.02 in EPH, 2.85 in EPH, and 3.29 in ENH). The correlation coefficient of HBsAg with HBV-DNA was 0.6828 in IT, 0.5759 in EPH, 0.3280 in IC, and 0.1083 in ENH. Serum HBsAg titers were significantly higher in HBeAg-positive patients than in HBeAg-negative patients. No correlation was found between HBsAg level and ALT in each phase of CHB. CONCLUSION: The median baseline serum HBsAg levels vary between different phases of CHB in Guangzhou, suggesting the value of HBsAg in accurate classification of hepatitis B patients and evaluation of the therapeutic effect and outcomes of the patients.

Comparison of MALDI-TOF MS, gene sequencing and the Vitek 2 for identification of seventy-three clinical isolates of enteropathogens.

OBJECTIVE: This study was performed to evaluate the analytical and practical performance of the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) compared to the sequencing method and the Vitek 2 system for identification of enteropathogens in the clinical microbiology laboratory. METHODS: Ten type strains and 73 clinical isolates of enteropathogens representing eight genera were analyzed by MALDI-TOF MS. All isolates were also characterized by gene sequencing allowing interpretation of the results from MALDI-TOF MS. In addition, MALDI-TOF MS was compared with the Vitek 2 system for the identification of ten isolates of Aeromonas and six of Salmonella. RESULTS: As previously known, identification between Shigella and Escherichia coli is not possible to distinguish. MALDI-TOF MS produced the correct identifications for all other type strains and clinical isolates to the genus level. Fifteen Campylobacter jejuni, six Campylobacter coli, three Plesiomonas shigelloides, three Yersinia enterocolitica, two Clostridium difficile, one Vibrio parahaemolyticus, one Vibrio fluvialis, and one Vibrio cholera were all correctly identified to the species level. Genus and species identifications of ten Aeromonas and six Salmonella isolates by MALDI-TOF MS were consistent with those by the Vitek 2, but with much less cost and about ten times faster. CONCLUSIONS: This study demonstrates that MALDI-TOF MS is a powerful tool for fast, accurate and low-cost identification of enteropathogens in the clinical microbiology laboratory.