Association of hepatitis B virus DNA levels with efficacy and safety outcomes in patients with hepatitis B virus-associated advanced hepatocellular carcinoma receiving tyrosine kinase inhibitor plus anti-PD-1 antibody: a multicenter propensity-matched study.

BACKGROUND: The efficacy and safety of tyrosine kinase inhibitors (TKIs) combined with anti-PD-1 antibodies (α-PD-1) in advanced hepatocellular carcinoma (HCC) with high hepatitis B virus (HBV) DNA levels (>500 IU/mL) remain unclear. METHODS: We retrospectively assessed patients from seven medical institutions diagnosed with HBV-related HCC, undergoing treatment with TKIs and α-PD-1 in conjunction with antiviral therapies. Based on HBV-DNA levels, patients were categorized into either high (HHBV-DNA, >500 IU/mL) or low HBV-DNA (LHBV-DNA, ≤500 IU/mL) cohorts Propensity score matching (PSM) was used to minimize baseline imbalance between groups. RESULTS: 149 patients were included, with 66 patients exhibiting HBV-DNA > 500 IU/mL and 83 patients presenting HBV-DNA ≤ 500 IU/mL. Compared with the LHBV-DNA cohort, the HHBV-DNA cohort had a greater incidence of serum HBeAg positivity, tumor diameter ≥ 10 cm, and vascular invasion. Following PSM, 57 individuals were enrolled in each group. Oncological outcomes were comparable between HHBV-DNA and LHBV-DNA cohorts before and after PSM. Before PSM, the median PFS and OS were 6.1 months and 17.5 months in the HHBV-DNA cohort and 6.7 months and 19.3 months in the LHBV-DNA cohort (all P > 0.05). After PSM, the median PFS and OS were 6.0 months and 19.5 months in the HHBV-DNA cohort and 6.0 months and 17.1 months in the LHBV-DNA cohort, respectively (all P > 0.05). Safety profiles were equivalent across cohorts with no fatal incidents reported. Seven patients (4.7 %) had HBV reactivation. 1 (0.7 %) from HHBV-DNA and 6 (4.0 %) from LHBV-DNA (P = 0.134). Only one patient developed HBV-related hepatitis. CONCLUSIONS: The effectiveness and safety of TKIs plus α-PD-1 in advanced HCC with HBV-DNA > 500 IU/mL were not compromised in the context of concomitant antiviral therapy.

Two-Dimensional Graphitic Carbon Nitride for Improving the Performance of Organic Solar Cells.

Organic solar cells (OSCs) have attracted lots of attention owing to their low cost, lightweight, and flexibility properties. Nowadays, the performance of OSCs is continuously improving with the development of active layer materials. However, the traditional hole transport layer (HTL) material Poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) presents insufficient conductivity and rapid degradation, which decreases the efficiency and stability of OSCs. To conquer the challenge, the two-dimensional (2D) graphitic carbon nitride (g-C3N4) nanomaterials incorporated into the PEDOT:PSS as hybrid HTL are reported. The addition of g-C3N4 into PEDOT:PSS enables the thickness of the HTL to decrease for enhancing the transmittance of the film and increase the conductivity of PEDOT:PSS. Thus, the device exhibts improved charge transport and suppressed carrier recombination, leading to the increase in short-circuit current density and power conversion efficiency of the devices. This work demonstrates that the incorporation of 2D g-C3N4 into PEDOT:PSS for D18:Y6 and PM6:L8-BO-based OSCs can significantly improve the device efficiency to 17.48% and 18.47% with the enhancement of 7.04% and 8.46%, respectively.

Effect of Diabetes Mellitus on Implant Osseointegration of Titanium Screws: An Animal Experimental Study.

OBJECTIVE: To explore the effect of diabetes mellitus (DM) on implant osseointegration of titanium screws. METHODS: Sixty rats were randomly divided into a DM group and a control group (each group, n = 30). DM group rats were injected with 1% Streptozotocin solution at 65 mg/kg to establish a DM model. Titanium screws were implanted into the rats' distal femurs in both groups. The rats were sacrificed for micro-CT scanning, micro-indentation, biomechanical detection, confocal Raman microspectroscopy, and histological and histomorphometric analysis at 4, 8, and 12 weeks post-implantation, respectively. Messenger RNA (mRNA) expression and protein expression of the related growth factors around the implant were analyzed using real-time polymerase chain reaction and Western blots. RESULTS: At 4, 8 and 12 weeks, micro-CT scanning, hematoxylin-eosin (HE) staining, Gieson's acid-magenta staining, and fluorescent labeled staining showed disorder in the bone tissue arrangement, a lack of new bone tissue, poor maturity and continuity, and poor trabecular bone parameters around the implant in the DM group. At 4, 8, and 12 weeks, the interfacial bone binding rate in the DM group was significantly lower (16.2% ± 4.8%, 25.7% ± 5.7%, 42.5% ± 5.8%, respectively) than that in the control group (23.6% ± 5.2%, 40.8% ± 6.3%, 64.2% ± 7.3%, respectively; P < 0.05). At 8 and 12 weeks, the elastic modulus (17.0 ± 1.8 and 15.1 ± 1.5 GPa, respectively) and trabecular bone hardness (571 ± 39 and 401 ± 37 MPa, respectively) in the DM group were significantly lower than the elastic modulus (23.4 ± 2.3 and 23.8 ± 1.8 GPa, respectively) and trabecular bone hardness (711 ± 45 and 719 ± 46 MPa, respectively) in the control group (P < 0.05). The maximum load required for the prosthesis pull-out experiment in the DM group at 4, 8, and 12 weeks (55.14 ± 6.74 N, 73.34 ± 8.43 N, and 83.45 ± 8.32 N, respectively) was significantly lower than that in the control group (77.45 ± 7.48 N, 93.28 ± 8.29 N, and 123.62 ± 9.43 N, respectively, P < 0.05). At 8 and 12 weeks, the mineral-to-collagen ratio in the DM group (6.56 % ± 1.35% and 4.45%± 1.25%, respectively) was significantly higher than that in the control group (5.31% ± 1.42% and 3.62% ± 1.33%, respectively, P < 0.05). At 12 weeks, mRNA and protein expression levels of bone morphogenetic protein 2, transforming growth factor-ß1, vascular endothelial growth factor, osteopontin, osteocalcin, and runt-related transcription factor 2 in the DM group were significantly lower than that in the control group. CONCLUSIONS: DM can negatively affect bone osseointegration, manifesting as disorder in bone tissue arrangement around the implant, a lack of new bone tissue, poor maturity and continuity, poor trabecular bone parameters and lower expression of the related growth factors.

Postoperative Adjuvant Transarterial Chemoembolization Plus Tyrosine Kinase Inhibitor for Hepatocellular Carcinoma: a Multicentre Retrospective Study.

Purpose: This study aimed to assess the efficacy and safety of adjuvant transarterial chemoembolization (TACE) plus tyrosine kinase inhibitor (TKI) treatment in patients with hepatocellular carcinoma (HCC) with a high risk of early recurrence after curative resection. Patients and Methods: Patients from multiple centres were divided into postoperative adjuvant TACE with (n=57) or without (n=142) TKI administration groups. The disease-free survival (DFS) curve was depicted by the Kaplan-Meier method, and the difference between the two groups was tested using the log rank test. Univariate and multivariate Cox analyses were performed to identify independent risk factors for DFS. Additionally, three propensity score analyses were performed to minimise the potential confounding factors to facilitate a more reliable conclusion. Adverse events (AEs) were assessed according to the Common Terminology Criteria for Adverse Events, version 4.0. Results: The 1-and 2-year DFS rates of the TACE plus TKI treatment group were 45.5% and 34.9%, respectively, which were significantly better than those of the TACE alone group (26.8% and 18.3%, respectively). Multivariate analysis identified adjuvant TACE plus TKI treatment as an independent prognostic factor for DFS (hazard ratio: 0.611, 95% confidence interval: 0.408-0.915, P=0.017). Further analysis based on the various propensity score methods yielded similar results. Subgroup analysis showed that patients with tumour diameter ≥5 cm, tumour number <3, absence of hepatic vein tumour thrombus and bile duct tumour thrombus, ruptured tumours, and stage IIIB could benefit more from TACE plus TKI treatment (all P<0.05). Some patients (33.33%) experienced grade ≥3 AEs in the TACE plus TKI group. Conclusion: TACE plus TKI treatment can reduce the incidence of early recurrence with tolerable adverse events in HCC patients at high risk of recurrence after hepatectomy and may be an appropriate option in postoperative anti-recurrence treatment.

Enhanced light harvesting and charge separation of carbon and oxygen co-doped carbon nitride as excellent photocatalyst for hydrogen evolution reaction.

Solar-driven water splitting has been regarded as a promising strategy for renewable hydrogen production. Among many semiconductor photocatalysts, graphitic carbon nitride (g-C3N4) has received tremendous attention due to its two-dimensional structure, appropriate band gap and decent photocatalytic activity. However, it suffers severe charge recombination problems, affecting its practical performance. In this work, we demonstrated that dual heteroatoms (C and O) doped g-C3N4 can exhibit about 3 times higher catalytic performance for hydrogen evolution than that of the normal g-C3N4 with a hydrogen evolution rate reaching 2595.4 umol g-1h-1 and an apparent quantum efficiency at 420 nm of 16.6%. The heteroatoms (C and O) doped g-C3N4 photocatalyst also exhibited superior removal performance when removing Rhodamine B (RhB) . X-ray photoelectron spectroscopy (XPS), solid-state nuclear magnetic resonance (ssNMR) and X-ray absorption near-edge structure (XANES) spectroscopy reveal that the carbon and oxygen dopants replace the sp2 nitrogen and bridging N atom, respectively. DFT calculations demonstrate the codoping of carbon and oxygen- induced the generation of mid-gap state, leading to the improvement of light harvesting and charge separation.

Sulfate modified g-C3N4 with enhanced photocatalytic activity towards hydrogen evolution: the role of sulfate in photocatalysis.

Sulfate modified graphitic carbon nitride (g-C3N4) was prepared by simple co-pyrolysis of dicyandiamide and ammonium sulfate, and shows seven times higher photocatalytic activity towards hydrogen production than pristine g-C3N4. The origin of its improved photocatalytic activity was comprehensively investigated, and it was found that there are two kinds of sulfate (strongly adsorbed sulfate and a weakly adsorbed one) in the modified sample, both of which play important but slightly different roles in the photocatalysis. Compared to the strongly adsorbed one, the weakly adsorbed sulfate is more beneficial for charge separation and thus promotes more electrons to participate in the photocatalytic reaction. By applying the above synthesis method, most sulfate in our best photocatalyst exists as weakly adsorbed species, which is confirmed by advanced characterization techniques as well as DFT calculations. The increased number of electrons and improved charge separation, which are induced by the weakly adsorbed sulfate, are key to boosting the photocatalytic activity of g-C3N4. Hence, this work provides comprehensive insights into the effect of sulfate on the photocatalytic activity of g-C3N4, which help in the design of more efficient photocatalysts by suitable surface modification.

Controllable local electronic migration induced charge separation and red-shift emission in carbon nitride for enhanced photocatalysis and potential phototherapy.

Electronic migration can be tailored by carefully manipulating the local electron donating and withdrawing nature of carbon nitride for charge separation and red-shift emission. A high yield of H2 (5 mmol h-1 g-1) with an apparent quantum yield of 20.98% at 420 nm and a preliminary study on phototherapy by labeling cell membranes are simultaneously provided.

Intramolecular Charge Transfer and Extended Conjugate Effects in Donor-π-Acceptor-Type Mesoporous Carbon Nitride for Photocatalytic Hydrogen Evolution.

Inspired by donor-acceptor (D-A) polymers in organic solar cell and the extended conjugation effect, a conceptual design of D-π-A-type mesoporous carbon nitride with benzene or thiophene as a π-spacer is proposed as an efficient photocatalyst for hydrogen evolution. The photocatalyst was successfully synthesized by a one-pot thermopolymerization based on nucleophilic substitution and a Schiff-base chemical reaction. On the molecular level, the insertion of an in-plane benzene as a π-spacer by forming covalent bonds C=N (acceptor) and C-N (donor) interrupts the continuity of tri-s-triazine units and maintains the intrinsic π-π conjugated electronic system. Synchronously, the enlarged electron delocalization and the intramolecular charge transfer induced by polarization provide force-directed migration of electrons, leading to boosted optical absorption capability and enhanced photogenerated carrier separation. With the synergistic effects of the mesoporous structure and excellent optical and electronic properties, a fivefold increase in the H2 evolution rate compared with that of pristine g-C3 N4 was achieved with robust performance. In addition, other simple aromatic heterocyclic compounds (e.g., pyridine, thiophene and furan)-based D-π-A structures with a higher hydrogen evolution rate (up to sevenfold increase) were also explored to broaden the application for the design of novel photocatalysts.

[Analysis of the factors related to glomerular filtration rate in type 2 diabetes without albuminuria].

OBJECTIVE: To analyze the risk factors affecting the glomerular filtration rate (GFR) in type 2 diabetic patients without albuminuria. METHODS: A total of 131 type 2 diabetic patients with normal urinary albumin excretion rate (UAER) were divided into normal GFR group and decreased GFR group. The factors relevant to GFR were analyzed by multiple factors regression. RESULTS: Age, course of diabetes, systolic blood pressure, prevalence of hypertension, the level of serum creatinine (SCr), blood urea nitrogen (BUN) and uric acid (UA) were significantly higher in decreased GFR group than in normal GFR group. Multivariate regression showed that SCr, age, systolic blood pressure, and UA were negatively correlated to GFR. CONCLUSION: Reduced GFR occurs in some type 2 diabetic patients without albuminuria. SCr, age, systolic blood pressure and UA are the major factors related to decreased GFR. The degree of early renal damage in diabetic patients can be better evaluated by combining GFR and UAER.

[Association of glycosylated hemoglobin A1c control with the complications in type 2 diabetic patients].

OBJECTIVE: To investigate the status of glycosylated hemoglobin A1c (GHbA(1c)) control in type 2 diabetic patients and its relation to diabetic complications. METHODS: A total of 676 patients with type 2 diabetes were investigated for GHbA(1c) level and the diabetic complications. The patients were divided into two groups with GHbA(1c) >7% and GHbA(1c)< or =7%, and the relation of GHbA(1c) with the complications was analyzed. RESULTS: The rate of good GHbA(1c) control (GHbA(1c)< or =7%) was 35.1% (237/676) in these patients, and 64.9% (439/676) of the patients showed poor GHbA(1c) control (GHbA(1c)>7%). The rates of hypertension and cerebralovascular complications were significantly higher in patients with GHbA(1c)>7% than in those with GHbA(1c)< or =7% (69.9% vs 55.7%, and 21.8% vs 8.9%, respectively, P<0.001), but the rate of coronary heart disease was comparable between the two groups (18.7% vs 17.3%, P>0.05). The patients with poor GHbA(1c) control had significantly higher incidences of diabetic peripheral neuropathy and fatty liver than those with good GHbA(1c) control (46.0% vs 35.0%, and 36.9% vs 25.3%, respectively, P<0.01), but no significant differences were found in the incidences of diabetic nephropathy (18.7% vs 16.5%), diabetic retinopathy (30.8% vs 27.4%) or diabetic feet (5.0% vs 3.8%) between the two groups (P>0.05). CONCLUSION: Type 2 diabetic patients have generally low rate of successful GHbA(1c) control, which can be associated with the occurrence of diabetic complications, suggesting the necessity of more rigorous diabetic health education and GHbA(1c) monitoring in these patients.

[The influence of elective course of emergency treatment for medical students on the cultivation of first aid knowledge and skill of cardio-pulmonary resuscitation].

OBJECTIVE: To investigate the influence of elective course of emergency treatment for medical students on the cultivation of first aid knowledge and skills of cardio-pulmonary resuscitation. METHODS: Senior students major in medicine of our university were randomly divided into observation group and contrast group with 30 students in each group according to whether an elective course of emergency treatment was given or not. All of them then received a test of first aid knowledge and cardio-pulmonary resuscitation skills. RESULTS: The theoretical exam scores in observation group and contrast group were respectively 78.5+/-9.1 and 46.7+/-15.6. The scores in observation group were significantly higher than that in contrast group (P < 0.01). Cardio-pulmonary resuscitation skills scores in observation group and contrast group were respectively 7.32+/-0.83 and 6.63+/-0.91. The scores in observation group were significantly higher than that in contrast group (P < 0.01). The number of failure for closed cardiac massage in 60 times in observation group and contrast group was respectively 5.06+/-0.58 and 5.77+/-0.63. The number of mouth to mouth artificial respiration in 4 times in observation group and contrast group was 0.92+/-0.16 and 1.10+/-0.17, respectively. There were notable differences in the number of failure in resuscitation maneuvers between two groups (both P < 0.01), observation group being obviously poorer than contrast group. CONCLUSION: An elective course of emergency treatment given to medical students plays an important role in the cultivation of first aid knowledge and skills in cardio-pulmonary resuscitation. It is therefore necessary that emergency medicine is included as a required course in medical college.