Analysis of related factors and treatment effect of chylothorax after lung surgery.

Background: Chylothorax is a seldom encountered complication following lung surgery. However, due to the widespread practice of lung surgery, postoperative complications have inevitably arisen. Chylothorax significantly affects a patient's discharge and recovery. This study investigates the risk factors for postoperative chylothorax at our center and analyzes various treatment modalities and prognostic outcomes. Methods: A retrospective analysis was conducted on all postoperative lung resections performed between January 2018 to August 2021 that met the inclusion criteria. Inclusion criteria covered patients undergoing various thoracic surgeries for lung conditions, while exclusion criteria included postoperative referrals for surgeries unrelated to lung tumors. Results: Postoperative chylothorax occurred in 42 of 5,706 patients after lung surgery. General information and disease-related data of the chylothorax and control group were analyzed by univariate and multivariate analyses. Multivariate analysis showed that serum albumin before surgery [odds ratio (OR) =0.86, 95% confidence interval (CI): 0.81-0.91, P<0.001], γ-glutamyl transferase level before surgery (after logarithmic transformation, OR =1.01, 95% CI: 1.00-1.01, P=0.01), squamous cell carcinoma (OR =2.77, 95% CI: 1.37-5.6, P=0.008), right mediastinal lymph node dissection (OR =3.15, 95% CI: 1.62-6.14, P<0.001) were independent risk factors for postoperative chylothorax. Among the 42 cases of postoperative chylothorax, 26 patients were improved with conservative treatments, and 6 patients were improved with chemical pleurodesis. Eight patients with postoperative chylothorax underwent thoracoscopic thoracic duct ligation. Three patients experienced severe postoperative complications: one was discharged after prolonged treatment, while the remaining two either succumbed or were discharged against medical advice. Conclusions: The incidence of chylothorax after lung surgery closely correlates with the intraoperative trauma and nutritional status of patients during the perioperative period. The majority of patients with postoperative chylothorax experienced relief through conservative measures, somatostatin administration, and chemical pleurodesis. Nevertheless, substantial postoperative chylothorax necessitated surgical intervention, involving thoracic duct ligation or drug pleurodesis.

Advances in efficacy prediction and monitoring of neoadjuvant immunotherapy for non-small cell lung cancer.

The use of immune checkpoint inhibitors (ICIs) has become mainstream in the treatment of non-small cell lung cancer (NSCLC). The idea of harnessing the immune system to fight cancer is fast developing. Neoadjuvant treatment in NSCLC is undergoing unprecedented change. Chemo-immunotherapy combinations not only seem to achieve population-wide treating coverage irrespective of PD-L1 expression but also enable achieving a pathological complete response (pCR). Despite these recent advancements in neoadjuvant chemo-immunotherapy, not all patients respond favorably to treatment with ICIs plus chemo and may even suffer from severe immune-related adverse effects (irAEs). Similar to selection for target therapy, identifying patients most likely to benefit from chemo-immunotherapy may be valuable. Recently, several prognostic and predictive factors associated with the efficacy of neoadjuvant immunotherapy in NSCLC, such as tumor-intrinsic biomarkers, tumor microenvironment biomarkers, liquid biopsies, microbiota, metabolic profiles, and clinical characteristics, have been described. However, a specific and sensitive biomarker remains to be identified. Recently, the construction of prediction models for ICI therapy using novel tools, such as multi-omics factors, proteomic tests, host immune classifiers, and machine learning algorithms, has gained attention. In this review, we provide a comprehensive overview of the different positive prognostic and predictive factors in treating preoperative patients with ICIs, highlight the recent advances made in the efficacy prediction of neoadjuvant immunotherapy, and provide an outlook for joint predictors.

A Robust Nonrigid Point Set Registration Method Based on Collaborative Correspondences.

The nonrigid point set registration is one of the bottlenecks and has the wide applications in computer vision, pattern recognition, image fusion, video processing, and so on. In a nonrigid point set registration problem, finding the point-to-point correspondences is challengeable because of the various image degradations. In this paper, a robust method is proposed to accurately determine the correspondences by fusing the two complementary structural features, including the spatial location of a point and the local structure around it. The former is used to define the absolute distance (AD), and the latter is exploited to define the relative distance (RD). The AD-correspondences and the RD-correspondences can be established based on AD and RD, respectively. The neighboring corresponding consistency is employed to assign the confidence for each RD-correspondence. The proposed heuristic method combines the AD-correspondences and the RD-correspondences to determine the corresponding relationship between two point sets, which can significantly improve the corresponding accuracy. Subsequently, the thin plate spline (TPS) is employed as the transformation function. At each step, the closed-form solutions of the affine and nonaffine parts of TPS can be independently and robustly solved. It facilitates to analyze and control the registration process. Experimental results demonstrate that our method can achieve better performance than several existing state-of-the-art methods.

Evaluation of a new point-of-care oral anti-HCV test for screening of hepatitis C virus infection.

BACKGROUND: Hepatitis C virus (HCV) infection is a public health issue for which an effective universal screening method is urgently needed. An oral anti-HCV test could provide a noninvasive and rapid screening strategy for HCV infection. This study evaluated the performance of a new point-of-care oral assay developed by Well for the detection of HCV antibody. METHODS: Individuals from three centers with and without HCV infection were enrolled. All participants were tested for oral HCV antibody using the Well assay and for serum HCV antibody using established tests (ARCHITECT i2000 anti-HCV assay and InTec serum anti-HCV assay). For participants who obtained positive results, HCV RNA was tested for verification. Some patients underwent the OraQuick HCV test at the same time, and some self-tested with the Well assay during the same period. RESULTS: A total of 1179 participants, including 486 patients with chronic HCV infection, 108 patients with other liver diseases, and 585 individuals who underwent physical examination, were enrolled. The Well anti-HCV test had a sensitivity of 91.88% (95% confidence interval [CI]: 88.97-94.09%) and a specificity of 98.00% (96.58-98.86%) for oral HCV antibody detection. The consistency between the Well and InTec assays was 97.02% (1138/1179). The consistency between the Well and OraQuick assays was 98.50% (197/200). Furthermore, the results of self-testing were highly consistent with those of researcher-administered tests (Kappa = 0.979). In addition, the HCV RNA results also showed that HCV RNA could only be detected on 1 of the 39 false-negative samples, and for 172 positive HCV RNA results, 171 could be detected by the Well oral anti-HCV assay. CONCLUSIONS: The Well oral anti-HCV test offers high sensitivity and specificity and performed comparably to both the OraQuick assay and InTec assay for HCV diagnosis. Thus, the Well test represents a new tool for universal HCV screening to identify infected patients, particularly in regions with limited medical resources.

Hydrolysis and carbonization of reactive dyes/cotton fiber in hydrothermal environment.

To understand the evolution and mechanism of the hydrothermal carbonization products of colored cotton fiber, hydrothermal carbonization experiments were carried out on colored cotton fiber dyed with reactive red X-3B and reactive blue KN-R. Fourier transform infrared spectroscopy, X-ray diffraction, and elemental analysis were used to characterize the hydrochar from colored cotton fiber and the hydrothermal behavior of reactive dyes under different reaction temperatures and time conditions. The study showed that when the reaction temperature was in the range of 210-250 °C, hydrolysis of reactive dyes was complete in 6 h, and organic acid that is produced by the degradation of cotton fiber accelerates the hydrolysis of dyes. Also, the hydrolysis products of dyes were involved in the hydrothermal carbonization of cotton fiber and covered the inside of the carbon microspheres; this led to changes in the elemental composition and functional group of the hydrochar. However, the dye content in colored fabric was limited because of limited dye-uptake. Consequently, the reactive activity of dyes was not strong enough to change the hydrothermal behavior of cotton fiber.

Replication Inhibition of Hepatitis B Virus and Hepatitis C Virus in Co-Infected Patients in Chinese Population.

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infections contributes to a substantial proportion of liver disease worldwide. The aim of this study was to assess the clinical and virological features of HBV-HCV co-infection. METHODS: Demographic data were collected for 3238 high-risk people from an HCV-endemic region in China. Laboratory tests included HCV antibody and HBV serological markers, liver function tests, and routine blood analysis. Anti-HCV positive samples were analyzed for HCV RNA levels and subgenotypes. HBsAg-positive samples were tested for HBV DNA. RESULTS: A total of 1468 patients had chronic HCV and/or HBV infections. Among them, 1200 individuals were classified as HCV mono-infected, 161 were classified as HBV mono-infected, and 107 were classified as co-infected. The HBV-HCV co-infected patients not only had a lower HBV DNA positive rate compared to HBV mono-infected patients (84.1% versus 94.4%, respectively; P < 0.001). The median HCV RNA levels in HBV-HCV co-infected patients were significantly lower than those in the HCV mono-infected patients (1.18[Interquartile range (IQR) 0-5.57] versus 5.87[IQR, 3.54-6.71] Log10 IU/mL, respectively; P < 0.001). Furthermore, co-infected patients were less likely to have detectable HCV RNA levels than HCV mono-infected patients (23.4% versus 56.5%, respectively; P < 0.001). Those HBV-HCV co-infected patients had significantly lower median HBV DNA levels than those mono-infected with HBV (1.97[IQR, 1.3-3.43] versus 3.06[IQR, 2-4.28] Log10 IU/mL, respectively; P < 0.001). The HBV-HCV co-infection group had higher ALT, AST, ALP, GGT, APRI and FIB-4 levels, but lower ALB and total platelet compared to the HBV mono-infection group, and similar to that of the HCV mono-infected group. CONCLUSION: These results suggest that co-infection with HCV and HBV inhibits the replication of both viruses. The serologic results of HBV-HCV co-infection in patients suggests more liver injury compared to HBV mono-infected patients, but is similar to HCV mono-infection.

Natural Killer p46 Controls Hepatitis B Virus Replication and Modulates Liver Inflammation.

Natural killer (NK) cells play an important role in hepatitis B virus (HBV) infection control, and are regulated by a complex network of activating and inhibitory receptors. However, NK cell activity in HBV patients remains poorly understood. The objective of this study was to investigate the phenotypic and functional characteristics of circulating NK cells in patients during different chronic hepatitis B (CHB) infection stages. We investigated NK cell phenotypes, receptor expression and function in 86 CHB patients and 20 healthy controls. NK cells were purified and NK cell subsets were characterized by flow cytometry. Cytotoxic activity (CD107a) and interferon-gamma (IFN-γ) secretion were examined, and Natural Killer p46 (NKP46) blockade and spontaneous NK cell cytolytic activity against K562, HepG2 and HepG2.215 cell lines was studied. Activating NKp46 receptor expression was higher in inactive HBsAg carriers when compared with other groups (p = 0.008). NKp46 expression negatively correlated with HBV DNA (R = -0.253, p = 0.049) and ALT (R = -0.256, p = 0.045) levels. CD107a was higher in immune-activated groups when compared with immune-tolerant groups (p = 0.039). CD107a expression was related to viral load (p = 0.02) and HBeAg status (p = 0.024). In vitro NKp46 blockade reduced NK cell cytolytic activity against HepG2 and HepG2.215 cell lines (p = 0.02; p = 0.039). Furthermore, NK cells from high viral load CHB patients displayed significantly lower specific cytolytic activity against anti-NKp46-loaded K562 targets (p = 0.0321). No significant differences were observed in IFN-γ secretion (p > 0.05). In conclusion, NKp46 expression regulates NK cell cytolytic function. NKp46 may moderate NK cell activity during HBV replication suppression and HBV-associated liver damage and may be critical for NK cell activity during CHB infection.

Etiology and prevalence of abnormal serum alanine aminotransferase levels in a general population in Northeast China.

BACKGROUND: Chronic liver diseases are a major burden in China. Alanine aminotransferase (ALT) can be used as an indicator of hepatocyte damage. In this study, we determined the prevalence and etiologies of elevated ALT in an adult population in Jilin, China. METHODS: A total of 4072 individuals aged between 18 and 79 years were first interviewed, and then underwent ultrasonography and blood tests. RESULTS: The prevalence of elevated ALT was 17.53%. The most noticeable risk factor for ALT elevation was non-alcoholic fatty liver disease (NAFLD) (accounting for 10.79%), metabolic syndrome (16.25%), or both (20.31%). The development of NAFLD occurred mostly in female peasants and small businessmen with increased income, age, fasting plasma glucose, body mass index, triglyceridemia, and low-density lipoprotein and decreased education level, high-density lipoprotein. Elevated ALT frequently occurred in low education level, male peasants and small businessmen with increased income, body mass index and triglyceride who had NAFLD and/or metabolic syndrome. However, elevated ALT with infection of hepatitis B or C virus was not associated with metabolic disorders, but rather with gender, occupation and increased age. CONCLUSION: The results from the current study demonstrate that elevated ALT is fairly high in the Northeast population (17.53%) and that the cause of its elevation is mostly due to NAFLD and metabolic syndrome.

Seroprevalence and risk factors for hepatitis B infection in an adult population in Northeast China.

BACKGROUND AND AIM: The prevalence of the hepatitis B virus (HBV) is higher in adults than in children. We determined the seroepidemiology of HBV infection in an adult population in JiLin, China, to guide effective preventive measures. METHODS: A cross-sectional serosurvey was conducted throughout JiLin, China. A total of 3833 people was selected and demographic and behavioral information gathered. Serum samples were tested for HBV markers and liver enzymes. RESULTS: The prevalence of the hepatitis B surface antigen (HBsAg), the antibody to the hepatitis B surface antigen (anti-HBs), the hepatitis B e antigen (HBeAg), the antibody to HBeAg (anti-HBe), and the antibody to the hepatitis B core antigen (anti-HBc) were 4.38%, 35.66%, 1.38%, 6.65%, and 40.88%, respectively. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were significantly higher among HBsAg (+) than HBsAg (-) subjects. By multivariate logistic regression analysis, independent predictors for chronic HBV infection were smoking, poor sleep quality; occupation as private small-businessmen, laborers, or peasants; male gender; family history of HBV; personal history of vaccination; and older age. Independent predictors for exposure to HBV were large family size, occupation as a private small-businessman, male gender, family history of HBV, personal history of vaccination, and older age. Independent predictors for immunity by vaccination were occupation as a private small-businessman, high income, personal history of vaccination, and young age. Independent predictors for immunity by exposure were drinking, male gender, personal history of vaccination, and older age. CONCLUSIONS: The prevalence rate of HBV infection (4.38%) was lower than the previous rate of general HBV vaccination. However, 44.59% of the population remained susceptible to HBV. The prevalence of HBV infection was high in young adults, private small-businessmen, peasants, those with a family history of HBV, and males. Therefore, immunization of the non-immune population is reasonable to reduce hepatitis B transmission between adults.

Risk factors for non-alcoholic fatty liver disease in a Chinese population.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a serious health concern in China. The goal of this cross-sectional study was to determine the prevalence of NAFLD and identify the risk factors associated with this disease in Northern China. METHODS: In 2007, a total of 6063 adults from Dehui, a city in Northern China, were surveyed and demographic and social-economic characteristics, life behaviors, and medical history were recorded. Among them, 3850 subjects were randomly selected for physical examination, fasting plasma glucose (FPG) test, fasting lipid and liver function profiles, hepatitis B and C infection screening, and ultrasound examination. The frequency of NAFLD in this population was analyzed by the Chi-square test and the association of potential risk factors was analyzed by logistic regression. RESULTS: The prevalence of NAFLD was 15.9% in this population and the prevalence in females was significantly higher than that in males, particularly for the elderly subgroup. Obesity, hypertension, FPG, diabetes, and metabolic syndrome (MS)-related hyperlipidemia were significantly associated with NAFLD. The data indicate that MS-related multiple risk factors synergistically increase the risk for NAFLD. CONCLUSION: The prevalence of NAFLD is high in Northern China, which may be associated with the high incidence of diabetes, hypertension, and MS in this area.

[Investigation of the characteristics of HCV genotypes of Han and Korean in Yanbian area of Jilin province].

OBJECTIVE: To investigate the characteristics of HCV genotypes of Han and Korean in Yanbian area of Jilin Province. METHODS: The HCV RNA load and genotypes of the 119 chronic hepatitis C patients in Yanbian area of Jilin Province were determined by real-time PCR and LiPA. The differences of the HCV genotypes in Han and Korean cases, in severity of the diseases, in HCV-RNA load, and in the relation with type 2 diabetes mellitus were analyzed. RESULTS: There was no significant difference in the distribution of each HCV genotype between Han and Korean patients (P > 0.05) with chronic hepatitis C. The difference between HCV genotype and HCV-RNA load was not significant (P > 0.05). With and without type 2 diabetes mellitus in these patients. The distribution of HCV genotype was also not significantly different (P > 0.05). The type 1b of HCV genotype in the moderate to severe chronic hepatitis C patients accounted for 58.06%. It was different compared with mild chronic hepatitis C patients (P < 0.05). CONCLUSION: 1) The type 1b is the most popular HCV genotype in Yanbian area of Jilin Province, type 2a is the second and there are still a few other genotypes. 2) There is no significant difference in the distribution of HCV genotypes between Han and Korean cases. 3) The HCV genotypes has nothing to do with the load of HCV-RNA. 4) The distribution of HCV genotypes in chronic hepatitis C patients with and without diabetes mellitus is not significantly different. 5) Type 1b of HCV infection is relatively severe.

Immunologic characterization of posthepatitis cirrhosis caused by HBV and HCV infection.

No specific treatment can reverse the liver injury in cirrhosis. This study aims to characterize immune status and correlations between cirrhosis induced by HBV and HCV. Phenotypes of peripheral blood lymphocyte subsets (T, NK, regulatory T cells) and Th cytokine secretion were analyzed using flow cytometry in 42 HBV-cirrhotic and 40 HCV-cirrhotic patients. Cirrhotic patients had a lower proportion of CD3(+)CD8(+)T cells and NK cells, while the proportion of CD3(+)CD4(+)T cells and Treg cells were higher than those of healthy controls. The levels of Th2 cytokine (IL-6) in cirrhotic patients were increased, while only the Th1 cytokine (IFN-gamma) increased in HBV-cirrhotic patients. These findings show that there is no difference between the cirrhotic groups except in the IFN-gamma level. In cirrhosis, defects in innate, adaptive immune cells are likely regardless of which virus is involved. A cytokine imbalance may play a role in the development of posthepatitic cirrhosis.