[Mechanism relevant to hepatocellular carcinoma occurrence after negative conversion of viral DNA in treatment of chronic hepatitis B patients with nucleos(t)ide drugs].

Hepatocellular carcinoma (HCC) is a common malignant tumor in China, and most of the patients have a background of chronic HBV infection. Nucleos(t)ide drugs (NAs) are currently recommended by major guidelines as a first-line treatments for chronic hepatitis B. However, it is still clinically possible to observe that some patients who have acquired virological response (HBV DNA below the lower detection limit) after NAS treatment progress to HCC, and its mechanism of development is still unclear. In this review, the mechanism relevant to HCC progression in treatment of chronic hepatitis B patients with NAs is analyzed mainly from the aspects of gene integration and persistent inflammatory injury.

The investigation of the luminescent structure of thallium-doped cesium iodide (CsI:Tl) basing on the first-principles coupled with spectral analysis.

The luminescent structure of thallium-doped cesium iodide (CsI:Tl) and the behavior of electrons during luminescence are studied at great length based on the conventional first-principles calculation combined with ordinary spectroscopic analysis befittingly in this work. The hybrid functionals based on a screened Coulomb potential (HSE) is used to visualize the energy band structure of the experimental sample's system, and the corresponding relationship between the transition behavior of CsI:Tl energy levels and the spectrum is studied more accurately. We show the complete energy conversion process clearly, which involves the crystal beginning to receive the energy of a photon until the moment of de-excitation. All the fluorescence process is completed by Tl+ions that replace Cs+ions. Our results verify and complement the previous theories and potentially provide important references for the adjustment and design of the detectors and imaging equipment in different fields.

Host-specific response to HCV infection in the chimeric SCID-beige/Alb-uPA mouse model: role of the innate antiviral immune response.

The severe combined immunodeficiency disorder (SCID)-beige/albumin (Alb)-urokinase plasminogen activator (uPA) mouse containing a human-mouse chimeric liver is currently the only small animal model capable of supporting hepatitis C virus (HCV) infection. This model was utilized to characterize the host transcriptional response to HCV infection. The purpose of these studies was to investigate the genetic component of the host response to HCV infection and also to distinguish virus-induced gene expression changes from adaptive HCV-specific immune-mediated effects. Gene expression profiles from HCV-infected mice were also compared to those from HCV-infected patients. Analyses of the gene expression data demonstrate that host factors regulate the response to HCV infection, including the nature of the innate antiviral immune response. They also indicate that HCV mediates gene expression changes, including regulation of lipid metabolism genes, which have the potential to be directly cytopathic, indicating that liver pathology may not be exclusively mediated by HCV-specific adaptive immune responses. This effect appears to be inversely related to the activation of the innate antiviral immune response. In summary, the nature of the initial interferon response to HCV infection may determine the extent of viral-mediated effects on host gene expression.

[Genotyping and drug susceptibility of Mycobacterium tuberculosis isolated in Changping district in Beijing, 2011-2015].

Objective: To understand the genotype distribution of Mycobacterium tuberculosis and the drug susceptibility of M. tuberculosis with different genotypes in Changping district of Beijing and evaluate the application of genotyping of M. tuberculosis in local tuberculosis (TB) prevention and control. Methods: A total of 1 099 M. tuberculosis strains isolated in Changping from 2011 to 2015 were used. Spoligotyping and 12-locus VNTR recommended by Gao were used for the genotyping of these isolates. In addition, the susceptibility of the M. tuberculosis isolates to rifampin (RFP), isoniazid (INH), ethambutol (EMB), streptomycin (SM), amikacin (AMK) and ofloxcin (OFX) were detected by using conventional drug susceptibility test. Results: From 2011 to 2015, the detection rate of OFX-resistance increased from 2.9% to 8.9% (P=0.01). Of all the M. tuberculosis isolates, 976 belonged to Beijing genotype (88.8%), and the other 123 belonged to non-Beijing genotype (11.2%). In addition, there were 189 ancient Beijing genotype isolates and 787 modern Beijing genotype isolates, respectively. The proportion of Beijing genotype strains showed no significant increase in the past five years (81.1% in 2011 vs. 82.0% in 2015). On the basis of VTNR genotyping, only 2 isolates belonged to one cluster (0.1%). In addition, the AMK resistant rate of Beijing genotype strains (1.7%) was significantly lower than that of non-Beijing genotype strains (4.9%, P=0.02). Compared with modern Beijing genotype strains, the SM resistant rate of ancient Beijing genotype strains was significantly higher (28.0% vs. 15.7%, P=0.01). Conclusions: In the past five years, the OFX- resistant rate of M.tuberculosis in Changping was in increase. There was no significant difference in the detection of Beijing genotype strains during this period. In addition, the low clustering rate indicated that the TB transmission rate was low in Changping.

Accelerated up-regulation of L-Sox5, Sox6, and Sox9 by BMP-2 gene transfer during murine fracture healing.

Fracture repair is the best-characterized situation in which activation of chondrogenesis takes place in an adult organism. To better understand the mechanisms that regulate chondrogenic differentiation of mesenchymal progenitor cells during fracture repair, we have investigated the participation of transcription factors L-Sox5, Sox6, and Sox9 in this process. Marked up-regulation of L-Sox5 and Sox9 messenger RNA (mRNA) and smaller changes in Sox6 mRNA levels were observed in RNAse protection assays during early stages of callus formation, followed by up-regulation of type II collagen production. During cartilage expansion, the colocalization of L-Sox5, Sox6, and Sox9 by immunohistochemistry and type II collagen transcripts by in situ hybridization confirmed a close relationship of these transcription factors with the chondrocyte phenotype and cartilage production. On chondrocyte hypertrophy, production of L-Sox5, Sox9 and type II collagen were down-regulated markedly and that of type X collagen was up-regulated. Finally, using adenovirus mediated bone morphogenetic protein 2 (BMP-2) gene transfer into fracture site we showed accelerated up-regulation of the genes for all three Sox proteins and type II collagen in fractures treated with BMP-2 when compared with control fractures. These data suggest that L-Sox5, Sox6, and Sox9 are involved in the activation and maintenance of chondrogenesis during fracture healing and that enhancement of chondrogenesis by BMP-2 is mediated via an L-Sox5/Sox6/Sox9-dependent pathway.

Time-related deviations of fibronectin and type I, II and III collagen on the interface between a hydroxyapatite disc and the rim of a calvarial trephine defect in rabbits.

To pursue the events around hydroxyapatite (HA) discs (diameter 9 mm), implanted in calvarial defects in rabbits (diameter 11 mm), immunohistochemical changes of fibronectin and type I, II and III collagen were quantitatively determined in the connective tissue-HA (CTHA) and host bone-HA (BHA) interface at 8, 12 and 16 wk postimplantation. A marked enhancement of type I collagen staining in the BHA interface was noted at the 12th and the 16th wk in comparison to the CTHA interface and connective tissue in the untreated control defect. However, one of the characteristics of the staining in the CTHA interface was the finding of exceptionally high fibronectin and type III collagen at the 8th and the 12th wk in contrast to the BHA interface and the untreated control defect. The change in these immunohistochemically determined compositions was probably due to an active proliferation of vascular components in the CTHA interface. Bone regeneration in the CTHA interface was parallel to an increase in type I collagen and a decrease in fibronectin and type III collagen from 8 to 16 wk. This study indicated that variances in composition or characteristics of connective tissue in CTHA interface have taken place ahead of bone morphogenesis. The time-related derivation of connective tissue matrix components in the BHA and CTHA interface was confined to the interaction of implanted HA with host tissues in contact with the implant.

Morphological and biomechanical difference in healing in segmental tibial defects implanted with Biocoral or tricalcium phosphate cylinders.

To evaluate the effects of two bioceramics on bone regeneration during repair of segmental bone defects, Biocoral and tricalcium phosphate cylinders were implanted in osteotomized sheep tibial defects 16 mm in length and followed up for 16 weeks. In comparison with the TCP-implanted defect, a significant increment in area and density of external callus was quantified radiomorphometrically at 3 weeks, and a marked increase in maximal torque capacity, maximal angle of deformation and absorption of energy was demonstrated mechanically in the Biocoral-implanted tibia at 16 weeks after implantation. Better bone integration with the substratum was microscopically observed in Biocoral cylinders. With good osteointegration and biomechanical-performance, Biocoral seems to be superior to TCP in repair of segmental defects in weight-bearing limbs.

Microscopic evaluation of bone-implant contact between hydroxyapatite, bioactive glass and tricalcium phosphate implanted in sheep diaphyseal defects.

In order to compare morphological discrepancies in bone-implant contact in vertebrates, cylinders of hydroxyapatite, bioactive glass and tricalcium phosphate were implanted in segmental defects of the tibia in sheep. Three types of visible bone-implant contact were observed microscopically at 4 months after implantation. The trabecular web-like bone-implant contact noted in tricalcium phosphate seemed superior to the disseminated patchy bone-implant contact in bioactive glass and the buttressed bone-implant contact in hydroxyapatite with respect to both bone ingrowth and bioresorption of the implant. Differences of physicochemical properties on the surface among the three kinds of bioceramic implants probably give rise to different types of bone-implant contact.

The role of autogeneic bone marrow in the repair of a skull trephine defect filled with hydroxyapatite granules in the rabbit.

For study of the effect of autogeneic bone marrow on the repair of skull defects filled with hydroxyapatite (HA) granules, 20 trephine defects 11 mm in diameter in 10 New Zealand rabbit skulls were made. Three defects were implanted with HA granules (HAg), and seven defects were implanted with HA granules mixed with autogeneic bone marrow (HAg/BM) from the femoral medullary canal. Autogeneic bone marrow (BM) was implanted in three defects, and seven defects were left unfilled. Histomorphometric quantitation of bone and connective-tissue ingrowth into defects showed that the area of new bone ingrowth in BM (70.3 +/- 8.4%) was significantly larger than that in HAg (34.4 +/- 3.9%) and in HAg/BM (24.0 +/- 5.1%) (P < 0.01 and P < 0.01, respectively). Immunohistologic staining detected fibronectin and collagen type III as the main components in the defects filled with HAg and HAg/BM. The osteoconductive capacity of HA granules was not stimulated by adding fresh autogeneic bone-marrow cells.

Low dosage of native allogeneic bone morphogenetic protein in repair of sheep calvarial defects.

A sheep skull trephine defect model was used to test the efficacy of allogeneic partially purified sheep bone morphogenetic protein (sBMP), extracted using a low-cost alternative technique based on 60% ammonium sulphate saturation of the guanethidine-HCI extract of pulverized bone matrix. Eight mg of partially purified sBMP was implanted in six 22-mm right-side sheep calvarial critical-size defects trephined in the diploë area using a midline incision; left-side defects implanted with an equal amount of type IV collagen served as controls. After 16 weeks the sheep were killed and the defects removed. Formation of new bone was evaluated using radiomorphometry and histomorphometry. The healing percentage in sBMP-implanted defects was 60.8 +/- 8.1% and in controls 49.8 +/- 6.7% (P < 0.05) as assessed by radiomorphometry. In cross-sectional histomorphometry, newly formed bone regenerated 50.9 +/- 15.1% in the defects with sBMP and 16.1 +/- 10.6% in controls (P < 0.01). The good result, considering the low dosage of sBMP, can be explained by the strong osteoinductivity and low immunogenicity of native allogeneic sBMP.

Xenogeneic moose (Alces alces) bone morphogenetic protein (mBMP)-induced repair of critical-size skull defects in sheep.

A standardized skull defect in adult sheep was used to test the healing capacity of xenogeneic, partially purified, moose-derived bone morphogenetic protein (mBMP) extracted from the fresh long bones of moose (Alces alces) calves. An amount of 52 mg of mBMP mixed with 13 mg of purified type IV collagen (5:1) (mBMP/COL) in gelatin capsules was implanted into six 22-mm-diameter skull defects in adult sheep for comparison with six defects implanted with fresh autogenous bone marrow (BM) and six other controls implanted with a gelatin capsule containing 13 mg of type IV collagen (C). The amount of new bone formed was quantified from radiographs by computerized image analysis and histology. The healing percentage in the mBMP/COL group was significantly higher (93.18 +/- 4.51%) than in the BM (33.17 +/- 20.05%) or C group (31.32 +/- 17.41%) at 16 weeks after implantation. The difference between BM and C was not statistically significant. The level of anti-BMP antibody in the serum showed a significant increase in the group implanted with mBMP, but returned to normal after 6 weeks. The experiment demonstrated that xenogeneic mBMP possesses a strong osteoinductive capacity and weak immunogenicity.

[Promoting effect of L-dopa on experimental fracture healing].

This study was planned to investigate the effect of oral administration of L-Dopa, made in China, on fracture healing and to look into its activity or metabolic influence on biomechanical healing process. Both the tibia and fibula of left leg of 185 Wistar rats were manually fractured, but left alone without fixation, and were treated for 15 days. For the experimental group of animals, L-Dopa in suspension, 0.4 gm/kg BW, was given daily; for the control one, only the same amount of saline solution. 12 to 24 hours following intraperitoneal injection of radioisotope tracers, 35S-sodium sulfate and 45Ca-calcium chloride non-carrier solution, were used. The animals in group were put to death at the 5 10 15 20 30- and 40-th day respectively after fracture. The fracture specimens were taken and processed for examination and quantitative assessment. The data showed that the amount of sulphur in the primary callus was increasing up to the peak on the tenth day; it was greater, statistically significant, in the test group (0.19 +/- 0.05 DPM%) than in the control one (0.13 +/- 0.05 DPM%). They showed too that the amount of calcium incorporated in the callus was also increasing up to a top point but at the 15-th day; it was as well greatly, statistically significant in the test group (4.50 +/- 1.16 DPM%) than in the control one (2.65 +/- 1.90 DPM%).(ABSTRACT TRUNCATED AT 250 WORDS)

[Manufacture and usage of a new rotatometer of spine].

The purposes of this research are to study the changes of some projective points of vertebrae on roentgenogram during consecutive axial rotation and to design and manufacture a new rotatometer of spine for clinical and research work. Using 2 anatomic specimens of normal spines, aged 10 and 17 years. We took anteroposterior roentgenograms for each vertebra during consecutive axial rotation from 0 th 90 degrees. Some projective points on the roentgenograms were selected. Changes of the projective points were measured. The data were analysed with the stepwise regression, linear fitting in a microcomputer. The rotatometer was designed and manufactured upon the linear regressional equation. The results showed that there was an excellent correlation between actual rotation of vertebra and changes of the projective points on anteroposterior roentgenograms. The distances between the center of vertebral pedicle and lateral edge on convex side of vertebra and rotation angle Q were the reliable references which express the actual axial rotation of vertebra. We thought that rotation angle Q was the mark which had advantages of definition, directness, precision and extended measurable range. The 3 sets of graduations were used to measure the segments of T3-6, T7-12 and L1-4 neuromuscular scoliosis, some congenital scoliosis and axial rotation of spine without certain causes in adolescents. Quantitative measurement of scoliotic rotation is very important for determinating and selecting schemes of operations on scoliosis. It is also helpful to predict prognosis of scoliosis and evaluate the results of corrective operations on spinal deformity.

Impact of diabetes on diagnostic delay for pulmonary tuberculosis in Beijing.

SETTING: Delays in the diagnosis of pulmonary tuberculosis (PTB) increase the risk of transmission and severity of the disease. Little information is available on PTB patients with diabetes mellitus (DM). OBJECTIVES: To examine the impact of DM on delays in diagnosing PTB and the effect of diagnostic delay on the clinical presentation of PTB among patients in Beijing, China. DESIGN: In a cross-sectional study conducted in two PTB dispensaries of Beijing, all confirmed PTB patients were screened for DM. Data relating to diagnostic delay and clinical presentation of PTB were collected and analysed. RESULTS: Of 1126 PTB patients selected, 182 (16.2%) were identified as having DM. The median delay for PTB patients with DM (25 days) was significantly higher than that of PTB patients without DM (6 days). In a subgroup analysis, diagnostic delay was associated with smear positivity among PTB patients with DM (OR 3.10, 95%CI 1.66-5.76) and associated with smear positivity (OR 4.38, 95%CI 3.19-6.04), pulmonary cavities (OR 2.62, 95%CI 1.85-3.71) and more symptoms (OR 1.81, 95%CI 1.20-2.73) among PTB patients without DM. CONCLUSIONS: DM was associated with longer diagnostic delays, which in turn was associated with more serious clinical presentations of PTB. It is thus necessary to examine risk factors associated with diagnostic delay among PTB patients with and without DM.

Functional carriers for bone morphogenetic proteins.

This review covers advances in current researches on delivery systems for bone morphogenetic protein. In summary, it notes that the diversity of carriers, inorganic, organic and synthetic composite, have possessed physiochemical and biological properties and efficacy of delivery of bone morphogenetic protein promoting bone induction in experimental animals. It also traces a new trend in research on carrier systems for bone morphogenetic protein. A desirable carrier of BMP will bridge basic research with clinical application of bone morphogenetic protein.

Granular hydroxyapatite and allogeneic demineralized bone matrix in rabbit skull defect augmentation.

To study the effect of hydroxyapatite (HA) granules on new bone formation induced by allogeneic demineralized bone matrix (DBM) and to ascertain the specific dose response of bone regeneration in rabbit calvarial defects, implantation with different doses of DBM, HA granules and a mixture of DBM with HA, respectively, was undertaken. The results showed that the largest quantity of cartilage in the fourth week and woven and remodeled bone covering almost the whole area of the defect in the tenth and twelfth week, was visible in the 20-30 mg but not in the 40 mg DBM groups. New bone formation in the defects implanted with DBM and HA was markedly less than in those implanted with DBM alone and a large amount of fibrous tissue was initiated by HA granules. A significant negative correlation between new bone formation and fibrous tissue ingrowth was noted. HA granules, as disturbing the bone regeneration induced by DBM, are thus not a desirable combination, and a dose-block phenomenon according to the amount of DBM must be anticipated in repairing skull defects.

Producing vascularized bone by heterotopic bone induction and guided tissue regeneration: a silicone membrane-isolated latissimus dorsi island flap in a rat model.

Transformation of mesenchymal-type tissue into cartilage and bone can be induced by bone morphogenetic protein, and by its parent substratum, demineralized bone matrix. The authors were interested in transforming muscle island flaps into vascularized bone that could be used as autogeneic skeletal replacement parts. In Wistar rats, tubular latissimus dorsi muscle island flaps were created, using microsurgical techniques. The flaps were inserted by a cylinder of demineralized bone matrix (DBM) and enclosed in silicone rubber membrane tubes. The animals were followed-up for 10, 21, or 35 days. Rats with DBM implanted in muscle pouches served as controls. Quantitative radiomorphometry and qualitative histology were performed. A statistically significant linear time-related increase in radiomorphometrically-measured calcified tissue was found in the flaps with DBM from 10 days to 5 weeks. At 3 and 5 weeks, lamellar and cancellous bone with fully developed marrow was detected microscopically. There was no significant difference in bone quantity in the island flaps after 35 days, compared with the muscle pouches implanted with DBM, although the difference at 21 days was still significantly in favor of the island flaps. Using allogeneic DBM in rat muscle island flaps surrounded with a silicone membrane, it was possible to generate in vivo autogenous new bone with a good vascular supply and good mobility, allowing later transfer to another site. The experiment provided a basic technique that can be used as a standard in testing various osteoinductive substances for the production of vascular-pedicled new bone.

Bone inductive potential and dose-dependent response of bovine bone morphogenetic protein combined with type IV collagen carrier.

Using type IV collagen as carrier, the expression of bovine bone morphogenetic protein (bBMP) activity and the relation of ectopic bone formation to BMP dosage in the reconstitution were investigated in BALB mice. Visible heterotopic bone was induced by GuHCl-extracted bovine BMP at a minimal dose of 0.5 mg within 21 days after the BMP was covalently bound to type IV collagen of weight 5.6 mg. The dose-dependent osteogenetic response of BMP was retained in the BMP/type IV collagen composite. As the BMP dose increased in the reconstitution, the integrated intensity and area of bone and cartilage formation, as quantified by a computerized scanner, were enhanced. Degradation of the collagenous carrier was improved by BMP, and neovascularization of the implant site initiated by type IV collagen was also observed. The covalent binding of BMP to type IV collagen postponed the time-sequence of ectopic bone development induced by BMP alone. The conclusion was that the exaggerated and extended effects of type IV collagen on BMP are mainly due to chemotaxis to progenitor cells, immunogenetically inert, vascular initiation and biodegradability in type IV collagen.