Increased Protection of Earlier Use of Immunoprophylaxis in Preventing Perinatal Transmission of Hepatitis B Virus.

BACKGROUND: Passive-active immunoprophylaxis against mother-to-child transmission (MTCT) of hepatitis B virus (HBV) recommends administering hepatitis B immunoglobulin (HBIG) and birth-dose hepatitis B vaccine in infants within 12 or 24 hours after birth. With this protocol, MTCT of HBV still occurs in 5-10% infants of HBV-infected mothers with positive hepatitis B e antigen (HBeAg). The present study aimed to investigate whether earlier administration of HBIG and hepatitis B vaccine after birth can further increase protection efficacy. METHODS: We conducted a prospective, multi-center observational study in infants born to mothers with HBV infection, in whom neonatal HBIG and birth dose hepatitis B vaccine were administered within one hour after birth. The infants were followed up for HBV markers at 7-14 months of age. RESULTS: A total of 1140 pregnant women with HBV were enrolled, and 982 infants (9 twins) of 973 mothers were followed up at 9.6 ± 1.9 months of age. HBIG and birth-dose vaccine were administered in newborn infants within a median of 0.17 (0.02-1.0) hours after birth. The overall rate of MTCT was 0.9% (9/982), with none (0%) of the 607 infants of HBeAg-negative mothers and 9 (2.4%) of 375 infants of HBeAg-positive mothers acquiring HBV. All 9 HBV-infected infants were born to mothers with HBV DNA >2.75 × 106 IU/mL. Maternal HBV DNA levels >2 × 106 IU/mL were an independent risk factor (odds ratio, 10.627; 95% confidence interval, 2.135-∞) for immunoprophylaxis failure. CONCLUSIONS: Earlier use (within 1 hour after birth) of HBIG and hepatitis B vaccine can provide better protection efficacy against MTCT of HBV.

Formation of Twin Boundaries in Rapidly Solidified Metals through Deformation Twinning.

The rapid solidification process is relevant to many emerging metallurgical technologies. Compared with conventional solidification processes, high-density microstructure defects and residual thermal stress are commonly seen in rapidly solidified metals. Among the various defects, potentially beneficial twin boundaries have been observed in the rapidly solidified nanocrystalline microstructures of many alloy systems. In this work, a pathway for forming twin boundaries in rapid solidification processes is proposed. A detailed derivation of strain inhomogeneities upon thermal shrinkage and the deformation twinning phase field method is given. By calculating cooling-induced thermal strain inhomogeneity in nanocrystalline metals and growth thresholds for deformation twinning using the phase field method, it is shown that residual thermal strain hotspots in the microstructure can reach the threshold for deformation twinning when the shear elastic property of grain boundaries is significantly different from the bulk.

Inverse Design of Valley-Like Edge States of Sound Degenerated Away from the High-Symmetry Points in a Square Lattice.

Robust edge states of periodic crystals with Dirac points fixed at the corners or centers of the Brillouin zones have drawn extensive attention. Recently, researchers have observed a special edge state associated with Dirac cones degenerated at the high symmetric boundaries of the first irreducible Brillouin zone. These nodal points, characterized by vortex structures in the momentum space, are attributed to the unavailable band crossing protected by mirror symmetry. By breaking the time reversal symmetry with intuitive rotations, valley-like states can be observed in a pair of inequivalent insulators. In this paper, an improved direct inverse design method is first applied to realize the valley-like states. Compared with the conventional strategy, the preparation of transition structures with degeneracy points is skipped. By introducing the quantitative gauge of mode inversion error, insulator pairs are directly obtained without manually tuning the structure with Dirac cone features.

Evaluation of cesarean delivery rates in different levels of hospitals in Jiangsu Province, China, using the 10-Group classification system.

OBJECTIVE: To compare cesarean delivery (CD) rates in referral and non-referral hospitals in Maternal Safety Collaboration in Jiangsu province, China. METHODS: Sixteen participants (4 referral hospitals, 12 non-referral hospitals) from Drum Tower Hospital Collaboration for Maternal Safety reported CD rates in 2019 using ten-group classification system and maternal/neonatal morbidity and mortality. RESULTS: A total of 22,676 CDs were performed among 52,499 deliveries and the average CD rate was 43.2% (range 34.8-69.6%). CD rate in non-referral hospitals (44.7%) was significantly higher than it was in referral hospitals (40.4%, p < .001). Term singleton cephalic nulliparous women with spontaneous labor (Group 1) or induced labor (Group 2a) had higher CD rates if they were cared in non-referral hospitals compared with those in referral hospitals (Group 1: 11.8% vs. 4.4%, p < .001; Group 2a: 29.1% vs. 21.3%, p < .001). In non-referral hospitals, CD rate in Group 5 and the proportion of Group 5 to the overall population were also significantly higher than those in referral hospitals (98.5% vs. 92.5%, p < .001; and 21.0% vs. 14.5%, p < .001). CONCLUSION: To decrease the CD rate, we need to take efforts in decreasing unnecessary operations for term singleton cephalic nulliparous women and increasing the rate of trial of labor after CD.

Incidence and seroprevalence of hepatitis E virus infection in pregnant women infected with hepatitis B virus and antibody placental transfer in infants.

BACKGROUND: Hepatitis E has poor outcomes in pregnant women. Superinfection of hepatitis E virus (HEV) in patients infected with hepatitis B virus (HBV) may worsen liver disease. OBJECTIVES: To estimate the incidence and seroprevalence of HEV infection among HBV-infected pregnant women, to investigate the transplacental transfer of maternal anti-HEV IgG, and to compare the maternal and neonatal outcomes in anti-HEV positive and negative pregnant women. STUDY DESIGN: Totally 391 HBV-infected pregnant women were recruited from April 2012 to October 2014. Paired mothers and infants were followed up at an average 9.8 months postpartum. Anti-HEV IgG and IgM were tested by ELISA. RESULTS: Of the pregnant women, none was anti-HEV IgM positive and 42 (10.7%) were IgG positive. At the follow-up, 3 seronegative women converted to anti-HEV IgG positive, with an estimated incidence of 17 per 1000 person-years. No significant differences of gestational age, preterm birth rate, Apgar score and birthweight were observed between newborns of anti-HEV IgG positive and negative mothers. Of the 42 neonates born to anti-HEV IgG positive mothers, 38 (90.5%) had anti-HEV IgG in their cord blood. The neonatal and maternal anti-HEV IgG levels were positively correlated (r=0.827, p<0.05). All infants were negative for both anti-HEV IgM and IgG at the follow-up. CONCLUSIONS: HBV-infected pregnant women rarely have novel HEV infection during late pregnancy in Jiangsu, China. Maternal anti-HEV IgG efficiently transfers into the fetuses, and disappears in infants before 10 months old.

Minimization of hepatitis B infection among children in Jiangsu, China, 12years after integration of hepatitis B vaccine into the expanded program on immunization.

BACKGROUND: China has integrated hepatitis B vaccine into the Expanded Program on Immunization since 2002. We aimed to survey the seroprevalence of and immunity to hepatitis B virus (HBV) in children born from 2002 to 2014 in Jiangsu, China. METHODS: Totally 3442 children (M:F=2072:1370) at the age of 7months to 12years (5.5±3.6), from five cities and rural areas across Jiangsu province, were enrolled. Blood samples were measured for HBV markers by ELISA and quantitative microparticle enzyme immunoassay. HBV DNA was tested by real-time PCR and S region was amplified by nested PCR. RESULTS: Twelve (0.35%) children were positive for hepatitis B surface antigen (HBsAg) and 34 (0.99%) were HBsAg negative and positive for antibody against hepatitis B core antigen (anti-HBc). Totally 2542 (73.85%) children had anti-HBs levels ⩾10mIU/ml and 535 (15.54%) with 2-9.9mIU/ml. All 12 HBsAg-positive children had detectable HBV DNA with a mean level of 6.1±1.7logIU/ml (3.3-8.1logIU/ml); 8 were genotype C and 4 were genotype B. No mutation was detected in the a determinant of HBsAg. HBV DNA was not detected in all the 34 children with positive anti-HBc and negative HBsAg. CONCLUSION: HBsAg prevalence among children in Jiangsu born after the introduction of universal vaccination against hepatitis B has significantly decreased. No mutation of S gene is associated with vaccine failure in the cohort of children.

Shikonin induces apoptosis and inhibits migration of ovarian carcinoma cells by inhibiting the phosphorylation of Src and FAK.

The present study identified that shikonin, a naphthoquinone extracted from the roots of Lithospermum erythrorhizon, inhibits the migration of ovarian cancer cells and induces their apoptosis by impairing the phosphorylation of two kinases, proto-oncogene tyrosine protein kinase Src (Src) and focal adhesion kinase (FAK). Ovarian carcinoma SKOV-3 cells were treated with various concentrations of shikonin and analyzed for the effects on cell migration, invasion and apoptosis via Transwell assays and flow cytometry. In addition, the effects of shikonin administration on the expression and phosphorylation of Src and FAK in the SKOV-3 cells were analyzed by western blotting. Shikonin appeared to induce apoptosis and decrease cell migration in the SKOV-3 ovarian cells. Furthermore, the present study provides evidence that shikonin may exert these effects on human ovarian carcinoma cells via the inhibition of the protein tyrosine kinases, Src and FAK. Thus, shikonin should be considered for additional investigation as a candidate agent for the prevention and treatment of human ovarian cancer.

MicroRNA-7 inhibits metastasis and invasion through targeting focal adhesion kinase in cervical cancer.

MicroRNAs (miRNAs) are aberrantly expressed in cervical cancer. miR-7 has been demonstrated to function as both an oncogene and a tumor suppressor in some types of human cancers. In the present study, miR-7 was significantly downregulated in cervical cancer, especially metastatic tumors. Ectopic expression of miR-7 significantly inhibited metastasis and invasion in Hela and C33A cells. Upregulated miR-7 significantly suppressed focal adhesion kinase (FAK) at transcriptional and translational levels. Furthermore, the level of FAK was negatively correlated with miR-7 in cervical cancer tissues. In conclusion, miR-7 inhibited the metastasis and invasion of cervical cancer at least partially through targeting FAK. The findings of this study provide novel insight with potential therapeutic applications for the treatment of metastatic cervical cancer.