[Real-world study on the efficacy and safety of first-line antiviral therapy for chronic hepatitis B].

Objective: To clarify the clinical efficacy of first-line oral antiviral drugs tenofovir alafenamide (TAF), tenofovir disoproxil fumarate (TDF), and entecavir (ETV) in the treatment of chronic hepatitis B (CHB) and their safety profiles with lipid, bone, and kidney metabolism. Methods: 458 CHB cases diagnosed and treated at the Department of Hepatology of Integrated Traditional Chinese and Western Medicine of the Third Hospital of Hebei Medical University from February 2010 to November 2022 were selected. TAF (175 cases), TDF (124 cases), and ETV (159 cases) were used as therapies. At 24 and 48 weeks, the virology, biochemical response, changes in liver stiffness measurement (LSM), and bone, kidney, and blood lipid metabolism safety profiles were compared and analyzed. Results: After 24 and 48 weeks of TAF, TDF, and ETV therapy, HBV DNA load decreased by 3.28, 2.69, and 3.14 log10 IU/ml and 3.28, 2.83, and 3.65 log10 IU/ml, respectively, compared with the baseline, and the differences between the three groups were statistically significant, P < 0.001. The complete virological response rates were 73.95%, 66.09%, 67.19%, and 82.22%, 72.48%, and 70.49%, respectively. The incidence rates of low-level viremia were 16.67%, 21.70%, and 23.08%, while poor response rates were 1.11%, 3.67%, and 4.10%. ALT normalization rates were 64.00%, 63.89%, 67.96%, and 85.33%, 80.56%, 78.64%, respectively, and there was no statistically significant difference among the groups. LSM was significantly improved in patients treated with TAF for 48 weeks, P = 0.022. Serum phosphorus level gradually decreased with the prolongation of TDF treatment. The TAF treatment group had a good safety profile for kidney, bone, and phosphorus metabolism, with no dyslipidemia or related occurrences of risk. Conclusion: There are some differences in the therapeutic effects of first-line anti-HBV drugs. TAF has the lowest incidence of low-level viremia after 48 weeks of treatment and has a good safety profile in kidney, bone, and blood lipid metabolism.

Development of a mental script for the mental practice of micro suturing: a methodological approach.

INTRODUCTION: Motor imagery and mental practice are important for the acquisition and mastery of surgical skills. The success of this technique relies on the use of a well-developed mental script. In this study, we shared how we developed a mental script for basic micro suturing training by using a low-fidelity rubber glove model. METHODS: This study applied the design and development research framework. Five expert surgeons developed a mental script by performing a cognitive walkthrough to repair a vertical opening in a rubber glove model, followed by hierarchical task analysis. A draft script was created, and its face and content validity assessed with a checking-back process. Twenty-eight surgeons used the Mental Imagery Questionnaire (MIQ) to assess the validity of the final script. RESULTS: The process of developing the mental script is detailed. The assessment by the expert panel showed the mental script had good face and content validity. The mean overall MIQ score was 5.2±1.1 (standard deviation), demonstrating the validity of generating mental imagery from the mental script developed in this study for micro suturing in the rubber glove model. CONCLUSION: The methodological approach described in this study is based on a design and development research framework to teach surgical skills. This model is inexpensive and easily accessible, addressing the challenges of reduced opportunities to practise surgical skills. However, although motor skills are important, the surgeon's other non-technical expertise is not addressed with this model. Thus, this model should act as one surgical training approach, but not replace it.

Integrating instructional design principles into surgical skills training models: an innovative approach.

OBJECTIVE: Surgical training programmes are evolving from time-based to competency-based schedules, which define expected learning outcomes in surgical knowledge, clinical and technical skills according to training levels. This article aims to review current models in surgical skills acquisition and to propose an integrative process-driven, outcomes-based model for surgical skills acquisition and mastery. DESIGN: A literature review was conducted on the theories of motor skills acquisition using PubMed, Web of Science and Google Scholar from 2010 to February 2020. The review was limited to theories and models on surgical skills acquisition and mastery. Four models of surgical skills acquisition were included: Fitts and Posner's three-stage model of motor skills acquisition, Bandura's social learning theory, Ericsson's deliberate practice model and Jeannerod's motor simulation theory. These models are deficient in that there is no universally accessible opportunity to practise the surgical procedure outside of the operating theatre and without access to physical simulators. RESULTS: We propose an innovative model that allows deliberate practice of the procedure without the need for expensive physical simulators, and provides an on-demand, self-directed practice by the trainees to achieve the level of mastery. This new model, which incorporates motor imagery and mental practice, augmented by deliberate practice, will provide an alternative training path for expert performance in surgical procedures. CONCLUSIONS: The innovative model provides a solution to the reduced opportunity for practice by surgical trainees to achieve mastery in surgical motor skills.

Source identification and ecological impact evaluation of PAHs in urban river sediments: A case study in Taiwan.

The Love River and Ho-Jin River, two major urban rivers in Kaohsiung City, Taiwan, are moderately to heavily polluted because different types of improperly treated wastewaters are discharged into the rivers. In this study, sediment and river water samples were collected from two rivers to investigate the river water quality and accumulation of polycyclic aromatic hydrocarbons (PAHs) in sediments. The spatial distribution, composition, and source appointment of PAHs of the sediments were examined. The impacts of PAHs on ecological system were assessed using toxic equivalence quotient (TEQ) of potentially carcinogenic PAHs (TEQcarc) and sediment quality guidelines. The average PAHs concentrations ranged from 2161 ng/g in Love River sediment to 160 ng/g in Ho-Jin River sediment. This could be due to the fact that Love River Basin had much higher population density and pyrolytic activities. High-ring PAHs (4-6 rings) contributed to 59-90% of the total PAHs concentrations. Benzo(a)pyrene (BaP) had the highest toxic equivalence quotient (up to 188 ng TEQ/g). Moreover, the downstream sediments contained higher TEQ of total TPHs than midstream and upstream sediment samples. The PAHs were adsorbed onto the fine particles with high organic content. Results from diagnostic ratio analyses indicate that the PAHs in two urban river sediments might originate from oil/coal combustion, traffic-related emissions, and waste combustion (pyrogenic activities). Future pollution prevention and management should target the various industries, incinerators, and transportation emission in this region to reduce the PAHs pollution.

Vitamin D supplementation for osteoporosis in older adults: can we make it help better?

With the increase of the average age of our population, the incidence of diseases specific for older adults has been increasing. One of such diseases is osteoporosis. The true incidence of osteoporosis is unknown. But the estimates indicate that this disease affects wide proportions of the population, ranging in millions or even ten millions in large countries like the United States. As this poses a significant burden on the health care system, interventions that could prevent or treat this condition are in the focus of clinical research. Vitamin D, the determinant of bone health, has been tested in clinical studies as the agent to treat osteoporosis. Despite the progress, there is still some controversy about the targeted blood levels of vitamin D, most efficient way to supplement this vitamin, and clinical efficacy of this supplementation in the elderly.In the present review, we will highlight the metabolism of vitamin D and the aforementioned unresolved issues, as well as review the recent interventional studies on vitamin D supplementation. In the present review, we will highlight the metabolism of vitamin D and the aforementioned unresolved issues, as well as review the recent interventional studies on vitamin D supplementation.

[The nutrition status of lactating women in China].

Nutritional status of lactating women is considered to be a quantitative indicator reflecting the status of reproductive health. To improve nutrition status of lactating women and promote breastfeeding through targeted intervention measures, their dietary and nutritional situations, and related problems, should be fully understood. Generally, energy and macronutrient intake of lactating women can reach or exceed recommended levels, especially during the first month postpartum. However, the intake of some micronutrients is difficult to meet the requirement. These include vitamin D and vitamin B12, iron and zinc, and calcium, if milk and dairy product consumption is very low, suggesting that extra supplementation should be considered. The percentage of obesity or postpartum weight retention showed an increasing trend in urban and rural areas and was related to decreased or delayed breastfeeding or early weaning. Common micronutrient deficiencies included in vitamin D, vitamin B12, iron and zinc. In this paper, we reviewed various characteristics of the lactating women, including nutritional status, postpartum weight retention and micronutrient deficiencies. We suggest that improved suggestions be developed for China, based on data from National Nutrition Survey, Chinese National Nutrition and Health Surveillance and related studies conducted over the past 10 years.

Identification of a novel LEMD3 Y871X mutation in a three-generation family with osteopoikilosis and review of the literature.

INTRODUCTION: Osteopoikilosis is a rare and benign autosomal dominant genetic disorder, characterized by a symmetric but unequal distribution of multiple hyperostotic areas in different parts of the skeleton. Recent studies have reported loss-of-function mutations in the LEM domain containing 3 (LEMD3) gene, encoding an inner nuclear membrane protein, as a cause of osteopoikilosis. METHODS: We investigated LEMD3 gene in a three-generation family from China, with six patients affected with osteopoikilosis. Peripheral blood samples were collected from family members and 100 healthy controls. All exons of the LEMD3 gene and adjacent exon-intron sequences were amplified by PCR and subsequently sequenced. RESULTS: A novel heterozygous c.2612_2613insA (p.Y871X) mutation in exon 13 of LEMD3 was identified, which resulted in a frame shift predicted to generate a premature stop codon at amino acid position 871. The mutation co-segregates with the osteopoikilosis phenotype and was not found in 100 ethnically matched controls. CONCLUSION: We identified a new mutation in LEMD3 gene, accounting for the familial case of osteopoikilosis. In addition we also review the clinical manifestation, diagnosis and treatment of osteopoikilosis.

Anxiolytic activity evaluation of four medicinal plants from Cameroon.

Afrormosia laxiflora (A. laxiflora), Chenopodium ambrosioides (C. ambrosioides), Microglossa pyrifolia (M. pyrifolia) and Mimosa pudica (M. pudica) are plants used in traditional medicine in Cameroon to treat insomnia, epilepsy, anxiety, and agitation. They were evaluated for their anxiolytic like activity in mice. Animal models (elevated plus maze and stress-induced hyperthermia tests) were used. The four plants showed anxiolytic activity. In stress-induced hyperthermia test, A. laxiflora, C. ambrosioides, M. pyrifolia and M. pudica significantly antagonised the increase of temperature. ΔT° decreased from 0.75°C in the control group to 0.36°C at the dose of 110 mg/kg for A. laxiflora; from 1°C in the control group to -1.1°C at the dose of 120 mg/kg for C. ambrosioides; from 1.7°C in the control group to 0.2°C at the dose of 128 mg/kg for M. pyrifolia and from 1.3°C in the control group to 0.5°C at the dose of 180 mg/kg for M. pudica. In the elevated plus maze test, the four plants increased the number of entries into, percentage of entries into, and percentage of time in open arms. A. laxiflora, C. ambrosioides and M. pudica also reduced the percentage of entries and time in closed arms. In addition, C. ambrosioides, M. pyrifolia and M. pudica showed antipyretic activity by reducing the body temperature. The results suggested that C. ambrosioides, M. pyrifolia and M. pudica posses anxiolytic-like and antipyretic activities while A. laxiflora possesses only anxiolytic-like properties. These plants could be helpful in the treatment of anxiety and fever in traditional medicine in Cameroon.

The auditory motion aftereffect: its tuning and specificity in the spatial and frequency domains.

In this paper, the auditory motion aftereffect (aMAE) was studied, using real moving sound as both the adapting and the test stimulus. The sound was generated by a loudspeaker mounted on a robot arm that was able to move quietly in three-dimensional space. A total of 7 subjects with normal hearing were tested in three experiments. The results from Experiment 1 showed a robust and reliable negative aMAE in all the subjects. After listening to a sound source moving repeatedly to the right, a stationary sound source was perceived to move to the left. The magnitude of the aMAE tended to increase with adapting velocity up to the highest velocity tested (20 degrees/sec). The aftereffect was largest when the adapting and the test stimuli had similar spatial location and frequency content. Offsetting the locations of the adapting and the test stimuli by 20 degrees reduced the size of the effect by about 50%. A similar decline occurred when the frequency of the adapting and the test stimuli differed by one octave. Our results suggest that the human auditory system possesses specialized mechanisms for detecting auditory motion in the spatial domain.

Characterization, chromosomal assignment, and tissue expression of a novel human gene belonging to the ARF GAP family.

We have identified and characterized a novel human ADP-ribosylation factor GTPase-activating protein (ARFGAP1) gene that is related to other members of the ARF GAP family. The full-length cDNA for human ARFGAP1 was cloned following the identification of an EST obtained by large-scale cDNA library sequencing through a Blast search of public databases. Structurally, ARFGAP1 encodes a polypeptide of 516 amino acids, which contained a typical GATA-1-type zinc finger motif (CXXCX(16)CXXC) with the four cysteine residues that are highly conserved among other members of the ARF GAP family. The conserved ARF GAP domain may emphasize the biological importance of this gene. The ARFGAP1 gene, which contained 16 exons ranging from 0.5 to 9.3 kb, was mapped to human chromosome 22q13.2-q13.3 using radiation hybridization and in silico analyses. ARFGAP1 is strongly expressed in endocrine glands and testis. Interestingly, the expression of ARFGAP1 in testis is about sixfold higher than that in ovary, indicating a possible role of ARFGAP1 in the physiological function of sperm. Expression of ARFGAP1 in four human fetal tissues and seven cancer cell lines was also detected.

Arabidopsis profilins are functionally similar to yeast profilins: identification of a vascular bundle-specific profilin and a pollen-specific profilin.

Four members of the Arabidopsis profilin (pfn) multigene family have been cloned, sequenced and analyzed. By RNA gel blot analysis it has been shown that these four genes fall into two groups: one group (pfn1 and pfn2) is expressed in all organs of the plant and the other group (pfn3 and pfn4) in floral tissues only. Based on amino acid sequence alignment Arabidopsis profilins can be divided into the same two groups: PFN1 and PFN2 are 89% identical and PFN3 and PFN4 are 91% identical. Between these two groups they are 71-75% identical. The Arabidopsis profilins bind poly-L-proline and can complement both the Saccharomyces cerevisiae profilin deletion mutant and the Schizosaccharomyces pombe cdc3-124/profilin mutation, showing that the plant profilins are functionally similar to yeast profilins despite the low amino acid sequence homology. Analysis of pfn promoter-GUS fusion genes in transgenic Arabidopsis shows that pfn2 is specifically expressed in the vascular bundles of roots, hypocotyls, cotyledons, leaves, sepals, petals, stamen filaments and stalks of developing seeds, whereas expression of pfn4 is restricted to mature and germinating pollen grains.

[Influence of moxibustion on TXA2 and PGI2 in plasma of rat infected epidemic hemorrhagic fever virus (EHFV)].

In this paper, the model of rat infected EHFV was made and the influence of moxibustion on TXA2 and PGI2 in its plasma was observed. The results show that the content of TXA2 increased and PGI2 decreased in rat significantly after the abdominal inoculation of EHFV, and the content of TXA2 decreased and PGI2 increased markedly in rat infected EHFV to normal level after treatment with moxibustion, suggesting that the regulative function of moxibustion on TXA2 and PGI2 is one of its nerve-endocrine-immune regulations to the body, and there is an important significance. This study provides an important reference for mechanism exploration of moxibustion preventing and treating EHF.

[Influence of zhuangling agent to metabolism of lipid in aged rats].

The influence of Zhuangling Agent to the metabolism of lipid in healthy old rats has been studied. The results indicate that the agent can decrease the level of serum total cholesterol, low-density lipoprotein low-density lipoprotein cholesterol and peroxilipid and meanwhile can increase serum superoxide-dismutase and enhance the activity of acid phosphatase in some parts of the tissues. The result suggests that Zhuangling Agent possibly has an effect of anti-arteriosclerosis.

[Experiment research on moxibustion treating infected EHFV rat].

In this experiment, we established a rat model of EHFV infected by abdominal cavity, and observed the effect of moxibustion on the changes of antigens, antibodies, neural transmitters in blood and tissue on 60 weanling Wistar rats with EHF. The rats were divided into three groups: normal control group (N. group), EHF control group (C. group) and EHF with moxibustion group (M. group) at random. Moxibustion was given at "Shenshu" for 30 minutes daily, 7 days. The 14th day after infection of EHFV, blood and lungs of the rats were fetched. The results obtained are as follows: 1. The effect value of EHF antibodies dilution: in C. group, it is 1:267 +/- 82 (n = 8), in M.group, it is 1:336 +/- 176 (n = 10), there is a significantly different of specific antibodies between C.group and M.group. The results show that moxibustion had an effect of enhancing the function of immune system in rats with EHF. 2. The examination rate of EHFV antigens in lungs, in C.group, it is 62.5% (n = 8), in M.group, it is 49.4% (n = 16). The results show that moxibustion may enhance the immune function and the effect of eliminating virus of lymphocytes in lungs. 3. The value of BUN in serum: in N.group, it is 15.3 +/- 2.50 (n = 10), in C.group, it is 24.63 +/- 7.24 (n = 10), and in M.group, it is 16.36 +/- 4.59 (n = 26). There is a significantly different between C.group and N.group or M.group (P less than 0.001). There is no significantly different between N.group and M.group (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)