DNA-Directed Assembly of Hierarchical MOF-Cellulose Nanofiber Microbioreactors with "Branch-Fruit" Structures.

Assembling metal-organic frameworks (MOFs) into ordered multidimensional porous superstructures promises the encapsulation of enzymes for heterogeneous biocatalysts. However, the full potential of this approach has been limited by the poor stability of enzymes and the uncontrolled assembly of MOF nanoparticles onto suitable supports. In this study, a novel and exceptionally robust Ni-imidazole-based MOF was synthesized in water at room temperature, enabling in situ enzyme encapsulation. Based on this MOF platform, we developed a DNA-directed assembly strategy to achieve the uniform placement of MOF nanoparticles onto bacterial cellulose nanofibers, resulting in a distinctive "branch-fruit" structure. The resulting hybrid materials demonstrated remarkable versatility across various catalytic systems, accommodating natural enzymes, nanoenzymes, and multienzyme cascades, thus showcasing enormous potential as universal microbioreactors. Furthermore, the hierarchical composites facilitated rapid diffusion of the bulky substrate while maintaining the enzyme stability, with ∼3.5-fold higher relative activity compared to the traditional enzyme@MOF immobilized in bacterial cellulose nanofibers.

Soy Protein Isolate-Chitosan Nanoparticle-Stabilized Pickering Emulsions: Stability and In Vitro Digestion for DHA.

The purpose of the study was to investigate the stability and oral delivery of DHA-encapsulated Pickering emulsions stabilized by soy protein isolate-chitosan (SPI-CS) nanoparticles (SPI-CS Pickering emulsions) under various conditions and in the simulated gastrointestinal (GIT) model. The stability of DHA was characterized by the retention rate under storage, ionic strength, and thermal conditions. The oral delivery efficiency was characterized by the retention and release rate of DHA in the GIT model and cell viability and uptake in the Caco-2 model. The results showed that the content of DHA was above 90% in various conditions. The retention rate of DHA in Pickering emulsions containing various nanoparticle concentrations (1.5 and 3.5%) decreased to 80%, while passing through the mouth to the stomach, and DHA was released 26% in 1.5% Pickering emulsions, which was faster than that of 3.5% in the small intestine. After digestion, DHA Pickering emulsions proved to be nontoxic and effectively absorbed by cells. These findings helped to develop a novel delivery system for DHA.

Biomimetic Microadhesion Guided Instant Spinning.

Animals create high-performance fibers at natural ambient conditions via a unique spinning process. In contrast, the spinning technologies developed by human beings are usually clumsy and require sophisticated skills. Here, inspired by adhesion-based silkworm spinning, we report a microadhesion guided (MAG) spinning technology for instant and on-demand fabrication of micro/nanofibers. Enabled by the adhesion between the spinning fluids and the microneedles, the MAG spinning can generate micro/nanofibers with programmable morphology. By further mimicking the head movement of the silkworm spinning, the MAG technology is extended with three different modes: straight, vibratory, and twisted spinning, which generate oriented fibers, hierarchical cross-linked fibers, and all-in-one fibers, respectively. Due to the prevalence of microadhesion and its unprecedented flexibility in operation, equipment-free MAG spinning is finally realized for instant fiber fabrication by only polymeric foams. Finally, the MAG spinning is demonstrated as a promising instant technology for emergent applications, such as wound dressing.

Confining Natural/Mimetic Enzyme Cascade in an Amorphous Metal-Organic Framework for the Construction of Recyclable Biomaterials with Catalytic Activity.

Integrating nanozymes with natural enzymes to form cascade reactions is one of the most promising ways to develop biocatalysts with versatile performance; however, the applicability of the cascade is typically hampered by the instability of enzymes and the hindrance of mass transfer in the host environment. Utilizing amorphous ZIF-90 (aZIF-90) as a host material, herein, we have reported a one-pot way to encapsulate glucose oxidase (GOx) and magnetic nanoparticles (MNP) to form GOx/MNP@aZIF-90. We reasoned that the amorphous structure of ZIF-90 not only provides a protected environment to confine the cascade reaction but also generates mesopores and internal voids to improve the performance of the enzymatic cascade. The catalytic activity of aZIF-90 was almost 4 times higher than that of crystalline composites, and the residual activity was higher than 80% after being stored for 9 days. This is the first time that GOx and MNP were simultaneously confined in aZIF-90 with mesopores, which suggested that an amorphous metal-organic framework is promising in the development of an enzymatic cascade.

Variants in STAT4 Associated With Cure of Chronic HBV Infection in HBeAg-positive Patients Treated With Pegylated Interferon-alpha.

BACKGROUND & AIMS: Variants in STAT4 (rs7574865) have been associated with seroconversion to hepatitis B e antigen (HBeAg) and reduction in levels of hepatitis B virus (HBV) DNA in patients with chronic infection treated with interferon alpha (IFNA). We evaluated the associations among rs7574865, loss of HB surface antigen (HBsAg, a marker of functional cure of HBV infection), and response to treatment with pegylated IFNA (PegIFN) or nucleos(t)ide analogues (NUCs) in HBeAg-positive patients with chronic HBV infection. METHODS: We performed a retrospective analysis of 1823 HBeAg-positive patients with chronic HBV infection (954 patients treated with PegIFN and 869 patients treated with NUCs) included in 4 phase-4 multicenter randomized controlled trials. The Cochran-Armitage trend test was used to evaluate the association of rs7574865 genotype with combined response (CR, defined as HBeAg seroconversion and HBV DNA level <2000 IU/mL) and loss of HBsAg at week 72, for patients given PegIFN, or week 104, for patients given NUCs. RESULTS: We found a significant association between rs7574865 genotype and CR (P = .004) and loss of HBsAg (P = .037) in patients treated with PegIFN. In patients with HBV genotype B infection, 43.6% of those with rs7574865 TT achieved a CR, compared to patients with rs7574865 GG (20.5%), and 7.7% had loss of HBsAg, compared to 1.9% of patients with rs7574865 GG. However, in patients treated with NUCs, we found no association of rs7574865 genotype with CR (P = .811) or loss of HBsAg (P=.439). CONCLUSIONS: In a retrospective analysis of data from 4 clinical trials, we found rs7574865 in STAT4 to be associated with functional cure of chronic HBV infection by PegIFN treatment, but not NUCs treatment, in HBeAg-positive patients with HBV genotype B infection.

The role of a multidisciplinary team in the management of portal hypertension.

BACKGROUND: Gastroesophageal variceal hemorrhage is the most severe complication of portal hypertension, with a high mortality rate. The current recommendations for gastroesophageal varices include pharmacological treatment, endoscopic treatment, transjugular intrahepatic portosystemic shunt (TIPS) placement, and splenectomy with devascularization surgery. Multidisciplinary team (MDT) comprises of a group of medical experts and specialists across a range of disciplines, providing personalized and targeted patient care tailored to each individual's condition, circumstances, and expectations. METHODS: Patients referred to the MDT clinic since its establishment in September 2014 were prospectively enrolled and followed-up for at least 12 months. Patient baseline characteristics, treatment methods, outcome and survival were compared to non-MDT patients retrieved from a prospectively maintained database with propensity score matching. RESULTS: Propensity-score matching (PSM) was carried out to balance available covariates, resulting in 58 MDT patients vs. 111 non-MDT patients. Overall survival and variceal rebleed was compared between the two groups. The rate of variceal rebleed was significantly higher in the non-MDT group, while no difference in overall survival was observed. CONCLUSIONS: This study is the first to investigate the role of a multidisciplinary team in the management of gastroesophageal varices secondary to portal hypertension. Patients treated based on MDT clinic recommendations had a significantly lower risk for variceal rebleed.

Effects of micro- and nano-plastics on growth, antioxidant system, DMS, and DMSP production in Emiliania huxleyi.

Due to the potential impacts of microplastics (MPs) and nanoplastics (NPs) on algal growth and thereby affect the climate-relevant substances, dimethylsulfoniopropionate (DMSP) and dimethyl sulfide (DMS), we studied the polystyrene (PS) MPs and NPs of 1 µm and 80 nm impacts on the growth, chlorophyll content, reactive oxygen species (ROS), antioxidant enzyme activity, and DMS/DMSP production in Emiliania huxleyi. E. huxleyi is a prominent oceanic alga that plays a key role in DMS and DMSP production. The results revealed that high concentrations of MPs and NPs inhibited the growth, carotenoid (Car), and Chl a concentrations of E. huxleyi. However, short-time exposure to low concentrations of PS MPs and NPs stimulated the growth of E. huxleyi. Furthermore, high concentrations of MPs and NPs resulted in an increase in the superoxide anion radical (O2.-) production rate and a decrease in the malondialdehyde (MDA) content compared with the low concentrations. Exposure to MPs and NPs at 5 mg L-1 induced superoxide dismutase (SOD) activity as a response to scavenging ROS. High concentrations of MPs and NPs significantly inhibited the production of DMSP and DMS. The findings of this study support the potential ecotoxicological impacts of MPs and NPs on algal growth, antioxidant system, and dimethylated sulfur compounds production, which maybe potentially impact the global climate.

Selectively multilayered distribution of stereocomplex crystallite and poly(3-hydroxybutyrate-co-3-hydroxyvalerate) ribbons to achieve highly ductile and strong poly(l-lactide) composites.

Blending poly(l-lactide) (PLLA) with elastic polymers is an efficient way to obtain highly ductile materials (> 300 %), but it is accompanied by a significant reduction in strength. In this work, a special alternating multilayered composites with alternating stereocomplex crystallite (SC) (PLLA/poly(d-lactide) (PDLA) layer) and highly oriented Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) ribbons (PLLA/PHBV layer) is in situ constructed during laminated structuring process. Experimental results show that in situ formed PHBV ribbons are limitedly distributed in the thickness direction and align parallel to the layer interfaces. More interestingly, not only highly oriented shish crystals but also sparse lamellae of PLLA, which are arrested by SC, shish crystals, and PHBV ribbons, are in situ formed. Compared with sea-island structured composites prepared by traditional compression molding, the alternating multilayered composites show an increase in elongation at break from 8.7 % to 345.1 % and an increase in yield strength from 61.4 MPa to 73.2 MPa. During the tensile testing, the PLLA/PHBV layers firstly form micro-fibrils and micro-voids, driving the molecular chains of the PLLA/PDLA layer to respond in time to external forces through stress transfer of rich continuous layer interfaces. Since shear yielding and plastic deformation can easily penetrate the entire matrix, the alternating multilayered composites go a brittle-ductile transformation and the ductility is improved significantly. The increased strength of the alternating multilayered material is ascribed to the stiff shish crystals and SC. This work provides important guidance for the durable application of strong and ductile PLLA-based materials.

Effect of Artificial Tiger Bone Powder (Jintiange Capsule®) on Vertebral Height Ratio, Cobb's Angle, Bone Mineral Density, and Visual Analog Score.

OBJECTIVES: To investigate the effect of Jintiange capsule on acute bone atrophy (vertebral height, Cobb's angle, bone mineral density, and visual analog score (VAS) in patients with osteoporotic vertebral compression fracture. METHODS: A total of 106 patients with osteoporotic vertebral compression fractures were selected and randomly divided into study and control group. Vertebral height ratio (VHR), Cobb's angle, bone mineral density (BMD), and VAS analyses were performed as study indexes. The study was performed from January 2019 to December 2019 as a double-blind, randomized, controlled trial and all the participants were blinded throughout the study. There were 24 males and 29 females in the study group, with 14 cases of thoracic fractures and 39 cases of lumbar fractures. The age was 61-75 years, with an average of 67.5 ± 2.7 years, and the course of disease was 1-9 days, with an average of 2.7 ± 0.5 days. There were 22 males and 31 females in the control group, with 17 cases of thoracic fractures and 36 cases of lumbar fractures. Patients in the control group received conventional postoperative treatment, while patients in the study group were treated with Jintiange capsule. The treatment continued for 3 months. The ages of the participants were from 60 to 70 years, while the average ages of both groups were 67 ± 2.8 years and the study recruited participants of both sexes. RESULTS: The clinical efficacy, vertebral imaging indexes before and after treatment, as well as pain and daily activity dysfunction scores were compared. The effect of the Jintiange capsule was followed for 3 months and both the groups were compared. The total effective score of the study group was significantly increased (90.6%) in contrast to the control group (67.9) and the P value was less than the 0.5. The vertebral height and bone mineral density of the study group was significantly improved compared to the control group (P < 0.034) using t-test. However, the Cobb's angle of the study group was significantly (P < 0.047) lower than the control group using t-test after the treatment. On the other hand, the VAS score and Oswestry score of the study group were significantly lower than control group at 1 month and 3 months after treatment (P < 0.05). There was no significance difference (all P > 0.05) in term of gender and ages in both the recruited groups. CONCLUSION: It can be concluded that Jintiange capsule can significantly improve the clinical efficacy rate, vertebral height, Cobb's angle, and bone mineral density, pain relief, and daily activity function.

Activation of the VpdmVGLUT1-VPM pathway contributes to anxiety-like behaviors induced by malocclusion.

Occlusal disharmony has a negative impact on emotion. The mesencephalic trigeminal nucleus (Vme) neurons are the primary afferent nuclei that convey proprioceptive information from proprioceptors and low-threshold mechanoreceptors in the periodontal ligament and jaw muscles in the cranio-oro-facial regions. The dorsomedial part of the principal sensory trigeminal nucleus (Vpdm) and the ventral posteromedial nucleus (VPM) of thalamus have been proven to be crucial relay stations in ascending pathway of proprioception. The VPM sends numerous projections to primary somatosensory areas (SI), which modulate emotion processing. The present study aimed to demonstrate the ascending trigeminal-thalamic-cortex pathway which would mediate malocclusion-induced negative emotion. Unilateral anterior crossbite (UAC) model created by disturbing the dental occlusion was applied. Tract-tracing techniques were used to identify the existence of Vme-Vpdm-VPM pathway and Vpdm-VPM-SI pathway. Chemogenetic and optogenetic methods were taken to modulate the activation of VpdmVGLUT1 neurons and the Vpdm-VPM pathway. Morphological evidence indicated the involvement of the Vme-Vpdm-VPM pathway, Vpdm-VPM-SI pathway and VpdmVGLUT1-VPM pathway in orofacial proprioception in wild-type mice and vesicular glutamate transporter 1 (VGLUT1): tdTomato mice, respectively. Furthermore, chemogenetic inhibition of VpdmVGLUT1 neurons and the Vpdm-VPM pathway alleviated anxiety-like behaviors in a unilateral anterior crossbite (UAC) model, whereas chemogenetic activation induced anxiety-like behaviors in controls and did not aggravate these behaviors in UAC mice. Finally, optogenetic inhibition of the VpdmVGLUT1-VPM pathway in VGLUT1-IRES-Cre mice reversed UAC-induced anxiety comorbidity. In conclusion, these results suggest that the VpdmVGLUT1-VPM neural pathway participates in the modulation of malocclusion-induced anxiety comorbidity. These findings provide new insights into the links between occlusion and emotion and deepen our understanding of the impact of occlusal disharmony on brain dysfunction.

The crosstalk between macrophages and bone marrow mesenchymal stem cells in bone healing.

Bone injury plagues millions of patients worldwide every year, and it demands a heavy portion of expense from the public medical insurance system. At present, orthopedists think that autologous bone transplantation is the gold standard for treating large-scale bone defects. However, this method has significant limitations, which means that parts of patients cannot obtain a satisfactory prognosis. Therefore, a basic study on new therapeutic methods is urgently needed. The in-depth research on crosstalk between macrophages (Mϕs) and bone marrow mesenchymal stem cells (BMSCs) suggests that there is a close relationship between inflammation and regeneration. The in-depth understanding of the crosstalk between Mϕs and BMSCs is helpful to amplify the efficacy of stem cell-based treatment for bone injury. Only in the suitable inflammatory microenvironment can the damaged tissues containing stem cells obtain satisfactory healing outcomes. The excessive tissue inflammation and lack of stem cells make the transplantation of biomaterials necessary. We can expect that the crosstalk between Mϕs and BMSCs and biomaterials will become the mainstream to explore new methods for bone injury in the future. This review mainly summarizes the research on the crosstalk between Mϕs and BMSCs and also briefly describes the effects of biomaterials and aging on cell transplantation therapy.

[Two optimized transformation protocols for a cellulose-utilizing fungus Chaetomium globosum NK-102].

OBJECTIVE: We developed the transformation methods of the strain Chaetomium globosum NK-102. METHODS: We constructed plasmid pUCATPH-Pgap and compared the transformation efficiency with pUCATPH and pCM768. We established the PEG mediated protoplast transformation and Agrobacterium tumefaciens EHA105 mediated transformation methods. RESULTS: In protoplast approach, approximately 3 -5 transformants/microg DNA could be obtained. The highest efficiency of transformation was obtained by employing pUCATPH-Pgap. A. tumefaciens EHA105 successfully mediated T-DNA insertion into the genome of C. globosum NK-102 and the transformation rate was 3.2 x 10(2) transformants/10(7) spores. The transformants retained stable after generations. Southern blot analyses confirmed that the DNA had integrated into the chromosomal DNA of C. globosum NK-102. CONCLUSION: The transformation systems were good basis for selection of C. globosum mutant strains that effectively utilizing cellulose.

Mechanism, prevention, and treatment for medication-related osteonecrosis of the jaws.

The morbidity rate of medication-related osteonecrosis of the jaws (MRONJ) increased rapidly in recent years. Thusfar, the mechanism of MRONJ has no consensus. The possible mechanisms may include bone remodeling inhibition theory, angiogenesis inhibition theory, oral microorganism infection theory, immunosuppression theory, cytotoxicity-targeted oral epithelial cells, microcrack formation of maxillary or mandibular bone, and single nucleotide polymorphism. However, the efficacy of prevention and treatment based on a single mechanism is not ideal. Routine oral examination before MRONJ-related drug treatment, treatment of related dental diseases, and regular oral follow-up during drug treatment are of great significance for the prevention of MRONJ. During the treatment of MRONJ, the stage of MRONJ must be determined accurately, treatment must be standardized in accordance with the guidelines, and personalized adjustments must be made considering the specific conditions of patients. This review aimed to combine the latest research and guidelines for MRONJ and the experiences on the treatment of MRONJ in the Maxillofacial Surgery Department of West China Hospital of Stomatology, Sichuan University, and discuss the strategies to improve the clinical process.

Cell-sorting centrifugal microfluidic chip with a flow rectifier.

Centrifugal microfluidic chips offer rapid, highly integrable and simultaneous multi-channel microfluidic control without relying on external pressure pumps and pipelines. Current centrifugal microfluidic chips mainly separate particles of differing density based on the sedimentation method. However, in some biological cells, the volume difference is more notable than the density difference. In particular, cancer cells are generally larger than normal cells. The instability of particle velocity caused by the non-steady flow of the fluid in the centrifugal microfluidic chip leads to low separation purity of particles of different sizes. Thus, we propose herein a centrifugal microfluidic chip with a flow rectifier that transforms the centrifugal non-steady flow into locally steady flow with continuous flow. This chip resolves the problems caused by particle sedimentation in the sample chamber and non-steady flow and greatly improves the recovery ratio and separation purity of target particles. Therefore, it can be used to separate particles of differing size. The experimental results show that the chip can separate an equal-volume mixture of 25 µm and 12 µm polystyrene particles diluted 50 times with a ratio of 1 : 6 and obtain a recovery ratio and separation purity better than 95% for the 25 µm particles. In addition, rare tumour cells are separated from high-concentration white blood cells (ratio 1 : 25) with a recovery ratio of 90.4% ± 2.4% and separation purity of 83.0% ± 3.8%. In conclusion, this chip is promising for sorting of various biological cells and has significant potential for use in biomedical and clinical applications.

Fabrication, characterization and properties of DHA-loaded nanoparticles based on zein and PLGA.

This study focused on the feasibility of delivering docosahexaenoic acid (DHA) via zein/ Poly(lactic-co-glycolic) acid stabilized nanoparticles (ZPDNPs). ZPDNPs with good encapsulation efficiency, water solubility, and chemical instability were prepared by the antisolvent precipitation method. The structure and interaction force of ZPDNPs was evaluated using transmission electron microscopy, circular dichroism, X-ray powder diffraction, and FTIR. The stabilities of ZPDNPs for heating, pH, NaCl aqueous solution were also investigated. The results showed that ZPDNPs can improve the water solubility (750-fold), salt tolerance, and heat-resistant processing stability of DHA. The ZPDNPs had high encapsulation efficiency (84.6%) and stability after 35 days of storage. The simulated digestion of the gastrointestinal tract can change particle size, interface potential, and aggregation state of different DHA nanoparticles. The bioavailability of ZPDNPs was 4.2 ~ 5.6-folds higher than free DHA. Overall, a useful method for ZPDNPs formulation was developed for the delivery of DHA.

Local anesthesia in oral and maxillofacial surgery: A review of current opinion.

Local anesthesia (LA) is the most important pain management process in oral and maxillofacial surgery. Safe and effective LA not only enable patients to obtain high-quality treatment, but also relieve the anxiety of patients when they come to the clinic. The choices of local anesthetic and injection methods determine the success of LA to a great extent. At present, in most countries or regions, common local anesthetics used in oral and maxillofacial surgery belong to amides and they are injected into patients' body mainly through block or infiltration anesthesia. In addition, the operators' technique level, patient's subjective psychology and anatomical variation of maxillofacial structure also have a strong influence on LA in dental clinic. Due to the existence of above factors, the worldwide success rates of LA in oral and maxillofacial surgery is very different. There are no specific LA methods that ensure 100% successful LA rates. Fortunately, the development of new local anesthetic and injection technology are providing us with new ideas to solve this problem. This review mainly report the new research progress on LA in oral and maxillofacial surgery in recent decades and help clinicians with dental LA operation.

Distal-triangular flap design for impacted mandibular third molars: a randomized controlled trial.

OBJECTIVES: This prospective study was performed to evaluate whether the distal-triangular flap was a practical alternative surgical approach for extracting mandibular third molars. METHODS: Sixty participants with impacted mandibular third molars were randomly divided into three groups: group A, distal-triangular flap; group B, Szmyd flap; and group C, envelope flap. The impacted third molars were extracted by the corresponding flapping method. During a three-month follow-up observation after the extraction, the postoperative pain, swelling, mouth opening, and periodontal status were recorded and analyzed by ANOVA and chi-square tests. RESULTS: The 60 participants had successful extraction and 3-month follow-up observation. No participant suffered from postoperative infections, lower lip disorder, or tongue sensory disorders. No statistical differences were found in the postoperative symptoms and signs of the three flap designs, such as postoperative pain, swelling, mouth opening, and periodontal status (P>0.05). CONCLUSIONS: The distal-triangular flap was as safe and reliable as the Szmyd and envelope flaps but more advantageous because of its convenient operative field exposure and low requirement for the patient's mouth opening. Thus, the distal-triangular flap is one of the alternative flap options for extracting impacted mandibular third molars.

[Clinical study of age-related sensory innervation of the anterior hard palate].

OBJECTIVES: The present study aimed to explore the innervation of the anterior hard palatine and its relationship with individual development stage. Specifically, the effects of anesthesia on patients of different ages were observed, and neurodevelopment in the maxillofacial region was invesitgated. References that are helpful in selecting local anesthesia were provided. METHODS: A total of 182 patients with mixed dentition were randomly divided into the nasopalatine nerve block and greater palatine nerve block groups. Then, 219 patients with permanent dentition were divided into an adolescent group (13-18 years old) and adult group (over 19 years old), all of whom underwent bilateral greater palatine nerve block. Palatal mucosal pain sensation was tested pre- and post-anesthesia with Von Frey hairs. RESULTS: Among the children with mixed dentition, bilateral greater palatine nerve block tended to result in better anesthetic effects than nasopalatine nerve block (P<0.05), except in the incisive papilla. No difference in anesthetic effect was observed between adolescents and adults (P>0.05). The bilateral greater palatine nerve block was more effective in inducing an anesthestic effect in the anterior hard palatine in mixed dentition than in permanent dentition (over 13 years old; P<0.05). CONCLUSIONS: The sensation of the anterior hard palatine seems mainly dominated by the greater palatine nerve until mixed dentition and gradually shifted to the nasopalatine nerve in conjunction with maxillary development and tooth replacement. Hence, the innervation of the anterior hard palatine induce a secondary development during the development of the maxilla.

[Antibiotic-loaded cement articulating spacer made by a self-made mold system in the treatment of the infected hip replacement].

OBJECTIVES: To summarize the experience and lessons of the using of antibiotic-loaded cement articulating spacer made by a self-made mold system for the treatment of the infected hip replacement, and to evaluate its efficiency and role in the two-stage revision of infected total hip arthroplasty (THA). METHODS: The patients with infected THA treated with two-stage revision protocol from August 2005 to December 2009 were reviewed. All of the 127 patients were debridement thoroughly and followed by implantation of an antibiotic-loaded cement articulated spacer made by a self-made mold system; Two-stage revisions were not followed until the infection were controlled. Among of them, 106 patients, 107 hips were gotten fully followed up. Evaluations were made for the efficiency of infection control, convenience of making, implanting and removing of the spacers, occurrence of complications, the deal of the special circumstances, the function and satisfaction of the patients. RESULTS: The 107 hips were gotten an average of 34.3 months' (3 - 55 months) follow-up. The infection control rate was 96.3% after the first-stage surgery, the infection control rate was 94.4% at last follow-up after two-stage revisions. The breakage rate of the spacer was 4.7%, dislocation rate was 2.8%, removal of the spacers with difficulty were seen in 15 patients (14.0%). The satisfactory rate of the patients was 93.5%. CONCLUSIONS: Antibiotic-loaded cement articulating spacer made by a self-made mold system is an effective methods for the two-stage revision of the infected hip replacement, characterized by simple, good reproducible, high rates of infection control, better joint function after surgeries, high rate of patients satisfaction and other advantages. And it can decrease the complications, such as the breakage, spacer dislocation of hip joint and difficulty in removal of spacer at the second stage revision. Using of metallic internal fixation or allograft bone combined with spacer does not affect the results of infection controlling.

A missense variant in complement factor B (CFB) is a potential predictor of 24-week off-treatment response to PegIFNα therapy in Chinese HBeAg-positive chronic hepatitis B patients.

BACKGROUND: To date, 14 single-nucleotide polymorphisms (SNPs) have been identified as susceptibility loci for chronic hepatitis B (CHB). AIM: To investigate if these SNPs are associated with treatment response of hepatitis B e antigen (HBeAg)-positive CHB patients. METHODS: We performed a retrospective analysis of 1623 Han Chinese HBeAg-positive CHB patients (782 patients treated with pegylated interferon alpha [PegIFNα] for 48 weeks plus 24 weeks follow-up, and 841 patients treated with nucleos(t)ide analogues [NUCs] for 104 weeks) included in four phase-IV multicentre randomised controlled trials. All 14 SNPs were genotyped for each CHB patient. A polygenic score (PGS) was used to evaluate the cumulative effect of multiple SNPs. The associations of SNPs or PGS with combined response (CR) and hepatitis B s antigen (HBsAg) loss were assessed. RESULTS: We found that rs12614, a missense variant of complement factor B (CFB), was significantly associated with CR in PegIFNα-treated patients, and the CR rate in patients with the rs12614 TT/CT genotype was less than one-third of that in patients with the CC genotype (7.4% vs 22.6%, P = 0.009). Moreover, a PGS integrating CFB rs12614 and STAT4 rs7574865 (previously reported to be associated with response to PegIFNα) was significantly associated with both CR (P-trend = 4.000 × 10-4 ) and HBsAg loss (P-trend = 0.010) in PegIFNα-treated patients. However, none of the SNPs were associated with treatment response in NUCs-treated patients. CONCLUSIONS: CFB rs12614 is an independent predictor of response to PegIFNα therapy in Chinese HBeAg-positive CHB patients. A PGS integrating CFB rs12614 with STAT4 rs7574865 can effectively discriminate responders to PegIFNα from nonresponders.