Low levels of tenofovir in breast milk support breastfeeding in HBV-infected mothers treated with tenofovir disoproxil fumarate.

OBJECTIVE: Tenofovir disoproxil fumarate (TDF) is recommended for the prevention of mother-to-infant transmission of the hepatitis B virus (HBV). This study investigated the safety of infants whose mothers continued to receive TDF while breastfeeding. PATIENTS AND METHOD: Thirty women taking TDF daily from the second or third trimester of pregnancy to three months postpartum were enrolled. Tenofovir (TFV) concentrations in breast milk were determined and compared with those in umbilical cord (UC) blood and amniotic fluid. Infant growth parameters were assessed at birth, and at 3, 6, and 12 months. TFV uptake experiments were conducted in vitro to elucidate the mechanisms of TFV exposure via breast milk. RESULTS: TFV concentrations in breast milk ranged from 1.4 to 11.7 ng/mL within 24 h after dosing in the third month postpartum. The median trough concentration of TFV in breast milk was 3.7 (interquartile range, 2.6-6.2) ng/mL, which is lower than that in UC blood (median = 53.5 ng/mL) and amniotic fluid (median = 531.0 ng/mL). The low permeability of TFV in MCF-10A cells may explain the minimal exposure to TFV in breast milk. Body weights, body lengths, and head circumferences of the breastfed infants were comparable to the national standards for physical development. CONCLUSION: Infant exposure to TFV from breast milk is much lower than the exposure from placental transfer and swallowing from amniotic fluid. The physical growth parameters of all infants in this study were normal. The findings indicate that breastfeeding is safe for infants of HBV-infected mothers who continue to receive TDF through three months postpartum.

Preliminary efficacy analysis of block iliac bone grafting in patients with alveolar cleft in mixed dentition.

OBJECTIVES: To investigate the efficacy of block iliac bone grafting in patients with unilateral alveolar cleft in mixed dentition. METHODS: A retrospective study was conducted on patients with unilateral alveolar clefts in mixed dentition who were treated in the Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital. All patients underwent unilateral alveolar cleft bone graft repair with autogenous block iliac bone blocks. The healing of bone blocks was analyzed at 1 week and 6-12 months after surgery. Mimics software was used for the three-dimensional reconstruction and volumetric measurement of the iliac bone blocks on the follow-up imaging data of 15 patients aged 9-12 years without the eruption of canines before surgery, and the bone resorption rate of the iliac bone blocks was comparatively analyzed. RESULTS: In the 37 patients, bone grafting was successful in 32 and failed in five. The success rate of bone grafting was 86.5%. In 15 patients aged 9-12 years without the eruption of canines before surgery, eruption through the bone graft area was observed in two patients 6-12 months after the operation. Cone beam computer tomography showed that the grafted bone block exhibited good bony connections, and its resorption mainly occurred on the crests and palatal sides of the alveolar ridge. Bone resorption rates varied considerably between patients with a mean bone resorption rate of 39.0%±13.8% at 6-12 months after surgery. CONCLUSIONS: For patients in mixed dentition, bone grafting with block iliac bone can achieve better osteogenesis effect.

Advances in the antiviral therapies for chronic hepatitis b virus among pregnant women.

Management of chronic hepatitis B virus (HBV) infection during pregnancy remains a challenging task. This review summaries the impact of HBV infection on both mothers and babies,the risks and benefits of various antiviral therapies during pregnancy, the patient and drug selection,and the management during follow-up.

Production of ethyl levulinate by direct conversion of wheat straw in ethanol media.

The production of ethyl levulinate from wheat straw by direct conversion in ethanol media was investigated. Response surface methodology (RSM) was applied to optimize the effects of processing parameters, and the regression analysis was performed on the data obtained. A close agreement between the experimental results and the model predictions was achieved. The optimal conditions for ethyl levulinate production from wheat straw were acid concentration 2.5%, reaction temperature 183°C, mass ratio of liquid to solid 19.8 and reaction time 36 min. Under the optimum conditions, the yield of ethyl levulinate 17.91% was obtained, representing a theoretical yield of 51.0%. The results suggest that wheat straw can be used as potential raw materials for the production of ethyl levulinate by direct conversion in ethanol media.