Real-World Effectiveness of Direct-Acting Antiviral Regimens against Hepatitis C Virus (HCV) Genotype 3 Infection: A Systematic Review and Meta-Analysis.

Patients with hepatitis C virus (HCV) genotype 3 (GT3) infection are resistant to direct-acting antiviral (DAA) treatments. This study aimed to analyze the effectiveness of sofosbuvir (SOF)+daclatasvir (DCV) ± ribavirin (RBV); SOF+velpatasvir (VEL)±RBV; SOF+VEL+voxilaprevir (VOX); and glecaprevir (GLE)+pibrentasvir (PIB) in the treatment of HCV GT3-infected patients in real-world studies. Articles were identified by searching the PubMed, EMBASE, and Cochrane Library databases from January 1, 2016 to September 10, 2019. The meta-analysis was conducted to determine the sustained virologic response (SVR) rate, using R 3.6.2 software. Thirty-four studies, conducted on a total of 7328 patients from 22 countries, met the inclusion criteria. The pooled SVR rate after 12/24 weeks of treatment was 92.07% (95% CI: 90.39-93.61%) for the evaluated regimens. Also, the SVR rate was 91.17% (95% CI: 89.23-92.94%) in patients treated with SOF+DCV±RBV; 95.08% (95% CI: 90.88-98.13%) in patients treated with SOF+VEL±RBV; 84.97% (95% CI: 73.32-93.91%) in patients treated with SOF+VEL+VOX; and 98.54% (95% CI: 96.40-99.82%) in patients treated with GLE+PIB. The pooled SVR rate of the four regimens was 95.24% (95% CI: 93.50-96.75%) in non-cirrhotic patients and 89.39% (95% CI: 86.07-92.33%) in cirrhotic patients. The pooled SVR rate was 94.41% (95% CI: 92.02-96.42%) in treatment-naive patients and 87.98% (95% CI: 84.31-91.25%) in treatment-experienced patients. The SVR rate of GLE+PIB was higher than other regimens. SOF+VEL+VOX can be used as a treatment regimen following DAA treatment failure.

Effects of biochar derived from sewage sludge and sewage sludge/cotton stalks on the immobilization and phytoavailability of Pb, Cu, and Zn in sandy loam soil.

Co-pyrolysis of sewage sludge and straws has been used to improve the pore structure and reduce the ecological risks of heavy metals in sewage sludge-derived biochars. However, to date, no study has focused on the effects of biochar derived from sewage sludge/straws on the immobilization and phytoavailability of heavy metals in soil. Here, we studied the effects of biochar derived from sewage sludge/cotton stalks (SCB) and that derived from sewage sludge alone (SSB) on the remediation of sandy loam soil contaminated by Pb, Cu, and Zn. SCB amendment decreased the bioavailable forms of Pb, Cu, and Zn in the soil by 19.0%, 34.9%, and 18.2%, respectively, and reduced their accumulation in ryegrass by 28.6%, 50.1%, and 30.0%, respectively, compared with those by SSB amendment. Furthermore, SCB amendment transformed more metals from the acid-soluble fraction to the oxidizable fraction than SSB amendment, indicating that complexation played a more critical role in SCB amendment than in SSB amendment. Both biochar amendments effectively improved soil water holding capacity, increased the supply of available P, N, and K, and promoted ryegrass growth. The findings of this study show the benefits of SCB over SSB for the remediation of heavy metal-contaminated soil.

Serum IL-21 levels predict HBeAg decline during rescue therapy in patients with partial response to nucleos(t)ide analogues.

To investigate whether IL-21 levels predict treatment outcomes of salvage therapy among patients with suboptimal response (SOR) to nucleos(t)ide analogues (NAs), serum IL-21 levels were measured in a prospective cohort of hepatitis B e antigen (HBeAg)-positive patients with SOR to antiviral therapy. The patients switched therapy to entecavir (ETV) with or without adefovir (ADV) for 104 weeks. IL-21 levels at treatment week 12 in patients who achieved HBeAg loss with undetectable levels of hepatitis B virus (HBV)-DNA at week 104 were the primary endpoint and the results were compared with those of corresponding patients without such an endpoint. Furthermore, IL-21 levels at treatment week 12 in patients who achieved an HBeAg-level decline at week 104 were assessed as the secondary endpoint. Among 24 enrolled patients with SOR to ADV (n=21), telbivudine (n=2) or ETV (n=1), the median (10-90th percentile) levels of HBeAg, HBV-DNA and ALT at baseline were 2.7 (0.2-3.1) log10 S/CO, 5.2 (3.5-7.5) log10 IU/ml and 0.9 (0.5-3.1) upper limit of normal, respectively. Comparison of the patients with and without HBeAg loss at week 104 indicated that their mean IL-21 levels did not significantly differ at week 12 (63.0±14.4 vs. 55.9±10.5 pg/ml; P=0.26). In the secondary endpoint analyses of patients with and without HBeAg level decline, the elevated levels of IL-21 at the first 12 weeks were significantly higher in the decline group (15.6±8.3 vs. 3.1±13.2 pg/ml; P=0.03). Following adjustment for confounding factors, the elevated levels of IL-21 from baseline to week 12 independently predicted an HBeAg level decline at week 104 (odds ratio=1.137, R2=0.23; P=0.047). In conclusion, the serum IL-21 levels at the first 12 weeks during the salvage therapy independently predicted HBeAg level decline at treatment week 104 in patients with SOR to NAs (ClinicalTrials.gov identifier: NCT01829685; date of registration, April 2013).

Management of Diabetes Mellitus in Patients with Chronic Liver Diseases.

Diabetes mellitus (DM) is a common chronic disease affecting humans globally. During the last few years, the incidence of diabetes has increased and has received more attention. In addition to growing DM populations, DM complications are involving injuries to more organs, such as the heart and cerebral vessel damage. DM complications can reduce quality of life and shorten life spans and eventually also impede social and economic development. Therefore, effective measures to curb the occurrence and development of diabetes assist in improving patients' quality of life, delay the progression of DM in the population, and ease a social burden. The liver is regarded as an important link in the management and control of DM, including the alleviation of glucose metabolism and lipid metabolism and others via glucose storage and endogenous glucose generation from glycogen stored in the liver. Liver cirrhosis is a very common chronic disease, which often lowers the quality of life and decreases life expectancy. According to a growing body of research, diabetes shows a close correlation with hepatitis, liver cirrhosis, and liver cancer. Moreover, coexistence of liver complications would accelerate the deterioration of patients with diabetes. Liver cirrhosis and diabetes influence each other. Thus, in addition to pharmacological treatments and lifestyle interventions, effective control of cirrhosis might assist in a better management of diabetes. When it comes to different etiologies of liver cirrhosis, different therapeutic methods, such as antiviral treatment, may be more effective. Effective control of cirrhosis might be a strategy for better management of diabetes.

One-step electrochemically co-assembled redox-active [Ru(bpy)2(tatp)]2+-BSA-SWCNTs hybrid film for non-redox protein biosensors.

A redox-active [Ru(bpy)(2)(tatp)](2+)-BSA-SWCNTs (bpy=2,2'-bipyridine, tatp=1,4,8,9-tetra-aza-triphenylene, BSA=bovine serum albumin, SWCNTs=single-walled carbon nanotubes) hybrid film is fabricated on an indium-tin oxide (ITO) electrode via one-step electrochemical co-assembly approach. BSA is inherently dispersive and therefore served as the linking mediator of SWCNTs, which facilitate the redox reactions of [Ru(bpy)(2)(tatp)](2+) employed as a reporter of BSA. The evidences from differential pulse voltammetry, cyclic voltammetry, scanning electron microscope, emission spectroscopy and fluorescence microscope reveal that the [Ru(bpy)(2)(tatp)](2+)-BSA-SWCNTs hybrid can be electrochemically co-assembled on the ITO electrode, showing two pairs of well-defined Ru(II)-based redox waves. Furthermore, the electrochemical co-assembly of the [Ru(bpy)(2)(tatp)](2+)-BSA-SWCNTs hybrid is found to be strongly dependent on the simultaneous presence of BSA and SWCNTs, indicating a good linear response to BSA in the range from 6 to 50mgL(-1). The results from this study provide an electrochemical co-assembly method for the development of non-redox protein biosensors.

Photoluminescence quenching/recovery kinetics of [Ru(bpy)2(tatp)]2+ and [Ru(bpy)2(dmtatp)]2+ intercalated within DNA by copper(II) ions and EDTA.

The quenching and recovery kinetics of photoluminescence of [Ru(bpy)(2)(tatp)](2+) (Ru1) and [Ru(bpy)(2)(dmtatp)](2+) (Ru2) intercalated within DNA (where bpy=2,2'-bipyridine, tatp=1,4,8,9-tetra-aza-triphenylene and dmtatp=2,3-dimethyl-1,4,8,9-tetra-aza-triphenylene) have been investigated by steady-state and time-resolved methods performed at various temperatures (293-333K). Two complexes Ru1 and Ru2 show a single-exponential luminescence decay with τ(Ru1)=246.0 ns and τ(Ru2)=513.5 ns, whose luminescence upon intercalating into DNA exhibits very consistent bi-exponential decay changes. The addition of Cu(2+) ions is found to dynamically quench the luminescence of both DNA-bound Ru(II) complexes, involving a spontaneous exothermic process. The sequential addition of EDTA can partially recover the luminescence quenched by Cu(2+), however depending on methyl substituents of the intercalative ligand. The chemical conversion and luminescence control mechanism of the two DNA-bound Ru(II) complexes is discussed in detail. The present results should be of value for better understanding chemical modulation of DNA-bound Ru(II) complexes as luminescence probes.

Preparation of a DNA-bound [Ru(bpy)2(mbpibH2)]²+ film and its two-mode luminescence tuning by copper(II) ions and EDTA.

An imidazophenanthroline-containing ruthenium(II) complex [Ru(bpy)(2)(mbpibH2)](2+) (bpy=2,2'-bipyridine, mbpibH2=1,3-bis([1,10]phenanthroline[5,6-d]imidazol-2-yl)benzene) can bind DNA through groove-binding and/or non-classical intercalation modes, revealed by spectrophotometric methods, viscosity measurements and variable ionic strength experiments. On the basis of binding interactions between cationic [Ru(bpy)(2)(mbpibH2)](2+) and anionic DNA at a molar ratio of 1:1, a yellow transparent cast film has been assembled on an indium-tin oxide (ITO) surface using a solution-based self-standing method. The prepared DNA-[Ru(bpy)(2)(mbpibH2)](2+) film shows a bi-exponential luminescence decay with τ(1)=62.1 ns (8.0%) and τ(2)=594.5 ns (92.0%), whose lifetimes become much shorter than those of DNA-bound [Ru(bpy)(2)(mbpibH2)](2+) in buffer solutions. The Ru(II) complex with a free bi-dentate coordination site in the DNA cast film shows tunable luminescence, quenched dynamically by Cu(2+) and restored by using EDTA to eliminate two modes of Cu(2+)-binding. The results from this study provide a significant foundation for better understanding the fabrication and modulation of a DNA-based solid luminescence device using the Ru(II) complexes as DNA-concentrating and signal-sensing agents.