Prediction model for hepatitis B e antigen seroconversion in chronic hepatitis B with peginterferon-alfa treated based on a responseguided therapy strategy

BACKGROUND Models for predicting hepatitis B e antigen(HBeAg)seroconversion in patients with HBeAg-positive chronic hepatitis B(CHB)after nucleos(t)ide analog treatment are rare.AIM To establish a simple scoring model based on a response-guided therapy(RGT)strategy for predicting HBeAg seroconversion and hepatitis B surface antigen(HBsAg)clearance.METHODS In this study,75 previously treated patients with HBeAg-positive CHB underwent a 52-week peginterferon-alfa(PEG-IFNα)treatment and a 24-wk follow-up.Logistic regression analysis was used to assess parameters at baseline,week 12,and week 24 to predict HBeAg seroconversion at 24 wk post-treatment.The two best predictors at each time point were used to establish a prediction model for PEG-IFNαtherapy efficacy.Parameters at each time point that met the corresponding optimal cutoff thresholds were scored as 1 or 0.RESULTS The two most meaningful predictors were HBsAg≤1000 IU/mL and HBeAg≤3 S/CO at baseline,HBsAg≤600 IU/mL and HBeAg≤3 S/CO at week 12,and HBsAg≤300 IU/mL and HBeAg≤2 S/CO at week 24.With a total score of 0 vs 2 at baseline,week 12,and week 24,the response rates were 23.8%,15.2%,and 11.1%vs 81.8%,80.0%,and 82.4%,respectively,and the HBsAg clearance rates were 2.4%,3.0%,and 0.0%,vs 54.5%,40.0%,and 41.2%,respectively.CONCLUSION We successfully established a predictive model and diagnosis-treatment process using the RGT strategy to predict HBeAg and HBsAg seroconversion in patients with HBeAg-positive CHB undergoing PEG-IFNαtherapy.

Organic geochemical and petrographic characteristics of the Cambrian-Ordovician organic-rich marine shales in Scandinavia

This work used organic geochemistry and organic petrology to study the depositional environment,organic matter characteristics,and thermal maturity of the Cambrian-Ordovician organic-rich marine shales in the Baltic Basin.The main macerals in Cambrian samples include alginite,bituminite and solid bitumen,while zooclastic macerals become the major proportion of organic matter in the Ordovician samples.As the maturity increase,solid bitumen becomes abundant and dispersed.Semifusinite-like maceral was observed only in Furongian of well DBH15/73,which probably indicates the local intrusion of Permo-Carboniferous dolerite dikes.The programmed pyrolysis results show that immature,early mature,and over-mature samples are developed.However,the data of high-uranium Furongian samples were greatly altered by igneous intrusives from local dikes.HIo calculation model is simulated based on pyrolysis data and fitted according to the least-square fitting method.The simulated fitting HIo:400mg HC/g TOC(369.5 mg HC/g TOC,430.5 mg HC/g TOC as 95%confidence bounds)is within the worldwide marine shale HI_(o)and indicates a marine anoxia and transgressive sea with shallow water column(organofacies B).

Successful upgrade to cardiac resynchronization therapy for cardiac implantation-associated left subclavian vein occlusion:A case report

BACKGROUND Subclavian vein stenosis or occlusion may be caused by a transvenous pacemaker,which makes the reimplantation of a new pacemaker lead difficult.Transvenous pacemaker lead implantation-related subclavian vein occlusion may present difficulty with regard to cardiac resynchronization therapy(CRT)upgrade.CASE SUMMARY We report the case of a 46-year-old man who was admitted with total subclavian vein occlusion caused by a permanent pacemaker that had been implanted 2 years previously.We successfully treated this patient with an upgrade to a CRT pacemaker by utilizing transferable interventional coronary and radiological techniques.The patient recovered uneventfully during the follow-up period.CONCLUSION CRT upgrade is still a viable technique for the treatment of subclavian vein obstruction caused by previous pacemaker implantation.