Evaluation of the clinical manifestations of COVID-19 in patients with aplastic anemia undergoing immunosuppressive therapy: a prospective cohort study (NICHE) / 中华血液学杂志

Objective: To investigate the clinical features of coronavirus disease 2019 (COVID-19) in patients with aplastic anemia (AA) undergoing immunosuppressive therapy (IST) . Methods: In this prospective cohort study, we collected the demographic and clinical data of patients with AA and COVID-19 from December 1, 2022, to January 31, 2023. We described the clinical features of COVID-19 among patients with AA and evaluated the effects of IST on the signs and severity of COVID-19. Results: A total of 170 patients with AA and COVID-19 were included. The common early symptoms, including fever, dizziness or headache, muscle or body aches, and sore throat, disappeared within 1-2 weeks. Approximately 25% of the patients had persistent fatigue within 2 weeks. Many patients experienced cough after an initial 1-3 days of infection, which lasted for more than 2 weeks. There were no differences in the duration of total fever episodes and maximum body temperature when patients were stratified according to whether or not they underwent IST, by IST duration, or by use of anti-lymphocyte globulin (ALG) (P>0.05). No differences were observed in the occurrence of symptoms in either the early or recovery stages when patients with AA were stratified according to whether or not they underwent IST, or by IST duration (P>0.05). However, patients who received ALG had fewer fever episodes within 1 week after infection (P=0.035) and more sore throat episodes within 2 weeks after infection (P=0.015). There were no other significant differences in clinical symptoms between patients who did and patients who did not receive ALG (P>0.05) . Conclusion: The majority of patients with AA and COVID-19 recovered within 2 weeks of noticing symptoms when treated with IST.

Progress in research of economic evaluation of COVID-19 vaccination strategies / 中华流行病学杂志

Objective: To understand the research progresses of economic evaluation of COVID-19 vaccination strategies both at home and abroad, and provide reference for the economic evaluation of COVID-19 vaccination strategies using real word data in China. Methods: Literature retrieval was conducted for related papers published from January, 2020 to December, 2021 in Chinese and English databases, including the economic evaluation of COVID-19 vaccination, and the results of the related literatures were narratively integrated. Results: A total of 16 English literatures (including 3 reviews) were included, and it was found that the COVID-19 vaccination was cost-effective or cost-saving regardless of the vaccine types, while the cost-effectiveness in different population and under different vaccination dose strategies varied due to vaccine efficacy, vaccine price, duration of natural immunity, duration of vaccination campaign, vaccine supply, and vaccination pace. Conclusions: China lacks suitable evidences of economic evaluation of COVID-19 vaccination strategies based on real-world data in the context of long-term epidemic. Therefore, further researches of suitable strategies of booster COVID-19 vaccination are needed.

Effects of estrogen on proliferation, apoptosis and differentiation of bone marrow macrophage / 上海交通大学学报（医学版）

Objective • To investigate the effects of estrogen on proliferation, apoptosis and differentiation of bone marrow macrophage (BMM) and the mechanism. Methods • BMMs were isolated from normal C57BL/6J mice and induced to differentiate to osteoclasts in vitro. BMMs in experimental group were administered with 10-8 mol/L exogenous estrogen and antagonist group with both estrogen and 1 μmol/L ICI-182780, an antagonist of estrogen receptor, and control group was designed as well. Five 12-week-old C57BL/6J mice underwent ovariectomy (OVX group) and sham group (n=5) underwent sham surgery. All mice were sacrificed after 3 months to isolate BMM. Proliferation ability of BMM was assessed using Prestoblue, TUNEL assay was performed to detect apoptosis in each group. Caspase 3 and caspase 8 were detected by Western blotting. Quantitative real time PCR was used to detect tartrate-resistant acid phosphatase (Trap) and cathepsin K (Ctsk) mRNA levels during osteoclastogenesis. TRAP staining of osteoclasts showed osteoclastogenesis ability. In addition, the downstream moleculars activated by receptor activator for nuclear factor-κB ligand (RANKL) in BMM were detected by Western blotting. Results • BMM multiplication ability was attenuated in experiment group compared with control group and it was stronger in OVX group than that in sham group. TUNEL assay showed that the apoptotic BMM in experimental group were more than those in control group and caspase 3 and caspase 8 expression were consisted with the results of TUNEL assay. PCR analysis showed that Trap and Ctsk mRNA levels significantly decreased in experiment group compared with control group. The mRNAs increased in OVX group in contrast to sham group. TRAP staining of osteoclasts and quantitative analysis showed that osteoclasts in experiment group were less than those in control group and osteoclasts in OVX group were more than those in sham group. The effects of estrogen on proliferation, apoptosis and differentiation of BMM were blocked by antagonist of estrogen receptor. Western blotting showed that the phosphorylation of IκKα/β, p65 and JNK activated by RANKL were attenuated in experimental group compared with that in control group. Conclusion • Estrogen inhibits proliferation and osteoclastogenesis of BMM, and aggravates their apoptosis through estrogen receptor.

Protective effects and underlying mechanisms of Panax notoginseng saponins against SH-SY5Y cell apoptosis induced by 6-hydroxydopamine / 药学学报

The aim of this study is to investigate the protective effects of Panax notoginseng saponins (PNS) against 6-hydroxydopamine (6-OHDA)-induced apoptosis in SH-SY5Y cells and the possible underlying mechanisms. Cell viability was examined by MTT assay. The levels of lactate dehydrogenase (LDH), reactive oxygen species (ROS), malondialdehyde (MDA) and the activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) were measured using the respective assay kits. Apoptosis was measured by TUNEL kit, JC-1 and ROS was measured by staining with fluorescent dyes. The activation of caspase-3 was measured with the caspase-3 assay kit. The expression of nuclear protein Nrf2 and HO-1 were determined by Western blot. PNS had significant protective effects against 6-OHDA-induced apoptosis in SH-SY5Y cells in a time- and dose-dependent manner. PNS could attenuate 6-OHDA-induced suppression of SOD, GAT, GSH-Px (PPP<0.01). Moreover, PNS pretreatment increased the expression of the nuclear Nrf2 and up-regulate HO-1. The protective effects of PNS could be inhibited by HO-1 inhibitor SnPP. In conclusion, PNS has significant protective effects against 6-OHDAinduced apoptosis in SH-SY5Y cells. The possible mechanisms of PNS are due to PNS-mediated activation of Nrf2, up-regulation of HO-1 and inhibition of oxidative stress.

Clinical value of cupping spot effect / 中国针灸

The cupping spot is considered as one kind of skin change due to cupping treatment. With literature regarding cupping spot, the influencing factors and value of cupping spot in clinical diagnosis and treatment were analyzed, which could make a further exploration on the action mechanism of cupping treatment. The literature showed that the formation of cupping spot was related with cupping temperature, pressure, cup-retaining time, cupping area, individual difference and health condition, etc; cupping spot had the ability to assist diagnosis, prevent disease, cure disease and evaluate clinical efficacy. Previous studies on cupping spot have already made some progress, and played a positive significance on finding cupping rule and studying its mechanism. However, the research for this area is still in the primary stage, which needed deeper study to reveal scientific connotations of cupping spot.

Viscoelasticity of porcine acellular dermal matrix / 医用生物力学

Objective To evaluate the viscoelastic properties of porcine acellular dermal matrix (PADM) by comparison and analysis on physical parameters of the skin. Methods Full-thickness skin defects were performed on the back of white rabbits as wound models, and randomly divided these wounds into 3 groups according to different methods of skin grafting: PADM group (autogenous skin and PADM were grafted to the surface of the wound), TS group (autogenous skin was grafted in situ), NS group (normal skin as the control). Experiments on the stress-strain relationship of the implanted skin in the three groups were conducted. Results The curves of stress relaxation, creep, and stress-strain relationship showed that under a given stress, PADM group had the lowest strain, NS group had the highest strain, while the strain of TS group was in between the PADM and NS group. Conclusions The skin viscoelasticity mechanical model is a four-parameter solid model. When the skin wounds are grafted by using PADM which may have poor elasticity, its recovery capacity after deformation is also poor, and this is in agreement with the clinical results.

Effect of different concentration of tamoxifen ointment on the expression of TGF-beta2 of hypertrophic scar at rabbit ears / 中华整形外科杂志

<p><b>OBJECTIVE</b>To observe the effect of different concentration of Tamoxifen ointment on the fibroblasts and transforming growth factor (TGF-beta2) of hypertrophic scar at rabbit ears, so as to explore the possibility of treatment of hypertrophic scar with Tamoxifen.</p><p><b>METHODS</b>The hypertrophic scar model was established in 96 New Zealand rabbits' ears. The wounds were divided into four groups (A, B, C and D), with 144 wounds in each group. Different concentration of tamoxifen ointment (0.5%, 1%, 2%) was topically administered in groups A, B and C respectively, and blank ointment in group D. On postoperative day 30, 60 and 90, the scar samples were harvested. The scar thickness, scar histological change and the content of TGF-beta2 were detected.</p><p><b>RESULTS</b>(1) On the 30th day after operation, the difference of scar tissue thickness among groups A, D and B, C reached statistical significance (group A, D < group B < group C). However, there was a contrary tendency in fibroblasts density and TGF-beta2 content of the scar tissue simultaneously. (2) On 60th, 90th day after injury, there was statistical difference in scar thickness, fibroblasts density and the content of TGF-beta2 in scar of four groups (P < 0.05). The content of TGF-beta2 in group A, B, C, D was (43.97 +/- 3.63) microg/L, (41.92 +/- 3.91) microg/L, (36.69 +/- 4.15) microg/L, (54.90 +/- 4.71) microg/L, respectively, on 60th day; and (45.69 +/- 2.63) microg/L, (40.43 +/- 3.87) microg/L, (38.76 +/- 3.24) microg/L, (52.59 +/- 4.92) microg/L, respectively, on 90th day. The fibroblasts density of scar in groups A, B, C, D was (4392.07 +/- 327.84) point/mm2, (4208.57 +/- 329.76) point/mm2 (4 033.44 +/- 427.91) point/mm2, (4863.03 +/- 387.98) point/mm2, respectively, on 60th day; and (4418.41 +/- 432.52) point/mm2, (4077.65 +/- 386.70) point/mm2, (3844.53 +/- 354.29) point/mm2, (4838.64 +/- 390.52) point/mm2, respectively, on 90th day. The content of TGF-beta2 and fibroblasts density of scar were lined up as group D > group A > group B > group C (P < 0.05).</p><p><b>CONCLUSIONS</b>Topical Tamoxifen can reduce the content of TGF-beta2 and fibroblast, decrease fibroblasts density and the formation of hypertrophic scar at rabbit ears. It offers a new way for the treatment of the hypertrophic scar.</p>

Application of thoracic skin flap with multiple blood supply in repair of tissue defects and deformities in jaw and neck / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore an appropriate measure to repair tissue defects and deformities in mandibulo-cervical region.</p><p><b>METHODS</b>Eighteen cases with severe tissue defects and deformity in jaw and neck were repaired with thoracic skin flap with multiple blood supply system in our unit from Jan. 2006 to Nov. 2008. Anterior cutaneous branch of transverse cervical artery, intercostal branch of internal thoracic artery and lateral thoracic artery were included in the pedicles.</p><p><b>RESULTS</b>All skin flaps survived, except in one patient in whom a small belb appeared at the distal end of the island flap with anterior cutaneous branch of transverse cervical artery, and it was healed after a few dressing changes. The functions and appearances were satisfactory after 6-month to 2-year follow-up, without showing secondary deformity.</p><p><b>CONCLUSIONS</b>The blood supply of thoracic skin flap is abundant and constant, which is an ideal method for repair of tissue defects and deformities in jaw and neck after taking into account some factors, such as the demand of the patient, general physical condition, and the size of the defect.</p>