Coronavirus disease 2019 in kidney transplant recipients: a systematic review and meta-analysis

INTRODUCTION@#The clinical presentation and outcomes of coronavirus disease 2019 (COVID-19) in kidney transplant recipients (KTRs) have not been well studied.@*METHODS@#We performed a meta-analysis to examine the presenting features, outcomes and the effect of treatment on outcomes of KTRs with COVID-19. Database search was performed up to 5 September 2020 through PubMed, Embase, Web of Science, Scopus and CENTRAL.@*RESULTS@#Overall, 23 studies (1,373 patients) were included in the review and meta-analysis. The most common presenting symptoms included fever (74.0%, 95% confidence interval [CI] 65.3-81.1), cough (63.3%, 95% CI 56.5-69.6) and dyspnoea (47.5%, 95% CI 39.6-55.6). Pooled rates of mortality and critical illness were 21.1% (95% CI 15.3-28.4) and 27.7% (95% CI 21.5-34.8), respectively. Acute kidney injury occurred in 38.9% (95% CI 30.6-48.1) and dialysis was required in 12.4% (95% CI 8.3-18.0) of the cases.@*CONCLUSION@#Kidney transplant recipients with COVID-19 have a similar clinical presentation as the general population, but they have higher morbidity and mortality. It is uncertain whether high-dose corticosteroid or hydroxychloroquine reduces the risks of mortality in KTRs with COVID-19.

Vancomycin-induced severe thrombocytopenia in a young infant

Abstract Vancomycin is a first-line drug for treating methicillin-resistant Staphylococcus aureus. Thrombocytopenia is a rare adverse reaction to vancomycin treatment, and there are no reports of vancomycin-induced thrombocytopenia (VIT) in infants. We describe the case of a 3-month-old girl who was diagnosed with purulent meningitis. After 13 days of treatment with vancomycin, her platelet count reduced to 8 × 109/L. Vancomycin was discontinued, and intravenous methylprednisolone was administered. The platelet count returned to normal after 4 days. Patients, especially young children, receiving vancomycin for a long clinical course should undergo careful monitoring of laboratory indicators and blood tests.

Propranolol for treatment of infantile hemangioma: a systematic evaluation / 中华医学美学美容杂志

Objective To systematically review the literature evaluating efficacy and adverse events of propranolol for infantile hemangiomas (IHs).Methods We searched the Cochrane,Medline,Wiley,CNKI and Wanfang Databases for all studies on the response of IHs to propranolol only which were published between June 2008 and May 2013.Results A total of 23 studies were collected,including 14 case reports and 2 follow-up studies which were without random and control;another 6 studies were clinical controlled trials and 1 study was RCT.Total 716 patients were included,and never received other treatments before propranolol.Propranolol was initiated at a mean age of (4.5 ± 0.5)months at a mean dose of 2.1 mg/kg/day and for a mean treatment duration of (9.7±9.2) months.The effective rate for patients with IHs treated with propranolol was 97％ (691/716),and patients after treatment completion reported IHs recurred in 8.6 ％ of patients.The adverse effects rate was 31％(223/7167) which most common adverse events were changes in sleep (n=35),gastrointestinal reaction (n =52) and decreased heart rate (n =73),and 5 patients discontinued the treatment because of the serious adverse events.Conclusions This systematic review of 716 patients treated with propranolol for IHs show a high rate of efficacy and a low rate of serious adverse events,and it is a better treatment of infantile hemangioma,but we should pay more attention to the serious adverse events and strictly select indications.

Synthesis of 13-β-elemene ester derivatives and evaluation of their antioxidant activity in human umbilical vein endothelial cells / 中国天然药物

In the present study, a series of 13-β-elemene ester derivatives were designed and prepared, and their antioxidant activity was investigated in the H2O2-treated human umbilical vein endothelial cells (HUVECs). Among the test compounds, the dimer compounds 5v and 5w exhibited the most potent antioxidant activity with significant ROS suppression being observed. Both compounds markedly inhibited the H2O2-induced changes in various biochemical substances, such as superoxide dismutase (SOD), malonyldialdehyde (MDA), nitric oxide (NO), and lactic dehydrogenase (LDH), which were superior to that of the positive control vitamin E. Further more, they did not produce any obvious cytotoxicity, but increased the viability of HUVECs injured by H2O2 in a dose-dependent manner. Additionally, compound 5w, designed as a prodrug-like compound, showed improved stability relative to compound 4 in vitro.

Synthesis and β-adrenergic blocking activity of oxime ether hybrids derived from a natural isochroman-4-one / 中国天然药物

AIM@#In a search for new cardiovascular drug candidates, a series of novel oxime ethers derived from a natural isochroman-4-one were synthesized.@*METHOD@#Compounds 3 and 6, derived from the natural antihypertensive compound 7, 8-dihydroxy-3-methyl-isochroman-4-one (XJP), were designed and synthesized. Subsequently, a series of novel isochroman-4-one oxime ether hybrids were prepared by hybridizing various N-substituted isopropanolamine functionalities to isochroman-4-one oxime. Furthermore, β1-adrenergic blocking activities of the synthesized compounds were assayed using the isolated rat left atria.@*RESULTS@#Twenty target compounds were obtained, and the preliminary structure-activity relationships were deduced. The most promising compound Ic exhibited β1-adrenoceptor blocking activity (inhibition: 52.2%) at 10(-7) mol·L(-1), which was superior to that of propranolol (inhibition: 49.7%).@*CONCLUSION@#The results suggested that natural product XJP/isopropanolamine moiety hybrids may provide a promising approach for the discovery of novel cardiovascular drug candidates.

Synthesis of A B C-ring subunit of C-nor-D-homo-steroidal alkaloids: towards the total synthesis of cyclopamine / 中国天然药物

A practical approach to the synthesis of the A, B and C-ring subunit of cyclopamine has been developed. This synthetic tactic highlights the utility of mandelate acetal-mediated resolution of the fused ring ketone (±)-4 and IBX-mediated oxidation cascades from 12 to 9. The availability of advanced intermediates from enantiomerically pure (+)-4 and 2 could provide efficient access to biologically active and structurally diverse C-nor-D-homo-steroidal alkaloids such as cyclopamine.

Risk factors for anastomotic leakage after anterior resection for rectal cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To identify the risk factors associated with anastomotic leakage following an anterior resection for rectal cancer.</p><p><b>METHODS</b>Between June, 1999 and June, 2009, 628 patients underwent anterior resection for rectal cancer. A retrospective study of the cases was performed to identify the risk factors for anastomotic leakage following the resection.</p><p><b>RESULTS</b>The overall incidence rate of anatomic leak was 8.6% (54/628) in these patients. A low albumin level (less than 35 g/L), diabetes, absence of a protective stoma, a distance less than 7 cm from the tumor to the anal edge, and a tumor diameter over 5 cm were identified as the risk factors for anastomotic leakage after anterior resection.</p><p><b>CONCLUSION</b>For patients at a high risk for anastomotic leakage, a protective stoma can significantly decrease the rate of clinical leaks and subsequent reoperation after low anterior resection for rectal cancer.</p>

Therapeutic effect of subtotal gastrectomy and Roux-en-Y gastrojejunostomy on type 2 diabetes mellitus in non-obese patients / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of Roux-en-Y anastomosis following subtotal gastrectomy on type 2 diabetes mellitus (T2DM) in non-obese patients.</p><p><b>METHODS</b>We performed a retrospective analysis of 16 non-obese patients with T2DM undergoing Roux-en-Y anastomosis following subtotal gastrectomy for stomach cancer and upper gastrointestinal tract ulcer.</p><p><b>RESULTS</b>All the patients were followed up for 6 months after the surgery. Roux-en-Y gastrojejunostomy significantly lowered the levels of fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2hPG), and glycated hemoglobin (HbA1c)(P<0.05). Of these patients, 8 (50%) achieved adequate glycemic control without antidiabetic medication and 5 (31.25%) showed obvious improvement. The total effectiveness rate of the surgery was 81.25%.</p><p><b>CONCLUSION</b>Roux-en-Y gastrectomy can effectively ameliorate the diabetic symptoms and might serve as a new treatment option for T2DM in non-obese patients.</p>

Chimeric molecules facilitate the degradation of androgen receptors and repress the growth of LNCaP cells / 亚洲男科学杂志(英文版)

Post-translational degradation of protein plays an important role in cell life. We employed chimeric molecules (dihydrotestosterone-based proteolysis-targeting chimeric molecule [DHT-PROTAC]) to facilitate androgen receptor (AR) degradation via the ubiquitin-proteasome pathway (UPP) and to investigate the role of AR in cell proliferation and viability in androgen-sensitive prostate cancer cells. Western blot analysis and immunohistochemistry were applied to analyse AR levels in LNCaP cells after DHT-PROTAC treatment. Cell counting and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) cell viability assay were used to evaluate cell proliferation and viability after AR elimination in both LNCaP and PC-3 cells. AR was tagged for elimination via the UPP by DHT-PROTAC, and this could be blocked by proteasome inhibitors. Degradation of AR depended on DHT-PROTAC concentration, and either DHT or an ALAPYIP-(arg)(8) peptide could compete with DHT-PROTAC. Inhibition of cell proliferation and decreased viability were observed in LNCaP cells, but not in PC-3 or 786-O cells after DHT-PROTAC treatment. These data indicate that AR elimination is facilitated via the UPP by DHT-PROTAC, and that the growth of LNCaP cells is repressed after AR degradation.

Treatment of severe post-kidney-transplant lung infection by integrative Chinese and Western medicine / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore treatments of severe post-kidney-transplant lung infection by integrative Chinese and Western medicine (ICWM), in order to elevate the curing rate as well as to lower the death rate.</p><p><b>METHODS</b>Based on conventional ways of Western medical treatments of 18 cases of severe post-kidney-transplant lung infection, such as putting the patients in single individual ward, antibiotics to prevent infection, respiratory machines, blood filtration, nutritional support, steroids, and maintaining electrolytes balance, we applied integrated Chinese medicinal treatments, like altering conventional prescription "pneumonia III", and conducted clinical observation of effectiveness, and indexes including white blood cell (WBC), neutrophilic granulocyte, blood urea nitrogen (BUN), blood creatinine (Cr), etc.</p><p><b>RESULTS</b>Of the 18 cases studied, 7 were already cured, 8 proved the treatment effective, 3 died. All clinical indexes had statistically significant changes compared with those of before treatment (P < 0.01).</p><p><b>CONCLUSION</b>ICWM can increase curing rate and lower death rate.</p>

Expression of survivin in human gastric adenocarcinomas: correlation with proliferation and apoptosis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the expression and significance of survivin, ki-67 and apoptosis index in patients with advanced gastric adenocarcinoma.</p><p><b>METHODS</b>Immunohistochemical SP method for survivin expression as well as cell proliferative index (ki-67) and apoptosis index (TUNEL) was conducted on 120 gastric adenocarcinomas.</p><p><b>RESULTS</b>The survivin was detected in the cytoplasm of carcinoma cells in 59 (49.17%) of the 120 gastric adenocarcinomas, in 32 (64.00%) of the lymph node metastasis, and in 21 (17.50%) of the 120 basal layer in normal gastric mucosa, respectively. The mean proliferative index (ki-67) in primary tumors was 7.55%, which was significantly lower than the mean proliferative index of 8.34% observed in lymph node metastasis. The mean apoptosis index in primary tumors was 1.16%, which was significantly higher than the mean apoptosis index of 0.89% observed in lymph node metastasis. The frequency of survivin expression was significantly higher in lymph node metastasis than in primary gastric adenocarcinoma. Expression of survivin was significantly correlated with histological subtypes, the depth of invasion, or lymph node metastasis (P < 0.05). There was negative correlation between weighted survivin score and apoptosis index (P < 0.05), but no correlation with proliferative index.</p><p><b>CONCLUSION</b>The high level expression of survivin might be a referenced indicator in evaluating differentiation of tumor and in predicting lymph nodes metastasis and estimating apoptosis index.</p>