Early application of tacrolimus extended-release capsule after kidney transplantation / 器官移植

Objective To evaluate the efficacy and safety of tacrolimus extended-release (Tac-ER) in the early stage after kidney transplantation. Methods Clinical data of 68 recipients undergoing kidney transplantation from 34 pairs of renal allografts were retrospectively analyzed. Two recipients who received bilateral kidneys from the same donor were treated with Tac-ER (Tac-ER group) and tacrolimus immediate-release (Tac-IR) (Tac-IR group) as one of the basic immunosuppressant. The changes of tacrolimus dosage and blood concentration, intra-patient variability (IPV), renal function, incidence of acute rejection, recipient and allograft survival rates and adverse events were statistically compared between two groups. Results The average daily dose of tacrolimus in the Tac-ER group was significantly higher than that in the Tac-IR group (F=8.386, P=0.005). In the Tac-ER group, the mean trough concentration at postoperative 4 d was (6.14±4.04) ng/mL, did not reach the target concentration, significantly lower than (9.41±5.47) ng/mL in the Tac-IR group (F=7.854, P=0.007). In the Tac-ER group, the IPV of trough concentration of tacrolimus within postoperative 1 month was significantly higher than that in the Tac-IR group (0.44±0.15 vs. 0.36±0.12, P=0.032). At postoperative 6 months, there was no significant difference in the renal function between two groups [serum creatinine level was (126±26) μmol/L vs. (120±28) μmol/L, and the estimated glomerular filtration rate was (56±13) mL/(min·1.73 m2) vs. (60±15) mL/(min·1.73 m2), both P > 0.05]. The allograft and recipient survival rates were 100% in both groups. The incidence of acute rejection within postoperative 1 month was 18% in the Tac-ER group and 3% in the Tac-IR group, with no significant difference (P > 0.05). The overall incidence of adverse events was 94% in the Tac-ER group and 97% in the Tac-IR group, with no significant difference (P > 0.05). Conclusions The efficacy and safety of Tac-ER are equivalent to those of Tac-IR, whereas a higher dose of Tac-ER should be orally given to reach the blood concentration similar to that of Tac-IR. During early-stage drug treatment, Tac-ER should be orally given before kidney transplantation or inittally with loading dose, aiming to increase the systemic exposure to tacrolimus early after kidney transplantation and prevent acute rejection caused by insufficient exposure.

Bioinformatics analysis and key gene verification of sepsis myocardial macrophage microarray data based on GEO database / 中华心血管病杂志

Objective: Bioinformatics analysis was used to screen differentially expressed genes (DEGs) in macrophages of sepsis myocardial injury and to verify key genes. Methods: Experiment 1 (gene chip and bioinformatics analysis): The gene chip data GSE104342 of cardiac macrophages in septic mice was downloaded from Gene Expression Omnibus database. DEGs were obtained by R language analysis. DAVID online database was used to obtain gene ontology and kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis of DEGs. STRING online database was used for protein-protein interaction network analysis of DEGs, and then key genes were screened by using Cytoscape software and molecular complex detection (MCODE) plug-ins. Experiment 2 (sepsis model construction and related protein verification): Ten male C57BL/6 mice, aged 8-14 weeks. Five mice were randomly selected as control group, and 5 mice were selected as the sepsis group by building a mice sepsis model in vivo. Echocardiography was used to detect the cardiac function. Hematoxylin-eosin staining was used to assess the cardiac morphology. TUNEL staining was used to evaluate cardiomyocyte apoptosis. Immunofluorescence staining was used to detect the expression of differentiation antigen cluster 206 (CD206),inducible nitric oxide synthases (iNOS),F4/80,suppressor of cytokine signaling 3 (Socs3) ,interleukin 1 receptor antagonist (Il1rn) and chemokine C-C motif ligand 7 (Ccl7) protein. RAW264.7 macrophages were cultured in vitro and divided into 2 groups: LPS groupstimulated by lipopolysaccharide (LPS, 1 mg/L) and blank control group treated with equal-volume phosphate buffer solution. Reverse transcription-polymerase chain reaction (RT-PCR) was used to evaluate the expression of Socs3, Il1rn and Ccl7 in vitro. Results: Experiment 1: 24 647 genes were screened in GSE104342 dataset and 177 genes (0.72%) were differential expression, including 120 up-regulated genes and 57 down-regulated genes. Gene ontology enrichment analysis showed that DEGs were mainly involved in inflammatory response, immune response, apoptosis regulation and antigen processing and presentation. KEGG signaling pathway analysis showed that DEGs in cardiac macrophages of septic mice were mainly enriched in cytokine-cytokine receptor interaction, tumor necrosis factor signaling pathway, NOD like receptor signaling pathway. Three hub genes were obtained by STRING and Cytoscape analysis, including Socs3, Il1rn and Ccl7. Experiment 2: In vivo, it was found that compared with the control group, the cardiac function of the sepsis mice decreased significantly, the myocardial cells were significantly edema, inflammatory cell infiltration, myocardial fiber rupture, some myocardial nuclei dissolved and disappeared, and the cardiomyocyte apoptosis increased, suggesting that the sepsis myocardial injury model of mice was successfully constructed. Compared with the control group, the expression of CD206 in the myocardium of septic mice was down-regulated, the expression of iNOS, F4/80, Socs3, Il1rn and Ccl7 were up-regulated. In addition, there was co-localization between Socs3, Il1rn, Ccl7 and F4/80 protein. Compared with the blank control group, the expression of Socs3, Il1rn and Ccl7 significantly upregulated after LPS intervention in vitro by RT-PCR. Conclusions: The selected key genes Socs3, Il1rn and Ccl7 were up-regulated in myocardial macrophages of septic mice. Socs3, Il1rn and Ccl7 are expected to become new targets for the diagnosis and treatment of sepsis cardiac injury.

Effects and mechanisms of SNP-9 on Parkinson''s disease cell model induced by rotenone / 中国药科大学学报

@#In this article, the effects and mechanisms of SNP-9 on Parkinson''s disease (PD) cell model were investigated.SH-SY5Y cells were treated with rotenone to establish PD cell model; the effects of rotenone and SNP-9 on cell viability were detected by MTT assay; Hoechst/PI double staining assay was used to detect the effects of rotenone and SNP-9 on cell apoptosis; DCFH-DA probe was used to detect the effects of rotenone and SNP-9 on cellular reactive oxygen species (ROS) levels; and Western blot was used to detect the effects of rotenone and SNP-9 on protein levels of tyrosine hydroxylase (TH), α-synuclein (α-syn), Bcl-2 and Bax.The results showed that SNP-9 could alleviate abnormalities in cell viability, levels of TH and α-syn, apoptosis, ROS and apoptotic relative protein Bax/Bcl-2 induced by rotenone.Our findings suggest that SNP-9 may alleviate rotenone-induced injury in neuronal cells by regulating cell apoptosis related pathway.

Superficial retinal blood flow density analysis and related factors in adolescents with different classification of high myopia / 中华眼底病杂志

Objective:To observe and analyze the superficial retinal blood flow density and its related influencing factors in the macular area of adolescents with different types of non-pathological high myopia (HM).Methods:A retrospective clinical study. From March to August 2022, 117 eyes of 117 adolescents who were admitted to Liaocheng Aier Eye Hospital due to myopia were included in the study. According to equivalent spherical degree (SE) and corneal curvature, subjects were divided into mild myopia or emmetropia group (control group), HM group, occult HM (OHM) group, and super HM (SHM) group, with 30 eyes, 28 eyes, 35 eyes, and 24 eyes, respectively. All subjects underwent medical optometry, intraocular pressure, optical coherence tomography (OCT), OCT angiography (OCTA), axial length (AL) and corneal curvature measurements. The diopter was SE. OCTA instrument was used to scan the macular region in the range of 6 mm×6 mm, and the software automatically divided it into three concentric circles centered on the fovea of the macular, namely, the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm. The superficial retinal vascular density (SRVD), vascular perfusion density (SBPD), the area, perimeter (PERIM), avascular index (AI) of foveal avascular area (FAZ) and retinal thickness were measured in the macular region as a whole and in different regions. One-way analysis of variance was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation of AL, corneal curvature and intraocular pressure with SRVD and SBPD in macula was analyzed by Pearson correlation analysis. Results:There were significant differences in SRVD and SBPD in the central, inner and outer regions of macula in control group, HM group, OHM group and SHM group ( P<0.05). There were statistically significant differences in the thickness of the retina above, below and on the temporal side of the central and outer ring regions ( P<0.05). However, no statistically significant difference was in the thickness of the retina on the nasal side ( P>0.05). There was no significant difference in PERIM ( P>0.05). There were significant differences in FAZ area and AI ( P<0.05). Correlation analysis showed that AL was negatively correlated with SRVD and SBPD in macular whole and central, inner and outer ring regions ( P <0.05). Corneal curvature and SE were positively correlated with the SRVD and SBPD of macular whole, central area and outer ring area ( P<0.05). AL was negatively correlated with retinal thickness in the outer ring region ( P<0.05). SE was positively correlated with the thickness of the retina above, below and temporally in the outer ring region ( P<0.05). AL was negatively correlated with FAZ area and AI ( P<0.05). SE was positively correlated with FAZ area and PERIM ( P<0.05). Retinal thickness was positively correlated with SRVD and SBPD ( P<0.05). Conclusions:The SRVD and SBPD of different types of HM in adolescents decreases to different degrees. The thickness of the retina in the central region is thicker, and the retina in the outer ring region is thinner. With the decrease of SRVD, the retinal thickness gradually is thinner.

Clinical and multimodal imaging features of acute macular neuroretinopahy associated with COVID-19 / 中华眼底病杂志

Objective:To observe the clinical and multimodal imaging characteristics of eyes with acute macular neuroretinopathy (AMN) associated with COVID-19.Methods:A retrospective clinical study. From December 18 to 26, 2022, 16 eyes of 8 patients with AMN associated with COVID-19 were included in the study. There were 4 males and 4 females; all cases were bilateral. The age was (31.5±9.6) years old. The time from fever to decreased vision was (3.75±1.04) days. The best corrected visual acuity (BCVA), intraocular pressure, slit lamp microscopy, indirect fundus microscopy, fundus color photography, and optical coherence tomography (OCT) were performed in all patients. Infrared fundus photography (IR), OCT angiography (OCTA) and fluorescein fundus angiography (FFA) were performed in 14, 6 and 4 eyes respectively. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logarithm of the minimum angle of resolution (logMAR) BCVA for statistics. The clinical data, IR, OCT and OCTA imaging features of the patients were retrospectively analyzed.Results:The logMAR BCVA of AMN eyes was 4.21±0.74, intraocular pressure was (14.87±1.50) mm Hg (1 mm Hg=0.133 kPa). Fundus color photography showed that multiple gray-white petal-shaped lesions were arranged around the macular fovea in 2 eyes; no obvious abnormality was found in the macular area in 14 eyes. Of the 14 eyes examined by IR, 6 eyes had irregular weak reflective lesions around the macular fovea. OCT showed strong reflex in the outer nuclear layer and outer plexiform layer of all eyes, including 15 eyes with elliptical zone injury. In 6 eyes examined by OCTA, the blood flow density of the superficial and deep capillary plexus (DCP) of retina decreased, and the blood flow density of DCP decreased significantly. The en-face image of DCP showed the wedge-shaped strong reflective lesion area with the tip pointing to the central fovea in 2 eyes. No abnormal fluorescence was observed in FFA.Conclusions:The characteristic manifestation of AMN associated with COVID-19 is weak reflex focus in IR; OCT shows strong reflection in outer core layer and outer plexiform layer; OCTA showed that retinal DCP blood flow density decreased.

Value of dynamic monitoring of absolute value and function of peripheral blood lymphocyte subsets in predicting the risk of early viral infection after kidney transplantation / 器官移植

Objective To investigate the predictive and diagnostic value of absolute value and function of different lymphocyte subsets in evaluating the risk of early viral infection after kidney transplantation. Methods Ninety-five kidney transplant recipients were enrolled in this prospective observational cohort study, and divided into the stable group (n=77) and infection group (n=18) according to postoperative immune status. Peripheral blood samples were collected for flow cytometry before operation, and 2 weeks, 1 month, 2 months and 6 months after operation. The dynamic changes of the absolute values of CD4+T cells, CD8+T cells and natural killer (NK) cells were compared between two groups. The function of lymphocyte subsets in two groups was evaluated by detecting the proportion of interferon (IFN)-γ+CD4+T cells, IFN-γ+CD8+T cells and IFN-γ+NK cells. The value of the absolute values and function of lymphocyte subsets in predicting and diagnosing viral infection in the early stage after kidney transplantation was evaluated. Results During viral infection, the absolute values of CD4+T cells, CD8+T cells and NK cells in the infection group were at a relatively low level. At 2 months after operation, the absolute values of CD4+T cells and NK cells in the infection group were lower than those in the stable group. At 6 months after operation, the absolute values of CD4+T cells and CD8+T cells in the infection group were significantly lower compared with those in the stable group (all P < 0.05). During viral infection, the proportion of IFN-γ+CD4+T cells, IFN-γ+CD8+T cells and IFN-γ+NK cells in the infection group were all at a relatively low level, especially that of IFN-γ+CD8+T cells decreased most significantly. At postoperative 2 months, the proportion of IFN-γ+CD8+T cells and IFN-γ+NK cells in the infection group was significantly higher than those in the stable group. At 6 months after operation, the proportion of IFN-γ+CD4+T cells and IFN-γ+CD8+T cells in the infection group was significantly higher than those in the stable group (all P < 0.05). Logistic regression analysis showed that the increasing proportion of IFN-γ+CD8+T cells and IFN-γ+NK cells was correlated with the increasing risk of viral infection at 2 months after operation (both P < 0.05). The receiver operating characteristic (ROC) curve demonstrated that the diagnostic value of absolute values of lymphocyte subsets combined with IFN-γ secretion function for viral infection in the immunocompromised recipients was significantly higher than that of absolute values of lymphocyte subsets alone (P < 0.05). Conclusions Dynamic monitoring of the changes of absolute values and function of lymphocyte subsets provides critical reference value for the prediction, diagnosis and medication guidance of viral infection.

Organ transplantation and vaccination / 器官移植

Organ transplant recipients are at a high risk of infection with high hospitalization rate, critical rate and fatality, due to low immune function caused by taking immunosuppressants for a period of long time after organ transplantation. Currently, vaccination is recognized as an effective approach to prevent infection. Organ transplant recipients may be vaccinated according to individual conditions. However, the sensitivity to vaccines may decline in organ transplant recipients. The types, methods and timing of vaccination have constantly been the hot spots of clinical trials. In this article, the general principles, specific vaccines and SARS-CoV-2 vaccines of vaccination in organ transplant recipients were briefly reviewed, aiming to provide reference for the vaccination of organ transplant recipients. Moreover, current status of SARS-CoV-2 vaccination for organ transplant recipients was illustrated under the global outbreak of novel coronavirus pneumonia pandemic.

Clinical application of serum Golgi protein 73 in patients with chronic liver diseases / 中华肝脏病杂志

Golgi protein 73 (GP73) is a transmembrane protein on the Golgi apparatus and can be cut and released into the blood. In recent years, an increasing number of clinical studies have shown that the elevated serum GP73 level is closely related to liver diseases. And thus GP73 is expected to be used as a new serum marker for assessing progress of chronic liver diseases. Herein, the clinical application of serum GP73 in chronic hepatitis, liver fibrosis, liver cirrhosis and hepatocellular carcinoma with different etiologies was reviewed based on available literatures; and a research outlook in this field is made.

Treatment and prognosis analysis of perineural invasion on sinonasal adenoid cystic carcinoma / 中华肿瘤杂志

Objective: To analyze the efficacy of sinonasal adenoid cystic carcinoma (ACC) with perineural invasion (PNI), and explore the prognostic value of PNI on sinonasal adenoid cystic carcinoma. Methods: The clinical data of 105 patients with sinonasal ACC admitted to Cancer Hospital, Chinese Academy of Medical Sciences from January 2000 to December 2016 were retrospectively reviewed. All patients were restaged according to American Joint Committee on Cancer 8th edition. Follow-up visits were conducted to obtain information of treatment failure and survival outcome. The Log rank test was used for univariate analysis of prognostic factors, and Cox regression model was used for multivariate prognostic analysis. Results: The maxillary sinus (n=59) was the most common primary site, followed by the nasal cavity (n=38). There were 93 patients with stage Ⅲ-Ⅳ. The treatment modalities included surgery alone (n=14), radiotherapy alone (n=13), preoperative radiotherapy plus surgery (n=10), and surgery plus postoperative radiotherapy (n=68). The median follow-up time was 91.8 months, the 5-year local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 72.6%, 73.0%, 52.9% and 78.0%, respectively. There were 33 patients (31.4%) with PNI-positive. The 5-year DMFS, PFS, and OS rates of PNI-positive group were 53.7%, 29.4% and 56.5%, respectively, which were significantly inferior to those of PNI-negative group (80.8%, 63.0% and 86.8%, respectively, P<0.05), while there was no significant difference in the 5-year LC rate between both groups (64.5% vs 76.5%, P=0.273). The multivariate Cox regression analysis showed PNI was one of the poor prognostic factors of DMFS (HR=3.514, 95%CI: 1.557-7.932), PFS (HR=2.562, 95%CI: 1.349-4.866) and OS (HR=2.605, 95%CI: 1.169-5.806). Among patients with PNI-positive, the 5-year LC, PFS and OS rates of patients received surgery combined with radiotherapy were 84.9%, 41.3% and 72.7%, respectively, which were significantly higher than 23.3%, 10.0% and 26.7% of patients receiving surgery or radiotherapy alone (P<0.05). Conclusion: The presence of PNI increases the risk of distant metastasis in patients with sinonasal ACC. Compared with patients with PNI-negative, the prognosis of patients with PNI-positive is relatively poor, and surgery combined with radiotherapy for PNI-positive sinonasal ACC results in good clinical outcomes.

Efficacy of repetitive transcranial magnetic stimulation combined with health education in the treatment of refractory depression and its effects on cognitive function and sleep quality / 中国基层医药

Objective:To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with health education in the treatment of refractory depression and its effects on cognitive function and sleep quality.Methods:Ninety patients with refractory depression who received treatment in Hangzhou Seventh People's Hospital from January 2018 to January 2021 were included in this study. They were randomly assigned to receive either rTMS (control group, n = 45) or rTMS combined with health education (observation group, n = 45). All patients received 4 weeks of treatment. Clinical efficacy, the scores of the Clinical Global Impressions (CGI) Scale and the Hamilton Rating Scale for Depression (HAMD), cognitive function, sleep quality, and quality of life pre- and post-intervention were compared between the two groups. Results:Total response rate was significantly higher in the observation group than in the control group [91.11% (41/45) vs. 71.11% (32/45), χ2 = 5.87, P < 0.05]. CGI scores post-intervention were significantly higher in the observation group than in the control group [(45.23 ± 7.89) points vs. (27.64 ± 4.53) points, t = 12.97, P < 0.05]. HAMD scores were significantly lower in the observation group than in the control group [(16.32 ± 2.76) points vs. (21.86 ± 3.98) points, t = 7.67, P < 0.05]. The number of categories achieved and the number of correct responses post-intervention in the observation group were (3.83 ± 0.61) and (85.45 ± 7.87), respectively, which were significantly higher than those in the control group [(2.98 ± 0.37), (73.25 ± 6.12), t = 7.99, 8.20, both P < 0.05]. The number of perseverative errors post-intervention in the observation group was significantly lower than that in the control group [(32.02 ± 1.89) vs. (35.12 ± 2.09), t = 7.38, P < 0.05]. The Pittsburgh Sleep Quality Index post-intervention was significantly lower in the observation group than in the control group [(9.84 ± 1.56) points vs. (12.32 ± 1.62) points, t = 7.39, P < 0.05). The scores of social function, material well-being, physical function, and psychological function post-intervention in the observation group were (59.98 ± 5.31) points, (34.23 ± 4.12) points, (56.87 ± 5.32) points, and (47.28 ± 5.65) points, which were significantly higher than those in the control group [(45.23 ± 6.57) points, (27.98 ± 2.65) points, (43.24 ± 4.53) points, (36.21 ± 4.12) points, t = 11.71, 8.55, 13.08, 10.62, all P < 0.05]. Conclusion:rTMS combined with health education is highly effective on refractory depression. The combined therapy can improve cognitive function and sleep quality and is of great innovation and science.

Application of short-term training path for prenatal ultrasound diagnostician in primary hospitals / 中华医学教育探索杂志

Objective:To explore the establishment and effect of short-term training path for prenatal ultrasound diagnosticians in primary hospitals.Methods:A total of 105 trainees from in total 5 batches of the "prenatal ultrasound screening training base" in Chongqing were selected as the research objects, and a combination of multiple teaching methods was used to carry out specialized training for primary prenatal ultrasound screening doctors before and after training. Theoretical examinations and practical operation assessments were performed, and after training, remote image quality control and continuous improvement methods were established for trainees to assess training effectiveness. SPSS 21.0 was used for t test, Wilcoxon test and chi-square test. Results:After training, the results of the theoretical examinations and practical operation examinations of the trainees were higher than those before the training ( P<0.05), and after the completion of the training, the number of trainees who returned to their original units to carry out prenatal ultrasound examination, the average number of prenatal ultrasound examinations per month and the number of referrals to higher prenatal diagnosis centers of each trainee increased significantly ( P<0.05). Conclusion:The establishment of short-term training path for prenatal ultrasound diagnosis can effectively improve the professional theoretical knowledge and practical operation level of prenatal ultrasound doctors in primary hospitals, and greatly solve the problem of technical promotion under the shortage of grassroots hospitals.

Clinical Efficacy of Modified Sanxiaoyin in Treatment of Mild or Moderate COVID-19 Patients： Based on Retrospective Analysis / 中国实验方剂学杂志

ObjectiveTo retrospectively analyze the clinical data of 52 patients with coronavirus disease-2019 （COVID-19） and explore the clinical efficacy of modified Sanxiaoyin on mild/moderate COVID-19 patients. MethodThe propensity score matching method was used to collect the clinical data of mild or moderate COVID-19 patients enrolled in the designated hospital of the Second Hospital of Jingzhou from December 2019 to May 2020. A total of 26 eligible patients who were treated with modified Sanxiaoyin were included in the observation group， and the 26 patients treated with conventional method were the regarded as the control. The disappearance of clinical symptoms， disappearance time of main symptoms， efficacy on traditional Chinese medicine （TCM） symptoms， hospitalization duration， laboratory test indicators， and CT imaging changes in the two groups were compared. ResultThe general data in the two groups were insignificantly different and thus they were comparable. After 7 days of treatment， the disappearance rate of fever， cough， fatigue， dry throat， anorexia， poor mental state， and poor sleep quality in the observation group was higher than that in the control group （P<0.05）， and the difference in the disappearance rate of expectoration and chest distress was insignificant. For the cases with the disappearance of symptoms， the main symptoms （fever， cough， fatigue， dry throat， anorexia， chest distress） disappeared earlier in the observation group than in the control group （P<0.01）. After 7 days of treatment， the scores of the TCM symptom scale of both groups decreased （P<0.01）， and the decrease of the observation group was larger that of the control group （P<0.01）. All patients in the two groups were cured and discharged. The average hospitalization duration in the observation group ［（12.79±2.68） d］ was shorter than that in the control group ［（15.27±3.11） d］ （P<0.01）. The effective rate in the observation group （92.31%， 24/26） was higher than that in the control group （76.92%， 20/26） . After 7 days of treatment， the lymphocyte （LYM） count increased （P<0.05）， and white blood cell （WBC） count and neutrophil （NEUT） count decreased insignificantly in the two groups. Moreover， levels of C-reactive protein （CRP）， erythrocyte sedimentation rate （ESR）， and procalcitonin （PCT） reduced in the two groups after treatment （P<0.01） and the reduction in the observation group was larger than that in the control group （P<0.01）. Through 7 days of treatment， the total effective rate on pulmonary shadow in the observation group （90.00%， 18/20） was higher than that in the control group （77.27%， 17/22） （P>0.05） and the improvement of lung shadow in the observation group was better than that in the control group （P<0.01）. ConclusionModified Sanxiaoyin can significantly alleviate fever， cough， fatigue， anorexia， chest distress， poor sleep quality， and other symptoms of patients with mild or moderate COVID-19， improve biochemical indicators， and promote the recovery of lung function. This paper provides clinical evidence for the application of modified Sanxiaoyin in the treatment of mild or moderate COVID-19.

Schisandrin B Inhibits NLRP3 Inflammasome Pathway and Attenuates Early Brain Injury in Rats of Subarachnoid Hemorrhage / 中国结合医学杂志

OBJECTIVE@#To determine whether Schisandrin B (Sch B) attenuates early brain injury (EBI) in rats with subarachnoid hemorrhage (SAH).@*METHODS@#Sprague-Dawley rats were divided into sham (sham operation), SAH, SAH+vehicle, and SAH+Sch B groups using a random number table. Rats underwent SAH by endovascular perforation and received Sch B (100 mg/kg) or normal saline after 2 and 12 h of SAH. SAH grading, neurological scores, brain water content, Evan's blue extravasation, and terminal transferase-mediated dUTP nick end-labeling (TUNEL) staining were carried out 24 h after SAH. Immunofluorescent staining was performed to detect the expressions of ionized calcium binding adapter molecule 1 (Iba-1) and myeloperoxidase (MPO) in the rat brain, while the expressions of B-cell lymphoma 2 (Bcl-2), Bax, Caspase-3, nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3), apoptosis-associated specklike protein containing the caspase-1 activator domain (ASC), Caspase-1, interleukin (IL)-1β, and IL-18 in the rat brains were detected by Western blot.@*RESULTS@#Compared with the SAH group, Sch B significantly improved the neurological function, reduced brain water content, Evan's blue content, and apoptotic cells number in the brain of rats (P<0.05 or P<0.01). Moreover, Sch B decreased SAH-induced expressions of Iba-1 and MPO (P<0.01). SAH caused the elevated expressions of Bax, Caspase-3, NLRP3, ASC, Caspase-1, IL-1β, and IL-18 in the rat brain (P<0.01), all of which were inhibited by Sch B (P<0.01). In addition, Sch B increased the Bcl-2 expression (P<0.01).@*CONCLUSION@#Sch B attenuated SAH-induced EBI, which might be associated with the inhibition of neuroinflammation, neuronal apoptosis, and the NLRP3 inflammatory signaling pathway.

Clinical observation on filiform-fire needling of "Biaoben acupoint combination" for 33 cases of sequelae of coronavirus disease 2019 during recovery period / 中国针灸

OBJECTIVE@#To observe the clinical therapeutic effect of filiform-fire needling of "Biaoben acupoint combination" on the sequelae of patients with coronavirus disease 2019 (COVID-19) during the recovery period.@*METHODS@#A total of 33 patients with COVID-19 during the recovery period were treated with filiform-fire needling at the acupoints of Mingmen (GV 4), Shenzhu (GV 12), Gaohuang (BL 43), Zusanli (ST 36) and Shangjuxu (ST 37), etc., once every other day, 3 times a week, and 3 times was one course of treatment and totally 2 courses of treatment were required. The TCM symptom, Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) scores, pulmonary function indexes (forced vital capacity [FVC], forced expiratory volume in one second [FEV1], peak expiratory flow [PEF]) and chest CT imaging change were observed before and after treatment, and the therapeutic effect was evaluated.@*RESULTS@#After treatment, the scores of TCM symptom, HAMA and HAMD were decreased compared with those before treatment (P<0.05), and the levels of FVC, FEV1 and PEF were increased compared with those before treatment (P<0.05), and the recovery rate of 22 patients with pulmonary ventilation dysfunction was 86.4% (19/22). After treatment, the lung shadow area was smaller than that before treatment (P<0.05). The effective rate of 25 patients with lung CT abnormalities was 84.0% (21/25). After treatment, 23 cases were cured, 5 cases were markedly effective, 4 cases were effective, 1 case was ineffective, the cured and markedly effective rate was 84.8%.@*CONCLUSION@#The filiform-fire needling of "Biaoben acupoint combination" could significantly reduce the sequelae of cough, fatigue, chest tightness, etc. and mental symptoms such as anxiety and depression in patients with COVID-19 during the recovery period, and promote inflammatory exudation absorption of pulmonary lesion and improve lung ventilation function.

Immunotherapy Based on Tumor Microenvironment in Renal Cell Carcinoma / 中国医学科学院学报

Renal cell carcinoma (RCC) is a common lethal urological cancer,the distant metastasis of which is the leading cause of death.Although targeted agents have remarkably improved the overall prognosis of RCC patients,nearly all the patients eventually acquire therapeutic resistance.With the advent of immune checkpoint inhibitors,immunotherapy based on tumor microenvironment (TME) has shown a broad scope in clinical application.The deepening understanding of TME leads to the changes of therapeutic strategies for advanced RCC,and the combination of targeted therapy and immunotherapy is exhibiting a promising prospect.Herein,we reviewed the TME characteristics,candidate predictive biomarkers,and possible targets for future development of drugs against RCC.

Thumb-tack needles based on "Biaoben acupoint compatibility" for sequela of COVID-19 during recovery period / 中国针灸

OBJECTIVE@#To observe the effect of thumb-tack needles based on "Biaoben acupoint compatibility" on sequela symptoms, mental state and pulmonary ventilation function in patients with coronavirus disease 2019 (COVID-19) during recovery period.@*METHODS@#Fifty cases of COVID-19 during recovery period were randomly divided into an observation group and a control group, 25 cases in each group. The patients in the observation group were treated with thumb-tack needles at Guanyuan (CV 4), Zusanli (ST 36) and Taiyuan (LU 9). The patients in the control group were treated with sham thumb-tack needles at identical acupoints as the observation group. The treatment in the two groups was given once a day, 7-day treatment was taken as a course of treatment, and totally two courses of treatment were given. The TCM symptom score, Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, pulmonary function (forced vital capacity [FVC], forced expiratory volume in the first second [FEV1], peak expiratory flow [PEF]), the severity of pulmonary ventilation dysfunction and pulmonary imaging changes in the two groups were compared before and after treatment.@*RESULTS@#Compared before treatment, the total scores and each item scores of TCM symptom scale, HAMA scores and HAMD scores in the two groups were reduced after treatment (P<0.05). Except for the symptom scores of dry throat and dry stool, the total score and each item score of TCM symptom scale, HAMA score and HAMD score in the observation group were lower than those in the control group (P<0.05). Compared before treatment, FVC, FEV1 and PEF in the two groups were increased after treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The severity of pulmonary ventilation dysfunction in the two groups was reduced after treatment (P<0.05), and the severity in the observation group was better than that in the control group (P<0.05). After treatment, the lung shadow area in the two groups was decreased (P<0.05), and that in the observation group was smaller than the control group (P<0.05). The improvement of imaging change in the observation group was better than that in the control group (P<0.05).@*CONCLUSION@#The thumb-tack needles based on "Biaoben acupoint compatibility" could significantly reduce the sequela symptoms, anxiety and depression in patients with COVID-19 during recovery stage, and improve the pulmonary ventilation function.

Epidemiological analysis and prevention and control of human parvovirus B19 infection in 39 recipients of renal transplantation / 中华器官移植杂志

Objective:To explore the epidemiological characteristics, risk factors, preventions and treatments of recent human parvovirus B19 (HPV-B19) infections in recipients of renal transplantation (RT).Methods:From May 2020 to June 2021, retrospective review was conducted for epidemiological characteristics, treatment protocols, preventions and outcomes of HPV-B19 infected recipients after RT.Risk factors were analyzed using uninfected recipients after RT in the same period as controls.And 78 recipients who were not infected after RT with similar operation time were used as a control group for risk factor analysis.The infection rates of the four liver transplant recipients infected with HPV-B19 during the same period were calculated and compared with those of the kidney transplant recipients.Chi-square test and Fisher's exact test were used for statistical analysis.Results:During the observation period, HPV-B19 infection occurred in 39/368 recipients after RT with an overall infection rate of 10.60%(39/368). In terms of clinical symptoms, all 39 recipients presented with pure red cell aplasia (PRCA). In terms of season of infection, HPV-B19 infections occurred predominantly in autumn and winter [74.3% (29/39) of infections in autumn and winter, including 48.7% (19/39) in autumn]. Comparing the infection rates of different transplant recipients, 4 out of 123 liver transplant recipients were infected with HPV-B19 during the same period.The rate of infection was lower in liver transplant recipients than in RT counterparts (3.25% vs.10.60%, χ2=6.225, P=0.013). Analysis of OR values showed that transfusion of blood products was a risk factor for recent postoperative infection ( χ2=4.806, P=0.028, OR=2.418, 95% CI=1.088-5.373). Conclusions:HPV-B19 infection in renal transplant patients is mainly manifested as PRCA and is more likely than in liver transplant patients.Autumn and winter may be susceptible seasons for HPV-B19 and protection should be increased to prevent infection.Transfusion of blood products is a risk factor for recent HPV-B19 infection after RT, therefore donors should be routinely examined and it is imperative to test the safety of blood products in patients after RT.Thus HPV-B19 infection is well-controlled so that further spread may be prevented to avoid an epidemic outbreak.

Recent research progress on the role of Hippo-Yap signaling pathway in retinal diseases / 中华眼底病杂志

The classical Hippo pathway leads to the phosphorylation of downstream effector molecules Hippo-Yes-associated protein (Yap) and transcriptional coactivator PDZ-binding motif (Taz) serine sites through a kinase response, thereby promoting cell proliferation, controlling cell polarity, changing cytoskeleton, it plays an important regulatory role in various pathophysiological processes such as epithelial-mesenchymal transition and inhibition of cell contact. Studies have shown that Yap/Taz can affect the progression of vitreoretinal diseases, opening up new prospects for the pathogenesis and clinical treatment of diabetic retinopathy, proliferative vitreoretinopathy, and retinal ischemia-reperfusion injury. Exploring the molecular mechanism of Yap/Taz provides a possible therapeutic target for future research in the treatment of retinal fibrosis diseases such as diabetic retinopathy and proliferative vitreoretinopathy. At the same time, regulating the activity of local Yap/Taz in the retina will also become an effective therapeutic target for damage-repair in retinal ischemia-reperfusion injury. However, Yap inhibitors have potential retinal toxicity and are still in the preclinical development stage. Further research on the mechanism of action and clinical safety of Yap inhibitors will provide new methods for the treatment of retinal diseases.

Choroid thickness analysis and related influencing factors in adolescents with different types of non-pathological high myopia / 中华眼底病杂志

Objective:To investigate the changes of choroid thickness in adolescents with different types of non-pathological high myopia (HM).Methods:A retrospective observational study. From January 2021 to April 2022, 179 eyes of 101 adolescents with myopia in Liaocheng Aier Eye Hospital were collected and analyzed. According to the spherical equivalent (SE) and corneal curvature, subjects were divided into mild myopia or emmetical eye group (control group), HM group, occult HM group (OHM group) and super HM group (SHM group). There were 52 eyes in 30 cases, 47 eyes in 26 cases, 42 eyes in 24 cases and 38 eyes in 21 cases, respectively. Medical optometry, intraocular pressure, optical coherence tomography (OCT), axial length (AL) and corneal curvature were measured. The macular foveal choroidal thickness was analyzed by using spectral-domain OCT. The diopter was expressed in SE. The thickness of choroid in the fovea of macular region was measured by enhanced deep imaging with frequency domain OCT. The thickness of choroid was measured in 9 regions within 1 mm, 3 mm from the fovea, including the upper, lower, nasal and temporal regions. Generalized estimating equation was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation between AL, corneal curvature, intraocular pressure and choroidal thickness was analyzed by Pearson correlation. Results:The choroidal thickness in the foveal macula and the areas 1 mm and 3 mm away from the fovea were compared among the control group, HM group, OHM group and SHM group, the difference were significant ( χ2=76.646, 36.715, 27.660, 35.301, 24.346, 38.093, 36.275, 33.584, 36.050; P<0.05). Compared with the control group, the choroidal thickness of the fovea and the choroidal thickness in each area within 1 and 3 mm from the fovea in the HM group, the OHM group and the SHM group were significantly thinner than those in the control group, and the difference was statistically significant ( P<0.05). There were statistically significant differences in choroidal thickness in each region between the group and the SHM group, and between the OHM group and the SHM group ( P<0.05). The results of correlation analysis showed that AL was negatively correlated with choroidal thickness in various regions ( P<0.05); SE was positively correlated with choroidal thickness in various regions ( P<0.05); corneal curvature and intraocular pressure had no significant correlation with choroidal thickness in various regions ( P>0.05). Conclusions:The choroidal thickness of SHM is significantly lower than that of OHM and HM; OHM patients have lower SE. However, the choroidal thickness is significantly thinner. AL and SE are the influencing factors of choroidal thickness.

Exploration of complement-dependent cytotoxicity technology for GTKO/hCD55 genetically engineered pig-to-human xenotransplantation / 中华器官移植杂志

Objective:To compare the inhibitory effect of human CD55(hCD55)expressed on porcine peripheral blood mononuclear cells(PBMC)on rabbit complement-and human complement-dependent cytotoxicity(CDC).Methods:Three α1, 3-galactosyltransferase gene knockout(GTKO)pigs from the same strain were selected.Two were transferred with hCD55 gene.According to the expression level of hCD55, the animals were divided into three groups of GTKO, GTKO/hCD55 Low(low-expression of hCD55)and GTKO/hCD55 High(high-expression of hCD55). After PBMC from these pigs were incubated with complement-inactivated pooled human serum(20 cases), rabbit complement-or human complement-dependent cytotoxicity and binding of antibodies(IgM/G)to pig PBMC were detected by flow cytometry. Results:No significant difference existed in binding of human serum xenoreactive antibodies to PBMC from three groups.The cytotoxicity to GTKO pig PBMC mediated by rabbit complement or human complement were 98.97%±0.50% and 82.73%±3.20% respectively.Both values were quite high.Compared with GTKO group, a low expression of hCD55 had no significant inhibitory effect on rabbit complement-dependent cytotoxicity(97.07%±2.25% vs. 98.9%±0.50%, P=0.2 267) while a high expression of hCD55 exerted a mild inhibitory effect on rabbit complement-dependent cytotoxicity(81.70%±5.86% vs. 98.9%±0.50%, P=0.0 355). Differently, a low expression of hCD55 had a potent inhibitory effect on human complement-dependent cytotoxicity(23.83%±3.53% vs. 82.73%±3.20%, P<0.0 001). Compared with hCD55 low-expression group, a high expression of hCD55 had a further inhibitory effect on human complement-dependent cytotoxicity(2.79%±0.45% vs. 82.73%±3.20%, P=0.009), attaining the level of negative control group.The inhibitory effect of low/high expression of hCD55 on human complement-mediated CDC was significantly better than that on rabbit complement-mediated CDC. Conclusions:Compared with traditional CDC counterpart using rabbit complement, modified CDC technology of commercial standard human complement is recommended for evaluating the regulatory effect of hCD55 expressed on cell surface from GTKO/hCD55 genetically engineered pigs.It thus provides experimental rationales for establishing a novel CDC experimental system of effectively evaluate the function of hCD55 after xenotransplantation.