Effectiveness of HPV vaccines in real-world study / 中华微生物学和免疫学杂志

Human papillomavirus (HPV) is an epitheliotropic virus. High-risk HPV infections lead to precancerous lesions which may progress to cancer in the cervix, vagina and vulva, while low-risk HPV infections cause benign lesions such as genital warts and recurrent respiratory papillomas. HPV infection remains one of the major public health problems threatening human health. To date, six prophylactic preventive HPV vaccines have been licensed, and the effectiveness of HPV vaccination has gradually appeared in some countries with earlier vaccination. HPV vaccination has been proved to be effective in protecting against diseases related to HPV infection, which leads to significant reductions in the incidence of vaccine-type HPV-related infection, high cervical lesions, anogenital warts, recurrent respiratory papillomatosis and other relevant diseases. The herd protection effect of the vaccines is outstanding. Meanwhile, a bivalent HPV vaccine has been demonstrated for the cross-protection against HPV infections of non-vaccine types (HPV31/33/45) in real-world vaccination practice.

Tocilizumab in patients with moderate or severe COVID-19: a randomized, controlled, open-label, multicenter trial / 医学前沿

Tocilizumab has been reported to attenuate the "cytokine storm" in COVID-19 patients. We attempted to verify the effectiveness and safety of tocilizumab therapy in COVID-19 and identify patients most likely to benefit from this treatment. We conducted a randomized, controlled, open-label multicenter trial among COVID-19 patients. The patients were randomly assigned in a 1:1 ratio to receive either tocilizumab in addition to standard care or standard care alone. The cure rate, changes of oxygen saturation and interference, and inflammation biomarkers were observed. Thirty-three patients were randomized to the tocilizumab group, and 32 patients to the control group. The cure rate in the tocilizumab group was higher than that in the control group, but the difference was not statistically significant (94.12% vs. 87.10%, rate difference 95% CI-7.19%-21.23%, P = 0.4133). The improvement in hypoxia for the tocilizumab group was higher from day 4 onward and statistically significant from day 12 (P = 0.0359). In moderate disease patients with bilateral pulmonary lesions, the hypoxia ameliorated earlier after tocilizumab treatment, and less patients (1/12, 8.33%) needed an increase of inhaled oxygen concentration compared with the controls (4/6, 66.67%; rate difference 95% CI-99.17% to-17.50%, P = 0.0217). No severe adverse events occurred. More mild temporary adverse events were recorded in tocilizumab recipients (20/34, 58.82%) than the controls (4/31, 12.90%). Tocilizumab can improve hypoxia without unacceptable side effect profile and significant influences on the time virus load becomes negative. For patients with bilateral pulmonary lesions and elevated IL-6 levels, tocilizumab could be recommended to improve outcome.

Application value of metagenomic next generation sequencing in diagnosis of osteoarticular infections / 中华临床感染病杂志

Objective:To evaluate the application of metagenomic next-generation sequencing (mNGS) in the diagnosis of osteoarticular infection.Methods:The clinical data of 37 inpatients aged 32-90 year with osteoarticular infection admitted in the Department of Spine Surgery of Qingdao Chest Hospital from January to December 2019 were retrospectively analyzed. There were 31 cases of spine infection and 6 cases of other joint infection. The tissue samples were obtained from the infected sites through puncture or surgical approach in all patients. The tissue samples were subjected to routine culture of mycobacteria, aerobic bacteria and anaerobic bacteria, respectively. The gene amplification and mNGS were performed for detection of mycobacterium tuberculosis DNA (MTB-DNA). The chi-square test or Fisher’s exact test were used to compare the detection rates of pathogen and simple bacterial infection between mNGS and conventional culture. The conventional culture, mNGS and MTB-DNA amplification detection were performed for all samples; with clinical diagnosis as the gold standard, the diagnostic values of 3 methods were evaluated with receiver operating characteristic curve (ROC). Paired sample t test was used to compare white blood cell(WBC) count, erythrocyte sedimentation rate, C-reactive protein of patients before and after treatment. P<0.05 was considered statistically significant. Results:The pathogens were detected by mNGS for 42 times: bacteria for 39 times (92.8%), fungi for twice (4.8%) and Kirks body for once (2.4%). Among 37 patients there were 29 cases of pure bacterial infection (78.4%), 2 cases of pure fungi infection (5.4%), 1 case of pure Kirks body infection (2.7%), and 5 cases of mixed infection of two or more pathogens (13.5%). The detection rates of mNGS and conventional culture were 100.0% (37/37) and 67.6% (25/37), respectively ( χ2=13.987, P<0.05). The detection rates of mNGS and conventional culture in 29 patients with pure bacterial infection were 100.0% (29/29) and 69.0% (20/29), respectively ( χ2=16.913, P<0.05). The area under the ROC curve (AUC) of conventional culture, mNGS, and MTB-DNA in the diagnosis of osteoarticular tuberculosis infection was 0.958 (95% CI: 0.866-1.000, P<0.05), 1.000 (95% CI: 1.000-1.000, P<0.05) and 0.958 (95% CI: 0.866-1.000, P<0.05). All the 37 patients were treated with anti-infective drugs according to the results of mNGS and conventional culture. Among them, 28 patients received surgical intervention. The patients were followed up until April 30, 2020, 1 patient died. After 3 months of follow-up, the WBC count, erythrocyte sedimentation rate and C-reactive protein were (5.5±1.5)×10 9/L, (41±38)mm/h and (5.0±4.6) mg/L, respectively, which were lower than those before anti-infection treatment [(8.0±2.9)×10 9/L, (79±42)mm/h and(63±52)mg/L] ( t=6.536, 8.302 and 6.373, all P<0.05). Conclusion:The metagenomic next-generation sequencing may have important clinical value in the differential diagnosis of osteoarticular infection.

Effects of Shuanghuanglian oral liquids on patients with COVID-19: a randomized, open-label, parallel-controlled, multicenter clinical trial / 医学前沿

We conducted a randomized, open-label, parallel-controlled, multicenter trial on the use of Shuanghuanglian (SHL), a traditional Chinese patent medicine, in treating cases of COVID-19. A total of 176 patients received SHL by three doses (56 in low dose, 61 in middle dose, and 59 in high dose) in addition to standard care. The control group was composed of 59 patients who received standard therapy alone. Treatment with SHL was not associated with a difference from standard care in the time to disease recovery. Patients with 14-day SHL treatment had significantly higher rate in negative conversion of SARS-CoV-2 in nucleic acid swab tests than the patients from the control group (93.4% vs. 73.9%, P = 0.006). Analysis of chest computed tomography images showed that treatment with high-dose SHL significantly promoted absorption of inflammatory focus of pneumonia, which was evaluated by density reduction of inflammatory focus from baseline, at day 7 (mean difference (95% CI), -46.39 (-86.83 to -5.94) HU; P = 0.025) and day 14 (mean difference (95% CI), -74.21 (-133.35 to -15.08) HU; P = 0.014). No serious adverse events occurred in the SHL groups. This study illustrated that SHL in combination with standard care was safe and partially effective for the treatment of COVID-19.

Investigation and Study on the Current Situation of Chronic Disease Management Service in Social Pharmacy of Chengdu / 中国药房

OBJECTIVE：To provide reference for chronic disease man agement service develophed in social pharmacy. METHODS：Questionnaire about the Status Quo of Chronic Disease Management and Service in Social Pharmacy of Chengdu was designed，using the quota sampling method ，social pharmacies in five main urban areas of Chengdu were selected from May to July，2018 to conduct a questionnaire survey （one questionnaire by each social pharmacy ） on the basic situation of social pharmacies，the development of chronic disease management services ，the cognition of chronic disease management services ，and the challenges faced by chronic disease management services ，and suggestions were proposed. RESULTS & CONCLUSIONS ：A total of 272 questionnaires were sent out ，and 252 valid questionnaire were actually collected （effective recovery rate of 92.65％）. Totally 189 sample pharmacies （75.00％） had carried out chronic disease management services ，of which 112 （59.26％） pharmacies had been launched for 1-3 years；87（46.03％）had set up service areas ；68（35.98％）had full-time staff ，and 54 （28.57％）had part-time staff ，most of which were licensed pharmactists. 116（61.37％）had trained related staff for 1-2 times per year. 176（93.12％）pharmacies could provide services such as basic indicator testing （176，93.12％），establishing health records （142，75.13.％），and rational medication guidance for patients （163，86.24％）. According to the survey ，the substantial benefits of chronic disease management services included changing the health status of patients （163，86.24％），improving patients ’trust in the pharmacy and staff （141，74.60％），improving patients ’quality of life （129，68.25％），etc. More than 50％ of pharmacies faced the challenges of limited number of licensed pharmacists （102，53.97％），difficulty in establishing professional teams （112， 59.26％），and lack of trust in services （101，53.44％）. The current chronic disease management service of social pharmacy in Chengdu is in the initial stage of active exploration ，which can bring many benefits to patients and pharmacies ，and is conducive to the promotion of medical and health policies ，but there are some weak links at the same time. It is suggested that relevant government departments should strengthen the support ofpolicies and regulations ， and social pharmacies constantly 85501387。 E-mail：2191043137@qq.com improve professional level and rely on the advantages of “Internet + ”to meet the diverse needs of the public for pharmaceutical care ，and publicity efforts are intensified to · enhance the awareness and participation of patients with chronic diseases.

Analysis of KIAA0196 gene mutation in a family with hereditary spastic paraplegia / 中华医学遗传学杂志

OBJECTIVE@#To identify pathogenic mutation in a Chinese family affected with hereditary spastic paraplegia (HSP) through genetic testing and a follow-up survey.@*METHODS@#Whole exome sequencing was performed on DNA samples of two patients and one unaffected member to screen candidate mutations. Sanger sequencing was used to validate the suspected mutations in all ten family members.@*RESULTS@#Four patients and three asymptomatic members (under 25 years old) carried a c.1771T>C mutation of the KIAA0196, while the other three asymptomatic members (over 40 years old) did not carry the mutation. The mutation was predicted to be "affect protein function", "probably damaging" and "disease causing" by SIFT, PolyPhen-2 and Mutation Taster, respectively. Three asymptomatic carriers were followed up and one of them developed HSP one year later, while the other two had no signs of the disease yet.@*CONCLUSION@#The clinical phenotype of the c.1771T>C mutation of KIAA0196 has a considerable heterogeneity and this mutation may be a common pathogenic site of KIAA0196 mutations among Chinese patients with hereditary spastic paraplegia.

Analysis of TGFBI gene mutation in a pedigree affected with corneal dystrophy / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To detect potential mutation in a large Chinese pedigree affected with congenital corneal dystrophy.</p><p><b>METHODS</b>Two patients from the pedigree were subjected to whole exome sequencing to determine the candidate gene. Suspected mutation was verified in 13 additional members by directional Sanger sequencing. Ccorrelation between genotype and phenotype was explored.</p><p><b>RESULTS</b>A missense mutation, c.1877A>C (p.His626Pro), was detected in exon 14 of the TGFBI gene in 8 patients from the pedigree, but not in five unaffected members and 100 unrelated healthy controls. Respectively, the mutation was predicted as "affecting protein function", "probably damaging" and "disease causing" by SIFT, PolyPhen-2 and MutationTaster.</p><p><b>CONCLUSION</b>The c.1877A>C mutation of the TGFBI gene probably underlies the disease in this pedigree.</p>

Biomimetic nanohydroxyapatite/gelatin composite material preparation and in vitro study / 中南大学学报(医学版)

OBJECTIVE@#To prepare nHA/gelatin porous scaffold and to evaluate its physical and chemical properties and biocompatibility.@*METHODS@#We used nano-powders of HA and gelatin to prepare 3D porous composite scaffold by freeze-drying technique, and used scanning electron microscope, fourier transform infrared spectroscopy and universal testing machine to characterize the composite material. Osteoblasts were primarily cultured, and the third-passage osteoblasts were co-cultured with the composite material. The cell adhesion and morphology were examined under scanning electron microscope. The cell viability analysis was performed by MTT assay, and the alkaline phosphatase activity was measured with alkaline phosphatase kit.@*RESULTS@#Scanning electron microscope showed that the scaffold possessed a 3-dimensional interconnected homogenous porous structure with pore sizes ranging from 150 to 400 μm. Fourier transform infrared spectroscopy showed that the composite material had a strong chemical bond between the inorganic phase and organic phase. The scaffold presented the compressive strength of (3.28 ± 0.51) MPa and porosities of (80.6 ± 4.1)%. Composite materials showed features of had good biocompatibility. Mouse osteoblasts were well adhered and spread on the materials. The grade of the cell toxicity ranged from I to II. On the 5th and 7th day the proliferative rate of osteoblasts on scaffolds in the composite materials was significantly higher than that in the control group. The activity of alkaline phosphatase was obviously higher than that in the control group on Day 1 and 3.@*CONCLUSION@#Nano-hydroxyapatite and gelatin in certain proportions and under certain conditions can be prepared into a composite biomimetic porous scaffolds with high porosity and three-dimensional structure using freeze-drying method. The scaffold shows good biocompatibility with mouse osteoblasts and may be a novel scaffolds for bone tissue engineering.

DNA double-strand breaks, potential targets for HBV integration / 华中科技大学学报（医学）（英德文版）

Hepatitis B virus (HBV)-induced hepatocellular carcinoma (HCC) is one of the most frequently occurring cancers. Hepadnaviral DNA integrations are considered to be essential agents which can promote the process of the hepatocarcinogenesis. More and more researches were designed to find the relationship of the two. In this study, we investigated whether HBV DNA integration occurred at sites of DNA double-strand breaks (DSBs), one of the most detrimental DNA damage. An 18-bp I-SceI homing endonuclease recognition site was introduced into the DNA of HepG2 cell line by stable DNA transfection, then cells were incubated in patients' serum with high HBV DNA copies and at the same time, DSBs were induced by transient expression of I-SceI after transfection of an I-SceI expression vector. By using nest PCR, the viral DNA was detected at the sites of the break. It appeared that integration occurred between part of HBV x gene and the I-SceI induced breaks. The results suggested that DSBs, as the DNA damages, may serve as potential targets for hepadnaviral DNA insertion and the integrants would lead to widespread host genome changes necessarily. It provided a new site to investigate the integration.

Risk factor assessment for lymph node regional metastasis of squamous cell carcinoma of tongue / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The purpose of this study was to investigate the risk factors involving lymph node metastasis of squamous cell carcinoma and evaluate if the risk factors would be effective in predicting neck lymph node metastasis.</p><p><b>METHODS</b>Based on the original data of 106 cases with carcinoma of tongue, four related factors, including maximal diameter, degree of differentiation, mode of invasion and histological grade of malignancy were analyzed statistically.</p><p><b>RESULTS</b>The maximal diameter and the grade of tumor cell differentiation showed no significant correlation with cervical lymph node metastasis; but the mode of invasion and the histological grade of malignancy demonstrated a significant correlation.</p><p><b>CONCLUSION</b>The results obtained suggested that the mode of invasion and the histological grade of malignancy were closely related to cervical lymph node metastasis.</p>

Preparation and Content Determination of Cholecalciferol Microcapsules / 中国药房

OBJECTIVE:To prepare cholecalciferol(VitD3)microcapsules and establish a method for their quantitative determination.METHODS:Microcapsules were prepared by complex coacervation method and VitD3 content was determined by HPLC.RESULTS:The prepared microcapsules had well-distributed particle size with average particle size of(103.9?26.2)?m and encapsulation efficiency of(90.8?2.68)%.The linear range of VitD3 was 0.1～1.0 ?g?mL-1(r=0.999 3)with mean recovery rate of 98.65% and a dissolution rate of above 75% at 45 min.CONCLUSION:VitD3 microcapsules was successfully prepared by the established method,and the established content determination method was proved to be simple and feasible.