Design, synthesis, and activity of 5-cyano-2-thiacetyl aromatic pyrimidinone as DENV NS5 RdRp inhibitors / 药学学报

To screen novel anti-dengue virus (DENV) NS5 RdRp enzyme inhibitors, a series of 5-cyano-2-thiacetoaryl pyrimidinone compounds were designed and synthesized by molecular hybridization method with HCV NS5B RdRp inhibitor 3jc and ZIKV NS5 RdRp inhibitor 4w as lead compounds. The anti-DENV activity of these compounds was evaluated by MTT assay and plaque assay and five compounds showed anti-DENV activity. The most active compound 7a'k showed better anti-DENV activity than that of the positive control ribavirin (EC50 = 7.86 μmol·L-1 vs EC50 = 18.07 μmol·L-1), and the other four compounds showed almost the same anti-DENV activity as ribavirin. Finally, the prediction and simulation of the binding mode through molecular provided new ideas for the further development of this new DENV NS5 RdRp inhibitor.

Distribution pattern of respiratory symptoms and the relevant risk factors in patients with pulmonary nodules: A cross-sectional study / 中国胸心血管外科临床杂志

@#Objective    To explore the distribution pattern of respiratory symptoms and relevant factors in patients with pulmonary nodules. Methods    Demographic and clinical information were collected from patients who visited the Thoracic Surgery Outpatient Clinic of Guangdong Provincial People’s Hospital from January 2021 to January 2022. Hospital Anxiety and Depression Scale (HADS) was used to assess their anxiety and depression level. Results    A total of 1 173 patients were enrolled, including 449 males and 724 females, with an average age of 46.94±11.43 years. Among the patients with pulmonary nodules, 37.7% of them had at least one respiratory symptom; 24.4% had cough, 14.0% had expectoration, 1.3% had hemoptysis and 14.9% had chest pain. Old age, male, exposure to second-hand smoking or environmental smoke, hair coloring and history of tuberculosis were major risk factors for respiratory symptoms (P<0.05). Middle age, old age, male, exposure to environmental smoke were major risk factors for cough (P<0.05); old age, smoking, larger maximum nodules diameters, exposure to environmental smoke and history of pneumonia were major risk factors for expectoration (P<0.05); male, multiple nodules, hair coloring, exposure to second-hand smoking and history of tuberculosis were major risk factors for chest pain (P<0.05). Symptomatic patients showed generally higher HADS scores than asymptomatic patients (P<0.001). Conclusion    Cough, expectoration and chest pain are the predominant respiratory symptoms for patients with pulmonary nodules. The presentation of respiratory symptoms increases patients' anxiety and depression.

Timing and safety of lung cancer surgery after SARS-CoV-2 infection: A multicenter retrospective study / 中国胸心血管外科临床杂志

@#Objective     To explore the timing and safety of limited-period lung cancer surgery in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods     Clinical data of of patients infected with COVID-19 undergoing lung cancer surgery (an observation group) in the Department of Thoracic Surgery of Guangdong Provincial People's Hospital, the Department of Thoracic Surgery of General Hospital of Southern Theater Command of PLA, and the Department of Cardiothoracic Surgery of the First Affiliated Hospital of Guangdong Pharmaceutical University from December 2022 to January 2023 were retrospectively analyzed and compared with patients who underwent surgery during the same period but were not infected with COVID-19 (a control group), to explore the impact of COVID-19 infection on lung cancer surgery. Results     We finally included 110 patients with 73 patients in the observation group (28 males and 45 females at age of 52.62±12.80 years) and 37 patients in the control group (22 males and 15 females at age of 56.84±11.14 years). The average operation time of the observation group was longer than that of the control group, and the incidence of anhelation was higher than that of the control group (P<0.05). There were no statistcal differences in blood loss, length of hospital stay, moderate or above fever rate, degree of cough and chest pain, or blood routine between the two groups. Conclusion    It is safe and feasible to perform lung cancer surgery early after recovery for COVID-19 patients with lung cancer.

Anxiety and depression in the patients with pulmonary nodules and its related influencing factors: A cross-sectional study / 中国胸心血管外科临床杂志

@#Objective     To identify the potential factors for psychological burdens and to better understand how the patients’ psychological status affect their treatment preferences. Methods     A questionnaire survey was conducted among 996 patients with pulmonary nodules who visited the Thoracic Surgery Clinic of Guangdong Provincial People's Hospital from January to November 2021, including 381 males and 615 females, aged 47.26±11.53 years. A self-administrated questionnaire was used to investigate the sociodemographic and clinical characteristics of the patients, and the Hospital Anxiety and Depression Scale (HADS) was used to evaluate the psychological status of the patients, with a score>7 points of each subscale indicating potential anxiety or depression. Results     Among the 996 patients with pulmonary nodules, the incidence of anxiety was 42.4% and the incidence of depression was 26.4%, while the incidence of both anxiety and depression was 24.7%. There was a significant correlation between anxiety and depression (ρ=0.834, P<0.05). Age, purpose of CT examination, number of pulmonary nodules and symptoms were independent factors for anxiety, while symptoms and number of pulmonary nodules were independent factors for depression (P<0.05). For treatment preferences, there was a statistical difference in educational level, symptoms, nodule size and anxiety level (P<0.05). Conclusion     Anxiety and depression are common in patients with pulmonary nodules. Symptoms are associated with anxiety and depression, which also make an impact on treatment preferences.

Design, synthesis and biological activity of DB02 amino acid derivatives as HIV-1 non-nucleoside reverse transcriptase inhibitors / 药学学报

To improve the stability of amino acid ester derivatives of DB02, a series of 24 amide derivatives of DB02 amino acids as non-nucleoside HIV-1 reverse transcriptase inhibitor were designed and synthesized based on bioisosterism by replacing amino acid ester scaffold with more stable amide bond. The anti-HIV-1 activity of these compounds was evaluated by MTT assay and counting the number of syncytia. Most of the target compounds showed a potential anti-HIV-1 activity, among which compounds 2d, 2i, 2l, 2s, and 2w had better antiviral effect than lead compound DB02, with a therapeutic index > 1 000.00. Finally, the structure-activity relationship of these compounds was discussed, which provided new ideas for the further development of DB02 derivatives.

Percutaneous endoscopic debridement with percutaneous pedicle screw fixation for lumbar pyogenic spondylodiscitis / 中华骨科杂志

Objective:To access the feasibility and efficacy of percutaneous endoscopic debridement (PED) combined with percutaneous pedicle screw fixation (PPSF) in the treatment of lumbar pyogenic spondylodiscitis.Methods:49 patients (male 29, female 20), aged 51.2±13.9 years (range 19-81 years), who were diagnosed with lumbar pyogenic spondylodiscitis and received PED with PPSF in Orthopedic Department, Sun Yat-Sen Memorial Hospital and Zhuhai People's Hospital from January 2014 to March 2017, were retrospectively reviewed. The patients were operated in the prone position with the infected locus thoroughly debrided, vertebrae fixed and clinical outcomes were assessed by observing the changes of complaining symptoms, laboratory parameters, clinical functional scores (American Spinal Injury Association impairment scale, AIS; visual analog scale, VAS; Oswestry disability index, ODI) and imaging studies during perioperative and follow-up stages.Results:The mean operative time was 110.1±19.8 min (80-165 min), with intra-operative blood loss 47.8±20.6 ml (range 20-120 ml). All patients reported relief of back pain. Causative pathogens were identified in 36 of 49 biopsy specimens, with staphylococcal bacteria being the most prevalent strain (accounting for 50.0%). During 3-12 months' follow-up, 95.9% (47/49) patients' infection was well-controlled. At 3 month post-operative, C-reactive protein declined from 62.1±37.2 mg/L to 7.5±5.8 mg/L, white blood cell declined from (14.2±3.9)×10 9/L to (6.2±1.1)×10 9/L, ESR declined from 90.3±37.4 mm/1 h to 16.9±7.2 mm/1 h, and the values at 3 months post-operative had significant difference compared with values at pre-operative ( t=10.15, P<0.001; t=13.49, P<0.001; t=13.82, P<0.001). Spontaneous fusion was observed among 56.8% (21/37) of the patients during long-term radiological follow-ups (more than 1.5 years). At the last follow-up, the VAS declined from 7.4±0.6 points pre-operative to 0.5±0.3 post-operative, ODI declined from 78.2%±9.1% pre-operative to 14.0%±8.6% post-operative, and the values at the last follow-up had significant difference compared with values at pre-operative ( t=72.00, P<0.001; t=35.89, P<0.001). There were 38 cases of AIS E, and 11 cases of AIS D at pre-operative, while 43 cases of AIS E and 6 cases of AIS D. However, there were 11 patients developed post-operative complications, among whom 2 with recurrent infection, 2 with secondary neurological impairment. Conclusion:PED combined with PPSF effectively eliminated infected locus, stabilized the affected vertebrae, improved patients' clinical outcomes with small trauma, thereby offering an alternative for the treatment of lumbar pyogenic spondylodiscitis.

Intraoperative IPC combined with 3M warming instrument to prevent lower extremity deep venous thrombosis in patients undergoing proximal femoral anti rotation intramedullary nailing / 中国骨伤

OBJECTIVE@#To explore the effect of intermittent pneumatic compression(IPC) combined with 3M thermometer on the prevention of deep venous thrombosis(DVT) in patients with femoral intertrochanteric fracture.@*METHODS@#From March 2016 to August 2019, 127 patients with femoral intertrochanteric fractures who underwent proximal femoral nail antirotation(PFNA) were retrospectively analyzed. They were divided into two groups according to different methods of thrombus prevention and treatment. Among them, 63 patients in group A did not use IPC and 3M thermometer;64 cases in group B were treated with IPC combined with 3M thermometer. Color Doppler ultrasound was used to dynamically monitor the DVT and changes of lower limbs during perioperative period. The venous thrombosis of lower limbs was monitored at 0, 24, 72 h and > 72 h after operation(recheck every 3 days until discharge).@*RESULTS@#Occurrence of DVT of lower limbs after PFNA operation in two groups:there were 5 cases (7.8%) in group B and 20 cases (31.7%) in group A, there was significant difference between two groups (P=0.001). There was no significant difference in lower limb DVT between two groups at 0, 72 and > 72 h after operation(P>0.05), but the formation rate of group A was significantly higher than that of group B at 24 h after operation (P=0.049). There was no significant difference in DVT formation between group A and group B(P>0.05). However, the formation of DVT in group A was significantly higher than that in group B(P=0.012).@*CONCLUSION@#Intraoperative IPC combined with 3M thermostat can effectively prevent DVT of lower limbs in patients undergoing PFNA surgery.

Studies on lithium in the environment and its effects on the central nervous system / 中华预防医学杂志

This paper introduces the distribution of global lithium resources and absorption, distribution, metabolism and excretion of lithium in the human body, discussing the positive effect of lithium in the environment on the nervous system and its neuroprotective mechanism. The tiny amounts of lithium that enter the body through the food chain have been linked to beneficial health effects, such as improved cognition and reduced depression and violence. However, the safe dose range of lithium is narrow, and the health effects of drinking high concentrations of lithium water in high-lithium areas are unclear. It is necessary to study the health effects and mechanisms of different doses of lithium, especially high concentrations of lithium in the environment.

Application value of Da Vinci robotic surgical system in radical resection of perihilar cholan-giocarcinoma / 中华消化外科杂志

Objective:To investigate the application value of Da Vinci robotic surgical system in radical resection of perihilar cholangiocarcinoma (pCCA).Methods:The retrospective and descrip-tive study was conducted. The clinicopathological data of 10 patients undergoing Da Vinci robotic radical resetion of pCCA in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from September 2018 to March 2021 were collected. There were 6 males and 4 females, aged (58±7)years. Observtaion indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. The patients were followed up by telephone interview and outpatient service to detect survival of patients and tumor recurrence up to June 2021. Measurement data with normal distribution were expressed as Mean± SD, and measurement data with skewed distribu-tion were represented as M(range). Count data were represented as absolute numbers. Results:(1) Surgical situations: 10 patients underwent Da Vinci robotic radical resection of pCCA succe-ssfully, without conversion to laparotomy or intraoperative blood transfusion. The operation time of 10 patients was (465±87)minutes, and the volume of intraoperative blood loss was (167±81)mL. Of the 10 patients, 1 case of Bismuth type Ⅲb had a positive surgical margin and the remaining 9 cases had R 0 resection. (2) Postoperative situations: the time to gastric tube extraction was (2.3±1.9)days, and the duration of postoperative hospital stay of the 10 patients was (19.9±9.0)days. Among the 10 patients, there was no second operation or perioperative death. Of the 10 patients, 6 cases had perioperative complications, including 5 cases wth pleural effusion, 3 cases with peritoneal effusion, and 1 case with intestinal obstruction, some patients had multiple complications. After symptomatic conservative treatment, pleural effusion and peritoneal effusion disappeared and intestinal obstruction was improved. None of the 10 patients had serious complica-tions such as bleeding, biliary fistula or intestinal fistula. (3) Follow-up: 10 patients were followed up for 3-20 months, with a median follow-up time of 11 months. During the follow-up, 3 of 10 patients had tumor recurrence which occurred in intrahepatic bile duct of residual liver, and no implantation metastasis was found in the rest of abdominal cavity. Of the 7 unrecurrent patients, 1 case died of gastrointestinal bleeding and multiple organ failure. Nine of 10 patients survived well. Conclusion:The Da Vinci robotic surgical system used for radical operation of pCCA is feasible.

Head Acupuncture Plus Schuell's Language Rehabilitation for Post-Stroke Aphasia: A Systematic Review and Meta-Analysis of 32 Randomized Controlled Trials / 中国结合医学杂志

OBJECTIVE@#To evaluate the existing randomized controlled trials (RCTs) for evidence of the efficacy and safety of head acupuncture (HA) plus Schuell's language rehabilitation (SLR) in post-stroke aphasia.@*METHODS@#Seven databases including Embase, PubMed, Cochrane Library, Technology Periodical Database, the China National Knowledge Infrastructure, SinoMed and Wanfang Data Information Site were searched for RCTs published from database inception until November 14, 2021. RCTs that compared HA plus SLR with sham (or blank) control, acupuncture therapy alone, certain language rehabilitation therapy alone or other therapies for post-stroke aphasia were included. Data were extracted and assessed, and the quality of RCTs was evaluated. Fixed-effects model was used, with meta-inflfluence analysis, meta-regression, and regression-based sub-group analyses applied for exploration of heterogeneity. Publication bias was estimated by funnel plots and Egger's tests.@*RESULTS@#A total of 32 RCTs with 1,968 patients were included and 51 comparisons were conducted classified as types of strokes and aphasia. (1) For patients with aphasia after ischemic stroke, HA plus PSA showed significantly higher accumulative markedly effective rate [relative risk (RR)=1.55, 95% confidence interval (CI): 1.19-2.02, I2=0%] and accumulative effective rate (RR=1.22, 95% CI: 1.09-1.36, I2=0%). (2) For patients with comprehensive types of stroke, HA plus PSA was more effective in increasing recovery rate (RR=1.89, 95% CI: 1.39-2.56, I2=0%), accumulative markedly effective rate (RR=1.53, 95% CI: 1.36-1.72, I2=9%) and accumulative effective rate (RR=1.14, 95% CI: 1.09-1.19, I2=34%). (3) For patients with aphasia after stroke, HA plus PSA was superior to PSA alone with statistical significance in increasing recovery rate (RR=2.08, 95% CI: 1.24-3.46, I2=0%), accumulative markedly effective rate (RR=1.49, 95% CI: 1.24-1.78, I2=0%) and accumulative effective rate (RR=1.15, 95% CI: 1.06-1.24, I2=39%). (4) For patients with multiple types of aphasia, HA plus PSA also demonstrated significantly higher recovery rate (RR=1.86, 95% CI: 1.28-2.72, I2=0%), accumulative markedly effective rate (RR=1.55, 95% CI: 1.35-1.78, I2=22%), and accumulative effective rate (RR=1.17, 95% CI: 1.11-1.23, I2=41%). (5) For patients with motor aphasia after ischemic stroke, compared with PSA alone, HA plus PSA showed significantly higher accumulative markedly effective rate (RR=1.38, 95% CI: 1.06-1.79, I2=0%) and accumulative effective rate (RR=1.20, 95% CI: 1.05-1.37, I2=0%). Meta-regression analyses were performed without significant difference, and publication bias was found in some comparisons.@*CONCLUSION@#HA plus SLR was significantly associated with better language ability and higher effective rate for patients with post-stroke aphasia, and HA should be operated cautiously especially during acupuncture at eye and neck. (Registration No. CRD42020154475).

Changes in the structure of intestinal mucosal flora in colorectal cancer patients / 南方医科大学学报

OBJECTIVE@#To investigate the changes in bacterial flora in fecal samples, at the tumor loci and in adjacent mucosa in patients with colorectal cancer (CRC).@*METHODS@#We collected fecal samples from 13 patients with CRC and 20 healthy individuals and tumor and adjacent mucosa samples from 6 CRC patients. The differences in bacterial composition between the fecal and mucosa samples were analyzed with 16S rDNA sequencing and bioinformatics methods. We also detected the total number of bacteria in the feces using flow cytometry, isolated and identified the microorganisms in the fecal and mucosa samples using common bacterial culture media. We further tested the effects of 7 isolated bacterial strains on apoptosis of 3 CRC cell lines using lactate dehydrogenase detection kit.@*RESULTS@#The bacterial α-diversity in the feces of healthy individuals and in adjacent mucosa of CRC patients was significantly higher than that in the feces and tumor mucosa in CRC patients (P < 0.05). Lactobacillaceae is a specific bacteria in the feces, while Escherichia, Enterococcus, and Fusobacterium are specific bacteria in tumor mucosa of CRC patients as compared with healthy individuals. Cell experiment with3 CRC cell lines showed that Bacteroides fragilis isolated from the tumor mucosa of CRC patients produced significant inhibitory effects on cell proliferation (P < 0.0001), while the isolated strain Fusobacterium nucleatum obviously promoted the proliferation of the cell lines (P < 0.001).@*CONCLUSION@#The bacterial flora in the feces, tumor mucosa and adjacent mucosa of CRC patients is significantly different from that in the feces of healthy individuals, and the fecal flora of CRC patients can not represent the specific flora of the tumor mucosa. Inhibition of F. nucleatum colonization in the tumor mucosa and promoting B. fragilis colonization may prove beneficial for CRC treatment.

Research progress on the portal vein thrombosis after esophagogastric devascularization and splenectomy / 中华肝胆外科杂志

Portal vein thrombosis is a common complication after esophagogastric devascularization and splenectomy (EDS), with concealment and potential risks, which limited the therapeutic effect. The patients undergoing EDS are often accompanied by severe liver cirrhosis, whose abnormal hemostasis poses a dilemma for antithrombotic therapy. This article reviewed on the research progress of hemostasis of these patients, and risk factors, mechanism, prevention, therapy of post-EDS portal vein thrombosis.

The significance of follicular helper T cells and galactose-deficient IgA 1 in the pathogenesis of Henoch-Sch?nlein purpura in children / 国际儿科学杂志

Objective:To investigate the role of follicular helper T(Tfh) cells and galactose deficiency IgA 1(Gd-IgA 1) in the children that were suffering from Henoch-Sch?nlein purpura(HSP) and Henoch-Sch?nlein purpura nephritis(HSPN)and the correlation between them. Methods:According to the presence or absence of renal injury, 62 children with HSP were divided into HSP group with 32 children and HSPN group with 30 children.Twenty children who underwent physical examination at outpatients were known as the healthy control group.Flow cytometry was used to measure the proportion of Tfh(CD4 + CXCR5 + PD-1 + ) in peripheral blood.Immunoturbidimetry and ELISA were used to measure the serum levels of IgA 1 and Gd-IgA 1 respectively. Results:(1) The proportion of Tfh cells in peripheral blood and the serum levels of Gd-IgA 1 in both HSP group and HSPN group had significantly increased than those in healthy control group( P<0.01). Compared result of the HSPN group with HSP group, the proportion of Tfh cells in peripheral blood and the serum levels of Gd-IgA 1 in HSPN group were higher than that in HSP group( P<0.05). (2) In the HSPN group, the proportion of peripheral blood Tfh cells and the serum levels of Gd-IgA 1 in group of renal pathology ≥ grade Ⅲ and heavy proteinuria were significantly elevated compared with group of renal pathology < grade Ⅲ and non-heavy proteinuria(<0.01). (3) In the healthy control group, the serum levels of Gd-IgA 1 was positively correlated with the proportion of Tfh cells in peripheral blood and the serum levels of Gd-IgA 1( P<0.05). Conversely, a non-positive correlation was shown in HSP and HSPN groups( P>0.05). Conclusion:The excessive activation of Tfh cells and the serum levels of Gd-IgA 1 may be one of the pathogenesis of HSP/HSPN, the degree of increment of the two factors may be related to the activity and severity of the disease.The mechanism of Tfh cells potentially leading to an increase of Gd-IgA 1 production requires further study.

Effects of Anchang Decoction on TLR 4/NF-κB Signaling Pathway and the Expression of Fecal Calprotectin in Rats with Ulcerative Colitis Induced by TNBS / 中国药房

OBJECTIVE：To st udy the effects of Anchang decoction on TLR 4/NF-κB signaling pathway and the expression of fecal calprotectin （FC）in TNBS-induced ulcerative colitis （UC）model rats . METHODS ：SD rats were randomly divided into blank group ，model group ，positive control group [Live Bifidobacterium capsules ，5 mL（containing Bifidobacterium 0.35 g）]， Anchang decoction low -dose，medium-dose and high-dose groups （1，5，10 mL，each milliliter is approximately equivalent to 0.11 g of total crude drug ），with 15 rats in each group. Other groups were given TNBS combined with ethanol enema to establish UC model rat ，except blank group was given normal saline. Two days after successful modeling ，blank group and model group were given normal saline 5 mL，administration groups were given relevant medicine intragastrically ，once a day ，for consecutive 14 d. After last medication ，HE staining was used to observe the pathological change of colon tissue in rats. Western blotting assay was used to detect the protein expression of TLR 4，TRAF6 and NF-κB in colon tissues of rats；Real-time fluorescent quantitative PCR was used to detect mRNA expression of TLR 4，TRAF6，TNF-α and NF-κB；ELISA assay was adopted to detect serum level of TNF-α，IL-6 and FC in stool samples. RESULTS ：Compared with blank group ，the colonic mucosa of model group was severely damaged，and the protein expression of TLR 4，TRAF6 and NF-κB，mRNA expression of TLR 4，TRAF6，TNF-α and NF-κb as well as serum levels of TNF-α，IL-6 and FC level in stool samples were increased significantly （P＜0.05）. Compared with model group，the pathological changes of colon tissue in rats were improved in different administration groups to different extents ，and above indexes were all decreased significantly （P＜0.05）. CONCLUSIONS ：Anchang decoction may relieve the inflammation of UC model rats by regulating the TLR 4/NF-κB signaling pathway and the expression of FC.

Anti-dengue virus activity of natural podocarpane-type diterpenoid in vitro / 药学学报

Dengue virus (DENV) is the most rapidly transmitted mosquito-borne pathogen, which is the main cause of seasonal outbreaks of dengue fever and dengue hemorrhagic fever in tropical and subtropical regions, and may cause serious life-threatening diseases. There is an urgent need to develop effective vaccines or antiviral therapies. In this paper, we found that a podocarpane-type diterpenoid, (3α,5β,10α)-13-methoxypodocarpa-8,11,13-triene-3,12-diol (MPTD), isolated from the stems and leaves of Aleurites moluccana, showed good effect against DENV. The anti-DENV activity of MPTD against four different DENV serotypes was studied by plaque assay. The cytotoxicity of MPTD in Vero and Huh7 cells was tested by MTT assay. qRT-PCR and Western blot assays were used to investigate the anti-DENV activity of MPTD at RNA and protein levels, respectively. The results showed that MPTD greatly reduced the virus titer in DENV infected Vero cells, and its 50% effective concentration (EC50) for DENV (1–4) were 2.72 ± 0.39, 10.99 ± 5.18, 18.72 ± 0.21, and 0.48 ± 0.28 μmol·L-1, respectively. The results showed that MPTD inhibits DENV RNA level and the expression of E protein. In addition, MPTD may inhibit the early stage of DENV replication and exert antiviral activity. Further studies showed that the inhibitory effect of MPTD against DENV infection is not targeting the viral entry stage. Therefore, MPTD has a significant anti-dengue virus effect, and is an anti-DENV compound with potential application value.

Research progress in downstaging treatment of hepatocellular carcinoma before liver transplantation / 中华肝胆外科杂志

Liver transplantation is an effective curative treatment for hepatocellular carcinoma patients. However, most patients lost the change of surgery when diagnosed as hepatocellular carcinoma. Through local or systemic treatment, hepatocellular carcinoma can be treated in a downstaging manner to reduce tumor burden, so that patients who are beyond the transplantation criteria can still be up to the transplantation criteria after treatment, and finally receive liver transplantation. At present, pre-transplant downstaging treatment has been widely accepted. In this review, we summarized the indications, treatment options, treatment endpoints, and treatment outcomes of pre-transplant downstaging treatment.

The necessity of post-maneuver postural restriction in treating posterior canal benign paroxysmal positional vertigo: a Meta-analytic study / 中华耳鼻咽喉头颈外科杂志

Objective: We conducted a Meta-analysis to investigate the necessity of postural restrictions after manual reduction in the treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV). Methods: We searched PubMed, EBSCO, Proquest, Web of Science databases, Ovid, and screened eligible studies that investigated the effect of post-maneuver postural restriction in treating patients with PC-BPPV. Outcomes included the efficacy of treatment and recurrence. Meta-analysis was performed using Stata 15.0 software. Results: Studies of the single visit efficiency included 11 references, with a sample size of 1 733 cases. The Meta-analysis results showed that the difference in the efficacy between the postural restricted group and the non-postural restricted group in PC-BPPV patients was statistically significant(RR=1.12, 95%CI=1.07-1.18, P<0.001). There were 12 references included in the study on the total efficiency, with a cumulative sample size of 1763 cases. There was no statistically significant difference between the effect of postural restriction after manipulative reduction and that of simple manipulative reduction (RR=1.03, 95%CI=0.99-1.08, P=0.118). There were 5 references included in the study of recurrence rate, and the cumulative sample size was 659 cases. There was no statistically significant difference in the recurrence rate between the postural restricted group and the non-postural restricted group(RR=0.98, 95%CI=0.62-1.54, P=0.937). Conclusions: In comparison with non-postural restriction group, post-maneuver postural restriction after a single visit can improve the treatment effective rate of PC-BPPV and contribute to the improvement in the symptoms of patients in a short term. However, postural restrictions has no significant effect on the final prognosis of PC-BPPV, and it also has no significant effect on the recurrence.

Epidemiological characteristics of acupuncturists who are sensitive to stimulation of moxa smoke: a face-to-face sectional survey based on 733 participants / 中国针灸

OBJECTIVE@#To explore the epidemiologic characteristics of acupuncturists who are sensitive to stimulation of moxa smoke, which could provide further direction for safety protection of exerting moxibustion and to further verify the feasibility of internet survey.@*METHODS@#A self-made questionnaire regarding body response to moxa smoke was established, which was used to conduct a face-to-face survey among acupuncturists who had performed long-term moxibustion. The Logistic regression model was used to analyze the factors affecting the stimulation response of acupuncturists and the epidemiological characteristics of acupuncturists was obtained.@*RESULTS@#A total of 733 valid data was obtained. The multivariate Logistic regression analysis showed that the history of chronic respiratory disease was the main risk factor of stimulus response including cough, phlegm in the throat, asthma, dyspnea, shortness of breath and nasal dryness after exposure to moxa smoke (<0.05, <0.01). The risk of stimulus response such as cough, tearing and nasal dryness was higher in women than in men (<0.05, <0.01). The risk of dry eyes and eyes pain in smokers was higher than those in non-smokers (<0.05). The risk of shortness of breath in those who were exposed to second-hand smoke was higher than those who were not exposed to second-hand smoke (<0.05). The analysis of index trend line showed that the results of internet survey were similar to those of face-to-face survey.@*CONCLUSION@#The stimulus response of acupuncturist after long-term exposure to moxa smoke is related to the history of chronic respiratory disease, being female, smoking or exposure of second-hand smoke, therefore more attention should be paid to those populations. In addition, the internet survey can be used for the epidemiological investigation of safety of moxa smoke.

Ciclesonide inhibits Zika virus replication in vitro / 药学学报

Zika virus (ZIKV) is an emerging mosquito-borne virus that is associated with severe congenital brain malformations in the fetus and Guillain-Barré syndrome in adults. However, there are currently no drugs or preventive vaccines approved for ZIKV infection. Here, ciclesonide has been found significantly against ZIKV activity by plaque and cytotoxicity assays in vitro, and its 50% effective concentration (EC50) to ZIKV SZ01 and MR766 are (0.40 ± 0.22) and (1.59 ± 1.08) μmol·L-1, respectively. Its 50% cytotoxic concentration (CC50) to Vero cells are (64.70 ± 7.33) μmol·L-1; Virus yield reduction and Western blot assays showed that ciclesonide can inhibit replication of ZIKV. In addition, ciclesonide can also inhibit the replication of ZIKV in A549 cells; the results of time of drug addition analysis indicated that ciclesonide mainly acts on the ZIKV RNA synthesis stage. Ciclesonide can also inhibit the internalization of ZIKV. These results indicated that ciclesonide is a potential drug against ZIKV.

Basic principles and quality control of surgical treatment for giant thoracic tumors / 中国胸心血管外科临床杂志

@#Giant thoracic tumor is currently one of the diagnostic and therapeutic challenges of thoracic surgery, with no established guideline or standard for diagnosis and treatment. The quality control of individualized surgical strategy and perioperative management with multi-disciplinary participation is the key to ensure the safety and improve the prognosis of patients. Based on the clinical experience of our institution and others, we hereby discussed and summarized the basic principles, surgical strategies and perioperative management of giant thoracic tumor, aiming to provide a reference of quality control.