Glycyrrhizic acid: a potential drug against COVID-19 / 药学学报

Pneumonia caused by SARS-CoV-2 has seriously threatened human life and health worldwide and caused a large number of deaths. Viral infection and acute inflammation are important causes of death, so it is particularly important to combine antiviral therapy with anti-inflammatory therapy. Glycyrrhizic acid, the main component of the glycyrrhizic root extract, has a wide range of pharmacological effects as well as high efficiency and low toxicity, its preparation has been widely used in the treatment of chronic hepatitis and other diseases. Glycyrrhizic acid can regulate the expression and release of a variety of cytokines and play a significant anti-inflammatory effect. At the same time, glycyrrhizic acid also showed significant inhibition towards a variety types of viruses. Therefore, the potential application of glycyrrhizic acid as COVID-19 treatment should be explored.

Early surgical outcomes of coronary heart disease with severe ischemic mitral regurgitation / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize the experience with surgical treatment of coronary artery disease with severe ischemic mitral valve regurgitation (IMR).</p><p><b>METHODS</b>From January 2006 to December 2009, 45 patients (35 males, 10 females aged 32-74 years) with the diagnosis of coronary artery disease complicated by IMR underwent coronary artery bypass grafting (CABG) combined with mitral valve plasty (MVP, 24 cases) or mitral valve replacement (MVR, 21 cases).</p><p><b>RESULTS</b>Perioperative deaths occurred in 2 cases due to multiple organ failure (MOF). Echocardiography showed a significant reduction of the mitral regurgitation area (from 11.80∓2.45 cm(2) to 2.83∓0.98 cm(2), t=22.80, P=0.00) after CABG combined with mitral valve surgery, with also significantly reduced postoperative left ventricular end diastolic diameter (LVEDD) (from 57.61∓10.06 mm to 51.84∓8.98 mm, t=2.85, P=0.005). No significant difference was detected in the left ventricular ejection fraction after the operation [(52.7∓15.4)% vs (53.2∓13.2)%, t=0.16, P=0.87)].</p><p><b>CONCLUSIONS</b>CABG combined with mitral valve surgery can improve early postoperative left ventricular function in patients with ischemic coronary heart disease complicated by severe mitral regurgitation, but further follow-up study is still needed for evaluation of the long-term results.</p>

Surgical treatment of 128 cases of constrictive pericarditis / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize the experience with surgical treatment of constrictive pericarditis.</p><p><b>METHODS</b>A retrospective analysis of the post-operative clinical data was conducted in 128 surgical patients with chronic constrictive pericarditis.</p><p><b>RESULTS</b>Two early postoperative death occurred in this group due to severe low cardiac output syndrome, with the mortality rate of 1.57%. The postoperative complications included low cardiac output syndrome (13.2%), arrhythmia (7.02%), acute renal insufficiency (3.9%), respiratory insufficiency (3.1%), wound infection (2.3%), postoperative chest bleeding (1.6%) and cerebral infarction (0.78%). Relapse occurred in one case because of incomplete pericardial resection.</p><p><b>CONCLUSIONS</b>Constrictive pericarditis should be confirmed as soon as possible with actively surgery, and the extent of pericardial resection should be decided according to the individual conditions. Complete untethering of the diseased pericardium should be performed with active prevention of postoperative complications.</p>

Combined slower plasma exchange and continuous veno-venous hemofiltration with a parallel circuit in the treatment of chronic severe viral hepatitis B patients / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the clinical effects of combined slower plasma exchange (PE) and continuous veno-venous hemofiltration (CVVH) with a parallel circuit in the treatment of chronic severe viral hepatitis B patients.</p><p><b>METHODS</b>104 patients with chronic severe viral hepatitis B were divided into three groups: 44 patients were treated with a parallel circuit of combined slower plasma exchange and continuous veno-venous hemofiltration (group A), 30 patients were treated with plasma exchange (group B), and 30 patients received routine treatment (group C). Efficacy of treatment and survival rate in three groups were investigated. The levels of cytokine, plasma sodium concentration and pH value were examined before and after artificial liver support system treatment.</p><p><b>RESULTS</b>In group A, 7 of 9 patients in coma regained normal consciousness, 6 of 9 patients with hepatorenal syndrome restored renal function, hyponatremia was improved, the balance of pH value was corrected, tumor necrosis factor (TNF)-alpha level was decreased, and the total survival rate was 56.82%. In group B, 2 of 7 patients in coma regained normal consciousness, 1 of 5 patients with hepatorenal syndrome restored renal function. Hyponatremia, pH value and TNF-alpha level were not changed; the total survival rate was 33.33%. Both IL-1 and IL-6 levels were significantly decreased after treatment in group A. IL-10 level was increased in both group A and group B. In group C, 1 of 6 patients regained normal consciousness from coma, none of them restored renal function, and the total survival rate was 16.67%.</p><p><b>CONCLUSIONS</b>Combined slower PE and CVVH with a parallel circuit is a new, safe and effective non-biological artificial liver in the treatment for chronic severe viral hepatitis B patients.</p>

Prospective study of cystatin C for diagnosis of acute kidney injury after cardiac surgery / 南方医科大学学报

<p><b>OBJECTIVE</b>To prospectively study the value of cystatin C in diagnosis of acute kidney injury (AKI) in patients after cardiac surgery.</p><p><b>METHODS</b>A total of 132 patients undergoing cardiopulmonary bypass were enrolled in this prospectively study. From each patient, blood samples were collected everyday before and after operation to detect the serum creatinine (Scr) and cystatin C levels by enzymatic method and particle-enhanced turbidimetric immunoassay (PETIA), respectively, and the glomerular filtration rate (eGFR) was estimated using MDRD equation. AKI diagnosis was made according to the RIFLE criteria of the Acute Dialysis Quality Initiative (ADQI) (R: Scr increased by > or =50%; I: Scr increased by > or =100%; F: Scr increased by > or =200%; L: Loss of kidney function; E: End-stage renal disease). Another AKI diagnostic criterion was also adopted according to the levels of cystatin C increment, namely an increase by > or =50%, > or =100%, and > or =200%.</p><p><b>RESULTS</b>Twenty-nine patients (21.9%) developed AKI of varied severities, including 10 meeting the R-criteria, 12 the I-criteria, 7 the F-criteria, with the other 103 patients without AKI serving as the control group. Cystatin C of the 29 AKI patients was drastically increased in comparison with that of the control group (P<0.001). Significant linear correlation was found between cystatin C and Scr (r=0.732, P<0.001) and between [cystatin C]-1 and estimated GFR (R=0.803, P<0.001). By the two diagnostic criteria based on cystatin C and Scr levels, respectively, the median diagnostic time of AKI was 2 days (range 1-4 days) and 3 days (range 2-5 days) for R criteria (10 patients, P=0.014), 3.5 days (range 1-6 days) and 5 days (range 2-8 days) for I criteria (12 patients, P=0.008), and 5 days (range 3-7 days) and 6.5 days (range 4-9 days) for F criteria (7 patients, P=0.02), respectively. ROC analysis confirmed excellent accuracy of cystatin C in AKI diagnosis (AUC=0.992). With the cut-off value of cystatin C increment by > or =50%, the diagnostic sensitivity and specificity of AKI was 92% and 95%, respectively.</p><p><b>CONCLUSION</b>Cystatin C can serve as a good indicator for AKI diagnosis to allow earlier detection of AKI than Scr-based diagnosis in patients after cardiac surgery.</p>

Transepicardial autologous transplantation of bone marrow mononuclear cells for acute myocardial infarction / 南方医科大学学报

<p><b>OBJECTIVE</b>To test the effect of intramyocardial injection of autologous bone marrow mononuclear cells (MNCs) in improving the cardiac function and myocardial revascularization in miniswine models of myocardial infarction.</p><p><b>METHODS</b>The miniswine models of myocardial infarction established by ligation of the anterior descending coronary artery were divided into 3 groups including a control and two MNC injection groups. Autologous bone marrow MNCs were injected via the epicardium into the infarcted area in the latter two groups at 1 and 2 weeks after the infarction, respectively. The ventricular segmental wall motion was evaluated after the treatment, and the infarcted myocardium observed with immunohistochemistry on frozen sections.</p><p><b>RESULTS</b>The left ventricular segmental wall motion differed significantly between the control and the MNC injection groups at 1 and 2 months after the treatment. CM-DiI-positive cells were detected in the infarcted myocardium where MNCs were implanted.</p><p><b>CONCLUSION</b>Intramyocardial injection of autologous bone marrow MNCs improves the infarcted ventricular segmental wall motion, and significantly increases the number of blood vessels in the infracted area. The transplanted cells can be integrated into the vascular walls of the capillaries and arterioles and differentiate into cardiomyocytes.</p>

Combined non-biological artificial liver in treatment of late stage chronic severe hepatitis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the clinical effects of combined non-biological artificial liver in the treatment of late stage chronic severe hepatitis and especially to observe their effects on hepatic encephalopathy, hepatorenal syndrome and disturbance of electrolytes.</p><p><b>METHODS</b>103 chronic severe hepatitis patients were treated with the same medical measures, including plasma exchange. Among them, 63 patients were also treated with combinations of non-biological artificial liver (treatment group), and the other 40 patients served as controls (control group). The efficacy of the treatments and survival rates of the two groups were compared.</p><p><b>RESULTS</b>In the treatment group, the rate of regaining normal consciousness was 72.7%, the rate of electrolyte disorder being rectified was 89.5%, the rate of restoring renal function was 66.7% and the total survival rate was 47.6%. In comparison, in the control group the rate of regaining normal consciousness was 16.7%, the rate of electrolyte disorder being rectified was 42.3%, none of their renal functions were restored and the total survival rate was 22.5%. The differences between the two groups were significant (chi2=6.56, P less than 0.05).</p><p><b>CONCLUSION</b>With other medical treatment, combined non-biological artificial liver can improve the survival rate of severe hepatitis patients.</p>