Immunogenicity and safety of a recombinant fusion protein vaccine (V-01) against coronavirus disease 2019 in healthy adults: a randomized, double-blind, placebo-controlled, phase II trial / 中华医学杂志(英文版)

BACKGROUND@#Innovative coronavirus disease 2019 (COVID-19) vaccines, with elevated global manufacturing capacity, enhanced safety and efficacy, simplified dosing regimens, and distribution that is less cold chain-dependent, are still global imperatives for tackling the ongoing pandemic. A previous phase I trial indicated that the recombinant COVID-19 vaccine (V-01), which contains a fusion protein (IFN-PADRE-RBD-Fc dimer) as its antigen, is safe and well tolerated, capable of inducing rapid and robust immune responses, and warranted further testing in additional clinical trials. Herein, we aimed to assess the immunogenicity and safety of V-01, providing rationales of appropriate dose regimen for further efficacy study.@*METHODS@#A randomized, double-blind, placebo-controlled phase II clinical trial was initiated at the Gaozhou Municipal Centre for Disease Control and Prevention (Guangdong, China) in March 2021. Both younger (n = 440; 18-59 years of age) and older (n = 440; ≥60 years of age) adult participants in this trial were sequentially recruited into two distinct groups: two-dose regimen group in which participants were randomized either to follow a 10 or 25 μg of V-01 or placebo given intramuscularly 21 days apart (allocation ratio, 3:3:1, n = 120, 120, 40 for each regimen, respectively), or one-dose regimen groups in which participants were randomized either to receive a single injection of 50 μg of V-01 or placebo (allocation ratio, 3:1, n = 120, 40, respectively). The primary immunogenicity endpoints were the geometric mean titers of neutralizing antibodies against live severe acute respiratory syndrome coronavirus 2, and specific binding antibodies to the receptor binding domain (RBD). The primary safety endpoint evaluation was the frequencies and percentages of overall adverse events (AEs) within 30 days after full immunization.@*RESULTS@#V-01 provoked substantial immune responses in the two-dose group, achieving encouragingly high titers of neutralizing antibody and anti-RBD immunoglobulin, which peaked at day 35 (161.9 [95% confidence interval [CI]: 133.3-196.7] and 149.3 [95%CI: 123.9-179.9] in 10 and 25 μg V-01 group of younger adults, respectively; 111.6 [95%CI: 89.6-139.1] and 111.1 [95%CI: 89.2-138.4] in 10 and 25 μg V-01 group of older adults, respectively), and remained high at day 49 after a day-21 second dose; these levels significantly exceed those in convalescent serum from symptomatic COVID-19 patients (53.6, 95%CI: 31.3-91.7). Our preliminary data show that V-01 is safe and well tolerated, with reactogenicity predominantly being absent or mild in severity and only one vaccine-related grade 3 or worse AE being observed within 30 days. The older adult participants demonstrated a more favorable safety profile compared with those in the younger adult group: with AEs percentages of 19.2%, 25.8%, 17.5% in older adults vs. 34.2%, 23.3%, 26.7% in younger adults at the 10, 25 μg V-01 two-dose group, and 50 μg V-01 one-dose group, respectively.@*CONCLUSIONS@#The vaccine candidate V-01 appears to be safe and immunogenic. The preliminary findings support the advancement of the two-dose, 10 μg V-01 regimen to a phase III trial for a large-scale population-based evaluation of safety and efficacy.@*TRIAL REGISTRATION@#http://www.chictr.org.cn/index.aspx (No. ChiCTR2100045107, http://www.chictr.org.cn/showproj.aspx?proj=124702).

Efficacy of Extended Myectomy on Reducing Mitral Regurgitation in Patients With Hypertrophic Obstructive Cardiomyopathy / 中国循环杂志

Objectives:To analyze the impact of extended myectomy on reducing mitral regurgitation in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods:We retrospectively analyzed 480 consecutive HOCM patients who underwent surgical treatment by the same surgeon in our institution from October 2002 to July 2017. The efficacy of extended myectomy for reducing mitral regurgitation and left ventricular outflow tract (LVOT) obstruction were evaluated by echocardiography after surgery. Results:Among the 480 patients, 22 (4.6%) received concomitant mitral repair or replacement because of their intrinsic mitral diseases. In the remaining 458 (95.4%) patients without concomitant mitral valve surgery, 1 (0.2%) died at the 5th day after surgery because of infective shock, and another 4 (0.9%) lost to follow-up, a total of 453 (98.9%) patients underwent echocardiographic follow-up (median follow-up time:6 months [3, 12]). During follow-up, left ventricular out flow tract gradient was significantly decreased from (89.1±30.6) to (12.8±11.6) mmHg (P＜0.001); the number of patients with systolic anterior motion (SAM) of mitral leaflets decreased from 451(98.5%) to 42 (9.3%) (P＜0.001); 297 (64.8%) patients presented with moderate or severe mitral regurgitation before surgery, which decreased to 14 (3.1%) at follow-up (P＜0.001); the multivariate regression analysis showed that patients with residual SAM were significantly associated with a higher incidence of moderate to severe mitral regurgitation during follow-up (odds ratio 30.334, 95% confidence interval:5.619-163.739, P＜0.001). Conclusions:Extended myectomy, combined with dividing the anomalous links between mitral apparatus and septum, and trimming papillary muscles, yields satisfactory outcomes of relieving LVOT obstruction and reducing mitral regurgitation in most of patients with HOCM. Concomitant mitral valve surgery is rarely required unless the patient have intrinsic mitral valve disease.

Effect of stent-assisted coil embolization for the treatment of A1 segment anterior cerebral artery aneu-rysms / 医学研究生学报

Objective It is difficult to conduct the intravascular interventional treatment of A1 segment anterior cerebral ar-tery aneurysms. This article aimed to investigate the effect of stent-assisted coil embolization for the treatment of A1 segment anterior cerebral artery aneurysms. Methods Retrospective analysis was made on the clinical data of 8 patients with A1 segment anterior cer-ebral artery aneurysms who were treated in Department of Neurosurgery in Nanjing General Hospital of Nanjing Military Command from June 2015 to July 2017. All the patients underwent endovascular intervention under static inhalation combined with general anesthesia. Immediately after the operation,angiography was performed to observe the embolization of the aneurysm and imaging follow-up was per-formed. The follow-up period was 6 to 30 months,with an average of (13±9) months,followed by Glasgow Outcome Scale (GOS) sco-ring. Results Immediate postoperative angiography showed that all 8 aneurysms were completely embolized and the parent artery re-mained. Seven patients had no ruptured hemorrhage and no new neu-rological dysfunction,with 5 points of GOS score and good prognosis. Five patients underwent DSA follow-up after surgery with no developed aneurysm. Conclusion Stent-assisted coil embolization is techni-cally feasible in treating A1 segment anterior cerebral artery aneu-rysms,which is a choice worthy of clinical promotion.

Application of dual vessel fusion technique in interventional treatment of complex anterior communicating artery aneurysms / 医学研究生学报

Objective Intravascular interventional embolization has become the preferred method for the treatment of anterior communicating artery aneurysms.The purpose of this paper was to study the guiding significance of dual vessel fusion technique for in -terventional surgery of complex anterior communicating artery aneurysms. Methods A retrospective analysis was conducted on the clinical data of 31 patients with complicated anterior communicating artery aneurysms in our department from March 2015 to June 2016. All patients underwent two-vessel fusion, DSA angiography, and three-dimensional reconstruction of unilateral internal carotid artery and the images were compared to identify whether the aneurysm met the true size,the exact convergence point of bilateral A 1 and ante-rior communicating artery, anterior communicating artery aneurysm and anterior communicating artery and so on. Results There were 31 cases identified by dual vessel fusion technique on the consistency of aneurysms to true volume and 28 cases by three-dimensional reconstruction of unilateral internal carotid artery.There were 31 cases identified by dual vessel fusion technique on the exact convergence point of bilateral A 1 and anterior communicating artery and 9 cases by DSA angiography.There were 31 cases identified by dual vessel fusion technique on variations of anterior communicating artery complex and 24 cases by DSA angiography.There were 27 pa-tients who attained the optimal DSA machine projection angle by the dual vessel fusion technique which was the same as that of the unilateral internal carotid artery,in addition,the other 4 cases got better optimal DSA machine projection angle than those by three-dimensional reconstruction of unilateral internal carotid artery. Conclusion The dual vessel fusion technique helps surgeons to fully understand the anatomical relationship between anterior communicating artery complex and aneurysm,which has important guiding significance in making surgical strategies for complicated anterior communicating artery aneurysms,selecting embolization work angles and real-time observation during embolization.

Stent-assisted technique for the management of subarachnoid hemorrhage caused by ruptured vertebral artery dissecting aneurysm / 医学研究生学报

Objective The stent-assisted technique is widely applied in the treatment of subarachnoid hemorrhage caused by ruptured vertebral artery dissecting aneurysm(VADA). This study investigated the perioperative complications and long-term clinical effect of stent-assisted coiling in the management of VADA-induced subarachnoid hemorrhage. Methods The clinical data on 19 cases of VADA-induced subarachnoid hemorrhage were analyzed retrospec-tively. All the patients underwent digital subtraction angiography (DSA)and stent-assisted coiling within 24 hours after admission.Two of the patients were diagnosed with bilateral VADA and treated with double stents,4 with a single stent,2 with the low-profile visualized intraluminal support device(LVIS),and 11 with double Enter-prise stents. Results Operations were successfully performed in all the cases. Three of the patients died within 2 weeks after surger-y,2 from post-operative rebleeding and the other 1 from some unknown cause;1 patient developed severe postoperative cognitive dys-function,while the other 15 were well recovered. The survived patients were followed up for 6 to 36 months,during which no obvious new neurological deficits were observed. Follow-up DSA revealed 2 cases of recurrence,1 case of stenosis in the stent,and 2 cases of vertebral artery occlusion. Conclusion Stent-assisted coiling is a safe and effective method for the management of VADA-induced subarachnoid hemorrhage,and double-stent implantation may achieve an even better effect.

Safety of external ventricular drainage after stent-assisted embolization for poor-grade ruptured aneurysm / 医学研究生学报

Objective The management of poor-grade ruptured aneurysm is important and challenging in intravascular inter-vention. This study aimed to investigate the safety of external ventricular drainage(EVD)after stent-assisted embolization for patients with poor-grade ruptured aneurysm in the acute stage. Methods From January 2015 to July 2017,27 patients with poor-grade rup-tured aneurysm underwent EVD after endovascular embolization by stent-assisted coiling(n=14)or simple coiling(n=13). We com-pared the clinical data about and the postoperative complications between the two groups of patients. Results There were no statisti-cally significant differences in the patients'age,gender,Glasgow Coma Scale(GCS)scores before embolization and discharge,the in-terval between EVD and the end of embolization,preoperative intraventricular hemorrhage and hydrocephalus,puncture-related bleed-ing after EVD,catheter-indwelling time,perioperative bleeding in other parts,or poor prognosis between the stent-assisted coiling and simple coiling groups(all P>0.05). Conclusion EVD after stent-assisted embolization is a relatively safe strategy for the treatment of poor-grade ruptured aneurysm in the acute stage.

Stent-assisted coiling for distal anterior cerebral artery aneurysm / 医学研究生学报

Objective Distal anterior cerebral artery aneurysm(DACAA)is rare and difficult to be treated. The aim of this study was to investigate the clinical effect of stent-assisted coiling in the treatment of DACAA. Methods We retrospectively analyzed the clinical data about 15 patients with 15 DACAAs treated by stent-assisted coiling,with all the aneurysms occluded and the parent ar-teries preserved,including 4 ruptured and 11 unruptured aneurysm,8 in the A2 and 7 in the A3 segment. The follow-up ranged from 6 to 33 months,during which we evaluated the prognosis of the patients by radiological and clinical examinations. Results There were no operation-related complications in any of the cases. One patient died of subarachnoid hemorrhage-induced cerebral vasospasm. Fol-low-up angiogram revealed complete occlusion of the aneurysms in 9 cases. The last follow-up Glasgow Outcome Scale score was 5 in all the 14 survived patients. No rupture,rebleeding or fresh neurologic deficits was observed in any of the patients. Conclusion Stent-assisted coiling is safe and effective,with a low short-term recurrence rate,in the treatment of distal anterior cerebral artery aneurysm.

Overlapping low-profile visualized intraluminal support device for blood blister-like aneurysm of the internal carotid artery / 医学研究生学报

Objective Reports are rarely seen on the treatment of blood blister-like aneurysm(BBA)of the internal carotid artery with the overlapping low-profile visualized intraluminal support device(LVIS)stent. This study was to investigate the effects of overlapping versus non-overlapping LVIS stent-assisted coiling in the treatment of BBA. Methods We retrospectively analyzed the clinical data about 15 cases of BBA of the internal carotid artery treated in our hospital from February 2015 to February 2017,11 by o-verlapping and the other 4 by non-overlapping LVIS stent-assisted coiling. Using Raymond-Roy Occlusion Classification(RROC),we evaluated the effects of treatment immediately and at 1 week after operation. We followed up the patients from April 2015 to October 2017 and analyzed the results of follow-up digital subtraction angiogra-phy(DSA)and modified Rankin Scale scores(mRS)of the patients. Results RROC showed 10 cases of grade Ⅰ and 1 case of grade Ⅲocclusion in the overlapping group and 3 cases of gradeⅠand 1 case of gradeⅡin the non-overlapping group right after operation. In com-parison,there were 11 cases of gradeⅠin the overlapping group and 2 cases of grade Ⅰ and 2 cases of grade Ⅱ in the non-overlapping group at 1 week postoperatively.DSA at the end of the follow-up exhibited 9 cases of gradeⅠand 1 case of gradeⅡin the overlapping group and 1 case of grade Ⅰ,2 cases of grade Ⅱ and 1 case of gradeⅢin the non-overlapping group. Satisfactory prognosis was ob-served in all the 15 cases,with mRS=0 in 9 cases and mRS = 1 in 2 cases in the overlapping group and with mRS=0 in 3 cases in mRS=1 in 1 case in the non-overlapping group. Conclusion Overlapping LVIS stent-assisted coiling is safe and effective for treat-ment of BBA of the internal carotid artery.

Application of muscular flap and induced membrane technique in the emergency treatment for limb salvage for Gustilo type Ⅲ B and Ⅲ C open fracture of lower leg / 中华显微外科杂志

Objective To investigate the clinical effectivity of the muscular flap transposition and induced membrane technique in the emergency treatment for the limb salvage of Gustilo type Ⅲ B/C open fracture of lower leg. Methods From July, 2015 to December, 2017, 10 cases of Gustilo type Ⅲ B/C fracture of lower leg with bone defects were performed limb salvage surgery. Induced membrane technique was used to fill the bone defects in the emergency room.The gastrocnemius and/or soleus muscular flaps were transposed to cover the bone cement or ex-posed bone simultaneously in emergence treatment. After the wound healed completely, traditional bone grafting was used to repair the bone defects. There were 4 cases of Gustilo type Ⅲ B and 6 cases of Gustilo type Ⅲ C. The aver-age length of bone defect was (5.25±1.70) cm ranging from 3.0 cm to 11.0 cm. The gastrocnemius medial head flaps were performed in 5 cases, the combined application with the gastrocnemius medial head flaps and the medial hemimuscular flaps of soleus were performed in 2 cases, and medial hemimuscular flaps of soleus were transposed in 3 cases. Results The wounds in 6 cases were healed at one stage, but 2 cases healed by dressing because the exudate after skin grafting.In 1 case, the cross-leg flap was used to cover the exposed bone cement due to the necro-sis of soleus flap. The other 1 was performed the transposition of the lateral gastrocnemius flaps because the exposure of bone cement after the necrosis of the upper and lateral muscles in lower leg. In the second-stage, the bone defects were reconstructed by traditional bone grafting. The average healed time of bone was 7.2 months ranging from 5 months to 9 months. At the last followed-up time, all patients recovered their function of weight-bearing. The Paley's score of the adjacent joints: excellent in 8 cases and good in 2 cases. Conclusion The combination with induced membrane technique and local muscular flap transposition in emergency surgery is an effective method to limb salvage for the Gustilo type Ⅲ B/C open fracture of lower leg.

Clinical observation of osteotomy and fusion for the treatment of severe rigid equinus deformity / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical efficacy of osteotomy and fusion in treating severe rigid equinus deformity.</p><p><b>METHODS</b>From April 2010 to October 2015, 13 patients(16 feet) with severe rigid equinus deformity were treated with osteotomy and fusion by hollow screw, including 6 males and 7 females aged from 39 to 62 years old with an average of(49.6±5.3) years old;the courses of diseases ranged from 5 to 27 years with an average of (9.0±4.8) years. Six patients (9 feet) were treated with osteotomy and fusion for three joints, 4 patients(4 feet) were treated with osteotomy and fusion for four joints, and 3 patients (3 feet) were treated with osteotomy and fusion for tibiotalar and calcaneal-talar joints. All patients manifested as foot pain, heel could not touch floor and walking before operation. Postoperative complications were observed, AOFAS score were applied to evaluate clinical effect.</p><p><b>RESULTS</b>Thirteen patients were followed up from 18 to 24 months with an average of 20 months. Only one patient occurred local skin necrosis after operation and healed by dressing change and anti-infective therapy. All feet obtained fracture healing, the time ranged from 12 to 16 weeks with an average of 13.2 weeks. AOFAS score were improved from 11.85±10.66 before operation to 81.38±3.69 after operation, and had significant difference(=-25.67, <0.05);15 feet good and 1 foot moderate.</p><p><b>CONCLUSIONS</b>Tibiotalar and calcaneal-talar joint fusion, osteotomy and fusion for three and four joints could treat severe rigid equinus deformity according to patients' individual and could obtain satisfied clinical effects.</p>

Study on the absorption of monosialotetrahexosylganglioside sodium in rats with in situ cycle intestinal perfusion methods / 中国医师杂志

Objective To investigate the duodenum absorptive character of monosialotetrahexosylganglioside sodium (GM1) in rats.Methods The contents of phenolsulfonphthalein (as indicators) and GM1 were determined with ultraviolet-visible (UV) method and high performance liquid chromatography (HPLC) method in rats with in situ cycle intestinal perfusion model.Results The ratio of duodenum absorption of GM1 was 10％ in 2 h after cycle and 22％ in 6 h after cycle,respectively.The Ka was (0.030± 0.012)h,and absorption t1/2 was (25.50 ± 8.56)h in 8 h after cycle.Conclusions GM1 is absorption in rat duodenum,and the accumulate absorption of GM1 is almost linearly related to the cycle time.The absorption dynamics of GM1 may be first-order kinetic process.

Clinical observation of implant immediate loading in periodontitis patients / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical performance of implants placed immediately after extraction of remaining teeth due to severe periodontitis and immediately loaded for prosthetic oral rehabilitation.</p><p><b>METHODS</b>Twelve patients in need of complete maxillary or mandibular rehabilitations due to severe periodontitis were enrolled in this study and received periodontal treatment for management of periodontitis. The remaining teeth were extracted, debridement around the periodontally compromised sites was performed. The implants were inserted under guidance by a surgical template, and a prefabricated screwed-retained provisional restoration was immediately delivered on implants. Definitive prostheses were inserted after 6 months. Clinical and radiographic analyses were performed at 1, 6, 12, 24 months.</p><p><b>RESULTS</b>A total of 84 implants were placed, 50 in the maxilla and 34 in the mandible. Thirty-two implants were placed directly in extraction sockets. Four implants in 3 patients failed within the first 6 months, resulting in a total implant survival rate of 95% (80/84). The survival rate was 92% (46/50) in the maxilla, 100% (34/34) in the mandible. Prosthetic success was 100%. All the failures occured in the first 6 months and no failure in the next two years of follow-up. The mean bone level change at 1 and 2 year were (-1.12 ± 0.18) mm and (-1.28 ± 0.14) mm. There were no significant differences in insertion torque and alveolar bone loss between the post-extraction sites and healed sites.</p><p><b>CONCLUSIONS</b>The immediate protocols in periodontally compromised maxilla or mandibular contributed to a satisfactory prosthetic success during the 2-year follow-up.</p>

Effects of edaravone on glial fibrillary acidic protein and interleukin-lβ expression and neuronal apoptosis in juvenile rat hippocampus after status convulsion / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effects of edaravone on glial fibrillary acidic protein (GFAP) and interleukin-1β (IL-lβ) expression and neuronal apoptosis in the juvenile rat hippocampus after status convulsion (SC).</p><p><b>METHODS</b>One hundred and ninety-five juvenile male Sprague-Dawley (SD) rats were randomly divided into 3 groups: normal saline control and SC with and without edaravone treatment. Each of the 3 groups was further subdivided into subgroups sacrificed at 4, 12, 24, 48 and 72 hrs after SC (n=15). The SC model was prepared using lithium-pilocarpine. The expression of GFAP and IL-lβ protein was detected with immunohistochemistry methods. The neuronal apoptosis was observed by TdT-mediated dUTP nick end labeling (TUNEL). The hippocampal GFAP mRNA expression was detected by RT-PCR.</p><p><b>RESULTS</b>The value of IOD of GFAP and IL-lβ positive cells measured by immunohistochemistry in the untreated SC group increased compared with the control group. Expression of GFAP and IL-lβ protein was significantly reduced in the edaravone treated SC group compared with the untreated SC group. RT-PCR showed the expression trend of GFAP mRNA was similar to that of protein. The TUNEL positive cells in the hippocampus CA1 in the untreated SC group increased significantly 12 hrs after SC and reached a peak at 48 hrs compared with the control group. The intervention with edaravone decreased significantly TUNEL positive cells between 12-48 hrs after SC, but the number of TUNEL positive cells in the intervention group remained significantly greater than in the control group.</p><p><b>CONCLUSIONS</b>The expression of GFAP and IL-lβ in the hippocampus increases after SC in rats. Edaravone may decrease the expression of GFAP and IL-1β and reduce the number of neuronal apoptosis. These results suggest that edaravone may have protective effects against brain damage caused by SC.</p>

Prevalence of psychiatric disorders in primary and middle school students in Hunan Province / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of psychiatric disorders in a representative sample of primary and middle school students in Hunan Province.</p><p><b>METHODS</b>A total of 9 495 children aged 5-17 years from Hunan urban and rural schools were enrolled by a cluster sampling and a two-phase design. The students' psychiatric status was assessed using the Investigation Screening Inventory for Child Mental Disorder and a semi-structured interview designed based on the DSM-IV criteria.</p><p><b>RESULTS</b>The overall prevalence of psychiatric disorders was 16.22%. Attention-deficit and disruptive behavior disorders were the commonest in the diagnostic categories of psychiatric disorders (10.69%). Regarding specific disorders, the most prevalent was attention-deficit/hyperactivity disorder (5.95%). Psychiatric disorders were more prevalent in boys than in girls (20.49% vs 11.16%; p<0.01). The prevalence of attention-deficit and disruptive behavior disorders in boys was higher than in girls (14.76% vs 5.87%; p<0.01). The prevalence of psychiatric disorders in middle school students (12-17 years) was significantly higher than in primary students (5-11 years) (18.38% vs 14.64%; p<0.01). There were no significant differences in the prevalence of psychiatric disorders between urban and rural students.</p><p><b>CONCLUSIONS</b>Psychiatric disorders are common among primary and middle school students in Hunan Province. The prevalence of this disorder in boys is higher than in girls. The middle school students have higher prevalence than primary students.</p>

Effects of edaravone on the expression of interleukin-1beta, nuclear factor-kappaB and neuron apoptosis in juvenile rat hippocampus after status convulsion / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the effect of edaravone on expression of interleukin-1beta (IL-1beta), nuclear factor-kappaB (NF-kappaB) and neuron apoptosis in the juvenile rat hippocampus after status convulsion (SC).</p><p><b>METHODS</b>One hundred and ninety-five juvenile male Sprague-Dawley (SD) rats were randomly divided into normal saline (NS) control group, status convulsive group and edaravone treatment group. Each group was further divided into five subgroups for different time points. The rats in status convulsive group were kindled into epilepsy by lithium-pilocarpine chemical method. Expressions of IL-1beta and NF-kappaB proteins were detected with immunohistochemistry methods. Expression of NF-kappaB mRNA was detected with reverse transcription-polymerase chain reaction (RT-PCR). The neuron apoptosis was observed by TdT-mediated dUTP nick end labeling (TUNEL).</p><p><b>RESULTS</b>(1) Measured by immunohistochemistry the value of IOD of IL-1beta (30.83 +/- 3.81, 41.00 +/- 5.61, 36.32 +/- 6.78 and 28.48 +/- 4.61, respectively, 12-72 h points) and NF-kappaB (67.60 +/- 5.81, 74.61 +/- 7.94, 82.43 +/- 10.67, 70.70 +/- 5.85 and 68.22 +/- 9.67, respectively, 4-72 h points) positive cells in the SC group increased,there was significant difference compared with NS group (IL-1beta: 11.74 +/- 2.32, 12.93 +/- 2.49, 13.02 +/- 2.83 and 12.98 +/- 5.29, respectively, 12-72 h points. NF-kappaB: 48.67 +/- 16.14, 44.62 +/- 7.82, 53.16 +/- 114.45, 54.27 +/- 5.25 and 55.56 +/- 7.56, respectively, 4-72 h points) (P < 0.01, or P < 0.05). By ED intervention in IL-1beta (22.01 +/- 4.45, 28.28 +/- 4.50 and 26.00 +/- 5.34, respectively, 12-48 h points) and NF-kappaB (58.56 +/- 6.37, 59. 86 +/- 6.73, 70.00 +/- 10.09, 64.78 +/- 7.56 and 64.45 +/- 6.51, respectively, 4-72 h points) positive cells value of the IOD decreased as compared with SC group (P < 0.01, or P < 0.05). (2) Measured by RT-PCR, the expression of NF-KB mRNA and protein trend was similar. (3)The TUNEL positive cells in hippocampus, CA1 of SC group (11.41 +/- 2.37) were more than that of NS group 12 h after the SC (P < 0.01), reached its highest level at48 h (28.78 +/- 5.11), after the intervention with edaravone (8.98 +/- 2.22, 13.09 +/- 2.54 and 20. 57 +/- 4.89, respectively, 12-48 h points) ,TUNEL positive cells showed a significant drop in SC group at 12-48 h time points (P < 0.01, or P < 0.05), but still significantly higher than that of the NS group (6.22 +/- 1.50, 6.57 +/- 1.61 and 6.72 +/- 1.14, respectively) (P < 0.01, or P < 0.05), at the 4 h time point(NS group 6.29 +/- 1.49, SC group 6.61 +/- 1.71, ED group 5.75 +/- 1.41) among the three groups, no significant difference in TUNEL positive cells was found (P = 0.759).</p><p><b>CONCLUSIONS</b>Edaravone inhibited expression of IL-1beta and NF-kappaB in pilocarpine-induced seizures in rat hippocampus, reduced the number of neuronal apoptosis. These results suggest that edaravone may have protective effect against the damage caused by status convulsion.</p>

Effects of edaravone on IRE1 mRNA expression and neuronal apoptosis in the hippocampus of rats with status convulsivus / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the expression of the key marker of endoplasmic reticulum stress (ERS) IRE1 mRNA and neuronal apoptosis in the rat hippocampus after status convulsivus (SC), and the intervention effects of edaravone, a novel free radical scavenger.</p><p><b>METHODS</b>Sprague-Dawley (SD) rats aged 19-21 days were randomly assigned to three groups: normal control, SC and edaravone-treated SC. SC was induced in the later two groups. The two groups were subdivided into 5 groups sacrificed at 4, 12, 24, 48, and 72 hrs after SC induction. IRE1 mRNA expression in the hippocampus was detected by RT-PCR. Neuronal apoptosis was observed by TdT-mediated dUTP nick end labeling (TUNEL). The ultramicrostructural changes of neuron were observed by electron microscopy.</p><p><b>RESULTS</b>IRE1 mRNA expression was obviously up-regulated 4 and 12 hrs after SC compared with the normal control group (P<0.01). IRE1 mRNA expression in the edaravone-treated SC group was notably higher than the untreated SC group 4, 12 and 24 hrs after SC and the normal control group (P<0.01). TUNEL positive cells in the hippocampus in the untreated SC group were significantly more than those in the normal control group (P<0.01). The number of TUNEL positive cells increased with the prolonged convulsion time. TUNEL positive cells in the edaravone-treated SC group were significantly reduced compared with those in the untreated SC group 12, 24, 48 and 72 hrs after SC (P<0.05 or P<0.01), but remained higher than the normal control group (P<0.05 or P<0.01). The peri-nucleus cell organ injuries were observed 4 hrs after SC and karyopycnosis and cytoplasm condensation were observed 12 hrs after SC in the SC and the edaravone-treated SC groups. The edaravone-treated SC group demonstrated less severe apoptosis than the untreated SC group.</p><p><b>CONCLUSIONS</b>Edaravone may have neuroprotections against SC by an up-regulation of IRE1 expression. It might serve as an effective agent for reducing ERS in vivo.</p>

Dose of glucocorticosteroids in the treatment of severe acute respiratory syndrome / 南方医科大学学报

<p><b>OBJECTIVE</b>To survey the dose of glucocorticosteroids administered in patients with severe acute respiratory syndrome (SARS) and assess the effect of glucocorticosteroid doses in improving the patients' lung function.</p><p><b>METHODS</b>A retrospective analysis was conducted among 225 SARS patients treated in our in 2003. Oxygenation index was used as the effectness index, and the criteria for effectiveness was defiend as increase of the value of OI by 20% or above.</p><p><b>RESULTS</b>Glococoticostecoids were used in 59.56% of the SARS cases. The average value of OI before intravenous use of glucocorticosteroids was 237.08 mmHg, and that after the administration was 335.08 mmHg. The glucocorticosteroid doses that produce better effects were 1-3 mg/kg and 160-240 mg daily, with the total accumulative dose of 1000-2000 mg. The optimal duration of glucocorticosteroid use was 8-14 days.</p><p><b>CONCLUSIONS</b>For SARS treatment, Glucocorticosteroids can effectively ameliorate the SARS patients' lung symptoms and improve the lung function. The appropriate daily dose of glucocorticosteroids is 1-3 mg/kg or 160-240 mg/d for a duration of 8-14 d; the accumulative dose should be controlled around 1500 mg.</p>

A case-control study on family environment related factors in attention deficit hyperactivity disorder with anxiety disorder / 中华流行病学杂志

Objective To study the family rearing pattern of attention deficit hyperactivity disorder(ADHD)with or without anxiety disorder and to explore its risk factors.Methods 9495 children and their parents were sampled at random in Hunan province,using two-stage investigation.Those who were diagnosed ADHD and the normal control filled out Egna Minnen av Barndoms Uppfostran and family adaptability and cohesion scale bv themselves.Results The comparison of factors as:actual family cohesion,parents' punishments,reiection,mother's excessive protection,intervention and father's excessive protection were significantly difierent between ADHD with or without anxiety disorder and normal children(P＜0.05).The comparison of parents' punishments,reiection,excessive protection and intervention were obviously different between ADHD with anxiety disorder and simple ADHD(P＜0.05).Mother's reiection was the influencing factor of simple ADHD,with OR as 1.122.Ideal family cohesion,mother's rejection and father's punishments were the influencing factors of ADHD with anxiety disorder,with OR as 0.966.1.215 and 1.089 respectively.Conclusion There were some problems in the parental rearing pattern of ADHD with or without anxiety disorder.Mother's rejection,father's punishments and ideal family cohesion were suggested to be correlated with ADHD and anxiety disorder.

Relationship between psychological distress and T lymphocyte in HIV/AIDS patients / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the relationship between psychological distress and T lymphocyte counts in HIV/AIDS patients.</p><p><b>METHODS</b>A total of 102 HIV/AIDS patients were measured by symptom check list (SCL-90), self-rating depressive scale (SDS) and self-rating anxiety scale (SAS). Patients were divided into 2 groups based on CD4+ T lymphocyte counts < 0.2 x 10(9)/L (group A) and > or = 0.2 x 10(9)/L(group B).</p><p><b>RESULTS</b>77 cases (75.49%) had psychological problems, including depression, relationship problems, psychosis, force etc. The prevalence of depression and anxiety were 67.65% (69/102) and 43.13% (44/102) respectively. The symptom of depression and anxiety of patients in group A were severer than those in group B (P < 0.05). The CD4+ T lymphocyte counts were significantly negatively correlated with the total score, depression score, paranoid score and psychosis score of SCL-90 (all P <0.05).</p><p><b>CONCLUSION</b>Most of the HIV/AIDS patients were in an obviously abnormal psychological status. The psychological distress symptom of HIV/AIDS patients might had negative effects on the number of CD4+ T lymphocyte.</p>

Cognitive function, serum BDNF levels and BDNF gene Val66Met polymorphism in amnestic mild cognitive impairment / 中南大学学报(医学版)

OBJECTIVE@#To investigate the relationship between serum brain-derived neurotrophic factor, concentrations and BDNF gene Val66Met polymorphism and amnestic mild cognitive impairment (aMCI), and neuropsychological characteristics.@*METHODS@#Ninety-nine aMCI patients and 99 matched normal controls were recruited for the study. Multi-dimension neuropsychologic tests were used to extensively assess the cognitive function, an enzyme-linked immunosorbent assay was applied to measure serum BDNF concentrations, and polymerase chain reaction-restriction fragment length polymorphism was used to analyse BDNF gene Val66Met polymorphism in the subjects.@*RESULTS@#The scores of neuropsychologic tests in aMCI patients were significantly lower than those in the normal controls (all P0.05).@*CONCLUSION@#aMCI is characterized by episodic memory impairment. Decreased BDNF concentrations may play a role in the pathophysiology of aMCI, and BDNF gene Val66Met polymorphism may not be an important genetic factor in susceptibility to aMCI.