Clinical study of artesunate in the treatment of coronavirus disease 2019 / 中华危重病急救医学

Objective:To discuss the effective of artesunate in the treatment of coronavirus disease 2019 (COVID-19).Methods:Using prospective method, the 43 cases of confirmed COVID-19 patients in Nanning Fourth People's Hospital from January 22nd to February 15th in 2020 were enrolled and divided into routine treatment group ( n = 25) and artesunate treatment group ( n = 18) by odd-even rule after admission. According to the guidelines, the routine treatment group was recommended to receive lopinavir/ritonavir 500 mg + α-aerosolized interferon 500×10 4 U, twice daily; the artesunate treatment group was given artesunate 60 mg, twice daily besides the routine treatment, for 10 days in both groups. During the treatment period, the pharynx swab test of 2019 novel coronavirus (2019-nCoV) nucleic acid was carried out every 2 days, and the routine blood test, liver and kidney functions, blood coagulation function and myocardial enzymes were re-examined. Chest CT was checked every 3 days after the treatment, and re-examined every 5 days after the condition was improved. The routine blood test and biochemical results of two groups were observed, and the efficacy evaluation was performed by monitoring the time for significant improvement of symptoms, negative conversion time of throat swab virus nucleic acid, lung lesion absorption time, adverse drug reactions and the length of hospital stay of the two groups. Results:There were no significant differences between the two groups in terms of gender, age, body weight, routine blood test and biochemical results before treatment. In artesunate treatment group, the time for significant improvement of symptoms (days: 3.33±1.91 vs. 4.84±2.19), negative conversion time of 2019-nCoV nucleic acid (days: 4.72±2.16 vs. 6.68±3.76), lung lesion absorption starting time (days: 5.39±2.36 vs. 7.48±3.78), lung lesion absorption greater than 70% time (days: 14.11±4.16 vs. 17.04±4.42) and the length of hospital stay (days: 16.56±3.71 vs. 18.04±3.97) were significantly shorter than those in routine treatment group, with significant differences (all P < 0.05). The incidence of adverse drug reactions in two groups had no significant difference (72.2% vs. 80.0%, P > 0.05). Conclusion:Artesunate can shorten the treatment time of COVID-19, improve prognosis and eliminate pathogens, with fewer adverse reactions and a good application prospect.

Study on the Irrational Prescription and Medical Orders and Interventions in Our Hospital / 中国药房

OBJECTIVE:To promote rational drug use clinically. METHODS:Sampling rate of prescriptions in outpatient and emergency departments was no less than 1‰ of total prescriptions and no less than 100 prescriptions were reviewed every month;the sampling rate (according to the hospital records of discharge) of ward (district) doctor’s advice was no less than 1% and no less than 30 prescriptions were reviewed every month. According to drugs evaluation indicators of rational drug use,the prescrip-tions were analyzed statistically,immediate intervention and administrative intervention were adopted for irrational prescriptions and medical orders. RESULTS:The average qualified rate of outpatient prescriptions was 97.86%and 0.92%was non-standard prescrip-tions,1.20% was inappropriate prescriptions and 0.01% was extraordinary prescriptions. The non-standard prescriptions in the sec-ond half year were significantly lowered,with statistical significance(P<0.05). The inappropriate usage and dosage was not effec-tively controlled. The average qualified rate of medical orders was 96.30% and drug replacement withont any reference and incom-plete diagnosis in the second half year were significantly lowered,with statistical significance(P<0.05). The utilization rate of an-tibiotics in emergency department was 41.51%and the other indicators were basic standard. The qualified rate of Majing drugs’pre-scriptions was 81.60%and non-standard prescriptions accounted for 88.37%in the irrational prescriptions. CONCLUSIONS:Imme-diate intervention and administrative intervention have achieved some success. Immediate intervention has mainly reduced the non-standard prescriptions and administrative intervention has controlled some specific irrational prescriptions.

Clinical predictors for the phenotypic heterogeneity of severe hemophilia A in China / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the phenotypic heterogeneity of severe hemophilia A in China and investigate the clinical factors for defining the severity of the clinical presentations.</p><p><b>METHODS</b>The data including the age of first bleeding and first joint bleeding, bleeding frequency, the number of joint deformities and body mass index (BMI) were collected from 223 patients with severe hemophilia A (FVIII:C≤2%).</p><p><b>RESULTS</b>The median age at first bleeding was 1 year (range: 0-35 years). The percentages of patients with first bleeding age<1 year, ≥2 years and ≥6 years were 44.3% (94/212), 34.4% (73/212), and 10.8% (23/212), respectively. The median age at first joint bleeding was 2.25 years. The percentages of patients with first joint bleeding age ≤1 year, ≥2 years and ≥6 years were 25.5% (24/94), 57.4% (54/94), and 18.1% (17/94), respectively. The percentage of patients who did not have joint bleeding was 7.4% (7/94). The median annual bleeding frequency was 24 per year (range: 1-120), and the proportion of patients with annual bleeding episodes of less than 6 times was 12.9%. Only 24.7% of the patients were free of any joint deformities. Analysis showed that milder cases had older ages of first bleeding and first joint bleeding than the severe cases, and the milder cases had also significantly lower BMI.</p><p><b>CONCLUSION</b>The age of first bleeding and first joint bleeding and BMI may predict the clinical severity of hemophilia A in China in the early stage.</p>

Effect of Pepper and Piper Longum on Hepatic Energy Metabolism Factors in Rats / 世界科学技术-中医药现代化

This study was aimed to explore the effect of heat-nature Chinese herbs of Pepper and Piper longum on hepatic energy metabolism of rats in order to research the impact of ratˊs physical activities with heat-nature Chinese herbs and establish the research foundation of Chinese herbal medicine nature . A total of 30 rats were randomly divided into three groups . Saline was given in the control group . Pepper water extract was given in the Pepper group . And Piper longum water extract was given in the Piper longum group . The administration dosage was 10 ml/kg intragastrically for 30 days . Changes of hepatic energy metabolism related enzymes were determined . The results showed that compared with the control group , Ca2+-ATPase , Ca2+-Mg2+-ATPase , and LDH enzyme of the Pepper group and Piper longum group were significantly increased . And the hepatic glycogen content was significantly reduced . It can obviously increase energy intake , digestible energy and metabolizable energy per body weight in rats . There was no statistical significance between the Pepper group and Piper longum group . It was concluded that the heat-nature Chinese herbs of Pepper and Piper longum can promote the decomposition of hepatic glycogen , increase the activity of LDH enzyme , Ca2+-ATPase , Ca2+-Mg2+-ATPase . It increases the consumption of ATPase in order to increase energy intake , digestible ener-gy and metabolizable energy per body weight in rats and promote the hepatic energy metabolism .

Analysis of infection-related mortality after allogeneic hematopoietic stem cell transplantation in patients with refractory/relapse acute leukemia / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate infection-related mortality (IRM) after allogeneic hematopoietic stem cell transplantation in patients with refractory/relapse acute leukemia.</p><p><b>METHODS</b>We conducted a retrospective analysis of 127 patients with refractory/relapse acute leukemia and investigated the incidence, causes and risk factors of IRM.</p><p><b>RESULTS</b>Sixty-seven of the patients died after the transplantation. The 5-year overall survival and disease-free survival was (35.2∓5.3)% and (30.8∓5.6)% among these patients, respectively. IRM occurred in 28.3% (36/127) of the patients. Multivariate analysis showed that grade II-IV acute graft-versus-host diseases (aGVDH, P=0.049, OR=3.017) and post-transplant invasive fungal infection (P=0.032, OR=3.223) were independent risk factors of IRM.</p><p><b>CONCLUSION</b>As a common cause of transplant-related mortality, IRM is more frequent in cases of refractory/relapse acute leukemia than in cases with a standard risk profile, and effective prophylaxis and treatment of severe GVHD remain currently the primary measures for reducing post-transplant IRM.</p>

Scutellarin starch microspheres' permeability through nasal mucosa of different animals in vitro / 中国中药杂志

<p><b>OBJECTIVE</b>To study scutellarin starch microspheres' permeability through nasal mucosa of different animals in vitro.</p><p><b>METHOD</b>The Franz diffusion cell method was used to experiment the permeability test (n = 4), taking fresh nasal mucosa of dog, swine and domestica in vitro as permeation barrier separately, with scutellarin starch microspheres (scutellarin 0.25 mg) above them, and blank pH 6.8 PBS as absorption liquid to detemine the scutellarin by HPLC.</p><p><b>RESULT</b>The permeability coefficient of scutellarin starch microspheres through nasal mucosa of dog, swine and domestica in vitro were (5.295 +/- 0.637) x 10(-3) (4.065 +/- 1.140) x 10(-3), (1.855 +/- 0.150) x 10(-3) cm x mL(-1) separately. The permeability coefficient order of scutellarin starch microspheres through nasal mucosa of different animals in vitro is dog > swine > domestica, and there are significant differences between the permeability coefficient of scutellarin starch microspheres through nasal mucosa of dog, swine in vitro, and that through nasal mucosa of swine and domestica in vitro.</p><p><b>CONCLUSION</b>Drugs in scutellarin starch microspheres could permeate through the above-mentioned nasal mucosa in vitro. There might be different permeability coefficient among different species.</p>

Genus Gentianella Moench:A Phytochemical and Ethnopharmacological Review / 中草药·英文版

The plants in genus Gentianella Moench (Gentianaceae) which comprised approximately 250 species, are mainly distributed in temperate regions of the world.Many Gentianella plants are intensely bitter and employed in traditional medicine to stimulate appetite, treat disorders of the gallbladder, and treat fever like the other bitter gentians in various regions of the world.Some species exhibit other remarkable therapeutic effects in the treatments of obesity,diabetes, and heart diseases.Eleven iridoids, twenty-eight xanthones, three C-glucoflavonoids, and eight other compounds have been isolated from the genus.Most of these compounds are associated with antimicrobial,anti-inflammatory, anti-oxidant, hypoglycemic, and antitumor activities, which provide an empirical base for the traditional utilization of the plants in genus Gentinella Moench.

Effect of Atorvastatin on Inflammation Markers and Intima-media Thickness of the Common Carotid Artery in Patient with Hyperlipidemic and Atherosclerosis / 医学研究杂志

Objective To investigate the effects of atorvastutin on the levels of plasm imflammation markers (hs - CRP, MMP - 3, TNF - α) and intima - media thickness(ITM) of the common carotid artery in patient with hyperlipidemic and atherosclerosis. Methods Fifty patient with hyperlipidemic and atherosclerosis were treated with atorvastatin (10mg qd) for 12 weeks. The levels of TC, TG, LDL -C, HDL -C, hs -CRP, TNF -α and MMP -3 were detected with radioimmmuneassay and eolorimetric methods. Color Doppler echo-cardiography was used to measure intima -media thickness(ITM) of the common carotid artery after 6 weeks and 12 weeks. Results TC, TG, LDL -C, hs -CRP, TNF -α and MMP -3 were decreased significantly(P < 0.01)after 12 weeks. IMT was decreased signifi-cantly(P < 0.05) and HDL - C was increased significantly (P < 0.05) after 12 weeks. Conclusion Atorvastatin could be effective in re-ducing blood - fat and anti - inflammatory action , regulating blood vessel endothelium (BVE) function and reversing structural chan-ges in IMT of the common carotid artery.

Clinical Effect Observation of Azithromycin and Ambroxol Hydrochloride in the Treatment of 56 Cases of Children with Acute Lower Respiratory Tract Infection Contraindicating to Penicillin and Cephalosporins / 医学研究杂志

Objective To observate the effects and reliability of azithromycin and ambroxol hydrochloride and glucose Injection in treatment of children with acute lower respiratory tract infection contraindicating to penicillin and cephalosporins. Methods 56 cases of children with acute lower respiratory tract infection for whom penicillin and cephalosporins were treated with azithromycin and ambroxol hydrochloride and glucose injection(group A) and other 100 cases without penicillin and cephalosporins contraindication were randomly divided into group B(treatment with cephalosporin) and group C (treatment with azithromycin). The clinical efficacy and adverse reactions of 3 groups after treatment in children were compared. Results In group A and group B, fever, cough, wheezing and other clinical symptoms, positive signs of the disappearance time of the lung were significantly shorter than those in the group C. The clinical efficacy of the two groups had significant difference as compared with group C (P0.05). Conclusion It is a good treatment with azithromycin and ambroxol hydrochloride and glucose injection to cure children cases with acute lower respiratory tract infection contraindicating to penicillin and cephalosporins, and it' s curative effect is equivalency with cephalosporin. It is worth to use this treatment in clinical practice.

5C5-a novel antigen restrictedly exprossed on human activated B cells / 中国免疫学杂志

Using a human activated B cell line 3D5 in immunization of mouse and as targets in screening, a hybridoma producing McAb 5C5 has been established. The antigen recognized by the McAb starts its expression on low dose anti-?-activated B cells at their G_1 phase at the 10th hour. The number of 5C5~+ cells increases with time. At the stimulation of PWM, the number of 5C5~+ cells in PBMNC also increases with time, and peaks on day 3 to 4, then docreases and comes to the background on day 7.5C5 antigen is positive on the B cell lines which can not be induced to differentiate to Ig-secre-ting cells (ISC), but negative on those being able to be driven to differentiate to ISC by BCDF. All the data indicate that 5C5 expresses at the early and mid stages, but disappears at the terminal stage of B cell activation and differentiation. 5C5 antigen does not expresses on resting B cells, resting T cells, PHA-activated T cells, monocytes, neutrophils, and the T cell and myeloid cell lines detected. Electrophoresis under both the nonreducing and reducing state for the ~(125)I-label led antigen immunoprecipi tated with McAb 5C5 shows a single band with a molecular weight of 52000, suggesting that 5C5 be a single chain cell surface protein. Since the MW of 5C5 is different from that of those B cell activation antigens reported in literature, and since ins specific expression on cell lines, 5C5 antigen might be a novel B eel I-restricted activation antigen.