Host protection against Omicron BA.2.2 sublineages by prior vaccination in spring 2022 COVID-19 outbreak in Shanghai / 医学前沿

The Omicron family of SARS-CoV-2 variants are currently driving the COVID-19 pandemic. Here we analyzed the clinical laboratory test results of 9911 Omicron BA.2.2 sublineages-infected symptomatic patients without earlier infection histories during a SARS-CoV-2 outbreak in Shanghai in spring 2022. Compared to an earlier patient cohort infected by SARS-CoV-2 prototype strains in 2020, BA.2.2 infection led to distinct fluctuations of pathophysiological markers in the peripheral blood. In particular, severe/critical cases of COVID-19 post BA.2.2 infection were associated with less pro-inflammatory macrophage activation and stronger interferon alpha response in the bronchoalveolar microenvironment. Importantly, the abnormal biomarkers were significantly subdued in individuals who had been immunized by 2 or 3 doses of SARS-CoV-2 prototype-inactivated vaccines, supporting the estimation of an overall 96.02% of protection rate against severe/critical disease in the 4854 cases in our BA.2.2 patient cohort with traceable vaccination records. Furthermore, even though age was a critical risk factor of the severity of COVID-19 post BA.2.2 infection, vaccination-elicited protection against severe/critical COVID-19 reached 90.15% in patients aged ≽ 60 years old. Together, our study delineates the pathophysiological features of Omicron BA.2.2 sublineages and demonstrates significant protection conferred by prior prototype-based inactivated vaccines.

Host protection against Omicron BA.2.2 sublineages by prior vaccination in spring 2022 COVID-19 outbreak in Shanghai / 医学前沿

The Omicron family of SARS-CoV-2 variants are currently driving the COVID-19 pandemic. Here we analyzed the clinical laboratory test results of 9911 Omicron BA.2.2 sublineages-infected symptomatic patients without earlier infection histories during a SARS-CoV-2 outbreak in Shanghai in spring 2022. Compared to an earlier patient cohort infected by SARS-CoV-2 prototype strains in 2020, BA.2.2 infection led to distinct fluctuations of pathophysiological markers in the peripheral blood. In particular, severe/critical cases of COVID-19 post BA.2.2 infection were associated with less pro-inflammatory macrophage activation and stronger interferon alpha response in the bronchoalveolar microenvironment. Importantly, the abnormal biomarkers were significantly subdued in individuals who had been immunized by 2 or 3 doses of SARS-CoV-2 prototype-inactivated vaccines, supporting the estimation of an overall 96.02% of protection rate against severe/critical disease in the 4854 cases in our BA.2.2 patient cohort with traceable vaccination records. Furthermore, even though age was a critical risk factor of the severity of COVID-19 post BA.2.2 infection, vaccination-elicited protection against severe/critical COVID-19 reached 90.15% in patients aged ≽ 60 years old. Together, our study delineates the pathophysiological features of Omicron BA.2.2 sublineages and demonstrates significant protection conferred by prior prototype-based inactivated vaccines.

The long-circulating effect of pegylated nanoparticles revisited via simultaneous monitoring of both the drug payloads and nanocarriers

The long-circulating effect is revisited by simultaneous monitoring of the drug payloads and nanocarriers following intravenous administration of doxorubicin (DOX)-loaded methoxy polyethylene glycol-polycaprolactone (mPEG-PCL) nanoparticles. Comparison of the kinetic profiles of both DOX and nanocarriers verifies the long-circulating effect, though of limited degree, as a result of pegylation. The nanocarrier profiles display fast clearance from the blood despite dense PEG decoration; DOX is cleared faster than the nanocarriers. The nanocarriers circulate longer than DOX in the blood, suggesting possible leakage of DOX from the nanocarriers. Hepatic accumulation is the highest among all organs and tissues investigated, which however is reversely proportionate to blood circulation time. Pegylation and reduction in particle size prove to extend circulation of drug nanocarriers in the blood with simultaneous decrease in uptake by various organs of the mononuclear phagocytic system. It is concluded that the long-circulating effect of mPEG-PCL nanoparticles is reconfirmed by monitoring of either DOX or the nanocarriers, but the faster clearance of DOX suggests possible leakage of a fraction of the payloads. The findings of this study are of potential translational significance in design of nanocarriers towards optimization of both therapeutic and toxic effects.

Correlation between hepcidin level and iron, mineral metabolism in maintenance hemodialysis patients / 中国医师进修杂志

Objective To investigate the correlation between serum hepcidin level and iron, mineral metabolism in maintenance hemodialysis (MHD) patients. Methods Seventy-five MHD patients were selected. The serum hepcidin, serum iron and mineral metabolism indexes were detected by enzyme-linked immunosorbent double antibody sandwich method, and their correlation was analyzed. Results The level of serum hepcidin in 75 MHD patients was 87- 264 μg/L. The patients were divided into 3 groups according to serum hepcidin level. In group A, the serum hepcidin level of 26 cases was＜120 μg/L; in group B, the serum hepcidin level of 24 cases was 120- 200 μg/L; in group C, the serum hepcidin level of 25 cases was>200 μg/L. There were no significant differences in age, gender, albumin and serum calcium among 3 groups (P > 0.05). The levels of ferritin, transferrin saturation (TS), serum phosphorus and parathyroid hormone (PTH) increased in the 3 groups as the hepcidin level increased, while hemoglobin, serum iron, total iron binding capacity (TIBC), and 25 hydroxy vitamin D decreased significantly, and there were statistical differences (P＜0.05). The Pearson correlation analysis result showed that serum hepcidin was positively correlated with ferritin, PTH, serum phosphorus (r = 0.862, 0.536 and 0.320; P＜0.01); and serum hepcidin was negative correlation with serum iron, TIBC, hemoglobin, 25 hydroxy vitamin D (r=-0.358,-0.270,-0.284 and-0.614; P＜0.01); but there was no correlation between serum hepcidin and albumin and serum calcium (r=0.018 and-0.005, P＞0.05). Conclusions The serum hepcidin level in MHD patients is closely related to iron and mineral metabolism.

Practices and experiences of training high-competence specialists in the hospital / 中华医院管理杂志

High-competence specialists are elites among health professionals.By means of the authoritative training system,the hospital took such measures as,strengthened management,rotary training without fixed posts,and cross training.Efforts of 8 years have helped the hospital to establish a high-competence specialists team,a good academic atmosphere,and enhanced capacity of disciplines. Key experiences of the hospital in this process include well-identified objectives,well-designed training programs, strict supervision of training process, and establishment of long-term management mechanism.

Effect of L-carnitine on plasma soluble tumor necrosis factor-like weak inducer of apoptosis protein in the patients with maintenance hemodialysis / 中国医师进修杂志

Objective To observe the effect of L-carnitine on plasma soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) protein in maintenance hemodialysis (MHD) patients.Methods Forty-six cases of MHD patients were enrolled as MHD group,and 40 cases of the same period healthy subjects were enrolled as control group.The levels of plasma sTWEAK protein,high-sensitivity C-reactive protein (hs-CRP),interleukin (IL)-6 and insulin-like growth factor (IGF)-1 were measured by enzyme-linked immunosorbent assay (ELISA).Twenty-six MHD patients with the levels of sTWEAK protein higher than control group mean value as treatment group,were treated for L-carnitine 1.0 g in 0.9％ sodium chloride solution 20 ml after hemodialysis by intravenous injection one time per week.Twenty MHD patients with the levels of sTWEAK protein lower than or equal to control group mean value as non-treatment group.The changes of sTWEAK protein,IGF-1,grip strength and protein energy waisting (PEW) were observed after 3 months treatment.Results The levels of plasma sTWEAK protein,IL-6 and hs-CRP in MHD group were higher than those in control group [(464 ± 102) ng/L vs.(346 ± 159) ng/L,(986.54 ± 123.12) ng/L vs.(407.12 ± 180.25) ng/L,(18.8 ± 2.9) mg/L vs.(1.0 ± 1.2) mg/L],there were significant differences (P＜ 0.05).Compared with non-treatment group,the levels of plasma sTWEAK protein,IL-6 and hs-CRP in treatment group after treatment of 3 months were decreased [(126 ± 92) ng/L vs.(243 ± 103) ng/L,(799.45 ± 105.34) ng/L vs.(966.04 ± 113.11) ng/L,(13.7 ± 1.9) mg/L vs.(26.8 ± 2.8) mg/L],IGF-1 was increased,grip strength was increased,PEW was improved,there were significant differences (P ＜ 0.01 or ＜ 0.05).The body mass index in treatment group was more than that in non-treatment group,but there was no significant difference (P ＞ 0.05).Conclusions L-carnitine can reduce the levels of plasma sTWEAK protein in MHD patients,reduce inflammatory reaction,improve the levels of IGF-1,increase strength,improve the PEW.

Clinical research of relationship between soluble tumor necrosis factor-like weak inducer of apoptosis levels and cardiovascular events in patients with maintenance hemodialysis / 中国医师进修杂志

Objective To investigate the relationship between soluble tumor necrosis factor-like weak inducer of apoptosis levels (sTWEAK) and cardiovascular events in patients with maintenance hemodialysis (MHD).Methods A prospective cohort study was conducted in 64 MHD patients(MHD group).The plasma level of sTWEAK was measured by enzyme-linked immunosorbent assay,N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitive C-reactive protein (hs-CRP) levels were measured by enzyme-linked immunofluorescence method,left ventricular end-diastolic diameter (LVEDd),left ventricular posterior wall thickness (LVPWT),end-diastolic ventricular septal thickness (IVST),left ventricular ejection fraction (LVEF) was determined by echocardiography.The general situation,clinical indicators and occurrence of cardiovascular events of MHD patients were recorded and followed up for 2 years.Fifty healthy people were selected as control group.Results The plasma level of sTWEAK was higher in MHD group than that in control group [(589 ± 122) ng/L vs.(346 ± 127) ng/L],and there was significant difference (P＜ 0.01).During the follow-up period,12 patients underwent cardiovascular events(3 patients died).The plasma level of sTWEAK in cardiovascular event patients was significantly higher than that in non-cardiovascular event patients (695 ng/L vs.458 ng/L),and there was significant difference (P ＜ 0.01).The plasma level of sTWEAK was positively correlated with NT-proBNP in MHD patients(r =0.698,P ＜ 0.05).Logistic repression analysis showed that sTWEAK was the predictor of cardiovascular events of MHD patients.Conclusion The plasma level of sTWEAK probably predicts the ocurrence of cardiovascular event in MHD patients.

Qualitative Study on Training Demand among Clinical Medical Postgraduate Students / 中华医学科研管理杂志

Objective To explore the training demand among clinical medical postgraduate students.Methods Focus Group Discussions and a research interview,two of the qualitative study methods were applied among medical students of a hospital.Results Different clinical medical postgraduate students need different levels training.The demand status related to the students' training styles.Students had desire to receive kinds of help of hospital administrative authority.Conclusion Training guide is importance during the growth of clinical medical postgraduate students.Hospital administrative authority should afford manifold ways to satisfy the demand of students for their training.

The Quadriplegia Index of Function in Use wiith Quadriplegic Patients:A Preliminary Report / 中国康复理论与实践

@# Presented in this paper is a report on the Quadriplegia Index of Function(QIF) in usewith 16 cases of quadriplegic patients.Compared with the Barthel Index and Japan ADL Scale,QIF wasfound to be more sensitive and effective to document the small but significant funtional gains made byquadriplegics during medical rehabilitation,therefore,authors suggest that QIF should be widely usedin the rehabilitation evaluation of quadriplegic patients.