Immunogenicity and reactogenicity of heterologous immunization schedules with COVID-19 vaccines: a systematic review and network meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Data on the immunogenicity and safety of heterologous immunization schedules are inconsistent. This study aimed to evaluate the immunogenicity and safety of homologous and heterologous immunization schedules.@*METHODS@#Multiple databases with relevant studies were searched with an end date of October 31, 2021, and a website including a series of Coronavirus disease 2019 studies was examined for studies before March 31, 2022. Randomized controlled trials (RCTs) that compared different heterologous and homologous regimens among adults that reported immunogenicity and safety outcomes were reviewed. Primary outcomes included neutralizing antibodies against the original strain and serious adverse events (SAEs). A network meta-analysis (NMA) was conducted using a random-effects model.@*RESULTS@#In all, 11 RCTs were included in the systematic review, and nine were ultimately included in the NMA. Among participants who received two doses of CoronaVac, another dose of mRNA or a non-replicating viral vector vaccine resulted in a significantly higher level of neutralizing antibody than a third CoronaVac 600 sino unit (SU); a dose of BNT162b2 induced the highest geometric mean ratio (GMR) of 15.24, 95% confidence interval [CI]: 9.53-24.39. Following one dose of BNT162b2 vaccination, a dose of mRNA-1273 generated a significantly higher level of neutralizing antibody than BNT162b2 alone (GMR = 1.32; 95% CI: 1.06-1.64), NVX-CoV2373 (GMR = 1.60; 95% CI: 1.16-2.21), or ChAdOx1 (GMR = 1.80; 95% CI: 1.25-2.59). Following one dose of ChAdOx1, a dose of mRNA-1273 was also more effective for improving antibody levels than ChAdOx1 (GMR = 11.09; 95% CI: 8.36-14.71) or NVX-CoV2373 (GMR = 2.87; 95% CI: 1.08-3.91). No significant difference in the risk for SAEs was found in any comparisons.@*CONCLUSIONS@#Relative to vaccination with two doses of CoronaVac, a dose of BNT162b2 as a booster substantially enhances immunogenicity reactions and has a relatively acceptable risk for SAEs relative to other vaccines. For primary vaccination, schedules including mRNA vaccines induce a greater immune response. However, the comparatively higher risk for local and systemic adverse events introduced by mRNA vaccines should be noted.@*REGISTRATION@#PROSPERO; https://www.crd.york.ac.uk/PROSPERO/ ; No. CRD42021278149.

Attaching importance to mechanical perfusion of donor liver and promoting high-quality development of liver transplantation / 器官移植

With the increasing quantity of organ donors and the continual expansion of the definition of extended criteria donor (ECD) livers, the quality of donor liver has become a prominent issue affecting the high-quality development of liver transplantation, which is also the study focus in related fields. Resolving the shortage of organs to the maximal extent and promoting the high-quality development of organ transplantation lead the development direction of organ donation and transplantation in China. In recent years, the application of mechanical perfusion (MP) for the perfusion, preservation, evaluation and repair of donor liver has become a hot topic to improve the quality of liver transplantation within the international community. In this article, according to different conditions of the application of ECD livers in liver transplantation at home and abroad in combination with the research progress on MP in the international community and relevant research experience of our center, the feasibility of establishing an organ intensive care unit (ICU) with integrated organ protection techniques was discussed, aiming to promote the high-quality development of organ transplantation in China and further expand the technical connotation of the "Chinese model" of organ donation and transplantation.

Application of situational simulation combined with video feedback in cardiopulmonary and abdominal probation of diagnostics / 中华医学教育探索杂志

Objective:To investigate the effect of situational simulation combined with video feedback in cardiopulmonary and abdominal clinical probation of diagnostics.Methods:Two hundred and twenty-four clinical undergraduates from the second affiliated hospital of Guangxi Medical University were randomized into the experimental group ( n=112) and the control group ( n=112). The experimental group applied situational simulation combined with video feedback methods in the cardiopulmonary and abdominal clinical probation. In other words, according to the assignment of diseases, two students played the role of "physician and patient" and conducted corresponding consultation and physical examination, in which the positive and negative video feedback were integrated to standardize students' physical examination skills. The control group adopted conventional teaching method. The teaching effect of the two groups was evaluated through unified and standardized scores of theoretical tests, cases analysis, and clinical skills operation, and the experimental group was conducted anonymous questionnaires to 112 students. SPSS 22.0 was used to perform the t test. Results:The evaluation results show that the average scores of theoretical tests (90.12±0.94), cases analysis (9.30±0.10) and physical examination (93.50±0.72) in the experimental group are higher than those of the control group, (83.20±1.66), (8.10±0.11), (85.00±1.75), respectively, with statistical significance ( P<0.05). All 112 questionnaires were collected, with an effective rate of 100%. The percentage of "yes" respondents is as follows, 91.1% of "Enhancing the mastery and application of knowledge"; 97.3% of "Cultivating clinical thinking"; 87.5% of "Improving doctor-patient communication skills"; however, there are 93.8% students believe that this new teaching approach takes more time to prepare before class, consequently, their initiative and enthusiasm of study and learning interest have slid into decline, with percentage of 80.4% and 83.0%, respectively. Conclusion:The teaching method of situational simulation and video feedback in cardiopulmonary and abdominal clinical probation of diagnostics is beneficial to enhance students' understanding and mastery of theoretical knowledge, standardize physical examinations, cultivate clinical thinking ability and improve the doctor-patient communication skills. However, it takes a lot of time for students to prepare before class. If they fail to make reasonable arrangements, the teaching effect will be half the effort and students' initiative and enthusiasm of learning will be reduced.

Effects, status and problems of liver transplantation in the treatment of portal hypertension / 中华消化外科杂志

Liver transplantation is the only effective treatment for portal hypertension (PHT) and end-stage liver disease.However,great therapeutic needs are far from satisfaction due to extreme shortage of donated livers.Good timing and indicator selection for PHT liver transplantation,and appropriate management of complications before or during on the waiting list,can avoid unnecessary liver transplantation and decrease the mortality rate of patients on waiting list.There are some particularities and issues worthy of attention.Understanding these particularities and handling these issues properly are extremely important to increase the success rate of PHT liver transplantation,enhance the recovery after surgery,and decrease the operative mortality.

Clinical study on flexible ureteroscopy lithotripsy for concurrent treatment of bilateral upper urinary tract calculi / 重庆医学

Objective To evaluate the effectiveness and safety of flexible ureteroscopy lithotripsy (FURL) combined with holmium laser for the concurrent treatment of bilateral upper ureteral tract calculi.Methods The clinical data in 43 patients with bilateral upper ureteral tract calculi concurrently treated by FURL combined with holmium laser in our hospital from September 2014 to November 2016 were retrospectively analyzed.All cases conducted CT scanning before operation.The flexible ureteroscope was intraoperatively placed and the lithotripsy was conducted by using 200 μm optical fiber at a power of 0.8-1.0 J/10-20Hz,which was coordinated by reticular basket.After lithotripsy,bilateral urethral stents were placed.KUB or CT was re-examined on postoperative 1 d.The cases of residual stone were performed KUB again after removing urethral stent after 4-6 weeks.Results All cases were successfully placed the flexible ureteroscope by one time.The mean operation time was (101.5±37.2) min and the overall stone-free rate (SFR) was 81.4 ％ (35/43).SFR was 100％ in the patients with the stone burden less than 30 mm and 63.2％ in the patients with the stone burden ≥30 mm,the difference was statistically significant(P＜0.05).One case appeared fever (39.5 ℃) after operation,1 case developed subcapsular renal hematoma and no other severe complications occurred.Conclusion FURL combined with holmium laser is an effective means to concurrently treating bilateral upper ureteral calculi,especially for the patients with stone burden ＜30 mm,which has higher stone clearance rate with good safety.

Clinical study on flexible ureteroscopy lithotripsy for concurrent treatment of bilateral upper urinary tract calculi / 重庆医学

Objective To evaluate the effectiveness and safety of flexible ureteroscopy lithotripsy (FURL) combined with holmium laser for the concurrent treatment of bilateral upper ureteral tract calculi.Methods The clinical data in 43 patients with bilateral upper ureteral tract calculi concurrently treated by FURL combined with holmium laser in our hospital from September 2014 to November 2016 were retrospectively analyzed.All cases conducted CT scanning before operation.The flexible ureteroscope was intraoperatively placed and the lithotripsy was conducted by using 200 μm optical fiber at a power of 0.8-1.0 J/10-20Hz,which was coordinated by reticular basket.After lithotripsy,bilateral urethral stents were placed.KUB or CT was re-examined on postoperative 1 d.The cases of residual stone were performed KUB again after removing urethral stent after 4-6 weeks.Results All cases were successfully placed the flexible ureteroscope by one time.The mean operation time was (101.5±37.2) min and the overall stone-free rate (SFR) was 81.4 ％ (35/43).SFR was 100％ in the patients with the stone burden less than 30 mm and 63.2％ in the patients with the stone burden ≥30 mm,the difference was statistically significant(P＜0.05).One case appeared fever (39.5 ℃) after operation,1 case developed subcapsular renal hematoma and no other severe complications occurred.Conclusion FURL combined with holmium laser is an effective means to concurrently treating bilateral upper ureteral calculi,especially for the patients with stone burden ＜30 mm,which has higher stone clearance rate with good safety.

Establishment and preliminary application of the McA-RH7777/Buffalo hepatoma rat model with bioluminescence imaging / 中华肝胆外科杂志

Objective To establish a luciferase labeled McA-RH7777 hepatoma rat model,which could be used for gross observation to further observe the effect of selective ligation of the portal vein and bile duct on tumor growth and metastasis.Methods The luciferase gene was transfected into rat McA-RH7777 hepatoma cells with pCDH-puromycin-CMV as the carrier,which were subcutaneously inoculated into Buffalo rats.Tumor pieces were then heterotransplanted into the left lateral lobe of the allogenic rat liver to observe the tumor growth in vivo.After the successful hepatoma modeling,the rats were randomly divided into three groups,namely the implanted portal vein group with combined portal vein and bile duct ligation,the implanted portal vein group with single portal vein ligation and sham operation group.The rats were executed at the 1 st week and 2nd week after ligation,and the livers were dissected to record the tumor growth and metastasis inside and outside the liver,respectively.Results The tumor formation rates of Buffalo rats after subcutaneous and intrahepatic implantation were both 100％.The fluorescence signal implanted into the liver lobe could be observed in vivo after the intrahepatic implantation of luciferase transfected Luc-McA-RH7777 at 2nd week,the range and intensity of which increased over time.Only local tumor growth could be found at the 4th week,without obvious intrahepatic and lung metastasis.However,both an increased in situ tumor volume and the pulmonary metastasis could be observed in the implanted portal vein group with combined portal vein and bile duct ligation at 2nd week after the ligation.Immunohistochemistry showed AFP positive immunoreactions in the vast majority of intrahepatic tumor cells and Luc positive immunoreactions in part of tumor cells.Conclusion Luc-McA-RH7777 cells could be used to establish the heptoma rat model and the in vivo analysis within the Buffalo rat liver demonstrated that the combined ligation of the portal vein and bile duct can accelerate the development and metastasis of liver cancer.

Inducing effect of IL-1βabout the release of HMGB1 in human bronchial epithelial cells / 重庆医学

Objective To investigate the effect of IL‐1βon the expression and release of high mobility group box 1 (HMGB1) from normal human bronchiolar epithelial cell (HBE) .Methods HBE135‐E6E7 was developed and methyltetrazolium (MTT) as‐say was used to assess the viability of HBE cell line under different concentration of IL‐1β.The mRNA expression of HMGB1 in HBE after stimulating with IL‐1βwere determined by Real‐time PCR;the level and location of HMGB1 in the cytoplasm ,nucleus and culture medium of HBE after stimulating with IL‐1β were detected by Western blot and ELISA assay .The expression and translocation of HMGB1 of HBE after stimulating with IL‐1β were detected by Immunofluorescence .Results 0 .1 ,1 .0 ,10 .0 ng/mL IL‐1βdid not influence the cell viability of HBE ;IL‐1β increased the mRNA expression of HMGB1 in HBE in does‐and time‐dependent manner and increased the protein expression of HMGB1 in HBE .In comparison with control group ,the levels of HMGB1 in the culture medium significantly increased after stimulation with IL‐1βat 1 .0 ,10 .0 ng/mL for 24 h(P<0 .05)in the dose dependent experiments;and in time dependent experiments ,10 .0 ng/mL IL‐1βsignificantly increased HMGB1 level in the cul‐ture medium after stimulation for both 12 h and 24 h (P< 0 .05) .After stimulation with IL‐1β (10 .0 ng/mL ) for 24 h ,the HMGB1 expression in cytoplasm significantly increased in plasmosin and decreased in nucleus .HMGB1 translocated from nuclei to cytoplasm after stimulation with IL‐1β(10 .0 ng/mL ) for 24 h .Conclusion IL‐1βcould induce HMGB1 expression and release in human bronchial epithelial cells ,which indicates that HMGB1 may involve in IL‐1β‐mediated chronic airway inflammation .

Serum interleukin- 20 levels and its clinical significance in asthma patients / 实用医学杂志

Objective To detect the pre- and post-treatment levels of serum interleukin (IL-20) in asthmatic patients during the acute exacerbation period and to investigate the role of IL-20 in the pathogenesis of bronchial asthma and relative clinical significance. Methods Forty-five cases of mild to moderate asthma outpatients in the First Affiliated Hospital of Guangxi Medical University from May 2013 to October 2013 were chosen as the asthma group and 32 healthy people who underwent routine physical examination as the control group. All the patients were treated with inhalation salmeterol and fluticasone 50/250 μg/μg (sucking twice a day) together with ventolin if necessary , and even with theophylline sustained-release tablets as the additional treatment in moderate asthma group for 1 week. The serum levels of IL-20 as well as immunoglobulin E (IgE) were detected by ELISA in the asthma group before and after treatment as well as in the control group. Other data including ECP , the number of eosinophil ceils (EOS) and the pulmonary function (FEV1%) were detected as well. The differences of IL-20 levels between the asthma group before and after treatment and the control group were analyzed and the correlation between IL-20 and Ig E, EOS, ECP and FEV1% were analyzed. Results Compared with the healthy control group [(13.58 ± 6.17)pg/L], the levels of IL-20 in the mild and moderate asthma pretreatment group were significantly increased [(23.43 ± 13.60)pg/L and (33.78 ± 22.69)pg/L]. Compared with the mild asthma group, the levels of IL-20 in the moderate asthma pretreatment group were significantly higher. After treatment , the levels of IL-20 [(15.73 ± 8.27)pg/L and (19.64 ± 11.69)pg/L] were decreased respectively in the asthmatic patients. The Pearson correlative analysis showed that there were positive correlations between the levels of 1L-20 and IgE , EOS and ECP respectively and there were negative correlations between IL-20 levels and FEV1%. Conclusion IL-20 may be involved in the pathogenesis of asthma.

Influences of congestion/reperfusion injury on remnant liver in rats after hepatectomy / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of congestion/reperfusion injury (CRI) and ischemia/reperfusion injury (IRI) on remnant liver in rats after hepatectomy.</p><p><b>METHODS</b>Male SD rats were divided into IRI, CRI, and control groups. In the former two groups, the left lateral lobe of the rats were subjected to IRI or CRI for 30 min with the rest lobes (about 70% of the total liver weight) resected; the rats in the control group received hepatectomy preserving only the left lateral lobe. The mortality rate of the rats was recorded, and the surviving rats were sacrificed at 1, 3 and 7 days after operation for analyses of ICG plasma disappearance rate (ICG-PDR), ALT, AST, liver regeneration rate, and Ki-67 labeling index.</p><p><b>RESULTS</b>The mortality rate was significantly higher in CRI group (34.3%) than in IRI group (8%, P<0.05) and control group (4%, P<0.01). On day 1 following hepatectomy, CRI group showed significantly higher liver enzyme levels and poorer liver functions than the control group (P<0.05) without significant differences from those in IRI group (P<0.05); Ki-67 labeling index in CRI group was significantly lower than that in the control group (P<0.01) and IRI group (P<0.01). Compared with the control group, CRI group showed a significantly lowered maximum Ki-67 labeling index with also a delayed occurrence (P<0.01); CRI resulted in poorer liver regeneration rate on day 3 after hepatectomy compared to the control group (P<0.01) and IRI (P<0.05).</p><p><b>CONCLUSION</b>Compared with IRI, CRI can result in severer liver damage and lowered liver regenerative capacity in rats early after hepatectomy.</p>

Effects of the expression of adhesion molecules on the metastasis of cirrhotic liver cancer in mice / 中华肝胆外科杂志

Objective To study the effects of a cirrhotic environment on the metastasis of liver cancer in mice.Methods Male BALB/c mice were randomly assigned to two groups:cirrhosis group and control group.The cirrhosis group was treated by an injection of carbon tetrachloride intraperitoneally.H22 liver cancer cells were directly implanted under the capsule of each group after cirrhosis was established.The animals were sacrificed at 1,2,and 3 weeks after the operation.The metastatic behavior of the cancer cells was observed by the naked eye and microscopically.Additionally,the adhesion ability of the liver was assessed by measuring the expression of vascular cell adhesion molecule 1 (VCAM-1),E-selectin,and E-cadherin.Results After the operation,the cirrhosis group showed an obvious metastatic tendency in both intrahepatic (14/19) and extrahepatic ways (4/19),compared with the control group's intrahepatic (5/17) and extrahepatic ways (1/17) (P＜0.05).Immunohistochemisty for VCAM-1 and E-selectin showed a significant increase in the cirrhosis (P＜0.05).However,there was no difference observed in the E-cadherin between the cirrhosis and control group.Conclusion A cirrhotic liver environment may promote the metastasis of liver cancer cells by increasing the ability of liver adhesion.

Prevention of acute renal failure in obstructive jaundice patients in perioperative period / 中国普通外科杂志

ObjectiveTo investigate the protection of renal function and the prevention of acute renal failue(ARF) in perioperative period in obstructive jaundice(OJ) patients. Methods In experimantal group, short time parenteral nutrition(PN) was given preoperatirely.Small dosage of dopamine was intravenously dripped.and rapid infusion of 20% mannitol periodically was done.In control group routine treatment was done. Postoperative blood BUN and Cr dynamic changes were examined and occurrence rate of ARF were recorded. Results No ARF occurred in the experimental group;but ARF occurred in 5 cases(29.4%)and 2 cases(17.6%) died (P

Relationship between changes in plasma GMP-140 and lipid levels in patients with acute pancreatitis and their clinical significance / 中国普通外科杂志

Objective To study the clinical significance of changes of plasma GMP-140 and lipid levels in patients with acute pancreatitis.Methods GMP-140 was determined by ELISA and plasm a lipid levels were determined with an auto-biochemical analyzer in 58 patients with acute pancreatitis and in 33 healthy(individuals) as control group.Results The levels of plasma GMP-140, total cholesterol(TC),low-density lipoprotein(LDL-C) in acute pancreatitis were higher than in the that control group(P