Chinese medicine (Q-14) in the Treatment of Patients with Coronavirus Disease 2019 (COVID-19): A Single-center, Open label, Randomised Controlled Trial

OBJECTIVETo evaluate the efficacy and safety of Chinese medicine (Q-14) plus standard care compared with standard care alone in adult with coronavirus disease 2019 (COVID-19). Study DESIGNSingle-center, open label, randomised controlled trial. SETTINGWuhan Jinyintan Hospital, Wuhan, China, February 27 to March 27, 2020. PARTICIPANTS204 patients with laboratory confirmed COVID-19 were randomised in to treatment group and control group, which was 102 patients each group. INTERVENTIONSIn treatment group, Q-14 was administrated at 10g (granules), twice daily for 14 days and plus standard care. In control group, patients were given standard care alone for 14 days. MAIN OUTCOME MEASUREThe primary outcome was conversion time of SARS-CoV-2 viral assay. Adverse events were analyzed in the safety population. RESULTSAmong 204 patients, 195 were analyzed according to the intention to treat principle. There were 149 patients (71 vs. 78 in treatment group and control group respectively) turning to negative via SARS-CoV-2 viral assay. No statistically significance showed in conversion time between treatment group and control group (FAS: Median (IQR): 10.00 (9.00-11.00) vs. 10.00 (9.00-11.00); Mean rank: 67.92 vs. 81.44; P=0.051.). Time to recovery of fever was shorter in treatment group as compared in control group. The disappearance rate of symptom in cough, fatigue, chest discomfort was significantly higher in treatment group. In chest computed tomography (Chest CT) examinations, overall evaluation of chest CT examination after treatment compared with baseline showed more patients improved in treatment group .There were no significant differences in the other outcomes. CONCLUSIONAdministration of Q-14 on standard care for COVID-19 was useful for improvement of symptoms (such as fever, cough, fatigue and chest discomfort), while did not result in a significantly higher probability of negative conversion of SARS-CoV-2 viral assay. No serious adverse events were reported. TRIAL REGISTRATIONChiCTR2000030288

Methane hydrate formation behaviors in high water-cut oil-in-water systems with hydrate promoters.

Hydrate slurry transport technology has become a focal point among worldwide researches, due to its high economic efficiency. However, the mechanism and law of hydrate growth kinetics in flow systems were still unclear, especially in high water-cut oil-water systems with hydrate promoters. On this basis, this paper conducted a series of growth kinetic experiments using a high-pressure transparent sapphire cell, and investigated systematically several influencing factors (such as initial pressure, the concentration of emulsifier, hydrate promoter, and the concentration of hydrate promoter) of growth kinetics, and obtained the quantitative relationship between these factors and gas consumption as well as the hydrate growth rate (gas consumption rate). It could be seen from the analysis of these influencing factors that the presence of hydrate promoters can promote hydrate nucleation rapidly and shorten the hydrate induction time, as compared with the (diesel oil + water) system. The concentration of emulsifier is positively correlated with the induction period of hydrate formation, whether it was sodium dodecyl sulfate (SDS) or l-leucine (l-l) systems. The SDS and l-l system could significantly improve the formation kinetics of methane hydrate in the emulsion system, while tetrabutylammonium bromide (TBAB) and polysorbate 80 (Tween80) significantly inhibited the nucleation and growth of methane hydrate in the emulsion. The kinetic curves of hydrate formation showed a trend of first increasing and then gradually decreasing, with the increase of SDS concentrations. However, the hydrate formation kinetics tended to increase gradually and reach equilibrium in the l-l system, with an increase in the concentration of l-l.

Distinct Prognosis of High Versus Mid/Low Rectal Cancer: a Propensity Score-Matched Cohort Study.

BACKGROUND: Rectal cancers have long been treated as a single-entity disease; however, whether the prognosis of high rectal cancer (inferior margin located 10.1 to 15.0 cm from the anal verge) differs from that of mid/low rectal cancer (0 to 10.0 cm) remains disputed. METHODS: Patients with stages I-III rectal adenocarcinomas undergoing curative-intent surgery were enrolled between 2007 and 2013 in this retrospective analysis. Exclusion criteria were neoadjuvant therapy or concurrent cancers. Propensity score matching and Cox regression analysis were performed to compare a 5-year overall and cancer-specific survival between patients with high and mid/low rectal cancer. RESULTS: Of 613 patients who met the inclusion criteria, 199 (32.5%) and 414 (67.5%) had high and mid/low rectal cancer, respectively. After propensity score matching (187 cases for each group), the high group showed a better overall survival (70.9 vs. 56.9%, p = 0.042) and cancer-specific survival (77.4 vs. 60.3%, p = 0.028) at 5 years compared with the mid/low group with stage III disease. However, high rectal cancer did not demonstrate prognostic superiority in stages I-II disease. Multivariate analysis identified high tumor location as an independent prognostic factor for cancer-specific survival (hazards ratio = 0.422, 95% confidence interval 0.226-0.786, p = 0.007) and overall survival (hazards ratio = 0.613, 95% confidence interval 0.379-0.991, p = 0.046). CONCLUSIONS: Patients with stage III high rectal adenocarcinoma demonstrated better overall and cancer-specific survival than those with mid/low type, and tumor location was an independent prognostic factor for patients with rectal carcinomas.

Trans-ethnic analysis of susceptibility variants in IgA nephropathy / 北京大学学报(医学版)

OBJECTIVE@#To compare the genetic architecture of susceptibility variants of IgA nephropathy (IgAN) in Chinese and Europeans.@*METHODS@#We selected the independent genome-wide significant variants of IgAN in European population as candidate variants. Their associations, risk alleles, risk allele frequencies, odds ratios and population attributable risk scores were derived and calculated, then compared with those in the current Chinese population, including 1 194 IgAN patients and 902 controls. Using the significant variants, genetic risk scores were calculated and compared between the East Asians and the Europeans. The correlation between the genetic risk scores and clinical manifestations was also evaluated.@*RESULTS@#There were 16 independent single nucleotide polymorphisms (SNPs) located in 11 loci showing significantly association with susceptibility to IgAN in the Europeans. 93.75% (15/16) of them also showed significant associations in the Chinese (P<0.05). The effects of all the associated SNPs were in the same direction, either risk or being protective for IgAN, between the Chinese and the Europeans. On the contrary, remarkable higher risk allelic odds ratio (P=1.94×10-2), higher risk allele frequency (P=3.09×10-2), and higher population attributable risk (P=3.03×10-4) were observed for most of the associated SNPs in the Chinese than in the Europeans. Furthermore, genetic risk scores were significantly larger in the Asian populations compared with the Europeans (P=1.78×10-163). While there was no significance among the subpopulations in both the East Asians and the Europeans. Compared with the healthy controls, the genetic risk score in the IgAN patients was significantly larger (P=3.60×10-27). Clinical analysis showed the genetic risk score was positively associated with serum levels of IgA and IgA1, phases of chronic kidney disease and Haas grades.@*CONCLUSION@#Our study provides further evidence in the shared genetic architecture between Chinese and Europeans, while differences with respect to the effect sizes and risk allele frequencies across ethnicities, contributing partially to the differences of disease prevalence.

Levels, sources and risk assessment of PAHs in multi-phases from urbanized river network system in Shanghai.

Spatial-temporal distributions, sources identification and risk assessment of polycyclic aromatic hydrocarbons (PAHs) in overlying water and surface sediments in urban river networks of Shanghai were studied. Analytical results showed that there was a significant seasonal variation in concentrations of ∑16PAHs in water, suspended particulate matter (SPM) and sediment phases in this study area. The PAHs pollution in these multi-phases were in the medium level compared with other areas around the world, and the levels of PAHs contamination in SPM and sediment phases in hierarchical rivers showed TS (the third-order stream) > FS (the first-order stream) > SS (the second-order stream). Two manners of isomer ratios and principal component analysis (PCA) were used to identify PAHs origins, and suggested that combustion processes are dominant for PAHs sources. The ratios of PAHs origins by fossil fuels combustion, coke burning and crude oil in hierarchical rivers were determined with FS > SS > TS in SPM and sediment phases, and the ratio of PAHs origins by traffic emissions was analyzed with TS > SS > FS. PAHs in water samples have a certain impact on aqueous ecological system especially due to the fact that the ∑ceq values of nine PAHs were calculated from 0.715 to 15.831 µg/L in winter, which inferred serious ecological risk to some special aquatic organisms. The calculations of MERMQ in sediment samples showed that the MERMQ values ranged from 0.021 to 1.209 in winter and 0.019 to 0.643 in summer, which suggested high toxicity at six sampling sites in winter and only one location in summer due to high levels of PAHs. Furthermore, the toxicity degree of sediments were demonstrated with TS > FS > SS.

Dissimilatory nitrate reduction processes in sediments of urban river networks: Spatiotemporal variations and environmental implications.

Urbanizations have increased the loadings of reactive nitrogen in urban riverine environments. However, limited information about dissimilatory nitrate reduction processes and associated contributions to nitrogen removal is available for urban riverine environments. In this study, sediment slurry experiments were conducted with nitrogen isotope-tracing technique to investigate the potential rates of denitrification, anaerobic ammonium oxidation (anammox) and dissimilatory nitrate reduction to ammonium (DNRA) and their contributions to nitrate reduction in sediments of urban river networks, Shanghai. The potential rates of denitrification, anammox and DNRA measured in the study area ranged from 0.193 to 98.7 nmol N g-1 h-1 dry weight (dw), 0.0387-23.7 nmol N g-1 h-1 dw and 0-10.3 nmol N g-1 h-1 dw, respectively. Denitrification and DNRA rates were higher in summer than in winter, while anammox rates were greater in winter than in summer for most sites. Dissolved oxygen, total organic carbon, nitrate, ammonium, sulfide, Fe(II) and Fe(III) were found to have significant influence on these nitrate reduction processes. Denitrification contributed 11.5-99.5%% to total nitrate reduction, as compared to 0.343-81.6% for anammox and 0-52.3% for DNRA. It is estimated that nitrogen loss of approximately 1.33 × 105 t N year-1 was linked to both denitrification and anammox processes, which accounted for about 20.1% of total inorganic nitrogen transported annually into the urban river networks of Shanghai. Overall, these results show the potential importance of denitrification and anammox in nitrogen removal and provide new insight into the mechanisms of nitrogen cycles in urban riverine environments.

Polycyclic aromatic hydrocarbons and black carbon in intertidal sediments of China coastal zones: Concentration, ecological risk, source and their relationship.

Polycyclic aromatic hydrocarbons (PAHs) and black carbon (BC) have attracted many attentions, especially in the coastal environments. In this study, spatiotemporal distributions of PAHs and BC, and the correlations between BC and PAHs were investigated in the intertidal sediments of China coastal zones. BC in sediments was measured through dichromate oxidation (BCCr) and thermal oxidation (BCCTO). The concentrations of BCCr in the intertidal sediments ranged between 0.61 and 6.32mgg(-1), while BCCTO ranged between 0.57 and 4.76mgg(-1). Spatial variations of δ(13)C signatures in TOC and BC were observed, varying from -21.13‰ to -24.87‰ and from -23.53‰ to -16.78‰, respectively. PAH contents of sediments ranged from 195.9 to 4610.2ngg(-1) in winter and 98.2 to 2796.5ngg(-1) in summer, and significantly seasonal variations were observed at most sampling sites. However, the results of potential toxicity assessment indicated low ecological risk in the intertidal sediments of China coastal zones. Greater concentrations of PAHs measured in the sediments of estuarine environments indicated that rivers runoff may have been responsible for the higher PAH pollution levels in the intertidal sediments of China coastal zones. Pearson's correlation analysis suggested that pyrogenic compounds of PAH were significantly related to BC, due to that both BC and these compounds derived mainly from the combustion process of fossil fuels and biomass. Overall, increasing energy consumptions caused by anthropogenic activities can contribute more emissions of BC as well as PAHs and thus improve the importance of BC in indicating pyrogenic compounds of PAHs in the intertidal sediments of China coastal zones.

Development of laparoscopic technology in biliary surgery in the past 23 years: a single-center experience / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize the 23-year experience of laparoscopic biliary surgery in General Hospital of PLA and evaluate the application of laparoscopic surgery in the treatment of biliary diseases.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 11 419 consecutive patients with biliary diseases undergoing laparoscopic surgery from April, 1992 and December, 2014. The disease spectrum was compared between patients treated before December 31, 2003 and those treated after the time point.</p><p><b>RESULTS</b>The 11419 patients receiving laparoscopic surgery accounted for 56.3% of the total patients undergoing biliary surgeries during the 23 years, including 4701 male and 6718 female patients with a mean age of 50.9∓13.2 years (6-93 years). Most (80.83%) of the patients received laparoscopic surgery for gallbladder stones, and 12.53% patients had the operation for gallbladder polyps. The laparoscopic operation rate was 84.81% in patients with gallbladder stones and 34.91% in patients with extrahepatic bile duct stones, but remained low in patients with biliary carcinoma. In laparoscopic operations, laparoscopic cholecystectomy was the most frequent (96.18%) followed by operations for extrahepatic bile duct stones, in which primary suture accounted for 1.38%, traditional T tube drainage for 0.90% and laparoscopic transcystic duct exploration for 0.72%. For malignant tumors, laparoscopic technique was used mainly for the purpose of exploration (0.34%). The application of laparoscopic technique in biliary surgery tended to increase after the year 2004, especially for benign gallbladder diseases and extrahepatic bile duct stones (P<0.05).</p><p><b>CONCLUSION</b>Laparoscopic technique in biliary surgery is gradually replacing the traditional open operation and becomes the gold standard for the treatment of benign biliary diseases.</p>

Evidence of Nitrogen Loss from Anaerobic Ammonium Oxidation Coupled with Ferric Iron Reduction in an Intertidal Wetland.

Anaerobic ammonium oxidation coupled with nitrite reduction is an important microbial pathway of nitrogen removal in intertidal wetlands. However, little is known about the role of anaerobic ammonium oxidation coupled with ferric iron reduction (termed Feammox) in intertidal nitrogen cycling. In this study, sediment slurry incubation experiments were combined with an isotope-tracing technique to examine the dynamics of Feammox and its association with tidal fluctuations in the intertidal wetland of the Yangtze Estuary. Feammox was detected in the intertidal wetland sediments, with potential rates of 0.24-0.36 mg N kg(-1) d(-1). The Feammox rates in the sediments were generally higher during spring tides than during neap tides. The tidal fluctuations affected the growth of iron-reducing bacteria and reduction of ferric iron, which mediated Feammox activity and the associated nitrogen loss from intertidal wetlands to the atmosphere. An estimated loss of 11.5-18 t N km(-2) year(-1) was linked to Feammox, accounting for approximately 3.1-4.9% of the total external inorganic nitrogen transported into the Yangtze Estuary wetland each year. Overall, the co-occurrence of ferric iron reduction and ammonium oxidation suggests that Feammox can act as an ammonium removal mechanism in intertidal wetlands.

Bioinformatics Analysis on Molecular Network and Bio-function ofBu-Fei-Yi- Shen Decoction / 世界科学技术-中医药现代化

This article was aimed to study the molecular network and bio-function ofBu-Fei-Yi-Shen (BFYS) decoction for chronic obstructive pulmonary disease (COPD) by bioinformatics analysis, in order to provide new ideas for research on pharmacological mechanism of Chinese medicine compound prescription. Components of herbs in BFYS decoction were searched in the databases. Targeted proteins of each component were found from PubChem. Comparison analyses were performed on molecular network, bio-function and canonical pathways by Ingenuity Pathway Analysis (IPA). The results showed that there were 239 target proteins of BFYS decoction. There were 9 molecular networks of BFYS decoction. The top 3 networks' functions were Cellular Development, Energy Production, and Cancer. The top 3 bio-function of BFYS decoction were Cellular Growth and Proliferation, Cell Death and Survival, and Inflammatory Response. The top 3 canonical pathways of BFYS decoction were Cell Cycle:G1/S Checkpoint Regulation, Chronic Myeloid Leukemia Signaling, and Cyclins and Cell Cycle Regulation. It was concluded that the search of target proteins for herbal compounds and bioinformatics analysis by IPA can be used to reveal the molecular network and bio-function of BFYS decoction.

Exploration on Medication Regularity of Epidemic Encephalitis B with Text Mining Technique / 中国中医药信息杂志

Objective To explore the clinical regularity of drugs on epidemic encephalitis B with text mining technique. Methods The data set on epidemic encephalitis B was downloaded from CBM database. The regularities of Chinese herbal medicine, Chinese patent medicine (CPM), western medicine and the combination of CPM and western medicine on epidemic encephalitis B were mined by data slicing algorithm. The results are showed visually with Cytoscape 2.8 software. Results The main function of herbal pieces was focused on clearing heat and removing toxicity. The herbal pieces such as Rehmanniae Radix Isatidis Raxis, Isatids Folium, Paeoniae Radis rubra and Scutellariae Radix were most often used. Angong Niuhuang Wan and Qingkailing Injection were usually used as CPM. For western medicine, antiviral drugs such as interferon and ribavirin were often used, and they were often used together with brain cells nutrition medicine, hormone, immunopotentiator and so on, and they were also frequently used together with CPM such as Angong Niuhuang Wan and Qingkailing Injection. Conclusion Text mining approach provides an important method in exploring the medication regularity for diseas, and provide refenrence for clinical use.

Clinical applications of abdominosacral resection for low rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility and safety of abdominosacral resection for patients with locally advanced primary low rectal cancer.</p><p><b>METHODS</b>A total of 97 low rectal cancer patients were amenable to surgery but not anal sphincter preservation were included in this study and divided into the abdominoperineal resection group(n=49) and abdominosacral resection group(n=48) according to the order of alternative admission time between June 2010 and January 2012. Intraoperative and postoperative parameters were compared between the two groups.</p><p><b>RESULTS</b>The surgery went well and no perioperative mortality in the two groups. Compared with abdominoperineal resection group, the operative time of abdominosacral resection group(including the 2nd position adjustment time) was longer[(188±45) min vs. (143±48) min, P=0.000], the unexpected prostate or vagina injury incidence was lower [0 vs. 14.3%(7/49), P=0.032), and the perineal wound infection rate was lower [2.1% (1/48) vs. 18.4% (9/49), P=0.040].</p><p><b>CONCLUSION</b>Abdominosacral excision is feasible and safe for patients with locally advanced primary low rectal cancer.</p>

Effect of Epimedium extract on osteoprotegerin and RANKL mRNA expressions in glucocorticoid-induced femoral head necrosis in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of glucocorticoid on the expression levels of osteoprotegerin (OPG) and receptor activator of nuclear factor kappa B ligand (RANKL) mRNAs in rat femoral head and the antagonistic effect of Epimedium, and explore the mechanism of Epimedium in preventing glucocorticoid-induced femoral head necrosis.</p><p><b>METHODS</b>Forty-eight adult SD rats were randomized into glucocorticoid group, Epimedium group and control group. In the former two groups, the rats received intramuscular injection of 12.5 mg prednisolone twice a week, and in Epimedium group, additional 1 ml/100 g aqueous Epimedium extract (equivalent to 0.1 g/ml of the crude drug) was administered intragastrically once daily. The control group received only intramuscular saline injection. After 4 weeks of treatment, osteonecrosis of the left femoral head was detected by HE staining, and the right femoral head was sampled for detection of OPG and RANKL mRNA expressions using real-time quantitative PCR.</p><p><b>RESULTS</b>In glucocorticoid, Epimedium and control groups, the mortality rate of the rats was 12.5% (2/16), 6.25% (1/16), 0 (0/16), and femoral head necrosis occurred at a rate of 71.43% (10/14), 26.67% (4/15), and 0 (0/16), respectively. In glucocorticoid group, the expression level of OPG mRNA was significantly lower, RANKL expression significantly higher, and OPG/RANKL ratio significantly lower than those in Epimedium and control groups (P<0.05). OPG, RANKL and their ratios showed no significant differences between Epimedium group and the control group.</p><p><b>CONCLUSION</b>Epimedium can prevent glucocorticoid-induced femoral head necrosis probably by antagonizing glucocorticiod-induced abnormal expressions of OPG and RANKL mRNA.</p>

Impact of number of retrieved lymph nodes and lymph node ratio on the prognosis in patients with stage II and III colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To discuss the impact of number of retrieved lymph nodes and lymph node ratio(LNR) on the prognosis in patients with stage II and III colorectal cancer.</p><p><b>METHODS</b>Clinicopathological data of 507 patients with stage II and III colorectal cancer were analyzed retrospectively. Follow-up was available in all the patients.</p><p><b>RESULTS</b>The total number of retrieved lymph nodes was 5801, of which 1122 had metastasis. There was a positive correlation between metastatic lymph nodes and retrieved lymph nodes(r=0.171, P<0.01). In stage II colorectal cancer there was a significant difference in 5-year survival rate between patients with more than 12 lymph nodes retrieved and those with less than 12 lymph nodes retrieved(P<0.01). LNR also affected the 5-year survival rate of patients with stage II and III colorectal cancer(P<0.05). In patients with similar LNR, the 5-year survival rate differed significantly among different regions of lymph node metastasis(P<0.05). LNR influenced the prognosis independent of the number of lymph nodes retrieved.</p><p><b>CONCLUSIONS</b>The number of retrieved lymph nodes is a prognostic factor for stage II and III colorectal cancer. More than 12 lymph nodes should be retrieved for better staging and prognosis. LNR is also a prognostic factor in stage II and III colorectal cancer. Regions of lymph nodes metastasis should be considered when evaluating the prognosis of patients using LNR.</p>

Influence of White Prepared Lateral Root of Aconite on Blood Biochemical Indicators in Normal and Kidney Yang Deficient Rats / 中国中医药信息杂志

Objective To explore the differences of blood biochemical indicators between normal and kidney Yang deficient rats administered orally different doses of white prepared lateral root of aconite.Method Eighty Sprague-Dawley(SD) male rats were divided randomly into normal group and kidney Yang deficient model group,forty rats in each group.After producing kidney Yang deficient model by injecting hydrocortisoni natrii succinas in intramuscular,normal and model rats were respectively and randomly divided into little,low,medium,great dose group and blank group,eight rats in each group.Those rats were administered orally with different concentrations of white prepared lateral root of aconite every day for two weeks.Twenty-four hours after the last oral administration,the blood were obtained and used for testing adrenocorticotrophic hormone(ACTH),cyclic adenosine monophosphate(cAMP),cyclic guanosine monophosphate(cGMP),glucose(GLU),cholesterol(CHO),alanine aminotransferase(ALT),urea nitrogen(BUN).Results Before taking medicine,model rats' cAMP/cGMP and ACTH were lower than normal rats',and they showed a trend of rise with adding dose.Before taking medicine,model rats' GLU was lower than normal rats'.With adding dose,model rats' GLU increased,however,normal rats' GLU reduced.When taken medium dose white prepared lateral root of aconite,model rats' CHO was higher than normal rats'.Taking medicine made both groups ALT rise,but normal rats' went up more quickly than model rats'.Model rats' BUN was higher than normal rats',and taking low dose or little dose medicine could lead to incline of reduction.Conclusion White prepared lateral root of aconite caused different blood biochemical effects on normal and kidney Yang deficient rats,and more remarkable toxicity effect on normal rats.

Effect of Scarring-moxibustion on Peyer’s Patch and T Cells Subsets of Intraepithelial Lymphocyte of Tumor-bearing Mice with Cyclophosphamide / 中国中医药信息杂志

Objective To explore the effect of scarring-moxibustion on Peyer’s patch and T cells subsets of intraepithelial lymphocyte of tumor-bearing mice with cyclophosphamide. Method The mucosal immune deficiency model was made by in site inoculating C-26 colon carcinoma with repeated intragastric administration of cyclophosphamide. The mice were treated with scarring- moxibustion for seventeen days after inoculation. The area of Peyer’s patch were measured, and T cells subsets of Lamina propria lymphocyte (LPL) were separated and detected by immunofluorescence test and flow cytometer. Result Tumor weight of tumor-bearing group was higher than cyclophosphamide group significantly (P