A cocktail containing two synergetic antibodies broadly neutralizes SARS-CoV-2 and its variants including Omicron BA.1 and BA.2

Neutralizing antibodies (NAbs) can prevent and treat infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, continuously emerging variants, such as Omicron, have significantly reduced the potency of most known NAbs. The selection of NAbs with broad neutralizing activities and the identification of conserved critical epitopes are still urgently needed. Here, we identified an extremely potent antibody (55A8) by single B-cell sorting from convalescent SARS-CoV-2-infected patients that recognized the receptor-binding domain (RBD) in the SARS-CoV-2 spike (S) protein. 55A8 could bind to wild-type SARS-CoV-2, Omicron BA.1 and Omicron BA.2 simultaneously with 58G6, a NAb previously identified by our group. Importantly, an antibody cocktail containing 55A8 and 58G6 (2-cocktail) showed synergetic neutralizing activity with a half-maximal inhibitory concentration (IC50) in the picomolar range in vitro and prophylactic efficacy in hamsters challenged with Omicron (BA.1) through intranasal delivery at an extraordinarily low dosage (25 g of each antibody daily) at 3 days post-infection. Structural analysis by cryo-electron microscopy (cryo-EM) revealed that 55A8 is a Class III NAb that recognizes a highly conserved epitope. It could block angiotensin-converting enzyme 2 (ACE2) binding to the RBD in the S protein trimer via steric hindrance. The epitopes in the RBD recognized by 55A8 and 58G6 were found to be different and complementary, which could explain the synergetic mechanism of these two NAbs. Our findings not only provide a potential antibody cocktail for clinical use against infection with current SARS-CoV-2 strains and future variants but also identify critical epitope information for the development of better antiviral agents.

Hetero-bivalent Nanobodies Provide Broad-spectrum Protection against SARS-CoV-2 Variants of Concern including Omicron

Following Delta, Omicron variant triggered a new wave of SARS-CoV-2 infection globally, adaptive evolution of the virus may not stop, the development of broad-spectrum antivirals is still urgent. We previously developed two hetero-bivalent nanobodies with potent neutralization against original WT SARS-CoV-2, termed aRBD-2-5 and aRBD-2-7, by fusing aRBD-2 with aRBD-5 or aRBD-7, respectively. Here, we resolved crystal structures of these nanobodies in complex with RBD, and found the epitope of aRBD-2 differs from that of aRBD-5, aRBD-7. aRBD-2 binds to a conserved epitope which renders its binding activity to all variants of concern (VOCs) including Omicron. Interestingly, although monovalent aRBD-5 and aRBD-7 lost binding to some variants, they effectively improved the overall affinity when transformed into the hetero-bivalent form after being fused with aRBD-2. Consistent with the high binding affinities, aRBD-2-5-Fc and aRBD-2-7-Fc exhibited ultra-potent neutralization to all five VOCs; particularly, aRBD-2-5-Fc neutralized authentic virus of Beta, Delta and Omicron with the IC50of 5.98[~]9.65 ng/mL or 54.3[~]87.6 pM. Importantly, aRBD-2-5-Fc provided in vivo prophylactic protection for mice against WT and mouse-adapted SARS-CoV-2, and provided full protection against Omicron in hamster model when administrated either prophylactically or therapeutically. Taken together, we found a conserved epitope on RBD, and hetero-bivalent nanobodies had increased affinity for VOCs over its monovalent form, and provided potent and broad-spectrum protection both in vitro and in vivo against all tested major variants, and potentially future emerging variants. Our strategy provides a new solution in the development of therapeutic antibodies for COVID-19 caused by newly emergent VOCs.

Omicron-specific mRNA vaccine elicits potent immune responses in mice, hamsters, and nonhuman primates

SARS-CoV-2 has infected more than 400 million people around the globe and caused millions of deaths. Since its identification in November 2021, Omicron, a highly transmissible variant, has become the dominant variant in most countries. Omicrons highly mutated spike protein, the main target of vaccine development, significantly compromises the immune protection from current vaccination. We develop an mRNA vaccine (SOmicron-6P) based on an Omicron-specific sequence. In mice, SOmicron-6P shows superior neutralizing antibodies inducing abilities to a clinically approved inactivated virus vaccine, a clinically approved protein subunit vaccine, and an mRNA vaccine (SWT-2P) with the same sequence of BNT162b2 RNA. Significantly, SOmicron-6P induces a 14.4[~]27.7-fold and a 28.3[~]50.3-fold increase of neutralizing activity against the pseudovirus of Omicron and authentic Omicron compared to SWT-2P, respectively. In addition, two doses SOmicron-6P significantly protects Syrian hamsters against challenge with SARS-CoV-2 Omicron variant and elicits high titers of nAbs in a dose-dependent manner in macaques. Our results suggest that SOmicron-6P offers advantages over current vaccines, and it will be helpful for those with weak immunity.

Harringtonine has the effects of double blocking SARS-CoV-2 membrane fusion

Fusion with host cell membrane is the main mechanism of infection of SARS-CoV-2. Here, we propose a new strategy to double block SARS-CoV-2 membrane fusion by using Harringtonine (HT), a small-molecule antagonist. By using cell membrane chromatography (CMC), we found that HT specifically targeted the SARS-CoV-2 S protein and host cell TMPRSS2, and then confirmed that HT can inhibit pseudotyped virus membrane fusion. Furthermore, HT successfully blocked SARS-CoV-2 infection, especially in the delta and Omicron mutant. Since HT is a small-molecule antagonist, it is minimally affected by the continuous variation of SARS-CoV-2. Our findings show that HT is a potential small-molecule antagonist with a new mechanism of action against SARS-CoV-2 infection, and thus HT mainly targets the S protein, and thus, greatly reduces the damage of the S proteins autotoxicity to the organ system, has promising advantages in the clinical treatment of COVID-19.

Single-dose AAV-based vaccine induces a high level of neutralizing antibodies and provides long-term protection against SARS-CoV-2 in rhesus macaques

Coronavirus disease 2019 (COVID-19), which is triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, continues to threaten global public health. Developing a vaccine that only requires single immunization but provides long-term protection for the prevention and control of COVID-19 is important. Here, we developed an adeno-associated virus (AAV)-based vaccine expressing a stable receptor-binding domain (SRBD) protein. The vaccine requires only a single shot but provides effective neutralizing antibodies (NAbs) over 598 days in rhesus macaques (Macaca mulatta). Importantly, our results showed that the NAbs were kept in high level and long lasting against authentic wild-type SARS-CoV-2, Beta, Delta and Omicron variants using plaque reduction neutralization test. Of note, although we detected pre-existing AAV2/9 antibodies before immunization, the vaccine still induced high and effective NAbs against COVID-19 in rhesus macaques. AAV-SRBD immune serum also efficiently inhibited the binding of ACE2 with RBD in the SARS-CoV-2 B.1.1.7 (Alpha), B.1.351 (Beta), P.1/P.2 (Gamma), B.1.617.2 (Delta), B.1.617.1/3(Kappa), and C.37 (Lambda) variants. Thus, these data suggest that the vaccine has great potential to prevent the spread of SARS-CoV-2.

Ultrapotent SARS-CoV-2 neutralizing antibodies with protective efficacy against newly emerged mutational variants

Accumulating mutations in the SARS-CoV-2 Spike (S) protein can increase the possibility of immune escape, challenging the present COVID-19 prophylaxis and clinical interventions. Here, 3 receptor binding domain (RBD) specific monoclonal antibodies (mAbs), 58G6, 510A5 and 13G9, with high neutralizing potency blocking authentic SARS-CoV-2 virus displayed remarkable efficacy against authentic B.1.351 virus. Each of these 3 mAbs in combination with one neutralizing Ab recognizing non-competing epitope exhibited synergistic effect against authentic SARS-CoV-2 virus. Surprisingly, structural analysis revealed that 58G6 and 13G9, encoded by the IGHV1-58 and the IGKV3-20 germline genes, both recognized the steric region S470-495 on the RBD, overlapping the E484K mutation presented in B.1.351. Also, 58G6 directly bound to another region S450-458 in the RBD. Significantly, 58G6 and 510A5 both demonstrated prophylactic efficacy against authentic SARS-CoV-2 and B.1.351 viruses in the transgenic mice expressing human ACE2 (hACE2), protecting weight loss and reducing virus loads. These 2 ultrapotent neutralizing Abs can be promising candidates to fulfill the urgent needs for the prolonged COVID-19 pandemic.

Comparative study on the perioperative results of different myocardial revasculariza-tion strategy in the treatment of elderly patients with coronary three-vessel disease / 中国胸心血管外科临床杂志

@#Objective    To compare the perioperative results of hybrid coronary revascularization (HCR), off-pump coronary artery bypass (OPCAB) and percutaneous coronary intervention (PCI) in elderly patients with three-vessel coronary artery disease involving left anterior descending (LAD) branch and explores the safety of surgery. Methods    We prospectively enrolled patients with coronary heart disease over 65 years who were admitted to General Hospital of People’s Liberation Army from January 2018 to September 2019. Coronary angiography results were all three-vessel lesions involving the anterior descending artery. After preoperative examination and assessment by the cardiovascular team, all patients were suitable for OPCAB or PCI treatment. According to the patient’s preference, HCR, OPCAB or PCI were performed. The preoperative baseline data and perioperative results were collected, and SPSS 22.0 was used for statistical analysis. Results    A total of 110 patients met the criteria and were included in the study, 28 in the HCR group, 45 in the OPCAB group, and 37 in the PCI group, with an average age of 71.4±5.6 years. There was no statistical difference in the preoperative baseline data of patients among the three groups. The intubation time (P=0.039), perioperative drainage volume (P<0.001), blood transfusion (P=0.021) in the HCR group were lower than those in the OPCAB group. There was no statistical difference in the main organ adverse events (MOAE, P=0.096) and in-hospital mortality (P=0.784) among the three groups of patients. The use of antibiotics in the PCI group was significantly lower than the other two groups (P<0.001). Conclusion    HCR combines the advantage of CABG and PCI including proved long-term patency rate with left internal mammary artery-LAD grafting, less trauma and superior long-term patency with PCI in non-LAD territory. Compared with OPCAB and PCI, there is no increase in perioperative major organ adverse events and in-hospital mortality. It is a safe and reliable minimally invasive myocardial revascularization technique for elderly patients with three-vessel coronary artery disease involving the anterior descending artery.

The feasibility of convalescent plasma therapy in severe COVID-19 patients: a pilot study

Currently, there are no approved specific antiviral agents for 2019 novel coronavirus disease (COVID-19). In this study, ten severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 days after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 days. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 days. Several parameters tended to improve as compared to pre-transfusion, including increased lymphocyte counts (0.65x109/L vs. 0.76x109/L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesionswithin 7 days. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was welltolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials. Significance StatementCOVID-19 is currently a big threat to global health. However, no specific antiviral agents are available for its treatment. In this work, we explored the feasibility of convalescent plasma (CP) transfusion to rescue severe patients. The results from 10 severe adult cases showed that one dose (200 mL) of CP was welltolerated and could significantly increase or maintain the neutralizing antibodies at a high level, leading to disappearance of viremia in 7 days. Meanwhile, clinical symptoms and paraclinical criteria rapidly improved within 3 days. Radiological examination showed varying degrees of absorption of lung lesions within 7 days. These results indicate that CP can serve as a promising rescue option for severe COVID-19 while the randomized trial is warranted.

Analysis of surveillance results of human brucellosis monitoring sites in Jiangsu Province from 2013 to 2017 / 中华地方病学杂志

Objective:To explore the epidemic situation and brucellosis in key occupational populations of brucellosis monitoring sites in Jiangsu Province, and provide a basis for development of prevention and control strategies against brucellosis.Methods:From 2013 to 2017, according to the requirements of the "National Brucella Surveillance Programme", two brucellosis monitoring sites in Yixing City of Wuxi and Huaiyin District of Huai'an, Jiangsu Province were established to monitor brucellosis. Brucellosis epidemic data were collected and analyzed of the two monitoring sites in Yixing City and Huaiyin District from 2013 to 2017 (data were from Jiangsu Provincial Legal Infectious Disease Reporting System). Blood samples were collected from the general occupational populations (health check-up population) and the key occupational populations (people engaged in livestock trading, livestock slaughtering, and the fur, milk and meat processing) in the monitoring sites. Tiger red plate agglutination test (RBPT) and serum tube agglutination test (SAT) were used for serological examination. Results:From 2013 to 2017, a total of 18 cases of brucellosis were reported at the two monitoring sites in Yixing City and Huaiyin District, Jiangsu Province, including 13 males and 5 females, with a male to female sex ratio of 2.6∶1.0; the age of onset was mainly 35 - 64 years, accounting for 72.22% (13/18); the time of onset was mainly from January to June, accounting for 94.44% (17/18); and the occupational distribution was mainly farmers, accounting for 77.78% (14/18); there was no epidemic and outbreaks of brucellosis. A general occupational populations survey was conducted in 17 743 cases, serological tests were negative, no infection and no signs and symptoms were found in the two monitoring sites. In 2013 - 2017, a total of 113 cases of serological tests were positive in the key occupational populations of brucellosis in Jiangsu Province, with a positive rate of 7.83% (113/1 444), and the overall trend was downward year by year ( t = 6.463, P < 0.05). Among them, the positive rates in Yixing City and Huaiyin District were 11.79% (106/899) and 1.28% (7/545), respectively. The difference between different regions was statistically significant (χ 2 = 51.926, P < 0.01). The positive rates of occupational groups engaged in livestock trading, livestock slaughtering, and the fur, milk and meat processing were 5.10% (20/392), 9.74% (49/503), and 8.01% (44/549), respectively. The differences were statistically significant between different occupations (χ 2 = 6.618, P < 0.05); and the positive rates of livestock slaughtering occupations and the fur, milk and meat processing occupations were higher than that of livestock trading occupations ( P < 0.05). Conclusions:The positive rate of brucellosis in key occupational populations has showed a general downward trend, the livestock slaughtering occupations and the fur, milk and meat processing occupations are more susceptible to Brucella infection. It is still necessary to strengthen the health education for the key occupational populations of brucellosis and inspection and quarantine work for prevention of the epidemic of brucellosis in humans.

Comparison of quality of life and long-term outcomes following mitral valve replacement through robotically assisted versus median sternotomy approach / 南方医科大学学报

OBJECTIVE@#To compare the mid- and long-term outcomes of patients receiving mitral valve replacement through robotically assisted and conventional median sternotomy approach.@*METHODS@#The data of 47 patients who underwent da Vinci robotic mitral valve replacement in our hospital between January, 2007 and December, 2015 were collected retrospectively (robotic group). From a total of 286 patients undergoing mitral valve replacement through the median thoracotomy approach between March, 2002 and June, 2014, 47 patients were selected as the median sternotomy group for matching with the robotic group at a 1:1 ratio. The perioperative data and follow-up data of the patients were collected, and the quality of life (QOL) of the patients at 30 days and 6 months was evaluated using the Quality of Life Short Form Survey (SF-12). The time of returning to work postoperatively and the patients' satisfaction with the surgical incision were compared between the two groups.@*RESULTS@#All the patients in both groups completed mitral valve replacement successfully, and no death occurred during the operation. In the robotic group, only one patient experienced postoperative complication (pleural effusion); in median sternotomy group, one patient received a secondary thoracotomy for management of bleeding resulting from excessive postoperative drainage, and one patient died of septic shock after the operation. The volume of postoperative drainage, postoperative monitoring time, ventilation time, and postoperative hospital stay were significantly smaller or shorter in the robotic group than in the thoracotomy group (@*CONCLUSIONS@#Robotically assisted mitral valve replacement is safe and reliable. Compared with the median sternotomy approach, the robotic approach is less invasive and promotes faster postoperative recovery of the patients, who have better satisfaction with the quality of life and wound recovery.

Analysis of pulmonary tuberculosis epidemic among students in Yixing City, 2014-2018 / 公共卫生与预防医学

Objective To analyze the treatment of pulmonary tuberculosis among students in Yixing City from 2014 to 2018, and to provide a basis for prevention and control of pulmonary tuberculosis in students. Methods A descriptive epidemiology method was used to analyze the cases of pulmonary tuberculosis in students from 2014 to 2018 in Yixing City. Results There were 1,614 pulmonary tuberculosis cases in 2014~2018 in Yixing City, among which 135 were students with pulmonary tuberculosis, accounting for 8.36% of the total cases. The average annual incidence rate was 2.27/100,000. There were more males than females. The age distribution ranged from 16 to 18 years old. High school students were the main population, and the peak incidence was mainly concentrated in June and December. Conclusion The tuberculosis epidemic in Yixing City has generally shown a downward trend, but the number of cases of tuberculosis in students has been on the rise in recent years, mainly due to the outbreak. The cooperation between the health and education departments should be strengthened in the future. Early detection of the cases is of great significance.

Cure ofpancreaticoduodenal anastomotic leakage after simultaneous pancreas-kidney transplantation with enteric drainage:a case report and literature review / 中华器官移植杂志

Objective To summarize the experience of one case of anastomotic leakage after simultaneous pancreas-kidney transplantation (SPK ) with enteric drainage .Methods One case of type 2 diabetes mellitus complicated with end-stage nephropathy undergoing SPK was retrospectively analyzed .Iliac venous systemic circulation was employed for pancreatic venous reflux ,transplanted pancreas exocrine via enteric drainage and side-to-side anastomosis between donor pancreaticoduodenum and recipient jejunum . Pancreatoduodenal anastomotic leakage occurred at 12 days post-operation .During re-operation ,Roux-en-Y anastomosis was established between donor pancreaticoduodenum and recipient jejunum .And the relevant domestic and foreign literatures were searched .Results The follow-up time was 3 month after a second operation .Recipient pancreas and kidney transplantation survived well . There was no onset of enteric leakage .The incidence of anastomotic leakage varies greatly between different transplantation centers both at home and abroad .The incidence ranged from 3 .6％ to 11 .3％ .And the risk of pancreatic loss was as high as 54 .6％ .Conclusions As a severe postoperative complication ,anastomotic fistula after SPK may cuase abdominal infection . Even after reparing enteric fistula , the risk of leakage remains high . Roux-en-Y anastomosis is other therapeutic option .

Study on the Quality Control Index System of Pharmaceutical Care in Medical Institutions Based on Delphi Method / 中国药房

OBJECTIVE： To provide reference for improving the level of pharmaceutical care in medical institution， and realizing the precision of pharmaceutical care. METHODS： A sampling survey of third grade class A hospitals in Guangxi was conducted on the basis of Guangxi Hospital Pharmaceutical Administration Quality Control Center. Based on the results of literature analysis and international standard， by using Delphi method， the expert consultation form was issued by E-mail and field investigation； the results of four rounds of expert consultation were analyzed and summarized. Pharmaceutical care quality control index system was established in medical institutions. RESULTS & CONCLUSIONS： All experts （100％） agreed that pharmaceutical care in medical institutions was very important and required a quality control index system. Finally， 5 first-level indicators （including the construction of pharmaceutical care management organizational framework， rational drug use management， pharmaceutical care professional capacity management， pharmaceutical care monitoring management and characteristic pharmaceutical care management） and 26 second-level indicators were fitted according to results of expert consultation. Among first-level indicators， the indicators of “the construction of pharmaceutical care management organizational framework”， “rational drug use management” and “pharmaceutical care professional competence management” were generally considered as important quality control indicators by experts； the proportion of “very important” and “important” were 96.65％， 100％ and 100％. Among second- level indicators， the indicators of “organization construction”“system construction”“prescription drug use management”“hospitalization medical order review”“adverse drug reaction monitoring”“medicine knowledge”“clinical knowledge” were generally considered as important quality control indicators by experts； the proportion of “very important” and “important” were 95.65％， 95.65％， 100％， 95.66％， 96.65％， 100％ and 91.30％. The quality control index system of pharmaceutical care in medical institutions fitted by this research institute is authoritative. Now， 15 medical institutions in Guangxi Zhuang Autonomous Region have been pilot implemented after audited and finalised by Guangxi  Hospital Pharmaceutical Administration Quality Control Center.

Improvement Effects of Panax Notoginsenosides on Renal Fibrosis in Cisplatin-induced Renal Injury Rats and Its Effects on the Expression of Renal Fibrosis Related Factors / 中国药房

OBJECTIVE： To study improvement effects of Panax notoginsenoside（PNS） on cisplatin-induced renal injury model rats and its effects on related factors. METHODS： Totally 72 SD rats were randomly divided into blank group， model group， positive drug group and PNS low-dose， medium-dose， high-dose groups， with 12 rats in each group. Except for blank group， other groups were given cisplatin via tail vein （3 mg/kg×4 times） to establish renal injury model. Since the first day after the first injection of cisplatin， positive group was given anfostine solution intraperitoneally （1.0 mg/kg）； PNS groups were given PNS solution intraperitoneally （15.63， 31.35， 62.70 mg/kg）； blank group and model groups were given constant volume of normal saline 0.2 mL， for consecutive 60 d. The 24 h urine of rats was collected； the contents of β-N-acetylaminoglycosidase（NAG） and 24 h urine protein （Upro/24 h） were detected； the serum contents of Scr and BUN were detected. mRNA and protein expression of CTGF， TGF-β1， Col-1， TIMP-1 and PAI-1 in renal tissue were determined by RT-PCR and immunohistochemistry respectively. RESULTS： Compared with blank group， the contents of NAG and Upro/24 h in urine， serum contents of Scr and BUN， mRNA and protein expression levels of CTGF， TGF-β1， Col-1， TIMP-1 and PAI-1 in renal tissue were increased significantly （P＜0.05）. Compared with model group， the contents of above urine and serum biochemical indicators were decreased significantly in PNS groups； mRNA expression of CTGF and TGF-β1 and protein expression of CTGF， TGF-β1， Col-1 and TIMP-1 in renal tissue of rats in PNS groups， mRNA expression of Col-1 in PNS high-dose group， and mRNA expression of TIMP-1 and protein expression of PAI-1 in PNS medium-dose and high-dose groups were decreased significantly （P＜0.05）. Compared with positive group， the contents of NAG and Upro/24 h in urine were decreased significantly in PNS medium-dose and high-dose groups （P＜0.05）. CONCLUSIONS： PNS can effectively improve the renal function of cisplatin-induced renal injury model rats， and relieve cisplatin-induced renal fibrosis by decreasing the expression of renal fibrosis related factors as CTGF， TGF-β1， Col-1， TIMP-1 and PAI-1 in renal tissue.

Correlation between characteristic parameters of photoplethysmography and severity of coronary artery lesions / 中华老年心脑血管病杂志

Objective To study the correlation between characteristic parameters of photoplethysmography( PPG)and severity of coronary artery lesions.Methods Two hundred and twenty-six CHD patients who underwent CAG in our hospital from August 2018to November 2018were divided into single-vessel lesion group(n=55),double-vessel lesion group(n=74)and multi-vessel lesion group(n=97)according to their CAG.Their stiffness index(SI),crest time(CT),normalized crest time(NCT)and crest time ratio(CTR)were recorded by PPG and analyzed by correlation analysis.Results The SI was significantly different in single-vessel lesion group,double-vessel lesion group and multi-vessel lesion group(6.479±0.819m/s,6.692±1.051m/s and 6.943±1.096m/s,P=0.024).No significant difference was detected in CT,NCT and CTR among single-vessel lesion group,double-vessel lesion group and multi-vessel lesion group(P＞0.05).The SI was positively correlated with the severity of coronary artery lesions(r=0.162,P=0.015).Conclusion The SI is correlated with the severity of coronary artery lesions,which is of a certain value in predicting the severity of coronary artery lesions.

Warming needling combined with decoction for arteriosclerosis obliterans with stasis / 中国针灸

<p><b>OBJECTIVE</b>To observe the effect difference of warming needling combined with decoction and ciloprost for arteriosclerosis obliterans (ASO) with stasis.</p><p><b>METHODS</b>A total of 96 ASO patients with stasis were randomly assigned into a combination group and a western medication group, 48 cases in each group. Anti-hypertension, glucose-lowering and lipid lowering therapies were applied in the two groups. Ciloprost was prescribed orally in the western medication group, twice a day, 100 mg a time. The main acupoints in the combination group were Sanyinjiao (SP 6), Yinlingquan (SP 9), Zusanli (ST 36), Guanyuan (CV 4), and Xuehai (SP 10), matched with Yanglingquan (GB 34) and Weizhong (BL 40). Warming needling was used at Sanyinjiao (SP 6), Zusanli (ST 36), Xuehai (SP 10) and Guanyuan (CV 4), 5 times a week, once a day, 20 min a time. At the same time, self-made decoction was applied in the combination group, 1 dose a day, twice a day. All the treatment was given for continuous 3 courses, 1 month as a course. The indexes were the symptom scores for cool limb skin, sour swelling, numbness, pain, abnormal complexion, ankle brachial index (ABI) and blood biochemical indexes, including fasting blood-glucose (FPG), triacylglycerol (TG), cholesterol total (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), glutamic-pyruvic transaminase (ALT), glutamic-oxalacetic transaminase (AST), serum creatinine (Scr) and blood urea nitrogen (BUN). The adverse reactions were recorded. The clinical effect was evaluated. Two-month follow-up was carried out.</p><p><b>RESULTS</b>After treatment, the symptom scores for cool limb skin, sour swelling, numbness, pain, abnormal complexion and total score decreased in the two groups (all <0.05), with better results in the combination group (all <0.05). The bilateral ABI were higher than those before treatment in the two groups (all <0.05), with better results in the combination group (both <0.05). The FPG, TG, TC, HDL-C, LDL-C, ALT, AST, Scr, BUN before and after treatment had no statistical significance in the two groups (all >0.05). There was no adverse reaction on acupuncture and moxibustion. The total effective rate of the combination group was 95.8% (46/48), which was better than 91.7% (44/48) of the western medication group (<0.05). The recurrence and aggravation rate in the combination group was 8.7% (4/46), which was lower than 18.2% (8/44) in the western medication group (<0.05).</p><p><b>CONCLUSION</b>Warming needling combined with decoction for ASO are better than simple oral ciloprost, with safety.</p>

Therapeutic effect of Fasudil combined Salmeterol Xinafoate and fluticasone propionate powder for in-halation on patients with COPD complicated PAH / 心血管康复医学杂志

Objective:To explore therapeutic effect of Fasudil combined Salmeterol Xinafoate and fluticasone propio‐nate powder for inhalation (Seretide) on patients with chronic obstructive pulmonary disease (COPD) combined pul‐monary arterial hypertension (PAH ) .Methods :A total of 120 patients ,who hospitalized in our department from Jan 2013 to Oct 2014 and conformed to diagnostic standards of COPD and PAH ,were selected .According to ran‐dom number table ,they were equally divided into routine treatment group (received routine therapeutic measures ) , Fasudil group (received Fasudil based on routine treatment group ) and combined treatment group (received Fasudil combined Seretide based on routine treatment ) . Pulmonary function indexes , mean pulmonary arterial pressure (mPAP) ,pulmonary arterial systolic pressure (PASP) ,6min walking distance (6MWD) and blood gas indexes were observed and compared among three groups before and after treatment .Results:Compared with routine treatment group after treatment ,there were significant reductions in mPAP [(54.1 ± 10.3) mmHg vs .(51.3 ± 9.5) mmHg vs . (48.5 ± 10.5) mmHg] and PASP [ (72.4 ± 9.7) mmHg vs .(63.4 ± 9.3) mmHg vs .(61.6 ± 9.1) mmHg] ,and sig‐nificant rise in 6MWD [ (259.4 ± 37.0) m vs .(274.2 ± 36.5) m vs .(288.3 ± 47.5) m] ,forced expiratory volume in one second [FEV1 ,(1.44 ± 0.32) L vs .(1.59 ± 0.38) L vs .(1.87 ± 0.34) L] and FEV1/forced vital capacity (FVC) [ (47.2 ± 11.9)% vs .(50.3 ± 12.1)% vs .(54.6 ± 11.7)% ];significant rise in partial pressure of oxygen in artery [PO2 ,(64.3 ± 9.8) mmHg vs .(68.9 ± 8.2) mmHg vs .(76.9 ± 9.5) mmHg] and saturation of arterial blood oxygen [SaO2 ,(65.0 ± 8.2)% vs .(71.0 ± 9.8)% vs .(76.8 ± 9.4)% ] ,and significant reduction in partial pressure of carbon dioxide in artery [PCO2 ,(63.6 ± 9.5) mmHg vs .(58.5 ± 9.6) mmHg vs .(51.3 ± 7.9) mmHg] in Fasud‐il group and combined treatment group ,and those of combined treatment group were significantly improved com‐pared to those of Fasudil group , P<0.05 or <0.01. Actual base excess of combined treatment group was signifi‐cantly higher than the other two groups , P<0. 01 both . Conclusion:Fasudil combined Seretide can significantly im‐prove pulmonary function reduction ,improve PAH ,quality of life and prognosis in COPD + PAH patients .

Effect of integrated traditional chinese and western medicine on hyperthyroidism and on blood glucose metabolism disorder / 中国生化药物杂志

Objective To explorer effect of integrated traditional chinese and western medicine on hyperthyroidism and on blood glucose metabolism disorder. Methods 70 cases of patients with hyperthyroidism during March 2014 to March 2016 were randomly divided into two groups with 35 cases respectively ,and control group were treated with propylthiouracil,while observation group were treated with traditional chinese medicine on the basis of the control group.Before and after treatment,serum thyroid stimulating hormone(TSH), triiodothyronine(FT3), thyroxine(FT4 ) and fasting plasma glucose (FPG) , 2 hours postprandial blood glucose(2hPG)were detected respectively,the curative effect and adverse reactions were observed. Results After treatment,the levels of TSH,FT3 and FT4 of the both two groups were significantly ameliorative (P<0.05),and FT3 ,FT4 of the observation group were significantly more ameliorative than the control group (P<0.05).The levels of FPG,2hPG of two groups were significantly depressed (P<0.05),and those of the observation group were significantly lower than those of the control group (P<0.05).The clinical effective rate of the observation group was significantly higher than those of the control group (P<0.05).Adverse reactions of two groups were not significantly different. Conclusion The treatment of hyperthyroidism with traditional chinese and western medicine can significantly improve the clinical curative effect and regulate the blood glucose metabolism, and the safety is high.

Effects of Panax Notoginsenosides on Proliferation and Oxidation Indices of Cisplatin-induced Nephroxicity in HK-2 Cells / 中国药师

Objective:To study the effects of panax notoginsenosides on the proliferation and oxidation indices of cisplatin-induced nephroxicity in HK-2 cells. Methods:HK-2 cells were cultured in vitro till the number was up to 1 × 106/ml. The cells were inoculated in 96-well culture plate and randomly divided into six groups:normal saline ( NS) group,the model group, the positive control group and the high dose group , medium dose group and low dose group of panax notoginsenosides ( PNS) . The nephroxicity model was dupli-cated with the addition of cisplatin (the final concentration was 6. 25μg·L-1). The model group, positive control group and the three panax notoginsenosides groups was treated with saline solutions, amifostine, panax notoginsenosides at the dose of 100,50 and 25 mg· L-1 , respectively. The cell viability was detected with an MTT method, the content of MDA and the activity of SOD, GSH-PX and LDH were measured and the cell structure was observed. DCFH-DA was used as the fluorescence probe to detect the level of ROS by a fluorescence microplate reader. Results:Compared with those in the model group, the cell viability and the activity of SOD and GSH-PX in the three PNS groups and the positive control group significantly increased (P<0. 05);the content of MDA, the level of ROS and the activity of LDH significantly decreased (P<0. 05); the cell structure was significantly improved. Conclusion: PNS can pro-mote the proliferation of HK-2 cells in vitro, and improve the biochemical parameters and enzyme levels. The results suggest that PNS has a protective effect on HK-2 cell,and the protective mechanisms may be related with its antioxidant effect.

Effect of tamsulosin hydrochloride combined with clear stasis and kidney decoction on chronic prostatitis and its influence on immune function and urine flow rate / 中国医师进修杂志

Objective To investigate the efficacy of tamsulosin hydrochloride combined with clear stasis and kidney decoction on chronic prostatitis and its influence on immune function and urine flow rate. Methods In this study, 115 patients with chronic prostatitis were selected and divided into treatment group (58 patients) and control group (57 patients) according to the random number table method.The control group used tamsulosin hydrochloride treatment, and the treatment group was treated with clear stasis and kidney decoction on the basis of the control group.The patients in two groups were treated continuously for 4 weeks. The clinical efficacy was evaluated and compared, the changes of immune function, free flow rate and maximum urinary flow rate were measured and compared between two groups.Results The total effective rate of the treatment group was significantly higher than that of the control group:94.83%(55/58)vs.78.95%(45/57)P<0.05.The levels of IgA and IgG before treatment in two groups had no significant differences(P>0.05).After treatment, the levels of IgA and IgG in two groups significantly decreased compared with those before treatment(P<0.05), and the levels of IgA and IgG in treatment group were significantly lower than those in control group(P<0.05).The levels of NIH-CPSI scores and WBC before treatment in two groups had no significant differences (P > 0.05). After treatment, The levels of NIH-CPSI scores and WBC significantly decreased compared with those before treatment(P<0.01), and the levels of NIH-CPSI scores and WBC in treatment group were significantly lower than those in control group (P < 0.01). After treatment lecithin (+- ++) and (+++- +++++) in treatment group was 3,55 cases, in control group was 12,45 cases, and there was significant difference (χ2= 6.392, P = 0.011). Before treatment, the levels of free urine flow rate, maximum urine flow rate, maximum urine flow rate time and residual urine volume in two groups had no significant differences(P>0.05). After treatment, the levels of free urine flow rate and maximum urine flow rate in two groups significantly increased, the levels of maximum urine flow rate time and residual urine volume in two groups significantly decreased, and there were significantly differences compared those before treatment (P < 0.05).The levels of free urine flow rate, maximum urine flow rate, maximum urine flow rate time and residual urine volume between two groups had significant differences after treatment(P<0.01).The adverse reaction rate in control group and treatment group was 3.51%(2/57),6.90%(4/58), and there was no significant difference(χ2=0.414,P=0.667).Conclusions Tamsulosin hydrochloride combined with clear stasis and kidney decoction in patients with chronic prostatitis can significantly relieve the clinical symptoms and improve the immune function of the local prostate, and the effect is exact.