Broad neutralizing nanobody against SARS-CoV-2 engineered from pre-designed synthetic library

SARS-CoV-2 infection is initiated with Spike glycoprotein binding to the receptor of human angiotensin converting enzyme 2 via its receptor binding domain. Blocking this interaction is considered as an effective approach to inhibit virus infection. Here we report the discovery of a neutralizing nanobody, VHH60, directly produced from a humanized synthetic nanobody library. VHH60 competes with human ACE2 to bind the receptor binding domain of the Spike protein with a KD of 2.56 nM, inhibits infections of both live SARS-CoV-2 and pseudotyped viruses harboring wildtype, escape mutations and prevailing variants at nanomolar level. VHH60 also suppresses SARS-CoV-2 infection and propagation 50-fold better and protects mice from death two times longer than that of control group after live virus inoculation on mice. VHH60 therefore is a powerful synthetic nanobody with a promising profile for disease control against COVID19.

Relationship between abuse experience with suicidal ideation and behavior of junior middle school students in Chongqing / 中国学校卫生

Objective@#To explore the relationship between abuse experience with suicidal ideation and suicide attempts of junior middle school students, and to provide a reference for suicide prevention of junior middle school students.@*Methods@#Cluster sampling method were used to selct 10 289 junior middle school students from 25 districts and counties of Chongqing were included in the analysis of this study from July to September in 2020. And Questionnaire on Abuse in Childhood and Mental Health Scale for Middle School Students were applied to collect the data about demographic information, suicide ideation and behavior.@*Results@#The prevalence of suicidal ideation and suicide attempts among junior middle school students were 20.93% and 10.83%, respectively. Multivariate Logistic regression model found that after controlling for demographic variables and mental health, emotional abuse ( OR =2.07) and emotional neglect ( OR =2.03) showed higher correlations with suicidal ideation than the other three types of childhood abuse( OR physical neglect =1.19, OR physical abuse =1.60, OR sexual abuse =1.37, P <0.05); and sexual abuse ( OR =2.29) and physical neglect ( OR =1.87) showed higher associations with suicide attempt than the other three types of abuse( OR emotional abuse =1.63, OR emotional neglect =1.59, OR physical abuse =1.50, P <0.01).@*Conclusion@#All five types of child abuse were independent risk factors for suicidal ideation and suicide attempts, and emotional neglect and emotional abuse had a greater effect on suicidal ideation, sexual abuse and physical neglect had a greater effect on suicide attempts.

Epidemiological characteristics of metabolic syndrome and its correlation factors in Harbin / 中华内分泌代谢杂志

Objective To assess epidemiological characteristics of metabolic syndrome(MS)and its attributing factors in a resident sample aged over 35 living in both rural and urban areas of Harbin in Heilongjiang province.Methods A cross-over sectional and cluster sampling was carried out in 5 984 residents aged over 35 years living in the rural and urban areas of Harbin.Height,body mass,waist circumference,blood pressure,fasting blood glucose,triglyeeride,and high density lipoprotein cholesterol were determined.In this survey,the prevalence of MS and its attributing factors were analyzed by logistic regression model according to the diagnostic criteria of international diabetes federation in 2005.Results The prevalence of MS in this sample was 24.60%(male 22.49%,female 26.29%),and the standardized prevalence rate was 23.31%(male 22.12%,female 25.19%).Compared to female population,male participants showed a much lower prevalence;and compared to urban area population,rural participants showed a much lower prevalence(26.70% vs 20.05%,P<0.05).The prevalence of MS rose progressively with age in females.The individuals with MS presented increased body mass index,hyperglycemia,and hypertriglyceridemia.Gender,age,employment,education,smoking or drinking habit,and family history of hypertension were identified as maior risk factors of MS.Conclusion The prevalence of MS in a sample of residents aged over 35 in Harbin Was 24.60%.It becomes an public health problem requiring urgent attention for prevention and treatment.

A 50-year study on the epidemiology of hypertension in Heilongjiang Province of China / 中华内科杂志

Objective To assess the epidemiological characteristics of hypertension and its attributing factors in Heilongjiang province and establish a comprehensive basis for the prevention and control of hypertension in this region. Methods Using the stratified chunk method, a survey lasting 50 years was conducted on a sample of 299 677 (including i 58 782 males and 140 895 females) patients, aged 15 and above, residing in both rural and urban areas of Heilongjiang province from 1958 to 2007. Both blood pressure measurement and analysis on attributing factors of hypertension were carried out in 1958, 1979, 1991, 1999 and 2007. Results The prevalence of hypertension was significantly higher in Heilongjiang than in other provinces. It elevated annually, reaching a 3-fold increase in 50 years with an accelerating pace ( 17.06% to 25. 69% ) in the recent 8 years. Among the people examined, the prevalence of hypertension increased with aging. Furthermore, the prevalence of hypertension varied among different professions. Office workers had the highest prevalence (41.67%). Compared with female population, male participants had a much higher prevalence before the age of 55 (P < 0.0001 ). Body mass index, gender, hypertriglyceridemia, age, low-high density lipoprotein cholesterol and family history were identified as major risk factors for the development of hypertension in Heilongjiang province. However, the awareness (48. 90% ), treatment (25.33%) and control (4. 32% ) rates of hypertension in this region were relatively low. Conclusion The results of the present study identified Heilongjiang province as a high-risk region for hypertension. It also suggests the necessity to plan and implement actions for the effective prevention and treatment of hypertension in this region.

Use of a high thoracic epidural analgesia for treatment of end-stage congestive heart failure secondary to coronary artery disease: effect of HTEA on CHF.

We present the case of a patient with end-stage congestive heart failure (NYHA class IV) secondary to ischemic cardiomyopathy despite maximally medical therapy, who needed to have a coronary artery bypass graft (CABG) surgery but whose risk was considered too high due to his deteriorating cardiac function. Cardiac sympathetic blockade by high thoracic epidural analgesia (HTEA) was added to stabilize the patient's critical condition before surgery. HTEA was performed at the T1 through T5 levels with a catheter placed percutaneously and then lidocaine (0.5%, 3-5 ml) was given as intermittent injections through the epidural catheter. The combination of HTEA treatment resulted in a rapid hemodynamic and clinical improvement and no serious catheter-related complications occurred. This case suggests that HTEA seems to be an effective and safe adjuvant therapeutics and can be used as a short-term bridge to CABG or cardiac transplantation in patients with end-stage congestive heart failure.

Effect of thoracic epidural blockade on plasma fibrinogen levels in patients with dilated cardiomyopathy / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effects of thoracic epidural blockade (TEB) on plasma fibrinogen (FIB) levels.</p><p><b>METHODS</b>Thirty cases of dilated cardiomyopathy (DCM) were selected randomly into a TEB group and a control group. TEB patients were subjected to a persistent TEB (T1 - 5), and injected with 0.5% lidocaine 3 - 5 ml every two or four hours for four weeks in addition to routine medicine, while patients in the control group were given routine medicine only. Plasma concentrations of FIB were measured using the micro-capillary assay. Doppler echocardiography was performed before and after the treatment.</p><p><b>RESULTS</b>Plasma concentrations of FIB in two groups were greater than the normal value before the treatment. There was a significant decrease of plasma concentrations of FIB in the TEB group after the treatment (4.2 +/- 1.3 g/L vs 3.6 +/- 0.9 g/L, P < 0.05), but there was no significant change in the control group (4.2 +/- 1.2 g/L vs 4.3 +/- 1.9 g/L, P > 0.05). After four weeks of treatment, the left ventricular end diastolic diameters (LVEDD) of TEB patients were reduced (72 +/- 10 mm vs 69 +/- 10 mm, P < 0.05) and the left ventricular ejection fraction (LVEF) of TEB patients increased significantly (33% +/- 13% vs 44% +/- 14%, P < 0.05). In contrast, LVEDD (73 +/- 11 mm vs 73 +/- 12 mm, P > 0.05) and LVEF (32% +/- 14% vs 33% +/- 12%, P > 0.05) did not change significantly in the control group.</p><p><b>CONCLUSIONS</b>The results suggest that plasma FIB levels in patients with DCM were decreased by performing a TEB, in addition to a reduction of the enlarged cardiac cavity and an improvement in cardiac systolic dysfunction. TEB might contribute to lowering the occurrence of thrombus and thromboembolism in patients with DCM. TEB might be a promising therapeutic method to improve the prognosis of DCM patients.</p>

Hypertensive epidemiology in Heilongjiang Province in China / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To assess the epidemiology features of hypertension in Heilongjiang Province, China.</p><p><b>METHODS</b>From 1959 to 1999, 289,157 people in total, ages > or = 15-year old (male 154,091, female 135,066) were investigated four times by a stratified chunk method in rural and urban areas in Heilongjiang Province. After a staff training program, this survey on blood pressure and risk factors was carried out under a worldwide uniform protocol with standardized method and interrelated quality control regulation. Among these samples, 1615 people (male 824, female 791) received blood-lipid analysis.</p><p><b>RESULTS</b>The hypertensive incidence of Heilongjiang was much higher than the average level in China (P < 0.01) and it has gotten higher from 1959 to 1999, especially in the last ten years. It increased more in males than in females (P < 0.01). It was also higher with age. The mean age of hypertensive onset became ten years younger recently. It is different in different areas and professions. Age, BMI (body mass index), drinking alcohol, gender, history of maternal hypertension, high salt diet and professional status were the main risk factors for hypertension in Heilongjiang Province in China.</p><p><b>CONCLUSION</b>The prophylaxis and treatment of hypertension should be enhanced in this area.</p>