RESUMO
Despite increasing research that examines language features of online medical consultation (OMC) conversations in China, limited attention has been directed to how medical professionals purposefully present themselves in their biographies on OMC websites, an emerging genre of health communication, with even fewer comparative studies on traditional Chinese medicine (TCM) and Western medicine (WM) medical professionals in this regard. To fill these gaps, this study compares the personal claims and self-presentational strategies used in TCM and WM medical professionals' biographies on a Chinese OMC website. It is found that while Chinese TCM and WM medical professionals present themselves in similar ways, they also demonstrate some important differences. The similarities may be driven by their shared goal of building trust in the OMC context, whereas the differences may be ascribed to TCM-WM differences in clinical philosophies, education histories, clinical cultures, and medical practices.
RESUMO
Few real-world analyses of the ability of vaccines to protect against severe COVID-19 have been published. In this real-world study, we compared the prevalence of severe or critical COVID-19 between patients at our hospital who were not vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or who had been vaccinated partial, full, or booster course with the CoronaVac, containing inactivated virus propagated in Vero cells. Data from electronic health records were retrospectively analyzed for 4090 inpatients with COVID-19 who were treated at West China Hospital, Chengdu between December 6, 2022 and February 14, 2023. Clinicodemographic characteristics and COVID-19 severity were compared among patients who had been vaccinated 0, 1, 2 or more times with inactivated vaccine CoronaVac. To evaluate vaccine effectiveness over time, we plotted Kaplan-Meier curves with the percentage of patients with the outcome of severe or critical COVID-19 from the time of their last vaccine dose according to vaccination status. Ordinal logistic regression was used to assess associations between vaccination status and COVID-19 severity. Cox regression was used to identify risk factors for severe or critical COVID-19. Among the 4090 patients, 171 had been vaccinated partial and 423 twice with the full CoronaVac regimens, while 905 had been vaccinated three times (boosted). The prevalence of severe or critical COVID-19 among patients was 11 percentage points lower among those vaccinated (40%) at least twice than among those unvaccinated (51%) (pï¼0.001), while it was 10% points lower among those who had received a booster (41%) than among those unvaccinated (51%) (pï¼0.001). Protection against severe or critical COVID-19 due to vaccination was significantly weakened by being older than 65 years, being male, or having diabetes, chronic heart disease, autoimmune disease, or chronic lung disease. Completing a full course of immunization with inactivated vaccine CoronaVac against SARS-CoV-2 can reduce the risk of severe or critical COVID-19 due to the Omicron BA.5 subvariant.
Assuntos
COVID-19 , Chlorocebus aethiops , Animais , Humanos , Masculino , Feminino , COVID-19/epidemiologia , COVID-19/prevenção & controle , SARS-CoV-2 , Estudos Retrospectivos , Células Vero , China/epidemiologia , Vacinas de Produtos InativadosRESUMO
Vaccines have proven effective in protecting populations against COVID-19, including the recombinant COVID-19 vaccine (Sf9 cells), the first approved recombinant protein vaccine in China. In this positive-controlled trial with 85 adult participants (Sf9 cells group: n = 44; CoronaVac group: n = 41), we evaluated the safety, immunogenicity, and protective effectiveness of a heterologous boost with the Sf9 cells vaccine in adults who had been vaccinated with the inactivated vaccine, and found a post-booster adverse events rate of 20.45% in the Sf9 cells group and 31.71% in the CoronaVac group (p = 0.279), within 28 days after booster injection. Neither group reported any severe adverse events. Following the Sf9 cells vaccine booster, the geometric mean titer (GMT) of binding antibodies to the receptor-binding domain of prototype SARS-CoV-2 on day 28 post-booster was significantly higher than that induced by the CoronaVac vaccine booster (100,683.37 vs. 9,451.69, p < 0.001). In the Sf9 cells group, GMTs of neutralizing antibodies against pseudo SARS-CoV-2 viruses (prototype and diverse variants of concern [VOCs]) increased by 22.23-75.93 folds from baseline to day 28 post-booster, while the CoronaVac group showed increases of only 3.29-10.70 folds. Similarly, neutralizing antibodies against live SARS-CoV-2 viruses (prototype and diverse VOCs) increased by 68.18-192.67 folds on day 14 post-booster compared with the baseline level, significantly greater than the CoronaVac group (19.67-37.67 folds). A more robust Th1 cellular response was observed with the Sf9 cells booster on day 14 post-booster (mean IFN-γ+ spot-forming cells per 2 × 105 peripheral blood mononuclear cells: 26.66 vs. 13.59). Protective effectiveness against symptomatic COVID-19 was approximately twice as high in the Sf9 cells group compared to the CoronaVac group (68.18% vs. 36.59%, p = 0.004). Our study findings support the high protective effectiveness of heterologous boosting with the recombinant COVID-19 vaccine (Sf9 cells) against symptomatic COVID-19 of diverse SARS-CoV-2 variants of concern, while causing no apparent safety concerns.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Adulto , Animais , Humanos , COVID-19/prevenção & controle , Leucócitos Mononucleares , Células Sf9 , SARS-CoV-2 , Anticorpos Neutralizantes , Vacinas de Produtos InativadosRESUMO
Fungal pleural infections are infrequent and insidious, for which there are neither large clinical studies nor targeted guidelines to provide standardized treatment options. We reported 4 cases of fungal pleural infection and reviewed the cases of fungal pleural infections in previous studies to provide a basis for the diagnosis and treatment of fungal pleural infections. There were 2 females and 2 males with a mean age of 58.5 years in our data. The average time from onset to diagnosis was 30.25 days. Risk factors most frequently included pulmonary diseases (nâ =â 4) and malignancy (nâ =â 1). Two patients underwent pleural biopsy through a thoracoscope, and no pathogens were detected. Pleural fluid culture was positive in 2 out of 3 cases. The diagnoses were "possible" (nâ =â 1), "probable" (nâ =â 1), and "proven" (nâ =â 2). All patients received systemic antifungal therapy, and 3 received combined thoracic drainage. The outcomes were cured (nâ =â 1), improved (nâ =â 2) and lost to follow-up (nâ =â 1). We reviewed 12 cases of fungal pleural infection in previous studies. The diagnosis was confirmed via culture in 7 cases and via biopsy in 8 cases. The pathogen was Aspergillus in 7 cases. After a combination of systemic antifungal (nâ =â 12) and local treatment (nâ =â 11), 10 patients improved and 2 patients died. Diagnosis of fungal pleural infection should incorporate risk factors, clinical presentation and fungal evidence, with pleural fluid culture being an important and feasible mean of confirming the diagnosis; and treatment should be based on systemic antifungal therapy supplemented by topical therapy.
Assuntos
Doenças Transmissíveis , Micoses , Doenças Pleurais , Masculino , Feminino , Humanos , Pessoa de Meia-Idade , Antifúngicos/uso terapêutico , Micoses/terapia , Micoses/tratamento farmacológico , Pleura , Prognóstico , Doenças Transmissíveis/tratamento farmacológico , Doenças Pleurais/diagnóstico , Doenças Pleurais/terapiaRESUMO
The emergence of adapted variants of the SARS-CoV-2 virus has led to a surge in breakthrough infections worldwide. A recent analysis of immune responses in people who received inactivated vaccines has revealed that individuals with no prior infection have limited resistance to Omicron and its sub-lineages, while those with previous infections exhibit a significant amount of neutralizing antibodies and memory B cells. However, specific T-cell responses remain largely unaffected by the mutations, indicating that T-cell-mediated cellular immunity can still provide protection. Moreover, the administration of a third dose of vaccine has resulted in a marked increase in the spectrum and duration of neutralizing antibodies and memory B cells in vivo, which has enhanced resistance to emerging variants such as BA.2.75 and BA.2.12.1. These results highlight the need to consider booster immunization for previously infected individuals and the development of novel vaccination strategies. The rapid spread of adapted variants of the SARS-CoV-2 virus presents a significant challenge to global health. The findings from this study underscore the importance of tailoring vaccination strategies based on individual immune backgrounds and the potential need for booster shots to combat emerging variants. Continued research and development are crucial to discovering new immunization strategies that will effectively protect public health against the evolving virus.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Vacinas contra COVID-19/uso terapêutico , COVID-19/prevenção & controle , SARS-CoV-2 , Linfócitos B , Anticorpos Neutralizantes/genéticaRESUMO
Immunotherapy has significantly improved clinical outcomes of non-small cell lung cancer (NSCLC), however, along with the popularization of immunotherapy, immune resistance has become an unavoidable problem. Immunotherapy can induce extensive cellular and molecular alterations in the tumor microenvironment. Considering the mechanisms of immune resistance are not yet fully understood and the efficacy of standard chemotherapy regimens is limited, more effective coping strategies based on resistance mechanisms are urgently needed. In this review, we intend to summarize the known mechanisms of immune resistance and feasible strategies, so as to provide a foundation for clinicians to develop more individualized and precise regimens and finally improve patients' prognosis.â©.
Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Humanos , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Prognóstico , Imunoterapia , Microambiente TumoralRESUMO
OBJECTIVE: The aim of this study was to investigate the utility of a balloon rectal channel catheter (BRCC) in complex anal fistula magnetic resonance imaging (MRI). METHODS: A prospective study was done on 54 patients with clinical diagnosis of complex anal fistula. Eighteen patients had preoperative MRI before and after inserting BRCC. Another 18 underwent MRI with BRCC and the rest without. Fistulas, internal openings, extensions, and abscesses were identified on MRI and compared with surgical findings. Intraindividual and interindividual differences with and without BRCC were analyzed. RESULTS: In intragroup patients, the accuracy of MRI in detecting the number of fistulas, internal openings, extensions, and abscesses before and after using BRCC was 100%/100%, 67%/90%, 95%/95%, and 100%/100%, respectively, with a significant difference on internal openings (P < 0.05). In intergroup patients with and without BRCC, the accuracy was 98%/96%, 88%/71%, 97%/100%, and 100%/100%, respectively, still with a significant difference on internal openings (P < 0.05). CONCLUSIONS: Magnetic resonance imaging with BRCC may facilitate detection of internal openings in complex anal fistula.
Assuntos
Oclusão com Balão/instrumentação , Aumento da Imagem/instrumentação , Aumento da Imagem/métodos , Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/métodos , Fístula Retal/diagnóstico por imagem , Adulto , Idoso , Oclusão com Balão/métodos , Desenho de Equipamento , Análise de Falha de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fístula Retal/patologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto JovemRESUMO
OBJECTIVE: The aim of this study was to investigate the significance of the combined use of BMI and AEC in reducing the radiation dose of CT volume scans of the lumbar spine. METHODS: A prospective study was performed to continuously collect data from 50 patients (age range from 19 to 60 years, male versus female 20/30) whose BMIs were less than 25 kg/m
Assuntos
Vértebras Lombares/diagnóstico por imagem , Tomografia Computadorizada Espiral/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Doses de Radiação , Adulto JovemRESUMO
MTA2 is a member of metastasis associated family, which is highly expressed in several solid tumors and associated with tumor cells migration and invasion. Here, we report that MTA2 is acetylated at K152 and histone acetyltransferase p300 binds to and acetylates MTA2. Furthermore, mutation of the MTA2 acetylation site inhibits the growth of colorectal cancer cells and migration and invasion of Rat1 fibroblasts. These results reveal a novel post-translational regulation of MTA2 by the way of p300-dependent acetylation, which is important for tumor cells growth and migration and provides a potential target for clinical cancer research.
Assuntos
Neoplasias Colorretais/patologia , Proteína p300 Associada a E1A/metabolismo , Histona Desacetilases/metabolismo , Proteínas Repressoras/metabolismo , Acetilação , Sequência de Aminoácidos , Animais , Neoplasias Colorretais/metabolismo , Histona Desacetilases/química , Humanos , Dados de Sequência Molecular , Ligação Proteica , Proteínas Repressoras/química , Homologia de Sequência de AminoácidosRESUMO
When 85 cervical type spondylosis patients randomly lay on one's back and on one's right side the 8 different tresles and pillows. We survey indexes of the cervical spine anatomy, for example cervical arcs and angles of cervical spine and level line. We appraise relation of balance between different trestle or pillow and cervical spine. liquid needle-free injection, jet power, stagnation pressure