Innate immune sensing of self-derived double-stranded RNA by RIG-I-MAVS-TNF-α regulates the survival and senescence fate of SARS-2-S syncytia

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains an important health threat. Syncytial formation by infected cells mediated by the SARS-CoV-2 spike protein (SARS-2-S) is a hallmark of COVID-19-associated pathology. Although SARS-CoV-2 infection evokes cellular senescence, as in other viruses, the direct link between SARS-2-S-induced syncytia with senescence in the absence of viral infection and their senescence fate determinants remain unknown. Here, we show that syncytia formed by cells expressing exogenously delivered SARS-2-S exhibited a senescence-like phenotype in vitro and that SARS-2-S mRNA induced senescence phenotype in vivo. Extracellular vesicles (EVs) containing SARS-2-S also induced senescent syncytium formation independent of the de novo synthesis of SARS-2-S. Mechanistically, we show that the accumulation of endogenous dsRNA, partially that whose formation is induced by activation of the unfolded protein response (UPR), in SARS-2-S syncytia triggers RIG-I-MAVS signalling to drive the TNF--dependent survival and senescence fate of SARS-2-S syncytia. Our findings suggest that the fusogenic ability of SARS-2-S might contribute to the side effects of particular COVID-19 vaccines or perhaps long COVID-19 syndrome and provide insight into how these effects can be prevented.

Impact of various vaccine boosters on neutralization against Omicron following prime vaccinations with inactivated or adenovirus-vectored vaccine

Since the first report on November 24, 2021, the Omicron SARS-CoV-2 variant is now overwhelmingly spreading across the world. Two SARS-CoV-2 inactivated vaccines (IAVs), one recombinant protein subunit vaccine (PRV), and one adenovirus-vectored vaccine (AdV) have been widely administrated in many countries including China to pursue herd immunity. Here we investigated cross-neutralizing activities in 341 human serum specimens elicited by full-course vaccinations with IAV, PRV and AdV, and by various vaccine boosters following prime IAV and AdV vaccinations. We found that all types of vaccines induced significantly lower neutralizing antibody titers against the Omicron variant than against the prototype strain. For prime vaccinations with IAV and AdV, heterologous boosters with AdV and PRV, respectively, elevated serum Omicron-neutralizing activities to the highest degrees. In a mouse model, we further demonstrated that among a series of variant-derived RBD-encoding mRNA vaccine boosters, it is only the Omicron booster that significantly enhanced Omicron neutralizing antibody titers compared with the prototype booster following a prime immunization with a prototype S-encoding mRNA vaccine candidate. In summary, our systematical investigations of various vaccine boosters inform potential booster administrations in the future to combat the Omicron variant.

Effects of high-frequency repetitive transcranial magnetic stimulation combined with electrical stimulation on dysphagia after stroke / 中国基层医药

Objective:To investigate the clinical efficacy of high-frequency repetitive transcranial magnetic stimulation combined with electrical stimulation in patients with dysphagia after stroke.Methods:Seventy-two stroke patients with dysphagia who received treatment in The First Hospital of Jiaxing from February 2019 to February 2020 were included in this study. They were randomly assigned to receive either electrical stimulation (control group, n = 36) or high-frequency repetitive transcranial magnetic stimulation combined with electrical stimulation (observation group, n = 36) for 2 weeks. Changes in serum brain-derived neurotrophic factor, neuron-specific enolase, and vascular endothelial growth factor levels after treatment relative to before treatment were observed in each group. Scores of the swallowing function assessment scale, neurological deficit, and quality of life were compared between the control and observation groups. Results:After treatment, serum levels of brain-derived neurotrophic factor and vascular endothelial growth factor in the observation group were (7.98 ± 1.14) μg/L, (168.78 ± 10.28) ng/L, respectively, which were significantly higher than those in the control group [(5.80 ± 1.10) μg/L, (110.34 ± 10.47) ng/L, t = 8.26, 23.90, both P < 0.01]. Serum neuron-specific enolase level was significantly lower in the observation group than in the control group [(7.57 ± 1.17) μg/L vs. (10.66 ± 1.30) μg/L, t = 10.60, P < 0.001). The scores of swallowing function assessment scale and neurological deficits in the observation group were (2.47 ± 1.16) points and (7.03 ± 1.14) points, respectively, which were significantly lower than those in the control group [(5.75 ± 1.10) points, (9.66 ± 1.20) points, t = 12.31, 9.53, both P < 0.001]. Total effective rate [97.22% (35/36) vs. 77.78% (28/36)] and the score of swallowing quality of life questionnaire [(160.40 ± 8.32) points vs. (146.74 ± 8.10) points] were significantly higher in the observation group than in the control group ( χ2 = 4.57, P = 0.03, t = 7.25, P < 0.001). Conclusion:High-frequency repetitive transcranial magnetic stimulation combined with electrical stimulation can greatly improve neurological function and swallowing function of stroke patients with dysphagia. The combined therapy is of certain clinical value and innovation.

Application of microprobe endoscopic ultrasonography in diagnosis and treatment of protuberant lesions in the upper gastrointestinal tract of children / 中华实用儿科临床杂志

Objective:To evaluate the clinical value of microprobe endoscopic ultrasonography in the diagnosis and treatment of children with protuberant lesions in the upper gastrointestinal tract.Methods:A retrospective study was performed to analyze the clinical data of children who underwent microprobe endoscopic ultrasonography for treating protuberant lesions in the upper gastrointestinal tract in the Department of Gastroenterology, Jinan Children′s Hospital from January 2018 to June 2021.The endoscopic ultrasound characteristics of children with protuberant lesions in the upper gastrointestinal tract were summarized and compared with the pathological results.Results:Microprobe endoscopic ultrasonography was performed in 29 children.Ectopic pancreas was found in 12 cases (41.4%), Brunner gland hyperplasia in 4 cases (13.8%), cysts in 3 cases (10.3%), duodenum accessory nipple in 3 cases (10.3%), extragastric compression in 2 cases (6.9%), lymphoma in 2 cases (6.9%), gastric duplication malformation in 1 case (3.4%), stromal tumor in 1 case (3.4%) and leiomyoma in 1 case (3.4%). According to the results of microprobe endoscopic ultrasonography, 15 cases with protuberant lesions were treated by deep biopsy and handled under endoscope.The tissue was checked by pathological examination.The microprobe endoscopic ultrasonography diagnosis of 14 cases were in accordance with their pathological diagnosis[93.3% (14/15)].Conclusions:Microprobe endoscopic ultrasonography can effectively diagnose and differentiate protuberant lesions in the upper gastroi-ntestinal tract of children, so it can be used to guide the clinical treatment under endoscope.Microprobe endoscopic ultrasonography is a safe and reliable treatment for children.

A potent neutralizing human antibody reveals the N-terminal domain of the Spike protein of SARS-CoV-2 as a site of vulnerability

The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents a global public health threat. Most research on therapeutics against SARS-CoV-2 focused on the receptor binding domain (RBD) of the Spike (S) protein, whereas the vulnerable epitopes and functional mechanism of non-RBD regions are poorly understood. Here we isolated and characterized monoclonal antibodies (mAbs) derived from convalescent COVID-19 patients. An mAb targeting the N-terminal domain (NTD) of the SARS-CoV-2 S protein, named 4A8, exhibits high neutralization potency against both authentic and pseudotyped SARS-CoV-2, although it does not block the interaction between angiotensin-converting enzyme 2 (ACE2) receptor and S protein. The cryo-EM structure of the SARS-CoV-2 S protein in complex with 4A8 has been determined to an overall resolution of 3.1 Angstrom and local resolution of 3.4 Angstrom for the 4A8-NTD interface, revealing detailed interactions between the NTD and 4A8. Our functional and structural characterizations discover a new vulnerable epitope of the S protein and identify promising neutralizing mAbs as potential clinical therapy for COVID-19.

Diagnosis and treatment of posterior atlantoaxial dislocation with odontoid retrolisthesis / 中华创伤骨科杂志

Objective:To report our experience in diagnosis and treatment of posterior atlantoaxial dislocation with odontoid retrolisthesis.Methods:A retrospective study was conducted of the 5 patients who had been treated from July 2012 to August 2018 at Department of Orthopaedics, General Hospital of Southern Theater Command for posterior atlantoaxial dislocation. They were 4 men and one woman, aged from 34 to 67 years (average, 47 years). All of them had a history of trauma. Of them, 4 were complicated with odontoid fracture and one with congenital free os odontoideum. Their posterior atlantoaxial dislocation ranged from 3 to 9 mm (average, 6 mm). By the American Spinal Injury Association (ASIA) grading system, their preoperative spinal injury was rated as grade B in one, as grade C in 3 cases and as grade D in one. All the 5 patients underwent skull traction at 10° flexion. Surgical trans-oralpharyngeal atlantoaxial reduction and internal fixation was performed for the one patient whose reduction had not been achieved by traction while posterior atlantoaxial screw-rod fixation or anterior odontoid screwing was conducted for the 4 patients whose reduction had been achieved by traction. The distance of posterior atlantoaxial dislocation was measured to evaluate their reduction and ASIA grade system was used to assess their spinal function after operation.Results:The postoperative distance of posterior atlantoaxial dislocation was 0 mm, showing a reduction rate of 100%. The 5 patients were followed up for 6 to 36 months (average, 15 months). By the ASIA grade system, the postoperative functional recovery of the spine was grade D in 4 cases and grade C in one. No implant loosening or breakage occurred.Conclusion:As a kind of high-energy hyperextension injury, posterior atlantoaxial dislocation is rare in clinic, but an appropriate treatment can be adopted to deal with its different clinical types to achieve good outcomes.

Design and Implementation of Ultra-micro Nucleic Acid Protein Analyzer / 中国医疗器械杂志

In this paper, a nucleic acid protein analyzer based on Lambert-Beer law and ultraviolet spectrophotometry is introduced, which is composed of ultraviolet monochromatic light generator, photoelectric signal detection module, vortex mixer, touch screen and embedded central controller. For ultra-micro measurement, a continuous-wavelength full-spectrum spectrophotometric detection circuit is designed in the hardware part. The transmitted light signal is collected by silicon photodiode, amplified and processed by subsequent circuit, and then transmitted to a single chip computer STM32F407VGT6 with CortexTM-M4 core after A/D conversion. The concentration and purity of nucleic acid protein are evaluated by assistant software detection algorithm. The instrument has the characteristics of compact size, flexible use, simple operation, high sensitivity and high detection efficiency. The experimental results show that the instrument has good sensitivity, repeatability and accuracy, and is suitable for the ultra-micro measurement of nucleic acid sample concentration, purity and protein concentration.

Relationship between impaired myocardial untwisting and left ventricular diastolic dysfunction in patients with autoimmune diseases / 中华心血管病杂志

Objective@#To observe the relationship between impaired myocardial untwisting and left ventricular diastolic dysfunction in patients with autoimmune diseases (AD).@*Methods@#In this retrospective study, 95 AD patients (27 males, (38.6±14.2) years old) were enrolled as AD group and 71 gender and age matched healthy subjects (24 males, (37.6±12.2) years old) were enrolled as control group, all underwent transthoracic echocardiography and two-dimensional speckle-tracking echocardiography (STE) in our hospital between January 2014 and June 2018. Left ventricular untwisting and diastolic function parameters were measured. Multiple logistic regression analysis was used to identify related factors of left ventricular diastolic dysfunction in AD patients. Receiver operating characteristic (ROC) curve was used to identify the diagnosis value of untwisting parameters for left ventricular diastolic dysfunction in AD patients.@*Results@#Compared with control group, left ventricular ejection fraction was lower (58(47, 66)% vs. 67 (62, 71) %, P<0.001), E/e′ was higher (10.78 (7.28, 13.65) vs. 6.30 (5.55, 7.25) , P<0.001), isovolumic relaxation time was longer (73.5 (56.5, 88.0) ms vs. 62.0 (58.0, 68.5) ms, P<0.001),and untwist slope during isovolumic relaxation period (USIR) was lower (31.92 (14.09, 54.92) °/s vs. 59.90 (40.09, 87.18) °/s, P<0.001) in AD group than in control group. Multiple logistic regression analysis showed heart rate (OR=0.885, 95%CI 0.840-0.931, P<0.001), E/e′ (OR=0.655, 95%CI 0.537-0.798, P<0.001) and USIR (OR=0.986, 95%CI 0.974-0.998, P=0.020) were independently related with left ventricular diastolic dysfunction in AD patients. ROC curve showed that area under the curve (AUC) was 0.919 (P<0.001), sensitivity was 87.6%, and specificity was 88.7%, when combining the heart rate, E/e′, and USIR as assessment parameters for the diagnosis of left ventricular diastolic dysfunction in AD patients at a cutoff of 0.51.@*Conclusions@#Impairment of myocardial untwisting indicates the presence of early stage left ventricular diastolic dysfunction in AD patients. USIR may be a sensitive parameter to evaluate early stage left ventricular diastolic dysfunction in AD patients.

Effect of Qutan-Tongyang decoction on cardiac function and myocardial remodeling in patients with chronic heart failure / 国际中医中药杂志

Objective@#To explore the effect of Qutan-Tongyang decoction on cardiac function and myocardial remodeling in patients with chronic heart failure.@*Methods@#According to the random table method, 96 patients with chronic heart failure were divided into the control group (n=48) and the research group (n=48). The patients in the control group were treated with conventional treatment, and the patients in the research group were treated with Qutan-Tongyang decoction on the basis of the control group. Two groups of patients were treated for 4 weeks. The clinical total effective rate of two groups of patients after treatment was counted. The LVESD, LVEDD, LVEF, IVST, LVPWT, LVMI, BNP, Ang2 were determined respectively before and after treatment. In addition, the adverse reaction incidence of two groups of patients were observed.@*Results@#The total effective rate of research group was 89.58% (43/48), while the total effective rate of control group was 72.92% (35/48), the difference between two groups was statistically significant (χ2=4.376, P=0.036). After treatment, the LVESD (45.12 ± 3.02 mm vs. 48.05 ± 3.11 mm, t=4.683), LVEDD (52.24 ± 3.65 mm vs. 56.79 ± 4.15 mm, t=5.704), IVST (7.13 ± 0.63 mm vs. 8.02 ± 0.71 mm, t=6.496), LVPWT (8.15 ± 0.58 mm vs. 8.62 ± 0.75 mm, t=3.434), LVMI (97.65 ± 6.28 g/m2 vs. 112.26 ± 8.47 g/m2, t=9.600), BNP (120.21 ± 19.87 ng/L vs. 188.95 ± 24.18 ng/L, t=15.217), Ang2 (252.52 ± 53.74 pg/ml vs. 330.39 ± 60.85 pg/ml, t=6.645) of the research group were significantly lower than those of the control group (P<0.05), while the LVEF (46.79% ± 3.88% vs. 41.52% ± 3.04%, t=7.407) of the research group were significantly higher than the control group (P<0.05). During treatment, there was no significantly difference of adverse reaction rates of the two groups (χ2=0.545, P=0.460).@*Conclusions@#The clinical curative effect of Qutan-Tongyang decoction on the basis of conventional treatment for the treatment of chronic heart failure is significantly, which can significantly improve cardiac function and inhibit cardiac remodeling. It has the high security of the curative effect.

Diagnosis of a patient with Dubin-Johnson syndrome by using next generation sequencing / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical characteristics and molecular basis for a Chinese boy affected with jaundiced skin and liver disease.@*METHODS@#The patient was subjected to clinical examination and laboratory tests. Genomic DNA of the patient and his parents was extracted and analyzed by using next generation sequencing (NGS). Suspected mutations were analyzed with bioinformatic software and verified by Sanger sequencing.@*RESULTS@#The patient had jaundice in his eyes and skin. Serum bilirubin was elevated along with hepatomegaly. Next generation sequencing showed that the patient has carried c.18C>A(p.C6X) and c.2556delA mutations in the MRP2 gene, which were respectively inherited from his father and mother.@*CONCLUSION@#The missense mutation c.18C>A and frameshift mutation c.2556delA probably account for the disease. NGS has provided a powerful tool for the diagnosis of rare genetic diseases including Dubin-Johnson syndrome.

Early repetitive pain in preterm infants in relation to brain development / 国际儿科学杂志

With the improvement of medical care the survival rate of preterm infants (gestational age ＜ 37 weeks) increased dramatically,however long-term neurodevelopmental and behavioral problems are still a concern.During their stay in neonatal intensive care unit preterm patients suffer lots of repeated painful procedures while it's a period of rapid brain development.Preterm infants have the nociceptive circuitry to feel the pain,but this system is functionally immature.Because the spinal neuromodulation system is immature that repeated pain stimulation leads to increased nociceptive signaling in the central nervous system.Besides,specific cell populations in the central nervous system of preterm infants are particularly vulnerable to oxidative stress and inflammation.Therefore,it is important that pain-related stress in preterm infants is appropriately managed.

Endoscopic treatment of esophageal stenosis caused by foreign bodies and corrosion in children / 中国小儿急救医学

Children′s esophageal stenosis is mainly benign stenosis. Esophageal foreign bodies and corrosion are common causes of esophageal stenosis in children requiring emergency management. Endoscop￣ic treatment of esophageal stricture includes endoscopic balloon dilatation,endoscopic radial incision,medical treatement,endoscopic stenting and so on. According to the cause of the stenosis,the nature of the lesion and the morphological structure of the lesion,formulating appropriate endoscopic treatment strategy are important for therapeutic effect and reducing the incidence of complications.

Effect of Qutan-Tongyang decoction on cardiac function and myocardial remodeling in patients with chronic heart failure / 国际中医中药杂志

Objective To explore the effect of Qutan-Tongyang decoction on cardiac function and myocardial remodeling in patients with chronic heart failure. Methods According to the random table method, 96 patients with chronic heart failure were divided into the control group (n=48) and the research group (n=48). The patients in the control group were treated with conventional treatment, and the patients in the research group were treated with Qutan-Tongyang decoction on the basis of the control group. Two groups of patients were treated for 4 weeks. The clinical total effective rate of two groups of patients after treatment was counted. The LVESD, LVEDD, LVEF, IVST, LVPWT, LVMI, BNP, Ang2 were determined respectively before and after treatment. In addition, the adverse reaction incidence of two groups of patients were observed. Results The total effective rate of research group was 89.58% (43/48), while the total effective rate of control group was 72.92% (35/48), the difference between two groups was statistically significant (χ2=4.376, P=0.036). After treatment, the LVESD (45.12 ± 3.02 mm vs. 48.05 ± 3.11 mm, t=4.683), LVEDD (52.24 ± 3.65 mm vs. 56.79 ± 4.15 mm, t=5.704), IVST (7.13 ± 0.63 mm vs. 8.02 ± 0.71 mm, t=6.496), LVPWT (8.15 ± 0.58 mm vs. 8.62 ± 0.75 mm, t=3.434), LVMI (97.65 ± 6.28 g/m2 vs. 112.26 ± 8.47 g/m2, t=9.600), BNP (120.21 ± 19.87 ng/L vs. 188.95 ± 24.18 ng/L, t=15.217), Ang2 (252.52 ± 53.74 pg/ml vs. 330.39 ± 60.85 pg/ml, t=6.645) of the research group were significantly lower than those of the control group (P<0.05), while the LVEF (46.79% ± 3.88% vs. 41.52% ± 3.04%, t=7.407) of the research group were significantly higher than the control group (P<0.05). During treatment, there was no significantly difference of adverse reaction rates of the two groups (χ2=0.545, P=0.460). Conclusions The clinical curative effect of Qutan-Tongyang decoction on the basis of conventional treatment for the treatment of chronic heart failure is significantly, which can significantly improve cardiac function and inhibit cardiac remodeling. It has the high security of the curative effect.

Injury of aldehyde dehydrogenase 2 in organ ischemia-reperfusion injury through autophagy / 中华肝胆外科杂志

With the rapid development of organ transplantation in China,the donation after cardiac death (DCD) donor organs are widely used.However,the quality of these organs is relatively poor,so the way to preserve and maintain organ still remains a severe problem.Among them,ischemic reperfusion injury (IRI) impairs the organs severely.Acetaldehyde dehydrogenase 2 (ALDH2) protects organs from stress conditions,including ischemia-reperfusion injury,and the activation and autophagy inhibition also protects the organs from stress conditions as well.Recent studies showed that ALDH2 can regulate autophagy to inhibit the organ injury during ischemia-reperfusion.Our study aims to discuss the new findings in this mechanism.

Analysis of SLC25A13 gene mutations in five infants with neonatal intrahepatic cholestasis caused by citrin deficiency / 中华医学遗传学杂志

OBJECTIVE To identify potential mutations in five infants with neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD). METHODS The SLC25A13 gene was analyzed by next-generation sequencing. Suspected mutations were confirmed by PCR and Sanger sequencing in the probands and their parents. Impact of novel mutations was predicted with PolyPhen-2 software. RESULTS All neonates have harbored mutations of the SLC25A13 gene. Eight mutations were discovered, which included two novel mutations (c.1357A>G and c.1663dup23). All parents were found to be carriers of the mutations. CONCLUSION Mutations of the SLC25A13 gene probably underlie the NICCD among the five patients, among which 851del4 and 1638-1660dup were the most common ones. This has enriched the spectrum of SLC25A13 mutation in association with NICCD.

Variant analysis of a patient with dyshormonogenesis due to congenital hypothyroidism / 中华医学遗传学杂志

OBJECTIVE@#To carry out variant analysis for a Chinese boy featuring dyshormonogenesis due to congenital hypothyroidism.@*METHODS@#DNA of the patient and his parents was extracted and sequenced by high-throughput sequencing. The results were validated with Sanger sequencing and analyzed with Bioinformatics software.@*RESULTS@#Sequencing result showed that the patient has carried compound variants of c.2654G>T(p.Arg885Leu) and c.943G>T(p.Gly315X) of the DUOX2 gene, which were inherited respectively from his mother and father.@*CONCLUSION@#The missense mutation c.2654G>T and nonsense mutation c.943G>T probably underlie the disease in this child.

The clinical outcomes and prognosis of older human immunodeficiency virus-infected patients under antiretroviral therapy / 中华传染病杂志

Objective To evaluate the clinical outcomes and prognosis of older human immunodeficiency virus (HIV )-infected patients under antiretroviral therapy (ART ) in China .Methods This study was carried out in a retrospective cohort of HIV-infected patients initiated ART between January 2004 and December 2012 at The First Affiliated Hospital ,China Medical University .The patients were enrolled and divided into two groups ,including <50 years group (young and middle-aged group) and≥50 years group (older group) .Immunological and virological responses and mortality were analyzed . Data were analyzed by t test ,chi-square test ,two-way analysis of variance and log-rank test .Results Totally 291 subjects were included ,among whom 97 subjects were older patients and 194 subjects were young and middle-aged patients .Male was predominate in both groups ,which accounted for 91 .8％ and 87 .6％ ,respectively .The CD4+ T lymphocyte count in the older group before treatment was (151 .9 ±96 .2) cells /μL ,which was significantly lower than that in the young and middle-aged group (183 .4 ± 93 . 5) cells/μL (t= 2 .657 , P=0 .009) .At month 12 of treatment ,the CD4+ T lymphocyte count in the older group was significantly lower than that in the young and middle-aged groups (t= 2 .120 , P=0 .035) ,while there was no statistically significant difference between the two groups at month 24 (t=1 .025 ,P=0 .299) .The percentage of CD4+ T lymphocyte count increasing to 500 cells/μL in the older and youth groups during follow-up were 11 .3％ and 16 .0％ ,respectively (χ2=1 .127 ,P =0 .376) .Log-rank analysis showed that the mean times of virus inhibition in older group and young and middle-aged group were 7 .9 (95％ CI:6 .8-8 .5) and 7 .6 (95％ CI:6 .5 -9 .3) ,respectively ,with no statistically significant difference (χ2 =0 .002 , P=0 .961) .Virological failure was reported in 4 patients (4 .1％ ) in older group and 11 patients (5 .7％ ) in young and middle-aged group . Chi-square test showed no statistically significant difference between the two groups (χ2 = 0 .15 , P= 0 .78) .During follow-up , 19 .6％ (19/97) in older group and 3 .6％ (7/194) in young and middle-aged group died .The former was significantly higher than the latter (χ2 = 21 .113 , P< 0 .01 ) .Conclusions Older patients show a poor immunologic response ,similar viral suppression and higher risk of mortality compared with young and middle-aged patients . Future research should be aimed at the feasible and specific strategy for early diagnosis and timely treatment for older patients to improve treatment efficacy and reduce mortality .

Bibliometric analysis on research hotspots on HIV post-exposure prophylaxis related articles in the world, 2000-2017 / 中华流行病学杂志

Objective To analyze and reveal the distribution,research hotspots and study trend of worldwide published articles correlated with HIV/AIDS post-exposure prophylaxis (PEP),and provide information for related studies in China.Methods CiteSpace software 5.1 was used to visualize all related papers in the web of science database published during 2000-2017.Results The average growth rate of international PEP-related papers was 10.78％,and number of published papers in 2016 was highest (n=34),relevant research hotspots have shifted from the prevention of occupational HIV exposure to the prevention of non-occupational HIV exposure in group at high risk,such as MSM,in recent years.Clustering analysis classified research hotspots into three categories,including risk reduction through enhanced intervention,current status of global HIV PEP and German-Austrian Recommendation.Conclusions Non-occupational HIV PEP in groups at high-risk,especially MSM,has received increasing attention in recent years,the research of PEP mainly focus on improving the awareness and use of PEP in MSM and compliance in the course of medication.In the context of severe HIV epidemic in MSM without effective control in China,PEP should be strengthened to assess and explore the risk of HIV infection in MSM to provide reference for medical personnel and related departments to implement HIV non-occupation exposure blockade and formulate PEP medication.

Bibliometric analysis on research hotspots on HIV post-exposure prophylaxis related articles in the world, 2000-2017 / 中华流行病学杂志

Objective To analyze and reveal the distribution,research hotspots and study trend of worldwide published articles correlated with HIV/AIDS post-exposure prophylaxis (PEP),and provide information for related studies in China.Methods CiteSpace software 5.1 was used to visualize all related papers in the web of science database published during 2000-2017.Results The average growth rate of international PEP-related papers was 10.78％,and number of published papers in 2016 was highest (n=34),relevant research hotspots have shifted from the prevention of occupational HIV exposure to the prevention of non-occupational HIV exposure in group at high risk,such as MSM,in recent years.Clustering analysis classified research hotspots into three categories,including risk reduction through enhanced intervention,current status of global HIV PEP and German-Austrian Recommendation.Conclusions Non-occupational HIV PEP in groups at high-risk,especially MSM,has received increasing attention in recent years,the research of PEP mainly focus on improving the awareness and use of PEP in MSM and compliance in the course of medication.In the context of severe HIV epidemic in MSM without effective control in China,PEP should be strengthened to assess and explore the risk of HIV infection in MSM to provide reference for medical personnel and related departments to implement HIV non-occupation exposure blockade and formulate PEP medication.

Clinical characteristics and outcome comparison between atrial fibrillation patients underwent catheter ablation under general aesthesia or local anesthesia and sedation / 中华心血管病杂志

Objective@#To compare the outcome of radiofrequency catheter ablation under local anesthesia/sedation (S) or general anesthesia(GA) in atrial fibrillation patients.@*Methods@#Data of 498 patients with atrial fibrillation undergoing radiofrequency catheter ablation in our departmentfrom January 2014 to December 2015 were retrospectively analyzed. Two hundred and twenty patients assigned to the GA group, the other 278 patients to the S group. Patients were followed clinically every 3 months within one year after procedure. Immediate electrocardiogram was performed in patients with palpitation or choking sensation in chest. The end point of the study was recurrence of any atrial tachyarrhythmia lasting >30 seconds in device interrogation, 24-hour Holter monitoring or 12-lead electrocardiogram after a single procedure. After the ablation procedure, a blanking period of 3 months was allowed according to the guidelines. Procedure time, radiofrequency time, fluoroscopy time, the detection of paroxysmal supraventricular tachycardia, the success rate and the complications were compared between the two groups.@*Results@#There was no difference in the baseline characteristics between the two groups, such as age, gender, BMI, complications, LVEF, LAD (all P>0.05). The duration of procedure ((117.8±51.7)minutes vs.(115.4±36.9)minutes, P=0.79), duration of fluoroscopy((12.5±11.2)minutes vs. (10.4±10.2)minutes, P=0.35), duration of radiofrequency((40.1±12.9)minutes vs. (48.6±44.3)minutes, P=0.48) were similar between the two groups (P>0.05). Compared with S group, discovery of the frequency of atrioventricular node reentrant tachycardia (AVNRT) was significantly lower in GA group (0 vs. 3.6%(10/278), P<0.01), but the difference disappeared with repeat electrophysiological examination when patients become conscious from GA(3.2%(7/220) vs. 3.6%(10/278), P=0.311). The difference of atrioventricular reentrant tachycardia (AVRT) was similar between the two groups(0.9%(2/220) vs. 0.7%(2/278), P=0.841). Compared with S group, reflection of vagus nerve was less in GA group (1.4%(3/220) vs. 8.6%(24/278), P=0.026). After following up of (356±92) days, freedom from atrial fibrillation/atrial flutter/atrial tachyarrhythmia was similar between the two groups(77.9%(162/208) vs. 79.9%(215/269), P=0.818).@*Conclusion@#General anesthesia is a promising method to atrial fibrillation ablation, in view of stable patient status and safety for the procedure. There is no difference in complications, recurrence of arrhythmia between the two groups, but detection rate of AVNRT is lower in GA group.