Study on the extraction of polysaccharides from Dendrobium officinale and its improvement effect on acute lung injury in mice / 中国药房

OBJECTIVE To optimize the extraction process of polysaccharides from Dendrobium officinale， and preliminarily study its effect on acute lung injury （ALI） in mice. METHODS Using D. officinale as raw material， the polysaccharides were extracted from D. officinale by ultrasonic-assisted hot water immersion. Using the extraction rate of D. officinale polysaccharides as response value， the single-factor experiments and Box-Behnken response surface method were used to optimize the ratio of material to liquid， extraction time and extraction temperature. ALI mice were induced by lipopolysaccharide. Using prednisone acetate （5 mg/kg） as the positive control， the effects on the mass ratio of wet and dry lung and pathological changes of lung tissue （HE staining and Masson staining） of low-dose， medium-dose and high-dose D. officinale polysaccharides （50，100，200 mg/kg） were investigated. RESULTS The optimal extraction technology of D. officinale polysaccharides was as follows： the ratio of material to liquid was 1∶25 （g/mL）， the extracting time was 1 h， and the extracting temperature was 58 ℃ . Under these conditions， the average extraction rate of D. officinale polysaccharides was 37.75% （RSD＝1.12%，n＝3）， the relative error of which with predicted value （38.63%） was 2.28%. Compared with the model group， the ratios of wet and dry lung in the positive control group and D. officinale polysaccharides groups were all decreased significantly （P＜0.05 or P＜0.01）， and the pathological changes in lung tissue （severe destruction of alveolar structure， significant widening of alveolar septa， extensive infiltration of inflammatory cells and proliferation of fibroblasts） were alleviated to varying degrees. CONCLUSIONS The optimal extraction process of D. officinale polysaccharides is feasible； the obtained polysaccharide extract has a certain improvement effect on ALI in mice.

Transmission in Latent Period Causes A Large Number of Infected People in the United States

The cumulative number of confirmed cases in the United States exceeded one million on 29 April 2020, becoming the country of the most serious pandemic in the world. We proposed a model to analyze the real situation and follow-up trend of the epidemic in the US. The proposed model divides the epidemic period into two phases, and includes three different categories of transmitters: the latent population, the documented infectious population, and the undocumented infectious population. We use metapopulation network to simulate the spread of the COVID-19 in the US, and apply the Bayesian inference to estimate the key parameters of the model. We also perform component analysis and sensitivity analysis, researching the compositions of the people with COVID-19. The results show that the basic reproduction number in the early period of propagation is 4.06. As of April 13, 2020, only 45% (95% CI: 35% - 73%) of symptom onset cases in the United States were documented. The incubation period of COVID-19 is 10.69 days (95% CI: 10.02 - 11.74). If the current level of interventions is continued, the cumulative number of confirmed cases is expected to reach more than 1.7 million in July and continue to grow.

Assessing the Global Tendency of COVID-19 Outbreak

COVID-19 is now widely spreading around the world as a global pandemic. In this report, we estimated the global tendency of COVID-19 and analyzed the associated global epidemic risk, given that the status quo is continued without further measures being taken. Based on official data of confirmed and recovered cases until May 21, 2020, the results showed that the global R0, excluding China, was estimated to be 2.76 (95% CI: 2.57 - 2.95). The United States, Germany, Italy, and Spain have peak values over 100,000. Using dynamical model and cluster analysis, we partition the globe into four regional epicenters of the outbreak: Southeast Asia extending southward to Oceania, the Middle East, Western Europe, and North America. Among them, Western Europe would become the major center of the outbreak. The peak values in Germany, Italy, and Spain were estimated to be 228,000, 291,000, and 298,000, respectively. Based on the current control measures by May 21, 2020, the peak value in the United States will reach 2,114,000. The cumulative number of 51 mainly researched countries patients might finally attain 6,542,000 (95% CI: 4,772,000 - 40,735,000). We also estimated the diagnosis rate, recovery rate, and infection degree of each country or region, and used clustering algorithm to retrieve countries or regions with similar epidemic characteristics. Several suggestions have been proposed for countries or regions in different clusters.

Estimating the Efficacy of Traffic Blockage and Quarantine for the Epidemic Caused by 2019-nCoV (COVID-19)

BackgroundSince the 2019-nCoV (COVID-19) outbreaks in Wuhan, China, the cumulative number of confirmed cases is increasing every day, and a large number of populations all over the world are at risk. The quarantine and traffic blockage can alleviate the risk of the epidemic and the infections, henceforth evaluating the efficacy of such actions is essential to inform policy makers and raise the public awareness of the importance of self-isolation and quarantine. MethodWe collected confirmed case data and the migration data, and introduced the quarantine factor and traffic blockage factor to the Flow-SEIR model. By varying the quarantine factor and traffic blockage factor, we simulated the change of the peak number and arrival time of infections, then the efficacy of these two intervation measures can be analyzed in our simulation. In our study, the self-protection at home is also included in quarantine. ResultsIn the simulated results, the quarantine and traffic blockage are effective for epidemic control. For Hubei province, the current quarantine factor is estimaed to be 0.405, which means around 40.5% of suceptibles who are close contacting with are in quarantine, and the current traffic blockage factor is estimaed to be 0.66, which indicates around 34% of suceptibles who had flowed out from Hubei. For the other provinces outside Hubei, the current quarantine factor is estimated to be 0.285, and the current traffic blockage factor is estimated to be 0.26. With the quarantine and traffic blockage factor increasing, the number of infections decrease dramatically. We also simulated the start dates of quarantine and traffic blockage at four time points, the simulated results show that the early of warning is also effective for epidemic containing. However, provincial level traffic blockage can only alleviate 21.06% - 22.38% of the peak number of infections. In general, the quarantine is much more effective than the traffic blockage control. ConclusionBoth of quarantine and traffic blockage are effective ways to control the spread of COVID-19. However, the eff icacy of quarantine is found to be much stronger than that of traffic blockage. Considering traffic blockage may also cause huge losses of economy, we propose to gradually deregulate the traffic blockage, and improve quarantine instead. Also, there might be a large number of asymptomatic carriers of COVID-19, the quarantine should be continued for a long time until the epidemic is totally under control.

EPIDEMIC TRENDS ANALYSIS AND RISK ESTIMATION OF 2019-NCOV OUTBREAK

Since December 1, 2019, the spread of COVID-19 is increasing every day. It is particularly important to predict the trend of the epidemic for the timely adjustment of the economy and industries. We proposed a Flow-SEHIR model in this paper to perform the trends of 2019-nCoV (COVID-19) in China. The results show that the number of daily confirmed new cases reaches the inflection point on Feb. 6 - 10 outside Hubei. For the maximum of temporal infected cases number, the predicted peak value in China except Hubei was estimated to be 21721 (95% CI: 18764 - 24929). The peak arrival time is on March 3 - 9. The temporal number of patients in most areas of China outside Hubei will peak from March 12 to March 15. The peak values of more than 73.5% provinces or regions in China will be controlled within 1000. According to Flow-SEHIR model and estimations from the data of evacuation of nationals from Wuhan, the real peak cumulative number of patients in Hubei is estimated to be 403481 (95% CI: 143284 - 1166936).

System and Function Study of Limb Compression after Total Knee Replacement / 医用生物力学

Objective A three-dimensional （3D） printing precise pressure device was designed specifically targeted at cambered limbs according to the requirement of postoperative rehabilitation of total knee replacement(TKR), and its effectiveness and safety was verified by finite element analysis. Methods Based on gastrocnemius muscle of lower limbs as the pressurized objects, the precise pressure device was designed, which contained an air pressure generating module, an inflatable airbag and a 3D printing brace. Through the closed loop control algorithm, the device stably supplied different pressures in the airbag. Distributed pressure data of the airbag-skin within contact surface were collected under different experimental conditions and imported into biomechanical simulation software which combined CT images to reconstruct 3D model of the lower limb mechanics. Finally, the effective compression area fraction and the joint micro-motion angle under each condition were obtained, to verify the effectiveness and safety of the system. Results Using generally preferred 4 cm-size offset and 4-barrel airbag configurations, under different intracapsular pressure of 5.32，6.65，7.98，9.31，10.64 kPa, the simulated knee joint micro-motion angles were 5.3°, 6.1°, 7.2°, 9.5°, 10.6°， respectively, and the effective compression area fraction could be up to 90-8%-95-2%. Conclusions For the optimized scheme, the dynamic range of joint micro-motion angle and the effective compression area fraction caused by different airbag pressure values were the best and met the design requirements of effectiveness and safety. The research findings can contribute to analyzing the influence of compression system on limb biomechanics, which are of great significance for effective and safe rehabilitation training after TKR.

Preliminary study of the relationship between novel coronavirus pneumonia and liver function damage: a multicenter study / 中华肝脏病杂志

Objective@#To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage.@*Methods@#Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate.@*Results@#32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34- ~ 21.15) mmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31- ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) mmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively.@*Conclusion@#The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.

Derma Safety of Miconazole and Chloramphenicol Cream for Guinea Pigs / 中国药房

OBJECTIVE:To evaluate the derma safety of miconazole and chloramphenicol cream (MCC) for Guinea pigs.METHODS:Blank matrix,positive sensitizing agent (2,4-dinitro-chlorobenzene) and MCC (high dose and low dose) were applied on normal or damaged areas of the unhairing backs of Guinea pigs to conduct acute toxicity test,sensitivity test and irritation test,respectively.RESULTS:MCC caused no acute toxicity when applied on the skin of Guinea pigs,nor skin/systemic hypersensitive reaction was noted after repeated sensitization.Single or multiple dosing of MCC caused no irritation on normal skin of Guinea pigs but caused mild irritation on damaged skin which disappeared after 48 h or 72 h.CONCLUSION:MCC has good dermo safety for Guinea pigs.

Antineoplastic Medicine-induced Adverse Drug Reaction Reported in Our Hospital: Analysis of 162 Cases / 中国药房

OBJECTIVE: To investigate the characteristics and regularity of antineoplastic medicine-induced adverse drug reaction (ADR) occurred in our hospital. METHODS: 162 antineoplastic medicine-induced ADR cases reported in our hospital from 2005 to 2008 were analyzed statistically in respect of patients’age and sex, categories of drugs, route of administration, drug combination,organs and systems involved in ADR and clinical manifestation, etc. RESULTS: Of the total 162 ADR cases, proportion of men was similar to women. 68 cases (41.98%) were old persons aged older than 60. 123 cases(75.93%) were single use of drugs, 39 cases(24.07%) were combined use of drugs. 39.51% of ADR cases were induced by antineoplastic medicine made from plants and took up the first place in terms of incidence of ADR. 36.42% of ADR cases dominantly manifested as lesion of skin and its appendants. CONCLUSION: ADR monitoring of antineoplastic medicine should be strengthened to ensure rational and standardized use of antineoplastic medicine, avoid or reduce the occurrence of severe ADR.