Efficacy and safety of Lianhua Qingwen as an adjuvant treatment for influenza in Chinese patients: A meta-analysis.

BACKGROUND: Lianhua Qingwen (LHQW) is a proprietary traditional Chinese medicine for the treatment of influenza (FLu). It is composed of 2 prescriptions, Maxing Shigan and Yinqiao, which has antiviral, antibacterial, and immunomodulatory effects. However its clinical suitability has not yet been investigated. OBJECTIVE: This study aimed to evaluate the efficacy and safety of LHQW in the treatment of FLu. METHODS: We searched several databases, including PubMed and China Biomedical Database for literature research, from inception to July 1, 2023. This meta-analysis included RCTs that compared the safety and efficacy of the combination of LHQW and conventional drugs (CD) with CD alone for IFU. The extracted data were analyzed using Revman5.4 software with risk ratio (RR), 95% confidence intervals (CI), and standardized mean difference. RESULTS: Our meta-analysis included 32 articles with 3592 patients. The results showed that the effects of LHQW adjuvant therapy were superior to those of CD (clinical effective rate: RR = 1.22, 95% CI: 1.18-1.26, P < .00001; cure rate: RR = 1.54, 95% CI: 1.35-1.75, P < .00001), and adverse reactions after treatment were significantly lower than those before treatment (RR = 0.70, 95% CI: 0.50-0.98, P = .04). CONCLUSION: This meta-analysis indicates that LHQW combined with CD may be more effective than CD alone for the treatment of FLu.

Single-injection subunit vaccine for rabies prevention using lentinan as adjuvant.

Current rabies vaccines require 5 doses to provide full protection from the deadly virus, which significantly reduce the compliance of recipients. To minimize the number of immunizations herein single injection vaccines were developed. First a single injection vaccine was designed using rabies virus glycoprotein (G protein) as antigen. A time-controlled release system which uses dynamic layer-by-layer films as erodible coating was employed to accomplish multiply pulsatile releases of G protein. The single-injection vaccine elicits potent humoral and cellular immune responses comparable to the corresponding multi-dose ordinary vaccines because of their similar release pattern of G protein. To further improve its performance, a second single injection vaccine, in which lentinan was added as adjuvant, was designed. This single-injection vaccine again elicits humoral and cellular immune responses comparable to the corresponding multi-dose ordinary vaccines because of their similar release pattern of antigen and adjuvant. In addition, the second single-injection vaccine elicits higher level immune response and provides higher efficiency on virus inhibition than the first one because lentinan can booster immune response.

Single-injection COVID-19 subunit vaccine elicits potent immune responses.

Current vaccination schedules, including COVID-19 vaccines, require multiple doses to be administered. Single injection vaccines eliciting equivalent immune response are highly desirable. Unfortunately because unconventional release kinetics are difficult to achieve it still remains a huge challenge. Herein a single-injection COVID-19 vaccine was designed using a highly programmable release system based on dynamic layer-by-layer (LBL) films. The antigen, S1 subunit of SARS-CoV-2 spike protein, was loaded in CaCO3 microspheres, which were further coated with tannic acid (TA)/polyethylene glycol (PEG) LBL films. The single-injection vaccine was obtained by mixing the microspheres coated with different thickness of TA/PEG films. Because of the unique constant-rate erosion behavior of the TA/PEG coatings, this system allows for distinct multiple pulsatile release of antigen, closely mimicking the release profile of antigen in conventional multiple dose vaccines. Immunization with the single injection vaccine induces potent and persistent S1-specific humoral and cellular immune responses in mice. The sera from the vaccinated animal exhibit robust in vitro viral neutralization ability. More importantly, the immune response and viral inhibition induced by the single injection vaccine are as strong as that induced by the corresponding multiple dose vaccine, because they share the same antigen release profile. STATEMENT OF SIGNIFICANCE: Vaccines are the most powerful and cost-effective weapons against infectious diseases such as COVID-19. However, current vaccination schedules, including the COVID-19 vaccines, require multiple doses to be administered. Herein a single-injection COVID-19 vaccine is designed using a highly programmable release system. This vaccine releases antigens in a pulsatile manner, closely mimicking the release pattern of antigens in conventional multiple dose vaccines. As a result, one single injection of the new vaccine induces an immune response and viral inhibition similar to that induced by the corresponding multiple-dose vaccine approach.

The use of generalized synthetic control method to evaluate air pollution control measures of G20 Hangzhou Summit.

The traditional campaign-style enforcement in environmental governance has been debated whether its rebound effect is likely to eat away the short-term environmental benefits and subsequently bring about severer pollution. There are methodological challenges in assessing the effect of temporary environmental intervention. By applying the generalized synthetic control method (GSCM), we quantified and characterized the effectiveness of environmental regulations implemented for the G20 Hangzhou Summit held on 4-5 September, 2016. The summit was successful in reducing Air Quality Composite Index by 17.40% (95% CI: 9.53%, 24.60%), 13.30% (95% CI: 4.23%, 21.50%), and 10.09% (95% CI: 2.01%, 17.51%) in the core, strictly-regulated and regulated areas respectively, comparing with the index expected under a "No-G20" scenario during the preparatory period and the summit period (July-September 2016), and the reduction of the levels in specific pollutants (PM10, PM2.5, NO2, and CO) was also observed. Besides, the environmental benefits lasted for at least 3 months after the summit. This study demonstrates that the pollution control measures during the G20 Hangzhou Summit improved air quality immediately and continuously, and the GSCM provides a useful tool for evaluating the intervention effects of environmental regulations.

Combined therapy of intensive statin plus intravenous rt-PA in acute ischemic stroke: the INSPIRE randomized clinical trial.

OBJECTIVE: To investigate the safety and efficacy of intensive statin in the acute phase of ischemic stroke after intravenous thrombolysis therapy. METHODS: A total of 310 stroke patients treated with rt-PA were randomly scheduled into the intensive statin group (rosuvastatin 20 mg daily × 14 days) and the control group (rosuvastatin 5 mg daily × 14 days). The primary clinical endpoint was excellent functional outcome (mRS ≤ 1) at 3 months, and the primary safety endpoint was symptomatic intracranial hemorrhage (sICH) in 90 days. RESULTS: The intensive statin users did not achieve a favorable outcome in excellent functional outcome (mRS ≤ 1) at 3 months compared with controls (70.3% vs. 66.5%, p = 0.464). Intensive statin also not significantly improved the overall distribution of scores on the modified Rankin scale, as compared with controls (p = 0.82 by the Cochran-Mantel-Haenszel test). The incidence of primary safety endpoint events (sICH) in 90 days did not significantly differ between the intensive statin group and control group (0.6% vs. 1.3%, p > 0.999). CONCLUSION: The INSPIRE study indicated that intensive statin therapy may not improve clinical outcomes compared with the low dose of statin therapy in AIS patients undergoing intravenous thrombolysis, and the two groups had similar safety profile. CLINICAL TRIAL REGISTRATION: URL: http://www.chictr.org . Unique identifier: ChiCTR-IPR-16008642.

Endoscopic injection with fibrin sealant versus epinephrine for arrest of peptic ulcer bleeding: a randomized, comparative trial.

BACKGROUND: endoscopic epinephrine and fibrin injection in the treatment of bleeding peptic ulcer are reported to be safe, effective, and easy to use. However, a wide range of rebleeding rates has been reported with epinephrine injection. GOALS: to compare the hemostatic effects of endoscopic injection with fibrin sealant versus epinephrine. STUDY: between December 1998 and July 2000, 51 patients with active bleeding or nonbleeding visible vessels entered this trial. The clinical parameters were comparable between both groups. In the epinephrine group, we injected 5 to 10 mL of 1:10,000 epinephrine, surrounding the bleeder. In the fibrin sealant group, we injected fibrin sealant 4 mL, surrounding the bleeder. RESULTS: initial hemostasis was obtained in all enrolled patients. Rebleeding was more in the epinephrine group than in the fibrin sealant group (4 [15%] of 26 vs. 14 [56%] of 25, = 0.003 on the intention-to-treat basis, and 4 [16.7%] of 24 vs. 14 [58.3%] of 24, = 0.003 on the per protocol basis, respectively). Volume of blood transfusion, number of surgeries, hospital stay, and number of deaths were similar between both groups. CONCLUSION: fibrin sealant injection is more effective in preventing rebleeding than epinephrine after endoscopic therapy, but this study showed no difference in outcomes with either therapy.