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OBJECTIVE: To investigate the correlation between the triglyceride-glucose (TyG) index and rheumatoid factor levels and the existence of cardiovascular disease in patients in the rheumatoid arthritis population and to analyze their potential value in predicting the risk of cardiovascular disease. METHODS: Patients with rheumatoid arthritis treated by the Traditional Chinese Medicine Department of Rheumatism of the China-Japan Friendship Hospital from 2019-01 to 2021-12 were included in this retrospective study. Regression analysis was performed with multifactor-corrected multimodal logistic models to observe the correlation between the TyG index and rheumatoid factor and cardiovascular disease risk, construct predictive models and assess the potential predictive value of the variables on cardiovascular disease risk with receiver operating characteristic curves. The results were further corrected by sensitivity analysis and trend tests. RESULTS: A total of 418 patients with rheumatoid arthritis were included in the study. In the rheumatoid arthritis population, high rheumatoid factor (OR = 1.002, 95% CI = 1.001-1.002, P < 0.001), high TyG index (OR = 1.057, 95% CI = 1.008-1.109, P = 0.022), advanced age (OR = 1.080, 95% CI = 1.050-1.112, P < 0.001), and low physical activity (OR = 2.848, 95% CI = 1.195-6.785, P = 0.018) were independent risk factors for the existence of cardiovascular disease in patients. The combined coefficient calculated on the basis of the TyG index and rheumatoid factor was used to plot the receiver operating characteristic curve with an area under the curve of 0.791, which can be used to predict the potential risk of cardiovascular disease in patients with rheumatoid arthritis. Further sensitivity analysis found that the marker of focus remained associated with cardiovascular disease risk in a high-physical activity population with rheumatoid arthritis. The final trend test found a linear trend between the TyG index, rheumatoid factor levels and the risk of cardiovascular disease. CONCLUSION: In the rheumatoid arthritis population, the TyG index and rheumatoid factor have some potential predictive value in determining the risk of cardiovascular disease, and the predictive efficacy is better when the two tests are combined.
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Artrite Reumatoide , Doenças Cardiovasculares , Humanos , Triglicerídeos , Fator Reumatoide , Glucose , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Glicemia/análise , Estudos Retrospectivos , Artrite Reumatoide/complicaçõesRESUMO
A novel Ebola virus (EBOV) first identified in March 2014 has infected more than 25,000 people in West Africa, resulting in more than 10,000 deaths. Preliminary analyses of genome sequences of 81 EBOV collected from March to June 2014 from Guinea and Sierra Leone suggest that the 2014 EBOV originated from an independent transmission event from its natural reservoir followed by sustained human-to-human infections. It has been reported that the EBOV genome variation might have an effect on the efficacy of sequence-based virus detection and candidate therapeutics. However, only limited viral information has been available since July 2014, when the outbreak entered a rapid growth phase. Here we describe 175 full-length EBOV genome sequences from five severely stricken districts in Sierra Leone from 28 September to 11 November 2014. We found that the 2014 EBOV has become more phylogenetically and genetically diverse from July to November 2014, characterized by the emergence of multiple novel lineages. The substitution rate for the 2014 EBOV was estimated to be 1.23 × 10(-3) substitutions per site per year (95% highest posterior density interval, 1.04 × 10(-3) to 1.41 × 10(-3) substitutions per site per year), approximating to that observed between previous EBOV outbreaks. The sharp increase in genetic diversity of the 2014 EBOV warrants extensive EBOV surveillance in Sierra Leone, Guinea and Liberia to better understand the viral evolution and transmission dynamics of the ongoing outbreak. These data will facilitate the international efforts to develop vaccines and therapeutics.
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Ebolavirus/genética , Evolução Molecular , Variação Genética/genética , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/virologia , Sequência de Bases , Surtos de Doenças/estatística & dados numéricos , Ebolavirus/isolamento & purificação , Monitoramento Epidemiológico , Genoma Viral/genética , Doença pelo Vírus Ebola/transmissão , Humanos , Epidemiologia Molecular , Taxa de Mutação , Filogenia , Filogeografia , Serra Leoa/epidemiologiaRESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: Bushen Quhan Zhiwang decoction (BQZD), a formula in traditional Chinese medicine (TCM), effectively delays bone destruction in rheumatoid arthritis (RA) patients. However, its chemical constituents, absorbed components, and metabolites remain unrevealed, and its mechanism in treating bone destruction in RA needs further investigation. AIM OF THE STUDY: Our objective is to identify the chemical constituents, absorbed components, and metabolites of BQZD and explore the potential mechanisms of BQZD in treating bone destruction in RA. MATERIALS AND METHODS: This study systematically identified the chemical constituents, absorbed components, and metabolites of BQZD using ultra-performance liquid chromatography with Q-Exactive Orbitrap mass spectrometry combined with parallel reaction monitoring. The absorbed components and metabolites were subjected to network pharmacology analysis to predict the potential mechanisms of BQZD in treating bone destruction in RA. The in vivo anti-osteoclastogenic and underlying mechanism were further verified in collagen-induced arthritis (CIA) rats. RESULTS: A total of 182 compounds were identified in BQZD, 27 of which were absorbed into plasma and organs and 42 metabolites were identified in plasma and organs. The KEGG analysis revealed that MAPK signaling pathway was highly prioritized. BQZD treatment attenuated paw swelling and the arthritis index; suppressed synovial hyperplasia, bone destruction, and osteoclast differentiation; and inhibited the levels of TNF-α, IL-1ß, and IL-6 in CIA rats. Mechanically, BQZD significantly decreased the protein expression levels of TRAF6, NFATc1, p-JNK, and p-p38, which might be related to 9 absorbed components and 1 metabolite. CONCLUSION: This study revealed the key active components and metabolites of BQZD. BQZD exhibits bone-protective effects via TRAF6/p38/JNK MAPK pathway, which may be associated with 9 absorbed components and 1 metabolite.
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Artrite Experimental , Artrite Reumatoide , Medicamentos de Ervas Chinesas , Humanos , Ratos , Animais , Medicamentos de Ervas Chinesas/farmacologia , Medicamentos de Ervas Chinesas/uso terapêutico , Farmacologia em Rede , Fator 6 Associado a Receptor de TNF , Artrite Reumatoide/tratamento farmacológico , Medicina Tradicional Chinesa , Artrite Experimental/tratamento farmacológicoRESUMO
INTRODUCTION: Rheumatoid arthritis (RA) is a progressive inflammatory autoimmune disease characterised by chronic systemic inflammation, which can cause swelling, stiffening and destruction of articular cartilage and bone. Early diagnosis and treatment of RA can improve outcomes and slow the progression of joint damage. Preliminary exploratory research had hinted an expected effect of modified Zhiwang decoction (MZWD) in treating early RA. However, few randomised clinical trials have evaluated the effectiveness of MZWD in early RA. Therefore, a parallel-group randomised controlled trial was designed to evaluate the efficacy and safety of MZWD combined with methotrexate (MTX) on early RA. METHODS AND ANALYSIS: This is a prospective, parallel-group, single-centre randomised controlled clinical study. A total of 150 patients will be randomly assigned to either the treatment (n=75) or control group (n=75). The treatment group will receive MZWD and MTX, and the control group will receive MTX for 12 weeks. The primary outcome of this study is Disease Activity Score-28, and the secondary outcomes are Fatigue Scale-14, Visual Analogue Scale pain scores and traditional Chinese medicine symptom scores. Safety outcomes, including adverse events and results of ECG and laboratory tests, will be monitored. ETHICS AND DISSEMINATION: Ethics approval was obtained from the Clinical Research Ethics Committee of the China-Japan Friendship Hospital (no. 2022-KY-124) on 8 July 2022. The findings will be disseminated in peer-reviewed publications. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT05508815).
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Antirreumáticos , Artrite Reumatoide , Medicamentos de Ervas Chinesas , Humanos , Metotrexato/efeitos adversos , Estudos Prospectivos , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/induzido quimicamente , Medicina Tradicional Chinesa/métodos , Medicamentos de Ervas Chinesas/efeitos adversos , Resultado do Tratamento , Método Duplo-Cego , Antirreumáticos/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
BACKGROUND: Jolkinolide B (JB), an entabietane-type diterpenoid in Euphorbia plants, has various pharmacological activities, including anticancer, anti-inflammatory, and anti-tuberculosis activities. However, no previous studies have proven whether JB can be regarded as a targeted drug for the treatment of rheumatoid arthritis (RA). PURPOSE: This study aimed to evaluate the anti-RA effects of JB and explore the potential mechanisms. METHODS: Components and targets of JB and RA were identified in different databases, and potential targets and pathways were predicted by protein-protein interaction (PPI) network analysis and pathway enrichment analysis. Then, molecular docking and surface-plasmon resonance (SPR) were used to confirm the predict. The anti-arthritic effects of JB were studied in vivo with collagen-induced arthritis (CIA) rat model and in vitro with lipopolysaccharide (LPS) and interleukin-6 (IL-6)-induced RAW264.7 macrophage. Potential mechanisms were further verified by in vivo and in vitro experiments. RESULTS: The Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that Th17 cell differentiation, prolactin signaling pathway, and JAK/STAT signaling pathway might be associated with anti-RA effects of JB. Molecular docking and SPR results showed that JB bound effectively to JAK2. JB significantly decreased body weight loss, arthritis index, paw thickness, and synovial thickness in CIA rats. Histomorphological results suggested the protective effects of JB on CIA rats with ankle joint injury. Molecular biology analysis indicated that JB suppressed the mRNA expression of inflammatory factors in ankle joints for CIA rats and reduced the concentration of these factors in LPS- induced RAW264.7 macrophage. The protein expression level of the JAK2/STAT3 pathway was also significantly decreased by JB. CONCLUSION: JB had a novel inhibitory effect on inflammation and bone destruction in CIA rats, and the mechanism might be related to the JAK2/STAT3 signaling pathway.
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Artrite Experimental , Artrite Reumatoide , Diterpenos , Ratos , Animais , Lipopolissacarídeos/farmacologia , Simulação de Acoplamento Molecular , Citocinas/metabolismo , Artrite Reumatoide/tratamento farmacológico , Transdução de Sinais , Diterpenos/efeitos adversos , Artrite Experimental/induzido quimicamenteRESUMO
Fibroblast-activated protein-α (FAP) is a type II integrated serine protease expressed by activated fibroblasts during fibrosis or inflammation. Fibroblast-like synoviocytes (FLSs) in rheumatoid arthritis (RA) synovial sites abundantly and stably overexpress FAP and play important roles in regulating the cellular immune, inflammatory, invasion, migration, proliferation, and angiogenesis responses in the synovial region. Overexpression of FAP is regulated by the initial inflammatory microenvironment of the disease and epigenetic signaling, which promotes RA development by regulating FLSs or affecting the signaling cross-linking FLSs with other cells at the local synovium and inflammatory stimulation. At present, several treatment options targeting FAP are in the process of development. This review discusses the basic features of FAP expressed on the surface of FLSs and its role in RA pathophysiology and advances in targeted therapies.
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Artrite Reumatoide , Sinoviócitos , Humanos , Sinoviócitos/metabolismo , Proliferação de Células/fisiologia , Artrite Reumatoide/metabolismo , Membrana Sinovial/metabolismo , Fibroblastos/metabolismoRESUMO
INTRODUCTION: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that may lead to bone erosion and disability. Although there are many biological therapies in RA treatment nowadays, such as etanercept and tofacitinib, there are still a considerable number of patients who cannot achieve clinical deep remission, which makes patients feel pain and stiffness of joints. As a traditional Chinese medicine preparation, Wangbi granule showed a synergistic role with methotrexate in the treatment of RA patients with "kidney deficiency and dampness" or "stasis blocking channels". Therefore, it is a promising therapeutic strategy for the clinical deep remission of RA. In this study, Wangbi granule will be used as the test drug. The investigators conduct this study to evaluate the efficacy and safety of Wangbi granule in the treatment of patients who have not achieved deep remission despite the use of methotrexate and tofacitinib. METHODS AND ANALYSIS: Two parallel randomized, triple-blind, placebo-controlled trials will be conducted. In six study centers, 340 eligible RA patients will be recruited and randomly allocated to either the intervention group or the control group (in a 1:1 ratio). They will receive Wangbi granule or Wangbi placebo 12.0 g each time, three times a day for 12 weeks. The primary outcome is the disease activity score derivative for 28 joints (DAS28). Secondary outcomes are patient-reported outcomes, American College of Rheumatology 50% response criteria (ACR50), fatigue scale-14 (FS-14), visual analogue scale for pain (VAS), health assessment questionnaire disability index (HAQ-DI) and biomarkers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). EXPECTED OUTCOMES: The success of this study will provide strong evidence to confirm the efficacy and safety of Wangbi granule in the treatment of RA. Trial registration The trial has been registered in the ClinicalTrials Registry (NCT05540938, Date: 09/15/2022, https://clinicaltrials.gov/ct2/show/NCT05540938 ).
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OBJECTIVE: To study the role of cytokines and lymphocyte subsets in the diagnosis, prognosis and efficacy evaluation of DLBCL patients, and the effects of Tislelizumab on immune function and cytokines in DLBCL patients. METHODS: Twenty-three patients with newly diagnosed DLBCL were selected as DLBCL group and 34 patients with megaloblastic anemia as the control group. The levels of peripheral blood cytokines IL-2, IL-4, IL-6, IL-10, TNF- α and IFN-γ by ELISA method. The levels of peripheral blood CD3+, CD4+, CD8+ T lymphocytes, B lymphocytes and NK cellsï¼ the ratio of CD4+/CD8+ were detected by flow cytometry. The levels of cytokins and lymphocyto subsets in DLBCL patients with different clinical data and different therapeutic effects were compared. RESULTS: The levels of cytokines IL-2, IL-6 and IL-10 in DLBCL group were significantly higher than those in control group, but there was no significant correlation between cytokine levels and age and gender. The higher IPI score, higher Ann Arbor stage, B symptoms, higher ß 2-MG, LDH and CRP levels, IL-6 and IL-10 levels were significantly higher, and IL-4 was also significantly higher in patients with high LDH levels. Compared with the ineffective group, the levels of IL-6 and IL-10 were significantly lower and the level of CD4+ T cells and the ratio of CD4+/CD8+ was significantly higher in the effective group before therapy. The levels of IL-6, IL-10 and B lymphocytes in the effective group decreased significantly after therapy compared to those before therapy. After 4 cycles of therapy, the level of IL-2 and the ratio of CD4+/CD8+ in the Tislelizumab group were significantly higher than those in the non-Tislelizumab group, and the level of CD8+ T cells was significantly lower than that in the non-Tislelizumab group(P<0.05). The level of B lymphocytes in both the Tislelizumab group and the non-Tislelizumab group after therapy was significantly lower than that before therapy. CONCLUSION: The expression of cytokines and lymphocyte subsets in peripheral blood of patients with DLBCL is abnormal, which is related to the severity, prognosis and therapeutic effect of the disease. Tislelizumab can improve the immune function of patients with DLBCL by affecting cytokines and lymphocyte subsets and strengthen anti-tumor immunity.
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BACKGROUND: The Coexistence of myeloid and lymphoid malignancies is rare. Myeloid leukemia occurs more frequently as a secondary event in patients receiving chemotherapy agents for lymphoid malignancies. Synchronous diagnoses of diffuse large B-cell lymphoma (DLBCL), acute myeloid leukemia (AML), and untreated lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM) in the same patient have not been reported. Here we report one such case. CASE SUMMARY: An 89-year-old man had a chest wall mass histopathologically diagnosed as DLBCL. The bone marrow and peripheral blood contained two groups of cells. One group of cells fulfilled the criteria of AML, and the other revealed the features of small B lymphocytic proliferative disorder, which we considered LPL/WM. Multiple chromosomal or genetic changes were detected in bone marrow mononuclear cells, including ATM deletion, CCND1 amplification, mutations of MYD88 (L265P) and TP53, WT1 overexpression, and fusion gene of BIRC2-ARAP1, as well as complex chromosomal abnormalities. The patient refused chemotherapy because of old age and died of pneumonia 1 mo after the final diagnosis. CONCLUSION: The coexistence of DLBCL, AML, and untreated LPL/WM in the same patient is extremely rare, which probably results from multiple steps of genetic abnormalities. Asymptomatic LPL/WM might have occurred first, then myelodysplastic syndrome-related AML developed, and finally aggressive DLBCL arose. Therefore, medical staff should pay attention to this rare phenomenon to avoid misdiagnoses.
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Public places favor the transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) due to dense population, large personal mobility, and higher contact opportunities. In order to protect the health of general public in operating public places during COVID-19 pandemic, this study proposed general precautions and control strategies from perspective of operation management, social distancing, cleaning and disinfection, and personal protection. In addition, with regard of risk level, specific precautions and control strategies were proposed for living service places, outdoor places, and confined places. The comprehensive application of above recommendations could effectively interrupt the spread of COVID-19, and protect the health of general public in public places. This study proposed general and specific precautions and control strategies in public places during COVID-19, and suggested further improvement of pandemic response.
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COVID-19 , Pandemias , Desinfecção , Humanos , Distanciamento Físico , SARS-CoV-2RESUMO
To prevent the spread of SARS-CoV-2 in cold-chain transportation in China, we developed specific cryogenic disinfectants. Carrier tests were performed against SARS-CoV-2 at - 20 °C for the four cryogenic disinfectants developed and qRT-PCR was used to test the virus RNA. Peracetic acid, chlorine disinfectants (two different concentrations), and quaternary ammonium disinfectant with their antifreeze can all inactivate SARS-CoV-2 in 5 min at - 20 °C. However, after 2-3 h of exposure, only chlorine disinfectant could destroy SARS-CoV-2 RNA. The viruses treated with peracetic acid and quaternary disinfectants showed positive Ct values even after 3 h detected with qRT-PCR. The conclusion was that the cold-chain disinfectants we tested could inactivate SARS-CoV-2 quickly and effectively, but only chlorine disinfectants could destroy nucleic acids in 3 h. Our study also illustrated that using qRT-PCR detection of viral nucleic acids to assess disinfection was inappropriate.
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COVID-19 , Desinfetantes , COVID-19/prevenção & controle , Desinfetantes/farmacologia , Desinfecção , Humanos , RNA Viral/análise , RNA Viral/genética , SARS-CoV-2 , TemperaturaRESUMO
Introduction: To explore the feasibility of pulsed ultraviolet (UV) light technology for low-temperature disinfection, a series of experiments were conducted. Methods: Pulsed UV technology's effectiveness in disinfecting Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli on different carriers were studied under varying temperatures. Results: Under different temperatures and constant radiation illumination (i.e., distance), the disinfection effect was correlated with irradiation time; among the three carriers, the disinfection effect of cloth sheets was the best, followed by stainless steel sheets, and corrugated paper sheet. The disinfection effect on Gram-negative bacteria Escherichia coli was better than that on Gram-positive bacteria Staphylococcus aureus overall. Discussion: Temperature has a limited effect on pulsed UV disinfection. Irradiation times and carrier types are influencing factors.
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Rheumatoid arthritis (RA) is a chronic, progressive inflammatory and systemic autoimmune disease resulting in severe joint destruction, lifelong suffering and considerable disability. Diverse prescriptions of traditional Chinese medicine (TCM) containing Epimedii Herba (EH) achieve greatly curative effects against RA. The present review aims to systemically summarize the therapeutic effect, pharmacological mechanism, bioavailability and safety assessment of EH to provide a novel insight for subsequent studies. The search terms included were "Epimedii Herba", "yinyanghuo", "arthritis, rheumatoid" and "Rheumatoid Arthritis", and relevant literatures were collected on the database such as Google Scholar, Pubmed, Web of Science and CNKI. In this review, 15 compounds from EH for the treatment of RA were summarized from the aspects of anti-inflammatory, immunoregulatory, cartilage and bone protective, antiangiogenic and antioxidant activities. Although EH has been frequently used to treat RA in clinical practice, studies on mechanisms of these activities are still scarce. Various compounds of EH have the multifunctional traits in the treatment of RA, so EH may be a great complementary medicine option and it is necessary to pay more attention to further research and development.
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RATIONALE: POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome is a rare and complicated disease related to multiple organs and systems. Here, we report a case of systemic mastocytosis (SM) that was misdiagnosed as a POEMS syndrome. PATIENT CONCERNS: A 42-year-old man presented with skin changes, diarrhea, and limb numbness. DIAGNOSES: Positron emission tomography/computed tomography revealed extravascular volume overload, organomegaly, lymphadenopathy, and bone lesions with mixed lesions of osteosclerosis and osteolysis. Therefore, POEMS syndrome was suspected. Further histopathological and immunohistochemical examination of the bone marrow, lymph nodes, and gastric mucosa suggested a diagnosis of mastocytosis. The c-Kit D816V mutation confirmed the diagnosis of SM. INTERVENTIONS: The patient received the treatment of pegylated interferon-alpha weekly and glucocorticoid daily. OUTCOMES: The symptoms relieved significantly. LESSONS: There are many similar features between POEMS syndrome and SM, probably leading to misdiagnosis. This study analyzed the different points between them which can provide help for differentiation.
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Mastocitose Sistêmica , Osteosclerose , Adulto , Medula Óssea , Diagnóstico Diferencial , Erros de Diagnóstico , Humanos , Linfonodos , Masculino , Mastocitose Sistêmica/diagnóstico , Osteosclerose/diagnóstico , Síndrome POEMS/diagnósticoRESUMO
WHAT IS ALREADY KNOWN ON THIS TOPIC?: Hydrogen peroxide sterilizeation is widely used for luminal devices. However, the low penetrability of the sterilant is of major concern. WHAT IS ADDED BY THIS REPORT?: This report investigated the effective sterilization of low-temperature hydrogen peroxide gas plasma sterilizers and compared the applicability of different biological monitoring methods based on medical luminal devices. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: It is recommended to use a biological process challenge device for monitoring the sterilization of luminal devices with low-temperature hydrogen peroxide gas plasma sterilizers.
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PURPOSE: Spina bifida occulta (SBO) is one of the most common congenital spinal deformities. Although many studies have demonstrated the influence of lumbosacral dysplasia on low back pain (LBP) in young athletes, there have been few studies on SBO among young people in other occupations. The purpose of this study is to investigate the distribution of SBO in young people with LBP and to classify SBO from the perspective of lamina development. METHODS: The X-ray films of 148 young patients with LBP were analyzed to quantify the distribution of SBO and classify abnormal laminae. RESULTS: Of the 148 patients, 93 (61.49%) had SBO: 83 cases involved S1 alone, 2 involved L5-S1, 5 involved S1-2, 2 involved S1-4, and 1 involved L4-S4. According to the degree of the defect, the patients with SBO were divided on the basis of five grades: 9 patients with grade I, 53 with grade II, 23 with grade III, and 8 with grade IV. The cases were classified by the shape of the laminae into 4 types: 15 cases of type a, 11 cases of type b, 37 cases of type c, and 30 cases of type d. CONCLUSION: Among the young people with LBP that we surveyed, SBO is the most common lumbosacral dysplasia, which frequently involves the S1 segment. Most laminae in SBO are in the developmental stage of the spinous process, and an abnormal laminar growth direction and laminar stenosis are the most common laminar morphologies in SBO.
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Dor Lombar/classificação , Dor Lombar/diagnóstico por imagem , Espinha Bífida Oculta/classificação , Espinha Bífida Oculta/diagnóstico por imagem , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Radiografia , Estudos Retrospectivos , Adulto JovemRESUMO
The coronavirus disease 2019 (COVID-19) pandemic increased the burden on many healthcare systems and in the process, exposed the need for medical resources and physical space. While few studies discussed the efficient utilization of medical resources and physical space so far. Therefore, this study aimed to summarize experiences related to facilities used for centralized isolation for medical observation and treatment during the COVID-19 pandemic in China and to provide suggestions to further improve the management of confirmed cases, suspected cases, and close contacts. In China, three types of facilities for centralized isolation (Fangcang shelter hospitals, refitted non-designated hospitals, and quarantine hotels) underwent retrofitting for the treatment and isolation of confirmed and suspected cases. These facilities mitigated the immediate high demand for space. Moreover, in order to minimize infection risks in these facilities, regulators and governmental agencies implemented new designs, management measures, and precautionary measures to minimize infection risk. Other countries and regions could refer to China's experience in optimally allocating social resources in response to the COVID-19 pandemic. As a conclusion, government should allocate social resources and construct centralized isolation and quarantine facilities for an emergency response, health authorities should issue regulations for centralized isolation facilities and pay strict attention to the daily management of these facilities, a multidisciplinary administration team is required to support the daily operation of a centralized isolation facility, in-depth studies and international collaboration on the centralized isolation policy are encouraged.
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OBJECTIVE: To establish 3 drinking water emergent disinfection processing models, separated medicate dispensing, specific duty medicate dispensing, and centralized filtering, in flood/waterlog areas, and compare the effects of these 3 models on the drinking water disinfection processing. METHODS: From October to December, 2008, 18 villages were selected as the trial field in Yanglinwei town, Xiantao city, Hubei province, which were divided into three groups, separated medicate dispensing, specific duty medicate dispensing, and centralized filtering. Every 2 weeks, drinking water source water, yielding water of emergency central filtrate water equipment (ECFWE) and container water in the kitchen were sampled and microbe indices of the water sample, standard plate-count bacteria, total coliforms, thermotolerant coliform bacteria, Escherichia coli were measured. RESULTS: The microbe pollution of the water of these 3 water source groups are heavy, all failed. The eliminating rate of the standard plate-count bacteria of the drinking water emergent centralized processing equipment is 99.95%; those of the separate medicate dispensing, specific duty medicate dispensing and centralized filtering are 81.93%, 99.67%, and 98.28%, respectively. The passing rates of the microbe indice of the resident contained water are 13.33%, 70.00%, and 43.33%, respectively. The difference has statistical significance. CONCLUSIONS: The drinking water disinfection effects of the centralized filtering model and of the specific duty medicate dispensing model are better than that of the separated medicate dispensing model in the flood/waterlog areas.
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Desastres , Desinfecção/métodos , Inundações , Poluição da Água/prevenção & controle , Abastecimento de Água , China , Modelos TeóricosRESUMO
OBJECTIVES: Haploidentical hematopoietic stem cell transplantation (Haplo-SCT) and matched unrelated donor transplantation (MUD-SCT) are two important options when a matched sibling donor (MSD) is unavailable. Several studies comparing Haplo-SCT and MUD-SCT have reported inconsistent clinical outcomes. Therefore, it is necessary to synthesize the existing evidence regarding outcomes of stem cell transplantations comparing Haplo-SCT with MUD-SCT. METHODS: We searched for titles of articles in MEDLINE (PubMed), Cochrane library, EMBASE database that compared transplantation with Haplo-SCT versus MUD-SCT. To compare clinical outcomes between Haplo-SCT and MUD-SCT, we performed a meta-analysis of 17 studies and reported the pooled odd ratios (OR) of 6 endpoints including overall survival (OS), progression free survival (PFS), non-relapse mortality (NRM), relapse rate (RR), acute graft-versus-host disease (aGVHD) and chronic graft- versus-host disease (cGVHD). RESULTS: We found that Haplo-SCT was associated with a comparable OS (pooled OR of 0.99, 95% Confidence Interval (CI) 0.86-1.14), PFS (OR 1.00, 95% CI 0.88-1.15), NRM (OR 0.83, 95% CI 0.65-1.04) and RR (OR 1.08, 95% CI 0.95-1.22) compared to MUD-SCT. We also found a significantly decreased risk of aGVHD (OR 0.74, 95% CI 0.62-0.88) and cGVHD (OR 0.50, 95% CI 0.38-0.66) in Haplo-SCT group. CONCLUSION: Results of this meta-analysis demonstrates that Haplo-SCT achieves comparable clinical outcomes compared to MUD-SCT in terms of OS, PFS, TRM and RR, but is better than MUD-SCT in terms of decreased aGVHD and cGVHD risk. Haplo-SCT is a valid option for patient needing urgent transplantation.