Electrophysiologic Characteristics of Nitrous-Oxide-Associated Peripheral Neuropathy:A Retrospective Study of 76 Patients

Background@#and Purpose The electrophysiologic characteristics of peripheral neuropathy secondary to nitrous oxide (N2O) abuse remain unclear. The paper therefore aimed to summarize the electrophysiologic characteristics of N2O-associated peripheral neuropathy and identify the risk factors of severe nerve injury. @*Methods@#The electrophysiologic results and clinical data of patients with peripheral neuropathy secondary to N2O abuse at our hospital between 2018 and 2020 were analyzed retrospectively, and their electrophysiologic changes were summarized. @*Results@#Most patients exhibited decreased sensory and motor nerve conduction velocities (75% and 76%), decreased sensory nerve and compound motor action potentials (57% and 59%), and prolonged distal motor latency (59%), while a response was absent in 36%. These findings indicate that N2O abuse can result in generalized injury to sensory and motor nerves. Electrophysiologic results indicated axonal neuropathy in 37 cases (49%), demyelinating peripheral neuropathy in 4 (5%), and mixed neuropathy in 12 (16%). Peripheral nerve injury was more common in the lower limbs (72%) than in the upper limbs (42%, p<0.0001). The upper and lower limbs were primarily affected by sensory nerve demyelination (35%) and motor axonal injury (67%), respectively. Subgroup analysis indicated that longer N2O exposure and longer disease course were associated with more-severe motor axonal injury in the lower limbs. @*Conclusions@#N2O-associated peripheral neuropathy can lead to sensory and motor nerve injury, with axonal injury being the most common. Injuries were more severe in the lower limbs. Prolonged N2O exposure and disease course increased the severity of motor axonal injury in the lower limbs.

Effect of melatonin on postoperative sleep quality: a meta-analysis / 中华麻醉学杂志

Objective:To systematically evaluate the effect of melatonin on postoperative sleep quality.Methods:Databases such as PubMed, Embase, Cochrane library, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database and China Science and Technology Journal Database were searched from inception to January 30, 2022 for randomized controlled trials (RCTs) comparing the effects of melatonin versus placebo on postoperative sleep quality.The outcomes analyzed were visual analog scale (VAS) score, sleep quality scale score, subjective sleep scale score, St.Mary′s Hospital sleep questionnaires score, sleep latency, total sleep time, number and duration of awakenings, and incidence of postoperative sleep disturbance.Statistical analysis was performed using the RevMan 5.4 software and Stata 16 software, and the trial sequential analysis (TSA) was conducted using the TSA 0.9.5.10 Beta software. Results:Eleven RCTs involving 822 patients were finally enrolled, with 431 patients in melatonin group and 391 patients in placebo group.The results of meta-analysis showed that melatonin significantly decreased postoperative VAS and sleep quality scale scores, and increased the postoperative subjective sleep scale and St.Mary′s Hospital sleep questionnaires scores, a daily dose of melatonin 6 mg produced a better efficacy, and it also prolonged the postoperative total sleep time and decreased the incidence of postoperative sleep disorders ( P<0.05), However, it had no effect on postoperative sleep latency and the number and duration of awakenings ( P>0.05). The results of TSA showed that although the actual sample size did not reach the expected sample size, the accumulated Z value crossed the traditional boundary value and the TSA boundary value, which indicated that the results of this meta-analysis had stability and further confirmed the efficacy of melatonin in improving postoperative sleep quality. Conclusions:Melatonin can improve postoperative sleep quality and a daily dose of melatonin 6 mg exerts a better efficacy.

Efficacy and safety of baricitinib in the treatment of moderate-to-severe atopic dermatitis: a clinical observation / 中华皮肤科杂志

Objective:To evaluate the efficacy and safety of baricitinib in the treatment of moderate-to-severe atopic dermatitis (AD) .Methods:From June 2020 to June 2021, patients with moderate-to-severe AD who were insensitive or intolerant to topical agents were enrolled from Department of Dermatology, Peking University First Hospital. Before treatment, the patients were evaluated by 4 scales, including the Investigator′s Global Assessment (IGA), Eczema Area and Severity Index (EASI), Itch Numeric Rating Scale (NRS), and Dermatology Life Quality Index (DLQI) ; meanwhile, photos of skin lesions were taken, routine blood test was performed, blood biochemical indices and total IgE levels were measured. After exclusion of contraindications, the patients were treated with oral baricitinib at a dose of 2 mg/d for 16 weeks. Regular follow-up was conducted at weeks 1, 2, 4, 8, 12, 16 and 20 after the start of treatment, clinical evaluation was carried out with the above 4 scales, and adverse events were recorded during the treatment.Results:A total of 24 patients were enrolled in the study, and all completed 16-week oral treatment and 20-week follow-up. All the 4 scale scores showed a continuous downward trend within 20 weeks after the start of treatment. At week 20, the patients′ IGA, EASI, NRS, and DLQI scores significantly decreased from 4.13 ± 0.61, 37.59 ± 14.86, 6.83 ± 2.26 and 18.67 ± 8.64 points respectively at baseline to 1.12 ± 0.49, 4.53 ± 3.78, 0.72 ± 0.58 and 1.39 ± 0.85 points respectively ( t = 22.70, 10.55, 10.69, 8.40, respectively, all P < 0.001). During the follow-up period, no serious adverse reactions were observed; 3 patients experienced gastric discomfort at the start of oral treatment, but the symptoms disappeared after the treatment continued; 3 developed acute allergic manifestations (1 case of allergic conjunctivitis, 2 cases of acute urticaria), which resolved rapidly after the use of antihistamines without recurrence. Conclusion:Baricitinib can provide a safer and more effective treatment option for patients with moderate-to-severe AD, especially those who are insensitive or intolerant to topical agents and need systemic treatments.

The 495th case: young female-hyperandrogenemia-severe insulin resistance / 中华内科杂志

A 22-year-old female has complained of hirsutism, acanthosis nigricans, enlarged clitoris, and menstrual disorders since puberty. Laboratory examinations revealed hyperandrogenemia. Severe insulin resistance and diabetes were found during hospitalization in our hospital. She was diagnosed with type A insulin resistance syndrome finally. After treatment with metformin, the acanthosis nigricans was significantly relieved, blood glucose was controlled satisfactorily, and the menstrual cycle was restored.

Meta-analysis on the effect of combining Lianhua Qingwen with Western medicine to treat coronavirus disease 2019 / 中西医结合学报

BACKGROUND@#Coronavirus disease 2019 (COVID-19) has become a worldwide life-threatening pandemic. Lianhua Qingwen is believed to possess the ability to treat or significantly improve the symptoms of COVID-19. These claims make it important to systematically evaluate the effects of using Lianhua Qingwen with Western medicine to treat COVID-19.@*OBJECTIVE@#To evaluate the safety and efficacy of combination therapy, employing Lianhua Qingwen with Western medicine, to treat COVID-19, using a meta-analysis approach.@*SEARCH STRATEGY@#China National Knowledge Infrastructure, Wanfang Database, VIP Database, PubMed, Embase, and Cochrane Library databases were searched for studies evaluating the effect of Lianhua Qingwen-Western medicine combination therapy in the treatment of COVID-19.@*INCLUSION CRITERIA@#(1) Research object: hospitalized patients meeting the diagnostic criteria of COVID-19 were included. (2) Intervention measures: patients in the treatment group received Lianhua Qingwen treatment combined with Western medicine, while the control group received either Western medicine or Chinese medicine treatment. (3) Research type: randomized controlled trials and retrospective study were included.@*DATA EXTRACTION AND ANALYSIS@#Two researchers extracted the first author, the proportion of males and females, age, body temperature, course of treatment, rate of disappearance of main symptoms, duration of fever, adverse reactions, and total effectiveness from the literature. Odds ratio (OR) and 95% confidence interval (CI) were used as the effect value for count data, and mean difference (MD) and 95% CI were used as the effect value for measurement data.@*RESULTS@#Six articles met the inclusion criteria, including a total of 856 COVID-19 patients. The meta-analysis showed that Lianhua Qingwen combination therapy achieved higher rates of fever reduction (OR = 3.43, 95% CI [1.78, 6.59], P = 0.0002), cough reduction (OR = 3.39, 95% CI [1.85, 6.23], P < 0.0001), recovery from shortness of breath (OR = 10.62, 95% CI [3.71, 30.40], P < 0.0001) and recovery from fatigue (OR = 2.82, 95% CI [1.44, 5.53], P = 0.003), higher total effectiveness rate (OR = 2.51, 95% CI [1.73, 3.64], P < 0.00001), and shorter time to recovery from fever (MD = -1.00, 95% CI [-1.04, 0.96], P < 0.00001), and did not increase the adverse reaction rate (OR = 0.65, 95% CI [0.42, 1.01], P = 0.06), compared to the single medication control.@*CONCLUSION@#The Lianhua Qingwen and Western medicine combination therapy is highly effective for COVID-19 patients and has good clinical safety. As only a small number of studies and patients were included in this review, more high-quality, multicenter, large-sample-size, randomized, double-blind, controlled trials are still needed for verification.

Flavor Characterization of Rhei Radix et Rhizoma Processed with Nine-time Repeating Steaming and Sun-drying Based on Intelligent Sensory Technology / 中国实验方剂学杂志

ObjectiveTo analyze the flavor substances and change rules of Rhei Radix et Rhizoma during the process of nine-time repeating steaming and sun-drying. MethodThe flavor response values of Rhei Radix et Rhizoma samples were obtained by using PEN3 electronic nose system. The data were processed and analyzed by principal component analysis （PCA）， linear discriminant analysis （LDA） and Loadings analysis. ResultRhei Radix et Rhizoma processed with nine-time repeating steaming and sun-drying could be effectively distinguished into two categories as the sixth sample was the turning point. The samples steamed and dried for one to five times could be grouped into one category， the other four samples were obviously distinguished from them. The main flavor components reached the maximum response in the sample processed with six-time repeating steaming and sun-drying， and its response value of inorganic sulfur compounds was about 2.7 times that of the sample processed with one-time repeating steaming and sun-drying. In addition， compared with the raw products， the flavors of Rhei Radix et Rhizoma processed with nine-time repeating steaming and sun-drying and wine stewing changed significantly， and the response value of inorganic sulfur compounds in sample processed with nine-time repeating steaming and sun-drying was about 2.2 times that of raw products. From the perspective of flavor analysis， the response values of inorganic sulfur compounds and nitrogen-oxygen compounds in sample processed with nine-time repeating steaming and sun-drying were higher than those of wine-stewed products， and the two were not completely equivalent. ConclusionElectronic nose technology preliminarily clarifies the dynamic change rules of the flavor of Rhei Radix et Rhizoma during the process of nine-time repeating steaming and sun-drying from the flavor characteristics， and clarifies the difference between products processed with nine-time repeating steaming and sun-drying and wine-stewed products from the odor characteristics， which lays a foundation for revealing the processing principle of Rhei Radix et Rhizoma processed with nine-time repeating steaming and sun-drying.

Retrospective analysis of omalizumab in the treatment of 27 cases of symptomatic dermographism / 中华皮肤科杂志

Objective:To evaluate clinical efficacy and safety of omalizumab in the treatment of symptomatic dermographism by analyzing real-world data.Methods:Clinical data were collected from patients with symptomatic dermographism who completed 16-week treatment with omalizumab in Department of Dermatology, Peking University First Hospital from February 2018 to May 2021, and retrospectively analyzed. The analysis was done by comparing data obtained before and after the treatment, including critical friction thresholds (CFTs) , pruritus scores in a provocation test, as well as urticaria control test (UCT) , dermatology life quality index (DLQI) and chronic urticaria quality of life questionnaire (CU-Q2oL) scores. Adverse events reported by patients during the treatment were recorded. Wilcoxon signed-rank test was applied for the analysis of clinical data before and after the treatment.Results:A total of 27 patients with symptomatic dermographism who completed 16 weeks of omalizumab treatment were included. At baseline, the CFTs of all the 27 patients were 4, and their UCT, DLQI and CU-Q2oL scores were 7.0 (5.0, 8.0) , 9.0 (6.0, 10.0) , 63.0 (50.0, 72.0) points respectively. At week 4, the CFTs decreased from 4 to 0 in 9 patients (33.3%) , the UCT scores increased to 14.0 (12.0, 16.0) points ( Z = 4.548, P<0.05) , and the DLQI and CU-Q2oL scores decreased to 2.0 (0.0, 2.0) and 32.0 (25.0, 41.0) points respectively in the 27 patients ( Z = 4.513, 4.433, respectively, both P<0.05) . At week 6, the UCT scores increased to 15.0 (14.0, 16.0) points, and the DLQI and CU-Q2oL scores decreased to 0.0 (0.0, 1.0) and 25.0 (23.0, 30.0) points respectively in the 27 patients. No drug-related serious adverse events were reported during the treatment. Conclusion:Omalizumab can effectively improve the symptoms of symptomatic dermographism and patients′ quality of life with a good safety profile.

Efficacy and safety of omalizumab for treatment of chronic spontaneous urticaria / 中华皮肤科杂志

Objective:To retrospectively evaluate efficacy and safety of omalizumab in the treatment of chronic spontaneous urticaria (CSU) , as well as recurrence after its withdrawal.Methods:Clinical data on patients with CSU, who received omalizumab treatment in Peking University First Hospital from February 2018 to January 2021, were collected and analyzed retrospectively. Through outpatient follow-up, urticaria control test (UCT) and dermatology life quality index (DLQI) were recorded to assess disease severity, and adverse events and recurrence after omalizumab withdrawal were monitored. Comparisons of normally distributed measurement data between groups were carried out using t test or analysis of variance, comparisons of non-normally distributed measurement data between groups using Mann-Whitney U test, Wilcoxon signed-rank test or Kruskal-Wallis H test, and comparisons of enumeration data between groups using chi-square test or Fisher′s exact test. Results:A total of 59 patients with CSU were included and treated with omalizumab for at least 3 months, of whom, 45 were treated for more than 6 months, and 15 for more than 12 months. After the start of omalizumab treatment, UCT scores increased from 3.0 (1.0, 6.0) points at baseline to 11.0 (3.0, 14.0) points at 1 month and 15.0 (12.0, 16.0) points at 3 months (both P < 0.05) ; DLQI scores decreased from 16.0 (12.0, 20.0) points at baseline to 7.0 (1.0, 13.0) points at 1 month and 1.0 (0.0, 4.0) points at 3 months (both P < 0.05) . The proportion of patients achieving partial or complete disease control increased from 0 at baseline to 44.1% at 1 month, 78.0% at 3 months, and 88.9% at 6 months. The proportion of patients whose quality of life was severely or extremely severely affected by CSU decreased from 84.7% at baseline to 30.5% at 1 month, 15.3% at 3 months, and 4.4% at 6 months. The disease duration was significantly shorter in the complete response group and partial response group than in the non-response group ( t = -2.894, -2.511, P = 0.011, 0.036, respectively) ; the treatment duration was significantly longer in the complete response group than in the partial response group and non-response group ( t = 2.479, 2.677, P = 0.039, 0.022, respectively) . Compared with the rapid response group, the slow response group showed higher DLQI scores ( Z = -2.622, P = 0.009) and lower UCT scores ( Z = -2.746, P = 0.006) at baseline. Nineteen patients withdrew omalizumab after complete control of CSU, of whom 13 (68.4%) experienced relapse 7.0 (5.0, 8.0) weeks after the withdrawal, and showed significantly higher UCT scores at relapse than at baseline ( Z = 3.172, P = 0.001) . The disease duration was significantly longer in the recurrence group than in the non-recurrence group ( Z = -2.635, P = 0.007) . After recurrence, 5 patients restarted omalizumab treatment, and all of them regained partial or complete disease control. The adverse events reported during the treatment were all mild to moderate. Conclusions:Omalizumab can effectively and safely control symptoms of CSU and improve the quality of life of patients with CSU. However, recurrence frequently occurs after omalizumab withdrawal, and reinitiating omalizumab treatment after recurrence is still effective.

Scoring systems for chronic spontaneous urticaria in clinical research and practice / 中华皮肤科杂志

Chronic spontaneous urticaria (CSU) greatly affects the quality of life of patients. Currently, no sensitive and convenient biomarkers are available to assess the severity of CSU and efficacy of drug therapies. It is particularly important to apply patient-reported outcome assessment tools with good reliability and validity in daily management of CSU, such as urticaria activity score, urticaria control test and chronic urticaria quality of life questionnaire. This review outlines the existing CSU assessment tools, analyzes their strengths, limitations and clinical application, aiming to establish a CSU clinical scoring system, and to facilitate personalized treatment and efficacy evaluation.

The classification and relavant theory of plague in Traditional Chinese Medicine / 国际中医中药杂志

Plague, infectious disease in modern medicine, refers to a type of disease with strong pathogenicity and infectiousness, it refers to the infectious diseases of western medicine. Due to its wide variety, the knowledge and understanding of plagues of Traditional Chinese Medicine (TCM) doctors in different stages have evolved and developed with the times. This article, via collating ancient documents, differentiatesthe classification in TCM and analyzes itsrelated theories to perfect the type of plagues in TCM, providing the theoretical basis for the research of plague in modern times.

Novel MSX1 variants identified in families with nonsyndromic oligodontia / 国际口腔科学杂志·英文版

The goal of this study was to identify MSX1 gene variants in multiple Chinese families with nonsyndromic oligodontia and analyse the functional influence of these variants. Whole-exome sequencing (WES) and Sanger sequencing were performed to identify the causal gene variants in five families with nonsyndromic oligodontia, and a series of bioinformatics databases were used for variant confirmation and functional prediction. Phenotypic characterization of the members of these families was described, and an in vitro analysis was performed for functional evaluation. Five novel MSX1 heterozygous variants were identified: three missense variants [c.662A>C (p.Q221P), c.670C>T (p.R224C), and c.809C>T (p.S270L)], one nonsense variant [c.364G>T (p.G122*)], and one frameshift variant [c.277delG (p.A93Rfs*67)]. Preliminary in vitro studies demonstrated that the subcellular localization of MSX1 was abnormal with the p.Q221P, p.R224C, p.G122*, and p.A93Rfs*67 variants compared to the wild type. Three variants (p.Q221P, p.G122*, and p.A93Rfs*67) were classified as pathogenic or likely pathogenic, while p.S270L and p.R224C were of uncertain significance in the current data. Moreover, we summarized and analysed the MSX1-related tooth agenesis positions and found that the type and variant locus were not related to the severity of tooth loss. Our results expand the variant spectrum of nonsyndromic oligodontia and provide valuable information for genetic counselling.

Schroth exercises improve health-related quality of life and radiographic parameters in adolescent idiopathic scoliosis patients / 中华医学杂志(英文版)

BACKGROUND@#Finding an optimal treatment strategy for adolescent idiopathic scoliosis (AIS) patients remains challenging because of its intrinsic complexity. For mild to moderate scoliosis patients with lower skeletal growth potential (Risser 3-5), most clinicians agree with observation treatment; however, the curve progression that occurs during puberty, the adolescent period, and even in adulthood, remains a challenging issue for clinicians. The aim of the study is to investigate the efficacy of Schroth exercise in AIS patients with lower skeletal growth potential (Risser 3-5) and moderate scoliosis (Cobb angle 20°-40°).@*METHODS@#From 2015 to 2017, data of 64 patients diagnosed with AIS in Peking University Third Hospital were reviewed. Forty-three patients underwent Schroth exercise were classified as Schroth group, and 21 patients underwent observation were classified as observation group. Outcomes were measured by health-related quality of life (HRQOL) and radiographic parameters. HRQOL was assessed using the visual analog scale (VAS) scores for back, Scoliosis Research Society-22 (SRS-22) patient questionnaire. Radiographic spinopelvic parameters were obtained from anteroposterior and lateral X-rays. The pre-treatment and post-treatment HRQOL and radiographic parameters were tested to validate Schroth exercise efficacy. The inter-rater reliability of the radiographic parameters was tested using the interclass correlation coefficient (ICC). The paired t test was used to examine HRQOL and radiographic parameters. Clinical relevance between C2-C7 sagittal vertical axis (SVA) and thoracic kyphosis was analyzed using Spearman correlation.@*RESULTS@#In Schroth group, VAS back score, SRS-22 pain, and SRS-22 self-image domain were significantly improved from pre-treatment 3.0 ± 0.8, 3.6 ± 0.5, and 3.5 ± 0.7 to post-treatment 1.6 ± 0.6 (t = 5.578, P = 0.013), 4.0 ± 0.3 (t = -3.918, P = 0.001), and 3.7 ± 0.4 (t = -6.468, P < 0.001), respectively. No significant improvements of SRS-22 function domain (t = -2.825, P = 0.088) and mental health domain (t = -3.174, P = 0.061) were observed. The mean Cobb angle decreased from 28.9 ± 5.5° to 26.3 ± 5.2° at the final follow-up, despite no statistical significance was observed (t = 1.853, P = 0.102). The mean C2-C7 SVA value decreased from 21.7 ± 8.4 mm to 17.0 ± 8.0 mm (t = -1.224 P = 0.049) and mean T1 tilt decreased from 4.9 ± 4.2 ° to 3.5 ± 3.1° (t = 2.913, P = 0.011). No significant improvement of radiographic parameters and HRQOL were observed in observation group.@*CONCLUSIONS@#For AIS patients with a Risser 3-5 and a Cobb angle 20°-40°, Schroth exercises improved HRQOL and halted curve progression during the follow-up period. Both cervical spine alignment and shoulder balance were also significantly improved after Schroth exercises. We recommend Schroth exercises for patients with AIS.

Study on the Activity of Lycorine to the in vivo Apoptosis of Tumor Cells in H 22-bearing Mice and Its Mechanism / 中国药房

OBJECTIVE：To investigate the activity of lycorine to the in vivo apoptosis of tumor cells in H 22-bearing mice and its mechanism. METHODS ：Kunming mice were inoculated subcutaneously with ascites of H 22 hepatoma mice in the armpit of forelimb to establish solid tumor model. After modeling ，mice were randomly divided into negative control group ，positive control group（hydroxycamptothecin 6 mg/kg），lycorine low-dose ，medium-dose and high-dose groups （10，20，40 mg/kg），with 10 mice in each group. Negative control group was given constant volume of normal saline intragastrically ，and administration groups were given relevant medicine intragastrically ，once a day ，for consecutive 7 days. After last medication ，the weight of tumor was detected and anti-tumor rate was calculated. Ascites tumor model of mice was established by intraperitoneal injection of H 22 hepatoma mice ascites ，and then were grouped with same method and given relevant medicine as above. After last medication ， survival time of mice was recorded and the life prolongation rate was calculated. The early apoptotic rate of tumor cells in mice was detected by flow cytometry. On the basis of normal control group （normal mice without tumor ），the mitochondrial membrane permeability of tumor cells in each group was investigated by Calcein AM staining. The changes of mitochondrial potential were investigated by Rhodamine 123 staining. Colorimetry and Western blot assay were adopted to detect the Caspase-3 activity and expression of apoptosis-related protein （Bcl-2，Bax，Cyt-C and Caspase- 9）. RESULTS ：Compared with negative control UN- group，the tumor weight of positive control group and lycorine PYSCT-2017208） groups were decreased significantly ，while the survival time was significantly prolonged ，and the early apoptotic rate of tumor cells was significantly increased （P＜0.05 or P＜0.01）；the anti-tumor rates were 39.41％ ， 23.36％ ， 36.50％ ， 56.93％，and life prolonga tion rates were 49.23％，29.09％， E-mail：ym913@yahoo.com.cn 50.19％，69.08％. Compared with normal control group ，the mitochondrial membrane permeability ，Caspase-3 protein activity and protein expression of Cyt-C and Caspase- 9 were significantly increased，while the mitochondrial membrane potential and Bcl- 2/Bax ratio were decreased significantly （P＜0.05 or P＜0.01）. Compared with negative control group ，mitochondrial membrane permeability and Bcl- 2/Bax ratio were decreased significantly in administration groups ，while mitochondrial permeability ，Caspase-3 protein activity and protein expression of Cyt-C and Caspase- 9 were significantly increased （P＜0.05 or P＜0.01）. CONCLUSIONS ：Lycorine can induce the apoptosis of tumor cells in H22-bearing mice ，the effects of which may be associated with opening mitochondrial membrane permeability transition pore to increase mitochondrial permeability ， decreasing mitochondrial membrane potential and up-regulating the expression of apoptosis-related proteins.

Evaluation of drug myocardial toxicity and biological activity by real time xCELLigence analysis: a review / 生物工程学报

Realtime xCELLigence analysis (RTCA) is a new cell detection technology to continuously monitor, record and analyze a variety of information generated by cell activity. In drug research, it plays an important role in assessing myocardial toxicity and cell biological activity. Here, we first introduce the underlying mechanisms and characteristics of RTCA. Then we review the applications of RTCA in the research of myocardial toxicity and cell biological activity, to provides the fundamental baseline for understanding and exploiting RTCA. With the real-time, unlabeled, non-invasive, high throughput, and high accuracy features, RTCA not only promotes drug research and development, but also has a broad and good application prospect in other fields.

Exploring an Integrative Therapy for Treating COVID-19: A Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVES@#To develop a new Chinese medicine (CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome (ARDS) in COVID-19 patients.@*METHODS@#A putative ARDS-suppressing drug Keguan-1 was first developed and then evaluated by a randomized, controlled two-arm trial. The two arms of the trial consist of a control therapy (alpha interferon inhalation, 50 µg twice daily; and lopinavir/ritonavir, 400 and 100 mg twice daily, respectively) and a testing therapy (control therapy plus Keguan-1 19.4 g twice daily) by random number table at 1:1 ratio with 24 cases each group. After 2-week treatment, adverse events, time to fever resolution, ARDS development, and lung injury on newly diagnosed COVID-19 patients were assessed.@*RESULTS@#An analysis of the data from the first 30 participants showed that the control arm and the testing arm did not exhibit any significant differences in terms of adverse events. Based on this result, the study was expanded to include a total of 48 participants (24 cases each arm). The results show that compared with the control arm, the testing arm exhibited a significant improvement in time to fever resolution (P=0.035), and a significant reduction in the development of ARDS (P=0.048).@*CONCLUSIONS@#Keguan-1-based integrative therapy was safe and superior to the standard therapy in suppressing the development of ARDS in COVID-19 patients. (Trial registration No. NCT04251871 at www.clinicaltrials.gov ).

Exploring an Integrative Therapy for Treating COVID-19: A Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVES@#To develop a new Chinese medicine (CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome (ARDS) in COVID-19 patients.@*METHODS@#A putative ARDS-suppressing drug Keguan-1 was first developed and then evaluated by a randomized, controlled two-arm trial. The two arms of the trial consist of a control therapy (alpha interferon inhalation, 50 µg twice daily; and lopinavir/ritonavir, 400 and 100 mg twice daily, respectively) and a testing therapy (control therapy plus Keguan-1 19.4 g twice daily) by random number table at 1:1 ratio with 24 cases each group. After 2-week treatment, adverse events, time to fever resolution, ARDS development, and lung injury on newly diagnosed COVID-19 patients were assessed.@*RESULTS@#An analysis of the data from the first 30 participants showed that the control arm and the testing arm did not exhibit any significant differences in terms of adverse events. Based on this result, the study was expanded to include a total of 48 participants (24 cases each arm). The results show that compared with the control arm, the testing arm exhibited a significant improvement in time to fever resolution (P=0.035), and a significant reduction in the development of ARDS (P=0.048).@*CONCLUSIONS@#Keguan-1-based integrative therapy was safe and superior to the standard therapy in suppressing the development of ARDS in COVID-19 patients. (Trial registration No. NCT04251871 at www.clinicaltrials.gov ).

The Chinese version of chronic urticaria quality of life questionnaire (CU-Q2oL) : validation of reliability and validity / 中华皮肤科杂志

Objective:To assess the reliability and validity of the Chinese version of chronic urticaria quality of life questionnaire (CU-Q2oL) .Methods:The original English version of CU-Q2oL was translated into Chinese after forward-backward translation and cultural adaption, and items of the Chinese version of CU-Q2oL were determined. From January to December 2019, 195 chronic spontaneous urticaria patients with or without chronic inducible urticaria were enrolled from Department of Dermatology and Venereology, Peking University First Hospital, and followed up every 2 weeks. A total of 2 follow-ups were carried out, and a questionnaire survey was conducted by using the Chinese version of CU-Q2oL, dermatology life quality index (DLQI) and urticaria activity score over 7 days (UAS7) during each follow-up. After each follow-up, the treatment protocol for each patient was adjusted by clinicians based on the patient′s condition. The number of questionnaire factors was extracted by exploratory factor analysis, convergent validity was estimated by analyzing correlations of CU-Q2oL with DLQI and UAS, and the internal consistency reliability of CU-Q2oL was evaluated by calculating Cronbach′s α coefficient; the sensitivity of CU-Q2oL was assessed by analyzing correlations of changes in UAS7 scores with changes in CU-Q2oL scores.Results:Four factors were extracted from the Chinese version of CU-Q2oL, namely "symptoms", "daily functional activities", "sleep problems" and "restrictions" factors. There were 23 items in total, and the cumulative variance contribution rate was 74.011%. The Cronbach′s α coefficient of all items in CU-Q2oL was 0.961, and the Cronbach′s α coefficient of the 4 factors ranged from 0.804 to 0.933, suggesting excellent internal consistency. The total score of CU-Q2oL was moderately correlated with DLQI and UAS7 scores, with correlation coefficients of 0.437 and 0.560, respectively (both P < 0.01) . A total of 71 patients completed the second follow-up. The change in the total score of CU-Q2oL was moderately correlated with that in the UAS7 score, with a correlation coefficient of 0.392 ( P < 0.01) . Conclusion:The Chinese version of CU-Q2oL has excellent internal consistency, good reliability and validity, and can be used to evaluate the quality of life of patients with chronic spontaneous urticaria in China.

Evaluation of reliability, validity and sensitivity of the Chinese version of pruritus-specific quality of life instrument / 中华皮肤科杂志

Objective:To evaluate the reliability, validity and sensitivity of the Chinese version of pruritus-specific quality of life instrument (ItchyQoL) .Methods:Based on the English version of ItchyQoL, items of the Chinese version of ItchyQoL were determined after forward-backward translation and cultural adaption. Totally, 218 patients with pruritus caused by skin diseases were enrolled from Department of Dermatology, Peking University First Hospital from January to December 2019, and a questionnaire survey was conducted. At the time of enrollment and 2 weeks after enrollment, the Chinese version of ItchyQoL, dermatology life quality index (DLQI) and numerical rating scale (NRS) were used to evaluate the effect of pruritus on the quality of life of patients. Confirmatory factor was used to assess the structural validity of the Chinese version of ItchyQoL, and Cronbach′s α coefficient was used to estimate its internal consistency reliability. Spearman correlation coefficient was used to analyze correlations (convergent validity) of the Chinese version of ItchyQoL score with DLQI and NRS scores, and correlations (sensitivity) of changes in the Chinese version of ItchyQoL score with changes in DLQI and NRS scores.Results:The Chinese version of ItchyQoL contained a total of 22 items, including 3 dimensions, i.e., "symptoms", "functions" and "emotions", with the Cronbach′s α coefficients being 0.946, 0.883 and 0.953 respectively, suggesting excellent internal consistency. At 2 weeks after enrollment, the NRS score was strongly correlated with the total ItchyQoL score ( rs = 0.700, P < 0.01) , and moderately correlated with the subscores of "emotions", "functions" and "symptoms" ( rs = 0.452, 0.673, 0.692 respectively, all P < 0.01) ; the DLQI score was also strongly correlated with the total ItchyQoL score ( rs = 0.887, P < 0.01) and the subscores of "functions" and "symptoms" ( rs = 0.886, 0.750 respectively, both P < 0.01) , and moderately correlated with the "emotions" subscore ( rs = 0.674, P < 0.01) . Compared with the scores at the time of enrollment, the change in the total ItchyQoL score after 2 weeks was moderately correlated with the change in the NRS score ( rs = 0.642, P < 0.01) , and strongly correlated with the change in the DLQI score ( rs = 0.757, P < 0.01) ; the changes in "symptoms" and "functions" subscores were moderately correlated with the change in the NRS score ( rs = 0.648, 0.549 respectively, both P < 0.01) , while there was a weak correlation between the changes in "emotions" subscore and NRS score ( rs = 0.225, P < 0.01) ; the changes in "symptoms" and "functions" subscores were strongly correlated with the change in the DLQI score ( rs = 0.755, 0.703 respectively, both P < 0.01) , while the change in "emotions" subscore was moderately correlated with the change in the DLQI score ( rs = 0.401, P < 0.01) . Moreover, the total score of the Chinese version of ItchyQoL and subscores of "symptoms", "functions" and "emotions" all significantly differed among different NRS and DLQI score groups at 2 weeks after enrollment (all P < 0.05) . Conclusion:The Chinese version of ItchyQoL has good reliability and validity, and can be used to evaluate the quality of life of patients with pruritus caused by skin diseases in China.

The Chinese version of the Urticaria Control Test and validation of its reliability and validity / 中华皮肤科杂志

Objective:To translate the Urticaria Control Test (UCT) into Chinese, and to assess reliability, validity, sensitivity and screening accuracy of the new-version scale.Methods:After forward-backward translation and cultural adaption, items of the Chinese version of UCT were determined. The scale was used in 51 patients with chronic spontaneous urticaria (CSU) , 41 with chronic inducible urticaria (CIndU) , and 11 with CSU complicated by CIndU. Within 8 weeks after enrollment, 81 patients were treated with antihistamines, 8 with omalizumab, and 14 with antihistamines combined with omalizumab. At the time of enrollment and 4 and 8 weeks after enrollment, dermatology life quality index (DLQI) and urticaria activity score (UAS) were used to assess the quality of life impairment and disease activity. The internal consistency reliability of the questionnaire was estimated using Cronbach′s α coefficient. By comparing with DLQI and UAS28 scores, the Chinese version of UCT was tested for convergent validity, known-group validity, sensitivity and screening accuracy.Results:The Chinese version of UCT contained 4 items, and could be used to retrospectively evaluate clinical symptoms and signs of the disease, impact on quality of life, treatment effects and overall disease control in the past 4 weeks. The Cronbach′s α coefficient of each item in the UCT scale was 0.886 - 0.945 in the CSU group, and 0.834 - 0.958 in the CIndU group. At the time of enrollment, the UCT score was significantly negatively correlated with the DLQI score in both the CSU group and CIndU group ( rs = -0.672, -0.578, respectively, both P < 0.01) . At 4 and 8 weeks, the UCT score was significantly negatively correlated with UAS28 and DLQI scores in the CSU group (4 weeks: rs = -0.654, -0.829, respectively, both P < 0.01; 8 weeks: rs = -0.717, -0.765, respectively,both P < 0.01) , and it was also significantly negatively correlated with the DLQI score in the CIndU group ( rs = -0.834, -0.778, respectively, both P < 0.01) . In the CSU group, the change in the UCT score between weeks 4 and 8 was significantly negatively correlated with the change in UAS score ( rs = -0.569, P < 0.01) ; compared with the baseline, the change in the UCT scores was also significantly negatively correlated with the change in the DLQI scores at weeks 4 and 8 ( rs = -0.693, -0.447, respectively, both P < 0.01) . In the CIndU group, compared with the baseline, the change in the UCT scores at weeks 4 and 8 also showed a significant correlation with the change in DLQI scores ( rs = -0.615, -0.408, respectively, both P < 0.01) . The UCT score significantly differed among different UAS and DLQI score groups (all P < 0.05) . Conclusions:The Chinese version of the UCT is a valid and reliable tool for the clinical management of patients with CSU/CIndU. It can be used to evaluate disease control, and reflect disease activity and disease-related quality of life to a certain extent.

Effect of sufentanil on activation of Schwann cells after peripheral nerve injury in mice / 中华麻醉学杂志

Objective:To evaluate the effect of sufentanil on activation of Schwann cells after peripheral nerve injury in mice.Methods:Eighty healthy pathogen-free male Balb/c mice, aged 6-8 weeks, weighing 18-22 g, were divided into 4 groups ( n=20 each) using a random number table method: peripheral nerve injury group (group PNI), high dose sufentanil group (group H), medium dose sufentanil group (group M) and low dose sufentanil group (group L). The model of unilateral sciatic nerve transaction was established in ketamine-anesthetized mice.Immediately after establishment of the model, sufentanil 10, 5 and 2.5 μg/kg was injected intraperitoneally once a day for 3 consecutive days in H, M and L groups, respectively, while the equal volume of normal saline was given instead in group PNI.Sciatic function index (SFI) was calculated at 4, 8 and 12 weeks after establishment of the model.At 2, 4, 8 and 12 weeks, 5 mice in each group were sacrificed, and segments of the injuried ipsilateral sciatic nerve were removed for examination of the ultrastructure of the sciatic nerve (with a transmission electron microscope) and for detection of the expression of glial fibrillary acidic protein (GFAP) of sciatic nerve (by immunohistochemistry). Results:Compared with group PNI, SFI was significantly increased, and the expression of GFAP was up-regluated at each time point after establishment of the model in H and M groups ( P<0.05) and no significant change was found in SFI and GFAP expression after establishment of the model in group L ( P>0.05). Compared with group L, SFI was significantly increased, and GFAP expression was up-regluated in H and M groups ( P<0.05). There was no significant difference in SFI and GFAP expression between group H and group M ( P>0.05). The thickness of myelin lamellae was dense, and the proliferation of Schwann cells was not marked in H and M groups.The thickness of myelin lamellae was thin, and the proliferation of Schwann cells was marked in L and MO groups. Conclusion:The mechanism by which sufentanil improves repair after peripheral nerve injury may be related to promoting activation of Schwann cells in mice.