Effective early strategy to prevent olfactory and gustatory dysfunction in COVID-19: A randomized controlled trial.

BACKGROUND: Olfactory and gustatory dysfunctions (OGDs) are key symptoms of COVID-19, which may lead to neurological complications, and lack of effective treatment. This may be because post-disease treatments may be too late to protect the olfactory and gustatory functions. AIM: To evaluate the effectiveness of early use of saline nasal irrigation (SNI), corticosteroid nasal spray, and saline or chlorhexidine gluconate mouthwash for preventing OGDs in COVID-19. DESIGN: This study was a double-blind randomized controlled trial. METHODS: The study was conducted from May 5 to June 16, 2022. We recruited patients from three hospitals who were admitted with COVID-19 but without OGDs on the day of admission. Olfactory and gustatory functions were evaluated using the Taste and Smell Survey and the numerical visual analog scale. Participants were randomized to the saline, drug, or control groups. The control group received no intervention, saline group received SNI plus saline nasal spray and mouthwash, and the trial group received SNI plus budesonide nasal spray and chlorhexidine gluconate mouthwash. Participants were assessed again on the day of discharge. RESULTS: A total of 379 patients completed the trial. The prevalence of OGDs was significantly lower in the saline (11.8%, 95% CI, 6.6-19.0%; P < 0.001) and trial (8.3%, 95% CI, 4.1-14.8%; P < 0.001) groups than in the control group (40.0%, 95% CI, 31.8-48.6%). Additionally, both interventions reduced the severity of OGDs. CONCLUSIONS: We demonstrated effective strategies for preventing COVID-19-related OGDs, and the findings may guide early management of SARS-CoV-2 infection to reduce the incidence of COVID-19-related complications.

Comparing the insertion and ventilation of laryngeal mask airway according to the patient's head position and muscle relaxation use. A prospective clinical trial.

OBJECTIVES: To assess the insertion and ventilation of the laryngeal mask airway (LMA) classic while using different head positions with or without muscle relaxant. METHODS: This is a double-blind randomized clinical trial. Patients scheduled for ureteral calculus surgery at Shanghai General Hospital, Shanghai, China were recruited between November 2017 and November 2018. A total of 132 adults were consecutively selected. Patients were randomly divided into 4 groups according to head positioning and muscle relaxant use. An 8-cm-high pillow was used to achieve the sniffing position. The insertion time, initial peak pressure (Ppeak), mean pressure (Pmean) of the airway during intermittent positive pressure ventilation (primary endpoint) and fiberoptic score of the LMA position (secondary endpoint) were evaluated via electronic bronchoscopy through the mask bar. All adverse events were recorded. Results: Data were analyzed by ANOVA, 2-way ANOVA, Chi-squared, Cochran-Mantel-Haenszel, and Kruskal-Wallis tests. The insertion time required for the first attempt, fiberoptic score, Ppeak and Pmean did not differ among the groups. However, the incidence of adverse events in groups not using muscle relaxant was higher than in those using muscle relaxant. Conclusion: Use of a sniffing position and muscle relaxant slightly eased the insertion of the LMA but did not affect the fiberoptic score or ventilation parameters. Using a muscle relaxant, but not the sniffing position, reduced the incidence of adverse effects.

Multifunctional Theranostic Nanoplatform Based on Fe-mTa2O5@CuS-ZnPc/PCM for Bimodal Imaging and Synergistically Enhanced Phototherapy.

Multifunctional nanotheranostic agent with high performance for tumor site-specific generation of singlet oxygen (1O2) as well as imaging-guidance is crucial to laser-mediated photodynamic therapy. Here, we introduced a versatile strategy to design a smart nanoplatform using phase change material (PCM) to encapsulate photosensitizer (zinc phthalocyanine, ZnPc) in copper sulfide loaded Fe-doped tantalum oxide (Fe-mTa2O5@CuS) nanoparticles. When irradiated by 808 nm laser, the PCM is melted due to the hyperthermia effect from CuS nanoparticles, inducing the release of ZnPc to produce toxic 1O2 triggered by 650 nm light with very low power density (5 mW/cm2). Then, the produced heat and toxic 1O2 can kill tumor cells in vitro and in vivo effectively. Furthermore, the special properties of Fe-mTa2O5 endow the nanoplatform with excellent computed tomography (CT) and T1-weighted magnetic resonance imaging ( T1-MRI) performance for guiding and real-time monitoring of therapeutic effect. This work presents a feasible way to design smart nanoplatform for controllable generation of heat and 1O2, achieving CT/ T1-MRI dual-modal imaging-guided phototherapy.

Reduction-sensitive fluorescence enhanced polymeric prodrug nanoparticles for combinational photothermal-chemotherapy.

In this study, a reduction-sensitive supramolecular polymeric drug delivery system was developed for combinational photothermal-chemotherapy of cancer. The multifunctional system was self-assembled by specific host-guest interactions between hydrophilic ß-cyclodextrin functionalized hyaluronic acid and adamantane linked camptothecin/dye conjugate, where a near-infrared (NIR) absorbing dye IR825 was loaded. The hydrophilic hyaluronic acid shell endows the assembly with excellent colloidal stability and biocompatibility. The embedded disulfide bond in the camptothecin/dye conjugate was cleaved under reducing environment, leading to the release of the conjugated drug and the recovery of fluorescence emission. Meanwhile, the dye IR825 could efficiently transfer the absorbed light into local heat, making the nanoplatform an effective system for photothermal therapy. As evident by confocal microscopy images, the nanoplatform was quickly internalized by HeLa, MCF-7, and U14 cancer cells and released drug molecules inside the cells. In vitro cell viability assays confirmed that the cancer cells were efficiently killed by the treatment of the nanoplatform under NIR light irradiation. Significant tumor regression was also observed in the tumor-bearing mice upon the administration of the nanoplatform through combinational photothermal-chemotherapy therapy. Hence, this nanoplatform presented a great potential in site-specific combined photothermal-chemotherapy of tumor.

Redox-responsive UCNPs-DPA conjugated NGO-PEG-BPEI-DOX for imaging-guided PTT and chemotherapy for cancer treatment.

The disulfide bond (-S-S-) is an enormously valuable functional group in a variety of chemical and biological agents that display effective reactivity or biological activities (e.g., antitumor activities). The disulfide bonds prevalent in proteins are somewhat oxidizing in the extracellular space; however, such disulfide bonds can rarely be found inside cells because of disulfide cleavage reactions facilitated by abundant free cellular thiols, including glutathione (GSH), which is the most important common thiol-containing small molecule. Interestingly, intracellular GSH concentrations are considerably higher in cancer cells than in analogous normal cells; this feature may prove to be significant in the development of anticancer drug delivery systems (DDS). Moreover, upconversion nanoparticles (UCNPs) have been extensively investigated in multimodal imaging, photodynamic therapy (PDT) and photothermal therapy. UCNPs exploit near-infrared excitation instead of ultraviolet excitation and possess exclusive properties, which include greatly increased penetration depth in biological samples and reductions in background autofluorescence, photobleaching and photodamage to biological specimens. These fascinating optical features of UCNPs may broaden their prospects in the fields of imaging and therapy. Graphene has emerged as a flat monolayer of carbon atoms that are tightly embedded in a two-dimensional (2D) honeycomb lattice. Widespread research has been carried out on graphene in recent years owing to its exclusive shape and size, as well as innumerable fascinating physical and chemical properties. Owing to their high optical absorption in the near-infrared (NIR) region, graphene and GO have been extensively employed for photothermal therapy (PTT). In this study, we attempted to merge the properties of these compounds by conjugating UCNPs and NGO-PEG-BPEI-DOX into a single platform for chemotherapy and photothermal therapy.

Reporting characteristics of case reports of acupuncture therapy with CARE guidelines.

OBJECTIVE: To investigate the reporting characteristics of case reports of acupuncture therapy with CAse Report (CARE) guidelines, and to explore the applicability of the guidelines for these case reports. METHODS: Case reports published from January 1, 2011 to December 31, 2013, were identified by searching PubMed and the China Biomedicine Database by using MeSH terms. Screening and data extraction of case reports were conducted by two independent researchers. Assessments based on CARE guidelines and data analysis were conducted by using Excel 2003 and RevMan 5.0. RESULTS: A total of 61 case reports published in 19 journals were identified, which involved 16 major types of diseases. Fifteen (24.6%) case reports declared no conflict of interests, and 5 (8.2%) reported funding sources. None of these case reports met all items of CARE guidelines, and only 6 subordinate items were fully reported among 50% of the case reports. Subgroup analysis indicated that case reports published in English or those that did not have competing interests had higher reporting quality. CONCLUSIONS: The reporting quality of case reports of acupuncture therapy is rather low. The reason might be a lack of awareness among authors and the poor dissemination of information regarding CARE guidelines in China. More evaluation studies are needed to promote and improve adherence to CARE guidelines. Moreover, an extended version of CARE guidelines should be developed for cases reports of special interventions such as acupuncture or adverse events caused by interventions.

Using AGREE II to evaluate the quality of traditional medicine clinical practice guidelines in China.

OBJECTIVE: To evaluate/assess the quality of the clinical practice guidelines (CPGs) of traditional medicine in China. METHODS: We systematically searched the literature databases WanFang Data, VIP, CNKI, and CBM for studies published between 1978 and 2012 to identify and select CPGs of traditional medicine. We used the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument to evaluate these guidelines. RESULTS: A total of 75 guidelines were included, of which 46 guidelines (62%) were on Traditional Chinese Medicine, 19 (25%) on Chinese Integrated Medicine, and 10 (13%) on Uyghur Medicine. Most traditional medicine CPGs published in domestic journals scored <20% (range: 0% to 63%). Eleven (14%) CPGs were developed following the methodology of evidence-based medicine. In each domain of AGREE II, traditional medicine CPGs performed clearly better than international CPGs. The same trend was seen in guidelines of modern medicine. CONCLUSIONS: An increasing amount of CPGs are being published, but their quality is low. Referring to the key points of international guidelines development, supervision through AGREE II, cooperating with international groups and exploring the strategy of guideline development could improve the quality of CPGs on traditional medicine.

Au25 cluster functionalized metal-organic nanostructures for magnetically targeted photodynamic/photothermal therapy triggered by single wavelength 808 nm near-infrared light.

Near-infrared (NIR) light-induced cancer therapy has gained considerable interest, but pure inorganic anti-cancer platforms usually suffer from degradation issues. Here, we designed metal-organic frameworks (MOFs) of Fe3O4/ZIF-8-Au25 (IZA) nanospheres through a green and economic procedure. The encapsulated Fe3O4 nanocrystals not only produce hyperthemal effects upon NIR light irradiation to effectively kill tumor cells, but also present targeting and MRI imaging capability. More importantly, the attached ultrasmall Au25(SR)18(-) clusters (about 2.5 nm) produce highly reactive singlet oxygen ((1)O2) to cause photodynamic effects through direct sensitization under NIR light irradiation. Furthermore, the Au25(SR)18(-) clusters also give a hand to the hyperthemal effect as photothermal fortifiers. This nanoplatform exhibits high biocompatibility and an enhanced synergistic therapeutic effect superior to any single therapy, as verified by in vitro and in vivo assay. This image-guided therapy based on a metal-organic framework may stimulate interest in developing other kinds of metal-organic materials with multifunctionality for tumor diagnosis and therapy.

[Discussion on the temperature characteristic of silver needle in the human body during the warm needling].

OBJECTIVE: To observe the temperature change of traditional silver needle in the human body during the burning of moxa ball. METHODS: Thirty-six healthy volunteers were randomly divided into a single-needle group and a multi-needle group, 18 cases in each group. For both groups, one silver needle (18 cm in length, 1.1 mm in diameter), which was adopted in this research to measure the temperature change, was punctured in the insertion point of the volunteer (inside the top of the left buttock, 7 cm under the edge of the highest point of the iliac crest, 7 cm lateral to the dorsomedian line), then another four silver needles were punctured 2 cm respectively anterior, posterior and lateral to the insertion point in the multi-needle group, and all the silver needles were inserted with 6 cm depth. Afterigniting the 1.3 g moxa ball on the needle tail, the temperature of the measuring points that were 3 mm, 33 mm, and 63 mm above the silver needle tip were recorded separately by digital temperature measuring instrument. RESULTS: The peak temperature of the three measuring points in the single-needle group was all around 41 degrees C, while those in the multi-needle group were around 43 degrees C, which had significant differences (all P < 0.05), but no significant differences among the highest temperature of the measuring points in the same group could be found (all P > 0.05). The highest temperature of moxa ball in the single needle group was (611.16 +/- 6.91) degrees C, while that of the central moxa ball in the multi-needle group was (628.94 +/- 8.99) degrees C, the difference of which was significant difference (P < 0.01). CONCLUSION: The temperature conductivity of the silver needle is very well, so the heat of the moxa ball could pass from the tail of needle to the tip during the warming treatment. The peak temperature on the body, tip of the silver needle in the multi-needle group is higher than those in the single needle group. Also, the peak temperature of multi-moxa ball is higher than that of single moxa ball.