RESUMO
BackgroundMales and females differ in their immunological responses to foreign pathogens. However, most of the current COVID-19 clinical practices and trials do not take sex as consideration. MethodsWe performed an unbiased sex-based comparative analysis for the clinical outcomes, peripheral immune cells, and SARS-CoV-2 specific antibody levels of 1,558 males and 1,499 females COVID-19 patients from a single center. The lymphocyte subgroups were measured by Flow cytometry. Total antibody, Spike protein (S)-, receptor binding domain (RBD)-, and nucleoprotein (N)-specific IgM and IgG levels were measured by chemiluminescence. ResultsWe found that the mortality and ICU admission rates were approximately 2-fold higher in males than that in females (P<0.005). Survival analysis revealed that sex is an independent prognostic factor for COVID-19 (Hazard ratio=2.2, P=0.003). The concentration of inflammatory factors in peripheral blood was significantly higher in males. Besides, the renal and hepatic abnormality induced by COVID-19 was more common in males during the hospitalization. The analysis of lymphocyte subsets revealed that the percentage of CD19+ B cell and CD4+ T cell was significantly higher in females (P<0.001) during hospitalization, indicating the stronger humoral immunity in females than males. Notably, the protective IgG sharply increased and reached a peak in the fourth week after symptom onset in females, while gradually increased and reached a peak in the seventh week in males. ConclusionsThe unfavorable prognosis of male COVID-19 patients may result from the weak humoral immunity and indolent antibody responses during SARS-CoV-2 infection and recovery. Early medical intervention and close monitoring are important, especially for male COVID-19 patients. Hormonal or convalescent plasma therapy may help improve the immunity of males to fight against SARS-CoV-2 infection.
RESUMO
The high mortality rate of COVID-19 patients is mainly caused by the progression from mild to critical illness. To identify the key laboratory indicators and stratify high-risk COVID-19 patients with progression to severe/critical illness, we compared 474 moderate patients and 74 severe/critical patients. The laboratory indicators, including lactate dehydrogenase (LDH), monocytes percentage, etc. were significantly higher in the severe/critical patients (P <0.001) and showed a noticeable change at about a week before the diagnosis. Based on these indicators, we constructed a risk-stratification model, which can accurately grade the severity of patients with COVID-19 (accuracy = 0.96, 95% CI: 0.94 - 0.989, sensitivity = 0.98, specificity = 0.84). Also, compared with non-COVID-19 viral pneumonia, we found that COVID-19 had weaker dysfunction to the heart, liver, and kidney. The prognostic model based on laboratory indicators could help to diagnose, monitor, and predict severity at an early stage to those patients with COVID-19.
RESUMO
Deciphering the dynamic changes of antibodies against SARS-CoV-2 is essential for understanding the immune response in COVID-19 patients. By comprehensively analyzing the laboratory findings of 1,850 patients, we describe the dynamic changes of the total antibody, spike protein (S)-, receptor-binding domain (RBD)-, and nucleoprotein (N)- specific IgM and IgG levels during SARS-CoV-2 infection and recovery. Our results indicate that the S-, RBD-, and N- specific IgG generation of severe/critical COVID-19 patients is one week later than mild/moderate cases, while the levels of these antibodies are 1.5-fold higher in severe/critical patients during hospitalization (P<0.01). The decrease of these IgG levels indicates the poor outcome of severe/critical patients. The RBD- and S-specific IgG levels are 2-fold higher in virus-free patients (P<0.05). Notably, we found that the patients who got re-infected had a low level of protective antibody on discharge. Therefore, our evidence proves that the dynamic changes of antibodies could provide an important reference for diagnosis, monitoring, and treatment, and shed new light on the precise management of COVID-19.
RESUMO
Objective To investigate the clinical effect of calcium hydroxide in the treatment of dental pulp diseases. Methods The control group in the treatment of the conventional mummification agent, the study group used calcium hydroxide in the treatment process, compared the two groups of clinical curative effect, dental pulp disease patients the incidence of adverse reactions. Results The study group of dental pulp disease in patients with clinical total efficiency up to 92.00％, the control group of dental pulp disease in patients with clinical total effective rate was only 72.00％, the difference between the two groups was statistically significant(P<0.05).After the treatment of different measures, the incidence of adverse reactions in the study group (8.00％) was significantly lower than that in the control group(28.00％), the difference between the two groups was statistically significant (P<0.05). Conclusion The use of calcium hydroxide in the treatment of patients with dental pulp disease can significantly improve the clinical efficacy, and help to protect the quality of life of patients, physical and mental health.
RESUMO
Objective:To observethe influence of electroacupuncture (EA) on histomorphologies of lacrimal glands, cornea and conjunctiva in experimental dry eye syndrome, and to explore the repair effects of EA on lacrimal glands and ocular surface damage. Methods:Twenty-four healthy male New Zealand rabbits were randomly divided into a normal group, a model group, an EA group and a medication group, 6 rabbits in each group. Experimental dry eye syndrome models were prepared in rabbits by using 0.1% benzalkonium chloride for eye drops. Tear secretion volume, break-up time of tear film (BUT) and corneal fluorescein staining score were observed before and after the treatment. Periodic acid Schiff (PAS) staining method was used to observe the changes of conjunctival goblet cells in rabbits. After hematoxylin eosin (HE) staining, morphological changes of rabbit cornea, conjunctiva and lacrimal gland tissues were observed under light microscope. Results: Compared with the normal group, tear secretion volume and BUT were significantly reduced (bothP<0.01), while the corneal fluorescein staining score was significantly increased (P<0.01) in the model group. Compared with the model group, tear secretion volume and BUT were significantly increased, while the corneal fluorescein staining score was significantly decreased in the EA group and the medication group (allP<0.01). Compared with the normal group, the number of conjunctival goblet cells in the model group was significantly reduced; compared with the model group, the numbers of conjunctival goblet cells were all relatively higher in the EA group and the medication group. Pathological lesions of cornea, conjunctiva and lacrimal glands all showed improvement by HE staining in the EA group and the medication group after the intervention. Conclusion:EA can improve tear secretion and tear film stability of rabbit dry eye syndrome, and repair the pathologic lesions of conjunctival goblet cells, corneal epithelia, cornea, conjunctiva and lacrimal glands.
RESUMO
Objective: To analyze and review the clinical efficacy of acupuncture (including electroacupuncture) alone for allergic rhinitis (AR) and to compare its efficacy with antihistamines and Chinese patent medicineBi Yan Kang Tablet. Methods: The search strategy, inclusion and exclusion criteria were made according to the principle of evidence-based medicine. We performed a systematic search on China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), Chinese Biomedical Literature Database (CBM), PubMed, Excerpta Medica Database (EMBASE), Web of Science, Cochrane Library, and Cochrane Central Register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) of acupuncture for allergic rhinitis between January 1990 and December 2015. The quality was evaluated by Cochrane Handbook for Systematic Reviews of Interventions Version 5.1, and the meta-analysis was conducted by RevMan 5.3 version. Results: Twenty eligible RCTs were included into the meta-analysis after selection. Compared with antihistamines, the meta-analysis showed RR=1.24>1, 95%CI[1.15, 1.33],P0, 95%CI[–10.84, 13.75],P=0.82, indicating that there was no statistical difference between acupuncture and antihistamines in regulating immunoglobulin E (IgE) in AR patients. Compared withBi Yan Kang Tablet, the meta-analysis has shown RR=1.50>1, 95%CI[1.30, 1.73],P<0.00001, indicating that acupuncture achieved a better total effective rate for AR than Chinese patent medicineBi Yan KangTablet. Conclusion: Acupuncture alone can achieve a better total effective rate for AR than antihistamines andBi Yan Kang Tablet. It is also better than antihistamines in improving clinical symptom scores; however, whether acupuncture is better thanBi Yan KangTablet needs further proof. As far as current data are concerned, there was no statistical difference between acupuncture and antihistamines in improving serum IgE; further study is needed in this regard. The risk of bias due to absent randomization methods or blinding implementation decreased the evidence level of the overall conclusion.
RESUMO
By organizing and classifying the literatures related to acupuncture-moxibustion at Jiaji (EX-B 2) points in treating intervertebral disc herniation (IDH) published before December 31, 2013, to summarize the application status and features of Jiaji (EX-B 2) points. It’s found that its most favorable indication is IDH. It also further analyzed the action mechanism of acupuncture-moxibustion at Jiaji (EX-B 2) points in treating IDH, and brought up some ideas to highlight the further study.
RESUMO
Objective:To observe the impact of herb-partitioned moxibustion and electroacupuncture on hyaluronic acid(HA),procollagen Ⅲ(PC Ⅲ)and collagen Ⅳ(CⅣ)of intestinal fibrosis in rats with Crohn's disease(CD),and discuss the effect and the mechanism of acupuncture on treating intestinal fibrosis of rats.Methods:SD rats were randomly divided into control group,model group,herb-partitioned moxibustion group,electroacupuncture group and medicine group.The model of CD was developed by trinitrobenzene sulfonic acid.Masson stain was used to observe the collagen fibers hyperplasia in colon and radioimmunoassay was adopted to detect the content of HA,PC Ⅲ and C Ⅳ in serum.Results:Compared with the control group,the proliferation of colonic collagen fibers,as well as the HA,PC Ⅲ and CⅣ in serum increased in the model group.Compared with the model group,the expression of collagen fibers,serum HA,PC Ⅲ and C Ⅳ decreased in the herb-partitioned moxibustion group,electroacupuncture group and medicine group.The expression of collagen fibers serum HA,PC Ⅲ and C Ⅳ in the herb-partitioned moxibustion group were lower than in the electroacupuncture group and medicine group.Conclusion:Herb-partitioned moxibustion and electroacupuncture effectively improved the pathological state of intestinal fibrosis in rats with CD and reduced the content of HA,PC Ⅲ and C Ⅳ in serum.
