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Severe acute respiratory syndrome CoV-2 (SARS-CoV-2) caused the Corona Virus Disease 2019 (COVID-19) cases in China has become a public health emergency of international concern (PHEIC). Based on angiotensin converting enzyme 2 (ACE2) as cell entry receptor of SARS-CoV, we used the hACE2 transgenic mice infected with SARS-CoV-2 to study the pathogenicity of the virus. Weight loss and virus replication in lung were observed in hACE2 mice infected with SARS-CoV-2. The typical histopathology was interstitial pneumonia with infiltration of significant lymphocytes and monocytes in alveolar interstitium, and accumulation of macrophages in alveolar cavities. Viral antigens were observed in the bronchial epithelial cells, alveolar macrophages and alveolar epithelia. The phenomenon was not found in wild type mice with SARS-CoV-2 infection. The pathogenicity of SARS-CoV-2 in hACE2 mice was clarified and the Kochs postulates were fulfilled as well, and the mouse model may facilitate the development of therapeutics and vaccines against SARS-CoV-2.
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Objective@#To evaluate, the method of different packing layer and sealing mode for the packaging of the infectious wastes in order to achieve better autoclave sterilization effect.@*Methods@#In the autoclave cycles P4 and P9, different packing layer (single, double and triple) and sealing mode (slightly folded, autoclave tape, nylon tape closure) were applied to the internal infectious waste sterilization, biological indicators were used to detect the effect of autoclave sterilization of the upper, middle and lower layers, respectively.@*Results@#1) In the autoclave cycle P4, the triple autoclave bags packaging sealing method was based on the slight folding, autoclave tape, and nylon taple, the biological indicator negative rate of the internal infectious waste in the upper layer, the middle layer and the lower layer were respectively in the upper layer 100%, 0%, 0%, in the middle layer 67%, 20%, 0%, and in the lower layer was 0%. The double autoclave bags packaging sealing method was based on the slight folding, autoclave tape, and nylon taple, the biological indicator negative rate of the internal infectious waste in the upper layer, the middle layer and the lower layer were respectively the in the upper layer 100%, 85%, 0%, the middle layer 45%, 0%, 0%, and the lower layer 10%, 0%, 0%. the single autoclave bag packaging sealing method wa based on the slight folding, autoclave tape, and nylon taple, the biological indicator negative rate of the internal infectious waste in the upper, middle and lower layers were respectively the upper layer 100%, 100%, 0%, the middle layer 70%, 45%, 0%, and the lower layer 12.5%, 0%, 0%. (2) In the autoclave cycle P9, the triple autoclave bags packaging sealing method was based on the slight folding, autoclave tape, and nylon taple, the biological indicator negative rate of the internal infectious waste in the upper layer, middle and lower layers were respectively the upper layer all 100%, the middle layer 100%, 100%, 70%, and the lower layer 100%, 100%, 30%. The double autoclave bags packaging sealing method was based on the slight folding, autoclave tape, and nylon taple, the biological indicator negative rate of the internal infectious waste in the upper, middle and lower layers were respectively the upper layer all 100%, the middle layer all 100% and the lower layer is 100%, 100%, and 60%. The single autoclave bag packaging sealing method was based on the slight folding, autoclave tape, and nylon taple, the biological indicator negative rate of the internal infectious waste in the upper, middle and lower layers were all 100%.@*Conclusions@#When autoclave is recommended for sterilization of infectious waste, the best effect was achieved with a single unsealed autoclave bag. If it is necessary to seal, the autoclave bag should not be completely sealed, avoiding incomplete penetration of steam into the interior space, otherwise the infectious waste can not be completely sterilized.
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Objective To study the effects of nano silver (Ag) and titanium dioxide (TiO2) on the content of nucleic acid in staphylococcus aureus in order to explore their antibacterial mechanisms.Methods After preparation of beef extract peptone liquid cultures,the effects of minimal inhibitory concentrations (MICs) of nano Ag and TiO2 on staphylococcus aureus strains were determined.With the 1/2 MICs nano Ag and TiO2,the contents of DNA and RNA macromolecules from staphylococcus aureus cultures were measured to determine the damage degree of staphylococcus aureus cell membranes by ultraviolet spectrophotometer,and then the fluorescence intensities of the staphylococcus aureus cells were observed under fluorescence microscope and the fluorescence values were tested by fluorescence spectrophotometer to determine the contents of nucleic acid DNA and RNA.Results The MICs of nano Ag and TiO2 were 1.6 mg/mL and 5.781 μg/mL.After treatment with the 1/2 MICs nano Ag and TiO2,nano Ag group and TiO2 group were compared with the control group (culture fluid without adding antibacterial agent),respectively,and there were no significant differences in the contents of DNA and RNA macromolecules from staphylococcus aureus cultures between n anoAg group and control group as well as between TiO2 group and control group were (P>0.05),and there were significant decreases in fluorescence intensities and the contents of nucleic acid DNA and RNA (P<0.01).Conclusions Nano Ag and TiO2 had obvious antibacterial effects on staphylococcus aureus and the antibacterial properties of nano Ag was stronger than that of TiO2.The antibacterial mechanisms of nano Ag and TiO2 against staphylococcus aureus may be associated with the inhibition of the synthesis of nucleic acid DNA and RNA,inhibiting protein synthesis and then bacterial growth.
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Objective To observe the expression of triggering receptor expressed on myeloid cells (TREM),Caspase-3 and interleukin (IL)-6 in optic nerve tissue of ischemic optic neuropathy (ION).Methods Twenty Sprague-Dawley rats were randomly divided into control group and model group,10 rats in each group.The permanent ligation of bilateral internal carotid arteries (BICA) was performed for 14 days to establish subacute ION model as model group.The control group were separated BICA without ligation.The expressions of TREM-1,TREM-2,Caspase-3 and IL-6 in rat retina were detected by reverse transcription PCR and Western blot,respectively.Results Compared with the control group,the expressions of TREM-1,Caspase-3,IL-6mRNA (t=6.058,7.86,6.055) and protein (t=9.671,9.524,14.501) in the optic nerve tissue of the model group were increased,while the expression ofTREM-2 mRNA and protein (t=9.283) was decreased,and the difference was statistically significant (P<0.05).Conclusion In ischemic optic nerve tissue,TREM-1 mRNA and protein were significantly expressed,the expressions of TREM-2 mRNA and protein decreased significantly.
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Objective@#To test the performance of two kinds of protective respirators (3M9332, 3M1860) used in Biosafety Level 3 Laboratory (BSL-3) to ensure whether it can fit well in different populations in order to reduce the risk of infection in the process of operating high-risk pathogenic microorganisms.@*Methods@#Using a 8038PortaCount®Pro+ respirator fit tester to examine the fitness of personnel wear 3M 1860 N95 and 9332 N99 respirators. The influence factors such as gender, age, shape of respirator were evaluated. Statistical analysis was performed by the fit factor(FF) of assigned actions.@*Results@#A total of 62 people conducted the respirator fit test, of which 45 people passed the test of 3M9332 respirators, the pass rate was 72.58%; only 6 people passed the test of 3M1860 respirators, the pass rate was 9.67%. The pass rate of two different types of respirators was analyzed statistically, P=0.000. The P value of assigned actions in deep breathing, head side to side, head up and down, talking, bending over were respectively 0.094, 0.076, 0.542, 0.000, 0.000.@*Conclusions@#The experimental results showed that the type of respirator had a significant effect on respirator fit in this study, but gender and age had no significant effect on factors. As to reduce the risk of leakage of the respirator, redundant actions should try to be avoided, especially loud talking and bending in the course of the experiment.
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Lower limb ischemia is common and refractory diseases,in severe cases,it can impact on life quality even threat life.The traditional treatment contain medical and surgical,but cannot obtain satisfactory results.And therapeutic angiogenesis has achieve satisfactory results in animal experimnents and clinical study as its put forward.In recent years,Cell Therapy as one of the research hotspot,the micle aims to introduce the research of progress about therapeutic angiogenesis in detail.
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Objective To establish an inactivated viral particle-based ELISA for the detection of antibodies against Middle East respiratory syndrome coronavirus (MERS-CoV) in serum samples collected from a MERS-CoV associated case. Methods Serum samples were collected from 10 newborns and 40 healthy adults. A viral particle-based ELISA was established by using the inactivated MERS-CoV virions as antigen. The levels of IgM and IgG antibodies in the serum samples were detected by the established ELISA and the cut-off values for positive detection were determined. Then the inactivated MERS-CoV virion-based ELISA was used to detect the antibodies against MERS-CoV in 5 serum samples collected from the first im-ported MERS case in China. Results The cut-off values of IgM and IgG antibodies in serum samples for ELISA were determined to be A450 readings of 0. 32 and 0. 42, respectively. The titers of IgM and IgG anti-bodies in serum samples collected at early admission to hospital from the first imported MERS case in China were both 1 ︰ 40. Seroconversion occurred 2 weeks after his admission to hospital with the titers of IgM and IgG reaching to 1 ︰ 320. Conclusion The inactivated MERS-CoV virion-based ELISA was established successfully and could be used for the detection of serum antibodies (IgG and IgM) in MERS associated cases.
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To investigate the genetic character and origin of the first imported infection case of middle East respiratory syndrome coronavirus (named as MERS-CoV_China GD01), RNA was extracted from swabs of this patient followed by RT-PCR amplification. All coding gene of structural (S, E, M, E) and accessory (ORF3, ORF4a, ORF4b, ORF5, ORF8b) proteins were sequenced and analyzed. Phylogenetic analyses of structural protein coding genes of MERS-CoV_ China GD01 indicates that several substitutes exists in S coding gene and its origin belong group 5 of MERS-CoV, which were recent circulated in Saudi Arabia area, while other three structural genes (N, E, M) were very conserved. Phylogenetic analyses of accessory protein coding genes of MERS-CoV China GD01 indicates that several substitutes exists among ORF3, ORF4a, ORF4b and ORF5, while ORF8b was conserved. In conclusion, genome of MERS-CoV_ China GD01 was general conserved although several genetic variations were found among structural and accessory protein coding genes. This is the first report on sequencing and phylogenetic analyses of the first imported MERS case in China, which may pay the way for prevention and control of imported MERS-CoV infection.
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Humanos , China , Sequência Conservada , Infecções por Coronavirus , Virologia , Evolução Molecular , Genômica , Coronavírus da Síndrome Respiratória do Oriente Médio , Genética , Fisiologia , Filogenia , Análise de Sequência , Proteínas Virais , GenéticaRESUMO
Objective To observation dynamic changes and gender difference of heart rate variability and blood pressure variability in unbonded spontaneously hypertensive rats using Telemetry technology .Method Taking sixteen spontaneously hypertensive rats of 3-month-old in SPF grade, there were implanted TL11M2-C50-PXT device intraperitoneally.Seven days later, respectively monitoring chainless blood pressure and electrocardiogram for 24 h continuously time using telemetry system when 3, 5, 7 months of age in spontaneously hypertensive rats .Analysing 24 h systolic pressure , mean blood pressure , diastolic blood pressure , heart rate variability and blood pressure variability . Result Systolic pressure , diastolic pressure and mean pressure , blood pressure variability increased with age of the moon increased in spontaneously hypertensive rats , moreover female SHR rats of blood pressure variability was significantly lower than that of the male rats .Correlated indexes of heart rate variability had no obvious change Between three to seven month -old in male spontaneously hypertensive rats .But RR interval , SDNN, TP, VLF and HF increased significantly with age of the moon increased in female spontaneously hypertensive rats , moreover the female SHR rats of TP , VLF and HF index of heart rate variability were lower than the male rats .Conclusion With the SHR rats age and blood pressure , blood pressure variability increased , and the female SHR rat variability in blood pressure and heart rate was significantly lower than that of the male .
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Objective To evaluate the feasibility,efficacy,and short to mid-term results of endovascular management of acute type B aortic dissection complicating visceral or lower limb malperfusion.Methods A retrospective study was conducted in 23 consecutive patients with acute type B dissection complicating visceral or lower limb malperfusion treated endovascularly at a single center between July 2001 to December 2012.Of the 23 patients identified [20 men,3 women; mean age (52 ±9) ranging 42-75]presented with clinical and imaging evidence of end-organ malperfusion:renal artary in 5 (21.7%),superior mesenteric artery in 9 (39.1%),celiac trunk in 3 (13%) and lower limb in 6 (20.1%),artary renal and lower limb in 2.Results All patients had stent-graft coverage of the proximal entry tear.11 (47.8%) patients needed additional branch vessel stenting.Successful correction of malperfusion was achieved in all the patients and the successful rate of operation and technology was 100%.In 1 patient,ischemia in the lower limb was resolved after a stent was implanted to the right iliac artery.In another patient,complicated with lower limb ischemic necrosis,amputation was performed after one stage stent-graft placement.The duration of follow-up was 6 months to 72 months,mean (21 ± 11)months.There was no migration of stent-graft and end-organ ischemia.No patients suffered from paraplegia in this group.Conclusions Endovascular coverage of the proximal entry tear in acute type B aortic dissections complicating end-organ malperfusion is a reasonable first line treatment.But some cases may need a combination branch vessel stenting.
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Nicotinamide N-methyltransferase (NNMT) is a S-adenosyl-L-methionine (SAM) dependent cytoplasm enzyme,which plays a vital role in the biotransformation and detoxification of many drugs and xenobiotic compounds.Recent studies have revealed abnormal expression of NNMT in many tumors,which may contribute to tumorigenesis and tumor development and radiotherapy or chemotherapy resistance.
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Objective To evaluate femoral artery ligation for femoral artery pseudoaneurysm secondary to drug injection. Methods Clinical data of 32 drug addicts of femoral artery pseudoaneursysm caused by drug injection undergoing femoral artery ligation and local debridement were reviewed retrospectively.The blood supply of affected limb was evaluated by oxygen saturation of distal limb and its function.All the cases were followed up at 3,6,9,and 12months after the operation. Results Surgery was successful in all cases. There were no significantly difference of the limb oxygen saturation between postoperative and preoperative period (95.1% ± 2.8% vs.96.9% ± 1.9% ; t =1.26,P =0.25 ).White blood cells and neutrophils percentage significantly decreased after surgery.All patients were followed up for 1 year.Lower extremity ischemia after 6 hours of operation in one case treated by autologous saphenous vein bypass recovered. On 3 months mild claudication was observed in 5 cases. On 6 months claudication remained in only 2 cases,which disappeared on 9 months.All patients were able to maintain normal life.Conclusions Femoral artery ligation is a safe, effective and simple treatment modality for femoral pseudoaneurysms secondary to drug injection.
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[Objective] To evaluate the influence of dexmedetomidine on median effective target effect-site concentration(EC50)of sufentanil-inhibiting urethroscope insertion response in patients undergoing transurethral resection of prostate(TURP).[Methods] Forty patients with ASA grading Ⅰ-Ⅱ who accepted selective TURP were divided by random digits table method into two groups with 20 cases each.The patients in dexmedetomidine group were treated with 0.6 μ g/kg dexmedetomidine intravenous infusion for more than 10 min,while control group were treated with equivalent capacity of 0.9% sodium chloride.At 5 min after stopping injection,target-controlled infusion of propofol was started and the plasma target concentration was 3.0 μ g/ml.At 10 min after infusion,target-controlled infusion of sufentanil began and the plasma target concentration was 0.20 ng/ml.The target concentration of sufentanil of the next patient accorded to the patient with or without the urethroscope insertion response and the adjacent rate of the target concentration was 1.1.The EC50 and 95% confidence interval(CI)of sufentanil were calculated.[Results] There were 20 cases in dexmedetomidine group ultimately selected and 19 cases in control group.There was no statistical significance in absolute value of ST segment of intraoperative electrocardiogram,systolic blood pressure,heart rate,pulse oxygen saturation and bispecual index between two groups(P>0.05).EC5o of sufentanil-inhibiting urethroscope insertion response in dexmedetomidine group was 0.1148 ng/ml(95% CI 0.1055-0.1249 ng/ml),which was significantly lower than that in control group[0.1454 ng/ml(95% CI 0.1339-0.1580 ng/ml)](P<0.05).[Conclusions] 0.6 μg/kg dexmedetomidine intravenous infusion before operation can reduce the EC50 of sufentanil-inhibiting urethroscope insertion response in patients undergoing TURP.
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Objective To summarize our experience in the diagnosis and management of popliteal artery entrapment syndrome (PAES). Methods This is a retrospective study on 10 patients (13 limbs)who were admitted for symptoms of claudication and the diagnosis of popliteal entrapment was established either with angiography,computed tomographic angiography,magnetic resonance angiogram or during the operation in recent 7 years (2002-2009).All patients were treated surgically. Results The mean age at the time of presentation was (25 ±7) years old (range,17-41 years).Claudication was the most frequent presenting symptom (12 limbs).The surgical procedures consisted of simple musculotendinous dissociation in 1 limb,thrombectomy with balloon angioplasty in 1 limb,musculotendinous dissociation plus thromboendarterectomy with autogenous saphenous vein (ASV)patch angioplasty in 2 limbs,ASV graft interposition or bypass in 6 limbs and graft interposition or bypass in 3 limbs.At a median follow-up of (35 ±27) months (range,2 months-7 years),there were no intraoperative or long-term postoperative complications and all the patients were cured. Conclusions PAES is an unusual but important cause of peripheral vascular insufficiency especially in young patients.A combined approach is necessary for diagnosis.Popliteal artery release alone or with vein bypass or reconstruction is the treatment of choice.
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Objective To evaluate endovascular treatment of Budd-Chiari syndrome(BCS)with occlusion of hepatic veins.Methods Retrospective analysis on the clinical materials of 32 BCS cases with occlusion of hepatic veins was made.Four cases received inferior vena cava(IVC)angioplasty or stent implant and splenorenal shunt;Transfemoral vein or transjugular hepatic vein angioplasty was performed in 10 cases,and percutaneous transhepatic recanalization combined with transjugular and/or transfemoral vein angioplasty of hepatic veins was performed in 16 cases,respectively.Two cases failed therapy attempt.Results A failure to find the main hepatic vein in percutaneous transhepatic venography lead to the abandent of therapy in 2 cases.Hepatic vein angioplasty and IVC angioplasty was successful in the other 30 cases.The pressure of hepatic vein decreased from(43±8)cm H_2O to(16±4)cm H_2O(t=21.23,P<0.01).The symptoms were obviously relieved,ascites disappeared,abdominal distension palliated,chest and abdominal wall varicose veins collapsed one week after endovascular treatment.During perioperative procedure,2 cases with liver puncture bleeding were cured by laparotomy.The follow-up duration was 5 months to 65 months and mean(26.0±2.0)months.There was no stent migration and hepatic vein restenosis and occlusion.Chest and abdominal wall varicose veins disappeared and esophagus phlebeurysma were ameliorated as shown by esophageal barium series.There were no pulmonary embolism and death.Conclusions The procedure of endovascular treatment of BCS with occlusion of hepatic veins is simple,mini-traumatic and effective.
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Objective To analyze the surgical technique of extraperitoneal laparoseopic radical prostatectomy with neurovascular bundle preservation and its effect on micturition control and sexual function in patients with prostate cancer. Methods Twenty-two patients with a median age of 66. 9 years underwent extraperitoneal laparoscopic radical prostatectomy with neurovascular bundle preservation from October 2005 to March 2009 in our hospital and Shanghai Changzheng hospital. All patients had no erectile dysfunction. According to the pathology, there were 2 cases of PIN high grade, 4 cases of Tla-b, 9 cases of Tlc, 4 cases of T2a-b, 2 cases of T2e and 1 case of T3a. Results All operation were successful and no case was conversed to open surgery. The average operation time was 225 min and the mean blood loss was 850ml. The amount of blood loss in 1 case was 1200 ml because of injuring deep dorsal vein of penis. 4 cases received blood transfusion, gatheters of all patients were removed 2 weeks after operation, and three cases with mild incontinence regained continence of urine after 6 months follow-up. No patient occurred postoperative vesicourethral anastomotic leakage of urine. The surgical margin of 1 case was positive. No biochemical index of prostatl cancer recurred during postoperative follow-up of 10-24 months (with an average of 16 months). 20 cases had sexual function recovery after operation. Conclusions The extraperitoneal laparoscopie radical prostatectomy with neurovascular bundle preservation for prostate cancer is a safe and effective treatment method with less bleeding, small damage and less complications. It can guarantee the maximum of micturition control and sexual function, which is worthy to be popularized in the clinic.
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Objective To evaluate endovascular treatment of segmental occlusive Budd-Chiari syndrome(BCS). Methods We retrospectively analyzed the clinical data of segmental occlusive BCS of 45 cases. Inferior vena cava (IVC) puncture, percutaneons transluminal angioplasty (PTA) and stent implant were performed, respectively. Three-dimensional digital subtraction angiography (3D-DSA) was used to evaluate the IVC lesion from multi-angles and to identify the best work angle in complex BCS cases during endovascular treatment. Results IVC puncture and dilation was successful in 43 cases. The pressure of IVC decreased from (35. 3 ± 3.9)cm H2O to (9.5 ± 2. 0) cm H2O (t = 43. 68, P < 0. 01). The puncture failed in 2 cases and the patients were converted to veno-atrial graft shunt. Acute pericardial tamponade developed during PTA in one case. Postoperatively 35 cases were followed-up for 3 months to 46 months and the follow-up rate was 77. 8%. IVC stent thrombosis was identified in one case necessitating veno-atrial graft shunt 15 months post-operatively. There were no stent migration and hepatic venous obstruction in the remaining cases. The case of pericardial tamponade was cured and discharged after IVC repair. Symptoms disappeared except for intercostal neuralgia during 6 months follow-up. There were no pulmonary embolism and death. Conclusions Good medium and long term result could be achieved after endovascular treatment of segmental occlusive BCS. 3D-DSA is helpful for endovascular treatment of BCS.
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Objective To investigate the effect and safety of administering magnesium sulphate as a technique of controlled hypotension during functional endoscopic sinus surgery. Methods Seventy-five patients arranged for selective functional endoscopic sinus surgery under general anesthesia, were randomly assigned into three groups: control group, magnesium sulphate group and nitroglycerin group(n=25). The patients of magnesium sulphate group received 10% magnesium sulphate 40 mg/kg before the induction of anaesthesia, and then 15 mg·kg~(-1)·h~(-1) by continuous infusion during the operation. The same volume of 5% glucose was administered to the patients in control group. Constant infusion of nitroglycerin beginning with 1 μg·kg~(-1)·min~(-1) was administered to the patients in nitroglycerin group. The hemodynamic indexes, amount of bleeding, fluid intake, operation time, recovery time, quality of surgery field, muscle relaxation and adverse reaction were recorded. Concentration of Mg~(2+) in magnesium sulphate group were compared before and after surgery.Results The patients in the magnesium sulphate group maintained balanced heart rates during the operation, while the heart rates of patients in control group and nitroglycerin group increased significantly (P<0.01). The patients of magnesium sulphate group had lower amount of bleeding and shorter operation time compared with control group (P<0.01). The quality of surgery field in magnesium sulphate group was significantly better than that in control group (P<0.01). Time for 75% recovery of myokymia and recovery index in magnesium sulphate group was higher than those in control group and nitroglycerin group(P<0.01). No adverse reaction was observed in all groups. Conclusion Magnesium sulphate can be effective and safe for controlled hypotension during functional endoscopic sinus surgery.
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Objective To evaluate interventional therapy for left iliac vein stenosis or occlusion (left iliac vein compressed syndrome or Cokkett syndrome).Method In this study 316 cases received interventional therapy for left iliac common vein lesions,189 cases underwent staged saphenous vein high ligation and stripping,and 82 cases received external prosthetic sleeve valvuloplasty.Two hundred and thirty-one cases were followed up from 6 to 120 months(average 52 months),with all cases being evaluated by colour ultrasound,and among those 116 cases received venography.Results The stenosis or occlusive segments of left iliac vein were successfully dilated in 305 cases,of which 272 cases received stents implanting therapy.There was no inhospital mortality nor pulmonary embolism.According to following up results.the symptom of varicose vein disappeared in about 95.8%patients.and the symptom of leg swelling disappeared or dramatically relieved in about 95.7%cases.among which 74%leg ulcers were completely healed.Stents were occluded by thrombus during venography in about 5.4%. Conclusions The long term result of interventional therapy is satisfactory for left iliac vein stenosis or occlusion caused by Cockett syndrome.
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[Objective]To observe the activity of anti-inflammatory and analgesia of Danweisan.[Methods]The analgesia action of Danweisan was determined with twisting method,and the anti-inflammatory effect of Danweisan was evaluated with xylene induced ear tumefaction.The effects of the small,medium,large dosages of Danweisan group(2,3,4g/kg) on twisting and ear tumefaction in mouse were assessed.[Results] Compared with the normal group,it was shown to exert dramatic inhibitory effect with concentration-dependence on mouse twisting and ear tumefaction in the Danweisan group.[Conclusion]Danwesan has a remarkable analgesia activity and a better anti-inflammatory action than asprine.