Potential transmission chains of variant B.1.1.7 and co-mutations of SARS-CoV-2

The presence of SARS-CoV-2 mutants, including the emerging variant B.1.1.7, has raised great concerns in terms of pathogenesis, transmission, and immune escape. Characterizing SARS-CoV-2 mutations, evolution, and effects on infectivity and pathogenicity is crucial to the design of antibody therapies and surveillance strategies. Here we analyzed 454,443 SARS-CoV-2 spike genes/proteins and 14,427 whole-genome sequences. We demonstrated that the early variant B.1.1.7 may not have evolved spontaneously in the United Kingdom or within human populations. Our extensive analyses suggested that Canidae, Mustelidae or Felidae, especially the Canidae family (for example, dog) could be a possible host of the direct progenitor of variant B.1.1.7. An alternative hypothesis is that the variant was simply yet to be sampled. Notably, the SARS-CoV-2 whole genome represents a large number of potential co-mutations with very strong statistical significances (p value

The effect of mechanical chest compression device on resuscitation in patients with cardiac arrest: A meta-analysis / 中华急诊医学杂志

Objective:To evaluate the effect of mechanical chest compression device in patients with cardiac arrest.Methods:The relevant literatures about mechanical cardiopulmonary resuscitation and manual cardiopulmonary resuscitation were systematically searched from China Knowledge Network (CNKI), VIP, Wanfang, PubMed, Web of Science and other databases. The effective data were extracted and analyzed by RevMan5.3 software.Results:A total of 20 clinical studies involving 29 727 patients were included, of which 11 104 patients received mechanical cardiopulmonary resuscitation and 18 623 patients received traditional manual cardiopulmonary resuscitation. The results of meta-analysis showed that mechanical cardiopulmonary resuscitation could not effectively improve the restoration of spontaneous circulation (ROSC) rate, admission survival rate, discharge survival rate and neurological prognosis in patients with cardiac arrest compared with manual cardiopulmonary resuscitation. ROSC occurrence rate ( RR=1.10, 95% CI: 0.99-1.23, P<0.01), admission survival rate ( RR=1.01, 95% CI: 0.95-1.08, P=0.67), discharge survival rate ( RR=1.00, 95% CI: 0.86-1.15, P=0.14), and good neurological function rate ( RR=0.81, 95% CI: 0.61-1.06, P=0.69) showed no significant differences between the mechanical cardiopulmonary resuscitation and manual cardiopulmonary resuscitation. Conclusions:Mechanical chest compression device has no advantage compared with manual cardiopulmonary resuscitation. Mechanical cardiopulmonary resuscitation is not recommended to completely replace manual chest compression in cardiopulmonary resuscitation.

Multi-site co-mutations and 5'UTR CpG immunity escape drive the evolution of SARS-CoV-2

The SARS-CoV-2 infected cases and the caused mortalities have been surging since the COVID-19 pandemic. Viral mutations emerge during the virus circulating in the population, which is shaping the viral infectivity and pathogenicity. Here we extensively analyzed 6698 SARS-CoV-2 whole genome sequences with specific sample collection dates in NCBI database. We found that four mutations, i.e., 5UTR_c-241-t, NSP3_c-3037-t, NSP12_c-14408-t, and S_a-23403-g, became the dominant variants and each of them represented nearly 100% of all virus sequences since the middle May, 2020. Notably, we found that co-occurrence rates of three significant multi-site co-mutational patterns, i.e., (i) S_a-23403-g, NSP12_c-14408-t, 5UTR_c-241-t, NSP3_c-3037-t, and ORF3a_c-25563-t; (ii) ORF8_t-28144-c, NSP4_c-8782-t, NSP14_c-18060-t, NSP13_a-17858-g, and NSP13_c-17747-t; and (iii) N_g-28881-a, N_g-28882-a, and N_g-28883-c, reached 66%, 90%, and nearly 100% of recent sequences, respectively. Moreover, we found significant decrease of CpG dinucleotide at positions 241(c)-242(g) in the 5UTR during the evolution, which was verified as a potential target of human zinc finger antiviral protein (ZAP). The four dominant mutations, three significant multi-site co-mutations, and the potential escape mutation of ZAP-target in 5UTR region contribute to the rapid evolution of SARS-CoV-2 virus in the population, thus shaping the viral infectivity and pathogenicity. This study provides valuable clues and frameworks to dissect the viral replication and virus-host interactions for designing effective therapeutics. One Sentence SummaryFour dominant mutations, three significant multi-site co-mutations, and 5UTR CpG escape contribute to the rapid evolution of SARS-CoV-2 virus.

Surgical treatment of complex acetabular fractures through the lateral-rectus approach with pelvic reconstructive plate and antegrade posterior-column lag screws / 中华创伤骨科杂志

Objective To evaluate the surgical treatment of complex acetabular fractures through the lateral-rectus approach with pelvic reconstructive plate and antegrade posterior-column lag screws.Methods Between January 2014 and April 2018,29 patients were surgically treated for complex acetabular fractures at Department of Orthopaedic and Trauma,Taihe Hospital.They were 22 males and 7 females,aged from 19 to 72 years(mean,41.7 years).According to the Letournel-Judet classification,there were 4 transverse fractures,7 T-shape fractures,15 both column fractures and 3 anterior plus posterior hemitransverse fractures.In all the patients,the lateral-rectus approach was adopted;their anterior column fractures were fixated with pelvic reconstructive plate and screws and their posterior column fractures with antegrade lag screws.The operation time,intraoperative bleeding,fracture reduction,fracture union time,function of the affected hip and complications were recorded.Results The operation time ranged from 50 to 140 min,averaging 85 min;the volume of intraoperative bleeding ranged from 150 to 1,100 mL,averaging 315 mL.By the Matta criteria,the reduction was rated as excellent in 21 cases,as good in 7 and as poor in one,giving an excellent to good rate of 96.6％.The average follow-up was 16.2 months (from 6 to 30 months) for the 29 patients.Their fractures got united after an average of 11 weeks (from 7 to 13 weeks).According to the Merle d'Aubigné & Postel scoring system at the last follow-up,the function of the affected hip was excellent in 20 cases,good in 7 and fair in 2,yielding an excellent to good rate of 93.1％.There was one case of vasospasm of external iliac artery.No such complications were observed by follow-up as infection,deep venous thrombosis,heterotopic ossification,osteoarthritis or avascular necrosis of the femoral head.Conclusions The lateral-rectus approach with pelvic reconstructive plate and antegrade posterior-column lag screws is a suitable surgical treatment for complex acetabular fractures,leading to satisfactory clinical results.The lateral-rectus approach provides adequate exposure of the quadrilateral surface and facilitates insertion of the posterior column antegrade lag screws.

Recent progress in nursing care for patients with osteoporotic vertebral compression fractures receiving percutaneous vertebroplasty / 介入放射学杂志

With the increasing incidence of osteoporosis, osteoporotic vertebral compression fracture (OVCF) has become a common disease in the elderly. Relevant researches have indicated that percutaneous vertebroplasty (PVP) has become the main treatment for painful osteoporotic vertebral compression fractures. In aspect of perioperative nursing care for PVP, both domestic and foreign scholars have published a large number of research reports, indicating that perioperative nursing intervention can alleviate the pain, reduce the incidence of complications, improve the quality of life of patients, and promote rehabilitation. This article aims to make a comprehensive review about the perioperative nursing care for patients with osteoporotic vertebral compression fractures who are receiving PVP so as to provide reference for clinical nursing staff in the implementation of nursing intervention. (J Intervent Radiol, 2018, 27:290-293)

The perioperative bundle of care for advanced HCC patients receiving CT-guided percutaneous minimally-invasive argon-helium knife cryoablation / 介入放射学杂志

Objective To discuss the clinical effect of perioperative bundle of care for patients with advanced hepatocellular carcinoma (HCC) who are receiving CT-guided percutaneous minimally-invasive argon-helium knife cryoablation.Methods A total of 30 HCC patients,who underwent percutaneous argonhelium knife cryoablation,were enrolled in this study.Perioperative measures based on the concept of bundle of care were implemented,which included training of nursing team members,perfect preoperative psychological nursing,dietary guidance,preoperative routine preparations,effective intraoperative guidance and close observation of the patient's condition,postoperative activity guidance,prevention and observation of complications,etc.Results All 30 advanced HCC patients could actively cooperate with physicians for the performance of percutaneous argon helium cryoablation.After the treatment,two patients developed nausea and vomiting and one patient developed chills and fever,which were improved after symptomatic treatment.All the 30 patients recovered well during the perioperative period and were discharged from hospital smoothly.Conclusion Perioperative bundle of care can help patients restore the surgical damage as soon as possible,reduce the pain and improve the quality of life.

t-PA negatively regulating p75NRT for involving in atherosclerosis by changing reconstruction of vascular outer membrane autonomic nerve / 重庆医学

Objective To study the effect of tissue plasminogen activator (t-PA) on p57NTR ,inflammatory reaction ,immune regulation and oxidative stress and its effect on intimal hyperplasia .Methods The vascular injury treatment was performed in the diabetic rabbit model with carotid arterial adventitia stripping ,meanwhile t-PA controlled release microspheres were given ,the nerve distribution in the local blood vessels was observed by immunohistochemical staining .The change of nerve remodeling in the control group and treatment group was observed ,meanwhile the effect of giving t-PA controlled release microspheres on the release of ace-tylcholine and norepinephrine was detected .RT-PCR was used to detect local vascular tissue inflammation ,immune effects and oxi-dative stress .The sympathetic neurons and smooth muscle cell co-culture was adopted ,then giving glyoxal treatment as the athero-sclerosis cell model .With the t-PA treatment group as the intervention group ,the effect of t-PA on the number of cholinergic neu-ron ,and synaptic connections between the smooth muscle cells and acetylcholine secretion was observed .The change of t-PA-MMP-p75NTR and NF-kappa B signaling pathway were detected by RT-PCR .Results The vascular injury treatment was performed in the diabetic rabbit model with carotid arterial adventitia stripping ,meanwhile t-PA controlled release microspheres were given ,the nerve distribution in the local blood vessels was observed by immunohistochemical staining .The change of nerve remodeling in the control group and treatment group was observed ,meanwhile the effect of giving t-PA controlled release microspheres on the release of acetylcholine and norepinephrine was detected .RT-PCR was used to detect local vascular tissue inflammation ,immune effects and oxidative stress .The sympathetic neurons and smooth muscle cell co-culture was adopted ,then giving glyoxal treatment as the ath-erosclerosis cell model .With the t-PA treatment group as the intervention group ,the effect of t-PA on the number of cholinergic neuron ,and synaptic connections between the smooth muscle cells and acetylcholine secretion was observed .The change of t-PA-MMP-p75NTR and NF-kappa B signaling pathway were detected by RT-PCR .Conclusion t-PA activates MMPs and feedback in-hibits p75NTR-NF-kappa B signaling pathway to increase vascular adventitia autonomic nerve reconstruction and delay the occur-rence and development of atherosclerosis disease .

Old trans-scaphoid perilunar dislocation treated with dorsal approach / 局解手术学杂志

Objective To evaluate the effectiveness of scaphoid fracture fixation through dorsal approach and dorsal joint capsule recon -struction in treatment of old trans-scaphoid perilunar dislocation .Methods From October 2010 to October 2013, 12 patients of old trans-scaphoid perilunar dislocation had been treated with open reduction and internal fixation as well as dorsal joint capsule reconstruction through dorsal approach.Among the 12 patients, 9 were males and 3 were females, and they were 22~54 years old (42.3 years old averagely). Preoperative and postoperative wrist functions were evaluated by visual analogue scale (VAS), range of motion (ROM), grip strength and Cooney's standard.Results All the 12 patients were followed-up for 15 to 28 months (24 months averagely).In the last follow-up, the aver-age VAS score was 1.6 point (0~6 point) , and 9 patients of them had no feeling of pain .According to the Cooney ’ s standard,the results were excellent in 2 cases, good in 8 cases, fair in 1 case,and bad in 1 case.The mean time of fracture union was 14~22 weeks (16.8 weeks averagely ) .Conclusion Scaphoid fracture fixation through dorsal approach and dorsal joint capsule reconstruction in treatment of old trans-scaphoid perilunar dislocation can receive good curative effect and satisfactory clinical effect .

Practice and analysis of bilingual teaching in medical imaging / 中华医学教育探索杂志

Bilingual teaching is the important teaching method of medical colleges to keep up with the international progress. This article summarizes the experience of bilingual teaching practice in medical imaging, makes a deep analysis on the problems that need to be solved promptly, and suggests some new ideas about the selection of textbook, preparation of teaching slides and teaching mode.

Value of oxygenation index in assessment of outcome of patients with acute respiratory distress syndrome treated by mechanical ventilator / 中华急诊医学杂志

Objective To determine the value of oxygenation index in assessing the outcome of mechanical ventilated patients with acute respiratory distress syndrome (ARDS).Methods From September 2008 to September 2013,patients meeting the Berlin definition of ARDS were evaluated in this retrospective study.Data included oxygenation index (PaO2/FiO2) on day before,and day 1 and day 3 after mechanical ventilation.The levels of PaO/FiO2 on day before and day 1 after mechanical ventilation were compared between 28-day survivors and non-survivors.Results There were 236 patients meeting the criteria of the Berlin Definition for diagnosis and treated with mechanical ventilation.The mean score of APACHIE Ⅱ and sequential organ failure assessment (SOFA) at the beginning were (19.1 ± 3.0) and (10.8 ±2.5),respectively,while oxygenation index on day before mechanical ventilation was (150.3 ± 62.6) mmHg.According to the hypoxemia grade,patients were divided into mild (n =36),moderate (n =122) and severe (n =78) ARDS,and their levels of PaO2/FiO2 were (80.1 ± 8.1),(162.3 ± 19.9) and (261.6 ± 22.3) mmHg,respectively.There were 92 non-survivors and 144 survivors.No obvious difference in oxygenation index of non-survivors among on day before、and day 1 and day 3 after mechanical ventilation.There was statistically significant difference in oxygenation index between on day before and day 1 after mechanical ventilation in survivors (P ＜ 0.05).Compared with the survivors,the score of APACHE Ⅱ,SOFA,and oxygenation index on day 3 were associated with increased mortality in the non-survivors,respectively (P ＜ 0.05).In respect to the mortality,the cut-off point of score of oxygenation index set at ＜ 180 mmHg on Day 3,an area under the receiver operating curve (AUC) was 0.749 with statistically significance (P ＜ 0.05),leading to sensitivity 61.7％ and specificity 93.2％.The relationship between prognosis and antibiotic resistance did not have statistically significance.Conclusions Data of oxygenation index on early phage of ARDS may be valuable to predict the outcome.A strong predictor of adverse outcome in such conditions was the score of oxygenation index on Day 3 ≤ 180 mmHg.

Gene expression of neuropilin-1 and its receptors, VEGF/Semaphorin 3a, in normal and cancer cells.

Extracellular domains of the transmembrane glycoprotein, neuropilin-1 (Np1), specifically bind an array of factors and co-receptors including class-3 semaphorins (Sema3a), vascular endothelial growth factor (VEGF), hepatocyte growth factor, platelet-derived growth factor BB, transforming growth factor-ß 1 (TGF-ß1), and fibroblast growth factor2 (FGF2). Np1 may have a role in immune response, tumor cell growth, and angiogenesis, but its relative expression in comparison to its co-primary receptors, VEGF and Sema3a, is not known. In this study we determined the mRNA expression of Np1 and its co-receptors, VEGF and Sema3a, and the ratio of VEGF/Sema3a in different human and rodent cell lines. Expression of Np1, VEGF and Sema3a is very low in cells derived from normal tissues, but these proteins are highly expressed in tumor-derived cells. Furthermore, the ratio of VEGF/Sema3a is highly variable in different tumor cells. The elevated mRNA expression of Np1 and its putative receptors in tumor cells suggests a role for these proteins in tumor cell migration and angiogenesis. As different tumor cells exhibit varying VEGF/Sema3a ratios, it appears that cancer cells show differential response to angiogenic factors. These results bring to light the individual variation among the cancer-related genes, Np1, VEGF, and Sema3a, and provide an important impetus for the possible personalized therapeutic approaches for cancer patients.

Clinical research in the effects of urokinase on acute cerebral infarction in very early stage / 中华急诊医学杂志

Objective To study the effects of thrombolysis for the treatment of acute cerebral infarction (ACI) in early stage (within 6 hours after onset) in hospital, and to demonstrate the benefit of urokinase in the treatment of acute cerebral infarction. Method The patients with cerebral infarction treated with UK within 3hours after onset in the emergency department were enrolled as the study group, and those treated with thrombolytics in the neurological unit over the same period were taken as the control group. Results The average time from onset of ACI to starting thrombolytic therapy was 45 minutes in the study group and 80 minutes in the control group.The number of patients treated with thrombolysis within 3 hours was 39 ( 14.4% ) in the study group and 29 (10.5%) in the control group. There were significant differences in the scores of the National Institutes of Health Stroke Scale (NIHSS) after thrombolytic therapy and in Bathel index of complete or nearly complete recovery rate between two groups. The length of hospital stay was shorter in patients of the study group than that in the control group. Conclusions The thrombolytic treatment with urokinase employed to the patients in the early stage of acute cerebral infarction leads to better outcomes than that in the later stage.

Effect of glutamine on Hsp70 expression and immune in patients with acute cerebral infarction / 肠外与肠内营养

Objective: To study the effects of glutamine on heat shock protein 70(Hsp70) expression and immune in patients with acute cerebral infarction.Methods: 60 patients with acute cerebral infarction were randomly divided into 2 groups,the control group(n=30) and the glutamine group.Patients in glutamine group were supplemented intravenously with alanyl-glutamine during 24 hours after hospitalization.Other treatments were the same as in the control group.Serum Hsp70 concentrations,immune parameters,and infection rates were compared.Results: The serum Hsp70 level,the immune globulin level,the CD4+ cell and CD4+/CD8+ in the glutamine group were significantly higher than those in the control group(P

Separation and Determination of Cinoxacin and Nalidixic Acid inHuman Plasma by Reverse-phase High Performance Liquid Chromatography / 分析化学

A method for the determination of cinoxacin and nalidixic acid in human plasma by reverse-phase high performance liquid chromatography is introduced. The single separation system involves a RP-C18 column, a ultraviolet detector at 254 mn and CH3CN-CH3OH-0.01 mol/L HOOCOOH (30:5:65;pH 4.55). The influence of two kind of buffer (phosphate buffer and oxalate buffer) in mobile phase on the separation were studied. Oxalate buffer can improve tailing peak and decrease detection limits. Three pH values (pH 2.80,4.08,4.55) were studied, pH 4.55 can give best separation result. The detection limits of cinoxacin and nalidixic acid were 0.14 ng and 0.24 ng, respectively.