Since the outbreak of COVID-19,severe acute respiratory syndrome coronavirus 2 genome is still mutating,forming a variety of variants with strong transmission capacity,causing the spread of the epidemic worldwide,posi...Since the outbreak of COVID-19,severe acute respiratory syndrome coronavirus 2 genome is still mutating,forming a variety of variants with strong transmission capacity,causing the spread of the epidemic worldwide,posing a serious threat to people's physical and mental health,and posing a major challenge to global public health.Omicron remains the main variant in several outbreaks worldwide,accounting for about 99%of the global genetic sequence.Recently,the World Health Organization announced that the subvariant of Omicron BA.5 has been found in more than 100 countries and regions around the world,causing the global epidemic rebound.However,there are few studies on the subvariant BA.5.This article reviews the latest research progress in epidemiology,infectivity,pathogenicity,vaccine and monoclonal antibody protection against Omicron subvariant BA.5,in order to provide reference for scientific prevention and control of Omicron subvariant BA.5.展开更多
目的观察针药并用治疗腹泻型肠易激综合征(diarrhea-irritable bowel syndrome,IBS-D)肝郁脾虚证的临床疗效以及对患者血清5-羟色胺(5-hydroxytryptamine,5-HT)、降钙素基因相关肽(calcitonin gene related peptide,CGRP)以及内皮素(end...目的观察针药并用治疗腹泻型肠易激综合征(diarrhea-irritable bowel syndrome,IBS-D)肝郁脾虚证的临床疗效以及对患者血清5-羟色胺(5-hydroxytryptamine,5-HT)、降钙素基因相关肽(calcitonin gene related peptide,CGRP)以及内皮素(endothelin,ET)的影响。方法选择60例IBS-D(肝郁脾虚证)患者作为研究对象,将患者随机分为观察组和对照组,每组30例。观察组患者采用针刺配合白术芍药散加减进行治疗,对照组仅采用针刺治疗。观察记录两组患者治疗总有效率、治疗前后中医临床症状积分差异以及IBS-D治疗前后专用生活质量量表(diarrhea-irritable bowel syndrome quality of life scale,IBS-QOL)评分差异以及两组患者治疗前后血清中5-HT、CGRP以及ET水平差异。结果观察组总有效率为83.3%,显著高于对照组的63.3%(P<0.05);治疗前两组患者中医临床症状总积分、各临床症状症状积分及IBS-QOL评分比较差异均无统计学意义(P>0.05);两组患者治疗后中医临床症状总积分、各临床症状症候积分及IBS-QOL评分与同组治疗前比较均显著降低(P<0.05);治疗后观察组中医临床症状总积分、IBS-QOL评分及治疗后3个月随访中医临床症状总积分、IBS-QOL评分与对照组比较均显著降低(P<0.05);治疗后观察组各种临床症状症状积分与对照组比较,均显著降低(P<0.05);治疗前两组患者血清中5-HT、CGRP以及ET水平比较差异无统计学意义(P>0.05);两组患者治疗后5-HT、CGRP以及ET水平与同组治疗前比较均显著降低(P<0.05);治疗后观察组5-HT、CGRP以及ET水平与对照组比较,显著降低(P<0.05)。结论针药并用治疗IBS-D(肝郁脾虚证)能够有效缓解患者临床症状,提高其生活质量,其作用机制可能是通过降低患者血清中的5-HT、CGRP以及ET水平来达到治疗的作用。展开更多
Large population passages of the SARS-CoV-2 in the past two and a half years have allowed the circulating virus to accumulate an increasing number of mutations in its genome. The most recently emerging Omicron subvari...Large population passages of the SARS-CoV-2 in the past two and a half years have allowed the circulating virus to accumulate an increasing number of mutations in its genome. The most recently emerging Omicron subvariants have the highest number of mutations in the Spike (S) protein gene and these mutations mainly occur in the receptor-binding domain (RBD) and the N-terminal domain (NTD) of the S gene. The European Centre for Disease Prevention and Control (eCDC) and the World Health Organization (WHO) recommend partial Sanger sequencing of the SARS-CoV-2 S gene RBD and NTD on the polymerase chain reaction (PCR)-positive samples in diagnostic laboratories as a practical means of determining the variants of concern to monitor possible increased transmissibility, increased virulence, or reduced effectiveness of vaccines against them. The author’s diagnostic laboratory has implemented the eCDC/WHO recommendation by sequencing a 398-base segment of the N gene for the definitive detection of SARS-CoV-2 in clinical samples, and sequencing a 445-base segment of the RBD and a 490 - 509-base segment of the NTD for variant determination. This paper presents 5 selective cases to illustrate the challenges of using Sanger sequencing to diagnose Omicron subvariants when the samples harbor a high level of co-existing minor subvariant sequences with multi-allelic single nucleotide polymorphisms (SNPs) or possible recombinant Omicron subvariants containing a BA.2 RBD and an atypical BA.1 NTD, which can only be detected by using specially designed PCR primers. In addition, Sanger sequencing may reveal unclassified subvariants, such as BA.4/BA.5 with L84I mutation in the S gene NTD. The current large-scale surveillance programs using next-generation sequencing (NGS) do not face similar problems because NGS focuses on deriving consensus sequence.展开更多
基金COVID-19 Emergency Medical Research Project of 940 Hospital(No.20yjky020)General Project of Huoshenshan Hospital Scientific Research Fund(No.HSS-217)。
文摘Since the outbreak of COVID-19,severe acute respiratory syndrome coronavirus 2 genome is still mutating,forming a variety of variants with strong transmission capacity,causing the spread of the epidemic worldwide,posing a serious threat to people's physical and mental health,and posing a major challenge to global public health.Omicron remains the main variant in several outbreaks worldwide,accounting for about 99%of the global genetic sequence.Recently,the World Health Organization announced that the subvariant of Omicron BA.5 has been found in more than 100 countries and regions around the world,causing the global epidemic rebound.However,there are few studies on the subvariant BA.5.This article reviews the latest research progress in epidemiology,infectivity,pathogenicity,vaccine and monoclonal antibody protection against Omicron subvariant BA.5,in order to provide reference for scientific prevention and control of Omicron subvariant BA.5.
文摘目的观察针药并用治疗腹泻型肠易激综合征(diarrhea-irritable bowel syndrome,IBS-D)肝郁脾虚证的临床疗效以及对患者血清5-羟色胺(5-hydroxytryptamine,5-HT)、降钙素基因相关肽(calcitonin gene related peptide,CGRP)以及内皮素(endothelin,ET)的影响。方法选择60例IBS-D(肝郁脾虚证)患者作为研究对象,将患者随机分为观察组和对照组,每组30例。观察组患者采用针刺配合白术芍药散加减进行治疗,对照组仅采用针刺治疗。观察记录两组患者治疗总有效率、治疗前后中医临床症状积分差异以及IBS-D治疗前后专用生活质量量表(diarrhea-irritable bowel syndrome quality of life scale,IBS-QOL)评分差异以及两组患者治疗前后血清中5-HT、CGRP以及ET水平差异。结果观察组总有效率为83.3%,显著高于对照组的63.3%(P<0.05);治疗前两组患者中医临床症状总积分、各临床症状症状积分及IBS-QOL评分比较差异均无统计学意义(P>0.05);两组患者治疗后中医临床症状总积分、各临床症状症候积分及IBS-QOL评分与同组治疗前比较均显著降低(P<0.05);治疗后观察组中医临床症状总积分、IBS-QOL评分及治疗后3个月随访中医临床症状总积分、IBS-QOL评分与对照组比较均显著降低(P<0.05);治疗后观察组各种临床症状症状积分与对照组比较,均显著降低(P<0.05);治疗前两组患者血清中5-HT、CGRP以及ET水平比较差异无统计学意义(P>0.05);两组患者治疗后5-HT、CGRP以及ET水平与同组治疗前比较均显著降低(P<0.05);治疗后观察组5-HT、CGRP以及ET水平与对照组比较,显著降低(P<0.05)。结论针药并用治疗IBS-D(肝郁脾虚证)能够有效缓解患者临床症状,提高其生活质量,其作用机制可能是通过降低患者血清中的5-HT、CGRP以及ET水平来达到治疗的作用。
文摘Large population passages of the SARS-CoV-2 in the past two and a half years have allowed the circulating virus to accumulate an increasing number of mutations in its genome. The most recently emerging Omicron subvariants have the highest number of mutations in the Spike (S) protein gene and these mutations mainly occur in the receptor-binding domain (RBD) and the N-terminal domain (NTD) of the S gene. The European Centre for Disease Prevention and Control (eCDC) and the World Health Organization (WHO) recommend partial Sanger sequencing of the SARS-CoV-2 S gene RBD and NTD on the polymerase chain reaction (PCR)-positive samples in diagnostic laboratories as a practical means of determining the variants of concern to monitor possible increased transmissibility, increased virulence, or reduced effectiveness of vaccines against them. The author’s diagnostic laboratory has implemented the eCDC/WHO recommendation by sequencing a 398-base segment of the N gene for the definitive detection of SARS-CoV-2 in clinical samples, and sequencing a 445-base segment of the RBD and a 490 - 509-base segment of the NTD for variant determination. This paper presents 5 selective cases to illustrate the challenges of using Sanger sequencing to diagnose Omicron subvariants when the samples harbor a high level of co-existing minor subvariant sequences with multi-allelic single nucleotide polymorphisms (SNPs) or possible recombinant Omicron subvariants containing a BA.2 RBD and an atypical BA.1 NTD, which can only be detected by using specially designed PCR primers. In addition, Sanger sequencing may reveal unclassified subvariants, such as BA.4/BA.5 with L84I mutation in the S gene NTD. The current large-scale surveillance programs using next-generation sequencing (NGS) do not face similar problems because NGS focuses on deriving consensus sequence.
