Role of deubiquitinase JOSD2 in the pathogenesis of esophageal squamous cell carcinoma

BACKGROUND Esophageal squamous cell carcinoma(ESCC)is a deadly malignancy with limited treatment options.Deubiquitinases(DUBs)have been confirmed to play a crucial role in the development of malignant tumors.JOSD2 is a DUB involved in con-trolling protein deubiquitination and influencing critical cellular processes in cancer.AIM To investigate the impact of JOSD2 on the progression of ESCC.METHODS Bioinformatic analyses were employed to explore the expression,prognosis,and enriched pathways associated with JOSD2 in ESCC.Lentiviral transduction was utilized to manipulate JOSD2 expression in ESCC cell lines(KYSE30 and RESULTS )Preliminary research indicated that JOSD2 was highly expressed in ESCC tissues,which was associated with poor prognosis.Further analysis demonstrated that JOSD2 was upregulated in ESCC cell lines compared to normal esophageal cells.JOSD2 knockdown inhibited ESCC cell activity,including proliferation and colony-forming ability.Moreover,JOSD2 knockdown decreased the drug resistance and migration of ESCC cells,while JOSD2 overexpression enhanced these phenotypes.In vivo xenograft assays further confirmed that JOSD2 promoted tumor proliferation and drug resistance in ESCC.Mechanistically,JOSD2 appears to activate the MAPK/ERK and PI3K/AKT signaling pathways.Mass spectrometry was used to identify crucial substrate proteins that interact with JOSD2,which identified the four primary proteins that bind to JOSD2,namely USP47,IGKV2D-29,HSP90AB1,and PRMT5.CONCLUSION JOSD2 plays a crucial role in enhancing the proliferation,migration,and drug resistance of ESCC,suggesting that JOSD2 is a potential therapeutic target in ESCC.

A Study on the Application of Audible Thinking Combined with Case Teaching Method in the Teaching of Nursing Room Visits for Trained Nurses

Objective:To investigate the effect of using audible thinking combined with the case teaching method in the teaching of nursing checkups for regulation nurses.Methods:The period was April 2023–April 2024,and a randomized controlled group study was carried out in which 76 regulation nurses in our hospital were randomly divided into a research group and a control group,with 38 regulation nurses in each group.The control group used conventional teaching methods,and the research group used audible thinking combined with the case teaching method,comparing the two groups’independent learning ability scores,assessment scores,and teaching satisfaction.Results:Independent learning ability score:after teaching,the research group was significantly higher than the control group(P<0.05);Assessment results:the research group was considerably higher than the control group(P<0.05);Teaching satisfaction:the research group was significantly higher than the control group(P<0.05).Conclusion:The use of audible thinking combined with the case teaching method in the teaching of nursing room visits for trained nurses can improve independent learning ability and assessment results and increase teaching satisfaction.

Thoracic endovascular aortic repair with left subclavian artery reconstruction for blunt traumatic aortic injury in elderly patients

Introduction:Blunt thoracic aortic injury(BTAI)is rare in elderly patients.As the population ages and life expectancy increases,the frequency of this injury will increase,while the treatment and outcomes remain unclear.Methods:We retrospectively analyzed the collected data of patients>60 years old with BTAI to investigate the mechanism of trauma;time interval from injury to diagnosis;type and timing of surgical intervention;aortic arch pattern;choice of left subclavian artery reconstruction;endograft to treat BTAI;length of the endovascular procedure;endoleaks;complications including stroke,paraplegia,and renal failure;length of hospital stay(LOS)and intensive care unit stay(L.ICUS);and 30-day mortality.Results:Five elderly trauma patients were found to have BTAI.Four(80%)were males,the cohort mean age was68 years,the major mechanism of trauma was fall injury,and the associated injury was thoracic trauma.All patients were transferred to our hospital,and emergency computed tomography angiography showed BTAI in each patient.The average time interval from injury to diagnosis was 2.7 days.Two patients suddenly showed signs of instability in their vital signs and underwent immediate endovascular repair,while 3 patients underwent delayed endovascular repair.The injury site was located in the aortic isthmus just distal to the origin of the left subclavian artery;the aortic arch pattern was II(80.0%)in 4 cases and III in 1 case(20.0%).The choice of left subclavian artery reconstruction included chimney,double chimney,prefenestration,and chimney combined with in situ fenestration.Endografts to treat BTAI included the Ankura(Lifetech Scientific,Shenzhen,China)and the C-TAG(W.L.Gore&Associates,Flagstaff,AZ USA).The length of the endovascular procedure was 75.4 min;there were no endoleaks and no complications including stroke,paraplegia,or renal failure.The average LOS was25 days,and the average L.ICUS of 2 patients was 15 days,with no 30-day mortality.Conclusion:Elderly patients with fall injury should promptly exclude BTAI.Thoracic endovascular aortic repair(TEVAR)with a left subclavian artery reconstruction technique provided good results without procedure-related or neurological complications.Because of the low incidence of this type of injury,we are unable to provide any evidence to guide the treatment option for this life-threatening condition.

Deep vein thrombosis in patient with left-sided inferior vena cava draining into the hemiazygos vein: A case report

BACKGROUND Abnormalities of the inferior vena cava(IVC)are uncommon,and in many cases they are asymptomatic.Even so,it is vital that clinicians be aware of such anomalies prior to surgery in affected individuals.In the present report,we describe a rare anatomical variation of the IVC.CASE SUMMARY A 66-year-old male was admitted to the hospital due to deep vein thrombosis of the right lower extremity.Upon contrast-enhanced computed tomography imaging,we found that this patient presented with a case of left-sided IVC draining into the hemiazygos vein,while his hepatic vein was directly draining into the atrium.CONCLUSION Cases of left-sided IVC can increase patient susceptibility to thromboembolism owing to the resultant changes in blood flow and/or associated vascular compression.

Endovascular stent treatment of the iliac vein stenosis caused by a pelvic lymphocele secondary to gynecologic malignancy

Over the past two years,6 patients had iliac vein stenosis caused by radiation and pelvic lymphocele secondary to gynecologic malignancy.Patients had symptomatic lymphoceles induced lower limb edema.Poor treatment of symptomatic lymphoceles,compression symptoms persist,all patients were performed endovascular stent therapy,clinical symptoms of lower limb were completely relieved.Iliac vein stenosis caused by radiation and pelvic lymphocele secondary to gynecologic malignancy,endovascular stent placement is a nonsurgical alternative for the reestablishment of venous flow and sustained relief of symptoms.

Linarin ameliorates innate inflammatory response in an experimental dry eye model via modulation of the NLRP3 inflammasome

Objective To investigate the effect and mechanism of linarin(LA) in an experimental dry eye model.Methods LA or vehicle was applied in two dry eye models: an in vitro hyperosmotic stress model and an in vivo desiccating stress(DS) murine model. The viability of human corneal epithelial cells(HCECs) was measured using a cell counting kit(CCK-8).Tear secretion was assessed using the phenol red cotton test. The tear break-up time(TBUT) was recorded using 0.1% liquid fluorescein sodium. Corneal epithelial permeability was evaluated through Oregon green dextran(OGD) staining.Conjunctival goblet cells were counted using periodic acid-Schiff(PAS) staining. Terminal deoxynucleotidyl transfer d UTP nickend labeling(TUNEL) staining was used to quantify apoptotic cells in both models. The expression of Ki-67 was measured in HCECs in the cell model while that of matrix metalloproteinase(MMP)-3 and-9 was measured in the murine model through immunofluorescence staining. Real-time quantitative PCR(RTqPCR) was performed to assess the expression of MMP-3 and MMP-9 in the corneal epithelium and NLRP3, ASC, Caspase-1,interleukin(IL)-1β, IL-18, and tumor necrosis factor(TNF)-α in the conjunctiva. The protein expression levels of NLRP3, ASC,Caspase-1, IL-1β, and IL-18 in the conjunctiva were assessed via Western blot.Results In the in vitro model, treatment of HCECs with LA showed no toxicity, increased proliferation, and reduced apoptosis. In the murine model, compared to the control, LA significantly increased tear production and TBUT, improved OGD staining, and increased the number of goblet cells. Topical treatment of LA to mice provided decreased expression of MMP-3, MMP-9, TNF-α, and apoptotic corneal epithelium. Topical administration of LA also suppressed the NLRP3 inflammasome in the dry eye disease(DED) murine model by decreasing the expression of NLRP3, ASC, Caspase-1, IL-1β, and IL-18 in the conjunctiva.Conclusion Our findings support the safety and efficacy of LA in the treatment of DED. LA alleviated corneal epithelial damage and suppressed NLRP3 inflammasome-mediated immunity in the conjunctiva in a murine model of DED.

3-to 24-month Follow-up on COVID-19 with Pulmonary Tuberculosis Survivors after Discharge:Results from a Prospective,Multicenter Study

Objective Coronavirus disease 2019(COVID-19)and tuberculosis(TB)are major public health and social issues worldwide.The long-term follow-up of COVID-19 with pulmonary TB(PTB)survivors after discharge is unclear.This study aimed to comprehensively describe clinical outcomes,including sequela and recurrence at 3,12,and 24 months after discharge,among COVID-19 with PTB survivors.Methods From January 22,2020 to May 6,2022,with a follow-up by August 26,2022,a prospective,multicenter follow-up study was conducted on COVID-19 with PTB survivors after discharge in 13 hospitals from four provinces in China.Clinical outcomes,including sequela,recurrence of COVID-19,and PTB survivors,were collected via telephone and face-to-face interviews at 3,12,and 24 months after discharge.Results Thirty-two COVID-19 with PTB survivors were included.The median age was 52(45,59)years,and 23(71.9%)were men.Among them,nearly two-thirds(62.5%)of the survivors were moderate,three(9.4%)were severe,and more than half(59.4%)had at least one comorbidity(PTB excluded).The proportion of COVID-19 survivors with at least one sequela symptom decreased from 40.6%at 3 months to 15.8%at 24 months,with anxiety having a higher proportion over a follow-up.Cough and amnesia recovered at the 12-month follow-up,while anxiety,fatigue,and trouble sleeping remained after 24months.Additionally,one(3.1%)case presented two recurrences of PTB and no re-positive COVID-19during the follow-up period.Conclusion The proportion of long symptoms in COVID-19 with PTB survivors decreased over time,while nearly one in six still experience persistent symptoms with a higher proportion of anxiety.The recurrence of PTB and the psychological support of COVID-19 with PTB after discharge require more attention.

Identification of the dominant loop of a dual-loop macro-reentry left atrial flutter without prior intervention using high-density mapping technology:A case report

BACKGROUND Left atrial flutter without prior cardiac interventions is uncommon,especially dual-loop macro-reentry atrial flutter.The critical step to ablate dual-loop macroreentry atrial flutter is to identify the dominant loop and key isthmus.Although entrainment mapping could help identify the dominant loop and key isthmus,it may alter or terminate tachycardia.High-density mapping allows the generation of electroanatomic maps without altering or terminating tachycardia.CASE SUMMARY Here,we report a case of symptomatic left atrial flutter without prior intervention.In this case,high-density mapping revealed a dual-loop macro-reentry around the mitral annulus and central scar of the anterior wall.The propagation result showed that the dominant loop was around the mitral annulus,and the key isthmus was between the central scar and mitral annulus.The atrial flutter terminated successfully after ablation was performed.CONCLUSION In this case,we demonstrate that high-density mapping technology may help identify the dominant loop of dual-loop atrial flutter without entrainment,which makes ablation easier.

Effect of postoperative adjuvant chemotherapyon the prognosis of patients with ypT0-3N0 rectalcancer undergoing neoadjuvant chemoradiotherapy

Objective The aim of this study was to investigate the effect of adjuvant chemotherapy (AC) on theprognosis of patients with ypT0-3N0 rectal cancer undergoing neoadjuvant chemoradiotherapy.Methods The study participants were 110 patients with locally advanced rectal cancer. Thirty-fourpatients did not receive postoperative AC treatment, and the other 76 patients received postoperative ACtreatment. The differences in the 5-year overall survival (OS) and disease-free survival (DFS) between thetwo groups were compared.Results Age was an important determinant of the patients’ decision to undergo postoperative treatment.Patients who did not receive AC treatment were significantly older than those who received AC treatment(P < 0.05). The tumor location (distance above anal margin) in the AC group was significantly larger thanthat in the non-AC group (P < 0.05). Moreover, there was no significant difference in the 5-year DFS andOS between the two groups. Postoperative AC did not significantly improve the prognosis of patients withrectal cancer. Age, tumor differentiation, and the number of resected lymph nodes were independent factorsaffecting the OS of patients (P < 0.05). Older patients, patients with lower degree of tumor differentiation,and patients with <12 resected lymph nodes showed worse prognosis (P < 0.05).Conclusion Patients with rectal cancer whose ypT0-3N0 stage is reduced after neoadjuvantchemoradiotherapy, especially those without adverse prognostic factors, do not need AC after surgery.

Prognostic value of serum carcinoembryonic antigen combined with nutritional status control score in patients with colorectal cancer

Objective To investigate the prognostic value of serum carcinoembryonic antigen(CEA)and controlling nutritional status(CONUT)score in patients with colorectal cancer.Methods We retrospectively studied 261 patients with colorectal cancer in our hospital.The patients were divided into two groups by CONUT=3 and CEA=5 ng/mL,and the effects of CONUT score and CEA level on the prognosis and clinicopathological parameters were statistically analyzed.Results(1)Different CONUT scores were significantly correlated with age,tumor diameter,differentiation type,and T stage(P<0.05).The older the patient was,the larger the tumor diameter,undifferentiated tumor,and T stage were,the higher the CONUT score was.(2)Seventy-five patients died during the follow-up period,and 45 patients died of progression or recurrence of colorectal cancer.The 5-year overall survival(OS)rate of the low CONUT score group was significantly higher than that of the high CONUT score group,and the 5-year OS rate of the low CEA group was significantly higher than that of the high CEA group;the difference was statistically significant(P<0.01).(3)According to the serum CEA level and CONUT score,the 5-year survival rates of CEAlow/CONUTlow,CEAlow/CONUThigh,CEAhigh/CONUTlow,and CEAhigh/CONUThigh were 84.7%,69%,55.3%,and 36.1%respectively,with statistical significance(P<0.01).(4)The Cox multivariate analysis showed that age,CONUT score,CEA combined with CONUT score,lymph node metastasis,and distant metastasis were independent risk factors for the prognosis of colorectal cancer patients.Conclusion:The combination of CEA detection and CONUT score can more accurately judge the prognosis of colorectal cancer patients.

Influence of ginkgolide combined with edaravone on the brain function of elderly patients with acute cerebral infarction and its preventive effect on ischemia reperfusion injury

Objective: To explore the influence of ginkgolide combined with edaravone on the brain function of elderly patients with acute cerebral infarction and its preventive effect on ischemia reperfusion injury. Methods: A total of 126 patients with acute cerebral infarction who were treated in Dazhou Central Hospital between February 2016 and May 2017 were divided into the control group (n=67) and ginkgolide group (n=59) according to different therapies. Control group received routine intravenous thrombolysis + edaravone therapy, and ginkgolide group received routine intravenous thrombolysis + edaravone + ginkgolide therapy. The differences in brain function and nerve ischemia reperfusion injury extent were compared between the two groups. Results: At T1 and T2, serum nerve function indexes NT-proBNP and NSE levels of ginkgolide group were lower than those of control group whereas BDNF levels were higher than those of control group;serum inflammatory mediators MCP-1, NF-κB, CRP and TNF-α levels were lower than those of control group;serum apoptosis molecules caspase-3 and Bax levels were lower than those of control group whereas Bcl-2 levels were higher than those of control group. Conclusion: Ginkgolide combined with edaravone therapy on the basis of intravenous thrombolysis can effectively optimize the brain function and alleviate the ischemia reperfusion injury caused by inflammatory response and apoptosisis in elderly patients with acute cerebral infarction.

Comparison of nerve conduction and injury degree in patients with lumbar disc herniation after microendoscopic discectomy and fenestration discectomy

Objective: To study the difference of nerve conduction and injury degree in patients with lumbar disc herniation after microendoscopic discectomy and fenestration discectomy. Methods: Patients with single-segment lumbar disc herniation who were treated in Dazhou Central Hospital between May 2014 and February 2017 were selected as the research subjects, the history data were reviewed and the operation methods were referred to divide them into FD group and MED group who received fenestration discectomy and microendoscopic discectomy respectively. The conduction velocity of common peroneal nerve and tibial nerve were detected before operation and 4 weeks after operation;serum levels of nerve and muscle injury-related molecules as well as inflammation and stress-related molecules were detected before operation and 3 days after operation. Results: MNCV levels of common peroneal nerve and tibial nerve 4 weeks after operation as well as serum CRP, TNF-α, MDA and AOPP contents 3 d after operation of both groups of patients were significantly higher than those before operation, and the MNCV levels of common peroneal nerve and tibial nerve of MED group 4 weeks after operation were significantly higher than those of FD group while serum CRP, TNF-α, MDA and AOPP contents of MED group 3 d after operation were not significantly different from those of FD group;serum NSE, S100B, Tau, pNF-H, CPK, Myo and LDH contents of FD patients 3 d after operation were significantly higher than those before operation while serum NSE, S100B, Tau, pNF-H, CPK, Myo and LDH contents of MED group were not significantly different from those before operation. Conclusion: Microendoscopic discectomy for lumbar disc herniation can relieve the nerve and muscle injury, and is equivalent to fenestration discectomy in activating the systemic stress and inflammatory response.

Association of Overlapped and Un-overlapped Comorbidities with COVID-19 Severity and Treatment Outcomes: A Retrospective Cohort Study from Nine Provinces in China

Objective Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.Methods A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients’ medical records. Multivariable logistic regression models were used to estimate the odds ratio(OR) and 95% confidence interval(95% CI) of the associations between comorbidities(cardiometabolic or non-cardiometabolic diseases), clinical severity, and treatment outcomes of COVID-19.Results Overall, 158(13.6%) patients were diagnosed with severe illness and 32(2.7%) had unfavorable outcomes. Hypertension(2.87, 1.30–6.32), type 2 diabetes(T2 DM)(3.57, 2.32–5.49),cardiovascular disease(CVD)(3.78, 1.81–7.89), fatty liver disease(7.53, 1.96–28.96), hyperlipidemia(2.15, 1.26–3.67), other lung diseases(6.00, 3.01–11.96), and electrolyte imbalance(10.40, 3.00–26.10)were independently linked to increased odds of being severely ill. T2 DM(6.07, 2.89–12.75), CVD(8.47,6.03–11.89), and electrolyte imbalance(19.44, 11.47–32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission(5.46,3.25–9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes(6.58, 1.46–29.64) within two weeks.Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.

A transferrin receptor targeting dual-modal MR/NIR fluorescent imaging probe for glioblastoma diagnosis

The prognosis of glioblastoma(GBM)remains challenging,primarily due to the lack of a precise,effective imaging technique for comprehensively characterization.Addressing GBM diagnostic challenges,our study introduces an innovative dual-modal imaging that merges near-infrared(NIR)fluorescent imaging with magnetic resonance imaging(MR).This method employs superparamagnetic iron oxide nanoparticies coated with NIR fluorescent dyes,specifically Cyanine 7,and targeted peptides.This synthetic probe facilitates MRI functionality through superparamagnetic iron oxide nanoparticles,provides NIR imaging capability via Cyanine 7 and enhances tumor targeting trough peptide interactions,offering a comprehensive diagnostic tool for GBM.Notably,the probe traverses the blood-brain barrier,targeting GBM in vivo via peptides,producing clear and discermible images in both modalities.Cytotoxicity and histopathology assessments confirm the probe's favorable safet profile.These findings suggest that the dual-modal MRINIR fluorescent imaging probe could revolutionize GBM prognosis and survival rate which can also be extended to other tumors type.

Retro-enantio isomer of angiopep-2 assists nanoprobes across the blood-brain barrier for targeted magnetic resonance/fluorescence imaging of glioblastoma

Glioblastoma(GBM),one of the most common primary intracranial malignant tumours,is very difficult to be completely excised by surgery due to its irregular shape.Here,we use an MRI/NIR fluorescence dual-modal imaging nanoprobe that includes superparamagnetic iron oxide nanoparticles(SPIONs)modified with indocyanine(Cy7)molecules and peptides(ANG orDANG)to locate malignant gliomas and guide accurate excision.Both peptides/Cy7-SPIONs probes displayed excellent tumour-homing properties and barrier penetrating abilities in vitro.

Rapid and accurate detection of carbapenem-resistance gene by isothermal amplification in Acinetobacter baumannii

Background:Acinetobacter baumannii(A.baumannii)is one of the pivotal pathogens responsible for nosocomial infections,especially in patients with low immune response,and infection with carbapenem-resistant A.baumannii has been increasing in recent years.Rapid and accurate detection of carbapenem-resistance genes in A.baumannii could be of immense help to clinical staff.Methods:In this study,a 15-μL reaction system for recombinase polymerase amplification(RPA)was developed and tested.We collected 30 clinical isolates of A.baumannii from the Burn Institute of Southwest Hospital of Third Military Medical University(Army Medical University)for 6 months and tested antibiotic susceptibility using the VITEK 2 system.A.baumannii was detected based on the blaOXA-51 gene by PCR,qPCR and 15μL-RPA,respectively.Sensitivity and specificity were evaluated.In addition,PCR and 15μL-RPA data for detecting the carbapenem-resistance gene blaOXA-23 were comparatively assessed.Results:The detection limit of the blaOXA-51 gene by 15μL RPA was 2.86 CFU/ml,with sensitivity comparable to PCR and qPCR.No positive amplification signals were detected in non-Acinetobacter isolates,indicating high specificity.However,only 18 minutes were needed for the 15μL RPA assay.Furthermore,an antibiotic susceptibility test showed that up to 90%of A.baumannii strains were resistant to meropenem and imipenem;15μL RPA data for detecting blaOXA-23 showed that only 10%(n=3)of A.baumannii isolates did not show positive amplification signals,and the other 90%of(n=27)isolates were positive,corroborating PCR results.Conclusion:We demonstrated that the new 15μL RPA assay for detecting blaOXA-23 in A.baumannii is faster and simpler than qPCR and PCR.It is a promising alternative molecular diagnostic tool for rapid and effective detection of A.baumannii and drug-resistance genes in the field and point-ofcare testing.

AI based colorectal disease detection using real-time screening colonoscopy

Colonoscopy is an effective tool for early screening of colorectal diseases.However,the application of colonoscopy in distinguishing different intestinal diseases still faces great challenges of efficiency and accuracy.Here we constructed and evaluated a deep convolution neural network(CNN)model based on 117055 images from 16004 individuals,which achieved a high accuracy of 0.933 in the validation dataset in identifying patients with polyp,colitis,colorectal cancer(CRC)from normal.The proposed approach was further validated onmulti-center real-time colonoscopy videos and images,which achieved accurate diagnostic performance on detecting colorectal diseases with high accuracy and precision to generalize across external validation datasets.The diagnostic performance of the model was further compared to the skilled endoscopists and the novices.In addition,our model has potential in diagnosis of adenomatous polyp and hyperplastic polyp with an area under the receiver operating characteristic curve of 0.975.Our proposed CNN models have potential in assisting clinicians in making clinical decisions with efficiency during application.

The SARS-CoV-2 spike L452R-E484Q variant in the Indian B.1.617 strain showed significant reduction in the neutralization activity of immune sera

To assess the impact of the key non-synonymous amino acid substitutions in the RBD of the spike protein of SARS-CoV-2 variant B.1.617.1(dominant variant identified in the current India outbreak)on the infectivity and neutralization activities of the immune sera,L452R and E484Q(L452R-E484Q variant),pseudotyped virus was constructed(with the D614G background).The impact on binding with the neutralizing antibodies was also assessed with an ELISA assay.Pseudotyped virus carrying a L452R-E484Q variant showed a comparable infectivity compared with D614G.However,there was a significant reduction in the neutralization activity of the immune sera from non-human primates vaccinated with a recombinant receptor binding domain(RBD)protein,convalescent patients,and healthy vaccinees vaccinated with anmRNA vaccine.In addition,there was a reduction in binding of L452R-E484Q-D614G protein to the antibodies of theimmune sera fromvaccinated nonhuman primates.These results highlight the interplay between infectivity and other biologic factors involved in the natural evolution of SARS-CoV-2.Reduced neutralization activities against the L452R-E484Q variant will have an impact on health authority planning and implications for the vaccination strategy/newvaccine development.

Observation on promoting resuscitation in the patients with coma of acute carbon monoxide poisoning by acupuncture combined with hyperbaric oxygen

Objective:To evaluate the effect of promoting resuscitation and the effect differences between acupuncture combined with hyperbaric oxygen therapy(HBOT)and simple HBOT in the patients with coma of acute carbon monoxide poisoning(ACMP).Methods:A total of 36 patients with ACMP coma were randomized into a simple HBOT group and acupuncture combined with HBOT group,18 cases in each one.In the simple HBOT group,HBOT was provided once a day for 2 weeks.In the acupuncture combined with HBOT group,acupuncture was provided during HBOT.The acupuncture was given before the patients were sent to the hyperbaric oxygen chamber and the needles were retained until the hyperbaric oxygen treatment was completed.The acupoints included B?ihuì(百会 GV 20),Shuǐgōu(水沟 GV 26),Sìshéncōng(四神聪 EX-HN1),Fēngchí(风池 GB20),Hégǔ(合谷 LI 4),Tàichōng(太冲 LR 3)and Yǒngquán(涌泉 KI 1).The needles were retained through the entire process of HBOT.Such combined treatment was given once a day for 2 weeks.Before the treatment,the score of Glasgow Coma Scale(GCS)was recorded,the levels of serum interleukin-6(IL-6),interleukin-8(IL-8)and brain-derived growth factor(BDNF)were tested and the time from unconsciousness to resuscitation was recorded of the two groups.After treatment,the levels of serum IL-6,IL-8 and BDNF were tested again and the clinical therapeutic effects were evaluated.Results:At last,there were 16 cases in the simple HBOT group and 17 cases in acupuncture combined with HBOT group got resuscitation.The time from unconsciousness to resuscitation was(5.17±1.10)h in the acupuncture combined with HBOT group,which was less than(6.83±2.73)h in the simple HBOT group,indicating the significant difference in statistic(P<0.05).After treatment,the total effective rate was 94.4% in the acupuncture combined with HBOT group,which was higher than 88.9% in the simple HBOT group,indicating the significant difference in statistic(P<0.05).After treatment,the levels of serum IL-6 and IL-8 were(29.72±3.49)and(67.17±7.61)pg/mL respectively in the acupuncture combined with HBOT group,which were lower as compared with those before treatment,indicating the significant differences in statistic(both P<0.05).The level of IL-8 in the acupuncture combined with HBOT group was lower than(72.67±7.17)pg/mL in the simple HBOT group after treatment,indicating the significant difference in statistic(P<0.05).After treatment,the level of BDNF was(14.78±3.90)pg/mL in the acupuncture combined with HBOT group,higher than the level before treatment,presenting the significant difference(P<0.05),and higher than(12.93 ± 2.59)pg/mL in the simple HBOT group after treatment,presenting the significant difference in statistic(P<0.05).Conclusion:Acupuncture combined with HBOT achieves the superior effect of promoting resuscitation and the clinical therapeutic effects as compared with the simple HBOT.Such combined treatment reduces the levels of serum IL-6 and IL-8,increases the level of serum BDNF in ACMP patients,as well as plays the active role in the prevention from delayed encephalopathy after acute carbon monoxide poisoning.

Combined fenestrated/chimney thoracic endovascular repair for the treatment of blunt traumatic aortic injury:A case report

Blunt traumatic thoracic aortic injury(BTAI)is an extremely serious medical condition with a high rate of associated mortality.Recent advances in techniques such as thoracic endovascular repair offer new opportunities to manage the critical BTAI patients in an efficacious yet less invasive manner.A 65 year-old-male suffered from multiple injuries after a fall,including BTAI in the aortic arch,which resulted in dissection of the descending thoracic-abdominal aorta and iliac artery,development of an intimal flap in the left common carotid artery,and dissection of the left subclavian artery.Based on the imaging information of this patient and our clinical experience,the combined treatment of fenestrated thoracic endovascular repair and a chimney technique was immediately planned to fully repair these dissections and moreover prevent further dissection of the branching vessels,additionally to ensure sufficient blood flow in the left subclavian artery and left common carotid artery.The intervention yielded satisfactory early outcomes.Follow-up assessment at six months reported no symptoms or complications associated with the stent-graft.Computed tomography angiography further confirmed adequate stent-graft coverage of the aortic injury.