Abstract: Due to the continued emergence of multiple variants of SARS-CoV-2, the ongoing pandemic has resulted in severe mortality over the past two years. After the Alpha, Beta, Gamma and Delta variants, the most recent new variant of concern (VOC) strain to emerge is Omicron (B.1.1.529), which evolved as a result of the accumulation of a large number of mutations. The Omicron variant, which has a much higher transmission rate than the Delta variant, soon replaced the Delta variant and others, is now the dominant variant worldwide. The emergence of Omicron poses new challenges for the prevention and control of COVID-19 and has raised a number of concerns worldwide. Recently, cases of Omicron infection have been reported in several parts of China, and therefore this paper provides a comprehensive analysis and summary of the epidemiology and immune escape mechanisms of the Omicron variant. We also suggest some therapeutic strategies against the Omicron variant, including rapid diagnosis, genome analysis of emerging variants, ramping up of vaccination drives and receiving booster doses, updating the available vaccines, designing of multivalent vaccines able to generate hybrid immunity, up-gradation of medical facilities and strict implementation of adequate prevention and control measures need to be given high priority to handle the on-going COVID-19 pandemic successfully.

Objective To investigate the effects of chronic intermittent hypoxia (CIH) on electromyograph (EMG) and uhrastructure of geniogloasus (GG) and the interventive effects with adiponectin supplement. Methods Forty-two healthy male Wistar rats were randomly divided into normal control(A), CIH (B) and adiponeetin treatment (C) groups with 14 rats in each. CIH was performed 8 hours per day for5 weeks in both group B and C. In group C, transvenous injection of adiponectin of 10μg dosage each time, twice a week for 5 weeks. While in group A and B, transvenous injection of saline was performed twice a week for 5 weeks. At the beginning of 6th week the GG EMG voltages were measured before, during and following hypoxia stimulation by inserted bipolar needle electrodes and compared among three groups. Transmission electron microscope was used for observation of uhrastrueture of GG. Results The serum adiponectin level in group B (1226.0±112.0) ng/ml((-)x±s) was significantly lower than that in group A (2491.8±117.9) ng/ml, q=38.2, P<0.01), and adiponectin level in group C (1988.3± 114.7)ng/ml was significantly higher than that in group B(q=23.0, P<0.01). Comparison of GG EMG activity showed that the baseline amplitude of GG EMG before hypoxia stimulation was significantly lower in group B than that in both group A and group C (all P<0.01). At the 5th min of hypoxia stimulation the GG EMG activities were significantly enhanced among three groups (all P<0.01). Such an enhancement was the most evident in group A but the least remarkable in group B, with a significant difference among three groups(q_(ab)=17.5;q_(ac)=8.9;q_(bc)=8.6, all P<0.01). 15 min,30 min and45 min after hypoxia stimulation the amplitude of GG EMG remained at relative higher levels in group A and C, significantly higher than that in group B (all P<0.01). CIH could cause significant ultrastructural pathological changes such as myofibril discontinuities, lysis of myofilament, edema of mitochondria and disruption of cristae, vacuolus and lysis of some mitochondria in group B. Venous supplement of adiponectin could improve pathological changes resulting from CIH. Conclusions CIH could resulted in pathological changes in EMG and ultrastructure of GG, which might be associated with hypoadiponectinemia caused by CIH.

The present study was designed to test the hypothesis that a medium-term simulated microgravity can induce region-specific remodeling in large elastic arteries with their innermost smooth muscle (SM) layers being most profoundly affected. The second purpose was to examine whether these changes can be prevented by a simulated intermittent artificial gravity (IAG). The third purpose was to elucidate whether vascular local renin-angiotensin system (L-RAS) plays an important role in the regional vascular remodeling and its prevention by the gravity-based countermeasure. This study consisted of two interconnected series of in-vivo and ex-vivo experiments. In the in-vivo experiments, the tail-suspended, hindlimb unloaded rat model was used to simulate microgravity-induced cardiovascular deconditioning for 28 days (SUS group); and during the simulation period, another group was subjected to daily 1-hour dorso-ventral (-G(x)) gravitation provided by restoring to normal standing posture (S + D group). The activity of vascular L-RAS was evaluated by examining the gene and protein expression of angiotensinogen (Ao) and angiotensin II receptor type 1 (AT1R) in the arterial wall tissue. The results showed that SUS induced an increase in the media thickness of the common carotid artery due to hypertrophy of the four SM layers and a decrease in the total cross-sectional area of the nine SM layers of the abdominal aorta without significant change in its media thickness. And for both arteries, the most prominent changes were in the innermost SM layers. Immunohistochemistry and in situ hybridization revealed that SUS induced an up- and down-regulation of Ao and AT1R expression in the vessel wall of common carotid artery and abdominal aorta, respectively, which was further confirmed by Western blot analysis and real time PCR analysis. Daily 1-hour restoring to normal standing posture over 28 days fully prevented these remodeling and L-RAS changes in the large elastic arteries that might occur due to SUS alone. In the ex-vivo experiments, to elucidate the important role of transmural pressure in vascular regional remodeling and differential regulation of L-RAS activity, we established an organ culture system in which rat common carotid artery, held at in-vivo length, can be perfused and pressurized at varied flow and pressure for 7 days. In arteries perfused at a flow rate of 7.9 mL/min and pressurized at 150 mmHg, but not at 0 or 80 mmHg, for 3 days led to an augmentation of c-fibronectin (c-FN) expression, which was also more markedly expressed in the innermost SM layers, and an increase in Ang II production detected in the perfusion fluid. However, the enhanced c-FN expression and increased Ang II production that might occur due to a sustained high perfusion pressure alone were fully prevented by daily restoration to 0 or 80 mmHg for a short duration. These findings from in-vivo and ex-vivo experiments have provided evidence supporting our hypothesis that redistribution of transmural pressures might be the primary factor that initiates region-specific remodeling of arteries during microgravity and the mechanism of IAG is associated with an intermittent restoration of the transmural pressures to their normal distribution. And they also provide support to the hypothesis that L-RAS plays an important role in vascular adaptation to microgravity and its prevention by the IAG countermeasure.
Angiotensinogen ; genetics ; metabolism ; Animals ; Aorta, Abdominal ; pathology ; physiopathology ; Carotid Artery, Common ; pathology ; physiopathology ; Hindlimb Suspension ; Male ; Muscle, Smooth, Vascular ; metabolism ; pathology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptor, Angiotensin, Type 1 ; genetics ; metabolism ; Renin-Angiotensin System ; physiology ; Weightlessness Simulation

OBJECTIVETo evaluate clinical effects of lumbar spinal stenosis by endoscopic transforaminal decompression, and to provide a theory basis for selection of surgical candidates.

METHODSFrom June 2014 to January 2016, clinical data of 87 patients with lumbar spinal stenosis were retrospectively analyzed, including 45 males and 42 females, aged from 25 to 81 years old with an average of 55.14 years old; 8 cases on L₃,₄, 61 cases on L₄,₅, 18 cases on L₅S₁. All patients underwent percutaneous edoscopic transforaminal decompression. Clinical symptoms and nerve functions were evaluated by VAS, ODI before operation, 3 and 6 months after operation, MacNab scoring was used to evaluate clinical effects.

RESULTSPostoperative incision of 87 patients healed well without complications, and obtained more than 6 months follow-up. VAS score before operation, 3 and 6 months after operation respectively were 63.88±8.56, 13.22±8.24, 6.83±9.43 respectively;ODI score before operation, 3 and 6 months after operation were 59.96±12.60, 9.08±10.55, 5.64±6.84 respectively. There was statistical significance in VAS and ODI score compared before operation and 3 and 6 months after operation. According to MacNab scoring, 41 cases obtained excellent results, 30 good, 7 moderate and 9 poor.

CONCLUSIONSPercutenous endoscopic transforaminal decompression for lumbar spinal stenosis could reach good clinical effects if choosing appropriate indications. For patients with yellow ligament hypertrophy or combined with some ossified stenosis, insufficient decompression may result in poor therapeutic effects.

Objective To summarize the follow-up outcomes of Draf Ⅱ b frontal sinusotomy and it's modified procedures,and to discuss the surgical indications and prognostic factors.Methods Thirty-two patients treated between 2004 and 2010 were enrolled in this study.There were 15 patients for recurrent frontal inverted papilloma ( IP),6 for mucocele,4 for recurrent frontal sinusitis,3 for osteoma,2 for meningoeneephalocele with cerebrospinal fluid rhinorrhea,1 for meningoencephalocele alone and 1 for acute frontal sinusitis.All patients underwent preoperative paranasal sinus computed tomography (CT) scans.Patients with tumor accepted magnetic resonance imaging (MRI).The patients with meningoencephalocele and cerebrospinal fluid rhinorrhea recieved magnetic resonance cistemography (MRC).The Draf Ⅱ b frontal sinusotomy and it's modified Draf Ⅱ b-1 -3 procedures were applied endoscopically under general anesthesia mainly by high speed bur and power system.The postoperative CT scan was obtained as a base line for follow-up 1 week after the operation.Postoperative follow-up was performed under endoscope.Results Among 19 cases of Draf Ⅱ b,12 were recurrent IP of frontal sinus,4 were mucocele,2 were recurrent frontal sinusitis and 1 were osteoma.Five cases received Draf Ⅱ b-1,2 for each recurrent IP of frontal sinus and recurrent frontal sinusitis and 1 for osteoma. Six cases received Draf Ⅱ b-2, 3 for meningoencephalocele,1 for each IP,acute frontal sinusitis and osteoma.Two cases received Draf Ⅱ b-3 were mucocele.The follow-up ranged from 8 to 73 months.Twenty-two cases of the frontal neoostium were widely opened,7 were stenosis and 3 were closed.Revision surgery was seen in 2 cases with IP.All of them had no complications.Conclusions The Draf Ⅱ b frontal sinusotomy and it's modified procedures are suitable for complex frontal sinus disease,which can be selected according to pathological and anatomical features,and have a good prospect for clinical application.

Objective To sum up the follow-up outcomes of endoscopic modified Lothrop procedure (EMLP) and retrospectively analyze the indications,methods and prognostic factors of EMLP.Methods The collected data of 73 cases who received EMLP with frontal sinus diseases were analyzed in this paper.The mean age was 45.6 (ranging from 14 to 72 years).There were 52 males and 21 females.Only patients with follow-up time greater or equal to 6 months were included.Paranasal sinus CT scan was adopted for all cases and MRI for tumor patients.All patients were followed under endoscope.Results There were 21 inverted papilloma in the frontal sinus,16 chronic sinusitis with asthma,12 frontal sinusitis,9 chronic sinusitis with or without polyps,7 osteoma of the frontal sinus,4 frontal mucocele,3 allergic fungal sinusitis and 1 congenital encephalocele.Sixty-one cases had prior surgical history ( 1.8 times on the average).Their mean follow-up was 25.0 months,(ranging from 6 to 122 months).At the end of follow-up,44 cases (60.3％ ) had well opened frontal drainage pathway.Twenty-five (34.2％ ) was re-stenosed and 4 (5.5％)closed.Seven cases (9.6％ ) underwent revision surgeries.There were no surgical complications.Conclusions EMLP is an effective and salvage procedure in dealing with tumor of frontal sinus and recurrent frontal sinusitis.Combined with medical treatment,EMLP will have a better results for chronic sinusitis with or without polyps and asthma.The degree of diseases,mucosal loss,anatomic variability and prior surgeries are important prognostic factors.

BACKGROUNDRecombinant human parathyroid hormone (1-34) (rhPTH (1-34)) is the first agent in a unique class of anabolic therapies acting on the skeleton. The efficacy and safety of long-term administration of rhPTH (1-34) in Chinese postmenopausal women had not been evaluated. This study compared the clinical efficacy and safety of rhPTH (1-34) with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China.

METHODSA total of 453 postmenopausal women with osteoporosis were enrolled in an 18-month, multi-center, randomized, controlled study. They were randomized to receive either rhPTH (1-34) 20 µg (200 U) daily for 18 months, or elcatonin 20 U weekly for 12 months. Lumbar spine (L1-4) and femoral neck bone mineral density (BMD), fracture rate, back pain as well as biochemical markers of bone turnover were measured. Adverse events were recorded.

RESULTSrhPTH (1-34) increased lumbar BMD significantly more than did elcatonin after 6, 12, and 18 months of treatment (4.3% vs. 1.9%, 6.8% vs. 2.7%, 9.5% vs. 2.9%, P < 0.01). There was only a small but significant increase of femoral neck BMD after 18 months (2.6%, P < 0.01) in rhPTH groups. There were larger increases in bone turnover markers in the rhPTH (1-34) group than those in the elcatonin group after 6, 12, and 18 months (serum bone-specific alkaline phosphatase (BSAP) 93.7% vs. -3.6%; 117.8% vs. -4.1%; 49.2% vs. -5.8%, P < 0.01; urinary C-telopeptide/creatinine (CTX/Cr) 250.0% vs. -29.5%; 330.0% vs. -41.4%, 273.0% vs. -10.6%, P < 0.01). rhPTH (1-34) showed similar effect of pain relief as elcatonin. The incidence of clinical fractures was 5.36% (6/112) in elcatonin group and 3.2% (11/341) in rhPTH (1-34) group (P = 0.303). Both treatments were well tolerated. Hypercaluria (9.4%) and hypercalcemia (7.0%) in rhPTH (1-34) group were transient and caused no clinical symptoms. Pruritus (8.2% vs. 2.7%, P = 0.044) and redness of injection site (4.4% vs. 0, P = 0.024) were more frequent in rhPTH (1-34). Nausea/vomiting (16.1% vs. 6.2%, P = 0.001) and hot flushes (7.1% vs. 0.6%, P < 0.001) were more common in elcatonin group.

CONCLUSIONSrhPTH (1-34) was associated with greater increases in lumbar spine BMD and bone formation markers. It could increase femoral BMD after 18 months of treatment. rhPTH could improve back pain effectively. The results of the present study indicate that rhPTH (1-34) is an effective, safe agent in treating Chinese postmenopausal women with osteoporosis.

Aged ; Bone Density ; drug effects ; Calcitonin ; analogs & derivatives ; therapeutic use ; China ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal ; drug therapy ; Parathyroid Hormone ; therapeutic use ; Treatment Outcome

BACKGROUND: Alcohol consumption has been observed to be a contributing factor in liver damage. However, very few studies have tried to decipher the correlation between patients with liver disease and alcohol consumption. Therefore, this study was planned to determine the prevalence of alcohol consumption among patients with liver disease, and to evaluate the risk factors, liver diseases, and chronic medical conditions associated with alcohol drinking. METHODS: A cross-sectional study was conducted among patients with liver disease in 30 provinces, autonomous regions, and municipalities across China. All participants answered the questionnaire, which led to the calculation of Alcohol Use Disorders Inventory Test (AUDIT) score for each patient. Based on this score, low-risk drinkers, hazardous drinkers, and harmful drinkers were defined as having AUDIT score of <8, between 8 and 15, and ≥16, respectively. RESULTS: A total of 1489 participants completed the questionnaire. Based on this information, 900 (60.44%) participants were classified as alcohol drinkers. Among these, 8.66% were ex-drinkers, 22.10% were low-risk drinkers, 17.13% were hazardous drinkers, and 12.56% were harmful drinkers. Further investigation of the association between alcohol consumption and other baseline characteristics of patients with liver disease revealed that usually men <40 years old, participants having higher family annual income, having college degree or higher education, living alone, having higher body mass index (BMI), current smokers, and ex-smokers had significant association with higher risk of alcohol consumption. In addition, among the 18.07% of the participants with cirrhosis, it was observed that risk of cirrhosis increased with higher alcohol consumption. Furthermore, harmful drinkers showed greater odds of hypertension and heart diseases, while hazardous drinkers and harmful drinkers, both had greater odds of hyperlipidemia. CONCLUSIONS Overall our analyses indicated that among the patients with liver disease in China, there was high rate of alcohol consumption and dependence. Alcohol consumption usually associated with men <40 years old, higher family income, education level, living alone, high BMI, and smoking. Increased alcohol consumption not only increased the risk of cirrhosis, but also enhanced the risk of hypertension, heart diseases, and hyperlipidemia.
Adult ; Aged ; Alcohol Drinking ; adverse effects ; Alcoholism ; etiology ; Cross-Sectional Studies ; Female ; Humans ; Liver Diseases ; etiology ; Male ; Middle Aged ; Smoking ; adverse effects

BACKGROUNDData on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.

METHODSThe survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, and/or use of antihypertensive medications. BP < 140/90 mmHg and < 130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.

RESULTSThe analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to < 140/90 mmHg and < 130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P < 0.001). When the threshold of BP < 130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P < 0.05). Using the threshold of < 140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P < 0.05).

CONCLUSIONSThe prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.

Adult ; Aged ; Awareness ; Female ; Humans ; Hypertension ; complications ; epidemiology ; therapy ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic ; complications