Objective To study the value of prealbumin(PAB) ,C reactive protein(CRP) and apolipoprotein A1(Apo A1) in e-valuating the prognosis of patients with severe pneumonia .Methods 63 cases of patients with severe pneumonia were selected ,and the fasting serum level of prealbumin ,C-reactive protein and apolipoprotein A1 were detected in 24 hours at the admission day ,and APACHE Ⅱ score was calcumulated .The patients were divided into group A (APACHEⅡscore <20) and group B(APACHEⅡscore≥20) ,with the incidence of MODS and mortality rate compared .The patients were divided into non-MODS group and MODS group .In addition ,the patients were divided into survival group and death group according to the prognosis .PAB ,CRP and Apo A1 in each group were compared .Results The incidence of MODS and mortality rate in group B (57 .9% ,47 .4% ) were higher than that in group A(24 .0% ,16 .0% )(P<0 .01 ,P<0 .05) .PAB and Apo A1 of patients in MODS group[(134 .13 ± 36 .20)mg/L , (0 .62 ± 0 .21)g/L] and death group[(129 .05 ± 52 .24)mg/L ,(0 .76 ± 0 .29)g/L] were respectively lower than that in non-MODS group[(215 .03 ± 72 .08)mg/L ,(1 .06 ± 0 .39)g/L] and survival group[(185 .52 ± 57 .63)mg/L ,(1 .15 ± 0 .36)g/L](P<0 .05) , while the CRP in MODS group(102 .37 ± 35 .65)mg/L and death group(96 .37 ± 34 .72)mg/L were higher than that in non-MODS group(69 .68 ± 32 .92)mg/L and survival group(62 .94 ± 38 .36)mg/L (P<0 .05) .Conclusion The measurement of PAB ,CRP and Apo A1 are valuable to evaluate the prognosis of the patients with severe pneumonia .

Objective To study the clinical effects of Ditan Xingnao Chengqi soup for treatment of patients with sepsis brain dysfunction. Methods Sixty-two cases of sepsis brain dysfunction were divided into treatment group(32 cases)and control group(30 cases)according to random digits table. Both groups received general clinical treatment,while the treatment group additionally accepted Ditan Xingnao Chengqi soup through nasal feeding. The changes of C-reactive protein(CRP)of two groups before treatment and after treatment for 12,24,48,72 hours and 1 week were observed. Besides,the Glasgow Outcome Scale(GOS)was used to assess the curative effect of two groups, and its clinical significance was judged. Meanwhile,the hospitalization costs,the times staying in hospital and total effective rates of the two groups after treatment were observed. In addition,cost-effectiveness analysis was carried out. Results With the extension of therapeutic time,the levels of CRP(mg/L)in the two groups were reduced effectively in comparison with those before treatment,and the change was more obvious in the treatment group;after treatment for 24 hours,the difference in the level of CRP between the two groups began to be statistically significant(106.5±22.3 vs. 201.6±25.4,P<0.05). The GOS of two groups after treatment had been increased markedly in comparison to that before treatment,and the change was more obvious in treatment group(72 hours:10.34±0.76 vs. 7.34±0.48,1 week:13.16±0.86 vs. 9.56±0.64,both P<0.05). Hospitalization costs(yuan)of treatment group in intensive care unit (ICU)was lower than that in control group(43276.16±1844.23 vs. 51347.75±2011.06,P<0.05),and the duration of staying(day)in ICU of treatment group was shorter than that in control group(15.11±2.25 vs. 20.30±2.97,P<0.05). The total effective rate of treatment group was higher than that of control group,but the difference had no statistical significance(87.5%vs. 60.0%,P>0.05).The ratio of cose effectiveness analysis in treatment group was smaller than that of control group(497.42 vs. 855.80,P<0.05). Conclusions Ditan Xingnao Chengqi soup has a relatively good effect on antagonizing inflammatory factors,controlling excessive inflammatory response and improving disturbance of consciousness. The early intervention with this agent for a patient with sepsis cognitive impairment can control the disease situation,improve the patient's prognosis and reduce his or her hospitalization costs.

Objective To investigate the influence of metformin on metabolic syndrome in patients with coronary artery disease.Methods 52 patients with coronary artery disease and metabolic syndrome were randomly assigned into 2 groups.the control group with 20 cases and the study group with 32 cases.All the patients were treated with standard coronary artery disease therapy and meanwhile the study group was administered with metformin in addition to the basic therapy above.The follow-up time is one year.FPG,2h postprandial glucose,FINS,TG,TC,HDL-C,insulin resistance index and other standards were compared before and after the therapy,and between the 2 groups when the observation was finished.The rate of cardiovascular events was also compared between the 2 groups.Results Compared with the control group,the study group had lower levels of FPG,2h postprandial glucose,FINS,TG and insulin resistance index when the therapy was completed(P<0.05),and the rate of cardiovascular events was also lower(P<0.05).Conclusion Metformin could lower the levels of glucose,FINS,BMI,TG and insulin resistance index in patients with coronary artery disease and metabolic syndrome.Thus,it could reduce and undermine cardlovascular risk factors,protect the cardiovascular system,reduce the rate of cardiovascular events,which fully benefits the patients.

Objective To investigate the regularity and predictors of weight loss during concurrent chemo-radiotherapy for nasopharyngeal carcinoma patients. Methods A retrospective study was carried out on 82 patients with nasopharyngeal carcinoma ,with average age of 45 years ,who received concurrent chemoradiotherapy at the Affiliated Cancer Hospital of Guangzhou Medical University. Paired t-test was used to analyze the weight loss pattern during chemoradiotherapy. The Spearman′s rank correlation analysis was used to investigate the correlation between high weight loss(HWL)and the clinical factors. Results The paired t-test showed that the weight of the patients decreased continuously every week during chemoradiotherapy(P < 0.05),and the value dropped most significantly during the 4th week. Among these 82 patients,32 were determined as HWL(weight loss > 10%). Spearman′s rank correlation analysis showed that HWL was associated with older age,female,higher T and TNM stage,3D-CRT technology,the higher dose of radiotherapy in nasopharynx and in neck lymph node,and decreases of leukopenia and hemoglobin over degree Ⅱ(P<0.05). Conlousions Weight may decrease continuously every week during chemoradiotherapy for nasopharyngeal carcinoma patients. Age,gender,T stage,TNM stage,radio-therapy dose,and leukopenia and hemoglobin decreases may be predictors for weight loss degree during concurrent chemoradiotherapy for nasopharyngeal carcinoma patients.

The emergence of SARS-CoV-2 variants of concern and repeated outbreaks of coronavirus epidemics in the past two decades emphasize the need for next-generation pan-coronaviral therapeutics. Drugging the multi-functional papain-like protease (PLpro) domain of the viral nsp3 holds promise. However, none of the known coronavirus PLpro inhibitors has been shown to be in vivo active. Herein, we screened a structurally diverse library of 50,080 compounds for potential coronavirus PLpro inhibitors and identified a noncovalent lead inhibitor F0213 that has broad-spectrum anti-coronaviral activity, including against the Sarbecoviruses (SARS-CoV-1 and SARS-CoV-2), Merbecovirus (MERS-CoV), as well as the Alphacoronavirus (hCoV-229E and hCoV-OC43). Importantly, F0213 confers protection in both SARS-CoV-2-infected hamsters and MERS-CoV-infected human DPP4-knockin mice. F0213 possesses a dual therapeutic functionality that suppresses coronavirus replication via blocking viral polyprotein cleavage, as well as promoting antiviral immunity by antagonizing the PLpro deubiquitinase activity. Despite the significant difference of substrate recognition, mode of inhibition studies suggest that F0213 is a competitive inhibitor against SARS2-PLpro via binding with the 157K amino acid residue, whereas an allosteric inhibitor of MERS-PLpro interacting with its 271E position. Our proof-of-concept findings demonstrated that PLpro is a valid target for the development of broad-spectrum anti-coronavirus agents. The orally administered F0213 may serve as a promising lead compound for combating the ongoing COVID-19 pandemic and future coronavirus outbreaks.
Animals ; Coronavirus Papain-Like Proteases/antagonists & inhibitors* ; Cricetinae ; Humans ; Mice ; Pandemics ; SARS-CoV-2/enzymology* ; COVID-19 Drug Treatment