Objective To discuss the diagnostic methods and therapeutical measures on acute portal vein thrombosis. Method Clinical data of 13 cases of acute portal vein thrombosis were retrospectively analyzed and its diagnosis and therapy were evaluated.Results In this group,8 cases were male and 5 were female.The average age was(54±26)years old and 6 of which had identified inducement.Diagnosis was made with enhanced CT or MRI/MRA in all cases,Among which 5 cases were treated with non-surgical method(anticoagulation and thrombolysis)and 2 died.The other 8 cases were cured with surgical procedures (thrombectomy and tube insertion for anticoagulation and thrombolysis though superior mesenteric vein).Segmental small intestinal necrosis necessitated small bowel resection in 5 cases.Conclusion Surgical procedures remain the important therapy of choice for acute portal vein thrombosis especially when bowel necrosis is suspected.

Objective This report was to discuss the efficacy and complications of non-surgical therapy for patients with early lower extremity deep vein thrombosis.Methods A total of 412 patients were treated with thrombolysis or anticoagulation in our department during January 2000 and December 2006.Their clinical data were retrospectively analyzed.Results All patients were followed up for 12 to 83 months (mean,41 months).After treatment,42 patients(10.2%)were completely recovered,331 patients (80.3%)experienced large improvement,32 patients(7.8%)had mild improvement and 7 patients (1.7%)were failed,resulting in total effective rate of 98.3%.In comparison with long clinical course group(>7 days),the recovery rate and improvement rate of short clinical course group(≤7 days)was significantly increased(11.0% vs 5.4%,χ2=4.17,P<0.05;8.7%vs 1.8%,χ2=4.96,P<0.05).Complications included bleeding(2.2%),pulmonary embolism(1.9%),cerebral accident(0.7%),post-thrombotic syndrome(84.0%)and recurrence(6.1%).Bleeding rate in patients≥60 years was significantly higher(4.3%vs 0.8%,χ2=6.82,P<0.01).Incidence of post-thrombotic syndrome was significantly increased in long clinical course group(98.2% vs 81.7%,χ2=3.67,P<0.05).Condusions Non-surgical therapy,including thrombolysis and anticoagulation,might be safe and effective for patients with early lower extremity deep vein thrombosis.Early identification and management would be helpful to improve outcomes and reduce post-thrombotic syndrome.

ObjectiveTo investigate the mechanism of α-naphthyl isothiocyanate (ANIT) inducing cholestatic hepatitis. MethodsA total of 60 healthy male Sprague-Dawley rats were randomly divided into normal control group (N group with 30 rats) and model group (ANIT group with 30 rats), and each group was further divided into three subgroups according to different time phases after gavage (at 24, 48, and 72 hours after gavage), with 10 rats in each group. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), and total bilirubin (TBil) were measured, and the level of malondialdehyde (MDA) in the liver was measured. A light microscope was used to observe the pathological changes in the liver, and a transmission electron microscope was used to observe the changes in the ultrastructure of the bile canaliculus. A confocal laser scanning microscope was used to analyze the mean fluorescence intensity of phalloidine labeled by fluorescein isothiocyanate in order to determine the change in the level of fibrous actin (F-actin). ResultsAfter the administration of ANIT by gavage, the model group showed significant increases in the serum levels of ALT, AST, GGT, and TBil and the level of MDA in liver tissue compared with the normal control group. The model group also showed damage in the structure of the hepatic lobules, hyaline degeneration of hepatocytes, spotted, patchy, and focal necrotic lesions, and neutrophil infiltration mostly confined to the hepatocytes around the bile duct, proliferation of biliary epithelial and fibrous tissues, widened perisinusoidal spaces, dilation of the bile canaliculi, extensive shedding of microvilli, and formation of bile thrombi in the bile capillaries, as well as a low fluorescence intensity of F-actin. The above changes were the most obvious at 48 hours; recovery began at 72 hours, but significant differences were still seen between the two groups. ConclusionANIT can cause lipid peroxidation in liver tissue and lead to degeneration and necrosis of liver cells, damage of microvilli of the bile canaliculi, and formation of bile thrombi, as well as reduction in the expression of F-actin in the bile canaliculi. Therefore, it affects the function of the liver to secrete bile and causes cholestatic hepatitis.

Objective:To explore the effect of Baduanjin functional exercise on the motor ability and self-management of the elderly patients with chronic knee osteoarthritis.Methods:From June 2018 to June 2019, 120 cases of elderly patients with chronic knee osteoarthritis who were treated in Ningbo Traditional Chinese Hospital were randomly divided into a control group and an experimental group with 60 cases each. The control group was given routine functional exercise, while the experimental group was given Baduanjin exercise. Three months later, isokinetic muscle strength (including peak torque and average power) of quadriceps femora was compared before and after exercise. After exercise, the motor ability was measured by the simple Fugl-Meyer motor function rating scale (FM), and the self-management efficacy was assessed by the general self-efficacy scale (GSES).Results:A total of 11 cases were lost in 120 patients, and 54 cases were included in the control group and 55 cases in the experimental group.After exercise, the peak torque and average power of quadriceps femoris in the experimental group were significantly higher than those in the control group [(75.5±5.4) vs.(68.9±5.6) N·m, (73.9±2.0) vs. (68.3±4.4) W], and the scores of part of lower limbsin the FM and GSEs were also significantly higher than those in the control group [(24.3±2.9) vs. (22.1±2.6) points, (3.1±0.4) vs. (2.7±0.4) points] (all P<0.001). Conclusion:Baduanjin functional exercise can improve the motor ability and self-management of elderly patients with chronic knee osteoarthritis.

Objective To evaluate traditional surgical treatment, intraluminal strategy and hybrid operation on revascularization of atherosclerosis obliterans (ASO) of the lower extremity. Methods Clinical data of 197 ASO cases receiving revascularization from January, 1998 to December, 2008 were retrospectively analyzed. Seventy-seven cases underwent surgical treatment, 82 cases received intraluminal therapy, and 38 cases were treated by hybrid operation. The indications, clinical effect, complication and perioperational mortality of these three strategies were evaluated. Results 71% patients (164 cases) were followed up from 2 to 112 months. Surgical and intraluminal method had no statistical difference on long-term patency of aortic-iliac and femoral-popliteal artery (57% vs. 51%;48% vs. 42%). Hybrid procedure led to higher patency on multi-level lesion and concurrent thrombosis. The complications after surgery was higher than intraluminal on aortic- iliac and femoral-popliteal artery (31% vs. 12%;31% vs. 11%), and higher than intraluminal and hybrid on multi-level lesion (36% vs. 12% vs. 15%). The perioperative mortality of surgical group was 1.5% and 2.0% on aortic-iliac and multilevel lesion and 0% on other site;and that of intraluminal and hybrid procedure was 0%. Conclusion For aortic-iliac and femoral-popliteal artery revascularization, surgery was preferred in cases of long occlusive lesion and intervention was preferred for cases with short non-occlusive lesion. Hybrid procedure was the best for multi-level and concurrent thrombosis.

Objective:To establish and identify a high-throughput culture platform for induced pluripotent stem cells to differentiated kidney organoids.Methods:Human urine-derived induced pluripotent stem cells were selected and plated at a suitable cell density, and differentiated using small molecule compounds such as CHIR99021/fibroblast growth factor 9/heparin during day 1-6. On day 7, cells with appropriate density were digested and resuspended, than added to a 96-well 3D culture plate for 24 hours. After the cells formed spheroids, fibroblast growth factor 9 and heparin were added to induce differentiation till day 24. The immunofluorescence and transmission electron microscopy were used to compare the differences of kidney organoids obtained by the reported differentiation protocol (transwell protocol) method and high-throughput culture platform.Results:Kidney organoids were successfully differentiated by two protocols. Immunofluorescence results showed that LTL, GATA-3, and synaptopodin, which were major kidney cell markers, were all expressed, and mature renal organoids were formed. The results of transmission electron microscopy showed that the kidney organoids successfully developed foot processes, the unique cellular feature of the glomerular podocytes, which were evenly distributed and neatly interspersed with each other. At the same intermediate mesodermal cell count of 1.0×10 7, approximately 7 renal organoids were obtained by the transwell protocol, while approximately 1 000 renal organoids were obtained by the high-throughput culture platform. Conclusion:A high-throughput culture platform for kidney organoids is successfully established, and a large amount of mature kidney organoids with complete structure and function can be obtained. The differentiation efficiency of kidney organoids is greatly improved.

BACKGROUND: Data on the immunogenicity and safety of heterologous immunization schedules are inconsistent. This study aimed to evaluate the immunogenicity and safety of homologous and heterologous immunization schedules. METHODS: Multiple databases with relevant studies were searched with an end date of October 31, 2021, and a website including a series of Coronavirus disease 2019 studies was examined for studies before March 31, 2022. Randomized controlled trials (RCTs) that compared different heterologous and homologous regimens among adults that reported immunogenicity and safety outcomes were reviewed. Primary outcomes included neutralizing antibodies against the original strain and serious adverse events (SAEs). A network meta-analysis (NMA) was conducted using a random-effects model. RESULTS: In all, 11 RCTs were included in the systematic review, and nine were ultimately included in the NMA. Among participants who received two doses of CoronaVac, another dose of mRNA or a non-replicating viral vector vaccine resulted in a significantly higher level of neutralizing antibody than a third CoronaVac 600 sino unit (SU); a dose of BNT162b2 induced the highest geometric mean ratio (GMR) of 15.24, 95% confidence interval [CI]: 9.53-24.39. Following one dose of BNT162b2 vaccination, a dose of mRNA-1273 generated a significantly higher level of neutralizing antibody than BNT162b2 alone (GMR = 1.32; 95% CI: 1.06-1.64), NVX-CoV2373 (GMR = 1.60; 95% CI: 1.16-2.21), or ChAdOx1 (GMR = 1.80; 95% CI: 1.25-2.59). Following one dose of ChAdOx1, a dose of mRNA-1273 was also more effective for improving antibody levels than ChAdOx1 (GMR = 11.09; 95% CI: 8.36-14.71) or NVX-CoV2373 (GMR = 2.87; 95% CI: 1.08-3.91). No significant difference in the risk for SAEs was found in any comparisons. CONCLUSIONS: Relative to vaccination with two doses of CoronaVac, a dose of BNT162b2 as a booster substantially enhances immunogenicity reactions and has a relatively acceptable risk for SAEs relative to other vaccines. For primary vaccination, schedules including mRNA vaccines induce a greater immune response. However, the comparatively higher risk for local and systemic adverse events introduced by mRNA vaccines should be noted. REGISTRATION PROSPERO; https://www.crd.york.ac.uk/PROSPERO/ ; No. CRD42021278149.
Adult ; Humans ; BNT162 Vaccine ; 2019-nCoV Vaccine mRNA-1273 ; Network Meta-Analysis ; Immunization Schedule ; COVID-19/prevention & control* ; COVID-19 Vaccines/adverse effects* ; Viral Vaccines ; mRNA Vaccines ; Antibodies, Neutralizing ; Antibodies, Viral

The many-banded krait, Bungarus multicinctus, has been recorded as the animal resource of JinQianBaiHuaShe in the Chinese Pharmacopoeia. Characterization of its venoms classified chief phyla of modern animal neurotoxins. However, the evolutionary origin and diversification of its neurotoxins as well as biosynthesis of its active compounds remain largely unknown due to the lack of its high-quality genome. Here, we present the 1.58 Gbp genome of B. multicinctus assembled into 18 chromosomes with contig/scaffold N50 of 7.53 Mbp/149.8 Mbp. Major bungarotoxin-coding genes were clustered within genome by family and found to be associated with ancient local duplications. The truncation of glycosylphosphatidylinositol anchor in the 3'-terminal of a LY6E paralog released modern three-finger toxins (3FTxs) from membrane tethering before the Colubroidea divergence. Subsequent expansion and mutations diversified and recruited these 3FTxs. After the cobra/krait divergence, the modern unit-B of β-bungarotoxin emerged with an extra cysteine residue. A subsequent point substitution in unit-A enabled the β-bungarotoxin covalent linkage. The B. multicinctus gene expression, chromatin topological organization, and histone modification characteristics were featured by transcriptome, proteome, chromatin conformation capture sequencing, and ChIP-seq. The results highlighted that venom production was under a sophisticated regulation. Our findings provide new insights into snake neurotoxin research, meanwhile will facilitate antivenom development, toxin-driven drug discovery and the quality control of JinQianBaiHuaShe.