Objective To explore the application effect of prone position ventilation combined with veno-venous extracorporeal membrane oxygenation (VV-ECMO) in the treatment of severe primary graft dysfunction (PGD) after lung transplantation. Methods The clinical data of 75 lung transplant recipients who developed severe PGD after lung transplantation and were treated with VV-ECMO from January 2021 to June 2024 at Wuxi People's Hospital Affiliated to Nanjing Medical University were collected. The patients with severe graft dysfunction after lung transplantation were divided into VV-ECMO group (control group, 45 cases) and prone position ventilation combined with VV-ECMO group (treatment group, 30 cases). The general data of the two groups of patients were compared, including the donors' clinical data (age, gender and oxygenation index, etc) and the recipients' clinical data [gender, age and body mass index (BMI), etc]. Cox regression analysis was used to analyze the influencing factors of the recipients' 30-day, 90-day and 180-day survival after surgery. The survival curves of the two groups of recipients were drawn using Kaplan-Meier method and compared using the log-rank test. Results The intensive care unit (ICU) stay time, ECMO application time and ventilator use time of control group were longer than those of treatment group. The proportion of male recipients and the BMI of control group were lower than those of treatment group. The 30-day, 90-day and 180-day survival of control group was worse than that of treatment group, and the differences were statistically significant (all P<0.05). The univariate Cox regression analysis of the recipients' 30-day survival after surgery showed that the recipients' BMI, history of diabetes, enlargement of the right atrium and right ventricle, intraoperative blood transfusion volume and intraoperative red blood cell transfusion volume were statistically significant (all P<0.05). The multivariate Cox regression analysis showed that the history of diabetes and enlargement of the right atrium and right ventricle were risk factors affecting the 30-day survival of lung transplant recipients (all P<0.05). The univariate Cox regression analysis of the recipients' 90-day survival after surgery showed that the recipients' BMI, history of diabetes, enlargement of the right atrium and right ventricle, intraoperative blood transfusion volume, intraoperative red blood cell transfusion volume and group variable were statistically significant (all P<0.05). The multivariate Cox regression analysis showed that the history of diabetes, enlargement of the right atrium and right ventricle and group variable were risk factors affecting the 90-day survival of lung transplant recipients (all P<0.05). The univariate Cox regression analysis of the recipients' 180-day survival after surgery showed that the recipients' BMI, history of diabetes, right atrium and right ventricle enlargement, intraoperative blood transfusion volume, intraoperative red blood cell transfusion volume and group variable were statistically significant (all P<0.05). The multivariate Cox regression analysis showed that the history of diabetes, enlargement of the right atrium and right ventricle and group variable were risk factors affecting the 180-day survival of lung transplant recipients (all P<0.05). The 30-day, 90-day and 180-day survival rates of control group were lower, and the differences between the two groups were statistically significant (all P<0.05), with a median survival time of 100 days in control group. Conclusions In the clinical treatment of severe PGD after lung transplantation, prone position ventilation combined with VV-ECMO may shorten ECMO application time, invasive ventilation time and ICU stay time, and improve the short-term prognosis of lung transplantation.

Objective To evaluate the effect of body mass index (BMI) on early prognosis of the recipients after lung transplantation. Methods Clinical data of 307 lung transplant recipients were retrospectively analyzed. According to preoperative BMI, all recipients were divided into the low (BMI <18.5 kg/m², n=114), normal (18.5 kg/m²≤BMI <24 kg/m², n=145) and high (BMI≥24.0 kg/m², n=48) BMI groups, respectively. Baseline data including age, sex, blood type, BMI, preoperative complications, preoperative pulmonary hypertension, and intraoperative use of extracorporeal membrane oxygenation (ECMO) of all recipients were compared among three groups. The survival rate of all recipients was estimated by Kaplan-Meier curve and the survival curve was delineated. The differences of survival rate were analyzed by log-rank test. The 30-, 90- and 180-d mortality risk of all recipients after lung transplantation in different BMI groups was compared by multivariate Cox regression analysis. Results There were significant differences in age and sex of recipients among three groups (both P<0.05). There was a significant difference regarding the 180-d survival rate after lung transplantation among different BMI groups (P<0.05). Multivariate Cox regression analysis showed that the 90-d mortality risk after lung transplantation in the high BMI group was 2.295 times higher than that in the normal BMI group [hazard ratio (HR) 2.295, 95% confidence interval (CI) 1.064-4.947, P=0.034]. In the high BMI group, the 180-d mortality risk after lung transplantation was 2.783 times higher compared with that in the normal BMI group (HR 2.783, 95%CI 1.333-5.810, P=0.006), and the 180-d mortality risk in the low BMI group was 2.181 times higher than that in the normal BMI group (HR 2.181, 95%CI 1.124-4.232, P=0.021). Conclusions Compared with the recipients with normal BMI, their counterparts with high and low preoperative BMI have higher mortality risk early after lung transplantation. Adjusting preoperative BMI to normal range contributes to improving early prognosis of lung transplant recipients.

Confronted with the Coronavirus disease 2019 (COVID-19) pandemic, China has become an asset in tackling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and mutation, with several innovative platforms, which provides various technical means in this persisting combat. Derived from collaborated researches, vaccines based on the spike protein of SARS-CoV-2 or inactivated whole virus are a cornerstone of the public health response to COVID-19. Herein, we outline representative vaccines in multiple routes, while the merits and plights of the existing vaccine strategies are also summarized. Likewise, new technologies may provide more potent or broader immunity and will contribute to fight against hypermutated SARS-CoV-2 variants. All in all, with the ultimate aim of delivering robust and durable protection that is resilient to emerging infectious disease, alongside the traditional routes, the discovery of innovative approach to developing effective vaccines based on virus properties remains our top priority.
Humans ; COVID-19 Vaccines ; COVID-19/prevention & control* ; SARS-CoV-2 ; China/epidemiology* ; Vaccine Development

OBJECTIVE: To investigate the value of hand-held retinal optometer and optical coherence tomography (OCT) in predicting postoperative visual acuity in patients with age-related cataract and idiopathic macular epiretinal membrane. METHODS: We retrospectively analyzed the data of patients undergoing phacoemulsification combined with intraocular lens implantation for age-related cataract in our hospital from January, 2019 to April, 2020.Preoperative examination detected idiopathic macular epiretinal membrane in 45 of the patients (52 eyes) with lens opacity grade C2N2P1 according to LOCSⅡ lens opacity classification criteria.Based on the thickness of the macular fovea, the eyes were divided into group A (9 eyes) with macular thickness < 300 μm by OCT examination, group B (25 eyes) with macular thickness of 300 to 400 μm, and group C (18 eyes) with macular thickness >400 μm.The best corrected visual acuity and retinal visual acuity before operation and the best corrected visual acuity on the first day and at 3 months after the surgery were compared among the 3 groups.The consistency between the preoperative retinal vision and the best corrected vision at 3 months after the surgery was analyzed. RESULTS: The best corrected visual acuity at one day and 3 months after the surgery differed significantly from that before the surgery in all the 3 groups ( CONCLUSIONS For patients with cataract and idiopathic macular epiretinal membrane, phacoemulsification combined with intraocular lens implantation can improve postoperative vision.Hand-held retinal optometer can accurately assess postoperative vision in patients with stage C2N2P1 cataract.Patients with a macular thickness >400 μm caused by idiopathic macular epiretinal membrane are likely to have poor postoperative visual outcomes.
Cataract/diagnostic imaging* ; Epiretinal Membrane/surgery* ; Humans ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy

Objective:To investigate the effect of Suhuang Zhike Capsule on airway inflammation in patients with acute episode of allergic rhinitis and asthma syndrome.Methods:Eighty patients with allergic rhinitis and asthma syndrome were admitted to North China University of Science and Technology Affiliated Hospital from June 2016 to September 2017.A prospective cohort study was carried out and randomly divided into treatment group and control group with 40 patients in each group.The control group was treated with conventional anti-inflammatory, expectorant and antiasthmatic therapy, while the treatment group was treated with Suhuang Zhike Capsule.The changes of nasal symptoms and asthma clinical symptoms in the two groups were compared before and after treatment, and the changes of nitric oxide in exhaled air, eosinophils in blood and induced sputum were measured.Results:Compared with the control group, there was no significant difference in the number of eosinophils in the exhaled nitric oxide, eosinophil count in blood and induced sputum before treatment in the treatment group ((161.45±4.67)×10 -9 vs.(163.12±4.56)×10 -9, (1.59±0.53)×10 9/L vs.(1.60±0.51)×10 9/L, (1.11±0.06)×10 9/L vs.(1.18±0.09)×10 9/L; t values were 0.10, 0.44, 1.75, respectively, all P>0.05). After treatment, the exhaled nitric oxide, eosinophil count in blood and induced sputum in the treatment group were significantly lower than those before treatment((30.86±5.54)×10 -9 vs. (161.45±4.67)×10 -9; (0.32±0.05)×10 9/L vs. (1.59±0.53)×10 9/L; (0.06±0.02)×10 9/L vs. (1.11±0.06)×10 9/L, t values were 91.32, 41.63, 51.77, respectively, all P<0.01). In the treatment group, the effective rate of nasal symptom control was 85.0% (34/40) significantly higher than 62.5% (25/40) in the control group (χ 2=5.23, P<0.05), and the effective rate of asthma clinical symptom control was significantly higher than that in the control group(90.0%(36/40), 72.5%(29/40), χ 2=4.02, P<0.05). Conclusion:Suhuang Zhike capsule can obviously improve the airway inflammatory response of patients with allergic rhinitis asthma syndrome in the acute attack stage, and the combination of conventional treatment plan is helpful to improve the curative effect.

Objective:The risk points of highly pathogenic virus culture in BSL-3 laboratory in basket bioreactor were evaluated, and the safety of virus culture in BSL-3 laboratory was judged by monitoring virus concentration in three stages of virus inoculation, culture and harvest.Methods:Smear samples were taken from the tank and joints of the basket biorereactor at three stages of virus inoculation, culture and harvest with sterilized swabs. At the same time, in the biological safety cabinet, air samples were taken for virus inoculation and harvesting operations using AirPortMD8 air sampler, and in the three stages after operation, the personal protective equipment of researchers was to apply sampling, with three ways to monitoring.Results:During the three stages of virus inoculation, culture and receipt, the virus test result of samples taken in the tank and the junction of the basket bioreactor were all negative, the virus test result of air samples taken during the operation stage of inoculation and receipt were all negative, and the virus test result of samples taken in the personal protective equipment of the experimenter were all negative.Conclusions:The basket bioreactor method for virus culture in BSL-3 laboratory is safe and reliable, and the test result show that there is no virus leakage during the whole operation process, thus ensuring the biosafety of experimenter and laboratory environment.

Objective The objective of this study was to investigate the effect of dauricine on the sensi-tivity of 5-fluorouracil(5-FU)in human breast cancer MCF-7 cells.Methods MCF-7 cells were treated with 2.5 μg/mL of dauricine,50 μg/mL of 5-FU,or 2.5 μg/mL of dauricine with 50 μg/mL of 5-FU,the cell proliferation was measured by MTT assay.The cell migration was determined by Transwell assay;The cell apopto-sis was detected by DAPI staining;The expression of cyclin D1 and Bcl-2 gene was examined by Western blot. Results The results showed that the combination of subthreshold concentration of dauricine enhanced the inhibi-tory effect of 5-FU on proliferation in MCF-7 cells.The combined use of subcutaneous concentration of dau-ricine further aggravated the inhibitory effect of 5-FU on cell migration.The combination of subcapsular dau-ricine enhanced the induction of apoptosis by 5-FU.The combination of dauricine with 5-FU could inhibit the expression of cyclin D1 and Bcl-2 protein in MCF-7 cells.Conclusion Dauricine can effectively enhance the sensitivity of 5-FU in human breast cancer MCF-7 cells.

Objective To investigate the effects of capsaicin on the invasion ability of human large cell carcinoma NCI-H460 and the expressions of E-cadherin and Snail;To discuss the possible mechanisms of anti-non-small cell lung cancer.Methods NCI-H460 cells were cultured in vitro and treated with capsaicin at various concentrations, and no capsacin-treated group was set as control group. Effects of capsaicin on NCI-H460 apoptosis, its invasion ability, and the changes in protein expressions of E-cadherin and Snail were evaluated by Hoechst33342 nuclear staining assay, Transwell chamber invasion assay, and Western blot respectively. Results Compared with the control group, Hoechst33342 nuclear staining assay showed that capsaicin could induce NCI-H460 cell apoptosis (P<0.05);Transwell invasion in vitro results showed that capsaicin could significantly inhibit invasion of penetrating cells (P<0.05);Western blot analysis showed that E-cadherin expression level was significantly elevated and snail expression level significantly decreased (P<0.05).Conclusion Capsaicin can induce NCI-H460 cell apoptosis. Decrease the Snail expression and stimulate E-cadherin expression so as to inhibit the invasion ability of NCI-H460, which may be one of its mechanisms of anti-non-small cell lung cancer.

Objective To evaluate prognostic significance of early lactate clearance rate for cardiogenic shock patients on extracorporeal membrane oxygenation(ECMO).Methods Forty-seven patients with cardiogenic shock supported by venoarterial ECMO were prospectively enrolled from May 2010 to May 2013.Arterial blood lactate at pre-ECMO support(0 h),at post-ECMO 6 hours(6 h) were measured and then 6 h lactate clearance rate was calculated.90 days after admission was the endpoint of research.Patients were divided into the survival group(n =25) and the death group(n =22).6 h lactate clearance rate was compared between groups.The 6 h lactate clearance rate for predicting death was evaluated by receiver operating characteristic(ROC) curves.The surviving curve was drawn using the Kaplan-Meier method,and the survival of the patients was analyzed by the Log-rank test.Factors influencing the prognosis were analyzed by applying the multiplelogistic regression analysis.Results The 6 h lactate clearance rate was higher in survivors than in nonsurvivors [(38.6 ± 15.1) ％ vs.(14.4 ± 13.8) ％,P ＜ 0.05].The area under the ROC curve of 6 h lactate clearance rate for predicting death was 0.869 ± 0.075 (95％ CI:0.753-0.991).The best cutoff point was 20.0％ with a sensitivity of 92.0％ and specificity of 85.0％.KaplanMeier survival analysis showed that 90 days survival rate of high lactate clearance rate group and low lactate clearance rate group were 66.7％ and 35.0％,with significant difference between the two groups(Log-rank test,P ＜ 0.05).Multivariate logistic regression analysis showed that 6 h lactate clearance rate (OR =3.156,95 ％ CI:2.326-7.253,P ＜ 0.05) was one of the independent risk factors associated with mortality of patients on ECMO.Conclusion Early lactate clearance rate could be used as an important maker for evaluating the prognosis of cardiogenic shock patients on ECMO.

BACKGROUNDThe mutation frequencies of three common deafness genes (MT-RNR1 m.1555A>G, GJB2, and SLC26A4) among patients with nonsyndromic sensorineural hearing loss (NSHL) were different in previous studies. Inconsistent selection criteria for recruiting patients could have led to differences in estimating the frequencies of genetic mutations thus resulting in different mutation frequencies among these studies. The aim of this study was to reveal the differences in the mutation spectrums of the three common genes between familial and sporadic Chinese Han patients.

METHODSTotally, 301 familial probands and 703 sporadic patients with NSHL were enrolled in this study. Three genes, MT-RNR1 m.1555A>G, GJB2, and SLC26A4, were screened for mutation in our study cohort. A χ(2) test was performed to compare the mutation frequencies between the two groups.

RESULTSThe study showed that the disease-causing mutation frequencies of MT-RNR1 m.1555A>G, GJB2, and SLC26A4 were 12.29%, 14.62%, and 18.27% in familial probands and 3.56%, 18.63%, and 18.92% in sporadic patients, respectively. The mutation frequency of MT-RNR1 m.1555A>G in familial probands was significantly higher than in sporadic patients (χ(2) test, P = 0.000), while there were no significant differences in the mutation frequencies of GJB2 and SLC26A4 between the familial and sporadic groups (χ(2) test, P > 0.05).

CONCLUSIONSIt is necessary to reveal the differences in gene mutation frequencies between patients of different sources or characteristics by comparative studies in order to avoid selection bias. The mutations of GJB2, SLC26A4, and MT-RNR1 m.1555A>G are the most important etiological factors in Chinese Han patients, among which SLC26A4 might be the most frequent.

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Child ; Child, Preschool ; Connexin 26 ; Connexins ; genetics ; Female ; Genetic Predisposition to Disease ; genetics ; Genetic Testing ; Hearing Loss, Sensorineural ; genetics ; Humans ; Infant ; Male ; Membrane Transport Proteins ; genetics ; Middle Aged ; Mutation ; genetics ; Young Adult