Background::Atopic dermatitis (AD) affects approximately 10% of adults worldwide. CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling. This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.Methods::This multicenter, randomized, double-blind, placebo-controlled, phase 2b trial was conducted in 21 medical institutions in China from February to November 2021. Totally 120 eligible patients were enrolled and randomized (1:1:1) to receive subcutaneous injections of 300 mg CM310, 150 mg CM310, or placebo every 2 weeks for 16 weeks, followed by an 8-week follow-up period. The primary endpoint was the proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (EASI-75) score from baseline at week 16. Safety and pharmacodynamics were also studied.Results::At week 16, the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups (70% [28/40] for high-dose and 65% [26/40] for low-dose) than that in the placebo group (20%[8/40]). The differences in EASI-75 response rate were 50% (high vs. placebo, 95% CI 31%–69%) and 45% (low vs. placebo, 95% CI 26%–64%), with both P values <0.0001. CM310 at both doses also significantly improved the EASI score, Investigator’s Global Assessment score, daily peak pruritus Numerical Rating Scale, AD-affected body surface area, and Dermatology Life Quality Index compared with placebo. CM310 treatment reduced levels of thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase, and blood eosinophils. The incidence of treatment-emergent adverse events (TEAEs) was similar among all three groups, with the most common TEAEs reported being upper respiratory tract infection, atopic dermatitis, hyperlipidemia, and hyperuricemia. No severe adverse events were deemed to be attributed to CM310. Conclusion::CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.Trial Registration::ClinicalTrials.gov, NCT04805411.

After the promulgation and implementation of the Vaccine Administration Law of the People’s Republic of China， the compensation of suspected adverse reactions in China is to be reformed and innovated. There have been attempts at compensation through government finance and insurance， but there has been no precedent for a fund of vaccine-related compensation in China， which means that this could be a new method of solving disputes of compensation for vaccine-related incidences and enhancing public confidence in vaccination. It is suggested that under the current system， we can select a province as a pilot to explore the fund compensation mechanism. The fund comes from special financial allocation， special taxation of vaccine enterprises， fund investment income， charitable donation and other channels. Through a special fund management organization， the independent identification and compensation process can be realized， so as to shorten the current compensation procedure， improve the amount of compensation， ultimately protect the interests of all parties， and promote the steady development of vaccination.

Objective:To investigate feasibility, efficiency and safety of kissing pancreatojejunostomy after pancreatoduodenectomy.Methods:From Jan 2006 to Sep 2020, the clinical data of 267 patients undergoing pancreatoduodenectomy and kissing pancreatojejunostomy were retrospectively analyzed.Results:Grade B postoperative pancreatic fistula (POPF) occurred in 6.37%, Grade C POPF in 2.25% of patients. There was no mortality within 30 days postoperatively as to pancreatic fistula, by cut-off of pancreatic duct diameter at 3mm, there was no significant difference between two subgroups (15/140 vs. 8/127, P=0.20). also, when grouped by texture of the pancreas, no there was significant difference (20/194 vs. 3/73, P=0.11). Conclusions:Kissing pancreatojejunostomy is feasible and easy to perform. It also does not increase the POPF rate when applied to the pancreatojejunostomy with thin pancreatic duct and soft texture.

Objective: To investigate the safety and feasibility of proximal partial gastrectomy with Cheng's Giraffe esophagogastric reconstruction for the treatment of early Siewert II adenocarcinoma of esophagogastric junction (AEG). Methods: Indication of Cheng's Giraffe esophagogastric reconstruction: (1) Siewert II AEG or Siewert III AEG with diameter < 4 cm; (2) preoperative staging as cT1-2N0M0. A descriptive case series study was carried out. Clinical data of 34 patients with Siewert II AEG undergoing proximal partial gastrectomy and Cheng's Giraffe esophagogastric reconstruction at Department of Abdominal Surgery of Zhejiang Cancer Hospital and Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from February to July 2018 were retrospectively collected and analyzed, including 14 cases in IA stage, 11 cases in IIA stage and 8 cases in IIB stage. Brief procedure of Cheng's Giraffe esophagogastric reconstruction was as follows: Firstly, 12 cm long tubular stomach was formed by longitudinal incision 4 cm away from the great curvature of the stomach. Secondly, the gastric fundus and His angle were formed. Finally, the distance from His angle to esophagal-tubular gastric anastomosis should be more than 5 cm. The reflux disease questionare (RDQ) scores, radionuclide gastric emptying scintigraphy, and 24-hour multichannel intraluminal (MII)-pH monitoring technology were used to evaluate postoperative gastric emptying and gastroesophageal reflux. Result: All 34 patients successfully completed proximal partial gastrectomy with Cheng's Giraffe esophagogastric reconstruction, including 13 cases by open surgery and 21 cases by laparoscopic surgery. The operation time was (144.6±39.8) minutes, the blood loss during operation was (35.4±17.2) ml. No laparoscopic case was converted to open surgery and no postoperative complication was observed. The postoperative hospital stay was (8.4±2.5) days. The postoperative RDQ score was 4.4±3.1 one month after operation, and 3.3±2.5 six months after operation. Gastric-half emptying time was (67.0±21.5) minutes, and the residual ratio was (52.2±7.7)% in 1 hour, (36.4±3.1)% in 2 hours and (28.8±3.6)% in 3 hours at postoperative 1-month. The 24-hour MII-pH monitoring at postoperative 2-month revealed the frequency of acid reflux was (12.6±7.9) times, frequency of non-acid reflux was (19.6±9.7) times, DeMeester score was 5.8±2.9. Conclusion Cheng's Giraffe esophagogastric reconstruction is safe and feasible in the treatment of Siewert type II AEG, and has good dynamic and anti-reflux effects.

Objective To investigate the relationship between the prevalence of isolated systolic hypertension (ISH) and the stages of chronic kidney disease (CKD) in chronic kidney disease outpatient clinic.Methods CKD patients of stages 1,2,3,4 and 5 were recruited (n=626).Based on office systolic pressure (SBP) and diastolic pressure (DBP),they were classified into four subtypes:normotension (＜ 140/90 mmHg),isolated diastolic hypertension (IDH,SBP ＜ 140 mmHg and DBP ≥ 90 mmHg),ISH (SBP≥ 140 mmHg and DBP ＜ 90 mmHg) and systolic-diastolic hypertension (SDH,SBP≥140 mmHg and DBP≥90 mmHg).Results The control rate of blood pressure was 86.4％,75.6％,65.3％,51.0％ and 37.0％ at CKD stage 1,2,3,4 and 5,respectively,which decreased with the advancement of CKD.There was a stepwise increase in the prevalence of ISH (0,9.2％,23.9％,28.6％ and 37.0％ at CKD stage 1,2,3,4 and 5,respectively) and SDH (4.5％,8.4％,8.0％,17.3％,21.9％ at CKD stage 1,2,3,4 and 5,respectively).Logistic regression analysis showed that age,diabetes and CKD stages were independent predictors of ISH.Compared with CKD stage 1-2,CKD stage 3,4 and 5 showed 2.388,2.697 and 5.980 folds risk in developing ISH.Conclusion The prevalence of ISH increases correspondingly with the advancement of stages of CKD,which may partially contribute to the increased cardiovascular mortality during the progress of CKD.

Objective To investigate whether there is any difference in aortic stiffness among different hypertension subtypes in patients with chronic kidney disease.Methods Six hundred and twenty-six patients with chronic kidney disease were included in the present analysis.They were classified into four groups:normotension (n =391) with systolic blood pressure (SBP) ＜ 140 mmHg and diastolic blood pressure (DBP) ＜ 90 mmHg; isolated systolic hypertension (ISH,n =141) with SBP≥ 140mmHg and DBP ＜ 90 mmHg; isolated diastolic hypertension (IDH,n =25) with SBP ＜ 140 mmHg and DBP≥ 90 mmHg; systolic-diastolic hypertension (SDH,n =69) with SBP≥ 140 mmHg and DBP≥ 90mmHg.Aortic stiffness was assessed by pulse pressure and pulse wave velocity.Results The IDH group had lower mean age than the other groups(P ＜ 0.01).The percentage of diabetes in the ISH group was higher than that in the other groups.The comparison of aortic stiffness showed that the ISH and SDH groups had higher aortic stiffness than the normotension and IDH groups (P ＜ 0.01),but no significant difference in aortic stiffness was observed neither between the normotension and IDH groups nor between ISH and SDH groups.Conclusion Aortic stiffness is significantly different among different hypertension subtypes,which may be an underlying cause for the different cardiovascular mortality among the hypertension subtypes.

Purpose To compare the mammography and ultrasound imaging features of triple-negative breast cancer (TNBC) and non-triple-negative breast cancer (NTNBC), and to improve TNBC diagnosis. Materials and Methods Using immunohistochemical staining technique, 387 patients with pathologically conifrmed breast cancer were divided into TNBC group (n=54) and NTNBC group (n=333). Mammography and ultrasound ifndings as well as pathological data were retrospectively reviewed. Results TNBC was associated with higher tumor grades. There were signiifcantly more grade III inifltrating ductal carcinomas and axillary lymph node involvement in TNBC group than in NTNBC group (χ2=47.009, P<0.001;χ2=4.658, P<0.05). On mammography, TNBC most frequently presented with a mass (n=37, 69.8%) and was less associated with microcalciifcations (n=10, 18.9%). TNBC masses were mostly round or oval (n=28, 62.2%) with circumscribed margin (n=16, 35.6%). Spiculated margins were rare (n=5, 11.1%). NTNBC most frequently presented as a mass with calciifcations (n=138, 42.1%), and was more irregular in shape (n=119, 46.5%). Spiculated margins were common (n=77, 30.1%). There was statistically signiifcant difference between these two groups in mass, microcalcification, shape and margin (χ2=24.618, 19.889, 32.605 and 21.102, P<0.001). On ultrasonograhy, TNBC most frequently presented as a mass (n=52, 96.3%) with less microcalciifcations (n=5, 9.3%). TNBC masses were more frequently round or oval (n=27, 51.9%) with circumscribed margins (n=25, 48.1%). Spiculated margins were rare (n=3, 5.8%). TNBC was less likely to show attenuating posterior echoes (n=5, 9.6%);NTNBC most frequently presented as a mass (n=318, 96.1%) with microcalcifications (n=135, 40.8%). NTNBC masses were more frequently irregular in shape (n=243, 76.4%) with spiculated margins (n=76, 23.9%). NTNBC was more likely to show attenuating posterior echoes (n=78, 24.5%). There was statistically signiifcant difference between these two groups in microcalciifcation, shape, margin and posterior echo (χ2=19.006 and 18.339, P<0.001;χ2=16.170 and 8.429, P<0.05). Conclusion TNBC demonstrates round or oval mass with circumscribed margin and is less likely to show attenuating posterior echoes on mammography and ultrasound with benign imaging features. NTNBC frequently presents as irregular mass with spiculated margin, and is more associated with microcalciifcations. These imaging ifndings are useful in early diagnosis of TNBC.

OBJECTIVETo study the arbuscular mycorrhiza and arbuscular mycorrhizal fungi associated with cultivated and wild Pinellia ternata in Guizhou province.

METHODWild and cultivated P. ternata roots were observed through staining and microscopic examination, the arbuscular mycorrhizal fungi spores were isolated through wet thieving according to Gerdemann & Nicolson (1963), the spores were identified following the description of Schenck & Pérez (1988), and some previous publications.

RESULTThe typical arbuscular mycorrhiza (AM) structure was showed according to a research of wild and cultivated P. ternata. In the survey of AM fungi species in the rhizosphere of wild and cultivated P. ternata, 3 genera and 21 species were found, 3 genera and 7 species were identified. 5 species of them belong to Glomus, 1 species belongs to Scutellospora, 1 species belongs to Gigaspora, including Glomus mosseae, G. intraradices, G. melanosporum, G. deserticola, G. aggregatum, Scutellospora castanea, Gigaspora albida, and one of them was a new record, i.e., Scutellospora castanea which was the dominant species in Bijie.

CONCLUSIONThe diversity of AM fungi between wild and cultivated Pinellia ternata was showed on this survey, the fungi associated with wild ones are different form the cultivated ones, such as Gigaspora albida only occurs in cultivated ones, Glomus melanosporum only occurs in wild ones, while Glomus mosseae and Glomus intraradices occur in both wild and cultivated ones, and there were specialization species in Bijie, all these can provide new though for solving degradation problem of cultivated Pinellia ternata.

Biodiversity ; Fungi ; classification ; cytology ; isolation & purification ; Mycorrhizae ; classification ; cytology ; isolation & purification ; Pinellia ; microbiology ; Plant Roots ; microbiology ; Soil Microbiology ; Spores, Fungal ; classification ; cytology ; isolation & purification

OBJECTIVETo study the influence of arbuscular mycorrhizal fungi to Pinellia ternata leaf index, propagation coefficient, tuber yield and chemical composition.

METHODThe Pinellia ternata leaf length, width, plant height and leafstalk diameter were measured during growing time till P. ternata loded. The leaf index was calculated and the tuber yield were measured after harvest. The contents of guanosine was determined by HPLC method, and the alkaloid contents were determined by spectrophotometric method.

RESULT AND CONCLUSIONInoculated AM fungi could increase P. ternata propagation coefficient and the yield of tuber. Inoculated AM fungi could increase P. ternata leaf index, made leaf tends to be more like bamboo leaf type. Inoculated AM fungi could delayed P. ternata lodging time; G. mosseae + G. intraradices treatment (early inolulation time) proved better influence on increasing fresh weight and dry weight of P. ternata tuber and the propagation coefficient. Inoculated AM fungi could increase guanosine and alkaloid contents of Pinellia ternata tuber, and the contents of guanosine and alkaloid in inoculated treatments were higher than those in cultivated P. ternata from Hezhang; G. mosseae + G. intraradices treatment (later inolulation time) proved good effect on increasing the contents of guanosine and alkaloid.

Alkaloids ; chemistry ; Chromatography, High Pressure Liquid ; Guanosine ; chemistry ; Mycorrhizae ; growth & development ; physiology ; Pinellia ; chemistry ; growth & development ; microbiology ; Plant Leaves ; chemistry ; growth & development ; microbiology

Objective To introduce the application of double liver hanging maneuver in anatomical right hemihepatectomy and share our own experience. Methods Twenty-four patients underwent right hemihepatectomy using double liver hanging maneuver, and the data were collected prospectively after operation. Another 49 patients underwent right hemihepatectomy using the traditional methods,serving as the control group. Results Retrohepatic tunnel was constructed in 27 patients, double liver hanging maneuver was successfully performed in 24 anatomical right hemihepatomy and failed in 3 patients due to the near proximity between the tumor and the middle line. Compared with the control group, blood loss was much less (t=3. 191 ,P＜0.05), ALT and liver function recovered more quickly postoperatively and the difference in operative duration between the 2 groups was not significant (t=-1. 695,P＞0. 05). There was about 1-2 cm wide space located between retrohepatic IVC and dorsal liver when the 2 tapes were tracted, and no injury in hepatic short veins and retrohepatic IVC occurred during the operation. Conclusion The double liver hanging maneuver can make anatomical right hemihepatectomy more accessible and safe.