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.

Central Nervous System Diseases ; etiology ; Child ; Female ; Humans ; Infant ; Lymphohistiocytosis, Hemophagocytic ; complications ; diagnosis ; genetics ; Magnetic Resonance Imaging ; Male ; Mutation ; Perforin ; genetics

Background:Recent studies show that microRNA-145 (miRNA-145) might be an attractive tumor biomarker of considerable prognostic value,but little is known about their relationship with acute myocardial infarction (AMI).This study investigated the correlation between the level ofmiR-145 and AMI.Methods:One-hundred patients were divided into three groups:no coronary artery disease (CAD) group,non-ST segment elevation myocardial infarction group,and ST segment elevation myocardial infarction group.The plasma levels of miR-145 were quantified using real-time quantitative polymerase chain reaction.Logarithmic transformation of miRNA-145 levels (Ln_miRNA-145) was used for statistical analysis due to the skewed data distribution.Results:Plasma levels of miR-145 were significantly lower in patients with AMI compared to patients in the non-CAD group (-6.38 ± 0.11 vs.-4.47 ± 0.17,P ＜ 0.0001).Compared to those without heart failure,the levels of miR-145 were significantly lower in patients with heart failure (-6.91 ± 0.20 vs.-5.35 ± 0.13,P ＜ 0.0001).We also found that the lower plasma levels of miRNA-145 significantly correlated with increased serum levels of B-type natriuretic peptide (Spearman p =-0.60,P ＜ 0.0001),troponin T (Spearman p =-0.62,P ＜ 0.0001),and decreased ejection fraction (Spearman p =0.65,P ＜ 0.0001).In a multivariable linear regression analysis,AMI and heart failure were independently associated with lower Ln_miRNA-145 (estimate-0.99,standard error [SE] 0.28;P =0.001 and estimate-0.62,SE 0.21;P=0.004).Conclusions:Our results suggest that decreased plasma levels of miR-145 are associated with AMI.Circulating miR-145 may be useful in prognosticating cardiac function and the risk of developing heart failure.

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

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

Objective To study the CT and MRI findings of lesions in unilateral maxillary sinus,and to compare the effect of CT and MRI in the differential diagnosis of lesions in unilateral maxillary sinus.Methods Retrospective analysis of CT and contract-enhanced MRI imaging data from 34 patients with lesions in unilateral maxillary sinus which were diagnosed by endoscopic sinus surgery and postoperative pathology.The CT and contract-enhanced MRI's value in the differential diagnosis in lesions in unilateral maxillary sinus was analysed.Results All 34 patients had unilateral maxillary sinus lesions.On CT:soft tissue density shadow in the unilateral maxillary sinus was found in all 34 cases.Five cases showed spot high density with thickening bone in the maxillary sinus wall.Eleven cases showed expansion of the opening of maxillary sinuses.Two cases showed broken lateral wall of nasal cavity.One case showed soft tissue density shadow in the maxillary sinus with curve edge with high density shadow which had a tooth shadow in it.Other 14 cases showed only soft density shadow in the maxillary sinuses.On MRI:all 34 cases revealed lower signals on T1WI compared to gray matter.Little loss signal were found in the inner of the maxillary sinus fungal balls on T1WI.Enhanced MR imaging showed no enhanced in nasal sinusitis,sinus cysts and polyp of posterior naris.Inhomogenous enhancing and "the cerebral convolution sign" were found in the hemorrhagic and necrotic nasal polyp,the nasal inverted papilloma and the malignant tumor cases.Higher signals were seen in the nasal sinusitis,fungal balls and the polyp of posterior naris cases on T2WI.Inhomogenous signal with different levels were found in the hemorrhagic and necrotic nasal polyp,the nasal inverted papilloma and the malignant tumor cases on T2WI.Conclusions CT and MRI examination are important in the diagnosis of the unilateral maxillary sinus lesions.Both CT and MRI had more differential diagnostic value in the unilateral maxillary sinus lesions than only CT used.

Objective To evaluate the treatment time and the anterior and posterior teeth movement pattern as closing extraction space for the Class Ⅲ surgical patients facilitated by accelerated osteogenic orthodontic treatment.Methods There were 10 skeletal Class Ⅲ patients in accelerated osteogenic orthodontic group (AOO) and 10 patients in control group.Upper first premolars were extracted in all patients.After leveling and alignment(T2),corticotomy was performed in the area of maxillary anterior teeth to accelerate space closing.Study models of upper dentition were taken before orthodontic treatment(T1) and after space closing(T3).All the casts were laser scanned,and the distances of the movement of incisors and molars were digitally measured.The distances of tooth movement in two groups were recorded and analyzed.Results The alignment time between two groups was not statistically significant.The treatment time in AOO group from T2 to T3 was less than that in the control group (less than 9.1 ± 4.1 months).The treatment time in AOO group from T1 to T3 was less than that in the control group (less than 6.3 ± 4.8 months),and the differences were significant(P ＜ 0.01).Average distances of upper incisor movement (D1) in AOO group and control group were (2.89 1.48) and (3.10 ±0.95) mm,respectively.Average distances of upper first molar movement(D2) in AOO group and control group were (2.17 ± 1.13) and (2.45 ± 1.04) mm,respectively.No statistically significant difference was found between the two groups (P ＞ 0.05).Conclusions Accelerated osteogenic orthodontic treatment could accelerate space closing in Class Ⅲ surgical patients and shorten preoperative orthodontic time.There were no influence on the movement pattern of anterior aud posterior teeth during pre-surgical orthodontic treatment.

The aim of the present study was to evaluate the active and passive mechanical properties and wall collagen and elastin contents of mesenteric small arteries (MSAs) isolated from rats of 28-day simulated microgravity (SUS), countermeasure [S + D: SUS plus 1 h/d -G(x) to simulate intermittent artificial gravity (IAG)] and control (CON) groups. Three mechanical parameters were calculated: the overall stiffness (β), circumferential stress (σ(θ))-strain (ε(θ)) relationship and pressure-dependent incremental elastic modulus (E(inc,p)). Vessel wall collagen and elastin percentage were quantified by electron microscopy. The results demonstrate that the active mechanical behavior of MSAs differs noticeably among the three groups: the active stress-strain curve of SUS vessels is very close to the passive curve, whereas the active σ(θ)-ε(θ) curves of CON and S + D vessels are shifted leftward and display a parabolic shape, indicating that for MSAs isolated from S + D, but not those from SUS rats, the pressure-induced myogenic constriction can effectively stiffen the vessel wall as the CON vessels. The passive mechanical behavior of MSAs does not show significant differences among the three groups. However, the percentage of collagen is decreased in the wall of SUS and S + D compared with CON vessels in the following order: SUS < S + D < CON. Thus, the relationship between passive mechanical behavior and compositional changes may be complex and yet depends on factors other than the quantity of collagen and elastin. These findings have provided biomechanical data for the understanding of the mechanism of postflight orthostatic intolerance and its gravity-based countermeasure.
Animals ; Biomechanical Phenomena ; Collagen ; metabolism ; Elasticity ; Hindlimb Suspension ; physiology ; Male ; Mesenteric Arteries ; physiology ; ultrastructure ; Muscle, Smooth, Vascular ; physiology ; ultrastructure ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Stress, Mechanical ; Vasoconstriction ; physiology ; Weightlessness Simulation

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

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.