Background::There is a need for effective and safe therapies for psoriasis that provide sustained benefits. The aim of this study was to assess the efficacy and safety of tildrakizumab, an anti-interleukin-23p19 monoclonal antibody, for treating moderate-to-severe plaque psoriasis in Chinese patients.Methods::In this multi-center, double-blind, phase III trial, patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned (1:1) to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4. Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12, 16, and every 12 weeks thereafter. Patients in the tildrakizumab group continued with tildrakizumab at week 16, and every 12 weeks until week 52. The primary endpoint was the Psoriasis Area and Severity Index (PASI 75) response rate at week 12.Results::At week 12, tildrakizumab demonstrated significantly higher PASI 75 response rates (66.4% [73/110] vs. 12.7% [14/110]; difference, 51.4% [95% confidence interval (CI), 40.72, 62.13]; P <0.001) and Physician’s Global Assessment (60.9% [67/110] vs. 10.0% [11/110]; difference, 49.1% [95% CI, 38.64, 59.62]; P <0.001) compared to placebo. PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups, reaching maximal efficacy after 28 weeks (86.8% [92/106] vs. 82.4% [89/108]) and maintained up to 52 weeks (91.3% [95/104] vs. 87.4% [90/103]). Most treatment-emergent adverse events were mild and not related to tildrakizumab. Conclusion::Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.Trial registration::ClinicalTrials.gov, NCT05108766.

This study was aimed at investigating the effect of lymphocyte activation gene-3(LAG3)on liver B lymphocyte subsets and their functions in WT and LAG3-KO mice infected with Echinococcus multilocularis(E.multilocularis).In a mouse model of E.multilocularis infection,the expression and localization of CD19 and α-SMA in liver were detected by immu nohistochemistry.CD80,CD86 and MHC-Ⅱ molecules expressed on B cells and their subsets in mice liver were detected by flow cytometry.After 12 weeks of infection,the area and percentage of CD19 in LAG3-KO group was slightly higher than that in WT group,but the difference was not statistically(t=-1.241、-1.237,P＞0.05).The area and percentage of a-SMA in LAG3-KO group was higher than that in WT group(t=-3.224、-3.227,P＜0.05).The proportion of CD80 and MHC-Ⅱ molecules expressed on liver B cells in LAG3-KO group was up-regulated(t=-2.379,-3.321,P＜0.05).The percentage of liver B2 cells in LAG3-KO group was higher than that in WT group(t=-2.695,P＜0.05).The expression of CD80 on Blb cells in LAG3-KO group was significantly up-regulated(t=-5.315,P＜0.001).The proportion of CD80 of B2 cells in LAG3-KO group was lower than that in WT group(t=2.806,P＜0.05).The expression of MHC-Ⅱ molecule in B2 cells in LAG3-KO group was up-regulated(t=-4.227,P＜0.01).It is suggested that LAG3 molecules affected the B cell subsets and func-tion of mouse liver in the middle stage of E.multilocularis infection,especially B2 lymphocytes.LAG3 molecule exerted an in-hibitory effect on the activation of B cells and the expression of MHC-class Ⅱ molecules,suggesting that it may be involved in B cell exhaustion caused by E.multilocularis.

Objective: To explore age, gender, and regional differences in physical activity among children and adolescents in China, and to provide a scientific reference for enhancing physical activity promotion. Methods: A total of 4 269 children and adolescents aged 7 to 18 years were selected from six administrative regions of China (East China, Northwest China, North China, Central China, Southwest China and South China) using a stratified random cluster sampling method from September to December 2018. A questionnaire was administered to evaluate the physical activity level of Chinese children and adolescents aged 7 to 18. Results: The overall detection rate of MVPA insufficiency in children and adolescents in China was 53.8%, of which the detection rate of MVPA insufficiency was 50.8% among boys and 57.1% among girls. Gender differences were statistically significant ( χ 2= 17.10 , P <0.05). Among the different age groups, the lowest detection rate of MVPA among 10-12 year olds was 43.6%, whereas the highest rate among 16-18 year olds was 63.0%, with significant differences between gender ( χ 2=4.33, 30.79, P <0.05). The P 50 values of total physical activity(TPA), light intensity physical activity(LPA), moderate intensity physical activity(MPA), vigorous intensity physical activity(VPA), moderate to vigorous physical activity(MVPA) were 92.9,24.3,41.4,7.1 and 55.7 min/d , respectively. The P 50 values of physical exercise, housework activities, entertainment activities and transportation activities were 34.3 , 2.1, 2.3 and 30.0 min/d, respectively, and the difference in age groups was statistically significant( H =95.03, 74.99, 300.26 , 64.16, P <0.05). There was a statistically significant difference in the detection rate of insufficient MVPA among children and adolescents in different regions ( χ 2=83.91, P <0.05). The lowest rate was 44.0% in North China, and the highest was 65.9% in East China. Conclusion The detection rate of MVPA insufficiency among Chinese children and adolescents firstly decreased and then increased with age. Boys participated in higher levels of physical activity than girls.

The epidemic of coronavirus disease 2019 (COVID-19) puts higher demands on critical care medicine. Lots of studies have been conducted to solve COVID-19-related problems. Therefore, we reviewed the annual progress for COVID-19-related issues including antivirals threapies, respiratory support and immunomodulatory therapies and other critical issues, including the effect of antibiotic on mitochondrial damage and its relationship with sepsis, the goal and direction of antimicrobial de-escalation, drug prophylaxis of constipation, bleeding in gastrointestinal disorders and management of critical illness in the informalization era and so on. We hope to provide reference for clinical and scientific research work of the intensivists.

Objective: To explore whether blood and polyp tissue eosinophil numbers are independent risk factors for poor disease control in patients with nasal polyp. Methods: By using the electronic medical records database and manual evaluation, 183 nasal polyp patients who had undergone endoscopic sinus surgery at least one year prior to the study with complete data of tissue specimens, baseline blood routine test, nasal endoscopy and sinus computed tomography, were identified and recruited to assess disease control based on the criteria of a European Position Paper on Rhinosinusitis and Nasal Polyps 2012 (EPOS 2012). Multiple logistic regression model was used to determine the association between blood and tissue eosinophil numbers and risk of poor disease control by adjusting for demographics and comorbidities. Results: We broke down the cohort into 4 groups according to blood (0.3×10⁹/L) and tissue (10%) eosinophils. The patients without eosinophilic inflammation represented the largest group (41.5%). The group with concordant blood and tissue eosinophilia represented the second largest (31.2%), and the patients with isolated tissue (15.3%) or blood (12.0%) eosinophilia were relatively rare. Multiple logistic regression models found blood eosinophil count and tissue eosinophil percentage were independently associated with increased risk for poor disease control after adjustments for covariates related to poor treatment outcome. Furthermore, subjects with concordant blood and tissue eosinophilia had a higher risk for poor disease control than those with isolated blood or tissue eosinophilia. Conclusion: Concordant blood and tissue eosinophilia relates to a higher likelihood of poor disease control than isolated blood or tissue eosinophilia after adjustment of potential confounders in nasal polyp patients.
Chronic Disease ; Eosinophilia ; Eosinophils ; Humans ; Nasal Polyps ; Rhinitis ; Sinusitis

OBJECTIVE: To explore the effect of electroacupuncture treatment on the levels of cortisol and immune factors in patients with occupational noise-induced deafness(ONID) combined with depressive symptoms. METHODS: A total of 78 ONID patients combined with depressive symptoms were randomly divided into control group(40 cases) and electroacupuncture group(38 cases) by a random number table method. The control group received routine therapy, while the electroacupuncture group was treated with routine therapy plus electroacupuncture on alternate days, 3 times a week for 4 consecutive weeks. The levels of salivary cortisol, as well as the serum levels of cortisol, tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6) and C-reactive protein(CRP) of the two groups were observed and compared before and after treatment. RESULTS: Before treatment, the levels of saliva cortisol in the morning and night, and the serum levels of cortisol, IL-6, TNF-α and CRP in the two groups were compared, and the differences were not statistically significant(P>0.05). After treatment, the serum cortisol level of patients in electroacupuncture group reduced than that before treatment in the same group(P<0.05). However, there was no significant difference in the levels of salivary cortisol in the morning and night, and serum cortisol before and after treatment both in control group and electroacupuncture group(P>0.05). After treatment, the serum levels of IL-6 and TNF-α decreased in electroacupuncture group as compared with those before treatment and those after treatment in control group(P<0.01). CONCLUSION: Electroacupuncture treatment could reduce the levels of TNF-α and IL-6 in serum of ONID patients combined with depressive symptoms. The regulation of electroacupuncture on the inflammatory cytokines may be one of the mechanisms in treating ONID combined with depressive symptoms.

Objective    To investigate the correlation between lung ultrasonography and pulmonary complications after cardiac surgery. Methods    Fifty-two patients after cardiac surgery in our hospital from January to May 2017 were recruited. There were 27 males and 25 females, aged 60.50±10.43 years. Lung ultrasonography was performed by specially trained observers, video data were saved, and lung ultrasound score (LUS) were recorded. The correlation between the LUS and the patients' pulmonary function was evaluated. Results    LUS was 17.80±3.87, which was negatively correlated to the ratio of arterial PO2 to the inspired oxygen fraction (PaO2/FiO2) during examination, without significant difference (r=–0.363, P=0.095), but significantly negatively correlated to PaO2/FiO2 changes 24 hours postoperatively (r=–0.464, P=0.034). Conclusion    The changes of lung ventilation area may occur earlier than the changes of lung function. Bedside LUS is an effective method for clinical monitoring of pulmonary complications.

Objective To investigate the protective effect of ischemia preconditioning(IPC)on apoptosis in-duced by renal ischemia - reperfusion(IR)and relations to the changing expressions of Bcl - 2,Bax in rat kidney. Methods Ischemia models were induced by clipping bilateral renal pedicles for 30 min by using the artery clamp;IPC group was induced by clipping bilateral renal pedicles for 15 min,4 days later IR was performed again by clipping bila-teral renal pedicle for 30 min. Rats were randomly divided into 5 groups with 5 animals in each group:control group(C group),sham - operation group(S group),IR group,IPC group(IPC ﹢ IR group),sham IPC group(S ﹢ IR group),all groups were randomly divided into 9 sub groups(0 h,3 h,6 h,12 h,24 h,48 h,3 d,5 d,7 d)except C group according to the time points after reperfusion. Occurrence of apoptosis was detected by terminal deoxynuleotidyl transferase media-ted dUTP nick end and labeling(TUNEL)method;the mRNA expression and protein levels of Bax and Bcl - 2 were de-tected by reverse transcriptase - polymerase chain reaction and quantitave immunohistochemisty. Results (1)Com-pared with S group and S ﹢ IR group,serum creatinine,blood urea nitrogen,kidney pathological damage scores in IR group gradually increased after IR,and peak point was 24 h after reperfusion;among all the subgroups there was a sig-nificant difference(all P ﹤ 0. 01). The expression of Bax,Bcl - 2 mRNA raised sharply in IR group after reperfusion, peaking at 6 h,24 h of reperfusion respectively,2. 66 ± 0. 12,2. 70 ± 0. 10,and among all the subgroups there was a sig-nificant difference(all P ﹤ 0. 01);the expression of Bax,Bcl - 2 protein had significant difference(all P ﹤ 0. 05). TUNEL immunofluorescence staining showed C group and S group had no obvious apoptosis cells in renal tubular epi-thelium;epithelial cell apoptosis after IR gradually increased in IR group,peaking at 24 h of reperfusion[(25. 07 ± 2. 29)% ].(2)Compared with IR group and S ﹢ IR group,pathological injury was significantly decreased in IPC ﹢ IR group;the expression of Bax,Bcl - 2 mRNA and protein,apoptosis cells were significantly decreased in IPC ﹢ IR group (all P ﹤ 0. 05). Conclusions Bax,Bcl - 2 are closely associated with kidney injury induced by IR. IPC may regulate acute kidney injuries by regulating Bax/ Bcl - 2.

Objective To investigate the expression and significance of microRNA - 21(miR - 21)in acute kidney injury mice model at the different time points following ischemic/ reperfusion. Methods C57BL/ 6J mice were divided into 3 major groups:the control group(C group),sham operation group(S group)and ischemia - reperfusion group(IR group). Later 2 groups were divided into 9 sub - groups respectively according to the time following reperfu-sion. Automatic biochemical analyzer detected serum creatinine(Scr),blood urea nitrogen(BUN)level. HE staining detected renal pathological damage. Renal tubulointerstitial pathological score accessed pathological damage. Real time - PCR tested the expression of miR - 21 and mitogen - activated protein kinase kinase 3(MKK3)mRNA in renal respectively. Immunohistochemistry staining tested expression of MKK3. Results IR group's Scr,BUN levels gradually increased following reperfusion,24 h reached its peak,then gradually declined. The Scr,BUN level had statistically sig-nificant difference between IR group and S group at the same time subgroup from 3 h to 168 h following reperfusion(all P ﹤ 0. 01). The change of kidney damage and pathological changes of interstitial and tubular injury score consensus with renal function. miR - 21 increased gradually in renal ischemia after reperfusion,24 h peaked and then stabilized at this high level. miR - 21 was positively correlated with pathological tubulointerstitial injury from 0 h to 168 h after reperfu-sion(r = 0. 969,P ﹤ 0. 05). IR group's MKK3 mRNA and protein expression rose sharply following ischemia/ reperfu-sion,24 h peaked,and then gradually decreased. From 3 h to 168 h,the expression of MKK3 mRNA and proteins had significant difference at each same time points subgroups between IR group and S group(all P ﹤ 0. 01). Conclusions miR - 21 increases gradually in renal ischemia after reperfusion,24 h peaked and then stabilized at this high level. miR - 21 is positively correlated with pathological tubulointerstitial injury,which may be associated with the negative regulated relationship between miR - 21 and MKK3.

Objective:To evaluate the application value of urine cell DNA quantitative analysis in the diagnosis of urinary tract tumors.Methods:There were 92 cases of urinary tract inflammation and 39 cases of patients with suspected bladder cancer urine were tested by DNA quantitative determination, conventional cytology test and urine cytology, pathological diagnosis as the gold standard,the value of the three methods in differential diagnosis of urinary tract inflammation and bladder cancer were assessed,the correlationship between urine cell DNA quantitative and tumor types was analyzed. Results:The sensitivity and specificity of urinary DNA ploidy analysis for the diagnosis of bladder cancer were 88.89% and 97.09%,respectively,and the diagnostic accuracy was 94.66%.The sensitivity and specificity of the traditional urine cytology test were 51.85%and 100%,respectively,and the accuracy was 90.07%.The sensitivity and specificity of urine liquid based cytology test in the diagnosis of bladder cancer were 81.48% and 99.04%,respectively,and the diagnostic accuracy was 95.41%.Urine DNA ploidy analysis results >5C cell number and the type of the urinary tract epithelial cancer were associated,high level of urinary tract epithelial cancer group (>5C)cell number was significantly higher than the low level group.Conclusions:The urine DNA quantitative analysis can identify the urinary system inflammation and bladder cancer, which is better than the traditional cytology test.