1.Clinical trial of Morinda officinalis oligosaccharides in the continuation treatment of adults with mild and moderate depression
Shu-Zhe ZHOU ; Zu-Cheng HAN ; Xiu-Zhen WANG ; Yan-Qing CHEN ; Ya-Ling HU ; Xue-Qin YU ; Bin-Hong WANG ; Guo-Zhen FAN ; Hong SANG ; Ying HAI ; Zhi-Jie JIA ; Zhan-Min WANG ; Yan WEI ; Jian-Guo ZHU ; Xue-Qin SONG ; Zhi-Dong LIU ; Li KUANG ; Hong-Ming WANG ; Feng TIAN ; Yu-Xin LI ; Ling ZHANG ; Hai LIN ; Bin WU ; Chao-Ying WANG ; Chang LIU ; Jia-Fan SUN ; Shao-Xiao YAN ; Jun LIU ; Shou-Fu XIE ; Mao-Sheng FANG ; Wei-Feng MI ; Hong-Yan ZHANG
The Chinese Journal of Clinical Pharmacology 2024;40(6):815-819
Objective To observe the efficacy and safety of Morinda officinalis oligosaccharides in the continuation treatment of mild and moderate depression.Methods An open,single-arm,multi-center design was adopted in our study.Adult patients with mild and moderate depression who had received acute treatment of Morinda officinalis oligosaccharides were enrolled and continue to receive Morinda officinalis oligosaccharides capsules for 24 weeks,the dose remained unchanged during continuation treatment.The remission rate,recurrence rate,recurrence time,and the change from baseline to endpoint of Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Clinical Global Impression-Severity(CGI-S)and Arizona Sexual Experience Scale(ASEX)were evaluated.The incidence of treatment-related adverse events was reported.Results The scores of HAMD-17 at baseline and after treatment were 6.60±1.87 and 5.85±4.18,scores of HAMA were 6.36±3.02 and 4.93±3.09,scores of CGI-S were 1.49±0.56 and 1.29±0.81,scores of ASEX were 15.92±4.72 and 15.57±5.26,with significant difference(P<0.05).After continuation treatment,the remission rate was 54.59%(202 cases/370 cases),and the recurrence rate was 6.49%(24 cases/370 cases),the recurrence time was(64.67±42.47)days.The incidence of treatment-related adverse events was 15.35%(64 cases/417 cases).Conclusion Morinda officinalis oligosaccharides capsules can be effectively used for the continuation treatment of mild and moderate depression,and are well tolerated and safe.
2.Implementation of surveillance,prevention and control of healthcare-asso-ciated infection in maternal and child healthcare institutions:A nation-wide investigation report
Shuo LI ; Xi YAO ; Hui-Xue JIA ; Wei-Guang LI ; Xun HUANG ; Shu-Mei SUN ; Xi CHENG ; Qing-Lan MENG ; Xiang ZHANG ; Jing-Ping ZHANG ; Ya-Wei XING ; Qing-Qing JIANG ; Lian-Xuan WU ; Bing-Li ZHANG ; Xiao-Jing LIU ; Liu-Yi LI
Chinese Journal of Infection Control 2024;23(3):323-329
Objective To investigate the implementation of surveillance,prevention and control measures for healthcare-associated infection(HAI)in maternal and child healthcare(MCH)institutions,and provide policy evi-dence for optimizing HAI prevention and control in MCH institutions.Methods Stratified sampling was conducted among the MCH institutions at provincial,municipal and county levels in 8 provinces/autonomous regions.A uni-fied questionnaire was designed and the online survey was conducted through"Questionnaire Star".Results The data from 123 MCH institutions were included in the analysis.90.24%of the MCH institutions carried out compre-hensive surveillance on HAI.The ratios of MCH institutions which implemented targeted surveillance on HAI in neonatal intensive care unit(NICU),surgical site infection,multidrug-resistant organisms(MDROs)and HAI in intensive care units(non-NICU excluded)were 89.66%,85.96%,80.77%,and 74.19%,respectively.51.22%MCH institutions adopted information surveillance system on HAI cases.94.31%MCH institutions carried out surveillance on hand hygiene compliance.Over 90%MCH institutions carried out surveillance on environment hy-giene in high-risk departments.71.54%MCH institutions conducted centralized cleaning,disinfection,sterilization and supply for reusable medical instruments in the central sterile supply department(CSSD).Over 90%MCH insti-tutions established three-level pre-examination triage systems.86.18%set up transitional wards.MCH institutions generally adopted a management model with established effective communication,full appointment visits,and sepa-rate visits for special medical groups,such as registered pregnant women,high-risk newborns,healthcare groups,and long-term rehabilitation patients.However,the ratio of institutions conducting on-line follow-up visits was less than 50%.Conclusion MCH institutions have generally carried out comprehensive and targeted surveillance on HAI.Information surveillance need to be facilitated.Hand hygiene and environmental hygiene surveillance has been popularized to a certain extent at all levels of MCH institutions.The cleaning,disinfection,sterilization,and supply processes of reusable medical devices in a few MCH institutions are not standardized.Special medical populations get effective management.On-line healthcare is to be further promoted.
3.Investigation on Traditional Chinese Medicine Constitutions of Patients with Perimenopausal Metabolic Syndrome in Guangzhou Based on STRAW+10 Staging
Shu-Xin LIN ; Li LI ; Ning-Ning XU ; Jia-Jia HUANG ; Ya-Lian JIANG ; Ling JIANG
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(9):2295-2301
Objective To investigate the distribution of traditional Chinese medicine(TCM)constitution types in patients with perimenopause metabolic syndrome in Guangzhou based on the Stages of Reproductive Aging Workshop+10(STRAW+10),so as to provide a theoretical basis for TCM constitution regulation for patients with PMS.Methods According to the diagnostic criteria of metabolic syndrome,a total of 90 patients with PMS were included.Based on the STRAW+10 staging criteria,the PMS patients were divided into early perimenopause group(-2 phase of STRAW+10,49 cases),late perimenopause group(-1 phase of STRAW+10,24cases),and early postmenopausal group(+la phase of STRAW+10,17 cases).Traditional Chinese Medicine Constitution Classification and Distinguishing Criteria were used to identify the TCM constitution types of all the subjects.At the same time,the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)were used for scoring anxiety and depression.The distribution of TCM constitution types in patients with different STRAW+10 stages was analyzed,and the SAS and SDS scores of patients with different STRAW+10 stages were compared.Results(1)The primary TCM constitution types in the early perimenopause group(-2 phase of STRAW+10)were yang deficiency constitution(14 cases,29.79%),balanced constitution(10 cases,21.28%),yin deficiency constitution(six cases,12.76%)and blood stasis constitution(six cases,12.76%).In the late perimenopause group(-1 phase of STRAW+10),the primary TCM constitution types were yang deficiency constitution(six cases,25.00%),balanced constitution(four cases,16.66%),blood stasis constitution(four cases,16.66%),qi deficiency constitution(three cases,12.50%)and phlegm-damp constitution(three cases,12.50%).In the early postmenopausal group(+la phase of STRAW+10),the primary TCM constitution types were yang deficiency constitution(seven cases,46.67%),balanced constitution(two cases,13.33%),phlegm-damp constitution(two cases,13.33%),blood stasis constitution(two cases,13.33%),qi deficiency constitution(one case,6.67%)and qi stagnation constitution(one case,6.67%).(2)The SAS score and SDS score in the early perimenopause group(-2 phase of STRAW+10)were(34.55±7.46)points and(35.55±10.61)points,respectively,which were higher than those in the late perimenopause group(-1 phase of STRAW+10)[(33.83±7.73)points and(35.46±11.35)points,respectively]and in the early postmenopausal group(+la phase of STRAW+10)[(35.65±8.67)points and(36.59±12.07)points,respectively].All of the scores were higher than the overall average level.Conclusion The TCM constitution of patients with perimenopause metabolic syndrome is predominated by yang deficiency constitution.The percentage of the balanced constitution gradually decreases with the progression of STRAW+10 staging,and the biased constitutions gradually develop from yin deficiency constitution and blood stasis constitution into qi deficiency constitution and phlegm-damp constitution,and then into phlegm-damp constitution and blood stasis constitution again.With the progression of the stage,the deficiency in the fundamental of the PMS patients becomes more deficient and the pathogens of excess in the incidental also grow.
4.Clinical Observation on External Application of Liangxue Chushi Zhiyang Powder in Treating Facial Dermatitis
Shu-Ping XU ; Lin-Ya NI ; De-Jian DUAN ; Dan HUANG ; Hai-Fang GAN ; Jia-Yao NIE
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(12):3179-3185
Objective To observe the clinical efficacy of external application of Liangxue Chushi Zhiyang Powder(composed of Isatidis Folium,Chrysanthemi Flos,Sophorae Flavescentis Radix,Schizonepetae Spica,and Zanthoxyli Pericarpium,etc.)in the treatment of facial dermatitis,and to analyze its effect on skin barrier function of the patients.Methods Seventy-two patients with facial dermatitis were randomly divided into the control group and the observation group,with 36 cases in each group.The control group was treated with Butyl Flufenamic Ointment for external use and Ebastine Tablets orally,while the observation group was given cold and wet compress of Liangxue Chushi Zhiyang Powder on the basis of treatment for the control group.The course of treatment of both groups covered three weeks.Before and after the treatment,the changes of subjective and objective symptom scores as well as skin barrier function indicators of the two groups were observed.After treatment,the clinical efficacy and incidence of adverse reactions of the two groups were assessed.Results(1)After three weeks of treatment,the total effective rate of the observation group was 75.00%(27/36),and that of the control group was 47.22%(17/36);the intergroup comparison showed that the therapeutic efficacy of the observation group was significantly superior to that of the control group(χ2=5.844,P<0.05).(2)After treatment,the scores of objective symptoms such as erythema,inflammatory papules,desquamation,swelling,and lesion area in the two groups were significantly decreased when compared with those before treatment(P<0.05),and the decrease of the scores of erythema,inflammatory papules and lesion area in the observation group was significantly superior to that in the control group(P<0.05).The differences in the scores of desquamation and swelling between the two groups were not statistically significant(P>0.05).(3)After treatment,the scores of subjective symptoms such as itching,burning,stabbing pain,dryness/tightness of the skin in the two groups were significantly decreased when compared with those before treatment(P<0.05),and the decrease of the scores of each subjective symptom in the observation group was significantly superior to that in the control group(P<0.05).(4)After treatment,the skin barrier function indicators such as trans-epidermal water loss(TEWL)and skin pH value of the two groups were significantly lowered(P<0.05),and stratum corneum hydration(SCH)and sebum(SEB)content were significantly increased when compared with those before treatment(P<0.05).The decrease of TEWL and pH value as well as the increase of SCH and SEB content in the observation group was significantly superior to that in the control group(P<0.05).(5)During the treatment,no serious adverse reactions occurred in the two groups of patients.The incidence of adverse reactions in the observation group was 8.33%(3/36),and that in the control group was 5.66%(2/36),and the difference was not statistically significant(χ2=0.215,P>0.05).Conclusion The cold and wet compress of Liangxue Chushi Zhiyang Powder exerts certain efficacy in the treatment of facial dermatitis,which is effective on markedly relieving the subjective and objective symptoms of the patients,and improving the skin barrier function,with few and mild adverse reaction.
5.Role of transient receptor potential channel 6 in homocysteine-induced podocyte autophagy of mouse kidney
Guan-Jun LU ; Le-Xin WANG ; Jing ZHAO ; Chao LIU ; Jian-Tuan XIONG ; Yun JIAO ; An-Ning YANG ; Yi-Deng JIANG ; Yu-Jia TIAN ; Yao-Qin XU ; Qing SHI ; Li LIU ; Ya-Lan ZHANG ; Zhi-Gang BAI ; Shu-Juan LI
Medical Journal of Chinese People's Liberation Army 2024;49(12):1400-1407
Objective To explore the regulatory role of transient receptor potential channel 6(TRPC6)on podocyte autophagy under the influence of homocysteine(Hcy)in mouse kidney.Methods Mouse renal podocytes were divided into control group and Hcy groups(stimulated by Hcy at 40,60,80 and 100 μmol/L for 48 h).The level of TRPC6 mRNA was assessed using quantitative reverse transcription polymerase chain reaction(qRT-PCR)to identify the optimal Hcy concentration for subsequent experiments.Western blotting was employed to evaluate the expression levels of autophagy-related proteins LC3 Ⅱ and p62,as well as the expression levels of podocyte structural proteins Nephrin and Podocin.The expression levels of TRPC6 mRNA and protein in both groups were determined using qRT-PCR,Western blotting and immunofluorescence.Transfections of cells with TRPC6 overexpression or interference were set as follows:(1)control group(untreated),negative control group of TRPC6 overexpression,and TRPC6 overexpression group;(2)control group(untreated),negative control group of TRPC6 interference,and TRPC6 interference group(si-1,si-2,si-3).The expression level of TRPC6 was detected using qRT-PCR.The cells after overexpressing or interfering of TRPC6 were further set as follows:(1)control group(untreated),Hcy group(80 μmol/L Hcy added),TRPC6 overexpression control+Hcy group,TRPC6 overexpression+Hcy group;(2)control group(untreated),Hcy group,TRPC6 interference control+Hcy group,and TRPC6 interference+Hcy group.The expression levels of p62,LC3 Ⅱ,and TRPC6 proteins were detected using Western blotting.Results qRT-PCR detection results showed that compared with control group,the expression level of TRPC6 mRNA in Hcy group increased with the increase of Hcy concentration,with the highest expression level observed at 80 μmol/L Hcy.Therefore,80 μmol/L Hcy was selected as the optimal concentration for intervention.At this time,the expression level of autophagy-related protein LC3 Ⅱ increased,and the expression level of p62 decreased(P<0.05).Western blotting results showed that compared with control group,the expression levels of podocyte-related proteins Nephrin and Podocin in Hcy group were significantly decreased(P<0.05).qRT-PCR results showed that compared with control group,the expression level of TRPC6 mRNA in Hcy group was significantly increased(P<0.05).Compared with negative control group for TRPC6 overexpression,both mRNA and protein expression levels of TRPC6 in TRPC6 overexpression group were significantly higher(P<0.05).Compared with negative control group for TRPC6 interference,both mRNA and protein expression levels of TRPC6 in TRPC6 interference group were significantly decreased(P<0.05).Western blotting results showed that compared with negative control group for TRPC6 overexpression,the expression level of autophagy-related protein LC3 Ⅱ in TRPC6 overexpression+Hcy group was significantly increased,and the expression level of p62 was significantly decreased(P<0.05).Compared with TRPC6 negative control+Hcy group for TRPC6 interference+Hcy,the expression level of autophagy-related protein LC3 Ⅱ in TRPC6 interference+Hcy group was significantly decreased,and the expression level of p62 was significantly increased(P<0.05).Conclusion Hcy can induce autophagy of renal podocytes.Inhibiting the expression of TRPC6 can significantly reduce the autophagy damage to podocytes.
6.Clinical characteristics of 11 patients with chronic lymphocytic leukemia with t (14;19) (q32;q13).
Cheng Hua CUI ; Ya Nan CHANG ; Ji ZHOU ; Cheng Wen LI ; Hui Jun WANG ; Qi SUN ; Yu Jiao JIA ; Qing Hua LI ; Ting Yu WANG ; Lu Gui QIU ; Shu Hua YI
Chinese Journal of Hematology 2023;44(5):418-423
Objective: To analyze the clinicopathological characteristics of 11 cases of chronic lymphocytic leukemia (CLL) with t (14;19) (q32;q13) . Methods: The case data of 11 patients with CLL with t (14;19) (q32;q13) in the chromosome karyotype analysis results of the Blood Diseases Hospital, Chinese Academy of Medical Sciences from January 1, 2018, to July 30, 2022, were retrospectively analyzed. Results: In all 11 patients, t (14;19) (q32;q13) involved IGH::BCL3 gene rearrangement, and most of them were accompanied by +12 or complex karyotype. An immunophenotypic score of 4-5 was found in 7 patients and 3 in 4 cases. We demonstrated that CLLs with t (14;19) (q32;q13) had a mutational pattern with recurrent mutations in NOTCH1 (3/7), FBXW7 (3/7), and KMT2D (2/7). The very-high-risk, high-risk, intermediate-risk, and low-risk groups consisted of 1, 1, 6, and 3 cases, respectively. Two patients died, 8 survived, and 2 were lost in follow-up. Four patients had disease progression or relapse during treatment. The median time to the first therapy was 1 month. Conclusion: t (14;19) (q32;q13), involving IGH::BCL3 gene rearrangement, is a rare recurrent cytogenetic abnormality in CLL, which is associated with a poor prognosis.
Humans
;
Leukemia, Lymphocytic, Chronic, B-Cell/genetics*
;
Retrospective Studies
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Translocation, Genetic
;
Chromosome Aberrations
;
Karyotyping
7.Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain: a national multi-center survey of 35 566 population.
Meng Fan LIU ; Rui Xia MA ; Xian Bao CAO ; Hua ZHANG ; Shui Hong ZHOU ; Wei Hong JIANG ; Yan JIANG ; Jing Wu SUN ; Qin Tai YANG ; Xue Zhong LI ; Ya Nan SUN ; Li SHI ; Min WANG ; Xi Cheng SONG ; Fu Quan CHEN ; Xiao Shu ZHANG ; Hong Quan WEI ; Shao Qing YU ; Dong Dong ZHU ; Luo BA ; Zhi Wei CAO ; Xu Ping XIAO ; Xin WEI ; Zhi Hong LIN ; Feng Hong CHEN ; Chun Guang SHAN ; Guang Ke WANG ; Jing YE ; Shen Hong QU ; Chang Qing ZHAO ; Zhen Lin WANG ; Hua Bin LI ; Feng LIU ; Xiao Bo CUI ; Sheng Nan YE ; Zheng LIU ; Yu XU ; Xiao CAI ; Wei HANG ; Ru Xin ZHANG ; Yu Lin ZHAO ; Guo Dong YU ; Guang Gang SHI ; Mei Ping LU ; Yang SHEN ; Yu Tong ZHAO ; Jia Hong PEI ; Shao Bing XIE ; Long Gang YU ; Ye Hai LIU ; Shao wei GU ; Yu Cheng YANG ; Lei CHENG ; Jian Feng LIU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(6):579-588
Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.
Female
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Humans
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Adolescent
;
SARS-CoV-2
;
Smell
;
COVID-19/complications*
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Cross-Sectional Studies
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COVID-19 Vaccines
;
Incidence
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Olfaction Disorders/etiology*
;
Taste Disorders/etiology*
;
Prognosis
8.The mediating effect of perceived social support in the relationship between maternal personality traits and pregnancy-related anxiety.
Jia Shu ZHU ; Rui WANG ; Ye LI ; You Juan FU ; Hong Ya LIU ; Jia Qi LI ; Gui Xiang YAO ; Su Zhen GUAN
Chinese Journal of Preventive Medicine 2023;57(2):187-192
Objective: Exploring the mediating effect of perceived social support between the maternal personality traits and pregnancy-related anxiety. Methods: Singleton pregnant women who underwent antenatal checkups in the obstetrics department of general hospital affiliated to Ningxia Medical University from July to December 2021 were enrolled in this study to investigate perceived social support, pregnancy-related anxiety and conscious personality traits. Pearson correlation analysis was used to analyze the association between the maternal personality traits, perceived social support, and pregnancy-related anxiety, and the mediating effect of perceived social support was analyzed using Bootstrap method. Results: A total of 1 259 subjects were included in the study, of which 170 (13.50%) pregnant women felt introverted. The total score of perceived social support was (46.37±8.38), and 31.45% of pregnant women had high perceived social support. The total score of pregnancy-related anxiety was (21.48±5.53). The score of worry about fetal health was (10.09±3.24), and 368 (29.23%) of pregnant women had pregnancy-related anxiety. Maternal personality traits and pregnancy-related anxiety were negatively correlated (r=-0.076, P<0.05) and positively correlated with perceived social support during pregnancy (r= 0.127, P<0.05). Perceived social support during pregnancy and pregnancy-related anxiety were negatively correlated (r=-0.236, P<0.05). Perceived social support partially mediated the relationship between the maternal personality traits and pregnancy-related anxiety, with a relative effect value of 37.50%. Conclusion: The maternal personality traits, level of perceived social support and pregnancy-related anxiety are all related. Perceived social support could mediate the relationship between the maternal personality traits and pregnancy-related anxiety.
Female
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Pregnancy
;
Humans
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Anxiety
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Pregnant Women
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Personality
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Social Support
;
Prenatal Care
9.Diagnosis and treatment of 4 cases imported severe malaria and COVID-19 co-infection
ZHANG Le ; MA Zhong-xu ; JIANG Jian-jie ; XIA Jia-wei ; LI Xiang ; TANG Ya-lin ; LIU Shu ; ZHANG Kai-yi
China Tropical Medicine 2023;23(5):556-
Abstract: To explore the clinical characteristics, diagnosis and treatment of imported severe malaria and COVID-19 co-infection cases, and to provide scientific basis for epidemic prevention and control measures. The epidemiological characteristics, clinical manifestations, laboratory tests, treatment process and prognosis of 4 cases of severe malaria and COVID-19 co-infection with confirmed diagnosis were analyzed retrospectively. Four cases of severe malaria were African returnees of the same batch, male, aged 40-54 years old, with the same journey track. They all had African work and life history and acute onset. The main clinical manifestations were fever (4/4), chills (3/4), chills (3/4), nausea and vomiting (3/4), diarrhea (4/4), fatigue and anorexia (4/4). Two cases had headache and dizziness, confusion, muscle aches, two cases had cough, one cases had sputum, sore throat and runny urine. All 4 cases were confirmed by positive nucleic acid detection of the new coronavirus (2019-nCOV) in throat swabs. Plasmodium falciparum was found by microscopic examination of peripheral blood smears of all patients, and all of them were consistent with high altitude helminthiasis. All cases were accompanied by abnormal liver function and severe hypoproteinemia, two cases were hyperbilirubinemia, three cases were dyslipidemia, three cases were involved in abnormal tertiary hemogram with different degrees of elevation of procalcitonin, two cases were lactic acid poisoning, and one case was hypoglycemia. One case showed viral pneumonia on chest CT. All cases were treated individually according to the different conditions and were discharged after improvement, and were rechecked for 2019-nCOV nucleic acid and microscopic examination of blood smear negative for Plasmodium.During the global COVID-19 epidemic, the emergence of coinfection cases of con-infection of imported malaria parasites and severe acuterespiratory syndrome coronavirus 2 (SARS-CoV-2) makes the clinical diagnosis and treatment more complicated. It is important to establish the awareness of simultaneous prevention and diagnosis of COVID-19 and malaria for local prevention and control and early warning of severe cases, and timely and effective formulation of treatment plan to improve the comprehensive treatment efficiency.
10. Rapamycin-induced β-Globin Family Locus Remodeling Regulates the Gene Switching Expression
Lan XU ; Yi-Shu XIAO ; Chun-Ya LIU ; Bing-Hao JIA ; Le DU ; Dong-Na LI ; Li-Cheng REN
Chinese Journal of Biochemistry and Molecular Biology 2023;39(9):1322-1331
β-Thalassemia caused by abnormal coding of the β-globin gene is the most common hemoglobinopathy in many Asian countries. The in-depth study of the molecular basis and epigenetic mechanism of globin gene expression is the key to explore a new treatment for thalassemia. In this study, FAIRE (formaldehyde-assisted isolation of regulatory elements), 3C (chromosome conformation capture) and ChIP (Chromatin Immunoprecipitation) were used to investigate the three-dimensional interaction network of β-globin family gene loci and the molecular mechanism of functional regulation of gene expression during rapamycin-induced chromatin remodeling in CD4+ T cells. The results showed that the opening degree of globin gene chromatin, the interaction frequency between the gene promoter region and the regulatory element LCR (Locus control regions), and the enrichment efficiency of CTCF (CCCTC-binding factor) in the gene promoter region changed differently during the change of rapamycin treatment concentration from low to high, which led to the same change trend of the gene expression pattern. At the 10 nmol/ L concentration, chromatin accessibility and gene expression decreased (P < 0. 05). At 20 nmol/ L and 50 nmol/ L concentrations, chromatin accessibility increased and gene expression was up-regulated (P < 0. 05). In this study, the molecular mechanism of gene expression regulation of the β-globin family was expounded through this dynamic change process. Our work provides a theoretical and clinical practice basis for clinical precision treatment.

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