Background::A phase II trial on recombinant human tenecteplase tissue-type plasminogen activator (rhTNK-tPA) has previously shown its preliminary efficacy in ST elevation myocardial infarction (STEMI) patients. This study was designed as a pivotal postmarketing trial to compare its efficacy and safety with rrecombinant human tissue-type plasminogen activator alteplase (rt-PA) in Chinese patients with STEMI.Methods::In this multicenter, randomized, open-label, non-inferiority trial, patients with acute STEMI were randomly assigned (1:1) to receive an intravenous bolus of 16 mg rhTNK-tPA or an intravenous bolus of 8 mg rt-PA followed by an infusion of 42 mg in 90 min. The primary endpoint was recanalization defined by thrombolysis in myocardial infarction (TIMI) flow grade 2 or 3. The secondary endpoint was clinically justified recanalization. Other endpoints included 30-day major adverse cardiovascular and cerebrovascular events (MACCEs) and safety endpoints.Results::From July 2016 to September 2019, 767 eligible patients were randomly assigned to receive rhTNK-tPA ( n = 384) or rt-PA ( n = 383). Among them, 369 patients had coronary angiography data on TIMI flow, and 711 patients had data on clinically justified recanalization. Both used a –15% difference as the non-inferiority efficacy margin. In comparison to rt-PA, both the proportion of patients with TIMI grade 2 or 3 flow (78.3% [148/189] vs. 81.7% [147/180]; differences: –3.4%; 95% confidence interval [CI]: –11.5%, 4.8%) and clinically justified recanalization (85.4% [305/357] vs. 85.9% [304/354]; difference: –0.5%; 95% CI: –5.6%, 4.7%) in the rhTNK-tPA group were non-inferior. The occurrence of 30-day MACCEs (10.2% [39/384] vs. 11.0% [42/383]; hazard ratio: 0.96; 95% CI: 0.61, 1.50) did not differ significantly between groups. No safety outcomes significantly differed between groups. Conclusion::rhTNK-tPA was non-inferior to rt-PA in the effect of improving recanalization of the infarct-related artery, a validated surrogate of clinical outcomes, among Chinese patients with acute STEMI.Trial registration::www.ClinicalTrials.gov (No. NCT02835534).

Purpose To investigate the clinicopathological and molecular genetic characteristics of epithelioid inflammatory myofibroblastic sarcoma(EIMS)in children.Methods Clini-cal data of 7 cases of EIMS in children was collected,the ex-pression of ALK,CD30,desmin,SMA,CK,Ki67,etc.was detected with immunohistochemistry EnVision method,ALK gene disruption and rearrangement was detected using FISH method,and ALK gene fusion was examined by NGS sequen-cing.Clinical and pathological characteristics was analyzed and relevant literatures were reviewed.Results Children aged from 6 months to 12 years.There were 3 cases in abdomen,1 case in intestinal wall,1 case in vocal cord,1 case in pleura and 1 case in maxillary sinus.Multiple in 6 cases and single in 1 case.Im-aging showed soft tissue shadow.Pathological examination showed that tumor cells were various in shape,including small round,spindle-shaped or larger round.There were abundant cy-toplasm with small or inconspicuous nucleoli,ganglion cell-like cells was unconspicuous.There were different cell atypia,hy-perplasia,sparseness or both of background collagen.The main inflammatory cells were lymphocytes with scattered neutrophils,and few plasma cells.Immunohistochemistry,tumor cells ex-pressed ALK,CD30,desmin,SMA,and CK,Ki67 were ex-pressed in tumor cells(3％-40％).ALK split probes were positive in 4 cases,and RANBP2-ALK fusion was found in 3 ca-ses by next generation sequencing.All 7 cases were treated by surgery,5 cases underwent further postoperative treatment(3 cases received chemotherapy and targeted drug therapy,1 case received radiotherapy and chemotherapy,and 1 case received ra-diotherapy).During the follow-up of 1-60 months,2 cases died,1 case recurred and 4 cases survived without tumor.Con-clusion EIMS in children has a wide range of onset ages,and is common in abdominal omentum.The clinical manifestations and imaging are not special,most of them are multiple,and the tumor cells are diverse.Immunohistochemical and FISH detec-tion are helpful for diagnosis of EIMS.

New threats posed by the emerging circulating variants of SARS-CoV-2 highlight the need to find conserved neutralizing epitopes for therapeutic antibodies and efficient vaccine design. Here, we identified a receptor-binding domain (RBD)-binding antibody, XG014, which potently neutralizes β-coronavirus lineage B (β-CoV-B), including SARS-CoV-2, its circulating variants, SARS-CoV and bat SARSr-CoV WIV1. Interestingly, antibody family members competing with XG014 binding show reduced levels of cross-reactivity and induce antibody-dependent SARS-CoV-2 spike (S) protein-mediated cell-cell fusion, suggesting a unique mode of recognition by XG014. Structural analyses reveal that XG014 recognizes a conserved epitope outside the ACE2 binding site and completely locks RBD in the non-functional "down" conformation, while its family member XG005 directly competes with ACE2 binding and position the RBD "up". Single administration of XG014 is effective in protection against and therapy of SARS-CoV-2 infection in vivo. Our findings suggest the potential to develop XG014 as pan-β-CoV-B therapeutics and the importance of the XG014 conserved antigenic epitope for designing broadly protective vaccines against β-CoV-B and newly emerging SARS-CoV-2 variants of concern.
Angiotensin-Converting Enzyme 2 ; Antibodies, Neutralizing ; Antibodies, Viral ; COVID-19 ; Epitopes ; Humans ; SARS-CoV-2/genetics* ; Spike Glycoprotein, Coronavirus/genetics*

Objective To explore the application effects of hip muscle training on female patients with stress urinary incontinence (SUI).Methods Totally 48 female patients with mild to moderate SUI were recruited in this study from the Second Hospital of Hebei Medical University from January to November 2015 by using purposive sampling method. According to the random number table,the participants were divided into the intervention group (n=24) and the control group (n=24). Patients in the intervention group received resisted hip muscle exercise,including the hip internal rotation and hip external rotation. Patients in the control group received conventional pelvic floor muscle exercise (PFME). The intervention lasted for 12 weeks,and the application effects were evaluated by the questionnaire of urinary incontinence quality of life (I-QOL) and the urine pad test before the intervention,eight weeks,and 12 weeks after the intervention.Results After the intervention,the urine leakage was significantly decreased,and the I-QOL score was increased (P<0.05). Although the urine leakage had no statistical difference between two groups (P>0.05),the total I-QOL scores and the scores of social barriers dimension were higher inr the intervention group compared with that in the control group (P<0.05). But on the dimension of limited behavior and the psychological impact,there were no statistical differences between two groups (P>0.05).Conclusions Resisted hip muscle training can effectively decrease the urine leakage and improve the quality of life of female patients with mild to moderate SUI.