1.Role and Mechanism of Polyunsaturated Fatty Acids on Potassium Ion Channels
Yu-Jiao SUN ; Chao CHANG ; Zhen-Hua WU ; Yi-Fei ZHANG ; Yu-Tao TIAN
Progress in Biochemistry and Biophysics 2024;51(1):5-19
		                        		
		                        			
		                        			Polyunsaturated fatty acids (PUFAs) have diverse health-promoting effects, such as potentially protecting in immune, nervous, and cardiovascular systems by targeting a variety of sites, including most ion channels. Voltage-gated potassium channels of the KV7 family and large-conductance Ca2+- and voltage-activated K+ (BKCa) channels are expressed in many tissues, therefore, their physiological importance is evident from the various disorders linked to dysfunctional KV7 channels and BKCa channels. Thus, it is extremely important to learn how potassium channels are regulated by PUFAs. The aim of this review is to provide an overview of the effects of PUFAs on KV7 channels and BKCa channels functions, as well as the mechanisms underlying these effects. In summarizing reported effects of PUFAs on KV7 and BKCa channels mediated currents, we generally conclude that PUFAs increase the current amplitude, meanwhile, differential molecular and biophysical mechanisms are associated with the current increase. In KV7 channels the currents increasement are associated with a shift in the voltage dependence of channel opening and increased maximum conductance in KV7 channels, while in BKCa channels, they are associated with destabilization the pore domain closed conformation. Furthermore, PUFA effects are influenced by auxiliary subunits of KV7 and BKCa channels, associate with channels in certain tissues. although findings are conflicting. A better understanding of how PUFAs regulate KV7 and BKCa channels may offer insight into their physiological regulation and may lead to new therapeutic strategies and approaches. 
		                        		
		                        		
		                        		
		                        	
2.Chinese Guideline on the Management of Polypoidal Choroidal Vasculopathy (2022).
You-Xin CHEN ; Yu-Qing ZHANG ; Chang-Zheng CHEN ; Hong DAI ; Su-Yan LI ; Xiang MA ; Xiao-Dong SUN ; Shi-Bo TANG ; Yu-Sheng WANG ; Wen-Bin WEI ; Feng WEN ; Ge-Zhi XU ; Wei-Hong YU ; Mei-Xia ZHANG ; Ming-Wei ZHAO ; Yang ZHANG ; Fang QI ; Xun XU ; Xiao-Xin LI
Chinese Medical Sciences Journal 2023;38(2):77-93
		                        		
		                        			
		                        			Background In mainland China, patients with neovascular age-related macular degeneration (nAMD) have approximately an 40% prevalence of polypoidal choroidal vasculopathy (PCV). This disease leads to recurrent retinal pigment epithelium detachment (PED), extensive subretinal or vitreous hemorrhages, and severe vision loss. China has introduced various treatment modalities in the past years and gained comprehensive experience in treating PCV.Methods A total of 14 retinal specialists nationwide with expertise in PCV were empaneled to prioritize six questions and address their corresponding outcomes, regarding opinions on inactive PCV, choices of anti-vascular endothelial growth factor (anti-VEGF) monotherapy, photodynamic therapy (PDT) monotherapy or combined therapy, patients with persistent subretinal fluid (SRF) or intraretinal fluid (IRF) after loading dose anti-VEGF, and patients with massive subretinal hemorrhage. An evidence synthesis team conducted systematic reviews, which informed the recommendations that address these questions. This guideline used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach to assess the certainty of evidence and grade the strengths of recommendations. Results The panel proposed the following six conditional recommendations regarding treatment choices. (1) For patients with inactive PCV, we suggest observation over treatment. (2) For treatment-na?ve PCV patients, we suggest either anti-VEGF monotherapy or combined anti-VEGF and PDT rather than PDT monotherapy. (3) For patients with PCV who plan to initiate combined anti-VEGF and PDT treatment, we suggest later/rescue PDT over initiate PDT. (4) For PCV patients who plan to initiate anti-VEGF monotherapy, we suggest the treat and extend (T&E) regimen rather than the pro re nata (PRN) regimen following three monthly loading doses. (5) For patients with persistent SRF or IRF on optical coherence tomography (OCT) after three monthly anti-VEGF treatments, we suggest proceeding with anti-VEGF treatment rather than observation. (6) For PCV patients with massive subretinal hemorrhage (equal to or more than four optic disc areas) involving the central macula, we suggest surgery (vitrectomy in combination with tissue-plasminogen activator (tPA) intraocular injection and gas tamponade) rather than anti-VEGF monotherapy. Conclusions Six evidence-based recommendations support optimal care for PCV patients' management.
		                        		
		                        		
		                        		
		                        	
3.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
		                        			;
		                        		
		                        			Translocation, Genetic
		                        			;
		                        		
		                        			Chromosome Aberrations
		                        			;
		                        		
		                        			Karyotyping
		                        			
		                        		
		                        	
4.A panel study on the effect of atmospheric PM2.5 exposure on the gut microbiome in healthy elderly people aged 60-69 years old.
En Min DING ; Jiao Nan WANG ; Fu Chang DENG ; Pei Jie SUN ; Chen Feng LI ; Chen Long LI ; Yu WANG ; Jian Long FANG ; Song TANG ; Xiao Ming SHI
Chinese Journal of Preventive Medicine 2023;57(7):1018-1025
		                        		
		                        			
		                        			Objective: To analyze the short-term effect of individual atmospheric PM2.5 exposure on the diversity, enterotype, and community structure of gut microbiome in healthy elderly people in Jinan, Shandong province. Methods: The present panel study recruited 76 healthy elderly people aged 60-69 years old in Dianliu Street, Lixia District, Jinan, Shandong Province, and followed them up five times from September 2018 to January 2019. The relevant information was collected by questionnaire, physical examination, precise monitoring of individual PM2.5 exposure, fecal sample collection and gut microbiome 16S rDNA sequencing. The Dirichlet multinomial mixtures (DMM) model was used to analyze the enterotype. Linear mixed effect model and generalized linear mixed effect model were used to analyze the effect of PM2.5 exposure on gut microbiome α diversity indices (Shannon, Simpson, Chao1, and ACE indices), enterotype and abundance of core species. Results: Each of the 76 subjects participated in at least two follow-up visits, resulting in a total of 352 person-visits. The age of 76 subjects was (65.0±2.8) years old with BMI (25.0±2.4) kg/m2. There were 38 males accounting for 50% of the subjects. People with an educational level of primary school or below accounted for 10.5% of the 76 subjects, and those with secondary school and junior college or above accounting for 71.1% and 18.4%. The individual PM2.5 exposure concentration of 76 subjects during the study period was (58.7±53.7) μg/m3. DMM model showed that the subjects could be divided into four enterotypes, which were mainly driven by Bacteroides, Faecalibacterium, Lachnospiraceae, Prevotellaceae, and Ruminococcaceae. Linear mixed effects model showed that different lag periods of PM2.5 exposure were significantly associated with a lower gut α diversity index (FDR<0.05 after correction). Further analysis showed that PM2.5 exposure was significantly associated with changes in the abundances of Firmicutes (Megamonas, Blautia, Streptococcus, etc.) and Bacteroidetes (Alistipes) (FDR<0.05 after correction). Conclusion: Short-term PM2.5 exposure is significantly associated with a decrease in gut microbiome diversity and changes in the abundance of several species of Firmicutes and Bacteroidetes in the elderly. It is necessary to further explore the underlying mechanisms between PM2.5 exposure and the gut microbiome, so as to provide a scientific basis for promoting the intestinal health of the elderly.
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Feces/microbiology*
		                        			;
		                        		
		                        			Gastrointestinal Microbiome
		                        			;
		                        		
		                        			Particulate Matter
		                        			;
		                        		
		                        			RNA, Ribosomal, 16S/genetics*
		                        			;
		                        		
		                        			Female
		                        			
		                        		
		                        	
5.Evaluation of the efficacy and safety of Nocardia rubra cell wall skeleton immunotherapy for cervical high-risk HPV persistent infection.
Fei CHEN ; Wen DI ; Yuan Jing HU ; Chang Zhong LI ; Fei WANG ; Hua DUAN ; Jun LIU ; Shu Zhong YAO ; You Zhong ZHANG ; Rui Xia GUO ; Jian Dong WANG ; Jian Liu WANG ; Yu Quan ZHANG ; Min WANG ; Zhong Qiu LIN ; Jing He LANG
Chinese Journal of Obstetrics and Gynecology 2023;58(7):536-545
		                        		
		                        			
		                        			Objective: To evaluate the efficacy and safety of Nocardia rubra cell wall skeleton (Nr-CWS) in the treatment of persistent cervical high-risk human papillomavirus (HR-HPV) infection. Methods: A randomized, double blind, multi-center trial was conducted. A total of 688 patients with clinically and pathologically confirmed HR-HPV infection of the cervix diagnosed in 13 hispital nationwide were recruited and divided into: (1) patients with simple HR-HPV infection lasting for 12 months or more; (2) patients with cervical intraepithelial neoplasia (CIN) Ⅰ and HR-HPV infection lasting for 12 months or more; (3) patients with the same HR-HPV subtype with no CINⅡ and more lesions after treatment with CINⅡ or CIN Ⅲ (CINⅡ/CIN Ⅲ). All participants were randomly divided into the test group and the control group at a ratio of 2∶1. The test group was locally treated with Nr-CWS freeze-dried powder and the control group was treated with freeze-dried powder without Nr-CWS. The efficacy and negative conversion rate of various subtypes of HR-HPV were evaluated at 1, 4, 8, and 12 months after treatment. The safety indicators of initial diagnosis and treatment were observed. Results: (1) This study included 555 patients with HR-HPV infection in the cervix (included 368 in the test group and 187 in the control group), with an age of (44.1±10.0) years. The baseline characteristics of the two groups of subjects, including age, proportion of Han people, weight, composition of HR-HPV subtypes, and proportion of each subgroup, were compared with no statistically significant differences (all P>0.05). (2) After 12 months of treatment, the effective rates of the test group and the control group were 91.0% (335/368) and 44.9% (84/187), respectively. The difference between the two groups was statistically significant (χ2=142.520, P<0.001). After 12 months of treatment, the negative conversion rates of HPV 16, 18, 52, and 58 infection in the test group were 79.2% (84/106), 73.3% (22/30), 83.1% (54/65), and 77.4% (48/62), respectively. The control group were 21.6% (11/51), 1/9, 35.1% (13/37), and 20.0% (8/40), respectively. The differences between the two groups were statistically significant (all P<0.001). (3) There were no statistically significant differences in vital signs (body weight, body temperature, respiration, pulse rate, systolic blood pressure, diastolic blood pressure, etc.) and laboratory routine indicators (blood cell analysis, urine routine examination) between the test group and the control group before treatment and at 1, 4, 8, and 12 months after treatment (all P>0.05); there was no statistically significant difference in the incidence of adverse reactions related to the investigational drug between the two groups of subjects [8.7% (32/368) vs 8.0% (15/187), respectively; χ2=0.073, P=0.787]. Conclusion: External use of Nr-CWS has good efficacy and safety in the treatment of high-risk HPV persistent infection in the cervix.
		                        		
		                        		
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Cervix Uteri/pathology*
		                        			;
		                        		
		                        			Uterine Cervical Neoplasms/pathology*
		                        			;
		                        		
		                        			Papillomavirus Infections/diagnosis*
		                        			;
		                        		
		                        			Cell Wall Skeleton
		                        			;
		                        		
		                        			Persistent Infection
		                        			;
		                        		
		                        			Powders
		                        			;
		                        		
		                        			Uterine Cervical Dysplasia/pathology*
		                        			;
		                        		
		                        			Immunotherapy
		                        			;
		                        		
		                        			Papillomaviridae
		                        			
		                        		
		                        	
6.Effect of miR-22 Targeting FMNL2 on Cell Migration and Apoptosis in Childhood Acute Myeloid Leukemia.
Jian LIU ; Jiao-Guo ZHANG ; Yin SUN ; Li QIU ; Yong YANG ; Rui YANG ; Ya JIN ; Chang-Mei LI ; Dao-Liang JIANG
Journal of Experimental Hematology 2023;31(6):1617-1623
		                        		
		                        			OBJECTIVE:
		                        			To investigate the effect of miR-22 targeting formin-like protein 2 (FMNL2) on the migration and apoptosis of childhood acute myeloid leukemia (AML) cells.
		                        		
		                        			METHOD:
		                        			Peripheral blood samples from 11 children with AML, 10 children with immune thrombocytopenia, human AML cell lines TF-1a, HL-60, THP-1 and human bone marrow stromal cells HS-5 were used as the research objects. UniCel DxH 800 automatic hematology analyzer detected platelet count, hemoglobin, and white blood cell count in peripheral blood samples, and RT-qPCR detected miR-22 expression in peripheral blood samples and AML cells. HL-60 cells were transfected with LipofectamineTM 2000 kit, the experiments were divided into seven groups: blank (no cells transfected), miR-NC, miR-22 mimics, si-NC, si-FMNL2 , miR-22 mimics+OE-NC and miR-22 mimics+OE-FMNL2 . RT-qPCR was used to detect the expression of miR-22 in each group. Transwell was used to detect cell migration. Flow cytometry was used to detect cell apoptosis. Dual-luciferase reporter gene detection experiments verified the targeting relationship between miR-22 and FMNL2 . Western blot was used to detect the expression of FMNL2 protein.
		                        		
		                        			RESULTS:
		                        			Compared with the control group, the number of leukocytes in the peripheral blood of children with AML was significantly increased (P <0.001), while the concentration of hemoglobin and the number of platelets were significantly decreased P <0.001). The expression level of miR-22 in peripheral blood of children with AML was significantly lower than that in control group (P <0.001). Compared with HS-5 cells, the expression levels of miR-22 in TF-1a, HL-60, and THP-1 cells were significantly decreased (P <0.05), and in HL-60 cells was the lowest. Therefore, HL-60 cells were selected for subsequent experiments. Up-regulation of miR-22 or silencing of FMNL2 could reduce the number of migrating cells and increase apoptosis rate (P <0.05). MiR-22 targeted and negatively regulated the expression of FMNL2 . FMNL2 overexpression reversed the effects of up-regulated miR-22 on migration and apoptosis of HL-60 cells.
		                        		
		                        			CONCLUSION
		                        			MiR-22 can inhibit the migration and promote apoptosis of HL-60 cells by down regulating the expression of FMNL2 .
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			MicroRNAs/metabolism*
		                        			;
		                        		
		                        			Leukemia, Myeloid, Acute/metabolism*
		                        			;
		                        		
		                        			Cell Proliferation
		                        			;
		                        		
		                        			Apoptosis
		                        			;
		                        		
		                        			Myeloproliferative Disorders
		                        			;
		                        		
		                        			Cell Movement
		                        			;
		                        		
		                        			Hemoglobins
		                        			;
		                        		
		                        			Cell Line, Tumor
		                        			;
		                        		
		                        			Formins
		                        			
		                        		
		                        	
7.Changes in percentage of GATA3+ regulatory T cells and their pathogenic roles in allergic rhinitis.
Liu SUN ; Wo Er JIAO ; Yong Kong KONG ; Chang Liang YANG ; Shan XU ; Yue Long QIAO ; Shi Ming CHEN
Journal of Southern Medical University 2023;43(2):280-286
		                        		
		                        			OBJECTIVE:
		                        			To investigate the changes in percentage of GATA3+ regulatory T (Treg) cells in patients with allergic rhinitis (AR) and mouse models.
		                        		
		                        			METHODS:
		                        			The nasal mucosa specimens were obtained from 6 AR patients and 6 control patients for detection of nasal mucosal inflammation. Peripheral blood mononuclear cells (PBMC) were collected from 12 AP patients and 12 control patients to determine the percentages of Treg cells and GATA3+ Treg cells. In a C57BL/6 mouse model of AR, the AR symptom score, peripheral blood OVA-sIgE level, and nasal mucosal inflammation were assessed, and the spleen of mice was collected for detecting the percentages of Treg cells and GATA3+ Treg cells and the expressions of Th2 cytokines.
		                        		
		                        			RESULTS:
		                        			Compared with the control patients, AR patients showed significantly increased eosinophil infiltration and goblet cell proliferation in the nasal mucosa (P < 0.01) and decreased percentages of Treg cells and GATA3+ Treg cells (P < 0.05). The mouse models of AR also had more obvious allergic symptoms, significantly increased OVA-sIgE level in peripheral blood, eosinophil infiltration and goblet cell hyperplasia (P < 0.01), markedly lowered percentages of Treg cells and GATA3+ Treg cells in the spleen (P < 0.01), and increased expressions of IL-4, IL-6 and IL-10 (P < 0.05).
		                        		
		                        			CONCLUSION
		                        			The percentage of GATA3+ Treg cells is decreased in AR patients and mouse models. GATA3+ Treg cells possibly participate in Th2 cell immune response, both of which are involved in the occurrence and progression of AR, suggesting the potential of GATA3+ Treg cells as a new therapeutic target for AR.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Cytokines/metabolism*
		                        			;
		                        		
		                        			Disease Models, Animal
		                        			;
		                        		
		                        			GATA3 Transcription Factor
		                        			;
		                        		
		                        			Inflammation
		                        			;
		                        		
		                        			Leukocytes, Mononuclear/metabolism*
		                        			;
		                        		
		                        			Mice, Inbred BALB C
		                        			;
		                        		
		                        			Mice, Inbred C57BL
		                        			;
		                        		
		                        			Nasal Mucosa/metabolism*
		                        			;
		                        		
		                        			Ovalbumin
		                        			;
		                        		
		                        			Rhinitis, Allergic/therapy*
		                        			;
		                        		
		                        			T-Lymphocytes, Regulatory
		                        			;
		                        		
		                        			Th2 Cells/metabolism*
		                        			;
		                        		
		                        			Humans
		                        			
		                        		
		                        	
8.Utilization and quality assessment of digestive endoscopy in China: results from 5-year consecutive nationwide surveys.
Lei XIN ; Ye GAO ; Zhiyuan CHENG ; Tianjiao WANG ; Han LIN ; Yanan PANG ; Chang SUN ; Zengjun FU ; Zhaoshen LI ; Xudong MA ; Luowei WANG
Chinese Medical Journal 2022;135(16):2003-2010
		                        		
		                        			BACKGROUND:
		                        			Worldwide, the volume and availability of digestive endoscopy have undergone dramatic development in recent years, with increasing attention on quality assurance. We investigated the utilization and quality of digestive endoscopy in China from 2015 to 2019 and developed a quantitative quality evaluation tool for medical institutions.
		                        		
		                        			METHODS:
		                        			We invited all tertiary/secondary hospitals in Chinese mainland to participate in the survey annually. The questionnaires included the personnel, annual volume, and quality indicators of endoscopy. An endoscopy quality index (EQI) was developed based on recorded quality indicators using principal component analysis to determine the relative weight.
		                        		
		                        			RESULTS:
		                        			From 2015 to 2019, 806, 1412, 2644, 2468, and 2541 hospitals were respectively enrolled in this study. The average annual volume of endoscopy increased from 12,445 to 16,206 (1.30-fold) and from 2938 to 4255 (1.45-fold) in tertiary and secondary hospitals, respectively. The most obvious growth was observed in diagnostic colonoscopy (1.44-fold for all hospitals after standardization). The proportion of early cancer among all esophageal and gastric cancers during diagnostic esophagogastroduodenoscopy increased from 12.3% (55,210/448,861) to 17.7% (85,429/482,647) and from 11.4% (69,411/608,866) to 16.9% (107,192/634,235), respectively. The adenoma detection rate of diagnostic colonoscopy increased from 14.9% (2,118,123/14,215,592) to 19.3% (3,943,203/20,431,104). The EQI model included 12 quality indicators, incorporating 64.9% (7.792/12) of the total variance into one comprehensive index. According to the EQI measurements, the quality of endoscopy was higher in tertiary hospitals and hospitals in developed areas with higher volume or more endoscopists than that in other hospitals.
		                        		
		                        			CONCLUSIONS
		                        			Digestive endoscopy in China has developed considerably in recent years in terms of both volume and quality. The EQI is a promising tool to quantify the quality of endoscopy at different hospitals.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Colonoscopy/methods*
		                        			;
		                        		
		                        			Endoscopy, Gastrointestinal
		                        			;
		                        		
		                        			Endoscopy, Digestive System/methods*
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			;
		                        		
		                        			Adenoma
		                        			;
		                        		
		                        			China
		                        			
		                        		
		                        	
9.Genomic Epidemiology of Imported Cases of COVID-19 in Guangdong Province, China, October 2020 - May 2021.
Dan LIANG ; Tao WANG ; Jiao Jiao LI ; Da Wei GUAN ; Guan Ting ZHANG ; Yu Feng LIANG ; An An LI ; Wen Shan HONG ; Li WANG ; Meng Lin CHEN ; Xiao Ling DENG ; Feng Juan CHEN ; Xing Fei PAN ; Hong Ling JIA ; Chun Liang LEI ; Chang Wen KE
Biomedical and Environmental Sciences 2022;35(5):393-401
		                        		
		                        			Objective:
		                        			The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been engendering enormous hazards to the world. We obtained the complete genome sequences of SARS-CoV-2 from imported cases admitted to the Guangzhou Eighth People's Hospital, which was appointed by the Guangdong provincial government to treat coronavirus disease 2019 (COVID-19). The SARS-CoV-2 diversity was analyzed, and the mutation characteristics, time, and regional trend of variant emergence were evaluated.
		                        		
		                        			Methods:
		                        			In total, 177 throat swab samples were obtained from COVID-19 patients (from October 2020 to May 2021). High-throughput sequencing technology was used to detect the viral sequences of patients infected with SARS-CoV-2. Phylogenetic and molecular evolutionary analyses were used to evaluate the mutation characteristics and the time and regional trends of variants.
		                        		
		                        			Results:
		                        			We observed that the imported cases mainly occurred after January 2021, peaking in May 2021, with the highest proportion observed from cases originating from the United States. The main lineages were found in Europe, Africa, and North America, and B.1.1.7 and B.1.351 were the two major sublineages. Sublineage B.1.618 was the Asian lineage (Indian) found in this study, and B.1.1.228 was not included in the lineage list of the Pangolin web. A reasonably high homology was observed among all samples. The total frequency of mutations showed that the open reading frame 1a (ORF1a) protein had the highest mutation density at the nucleotide level, and the D614G mutation in the spike protein was the commonest at the amino acid level. Most importantly, we identified some amino acid mutations in positions S, ORF7b, and ORF9b, and they have neither been reported on the Global Initiative of Sharing All Influenza Data nor published in PubMed among all missense mutations.
		                        		
		                        			Conclusion
		                        			These results suggested the diversity of lineages and sublineages and the high homology at the amino acid level among imported cases infected with SARS-CoV-2 in Guangdong Province, China.
		                        		
		                        		
		                        		
		                        			Amino Acids
		                        			;
		                        		
		                        			COVID-19/epidemiology*
		                        			;
		                        		
		                        			Genomics
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Mutation
		                        			;
		                        		
		                        			Phylogeny
		                        			;
		                        		
		                        			SARS-CoV-2/genetics*
		                        			
		                        		
		                        	
10.Naoxintong Capsule for Secondary Prevention of Ischemic Stroke: A Multicenter, Randomized, and Placebo-Controlled Trial.
Xiao-Fei YU ; Xu-Ying ZHU ; Can-Xing YUAN ; Dan-Hong WU ; Yu-Wu ZHAO ; Jia-Jun YANG ; Chang-de WANG ; Wei-Wen WU ; Xue-Yuan LIU ; Zhen-Guo LIU ; Zhi-Yu NIE ; Ben-Qiang DENG ; Huan BAO ; Long-Xuan LI ; Chun-Yan WANG ; Hong-Zhi ZHANG ; Jing-Si ZHANG ; Ji-Han HUANG ; Fan GONG ; Ming-Zhe WANG ; Yong-Mei GUO ; Yan SUN ; Ding-Fang CAI
Chinese journal of integrative medicine 2022;28(12):1063-1071
		                        		
		                        			OBJECTIVE:
		                        			To examine whether the combination of Naoxintong Capsule with standard care could further reduce the recurrence of ischemic stroke without increasing the risk of severe bleeding.
		                        		
		                        			METHODS:
		                        			A total of 23 Chinese medical centers participated in this trial. Adult patients with a history of ischemic stroke were randomly assigned in a 1:1 ratio using a block design to receive either Naoxintong Capsule (1.2 g orally, twice a day) or placebo in addition to standard care. The primary endpoint was recurrence of ischemic stroke within 2 years. Secondary outcomes included myocardial infarction, death due to recurrent ischemic stroke, and all-cause mortality. The safety of drugs was monitored. Results were analyzed using the intention-to-treat principle.
		                        		
		                        			RESULTS:
		                        			A total of 2,200 patients were enrolled from March 2015 to March 2016, of whom 143 and 158 in the Naoxintong and placebo groups were lost to follow-up, respectively. Compared with the placebo group, the recurrence rate of ischemic stroke within 2 years was significantly lower in the Naoxintong group [6.5% vs. 9.5%, hazard ratio (HR): 0.665, 95% confidence interval (CI): 0.492-0.899, P=0.008]. The two groups showed no significant differences in the secondary outcomes and safety, including rates of severe hemorrhage, cerebral hemorrhage and subarachnoid hemorrhage (P>0.05).
		                        		
		                        			CONCLUSION
		                        			The combination of Naoxintong Capsule with standard care reduced the 2-year stroke recurrence rate in patients with ischemic stroke without increasing the risk of severe hemorrhage in high-risk patients. (Trial registration No. NCT02334969).
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Secondary Prevention/methods*
		                        			;
		                        		
		                        			Ischemic Stroke
		                        			;
		                        		
		                        			Stroke/prevention & control*
		                        			;
		                        		
		                        			Cerebral Hemorrhage/complications*
		                        			;
		                        		
		                        			Double-Blind Method
		                        			;
		                        		
		                        			Platelet Aggregation Inhibitors
		                        			
		                        		
		                        	
            
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