Safety and efficacy of oral nemonoxacin versus levofloxacin in treatment of community-acquired pneumonia: A phase 3, multicenter,randomized, double-blind,double-dummy,active-controlled,non-inferiority trial

Background/Purpose

Nemonoxacin is a novel nonfluorinated quinolone with excellent in vitro activity against most pathogens in community-acquired pneumonia (CAP), especially Gram-positive isolates. The purpose of this study was to assess the efficacy and safety of nemonoxacin compared with levofloxacin in patients with CAP.

Penetration moxibustion for postpartum subinvolution of uterus: Two case reports and mechanism analysis: 透灸法成功治疗产后子宫复旧不良:两则病例报告及机制分析

This article introduced the application of penetration moxibustion in successfully treating two cases of postpartum subinvolution of uterus. The main complaint of one case was increasing volume of abnormal vaginal bleeding for five days after delivery. The bleeding stopped after the patient received 7 times treatment of warming needle and penetration moxibustion on Zhōngjí (中极CV3), Guānyuán (关元CV4) and Qìhăi (气海CV6). The other case complained about persistent abdominal pain for 15 days, which was worsening for the recent 2 days. The symptom of abdominal pain was relieved after the penetration moxibustion was applied on CV4, CV6 and Zǐgōng (子宫 EX-CA1) for 5 times for the case. Penetration moxibustion can relieve abdominal pain during the postpartum period, accelerate lochia discharge, and recovery of menstrual and uterine cavity. Àiyè (艾叶 Artemisiae Argyi Folium) was proved to have antibacterial, hemostatic, and analgesic effects. The warming function and radiation features of moxibustion can help to alleviate spasm of the smooth muscle in the uterus and enhance the metabolism of the uterine tissue by expanding microvessels and improving the circulations of both blood and lymph. It can also activate cells in the uterine tissue by increased temperature in order to enhance the decomposition and elimination of pathological wastes, such as inflammation and hematoma. In addition, it can also relieve pelvic pain by inhibiting neuronal excitability.     

Expression pattern of NMDA receptors reveals antiepileptic potential of apigenin 8-C-glucoside and chlorogenic acid in pilocarpine induced epileptic mice

The present study was aimed to evaluate the effect of apigenin 8-C-glucoside (Vitexin) and chlorogenic acid on epileptic mice induced by pilocarpine and explored its possible mechanisms. Intraperitonial administration of pilocarpine (85 mg/kg) induced seizure in mice was assessed by behavior observations, which is significantly (p > 0.05) reduced by apigenin 8-C-glucoside (AP8CG) (10 mg/kg) and chlorogenic acid (CA) (5 mg/kg), similar to diazepam. Seizure was accompanied by an imbalance in the levels of Gamma-aminobutyric acid (GABA) and glutamate in the pilocarpine administered group. Moreover, convulsion along with reduced acetylcholinesterase, increased monoamine oxidase and oxidative stress was observed in epileptic mice brain. AP8CG and CA significantly restored back to normal levels even at lower doses. Further, increased lipid peroxidation and nitrite content was also significantly attenuated by AP8CG and CA. However, CA was found to be more effective when compared to AP8CG. In addition, the mRNA expression of N-methyl-d-aspartate receptor (NMDAR), mGluR1 and mGlu5 was significantly (P ≤ 0.05) inhibited by AP8CG and CA in a lower dose. The mRNA expression of GRIK1 did not differ significantly in any of the group and showed a similar pattern of expression. Our result shows that AP8CG and CA selectively inhibit NMDAR, mGluR1 and mGlu5 expression. Modification in the provoked NMDAR calcium response coupled with neuronal death. Hence, these findings underline that the polyphenolics, AP8CG and CA have exerted antiepileptic and neuroprotective activity by suppressing glutamate receptors.     

达芬奇机器人手术系统辅助与腹腔镜辅助近端胃癌根治性全胃切除+保脾脾门淋巴结清扫的短期疗效研究

目的 探讨达芬奇机器人手术系统辅助对近端胃癌根治性全胃切除+保脾脾门淋巴结清扫的安全性、可行性及短期临床疗效,以明确达芬奇机器人手术系统相较于传统腹腔镜在保脾脾门淋巴结清扫上是否具有优势。方法 回顾性分析2017年1月—2020年12月中国人民解放军联勤保障部队第九四〇医院119例行根治性全胃切除+保脾脾门淋巴结清扫的近端胃癌患者的临床资料。其中,62例行达芬奇机器人手术系统根治性全胃切除+保脾脾门淋巴结清扫（机器人组）,57例行腹腔镜根治性全胃切除+保脾脾门淋巴结清扫（腹腔镜组）。比较两组患者一般资料、术中情况、术后及并发症情况。结果 两组患者年龄、性别构成、BMI、TNM分期、肿瘤直径、pT分期、pN分期、分化程度、病理类型、肿瘤部位等一般资料比较,差异无统计学意义（P>0.05）。机器人组术中出血量少于腹腔镜组（P <0.05）,淋巴结清扫总数和第一站淋巴结数目多于腹腔镜组（P <0.05）,术后首次排气时间早于腹腔镜组（P <0.05）;两组第二站淋巴结数目、脾门淋巴结总数、脾门淋巴结阳性率、手术时间、引流管拔管时间、术后住院时间及术后并发症比较,差异无...     

Rosmarinic acid ameliorates acute liver damage and fibrogenesis in carbon tetrachloride-intoxicated mice

The aim of this study was to investigate the therapeutic potential of rosmarinic acid (RA), a natural phenolic, in the treatment of acute liver toxicity. RA at 10, 25 and 50 mg/kg was administered by gavage once daily for 2 consecutive days, 6 h after CCl₄ intoxication. CCl₄ intoxication caused hepatic necrosis and increased serum ALT activity. In the livers, oxidative/nitrosative stress was evidenced by increased 3-nitrotyrosine (3-NT) and thiobarbituric acid reactive substances (TBARS) formation and a significant decrease in Cu/Zn superoxide dismutase (SOD) activity. CCl₄ administration triggered inflammatory response in mice livers by activating nuclear factor-kappaB (NF-κB), which coincided with the induction of tumor necrosis factor-alpha (TNF-α) and cyclooxygenase-2 (COX-2). RA improved histological and serum markers of liver damage and significantly ameliorated oxidative/nitrosative stress and inflammatory response in liver tissue. Additionally, RA prevented transforming growth factor-beta1 (TGF-β1) and alpha-smooth muscle actin (α-SMA) expression, suggesting suppression of profibrotic response. Furthermore, RA significantly inhibited the CCl₄-induced apoptosis, which was evident from decreased cleavage of caspase-3. The hepatoprotective activity of RA coincided with enhanced NF-E2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) expression. The results of this study indicates that RA possesses antioxidant, anti-inflammatory, antiapoptotic and antifibrotic activity against acute liver toxicity.     

短链脂肪酸在肿瘤免疫治疗中的作用及机制研究进展

免疫治疗的临床应用显著提高了肿瘤患者的生存率,其机制除了其本身具有增强免疫细胞介导的抗肿瘤反应外,肠道微生物及其代谢产物的变化也发挥着重要作用。短链脂肪酸是结肠中细菌发酵未被小肠吸收的碳水化合物的主要产物,有研究表明短链脂肪酸具有免疫调节功能,可以影响肿瘤对免疫检查点抑制剂的应答。本文就近年来短链脂肪酸在肿瘤的免疫治疗过程中发挥作用的研究进展进行综述。     

Secondary Heterotypic Versus Homotypic Infection by Coxsackie B Group Viruses: Impact on Early and Late Histopathological Lesions and Virus Genome Prominence

The impact of prior exposure to a different or identical strain of Coxsackievirus B (CVB) on murine CVB myocarditis was studied using a susceptible murine host (A/J[H-2 ^a]) and myocarditic CVB3 or avirulent CVB2 as primary or secondary infectants. The effects of secondary heterotypic infection (CVB2 followed by CVB3) and homotypic infection (CVB3 followed by CVB3) 28 days after primary inoculation, versus CVB2 or CVB3 alone, on injury and viral genomic replication, both early (day 7) and late (days 28 and 56), were evaluated. After the primary infection by CVB2, trivial viral RNA was present in the heart and other organs, and a substantial positivity was observed with CVB3 infection. Seven days after secondary heterotypic (CVB2-CVB3) infection, the quantity of CVB genome in heart, pancreas, liver, and spleen was increased compared with the virus genome in the CVB3-CVB3 group and in the group with primary CVB3 infection alone. This phenomenon was seen in the heart and spleen up to day 28 postsecondary infection. Tissue inflammation and necrosis in heart and pancreas were prominent 7 days postsecondary infection with CVB2-CVB3 and correlated well with an increased quantity of CVB genome. Virus genome was present in heart and spleen 28 days after CVB3 infection alone. Serum CVB3 neutralization titer was increased to 1:128 in CVB2-CVB3 group at days 7 and 28 postsecondary infection, and serum completely neutralized cytopathological effects of CVB3 in the CVB3-CVB3 group at day 7 and 28 postsecondary infection. Our results indicate that secondary heterotypic infection by CVB causes increased injury, inflammation, and CVB replication in target organs such as the heart and pancreas, as well as in immune compartments like the spleen. Compared with CVB3 alone, the intense inflammatory infiltrate in the CVB2-CVB3 group is as not due solely to postviral sensitization of the immune system, but rather to the inability of the host to eradicate the virus.     

不可逆电穿孔术联合新辅助化疗治疗局部进展期胰腺癌安全性和有效性的Meta分析

目的 评估不可逆电穿孔术（IRE）联合新辅助化疗治疗局部进展期胰腺癌患者的安全性和有效性。方法 检索PubMed、Embase、Cochrane Library、Web of Science、中国生物医学文献数据库、知网、万方和维普等数据库从建库至2022年3月发表的相关文献。采用RevMan5.4软件进行Meta分析。结果 最终纳入8项研究,其中随机对照试验1项、回顾性研究4项和前瞻性研究3项。共3 970例局部进展期胰腺癌患者,其中联合组344例,单纯化疗组3 626例。Meta分析显示联合组患者的总生存期明显高于单纯化疗组（OR=4.52, 95%CI: 2.63~7.77, P<0.00001）。但是联合组和单纯化疗组患者的疾病控制率差异无统计学意义（OR=0.58, 95%CI: 0.02~18.74, P=0.76）,疾病进展两组差异无统计学意义（OR=0.49, 95%CI: 0.23~1.02, P=0.06）。新辅助化疗联合IRE对患者治疗期间胃肠道反应（OR=0.37, 95%CI: 0.10~1.34, P=0.13）和骨髓抑制（OR=0.61, 95%CI: 0.26~1.40, P=0.24）等不良反应的发生率并无明显影响。结论 不可逆电穿孔术联合新辅助化疗可以显著改善局部进展期胰腺癌患者的预后,明显提高患者的总生存时间。