Role and mechanism of angiotensin-converting enzyme 2 in acute lung injury in coronavirus disease 2019

Coronavirus disease 2019 is a major threat to public health globally. Though its pathogenesis has not been fully elucidated, angiotensin-converting enzyme 2 (ACE2) has been recently identified as a receptor for the entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into the cell. Here, we aimed to clarify the potential role of ACE2 in SARS-CoV-2-induced acute lung injury and its underlying mechanism. As a receptor for coronavirus, ACE2 mediates the entry of SARS-CoV-2 into cells in a similar way as for severe acute respiratory syndrome coronavirus (SARS-CoV). The high binding affinity of SARS-CoV-2 to ACE2 correlates with its efficient spread among humans. On the other hand, ACE2 negatively regulates the renin-angiotensin-aldosterone system (RAAS) primarily by converting angiotensin II to angiotensin 1–7, which exerts a beneficial effect on coronavirus-induced acute lung injury. Human recombinant ACE2 has been considered as a potential therapy for SARS-CoV-2 by blocking virus entry and redressing the imbalance of RAAS in SARS-CoV-2 infection. The level of ACE2 expression can be upregulated by treatment with an ACE inhibitor (ACEI) or angiotensin Ⅱ type 1 receptor blocker (ARB). To date, no evidence shows that ACEIs or ARBs increase the susceptibility and mortality of patients infected with SARS-CoV-2, and hence, it is not advisable to discontinue such drugs in patients with cardiovascular disease.     

进展期胃癌术后腹腔热灌注化疗的研究进展

胃癌为临床常见恶性肿瘤之一, 外科手术是其重要治疗方案, 进展期胃癌患者术后5年生存率较低, 而术后癌灶复发成为影响患者预后的重要因素。随着国内医学水平不断发展, 腹腔热灌注化疗技术得以不断改进, 其在进展期胃癌患者术后辅助治疗中的应用日益广泛, 长期临床实践表明预防性运用腹腔热灌注化疗可明显降低进展期胃癌术后复发率并提高其5年生存率, 在改善患者生存质量及总体临床疗效方面的作用明确。本文旨在对中国进展期胃癌术后腹腔热灌注化疗的临床应用进展进行综述。      

Proteomic genotyping of fingermark donors with genetically variant peptides

Proteomic genotyping detects single amino acid polymorphisms to infer the genotype of corresponding non-synonymous SNPs. Like any DNA genotype, these inferences can be used to estimate random match probability. Fingermarks are a common source of biological evidence that is sample limited and a highly variable source of identifying DNA. Genetically variant peptides from fingermarks, that contain single amino acid polymorphisms, are an additional source of identifying genetic information. To discover these peptide biomarkers epidermal corneocytes from 9 subjects were isolated, processed, digested with trypsin and applied to mass spectrometry. The resulting proteomic and matching exome datasets were used to discover, characterize and validate 60 genetically variant peptides. An average of 28.8 ± 4.4 genetically variant peptides were detected from each subject resulting in a total of 264 SNP allele inferences with 260 true and 4 false positives, a false discovery rate of 1.5%. Random match probabilities were estimated using the genotype frequencies from the matching major populations in the 1000 Genomes Project. Estimates ranged up to a value of 1 in 1.7 × 10⁸, with a median probability of 1 in 2.4 × 10⁶. Furthermore, the proteomically-inferred genotypes are likely to be compatible with the STR-based random match probability estimates since the closest STR locus was 2.2 Mb from the nearest GVP-inferred SNP. This project represents a novel mode of genetic information that can be obtained from fingermarks and has the potential to complement other methods of human identification including analysis of ridge patterns or touch DNA.     

Can acupuncture combined with SSRIs improve clinical symptoms and quality of life in patients with depression? Secondary outcomes of a pragmatic randomized controlled trial

ObjectivesTo explore the effects of acupuncture (manual acupuncture or electroacupuncture) combined with SSRIs for moderate to severe depression improving major clinical symptoms and life quality of the patients on secondary outcomes.DesignPragmatic, parallel, randomized controlled trial.Setting6 hospitals in China.Interventions6 weeks of manual acupuncture (MA)+selective serotonin reuptake inhibitors (SSRIs), electroacupuncture (EA)+SSRIs, and SSRIs alone.Main outcome measuresThe primary outcome was response rate of 17-item Hamilton Depression Scale (HAMD-17) total score at 6^th week. The secondary outcomes reported in this analysis were HAMD-17 factor scores at 1^st, 2^nd, 4^th, 6^th, 10^th week and WHO Quality of Life-BREF (WHOQOL-BREF) scores at 6^th week.Results477 patients were randomly assigned into MA + SSRIs (n = 161), EA + SSRIs (n = 160), or SSRIs alone (n = 156) groups. For HAMD-17 (at 6^th week), the MA + SSRIs group was significantly better than the SSRIs alone group in retardation factor (p = 0.008), while the EA+SSRIs group was significantly better than the SSRIs alone group in anxiety/somatization factor (p<0.001) and sleep disturbance factor (p = 0.002). For WHOQOL-BREF (at 6^th week), the EA + SSRIs group, compared with the SSRIs alone group, produced a more significant improvement in the overall quality of life, general health, physical health, and psychological health (p<0.05). While, the MA + SSRIs group, compared to the SSRIs alone group, showed significant advantage only in psychological health (p = 0.023).ConclusionsEither MA or EA combined SSRIs treatment could improve symptoms and quality of life for patients with moderate to severe depression. The main limitation of this trial was not using a sham control therefore the placebo effect could not be excluded.     

奥马珠单抗治疗慢性自发性荨麻疹的疗效及安全性分析

【摘要】 目的 回顾分析奥马珠单抗治疗慢性自发性荨麻疹（CSU）的疗效、安全性及停药复发情况。方法 回顾北京大学第一医院皮肤科门诊2018年2月至2021年1月使用奥马珠单抗治疗的CSU病例，分析其临床特征，采用门诊随访形式，通过荨麻疹控制评分（UCT）、皮肤病生活质量指数（DLQI）评估疾病严重程度，监测不良事件及停药后复发情况。正态分布的计量资料组间比较采用独立样本t检验或方差分析，非正态分布的计量资料组间比较采用Mann-Whitney U检验、Wilcoxon符号秩和检验或Kruskal-Wallis H检验，计数资料组间比较采用卡方检验或Fisher 精确检验。结果 纳入59例CSU患者，奥马珠单抗治疗至少3个月，其中45例治疗达6个月，15例达12个月。经奥马珠单抗治疗，UCT从基线期3.0（1.0，6.0）分上升至第1个月11.0 （3.0，14.0）分和第3个月15.0 （12.0，16.0）分（均P < 0.05）。DLQI从基线期16.0（12.0，20.0）分下降至第1个月7.0 （1.0，13.0）分和第3个月1.0 （0.0，4.0）分（均P < 0.05）。疾病部分或完全控制的比例在基线期为0，第1个月上升至44.1%，第3个月达78.0%，第6个月达88.9%。疾病对生活质量存在重度或极重度影响的比例在基线期为84.7%，第1个月降至30.5%，第3个月降至15.3%，第6个月降至4.4%。对奥马珠单抗治疗完全反应组和部分反应组比无反应组病程更短（t = -2.894，P = 0.011；t = -2.511，P = 0.036）；完全反应组比部分反应组和无反应组治疗时间更长（t = 2.479，P = 0.039；t = 2.677，P = 0.022）。慢反应组与快反应组相比，基线DLQI更高（Z = -2.622，P = 0.009），基线UCT更低（Z = -2.746，P = 0.006）。19例患者病情完全控制后停药，其中13例（68.4%）在停药7（5，8）周后复发，复发后UCT评分高于治疗前（Z = 3.172，P = 0.001），复发组比未复发组病程更长（Z = -2.635，P = 0.007）。复发后5例重新开始奥马珠单抗治疗，均再次得到部分或完全控制。治疗期间报告不良反应事件均为轻中度。结论 奥马珠单抗能够有效控制CSU症状，提高患者生活质量，且安全性较好，但停药后复发率高，复发后重新开始奥马珠单抗治疗仍有效。     

Coexistent light chain deposition disease,light chain cast nephropathy,and vascular light chain amyloidosis in a patient with IgD lambda multiple myeloma

International Urology and Nephrology -     

早产儿的神经发育

随着医学的进步, 早产儿的成活率显著提高。但早产儿的神经发育障碍性疾病的发生率明显高于正常足月新生儿。本文简单总结影响早产儿神经发育的相关危险因素、可能出现的神经发育障碍和综合管理, 旨在提醒家长和临床医生重视早产儿的神经发育和干预。     

《药物分析》课程本科教学改革和思考

目的　分析《药物分析》课程在当今药学本科教育培养过程中的现状，探索《药物分析》课程在新时代药学教育背景下的教学改革与创新，构建符合药学培养要求、满足社会市场需要的复合型药学人才培养模式。方法　第一阶段，开展教学改革的建议和需求调查；第二阶段，开展《药物分析》课程改革探索与实践；第三阶段，教学效果评价。结果　需求调查显示《药物分析》课程的教学内容、课程设计、教学手段亟须进一步优化和拓展。结论　该课程通过调整教学内容、拓展教学手段、创新多元化实践教学、融入"课程思政"建设等，激发了学生的学习兴趣和创新精神，强化了学生理论素养和实践能力，培养了其国际化视野和崇高的职业道德。