Ammonium detoxification mechanism of ammonium-tolerant duckweed (Landoltia punctata) revealed by carbon and nitrogen metabolism under ammonium stress

In this work, the ammonium-tolerant duckweed Landoltia punctata 0202 was used to study the effect of ammonium stress on carbon and nitrogen metabolism and elucidate the detoxification mechanism. The growth status, protein and starch content, and activity of nitrogen assimilation enzymes were determined, and the transcriptional levels of genes involved in ion transport and carbon and nitrogen metabolism were investigated. Under high ammonium stress, the duckweed growth was inhibited, especially when ammonium was the sole nitrogen source. Ammonium might mainly enter cells via low-affinity transporters. The stimulation of potassium transport genes suggested sufficient potassium acquisition, precluding cation deficiency. In addition, the up-regulation of ammonium assimilation and transamination indicated that excess ammonium could be incorporated into organic nitrogen. Furthermore, the starch content increased from 3.97% to 16.43% and 26.02% in the mixed-nitrogen and ammonium-nitrogen groups, respectively. And the up-regulated starch synthesis, degradation, and glycolysis processes indicated that the accumulated starch could provide sufficient carbon skeletons for excess ammonium assimilation. The findings of this study illustrated that the coordination of carbon and nitrogen metabolism played a vital role in the ammonium detoxification mechanism of duckweeds.

Thirteen bisbenzylisoquinoline alkaloids in five Chinese medicinal plants: Botany, traditional uses, phytochemistry, pharmacokinetic and toxicity studies

RELEVANCE

Bisbenzylisoquinoline (BBIQ) alkaloids are generally present in plants of Berberidaceae, Monimiaceae and Ranunculaceae families in tropical and subtropical regions. Some species of these families are used in traditional Chinese medicine, with the effects of clearing away heat and detoxification, promoting dampness and defecation, and eliminating sores and swelling. This article offers essential data focusing on 13 representative BBIQ compounds, which are mainly extracted from five plants. The respective botany, traditional uses, phytochemistry, pharmacokinetics, and toxicity are summarized comprehensively. In addition, the ADME prediction of the 13 BBIQ alkaloids is compared and analyzed with the data obtained.

MATERIALS AND METHODS

We have conducted a systematic review of the botanical characteristics, traditional uses, phytochemistry, pharmacokinetics and toxicity of BBIQ alkaloids based on literatures collected from PubMed, Web of Science and Elsevier during 1999-2020. ACD/Percepta software was utilized to predict the pharmacokinetic parameters of BBIQ alkaloids and their affinity with enzymes and transporters.

RESULTS

Botany, traditional uses, phytochemistry, pharmacokinetic and toxicity of 13 alkaloids, namely, tetrandrine, dauricine, curine, trilobine, isotrilobine, cepharanthine, daurisoline, thalicarpine, thalidasine, isotetrandrine, liensinine, neferine and isoliensinine, have been summarized in this paper. It can't be denied that these alkaloids are important material basis of pharmacological effects of family Menispermaceae and others, and for traditional and local uses which has been basically reproduced in the current studies. The 13 BBIQ alkaloids in this paper showed strong affinity and inhibitory effect on P-glycoprotein (P-gp), with poor oral absorption and potent binding ability with plasma protein. BBIQ alkaloids represented by tetrandrine play a key role in regulating P-gp or reversing multidrug resistance (MDR) in a variety of tumors. The irrationality of their usage could pose a risk of poisoning in vivo, including renal and liver toxicity, which are related to the formation of quinone methide during metabolism.

CONCLUSION

Although there is no further clinical evaluation of BBIQ alkaloids as MDR reversal agents, their effects on P-gp should not be ignored. Considering their diverse distribution, pharmacokinetic characteristics and toxicity reported during clinical therapy, the quality standards in different plant species and the drug dosage remain unresolved problems.

Metagenomic analysis of a keratin-degrading bacterial consortium provides insight into the keratinolytic mechanisms

Keratin is an insoluble fibrous protein from natural environments, which can be recycled to value-added products by keratinolytic microorganisms. A microbial consortium with efficient keratinolytic activity was previously enriched from soil, but the genetic basis behind its remarkable degradation properties was not investigated yet. To identify the metabolic pathways involved in keratinolysis and clarify the observed synergy among community members, shotgun metagenomic sequencing was performed to reconstruct metagenome-assembled genomes. More than 90% genera of the enriched bacterial consortium were affiliated to Chryseobacterium, Stenotrophomonas, and Pseudomonas. Metabolic potential and putative keratinases were predicted from the metagenomic annotation, providing the genetic basis of keratin degradation. Furthermore, metabolic pathways associated with keratinolytic processes such as amino acid metabolism, disulfide reduction and urea cycle were investigated from seven high-quality metagenome-assembled genomes, revealing the potential metabolic cooperation related to keratin degradation. This knowledge deepens the understanding of microbial keratinolytic mechanisms at play in a complex community, pinpointing the significance of synergistic interactions, which could be further used to optimize industrial keratin degradation processes.

Advances in Aptamer-Based Biomarker Discovery

The discovery and identification of biomarkers promote the rational and fast development of medical diagnosis and therapeutics. Clinically, the application of ideal biomarkers still is limited due to the suboptimal technology in biomarker discovery. Aptamers are single-stranded deoxyribonucleic acid or ribonucleic acid molecules and can selectively bind to varied targets with high affinity and specificity. Compared with antibody, aptamers have desirable advantages, such as flexible design, easy synthesis and convenient modification with different functional groups. Currently, different aptamer-based technologies have been developed to facilitate biomarker discovery, especially CELL-SELEX and SOMAScan technology. CELL-SELEX technology is mainly used to identify cell membrane surface biomarkers of various cells. SOMAScan technology is an unbiased biomarker detection method that can analyze numerous and even thousands of proteins in complex biological samples at the same time. It has now become a large-scale multi-protein biomarker discovery platform. In this review, we introduce the aptamer-based biomarker discovery technologies, and summarize and highlight the discovered emerging biomarkers recently in several diseases.

Leptin Receptor (LEPR) promotes proliferation, migration, and invasion and inhibits apoptosis in hepatocellular carcinoma by regulating ANXA7

Background

Leptin Receptor (LEPR) has been suggested to have several roles in cancer metastasis. However, the role of LEPR and its underlying mechanisms in lymphatic metastasis of hepatocarcinoma have not yet been studied.

Methods

We performed bioinformatics analysis, qRT-PCR, western blotting, immunohistochemistry, immunofluorescence, enzyme-linked immunosorbent, coimmunoprecipitation assays and a series of functional assays to investigate the roles of LEPR in hepatocellular carcinoma.

Results

We discovered that LEPR was highly expressed in liver cancer tissues, and the expression of LEPR in Hca-F cells was higher than that in Hca-P cells. Furthermore, LEPR promotes the proliferation, migration and invasion and inhibits the apoptosis of hepatocarcinoma lymphatic metastatic cells. Further studies indicated that LEPR interacts with ANXA7. Mechanistically, LEPR regulated ERK1/2 and JAK2/STAT3 expression via ANXA7 regulation.

Conclusions

These findings unveiled a previously unappreciated role of LEPR in the regulation of lymphatic metastatic hepatocellular carcinoma, assigning ANXA7-LEPR as a promising therapeutic target for liver cancer treatments.

Theoretical insight into the CdS/FAPbI3 heterostructure: a promising visible-light absorber

The optical absorption performance of the perovskite FAPbI₃ in the visible-light range is significantly improved by constructing a CdS/FAPbI₃ heterostructure.

Strain engineering the electronic and photocatalytic properties of WS2/blue phosphene van der Waals heterostructures

The effects of −8–8% in-plane uniaxial and biaxial strains on the electronic and photocatalytic activity of tungsten disulfide/blue phosphene (WS₂/BlueP) are investigated within the framework of first-principles calculations.

Lead-free perovskite compounds CsSn1-xGexI3-yBry explored for superior visible-light absorption

Hybrid perovskites are favoured over other numerous optoelectronic materials, thanks to their rapidly enhanced power conversion efficiency (PCE) and facile processing. At present, future developments are seriously hampered by the high toxicity of heavy metals and poor stability. Inorganic lead-free perovskites, CsSn1-xGexI3-yBry, are herein explored for superior optical performance by first-principles calculations based on density functional theory (DFT). It is unveiled that the valence band maximum (VBM) is mainly occupied by the p-orbit of halide ions, while the conduction band minimum (CBM) is composed of the p-orbit of the metal ion. Moreover, Bader charge analysis shows that CsSn0.5Ge0.5I3 corresponds to the most obvious charge transfer compared to the others. The defect formation energy indicates that perovskite compounds CsSn1-xGexI3-yBry, are more easily synthesized than the series CsSn1-xGexI3, and the physically accessible area is also determined in the coordinate system defined by the chemical potential change of the host atoms, ΔμSn and ΔμI. Additionally, the absorption spectra show that among the doped compounds of the form CsSn0.5Ge0.5I3-yBry, perovskite CsSn0.5Ge0.5I2Br is superior in terms of optical response in the visible-light range. The results shed a new light on the study of highly efficient and stable lead-free perovskite-based solar cells (PSCs).

[Epidemiological characteristics of COVID-19 in Wuchang district of Wuhan]

Objective: To analyzes epidemiological characteristics of COVID-19 and provide evidence for adjustment for COVID-19 prevention and control strategies. Methods: The data of COVID-19 cases in Wuchang district reported as of 19 March, 2020 were obtained from National Notifiable Disease Report System of Chinese Disease Prevention and Control Information System. The software's of Excel 2010, SPSSS 22.0, Arc GIS10.2 and Joinpoint regression program 4.8.0.0 were used for statistical analysis. Results: A total of 7547 COVID-19 cases had been reported as of 19 March, 2020 in Wuchang district, including 5 448 confirmed cases (72.19%), 2009 clinical diagnosed cases (26.62%) and 90 asymptomatic cases case (1.19%). The age of the cases was (56.65±16.25) years and age ranged from 2 days to 105 years among confirmed cases, 2634 were males (48.35%) and 2814 were females (51.65%), 2 492 were retirees (45.74%). A total of 545 health workers were infected with SARS-CoV-2 (7.22% of all cases) including 365 confirmed cases and 5 cases have died. A total of 430 cases of death were reported with case fatality rate of 7.89% (430/5 448), case fatality rate of males (10.9%, 266/2 634) was higher than that of females (5.82%, 164/2 814). The first phase of epidemic peak was from January 24 to January 26, the second phase of epidemic peak was from February 1 to February 5 and there was no one of new confirmed case in one day for the first time on March 18. The first four Streets with the highest incidence rates of confirmed cases were Huanghelou Street (1 043.77/100 000), Ziyang Street (627.97/100 000), Yangyuan Street (503.67/100 000) and Shuiguohu Street (486.02/100 000). Compared with females, aged ≤50 years and mild cases of clinical classification respectively, males (RR=0.690, 95%CI: 0.322-1.478), aged >50 years (RR=11.745, 95%CI: 6.878-20.058), severe cases (RR=2.317, 95%CI: 1.789-3.000) and critical cases of clinical classification (RR=10.794, 95%CI: 7.997-14.569), and gender time-dependent covariate (RR=1.392, 95%CI: 1.053-1.840) were major influencing factors of prognosis of COVID-19 confirmed cases. Conclusions: The gender, ages and occupation of distribution were wide among COVID-19 cases in Wuchang district. Males, aged >50 years, severe cases and critical cases of clinical classification were influencing factors of prognosis of COVID-19 confirmed cases. The standardized management of discharged cases, asymptomatic infected cases and close contact persons were main measures to reduce incidence rates of COVID-19 cases.

Structure-Based Reactivity Profiles of Reactive Metabolites with Glutathione

Therapeutic agents can be transformed into reactive metabolites under the action of various metabolic enzymes in vivo and then covalently combine with biological macromolecules (such as protein or DNA), resulting in increasing toxicity. The screening of reactive metabolites in drug discovery and development stages and monitoring of biotransformation in post-market drugs has become an important research field. Generally, reactive metabolites are electrophilic and can be captured by small nucleophiles. Glutathione (GSH) is a small peptide composed of three amino acids (i.e., glutamic acid, cysteine, and glycine). It has a thiol group which can react with electrophilic groups of reactive metabolic intermediates (such as benzoquinone, N-acetyl-p-benzoquinoneimine, and Michael acceptor) to form a stable binding conjugate. This paper aims to provide a review on structure-based reactivity profiles of reactive metabolites with GSH. Furthermore, this review also reveals the relationship between drugs' molecular structures and reactive metabolic toxicity from the perspective of metabolism, giving a reference for drug design and development.

Novel keratinolytic enzymes, discovered from a talented and efficient bacterial keratin degrader

Huge quantities of keratinaceous waste are a substantial and almost totally unexploited protein resource which could be upgraded for use as high value-added products by efficient keratinolytic enzymes. In this study, we found that Bacillus sp. 8A6 can efficiently degrade chicken feather after 24 h growth. According to phylogenetic analysis, the strain (formerly identified as Bacillus pumilus 8A6) belongs to the B. pumilus species clade but it is more closely related to B. safensis. Hotpep predicted 233 putative proteases from Bacillus sp. 8A6 genome. Proteomic analysis of culture broths from Bacillus sp. 8A6 cultured on chicken feathers or on a mixture of bristles and hooves showed high abundance of proteins with functions related to peptidase activity. Five proteases (one from family M12, one from family S01A, two from family S08A and one from family T3) and four oligopeptide and dipeptide binding proteins were highly expressed when Bacillus sp. 8A6 was grown in keratin media compared to LB medium. This study is the first to report that bacterial proteases in families M12, S01A and T3 are involved in keratin degradation together with proteases from family S08.

[Novel compound heterozygous LoF mutations in SRD5A2 may result in disorders of sex development]

Objective: To investigate the novel genetic cause associated with hypospadias and the strategy for preventing offspring genetic defects in these patients. Methods: In March 2019, a patient with gonadal dysplasia (hypospadias associated with cryptorchidism) was referred to Shanghai General Hospital. His secondary sex characters, level of sex hormones and the development of male reproductive system was assessed through physical examination, sex hormone examination, male reproductive system B-ultrasound and computed tomography (CT). Whole-exome sequencing (WES) was preformed to investigate the pathogenic genetic variations associated with hypospadias and cryptorchidism. Also, Sanger sequencing was conducted to verify the WES results in the pedigree. Semen analysis was used to assess the fertility of the proband and the SRD5A2 gene analysis of his spouse was performed to assess the risk of genetic defects in the offspring. Results: The patient suffered from gonadal dysplasia (hypospadias associated with cryptorchidism). Physical examination showed an inverted triangular distribution of pubic hair, small penis and the volume of the testis was 8 ml. Sex hormone examination revealed the level of FSH, LH, Pituitary prolactin (PRL), estrogen (E(2)), testosterone (T), and sex hormone-binding globulin (SHBG) was 25.81 U/L, 10.84 U/L, 21.09 μg/L, 153 pmol/L, 16.95 nmol/L, and 36.15 nmol/L respectively. B-ultrasound and computed tomography (CT) showed left inguinal testis. Also, semen analysis illustrated that the volume was 0.05 ml and sperm concentration<2×10(6)/ml, suggesting oligospermia in this case. WES sequencing and Sanger sequencing showed compound heterozygous LoF mutations in SRD5A2 [NM_000348.3:C.679C>T(p.Arg227Ter) and NM_000348.3:C.16C>T(p.Gln6Ter)] in this patient. And there were no pathogenic genetic variations of SRD5A2 in the spouse. Conclusion: Novel compound heterozygous LoF mutations in SRD5A2[NM_000348.3:C.679C>T(p.Arg227Ter) and NM_000348.3:C.16C>T(p.Gln6Ter)] may be the primary cause of disorders of sex development.

[Efficacy and safety of low-intensity pulsed ultrasound at different intervals by mechanical force in treating erectile dysfunction: a preliminary study]

Objective: To study the efficacy and safety of low-intensity pulsed ultrasound (LIPUS) at different intervals by mechanical force in treating erectile dysfunction (ED). Method: Forty patients with mild to moderate ED were randomized in a 1∶1 ratio to receive 16-treatment sessions of LIPUS in group A and group B, applied 3 times per week and 2 times per week, respectively. End-point assessments were made at 8th week after treatment. Efficacy were evaluated using International Index of Erectile Function-Erectile Function domain score (IIEF-EF), Erectile Hardness Score (EHS), Self-Esteem and Relationship Questionnaire (SEAR), Sexual Encounter Profile (SEP), Global Assessment Question (GAQ), and pain were assessed by Visual Analogue Score (VAS).Treatment response was confirmed by a minimal clinically importance difference (MCID) at 8th week. Results: Compared with baseline, IIEF-EF score [(17.1±5.48 vs 23.4±3.75, P<0.05) and (18.9±4.34 vs 24.1±4.32, P<0.05)], proportion of EHS 4 [(0 vs 40%, P<0.05) and (16.7% vs 55.6%, P<0.05)], and Overall Relationship score [(50.6 vs 67.5, P<0.05) and (44.4 vs 70.1, P<0.05)] were significantly improved at 8th week in two groups, respectively. Compared with baseline, the positive responses to SEP-3 increased significantly at 8th week in two groups (50.0% vs 80.0%,P<0.05) and (44.4% vs 88.9%, P<0.05), respectively. The positive responses to GAQ-2 were 90.0% and 88.9% at 8th week in two groups, respectively. There were no significant differences in IIEF-EF, EHS, SEAR, SEP and GAQ at 8th week between two groups. There was no significant difference in treatment response using MCID between two groups at end-point (80.5% vs 77.5%). The treatment duration for full sessions were 2.5 weeks less in group A than group B. No adverse effects were reported in all cases. Conclusion: LIPUS at two different intervals is effective and safe for mild to moderate ED, and the regimen at 3 times per week can achieve quite good effect in relatively short duration,while the long-term effects is still be clarified in further study.

Core Outcome Set for Clinical Trials on Coronavirus Disease 2019 (COS-COVID)

Since its outbreak in December 2019, a series of clinical trials on coronavirus disease 2019 (COVID-19) have been registered or carried out. However, the significant heterogeneity and less critical outcomes of such trials may be leading to a waste of research resources. This study aimed to develop a core outcome set (COS) for clinical trials on COVID-19 in order to tackle the outcome issues. The study was conducted according to the Core Outcome Measures in Effectiveness Trials (COMET) Handbook: Version 1.0, a guideline for COS development. A research group was set up that included experts in respiratory and critical medicine, traditional Chinese medicine (TCM), evidence-based medicine, clinical pharmacology, and statistics, in addition to medical journal editors. Clinical trial registry websites (www.chictr.org.cn and clinicaltrials.gov) were searched to retrieve clinical trial protocols and outcomes in order to form an outcome pool. A total of 78 clinical trial protocols on COVID-19 were included and 259 outcomes were collected. After standardization, 132 outcomes were identified within seven different categories, of which 58 were selected to develop a preliminary outcome list for further consensus. After two rounds of Delphi survey and one consensus meeting, the most important outcomes for the different clinical classifications of COVID-19 were identified and determined to constitute the COS for clinical trials on COVID-19 (COS-COVID). The COS-COVID includes one outcome for the mild type (time to 2019 novel coronavirus (2019-nCoV) reverse transcription-polymerase chain reaction (RT-PCR) negativity), four outcomes for the ordinary type (length of hospital stay, composite events, score of clinical symptoms, and time to 2019-nCoV RT-PCR negativity), five outcomes for the severe type (composite events, length of hospital stay, arterial oxygen partial pressure (PaO₂)/fraction of inspired oxygen (FiO₂), duration of mechanical ventilation, and time to 2019-nCoV RT-PCR negativity), one outcome for critical type (all-cause mortality), and one outcome for rehabilitation period (pulmonary function). The COS-COVID is currently the most valuable and practical clinical outcome set for the evaluation of intervention effect, and is useful for evidence assessment and decision-making. With a deepening understanding of COVID-19 and application feedback, the COS-COVID should be continuously updated.

Prognostic roles of miR-124-3p and its target ANXA7 and their effects on cell migration and invasion in hepatocellular carcinoma

Recent studies have indicated that ANXA7 promotes progression and metastasis of hepatocellular carcinoma (HCC). In this study we found a significant negative correlation between the levels of miR-124-3p and ANXA7 protein in HCC. Level of miR-124-3p in tumor tissues was negatively correlated, while ANXA7 protein was positively correlated, with TNM stage and tumor metastasis. Furthermore, we confirmed ANXA7 was a target gene of miR-124-3p by a dual luciferase reporter assay. In vitro, up-regulation of miR-124-3p promotes apoptosis and inhibits migration and invasion of Hca-F. Bcl-2 correlates X protein (Bax) protein level was up-regulated, while ANXA7, B-cell lymphoma-2 (Bcl-2), Matrix metalloproteinase (MMP-9) and C-X-C motif chemokine 12 (CXCL12) protein levels were suppressed relative to miR-124-3p over-expression. In vivo, up-regulation of miR-124-3p suppresses lymph node metastasis (LNM) and tumorigenicity of Hca-F cells. The expression of ANXA7, MMP-9, and CXCL12 protein in transplanted tumors was suppressed relative to miR-124-3p overexpression. In addition, we found the levels of Bcl-2, MMP-9, and CXCL12 in Hca-F cells decreased significantly after transfection of shRNA-Anxa7 in vitro. In conclusion, our study revealed miR-124-3p inhibits tumor growth, invasion, and lymphatic metastasis in HCC by down-regulation of ANXA7 gene, thereby reducing the expression of Bcl-2, MMP-9, and CXCL12.

Thermoelectric Properties of NiCl3 Monolayer: A First-Principles-Based Transport Study

By employing the first-principles-based transport theory, we investigate the thermoelectric performance based on the structural and electronic properties of NiCl 3 monolayer. The NiCl 3 monolayer is confirmed to be a stable Dirac spin gapless semiconductor with the linear energy dispersion having almost massless carrier, high carrier mobility and fully spin-polarization. Further, NiCl 3 monolayer processes the optimum power factor of 4.97 mWm - 1 K - 2 , the lattice thermal conductivity of 1.89 Wm - 1 K - 1 , and the dimensionless figure of merit of 0.44 at room temperature under reasonable carrier concentration, indicating that NiCl 3 monolayer may be a potential matrix for promising thermoelectrics.

Stability and Sensing Enhancement by Nanocubic CeO2 with {100} Polar Facets on Graphene for NO2 at Room Temperature

Metal oxides with a polar surface interact strongly with polar NO₂ molecules, thus facilitating sensitive detection of NO₂. In this work, the composites comprising graphene and cubic CeO₂ nanoparticles with the {100} polar surface are prepared by a hydrothermal technique, and they exhibit fast response, excellent selectivity, stable recovery, and sensitive detection with a low detection limitation of 1 ppm for NO₂ at room temperature. According to the first-principle calculations, the adsorption energy of NO₂ on the CeO₂{100} polar surface is the most negative corresponding to the strongest interactions between them. The formation energy of oxygen vacancies (O_v) on the {100} polar plane is also negative, and the abundant O_v facilitates the adsorption of NO₂. The internal electric field near the polar surface promotes the charge separation and accelerates the charge exchange between NO₂ and the composites. In addition, graphene promotes electron transfer at the interface and improves the stability of the CeO₂{100} polar surface. The composites of graphene and metal oxides with a polar surface are excellent for NO₂ detection, and the discovery reveals a new sensing strategy.

[Philology research on the quoting from Compendium of Effective Prescriptions for Women in Korean Euibangyoochui]

Euibangyoochui compiled by the Korean government was finished in 1445. This book is a collection of Korean medicine. It quoted some contents from Compendium of Effective Prescriptions for Women. This paper use the photocopy of the Japanese edition of the first year of Fumihisa(1861)printed in Korea as the master copy of Euibangyoochui, the microfilm of the edition of Qin You Shu Tang in Yuan Dynasty as the master copy of Compendium of Effective Prescriptions for Women, in order to compare the content of Compendium of Effective Prescriptions for Women quoted in Euibangyoochui. There are 42 direct citations from Compendium of Effective Prescriptions for Women in Euibangyoochui, 41 of which are in gynecology, and 1 of which is in pediatrics. The indirect citations are divided into two types: single line big characters and double line small characters, no obvious rules. Meanwhile, it is found that the direct quotation is adjusted according to the style and content, and the differences between the quotation and the yuan edition are mostly small, which can be corrected and supplemented each other, it is of great reference value for collating the Compendium of Effective Prescriptions for Women.

Azithromycin as an add-on treatment for persistent uncontrolled asthma in adults: protocol of a systematic review and meta-analysis

INTRODUCTION

Clinical management of asthma remains a public challenge. Despite standard treatment with inhaled corticosteroids (ICS) and long-acting beta-agonists (LABAs), asthma remains uncontrolled in a substantial number of chronic asthma patients who risk reduced lung function and severe exacerbations. Azithromycin could have add-on effects for these patients. This study is proposed to systematically evaluate the efficacy of azithromycin as an add-on treatment for adults with persistent uncontrolled symptomatic asthma.

METHODS AND ANALYSIS

Two reviewers will perform a comprehensive search of PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and four Chinese electronic databases including China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), WanFang Data and VIP Database from inception to May 2019. Only randomised controlled trials will be included. There is no restriction on language or publication status. Combined oral azithromycin and an ICS or/and a LABA will be compared with standard treatment alone or with a placebo. The primary outcomes are the number or frequency of asthma exacerbations, changes in asthma symptoms and lung function. Secondary outcomes include the number or frequency of inhalations of beta-agonists with or without corticosteroids for rescue use, eosinophil counts in blood or sputum, adverse events and others. A meta-analysis will be attempted to provide an estimate of the pooled treatment effect. Otherwise, qualitative descriptions of individual studies will be given.

ETHICS AND DISSEMINATION

Ethical approval is not required because no primary data will be collected. Study findings will be presented at scientific conferences or published in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42019117272.

[Clinical characteristics and analysis of prognostic factors of 222 patients diagnosed with Hodgkin's lymphoma]

Objective: To analyze the clinical characteristics and prognostic factors of patients with Hodgkin's lymphoma(HL). Methods: The clinical data of HL patients who were newly treated in Guizhou Cancer Hospital from August 2007 to March 2019 was retrospectively collected, and the efficacy and prognostic factors were analyzed. Results: The clinical data of a total of 222 patients were analyzed in this study. The 5-year progression-free survival (PFS) and overall survival (OS)rate of them were 82.8% and 81.3%, respectively. The 5-year PFS rate and OS rate of early (stage Ⅰ-Ⅱ) HL were 87.3% and 86.1%, respectively, and the 5-year PFS rate and OS rate of progressive (stage Ⅲ-Ⅳ) HL were 77.9% and 76.3%, respectively. Among the 118 patients with early Hodgkin's lymphoma, the complete remission(CR) rate of chemotherapy alone was 55.6%(15/27), and chemotherapy plus radiotherapy was 86.8% (79/91), the difference between which was statistically significant (P<0.05). Compared with chemotherapy plus radiotherapy in early stage patients, 5-year PFS (93.0%) and 5-year OS (92.0%) rate in patients with chemotherapy plus radiotherapy were better than those with chemotherapy alone which were 63.7% and 62.1%, respectively. Multivariate analysis showed that age, LDH, ABVD cycle number and chemoradiotherapy were independent prognostic factors for 5-year OS and PFS rate in HL patients. The adverse reactions were increased level Ⅰ-Ⅱ aminotransferase with an incidence of 47.7% (106/222), decreased level Ⅰ-Ⅱ neutrophils with an absolute value of 54.1% (120/222), and decreased level Ⅲ-Ⅳ neutrophils with an absolute value of 45.9% (102/222). No adverse cardiac and pulmonary reactions or secondary tumors associated with chemotherapy was found in all patients. Conclusions: HL is a type of malignant tumor with good prognosis, and the short-term and long-term efficacy of chemotherapy combined with radiotherapy in early patients is better than that of chemotherapy alone. Age, LDH, ABVD cycle number and chemoradiotherapy are associated with prognosis in patients with Hodgkin's lymphoma. Adverse reactions can be tolerated.

[Correlation between multi-slice spiral CT determined epicardial adipose tissue volume and atrial fibrillation]

Objective: To determine the relationship between volume of epicardial adipose tissue (EAT) and atrial fibrillation (AF) . Methods: A total of 207 patients who hospitalized in the Department of Cardiology, Nantong University Affiliated Hospital from January 2016 to June 2018 were included in this study. They were divided into two groups, including AF group (n=125) and sinus rhythm group (n=82). The AF group included 80 paroxysmal AF (PAF) and 45 persistent AF (PeAF) patients. Total EAT and left atrial EAT (LA-EAT) volume were measured using 256 rows of multi-slice spiral CT in all patients. Echocardiographic derived left ventricular ejection fraction (LVEF) and left atrial diameter (LAD) were analyzed. Hospholipase A2 and blood lipids were examined in all patients. The baseline data and EAT volume of all groups were compared. The multivariate logistic regression was used to analyze the risk factors related to the occurrence of AF. The correlation between total EAT volume and LA-EAT volume and LAD were analyzed by Pearson correlation. Result: The volume of total EAT in patients with sinus rhythm, AF, PAF and PeAF were (92.2±32.1), (136.0±46.0), (134.2±46.3) and (140.1±52.6)cm(3), respectively. The volume of LA-EAT in patients with sinus rhythm, AF, PeAF and PAF were (27.1±7.5), (39.2±19.2), (35.9± 17.0) and (45.1±21.5)cm(3), respectively. Total EAT and LA-EAT volume were significantly larger in PAF and PeAF groups than in sinus rhythm group (all P<0.01). The LA-EAT volume was larger in PeAF group than in PAF group (P<0.01), but total EAT volume was similar between two groups (P>0.05). Logistic regression analysis showed that total EAT volume (OR=1.202, 95%CI 1.083-1.334, P=0.001), LA-EAT volume (OR=1.051, 95%CI 1.003-1.101, P=0.037) and LAD (OR=1.019, 95%CI 1.005-1.032, P=0.006) were the independent related factors of AF. Pearson correlation analysis showed that the total EAT volume was positively correlated with LAD (r=0.466, P<0.01) and LA-EAT volume was positively correlated with LAD (r=0.290, P<0.01). Conclusion: The volume of total EAT and LA-EAT measured by 256-row multi-slice spiral CT is significantly correlated with the incidence of AF.

[Medical historians and traditional Chinese physicians in early Chinese Society of Medical History]

In the early 20th century, the Chinese Society of Medical History was the only specialty society accepting members with traditional Chinese medicine background in the Chinese medical association. Therefore, it is of special significance to study the TCM members of the early Chinese Society of Medical History. By combing the medical journals of this period and referring to the researches today, this paper makes a comprehensive investigation on the life stories and academic works of the early 14 TCM doctors and scholars of the Chinese Society of Medical History, so as to understand their contributions to the development of Chinese medicine and the institute of medical history in this special historical period.

[Clinical analysis of FRAX in the assessment of fracture risk in patients with rheumatic disease in three medical center]

Objective: The aim is to analyze the fracture risk in rheumatic patients by fracture risk assessment tool (FRAX), which is recommended by World Health Organization (WHO), so that we can prevent the occurrence of osteoporotic fracture earlier. Methods: Totally 617 participants, 204 out-patients with rheumatism, 204 in-patients with rheumatism and 209 healthy controls, from March to October in 2018 of Fourth Medical Center of PLA General Hospital, Jishuitan Hospital and China-Japan Friendship Hospital, were enrolled in this study. The probability of hip fracture (PHF) and major osteoporotic fracture (PMOF) in 10 years with FRAX were compared, and the differences between taking sleroids or not and with or without bone mass density (BMD) of femoral neck were evaluated. Correlation analysis was conducted between PHF, PMOF and clinical information, including age, disease duration, gender, steroid usage, osteocalcin, P1NP and β-crosslaps. Results: There was no significant difference in PMOF within 10 years (3.455±2.690 vs 2.973±2.149 vs 3.323±1.828) among the three groups (P>0.05), but the PHF (0.986±1.619 vs 0.515±0.873 vs 0.149±0.311) was different (P<0.05). PHF and PMOF increased gradually with age. PMOF of patients without glucocorticoid therapy in 10 years was lower than that of patients with glucocorticoid (3.554±2.584 vs 2.857±2.238, P<0.05). There is no difference between the results of FRAX calculated with BMD or not (3.012±2.231 vs 3.207±2.601, P>0.05). PHF and PMOF were positively correlated with age, course of disease, glucocorticoid use and osteocalcin level, while PHF was negatively correlated with TP1NP among in-patients. Conclusion: The prevalence of 10-year hip fracture calculated by FRAX in rheumatism patients is higher than that of healthy group. FRAX can be used to calculate fracture risk without BMD. Combination of FRAX and bone turnover markers may be more effective in prediction of osteoporotic fracture in rheumatic patients.