[Epidemiology and molecular biology of respiratory syncytial virus among hospitalized children in Guangzhou from 2013 to 2017]

Objective: To understand the genetic variation and epidemiological characteristics of human respiratory syncytial virus (HRSV) in Guangzhou. Methods: Nasopharyngeal swabs specimens were collected from 0-6 year old children hospitalized with acute respiratory infection, then HRSV was tested and genotyped by RT-PCR. Phylogenetic tree was bulit using MEGA 6.0 software. NetNGlyc 1.0 server was used to predict the potential N-linked glycosylation sites. Results: A total of 1 225 nasopharyngeal specimens were collected, including 783 males and 442 females. The median (P(25), P(75)) age was 8 (3, 24) months. Among the 209 HRSV-positive cases (17.06%), 117 cases (55.98%) were HRSV-A and 92 cases (44.02%) were HRSV-B. The two distinct subgroups (HRSV-A and HRSV-B) alternately played dominant role to cause HRSV infection and exchange almost once every two years. The HRSV prevalence rate decreased with age. The HRSV-positive rate among children under 2 years old was 18.83% (196 cases), accounting for 93.78% of the total positive cases. There were 32 HRSV positive cases co-infected with at least one respiratory virus, with the co-infection rate of 15.31%. Phylogenetic tree analysis of the second hypervariable region (HVR2) of the G protein classified the HRSV-A specimens into ON1 (n=62) and NA1 (n=2) genotypes while all HRSV-B specimens belonged to BA genotype (n=53). The HVR2 of the G protein varied in using stop condon, amino acid substitutions, glycosylation sites. Conclusion: Children under 2 years old were the high risk population of HRSV infection in Guangzhou. ON1 genotype turned into a primary genetype of the HRSV-A subgroup while BA genotype dominated the HRSV-B subgroup. A greater diversification of amino acid substitutions, and some deletion and insertion of glycosylation sites embodied the polymorphism of G protein as main protective antigen.

Comparative comprehension on the anti-rheumatic Chinese herbal medicine Siegesbeckiae Herba: Combined computational predictions and experimental investigations

ETHNOPHARMACOLOGICAL RELEVANCE

Siegesbeckiae Herba (SH) is a traditional anti-rheumatic herbal medicine in China. The SH-derived product is the first licensed traditional herbal medicinal product for the management of rheumatism-induced joint and muscle pain in United Kingdom. The authenticated plant origins listed in the official Chinese Pharmacopeia for SH include Siegesbeckia orientalis L. (SO), S. pubescens Markino (SP) and S. glabrescens Markino (SG). Although the therapeutic effects of these SH species in treating rheumatoid arthritis (RA) are similar, their difference in chemical profiles suggested their anti-rheumatisms mechanisms and effects may be different.

AIM OF THE STUDY

This study was designed to comparatively comprehend the chemical and biological similarity and difference of SO, SP and SG for treating rheumatoid arthritis based on the combination of computational predictions and biological experiment investigations.

MATERIALS AND METHODS

The reported compounds for SO, SP and SG were obtained from four chemical databases (SciFinder, Combined Chemical Dictionary v2009, Dictionary of Natural Products and Chinese academy of sciences Chemistry Database). The RA-relevant proteins involved in nuclear factor-kappa B (NF-κB), oxidative stress and autophagy signaling pathways were collected from the databases of Kyoto Encyclopedia of Genes and Genomes and Biocarta. The comparative comprehension of SH plants was performed using similarity analysis, molecular docking and compounds-protein network analysis. The chemical characterization of different SH extracts were qualitatively and quantitatively analyzed, and their effects on specific RA-relevant protein expressions were investigated using Western blotting analysis.

RESULTS

Chemical analysis revealed that SO contains mainly sequiterpenes and pimarenoids; SP contains mainly pimarenoids, sequiterpenes, and kaurenoids; and SG contains mainly pimarenoids, flavonoids and alkaloids. Moreover, coincided with the predicted results from computational analysis, different SH species were observed to present different chemical constituents, and diverse effects on RA-relevant proteins at the biological level.

CONCLUSIONS

The chemical and biological properties of SO, SP and SG were different and distinctive. The systematic comparison between these three confusing Chinese herbs provides reliable characterization profiles to clarify the pharmacological substances in SH for the precise management of rheumatism/-related diseases in clinics.

Dual-functional Brij-S20-modified nanocrystal formulation enhances the intestinal transport and oral bioavailability of berberine

Introduction

Berberine (BBR) is a plant-derived benzylisoquinoline alkaloid and has been demonstrated to be a potential treatment for various chronic diseases. The poor water solubility and P-glycoprotein (Pgp)-mediated drug efflux are the main challenges for its further application in a clinical setting.

Materials and methods

In this study, a Brij-S20 (BS20)-modified nanocrystal formulation (BBR-BS20-NCs) has been developed and investigated with the purpose of improving the intestinal absorption of BBR. The physicochemical properties of the developed BBR-BS20-NCs were characterized and the enhancement of the BBR-BS20-NCs on BBR absorption were investigated both in vitro and in vivo.

Results

The results indicated that BS20 could significantly enhance the intracellular uptake of BBR in MDCK-MDR1 cells via a short-term and reversible modulation on the Pgp function, accompanied by a marked increase in Pgp mRNA expression but without significant influence on the Pgp protein expression. Moreover, the morphology of the prepared BBR-BS20-NCs was observed to be prism-like, with a smooth surface and an average diameter of 148.0 ± 3.2 nm. Compared to raw BBR and physical mixture, BBR-BS20-NCs facilitated the dissolution rate and extent of release of BBR in aqueous solution, and further increased the absorption of BBR in MDCK-MDR1 monolayer by overcoming the Pgp-mediated secretory transport (P_app[BL-AP] values of 2.85 ± 0.04 × 10⁻⁶ cm/s, 2.21 ± 0.14 × 10⁻⁶ cm/s, and 2.00 ± 0.07 × 10⁻⁶ cm/s for pure BBR, physical mixture, and BBR-BS20-NCs, respectively). Significant improvements in the maximum concentration observed (C_max) and area under drug concentration-time curve (AUC_0–t) of BBR-BS20-NCs were obtained in pharmacokinetic studies compared to pure BBR, and the relative bioavailability of BBR-BS20-NCs to pure BBR was 404.1%.

Conclusion

The developed BBR-BS20-NCs combine the advantages of nanocrystal formulation and functional excipient. The novel pharmaceutical design provides a new strategy to improve the oral bioavailability of those drugs with both poor water solubility and Pgp-mediated efflux.

Perceptions of caring in China: patient and nurse questionnaire survey

BACKGROUND

The concept of caring is important to both patients and nurses. If patients and nurses perceive caring behaviours differently, patients may not have their needs met or will be dissatisfied with the nursing.

AIM

This study conducted in mainland China compared the perceptions of nurses and patients concerning nurses' caring behaviours.

METHODS

From November 2011 to June 2012, 680 patients and 540 of their nurses in five hospitals in southern, central and eastern China were invited to complete a descriptive comparative survey with four subcategories, the Caring Behaviors Inventory-24. Respondents scored each of the 24 items on the survey from 1 (low) to 6 (high). Of those invited, 595 patients (87.50%) and 445 (82.41%) nurses completed the survey.

RESULTS

The mean item score on the Caring Behaviors Inventory-24 was 4.32 and 4.96 for patients and nurses, respectively. The subcategory with the highest mean score for both groups was knowledge and skills (4.73, 5.25), and the lowest for both groups was positive connectedness (3.98, 4.51). Nurses' scores were significantly higher than those of patients for all four subcategories (P < 0.001).

CONCLUSIONS

The gap between the two groups indicates that nurses need to improve their understanding and response to patients' actual and perceived needs and expectations. In China, patients require more support from nurses of their psychological needs.

STUDY LIMITATIONS

Participants came from a limited number of hospitals in three cities. A larger sample from different hospitals in mainland China could have increased the power of the study.