关键词： 老年人   梯度压力袜   间歇充气加压   新型冠状病毒肺炎   下肢深静脉血栓形成  

摘要： 目的探讨梯度压力袜(gradient compression stockings,GCS)联合间歇充气加压(intermittent pneumatic compression,IPC)在老年新型冠状病毒肺炎(corona virus disease 2019,COVID-19)患者预防下肢深静脉血栓形成(lower extremity deep vein thrombosis,LEDVT)中的应用效果。方法纳入2022年11月至2023年1月南京医科大学附属南京医院老年COVID-19患者60例,通过在线随机数字生成器随机分为观察组和对照组,每组各30例。对照组给予常规预防干预,观察组在常规干预的基础上采用GCS联合IPC物理干预。对比分析两组患者活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)、双侧股静脉血流速度、血清肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素6(interleukin-6,IL-6)、患者满意度、下肢肿胀和LEDVT的发生率。结果两组患者一般资料比较,差异无统计学意义(P>0.05)。观察组APTT、TT、双侧股静脉血流速度均高于对照组,差异有统计学意义(P<0.05);观察组下肢肿胀及LEDVT发生率、TNF-α、IL-6水平均低于对照组,差异有统计学意义(P<0.05);观察组患者满意度显着高于对照组,差异有统计学意义(P<0.05)。结论GCS联合IPC能改善老年COVID-19患者的凝血功能,减轻炎症反应,增加双侧股静脉血流速度,显著降低LEDVT的发生率。

关键词： Ad5-nCoV   nebulized inhalation vaccine   Omicron   pediatric liver transplantation  

摘要： Amidst the COVID-19 pandemic, uncertainty persists among caregivers regarding the vaccination of pediatric liver transplant recipients (PLTRs). This study evaluates the immunogenicity and safety of COVID-19 vaccination in this vulnerable population. A cohort of 30 PLTRs underwent sequential vaccinations with an inactivated SARS-CoV-2 vaccine followed by an Ad5-nCoV booster. We collected and analyzed blood samples pre-vaccination and four weeks post-vaccination to quantify antibody and IGRA (IFN-gamma Release Assay) levels. We also documented any adverse reactions occurring within seven days post-vaccination and monitored participants for infections over six months post-vaccination, culminating in a comprehensive statistical analysis. The Ad5-nCoV booster substantially elevated IgG (T1: 18.01, 20%;T2: 66.61, 55%) and nAb (T1: 119.29, 8%;T2: 3799.75, 80%) levels, as well as T-cell responses, in comparison to the initial dose. The first dose was associated with some common adverse reactions, such as injection site pain (13.3%) and fever (16.6%), but a low rate of systemic reactions (16.0%). There was no significant difference in Omicron infection rates or RTPCR conversion times between vaccinated and unvaccinated groups. Notably, following Omicron infection, vaccinated individuals exhibited significantly higher SARS-CoV-2 IgG and nAb titers (average IgG: 231.21 vs. 62.09 S/CO, p=0.0003;nAb: 5246.11 vs. 2592.07 IU/mL, p=0.0002). The use of inactivated vaccines followed by an Ad5-nCoV booster in PLTRs is generally safe and elicits a robust humoral response, albeit with limited T-cell responses.

关键词： Vaccine response   COVID   Seropositive   Covaxin   Covishield   Immune response   Antibodies   T cells  

摘要： Background There are limited global data on head-to-head comparisons of vaccine platforms assessing both humoral and cellular immune responses, stratified by pre-vaccination serostatus. The COVID-19 vaccination drive for the Indian population in the age group 18-45 years began in April 2021 when seropositivity rates in the general population were rising due to the delta wave of COVID-19 pandemic during April-May 2021. Methods Between June 30, 2021, and Jan 28, 2022, we enrolled 691 participants in the age group 18-45 years across four clinical sites in India. In this non-randomised and laboratory blinded study, participants received either two doses of Covaxin (R) (4 weeks apart) or two doses of Covishield (TM) (12 weeks apart) as per the national vaccination policy. The primary outcome was the seroconversion rate and the geometric mean titre (GMT) of antibodies against the SARS-CoV-2 spike and nucleocapsid proteins post two doses. The secondary outcome was the frequency of cellular immune responses pre- and post-vaccination. Findings When compared to pre-vaccination baseline, both vaccines elicited statistically significant seroconversion and binding antibody levels in both seronegative and seropositive individuals. In the per-protocol cohort, Covishield (TM) elicited higher antibody responses than Covaxin (R) as measured by seroconversion rate (98.3% vs 74.4%, p < 0.0001 in seronegative individuals;91.7% vs 66.9%, p < 0.0001 in seropositive individuals) as well as by anti -spike antibody levels against the ancestral strain (GMT 1272.1 vs 75.4 binding antibody units/ml [BAU/ml], p < 0.0001 in seronegative individuals;2089.07 vs 585.7 BAU/ml, p < 0.0001 in seropositive individuals). As participants at all clinical sites were not recruited at the same time, site-specific immunogenicity was impacted by the timing of vaccination relative to the delta and omicron waves. Surrogate neutralising antibody responses against variants-of-concern including delta and omicron was

关键词： 急性呼吸道感染   儿童   呼吸道病原体   上海  

摘要： [目的] 了解新型冠状病毒感染（简称“新冠”）防控措施对上海市浦东新区12岁以下儿童急性呼吸道感染的影响。[方法] 收集2019—2023年上海市浦东新区3家哨点医院12岁以下儿童急性呼吸道感染样本，用微流体芯片检测流感病毒、人腺病毒、副流感病毒、呼吸道合胞病毒、人肠道病毒/鼻病毒、人肺病毒、人博卡病毒、冠状病毒（229E、HKU1、NL63和OC43）、新型冠状病毒等42种呼吸道感染病原体。分析新冠前（2019.1—2019.12）、新冠乙类甲管期（2020.1.20—2023.1.7）和新冠乙类乙管期（2023.1.8—2023.6）浦东新区门急诊患儿和住院患儿的急性呼吸道感染情况。[结果] 2019—2023年共采集样本1 770份，检出各类病原体445份，检出率为25.14%（445/1 770）。研究期间主要的检出病原体为流感病毒（8.70%，154/1 770）、呼吸道合胞病毒（4.41%，78/1 770）、人肠道病毒/鼻病毒（2.66%，47/1 770）、人腺病毒（2.49%，44/1 770）、副流感病毒（2.20%，39/1 770）。新冠前门诊患儿以感染流感、副流感病毒和呼吸道合胞病毒为主，检出率分别为8.18%、4.55%和4.09%；住院患儿以感染流感、呼吸道合胞病毒和副流感病毒为主，检出率分别为4.55%、3.86%和3.18%。新冠疫情乙类甲管期，门诊患儿样本以流感、鼻病毒和呼吸道合胞病毒检出为主，检出率分别为1.42%、1.26%和0.90%；住院患儿样本以呼吸道合胞病毒、鼻病毒和流感病毒检出为主，检出率分别为1.26%、0.71%和0.63%。新冠疫情乙类乙管期，流感、鼻病毒和呼吸道合胞病毒为门诊患儿主要检出病原体，检出率分别为14.52%、4.29%和2.97%；流感、呼吸道合胞病毒和鼻病毒为住院患儿主要检出病原体，检出率分别为9.24%、2.31%和1.98%。[结论] 新冠防控对儿童急性呼吸道感染相关病原体的流行产生了影响，相关的措施有助于预防相关呼吸道病原体流行。

关键词： Hormones   Mpro of nCoV   Molecular dynamics simulations   DFT calculations.  

摘要： Amidst the unprecedented 2019 coronavirus outbreak and the substantial loss of lives due to the scarcity of information about the virus and lack of viable drugs, understanding the impact of the nCoV Main Protease (Mpro) on the endocrine system has emerged as a critical topic to pursue. This study explores the potential interactions between four key hormones (cortisol, cortisone, estradiol, and estrone) and the Mpro of nCoV using various in-silico methodologies. Density Functional Theory (DFT) calculations scrutinized the electron density delocalization of these hormones. Through molecular docking, the molecular-level binding of Mpro of nCoV with these hormones was studied, revealing cortisol as the hormone exhibiting the most promising binding affinity (-100.05 kcal/mol). Furthermore, molecular dynamics (MD) simulations, emulating human body conditions at distinct temperatures, were employed to study the implications of these interactions. The study analysed the various trajectories such as root mean square deviation (RMSD), root mean square fluctuations (RMSF), radius of gyration (Rg), and H-bond trajectories to understand the potential impact on biological systems. The findings demonstrate the binding potential of the Mpro of nCoV with these hormones, raising plausible concerns regarding consequential physiological changes within the human body. 1. Impact of Mpro of nCoV on the hormones was investigated using computational studies. 2. Based on molecular docking, Mpro of nCoV showed good binding with hormones. 3. Rg, RMSD, RMSF, and H-bond trajectories showed most effective binding between Mpro of nCoV and cortisol. 4. This observation may conclude impact on the biological pathways.+ image

关键词： 新型冠状病毒   血清分型   多价/广谱疫苗   疫情防控   抗原分化  

摘要： 当前,SARS-CoV-2各变异株之间交叉中和活性的下降提示出现不同的血清型。对病毒进行血清分型是多价/广谱疫苗研究的重要参考依据,也是疫情防控的重要指导。近日已有文献基于血清中和数据对SARS-CoV-2的抗原性分化和血清分型进行了研究和讨论。因此,本文对SARS-CoV-2血清分型的必要性、最新进展和重要价值进行综述。

关键词： 中医药   预防   治疗   新型冠状病毒感染   复阳  

摘要： 目的通过分析中药预防汤剂、治疗汤剂和康复汤剂对新型冠状病毒感染康复患者复阳的治疗效果,总结长寿区中医药防治新型冠状病毒感染的经验,为建立中医药防治新型冠状病毒感染长效机制提供实践依据。方法通过问卷调查的形式分析对长寿区2023年6月采用中医药汤剂防治新型冠状病毒感染康复后复阳患者的效果进行问卷调查,共发放调查问卷25000份。本研究统计长寿区复阳率,并比较不同性别、年龄、职业患者复阳率,比较不同新型冠状病毒疫苗接种情况患者复阳率,比较复阳患者中药预防汤剂、治疗汤剂、康复汤剂服用情况和症状改善情况。结果收回有效问卷23489份。调查结果显示,长寿区新型冠状病毒感染康复后复阳患者为17381例,复阳率为74.00%。女性复阳率(78.10%)大于男性(69.41%),差异有统计学意义(P<0.05);不同年龄段患者复阳率比较,差异有统计学意义(P<0.05),且20~35岁患者复阳率最高(80.35%),其次为>35~50岁患者(75.73%),而<20岁患者复阳率最低(51.21%)。不同职业患者复阳率比较,差异有统计学意义(P<0.05),且医务人员复阳率最高(87.41%),其次为公安人员(86.19%)。参与问卷调查的患者中,22073例完成了新型冠状病毒疫苗全程接种,其中11564例完成了一剂次加强免疫,2826例完成了二次加强免疫;全程接种、部分接种及未接种疫苗患者的复阳率比较,差异有统计学意义(P<0.05)。复阳患者症状持续时间均值为10.97 d;大多数复阳患者的症状为发热(73.94%),其次为咳嗽、咳痰(67.41%)和乏力(65.66%)。复阳患者中,服用中药预防汤剂≥3 d、治疗汤剂≥3 d和康复汤剂≥3 d分别占63.06%、46.46%和45.39%。服用治疗汤剂≥3 d患者的体力差、疲惫感持续时间均值(11.70 d)均短于未服用治疗汤剂患者(13.07 d),差异有统计学意义(P=0.01)。服用康复汤剂≥3 d患者中,4234例自觉体力差、疲惫感症状有所缓解,占53.66%。结论针对新型冠状病毒感染康复后复阳患者需要加强对复阳的监测和评估,及时调整和改进预防措施;同时要加大中医药防治复阳的宣传力度,鼓励公众积极参与中医药防治工作。

关键词： 失眠   新冠肺炎   针刺   热敏灸  

摘要： 目的:观察针刺结合热敏灸治疗新冠后遗症失眠患者的临床疗效。方法:选择新冠后遗症失眠患者54例,随机分为两组各27例。对照组予头针结合常规针刺治疗,治疗组在对照组基础上予热敏灸治疗,观察两组睡眠质量及焦虑程度变化。结果:治疗组总有效率为88.89%,对照组总有效率为62.96%,两组比较有统计学差异(P<0.05)。治疗后,两组匹兹堡睡眠质量指数量表(PSQI)总分及各项评分均低于治疗前,且治疗组较对照组低,差异有统计学意义(P<0.05);两组焦虑自评量表(SAS)各项评分均低于治疗前,且治疗组较对照组低(P<0.05)。结论:采用针刺结合热敏灸治疗新冠后遗症失眠患者可显著缓解临床症状,改善患者睡眠质量,减轻患者焦虑程度。

关键词： 冠状病毒感染   神经元兴奋性   免疫反应   中枢神经系统损伤   热性惊厥   MIS   病毒侵入  

摘要： 新型冠状病毒是一种包膜RNA病毒,并且与中枢神经系统损伤有关[1]。其机制可能与病毒侵入体内引发过度的免疫反应有关,通过释放大量白介素以及其他细胞因子(肿瘤坏死因子-α),导致以发热和多器官功能障碍为特征的急性多系统炎症综合征(multisystem inflammatory syndrome,MIS)[2]。由于儿童正在发育的神经系统的神经元兴奋性较高,当发生新型冠状病毒导致的MIS时,可能发生危及生命的神经系统损害。