关键词： SARS-CoV-2   Adenovirus type 5-vectored vaccine   Inactivated vaccine   Heterologous immunisation   Elderly  

摘要： Background People over 60 have been found to develop less protection after two doses of inactivated COVID-19 vaccines than younger people. Heterologous immunisation could potentially induce more robust immune responses compared to homologous immunisation. We aimed to assess the immunogenicity and safety of a heterologous immunisation with an adenovirus type 5-vectored vaccine (Ad5-nCOV, Convidecia) among elderly who were primed with an inactivated vaccine (CoronaVac) *** We did a randomised, observer-blinded, non-inferiority trial in healthy adults aged 60 years and older in Lianshui County (Jiangsu, China) between August 26, 2021 and May 15, 2022. 199 eligible participants who had received two doses of CoronaVac in the past 3-6 months were randomised (1:1) to receive a third dose of Convidecia (group A, n = 99) or CoronaVac (group B, n = 100), while 100 participants primed with one dose of CoronaVac in the past 1-2 months were randomised equally to receive a second dose of Convidecia (group C, n = 50) or CoronaVac (group D, n = 50). Participants and investigators were masked to the vaccine received. Primary outcomes were the geometric mean titers (GMTs) of neutralising antibodies against live SARS-CoV-2 virus 14 days after boosting and 28-day adverse reactions. This study was registered with *** *** A heterologous third dose of Convidecia resulted in a 6.2-fold (GMTs: 286.4 vs 48.2), 6.3-fold (45.9 vs 7.3) and 7.5-fold (32.9 vs 4.4) increase in neutralising antibodies against SARS-CoV-2 wild-type, delta (B.1.617.2) and omicron (BA.1.1) 14 days post boosting, respectively, compared with the homologous boost. The heterologous booster with Convidecia induced significantly higher neutralsing activities, with up to 91% inhibition in binding of Spike to ACE2 for BA.4 and BA.5 variants, compared with 35% inhibition induced by three doses of CoronaVac. For participants primed with one dose of CoronaVac, a heterologous dose of

摘要： Background: There is limited data directly comparing the effectiveness of different COVID-19 ***: We compared rates of SARS-CoV-2 Omicron BA.1/2 infection during March to May 2022 in Australian adults who had received one of four COVID-19 vaccines in the last 14-63 days as either a primary course or a booster dose using Cox proportional hazards models adjusting for age and other ***: As a primary course, over 2318 person-years and 1033 infections, compared to recipients of BNT162b2 mRNA vaccine, adjusted hazard ratios for SARS-CoV-2 infection were 1.03 (95%CI 0.82-1.30), 1.19 (0.95-1.49), 1.70 (1.46-1.97) for respectively mRNA-1273, ChAdOx-1 nCov-19 and NVX-CoV2373. For the booster dose, over 154,984 person-years and 93,580 infections the respective adjusted hazard ratios compared to BNT162b2 mRNA vaccine were 1.02 (95%CI 1.00-1.04), 1.20 (1.10-1.32), 1.39 (1.20-1.60).Conclusions: Our findings suggest relatively higher effectiveness of ancestral strain mRNA vaccines against SARS-CoV-2 Omicron infection than viral vector and protein subunit vaccines and provide clinical confirmation of immunological data on differences in COVID-19 vaccine performance.

关键词： 新型冠状病毒   主蛋白酶   荧光偏振筛选模型   桑辛素   抑制作用  

摘要： 目的探讨桑辛素对新型冠状病毒主蛋白酶的抑制作用。方法利用软件AutoDock将桑辛素与主蛋白酶晶体结构6LU7的活性位点进行分子对接；而后利用主蛋白酶荧光偏振筛选模型检验桑辛素对于新型冠状病毒主蛋白酶的抑制活性。结果桑辛素与主蛋白酶活性位点具有较强的分子间相互作用，分子对接过程释放的自由能为-8.3kcal/mol；在药理活性测试中，桑辛素在400μmol/L、200μmol/L、100μmol/L、25μmol/L浓度对主蛋白酶的抑制率分别45%、34%、8%、1%。结论 实验表明，桑辛素具有一定的主蛋白酶抑制活性。与笔者既往报道的小分子黄酮类化合物相比，桑辛素对主蛋白酶的抑制活性明显增强，其原因可能为黄酮母核引入了脂溶性取代基进而增强了其与主蛋白酶活性位点处的结合能力相关，为黄酮母核类主蛋白酶抑制剂的结构优化提供参考。

关键词： Randomized controlled trials   SARS-CoV-2   Vaccines  

摘要： Data on the safety and immunity of a heterologous booster (fourth dose) after three-doses of inactivated SARS-CoV-2 vaccine in Chinese adults are limited. We evaluate the safety and immunogenicity of Ad5-nCoV in a randomized, double-blind, parallel-controlled phase 4 clinical trial in Zhejiang, China (NCT05373030). Participants aged 18-80 years (100 per group), administered three doses of inactivated SARS-CoV-2 vaccine & GE;6 months earlier, are enrolled and randomized 1:1 into two groups, which are administered intramuscular Ad5-nCoV or inactivated SARS-CoV-2 vaccine (CoronaVac or Covilo). All observed adverse reactions are predictable and manageable. Ad5-nCoV elicits significantly higher RBD-specific IgG levels, with a geometric mean concentration of 2924.0 on day 14 post-booster, 7.8-fold that of the inactivated vaccine. Pseudovirus-neutralizing antibodies to Omicron BA.4/5 show a similar pattern, with geometric mean titers of 228.9 in Ad5-nCoV group and 65.5 in inactivated vaccine group. Ad5-nCoV booster maintains high antibody levels on day 90, with seroconversion of 71.4%, while that of inactivated vaccine is 5.2%, almost pre-booster levels. A fourth Ad5-nCoV vaccination following three-doses of inactivated SARS-CoV-2 vaccine is immunogenic, tolerable, and more efficient than inactivated SARS-CoV-2 vaccine. Ad5-nCoV elicits a stronger humoral response against Omicron BA.4/5 and maintains antibody levels for longer than homologous boosting. Here the authors provide safety and immunogenicity data for an AdV5-based SARS-CoV-2 vaccine, administered intramuscularly as heterologous booster after three-doses of inactivated SARS-CoV-2 vaccine in Chinese adults.

关键词： 新型冠状病毒   鼻腔感染   鼻腔盐水冲洗   防治  

摘要： 新型冠状病毒(如奥密克戎亚型)感染患者的临床潜伏期似乎越来越短,传染性越来越强,症状主要发生在上呼吸道。因此,现阶段,以鼻腔为代表的上呼吸道病毒感染的预防与治疗已成为防控重点。除了规范佩戴口罩外,鼻腔盐水冲洗可作为常用的鼻腔局部护理或治疗方法,能预防病毒感染或减少病毒感染概率并降低鼻腔病毒载量,缩短感染后康复时间,成本低且副作用小,可作为防治新型冠状病毒感染的经济、有效手段。在2022版《鼻腔盐水冲洗预防新型冠状病毒感染专家共识》的基础上,中国鼻病研究协作组的中青年鼻科专家,结合新型冠状病毒亚型的致病特征,参考国内外循证医学证据,总结当下疫情防控的临床经验,制订了《2023版鼻腔盐水冲洗防治新型冠状病毒感染的临床指引》,以期更快速有效地指导临床防治。

关键词： 新型冠状病毒肺炎   医务人员   危险因素   防控对策  

摘要： 新型冠状病毒肺炎是目前蔓延全球的一种呼吸道感染病原体,全球范围内累计确诊病例超过2亿。流行病学数据显示,新型冠状病毒肺炎的传播途径包括飞沫、密切接触和封闭条件下的气溶胶传播。作为新型冠状病毒肺炎疫情防控的一线医务人员,属于感染患者的密切接触者,也是病毒感染的高危人群。由于病毒变异株出现于世界多个国家和地区,了解医务人员新型冠状病毒肺炎感染的风险因素并以此为基础制订防控对策,不仅能够最大限度地保证一线医务人员的安全,同时也是保护疫情防控成果的关键。