Objectives:To develop a new Chinese medicine(CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome(ARDS)in COVID-19 patients.Methods:A putative ARDS-suppressing drug ...Objectives:To develop a new Chinese medicine(CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome(ARDS)in COVID-19 patients.Methods:A putative ARDS-suppressing drug Keguan-1 was first developed and then evaluated by a randomized,controlled two-arm trial.The two arms of the trial consist of a control therapy(alpha interferon inhalation,50(x g twice daily;and lopinavir/ritonavir,400 and 100 mg twice daily,respectively)and a testing therapy(control therapy plus Keguan-119.4 g twice daily)by random number table at 1:1 ratio with 24 cases each group.After 2-week treatment,adverse events,time to fever resolution,ARDS development,and lung injury on newly diagnosed COVID-19 patients were assessed.Results:An analysis of the data from the first 30 participants showed that the control arm and the testing arm did not exhibit any significant differences in terms of adverse events.Based on this result,the study was expanded to include a total of 48 participants(24 cases each arm).The results show that compared with the control arm,the testing arm exhibited a significant improvement in time to fever resolution(P=0.035),and a significant reduction in the development of ARDS(P=0.048).Conclusions:Keguan-1-based integrative therapy was safe and superior to the standard therapy in suppressing the development of ARDS in COVID-19 patients.(Trial registration No.NCT 04251871 at www.clinicaltrials.gov).展开更多
Large-scale shaking table tests were conducted to study the dynamic response of a slope reinforced by double-row anti-sliding piles and prestressed anchor cables. The test results show that the reinforcement suppresse...Large-scale shaking table tests were conducted to study the dynamic response of a slope reinforced by double-row anti-sliding piles and prestressed anchor cables. The test results show that the reinforcement suppressed the acceleration amplification effectively. The axial force time histories are decomposed into a baseline part and a vibration part in this study. The baseline part of axial force well revealed the seismic slope stability, the peak vibration values of axial force of the anchor cables changed significantly in different area of the slope under seismic excitations. The peak lateral earth pressure acting on the back of the anti-sliding pile located at the slope toe was much larger than that acting on the back of the anti-sliding pile located at the slope waist. The test results indicate an obvious load sharing ratio difference between these two anti-slide piles, the load sharing ratio between the two anti-sliding piles located at the slope toe and the slope waist varied mainly in a range of 2-5. The anti-slide pile at the slope waist suppressed the horizontal displacement of the slope surface.展开更多
Background Immune-related hematocytopenia （IRH） is considered to be related with the production of autoantibody, as well as the activation of humoral immunity which is stimulated by B lymphocyte. This study aimed to...Background Immune-related hematocytopenia （IRH） is considered to be related with the production of autoantibody, as well as the activation of humoral immunity which is stimulated by B lymphocyte. This study aimed to observe the levels of various cytokines in the blood serum and the in situ active state of macrophage （Me） in the medullary hematopoietic microenvironment of IRH patients, and to probe into the immune mechanism and clinical significance of Me in hematopoietic cell injury. Methods ELISA is used to detect the IL-4, IL-6, IL-12, IL-17, and IFN-y levels in the peripheral blood serum of 376 patients in pre- and post-therapy. Cytochemistry and cell immunochemistry methods are used to observe the peroxidase （POX）, nonspecific esterase （NSE）, hemosiderin granules, and HLA-DR activity of Me in the bone marrow of patients. Immunofluorescence is used to observe the expression of hemocyte antihuman globulin IgG antibody, lymphocytes CD4 molecule, Me membrane Fcyllreceptor （FcyllR）, mannitose receptor （MR）, IFN-y, ICAM-1, IL-12, and IL-17A and the formation mechanism of antibody-dependent cell-mediated cytotoxicity （ADCC） hematopoietic cell islands （HI） in the medullary hematopoietic microenvironment of patients. Glucocorticoid is used for treatment on the basis of anti-infection therapy, and gamma globulin stoss therapy is used for the appearance of ADCC-type HI or serious Me bloodthirsty phenomenon; if necessary, association of Cyclosporine A （CsA） should be used and chalybeate should be supplemented. Results In the patient group, the levels of IL-4, IL-6, IL-12, IL-17, and IFN-y were increased. After treatment, the cytokine levels gradually became normal. The activated Me in the marrow highly expressed NSE and POX, and Me swallowed more hemosiderin particles, but the iron in the cytoplasm of immature erythrocytes decreased. The activated Me expressed HLA-DR, MR, ICAM-1, IFN-y, and IL-12. For patients with humoral immunity activation and bacterial infection, Me weakly expresse展开更多
Objective To observe the expression of inlfammatory molecules in bone marrow immune cells of patients with immune-related hematocytopenia (IRH), and to investigate the immune mechanism and clinical signiifcance of the...Objective To observe the expression of inlfammatory molecules in bone marrow immune cells of patients with immune-related hematocytopenia (IRH), and to investigate the immune mechanism and clinical signiifcance of the disease. Methods Total of 36 IRH patients were selected as observation group and 30 healthy people were taken as control group. Serum cytokines levels, activity of immunocytes and expression of HLA-DR were detected. Immune lfuorescence was applied to observe the expression state of immunologic molecules and cytokines in IRH patients. Results Serum cytokines were elevated in various degrees in observation group. Compared with the control group, the cytokines levels were significantly higher (P < 0.05). After treatement with immunosuppressive drugs, the serum levels of cytokines in observation group reduced to a level close to the control group. HLA-DR were upregulated in activated tissue basophils, eosinophils, dendritic cells (DC) and macrophages of bone marrow in IRH patients, and POX activity in these immunocytes of IRH was higher than that of the control group. Immune molecules were highly expressed in eosinophils, DC and macrophages. Conclusions It is demonstrated that antibodies or self-reactive lymphocytes were produced in IRH marrow, which would cause lesions of hemocytes, and lead to pathological process ifnally. Structure of hematopoietic cells mutated and these cells might be acted as target cells of immunocytes in the pathological process. Immunocytes could secrete inlfammatory factors and lead to immunologic injury of hemocyte.展开更多
The existing studies have primarily focused on the effect of cyclic load characteristics(namely,cyclic load ratio and amplitude ratio)on cyclic lateral response of monopiles in sand,with little attention paid to the e...The existing studies have primarily focused on the effect of cyclic load characteristics(namely,cyclic load ratio and amplitude ratio)on cyclic lateral response of monopiles in sand,with little attention paid to the effect of pile−soil relative stiffness(K_(R)).This paper presents a series of 1-g cyclic tests aimed at improving understanding of the cyclic lateral responses of monopiles under different pile−soil systems.These systems are arranged by two model piles with different stiffness,including four different slenderness ratios(pile embedded length,L,normalized by diameter,D)under medium dense sand.The K_(R)-values are calculated by a previously proposed method considering the real soil stress level.The test results show that the lateral accumulation displacement increases significantly with the increment of the K_(R)-value,while the cyclic secant stiffness performs inversely.The maximum pile bending moment increases with the cycle number for the rigid pile−soil system,but shows a decreasing trend in the flexible system.For an uppermost concern,an empirical model is proposed to predict the accumulated displacement of arbitrary pile−soil systems by combining the results from this study with those from previous experimental investigations.The validity of the proposed model is demonstrated by 1-g and centrifuge tests.展开更多
目的探讨人工全膝关节置换术中3D打印截骨导板技术的应用及其临床疗效。方法回顾性分析2016年1月~2018年12月我院收治的行人工膝关节置换术的110例患者的临床资料,按治疗方式分组:对照组(n=55)行常规全膝关节置换术,研究组(n=55)应用3D...目的探讨人工全膝关节置换术中3D打印截骨导板技术的应用及其临床疗效。方法回顾性分析2016年1月~2018年12月我院收治的行人工膝关节置换术的110例患者的临床资料,按治疗方式分组:对照组(n=55)行常规全膝关节置换术,研究组(n=55)应用3D打印截骨导板技术行全膝关节置换术。结果研究组手术时间、出血量以及输血量均少于对照组,差异有统计学意义(P<0.05);两组术后1、2、7、14 d VAS评分比较,差异均无统计学意义(P>0.05)。术后2周两组患者膝关节活动范围、下肢力线角度及膝关节功能HSS评分均较术前改善明显,差异均有统计学意义(P<0.05),但两组间膝关节活动范围、下肢力线角度、膝关节功能评分及膝关节恢复优良率比较,差异均无统计学意义(P>0.05)。结论采用3D打印截骨导板行全膝关节置换术可以有效缩短手术时间,降低出血量,更有利于患者术后恢复,值得临床上进一步推广应用。展开更多
基金the National Administration of Traditional Chinese Medicine Project(No.2020ZYLCYJ05-1)the National Natural Science Foundation of China(Nos.81630100,81721002,81930110)+2 种基金China PLA Biosecurity Project(No.19SWAQ13)China PLA Emergency Project(BWS20J006)the Beijing Administration of Traditional Chinese Medicine Project(Nos.YJ2020-03,SYFY202011)。
文摘Objectives:To develop a new Chinese medicine(CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome(ARDS)in COVID-19 patients.Methods:A putative ARDS-suppressing drug Keguan-1 was first developed and then evaluated by a randomized,controlled two-arm trial.The two arms of the trial consist of a control therapy(alpha interferon inhalation,50(x g twice daily;and lopinavir/ritonavir,400 and 100 mg twice daily,respectively)and a testing therapy(control therapy plus Keguan-119.4 g twice daily)by random number table at 1:1 ratio with 24 cases each group.After 2-week treatment,adverse events,time to fever resolution,ARDS development,and lung injury on newly diagnosed COVID-19 patients were assessed.Results:An analysis of the data from the first 30 participants showed that the control arm and the testing arm did not exhibit any significant differences in terms of adverse events.Based on this result,the study was expanded to include a total of 48 participants(24 cases each arm).The results show that compared with the control arm,the testing arm exhibited a significant improvement in time to fever resolution(P=0.035),and a significant reduction in the development of ARDS(P=0.048).Conclusions:Keguan-1-based integrative therapy was safe and superior to the standard therapy in suppressing the development of ARDS in COVID-19 patients.(Trial registration No.NCT 04251871 at www.clinicaltrials.gov).
基金financially supported by the National Key R&D Program of China(No.2018YFC1508601)the Fundamental Research Funds for the Central University(20822041B4038)
文摘Large-scale shaking table tests were conducted to study the dynamic response of a slope reinforced by double-row anti-sliding piles and prestressed anchor cables. The test results show that the reinforcement suppressed the acceleration amplification effectively. The axial force time histories are decomposed into a baseline part and a vibration part in this study. The baseline part of axial force well revealed the seismic slope stability, the peak vibration values of axial force of the anchor cables changed significantly in different area of the slope under seismic excitations. The peak lateral earth pressure acting on the back of the anti-sliding pile located at the slope toe was much larger than that acting on the back of the anti-sliding pile located at the slope waist. The test results indicate an obvious load sharing ratio difference between these two anti-slide piles, the load sharing ratio between the two anti-sliding piles located at the slope toe and the slope waist varied mainly in a range of 2-5. The anti-slide pile at the slope waist suppressed the horizontal displacement of the slope surface.
文摘Background Immune-related hematocytopenia （IRH） is considered to be related with the production of autoantibody, as well as the activation of humoral immunity which is stimulated by B lymphocyte. This study aimed to observe the levels of various cytokines in the blood serum and the in situ active state of macrophage （Me） in the medullary hematopoietic microenvironment of IRH patients, and to probe into the immune mechanism and clinical significance of Me in hematopoietic cell injury. Methods ELISA is used to detect the IL-4, IL-6, IL-12, IL-17, and IFN-y levels in the peripheral blood serum of 376 patients in pre- and post-therapy. Cytochemistry and cell immunochemistry methods are used to observe the peroxidase （POX）, nonspecific esterase （NSE）, hemosiderin granules, and HLA-DR activity of Me in the bone marrow of patients. Immunofluorescence is used to observe the expression of hemocyte antihuman globulin IgG antibody, lymphocytes CD4 molecule, Me membrane Fcyllreceptor （FcyllR）, mannitose receptor （MR）, IFN-y, ICAM-1, IL-12, and IL-17A and the formation mechanism of antibody-dependent cell-mediated cytotoxicity （ADCC） hematopoietic cell islands （HI） in the medullary hematopoietic microenvironment of patients. Glucocorticoid is used for treatment on the basis of anti-infection therapy, and gamma globulin stoss therapy is used for the appearance of ADCC-type HI or serious Me bloodthirsty phenomenon; if necessary, association of Cyclosporine A （CsA） should be used and chalybeate should be supplemented. Results In the patient group, the levels of IL-4, IL-6, IL-12, IL-17, and IFN-y were increased. After treatment, the cytokine levels gradually became normal. The activated Me in the marrow highly expressed NSE and POX, and Me swallowed more hemosiderin particles, but the iron in the cytoplasm of immature erythrocytes decreased. The activated Me expressed HLA-DR, MR, ICAM-1, IFN-y, and IL-12. For patients with humoral immunity activation and bacterial infection, Me weakly expresse
文摘Objective To observe the expression of inlfammatory molecules in bone marrow immune cells of patients with immune-related hematocytopenia (IRH), and to investigate the immune mechanism and clinical signiifcance of the disease. Methods Total of 36 IRH patients were selected as observation group and 30 healthy people were taken as control group. Serum cytokines levels, activity of immunocytes and expression of HLA-DR were detected. Immune lfuorescence was applied to observe the expression state of immunologic molecules and cytokines in IRH patients. Results Serum cytokines were elevated in various degrees in observation group. Compared with the control group, the cytokines levels were significantly higher (P < 0.05). After treatement with immunosuppressive drugs, the serum levels of cytokines in observation group reduced to a level close to the control group. HLA-DR were upregulated in activated tissue basophils, eosinophils, dendritic cells (DC) and macrophages of bone marrow in IRH patients, and POX activity in these immunocytes of IRH was higher than that of the control group. Immune molecules were highly expressed in eosinophils, DC and macrophages. Conclusions It is demonstrated that antibodies or self-reactive lymphocytes were produced in IRH marrow, which would cause lesions of hemocytes, and lead to pathological process ifnally. Structure of hematopoietic cells mutated and these cells might be acted as target cells of immunocytes in the pathological process. Immunocytes could secrete inlfammatory factors and lead to immunologic injury of hemocyte.
基金This work was financially supported by the National Natural Science Foundation of China(Grant Nos.51808112,51878160,and 52078128)the Natural Science Foundation of Jiangsu Province(Grant No.BK20180155).
文摘The existing studies have primarily focused on the effect of cyclic load characteristics(namely,cyclic load ratio and amplitude ratio)on cyclic lateral response of monopiles in sand,with little attention paid to the effect of pile−soil relative stiffness(K_(R)).This paper presents a series of 1-g cyclic tests aimed at improving understanding of the cyclic lateral responses of monopiles under different pile−soil systems.These systems are arranged by two model piles with different stiffness,including four different slenderness ratios(pile embedded length,L,normalized by diameter,D)under medium dense sand.The K_(R)-values are calculated by a previously proposed method considering the real soil stress level.The test results show that the lateral accumulation displacement increases significantly with the increment of the K_(R)-value,while the cyclic secant stiffness performs inversely.The maximum pile bending moment increases with the cycle number for the rigid pile−soil system,but shows a decreasing trend in the flexible system.For an uppermost concern,an empirical model is proposed to predict the accumulated displacement of arbitrary pile−soil systems by combining the results from this study with those from previous experimental investigations.The validity of the proposed model is demonstrated by 1-g and centrifuge tests.
文摘目的探讨人工全膝关节置换术中3D打印截骨导板技术的应用及其临床疗效。方法回顾性分析2016年1月~2018年12月我院收治的行人工膝关节置换术的110例患者的临床资料,按治疗方式分组:对照组(n=55)行常规全膝关节置换术,研究组(n=55)应用3D打印截骨导板技术行全膝关节置换术。结果研究组手术时间、出血量以及输血量均少于对照组,差异有统计学意义(P<0.05);两组术后1、2、7、14 d VAS评分比较,差异均无统计学意义(P>0.05)。术后2周两组患者膝关节活动范围、下肢力线角度及膝关节功能HSS评分均较术前改善明显,差异均有统计学意义(P<0.05),但两组间膝关节活动范围、下肢力线角度、膝关节功能评分及膝关节恢复优良率比较,差异均无统计学意义(P>0.05)。结论采用3D打印截骨导板行全膝关节置换术可以有效缩短手术时间,降低出血量,更有利于患者术后恢复,值得临床上进一步推广应用。
