Metformin Combined LMWH Intervention in 25 Pregnant Women with History of Hyperlipidemia Pancreatitis in Pregnancy

Objective: To explore the early preventive treatment of hypertriglyceridemia-induced acute pancreatitis (HTGP) in pregnancy. Methods: A retrospective cohort analysis was performed to examine the drug intervention on recurrent HTGP and related pregnancy outcomes among women who had HTGP in their past pregnancy and developed hyperlipidemia during the second pregnancy. Participants were identified through inpatient case records under a single physician at the clinic and divided into two groups. The intervention group was given metformin lipid-lowering combined with low-molecular-weight heparin to prevent thrombosis when hypertriglyceridemia was developed during the pregnancy. In contrast, the non-intervention group includes those who did not receive active drug treatment until they developed recurrent HTGP. Metabolic markers were also examined by comparing them with their respective past pregnancies. Results: All participants experienced elevated triglycerides during their two consecutive pregnancies. No pregnant women developed HTGP in the intervention group (n=12), while 10 of 13 (76.9%) women developed HTGP in the non-intervention group. Thus, the outcome seemed to be markedly different. In the intervention group, 11 women were gestated to term, and one was premature; one of 12 (8.3%) births was neonatal asphyxia; there was no low-weight birth, and the prognosis of mother and baby was favorable. Of 10 women who developed recurrent HTGP in the non-intervention group, four suffered from fetal loss, four had premature, and two had full-term delivery; among the three pregnant women without HTGP, one had a premature and two had full-term births; five of thirteen (38.5%) births were neonatal asphyxia. Conclusion: Pregnant women with HTGP history, if not treated, are likely to develop the condition recurrently during pregnancy, but timely intervention on hypertriglyceridemia with lipid-lowering and thrombosis-preventing seemed complete to reduce the recurrent HTGP and improve the pregnancy outcomes.

Application of Chinese Herbal Medicine in COVID-19

Traditional Chinese herbal medicine has a long history in treating febrile diseases, according to the Shang Han Lun, a classical theory of traditional Chinese medicine developed by Zhang Zhongjing in the Han Dynasty. Some herbs have been formulated as prescription formulae or manufactured as finished medicine such as pills, capsules or injections. The Chinese government has recommended specific TCM prescriptions alone or combined with Western medicine to treat patients with COVID-9. Here, we introduce three prescription formulae, Qingfei Paidu Decoction, Huashi Baidu Formula, and Xuanfei Baidu Formula, three finished medicines, Lianhua Qingwen Capsule, Jinhua Qinggan Granule, and Xuebijing Injection; following this, several single herbs such as Ephedra herba, Honeysuckle, Scutellaria, Glycyrrhizae radix, Armeniacae semen, Sophorae flavescentis radix, and Curcuma longa. We review existing evidence of these traditional medicines and herbs for their related antiviral activities, efficacy, and underlying mode of action in virus-related diseases. Most of these drugs have been traditionally used in Chinese medicine for over a thousand years, and they have been proved to be safe in treating flu-like virus infections. It will be adequate to further test for their efficacy for COVID-19 and understand the underlying molecular mechanism.

Natural Products and Potential Therapeutic Intervention for COVID-19

The coronavirus disease 19 (COVID-19) caused pandemic is still prevailing, but few approved medications are available. While the vaccinations have begun in some areas, it is of concern how the virus mutations will affect the vaccine effectiveness in populations. Various natural products exhibit good pharmacological properties of antiviral, antioxidant, and anti-inflammatory activities that may offer preventive intervention benefits. In addition to that, adequate essential minerals and trace elements (e.g., selenium and zinc) are required for healthy immune function; many natural products from prokaryotic and eukaryotic organisms can be potential drug targets. Among them are plant extracts traditionally used for antiviral and parasite infections. Two phytochemicals, hesperidin, and sulforaphane might be the most promising candidates for effective prophylaxis and mitigating disease severity. Therefore, they deserve a further study of their antiviral mechanisms of action then move to randomized clinical trials to determine appropriate dosing, pharmacokinetic parameters, and their potential efficacy and safety in humans.

IFN-gamma Signaling in Lichen Planus

Lichen planus (LP) is a chronic inflammatory disease that affects the skin, nails, urogenital tract, and oral mucosa. It ranges from mild inflammation to the destruction of the epithelial surface with painful wounds and squamous cell carcinoma development. The LP lesion differences in location and morphology determine the clinical disease subtypes which all share a histological feature of dense band-like sub-epithelial infiltration of lymphocytes and keratinocyte apoptosis. Despite the well-characterized clinical manifestations of LP, its pathogenesis remains mostly unknown. Recent studies revealed a role of IFN-γ signaling that renders keratinocytes more susceptible to T-cell-mediated cytotoxicity via upregulation of MHC class I molecules. Targeting IFN-γ signaling in LP has been proposed as a treatment option. These latest developments in research on the etiology of LP will be discussed herein.

Pathogen Genomics and Host Cellular Susceptibility Factors of COVID-19

Coronavirus disease 19 (COVID-19) caused by infection with a novel severe acute respiratory syndrome virus -2 (SARS-CoV2) has evolved into a pandemic and a global public health emergency. The viral genomics, host cellular factors, and interactions are critical for establishing a viral infection and developing a related disease. This paper aims to provide an overview of viral genomics and discuss host cellular factors so far identified to be involved with the disease susceptibility. The novel pathogen is a beta coronavirus and one of seven that cause diseases to humans. It is a single strand positive-sense RNA genome virus that encodes 27 proteins, including the structural Spike protein that binds to host cell surface receptors and is a key for viral entry, and 16 nonstructural proteins play a critical role in viral replication and virulence. While the angiotensin-converting enzyme, ACE2 receptor, and the proteases TMPRSS2 and furin are established as necessary for viral entry, host factors CD147, Cathepsins, DPP4, GRP78, L-SIGN, DC-SIGN, Sialic acid, and Plasmin(ogen) may also play a role in the viral entry. The Spike protein and nonstructural proteins, and various host factors working together may contribute to the infection kinetics, high infectivity, rapid transmission, and a spectrum of clinical manifestations of COVID-19. More importantly, they can serve as potential targets in developing strategies for therapeutical prevention and intervention.

Ecological Analysis of Gastroschisis Incidence Decline in Liaoning, China, 2006-2016

Background: A gastroschisis incidence decline has recently been reported in Liaoning, China, from 2006-2015; we suspect that this decline could be associated with the fall in industrial manufacturing activities. Methods: The outcome variable, gastroschisis incidence, was from a previous publication. The industrial manufacturing activities were measured by relative job participation and production in the primary and secondary economic sectors, and the corresponding data were collected in 14 cities from 2005 to 2015. The general linear model and a random-effect Poisson regression model were performed to assess the association and time-series trend of gastroschisis with the manufacturing activities. Results: The relative job participation in the first economic sector was marginally associated with gastroschisis incidence in 2006 (p=0.070), but more significantly associated (Beta=-0.040; p=0.014) in the cross-sectional and time-series analysis with one-year lag in the outcome variable. Conclusion: The gastroschisis incidence decline in Liaoning is likely due to the reduced job participation in manufacturing and heavy industry, which might be an indication of reduced risk exposure associated with the industrial manufacturing activities.

Clinical Characteristics of Coronavirus Disease 2019: A Review on Laboratory Tests, Comorbidity, and Complication

Coronavirus Disease 2019 (COVID-19), a new respiratory disease caused by severe acute respiratory syndrome virus 2, has emerged as an ongoing pandemic and global health emergency. This article primarily aims to describe laboratory tests, comorbidities, and complications, specifically comprise 1) the incubation period and basic epidemiological parameters, 2) clinical manifestations, 3) laboratory tests, including routine blood tests, inflammatory biomarkers, cardiac biomarkers, liver and renal function, and blood coagulation function, 4) chest imaging features, 5) significant comorbidities and complications. This information on the disease conditions would help dissect the disease heterogeneity for appropriately selecting clinical treatment strategies and therapeutic development.

Prevalence of Hypertension in Older and Middle-aged Adults in China: Estimates from Two National Longitudinal Surveys

Hypertension is a leading chronic risk for population health in China, especially for older and middle-aged adults. However, a representative estimate of hypertension prevalence lacks for general older populations. With datasets from the Chinese Longitudinal Healthy Longevity Study (CLHLS) and China Health and Retirement Longitudinal Study (CHARLS), two nationally representative longitudinal surveys, this report aims to provide some estimates of hypertension prevalence in older and middle-aged adults overall and by social and demographic variables. There had been a marked increase in hypertension prevalence from 41% to 52% among older adults over the past two decades. Older adults, who were females, with urban residence, high income, from eastern China, and engaged in non-agricultural work, were more likely to be hypertensive. About 30% of middle-aged people in China were suffering from hypertension. These findings are significant in identifying potentially vulnerable populations with hypertension, which may have implications for clinical intervention.