Publications by authors named "Rui Gao"

657 Publications

The Association Between Genetically Predicted Systemic Inflammatory Regulators and Polycystic Ovary Syndrome: A Mendelian Randomization Study.

Front Endocrinol (Lausanne) 2021 27;12:731569. Epub 2021 Sep 27.

Reproductive Centre, Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, Chengdu, China.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic diseases among women of reproductive age. Inflammation may be involved in the pathogenesis of PCOS, but its exact relationship with PCOS remains unclear. Herein, we investigate the causal association between systemic inflammatory regulators and PCOS risk through a two-sample Mendelian randomization (MR) approach based on the latest and largest genome-wide association study (GWAS) of 41 systemic inflammatory regulators in 8293 Finnish participants and a GWAS meta-analysis consisting of 10,074 PCOS cases and 103,164 controls of European ancestry. Our results suggest that higher levels of IL-17 and SDF1a, as well as lower levels of SCGFb and IL-4, are associated with an increased risk of PCOS (OR = 1.794, 95% CI = 1.150 - 2.801, P = 0.010; OR = 1.563, 95% CI = 1.055 - 2.315, P = 0.026; OR = 0.838, 95% CI = 0.712 - 0.986, P = 0.034; and OR = 0.637, 95% CI = 0.413 - 0.983, P = 0.042, respectively). In addition, genetically predicted PCOS is related to increased levels of IL-2 and VEGF (OR = 1.257, 95% CI = 1.022 - 1.546, P = 0.030 and OR = 1.112, 95% CI = 1.006 - 1.229, P = 0.038, respectively). Our results indicate the essential role of cytokines in the pathogenesis of PCOS. Further studies are warranted to assess the possibility of these biomarkers as targets for PCOS prevention and treatment.
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http://dx.doi.org/10.3389/fendo.2021.731569DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8503255PMC
September 2021

The PERK/PKR-eIF2α pathway negatively regulates porcine hemagglutinating encephalomyelitis virus replication by attenuating global protein translation and facilitating stress granule formation.

J Virol 2021 Oct 13:JVI0169521. Epub 2021 Oct 13.

Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun, China.

The replication of coronaviruses, including severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and the recently emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is closely associated with the endoplasmic reticulum (ER) of infected cells. The unfolded protein response (UPR), which is mediated by ER stress (ERS), is a typical outcome in coronavirus-infected cells and is closely associated with the characteristics of coronaviruses. However, the interaction between virus-induced ERS and coronavirus replication is poorly understood. Here, we demonstrated that infection with the betacoronavirus porcine hemagglutinating encephalomyelitis virus (PHEV) induced ERS and triggered all three branches of the UPR signaling pathway both in vitro and in vivo. In addition, ERS suppressed PHEV replication in mouse neuro-2a (N2a) cells primarily by activating the protein kinase R-like ER kinase (PERK)-eukaryotic initiation factor 2α (eIF2α) axis of the UPR. Moreover, another eIF2α phosphorylation kinase, IFN-induced double-stranded RNA-dependent protein kinase (PKR), was also activated and acted cooperatively with PERK to decrease PHEV replication. Furthermore, we demonstrated that the PERK/PKR-eIF2α pathways negatively regulated PHEV replication by attenuating global protein translation. Phosphorylated eIF2α also promoted the formation of stress granule (SG), which in turn repressed PHEV replication. In summary, our study presents a vital aspect of the host innate response to invading pathogens and reveals attractive host targets (e.g., PERK, PKR and eIF2α) for antiviral drugs. Coronavirus diseases are caused by different coronaviruses of importance in humans and animals, and specific treatments are extremely limited. ERS, which can activate the UPR to modulate viral replication and the host innate response, is a frequent occurrence in coronavirus-infected cells. PHEV, a neurotropic β-coronavirus, causes nerve cell damage, which accounts for the high mortality rates in suckling piglets. However, it remains incompletely understood whether the highly developed ER in nerve cells plays an antiviral role in ERS and how ERS regulates viral proliferation. In this study, we found that PHEV infection induced ERS and activated the UPR both in vitro and in vivo and that the activated PERK/PKR-eIF2α axis inhibited PHEV replication through attenuating global protein translation and promoting SG formation. A better understanding of coronavirus-induced ERS and UPR activation may reveal the pathogenic mechanism of coronavirus and facilitate the development of new treatment strategies for these diseases.
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http://dx.doi.org/10.1128/JVI.01695-21DOI Listing
October 2021

Cancer cell immune mimicry delineates onco-immunologic modulation.

iScience 2021 Oct 15;24(10):103133. Epub 2021 Sep 15.

Department of Medical Oncology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 510275, P.R. China.

Immune transcripts are essential for depicting onco-immunologic interactions. However, whether cancer cells mimic immune transcripts to reprogram onco-immunologic interaction remains unclear. Here, single-cell transcriptomic analyses of 7,737 normal and 37,476 cancer cells reveal increased immune transcripts in cancer cells. Cells gradually acquire immune transcripts in malignant transformation. Notably, cancer cell-derived immune transcripts contribute to distinct prognoses of immune gene signatures. Optimized immune response signature (oIRS), obtained by excluding cancer-related immune genes from immune gene signatures, and offers a more reliable prognostic value. oIRS reveals that antigen presentation, NK cell killing and T cell signaling are associated with favorable prognosis. Patients with higher oIRS expression are associated with favorable responses to immunotherapy. Indeed, CD83 cell infiltration, which indicates antigen presentation activity, predicts favorable prognosis in breast cancer. These findings unveil that immune mimicry is a distinct cancer hallmark, providing an example of cancer cell plasticity and a refined view of tumor microenvironment.
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http://dx.doi.org/10.1016/j.isci.2021.103133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8487027PMC
October 2021

Evidence for Cognitive Decline in Chronic Pain: A Systematic Review and Meta-Analysis.

Front Neurosci 2021 22;15:737874. Epub 2021 Sep 22.

Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.

People with chronic pain (CP) sometimes report impaired cognitive function, including a deficit of attention, memory, executive planning, and information processing. However, the association between CP and cognitive decline was still not clear. Our study aimed to assess the association of CP as a risk factor with cognitive decline among adults. We included data from clinical studies. Publications were identified using a systematic search strategy from PubMed, Embase, and Cochrane Library databases from inception to October 10, 2020. We used the mean cognitive outcome data and the standard deviations from each group. The standardized mean difference (SMD) or odds ratio (OR), and 95% confidence intervals (CI) were performed for each cognitive decline outcome. -values were assessed to quantify the heterogeneities. We included 37 studies with a total of 52,373 patients with CP and 80,434 healthy control participants. Because these studies used different evaluative methods, we analyzed these studies. The results showed CP was associated with cognitive decline when the short-form 36 health survey questionnaire (SF-36) mental component summary (SMD = -1.50, 95% CI = -2.19 to -0.81), the Montreal cognitive assessment (SMD = -1.11, 95% CI = -1.60 to -0.61), performance validity testing (SMD = 3.05, 95% CI = 1.74 to 4.37), or operation span (SMD = -1.83, 95% CI = -2.98 to -0.68) were used. However, we got opposite results when the studies using International Classification of Diseases and Related Health Problems classification (OR = 1.58, 95% CI = 0.97 to 2.56), the Mini-Mental State Examination (SMD = -0.42, 95% CI = -0.94 to 0.10; OR = 1.14, 95% CI = 0.91 to 1.42), and Repeatable Battery for the Assessment of Neuropsychological Status memory component (SMD = -0.06, 95% CI = -0.37 to 0.25). There may be an association between CP and the incidence of cognitive decline when some cognitive, evaluative methods were used, such as short-form 36 health survey questionnaire, Montreal cognitive assessment, performance validity testing, and operation span.
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http://dx.doi.org/10.3389/fnins.2021.737874DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8492915PMC
September 2021

Astragaloside IV alleviates Schwann cell injury in diabetic peripheral neuropathy by regulating microRNA-155-mediated autophagy.

Phytomedicine 2021 Nov 16;92:153749. Epub 2021 Sep 16.

Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China; NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing 100091, China; National Clinical Research Center for Chinese Medicine Cardiology, Beijing 100091, China. Electronic address:

Background: MicroRNA-155(miR-155) is closely associated with diabetic peripheral neuropathy (DPN). Astragaloside IV (AST) is a significant extract of Astragalus membranaceus, which has been found to be effective in the treatment of DPN. However, whether astragaloside IV alleviate DPN via regulating miR-155-mediated autophagy remains unclear.

Purpose: This study was designed to evaluate the effects of AST on DPN myelin Schwann cells injury and explore the mechanism of AST in treating DPN for the first time.

Methods: GK rats fed with high-fat diet and RSC96 cells cultured in high glucose were used to establish DPN Schwann cells injury in vivo and in vitro model. The effects of AST on DPN were explored through blood glucose detection, nerve function detection, pathological detection and the expression of Neuritin detected by immunohistochemical. To study the effect of AST on the DPN Schwann cells autophagy and the upstream PI3K/Akt/mTOR pathway, the expressions of beclin-1 and LC3 were detected by western blot (WB) in sciatic nerves and by immunofluorescence (IFC) in RSC96 cells. The real-time polymerase chain reaction (RT-PCR) was applied to detect the expressions of miR-155, ATG5, ATG12 both in vivo and in vitro. The binding effect of miR-155 and target gene PI3KCA was verified by luciferase reporter gene assay. The expressions of PI3K, p-Akt/Akt, p-mTOR/mTOR were detected by WB and the expressions of PI3KCA were detected by RT-PCR in vitro. The apoptosis was detected by flow cytometry. Meanwhile, the influence of miR-155 overexpression and knocked down on the above indicators was also detected in RSC96 cells. At last, further mechanism experiments were conducted to verify the mechanism of AST regulating the autophagy and apoptosis of RSC96 cells.

Results: AST reduced blood glucose levels, alleviated peripheral nerve myelin sheath injury, and improved neurological function in DPN rats. In addition, AST enhanced the autophagy activity and alleviated the apoptosis in RSC96 cell. Mechanism study shown that AST promote autophagy via regulating miR-155-mediated PI3K/Akt/mTOR signaling pathways. AST reduced RSC96 cells apoptosis by promoting autophagy.

Conclusion: AST alleviate the myelin sheath injury of DPN caused by the apoptosis of Schwann cells via enhancing autophagy, which was attributed to inhibiting the activation of the PI3K/Akt/mTOR signaling pathway by upregulating miR-155 expression.
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http://dx.doi.org/10.1016/j.phymed.2021.153749DOI Listing
November 2021

Novel serological biomarker models composed of bone turnover markers, vitamin D, and estradiol and their auxiliary diagnostic value in girls with idiopathic central precocious puberty.

Bone 2021 Sep 30;154:116221. Epub 2021 Sep 30.

Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Ren Min Nan Lu, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, No. 17, Section 3, Ren Min Nan Lu, Chengdu, Sichuan, China. Electronic address:

Objective: To establish serological biomarker models composed of bone turnover markers (BTMs), vitamin D (Vit D), and estradiol (E2) and to explore their auxiliary diagnostic value in girls with idiopathic central precocious puberty (ICPP).

Methods: Ninety-three girls with ICPP and 93 healthy girls were included in the ICPP group and the control group, respectively. The serum levels of total procollagen type 1 N-terminal propeptide (P1NP), N-terminal midfragment of osteocalcin (N-MID), β-C-terminal telopeptide of type 1 collagen (β-CTX), Vit D, E2, and other biochemical parameters were detected in all participants. Serological biomarker models for assistance with ICPP diagnosis were established by logistic regression analyses.

Results: Serum P1NP, β-CTX, Vit D, and E2 levels differed significantly between the two groups (p < 0.05). Three models were established. Model 1 consisted of P1NP and β-CTX, and had an area under curve (AUC) of 0.764, sensitivity of 74.19%, and specificity of 72.04%. Model 2 consisted of P1NP, β-CTX, and Vit D, and had an AUC of 0.840, sensitivity of 83.87%, and specificity of 72.04%. Model 3 consisted of P1NP, β-CTX, Vit D, and E2, and had an AUC of 0.917, sensitivity of 82.80%, and specificity of 86.02%.

Conclusions: Serum P1NP, β-CTX, Vit D, and E2 levels may be effective indicators for auxiliary diagnosis of ICPP. Serological biomarker models composed of P1NP, β-CTX, Vit D, and E2 (models 1, 2, and 3) may have auxiliary diagnostic value for ICPP.
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http://dx.doi.org/10.1016/j.bone.2021.116221DOI Listing
September 2021

A Foodborne Bongkrekic Acid Poisoning Incident - Heilongjiang Province, 2020.

China CDC Wkly 2020 Dec;2(51):975-978

National Institute for Occupational Health and Poison Control, China CDC, Beijing, China.

Poisoning incidents caused by bongkrekic acid (BA), one of the metabolites of pathovar (), have been reported in Indonesia, Mozambique, and China. The reported case fatality rates averaged 60%, 32%, and 26.5%, respectively. In China, is often called subsp. .



In October 2020, 9 persons in Jidong County, Heilongjiang Province died after consuming a homemade fermented corn flour product - sour soup - with a case fatality rate of 100%. BA was detected in both food samples and biological samples with a content of 330 mg/kg and 3 mg/L, respectively. The doses of BA consumed by the cases were approximately 22-33 times the lethal dose in human.



The consumption of fermented corn flour products, deteriorated fresh tremella, or black fungus and metamorphic starch products may cause BA poisoning. Health education should be strengthened so that homemade-starch-fermented food should be avoided and foods that have been kept for a long time should not be consumed. Meanwhile, training and emergency capacity building for primary healthcare workers should be strengthened to provide timely diagnosis and response.
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http://dx.doi.org/10.46234/ccdcw2020.264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393157PMC
December 2020

Jasmonic Acid and Ethylene Participate in the Gibberellin-Induced Ovule Programmed Cell Death Process in Seedless Pear '1913' ().

Int J Mol Sci 2021 Sep 11;22(18). Epub 2021 Sep 11.

College of Horticulture, Northwest A&F University, Taicheng Road. 3, Yangling, Xianyang 712100, China.

Seedless fruit is a feature appreciated by consumers. The ovule abortion process is highly orchestrated and controlled by numerous environmental and endogenous signals. However, the mechanisms underlying ovule abortion in pear remain obscure. Here, we found that gibberellins (GAs) have diverse functions during ovules development between seedless pear '1913' and seeded pear, and that GA activates a potential programmed cell death process in '1913' ovules. After hormone analyses, strong correlations were determined among jasmonic acid (JA), ethylene and salicylic acid (SA) in seedless and seeded cultivars, and GA treatments altered the hormone accumulation levels in ovules, resulting in significant correlations between GA and both JA and ethylene. Additionally, SA contributed to ovule abortion in '1913'. Exogenously supplying JA, SA or the ethylene precursor 1-aminocyclopropane-1-carboxylic acid promoted 'Bartlett' seed death. The regulatory mechanism in which ethylene controls ovule death has been demonstrated; therefore, JA's role in regulating '1913' ovule abortion was investigated. A further study identified that the JA signaling receptor MYC2 bound the promoter and triggered its expression to regulate ovule abortion. Thus, we established ovule abortion-related relationships between GA and the hormones JA, ethylene and SA, and we determined their synergistic functions in regulating ovule death.
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http://dx.doi.org/10.3390/ijms22189844DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8466629PMC
September 2021

Bmi1 Regulates Wnt Signaling in Hematopoietic Stem and Progenitor Cells.

Stem Cell Rev Rep 2021 Sep 24. Epub 2021 Sep 24.

Department of Pediatrics, Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.

Polycomb group protein Bmi1 is essential for hematopoietic stem cell (HSC) self-renewal and terminal differentiation. However, its target genes in hematopoietic stem and progenitor cells are largely unknown. We performed gene expression profiling assays and found that genes of the Wnt signaling pathway are significantly elevated in Bmi1 null hematopoietic stem and progenitor cells (HSPCs). Bmi1 is associated with several genes of the Wnt signaling pathway in hematopoietic cells. Further, we found that Bmi1 represses Wnt gene expression in HSPCs. Importantly, loss of β-catenin, which reduces Wnt activation, partially rescues the HSC self-renewal and differentiation defects seen in the Bmi1 null mice. Thus, we have identified Bmi1 as a novel regulator of Wnt signaling pathway in HSPCs. Given that Wnt signaling pathway plays an important role in hematopoiesis, our studies suggest that modulating Wnt signaling may hold potential for enhancing HSC self-renewal, thereby improving the outcomes of HSC transplantation.
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http://dx.doi.org/10.1007/s12015-021-10253-4DOI Listing
September 2021

Age at Diabetes Onset and Subsequent Risk of Dementia.

JAMA 2021 09;326(9):871

Department of Anesthesiology, West China Hospital, Chengdu, China.

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http://dx.doi.org/10.1001/jama.2021.10485DOI Listing
September 2021

sp. nov., a novel actinobacterium isolated from rhizosphere of .

Int J Syst Evol Microbiol 2021 Sep;71(9)

State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Science, Sun Yat-Sen University, Guangzhou, 510275, PR China.

A Gram-stain-positive, non-motile and short rod-shaped actinobacterium, designated strain LNNU 22110, was isolated from the rhizosphere soil of the halophyte (Bunge) Freitag and Schütze, which collected in Xinjiang, north-west China. Growth occurred at 10-45 °C, pH 6.0-10.0 and in the presence of 0-11 % NaCl (w/v). Based on the results of 16S rRNA gene sequence phylogenetic analyses, strain LNNU 22110 belonged to the genus and had 97.5 and 95.5 % sequence similarity to KCTC 19413 and CGMCC 4.3142, respectively. The digital DNA-DNA hybridization relatedness values between strain LNNU 22110 and KCTC 19413 and CGMCC 4.3142 were 23.2 and 19.9 %, respectively. The highest average nucleotide identity value between strain LNNU 22110 and its closest related strain ( KCTC 19413) was 80.2 %, much lower than the species delineation threshold of 95-96 %. The genome of strain LNNU 22110 was 4.4 Mb, with a genomic DNA G+C content of 68.4 mol%. The diagnostic diamino acids in the peptidoglycan layer of strain LNNU 22110 were lysine, alanine, glycine, glutamic acid and aspartic acid. The predominant menaquinone was MK-8(H). The major fatty acid (>10 %) was anteiso-C. The polar lipid profile of strain LNNU 22110 included diphosphatidylglycerol, phosphatidylglycerol, phosphatidylinositol, diacylated phosphatidyl dimannoside, one unidentified glycolipid and two unidentified phospholipids. According to the phenotypic, phylogenetic and chemotaxonomic results, strain LNNU 22110 is considered to represent a novel species of the genus , for which the name sp. nov. is proposed. The type strain is LNNU 22110 (=KCTC 39807=CGMCC 1.17105).
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http://dx.doi.org/10.1099/ijsem.0.005007DOI Listing
September 2021

Interleukin-1β as clinically predictive risk marker for recurrent pregnancy loss in women positive for antinuclear antibody.

Int J Clin Pract 2021 Sep 19:e14887. Epub 2021 Sep 19.

The Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.

Aims: Antinuclear antibody (ANA) was found to be associated with recurrent pregnancy loss (RPL). This study was designed to explore the immunological predictive indicators of RPL in women with positive ANA.

Methods: A retrospective case-control study in a university hospital from March 2020 to January 2021 was performed, including 56 cases of women with RPL and 56 controls matched for age, all of which were positive for ANA. Levels of cytokines, lymphocyte subsets, immune globulin and complement in peripheral blood among two groups were compared. Statistical analyses in this study were performed using SPSS 25.0.

Results: The level of IL-1β was higher in RPL women compared with controls according to univariable analysis and multivariable regression logistic analysis (7.67 [5.86-11.35] vs 5.00 [5.00-5.00], P = .000). After the cut-off value of IL-1β was set as 5.66 pg/mL, the prevalence of RPL was significantly elevated in the high IL-1β group as compared with the low IL-1β group (P < .05). The sensitivity and specificity of IL-1β predicting RPL in ANA-positive women were 76.8% and 91.1%, respectively.

Conclusion: Increased IL-1β may play roles in the occurrence of RPL among women with positive ANA. The level of the IL-1β has the potential to be a predictive indicator of RPL in women with positive ANA.
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http://dx.doi.org/10.1111/ijcp.14887DOI Listing
September 2021

miR‑4792 regulates inflammatory responses in ‑infected microglia.

Int J Mol Med 2021 11 9;48(5). Epub 2021 Sep 9.

Department of Dermatology, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai 200434, P.R. China.

Investigating the factors that influence the inflammatory response of microglial cells is crucial for understanding the pathogenesis of cryptococcal meningitis (CM). MicroRNAs (miRNAs/miRs) play an important role in inducing host defenses and activating the immune response during microbial infection; however, the regulatory mechanisms of miRNAs in cryptococcal meningitis remain poorly defined. In a previous study, the authors assessed the miRNA profiles of THP‑1 (human acute monocytic leukemia cells) cells following infection. In the present study, it was found that miR‑4792 expression was downregulated in BV2 cells infected with , whilst that of its target gene, epidermal growth factor receptor (EGFR), was upregulated. Infected cells in which miR‑4792 was overexpressed exhibited a decreased EGFR transcript expression, reduced mitogen‑activated protein kinase (MAPK) signaling and a decreased secretion of inflammatory cytokines. In addition, following antifungal treatment in patients with cryptococcal meningitis, the levels of miR‑4792 in the cerebrospinal fluid significantly increased, whilst the expression of EGFR significantly decreased. In addition, receiver operator characteristic analysis revealed miR‑4792 (AUC=0.75) and EGFR (AUC=0.79) as potential diagnostic markers in patients with cryptococcal meningitis.
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http://dx.doi.org/10.3892/ijmm.2021.5031DOI Listing
November 2021

Boosting Hydrogen Evolution Reaction via Electronic Coupling of Cerium Phosphate with Molybdenum Phosphide Nanobelts.

Small 2021 Oct 7;17(40):e2102413. Epub 2021 Sep 7.

School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, 637459, Singapore.

Molybdenum phosphide (MoP) is regarded as one of the most promising alternatives to noble-metal based electrocatalysts for efficient hydrogen evolution reaction (HER) due to its similar d-band electronic structure to noble metals and tunable features associated with phase and composition. However, it still remains a great challenge to construct MoP electrocatalysts with abundant active sites that possess ideal H binding strength to promote catalytic performance. In this work, it is found that by anchoring a rare earth compound, cerium phosphate (CePO ) on MoP (CePO /MoP), the stabilized Ce in CePO can significantly boost the formation of oxygen vacancies in ceria (CeO ) in situ formed on CePO surface during HER, which effectively regulates the d-band electronic density-of-states of MoP, increases the numbers of active sites, and promotes the vectorial electron transfer, therefore greatly enhancing the HER performance of MoP. The optimized CePO /MoP/carbon cloth (CC) electrocatalyst exhibits a significantly improved HER performance with an overpotential of 48 mV at 10 mA cm and a Tafel slope of 38 mV dec , about two times better than the HER performance of MoP catalyst without CePO (with an overpotential >80 mV dec at 10 mA cm ), very close to commercial Pt/C catalyst.
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http://dx.doi.org/10.1002/smll.202102413DOI Listing
October 2021

Recent advances in the discovery, characterization, and engineering of poly(ethylene terephthalate) (PET) hydrolases.

Enzyme Microb Technol 2021 Oct 8;150:109868. Epub 2021 Jul 8.

Key Laboratory of Biomass Chemical Engineering of Ministry of Education, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou, 310027, China; Hangzhou Global Scientific and Technological Innovation Center, Zhejiang University, Hangzhou, 310027, China. Electronic address:

Poly(ethylene terephthalate) (PET) is a class of polyester plastic composed of terephthalic acid (TPA) and ethylene glycol (EG). The accumulation of large amount of PET waste has resulted in severe environmental and health problems. Microbial polyester hydrolases with the ability to degrade PET provide an economy- and environment-friendly approach for the treatment of PET waste. In recent years, many PET hydrolases have been discovered and characterized from various microorganisms and engineered for better performance under practical application conditions. Here, recent progress in the discovery, characterization, and enzymatic mechanism elucidation of PET hydrolases is firstly reviewed. Then, structure-guided protein engineering of PET hydrolases with increased enzymatic activities, expanded substrate specificity, as well as improved protein stability is summarized. In addition, strategies for efficient expression of recombinant PET hydrolases, including secretory expression and cell-surface display, are briefly introduced. This review is concluded with future perspectives in biodegradation and subsequent biotransformation of PET wastes to produce value-added compounds.
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http://dx.doi.org/10.1016/j.enzmictec.2021.109868DOI Listing
October 2021

Transition metal-based layered double hydroxides for photo(electro)chemical water splitting: a mini review.

Nanoscale 2021 Aug 4;13(32):13593-13603. Epub 2021 Aug 4.

Beijing Key Laboratory of Energy Conversion and Storage Materials, College of Chemistry, and Key Laboratory of Radiopharmaceuticals, Ministry of Education, Beijing Normal University, Beijing 100875, P. R. China.

The conversion of solar energy into usable chemical fuels, such as hydrogen gas, via photo(electro)chemical water splitting is a promising approach for creating a carbon neutral energy ecosystem. The deployment of this technology industrially and at scale requires photoelectrodes that are highly active, cost-effective, and stable. To create these new photoelectrodes, transition metal-based electrocatalysts have been proposed as potential cocatalysts for improving the performance of water splitting catalysts. Layered double hydroxides (LDHs) are a class of clays with brucite like layers and intercalated anions. Transition metal-based LDHs are increasingly popular in the field of photo(electro)chemical water splitting due to their unique physicochemical properties. This article aims to review recent advances in transition metal-based LDHs for photo(electro)chemical water splitting. This article provides a brief overview of the research in a format approachable for the general scientific audience. Specifically, this review examines the following areas: (i) routes for synthesis of transition metal-based LDHs, (ii) recent developments in transition metal-based LDHs for photo(electro)chemical water splitting, and (iii) an overview of the structure-property relationships therein.
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http://dx.doi.org/10.1039/d1nr03409jDOI Listing
August 2021

Polymer Composite Sponges with Inherent Antibacterial, Hemostatic, Inflammation-Modulating and Proregenerative Performances for Methicillin-Resistant Staphylococcus aureus-Infected Wound Healing.

Adv Healthc Mater 2021 Sep 2:e2101247. Epub 2021 Sep 2.

Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, 300192, China.

Clinical wound management remains a major challenge due to massive bleeding, bacterial infection, and difficult wound healing after tissue trauma. To simultaneously address these issues, composite polymer sponges for accelerating drug-resistant bacterial infected wound healing are fabricated by facilely mixing sodium polyacrylate (PAAS), double quaternary ammonium salts-conjugated chitosan (QAS-CS), and collagen (COL) in aqueous solution, followed by lyophilization. Composite sponges (PAAS/QAS-CS/COL, PQC) show highly porous microstructures (porosity ≈90%) with moderate compress modulus (≈0.3 MPa), tensile strength (0.004 MPa), and high swelling ratio (≈3500%). Importantly, PQC sponge demonstrates superior hemostasis ability over commercially available CS sponge by inducing rapid hemagglutination, and exhibits significantly better antibacterial activity against both methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli by destroying cell membrane and causing the leakage of bioactive components such as potassium ion and β-galactosidase from treated bacterial. Furthermore, PQC sponge can efficiently promote cell proliferation. Significantly, the sponge greatly expedites the regeneration of MRSA-infected full-thickness skin wound in rabbit by successfully eradicating bacterial infection, and reducing inflammation. PQC sponge also improves both early angiogenesis and blood vessel maturation at the wound site. Overall, this multifunctional sponge is a promising wound dressing for clinical use and holds great potential for rapid clinical translation.
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http://dx.doi.org/10.1002/adhm.202101247DOI Listing
September 2021

[Analysis of clinical research outcome indicators of traditional Chinese medicine in treatment of diabetic foot].

Zhongguo Zhong Yao Za Zhi 2021 Aug;46(15):4008-4015

Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences Beijing 100091, China.

To analyze the outcome indicators from the randomized controlled trials(RCTs) on traditional Chinese medicine(TCM) treatment for diabetic foot, and to lay a foundation for the establishment of the core index set of the clinical trials on TCM treatment of diabetic foot. Computer retrieval of RCTs on TCM treatment of diabetic foot was performed in CNKI, Wanfang, SinoMed, PubMed, Cochrane Library, EMbase and Web of Science databases. Literature screening and data extraction were conducted independently by two researchers in strict accordance with inclusion and exclusion criteria. Any difference was resolved through discussion. A total of 72 RCTs involving 5 791 patients were included and 204 indicators were used. The number of indicators used in a single study was 2-22, with an average of 3 indicators used for each RCT. The indicators with top 16 frequency were clinical total effective rate, ankle brachial index(ABI), ulcer area, TCM syndrome integral, fibrinogen(FIB), fasting blood glucose(FBG), plasma viscosity(PV), c-reactive protein(CRP), saccharification blood of eggs(HbAlc), 2 h postprandial blood glucose(2 hPG), wound healing time, triglyce-rides(TC), TCM efficacy for syndromes, total cholesterol(TG), percutaneous oxygen partial pressure(TCPO2) and TCM symptom scores. The difference in selection of RCT indicators was large among TCM treatment methods for diabetic foot, and the combination of outcome indicators was arbitrary. The description on indexes was not standardized. Some non-laboratory examination indicators, some indicators not recommended in guidelines or not recognized in clinical practice, and some self-made indicators were not explained in detail. There was a lack of standardized evaluation criteria for indicators. The indicators had large time-point difference in measurement, and the time points were not distinguished in the measurement for diabetic foot patients with different degrees of severity. In addition, the patients with long course of treatment weren't timely measured. The characteristics of TCM or significant endpoint indicators were insufficient. It was urgent to establish the core index set of TCM in treating diabetic foot.
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http://dx.doi.org/10.19540/j.cnki.cjcmm.20201218.501DOI Listing
August 2021

Systemic autoimmune diseases and recurrent pregnancy loss: research progress in diagnosis and treatment.

Chin Med J (Engl) 2021 Aug 25;134(17):2140-2142. Epub 2021 Aug 25.

Department of Obstetrics and Gynecology, The Reproductive Medical Center, West China Second University Hospital, Sichuan University, Chengdu 610041, China.

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http://dx.doi.org/10.1097/CM9.0000000000001691DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8439985PMC
August 2021

Zebrafish Models in Therapeutic Research of Cardiac Conduction Disease.

Authors:
Rui Gao Jie Ren

Front Cell Dev Biol 2021 4;9:731402. Epub 2021 Aug 4.

Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China.

Malfunction in the cardiac conduction system (CCS) due to congenital anomalies or diseases can cause cardiac conduction disease (CCD), which results in disturbances in cardiac rhythm, leading to syncope and even sudden cardiac death. Insights into development of the CCS components, including pacemaker cardiomyocytes (CMs), atrioventricular node (AVN) and the ventricular conduction system (VCS), can shed light on the pathological and molecular mechanisms underlying CCD, provide approaches for generating human pluripotent stem cell (hPSC)-derived CCS cells, and thus improve therapeutic treatment for such a potentially life-threatening disorder of the heart. However, the cellular and molecular mechanisms controlling CCS development remain elusive. The zebrafish has become a valuable vertebrate model to investigate early development of CCS components because of its unique features such as external fertilization, embryonic optical transparency and the ability to survive even with severe cardiovascular defects during development. In this review, we highlight how the zebrafish has been utilized to dissect the cellular and molecular mechanisms of CCS development, and how the evolutionarily conserved developmental mechanisms discovered in zebrafish could be applied to directing the creation of hPSC-derived CCS cells, therefore providing potential therapeutic strategies that may contribute to better treatment for CCD patients.
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http://dx.doi.org/10.3389/fcell.2021.731402DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8371477PMC
August 2021

The Association Among Achievement Goal Orientations, Academic Performance, and Academic Well-Being Among Chinese Medical Students: A Cross-Sectional Study.

Front Psychol 2021 2;12:694019. Epub 2021 Aug 2.

Department of Health Management, School of Health Management, Harbin Medical University, Harbin, China.

Learning motivation is a significant factor that ensures quality in medical education, and might affect the academic performance and well-being of medical students. This study aimed to explore the status of achievement goal orientations among medical students in China and to further identify the association among academic performance, academic well-being, and achievement goal orientations. Data were collected through a cross-sectional, anonymous survey conducted with 3,511 respondents (effective response rate = 81.7%), from four medical universities in China, and demographic factors, achievement goal orientations, academic performance, and academic well-being were assessed. The average score of achievement goal orientations of Chinese medical students suggested a difference in demographic factors, including sex, year of study, experience of leadership cadre, and family income. Both mastery and performance-avoidance goals were associated with academic performance, subjective academic stress, subjective learning adaptability, subjective sleep quality, and subjective well-being. Performance-approach goals were related to academic performance, subjective academic stress, and subjective learning adaptability. The achievement goal orientations of the medical students in this study were at a middle level. The findings emphasize the importance of mastery goals for promoting the academic performance and well-being of medical students. More care and attention toward achievement goal orientations can be beneficial for the improvement of the academic performance and well-being among medical students.
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http://dx.doi.org/10.3389/fpsyg.2021.694019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8365171PMC
August 2021

Evaluation on Effectiveness of a New System as well as Analysis on Optimal Horizontal Eye Position for Vertical Video Head Impulse Test.

Curr Med Sci 2021 Aug 17;41(4):705-711. Epub 2021 Aug 17.

ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China.

Objective: To compare the performances among three different systems for video head impulse test (vHIT), and to identify an optimal target angle for precisely evaluating the function of vertical semicircular canals in vHIT.

Methods: A two-center prospective study was done. Participants were sit 1.2 m away from the wall in a noise-proved room that dedicated for vHIT experiments. During the comparison experiments, similar settings were ensured in both hospitals, with the same distance to wall and angle of staring. For each equipment, the procedures followed the developers' recommendations. The same examiner performed the comparison between two systems in one location. For the eye-position projects, targets were placed on the wall sequentially at the pre-marked lines for different angles. For the comparison projects, 9 and 13 participants were recruited, respectively. Any participant with otologic or vestibular disorders was excluded. A total of 26 healthy participants were recruited in the eye-position experiments, 16 of which were further involved in inter-examiner tests.

Results: Our evaluations of three different systems showed that a new vHIT system, VertiGoggles® ZT-VNG-I (VG) performed as good as the long-tested Otometrics® ICS impulse (Oto) and EyeSeeCam® (ESC). During the comparison, we validated 25-degree, instead of right ahead at 0 degree, is a better place to set the targets when torsion was applied at vertical semicircular canal planes.

Conclusion: The new VG system is good for clinical practices. Furthermore, we proposed a new protocol to set the targets 25 degrees from right ahead after tilting head 45 degrees to evaluate vertical canals during vHIT.
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http://dx.doi.org/10.1007/s11596-021-2415-1DOI Listing
August 2021

The Value of Subjective Visual Vertical in Diagnosis of Vestibular Migraine.

Curr Med Sci 2021 Aug 17;41(4):654-660. Epub 2021 Aug 17.

Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Objective: To study the value of the subjective visual vertical (SVV) in the diagnosis of vestibular migraine (VM).

Methods: This study recruited 128 VM patients and 64 age-matched normal subjects. We detected the SVV during the interval between attacks in both groups, in sitting upright, and the head tilted at 45° to the left or right. We then examined the correlation between the SVV results with the vestibular evoked myogenic potential (VEMP) and canal paresis (CP).

Results: It was found there was a significant difference in SVV at the upright position between VM patients and normal controls (P=0.006) and no significant difference was found at the tilts of 45° to the left or right between the two groups. The SVV results at the upright position were significantly correlated with cervical VEMP (P=0.042) whereas not significantly correlated with CP and VEMP. There existed no significant difference in the conformity to the Müller effect (M effect) between the two groups. ROC analysis exhibited that the sensitivity, specificity of SVVs at the upright were 67.200% and 62.500% respectively. The diagnostic value of SVV at the upright position was significantly higher than that at tilts of 45° to the left and right (P=0.006). Nonetheless the diagnostic accuracy was relatively low.

Conclusion: Abnormality in SVV possibly stems from the lasting functional disorder of cerebellar or high-level cortical centers in VM patients or is linked to the vestibular compensation. The SVV is of low diagnostic value for VM and the value of SVV in VM warrants further study.
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http://dx.doi.org/10.1007/s11596-021-2418-yDOI Listing
August 2021

Thyroglobulin Measurement Through Fine-Needle Aspiration for Optimizing Neck Node Dissection in Papillary Thyroid Cancer.

Ann Surg Oncol 2021 Aug 12. Epub 2021 Aug 12.

Department of Nuclear Medicine, The First Affiliated Hospital of Xian Jiaotong University, Xi'an, Shaanxi, China.

Background: Thyroglobulin measurement in fine-needle aspiration (FNA-Tg) is an additional diagnostic tool of lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC). However, its performance as a preoperative indicator of lateral neck LNM in PTC is unclear. We evaluated the use of FNA cytology and FNA-Tg to detect neck LNM presurgery using a simple methodology, and established a cut-off value for diagnosing LNM in PTC.

Methods: We performed a retrospective cohort study based on hospital records, including 299 FNA-Tg measurements from 228 patients with PTC. The cut-off value for FNA-Tg was obtained through a receiver operating characteristic (ROC) curve analysis. The relationships between various parameters and FNA-Tg were analyzed using Spearman's correlation.

Results: Of 299 lymph nodes (LNs) from 228 patients following surgery, 151 were malignant and 148 were benign. The median FNA-Tg levels were 414.40 ng/mL and 6.36 ng/mL in the metastatic and benign LNs, respectively. An FNA-Tg cut-off value of 28.3 ng/mL had the best diagnostic performance (93.38% sensitivity, 70.27% specificity, area under the ROC curve [AUC] 0.868) in the whole cohort. The diagnostic value performed better in the lateral neck group (level II-V, n = 163) than in the central neck group (level VI, n = 136); in the lateral neck group, the sensitivity and specificity of the FNA-Tg cut-off (16.8 ng/mL) were 96.25% and 96.36%, respectively.

Conclusions: FNA-Tg is a useful technique for the diagnosis of LNM before surgery, especially in lateral neck dissection.

Clinical Trial Registration Number: ChiCTR1900028547.
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http://dx.doi.org/10.1245/s10434-021-10549-2DOI Listing
August 2021

ASO Author Reflection: Optimizing Lateral Neck Dissection Extent of PTC by FNA-Tg.

Ann Surg Oncol 2021 Aug 12. Epub 2021 Aug 12.

Department of Nuclear Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.

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http://dx.doi.org/10.1245/s10434-021-10636-4DOI Listing
August 2021

Low-Cost, Unsinkable, and Highly Efficient Solar Evaporators Based on Coating MWCNTs on Nonwovens with Unidirectional Water-Transfer.

Adv Sci (Weinh) 2021 Oct 11;8(19):e2101727. Epub 2021 Aug 11.

Engineering Research Center of Technical Textiles, Ministry of Education, College of Textiles, Donghua University, Shanghai, 201620, China.

Solar vapor generation technology is promising in seawater desalination, sewage purification, and other fields. However, wide application of this technology is still largely confined due to its high cost and difficulties for scalable production. In this study, an ever-floating solar evaporator is fabricated by coating multiwall carbon nanotubes on a bicomponent nonwoven composed of polypropylene/polyethylene core-sheath fibers. This all-fiber structure is highly porous and ultralight, with large specific area (for efficient water evaporation), interconnected channels (for easy vapor escape), and low thermal conductivity (to avoid heat loss). The unique unidirectional water-transfer behavior of the nonwoven enables it to spontaneously pump an adjustable amount of water for interfacial solar heating and a delicate balance between water supply and loss may accelerate the evaporation speed of water. These distinct benefits endow the solar evaporator with excellent evaporation rates of 1.44 kg m  h under the simulated irradiation of 1 sun and 12.81 kg m  d under natural sunlight. Moreover, the evaporator can be fabricated by using low-cost materials and industrialized methods (overall cost ≈2.4 USD m ), making one believe its practical significance for commercial solar steam evaporation.
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http://dx.doi.org/10.1002/advs.202101727DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8498870PMC
October 2021

[Effect of Petroleum Ether Extract of Rhizoma Amorphophalli on Biological Characteristics of K562 Cells and Its Mechanism].

Zhongguo Shi Yan Xue Ye Xue Za Zhi 2021 Aug;29(4):1028-1033

Key Laboratory of Bone Arthromyodynia, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006,Zhejiang Province, China,Email:

Objective: To investigate the role of petroleum ether extract of Rhizoma Amorphophalli (SLG) in inhibiting proliferation and promoting apoptosis and differentiation of leukemia K562 cells.

Methods: K562 cells were processed by SLG and PD98059 which was the ERK signaling pathway blocker. Then cell vitality was tested by MTT. Cell apoptosis rate and positive percentage of antigen expression related with differentiation were detected by flow cytometry. The protein expression levels of ERK1/2 and pERK1/2 were detected by Western blot.

Results: The proliferation activity of K562 was reduced by 50, 100, 200 mg/L SLG in a concentration dependent manner (r=0.9997). The apoptosis rate and positive expression rate of CD11b, CD14 and CD42b which were related with differentiation were raised by SLG, as well as the expression of pERK1/2, while PD98059 could reverse the promoting effect of SLG on apoptosis and differentiation partially.

Conclusion: SLG can inhibit the proliferation and promote apoptosis and differentiation of K562 cells through ERK signaling pathway.
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http://dx.doi.org/10.19746/j.cnki.issn.1009-2137.2021.04.003DOI Listing
August 2021

Spectral domain-optical coherence tomography retinal biomarkers in choroidal neovascularization of multifocal choroiditis, myopic choroidal neovascularization, and idiopathic choroidal neovascularization.

Ann Med 2021 12;53(1):1270-1278

Ophthalmology Department, Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei province, China.

Objective: To use optical coherence tomography (OCT) to compare retinal biomarkers of choroidal neovascularization (CNV) secondary to multifocal choroiditis (MFC), myopic choroidal neovascularization (mCNV), and idiopathic choroidal neovascularization (ICNV) and to provide a basis for its clinical diagnosis and treatment.

Methods: In this retrospective case study, patients admitted to the Second Hospital of Hebei Medical University between January 2018 and January 2021 who were initially diagnosed with CNV secondary to MFC, mCNV, and ICNV were categorized into groups, by disease, for analysis. Spectral domain-OCT (SD-OCT) was used to describe and measure the morphological characteristics of CNV lesions in each group. The retinal biomarkers of CNV in MFC, mCNV, and ICNV were compared.

Results: Sixty-eight patients (71 eyes) were included and all eyes were diagnosed with active type 2 CNV. The MFC group had higher refraction than the ICNV group (P2 < 0.05). The choroidal thickness (CT) and CNV diameter of the MFC group were significantly greater than those of the mCNV group (P1 < 0.05). The number of eyes with sub-retinal fluids (SRF) and a "pitchfork sign" was significantly greater in the MFC group than in the mCNV group (P1 < 0.05). There was a significant difference only in CT) values between the MFC and ICNV groups (P2 < 0.001), but not in the other observation indicators (P2 > 0.05).

Conclusions: OCT biomarkers, such as the diameter of the CNV, SRF, the "pitchfork sign," and CT under CNV are useful in distinguishing CNV secondary to MFC from mCNV, which can allow the timely selection of treatment in some difficult cases. There were no differences between the MFC group and ICNV group except in refractive error, which indicates that some ICNV cases may be an early stage of a type of occult chorioretinitis. Long-term follow-up is needed for ICNV patients to confirm whether there is any potential inflammation.Key messagesSometimes, it is difficult to separate MFC with CNV from myopic CNV and ICNV in clinical.OCT biomarkers, such as the diameter of the CNV, SRF, the "pitchfork sign," and CT under CNV are useful in distinguishing CNV secondary to MFC from mCNV.There were no differences between the MFC group and ICNV group except in refractive error.
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http://dx.doi.org/10.1080/07853890.2021.1961015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354171PMC
December 2021

Identification of potential targets of triptolide in regulating the tumor microenvironment of stomach adenocarcinoma patients using bioinformatics.

Bioengineered 2021 12;12(1):4304-4319

School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

This study aimed to identify potential pharmacological targets of triptolide regulating the tumor microenvironment (TME) of stomach adenocarcinoma (STAD) patients. A total of 343 STAD cases from The Cancer Genome Atlas (TCGA) were assigned into high- or low-score groups applying Estimation of STromal and Immune cells in MAlignant Tumor tissues using Expression data (ESTIMATE). Hub genes were identified from differentially expressed genes (DEGs) shared by stromal- and immune-related components in the TME of STAD patients using R software. Cox regression analysis was used to identify genes significantly correlated with STAD patient survival. Triptolide target genes were predicted from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). Top 30 genes filtered by Cytohubba from 734 DEGs were screened as hub genes. Forty-two genes were found to be at high risk for STAD prognosis. Thirty-four targets of triptolide were predicted using the TCMSP database. Importantly, C-X-C chemokine receptor type 4 (CXCR4) was identified as a potential target of triptolide associated with the TME in STAD. Analysis of survival highlighted the association between CXCR4 upregulation with STAD progression and poor prognosis. Gene Set Enrichment Analysis (GSEA) confirmed that genes in the CXCR4- upregulated group had significant enrichment in immune-linked pathways. Additionally, triptolide targets were found to be significantly enriched in CXCR4-related chemokine and cancer-related p53 signaling pathways. Molecular docking demonstrated a high affinity between triptolide and CXCR4. In conclusion, CXCR4 may be a therapeutic target of triptolide in the treatment of STAD patients by modulating the TME.
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http://dx.doi.org/10.1080/21655979.2021.1945522DOI Listing
December 2021

Resumption of the treatment of non-COVID-19 gynecologic patients after lifting lockdown: Triage and infection prevention experiences from Wuhan.

J Obstet Gynaecol Res 2021 Sep 28;47(9):3297-3302. Epub 2021 Jul 28.

Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Aim: To share our experiences of resuming the treatments for gynecologic patients after lifting the lockdown in a hotspot area for the Coronavirus Disease 2019 (COVID-19) pandemic.

Methods: The triage process used to resume medical activities for gynecologic patients at the Wuhan Union Hospital after a 76-day lockdown of the city is described, and its effectiveness in preventing COVID-19 nosocomial transmission is shown.

Results: Nonemergency patients were pretriaged based on their contact history and body temperature at an outpatient clinic, and negative COVID-19 screening test results were required for admission to the buffering rooms at the gynecologic department. The buffering lasted at least 3 days for symptom monitoring, and a second round of COVID-19 testing was required before patients could be transferred to the regular gynecologic wards. For patients who needed emergency surgery, the first screening was completed at the isolation wards after surgery, followed by buffering at the gynecologic department. We received 19 298 outpatient visits, admitted 326 patients, and performed 223 operations in the first 2 months after the lockdown was lifted. No COVID-19 cases occurred in the hospitalized patients, while the proportion of potentially high-risk patients with cancer and severe anemia was increased in comparison to that observed during the same period in 2019 and the first 2 months of 2020 before the lockdown.

Conclusions: We provide an effective triage system with buffering at two levels to guarantee safe and timely treatment for non-COVID-19 gynecologic patients in the postlockdown phase.
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http://dx.doi.org/10.1111/jog.14917DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8457066PMC
September 2021
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