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Background We evaluated an inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine for immunogenicity and safety in adults aged 18–59 years. Methods In this randomized, double-blinded, controlled trial, healthy adults received a medium dose (MD) or a high dose (HD) of the vaccine at an interval of either 14 days or 28 days. Neutralizing antibody (NAb) and anti-S and anti-N antibodies were detected at different times, and adverse reactions were monitored for 28 days after full immunization. Results A total of 742 adults were enrolled in the immunogenicity and safety analysis. Among subjects in the 0, 14 procedure, the seroconversion rates of NAb in MD and HD groups were 89% and 96% with geometric mean titers (GMTs) of 23 and 30, respectively, at day 14 and 92% and 96% with GMTs of 19 and 21, respectively, at day 28 after immunization. Anti-S antibodies had GMTs of 1883 and 2370 in the MD group and 2295 and 2432 in the HD group. Anti-N antibodies had GMTs of 387 and 434 in the MD group and 342 and 380 in the HD group. Among subjects in the 0, 28 procedure, seroconversion rates for NAb at both doses were both 95% with GMTs of 19 at day 28 after immunization. Anti-S antibodies had GMTs of 937 and 929 for the MD and HD groups, and anti-N antibodies had GMTs of 570 and 494 for the MD and HD groups, respectively. No serious adverse events were observed during the study period. Conclusions Adults vaccinated with inactivated SARS-CoV-2 vaccine had NAb as well as anti-S/N antibody and had a low rate of adverse reactions. Clinical Trials Registration NCT04412538. [ABSTRACT FROM AUTHOR]

Background: Infliximab (IFX) and calcineurin inhibitors (cyclosporine [CYS] and tacrolimus [TAC]) were considered as rescue therapy in steroid-refractory ulcerative colitis (UC). The objective of our study was to perform a meta-analysis evaluating the short-term and long-term efficacy and safety of IFX and calcineurin inhibitors in steroid-refractory UC. Methods: We systematically searched the databases from inception to September 2020 that evaluated IFX, CYS, and TAC in steroid-refractory UC. The primary outcome was the response rates, remission rates, mucosal healing rates, and colectomy rates after therapy initiation. The secondary outcomes were the rates of adverse events (AE), serious adverse events (SAE), and mortality. Odds ratios (OR) with 95% confidence intervals (CIs) were calculated. Results: Nineteen studies comprising 1323 Acute severe ulcerative colitis (ASUC) patients were included in the meta-analysis. Among the non-randomized studies, a significantly higher therapeutic response rate was seen with IFX treatment, with a pooled OR of 3.15 (95% CI 2.26–4.40). Among non-randomized studies, IFX was associated with a significantly lower first-year OR (0.46 [95% CI 0.27–0.79]), second-year (OR 0.53 [95% CI 0.28–0.97]), third-year (OR 0.43 [95% CI 0.24–0.75]) colectomy rate. But the randomized controlled trials (RCTs) did not suggest any difference between IFX and CYS as rescue therapies for steroid-refractory UC. There were no significant differences among IFX, CYS, and TAC in the rates of AE, SAE, or mortality. Conclusion: Our meta-analysis suggested a better treatment response rate and lower risk of colectomy in the first, second and third year, with IFX, compared with CYS in steroid-refractory UC patients. There was no significant difference among IFX and calcineurin inhibitors in AE, SAE, and mortality. [ABSTRACT FROM AUTHOR]

Background: The majority of previous studies of the clinical outcome of video‐assisted thoracoscopic surgery (VATS) versus open lobectomy for pathological N2 non‐small cell lung cancer (pN2 NSCLC) have been single‐center experiences with small patient numbers. The aim of this study was therefore to investigate these procedures but in a large cohort of Chinese patients with pathological N2 NSCLC in real‐world conditions. Methods: Patients who underwent lobectomy for pN2 NSCLC by either VATS or thoracotomy were retrospectively reviewed from 10 tertiary hospitals between January 2014 and September 2017. Perioperative outcomes and overall survival of the patients were analyzed. Cox regression analysis was performed to identify potential prognostic factors. Propensity‐score analysis was performed to reduce cofounding biases and compare the clinical outcomes between both groups. Results: Among 2144 pN2 NSCLC, 1244 patients were managed by VATS and 900 by open procedure. A total of 305 (24.5%) and 344 patients died during VATS and the thoracotomy group during a median follow‐up of 16.7 and 15.6 months, respectively. VATS lobectomy patients had better overall survival when compared with those undergoing the open procedure (P < 0.0001). Multivariate COX regression analysis showed VATS lobectomy independently favored overall survival (HR = 0.75, 95% CI: 0.621–0.896, P = 0.0017). Better perioperative outcomes, including less blood loss, shorter drainage time and hospital stay, were also observed in patients undergoing VATS lobectomy (P < 0.05). After propensity‐score matching, 169 patients in each group were analyzed, and no survival difference were found between the two groups. Less blood loss was observed in the VATS group, but there was a longer operation time. Conclusions: VATS lobectomy might be a feasible alternative to conventional open surgery for resectable pN2 NSCLC. Key points: Significant findings of the study: VATS lobectomy has comparative OS in pN2 NSCLC versus open procedure in resectable patients.What this study adds: VATS lobectomy might be feasible for pN2 NSCLC. [ABSTRACT FROM AUTHOR]

Introduction. Nonspecific chronic low back pain (NCLBP) became a public health and economic problem. Acupoint injection was used widely for patients with NCLBP. However, there were inconsistent results on the efficacy for these people. Therefore, this review was performed to systematically assess the efficacy and safety of acupoint injection. Materials and Methods. The literature sources were collected via EMBASE, Medline, CENTRAL, CINAHL, CNKI, VIP, Wanfang, and Sino-Med Database from their inception to October 13, 2019. Endnote X7, widely used document management software, was used to manage and screen the literature sources. Each record was screened according to the predetermined inclusion criteria by two review authors independently. Quality assessment tool, "Risk of table," was used to assess the quality of the included studies according to the recommendation of the Cochrane Handbook for Systematic Reviews of Interventions. Data extraction was performed by one reviewer and verified by another reviewer. Any disagreement was addressed via consulting with a third reviewer in the abovementioned processes. All procedures were performed according to the Cochrane Handbook for Systematic Reviews of Interventions. Results. This review included 13 studies involving 1381 patients with NCLBP. Quantitative analysis results indicated that there is no sufficient evidence that acupoint injection can improve the pain of patients with low back pain based on two trails: Visual Analogue Scale (VAS: MD = −1.33, 95% confidence interval (95% CI) −3.30 to 0.64, P = 0.18 , random-effect model). When assessing the effectiveness of acupoint injection therapy, the results indicated that acupoint injection can improve the effective rate for nonspecific chronic low back pain (OR = 3.64, 95% CI 2.4 to 5.21, P < 0.0001 , fixed-effect model). Conclusion. There is insufficient evidence to indicate that acupoint injection therapy could improve the pain for patients with NCLBP. However, the level of evidence was downgraded to "very low quality" because of the poor methodological quality and clinical heterogeneity. The results should be interpreted with caution. Higher quality RCTs with more appropriate comparison, more objective outcome instruments, and adequate follow-up periods are necessary to assess the efficacy of acupoint injection for NCLBP. The PROSPERO Research registration identifying number is CRD42019119158. [ABSTRACT FROM AUTHOR]

Background Pleomorphic carcinoma is a rare epithelial malignant tumor. Because the clinical characteristics and behavior of the disease remain unclear, we investigated the clinicopathological findings and prognosis of 60 patients with pleomorphic carcinoma. Methods The clinicopathological characteristics of 60 cases of pulmonary pleomorphic carcinoma identified between 1999 and 2011 were studied. Of these, 55 patients had peripheral disease and five had central disease. The tumor size in all patients was 1-9.5 cm (mean, 5.8 ± 4.5 cm), while 30 had lesions with a diameter larger than 5 cm. All patients underwent pulmonary resection. Results There were no in-hospital deaths. The three and five year survival rates of all patients were 47.2% and 25.6%, respectively. The three and five year survival rates were 57.3% and 32.5% for N0 patients, and 25.4% and 17.1% for N1-2 patients, respectively. Overall survival was significantly different between the radical resection and incomplete resection groups. Multivariate Cox regression analyses of overall survival for all 60 patients indicated that radical resection ( P = 0.041), tumor node metastasis ( TNM) stage ( P = 0.044), and nodal status ( P = 0.029) were significant independent prognostic factors. Conclusion Pleomorphic carcinoma is a rare type of lung cancer. In our study, pleomorphic carcinoma of the lung was often found as a peripherally located large mass and was associated with a poor prognosis. Radical resection, TNM stage and nodal status were significant independent prognostic factors. [ABSTRACT FROM AUTHOR]