Pub Date : 2020-02-27DOI: 10.3760/CMA.J.ISSN.1000-6680.2020.0015
Shi Chen, Juan Wu, Zhi Ming Li, Dixiong Xu, Ziyang Zhu, Chuanhai Wang, Cheng-hong Li, P. He
Objective To observe theepidemiology, clinical manifestations, laboratory tests, imaging findings, treatment and prognosis of patients with novel coronavirus pneumonia. Methods Clinical data of 109 patients with suspected and definite novel coronavirus pneumonia admitted to Wuhan Sixth Hospital from December 24, 2019 to January 28, 2020 were retrospectively analyzed. Statistical analysiswas performed by using t test or chi-square test. Results Among the 109 patients, 48 (44%) were male and 61 (56%) were female, with the average age of (52.5±10.8) years. Fifty-four patients (49.5%) had definite contact history. Among the 109 patients, 104 (95.5%) presentedwith fever, 37(33.7%) with headache, 78 (71.9%) with general pain, 88 (80.8%) with fatigue and poor appetite, 23 (21.3%) with diarrhea, 94 (86.5%) withcoughing, 23 (21.3%) with shortness of breath, 57 (52.8%) withpalpitation, 45 (41.5%) with chest distress, 4 (3.3%) with chest pain, 40 (37.0%) with lung rales. Forty-two cases (38.5%) had leukocyte count 230 mmol/L, 29 cases (26.6%) had brain natriuretic peptide precursor>300 ng/mL, 87 cases (79.8%) had hypersensitive C-reactive protein >10mg/L, 26 cases (23.9%) had D-dimer >0.5 mg/L, 35 cases (32.1%) had coagulation disorder. The leukocyte counts, LDH, brain natriuretic peptide precursor and D-dimer of severe/critical cases[(11.33±4.87)×109/L, (527.51±260.87) mmol/L, (722.88±189.56) ng/mL, (1.89±4.24) mg/L, respectively] were all significantly higher than those of common cases [(4.02±1.49)×109/L, (159.75±30.31)mmol/L, (428.22±124.76)ng/mLand (0.41±0.22)mg/L, respectively], while the lymphocyte count of severe/critical cases [(0.60±0.17)×109/L] was significantly lower than common cases [(1.13±0.43)×109/L] (t=11.36, 11.33,9.81,2.81 and 7.77,all P<0.05). On admission, chest CT showed that 27 cases (24.8%) of pneumonia were unilateral, 82 cases (75.2%) werebilateral, and most of them were ground glass. The pneumonia progressed in a short time and reached the peak within 10 days. The comprehensive treatment included antiviral drugs, prevention ofbacterialinfection and supportive treatment, and glucocorticoid and respiratory support treatment wereadministrated when necessary. Conclusions The novel coronavirus pneumonia is characterized by highly infectious, rapid progress, and diverse clinical and imaging features. Early diagnosis and active comprehensive treatment could improve theprognosis and reduce themortality. Key words: Coronaviru infection; Pneumonia; Coronavirus disease 2019; Clinical characteristics
{"title":"Clinical features of 109 cases of novel coronavirus pneumonia","authors":"Shi Chen, Juan Wu, Zhi Ming Li, Dixiong Xu, Ziyang Zhu, Chuanhai Wang, Cheng-hong Li, P. He","doi":"10.3760/CMA.J.ISSN.1000-6680.2020.0015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2020.0015","url":null,"abstract":"Objective \u0000To observe theepidemiology, clinical manifestations, laboratory tests, imaging findings, treatment and prognosis of patients with novel coronavirus pneumonia. \u0000 \u0000 \u0000Methods \u0000Clinical data of 109 patients with suspected and definite novel coronavirus pneumonia admitted to Wuhan Sixth Hospital from December 24, 2019 to January 28, 2020 were retrospectively analyzed. Statistical analysiswas performed by using t test or chi-square test. \u0000 \u0000 \u0000Results \u0000Among the 109 patients, 48 (44%) were male and 61 (56%) were female, with the average age of (52.5±10.8) years. Fifty-four patients (49.5%) had definite contact history. Among the 109 patients, 104 (95.5%) presentedwith fever, 37(33.7%) with headache, 78 (71.9%) with general pain, 88 (80.8%) with fatigue and poor appetite, 23 (21.3%) with diarrhea, 94 (86.5%) withcoughing, 23 (21.3%) with shortness of breath, 57 (52.8%) withpalpitation, 45 (41.5%) with chest distress, 4 (3.3%) with chest pain, 40 (37.0%) with lung rales. Forty-two cases (38.5%) had leukocyte count 230 mmol/L, 29 cases (26.6%) had brain natriuretic peptide precursor>300 ng/mL, 87 cases (79.8%) had hypersensitive C-reactive protein >10mg/L, 26 cases (23.9%) had D-dimer >0.5 mg/L, 35 cases (32.1%) had coagulation disorder. The leukocyte counts, LDH, brain natriuretic peptide precursor and D-dimer of severe/critical cases[(11.33±4.87)×109/L, (527.51±260.87) mmol/L, (722.88±189.56) ng/mL, (1.89±4.24) mg/L, respectively] were all significantly higher than those of common cases [(4.02±1.49)×109/L, (159.75±30.31)mmol/L, (428.22±124.76)ng/mLand (0.41±0.22)mg/L, respectively], while the lymphocyte count of severe/critical cases [(0.60±0.17)×109/L] was significantly lower than common cases [(1.13±0.43)×109/L] (t=11.36, 11.33,9.81,2.81 and 7.77,all P<0.05). On admission, chest CT showed that 27 cases (24.8%) of pneumonia were unilateral, 82 cases (75.2%) werebilateral, and most of them were ground glass. The pneumonia progressed in a short time and reached the peak within 10 days. The comprehensive treatment included antiviral drugs, prevention ofbacterialinfection and supportive treatment, and glucocorticoid and respiratory support treatment wereadministrated when necessary. \u0000 \u0000 \u0000Conclusions \u0000The novel coronavirus pneumonia is characterized by highly infectious, rapid progress, and diverse clinical and imaging features. Early diagnosis and active comprehensive treatment could improve theprognosis and reduce themortality. \u0000 \u0000 \u0000Key words: \u0000Coronaviru infection; Pneumonia; Coronavirus disease 2019; Clinical characteristics","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47412561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-27DOI: 10.3760/CMA.J.ISSN.1000-6680.2020.0014
Xueyan Liu, G. Tang, Chunhua Li, Yanqiu Lu, Jia Yang, W. Shu, Xin Dai, S. Lyu
Objective To investigate the features of chest CT imaging and dynamic changes of severe coronavirus disease 2019 (COVID-19). Methods The clinical and computed tomography (CT) data of 17 patients diagnosed with severe COVID-19 admitted to Chongqing Public Health Medical Center from January 24 to February 6, 2020 were collected. The first chest CT manifestations and the dynamic changes of imaging during treatment were retrospectively analyzed. Results The first chest CT manifestations of the 17 patients showed that 16 cases presented with peripheral and subpleural distributions, and 2 cases presented with 3 lobes involved, one case with 4 lobes involved and 14 cases with 5 lobes involved, and 17 cases presented with ground-glass opacities, ten cases with consolidation, seven cases with subpleural line, nine cases with air bronchogram, 3 cases with thickened lobular septum, two cases with bronchiectasis, two cases with pleural effusion, two cases with lymphadenopathy with the short diameter of 1.0-1.2cm. Among 16 patients who underwent repeated CT examination, the lesions of 8 patients showed continuous improvement, and those of the other 8 patients showed fluctuating changes. Conclusions The CT findings of severe COVID-19 patients are mainly ground-glass opacities and consolidation, with the peripheral distribution. The range of lesions is wide, with 5-lobe involvement mostly. Lymphadenopathy or pleural effusion is rare. Chest CT is useful for the evaluation for the therapeutic effects. Key words: Coronavirus Infections; Pneumonia; 2019 novel coronavirus; Corona virus disease 2019; CT features; Tomography, X-ray computed
{"title":"Chest computed tomography findings and dynamic changes of severe coronavirus disease 2019","authors":"Xueyan Liu, G. Tang, Chunhua Li, Yanqiu Lu, Jia Yang, W. Shu, Xin Dai, S. Lyu","doi":"10.3760/CMA.J.ISSN.1000-6680.2020.0014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2020.0014","url":null,"abstract":"Objective \u0000To investigate the features of chest CT imaging and dynamic changes of severe coronavirus disease 2019 (COVID-19). \u0000 \u0000 \u0000Methods \u0000The clinical and computed tomography (CT) data of 17 patients diagnosed with severe COVID-19 admitted to Chongqing Public Health Medical Center from January 24 to February 6, 2020 were collected. The first chest CT manifestations and the dynamic changes of imaging during treatment were retrospectively analyzed. \u0000 \u0000 \u0000Results \u0000The first chest CT manifestations of the 17 patients showed that 16 cases presented with peripheral and subpleural distributions, and 2 cases presented with 3 lobes involved, one case with 4 lobes involved and 14 cases with 5 lobes involved, and 17 cases presented with ground-glass opacities, ten cases with consolidation, seven cases with subpleural line, nine cases with air bronchogram, 3 cases with thickened lobular septum, two cases with bronchiectasis, two cases with pleural effusion, two cases with lymphadenopathy with the short diameter of 1.0-1.2cm. Among 16 patients who underwent repeated CT examination, the lesions of 8 patients showed continuous improvement, and those of the other 8 patients showed fluctuating changes. \u0000 \u0000 \u0000Conclusions \u0000The CT findings of severe COVID-19 patients are mainly ground-glass opacities and consolidation, with the peripheral distribution. The range of lesions is wide, with 5-lobe involvement mostly. Lymphadenopathy or pleural effusion is rare. Chest CT is useful for the evaluation for the therapeutic effects. \u0000 \u0000 \u0000Key words: \u0000Coronavirus Infections; Pneumonia; 2019 novel coronavirus; Corona virus disease 2019; CT features; Tomography, X-ray computed","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44837793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-26DOI: 10.3760/CMA.J.CN311365-20200219-00086
Ke Wen, Wen-gang Li, Dawei Zhang, Aimin Zhang, Tao Zhang, Peng Zhao, E. Qin
Objective To investigate and analyze the epidemiological and clinical characteristics of some cases of coronavirus disease 2019 (COVID-19) in Beijing. Methods A retrospective study was conducted to analyze the data of 46 patients with COVID-19 in Beijing from 20th January 2020 to 8th February 2020 at the Fifth Medical Center of the PLA General Hospital. Features of clinical symptoms, laboratory inspections and imaging inspections were analyzed. Statistical analysis used Fisher exact test. If P<0.05, post-hoc test was used for pairwise comparison, and the statistics were corrected by Bonferroni test. Results Among the 46 patients included in this study, 27 were male and 19 were female. The age range was between 3 - 79 years old, and the mean age was (41.8 ± 16.3) years old. The average incubation period was (4.85 ± 3.00) days. A total of 26 cases (56.5%) were clustered patients, and 12 (26.1%), 23 (50.0%) and 11 patients (23.9%)were assigned to the mild group, common group, and sever group, respectively. Fever (39.8%), cough (27.6%), and fatigue (25.3%) was the main clinical symptom for these patients. The decrease in white blood cell counts occurred in 12 patients, four had the decrease in T lymphocyte counts, 17 had the decrease in CD4 + T lymphocyte counts, seven had the decrease in CD8 + T lymphocyte counts, 21 had the increase level of C-reactive protein (45.7%), and IL-6 level increased in 32 cases (69.6%), erythrocyte sedimentation rate increased in 20 cases(50.0%), serum ferritin level increased in 26 cases (56.5%), and blood lactate level increased in nine cases. There was a statistically significant difference in the number of cases in which the absolute value of T lymphocytes and of CD8 + T lymphocytes decreased among the mild, common and severe groups (all P<0.05). Comparing the number of cases in the three groups with elevated C-reactive protein, interleukin-6, erythrocyte sedimentation rate, serum ferritin and blood lactate levels, the differences were statistically significant (all P<0.05). The number of cases with elevated C-reactive protein levels was higher in severe group than that in mild and common group. The number of cases with elevated interleukin-6, erythrocyte sedimentation rate, and serum ferritin levels were higher in severe group than in mild group. The number of cases with elevated blood lactic acid levels was higher in severe group than in mild group. The differences between the above groups were statistically significant (both adjusted P<0.017). Analysis of chest X-rays showed that 34 patients (73.9%) had inflammation in the lungs. Conclusions The epidemiological characteristics of cases with COVID-19 in Beijing are mainly imported cases and clustered cases. The clinical manifestations are mainly fever , fatigue and cough. C-reactive protein, interleukin-6, red blood cell sedimentation rate, serum ferritin and blood lactate levels are higher in severe patients. Key words: COVID-19; Epidemiol
{"title":"Epidemiological and clinical characteristics of 46 newly-admitted coronavirus disease 2019 cases in Beijing/ 中华传染病杂志","authors":"Ke Wen, Wen-gang Li, Dawei Zhang, Aimin Zhang, Tao Zhang, Peng Zhao, E. Qin","doi":"10.3760/CMA.J.CN311365-20200219-00086","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311365-20200219-00086","url":null,"abstract":"Objective \u0000To investigate and analyze the epidemiological and clinical characteristics of some cases of coronavirus disease 2019 (COVID-19) in Beijing. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted to analyze the data of 46 patients with COVID-19 in Beijing from 20th January 2020 to 8th February 2020 at the Fifth Medical Center of the PLA General Hospital. Features of clinical symptoms, laboratory inspections and imaging inspections were analyzed. Statistical analysis used Fisher exact test. If P<0.05, post-hoc test was used for pairwise comparison, and the statistics were corrected by Bonferroni test. \u0000 \u0000 \u0000Results \u0000Among the 46 patients included in this study, 27 were male and 19 were female. The age range was between 3 - 79 years old, and the mean age was (41.8 ± 16.3) years old. The average incubation period was (4.85 ± 3.00) days. A total of 26 cases (56.5%) were clustered patients, and 12 (26.1%), 23 (50.0%) and 11 patients (23.9%)were assigned to the mild group, common group, and sever group, respectively. Fever (39.8%), cough (27.6%), and fatigue (25.3%) was the main clinical symptom for these patients. The decrease in white blood cell counts occurred in 12 patients, four had the decrease in T lymphocyte counts, 17 had the decrease in CD4 + T lymphocyte counts, seven had the decrease in CD8 + T lymphocyte counts, 21 had the increase level of C-reactive protein (45.7%), and IL-6 level increased in 32 cases (69.6%), erythrocyte sedimentation rate increased in 20 cases(50.0%), serum ferritin level increased in 26 cases (56.5%), and blood lactate level increased in nine cases. There was a statistically significant difference in the number of cases in which the absolute value of T lymphocytes and of CD8 + T lymphocytes decreased among the mild, common and severe groups (all P<0.05). Comparing the number of cases in the three groups with elevated C-reactive protein, interleukin-6, erythrocyte sedimentation rate, serum ferritin and blood lactate levels, the differences were statistically significant (all P<0.05). The number of cases with elevated C-reactive protein levels was higher in severe group than that in mild and common group. The number of cases with elevated interleukin-6, erythrocyte sedimentation rate, and serum ferritin levels were higher in severe group than in mild group. The number of cases with elevated blood lactic acid levels was higher in severe group than in mild group. The differences between the above groups were statistically significant (both adjusted P<0.017). Analysis of chest X-rays showed that 34 patients (73.9%) had inflammation in the lungs. \u0000 \u0000 \u0000Conclusions \u0000The epidemiological characteristics of cases with COVID-19 in Beijing are mainly imported cases and clustered cases. The clinical manifestations are mainly fever , fatigue and cough. C-reactive protein, interleukin-6, red blood cell sedimentation rate, serum ferritin and blood lactate levels are higher in severe patients. \u0000 \u0000 \u0000Key words: \u0000COVID-19; Epidemiol","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49580462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-19DOI: 10.3760/CMA.J.ISSN.1000-6680.2020.0007
Mengdie Li, Ming Xu, Weiqiang Zhan, Tao Han, Guosheng Zhang, Yibin Lu
Objective To report the first case of a neonatal pneumonia with 2019-nCoV infection, and the experience of successfully diagnosis and treatment in late pregnancy woman with novel coronavirus pneumonia (critical type) in Xinyang city. Methods The successfully diagnosis and treatment of a woman with 38 weeks singleton pregnancy complicated with novel coronavirus pneumonia (critical type), and a case of neonatal pneumonia with 2019-nCoV infection were retrospectively analyzed. Results A single male was successfully delivered at 38-week gestation of his mother by cesarean section under third level protection in operation room. The delivery woman was diagnosed with 2019-nCoV infection at day 2 of delivery. Dyspnea and severe hypoxemia soon developed, and invasive mechanical ventilation was given. After active rescue and treatment, the delivery woman had been taken off line successfully and the condition was stable. Pharyngeal swab specimen of the neonate was sent for examination 3 days after birth, and was positive for novel coronavirus nucleic acid by fluorescence reverse transcript polymerase chain reaction. Conclusion 2019-nCoV may be transmitted vertically from mother to child. Key words: Pregnancy; 2019 novel coronavirus; Pneumonia; Vertical transmission
{"title":"Report of the first cases of mother and infant infections with 2019 novel coronavirus in Xinyang City Henan Province/ 中华传染病杂志","authors":"Mengdie Li, Ming Xu, Weiqiang Zhan, Tao Han, Guosheng Zhang, Yibin Lu","doi":"10.3760/CMA.J.ISSN.1000-6680.2020.0007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2020.0007","url":null,"abstract":"Objective \u0000To report the first case of a neonatal pneumonia with 2019-nCoV infection, and the experience of successfully diagnosis and treatment in late pregnancy woman with novel coronavirus pneumonia (critical type) in Xinyang city. \u0000 \u0000 \u0000Methods \u0000The successfully diagnosis and treatment of a woman with 38 weeks singleton pregnancy complicated with novel coronavirus pneumonia (critical type), and a case of neonatal pneumonia with 2019-nCoV infection were retrospectively analyzed. \u0000 \u0000 \u0000Results \u0000A single male was successfully delivered at 38-week gestation of his mother by cesarean section under third level protection in operation room. The delivery woman was diagnosed with 2019-nCoV infection at day 2 of delivery. Dyspnea and severe hypoxemia soon developed, and invasive mechanical ventilation was given. After active rescue and treatment, the delivery woman had been taken off line successfully and the condition was stable. Pharyngeal swab specimen of the neonate was sent for examination 3 days after birth, and was positive for novel coronavirus nucleic acid by fluorescence reverse transcript polymerase chain reaction. \u0000 \u0000 \u0000Conclusion \u00002019-nCoV may be transmitted vertically from mother to child. \u0000 \u0000 \u0000Key words: \u0000Pregnancy; 2019 novel coronavirus; Pneumonia; Vertical transmission","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45992529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2020.02.010
Xueshi Zhou, Y. Ye, Ya-Ni Mao, Tingting Su, Hejuan Du, Xiaoye Guo, Lingxiao Zhou, Ying Zhang, Lihua Huang, Yuanwang Qiu
Objective To analyze the relationship between antithrombin Ⅲ(AT-Ⅲ) activity and survival, bleeding and thrombosis complications in patients with acute-on-chronic liver failure (ACLF), and to explore the prediction value of AT-Ⅲ activity in the prognosis of ACLF patients. Methods The clinical data of 130 hospitalized patients with ACLF were retrospectively collected in Wuxi No.5 People′s Hospital from January 1, 2013 to April 1, 2019. The liver function, international normalized ratio (INR), and 90-day survival rate were detected. The AT-Ⅲ activity values at admission, week two, week four, and week eight of hospitalization were recorded, and the occurrences of fecal occult blood and femoral vein thrombosis were also recorded. The measurement data were compared by t test, analysis of variance, or rank sum test, and the categorical data were compared by chi-square test. The risk factors affecting the survival of ACLF patients were analyzed by Cox regression. The survival analysis was performed using the Kaplan-Meier method. Results At the end of 90-day follow-up of 130 patients, 56 patients died, 20 patients (15.38%) were fecal occult blood positive and 15 (11.54%) had femoral vein thrombosis. The baseline AT-Ⅲ activity in the death group was lower than that in the survival group ((17.89±13.68)% vs (36.03±11.96)%), and the difference was statistically significant (t=-8.045, P 0.05). The Cox regression analysis suggested INR (odds ratio (OR)=1.364, 95% confidence interval (CI) 1.078-1.726, P=0.010) and AT-Ⅲ activity (OR=0.930, 95%CI 0.906-0.954, P<0.01) were the independent factors affecting the survival of patients with ACLF. The area under the receiver operator characteristic curve of the AT-Ⅲ activity for predicting 90-day survival outcome of the patient was 0.706 (95%CI 0.773-0.952, P<0.01), and the cut-off value was 25%. Patients with AT-Ⅲ activity ≥ 25% had a higher survival rate than those with AT-Ⅲ activity <25% (χ2=58.20, P<0.01). Conclusions AT-Ⅲ activity is associated with fecal occult blood positive and femoral vein thrombosis in ACLF patients. The AT-Ⅲ activity is an independent influencing factor for predicting the prognosis of ACLF patients. Patients with AT-Ⅲ activity less than 25% have the higher mortality rate. Key words: Antithrombin Ⅲ, activity; Liver failure, acute-on-chronic; Prognosis; Forecasting
{"title":"Prediction value of antithrombin III activity in the prognosis of patients with acute-on-chronic liver failure","authors":"Xueshi Zhou, Y. Ye, Ya-Ni Mao, Tingting Su, Hejuan Du, Xiaoye Guo, Lingxiao Zhou, Ying Zhang, Lihua Huang, Yuanwang Qiu","doi":"10.3760/CMA.J.ISSN.1000-6680.2020.02.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2020.02.010","url":null,"abstract":"Objective \u0000To analyze the relationship between antithrombin Ⅲ(AT-Ⅲ) activity and survival, bleeding and thrombosis complications in patients with acute-on-chronic liver failure (ACLF), and to explore the prediction value of AT-Ⅲ activity in the prognosis of ACLF patients. \u0000 \u0000 \u0000Methods \u0000The clinical data of 130 hospitalized patients with ACLF were retrospectively collected in Wuxi No.5 People′s Hospital from January 1, 2013 to April 1, 2019. The liver function, international normalized ratio (INR), and 90-day survival rate were detected. The AT-Ⅲ activity values at admission, week two, week four, and week eight of hospitalization were recorded, and the occurrences of fecal occult blood and femoral vein thrombosis were also recorded. The measurement data were compared by t test, analysis of variance, or rank sum test, and the categorical data were compared by chi-square test. The risk factors affecting the survival of ACLF patients were analyzed by Cox regression. The survival analysis was performed using the Kaplan-Meier method. \u0000 \u0000 \u0000Results \u0000At the end of 90-day follow-up of 130 patients, 56 patients died, 20 patients (15.38%) were fecal occult blood positive and 15 (11.54%) had femoral vein thrombosis. The baseline AT-Ⅲ activity in the death group was lower than that in the survival group ((17.89±13.68)% vs (36.03±11.96)%), and the difference was statistically significant (t=-8.045, P 0.05). The Cox regression analysis suggested INR (odds ratio (OR)=1.364, 95% confidence interval (CI) 1.078-1.726, P=0.010) and AT-Ⅲ activity (OR=0.930, 95%CI 0.906-0.954, P<0.01) were the independent factors affecting the survival of patients with ACLF. The area under the receiver operator characteristic curve of the AT-Ⅲ activity for predicting 90-day survival outcome of the patient was 0.706 (95%CI 0.773-0.952, P<0.01), and the cut-off value was 25%. Patients with AT-Ⅲ activity ≥ 25% had a higher survival rate than those with AT-Ⅲ activity <25% (χ2=58.20, P<0.01). \u0000 \u0000 \u0000Conclusions \u0000AT-Ⅲ activity is associated with fecal occult blood positive and femoral vein thrombosis in ACLF patients. The AT-Ⅲ activity is an independent influencing factor for predicting the prognosis of ACLF patients. Patients with AT-Ⅲ activity less than 25% have the higher mortality rate. \u0000 \u0000 \u0000Key words: \u0000Antithrombin Ⅲ, activity; Liver failure, acute-on-chronic; Prognosis; Forecasting","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"38 1","pages":"105-110"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42578802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Discussion on key issues of infection prevention and control in patients with novel coronavirus pneumonia using mechanical ventilator","authors":"Qixing Wang, Xin Jing, Zhengfang Zhu, J. Zheng, R. Kong, Xiangyu Zhang","doi":"10.3760/CMA.J.ISSN.1000-6680.2020.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2020.02.005","url":null,"abstract":"新型冠状病毒肺炎疫情引起全球关注，其强传播力导致感染人数众多，且医务人员占一定比例。在当前患者多且负压病房\"供不应求\"的情况下，如何做到最大限度的环境保护，加强对各种传播风险的防范，尽可能避免医务人员和其他患者的二次感染，显得尤为重要。因此，现着重探讨新型冠状病毒肺炎患者在机械通气条件下如何通过细节管理进行感染防控，以减少病毒对患者的污染。","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"38 1","pages":"83-85"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49005486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2020.02.008
Siran Lin, Yuzhen Xu, Wei Zhang, Qianqian Liu, Jing Wu, Bin Xu, Sheng-lei Yu, Sen Wang, Lei Zhou, Yuefeng Hu, Wenhong Zhang, L. Shao, Yan Gao
Objective To analyze the differences of peripheral blood transcriptome between mild and severe influenza A (H1N1) patients, and to find indicators for the assessment of disease severity. Methods A total of ten patients (five patients with mild disease and five patients with severe disease) diagnosed with H1N1 infection from January to May 2018 at Huashan Hospital, Fudan University in Shanghai were enrolled, and five healthy people were also enrolled as controls. The peripheral blood of patients was collected for transcriptome sequencing at the time when they were first diagnosed. Measurement data were compared using t test or Mann-Whitney U test. The count data were compared using Fisher exact test when appropriate. Data analysis of transcriptome predictions was performed using bioinformatics methods. Results The platelet counts were significantly different between mild and severe groups ((163.4±21.5 )×109/L vs (255.6±52.5)×109/L, t=3.636, P=0.007). There were no differences between the two groups in gender, age, white blood cell counts, neutrophil percentage, lymphocyte percentage and hemoglobin levels (all P>0.05). However, the average expression levels of matrix metalloproteinase (MMP) 8 and MMP9 in severe group (18.41 and 174.00, respectively) were both higher than those in mild group (2.33 and 22.91, respectively) and healthy control (1.43 and 34.65, respectively; all P<0.01). Conclusion MMP8 and MMP9 could be expected to serve as the molecular biological markers for predicting the disease severity in patients with influenza A (H1N1) infection. Key words: Influenza A virus, H1N1; Matrix metalloproteinase 8; Matrix metalloproteinase 9; RNA sequencing
{"title":"Preliminary study on predictive indicators of disease severity in patients with influenza A (H1N1)","authors":"Siran Lin, Yuzhen Xu, Wei Zhang, Qianqian Liu, Jing Wu, Bin Xu, Sheng-lei Yu, Sen Wang, Lei Zhou, Yuefeng Hu, Wenhong Zhang, L. Shao, Yan Gao","doi":"10.3760/CMA.J.ISSN.1000-6680.2020.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2020.02.008","url":null,"abstract":"Objective \u0000To analyze the differences of peripheral blood transcriptome between mild and severe influenza A (H1N1) patients, and to find indicators for the assessment of disease severity. \u0000 \u0000 \u0000Methods \u0000A total of ten patients (five patients with mild disease and five patients with severe disease) diagnosed with H1N1 infection from January to May 2018 at Huashan Hospital, Fudan University in Shanghai were enrolled, and five healthy people were also enrolled as controls. The peripheral blood of patients was collected for transcriptome sequencing at the time when they were first diagnosed. Measurement data were compared using t test or Mann-Whitney U test. The count data were compared using Fisher exact test when appropriate. Data analysis of transcriptome predictions was performed using bioinformatics methods. \u0000 \u0000 \u0000Results \u0000The platelet counts were significantly different between mild and severe groups ((163.4±21.5 )×109/L vs (255.6±52.5)×109/L, t=3.636, P=0.007). There were no differences between the two groups in gender, age, white blood cell counts, neutrophil percentage, lymphocyte percentage and hemoglobin levels (all P>0.05). However, the average expression levels of matrix metalloproteinase (MMP) 8 and MMP9 in severe group (18.41 and 174.00, respectively) were both higher than those in mild group (2.33 and 22.91, respectively) and healthy control (1.43 and 34.65, respectively; all P<0.01). \u0000 \u0000 \u0000Conclusion \u0000MMP8 and MMP9 could be expected to serve as the molecular biological markers for predicting the disease severity in patients with influenza A (H1N1) infection. \u0000 \u0000 \u0000Key words: \u0000Influenza A virus, H1N1; Matrix metalloproteinase 8; Matrix metalloproteinase 9; RNA sequencing","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"38 1","pages":"94-98"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44596518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2020.02.006
Jun Chen, Y. Ling, X. Xi, Ping Liu, Feng Li, Tao Li, Zhiyin Shang, Mei Wang, Yinzhong Shen, Hongzhou Lu
Objective To evaluate the efficacies of lopinavir/ritonavir and abidol in the treatment of novel covonavirus pneumonia (NCP). Methods The clinical data of 134 patients with NCP receiving treatment at Shanghai Public Health Clinical Center during January 20 to February 6, 2020 were retrospectively collected. All the patients received interferon-α2b spray and symptomatic supportive treatment, and 52 cases received oral lopinavir/ritonavir treatment, 34 cases received oral abidol treatment, the remaining 48 cases did not take any antiviral drugs. The efficacies of the three groups were compared, and Chi-square test was used for statistical analysis. Results The 134 patients included 69 males (51.5%) and 65 females (48.5%), aged 35 to 62 years with the average of 48 years. The median time to temperature normalization in patients receiving abidol or lopinavir/ritonavir treatment was both six days after admission, and that was four days in the control group, with no significant difference (χ2=2.37, P=0.31). The median time for polymerase chain reaction (PCR) negative in the respiratory specimens in the three groups was all seven days after admission, and the PCR negative rates at day seven after admission in lopinavir/ritonavir, abidol and control groups were 71.8% (28/39), 82.6% (19/23) and 77.1% (27/35), respectively, which were not significantly different (χ2=0.46, P=0.79). Radiological worsening at day seven was observed in comparable proportions of patients in the three groups, which were 42.3% (22/52), 35.3% (12/34) and 52.1% (25/48), respectively(χ2=2.38, P=0.30). Adverse reactions occurred in 17.3% (9/52), 8.8% (3/34) and 8.3% (4/48) patients, respectively in the three groups (χ2=2.33, P=0.33). Conclusions This study does not find any effects of lopinavir/ritonavir and abidol on relieving symptoms or accelerating virus clearance. The efficacies of these two drugs in NCP treatment need further investigation. Key words: Coronavirus infections; Pneumonia; Validation studies; 2019 novel coronavirus; Lopinavir/ritonavir; Abidol
{"title":"Efficacies of lopinavir/ritonavir and abidol in the treatment of novel coronavirus pneumonia","authors":"Jun Chen, Y. Ling, X. Xi, Ping Liu, Feng Li, Tao Li, Zhiyin Shang, Mei Wang, Yinzhong Shen, Hongzhou Lu","doi":"10.3760/CMA.J.ISSN.1000-6680.2020.02.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2020.02.006","url":null,"abstract":"Objective \u0000To evaluate the efficacies of lopinavir/ritonavir and abidol in the treatment of novel covonavirus pneumonia (NCP). \u0000 \u0000 \u0000Methods \u0000The clinical data of 134 patients with NCP receiving treatment at Shanghai Public Health Clinical Center during January 20 to February 6, 2020 were retrospectively collected. All the patients received interferon-α2b spray and symptomatic supportive treatment, and 52 cases received oral lopinavir/ritonavir treatment, 34 cases received oral abidol treatment, the remaining 48 cases did not take any antiviral drugs. The efficacies of the three groups were compared, and Chi-square test was used for statistical analysis. \u0000 \u0000 \u0000Results \u0000The 134 patients included 69 males (51.5%) and 65 females (48.5%), aged 35 to 62 years with the average of 48 years. The median time to temperature normalization in patients receiving abidol or lopinavir/ritonavir treatment was both six days after admission, and that was four days in the control group, with no significant difference (χ2=2.37, P=0.31). The median time for polymerase chain reaction (PCR) negative in the respiratory specimens in the three groups was all seven days after admission, and the PCR negative rates at day seven after admission in lopinavir/ritonavir, abidol and control groups were 71.8% (28/39), 82.6% (19/23) and 77.1% (27/35), respectively, which were not significantly different (χ2=0.46, P=0.79). Radiological worsening at day seven was observed in comparable proportions of patients in the three groups, which were 42.3% (22/52), 35.3% (12/34) and 52.1% (25/48), respectively(χ2=2.38, P=0.30). Adverse reactions occurred in 17.3% (9/52), 8.8% (3/34) and 8.3% (4/48) patients, respectively in the three groups (χ2=2.33, P=0.33). \u0000 \u0000 \u0000Conclusions \u0000This study does not find any effects of lopinavir/ritonavir and abidol on relieving symptoms or accelerating virus clearance. The efficacies of these two drugs in NCP treatment need further investigation. \u0000 \u0000 \u0000Key words: \u0000Coronavirus infections; Pneumonia; Validation studies; 2019 novel coronavirus; Lopinavir/ritonavir; Abidol","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"38 1","pages":"86-89"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44199286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The emergence and popularization of antiretroviral therapy (ART) have greatly extended the survival period of people infected with human immunodeficiency virus (HIV), but at the same time, the incidence of cardiovascular diseases in this population is gradually increasing. Based on the domestic and foreign guidelines and academic reports, and combined with the clinical experience of experts in the field of AIDS and cardiovascular disease in China, this paper puts forward suggestions on the prevention of cardiovascular disease of HIV infected people in China, especially the management of the two risk factors of dyslipidemia and hypertension, so as to provide reference for clinical doctors and nurses. The risk factors for cardiovascular disease in HIV infected individuals may vary depending on region and cause of infection. Based on existing clinical evidence and domestic and foreign literature, this recommendation suggests that medical staff should determine treatment strategies for patients in clinical practice, taking into account the specific situation of local HIV infection.
{"title":"Suggestions on the management of cardiovascular disease risk factors in patients with human immunodeficiency virus infection","authors":"W. Lyu, Xue Lin","doi":"10.3760/CMA.J.ISSN.1000-6680.2020.02.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2020.02.003","url":null,"abstract":"抗反转录病毒治疗(antiretroviral therapy，ART)的出现与普及大大延长了人类免疫缺陷病毒(human immunodeficiency virus，HIV)感染者的生存期，但同时该人群的心血管疾病患病率也逐步升高。现借鉴国内外指南及学术报道，结合我国艾滋病和心血管病领域专家的临床经验，对中国HIV感染者的心血管疾病预防，特别是血脂异常和高血压这两个危险因素的管理提出建议，为临床医护人员提供参考。HIV感染者的心血管疾病危险因素会随着地域、感染原因的不同而有所差异，本建议基于现有临床证据和国内外文献提出，医护人员在临床实践时需结合当地HIV感染的具体情况确定患者的治疗策略。","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"38 1","pages":"72-79"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41415255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2020.02.001
Hongfei Zhang
儿童期感染乙型肝炎病毒(hepatitis B virus，HBV)易慢性化，是成人期慢性乙型肝炎(chronic hepatitis B，CHB)的重要来源。儿童CHB与成人CHB相比，既有相同之处，又有其鲜明的特殊性。目前，我国儿童肝病诊疗专科人员不足，存在对儿童CHB的危害、治疗认识不足，以及诊疗经验缺乏等多方面问题，亟需制订适合我国儿童CHB的诊疗指南，为临床诊疗决策提供参考。
儿童期感染乙型肝炎病毒(hepatitis B virus，HBV)易慢性化，是成人期慢性乙型肝炎(chronic hepatitis B，CHB)的重要来源。儿童CHB与成人CHB相比，既有相同之处，又有其鲜明的特殊性。目前，我国儿童肝病诊疗专科人员不足，存在对儿童CHB的危害、治疗认识不足，以及诊疗经验缺乏等多方面问题，亟需制订适合我国儿童CHB的诊疗指南，为临床诊疗决策提供参考。
{"title":"Problems and challenges in the diagnosis and treatment of chronic hepatitis B in Chinese children","authors":"Hongfei Zhang","doi":"10.3760/CMA.J.ISSN.1000-6680.2020.02.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2020.02.001","url":null,"abstract":"儿童期感染乙型肝炎病毒(hepatitis B virus，HBV)易慢性化，是成人期慢性乙型肝炎(chronic hepatitis B，CHB)的重要来源。儿童CHB与成人CHB相比，既有相同之处，又有其鲜明的特殊性。目前，我国儿童肝病诊疗专科人员不足，存在对儿童CHB的危害、治疗认识不足，以及诊疗经验缺乏等多方面问题，亟需制订适合我国儿童CHB的诊疗指南，为临床诊疗决策提供参考。","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"38 1","pages":"65-68"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42733667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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