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Objective:To analyze the clinical characteristics of patients with different types of coronavirus disease 2019 (COVID-19).Methods:A total of 272 eligible COVID-19 patients who were admitted to Guangzhou Eighth People′s Hospital, Guangzhou Medical University from January 22 to February 15, 2020 were retrospectively enrolled. General characteristics, the first laboratory examination and imaging data of these patients were collected. According to the clinical classification, there were 236 cases in non-severe group (mild+ common type) and 36 cases in severe group (severe+ critical type). Comparisons between groups were performed by t test, chi-square test or rank-sum test when appropriate. Results:There were 23 males and 13 females in the severe group, 103 males and 133 females in the non-severe group, and the difference was statistically significant ( χ2=5.149, P=0.023). The age of severe group was (60.5±11.2) years, which was higher than that of non-severe group (46.8±15.7) years. The difference was statistically significant ( t=6.43, P<0.01). The lymphocyte (LYM) count, platelet (PLT) count and arterial partial pressure of oxygen (PaO 2) in the severe group were 0.90(0.55, 1.10)×10 9/L, 170.00(143.50, 198.00)×10 9/L and 73.50(69.70, 83.00) mmHg(1 mmHg=0.133 kPa), respectively, which were all lower than those in the non-severe group (1.42(1.09, 1.95)×10 9/L, 187.00(148.00, 230.00)×10 9/L and 96.00(83.20, 108.00) mmHg, respectively). The differences were all statistically significant ( Z=5.59, 2.00 and 5.00, respectively, all P<0.05). The levels of creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), C reaction protein (CRP) and procalcitonin (PCT) in the severe group were 123.00(79.00, 212.00) U/L, 32.10(27.00, 47.40) U/L, 305.50(216.00, 396.00) U/L, 37.02(23.92, 63.66) mg/L and 0.09(0.05, 0.19) μg/L, respectively, which were all higher than those in the non-severe group (68.00(48.00, 103.00) U/L, 20.10(16.70, 26.20) U/L, 179.00(150.00, 222.00) U/L, 26.55(18.11, 36.96) mg/L and 0.04(0.03, 0.06) μg/L respectively), and the differences were all statistically significant ( Z=3.89, 5.60, 5.12, 2.85 and 5.43, respectively, all P<0.01). No significant differences were observed in white blood cell count, creatine kinase isoenzyme and blood lactate between the two groups ( Z=1.53, 0.41 and 1.00, respectively, all P>0.05). Conclusion:Gender, age, LYM count, PLT count, PaO 2, CK, AST, LDH, CRP and PCT could be used to provide reference for clinical classification of COVID-19 patients.
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ObjectiveTo investigate the clinical features, treatment, and prognosis of hepatocellular carcinoma (HCC) in pregnancy. MethodsA retrospective analysis was performed for the clinical data of two patients who were diagnosed with HCC in pregnancy from January 2011 to November 2017, 23 patients with HCC in pregnancy reported in medical literature in China and foreign countries published from 2010 to 2017, and 25 non-pregnant female patients of childbearing age with HCC (control group) who were treated from January 2011 to November 2017. ResultsThe patients′ age ranged from 18 to 45 years, and most patients had a history of hepatitis B, with normal liver function or mild to moderate elevations. The most common clinical symptom was abdominal pain, and the therapies included hepatic artery embolization, interventional therapy, chemotherapy, and liver tumor resection. The 25 patients with HCC in pregnancy had poor prognosis, among whom 17 died, and among these 17 patients, 13 had available information on overall survival time, which ranged from 1 month to 2 years, with a median survival time of 2 months; 16 patients gave birth to healthy infants by cesarean section. Among the 25 non-pregnant female patients of childbearing age with HCC, 18 died, and the survival time ranged from 4 months to 6 years, with a median survival time of 1 year; 1 patient was lost to follow-up, and 6 patients were still alive before the deadline. ConclusionMost patients with HCC in pregnancy are found to have advanced HCC at the time of diagnosis. This disease has rapid progression and poor prognosis, and surgery and interventional therapy are major treatment regimens. Early identification can increase surgical rate and the opportunity for multimodality therapy.
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Objective To evaluate bone marrow smear examination in early diagnosis of AIDS complicated with disseminated Penicillium marneffei infection. Methods Seventy-three clinically suspected AIDS patients complicated with disseminated PeniciUium marneffei infection were included in the study. Peripheral blood and bone marrow smear examinations, and the fungal thermally dimorphic culture were performed in all cases. Results PeniciUium marneffei infection was identified in 44 patients by peripheral blood and bone marrow fungal thermally dimorphic culture. The features of the bone marrow smear were as follows : they were all hyperplastic or significantly hyperplastic; there were thickened and increased granules, vacuolization and band-formed in most granulocytes; there were increased and augmented histiocytes, and increased plasma cells. In 12 samples of bone marrow smear, there were phagncytized mulberry-like Penicillium marneffei organisms in the cytoplasm of the histiocytes or the organisms found extracellularly. One sample demonstrated the increased granulocytes and the phagocytized organisms in the neutrophils and monocytes. In 4 samples of peripheral blood smear, there were phagocytized Penicillium marneffe organisms in the neutrophils and monocytes. Conclusion Bone marrow smear examination is of value in early diagnosis of AIDS complicated with disseminated Penicillium marneffei infection, which is 7 to 10 days earlier than routine fungal thermally dimorphic culture.
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Objective To investigate the prevalence and clinical characteristics of thyroid dysfunction induced by IFNα therapy in patients with chronic hepatitis.Methods Thyroid function of 310 patients with chronic hepatitis receiving IFNα therapy were evaluated.Results Serum free tri-iodothymnine (F13),free thyroxine(FT4)and sensitive thyroid-stimulating hormone(sTSH)of all patients were normal and TGAb was negative before IFNα therapy.After the treatment,10 patients(10/3 10,3.22%)had thyroid dysfunction,in which 7 were of hypothyroidism and 3 were of hyperthyroidism.The thyroid function of all patients recovered within 1-year follow-up.Conclusions IFNα therapy may induce thyroid dysfunction in patients with chronic hepatitis,in which prognosis can be good when appropriate treatment is given.