Clinical features and risk factors associated with severe COVID-19 patients in China / 中华医学杂志(英文版)

BACKGROUND@#Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout the world. In this study, we aimed to identify the risk factors for severe COVID-19 to improve treatment guidelines.@*METHODS@#A multicenter, cross-sectional study was conducted on 313 patients hospitalized with COVID-19. Patients were classified into two groups based on disease severity (nonsevere and severe) according to initial clinical presentation. Laboratory test results and epidemiological and clinical characteristics were analyzed using descriptive statistics. Univariate and multivariate logistic regression models were used to detect potential risk factors associated with severe COVID-19.@*RESULTS@#A total of 289 patients (197 nonsevere and 92 severe cases) with a median age of 45.0 (33.0, 61.0) years were included in this study, and 53.3% (154/289) were male. Fever (192/286, 67.1%) and cough (170/289, 58.8%) were commonly observed, followed by sore throat (49/289, 17.0%). Multivariate logistic regression analysis suggested that patients who were aged ≥ 65 years (OR: 2.725, 95% confidence interval [CI]: 1.317-5.636; P = 0.007), were male (OR: 1.878, 95% CI: 1.002-3.520, P = 0.049), had comorbid diabetes (OR: 3.314, 95% CI: 1.126-9.758, P = 0.030), cough (OR: 3.427, 95% CI: 1.752-6.706, P < 0.001), and/or diarrhea (OR: 2.629, 95% CI: 1.109-6.231, P = 0.028) on admission had a higher risk of severe disease. Moreover, stratification analysis indicated that male patients with diabetes were more likely to have severe COVID-19 (71.4% vs. 28.6%, χ2 = 8.183, P = 0.004).@*CONCLUSIONS@#The clinical characteristics of those with severe and nonsevere COVID-19 were significantly different. The elderly, male patients with COVID-19, diabetes, and presenting with cough and/or diarrhea on admission may require close monitoring to prevent deterioration.

Influence of Air Pollution on Hospital Admissions in Adult Asthma in Northeast China / 中华医学杂志(英文版)

<p><b>Background</b>Asthma is a common chronic respiratory disease and is related to air pollution exposure. However, only a few studies have concentrated on the association between air pollution and adult asthma. Moreover, the results of these studies are controversial. Therefore, the present study aimed to analyze the influence of various pollutants on hospitalization due to asthma in adults.</p><p><b>Methods</b>A total of 1019 unrelated hospitalized adult asthma patients from Northeast China were recruited from 2014 to 2016. Daily average concentrations of air pollutants (particulate matter <2.5 μm [PM], particulate matter <10 μm [PM], sulfur dioxide [SO], nitrogen dioxide [NO], and carbon monoxide [CO]) were obtained from the China National Environmental Monitoring Centre website from 2014 to 2016. Cox logistic regression analysis was used to analyze the relationship between air pollutants and hospital admissions in adult asthma.</p><p><b>Results</b>The maximum odds ratio (OR) value for most air pollutants occurred on lag day 1. Lag day 1 was chosen as the exposure period, and 8 days before onset was chosen as the control period. Three pollutants (PM, CO, and SO) were entered into the regression equation, and the corresponding OR (95% confidence interval) was 0.995 (0.991-0.999), 3.107 (1.607-6.010), and 0.979 (0.968-0.990), respectively.</p><p><b>Conclusions</b>A positive association between hospital admissions and the daily average concentration of CO was observed. CO is likely to be a risk factor for hospital admissions in adults with asthma.</p>

Case-control study on cannulated screw fixation and percutaneous autogenous bone marrow grafting for the treatment of femoral neck fractures / 中国骨伤

<p><b>OBJECTIVE</b>To compare clinical results of two methods for the treatment of femoral neck fracture, which are cannulated screw fixation combined with percutaneous autogenous bone marrow grafting, and simple cannulated screw fixation. To investigate the curative effects of cannulated screw fixation combined with percutaneous autogenous bone marrow garfting to promote fracture healing and reducing femoral neck necrosis.</p><p><b>METHODS</b>The clinical data of 60 cases, which were enrolled from December 2000 to December 2008 consecutively in our hospital, were analyzed retrospectively. Thirty patients with femoral neck fractures were treated with cannulated screw fixation and percutaneous autogenous bone marrow grafting. There were 20 males and 10 females, ranging in ages from 18 to 89 years,with an average of (52.3 +/- 0.2) years. There were 13 patients with traffic accident, 3 patients with falling injuries and 14 patients with tumble. Based on the Garden classification for femoral neck fractures, 1 patient was type I, 6 patients were type II, 12 patients were type III and 11 patients were type IV. Among 30 patients in the control group, 16 patients were male and 14 patients were female, ranging in age from 18 to 91 years, with an average of (51.9 +/- 0.1) years. Twelve patients injured with traffic accident, 1 patient with falling injuries and 17 patients with tumble. Based on the Garden classification for femoral neck fractures, 5 patients were type I, 2 patients were type II,15 patients were type III, and 8 patients were type IV. Patients in the control group were treated with cannulated screw fixation only. All the patients were followed up for 2 years after operation. The fracture healing and complications were evaluated and compared between the two groups.</p><p><b>RESULTS</b>The average healing time was (7.1 +/- 1.2) months in the observing group and (8.0 +/- 1.4) months in the control group. The healing of femoral neck fracture occurred in 29 cases in observing group while in 24 cases in the control group contrast to femoral head necrosis occurred in 1 case in the observing group while in 6 cases in the control group. According to Harris scoring system, the good and excellent rate of the two groups had statistical difference (P < 0.05).</p><p><b>CONCLUSION</b>Cannulated screw fixation and percutaneous autogenous bone marrow grafting is a more efficient method for accelerating healing of femoral neck fractures and reducing femoral head necrosis.</p>

A controlled clinical trial on the therapy of injured shoulder arthrochalasis by shoulder-elbow elastic band immobilization with functional exercise / 中国骨伤

<p><b>OBJECTIVE</b>To observe the therapeutic effects of shoulder-elbow elastic immobilization and functional exercise for injured shoulder arthrochalasis, and compare it with forearm-suspending immobilization and functional exercise therapy.</p><p><b>METHODS</b>The patients with injured shoulder arthrochalasis were randomly divided into treatment group (38 cases) and control group (37 cases). Treatment group underwent the therapy of shoulder-elbow elastic band immobilization and functional exercise; control group was managed by forearm-suspending band immobilization and functional exercise therapy.</p><p><b>RESULTS</b>In treatment group, 29 (76.3%) cases recovered, 7 (18.4%) improved and 2 (5.3%) failed; in control group, 15 (40.5%) cases recovered, 15 (40.5%) cases improved and 7 (19.0%) failed. The differences between two groups were statistically significant (P<0.01). The AHI (acromio-humeral interval) ranged from 8 to 19 mm (11.9+/-5.1) in treatment group and 8 to 27 mm (14.2+/-5.4) in control group, and the difference was also statistically distinct (t=2.7525, P<0.01).</p><p><b>CONCLUSION</b>The treatment with shoulder-elbow elastic band immobilization and exercise therapy for injured shoulder arthrochalasis is a safe and effective method. Immobilization with shoulder-elbow elastic band is better than forearm-suspending band for injured shoulder arthrochalasis.</p>

Prognostic factors of invasive non-Hodgkin's lymphoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>There is heterogeneity in non-Hodgkin's lymphoma. The purpose of this study is to investigate the prognostic factors of invasive non-Hodgkin's lymphoma.</p><p><b>METHODS</b>From June 2002 to June 2006, 137 patients with invasive non-Hodgkin's lymphoma were treated by regular regimen consisting of radiotherapy and chemotherapy. The clinical data including prognostic factors was analyzed by SPSS 10.0.</p><p><b>RESULTS</b>After treated with chemotherapy and radiotherapy, 35 (25.5%) patients achieved CR, 67 (48.9%) PR, 6 (4.3%) SD, 29 (21.2%) PD, ORR (objective response rate) of this series was 74.5%. The overall 4-year survival rate was 70.8%. The PFS (prognosis free survival) was 42.7%. Multivariate analysis using Cox model indicated that clinical stage III-IV, PS score > or = 2, more than 2 external nodal involvement were closely correlated with overall survival.</p><p><b>CONCLUSION</b>The overall survival of invasive non-Hodgkin's lymphoma treated with present combined therapy regimen has been improved greatly. However, further investigation is still needed for exploring more effective individualized treatment regimen.</p>