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COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.
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Objective:To explore the efficacy of a combination regimen by Lopinave/Litonawe (LPV/r), emtricitabine and tenofovir alafenamide fumarate (FTC/TAF) for the treatment of novel coronavirus pneumonia.Methods:We design the protocol as a real world study, which includes two groups: prospective intervention cohort (T1) and historical control group (T2). For the T1 group, ninety patients who are diagnosed as NCP will be enrolled. All patients in the T1 group will receive standard therapies following the recommendation in the Guidelines of National Commission of Health, and will be administered an anti-virus regimen including LPV/r and FTC/TAF. The T2 group will enroll patients who have received single regimen of LPV/r. The major outcome is the survival rate of patients. Secondary outcomes are the time of seroconversion of RNA, ARDS progression rate and length of hospital stay.Conclusions:The results of this real world study might provide clinical practitioners a high efficiency and fast antivirus regimen for novel coronavirus pneumonia patients. In addition, the conduction of this study will accelerate screening for other new effective therapeutic method.
ABSTRACT
Objective@#To explore the efficacy of a combination regimen by Lopinave/Litonawe (LPV/r), emtricitabine and tenofovir alafenamide fumarate (FTC/TAF) for the treatment of novel coronavirus pneumonia (NCP).@*Methods@#We design the protocol as a real world study, which includes two groups: prospective intervention cohort (T1) and historical control group (T2). For T1 group, ninety patients will be enrolled who are diagnosed as NCP. All patients in T1 group will receive standard therapies following the recommendation in the guidelines of National Commission of Health, and they will be administered an anti-virus regimen includes LPV/r and FTC/TAF. The T2 group will enroll patients who have received single regimen includes LPV/r. The major outcome is the survival rate of patients. Secondary outcomes are the time of seroconversion of RNA, ARDS progression rate and length of hospital stay.@*Conclusions@#The results of this real world study might provide clinical practitioners a high efficiency and fast antivirus regimen for NCP. In addition, the conduction of this study will accelerate screening for other new effective therapeutic method.
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Objective The relationship was analyzed between clinic and the expression intensity of HBsAg and HBcAg with in the hepatic tissue from the serum HBeAg negative group and the positive group.Methods A total of 317 liver biopsy specimens were divided into the HBeAg negative group and the positive group,and the relationship was analyzed between the expression inten sity of HBsAg and HBcAg within the hepatic tissue and their age,gender,ALT level,serum HBV-DNA load,hepatic inflammatory activity grading and fibrosis staging in the two groups.Results Age,ALT level,hepatic inflammatory activity grading and fibrosis of the serum HBeAg negative patients were greater than those of the serum HBeAg positive patients,while their serum HBV-DNA load and the expression intensity of HBcAg within the hepatic tissue were lower than those of the serum HBeAg positive patients (P＜0.05).The expression intensity of HBsAg within the hepatic tissue between the serum HBeAg patients and the serum HBeAg positive patients was not significantly different,and it was not correlated with age,ALT level,hepatic inflammatory grading and fi brosis staging (P＞0.05).After the serum HBeAg turned negative,the expression intensity of HBcAg within the hepatic tissue was decreased (P=0.00,t=12 349.0),and it became positively correlated with the serum HBV DNA load(P=0.007,r=0.251) and its negative correlation with the hepatic inflammatory activity and fibrosis was weakened.Conclusion After the serum HBeAg turned negative,other antigenic components of HBV may still maintain the adequately active immune status within the hepatic tis sue of organisms.After the serum HBeAg turned negative,the expression intensity of HBcAg within the hepatic tissue was de creased and became positively correlated with the serum HBV DNA,while its negative correlation with the hepatic inflammatory activity grade and fibrosis stagings was weakened.
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Objective To evaluate the clinical,microbiological and epidemiological characteristics of enterococcal bloodstream infections (BSIs).Methods Microbiological and clinical data were retrospectively collected and reviewed for the adult patients with enterococcal BSI who were treated in Sichuan Provincial People′s Hospital from January 1,2011 to November 30,2013. Results Of the 92 cases of enterococcal BSIs,21 were due to E.faecalis and 71 were caused by E.faecium,respectively.The BSI was hospital acquired in 67 cases.The other were community acquired BSI.E.faecalis BSIs were complicated with uremia (42.9%),heart disease (23.8%),pulmonary infection (19.0%)and central neurological disorder (19.0%),while E. faecium BSIs were complicated with hepatobiliary and pancreatic diseases (40.8%),neoplastic disease(40.8%)and pulmonary infection (40.8%).Risk factors for E.faecium acquisition were mainly central venous catheter (73.2%),recent surgey within 30 days (62.0%),elderly patients (52.1%),ICU admission (32.4%)and invasive mechanical ventilation (26.8%).Strains of E.faecalis were 100% susceptible to ampicillin and vancomycin,90.4% to linezolid.Strains of E.faecium were 100%susceptible to linezolid,96.9% to vancomycin, and approximately 90% resistant to ampicillin and penicillin. Logistic with hepatobiliary and pancreatic diseases had lower mortality rate than other patients.Conclusions E .faecium is responsible for majority of the enterococcal BSIs.E .faecium strains have higher resistance rate to most antimicrobial agents tested than E . fecalis .Elderly patients,ICU admission,invasive mechanical ventilation and neoplastic diseases are the independent risk factors of 15-day mortality.Adequate antimicrobial therapy within 48 hours can decrease the mortality rate effectively.
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Wound secretion from 20 patients with gaseous gangrene was collected for Gram staining,bacterial culture and drug sensitivity tests.The results indicated that gaseous gangrene was caused by the co-infection of both aerobic and anaerobic bacteria.Gram-negative bacilli were slishtly more common than other aerobic bacteria in gageous gangrene wound,which was different from the findings of ordinary gaseous gangrene.