Clinical characteristics of coronavirus disease 2019 in patients aged 80 years and older / 中西医结合学报

OBJECTIVE@#Coronavirus disease 2019 (COVID-19) has raised concern around the world as an epidemic or pandemic. As data on COVID-19 has grown, it has become clear that older adults have a disproportionately high rate of death from COVID-19. This study describes the early clinical characteristics of COVID-19 in patients with more than 80 years of age.@*METHODS@#Epidemiological, clinical, laboratory, radiological, and treatment data from 17 patients diagnosed with COVID-19 between January 20 and February 20, 2020 were collected and analyzed retrospectively. Treatment outcomes among subgroups of patients with non-severe and severe symptoms of COVID-19 were compared.@*RESULTS@#Of the 17 hospitalized patients with COVID-19, the median age was 88.0 years (interquartile range, 86.6-90.0 years; range, 80.0-100.0 years) and 12 (70.6%) were men. The age distribution of patients was not significantly different between non-severe group and severe group. All patients had chronic pre-existing conditions. Hypertension and cardiovascular diseases were the most common chronic conditions in both subgroups. The most common symptoms at the onset of COVID-19 were fever (n = 13; 76.5%), fatigue (n = 11; 64.7%), and cough (n = 5; 29.4%). Lymphopenia was observed in all patients, and lymphopenia was significantly more severe in the severe group than that in non-severe group (0.4 × 10/L vs 1.2 × 10/L, P = 0.014). The level of serum creatinine was higher in the severe group than in the non-severe group (99.0 μmol/L vs 62.5 μmol/L, P = 0.038). The most common features of chest computed tomography images were nodular foci in 10 (58.8%) patients and pleural thickening in 7 (41.2%) patients. All patients received antiviral therapy, while some patients also received intravenous antibiotics therapy (76.5%), Chinese medicinal preparation therapy (Lianhuaqingwen capsule, 64.7%), corticosteroids (35.3%) or immunoglobin (29.4%). Eight patients (47.1%) were transferred to the intensive care unit because of complications. Ten patients (58.8%) received intranasal oxygen, while 3 (17.6%) received non-invasive mechanical ventilation, and 4 (23.5%) received high-flow oxygen. As of June 20, 7 (41.2%) patients had been discharged and 10 (58.8% of this cohort, 77.8% of severe patients) had died.@*CONCLUSION@#The mortality of patients aged 80 years and older with severe COVID-19 symptoms was high. Lymphopenia was a characteristic laboratory result in these patients, and the severity of lymphopenia was indicative of the severity of COVID-19. However, the majority of patients with COVID-19 in this age cohort had atypical symptoms, and early diagnosis depends on prompt use of a viral nucleic acid test.

Clinical characteristics of coronavirus disease 2019 in patients aged 80 years and older / 中西医结合学报

OBJECTIVE@#Coronavirus disease 2019 (COVID-19) has raised concern around the world as an epidemic or pandemic. As data on COVID-19 has grown, it has become clear that older adults have a disproportionately high rate of death from COVID-19. This study describes the early clinical characteristics of COVID-19 in patients with more than 80 years of age.@*METHODS@#Epidemiological, clinical, laboratory, radiological, and treatment data from 17 patients diagnosed with COVID-19 between January 20 and February 20, 2020 were collected and analyzed retrospectively. Treatment outcomes among subgroups of patients with non-severe and severe symptoms of COVID-19 were compared.@*RESULTS@#Of the 17 hospitalized patients with COVID-19, the median age was 88.0 years (interquartile range, 86.6-90.0 years; range, 80.0-100.0 years) and 12 (70.6%) were men. The age distribution of patients was not significantly different between non-severe group and severe group. All patients had chronic pre-existing conditions. Hypertension and cardiovascular diseases were the most common chronic conditions in both subgroups. The most common symptoms at the onset of COVID-19 were fever (n = 13; 76.5%), fatigue (n = 11; 64.7%), and cough (n = 5; 29.4%). Lymphopenia was observed in all patients, and lymphopenia was significantly more severe in the severe group than that in non-severe group (0.4 × 10/L vs 1.2 × 10/L, P = 0.014). The level of serum creatinine was higher in the severe group than in the non-severe group (99.0 μmol/L vs 62.5 μmol/L, P = 0.038). The most common features of chest computed tomography images were nodular foci in 10 (58.8%) patients and pleural thickening in 7 (41.2%) patients. All patients received antiviral therapy, while some patients also received intravenous antibiotics therapy (76.5%), Chinese medicinal preparation therapy (Lianhuaqingwen capsule, 64.7%), corticosteroids (35.3%) or immunoglobin (29.4%). Eight patients (47.1%) were transferred to the intensive care unit because of complications. Ten patients (58.8%) received intranasal oxygen, while 3 (17.6%) received non-invasive mechanical ventilation, and 4 (23.5%) received high-flow oxygen. As of June 20, 7 (41.2%) patients had been discharged and 10 (58.8% of this cohort, 77.8% of severe patients) had died.@*CONCLUSION@#The mortality of patients aged 80 years and older with severe COVID-19 symptoms was high. Lymphopenia was a characteristic laboratory result in these patients, and the severity of lymphopenia was indicative of the severity of COVID-19. However, the majority of patients with COVID-19 in this age cohort had atypical symptoms, and early diagnosis depends on prompt use of a viral nucleic acid test.

Clinic value of combination of high-risk human papillomavirus test and cervical cytology test in diagnosing cervical lesions / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the clinic value of combination of high-risk human papillomavirus test and cervical cytology test in diagnosis of cervical lesions.</p><p><b>METHODS</b>Patients underwent physical examination at our department were checked by high-risk human papillomavirus test, cervical cytology test and colposcope from October 2004 to December 2006. Abnormal patients with cervical abnormalities were asked for pathological test.The diagnostic value of cervical lesions among these different methods were compared.</p><p><b>RESULTS</b>Based on the criteria of histopathology, the sensitivity, specificity, positive-predictive value and negative-predictive value of high-risk human papillomavirus test for detecting all cases of CIN II and CIN III were 94.83%, 31.06%, 55.22% and 87.02% respectively, and those of the cervical cytology were 92.10%, 31.06%, 54.50% and 81.43% respectively.Those values changed to 99.65%, 18.55%, 61.46% and 97.62% respectively if two methods were combined.</p><p><b>CONCLUSIONS</b>Human papillomavirus test and cervical cytology test combined with pathological test can improve the detective rate of cervical lesions and facilitate the treatment.</p>

Significance of human papillomavirus test in triage of patients with atypical squamous cell of undetermined significance / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the significance of human papillomavirus test in triage of patients with atypical squamous cell of undetermined significance (ASCUS) diagnosed by cervical cytology.</p><p><b>METHODS</b>Human papillomavirus test,colposcope and cervical biopsy were performed in 184 patients with a referral diagnosis of ASCUS by cervical cytology.</p><p><b>RESULTS</b>Confirmed by pathological diagnosis of cervical biopsy, 112 cases were chronic inflammation (60.87%), 33 CIN I (17.93%), 17 CIN II (9.24%), 8 CIN III (4.35%), 4 cervical squamous carcinoma (2.17%) and 10 condyloma (5.43%). Of the 184 women with cytological ASCUS, 124 (67.39%) cases were positive in high-risk HPV test among which 66 cases were histologically confirmed as chronic inflammation (53.23%), 22 as CIN I (17.74%), 16 as CIN II (12.90%), 8 as CIN III (6.45%), 4 as cervical squamous carcinoma (3.23%) and 8 as condyloma (6.45%). The positive rate of HPV in groups of ASCUS were higher than those with negative HPV (P < 0.003).</p><p><b>CONCLUSION</b>Women with ASCUS should be tested for HPV. Cervical biopsy under colposcopy is recommended for women with HR-HPV infection.</p>

Association between human papillomavirus (HPV) type 16 infection and E6/E7 gene variant and the cervical lesions in Beijing / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the association between HPV16 infection, E6/E7 variations and the cervical lesions.</p><p><b>METHODS</b>HPV subtypes were detected by using flow-through hybridization technique, E6/E7 gene was extracted from cervical lesions in 80 patients with HPV16 infection, PCR amplified, cloned into plasmid pMD18-T and sequenced.</p><p><b>RESULTS</b>HPV 16 was the most common type which accounted for 33.3% (154/463), the HPV16 infection rates increased with the severity of cervical lesions (P < 0.05). Totally in 72 cases the complete E6 and E7 regions were successfully sequenced, the DNA mutation rate of E6/E7 was 88.9% (64/72). A mutation, E6-D32E (T96G) coincided with a specific type of E7 mutation, N29S (A86G). D32E/N29S mutation rate was 38.9% (28/72), the detection rate increased with the severity of cervical lesions (P < 0.05).</p><p><b>CONCLUSION</b>HPV 16 was the most common type in women with cervical lesions in Beijing, D32E/N29S variant associated with the cervical lesions.</p>

Effect of Nocardia rubra cell wall skeleton (Nr-CWS) on oncogenicity of TC-1 cells and anti-human papillomavirus effect of Nr-CWS in lower genital tract of women / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To detect the effect of Nocardia rubra cell wall skeleton (Nr-CWS) on tumorigenicity induced by TC-1 cells and to clinically study anti-human papillomavirus effect of Nr-CWS in lower genital tract of women.</p><p><b>METHODS</b>Tumor model was established by injecting TC-1 cells subcutaneously in SCID mice, then divided them into 3 groups randomly and injected with isovolumetric physiological saline, 60 micrograms/ml Nr-CWS and 120 micrograms/ml Nr-CWS respectively, the growth of tumors was measured one week later. Nr-CWS was applied on 45 HPV positive women whose TCT test was normal and without cervical erosion 2-3 days after menstruation. HPV was detected again 3 months later to explore the effect of Nr-CWS on HPV infection in female lower genital tract.</p><p><b>RESULTS</b>The animal experiment showed the weight of transplanted tumors in treated group was less than that of control group (chi2=12.5, P= 0.002). The tumor inhibition rate was 59.1 percent and 84.2 percent in the groups treated with Nr-CWS 60 and 120 micrograms/ml Nr-CWS; the results of HPV detection in 23 out of the 45 cases (51.1 percent) became negative after the 3-month treatment; the viral load was reduced in 9, and there was no change in viral load in 13 cases. Significant difference was found between the rates of undetectable viral load and the natural viral disappearance rate (P less than 0.05).</p><p><b>CONCLUSION</b>Nr-CWS has an inhibitory effect to TC-1 cell tumorigenesis and clinical application of Nr-CWS may eliminate the HPV infection in lower genital tract of a considerable proportion of women with HPV infection.</p>

A clinical observation of different methods of methotrexate in conservative treatment of ectopic pregnancy / 中国基层医药

0.05)and no significant statistical difference was found.But the successful rate of first therapy of group A was 71.42%(85/119)and group B was 56.20%(77/137)(P