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Tocilizumab has been reported to attenuate the "cytokine storm" in COVID-19 patients. We attempted to verify the effectiveness and safety of tocilizumab therapy in COVID-19 and identify patients most likely to benefit from this treatment. We conducted a randomized, controlled, open-label multicenter trial among COVID-19 patients. The patients were randomly assigned in a 1:1 ratio to receive either tocilizumab in addition to standard care or standard care alone. The cure rate, changes of oxygen saturation and interference, and inflammation biomarkers were observed. Thirty-three patients were randomized to the tocilizumab group, and 32 patients to the control group. The cure rate in the tocilizumab group was higher than that in the control group, but the difference was not statistically significant (94.12% vs. 87.10%, rate difference 95% CI-7.19%-21.23%, P = 0.4133). The improvement in hypoxia for the tocilizumab group was higher from day 4 onward and statistically significant from day 12 (P = 0.0359). In moderate disease patients with bilateral pulmonary lesions, the hypoxia ameliorated earlier after tocilizumab treatment, and less patients (1/12, 8.33%) needed an increase of inhaled oxygen concentration compared with the controls (4/6, 66.67%; rate difference 95% CI-99.17% to-17.50%, P = 0.0217). No severe adverse events occurred. More mild temporary adverse events were recorded in tocilizumab recipients (20/34, 58.82%) than the controls (4/31, 12.90%). Tocilizumab can improve hypoxia without unacceptable side effect profile and significant influences on the time virus load becomes negative. For patients with bilateral pulmonary lesions and elevated IL-6 levels, tocilizumab could be recommended to improve outcome.
Asunto(s)
Humanos , Anticuerpos Monoclonales Humanizados , COVID-19/tratamiento farmacológico , SARS-CoV-2 , Resultado del TratamientoRESUMEN
Objective@#To assess the olfactory function in children with adenoid hypertrophy and investigate the changes of both olfactory function and appetite in children with adenoid hypertrophy before and after adenoidectomy.@*Methods@#Forty-four children with adenoid hypertrophy admitted for adenoidectomy, aged 7-12 years, mean age (10.0±2.0) years were tested by Sniffin′ Sticks test and visual analog scale(VAS) of the children′s appetite preoperatively between March and August 2015.In a appointment 6 months after operation, all of them returned and were tested again. The control group consisted of 40 healthy children, aged 7-12 years, mean age (11.2±0.8) years.SPSS 13.0 software was used for statistical analysis@*Results@#The olfactory function of the study group TDI scores (32.4±3.5) preoperatively were significantly lower in comparison with the results of the control group TDI scores (37.3±2.8)(t=7.057, P<0.001). Significant improvement of olfaction TDI scores (36.8±1.9) was observed in the follow-up appointment(t=13.573, P<0.001). The VAS of the children′s appetite during post-adenoidectomy was higher compared to pre-adenoidectomy(t=16.765, P<0.001). There was a strong correlation between the increase in appetite of children and the change of TDI score (r=0.59, P<0.01).@*Conclusions@#Children with adenoid hypertrophy have a reduced ability of both olfactory function and appetite. Surgery had a greater impact on olfaction and appetite.
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Objective:To develop a method to determine the contents of emodin, rhien and chrysophanol in Huangdanyinchen Granules. Methods: HPLC was used to determine the contents of emodin, rhien and chrysophanol in Huangdanyinchen Granules. The separation was performed on YWG ODS column with methol perchloric acid (1%) (8∶2) as a mobile phase and the wavelength of UV detector was 280nm.Results: The separating degree and the linearity of this method was well with the average recovery of rhien: 97.43%, RSD= 1.90%; Emodin:98.45%,RSD=1.62%;Chrysophanol: 98.87%, RSD=1.50%, respectively.Conclusions:The method is simple and rapid and gives satisfactory results. It can be suitable for quality controll of Huangdanyinchen Granules.