Tocilizumab in patients with moderate or severe COVID-19: a randomized, controlled, open-label, multicenter trial / 医学前沿

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.

The smoking cessation effect on pulmonary function of chronic obstructive pulmonary disease and its mechanism / 安徽医科大学学报

Objective To explore the smoking cessation intervention impact on lung with genetic polymorphism of SOD3. The aim is to further reveal the importance of smoking cessation intervention on early COPD patients. Meth-ods 60 COPD patients with smoking cessation intervention and 40 COPD patients without intervention ( the control group) were enrolled in this study. Limosis peripheral blood was taken and whole blood corpuscle genomic DNA was extracted. The genetic polymorphism of SOD3 genes was determined by ligase detection reaction and polymerase chain reaction ( LDR-PCR) and serum SOD3 concentration was measured using ELISA. Lung function between the two groups before and after intervention were detected by microspirometry. Results ①The FEV1% and the FEV1/FVC% were increased after 3 and 6 months intervention in smoking cessation group(P0.05). ③The serum of SOD3 concentration of COPD intervention group and the control have no significance after intervention ( P>0.05 ) . ④ The serum of SOD3 concentration a-bout CC and CG/GG genotype in COPD intervention group have no significance after 3 and 6 months intervention ( P>0.05 ) . Conclusion Smoking cessation interventions for patients with COPD pulmonary function improves significance in short-term. But different SOD3 genotypes have no effect on lung function after intervention. Smoking cessation intervention has no effect on in serum SOD3 concentration of COPD patients, and has no relationship be-tween the expression of SOD3 genetype.

Pathogens Caused Acute Respiratory Tract Infection in Hefei Area:Epidemiological Studies / 中华医院感染学杂志

OBJECTIVE To investigate the etiology of acute respiratory tract infection(ARI)in Hefei area and risk factors that may influence the distribution of common pathogens.METHODS Direct immunofluorescence assay was applied to detect the respiratory syncytial virus(RSV),adenovirus(ADV),influenza virus A(FluA),influenza virus B(FluB),parainfluenza virus PIV(1,2,3)and real time fluorescent quantitation polymerase chain reaction (FQ-PCR)was applied to measuring Mycoplasma pneumoniae(MP)and Chlamydia pneumoniae(CP)in nasopharyngeal secretions and sputum specimens.RESULTS Among 530 cases included in this study,421 cases (79.43%)showed positive viral etiology.ADV accounted for 73(13.77%),FluA-68(12.83%),FluB-56 (10.56%),RSV-48(9.05%),PIVl-47(8.86%),PIV3-42(7.92%),PIV2-33(6.22%),MP-32(6.03%)and CP-22(4.15%).The detected positive rate of pathogens isolated in winter was the highest(85.07%).CONCLUSIONS Acute upper respiratory tract infection(AURTI)is common and more than 75%pathogens in Hefei area are virus in which the most commonly virus is ADV.Meanwhile atypical pathogens of infection should not be ignored.