Effects of Shuanghuanglian oral liquids on patients with COVID-19: a randomized, open-label, parallel-controlled, multicenter clinical trial / 医学前沿

We conducted a randomized, open-label, parallel-controlled, multicenter trial on the use of Shuanghuanglian (SHL), a traditional Chinese patent medicine, in treating cases of COVID-19. A total of 176 patients received SHL by three doses (56 in low dose, 61 in middle dose, and 59 in high dose) in addition to standard care. The control group was composed of 59 patients who received standard therapy alone. Treatment with SHL was not associated with a difference from standard care in the time to disease recovery. Patients with 14-day SHL treatment had significantly higher rate in negative conversion of SARS-CoV-2 in nucleic acid swab tests than the patients from the control group (93.4% vs. 73.9%, P = 0.006). Analysis of chest computed tomography images showed that treatment with high-dose SHL significantly promoted absorption of inflammatory focus of pneumonia, which was evaluated by density reduction of inflammatory focus from baseline, at day 7 (mean difference (95% CI), -46.39 (-86.83 to -5.94) HU; P = 0.025) and day 14 (mean difference (95% CI), -74.21 (-133.35 to -15.08) HU; P = 0.014). No serious adverse events occurred in the SHL groups. This study illustrated that SHL in combination with standard care was safe and partially effective for the treatment of COVID-19.

Analysis of occurrence time and risk factors of acute cerebral infarction complicated with deep venous thrombosis / 中国医师杂志

Objective:To explore the occurrence time and risk factors of deep vein thrombosis (DVT) in patients with acute cerebral infarction, so as to guide clinical prevention and treatment.Methods:1 129 patients with acute cerebral infarction treated in Beijing Tiantan Hospital from May 2014 to May 2016 were selected as the research objects. According to whether DVT occurred, the patients were divided into DVT group ( n=22) and non DVT group ( n=1 107); The information was analyzed retrospectively and the occurrence time of DVT was counted. The independent risk factors of acute cerebral infarction complicated with DVT were analyzed by univariate and multivariate logistic regression. Results:The time of DVT in patients with acute cerebral infarction was 10.5 (4-14) days. Univariate analysis showed that there were significant differences in age, gender, atrial fibrillation, smoking, drinking, chronic obstructive pulmonary disease, peripheral artery disease, renal failure, anticoagulants, BMI, white blood cell, blood glucose at admission and length of stay between the DVT group and the non DVT group ( P<0.05). Multiple factors further confirmed that renal failure [odds ratio ( OR)=57.421; 95% confidence interval ( CI), 5.792-569.314)] and length of hospital stay ( OR=1.148; 95% CI: 1.071-1.232) were independent risk factors for DVT. Conclusions:The median time of DVT in patients with acute cerebral infarction was 10.5 days. Renal failure and hospital stay were independent influencing factors of DVT in patients with acute cerebral infarction. This is helpful to determine the best prevention and treatment duration of DVT in patients with acute cerebral infarction, make rational use of medical resources and formulate personalized prevention and treatment strategies.

Association between hemoglobin concentration and stroke severity on admission in ischemic stroke with-out diabetes / 中国综合临床

Objective To evaluate the association between hemoglobin concentration and stroke severity on admission in ischemic stroke without diabetes. Methods Based on the China National Stroke Registry,the information of acute stroke patients were collected by trained research coordinators and investigators with the methods of review clinical records or interview. Demography, disease history, behavior and habits, hemoglobin concentration,and NIHSS score on admission were collected in this study. The iIncluded patients with the integri?ty of the information of non diabetes,3 h to the hospital,no gastrointestinal bleeding and Hb concentration and NIHSS score at admission. Hemoglobin concentration was classed according to quintiles and the outcome was grouped into ≤3 and >3 groups. The method of logistic regression was used to explore the association between hemoglobin and NIHSS. Results A total of 1 419 individuals was included in this study,including 883 males and 536 females. The mean age was 67. 24±12. 46 years old and the proportion of NIHSS>3 was 67. 51% (958/1419). With respect to non?minor stroke (NIHSS>3),the odds rations and 95% confident intervals of patients with hemoglobin ≤121. 0 g/L(Q1),>122. 1-≤132. 0 g/L(Q2),>141. 0-≤152. 0 g/L(Q4),≥152. 1 g/L (Q5) were 1. 84(95%CI 1. 21-2. 79,P=0. 004),1. 24(95%CI 0. 83-1. 86,P=0. 294),1. 32(95%CI 0. 88-1. 96,P=0. 178) ,1. 52( 95%CI 1. 01-2. 28,P=0. 044) respectively,compared with hemoglobin between 132. 0 and 141. 0 g/L( Q3) . Conclusion Stroke severity is associated with lower and higher hemoglobin concentration in acute ischemic stroke without diabetes.