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Background This paper is a protocol for an evaluator-blinded, randomized crossover trial. It aims to assess the sleep efficiency of hospitalized very preterm infants (VPIs) by providing multisensory stimulation bundles. In addition, it will observe the intervention impacts on sleep during hospitalization and the sleep and neurodevelopmental outcomes during the first year of post-discharge follow-up.Methods The study will be conducted in the neonatology department of a tertiary pediatric teaching hospital. All eligible VPIs will undergo two types of care in random order: “standard care” (2 weeks) and “standard care plus multisensory stimulation bundles” (2 weeks). A generated list of random numbers will be used for case sequence allocation. Sleep outcomes will be evaluated using the Actiwatch-2 Actigraph. Moreover, the amplitude-integrated electroencephalography and the Griffiths Mental Development Scales will be used to measure the neurodevelopmental outcomes during hospitalization and in the first year of follow-up of VPIs.Discussion The intervention protocol of this study differs from other traditional interventions by producing precise and consistent supportive stimulations, similar to the maternal tactile, auditory, posture, and visual effects for hospitalized preterm infants. This protocol could be an effective measure to facilitate sleep and early neurodevelopment of VPIs. The expected outcomes will help confirm implementing and generalizing of the multisensory stimulation bundles care protocol in neonatology departments. We expect the study to positively impact hospitalized VPIs, specifically for their sleep and early neurodevelopmental outcomes. The study will also provide a new perspective regarding parent and infant interaction strategies, particularly for newborn intensive care units that limit visits due to the global spread of COVID-19.Trial registration: Chinese Clinical Trial Registry (Registry Number: ChiCTR 2200059099), Registered 25 April 2022, https://www.chictr.org.cn/showproj.html?proj=166980
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COVID-19 , Abnormalities, Drug-InducedABSTRACT
Objective To analyze the epidemic trend of respiratory pathogens under non-pharmaceutical interventions during the COVID-19 pandemic in Guangzhou and to explore the causes. Methods Respiratory pathogens, namely influenza A virus (FluA), influenza B virus (FluB), respiratory syncytial virus (RSV), human parainfluenza virus (PIV), adenovirus (AdV), Mycoplasma pneumoniae (MP) and Chlamydia pneumoniae (Cpn), were selected from a total of 14549 patients from December 1, 2019 to November 30, 2022. The differences in the positive constituent ratios and detection rates of each pathogen were analyzed and compared among different years, ages, genders, and seasons. Results The detection rate of RSV (1.03%) was higher than that of FluA (0.42%), PIV (0.41%), MP (0.23%), AdV (0.10%), FluB (0.06%) and Cpn (0.01%), and the difference was statistically significant. There was a statistically significant difference between two comparisons of the detection rates of FluA in different years, with the lowest in 2021 (0%) and the highest in 2022 (1.32%). The detection rate of RSV in 2021 (0.80%) showed a decreasing trend compared to 2020 (1.43%). FluA replaced RSV in 2020 and 2021 as the dominant strain in 2022. The detection rates of RSV (5.21%), PIV (1.88%) and AdV (0.47%) in children were higher than those of 0.97%, 0.44% and 0.09% in young and middle-aged adults, respectively. They were also higher than 0.20%, 0.10% and 0.03% in the elderly, respectively, with statistically significant differences. The detection rate of FluA in children (0.89%) was higher than that in the elderly (0.36%), with a statistically significant difference. There was a statistically significant difference in the detection rates of RSV and PIV between young and middle-aged adults and the elderly. RSV was the predominant strain in both children and young and middle-aged adults, but it was replaced by FluA in the elderly. The detection rates of RSV (1.31%) and PIV (0.58%) were higher in female than in male (0.88% and 0.32%, respectively), and the differences were statistically significant. The predominant strain in both male and female was RSV. There were seasonal differences in the detection rates of FluA, RSV and PIV. The detection rate of FluA was highest in summer (1.34%), followed by winter (0.47%), spring and autumn were lowest, both were 0%. The detection rate of RSV was highest in autumn (2.19%), followed by summer (1.32%), spring and winter were lower (0.32% and 0.45%, respectively). The detection rate of PIV was highest in winter (1.01%), and 0.16%, 0.23%, and 0.21% in spring, summer, and autumn, respectively. The dominant strain was RSV in spring, summer and autumn, which was replaced by PIV in winter. Among the 13,270 patients who were screened for all seven of these pathogens simultaneously, the top four pathogen-positive composition ratios were RSV (41.54%), FluA (21.15%), PIV (18.46%) and MP (10.38%). Single pathogen infection was dominated by RSV infection, accounting for 0.81%, and two pathogen infections were dominated by FluA+PIV and RSV+ MP infection, with one case each. Conclusions RSV was more prevalent and Cpn was less common among respiratory pathogens infections in Guangzhou under non-pharmacological intervention during the New Coronavirus-19 pandemic. Annual differences existed in the detection rates of FluA and RSV. The detection rates of RSV and PIV were highest in children, followed by young and middle-aged adults, and the elderly. The detection rates of RSV and PIV were higher in females than in males. There were seasonal differences in the detection rates of FluA, RSV and PIV, with the highest detection rates of FluA in summer, RSV in autumn and PIV in winter. Infection patterns were more common with single pathogens. The predominant strain was mostly RSV, except in 2022 and in the elderly was replaced by FluA, and was replaced by PIV in winter.
Subject(s)
COVID-19 , Respiratory Syncytial Virus Infections , Chlamydia Infections , Pneumonia, MycoplasmaABSTRACT
INTRODUCTION Primary CNS lymphoma is a rare aggressive hematological malignancy. Current chemotherapy for induction phase is HD-MTX single agent or HD-MTX based combination regimen. We report a rare case whose left and right parietal lymphoma lesions in the brain responded to different induction therapy regimens during the induction phase. CASE REPORT A 43-year-old female presented with seizure and her brain MRI showed bilateral parietal brain lesions in January of 2020. Biopsy and work-up revealed primary CNS diffuse large B-cell lymphoma (DLBCL). The patient underwent HD-MTX therapy. Brain MRI showed clear progression of left parietal lymphoma but stable right parietal lymphoma after two cycles of HD-MTX at 8 g/m2. The treatment was switched to a rituximab 750 mg/m2 weekly and temozolomide 150 mg/m2 daily one-week-on and one-week-off regimen. After 8 weeks, her brain MRI showed nearly complete response of her left parietal lymphoma to rituximab/temozolomide but progression of her right parietal lymphoma. She was switched back to HD-MTX and completed total 8 cycles. Her right parietal lymphoma lesion showed complete response to HD-MTX. The patient is doing well and has been off the treatment over the past 10 months and is waiting for consolidation therapy with autologous stem cell transplantation that has been postponed due to the COVID pandemic. DISCUSSION Our case highlights the very rare heterogenous feature of primary CNS lymphoma responding to different treatment regimen. Biopsy of bilateral heterogeneous lesions may be indicated to compare the different molecular features of the lymphoma to find underlying mechanism if they respond to treatment differently. Specific treatment regimen should be selected based on the responsiveness of CNS lymphoma lesions or combination therapy is selected to cover the heterogeneous susceptibility to chemotherapy regimens.
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Objective: To explore the pharmacological mechanism of Xuanbai Qingfei Jiedu Decoction in the treatment of coronavirus disease 2019 (COVID-19) on account of network pharmacology.
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As the kinetics of novel coronavirus pneumonia (COVID-19) outbreak still going all over the world and we can't predict when it'll make that turnaround and start coming down, seeking ways to prevent and control this disease is particularly important. Here we describe the role of traditional Chinese medicine in preventing COVID-19. In this clinical observation study, we selected 65 people who came back from Hubei province as subjects and launched a mass drug administration with them. We collected the data of the days from Hubei, non-symptoms rate, temperature before and after administration of these people. We treated them by isolating for 14 days and taking Deng's Herbal Tea Granula once a day for seven days. Then we assessed the possible efficacy of Deng's Herbal Tea Granula on COVID-19. Enrolled people had an average age of 27 years old (3–66 years old), among which 34 (53.97%) were females, with a median temperature of 36.4℃ (36.1–36.8℃). The median of the days from Hubei was 16 days (10–27 days). None of them presents any abnormal clinical manifestation. Isolation is the most effective way to defend and control COVID-19, but accompanied by the treatment of Deng's Herbal Tea Granula may increase the power of prevention. Not only this plant solid beverage which made of Chinese medicine can keep the temperature of all the suspected people at a healthy and stable level, but also is suitable for a large group of ages.