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COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.
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ObjectIt remains unelucidated regarding the effects of vaccination on disease severity and factors for viral clearance and hospitalization in omicron-infected patients. MethodsThe clinical manifestations of 3,265 Omicron-infected patients (BA.2 variant; the Omicron group) were compared with those of 226 Delta-infected patients (the Delta group).A Multi-class logistic regression model was employed to analyze the impacts of vaccination doses and intervals on disease severity; a logistic regression model to evaluate the risk factors for hospitalization; R 4.1.2 data analysis to investigate the factors for time for nucleic acid negativization (NAN). ResultsCompared with the Delta group, the Omicron group reported a fast transmission, mild symptoms, and lower severity incidence, and a significant inverse correlation of vaccination dose with clinical severity (OR: 0.803, 95%CI: 0.742-0.868, p<0.001). Of the 7 or 5 categories of vaccination status, the risk of severity significantly decreased only at [≥]21 days after three doses (OR: 0.618, 95% CI: 0.475-0.803, p<0.001; OR: 0.627, 95% CI: 0.482-0.815, p<0.001, respectively). The Omicron group also reported underlying illness as an independent factor for hospitalization, sore throat as a protective factor, and much shorter time for NAN [15 (12,19) vs. 16 (12,22), p<0.05]. NAN was associated positively with age, female gender, fever, cough, and disease severity, but negatively with vaccination doses. ConclusionBooster vaccination should be advocated for COVID-19 pandemic-related control and prevention policies and adequate precautions should be taken for patients with underlying conditions.
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Objective:To analyze the clinical characteristics of children with 2019 novel coronavirus (2019-nCoV) infection in Putian City, and to provide a reference for the diagnosis and treatment of children with 2019-nCoV infection.Methods:Clinical characteristics, laboratory examination, pulmonary compated tomography findings, treatment, and clinical outcomes of 78 children with 2019-nCoV infection who were admitted to Putian University Affiliated Hospital Medical Group Putian City Children′s Hospital from September 10 to October 20, 2021 were retrospectively collected and analyzed.Results:Of the 78 children included in the analysis, two cases (2.6%) were asymptomatic infection, 36 cases (46.2%) were mild and 40 cases (51.3%) were ordinary. Five children were vaccinated against 2019-nCoV. The main symptoms were fever (24 cases), cough (13 cases), and fatigue (nine cases). A total of 34 cases (43.6%) had neutropenia, 29 cases (37.2%) had lymphopenia, 36 cases (46.2%) had D-dimer increase, 38 cases (48.7%) had hypokalemia, 27 cases (34.6%) had hypoglycemia and 11 cases (14.1%) had elevated creatine kinase isoenzyme. The neutropenia mostly occurred two to four days after admission. Fifty-six cases (71.8%) showed pulmonary computed tomography abnormalities. The cycle threshold of virus open reading frame ( ORF)1 ab was 20.90±7.15 and the cycle threshold of N gene was 20.29±7.78 in the first nucleic acid detection of 78 children after admission. The time of nucleic acid negative conversion of the 78 children was (20.73±6.94) days. IgM antibody titer in five vaccinated children was 0.36 (0.34, 4.89) and IgG antibody was 10.42 (0.50, 19.42). IgM antibody titer was 1.82 (1.66, 8.12) and IgG antibody was 76.63 (16.92, 79.84) in cases with disease duration ≥10 days. Nine children (11.5%) had resurgence of virus and were sent to the isolation site. All the other children were cured and discharged from hospital. Conclusions:Children with 2019-nCoV infection have mild clinical symptoms, and some children have lymphopenia, neutropenia, and D-dimer elevation during the course of the disease. The overall prognosis is good. The children vaccinated against 2019-nCoV have higher antibody levels.
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ObjectiveTo evaluate the necessity of Covid-19 vaccination in children aged < 12 y by comparing the clinical characteristics in unvaccinated children aged < 12 y with vaccinated patients aged [≥] 12y during the Delta surge (B.1.617.2) in Putian, Fujian, China. MethodsA total of 226 patients with SARS-Cov-2 Delta variant (B.1.167.2; confirmed by Realtime PCR positive and sequencing) were enrolled from Sep 10th to Oct 20th, 2021, including 77 unvaccinated children (aged < 12y) and 149 people aged [≥] 12y, mostly vaccinated. The transmission route was explored and the clinical data of two groups were compared; the effect factors for the time of the nucleic acid negativization (NAN) were examined by R statistical analysis. ResultsThe Delta surge in Putian spread from children in schools to factories, mostly through family contact. Compared with those aged [≥] 12y, patients aged < 12y accounted for 34.07% of the total and showed milder fever, less cough and fatigue; they reported higher peripheral blood lymphocyte counts [1.84(1.32,2.71)x10^9/L vs. 1.31(0.94,1.85)x10^9/L; p<0.05), higher normal CRP rate (92.21% vs. 57.72%), lower IL-6 levels [5.28(3.31,8.13) vs. 9.10(4.37,15.14); p< 0.05]. Upon admission, their COVID19 antibodies (IgM and IgG) and IgG in convalescence were lower [0.13(0.00,0.09) vs. 0.12(0.03,0.41), p<0.05; 0.02(0.00,0.14) vs. 1.94(0.54,6.40), p <0.05; 5.46(2.41,9.26) vs. 73.63 (54.63,86.55), p<0.05, respectively], but longer NAN time (18 days vs. 16 days, p=0.13). ConclusionChildren aged < 12y may be critical hidden spreaders, which indicates an urgent need of vaccination for this particular population.
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ObjectiveTo evaluate the diagnostic efficiency of different methods in detecting COVID-19 to provide preliminary evidence on choosing favourable method for COVID-19 detection. MethodsPubMed, Web of Science and Embase databases were searched for identifing eligible articles. All data were calculated utilizing Meta Disc 1.4, Revman 5.3.2 and Stata 12. The diagnostic efficiency was assessed via these indicators including summary sensitivity and specificity, positive likelihood ratio (PLR), negative LR (NLR), diagnostic odds ratio (DOR), summary receiver operating characteristic curve (sROC) and calculate the AUC. Results18 articles (3648 cases) were included. The results showed no significant threshold exist. EPlex: pooled sensitivity was 0.94; specificity was 1.0; PLR was 90.91; NLR was 0.07; DOR was 1409.49; AUC=0.9979, Q*=0.9840. Panther Fusion: pooled sensitivity was 0.99; specificity was 0.98; PLR was 42.46; NLR was 0.02; DOR was 2300.38; AUC=0.9970, Q*=0.9799. Simplexa: pooled sensitivity was 1.0; specificity was 0.97; PLR was 26.67; NLR was 0.01; DOR was 3100.93; AUC=0.9970, Q*=0.9800. Cobas(R): pooled sensitivity was 0.99; specificity was 0.96; PLR was 37.82; NLR was 0.02; DOR was 3754.05; AUC=0.9973, Q*=0.9810. RT-LAMP: pooled sensitivity was 0.98; specificity was 0.99; PLR was 36.22; NLR was 0.04; DOR was 751.24; AUC=0.9905, Q*=0.9596. Xpert Xpress: pooled sensitivity was 0.99; specificity was 0.97; PLR was 27.44; NLR was 0.01; DOR was 3488.15; AUC=0.9977, Q*=0.9829. ConclusionsThese methods (ePlex, Panther Fusion, Simplexa, Cobas(R), RT-LAMP and Xpert Xpress) bear higher sensitivity and specificity, and might be efficient methods complement to the gold standard.
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ObjectiveThis study aimed to summarize the characteristics of chest CT imaging in Chinese patients with Coronavirus Disease 2019 (COVID-19) to provide reliable evidence for further guiding clinical routine. MethodsPubMed, Embase and Web of Science databases were thoroughly searched to identified relevant articles involving the features of chest CT imaging in Chinese patients with COVID-19. All data were analyzed utilizing R software version i386 4.0.0. Random-effects models were employed to calculate pooled mean differences. Results19 trials incorporating 1332 cases were included in the study. The results demonstrated that the incidence of ground-glass opacities (GGO) was 0.79, consolidation was 0.34; mixed GGO and consolidation was 0.46; air bronchogram sign was 0.41; crazy paving pattern was 0.32; interlobular septal thickening was 0.55; reticulation was 0.30; bronchial wall thickening was 0.24; vascular enlargement was 0.74. subpleural linear opacity was 0.28; intrathoracic lymph node enlargement was 0.03; pleural effusions was 0.03. The distribution in lung: the incidence of central was 0.05; peripheral was 0.74; peripheral involving central was 0.38; diffuse was 0.19; unifocal involvement was 0.09; multifocal involvement was 0.57; unilateral was 0.16; bilateral was 0.83; The incidence of lobes involved (>2) was 0.70; lobes involved ([less double equals]2) was 0.35. ConclusionGGO, vascular enlargement, interlobular septal thickening more frequently occurred in patients with COVID-19. Peripheral, bilateral, involved lobes >2 might be the features of COVID-19 in the distribution aspect. Therefore, based on the aboved features of COVID-19 in chest CT imaging, it might be a promising means for identifying COVID-19.
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<p><b>BACKGROUND</b>Livin is a novel inhibitor of apoptosis protein(IAP),recent studies showed that it overexpressed in many carcinomas including lung cancer and contributed much to the cancerous development.The objective of this study is to explore the expression of the two isoforms of livin in lung cancer tissues and their relationship with histological types and chemotherapy,and to explore their relationship to the expression of caspase-3 as well.</p><p><b>METHODS</b>Expression of livin α,livin β and caspase-3 mRNAs were detected by reverse transcription polymerase chain reaction(RT-PCR) assay in lung cancer tissues as well as in controls.</p><p><b>RESULTS</b>Livin α and livin β were expressed in 12 of 27 and 19 of 27 lung cancer tissues respectively,much higher than those in lung para-cancerous(0/6,0/6) or benign disease lung tissues(0/12,1/12)(both P < 0.01).Moreover,the positive rate was 7/14 and 9/14 in lung adenocarcinoma and 4/12 and 9/12 in squamous and large cell carcinoma respectively,and both of them were detected in one small cell carcinoma.The levels of these two isoforms in lung cancer were significantly higher than those in controls by Gel Imaging System(both P < 0.05),the level of livin α was remarkably higher in adenocarcinoma than that in squamous cell carcinoma(P < 0.05),while the level of livin β was similar in both carcinomas(P > 0.05).Meanwhile,the level of caspase-3 in lung cancer was significantly lower than that in controls,the levels of either each of two isoforms or their sum were negatively associated with that of caspase-3(P < 0.05,P < 0.01,P < 0.01).Two isoforms of livin mRNA expression seemed to increase after chemotherapy but not related to clinical stages(P > 0.05).</p><p><b>CONCLUSIONS</b>Two isoforms of livin are differently expressed in different histological types of lung cancer and may contribute to corresponding cancerous development;the levels of livin are negatively associated with those of caspase-3,this may due to the fact that livin could resist against apoptosis;high expression of livin seems to be related to chemotherapy but not clinical stage.</p>
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OBJECTIVE To investigate the clinical pathologic features and therapeutic tools of pulmonary cryptococcosis.METHODS The clinical data about 16 cases of pulmonary cryptococcosis which were diagnosed by histopathologic examinations were reviewed.The survey data recorded over a 15-year period,from 1982 to 2007,were summarized.We analyzed their clinical situations,radiographic manifestations,final diagnosis and therapeutic tools.RESULTS The majority of the patients were middle-aged males.The health condition of the most of the patients was good before infection.six months to five years after surgery and antifungal theragy,no relapse,dissemination and death were observed.CONCLUSIONS The majority of primary pulmonary cryptococcosis patients have not underlying diseases,and their radiography manifestations show single or multiple nodular shadows,tumor shadows and infiltrative shadows.The limited pathological change can be excised and applied with the antifungal drugs.Fluconazole is the first-choice drug for curing pulmonary cryptococcosis.
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BACKGROUND: Disturbed regulation of cell cycle is the essential mechanism on abnormal proliferation of cell and incidence of cancer. CyclinD1 /cyclin-dependent-kinase pathway involved with p16 and retinoblastoma gene protein is an important.approach on regulation of cell cycle.OBJECTIVE: To understand the expressions of cyclinD1, p16 and retinohlastoma gene protein in non-small-cell lung cancer and probe into the relationship with the prognosis of cancer.DESIGN: Immunohistochemical assay was used to measure the expressions of relevant indexes and follow-up data were utilized for comparative analysis on survival rate and prognostic factor.SETTING: Department of Respiratory Disease, Fujian Provincial Hospital PARTICIPANTS: The experiment was performed in Department of Pathology of Fujian Provincial Hospital from January to June 2002. Tissue specimens of lung cancer were from 68 cases of non-small-cell lung cancer.Histological classification of lung cancer was based on the standards implemented by WHO in 1981 and TNM staging was on the standards revised by International Union Against Cancer (UICC) in 1997.METHODS: Tissue specimens of lung cancer were stained with immunohistochemical method, the positive-stained splices of lung cancer were taken as positive control and those with 1st antibody replaced by phosphate buffer were taken as negative control. The positive was identified if tumor cell nucleus or cytoplasm presented brown-yellow granules. 5 high-power visual fields were observed at randomize in each specimen and 200 tumor cells were counted and the average was obtained. According to the perceptions of positive cell, in which, positive cell count was less by 5% or no obvious positive cell appeared "-", positive cell count was in range from 5% to 20% "+", positive cell count was in range from 21% to 50% "++"and positive cell count was over 50% "(#)", the expression of cyclinD1,p16 and retinoblastoma gene protein in 68 cases of non-small-cell lung cancer were assayed.MAIN OUTCOME MEASURES: Expressions of cyclinD1, p16 and retinoblastoma gene protein and survival phase of patients after operation.retinoblastoma gene protein: The expressive rates were 55.9%, 48.5% and 52.9% respectively. X2 was applied for analysis on the data and it was indicated that there was no remarkable correlation among their expressions.gene protein and prognosis of non-small-cell lung cancer: The average survival phase of cyclinD1 positive expression was shorter than that of negative expression [(12.40, 35.40) months, (x2=5.31 ,P =0.021)]. The average survival phase of positive case of p16 positive expression was longer than that of negative one [(27.84, 15.95) months, (X2=4.38 ,P =0.036)].The average survival phase of positive expression of retinoblastoma gene protein was not more different significantly from the negative one [(18.50,of non-small-cell lung cancer with Cox proportional hazard model: It was indicated that the prognosis of excessive expression of cyclinD1 was poor (P=0.057) and that of p16 only presented 1 prognostic protective factor (P=0.039).CONCLUSION: CyclinD1, p16 and retinoblastoma gene associated with cyclinG1-S regulation are all involved in incidence and development of non-small-cell lung cancer. The assay of expressions of cyclinD1 and p16is essentially significant for prognosis.
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0.05). Tumors metastasized in 10 of 25 primary NSCLC overexpressing cyclin D 1, but only in one of 21 cases that cyclin D 1 negatively expressed ( P
