The association of typical and atypical symptoms on in-hospital mortality of older adults with COVID-19: a multicentre cohort study

Atypical disease presentations are common in older adults with COVID-19. The objective of this study was to determine the prevalence of atypical and typical symptoms in older adults with COVID-19 through progressive pandemic waves and the association of these symptoms with in-hospital mortality. This retrospective cohort study included consecutive adults aged over 65 years with confirmed COVID-19 infection who were admitted to seven hospitals in Toronto, Canada from March 1, 2020 to June 30, 2021. The median age for the 1786 patients was 78.0 years and 847 (47.5%) were female. Atypical symptoms (as defined by geriatric syndromes) occurred in 1187 patients (66.5%), but rarely occurred in the absence of other symptoms (n=106, 6.2%). The most common atypical symptoms were anorexia (n=598, 33.5%), weakness (n=519, 23.9%), and delirium (n=449, 25.1%). Dyspnea (adjusted odds ratio [aOR] 2.05, 95% confidence interval [CI] 1.62-2.62), tachycardia (aOR 1.87, 95% CI 1.14-3.04), and delirium (aOR 1.52, 95% CI 1.18-1.96) were independently associated with in-hospital mortality. In a cohort of older adults hospitalized with COVID-19 infection, atypical presentations frequently overlapped with typical symptoms. Further research should be directed at understanding the cause and clinical significance of atypical presentations in older adults.

Monitoring and detection of leprosy patients in Southwest China: A retrospective study, 2010-2014.

More than 100 counties, mainly in southwest China, report incidence rates of leprosy >1/100,000. The current study analysed the epidemiology of leprosy in southwest China to improve our understanding of the transmission pattern and improve control programs. 207 counties were selected in southwest China. Leprosy patients and their household contacts were recruited. The data from the medical interview and the serological antileprosy antibody of the leprosy patients were analysed. A total of 2,353 new cases of leprosy were interviewed. The distribution of leprosy patients was partly associated with local natural and economic conditions, especially several pocket areas. A total of 53 from 6643 household contacts developed leprosy, and the incidence rate of leprosy in the household contacts was 364/100,000 person-years. We found that NDO-BSA attained higher positive rates than MMP-II and LID-1 regardless of clinical types, disability and infection time in leprosy patients. By means of combination of antigens, 88.4% patients of multibacillary leprosy were detected, in contrast to 59.9% in paucibacillary leprosy. Household contacts should be given close attention for the early diagnosis, disruption of disease transmission and precise control. Applications of serology for multi-antigens were recommended for effective coverage and monitoring in leprosy control.

Spinal Cord Stimulation Frequency Influences the Hemodynamic Response in Patients with Disorders of Consciousness / 神经科学通报·英文版

Spinal cord stimulation (SCS) is a promising technique for treating disorders of consciousness (DOCs). However, differences in the spatio-temporal responsiveness of the brain under varied SCS parameters remain unclear. In this pilot study, functional near-infrared spectroscopy was used to measure the hemodynamic responses of 10 DOC patients to different SCS frequencies (5 Hz, 10 Hz, 50 Hz, 70 Hz, and 100 Hz). In the prefrontal cortex, a key area in consciousness circuits, we found significantly increased hemodynamic responses at 70 Hz and 100 Hz, and significantly different hemodynamic responses between 50 Hz and 70 Hz/100 Hz. In addition, the functional connectivity between prefrontal and occipital areas was significantly improved with SCS at 70 Hz. These results demonstrated that SCS modulates the hemodynamic responses and long-range connectivity in a frequency-specific manner (with 70 Hz apparently better), perhaps by improving the cerebral blood volume and information transmission through the reticular formation-thalamus-cortex pathway.

Association study between G-protein β3 subunit gene polymorphism and olanzapine-induced weight gain / 中国神经精神疾病杂志

Objective To explore the relationship between G-protein β3 subunit (GNB3) gene C825T polymor?phism and the weight gain of schizophrenics treated with olanzapine. Methods Ninety schizophrenics of first time hospi?talization were collected and treated with olanzapine for 12 weeks. The changes of body weight and body mass index (BMI) were detected before and after 12-week olanzapine treatment. The GNB3 gene C825T polymorphism in patients was determined by polymerase chain reaction (PCR) and DNA sequencing technique. The correlation of GNB3 gene C825T polymorphism and change of clinical parameters was analyzed. Results Body weight and BMI in patients were all increased significantly after treatment (all P<0.01). Weight gain rate (WGR) and increase of BMI in the TT genotype group were higher than those in the CC genotype group (all P<0.01). WGR and increase of BMI in the T-allele carrier (TT and CT genotypes) were higher than those in the T-allele non-carrier (CC genotype) (all P<0.01). There was signifi?cant difference in distribution of genotypes between WGR ≥7% group (CC 15.69%, CT 54.90%, TT 29.41%) and WGR <7% group (CC 38.46%, CT 43.59%, TT 17.95%) (P<0.05). The frequency of T-allele in the WGR≥7% group (63.33%) was higher than that in the WGR<7%group (39.74%) (P<0.05). Multi-variable linear regression indicated that TT genotype (contrasted with CC genotype) was an influential factor for change of body weight after treatment with olan?zapine (β=1.83, standardized β=0.29, P<0.01). Conclusions The GNB3 gene C825T polymorphism is associated with olanzapine-induced weight gain.

Association study between G-protein β3 subunit gene polymorphism and antipsychotic agent-induced obesity / 中华行为医学与脑科学杂志

Objective To explore the relationship between G-protein β3 subunit (GNB3) gene C825T polymorphism and antipsychotic agent-induced obesity.Methods 126 schizophrenic inpatients with long-term antipsychotics treatment were collected.According to body mass index ( BMI),patients were divided into obesity group ( n =62) and non-obesity group ( n =64).The GNB3 gene C825T polymorphism was detected by polymerase chain reaction and DNA sequencing technique.Levels of fasting blood glucose,2-hour postprandial blood glucose,blood lipids and blood uric acid of all patients were routinely measured.Results (1)The GNB3 gene C825T polymorphism were found in obesity group and non-obesity group respectively,and the distribution of genotypes in two groups were both consistent with Hardy-Weinberg equilibrium.(2)There was no significant difference in genotype frequencies between obesity group ( CC 17.75％,CT 58.06％,TT 24.19％ ) and non-obesity group( CC 18.75％,CT 62.50％,T T 18.75％ )( x2 =0.59,P ＞ 0.05 ).There was also no significant difference in allele frequencies between obesity group ( C 46.77％,T 53.23 ％ ) and non-obesity group ( C 50％,T 50％ ) ( x2 =0.26,P ＞ 0.05 ).(3)No significant differences were observed in BMI,fasting blood glucose,2-hour postprandial blood glucose,blood lipids and blood uric acid among different genotype groups (all P ＞ 0.05 ).Also no significant differences were observed in BMI,fasting blood glucose,2-hour postprandial blood glucose,blood lipids and blood uric acid between Tallele carrier (TT and CT genotypes) and T-allele non-carrier( CC genotype) ( all P ＞ 0.05 ).Conclusion The GNB3 gene C825T polymorphism may not be a genetic risk factor for antipsychotic agent-induced obesity.

Determination of Theophylline Concentration in Human Plasma by Micellar Electrokinetic Capillary Chromatography / 中国药房

OBJECTIVE:To develop a simple micellar electrokinetic capillary chromatography for determination of theophylline concentration in human plasma. METHODS: The determination of plasma sample(without any pretreatment) was performed on un-coated fused-silica capillaries (at an effective length of 21 cm) in which the cathodic buffer solution (solution A) was 15 mmol?L-1 borax(pH=10) and the running buffer solution(solution B) was sodium dodecyl sufate (SDS)(200 mmol?L-1) -contained solution A. The sample was injected into capillary by pressure with separation voltage of 12 kV;the UV detection wavelength was set at 280 nm;quantitation was performed by external standard peak area method. RESULTS: The average determination time of each sample was 11 min;the linear range of theophylline was 1.25～40 ?g?mL-1 with its lowest detectable limit at 0.5 ?g?mL-1;the average methodological recovery was 90.33%(RSD=2.51%);the intra-day RSD was 2.34%～3.36% and the inter-day RSD was 2.03%～6.51%,respectively. CONCLUSION: The developed method is simple,rapid and sensitive and it is applicable for the therapeutic drug monitoring of theophylline.

Practice and Research Mode of 6-year Grade Postgraduates of Clinical Pharmacy Major / 中国药房

OBJECTIVE: To develop in 6-year grade postgraduates the expert knowledge and capability in clinical pharmacy through systematic training and practice. METHODS: In the early post-graduate stage,the postgraduate students were assigned to different specific areas. Training methods such as clinical tutoring system,multi-angle training,regular training etc were taken,and a training procedure of pharmacy practice,clinical practice and joining in specialized subjects etc was set up for the students. RESUTLS: After training,the students had adapted to the routine work in hospital pharmacy,developed the knowledge and skills to provide clinical pharmaceutical care,and mastered the clinical pharmacy research methodologies to set up subjects and solve clinical problems. CONCLUSION: The training program for the 6-year grade postgraduates majored in clinical pharmacy achieved a satisfactory outcome in either practice or scientific research.