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Objective:To analyze the clinical characteristics of patients infected with 2019-nCoV Omicron variants BA.1 and BA.2 in Zhuhai city.Methods:A retrospective study was conducted to compare clinical characteristics of patients infected with 2019-nCoV Omicron variants BA.1 and BA.2, who were admitted in the Fifth Affiliated Hospital of Sun Yat-sen University during January 13 to March 8 2022. The Mann-Whitney U-test or Kruskal-Wallis H test was used for quantitative data, and the χ2 test or Fisher’s exact test was used for qualitative data. Results:Among 122 patients infected with the Omicron variant, there was 79 adults (BA.1 23 cases, BA.2 56 cases) and 43 children (BA.1 19 cases, BA.2 24 cases). In adults, patients infected with BA.2 sub-variant had a higher baseline viral loads at admission than BA.1 infected patients [7.64(6.92, 8.55) lg copies/mL vs. 6.64(6.04, 7.34) lg copies/mL; Z=-3.022, P=0.003]; compared to BA.1 patients, BA.2 patients had a higher proportion of mild and asymptomatic cases and a lower proportion of common infection cases ( χ2=8.052, P=0.012); the proportion of patients with pneumonia imaging changes in BA.1 patients was higher than that in BA.2 infected patients [(6/23, 26.1%) vs. (2/56, 3.6%); χ2=6.776, P=0.009). In children, the rate of fever in BA.2 group was higher than that in BA.1 group [(16/24, 66.7%) vs. ( 5/19, 26.3%); χ2=6.910, P=0.009); the proportion of patients with reduced lymphocyte counts in BA.2 group was higher than that in BA.1 group [(17/24, 70.8%) vs.(1/19, 5.3%); χ2=18.734, P<0.001). Compared with adult cases, children with BA.2 sub-variant infection had higher fever rate [(16/24, 66.7%) vs. (19/56, 33.9%); χ2=7.317, P=0.007). The viral loads of daily nasal swabs in BA.2 infected patients increased first and then decreased in both adults and children, with a greater decrease than BA.1 during the first two weeks. Conclusions:Compare with 2019-nCoV Omicron variant BA.1, BA.2 has a higher baseline viral loads in adults, which means much more contagious in the early stages. But the viral load drops faster in BA.2 infected patients. In children, BA.2 patients are more likely to have fever and reduced lymphocyte counts, which indicates that the prevention and control of 2019-nCoV Omicron sub-variant BA.2 is more difficult.
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BackgroundEffective therapies are urgently needed for the SARS-CoV-2 pandemic. Chloroquine has been proved to have antiviral effect against coronavirus in vitro. In this study, we aimed to assess the efficacy and safety of chloroquine with different doses in COVID-19. MethodIn this multicenter prospective observational study, we enrolled patients older than 18 years old with confirmed SARS-CoV-2 infection excluding critical cases from 12 hospitals in Guangdong and Hubei Provinces. Eligible patients received chloroquine phosphate 500mg, orally, once (half dose) or twice (full dose) daily. Patients treated with non-chloroquine therapy were included as historical controls. The primary endpoint is the time to undetectable viral RNA. Secondary outcomes include the proportion of patients with undetectable viral RNA by day 10 and 14, hospitalization time, duration of fever, and adverse events. ResultsA total of 197 patients completed chloroquine treatment, and 176 patients were included as historical controls. The median time to achieve an undetectable viral RNA was shorter in chloroquine than in non-chloroquine (absolute difference in medians -6.0 days; 95% CI -6.0 to -4.0). The duration of fever is shorter in chloroquine (geometric mean ratio 0.6; 95% CI 0.5 to 0.8). No serious adverse events were observed in the chloroquine group. Patients treated with half dose experienced lower rate of adverse events than with full dose. ConclusionsAlthough randomised trials are needed for further evaluation, this study provides evidence for safety and efficacy of chloroquine in COVID-19 and suggests that chloroquine can be a cost-effective therapy for combating 102 the COVID-19 pandemic.
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BackgroundSince the pandemic outbreak of coronavirus disease 2019 (COVID-19), the health system capacity in highly endemic areas has been overwhelmed. Approaches to efficient management are urgently needed. We aimed to develop and validate a score for early prediction of clinical deterioration of COVID-19 patients. MethodsIn this retrospective multicenter cohort study, we included 1138 mild to moderate COVID-19 patients admitted to 33 hospitals in Guangdong Province from December 27, 2019 to March 4, 2020 (N =818; training cohort), as well as two hospitals in Hubei Province from January 21 to February 22, 2020 (N =320; validation cohort) in the analysis. ResultsThe 14-day cumulative incidences of clinical deterioration were 7.9% and 12.1% in the training and validation cohorts, respectively. An Early WArning Score (EWAS) (ranging from 0 to 4.5), comprising of age, underlying chronic disease, neutrophil to lymphocyte ratio, C-reactive protein, and D-dimer levels, was developed (AUROC: 0.857). By applying the EWAS, patients were categorized into low-, medium-, and high risk groups (cut-off values: two and three). The 14-day cumulative incidence of clinical deterioration in the low-risk group was 1.8%, which was significantly lower than the incidence rates in the medium-(14.4%) and high-risk (40.9%) groups (P <.001). The predictability of EWAS was similar in the validation cohort (AUROC =0.781), patients in the low-, medium-, and high-risk groups had 14-day cumulative incidences of 2.6%, 10.0%, and 25.7%, respectively (P <.001). ConclusionThe EWAS, which is based on five common parameters, can predict COVID-19-related clinical deterioration and may be a useful tool for a rapid triage and establishing a COVID-19 hierarchical management system that will greatly focus clinical management and medical resources to reduce mortality in highly endemic areas.
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The new coronavirus (SARS-CoV-2) outbreak originating from Wuhan, China, poses a threat to global health. While its evident that the virus invades respiratory tract and transmits from human to human through airway, other viral tropisms and transmission routes remain unknown. We tested viral RNA in stool from 73 SARS-CoV-2-infected hospitalized patients using rRT-PCR. 53.42% of the patients tested positive in stool. 23.29% of the patients remained positive in feces even after the viral RNA decreased to undetectable level in respiratory tract. The viral RNA was also detected in gastrointestinal tissues. Furthermore, gastric, duodenal and rectal epithelia showed positive immunofluorescent staining of viral host receptor ACE2 and viral nucleocapsid protein in a case of SARS-CoV-2 infection. Our results provide evidence for gastrointestinal infection of SARS-CoV-2, highlighting its potential fecal-oral transmission route.
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<p><b>OBJECTIVE</b>To investigate the efficacy of anti-hepatitis B virus (HBV) drugs for preventing vertical transmission of HBV and the safety of these drugs when given as treatment during pregnancy (to women) or insemination (to men).</p><p><b>METHODS</b>Cases of women and men who had taken anti-HBV drug therapy during pregnancy or insemination, respectively, were retrospectively selected for study from among 18 hospitals and 33 specialists in the Guangdong Province. Demographic, HBV infection and treatment data was collected for puerperal men or women and their newborns from the medical records.</p><p><b>RESULTS</b>A total of 122 cases with detailed follow-up data were included in the study and including 74 women who were administered lamivudine (LAM) more than telbivudine (LdT) more than adefovir (ADV)more than entecavir (ETV) (hierarchy ranking by number of cases) and 48 men who were administered LAM more than ADV more than LdT more than ETV.None of the 122 newborns related to these cases showed HBV infection at 7 months of follow-up.None of the 74 puerperal women showed complications related to reproduction.There was one ease of a newborn being underweight at birth (2.1 kg), for which the mother had taken LdT during pregnancy. There was also one case of a newborn with a harelip and one case of a newborn with an inguinal hernia, for which both of the fathers had taken ADV during the time of insemination.</p><p><b>CONCLUSION</b>This retrospective investigation carried out in Guangdong Province indicated that not only are anti-HBV drugs efficacious for blocking vertical transmission of HBV but also are safe for both mothers and infants when taken by fathers or mothers during the reproduction phases of insemination and pregnancy.</p>
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Femenino , Humanos , Lactante , Recién Nacido , Masculino , Embarazo , Adenina , Antivirales , Usos Terapéuticos , Guanina , Hepatitis B , Quimioterapia , Virus de la Hepatitis B , Transmisión Vertical de Enfermedad Infecciosa , Lamivudine , Madres , Organofosfonatos , Estudios Retrospectivos , Timidina , Factores de TiempoRESUMEN
Objective To investigate the apearance and characteristics of skin rashes in patients suffering from dengue fever.Methods Clinical data were retrospectively analyzed for 126 hospitalized patients with dengue fever collected from August to October,2007.Results Out of 126 patients with dengue fever,69.0% (87/126)had skin rashes,which usually developed from day 1 and 11 after fever.About 59.7%(52/87)of these patients developed skin rashes from day 3 to 7 after fever.No eruption order was evidenced in 59(67.8%)patients.Skin rashes were located in both the trunk and limbs in 38(43.7%)patients,and only in the limbs in 30 (34.5%)patients.The incidence rates of maculae,maculopapules,papules.hemorrhagic rash and mixed eruptions were 14.9%(13/87),14.9%(13/87),18.4%(16/87),26.4%(23/87)and 21.8%(19/87),respectively.Conclusions Most patients with dengue fever developed skin rashes from day 3 to 7 after fever.Limbs and trunk are predilection sites of skin rashes in dengue fever.Skin rashes in dengue fever is complex,including maculae,papules,hemorrhagic rashes,vesicles and mixed rashes.
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SRP-27 (sarcoplasmic reticulum protein of 27 kDa) is a newly identified integral membrane protein constituent of the skeletal muscle SR (sarcoplasmic reticulum). We identified its primary structure from cDNA clones isolated from a mouse skeletal muscle cDNA library. ESTs (expressed sequence tags) of SRP-27 were found mainly in cDNA libraries from excitable tissues of mouse. Western blot analysis confirmed the expression of SRP-27 in skeletal muscle and, to a lower extent, in heart and brain. Mild trypsin proteolysis combined with primary-structure prediction analysis suggested that SRP-27 has four transmembrane-spanning alpha helices and its C-terminal domain faces the cytoplasmic side of the endo(sarco)plasmic reticulum. The expression of SRP-27 is higher in fast twitch skeletal muscles compared to slow twitch muscles and peaks during the first month of post-natal development. High-resolution immunohistochemistry and Western blot analysis of subcellular fractions indicated that SRP-27 is distributed in both longitudinal tubules and terminal cisternae of the SR, as well as in the perinuclear membrane systems and the nuclear envelope of myotubes and adult fibres. SRP-27 co-sediments with the RyR (ryanodine receptor) macromolecular complex in high-salt sucrose-gradient centrifugation, and is pulled-down by anti-RyR as well as by maurocalcin, a well characterized RyR modulator. Our results indicate that SRP-27 is part of a SR supramolecular complex, suggesting the involvement of SRP-27 in the structural organization or function of the molecular machinery underlying excitation-contraction coupling.
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Proteínas de la Membrana/metabolismo , Contracción Muscular , Proteínas Musculares/metabolismo , Músculo Esquelético/metabolismo , Transducción de Señal , Secuencia de Aminoácidos , Animales , Línea Celular , Chlorocebus aethiops , Clonación Molecular , Secuencia Conservada , ADN Complementario/genética , Retículo Endoplásmico/metabolismo , Regulación del Desarrollo de la Expresión Génica , Humanos , Proteínas de la Membrana/química , Proteínas de la Membrana/genética , Ratones , Datos de Secuencia Molecular , Proteínas Musculares/química , Proteínas Musculares/genética , Ratas , Ratas Wistar , Canal Liberador de Calcio Receptor de Rianodina/metabolismo , Alineación de SecuenciaRESUMEN
OBJECTIVE: To study the relationship between the infection of hepatitis B virus (HBV) in gastric mucosa and the syndrome of disharmony between liver and stomach. METHODS: Subjects were divided into 2 groups: 30 patients with chronic hepatitis B (CHB) and the syndrome of disharmony between liver and stomach in hepatitis group, and 30 patients with chronic gastritis and the syndrome of disharmony between liver and stomach in gastritis group. Liver function and the markers of HBV were detected. The contents of HBV-DNA in serum and in gastric mucosa were assayed respectively by fluorescence quantitative polymerase chain reaction (FQ-PCR). RESULTS: (1) The incidence of gastric mucosal lesion in hepatitis group was up to 96.7% (29/30). (2) Scores of the syndrome of disharmony between liver and stomach in hepatitis group were significantly lower than those in gastritis group (P<0.05). The positive rates of HBV-DNA in serum, gastric fundus, body and antrum were 56.7%, 76.7%, 76.7% and 70.0%, respectively. (3) A positive correlation was found not only among the content of HBV-DNA in serum and the contents of HBV-DNA in gastric mucosa (r=0.66-0.94, P<0.01), but also among the contents of HBV-DNA in serum, gastric mucosa and the total score of the syndrome of disharmony between liver and stomach in hepatitis group (r=0.36-0.52, P<0.05). CONCLUSION: The infection of HBV is involved in the syndrome of disharmony between liver and stomach. Gastric mucosal lesion is universal in CHB patients with the syndrome of disharmony between liver and stomach.
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Objective: To observe effects of Ganzhikang Capsule on ultrastructures in non-alcoholic fatty liver model rats so as to provide morphological basis for clinical treatment. Methods: Fatty liver model rats were induced by high fat diet, and the effects of Ganzhikang Capsule on microstructures in liver tissue were investigated with Dong Bao Gan Tai used as control medicine. Results: In the model group, serious fatty degeneration of hepatocytes with inflammatory infiltration, degeneration and necrosis, and deforming, swelling of mitochondrion, dilatation of endoplasmic reticulum were found. After treatment of Ganzhikang Capsule, microstructures of hepatocytes restored obviously, fatty degeneration relieved significantly, and Ganzhikang Capsule was superior to Dong Bao Gan Tai in restoration of fatty degeneration (P
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0.05).The results of electrocardiography and the laboratory ex-amination showed that neither ANWin cluding natural Calculus Bovis nor A NWincluding in -vitro cultured Calc ulus Bo-vis had obviously toxic and side effe cts in treating epidemic encephalitis B.Conclusion ANW including in -vitro cul-tured Calculus Bovis has an markedly effect in the treatment of epidemic e ncephalitis B.