Associations of clinical characteristics and antiviral drugs with viral RNA clearance in patients with COVID-19 in Guangzhou, China: a retrospective cohort study

BackgroundThe novel coronavirus disease 2019 (COVID-19) characterized by respiratory symptoms has become a global pandemic although factors influencing viral RNA clearance remained unclear to inform optimal isolation period and treatment strategies. MethodsIn this retrospective study, we included patients with confirmed COVID-19 admitted to Guangzhou Eighth Peoples Hospital from 20th January 2020 to 15th March 2020. The associations of clinical characteristics and treatment regimens on time to viral RNA clearance were analyzed. ResultsWe examined 284 consecutive COVID-19 cases, accounting for 82% of confirmed cases in Guangzhou during this period. At the time of reporting (20th March 2020), 276 (97.2%) had recovered and were discharged from hospital with a median hospital stay of 18 days (interquartile range [IQR]:13-24). Overall, 280 patients achieved viral RNA clearance with a median length of 12 days (IQR: 8-16) after onset of illness. Amongst them, 66.1% had viral RNA cleared within 14 days, and 89.3% within 21 days. Older age, severity of disease, time lag from illness onset to hospital admission, high body temperature, and corticosteroid use were associated with delayed clearance of viral RNA. None of the antiviral regimens (chloroquine, oseltamivir, arbidol, and lopinavir/ritonavir) improved viral RNA clearance. The use of lopinavir/ritonavir was associated with delayed clearance of viral RNA after adjusting for confounders. ConclusionIn patients with COVID-19, isolation for a minimum of 21 days after onset of illness may be warranted, while the use of antiviral drugs does not enhance viral RNA clearance. Brief SummaryViral RNA was cleared in 89% of the COVID-19 patients within 21 days after illness onset. The use of antiviral drugs (chloroquine, oseltamivir, arbidol, and lopinavir/ritonavir) did not shorten viral RNA clearance, especially in non-serious cases.

The classification of ureter disease by the level of difficulty and risk during rigid ureteroscopic surgery / 中华泌尿外科杂志

Objective To summarize the common types and clinical characteristics of ureter disease;which can increase manipulation difficulties and adverse events during rigid ureteroscopic procedures. Methods From Jan 2001 to Dec 2010,our team performed 317 rigid ureteroscopic Drocedures for ureteroscopic examination or treatment;including 60 difficult procedures(34 male and 26 female).The mean age of the patients was 37 years (range,18 to 71).The ureteral diseases were classifted into five types according to the pathological characteristics:Type Ⅰ calculous stenosis,Type Ⅱ neoplastic stenosis;Type Ⅲ non-congenital stenosis,Type Ⅳ congenital stenosis,Type Ⅴ expansion of tortuous ureters.The operative time,complications,and conversion to open surgery were evaluated,and the therapeutic methods were analyzed. Results Of the 60 difficuhly-manipulated procedures,the mean manipulated time was 75 min (range,31 to 200).Intra-operative complications occurred in 9 procedures,including 4 cases of mucosal bleeding,2 cases of submucosaI false passage and 3 cases of ureteral perforation.Eleven procedures were converted to open surgery. In five procedures only a double J tube was inserted for drainage due to the difficulty of entering the ureter.Fiftyfive patients were followed up for 17 months (range,3 to 110);48 patients were cured,5 patients improved and 2 patients were unchanged. Conclusions The five types of ureteral disease can increase operative difficulties and risks of rigid ureteroscopic procedures.We should be cautious during surgery and should stop manipulation or convert to other surgeries if necessary.

Research and Practice of Clinical Teaching of Ophthalmology / 中华医学教育探索杂志

Clinical practice is a key step that students take to become doctors.This paper does research in clinical teaching methods for ophthalmology through analyzing current problem of clinical practice in ophthalmology.In the clinical teaching,we should strength the building up of clinical teachers,stimulate students' interest and activity,take PBL(problem-based learning) into teaching method,make use of the principle of optimization medical care and the evidence-based medicine in clinical practice teaching,strength medical students' legal consciousness and cultivate capability of building up cooperative doctor-patient relationship,and improve quality of clinical teaching.

The effect of sodium selenite on heat induced aggregation of lens crystallin / 解放军医学杂志

Objective To study the effect of sodium selenite on heat aggregation of lens crystallin. Methods 12 fresh and intact bovine lenses were incubated with different concentrations of sodium selenite for 72 hours. The lenses of the control group were incubated without sodium selenite for the same length of time. After removing the capsule homogenate, the ?-, ?- and ?-crystallin from the lenses were separated by gel filtration chromatography. After the separation and purification, the crystallin were heated at 60℃ for 30 minutes. Then the absorption value at 360nm was measured again. The difference in the percentage of the absorption value after aggregation was analyzed. Results Comparing with the control group, the lenses incubated with sodium selenite showed earlier opacification in a concentration-dependent manner. After the separation by gel filtration chromatography, the ?-crystallin peak showed an antelocation on the chromatogram, suggesting that there was some high molecular aggregation formation. The aggregation of selenite-treated fractions showed a concentration-dependent increasing absorption compared with normal control portions (P