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Background2019-Novel coronavirus (2019-nCoV) outbreaks create challenges for hospital laboratories because thousands of samples must be evaluated each day. Sample types, interpretation methods, and corresponding laboratory standards must be established. The possibility of other infections should be assessed to provide a basis for clinical classification, isolation, and treatment. Accordingly, in the present study, we evaluated the testing methods for 2019-nCoV and co-infections. MethodsWe used a fluorescence-based quantitative PCR kit urgently distributed by the Chinese CDC to detect 8274 close contacts in the Wuhan region against two loci on the 2019-nCoV genome. We also analyzed 613 patients with fever who underwent multiple tests for 13 respiratory pathogens; 316 subjects were also tested for 2019-nCoV. FindingsAmong the 8274 subjects, 2745 (33.2%) had 2019-nCoV infection; 5277 (63.8%) subjects showed negative results in the 2019-nCoV nucleic acid test (non-2019-nCoV); and 252 cases (3.0%) because only one target was positive, the diagnosis was not definitive. Eleven patients who originally had only one positive target were re-examined a few days later; 9 patients (81.8%) were finally defined as 2019-nCoV-positive, and 2 (18.2%) were finally defined as negative. The positive rates of nCoV-NP and nCovORF1ab were 34.7% and 34.7%, respectively. nCoV-NP-positive only and nCovORF1ab-positive cases accounted for 1.5% and 1.5%, respectively. In the 316 patients with multiple respiratory pathogens, 104 were positive for 2019-nCov and 6/104 had co-infection with coronavirus (3/104), influenza A virus (2/104), rhinovirus (2/104), and influenza A H3N2 (1/104); the remaining 212 patients had influenza A virus (11/202), influenza A H3N2 (11/202), rhinovirus (10/202), respiratory syncytial virus (7/202), influenza B virus (6/202), metapneumovirus (4/202), and coronavirus (2/202). InterpretationClinical testing methods for 2019-nCoV require improvement. Importantly, 5.8% of 2019-nCoV infected and 18.4% of non-2019-nCoV-infected patients had other pathogen infections. It is important to treat combined infections and perform rapid screening to avoid cross-contamination of patients. A test that quickly and simultaneously screens as many pathogens as possible is needed. FundingNo founding was received Research in contextO_ST_ABSEvidence before this studyC_ST_ABSWe searched PubMed for articles published up to January 31, 2020 using the keywords "2019 novel coronavirus" or "2019-nCoV". No published study on the characteristics of 2019-nCoV tests or 2019-nCoV co-infections was found. We only noted recent laboratory findings for other tests of patients infected with 2019-nCoV. Added value of this studyPositive detection of nCoV-NP or nCovORF1ab is presented, and individuals with/without 2019-nCoV infections or with inconclusive results were identified. Patients with inconclusive results may be diagnosed with 2019-nCoV infection or found to be negative for the infection after resampling and retesting in the next few days. Approximately 5.8% of the subjects diagnosed with 2019-nCoV had co-infection. Implications of all the available evidenceManagement of the population showing inconclusive results should be given attention; additionally, such results can be minimized by improving the sampling, sample pretreatment, and testing methodologies. When diagnosing 2019-nCoV subjects, the possibility of co-infection should be considered. Finally, better clinical detection methods are needed to simultaneously screen as many pathogens as possible.
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Objective:To investigate the positive rate for 2019-nCoV tests and co-infections in Wuhan district.Methods:A total of 8 274 cases in Wuhan were enrolled in this cross-sectional study during January 20 to February 9 in 2020, and were tested for 2019-nCoV using fluorescence quantitative PCR. Both respiratory tract samples (nasopharynx, oropharynx, sputum and alveolar lavage fluid) and non-respiratory tract samples (urine, feces, anal swabs, blood and conjunctival sac swabs) were collected. If both orf1ab and N genes are positive, they are classified as nucleic acid test positive group; if both orf1ab and N genes are negative, they are classified as negative group; if single gene target is positive, they are classified as suspicious group. Individuals were divided into male group and female group according to sex. At the same time, 316 patients were tested for 13 respiratory pathogens by multiplex PCR.Results:Among the 8 274 subjects, 2 745 (33.17%) were 2019-nCoV infected; 5 277 (63.77%) subjects showed negative results in the 2019-nCoV nucleic acid test; and 252 cases (3.05%) was not definitive (inconclusive result). The age of cases with COVID-19 patients and inconclusive cases was significantly higher than that of cases without 2019-nCoV infection (56>40, t=27.569, P<0.001; 52>40, t=6.774, P<0.001). The positive rate of 13 respiratory pathogens multiple tests was significantly lower in 104 subjects who were positive for 2019-nCoV compared with those in subjects who were negative for 2019-nCoV test (5.77% vs 18.39%, χ 2=24.105, P=0.003). Four types of respiratory tract samples and five types of non-respiratory tract sampleswere found to be positive for 2019-nCoV nucleic acid test. Conclusion:The 2019-nCoV nucleic acid positive rate inmale is higher than infemale. Co-infections should be pay close attention in COVID-19 patients. 2019-nCoV nucleic acid can be detected in non-respiratory tract samples.
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Objective@#To investigate the positive rate for 2019-nCoV tests and co-infections in Wuhan district.@*Methods@#A total of 8 274 cases in Wuhan were enrolled in this cross-sectional study during January 20 to February 9, 2020, and were tested for 2019-nCoV using fluorescence quantitative PCR. Both respiratory tract samples (nasopharynx, oropharynx, sputum and alveolar lavage fluid) and non-respiratory tract samples (urine, feces, anal swabs, blood and conjunctival sac swabs) were collected. If both orf1ab and N genes are positive, they are classified as nucleic acid test positive group; if both orf1ab and N genes are negative, they are classified as negative group; if single gene target is positive, they are classified as suspicious group. Individuals were divided into male group and female group according to sex. At the same time, 316 patients were tested for 13 respiratory pathogens by multiplex PCR.@*Results@#Among the 8 274 subjects, 2 745 (33.2%) were 2019-nCoV infected; 5 277 (63.8%) subjects showed negative results in the 2019-nCoV nucleic acid test; and 252 cases (3.05%) was not definitive (inconclusive result). The age of cases with COVID-19 patients and inconclusive cases was significantly higher than that of cases without 2019-nCoV infection (40 vs 56, t=27.569, P<0.001; 52 vs 56, t=6.774, P<0.001). The positive rate of 13 respiratory pathogens multiple tests was significantly lower in 104 subjects who were positive for 2019-nCoV compared with those in subjects who were negative for 2019-nCoV test (5.77% vs 18.39%, χ2=24.105, P=0.003). Four types of respiratory tract samples and five types of non-respiratory tract samples were found to be positive for 2019-nCoV nucleic acid test.@*Conclusion@#The 2019-nCoV nucleic acid positive rate in male is higher than in female. Co-infections should be pay close attention in COVID-19 patients. 2019-nCoV nucleic acid can be detected in non-respiratory tract samples.
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[Objective] To observe the clinical curative effect of moxibustion treatment of insomnia patients with type 2 diabetes mellitus, and compare in the moxibustion time under different conditions.[Methods] 90 patients were divided into three groups randomizedly. Both 15min moxibustion group and 30 min moxibustion group receive moxibustion on Shenmen and Sanyinjiao, while compared with wectern medicine grouping receive estazolam. After two weeks, total effective rate, PSQI scale and ISI scale were analyzed. [Results] Total effective rate of 30min moxibustion group was 96.2%, which was significantly higher than 15min moxibustion group(P<0.05)and had no significant difference of the control group(P>0.05). 30min moxibustion group was better than 15min moxibustion group and the control group compared with PSQI total score( P<0.001). ISI score of 15min moxibustion group was significantly higher than control group (P<0.001), then compared with western medicine control group, the score of PSQI in moxibustion 30min group was not statistically significant(P>0.05).[Conclusion] Moxibustion therapy can improve the symptoms of insomnia in patients with type 2 diabetes, significantly improve the quality of sleep, there is a positive correlation between the therapeutic effect of moxibustion and moxibustion time and is helpful to improve the therapeutic effect of moxibustion.
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Objective To analyze the correlation of serum estradiol (E2),testosterone (T),estradiol/testosterone (E2 /T) ratio and BMD(Bone mineral density), bone turnover markers in postmenopausal women, and then to provide a theoretical basis for the pathogenesis of postmenopausal osteoporosis.It might point to a new diagnostic indicator for postmenopausal osteoporosis (PMOP).MethodsFrom October 2014 to September 2016, 283 cases of postmenopausal women were recruited from the Renmin Hospital of Wuhan University.Bone mineral density was measured by dual energy X-ray absorption apparatus, and the recruiters were classified into three group: normal controls (95 cases), osteopenia (94 cases) and osteoporosis group (94 cases).Serum calium (Ca),alkaline phosphatase (ALP),and propetide of type-Ⅰ procollagen (PINP) and β C-terminal cross-linked telopeptide of type I collagen (β-CTX) were detected by Roche cobas 6000 analyzer.Serum E2 and T were measured by Siemens Advia Centaur XP analyzer.All statistical analyses were carried out using SPSS 15.0 software.Results Compared with the normal controls, Serum E2[(22.65±5.35)pg/ml vs (18.64±6.18 )pg/ml,(17.04±6.73) pg/ml,P<0.01]and E2/T ratio (9.03±3.21 vs 7.44±1.78,6.67±1.50,P=0.01) were significantly decreased in the group of osteopenia and osteoporosis.But the bone turnover marker PINP was significantly increased[(38.92±19.23) ng/ml vs (43.94±15.52) ng/ml,(46.28±19.21) ng/ml,P=0.04].Correlation analysis results showed that serum E2 and E2/T ratio was negatively correlated with PINP (r=-0.273,P<0.05;r=-0.284,P<0.05),but positively associated with total hip BMD(r2=0.053,P=0.001;r2=-0.136,P<0.001).Multiple linear regression analysis showed serum E2 and E2/T ratio could explain 17.6% and 28.9% of the total hip BMD variance after adjustment for age, BMI and years after menopause.The area under curve (AUC) of combined E2 and E2/T as a indicator for the diagnosis of PMOP was 0.824 (95% CI:0.765-0.884,P<0.01), which was significantly better than that of E2 or E2/T (P<0.01) only.Conclusions Serum E2 and E2/T ratio was negatively correlated with PINP, but positively associated with total hip BMD.The decrease of serum E2 and E2/T ratio showed a strong association with PMOP.The combined detection of E2 and E2/T is expected to be a valuable indicator for the prediction of PMOP and to monitor the process of osteoporosis.
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Objective To discuss the effect and clinical value of serum sialic acid (SA) and lactadherin(MFG-E8) in the coronary atherosclerotic heart disease(CHD).Methods Selected 295 patients who visited to Wuhan University Renmin's Hospital cardiovascular medicine (from January to June, 2014), and then according to the results of coronary angiography divide the subjects into control group (n =78, the result of coronary angiography completely normal)and coronary heart disease group(n =217, the results of coronary angiography showed that one major coronary stenosis was more than 30％).Detected their serum level of lipid, SA, MFG-E8, hs-CRP index.At last, analyze the differences of SA and MFG-E8 between these groups, and the correlation with the severity of coronary stenosis (symbolize with Gensini score), use the binary logistic regression analysis to research the relationship among the serum level of SA, MFG-E8 and the risk of CHD.Results Compared with the control group, the patients with CHD have a higher level of serum SA and a lower level of MFG-E8 (U =4 402.5, 2 736.0 respectively,P ＜0.001);the AMI group has a higher level of serum SA than the StA and UA groups (U =1 329.0,957.5 respectively, P ＜0.001);the AMI group has a lower level of serum MFG-E8 than the StA groups (U =1517.0, P ＜ 0.001).The spearman correlation analysis showed that the serum SA has a positively correlation with the level of TG, hsCRP and Gensini score, and has a negatively correlated with the level of MFG-E8 (r =0.214, 0.462, 0.378,-0.322 respectively,P ＜0.01);the MFG-E8 has a negatively correlated with the level of TG, hsCRP and Gensini score (r =-0.18,-0.425,-0.564 respectively, P ＜0.01).Binary logistic regression analysis showed that there was a positive correlation between the serum SA and the risk of CHD (OD =4.782, 5.319, 4.179 3.832, 3.648 respectively, P ＜0.001), and the was a negative correlation between the serum MFG-E8 and the risk of CHD (OD =O.118, 0.112, 0.127, 0.135, 0.134 respectively, P ＜ 0.001).Conclusion With the serum SA rised and the MFG-E8 reduced, the risk of coronary heart disease was higher, combined detection these two indexes may be able to diagnose the CHD and assess the degree of stenosis and the risk of CHD.
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To explore the depression in type 2 diabetic patients treated with insulin and compared to those treated with oral anti-diabetic drugs.283 type 2 diabetics were seclected randomly from outpatient and inpatient departments of endocrionology in Jiangsu Province Hospital of Traditional Chinese Medicine,with the self-designed questionnaire and Zung self-rating depression scale to conduct the survey.Comparisons between the two groups were carried out with t-test or x2 test for quantitative and qualitative data,respectively.Logistic regression were used for the analysis of the relationship between the therapeutic regimen and depression.Overall,43.1％ of the type 2 diabetic subjects showed depressive symptoms in different degrees.Compared to the oral drug group,the insulin group showed a significantly higher prevalence of depressive symptoms (insulin group,53.5％,oral drug group,30.5％;P＜0.01)and higher self-rating depression scale scores (insulin group,51.7 ± 12.4,oral drug group,44.8 ± 10.6;P＜0.01).Moreover,after an adjustment for age,sex,body mass index,diabetic duration,complications,HbA1Cand so on,the insulin group showed a significantly higher frequency of depression (OR=4.218,95％ CI 1.764-13.285,P=0.004),compared to the oral drug group.The data showed that insulin treatment is an independent risk factor to the presence of depressive symptoms in type 2 diabetics,and it is necessary to pay more attention to their psychological support.
