Epidemiological and clinical characteristics of 65 hospitalized patients with COVID-19 in Liaoning, China.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread rapidly to multiple countries through its infectious agent severe acute respiratory syndrome coronavirus 2. The severity, atypical clinical presentation, and lack of specific anti-viral treatments have posed a challenge for the diagnosis and treatment of COVID-19. Understanding the epidemiological and clinical characteristics of COVID-19 cases in different geographical areas is essential to improve the prognosis of COVID-19 patients and slow the spread of the disease. AIM: To investigate the epidemiological and clinical characteristics and main therapeutic strategy for confirmed COVID-19 patients hospitalized in Liaoning Province, China. METHODS: Adult patients (n = 65) with confirmed COVID-19 were enrolled in this retrospective study from January 20 to February 29, 2020 in Liaoning Province, China. Pharyngeal swabs and sputum specimens were collected from the patients for the detection of severe acute respiratory syndrome coronavirus 2 nucleic acid. Patient demographic information and clinical data were collected from the medical records. Based on the severity of COVID-19, the patients were divided into nonsevere and severe groups. All patients were followed until March 20, 2020. RESULTS: The mean age of 65 COVID-19 patients was 45.5 ± 14.4 years, 56.9% were men, and 24.6% were severe cases. During the 14 d before symptom onset, 25 (38.5%) patients lived or stayed in Wuhan, whereas 8 (12.3%) had no clear history of exposure. Twenty-nine (44.6%) patients had at least one comorbidity; hypertension and diabetes were the most common comorbidities. Compared with nonsevere patients, severe patients had significantly lower lymphocyte counts [median value 1.3 × 109/L (interquartile range 0.9-1.95) vs 0.82 × 109/L (0.44-1.08), P < 0.001], elevated levels of lactate dehydrogenase [450 U/L (386-476) vs 707 U/L (592-980), P < 0.001] and C-reactive protein [6.1 mg/L (1.5-7.2) vs 52 mg/L (12.7-100.8), P < 0.001], and a prolonged median duration of viral shedding [19.5 d (16-21) vs 23.5 d (19.6-30.3), P = 0.001]. The overall median viral shedding time was 19.5 d, and the longest was 53 d. Severe patients were more frequently treated with lopinavir/ritonavir, antibiotics, glucocorticoid therapy, immunoglobulin, thymosin, and oxygen support. All patients were discharged following treatment in quarantine. CONCLUSION: Our findings may facilitate the identification of severe cases and inform clinical treatment and quarantine decisions regarding COVID-19.

Effects of different bolus and swallow patterns on esophageal manometry in patients with gastroesophageal reflux disease / 西安交通大学学报(医学版)

Objective To investigate the effects of different bolus and swallow patterns on esophageal manometry in patients with gastroesophageal reflux disease by high resolution manometry .Methods Patients with gastroesophageal reflux disease questionnaire score of more than 8 points and positive 24-hour pH monitoring were included in the study .All the patients were detected by liquid swallow ,solid swallow and continuous swallow .The parameters and comprehensive diagnosis were in accordance with the Chicago Standard .Results A total of 42 patients with gastroesophageal reflux disease were enrolled . Compared with the dynamic parameters of liquid swallow ,the residual pressure of upper esophageal sphincter [(11 .07 ± 3 .97 ,5 .29 ± 3 .36)mmHg] decreased ,the distal latency [(6 .28 ± 1 .87 ,8 .98 ± 2 .25)s] ,and lower esophageal sphincter relaxation time [(7 .79 ± 0 .98 ,10 .69 ± 13 .04)s] prolonged significantly (all P<0 .05) .In the comprehensive diagnosis of esophageal motility ,compared with liquid swallow (38 .1% ) , continuous liquid swallow showed a more sensitive positive diagnostic rate of ineffective esophageal motility (IEM) (63 .2% ) ,with a significant difference (P=0 .008) .Compared with that of liquid swallow ,the diagnostic rate (45 .2% ) of IEM by the solid swallow did not differ significantly (P=0 .581) . Among the ineffective contraction ,the rate of failed contraction (44.3% ) of solid swallow was higher than that of liquid swallow (22 .6% ) .Conclusion Solid swallow is more likely to induce severe esophageal hypomotility disorders than liquid swallow.Continuous swallow has more sensitivity in the diagnosis of IEM.Therefore.it can be used as a supplement to routine manometry in patients with eastroesophageal reflux disease.

Research progress of hydroxychloroquine and autophagy inhibitors on cancer.

PURPOSE: Hydroxychloroquine (HCQ), the analog of chloroquine, augments the effect of chemotherapies and radiotherapy on various tumors identified in the current clinical trials. Meanwhile, the toxicity of HCQ retinopathy raises concern worldwide. Thus, the potent autophagy inhibitors are urgently needed. METHODS: A systematic review was related to 'hydroxychloroquine' or 'chloroquine' with 'clinical trials,' 'retinopathy' and 'new autophagy inhibitors.' This led to many cross-references involving HCQ, and these data have been incorporated into the following study. RESULTS: Many preclinical studies indicate that the combination of HCQ with chemotherapies or radiotherapies may enhance the effect of anticancer, providing base for launching cancer clinical trials involving HCQ. The new and more sensitive diagnostic techniques report a prevalence of HCQ retinopathy up to 7.5%. Lys05, SAR405, verteporfin, VATG-027, mefloquine and spautin-1 may be potent autophagy inhibitors. CONCLUSION: Additional mechanistic studies of HCQ in preclinical models are still required in order to answer these questions whether HCQ actually inhibits autophagy in non-selective tumors and whether the extent of inhibition would be sufficient to alter chemotherapy or radiotherapy sensitivity.

Compatibility law of Schisandra chinensis prescription of Chinese patent medicine in Chinese pharmacopoeia / 中国药理学通报

Aim To summarize the 2015 version of the prescrip-tion preparations containing Schisandra chinensis in "Chinese Pharmacopoeia",and discover meaningful compatibility law of Schisandra chinensis. Methods The statistics of prescription preparations relating to Schisandra chinensis in 2015 edition of "Chinese Pharmacopoeia" were gathered to find the frequency of each herbal medicine,efficacy,medicine category,and dosage. A database was constructed and frequency statistics were coun-ted,the dendrogram was built by cluster analysis to get compati-bility law of herbal medicines,and then some modern research analysis was conducted. Results A total 100 kinds of prescrip-tion preparations were included,including 128 Chinese medi-cines,and the total using frequency was 906 times. A sum of 17 types of traditional Chinese medicine were used in this study, and most commonly used herbals were Qi-invigorating herbs(fre-quency 150,0. 1656),antipyretic(frequency 115,0. 1269), yin-nourishing herbs(frequency 91,0. 1004),Yang-invigorat-ing herbs(frequency 78,0. 8610),Hematinic(frequency 78, 0. 8610)and so on. The herb medicine of using frequency ranking the first 20 was Prepared Radix Rehmanniae(47),Ra-dix Ophiopogonis (39 ), tuckahoe (38 ), Membranous Milkvetch(36),Ural Licorice (35),ginseng (32),angelica (23),salvia miltiorrhiza(23),wolfberry fruit(21),respective-ly;cluster analysis showed that the traditional Chinese medicine with frequency more than 10 times could be divided into five cat-egories,while Radix Rehmanniae was classified as a separate class. Conclusions The main therapeutic theory about Schisan-dra is astringency,replenishing and promoting production of body fluid and tonifying the kidney to relieve mental strain in 2015 edition of "Chinese Pharmacopoeia". The prescription compatibility can be used for rational medicine Schisandra com-patibility,guiding rational administration for Schisandra chinen-sis,in-depth research and development of modern prescription provide reference.