Comparison between original SARS-CoV-2 strain and omicron variant on thin-section chest CT imaging of COVID-19 pneumonia.

OBJECTIVES: We investigated different computed tomography (CT) features between Omicron-variant and original-strain SARS-CoV­2 pneumonia to facilitate the clinical management. MATERIALS AND METHODS: Medical records were retrospectively reviewed to select patients with original-strain SARS-CoV­2 pneumonia from February 22 to April 22, 2020, or Omicron-variant SARS-CoV­2 pneumonia from March 26 to May 31, 2022. Data on the demographics, comorbidities, symptoms, clinical types, and CT features were compared between the two groups. RESULTS: There were 62 and 78 patients with original-strain or Omicron-variant SARS-CoV­2 pneumonia, respectively. There were no differences between the two groups in terms of age, sex, clinical types, symptoms, and comorbidities. The main CT features differed between the two groups (p = 0.003). There were 37 (59.7%) and 20 (25.6%) patients with ground-glass opacities (GGO) in the original-strain and Omicron-variant pneumonia, respectively. A consolidation pattern was more frequently observed in the Omicron-variant than original-strain pneumonia (62.8% vs. 24.2%). There was no difference in crazy-paving pattern between the original-strain and Omicron-variant pneumonia (16.1% vs. 11.6%). Pleural effusion was observed more often in Omicron-variant pneumonia, while subpleural lesions were more common in the original-strain pneumonia. The CT score in the Omicron-variant group was higher than that in the original-strain group for critical-type (17.00, 16.00-18.00 vs. 16.00, 14.00-17.00, p = 0.031) and for severe-type (13.00, 12.00-14.00 vs 12.00, 10.75-13.00, p = 0.027) pneumonia. CONCLUSION: The main CT finding of the Omicron-variant SARS-CoV­2 pneumonia included consolidations and pleural effusion. By contrast, CT findings of original-strain SARS-CoV­2 pneumonia showed frequent GGO and subpleural lesions, but without pleural effusion. The CT scores were also higher in the critical and severe types of Omicron-variant than original-strain pneumonia.

Primary hepatic carcinoma with paraneoplastic syndrome: research progresses on clinical types and their basic mechanisms / 中华肝胆外科杂志

The onset of primary hepatic carcinoma (PHC) is usually occult, and early symptoms are not obvious. Most patients are at advanced stages of disease at diagnosis, and the prognosis is poor. Paraneoplastic syndrome (PNS) refers to the clinical manifestations indirectly caused by tumor metabolites or abnormal immune reactions that cannot be explained by the primary lesion, local tumor spread or distant metastasis. Hypercholesterolemia, hypercalcemia and hypoglycemia are the most commonly seen clinical presentations of PNS in PHC patients. Adequate understanding of PNS is of great importance in early diagnosis and treatment of PHC. In this review, we summarized the clinical manifestations and prognostic mechanisms of PNS in patients with PHC.

Clinical types of checkpoint inhibitor-related pneumonitis in lung cancer patients: a multicenter experience.

BACKGROUND: Checkpoint inhibitor-related pneumonitis (CIP) is not well classified according to clinical factors. We propose different clinical sub-types of CIP based on clinical factors and investigated the corresponding clinical features, treatments, and outcomes. METHODS: We conducted a multicenter retrospective study of patients with lung cancer (including non-small cell lung cancer and small cell lung cancer) who developed CIP. The clinical characteristics, radiologic features, treatments, and outcomes of CIP were analyzed. RESULTS: A total of 55 patients developed CIP and were classified into 3 groups as follows: 21 in the pure type (PT) group, 14 in the induced type (IT) group, and 20 in the mixed type (MT) group. The incidence of severe (grade 3-5) pneumonitis was significantly higher in the IT group than in the PT and MT groups (71.4% vs. 14.3% vs. 50.0%, P=0.002). Antiviral therapy was significantly more frequent in the IT group than in the PT and MT groups. Antibiotic therapy was administered in 23.8%, 71.4%, and 80.0% of patients with the PT, IT, and MT, respectively. The improvement time in the PT group was longer than that in the IT and MT groups (0.9 vs. 0.5 vs. 0.3 months, P=0.028). Patients with the PT had a better tumor response to immune checkpoint inhibitors (ICIs) than those with the other 2 types [overall response rate (ORR), 78% vs. 31% vs. 44%, P=0.027]. CONCLUSIONS: The clinical classification of CIP may favor strategies for treatments and predict the tumor response to ICIs.

Mental health status of patients with coronavirus disease 2019 in Changsha. / 长沙地区2019å† çŠ¶ç— æ¯’ç— æ‚£è€ çš„å¿ƒç†å¥åº·çŠ¶å†µ.

OBJECTIVES: The epidemic of coronavirus disease 2019 (COVID-19) brought psychological stress to the public, especially to patients. This study aims to investigate the mental health of patients with COVID-19 in Changsha. METHODS: We took cross-section investigation for the mental health of 112 patients with COVID-19 via questionnaires. Mann-Whitney U test, Chi-square test, and Fisher's exact test were performed to compare general and clinical data between the slight-ordinary patients and severe patients. Single sample t-tests were used to compare the difference between the factor scores of the Symptom Check-List 90 (SCL-90) in COVID-19 patients with the norm of 2015 and factor scores of SCL-90 in patients with the severe acute respiratory syndrome (SARS). RESULTS: The obsessive-compulsive, depression, sleep and eating disorders had the highest frequency among the positive symptoms of SCL-90 in patients with COVID-19 in Changsha. The factor scores of somatization, depression, anxiety, phobia anxiety, sleep and eating disorders in patients with COVID-19 were higher than those of the norm (P≤0.001 or P<0.05). Slight-ordinary patients with COVID-19 in Changsha showed lower factor scores of somatization, depression, anxiety, and hostility compared with the patients with SARS (P<0.001 or P<0.05). There was no difference in factor scores of SCL-90 between the patients with severe COVID-19 and those with SARS(P>0.05). CONCLUSIONS: The levels of somatization, depression, anxiety, phobia anxiety, sleep and eating disorders in patients with COVID-19 in Changsha are higher than those of the norm. However, the mental health of slight-ordinary patients with COVID-19 is better than that of patients with SARS. It needs to provide targeting psychological interventions depending on the severity of patients.

Mental health status of patients with coronavirus disease 2019 in Changsha / 中南大学学报(医学版)

OBJECTIVES@#The epidemic of coronavirus disease 2019 (COVID-19) brought psychological stress to the public, especially to patients. This study aims to investigate the mental health of patients with COVID-19 in Changsha.@*METHODS@#We took cross-section investigation for the mental health of 112 patients with COVID-19 via questionnaires. Mann-Whitney test, Chi-square test, and Fisher's exact test were performed to compare general and clinical data between the slight-ordinary patients and severe patients. Single sample -tests were used to compare the difference between the factor scores of the Symptom Check-List 90 (SCL-90) in COVID-19 patients with the norm of 2015 and factor scores of SCL-90 in patients with the severe acute respiratory syndrome (SARS).@*RESULTS@#The obsessive-compulsive, depression, sleep and eating disorders had the highest frequency among the positive symptoms of SCL-90 in patients with COVID-19 in Changsha. The factor scores of somatization, depression, anxiety, phobia anxiety, sleep and eating disorders in patients with COVID-19 were higher than those of the norm (≤0.001 or 0.05).@*CONCLUSIONS@#The levels of somatization, depression, anxiety, phobia anxiety, sleep and eating disorders in patients with COVID-19 in Changsha are higher than those of the norm. However, the mental health of slight-ordinary patients with COVID-19 is better than that of patients with SARS. It needs to provide targeting psychological interventions depending on the severity of patients.

[Scleredema adultorum : Clinical presentation, diagnostic workup, differential diagnosis, treatment option]. / Scleroedema adultorum : Klinik, Diagnostik, Differenzialdiagnose, therapeutisches Vorgehen.

Scleredema adultorum (SA) is a rare scleromucinous disease of unknown etiology that characteristically leads to wodden induration located on the neck and upper trunk. Three types of SA can be distinguished according to the association with pre-existing or underlying disease: SA in association with infections (mostly streptococcal infections of the upper respiratory tract), SA in association with monoclonal gammopathy, and SA in association with diabetes. The clinical findings, extent of disease, and course substantially differ depending on the subtype of SA. Spontaneous regression often occurs in infection-associated SA, whereas patients with diabetes or monoclonal gammopathy usually show a chronic progressive course of disease. Phototherapy and methotrexate are the current recommended first-line treatments for SA, clinical improvement often takes several months, and treatment failure is frequent. Physiotherapy should be offered in all types of SA in order to improve motility.

Treatment strategy and efficacy for moyamoya disease of different clinical types and radiographic stages / 第二军医大学学报

Objective: To assess the therapeutic strategies and efficacy of moyamoya disease of different clinical types and radiographic stages. Methods: The clinical types, radiographic stages and treatment strategies of 39 patients with moyamoya disease, who were treated in our medical centers from April 2010 to December 2013, were retrospectively analyzed. The treatment efficacies were analyzed by CT angiography, CT perfusion and DSA. The average follow-up time was (21.3±3.1) months (range: 7-44 months).Results: Thirty-four patients had type I - V moyamoya disease, including 6 treated by encepho-duro-myo-synangiosis (EDMS) and 28 by STA-MCA anastomosis combined with EDMS, with 4 receiving a second surgery on the other hemisphere 6 months after first surgery. Five patients with type VI moyamoya disease underwent emergency surgery: cerebral hematoma evacuation+decompressive craniectomy EDMS. Stage I and II patients were treated by conservative therapies. Stage III - VI patients were treated by EC-IC cerebrovascular reconstruction. The skin incision, bone window, and dura incision were designed individually in order to protect anastomoses formed pre-op in stage V & VI patients. All patients had improved clinical condition during follow-up. CTP imaging showed significantly increased relative cerebral blood flow and relative cerebral blood volume, and decreased time-to-peak after the operation (P<0.05), and these changes were intensified with the prolong of follow-up.Conclusion: Selection of appropriate treatment strategy according to different clinical types and radiographic stages can achieve better therapeutic efficacy for moyamoya disease patients.

Curative effect of endoscopic sinusitis surgery curing chronic sinusitis / 中国基层医药

Objective To discuss curative effect of endoscopic sinusitis surgery(ESS) curing chronic sinusitis and the relation between different clinical types. Methods 106 patients who suffered from chronic sinusitis and met the standard of the diagnosis were given drugs before surgery and then were given themendosopic surgery, and were followed regularly up the patients after endoscope. Results Cure rate was 88.9% for type Ⅰ ,80%for type Ⅱ,52.4% for type Ⅲ ,there was significant statistical difference in cure rate between type Ⅰ and type Ⅱ ,type Ⅱ and type Ⅲ ;Three cases had minor complications, no other had serious complications. Conclusion ESS was an effective method of curing chronic sinusitis, and the effect was influenced by clinical types.

Approaches for Definition, Clinical Types and Function Classification of Cerebral Palsy Domestic and Abroad (review) / 中国康复理论与实践

@#It is very important to have a clear and widely accepted definition and classification for clinical diagnosis, rehabilitation, research and social support of children with cerebral palsy, as well as in establishing a regional, national and global monitoring database. There are some new changes about the definition, clinical types and function classification of cerebral palsy recently domestic and abroad, which pay more attention to assessments on function and participation in daily life.

The Relationship between the Sign of the Lumbar Disc Protrusion on MRI and the Clinical Types of the Lumbar Disc Protrusion / 中国中医药信息杂志

Objective To research the relationship among the disc protrusion on MRI, sex, age, course and the clinical types. Methods MRI was performed for 102 patients. The disc protrusion was divided into three types. According to clinical types, the patients were divided into four types. Statistically, age, course, clinical type and protrusion on MRI were analyzed by SPSS13.0. Results The age was not related with the clinical types and disc protrusion on MRI. There were obvious relations between clinical types and course. There were obvious relations between clinical types and disc protrusion. Conclusion The clinical types are very important on diagnosis of disease stages and choice of therapy in treating lumbar disc protrusion.

Reclassification of Staphylococcal Scalded Skin Syndrome by Clinical Analysis of 25 Cases / 대한피부과학회지

BACKGROUND: Staphylococcal scalded skin syndrome (SSSS) is defined as a spectrum of superficial blistering skin disease caused by the exfoliative toxins of Staphylococcus (S.) aureus. The spectrum of the disease includes generalized, localized (bullous impetigo), abortive and intermediate forms. OBJECTIVE: The purpose of this study is to reclassify clinical types of SSSS by reviewing the clinical and microbiologic features of SSSS and to redefine the clinical types exactly. METHODS: We retrospectively reviewed medical records, clinical photographs and the microbiologic results of 25 patients with SSSS and studied them according to the new classification. We defined the 3 clinical types as follows: i) The Generalized type is defined as a case where tender erythroderma and large thin bullae occur on the whole body excluding the mucous membrane, palms and soles. The nikolsky sign is positive. ii) The intermediate type is defined as a case where tender erythroderma and vesicles or pustules occur in the regionally limited area. The Nikolsky sign is positive. iii) The abortive type is defined as a case where tender erythema occurs only on the whole body or in regionally limited areas. The nikolsky sign is negative. All patients of SSSS have periorificial, radial crusting and fissuring. RESULTS: We could reclassify the clinical types of SSSS into 3 types (generalized, intermediate, abortive) according to this retrospective clinical study. Of the 25 patients, 3 patients were of the generalized type, 13 patients were of the intermediate type and 9 patients were of the abortive type. All the types have the acute eczematous lesion on the periorbital and perioral areas. The male to female sex ratio was 1: 1.3. The mean age of onset was 2.9 years. Cultures from the suspected site of the primary infection were positive in 14 out of 21 patients, and colonized sites were the throat (29%), conjunctiva (21%), nasal cavity (21%), ear (21%) and skin (8%) in 14 patients. Methicillin-sensitive S. aureus and methicillin-resistant S. aureus were 8 cases and 6 cases, respectively. In all clinical types, the most common complication was conjunctivitis (54.5%). Four cases were accompanied by atopic dermatitis. All the patients were cured with first generation cephalosporin without significant sequelae. CONCLUSION: We reclassified SSSS into generalized, intermediate and abortive types with reference to our 25 cases and previously existing papers, and offered a correct definition for the 3 types.