1. Clinical characteristics of 28 patients with novel coronavirus pneumonia
Rui ZHAO ; Yunguang LIANG ; Yanrong LIN ; Ning LU ; Qiulian LI ; Youling LI ; Pan PAN ; Wei HE
Chinese Journal of Infectious Diseases 2020;38(0):E006-E006
Objective:
To analysis the clinical characteristics and experiences in diagnosis and treatment of the patients with novel coronavirus pneumonia (NCP).
Methods:
Clinical data of 28 patients with NCP in Nanning Fourth People's Hospital from January 22 to February 5 in 2020 were collected. The clinical manifestations, epidemiological history, laboratory tests, imaging examinations and treatments of patients were analyzed retrospectively.
Results:
The 28 patients with confirmed viral pneumonia included 11 males and 17 females, ranging from 11 to 68 years. They all had history of epidemiological exposure and were all positive for 2019-nCoV nucleic acid in throat swabs. There were one mild case, 25 ordinary cases and two severe cases. There were four groups of family clusters. The illness onset ranged from 1 to 12 days after exposure, and the time from the symptom onset to the positive result of the nucleic acid test was 0 to 13 days. The clinical symptoms were mainly fever and cough, which progressed rapidly in a short period of time. Since the onset of illness, the peak values of axillary temperature of the 28 patients were 36.6~39.5 ℃, while five patients had no fever throughout the course of the disease with the peak temperature of ≤37 ℃. There were two patients presented with decreased white blood cell counts, five patients with elevated C reactive protein, six patients with abnormal alanine aminotransferase, three patients with abnormal aspartate aminotransferase,10 patients with elevated creatine kinase, three patients with elevated creatine kinase isoenzyme, four patients with elevated lactate dehydrogenase, and all with normal procalcitonin levels. The chest computed tomography examinations showed that the common features were ground glass shadows (21 cases), blurred edges (18 cases), speckles and patchy shadows (17 cases), thickening and disorder of some lung textures (7 cases), and visible band shadows (7 cases). Pulmonary lesions often progressed rapidly. One 11-year-old child was treated with alpha-interferon alone, and 27 patients were treated with alpha-interferon inhalation plus lopinavir/ritonavir with 4 withdrawal due to adverse reactions. Up to February 12, nine patients had been discharged from the hospital, who were ordinary cases, without death cases.
Conclusions
The NCP patients mostly present with fever and cough. Pulmonary lesions often progress rapidly. Respiratory pathogen testing should be conducted as early as possible and repeatedly. Disisolation should be cautious for suspected people who are negative for 2019-nCoV nucleic acid in pharynx swabs.
2.Clinical characteristics of 28 patients with novel coronavirus pneumonia
Rui ZHAO ; Yunguang LIANG ; Yanrong LIN ; Ning LU ; Qiulian LI ; Youling LI ; Pan PAN ; Wei HE
Chinese Journal of Infectious Diseases 2020;38(2):90-93
Objective:To analyze the clinical characteristics and experiences in diagnosis and treatment of the patients with novel coronavirus pneumonia (NCP).Methods:Clinical data of 28 patients with NCP in the Fourth People′s Hospital of Nanning from January 22 to February 5 in 2020 were collected. The clinical manifestations, epidemiological history, laboratory tests, imaging examinations and treatments of patients were analyzed retrospectively.Results:The 28 patients with NCP included one mild case, 25 ordinary cases and two severe cases. They were all positive for 2019 novel coronavirus (2019-nCoV) nucleic acid in throat swabs. There were four groups of family clusters. The clinical symptoms were mainly fever and cough, which progressed rapidly in a short period of time. Since the onset of illness, the peak values of axillary temperature of the 28 patients were 36.6 ℃ to 39.5 ℃, while five patients had no fever throughout the course of the disease with the peak temperature ≤37.0 ℃. The illness onset ranged from 1 to 12 days after exposure, and the time from the symptom onset to the positive results of the nucleic acid tests was 0 to 13 days. There were two patients presented with decreased white blood cell counts, five patients with elevated C reactive protein, six patients with abnormal alanine aminotransferase, three patients with abnormal aspartate aminotransferase, 10 patients with elevated creatine kinase, three patients with elevated creatine kinase isoenzyme, four patients with elevated lactate dehydrogenase, and all with normal procalcitonin levels. The chest computed tomography examinations showed that the common features of patients with NCP were ground glass shadows (21 cases), blurred edges (18 cases), speckles and patchy shadows (17 cases), thickening and disorder of some lung textures (seven cases), and visible band shadows (seven cases). Pulmonary lesions often progressed rapidly. A included 11-year-old child was treated with alpha-interferon alone. A total of 27 patients were treated with alpha-interferon inhalation and lopinavir/ritonavir, while four occured withdrawal due to adverse reactions. Up to February 12, nine patients had been cured and discharged who were all ordinary cases, without death cases.Conclusions:The NCP patients mostly present with fever and cough. Pulmonary lesions often progress rapidly. Respiratory pathogen testing should be conducted as early as possible and repeatedly. Disisolation should be cautious for suspected people who are negative for 2019-nCoV nucleic acid in pharynx swabs.
3.Changes of cerebral blood flow perfusion in bipolar disorder patients with suicidal ideation: a resting-state functional magnetic resonance imaging study
Youling PAN ; Feng CHEN ; Guanmao CHEN ; Pan CHEN ; Yanbin JIA ; Shuming ZHONG ; Shunkai LAI ; Jurong WANG ; Zhenye LUO ; Guixian TANG ; Li HUANG ; Ying WANG
Chinese Journal of Psychiatry 2020;53(6):493-500
Objective:To compare the changes of cerebral blood flow (CBF) in bipolar disorder type Ⅱ patients with and without suicidal ideation.Methods:Pseudo-continuous arterial spin labelling (pCASL) was examined with resting-state functional magnetic resonance imaging(rs-fMRI) on all subjects, CBF images of bipolar disorder type Ⅱ depression with suicidal ideation ( n=48), Bipolar Disorder type Ⅱ without suicidal ideation ( n=41), healthy controls ( n=62) at rest were collected. One-way ANOVA and Gaussian random field (GRF) were used to compare the CBF values between the groups to locate the regions with significant change. Results:Compared with the control group, CBF of left superior temporal gyrus (extending to the temporal pole) ( t=3.87, P<0.01; t=4.44, P<0.01) and left putamen ( t=4.04, P<0.01; t=3.19, P<0.01) increased in bipolar disorder type Ⅱ patients with and without suicidal ideation, and CBF of the right posterior cingulate gyrus (extending to the calcarine gyrus) decreased in bipolar disorder type Ⅱ patients with suicidal ideation( t=-4.66, P<0.01). Conclusions:There were abnormal CBF in left superior temporal gyrus and left putamen in bipolar disorder type Ⅱ patients with suicidal ideation and bipolar disorder type Ⅱ patients without suicidal ideation, while the decreased CBF in right posterior cingulate gyrus may be the specific brain change in bipolar disorder type Ⅱ patients with suicidal ideation.
4.Analysis of adverse reactions of lopinavir/ritonavir in the treatment of coronavirus disease 2019
Qiulian LI ; Qingdong ZHU ; Wei HE ; Rui ZHAO ; Ning LU ; Yunguang LIANG ; Youling LI ; Pan PAN ; Yanrong LIN
Adverse Drug Reactions Journal 2020;22(10):559-562
Objective:To explore the occurrence of adverse reactions of lopinavir/ritonavir (LPV/r) in the treatment of coronavirus disease 2019 (COVID-19).Methods:The medical records of patients with COVID-19 who received LPV/r treatment in the Fourth People′s Hospital of Nanning from January 24th to February 6th, 2020 were collected and the occurrence of adverse events during the treatment was retrospectively analyzed. According to the 5 principles of adverse drug reaction correlation evaluation proposed in the Handbook of Adverse Drug Reaction Reporting and Monitoring in China, adverse events that were certainly related, probably related, and possibly related to LPV/r were defined as LPV/r-related adverse reactions. The incidence of adverse reactions was calculated and the main clinical manifestations and severity of adverse reactions [grade 1 (mild), grade 2 (moderate), grade 3 (severe), grade 4 (life-threatening), and grade 5 (death); grade 3-5 was defined as severe adverse reaction] were analyzed. Results:A total of 28 patients were enrolled in the analysis, including 13 males and 15 females, aged from 18 to 70 years with an average age of 44 years. The courses of treatment with LPV/r of patients ranged from 2 to 12 days, with a median course of 6 days. Of the 28 patients, 18 developed LPV/r related adverse reactions, with an incidence of 64.3%. The LPV/r-related adverse reactions in 18 patients included gastrointestinal reactions in 14 patients (grade 1 in 13 patients and grade 2 in 1 patient), bradycardia in 2 patients (grade 2 in both patients), and acute hemolysis in 1 patient (grade 3), and liver injury in 1 patient (grade 3), and no grade 4 or 5 adverse reactions occurred. The incidence of severe adverse reactions was 7.1%. Thirteen patients with grade 1 adverse reactions did not affect the treatment, and the symptoms were relieved after 2-7 days of continuous medication. LPV/r was discontinued in 5 patients with grade 2 or 3 adverse reactions, 4 of whom received symptomatic treatment, and the symptoms disappeared 2-10 days later.Conclusions:The incidence of adverse reactions in COVID-19 patients treated with LPV/r in our hospital was 64.3%. LPV/r mainly leads to mild gastrointestinal reactions and can also lead to bradycardia, acute hemolysis, and liver injury. Blood routine, liver function, and electrocardiogram need to be monitored during the treatment.
5.Analysis of adverse reactions of lopinavir/ritonavir in the treatment of coronavirus disease 2019
Qiulian LI ; Qingdong ZHU ; Wei HE ; Rui ZHAO ; Ning LU ; Yunguang LIANG ; Youling LI ; Pan PAN ; Yanrong LIN
Adverse Drug Reactions Journal 2020;22(10):559-562
Objective:To explore the occurrence of adverse reactions of lopinavir/ritonavir (LPV/r) in the treatment of coronavirus disease 2019 (COVID-19).Methods:The medical records of patients with COVID-19 who received LPV/r treatment in the Fourth People′s Hospital of Nanning from January 24th to February 6th, 2020 were collected and the occurrence of adverse events during the treatment was retrospectively analyzed. According to the 5 principles of adverse drug reaction correlation evaluation proposed in the Handbook of Adverse Drug Reaction Reporting and Monitoring in China, adverse events that were certainly related, probably related, and possibly related to LPV/r were defined as LPV/r-related adverse reactions. The incidence of adverse reactions was calculated and the main clinical manifestations and severity of adverse reactions [grade 1 (mild), grade 2 (moderate), grade 3 (severe), grade 4 (life-threatening), and grade 5 (death); grade 3-5 was defined as severe adverse reaction] were analyzed. Results:A total of 28 patients were enrolled in the analysis, including 13 males and 15 females, aged from 18 to 70 years with an average age of 44 years. The courses of treatment with LPV/r of patients ranged from 2 to 12 days, with a median course of 6 days. Of the 28 patients, 18 developed LPV/r related adverse reactions, with an incidence of 64.3%. The LPV/r-related adverse reactions in 18 patients included gastrointestinal reactions in 14 patients (grade 1 in 13 patients and grade 2 in 1 patient), bradycardia in 2 patients (grade 2 in both patients), and acute hemolysis in 1 patient (grade 3), and liver injury in 1 patient (grade 3), and no grade 4 or 5 adverse reactions occurred. The incidence of severe adverse reactions was 7.1%. Thirteen patients with grade 1 adverse reactions did not affect the treatment, and the symptoms were relieved after 2-7 days of continuous medication. LPV/r was discontinued in 5 patients with grade 2 or 3 adverse reactions, 4 of whom received symptomatic treatment, and the symptoms disappeared 2-10 days later.Conclusions:The incidence of adverse reactions in COVID-19 patients treated with LPV/r in our hospital was 64.3%. LPV/r mainly leads to mild gastrointestinal reactions and can also lead to bradycardia, acute hemolysis, and liver injury. Blood routine, liver function, and electrocardiogram need to be monitored during the treatment.
6.Changes of cerebral blood flow perfusion in bipolar disorder patients with suicidal ideation: a resting-state functional magnetic resonance imaging study
Youling PAN ; Feng CHEN ; Guanmao CHEN ; Pan CHEN ; Yanbin JIA ; Shuming ZHONG ; Shunkai LAI ; Jurong WANG ; Zhenye LUO ; Guixian TANG ; Li HUANG ; Ying WANG
Chinese Journal of Psychiatry 2020;53(6):493-500
Objective:To compare the changes of cerebral blood flow (CBF) in bipolar disorder type Ⅱ patients with and without suicidal ideation.Methods:Pseudo-continuous arterial spin labelling (pCASL) was examined with resting-state functional magnetic resonance imaging(rs-fMRI) on all subjects, CBF images of bipolar disorder type Ⅱ depression with suicidal ideation ( n=48), Bipolar Disorder type Ⅱ without suicidal ideation ( n=41), healthy controls ( n=62) at rest were collected. One-way ANOVA and Gaussian random field (GRF) were used to compare the CBF values between the groups to locate the regions with significant change. Results:Compared with the control group, CBF of left superior temporal gyrus (extending to the temporal pole) ( t=3.87, P<0.01; t=4.44, P<0.01) and left putamen ( t=4.04, P<0.01; t=3.19, P<0.01) increased in bipolar disorder type Ⅱ patients with and without suicidal ideation, and CBF of the right posterior cingulate gyrus (extending to the calcarine gyrus) decreased in bipolar disorder type Ⅱ patients with suicidal ideation( t=-4.66, P<0.01). Conclusions:There were abnormal CBF in left superior temporal gyrus and left putamen in bipolar disorder type Ⅱ patients with suicidal ideation and bipolar disorder type Ⅱ patients without suicidal ideation, while the decreased CBF in right posterior cingulate gyrus may be the specific brain change in bipolar disorder type Ⅱ patients with suicidal ideation.
7.Questionnaire investigation of the awareness of doctors' attitude to geriatric syndrome in old patients with cancer
Lingxiao WANG ; Zhangmin MENG ; Shuangshuang NIE ; Bing XIANG ; Jun LI ; Qianqian SUN ; Hai QIN ; Youling GONG ; Changchuan PAN ; Cheng YI ; Yongxue YANG ; Shuang WANG
Chinese Journal of Geriatrics 2017;36(5):579-582
Objective To improve the quality of the management of the elderly patients with cancer in Sichuan province,and to understand the attitudes and perspectives of elderly surgeons and oncologists for the management and treatment of elderly patients with cancer.Methods A face-toface questionnaire interview was conducted with oncologists (n 64) and geriatricians (n =64).128 physicians were involved in this study.Results The cancer management and therapeutics were deemed appropriate at present by 9.38% (6/64)of the geriatricians and 25.00% (16/64)of the oncologists.The 39.06% (25/64) of geriatricians used to notice geriatric syndromes,while 81.25% (52/64)of oncologists never concerned about the geriatric syndrome(P=0.011).As for the causes of the therapy-associated toxicity,oncologist versus geriatrician payed an attention to malnutrition (100.00% vs.100.00% in both groups),to mobility disorders(65.63% vs.65.63%,84/128 in both groups),to cognitive impairment/mood disorder (89.06% in geriatrician group vs.75.00% in oncologist group,P=0.038).For the factors affecting treatment decisions,a physical ability attention (oncologists vs geriatricians:70.31% vs.92.19%;P =0.002),and comorbidity (oncologists vs geriatricians:62.50% vs.79.69%,P =0.032) had statistically significant difference.In addition,lack of geriatrics knowledge was also reported by more oncologists.However,one hundred percent of participants wanted very much to cooperate with each other in their clinical work.When responding to the clinical scenario,the 10.94% (7/64)of geriatricians and 32.81% (21/64)of oncologists chose modified treatment for 65-74 years old patient with cancer(P =0.003).When the age of the patients was 75-84 years old,only 12.50 % (8/64) of geriatricians prefer end-of-life care,while 31.25 % (20/64) of oncologists chose it (P =0.010).Conclusions Selection of treatment decisions in the elderly patients with cancer affect by ageing.Both oncologists and geriatricians are concerned with the elderly patients with cancer,ageing syndrome,total sickness and functional status.And these doctors support an establishment of a multi disciplinary team cooperation for the elderly patients with cancer.Therefore,the establishment of mutual cooperation between the two professionals is necessary and feasible.

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