Objective: During the follow-up of patients recovered from coronavirus disease 2019 (COVID-19) in the quarantine and observation period, some of the cured patients showed positive results again. The recurrent positive RT-PCR test results drew widespread concern. We observed a certain number of cured COVID-19 patients with positive RT-PCR test results and try to analyze the factors that caused the phenomenon. Methods: We conducted an observational study in COVID-19 patients discharged from 6 rehabilitation stations in Wuhan, China. All observed subjects met the criteria for hospital discharge and were in quarantine. Data regarding age, sex, body mass index (BMI), course of disease, comorbidity, smoking status and alcohol consumption, symptoms in and out of quarantine, and intervention were collected from the subjects' medical records and descriptively analyzed. The main outcome of this study was the RT-PCR test result of the observed subjects at the end of quarantine (negative or positive). Logistic regression analysis was used to identify the influencing factors related to recurrent positive RT-PCR test results. Results: In this observational study, 420 observed subjects recovered from COVID-19 were included. The median age was 56 years, 63.6% of the subjects were above 50 years old, and 50.7% (213/420) were female. The most common comorbidities were hypertension [26.4% (111/420)], hyperlipidemia [10.7% (45/420)], and diabetes [10.5% (44/420)]. 54.8% (230/420) manifested one or more symptoms at the beginning of the observation period, the most common symptoms were cough [27.6% (116/420)], shortness of breath 23.8% (100/420)], and fatigue [16.2% (68/420)], with fever rare [2.6% (11/420)]. A total of 325 subjects were exposed to comprehensive intervention; 95
Background: Since December 2019, the outbreak of the novel coronavirus has impacted nearly >90,000 people in more than 75 countries. In this case report, we aim to define the chest computed tomography findings of 2019-novel coronavirus associated with pneumonia and its successful resolution after treatment. Case Report: A fifty-year-old female patient, who is a businesswoman, presented with chief complaints of "fever for one week, diarrhea, anorexia, and asthenia." Initially, she was given Tamiflu. The influenza A virus serology was negative. Three days later, levofloxacin was started because the patient's symptoms did not improve. The novel coronavirus nucleic acid test was negative. It was noted that before the onset of the disease, the patient went to Wuhan on a business trip.Despite the given treatment, her body temperature rose to 39.2°C and she was referred to our clinic for further evaluation. Then, chest computed tomography was performed and showed bilateral multifocal ground glass opacities with consolidation which suggested viral pneumonia as a differential diagnosis, and the subsequent 2019-novel coronavirus pneumonia nucleic acid test was positive. Conclusion:Chest computed tomography offers fast and convenient evaluation of patients with suspected 2019-novel coronavirus pneumonia.
Cerebral ischemia triggers vascular dementia (VD), which is characterized by memory loss, cognitive deficits, and vascular injury in the brain. Puerarin (Pur) represents the major isoflavone glycoside of Radix Puerariae, with verified neuroprotective activity and cardiovascular protective effects. However, whether Pur ameliorates cognitive impairment and vascular injury in rats with permanent occlusion of bilateral common carotid arteries (BCCAO) remains unknown. This work aimed to assess Pur’s effects on BCCAO-induced VD and to dissect the underlying mechanisms, especially examining the function of transient receptor potential melastatin-related 2 (TRPM2) in alleviating cognitive deficits and vascular injuries. Rats with BCCAO developed VD. Pur (50, 100, and 150 mg/kg) dose-dependently attenuated the pathological changes, increased synaptic structural plasticity in the dorsal CA1 hippocampal region and decreased oxidative stress, which eventually reduced cognitive impairment and vascular injury in BCCAO rats. Notably, Pur-improved neuronal cell loss, synaptic structural plasticity, and endothelial vasorelaxation function might be mediated by the reactive oxygen species (ROS)-dependent TRPM2/NMDAR pathway, evidenced by decreased levels of ROS, malondialdehyde (MDA), Bax, Bax/Bcl2, and TRPM2, and increased levels of superoxide dismutase (SOD), Bcl2, and NR2A. In conclusion, Pur has therapeutic potential for VD, alleviating neuronal cell apoptosis and vascular injury, which may be related to the ROS-dependent TRPM2/NMDAR pathway.
Background and objective: Acute kidney injury (AKI) is recognized as an independent predictor for mortality in very-low-birth-weight (VLBW) infants and is reported to have a high incidence. In this study, we sought to identify the predictors for AKI in VLBW infants and thereby develop a prediction nomogram for the early detection and management of VLBW infants at high risk of developing AKI.Methods: We designed a retrospective study wherein we investigated the baseline hospitalization data of VLBW infants treated at our hospital between January 2012 and October 2018. Independent predictors of AKI in VLBW infants, as identified by multivariate logistic regression, were incorporated into a model. Hosmer–Lemeshow test was used to test the goodness of fit of the model, and a receiver operating characteristic (ROC) curve was plotted to assess the discriminative ability of the model. The model was internally validated using the 10-fold cross-validation method. A nomogram was plotted to predict the risk of AKI in VLBW infants on the basis of the results of multivariate logistic regression analysis.Results: We investigated the data of 604 VLBW infants, of which 144 (23.8%) developed AKI; in 111 (77.1%) of these infants, AKI occurred within 7 days of birth. Multivariate logistic regression analysis identified the following as predictive factors for AKI in VLBW infants: gestational age, red blood cell count within 3 days of birth, serum calcium concentration within 3 days of birth, maternal age of ≥35 years, and pulmonary arterial hypertension or myocardial injury. Furthermore, the nomogram was found to be effective in estimating the risk of AKI in VLBW infants, with an area under the curve (AUC) of 0.794 [95% confidence interval (CI): 0.754–0.834; P < 0.001]. Internal validation done by cross-validation showed that the average AUC was 0.788.Conclusion: The nomogram developed in this study was found to be sensitive and specific for the preoperative prediction of AKI in VLBW infants, as per the Kidney Disease: Improving Global Outcomes (KDIGO) criteria modified for neonates.
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