Background: Coronavirus disease 2019 (COVID-19) is a highly infectious disease, mainly causing respiratory symptoms. However, a few patients may also have neurological symptoms. Herein, we report a case of COVID-19 infection complicated with Bell’s palsy.Case presentation: A 65-year-old woman was admitted due to left facial drooping. Physical examination showed left peripheral facial paralysis. Brain MRI showed no abnormality. However, the chest CT revealed the ground-glass shadows in the right lower lung. The real-time reverse transcription-polymerase chain reaction (RT-PCR) results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA were positive through throat swabs, while the common influenza virus antigens were tested negative. The symptoms of left facial paralysis relieved after antiviral treatment. She patient was discharged in the context of 3 consecutively negative RT-PCR test results for SARS-CoV-2 RNA and complete absorption of the right lung lesions. Conclusion: This case suggests that COVID-19 may be presented with Bell’s palsy and may be a potential cause of facial paralysis.
Basilar artery (BA) dolichosis is not uncommon in patients with acute isolated pontine infarction. The effect of this abnormal BA geometrical form on the outcomes of pontine infarction has not been closely examined. This study aims to elucidate whether BA dolichosis contributes to a poor 90-day outcome in acute isolated pontine infarction. A total of 101 patients were enrolled with a median age of 65 years. the BA diameter (p = 0.026), basilar artery length (BAL) (p < 0.001), bending length (BL) (p < 0.001) and the proportion of BA bending (p < 0.001) were significantly higher in the BA dolichosis group. A poor outcome was closely associated with the baseline National Institute of Health Stroke Scale (NIHSS) score (p < 0.001), and BL (p = 0.042) as well as the proportions of BA dolichosis (p = 0.007) and BA bending (p = 0.010) in univariate analysis. Multivariate logistic regression analysis determined that BA dolichosis (adjusted oR = 4.724, 95% CI: 1.481~15.071, p = 0.009) and baseline NIHSS score (adjusted oR = 1.805, 95% CI: 1.296~2.513, p < 0.001) were independently associated with a poor outcome at 90 days. In conclusion, BA dolichosis may be a predictor of concern for a poor 90-day outcome in patients with acute isolated pontine infarction. ResultsClinical and demographic data of the study. In total, 131 patients with acute isolated pontine infarction were admitted during the study period between July 2015 and June 2018. Among these patients, 30 were excluded according to the exclusion criteria. There was no loss of follow-up or death during the 90-day follow-up. Therefore, 101 patients were finally enrolled in the present study (Fig. 1). All patients were Chinese Hans. Among the 101 patients, 60 (59.4%) were male and 41 (40.6%) were female with an age of 65 (20) (years, median (M) and interquartile range (IQR)). The infarct sites of 80 (79.2%) were located in the paramedian pontine area, 4 (4.0%) were in the anterior lateral pontine area, 9 (8.9%) were in the lateral pontine area and 8 (7.9%) were in multiple infarct areas. Patients with simple BA dolichosis accounted for 32.7% (33 cases), but no patients had simple BA ectasia. BADE patients accounted for only 1.0% (1 case). Of the 101 patients, 34 (33.7%) patients were divided into the BA dolichosis group, and the other 67 (66.3%) patients were divided into the non-BA dolichosis group. There were 81 (80.2%) patients with good outcomes versus 20 (19.8%) patients with a poor outcome at 90 days. The characteristics of the study population divided by group are summarized in Fig. 2 and Supplementary Table 1.
Objectives: This study aimed to evaluate the bioequivalence, safety, tolerability and immunogenicity of the biosimilar trastuzumab (SIBP-01) compared to Herceptin®. Methods: In this Phase I randomized double-blind parallel-group trial, 100 healthy male volunteers were randomized in a1:1 ratio to receive a single 6 mg•kg-1 intravenous dose of SIBP-01 or Herceptin®. Serum concentrationswere analyzed using a validated ELISA. Results: The two groups had similar baseline characteristics. The geometric mean ratios (90% CI) of C max , AUC 0-t and AUC inf between the trial group and the reference group were 93.55%-104.27%, 91.98%-102.35% and 91.88%-102.34%, respectively; the geometric mean ratios (90% CI) of AUC 0-t and AUC inf in the sensitivity analysis were 92.29%-102.63% and 91.81%-102.16%, respectively. These values were within the prespecified equivalence margins, establishing the bioequivalence of SIBP-1 and Herceptin®. AEs were similar across all subjects in the SIBP-01 and Herceptin® arms, with treatmentrelated AEs reported by 72.00% and 80.00%, respectively. In each group, there was one AE that caused a subject to discontinue the study. Expert opinion: Trastuzumab (Herceptin®) is significantly more effective than chemotherapy in reducing exacerbations and tumor cell growth, and its adverse events are far lower than chemotherapy. Herceptin®is very expensive for most patients in China. The protein molecular primary structure of the biosimilar trastuzumab (SIBP-01) is consistent with Herceptin®, with highly similar high level structure, biologocal activity and purity.But there are few studies comparing the bioequivalence of SIBP-01 and Herceptin® in healthy subjects and cancer patients. Conclusions: This study showed the PK similarity of SIBP-01 to Herceptin®. SIBP-01 was safe and well tolerated in healthy male volunteers, with no significant differences from the reference drug in safety or immunogenicity.
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