Coronavirus disease(COVID-19)was first diagnosed in Wuhan in December 2019.The World Health Organization defined the subsequent outbreak of COVID-19 worldwide as a public health emergency of international concern.Epid...Coronavirus disease(COVID-19)was first diagnosed in Wuhan in December 2019.The World Health Organization defined the subsequent outbreak of COVID-19 worldwide as a public health emergency of international concern.Epidemiological data indicate that at least 20%of COVID-19 patients have severe disease.In addition to impairment of the respiratory system,acute kidney injury(AKI)is a major complication.Immune damage mediated by cytokine storms and concomitant AKI is a key factor for poor prognosis.Based on previous experience of blood purification for patients with severe acute respiratory syndrome and Middle East respiratory syndrome combined with clinical front-line practice,we developed a blood purification protocol for patients with severe COVID-19.This protocol is divided into four major steps.The first step is to assess whether patients with severe COVID-19 require blood purification.The second step is to prescribe a blood purification treatment for patients with COVID-19.The third step is to monitor and adjust parameters of blood purification.The fourth step is to evaluate the timing of discontinuation of blood purification.It is expected that blood purification will play a key role in effectively reducing the mortality of patients with severe COVID-19 through the standardized implemenlation of the present protocol.展开更多
Background: Urine output (UO) is an essential criterion of the Kidney Disease Improving Global Outcomes (KD1GO) definition and classification system tbr acute kidney injury (AKI), of which the diagnostic value ...Background: Urine output (UO) is an essential criterion of the Kidney Disease Improving Global Outcomes (KD1GO) definition and classification system tbr acute kidney injury (AKI), of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO UO criteria (KDtGOLro) could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria (KDIGOscr).Methods: We conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group (CCCCTG), which was a 2-month prospective cohort study (July 1,2009 to August 31,2009) involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China. AKI was diagnosed and classified separately based on KDIGOt,o and KDlGOsc,. Hospital mortality of patients with more severe AKI classification based on KDIGOvo was compared with other patients by univariate and multivariate regression analyses. Results: The prevalence of AKl increased from 52.4% based on KDIGOscr to 55.4% based on KD1GOsc~ combined with KDIGOuo. KDIGOv~~ also restllted in an upgrade of AKI classification in 7.3% of patients, representing those with more severe AK1 classification based on KDIGOvo. Compared with non-AKI patients or those with maximum AKI classification by KDIGOscr, those with maximum AKI classification by KDIGOuo had a significantly higher hospital mortality of 58.4% (odds ratio [OR]: 7.580, 95% confidence interval [CI]: 4.141-13.873, P 〈 0.001). In a multivariate logistic regression analysis, AKI based on KDIGOuo (OR: 2.891, 95% CI: 1.964-4.254, P 〈 0.001), but not based on KDIGOscr (OR: 1.322, 95% CI: 0.902-1.939, P = 0.152), was an independent risk factor for hospital mortality. Conclusion: UO was a criterion with additional value beyond creatinine criterion for AKI diagnosis and classification, which can help identify a group of patients with high risk of death.展开更多
To the Editor: Bacterial vaginosis (BV) is the most prevalent form ofvaginitis among women of reproductive age, affecting 8-23% of women globally. Clinically, BV is typically diagnosed using Amsel's criteria and t...To the Editor: Bacterial vaginosis (BV) is the most prevalent form ofvaginitis among women of reproductive age, affecting 8-23% of women globally. Clinically, BV is typically diagnosed using Amsel's criteria and the Nugent scoring system. However, these methods are inaccurate in many cases. In this study, we explored the feasibility of using length-heterogeneity-polymerase chain reaction (LH-PCR) for diagnosis of BV.展开更多
The coronavirus disease 2019(COVID-19)has been declared a global pandemic and is a major public health issue worldwide.COVID-19 is a systemic disease damaging multiple organs,including the lung as the main target organ.
The coronavirus disease 2019(COVID-19)has caused a global outbreak and became a major public health issue globally.It has been found that COVID-19 patients are commonly complicated with coagulation abnormities,which a...The coronavirus disease 2019(COVID-19)has caused a global outbreak and became a major public health issue globally.It has been found that COVID-19 patients are commonly complicated with coagulation abnormities,which are closely associated with the severity and prognosis of patients.A thorough understanding of the prevalence of coagulopathy and potential causes of abnormities of coagulation parameters in COVID-19 patients is crucial for clinicians to standardize the diagnosis and management of COVID-19 associated coagulopathy.展开更多
基金Zhejiang Provincial Science and Tech no logy Department 2019 Provincial Key R&D Program Project(2019C03024).
文摘Coronavirus disease(COVID-19)was first diagnosed in Wuhan in December 2019.The World Health Organization defined the subsequent outbreak of COVID-19 worldwide as a public health emergency of international concern.Epidemiological data indicate that at least 20%of COVID-19 patients have severe disease.In addition to impairment of the respiratory system,acute kidney injury(AKI)is a major complication.Immune damage mediated by cytokine storms and concomitant AKI is a key factor for poor prognosis.Based on previous experience of blood purification for patients with severe acute respiratory syndrome and Middle East respiratory syndrome combined with clinical front-line practice,we developed a blood purification protocol for patients with severe COVID-19.This protocol is divided into four major steps.The first step is to assess whether patients with severe COVID-19 require blood purification.The second step is to prescribe a blood purification treatment for patients with COVID-19.The third step is to monitor and adjust parameters of blood purification.The fourth step is to evaluate the timing of discontinuation of blood purification.It is expected that blood purification will play a key role in effectively reducing the mortality of patients with severe COVID-19 through the standardized implemenlation of the present protocol.
文摘Background: Urine output (UO) is an essential criterion of the Kidney Disease Improving Global Outcomes (KD1GO) definition and classification system tbr acute kidney injury (AKI), of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO UO criteria (KDtGOLro) could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria (KDIGOscr).Methods: We conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group (CCCCTG), which was a 2-month prospective cohort study (July 1,2009 to August 31,2009) involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China. AKI was diagnosed and classified separately based on KDIGOt,o and KDlGOsc,. Hospital mortality of patients with more severe AKI classification based on KDIGOvo was compared with other patients by univariate and multivariate regression analyses. Results: The prevalence of AKl increased from 52.4% based on KDIGOscr to 55.4% based on KD1GOsc~ combined with KDIGOuo. KDIGOv~~ also restllted in an upgrade of AKI classification in 7.3% of patients, representing those with more severe AK1 classification based on KDIGOvo. Compared with non-AKI patients or those with maximum AKI classification by KDIGOscr, those with maximum AKI classification by KDIGOuo had a significantly higher hospital mortality of 58.4% (odds ratio [OR]: 7.580, 95% confidence interval [CI]: 4.141-13.873, P 〈 0.001). In a multivariate logistic regression analysis, AKI based on KDIGOuo (OR: 2.891, 95% CI: 1.964-4.254, P 〈 0.001), but not based on KDIGOscr (OR: 1.322, 95% CI: 0.902-1.939, P = 0.152), was an independent risk factor for hospital mortality. Conclusion: UO was a criterion with additional value beyond creatinine criterion for AKI diagnosis and classification, which can help identify a group of patients with high risk of death.
基金This work was supported by grants from the National Natural Science Foundation of China (No. 81200411) and the Specialized Research Fund for the Doctoral Program of Higher Education Project of the New Teacher (No. 20120001120037).
文摘To the Editor: Bacterial vaginosis (BV) is the most prevalent form ofvaginitis among women of reproductive age, affecting 8-23% of women globally. Clinically, BV is typically diagnosed using Amsel's criteria and the Nugent scoring system. However, these methods are inaccurate in many cases. In this study, we explored the feasibility of using length-heterogeneity-polymerase chain reaction (LH-PCR) for diagnosis of BV.
基金supported by a grant from the China Health Information and Health Care Big Data Society:Special Research Fund for Analgesia and Sedation of Severe Infection(No.Z-2019-1-001)。
文摘The coronavirus disease 2019(COVID-19)has been declared a global pandemic and is a major public health issue worldwide.COVID-19 is a systemic disease damaging multiple organs,including the lung as the main target organ.
文摘The coronavirus disease 2019(COVID-19)has caused a global outbreak and became a major public health issue globally.It has been found that COVID-19 patients are commonly complicated with coagulation abnormities,which are closely associated with the severity and prognosis of patients.A thorough understanding of the prevalence of coagulopathy and potential causes of abnormities of coagulation parameters in COVID-19 patients is crucial for clinicians to standardize the diagnosis and management of COVID-19 associated coagulopathy.