To the Editor:Following H7N9infection,the host lymphocyte immunity plays an antiviral role.[l] Furthermore,low frequencies of T-cells correlate with disease severity.[2]Herein,we present a H7N9-infected patient with l...To the Editor:Following H7N9infection,the host lymphocyte immunity plays an antiviral role.[l] Furthermore,low frequencies of T-cells correlate with disease severity.[2]Herein,we present a H7N9-infected patient with life-threatening lymphopenia (only 0.06× 10^9/L in the peripheral blood),which we have barely ever seen before.We also measured the proportidns of T-cell subpopulations in the blood and bronchoalveolar lavage fluid (BALF).展开更多
BACKGROUND: Exertional heatstroke(EHS) is a life-threatening disease without ideal prognostic markers for predicting hospital mortality.METHODS: This is a single-center retrospective study. Clinical data from EHS pati...BACKGROUND: Exertional heatstroke(EHS) is a life-threatening disease without ideal prognostic markers for predicting hospital mortality.METHODS: This is a single-center retrospective study. Clinical data from EHS patients admitted to the Intensive Care Unit(ICU) of the General Hospital of Southern Theatre Command between January 1, 2008, and December 31, 2020, were recorded and analyzed. Univariate and multivariate logistic regression were used to identify the factors for mortality. The prediction model was developed with the prognostic markers, and a nomogram was established.RESULTS: The study ultimately enrolled 156 patients, and 15(9.6%) of patients died before discharge. The lymphocyte count(Lym) and percentage(Lym%) were significantly lower in nonsurvivors(P<0.05). The univariate and multivariate logistic regression analyses indicated that Lym% at the third day of admission(Lym% D3)(OR=0.609, 95%CI: 0.454–0.816) and hematocrit(HCT)(OR=0.908, 95%CI: 0.834–0.988) were independent protective factors for hospital mortality. A nomogram incorporating Lym% D3 with HCT was developed and demonstrated good discrimination and calibration ability. The comparison between the prediction model and scoring systems revealed that the prediction model had the largest area under the curve(AUC)(0.948, 95%CI: 0.900–0.977), with 100.00% sensitivity and 83.69% specificity, and a greater clinical net benefit.CONCLUSION: Severe EHS patients had a higher risk of experiencing prolonged lymphopenia. A nomogram based on Lym% D3 and HCT was developed to facilitate early identification and timely treatment of patients with potentially unfavorable prognoses.展开更多
Objectives:To determine the correlation between lymphocyte count and A-DROP score in COVID-19 patients and their role in predicting poor outcomes.Methods:This retrospective observational single-center study was conduc...Objectives:To determine the correlation between lymphocyte count and A-DROP score in COVID-19 patients and their role in predicting poor outcomes.Methods:This retrospective observational single-center study was conducted in a tertiary care hospital in Vidisha district,India.COVID-19 patients were included in this study,who were admitted to ICU and the COVID Care Centre from August 2020 to October 2020.Demographic profile,clinical characteristics,medical history,A-DROP score,complete blood counts including lymphocyte counts(on admission),the severity of the disease course,and duration of hospitalization were collected.The correlation between lymphopenia and A-DROP score was determined,and their role in predicting poor outcomes was investigated.Results:This study included 220 patients,among which 134 were male,and 86 were female[mean age(48.98±16.98)years,95%CI:46.72-51.23].Lymphocyte count in COVID-19 patients negatively correlated with the A-DROP score(r=-0.67,P<0.001).The area under the ROC curve was 0.892(95%CI:0.80-0.98,P<0.001)for the lymphocyte count,and the area under the ROC curve was 0.93(95%CI:0.84-1.00,P<0.001)for lymphocyte count-A-DROP.Conclusion:Lymphocyte count along with the A-DROP score on admission could be used to predict the severity of COVID-19 pneumonia and unfavorable outcome.展开更多
HIV/AIDS patients were treated, daily, with MSAMS (50 mg/kg), MSAMS-stabilized Ampicillin trihydrate (7.5 mg/kg) and immunace extra-protectionM<sup>?</sup> (1 tablet), for one month and then, with only MSA...HIV/AIDS patients were treated, daily, with MSAMS (50 mg/kg), MSAMS-stabilized Ampicillin trihydrate (7.5 mg/kg) and immunace extra-protectionM<sup>?</sup> (1 tablet), for one month and then, with only MSAMS and the immune stimulants. They were tested, monthly, for viral loads and CD4- lymphocytes counts. Those whose viral loads became undetectable were tested for HIV confirmation (antigens/antibody). Their mean-viral load increased (P = 0.020) from 1820.30 ± 868.75 to 2855.90 ± 960.98 after first month, before reducing (P = 0.0.030) to: 1565.20 ± 743.17;759.20 ± 473.65;345.50 ± 115.01;192.80 ± 97.40;95.00 ± 55.80;37.40 ± 26.46;17.50 ± 16.88 (undetectable). Their mean-CD4 count was 496.80 ± 194.39 (lymphopenia). It reduced (P = 0.008) to 263.90 ± 149.26 after first month, before increasing (P = 0.001) to: 507.90 ± 133.19;692.70 ± 113.34;840.20 ± 139.41;1007.30 ± 163.50;1537.10 ± 302.10;1924.60 ± 247.45;2707.00 ± 837.87 (lymphocytosis). Patients whose viral loads became undetectable tested HIV-negative, one month after. CD4-lymphocytes count, approximating to zero-viral load, calculated from equation (Y = 2297.80 - 1.4731X) of line of best fit of graph of their viral loads onCD4-lymphocytes counts, was 1559.84/ml.展开更多
基金the grants from the National Natural Science Foundation of China (Nos.1470270and 81401629) the National Key Research and Development Program ofChina (No.2016YFC1304300)the Capital Clinical Features Applied Research and Achievement Promotion Project of Beijing, China (No.Z 161100000516116).
文摘To the Editor:Following H7N9infection,the host lymphocyte immunity plays an antiviral role.[l] Furthermore,low frequencies of T-cells correlate with disease severity.[2]Herein,we present a H7N9-infected patient with life-threatening lymphopenia (only 0.06× 10^9/L in the peripheral blood),which we have barely ever seen before.We also measured the proportidns of T-cell subpopulations in the blood and bronchoalveolar lavage fluid (BALF).
基金supported by the Natural Science Foundation of Guangdong Province (2022A1515010353)Science and Technology Projects of Guangzhou (SL2024A03J00951)Military Medical Innovation Project (18CXZ032)。
文摘BACKGROUND: Exertional heatstroke(EHS) is a life-threatening disease without ideal prognostic markers for predicting hospital mortality.METHODS: This is a single-center retrospective study. Clinical data from EHS patients admitted to the Intensive Care Unit(ICU) of the General Hospital of Southern Theatre Command between January 1, 2008, and December 31, 2020, were recorded and analyzed. Univariate and multivariate logistic regression were used to identify the factors for mortality. The prediction model was developed with the prognostic markers, and a nomogram was established.RESULTS: The study ultimately enrolled 156 patients, and 15(9.6%) of patients died before discharge. The lymphocyte count(Lym) and percentage(Lym%) were significantly lower in nonsurvivors(P<0.05). The univariate and multivariate logistic regression analyses indicated that Lym% at the third day of admission(Lym% D3)(OR=0.609, 95%CI: 0.454–0.816) and hematocrit(HCT)(OR=0.908, 95%CI: 0.834–0.988) were independent protective factors for hospital mortality. A nomogram incorporating Lym% D3 with HCT was developed and demonstrated good discrimination and calibration ability. The comparison between the prediction model and scoring systems revealed that the prediction model had the largest area under the curve(AUC)(0.948, 95%CI: 0.900–0.977), with 100.00% sensitivity and 83.69% specificity, and a greater clinical net benefit.CONCLUSION: Severe EHS patients had a higher risk of experiencing prolonged lymphopenia. A nomogram based on Lym% D3 and HCT was developed to facilitate early identification and timely treatment of patients with potentially unfavorable prognoses.
文摘Objectives:To determine the correlation between lymphocyte count and A-DROP score in COVID-19 patients and their role in predicting poor outcomes.Methods:This retrospective observational single-center study was conducted in a tertiary care hospital in Vidisha district,India.COVID-19 patients were included in this study,who were admitted to ICU and the COVID Care Centre from August 2020 to October 2020.Demographic profile,clinical characteristics,medical history,A-DROP score,complete blood counts including lymphocyte counts(on admission),the severity of the disease course,and duration of hospitalization were collected.The correlation between lymphopenia and A-DROP score was determined,and their role in predicting poor outcomes was investigated.Results:This study included 220 patients,among which 134 were male,and 86 were female[mean age(48.98±16.98)years,95%CI:46.72-51.23].Lymphocyte count in COVID-19 patients negatively correlated with the A-DROP score(r=-0.67,P<0.001).The area under the ROC curve was 0.892(95%CI:0.80-0.98,P<0.001)for the lymphocyte count,and the area under the ROC curve was 0.93(95%CI:0.84-1.00,P<0.001)for lymphocyte count-A-DROP.Conclusion:Lymphocyte count along with the A-DROP score on admission could be used to predict the severity of COVID-19 pneumonia and unfavorable outcome.
文摘HIV/AIDS patients were treated, daily, with MSAMS (50 mg/kg), MSAMS-stabilized Ampicillin trihydrate (7.5 mg/kg) and immunace extra-protectionM<sup>?</sup> (1 tablet), for one month and then, with only MSAMS and the immune stimulants. They were tested, monthly, for viral loads and CD4- lymphocytes counts. Those whose viral loads became undetectable were tested for HIV confirmation (antigens/antibody). Their mean-viral load increased (P = 0.020) from 1820.30 ± 868.75 to 2855.90 ± 960.98 after first month, before reducing (P = 0.0.030) to: 1565.20 ± 743.17;759.20 ± 473.65;345.50 ± 115.01;192.80 ± 97.40;95.00 ± 55.80;37.40 ± 26.46;17.50 ± 16.88 (undetectable). Their mean-CD4 count was 496.80 ± 194.39 (lymphopenia). It reduced (P = 0.008) to 263.90 ± 149.26 after first month, before increasing (P = 0.001) to: 507.90 ± 133.19;692.70 ± 113.34;840.20 ± 139.41;1007.30 ± 163.50;1537.10 ± 302.10;1924.60 ± 247.45;2707.00 ± 837.87 (lymphocytosis). Patients whose viral loads became undetectable tested HIV-negative, one month after. CD4-lymphocytes count, approximating to zero-viral load, calculated from equation (Y = 2297.80 - 1.4731X) of line of best fit of graph of their viral loads onCD4-lymphocytes counts, was 1559.84/ml.