Contingency management strategies of the Nursing Department in centralized rescue of patients with coronavirus disease 2019

Objectives:This article aims to summarize a series of contingency management strategies of the Nursing Department in the centralized treatment of patients with coronavirus disease 2019(COVID-19).Methods:The strategies of the Nursing Department included an early warning for prevention and control,taking functions of vertically commanding and horizontally coordinating,and reasonably allocating nursing workforce,to facilitate centralized treatment work in the in-hospital fever clinic,isolation wards and ICU,and referral and admission of critical patients.Five special groups were established in charge of training and examination,management and supervision,psychological support,logistical support,and reporting and publicity,respectively.Results:It was achieved that no deaths from critical patients and no medical staff,no other patients were infected.Conclusion:Through the implementation of these strategies,safe and efficient centralized treatment was ensured timely,orderly and sustainably.

A study on the Appearance of HBV DNA in the Liver and Serum of Patients with HDV/HBV Infection

The appearance of HBV DNA in the liver and serum of 15 patients with hepatitisB conifected with HDV was observed and compared with that of 13 HDV-negative cases.Itwas found that HBsAg titer was lower than or equal to 1:4 in 8 HDV-positive patients,inwhom it was temporally negative in 5,and negative during the,two-day hospitalization in 1.No similar result could be observed in the HDV-negative cases.The detection rate of HBVDNA in both the HDV positive and negative groups was 20.0％ (3/15) and 25％ (3.12) in se-rum,and 46.7％ (7/15) and 61.5％ (8/13) in the liver rcspectively.There was no signif-icant statistical difference between the 2 groups.The HBV DNA grains detected with in situ hybridization,with biotinylated HBV DNAprobe were demonstrated in the sparse type of distribution in 3 cases and lightly stained in 2.Itis believed that HBV DNA replication activity might be suppressed by HDV.However activeHRV DNA replication was also present in some HDV-positive patients and HBV DNA was posi-tive in both the liver and serum in 3 such patients.It was concluded that the difference of the detection rate of HBV DNA in HDV-positivepatients might be related to the different stages of HDV infection.

The Relationship between the Plasmodium Falciparum Clearance and the Clinical Effect of the Case with Cerebral Malaria Treated with Artemisinin

Malaria is 1 mosquito-borne disease,which is most commonly caused by a parasite called Plasmodium falciparum(P.falciparum).Cerebral malaria is the most severe neurological complication presented in

Kaposi’s sarcoma manifested as lower gastrointestinal bleeding in a HIV/HBV-co-infected liver cirrhosis patient: A case report

BACKGROUND Kaposi’s sarcoma(KS)is one of the most common cancers in human immunodeficiency virus(HIV)-positive patients and leads to a high prevalence of morbidity and mortality.It usually appears as cutaneous or mucous lesions.Patients with visceral KS are asymptomatic and clinically silent.As the disease advances,patients may progress from a normal condition to exhibiting severe symptoms.CASE SUMMARY A 27-year-old man presented with a 2-mo history of fever,bearing-down pain,and rectal bleeding.His hepatitis B virus DNA level was 2.7×107 IU/mL.Abdominal computed tomography(CT)indicated liver cirrhosis.Before he was admitted to our hospital,he was diagnosed with HIV infection.His CD4 count was 24 cells/μL.Pelvic cavity CT suggested a thickened rectum wall accompanied by multiple enlarged lymph nodes.The patient was initially treated as having haemorrhoidal varices with bleeding,telbivudine for anti-hepatitis B virus treatment,and antibiotics for anti-infection.After half a month of treatment,the patient felt that his lower lumbus ache and bearing-down pain had not improved,and a colonoscopy was conducted.The result revealed a rectal mass that was histologically confirmed as KS with rectal spindle cells that were positive for cluster of differentiation 117(CD117),CD34,human herpes virus 8,and CD31.He was administered systemic chemotherapy with 36 mg/d liposomal doxorubicin six times.The patient experienced no sign of lower gastrointestinal bleeding again.CONCLUSION This case highlights the diagnosis of primary KS with lower gastrointestinal bleeding in HIV-positive patients,which means visceral KS could not be excluded.The gold standard relies on colonoscopy and biopsy findings.

Seroprevalence of influenza viruses in Shandong,Northern China during the COVID-19 pandemic

Nonpharmaceutical interventions(NPIs)have been commonly deployed to prevent and control the spread of the coronavirus disease 2019(COVID-19),resulting in a worldwide decline in influenza prevalence.However,the influenza risk in China warrants cautious assessment.We conducted a cross-sectional,seroepidemiological study in Shandong Province,Northern China in mid-2021.Hemagglutination inhibition was performed to test antibodies against four influenza vaccine strains.A combination of descriptive and meta-analyses was adopted to compare the seroprevalence of influenza antibodies before and during the COVID-19 pandemic.The overall seroprevalence values against A/H1N1pdm09,A/H3N2,B/Victoria,and B/Yamagata were 17.8%(95%CI 16.2%–19.5%),23.5%(95%CI 21.7%–25.4%),7.6%(95%CI 6.6%–8.7%),and 15.0(95%CI 13.5%–16.5%),respectively,in the study period.The overall vaccination rate was extremely low(2.6%).Our results revealed that antibody titers in vaccinated participants were significantly higher than those in unvaccinated individuals(P<0.001).Notably,the meta-analysis showed that antibodies against A/H1N1pdm09 and A/H3N2 were significantly low in adults after the COVID-19 pandemic(P<0.01).Increasing vaccination rates and maintaining NPIs are recommended to prevent an elevated influenza risk in China.

HFRS with Severe Heart Liver and Renal Failure:a Case Report

Hemorrhagic fever with renal syndrome(HFRS) is caused by hantavirus infection,which was characterized by abrupt high fever,systemic hemorrhage,hypotension and renal damage.Although multiple system organ damage was not uncommon,but multiple organ system failure were rare.Hereafter we report one case with simultaneous renal,heart and liver failure.In this case,we received some experience and lessons.

HBsAg Loss Due to Tenofovir Treatment for HBV Reactivation Following DAAs Therapy in One Patient with HBV-HCV Coinfection

Hepatitis B virus(HBV)reactivation induced by administration of direct-acting antiviral agents(DAAs)to treat hepatitis C virus(HCV)infection has been reported in previous studies,the subsequent clinical outcomes varied from no symptom to liver failure or death,however,the timing of anti-HBV treatment is controversial.We report the clinical HBV reactivation in a 51 years old female fibrotic patient with chronic HBV-HCV infection during the paritaprevir/ritonavir/ombitasvir and dasabuvir(PrOD)therapy.Her baseline HCV RNA,HBV DNA,alanine aminotransferase(ALT),and liver stiffness measurement levels were 5,560,000IU/mL,<15IU/mL,48U/L,and 11.8 kPa,respectively.At 8weeks of PrOD treatment,her HCV RNA,HBV DNA,and ALT levels were<15IU/mL,2,880,000 IU/mL,and 837U/L,respectively,and clinical reactivation was diagnosed.Meanwhile,tenofovir was immediately used for anti-HBV treatment.Fortunately,HBV DNA and ALT were undetectable and normalized after 16weeks of anti-HBV therapy,and unexpectedly,hepatitis B surface antigen loss occurred at 80weeks of anti-HBV treatment.This study may extend our understanding of the timing of anti-HBV therapy to prevent potential HBV reactivation during DAAs treatment in HBVHCV coinfected patients,and proper initiation timing may lead to functional cure of chronic HBV infection.

Clinical observation of serum IL-18,IL-10 and sIL-2R levels in patients with chronic hepatitis Cpre-and post antiviral treatment

To discuss the roles of serum interleukin-18 (IL-18), interleukin-10 (IL-10) and soluble interleukin-2R (sIL-2R) in the pathogenesis of chronic hepatitis C and to observe the effects of interferon (IFN) on the above- mentioned serum cytokines Methods The levels of above- mentioned cytokines were detected in 10 healthy individuals, 24 asymptomatic hepatitis virus C (HCV) carriers and 27 patients with chronic hepatitis C ( before and after IFN treatment) using enzyme linked immunosorbent assay (ELISA) Results The levels of the cytokines in patients with chronic hepatitis C are higher than in healthy people (P<0 05) and in asymptomatic HCV carriers(P<0 05) The values of the cytokines show a significant positive correlation to ALT (P<0 05) Levels of tested cytokines decreased observably after IFN treatment (P<0 05) The grades of the serum levels for sIL-2R and IL-10 before IFN treatment (from high to low) were categorized accordingly: non-response group> partial- response group >complete- response group (P<0 05) Conclusions The tested cytokines co-participate in the pathogenesis of chronic hepatitis C, and can be used to evaluate the effect of IFN on the immune state of organisms Furthermore, sIL-2R and IL-10 are important for predicting the anti-viral efficacy of IFN

MuSK Myasthenia Gravis in an HIV-infected Chinese old man successfully treated with pyridostigmine

Introduction Different autoimmune conditions have been described in human immunodeficiency virus(HIV)patients on antiretroviral therapy(ART),but muscle-specific kinase(MuSK)myasthenia gravis(MG)coexisting with HIV is rare.We report a case of a Chinese patient with an asymptomatic HIV infection who presented with newly-onset MuSK MG and was managed successfully with the acetylcholinesterase inhibitor pyridostigmine.

Clinical efficacy of low-dose emetine for patients with COVID-19:a real-world study

Objective:Emetine,an isoquinoline alkaloid that is enriched at high concentrations in the lung,has shown potent in vitro activity against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).The aim of this study was to better understand the effectiveness of low-dose emetine for patients with coronavirus disease 2019(COVID-19).Methods:In this real-world study,63 patients with mild or common COVID-19 were recruited from Wuhan Fangcang Shelter Hospital and five COVID-19-designated hospitals in Anhui Province,China from February to March 2020.Thirty-nine patients from Wuhan Fangcang Shelter Hospital were assigned to a pragmatic randomized controlled clinical trial,and 24 patients from the 5 COVID-19-designated hospitals in Anhui Province underwent a real-world study.The medication course of emetine was less than 10 days.The main symptoms and adverse reactions of all patients were observed and recorded.The primary outcome measure was the time required for a negative SARS-CoV-2 RNA result or the negative result rate on day 10.Secondary outcomes included axillary temperature,transcutaneous oxygen saturation,and respiratory frequency recovery.The study was approved by the Ethics Committee of The First Affiliated Hospital of Anhui Medical University on February 20,2019(approval No.PJ2020-03-19)and was registered with the Chinese Clinical Trial Registry on February 20,2019(registration number:ChiCTR2000030022).Results:The oxygen saturation values were higher in the treatment group than in the control group on the first day after enrollment for patients treated at Fangcang Shelter Hospital.The axillary body temperature,respiratory rate,and oxygen saturation among patients in Fangcang Shelter Hospital were related to the time effect but not to the intervention measures.The respiratory rate and oxygen saturation of patients in the Anhui designated hospitals were related to the intervention measures but not to the time effect.The axillary body temperature of patients in Anhui designated hospitals was related to the time effect but not to the intervention measures.Conclusion:Our preliminary study shows that low-dose emetine combined with basic conventional antiviral drugs improves clinical symptoms in patients with mild and common COVID-19 without apparent adverse effects,suggesting that moderately increased doses of emetine may have good potential for treatment and prevention of COVID-19.

Allicin and Glycyrrhizic Acid Display Antiviral Activity Against Latent and Lytic Kaposi Sarcoma-associated Herpesvirus

Kaposi sarcoma-associated herpesvirus(KSHV)triggers the development of Kaposi sarcoma,a skin malignancy that is one of the most widespread defining symptoms in acquired immunodeficiency syndrome patients.KSHV manifests in two distinct cycles,a chronic latent cycle and an acute lytic cycle.Current clinical anti-herpesvirus therapeutic agents are predominantly composed of nucleoside analogues that target viral replication in the lytic cycle only,while KSHV latent genes are at the basis tumorigenesis.Currently,there are no effective therapies targeting latent KSHV infections.Therefore,the aim of this study was to identify putative therapeutic compounds with inhibitory activity against latent KSHV.The KSHV-infected primary effusion lymphoma cell line BC-3 was used to study antiviral activity of glycyrrhizic acid(GA),Allicin,and epigallocatechin-3-gallate(EGCG)against latent and lytic KSHV.Activity of GA,Allicin,EGCG,and the established anti-lytic cycle control compound ganciclovir was quantified by real-time polymerase chain reaction of nuclear and virion KSHV DNA yields after treatment compared with the untreated control.GA and Allicin showed antiviral activity against both latent and lytic KSHV,while EGCG displayed activity against lytic KSHV only.Therefore,GA and Allicin are interesting compounds for further development of anti-KSHV therapy against latent cycle infections.

A linear relationship between De Ritis ratio and mortality in hospitalized patients with COVID-19:A secondary analysis based on a large retrospective cohort study

Background and aims:Although some studies have identified a possible link between the De Ritis ratio and the mortality of patients with COVID-19),the predictive value and the optimal cut-value remain unclear.This study aimed to explore the correlation between the De Ritis ratio and mortality in hospitalized COVID-19.Methods:The data for this cohort study came from a retrospective cohort study that was carried out in a medical system in New York City.The primary outcome was the in-hospital mortality of included patients.The researchers ran multivariate Cox regression analyses,curve fitting,and subgroup analysis to support our findings.Overall survival in different De Ritis ratio groups was plotted as Kaplan-Meier survival curves.Results:The study enrolled 4371 participants with COVID-19 from March 1,2020 to April 16,2020.The overall mortality was 24.8%(1082/4371).The curve fitting analyses indicated that the De Ritis ratio has a positive linear connection with mortality in patients with COVID-19.After adjusting for all covariates,participants with a De Ritis ratio≥2 exhibited 1.29 times the risk of in-hospital mortality compared with those with a De Ritis ratio<1(hazard ratio 1.29,95%confidence interval 1.02-1.62,p=0.031).The p for trend was<0.05 for all models.Patients in the group with a De Ritis ratio≥2 experienced the shortest survival time in the Kaplan-Meier survival analysis.Conclusions:A higher baseline De Ritis ratio is correlated with a corresponding higher mortality among hospitalized people with COVID-19.