武汉大学学报(医学版)最新文献

{"title":"Clinical characteristics and outcomes of COVID-19 patients with chronic underlying diseases","authors":"T. Suo, Yanni Wang, Kaochang Zhao, Guo-zhong Chen","doi":"10.14188/J.1671-8852.2020.0233","DOIUrl":"https://doi.org/10.14188/J.1671-8852.2020.0233","url":null,"abstract":"","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46137969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research status of mesenchymal stem cell therapy for COVID-19","authors":"M. Wang, D. Yang, H. Cai","doi":"10.14188/j.1671-8852.2020.0367","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0367","url":null,"abstract":"The COVID-19 pandemic caused by SARS-CoV-2 is rapidly and continuously spreading globally, posing a great threat to human life and health. It is urgent to find a safe and effective treatment. Studies have found that mesenchymal stem cells (MSCs) have powerful immunoregulatory and anti-inflammatory functions. They can mitigate and repair lung injury caused by the excessive immune response to the virus and reduce the risk of cytokine storm syndrome (CSS) and acute respiratory distress syndrome (ARDS), by regulating the function of immune cells, reducing the secretion of inflammatory factors, upregulating the anti-inflammatory factors and secreting a variety of cell growth factors. In addition, MSCs are also characterized by abundant sources, easy access, low immunogenicity, no ethical controversy, the ability to target chemotaxis in damaged tissues, and virus resistance. Therefore, it is considered an effective way to treat COVID-19. In this article, we evaluated the safety and efficacy of MSCs in the treatment of COVID-19 and its possible mechanism. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"42 1","pages":"584-588"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66656743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary of perioperative hemodynamic management of 19 lung transplant recipients","authors":"X. Zuo, Z. Zhong, W. Gao, G. Li, Q. Zhou, L. Zhan","doi":"10.14188/j.1671-8852.2021.6006","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2021.6006","url":null,"abstract":"Objective: To summarize and discuss the experience of perioperative hemodynamic management of lung transplant recipients. Methods: A total of 19 lung transplant recipients from December 2016 to December 2020 were investigated in Renmin Hospital of Wuhan University, all of which were transferred to the intensive care unit for further monitoring and treatment, and their clinical data were retrospectively analyzed. Results: The 19 lung transplant recipients included 5 cases of chronic obstructive pulmonary disease (COPD), 5 cases of idiopathic pulmonary fibrosis (IPF), 4 cases of pneumoconiosis, 2 cases of bronchiectasis, 1 case of later lung fibrosis associated with COVID-19, 1 case of connective tissue disease-related pulmonary fibrosis, and 1 case of Kartagener syndrome. Twelve cases adopted double lung transplantation, while seven cases reveived unilateral lung transplantation (4 cases of left single lung transplantation and 3 cases of right single lung transplantation). There were 6 deaths during the perioperative period. One case died of multi-drug resistant bacteria infection, one case died of circulatory failure caused by active thoracic hemorrhage post-operation, the third case died of intraoperative cardiac arrest, and the other 3 cases were given up because of multiple organs failure. The remaining 13 cases were cured and discharged. Of the 19 recipients, 14 received vasopressors. The total and daily fluid output of the recipients in 3 postoperation days were greater than the input volume (P<0.05). Conclusion: Lung transplantation is an effective method for the treatment of end-stage lung disease. The hemodynamic management is a keypoint during perioperative period. It is import to maintain the blood volume as low as possible under the premise of systemic perfusion, limit the amount of fluid, choose albumin or plasma to increase the colloidal osmotic pressure, and strengthen the maintenance of right heart function. These abobe measures may improve the prognosis of lung transplant recipients. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"42 1","pages":"534-538"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66656904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of prognostic indicators for COVID⁃19 patients with diabetes","authors":"R. Shang, H. Liu, J. Ni","doi":"10.14188/j.1671-8852.2020.0497","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0497","url":null,"abstract":"Objective: To retrospectively explore the prognostic indicators of COVID‑19 patients with diabetes. Methods: The clinical data of COVID‑19 patients with diabetes admitted to Huoshenshan Hospital in Wuhan from February 2020 to April 2020 was collected. Patients were divided into survival group and death group according to their outcomes. The differences of various indexes between the two groups were compared and the prognostic factors were screened by multivariate logistic regression analysis. The receiver operation characteristic (ROC) curve was used to evaluate the prognostic value of these factors. Results: Of the 80 patients, 49 were males and 31 were females, with an average age of 65.2 years. There were 61 cases discharged after treatment and 19 cases died. Age, leukocyte count, lymphocyte count, platelet count, C‑reactive protein (CRP), D‑dimer, lactate dehydrogenase(LDH), urea nitrogen, serum albumin, and serum sodium were significantly different between the survival group and the death group ( P <0.05). Multivariate logistic regression analysis showed that CRP ( OR =1.030, 95% CI =1.011‑1.048, P =0.002) and LDH ( OR =1.015, 95% CI =1.006‑1.025, P =0.002) correlated significantly with the mortality risk of the patients. The ROC curve analysis showed that the area under curve ( AUC ) of CRP was 0.884, when the optimal cut‑off value in predicting death events was 40.335 mg/L, the sensitivity, specificity, and accuracy was 78.9%, 82.0%, and 81.3%, respectively. The AUC of lactate dehydrogenase was 0.930, when the optimal cut‑off value in predicting death events was 273.450 U/L, the sensitivity, specificity, and accuracy was 94.7%, 86.9%, and 88.8%, respectively. Conclusion: Both CRP and LDH at admission has obvious correlation with the prognosis of COVID‑19 patients with diabetes and could be used to predict their prognosis. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"42 1","pages":"694-697"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66656883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of patients with COVID-19 combined with cardiovascular disease","authors":"Yi Zhang, A. Zhang, H. Ming, Z. Qiu, Yifan Jia, S. Lei, Z. Xia","doi":"10.14188/j.1671-8852.2020.0328","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0328","url":null,"abstract":"Objective: To retrospectively analyze the clinical characteristics of coronavirus disease 2019 (COVID-19) and the impact of cardiovascular disease (CVD) on the clinical manifestations of COVID-19. Methods: A total of 128 patients diagnosed with COVID-19 in Renmin Hospital of Wuhan University from February 1 to February 29, 2020 were divided into CVD group (n=62) and non-CVD group (n=66). The general data, admission symptoms and laboratory examination results including blood routine, immunity, heart, liver and kidney function were obtained and statistically analyzed by SPSS 22.0 statistical software. The differences of various indexes between CVD group and non-CVD group were compared. Results: There was no significant difference in gender between CVD group and non-CVD group(P>0.05).The average age of CVD group was higher than that of non-CVD group (P 0.05). The average levels of eukocyte count, neutrophil ratio, neutrophil count, monocyte count, and C-reactive protein in CVD group were higher than those in non-CVD group (all P 0.05). The average LDH, myohemoglobin, CK-MB, NT-proBNP, TBIL, and Urea in CVD group were higher than those in non-CVD group (all P 0.05). Conclusion: Compared with non-CVD patients with COVID-19, CVD patients with COVID-19 are older, have more obvious symptoms, with a higher risksin heart, liver, and kidney injury, but the mechanism is not clear yet. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"42 1","pages":"599-602"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66657148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial chest CT imaging features of COVID-19 and their relation to clinical types","authors":"N. Fan, W. Yang, Y. Liang, W. Fan","doi":"10.14188/j.1671-8852.2020.0351","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0351","url":null,"abstract":"Objective: To investigate the initial chest CT imaging features and clinical types of patients with COVID-19. Methods: A total 165 patients with COVID-19 were retrospectively analyzed according to different age groups and different clinical classifications. Results: There were statistically significant differences in involvement sites, involvement range, lesion distribution and largest diameter of the lesions in COVID-19 patients among different age groups. Logistic regression analysis of age between normal type group and severe type group showed statistical significance (P<0.05). The maximum sensitivity and specificity were 64.20% and 69.00%. The corresponding age threshold was 50.5 years old. Conclusion: The main manifestations of initial chest CT in COVID-19 patients were ground-glass opacities, most often involving the posterior basal segment of the lower lung. Single site involvement was more common in 17-35 years patients. Most of the lesions were distributed around the subpleural and bronchovascular bundle in 36-90 years patients, involving both lungs and reaching more than two pulmonary lobes. For the COVID-19 patients with diabetes, hypertension, or older than 50.5 years, early diagnosis, isolation and treatment are necessary, and the changes of their conditions should be closely mornitored. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"42 1","pages":"589-593"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66657194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of discharged COVID‑19 patients with reappeared positive nucleic acid test","authors":"X. Hu, L. Ni, Y. Chen, L. Zhang, Z. Cheng","doi":"10.14188/j.1671-8852.2020.0580","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0580","url":null,"abstract":"Objective: To investigate the incidence of reappearance of positive results of nucleic acid (NA) test in discharged COVID‑19 patients, and retrospectively evaluate and compare the clinical characteristics between reappeared NA‑positive group and NA‑negative group, so as to provide the decision‑making basis for the quarantine management, health monitoring, and epidemic prevention. Methods: A total of 188 cases of discharged COVID‑19 patients from 3 quarantine observation sites in Wuhan from February to March 2020 were divided into reappeared NA‑positive group and NA‑negative group, based on the NA test. Clinical characteristics including general information, symptoms, underlying diseases, severity of disease, steroid administration, duration of hospitalization, duration from the beginning of positive to negative and time of onset of reappearance of positive for NA test, were compared between the two groups. Results: Of the 188 cases, 30 cases (15.96%) reappeared positive for NA test, and onset of reappearance ranged from day 1 to day 16 since the last NA negative, with a median time of 5 days after onset. A total of 51 cases (32.28%) in NA‑negative group had underlying diseases, while 18 (60.0%) cases reappeared NA‑positive had underlying diseases, and the rate of underlying diseases showed significant difference between the two groups (P<0.01). However, there were no statistical differences in gender, age, and symptoms on admission, severity of disease, steroid administration, duration from the beginning of positive to negative for NA test between the two groups. Conclusion: Since COVID‑19 patients with underlying diseases showed higher incidence of reappearance of positive NA test, COVID‑19 patients after discharge need to strengthen for quarantine control, further continuous health monitoring, and re‑tests of SARS‑CoV‑2 nucleic acid. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"42 1","pages":"867-871"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66657157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advance on clinical characteristics and injury mechanism of diabetic patients with coronavirus pneumonia","authors":"Z. Liu, W. Dong","doi":"10.14188/j.1671-8852.2020.0516","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0516","url":null,"abstract":"Currently, there are seven types of coronaviruses that can infect humans. Among them, severe acute respiratory syndrome coronavirus (SARS‑CoV), middle east respiratory syndrome coronavirus (MERS‑CoV) and severe acute respiratory syndrome coronavirus‑2 (SARS‑CoV‑2) are three types of coronavirus which have the greatest impact on human health in the past 20 years. Diabetic patients with hypoimmunity may have adverse outcomes and different injury mechanisms when infected with coronaviruses. This review is about the advance on clinical characteristics and injury mechanism of diabetic patients with SARS‑CoV, MERS‑CoV, or SARS‑CoV‑2. The purpose of writting this review is to arouse the attention of clinicians to diabetic patients with coronavirus infection and provide help for clinicians in the treatment of coronavirus disease 2019. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"42 1","pages":"888-894"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66657017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical observation of heart damage caused by coronavirus disease 2019","authors":"F. Li, Z. Zhu, S. Chen, X. Gao, C. Li","doi":"10.14188/j.1671-8852.2020.0375","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0375","url":null,"abstract":"Objective: To investigate the heart damage of coronavirus disease 2019 (COVID-19) patients. Methods: A total of 785 cases of COVID-19 treated in the Affiliated Hospital of Jianghan University from December 25, 2019 to February 18, 2020 were retrospectively studied. Patients with myocardial injury were screened out and then were divided into survival and non-survival groups. The clinical manifestations, laboratory examinations, electrocardiograms, imaging examinations, and clinical outcomes of the two groups were observed, and the characteristics and prognosis of myocardial injury related to COVID-19 were analyzed. Results: (1) Of the 785 patients, 90 had elevated serum troponin and were identified as myocardial injury patients. (2) COVID-19 related myocardial injury correlated to age and history of underlying diseases. Most of them were elderly (mean age 71.64±16.42 years), accompanied by basic diseases such as hypertension, coronary heart disease, and diabetes.(3) The main clinical manifestations in COVID⁃19 with myocardial injury were palpitations (76.7%), chest tightness (60%), and chest pain (6.67%). There was no statistical difference between survival and non-survival groups ( P >0.05);Laboratory examinations showed that myocardial enzymes (CK, CK-MB, and LDH), myoglobin, hypersensitive troponin, and NT-ProBNP all increased in varying degrees, especially in non-survivors ( P <0.001). Hypersensitive troponin and NT-ProBNP were independent risk factors for death in COVID⁃19 patients with myocardial injury. (4) Of the 90 patients with myocardial injury, 84 showed abnormal electrocardiograms, including atrial/ventricular premature beats, ST-segment elevation, ST-segment shift, conduction block, and abnormal Q waves. There were significant difference in conduction block rate between survival and non⁃survival groups ( P <0.05). Conlusion: COVID⁃19 can cause myocardial damage. Troponin is an important indicator for myocardial damage. Troponin and NT-ProBNP are independent risk factors for predicting death of COVID⁃19. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"42 1","pages":"698-703"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66656778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of chest CT scans in the diagnosis and treatment of COVID⁃19","authors":"Kaochang Zhao, T. Suo, Yanni Wang, Y. Huang, B. Xing, Guo-zhong Chen, J. Zou","doi":"10.14188/j.1671-8852.2020.0344","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0344","url":null,"abstract":"Objective: To investigate the role of chest CT scan in the diagnosis and evaluation of COVID⁃19 by analyzing the imaging features of patients with COVID⁃19 at different stages. Methods: The clinical data and radiologic findings were retrospectively collected in medical staff who were confirmed COVID⁃19 and admitted in our hospital from January 10 to March 20, 2020. We analyzed the characteristics of clinical manifestations, the frequency and interval of chest CT scans in the course of illness, imaging features in different stages of diseases, and the CT imaging outcomes during follow⁃up. Results: A total of 95 patients who met the criteria were included. The average time from symptom onset to aggravation and to alleviation were 8.3 days and 17.6 days, respectively. Patients received an average of 5 chest CT scans. The average intervals from onset to the first positive CT signs, the most serious CT signs, and the CT signs starting to disappear were 3.5 days, 7.8 days and 15.7 days, respectively. The mean CT follow⁃up time were 38.2 days. The lung lesions were completely absorbed on CT images in 38 patients, or presented with disappearing of the CT signs in the other patients. No patients had serious fibrosis residues. Conclusion: Chest CT has high sensitivity for early diagnosis of COVID⁃19. The moderate and some serious COVID⁃19 patients have good outcomes on CT images by recent follow⁃up. The changes of clinical symptoms are consistent with the changes of chest CT signs, and both are easy indicators for the outcomes of COVID⁃19 patients. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"42 1","pages":"704-708"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66657185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}