武汉大学学报(医学版)最新文献

{"title":"Coronavirus disease 2019 combined with venous thromboembolism: Clinical features and prevention","authors":"P. Tang, H. Deng, H. Liu, J. Li, X. Yu, J. Zhuang, Y. Zhang, Q. Deng, Q. Li, J. Chen","doi":"10.14188/j.1671-8852.2020.0270","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0270","url":null,"abstract":"Objective: To analyze the clinical characteristics and control methods of coronavirus disease 2019 (COVID-19) complicated with venous thromboembolism(VTE), and to provide scientific basis for disease prevention, diagnosis and treatment. Methods: We retrospectively studied the cases of COVID-19 complicated with VTE in Renmin Hospital of Wuhan University from January 30, 2020 to March 19, 2020, and their clinical features, results of exmaninations, treatment methods, complications, and prognosis were reviewed. Results: Among the 1 448 COVID-19 patients, 17(1.17%) were VTE positive, 60-69 years old patients were more common. The main clinical types were critical (64.7%) and severe (35.7%) types. The main clinical symptoms were lower extremity swelling (70.6%) and pain (35.7%);58.8% of the patients had a history of high risk factors related to VTE. Most VTE patients were peripheral (58.8%) and involved bilateral limbs (41.2%). The proportion of neutrophils, D-dimer and fibrin degradation products at the last examination were lower than those on admission to the hospital, while the total number and proportion of lymphocytes were higher. Of the 17 VTE cases, 64.7% received venous catheterization, 58.8% received endotracheal intubation or tracheotomy, and 2 patients received extracorporeal membrane oxygenation (ECMO). The rate of bleeding was as high as 53%, and the risk of cardiovascular and cerebrovascular accidents was very high;the prognosis of the patients was poor, and the mortality rate was 23.5%. The cure rate was 17.6%, and the improvement rate was 47.1%. Two patients were still in critically ill. Conclusion: Venous thromboembolism was common in elderly COVID-19 patients with severe types and critical types. Most patients were male and characterized by atypical symptoms, and the early active VTE risk assessment and prevention procedures should be adopted. The risk for bleeding and cardiovascular/cerebrovascular accidents was high, although most cases had good outcomes after active treatment. © 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":"579-583"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66657042","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":"Values of prognostic nutritional index in predicting the outcomes of COVID-19 patients","authors":"D. Xie, D. Wen, Y. Liu","doi":"10.14188/j.1671-8852.2020.0304","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0304","url":null,"abstract":"Objective: To assess the association between prognostic nutritional index (PNI) and survival in patients hospitalized for coronavirus disease 2019 (COVID-19). Methods: In this retrospective study, we collected data of COVID-19 patients in Wuhan Jinyintan Hospital. The PNI were calculated on the basis of blood test results. Results: The PNI in severe patients was significantly lower than that in mild group (29.7 versus 46.8, P<0.001);while the PNI value also showed signifcant difference between death group and survival group (28.15 versus 38.1, P<0.001). ROC analysis revealed that PNI was important for the diagnosis of severe COVID-19, and could be used as an independent predictor of survival in severe patients (P<0.01). Conclusion: Low prognostic nutritional index was remarkably associated with a poor prognosis in severe patients with SARS-CoV-2 pneumonia. © 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":"603-607"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66657138","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 psychological status of 82 patients with rectal cancer after operation in Wuhan epidemic area of COVID‑19 and the value of WeChat follow‑up by doctors","authors":"Z. Li, J. Chen, Y. Zhou, J. Li, F. Xiong, J. Xu, C. Chen, Q. Wang, Yilei Zhang","doi":"10.14188/j.1671-8852.2020.0465","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0465","url":null,"abstract":"Objective: To investigate the postoperative psychological status of rectal cancer patients during the outbreak of coronavirus disease 2019 (COVID‑19) epidemic in Wuhan, and to evaluate the outcomes of WeChat follow‑up. Methods: A total of 41 patients with rectal cancer after operation were included into observation group and were followed up by doctors through WeChat, and another 41 postoperative cases without WeChat follow⁃up were set as control group. The Symptom Checklist 90 (SCL‑90), Self‑Rating Depression Scale (SDS), Self‑Rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI) were adopted to evaluate all the patients' postoperative psychological status before discharge from hospital and two months later. Results: After two months, the scores of SCL‑90, SAS, and SDS, respectively,of all patients showed significantly changes (t=1.487, 1.203, and 1.578, respectively, all P 0.05), but the total scores of PSQI in observation group showed a significant decrease after two months' WeChat follow⁃up and were lower than in control group (t=8.369, P<0.05). Conclusion: During the outbreaking of COVID⁃19 epidemic in Wuhan, the scores of SCL‑90, SAS, and SDS in the post⁃operative patients were all decreased, but the total scores of PSQI in WeChat follow‑up group was significantly lower than that in the control group. Doctors' active WeChat follow‑up on patients can alleviate their fear, anxiety, depression, and especially, and improve their sleep quality. © 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":"884-887"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66656832","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":"Impact of the COVID⁃19 outbreak on depression and anxiety among perinatal women in Wuhan","authors":"X. Wan, J. Hou, M. Hu","doi":"10.14188/j.1671-8852.2020.0582","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0582","url":null,"abstract":"Objective: To evaluate the effect and analysis of coronavirus disease 2019 (COVID‑19) on depression and anxiety of perinatal women in Wuhan. Methods: A total of 176 perinatal women were selected, who were delivered in Renmin Hospital of Wuhan University from January 24 to March 29, 2020. The general information of the patients was evaluated. The anxiety self‑assessment scale (SAS) and depression self‑assessment (SDS) were used before delivery. The Edinburgh Postpartum Depression Scale (EPDS) was used to assess depression from 10 days to 14 days after delivery. The main factors affecting maternal depression and anxiety were investigated and analyzed. Results: During the outbreak of COVID‑19, the incidence of anxiety (SAS score ≥50) was 47.73% (84 cases), and the incidence of depression (SDS score ≥0.5) was 54.55% (96 cases) before delivery. The incidence of depression (EPDS score≥0.5) was 44.89% (79 cases) after delivery. The prenatal SAS score was related to depression after delivery ( r =0.641, P <0.001), and the prenatal SDS score was also related to depression after delivery ( r =0.740, P <0.001). Logistic analysis indicated that worrying about the risk of COVID‑19 infection ( OR =3.816, 95% CI :1.688⁃8.627, P =0.001), poor sleep quality ( OR =2.448, 95% CI : 1.053~5.694, P =0.038) and dyspnea in mask ( OR =2.464, 95% CI : 1.009⁃6.014, P =0.048) were the main risk factors for postpartum depression in pregnant women during outbreak of COVID‑19. Conclusion: The outbreak of COVID‑19 increased the incidence of maternal depression and anxiety during perinatal period, which was significantly related to the combination of multiple risk factors caused by the outbreak of COVID‑19. These provide an effective prevention strategy for preventing the postpartum depression during the outbreak 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":"28 1","pages":"724-728"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66657169","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":"Echocardiographic findings and clinical features of COVID‑19 patients","authors":"H. Wang, Q. Deng, Y. Zhang, W. Hu, Y. Cheng, X. Zhou, J. Yan, H. Ping, B. Hu","doi":"10.14188/j.1671-8852.2020.0605","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0605","url":null,"abstract":"Objective: To analyze the echocardiographic manifestations and clinical features of 98 patients with COVID‑19, and to explore whether there is potential myocardial injury in COVID‑19 patients. Methods: Patients diagnosed with COVID‑19 in Renmin Hospital of Wuhan University were retrospectively investigated. Echocardiography was performed on all the patients. Diameters of chamber, thickness of ventricular wall were measured routinely to explore whether there were structural changes, while left ventricular ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) were assessed for function evaluation. Signs of pericardial effusion and pulmonary hypertension were also focused on in our study. At the same time, clinical data related to the myocardial injury was collected, including Troponin I (cTnI), creatine kinase‑MB (CKMB), and N‑terminal pro‑brain natriuretic peptide (NT‑pro BNP). Patients were divided into the severe group and the non‑severe group, and the differences of ultrasound results and clinical data between the two groups were analyzed. Results: No typical echocardiographic signs of viral myocarditis were observed in our study, such as ventricular enlargement, thickening of the ventricular wall and cardiac dysfunction. Positive findings in echocardiography observed mainly included signs of pericardial effusion and pulmonary hypertension. By comparing the clinical data of the two groups, the age of the severe group was significantly older (median age 66.0 years [IQR: 56.0‑77.0] vs 59.0 years [IQR: 42.0‑69.0], P=0.02), and the levels of CRP, procalcitonin and D‑Dimer were significantly increased in the severe group. Conclusion: Although the echocardiography of patients with COVID‑19 had no typical manifestations, the level of myocardial markers was significantly increased in severe patients, suggesting the potential myocardial injury. © 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":"872-877"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66657212","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":"Laboratory test analysis of sixty-two COVID-19 patients","authors":"Dan Li, Menglong Wang, Bing He, Yao Xu, Xiaoyang Zhou, Wen-jing Li, Wenfeng Lu, Jun Wan","doi":"10.14188/J.1671⁃8852.2020.0220","DOIUrl":"https://doi.org/10.14188/J.1671⁃8852.2020.0220","url":null,"abstract":"","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66656988","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":"CT features and dynamic changes of different clinical types of COVID-19","authors":"Hongmei Yu, Shenglan Li, Gang Deng, Miao Liu, Fu-Qiang Xing, Liguo Jiang, Yi Jiang","doi":"10.14188/J.1671⁃8852.2020.0179","DOIUrl":"https://doi.org/10.14188/J.1671⁃8852.2020.0179","url":null,"abstract":"","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66656979","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":"A case report of a critically ill COVID-19 patient with prolonged mechanical ventilation in prone position and literature review","authors":"Xiaowei Wu, Bin Song, Wen-juan Wu, W. Zou","doi":"10.14188/J.1671⁃8852.2020.0151","DOIUrl":"https://doi.org/10.14188/J.1671⁃8852.2020.0151","url":null,"abstract":"A review To report one case of severe coronavirus disease 2019 (COVID19) with prolonged mech ventilation in prone position, and to review the related literature A case of severe COVID19 underwent prolonged(8 days) prostrate ventilation due to clin needs was retrospectively analyzed, and the literature was reviewed Respiratory compliance and oxygenation index were improved after prolonged prostration, but the outcomes were poor due to septic shock and multiple organ failure After sedation, COVID19 patients with mech ventilation can be considered to receive prone position ventilation after exclusion of contraindication If the patient′s oxygenation and respiratory mechanics improve, the time of prone position can be prolonged according to the situation","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66656633","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":"Mental health status of medical staff during the outbreak of coronavirus disease 2019","authors":"Yueying Wang, X. Jia, Jiquan Song, Xuanzhen Lu, Zeng Li, K. Ouyang, Jun Xie","doi":"10.14188/J.1671-8852.2020.0154","DOIUrl":"https://doi.org/10.14188/J.1671-8852.2020.0154","url":null,"abstract":"A review","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45172444","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 application value of immunochromatography in detecting SARS-CoV-2 IgM and IgG antibodies","authors":"Tengfei Bao, Junjuan Gu, Ying-juan Liu, Yongwei Duan, Xin Jin, Yawen Chen, Yirong Li, W. Xie","doi":"10.14188/J.1671-8852.2020.0193","DOIUrl":"https://doi.org/10.14188/J.1671-8852.2020.0193","url":null,"abstract":"","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43145359","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}