COVID-19 combined with liver injury: Current challenges and management

Coronavirus disease 2019 (COVID-19) combined with liver injury has become a very prominent clinical problem. Due to the lack of a clear definition of liver injury in patients with COVID-19, the different selection of evaluation parameters and statistical time points, there are the conflicting conclusions about the incidence rate in different studies. The mechanism of COVID-19 combined with liver injury is complicated, including the direct injury of liver cells caused by severe acute respiratory syndrome coronavirus 2 replication and liver injury caused by cytokines, ischemia and hypoxia, and drugs. In addition, underlying diseases, especially chronic liver disease, can aggravate COVID-19 liver injury. In the treatment of COVID-19 combined with liver injury, the primary and basic treatment is to treat the etiology and pathogenesis, followed by support, liver protection, and symptomatic treatment according to the clinical classification and severity of liver injury. This article evaluates the incidence, pathogenesis and prevention and treatment of COVID-19 combined with liver injury, and aims to provide countermeasures for the prevention and treatment of COVID-19 combined with liver injury.     

Pharmacokinetics of Pazufloxacin Mesilate Sodium Chloride in healthy Chinese volunteers after intravenous injection

In the present study, we aimed to investigate the pharmacokinetics and dosage proportionality for a single, intravenous utilization of Pazufloxacin Mesilate Sodium Chloride, an injectable synthetic fluoroquinolone antibacterial agent, in healthy Chinesevolunteers.In this open-labeled, three-dosage parallel study, subjects were randomized to receive a single dose of PazufloxacinMesilate at 150, 300 or 600 mg (n = 10, 10 and 10, respectively) administered as a 30-min intravenous infusion. Blood and urine samples were serially collected from 0 to 24 h after drug administration. Moreover, the sample’s drug concentrations were analyzed via validated RP-HPLC method.Subjects receiving a single dose of Pazufloxacin Mesilate 150, 300 or 600 mg were in accordance with the two compartment model. The C_max for each dosage group was 2.37±0.89, 4.27±0.74 and 10.74±4.06 mg·mL^–1, respectively; and the AUC_0→∞ was 3.24±1.2, 5.89±1.51 and 13.32±2.35 mg·h·mL^–1, respectively. In addition, T_max for groups treated with 150, 300 and 600 mg was 0.48±0.08, 0.50±0.00 and 0.53±0.08 h, respectively. The correlation analysis for AUC_0→∞, C_max and dosage suggested that pazufolxacin mesilate displayed dose proportion at the dose ranging from 150 to 600 mg. The data suggested that all three different dosage regimens fit with the two compartment model. Meanwhile, it presented a linear correlation between AUC_0→∞, C_max and dosage over the range of 150–600 mg.     

鄱阳湖区实施"麋鹿回家计划"对血吸虫病传播影响的调查

目的　了解放归鄱阳湖区的麋鹿血吸虫感染情况,评价“麋鹿放归野外自然繁衍生长计划”（“麋鹿回家计划”）对鄱阳湖区血吸虫病传播的影响。方法　采用GPS项圈定位、人工跟踪观察等方法,于2018年4月-2019年12月调查放归鄱阳湖区麋鹿的种群分布、栖息活动和自然增殖等情况,采用塑料杯顶管孵化法检测麋鹿栖息地动物野粪血吸虫感染情况,采取系统抽样法对麋鹿栖息地草洲进行钉螺分布调查。结果　2018年,共有51头麋鹿放归鄱阳湖区,形成了银宝湖、龙口、南池湖、莲子湖和珠湖等5个麋鹿栖息地,栖息环境主要为鄱阳湖区草洲、圩内农田和山丘林地等。对银宝湖麋鹿栖息地调查显示,至2019年该地麋鹿自然增殖率为25.0%,平均钉螺密度为0.009 ~ 0.039只/0.1 m2,未发现血吸虫感染性钉螺;麋鹿和牛粪平均密度分别为4.6份/hm2和2.1份/hm2,血吸虫阳性率分别为4.35%和13.16%（P ＝ 0.236）,感染强度分别为“+++”和“+”。结论　放归鄱阳湖区的麋鹿可感染血吸虫,并可通过粪便对草洲污染而引起血吸虫病传播扩散。应积极探索麋鹿放归湖区后对当地血吸虫病传播的影响和应对策略,确保鄱阳湖区消除血吸虫病目标的实现和“麋鹿回家计划”的顺利实施。     

Pronuclear removal of tripronuclear zygotes can establish heteroparental normal karyotypic human embryonic stem cells

Purpose

This study aimed to derive heteroparental normal karyotypic human embryonic stem cells (hESCs) from microsurgically corrected tripronuclear (3PN) zygotes.

Methods

After sequential culture for 5–6 days, embryos developed from microsurgically corrected 3PN zygotes were analyzed by fluorescence in situ hybridization (FISH) using probes for chromosomes 17, X and Y. Intact 3PN zygotes from clinical in vitro fertilization (IVF) cycles were cultured as the control group. The inner cell mass (ICM) of blastocysts that developed from microsurgically corrected 3PN zygotes was used to derive hESC lines, and the stem cell characteristics of these lines were evaluated. G-banding analysis was adopted to identify the karyotype of the hESC line, and the heteroparental inheritance of the hESC line was analyzed by DNA fingerprinting analysis.

Results

The blastocyst formation rate (13.5 %) of the microsurgically corrected 3PN zygotes was significantly higher (P?<?0.05) than that of intact 3PN zygotes (8.7 %). The diploid rate of the blastocysts (55.0 %) was significantly higher (P?<?0.05) than that of the arrested cleavage-stage embryos (18.4 %) in microsurgically corrected 3PN zygotes. The triploid rate of the microsurgically corrected 3PN zygotes (5.7 %) was significantly lower (P?<?0.01) than that of intact 3PN zygotes (19.4 %). Furthermore, we established one heteroparental normal karyotypic hESC line from the microsurgically corrected tripronuclear zygotes.

Conclusions

Pronuclear removal can effectively remove the surplus chromosome set of 3PN zygotes. A combination of pronuclear removal and blastocyst culture enables the selection of diploidized blastocysts from which heteroparental normal karyotypic hESC lines can be derived.

     

Clinical Features of Adult/Adolescent Atopic Dermatitis and Chinese Criteria for Atopic Dermatitis

Background:

Atopic dermatitis (AD) is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several criteria have been proposed for the diagnosis of AD. Although the clinical features of childhood AD have been widely studied, there has been less large-scale study on adult/adolescent AD. The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczema/AD and to propose Chinese diagnostic criteria for adult/adolescent AD.

Methods:

A hospital-based study was performed. Forty-two dermatological centers participated in this study. Adult and adolescent patients (12 years and over) with chronic symmetrical eczema or AD were included in this study. Questionnaires were completed by both patients and investigators. The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software.

Results:

A total of 2662 valid questionnaires were collected (1369 male and 1293 female). Of all 2662 patients, 2062 (77.5%) patients had the disease after 12 years old, while only 600 (22.5%) patients had the disease before 12 years old, suggesting late-onset eczema/AD is common. Two thousand one hundred and thirty-nine (80.4%) patients had the disease for more than 6 months. One thousand one hundred and forty-four (43.0%) patients had a personal and/or family history of atopic diseases. One thousand five hundred and forty-eight (58.2%) patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE. Based on these clinical and laboratory features, we proposed Chinese criteria for adult/adolescent AD. Of all 2662 patients, 60.3% were satisfied with our criteria, while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria, suggesting a good sensitivity of our criteria in adult/adolescent AD patients.

Conclusion:

Late-onset of eczema or AD is common. The clinical manifestations of AD are heterogeneous. We have proposed Chinese diagnostic criteria for adolescent and adult AD, which are simple and sensitive for diagnosis of adult/adolescent AD.     

The effect of concurrent nasal surgery on the eustachian tube function and myringoplasty outcomes

ObjectiveTo investigate the Effect of concurrent nasal surgery on the eustachian tube function (ETF) and myringoplasty outcomes for the chronic perforations with coexistent nasal pathology.Materials and methodsWe retrospectively reviewed the records of 93 patients with perforations who underwent same-day myringoplasty and nasal-septal surgery. Group A exhibited septal deviations (n = 34) and Group B inflammatory sinus disease (n = 59). Groups were compared with respect to pre- and postoperative air-bone gaps (ABGs), graft success rates and ETF (Eustachian tube score [ETS] and seven-item Eustachian Tube Dysfunction Questionnaire [ETDQ-7]) at 6 and 24 months.ResultsGraft success rates were 100.0% in Group A and 98.3% in Group B at 6 months postoperatively (P = 0.445). Graft success rates were 85.3% in Group A and 96.6% in Group B at 24 months postoperatively (P = 0.046), the re-perforation rate was significantly higher in Group A than in Group B (P = 0.015). Although the preoperative ETS was similar between two groups, the postoperative ETS in the Group B was significantly higher compared with Group A regardless of at postoperative 6th and 24th months. In addition, difference was significant for the patients with positive Valsalva maneuver among two groups at postoperative 24th months. Also, the improvement in the ETDQ-7 score in the B group was significantly higher than that in the A group at postoperative 6th and 24th months.ConclusionsConcurrent nasal surgery and myringoplasty is feasible. In addition, ESS improves ETF and thus long-term outcomes of myringoplasty for the chronic perforations with inflammatory sinus disease.     

Transient-evoked otoacoustic emission signals predicting outcomes of acute sensorineural hearing loss in patients with Ménière’s disease

Abstract

Background: Fluctuating hearing loss is characteristic of Ménière’s disease (MD) during acute episodes. However, no reliable audiometric hallmarks are available for counselling the hearing recovery possibility.

Aims/objectives: To find parameters for predicting MD hearing outcomes.

Material and methods: We applied machine learning techniques to analyse transient-evoked otoacoustic emission (TEOAE) signals recorded from patients with MD. Thirty unilateral MD patients were recruited prospectively after onset of acute cochleo-vestibular symptoms. Serial TEOAE and pure-tone audiogram (PTA) data were recorded longitudinally. Denoised TEOAE signals were projected onto the three most prominent principal directions through a linear transformation. Binary classification was performed using a support vector machine (SVM). TEOAE signal parameters, including signal energy and group delay, were compared between improved (PTA improvement: ≥15?dB) and nonimproved groups using Welch’s t-test.

Results: Signal energy did not differ (p?=?.64) but a significant difference in 1-kHz (p?=?.045) group delay was recorded between improved and nonimproved groups. The SVM achieved a cross-validated accuracy of >80% in predicting hearing outcomes.

Conclusions and significance: This study revealed that baseline TEOAE parameters obtained during acute MD episodes, when processed through machine learning technology, may provide information on outer hair cell function to predict hearing recovery.