Clinical Characteristics,Treatment, and Outcomes of Critically Ill Patients With COVID-19: A Scoping Review

A growing number of studies on coronavirus disease 2019 (COVID-19) are becoming available, but a synthesis of available data focusing on the critically ill population has not been conducted. We performed a scoping review to synthesize clinical characteristics, treatment, and clinical outcomes among critically ill patients with COVID-19. Between January 1, 2020, and May 15, 2020, we identified high-quality clinical studies describing critically ill patients with a sample size of greater than 20 patients by performing daily searches of the World Health Organization and LitCovid databases on COVID-19. Two reviewers independently reviewed all abstracts (2785 unique articles), full text (218 articles), and abstracted data (92 studies). The 92 studies included 61 from Asia, 16 from Europe, 10 from North and South America, and 5 multinational studies. Notable similarities among critically ill populations across all regions included a higher proportion of older males infected and with severe illness, high frequency of comorbidities (hypertension, diabetes, and cardiovascular disease), abnormal chest imaging findings, and death secondary to respiratory failure. Differences in regions included newly identified complications (eg, pulmonary embolism) and epidemiological risk factors (eg, obesity), less chest computed tomography performed, and increased use of invasive mechanical ventilation (70% to 100% vs 15% to 47% of intensive care unit patients) in Europe and the United States compared with Asia. Future research directions should include proof-of-mechanism studies to better understand organ injuries and large-scale collaborative clinical studies to evaluate the efficacy and safety of antivirals, antibiotics, interleukin 6 receptor blockers, and interferon. The current established predictive models require further verification in other regions outside China.     

Standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori eradication

AIM: To compare the effectiveness of standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori (H. pylori ) eradication in a randomized, double-blinded, comparative clinical trial in China. METHODS: A total of 215 H. pylori -positive patients were enrolled in the study and randomly allocated into three groups: group A (n = 72) received a 10-d bismuth pectin quadruple therapy (20 mg rabeprazole bid , 1000 mg amoxicillin bid , 100 mg bismuth pectin qid , and 500 mg levofloxaci...     

序贯疗法与10d四联疗法抗Hp疗效对比分析

目的：比较10d序贯疗法和10d四联疗法根除Hp疗效和患者依从性,进一步探讨序贯疗法的机制。方法：将经胃镜检查确诊为慢性胃炎和消化性溃疡且Hp检测（尿素酶试验）阳性的患者170例随机分为A组和B组各85例,A组采用前5d奥美拉唑＋阿莫西林、后5d奥美拉唑＋克拉霉素＋替硝唑序贯疗法;B组采用奥美拉唑＋阿莫西林＋克拉霉素＋替硝唑四联疗法,疗程10d,观察Hp根除情况和患者的依从性。结果：Hp根治率A组明显优于B组（P〈0.05）,且A组依从性优于B组。结论：在疗程和药物选择相同的情况下,序贯疗法明显优于10d四联疗法。     

Bivalent sequential binding of docetaxel to methyl-β-cyclodextrin

New docetaxel (Dtx) and cyclodextrin (CD) inclusion complexes having improved apparent water solubility (up to 9.98 mg mL⁻¹) were obtained from phase solubility diagrams. γ-CD and SBE-β-CD offered only poor solubility enhancements while considerable increases in apparent solubility were obtained with Me-β-CD (20%, w/w) and HP-β-CD (40%, w/w) (9.98 mg mL⁻¹ and 7.43 mg mL⁻¹, respectively). The complexation mechanism between Dtx and Me-β-CD was investigated by circular dichroism spectrometry, two-dimensional ¹H NMR (NOESY) in D₂O, isothermal titration calorimetry (ITC) and molecular docking calculations. Circular dichroism and NOESY confirmed the existence of non-covalent interactions between Dtx and Me-β-CD and suggested that the tert-butyl group (C₆-C₉) and two aromatic groups (C₂₄-C₂₉ and C₃₀-C₃₅) of Dtx interacted with the Me-β-CD molecules. The combination of ITC results to molecular docking calculations led to the identification of an unconventional sequential binding mechanism between Me-β-CD and Dtx. In this sequential binding, a Me-β-CD molecule first interacted with both tert-butyl and C₃₀-C₃₅ aromatic groups (K₁: 744 M⁻¹). Then a second Me-β-CD molecule interacted with the C₂₄-C₂₉ aromatic group (K₂: 202 M⁻¹). The entropy of the first interaction was positive, whereas a negative value of entropy was found for the second interaction. The opposite behavior observed for these two sites was explained by differences in the hydrophobic contact surface and functional group flexibility.     

有创无创序贯机械通气治疗冠状动脉旁路移植术后呼吸衰竭的疗效观察

目的探讨有创无创序贯机械通气在治疗冠状动脉旁路移植术后呼吸衰竭的应用价值。方法 38例冠状动脉旁路移植术后呼吸衰竭的患者(治疗组)在经口气管插管、机械辅助通气治疗后改为无创通气;另41例冠状动脉旁路移植术后呼吸衰竭的患者(对照组)继续维持经口气管插管、机械辅助通气。两组患者进行氧动力学指标的比较及完全撤机后发生呼吸机相关性肺炎发生率、机械通气总时间和ICU监护时间的比较。结果治疗组氧动力学各项指标与对照组,两组差异没有统计学意义(均P>0.05)。治疗组发生呼吸机相关性肺炎例数、总机械通气时间和ICU监护时间均少于对照组,有统计学意义(均P<0.05)。结论有创无创序贯机械通气治疗冠状动脉旁路移植术后呼吸衰竭较单纯的有创机械通气具有更安全可靠的效果。     

左氧氟沙星及阿奇霉素序贯疗法治疗社区获得性肺炎的疗效观察

目的 探讨左氧氟沙星及阿奇霉素序贯疗法治疗社区获得性肺炎（CAP）的临床效果.方法 将2009年1月-2010年1月间在我院住院治疗的CAP患者56例随机分为左氧氟沙星组和阿奇霉素组,各28例;阿奇霉素组给予阿奇霉素序贯疗法,左氧氟沙星组给-予左氧氟沙星治疗.结果 左氧氟沙星组总有效率为85.71%,阿奇霉素组为82.14%,两组比较差异无显著性（P〉0.05）.左氧氟沙星组细菌清除率为80.00%,阿奇霉素组为76.92%,两组比较差异无显著性（P〉0.05）.两组患者均未见明显的药物不良反应.结论 左氧氟沙星及阿奇霉素序贯疗法治疗社区获得性肺炎疗效相当.     

2006—2010年广西壮族自治区皮肤病医院抗组胺药应用分析

目的:了解广西壮族自治区皮肤病医院抗组胺药应用情况和发展趋势,探讨抗组胺药的合理应用问题。方法:采用用药频度(DDDs)、日均费用(DDC)、DDDs排序、金额排序及排序比(B/A),结合处方点评结果,分析我院2006—2010年抗组胺药应用情况。结果:我院抗组胺药的用药金额、DDDs呈逐年增长态势。结论:安全、有效、应用方便的第2、3代抗组胺药是我院临床应用的主要药物,价格低廉但作用肯定的第1代抗组胺药仍发挥其独特效应,医疗机构应加强抗组胺药管理,提高药物治疗水平。     

“10日序贯疗法”治疗幽门螺杆菌感染患者的护理观察

目的探讨10日序贯疗法治疗幽门螺杆菌(Hp)感染患者的护理。方法对96例Hp阳性患者采用10日序贯疗法进行Hp根除治疗,同时加强口服药的管理、健康宣教、药物不良反应的观察、心理护理等。结果 96例患者治疗后临床症状得到缓解,4周后经14C尿素呼气试验复查杀菌效果,87例阴性;9例阳性,90.63%的患者杀菌取得满意疗效。结论加强对Hp阳性患者采用序贯疗法进行Hp根除治疗的护理可以明显增加患者的依从性,也是患者治疗成功的关键。     

The APC-PCI complex concentration predicts outcome of aortic surgery

INTRODUCTION: Coagulation activation may be related to complications during surgery for abdominal aortic aneurysm. The complex formed between activated protein C (APC) and the serpin, protein C inhibitor (PCI), is a sensitive indicator of the activation of blood coagulation. The purpose of the study was to establish whether the APC-PCI complex can provide information useful for the assessment of outcome after aortic surgery. MATERIALS AND METHODS: In 38 patients, the APC-PCI complex was initially determined every 6 h and daily from day three. Protein C, antithrombin, global haemostatic tests, and clinical scores were investigated. Length of stay at the intensive care unit (ICU) and hospital, and vital status up to two years were recorded. RESULTS: The median APC-PCI complex concentration in samples drawn 0-6 h after surgery was more than 20-fold higher than the upper limit of the reference interval. The level then declined rapidly, but remained elevated during the first two days. In patients with higher initial APC-PCI complex concentrations, Sequential Organ Failure Assessment (SOFA) scores were higher, the ICU stay was longer, and survival up to two years was lower. Patients who did not survive the ICU care had higher APC-PCI complex levels at 6-12 h and 12-18 h. CONCLUSIONS: High concentrations of the APC-PCI complex within 6-18 h after the aortic surgery predict a sinister outcome. The results suggest that the APC-PCI complex is indicative of the severity of the disease.