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ObjectiveTo observe the clinical course and explore the risk factors for SARS-CoV-2 RNA negative conversion duration （NCD） in asymptomatic and mild-symptomatic patients infected with the SARS-CoV-2 Omicron variant. MethodsClinical data were collected from 244 confirmed cases of corona virus disease （COVID-19） with Omicron variant infection admitted to a temporal makeshift hospital in Shanghai from April 9， 2022 to May 20， 2022. Demographic and clinical data were analyzed， with a primary focus on the time of COVID-19 nucleic acid conversion. Univariate and multivariate Cox regression analysis were used to determine identify risk factors associated with NCD. ResultsThe median duration of negative RNA conversion was 9 days （ranged 7‒12 days）. The percentage of patients with positive nucleic acid results on the 5th， 7th， 10th， and 14th days after confirmed infection was 68.4%， 47.1%， 20.1%， and 5.7%， respectively. Kaplan-Meier curves indicated a median nucleic acid conversion time of 12 days （ranged 10‒14 days） for patients with hypertension， 9 days （ranged 7‒11 days） in patients without hypertension， and 11 days （ranged 9‒13 days） for patients aged ≥60 years， and 9 days （ranged 7‒11 days） for patients aged <60 years. Multivariate Cox regression analysis showed that only hypertension was an independent risk factor of NCD （RR=1.60； 95% CI： 1.03‒2.49， P=0.036）. ConclusionIn asymptomatic or mildly symptomatic patients infected with the Omicron variant， 20.1% patients continue to exhibit positive viral nucleic acid on the 10th days of infection. The independent risk factor associated with the conversion of SARS-CoV-2 nucleic acid to negative is hypertension.
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ObjectiveTo investigate the effects of dopamine receptor agonist pramipexole and levodopa on emotion and cognition, and mitochondrial membrane potential of rats after global cerebral ischemia-reperfusion injury. MethodsA total of 80 male Sprague-Dawley rats were divided into sham group (n = 20), model group (n = 20), pramipexole group (n = 20) and combined group (n = 20). The latter three groups were used to prepare the model of global cerebral ischemia-reperfusion injury with Pulsinelli's four-vessel occlusion. The pramipexole group was intraperitoneally injected pramipexole 0.5 mg/kg once a day, while the combined group was injected levodopa 50 mg/kg and pramipexole 0.5 mg/kg, for 14 days. Five rats in each group were tested with open field test three, seven and 14 days after modeling; five were tested with Y-maze test seven and 14 days after modeling; five were detected mitochondrial membrane potential three, seven and 14 days after modeling; and five were observed under Nissl's staining14 days after modeling. ResultsCompared with the model group, the number of entries into the central zone (P < 0.05), total distance travelled (P < 0.05) and average velocity (P < 0.05) in the open field test increased in the pramipexole and combined groups seven and 14 days after modeling, duration spent in the central zone increased in the pramipexole and combined groups seven days after modeling (P < 0.05); the rate of spontaneous alternation of Y-maze test increased in the pramipexole and combined groups 14 days after modeling (P < 0.05); mitochondrial membrane potential in hippocampus increased in the pramipexole and combined groups seven and 14 days after modeling (P < 0.05), and it was less in the pramipexole group than in the combined group 14 days after modeling (P < 0.05); and the number of surviving neurons in the hippocampal CA1 increased in the pramipexole and combined groups 14 days after modeling (P < 0.05). ConclusionPramipexole may improve emotion and cognition of rats after global cerebral ischemia-reperfusion injury, and it may be helpful for restoring mitochondrial membrane potential as combining with levodopa.
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Objective:To investigate the feasibility of absolute ethanol in the treatment of brain arteriovenous malformation (bAVM).Methods:The clinical data of 25 patients with bAVM treated with absolute ethanol in the specialty of intracranial vascular malformations in Henan Provincial People′s Hospital from September 2018 to May 2019 were retrospectively analyzed. There were 14 males and 11 females, aged 7-62 years, with a median age of 26 years. Among the 25 patients, 18 cases had ruptured bAVM, 7 cases had unruptured bAVM. Spezler-Martin grade<Ⅲ were found in 14 cases, Ⅲ grade in 7 cases, and >Ⅲ grade in 4 cases. The clinical effect and perioperative complications were observed.Results:Among 25 patients, the overall technical success rate was 96.0% (24/25), one of which the target lesion with anhydrous ethanol could not be ablated. The overall complication rate was 28.0% (7/25) with no death. All complications were ischemic, and the incidence of severe complications was 12.0% (3/25). Twenty-five patients were followed up 3 months after the operation, 4 of which had mild complications, 2 recovered completely and 2 made reasonable recovery. In the 3 patients with severe complications, 2 patients made reasonable recovery and 1 patient had significant improvement. The modified rankin scale (MRS) score of all patients with complications was ≤2, and the remaining 18 patients had no new onset clinical symptoms. Thirteen patients were followed up by DSA and MRI. DSA showed no recurrence in the lesions ablated by absolute ethanol. In 2 patients with partial residual malformation after operation, the residual deformities disappeared completely at the time of reexamination. MRI showed that brain edema disappeared in all patients.Conclusions:The ablation of absolute ethanol in bAVM has a high operation success rate, definite clinical effect and low recurrence rate of postoperative bAVM. It can be used as an exploratory treatment.
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Objective To systemically evaluate the efficacy of all kinds of therapies of cerebral venous sinus thrombosis (CVST) associated with intracranial hematoma (ICH) and provide reference for making treatment scheme.Methods We searched English databases (Pubmed,ISI Web of science and Cochrane library databases) for publications on CVST associated with ICH and the relevant references of those articles.Retrieval time deadline was up to January 2015,and the language was set to English.All publications were searched without restrictions of publication type or published fields.Documents were screened to extract data and to analyze systemically.Results In total,17 articles fulfilled the inclusion criteria and included 31 patients.Because of the severities of reported cases were greatly different and treatments were varied,these patients were divided into 3 levels to get a better understanding of the efficacy.In 6 patients of stage Ⅰ,3 accepted anticoagulation,1 operative treatment,1 endovascular intervention and the left one used more than one methods;the prognosis was good and modified Rankin scale (mRS) score was 0 no matter which kind of therapy was performed.In 11 patients of stage Ⅱ,2 accepted anticoagulation enjoyed mRS scores of 0 and 6,3 operative treatment enjoyed mRS scores of 0,1 and 6,1 endovascular intervention enjoyed mRS scores of 0,and the left 5 used more than one method enjoyed mRS scores of 0,1,1,2 and 2.In 8 patients of stage Ⅲ,1 accepted anticoagulation enjoyed mRS scores of 2,3 operative treatment enjoyed mRS scores of 1,2 and 4,and 4 endovascular intervention enjoyed mRS scores of 0,1,1 and 1.Conclusion It seems that anticoagulation therapy alone may not be effectively enough for those patients that with severe clinical or imaging features;individualized therapy strategies with different types would be more effective.