Diagnosis and Treatment Strategy of Nasogenic Olfactory Dysfunction.

Since the global outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a symptom of the onset of SARS-CoV-2, olfactory dysfunction (OD), has attracted tremendous attention. OD is not only a negative factor for quality of life but also an independent hazard and early biomarker for various diseases, such as Parkinson's and Huntington's diseases. Therefore, early identification and treatment of OD in patients are critical. Many etiological factors are responsible for OD based on current opinions. Sniffin'Sticks are recommended to identify the initial position (central or peripheral) for OD when treating patients clinically. It is worth emphasizing that the olfactory region in nasal cavity is recognized as the primary and critical olfactory receptor. Many nasal diseases, such as those with traumatic, obstructive and inflammatory causes, can lead to OD. The key question is no refined diagnosis or treatment strategy for nasogenic OD currently. This study summarizes the differences in medical history, symptoms, auxiliary examination, treatment and prognosis of different types of nasogenic OD by analyzing the current studies. We propose using olfactory training after 4-6 weeks of initial treatment for nasogenic OD patients with no significant improvement in olfaction. We hope that our research can provide valuable clinical guidance by systematically summarizing the clinical characteristics of nasogenic OD.

The Prognostic Values Of Circulating Tumor Cells In Lung Carcinoma: An Analysis On 98 Chinese Patients.

AIM: To examine the prognostic values of circulating tumor cells (CTCs) in patients with advanced lung cancer. PATIENTS AND METHODS: A total of 98 patients with their CTCs enumerated in 2017 was recruited. Data were retrieved from medical records for comparison. Patients' overall survival (OS) and progression-free survival (PFS) were studied using Kaplan-Meier curve with log rank test. RESULTS: Seventy-three percent of the patients were male, and nearly half of the patients (44.8%) were smokers. Most tumors were adenocarcinoma (73.4%), and about 60% of the cases were diagnosed at stage IV. Half of the patients showing less than nine CTCs. Patients' OS were significantly associated with total CTC count (P=0.047), epithelial CTC count (P=0.027), mixed CTC count (P=0.004), and use of adjuvant chemotherapy (P=0.001). For PFS, it was strongly associated with tumor backgrounds (T stage, P=0.002; M stage, P=0.001; TMN stage, P<0.001), cancer biomarkers (CEA, P=0.004; CA125, P=0.004; CA153, P=0.045), and treatment strategy (surgical intervention, P=0.025; first-line chemotherapy, P<0.001). CONCLUSION: The present study clearly indicated the significant associations between CTC and overall survival of patients with lung cancer.

Efficacy and safety of combined directly acting antivirals for treatment of Chinese chronic hepatitis C patients in a real-world setting.

AIM: To assess the efficacy and safety of combined directly acting antivirals (DAAs) for the treatment of Chinese chronic hepatitis C (CHC) patients in a real-world setting. METHODS: Hospitalized CHC patients who were treated with DAAs at Peking University First Hospital between January 2015 and December 2016 were enrolled. Samples and clinical data were collected at 0 wk, 2 wk, 4 wk, 8 wk, 12 wk, or 24 wk during DAAs treatment and at 4 wk, 12 wk, and 24 wk after the end of treatment. RESULTS: Fifty-four patients who underwent DAAs treatment were included in our study, of whom 83.3% (45/54) achieved rapid virological response at 2 wk after treatment initiation (RVR 2) and 94.4% (51/54) achieved sustained virological response at 24 wk after the end of treatment (SVR 24). Serum creatinine and uric acid levels at the end of treatment were significantly increased compared with baseline levels (83.6 ± 17.9 vs 88.8 ± 19.4, P01 < 0.001; 320.8 ± 76.3 vs 354.5 ± 87.6, P01 < 0.001), and no significant improvements were observed at 24w after the end of treatment (83.6 ± 17.9 vs 86.8 ± 19.1, P02 = 0.039; 320.8 ± 76.3 vs 345.9 ± 89.4, P02 = 0.001). The total frequency of adverse events (AEs) during treatment was 33.3% (18/54), with major AEs being fatigue (16.7%), headache (7.4%), anorexia (7.4%), and insomnia (5.6%). CONCLUSION: Though based in a small cohort of patients, the abnormal changes in renal function indices and relative high frequency of AEs during combined DAAs treatment should be taken as a note of caution.

Antibody to hepatitis B core antigen levels in the natural history of chronic hepatitis B: a prospective observational study.

Previous studies have revealed antibody to hepatitis B core antigen (anti-HBc) levels as a predictor of treatment response in hepatitis B early antigen (HBeAg)-positive chronic hepatitis B (CHB) patients in both interferon and nucleos(t)ide analog therapy cohorts. However, there is no information about anti-HBc levels in the natural history of CHB. This study aimed to define anti-HBc levels of different phases in the natural history of CHB. Two hundred eleven treatment-naive CHB patients were included in the study. They were classified into 4 phases: immune tolerance (IT) phase (n = 39), immune clearance (IC) phase (n = 48), low or no-replicative (LR) phase (n = 55), and HBeAg-negative hepatitis (ENH, n = 69). Fifty patients who were HBsAg negative and anti-HBc positive were also recruited as past HBV infection (PBI) control group. Anti-HBc levels were measured by a newly developed double-sandwich immunoassay. Correlation of anti-HBc levels with alanine aminotransferase (ALT) and other HBV-related markers within each phase was performed. Serum anti-HBc levels were statistically significant between patients in different phases of CHB (P < 0.001). The median anti-HBc levels were: IT (3.17 log 10 IU/mL), IC (4.39 log 10 IU/mL), LR (3.29 log 10 IU/mL), ENH (4.12 log 10 IU/mL), and PBI (0.61 log 10 IU/mL). There existed a strong correlation in IC (r = 0.489, P < 0.001), a poor correlation in ENH (r = 0.275, P = 0.042), and no correlation in patients with ALT reached 5 times upper limit of normal (r = 0.120, P = 0.616). Anti-HBc levels show significant differences during the natural course of CHB. These results may provide some potentially useful insights into hepatitis B pathogenesis and immune activation against hepatitis B virus.

[SGP polymorphism in cultivated naked barley from Qinghai-Tibet plateau in China and the relationship between SGPs and starch content].

Starch granule proteins (SGPs) are minor components bound with starch granule, which mutation may be related to starch properties. This study investigated the variation of SGPs in cultivated naked barley from Qinghai-Tibet Plateau in China for the first time, and the relationship between SGPs and starch content was preliminarily done. Ten major SGPs and 16 types of patterns were present in 66 cultivated naked varieties, indicating SGPs in cultivated naked barley from Qinghai-Tibet Plateau in China are polymorphic. SGPs in Tibet and Sichuan naked barley were greatly different and SGPs were specific to origin of site. Significance test analysis demonstrates SGPs described in this study except for SGP1 may be related with the variation of starch content in different naked barley.