[Clinical features and high resolution CT imaging evolution of coronavirus disease 2019].

Objective: To investigate the clinical manifestations of the clinical characteristics of 141 patients with coronavirus disease 2019 (COVID-19) and the imaging evolution characteristics of High Resolution CT (HRCT) in the chest. Methods: From January 20, 2020 to February 8, 141 COVID-19 patients in Renmin Hospital of Wuhan University, 77 males and 64 females, with a median age of 49 (9,87) , were retrospectively analyzed. The clinical features, laboratory examination indexes and HRCT evolution findings of 141 COVID-19 patients were analyzed. Results: Laboratory examinations of 141 COVID-19 patients showed a decrease in white blood cell count and lymphocyte ratio. Among the 141 patients with COVID-19, fever (>37.5 â„ƒ) was the most common clinical manifestation in 139 cases (98.58%) , and occasionally non-respiratory symptoms such as diarrhea in 4 cases (2.84%) . 141 patients with COVID-19 had abnormal HRCT. 52 (36.88%) chest HRCT images showed ground-glass opacity (GGO) , mainly under pleural; 23 (16.31%) GGO with focal consolidation; 27 (19.15%) small flaky shadows; 20 cases (14.18%) large flaky consolidation shadows; 48 cases (34.04%) bronchovascular bundle thickening and vascular penetrating signs; 5 cases (3.55%) had air bronchial signs; 7 cases (4.96%) of small nodule shadows; 5 cases (3.55%) of fibrosis, grid shadows or strand shadows.135 cases (95.74%) were positive for the first time nucleic acid test, 6 cases (4.26%) were negative, and 71 cases (50.35%) of common type, 47 cases (33.33%) of severe type and 23 cases (16.31%) of critical type were found during the same period. The average time from onset of each type to the first CT examination was: (2.51±1.32) , (5.02±2.01) , and (5.91±1.76) days; 19 (19/47, 40.43%) of which were severe for the first time CT classification worsened at the second examination and lessened at the third examination. 141 cases (100%) were positive for the second nucleic acid test, and the HRCT results for the same period were 44 cases (31.21%) of common type, 53 cases (37.59%) of severe type, and 44 cases (31.21%) of critical type; the average interval time was (3.32±1.61) , (3.93±1.84) , (4.15±1.57) days;the third nucleic acid test were positive among 113 cases and 28 cases were negative, HRCT results of the same period were 79 cases (56.03%) of common type, 46 cases (32.62%) of severe type, and 16 cases (11.35%) of critical type;the average interval from the first CT examination were: (5.59±1.83) , (7.32±1.37) , (7.55±1.78) days. The differences in CT typing at different time were statistically significant (P<0.05) . Conclusion: The clinical features of COVID-19 and HRCT images are diverse, extensive GGO and infiltrates in both lungs are typical. Viral nucleic acid tests usually occur earlier or at the same time as the CT examination positive, and there are false negatives in nucleic acid tests. In some epidemiological backgrounds, CT imaging manifestations and evolutionary characteristics are of great significance for early warning of lung injury, assessment of disease severity, and assistance in clinical typing and post-treatment follow-up.

Drug-drug interaction between valproic acid and meropenem: a retrospective analysis of electronic medical records from neurosurgery inpatients.

WHAT IS KNOWN AND OBJECTIVE: A series of studies have indicated that valproic acid (VPA) plasma concentration decreased rapidly when used concomitantly with carbapenem antibiotics, including meropenem (MEPM), imipenem and panipenem, which may increase the risk of seizure breakthrough. However, the cause for the change in VPA pharmacokinetics is unclear. A retrospective analysis of VPA therapeutic drug monitoring (TDM) records was performed to investigate this VPA pharmacokinetics drug-drug interaction. METHODS: Three hundred and eighty one VPA TDM records from the Department of Neurosurgery of Xiangya Hospital from January 2012 to December 2014 were collected. The VPA TDM records were categorized by VPA and MEPM daily dosages in grams/day (g/day). A comparison of VPA plasma levels among different groups was performed to investigate the change in VPA level in this drug interaction. RESULTS AND DISCUSSION: Remarkable decreases in VPA plasma level were observed when the drug was used concomitantly with MEPM in both 1.2 g/d and 1.6 g/d VPA groups (67·3 ± 4·6 µg/mL, n = 21 vs. 15·3 ± 1·9 µg/mL, n = 15, P < 0·001; 67·6 ± 1·2 µg/mL vs. 18·1 ± 2·6 µg/mL, n = 38, P < 0·001). No significant difference in VPA plasma concentrations was observed between the 1·2 g/day VPA + MEPM, 1·6 g/day VPA + MEPM and 2·0 g/day VPA + MEPM groups (15·3 ± 1·9 µg/mL, n = 15 vs. 18·1 ± 2·6 µg/mL, n = 38 vs. 9·0 ± 3·0 µg/mL, n = 7; P = 0·252). The decrease in VPA concentration was independent of MEPM daily dose (14·0 ± 5·1 µg/mL, n = 4 for high MEPM daily dose vs. 16·5 ± 1·9 µg/mL, n = 56 for low MEPM daily dose; P = 0·729). After discontinuation of MEPM for more than 7 days, VPA plasma concentration recovered to a value comparable to that before MPEM initiation (69·7 ± 4·2 µg/mL, n = 21 vs. 51·2 ± 8·1 µg/mL, n = 9; P = 0·48). WHAT IS NEW AND CONCLUSION: This is the first study using a large number of VPA TDM records to investigate the change in VPA levels caused by concomitant use of MEPM. Our results imply that the decrease in drug concentration cannot be reversed by increasing VPA dose. Moreover, MEPM daily dose did not influence the drop in VPA plasma level. At least 7 days are required for the recovery of VPA plasma concentration after discontinuation of MEPM.

Isolation, identification, and antioxidant activity of polysaccharides from the shell of abalone (Haliotis discus hannai Ino).

In this study, two antioxidative substances, a homogeneous polysaccharide [abalone shell polysaccharide (ASP-1), corresponding to the first peak by size exclusion chromatography] and a non-polysaccharide compound [abalone shell compound (ACS-2), corresponding to the second peak by size exclusion chromatography], were extracted from the abalone (Haliotis discus hannai Ino) shell. We primarily focused on the investigation of ASP-1. As a heteropolysaccharide, ASP-1 is comprised of 9.3% uronic acid and 86.4% saccharide, the latter including mannose, ribose, rhamnose, glucose, galactose, arabinose, and two unknown monosaccharides, NO1 and NO2, with a mass ratio of 9.5:10.1:2.2:18.2:21.8:5.5:16.5:16.2. The antioxidant activity assays indicated that 5.0 mg/mL ASP-1 has significant scavenging effects on superoxide radicals (86.2%) compared to the positive control of ascorbic acid (95.6%).

Effects of early-cleavage embryo transfer on in vitro fertilization-embryo transfer pregnancy outcomes.

PURPOSE: To observe the effects of early-cleavage embryo transfer (ET) on pregnancy outcomes in vitro fertilization-embryo transfer (IVF-ET). MATERIALS AND METHODS: The data of 6,548 two pro-nucleate (2PN) embryos and 968 patients who underwent IVF or intracytoplasmic sperm injection (ICSI) were analyzed. Of the 968 cycles, early-cleavage embryos were used in 432 cycles (early-cleavage group), late-cleavage embryos were used in 246 cycles (late-cleavage group), and both early and late-cleavage embryos were used in 290 cycles (mixed group). RESULTS: High-quality embryo rate was significantly higher in early-cleavage group than in late-cleavage group (82.74% vs 59.83%; p < 0.01). Both clinical pregnancy and implantation rates in IVF or ICSI were significantly higher in early-cleavage group than in late-cleavage group (all p < 0.01). In ICSI, both clinical pregnancy and implantation rates were significantly higher in mixed group than in late-cleavage group (all p < 0.05). CONCLUSION: Early-cleavage ET can improve pregnancy outcomes in IVF or ICSI.