Twelve-month specific IgG response to SARS-CoV-2 receptor-binding domain among COVID-19 convalescent plasma donors in Wuhan

To investigate the duration of humoral immune response in convalescent coronavirus disease 2019 (COVID-19) patients, we conduct a 12-month longitudinal study through collecting a total of 1,782 plasma samples from 869 convalescent plasma donors in Wuhan, China and test specific antibody responses. The results show that positive rate of IgG antibody against receptor-binding domain of spike protein (RBD-IgG) to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the COVID-19 convalescent plasma donors exceeded 70% for 12 months post diagnosis. The level of RBD-IgG decreases with time, with the titer stabilizing at 64.3% of the initial level by the 9th month. Moreover, male plasma donors produce more RBD-IgG than female, and age of the patients positively correlates with the RBD-IgG titer. A strong positive correlation between RBD-IgG and neutralizing antibody titers is also identified. These results facilitate our understanding of SARS-CoV-2-induced immune memory to promote vaccine and therapy development.

The feasibility of convalescent plasma therapy in severe COVID-19 patients: a pilot study

Currently, there are no approved specific antiviral agents for 2019 novel coronavirus disease (COVID-19). In this study, ten severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 days after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 days. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 days. Several parameters tended to improve as compared to pre-transfusion, including increased lymphocyte counts (0.65x109/L vs. 0.76x109/L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesionswithin 7 days. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was welltolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials. Significance StatementCOVID-19 is currently a big threat to global health. However, no specific antiviral agents are available for its treatment. In this work, we explored the feasibility of convalescent plasma (CP) transfusion to rescue severe patients. The results from 10 severe adult cases showed that one dose (200 mL) of CP was welltolerated and could significantly increase or maintain the neutralizing antibodies at a high level, leading to disappearance of viremia in 7 days. Meanwhile, clinical symptoms and paraclinical criteria rapidly improved within 3 days. Radiological examination showed varying degrees of absorption of lung lesions within 7 days. These results indicate that CP can serve as a promising rescue option for severe COVID-19 while the randomized trial is warranted.

Analysis of the Distribution and Drug Resistance of Pathogenic Bacteria in Bloodstream Infection in Three Third-class Comprehensive Hospital of Zigong District / 中国药房

OBJECTIVE： To investigate the clinical distribution and drug resistance of pathogenic bacteria of bloodstream infection in Zigong area， and to provide reference for the diagnosis and treatment of bloodstream infection in the region. METHODS： The blood culture positive strains and drug susceptibility results of 3 third-class comprehensive hospital of Zigong district during Jan.-Dec. 2017 were collected. Using Escherichia coli ATCC25922， Staphylococcus aureus ATCC25923， Pseudomonas aeruginosa ATCC27853， Streptococcus pneumoniae ATCC49619 as quality control bacteria， clinical distribution and drug resistance of pathogens of bloodstream infection were analyzed by using WHONET 5.6 and SPSS 19.0 software. RESULTS： A total of 879 strains of bacteria were isolated， including 212 strains of Gram-positive bacteria （24.1％） and 667 strains of Gram-negative bacteria （75.9％）. Top 5 bacteria were E. coli （50.7％）， Klebosiella pneumoniae （10.2％）， Staphylococcus aureus （6.5％）， S. epidermidis （3.2％） and S. pneumoniae （2.6％）， respectively. The age and gender distribution of pathogenic bacteria was 88.5％ in the population over 40 years old， and the scale of male to female was 1.15 ∶ 1. Drug resistance of common Gram-positive bacteria showed that S. aureus， Coagulase negative staphylococcus， Enterococcus faecalis， Enterococcus faecium and S. pneumoniae resistant to vancomycin and linezolid were not isolated； the detection rates of MRSA and MRCN were 15.8％ and 64.2％， respectively. E. faecium was more resistant to common antibiotics than E. faecalis. Drug resistance rate of E. faecalis to penicillin and ampicillin was 0， and penicillin-resistant S. pneumoniae was not detected. The drug resistance of common Gram-negative bacteria showed that E. coli and K. pneumoniae resistant to ertapenem were not isolated. The drug resistance of two bacteria to amikacin， cefotetan， cefepime， piperacillin/tazobactam and imipenem were lower （＜10％）， among which the detection rates of ESBLs-producing stain were 42.2％ and 24.4％； detection rate of ESBLs-producing stain to common antibiotics was higher than that of non-producing ESBLs stain. The resistance of Acinetobacter baumannii was higher than that of P. aeruginosa to common antibiotics， and the resistant rates to imipenem were 68.8％ and 13.6％， respectively. And amikacin-resistant or tobramycin-resistant P. aeruginosa were not isolated. CONCLUSIONS： The bloodstream infection is mainly caused by Enterobacteriaceae in Zigong area， and the drug resistance of A. baumannii is serious. It is necessary to strengthen the hospital infection control and management.

Efficacy of Nutritioned Intervention with Nutritional Suspensions in Patients with Severe Stroke / 中国药师

Objective:To observe the efficacy of enteral nutritional suspensions in the patients with severe stroke. Methods:To-tally 823 cases of severe stroke patients were divided into the observation group and the control group according to the visiting se-quence. The 423 cases in the observation group were treated with enteral nutritional suspensions, while another 400 patients in the con-trol group were given the home-made meals with nasal feeding, and relative routine treatment was given the patients according to the disease type in the two groups. Before and after the treatment, serum total protein ( TB) , hemoglobin ( HB) , serum albumin ( ALB) and TG of the two groups were recorded, neurological deficit scores ( NIHSS) , Barthel index, muscle recovery and complications were also studied and compared. Results:After the treatment, TB, HB, ALB and TG of the two groups were significantly decreased ( P0. 05). Conclusion: Enteral nutritional suspensions can improve the nutritional status of the pa-tients with severe stroke with fewer complications and better safety, which are worthy of clinical application.

Analgesic effect of dexmedetomidine versus propofol on patients with coronary heart disease undergoing noncardiac surgery / 中华老年医学杂志

Objective To compare the analgesic effect of dexmedetomidine and propofol on patients with coronary heart disease undergoing noncardiac surgery.Methods 86 patients in our hospital from Sep 2009 to Sep 2011 aged 55-76 years weighing 42-60 kg,who were scheduled for epidural anesthesia in routine,were randomly assigned to 2 groups:dexmedtomidine (Dex) group and propofol group (n=43,each).Visual analogue scale/score (VAS) analgesia score and ramsay sedation score were used to observe the analgesic effect after surgery.Serum concentration of cortisol,insulin and glucose were observed and compared between Dex and propofol group before and 4,24,48h after surgery.Patient satisfaction was surveyed.Results The analgesic effect evaluated by VAS and Ramsay scores was better in Dex group than in propofol group at different time after surgery (t=5.368,2.262,7.147,5.881,7.861,4.810,all P＜0.05).Serum concentrations of cortisol,insulin and glucose were lower in Dex group than in propofol group before and 4,24,48 h after surgery (t=3.076,2.042,4.090,all P＜0.05).The satisfaction rate was 93.0％ (40/43) in Dex group.Conclusions Dexmedetomidine has a better analgesic effect than propofol,and it is safe and feasible for patients with coronary heart disease undergoing noncardiac surgery.

Curative Effect of Implantation of AMS Three-piece Inflatable Penile Prosthesis on Severe Erectile Dysfunction / 昆明医科大学学报

Objective To observe the clinical efficacy of AMS three- piece inflatable penile prosthesis on erectile dysfunction (ED).Methods From Dec 2008 to Sep 2012, 7 patiens with of serve erectile dysfunction (ED),whose ages were 28~55 years (average 47 years) were implanted with AMS three- piece inflatable penile prosthesis in our hospital. The 7 patients with serve erectile dysfunction included 3 patients with neurogenic ED,2 patients with arteriovenous fistula in corpus cavernosum penis and 2 patients with fibrosis of corpus cavernosum penis. Results All of the patients were performed smoothly with implantation of AMS three- piece inflatable penile prosthesis, among them 3 cases appeared foreskin edema, but it disappeared after 2 weeks. After 6~36 months (average 18 months) follow up, there was no rejection, no implant failure, and no urethral injury in our group, all patients got satisfaction on sexual life, and one patient with arteriovenous fistula in corpus cavernosum penis after treatment made his wife pregnant. Conclusion AMS three- piece inflatable penile prosthesis is close to human physiological penis, it has good concealment, less surgical trauma , high success rate, satisfying clinical efficacy, safe and reliable mechanical behavior.

Clinical Research on Treatment of Oligospermia and Asthenospermia with Guiqishengjing Capsule / 昆明医科大学学报

Objective To observe the clinical efficacy of Guiqi shengjing capsule on infertility caused by oligospermia and asthenospermia. Methods All of 126 oligospermia and asthenospermia outpatients in theDepartment of Andrology from Sep 2011 to Dec 2012 were divided into 2 groups randomly:experimental group and control group (63 patients in each group), which were taken Guiqishengjing capsule and Huangjing zanyu capsule respectively, with a course of 3 months. Then we observed and compared the clinical efficacy and semen parameters of the patients in the 2 groups before and after treatment. Results There was no significant differences in semen parameters between two groups before treatment ( >0.05) .And also there was no significant differences in total clinical effective rate and semen parameters between two groups after treatment ( >0.05) .But, the extremely significant difference presented in sperm activity and density before and after treatment in two groups (<0.01) . Conclusion Guiqishengjing capsule can promote spermatogenesis, improve sperm quality, and has definite effect on oligospermia and asthenospermia in infertility .

Spectral entropy monitoring reduces anesthetic dosage for patients undergoing off-pump coronary artery bypass graft surgery.

OBJECTIVES: The measurement of the depth of anesthesia is of clinical interest for patients undergoing off-pump coronary artery bypass graft (OPCAB) surgery in order to avoid intraoperative awareness and cardiac depression. Entropy recently was introduced as a monitor of anesthetic depth. This study was conducted to investigate the feasibility of entropy monitoring during the conduct of OPCAB surgery and to find out whether it reduced the anesthetic dosage for patients undergoing OPCAB surgery. DESIGN: A prospective, randomized, single-blind, controlled study. SETTING: A teaching hospital. PARTICIPANTS: Seventy patients scheduled for OPCAB surgery were randomized to receive propofol-sufentanil anesthesia either with the entropy values visible (the entropy group, n = 35) or without the entropy values visible (the control group, n = 35). INTERVENTIONS: In the entropy group, propofol and sufentanil infusion rates were titrated to maintain a state entropy (SE) value of 45 to 55 and a response entropy (RE)-SE difference below 10 U. In the control group, patients were anesthetized to keep the heart rate and blood pressure within 25% of the baseline values. MEASUREMENTS AND MAIN RESULTS: The course of surgery, the consumption of anesthetics, and intraoperative recall were recorded. Plasma levels of adrenocorticotropic hormone (ACTH) and cortisol were measured. The average SE during anesthesia was 50 ± 5 in the entropy group; the entropy values were lower in the control group (p < 0.05). Compared with the control group, propofol and sufentanil consumption were significantly less in the entropy group, which shortened the time to tracheal extubation (p < 0.05). Significantly, patients in the control group needed more phenylephrine to maintain arterial pressure than patients in the entropy group (p < 0.05). ACTH and cortisol release were prevented completely, and there was no intraoperative recall reported in the 2 groups. CONCLUSIONS: Entropy monitoring reduced propofol and sufentanil dosage for patients undergoing OPCAB surgery.

Rectal probe electroejacnlation / 中华泌尿外科杂志

Objective To search a new,safe and effective method to obtain semen using rectal Drobe electroejaculation(RPE).Methods RPE procedures were performed in 8 men with psychological ejaculatory failure,used the electrical stimulate instrument(CGS model,made in Italy).The average age was 26 years.Seminal vesicle was normal by B Uhrasonography or CT examination.Except for 1 case of diabetes,the other 7 cases found no hormones,blood,biochemical and nervous system abnormalities.Three cases had nocturnal emission,but no sexual intercourse ejaculation.Results Adequate sperm was successfully taken out from the 8 patients.Mean seminal fluid volume was 2.3 ml,mean total sperm count was 67×106/ml and mean total motile sperm was 21.3%.Three patients felt abdominal distension during the RPE course.Conclusion RPE is a safe,reliable,non-in-vasive,repeatable method to obtain semen.

?-Lactamase Genes and Virulence Genes in Escherichia coli Isolated from Old Patients / 中华医院感染学杂志

OBJECTIVE To investigate the ?-lactamase genes and virulence gene in Escherichia coli isolated from the old patients.METHODS Twenty strains of E. coli were selected to test 15 kinds of ?-lactamase genes (TEM,SHV,CTX-M-1 group,CTX-M-2 group,CTX-M-9 group,OXA-1 group,OXA-2 group,OXA-10 group,PER,GES,VEB/CEF,CARB,DHA,ACT/MIR and LAT/CMY) and two virulence genes (CNF-1 and CNF-2).RESULTS Six ?-lactamase genes and one virulence gene have been found out from these 20 strains of E. coli. The results showed that there were 14,3,1,5,2,2 and 1 strain which carried TEM,SHV,CTX-M-1 group,OXA-1 group,DHA,ACT/MIR and CNF-1,respectively. These 20 E. coli strains contained at least 1 ?-lactamase gene and 7 E. coli strains were found containing more than 2 kinds of ?-lactamase at the same time.CONCLUSIONS The resistance of these 20 E. coli strains to ?-lactam antibiotics is closely relative to ?-lactamase.