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.

Paying close attention to diabetic patients with novel coronavirus infection / 中华内分泌代谢杂志

A major infectious disease associated with severe acute respiratory syndrome coronavirus 2 (2019-nCoV)has emerged in Wuhan, China. Current clinical studies have shown that diabetes is commonly complicated with this disorder. Hyperglycemia is a risk factor for severe infection, and also an independent risk factor for the progression of mild infection to severe infection. This may be related to the immune deficiency of diabetics. Besides, virus may cause direct damage to the islets and induce acute stress hyperglycemia. Special attention should be payed to diabetics with 2019-nCoV infection. Systemic steroid hormones should be used with particular caution in patients with 2019-nCoV infection, especially those with diabetes.

Paying close attention to diabetic patients with novel coronavirus infection / 中华内分泌代谢杂志

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major infectious disease. Current clinical studies have shown that diabetes is commonly complicated with this disorder. Hyperglycemia is a risk factor for severe infection, and also an independent risk factor for the progression of mild infection to severe ones. This may be related to the immune deficiency of diabetics. Besides, virus may cause direct damage to the islets and induce acute stress hyperglycemia. Special attention should be paid to the diabetics with SARS-CoV-2 infection. Systemic steroid hormones should be used with particular caution in patients with SARS-CoV-2 infection, especially those with diabetes.

Angioimmunoblastic T-cell lymphoma: histopathological grading and prognosis / 中华病理学杂志

Objective@#To investigate the histological features and prognostic factors of angioimmunoblastic T-cell lymphoma (AITL).@*Methods@#The pathological data of 62 patients with AITL with complete follow-up information were retrospectively collected and analyzed from Changhai Hospital during September 2012 and September 2017. Histological and immunohistochemical (IHC) examination, in situ hybridization (ISH), and single nucleotide polymorphisms (SNP) gene mutation analysis were done. Subgroup evaluation with histology, IHC, ISH, SNP gene mutation, and association with clinical progression were performed.@*Results@#The cohort included 62 cases of AITL, including 46 males and 16 females patients, with a median age of 64 years. Follicular dendritic cells (FDC) area showed significantly expansion (≥30%) in 40 cases; increased plasma cells (≥10%) was seen in 37 cases; B cells were distributed around blood vessels in 37 cases; and increased p53 mutation positive cells (≥40%) were seen in 39 cases; high Ki-67 index (≥40%) was seen in 39 cases; RHOA mutation was seen in 19 cases; TET2 mutation was seen in 9 cases. Overall survival analysis showed these factors were significantly correlated with tumor prognosis (P<0.05). Multivariate analysis showed that CD38 positive cells<10%, Ki-67≥40%, RHOA and TET2 mutations were risk factors associated with overall survival.@*Conclusions@#AITL could be divided into two different prognostic groups, low-grade and high-grade, with statistically significance outcome, based on the FDC area expansion, degree of plasma cell proliferation, B cells distribution pattern combined with gene mutations and clinical progression. Low-grade malignant group progresses slowly, and high-grade malignant group is highly invasive.

Clinical Research of Compound Changpu Yizhi Decoction Combined with Nimodipine in the Treatment of Mild Cognitive Impairment after Stroke / 中国药房

OBJECTIVE:To investigate the effects of Compound changpu yizhi decoction combined with nimodipine on clini-cal symptoms,cognitive function and cerebral blood flow velocity of patients with mild cognitive impairment(MCI)after stroke, and its medication safety. METHODS:84 MCI patients after stroke in our hospital from Feb. 2012 to Oct. 2014 were selected as re-search objects and randomly divided into observation group and control group,42 cases in each group. All patients received basic preventive treatment;control group was additionally given Nimodipine tablet 30 mg,tid,po;based on it,observation group was given Compound changpu yizhi decoction,one dose a day,taking with warm water every morning and evening. They were treated for 3 months. Clinical symptoms of patients were compared by vascular dementia TCM syndrome table before and after treatment, mini-mental state examination(MMSE)was used to compare the cognitive function of patients before and after treatment,cerebral blood flow velocity before and after treatment and incidence of adverse reactions in 2 groups were compared. RESULTS:Before treatment,there was no statistical significance in clinical symptom scores,cognitive function score and blood flow velocity of main artery between 2 groups(P>0.05). Clinical symptom scores of 2 groups were decreased significantly,while cognitive function and cerebral blood flow velocity were increased significantly;there was statistical significance,compared to before treatment (P0.05). CONCLUSIONS:Compound changpu yi-zhi decoction combined with nimodipine helps to relieve clinical symptoms of MCI patients after stroke,improve cerebral blood circulation and cognitive function,with good safety.

Clinicopathological significance and expression of Numb and α-catenin in gastric carcinoma / 国际肿瘤学杂志

Objective To detect the expressions of Numb and α-catenin in the gastric cancer and matched normal gastric mucosa,and to analyze their relationship with clinicopathological factors of gastric cancer and explore their roles in gastric carcinogenesis and progression.Methods Immunohistochemical method was used to detect the expressions of Numb and α-catenin in 109 cases of tumor specimens and 97 cases of matched normal gastric mucosa.The correlations between Numb,α-catenin and clinicopathological factors were analyzed.Results The positive rates of Numb and α-catenin in gastric cancer were significantly lower than those in normal gastric mucosa (60.6％ ∶ 100.0％,x2 =48.361,P =0.000;76.1％ ∶ 100.0％,x2 =26.480,P=0.000).The expression of Numb protein was correlated with Lauren type (x2 =17.018,P =0.000) and tubular adenocarcinoma differentiation (x2 =17.586,P =0.000).The expression of α-catenin protein was correlated with Borrmann type (x2 =6.700,P =0.035),Lauren type (x2 =11.098,P =0.001),tubular adenocarcinoma differentiation (x2 =8.203,P =0.017) and lymph node metastasis (x2 =6.402,P =0.011).The expressions of Numb and α-catenin were statistically correlated in 109 cases of gastric cancer (rk =0.184,P =0.028).Conclusion Compared with normal gastric mucosa,both Numb and α-catenin expressions are down-regulated and the two expressions are correlated in gastric cancer.Numb and α-catenin may be involved in the regulation of histological differentiation of gastric cancer by certain passages,Numb protein may be adjusted by α-catenin pathway which is involved in Wnt-β-catenin pathway,and thus plays an important role in promoting cell proliferation,invasion and metastasis in human gastric cancer.