Epidemiological characteristics of COVID-19 patients in convalescence period.

This study aimed to investigate the clinical characteristics and to analyse the epidemiological features of coronavirus disease 2019 (COVID-19) patients during convalescence. In this study, we enrolled 71 confirmed cases of COVID-19 who were discharged from hospital and transferred to isolation wards from 6 February to 26 March 2020. They were all employees of Zhongnan Hospital of Wuhan University or their family members of which three cases were <18 years of age. Clinical data were collected and analysed statistically. Forty-one cases (41/71, 57.7%) comprised medical faculty, young and middle-aged patients (aged ⩽60 years) accounted for 81.7% (58/71). The average isolation time period for all adult patients was 13.8 ± 6.1 days. During convalescence, RNA detection results of 35.2% patients (25/71) turned from negative to positive. The longest RNA reversed phase time was 7 days. In all, 52.9% of adult patients (36/68) had no obvious clinical symptoms, and the remaining ones had mild and non-specific clinical symptoms (e.g. cough, sputum, sore throat, disorders of the gastrointestinal tract etc.). Chest CT signs in 89.7% of adult patients (61/68) gradually improved, and in the others, the lesions were eventually absorbed and improved after short-term repeated progression. The main chest CT manifestations of adult patients were normal, GGO or fibre streak shadow, and six patients (8.8%) had extrapulmonary manifestations, but there was no significant correlation with RNA detection results (r = -0.008, P > 0.05). The drug treatment was mainly symptomatic support therapy, and antibiotics and antiviral drugs were ineffective. It is necessary to re-evaluate the isolation time and standard to terminate isolation for discharged COVID-19 patients.

Spectrum and features of congenital heart disease in Xi'an, China as detected using fetal echocardiography.

This study aimed to investigate the spectrum and features of congenital heart disease (CHD) in Xi'an, China using fetal echocardiography. All pregnant women referred for fetal echocardiography underwent a systematic fetal echocardiographic examination. Each case of complex defects was diagnosed according to the predominant pathophysiology, and the overall frequency of each defect was recorded and classified according to its location in the fetal heart. CHD was diagnosed in 195 fetuses. The top 5 types of CHD were, in order, single ventricle (15.9%, 31/195), atrioventricular septal defect (12.3%, 24/195), ventricular septal defect (VSD) (11.8%, 23/195), tetralogy of Fallot (10.8%, 21/195), and double-outlet right ventricle (8.2%, 16/195). The 195 cases of CHD comprised 316 defects in total. The most common defect was ventricular malformation (40.5%, 128/316), followed by great artery anomalies (38.0%, 120/316), endocardial cushion abnormalities (11.7%, 37/316), atrial abnormalities (6.6%, 21/316), and semilunar valve abnormalities (3.2%, 10/316). VSD accounted for the largest proportion (24.4%, 77/316) of the ventricular malformations. The total proportion of obstructive lesions in this group was much higher for the right than for the left side of the heart (18.4% (58/316) vs 9.5% (30/316), respectively). The spectrum of fetal CHD detected by echocardiography was much different compared to that accepted in the past. Complex defects were more common prenatally. Ventricular malformations were the largest constituent of all of the defects associated with fetal CHD, and VSD was the most common component of complex defects. Chinese fetal CHD encompassed more right-sided than left-sided obstructive lesions.

Lack of an association between the XRCC1 Arg399Gln polymorphism and gastric cancer based on a meta-analysis.

Association between the XRCC1 Arg399Gln polymorphism and susceptibility to gastric cancer has been investigated; overall, the results have been inconclusive. We made a meta-analysis of 13 case-control studies, including 3278 cases and 6243 controls. Crude odds ratios (OR) with 95% confidence intervals (95%CI) were used to assess this possible association. We found no evidence of a significant association between the XRCC1 Arg399Gln polymorphism and gastric cancer risk (in the additive inheritance model, OR = 0.986, 95%CI = 0.831-1.156, in the dominant inheritance model, OR = 1.044, 95%CI = 0.890-1.224 and in the recessive inheritance model, OR = 0.975, 95%CI = 0.894-1.063). We conclude that the XRCC1 Arg399Gln polymorphism is not a risk factor for developing gastric cancer.

[Epidemiological analysis of pathogens causing bloodstream infections in department of hematology in Guangdong Province].

Objective: To evaluate the epidemiology of bacterial bloodstream infections in patients submitted to hematologic wards in southern China. Methods: A total of 50 teaching hospitals were involved based on the China Antimicrobial Resistance Surveillance System. The data of clinical isolates from blood samples were collected from January 1, 2019, to December 31, 2019. Antimicrobial susceptibility testing was conducted by the Kirby-Bauer automated systems, and the results were interpreted using the CLSI criteria. Results: The data of 1,618 strains isolated from hematologic wards in 2019 were analyzed, of which gram-negative bacilli and gram-positive cocci accounted for 71.8% and 28.2%, respectively. Of those, the five major species were most often isolated, including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, coagulase-negative staphylococcus, and Streptococcus viridans. The prevalence rates of methicillin-resistant strains in Staphylococcus aureus and coagulase-negative staphylococcus were 19.7% and 80.6%, respectively. No gram-positive cocci were resistant to vancomycin, linezolid, and teicoplanin, and none of the enterococci were resistant to linezolid. The resistance rate of S. viridans to penicillin G was 6.9%, and those to ceftriaxone and cefotaxime were more than 25%. The resistance rate of E. coli and K. pneumoniae in Enterobacteriaceae was higher in children than that in adults. The resistance rate of K. pneumoniae to meropenem was 14.1%. The resistant rate of Enterobacter cloacae to carbapenem was more than 25%. P. aeruginosa was more sensitive to more antibiotics than 80%, but the resistance rate to meropenem in children was higher than that in adults (11.8% vs. 6.5%). The proportion of gram-positive cocci in the ICU and respiratory departments was higher than that in the hematology department. The detection rates of carbapenem-resistant E. coli and K. pneumoniae in the respiratory department were the lowest with 0.3% and 3.7%, respectively, while those of CRPA and CRAB in the hematology department were the lowest with 8.3% and 25.8%, respectively. The detection rate of all carbapenem-resistant organisms in the ICU was the highest among the three departments. Conclusion: The etiology and drug resistance of bacteria from blood samples in the hematology department are different from those in the ICU and respiratory departments. The proportions of K. pneumoniae, P. aeruginosa, E. cloacae, and S. viridans dominating in the department of Hematology were significantly higher than those in the ICU and respiratory departments in Guangdong region.

Fluorescence decay kinetics of pyrene in membrane vesicles.

The fluorescence decay kinetics of pyrene incorporated into artificial and natural membrane vesicles has been studied by pulse fluorimetry. The emission of monomeric pyrene and its excimer embedded in sonicated liposomes prepared from dipalmitoylphosphatidylcholine and a mixture of this phospholipid and dipalmitoylphosphatidylserine follows a multiple exponential decay law at temperatures both below and above their thermal transitions (10--48 degrees C). When pyrene is incorporated into fragmented skeletal sarcoplasmic reticulum vesicles, the emission decay exhibits similar multiple exponential character. The decay of the monomer in the phospholipid vesicles can be adequately described by three exponential terms. The experimental decays observed with both types of vesicles deviate significantly from a previously proposed model in which departure of the decay of pyrene monomer from monoexponentiality is qualitatively related to a time dependence in the diffuslipid vesicles can be adequately described by three exponential terms. The experimental decays observed with both types of vesicles deviate significantly from a previously proposed model in which departure of the decay of pyrene monomer from monoexponentiality is qualitatively related to a time dependence in the diffuslipid vesicles can be adequately described by three exponential terms. The experimental decays observed with both types of vesicles deviate significantly from a previously proposed model in which departure of the decay of pyrene monomer from monoexponentiality is qualitatively related to a time dependence in the diffusion-controlled formation of excimers from ground state and excited monomers. It is suggested that the observed decays are compatible with a reaction scheme involving excited state interaction.

Home care expenses for the disabled elderly.

This article presents descriptive statistics from the 1982 Long-Term Care Survey on noninstitutionalized elderly Americans with limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL). The focus of this article is on private expenses for home-based care related to ADL and IADL limitations. We describe the amounts of out-of-pocket payments expended relative to the characteristics of the home-based, disabled elderly population. We also discuss several possible implications of the findings for policymakers and further research.

[Pharmacokinetic studies on actinodaphine hydrochloride in rabbits by UV secondary derivative spectroscopy].

A specific method of analysis for actinodaphine HCl in plasma by UV secondary spectroscopy was established. The actinodaphine in plasma was extracted with chloroform, then the combined extracts were evaporated to dryness under room temperature. The residue was dissolved in 5 ml of 95% ethanol and the secondary derivative spectra was measured at wavelength of 400 nm to 240 nm Select their 316 nm and 330 nm as analytical wavelength. The D values of the derivative amplitude were measured with peak-peak method between 316 nm and 330 nm. The standard curve was linear over 0.5-20 micrograms/ml. The average recovery was 97.6 +/- 5.5%, the coefficient of variation was 5.64%. After intravenous administration of 10 mg/kg, the plasma concentration vs time data were fitted to curves employing a non-linear method based on a simple method in optimization theory. The statistical comparison (r2, F-test and AIC) of fits of one and two compartment model to plasma concentration time data indicated that the data would be described best by an open two compartment model. The pharmacokinetic parameters (mean +/- SD) were T1/2 (alpha), 0.705 +/- 0.142 min; T1/2 (beta), 17.869 +/- 5.383 min; K21, 0.292 +/- 0.035 min-1; K10, 0.145 +/- 0.054 min-1; K12, 0.621 +/- 0.153 min-1; Vc, 0.152 +/- 0.029 L/kg; Vp, 0.367 +/- 0.045 L/kg; Vd, 0.518 +/- 0.062 L/kg; Clr, 0.021 +/- 0.004 ml/kg; AUC, 492.263 +/- 101.574 micrograms.min.ml-1. These results show that actinodaphine HCl is distributed and eliminated rather rapidly without marked accumulation and the distribution is mainly in the blood.

[Determination of nodakenin in Peucedanum].

OBJECTIVE: To establish a HPLC method to determine the contents of nodakenin in Peucedanum. METHOD: The determination method was achieved by RP-HPLC on an ODS column by UV detection at 334 nm; with nodakenin as external standard and H2O-CH3OH-CH3CN(75:5:20) as mobile phase. RESULT: Several samples of 6 species of Peucedanum were analyzed by this method. The contents of nodakenin ranged from 0.005%-3.090%. CONCLUSION: Nodakenin cannot be used to control the quality of Peucedanum for pharmaceutical use, but this method is a simple and feasible way to control the quality of P. decursivum.

Distance between nucleotide site and cysteine-373 of G-actin by resonance energy transfer measurements.

The distance between the nucleotide site and the reactive cysteine-373 of G-actin was determined from resonance energy transfer measurements by using 1,N6-ethenoadenosine triphosphate (epsilon ATP) as the donor and 4-[N-(iodoacetoxy)ethyl N methyl]amino 7 nitrobenz 2 oxa 1,3 diazole covalently attached to the sulphydryl group as acceptor. The quenching of the lifetime of bound donor in the presence of attached acceptor arose predominantly from transfer of excitation energy. The polarization spectrum of free epilson ATP in glycerol revealed that the minimum value of its fundamental anisotropy is 0.32 at 340 nm, indicating that the maximum value of the angle between the absorption and emission dipoles of the ethenoadenosine moiety is 21 degrees. The polarization result indicates that the bound nucleotide is depolarized and has considerable motional freedom. This motion is restricted and unlikely to be rapid or isotropic during the time interval of energy transfer. The attached acceptor is highly immobile, however. The range of the donor-acceptor distance is 24-45 A. This range was not affected by polymerization. In the absence of independent structural information it is not possible to assign a single value to the donor-acceptor separation.

Nanosecond fluorescence spectroscopy of human immunoglobulin A.

The solution properties of five samples of human immunoglobulin A (IgA) were investigated with covalent and hydrophobic fluorescence probes. The immunoglobulins included a secretory IgA and four myeloma proteins of both IgA1 and IgA2 subclasses in the monomeric and dimeric forms. The probe 8-anilinonaphthalene-1-sulfonate (ANS) was found to bind to both monomeric and dimeric IgA with comparable affinity. Pyrenesulfonyl chloride covalently linked to the proteins exhibited multiexponential decays. The decay of ANS complexed to the same proteins showed similar multiple exponential character. The rotational motions of the immunoglobulins were investigated by the nanosecond fluorescence anisotropy decay method. The decay of both probes attached to these proteins was characterized by a fast component followed by a slow component. The rapid component was in the range 14-26 ns for th covalent conjugates and 26-41 ns for the ANS complexes. These results are interpreted in terms of a segmental motion arising from a mass in the range 60 000-100 000 daltons, If the decrease in the anisotropy value at long times is taken as a measure of restricted diffusion of the mobile fragment, the half-angle of a cone within which the fragment traverses may provide a qualitative measure of the extent of flexibility. By this criterion, monomeric and dimeric IgA's of the same subclass appear to be qualitatively similar in flexibility.

Morbidity, disability, and long-term care of the elderly: implications for insurance financing.

A scarcity of empirical information to specify appropriate provisions and base rates for coverage has hindered the development of long-term-care (LTC) insurance. Data from three nationally representative surveys on the prevalence of morbidity and functional limitations among the elderly population suggest that health status among older Americans is highly dynamic, especially at higher disability levels. The bioactuarial data may help insurers define potential markets of purchasers of policies, and identify the numbers of persons with disabilities severe enough to trigger use of benefits. If the accuracy of individual service predictions could be increased further, reserve requirements and overall costs to LTC insurance carriers might be reduced.

The properties of immune complex-forming systems. A new theoretical approach.

A new mathematical model for antigen-antibody interactions has been developed. The new model is based on the assumption that the formation of complexes between a bivalent antibody and a multivalent antigen is determined thermodynamically by the concentrations and valences of antigen as well as antibody, together with one association constant which is common to all mutual interactions. Formulae have been derived for calculation of the distributions of compositionally different antigen-antibody complexes either from knowledge of equilibrium concentrations of free antigen and antibody, or from knowledge of total amounts of antigen and antibody in the system. A computer program for these calculation is described. The model is found to yield precise predictions of the formation of soluble immune complexes, as studied by zonal centrifugation. It is found through use of the model that 'complex formation' as such differs in binding characteristics from adsorption, especially for high concentrations of antigens and antibodies. 'Complex formation' implies that association constants estimated through a Sips plot method will vary with antibody concentration, and that certain curvatures of the lines in a Sips plot reflect inherent properties of complex-forming systems.

Influential factors affecting prognosis of snakebite patients management: Kaohsiung Chang Gung Memorial Hospital experience.

BACKGROUND: The objective of this study was to determine the most influential factors affecting the prognosis of snakebite patients in Kaohsiung Chang Gung Memorial Hospital. METHODS: A thorough review of the medical records of poisonous snakebite from June 1986 to November 1999 was carried out in this retrospective study. RESULTS: Of the identified snakes in 39 bite victims, 70% of these cases were hemorrhagic type: Trimeresurus stejnegeri 20/27, T. mucrosquamatus 6/27, and Agkistrodon acutus 1/27; 28% were neurotoxic type: Naja naja atra 6/11 and Bungarus multicinctus 5/11; and 2% was mixed type: Vipera russelli formosensis 1/39. Three of four acute renal failure victims were bitten by T. mucrosquamatus. Two of the 5 victims bitten by B. multicinctus required endotracheal intubation to maintain their respiration. Five patients received skin grafting, 3 of whom were bitten by Naja naja atra. Most of our patients (55%) received only a single dose of antivenin, and 83% (29/35) of the antivenin was given within 6 hours after the bite; the antivenin infusion was finished in less than 2 hours in most cases (33/36). CONCLUSION: Bites from Trimeresurus stejnegeri are the most common poisonous snakebite recorded in our emergency department. T. mucrosquamatus is prominent in causing bleeding tendency and acute renal failure. Bungarus multicinctus is more prominent than Naja naja atra in causing acute respiratory failure. The dosage of antivenin used to treat patient bitten by cobra was less than that recommended by the poison control center, and the complication of skin necrosis requiring skin grafting was more severe than that of the other species.

Health statistics on older persons United States, 1986.

The National Center for Health Statistics (NCHS) collects data on the health of older persons through numerous data systems. The Vital Statistics Program and the National Health and Nutrition Examination Survey (NHANES) are examples. This report contains statistics from the data systems covering four general areas-mortality, other measures of health status and determinants of health, use of health care, and health costs . The structure of this report is patterned after the annual publication Health, United States, with detailed tables and accompanying text. Where data permit, the tables contain age, sex, and race categorizations including the age group 85 years and over as well as aggregated data for persons aged 65 years and over and 75 years and over. For comparison purposes, the tables also include data concerning the transition age group 55-64 years of age.