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2019 novel coronavirus outbreak: a quiz or final exam?

Jiuyang Xu, Yijun Chen, Hao Chen, Bin Cao

《医学前沿（英文）》 2020年 第14卷 第2期   页码 225-228 doi: 10.1007/s11684-020-0753-1

摘要： The 2019 novel coronavirus (2019-nCoV) is an emerging pathogen and is threatening the global health. Strikingly, more than 28 000 cases and 550 deaths have been reported within two months from disease emergence. Armed with experience from previous epidemics in the last two decades, clinicians, scientists, officials, and citizens in China are all contributing to the prevention of further 2019-nCoV transmission. Efficient preliminary work has enabled us to understand the basic characteristics of 2019-nCoV, but there are still many unanswered questions. It is too early now to judge our performance in this outbreak. Continuous and strengthened efforts should be made not only during the epidemic, but also afterwards in order to prepare for any incoming challenges.

关键词： 2019-nCoV     novel coronavirus     epidemic     public response    

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China’s local governments are combating COVID-19 with unprecedented responses – from a Wenzhou governance perspective

Fanghua Gong, Yong Xiong, Jian Xiao, Li Lin, Xiaodong Liu, Dezhong Wang, Xiaokun Li

《医学前沿（英文）》 2020年 第14卷 第2期   页码 220-224 doi: 10.1007/s11684-020-0755-z

摘要： The COVID-19 caused by a novel strain of coronavirus has been spreading rapidly since its onset in Wuhan, the capital city of central China’s Hubei Province, in December 2019. It is highly communicable through human-to-human transmission. China has been making unprecedented efforts in treating the confirmed cases, identifying and isolating their close contacts and suspected cases to control the source of infection and cut the route of transmission. China’s devotion in handling this epidemic has effectively and efficiently curbed communication domestically and across the border. Representative measures adopted by Wenzhou, the worst hit city out of Hubei Province, are examined to elucidate those massive undertakings with the aim of enhancing international understanding and building global rapport in fighting this evolving epidemic situation.

关键词： COVID-19     novel coronavirus pneumonia     2019-nCoV     epidemic management    

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利用深度学习系统筛查新冠病毒肺炎 Article

徐小微, 蒋贤高, 马春莲, 杜鹏, 李旭坤, 吕双志, 俞亮, 倪勤, 陈燕飞, 苏俊威, 郎观晶, 李永涛, 赵宏, 刘俊, 徐凯进, 阮凌翔, 盛吉芳, 裘云庆, 吴炜, 梁廷波, 李兰娟

《工程（英文）》 2020年 第6卷 第10期   页码 1122-1129 doi: 10.1016/j.eng.2020.04.010

摘要：

实时逆转录聚合酶链反应（RT-PCR）检测早期新冠病毒肺炎（COVID-19）患者的痰液或鼻咽拭子中的病毒RNA阳性率较低。同时，COVID-19的计算机断层扫描（CT）影像学的临床表现有其自身的特点，不同于甲型流感病毒性肺炎（IAVP）等其他类型的病毒性肺炎。本研究旨在应用深度学习技术，建立COVID-19、IAVP及健康人群肺部CT的早期筛查模型。本研究共采集618份CT样本，其中219份样本来自110例COVID-19患者（平均年龄50岁，其中男性63例，占57.3%），224份样本来自224例IAVP患者（平均年龄61岁，其中男性156例，占69.6%），175份样本来自健康人群（平均年龄39岁，其中男性97例，占55.4%）。所有CT样本均来自浙江省三家COVID-19定点收治医院。我们首先利用胸部CT图像集的三维（3D）深度学习模型分割出候选感染区域，然后利用位置敏感机制深度学习网络将这些分离的图像归类为COVID-19、IAVP以及与感染无关（ITI）的图像，并且输出相应置信度得分。最后，用Noisy-OR贝叶斯函数计算每份CT病例的感染类型及总置信度。测试数据集的实验结果表明，从整体CT病例来看，本研究利用深度学习系统建立的COVID-19患者的早期筛查模型的总体准确率为86.7%。该模型有望成为一线临床医生诊断COVID-19的一种有效的辅助方法。

关键词： COVID-19     位置敏感机制深度学习网络     计算机断层扫描    

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新冠病毒肺炎肺部超声的特点及其在病情评估中的价值——一项回顾性观察研究 Article

朱凤雪, 赵秀娟, 王天兵, 王振洲, 郭辅政, 薛海岩, 常盼盼, 梁汉生, 倪文涛, 王雅心, 陈雷, 姜保国

《工程（英文）》 2021年 第7卷 第3期   页码 367-375 doi: 10.1016/j.eng.2020.09.007

摘要：

肺部超声（lung ultrasound, LUS）在新冠病毒肺炎（简称新冠肺炎）病情严重程度评估中的价值不明确。本研究旨在探讨新冠肺炎的LUS影像学特征，并分析LUS征象与新冠肺炎疾病严重程度的关系。本研究为在同济医院进行的一项回顾性观察研究，连续入选48例新冠肺炎患者，并将其分为32例非危重患者和16例危重患者。出现症状后0~7 d、8~14 d和15~21 d进行LUS检查并记录ROX（respiratory rate oxygenation）指数、疾病严重程度和CURB-65评分。根据LUS检查方案，将肺部分为12个区域，计算LUS评分（0~36分）。出现症状后0~7 d评估胸部计算机断层扫描（computed tomography, CT）评分（0~20分）。观察LUS评分与CURB-65和ROX指数的相关性。通过LUS发现新冠肺炎患者38例。新冠肺炎的LUS征象包括B线（34/38, 89.5%）、实变（6/38,15.8%）和胸腔积液（2/38, 5.3%）。多发病变（32/38, 84.2%）和双肺病变（28/38, 73.7%）较多。与非危重患者相比，危重患者的LUS评分更高[12 (10~18) vs 2 (0~5), p < 0.001]。LUS评分与出现症状后0~7 d（r = −0.85, p  <  0.001）、8~14 d（r  =  −0.71, p  <  0.001）和15~21 d（r  =  −0.76, p  <  0.001）的ROX指数负相关。LUS评分与CT评分为正相关（r  =  0.82，p  <  0.001）。从出现症状后0~7 d到17~21 d，通过LUS发现肺部病变的病例数从27例（81.8%）减少至20例（46.5%），LUS评分从4 (2~10)分明显降至0 (0~5) 分（p  <  0.001）。因此，LUS在新冠肺炎患者中能简便、实时、安全地检测肺部病变，LUS有助于在危重患者中评估新冠肺炎的严重程度。

关键词： 新冠病毒肺炎     肺部超声     肺炎    

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Risk factors for ventilator-associated pneumonia among patients undergoing major oncological surgery

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《医学前沿（英文）》 2017年 第11卷 第2期   页码 239-246 doi: 10.1007/s11684-017-0509-8

摘要：

Patients undergoing major oncological surgery for head and neck cancer (SHNC) have a particularly high risk of nosocomial infections. We aimed to identify risk factors for ventilator-associated pneumonia (VAP) in patients undergoing SHNC. The study included 465 patients who underwent SHNC between June 2011 and June 2014. The rate of VAP, risk factors for VAP, and biological aspects of VAP were retrospectively evaluated. The incidence of VAP was 19.6% (n=95) in patients who required more than 48 h of mechanical ventilation. Staphylococcus (37.7%), Enterobacteriaceae (32.1%), Pseudomonas(20.8%), and Haemophilus (16.9%) were the major bacterial species that caused VAP. The independent risk factors for VAP were advanced age, current smoking status, chronic obstructive pulmonary disease, and a higher simplified acute physiology score system II upon admission. Tracheostomy was an independent protective factor for VAP. The median length of stay in the ICU for patients who did or did not develop VAP was 8.0 and 6.5 days, respectively (P=0.006). Mortality among patients who did or did not develop VAP was 16.8% and 8.4%, respectively (P<0.001). The potential economic impact of VAP was high because of the significantly extended duration of ventilation. A predictive regression model was developed with a sensitivity of 95.3% and a specificity of 69.4%. VAP is common in patients who are undergoing SHNC and who require more than 48 h of mechanical ventilation. Therefore, innovative preventive measures should be developed and applied in this high-risk population.

关键词： ventilator-associated pneumonia (VAP)     pneumonia     risk factors     surgery for head and neck cancer (SHNC)    

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Analysis of antibiotic usage for viral community-acquired pneumonia in adults

Rongmeng Jiang, Bing Han, Chang Dou, Fei Zhou, Bin Cao, Xingwang Li

《医学前沿（英文）》 2021年 第15卷 第1期   页码 139-143 doi: 10.1007/s11684-019-0736-2

摘要： The rationale for the antibiotic treatment of viral community-acquired pneumonia (CAP) in adults was analyzed to develop a clinical reference standard for this condition. Clinical data from 166 patients diagnosed with viral pneumonia across 14 hospitals in Beijing from November 2010 to December 2017 were collected. The indications for medications were evaluated, and the rationale for the use of antibiotics was analyzed. A total of 163 (98.3%) patients with viral pneumonia were treated with antibiotics. A combination of C-reactive protein (CRP) and procalcitonin (PCT) was used as markers to analyze the possible indications for antibiotic use. With threshold levels set at 0.25 µg/L for PCT and 20 mg/L for CRP, the rate of unreasonable use of antibiotics was 55.2%. By contrast, at a CRP level threshold of 60 mg/L, the rate of antibiotic misuse was 77.3%. A total of 39 of the 163 (23.9%) patients did not meet the guidelines for drug selection for viral CAP in adults. The unreasonable use of antibacterial drugs for the treatment of viral CAP in adults is a serious concern. Clinicians must reduce the unnecessary use of antibiotics.

关键词： adult     antibiotic     viral pneumonia    

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Proteomics study of Mycoplasma pneumoniae pneumonia reveals the Fc fragment of the IgG-binding protein

《医学前沿（英文）》 2022年 第16卷 第3期   页码 378-388 doi: 10.1007/s11684-021-0840-y

摘要： Macrolide and corticosteroid resistance has been reported in patients with Mycoplasma pneumoniae (MP) pneumonia (MPP). MP clearance is difficult to achieve through antibiotic treatment in sensitive patients with severe MPP (SMPP). SMPP in children might progress to airway remodeling and even bronchiolitis/bronchitis obliterans. Therefore, identifying serum biomarkers that indicate MPP progression and exploring new targeted drugs for SMPP treatment require urgency. In this study, serum samples were collected from patients with general MPP (GMPP) and SMPP to conduct proteomics profiling. The Fc fragment of the IgG-binding protein (FCGBP) was identified as the most promising indicator of SMPP. Biological enrichment analysis indicated uncontrolled inflammation in SMPP. ELISA results proved that the FCGBP level in patients with SMPP was substantially higher than that in patients with GMPP. Furthermore, the FCGBP levels showed a decreasing trend in patients with GMPP but the opposite trend in patients with SMPP during disease progression. Connectivity map analyses identified 25 possible targeted drugs for SMPP treatment. Among them, a mechanistic target of rapamycin kinase (mTOR) inhibitor, which is a macrolide compound and a cell proliferation inhibitor, was the most promising candidate for targeting SMPP. To our knowledge, this study was the first proteomics-based characterization of patients with SMPP and GMPP.

关键词： severe Mycoplasma pneumoniae pneumonia     children     proteomics     Fc fragment of the IgG-binding protein     mechanistic target of rapamycin kinase inhibitor    

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新冠病毒肺炎临床试验核心指标集（COS-COVID） Article

金鑫瑶, 庞博, 张俊华, 刘清泉, 杨忠奇, 封继宏, 刘学政, 张磊, 王保和, 黄宇虹, Alice Josephine Fauci, 马玉玲, Myeong Soo Lee, 元唯安, 谢雁鸣, 唐健元, 高蕊, 杜亮, 张硕, 祁寒梅, 孙宇, 郑文科, 杨丰文, 蔡慧姿, 王可仪, 欧益, 黄明, 朱彦, 喻佳洁, 田金徽, 赵敏, 胡镜清, 姚晨, 李幼平, 张伯礼

《工程（英文）》 2020年 第6卷 第10期   页码 1147-1152 doi: 10.1016/j.eng.2020.03.002

摘要：

自2019年12月新型冠状病毒肺炎（Coronavirus Disease 2019, COVID-19）暴发以来，已有大量相关临床研究完成注册或已启动。

关键词： 核心指标集     COVID-19     2019-nCoV     冠状病毒疾病     临床试验    

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Middle East respiratory syndrome coronavirus: current situation and travel-associated concerns

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《医学前沿（英文）》 2016年 第10卷 第2期   页码 111-119 doi: 10.1007/s11684-016-0446-y

摘要：

The emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012 brought back memories of the occurrence of severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002. More than 1500 MERS-CoV cases were recorded in 42 months with a case fatality rate (CFR) of 40%. Meanwhile, 8000 cases of SARS-CoV were confirmed in six months with a CFR of 10%. The clinical presentation of MERS-CoV ranges from mild and non-specific presentation to progressive and severe pneumonia. No predictive signs or symptoms exist to differentiate MERS-CoV from community-acquired pneumonia in hospitalized patients. An apparent heterogeneity was observed in transmission. Most MERS-CoV cases were secondary to large outbreaks in healthcare settings. These cases were secondary to community-acquired cases, which may also cause family outbreaks. Travel-associated MERS infection remains low. However, the virus exhibited a clear tendency to cause large outbreaks outside the Arabian Peninsula as exemplified by the outbreak in the Republic of Korea. In this review, we summarize the current knowledge about MERS-CoV and highlight travel-related issues.

关键词： coronavirus     MERS     Middle East respiratory syndrome    

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microbiota and important taxa predicting clinical prognosis in patients with severe community-acquired pneumonia

《医学前沿（英文）》 2022年 第16卷 第3期   页码 389-402 doi: 10.1007/s11684-021-0856-3

摘要： Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R2=0.033; P=0.018), followed by acute kidney injury (AKI; R2=0.032; P=0.011) and plasma MIP-1β level (R2=0.027; P=0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients’ lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.

关键词： severe community-acquired pneumonia     lung microbiota     clinical improvements     7-category ordinal scale     Prevotellaceae    

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Middle East respiratory syndrome coronavirus: a comprehensive review

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《医学前沿（英文）》 2016年 第10卷 第2期   页码 120-136 doi: 10.1007/s11684-016-0430-6

摘要：

The Middle East respiratory syndrome coronavirus was first identified in 2012 and has since then remained uncontrolled. Cases have been mostly reported in the Middle East, however travel-associated cases and outbreaks have also occurred. Nosocomial and zoonotic transmission of the virus appear to be the most important routes. The infection is severe and highly fatal thus necessitating rapid and efficacious interventions. Here, we performed a comprehensive review of published literature and summarized the epidemiology of the virus. In addition, we summarized the virological aspects of the infection and reviewed the animal models used as well as vaccination and antiviral tested against it.

关键词： MERS     coronavirus     review    

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Epidemiology, pathogenesis, and management of coronavirus disease 2019-associated stroke

《医学前沿（英文）》 doi: 10.1007/s11684-023-1041-7

摘要： The coronavirus disease 2019 (COVID-19) epidemic has triggered a huge impact on healthcare, socioeconomics, and other aspects of the world over the past three years. An increasing number of studies have identified a complex relationship between COVID-19 and stroke, although active measures are being implemented to prevent disease transmission. Severe COVID-19 may be associated with an increased risk of stroke and increase the rates of disability and mortality, posing a serious challenge to acute stroke diagnosis, treatment, and care. This review aims to provide an update on the influence of COVID-19 itself or vaccines on stroke, including arterial stroke (ischemic stroke and hemorrhagic stroke) and venous stroke (cerebral venous thrombosis). Additionally, the neurovascular mechanisms involved in SARS-CoV-2 infection and the clinical characteristics of stroke in the COVID-19 setting are presented. Evidence on vaccinations, potential therapeutic approaches, and effective strategies for stroke management has been highlighted.

关键词： SARS-CoV-2     ischemic stroke     stroke     hemorrhagic stroke     cerebral venous thrombosis     vaccination    

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Combination of western medicine and Chinese traditional patent medicine in treating a family case of COVID-19 in Wuhan

Li Ni, Ling Zhou, Min Zhou, Jianping Zhao, Dao Wen Wang

《医学前沿（英文）》 2020年 第14卷 第2期   页码 210-214 doi: 10.1007/s11684-020-0757-x

摘要： In December 2019, an outbreak of novel coronavirus (2019-nCoV) occurred in Wuhan, Hubei Province, China. By February 14, 2020, it has led to 66 492 confirmed patients in China and high mortality up to ~2.96% (1123/37 914) in Wuhan. Here we report the first family case of coronavirus disease 2019 (COVID-19) confirmed in Wuhan and treated using the combination of western medicine and Chinese traditional patent medicine Shuanghuanglian oral liquid (SHL). This report describes the identification, diagnosis, clinical course, and management of three cases from a family, suggests the expected therapeutic effects of SHL on COVID-19, and warrants further clinical trials.

关键词： novel coronavirus (2019-nCoV)     COVID-19     Chinese traditional patent medicine     Shuanghuanglian oral liquid    

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A pilot study on Paxlovid therapy for hemodialysis patients with severe acute respiratory syndrome coronavirus

《医学前沿（英文）》 doi: 10.1007/s11684-023-1011-0

摘要： We aimed to investigate the safety and efficacy of nirmatrelvir/ritonavir (Paxlovid) therapy for hemodialysis-dependent patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Thirteen hemodialysis patients infected with the Omicron variant of SARS-CoV-2 from April 3 to May 30, 2022, were recruited. Laboratory parameters and chest CT (computed tomography) imaging were analyzed. The treatment group included six patients who received 150 mg/100 mg of Paxlovid orally once daily for 5 days, whereas the control group included seven patients who received basic treatment. No serious adverse reactions or safety events were recorded. Four control patients progressed to moderate disease, and none in the treatment group showed progression of chest CT findings (P < 0.05). Paxlovid therapy tended toward early viral clearance and low viral load on Day 8. Moreover, 83.3% of the patients in the treatment group and 57.1% of the patients in the control group turned negative within 22 days. In the Paxlovid treatment group, we found significantly increased levels of lymphocytes (P=0.03) and eosinophils (P=0.02) and decreased levels of D-dimer on Day 8 compared with those on Day 1. Paxlovid therapy showed a potential therapeutic effect with good tolerance in hemodialysis patients. The optimal dose and effectiveness evaluation must be further investigated in a largeer cohort.

关键词： Paxlovid     hemodialysis     SARS-CoV-2     viral load     chest CT scan    

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Mouth the mirror of lungs: where does the connection lie?

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《医学前沿（英文）》 2016年 第10卷 第4期   页码 405-409 doi: 10.1007/s11684-016-0476-5

摘要：

Periodontitis is the chronic destructive disease of the periodontium (Gums) caused by host bacterial interactions. The effect of such host bacterial interactions in oral cavity also evokes a systemic response. Numerous studies have found common mechanisms of destruction for periodontal diseases and other chronic diseases like diabetes mellitus, atherosclerosis, respiratory diseases, and adverse pregnancy outcomes. Oral colonization by respiratory pathogens appears to be a risk factor for development of respiratory diseases and oral interventions aimed at reducing oral bacterial count have resulted in reduced incidence of these reparatory illness. This reflects the importance of oral hygiene among patients with respiratory illness. This review highlights the association between periodontal diseases and respiratory diseases.

关键词： periodontitis     respiratory diseases     acute pneumonia     COPD    

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标题 作者 时间 类型 操作

2019 novel coronavirus outbreak: a quiz or final exam?

Jiuyang Xu, Yijun Chen, Hao Chen, Bin Cao

期刊论文

China’s local governments are combating COVID-19 with unprecedented responses – from a Wenzhou governance perspective

Fanghua Gong, Yong Xiong, Jian Xiao, Li Lin, Xiaodong Liu, Dezhong Wang, Xiaokun Li

期刊论文

利用深度学习系统筛查新冠病毒肺炎

徐小微, 蒋贤高, 马春莲, 杜鹏, 李旭坤, 吕双志, 俞亮, 倪勤, 陈燕飞, 苏俊威, 郎观晶, 李永涛, 赵宏, 刘俊, 徐凯进, 阮凌翔, 盛吉芳, 裘云庆, 吴炜, 梁廷波, 李兰娟

期刊论文

新冠病毒肺炎肺部超声的特点及其在病情评估中的价值——一项回顾性观察研究

朱凤雪, 赵秀娟, 王天兵, 王振洲, 郭辅政, 薛海岩, 常盼盼, 梁汉生, 倪文涛, 王雅心, 陈雷, 姜保国

期刊论文

Risk factors for ventilator-associated pneumonia among patients undergoing major oncological surgery

null

期刊论文

Analysis of antibiotic usage for viral community-acquired pneumonia in adults

Rongmeng Jiang, Bing Han, Chang Dou, Fei Zhou, Bin Cao, Xingwang Li

期刊论文

Proteomics study of Mycoplasma pneumoniae pneumonia reveals the Fc fragment of the IgG-binding protein

期刊论文

新冠病毒肺炎临床试验核心指标集（COS-COVID）

金鑫瑶, 庞博, 张俊华, 刘清泉, 杨忠奇, 封继宏, 刘学政, 张磊, 王保和, 黄宇虹, Alice Josephine Fauci, 马玉玲, Myeong Soo Lee, 元唯安, 谢雁鸣, 唐健元, 高蕊, 杜亮, 张硕, 祁寒梅, 孙宇, 郑文科, 杨丰文, 蔡慧姿, 王可仪, 欧益, 黄明, 朱彦, 喻佳洁, 田金徽, 赵敏, 胡镜清, 姚晨, 李幼平, 张伯礼

期刊论文

Middle East respiratory syndrome coronavirus: current situation and travel-associated concerns

null

期刊论文

microbiota and important taxa predicting clinical prognosis in patients with severe community-acquired pneumonia

期刊论文

Middle East respiratory syndrome coronavirus: a comprehensive review

null

期刊论文

Epidemiology, pathogenesis, and management of coronavirus disease 2019-associated stroke

期刊论文

Combination of western medicine and Chinese traditional patent medicine in treating a family case of COVID-19 in Wuhan

Li Ni, Ling Zhou, Min Zhou, Jianping Zhao, Dao Wen Wang

期刊论文

A pilot study on Paxlovid therapy for hemodialysis patients with severe acute respiratory syndrome coronavirus

期刊论文

Mouth the mirror of lungs: where does the connection lie?

null

期刊论文