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Clinical manifestations and pathogen characteristics in children admitted for suspected COVID-19

Xiaofang Cai, Hanlan Jiang, Simin Zhang, Shengying Xia, Wenhui Du, Yaoling Ma, Tao Yu, Wenbin Li

Frontiers of Medicine 2020, Volume 14, Issue 6,   Pages 776-785 doi: 10.1007/s11684-020-0820-7

Abstract: Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread around the world. However, approaches to distinguish COVID-19 from pneumonia caused by other pathogens have not yet been reported. We retrospectively analyzed the clinical data of 97 children with probable COVID-19. A total of 13 (13.4%) patients were confirmed positive for SARS-CoV-2 infection by nucleic acid RT-PCR testing, and 41 (42.3%) patients were found to be infected with other pathogens. Notably, no pathogen was detected in 43 (44.3%) patients. Among all patients, 25 (25.8%) had familial cluster exposure history, and 52 (53.6%) had one or more coexisting conditions. Fifteen (15.5%) patients were admitted or transferred to the PICU. In the 11 confirmed COVID-19 cases, 5 (45.5%) and 7 (63.6%) were positive for IgM and IgG against SARS-CoV-2, respectively. In 22 patients with suspected COVID-19, 1 (4.5%) was positive for IgG but negative for IgM. The most frequently detected pathogen was (29, 29.9%). One patient with confirmed COVID 19 died. Our results strongly indicated that the detection of asymptomatic COVID 19 or coexisting conditions must be strengthened in pediatric patients. These cases may be difficult to diagnose as COVID-19 unless etiologic analysis is conducted. A serologic test can be a useful adjunctive diagnostic tool in cases where SARS-CoV-2 infection is highly suspected but the nucleic acid test is negative.

Keywords： coronavirus disease 2019     pediatrics     emergency     retrospective investigation     severe acute respiratory syndrome    

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Aortic aneurysm and chronic disseminated intravascular coagulation: a retrospective study of 235 patients

Yun Zhang,Chen Li,Min Shen,Bao Liu,Xuejun Zeng,Ti Shen

Frontiers of Medicine 2017, Volume 11, Issue 1,   Pages 62-67 doi: 10.1007/s11684-017-0498-7

Abstract:

Chronic disseminated intravascular coagulation (DIC) is a rare but devastating complication of aortic aneurysm (AA). This study investigated the clinical manifestations, laboratory findings, and treatment of patients with AA-associated chronic DIC (AA-DIC) and explored the mechanisms, duration, and therapeutic response of AA-DIC. We retrospectively reviewed the medical records of 235 AA patients admitted at the Peking Union Medical College Hospital between September 2009 and January 2015. The patients were classified as those with DIC (AA-DIC) and those without DIC (non-DIC). The AA-DIC group showed a significantly higher proportion of female patients and a significantly longer AA disease course than the non-DIC group did. The AA-DIC patients presented mural thrombi, dissecting aneurysms, a family history of AA, and diabetes significantly more frequently than the non-DIC patients did. Furthermore, multiple regression analyses revealed that sex, mural thrombus, aneurysm type, diabetes, and stent surgery are possible independent risk factors for AA-DIC patients. Fifty-two (22.1%) patients presented AA-DIC. Among these patients, 43 had non-typical DIC and 9 had typical DIC; the mortality rate of the latter was 22.2%. The mean age of the patients with typical DIC was significantly higher than of that of patients with non-typical DIC. The non-typical DIC patients also presented abnormal coagulation disorders of varying degrees. Furthermore, heparin or low-molecular-weight heparin improved the clinical symptoms and laboratory parameters in patients with AA and typical DIC. Thus, chronic DIC should be considered in patients with AA.

Keywords： aortic aneurysm     disseminated intravascular coagulation     anticoagulation therapy    

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Clinical characteristics and risk factors of COVID-19 patients with chronic hepatitis B: a multi-center retrospective

Frontiers of Medicine 2022, Volume 16, Issue 1,   Pages 111-125 doi: 10.1007/s11684-021-0854-5

Abstract: In this multi-center, retrospective, and observational cohort study, 109 CHB and 327 non-CHB patients

Keywords： COVID-19     chronic hepatitis B     liver injury     coagulation dysfunction    

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infections among diarrheal outpatients in Shanghai: a retrospective case study

Yanyan Jiang, Zhongying Yuan, Guoqing Zang, Dan Li, Ying Wang, Yi Zhang, Hua Liu, Jianping Cao, Yujuan Shen

Frontiers of Medicine 2018, Volume 12, Issue 1,   Pages 98-103 doi: 10.1007/s11684-018-0614-3

Abstract:

Cyclospora cayetanensis is a foodborne and waterborne pathogen that causes endemic and epidemic human diarrhea worldwide. A few epidemiological studies regarding C. cayetanensis infections in China have been conducted. During 2013, a total of 291 stool specimens were collected from patients with diarrhea at a hospital in urban Shanghai. C. cayetanensis was not detected in any of the stool specimens by traditional microscopy, whereas five stool specimens (1.72%, 5/291) were positive by PCR. These positive cases confirmed by molecular technology were all in the adult group (mean age 27.8 years; 2.94%, 5/170) with watery diarrhea. Marked infection occurred in the rainy season of May and July. Sequence and phylogenetic analyses of the partial 18S rRNA genes of C. cayetanensis isolated showed intra-species diversity of this parasite. This study showed, for the first time, that C. cayetanensis is a pathogen in outpatients with diarrhea in Shanghai, albeit at a low level. However, the transmission dynamics of this parasite in these patients remain uncertain.

Keywords： Cyclospora cayetanensis     outpatients with diarrhea     stool specimens     18S rRNA gene    

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prognostic factors of patients with epithelial ovarian cancer subjected to first-line treatment: a retrospective

Yunfeng Fu, Xinyu Wang, Zimin Pan, Xing Xie

Frontiers of Medicine 2014, Volume 8, Issue 1,   Pages 91-95 doi: 10.1007/s11684-014-0305-7

Abstract:

A total of 251 patients with epithelial ovarian cancer (EOC) treated between 2002 and 2008 was retrospectively analyzed to investigate the long-term outcomes and prognostic factors of these patients, particularly those who underwent primary debulking surgery followed by platinum-based chemotherapy. Clinico-pathological parameters, including progression-free survival (PFS) and overall survival (OS), were also analyzed. The median follow-up period from the end of initial treatment to June 2010 was 58 months. The three-year PFS rate was 61.7% for International Federation of Gynecology and Obstetrics (FIGO) I–II, 19.9% for FIGO III–IV, and 33.9% for all stages. By comparison, the five-year PFS rate was 44.6% for FIGO I–II, 17.7% for FIGO III–IV, and 28.3% for all stages. The three-year OS rate was 67.9% for FIGO I–II, 41.7% for FIGO III–IV, and 50.2% for all stages. The five-year OS rate was 52.7% for FIGO I–II, 30.8% for FIGO III–IV, and 39.2% for all stages. Univariate analysis revealed that advanced FIGO stage, serum CA125, and suboptimal debulking were significant factors affecting PFS and OS. In multivariate analysis, PFS was significantly influenced by FIGO stage and suboptimal debulking. However, OS was significantly influenced by advanced FIGO stage only. Our study confirms the efficacy of surgery followed by platinum-based chemotherapy for EOC. FIGO stage is considered as one of the most reliable predictors of the prognosis of patients with EOC.

Keywords： ovarian carcinoma     prognostic factors     surgery     chemotherapy     survival    

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cervical high-grade squamous intraepithelial lesion patients with positive margin by conization: a retrospective

Yuya Dou, Xiaodan Zhang, Yang Li, Fenfen Wang, Xing Xie, Xinyu Wang

Frontiers of Medicine 2017, Volume 11, Issue 2,   Pages 223-228 doi: 10.1007/s11684-017-0517-8

Abstract:

The objective of this study is to guide a triage for the management of cervical high-grade squamous intraepithelial lesion (HSIL) patients with positive margin by conization. Clinico-pathological data of HSIL patients with positive margin by conization were retrospectively collected from January 2009 to December 2014. All patients underwent secondary conization or hysterectomy within 6 months. The rate of residual lesion was calculated, and the factors associated with residual lesion were analyzed by univariate and multivariate analyses. Among a total of 119 patients, 56 (47.06%) patients presented residual HSIL in their subsequent surgical specimens, including 4 cases of invasive cervical carcinoma (3 stage IA1 and 1 stage IA2 patients). Univariate analysis showed that patient age>35 years (P=0.005), menopausal period>5 years (P=0.0035), and multiple-quadrant involvement (P=0.001) were significantly correlated with residual disease; however, multivariate analysis revealed that multiple-quadrant involvement (P=0.001; OR, 3.701; 95%CI, 1.496–9.154) was an independent risk factor for residual disease. Nearly half of HSIL patients with positive margin by conization were disease-free in subsequent surgical specimens, and those with multiple positive margins may consider re-conization or re-assessment.

Keywords： cervical high-grade squamous intraepithelial lesion     conization     positive surgical margin     hysterectomy    

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survival and increased response to immune checkpoint blockade in metastatic uveal melanoma: results from a retrospective

Frontiers of Medicine doi: 10.1007/s11684-023-0993-y

Abstract: Metastases of uveal melanoma (UM) spread predominantly to the liver. Due to low response rates to systemic therapies, liver-directed therapies (LDT) are commonly used for tumor control. The impact of LDT on the response to systemic treatment is unknown. A total of 182 patients with metastatic UM treated with immune checkpoint blockade (ICB) were included in this analysis. Patients were recruited from prospective skin cancer centers and the German national skin cancer registry (ADOReg) of the German Dermatologic Cooperative Oncology Group (DeCOG). Two cohorts were compared: patients with LDT (cohort A, n = 78) versus those without LDT (cohort B, n = 104). Data were analyzed for response to treatment, progression-free survival (PFS), and overall survival (OS). The median OS was significantly longer in cohort A than in cohort B (20.1 vs. 13.8 months; P = 0.0016) and a trend towards improved PFS was observed for cohort A (3.0 vs. 2.5 months; P = 0.054). The objective response rate to any ICB (16.7% vs. 3.8%, P = 0.0073) and combined ICB (14.1% vs. 4.5%, P = 0.017) was more favorable in cohort A. Our data suggest that the combination of LDT with ICB may be associated with a survival benefit and higher treatment response to ICB in patients with metastatic UM.

Keywords： uveal melanoma     liver-directed therapy     immune checkpoint blockade     SIRT     anti-PD-1     anti-CTLA-4    

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pemetrexed and platinum for elderly patients with advanced non-squamous non-small-cell lung cancer: a retrospective

Frontiers of Medicine 2022, Volume 16, Issue 4,   Pages 610-617 doi: 10.1007/s11684-021-0827-8

Abstract: However, the safety and efficacy of bevacizumab for elderly patients with advanced NSCLC require further investigationThus, 59 patients were included in the present retrospective study, 22 patients in the bevacizumab plus

Keywords： bevacizumab     elderly patient     advanced non-small-cell lung cancer     overall survival     toxicity    

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Conservation and adaptive reuse of industrial heritage in Shanghai

ZHANG Song

Frontiers of Structural and Civil Engineering 2007, Volume 1, Issue 4,   Pages 481-490 doi: 10.1007/s11709-007-0065-4

Abstract: This paper takes a retrospective review of the evolution of the conservation of industrial heritage in

Keywords： evolution     industrial     international industrial     retrospective     Shanghai    

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the new maternity insurance scheme on medical expenditures for caesarean delivery in Wuxi, China: a retrospective

Chun Chen,Zhihong Cheng,Ping Jiang,Mei Sun,Qi Zhang,Jun Lv

Frontiers of Medicine 2016, Volume 10, Issue 4,   Pages 473-480 doi: 10.1007/s11684-016-0479-

Abstract:

Aiming to control rising medical expenditures and help improve China’s healthcare systems, this study examined whether a cap-based medical insurance scheme with shared financial interest between the insurance and healthcare providers is effective in containing hospitals’ C-section medical expenditures. We used 6547 caesarean delivery case records from a teaching tertiary-level general public hospital located in Wuxi, China (2004–2013), and used the Chow test to investigate the possibility of significant variation in mean medical expenditures for caesarean deliveries pre- and post-reform. We also used paired sample t-tests and linear regression models to compare the mean medical expenditures between insured and uninsured women undergoing caesarean delivery during the post-reform period. After the scheme’s implementation, medical expenditures for caesarean deliveries declined and the medical expenditures of women covered by the scheme were significantly lower than those of uninsured patients. These findings indicated the scheme’s effectiveness in minimizing caesarean delivery expenditures. The cap-based medical insurance scheme with shared financial interest between insurance and healthcare providers would likely steer healthcare providers’ behaviors in a more cost-effective direction.

Keywords： maternity insurance scheme     financial incentive     caesarean delivery     medical expenditure     China    

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herbal medicine reduces mortality in patients with severe and critical coronavirus disease 2019: a retrospective

Guohua Chen, Wen Su, Jiayao Yang, Dan Luo, Ping Xia, Wen Jia, Xiuyang Li, Chuan Wang, Suping Lang, Qingbin Meng, Ying Zhang, Yuhe Ke, An Fan, Shuo Yang, Yujiao Zheng, Xuepeng Fan, Jie Qiao, Fengmei Lian, Li Wei, Xiaolin Tong

Frontiers of Medicine 2020, Volume 14, Issue 6,   Pages 752-759 doi: 10.1007/s11684-020-0813-6

Abstract: In this retrospective study, data were collected from 662 patients with severe/critical COVID-19 who

Keywords： COVID-19     CHM     mortality     a retrospective cohort study    

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Clinical laboratory features of Meigs’ syndrome: a retrospective study from 2009 to 2018

Wenwen Shang, Lei Wu, Rui Xu, Xian Chen, Shasha Yao, Peijun Huang, Fang Wang

Frontiers of Medicine 2021, Volume 15, Issue 1,   Pages 116-124 doi: 10.1007/s11684-019-0732-6

Abstract: Meigs’ syndrome (MS), a rare complication of benign ovarian tumors, is easily misdiagnosed as ovarian cancer (OC). We retrospectively reviewed the clinical laboratory data of patients diagnosed with MS from 2009 to 2018. Serum carbohydrate antigen 125 and HE4 levels were higher in the MS group than in the ovarian thecoma-fibroma (OTF) and healthy control groups (all <0.05). However, the serum HE4 levels were lower in the MS group than in the OC group ( <0.001). A routine blood test showed that the absolute counts and percentages of lymphocytes were significantly lower in the MS group than in the OTF and control groups (all <0.05). However, these variables were higher in the MS group than in the OC group (both <0.05). The neutrophil-to-lymphocyte ratio (NLR) was also significantly lower, whereas the lymphocyte-to-monocyte ratio was higher in the MS group than in the OC group (both <0.05). The NLR, platelet-to-lymphocyte ratio, and systemic immune index were significantly higher in the MS group than in the OTF and control groups (all <0.05). The hypoxia-inducible factor-1 mRNA levels were also significantly higher, whereas the glucose transporter 1, lactate dehydrogenase, and enolase 1 mRNA levels were lower in peripheral CD4 T cells obtained preoperatively in a patient with MS than those in patients with OTF, patients with OC, and controls (all <0.05). The expression of these four glucose metabolism genes was preferentially restored to normal levels after the tumor resection of MS ( <0.001). These clinical laboratory features can be useful in improving the preoperative diagnostic accuracy of MS.

Keywords： Meigs’ syndrome     ovarian thecoma-fibroma     NLR (neutrophil to lymphocyte ratio)     CD4+ T cells     glucose metabolism    

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Retrospective study of the efficacy and complication of thoracoabdominal incision for nephrectomy: a

Minggen YANG, Xiaokun ZHAO

Frontiers of Medicine 2009, Volume 3, Issue 2,   Pages 191-196 doi: 10.1007/s11684-009-0026-5

Abstract: This retrospective study was performed to compare the outcome of thoracoabdominal incision flank incisionA case retrospective analysis assessing operation time, perioperative hemorrhage volume, size of tumor

Keywords： surgery     renal tumors     nephrectomy    

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An investigation on modification mechanism of CH

Qiang XIN, Shanghong HUANG

Frontiers of Structural and Civil Engineering 2017, Volume 11, Issue 3,   Pages 293-300 doi: 10.1007/s11709-017-0403-0

Abstract: Rising oil price has brought huge cost pressure for low grade highway construction, and it is urgent to find alternative resources. At the same time, there are nearly 50000–60000 tons of low temperature coal output in inner Mongolia region, China, which has high toxicity and high polluting. To make the low temperature coal be applicable for road constructions, the formaldehyde is used as cross linking agent, the concentrated sulfuric acid is used as catalyst, and the chemical modification of low temperature coal tar pitch in Inner Mongolia region is investigated. The road performance (softening point, penetration and ductility) of modified low temperature coal are tested. Results shown that the road performance of modified low temperature coal is increased significantly. Modification mechanism of low temperature coal is studied by Scanning Electron Microscopy and other analytical tools. Results show that, in the modified low temperature coal, resin content increases and the resin fiber diameter becomes larger with the increasing of formaldehyde content.

Keywords： low temperature     coal tar pitch     modification     road performance    

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Multi-scale investigation of active failure for various modes of wall movement

Frontiers of Structural and Civil Engineering 2021, Volume 15, Issue 4,   Pages 961-979 doi: 10.1007/s11709-021-0738-4

Abstract: Retained backfill response to wall movement depends on factors that range from boundary conditions to the geometrical characteristic of individual particles. Hence, mechanical understanding of the problem warrants multi-scale analyses that investigate reciprocal relationships between macro and micro effects. Accordingly, this study attempts a multi-scale examination of failure evolution in cohesionless backfills. Therefore, the transition of retained backfills from at-rest condition to the active state is modeled using the discrete element method (DEM). DEM allows conducting virtual experiments, with which the variation of particle and boundary properties is straightforward. Hence, various modes of wall movement (translation and rotation) toward the active state are modeled using two different backfills with distinct particle shapes (spherical and nonspherical) under varying surcharge. For each model, cumulative rotations of single particles are tracked, and the results are used to analyze the evolution of shear bands and their geometric characteristics. Moreover, dependencies of lateral pressure coefficients and coordination numbers, as respective macro and micro behavior indicators, on particle shape, boundary conditions, and surcharge levels are investigated. Additionally, contact force networks are visually determined, and their influences on pressure distribution and deformation mechanisms are discussed with reference to the associated modes of wall movement and particle shapes.

Keywords： discrete-element modelling     granular materials     retaining walls     particle shape     arching    

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Title Author Date Type Operation

Clinical manifestations and pathogen characteristics in children admitted for suspected COVID-19

Xiaofang Cai, Hanlan Jiang, Simin Zhang, Shengying Xia, Wenhui Du, Yaoling Ma, Tao Yu, Wenbin Li

Journal Article

Aortic aneurysm and chronic disseminated intravascular coagulation: a retrospective study of 235 patients

Yun Zhang,Chen Li,Min Shen,Bao Liu,Xuejun Zeng,Ti Shen

Journal Article

Clinical characteristics and risk factors of COVID-19 patients with chronic hepatitis B: a multi-center retrospective

Journal Article

infections among diarrheal outpatients in Shanghai: a retrospective case study

Yanyan Jiang, Zhongying Yuan, Guoqing Zang, Dan Li, Ying Wang, Yi Zhang, Hua Liu, Jianping Cao, Yujuan Shen

Journal Article

prognostic factors of patients with epithelial ovarian cancer subjected to first-line treatment: a retrospective

Yunfeng Fu, Xinyu Wang, Zimin Pan, Xing Xie

Journal Article

cervical high-grade squamous intraepithelial lesion patients with positive margin by conization: a retrospective

Yuya Dou, Xiaodan Zhang, Yang Li, Fenfen Wang, Xing Xie, Xinyu Wang

Journal Article

survival and increased response to immune checkpoint blockade in metastatic uveal melanoma: results from a retrospective

Journal Article

pemetrexed and platinum for elderly patients with advanced non-squamous non-small-cell lung cancer: a retrospective

Journal Article

Conservation and adaptive reuse of industrial heritage in Shanghai

ZHANG Song

Journal Article

the new maternity insurance scheme on medical expenditures for caesarean delivery in Wuxi, China: a retrospective

Chun Chen,Zhihong Cheng,Ping Jiang,Mei Sun,Qi Zhang,Jun Lv

Journal Article

herbal medicine reduces mortality in patients with severe and critical coronavirus disease 2019: a retrospective

Guohua Chen, Wen Su, Jiayao Yang, Dan Luo, Ping Xia, Wen Jia, Xiuyang Li, Chuan Wang, Suping Lang, Qingbin Meng, Ying Zhang, Yuhe Ke, An Fan, Shuo Yang, Yujiao Zheng, Xuepeng Fan, Jie Qiao, Fengmei Lian, Li Wei, Xiaolin Tong

Journal Article

Clinical laboratory features of Meigs’ syndrome: a retrospective study from 2009 to 2018

Wenwen Shang, Lei Wu, Rui Xu, Xian Chen, Shasha Yao, Peijun Huang, Fang Wang

Journal Article

Retrospective study of the efficacy and complication of thoracoabdominal incision for nephrectomy: a

Minggen YANG, Xiaokun ZHAO

Journal Article

An investigation on modification mechanism of CH

Qiang XIN, Shanghong HUANG

Journal Article

Multi-scale investigation of active failure for various modes of wall movement

Journal Article