Objective:To analyze the characteristics,dynamic changes,and outcomes of the first imaging manifestations of 3 patients with severe COVID-19 in our hospital.Methods:Computed tomography(CT)findings of 3 patients with s...Objective:To analyze the characteristics,dynamic changes,and outcomes of the first imaging manifestations of 3 patients with severe COVID-19 in our hospital.Methods:Computed tomography(CT)findings of 3 patients with severe COVID-19 who tested positive by the nucleic acid test in our hospital were selected,mainly focusing on the morphology,distribution characteristics,and dynamic changes of the first CT findings.Results:3 patients with severe pneumonia were older,with one aged 80.The first chest CT examination for all 3 patients differed.Imaging showed a leafy distribution of consolidation,primarily affecting the lower lobes of both lungs and extending subpleurally.A grid-like pattern was observed,along with changes in the consolidation and air bronchogram.These changes had slower absorption,especially in patients with underlying diseases.Conclusion:CT manifestations of severe COVID-19 have specific characteristics and the analysis of their characteristics and dynamic changes provide valuable insights for clinical treatment.展开更多
To the Editor:There are 1.25 million people living with human immunodeficiency virus(HIV)(PLWH)in China,with more than 135,000 newly diagnosed cases in 2018.[1]HIV-positive patients who suffer a fracture have extremel...To the Editor:There are 1.25 million people living with human immunodeficiency virus(HIV)(PLWH)in China,with more than 135,000 newly diagnosed cases in 2018.[1]HIV-positive patients who suffer a fracture have extremely high complication rates following operations,and medical staff frequently experience occupational exposure during the perioperative period.Therefore,surgeons are often worried about operating on HIV-positive patients.To ensure the safety of surgeons and reduce patients’postoperative complications,we attempted to maximally suppress the viral load(VL)prior to operation.Previous studies have shown that PLWH demonstrated high uptake of highly active antiretroviral therapy(HAART)and rapid VL suppression.[2]In recent years,more rapid VL suppression has been observed with newly introduced antiretroviral drugs,for example,a combination of the integrase strand transfer inhibitor(INSTI),in a single-tablet regimen(STR)containing elvitegravir,cobicistat,emtricitabine,and tenofovir alafenamide(E/C/F/TAF)(150/150/200/10 mg).[3]Studies have shown that STRs have more reliable virus suppression success rates than multiple-tablet regimens(MTRs).[4]Generally,patients prefer freely available HAART drugs that are available nationally,containing tenofovir disoproxil fumarate,lamivudine,and efavirenz(TDF/3TC/EFV)(400/300/600 mg).In this study,we compared the preoperative effect of E/C/F/TAF and TDF/3TC/EFV regimens in the treatment for HIV-positive patients to reduce VL and improve the immune function in 7 and 10 days.展开更多
基金Qinghai Provincial Health Commission Medical and Health Science and Technology Project Guiding Topics“Analysis of Dynamic Changes in Chest Imaging of New Coronavirus Pneumonia in Qinghai Province”(2022-wjzdx-63)。
文摘Objective:To analyze the characteristics,dynamic changes,and outcomes of the first imaging manifestations of 3 patients with severe COVID-19 in our hospital.Methods:Computed tomography(CT)findings of 3 patients with severe COVID-19 who tested positive by the nucleic acid test in our hospital were selected,mainly focusing on the morphology,distribution characteristics,and dynamic changes of the first CT findings.Results:3 patients with severe pneumonia were older,with one aged 80.The first chest CT examination for all 3 patients differed.Imaging showed a leafy distribution of consolidation,primarily affecting the lower lobes of both lungs and extending subpleurally.A grid-like pattern was observed,along with changes in the consolidation and air bronchogram.These changes had slower absorption,especially in patients with underlying diseases.Conclusion:CT manifestations of severe COVID-19 have specific characteristics and the analysis of their characteristics and dynamic changes provide valuable insights for clinical treatment.
基金This work was supported by the grants from the Capital’s Funds for Health Improvement and Research(No.2018-2-2174)Scientific Research Common Program of the Beijing Municipal Commission of Education(No.KM201810025029)the Beijing Municipal Science&Technology Commission(No.Z191100006619060)。
文摘To the Editor:There are 1.25 million people living with human immunodeficiency virus(HIV)(PLWH)in China,with more than 135,000 newly diagnosed cases in 2018.[1]HIV-positive patients who suffer a fracture have extremely high complication rates following operations,and medical staff frequently experience occupational exposure during the perioperative period.Therefore,surgeons are often worried about operating on HIV-positive patients.To ensure the safety of surgeons and reduce patients’postoperative complications,we attempted to maximally suppress the viral load(VL)prior to operation.Previous studies have shown that PLWH demonstrated high uptake of highly active antiretroviral therapy(HAART)and rapid VL suppression.[2]In recent years,more rapid VL suppression has been observed with newly introduced antiretroviral drugs,for example,a combination of the integrase strand transfer inhibitor(INSTI),in a single-tablet regimen(STR)containing elvitegravir,cobicistat,emtricitabine,and tenofovir alafenamide(E/C/F/TAF)(150/150/200/10 mg).[3]Studies have shown that STRs have more reliable virus suppression success rates than multiple-tablet regimens(MTRs).[4]Generally,patients prefer freely available HAART drugs that are available nationally,containing tenofovir disoproxil fumarate,lamivudine,and efavirenz(TDF/3TC/EFV)(400/300/600 mg).In this study,we compared the preoperative effect of E/C/F/TAF and TDF/3TC/EFV regimens in the treatment for HIV-positive patients to reduce VL and improve the immune function in 7 and 10 days.
