Medical science monitor : international medical journal of experimental and clinical research
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Traced back to December 2019, an unexpected outbreak of a highly contagious new coronavirus pneumonia (COVID-19) has rapidly swept around China and the globe. There have now been an estimated 2 580 000 infections and more than 170 000 fatal cases around the world. The World Health Organization (WHO) estimated that approximately 14% of infections developed into severe disease, 5% were critically ill, and the mortality rate of critically ill patients is reported to be over 50%. ⋯ This difficult situation calls for the use of extracorporeal membrane oxygenation (ECMO) for assisting respiration and circulation if necessary. This article reviews the pertinent clinical literature, technical guidance, and expert recommendations on use of ECMO in critically ill cases of COVID-19. Here, we present basic knowledge and opinions about COVID-19 and ECMO, review the evidence on ECMO use in Middle East Respiratory Syndrome (MERS) and H1N1 influenza, share the technical guidance and recommendations on use of ECMO in COVID-19, summarize the current use of ECMO against COVID-19 in China, and discuss the issues in use of ECMO in COVID-19.
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BACKGROUND Long non-coding RNAs (lncRNAs) play key roles in the development and progression of diseases, including sepsis. Therefore, this study aimed to clarify the role and underlying molecular mechanisms of lncRNA NEAT1 in sepsis. MATERIAL AND METHODS We used real-time quantitative polymerase chain reaction (RT-qPCR) to analyze the expression of lncRNA nuclear paraspeckle assembly transcript 1 (NEAT1), let-7b-5p, and tumor necrosis factor receptor-associated factor 6 (TRAF6). ⋯ In addition, overexpression of TRAF6 abolished the overexpression of let-7b-5p-induced effects on apoptosis, inflammation, and growth of HK-2 cells exposed to LPS. In summary, NEAT1 regulated TRAF6 expression by sponging let-7b-5p in HK-2 cells, which promotes LPS-induced injury and inflammation in HK-2 cells. CONCLUSIONS Our data show that the lower expression of NEAT1 impeded sepsis development and LPS-induced injury inflammation by targeting let-7b-5p/TRAF6 axis, and NEAT1 may be a target for treatment of sepsis patients.
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BACKGROUND Anterior cervical corpectomy and fusion (ACCF), together with anterior cervical discectomy and fusion (ACDF) are both effective clinical treatments for cervical spondylotic myelopathy (CSM). Cervical sagittal balance is critical to preserving normal alignment, and is also associated with clinical outcomes. MATERIAL AND METHODS We retrospectively reviewed patients who had suffered from CSM and had undergone 1-level ACCF or 2-level ACDF surgery between December 2016 and November 2017. ⋯ No significant difference was found between ACCF and ACDF in clinical outcomes or representative global sagittal parameters. ACDF achieved more lordosis improvement than ACCF, with higher T1S. Surgeons need to pay extra attention to cervical sagittal balance, rather than focusing solely on decompression.
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Comparative Study Observational Study
A Comparison of Clinical Characteristics and Outcomes in Elderly and Younger Patients with COVID-19.
BACKGROUND The aim of this study was to describe the clinical characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) and compare these parameters in an elderly group with those in a younger group. MATERIAL AND METHODS This retrospective, single-center observational study included 69 hospitalized patients with laboratory-confirmed COVID-19 from a tertiary hospital in Wuhan, China, between January 14, 2020, and February 26, 2020. Epidemiological, demographic, clinical, and laboratory data, as well as treatments, complications, and outcomes were extracted from electronic medical records and compared between elderly patients (aged ≥60 years) and younger patients (aged <60 years). ⋯ Of those who were discharged or died, the median duration of hospitalization was 13.5 days (interquartile range, 10-18 days). CONCLUSIONS Elderly patients with confirmed COVID-19 were more likely to develop ARDS and cardiac injury than younger patients and were more likely to be admitted to the intensive care unit. In addition to routine monitoring and respiratory support, cardiac monitoring and supportive care should be a focus in elderly patients with COVID-19.
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Multicenter Study
Factors Influencing Anxiety of Health Care Workers in the Radiology Department with High Exposure Risk to COVID-19.
BACKGROUND During the outbreak of COVID-19, health care workers in the radiology department frequently interact with suspected patients and face a higher risk of infection and sudden surges in workload. High anxiety levels seriously harm physical and mental health and affect work efficiency and patient safety. Therefore, it is critical to determine anxiety levels of health care workers and explore its risk factors. ⋯ Multiple linear regression analysis showed that age, job position, availability of protective materials, signs of suspected symptoms, and susceptibility to emotions and behaviors of people around them were identified as risk factors for anxiety, whereas psychological resilience was identified as a protective factor. CONCLUSIONS Our study suggests that the anxiety level of health care workers in the radiology department with a high exposure risk to COVID-19 was high in the early stage of the outbreak, although the majority remained within normal limits. Timely assessment and effective intervention measures can improve the mental health of these at-risk populations.