关键词： 2019新型冠状病毒肺炎   肺结核   体层摄影术   X线计算机  

摘要： 结核病是以呼吸道传播为主的慢性传染病。中国是结核高负担国家,2020年感染率排在全球第二位[1]。COVID-19是一种以呼吸道传播为主的急性传染病,自2019年底以来,在全球范围广泛流行,已成为全球每日死亡人数最多的传染病[2]。两种疾病在传播途径、临床症状及影像表现等方面存在一些相似之处[3],给临床的诊疗工作带来一定困难。现报道4例COVID-19合并肺结核患者的诊疗情况及结合文献进行复习。

关键词： 甲状腺炎   亚急性甲状腺炎   新型冠状病毒   新型冠状病毒感染   糖皮质激素   非甾体抗炎药  

摘要： 目的总结亚急性甲状腺炎(SAT)治疗过程中合并新型冠状病毒(SARS-CoV-2)感染的有效治疗方法。方法对1例SAT治疗过程中合并SARS-CoV-2感染的患者的临床资料作回顾性分析。结果患者男,33岁,因“发热半月余,颈部疼痛10余天”就诊,患者血沉加快、甲状腺破坏、摄锝功能明显减低,诊断为SAT,经布洛芬缓释胶囊治疗后症状减轻。治疗期间因“体温复升高达40℃,颈部疼痛明显加重,以右侧为著”住院,患者甲状腺超声检查显示甲状腺破坏较前增多,血沉较前增快,且新型冠状病毒核酸检测阳性,诊断为SAT、新型冠状病毒感染。应用非甾体抗炎药布洛芬缓释胶囊效果不佳,改为糖皮质激素强的松治疗后症状明显好转,4周后血沉降至正常范围,逐渐减停后康复出院。结论SAT患者在治疗过程中感染SARS-CoV-2可能导致SAT症状加重,表现为颈部疼痛加重、甲状腺破坏增多、血沉增快,病毒核酸检测有助于明确诊断。感染SARS-CoV-2的SAT首选糖皮质激素治疗,疗效较好。

关键词： 新型冠状病毒感染   慢性咳嗽   中西医结合护理   中药膏摩   耳穴压丸  

摘要： 本文总结1例新型冠状病毒感染合并慢性咳嗽患者的中西医结合护理体会。基于护理评估和中医辨证,在俯卧位通气、健康宣教、情志护理等常规护理干预基础上,开展衣冠疗法、中药膏摩、穴位贴敷、耳穴压丸、五音疗法等中医适宜技术,有效改善患者负性情绪,缓解咳嗽症状,提高生活质量。

关键词： 抗中性粒细胞胞质抗体相关性血管炎   新型冠状病毒感染   肾小球肾炎  

摘要： 抗中性粒细胞胞质抗体(ANCA)相关性血管炎(AAV)是一组以血清中能够检测到ANCA为最突出特点的系统性小血管炎,主要累及小血管。病理特点为小血管全层炎症、坏死、伴或不伴肉芽肿形成。常见症状有发热、关节痛、肌痛、乏力等,当累及肺脏、肾脏时会出现相应的临床表现。越来越多的证据表明,新型冠状病毒感染(COVID-19)会触发自身免疫,诱发AAV,且AAV的肺受累症状可与COVID-19表现相类似,对临床诊断造成困难。AAV的早期诊断和治疗对患者预后有重要意义。

关键词： SARS-CoV-2 infections   Omicron variants   Oral therapeutic drugs   Research progress  

摘要： SARS-CoV-2 has undergone five major transformations from its original strain,evolving through Alpha,Beta,Gamma,Delta,and now *** Omicron variant stands out for its high transmissibility,reduced severity,mild symptoms,and low ***,Omicron infections have become akin to common upper respiratory tract infections,underscoring the critical role of oral therapeutic drugs in clinical *** small-molecule oral antivirals are game-changers,effectively preventing mild and moderate cases from escalating to severe conditions and significantly reducing mortality among severe *** have emerged as the frontline defenders in the fight against ***,eight oral antiviral drugs have been approved for use,including four 3CL protease inhibitors(nirmatrelvir/ritonavir,simnotrelvir/ritonavir,atilotrelvir/ritonavir,ensitrelvir,and leritrelvir),and three RNA polymerase inhibitors(molnupiravir,azvudine,and deuterium remdesivir).These medications are readily available and have ensured an uninterrupted clinical *** the establishment of a robust post-infection immune barrier and the widespread clinical use of oral antiviral drugs,the global threat posed by the COVID-19 pandemic has significantly *** relentless march of scientific progress and medical innovation has turned the tide,making COVID-19 a manageable part of our lives.

关键词： 敦煌医学   “三才”思想   新型冠状病毒感染   疫病   瘟疫   防治  

摘要： 敦煌医学是古籍医学文献的新发现,其中“三才”思想贯穿于整个敦煌医学文献。虽然当前新型冠状病毒(简称“新冠病毒”)感染不再是国际关注的突发公共卫生事件,但新冠病毒仍在不断变异。目前国内新冠病毒感染总体处于局部零星散发状态,但疾病危害仍然存在。中医药在防治新冠病毒感染方面彰显出独特优势。该文认为从敦煌医学“三才”思想出发,强调“天人合一”“地人相应”,因时、因地、因人制宜,可指导新冠病毒感染的防治。

关键词： 新型冠状病毒感染   肺纤维化   中药组方预测   逆向网络药理学   分子对接  

摘要： 目的探讨新型冠状病毒感染(新冠感染,COVID-19)后肺纤维化的发病机制,并基于逆向网络药理学思维进行中药组方预测。方法于Genecards数据库获取COVID-19和PF的靶点取交集得出二者共有靶点后,通过String平台进行蛋白互作网络分析,运用Cytoscape软件计算Degree值以确定关键靶点,而后进行GO和KEGG富集分析以明确发病机制与通路。关键靶点通过Uniprot数据库转换后于TCMSP数据库逆向收集中药成分,选用度值较高的靶点与有效成分进行分子对接验证,再由有效成分收集对应中药,构建关键靶点-有效成分-中药网络,确定度值较高中药并整理其性、味、归经。结果共获取142个COVID-19与PF的共有靶点,保留度值较高的50个关键靶点,其中有32个关键靶点能于TCMSP数据库中匹配到中药成分化合物信息,筛选后有18个关键靶点匹配到31种有意义的中药成分,以度值最高的4个靶点蛋白与度值≥3的7种中药成分进行28次分子对接验证,结果稳定且良好。GO富集分析主要得出炎症反应、血管系统发育的调节等生物过程,KEGG富集分析显示冠状病毒病-新冠肺炎、Th17细胞分化、HIF-1信号通路、IL17信号通路等信号通路。逆向收集到287种中药,其中度值≥3的73种中药以寒性药、苦味药居多,其次为温性药、辛味药,并且肝、肺经居多,度值≥6的中药分别为苦参、连翘、木蝴蝶、山豆根。结论运用逆向网络药理学思维及分子对接技术对新冠感染后肺纤维化进行靶点、通路、成分和中药预测,为今后临床辨证论治中药组方拓宽思路。

摘要： This phase 3, observer-blinded, non-inferiority randomized trial (***: NCT05517642), conducted from September 2022 to May 2023 at three Malaysian sites, involved 540 adults previously vaccinated with three COVID-19 doses. Participants were randomized 1:1 to receive either one dose of inhaled Recombinant COVID-19 Vaccine (Ad5-nCoV-IH) or intramuscular tozinameran (BNT-IM). The study assessed safety, vaccine efficacy (VE) and immunogenicity against SARS-CoV-2 variants. The primary outcome was the non-inferiority of anti-spike protein receptor-binding domain (S-RBD IgG) antibodies, with a 97.5% confidence interval lower limit for the geometric mean concentration (GMC) ratio >0.67. Ad5-nCoV-IH showed lower immunogenicity than BNT-IM, with a GMC ratio of 0.22 and a seroconversion rate difference of -71.91%. Adverse drug reactions (ADRs) were less frequent with Ad5-nCoV-IH (39.26%) compared to BNT-IM (64.68%). No serious vaccine-related adverse events were reported. Both vaccines had comparable efficacy against COVID-19 variants. This study was funded by Tianjin Biomedical Science and Technology Major Project.