自2020年1月份首次在我国武汉报道以来,新型冠状病毒病(coronavirus disease 2019,COVID-19)在全球全面爆发.根据世界卫生组织(world health organization,WHO)数据[1],截至2020年5月6日10时,全球累计确诊病例达3 588 773例,累计死亡病例达247 503例,单日新增确诊病例仍高达7万余例,新增死亡人数仍达4千余例,目前全球除南极洲外各大洲均已发现新型冠状病毒(2019 novel coronavirus,2019-nCoV)感染者.我国抗击COVID-19疫情行动迅速,国家卫生健康委员会(简称国家卫健委)办公厅在2020年1月16日制定印发了首个新型冠状病毒感染的肺炎诊疗方案(试行第一版),并进行不断更新,3月3日印发了《新型冠状病毒肺炎诊疗方案(试行第七版)》(下称中国方案)[2].在2020年4月21日,美国国立卫生研究院(national institutes of health,NIH)发布了新冠病毒病治疗指南(下称美国指南)[3].笔者通过将中国方案与美国指南进行对比和评价,发现中美诊治COVID-19的异同点,帮助中国临床医务工作者更好地进行诊治,提高COVID-19的治疗效果.

Objective:Prostate cancer antigen 3 (PCA3) is a prostate specific gene-based marker,and nowadays it has been used in predicting the presence of prostate cancer (PCa) in men.In the present study,we explored the effectiveness of urinary PCA3 score in PCa diagnosis and its potential role in predicting the presence of pathological significance for PCa.Method:From July 2014 to August 2015,quantitative real-time PCR was used to detect the differential expression of urinary PCA3 in 237 men including healthy people who matched age but without cancer or infection,and patients with chronic prostatitis (CP),prostatic hyperplasia (BPH),PCa,kidney cancer,bladder cancer and other cancers.Patients were initially diagnosed as PCa based on digital rectal examination (DRE),PSA kinetics and family history of PCa.Prior to biopsy,the patients underwent clinical and biological evaluation including DRE and transrectal ultrasonography (TRUS).Spearman correlation was used for comparison and evaluation of correlations between PCA3 score and concentration of PSA,Gleason score and TNM stage.Receiver operating curve (ROC) analysis was conducted to explore the predictive value of PCA3 score.Result:The 237 subjects included 35 healthy people,31 patients with CP,30 patients with BPH,74 patients with PCa,21 patients with kidney cancer,25 patients with bladder cancer and 21 patients with other urogenital cancers.The PCA3 score was found significantly higher in urine of PCa patients (P＜0.05),and especially in high-grade PCa (t=4.411,P＜0.05).Bivariate correlation analysis indicated that the higher presence of PCA3 score was positively correlated with Gleason grade (r=0.244,P=0.036) but no correlation with PSA (r=-0.019,P ＞0.05) or TNM stage (r=0.069,P＞0.05).Moreover,ROC analysis further showed that PCA3 score was a better prognosticator compared to PSA in diagnosing PCa.Conclusion:The urinary PCA3 score may be a valuable tool in identifying patients at risk of PCa.Obviously,a higher PCA3 score is associated with PCa aggression.

Objective:To observe the efficacy and safety of combination of pinaverium bromide and compound eosinophil-lactobacillus in the treatment of diarrhea-dominant irritable bowel syndrome (IBS).Methods:One hundred and twenty-four patients with diarrhea-dominant IBS were divided into 3 groups,piveronium bromide group (group PB,n =41),compound eosinophil-lactobacillus group (group EL,n =34) and combination drug group (group CB,n =49,pinaverium bromide combined with compound eosinophil-lactobacillus was used).After four weeks of treatment,the curative results (marked effective rate and total effctive rate) of the 3 groups were compared,in terms of abdominal symtoms including abodominal pain and distention,stool characters and adverse reactions.Results:After 4 weeks of treatment,scores of abdominal pain and distension in group CB were lower than those in groups PB and EL (P ＜ 0.05) and the effective rate and total effective rate were higher than those in groups PB and EL,even though only statistically significant difference showed in effective rate (P ＜0.05).Defection frequency in group CB was smaller than in the other groups (P ＜ 0.05),and the improvement of the defecate character was better in groups CB and EL than in group PB.No obvious adverse reaction was found in the three groups.Conclusion:Pinaverium bromide combined with compound eosinophil-lactobacillus in the treatment of diarrhea-dominant IBS is more efficient than be used alone,and is safe.