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Background@#Long coronavirus disease 2019 (COVID-19) in recovered patients (RPs) is gradually recognized by more people. However, how long it will last and the underlining mechanism remains unclear. @*Methods@#We conducted a prospective follow-up study to evaluate the long-term symptoms and clinical indices of RPs at one-year after discharge from Union Hospital, Wuhan, China between December 2020 to May 2021. We also performed the 16S rRNA sequencing of stool samples from RPs and healthy controls (HCs) and analyzed the correlation between the gut microbiota and long COVID-19. @*Results@#In total, 187 RPs were enrolled, among them, 84 (44.9%) RPs reported long COVID-19 symptoms at one-year after discharge. The most common long-term symptoms were cardiopulmonary symptoms, including chest tightness after activity (39/187, 20.9%), palpitations on exercise (27/187, 14.4%), sputum (21/187, 11.2%), cough (15/187, 8.0%) and chest pain (13/187, 7.0%), followed by systemic symptoms including fatigue (34/187, 18.2%) and myalgia (20/187, 10.7%), and digestive symptoms including constipation (14/187, 7.5%), anorexia (13/187, 7.0%), and diarrhea (8/187, 4.3%). Sixty-six (35.9%) RPs presented either anxiety or depression (42/187 [22.8%] and 53/187 [28.8%] respectively), and the proportion of anxiety or depression in the long symptomatic group was significantly higher than that in the asymptomatic group (41/187 [50.6%] vs. 25/187 [24.3%]). Compared with the asymptomatic group, scores of all nine 36-Item Short Form General Health Survey domains were lower in the symptomatic group (all P < 0.05). One hundred thirty RPs and 32 HCs (non-severe acute respiratory syndrome coronavirus 2 infected subjects) performed fecal sample sequencing.Compared with HCs, symptomatic RPs had obvious gut microbiota dysbiosis including significantly reduced bacterial diversities and lower relative abundance of short-chain fatty acids (SCFAs)-producing salutary symbionts such as Eubacterium_hallii_group, Subdoligranulum, Ruminococcus, Dorea, Coprococcus, and Eubacterium_ventriosum_group. Meanwhile, the relative abundance of Eubacterium_hallii_group, Subdoligranulum, and Ruminococcus showed decreasing tendencies between HCs, the asymptomatic group, and the symptomatic group. @*Conclusion@#This study demonstrated the presence of long COVID-19 which correlates with gut microbiota dysbiosis in RPs at one-year after discharge, indicating gut microbiota may play an important role in long COVID-19.
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BACKGROUND@#Although intensively studied in patients with cardiovascular diseases (CVDs), the prognostic value of diastolic blood pressure (DBP) has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study aimed to reveal the prognostic value of DBP in AECOPD patients.@*METHODS@#Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July 2021. DBP was measured on admission. The primary outcome was all-cause in-hospital mortality; invasive mechanical ventilation and intensive care unit (ICU) admission were secondary outcomes. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio (HR) and 95% confidence interval (CI) for adverse outcomes.@*RESULTS@#Among 13,633 included patients with AECOPD, 197 (1.45%) died during their hospital stay. Multivariable Cox regression analysis showed that low DBP on admission (<70 mmHg) was associated with increased risk of in-hospital mortality (HR = 2.16, 95% CI: 1.53-3.05, Z = 4.37, P <0.01), invasive mechanical ventilation (HR = 1.65, 95% CI: 1.32-2.05, Z = 19.67, P <0.01), and ICU admission (HR = 1.45, 95% CI: 1.24-1.69, Z = 22.08, P <0.01) in the overall cohort. Similar findings were observed in subgroups with or without CVDs, except for invasive mechanical ventilation in the subgroup with CVDs. When DBP was further categorized in 5-mmHg increments from <50 mmHg to ≥100 mmHg, and 75 to <80 mmHg was taken as reference, HRs for in-hospital mortality increased almost linearly with decreased DBP in the overall cohort and subgroups of patients with CVDs; higher DBP was not associated with the risk of in-hospital mortality.@*CONCLUSION@#Low on-admission DBP, particularly <70 mmHg, was associated with an increased risk of adverse outcomes among inpatients with AECOPD, with or without CVDs, which may serve as a convenient predictor of poor prognosis in these patients.@*CLINICAL TRIAL REGISTRATION@#Chinese Clinical Trail Registry, No. ChiCTR2100044625.
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Humans , Blood Pressure , Pulmonary Disease, Chronic Obstructive/therapy , Cohort Studies , Respiration, Artificial , Inpatients , Hospital MortalityABSTRACT
Objective To analyze the image features and prognosis of primary central airway salivary gland-type tumor (SGT).Methods The clinical and imaging data of 25 cases with SGT confirmed by histopathology were retrospectively analyzed in our hospital from October 2009 to November 2017.Follow up of patients for survival was performed.Among 25 cases of SGT,there were 14 cases of adenoid cystic carcinoma (ACC),ten cases of mucoepidermoid carcinoma (MEC) and one case of mucoepidermoid carcinoma (EMC).All cases had non-enhanced CT scans (among which 20 cases underwent CT scan with contrast).Post-processing were performed to evaluate the location,range,density,degree of enhancement of the lesions and involvement of hilar or mediastinal lymph nodes.Eight cases underwent PET/CT imaging and one underwent MR imaging,respectively.Independent sample t test was used to compare difference in ages between ACC group and MEC group.Nonparametric test was performed to compare difference in tumor's diameter between ACC group and MEC group.Comparison of genders,history of smoking,tumor-node-metastasis (TNM) stage and CT features between ACC group and MEC group were tested using Fisher's exact tests.Survival was calculated using the Kaplan-Meier method,and the survival curves were compared by the log-rank test.Results Compared to MEC,patients with ACC were older.There were significant difference between the two groups (t=3.154,P＜0.05).ACC tended to involved trachea or main bronchi (13/14) while MEC were mostly located at lobar or segment bronchi (6/10).The shape of ACC tumors were mainly lobulated or presented as circumferential wall thickening (13/14),while MECs were smoothly oval (7/10).On contrast-enhanced CT scans,ACC mainly showed mild or moderate enhancement (9/10),While most of MEC had shown avid enhancement (8/10).CT findings suggestive of airway obstructive disease were seen more with MEC (9/10) than ACC (4/14).There were significant differences of the above CT features between ACC and MEC group (P＜0.05).A case of EMC in an 43 years old female presented rounded nodule in tracheal;The SUVmax in 6 of 8 cases of PET/CT exceeded 2.2;Overall survival (OS) was 87.5％ in all cases.No significant difference was found between ACC and MEC groups regarding OS (x2=0,P=1.000).Ages,surgical and nonsurgical patients and TNM stage were found to be related to OS (x2=13.799,13.799,13.171,respectively,P＜0.05).Conclusions Primary central airway salivary gland-type tumors are commonly occurred in patients at a low age,with weak invasive feature and good prognosis.The predominant site and CT characteristics between ACC and MEC were significantly different.
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The expression of CD(8) (+)CD(25) (+)FoxP(3) (+) regulatory T cells (CD(8) (+)Tregs) in the peripheral blood of patients with stable chronic obstructive pulmonary disease (COPD), and the effect of muscarinic cholinergic receptor antagonist tiotropium bromide on the expression of CD(8) (+)Tregs were investigated. Twenty-three patients with moderate to severe stable COPD were enrolled in this study. All patients inhaled tiotropium bromide (18 μg daily) for 3 months. Before and after inhalation of tiotropium bromide, peripheral blood samples were collected from the patients, and T cells were labeled by three-color labeled monoclonal antibodies. Flow cytometry was used to detect the quantity and percentage of CD(8) (+)T cells, CD(8) (+)CD(25) (+)T cells, CD(8) (+)Tregs, CD(4) (+)T cells, CD(4) (+)CD(25) (+)T cells and CD(4) (+)CD(25) (+)FoxP(3) (+) regulatory T cells (CD(4) (+)Tregs) respectively. The percentage of CD(4) (+)T cells was increased from (27.82±2.18)% to (35.53±1.3)% (t=3.20, P=0.004) in the peripheral blood of patients with stable COPD after inhalation of tiotropium bromide for 3 months, that of CD(4) (+)CD(25) (+)T cells was decreased from (10.03 ±1.42)% to (4.21 ±0.65)% (t=3.78, P=0.001), and that of CD(8) (+)Tregs was increased from (8.41 ±1.68)% to (21.34 ±4.20)% (t=2.72, P=0.013). At baseline, CD(8) (+)T cells, CD(8) (+)CD(25) (+)T cells and CD(4) (+)Tregs were detectable in the peripheral blood, but no significant changes were observed after treatment. Linear correlation analysis revealed that the difference before and after treatment in CD(4) (+)T cells and CD(4) (+)CD(25) (+)T cells was negatively correlated with the ratio of change in CD(8) (+)Tregs before and after treatment (r=-0.61, P=0.013; r=-0.72, P=0.001 respectively). In the peripheral blood of patients with stable COPD, there was the expression of CD(8) (+)Tregs and CD(4) (+)Tregs. Muscarinic receptor antagonist, tiotropium bromide, can promote the amplification of CD(4) (+)T cells, inhibit the expression of CD(25) (+)T cells, and enhance the expression of CD(8) (+)Tregs. CD(8) (+)Tregs and CD(4) (+)Tregs can be used as new indicators to understand the immune status of patients. They are helpful in judging the treatment efficacy and disease immunophenotype.
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Objective To test the reliability and validity of ICF Core Sets for Chinese COPD patients.Methods Fifty-two COPD patients were measured with ICF Core Sets for COPD patients and SF-36. For reliability test, the internal consistency was analyzed and expressed by Cronbach α coefficients and split-half reliability. For va-lidity test, the content validity and criterion validity were analyzed and expressed with Spearman rank correlation coef-ficients. Results For body function, body structure and activity and participation, there were good internal consis-tency (Cronbach α coefficients 0. 698～0.957). For environmental factors Crnnbach α coefficient and split-half reli-ability did not exist. Most items of body function, activity and participation and body structure possessed good content validity. There was concurrent validity for ICF components of body function, body structure and activity and participa-tion with SF-36, FEV1/FVC, COPD grade and health self-assessment. The environmental factors demonstrated poor reliability and validity. Conclusion The ICF Core Sets for COPD patients showed good reliability and validity. It is a good comprehensive functional measurement scale for COPD patients, but it is necessary to test the generality of this result, and some items need to be adjusted.
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The influence of L-arginine on endothelial nitric oxide synthase (eNOS) and cyclooxygenase 2 (COX2) was observed in experimental pulmonary thromboembolism and the action mechanism on pulmonary thromboembolism was explored. Wistar rats were randomly divided into control group, model group and treatment group. Pulmonary thromboembolism models were established by auto-blood back transfusion, and L-Arg 100 mg/kg was intraperitoneally injected after successful model preparation. The animals were sacrificed at 3 h, 1 day, 3 days and 7 days after embolism.Plasma NO, TXB2 and 6-Keto-PGF1α were detected. The expression of eNOS and COX2 protein and mRNA in pulmonary tissues was detected by immunohistochemistry and RT-PCR respectively.The results showed that pulmonary thrombosis could be seen post pulmonary embolism and inflammatory reaction was significant. Plasma NO was decreased (P＜0.01), and the levels of TXB2,6-Keto-PGF1α and T/P ratio were all elevated. The expression of eNOS protein and mRNA in the pulmonary tissue was down-regulated (P＜0.05), while that of COX2 protein and mRNA was upregulated (P＜0.01). In treatment group, the level of NO was increased, the levels of TXB2 and T/P ratio were decreased, but the level of 6-Keto-PGF1 α was increased. The expression of eNOS protein and mRNA in pulmonary tissue was upregulated (P＜0.05), while that of COX2 protein and mRNA was down-regulated (P＜0.05). In conclusion, L-arginine can educe the role of pulmonary tissue protection through up-regulating the expression of intra-pulmonary NOS and down -regulating COX2 in pulmonary thromboembolism.
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The influence of L-arginine on endothelial nitric oxide synthase (eNOS) and cyclooxygenase 2 (COX2) was observed in experimental pulmonary thromboembolism and the action mechanism on pulmonary thromboembolism was explored. Wistar rats were randomly divided into control group, model group and treatment group. Pulmonary thromboembolism models were established by auto-blood back transfusion, and L-Arg 100 mg/kg was intraperitoneally injected after successful model preparation. The animals were sacrificed at 3 h, 1 day, 3 days and 7 days after embolism. Plasma NO, TXB2 and 6-Keto-PGFla were detected. The expression of eNOS and COX2 protein and mRNA in pulmonary tissues was detected by immunohistochemistry and RT-PCR respectively. The results showed that pulmonary thrombosis could be seen post pulmonary embolism and inflammatory reaction was significant. Plasma NO was decreased (P<0.01), and the levels of TXB2, 6-Keto-PGF1alpha and T/P ratio were all elevated. The expression of eNOS protein and mRNA in the pulmonary tissue was down-regulated (P<0.05), while that of COX2 protein and mRNA was upregulated (P<0.01). In treatment group, the level of NO was increased, the levels of TXB2 and T/P ratio were decreased, but the level of 6-Keto-PGF1alpha was increased. The expression of eNOS protein and mRNA in pulmonary tissue was upregulated (P<0.05), while that of COX2 protein and mRNA was down-regulated (P<0.05). In conclusion, L-arginine can educe the role of pulmonary tissue protection through up-regulating the expression of intra-pulmonary NOS and down -regulating COX2 in pulmonary thromboembolism.
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Objective: To observe the efficacy of azithromycin in treating the bacterial infectious diseases. Methods: Intravenous administration of azithromycin was carried out in 40 cases. Results: The clinical cure rate and eradication rate were 85.0% and 84.8%, respectively. Drug sensitivity tests showed that more isolates were sensitive to azithromycin (87.9%) than to erythromycin (42.4%). The MIC of azithromycin was lower than that of erythromycin. In addition, the adverse effects occurred with low frequency and were usually mild. Conclusion: Azithromycin is effective and safe in treating bacterial infectious diseases.
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AIM: To detect the changes of serum vascular endothelial growth factor(VEGF) level and the expression of peripheral blood cytokeratin 19(CK19) mRNA in patients with non-small cell lung cancer(NSCLC).METHODS: 96 patients with NSCLC,40 patients with benign lung diseases and 25 healthy controls were investigated.The VEGF level in serum was detected by ELISA and CK19 mRNA in peripheral blood was determined by using reverse transcriptase-polymerase chain reaction(RT-PCR).RESULTS: In NSCLC group,the serum VEGF level and the positive rate of CK19 mRNA in peripheral blood were(346.3?95.6) ng/L and 63.5%,which were significantly higher than those in other two groups respectively(P0.05).VEGF serum level in the patients who showed positive CK19 mRNA in peripheral blood was(407.4?121.2) ng/L.It is significantly higher than that in the negative patients(P
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AIM: To localize the expression of forkhead/winged helix transcription factor(FOXP3) gene in different types of pathological lung tissues and explore its biological role in pathogenesis of human lung cancer.METHODS: By using RT-PCR and Western blotting,the expressions of FOXP3 mRNA and related protein in 153 samples including lung cancer(n=63),lung benign lesion(n=45) and normal lung tissues(n=45) were analyzed.RESULTS: The positive expressions of FOXP3 mRNA and its protein were observed in lung cancer and in benign lesion lung tissue samples with significant difference(P0.05).CONCLUSION: FOXP3 is a biomarker of CD4+CD25+ regulatory T cell.They are expressed both in lung cancer and benign lesion lung tissues,but not in normal lung tissue.The expression of FOXP3 is more intensive in cancer tissues than that in benign lesions.
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AIM:To investigate the effect of Polo-like kinase-1(Plk1) depletion on cell cycle progression and cell growth in lung cancer cells.METHODS:A recombinant plasmid containing antisense RNA targeting Plk1(pcDNA3-Plk1) was transfected into A549 cells by lipofectine.RT-PCR and Western blotting were used to examine Plk1 gene expression.Cell proliferation was evaluated by cell counting and BrdU labeling.Cell cycle distribution and apoptosis were examined by flow cytometry.Inhibition rate(IR) of vinorebline(NVB) was determined by MTT assay.RESULTS:After transfected with pcDNA3-Plk1 into A549 cells,the expression levels of Plk1 mRNA and protein were greatly decreased.Abnormal morphological changes of cells and growth inhibition were observed in pcDNA3-Plk1 transfected cells.The BrdU labeling index was significantly lower than that in control group(P