Analysis of clinical features and related factors of coronavirus disease 2019 in Shanghai / 上海交通大学学报（医学版）

Objective • To explore the common clinical features of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)-infected local patients in Shanghai and their related influencing factors. Methods • A total of 320 patients admitted to Shanghai Public Health Clinical Center from January to March 2020 and diagnosed as having coronavirus disease 2019(COVID-19) were selected. Clinical data of the patients were collected to analyze their characteristics. Using the statistical operation formula of R language, the correlation analysis of hospitalization days, days of increased hypersensitive C-reactive protein concentration (allergic days), days of lung CT improvement (CT days), and days required for nucleic acid turning negative with the main clinical manifestations and laboratory data was carried out. The correlation factors affecting the above four variables were analyzed. Results • Among the 320 patients, the proportions of mild type, moderate type, serious type and critical type were 6.25%, 83.44%, 6.88% and 3.44%, respectively; 91.25% of them had a history of exposure to Hubei. The proportions of fever, cough, sputum and fatigue were 79.06%, 46.56%, 21.56% and 15.31%, respectively. Spearman correlation analysis showed that the concentrations of lactate dehydrogenase, interleukin-2(IL-2) and IL-6 were positively correlated with the above four variables, respectively (all P<0.05), albumin concentration was negatively correlated with allergic days (P=0.018), and CD4+ cell count was negatively correlated with CT days and days required for nucleic acid turning negative (both P<0.05). Stepwise multiple linear regression analysis showed that procalcitonin (PCT) concentration was negatively correlated with hospitalization days, CT days and allergic days (both P<0.05), and disease type was positively correlated with hospitalization days, allergic days, CT days and days required for nucleic acid turning negative (all P<0.05). Conclusion • Moderate type is common in the local patients in Shanghai; fever, cough and fatigue are common symptoms, and most of the patients are accompanied by lung CT abnormalities. The therapeutic effect and prognosis of these patients are closely related to disease type, concentrations of PCT and IL-6, as well as CD4+ cell count.

Acupuncture combined with western medicine on rheumatoid arthritis and effects on blood stasis / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy of acupuncture combined with western medicine in the treatment of rheumatoid arthritis (RA) and its effect on blood stasis, and to explore ways to improve the clinical curative effect.</p><p><b>METHODS</b>A total of 56 patients of RA were randomly divided into an observation group and a control group, 28 cases in each one. ① ibuprofen sustained-release tablets, 2 times a day, each time 0.3 g; ② methotrexate tablets (MTX), once a week, each time 10 mg ③ folic acid tablets, once a week, each time 5 mg were given in the control group, 30 days as one course, a total of 3 courses were required. In the observation group, acupuncture was adopted on the basis of the treatment as the control group. The main acupoints were Ganshu (BL 18), Pishu (BL 20), Shenshu (BL 23), Hegu (LI 4), Quchi (LI 11), Zusanli (ST 36) combined with local points. The treatment was given once every day for continuous 6 days a week, the treatment for 30 days as one course, a total of 3 courses were required. The serological indexs were evaluated before and after treatment, including the rheumatoid factor (RF), hypersensitive C-reactive protein (hs-CRP), erythrocyte sedirnentation rate (ESR), platelet (PLT), fibrinogen (FBG) and D-dimer (D-D), the changes of disease activity score (DAS-28), symptom grade quantitative score, blood stasis syndrome symptom (the joint tingling, lip color, tongue, pulse, subcutaneous ecchymosis, squamous and dry skin) score were observed.</p><p><b>RESULTS</b>① The scores of RF, hs-CRP, ESR, PLT, D-D, FBG, DAS-28 and symptom grade quantitative were significantly improved in the two groups compared with those before treatment (all <0.05), and the scores of hs-CRP, ESR, DAS-28 and symptom grading in the observation group were more better than those in the control group (all <0.05). ② The total score of joint tingling, lip color, tongue, pulse, subcutaneous ecchymosis, squamous and dry skin and blood stasis syndrome in both groups were decreased after treatment (all <0.05), the joint tingling, tongue, lip color and subcutaneous ecchymosis were improved obviously in the observation group than those in the control group (all <0.05). ③ The total effective rate in the observation group was 85.7% (24/28), which was better than 75.0% (21/28) in the control group (<0.05).</p><p><b>CONCLUSION</b>Acupuncture combined with western medicine can not only improve the clinical efficacy of RA patients but also improve the blood stasis.</p>

Expression Levels of Serum LCN1 and LCN2 in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Its Clinical Significance / 现代检验医学杂志

Objective To investigate the expression level of serum LCN1 and LCN2 in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)and its clinical significance.Methods From May 2015 to April 2017 in Shanghai Yangpu Hospital Affiliated to Tongji University 93 cases with chronic obstructive pulmonary disease were collect-ed as the research object,the acute exacerbation of chronic obstructive pulmonary disease(COPD)in 53 patients,was as the exacerbation group,and chronic obstructive pulmonary disease(COPD)in 40 patients,was as stable group.Another 40 cases were selected to hospital for physical examination,volunteers were set as normal control group.Venous blood was collected, patients sera by ELISA kit for detection of LCN1,LCN2 and high sensitive C reactive protein(hs-CRP),correlation analysis between LCN1,LCN2 and clinical parameters of patients respectively.Results The exacerbation group,stable group and normal control group with age,gender,BMI had no significant difference(F/χ2=1.599~2.028,all P>0.05).In the exac-erbation group,the expression of hs-CRP,neutrophil percentage,and white blood cell count were significantly increased,but FEV1/FVC,FEV1% pred and PaO2were significantly decreased(F=64.942~481.808,all P<0.05).The serum levels of LCN1 and LCN2 in the exacerbation group were significantly higher than those in the stable group(t=19.088,18.904,all P<0.05).The expression of LCN1,LCN2 in serum of COPD patients with age,sex,BMI had no significant correlation(r=0.010~0.161,all P>0.05),it showed a significant positive correlation with hs-CRP,neutrophil percentage,white blood cell count(r=0.418~0.712,all P<0.05),and there was a negative correlation with FEV1/FVC,FEV1% pred and PaO2(r=-0.482~-0.782,P<0.05).Multiple linear regression analysis showed that the percentage of hs-CRP,the percentage of neutrophils,WBC count,and FEV1/FVC,FEV1% pred were independent factors of LCN1,LCN2(OR=0.329~4.035,P<0.05).Conclusion Both LCN1 and LCN2 are highly expressed in serum of patients with COPD,and the expression of LCN1 and LCN2 was closely related to the acute attack of COPD.It would be speculated that LCN1 and LCN2 may be po-tential molecular marker for the diagnosis of acute exacerbation of COPD.