Effects of smoking on the severity and transmission of pulmonary tuberculosis: A hospital-based case control study.

Introduction: There is a high incidence of both smoking and tuberculosis (TB) in China. This study examined the risk factors for severe pulmonary TB (PTB) and positive tubercle bacilli in sputum. Methods: We conducted a retrospective case-control study in a tertiary hospital from January 2017 to December 2018 (n = 917). The clinical and biological characteristics of patients were collected, and univariable and multivariable logistic regression analyses were performed to assess the factors associated with smoking in terms of the severity and transmission of PTB. Results: Positive tubercle bacilli in sputum and severe PTB were much higher in smoking patients. Together with nutrition status, heavy smoking exhibited a 284% greater risk in severe PTB. Positive tubercle bacilli in sputum was significantly associated with hypoproteinemia and smoking regardless of the status, duration, and degree. Conclusion: Because cigarette smoking was strongly and inversely associated with hypoproteinemia, we conclude that smoking plays a critical role in the severity and transmission of PTB. Smoking cessation interventions should be employed to prevent severe PTB and decrease the transmission of PTB.

Chaotic Mapping-Based Anti-Sorting Radio Frequency Stealth Signals and Compressed Sensing-Based Echo Signal Processing Technology.

Radio frequency (RF) stealth anti-sorting technology can improve the battlefield survival rate of radar and is one of the research hotspots in the radar field. In this study, the signal design principle of anti-sequential difference histogram (SDIF) sorting was explored for the main sorting algorithm of the SDIF. Furthermore, we designed a piecewise linear chaotic system with interval number parameterization based on random disturbance and proposed a method to modulate the repetition period of widely spaced signal pulses using a chaotic system. Then, considering the difficulty of the traditional signal processing method to measure the velocity of the highly random anti-sorting signals designed in this paper, we used compressed sensing (CS) technology to process the echoes of the signals to solve the velocity and distance of the detection targets. Finally, simulation verification was performed from the correctness of the signal design principle, the performance of the chaotic system, the anti-sorting performance of the designed signals and the recovery and reconstruction performance of the signals by CS. The results show that: (a) the signal design principle presented in this paper can guide the signal design correctly; (b) the performance of the piecewise linear chaotic system with interval number parameterization is better than that of the classical one-dimensional chaotic system; (c) the anti-sorting signal modulated by the chaotic system can achieve anti-SDIF sorting, and the anti-sorting signals designed in this paper can be processed to obtain the velocity and distance of the targets.

Design of Multi-Parameter Compound Modulated RF Stealth Anti-Sorting Signals Based on Hyperchaotic Interleaving Feedback.

Radio frequency (RF) stealth anti-sorting technology is a research hotspot in the radar field. In this study, the signal design principles of anti-cluster and anti-SDIF sorting were investigated for processes of clustering pre-sorting and sequence-difference-histogram main sorting. Then, in accordance with the signal design principle, a 2D interleaving feedback hyperchaotic system based on the cosine-exponential was designed. A method to modulate the pulse repetition interval (PRI) of the signal parameters and carrier frequency with wide intervals through the hyperchaotic system was developed. Finally, we verified the correctness of the signal design principle, the performance of the hyperchaotic system, and the anti-sorting performance of the designed signal using simulations. The results showed that the signal design principle could guide the signal design. The hyperchaotic system outperformed the classical 1D and 2D chaotic systems and the classical 3D Lorenz systems in terms of randomness and complexity. Anti-cluster sorting and anti-SDIF sorting could be realized by anti-sorting signals modulated by a hyperchaotic system, with the anti-SDIF sorting performance being better than that of the PRI random jitter signal.

Clinical and Demographic Characteristics of Cluster Cases and Sporadic Cases of Coronavirus Disease 2019 (COVID-19) in 141 Patients in the Main District of Chongqing, China, Between January and February 2020.

BACKGROUND In December 2019, an outbreak of coronavirus disease 2019 (COVID-19), due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in Wuhan, China. Patients with COVID-19 were also identified in Chongqing. This study aimed to investigate the clinical and demographic characteristics of cluster cases and sporadic cases of COVID-19 in 141 patients in the main district of Chongqing during one month, between January and February 2020. MATERIAL AND METHODS A retrospective study included 141 patients with a diagnosis of COVID-19. The diagnosis was confirmed using real-time reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2. The patients were divided into cluster cases (n=90) and sporadic cases (n=51). Demographic and clinical characteristics were compared between the two study groups and included the presence of comorbidities, the presenting symptoms, chest computed tomography (CT) imaging findings, and laboratory findings. RESULTS The mean age of the 141 patients diagnosed with COVID-19 was 47.3 years, and the most common presenting symptom was a persistent cough (48.9%). The 90 cluster cases (63.8%) were older than the sporadic cases, and cross-infection from family gathering occurred in 82.2%, and cough was more common than fever, and there was an increased prevalence of asymptomatic, mild, and moderate cases. Cluster cases showed fewer typical manifestations of COVID-19 on chest CT. However, the laboratory findings between the cluster and sporadic cases showed no significant differences. CONCLUSIONS There were demographic and clinical differences between cluster cases and sporadic cases of COVID-19 in the main district of Chongqing during the month between January to February 2020.

Epidemiological and clinical characteristics of 136 cases of COVID-19 in main district of Chongqing.

BACKGROUND: We did a comprehensive exploration of the epidemiological and clinical characteristics of 136 patients with confirmed COVID-19 in main district of Chongqing which was adjacent to the west of Hubei province. METHODS: This study was conducted on 136 patients with COVID-19 in main district of Chongqing from Jan 25 to Feb 20, 2020. Data of patients included demographic, epidemiological, clinical features, chest radiographs of imported cases, local cases, second-generation cases and third-generation cases. Student's t-test was adopted for quantitative variables while Pearson Chi-squared test or Fisher's exact test for categorical variables. RESULTS: The median age was 47 years and common symptoms of illness were cough (50.7%), fever (47.1%) and fatigue (14.0%). The time from contact symptomatic case to illness was 7.7 days, and 88 patients (64.7%) were cluster cases, radiological evidence found bilateral lung involvement was common (57.4%).Compared with the imported cases, the local cases were significantly older, the proportion of men is lower. There was higher proportion of cluster cases in local cases. Unlike imported cases, which fever was the dominant symptom, the local cases have more cough patients, with a significant higher proportion of asymptomatic patients. The third-generation cases have a significant higher proportion of asymptomatic patients. CONCLUSION: We concluded the epidemiological and clinical characteristics of the cases andsuggested to take more comprehensive measures for screening patients, especially for elderly person, avoid family gatherings, and implement more closely surveillance of suspect patients and their close contacts.

Clinical significance of annexin II expression in human non-small cell lung cancer.

The aim of the present study is to explore the role of annexin II in the development and progression of human non-small cell lung cancer (NSCLC). Real-time quantitative reverse transcription-polymerase chain reaction was conducted to detect annexin II mRNA expression. Annexin II protein expression was also determined by western blot. In addition, annexin II expression was analyzed by immunohistochemistry in 137 clinicopathologically characterized NSCLC cases. The correlation of annexin II expression with patients' survival rate was assessed by Kaplan-Meier analysis and Cox regression. Our results showed that the expression levels of annexin II mRNA and protein in NSCLC tissues were significantly higher than those in non-cancerous tissues. Immunohistochemistry analysis showed that annexin II expression was significantly correlated with tumor diameter, pathological grade, pT status, pN status, and pleural invasion. The results of the Kaplan-Meier analysis indicated that a high expression level of annexin II resulted in a significantly poor prognosis of NSCLC patients. Multi-variate Cox regression analysis revealed that annexin II expression level was an independent prognostic parameter for the overall survival rate of NSCLC patients. In conclusion, these results suggested that annexin II up-regulation was associated with poor prognosis in NSCLC; therefore, it might act as a prognostic marker and a new potential target for NSCLC treatment.

Protocol-directed versus physician-directed weaning from noninvasive ventilation: the impact in chronic obstructive pulmonary disease patients.

BACKGROUND: Noninvasive ventilation (NIV), a technique widely used in intensive care units (ICUs), eliminates the need for many patients in respiratory failure to undergo intubation. However, few articles have described how to wean patients from NIV. Herein, we put forward a protocol to be performed by respiratory therapists to wean patients from NIV. METHODS: A prospective, randomized, controlled trial was performed in a respiratory ICU of a teaching hospital. Respiratory therapists screened patients daily. In the protocol-directed weaning group, the weaning attempt was initiated according to the protocol. In the physician-directed weaning group, the weaning attempt was initiated according to physicians' orders. RESULTS: At randomization, patients in the two groups had similar clinical characteristics. A total of 73 patients were successfully weaned from NIV (37 in the protocol-directed group and 36 in the physician-directed group). The preponderance of them (64%) was chronic obstructive pulmonary disease patients. Compared with physician-directed weaning, protocol-directed weaning reduced the duration of NIV (4.4 ± 2.5 days vs. 2.6 ± 1.5 days, respectively, p < 0.001) and the duration of the ICU stay (8.1 ± 5.5 days vs. 5.8 ± 2.7 days, respectively, p = 0.02). In the protocol-directed group, the successful weaning rate was 57%, 27%, 13%, 0%, and 3% on the 1st, 2nd, 3rd, 4th, and 5th days after randomization, respectively. CONCLUSIONS: Protocol-directed weaning reduces the duration of NIV and the duration of the ICU stay. LEVEL OF EVIDENCE: II.

Dual-mode weaning strategy for difficult-weaning tracheotomy patients: a feasibility study.

BACKGROUND: Tracheotomy patients who are difficult to wean from ventilation consume a substantial portion of intensive care unit (ICU) resources. These patients also typically undergo a long period of mechanical ventilation (MV) and have a high mortality rate. The efficacy of a dual-mode weaning strategy (alternation of invasive and noninvasive MV) in tracheotomy patients who are difficult to wean is unknown. METHODS: We performed this prospective, randomized, controlled trial in a 17-bed respiratory ICU from July 2009 to October 2011. After tracheotomy, patients who failed for 3 consecutive days in a spontaneous breathing trial were enrolled (n = 32) and randomly allocated to either the dual-mode (n = 15) or conventional (n = 17) weaning group. RESULTS: Compared with the conventional group, patients in the dual-mode group had a shorter duration of MV during the entire study (median 38 days, interquartile range [IQR]: 28-53 vs 59, IQR: 39-88, P = 0.03) and after randomization (median 10 days, IQR: 4-21 vs 37, IQR: 16-51, P < 0.01). They also had a shorter ICU stay (median 44 days, IQR: 32-54 vs 72, IQR: 52-102, P = 0.01), a lower mortality rate during weaning (1 of 15 vs 7 of 17, P = 0.04), and a lower rate of pulmonary infection after randomization (3 of 15 vs 12 of 17, P < 0.01). CONCLUSIONS: Dual-mode weaning is a promising strategy for treating tracheotomy patients who are difficult to wean. In a small cohort of patients with tracheotomies, we demonstrated that dual-mode weaning reduced the total duration of MV and ICU stay; we recommend additional studies to assess its effect on pulmonary infections and mortality.