The respiratory sound features of COVID-19 patients fill gaps between clinical data and screening methods

BackgroundThe 2019 novel coronavirus (COVID-19) has continuous outbreaks around the world. Lung is the main organ that be involved. There is a lack of clinical data on the respiratory sounds of COVID-19 infected pneumonia, which includes invaluable information concerning physiology and pathology. The medical resources are insufficient, which are now mainly supplied for the severe patients. The development of a convenient and effective screening method for mild or asymptomatic suspicious patients is highly demanded. MethodsThis is a retrospective case series study. 10 patients with positive results of nucleic acid were enrolled in this study. Lung auscultation was performed by the same physician on admission using a hand-held portable electronic stethoscope delivered in real time via Bluetooth. The recorded audio was exported, and was analyzed by six physicians. Each physician individually described the abnormal breathing sounds that he heard. The results were analyzed in combination with clinical data. Signal analysis was used to quantitatively describe the most common abnormal respiratory sounds. ResultsAll patients were found abnormal breath sounds at least by 3 physicians, and one patient by all physicians. Cackles, asymmetrical vocal resonance and indistinguishable murmurs are the most common abnormal breath sounds. One asymptomatic patient was found vocal resonance, and the result was correspondence with radiographic computed tomography. Signal analysis verified the credibility of the above abnormal breath sounds. ConclusionsThis study describes respiratory sounds of patients with COVID-19, which fills up for the lack of clinical data and provides a simple screening method for suspected patients.

Effect of HSP70 on apoptotic of cartilage cells in knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the expression and relationship between HSP70 and caspase-3 in knee osteoarthritis.</p><p><b>METHODS</b>Forty adult SD rats were divided into experimental group and control group. Thirty rats in experimental group, anterior cruciate ligament transaction (ACLT) was cut off and partial meniscectomy of 1/3 inside incision were performed to reproduce knee osteoarthritis (KOA) model according to Hulth methos, and the other 10 rats was treated with nothing as control group. The rats were sent to the cage and free to move. At 1, 2 and 4 weeks later, the arthritis cartilage of femoral and tibial end were observed through immunohistochemistry staining and light microscope. Meanwhile, Mankin scale system was adopted for histomorphology evaluation.</p><p><b>RESULTS</b>Changes of KOA such as hyperplastic synovium,erosion on the surface of cartilage and so on were found in experiment group, the expression of HSP70 was augmentation all the time, but the expression of caspase-3 was reduction 1 week later; no similar changes were found in control group. Mankin scale system showed that there were significant differences in the first week as compared with the second week and 4th week (both P < 0.01).</p><p><b>CONCLUSION</b>Heat shock protein inhibit the apoptosis of cartilage cells and protect the cartilage cells in knee osteoarthritis, the conservative treatment for clinical provide objective scientific basis.</p>

Multiple primary malignant neoplasms of three early cancer lesions: a case report / 中华医学杂志(英文版)

Multiple primary malignant neoplasms (MPMNs) are rarely reported and it is important to give early diagnosis and proper therapy for these patients. Here reported a case of 62-year-old man with concomitant three early stage cancer lesions in upper gastrointestinal tract, all of which were detected by endoscopy. The first one was an IIc-type lesion at angular part of stomach under endoscopy, which was histologically confirmed to be a mucosal well-differentiated adenocarcinoma. The patient underwent a standard radical gastrectomy for the lesion after the failure of endoscopic treatment. The other two neoplasms were observed during follow-up and were indicated as early stage lesions by synthesizing information from endoscopy, endoscopic ultrasonography, computed tomography and biopsy. One displayed as a hyperemic patch (3 cm×4 cm in size) located at the part of esophagus 27 cm away from the incisor teeth and was proved to be moderately differentiated squamous cancer by histopathological examination. The other was an IIc-type lesion (3.0 cm×3.5 cm in size) located at the part of esophagus 36 cm away from the incisor teeth, and the biopsy result showed a poorly differentiated squamous carcinoma. Both the two lesions were treated with radical radiation because the patient refused surgery management. No recurrence of former lesions or occurrence of novel lesions were observed during post-treatment follow-up, suggesting radical radiation might be effective for this patient.

Clinicopathological and biological features of micrometastasis in early gastric cancers / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the clinicopathological and biological features of micrometastasis in early gastric cancers.</p><p><b>METHODS</b>Eleven cases of early gastric cancer with micrometastasis (micrometastatic, MM group) and 46 cases of early gastric cancer with lymph node metastasis (control group) were included in the study. Immunochemical staining of ssDNA, bcl-2, p53, E-cadherin, Ki-67, CD34 was performed. The superficial lesions, invasive fronts and lymph nodes were examined in both groups.</p><p><b>RESULTS</b>Positive rate of ssDNA at the superficial lesions in MM group was higher than that in control group. In MM group the positive rate of ssDNA in micrometastasis was higher than that at invasive fronts and in lymph nodes. Positive rate of bcl-2 at the superficial lesions in micrometastasis was higher than that at invasive fronts and lymph nodes. Positive rate of c-myc at the superficial lesions in MM group was higher than that in control group. Positive rate of E-cadherin and the percentage of microvascular areas at the lymph nodes in MM group was lower than those in control group. Proliferative ability of cancer cells at superficial lesions and lymph nodes in MM group was lower than those in control group. Lymph nodes <3 mm in micrometastasis accounted for 27.3%.</p><p><b>CONCLUSION</b>The pathological and biological features of micrometastasis in early gastric cancer show low positive rate of ssDNA, E-cadherin, Ki-67 and low percentage of microvascular areas at the lymph nodes.</p>