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ImportanceHeart injury can be easily induced by viral infection such as adenovirus and enterovirus. However, whether coronavirus disease 2019 (COVID-19) causes heart injury and hereby impacts mortality has not yet been fully evaluated. ObjectiveTo explore whether heart injury occurs in COVID-19 on admission and hereby aggravates mortality later. Design, Setting, and ParticipantsA single-center retrospective cohort study including 188 COVID-19 patients admitted from December 25, 2019 to January 27, 2020 in Wuhan Jinyintan Hospital, China; follow up was completed on February 11, 2020. ExposuresHigh levels of heart injury indicators on admission (hs-TNI; CK; CK-MB; LDH; -HBDH). Main Outcomes and MeasuresMortality in hospital and days from admission to mortality (survival days). ResultsOf 188 patients with COVID-19, the mean age was 51.9 years (standard deviation: 14.26; range: 21[~]83 years) and 119 (63.3%) were male. Increased hs-TnI levels on admission tended to occur in older patients and patients with comorbidity (especially hypertension). High hs-TnI on admission ([≥] 6.126 pg/mL), even within the clinical normal range (0[~]28 pg/mL), already can be associated with higher mortality. High hs-TnI was associated with increased inflammatory levels (neutrophils, IL-6, CRP, and PCT) and decreased immune levels (lymphocytes, monocytes, and CD4+ and CD8+ T cells). CK was not associated with mortality. Increased CK-MB levels tended to occur in male patients and patients with current smoking. High CK-MB on admission was associated with higher mortality. High CK-MB was associated with increased inflammatory levels and decreased lymphocytes. Increased LDH and -HBDH levels tended to occur in older patients and patients with hypertension. Both high LDH and -HBDH on admission were associated with higher mortality. Both high LDH and -HBDH were associated with increased inflammatory levels and decreased immune levels. hs-TNI level on admission was negatively correlated with survival days (r= -0.42, 95% CI= -0.64[~]-0.12, P=0.005). LDH level on admission was negatively correlated with survival days (r= -0.35, 95% CI= -0.59[~]-0.05, P=0.022). Conclusions and RelevanceHeart injury signs arise in COVID-19, especially in older patients, patients with hypertension and male patients with current smoking. COVID-19 virus might attack heart via inducing inflammatory storm. High levels of heart injury indicators on admission are associated with higher mortality and shorter survival days. COVID-19 patients with signs of heart injury on admission must be early identified and carefully managed by cardiologists, because COVID-19 is never just confined to respiratory injury. Key pointsO_ST_ABSQuestionC_ST_ABSDoes coronavirus disease 2019 (COVID-19) cause heart injury and hereby impact mortality? FindingsIn this retrospective cohort study including 188 patients with COVID-19, patients with high levels of high-sensitivity cardiac troponin I (hs-TNI) on admission had significantly higher mortality (50.0%) than patients with moderate or low levels of hs-TNI (10.0% or 9.1%). hs-TNI level on admission was significantly negatively correlated with survival days (r= -0.42, 95% CI= -0.64[~]-0.12, P=0.005). MeaningCOVID-19 patients with signs of heart injury on admission must be early identified and carefully managed by cardiologists, in order to maximally prevent or rescue heart injury-related mortality in COVID-19.
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Objective To investigate the expression of Nodal and its receptors in different tissues and organs of different development stages of mice.Methods Ten pairs(male and female each for a pair) of mice were divided into the four groups:3 pairs served as adult mice group,the rest 7 pairs were allowed to mate,among them 3 pregnant mice served as the fetal group,and 3 pregnant mice served as the neonatal group and 1 pregnant mouse served as filial group.The multiple tissues and organs such as brain,liver,kidney,heart,lung were selected from fetal,neonatal,filial and adult mice for preparing the protein samples.Western blot was performed to detect the expression of Nodal and its type Ⅰ receptors of ALK7 and ALK4 as well as auxiliary receptor Cripto-1.Results Only cerebrum,cerebellum,liver and kidney had Nodal express in the four different mouse ontogenetic stages,in which only liver and kidney simultaneously expressed Nodal and its receptor protein in the whole four ontogenetic stages.Besides,most tissues and organs of adult mice expressed Nodal and its receptor protein,which was significantly different from the fetal,neonatal and filial mice.Conclusion Nodal signaling might have a certain effect on the growth and development of mouse liver and kidney during the late development stage.
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Objective To obsevre the clinical efficacy of acupuncture at bilateral sphenopalatine ganglions in treating allergic rhinitis. Methods Patients with allergic rhinitis were selected, and then were randomly divided into bilateral group, unilateral group, and control group, with 35 cases in each group. By the end of the study, 5 cases of bilateral group, 3 cases of unilateral group, and 2 cases of control group were removed. The bilateral sphenopalatine ganglions were acupunctured simultaneously in bilateral group, and the unilateral sphenopalatine ganglion was treated by acupuncture in unilateral group, once a week, for 4 weeks. The control group received routine acupuncture on Yingxiang (LI20), Bitong (EX-HN8), Yintang (EX-HN3), and Hegu (LI4), twice a week, for 4 weeks. Rhinitis symptom scale and life quality of nasal conjunctival scale score before and after treatment in the three groups were observed. The clinical efficacy was evaluated and the adverse reactions were recorded. Results The total effective rates of bilateral group, unilateral group and control group were 93.33% (28/30), 90.63% (29/32) and 72.73% (24/33), respectively, and the bilateral group and unilateral group were better than the control group (χ2=19.507, P=0.001), without statistical significance between bilateral group and unilateral group (P>0.05). Rhinitis symptoms and life quality were improved in the three groups (P0.05). Only 1 case of subcutaneous hematoma showed in unilateral group. Conclusion Acupuncture at sphenopalatine ganglions has confirmed efficacy, and there is no difference in the efficacy between acupuncture on bilateral sphenopalatine ganglions and unilateral sphenopalatine ganglion.
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ObjectiveTo discuss the epidemiological characteristic s of road traffic injuries in the Qinghai-Tibet Plateau and explore effective pre ventive measures against traffic accidents in the plateau as well as correspondi ng emergency treatment methods.MethodsA retrospective statis tical analysis was carried out in 1 894 cases of traffic injuries with detailed data admitted in our hospital from January 1980 to December 2000. Resu ltsMost of the traffic accidents occurred on the Qinghai-Tibet road, accounting for 68.0% (1 288/1 894). Of the patients with serious traffic inju ries, 54.0% (1 022/1 894) were in need of hospitalization. The patients who first entered into the plateau accounted for 61.1% (1 158/ 1 894). Death occurre d in 108 cases accounting for 5.7%. The duration from injury to treatment was ve ry long, average over six hours. Furthermore, the patients received no any manag ement before treatment in the hospital. ConclusionsHypoxia i n the plateau, unclear road sign and fatigue driving are the main factors leadin g to traffic accidents. Lack of health care units, serious hypoxia, long deliver y time and carriers' deficiency in medical knowledge are the main causes for gr eat amount of casualties.
