Pulmonary fibrosis in patients with COVID-19: A retrospective study.

Background: Coronavirus disease 2019 (COVID-19) pandemic has caused substantial threats to people's physical health and lives, claiming the lives of over 6 million people worldwide. Although the mortality rate of COVID-19 is very low, many survivors may have different degrees and various sequelae. Previous studies have shown that pulmonary fibrosis (PF) were common on discharged COVID-19 patients, and PF itself is a poor prognostic factor. Methods: 227 COVID-19 hospitalized patients' clinical and laboratory data from the first 15 days following admission were collected in this retrospective study. Groups were based on with or without PF of COVID-19. Categorical variables were compared with the chi-square test or Fisher's exact test. Continuous variables were tested by Wilcoxon rank-sum test for the non-normal distribution. Spearman correlations were used to assess the correlations between PF with clinic parameters of multiple time points. Univariate and multivariate logistic regression were used to analyze for risk factors of COVID-19 patients with pulmonary fibrosis. Results: Sixty cases of COVID-19 patients were diagnosed with PF. Compared with 167 non-PF patients, those with PF were older and had higher proportions of fever, shortness of breath, hemoptysis, abdominal pain, hypertension, cardiovascular, diabetes, high flow nasal cannula (HFNC), severe disease, and virus shedding duration. Furthermore, the correlation analysis between PF and clinic parameters showed that PF were positively related to the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and negatively correlated with hemoglobin (HGB) and albumin (ALB) at all time points in the first 15 days after admission. Moreover, We found that PF were significantly correlated with coagulation indexes prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib) and fibrinolysis index D-Dimer at some phases. In addition, Univariate logistic regression analyses showed that age, fever, shortness of breath, hemoptysis, hypertension, cardiovascular, diabetes, HFNC, severe disease were the risk factors of COVID-19 patients with PF. However, multivariate logistic regression showed that age was the risk factor of COVID-19 patients with PF. Conclusion: Combining various factors, advanced age is an independent risk factor of COVID-19 patients with PF. PF was significantly related with clinic parameter of inflammation/coagulopathy/fibrinolysis.

Predicting mendelian disease-causing non-synonymous single nucleotide variants in exome sequencing studies.

Exome sequencing is becoming a standard tool for mapping Mendelian disease-causing (or pathogenic) non-synonymous single nucleotide variants (nsSNVs). Minor allele frequency (MAF) filtering approach and functional prediction methods are commonly used to identify candidate pathogenic mutations in these studies. Combining multiple functional prediction methods may increase accuracy in prediction. Here, we propose to use a logit model to combine multiple prediction methods and compute an unbiased probability of a rare variant being pathogenic. Also, for the first time we assess the predictive power of seven prediction methods (including SIFT, PolyPhen2, CONDEL, and logit) in predicting pathogenic nsSNVs from other rare variants, which reflects the situation after MAF filtering is done in exome-sequencing studies. We found that a logit model combining all or some original prediction methods outperforms other methods examined, but is unable to discriminate between autosomal dominant and autosomal recessive disease mutations. Finally, based on the predictions of the logit model, we estimate that an individual has around 5% of rare nsSNVs that are pathogenic and carries ~22 pathogenic derived alleles at least, which if made homozygous by consanguineous marriages may lead to recessive diseases.

[Effects of acupuncture of Jianjing (GB 21) on gallbladder volume and symptoms of cholecystitis patients].

OBJECTIVE: To observe the effect of acupuncture of Jianjing (GB 21) and non-acupoint on gallbladder volume and clinical symptoms of chronic cholecystitis patients. METHODS: Sixty cases of chronic cholecystitis patients were equally randomized into Jianjing (GB 21) group and non-acupoint group. A filiform needle was inserted into Jianjing (GB 21) or non-acupoint (2 cun lateral to the mid-point between the spinous processes of the 6th and 7th cervical vertebrae) on the right side, manipulated for a while till "Deqi", and retained for 30 min. A color Doppler ultrasound scanner was used to detect the volume of the gallbladder before and 15 min after acupuncture stimulation and 30 min after withdrawal of the acupuncture needle. Changes of the patients symptoms of shoulder-back pain, stomachache, distension and nausea were evaluated according to the patients' complaints. RESULTS: After acupuncture intervention, the remission rates of shoulder-back pain and stomachache in non-acupoint and GB 21 groups were 56.67% and 90.00% respectively, while the effective rates of the patients' gastric distention and nausea in non-acupoint and GB 21 groups were 16.67% and 23.33%, respectively. The therapeutic effect of Jianjing (GB 21) was apparently superior to that of non-acupoint in pain relief (P < 0.05). Fifteen min following acupuncture stimulation and 30 min after withdrawal of the acupuncture needle, the gallbladder volume in cholecystitis patients with deflated gallbladder was increased apparently in GB 21 group (P < 0.01), and that in patients with expanded gallbladder was decreased significantly (P < 0.01). No significant differences were found among pre-, during and post-treatment in the non-acupoint group in the effects of acupuncture on regulation of the deflated and expanded gallbladder volume (P > 0.05). CONCLUSION: Acupuncture stimulation of Jianjing (GB 21) can effectively relieve shoulder-back pain and stomachache, and regulate the volume of the deflated and expanded gallbladder in cholecystitis patients. The effect of acupuncture of non-acupoint is relatively poorer in relieving the cholecystitis patients' symptoms and regulating the gallbladder volume.

[Observation of effect on contraction function of gallbladde by acupuncture at Jianjing (GB 21)].

OBJECTIVE: By B ultrasound, the changes of contraction function of gallbladder by acupuncture at Jianjing (GB 21) were observed and the internal relations between Jianjing (GB 21) and cholecystitis were explored, in order to explore the better therapy. METHODS: Two hundreds cases who had been diagnosed as cholecystitis (acalculous cholecystitis) were classified in observation group, including gallbladder expanding (84 cases) and gallbladder constricting (116 cases); 100 cases who had examined as healthy were taken in control group. Acupuncture at Jianjing (GB 21) on right shoulder was applied in both groups. Through B ultrasound examination, the changes of gallbladder volume in both groups were compared before acupuncture, 15 min after needle insertion and 30 min after needle withdrawing. RESULTS: The gallbladder volume of gallbladder expanding and gallbladder constricting cases were constricted or expanded 15 min after needle insertion and 30 min after needle withdrawing, and there were statistical significances (all P < 0.01). Compared the outcomes at different time points after acupuncture with that before acupuncture, the changes of gallbladder constricting were unobvious (both P > 0.05) in control group. In observation group, the pain relief rate for 142 cases companied with shoulder and back pain was 98.6% (140/142). CONCLUSION: Acupuncture at Jianjing (GB 21) can improve the gallbladder constricting, regulate bidirectional function of expanding and constricting, and efficiently relieve shoulder and back pain.

[Impacts of Taichong (LR 3) on blood flow velocity in patients with vertebrobasilar insufficiency].

OBJECTIVE: To observe the intervention on the disturbance of blood flow velocity in vertebral artery in patients with vertebrobasilar insufficiency (VBI) treated with acupuncture at Taichong (LR 3) so that the clinical evidences could be provided for the research of acupoint specificity. METHODS: One hundred cases of VBI were tested with Transcranial Doppler (TCD) and 43 vessels of low velocity of blood flow and 79 vessels of high velocity of blood flow were discovered. Additionally, 50 cases of normal people were selected in control group, including totally 100 vertebral arteries. The velocity changes in systolic period (Vs) of vertebral artery were observed before and after acupuncture at Taichong (LR 3). RESULTS; After acupuncture at Taichong (LR 3), Vs of vertebral artery in low velocity cases was increased apparently. Vs in 5 to 10 min after acupuncture and half a hour after needle withdrawal was different significantly in statistics as compared with Vs before acupuncture (both P < 0.01). Vs of vertebral artery in high velocity cases was reduced apparently. Vs in 5 to 10 min after acupuncture and half a hour after needle withdrawal was different significantly in statistics as compared with Vs before acupuncture (both P < 0.01). There was no significant difference in statistics in comparison before and after acupuncture in control group (P > 0.05). CONCLUSION: Acupuncture at Taichong (LR 3) improves blood supply in vertebral artery in the mode of dual regulation and rectifies the disturbance of vertebral artery blood flow in dynamics.