Clinical characteristics and related risk factors of disease severity in 101 COVID-19 patients hospitalized in Wuhan, China.

Coronavirus disease 2019 (COVID-19) broke out in December 2019. Due its high morbility and mortality, it is necessary to summarize the clinical characteristics of COVID-19 patients to provide more theoretical basis for future treatment. In the current study, we conducted a retrospective analysis of the clinical characteristics of COVID-19 patients and explored the risk factors for the severity of illness. A total of 101 COVID-19 patients hospitalized in Leishenshan Hospital (Wuhan, China) was classified into three sub-types: moderate (n = 47), severe (n = 36), and critical (n = 18); their clinical data were collected from the Electronic Medical Record. We showed that among the 101 COVID-19 patients, the median age was 62 years (IQR 51-74); 50 (49.5%) patients were accompanied by hypertension, while 25 (24.8%) and 22 (21.8%) patients suffered from diabetes and heart diseases, respectively, with complications. All patients were from Wuhan who had a definite history of exposure to the epidemic area. Multivariate logistic regression analysis revealed that older age, diabetes, chronic liver disease, percentage of neutrophils (N%) > 75%, CRP > 4 mg/L, D-dimer > 0.55 mg/L, IL-2R > 710 U/mL, IL-8 > 62 pg/mL, and IL-10 > 9.1 pg/mL were independent variables associated with severe COVID-19. In conclusion, we have identified the independent risk factors for the severity of COVID-19 pneumonia, including older age, diabetes, chronic liver disease, higher levels of N%, CRP, D-dimer, IL-2R, IL-8, and IL-10, providing evidence for more accurate risk prediction.

Predictive role of monocyte-to-lymphocyte ratio in patients with Klebsiella pneumonia infection: A single-center experience.

The aim of the study is to explore whether monocyte-to-lymphocyte ratio (MLR) provides predictive value of the severity in patients with Klebsiella pneumonia infection (KPI).Patients in a tertiary medical center with Klebsiella pneumonia infection from 2014 to 2017 were recruited in this study. Patients with Klebsiella pneumonia infection were stratified into two groups based on the National Early Warning Score (NEWS). MLR was calculated by dividing monocytes count by lymphocytes count obtained from routine blood examination. The area under the curve (AUC) values was determined using the receiver-operating characteristic (ROC) curve. The correlation between the variables was tested with Pearson or Spearman correlation analysis. Ordinal logistic regression analysis was used to assess the relationship between MLR and the severity of Klebsiella pneumonia infection.One hundred fifty-two patients were finally enrolled for analysis. Among those, 43 (28.29%) cases had severe KPI. MLR was found to be an independent risk factor of the serious Klebsiella pneumonia infection (OR: 23.74, 95% CI: 5.41-104.11, P < .001). Besides, MLR was positively correlated with NEWS score (r = 0.57, P < .001). In the receiver-operating characteristic (ROC) curve analysis, MLR, with an optimal cut-off value of 0.665, predicted the severe coronary lesion with a sensitivity of 79.4% and specificity of 84.4%.MLR was an independent predictor of the severe Klebsiella pneumonia infection. Compared with neutrophil-to-lymphocyte ratio (NLR), MLR has a better performance to evaluate the severity of Klebsiella pneumonia infection.

Low FT3 is a valuable predictor of severe acute pancreatitis in the emergency department.

OBJECTIVE: To investigate the relationship between serum levels of thyroid hormones and disease severity at the early stage of acute pancreatitis (AP). METHODS: Cohort data from 172 patients with AP attending the Emergency Department of our hospital from 2012 to 2017 were retrospectively reviewed and analyzed. Patients were categorized into mild (MAP), moderately severe (MSAP) and severe AP (SAP) groups based on the disease severity. The MSAP and SAP groups were combined into a non-MAP group for analysis. The predictive values of C-reactive protein (CRP) levels, Ranson score, APACHE II score and serum thyroid hormone levels were analyzed. RESULTS: In total, 76 (44.2%), 85 (49.4%) and 11 (6.4%) patients were included in the MAP, MSAP and SAP groups, respectively. The free triiodothyronine (FT3) levels were significantly lower in the combined non-MAP group than in the MAP group. The tetraiodothyronine (T4) levels were significantly lower in the SAP group than in the MAP and MSAP groups (P = 0.002). Logistic regression analysis revealed that a low FT3 level was an independent risk factor for the incidence of non-MAP (P = 0.004). The area under the receiver operating characteristic curve and sensitivity of FT3 were 0.729 and 88.2%, respectively, which were higher than those of CRP, Ranson and APACHE II scores. CONCLUSION: Monitoring FT3 levels in the early stage of AP is helpful for evaluating disease severity and predicting the incidence of non-MAP, making it a useful tool for guiding AP treatment.

Treatment of direct blending dye wastewater and recycling of dye sludge.

A new sorbent material, barium sulfate-Direct Blending Yellow D-3RNL hybrid (BSD), was synthesized and characterized by various methods. Both the anionic dyes, Reactive Brilliant Red X-3B and Weak Acid Green GS were hardly adsorbed by the BSD material, while the sorption of Ethyl Violet (EV) and Victoria Blue B were extremely obvious. The sorption of cationic dyes obeyed the Langmuir isotherm model, which depended on the electric charge attraction. The saturation amount of EV adsorbed onto the BSD material approached to 39.36 mg/g. The sorption of EV changed little with pH from 3 to 12 while it increased with increasing levels of electrolyte. A dye wastewater sampled from Jinjiang Chemicals was treated, and the color removal rate was more than the COD removal rate. In addition, the cationic dye-BSD sludge was utilized as a colorant fill-in coating. The light stability and thermal stability of the colorant was measured and exhibited good features. This work provided a simple and eco-friendly method for dye wastewater treatment with recycling of waste.

CR@BaSO4: an acid rain-indicating material.

The CR@BaSO(4) hybrid was synthesized, characterized and used as an acid rain-indicating (ARI) material. A painted ARI umbrella was discolored after exposure to simulated acid rain of pH 5 or less and returned to the initial color after the rain stopped. Such a functionalized material may make acid rain visual to remind people in real-time.

Early tracheotomy for acute severe asthma.

BACKGROUND: Few studies have reported the effects of early tracheotomy in acute severe asthmatic patients. We report two patients with acute severe asthma who were successfully treated with early tracheotomy. METHODS: The two patients with acute severe asthma were retrospectively reviewed. They had been treated at the Department of Emergency and Critical Care, Renji Hospital, Shanghai Jiaotong University School of Medicine. RESULTS: They developed progressively hypercapnia and severe acidosis, and were not improved after conventional therapies. Early tracheotomy after mechanical ventilation decreased airway resistance and work of breathing, and corrected hypercapnia and acidosis. Adequate gas exchange was maintained after tracheotomy. The two patients were subsequently weaned from mechanical ventilation and discharged. CONCLUSION: Early tracheotomy could be a valuable approach in certain patients with severe asthma.

[Effect of ethyl pyruvate on expression of inflammatory factors and mitogen-activated protein kinase proteins in renal ischemic/reperfusion injury in BABL/c mice].

OBJECTIVE: To investigate the effects of ethyl pyruvate (EP) on expression of proinflammatory related gene and proteins of mitogen-activated protein kinase (MAPK) in renal tissues in ischemic/reperfusion (I/R) injury in mice. METHODS: Fifty male BABL/c mice were randomly divided into sham operation group (n=8), model group (n=10), and EP treatment group (n=32). EP treatment group was subdivided into EP pretreatment group (administration of 40 mg/kg EP 30 minutes before reproduction of model, n=8), and 4, 6 and 12 hours treatment groups (administration of 40 mg/kg EP 4, 6 and 12 hours after reproduction of model, respectively, n=8 in each group). Bilateral renal artery was occluded with a microvascular clamp for 30 minutes to reproduce kidney I/R injury model, and the kidney was harvested at 24 hours after I/R. The mRNA expressions of interleukins (IL-1ß, IL-6), tumor necrosis factor-α (TNF-α), intercellular adhesion molecule-1 (ICAM-1) and high-mobility group box 1 (HMGB1) were determined by real time reverse transcription-polymerase chain reaction (RT-PCR). The changes in protein levels of MAPKs [extracellular regulated protein kinase 1/2 (ERK1/2), c-Jun N-terminal kinase (JNK), p38MAPK] were determined by Western blotting analysis. RESULTS: Real-time PCR assay showed that the mRNA expressions of IL-1ß, IL-6, TNF-α, ICAM-1, HMGB1 in renal tissue were much higher than those in sham operation group (IL-1ß: 12.05±8.08 vs. 3.18±1.13, IL-6: 10.26±6.85 vs. 0.81±0.34, TNF-α: 5.83±3.85 vs. 0.67±0.34, ICAM-1: 3.87±2.02 vs. 0.29±0.13, HMGB1: 652.82±78.50 vs. 112.31±32.50, all P<0.05); and the expression in EP treatment groups was markedly down-regulated than that in model group, especially in 12-hour treatment group (0.45±0.26, 0.66±0.13, 0.21±0.11, 0.05±0.02, 212.26±3.20, respectively, all P<0.05). Western blotting analysis revealed that the expression of the phosphorylated forms of ERK1/2, JNK, p38MAPK proteins was significantly higher than in sham operation group (p-ERK1/2: 1.13±0.38 vs. 0.48±0.34, p-JNK: 1.40±0.15 vs. 0.36±0.15, p-p38MAPK: 0.47±0.15 vs. 0.21±0.17, all P<0.05); the expression of the phosphorylated forms of ERK1/2, JNK, p38MAPK in each EP treatment group was significantly down-regulated compared with that in model group (all P<0.05). CONCLUSION: EP can effectively protect kidney from acute injury produced by I/R, which may be related to the regulation of proinflammatory genes and the MAPKs in renal tissue.