Nurses' knowledge, attitude, and practice regarding the use of physical restraints in children in the intensive care setting in China: A cross-sectional multicentre study.

OBJECTIVE: The objectives of this study were to investigate paediatric nurses' knowledge, attitude, and practice (KAP) regarding the use of physical restraints and to explore the factors related to the use of physical restraints. Findings will provide a reference to develop standard procedures and training. BACKGROUND: Nurses' KAP regarding the use of physical restraints affect the use of physical restraints in the paediatric intensive care unit and neonatal intensive care unit. Understanding nurses' decision-making processes should inform strategies and methods for effectively reducing and regulating the use of physical restraints in paediatric patients in the intensive care unit (ICU) in China. METHODS: We conducted a cross-sectional survey of 823 registered ICU nurses from 12 children's hospitals in China between April and June, 2020. ICU nurses' KAP regarding the use of physical restraints in children were evaluated using a structured self-administered questionnaire that was distributed through an online platform. Descriptive and multiple linear regression analyses were used to examine the factors that influenced ICU nurses' KAP regarding the use of physical restraints in children. RESULTS: Overall, 49.8% of respondents were paediatric intensive care unit nurses, 25.0% of respondents were neonatal intensive care unit nurses, and 25.2% of respondents were other ICU nurses; 58.44% of nurses had received some training on the use of physical restraints in children. Mean total scores on the items addressing ICU nurses' knowledge (range, 0 [lowest level of knowledge] -11 [highest level of knowledge]), attitude (range, 11 [least likely to use physical restraint] - 55 [most likely to use physical restraint]), and practice (range, 14 [few skills] - 42 [good skills]) regarding the use of physical restraints in children were 8.00 ± 1.46, 30.67 ± 5.31, and 37.61 ± 3.46, respectively. Multiple linear regression analysis showed a higher level of education and less work experience (years) were related to higher knowledge scores; prior training in the use of physical restraint was related to lower attitude scores; and female, prior training in the use of physical restraints, and a higher level of education were related to higher practice scores. CONCLUSIONS: Nurses would like to use physical restraints without physician approval in an emergency or when they could not pay close attention to a child. There are a few standardised training and lack of clinical guidelines for paediatric nurses. We recommend establishing a standard of care for physical restraints in paediatric patients.

Hierarchically structural layered double oxides with stretchable nanopores for highly effective removal of protein-bound uremic toxins.

The global outbreak and prevalence of coronavirus disease 2019 (COVID-19) has triggered an urgent demand for family hemodialysis equipment. It is particularly vital to design and apply superior adsorbents to adsorb toxins for reducing the usage of dialysate. In this work, hierarchically structural MgAl layered double oxides (LDO) with stretchable nanopores were exploited through a facile one-pot trisodium citrate (TSC) assistant hydrothermal reaction followed by calcination treatment for effectively adsorbing protein-bound uremic toxins such as hippuric acid (HA) or indoxyl sulfate (IS). The optimized MgAl LDO possessed flower-like spherical morphology, ultrahigh specific surface area (187.3 m2/g) and uniquely stretchable nanopores, which were more conducive to incorporating anions due to their unique memory effect endowing them with promising adsorption capacities for HA or IS. And the adsorption data could be better conformed to pseudo-second-order kinetic model and Langmuir isotherm determining that the maximum adsorption capacity of HA and IS was 129.8 mg/g and 63.1 mg/g, respectively. Furthermore, the computation of molecular size paired with the analysis of adsorption mechanism accurately revealed that high-efficiency toxin capture was mainly attributed to electrostatic interaction for internal intercalation and surface adsorption. Therefore, the application of such delicate LDO as new premium adsorbent would facilitate the development and popularization of family hemodialysis equipment.

A Novel and Facile Method to Prepare Integrated Electrospun Nanofibrous Membrane with Soldered Junctions.

Integrated electrospun nanofibrous membrane was prepared by creating soldered junctions between nanofibers via a facile strategy. Polyacrylonitrile (PAN) mixed with poly(vinylidene fluoride) (PVDF) at different ratios of PVDF were prepared in N,N'-dimethyl formamide (DMF), then electrospun to fabricate PAN/PVDF membranes. PVDF can form microgels in DMF which slows down volatile speed of DMF and affects the solidification of PAN/PVDF nanofibers. The resulting membranes were investigated by Fourier transform infrared spectroscopy, scanning electron microscopy, dynamic water contact angle and tensile testing to confirm the morphology and mechanical properties. Soldered junctions were observed between nanofibers with the increase of PVDF content. These junctions made the membrane integrated and greatly enhanced tensile strength from 5.1 to 8.1 MPa (increased by ~60%) and tensile modulus from 49.4 to 117.9 MPa (increased by ~139%) without compromising porosity when the content of PVDF increased from 0 to 60 wt%.

Crosslinking and fluorination reinforced PTFE nanofibrous membrane with excellent amphiphobic performance for low-scaling membrane distillations.

Membrane distillation (MD) has emerged as a promising technology for desalination and concentration of hypersaline brine. However, the efficient preparation of a structurally stable and salinity-resistant membrane remains a significant challenge. In this study, an amphiphobic polytetrafluoroethylene nanofibrous membrane (PTFE NFM) with exceptional resistance to scaling has been developed, using an energy-efficient method. This innovative approach avoids the high-temperature sintering treatment, only involving electrospinning with PTFE/PVA emulsion and subsequent low-temperature crosslinking and fluorination. The impact of the PVA and PTFE contents, as well as the crosslinking and subsequent fluorination on the morphology and MD performance of the NFM, were systematically investigated. The optimized PTFE NFM displayed robust amphiphobicity, boasting a water contact angle of 155.2º and an oil contact angle of 132.7º. Moreover, the PTFE NFM exhibited stable steam flux of 52.1 L·m-2·h-1 and 26.7 L·m-2·h-1 when fed with 3.5 wt % and 25.0 wt % NaCl solutions, respectively, and an excellent salt rejection performance (99.99 %, ΔT = 60 °C) in a continuous operation for 24 h, showing exceptional anti-scaling performance. It also exhibited stable anti-wetting and anti-fouling properties against surfactants (sodium dodecyl sulfate) and hydrophobic contaminants (diesel oil). These results underscore the significant potential of the PTFE nanofibrous membrane for practical applications in desalination, especially in hypersaline or polluted aqueous environments.

3D stem cell spheroids with urchin-like hydroxyapatite microparticles enhance osteogenesis of stem cells.

Cell therapy (also known as cell transplantation) has been considered promising as a next-generation living-cell therapy strategy to surpass the effects of traditional drugs. However, their practical clinical uses and product conversion are hampered by the unsatisfied viability and efficacy of the transplanted cells. Herein, we propose a synergistic enhancement strategy to address these issues by constructing 3D stem cell spheroids integrated with urchin-like hydroxyapatite microparticles (uHA). Specifically, cell-sized uHA microparticles were synthesized via a simple hydrothermal method using glutamic acid (Glu, E) as the co-template with good biocompatibility and structural antimicrobial performance (denoted as E-uHA). Combining with a hanging drop method, stem cell spheroids integrated with E-uHA were successfully obtained by culturing bone marrow mesenchymal stem cells (BMSCs) with a low concentration of the E-uHA suspensions (10 µg mL-1). The resulting composite spheroids of BMSCs/E-uHA deliver a high cellular viability, migration activity, and a superior osteogenic property compared to the 2D cultured counterpart or other BMSC spheroids. This work provides an effective strategy for integrating a secondary bio-functional component into stem cell spheroids for designing more cell therapy options with boosted cellular viability and therapeutic effect.

A multicentre, randomised, double-blind, double-dummy, parallel-controlled, phase 3 clinical trial assessing the efficacy and safety of intravenous nemonoxacin malate vs. levofloxacin for community-acquired pneumonia in adult patients.

BACKGROUND: Nemonoxacin malate is a novel non-fluorinated quinolone for oral and intravenous (IV) administration. This phase 3, multicentre, randomised, double-blind, double-dummy, parallel-controlled clinical trial (NCT02205112) evaluated the efficacy and safety of IV nemonoxacin vs. levofloxacin for the treatment of community-acquired pneumonia (CAP) in adult patients. METHODS: Eligible patients were randomised to receive 500 mg nemonoxacin or levofloxacin via IV infusion, once daily for 7-14 days. The primary endpoint was the clinical cure rate at the test-of-cure (TOC) visit in the modified intent-to-treat (mITT) population. Secondary efficacy and safety were also compared between nemonoxacin and levofloxacin. RESULTS: Overall, 525 patients were randomised and treated with nemonoxacin (n = 349) or levofloxacin (n = 176). The clinical cure rate was 91.8% (279/304) for nemonoxacin and 85.7% (138/161) for levofloxacin in the mITT population (P > 0.05). The clinical efficacy of nemonoxacin was non-inferior to levofloxacin for treatment of CAP. Microbiological success rate with nemonoxacin was 88.8% (95/107) and with levofloxacin was 87.8% (43/49) (P > 0.05) at the TOC visit in the bacteriological mITT population. The incidence of drug-related adverse events (AEs) was 37.1% in the nemonoxacin group and 22.2% in the levofloxacin group. These AEs were mostly local reactions at the infusion site, nausea, elevated alanine aminotransferase/aspartate aminotransferase (ALT/AST), and QT interval prolongation. The nemonoxacin-related AEs were mostly mild and resolved after discontinuation of nemonoxacin. CONCLUSIONS: Nemonoxacin 500 mg IV once daily for 7-14 days is effective and safe and non-inferior to levofloxacin for treating CAP in adult patients.

Profiles of Cough and Associated Risk Factors in Nonhospitalized Individuals With SARS-CoV-2 Omicron Variant Infection: Cross-Sectional Online Survey in China.

BACKGROUND: Cough is a common symptom during and after COVID-19 infection; however, few studies have described the cough profiles of COVID-19. OBJECTIVE: The aim of this study was to investigate the prevalence, severity, and associated risk factors of severe and persistent cough in individuals with COVID-19 during the latest wave of the Omicron variant in China. METHODS: In this nationwide cross-sectional study, we collected information of the characteristics of cough from individuals with infection of the SARS-CoV-2 Omicron variant using an online questionnaire sent between December 31, 2022, and January 11, 2023. RESULTS: There were 11,718 (n=7978, 68.1% female) nonhospitalized responders, with a median age of 37 (IQR 30-47) years who responded at a median of 16 (IQR 12-20) days from infection onset to the time of the survey. Cough was the most common symptom, occurring in 91.7% of participants, followed by fever, fatigue, and nasal congestion (68.8%-87.4%). The median cough visual analog scale (VAS) score was 70 (IQR 50-80) mm. Being female (odds ratio [OR] 1.31, 95% CI 1.20-1.43), having a COVID-19 vaccination history (OR 1.71, 95% CI 1.37-2.12), current smoking (OR 0.48, 95% CI 0.41-0.58), chronic cough (OR 2.04, 95% CI 1.69-2.45), coronary heart disease (OR 1.71, 95% CI 1.17-2.52), asthma (OR 1.22, 95% CI 1.02-1.46), and gastroesophageal reflux disease (GERD) (OR 1.21, 95% CI 1.01-1.45) were independent factors for severe cough (VAS>70, 37.4%). Among all respondents, 35.0% indicated having a productive cough, which was associated with risk factors of being female (OR 1.44, 95% CI 1.31-1.57), having asthma (OR 1.84, 95% CI 1.52-2.22), chronic cough (OR 1.44, 95% CI 1.19-1.74), and GERD (OR 1.22, 95% CI 1.01-1.47). Persistent cough (>3 weeks) occurred in 13.0% of individuals, which was associated with the risk factors of having diabetes (OR 2.24, 95% CI 1.30-3.85), asthma (OR 1.70, 95% CI 1.11-2.62), and chronic cough (OR 1.97, 95% CI 1.32-2.94). CONCLUSIONS: Cough is the most common symptom in nonhospitalized individuals with Omicron SARS-CoV-2 variant infection. Being female, having asthma, chronic cough, GERD, coronary heart disease, diabetes, and a COVID-19 vaccination history emerged as independent factors associated with severe cough, productive cough, and persistent cough.

Mediating effect of anxiety and depression between family function and hope in patients receiving maintenance hemodialysis: a cross-sectional study.

OBJECTIVES: This study aimed to explore the levels of hope in patients receiving maintenance hemodialysis (MHD), and whether anxiety and depression mediate the relationship between family function and hope. METHODS: The family APGAR index, hospital anxiety and depression scale, and Herth hope index were recorded using the self-reported questionnaires completed by 227 MHD patients. RESULTS: The family function can directly predict hope, positively predict hope through depression (ß = 0.052, p = 0.001), and positively predict hope through the chain mediating of anxiety and depression (ß = 0.087, p = 0.001), according to chain mediation analysis. The total effect size was 28.31%. The total indirect effect value was 0.139, and the total effect value was 0.491. CONCLUSIONS: Our findings suggest that family function had a direct impact on MHD patients' hope, and that lowering anxiety and depression can help to feel more hopeful.

Silk Nanofibril-Palygorskite Composite Membranes for Efficient Removal of Anionic Dyes.

To develop membrane materials with good performance for water purification that are green and low cost, this work reports an organic-inorganic composite membrane composed of silk nanofibrils (SNFs) and palygorskite (PGS). To improve the stability of the the composite membrane, genipin was used as a crosslinking agent to induce the conformational transition of SNF chains from random coils to ß-sheets, reducing the swelling and hydrolysis of the membrane. The separation performance can be adjusted by tailoring the component ratio of the nanomaterial. The results showed that these membranes can effectively remove anionic dyes from water, and they exhibit excellent water permeability. The SNF-based membrane had strong mechanical and separation properties, and the PGS could tune the structure of composite membranes to enhance their permeability, so this green composite membrane has good prospects in water treatment and purification applications.

Lignin-based carbon fibers: Insight into structural evolution from lignin pretreatment, fiber forming, to pre-oxidation and carbonization.

Lignin remains the second abundant source of renewable carbon with an aromatic structure. However, most of the lignin is burnt directly for power generation, with an effective utilization rate of <2 %, making value addition on lignin an urgent requirement. From this perspective, preparation of lignin-based carbon fibers has been widely studied as an effective way to increase value addition on lignin. However, lignin species are diverse and complex in structure, and the pathway that enables changes in lignin structure during pretreatment, fiber formation, stabilization, and carbonization is still uncertain. In this review, we condense the common structural evolution route from the previous studies, which can serve as a guide towards engineered lignin carbon fibers with high performance properties.

Highly conductive and porous lignin-derived carbon fibers.

Bio-based carbon fibers derived from lignin have gained significant attention due to their diverse and renewable sources, ease of extraction, and low cost. However, the current limitations of low specific surface area and insufficient electrical conductivity hinder the widespread application of lignin-derived carbon fibers (LCFs). In this work, highly conductive and porous LCFs are developed through melt-blowing, pretreatment, and carbonization processes. The effects of the carbonization temperature and heating rate on the structures and properties of the LCFs are systematically investigated. The resultant LCFs exhibit high electrical conductivity (71 400 S m-1) and a large specific surface area (923 m2 g-1). The assembled lithium-ion battery based on the LCF anodes demonstrates a long cycle life of >800 cycles and a high specific capacity of 466 mA h g-1. The findings of this study hold practical significance for promoting the utilization of lignin in the fields of energy storage, adsorption, and beyond.

Interfacial-Crystallization-Constructed Fractal Nanofiber-Based Bio-Platforms Enable Highly Effective Culture of Three-Dimensional Stem Cell Spheroids.

Artificial cell spheroids are gaining importance in tissue engineering and regenerative medicine fields. Biomimetic construction of stem cell spheroids is nevertheless challenging, and bioplatforms permitting controllable and high-efficient fabrication of functional stem cell spheroids are needed. Here, a fractal nanofiber-based bioplatform is developed based on a tunable interfacial-induced crystallization approach, allowing a programmed culture of artificial stem cell spheroids under an ultralow cell seeding density. Specifically, starting with the nanofibers of poly(L-lactide) (PLLA) and gelatin (PmGn), an interfacial growth of PLLA nanocrystals is subsequently performed to construct the fractal nanofiber-based biotemplates (C-PmGn). Cell experiments with human dental pulp stem cells (hDPSCs) demonstrate that the fractal C-PmGn could effectively decrease cell-matrix interactions, thus facilitating spontaneous cell spheroid formation even under a low cell seeding density (1 × 104 cells/cm2). Nanotopological properties of the C-PmGn bioplatform can be tuned by adjusting the fractal degree, thus enabling its suitability for the 3D culture of diverse hDPSC spheroids. Such a strategy provides a relatively simple and low-cost option for formation, expansion, and utility of stem cell spheroids. It offers another promising pathway to advance the development of stem cell therapies.

[Clinical study of induced abortion of early-early pregnancy: an analysis of 10, 404 cases].

OBJECTIVE: To evaluate the advantages and disadvantages of early-early pregnancy induced abortion (EPIA). METHODS: A total of 10 404 cases of EPIA performed at our hospital from January 1993 to December 2003 were retrospectively analyzed and compared with 9434 cases of common induced abortion (CIA). The amount of hemorrhage and operative duration, degree of pain, rate of induced-abortion syndrome, rate of incomplete abortion, menstrual changes and post-operative onset of Asherman's syndrome were observed and compared between 2 groups. RESULTS: The average age, ratio of parous cases, ratio of the cases of first-pregnancy induced abortion were not different between 2 groups (P > 0.05). The amount of hemorrhage bleeding ((4.9 ± 3.2) ml), operative duration ((90.3 ± 12.4) s), degree of pain, rate of induced-abortion syndrome, menstrual changes and the rate of Asherman's syndrome in the EPIA group were all significantly less than those in the CIA group (P < 0.05). However, the rate of incomplete abortion (0.44%) in the EPIA group was significantly higher than that (0.21%) in the CIA group (P < 0.05). CONCLUSION: EPIA has the advantages of lesser hemorrhage, less pain, shorter operative duration and fewer complications over CIA. Therefore the recovery of EPIA cases is earlier than that of CIA cases. While the risk of incomplete abortion stays high.

High-performance TFNC membrane with adsorption assisted for removal of Pb(II) and other contaminants.

Rapid and thorough removal of heavy metal ions in wastewater is critical for the urgent need of clean water. Herein, we prepared a high-performance thin film nanofibrous composite (TFNC) membrane consisting of a polyacrylonitrile (PAN)-UiO-66-(COOH)2 composite nanofibrous substrate (CPAN) and a calcium alginate (CaAlg) skin layer. Owing to abundant adsorption sites of UiO-66-(COOH)2 MOF, the optimal CPAN-2 nanofibrous substrate showed excellent adsorption capacity for lead ions. The maximum Pb2+ adsorption capacity of CPAN-2 substrate calculated by Langmuir isotherm model was 254.5 mg/g. Meanwhile, due to the relatively loose structure of CaAlg skin layer, this TFNC membrane showed high water permeate flux about 50 L m-2h-1 at 0.1 MPa, and the rejection for dyes was higher than 95%. Therefore, CaAlg/CPAN TFNC membranes were appropriate for dynamic adsorption/filtration to remove Pb2+. Compared with original CaAlg/PAN membrane, the optimal CaAlg/CPAN TFNC membrane showed much better ability to treat Pb(II)-containing wastewater and had good recyclability. Most importantly, the CaAlg/CPAN TFNC membrane could treat 7659 L m-2 wastewater containing single lead ions under WHO drinking water standard, and effectively deal with more simulated lead-containing wastewater. This work could provide a substitutable solution for effective removal of heavy metal ions and other various contaminants in wastewater.

Effect of pre-oxidation temperature and heating rate on the microstructure of lignin carbon fibers.

Lignin is a biopolymer with high carbon content, making lignin-based carbon fiber an important research direction. In the process of carbonization to prepare carbon fibers, lignin fibers are easily softened and fused, which destroys the microstructure of fibers, thereby reducing the quality of lignin-based carbon fibers. Therefore, it is non-negligible to pre-oxidize lignin fibers before carbonization to prevent fiber fusion and maintain fiber structure. Therefore, the effects of pre-oxidation temperature and heating rate on the structure of pre-oxidation lignin fibers with controllable diameter and thickness prepared by melt-blowing were studied in detail. During pre-oxidation, crosslinking and aromatization of lignin fibers occurred, and alkyl and benzene rings were mainly oxidized to form carbonyl groups. The aromatization degree of the pre-oxidized product was recorded at 280 °C and 0.25 °C/min, and the oxygen content reached 15 %-20 %, making it suitable for the preparation of bio-based carbon fibers. On this basis, carbon fibers with porous morphology can be prepared with a graphitization of 0.54 and a resistivity of 0.02 Ω cm-1. These materials are expected to be applicable in sensors, catalytic materials and other fields.

Fabrication of micro-nano structure nanofibers by solvent etching.

Micro-Nano structure nanofibrous affinity membranes of poly(ether sulfones) (PES) blended with a functional polymer poly(ethyleneimine) (PEI) were fabricated by electrospinning technique followed by solvent etching in crosslinking solution. The surface SEM image of the water washed PES/PEI nanofibrous membrane confirmed that PEI was concentrated on the fiber surface. The nanofibrous PES/PEI membranes were crosslinked in a mixture of acetone and water with glutaraldehyde (crosslinking agent, GA), and the micro-nano structural surface of the nanofibrous membranes was created by solvent etching due to the solvation between PEI and the solvent water in the crosslinking solution during the crosslinking process. The influence of the component of the crosslinking bath on the mophology of the resulting PES/PEI nanofibers was investigated. It was found that the relatively uniform micro-nano spherules grew on the surface of the nanofibers when the content of water in crosslinking solution was more than 20 wt%, and the diameters of the spherules were in the range of 50-250 nm. The advantage of the micro-nano structrue for the heavy metal ions removal in wastwater has been demonstrated by taking a series of static adsorption experiments. It was found that the micro-nano structrue of PES/PEI nanofibrous membranes could bring high performance of adsorption capacity for heavy metal ions, indicating that the unique morphology could bring much more large surface area per unit mass and high effectivity for heavy metal ions removal from aqueous solutions.

Diagnosis and treatment of primary pulmonary enteric adenocarcinoma: Report of Six cases.

BACKGROUND: Primary pulmonary enteric adenocarcinoma (PEAC) is a very rare subtype of invasive adenocarcinoma, and there have been no large studies on PEAC to date. Therefore, it is necessary to obtain much more information about the clinical and pathological features, diagnosis, differential diagnosis, and treatment of PEAC. CASE SUMMARY: All clinical data of six patients with confirmed PEAC from 2013 to 2018 were collected, and data on diagnosis, differential diagnosis, and treatment of PEAC are discussed combined with all the associated literature. The mean age of six patients was 64.0 ± 5.6 (59-73) years old. Their clinical manifestations were heterogeneous, and during their disease course, there were no gastrointestinal symptoms. There was no evidence from colonoscopy or imaging studies to suggest digestive tract tumors or new metastases. The most commonly mutated gene was KRAS (50.0%), and the pathological features of the six cases were similar to those of colorectal cancer. CDX2 (83.3%) and CK7 (66.7%) had the highest positive rates upon immunohistochemical examination. In the associated literature, 252 cases were identified, and the most commonly mutated gene was KRAS (42.9%). Additionally, CDX2 (68.3%) and CK7 (85.8%) had the highest positive rates. Patients mainly received surgery, chemotherapy, and radiotherapy, immunotherapy was not included. CONCLUSION: Positive results for CDX2 and CK7 play an important role in the diagnosis and differential diagnosis of PEAC, and immunotherapy or targeted therapy focused on KRAS needs to be further studied for the treatment of PEAC.

Hypertension as a sequela in patients of SARS-CoV-2 infection.

BACKGROUND: COVID-19 is a respiratory infectious disease caused by SARS-CoV-2, and cardiovascular damage is commonly observed in affected patients. We sought to investigate the effect of SARS-CoV-2 infection on cardiac injury and hypertension during the current coronavirus pandemic. STUDY DESIGN AND METHODS: The clinical data of 366 hospitalized COVID-19-confirmed patients were analyzed. The clinical signs and laboratory findings were extracted from electronic medical records. Two independent, experienced clinicians reviewed and analyzed the data. RESULTS: Cardiac injury was found in 11.19% (30/268) of enrolled patients. 93.33% (28/30) of cardiac injury cases were in the severe group. The laboratory findings indicated that white blood cells, neutrophils, procalcitonin, C-reactive protein, lactate, and lactic dehydrogenase were positively associated with cardiac injury marker. Compared with healthy controls, the 190 patients without prior hypertension have higher AngⅡ level, of which 16 (8.42%) patients had a rise in blood pressure to the diagnostic criteria of hypertension during hospitalization, with a significantly increased level of the cTnI, procalcitonin, angiotensin-II (AngⅡ) than those normal blood pressure ones. Multivariate analysis indicated that elevated age, cTnI, the history of hypertension, and diabetes were independent predictors for illness severity. The predictive model, based on the four parameters and gender, has a good ability to identify the clinical severity of COVID-19 in hospitalized patients (area under the curve: 0.932, sensitivity: 98.67%, specificity: 75.68%). CONCLUSION: Hypertension, sometimes accompanied by elevated cTnI, may occur in COVID-19 patients and become a sequela. Enhancing Ang II signaling, driven by SARS-CoV-2 infection, might play an important role in the renin-angiotensin system, and consequently lead to the development of hypertension in COVID-19.

A multicenter, prospective, observational study on montelukast monotherapy or montelukast-based combinations treating cough variant asthma.

BACKGROUND: Evidence of treatment against cough variant asthma (CVA) is insufficient for the clinical practice in China. We aimed at evaluating the real-world effectiveness of montelukast (MONT) alone or in combination with low-dose inhaled corticosteroids (ICS) and low-dose ICS plus long-acting beta-2-agonists (LABA) for Chinese CVA patients in a multicentre, prospective, cohort study. METHODS: Adult patients diagnosed with CVA defined as chronic cough >8 weeks with a positive bronchial provocation test and normal chest X-ray findings were enrolled at respiratory clinics. Study treatment followed routine clinical practice. The investigators initiated MONT by 10 mg/day alone or in combination with a low-dose ICS +/- LABA and followed up treatment outcomes for 4 weeks. The primary outcome measure was the change in cough score (CS) from baseline. RESULTS: The study enrolled 247 patients (MONT =146, MONT + ICS =38, MONT + ICS/LABA =63). In the primary analysis, the mean change (95% CI) in CS at the end of the study was -1.2 (-1.6, -0.9), -0.9 (-1.5, -0.4), and -1.3 (-1.7, -0.8) in the three groups, respectively. MONT monotherapy had a satisfactory rate of weekly asthma control at the end of the study (83.5%, 95% CI: 75.1%, 89.4%) in the per-protocol analysis. Rates of weekly asthma control were similar in two MONT-based combination regimens (83.9%, 81.4%). Short-acting beta-2-agonist (SABA) user (≥2 times per week) was 16.8% in the MONT group. CONCLUSIONS: The real-world effectiveness of MONT alone or in combination with ICS or ICS and LABA was acceptable for CVA short-term control.