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.

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.

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.

Effect of Different Heat Treatments on In Vitro Digestion of Egg White Proteins and Identification of Bioactive Peptides in Digested Products.

Chicken eggs are ingested by people after a series of processes, but to date, only a few studies have explored the nutrient variations caused by different heat treatments. In this work, the impacts of different heat treatments (4, 56, 65, and 100 °C on the in vitro digestibility of egg white proteins were investigated by hydrolysis with pepsin or pepsin + pancreatin to simulate human gastrointestinal digestion, and the digested products were identified using Nano-LC-ESI-MS/MS. Egg white proteins treated at 65 °C had the highest in vitro pepsin digestibility value whereas the pepsin + pancreatin digestibility increased significantly (P < 0.05) as the cooking temperature was raised. The molecular weight distribution of the digested products indicated that, when compared to pepsin-treated samples, pepsin + pancreatin-treated samples contained more low-molecular-weight peptides (m/z < 849.2) with higher signal intensities. The number of unique peptides identified in every digestion product showed a positive correlation with their in vitro digestibility. Additionally, bioactive peptides such as antioxidant, antimicrobial and antihypertensive peptides were found present in egg white digested products, especially in samples treated at 4 and 100 °C. PRACTICAL APPLICATION: These findings may facilitate a better understanding of nutritive values of egg white proteins and their digested products under different cooking temperatures, such as antibacterial and antioxidant peptides identified in the digestion samples treated, respectively at 4 and 100 °C. This study also provided information for improving the applications of eggs in the food industry as well as a theoretical basis for egg consumption.

Expression of Wnt11 and Rock2 in esophageal squamous cell carcinoma by activation of the WNT/PCP pathway and its clinical significance.

The purpose of this study was to investigate the relation between expression of Wnt11, Rho-associated protein kinase 2 (Rock2), and its clinical characteristics in esophageal squamous cell carcinoma (ESCC). Expression of Wnt11 and Rock2 protein was examined by using immunohistochemistry that contained 260 paraffin-embedded specimens of ESCC and its adjacent normal tissues; expression of Wnt11 and Rock2 protein was verified by Western-blotting that contained 20 specimens of ESCC and its adjacent normal tissues. The positive rates of Wnt11 protein in normal esophageal epithelium tissue was 29.8% and in esophageal carcinomas tissue was 31.9%; there was no significant difference between the two groups(P>0.05); The positive rates of Rock2 protein in normal esophageal epithelium tissue was 12.3% and in esophageal carcinomas tissues was 56.5%, there was a significant difference between the two groups (p<0.05). The expression of Rock2 protein was significantly related with the invasion of vascular and there was no significantly difference between the expression of Rock2 protein and ESCC patients' tumor location, differentiation, T stage, and lymph node metastases. The abnormal expression of Rock2 protein may promote tumor cell invasion.

Diagnose of occult bronchial foreign body: A rare case report of undetected Chinese medicine aspiration for 10 long years.

BACKGROUND: Occult bronchial foreign body can be very difficult to diagnose early in an adult patient without acute symptoms. This report describes a rare case of undetected Chinese medicine "Coptis chinensis" aspiration for 10 long years. METHODS: A case was reported that a female patient complained of a 10-year history of productive cough. A battery of tests were given to confirm the diagnosis. RESULTS: Chest computed tomography (CT) showed extensive bronchiectasis and multiple nodules, along with stenosis of left lower lobar bronchus. An extensive solid lesion with surrounding inflammatory granulation tissue was seen on her first bronchoscopy and biopsy revealed chronic mucosal inflammation. A neglected history of Coptis chinensis regularly kept in-mouth while sleeping for the last 10 years in this patient provided clues for a final diagnosis. Confirmatory diagnosis of bilateral tracheobronchial foreign bodies caused by recurrent inhalation of Coptis chinensis was made by a second bronchoscopy. CONCLUSIONS: This case clearly demonstrates that a precise medical history is often overlooked. A high index of suspicion, a precise medical history, radiographic features of chronic respiratory symptoms not explained by other conditions were keys to diagnosing this case.

The tracheobronchial foreign body in welder without the history of allotriophagy and foreign body aspiration.

The typical chest computed tomography (CT) finding of the arc welders is ill-defined micronodules diffusely distributed in the lung. We report a rare case of tracheobronchial foreign body in welder without the history of allotriophagy and foreign body aspiration. We used the CT and mineralogical analysis in diagnosis and the flexible fiberoptic bronchoscope in therapy. The CT showed bronchiectasis with pulmonary infiltration of the right lower lobe and high-density shadow in the basal bronchus of the right lower lobe. The foreign bodies were removed by a fibreoptic bronchoscope. Semiquantitative chemical analyses showed that the constituent of foreign body was similar to the dregs which were collected in the same garage. This is an unusual case of the welding-related respiratory diseases, which is different from Welder's siderosis and broncholith.

Facile immobilization of ag nanocluster on nanofibrous membrane for oil/water separation.

Superhydrophobic and superoleophilic electrospun nanofibrous membranes exhibiting excellent oil/water separation performance were green fabricated by a facile route combining the amination of electrospun polyacrylonitrile (APAN) nanofibers and immobilization of a Ag nanocluster with an electroless plating technique, followed by n-hexadecyl mercaptan (RSH) surface modification. By introducing the hierarchically rough structures and low surface energy, the pristine superhydrophilic APAN nanofibrous membranes could be endowed with a superhydrophobicity with water contact angle of 171.1 ± 2.3°, a superoleophilicity with oil contact angle of 0° and a self-cleaning surface arising from the extremely low water contact angle hysteresis (3.0 ± 0.6°) and a low water-adhesion property. Surface morphology studies have indicated that the selective wettability of the resultant membranes could be manipulated by tuning the electroless plating time as well as the hierarchical structures. More importantly, the extremely high liquid entry pressure of water (LEPw, 175 ± 3 kPa) and the robust fiber morphology of the APAN immobilized Ag nanocluster endowed the as-prepared membranes with excellent separation capability and stability for oil/water separation by a solely gravity-driven process. The resultant membranes exhibited remarkable separation efficiency in both hyper-saline environment and broad pH range conditions, as well as excellent recyclability, which would make them a promising candidate for industrial oil-contaminated water treatments and marine spilt oil cleanup, and provided a new prospect to achieve functional nanofibrous membranes for oil/water separation.

[Correlation of CerbB-2 to Ki-67 and P53 expressions in hormone-independent breast cancer].

OBJECTIVE: To investigate the relation of CerbB-2 with Ki-67 and P53 expressions in hormone-independent breast cancer. METHODS: A total of 180 patients with breast cancer were examined for the positivity to estrogen receptor (ER) and progesterone receptor (PR), and subsequently divided into hormone-dependent group (positive for both ER and PR) and hormone-independent group (negative for both). CerbB-2, Ki-67 and P53 expressions were detected in these patients using an improved Envision immunohistochemical staining with the corresponding antibodies. Twenty-nine patients without definite immunohistochemical results of C-erbB-2 were excluded from further analysis. The 51 hormone-independent and 100 hormone-dependent cases were analyzed for the correlation of CerbB-2 to Ki-67 and P53 expressions. RESULTS: In hormone-independent cases negative for CerbB-2, Ki-67 and P53 expressions were significantly higher than that in hormone-dependent CerbB-2-negative cases (P<0.05), but in CerbB-2-positive cases, their expressions showed no significant differences (P>0.05) with respect to hormonal dependence. CONCLUSION: In hormone-independent CerbB-2-negative cases, the tumor cells show a higher proliferative activity and P53 expression than those in hormone-dependent cases, which can be an important reason for the high malignancy and poor prognosis of hormone-independent breast cancer negative for CerbB-2.

Pulmonary epithelioid haemangioendothelioma mimicking central lung cancer.

A 40-year-old woman was hospitalized for investigation of dry cough, dyspnoea, and pain and swelling in the large joints of the arms and legs. Chest CT revealed a left hilar mass with partial atelectasis in the apical segment of the left lower lobe. X-ray of the wrists, elbows, ankles and knee joints showed a periosteal reaction, associated with hypertrophic pulmonary osteoarthropathy. Endobronchial biopsy suggested a pulmonary epithelioid haemangioendothelioma. Whole left lung resection was performed and the patient died of respiratory failure 1 month postoperatively.

Inhibition of expression of vascular endothelial growth factor and its receptors in pulmonary adenocarcinoma cell by TNP-470 in combination with gemcitabine.

Angiogenesis is required for solid tumor growth and facilitates tumor progression and metastasis. The inhibition effects of O-(chloroacetyl-carbamoyl) fumagillol (TNP-470), an angiogenesis inhibitor, and gemcitabine, a chemotherapeutic agent, on expression of growth factors were investigated using human pulmonary adenocarcinoma cell line, A549. The A549 cells were divided into four groups: control group, 10(-6) mg/ml gemcitabine treated group, 10(-4) mg/ml TNP-470 treated group and gemcitabine+TNP-470 treated group. The mRNA and protein expression of vascular endothelial growth factor (VEGF) and its receptors, FMS-like tyrosine kinase-1 (FLT-1) and kinase insert domain-containing receptor (KDR), in different groups were measured. The growth of A549 cell cultured with gemcitabine or TNP-470 was inhibited in an almost dose-dependent manner. Although gemcitabine (10(-6) mg/ml) alone and TNP-470 (10(-4) mg/ml) alone had no effect on the mRNA and protein expression of VEGF and its receptors (FLT-1, KDR) in A549 cells compared to the control (P>0.05), 10(-6) mg/ml gemcitabine in combination with 10(-4) mg/ml TNP-470 had significant effect (P<0.01). Moreover, combination of the two drugs significantly inhibited the mRNA expression of VEGF, FLT-1 and KDR compared to either drug alone (P<0.05). This study suggests that combined treatment with TNP-470 plus gemcitabine may augment the antiangiogenic and antineoplastic effects in lung cancer cells in vitro.

[Chronic necrotizing pulmonary aspergillosis: diagnosis and treatment].

OBJECTIVE: The purpose of this study was to describe the approaches to the diagnosis and the treatment of chronic necrotizing pulmonary aspergillosis (CNPA). METHODS: The study included 8 patients with CNPA confirmed by histopathological studies. The patients were admitted to the First Affiliated Hospital of College of Medicine of Zhejiang University during 2000-2004. The clinical data were analyzed, and related literature was reviewed. The clinical, radiological and pathological characteristics, and the approaches to the diagnosis and the treatment were described. RESULTS: CNPA was a rare form of pulmonary aspergillosis. Common presentations included productive cough (8/8), haemoptysis (7/8) and constitutional symptoms (5/8). Radiographically, the air crescent sign was suggestive of the diagnosis, which was found in 4 patients. Consolidation was also common in the other 4 cases. The histological feature of CNPA included the presence of tissue invasion by Aspergillus, tissue necrosis and granulomatous inflammation. CONCLUSIONS: The clinical manifestations of CNPA are non-specific. Radiography plays a pivotal role in the diagnosis of CNPA. Treatment with antifungal medications is indicated once the diagnosis is made. Pulmonary resection should be considered when patients have prolonged illness or frequent haemoptysis.