The Issue of Recurrently Positive Patients Who Recovered From COVID-19 According to the Current Discharge Criteria: Investigation of Patients from Multiple Medical Institutions in Wuhan, China.

The current discharge criteria for COVID-19 require that patients have 2 consecutive negative results for reverse transcription polymerase chain reaction (RT-PCR) detection. Here, we observed that recurrent positive RT-PCR test results in patients with 3 consecutive negative results (5.4%) were significantly decreased compared with those in patients with 2 consecutive negative results (20.6%); such patients reported positive RT-PCR test results within 1 to 12 days after meeting the discharge criteria. These results confirmed that many recovered patients could show a positive RT-PCR test result, and most of these patients could be identified by an additional RT-PCR test prior to discharge.

The activation and function of IL-36γ in neutrophilic inflammation in chronic rhinosinusitis.

BACKGROUND: Although increased accumulation of neutrophils has been noted in chronic rhinosinusitis (CRS), the function and regulation of neutrophils in CRS are largely unknown. IL-36 family cytokines may play an important role in neutrophilic inflammation. OBJECTIVE: This study sought to investigate the expression and function of IL-36 cytokines in CRS. METHODS: Quantitative RT-PCR, immunohistochemistry, immunofluorescence, and ELISA were used to investigate the expression of IL-36 cytokines and IL-36 receptor (IL-36R) in sinonasal mucosa. The expression of IL-36R on neutrophils in polyps and blood was measured by flow cytometry. Purified blood neutrophils were cultured to investigate the regulation of IL-36R expression. The cleavage of IL-36γ was detected by Western blotting. Dispersed nasal polyp cells were treated with IL-36γ with or without elastase inhibitor and dexamethasone. RESULTS: Neutrophil infiltration and expression of IL-36 cytokines and IL-36R were upregulated in both CRS with and without nasal polyps. IL-36γ was the most abundant isoform and mainly expressed by epithelial cells in CRS. Neutrophils were the principal IL-36R+ cell type in polyps. IL-36R expression was almost absent in blood neutrophils and upregulated by IL-6, IL-1ß, and Dermatophagoides pteronyssinus group 1. Elastase activity was increased in polyps and degraded full-length IL-36γ. Consistently, the levels of cleaved IL-36γ were increased in polyps. Full-length IL-36γ promoted the production of matrix metalloproteinase 9; IL-17A; and chemokine (C-X-C motif) ligands 1, 2, and 8 from dispersed nasal polyp cells, which was abolished by elastase inhibitor. The proinflammatory effect of IL-36γ was not suppressed by dexamethasone. CONCLUSIONS: Increased production and activation of IL-36γ may act on neutrophils and further exaggerate neutrophilic inflammation in CRS.

Factors affecting recurrent positive RT-PCR results in clinically cured COVID-19 patients: a multicenter study.

The aim of this study was to evaluate factors affecting the recurrence of positive RT-PCR results. By performing a retrospective analysis, we evaluated the clinical data of recurrent positive coronavirus disease 2019 (COVID-19) patients in multiple medical institutions in Wuhan. We recruited COVID-19 patients who were hospitalized from January 1 to March 10, 2020, in three tertiary hospitals in Wuhan, met the discharge criteria and received at least one additional nucleic acid test before leaving the hospital. According to the RT-PCR results, patients were split into a recurrent positive group (RPos group) and a nonrecurrent positive group (non-RPos group). Clinical characteristics, therapeutic schedules and antibody titers were compared between the two groups. AI-assisted chest high-resolution computed tomography (HRCT) technology was applied to investigate pulmonary inflammatory exudation and compare the extent of lung areas with different densities. This study involved 122 COVID-19 patients. There were no significant differences in age, sex, preexisting diseases, clinical symptoms, clinical classification, course of disease, therapeutic schedules or serum-specific antibodies between the two groups. A higher proportion of patients who showed pulmonary inflammatory exudation on HRCT scans were recurrent positive at the time of discharge than other patients (81.6% vs 13.7%, P < 0.01). In addition, the degree of pulmonary fibrosis was higher in the RPos group than in the non-RPos group (P < 0.05). Subpleural exudation at the peripheral edge of the lung and extensive pulmonary fibrosis at the time of discharge represent risk factors for the recurrence of COVID-19.

Let-7a microRNA functions as a potential tumor suppressor in human laryngeal cancer.

MicroRNAs (miRNAs) are endogenously expressed non-coding RNAs, which are involved in the gene expression regulation. Lethal-7a (let-7a) is a founding member of miRNA family and recently it was found to be associated with several cancers, such as lung and colon cancers. In the present study, we found that let-7a miRNA expression was significantly downregulated both in human laryngeal squamous cancer tissues and in Hep-2 cells, a laryngeal cancer cell line, as compared with adjacent normal tissues and BEAS-2B cells, respectively. Moreover, we found that let-7a expression levels were significantly further decreased in non-differentiated (G3) cancer tissues as compared with moderately and well differentiated cancer tissues (G2 and G1), although no significant difference in let-7a expression levels between the cancer specimens with different T stages or specimens from patients with different lymph node metastasis status was revealed. In Hep-2 cells, let-7a mimics transfection markedly suppressed proliferation and induced apoptosis of Hep-2 cells under the treatment of diamminedichloroplatinum or not and downregulated RAS and c-MYC protein expression without affecting the mRNA levels. In parallel, RAS and c-MYC protein levels were found significantly upregulated only in cancer tissues with downregulated let-7a expression. Thus, we propose that let-7a may be a tumor suppressor in laryngeal cancer by inhibiting cell growth, inducing cell apoptosis and downregulating the oncogenes expression.

[Logistic regression analysis on influence factors of chronic sinusitis after endoscopic sinus surgery].

OBJECTIVE: To explore the clinical effect and the influence factors after endoscopic surgery for chronic sinusitis. METHODS: The clinical data of 337 patients with chronic sinusitis treated by endoscopic surgery were analyzed, including gender, age, culture level, course of the disease, the days of hospitalization, medical history, smoking, drinking, early surgery history, allergic rhinitis (AR) history, clinical classification, visual analogue scale (VAS) score, nasal endoscopy score, nasal polyps, CT examination score, side, nasal adhesion and postoperative follow-up compliance. The clinical effect of endoscopic sinus surgery was evaluated 6 months after operation according to the 1997 Haikou standard. SPSS 18.0 software and conducted chi-square test and logistic regression analysis were used to analyze the data. RESULTS: Three hundred and thirty-seven chronic sinusitis patients were followed up after endoscopic surgery. It was found that 298 cases (88.4%) cured, 29 cases (8.6%) improved, 10 cases (3.0%) invalid. The clinical curative effect of the patients with chronic rhinosinusitis without nasal polyp was better than that of the patients with chronic rhinosinusitis with nasal polyp, the difference was statistically significant (χ(2) = 10.932, P < 0.01). After many factors Logistic regression analysis, the most important effect factor in the clinical curative effect were clinical type, AR or not, VAS score, nasal endoscopic examination score, CT examination score, multiple nasal polyp or not, postoperative nasal adhesion or not and postoperative follow-up compliance. CONCLUSION: The clinical effective of endoscopic sinus surgery is influenced by not only surgery itself, but also by clinical classification, whether and not with AR and so on.

[Correlation analysis of subjective and objective scoring of chronic rhinosinusitis with nasal polyps].

OBJECTIVE: To explore the relationship of of subjective and objective scoring chronic rhinosinusitis with nasal polyps. METHODS: The clinical data of 159 patients with chronic rhinosinusitis were analyzed. SPSS 18.0 software was used to analyze the data. Pearson regression was used to analyze the relationship. RESULTS: The Pearson correlation coefficient r between VAS score (16.380 ± 5.809)and the whole discomfort (5.070 ± 1.361) was 0.710, there were correlation (P < 0.01). The Pearson correlation coefficient r between Lund-Kennedy score (3.724 ± 1.107) and Lund-Mackay score (5.983 ± 2.984) was 0.513, there were correlation (P < 0.01). The Pearson correlation coefficient r between VAS score and Lund-Kennedy score was 0.417, there were correlation (P < 0.05). VAS score had no correlation with Lund-Mackay(r = 0.113, P > 0.05). The whole discomfort had no correlation with Lund-Kennedy score and Lund-Mackay score (r value were 0.309 and 0.022, all P > 0.05). CONCLUSIONS: The subjective and objective score of chronic rhinosinusitis with nasal polyps were contradict sometimes.

Diagnostic significance of blood eosinophil count in eosinophilic chronic rhinosinusitis with nasal polyps in Chinese adults.

OBJECTIVES/HYPOTHESIS: Over half of chronic rhinosinusitis with nasal polyps (CRSwNP) patients in China show noneosinophilic inflammation. The aim of this study was to compare the clinical characteristics of eosinophilic and noneosinophilic CRSwNP and to identify the predictors of eosinophilic CRSwNP. STUDY DESIGN: A retrospective study. METHODS: There were 155 CRSwNP patients enrolled in the Tongji cohort. Eosinophilic CRSwNP was diagnosed according to our previously published histologic criterion. The demographic and clinical features were compared between eosinophilic and noneosinophilic CRSwNP. Factors associated with eosinophilic CRSwNP were determined with regression analysis, and optimal cutoff points of the predictors were determined by a receiver operating characteristic curve. The optimal cutoff points of the predictors were validated in an independent group of 35 CRSwNP patients referred to as the Taizhou cohort. RESULTS: A male preponderance, a higher prevalence of smoking and atopy, and higher peripheral blood eosinophil absolute count and percentage and blood IgE levels were found in eosinophilic CRSwNP compared with noneosinophilic CRSwNP. Peripheral eosinophil absolute count and percentage were independently and significantly associated with eosinophilic CRSwNP. An absolute blood eosinophil count ≥ 0.215 × 10(9) /L yielded a sensitivity of 74.2% and a specificity of 86.5%, and a blood eosinophil percentage ≥ 3.05% yielded a sensitivity of 80.3% and a specificity of 75.3% for the diagnosis of eosinophilic CRSwNP in the Tongji cohort. The validation study in the Taizhou cohort revealed a lower sensitivity and specificity. CONCLUSIONS: Eosinophilic and noneosinophilic CRSwNP displayed significant differences in certain clinical features. Peripheral blood eosinophil count could distinguish eosinophilic and noneosinophilic CRSwNP in Chinese adults.