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Objective@#To explore the clinical characteristics and prognosis of the new coronavirus 2019-nCoV patients combined with cardiovascular disease (CVD).@*Methods@#A retrospective analysis was performed on 112 COVID-19 patients with CVD admitted to the western district of Union Hospital in Wuhan, from January 20, 2020 to February 15, 2020. They were divided into critical group (ICU, n=16) and general group (n=96) according to the severity of the disease and patients were followed up to the clinical endpoint. The observation indicators included total blood count, C-reactive protein (CRP), arterial blood gas analysis, myocardial injury markers, coagulation function, liver and kidney function, electrolyte, procalcitonin (PCT), B-type natriuretic peptide (BNP), blood lipid, pulmonary CT and pathogen detection.@*Results@#Compared with the general group, the lymphocyte count (0.74×109 (0.34×109, 0.94×109)/L vs. 0.99×109 (0.71×109, 1.29×109)/L, P=0.03) was extremely lower in the critical group, CRP (106.98 (81.57, 135.76) mg/L vs. 34.34 (9.55,76.54) mg/L, P<0.001) and PCT (0.20 (0.15,0.48) μg/L vs. 0.11 (0.06,0.20)μg/L, P<0.001) were significantly higher in the critical group. The BMI of the critical group was significantly higher than that of the general group (25.5 (23.0, 27.5) kg/m2 vs. 22.0 (20.0, 24.0) kg/m2, P=0.003). Patients were further divided into non-survivor group (17, 15.18%) group and survivor group (95, 84.82%). Among the non-survivors, there were 88.24% (15/17) patients with BMI> 25 kg/m2, which was significantly higher than that of survivors (18.95% (18/95), P<0.001). Compared with the survived patients, oxygenation index (130 (102, 415) vs. 434 (410, 444), P<0.001) was significantly lower and lactic acid (1.70 (1.30, 3.00) mmol/L vs. 1.20 (1.10, 1.60) mmol/L, P<0.001) was significantly higher in the non-survivors. There was no significant difference in the proportion of ACEI/ARB medication between the critical group and the general group or between non-survivors and survivors (all P>0.05).@*Conclusion@#COVID-19 patients combined with CVD are associated with a higher risk of mortality. Critical patients are characterized with lower lymphocyte counts. Higher BMI are more often seen in critical patients and non-survivor. ACEI/ARB use does not affect the morbidity and mortality of COVID-19 combined with CVD. Aggravating causes of death include fulminant inflammation, lactic acid accumulation and thrombotic events.
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Objective To analyze the genetic characteristics of Legionella pneumophila isolated from cooling water of central air conditioning system in public places in Zhongshan from 2012 to 2018, and to understand the spatiotemporal distribution of homologous strains, in order to provide evidence for the prevention, control and traceability of Legionella pneumophila infection. Methods Eighty-five Legionella pneumophila strains were isolated for serotype identification, and the molecular typing of the 85 isolates was performed using pulsed field gel electrophoresis (PFGE). The strain location data was converted into latitude and longitude coordinates by GIS geocoding technology. The converted location data was overlaid on the map of Zhongshan City, mapping the molecular typing distribution of clusters using Qgis2.18.11 spatial processing software. Results Eighty-five strains of Legionella pneumophila included 9 serotypes, and the highest proportion was LP1, accounting for 61.18% (52/85). According to the similarity of 100%, 85 strains of Legionella pneumophila were divided into 56 patterns of PFGE bands (T1-T56), with 3 types being dominant. Same serotype of Legionella pneumophila strains showed diverse PFGE patterns. Different serotypes of Legionella pneumophila strains were basically identified as different PFGE patterns, while some were identified as same PFGE pattern. According to over 85% similarity, 8 clusters (A-H) were designated, strains of which were distributed in 12 districts. PFGE clustering clusters did not display obvious temporal and regional distribution differences, nor did they have temporal and regional clustering distributions. Conclusion Strains of Legionella pneumophila isolated from cooling water of central air conditioning system in public places in Zhongshan from 2012 to 2018 showed genetic diversity, and the main serotype was LP1. Isolates of clusters did not exist in different years or regions.
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Objective:To investigate the expression of transcription factor BACH2 on PBMC in patients with coronary artery disease( CAD) and discuss its significance and role.Methods:The circulating levels of BACH2 and TLR4 in PBMC were evaluated by RT-PCR and Western blot separately.Serum levels of signature cytokines of T-helper cells,cytokines and ox-LDL were evaluated by ELISA.The data among groups were analyzed by one-way ANOVA.Correlation between variables were subjected to linear regression analysis.Results:The expression level of BACH2 down-regulated and TLR4 up-regulated significantly in PBMCs of ACS patients had significantly higher concentrations of serum ox-LDL,cytokines of TH1 cells,TH2 cells and TH17 cells and low level of cytokine of Treg cells.Negative correlation exists significantly between BACH2 and TLR4 in patients with CAD and between BACH2 and IFN-γ,IL-4 and IL-17,and between BACH2 and ox-LDL in serum.However, positive correlation exists significantly between BACH2 and TGF-β1.Conclusion:Increased serum concentrations of ox-LDL probably down-regulated the expression of BACH2 in ACS patients by activating TLR4 on PBMC, resulting in promoting production of pro-inflammatory cytokines and suppressing production of anti-inflammatory cytokine and then might cause ACS.
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Objective To discuss the spiral CT features of the bowel obstruction induced incarcerated abdominal external hernia and its value in clinical application.Methods The spiral CT feature of the bowel obstmction induced incarcerated abdominal external hernia which were confirmed by surgery in 14 cases were retrospectively analyzed and were compared with surgical results.Results The hernia sac of incarcerated abdominal external hernia in all cases of bowel obstruction were displayed by CT,in which the positions and varieties of the hernia were determined in 12 CaSes.the intestinal images within the hernia SaC were displayed in 10 cases,the epiploon image within the hernia sac was displayed in 1 case.homogeneus soft tissue density shadows were displayed in 3 cases,the intestinal wall thickening within the hernia sac was displayed in 4 cases.in which in 2 cases were involved in delamination of the intestinal wall.The intestinal wall thickening in abdominal cavity was displayed in 2 cases,the nuidify in abdominal cavity was displayed in 3 cases.the volvulus was displayed in 2 cases.Conclusion The spiral CT has an important value in determing the positions of bowel obstruction,varieties of the contents of hernia sac,th blood supply of the bowel within the hernia sac and proximate obstmction and other complieations.