Health outcomes of COVID-19 patients from Wuhan, China 3-year after hospital discharge: a cohort study.

OBJECTIVES: To evaluate changes in health outcomes between years 2 and 3 after discharge following COVID-19 and to identify risk factors for poor health 3-year post-discharge. DESIGN: This is a multicentre observational cohort study. SETTING: This study was conducted in two centres from Wuhan, China. PARTICIPANTS: Eligibility screening has been performed in 3988 discharged laboratory-confirmed adult COVID-19 patients. Exclusion criteria were refusal to participate, inability to contact and death before follow-up. The WHO COVID-19 guidelines on defining disease severity were adopted. RESULTS: 1594 patients participated in the 1-year, 2-year and 3-year follow-ups, including 796 (49.9%) male patients, and 422 (26.5%) patients were classified in the severe disease group. 3 years after discharge, 182 (11.4%) patients still complained of at least one symptom. The most common symptoms were fatigue, myalgia, chest tightness, cough, anxiety, shortness of breath and expectoration. Fatigue or myalgia, the most common symptom cluster, frequently coexisted with chest symptoms and anxiety. Symptom persistence between years 2 and 3 was reported in 70 patients (4.4%) for which intensive care unit (ICU) admission was a risk factor (p=0.038). Of the 1586 patients who completed the chronic obstructive pulmonary disease assessment test (CAT), 97 (6.1%) scored ≥10, with older age being associated with CAT ≥10 (p=0.007). CONCLUSIONS: Between years 2 and 3 after SARS-CoV-2 infection, most patients returned to an asymptomatic state, and only a few were still symptomatic. ICU admission was a risk factor for symptom persistence.

Generation mechanism and empirical model of eddy current force and torque in drum-type eddy current separation.

Enhancing the recovery efficiency of non-ferrous metals in eddy current separation is of great significance. In this study, the accuracy of the simulation model was verified by comparing the eddy current force. The transformation mechanism of the Lorentz forces into the eddy current force and torque in non-ferrous metal particles was revealed by analyzing various physical fields. Then, the influence of magnetic field parameters on eddy current, eddy current force, and torque was studied. It shows that the eddy current force and torque are affected by the vector gradient of the magnetic field and the magnetic flux density, respectively. Additionally, the time derivative of the magnetic field impacts the magnitude of the eddy current force and torque by controlling the eddy current. On this basis, the empirical models of eddy current force and torque were established by similarity theory. The results obtained can improve and expand the application of eddy current separation.

Aetiology and prognostic risk factors of mortality in patients with pneumonia receiving glucocorticoids alone or glucocorticoids and other immunosuppressants: a retrospective cohort study.

OBJECTIVES: Long-term use of high-dose glucocorticoids can lead to severe immunosuppression and increased risk of treatment-resistant pneumonia and mortality. We investigated the aetiology and prognostic risk factors of mortality in hospitalised patients who developed pneumonia while receiving glucocorticoid therapy alone or glucocorticoid and other immunosuppressant therapies. DESIGN: Retrospective cohort study. SETTING: Six secondary and tertiary academic hospitals in China. PARTICIPANTS: Patients receiving glucocorticoids who were hospitalised with pneumonia between 1 January 2013 and 31 December 2019. MAIN OUTCOMES: We analysed the prevalence of comorbidities, microbiology, antibiotic susceptibility patterns, 30-day and 90-day mortality and prognostic risk factors. RESULTS: CONCLUSIONS: A total of 716 patients were included, with pneumonia pathogens identified in 69.8% of patients. Significant morbidities occurred, including respiratory failure (50.8%), intensive care unit transfer (40.8%) and mechanical ventilation (36%), with a 90-day mortality of 26.0%. Diagnosis of pneumonia occurred within 6 months of glucocorticoid initiation for 69.7% of patients with Cytomegalovirus (CMV) pneumonia and 79.0% of patients with Pneumocystis jirovecii pneumonia (PCP). Pathogens, including Pneumocystis, CMV and multidrug-resistant bacteria, were identified more frequently in patients with persistent lymphocytopenia and high-dose glucocorticoid treatment (≥30 mg/day of prednisolone or equivalent within 30 days before admission). The 90-day mortality was significantly lower for non-CMV viral pneumonias than for PCP (p<0.05), with a similar mortality as CMV pneumonias (24.2% vs 38.1% vs 27.4%, respectively). Cox regression analysis indicated several independent negative predictors for mortality in this patient population, including septic shock, respiratory failure, persistent lymphocytopenia, interstitial lung disease and high-dose glucocorticoid use.Patients who developed pneumonia while receiving glucocorticoid therapy experienced high rates of opportunistic infections, with significant morbidity and mortality. These findings should be carefully considered when determining treatment strategies for this patient population.

Transmembrane protein 126B protects against high fat diet (HFD)-induced renal injury by suppressing dyslipidemia via inhibition of ROS.

High-fat diet (HFD)-induced metabolic syndrome followed by chronic kidney disease (CKD) have received extensive attention. However, the pathogenesis that contributes to HFD-induced renal injury still remains unclear. Transmembrane protein 126B (Tmem126b) is a complex I assembly factor, playing critical role in controlling important biological processes. In the study, we showed that Tmem126b levels were increased in kidney of HFD-fed mice. Tmem126b knockout (KO) attenuated metabolic disorders in mice challenged with HFD. Further, Tmem126b-KO mice showed alleviated kidney damage in response to HFD treatment. Mechanistically, we suggested that in kidney of mice, the dyslipidemia, apoptosis, and mitochondria dysfunction generated by HFD were prevented by Tmem126b deletion via regulating the expression of associated signals. Further, we demonstrated that HFD-induced renal inflammation was ameliorated by Tmem126b knockout, as evidenced by the down-regulated expression of inflammatory factors, including tumor necrosis factor a (TNF-α), interleukin (IL)-6, IL-1ß and monocyte chemotactic protein (MCP)-1, which was through repressing nuclear factor kappa B (NF-κB) signaling pathways. Additionally, Tmem126b ablation repressed oxidative stress in renal samples of HFD-fed mice partly by promoting nuclear factor-erythroid 2 related factor-2 (Nrf-2) and heme oxygenase-1 (HO-1) expression. The role of Tmem126b knockout in protecting against HFD-triggered renal injury was verified in palmitate (PA)-incubated cells with Tmem126b knockdown. Importantly, inhibiting Nrf-2 expression abolished Tmem126b knockdown-alleviated lipid deposition, apoptosis, inflammation, ROS generation and mitochondrial dysfunction. Collectively, our study identified Tmem126b as a positive regulator for the progression of CKD induced by HFD through meditating Nrf-2 expression.

The effect of microRNA-129 on the migration and invasion in NSCLC cells and its mechanism.

PURPOSE: To investigate the effect of microRNA-129 on the migration and invasion in (Non small cell lung cancer) NSCLC cells and involved mechanism. MATERIALS AND METHODS: A549 cells were cultured and transfected with microRNA-129 (miR-129) mimic. Wound-healing assay and transwell assay were used to analyses the migration and invasion of A549 cells, respectively. The SOX4 expression changes were detected by qRT-PCR and Western blot. Dual-luciferase reporter assay was used to determine the binding site between miR-129 and the 3'-UTR of SOX4. A549 cells, miR-129 up-regulated A549 cells and miR-129 + SOX4 up-regulated A549 cells were treated with TGF-ß in order to induce the epithelial-mesenchymal transition (EMT). The miR-129 and SOX4 after TGF-ß treatment were measured. The EMT markers level changes were detected by western blot. RESULTS: Up-regulation of miR-129 significantly inhibited the migration and invasion of A549 cells. miR-129 mimic transfection could reduce the mRNA and protein level of SOX4. Dual-luciferase reporter assay showed that miR-129 could bind to the 3'-UTR of SOX4. TGF-ß induced EMT accompanied by the reduction of miR-129 and elevating of SOX4. Up-regulation of miR-129 could reverse the EMT marker changes caused by TGF-ß, however, the SOX4 overexpression antagonized this effect of miR-129. CONCLUSIONS: miR-129 could suppress the migration and invasion of A549 cells. The potential mechanism may be that miR-129 inhibit EMT via targeting SOX4.

Cost of nosocomial pneumonia: the example of vancomycin versus linezolid-shorter stay or fewer complications?

Hospital and national committees often focus on drug acquisition costs when taking decisions on the use of new drugs, but antimicrobial agent costs represent a minor part of the bill compared with the indirect costs of hospitalization or loss in days of productivity in working people. Although reducing the length of stay should be a main priority in the USA due to the indirect costs associated with hospitalization, adverse events, such as renal failure, have a major impact on healthcare resource use and costs. However, where hospital reimbursement is based on closed budgets, the paradox is that treating more patients due to reductions in length of stay may not be attractive to administrators, because the cost of discharging patients earlier is not compensated by the increase in severity in replacing stays of newer patient admissions. Furthermore, neuropsychological, physical, and immune impairment caused by sepsis has an extreme impact on long-term quality of patient life and health care resource consumption. Future research is warranted to further explore the potential impact of newer therapies for infections and sepsis, taking into account the costs of complications, effects on long-term quality of life, and particularly an international perspective, which requires customization for each national payer's system.

[Investigation on current situation of malaria blood examinations in township-level hospitals of Nantong City].

OBJECTIVE: To understand the quality of malaria blood examinations in township-level hospitals, so as to provide the evidence for continuing the malaria blood examinations in the stage of post-malaria elimination. METHODS: A total of 64 township hospitals were investigated and 640 negative malaria blood slides were scored individually according to 10 indicators in "Malaria Elimination Technical Scheme" in 2013 and 2014. The single and multiple indicators were calculated, and the work of blood examinations and situation of technicians were investigated. The data of malaria blood examinations and patient discovery in township hospitals of Nantong City were collected and analyzed during the period of 2011-2014. RESULTS: For the single indicator, 29.5% of the thick blood films did not reach the standard, and 35.8% of thin blood films did not reach the standard. For the multiple indicators, blood slides with more than 4 indicators below the standard (poor quality) accounted for 32.5%. From malaria blood examinations and malaria situation, the number of slides was 194 635 during the period of 2011-2014, and there were no local vivax malaria casesin 4 consecutive years from 2011 to 2014, and local malaria has been effectively controlled in Nantong City. For health facilities where malaria patients initially presented, the township and village level accounted for 16.3%, and county and higher level accounted for 83.7%. CONCLUSIONS: The quality of malaria blood examinations in township level hospitals of Nantong City is not high and the microscopic examination has a relatively low efficiency in the discovery of malaria cases. A new model for malaria blood examinations needs to be further explored.

Effects of simvastatin on the expression of inducible nitric oxide synthase and brain-derived neurotrophic factor in a lipopolysaccharide-induced rat model of Parkinson disease.

OBJECTIVE: To investigate the effects of simvastatin on the expression of inducible nitric oxide synthase (iNOS) and brain-derived neurotrophic factor (BDNF) in the substantia nigra in a lipopolysaccharide (LPS)-induced rat model of Parkinson disease (PD), and to study the mechanisms underlying the neuroprotective effects of simvastatin in PD. METHODS: The LPS-PD model was established by injection of LPS (5 mg/mL, 2.0 µL) into the right substantia nigra compacta (SNC). Rats in the sham-operated group received saline. The simvastatin treatment group was intraperitoneally administered simvastatin (5 mg/kg, 2.0 µL) at 1 h before, and daily for 14 days after surgery, while the sham-operated and LPS-model groups received saline. Iba-1-positive cells and tyrosine hydroxylase (TH), as well as iNOS and BDNF in the SNC were detected by immunohistochemistry and Western blotting, respectively. The effect of simvastatin in the PD model was also examined in behavioral tests. RESULTS: The LPS-model group exhibited typical animal PD behaviors. Compared with the control group, the LPS-model group exhibited a decreased number of DA neurons (p < 0.01) in the SNC, as well as increases in the Iba-1-positive cell number and iNOS expression (p < 0.05), while BDNF expression was downregulated (p < 0.01). These effects were inhibited by simvastatin treatment (p < 0.05). CONCLUSION: Simvastatin mediates a protective effect on dopaminergic neurons in the SNC in the LPS-PD model, possibly by promoting neuronal repair and regeneration, and by inhibiting oxidative stress, thus improving substantia nigra function.

Beneficial effects of Xuebijing injection on random skin flap survival in rats.

BACKGROUND: Improving survival of random skin flaps has important implications of reconstruction, and various kinds of agents have been tested for this purpose. In this study, the effects of Xuebijing (XBJ) injection on random skin flap survival in rats were evaluated. MATERIALS AND METHODS: McFarlane flaps were established in 40 rats divided into two groups. XBJ was injected into the test group, and the same concentration of saline was injected into controls. Tissues were stained with hematoxylin and eosin stain and immunohistochemically evaluated, and the survival area of the flaps, superoxide dismutase, and malondialdehyde contents were examined. RESULTS: Compared with the control group, we found the mean survival area of the flaps in the test group was significantly larger, expression of vascular endothelial growth factor and superoxide dismutase activity increased markedly in the test group, malondialdehyde level in the test group was significantly lower, and the hematoxylin and eosin-stained slices showed that inflammation was clearly inhibited in the test group. CONCLUSIONS: In summary, XBJ improved survival of random skin flaps.

Simultaneous detection of ochratoxin A and fumonisin B1 in cereal samples using an aptamer-photonic crystal encoded suspension array.

A simple, new aptamer-photonic crystal encoded suspension array was designed to simultaneously quantify and qualify ochratoxin A(OTA) and fumonisin B1(FB1) in cereal samples. The aptamers of OTA and FB1 were immobilized on the surfaces of photonic crystals by chemical bonding. When the target mycotoxins appear in a sample, the fluorescence-labeled complementary DNA of the aptamer dissociates from their double DNA hybrid and results in an obvious decrease in fluorescence intensity of the microsphere. The difference value of fluorescent intensities for each kind of silica photonic crystal microsphere (SPCM) quantitatively conveys the concentration of mycotoxin, and the structure colors or reflectance peak positions of the SPCMs confirm the kind of mycotoxin detected. The reaction conditions including the immobilization method for aptamers, hybridization, and incubation conditions have been optimized. This developed method displayed a wide linear detection range (0.01-1 ng/mL for OTA and 0.001-1 ng/mL for FB1) and a low limit of detection (0.25 pg/mL for OTA and 0.16 pg/mL for FB1). The recovery rates in the spiked cereal samples ranged from 81.80% to 116.38% for OTA and 76.58%-114.79% for FB1. The positive detection results in the naturally contaminated cereal samples were in agreement with those of classic enzyme-linked immunosorbent assay (ELISA). This simple suspension array scheme displays a great application potential for the high throughput screen assay of mycotoxins.

Clinical and epidemiologic characteristics of 3 early cases of influenza A pandemic (H1N1) 2009 virus infection, People's Republic of China, 2009.

On May 7, 2009, a national network was organized in the People's Republic of China for the surveillance, reporting, diagnosis, and treatment of influenza A pandemic (H1N1) 2009 virus infection (pandemic [H1N1] 2009). Persons with suspected cases are required to report to the Chinese Center for Disease Control and Prevention and the Ministry of Health within 24 hours; the patient's close contacts are then traced and placed in quarantine for 7 days. We report 3 confirmed early cases of pandemic (H1N1) 2009. Two cases were imported from United States; the other was imported from Canada. The patients exhibited fever and signs and other symptoms that were indistinguishable from those of seasonal influenza. Serial virologic monitoring of pharyngeal swabs showed that they were negative for pandemic (H1N1) 2009 virus by real-time reverse transcription-PCR 4-6 days after onset of illness. One close contact whose sample tested positive for pandemic (H1N1) 2009 virus had no symptoms during quarantine. A national network is essential for controlling pandemic (H1N1) 2009.

Outcome of cephalosporin treatment of bacteremia due to CTX-M-type extended-spectrum beta-lactamase-producing Escherichia coli.

The aim of the study was to analyze the outcome of different antibiotic treatments for bacteremia due to CTX-M-type extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. In a prospective controlled clinical study from October 2002 to April 2005, 22 consecutive cases of bacteremia due to ESBL-producing E. coli with a ceftazidime-inhibition zone diameter of > or =18 mm were studied. The Etest method was used to determine the MIC values of cefotaxime, ceftazidime, imipenem, gentamicin, and ciprofloxacin against 22 isolates of E. coli. The polymerase chain reaction and sequencing analyses were used to determine the genotypes of the ESBLs. Of these 22 episodes, 7 were treated with ceftazidime, 8 were treated with imipenem/cilastatin, and 7 were treated with cefoperazone/sulbactam after detection of bacteremia. The demographic characteristics were comparable between the 3 groups. The treatment success ratio was similar (ceftazidime 85.7%, imipenem/cilastatin 87.5%, cefoperazone/sulbactam 71.4%, P = 0.637). Difficulties arose during treatment of peritonitis caused by CTX-M-producing E. coli bacteremia. Patients with bacteremia associated with urinary tract infection or biliary tract infection had a better chance of survival. All the 22 strains of E. coli produced CTX-M ESBLs (CTX-M-3, CTX-M-14, or CTX-M-27). The MICs of ceftazidime for 22 strains of E. coli were < or =8 microg/mL. All 7 patients who received ceftazidime survived, 6 of them were cured. Treatment in one patient with a ceftazidime MIC of 2 mug/mL failed because of abdominal abscess. Treatment with ceftazidime in vivo was effective against cases of CTX-M ESBL-producing E. coli bacteremia due to urinary tract infections and biliary tract infection when the MICs of ceftazidime were < or =8 microg/mL.