Effects of Smoking on ACE2 Expression Pattern: Risk and Severity of SARS-CoV-2 Infection.

BACKGROUND: Respiratory epithelium expressing angiotensin-converting enzyme 2 (ACE2) is the entry for novel coronavirus (SARS-CoV-2), pathogen of the COVID-19 pneumonia outbreak, although a few recent studies have found different ACE2 expression in lung tissue of smokers. The effect of smoking on ACE2 expression and COVID-19 is still not clear. So, we did this research to determine the effect of smoking on ACE2 expression pattern and its relationship with the risk and severity of COVID-19. METHODS: The clinical data of COVID-19 patients with smoking and non-smoking were analyzed, and ACE2 expression of respiratory and digestive mucosa epithelia from smoker and non-smoker patients or healthy subjects were detected by immunohistochemical (IHC) staining. RESULTS: Of all 295 laboratory-confirmed COVID-19 patients, only 24 (8.1%) were current smokers with moderate smoking or above, which accounted for 54.2% of severe cases with higher mortality than non-smokers (8.3% vs. 0.4%, p = 0.018). Data analysis showed the proportion of smokers in COVID-19 patients was lower than that in general population of China (Z = 11.65, P < 0.001). IHC staining showed ACE2 expression in respiratory and digestive epithelia of smokers were generally downregulated. CONCLUSIONS: The proportion of smokers in COVID-19 patients was lower, which may be explained by ACE2 downregulation in respiratory mucosa epithelia. However, smoking COVID-19 patients accounted for a higher proportion in severe cases and higher mortality than for non-smoking COVID-19 patients, which needs to be noted.

Abnormal regional homogeneity of resting-state brain activity in patients with HBV-related cirrhosis without overt hepatic encephalopathy.

BACKGROUND: Many studies have reported that cognitive deficits exist in cirrhotic patients without overt hepatic encephalopathy (OHE). However, the neurobiological mechanisms underlying these deficits are still not fully understood. AIM: To investigate regional activity abnormalities in patients with hepatitis B virus-related cirrhosis (HBV-RC) without OHE using resting-state functional MRI (Rs-fMRI), and to examine the relationship between regional activity abnormalities and impaired cognition. METHODS: A newly reported regional homogeneity (ReHo) approach was used to compare the local synchronization of Rs-fMRI signals in 32 patients with HBV-RC without OHE and 32 well-matched healthy controls. Cognition was measured in all patients using psychometric hepatic encephalopathy score (PHES) tests, and the relationship between ReHo variation and PHES was analysed. RESULTS: Relative to healthy controls, the cirrhosis group showed high ReHo in the prefrontal cortex, and widespread low ReHo in visual association areas (left lingual gyrus, middle temporal gyrus and right middle occipital gyrus), motor association areas (bilateral precentral gyrus and paracentral lobule) and the bilateral precuneus. Correlation analysis of the mean ReHo values in different brain areas and PHES in cirrhotic patients revealed a significantly positive correlation in the left lingual gyrus (r = 0.352; P = 0.048), right middle occipital gyrus (r = 0.453; P = 0.009) and bilateral precentral gyrus (left: r = 0.436, P = 0.013; right: r = 0.582, P < 0.001), paracentral lobule (r = 0.485; P = 0.005) and precuneus (r = 0.468; P = 0.007). CONCLUSIONS: Our results provide information on the pathophysiological mechanisms underlying cognitive alterations in cirrhotic patients and demonstrate the feasibility of using Rs-fMRI with ReHo analysis as a noninvasive modality with which to detect the progression of cognitive changes in cirrhotic patients.

Diagnostic value of blood parameters for community-acquired pneumonia.

BACKGROUND: Community-acquired pneumonia (CAP) has a high rate of morbidity and mortality. Blood parameters, including neutrophil, platelet, lymphocyte, monocyte, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte ratio (MLR), have been proposed as indicators of systemic inflammation and infection. However, few studies have focused on the diagnostic value of blood parameters for CAP. OBJECTIVE: The study aims to determine the diagnostic value of blood parameters for CAP and to investigate their relationship with disease severity. METHODS: CAP patients who fulfilled the inclusion criteria were enrolled in this study. Healthy age- and gender-matched subjects were also enrolled as a control group. Blood parameters, blood biochemistry, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), days in hospital, body temperature, pneumonia severity index (PSI), and CURB-65 were recorded. The area under the curve (AUC) values was determined using the receiver-operating characteristic (ROC) curve. The correlation between the variables was tested with Pearson correlation analysis. RESULTS: The study included 80 CAP patients and 49 healthy subjects. White blood cell (WBC), neutrophil, monocyte, MLR, PLR, and NLR levels in the CAP group were higher than that of control group, while lymphocyte and hemoglobin (HGB) levels were lower (P < 0.05). The ROC curve result showed that NLR and MLR yielded higher AUC values than other variables. Monocyte was positively correlated with ESR and negatively with body temperature, aspartate aminotransferase (AST), and creatinine (CREA). NLR was positively correlated with CRP, PCT, days in hospital, alanine aminotransferase (ALT), AST, and PSI. MLR was positively correlated with CRP, PCT, and body temperature. An increase in ALT or AST of >2 times of normal was defined as liver injury, and CAP patients were divided into the liver normal group and liver injury group. Sixty-nine patients belonged to the liver normal group, and 11 patients belonged to the liver injury group. Blood parameters, ESR, CRP, PCT, PSI, and CURB-65 were compared between the two groups. The results demonstrated that the monocyte level in the liver injury group was lower than that of the liver normal group (P < 0.05). The ROC curve result showed that the AUC value of monocyte for liver injury was 0.838 (95% confidence interval: 0.733-0.943), which was higher than other variables. CONCLUSIONS: NLR and MLR were elevated in CAP patients, resulting in a higher diagnostic value for CAP. NLR showed a significant correlation to PSI, indicating the disease severity of CAP. Monocyte had a higher diagnostic value for liver injury in CAP patients.

The association between hepatitis B mutants and hepatocellular carcinoma: A meta-analysis.

BACKGROUND: More and more studies focus on the relationship between hepatitis B virus (HBV) basal core promoter/precore (BCP/PC) mutations, but it remains controvercial, we conducted a meta-analysis to investigate the features of hepatitis B virus basal core promoter/precore mutations on the progression of hepatocellular carcinoma (HCC). METHODS: A comprehensive search was conducted for articles published between January 1, 2005 and December 31, 2015 using the following databases: PubMed, Embase, Cochrane Library, Wanfang, and China National Knowledge Infrastructure. Medical subject heading terms were prioritized in setting the search strategy. Search terms included ("hepatitis B virus"), ("mutation or mutations or mutant"), and ("hepatocellular carcinoma" or "liver cancer" or hepatoma). A meta-analysis of pooled results from case-control studies examined the association between mutations G1896A, A1762T, G1764A, and A1762T/G1764A and the risk of HCC. RESULTS: We included 29 articles for analysis and found that G1896A (summary odds ratios [OR] = 2.04, 95% confidence interval [CI] = 1.41-2.95), A1762T (summary OR = 3.96, 95% CI = 1.98-7.92), G1764A (summary OR = 3.48, 95% CI = 1.99-6.09), and A1762T/G1764A (summary OR = 3.96, 95% CI = 2.77-5.65) are each associated with a statistically significant increase in the risk of HCC. CONCLUSION: In summary, we found that G1896A, A1762T, G1764A, and A1762T/G1764A are associated with an increased risk of HCC.