[Goods syndrome in chronic active SARS-CoV-2 infection: a case report].

A 54-year-old female patient presented with recurrent cough and sputum production over the past year and was hospitalized several times. CT examination revealed exudative lesions in both lungs, which were partially absorbed after treatment. However, they recurred shortly after discharge, and the patient had to be readmitted. In the past year, the patient had been hospitalized six times, and her throat swabs were positive for SARS-CoV-2 at four different points in time. After receiving anti-infective and antiviral treatment in other hospitals, the above symptoms were relieved. The patient tested negative for SARS-CoV-2, but symptoms recurred soon after. Eventually, the diagnosis of Goods syndrome was made based on the presence of B-cell loss, decreased immunoglobulin levels, an inverted CD4+/CD8+ ratio on admission, and a previous history of thymoma.

[A case report of chronic granulomatous disease with CYBB gene mutation in an adult].

We reported a 28-year-old male patient who had been admitted to a local hospital for several times in the past four years because of recurrent fever and cough. Each chest CT scan during hospitalization showed consolidation accompanied by exudation and mild pleural effusion. After treatment, the consolidation apparently absorbed, but similar symptoms recurred within half a year, and the new consolidation appeared. For this reason, he was diagnosed with tuberculosis or bacterial pneumonia several times in other hospitals, and was hospitalized two to three times a year. Finally, he was diagnosed with chronic granulomatous disease (CGD) with CYBB gene mutation through whole-exome sequencing.

[Sleep-disordered breathing in patients with chronic heart failure before and after heart transplantation].

Objective: To explore the characteristics of sleep-disordered breathing (SDB) in chronic heart failure patients waiting for heart transplantation and the changes of SDB after transplantation. Methods: From September 2018 to December 2019, 34 patients with chronic heart failure were prospectively enrolled into this study, who were hospitalized for waiting for heart transplantation in the departments of cardiovascular medicine and cardiovascular surgery, Renmin Hospital of Wuhan University. All of them received portable sleep physiological monitoring. The characteristics of their SDB were analyzed before and after heart transplantation. Results: Of the 34 patients waiting for heart transplantation, 22 had central sleep apnea, 4 had obstructive sleep apnea and 8 had no SDB. The cycle length of Cheyne-Stokes respiration was negatively correlated with left ventricular ejection fraction. After heart transplantation, 15 patients received repeat sleep physiological monitoring and their results showed that the SDB was significantly improved, with the elimination of Cheyne-Stokes respiration. Conclusions: Patients waiting for heart transplantation had a high prevalence of SDB, with Cheyne-Stokes respiration with central sleep apnea as the main type. However, heart transplantation may eliminate the Cheyne-Stokes respiration in patients with chronic heart failure.

[Analysis of risk factors and consequences for concurrent obstructive sleep apnea in chronic obstructive pulmonary disease patients].

Objective: To compare clinical characteristics between patients with chronic obstructive pulmonary disease (COPD) and COPD -OSA overlap, and to analyze the risk factors for OSA in patients with COPD. Methods: A total of 431 patients with COPD were divided into a COPD-OSA group with AHI>15 events/h or a COPD group with AHI ≤ 15 events/h according to the results of polysomnography, and their clinical characteristics were summarized. Risk factors for OSA overlap in COPD patients were identified by univariate and multivariate logistic regression analyses. Results: There were no significant differences in gender composition, dyspnea scale (mMRC) score, the numbers of acute exacerbations and hospitalizations in the last year, prevalence of coronary heart disease, or cor pulmonale or diabetes mellitus in the two groups (all P>0.05). Age, BMI, neck circumference, smoking index, COPD assessment test (CAT) score, the values of FEV(1) or FEV(1)%, FEV(1)/FVC ratios, and the prevalence of hypertension in the COPD-OSA group with AHI>15 events/h were significantly higher than in the COPD group with AHI ≤15 events/h, while the duration of COPD and the proportion of severe COPD were lower than the COPD group with AHI≤ 15 (P<0.05). The scores of Charlson Comorbidity Index, Epworth Sleepiness Scale (ESS) and Sleep Apnea Clinical Score (SACS) in the COPD-OSA group were significantly higher than in the COPD group with AHI≤ 15, with all P values<0.05. Risk factors for AHI>15 OSA coinciding in patients with COPD included BMI, neck circumference, ESS, SACS and CAT (P<0.05). Furthermore, BMI, ESS and CAT were independent risk factors for OSA in COPD patients (P<0.05). Compared with mild or moderate COPD cases, patients with severe COPD (FEV(1)%<50%) had a lower risk of having OSA (ß=-0.459, OR=0.632, 95% CI 0.401-0.997, P=0.048). Conclusions: Compared to COPD patients with AHI ≤ 15 events/h, OSA-COPD overlap patients (AHI>15 events/h) had a worse quality of life, more daytime sleepiness and higher prevalence of hypertension. BMI, ESS and CAT were independent risk factors for AHI>15 OSA in patients with COPD. The risk of having OSA in severe COPD patients was lower than cases with mild or moderate COPD.

Radiotracer study on mancozeb residues in tomato plants.

A study on the persistence, residues and residue distribution of mancozeb in tomato plant-soil system, as well as effects of cooking on transformation of residual mancozeb were carried out with radiotracer technique. Half-life values for total mancozeb residues on tomato leaves and in soil were observed to be 9.5 and 7.6 days, respectively. The results also suggested that mancozeb residues in soil were readily uptaken by plants and leach to soil layer as deep as 28cm within two weeks, although over 90% of the residues remained in the upper layer (0-6cm) of the soil. Translocation of the residues of mancozeb, especially the water soluble metabolites including ETU, throughout the plants could be one of the factors responsible for the contamination of tomato fruits. Deposit of sprayed mancozeb on the fruit skin was another important factor leading to the contamination of fruits. Fruit skin contained higher levels of residues than the pulp. Washing with water could remove more than 50% of the residues on the skin. It was also found that 20-30% of the residual mancozeb degraded to ETU during cooking process. The tomatoes should be washed to reduce the residues of the fungicide and ETU in food.

Radiotracer study on residues and residue distribution of zineb in plant-soil system.

In view of the widespread use of zineb on food plants and the toxicity of one of its metabolites, ETU, a study on the residues and residue distribution of zineb and ETU in plant-soil systems was carried out. The half-life values for total zineb residues on egg-plant leaves and in soil were observed to be over three and two weeks, respectively. Egg-plant skin contained higher amount of zineb residues than the fruit pulp. Washing with water greatly reduced zineb residue levels, especially those in the fruit skin. Compared with zineb, ETU is much easier to be uptaken by plants and to leach into deeper layer of soil due to its high water solubility. Therefore, attention should be paid to the contents of ETU in zineb formulations as impurity and formation of ETU in the environment.