[Investigation on cognition, diagnosis and treatment status of chest tightness variant asthma among Chinese pediatricians].

Objective: To evaluate the awareness, diagnosis and treatment of chest tightness variant asthma (CTVA) among pediatricians in China. Methods: The survey was conducted by convenient sampling method. Pediatricians with professional title of attending physician and above from different grades hospitals in 30 provinces were invited to conduct online questionnaire surveys through WeChat, pediatricians scan QR codes to complete electronic questionnaires in the mini program from January 16th to February 4th, 2021. The contents of questionnaire included the awareness, diagnosis and treatment of CTVA, and comparing the differences between pediatricians in secondary hospitals and tertiary hospitals. Results: A total of 1 529 pediatricians participated in the survey, and 1 484 (97.06%) pediatricians completed the questionnaire and included in the analysis, including 420 males (28.30%). The awareness rate of CTVA among pediatricians was 77.83 % (1 155/1 484). Pediatricians in tertiary hospitals had higher rates of awareness of CTVA than pediatricians in secondary hospitals [81.86% (898/1 097) vs 66.41% (257/387), P<0.001] and had better execution of the guidelines [89.15% (978/1 097) vs 79.59% (308/387), P<0.001]. A total of 93.06 % (1 381/1 484) of pediatricians' first-line treatment included inhaled corticosteroids (ICS) for CTVA. Among them, a higher proportion of pediatricians in tertiary hospitals used ICS included regimens for first-line treatment of CTVA compared with pediatricians in secondary hospitals [94.90% (1 041/1 097) vs 87.86% (340/387), P<0.001]. The reported well control rate of CTVA was 32.08% (476/1 484), which was significantly lower in secondary hospitals than that in tertiary hospitals [17.31% (67/387) vs 37.28% (409/1 097), P<0.001]. Conclusion: Most pediatricians are well aware of CTVA, among which there is a certain gap in clinical practice between pediatricians in secondary hospitals and tertiary hospitals in terms of understanding, diagnosis, and treatment of CTVA.

[Clinical features and related factors of invasive pulmonary aspergillosis in patients with acute exacerbation of chronic obstructive pulmonary disease].

Objective: To study the clinical features and related factors of invasive pulmonary aspergillosis (IPA) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: This retrospective study enrolled patients hospitalized for AECOPD in ten tertiary hospitals of China from September 2017 to July 2021. AECOPD patients with IPA were included as case group, AECOPD patients without IPA were randomly selected as control group from the same hospitals and same hospitalization period as the patients with IPA using the random function in the software of Microsoft Excel 2003, at a ratio of 2∶1. The clinical characteristics, treatment and outcome were compared between the two groups. Binary logistic regression model was used to analyze the factors associated with IPA in AECOPD patients. Results: A total of 14 007 inpatients with AECOPD were included in this study, and 300 patients were confirmed to have IPA, with an incidence rate of 2.14%. According to the above matching method, 600 AECOPD patients without aspergillus infection were enrolled as the control group. The age of the case group and the control group were (72.5±9.7) and (73.5±10.3) years old, with 78.0%(n=234) male and 76.8%(n=461) male, respectively. There were no significant differences in age and gender composition between the two groups (all P>0.05). The prognosis of case group was significantly worse than that of the control group, with longer hospital stay [M(Q1,Q3)], [14 (10-20) d vs 11 (8-15) d, P<0.001], higher ICU admission rate [16.3% (49 case) vs 10.0% (60 case), P=0.006], higher in-hospital mortality [4.0% (12 cases) vs 1.3% (8 cases), P=0.011], and higher hospitalization costs (28 000 ¥ vs 13 700 ¥, P<0.001). The smoking index of the case group and proportions of patients with diabetes mellitus, chronic pulmonary heart disease in the case group were significantly higher than those in control group (all P<0.05). In terms of clinical features, the proportions of patients with cough, expectoration, purulent sputum, hemoptysis and fever in the case group were higher than those in the control group, the serum albumin was significantly lower than that in the control group, and the proportions of patients with bronchiectasis and pulmonary bullae on imaging were significantly higher than those in the control group (all P<0.05). Diabetes (OR=1.559, 95%CI: 1.084-2.243), chronic pulmonary heart disease (OR=1.476, 95%CI: 1.075-2.028), bronchiectasis (OR=1.506, 95%CI: 1.092-2.078), pulmonary bullae (OR=1.988, 95%CI: 1.475-2.678) and serum albumin<35 g/L (OR=1.786, 95%CI: 1.325-2.406) were the related factors of IPA in patients with AECOPD. Conclusions: The incidence of IPA in AECOPD patients is relatively high and the prognosis of these patients is worse. Diabetes, chronic pulmonary heart disease, bronchiectasis, pulmonary bulla, hypoproteinemia are the related factors of IPA in patients with AECOPD.

[Influencing factors of poor treatment adherence in uncontrolled asthma patients in China].

Objective: To evaluate the influencing factors of poor treatment adherence in patients with uncontrolled asthma in China. Methods: From April 2017 to April 2018, all asthma patients with uncontrolled asthma and poor compliance in 32 third-class hospitals in 28 provinces and cities of China mainland included in the "National Mobile Asthma Assessment and Management Project" were selected as the subjects. A total of 923 patients were enrolled in the study including 388 males and 535 females. By analyzing the baseline data of the patients at the initial visit when enrolled, the influencing factors of poor adherence of adult asthma was analyzed by inter-group comparison and χ2 test. Results: Poor compliance in asthma was related to the following factors: age from 59 to 68 years old, course of disease more than 20 years, low education level, non-local follow-up, having obstructive ventilation dysfunction and low awareness of the disease[P values were 0.026(t=1.20), 0.004(t=3.97), 0.001(t=4.92), 0.003(t=3.98), 0.032(t=1.22) and 0.001(t=4.99), respectively]. Totally, 243 patients (26.33%) answered all the questions about asthma correctly. Their medication adherence rating scale (MARS-A) scores were significantly higher than those who answered incompletely correctly (36.23±5.85 vs. 31.77±5.74, P=0.001). Conclusions: The adherence of adult asthma patients was affected by individual and external environment factors. Clinicians should choose individualized methods based on the characteristics of patients. Patient education should be strengthened to improve patients' awareness of the disease at the same time.

Dietary metabolizable energy and crude protein levels affect pectoral muscle composition and gut microbiota in native growing chickens.

The experiment aimed to study effects of dietary metabolizable energy (ME) and crude protein (CP) levels alone and in interaction on performance, pectoral muscle composition and gut microbiota in native growing chickens. A total of 648 10-wks-old Beijing-You Chicken (BYC) female chickens were randomly allocated to 9 groups with 6 replicates per group and 12 chickens per replicate, and the chickens were fed with a 3 × 3 factorial diets (3 levels of dietary ME: 11.31 MJ/kg, 11.51 MJ/kg, 11.71 MJ/kg; and 3 levels of dietary CP: 14%, 15%, 16%). The results showed that dietary ME and CP levels didn't affect average feed intake (AFI), body weight gain, feed gain ratio (P > 0.05), but ME level significantly affected the AFI (P < 0.05); mortality rate of 11.31 MJ/kg group was the highest (P < 0.05). Dietary ME, CP levels, and the interaction significantly affected pectoral CP and crude fat (CF) content of the growing chickens (P < 0.01). Dietary CP level had opposite effects on pectoral CP and CF content (P < 0.01). The 16% CP increased the pectoral CF content, which may have a negative impact on meat flavor. Dietary ME level affected 11 types of pectoral free amino acids (FAA) contents, including aspartic acid, L-threonine (P < 0.05), also amino acid classification, for example, total amino acid (TAA) and essential amino acid (EAA) content (P < 0.05). The 11.51 MJ/kg group had the highest TAA, EAA, delicious amino acid (DAA) content and EAA percentage (P < 0.05), while 11.31 MJ/kg group had the lowest bitter amino acid (BAA) content and BAA percentage and the highest fresh and sweet amino acid (FSAA) percentage (P < 0.05). Dietary CP level significantly affected glutamine and tyrosine content (P < 0.05). The interaction of dietary ME and CP level affected C20:3n6 content, saturated fatty acid (SFA), and unsaturated fatty acid (UFA) percentage (P < 0.05). The CP level significantly affected SFA percentage (P < 0.05). The 16% CP level increased the diversity of gut microbiota, but at the same time increased the relative abundance of Proteobacteria (P < 0.05), which is a sign of microbiota disorder. The increase of dietary ME level resulted in a gradual decrease in the diversity and relative abundance of gut microbiota. In conclusion, the present study suggested that the medium dietary ME (11.51 MJ/kg) and low CP (14-15%) levels can be helpful for enhancing pectoral muscle composition, increase meat quality such as flavor and nutritional value, and benefit for gut microbiota in native growing chickens.

Lighting pattern and photoperiod affect the range use and feather cover of native laying hens under free range condition.

The study aimed to investigate the effects of lighting pattern and photoperiod on range use, feather cover and gait score of native laying hens. Six hundred and thirty 19-wks-old Beijing You Chicken (BYC) pullets were randomly allocated to 6 groups with 105 birds each, 3 replicates per group, reared in individually lit indoor pens with separate covered shed and outdoor areas. A 2 × 3 factorial experiment (2 lighting patterns: continuous and intermittent lighting; 3 photoperiods: 16 h, 14 h, 12 h) was arranged indoors, including 16L:8D (6:00-22:00) for group 1; 12L:2D:4L:6D (6:00-18:00,20:00-24:00) for group 2; 14L:10D (6:00-20:00) for group 3; 10L:2D:4L:8D (6:00-16:00,18:00-22:00) for group 4; 12L:12D (6:00-18:00) for group 5, and 8L:4D:4L:8D (6:00-14:00,18:00-22:00) for group 6, respectively. The number of hens in indoor pen, covered shed and outdoor area were counted at 8:00, 9:00, 10:00, 11:00, 12:00, 13:00, 14:00 for consecutive 3 sunny days at 34 wks and 36 wks of age, feather cover and gait score of the laying hens were assessed at the end of 36 wks. The results showed that daily average hen percentage was the highest in continuous 12 h group (63.67%), and the lowest in intermittent 14 h group (58.36%) in indoor pen (P < 0.05); the daily average hen percentage was the lowest in continuous 12 h group (16.05%), and the highest in intermittent 14h group (21.22%) in outdoor area (P < 0.05). Lighting pattern significantly affected hen percentage in indoor pen and outdoor area, the hen percentage in indoor pen was higher in continuous lighting groups than in intermittent lighting groups (62.09% vs. 59.23%) (P < 0.05), the hen percentage in outdoor area was lower in continuous lighting groups than in intermittent lighting groups (16.60% vs. 19.95%) (P < 0.05). Photoperiod had no effect on the hen percentage (P > 0.05), but time of day affected the hen percentage in different areas (P < 0.05). The feather cover score was higher in intermittent lighting groups than in continuous lighting groups (17.43 vs. 15.04, P < 0.05). The average hen percentage in indoor pen is strongly negatively correlated with the feather cover score (r = -0.880, P = 0.050), and the hen percentage in outdoor area is strongly positively correlated with the feather cover score in intermittent lighting condition (r = 0.811, P < 0.05). The present study suggested that more range use is beneficial for the feather cover and physical health of laying hens under free range condition, and intermittent lighting is more conducive to range use and feather cover of native laying hens, which may be related to its affecting hens' rhythmic activities, increasing adaptation to outdoor environment, and reducing the incidence of feather pecking and parasites.

Emotional responses of piglets under long-term exposure to negative and positive auditory stimuli.

The stress caused by sound is inevitable. The stress caused by noise and the positive effects of music can affect the endocrine of animals and their welfare. In this study, a total of 72 hybrid piglets (Large White × Duroc × Min pig) were randomly divided into 3 groups, including music (Mozart K.448, 60-70 dB), noise (recorded mechanical noise, 80-85 dB), and control (natural background sound, <40 dB) groups. S-IgA (secretory immunoglobulin A), IL-6 (interleukin-6), IL-8 (interleukin-8), and positive emotion-related behaviors were used as indicators to discuss whether noise induced stress and inflammation in piglets or whether music could have positive effects. Six hours of auditory exposure were given daily (10:00-16:00), which lasted for 56 days. Behavioral responses of the piglets were observed, and the concentrations of salivary S-IgA and serum IL-6 and IL-8 were measured. The results showed that the concentration of S-IgA increased in the noise and control groups on the 57th day (P < 0.05); S-IgA concentration in the music group was unchanged after long-term music exposure. The concentrations of IL-6 and IL-8 showed that long-term noise exposure might lead to stress and inflammation in piglets. Tail-wagging and play behaviors of the piglets in the music group were significantly greater than those in the noise and control groups, which implied that long-term music exposure improved the emotional state of the piglets in a restricted and barren environment.

[Imaging and cerebrospinal fluid features of two cases with lymphomatosis cerebri].

This article reported the clinical experience of diagnosis and treatment for two patients with lymphomatosis cerebri. Case 1 was female and aged 53 years old, while case 2 was male and aged 69 years old. Progressive cognitive impairment was the main clinical manifestation in both patients. Brain magnetic resonance imaging (MRI) suggested leukoencephalopathy with patchy or mass enhancement. Cerebral blood flow was reduced on perfusion imaging in one patient. Brain biopsy confirmed diffuse large B-cell lymphoma in both cases. The concentration of interleukin-10 in cerebrospinal fluid (CSF) of two patients was significantly increased, however, the result of CSF flow cytology was negative. The current study suggests that interleukin-10 in CSF is an important biological indicator for the diagnosis of lymphomatosis cerebri, but CSF flow cytometry may not be helpful. Moreover, cerebral hypoperfusion can be present in patients with lymphomatosis cerebri.

[The outcomes of Tiantan first-aid protocol on critically ill patients with primary central nervous system lymphoma].

Objective: To examine the outcomes of Tiantan first-aid protocol on critically ill patients with primary central nervous system lymphoma (PCNSL). Methods: The clinical data of 18 patients with PCNSL who were treated according to Tiantan first-aid protocol at Department of Neurosurgery,Beijing Tiantan Hospital, Capital Medical University from November 2019 to December 2021 were retrospectively analyzed. There were 9 males and 9 females, aged (56.9±11.1)years (range: 29 to 77 years). The median Karnofsky performance status(KPS) score at admission was 40 (range: 20 to 60). Three patients were mild coma, 3 were lethargy and 12 were conscious. The mean midline shift was 0.7 cm (range: 0 to 1.8 cm). After admission, all patients were treated according to the plan of rapid biopsy, rapid routine pathology and rapid salvage chemotherapy. The treatment procedures, clinical and radiographic outcomes, KPS score and adverse reactions of patients after chemotherapy were collected. Results: All of the 18 patients completed the first-aid treatment. The median duration from admission to the biopsy was 1 day (range: 0 to 5 days), from biopsy to routine pathological diagnosis was 1 day (range: 1 to 4 days) and from routine pathology to salvage chemotherapy was 1 day (range: 0 to 4 days). All the patients were pathologically confirmed with diffuse large B cell lymphoma, 1 patient was double-hit lymphoma. Seventeen patients underwent clinical remission and 1 died of cardiac dysfunction. The successful salvage rate was 17/18. Radiologically, complete remission was observed in 1 case, partial remission in 16 cases, and stable disease in 1 case. The median KPS score at discharge was 60 (range: 30 to 80). The mild gastrointestinal, hematological and hepatic adverse effects were observed after chemotherapy. Conclusion: Tiantan first-aid protocol is effective for critically ill patients with PCNSL, which has the merit to be popularly used and improved.

[IgG4-related disease in nasal cavity and paranasal sinuses: a clinicopathological analysis of ten cases].

Objective: To study clinicopathological features and differential diagnosis of IgG4-related diseases (IgG4-RD) in nasal cavity and paranasal sinuses. Methods: A retrospective analysis was performed in patients presenting initially with rhinosinusitis or a nasal mass, who also underwent nasal mucosa biopsy in Beijing Tongren Hospital Affiliated to Capital Medical University, from March 2016 to March 2021. According to the latest international classification diagnostic criteria of IgG4-RD published by the American Society of Rheumatology (ACR)/European Association for Rheumatology (EULAR) in 2019, 10 cases of nasal cavity and paranasal sinuses IgG4-RD were diagnosed and included in the study. The clinical features, histopathology and immunohistochemical expression of IgG and IgG4 were analyzed. Results: Among the 10 patients, five patients were male and five female. The age ranged from 30 to 71 years (median 52.7 years). Nasal polyp/nasal masses were seen in six cases, and lacrimal gland swelling was found in four cases. The serum IgG and IgG4 level was increased in four cases. Microscopically, all 10 cases showed intense lymphoplasmocytic infiltration and varying degrees of fibrosis in nasal or sinus mucosa, while four cases showed occlusive vasculitis. The number of IgG4 positive plasma cells in nasal mucosa was more than 10/high power field (HPF), with a mean of 67/HPF. The number of IgG4 positive plasma cells in the cases with severe fibrosis was significantly lower than in those without. The ratio of IgG4+/IgG+plasma cells was higher than 40% in six cases. Conclusions: IgG4-RD in nasal cavity and paranasal sinuses is a local manifestation of a systemic disease, while nasal cavity and paranasal sinuses are rarely involved by IgG4-RD. The diagnosis is based on clinical symptoms, imaging, IgG4-related serology and histopathologic scores. Histopathology has a core diagnostic value. IgG4 serology and imaging have important diagnostic values in the cases without biopsy.

Effects of light regime on circadian rhythmic behavior and reproductive parameters in native laying hens.

The paper aimed to study the effects of light regime on circadian rhythmic behavior and reproductive parameters in a native laying hen, Beijing You Chicken (BYC) during 22 to 30 wk. A total of 630 19-wk-old BYC female chicken were allocated to 6 light regime groups with 3 replicates per group and 35 birds per replicate, reared in individually lit floor pens with separate outdoor areas. A 2 × 3 factorial experiment (2 lighting patterns: continuous and intermittent lighting; 3 photoperiods: 16 h, 14 h, 12 h) was arranged, including 16L:8D for group 1; 12L:2D:4L:6D for group 2; 14L:10D for group 3; 10L:2D:4L:8D for group 4; 12L:12D for group 5, and 8L:4D:4L:8D for group 6, respectively. The circadian rhythmic behavior of the hens, including feeding, egg-laying and sleeping behaviors were observed by scan sampling and target sampling method for consecutive 3 d every other week during 22 to 30 wk. Infrared cameras were set outside each pen to record the rhythmic behaviors of the birds every other hour (6:00-7:00;8:00-9:00;10:00-11:00;12:00-13:00;14:00-15:00;16:00-17:00;18:00-19:00;20:00-21:00;22:00-23:00;0:00-1:00;2:00-3:00;4:00-5:00). Theovarian weight, oviduct weight, oviduct length, the number of large yellow follicles (LYF), and small yellow follicles (SYF) were measured at the end of 30 wk. The egg-laying rate during 22 to 30 wk was measured. The results showed that the highest feeding frequency was given by the 16L:8D, and the lowest given by the 12L:12D (P < 0.05). The average feeding duration was the longest in the 8L:4D:4L:8D at 6:00 to 8:00 (18.67 min/hen) (P < 0.05), and the shortest in the 8L:4D:4L:8D at 18:00 to 20:00 (3.75 min/hen) (P < 0.05). The highest egg-laying frequency was given by the 8L:4D:4L:8D (0.28), the lowest given by the 10L:2D:4L:8D (0.21) (P < 0.05). The shortest egg-laying duration occurred at 6:00 to 8:00, was given by the 16L:8D (8 min/hen), and the longest egg-laying duration occurred at 18:00 to 20:00, was given by 16L:8D and 8L:4D:4L:8D (>20.5 min/hen) (P < 0.05). The highest sleeping frequency was given by the 12L:2D:4L:6D, the lowest was given by the 12L:12D (P < 0.05). At 6:00 to 8:00, the shortest sleeping duration was given by 12L:2D:4L:6D (1.5 s/hen), at 18:00 to 20:00, the longest given by 8L:4D:4L:8D (14.3 s/hen) (P < 0.05). Lighting pattern and photoperiod alone or in interaction had no effect on egg-laying rate during 22 to 30 wk (P > 0.05), but had significant effects on ovarian weight, oviduct weight, oviduct length, the number of LYF and SYF (P < 0.05), and the continuous groups were all significantly higher than the intermittent groups (P < 0.05). The present study indicated that light regimes affected the frequency and duration of circadian behavior in BYC laying hens, and the continuous light was more beneficial to the reproductive development than the intermittent light in the early laying period.

Effects of lighting regimes on performance, pineal melanopsin expression and melatonin content in native laying hens aged from 19 to 34 weeks.

Melanopsin, a key light sensitive pigment, plays an important role in the regulation of bio-rhythm and photo-adaptation in poultry. This study aimed to investigate the effects of different lighting regimes on performance, pineal melanopsin expression and melatonin content in a native chicken, Beijing You Chicken (BYC) aged from 19 to 34 wk. A total of 900 nineteen-wk-old BYC female chicken having no significant body weight differences were randomly allocated to 3 groups with 3 replicates each, 100 birds each replicate, reared in individually lit floor pens with separate outdoor areas. Three different lighting regimes were used, including continuous 16 h (16L:8D, 6:00-22:00) for group 1, intermittent 16 h (12L:2D:4L:6D, 6:00-18:00, 20:00-24:00) for group 2, and continuous 12 h (12L:12D, 6:00-18:00) for group 3, respectively. The performance was measured for 19 to 34 wk. Serum melatonin (Mel), prolactin (Prl), luteinizing hormone (LH), and 17-beta estradiol (E2) contents were measured at 24 wk, 29 wk, and 34 wk of age, the relative expression of pineal melanopsin gene (Opn4 mRNA) was measured on 1 d at 9:00, 13:00, 17:00, 21:00, 1:00, and 5:00 at 29 wk of age, and at the end of 29 wk and 34 wk. The results showed that the egg mass, egg-laying rate, and feed egg ratio of BYC were not affected by lighting regimes for 19 to 34 wk (P > 0.05), except for the average feed intake (AFI) (P < 0.05). The AFI in the 12L:12D group was significantly higher than that in the 16L:8D group (P < 0.05), but had no difference with that in the 12L:2D:4L:6D group. The pineal Opn4 mRNA level was significantly upregulated in the 12L:2D:4L:6D group and downregulated in the 12L:12D group when compared with 16L:8D group at 29 and 34 wks of age (P < 0.05). The Mel content in the 16L:8D group was lower than that in the other 2 groups at 29 wk of age (P < 0.05), there was no difference in Mel content between 16L:8D group and 12L:2D:4L:6D group at 34 wk of age (P > 0.05). The present study suggested that the pineal melanopsin expression of the birds in the intermittent 16 h lighting group was higher than in the continuous 16 h and 12 h lighting group, and a significant negative correlation was found between melanopsin expression and Mel content at 34 wk of age, which may interact to promote the photo-adaptation of the native chicken and affect the future laying performance.

[Risk factors associated with in-hospital mortality in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease: a multicenter retrospective study].

Objective: To investigate the risk factors associated with in-hospital mortality in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: A total of 6 668 patients hospitalized for AECOPD in seven tertiary hospitals from September 2017 to January 2021 were consecutively included, and clinical data related to medical history, laboratory tests, treatment and prognosis were collected, and patients were divided into death group and survival group according to whether they died during hospitalization. After univariate analysis, multivariate logistic regression analysis was then performed to explore the independent risk factors related to in-hospital mortality. Results: Among 6 668 patients hospitalized for AECOPD, 128 patients experienced in-hospital death, with a mortality rate of 1.9%. The mean age of the death group was (81±9) years, which was significantly older than that of the survival group ((72±11) years P<0.001). The proportion of patients in the AECOPD in-hospital death group with a combination of prolonged bed rest, hypertension, myocardial infarction within 3 months, cardiac insufficiency, chronic pulmonary heart disease, pneumonia, type 2 diabetes, venous thromboembolism (VTE), and chronic renal insufficiency was also significantly higher than in the survival group (all P<0.05) The median length of stay in the in-hospital death group was 18 d, which was significantly longer than that in the survival group (9 d, P<0.001), and the proportion of patients admitted to the ICU, receiving invasive mechanical ventilation and non-invasive mechanical ventilation was also significantly higher than that in the survival group (all P<0.05). The white blood cell count, glutamic transaminase, blood creatinine, calcitoninogen, C-reactive protein, D-dimer, N-terminal B-type natriuretic and Pseudomonas aeruginosa infection rates were significantly higher than those in the survival group (all P<0.05). Multifactorial analysis showed that age>80 years (OR=3.82, 95%CI 2.36 to 6.18, P<0.001), prolonged bed rest (OR=2.95, 95%CI: 1.79 to 4.86, P<0.001), chronic pulmonary heart disease (OR=1.85, 95%CI: 1.14 to 3.00, P=0.012), and pneumonia (OR=2.75, 95%CI: 1.65 to 4.60, P<0.001), invasive mechanical ventilation (OR=7.33, 95%CI: 4.40 to 12.21, P<0.001), noninvasive mechanical ventilation (OR=3.73, 95%CI: 2.30 to 6.04, P<0.001), anemia (OR=2.03. 95%CI: 1.21 to 3.42, P=0.008), and calcitoninogen>0.5 ng/ml (OR=2.38, 95%CI: 1.41 to 4.02, P=0.001) were independent risk factors for in-hospital mortality in patients with AECOPD. Conclusion: Advanced age (>80 years), prolonged bed rest, chronic pulmonary heart disease, pneumonia, invasive mechanical ventilation, noninvasive mechanical ventilation, anemia, and calcitoninogen>0.5 ng/ml were independent risk factors for in-hospital mortality in patients hospitalized with AECOPD.

[Expression of VHL, VEGF and HIF-1α in endolymphatic sac tumors].

Objective: To investigate the expression of von Hippel-Lindau (VHL), vascular endothelial growth factor (VEGF) and hypoxia inducible factor-1α (HIF-1α) in endolymphatic sac tumor (ELST) and its clinical significance, and to analyze its association with VHL gene mutation. Methods: Twenty-four cases of ELST, which were surgically resected and diagnosed by pathological examination in Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing, China during 2012-2020, were recruited as the ELST group, and 24 cases of otitis media diagnosed in the same hospital were selected as the control group. The expression of VHL, VEGF, and HIF-1α was assessed using EnVision immunohistochemical staining and compared between the ELST and control groups. Sanger sequencing was performed to detect the VHL mutation status in 24 ELSTs. The correlations among VHL, VEGF and HIF-1α expression were analyzed. The associations of VHL, VEGF and HIF-1α expression with age of onset, gender, tumor size, bone invasion and clinical stage in ELST were also analyzed. Results: The expression rate of VHL in the ELST group was significantly lower than that in the control group (P<0.05), but the expression rates of VEGF and HIF-1α in the ELST group were significantly higher than those in the control group (P<0.05). VHL expression was inversely correlated with VEGF and HIF-1α expression. The expression of VEGF and HIF-1α was associated with bone invasion and clinical stage (P<0.05), but the expression of VHL, VEGF and HIF-1α had no significant associations with the age of onset, gender, or tumor size of ELST (P>0.05). Conclusions: The expression of VHL is decreased while that of VEGF and HIF-1α increased in ELST. Expression of VHL is inversely correlated with that of VEGF and HIF-1α. The expression of VEGF and HIF-1α is correlated with bone invasion and clinical stage. Thus, VEGF and HIF-1α may be therapeutic targets of ELST.

[Clinicopathological characteristics of SMARCB1(INI1)-deficient sinonasal carcinoma].

Objective: To investigate the clinicopathological characteristics, diagnosis, differential diagnosis and prognostic factors of SMARCB1 (INI1)-deficient sinonasal carcinoma (SDSC). Methods: Sixteen cases of SDSC diagnosed in the Department of Pathology, Beijing Tongren Hospital from January 2016 to September 2020 were enrolled. Ninety-nine cases of small round cell malignant tumors of the head and neck were selected as the control, including poorly-differentiated squamous cell carcinoma (n=10), poorly-differentiated adenocarcinoma (n=5), undifferentiated carcinoma (SNUC, n=4), NUT carcinoma (n=5), neuroendocrine carcinoma (n=10), and other non-epithelial tumors [olfactory neuroblastoma (n=10), rhabdomyosarcoma (n=10), NK/T-cell lymphoma (n=10), malignant melanoma (n=10), Ewing's sarcoma/primitive neuroectodermal tumor (EWS/PNET, n=5)] and non-keratinizing undifferentiated nasopharyngeal carcinoma (n=20). The clinical and pathologic characteristics of SDSC, and immunohistochemical (IHC) expression of broad-spectrum CKpan, CK7, CK8/18, CK5/6, p63, p40, p16, INI1, NUT and neuroendocrine markers (Syn, CgA, CD56) were evaluated. In situ hybridization (ISH) was used to detect EBER and fluorescence in situ hybridization (FISH) to detect INI1 gene deletion. Results: The 16 cases of SDSC accounted for 1.3% (16/1 218) of all malignant sinonasal tumors in the author's unit during this time period, and 2.4% (16/657) of all malignant epithelial tumors. Microscopically, there was no clear squamous and adenomatous differentiation, but "rhabdoid-like" cells, are often seen. All SDSC cases were positive for CKpan and CK8/18, negative for INI1; Epstein-Barr virus was not detected by ISH; and INI1 gene deletion was observed in all 11 SDSC patients with FISH. Twelve cases were followed up for 3-47 months. One died of tumor-related diseases half a year after diagnosis, and the remaining patients were alive with tumor, the longest survival time was 47 months. Conclusion: SDSC should be differentiated from a variety of poorly-differentiated tumors in the sinonasal area. Histologically, SDSC has no clear differentiation, but the tumor cells are characteristically basal-like or rhabdoid-like, with non-specific vacuoles, translucent or vacuolar nuclei, prominent nucleoli and necrotic foci. They are negative for INI1 IHC staining, and FISH demonstrates INI1 gene deletion. The clinical prognosis is still unclear, further studies on its biologic behavior and treatment methods are warranted.

Early social contact alters the community structure and functions of the faecal microbiome in suckling-growing piglets.

Social contact during suckling, in an enriched social environment, can reduce the aggressive behaviours of piglets during regrouping at weaning, and improve their production performance and welfare. The aim of this study was to determine the possible impact of suckling social contact on gut microbes. We performed 16S rRNA sequencing to measure the faecal microbial structure and function in piglets experiencing social contact. Eighteen-litter piglets were allocated to two treatments: an early continuous social contact (CSC) group where piglets from adjacent pens shared a mutual pen starting at 14 days postpartum and a control (CON) group where piglets had no contact with individuals from adjacent pens during the suckling period. The piglets were regrouped at 36 days of age. The litter weights at 35 and 63 days of age were measured. Faecal samples were randomly collected at 16, 35, 42, and 63 days of age and faecal DNA was determined. The results showed that the litter weight of piglets in the CSC group was significantly decreased at 63 days compared with the CON group. Continuous social contact also significantly decreased the microbial richness at 16 and 35 days of age (P < 0.05). Firmicutes was the most abundant bacterial phylum in both groups at all detected time-points and the abundance increased with social contact. At the genus level, Lactobacillus was the most abundant bacterium after weaning and the abundance increased in the piglets with social contact. Compared with the faecal microbiota of control piglets, a total of 22 genera at 16 days, 20 genera at 35 days, 12 genera at 42 days, and 27 genera at 63 days in the faeces of CSC piglets were observed to be significantly different in abundance (linear discriminant analysis score > 3, P < 0.05). Furthermore, functional analysis of the microbial composition showed that the changes induced by early CSC mainly altered the relative abundance of metabolic and related pathways. The social contact notably had an effect on the abundance of microbial pathways for amino acid and carbohydrate metabolism. In conclusion, CSC changed the microbial composition in the faeces of piglets, which might have a negative effect on nutrient metabolism for the suckling-growing piglets. Our study provided new insight into the influence of social contact on the suckling-growing piglets.