Objective To explore the dynamic changes of the cellular immune function in severe infection after liver transplantation,and to guide the individualized immunology adjustment. Methods 378 cases of liver transplantatio...Objective To explore the dynamic changes of the cellular immune function in severe infection after liver transplantation,and to guide the individualized immunology adjustment. Methods 378 cases of liver transplantation were analyzed retrospectively. Seventy - four cases ( infection group) suffered serious infection,including 54 cases cured ( cure group) ,20 cases died (展开更多
[Objectives]To investigate the clinical effect of Yinhuang Qingfei capsules in the treatment of asymptomatic and mild/common severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.[Methods]A total of 362...[Objectives]To investigate the clinical effect of Yinhuang Qingfei capsules in the treatment of asymptomatic and mild/common severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.[Methods]A total of 362 patients with SARS-CoV-2 infection were divided into the treatment group with 242 patients and control group with 120 patients according to their treatment regimen.The patients in the control group were given standard treatment regimen and those in the treatment group were given Yinhuang Qingfei capsules in addition to the treatment in the control group.The two groups were observed in terms of average length of hospital stay,mean time for nucleic acid clearance,TCM syndrome score,and progression to severe/critical illness,and clinical outcome was compared between the two groups.[Results]There was a significant difference in the overall response rate between the treatment group and the control group[97.52%(236/242)vs 95.00%(114/120),P<0.05].Compared with the control group,the treatment group had significantly shorter length of hospital stay and time for nucleic acid clearance(P<0.05).After 7 days of treatment,both groups had a significant change in TCM syndrome score,and there was a significant difference in TCM syndrome score between the two groups(P<0.05);after 15 days of treatment,both groups had a TCM syndrome score of 0.Progression to severe/critical illness was not observed in either group.[Conclusions]Compared with the standard treatment regimen alone,standard treatment regimen combined with Yinhuang Qingfei capsules can effectively shorten the length of hospital stay and time for nucleic acid clearance and improve TCM symptoms in patients with asymptomatic and mild/common SARS-CoV-2 infection.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has led to millions of confirmed cases and deaths worldwide.Elderly patients are at high risk of deve...BACKGROUND Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has led to millions of confirmed cases and deaths worldwide.Elderly patients are at high risk of developing and dying from COVID-19 due to advanced age,decreased immune function,intense inflammatory response,and comorbidities.Shanghai has experienced a wave of infection with Omicron,a new variant of SARS-CoV-2,since March 2022.There is a pressing need to identify clinical features and risk factors for disease progression among elderly patients with Omicron infection to provide solid evidence for clinical policy-makers,public health officials,researchers,and the general public.AIM To investigate clinical characteristic differences and risk factors between elderly patients with severe and nonsevere Omicron SARS-CoV-2 variant infection.METHODS A total of 328 elderly patients with COVID-19 admitted to the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 2022 to June 2022 were enrolled and divided into a severe group(82 patients)and a nonsevere group(246 patients)according to the diagnosis and treatment protocol of COVID-19(version 7).The clinical data and laboratory results of both groups were collected and compared.A chi-square test,t test,Mann-Whitney U test,hierarchical log-rank test,univariate and multivariate logistic regression,and hierarchical analyses were used to determine significant differences.RESULTS The severe group was older(84 vs 74 years,P<0.001),included more males(57.3%vs 43.9%,P=0.037),had a lower vaccination rate(P<0.001),and had a higher proportion of comorbidities,including chronic respiratory disease(P=0.001),cerebral infarction(P<0.001),chronic kidney disease(P=0.002),and neurodegenerative disease(P<0.001),than the nonsevere group.In addition,severe disease patients had a higher inflammatory index(P<0.001),greater need for symptomatic treatment(P<0.001),longer hospital stay(P=0.011),extended viral shedding time(P=0.014),and higher mortality than nonsevere disease patients(P<0.001).No difference was observed in the application of Paxlovid in the severe and nonsevere groups(P=0.817).Oxygen saturation,cerebral infarction,and D-dimer were predictive factors for developing severe disease in patients with COVID-19,with D-dimer having an excellent role(area under the curve:90.1%,95%CI:86.1-94.0%).In addition,D-dimer was a risk factor for developing severe COVID-19 according to multivariate stratified analysis.CONCLUSION The clinical course of severe COVID-19 is complex,with a higher need for symptomatic treatment.D-dimer is a suitable biomarker for identifying patients at risk for developing severe COVID-19.展开更多
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, which is widely referred to as “COVID-19”, has been infecting more than 5.5 million over 144 countries. A vaccine is considered to be the mo...The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, which is widely referred to as “COVID-19”, has been infecting more than 5.5 million over 144 countries. A vaccine is considered to be the most awaiting intervention and hundreds of global R&D institutions engaged in unprecedented speed to develop the vaccine. The availability of COVID-19 vaccines may not translate into its uptake. Although governments will provide the vaccines, their uptake is voluntary. <strong>Objective:</strong> This study was carried out to evaluate the level of acceptance of COVID-19 vaccine and it’s determinants among high risk groups for severe COVID-19 infection living in Mogadishu Somalia.<strong> Methods:</strong> The study was cross-sectional, descriptive analysis conducted to obtain reliable information about the acceptance of COVID-19 vaccine and it is determinants among high-risk groups living in Mogadishu, Somalia. The calculated sample size was 404 using Cochran’s formula = Z<sup>2</sup>p(1 <span style="white-space:nowrap;"><span style="white-space:nowrap;">−</span></span> p)/d<sup>2</sup> and addition of 5% non-respondent rate. According to PESS population estimate in 2020, there are 17 districts. We grouped them into 2 strata and through simple random sampling one district was selected from each strata. After randomly selecting the two districts, three sub districts were randomly selected from each and then every second house (1, 3, 5) in the main roads will be selected. If target population were not found in the second selected house, the next house will be taken until sample size is obtained. <strong>Results:</strong> 59.4% of respondents were willing to accept and take vaccination while 40.6% of them were not accepting the vaccination. Being afraid of the side effect was the most common reason for not accepting the vaccine <strong>Conclusion: </strong>More than one third of respondents (40.6%) were not willing to accept the vaccination, knowledge towards COVID-19 was strongly associated with acceptance level of COVID-19 vaccine. <strong>Recommendation:</strong> Multi-sector organized awareness campaigns involving FMH as well as local authorities and civil society to enhance level of knowledge of community towards COVID-19.展开更多
Severe surgical infection refers to infection after surgical treatment or surgical operation,accounting for approximately 30% of surgical diseases. This type of infection can cause extensive inflammation and tissue in...Severe surgical infection refers to infection after surgical treatment or surgical operation,accounting for approximately 30% of surgical diseases. This type of infection can cause extensive inflammation and tissue injury and reduce success rate of surgical treatments.Immune defense plays an important role in antiinfection treatment of hosts. Infection immunity is a series of physiological defense mechanisms for recognition of immune system and removal of pathogens. As for severe surgical infection, immunotherapy becomes an important and promising therapy for severe surgical infection. This study summarizes recent progresses achieved in immunization and immunotherapy of surgical infection.展开更多
Since the first reported case of monkeypox in the UK in May 2022,there has been an upward trend in monkeypox cases and a global outbreak.However,reports of severe cases are relatively limited.In this study,we report a...Since the first reported case of monkeypox in the UK in May 2022,there has been an upward trend in monkeypox cases and a global outbreak.However,reports of severe cases are relatively limited.In this study,we report a case of severe monkeypox in a patient with HIV.The patient presented with skin lesions that started on his face and around the penis and persisted for several months.Throughout the course of the disease,he received systematic symp-tomatic supportive treatment,topical remedies,and special care for the rash.He also underwent cidofovir antiviral therapy and smallpox‐vaccinated healthy population‐derived plasma therapy in succession,with the condition ultimately showing improvement after plasma treatment.After more than 3 months of hospitalization,he fully recovered.To the best of our knowledge,this is the first reported use of smallpox‐vaccinated healthy population‐derived plasma in the treatment of severe monkeypox cases.展开更多
The risk factors of severe infections in children during the severe acute respiratory syndrome coronavirus 2(SARS‐CoV‐2)outbreak in Beijing remain elusive.SARS‐CoV‐2‐positive children admitted to the intensive ca...The risk factors of severe infections in children during the severe acute respiratory syndrome coronavirus 2(SARS‐CoV‐2)outbreak in Beijing remain elusive.SARS‐CoV‐2‐positive children admitted to the intensive care unit(ICU)with collected plasma specimens were enrolled and screened for common pathogens using capillary electrophoresis‐based multiplex PCR from December 12,2022,to January 24,2023.The SARS‐CoV‐2 subvariants were identified using next‐generation sequencing.Plasma was positive for two(positive;P),one(suspicious;S),or no(negative;N)SARS‐CoV‐2 genes were classified as plasmatic RNA‐positive(RNAemia;P+S)or without RNAemia(N).Clinical and laboratory data of the enrolled cases were then collected and analyzed.The 34 enrolled children included 26 males and 24 younger than three years.All were negative for other respiratory pathogens.BF.7.14(18/29)was the predominant subvariant.Viral loads in respiratory specimens,hours from symptom onset to the first respiratory specimen collection(time‐variable),with comorbidities and BF.7.14 and BA.5.2 distributions were significantly different in P vs.N and RNAemia vs.without RNAemia group.Among most cases,the T lymphocyte ratios decreased,while the cytokine level and the B lymphocyte ratio increased.The time variables were 2.22±2.05 and 4.00±2.49 days in BF.7.14 and BA.5.2 infections,respectively.In conclusion,SARS‐CoV‐2 was more likely to cause severe infections among males aged≤3 years old with comorbidities during the SARS‐CoV‐2 outbreak in Beijing,while RNAemia is more common in children at the early stage of severe BF.7.14 infections,and most had high cytokine levels and B‐cell activation.展开更多
Understanding the immunological characteristics of monocytes-including the characteristics associated with fibrosis-in severe coronavirus disease 2019(COVID-19)is crucial for understanding the pathogenic mechanism of ...Understanding the immunological characteristics of monocytes-including the characteristics associated with fibrosis-in severe coronavirus disease 2019(COVID-19)is crucial for understanding the pathogenic mechanism of the disease and preventing disease severity.In this study,we performed single-cell transcriptomic sequencing of peripheral blood samples collected from six healthy controls and 14 COVID-19samples including severe,moderate,and convalescent samples from three severely/critically ill and four moderately ill patients.We found that the monocytes were strongly remodeled in the severely/critically ill patients with COVID-19,with an increased proportion of monocytes and seriously reduced diversity.In addition,we discovered two novel severe-disease-specific monocyte subsets:Mono 0 and Mono 5.These subsets expressed amphiregulin(AREG),epiregulin(EREG),and cytokine interleukin-18(IL-18)gene,exhibited an enriched erythroblastic leukemia viral oncogene homolog(ErbB)signaling pathway,and appeared to exhibit pro-fibrogenic and pro-inflammation characteristics.We also found metabolic changes in Mono 0 and Mono 5,including increased glycolysis/gluconeogenesis and an increased hypoxia inducible factor-1(HIF-1)signaling pathway.Notably,one pre-severe sample displayed a monocyte atlas similar to that of the severe/critical samples.In conclusion,our study discovered two novel severedisease-specific monocyte subsets as potential predictors and therapeutic targets for severe COVID-19.Overall,this study provides potential predictors for severe disease and therapeutic targets for COVID-19 and thus provides a resource for further studies on COVID-19.展开更多
Numerous risk variables,including age,medical co-morbidities,and deranged inflammatory response,lead to higher mortality in a senior population with coronavirus disease 2019.C-reactive protein(CRP),an acute phase infl...Numerous risk variables,including age,medical co-morbidities,and deranged inflammatory response,lead to higher mortality in a senior population with coronavirus disease 2019.C-reactive protein(CRP),an acute phase inflammatory protein secreted by the liver,was tested in the elderly,showing a diagnostic and prognostic role.However,recent research has shed light on new applications for CRP in geriatrics.It was used as a follow-up marker and as a therapeutic target.Early and accurate identification of patients’ risks may mitigate the devastation of the invading virus in older cases and permit the implementation of a quick treatment plan for those most likely to deteriorate.展开更多
Objective Investigate the clinical effects of Vacuum Sealing Drainage(VSD)in the treatment of 11 cases of foot tophi rupture with severely infected wounds.Methods From January 2017 to January 2019,11 patients with foo...Objective Investigate the clinical effects of Vacuum Sealing Drainage(VSD)in the treatment of 11 cases of foot tophi rupture with severely infected wounds.Methods From January 2017 to January 2019,11 patients with foot tophi rupture and severe infection were enrolled in our department.There were 9 males and 2 females,aged from 27 to 68 years old.All patients were treated with VSD after debridement.The treatment time was 7d-42d,with an average of 17d.Results All patients were followed up for 6 months after VSD treatment.All the wounds healed well without complications.Conclusion VSD is used to treat foot tophus rupture with severe infection of wounds.It is easy to operate and satisfactory in clinical results.展开更多
The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has triggered a widespread outbreak since December 2019.The SARS-CoV-2 infection-related illness has been dubbed the coronavirus disease 2019(COVID-19)by ...The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has triggered a widespread outbreak since December 2019.The SARS-CoV-2 infection-related illness has been dubbed the coronavirus disease 2019(COVID-19)by the World Health Organization.Asymptomatic and subclinical infections,a severe hyperinflammatory state,and mortality are all examples of clinical signs.After attaching to the angiotensin converting enzyme 2(ACE2)receptor,the SARSCoV-2 virus can enter cells through membrane fusion and endocytosis.In addition to enabling viruses to cling to target cells,the connection between the spike protein(S-protein)of SARS-CoV-2 and ACE2 may potentially impair the functionality of ACE2.Blood pressure is controlled by ACE2,which catalyzes the hydrolysis of the active vasoconstrictor octapeptide angiotensin(Ang)II to the heptapeptide Ang-(1-7)and free L-Phe.Additionally,Ang I can be broken down by ACE2 into Ang-(1-9)and metabolized into Ang-(1-7).Numerous studies have demonstrated that circulating ACE2(cACE2)and Ang-(1-7)have the ability to restore myocardial damage in a variety of cardiovascular diseases and have antiinflammatory,antioxidant,anti-apoptotic,and anti-cardiomyocyte fibrosis actions.There have been some suggestions for raising ACE2 expression in COVID-19 patients,which might be used as a target for the creation of novel treatment therapies.With regard to this,SARS-CoV-2 is neutralized by soluble recombinant human ACE2(hrsACE2),which binds the viral S-protein and reduces damage to a variety of organs,including the heart,kidneys,and lungs,by lowering Ang II concentrations and enhancing conversion to Ang-(1-7).This review aims to investigate how the presence of SARS-CoV-2 and cACE2 are related.Additionally,there will be discussion of a number of potential therapeutic approaches to tip the ACE/ACE-2 balance in favor of the ACE-2/Ang-(1-7)axis.展开更多
文摘Objective To explore the dynamic changes of the cellular immune function in severe infection after liver transplantation,and to guide the individualized immunology adjustment. Methods 378 cases of liver transplantation were analyzed retrospectively. Seventy - four cases ( infection group) suffered serious infection,including 54 cases cured ( cure group) ,20 cases died (
基金Supported by the Science and Medicine Joint Fund Project of Natural Science Foundation of Hunan Province(2022JJ80001).
文摘[Objectives]To investigate the clinical effect of Yinhuang Qingfei capsules in the treatment of asymptomatic and mild/common severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.[Methods]A total of 362 patients with SARS-CoV-2 infection were divided into the treatment group with 242 patients and control group with 120 patients according to their treatment regimen.The patients in the control group were given standard treatment regimen and those in the treatment group were given Yinhuang Qingfei capsules in addition to the treatment in the control group.The two groups were observed in terms of average length of hospital stay,mean time for nucleic acid clearance,TCM syndrome score,and progression to severe/critical illness,and clinical outcome was compared between the two groups.[Results]There was a significant difference in the overall response rate between the treatment group and the control group[97.52%(236/242)vs 95.00%(114/120),P<0.05].Compared with the control group,the treatment group had significantly shorter length of hospital stay and time for nucleic acid clearance(P<0.05).After 7 days of treatment,both groups had a significant change in TCM syndrome score,and there was a significant difference in TCM syndrome score between the two groups(P<0.05);after 15 days of treatment,both groups had a TCM syndrome score of 0.Progression to severe/critical illness was not observed in either group.[Conclusions]Compared with the standard treatment regimen alone,standard treatment regimen combined with Yinhuang Qingfei capsules can effectively shorten the length of hospital stay and time for nucleic acid clearance and improve TCM symptoms in patients with asymptomatic and mild/common SARS-CoV-2 infection.
基金This study was reviewed and approved by the Ethics Committee of the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine(Ethics Approval No.:SH9H-2022-T139-1).
文摘BACKGROUND Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has led to millions of confirmed cases and deaths worldwide.Elderly patients are at high risk of developing and dying from COVID-19 due to advanced age,decreased immune function,intense inflammatory response,and comorbidities.Shanghai has experienced a wave of infection with Omicron,a new variant of SARS-CoV-2,since March 2022.There is a pressing need to identify clinical features and risk factors for disease progression among elderly patients with Omicron infection to provide solid evidence for clinical policy-makers,public health officials,researchers,and the general public.AIM To investigate clinical characteristic differences and risk factors between elderly patients with severe and nonsevere Omicron SARS-CoV-2 variant infection.METHODS A total of 328 elderly patients with COVID-19 admitted to the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 2022 to June 2022 were enrolled and divided into a severe group(82 patients)and a nonsevere group(246 patients)according to the diagnosis and treatment protocol of COVID-19(version 7).The clinical data and laboratory results of both groups were collected and compared.A chi-square test,t test,Mann-Whitney U test,hierarchical log-rank test,univariate and multivariate logistic regression,and hierarchical analyses were used to determine significant differences.RESULTS The severe group was older(84 vs 74 years,P<0.001),included more males(57.3%vs 43.9%,P=0.037),had a lower vaccination rate(P<0.001),and had a higher proportion of comorbidities,including chronic respiratory disease(P=0.001),cerebral infarction(P<0.001),chronic kidney disease(P=0.002),and neurodegenerative disease(P<0.001),than the nonsevere group.In addition,severe disease patients had a higher inflammatory index(P<0.001),greater need for symptomatic treatment(P<0.001),longer hospital stay(P=0.011),extended viral shedding time(P=0.014),and higher mortality than nonsevere disease patients(P<0.001).No difference was observed in the application of Paxlovid in the severe and nonsevere groups(P=0.817).Oxygen saturation,cerebral infarction,and D-dimer were predictive factors for developing severe disease in patients with COVID-19,with D-dimer having an excellent role(area under the curve:90.1%,95%CI:86.1-94.0%).In addition,D-dimer was a risk factor for developing severe COVID-19 according to multivariate stratified analysis.CONCLUSION The clinical course of severe COVID-19 is complex,with a higher need for symptomatic treatment.D-dimer is a suitable biomarker for identifying patients at risk for developing severe COVID-19.
文摘The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, which is widely referred to as “COVID-19”, has been infecting more than 5.5 million over 144 countries. A vaccine is considered to be the most awaiting intervention and hundreds of global R&D institutions engaged in unprecedented speed to develop the vaccine. The availability of COVID-19 vaccines may not translate into its uptake. Although governments will provide the vaccines, their uptake is voluntary. <strong>Objective:</strong> This study was carried out to evaluate the level of acceptance of COVID-19 vaccine and it’s determinants among high risk groups for severe COVID-19 infection living in Mogadishu Somalia.<strong> Methods:</strong> The study was cross-sectional, descriptive analysis conducted to obtain reliable information about the acceptance of COVID-19 vaccine and it is determinants among high-risk groups living in Mogadishu, Somalia. The calculated sample size was 404 using Cochran’s formula = Z<sup>2</sup>p(1 <span style="white-space:nowrap;"><span style="white-space:nowrap;">−</span></span> p)/d<sup>2</sup> and addition of 5% non-respondent rate. According to PESS population estimate in 2020, there are 17 districts. We grouped them into 2 strata and through simple random sampling one district was selected from each strata. After randomly selecting the two districts, three sub districts were randomly selected from each and then every second house (1, 3, 5) in the main roads will be selected. If target population were not found in the second selected house, the next house will be taken until sample size is obtained. <strong>Results:</strong> 59.4% of respondents were willing to accept and take vaccination while 40.6% of them were not accepting the vaccination. Being afraid of the side effect was the most common reason for not accepting the vaccine <strong>Conclusion: </strong>More than one third of respondents (40.6%) were not willing to accept the vaccination, knowledge towards COVID-19 was strongly associated with acceptance level of COVID-19 vaccine. <strong>Recommendation:</strong> Multi-sector organized awareness campaigns involving FMH as well as local authorities and civil society to enhance level of knowledge of community towards COVID-19.
文摘Severe surgical infection refers to infection after surgical treatment or surgical operation,accounting for approximately 30% of surgical diseases. This type of infection can cause extensive inflammation and tissue injury and reduce success rate of surgical treatments.Immune defense plays an important role in antiinfection treatment of hosts. Infection immunity is a series of physiological defense mechanisms for recognition of immune system and removal of pathogens. As for severe surgical infection, immunotherapy becomes an important and promising therapy for severe surgical infection. This study summarizes recent progresses achieved in immunization and immunotherapy of surgical infection.
基金Science and Technology Research Projects of Shenzhen,Grant/Award Number:JSGG20220606141001003National Key Research and Development Program of China,Grant/Award Number:2022YFC2304403,2022YFC2304404+2 种基金National Natural Science Foundation of China,Grant/Award Number:81971915,82272318Shenzhen Fund for Guangdong Provincial High‐level Clinical Key Specialties,Grant/Award Number:No.SZGSP011Shenzhen Fund for Guangdong Provincial High‐level Clinical Key Specialties(No.SZGSP011)。
文摘Since the first reported case of monkeypox in the UK in May 2022,there has been an upward trend in monkeypox cases and a global outbreak.However,reports of severe cases are relatively limited.In this study,we report a case of severe monkeypox in a patient with HIV.The patient presented with skin lesions that started on his face and around the penis and persisted for several months.Throughout the course of the disease,he received systematic symp-tomatic supportive treatment,topical remedies,and special care for the rash.He also underwent cidofovir antiviral therapy and smallpox‐vaccinated healthy population‐derived plasma therapy in succession,with the condition ultimately showing improvement after plasma treatment.After more than 3 months of hospitalization,he fully recovered.To the best of our knowledge,this is the first reported use of smallpox‐vaccinated healthy population‐derived plasma in the treatment of severe monkeypox cases.
文摘The risk factors of severe infections in children during the severe acute respiratory syndrome coronavirus 2(SARS‐CoV‐2)outbreak in Beijing remain elusive.SARS‐CoV‐2‐positive children admitted to the intensive care unit(ICU)with collected plasma specimens were enrolled and screened for common pathogens using capillary electrophoresis‐based multiplex PCR from December 12,2022,to January 24,2023.The SARS‐CoV‐2 subvariants were identified using next‐generation sequencing.Plasma was positive for two(positive;P),one(suspicious;S),or no(negative;N)SARS‐CoV‐2 genes were classified as plasmatic RNA‐positive(RNAemia;P+S)or without RNAemia(N).Clinical and laboratory data of the enrolled cases were then collected and analyzed.The 34 enrolled children included 26 males and 24 younger than three years.All were negative for other respiratory pathogens.BF.7.14(18/29)was the predominant subvariant.Viral loads in respiratory specimens,hours from symptom onset to the first respiratory specimen collection(time‐variable),with comorbidities and BF.7.14 and BA.5.2 distributions were significantly different in P vs.N and RNAemia vs.without RNAemia group.Among most cases,the T lymphocyte ratios decreased,while the cytokine level and the B lymphocyte ratio increased.The time variables were 2.22±2.05 and 4.00±2.49 days in BF.7.14 and BA.5.2 infections,respectively.In conclusion,SARS‐CoV‐2 was more likely to cause severe infections among males aged≤3 years old with comorbidities during the SARS‐CoV‐2 outbreak in Beijing,while RNAemia is more common in children at the early stage of severe BF.7.14 infections,and most had high cytokine levels and B‐cell activation.
基金supported by the National Science and Technology Major Project(2017ZX10204401001002)the National Key Research and Development Project of China(2017ZX10204401001002008)+1 种基金the Key Research and Development Project of Zhejiang Province(2020C03123)Zhejiang Provincial Nature Science Foundation of China(LED20H19001)。
文摘Understanding the immunological characteristics of monocytes-including the characteristics associated with fibrosis-in severe coronavirus disease 2019(COVID-19)is crucial for understanding the pathogenic mechanism of the disease and preventing disease severity.In this study,we performed single-cell transcriptomic sequencing of peripheral blood samples collected from six healthy controls and 14 COVID-19samples including severe,moderate,and convalescent samples from three severely/critically ill and four moderately ill patients.We found that the monocytes were strongly remodeled in the severely/critically ill patients with COVID-19,with an increased proportion of monocytes and seriously reduced diversity.In addition,we discovered two novel severe-disease-specific monocyte subsets:Mono 0 and Mono 5.These subsets expressed amphiregulin(AREG),epiregulin(EREG),and cytokine interleukin-18(IL-18)gene,exhibited an enriched erythroblastic leukemia viral oncogene homolog(ErbB)signaling pathway,and appeared to exhibit pro-fibrogenic and pro-inflammation characteristics.We also found metabolic changes in Mono 0 and Mono 5,including increased glycolysis/gluconeogenesis and an increased hypoxia inducible factor-1(HIF-1)signaling pathway.Notably,one pre-severe sample displayed a monocyte atlas similar to that of the severe/critical samples.In conclusion,our study discovered two novel severedisease-specific monocyte subsets as potential predictors and therapeutic targets for severe COVID-19.Overall,this study provides potential predictors for severe disease and therapeutic targets for COVID-19 and thus provides a resource for further studies on COVID-19.
文摘Numerous risk variables,including age,medical co-morbidities,and deranged inflammatory response,lead to higher mortality in a senior population with coronavirus disease 2019.C-reactive protein(CRP),an acute phase inflammatory protein secreted by the liver,was tested in the elderly,showing a diagnostic and prognostic role.However,recent research has shed light on new applications for CRP in geriatrics.It was used as a follow-up marker and as a therapeutic target.Early and accurate identification of patients’ risks may mitigate the devastation of the invading virus in older cases and permit the implementation of a quick treatment plan for those most likely to deteriorate.
文摘Objective Investigate the clinical effects of Vacuum Sealing Drainage(VSD)in the treatment of 11 cases of foot tophi rupture with severely infected wounds.Methods From January 2017 to January 2019,11 patients with foot tophi rupture and severe infection were enrolled in our department.There were 9 males and 2 females,aged from 27 to 68 years old.All patients were treated with VSD after debridement.The treatment time was 7d-42d,with an average of 17d.Results All patients were followed up for 6 months after VSD treatment.All the wounds healed well without complications.Conclusion VSD is used to treat foot tophus rupture with severe infection of wounds.It is easy to operate and satisfactory in clinical results.
文摘The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has triggered a widespread outbreak since December 2019.The SARS-CoV-2 infection-related illness has been dubbed the coronavirus disease 2019(COVID-19)by the World Health Organization.Asymptomatic and subclinical infections,a severe hyperinflammatory state,and mortality are all examples of clinical signs.After attaching to the angiotensin converting enzyme 2(ACE2)receptor,the SARSCoV-2 virus can enter cells through membrane fusion and endocytosis.In addition to enabling viruses to cling to target cells,the connection between the spike protein(S-protein)of SARS-CoV-2 and ACE2 may potentially impair the functionality of ACE2.Blood pressure is controlled by ACE2,which catalyzes the hydrolysis of the active vasoconstrictor octapeptide angiotensin(Ang)II to the heptapeptide Ang-(1-7)and free L-Phe.Additionally,Ang I can be broken down by ACE2 into Ang-(1-9)and metabolized into Ang-(1-7).Numerous studies have demonstrated that circulating ACE2(cACE2)and Ang-(1-7)have the ability to restore myocardial damage in a variety of cardiovascular diseases and have antiinflammatory,antioxidant,anti-apoptotic,and anti-cardiomyocyte fibrosis actions.There have been some suggestions for raising ACE2 expression in COVID-19 patients,which might be used as a target for the creation of novel treatment therapies.With regard to this,SARS-CoV-2 is neutralized by soluble recombinant human ACE2(hrsACE2),which binds the viral S-protein and reduces damage to a variety of organs,including the heart,kidneys,and lungs,by lowering Ang II concentrations and enhancing conversion to Ang-(1-7).This review aims to investigate how the presence of SARS-CoV-2 and cACE2 are related.Additionally,there will be discussion of a number of potential therapeutic approaches to tip the ACE/ACE-2 balance in favor of the ACE-2/Ang-(1-7)axis.
