Background: In December 2019, an outbreak of a novel coronavirus disease (COVID-19; previously known as 2019-nCoV) was reported in Wuhan, Hubei province, China, which has subsequently affected more than 200 countries worldwide including Europe, North America, Oceania, Africa and other places. The number of infected people is rapidly increasing, while the diagnostic method of COVID-19 is only by nucleic acid testing. Objective: To explain the epidemiological characteristics, clinical features, imaging manifestations and to judge diagnostic value of COVID-19 by analyzing the clinical data of COVID-19 suspected and confirmed patients in a non-outbreak, Shanghai, China. To clarify the early epidemiology and clinical characteristics about COVID-19. Methods: Cross-sectional, single-center case reports of the 86 patients screened at Zhoupu Hospital in Pudong New District, Shanghai, China, from January 23 to February 16, 2020. Epidemiology, demography, clinical, laboratory and chest CTs were collected and analyzed. The screened patients were divided into COVID-19 and non-COVID-19 based on nucleic acid test results. Results: Of the 86 screened patients, 11 were confirmed (12.8%) by nucleic acid testing (mean age 40.73 ± 11.32, 5 males). No significant differences were found in clinical symptoms including fever, cough, dyspnea, sore throat, and fatigue (P > 0.05). No statistical difference was observed in plasma C-reactive protein (CRP) between the two groups (COVID-19 and non-COVID-19 ) of patients (P = 0.402), while the white blood cell count and lymphocyte count of the confirmed patients were slightly lower than those of the suspected patients (P < 0.05). Some non-COVID-19 chest CTs also showed subpleural lesions, such as ground-glass opacities (GGO) combined with bronchiectasis; or halo nodules distributed under the pleura with focal GGO; consolidation of subpleural distribution or combined with air bronchi sign and vascular bundle sign, etc. Conclusion: The early clinical manifestations and imaging findings of COVID-19 are not characteristic in non-outbreak areas. Etiological testing should be performed as early as possible for clinically suspected patients.

ObjectivesSince a genome-wide association study revealed that Interleukin-23 receptor (IL-23R) gene is a candidate gene for Ulcerative Colitis (UC), many studies have investigated the association between the IL-23R polymorphisms and UC. However, the results were controversial. The aim of the study was to determine whether the IL-23R polymorphisms confer susceptibility to UC.MethodsA systematic literature search was carried out to identify all potentially relevant studies. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to estimate the strength of association.ResultsA total of 33 studies in 32 articles, including 10,527 UC cases and 15,142 healthy controls, were finally involved in the meta-analysis. Overall, a significant association was found between all UC cases and the rs11209026A allele (OR = 0.665, 95% CI = 0.604~0.733, P < 0.001). Similarly, meta-analyses of the rs7517847, rs1004819, rs10889677, rs2201841, rs11209032, rs1495965, rs1343151 and rs11465804 polymorphisms also indicated significant association with all UC (all P < 0.05). Stratification by ethnicity revealed that the rs11209026, rs7517847, rs10889677, rs2201841 andrs11465804 polymorphisms were associated with UC in the Caucasian group, but not in Asians, while the rs1004819 and rs11209032 polymorphisms were found to be related to UC for both Caucasian and Asian groups. However, subgroup analysis failed to unveil any association between the rs1495965 and rs1343151 polymorphisms and UC in Caucasians or Asians.ConclusionsThe meta-analysis suggests significant association between IL-23R polymorphisms and UC, especially in Caucasians.

Background: The differential diagnosis of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with acute pulmonary embolism (APE) complications are difficult because of the variability of clinical presentations and the shortage of an unfailing screening biomarkers or instruments. Objective: Aimed to detect and compare the expression of serum microRNAs (miR-1233, miR-134) in AECOPD patients complicated with APE. Patients/Methods: Blood samples were collected from 52 AECOPD patients (13 patients with APE complications, 39 patients without APE) and 10 patients with stable COPD. Serum miRNAs expression was detected with real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). The levels of plasma D-dimers were determined by detection with an enzyme-linked immunosorbent assay (ELISA). The receiver-operator characteristic (ROC) curve was used for evaluating the diagnostic accuracy of the studied miRNAs. Results: According to the Wells score, 42 of the 52 AECOPD patients were unlikely to have APE (≤4 points), whereas the remaining 10 (>4 points) were likely to have APE. There were 4 cases (4/13 30.8%) in the AECOPD combined with APE group with a Wells score of >4 points. The expression levels of miR-1233 and miR-134 in the serum were considerably upregulated in the AECOPD+APE group compared with the AECOPD group and the stable COPD group (P<0.05). The areas under the curve (AUCs) for miR-134 and miR-1233 were, respectively, 0.931 (95% CI 0.863-0.999) (P<0.05) and 0.884 (95% CI 0.79-0.978) (P<0.05) and were higher compared with the AUC for D-dimer of 0.628 (95% CI 0.447-0.809), the AUC for age-adjusted D-dimer of 0.705 (95% CI 0.525-0.885) and the AUC for Wells score of 0.577 (95% CI 0.389-0.765). Conclusion: Our study indicated that serum miR-1233 and miR-134 have high clinical value in the early diagnosis of AECOPD patients combined with APE, or could be used as potential biomarkers for clinical identification of AECOPD with or without APE complication.

BACKGROUND: The occurrence of pulmonary thromboembolism (PTE) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is not rare, which would seriously affect the prognosis and cause high mortality of patients. OBJECTIVE: To investigate the prevalence, risk factors, and clinical characteristics of AECOPD patients with pulmonary embolism (PE) complications in a tertiary care center, aiming to reduce the rate of missed diagnosis of PE in patients with AECOPD. MATERIALS AND METHODS: We performed a retrospective analysis of patients admitted to our hospital with the first diagnosis of AECOPD from January 2015 to November 2019. Patients were divided into AECOPD and AECOPD +PE groups according to whether or not they had PE complications. The clinical data of the two groups were compared and multiple regression analysis was used to explore the risk factors. RESULTS: From January 2015 to November 2019, a total of 636 AECOPD patients (aged 76.60±8.38 years, 529 males) were enrolled in this study. Of them, 7.4% (47/636) were diagnosed with PE. Clinical features including age, chest pain, dyspnea, hemoptysis, syncope, electrocardiogram (ECG), mMRC score, annual acute exacerbation times, history of thrombus, history of surgery within 6 weeks, prolonged immobility ≥3 days, wet rales, pleural effusion, asymmetrical lower extremity edema, history of stroke, pulmonary heart disease, pulmonary encephalopathy, hospitalization days, GOLD grade, total duration, PH, PaCO2, the level of plasma D-dimer and N-terminal pro-brain natriuretic peptide (NT-proBNP) were statistically significant between the two groups (P <0.05). Considering patients with PE as the dependent variables and statistically significant risk factors in the univariate analysis as independent variables, the logistic model analysis was performed. The results indicated that chest pain, syncope, premature ventricular contractions, prolonged immobility ≥3 days, history of stroke, pulmonary heart disease, pulmonary encephalopathy, hospitalization days, D-dimer levels, and acute exacerbation times were independent risk factors for AECOPD complicated with PE (P <0.05). CONCLUSION: Patients hospitalized for AECOPD should have multi-slice spiral computed tomography pulmonary angiography (CTPA) to determine whether they present PE complications as soon as possible when combined with chest pain, pulmonary heart disease, prolonged immobility ≥3 days, plasma D-dimer levels higher, and the times of acute exacerbations has increased significantly in the last year.