Objective : To evaluate the long-term consequences of survivors with COVID-19 one year after recovery, and to identify the risk factors associated with abnormal patterns in chest imaging manifestations, or impaired lung function. Methods : COVID-19 patients were recruited and prospectively followed up with symptoms, HRQoL (health-related quality of life), psychological questionnaires, 6MWT (6-minute walking test), chest CT, PFTs and blood tests. Multivariable logistic regression models were used to evaluate the association between the clinical characteristics and the chest CT abnormalities or the pulmonary function. Results : Ninety-four patients with COVID-19 were recruited between January 16 and February 6, 2021. Muscle fatigue and insomnia were the most common symptoms. Chest CT scan were abnormal in 71.28% of participants. Results of multivariable regression showed an increase odd in age. Ten patients had impairment of DLCO (diffusing capacity of the lung for carbon monoxide). Urea nitrogen concentration on admission was significantly associated with impaired DLCO. The level of IgG and the neutralizing activity were significantly lower compared with those at the early phase. Conclusions : One year after hospitalization for COVID-19, a cohort of survivors were mainly troubled with muscle fatigue and insomnia. Pulmonary structural abnormalities and pulmonary diffusion capacities were highly prevalent in surviving COVID-19 patients. It is necessary to intervene main target population for long-term recovery.
Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising target for lowering plasma low-density lipoprotein cholesterol and preventing cardiovascular (CV) disease. Whether plasma PCSK9 measured during the acute phase predicts recurrent CV events in patients with acute myocardial infarction (AMI) remains unresolved. Methods and Results: Plasma PCSK9 levels were measured in 1,646 patients with AMI from the China PEACE-Prospective AMI Study at the acute phase. Additionally, 248 patients were resampled and measured at 1 month post-AMI. Associations of acute-phase PCSK9 tertiles with clinical characteristics and recurrent CV events within 1 year were assessed. Female gender (OR 1.94, 95% CI 1.24–3.03), premature coronary heart disease (CHD; OR 2.12, 95% CI 1.37–3.26), higher high-sensitivity C-reactive protein (OR 1.67, 95% CI 1.44–1.95), and higher triglycerides (OR 1.46, 95% CI 1.03–2.09) were associated with higher baseline PCSK9. Plasma PCSK9 levels in the highest tertile (versus lowest) did not have an increased risk of 1-year recurrent CV events in the AMI cohort (HR 0.78, 95% CI 0.52–1.16) or any subgroup. There was also no association between percentage changes in PCSK9 over the first month and 1-year recurrent events, although there was a trend of differences between patients in the upper versus lower tertiles. Conclusion: Plasma PCSK9 levels measured during the acute phase were associated with high-sensitivity C-reactive protein, triglycerides, premature CHD, and gender in patients with AMI but did not predict recurrent CV events within 1 year. Dynamic changes in PCSK9 suggested a trend yet no significance value in predicting recurrent CV events.
Background The poor viability of transplanted mesenchymal stem cells (MSCs) hampers their therapeutic efficacy for ischemic heart disease. Micro RNA s are involved in regulation of MSC survival and function. The present study was designed to investigate the molecular effects of mi R ‐15a/15b on MSC survival, focusing on the role of vascular endothelial growth factor receptor 2. Methods and Results We first harvested donor luc(Luciferase)‐ MSC s (5×10 5 ) isolated from the luciferase transgenic mice with FVB background. Luc‐ MSC s were transfected with miR‐15a/15b mimics or inhibitors and cultured under oxygen glucose deprivation condition for 12 hours to mimics the harsh microenvironment in infarcted heart; they were subjected to MTT (3‐(4,5‐dimethyl‐2‐thiazolyl)‐2,5‐diphenyl‐2‐H‐tetrazolium bromide?Thiazolyl Blue Tetrazolium Bromide) assay, bioluminescence imaging, quantitative reverse transcription–polymerase chain reaction, transferase‐mediated deoxyuridine triphosphate–digoxigenin nick‐end labeling assay, and flow cytometry. Furthermore, the levels of vascular endothelial growth factor receptor 2, protein kinase B, p(Phosphorylate)‐protein kinase B, Bcl‐2, Bax, and caspase‐3 proteins were available by Western blotting assay. In vivo, acute myocardial infarction was induced in 24 mice by coronary ligation, with subsequent receipt of Luc‐ MSC s, Luc‐ MSC s+miR‐15a/15b inhibitors, or PBS treatment. The therapeutic procedure and treatment effects were tracked and assessed using bioluminescence imaging and echocardiographic measurement. Next, ex vivo imaging and immunohistochemistry were conducted to verify the distribution of MSC s. We demonstrated that miR‐15a/15b targeted vascular endothelial growth factor receptor 2 to modulate MSC survival, possibly via phosphatidylinositol 3‐kinase/protein kinase B signaling pathway, which was proved by bioluminescence imaging, immunohistochemistry analysis, and echocardiographic measurement. Conclusions Luc‐ MSC s could be followed dynamically in vitro and in vivo by bioluminescence imaging, and the role of mi R ‐15a/b could be inferred from the loss of signals from luc‐ MSC s. This finding may have practical clinical implications in mi R ‐15a/15b–modified MSC transplantation in treating myocardial infarction.
Routine test of cerebrospinal fluid (CSF), such as glucose concentrations, chloride ion, protein and leukocyte, as well as color, turbidity and clot, were important indicators for intracranial infection. However, there were no models to predict the intracranial infection with these parameters. We collected data of 221 cases with CSF positive-culture and 50 cases with CSF negative culture from January 1, 2016 to December 31, 2018 in the First Affiliated Hospital of Nanchang University, China. SPSS17.0 software was used to establish the model by adopting seven described indicators, and P < 0.05 was considered as statistically significant. Meanwhile, 40 cases with positive-culture and 10 cases with negative-culture were selected to verify the sensitivity and specificity of the model. The results showed that each parameter was significant in the model establishment (P < 0.05). To extract the above seven parameters, the interpretation model C was established, and C = 0.952-0.183 × glucose value (mmol/L)-0.024 × chloride ion value (mmol/L)-0.000122 × protein value (mg/L)-0.0000859 × number of leukocytes per microliter (× 10 6 /L) + 1.354 × color number code + 0.236 × turbidity number code + 0.691 × clot number code. In addition, the diagnostic sensitivity and specificity of the model were 85.0 and 100%, respectively. The combining application of seven physicochemical parameters of CSF might be of great value in the diagnosis of intracranial infection for adult patients.
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