Background：Chronic Obstructive Pulmonary Disease（COPD) is an inflammatory airway disease characterized by the presence of expiratory flow limitation. Exacerbations of COPD are common acute events. During epidemic of COVID-19, concerns have been raised with regard to mask- using because of increasing respiratory resistance. In this study, we aimed to evaluate the relationship between the vital signs , inflammation index, hypercapnia, hypoxia and mask-using in AECOPD patients.Methods：This retrospective study was performed at a tertiary hospital, and enrolled 23 patients with AECOPD who were hospitalized three or more times in the respiratory department. Patients in Group C were hospitalized and used masks during the epidemic period of COVID-19. Patient’s data of the previous two hospitalizations from the medical record system divided into group A and group B according to the time sequence. Vital signs, inflammation index, artery blood gas from medical record system and questionnaires of three hospitalizations in the same patient were collected to perform paired test.Results: Surgical mask using increased the levels of PaCO2 (8.98mm Hg; p = 0.004), HCO3-act (4.1mmol/L; p =0.006), BE (3.01mmol/L; p =0.019) and systolic blood pressure (11.39mm Hg; p = 0.01) in patients with AECOPD compared to last hospitalization. Surgical mask using for 30 to 120 minutes is associated with hypercapnia. There were no significant differences observed between group B and group A without using mask in vital signs, inflammation index, and artery blood gas.Conclusions: In this study, we found that systolic blood pressures and PaCO2, HCO3-act, BE were significantly elevated in AECOPD patients using masks compared to the other groups without masks. In addition，the changes in PaCO2,HCO3-act,BE is closely related to serum chloride concentration. Therefore, it is need to increase awareness and understanding of the use of masks in patients with chronic cardiopulmonary diseases.

Background: The relationship between cytochrome P450 2C19 (CYP2C19) polymorphisms and clopidogrel efficacy in patients with percutaneous coronary intervention (PCI) has been widely studied.However, the relationship between CYP2C19 polymorphisms and the response to clopidogrel in patients treated for ischemic stroke (IS) remains controversial. What's more, few data address the relevance of CYP2C19 polymorphisms in patients taking clopidogrel for secondary prevention of ischemic stroke. This study investigates whether carrying CYP2C19 loss-of-function (LOF) alleles affects the risk of recurrent stroke in IS patients.Methods: One hundred twenty-two IS patients were CYP2C19 genotype screened and enrolled in the study from January 2016 to December 2017. Those with stroke recurrence, stroke sequelae, or bleeding diseases were excluded. The remaining 89 patients were divided into the following 2 groups: non-carriers of CYP2C19 LOF alleles (n=38) and carriers (n=51) of CYP2C19 LOF alleles. The variables that could influence the rate of recurrent stroke were assessed in a multivariate analysis to determine the independent risk factors.Results: The CYP2C19*2 and *3 alleles frequencies among the 122 patients were 31.97% and 4.10%, respectively. Carriers of LOF alleles had a more significant history of hypertension compared with noncarriers [n=43/51 (86.7%) versus n=23/38 (60.5%), P=0.01]. In addition, the inclusion rate of aspirin in discharge medication was significantly higher for carriers than for non-carriers [n=19/51 (37.3%) versus n=5/38 (13.2%), P=0.01]. CYP2C19 LOF alleles were significantly associated with an increased risk of recurrent stroke [odds ratio (OR): 7.586; 95% confidence interval (CI): 1.346-42.770, P=0.022].Conclusions: CYP2C19 LOF alleles may increase the risk of recurrent IS. The polymorphisms of CYP2C19 may be predictors of a poor functional outcome in patients with recurrent stroke. Instead of clopidogrel, aspirin can be prescribed as a secondary preventative measure against stroke in carriers of CYP2C19 LOF alleles.

The first affiliated hospital of shantou university medical college Duncan Wei The first affiliated hospital of shantou university medical college Xiulian DengThe first affiliated hospital of shantou university medical college Haohao ChenThe first affiliated hospital of shantou university medical college ZhouWu ShuThe first affiliated hospital of shantou university medical college You MoThe first affiliated hospital of shantou university medical college moyou.moyou@163.comCorresponding Author Abstract Background: To analyze the perceptions and behaviors related to mask-using in non-medical staff.To protect against respiratory and provide insights on using mask and provide directions for the prevention of infection and health protection. Methods:We conducted semi-structured interviews with 24 non-medical staff from various backgrounds to reflect a diversity of viewpoints during the peak season of coronavirus disease 2019(COVID-19) since February to March in 2020. A phenomenological approach was adopted for data analysis.Results: Multiple themes emerged: (1) Effective informs and reporting of disease information had raised public awareness of wearing mask. (2) Shortage of masks and reuse exist in the implementation process. (3) The shortage of masks will be dealt by distribution in unified way and increasing production. Conclusions:This study documented non-medical staff perceptions and experiences using mask before the outbreak and this epidemic period. Participants felt that the most effective approach to solve the problem of mask shortage in China is combine prevention infection measures, uniform distribution of masks, material reserve in public health system.