Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has spread throughout the world,which becomes a global public health emergency.Undernourishment prolongs its convalescence and has an adverse effect...Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has spread throughout the world,which becomes a global public health emergency.Undernourishment prolongs its convalescence and has an adverse effect on its prognosis,especially in diabetic patients.The purpose of this study was to evaluate the prevalence and characteristics of undernourishment and to determine how it is related to the prognostic outcomes in the diabetic patients with coronavirus disease 2019(COVID-19).A retrospective,multicenter study was conducted in 85 diabetic COVID-19 patients from three hospitals in Hubei Province.All patients were assessed using the European Nutritional Risk Screening 2002(NRS-2002)and other nutritional assessments when admitted.Of them,35(41.18%)were at risk of malnutrition(NRS score≥3).Severe COVID-19 patients had a significantly lower level of serum albumin and prealbumin and higher NRS score than non-severe patients.Multivariate logistic regression analysis showed that serum prealbumin and NRS score increased the likelihood of progression into severe status(P<0.05).Meanwhile,single factor and multivariate analysis determined that grade of illness severity was an independent predictor for malnutrition.Furthermore,prealbumin and NRS score could well predict severe status for COVID-19 patients.The malnutrition group(NRS score≥3)had more severe illness than the normal nutritional(NRS score<3)group(P<0.001),and had a longer length of in-hospital stay and higher mortality.Malnutrition is highly prevalent among COVID-19 patients with diabetes.It is associated with severely ill status and poor prognosis.Evaluation of nutritional status should be strengthened,especially the indicators of NRS-2002 and the level of serum prealbumin.展开更多
<strong>Objective: </strong>To investigate the effect of hard bed on postoperative complications and comfort level of patients after renal puncture biopsy. <strong>Methods:</strong> A total of ...<strong>Objective: </strong>To investigate the effect of hard bed on postoperative complications and comfort level of patients after renal puncture biopsy. <strong>Methods:</strong> A total of 115 patients who underwent renal needle biopsy in the Department of Nephrology of The First Affiliated Hospital of Jinan University from May 2020 to February 2021 were selected, and 57 patients who received hard bed nursing after renal needle biopsy were set as the control group, the others were selected as the observation group. The incidence of postoperative bleeding at the puncture mouth, gross hematuria and dysuria, as well as the postoperative comfort level of 6 h and 18 h were compared between the two groups.<strong> Results:</strong> There was no significant difference in the incidence of postoperative bleeding, gross hematuria and dysuria between the two groups (<em>P</em> > 0.05), but the comfort scores at 6 h and 18 h in the observation group were higher than those in the control group (<em>P</em> < 0.05). <strong>Conclusion:</strong> There is no significant difference in the incidence of postoperative complications, such as bleeding at the puncture mouth, gross hematuria and dysuria, among patients with renal needle biopsy, whether to use hard bed nursing or not. Eliminate hard bed nursing can improve the comfort level of patients, reduce the occurrence of pressure ulcers, and relieve the negative psychological emotions of patients.展开更多
Dear Editor,The first coronavirus disease 2019(COVID-19)outbreak was reported in Wuhan,Hubei,China.As one of the cities closest to Wuhan,Huangshi is considered a subcenter of the Wuhan metropolitan area.This study was...Dear Editor,The first coronavirus disease 2019(COVID-19)outbreak was reported in Wuhan,Hubei,China.As one of the cities closest to Wuhan,Huangshi is considered a subcenter of the Wuhan metropolitan area.This study was carried out to describe the characteristics of adult patients with confirmed COVID-19 in Huangshi.展开更多
Physicians with expertise in providing training for family medicine,at both undergraduate level and postgraduate level,are frequently invited to run training workshops in countries with developing systems of family me...Physicians with expertise in providing training for family medicine,at both undergraduate level and postgraduate level,are frequently invited to run training workshops in countries with developing systems of family medicine but this approach is often a challenge for the incoming external trainers.There are general challenges in working across different contexts,especially cul-tural factors,the different approaches to training,including the aims,methods,and assessment,and additional organizational factors,influenced by the wider sociopolitical environment of the host country.Practical responses to these challenges are discussed,with relevance to both external trainers and those responsible for requesting training.This commentary contains insights from the experiences of the authors in providing training for family medicine in China.展开更多
Background:Pulmonary microvascular endothelial cells(PMVECs)were not complex,and the endothelial barrier was destroyed in the pathogenesis progress of acute lung injury(ALI)/acute respiratory distress syndrome(ARDS).P...Background:Pulmonary microvascular endothelial cells(PMVECs)were not complex,and the endothelial barrier was destroyed in the pathogenesis progress of acute lung injury(ALI)/acute respiratory distress syndrome(ARDS).Previous studies have demonstrated that hepatocyte growth factor(HGF),which was secreted by bone marrow mesenchymal stem cells,could decrease endothelial apoptosis.We investigated whether mTOR/STAT3 signaling acted in HGF protective effects against oxidative stress and mitochondria-dependent apoptosis in lipopolysaccharide(LPS)-induced endothelial barrier dysfunction and ALI mice.Methods:In our current study,we introduced LPS-induced PMEVCs with HGF treatment.To investigate the effects of mammalian target of rapamycin(mTOR)/signal transducer and activator of transcription 3(STAT3)pathway in endothelial oxidative stress and mitochondria-dependent apoptosis,mTOR inhibitor rapamycin and STAT3 inhibitor S3I-201 were,respectively,used to inhibit mTOR/STAT3 signaling.Moreover,lentivirus vector-mediatedmTORC1(Raptor)andmTORC2(Rictor)gene knockdown modifications were introduced to evaluatemTORC1 andmTORC1 pathways.Calcium measurement,reactive oxygen species(ROS)production,mitochondrial membrane potential and protein,cell proliferation,apoptosis,and endothelial junction protein were detected to evaluate HGF effects.Moreover,we used the ALI mouse model to observe the mitochondria pathological changes with an electron microscopein vivo.Results:Our study demonstrated that HGF protected the endothelium via the suppression of ROS production and intracellular calcium uptake,which lead to increased mitochondrial membrane potential(JC-1 and mitochondria tracker green detection)and specific proteins(complex I),raised anti-apoptosis Messenger Ribonucleic Acid level(B-cell lymphoma 2 and Bcl-xL),and increased endothelial junction proteins(VE-cadherin and occludin).Reversely,mTOR inhibitor rapamycin and STAT3 inhibitor S3I-201 could raise oxidative stress and mitochondria-dependent apoptosis even with HGF treatment in LPS-induced endothelial cells.Similarly,mTORC1 as well as mTORC2 have the same protective effects in mitochondria damage and apoptosis.Inin vivo experiments of ALI mouse,HGF also increased mitochondria structural integrity via the mTOR/STAT3 pathway.Conclusion:In all,these reveal that mTOR/STAT3 signaling mediates the HGF suppression effects to oxidative level,mitochondria-dependent apoptosis,and endothelial junction protein in ARDS,contributing to the pulmonary endothelial survival and barrier integrity.展开更多
Background:There have been many studies about coronavirus disease 2019(COVID-19),but the clinical signifi-cance of quantitative serum severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2)-specific IgM and IgG le...Background:There have been many studies about coronavirus disease 2019(COVID-19),but the clinical signifi-cance of quantitative serum severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2)-specific IgM and IgG levels of COVID-19 patients have not been exhaustively analyzed.We aimed to investigate the time profiles of these IgM/IgG levels in COVID-19 patients and their correlations with clinical features.Methods:A multicenter clinical study was conducted from February 20 to March 52020.It involved 179 COVID-19 patients(108 males and 71 females)from five hospitals in Huangshi in Hubei Province,China.To detect SARS-CoV-2-specific IgM/IgG,quantitative antibody assays(two-step indirect immunoassays with direct chemilu-minescence technology)based on the nucleocapsid protein(NP)and spike protein 1(S1)were used.For normally distributed data,means were compared using the t-test,𝜒2-test,or exact probability method.For categorical data,medians were compared using Mann-Whitney U test.Results:The median age was 57(44-69)years(58[38-69]for males and 57[49-68]for females).The median duration of positive nucleic acid test was 22.32(17.34-27.43)days.The mortality rate was relatively low(3/179,1.68%).Serum SARS-CoV-2-specific IgG was detected around week 1 after illness onset,gradually increased until peaking in weeks 4 and 5,and then declined.Serum IgM peaked in weeks 2 and 3,then gradually declined and returned to its normal range by week 7 in all patients.Notably,children had milder respiratory symptoms with lower SARS-CoV-2-specific IgM/IgG levels.The duration of positive nucleic acid test in the chronic obstructive pulmonary disease(COPD)group was 30.36(18.99-34.76)days,which was significantly longer than that in the non-COPD group(21.52[16.75-26.51]days;P=0.025).The peak serum SARS-CoV-2-specific IgG was sig-nificantly positively correlated with the duration of positive nucleic acid test.The incidence rate of severe and critical cases in the IgM hi group(using the median IgM level of 29.95 AU/mL as the cutofffor grouping)was about 38.0%(19/50),which was twice as much as that in the IgM lo group(18.4%;9/49).The patients with positive chest imaging and lymphocytopenia(<1×10^(9)/L)had a higher SARS-CoV-2-specific IgM level.Conclusions: Quantitative SARS-CoV-2-specific IgM and IgG levels are helpful for the diagnosis, severity classifi- cation, and management of COVID-19 patients, and they should be monitored in each stage of this disease.展开更多
基金the National Natural Science Foundation of China(No.81970217 to WG)Science and Technology Development Foundation,Nanjing Medical University,China(No.NMUB2019074 to CZ)+2 种基金Natural Science Foundation for Colleges and Universities in Jiangsu Province(No.20KJB320010 to CZ)Science and Technology Development Foundation of Geriatric,Geriatrics Society of Jiangsu(No.JGS2019ZXYY06 to XL)National Key R&D Program of China(No.2020YFC2008505 to XL)。
文摘Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has spread throughout the world,which becomes a global public health emergency.Undernourishment prolongs its convalescence and has an adverse effect on its prognosis,especially in diabetic patients.The purpose of this study was to evaluate the prevalence and characteristics of undernourishment and to determine how it is related to the prognostic outcomes in the diabetic patients with coronavirus disease 2019(COVID-19).A retrospective,multicenter study was conducted in 85 diabetic COVID-19 patients from three hospitals in Hubei Province.All patients were assessed using the European Nutritional Risk Screening 2002(NRS-2002)and other nutritional assessments when admitted.Of them,35(41.18%)were at risk of malnutrition(NRS score≥3).Severe COVID-19 patients had a significantly lower level of serum albumin and prealbumin and higher NRS score than non-severe patients.Multivariate logistic regression analysis showed that serum prealbumin and NRS score increased the likelihood of progression into severe status(P<0.05).Meanwhile,single factor and multivariate analysis determined that grade of illness severity was an independent predictor for malnutrition.Furthermore,prealbumin and NRS score could well predict severe status for COVID-19 patients.The malnutrition group(NRS score≥3)had more severe illness than the normal nutritional(NRS score<3)group(P<0.001),and had a longer length of in-hospital stay and higher mortality.Malnutrition is highly prevalent among COVID-19 patients with diabetes.It is associated with severely ill status and poor prognosis.Evaluation of nutritional status should be strengthened,especially the indicators of NRS-2002 and the level of serum prealbumin.
文摘<strong>Objective: </strong>To investigate the effect of hard bed on postoperative complications and comfort level of patients after renal puncture biopsy. <strong>Methods:</strong> A total of 115 patients who underwent renal needle biopsy in the Department of Nephrology of The First Affiliated Hospital of Jinan University from May 2020 to February 2021 were selected, and 57 patients who received hard bed nursing after renal needle biopsy were set as the control group, the others were selected as the observation group. The incidence of postoperative bleeding at the puncture mouth, gross hematuria and dysuria, as well as the postoperative comfort level of 6 h and 18 h were compared between the two groups.<strong> Results:</strong> There was no significant difference in the incidence of postoperative bleeding, gross hematuria and dysuria between the two groups (<em>P</em> > 0.05), but the comfort scores at 6 h and 18 h in the observation group were higher than those in the control group (<em>P</em> < 0.05). <strong>Conclusion:</strong> There is no significant difference in the incidence of postoperative complications, such as bleeding at the puncture mouth, gross hematuria and dysuria, among patients with renal needle biopsy, whether to use hard bed nursing or not. Eliminate hard bed nursing can improve the comfort level of patients, reduce the occurrence of pressure ulcers, and relieve the negative psychological emotions of patients.
基金The study was supported by the National Natural Science Foundation of China(Grant No.81971812)the Natural Science Foundation of Jiangsu Province(Grant No.SBK2019022548)the Science Foundation of the Commission of Health of Jiangsu Province(Grant No.ZDB2020009).
文摘Dear Editor,The first coronavirus disease 2019(COVID-19)outbreak was reported in Wuhan,Hubei,China.As one of the cities closest to Wuhan,Huangshi is considered a subcenter of the Wuhan metropolitan area.This study was carried out to describe the characteristics of adult patients with confirmed COVID-19 in Huangshi.
文摘Physicians with expertise in providing training for family medicine,at both undergraduate level and postgraduate level,are frequently invited to run training workshops in countries with developing systems of family medicine but this approach is often a challenge for the incoming external trainers.There are general challenges in working across different contexts,especially cul-tural factors,the different approaches to training,including the aims,methods,and assessment,and additional organizational factors,influenced by the wider sociopolitical environment of the host country.Practical responses to these challenges are discussed,with relevance to both external trainers and those responsible for requesting training.This commentary contains insights from the experiences of the authors in providing training for family medicine in China.
基金the National Natural Science Foundation of China(Nos.81671892,81971888,81971812,82102300)the Jiangsu Natural Science Foundation(Nos.BK20200367,BK20161433,BK20191264,BK20200356)+2 种基金the Jiangsu Province Medical Key Talent(No.ZDRCA2016082)the Jiangsu Province Key Medical Discipline(laboratory)(No.ZDXKA2016025)the Jiangsu Entrepreneurship and Innovation Doctors。
文摘Background:Pulmonary microvascular endothelial cells(PMVECs)were not complex,and the endothelial barrier was destroyed in the pathogenesis progress of acute lung injury(ALI)/acute respiratory distress syndrome(ARDS).Previous studies have demonstrated that hepatocyte growth factor(HGF),which was secreted by bone marrow mesenchymal stem cells,could decrease endothelial apoptosis.We investigated whether mTOR/STAT3 signaling acted in HGF protective effects against oxidative stress and mitochondria-dependent apoptosis in lipopolysaccharide(LPS)-induced endothelial barrier dysfunction and ALI mice.Methods:In our current study,we introduced LPS-induced PMEVCs with HGF treatment.To investigate the effects of mammalian target of rapamycin(mTOR)/signal transducer and activator of transcription 3(STAT3)pathway in endothelial oxidative stress and mitochondria-dependent apoptosis,mTOR inhibitor rapamycin and STAT3 inhibitor S3I-201 were,respectively,used to inhibit mTOR/STAT3 signaling.Moreover,lentivirus vector-mediatedmTORC1(Raptor)andmTORC2(Rictor)gene knockdown modifications were introduced to evaluatemTORC1 andmTORC1 pathways.Calcium measurement,reactive oxygen species(ROS)production,mitochondrial membrane potential and protein,cell proliferation,apoptosis,and endothelial junction protein were detected to evaluate HGF effects.Moreover,we used the ALI mouse model to observe the mitochondria pathological changes with an electron microscopein vivo.Results:Our study demonstrated that HGF protected the endothelium via the suppression of ROS production and intracellular calcium uptake,which lead to increased mitochondrial membrane potential(JC-1 and mitochondria tracker green detection)and specific proteins(complex I),raised anti-apoptosis Messenger Ribonucleic Acid level(B-cell lymphoma 2 and Bcl-xL),and increased endothelial junction proteins(VE-cadherin and occludin).Reversely,mTOR inhibitor rapamycin and STAT3 inhibitor S3I-201 could raise oxidative stress and mitochondria-dependent apoptosis even with HGF treatment in LPS-induced endothelial cells.Similarly,mTORC1 as well as mTORC2 have the same protective effects in mitochondria damage and apoptosis.Inin vivo experiments of ALI mouse,HGF also increased mitochondria structural integrity via the mTOR/STAT3 pathway.Conclusion:In all,these reveal that mTOR/STAT3 signaling mediates the HGF suppression effects to oxidative level,mitochondria-dependent apoptosis,and endothelial junction protein in ARDS,contributing to the pulmonary endothelial survival and barrier integrity.
基金the Ministry of Science and Technology of the People’s Republic of China[Grant Number 2020YFC0843700]the fifth round of the Gusu Health Person Training Project[Grant Number GSWS2019050]the Six Talent Peaks Project in Jiangsu Province[Grant Number WSN-058,YY-053,2019].
文摘Background:There have been many studies about coronavirus disease 2019(COVID-19),but the clinical signifi-cance of quantitative serum severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2)-specific IgM and IgG levels of COVID-19 patients have not been exhaustively analyzed.We aimed to investigate the time profiles of these IgM/IgG levels in COVID-19 patients and their correlations with clinical features.Methods:A multicenter clinical study was conducted from February 20 to March 52020.It involved 179 COVID-19 patients(108 males and 71 females)from five hospitals in Huangshi in Hubei Province,China.To detect SARS-CoV-2-specific IgM/IgG,quantitative antibody assays(two-step indirect immunoassays with direct chemilu-minescence technology)based on the nucleocapsid protein(NP)and spike protein 1(S1)were used.For normally distributed data,means were compared using the t-test,𝜒2-test,or exact probability method.For categorical data,medians were compared using Mann-Whitney U test.Results:The median age was 57(44-69)years(58[38-69]for males and 57[49-68]for females).The median duration of positive nucleic acid test was 22.32(17.34-27.43)days.The mortality rate was relatively low(3/179,1.68%).Serum SARS-CoV-2-specific IgG was detected around week 1 after illness onset,gradually increased until peaking in weeks 4 and 5,and then declined.Serum IgM peaked in weeks 2 and 3,then gradually declined and returned to its normal range by week 7 in all patients.Notably,children had milder respiratory symptoms with lower SARS-CoV-2-specific IgM/IgG levels.The duration of positive nucleic acid test in the chronic obstructive pulmonary disease(COPD)group was 30.36(18.99-34.76)days,which was significantly longer than that in the non-COPD group(21.52[16.75-26.51]days;P=0.025).The peak serum SARS-CoV-2-specific IgG was sig-nificantly positively correlated with the duration of positive nucleic acid test.The incidence rate of severe and critical cases in the IgM hi group(using the median IgM level of 29.95 AU/mL as the cutofffor grouping)was about 38.0%(19/50),which was twice as much as that in the IgM lo group(18.4%;9/49).The patients with positive chest imaging and lymphocytopenia(<1×10^(9)/L)had a higher SARS-CoV-2-specific IgM level.Conclusions: Quantitative SARS-CoV-2-specific IgM and IgG levels are helpful for the diagnosis, severity classifi- cation, and management of COVID-19 patients, and they should be monitored in each stage of this disease.
