OBJECTIVE:To investigate and summarize the chest CT imaging features of patients with novel coronavirus pneumonia (COVID-19), bacterial pneumonia and other viral pneumonia. METHODS:Chest CT data of 102 patients with pulmonary infection due to different etiologies were retrospectively analyzed, including 36 patients with COVID-19 admitted to Hainan Provincial People's Hospital and the Second Affiliated Hospital of Hainan Medical University from December 2019 to March 2020, 16 patients with other viral pneumonia admitted to Hainan Provincial People's Hospital from January 2018 to February 2020, and 50 patients with bacterial pneumonia admitted to Haikou Affiliated Hospital of Central South University Xiangya School of Medicine from April 2018 to May 2020. Two senior radiologists and two senior intensive care physicians were participated to evaluated the extent of lesions involvement and imaging features of the first chest CT after the onset of the disease. RESULTS:Bilateral pulmonary lesions were more common in patients with COVID-19 and other viral pneumonia, and the incidence was significantly higher than that of bacterial pneumonia (91.6%, 75.0% vs. 26.0%, P < 0.05). Compared with other viral pneumonia and COVID-19, bacterial pneumonia was mainly characterized by single-lung and multi-lobed lesion (62.0% vs. 18.8%, 5.6%, P < 0.05), accompanied by pleural effusion and lymph node enlargement. The proportion of ground-glass opacity in the lung tissues of patients with COVID-19 was 97.2%, that of patients with other viral pneumonia was 56.2%, and that of patients with bacterial pneumonia was only 2.0% (P < 0.05). The incidence rate of lung tissue consolidation (25.0%, 12.5%), air bronchial sign (13.9%, 6.2%) and pleural effusion (16.7%, 37.5%) in patients with COVID-19 and other viral pneumonia were significantly lower than those in patients with bacterial pneumonia (62.0%, 32.0%, 60.0%, all P < 0.05), paving stone sign (22.2%, 37.5%), fine mesh sign (38.9%, 31.2%), halo sign (11.1%, 25.0%), ground-glass opacity with interlobular septal thickening (30.6%, 37.5%), bilateral patchy pattern/rope shadow (80.6%, 50.0%) etc. were significantly higher than those of bacterial pneumonia (2.0%, 4.0%, 2.0%, 0%, 22.0%, all P < 0.05). The incidence of local patchy shadow in patients with COVID-19 was only 8.3%, significantly lower than that in patients with other viral pneumonia and bacterial pneumonia (8.3% vs. 68.8%, 50.0%, P < 0.05). There was no significant difference in the incidence of peripheral vascular shadow thickening in patients with COVID-19, other viral pneumonia and bacterial pneumonia (27.8%, 12.5%, 30.0%, P > 0.05). CONCLUSIONS:The probability of ground-glass opacity, paving stone and grid shadow in chest CT of patients with COVID-19 was significantly higher than those of bacterial pneumonia, and it was more common in the lower lungs and lateral dorsal segment. In other patients with viral pneumonia, ground-glass opacity was distributed in both upper and lower lungs. Bacterial pneumonia is usually characterized by single lung consolidation, distributed in lobules or large lobes and accompanied by pleural effusion.

Mild hypothermia (MH) and edaravone (EDA) exert neuroprotective effects against cerebral ischemia/reperfusion (I/R) injury through activation of the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway. However, whether MH and EDA exert synergistic effects against cerebral I/R injury remains unknown. The aim of the present study was to investigate the effects and mechanism of action of MH in combination with EDA in cerebral I/R injury. A rat cerebral I/R injury model was constructed by middle cerebral artery occlusion (MCAO) followed by reperfusion, and the mice were treated by MH, EDA or the inhibitor of the Nrf2 signaling pathway brusatol (Bru). It was observed that mice treated by MCAO had higher neurological deficit scores and oxidative stress levels, and low spatial learning and memory capacity; moreover, the CA1 region of the hippocampi of the mice exhibited reduced neuronal density and viability, and reduced mitochondrial dysfunction. However, MH in combination with EDA reversed the effects of MCAO, which were blocked by Bru injection. The levels of glutathione (GSH), GSH peroxidase, catalase and superoxide dismutase in rat ischemic hemisphere tissues were reduced by Bru. Western blotting demonstrated that the combined treatment with MH and EDA promoted the nuclear localization of Nrf2, and increased the levels of NAD(P)H quinone oxidoreductase and heme oxygenase (HO)-1. In conclusion, MH combined with EDA exerted synergistic neuroprotective effects against cerebral I/R injury involving changes in the Nrf2/HO-1 pathway.

目的 探讨亚低温联合氯丙嗪对脑缺血再灌注损伤(CIRI)大鼠氧化应激反应的影响.方法 将75只SD大鼠随机分为假手术组、CIRI组、亚低温组、氯丙嗪组和亚低温联合氯丙嗪组,每组15只.采用神经功能损伤评分(NDS)评价神经功能,酶联免疫吸附法测定神经元特异性烯醇酶(NSE)和S-100β蛋白表达,化学比色法检测超氧化物歧化酶(SOD),硫代巴比妥酸比色法检测丙二醛(MDA),Western Blotting检测NF-E2相关因子2(Nrf2)、血红素加氧酶(HO-1)蛋白表达.结果 亚低温组、氯丙嗪组和亚低温联合氯丙嗪组NDS评分和NSE、S-100β、MDA水平均低于CIRI组(P<0.05或P<0.01),SOD、Nrf2和HO-1水平均高于CIRI组(P<0.05或P<0.01).亚低温联合氯丙嗪组NDS评分及NSE、S-100β、MDA水平均低于亚低温组和氯丙嗪组(P<0.05),SOD、Nrf2和HO-1水平均高于亚低温组和氯丙嗪组(P<0.05或P<0.01).结论 亚低温联合氯丙嗪上调Nrf2/HO-1通路发挥抗氧化作用,进而对脑缺血再灌注大鼠起到神经保护作用.

Objective: To observe the differentiation of macrophages in lung tissue and alveolar lavage fluid of mice with severe pulmonary infection and the changes after intervention with ceftriaxone and ulinastatin, and to explore the pathogenesis of severe pulmonary infection under immunosuppressive state and the intervention effect of two drugs. Methods: 40 male Balb/c mice are randomly divided into normal group, model group, ulinastatin group, and ceftriaxone group with 10 mice in each group. Mice models of acute lung injury with immunodeficiency are established by methylprednisolone and endotoxin, and then treated with ulinastatin and ceftriaxone. Respiratory frequencies of mice in each group are measured at 3 h and 6 h after drug use through trachea, and then the mice are anaesthetized with uratan and killed 6 h after drug use. The number of alveolar macrophages and neutrophils in alveolar lavage fluid is collected and detected, and the pathological changes are observed. The positive expression of CD163 in lung tissue is detected by IHC (immunohistochemistry), and real-time quantitative PCR (Polymerase Chain Reaction) is used to detect the expression of M1 and M2 markers in bronchoalveolar lavage fluid (BALF). Result: Compared with the normal group, the mice in the model group breathed shallowly and quickly, occasionally nodded breathing, respiratory distress, and respiratory rate increased. Compared with the model group, the mice in the ulinastatin group and ceftriaxone group breathed slowly, occasionally have shortness of breath, smooth breathing, and slow breathing rate, and the mice in ulinastatin group breathe more smoothly. The number of macrophages and neutrophils in BALF of model group is higher than that of normal group. The number of macrophages and neutrophils in ulinastatin group and ceftriaxone group is lower than that of model group and the difference is statistically significant, and the number of macrophages and neutrophils in ulinastatin group is relatively less than that in model group. Conclusion: In the early stage of severe pulmonary infection under immunosuppressive state, the organism is in the CARS (Compensatory Anti-inflammatory Response Syndrome) stage; M1 macrophages had immune paralysis and M2 macrophages are abnormally activated. Compared with ceftriaxone, ulinastatin can alleviate lung injury more effectively and protect the lung of mice with acute lung injury. The protective mechanism of ulinastatin on lung of mice infected with immunocompromised endotoxin may be through inhibiting M1 macrophages and regulating non-specific immune function. (C) 2020 The Author(s). Published by Elsevier B.V. on behalf of King Saud University.

BackgroundA novel coronavirus (2019-nCOV) has attracted worldwide attention since December 2019 when it appeared in Wuhan, China. The coronavirus disease (COVID-19) can cause respiratory distress syndrome or multiple organ dysfunction syndrome and be life-threatening. Covid-19 incidence can be reduced by using an outbreak map based on Geoinformatics. MethodsThis article introduces geographic mapping on the Internet and uses epidemic maps such as rank circles, choropleth rendering, overlay analysis and animation and other technologies to guide people’s behavior, reduce entry into areas with severe epidemics, and prevent new crowd infections. ResultsBy using various epidemic maps, households can reduce the access of people to the epidemic area (especially travellers to potentially at-risk areas), reduce the possibility of COVID-19 infection, and facilitate the timely diagnosis and treatment of fevered patients or suspected COVID-19. In addition, public health managers can intuitively understand the dynamics of the epidemic and spatial analysis of trends in outbreak dynamics and COVID-19 patterns helped to assist the public health sector and to evaluate/revise current control measures. ConclusionThe purpose of these online epidemic data collect and visualize is to notify travellers and assist the public or to analyzing the spatial and current trends and patterns of COVID-19 for public health authorities in assessing/revising current control measures.

目的 探讨经颅多普勒超声(TCD)评价重度颈内动脉狭窄患者接受颈动脉支架植入术(CAS)后脑血流动力学参数的变化情况及对术后近期转归的预测效果.方法 纳入接受CAS的50例颈内动脉狭窄患者为对象,采用TCD技术检测手术前后患者脑血流动力学参数.对患者持续随访1年,观察不良转归事件发生情况,测评脑血流动力学参数对预测不良转归事件的效能.结果 50例患者中12例在术后1年内出现不良转归.不良转归组患侧大脑中动脉(MCA)平均血流速度(Vm)及搏动指数(PI)在手术前后的变化量均明显低于转归良好组,差异有统计学意义(P＜0.05).手术前后MCA Vm和MCA PI均与美国国立卫生研究院卒中量表(NIHSS)评分呈正相关(P＜0.05).手术前后MCA Vm和MCA PI的增加量均能够有效预测不良转归,ROC曲线下面积分别为0.656、0.884.结论 动脉狭窄患者经CAS治疗后,患侧MCA Vm和MCA PI明显提升,且提升量能够预测患者的近期转归.

Objective: To analyze the clinical efficacy of Naogengtong decoction combined with Shuxuening injection in the treatment of patients with cerebral infarction and its effects on levels of IL-6, IL-10, TNF-α and MMP-9. Methods: 176 cases of cerebral infarction in the first affiliated hospital of Nanchang University from February 2014 to February 2017 were devided into two groups according to the order of admission, each with 88 cases. Patients were all treated with routine treatment, in addition, patients in the control group were treated with Shuxuening injection, and those in the observation group were treated with Naogengtong decoction combined with Shuxuening injection. All patients were treated for 4 weeks. The Barther Index, the Foggel's score (FMMS), the modified Ashworth score (Ashwoeth), IL-6, TNF-α, and MMP-9 scores before and after the treatment in two groups were compared. Results: The clinical efficacy in the observation group was significantly better than that in the control group (P ＜0. 05). BI score and FMMS score in the observation group were higher than those in the control group (P ＜0. 05). After the treatment, the ashworth score and CSS score in the observation group were lower than those in the control group (P ＜0. 05). Levels of IL-6, IL-10, TNF-α and MMP-9 in the observation group were lower than those in the control group (P ＜0.05). Conclusion: The clinical efficacy of Naogengtong decoction combined with Shuxuening injection in the treatment of cerebral infarction is significant, which can effectively improve levels of IL-6, IL-10, TNF-α and MMP-9 in patients.