pneumonia

摘要： Theoretically, mesenchymal stem cells (MSCs) are very promising as adjuvanttherapy to alleviate coronavirus disease 2019 (COVID-19)-associated acute lunginjury and cytokine storm. Several published studies, which used MSCs toalleviate COVID-19-associated acute lung injury and cytokine storm, reportedpromising results. However, the evidence came from a case report, case series,and clinical trials with a limited number of participants. Therefore, more studiesare needed to get robust proof of MSC beneficial effects.

摘要： 丙氨酸转氨酶(alanine aminotransferase,ALT)天冬氨酸转氨酶(aspartate aminotransferase,AST)碱性磷酸酶(alkaline phosphatase,ALP)总胆红素(total bilirubin,TBiL)肌酐(creatinine,CREA)呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)重症监护病房(intensive care unit,ICU)。

摘要： BACKGROUND Factors that are associated with the short-term rehospitalization have been investigated previously in numerous studies.However,the majority of these studies have not produced any conclusive results because of their smaller sample sizes,differences in the definition of pneumonia,joint pooling of the in-hospital and post-discharge deaths and lower generalizability.AIM To estimate the effect of various risk factors on the rate of hospital readmissions in patients with pneumonia.METHODS Systematic search was conducted in PubMed Central,EMBASE,MEDLINE,Cochrane library,ScienceDirect and Google Scholar databases and search engines from inception until July 2021.We used the Newcastle Ottawa(NO)scale to assess the quality of published studies.A meta-analysis was carried out with random-effects model and reported pooled odds ratio(OR)with 95%confidence interval(CI).RESULTS In total,17 studies with over 3 million participants were included.Majority of the studies had good to satisfactory quality as per NO scale.Male gender(pooled OR=1.22;95%CI:1.16-1.27),cancer(pooled OR=1.94;95%CI:1.61-2.34),heart failure(pooled OR=1.28;95%CI:1.20-1.37),chronic respiratory disease(pooled OR=1.37;95%CI:1.19-1.58),chronic kidney disease(pooled OR=1.38;95%CI:1.23- 1.54) and diabetes mellitus (pooled OR = 1.18;95%CI: 1.08-1.28) had statistically significantassociation with the hospital readmission rate among pneumonia patients. Sensitivity analysisshowed that there was no significant variation in the magnitude or direction of outcome,indicating lack of influence of a single study on the overall pooled estimate.CONCLUSIONMale gender and specific chronic comorbid conditions were found to be significant risk factors forhospital readmission among pneumonia patients. These results may allow clinicians and policymakersto develop better intervention strategies for the patients.

摘要： The coronavirus disease 2019(COVID-19)global pandemic can be a severe illness that leads to morbidity and mortality.With the increasing number of COVID-19 pneumonia survivors,several long-term changes may persist,including abnormal imaging of lung parenchyma.In addition to the clinical course,it is vital to follow up on pulmonary imaging during the post-infectious period,which is not routinely required in other common pulmonary diagnoses.Computed tomography(CT)scan of the chest is an effective and diagnostic tool for pneumonia which gives an insight into structural abnormalities within the lungs,complications,and possible progression of the disease.Several studies have monitored COVID-19 pneumonia and its complications using serial CT chest imaging from the initial phase of infection,hospitalization,and post-discharge.Nonetheless,long-term follow-up imaging data in post-COVID-19 is still limited.We have summarized the findings utilizing a systematic review of the literature regarding COVID-19 pneumonia imaging,including long-term follow-up.

摘要： BACKGROUND Even though coronavirus 2019 disease(COVID-19)clinical course in children is much milder than in adults,pneumonia can occur in the pediatric population as well.Here,we reported a single-center pediatric case series of COVID-19 from Kazakhstan during the first wave of pandemic.AIM To analyze the main clinical and laboratory aspects in severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)positive and negative children diagnosed with pneumonia.METHODS This is a retrospective analysis of 54 children,who were medically assessed as close contacts of COVID-19 adults in their family setting,between June and September 2020.These children were all hospitalized:We compared the clinical and laboratory characteristics of children affected with pneumonia in the presence(group 1)or absence(group 2)of SARS-CoV-2 infection.RESULTS Overall,the main clinical manifestations at the admission were fever,cough,loss of appetite,fatigue/weakness,nasal congestion and/or rhinorrhea,and dyspnea.Based on the SARS-CoV-2 polymerase chain reaction(PCR)test,24 positive children with pneumonia(group 1)and 20 negative children with pneumonia(group 2)were identified;10 positive children did not show any radiological findings of pneumonia.No significant differences were found between the two pneumonia study groups for any clinical and laboratory parameters,except for C-reactive protein(CRP).Of course,both pneumonia groups showed increased CRP values;however,the COVID-19 pneumonia group 1 showed a significantly higher increase of CRP compared to group 2.CONCLUSION In our case series of children assessed for SARS-CoV-2 infection based on contact tracing,the acute inflammatory response and,in detail,CRP increase resulted to be more pronounced in COVID-19 children with pneumonia than in children with SARS-CoV-2-unrelated pneumonia.However,because of multiple limitations of this study,larger,controlled and more complete clinical studies are needed to verify this finding.

摘要： Objective Phillyrin(KD-1)is a traditional Chinese monomer and the main active component in Lianhua Qingwen.At present,sufficient studies have confirmed that KD-1 has significant anti-SARS-CoV-2 activity and antiinflammatory effects in vitro and in vivo.However,evidence-based studies to evaluate its therapeutic effect on COVID-19 are lacking.Therefore,we designed a clinical trial to evaluate the efficacy and safety of KD-1 in the treatment of moderate COVID-19 infection.Methods This is a multicenter,randomized,double-blind,placebo-controlled clinical trial.A total of 120 participants will be recruited and randomized to receive KD-1 capsule or placebo treatment for 14 days,50 mg per capsule,four capsules each time,three times a day.If the SARS-CoV-2 nucleic acid test results are negative twice within 14 days,the KD-1 capsule will be stopped the following day.Symptoms,patient compliance,and adverse reactions will be recorded,and nucleic acid testing will be conducted daily.Primary and secondary outcomes,as well as safety indicators,will be used to evaluate the efficacy and safety of the KD-1 capsule in the treatment of COVID-19.Discussion Herein,we describe the first clinical trial in China to treat COVID-19 using a traditional Chinese medicine monomer.A randomized,double-blind,placebo-controlled clinical trial is the best way to evaluate the efficacy and safety of KD-1 against moderate COVID-19 infection.If a good clinical benefit is observed,this represents the first step toward the use of KD-1 capsules to treat COVID-19.This clinical trial can serve as a model for other evidence-based research of traditional herbal medicines.Trial registration This study is registered at chinadrugtrials.org.cn,with registration number:CTR20211800.

摘要： For many years,ultrasound was thought to have no indications in pulmonary imaging because lungs are filled with air,creating no acoustic mismatch,as encountered by ultrasound wave beam.Lung ultrasound(LUS)was started in adult critical care settings to detect pleural effusion and acquired more indications over time.In the neonatal intensive care unit(NICU),the use of chest ultrasound has gained more attention during the last two decades.Being a radiation-free,bedside,rapid,and handy tool,LUS started to replace chest X-rays in NICU.Using LUS depends upon understanding the nature of normal lungs and the changes induced by different diseases.With the help of LUS,an experienced neonatologist can detect many of the respiratory problems so fast that interventional therapy can be introduced as early as possible.LUS can diagnose pleural effusion,pneumothorax,pneumonia,transient tachypnoea of the newborn,respiratory distress syndrome,pulmonary atelectasis,meconium aspiration syndrome,bronchopulmonary dysplasia,and some other disorders with very high accuracy.LUS will be helpful in initial diagnosis,follow-up,and predicting the need for further procedures such as mechanical ventilation,diuretic therapy,surfactant therapy,etc.There are some limitations to using LUS in some respiratory disorders such as bullae,interstitial emphysema,and other conditions.This review will highlight the importance of LUS,its uses,and limitations.

摘要： Objective:To study the molecular mechanism of Mori cortex-Lycii cortex in the treatment of pneumonia in children based on network pharmacology. Methods:TCMSP and BATMAN-TCM online prediction database were used to screen and collect the active ingredients and targets of Mori cortex-Lycii cortex based on oral bioavailability and drug-like. Predictive analysis of disease targets was conducted through PubMed,GeneCards and DrugBank databases. The component-target regulation network was constructed by using Cytoscape 3.7.2 software,and the network topology of the core target was analyzed. Finally,the Bioconductor platform and R language were used for GO function analysis and KEGG pathway enrichment analysis,and the target-key pathway network diagram was constructed. Results:A total of 43 active components,including quercetin,kaempferol,acacetin,and beta-sitosterol,were identified with 242 potential targets. There were 3 271 pneumonia targets in children,among which the key targets were IL-6,AKT1,MAPK8,etc. There were 31 common targets of MMP9,TNF,AKT1 and so on. GO biological processes included the response to lipopolysaccharides,molecule of bacterial origin,metal ions,regulation of apoptotic signaling pathway,and T cell activation. The KEGG signaling pathways involved mainly included TNF,PI3 K/AKT and MAPK signaling pathway. Conclusion:Quercetin,kaempferol,beta-sitosterol and acacetin in Mori cortex-Lycii cortex may act on several signal transduction pathways such as TNF,PI3 K/AKT,MAPK signal pathways through AKT1,MAPK8,IL-6 and MMP9 targets,then treat children pneumonia via antiinflammation action. The results can provide references for the further study on the treatment of pneumonia in children with Mori Ccortex-Lycii cortex.

摘要： BACKGROUND Coronavirus disease 2019(COVID-19)is amid an ongoing pandemic.It has been shown that patients with cardiovascular comorbidities are at higher risk of severe illness of COVID-19.AIM To find out the relationship between cardiovascular comorbidities and severe illness of COVID-19.METHODS The clinical data of 140 COVID-19 patients treated from January 22,2020 to March 3,2020 at our hospital were retrospectively collected.The clinical characteristics were compared between patients with mild illness and those with severe illness.RESULTS There were 75 male patients and 65 female patients(53.6%vs 46.4%).The mean age was 45.4±14.6 years(range,2-85 years).Most of the patients had mild illness(n=114,81.4%)and 26 patients had severe illness(18.6%).The most common symptom was fever(n=110,78.6%),followed by cough(n=82,58.6%)and expectoration(n=51,36.4%).Eight patients were asymptomatic but were positive for severe acute respiratory syndrome coronavirus 2 RNA.Patients with severe illness were significantly more likely to be hypertensive than those with mild illness[(10/26,38.4%)vs(22/114,19.3%),P=0.036].The levels of lactate dehydrogenase were significantly higher in the severe illness group than in the mild illness group(299.35±68.82 vs 202.94±63.87,P<0.001).No patient died in either the severe illness or the mild illness group.CONCLUSION Hypertension and elevated levels of lactate dehydrogenase may be associated with severe illness of COVID-19.

摘要： Objectives:To determine the correlation between lymphocyte count and A-DROP score in COVID-19 patients and their role in predicting poor outcomes.Methods:This retrospective observational single-center study was conducted in a tertiary care hospital in Vidisha district,India.COVID-19 patients were included in this study,who were admitted to ICU and the COVID Care Centre from August 2020 to October 2020.Demographic profile,clinical characteristics,medical history,A-DROP score,complete blood counts including lymphocyte counts(on admission),the severity of the disease course,and duration of hospitalization were collected.The correlation between lymphopenia and A-DROP score was determined,and their role in predicting poor outcomes was investigated.Results:This study included 220 patients,among which 134 were male,and 86 were female[mean age(48.98±16.98)years,95%CI:46.72-51.23].Lymphocyte count in COVID-19 patients negatively correlated with the A-DROP score(r=-0.67,P<0.001).The area under the ROC curve was 0.892(95%CI:0.80-0.98,P<0.001)for the lymphocyte count,and the area under the ROC curve was 0.93(95%CI:0.84-1.00,P<0.001)for lymphocyte count-A-DROP.Conclusion:Lymphocyte count along with the A-DROP score on admission could be used to predict the severity of COVID-19 pneumonia and unfavorable outcome.