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Weather Variability,Socioeconomic Factors,and pneumonia in Children Under Five-Years Old——Bangladesh,2012−2016

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China CDC weekly 2021年第29期3卷 620-623,I0001,I0002页

作者： Mohammad Zahid Hossain Shilu Tong Hilary Bambrick Md Alfazal Khan Wenbiao Hu School of Public Health and Social Work Institute of Health and Biomedical InnovationQueensland University of TechnologyBrisbaneQueenslandAustralia Infectious Diseases Division International Centre for Diarrhoeal Disease ResearchBangladeshMohakhaliDhakaBangladesh Shanghai Children’s Medical Centre School of MedicineShanghai Jiao Tong UniversityShanghaiChina School of Public Health Institute of Environment and Population HealthAnhui Medical UniversityHefeiAnhuiChina Center for Global Health School of Public HealthNanjing Medical UniversityNanjingJiangsuChina Health System and Population Studies Division International Centre for Diarrhoeal Disease ResearchBangladeshMohakhaliDhakaBangladesh

Summary What is already known on this topic?Different socioecological factors were associated with childhood pneumonia in Bangladesh.However,previous studies did not assess spatial patterns,and socioecological factors and spatial variation have the potential to improve the accuracy and predictive ability of existing models.What is added by this report?

关键词： pneumonia Bangladesh ecological

Reduning plus ribavirin display synergistic activity against severe pneumonia induced by H1N1 influenza A virus in mice

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Journal of Traditional Chinese Medicine 2020年第5期40卷 803-811页

作者： Chen Weitao Ma Yuexia Zhang Hong Guo Yali Guan Mengyue Wang Yuguang Department of Respiratory Medicine Beijing Hospital of Traditional Chinese MedicineCapital Medical UniversityBeijing 100010China Department of Respiratory Medicine Fangshan HospitalBeijing University of Chinese MedicineBeijing 102400China Department of Internal Medicine Fangshan HospitalBeijing University of Chinese MedicineBeijing 102400China

OBJECTIVE:To investigate synergistic effect of Reduning(RDN)injection plus ribavirin against severe pneumonia induced by H1 N1 influenza A virus in mice.METHODS:We established a mouse model of severe pneumonia induced by influenza A virus by infecting Balb/c mice with CA07 virus.We randomly assigned the infected mice into four groups,and treated them with normal saline(NS group),RDN(injection,86.6 mg/kg),ribavirin(injection,66.6 mg/kg)or double Ribavirin plus RDN group,the same dosage as used in the single treatments)for 5 d.Lung index and lung pathology were recorded or calculated in terms of the curative effective.Cytokines,NOD-like receptor family pyrin domain containing 3(NLRP3)inflammasome related protein including caspase-associated recruitment domain(CARD)domain Apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),caspase-1 and NOD-like receptor family,pyrin domain containing 3(NLRP3),and reactive oxygen species were simultaneously investigated.RESULTS:RDN plus ribavirin treatment,not RDN or ribavirin alone,provided a significant survival benefit to the influenza A virus-infected mice.The combination treatment protected the mice against severe influenza infection by attenuating the severe lung injury.The combined treatment also reduced the viral titers in mouse lungs and lung index,downregulated their immunocytokine levels,including IL-1βand IL-18,and down regulated the NLRP3,especially the transcription and translation of caspase-1.Meanwhile NS group had significantly higher reactive oxygen species(ROS)expression which could was dramatically reduced by the treatment of RDN plus ribavirin.CONCLUSION:Our study showed that RDN combined with ribavirin could protect the mice,and reduce the lung immunopathologic damage caused by severe influenza pneumonia.The mechanism could be that it reduced ROS produce and inhibited NLRP3 inflammasome activation so that mainly lower the downstream inflammatory cytokines IL-1βand IL-18.

关键词： Influenza A Virus,H1N1 Subtype pneumonia NLR Family,Pyrin domain-containing 3 protein Inflammasomes Ribavirin Reduning

Ultrasonic Characteristics and Severity Assessment of Lung Ultrasound in COVID-19 pneumonia:A Retrospective,Observational Study

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Engineering 2021年第3期7卷 367-375页

作者： Fengxue Zhu Xiujuan Zhao Tianbing Wang Zhenzhou Wang Fuzheng Guo Haiyan Xue Panpan Chang Hansheng Liang Wentao Ni Yaxin Wang Lei Chen Baoguo Jiang Trauma Center Citical Care Medicine DepartmentPeking University People's HospitalBeijing 100044China Trauma Center Key Laboratory of Trauna and Neurad Regeneration(Peling Univerity)Minisiry of EducationPeking Universty Peole's Hiospital lejing 100044China Anesthesioogy Department Peking Uhniversity People's HospitalBeijing 100044China Respiratory and Griticnl Care Medicine Depariment Peking Lniversity People's HospitalBeiing 10004China Raiology Deparment Peking University People's HospitalBeijing 100044China

The clinical application of lung ultrasound(LS)in the assessment of coronavirus disease 2019(COVID-19)pneumonia severity remains limited,Herein,we investigated the role of LUS imaging in CoVID-19pneumonia patients and the relationship between LUS findings and disease severity.This was a retro-spective,observational study at Tongji Hospital,on 48 recruited patients with COVID-19 pneu-monia,including 32 non-critically ill patients and 16critically ill patients.LUS was performed and the respiratory rate oxygenation(ROX)index,disease severity,and confusion,blood urea nitrogen,respira-tory rate,blood pressure,and age(CURB-65)score were recorded on days 0-7,8-14,and 15-21 after symptomonset.Lung images were divided into 12 regions,and the luS score(0-36 points)was calcu-lated.hestcomputed tomography(CT)scores(0-20 points)were also recorded on days O-7.Coelations between the LUS score,ROX index,and CURB-65 scores were examined.LUS detected COVID-19 pneumonia in 38patients.LUS signs included B lines(34/38,89.5%),consolidations(6/38,15.8%),and pleural effusions(2/38,5.3%).Most cases showed more than one lesion(32/38,84.2%)and involved both lungs(28/38,73.7%).Compared with non-critically ill patients,the LUS scores of critically ill patients were higher(12(10-18)vs 2(0-5),p<0.001).The LUS score showed significant negative cor-relations with the ROX indexon days O-7(r=-0.85,p<0.001),days 8-14(r=-0.71,p<0.001),and days 15-21(r=-0.76,p<0.001)after symptom onset.However,the LUS score was positively correlated with the CT score(r=0.82,p<0.001).The number of patients with LUS-detected lesions decreased from 27 cases(81.8%)to 20 cases(46.5%),and the lus scores significantly decreased from 4(2-10)to 0(0-5),(p<0.001) from days O-7 to 17-21.We conclude that LUS can detect lunglesions in COVID-19 pneumo-nia patients in a portable,real-time,and safe manner.Thus,LUS is helpful in assessing COVID-19 pneu-monia severity in critically ill patients.

关键词： Coronavirus disease 2019 Lung ultrasound pneumonia

Evaluating the Health Risks of pneumonia from Airborne Bacterial Communities Using 16S rDNA Sequences of pneumonia-related Pathogens

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Biomedical and Environmental Sciences 2021年第4期34卷 265-271页

作者： GUO Jian Guo KONG Qi LIU Ce KANG Tai Sheng QIN Chuan NHC Key Laboratory of Human Disease Comparative Medicine Institute of Laboratory Animal SciencesCAMS&PUMCBeijing 100021China Key Laboratory of Human Diseases Animal Model State Administration of Traditional Chinese MedicineBeijing 100021China Department of Infectious Disease Beijing Chuiyangliu Hospital affiliated to Tsinghua UniversityBeijing 100022China

Objective Airborne microbial communities include a significant number of uncultured and poorly characterized bacteria.No effective method currently exists to evaluate the health risks of such complex bacterial populations,particularly for pneumonia.Methods We developed a method to evaluate risks from airborne microorganisms,guided by the principle that closer evolutionary relationships reflect similar biological characteristics,and thus used16 S rDNA sequences of 10 common pneumonia-related bacterial pathogens.We calculated a risk of breath-related(Rbr)index of airborne bacterial communities and verified effectiveness with artificial flora and a clinical project.Results We suggested applying Rbr80 to evaluate the health risks of airborne bacterial communities that comprise 80% of dominant operational taxonomic units(OTUs).The feasibility of Rbr80 was confirmed by artificial flora and by pneumonia data from a hospital.A high Rbr80 value indicated a high risk of pneumonia from airborne bacterial communities.Conclusion Rbr80 is an effective index to evaluate the pneumonia-associated risk from airborne bacteria.Values of Rbr80 greater than 15.40 are considered high risk.

关键词： Airborne bacteria The risk of breath related index(Rbr) pneumonia Health risk

A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV) infected pneumonia(standard version)

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Military Medical Research 2020年第1期7卷 1-22页

作者： Ying-Hui Jin Lin Cai Zhen-Shun Cheng Hong Cheng Tong Deng Yi-Pin Fan Cheng Fang Di Huang Lu-Qi Huang Qiao Huang Yong Han Bo Hu Fen Hu Bing-Hui Li Yi-Rong Li Ke Liang Li-Kai Lin Li-Sha Luo Jing Ma Lin-Lu Ma Zhi-Yong Peng Yun-Bao Pan Zhen-Yu Pan Xue-Qun Ren Hui-Min Sun Ying Wang Yun-Yun Wang Hong Weng Chao-Jie Wei Dong-Fang Wu Jian Xia Yong Xiong Hai-Bo Xu Xiao-Mei Yao Yu-Feng Yuan Tai-Sheng Ye Xiao-Chun Zhang Ying-Wen Zhang Yin-Gao Zhang Hua-Min Zhang Yan Zhao Ming-Juan Zhao Hao Zi Xian-Tao Zeng Yong-Yan Wang Xing-Huan Wang 无 Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Institute of Hospital Management Wuhan UniversityWuhan 430071China Department of Respiratory Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Pharmacy Zhongnan Hospital of Wuhan UniversityWuhan 430071China Institute of Evidence-Based Medicine and Knowledge Translation Henan UniversityKaifeng 475000China China Academy of Chinese Medical Sciences Beijing 100700China China Center for Evidence Based Traditional Chinese Medicine(CCEBTCM) Beijing 100700China Department of Critical Care Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Clinical Laboratory Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Infectious Diseases Zhongnan Hospital of Wuhan UniversityWuhan 430071China Division of Medical Affairs Zhongnan Hospital of Wuhan UniversityWuhan 430071China Division of Nursing Affairs Zhongnan Hospital of Wuhan UniversityWuhan 430071China Office of Nosocomial Infection Control Zhongnan Hospital of Wuhan UniversityWuhan 430071China Emergency Center Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Radiology Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Health Research Methods Evidenceand ImpactMcMaster UniversityHamiltonON L8S 4L8Canada Department of Traditional Chinese Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Global Health Institute Wuhan UniversityWuhan 430072China the Zhongnan Hospital of Wuhan University Novel Coronavirus Management and Research Team Evidence-Based Medicine Chapter of China International Exchange and Promotive Association for Medical and Health Care(CPAM)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

关键词： 2019 novel coronavirus 2019-nCoV Respiratory disease pneumonia Infectious diseases Rapid advice guideline Clinical practice guideline Evidence-based medicine

Etiology and antimicrobial resistance of community-acquired pneumonia in adult patients in China

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Chinese Medical Journal 2012年第17期125卷 2967-2972页

作者： TAO Li-li HU Bi-jie HE Li-xian WEI Li XIE Hong-mei WANG Bao-qing LI Hua-ying CHEN Xue-hua ZHOU Chun-mei DENG Wei-wu Department of Respiratory Medicine Zhongshan Hospital Fudan University Shanghai 200032. China Department of Respiratory Medicine Taishan Medical University Affiliated Hospital Taian Shandong 271000 China Department of Respiratory Medicine Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200025 China

Background Appropriate antimicrobial therapy of community-acquired pneumonia （CAP） is mainly based on the distribution of etiology and antimicrobial resistance of major pathogens. We performed a prospective observational study of adult with CAP in 36 hospitals in China. Methods Etiological pathogens were isolated in each of the centers, and all of the isolated pathogens were sent to Zhongshan Hospital for antimicrobial susceptibility tests using agar dilution. Results A total of 593 patients were enrolled in this study, and 242 strains of bacteria were isolated from 225 patients. Streptococcus pneumoniae （79/242, 32.6%） was the most frequently isolated pathogen, followed by Haemophilus influenzae （55/242, 22.7%） and Klebsiella pneumoniae （25/242, 10.3%）. Totally 527 patients underwent serological tests for atypical pathogens; Mycoplasma pneumoniae and Chlamydia pneumoniae infections were identified in 205 （38.9%） and 60 （11.4%） patients respectively. Legionella pneumophila infections were identified in 4.0% （13/324） of patients. The non-susceptibility rate of isolated Streptococcus pneumoniae to erythromycin and penicillin was 63.2% and 19.1% respectively. Six patients died from the disease, the 30-day mortality rate was 1.1% （6/533）. Conclusions The top three bacteria responsible for CAP in Chinese adults were Streptococcus pneumonia, Haemophilus influenza and Klebsiella pneumonia. There was also a high prevalence of atypical pathogens and mixed pathogens. The resistance rates of the major isolated pathogens were relatively low except for the high prevalence of macrolide resistance in Streptococcus pneumoniae.

关键词： community-acquired infection pneumonia etiology antimicrobial drug resistance epidemiology

Identification of a novel coronavirus causing severe pneumonia in human:a descriptive study

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Chinese Medical Journal 2020年第9期133卷 1015-1024页

作者： Li-Li Ren Ye-Ming Wang Zhi-Qiang Wu Zi-Chun Xiang Li Guo Teng Xu Yong-Zhong Jiang Yan Xiong Yong-Jun Li Xing-Wang Li Hui Li Guo-Hui Fan Xiao-Ying Gu Yan Xiao Hong Gao Jiu-Yang Xu Fan Yang Xin-Ming Wang Chao Wu Lan Chen Yi-Wei Liu Bo Liu Jian Yang Xiao-Rui Wang Jie Dong Li Li Chao-Lin Huang Jian-Ping Zhao Yi Hu Zhen-Shun Cheng Un-Lin Liu Zhao-Hui Qian Chuan Qin Qi Jin Bin Cao Jian-Wei Wang National Health Commission of the People’s Republic of China Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory Institute of Pathogen BiologyChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Pulmonary and Critical Care Medicine Center of Respiratory MedicineNational Clinical Research Center for Respiratory DiseasesChina-Japan Friendship HospitalBeijing 100029China Institute of Respiratory Medicine Chinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100029China National Health Commission of the People’s Republic of China Key Laboratory of Systems Biology of Pathogens Institute of Pathogen BiologyChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Vision Medicals Co. LtdGuangzhouGuangdong 510000China Hubei Provincial Center for Disease Control and Prevention WuhanHubei 430079China Wuhan Center for Disease Control and Prevention WuhanHubei 430022China Clinical and Research Center of Infectious Diseases Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Institute of Clinical Medical Sciences China-Japan Friendship HospitalBeijing 100029China Institute of Laboratory Animal Science Chinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100021China Department of Basic Medical Sciences Tsinghua University School of MedicineBeijing 100084China Wuhan Jinyintan Hospital WuhanHubei 430022China Department of Pulmonary and Critical Care Medicine Tongji HospitalTongji Medical CollegeHuazhong University of Sciences and TechnologyWuhanHubei 430030China Department of Pulmonary and Critical Care Medicine The Central Hospital of WuhanTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430014China Department of Respiratory Medicine Zhongnan Hospital of Wuhan UniversityWuhanHubei 430071China

Background:Human infections with zoonotic coronaviruses(CoVs),including severe acute respiratory syndrome(SARS)-CoV and Middle East respiratory syndrome(MERS)-CoV,have raised great public health concern globally.Here,we report a novel batorigin CoV causing severe and fatal pneumonia in humans.Methods:We collected clinical data and bronchoalveolar lavage(BAL)specimens from five patients with severe pneumonia from Wuhan Jinyintan Hospital,Hubei province,China.Nucleic acids of the BAL were extracted and subjected to next-generation sequencing.Virus isolation was carried out,and maximum-likelihood phylogenetic trees were constructed.Results:Five patients hospitalized from December 18 to December 29,2019 presented with fever,cough,and dyspnea accompanied by complications of acute respiratory distress syndrome.Chest radiography revealed diffuse opacities and consolidation.One of these patients died.Sequence results revealed the presence of a previously unknownβ-CoV strain in all five patients,with 99.8%to 99.9%nucleotide identities among the isolates.These isolates showed 79.0%nucleotide identity with the sequence of SARS-CoV(GenBank NC_004718)and 51.8%identity with the sequence of MERS-CoV(GenBank NC_019843).The virus is phylogenetically closest to a bat SARS-like CoV(SL-ZC45,GenBank MG772933)with 87.6%to 87.7%nucleotide identity,but is in a separate clade.Moreover,these viruses have a single intact open reading frame gene 8,as a further indicator of bat-origin CoVs.However,the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV,indicating that these viruses might use the same receptor.Conclusion:A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.

关键词： Bat-origin Coronavirus Zoonotic transmission pneumonia Etiology Next-generation sequencing

Clinical characteristics and prognosis of community-acquired pneumonia in autoimmune disease-induced

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World Journal of Emergency Medicine 2020年第3期11卷 145-151页

作者： Zhong-shu Kuang Yi-lin Yang Wei Wei Jian-li Wang Xiang-yu Long Ke-yong Li Chao-yang Tong Zhan Sun Zhen-ju Song Department of Emergency Medicine Zhongshan HospitalFudan UniversityShanghai 200032China Department of Pharmacology University of Virginia School of Medicine CharlottesvilleVirginiaUSA

BACKGROUND:Community-acquired pneumonia(CAP)in autoimmune diseases(AID)-induced immunocompromised host(ICH)had a high incidence and poor prognosis.However,only a few studies had determined the clinical characteristics of these patients.Our study was to explore the characteristics and predictors of mortality in CAP patients accompanied with AID-induced ICH.METHODS:From 2013 to 2018,a total of 94 CAP patients accompanied with AID-induced ICH,admitted to Emergency Department of Zhongshan Hospital,Fudan University,were enrolled in this study.Clinical data and the risk regression estimates of repeated predictors were evaluated by generalized estimating equations(GEEs)analysis.An open-cohort approach was used to classify patient's outcomes into the survival or non-survival group.RESULTS:The hospital mortality of patients with CAP occurring in AID-induced ICH was 60.64%.No significant differences were found with respect to clinical symptoms and lung images between survival and non-survival groups,while renal insufficiency and dysfunction of coagulation had higher proportions in non-survival patients(P<0.05).Both noninvasive ventilation(NIV)and invasive mechanical ventilation(IMV)were performed more frequently in non-survival group(P<0.05).By the multivariate GEEs analysis,the repeated measured longitudinal indices of neutrophilto-lymphocyte ratio(NLR)(odds ratio[OR]=1.055,95%confidence interval[95%CI]1.025–1.086),lactate dehydrogenase(LDH)(OR=1.004,95%CI 1.002–1.006)and serum creatinine(s Cr)(OR=1.018,95%CI 1.008–1.028),were associated with a higher risk of mortality.CONCLUSION:The CAP patients in AID-induced ICH had a high mortality.A significant relationship was demonstrated between the factors of NLR,LDH,s Cr and mortality risk in these patients.

关键词： Community-acquired pneumonia Immunocompromised hosts Autoimmune disease Prognostic marker

Analysis of clinical efficacy of different initial antimicrobial treatment in healthcare associated pneumonia patients in emergency department

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Chinese Medical Journal 2014年第10期127卷 1814-1819页

作者： Cao Guohui Chen Xuyan Wu Sheng Department of Emergency Medicine Peking University First Hospital Beijing 100034 China

Background Community acquired pneumonia （CAP） is one of the most common infectious disease in emergency department.In 2005 the concept of healthcare associated pneumonia （HCAP） was proposed by the ATS/IDSA guidelines.The clinical features and microbiology of HCAP are different from CAP,however,the initial antimicrobial treatment is still controversial.We aimed to compare the clinical efficacy between HCAP patients treated initially with HCAP guidelineconcordant antimicrobial agents and those with CAP guideline-concordant antimicrobial agents.Methods We conducted a retrospective observational study on HCAP patients who were admitted to emergency department between December 2011 and December 2012.Patients were divided into 2 groups according to their different initial antimicrobial treatment.We compared clinical features,distribution of pathogen,severity,days and spending on intravenous antimicrobial,length and charge of hospitalization and clinical outcomes,and meanwhile analyzed the clinical efficacy as well.Results Of the 125 HCAP patients,55 patients received CAP guideline-concordant antimicrobial agents and 70 received HCAP agents.The major pathogens were Klebsiella pneumoniae,methicillin-resistant staphylococcus aureus （MRSA）,Pseudomonas aeruginosa and Escherichia coll The 2 groups were similar at baseline,including old age,comorbidities,pneumonia Severity Index scores,APACHE scores,and length of intravenous antimicrobial use and hospitalization duration,and in-hospital mortality.Overall efficacy rate occurred in 70.0％ of HCAP agent patients and 50.9％ of CAP agent patients （P=0.029）.Antimicrobial charge and total hospital charge for HCAP agent patients were significantly higher than that for CAP agent patients.Conclusions Initial treatment of HCAP patients in emergency department with HCAP guideline-concordant antimicrobial could increase clinical efficacy rate,as well as antimicrobial charge and total hospital charge,but was not associated with shortening the length of stay,or lowering in-hospital mortality.

关键词： pneumonia health care drug resistance treatment efficacy