[Autophagy regulates multiple organ injury in obstructive sleep apnea and its related mechanisms]

Obstructive sleep apnea is a sleep-related hypoxia/reoxygenation syndrome that can lead to cardiovascular and cerebrovascular diseases, glucose and lipid metabolism, nervous system and even multiple organ damage, and is a serious threat to human health. Autophagy is a process by which eukaryotic cells rely on the lysosome pathway to degrade abnormal proteins and organelles, maintain homeostasis of intracellular environment and achieve self-renewal. Many studies have found that obstructive sleep apnea causes damage to myocardial, hippocampus, kidney and other organs, and its mechanism may be related to autophagy.

[Preliminary study of the relationship between novel coronavirus pneumonia and liver function damage: a multicenter study]

Objective: To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Methods: Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate. Results: 32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34 ~ 21.15) μmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31 ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) μmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) μmol/L, respectively. Conclusion: The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.

[The distribution characteristics of etiology of chronic cough in Lanzhou]

OBJECTIVE

To explore the distribution characteristics of etiology and clinical feature of chronic cough in Lanzhou.

METHODS

Based on the guidelines of the diagnostic process of chronic cough in China, data of medical history and physical examinations were collected, and chest X-ray, pulmonary function plus airway hyperresponsiveness, induced sputum eosinophils, sinus X-ray or CT, 24 h esophageal pH monitoring, chest high-resolution CT and bronchoscopy were performed accordingly for outpatients with chronic cough. The cause of chronic cough was identified by the test results and treatment response. The results were compared with those reported previously in other areas of China.

RESULTS

A total of 173 patients with completed data were collected, including 90 males and 83 females.The causes were as follows: 45 cases (26.01%) of cough variant asthma, 35 (20.23%) upper airway cough syndrome, 20 (11.56%) allergic cough, 17 (9.83%) chronic pharyngitis, 14 (8.09%) gastroesophageal reflux, 14 (8.09%)postinfectious, 13 (7.51%) eosinophilic bronchitis, 8 (4.62%) chronic bronchitis, 4 (2.31%) cough associated with ACEI, 3 (1.73%) bronchial tuberculosis, 2 (1.16%) pulmonary fibrosis and bronchiectasis repectively. The causes of the remaining 14 patients (8.09%)were unknown. The causes of chronic cough were identified in 159 patients (91.91%), of which 141 (88.68%) with a single cause and 18(11.32%)with more than 2 etiological factors.The percentage of cough variant asthma in our series was significantly higher than that reported in Guangzhou (13.6%, χ(2)=5.60, P=0.018, P<0.05), but lower than that reported in Shenyang (39.4%, χ(2)=7.91, P=0, 004, P<0.01). The percentage of allergic cough was higher than that reported in Beijing (3.3%, χ(2)=6.66, P=0.010, P<0.05), and that of eosinophilic bronchitis was lower than those reported in Guangzhou(22.4%, χ(2)=22.38, P=0.000, P<0.01) and Shenyang (12.5%, χ(2)=8.09, P=0.005, P<0.01). The percentage of esophageal reflux cough was lower than that reported in Beijing (20.3%, χ(2)=9.40, P=0.002, P<0.01) but higher than that reported in Shenyang (1.9%, χ(2)=3.98, P=0.036, P<0.05).

CONCLUSION

In Lanzhou, cough variant asthma, upper airway cough syndrome, allergic cough, chronic pharyngitis and gastroesophageal reflux were the main causes of chronic cough, and the etiological distribution was different from Guangzhou, Beijing, Shenyang and other areas.