Suchergebnisse

Rong Jiang,1 Cheng Wu,2 Bigyan Pudasaini,1 Lan Wang,1 Qin-Hua Zhao,1 Rui Zhang,1 Wen-Hui Wu,1 Ping Yuan,1 Zhi-Cheng Jing,1 Jin-Ming Liu1 1Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 2Department of Health Statistics, Second Military Medical University, Shanghai, People's Republic of China Background: Severe pulmonary hypertension (PH) resulting from a chronic lung disease (CLD) (severe CLD-PH) requires more aggressive treatment due to its increased mortality compared with mild PH. Therefore, we developed a Doppler echocardiography scoring index (ESI) to predict severe CLD-PH.Methods: A derivation cohort of 107 patients with CLD who underwent echocardiography was classified into two groups, the normal/mild PH group and the severe PH group, based on the right heart catheterization. Meanwhile, we designed the ESI by multivariate logistic regression to validate the predicted outcomes. The ESI was calculated using the following formula: ESI = ESIRVEDTD + ESIPASP + ESIPAd - ESITAPSE. Additionally, the ESI was weighted by +2 points for right ventricular end-diastolic transverse dimension ≥3.8 cm or pulmonary artery diameter ≥2.7 cm, +3 points for systolic pulmonary artery pressure (PASP) ≥61 mmHg, and -3 points for tricuspid annular plane systolic excursion ≥1.65 cm.Results: In the derivation cohort, PASP ≥61 mmHg estimated by echocardiography exhibited 80.4% sensitivity and 84.3% specificity with area under receiver-operating characteristic curve of 0.823 (95% CI: 0.797–0.942, P<0.0001). Compared with PASP, ESI ≥1.0 exhibited 91.1% sensitivity and 80.4% specificity, resulting in a net improvement in model performance with a change in the c-statistic from 0.823 to 0.937 and an integrated discrimination improvement of 11.3% (95% CI: 4.5%–18.2%, P=0.001). The ESI was applied to the validation cohort, resulting in 84.2% sensitivity and 81.3% specificity with 82.9% accuracy. Conclusion: The ESI showed high capacity for predicting severe CLD-PH, further implying the value of noninvasive examinations in clinic. Keywords: pulmonary hypertension, echocardiography, hemodynamics, right heart catheterization, chronic lung disease

One of the essential aspects in analyzing the topic of managing people's risk behavior in extreme situations is related to the issue of risk perception. The subject of this study was to reveal whether certain factors, such as cultural context, gender, age, education, religious beliefs, etc., mediate the perceived risk during the COVID-19 pandemic. The study was conducted online from April to June 2020. The two samples included a total of 2617 participants aged between 18 and 70 years, where 1412 of which were drawn from Asia and 1205 were representatives of Europe. Participants were asked to complete an internet-based version of a short questionnaire that described the COVID-19 pandemic situation, as one of the questions referred to the hazard perception of the infection. Results obtained showed that there was a higher level of perceived risk among members of the Asian culture group in comparison with the European study participants. Furthermore, it was revealed that gender is not a significant factor in the perception of risk in either the European or the Asian cultural group (p> 0.05). The results showed that levels of the perceived risk increased with age and that there were significant differences between young and old in threat perception for the European sample (p<0.001). Regarding the Asian sample, it turned out that all age groups perceive the risk of infection almost equally. Several demographic characteristics also emerged as important mediators of risk perception. For example, people with the lowest education, married, religious, and families with children fear the hazard of COVID-19 infection to the greatest extent, compared to people with the highest education, singles, atheists, and families without children, who do not perceive the virus as a high-risk factor.

PURPOSE: Blast lung injury (BLI) is the most common damage resulted from explosion-derived shock wave in military, terrorism and industrial accidents. However, the molecular mechanisms underlying BLI induced by shock wave are still unclear. METHODS: In this study, a goat BLI model was established by a fuel air explosive power. The key genes involved in were identified. The goats of the experimental group were fixed on the edge of the explosion cloud, while the goats of the control group were 3 km far away from the explosive environment. After successful modeling for 24 h, all the goats were sacrificed and the lung tissue was harvested for histopathological observation and RNA sequencing. Gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) analysis were performed to identify the main enriched biological functions of differentially expressed genes (DEGs). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to verify the consistency of gene expression. RESULTS: Of the sampled goat lungs, 895 genes were identified to be significantly differentially expressed, and they were involved in 52 significantly enriched GO categories. KEGG analysis revealed that DEGs were highly enriched in 26 pathways, such as cytokine-cytokine receptor interaction, antifolate resistance, arachidonic acid metabolism, amoebiasis and bile secretion, JAK-STAT, and IL-17 signaling pathway. Furthermore, 15 key DEGs involved in the biological processes of BLI were confirmed by qRT-PCR, and the results were consistent with RNA sequencing. CONCLUSION: Gene expression profiling provide a better understanding of the molecular mechanisms of BLI, which will help to set strategy for treating lung injury and preventing secondary lung injury induced by shock wave.