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BackgroundIn January 19, 2020, first case of 2019 novel coronavirus (2019-nCoV) pneumonia (COVID-19) was confirmed in Chongqing municipality, China. MethodsIn this retrospective, descriptive, multiple-center study, total of 267 patients with COVID-19 confirmed by real-time RT-PCR in Chongqing from Jan 19 to Feb 16, 2020 were recruited. Epidemiological, demographic, clinical, radiological characteristics, laboratory examinations, and treatment regimens were collected on admission. Clinical outcomes were followed up until Feb 16, 2020. Results267 laboratory-confirmed COVID-19 patients admitted to 3 designated-hospitals in Chongqing provincial municipality from January 19 to February 16, 2020 were enrolled and categorized on admission. 217 (81.27%) and 50 (18.73%) patients were categorized into non-severe and severe subgroups, respectively. The median age of patients was 48.0 years (IQR, 35.0-65.0), with 129 (48.3%) of the patients were more than 50 years of age. 149 (55.8%) patients were men. Severe patients were significantly older (median age, 71.5 years [IQR, 65.8-77.0] vs 43.0 years [IQR, 32.5-57.0]) and more likely to be male (110 [50.7%] vs 39 [78.0%]) and have coexisting disorders (15 [30.0%] vs 26 [12.0%]). 41 (15.4%) patients had a recent travel to Hubei province, and 139 (52.1%) patients had a history of contact with patients from Hubei. On admission, the most common symptoms of COVID-19 were fever 225(84.3%), fatigue (208 [77.9%]), dry cough (189 [70.8%]), myalgia or arthralgia (136 [50.9%]). Severe patients were more likely to present dyspnea (17 [34.0%] vs 26 [12.0%]) and confusion (10 [20.0%] vs 15 [6.9%]). Rales (32 [12.0%]) and wheezes (20 [7.5%]) are not common noted for COVID-19 patients, especially for the non-severe (11 [5.1%], 10 [4.6%]). 118 (44.2%). Most severe patients demonstrated more laboratory abnormalities. 231 (86.5%), 61 (22.8%) patients had lymphopenia, leukopenia and thrombocytopenia, respectively. CD4+T cell counts decrease was observed in 77.1 % of cases, especially in the severe patients (45, 100%). 53.1% patients had decreased CD+3 T cell counts, count of CD8+T cells was lower than the normal range in part of patients (34.4%). More severe patients had lower level of CD4+ T cells and CD+3 T cells (45 [100.0%] vs 29[56.9%], 31 [68.9%] vs 20 [39.2%]). Most patients had normal level of IL-2, IL-4, TNF- and INF-{gamma}, while high level of IL-6 and IL-17A was common in COVID-19 patients (47 [70.1%], 35 [52.2%]). Level of IL-6, IL-17A and TNF- was remarkably elevated in severe patients (32 [84.2%] vs 15 [51.7%], 25 [65.8%] vs 10 [34.5%], 17 [44.7%] vs 5 [17.2%]). All patients received antiviral therapy (267, 100%). A portion of severe patients (38, 76.0%) received systemic corticosteroid therapy. Invasive mechanical ventilation in prone position, non-invasive mechanical ventilation, high-flow nasal cannula oxygen therapy was adopted only in severe patients with respiratory failure (5[10.0%], 35[70.0%], 12[24.0%]). Traditional Chinese medicine was adopted to most of severe patients (43,86.0%). ConclusionOur study firstly demonstrated the regional disparity of COVID-19 in Chongqing municipality and further thoroughly compared the differences between severe and non-severe patients. The 28-day mortality of COVID-19 patients from 3 designed hospitals of Chongqing is 1.5%, lower than that of Hubei province and mainland China including Hubei province. However, the 28-mortality of severe patients was relatively high, with much higher when complications occurred. Notably, the 28-mortality of critically severe patients complicated with severe ARDS is considerably as high as 44.4%. Therefore, early diagnosis and intensive care of critically severe COVID-19 cases, especially those combined with ARDS, will be considerably essential to reduce mortality.

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<p><b>OBJECTIVE</b>To investigate the protective effect of rutin against acute lung injury induced by lipopolysaccharide (LPS).</p><p><b>METHODS</b>Thirty C57BL/6 mice were randomly divided into control group, LPS-induced acute lung injury model group and treatment (LPS+Rutin) group. The pathological changes of the lung tissue were observed microscopically on paraffin sections with HE staining, and the lung wet/dry weight ratio was measured. The levels of TNF-α and IL-1β in the bronchoalveolar lavage fluid (BALF) were measured with ELISA, and the expressions of α-ENaC were detected with RT-PCR and Western blotting.</p><p><b>RESULTS</b>Pathological examination of the lung tissue revealed distinct inflammation, congestion and edema in the model group. The mice in the treatment group showed significantly milder lung injuries than those in the model group. Compared with the control group, the model group showed significantly increased lung wet/dry ratio and contents of TNF-α and IL-1β in BALF but lowered expressions of α-ENaC mRNA and protein. Compared with the model group, rutin treatment significantly decreased the lung wet/dry ratio and TNF-α and IL-1β levels in the BALF and increased the expressions of α-ENaC mRNA and protein.</p><p><b>CONCLUSION</b>Rutin can inhibit the pulmonary inflammation and increase the expression of alveolar epithelial sodium channel protein to alleviate LPS-induced acute lung injury in mice.</p>

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Objective To review the effect of non-invasive bi-level positive airway pressure ventilation combined with naloxone in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pulmonary encephalopathy (PE).Methods Related published studies involving BiPAP combined with naloxone in the treatment of AECOPD complicated with PE were recruited and identified from Pubmed,ISI Web of knowledge,CBM Disc,CNKI,Wanfang Data,and randomized controlled trails(RCTs) primarily collected were screened according to inclusive criteria and exclusive criteria.Valid data were extracted after quality evaluation for meta-analysis utilizing RevMan 5.2.Results A total of 10 Chinese RCTs were enrolled,including 697 patients (353 patients in experimental group while 343 patients in control group).The results of metaanalysis indicated that BiPAP combined with naloxone improved PaO2 (WMD =4.10,95％ CI (2.83,5.38),P＜0.00001),PH value(WMD =0.04,95％ CI (0.02,0.05),P ＜ 0.00001) and clinical efficiency rate (OR =3.58,95 ％ CI ((2.22,5.76),P ＜ 0.00001),and reduced PaCO2 (WMD =-5.78,95 ％ CI (-6.87,4.69),P ＜ 0.00001),re-endotracheal intubation rate (OR =0.19,95 ％ CI (0.11,0.35),P ＜ 0.00001),but failed to decrease mortality(OR =0.38,95％ CI (0.11,1.34),P =0.13) of patients with AECOPD complicated with PE.Conclusions BiPAP combined with naloxone play a protective role in enhancing arterial blood gas indexes,improving clinical efficiency rate and limiting re-endotracheal intubation rate.However,the mortality of patients cannot be reduced.