RESUMEN
BACKGROUND: The aim of this was to analyze 4 chest CT imaging features of patients with coronavirus disease 2019 (COVID-19) in Shenzhen, China so as to improve the diagnosis of COVID-19. METHODS: Chest CT of 34 patients with COVID-19 confirmed by the nucleic acid test (NAT) were retrospectively analyzed. Analyses were performed to investigate the pathological basis of four imaging features("feather sign","dandelion sign","pomegranate sign", and "rime sign") and to summarize the follow-up results. RESULTS: There were 22 patients (65.2%) with typical "feather sign"and 18 (52.9%) with "dandelion sign", while few patients had "pomegranate sign" and "rime sign". The "feather sign" and "dandelion sign" were composed of stripe or round ground-glass opacity (GGO), thickened blood vessels, and small-thickened interlobular septa. The "pomegranate sign" was characterized as follows: the increased range of GGO, the significant thickening of the interlobular septum, complicated with a small amount of punctate alveolar hemorrhage. The "rime sign" was characterized by numerous alveolar edemas. Microscopically, the wall thickening, small vascular proliferation, luminal stenosis, and occlusion, accompanied by interstitial infiltration of inflammatory cells, as well as numerous pulmonary interstitial fibrosis and partial hyaline degeneration were observed. Repeated chest CT revealed the mediastinal lymphadenectasis in one patient. Re-examination of the NAT showed another positive anal swab in two patients. CONCLUSION: "Feather sign" and "dandelion sign" were typical chest CT features in patients withCOVID-19; "pomegranate sign" was an atypical feature, and "rime sign" was a severe feature. In clinical work, accurate identification of various chest CT signs can help to improve the diagnostic accuracy of COVID-19 and reduce the misdiagnosis or missed diagnosis rate.
Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico por imagen , Pulmón/patología , Neumonía Viral/diagnóstico por imagen , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Adulto , Anciano , Betacoronavirus/genética , COVID-19 , China , Infecciones por Coronavirus/patología , Femenino , Humanos , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/patología , SARS-CoV-2 , Tomografía Computarizada por Rayos XRESUMEN
<p><b>OBJECTIVE</b>To investigate the effect of bicuculline, a selective GABAA receptor antagonist, on airway remodeling in the murine model of chronic allergen-induced asthma.</p><p><b>METHODS</b>Forty BALB/C mice were randomized into 4 groups, namely the control group, asthmatic model (induced by ovalbumin sensitization and challenge) group, budesonide inhalation group and bicuculline inhalation group. The mice were sacrificed 24 h after the last ovalbumin inhalation, and the lungs were lavaged with PBS and the total cells, eosinophils and lymphocytes counts were examined. Periodic acid-Schiff (PAS) staining was used for counting mucin-positive goblet cells in the lung tissue, and Masson Trichrome staining was used to evaluate collagen deposition. GABAARbeta2 and VEGF were quantified by immunohistochemistry.</p><p><b>RESULTS</b>The numbers of the total cells, eosinophils and lymphocytes counts in BALF were significantly greater in the bicuculline group than in the control and budesonide groups (P<0.01), but comparable to those in the asthmatic model group (P>0.05). The airway collagen deposition in the bicuculline group was comparable to that in the control and budesonide group (P>0.05), but was significantly less than that in the asthmatic model group (P<0.05). Significant differences were found in the airway histological mucus index between the bicuculline group and the other 3 groups (P<0.05). The airway GABAARbeta2-positive cell percentage in the bicuculline group was significantly greater that those in the control and budesonide (P<0.01 and 0.05), but similar with that in the asthmatic model group (P>0.05). The percentage of pulmonary perivascular VEGF-positive cells in the bicuculline group was significantly greater in the control and budesonide groups (P<0.01 and P<0.05), but comparable to that in the asthmatic model group (P>0.05).</p><p><b>CONCLUSION</b>GABAARbeta2 is expressed in both the airway epithelium and smooth muscles. Bicuculline inhalation can effectively suppress collagen deposition with a stronger inhibitory effect on mucus hypersecretion than budesonide.</p>