The first case of 2019-nCoV pneumonia infection occurred in Wuhan, Hubei Province, South China Seafood Market in December 2019. As a group with a high probability of infection, health workers are faced with a certain degree of psychological challenges in the process of facing the epidemic. This study attempts to evaluate the impact of 2019-nCoV outbreak on the psychological state of Chinese health workers and to explore the influencing factors. During the period from 31 January 2020 to 4 February 2020, the ‘Questionnaire Star’ electronic questionnaire system was used to collect data. The 2019-nCoV impact questionnaire and The Impact of Event Scale (IES) were used to check the psychological status of health workers in China. A total of 442 valid data were collected in this study. Seventy-four (16.7%) male and 368 (83.3%) female individuals participated in this study. The average score of high arousal dimension was 5.15 (s.d. = 4.71), and the median score was 4.0 (IQR 2.0, 7.0). The average score of IES was 15.26 (s.d. = 11.23), and the median score was 13.5 (IQR 7.0, 21.0). Multiple regression analysis showed that there were critical statistical differences in high arousal scores among different gender groups (male 3.0 vs. female 5.0, P = 0.075). Whether being quarantined had significant statistical differences of IES scores (being quarantined 16.0 vs. not being quarantined 13.0, P = 0.021). The overall impact of the 2019-nCoV outbreak on health workers is at a mild level. Chinese health workers have good psychological coping ability in the face of public health emergencies.

Although persistent hepatitis B virus (HBV) infection is associated with natural killer (NK) cell dysfunction, it remains obscure whether HBV viral antigens are responsible for NK cell dysfunction in patients with chronic hepatitis B (CHB) infection. In this study, we found that the percentage of NK cells expressing the inhibitory receptor, NKG2A, was increased in CHB patients, and NKG2A blockade restored NK cell function. Furthermore, in CHB patients, the frequency of NK cells expressing NKG2A positively correlated with the number of regulatory T cells (Tregs) and production of interleukin-10 (IL-10) in these Tregs. Moreover, exposure of peripheral blood mononuclear cells (PBMCs) isolated from healthy controls to sera from CHB patients resulted in increased proportion of NKG2A⁺ NK cells; IL-10 blockade reduced the frequency of NKG2A⁺ NK cells while increasing the percentage of IFN-γ⁺ NK cells. In addition, stimulation of NK cells and Tregs from healthy controls with CHB sera together with anti-IL-10 antibody increased IFN-γ production in the culture supernatant. The frequencies of NKG2A⁺ NK cells and IL-10⁺ Tregs, along with serum levels of alanine transferase and HBV DNA, were significantly increased in CHB patients positive for the Hepatitis B e antigen (HBeAg, a marker of viral replication) when compared to HBeAg-negative CHB patients. Importantly, exposure of PBMCs from healthy controls to HBeAg resulted in increased IL-10 production but reduced levels of TNF and IFN-γ, and IL-10 blockade rescued the generation of TNF and IFN-γ in this assay. The reduced production of TNF and IFN-γ was also observed in NK cells and Tregs from healthy controls that were stimulated with HBeAg, while IL-10 blockade increased the secretion of these two cytokines. We conclude that HBeAg induces IL-10 production in Tregs, thereby leading to increased expression of NKG2A on NK cells, which contributes to NK cell dysfunction during CHB infection. These data suggest that HBeAg is associated with NK cell dysfunction in CHB.

Objective: To investigate the association of body mass index (BMI) with multivessel coronary artery disease in patients with myocardial infarction. Methods: This study was performed in 1566 patients with myocardial infarction in the Department of Cardiology, Affiliated Hospital of Jining Medical University, China. Independent and dependent variables were BMI measured at baseline and multivessel coronary artery disease, respectively. The covariates examined in this study were age, systolic blood pressure, diastolic blood pressure, heart rate, creatinine, uric acid, bilirubin, cholesterol, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, left ventricular ejection fraction, sex, heart failure, atrial fibrillation, chronic obstructive pulmonary disease, stroke, hypertension, diabetes mellitus, and smoking. Results: A nonlinear relationship was detected between BMI and multivessel coronary artery disease, and this was an inverted U-shaped curve and the cutoff point was 26.3 kg/m². The effect sizes and confidence intervals on the left and right sides of the inflection point were 1.10 (1.01–1.20) and 0.85 (0.74–0.97), respectively. Conclusions: There is an obesity paradox for BMI > 26.3 kg/m². Future studies should examine the relationship between BMI and prognosis in patients with myocardial infarction, which may be important for improving the prognosis through control of BMI.

Background. The risk of cognitive impairment in patients with atrial fibrillation is significantly increased. Its occurrence may be related to blood hypercoagulable state and immune inflammatory reaction. Platelets can mediate immune inflammatory response, but there is no evidence about the relationship between platelet count and cognitive function in patients with atrial fibrillation. Purpose. To explore whether there is a certain correlation between platelet count and cognitive function in patients with atrial fibrillation. Methods. A cross-sectional study was conducted in a single center in China, including 254 patients with atrial fibrillation. Cognitive function assessment and clinical and laboratory examinations were performed on all participants. After adjusting the related confounding factors, the relationship between platelet count and cognitive function was analyzed. Results. A total of 254 subjects with an average age of 59.71±11.14years were included. The average platelet count was 208.15±68.30, and the average score of cognitive function was 19.29±6.78. Result of fully adjusted binary logistic regression showed platelet count was negatively associated with the cognitive function score after adjusting confounders (hazard ratio (HR)=0.000, 95CI 0.01, 0.01). A nonlinear relationship was detected between platelet count and the cognitive function score, whose point was 230. The effect sizes and the confidence intervals of the left and right sides of the inflection point were 0.03 (0.010.05, P for nonlinearity=0.011) and 0.03 (0.050.00, P for nonlinearity=0.023), respectively. Conclusion. Platelets have a nonlinear relationship with cognitive function in patients with atrial fibrillation. This finding suggests that, in patients with atrial fibrillation, platelets should be maintained at about 230.

Background. Evidence regarding the relationship between body mass index (BMI) and cognitive function was limited. Therefore, the objective of this research is to investigate whether BMI is independently related to cognitive function in Chinese patients with atrial fibrillation after adjusting for other covariates. Methods. The present study is a cross-sectional study. A total of 281 patients with atrial fibrillation who were hospitalized at the Affiliated Hospital of Jining Medical University in Shandong Province from January 2021 to November 2021 were included in the study. The target independent variable and the dependent variable were BMI and cognitive function in patients with atrial fibrillation, respectively. The patients’ general information, BMI, past history, medication history, and other disease-related data were collected. The Montreal cognitive assessment scale (MoCA) was used to evaluate cognitive function. Results. A total of 244 patients with atrial fibrillation were collected in this study, with an average age of (67.28 ± 10.33) years, of whom 55.3% were male. The average BMI was (25.33 ± 4.27) kg/m², and the average cognitive function score was (19.25 ± 6.88) points. The results of the smooth curve fitting and threshold effect tests showed that there was a curve correlation between BMI and cognitive function score, and its inflection point was 24.56 kg/m². To the left of the inflection point, the relationship was significant; the effect size and the confidence interval were 0.43 and 0.01–0.85, respectively. To the right of the inflection point, there was no significant correlation between BMI and cognitive function ( ). Conclusion. When BMI is lower than 24.56 kg/m², the cognitive function score increases by 0.43 points for each unit increase in BMI in patients with atrial fibrillation. An increase in BMI at this time is a protective factor for cognitive function. Within the normal range of BMI, the higher the BMI in atrial fibrillation patients, the higher the cognitive function score. We encourage atrial fibrillation patients with normal BMI to maintain their current weight.

Background. Evidence regarding the relationship between body mass index (BMI) and 1-year unplanned readmission was limited. Therefore, the objective of this research is to investigate whether BMI was independently related to 1-year unplanned readmission in Chinese patients with acute myocardial infarction (AMI) after percutaneous transluminal coronary intervention (PCI) after adjusting for other covariates. Methods. The present study was a cohort study. A total of 214 participants with AMI after PCI were involved in a hospital in China from 1^st January 2017 to 1^st January 2018. The target independent variable and the dependent variable were BMI measured at baseline and 1-year unplanned readmission, respectively. Covariates involved in this study included age, gender, TC, triglyceride, HDL-C, LDL-C, PT, APTT, INR, creatinine, HGB, LVEF, discharge medication, marital status, educational level, COPD, diabetes mellitus, heart failure, history of ischemic stroke, history of hemorrhagic stroke, arrhythmia, and hypertension. Results. The average age of 172 selected participants was 60.2 ± 10.8 years old, and about 68.6% of them was male. The rate of readmission in patients with AMI was 26.14%. The result of fully adjusted binary logistic regression showed BMI was negatively associated with risk of readmission after adjusting confounders (hazard ratio (HR) = 1.1, 95% CI 0.93–1.29). Nonlinear relationship was detected between BMI and 1-year unplanned readmission, whose point was 29.3. The effect sizes and the confidence intervals of the left and right sides of inflection point were 0.9 (0.7–1.2, P for nonlinearity = 0.530) and 2.8 (1.3–5.8, P for nonlinearity = 0.008), respectively. Conclusion. BMI has a nonlinear relationship with 1-year unplanned readmission in patients with myocardial infarction. The 1-year unplanned readmission rate of overweight patients (BMI > 29.3 kg/m²) has increased significantly. Obesity paradox does not exist in terms of readmission of Chinese patients with myocardial infarction after PCI.