Background: Since mid-December 2019, a cluster of pneumonia-like diseases caused by a novel coronavirus, now designated COVID-19 by the WHO, emerged in Wuhan city and rapidly spread throughout China. Here we identify the clinical characteristics of COVID-19 in a cohort of patients in Shanghai. Methods: Cases were confirmed by real-time RT-PCR and were analysed for demographic, clinical, laboratory and radiological features. Results: Of 198 patients, the median duration from disease onset to hospital admission was 4 days. The mean age of the patients was 50.1 years, and 51.0% patients were male. The most common symptom was fever. Less than half of the patients presented with respiratory systems including cough, sputum production, itchy or sore throat, shortness of breath, and chest congestion. 5.6% patients had diarrhoea. On admission, T lymphocytes were decreased in 45.8% patients. Ground glass opacity was the most common radiological finding on chest computed tomography. 9.6% were admitted to the ICU because of the development of organ dysfunction. Compared with patients not treated in ICU, patients treated in the ICU were older, had longer waiting time to admission, fever over 38.5° C, dyspnoea, reduced T lymphocytes, elevated neutrophils and organ failure. Conclusions: In this single centre cohort of COVID-19 patients, the most common symptom was fever, and the most common laboratory abnormality was decreased blood T cell counts. Older age, male, fever over 38.5°C, symptoms of dyspnoea, and underlying comorbidity, were the risk factors most associated with severity of disease.

Objective: This study aimed to elucidate the mechanisms underlying the protective effects of Zhenxin Formula (ZXF) against doxorubicin (Dox)-induced HF through the integration of network pharmacology, phospho-antibody array analysis, and experimental validation. Methods: The active components and potential targets of ZXF were identified via the Traditional Chinese Medicine Systems Pharmacology (TCMSP) platform, while HF-associated target genes were retrieved from the OMIM, Genecards, and TTD databases. Protein-protein interaction (PPI) networks and compound-disease target networks were constructed using Cytoscape 3.7.2, with functional annotations performed through GO enrichment and KEGG pathway analyses using R software. Experimental validation involved the establishment of a Dox-induced HF model via intraperitoneal injection, with ZXF’s therapeutic effects evaluated using cardiac ultrasound, morphological staining, and Western blot analysis. Additionally, a phospho-antibody array was utilized to screen over 300 molecules across 16 canonical signaling pathways in ZXF-treated HF models, with Western blot analysis confirming the specific pathways implicated in ZXF’s therapeutic effects. Results: Network pharmacology analysis identified 56 potential active ingredients in ZXF, 47 of which were associated with HF-related targets. AKT1 emerged as the target most strongly correlated with HF improvement. In vivo, ZXF significantly enhanced cardiac function and mitigated myocardial fibrosis and cardiomyocyte apoptosis. Phospho-antibody array analysis revealed that 16 phosphorylated proteins were upregulated and 3 downregulated in the Dox-treated group. ZXF intervention resulted in the upregulation of 10 phosphorylated proteins and downregulation of 5. Comparative analysis highlighted PDK1-Phospho and FOXO1/3/4-Phospho as pivotal phosphorylated proteins mediating ZXF’s cardioprotective effects. Western blot analysis confirmed that ZXF enhanced phosphorylation levels of PI3K, PDK1, AKT, and FOXO1 in the Dox-induced HF model. Conclusion: This study, employing network pharmacology, phospho-antibody array analysis, and experimental validation, demonstrates that ZXF ameliorates cardiac dysfunction and suppresses myocardial apoptosis in Dox-induced HF through modulation of the PI3K/PDK1/AKT/FOXO1 signaling pathway.

Objective: The objective of this study was to systematically identify and evaluate scoring systems that predict the prognosis of patients with sepsis-induced myocardial injury (SIMI).Methods: Data were retrieved from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Logistic and Cox regression analyses were conducted to identify risk factors associated with 28-day mortality in patients with sepsis-induced myocardial injury (SIMI). The prognostic performance of the scoring systems was comprehensively assessed using receiver operating characteristic (ROC) curves, Kaplan-Meier survival and decision curve analysis (DCA).Results: Logistic regression analysis showed that Acute Physiology Score III (APSIII) (Odds Ratio [OR] =1.011, 95% Confidence Interval [CI] 1.002–1.018, P=0.005), Sequential Organ Failure Assessment (SOFA) (OR =1.097, 95% CI 1.045–1.144, P<0.001), and Charlson Comorbidity Index (CHARLSON) (OR=1.095, 95% CI 1.048–1.145, P=0.036) were independent risk factors for 28-day mortality in SIMI patients. Cox regression analysis confirmed that SOFA (HR=1.082, 95% CI 1.054– 1.111, P<0.001), APSIII (HR=1.010, 95% CI 1.005–1.015, P<0.001), and CHARLSON (HR=1.044, 95% CI 1.012–1.077, P=0.007) were independent risk factors. ROC curve analysis showed that SOFA (AUC=0.685, 95% CI 0.663–0.707) and APSIII (AUC=0.683, 95% CI 0.662–0.705) had significantly higher AUC values compared to other scoring systems. DCA results showed that APSIII and SOFA had better net benefit than other scoring systems.Conclusions: The SOFA and APSIII scores effectively identified high-risk patients with SIMI, providing evidence-based support for early clinical intervention.

Background:Coronavirus disease (COVID-19) seriously endangers global public health. Pupingqinghua prescription (PPQH) is an herbal formula from traditional Chinese medicine used for treatment of SARS-CoV-2 infection. This study aims to evaluate the clinical efficacy and safety of PPQH in Chinese participants infected with the SARS-CoV-2 Omicron variant.Methods:A total of 873 SARS-CoV-2 (Omicron)-infected patients were included. Among them, the patients were divided into the PPQH group (653 cases) and LHQW group (220 cases) according to different medications. The effectiveness indicators (hematological indicators, Ct values of novel Coronavirus nucleic acid tests, and viral load-shedding time) and safety indicators (liver and kidney function and adverse events) were analyzed.Results:There was no significant difference in baseline characteristics between the PPQH group and the LHQW group, except the gender; After the treatment, the levels of IL-5, IL-6, IL-10, NK cells, and INF-α of the patients in the PPQH group showed a downward trend (p< 0.05); The viral load shedding time was 5.0 (5.0, 7.0) in the PPQH group and 5.0 (4.0, 7.0) in the LHQW group; both PPQH and LHQW can shorten the duration of symptoms of fever, cough, and sore throat. The re-positive rate of COVID-19 test was 1.5 % in the PPQH group and 2.3 % in the LHQW group. In terms of safety, the levels of γ-GTT decreased significantly (p< 0.01); gastrointestinal reaction was the primary adverse reaction, and the reaction rate was 4.7 % in the PPQH group and 9.5 % in the LHQW group.Conclusion:PPQH can shorten the length of hospital stay and improve clinical symptoms of patients with SARS-COV-2 (Omicron), and it also has a good safety profile.

Although remnant cholesterol has been associated with cardiovascular disease, the risk of remnant cholesterol and blood pressure remains unclear. This study aimed to investigate the association between remnant cholesterol and new-onset hypertension. We used middle-aged and older adults aged ≥ 45 years from the first three waves of the China Health and Retirement Longitudinal Study (CHARLS). Estimated remnant cholesterol was calculated as total cholesterol minus high-density lipoprotein cholesterol minus low-density lipoprotein cholesterol. Multiple linear regression analysis and Cox proportional hazards modeling were used to assess the association between remnant cholesterol levels and blood pressure levels and new-onset hypertensive events, respectively. Nonlinear associations were assessed using restricted cubic spline models. A total of 3,044 participants were included, and 839 new-onset hypertensive events (76.5 events per 1000 person-years) were documented during a median follow-up period of 4.0 years. After adjustment for age, sex, lifestyle factors, and other cardiovascular risk factors, compared with participants with normal-range (< 31 mg/dl), those with significantly elevated (≥ 46 mg/dl) remnant cholesterol had elevated systolic blood pressure by 2.36 (95% confidence interval [95% CI]: 0.55, 4.17) mmHg and diastolic blood pressure by 1.66 mmHg (95% CI: 0.47, 2.84), and the risk of new-onset hypertension was 28% higher (hazard ratio [HR]: 1.28; 95% CI: 1.03, 1.59), with no significant association observed in the mildly elevated group (31–46 mg/dl). This association showed similar results in different subgroups. Elevated remnant cholesterol is significantly associated with blood pressure levels and risk of new-onset hypertension, suggesting that remnant cholesterol might be a potential therapeutic target for hypertension prevention.