This study was to evaluate the prognostic value of the Naples prognostic score (NPS) in adult patients with asthma. Data on 44 601 participants from the 1999–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. The NPS was calculated based on serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR), and participants were divided into 3 groups. Self-administered questionnaires were used to collect information on asthma, and mortality was identified using the National Death Index through December 31, 2019. Multiple logistic regressions were used to analyze the relationship between NPS and its components and the prevalence of asthma. Kaplan-Meier survival analysis, Cox proportional regressions, and the random survival forest (RSF) were used to assess the significance of NPS and its components in predicting all-cause and cause-specific (cardiovascular, cancer, and respiratory diseases) mortality in asthma patients. The mean age of the participants was 47.59 ± 0.18 years, and 48.47% were male. The prevalence of asthma was 13.11%. The participants were categorized into 3 groups: 8306 (18.6%) participants were in group 0 (NPS 0), 30 842 (69.2%) were in group 1 (NPS 1 or 2), and 5453 (11.2%) were in group 2 (NPS 3 or 4). Compared to the reference group, participants in group 2 had a higher prevalence of asthma (odds ratio [OR] = 1.40 [1.24–1.56]). Participants with asthma in group 2 had a significantly increased risk of all-cause mortality (hazard ratio [HR] = 2.42 [1.67–3.50]), cardiovascular mortality (HR = 2.68 [1.50–4.79]), cancer mortality (HR = 2.10 [1.00–4.45]), and respiratory disease mortality (HR = 3.00 [1.18–7.65]) compared to those with asthma in group 0. The RSF showed that NPS had the highest value in predicting all-cause mortality in adults with asthma, compared to its components. The results of this study indicate that the NPS is a powerful prognostic indicator for outcomes in asthma patients.

Objective: The aim of the present study was to explore the diagnostic value and safety of color Doppler ultrasound (US)-guided transthoracic core needle biopsy (CNB) of peripheral lung, chest wall and mediastinal lesions using automated biopsy guns. Materials and methods: We analyzed clinical and image data, histopathologic and microbiologic details and complications from 121 patients with peripheral lung, chest wall and mediastinal lesions who underwent color Doppler US-guided transthoracic CNB in Ningbo First Hospital between January 2015 and June 2018. Results: Color Doppler US-guided transthoracic CNB performed with a freehand technique using automated biopsy guns had a sensitivity of 93.94%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 78.57%, and a diagnostic accuracy of 95.04%. Lesion size did not affect the diagnostic rate (P=0.40). No serious complications of the procedure were noted. Conclusion: Color Doppler US-guided transthoracic CNB of peripheral lung, chest wall and mediastinal lesions is a safe and inexpensive procedure. The diagnostic accuracy of color Doppler US-guided transthoracic CNB was higher than that of color Doppler US-guided transthoracic fine needle aspiration biopsy (FNAB).

Cotinine, the primary metabolite of nicotine, can be utilized as a marker for active smoking and as an indicator of exposure to secondhand smoke. However, the direct relationship between dietary flavonoid intake and serum cotinine levels remains a subject of ongoing investigation. In this study, we utilized data from the National Health and Nutrition Examination Survey (NHANES) 2007–2010 and 2017–2018 to assess the association between dietary flavonoid intake and serum cotinine levels in adults through multiple linear regression analysis. A weighted quantile sum (WQS) regression model was used to assess the association of the mixture of six dietary flavonoids with serum cotinine levels in adults, which could represent the overall effect of the mixture of six dietary flavonoids. We also conducted stratified analyses by smoke status to explore multiple linear regression associations between different flavonoid intake and serum cotinine levels. A total of 14,962 adults were included in the study. Compared to the group with the lowest dietary flavonoid intake, total flavonoid intake in the second (β = −0.29 [−0.44, −0.14]), third (β = −0.41 [−0.58, −0.24]), and highest groups (β = −0.32 [−0.49, −0.16]) was inversely related to the levels of serum cotinine after adjusting the full model. An RCS model showed that when the total dietary flavonoid intake was less than 99.61 mg/day, there was a negative linear association between dietary flavonoid intake and the serum cotinine. The WQS regression model also showed that the intake of a mixture of six dietary flavonoids was significantly negatively correlated with serum cotinine levels (β = −0.54 [−0.61, −0.46], p <0.01), with anthocyanins having the greatest effect (weights = 32.30%). Our findings imply a significant correlation between dietary flavonoid intake and serum cotinine levels among adults. The consumption of a combination of six dietary flavonoids was consistently linked to lower serum cotinine levels, with anthocyanins displaying the most pronounced impact.

Summary: Background: Starting from early December 2019, cases of human infection with a novel coronavirus were identified in Wuhan, Hubei Province, China. It spreads rapidly to other cities and numerous countries. This study was performed to investigate clinical features of patients with severe SARS-CoV-2 pneumonia and identify risk factors for converting to severe cases in those who had mild to moderate diseases. Methods: In this retrospective, multicenter cohort study, patients with mild to moderate SARS-CoV-2 pneumonia were included from Ningbo First Hospital and Jingzhou Central Hospital. Demographic data, symptoms, laboratory values, comorbidities, and clinical outcomes were collected. Data were compared between non-severe and severe patients. Logistic regression analysis was performed to assess risk factors in predicting the patients with SARS-CoV-2 pneumonia who would convert to severe cases. Findings: 120 patients (36 from Ningbo First Hospital and 84 from Jingzhou Central Hospital) were included in this study, among which 62 were excluded and 58 were included in the final analysis. Compared with non-severe cases, severe patients with SARS-CoV-2 pneumonia had a longer: time to clinical recovery (12.9±4.4 vs 8.3±4.7; p=0.0011), duration of viral shedding (15.7±6.7 vs 11.8±5.0; p=0.0183), and hospital stay (20.7±1.2 vs 14.4±4.3; p=0.0211). Multivariate logistic regression indicated that lymphocyte count was significantly associated with the rate of converting to severe cases (odds ratio 1.28, 95%CI 1.06–1.54, per 0.1×10 ⁹ /L reduced; p=0.007), while using of low-to-moderate doses of systematic corticosteroids was associated with reduced likelihood of converting to a severe case (odds ratio 0.14, 95%CI 0.02–0.80; p=0.0275). Interpretation: The low peripheral blood lymphocyte count was an independent risk factor for SARS-CoV-2 pneumonia patients converting to severe cases. This finding may help clinicians more accurately predict prognosis, and triage priorities to improve clinical outcomes. Research in context: Evidence before this study: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) is a novel coronavirus that have emerged in early December 2019, and has caused a novel coronavirus disease (COVID-19). It has been deemed as a public health emergency of global concern by The World Health Organization (WHO). We searched PubMed for articles published up to March 11, 2020, using the search terms (“novel coronavirus” OR “SARS-CoV-2” OR “COVID-19”) with no language or time restrictions. Previous work has described clinical characteristics of critically ill and non-critically ill patients with COVID-19. However, no published works have focused on clinical features of patients with severe SARS-CoV-2 pneumonia and identify risk factors for converting to severe cases in those who had mild to moderate diseases. Added value of this study: In this retrospective and multicenter cohort study, we reported demographics characteristics, baseline symptoms, laboratory findings, corticosteroid usage and hospital course of patients with non-severe COVID-19 and severe COVID-19. Comparing with non-severe patients, severe patients with COVID-19 was found to have a longer: time to clinical recovery (12.9±4.4 vs 8.3±4.7; p=0.0011), duration of viral shedding (15.7±6.7 vs 11.8±5.0; p=0.0183), and hospital stay (20.7±1.2 vs 14.4±4.3; p=0.0211). By multivariate logistic regression, we found increasing odds of converting to severe cases associated with lower lymphocyte count (odds ratio 1.28, 95%CI 1.06–1.54, per 0.1×10 ⁹ /L reduced; p=0.007). Using of low-to-moderate doses of systematic corticosteroids was associated with reduced likelihood of converting to a severe case (odds ratio 0.14, 95%CI 0.02–0.80; p=0.0275). Implications of all the available evidence: Low lymphocyte count in peripheral blood was an independent risk factor for patients who converted to severe cases. In addition, using of systematic corticosteroids in mild to moderate patients with SARS-CoV-2 pneumonia was associated with a reduced risk of converting to severe cases. These findings may help clinicians predict prognosis more accurately, and triage priorities to improve clinical outcomes. Further prospective studies are warranted to confirm these findings.

Asthma is a chronic inflammatory airway disease imposing a substantial global health burden. NLRP3 is an immune sensor involved in infection and cellular stress responses. Recent studies suggest that NLRP3 may be involved in the pathogenesis of asthma. We hypothesized that genetic variation in NLRP3 may contribute to asthma susceptibility. However, the causal relationship between NLRP3 and asthma still remains unclear. In this study, bioinformatics analysis using asthma data and R software was performed to identify NLRP3 -related genes. We performed weighted gene co-expression network analysis to identify co-expressed genes, resulting in 12 candidate genes. Kyoto Encyclopedia of Genes and Genomes and Gene Ontology enrichment analyses were used to identify the functions of these candidate genes, revealing their involvement in cellular metabolism. Mendelian randomization analysis of the 12 candidate genes identified 2 biomarkers: NLRP3 and TNFAIP8L2 (TIPE2 ). We validated their diagnostic value for asthma using the GSE182503 dataset, with area under the curve values of 0.83 and 0.66 for NLRP3 and TIPE2 , respectively. This project discusses how NLRP3 promotes asthma pathogenesis, whereas TIPE2 may alleviate it, and explores the potential interplay between them. NLRP3 and TIPE2 may serve as diagnostic biomarkers for asthma: NLRP3 may promote, whereas TIPE2 may alleviate asthma development. Both genes represent potential diagnostic biomarkers and therapeutic targets that warrant further functional investigation.