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Objective To investigate neutrophil lymphocyte ratio (NLR) in early-stage diabetic nephropathy and its clinic significance. Methods The 145 subjects were divided into two groups: the healthy control group (n=54) and early stage diabetic nephropathy group (n=91). The numbers of neutrophils (N) and lymphocytes (L) as well as the NLR values of peripheral blood and other biochemistry index were examined. Factors of early stage diabetic nephropathy were calculated using variance and logistic regression analysis. Results Creatinine(Cr), total cholesterol(TC), triglyceride(TG), LDL-C, neutrophils number and CRP in DN group were significantly higher than those of the control group and lymphocytes numbers of DN group were significantly lower than that of the control group (P < 0.05 respectively); NLR values were significantly higher in diabetic nephropathy group compared with those of healthy control group (2.52±0.57 vs 1.82±0.60, t=6.997, P < 0.01). Logistic regression analysis showed that the risk factors of DN include NLR, TG and total cholesterol. NLR (P <0.001, OR=8.951, OR 95% CI: 3.595-22.287) was significantly associated with DN. Conclusion High NLR values may be a predictive and reliable marker of early-stage DN. [ABSTRACT FROM AUTHOR]

Objective: To assess the predictors and outcomes of acute kidney injury (AKI) among patients with coronavirus disease 2019 (COVID-19)., Objective: This retrospective observational study was conducted among patients with a confirmed diagnosis of COVID-19 admitted to Hankou Hospital between January, 5 and March 8, 2020. We evaluated the association of AKI with the demographic and biochemical parameters and clinical outcomes of the patients using univariate regression analysis., Objective: Atotal of 287 COVID-19 patients, including 55 with AKI and 232 without AKI, were included in the analysis. Compared with the patients without AKI, the patients with AKI were older, predominantly male, and were more likely to have hypoxia and pre-existing hypertension and cerebrovascular diseases. The patients with AKI also had higher levels of white blood cells, D-dimer, aspartate aminotransferase, total bilirubin, creatine kinase, lactate dehydrogenase, procalcitonin, C-reactive protein, a higher prevalence of hyperkalemia, lower lymphocyte counts, and higher chest computed tomographic scores. The incidence of stage 1 AKI was 14.3% and that of stage 2 or 3 AKI was 4.9%. The patients with AKI had much higher mortality rate than those without AKI., Objective: AKI is an important complication of COVID-19. An older age, a male gender, multiple pre- existing comorbidities, lymphopenia, increased infection indicators, elevated D-dimer, and impaired heart and liver functions are all potential risk factors ofAKI. COVID- 19 patients with AKI that progresses into stages 2 or 3 AKI have a high mortality rate. Prevention of AKI and monitoring kidney function is critical in the care of COVID-19 patients.

Objective: To explore the clinical characteristics and outcomes of adult critically ill patients with COVID-19 and identify the risk factors correlated with in-hospital deaths., Methods: This study was conducted among 20 confirmed adult cases of COVID-19 in the Intensive Care Unit (ICU) of Honghu People's Hospital in Jingzhou City, Hubei Province. According to the final outcome, the patients were divided into survivor group and death group with 10 patients each. The demographic data, clinical manifestations and signs, laboratory findings, treatment measures and clinical outcomes were obtained from electronic medical records to compare the clinical characteristics and outcomes between the two groups. Univariate logistic analysis was used to analyze the risk factors associated with in-hospital death., Results: The mean age of patients with confirmed COVID-19 was 70 ± 12 years, and 40% of them were male. The patients were admitted to ICU 11 ± 9 days after symptom onset. The most common symptoms on admission were cough (19 cases), fatigue or myalgia (18 cases), fever (17 cases) and dyspnea (16 cases). Eleven (55%) of the patients had underlying diseases, among which hypertension was the most common (11 cases), followed by cardiovascular disease (4 cases) and diabetes (3 cases). Six (30%) of the patients received invasive mechanical ventilation and continued renal replacement therapy but eventually died. Acute cardiac injury was the most common complication (19 cases). Half of the patients died between the 2nd and 19th day after ICU admission. Compared with dead patients, the surviving patients had a lower average body weight (61.70±2.36 vs 68.60±7.15 kg, P =0.01) and a higher Glasgow Coma Index (14.69 ± 0.70 vs 12.70 ± 2.45, P =0.03), and were less likely to develop shock (2 vs 10, P =0.001) or acute respiratory distress syndrome (2 vs 10, P =0.001)., Conclusions: Critically ill patients with COVID-19 are generally older. A higher body weight and a lower lymphocyte count are potentially associated with a greater likeliness of fatality in ICU patients with COVID-19.

We review the experience with the diagnosis and treatment of secondary cerebral infarction in an elderly patient with coronavirus disease 2019 (COVID-19). COVID-19 has rapid disease progression with a high mortality rate in elderly patients, and physicians should be alert to secondary bacterial infection that may result in coagulation dysfunction and cerebral infarction. Early anti-infection therapy, immune regulation and appropriate anticoagulation intervention may help improve the prognosis of the patients.

Objective: Sepsis, life-threatening organ dysfunction caused by a dysregulated host response to infection, is a major public health concern. To date, the mechanism of sepsis is not completely understood, which is still a huge task ahead of numerous clinical and laboratory researchers. Recently, increasing evidences show that deacetylase sirtuins play an important role in sepsis and the function of sirtuins are varied in different stages of sepsis. More importantly, the mechanism of sirutins is not fully understood. The sirtuins family is composed by sirtuin 1-7 members. Among them, sirtuin 1 is widely reported. In addition to sirtuin 1, other members of sirtuins are also involved in the regulation of inflammation or metabolism signaling following sepsis. Of note, the sirtuins may interact with each other and form a precious control mechanism. Herein, we tried to summarize the recent paper from PubMed, to explain the possible mechanism of distinct role of sirtuin 1/2, to generalize the downstream effects of sirtuin 3 action, and to describe the interactions among sirtuins members on sepsis, which might be helpful for our future research and potential clinical applications.