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Feng-Feng Zhu,1,* Bin-Bin Gu,1,* Yu-Jia Jin,2,* Lin Yao,3 Lin Zhou,3 Di Zou,1 Jian Ding,1 Teng Zhou,1 Xing-Hua Shen,1 Cheng Chen2 1Intensive Care Unit, The Fifth People’s Hospital of Suzhou, The Affiliated Infectious Disease Hospital of Soochow University, Suzhou, 215000, People’s Republic of China; 2Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Soochow University, Suzhou, 215000, People’s Republic of China; 3Department of Pulmonary, The Fifth People’s Hospital of Suzhou, The Affiliated Infectious Disease Hospital of Soochow University, Suzhou, 215000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xing-Hua Shen, Soochow University Affiliated Infectious Disease Hospital, 10 Guangqian Road, Suzhou, 215000, People’s Republic of China, Tel +8613606217315, Email shenxinghua2010@163.com Cheng Chen, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215000, People’s Republic of China, Tel +8613771775292, Email chencheng@suda.edu.cnPurpose: Recently, the SARS-CoV-2 Omicron variant was identified as responsible for a novel wave of COVID-19 worldwide. We perform a retrospective study to identify potential risk factors contributing to radiological progression in the COVID-19 patients due to the Omicron variant infection. These findings would provide guiding information for making clinical decisions that could improve the Omicron infection prognosis and reduce disease-related death.Methods: This is a retrospective cohort study from a single center in China. According to the radiological change within admissive one week, enrolled cases were divided into two groups: the progressive (1w-PD) and the stable or improved disease (1w-non-PD). Separate analyses were performed on patients stratified into subgroups using the Mann–Whitney U-test, the Fisher exact test, or the Chi-squared test and a multivariable logistic regression analysis.Results: Both the 1w-non-PD and 1w-PD cohorts displayed comparable asymptomatic infection, have similar underlying disease, impairment in respiratory function, coagulation dysfunction, tissue injury, SARS-CoV-2 viral load, and disease severity. However, the 1w-PD cohort was more inclined to cluster in populations presented with age between 41 and 65, higher CURB-65 scores, undetectable SARS-CoV-2 IgG, and lung affection. Based on the multiple logistic regression analysis, complicated bilateral and ground-glass opacities (GGOs) like pneumonia at admission were independent risk factors to radiological progression within admissive one week.Conclusion: This study provided preliminary data regarding disease progression in Omicron-infected patients that indicated the development of pneumonia in the context of Omicron infection was worthy of potential risk factors.Keywords: COVID-19, Omicron, pneumonia, radiology, risk

Objective To analyze the influence of personality factors on mental health and its mediating variables in the support officers and soldiers of a certain navy air force unit. Methods A total of 1311 participants from the support officers and soldiers of a certain navy air force unit were selected. Cattell's 16 Personality Factors Questionnaire (16PF), Automatic Thoughts Questionnaire (ATQ), Military General Information Questionnaire designed by authors, Zung's Self-rating Anxiety Scale (SAS), Zung's Self-rating Depression Scale (SDS) and Self-Rating Scale of Sleep (SRSS) were used to assess the personality factors, automatic thoughts, general events and mental health level respectively. And structural equation model was used to analyze the mediating effect of automatic thoughts and general events between the personality factors and mental health, and the significance of mediating effect was tested with Bootstrap method. Results The participants' average rough scores of SAS were (29.72±6.26), and 6.10% of the subjects (80/1311) were anxious (standard score of SAS≥50); while the average standard scores of SDS were (38.83±10.76), 11.21% (147/1311) of the subjects were depressive (standard score of SDS≥53); and the average scores of SRSS were (19.59±5.81). There is a significant correlation between the subjects' adaptation and anxiety type, mental health factors and ATQ total score, general evaluation total score and SDS, SAS, SRSS score (P0.05), which indicated that general events and automatic thoughts totally mediated the relationship between the personality factors and mental health. While for indirect effects of mental health personality factors model, the 95%CI was (–0.307-–0.217, P

The coronavirus disease 2019 (COVID-19) has been a worldwide pandemic diseases, nearly 400,000 people died at now. The data of status of pregnant women and neonates after infection of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is limited. We report a case of pregnant woman in her third trimester with critical COVID-19, and amniotic fluid, umbilical cord blood, placenta, and neonatal gastric fluid were retained during cesarean section. The SARS-COV-2 nucleic acid test results of these specimens were negative. There is no evidence of intrauterine vertical transmission during delivery in the third trimester, but the data are limited and need to be further explored.

Background: Depression is associated with declining duty performance, suicide and other serious problems in the army. Prolonged deployment at high altitude may result in depression among military personnel. The present study aimed to investigate the prevalence of depression among Chinese military plateau drivers and determine the associated factors.Methods: The participants were military drivers selected from Golmud motor transport base (high altitude group) and Fuzhou motor transport base (low altitude group). All participants were asked to complete a self-administrated questionnaire. The questionnaire included demographic and working characteristics, the Self Rating Depression Scale (SDS), the 14-item Fatigue Scale (FS-14), the Global Assessment of Migraine Severity (GAMS), the numeric rating scale (NRS) for dyspnea, and item three of the Patient Health Questionnaire-9-item (PHQ-9) for screening sleep disturbance.Results: A total of 400 questionnaires were distributed (200 for each group); 400 questionnaires were collected (the response rate was 100%). After eliminating 16 invalid questionnaires, 194 plateau drivers and 190 lowland drivers provided valid response (96.0%). In comparison to lowland drivers, the plateau drivers had severer fatigue (t = 4.298, p < 0.001), severer migraine (t = 11.440, p < 0.001), severer breathlessness (t = 12.094, p < 0.001), severer sleep disturbance (t = 3.353, p = 0.001), and higher prevalence of depression symptoms (χ2 = 15.123, p < 0.001). The possibility of having depression symptoms was significantly higher among military plateau drivers who were suffering severer fatigue (OR = 1.14, 95% CI: 1.01-1.29), migraine (OR = 1.83, 95% CI: 1.13-2.95), breathlessness (OR = 1.69, 95% CI: 1.04-1.73), and sleep disturbance (OR = 1.78, 95% CI: 1.03-3.07).Conclusion: Prevalence of depression was high among Chinese military plateau drivers. The risk factors were fatigue, severity of migraine, severity of breathlessness, and poor sleep quality. It is essential to become aware of these risk factors and their causes to intervene and help prevention of depression among Chinese military plateau drivers.

Background: Job burnout among military personnel is associated with many negative consequence including depression, various forms of job withdrawal, and poor job performance. The present study aimed to investigate how chronic exposure to HA, fatigue, and deployment duration may influence burnout among Chinese military personnel. Methods: Military plateau drivers at Golmud (average altitude: 2,890m) as high altitude group (N = 194) and military drivers at Fuzhou (average altitude: 84m) as low altitude group (N = 190) completed the self-administrated questionnaires. Path analysis with ordinary least squares regression procedures were used to test the mediating effect of fatigue and moderating effect of deployment duration.Results: A simple mediation from altitude to burnout through fatigue was supported by the results. Military personnel at high altitude experienced severer fatigue than those at low altitude (B = 1.215, t = 4.303, p < 0.001), and fatigue in turn caused greater job burnout (B = 0.347, t = 6.132, p < 0.001). The mediating effect of fatigue was significant (M = 0.421, Boot LLCI = 0.207, Boot ULCI = 0.668) and explained 15.21% of the total effect of altitude on burnout. However, the moderating effects of deployment duration were not supported in the present study. Conclusion: The problem of job burnout among military personnel on the plateau may be diminished by relieving their mental and physical fatigue induced by chronic exposure to high altitude and increasing the number of vacation days away from plateau.

Background:Psychomotor functions are necessary for Chinese military plateau motor vehicle operators (PMVOs) to complete their driving tasks. This study aimed to investigate (1) the influence of chronic exposure to high altitude (HA) on psychomotor functions among PMVOs; (2) whether deployment duration at HA moderated the effect of HA.Methods: 196 male PMVOs in Golmud (average altitude: 2,890 m) and 192 male lowland motor vehicle operators (LMVOs) were recruited as the studygroup (HA group) and control group (LA group). Both groups were in turn categorized into 3 groups by deployment duration: Group A (less than 1 year), Group B (between 1 year and 2 years), and Group C (more than 2 years). All participants completed simple reaction time, bimanual coordination test, fine motor dexterity test, and eye-hand coordination test. Between-altitude and deployment duration differences were explored usinganalysis of variance (ANOVA).Results: HA group participants had slower simple reaction time in comparison to LA group (F(1, 387) = 18.041, p< 0.001, ηp2 = 0.045).HA group needed less time to complete the bimanual coordination test (F(1, 387) = 2295.648, p< 0.001, ηp2 = 0.857). HA group had more error times in fine motor dexterity test (F(1, 387) = 5.980, p = 0.015, ηp2 = 0.015). HA group participants had better left aim index (F(1, 387) = 13.205, p< 0.001, ηp2 = 0.033) and more right hits (F(1, 387) = 3.916, p = 0.049, ηp2 = 0.010) in aiming test. The interaction effect of altitude and duration was significant on hit number with left hand in the tapping test (F(2, 387) = 3.327, p = 0.037, ηp2 = 0.017). Butsimple effect analysis showed that the effect of duration was not significant among HA group (p = 0.129).Conclusions: In this study, we found that prolonged exposure to HA may cause psychomotor slowing and declining fine motor dexterity. But, the moderating effect of deployment duration was not supported by this study.

Accumulating evidence demonstrates that CD8+CD28- regulatory T cells increase in chronic viral infection as well as tumorigenesis. However, it is still not clear about their characteristics in hepatitis B virus (HBV) infection. In addition, it is not understood whether this regulatory immune subset is distinct from CD4+CD25high regulatory T cells in the aspect of impact on or relationship to the progression of HBV infection. Hence, we investigated their dynamics and compared their correlations with clinical parameters in the chronic and advanced phases of HBV infection. The data showed that compared with healthy controls, the frequencies of CD28+CD8- and CD4+CD25high T cells increased in both chronic and advanced phases, while there is no significant difference between the two case groups. Interestingly, we found that in chronic phase, the frequency of CD8+CD28- subset was negatively correlated with the levels of alanine aminotransaminase (ALT) and aspartate aminotransferase (AST), respectively, and did not present association with HBV DNA load, whereas that of CD4+CD25high T cells was positively correlated with HBV DNA load and the levels of ALT and AST, respectively. Amazingly, in advanced phase, the frequency of CD4+CD25high T cells was negatively correlated with HBV DNA load and the levels of ALT, respectively, while there is no significant correlation between the frequency of CD8+CD28- subset and those clinical parameters. Thereby, our findings demonstrated that CD28+CD8- and CD4+CD25high regulatory T cells might exert distinct effect on modulating antiviral immune responses and mitigate immunomediated liver damage in different phases of HBV infection, which represent potential prognostic markers and therapeutic targets for HBV-infected patients based on further exploration of detailed mechanism.

Background The outbreak of COVID-19 has caused ever-increasing attention and public panic all over the world. Until now, data are limited about the risk factors to virus shedding in COVID-19 infected patients. Methods In this retrospective study, data were collected from 87 patients hospitalized with COVID-19 infection in Suzhou. Using Cox proportional hazards regression and Kaplan-Meier survival analysis, the risk factors to COVID-19 RNA shedding was to be established according to demographic information, clinical characteristics, epidemiological history, antiviral medicine and corticosteroid administration. Results The median duration of COVID-19 RNA shedding from admission was 13.11 ± 0.76 days. There was no significant difference in viral shedding duration in terms of gender, age, history of Hubei province stay, characteristics of chest CT on admission, lymphocytopenia and clinical severity. By Cox proportional hazards model, excessive 200 mg cumulative corticosteroid (HR, 3.425 [95% CI, 1.339–7.143]), time from illness onset to hospitalization (

Accumulating evidence demonstrates that CD8

The aim of this study was to investigate whether norepinephrine (NE) could regulate macrophage production of tumor necrosis factor alpha (TNF-α) by influencing the phosphorylation of mitogen-activated protein kinases (MAPKs). Primary macrophages from male BALB/c mice were applied to explore the mechanism by which NE influences the the secretion of TNF-α when macrophages were activated by lipopolysaccharides (LPS). We found that NE could increase crophage production of TNF-α when macrophages were activated by LPS, and this effect could be inhibited by α adrenergic antagonist phentolamine. Also, NE could increase the phosphorylation of c-Jun N-terminal kinase (JNK), extracellular signal-regulated kinases (ERK), and p38, through α receptor. Furthermore, JNK inhibitor SP600125, ERK inhibitor U0126, and p38 inhibitor SB203580 could all partially counteract NE's effect on the phosphorylation of MAPKs, as well as TNF-α production by macrophages. This study revealed that as macrophages were activated by LPS, NE promoted the secretion of inflammatory factors by increasing the phosphorylation of MAPKs through an α receptor-dependent pathway. Our results provide the evidence of a relationship between stress and diseases, as well as the mechanism by which stress induces or affects the inflammation-related diseases.

Using the high spatial resolution (2.5 m) color-infrared aerial photos acquired in 1989, 1994, 2000 and 2005, this paper analyzed the spatiotemporal characteristics of rapid urban expansion in central Shanghai with urban expansion intensity index and gradient analysis. Results showed that urban land use in Shanghai increased rapidly in a "pancake" style during the study period, and the anisotropic urban expansion moved the urban center 2.62 km toward southwest. The urban land use expansion intensity doubled and showed a rural-urban gradient. The most intensive urban expansion zone fell in the rural-urban transition zone, indicating the dominance of peripheral expansion as the primary urban expansion mode in Shanghai. However, the urban land use intensity decreased with time at the urban center. The primary driving forces of urban expansion included support from government policies and decision-making, enhanced economic activities, societal fixed assets investment, urban infrastructure investment, extension of transportation routes, as well as increase in urban population.

The immunomodulatory effects of glucocorticoids (GCs) have been described as bimodal. High concentration of GCs exerts immunosuppressive effects and low levels of GCs are immunopermissive. While the immunosuppressive mechanisms of GCs have been investigated intensely, the immunopermissive effects of GCs remain unclear. A lot of studies showed GCs could exert rapid non-genomic actions. We herein studied the rapid immunopromoting effects of GCs.We observed the rapid (within 30 minutes) effects of corticosterone on respiratory burst of mouse peritoneal macrophages and studied their mechanisms. The superoxide anions were measured by cytochrome C reduction assay. Protein kinase C phosphorylation was measured by Western blotting and membrane fluidity was evaluated by fluorescence polarization measurement.The 10(-8) mol/L and 10(-7) mol/L corticosterone rapidly increased the superoxide anions production by macrophages, which were insensitive to GC-receptor antagonist, mifepristone, and protein-synthesis inhibitor, cycloheximide. Corticosterone coupled to bovine serum albumin was able to mimic the effects of corticosterone. The effects were independent of protein kinase C pathway and the change in membrane fluidity.The results indicate that corticosterone rapidly promote the superoxide anions production by mouse peritoneal macrophages may through non-genomic mechanisms. This study may contribute to understanding the effects of GCs under stress condition and the physiological significance of nongenomic effects of GCs.