Yanchao He

A Detailed Epidemiological and Clinical Description of 6 Human Cases of Avian-Origin Influenza A (H7N9) Virus Infection in Shanghai

Background The world’s first reported patient infected with avian influenza H7N9 was treated at the Fifth People’s Hospital of Shanghai. Shortly thereafter, several other cases emerged in the local area. Here, we describe the detailed epidemiological and clinical data of 6 cases of avian influenza H7N9. Methods and Findings We analyzed the epidemiologic and clinical data from clustered patients infected with H7N9 in the Minhang District of Shanghai during a 2-week period. Of the 6 patients, 2 were from a single family. In addition, 3 patients had a history of contact with poultry; however, all 6 patients lived in the proximity of 2 food markets where the H7N9 virus was detected in chickens and pigeons. The main symptoms were fever, cough, and hemoptysis. At onset, a decreased lymphocyte count and elevated creatine kinase, lactate dehydrogenase, procalcitonin, and C-reactive protein levels were observed. As the disease progressed, most patients developed dyspnea and hypoxemia. Imaging studies revealed lung consolidation and multiple ground-glass opacities in the early stage, rapidly extending bilaterally. All patients were treated with oseltamivir tablets beginning on days 3–8 after onset. The main complications were as follows: acute respiratory distress syndrome (ARDS; 83.3%), secondary bacterial infection (66.7%), pleural effusion (50%), left ventricular failure (33.3%), neuropsychiatric symptoms (33.3%), and rhabdomyolysis (16.7%). Of the 6 patients, 4 died of ARDS, with 2 patients recovering from the infection. Conclusions An outbreak of H7N9 infection occurred in the Minhang District of Shanghai that easily progressed to acute respiratory distress syndrome. Two cases showed family aggregation, which led us to identify the H7N9 virus and indicated that human transmission may be involved in the spread of this infection.

MicroRNA-141 promotes the proliferation of non-small cell lung cancer cells by regulating expression of PHLPP1 and PHLPP2

The dysregulation of microRNAs (miRNAs) is crucially implicated in the development of various cancers. In this study, we explored the biological role of miR‐141 in non‐small cell lung cancer (NSCLC). miR‐141 expression was significantly up‐regulated in NSCLC tissues, and its overexpression accelerated NSCLC cell proliferation in vitro and tumor growth in vivo. We subsequently identified the antagonists of PI3K/AKT signaling, PH domain leucine‐rich‐repeats protein phosphatase 1 (PHLPP1) and PHLPP2, as direct targets of miR‐141. Re‐introduction of PHLPP1 and PHLPP2 abrogated miR‐141‐induced proliferation of NSCLC cells. Together, the results of this study suggest that miR‐141 and its targets PHLPP1 and PHLPP2 play critical roles in NSCLC tumorigenesis, and provide potential therapeutic targets for NSCLC treatment.

Family Outbreak of Severe Pneumonia Induced by H7N9 Infection

monary function impairment. These findings from their patient cohort are consistent with the experience of the BAL guideline committee members in their clinical practice when BAL is used to evaluate patients with suspected ILD (1). Although significant complications have been associated with the performance of diagnostic BAL in patients with a suspected or established diagnosis of ILD (2, 3), such complications are rare. BAL not only has been widely used in patients with suspected ILD, but it can be used safely in patients with airway disorders (e.g., asthma or bronchiectasis) or lung transplant recipients when protocols are in place to ensure that adequate precautions are taken to maintain adequate monitoring throughout the procedure and during the post-procedure recovery period (4–6). It was our hope that the publication of this guideline would (1) enhance the safety and efficacy of BAL as a useful clinical tool for the evaluation of patients with suspected ILD, (2) lead to better standardization of the BAL procedure when performed in centers around the world, and (3) increase recognition of the potential for BAL cell analysis to enhance clinicians’ ability to make a confident diagnosis of specific forms of ILD in the appropriate clinical setting. When BAL is properly performed and analyzed, the BAL cell differential count can provide very useful diagnostic information when combined with clinical findings and appropriate thoracic high-resolution computed tomography imaging (1, 7). The study by Agarwal and colleagues nicely demonstrates that BAL can be performed safely with adequate retrieval of lavage fluid for subsequent analysis when a protocol consistent with the ATS clinical practice guideline is used.

Association between genetic polymorphisms in XPD and XRCC1 genes and risks of non-small cell lung cancer in East Chinese Han population.

Lung cancer is a multifactorial disease. Xeroderma pigmentosum group D (XPD) and X‐ray repair cross‐complementing 1 (XRCC1) genes are 2 important susceptibility genes related to lung cancer. In this study, we explored the correlation between genetic polymorphisms in XPD and XRCC1 and the risk of non‐small cell lung cancer (NSCLC) in the East Chinese Han population. We also investigated risk factors associated with non‐small cell lung cancer in this population.

IL‐17A and IL‐17F single nucleotide polymorphisms associated with lung cancer in Chinese population

Genetic predisposition and environmental factors impact the development of lung cancer. The aim of this study was to investigate the association of single nucleotide polymorphisms (SNPs) of the IL‐17A and IL‐17F genes with lung cancer risk in Chinese Han population.

Full-Genome Analysis of Influenza A(H7N9) Virus from Shanghai, China, 2014

ABSTRACT We analyzed the complete genome sequence of the A/Shanghai/01/2014 (H7N9) strain, which will provide a better understanding of the evolution of influenza A(H7N9) virus.

Analysis of viral infection and biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease

To investigate viral infection in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Shanghai, and to analyze the clinical characteristics and biomarkers in viral infection.

Respiratory Syncytial virus infection compromises asthma tolerance by recruiting interleukin-17A-producing cells via CCR6-CCL20 signaling

HIGHLIGHTSAsthma and oral tolerance mouse models were established.RSV infection in tolerized mice incited asthma‐like inflammatory responses.IL‐17A producing cells were increased in the lungs and hilar LN and reduced in mesenteric LN in RSV‐infected tolerized mice.Blockade of CCL20 reduced presentation of CCR6+ cells in RSV‐infected tolerized HLN.Neutralization of IL‐17A mitigated RSV infection‐induced proinflammatory responses on asthma tolerance. ABSTRACT Asthma tolerance can be induced by breast‐feeding or oral feeding with ovalbumin (OVA). Anergy or deletion of specific T cells and generation of T regulatory cells might contribute to this process. However, whether respiratory syncytial virus (RSV) infection would affect asthma tolerance is not very clear. Here, we first established asthma and oral tolerance mouse models and then analyzed airway hypersensitivity and asthma‐related genes in the lung, CCR6‐expressing IL‐17A+ cells in the lungs, hilar or mesenteric lymph nodes (HLN or MLN) among control, asthmatic, tolerized, RSV infection, and RSV‐infected asthmatic and tolerized groups. We also administrated CCL20 or IL‐17A neutralizing antibody to RSV‐infected tolerized mice to test whether RSV infection would mobilize CCR6‐expressing IL‐17A+ cells from MLN to the infected lungs. We found that tolerized mice infected with RSV developed asthma‐like responses manifested by increasing airway hypersensitivity, exacerbating peribronchial inflammation, elevating lung asthma‐related genes (Il17a, Mu5ac, and Gob5), accumulating CCR6‐expressing IL‐17A+ cells in the lungs and HLN with a reduction of this cell population in MLN. CCL20‐CCR6 co‐expression in RSV‐infected tolerized MLN was reduced. Neutralization of CCL20 reduced CD3+CD4+CCR6+ cells in the RSV‐infected tolerized HLN. Neutralization of IL‐17A mitigated the compromising effects of RSV infection on asthma tolerance. Taken together, RSV infection impairs asthma tolerance by recruiting IL‐17A‐producing cells via CCR6‐CCL20 signaling. The findings provide novel insight into exacerbation and therapeutic strategy of asthma under RSV infection.

The first patient recovered from avian influenza A H7N9 viral infection: A case report and review of the literature.

In March 2013, a novel avian-origin influenza A (H7N9) virus was isolated from throat swabs of 2 patients at the Fifth Peoples Hospital of Shanghai, China. Subsequently, 4 more patients infected by H7N9 were identified. Of the 6 patients, 4 died of acute respiratory distress syndrome. Here, we report the first case of a patient who recovered from pneumonia induced by H7N9 infection. The patient presented with fever, cough, and blood in sputum. Laboratory tests showed a low level of leukocytes, hypoxaemia, and increased levels of creatine kinase and lactate dehydrogenase. Imaging showed multiple areas of segmental ground-glass opacity in the right lung. Oseltamivir and antibiotics were administered. Supplemental oxygen helped relieve symptoms. Approximately 2 weeks after treatment, the patient finally recovered. A follow-up chest computed tomography scan taken 8 weeks later revealed that the ground-glass opacity was clearly absorbed. Therefore, timely intervention with oseltamivir and supplemental oxygen may be very important in the treatment of H7N9 infection.