Clinical value of outpatient screening in department of general surgery during the COVID-19 outbreak.

Objective: To investigate the clinical value of outpatient screening in department of general surgery during the Corona Virus Disease 2019 (COVID-19) outbreak. Method(s): The retrospective and descriptive study was conducted. The clinical data of 57 patients who visited surgery clinic and emergency department of Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology between February 1st and 26th in 2020 were collected. There were 30 males and 27 females, aged (53+/-16)years, with a range from 17 to 87 years. All the 57 patients were measured score of outpatient screening in department of general surgery. The score >=3 indicated high risk and the score < 3 indicated low risk. Observation indicators: (1) clinical data of patients;(2) score of outpatient screening for COVID-19 of patients. Measurement data with normal distribution were represented as Mean+/-SD, and comparison between groups was analyzed by the t test. Measurement data with skewed distribution were described as M (IQR), and comparison between groups was analyzed by the rank sum test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Result(s): (1) Clinical data of patients: of the 57 patients, there were 12 males and 14 females of the 26 confirmed or suspected cases, versus 18 males and 13 females of the 31 non-infection cases, showing no significant difference between the two groups (chi2=0.805, P>0.05). The 26 confirmed or suspected cases of COVID-19 had an age of (57+/-16)years, and 31 non-infection cases had an age of (50+/-16) years, with no significant difference between the two groups (t=-1.646, P>0.05). (2) Score of outpatient screening for COVID-19 of patients: the score of outpatient screening for COVID-19 of the 26 confirmed or suspected cases was 3.0(4.0), versus 1.0(1.0) of the 31 non-infection cases, showing a significant difference between the two groups (Z=-3.695, P<0.05). There were 17 and 9 of the 26 confirmed or suspected cases with high risks and low risks, respectively, versus 3 and 28 of the 31 non-infection cases, with a significant difference between the two groups (chi2=19.266, P<0.05). Conclusion(s): During the COVID-19 outbreak, outpatient screening in department of general surgery can effectively screen out high-risk patients.Copyright © 2020 by the Chinese Medical Association.

[Related factors of negative conversion time of nucleic acid in children with COVID-19].

Objective: To explore the related factors of negative conversion time (NCT) of nucleic acid in children with COVID-19. Methods: A retrospective cohort study was conducted. A total of 225 children who were diagnosed with COVID-19 and admitted to Changxing Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 3rd to May 31st 2022 were enrolled in the study. The infection age, gender, viral load, basic disease, clinical symptoms and information of accompanying caregivers were retrospectively analyzed. According to age, the children were divided into<3 years of age group and 3-<18 years of age group. According to the viral nucleic acid test results, the children were divided into positive accompanying caregiver group and negative accompanying caregiver group. Comparisons between groups were performed using Mann-Whitney U test or Chi-square test. Multivariate Logistic regression analysis was used to analyze the related factors of NCT of nucleic acid in children with COVID-19. Results: Among the 225 patients (120 boys and 105 girls) of age 2.8 (1.3, 6.2) years, 119 children <3 years and 106 children 3-<18 years of age, 19 cases were diagnosed with moderate COVID-19, and the other 206 cases were diagnosed with mild COVID-19. There were 141 patients in the positive accompanying caregiver group and 84 patients in the negative accompanying caregiver group.Patients 3-<18 years of age had a shorter NCT (5 (3, 7) vs.7 (4, 9) d, Z=-4.17, P<0.001) compared with patients <3 years of age. Patients in the negative accompanying caregiver group had a shorter NCT (5 (3, 7) vs.6 (4, 9) d,Z=-2.89,P=0.004) compared with patients in the positive accompanying caregiver group. Multivariate Logistic regression analysis showed that anorexia was associated with NCT of nucleic acid (OR=3.74,95%CI 1.69-8.31, P=0.001). Conclusion: Accompanying caregiver with positive nucleic acid test may prolong NCT of nucleic acid, and decreased appetite may be associated with prolonged NCT of nucleic acid in children with COVID-19.

Short-course radiotherapy and subsequent CAPOX pluscamrelizumab followed by delayedsurgery for locally advanced rectalcancer: Short-term results of aphase II trial

Background: Chemoradiotherapy followed byradical surgery is standard treatment for patients with locally advanced rectal cancer(LARC). Short-course radiotherapy (SCRT), either with immediate or delayed surgery, providessimilar oncological results compared with long-course radiotherapy with delayed surgery.Delayed surgery with the addition of neoadjuvant immunotherapy may bring betterdownstaging effect and minimize the risk of distant relapse. We conducted this single-armphase 2 trial to investigate the efficacy and safety of SCRT combined with subsequentcapecitabine and oxaliplatin (CAPOX) plusCamrelizumab (anti-PD-1 antibody) followed bydelayed surgery in patients with LARC. Methods: Patients with histologically confirmed T3-4 N0 M0 or T1-4 N+ M0 rectal cancer, previouslyuntreated disease, and ECOG performancestatus of 0-1, received SCRT (5×5 Gy) withsubsequent two 21-day cycles of CAPOX(oxaliplatin 130 mg/m2 ivgtt, d1;capecitabine1000 mg/m2 po bid, d1-14) plus Camrelizumab(200 mg iv drip, d1) after 1 week, followed byradical surgery after 1 week. Adjuvant therapy was decided by the investigator. The primaryendpoint was pathological complete response(pCR) rate, defined as the absence of viabletumor cells in the primary tumor and lymphnodes. The study is ongoing to follow up thesurvival outcomes and obtain the results of nextgeneration sequencing and PD-L1 expression.The data cutoff date was September 8, 2020. Results: From November 2019 to September2020, a targeted number of patients (n = 29)were enrolled and are expected to complete thesurgery by November 2020. The median age was 57 (range 31-73) years, 55% (16/29) of patients had ECOG performance status of 1, and the median distance from tumor to the anal verge was 5 (range, 1.9-9) cm. At data cutoff, 10 patients had undergone the surgery, with R0 resection rate of 100%. The pCR rate was 60% (6/10), including 56% (5/9) for those with mismatch repair-proficient, and 100% (1/1) for those with mismatch repair-deficient. Of 4 patients without pCR, 2 only received one cycle of CAPOX plus Camrelizumab due to the outbreak of COVID-19 in Wuhan, and 1 had signet-ring cell rectal carcinoma. At data cutoff, 20 patients had received at least one dose of Camrelizumab. Immune-related adverse events (irAEs) were all grade 1-2, and the most common irAE was reactive cutaneous capillary endothelial proliferation in 10 (50%) of 20 patients. Postoperative bleeding and infection occurred in 1 (10%) and 2 (20%) of 10 patients, respectively. No treatment-related death was observed. Conclusions: SCRT combined with subsequent CAPOX plus Camrelizumab followed by delayed surgery showed promising pCR rate with good tolerance in patients with LARC, regardless of the mismatch repair status, suggesting a candidate strategy for the neoadjuvant therapy.

Spatiotemporal analysis on the impact of COVID-19 pandemic on NO2 emission in China

Based on the high-resolution TROPOMI data, this paper analyzed the spatial distribution of NO2 column density during the COVID-19 outbreaking period in China, and revealed the spatial variations in the NO2 changes during the year-on-year and month-on-month COVID-19 pandemic. The analysis showed that during the pandemic, the nationwide decline in NO2 column density compared to the NO2 level during the same period in 2019 (year-on-year) and during one-month before (month-on-month) the pandemic reached 40.46% and 50.09%, respectively. The economically developed and populous urban agglomerations had a significant decrease in emissions. Specifically, provinces with high historical NO2 emissions, including Jiangsu, Henan, Shandong, Zhejiang, etc., were more affected by the epidemic. Hubei showed the lowest NO2 column density (1.63×1015molec/cm2) during the epidemic period among the central and eastern provinces, with the NO2 decrease compared to the NO2 level during the same period in 2019 and during one-month before the pandemic greater than 50%. Regarding different cities in Hubei, the influence of the COVID-19 pandemic on the surrounding cities, e.g. Wuhan and Xiaogan, was much greater than that on the western mountainous cities, e.g. Shiyan and Enshi. The measurements of NO2 concentration at the ground-based national air quality monitoring stations also showed a consistent spatiotemporal trend with satellite observations, indicating that the "top-down" remote sensing method can efficiently reflects the intensity of air pollution emissions and the level of socio-economic activities in different regions. © 2021, Editorial Board of China Environmental Science. All right reserved.

Clinical value of outpatient screening in department of general surgery during the COVID-19 outbreak

Objective: To investigate the clinical value of outpatient screening in department of general surgery during the Corona Virus Disease 2019 (COVID-19) outbreak. Methods: The retrospective and descriptive study was conducted. The clinical data of 57 patients who visited surgery clinic and emergency department of Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology between February 1st and 26th in 2020 were collected. There were 30 males and 27 females, aged (53±16)years, with a range from 17 to 87 years. All the 57 patients were measured score of outpatient screening in department of general surgery. The score ≥3 indicated high risk and the score <3 indicated low risk. Observation indicators: (1) clinical data of patients;(2) score of outpatient screening for COVID-19 of patients. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed by the t test. Measurement data with skewed distribution were described as M (IQR), and comparison between groups was analyzed by the rank sum test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Results: (1) Clinical data of patients: of the 57 patients, there were 12 males and 14 females of the 26 confirmed or suspected cases, versus 18 males and 13 females of the 31 non-infection cases, showing no significant difference between the two groups (χ2=0.805, P>0.05). The 26 confirmed or suspected cases of COVID-19 had an age of (57±16)years, and 31 non-infection cases had an age of (50±16) years, with no significant difference between the two groups (t=-1.646, P>0.05). (2) Score of outpatient screening for COVID-19 of patients: the score of outpatient screening for COVID-19 of the 26 confirmed or suspected cases was 3.0(4.0), versus 1.0(1.0) of the 31 non-infection cases, showing a significant difference between the two groups (Z=-3.695, P<0.05). There were 17 and 9 of the 26 confirmed or suspected cases with high risks and low risks, respectively, versus 3 and 28 of the 31 non-infection cases, with a significant difference between the two groups (χ2=19.266, P<0.05). Conclusion: During the COVID-19 outbreak, outpatient screening in department of general surgery can effectively screen out high-risk patients. Copyright © 2020 by the Chinese Medical Association.

Coronavirus disease 2019: A new severe acute respiratory syndrome from Wuhan in China.

An outbreak of new severe acute respiratory syndrome coronavirus disease, coronavirus disease 2019 (COVID-19), has emerged during December 2019. The ongoing outbreak in Wuhan City spread rapidly throughout China, where the fatality rate ranged from 2.1 to 4.9%. Due to its high transmissibility, the World Health Organization (WHO) declared a public health emergency of international concern on 30 January 2020. The current outbreak has the potential to become the first pandemic of the new millennium. Most patients who were first diagnosed with COVID-19 worked at or lived in the vicinity of the local Huanan Seafood Wholesale  Market, where live animals were also on sale. The concerted efforts of Chinese scientists led to the independent isolation from patients and identification of a novel coronavirus, SARS coronavirus 2 (SARS-CoV-2), on 6 January 2020; this has been an important step in the development of treatment. The purpose of this article is to overview the history, epidemiology, clinical characteristics, diagnosis, and treatment of COVID 2019 reported in recently published studies. Based on the results of virus genome sequencing and a model of the interaction between host cells and the virus, we propose several possible targets for antiviral drugs, which may provide new ideas for epidemic control and vaccine development. Keywords: 2019 novel coronavirus; pneumonia; SARS-CoV-2; Coronaviridae; COVID-19.