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Background The coronavirus disease 2019 (COVID-19) cases continue to rise, and the demand for medical treatment and resources in healthcare systems surges. Assessing the viral shedding time (VST) of patients with COVID-19 can facilitate clinical decision making. Although some studies have been conducted on the factors affecting the VST of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), few prediction models are currently available. Methods This retrospective study included the consecutive patients with COVID-19 admitted to Xi'an Chest Hospital in Shaanxi, China, for treatment between December 19, 2021 and February 5, 2022. The clinical data of the patients were extracted from their electronic medical records. Combining significant factors affecting the VST, a nomogram was developed to predict the VST of the SARS-CoV-2 Delta variant in patients with COVID-19. Results We included 332 patients in this study. The average VST was 21 d. VST was significantly prolonged in patients with severe clinical symptoms, sore throat, old age, long time from onset to diagnosis, and an abnormal white blood cell count. Consequently, we developed a nomogram prediction model using these 5 variables. The concordance index (C-index) of this nomogram was 0.762, and after internal validation using bootstrapping (1000 resamples), the adjusted C-index was 0.762. The area under the nomogram's receiver operator characteristic curve showed good discriminative ability (0.965). The calibration curve showed high consistency. The VST was prolonged in the group with lower model fitting scores according to the Kaplan-Meier curve (χ2=286, log-rank P < 0.001). Conclusions We developed a nomogram for predicting VST based on 5 easily accessible factors. It can effectively estimate the appropriate isolation period, control viral transmission, and optimize clinical strategies. © Wolters Kluwer Health, Inc. All rights reserved.
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Objective: To provide a basis for the early identification and treatment of severe and critical coronavirus disease 2019 (COVID - 19) by analyzing the clinical characteristics of the death cases. Methods: We retrospectively analyzed the clinical characteristics of 71 COVID - 19 cases which died during hospitalization. The clinical data included general data, underlying disease, clinical manifestation, biochemical laboratory examination, imaging examination, complications, and treatment, then the influencing factors of in - hospital survival were analyzed. Results: Most of the 71 patients were ≥60 years old (78. 9%) and had underlying diseases (74. 6%), in which hypertension ranked first, and fever was the most common first symptom. Biochemical laboratory tests showed that D-Dimer and C-reactive protein maintained at high levels during hospitalization, and lymphocyte count declined. Leukocyte/neutrophil counts, neutrophil to lymphocyte ratio, procalcitonin, creatine kinase, and lactate dehydrogenase increased. The main imaging features of the dead cases were the multifocal ground glass changes and consolidation of the lungs. The most common complications were acute respiratory distress syndrome (89. 9%), shock (34. 3%), and acute myocardial injury (30. 4%). 90% of the patients received auxiliary ventilation, and the decrease of blood oxygen saturation and the increase of procalcitonin may be the risk factors for shorter in-hospital survival. Conclusion: Severe and critical COVID-19 patients show different characteristics in clinical manifestations, biochemical laboratory examination, imaging examination, complications, and treatment reactions, which need early identification and treatment, and bewaring of acute respiratory distress syndrome and multiple organs failure. © 2022 Editorial Board of Medical Journal of Wuhan University. All rights reserved.
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Objective: To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon alpha-2b (rIFNalpha-2b) and the combination of lopinavir/ritonavir plus rIFNalpha-2b for patients with COVID-19 in Zhejiang province. Method(s): A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNalpha-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: <48 h, 3-5 d and >5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data. Result(s): The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2+/-4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0+/-5.0) d] (t=6.159, P<0.01). The length of hospital stay in the triple combination group [12.0 (9.0, 17.0) d] was also shorter than that in the dual combination group [15.0 (10.0, 18.0) d] (H=2.073, P<0.05). Compared with the antiviral treatment which was started within after the symptom onset of in the triple combination group, the time from the symptom onset to the viral negative conversion was 13.0 (10.0, 17.0), 17.0 (13.0, 22.0) and 21.0 (18.0, 24.0) d in subgroups of 48 h, 3-5 d and >5 d, respectively (Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8+/-3.9), (13.5+/-5.1) and (11.2+/-4.3) d, respectively(Z=6.722, P<0.05). Conclusion(s): The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNalpha-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy;and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy.Copyright © 2020 by the Chinese Medical Association.
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Climate change has become mankind's main challenge. Greenhouse gas (GHG) emissions from shipping are not totally irresponsible for this representing, roughly, 3% of the global total;an amount equal to that of Germany's total GHG emissions. The Fourth Greenhouse Gas Study 2020 of the International Maritime Organization (IMO) predicts that the share of GHG emissions from shipping will increase further, as international trade recovers and continues to grow, alongside with the economic development of India, China, and Africa. China and the European Union have proposed to include shipping in their carbon emissions trading systems (ETS). As a result, the study of the relationship between the carbon finance market and the shipping industry, attempted here for the first time, is both important and timely, both for policymakers and shipowners. We use wavelet analysis and the spillover index methods to explore the dynamic dependence and information spillovers between the carbon finance market and shipping. We discover a long-term dependence and information linkages between the two markets, with the carbon finance market being the dominant one. Major events, such as the 2009 global financial crisis;Brexit in 2016;the 2018 China-US trade frictions;and COVID-19 are shown to strengthen the dependence of carbon finance and shipping. We find that the dependence is strongest between the EU carbon finance market and dry bulk shipping, while the link is weaker in the case of tanker shipping. Nonetheless, carbon finance and tanker shipping showed a relatively stronger dependence when OPEC refused to cut production in 2014, and when the China-US trade disputes led to the collapse of oil prices after 2018. We show that information spillovers between carbon finance and shipping are bidirectional and asymmetric, with the carbon finance market being the principal transmitter of information. Our results and their interpretation provide guidance to governments on whether (and how) to include shipping in emissions trading schemes, supporting at the same time the environmental sustainability decisions of shipping companies. © 2023 The Authors
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Objective To assess the quality of nucleic acid testing in 43 Novel Coronavirus laboratories of disease control institutions in Qinghai Province that have passed the acceptance inspection, so as to ensure the accuracy and reliability of nucleic acid testing results. Methods Five samples for quality control assessment were distributed to each testing institution. The quality of nucleic acid testing was carried out following the requirements of the testing technical guidelines in the Novel Coronavirus Pneumonia Prevention and Control Program (Seventh Edition) issued by the Chinese Center for Disease Control and Prevention. Each detection reagentwas prepared by the member units participating in the assessment. The nucleic acid detection ability of each institution was evaluated by comparing the testing results with the expected results of the assessment samples. Results Fortythree disease control institutions participated in the assessment, all the testing results were collected within the specified time. The overall compliance rate of this assessment was 100. 00%. A total of 10 manufacturers' nucleic acid extraction kits and 9 manufacturers' nucleic acid amplification kits were involved. One hundred percent of the kits detected the ORF1ab gene and N gene of the Novel Coronavirus. Conclusion The nucleic acid detection capacity of the disease control institutions in Qinghai has been further improved by making this Novel Coronavirus quality control assessment. The assessment createsa solid foundation for the prevention and control of the Novel Coronavirus epidemic in Qinghai. © 2023, Editorial Department of Medical Pest Control. All rights reserved.
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Objective To assess the quality of nucleic acid testing in 43 Novel Coronavirus laboratories of disease control institutions in Qinghai Province that have passed the acceptance inspection, so as to ensure the accuracy and reliability of nucleic acid testing results. Methods Five samples for quality control assessment were distributed to each testing institution. The quality of nucleic acid testing was carried out following the requirements of the testing technical guidelines in the Novel Coronavirus Pneumonia Prevention and Control Program (Seventh Edition) issued by the Chinese Center for Disease Control and Prevention. Each detection reagentwas prepared by the member units participating in the assessment. The nucleic acid detection ability of each institution was evaluated by comparing the testing results with the expected results of the assessment samples. Results Fortythree disease control institutions participated in the assessment, all the testing results were collected within the specified time. The overall compliance rate of this assessment was 100. 00%. A total of 10 manufacturers' nucleic acid extraction kits and 9 manufacturers' nucleic acid amplification kits were involved. One hundred percent of the kits detected the ORF1ab gene and N gene of the Novel Coronavirus. Conclusion The nucleic acid detection capacity of the disease control institutions in Qinghai has been further improved by making this Novel Coronavirus quality control assessment. The assessment createsa solid foundation for the prevention and control of the Novel Coronavirus epidemic in Qinghai. © 2023, Editorial Department of Medical Pest Control. All rights reserved.
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In order to improve the cure rate of critically ill patients in Wuhan epidemic area and reduce the fatality rate, the state have dispatched medical staffs from the whole country to support Wuhan and treat critically ill patients in dedicated facilities. A medical team from the First Affiliated Hospital of Xi'an Jiaotong University, consisting of 133 medical staffs major in critical care medicine, respiralogy, infection, cardiology, and general surgery, entirely took over the critical care unit of the East Hospital of the Renmin Hospital of Wuhan University, and formed a multidisciplinary collaboration team with local medical staffs to treat patients together. Up to March 13th in 2020, the author's medical team has admitted a total of 109 patients, of which 48 had been discharged up on recovery. Critically ill patients with Corona Virus Disease 2019 mainly have elder age, comorbidities, complicated conditions, and difficult diagnosis and treatment. The author and the author's team combined with clinical practice, share experience and strategies of general surgery related issues in the treatment of critically ill patients, providing reference for collegues in general surgery.Copyright © 2020 by the Chinese Medical Association.
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Spatial skills are critical for understanding the relations among objects and people, playing an important role in how we interact with the world. Spatial relationships are built through interactions with physical objects;however, in computational/online environments, these change to bi-dimensional media and computer-assisted design comprised of 3D representations viewable through a flat screen. Due to spatial immersion and interaction limitations, a traditional 2D and 3D approach presents challenges to partially sighted, blind, and sighted individuals. This paper presents the prototyping of a co-design Augmented Reality (AR) authoring tool by recruiting inclusive emerging affordances of consumer-level AR technologies within the context of current e-learning provisions in subject matters, including inclusive design, engineering design, game hardware design, and health sciences. This work has been inspired by the COVID-19 pandemic that has shown the need to level the field in inclusive design for teaching a subject typically oriented to the sighted. Our prototype allows users to create e-learning content for visualization, interaction, collaboration, and inclusive learning. Future work will investigate our tool's impact on skills development and content creation. © 2022 IEEE.
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Objective: To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon alpha-2b (rIFNalpha-2b) and the combination of lopinavir/ritonavir plus rIFNalpha-2b for patients with COVID-19 in Zhejiang province. Method(s): A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNalpha-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: <48 h, 3-5 d and >5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data. Result(s): The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2+/-4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0+/-5.0) d] (t=6.159, P<0.01). The length of hospital stay in the triple combination group [12.0 (9.0, 17.0) d] was also shorter than that in the dual combination group [15.0 (10.0, 18.0) d] (H=2.073, P<0.05). Compared with the antiviral treatment which was started within after the symptom onset of in the triple combination group, the time from the symptom onset to the viral negative conversion was 13.0 (10.0, 17.0), 17.0 (13.0, 22.0) and 21.0 (18.0, 24.0) d in subgroups of 48 h, 3-5 d and >5 d, respectively (Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8+/-3.9), (13.5+/-5.1) and (11.2+/-4.3) d, respectively(Z=6.722, P<0.05). Conclusion(s): The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNalpha-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy;and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy.Copyright © 2020 by the Chinese Medical Association.
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Background: Shengmai decoction, which has been included in the diagnosis and treatment of coronavirus disease 2019 (COVID-19), is effective in the early treatment of patients with severe COVID-19. Yiqi Fumai lyophilized injection (YQFM) is a modern Chinese medicine preparation of the Shengmai decoction. The mechanism of its intervention at the molecular level in the severe stage of COVID-19 remains unclear. Therefore, it is necessary to investigate the mechanism of YQFM in the treatment of patients with severe COVID-19. Methods: The corresponding target genes of the main active ingredients in YQFM and COVID-19 were obtained by using multiple databases and literature retrieval. A protein-protein interaction network was constructed, and enrichment analysis of the target was performed using Cytoscape 3.8.1. Lastly, the docking of all the identified compounds with angiotensin-converting enzyme II was confirmed by applying molecular docking technology. Results: YQFM has anti-inflammatory effects on RAW267.4 macrophages. The main active compounds of YQFM are all effective anti-inflammatory agents, and these active compounds also show beneficial physiological functions, such as anti-oxidation, anti-bacterial, and anticancer activities. Gene Ontology analysis showed enrichment in the following pathways: lipopolysaccharides, interleukins, NF-kappa B, interleukin-2 and others, revealing that YQFM may play a role in the treatment of patients with severe COVID-19 through these pathways. Conclusion: YQFM has multicomponent and multitarget characteristics, and it could reduce lung injury by inhibiting inflammatory reactions, promoting antiviral activities, and regulating immunity, among other functions, to treat patients with severe COVID-19.
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Viruses are one of the main pathogens that endanger human health. The infectious diseases caused by virus infection and transmission seriously threaten human health. At present, viral diseases with high morbidity and low cure rate such as AIDS and viral hepatitis are still spreading around the whole world, and respiratory viruses such as influenza virus and corona virus are constantly mutating. Since 2019, the global epidemic caused by SARS-CoV-2 has brought severe challenges to the world, and there are still great uncertainties in the future course of the epidemic. Therefore, the development of safe and effective antiviral drugs has become an important means to deal with viral diseases. On the basis of summarizing the overall status of global antiviral drug research and development, this paper intends to analyze the progress of new drug research in key areas such as anti-HIV, hepatitis virus and SARS-CoV-2, and put forward suggestions to provide guidance and reference for the development of more efficient antiviral drugs in the future. © 2022, China Biotechnology Press. All rights reserved.
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As the mobile Internet emerges, numerous Instagram-worthy locations gradually constitute new spaces of urban tourism. For instance, the Xiaohongshu application, a community with shared content, has increasingly become a platform for people to share well-known tourist attractions, providing a new perspective for the study of the popularity of tourism spaces. On the basis of data of ticking off Instagram-worthy locations from the Xiaohongshu application, the present study aims to identify tourism hotspots in Beijing, analyze their spatial characteristics, and explore their evolution features from two dimensions of time and space. In addition, the emotional images of tourism hotspots in Beijing are interpreted by semantic analysis with an internal mechanism that influences those locations explored. The results of the study show that (1) the overall spatial structure of tourism hotspots in Beijing is C-shaped, which expands from the core area to the periphery with the feature of a circle layer. (2) under the influence of the COVID-19 pandemic, the spatial distribution center of tourism hotspots in Beijing is gradually shifting to the Southeast with the tendency of expanding to the surrounding suburbs. (3) the reception and serviceability of the tourist attractions have a significant influence on the popularity of tourism hotspots. To date, less research has been focused on the data of ticking off emerging Instagram-worthy locations like the Xiaohongshu application, and there is a dearth of the study related to in-depth excavation of the internal influencing mechanism of their popularity. This paper, therefore, under the interaction of virtual and reality, provides new ideas and methods for studying the popularity of urban tourist attractions.
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In assessing the occurrence of an unexpected medical adverse event following pharmaceutical,medical, or surgical treatment, the causal or contributory roles played by bias, systemic racism, and social determinants of health should be investigated. Up to 80% of clinical outcomes are estimated to be driven by social determinants including the environments in which patients live, work, learn, worship, and play. Among women, there are racial health disparities in sterilization procedures, method of hysterectomy, cesarean birth rates, preterm birth rates, and, most recently, the rates of COVID-19 death and hospitalizations. At the same time, there is little specific guidance of how to investigate social determinants of health that affect patient outcomes. Differences in health equity-related factors affect the quality of gynecologic care. There is immeasurable potential for bias in patient characteristics: race;ethnicity;persons with obesity;LGBTQ+ (lesbian, gay, bisexual, transgender, queer+) persons;socioeconomic factors;and young and old age. Within existing models for patient safety, inclusion of equity-related aspects of care may improve the current understanding of the causes of medical adverse events. It is critical to consider social determinants of health, structural racism, and both overt and implicit bias. The aim of this studywas to establish a sustainable and trackable process to determine the role of social determinants of health, bias, and racism in adverse gynecologic events. Each adverse event case is assessed for preventability, harm, and standards of care. Cases are identified for review utilizing existing hospital event-reporting systems (RLDatix) and enhanced by resident and attending physician self-reporting. The following equity-focused process was used: (1) creating a standardized health equity checklist;(2) applying the checklist to each gynecologic adverse event beginning on September 1, 2020;(3) collecting event review data in a secure central digital repository;(4) reviewing each adverse case to understand apparent causes of the event;(5) exploring areas for improvement using standard fields;and (6) identifying specific ideas for improvement. Within 15 months (between September 1, 2020, and November 30, 2021), 46 safety cases were identified using standard criteria. Twenty-four of these were deemed preventable.Of the 24 cases, 12 cases were identified inwhich social determinants of health, bias, or both had a role. Delays in diagnosis and care were attributed to social determinants of health and implicit bias. This process has mapped areas of infrastructure as well as the need for culture improvement and restorative work to address implicit bias and improve approaches to shared decision-making. These findings show that with use of a health equity checklist, it is feasible to create a systematic and trackable process to begin delineating the role of social determinants of health, bias, and racism in adverse gynecologic events. Copyright © 2023 Lippincott Williams and Wilkins. All rights reserved.
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This article reports on a study using machine learning to identify incidences and shifting dynamics of hate speech in social media archives. To better cope with the archival processing need for such large-scale and fast evolving archives, we propose the Data-driven and Circulating Archival Processing (DCAP) method. As a proof-of-concept, our study focuses on an English language Twitter archive relating to COVID-19: Tweets were repeatedly scraped between February and June 2020, ingested and aggregated within the COVID-19 Hate Speech Twitter Archive (CHSTA), and analyzed for hate speech using the Generative Adversarial Network-inspired DCAP method. Outcomes suggest that it is possible to use machine learning and data analytics to surface and substantiate trends from CHSTA and similar social media archives that could provide immediately useful knowledge for crisis response, in controversial situations, or for public policy development, as well as for subsequent historical analysis. The approach shows potential for integrating multiple aspects of the archival workflow and supporting automatic iterative redescription and reappraisal activities in ways that make them more accountable and more rapidly responsive to changing societal interests and unfolding developments.
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Aim Human TMPRSS2 is a transmembrane serine protease.In this paper, the structure and function of the protein were systematically analyzed by bioinformatics, the codon was optimized and the pro- karvotie expression vector was constructed to explore the molecular mechanism of SARS-CoV-2 infecting host cells.Methods The recombinant expression vector pET-22b-TMPRSS2 was generated by molecular cloning technology.The homology, functional sites, subcellular localization, three-dimensional structure and evolutionary characteristics of TMPRSS2 protein were systematically analyzed by using analytical tools such as Protparam, NetPhos3.1, Blast, Clustal X2 and MEGA7.0.Results The prokarvotic expression plas- mid was constructed correctly;TMPRSS2 belongs to medium molecular weight protein, which is composed of 492 amino acid residues.The theoretical isoelectric point is 8.12, the molecular extinction coefficient is 118 145 L * mol~1 * cm"1 , and the half-life is 30 h;TMPRSS2 has 15 potential glycosylation sites and 49 possible phosphorylation sites.It is a transmembrane hydrophilie protein without signal sequenee.In addition, the protein has 13 potential B-cell epitopes and 7 T-eell epitopes.Seeondarv structure analysis showed that random coil accounted for the highest proportion of TMPRSS2 protein ( 0.453 3) , followed by extended strand (0.252 0).Sequence comparison and evolutionary analysis showed that the highest sequence consistency and closest genetic relationship with human TMPRSS2 was Pan troglodytes, followed by gorilla.Conclusions Human-derived TMPRSS2 protein is ev- olutionarilv conserved and functionally important.Hie results of this study can help to reveal the structure and mechanism of action of TMPRSS2 protein, provide ideas for the diagnosis and treatment of COYID-19, and accelerate the research and development process of new drugs targeting TMPRSS2 protein. Copyright © 2022 Publication Centre of Anhui Medical University. All rights reserved.
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As a huge disaster for humanity, the COVID-19 has caused many negative effects on the lives of people around the world with a rapid growth. Moreover, the global pandemic of Neocoronavirushas produced many mutated strains. Although the most commonly used test for COVID-19 is reverse transcription-polymerase chain reaction (RT-PCR), CXR becomes an irreplaceable tool for the diagnosis and analysis for a more complete and accurate visualization of the lung lesion process. Therefore, it is of high value for classification and identification studies. In this paper, the high-frequency emphasis filtering based convolutional neural networks (HFEF-CNN) are proposed for solving the automatic detection of COVID-19. Firstly, the HFEF is used to denoise the image data to make some features in the image more obvious. Then some major CNNs are used to train image classification models to achieve better detection performance. Finally, Some experiments are conducted on the 'COVID-19 Chest X-Ray Database' dataset. To verify the effectiveness of the HFEF-CNN, a histogram equalization based CNN (HE-CNN) and a restricted contrast adaptive histogram equalization based CNN (CLAHE-CNN) are compared. The experimental results show that the HFEF-CNN outperformed the above two methods. © 2022 IEEE.
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Background: Pathological complete response (pCR) is associated with improved prognosis in triple-negative breast cancer (TNBC). Anlotinib, a novel multi-target tyrosine kinase inhibitor that effectively inhibits VEGFR, FGFR, c-KIT, c-MET, and RET, monotherapy has been proven effective in HER-2 negative metastatic breast cancer, but its efficacy in early-stage TNBC is unknown. This phase 2 study aims to evaluate the efficacy and safety of adding anlotinib to neoadjuvant chemotherapy in patients (pts) with primary TNBC. Methods: Pts with clinical stage II/III TNBC were to be treated with 5 cycles of anlotinib (12mg, d1-14, q3w) plus 6 cycles of taxanes (docetaxel 75 mg/m2 or nab-paclitaxel 260 mg/m2, d1, q3w) and lobaplatin (30 mg/m2, d1, q3w), followed by surgery. The primary endpoint was the total pCR (tpCR;ypT0/is ypN0). A Simon's two-stage optimum design was used, and > 5 of 11 pts were required to achieve tpCR in the first stage, with a pre-specified tpCR rate of 54.5% before proceeding to the second stage. A total of 31 participants was required for the study. Results: Six out of 11 pts achieved tpCR in the first stage, reaching the threshold for the second stage. From Jan 2021 to Jan 2022, a total of 22 pts were enrolled and 12 received surgery after the completion of neoadjuvant therapy, but a total of 2 pts withdrew from the study due to the COVID-19 pandemic or serious adverse events. Of the 22 eligible pts, the median age was 49 years (range, 29-64), 64% were postmenopausal, and 73% were nodal involved. At the time of surgery, 58.3% (7/12) achieved tpCR. Of the 9 pts with the node-positive disease at diagnosis, 88.9% (8/9) became ypN0. The results of FUSCC TNBC classification (IHC-based) revealed the tpCR rates were 57.1% (4/7), 100% (3/3), and 0% (0/2) for BLIS subtype, IM subtype and LAR/unknown subtypes, respectively. Biomarker analysis showed the tpCR rates were 100% (3/3) and 100% (4/4) in patients with gBRCA1 mutation and MYC amplification, respectively. The most common grade 3 or 4 treatment-related adverse events were leucopenia (6/22, 27%), neutropenia (6/22, 27%), anemia (5/22, 23%), decreased appetite (5/22, 23%), hypertension (2/22, 9%), ALT increased (1/22, 5%) and oral mucositis (1/22, 5%). No treatment-related deaths occurred. The trial is ongoing. Conclusions: The addition of anlotinib to neoadjuvant chemotherapy showed manageable toxicity and promising antitumor activity for patients with early-stage TNBC.
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With the COVID-19 epidemic quickly under control in China in the early stage of 2020, global cooperation/ communications may pose great challenges to epidemic control and prevention in the country. Large-scale spread by asymptomatic carriers was a concern. We obtained data on new cluster outbreak regions with COVID-19 caused by asymptomatic carriers from June 2020 to May 2021 in China, and reported the epidemiological characteristics, the possible routes of viral transmission and infection, and different control strategies. These results show the importance of regular screening for high-risk populations and differential management strategies for epidemic control, which provide an objective basis for suppressing the spread of the SARS-CoV-2 virus. These experiences can be used as a reference to minimize the subsequent spread of virus mutants in various places.