Four new eudesmane-type and one new eremophilane-type sesquiterpenes from the whole plant of Carpesium abrotanoides L.

The extract of the whole plant of Carpesium abrotanoides L. yielded five new sesquiterpenes including four eudesmanes (1-4) and one eremophilane (5). The new compounds were characterized by spectroscopic analysis especially 1D and 2D NMR spectroscopy and HRESIMS data. Structurally, both compounds 1 and 2 were sesquiterpene epoxides and 2 owned an epoxy group at C-4/C-15 position to form a spiro skeleton. Compounds 4 and 5 were two sesquiterpenes without lactones and 5 possessed a carboxy group in the molecule. Additionally, all the isolated compounds were preliminarily evaluated for the inhibitory activity against SARS-CoV-2 main protease. As a result, compound 2 showed moderate activity with an IC50 value of 18.79 µM, while other compounds were devoid of noticeable activity (IC50 > 50 µM).

Impact of the COVID-19 pandemic on surgical outcomes in patients undergoing colorectal cancer surgery: A retrospective study and meta-analysis of data from 11,082 participants

Background The COVID-19 pandemic is affecting the care of patients with colorectal cancer worldwide, resulting in the postponement of many colorectal cancer surgeries. However, the effectiveness and safety of performing colorectal cancer surgery during the COVID-19 pandemic is unknown. This study evaluated the impact of the COVID−19 pandemic on surgical outcomes in patients undergoing colorectal cancer surgery. Methods We retrospectively identified patients undergoing colorectal cancer surgery in January 21, 2019, to April 1, 2019, vs. January 21, 2020, to April 1, 2020. Data regarding perioperative outcomes (postoperative complications, conversion rate, duration of surgery, intraoperative blood loss, transfusion, reoperation, intensive care, histological examination, morbidity, and length of hospital stay) were retrieved and compared between the two cohorts. A meta-analysis of 14 studies was also conducted to assess the impact of the COVID−19 pandemic on surgical outcomes in patients undergoing colorectal cancer surgery. Results The sample included 68 patients who underwent surgery in 2020 and 136 patients who underwent surgery in 2019. No patient was converted from laparoscopy to laparotomy or required reoperation. R0 resection was completed in all patients in both groups. There was no significant difference in postoperative complications (p = 0.508), duration of surgery (p = 0.519), intraoperative blood loss (p = 0.148), transfusion (0.217), intensive care (p = 0.379), mean lymph node yield (p = 0.205), vascular positivity rate (p = 0.273), nerve invasion rate (p = 0.713), anastomosis leak rate (p = 1), morbidity (p = 0.478), and length of hospital stay (p = 0.623) between the two groups. The meta-analysis also showed no significant difference in short-term outcomes between the two groups. Conclusions Our study shows that the COVID-19 pandemic has not led to a deterioration in the surgical outcomes of colorectal cancer surgery or reduction in the quality of cancer removal. Therefore, we do not recommend postponing elective colorectal cancer surgery during the COVID-19 pandemic.

Impact of internet usage on consumer impulsive buying behavior of agriculture products: Moderating role of personality traits and emotional intelligence.

E-commerce has led to a significant increase in internet purchases. The marketing sector is very competitive these days, and marketers have a difficult task: understanding the behavior of their customers. Strategic marketing planning relies heavily on consumer behavior since the consumer acts as the user, buyer, and payer in that process. Consumers' behavior changes in response to shifts in the factors that influence it. The purpose of this research is to show how Internet usage influence on consumer impulsive buying behavior of agriculture products through moderating role personality traits and emotional intelligence in China organic market. The data gathered in three months from January to March 2022, due to COVID-19 pandemic data was gathered through an online survey questionnaire sent by Chinese social media platforms including WeChat and an email address. The PLS-SEM technique and the SmartPLS software version 3.2.8 were used for data analyses. The result revealed that internet usage positively and significantly influences consumer impulsive buying behavior. Also, both moderator personality trait and emotional intelligence positively and significantly moderate the relationship between internet usage and consumer impulsive buying behavior. Lastly, theoretical and practical implications, and future directions were discussed.

Rapid Deployment and Application Exploration of the Mobile Shelter Laboratories Under T He Outbreak of COVID-19 Epidemic (preprint)

Since the end of 2019, the COVID-19 epidemic has swept the world. With the widespread spread of the COVID-19 and the continuous emergence of mutated strains, the situation for the prevention and control of the COVID-19 epidemic remains severe. On May 21, 2021, Guangzhou City, Guangdong Province, notified the discovery of a new locally confirmed case. Guangzhou became the first city in mainland China to compete with the delta mutant strain. As a local hospital with strong nucleic acid detection capabilities, Sun Yat-sen University Sun Yat-sen Memorial Hospital took the lead in launching the construction and deployment of the Mobile Shelter Laboratories and large-scale screening work in Foshan and Zhanjiang, Guangdong Province. Through summarizing "practical" experience, observation and comparison data analysis, we use real data to verify a feasible solution for rapid expansion of detection capabilities in a short period of time. We hope that these experiences will have certain reference value for other countries or regions, especially the underdeveloped areas of medical and health care.

The Self-examination Physiological Health Level of Medical Staffs under Three-level Protection and Analysis

Abstract: Objective: To investigate the self-examination physiological health level of medical staffs under the tertiary protection, and analyze the physiological health problems and influencing factors of the medical staffs under the three-level protection. Methods: from March 19, 2020 to April 3, 2020, using snowball sampling method, a total of 103 anti epidemic medical staffs from two top three hospitals in Guangdong Province were invited to conduct a network questionnaire survey. Results: a total of 102 valid online questionnaires were analyzed. The results showed that the health status and organ function of medical staffs were 6.37％ ± 77, daily life function was 10. 19 ± 63 and 9. 97 respectively ± 22 points, all above the middle level;The analysis showed that the self-examination physiological health level was affected by the gender of medical staffs, whether drinking, health status and intuitive feelings under three-level protection. Conclusion: the self-examination physiological health of medical staffs under the three-level protection is in the upper middle level, so we should pay more attention to and support the physiological health of medical staffs under the three-level protection.

Investigate thenovel coronaviruses in external environmentof COVID-19 / 中华实验和临床病毒学杂志

Objective To understand the distribution of novel coronaviruses in the external environment of confirmed COVID-19 cases. Methods Environmental surface swab specimens such as bed rails, doorknob, closestool, hand washing sink, table, locker,ward pager, mobile phone, cup, clothes, were collected from the sentinel hospital of COVID-19, and samples were collected for the nucleic acid detection by RT-PCR. Results A total of 150 environmental samples were collected from 30 confirmed COVID-19 cases, 6 samples were determined to be novel coronaviruses postive (positive rate 4.00%). The total 14 mobile phone showed 3 novel coronaviruses positive.Among the 30 confirmed COVID-19 cases, 6 cases (positive rate 20.00%)were found novel coronaviruses in the external environment. Conclusions Novel coronaviruses exists in external environment of confirmed COVID-19 cases, which indicates the potential risk of COVID-19 infection.

Efficacy and tolerability of bevacizumab in patients with severe Covid -19 (preprint)

On the basis of Covid-19-induced pulmonary pathological and vascular changes, we hypothesized that the anti-VEGF drug bevacizumab might be beneficial for treating Covid-19 patients. We recruited 26 patients from 2-centers (China and Italy) with confirmed severe Covid-19, with respiratory rate [≥] 30 times/min, oxygen saturation [≤] 93% with ambient air, or partial arterial oxygen pressure to fraction of inspiration O2 ratio (PaO2/FiO2) >100mmHg and [≤] 300 mmHg, and diffuse pneumonia confirmed by chest radiological imaging. This trial was conducted from Feb 15 to April 5, 2020, and followed up for 28 days. Relative to comparable control patients with severe Covid-19 admitted in the same centers, bevacizumab showed clinical efficacy by improving oxygenation and shortening oxygen-support duration. Among 26 hospitalized patients with severe Covid-19 (median age, 62 years, 20 [77%] males), bevacizumab plus standard care markedly improved the PaO2/FiO2 ratios at days 1 and 7 (elevated values, day 1, 50.5 [4.0,119.0], p<0.001; day 7, 111.0 [85.0,165.0], p<0.001). By day 28, 24 (92%) patients showed improvement in oxygen-support status, 17 (65%) patients were discharged, and none showed worsen oxygen-support status nor died. Significant reduction of lesion areas and ratios were shown in chest CT or X-ray analysis within 7 days. Of 14 patients with fever, body temperature normalized within 72 hours in 13 (93%) patients. Lymphocyte counts in peripheral blood were significantly increased and CRP levels were markedly decreased as shown in available data. Our findings suggested bevacizumab plus standard care was highly beneficial for treating patients with severe Covid-19. Clinical efficacy of bevacizumab warrants double blind, randomized, placebo-controlled trials. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04275414, URL: https://clinicaltrials.gov/ct2/show/NCT04275414.

Association between lung injury and cytokine profile in COVID-19 pneumonia (preprint)

Background: Coronavirus disease 2019 (COVID-19) is a systemic disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The purpose of the present study was to investigate the association between lung injury and cytokine profile in COVID-19 pneumonia.Methods: This retrospective study was conducted in COVID-19 patients. Demographic characteristics, symptoms, signs, underlying diseases, and laboratory data were collected. The patients were divided into COVID-19 with pneumonia and without pneumonia. CT severity score and PaO2/FiO2 ratio and were used to assess lung injury.Results: 106 patients with 12 COVID-19 without pneumonia and 94 COVID-19 with pneumonia were included. Compared with COVID-19 without pneumonia, COVID-19 with pneumonia had significant higher serum interleukin (IL)-2R, IL-6, and tumor necrosis factor (TNF)-α. Correlation analysis showed that CT severity score and PaO2/FiO2 were significantly correlated with age, presence of any coexisting disorder, lymphocyte count, procalcitonin, IL-2R, and IL-6. In multivariate analysis, log IL6 was only independent explanatory variables for CT severity score (β=0.397, p<0.001) and PaO2/FiO2 (β=-0.434, p=0.003).Conclusions: Elevation of circulating cytokines was significantly associated with presence of pneumonia in COVID-19 and the severity of lung injury in COVID-19 pneumonia. Circulating IL-6 independently predicted the severity of lung injury in COVID-19 pneumonia.

Report of a COVID-19 Case Combined with HIV Infection (preprint)

Background: Confirmed as a familial clustered case, a COVID-19 patient displaying established symptoms was simultaneously diagnosed with an HIV infection, and treated with several antiviral and compassionate drugs.Case presentation: The upper respiratory tract Nucleic Acid Testing (NAT) for the novel coronavirus continued to be positive for consecutive 49 days. During the course of treatment, it was observed that the other six cases in the family were non-HIV infected and displaying common Covid-19 symptoms, the familial cluster received parallel treatment along with the aforementioned patient, and the median time for the NAT to present as negative was 29 days. Conclusions: The results of this research indicate that the novel coronavirus attacks T lymphocyte subsets, andfurther studies with larger sample sizes are required to verify how the immune escape mechanism of the new coronavirus interacts with HIV infection.

Prognostic value of neutrophil-to-lymphocyte ratio, lactate dehydrogenase, D-dimer and CT score in patients with COVID-19 (preprint)

Background To explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19).Methods Patients with laboratory confirmed COVID-19 were retrospectively enrolled. The baseline data, laboratory findings, chest computed tomography (CT) results evaluating by CT score on admission, and clinical outcomes were collected and compared. The logistic regression was used to assess the independent relationship between the baseline level of four indicators (NLR, LDH, D-dimer, CT score) and the severity of COVID-19.Results Among 432 patients, 125 (28.94%) cases were divided into severe group, the remaining (n = 307, 71.06%) were in non-severe group. In multivariate logistic regression, high level of NLR, LDH were independent predictor of the severe group in COVID-19 (OR = 2.163; 95%CI = 1.162–4.026; p = 0.015 for NLR > 3.82; OR = 2.298; 95%CI = 1.327–3.979; p = 0.003 for LDH > 246U/L). Combining NLR > 3.82 and LDH > 246U/L increased the sensitivity of diagnosis in severe patients (NLR > 3.82 [50.40%] vs. Combined diagnosis [72.80%]; p = 0.0007; LDH > 246 [59.2%] vs. Combined diagnosis [72.80%]; p < 0.0001).Conclusions High levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis.

Acute Kidney Injury in COVID-19: clinical outcomes and risk factors (preprint)

Background:Understanding of the incidence and effects of acute kidney injury (AKI) in patients diagnosed with COVID-19 is limited. The purpose of this study was to examine risk factors and related outcomes associated with AKI among patients diagnosed with COVID-19. Method:  This is a retrospective cohort study of patients diagnosed with COVID-19 associated-pneumonia admitted to a tertiary hospital in Wuhan between January to February 2020. AKI was defined and staged according to the Kidney Disease: Improving Global Outcome (KDIGO) classification criteria. Cox’s multivariate regression and logistic regression modelling were used to assess the effects of AKI on hospital mortality and risk factors associated with occurrence of AKI. Primary outcomes were risk-adjusted in-hospital mortality.Results:342 patients were finally enrolled in this study. AKI occurred in 13.4% (n = 46), among them 7.0% (n = 24) developed stage 1AKI, and 6.4% (n = 22) developed stage 2 - 3 AKI. Overall 26.9% (n = 92) died during hospitalization. Among them 19.3% (57/296) of the non-AKI patients died, 62.5%(15/24) of stage 1 AKI patients, and 90.9% (20/22) of stage 2 - 3 AKI patients died. AKI was strongly associated with mortality (HR 2.52; 95% CI, 1.59-3.96; p＜0.001). Further analysis shows that progression to AKI stage 2 - 3 doubles the hazard ratio for death. Age, leukocytes number, fibrinogen concentration, C-reative protein level, and severity of pneumonia at admission were independent risk factors associated with the development of AKI. Conclusion:Acute kidney injury is common among hospitalized COVID-19 patients and strongly associated with increased mortality, early detection and prevention of the progression of AKI may be critical to reduce mortality of these patients. 

Comparison and Clinical Characteristics of COVID-19 in Different Time Period in Wuhan, China (preprint)

Background SARS-CoV-2 is making deadly impact on the human lives all over the world. Therefore, we aimed to analyze the changes involved in clinical characteristics of COVID-19 patients over time. Methods We conducted a retrospective study to compare the patients whose onset of illness in January with the patients whose onset of illness in February in Wuhan, China.Results Among enrolled 896 patients, the median age was 60 years (47-69 years), 685 (76.5%) were categorized into group A (patients with illness onset in January), and 211 (23.5%) were categorized into group B (patients with illness onset in February). Compared with group B, group A had a higher rate of fever (p<0.001), the lower rate of asymptomatic (p<0.001). Group A had a higher incidence of neutrophilia (p=0.043), elevated D-miner (p<0.001), increased LDH (p=0.002), but lower incidence of normal CT scan (p=0.001). CD3 cells (p=0.015) and CD4 cells p=0.04) count significantly reduced in group A. Critical patients decreased (p=0.005) and mild patients increased (p=0.001) in group B. The fatality rate significantly decreased in group B (p=0.028).Conclusions The condition of patients with onset of illness in January were more serious than patients with onset of illness in February. It indicates that virulence showed reducing effect, but more basic research is required to support the hypothesis.

Prognostic Value of Neutrophil-To-Lymphocyte Ratio, Lactate Dehydrogenase, D-Dimer and CT Score in Patients with COVID-19 (preprint)

Background: To explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19) in two centers of Hubei, China.Methods: A total of 432 patients with laboratory confirmed COVID-19 were retrospectively enrolled and divided into non-severe and severe groups. The baseline data, laboratory findings, chest computed tomography (CT) results evaluating by CT score on admission, and clinical outcomes were collected and compared. The logistic regression was used to assess the independent relationship between the baseline level of four indicators (NLR, LDH, D-dimer, CT score) on admission and the severity of COVID-19, respectively.Results: Among 432 patients, 125 (28.94%) cases were divided into severe group, the remaining (n = 307, 71.06%) were in non-severe group. In multivariate logistic regression, the high level of NLR, LDH were independent predictor in the early classification of patients with COVID-19 (OR = 2.163; 95%CI = 1.162–4.026; p = 0.015 for NLR > 3.82; OR = 2.298; 95%CI = 1.327–3.979; p = 0.003 for LDH > 246U/L). Furthermore, combining NLR > 3.82 and LDH > 246U/L could increase the sensitivity of diagnosis in severe patients (NLR > 3.82 [50.40%] vs. Combined diagnosis [72.80%]; p = 0.0007; LDH > 246 [59.2%] vs. Combined diagnosis [72.80%]; p < 0.0001).Conclusions: The high levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis.Importance: COVID-19 has been a global pandemic. The mortality rate is range from 3.5-6.0%. In order to predict the risk factors of severity of COVID-19. we explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19) in two centers of Hubei, China. We found that the high levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis.

Facemasks prevent influenza-like illness: implications for COVID-19 (preprint)

The coronavirus disease 2019 (COVID-19) pandemic is causing a huge toll on individuals, families, communities and societies across the world. Currently, whether wearing facemasks in public should be a measure to prevent transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) remains contraversial.1 This is largely because there have been no randomized controlled trials (RCTs) for coronavirus to directly support this. However, lessons may be taken from published RCTs examining influenza-like illness (ILI).2,3 Recent studies suggested that SARS-CoV-2 shares similar transmission route with influenza virus,4 and the incidence of community transmission of SARS-CoV-2 in individuals with ILI is high.5 Therefore, we undertook this meta-analysis of RCTs examining the efficacy of wearing facemasks to prevent ILI in community settings, irrespective of confirmatory testing for the causative virus. We undertook a systematic literature search for RCTs related to facemasks and ILI between 1966 and April 2020 using PUBMED, EMBASE, and Cochrane library. RCTs undertaken in community (not hospital) settings comparing wearing and not wearing facemasks for ILI were included. Incidence of ILI (e.g., fever, cough, headache, sore throat, aches or pains in muscles or joints) was estimated per group. Relative risk (RR) and 95% confidence interval (CI) were calculated. We screened 899 related abstracts and eventually included 8 RCTs (Figure S1). Basic characteristics and quality of included RCTs are listed in Supplement. Participants wearing facemasks had a significantly lower risk of developing ILI than those not wearing facemasks (pooled RR=0.81, 95% CI: 0.70-0.95) and there was no heterogeneity (Figure 1). The decreased risk of ILI was more pronounced if everyone wore facemask irrespective of whether they were infected or not (RR=0.77, 95% CI: 0.65-0.91), compared to those wearing facemasks when infected (RR=0.95, 95% CI: 0.58-1.56) or uninfected (RR=1.26, 95% CI: 0.69-2.31). This study shows that wearing facemasks, irrespective of infection status, is effective in preventing ILI spread in the community. This situation mirrors what is happening now in public settings where we do not know who has been infected and who has not. Although there are no RCTs of facemasks for SARS-CoV-2, as with other simple measures such as social distancing and handwashing, these data support the recommendation to wear facemasks in public to further reduce transmission of SARS-CoV-2 and flatten the curve of this pandemic, especially when social distancing is impractical, such as shopping, or travelling with public transport for work that cannot be done from home.

Anti-hypertensive Angiotensin II receptor blockers associated to mitigation of disease severity in elderly COVID-19 patients (preprint)

Summary Background The novel coronavirus (CoV) severe acute respiratory syndrome (SARS)-CoV-2 outbreak started at the end of 2019 in Wuhan, China, and spread over 100 countries. SARS-CoV-2 uses the membrane protein Angiotensin I converting enzyme 2(ACE2) as a cell entry receptor. Indeed, it was reported that the balance of Renin-Angiotensin System (RAS), regulated by both ACE and ACE2, was altered in COVID-19 patients. It is controversial, however, whether commonly used anti-hypertensive drugs Angiotensin I converting enzyme inhibitor (ACEI) and Angiotensin II receptor blocker (ARB) shall be continued in the confirmed COVID-19 patients. This study was designed to investigate any difference in disease severity between COVID-19 patients with hypertension comorbidity. The included COVID-19 patients used ACEI, ARB, calcium channel blockers (CCB), beta blockers (BB), or thiazide to treat preexisting hypertension prior to the hospital were compared to patients who did not take any of those drugs. Methods In this multicentre retrospective study, clinical data of 511 COVID-19 patients were analyzed. Patients were categorized into six sub-groups of hypertension comorbidity based on treatment using one of anti-hypertension drugs (ACEI, ARB, CCB, BB, thiazide), or none. A meta-analysis was performed to evaluate the use of ACEI and ARB associated with pneumonia using published studies. Findings Among the elderly (age>65) COVID-19 patients with hypertension comorbidity, the risk of COVID-19-S (severe disease) was significantly decreased in patients who took ARB drugs prior to hospitalization compared to patients who took no drugs (OR=0.343, 95% CI 0.128-0.916, p=0.025). The meta-analysis showed that ARB use has positive effects associated with morbidity and mortality of pneumonia. Interpretation Elderly (age>65) COVID-19 patients with hypertension comorbidity who are taking ARB anti-hypertension drugs may be less likely to develop severe lung disease compared to patients who take no anti-hypertension drugs. Funding National Natural Science Foundation of China, Chinese Academy of Medical Sciences

A Peptide-based Magnetic Chemiluminescence Enzyme Immunoassay for Serological Diagnosis of Corona Virus Disease 2019 (COVID-19) (preprint)

A respiratory illness has been spreading rapidly in China, since its outbreak in Wuhan city, Hubei province in December 2019. The illness was caused by a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clinical manifestations related to SARS-CoV-2 infection ranged from no symptom to fatal pneumonia. World Health Organization (WHO) named the diseases associated with SARS-CoV-2 infection as COVID-19. Real time RT-PCR is the only laboratory test available till now to confirm the infection. However, the accuracy of real time RT-PCR depends on many factors, including sampling location and of methods, quality of RNA extraction and training of operators etc. Variations in these factors might significantly lower the sensitivity of the detection. We developed a peptide-based luminescent immunoassay to detect IgG and IgM. Cut-off value of this assay was determined by the detection of 200 healthy sera and 167 sera from patients infected with other pathogens than SARS-CoV-2. To evaluate the performance of this assay, we detected IgG and IgM in the 276 sera from confirmed patients. The positive rate of IgG and IgM were 71.4% (197/276) and 57.2% (158/276) respectively. By combining with real time RT-PCR detection, this assay might help to enhance the accuracy of diagnosis of SARS-CoV-2 infection.