Efficacy of Fuzheng Huayu Tablets for Treating Pulmonary Inflammation in COVID-19 Patients.

Objective:To observe the efficacy and safety of Fuzheng Huayu tabletsFHTfor treating pulmonary inflammation in patients with coronavirus disease 2019COVID-19. Method(s):A total of 704 cases were lost to follow-up, and 66 cases were finally completedCOVID-19 patients were recruited from February 1 to April 15 in 2020. They were assigned to a control group35 patientsand a FHT group31 patients. The patients in the control group received routine treatment alone and those in the FHT group received FHT in addition to routine treatment. The primary outcome was the ratio of patients showing improvement in chest computed tomographic manifestations after 14 days. The secondary outcome measures included remission rate or progression rate of critical illness,clinical remission rate of respiratory symptoms,routine blood examination, C-reactive proteinCPRlevel,procalcitoninPCTlevel,and blood oxygen saturationSPO2 . The safety was assessed based on liver and kidney functions and adverse events. Result(s): After the 14-day treatment,the ratio of patients showing improvement in the FHT group100%was higher than that in the control group 77.1%chi2 =8.063,P<0.01. The ratio of disease stages after treatment showed no significant difference between two groups. In the FHT group,the symptoms including cough,dyspnea,and fatigue were alleviated after treatmentP<0.01. In the control group,the symptoms including fever,cough,and dyspnea were alleviatedP<0.01,while the fatigue was not relieved after treatment. No significant difference was observed in the clinical symptoms between the two groups after treatment. After treatment,the FHT group showed decreased white blood cellWBCcount and neutrophil-to-lymphocyte ratioNLRP<0.01,elevated plateletPLTlevelP<0.05,lowered CRP levelP<0.05,and no significant difference in lymphocyte LYM,hemoglobinHb,SPO2 or PCT level. The control group showed decreased NLRP<0.05and WBC countP<0.01,elevated PCT levelP<0.05,and no significant change in LYM,Hb,PLT,SPO2 or CRP level after treatment. Furthermore,the FHT group had higher PLT level than the control groupP<0.05after treatment,and other indicators had no significant differences between the two groups. The liver and kidney functions had no significant difference between the two groups after treatment. Conclusion(s): FHT can safely promote the absorption of acute pulmonary inflammation in COVID-19 patients.Copyright © 2022, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

[Progress in research of epidemiology of 2019-nCoV reinfection].

Continuous evolution of Omicron variant of 2019-nCoV has resulted in a rapid and simultaneous emergences of novel sub-variants with increased immune escape ability, higher reinfection risk and shorter time interval between infections. Compared with the first infection, the reinfection would still pose exceed risk to people's health although the clinical manifestations of the reinfection might be milder and the risk for severe illness or death is lower. The reinfection is highly associated with people's vaccination status, immunity level, age, working and residential factors. Those who have not received 2019-nCoV vaccination, the elderly and those with comorbidities, especially the previous 2019-nCoV patients with severe/critical illness, are at high risk for the reinfection. Booster doses of vaccine might play an additional role in the prevention of the reinfection and severe illness on the basis of natural immunity.

Physiological Metrics Collected from Wearable Devices Identify Inflammatory and Clinical Inflammatory Bowel Disease Flares

BACKGROUND: Inflammatory bowel disease (IBD) flares are common and unpredictable. Disease monitoring relies on symptom reporting or single timepoint assessments of stool, blood, imaging, or endoscopy-these are inconvenient and invasive and do not always reflect the patient perspective. Advances in wearable technology allow for passive, continuous and non-invasive assessment of physiological metrics including heart rate variability (HRV), the measure of small time differences between each heartbeat, a marker of autonomic nervous system function. Our group has previously demonstrated that changes in autonomic function precedes an IBD flare, can predict psychological state transitions and even identify inflammatory events including SARS-CoV-2 infection. To develop algorithms that can predict IBD flares using wearable device signatures, we launched a national wearable device study called The IBD Forecast study. To assess data quality and feasibility, the first 125 Apple Watch users to enroll were evaluated. METHOD(S): The IBD Forecast study is a prospective cohort study enrolling anyone >=18 years of age in the United States (US) with IBD who is willing to (1) use a commercially available wearable device, (2) download our custom eHive app and (3) answer daily survey questions. HRV metrics (mean of the standard deviations of all the NN intervals [SDNN]) were analyzed using a mixed-effect cosigner model that incorporated body mass index, age, and sex. SDNN is a time domain HRV index that reflects both sympathetic and parasympathetic nervous system activity and is calculated from the variance of intervals between adjacent QRS complexes (the normal-to-normal [NN] intervals). Clinical flare was assessed with daily Patient Reported Outcome (PRO)-2 surveys (flare;PRO-2 Crohn's disease >7, PRO-2 ulcerative colitis >2). Inflammatory flare was assessed via patient reported C-reactive protein (CRP), with inflammatory flare defined as >5 mg/L. RESULT(S): The first 125 study participants were enrolled across 29 states in the US (Table 1). Circadian features of changes of HRV were modelled (Figure 1). The mesor, or midline of the circadian pattern of the SDNN was higher in those with clinical flare (mean 44.43;95% CI 41.25-47.75) compared to those in clinical remission (mean 43.03;95% CI 39.94-46.22) (p<0.004). The mesor of the circadian pattern of the SDNN was lower in those with an inflammatory flare (mean 38.16;95% CI 30.86-45.72) compared to those with normal inflammatory markers (mean 49.51;95% CI 43.12-56.26) (p<0.001). CONCLUSION(S): Longitudinally collected HRV metrics from a commonly worn commercial wearable device can identify symptomatic and inflammatory flares. This preliminary analysis of a small proportion of the IBD Forecast Study cohort demonstrates the feasibility of using wearable devices to identify, and may potentially predict, IBD flares. [Formula presented] [Formula presented]Copyright © 2023

Physiological Metrics Collected from Wearable Devices Identify Inflammatory and Clinical Inflammatory Bowel Disease Flares

BACKGROUND: Inflammatory bowel disease (IBD) flares are common and unpredictable. Disease monitoring relies on symptom reporting or single timepoint assessments of stool, blood, imaging, or endoscopy-these are inconvenient and invasive and do not always reflect the patient perspective. Advances in wearable technology allow for passive, continuous and non-invasive assessment of physiological metrics including heart rate variability (HRV), the measure of small time differences between each heartbeat, a marker of autonomic nervous system function. Our group has previously demonstrated that changes in autonomic function precedes an IBD flare, can predict psychological state transitions and even identify inflammatory events including SARS-CoV-2 infection. To develop algorithms that can predict IBD flares using wearable device signatures, we launched a national wearable device study called The IBD Forecast study. To assess data quality and feasibility, the first 125 Apple Watch users to enroll were evaluated. METHOD(S): The IBD Forecast study is a prospective cohort study enrolling anyone >=18 years of age in the United States (US) with IBD who is willing to (1) use a commercially available wearable device, (2) download our custom eHive app and (3) answer daily survey questions. HRV metrics (mean of the standard deviations of all the NN intervals [SDNN]) were analyzed using a mixed-effect cosigner model that incorporated body mass index, age, and sex. SDNN is a time domain HRV index that reflects both sympathetic and parasympathetic nervous system activity and is calculated from the variance of intervals between adjacent QRS complexes (the normal-to-normal [NN] intervals). Clinical flare was assessed with daily Patient Reported Outcome (PRO)-2 surveys (flare;PRO-2 Crohn's disease >7, PRO-2 ulcerative colitis >2). Inflammatory flare was assessed via patient reported C-reactive protein (CRP), with inflammatory flare defined as >5 mg/L. RESULT(S): The first 125 study participants were enrolled across 29 states in the US (Table 1). Circadian features of changes of HRV were modelled (Figure 1). The mesor, or midline of the circadian pattern of the SDNN was higher in those with clinical flare (mean 44.43;95% CI 41.25-47.75) compared to those in clinical remission (mean 43.03;95% CI 39.94-46.22) (p<0.004). The mesor of the circadian pattern of the SDNN was lower in those with an inflammatory flare (mean 38.16;95% CI 30.86-45.72) compared to those with normal inflammatory markers (mean 49.51;95% CI 43.12-56.26) (p<0.001). CONCLUSION(S): Longitudinally collected HRV metrics from a commonly worn commercial wearable device can identify symptomatic and inflammatory flares. This preliminary analysis of a small proportion of the IBD Forecast Study cohort demonstrates the feasibility of using wearable devices to identify, and may potentially predict, IBD flares. (Table Presented).

The effect of innovation on tourists' revisit intention toward tourism destinations

Purpose: Drawing on Schumpeter's theory of innovation and stereotype content model, this study aims to arrive at an integrated model that relates destination innovation type, destination innovativeness and revisit intention to uncover more about the drivers and outcomes of destination innovativeness from a consumer-centric perspective. Design/methodology/approach: Three studies, including content analysis of news media, an onsite survey and an online survey in Chinese special featured towns, were conducted. Findings: This study develops a consumer-centric destination innovation measure. The results reveal that input innovation and product innovation positively influence revisit intention through the serial mediation of destination innovativeness and perceived competence. Research limitations/implications: As the data was collected from tourists in China, any generalization of the results to other regions should be made with caution;accordingly, replication is needed to test the proposed model in different cultural contexts. Second, during the onsite data collection period, special featured town destinations were still recovering from the COVID-19 pandemic, which may have affected the perceptions of tourists. Third, the second round of data was collected using an online survey, which may have introduced bias due to a potential lack of representativeness. Fourth, some potential missing variables could also influence the links among innovation, destination innovativeness and revisit intention. Originality/value: This study presents the first empirical test of the impact of innovation type and innovativeness on tourists' response to tourism destinations. The results of this study could guide destinations to deliver more effective consumer-centric innovations to generate competitiveness. © 2022, Emerald Publishing Limited.

Strategic Perspective of Leveraging New Generation Information Technology to Enable Modernization of Emergency Management

The application and development of the new generation information technology is a vital support to realize the modernization of emergency management. At present, the new generation information technology such as big data and artificial intelligence has been widely used in natural disasters, safe production, and other fields. It has improved the monitoring and early warning, regulation and law enforcement, command and decision support, rescue, and social mobilization capabilities of governments, promoted the level of intrinsic safety of enterprises, provided important support for the precise prevention and control of the COVID-19, and increased the efficiency of China's emergency management and sense of security of the public. In the process of comprehensively promoting the great rejuvenation of the Chinese nation with the Chinese modernization, driven by the strategic need of using the new security paradigm to ensure the new development paradigm, the application of the new generation information technology shall not only meet single and specific needs of operations, but also pay more attention to the management of unconventional emergencies, the value guidance of the overall national security concept, the support to the institutional advantages of China's emergency management, and the standard articulation, open innovation of data resources, and intelligent utilization, so as to realize the co-evolution between emergency management and information technology based on the decrease of uncertainty. The modernization of emergency management supported by the new generation information technology also needs to play an important role in developing independent knowledge, promoting interdisciplinary integration, leading information technology innovation, facilitating industrial prosperity and development, and making more contributions to the Chinese modernization. © 2022, Science Press. All rights reserved.

[Progress in research of etiology and epidemiology of 2019-nCoV Omicron variant].

2019-nCoV Omicron variant has become predominant in the world. New subvariants with further mutations in their spike proteins are continuously emerging. Compared with the wild type and other variants of concern, Omicron variant exhibits altered etiological and epidemiological characteristics, with weakened pathogenicity and toxicity in laboratory mice and hamsters as well as enhanced immune escape capacity. The human infections are more likely to be asymptomatic and mild characterized by upper respiratory tract symptoms with reduced risk of hospitalization and death. In addition, Omicron variant can transmit more rapidly and shows shorter incubation period to cause infection, and the variant is more likely to transmit through contamination of object surfaces and aerosols spread. This paper summarizes the etiological and epidemiological characteristics of Omicron variant to provide a reference for the effective prevention and control of Omicron variant infection.

Discussion on the Social Return after the Outbreak of COVID-19

After COVID-19, patients, medical workers and the whole society in COVID-19 were faced with the challenge of how to quickly return to normal life. Patients cured in COVID-19 would face mental or psychological barriers, or be discriminated against, or face problems such as overweight of local epidemic prevention policies. The front-line medical personnel experienced job burnout and a variety of mental and psychological disorders, with some even developing physical symptoms. During the epidemic, ordinary people were in a state of psychological stress, education, production and economic activities were affected, and the incidence of mental or psychological disorders increases. It was necessary to provide COVID-19 patients with mental health monitoring and counseling. Give professional guidance to front-line medical staff, arrange rotation reasonably, and pay attention to their mental health status. Local governments should strictly implement the national epidemic prevention system, formulate epidemic prevention policies with humanistic care, actively publicize epidemic related knowledge and safeguard the rights and interests of the people. © 2022, Editorial department of Chinese Medical Ethics. All rights reserved.

[Development and applications of digital public health].

Rapidly upgraded digital technology has impacted all walks of life, and public health field is also undergoing a digital transformation. The COVID-19 pandemic has accelerated the wide use of digital technology in the prevention and control of infectious diseases, greatly enhancing the capacity of public health system in emergency response and routine disease prevention and control. This article summarizes the definition of digital public health, applications of digital technology in the prevention and control of infectious diseases and chronic non-communicable diseases, as well as in public health surveillance, discusses the challenges in the development of digital public health and introduces the eight principles for digital transformation of public health proposed by the Pan American Health Organization.

Efficacy of Fuzheng Huayu Tablets for Treating Pulmonary Inflammation in COVID-19 Patients

Objective：To observe the efficacy and safety of Fuzheng Huayu tablets（FHT）for treating pulmonary inflammation in patients with coronavirus disease 2019（COVID-19）. Method：A total of 70（4 cases were lost to follow-up, and 66 cases were finally completed）COVID-19 patients were recruited from February 1 to April 15 in 2020. They were assigned to a control group（35 patients）and a FHT group（31 patients）. The patients in the control group received routine treatment alone and those in the FHT group received FHT in addition to routine treatment. The primary outcome was the ratio of patients showing improvement in chest computed tomographic manifestations after 14 days. The secondary outcome measures included remission rate or progression rate of critical illness，clinical remission rate of respiratory symptoms，routine blood examination， C-reactive protein（CPR）level，procalcitonin（PCT）level，and blood oxygen saturation（SPO2 ）. The safety was assessed based on liver and kidney functions and adverse events. Result： After the 14-day treatment，the ratio of patients showing improvement in the FHT group（100%）was higher than that in the control group （77.1%）（χ2 =8.063，P<0.01）. The ratio of disease stages after treatment showed no significant difference between two groups. In the FHT group，the symptoms including cough，dyspnea，and fatigue were alleviated after treatment（P<0.01）. In the control group，the symptoms including fever，cough，and dyspnea were alleviated（P<0.01），while the fatigue was not relieved after treatment. No significant difference was observed in the clinical symptoms between the two groups after treatment. After treatment，the FHT group showed decreased white blood cell（WBC）count and neutrophil-to-lymphocyte ratio（NLR）（P<0.01），elevated platelet（PLT）level（P<0.05），lowered CRP level（P<0.05），and no significant difference in lymphocyte （LYM），hemoglobin（Hb），SPO2 or PCT level. The control group showed decreased NLR（P<0.05）and WBC count（P<0.01），elevated PCT level（P<0.05），and no significant change in LYM，Hb，PLT，SPO2 or CRP level after treatment. Furthermore，the FHT group had higher PLT level than the control group（P<0.05）after treatment，and other indicators had no significant differences between the two groups. The liver and kidney functions had no significant difference between the two groups after treatment. Conclusion： FHT can safely promote the absorption of acute pulmonary inflammation in COVID-19 patients. © 2022, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

Clinical characteristics of liver and kidney injuries and correlation with severity and mortality in patients with COVID-19

Objective To describe the clinical characteristics of liver and kidney injuries and investigate its effect on the severity and mortality in the COVID-19 patients.Methods A total of 3 548 patients diagnosed with COVID-19 hut without liver and kidney diseases admitted in the Huoshenshan Hospital, Jinyintan Hospital and Taikang Tongji Hospital from February 4, 2020 to April 16, 2020 were recruited in this study.Their clinical data were extracted from medical database, including general information, clinical features, laboratory results and outcomes such as death were collected and analyzed.SPSS statistics 23.0 was used to perform the statistical description and analysis.Results Among the 3 548 patients with COYID-19, 875 (24.7%) cases were severe illness and above and 91 (2.6%) died during hospitalization.The proportions of the patients with higher alanine amiotransferase ( ALT) , aspartate aminotransferase ( AST) and creatinine (Cr) were 14.6% (513/3 548) , 3.4% ( 1 19/3 548) and 2.8% ( 101/3 548), respectively.Compared with the patients with normal ALT, AST and Cr, the patients with elevated ALT did not have a significantly increased risk of severe illness or death ( /-∗>().05) , and the risk of severe illness and death was significantly increased in those with elevated AST and Cr ( P<0.05).The risk of severe disease was 2.32 times (95%CI: 1.73-3.10) and 1 1.40 times ( 95% CI: 2.36-54.98 ) for those with single or both liver and kidney injuries, and the risk of death was 5.21 times (95% CI: 3.10-8.75 ) and 13.53 times (95% CI: 2.76-66.32) for those with normal liver and kidney function, respectively.Logistic regression analysis indicated that after independent factors related to severe illness and death screened out as correction factors, the risk of severe illness and death was 1.612 times (95% CI: 1.17-2.22) and 2.907 times (95% CI: 1.61-5.24) of patients with liver or kidney injuries when compared with those with normal function, respectively.Conclusion The COYID-19 patients with liver and renal injuries have a significantly increased tendency to become severity and mortality, and should undergo early intervention. © 2021 Editorial Office of Journal of Third Military Medical University. All rights reserved.

[Current status of COVID-19 pandemic and progress in response strategy].

As the approaching of autumn and winter in northern hemisphere, COVID-19, mainly transmitted through respiratory droplets and close contact, has posed new challenge to the countries across the world. This paper summarizes the current status of COVID-19 pandemic and related responses performed in terms of the variation of SARS-CoV-2, global situation reports, herd immunity and the influence of asymptomatic infection on COVID-19 prevention and control in China, as well as vaccine development progress and case treatment for the purpose of providing reference to further improve the COVID-19 prevention and control strategy in China.

[Application of healthcare big data in active case finding of COVID-19 in Yinzhou district of Ningbo].

During the prevention and control of the COVID-19 epidemic, identifying and controlling the source of infection has become one of the most important prevention and control measures to curb the epidemic in the absence of vaccines and specific therapeutic drugs. While actively taking traditional and comprehensive "early detection" measures, Yinzhou district implemented inter-departmental data sharing through the joint prevention and control mechanism. Relying on a healthcare big data platform that integrates the data from medical, disease control and non-health sectors, Yinzhou district innovatively explored the big data-driven COVID-19 case finding pattern with online suspected case screening and offline verification and disposal. Such effort has laid a solid foundation and gathered experience to conduct the dynamic and continuous surveillance and early warning for infectious disease outbreaks more effectively and efficiently in the future. This article introduces the exploration of this pattern in Yinzhou district and discusses the role of big data-driven disease surveillance in the prevention and control of infectious diseases.

[Rethinking public health education and public health workforce development in China].

During the fighting against COVID-19, both the public health education and public health workforce of China have exposed important challenges. The present review discusses dilemmas and weakness that relate to the position of public health education in the higher education system, public health education system, curriculum system, teaching methods, practice-based teaching, training of highly qualified personnel in public health, public health teachers, remuneration and non-monetary honorable rewards for the public health workforce. Suggestions are also proposed for each of the challenges.

[Analysis on cluster cases of COVID-19 in Tianjin].

Objective: To understand the characteristics of clusters of COVID-19 cases in Tianjin, and provide epidemiological evidence for the prevention and control of COVID-19. Methods: The data of all the COVID-19 cluster cases in Tianjin, reported by 22 February 2020, were collected to analyze the characteristics of different types of the clusters. Results: A total of 115 COVID-19 cases were reported in 33 clusters in Tianjin included 28 family clusters (71 cases), 1 work place cluster (10 cases), 3 transport vehicle clusters (8 cases) and 1 public place cluster (26 cases). Family clusters were caused by the cases from the working place or public place clusters. Numbers of secondary cases of family clusters was between 1 to 7, the median number was 2. The interval from onset to diagnosis for the first case was longer than those of other cases in the familial clusters (Z=-2.406, P=0.016). The median of incubation period of the public place clusters was 2 days. The intervals from onset to diagnosis were significant different among the family, working place and public place clusters (H=8.843, P=0.012), and also significant differences in onset time among the secondary cases (H=16.607, P=0.000). Conclusions: In the surveillance of COVID-19 epidemic, special attention should be paid to places where clustering are prone to occur, and the epidemiological investigation should be carried out timely to confirm the cluster. To prevent the transmission of COVID-19, the close contacts of the patients should be transferred to an assigned observation place on time for single room isolation. The awareness of COVID-19 prevention is low in some rural areas, reflected by many mass gathering activities and delayed medical care seeking after onset. It is necessary to strengthen the health education and take control measures in early period of epidemic.