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The molecular docking-based virtual screening technique evaluates the binding abilities between multiple ligand compounds and receptors to screen for the active compounds. In the context of the global spread of the COVID-19 pandemic, large-scale and rapid drug virtual screening is crucial for identifying potential drug molecules from massive datasets of ligand structures. The powerful computing power of supercomputer provides hardware guarantee for drug virtual screening, but the super large-scale drug virtual screening still faces many challenges that affects the effective execution of the calculation. Based on the analysis of the challenges, this paper proposes a centralized task distribution scheme with a central database, and designs a multi-level task distribution framework. The challenges are effectively solved through multi-level intelligent scheduling, multi-level compression processing of massive small molecule files, dynamic load balancing and high error tolerance management technology. An easy-touse"tree”multi-level task distribution system is implemented. A fast, efficient and stable drug virtual screening task distribution, calculation and result analysis function is realized, and the computing efficiency is nearly linear. Then, heterogeneous computing technology is used to complete the drug virtual screening of more than 2 billion compounds, for two different active sites for COVID-19, on the domestic super computing system, which provides a powerful computing guarantee for the super large-scale rapid virtual screening of explosive malignant infectious diseases. © 2023, Journal of Computer Engineering and Applications Beijing Co., Ltd.;Science Press. All rights reserved.
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Vaccination has been proved to be the most effective strategy to prevent the Corona Virus Disease 2019 (COVID-19). The mRNA vaccine based on nano drug delivery system (NDDS) - lipid nanoparticles (LNP) has been widely used because of its high effectiveness and safety. Although there have been reports of severe allergic reactions caused by mRNA-LNP vaccines, the mechanism and components of anaphylaxis have not been completely clarified yet. This review focuses on two mRNA-LNP vaccines, BNT162b2 and mRNA-1273. After summarizing the structural characteristics, potential allergens, possible allergic reaction mechanism, and pharmacokinetics of mRNA and LNP in vivo, this article then reviews the evaluation methods for patients with allergic history, as well as the regulations of different countries and regions on people who should not be vaccinated, in order to promote more safe injection of vaccines. LNP has become a recognized highly customizable nucleic acid delivery vector, which not only shows its value in mRNA vaccines, but also has great potential in treating rare diseases, cancers and other broad fields in the future. At the moment when mRNA-LNP vaccines open a new era of nano medicine, it is expected to provide some inspiration for safety research in the process of research, development and evaluation of more nano delivery drugs, and promote more nano drugs successfully to market.Copyright © 2023, Chinese Pharmaceutical Association. All rights reserved.
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Background & Aim: The long-term effects of human mesenchymal stem cell (MSC) treatment on COVID-19 patients have not been fully characterized. The aim of this study was to evaluate the safety and efficacy of a MSC treatment administered to severe COVID-19 patients enrolled in a randomized, double-blind, placebo-controlled clinical trial (NCT 04288102). Methods, Results & Conclusion(s): A total of 100 patients experiencing severe COVID-19 received either MSC treatment (n = 65, 4x107 cells per infusion) or a placebo (n = 35) combined with standard of care on days 0, 3, and 6. Patients were subsequently evaluated 18 and 24 months after treatment to evaluate the long-term safety and efficacy of the MSC treatment. The outcomes measured included: 6-minute walking distance (6-MWD), lung imaging, quality of life according to the Short Form 36 questionnaire, COVID-19-related symptoms, titers of SARS-CoV-2 neutralizing antibodies, MSC-related adverse events (AEs), and tumor markers. Two years after treatment, a marginally smaller proportion of patients had a 6-MWD below the lower limit of the normal range in the MSC group than in the placebo group (OR = 0.19, 95% CI: 0.04-0.80, Fisher's exact test, p = 0.015). On the SF-36 questionnaire, a marginally higher general health score was received by the MSC group at month 18 compared with the placebo group (50.00 vs. 35.00;95% CI: 0.00-20.00, Wilcoxon rank sum test, p = 0.016). In contrast, there were no differences in the total severity score of lung imaging or the titer of neutralizing antibodies between the two groups. Meanwhile, there were no MSC-related AEs reported at the 18- or 24-month follow-ups. The serum levels of most of the tumor markers examined remained within normal ranges and were similar between the MSC and placebo groups. Long-term safety was observed for the COVID-19 patients who received MSC treatment. Yet few sustained efficacy of MSC treatment was observed at the end of the 2-year follow-up period. Funding(s): The National Key Research and Development Program of China (2022YFA1105604, 2020YFC0860900), the specific research fund of The Innovation Platform for Academicians of Hainan Province (YSPTZX202216) and the Fund of National Clinical Center for Infectious Diseases, PLA General Hospital (NCRCID202105,413FZT6). [Figure presented]Copyright © 2023 International Society for Cell & Gene Therapy
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Objective To explore the clinical effect and safety of Suhexiang Pills () in the treatment of patients infected with SARS-CoV-2. Methods A total of 192 patients infected with SARS-CoV-2 admitted to 17 hospitals including Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from December 2022 to January 2023 were randomly divided into control group and treatment group, with 89 patients in the treatment group and 103 in the control group. The patients in control group received basic treatment according to the Diagnosis and Treatment Protocol for COVID-19 (Trial Version 10). The patients in treatment group were oral administered with Suhexiang Pills on the basis of the control group, one pill each time, twice day. The patients in two groups were treated for 5 d. The clinical efficacy of the two groups after treatment was compared. The differences in scores of headache, chest pain, limb pain and inflammatory indexes before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was 95.51%, which was significantly higher than that of the control group (81.55%, P < 0.05). After treatment, headache, chest pain and limb pain scores were significantly decreased in both groups (P < 0.05), the headache score of the treatment group was significantly lower than that of the control group from the first day of treatment (P < 0.05), the chest pain score of the treatment group was significantly lower than that of the control group on the fifth day of treatment (P < 0.05), the limb pain score of the treatment group was significantly lower than that of the control group from the third day of treatment (P < 0.05). After treatment, the levels of C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6) in the two groups were decreased significantly (P < 0.05) and the levels of CRP and IL-6 in the treatment group were significantly lower than those of the control group (P < 0.05). There was no significant difference in the incidence of adverse events between the two groups. Conclusion Suhexiang Pills have a certain effect on headache, chest pain and limb pain, inhibiting the inflammatory response in patients infected with SARS-CoV-2, with good safety.Copyright © 2023 Editorial Office of Chinese Traditional and Herbal Drugs. All rights reserved.
ABSTRACT
Vaccination has been proved to be the most effective strategy to prevent the Corona Virus Disease 2019 (COVID-19). The mRNA vaccine based on nano drug delivery system (NDDS) - lipid nanoparticles (LNP) has been widely used because of its high effectiveness and safety. Although there have been reports of severe allergic reactions caused by mRNA-LNP vaccines, the mechanism and components of anaphylaxis have not been completely clarified yet. This review focuses on two mRNA-LNP vaccines, BNT162b2 and mRNA-1273. After summarizing the structural characteristics, potential allergens, possible allergic reaction mechanism, and pharmacokinetics of mRNA and LNP in vivo, this article then reviews the evaluation methods for patients with allergic history, as well as the regulations of different countries and regions on people who should not be vaccinated, in order to promote more safe injection of vaccines. LNP has become a recognized highly customizable nucleic acid delivery vector, which not only shows its value in mRNA vaccines, but also has great potential in treating rare diseases, cancers and other broad fields in the future. At the moment when mRNA-LNP vaccines open a new era of nano medicine, it is expected to provide some inspiration for safety research in the process of research, development and evaluation of more nano delivery drugs, and promote more nano drugs successfully to market.Copyright © 2023, Chinese Pharmaceutical Association. All rights reserved.
ABSTRACT
At present, coronavirus disease-19 (COVID-19) caused by novel coronavirus (SARS-CoV-2) has been spreading around the world, but no specific therapeutic drug or vaccine has been developed for the virus. By collecting the latest literature and searching related database websites, the biological characteristics and main targets of SARS-CoV-2, the clinical therapeu tic drugs and the latest drug research were reviewed to provide information for clinical treatment and provide reference for the research and development of new drugs against SARS-CoV-2.Copyright © 2020 Publication Centre of Anhui Medical University. All rights reserved.
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Background The continued spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains an international public health emergency, resulting in a significant global disease burden. The long-term effects of SARS-CoV-2 infection in humans and the long-term prognosis of patients with coronavirus disease 2019 (COVID-19) after discharge remain unclear. We aimed to assess the quality of life (QoL) and sequelae in patients with COVID-19 after discharge from the hospital by conducting multiple follow-up visits to understand the long-term effects of SARS-CoV-2 on patients' health and its possible influencing factors. Methods COVID-19 patients discharged from Huoshenshan Hospital (Wuhan, China) between February 15 and April 5, 2020, were followed up at 6, 9, and 12 months after discharge. They completed questionnaires on postdischarge QoL and sequelae under the guidance of medical staff with professional training. The demographic and clinical characteristics of the COVID-19 patients were analyzed using descriptive statistics. A generalized estimating equation model was used to analyze the QoL-related factors. The χ2 test (or Fisher exact test) and multivariate logistic regression analysis were used to analyze the sequelae and influencing factors. Results A total of 175 patients participated in at least 1 follow-up visit, and 120 completed all 3 follow-up visits. Patients diagnosed with severe and critically ill COVID-19 had worse mental conditions (χ2 = 7.653, P = 0.022) than those with the nonsevere type (not severe or critical) and were more likely to feel fatigued (χ2 = 4.836, P = 0.028). Female patients had a higher risk of sleep disturbance (χ2 = 10.026, P = 0.002) and dyspnea (χ2 = 5.672, P = 0.017) and had more difficulty returning to their original work and life (χ2 = 8.922, P = 0.003) than male patients. Patients with diabetes had a worse appetite (χ2 = 4.669, P = 0.031) and were more prone to sleep disturbance (χ2 = 4.417, P = 0.036) after discharge. The proportion of patients with at least 1 sequela increased from 29.76% (50/168) at 6 months to 51.11% (69/135) at 9 months (χ2 = 14.305, P < 0.001). Compared with the nonsevere type, patients diagnosed with severe and critically ill COVID-19 had an odds ratio (OR) of 4.325 (95% confidence interval [CI], 1.215-15.401) for memory decline. Female patients had an OR of 4.632 (95% CI, 1.716-12.501) for joint or muscle pain. Patients with hypertension had an OR of 3.014 (95% CI, 1.193-7.615) for joint or muscle pain. Conclusion One year after discharge, there were still some patients with varying degrees of decline in QoL and sequelae, which occurred in all follow-up visits. Moreover, QoL and sequelae after discharge were related to sex, clinical classification of COVID-19, and underlying diseases. © Wolters Kluwer Health, Inc. All rights reserved.
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A model that can obtain rapid and accurate detection of coronavirus disease 2019 (COVID-19) plays a significant role in treating and preventing the spread of disease transmission. However, designing such a model that can balance the detection accuracy and weight parameters of memory well to deploy a mobile device is challenging. Taking this point into account, this paper fuses the convolutional neural network and residual learning operations to build a multi-class classification model, which improves COVID-19 pneumonia detection performance and keeps a trade-off between the weight parameters and accuracy. The convolutional neural network can extract the COVID-19 feature information by repeated convolutional operations. The residual learning operations alleviate the gradient problems caused by stacking convolutional layers and enhance the ability of feature extraction. The ability further enables the proposed model to acquire effective feature information at a low cost, which can make our model keep small weight parameters. Extensive validation and comparison with other models of COVID-19 pneumonia detection on the well-known COVIDx dataset show that (1) the sensitivity of COVID-19 pneumonia detection is improved from 88.2% (non-COVID-19) and 77.5% (COVID-19) to 95.3% (non-COVID-19) and 96.5% (COVID-19), respectively. The positive predictive value is also respectively increased from 72.8% (non-COVID-19) and 89.0% (COVID-19) to 88.8% (non-COVID-19) and 95.1% (COVID-19). (2) Compared with the weight parameters of the COVIDNet-small network, the value of the proposed model is 13 M, which is slightly higher than that (11.37 M) of the COVIDNet-small network. But, the corresponding accuracy is improved from 85.2% to 93.0%. The above results illustrate the proposed model can gain an efficient balance between accuracy and weight parameters. © 2023 Tech Science Press. All rights reserved.
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The outbreak of Covid-19 has exposed the lack of medical resources, especially the lack of medical personnel. This results in time and space restrictions for medical services, and patients cannot obtain health information all the time and everywhere. Based on the medical knowledge graph, healthcare bots alleviate this burden effectively by providing patients with diagnosis guidance, pre-diagnosis, and post-diagnosis consultation services in the way of human-machine dialogue. However, the medical utterance is more complicated in language structure, and there are complex intention phenomena in semantics. It is a challenge to detect the single intent, multi-intent, and implicit intent of a patient's utterance. To this end, we create a high-quality annotated Chinese Medical query (utterance) dataset, CMedQ (about 16.8k queries in medical domain which includes single, multiple, and implicit intents). It is hard to detect intent on such a complex dataset through traditional text classification models. Thus, we propose a novel detect model Conco-ERNIE, using concept co-occurrence patterns to enhance the representation of pre-trained model ERNIE. These patterns are mined using Apriori algorithm and will be embedded via Node2Vec. Their features will be aggregated with semantic features into Conco-ERNIE by using an attention module, which can catch user explicit intents and also predict user implicit intents. Experiments on CMedQ demonstrates that Conco-ERNIE achieves outstanding performance over baseline. Based on Conco-ERNIE, we develop an intelligent healthcare bot, MedicalBot. To provide knowledge support for MedicalBot, we also build a Chinese medical graph, CMedKG (about 45k entities and 283k relationships). © 2023 Association for Computing Machinery.
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Rapid and accurate detection of COVID-19 plays a significant role in treating and preventing the spread of disease transmission. To this end, we fuse the convolutional neural network and residual learning operation to build a multi-class classification model, which has a few parameters and is more conducive to be deployed on a mobile device. Extensive experiments show that our proposed model gains competitive performance. Compared with the COVIDNet-small network, the sensitivity of COVID-19 pneumonia detection is improved from 88.2% (non-COVID-19) and 77.5% (COVID-19) to 95.3% (non-COVID-19) and 96.5% (COVID-19). Alternatively, the Positive predictive value is increased from 72.8% (non-COVID-19) and 89.0% (COVID-19) to 88.8% (non-COVID-19) and 95.1 % (COVID-19). The accuracy is also improved from 85.2 % to 93.0 %, which is very close to the value (93.3 %) of the COVIDNet-large network. But, the weight parameters (13M) of the proposed model are slightly higher than that (11.37M) of the COVIDNet-small network, but only about one-third of that (37.85M) of the COVIDNet-large network. © 2022 IEEE.
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Objectives: This study investigated the perceived impact of the COVID-19 pandemic on youth with chronic tic disorders (CTD) and/or obsessive-compulsive disorder (OCD) based on subjective reports, objective measures, and parental feedback. This study also sought to investigate whether and how these reported experiences differed based on the presence of underlying tic and/or OCD spectrum diagnoses. Method(s): Children with CTD, OCD, and Tics + OCD and their parents were recruited to complete an online survey from July 2020 through April 2021. Forty-eight responses were received;child respondents had a median age of 12 years. Result(s): On average, youth reported that the pandemic negatively impacted them in several domains, particularly after-school activities, relationships with friends, and social/community gatherings. Despite the small sample size, youth with OCD appeared to experience a greater negative impact compared to other subgroups. Median screen use in this sample was 3-8 hours a day, and youth who reported > 8 hours on weekends trended towards increased depressive symptoms. Conclusion(s): Consistent with the physician-authors' clinical experiences, youth with CTD, OCD, and Tics + OCD and their parents reported a subjective negative impact of the pandemic on various symptoms and psychosocial domains. Going forward, if another lockdown loomed, it would be valuable to stay attuned to these vulnerable youth, particularly those with OCD symptoms, and consider providing support in specific psychosocial domains, such as relationship with peers and home life.Copyright © 2023 Elsevier Inc.
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Objective To explore the clinical effect and safety of Suhexiang Pills () in the treatment of patients infected with SARS-CoV-2. Methods A total of 192 patients infected with SARS-CoV-2 admitted to 17 hospitals including Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from December 2022 to January 2023 were randomly divided into control group and treatment group, with 89 patients in the treatment group and 103 in the control group. The patients in control group received basic treatment according to the Diagnosis and Treatment Protocol for COVID-19 (Trial Version 10). The patients in treatment group were oral administered with Suhexiang Pills on the basis of the control group, one pill each time, twice day. The patients in two groups were treated for 5 d. The clinical efficacy of the two groups after treatment was compared. The differences in scores of headache, chest pain, limb pain and inflammatory indexes before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was 95.51%, which was significantly higher than that of the control group (81.55%, P < 0.05). After treatment, headache, chest pain and limb pain scores were significantly decreased in both groups (P < 0.05), the headache score of the treatment group was significantly lower than that of the control group from the first day of treatment (P < 0.05), the chest pain score of the treatment group was significantly lower than that of the control group on the fifth day of treatment (P < 0.05), the limb pain score of the treatment group was significantly lower than that of the control group from the third day of treatment (P < 0.05). After treatment, the levels of C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6) in the two groups were decreased significantly (P < 0.05) and the levels of CRP and IL-6 in the treatment group were significantly lower than those of the control group (P < 0.05). There was no significant difference in the incidence of adverse events between the two groups. Conclusion Suhexiang Pills have a certain effect on headache, chest pain and limb pain, inhibiting the inflammatory response in patients infected with SARS-CoV-2, with good safety.Copyright © 2023 Editorial Office of Chinese Traditional and Herbal Drugs. All rights reserved.
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Some policies implemented during the pandemic extended the time that students spend on electronic devices, increasing the risk of physical and eye strain. However, the role of different environments on eye strain recovery has not been determined. We recruited 20 undergraduate students (10 males and 10 females) from a university in eastern China and explored the restoration effects of their eye strain in different types of spaces (wayside greenspace, a playground, a square, and woodland) on campus through scale measurements. The results showed that the eye strain of the students accumulated by 15 min of e-learning was significantly relieved after 10 min of greenspace exposure compared to the indoor environment, and the recovery effect varied depending on the type of landscape. The effect of eye strain relief was found to be positively correlated with temperature, wind speed, visible sky ratio, canopy density, tree density, and solar radiation intensity, while it was negatively correlated with relative humidity. These findings enrich the research on the restoration benefits of greenspaces and provide a basis for predicting the effect of different environments on the relief of eye strain. © 2022 by the authors.
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Objective: To investigate the clinical evaluation effects of Corona Virus Disease 2019 (COVID-19) risk assessment scale on preoperative and surgical risk of liver transplantation during the COVID-19 outbreak. Method(s): The retrospective and descriptive study was conducted. The clinicopathological data of 6 liver transplant recipients who were admitted to Southern Theater Command General Hospital of PLA between January 20 and March 27, 2020 were collected. There were 5 males and 1 female, aged from 42.0 to 62.0 years, with a median age of 53.0 years. There were 6 donors including 5 males and 1 female, aged from 24.0 to 60.0 years, with a median age of 41.5 years. All the donor livers were obtained through the China Organ Transplant Response System. Liver transplantation was performed in the fixed negative pressure operating room, and secondary protective measures were adopted for low-risk donors. Classic orthotopic liver transplantation or Piggyback liver transplantation was performed according to the specific situations of the recipients. Medical staffs in the ward were exposed to the secondary protective measures, and the three-grade protective measures were adopted for medical staffs when the liver transplant recipients had fever or suspected infection. Observation indicators: (1) risk assessment of COVID-19 on liver transplant recipients;(2) risk assessment of COVID-19 on medical staffs of liver transplantation;(3) treatment situations of liver transplant recipients;(4) postoperative situations of liver transplant recipients;(5) follow-up of liver transplant recipients;(6) infection of medical staffs of liver transplantation. Follow-up was performed using outpatient examination or telephone interview to detect whether liver transplant recipients had suspected or confirmed COVID-19 infection up to March 2020. Medical staffs who were involved in organ acquisition, transplantation surgery and ward management were followed up to detect whether they had suspected or confirmed COVID-19 infection within 14 days. Measurement data with normal distribution were represented as Mean+/-SD, and measurement data with skewed distribution were described as M (range). Count data were expressed as absolute numbers. Result(s): (1) Risk assessment of COVID-19 on liver transplant recipients: all the 6 recipients and their related families were confirmed no contact with suspected COVID-19 patients or travel history in the epidemic area within 14 days. Of the 6 recipients, 1 was diagnosed with fever with body temperature of 38.1 and was tested negative for chest computer tomography (CT) examination and nucleic acid test for COVID-19;1 was diagnosed with fever and hypoxemia with body temperature of 38.5 and was tested negative for nucleic acid test for COVID-19, and the results of chest CT examination showed large amount of pleural effusion in both lungs without invasive pneumonia;other 4 recipients had no clinical symptoms of COVID-19 with negative results of chest CT examination and nucleic acid test for COVID-19. Five of the 6 recipients had no history of contact with COVID-19 patients and 1 recipient had treatment history at hospital of risk level 1. The preoperative risk level of COVID-19 was low in all the 6 liver transplant recipients. (2) Risk assessment of COVID-19 on medical staffs of liver transplantation: of the 6 recipients, 5 had the waiting hospital of risk level 0 and 1 had the waiting hospital of risk level 1. Six recipients had the transplant hospital of risk level 0. (3) Treatment situations of liver transplant recipients: of the 6 recipients, 2 underwent classic orthotopic liver transplantation and 4 underwent piggyback liver transplantation. The cold ischemia time of liver, time of anhepatic phase, volume of intraoperative blood loss, operation time, treatment time at intensive care unit of the 6 recipients were (5.9+/-2.4)hours, (49+/-14)minutes, 1 500 mL(range, 800-1 800 mL), (8.9+/-2.1)hours, 2 days(range, 1-4 days), respectively. Of the 6 recipients, 2 required adjustment of the immunosuppression progr m, and 4 did not change the immunosuppression program. (4) Postoperative situations of liver transplant recipients: of the 6 recipients, 5 had no postoperative serious infection and 1 had postoperative serious infection. The 5 recipients without postoperative serious infection had the range of the highest temperature as 37.8-38.5 , and returned to normal temperature within postoperative 3 days. All of the 5 recipients who had no postoperative serious infection received chest CT examination with no obvious manifestation of viral pneumonia and were tested negative for nucleic acid test for COVID-19 at 1 week postoperatively, and then were discharged from hospital. One recipient who had postoperative serious infection had gastrointestinal fistula and repeated fever at postoperative 7 days with the highest temperature as 39.2 . This recipient had body temperature returned to normal and good function of the graft after treatment in the isolation ward with active drainage, and was transferred back to local hospital for further rehabilitation treatment. The duration of hospital stay of the 6 recipients were 30 days(range, 15-74 days). (5) Follow-up of liver transplant recipients: all the 6 recipients were followed up for 31.5 days(range, 12.0-64.0 days) with the normal body temperature, and they had negative results of viral pneumonia for chest CT examination and nucleic acid test for COVID-19. (6) Infection of medical staffs of liver transplantation: surgeons, nurses, anesthetists, medical staffs at ICU and medical staffs at liver transplantation center who participated in liver transplantation had good health within postoperative 14 days, without suspected or confirmed cases of COVID-19 infection. Conclusion(s): The COVID-19 risk assessment scale has good safety for liver transplant recipients during the COVID-19 outbreak. It is suggested that organ transplantation can be carried out in low-risk recipients and cautiously carried out in recipients of uncertain risk, but organ transplantation should not be carried out in high-risk recipients.Copyright © 2020 by the Chinese Medical Association.
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Objective: To investigate the clinical evaluation effects of Corona Virus Disease 2019 (COVID-19) risk assessment scale on preoperative and surgical risk of liver transplantation during the COVID-19 outbreak. Method(s): The retrospective and descriptive study was conducted. The clinicopathological data of 6 liver transplant recipients who were admitted to Southern Theater Command General Hospital of PLA between January 20 and March 27, 2020 were collected. There were 5 males and 1 female, aged from 42.0 to 62.0 years, with a median age of 53.0 years. There were 6 donors including 5 males and 1 female, aged from 24.0 to 60.0 years, with a median age of 41.5 years. All the donor livers were obtained through the China Organ Transplant Response System. Liver transplantation was performed in the fixed negative pressure operating room, and secondary protective measures were adopted for low-risk donors. Classic orthotopic liver transplantation or Piggyback liver transplantation was performed according to the specific situations of the recipients. Medical staffs in the ward were exposed to the secondary protective measures, and the three-grade protective measures were adopted for medical staffs when the liver transplant recipients had fever or suspected infection. Observation indicators: (1) risk assessment of COVID-19 on liver transplant recipients;(2) risk assessment of COVID-19 on medical staffs of liver transplantation;(3) treatment situations of liver transplant recipients;(4) postoperative situations of liver transplant recipients;(5) follow-up of liver transplant recipients;(6) infection of medical staffs of liver transplantation. Follow-up was performed using outpatient examination or telephone interview to detect whether liver transplant recipients had suspected or confirmed COVID-19 infection up to March 2020. Medical staffs who were involved in organ acquisition, transplantation surgery and ward management were followed up to detect whether they had suspected or confirmed COVID-19 infection within 14 days. Measurement data with normal distribution were represented as Mean+/-SD, and measurement data with skewed distribution were described as M (range). Count data were expressed as absolute numbers. Result(s): (1) Risk assessment of COVID-19 on liver transplant recipients: all the 6 recipients and their related families were confirmed no contact with suspected COVID-19 patients or travel history in the epidemic area within 14 days. Of the 6 recipients, 1 was diagnosed with fever with body temperature of 38.1 and was tested negative for chest computer tomography (CT) examination and nucleic acid test for COVID-19;1 was diagnosed with fever and hypoxemia with body temperature of 38.5 and was tested negative for nucleic acid test for COVID-19, and the results of chest CT examination showed large amount of pleural effusion in both lungs without invasive pneumonia;other 4 recipients had no clinical symptoms of COVID-19 with negative results of chest CT examination and nucleic acid test for COVID-19. Five of the 6 recipients had no history of contact with COVID-19 patients and 1 recipient had treatment history at hospital of risk level 1. The preoperative risk level of COVID-19 was low in all the 6 liver transplant recipients. (2) Risk assessment of COVID-19 on medical staffs of liver transplantation: of the 6 recipients, 5 had the waiting hospital of risk level 0 and 1 had the waiting hospital of risk level 1. Six recipients had the transplant hospital of risk level 0. (3) Treatment situations of liver transplant recipients: of the 6 recipients, 2 underwent classic orthotopic liver transplantation and 4 underwent piggyback liver transplantation. The cold ischemia time of liver, time of anhepatic phase, volume of intraoperative blood loss, operation time, treatment time at intensive care unit of the 6 recipients were (5.9+/-2.4)hours, (49+/-14)minutes, 1 500 mL(range, 800-1 800 mL), (8.9+/-2.1)hours, 2 days(range, 1-4 days), respectively. Of the 6 recipients, 2 required adjustment of the immunosuppression progr m, and 4 did not change the immunosuppression program. (4) Postoperative situations of liver transplant recipients: of the 6 recipients, 5 had no postoperative serious infection and 1 had postoperative serious infection. The 5 recipients without postoperative serious infection had the range of the highest temperature as 37.8-38.5 , and returned to normal temperature within postoperative 3 days. All of the 5 recipients who had no postoperative serious infection received chest CT examination with no obvious manifestation of viral pneumonia and were tested negative for nucleic acid test for COVID-19 at 1 week postoperatively, and then were discharged from hospital. One recipient who had postoperative serious infection had gastrointestinal fistula and repeated fever at postoperative 7 days with the highest temperature as 39.2 . This recipient had body temperature returned to normal and good function of the graft after treatment in the isolation ward with active drainage, and was transferred back to local hospital for further rehabilitation treatment. The duration of hospital stay of the 6 recipients were 30 days(range, 15-74 days). (5) Follow-up of liver transplant recipients: all the 6 recipients were followed up for 31.5 days(range, 12.0-64.0 days) with the normal body temperature, and they had negative results of viral pneumonia for chest CT examination and nucleic acid test for COVID-19. (6) Infection of medical staffs of liver transplantation: surgeons, nurses, anesthetists, medical staffs at ICU and medical staffs at liver transplantation center who participated in liver transplantation had good health within postoperative 14 days, without suspected or confirmed cases of COVID-19 infection. Conclusion(s): The COVID-19 risk assessment scale has good safety for liver transplant recipients during the COVID-19 outbreak. It is suggested that organ transplantation can be carried out in low-risk recipients and cautiously carried out in recipients of uncertain risk, but organ transplantation should not be carried out in high-risk recipients.Copyright © 2020 by the Chinese Medical Association.
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Objective To analyze the detection of SARS-CoV-2 in household environment and public place environment of Huangpu District, and describe the feature of SARS-CoV-2 contamination in the environment exposure to the infected cases, so as to support the control strategies such as disinfection and health communication. Methods The results of RT-PCR test for the environmental samples exposure to the cases infected by SARS-CoV-2 during February 1 to March 31 2022 in Huangpu District of Shanghai were collected as the research data. Pearson χ2 was used to test the significance of the differences between positive rates of SARS-CoV-2 contamination. Results From February 1 to March 31, household environment samples had a higher positive rate (6.47%, 234/3 618) of SARS-CoV-2 contamination while the public place samples had a lower one (1.22%, 47/3 582) in Huangpu District of Shanghai (χ2=141.908, P<0.01). Among the household buildings, the lane houses of old style representing poorer living condition had the highest positive rates (8.31%, 96/1 155) of SARS-CoV-2 contamination while the apartments representing better living condition had the lowest (3.59%, 22/612) (F=5.25 P<0.05). Among the samples from household environment, samples regarding sewerage had the highest positive rates (13.30%, 58/436) of SARS-CoV-2 contamination, while samples regarding the tool of cooking and sweeping had the lowest (3.10%, 17/548) (F=9.84 P<0.01). Among the samples from public place environment, samples regarding entertainment tools had the highest positive rates (13.33%, 2/15) of SARS-CoV-2 contamination, while samples regarding the tool of cooking and sweeping had the lowest (0.62%, 4/646) (F=4.22 P<0.01). Conclusion In the environment exposure to the SARS-CoV-2 infected cases, the disinfection, ventilation and cleaning should be intensified strictly. SARS-CoV-2's surviving in sewage environment should be evaluation dynamically. More health communication should be pushed to people of poorer living condition. © 2022 Editorial Office of Chinese Journal of Schistosomiasis Control. All rights reserved.
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Nowadays, malignant brain tumors are still mostly lethal diseases with poor prognosis and a clinical median survival rate of fewer than 2 years after therapeutic intervention. It is difficult to achieve complete remission of brain tumors due to blood-brain barrier (BBB) and a lack of efficient drug delivery systems to targeted transportation of brain tumor medicines. Nanoparticle delivery systems have shown merits including stability and high carrier capacity for the transportation of different drugs to treat brain tumors. The application of mRNA nanomedicines brings in great promise not only in COVID-19, but also for malignant brain tumor immunotherapy. The appropriate delivery system facilitates mRNA delivery efficiency and enhances the immune response successfully, for optimal treatment outcomes on malignant brain tumors. Herein, we do an updated review on the development of mRNA nanomedicines for malignant brain cancer treatment. We focus on how to design mRNA-loaded nanoparticle-based delivery systems with optimized pharmacokinetics and pharmacodynamics for efficient therapy of brain cancers. In addition, we point out the challenges and solutions for further development of mRNA nanomedicines for brain cancer therapy. We hope this review would stimulate interest among researchers with different backgrounds and expedite the translation from bench to bedside for the mRNA nanomedicines. © 2022 The Authors
ABSTRACT
The coronavirus (COVID-19) global pandemic has made a significant impact on people's social activities. Cell phone mobility data provide unique and rich information on studying this impact. The motivating dataset of this study is the daily leaving-home index data at Harris County in Texas provided by SafeGraph. To study changes in daily leaving-home index and how they relate to public policy and sociodemographic variables, we propose a new Bayesian wavelet model for modeling and clustering spatial functional data, where domain partitioning is achieved by operating on the spanning trees. The resulting clusters can have arbitrary shapes and are spatially contiguous in the input domain. An efficient tailored reversible jump Markov chain Monte Carlo algorithm is proposed to implement the model. The method is applied to the spatial functional data of the daily percentages of people who left home. We focus on the time period covering both lockdown and phased reopening in Texas during the COVID-19 pandemic and study the changing behaviors of those functional curves. By linking the clustering results with the sociodemographic information, we identify several covariates of census blocks that have a noticeable impact on the clustering patterns of people's mobility behaviors. © Institute of Mathematical Statistics, 2023.
ABSTRACT
Social distancing is widely acknowledged as an effective public health policy combating the novel coronavirus. But extreme forms of social distanc-ing, like isolation and quarantine, have costs, and it is not clear how much social distancing is needed to achieve public health effects. In this article we develop a design-based framework to test the causal null hypothesis and make inference about the dose-response relationship between reduction in social mobility and COVID-19 related public health outcomes. We first dis-cuss how to embed observational data with a time-independent, continuous treatment dose into an approximate randomized experiment and develop a randomization-based procedure that tests if a structured dose-response relationship fits the data. We then generalize the design and testing procedure to a longitudinal setting and apply them to investigate the effect of social distancing during the first phased reopening in the United States on public health outcomes using data compiled from Unacast™, the United States Census Bu-reau, and the County Health Rankings and Roadmaps Program. We rejected a primary analysis null hypothesis that stated the social distancing from April 27, 2020 to June 28, 2020, had no effect on the COVID-19-related death toll from June 29, 2020 to August 2, 2020 (p-value < 0.001), and found that it took more reduction in mobility to prevent exponential growth in case num-bers for nonrural counties compared to rural counties. © Institute of Mathematical Statistics, 2023.