Adverse events following immunization associated with the ChAdOx1nCoV-19 and BBV152 vaccine-a cross-sectional study

COVID-19, an infectious disease, has become a leading cause of death in many people. The rapid emergence of the pandemic prompted the development of a vaccine to mitigate the disease's harmful consequences. Vaccination is the only effective way to prevent infection from spreading and build immunity to the virus. However, developing adverse effects has become a major problem for vaccine reluctance. Accordingly, the interest has been shifted towards identifying the adverse effects developed following immunization. The current study objective is to assess and compare the intensity of adverse effects following 1st and 2nd dose of COVID-19 vaccination and the medication administered to relieve the symptoms associated with vaccination. A cross-sectional study was performed in a community over six months. A total of 836 participants were involved in the study. All the data regarding the vaccination were collected through a specially designed questionnaire form and analyzed in all the participants within the study group. According to the study, at least 1 AEFI was developed in about 90% of the study population. The most common systemic and local effect developed in the study population was fever (59.42%) and pain at the injection site (69.82%), respectively. With both vaccines (ChAdOx1 nCoV-19 and BBV152), the incidence and severity of AEFIs were lower after the second dose than after the first dose, and most of the symptoms associated with vaccination were alleviated by taking home remedies and symptomatic treatment. The adverse effects reported after receiving the ChAdOx1 nCoV-19 and BBV152 vaccines are typical of most vaccines, and the majority of them were tolerated, and most subsided in less than 24 hours.

Research progress on the regulation of endothelial cells by natural products of traditional Chinese medicine in the prevention and treatment of atherosclerosis

[] Atherosclerosis (As) is the pathological basis of coronary heart disease, and vascular endothelial injury is the initiating factor of coronary atherosclerosis. Vascular endothelial cells are a single layer of cells located in the inner layer of blood vessels and regulates exchanges between the blood stream and the surrounding tissues, and their integrity is very important. Many active monomers and the derivatives in natural products of traditional Chinese medicine modulate the function of endothelial cells by intervening oxidative stress, regulating the release of vasoactive substances, reducing inflammation, and equilibrating coagulation and anticoagulant system. They have the advantages of multi-pathway, multi-link and multi-target regulation in protecting from endothelial injury and attenuating atherogenesis. They have also been used to protect against corona virus disease 2019 (COVID-19) induced endothelial injury and atheroslerosis. This article reviews the research progress of the above issues in this field. © 2023, Editorial Office of Chinese Journal of Arteriosclerosis. All rights reserved.

Body composition and physical activity of university students during COVID-19 lockdowns.

[Purpose] Behavioral restrictions during the corona virus disease 2019 (COVID-19) pandemic may have affected the physical activity levels of college students. We aimed to characterize the body composition and physical activity of college students during these behavioral restrictions. [Participants and Methods] The body composition (height, weight, body mass index, body fat mass, body fat percentage, total body muscle mass, free-fat muscle index [FFMI], and fat mass index [FMI]), physical activity, amount the of walking, amount of daily activity, and the number of steps were measured in 52 university students. [Results] For both male and females, the number of steps taken was lower than the average steps reported by the Ministry of Health, Labour and Welfare. In males, FFMI had a strong positive correlation with physical activity, amount of walking, and the number of steps taken. In females, FFMI had a strong positive correlation with physical activity and the amount of walking, as well as a moderate positive correlation with the amount of daily activity. [Conclusion] Since physical activity and walking of university students during COVID-19 affect FFMI, it is necessary to develop an exercise program that considers behavioral patterns.

Characteristics of Traditional Chinese Medicine Syndromes and Treatments of COVID-19 Patients from Two Hospitals Based on "Treatment of Disease in Accordance with Three Conditions".

Objective: To explore the guidance value of "treatment of disease in accordance with three conditions" theory in the prevention and treatment of corona virus disease 2019 (COVID-19) based on the differences of syndromes and traditional Chinese medicine (TCM) treatments in COVID-19 patients from Xingtai Hospital of Chinese Medicine of Hebei province and Ruili Hospital of Chinese Medicine and Dai Medicine of Yunnan province and discuss its significance in the prevention and treatment of the unexpected acute infectious diseases. Method(s): Demographics data and clinical characteristics of COVID-19 patients from the two hospitals were collected retrospectively and analyzed by SPSS 18.0. The information on formulas was obtained from the hospital information system (HIS) of the two hospitals and analyzed by the big data intelligent processing and knowledge service system of Guangdong Hospital of Chinese Medicine for frequency statistics and association rules analysis. Heat map-hierarchical clustering analysis was used to explore the correlation between clinical characteristics and formulas. Result(s): A total of 175 patients with COVID-19 were included in this study. The 70 patients in Xingtai, dominated by young and middle-aged males, had clinical symptoms of fever, abnormal sweating, and fatigue. The main pathogenesis is stagnant cold-dampness in the exterior and impaired yin by depressed heat, with manifest cold, dampness, and deficiency syndromes. The therapeutic methods highlight relieving exterior syndrome and resolving dampness, accompanied by draining depressed heat. The core Chinese medicines used are Poria, Armeniacae Semen Amarum, Gypsum Fibrosum, Citri Reticulatae Pericarpium, and Pogostemonis Herba. By contrast, the 105 patients in Ruili, dominated by young females, had atypical clinical symptoms, and most of them were asymptomatic patients or mild cases. The main pathogenesis is dampness obstructing the lung and the stomach, with obvious dampness and heat syndromes. The therapeutic methods are mainly invigorating the spleen, resolving dampness, and dispersing Qi with light drugs. The core Chinese medicines used are Poria, Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Coicis Semen, Platycodonis Radix, Lonicerae Japonicae Flos, and Pogostemonis Herba. Conclusion(s): The differences in clinical characteristics, TCM syndromes, and medication of COVID-19 patients from the two places may result from different regions, population characteristics, and the time point of the COVID-19 outbreak. The "treatment of disease in accordance with three conditions" theory can help to understand the internal correlation and guide the treatments.Copyright © 2022, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

Towards Neuro-CoViD-19.

CoViD-19 is the current pandemic caused by the Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2). Infection by SARS-CoV-2 occurs via the binding of its S protein to the angiotensin-converting enzyme-2 receptor (ACE2-R). S binding to ACE2-R leads to a drop in ACE2, a homolog of angiotensin converting enzyme (ACE). In the central nervous system (CNS), ACE mediates neuroinflammation, neurodegeneration and neurotoxicity responsible for several CNS disorders. ACE2 counteracts the damaging effects of ACE on CNS neurons. SARS-CoV-2 can directly access the CNS via the circulation or via cranial nerve I and the olfactory bulb. Inactivation of ACE2 following binding of SARS-CoV-2 S protein to ACE2-R in situ might blunt ACE2-moderating effects upon ACE CNS neurotoxicity and neurodegeneration. Here, we propose a neurobiological mechanism directly involving SARS-CoV-2 binding to ACE2-R in the etiology of putative Neuro-CoViD-19.

Comparison of Atmospheric Environment in China during Sars and Covid-19 Pandemics

Satellite remote sensing has advantages in monitoring environmental changes during the global pandemics such as the Severe Acute Respiratory Syndrome Coronavirus (SARS) and the Corona Virus Disease 2019 (COVID-19). In this paper, the variations of atmospheric environment during SARS and COVID-19 pandemics were calculated and analyzed based on the Moderate Resolution Imaging Spectroradiometer (MODIS) Atmosphere Monthly Global Product. Preliminary results show that: (1) aerosol optical depth is most affected by the pandemics, especially the duration and prevention and control measures;(2) the correlations between the variables of aerosol optical depth, cloud fraction, total column ozone and precipitable water vapor were not very strong during the two pandemics.

Clinical Evidence and Theory of COVID-19 by Traditional Chinese Medicine.

This study aims to investigate the etiology, pathogenic properties and pathogenic characteristics of corona virus disease-2019(COVID-19)in traditional Chinese medicine(TCM),so as to provide ideas for clinical treatment based on syndrome differentiation. Efforts were made to retrive relevant literature concerning clinical studies,theoretical discussions and TCM diagnosis and treatment schemes issued by the state and various provinces,municipalities,autonomous regions and municipalities directly under the central government in relation to TCM from China Knowledge Network(CNKI)and Wanfang Database,and to analyze and summarize the etiology,pathology,theoretical viewpoints,clinical symptoms and signs,syndrome differentiation and medication rules. Currently,the common understanding of the etiology of COVID-19 in the field of TCM is the infection of "pestilential pathogen". However,there is a dispute over cold and heat or mixed understanding of cold and heat in terms of pathogenic attributes. The pathogenic factors are different from each other in dampness,toxin,dryness,fire(heat),wind,filth,depression,etc. There are various understandings on the pathogenesis including dampness,cold,heat,toxin,stasis,phlegm,stagnation,knot,dryness,filth, deficiency,blocking,collapse and asthma,etc. The etiology and pathogenesis are often mixed up. Integration of cold and heat,dryness and dampness,and other contradictory pathogens or pathogenesis is widely seen,which lacks the logicality of theoretical systems,and does not in line with the thinking characteristics of TCM on the etiology,pathogenesis,and syndrome differentiation of exogenous diseases. The main idea of medication in treatment is to diffuse the lung,clear away heat,eliminate dampness,resolve phlegm and repel foulness with aromatics. Maxing Shigantang is used as the core prescription. Chosen warm acrid drugs are mainly the ones with the effect of fragrance,removing dampness,resolving phlegm,and invigorating spleen. They are not the ones with the effects of warming yang and dissipating cold,but the combination of cold and heat,suggesting the complexity of etiology and pathogenesis. COVID-19 is categorized as plaque in TCM,and its etiology is "pestilential pathogen". This pestilential pathogen possesses not only the basic properties of toxin and filth,but also the characteristics of dampness,heat and wind. Throughout the course of the disease,phlegm,stasis,stagnation and other secondary pathogenic factors also occur. The evolution of pathogenesis is characterized by depression,blocking,and deficiency. There are more evidences that the pestilential pathogen of COVID-19 belongs to heat property no matter in the aspects of clinical manifestation,transmission law(syndrome differentiation at different stages),or in compatibility of medication.Copyright © 2021, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

ICT for Sustainable Development and Women Empowerment: A Post-pandemic Strategy

The Covid-19 pandemic has not only radically affected lives and ways of living but has wreaked havoc on education systems globally. United Nations estimates that over 1.6 billion students worldwide have been affected by school closures that were necessitated by the pandemic. Although learning and teaching continued virtually in various countries, the challenges of this new mode of education were more burdensome in some countries than in others. While studies on the impact of the pandemic on education and gender inequalities have been conducted, few have focused specifically on the impact of the pandemic on girl child education. This chapter discusses the impact of the pandemic on girl child education in Africa. Although the authors present the cases of two of Africa's biggest economies, Nigeria and South Africa, the recommendations for research and policy presented will undoubtedly prove useful to other countries on the continent and improve education generally. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021.

An optimal aggregation method for interval grey numbers using on Steiner-Weber point with application

Aiming at the problem of low accuracy of two-dimensional preference information aggregation, this paper takes two-dimensional interval grey numbers as an example to define its preference information mapping rules. This rule maps preference information to preference points on a two-dimensional plane. Based on the theory of plane Steiner-Weber point, we construct a two-dimensional optimal model, and prove the optimality of the model theoretically. Then, adopt plant growth simulation algorithm (PGSA) to solve the proposed model. The obtained optimal aggregation point that can represent the comprehensive opinions. Finally, by analyzing the selection problem of Fangcang shelter hospital and comparing it with the particle swarm optimization (PSO) method, we conclude that the sum of weighted Euclidean distance obtained by our method is minimal. The aggregation precision of our method is higher than that of other aggregation method to a certain extent. © 2023 Elsevier Ltd

Invulnerability analysis for airport weighted networks before and after COVID-19

In order to improve airport network ' s ability to cope with emergencies, topological characteristics of Chinese airport network before and after COVID-19 were analyzed based on complex network theory. And the network was weighted by using node strength, and an invulnerability assessment method was developed after identifying inflection points of loss fitting curves for weighted network characteristics metrics under different attack strategies. The results show that the topological structure of airport weighted network has no significant changes before and after the pandemic, but its connectivity is slightly sparse. And the airport network in China is much more vulnerable under different intentional attack strategies. When attack ratio reaches 8. 6%, inflection point of loss fitting curves will appear, and relative loss of global network efficiency will amount to 24. 39%, while reduction rate of the largest connected subgraph reaches 14. 67%, and relative loss of average degree and average clustering coefficient is up to 76. 87% and 68. 84%, respectively. Moreover, loss of network efficiency and the largest connected subgraph reduction rate accelerates after inflection points, in which stage the network will be paralyzed. © 2022 China Safety Science Journal. All rights reserved.

Scenario deduction and analysis for spillover risks of international sports events under influence of COVID-19

In order to improve risk prevention and control capabilities for international sports events under the background of COVID-19, case data of 23 international sports since the pandemic outbreak were collected, and an evolutionary network model with COVID-19 as risk source was established. Then, risk analysis on the model was carried out based on in-and-out degree, number of sub-net nodes, the shortest path and average path of complex network theory, key risk event nodes were identified, and preventive measures were put forward. Finally, critical chains were obtained by analyzing causal mechanism and types of risk chains, and countermeasures and suggestions for chain disconnection and disaster mitigation were put forward. The results show that severe epidemic situation and rising risk of virus transmission in host cities are the key nodes in evolutionary network, and cycle chain of political relations and public opinion is the most destructive one. Therefore, it is necessary to promote the development of a public opinion monitoring system and strengthen positive publicity of sports events. © 2020 China Safety Science Journal. All rights reserved.

Application of chest low-dose CT screening of Corona Virus Disease 2019 with a third-generation dual-source scanner.

Objective: To investigate the application value of third-generation dual-source CT(3-G DSCT) low-dose scan mode combined with iterative reconstruction technology in the screening of COVID-19 and to evaluate the radiation dose. Method(s): One hundred and twenty patients suspected of COVID-19 from December 2019 to February 2020 were retrospectively analysed and randomly divided into two groups (test group and conventional group, 60 patients in each). The parameters for test group included 3-G DSCT, Turbo Flash scan mode, CARE kV, with reference 90 kV, pitch 2.0, and ADMIRE algorithm, while those parameters for conventional group included the 128-slice CT, conventional spiral scan mode, 120 kV, pitch 1.2, and FBP algorithm. The CT values of aorta, spinal posterior muscle, and subcutaneous fat, the aortic noise, signal-to-noise ratio (SNR), and contrast noise ratio (CNR) were compared to evaluate the image quality between two groups. Two experienced doctors scored the image quality using a double-blind method, and compared the CT dose index volume (CTDIvol), dose-length product (DLP), and effective dose (E) of the two groups. Result(s): The CT value of the aorta and spinal posterior muscle and the aortic SNR in the test group were (45.38+/-4.77), (53.41+/-8.44) HU, and 2.82+/-0.59, and significantly higher than those in the conventional group [(39.68+/-6.26), (42.66+/-6.32) HU, 2.58+/-0.61, t=5.608, 7.897, 2.162, P<0.05]. The aortic noise, CNR and subjective scores between the two groups had no significant difference( P>0.05). The CTDIvol, DLP, and E in the test group were (3.09+/-1.02) mGy, (107.57+/-32.81) mGy*cm, (1.51+/-0.46) mSv, significantly lower than those in the conventional group [(7.00+/-1.80) mGy, (261.65+/-73.93) mGy*cm, (3.66+/-1.03) mSv;t=-14.680, -14.756, -14.756, P<0.05]. Conclusion(s): In the screening of COVID-19, using low-dose scanning mode of 3-G DSCT combined with iterative reconstruction technology would provide diagnostic quality images and meanwhile effectively reduce the radiation dose and improve the SNR of the image.Copyright © 2020 by the Chinese Medical Association.

Scenario deduction and analysis for spillover risks of international sports events under influence of COVID-19

In order to improve risk prevention and control capabilities for international sports events under the background of COVID-19, case data of 23 international sports since the pandemic outbreak were collected, and an evolutionary network model with COVID-19 as risk source was established. Then, risk analysis on the model was carried out based on in-and-out degree, number of sub-net nodes, the shortest path and average path of complex network theory, key risk event nodes were identified, and preventive measures were put forward. Finally, critical chains were obtained by analyzing causal mechanism and types of risk chains, and countermeasures and suggestions for chain disconnection and disaster mitigation were put forward. The results show that severe epidemic situation and rising risk of virus transmission in host cities are the key nodes in evolutionary network, and cycle chain of political relations and public opinion is the most destructive one. Therefore, it is necessary to promote the development of a public opinion monitoring system and strengthen positive publicity of sports events. © 2020 China Safety Science Journal. All rights reserved.

Simulation of COVID-19 Outbreak in Nanjing Lukou Airport Based on Complex Dynamical Networks

The Corona Virus Disease 2019 (COVID-19) pandemic is still imposing a devastating impact on public health, the economy, and society. Predicting the development of epidemics and exploring the effects of various mitigation strategies have been a research focus in recent years. However, the spread simulation of COVID-19 in the dynamic social system is relatively unexplored. To address this issue, considering the outbreak of COVID-19 at Nanjing Lukou Airport in 2021, we constructed an artificial society of Nanjing Lukou Airport based on the Artificial societies, Computational experiments, and Parallel execution (ACP) approach. Specifically, the artificial society includes an environmental model, population model, contact networks model, disease spread model, and intervention strategy model. To reveal the dynamic variation of individuals in the airport, we first modeled the movement of passengers and designed an algorithm to generate the moving traces. Then, the mobile contact networks were constructed and aggregated with the static networks of staff and passengers. Finally, the complex dynamical network of contacts between individuals was generated. Based on the artificial society, we conducted large-scale computational experiments to study the spread characteristics of COVID-19 in an airport and to investigate the effects of different intervention strategies. Learned from the reproduction of the outbreak, it is found that the increase in cumulative incidence exhibits a linear growth mode, different from that (an exponential growth mode) in a static network. In terms of mitigation measures, promoting unmanned security checks and boarding in an airport is recommended, as to reduce contact behaviors between individuals and staff. © 2021 TUP.

Clinical Evidence and Theory of COVID-19 by Traditional Chinese Medicine.

This study aims to investigate the etiology, pathogenic properties and pathogenic characteristics of corona virus disease-2019(COVID-19)in traditional Chinese medicine(TCM),so as to provide ideas for clinical treatment based on syndrome differentiation. Efforts were made to retrive relevant literature concerning clinical studies,theoretical discussions and TCM diagnosis and treatment schemes issued by the state and various provinces,municipalities,autonomous regions and municipalities directly under the central government in relation to TCM from China Knowledge Network(CNKI)and Wanfang Database,and to analyze and summarize the etiology,pathology,theoretical viewpoints,clinical symptoms and signs,syndrome differentiation and medication rules. Currently,the common understanding of the etiology of COVID-19 in the field of TCM is the infection of "pestilential pathogen". However,there is a dispute over cold and heat or mixed understanding of cold and heat in terms of pathogenic attributes. The pathogenic factors are different from each other in dampness,toxin,dryness,fire(heat),wind,filth,depression,etc. There are various understandings on the pathogenesis including dampness,cold,heat,toxin,stasis,phlegm,stagnation,knot,dryness,filth, deficiency,blocking,collapse and asthma,etc. The etiology and pathogenesis are often mixed up. Integration of cold and heat,dryness and dampness,and other contradictory pathogens or pathogenesis is widely seen,which lacks the logicality of theoretical systems,and does not in line with the thinking characteristics of TCM on the etiology,pathogenesis,and syndrome differentiation of exogenous diseases. The main idea of medication in treatment is to diffuse the lung,clear away heat,eliminate dampness,resolve phlegm and repel foulness with aromatics. Maxing Shigantang is used as the core prescription. Chosen warm acrid drugs are mainly the ones with the effect of fragrance,removing dampness,resolving phlegm,and invigorating spleen. They are not the ones with the effects of warming yang and dissipating cold,but the combination of cold and heat,suggesting the complexity of etiology and pathogenesis. COVID-19 is categorized as plaque in TCM,and its etiology is "pestilential pathogen". This pestilential pathogen possesses not only the basic properties of toxin and filth,but also the characteristics of dampness,heat and wind. Throughout the course of the disease,phlegm,stasis,stagnation and other secondary pathogenic factors also occur. The evolution of pathogenesis is characterized by depression,blocking,and deficiency. There are more evidences that the pestilential pathogen of COVID-19 belongs to heat property no matter in the aspects of clinical manifestation,transmission law(syndrome differentiation at different stages),or in compatibility of medication.Copyright © 2021, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

The First Domestic Original Drug for the Treatment of COVID-19: Azvudine.

OBJECTIVE To summarize the basic information, mechanism of action, pharmacokinetics, efficacy, safety, interactions, and precautions of azvudine, to provide references for its clinical use. METHODS Literatures related to azvudine from the official website of Chinese clinical trial regi stry, clinicaltrials.gov, Pubmed, CNKI and Wanfang were systematically searched and summarized. RESULTS Azvudine is an oral small-molecule corona virus disease(COVID-19) treatment drug independently developed by China. As a nucleoside analogue targeting to viral RNA-dependent RNA polymerases (RdRp), it can inhibit RNA virus reverse transcription process and replication process. The results of phase III clinical trials showed that azvudine could significantly shorten the time of nucleic acid conversion in patients with mild to moderate corona virus disease (COVID-19). Compared with the control group, the azvudine group can significantly shorten the improvement time of pneumonia. For moderate and severe patients, azvudine treatment also showed significant therapeutic effects in the time of nucleic acid conversion, discharge, and rehabilitation. CONCLUSION The drug possesses good safety and tolerability in patients, which provide a choice for the clinical treatment of COVID-19.Copyright © 2022 Chinese Pharmaceutical Association. All rights reserved.

Effective multidimensional approach for practical management of the emergency department in a COVID-19 designated children's hospital in east China during the Omicron pandemic: a cross-sectional study.

Background: Characterized by rapid transmission but lower severity, the new Omicron wave brought about an acute increase in local corona virus disease 2019 (COVID-19) cases in Shanghai, followed by stricter infection prevention and control strategies. Inevitably, more time was required for emergency consultation and treatment of children with critical illnesses. Therefore, a multidimensional approach was designed to streamline the emergency service and reduce the incidence of nosocomial infection of sever acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the Omicron wave for the emergency department (ED) at the Children's Hospital of Fudan University (CHFU). Methods: A multidimensional approach was implemented in the ED to help achieve a balance between the demand for emergency services and pandemic control, consisting of ED layout adjustment; electronic screening (E-screening) measures; standard management processes for patients, medical staff, and goods transfer; reliable disinfection measures; and a surveillance system for infection prevention and control. To evaluate the effect of the management strategy, the data on nosocomial infection cases and occupational exposure episodes among staff in the ED were collected. The demographic and clinical characteristics of level I/II children by the five-level pediatric triage tool and their mean duration of stay in the resuscitation room were collected. Results: There were 12,114 ED visitors from March 1 to May 31 in 2022, among which 53.24% were medical emergencies (6,449/12,114) and 46.76% were surgical emergencies (5,665/12,114). Twenty-nine patients were sent to the buffer zone, four of whom were transferred to the pediatric intensive care unit (PICU) because of the critical situation. Six patients tested positive for COVID-19 after entering ED, including three in the buffer zone and three in the ED clinic, causing a temporary closure of the ED for disinfection. There were no reports on medical care delays, unintended deaths, staff with COVID-19 infection, or occupational exposures to COVID-19. Conclusions: Our findings highlight the effectiveness of the multidimensional approach, which can simultaneously meet the emergency care needs of patients as well as pandemic prevention and control. However, the results were obtained against the proportional decrease in clinic visitors due to the Shanghai lockdown. Dynamic assessment and further optimization may be adopted to cope with the pre-pandemic visit volume.

The First Domestic Original Drug for the Treatment of COVID-19: Azvudine.

OBJECTIVE To summarize the basic information, mechanism of action, pharmacokinetics, efficacy, safety, interactions, and precautions of azvudine, to provide references for its clinical use. METHODS Literatures related to azvudine from the official website of Chinese clinical trial regi stry, clinicaltrials.gov, Pubmed, CNKI and Wanfang were systematically searched and summarized. RESULTS Azvudine is an oral small-molecule corona virus disease(COVID-19) treatment drug independently developed by China. As a nucleoside analogue targeting to viral RNA-dependent RNA polymerases (RdRp), it can inhibit RNA virus reverse transcription process and replication process. The results of phase III clinical trials showed that azvudine could significantly shorten the time of nucleic acid conversion in patients with mild to moderate corona virus disease (COVID-19). Compared with the control group, the azvudine group can significantly shorten the improvement time of pneumonia. For moderate and severe patients, azvudine treatment also showed significant therapeutic effects in the time of nucleic acid conversion, discharge, and rehabilitation. CONCLUSION The drug possesses good safety and tolerability in patients, which provide a choice for the clinical treatment of COVID-19. Copyright © 2022 Chinese Pharmaceutical Association. All rights reserved.

The First Domestic Original Drug for the Treatment of COVID-19: Azvudine

OBJECTIVE To summarize the basic information, mechanism of action, pharmacokinetics, efficacy, safety, interactions, and precautions of azvudine, to provide references for its clinical use. METHODS Literatures related to azvudine from the official website of Chinese clinical trial regi stry, clinicaltrials.gov, Pubmed, CNKI and Wanfang were systematically searched and summarized. RESULTS Azvudine is an oral small-molecule corona virus disease(COVID-19) treatment drug independently developed by China. As a nucleoside analogue targeting to viral RNA-dependent RNA polymerases (RdRp), it can inhibit RNA virus reverse transcription process and replication process. The results of phase III clinical trials showed that azvudine could significantly shorten the time of nucleic acid conversion in patients with mild to moderate corona virus disease (COVID-19). Compared with the control group, the azvudine group can significantly shorten the improvement time of pneumonia. For moderate and severe patients, azvudine treatment also showed significant therapeutic effects in the time of nucleic acid conversion, discharge, and rehabilitation. CONCLUSION The drug possesses good safety and tolerability in patients, which provide a choice for the clinical treatment of COVID-19. Copyright © 2022 Chinese Pharmaceutical Association. All rights reserved.

A MHA-based integrated diagnosis and segmentation method for COVID-19 pandemic

Objective In order to alleviate the COVID-19 (corona virus disease 2019) pandemic, the initial implementation is focused on targeting and isolating the infectious patients in time. Traditional PCR (polymerase chain reaction) screening method is challenged for the costly and time-consuming problem. Emerging AI (artificial intelligence) -based deep learning networks have been applied in medical imaging for the COVID-19 diagnosis and pathological lung segmentation nowadays. However, current networks are mostly restricted by the experimental datasets with limited number of chest X-ray (CXR) images, and it merely focuses on a single task of diagnosis or segmentation. Most networks are based on the convolution neural network (CNN). However, the convolution operation of CNN is capable to extract local features derived from intrinsic pixels, and has the long-range dependency constraints for explicitly modeling. We develop a vision transformer network (ViTNet). The multi-head attention (MHA) mechanism is guided for long-range dependency model between pixels. Method We built a novel transformer network called ViTNet for diagnosis and segmentation both. The ViTNet is composed of three parts, including dual-path feature embedding, transformer module and segmentation-oriented feature decoder. 1) The embedded dual-path feature is based on two manners for the embedded CXR inputs. One manner is on the basis of 2D convolution with the sliding step equal to convolution kernel size, which divides a CXR to multiple patches and builds an input vector for each patch. The other manner is concerned of a pre-trained feature map (ResNet34-derived) as backbone in terms of deep CXR-based feature extraction. 2) The transformer module is composed of six encoders and one cross-attention module. The 2D-convolution-generated vector sequence is as inputs for transformer encoder. Owing that the encoder inputs are directly extracted from image pixels, they can be considered as the shallow and intuitive feature of CXR. The six encodes are in sequential, transforming the shallow feature to advanced global feature. The cross-attention module is focused on the results obtained by backbone and transformer encoders as inputs, the network can combine the deep feature and encoded shallow feature, and absorb both the global information and the local information in terms of the encoded shallow feature and deep feature, respectively. 3) The feature decoder for segmentation can double the size of feature map and provide the segmentation results. Our network is required to deal with two tasks simultaneously for both of classification and segmentation. A hybrid loss function is employed for their training, which can balance the training efforts between classification and segmentation. The classification loss is the sum of a contrastive loss and a multi-classes cross-entropy loss. The segmentation loss is a binary cross-entropy loss. What is more, a new five-levels CXR dataset is compiled. The dataset samples are based on 2 951 CXRs of COVID-19, 16 964 CXRs of healthy, 6 103 CXRs of bacterial pneumonia, 5 725 CXRs of viral pneumonia, and 6 723 CXRs of opaque lung. In this dataset, COVID-19 CXRs are all labeled with COVID-19 infected lung masks. In our training process, the input images were resized as 448 × 448 pixels, the learning rate is initially set as 2 × 10 - 4 and decreased gradually in a self-adaptive manner, and the total number of iterations is 200, the Adam learning procedure is conducted on four Tesla K80 GPU devices. Result In the classification experiments, we compared ViTNet to a general transformer network and five popular CNN deep-learning models (i. e., Res-Net18, ResNet50, VGG16 (Visual Geometry Group), Inception _ v3, and deep layer aggregation network (DLAN) in terms of overall prediction accuracy, recall rate, F1 and kappa evaluator. It can be demonstrated that our model has the best with 95. 37% accuracy, followed by Inception_ v3 and DLAN with 95. 17% and 94. 40% accuracy, respectively, and the VGG16 is reached 94. 19% ac uracy. For the recall rate, F1 and kappa value, our model has better performance than the rest of networks as well. For the segmentation experiments, ViTNet is in comparison with four commonly-used segmentation networks like pyramid scene parsing network (PSPNet), U-Net, U-Net + and context encoder network (CE-Net) . The evaluation indicators used are derived of the accuracy, sensitivity, specificity, Dice coefficient and area under ROC (region of interest) curve (AUC) . The experimental results show that our model has its potentials in terms of the accuracy and AUC. The second best sensitivity is performed inferior to U-Net + only. More specifically, our model achieved the 95. 96% accuracy, 78. 89% sensitivity, 97. 97% specificity, 98. 55% AUC and a Dice coefficient of 76. 68% . When it comes to the network efficiency, our model speed is 0. 56 s per CXR. In addition, we demonstrate the segmentation results of six COVID-19 CXR images obtained by all the segmentation networks. It is reflected that our model has the best segmentation performance in terms of the illustration of Fig. 5. Our model limitation is to classify a COVID-19 group as healthy group incorrectly, which is not feasible. The PCR method for COVID-19 is probably more trustable than the deep-leaning method, but the feedback duration of tested result typically needs for 1 or 2 days. Conclusion A novel ViTNet method is developed, which achieves the auto-diagnosis on CXR and lung region segmentation for COVID-19 infection simultaneously. The ViTNet has its priority in diagnosis performance and demonstrate its potential segmentation ability. © 2022 Editorial and Publishing Board of JIG. All rights reserved.