COVID-19 infection with keratitis as the first clinical manifestation.

AIM: To report a case which keratitis is the first clinical manifestation of COVID-19 that occurred 3d earlier than the common COVID-19 symptoms. METHODS: Regular slit lamp examination, corneal scraping test, and chest computed tomography (CT) were performed for patients with COVID-19 infection. The ophthalmologic treatment included ganciclovir eye drop (50 mg/mL, 6 times/d). The treatment for diarrhea included Guifu Lizhong pills (TID). The antiviral therapy consisted of oseltamivir (75 mg capsule Q12H); therapy preventing bacterial infection consisted of azithromycin (250 mg tablet QD) and moxifloxacin (0.4 g tablet Q12H); and therapy for cough relief and fever prevention consisted of Chinese herbal decoction. RESULTS: A 35-year-old male suddenly suffered pain, photophobia, and tears in his right eye for one day without systemic COVID-19 symptoms. Patient was diagnosed with keratitis, which was seemingly different from common keratitis. Ganciclovir eye drop was initiated. The corneal scraping test for COVID-19 was positive. The chest CT images were abnormal confirming the diagnosis of COVID-19 infection. The antiviral and antibacterial therapies were initiated. Chinese herbal therapy was used for cough relief and fever prevention. After roughly two weeks, patient recovered from COVID-19. CONCLUSION: A new type of keratitis, atypical keratitis, is a clinical manifestation of COVID-19, and this clinical manifestation could appear 3d earlier than fever and cough. The earlier a COVID-19 clinical manifestation is identified, the earlier can a patient be directed to stay at home, and significantly fewer people would be infected.

High-Porosity Lamellar Films Prepared by a Multistage Assembly Strategy for Efficient Photothermal Water Evaporation and Power Generation.

The frame structure combined with water- and heat-transfer capabilities fully satisfies the requirements of photothermal conversion materials in seawater evaporation applications. Meanwhile, it must integrate the characteristics of a high photothermal conversion rate, thermal management, and water transportation. Herein, lamellar porous films were successfully designed and synthesized by a simple ultrasonic-assisted vacuum filtration method. In this process, polystyrene sulfonate@carbon nanotubes/reduced graphene oxide (PSS@CNT/rGO) lamellar films were constructed by the one-dimensional synthesis of PSS@CNT self-assembled at the molecular scale and the two-dimensional matrix material rGO. It is worth noting that the lamellar film exhibits a high specific surface area (285.5 m2·g-1), which is reflected in its abundant nanopores. Among them, the porous network system composed of nanochannels can provide efficient water supply and steam-transfer ability and strengthen the heat insulation performance of thermal localization, which is beneficial to photothermal evaporation. The obtained PSS@CNT/rGO lamellar films achieved a condensed water yield of 1.825 kg·m-2·h-1 under 1 sun illumination (1 kW·m-2), and their solar-vapor conversion efficiency was 97.1%. Simultaneously, the interaction between the water flow and the carbon material interface was also used to generate additional electric energy output. The maximum open-circuit voltage of 0.46 V was generated at both termini of the PSS@CNT/rGO lamellar film, which successfully realized the multieffect utilization of energy. These results show that the multistage assembly strategy is a facile and effective means for the development of an efficient evaporation photothermal film, which offers significant value in the field of photothermal seawater evaporation and power generation.

Assessing the post-treatment therapeutic effect of tongxie in irritable bowel syndrome: A randomized controlled trial.

Diarrhea predominant irritable bowel syndrome (IBS) is a highly relapsing gastrointestinal disorder decreasing the quality of life. Existing studies indicated that the therapeutic effects maintained for a period of time after the treatments were discontinued (post-treatment therapeutic effects or PTTE). In this study, we aim to assess the PTTE of tongxie. We performed a multiple center, controlled, double blind study of patients with IBS randomized to tongxie (n = 120) or placebo (n = 120) for 4 weeks and followed up for 57 weeks. The primary outcomes were abdominal pains and stool consistency. The secondary outcomes were pain frequency and stool frequency. Tertiary outcomes were adverse effects and global overall symptom. The outcome data were collected at days 1, 2, 3, weeks 1 and 4 during the treatment and at days 1, 2, 3, until week 57 during the post-treatment. Significantly more patients receiving tongxie were clinical responders to the primary and secondary endpoints from day 1 until the end of the treatment. The positive effects of tongxie were maintained until 17-25 weeks after tongxie was discontinued. The relapse-free probabilities in the tongxie group were significantly higher than those in the placebo group (P < .001). Twenty-five weeks after the therapies were discontinued could be considered as IBS natural history. During this period, an average of 53.8-56.3% of patients (pool tongxie and placebo data together) had IBS symptoms (pain scale ≥ 3, stool consistency ≥ 5). In particular, at the end of this study (week 61), 145 (54.2%) patients had IBS symptoms. Our results provide clinical insights into efficient and cost-effective management of refractory IBS, and lend support to the IBS management that the selection of a therapy should consider both its effectiveness during treatment and its PTTE after the treatment.