MINERVA: A facile strategy for SARS-CoV-2 whole genome deep sequencing of clinical samples

The novel coronavirus disease 2019 (COVID-19) pandemic poses a serious public health risk. Analyzing the genome of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from clinical samples is crucial for the understanding of viral spread and viral evolution, as well as for vaccine development. Existing sample preparation methods for viral genome sequencing are demanding on user technique and time, and thus not ideal for time-sensitive clinical samples; these methods are also not optimized for high performance on viral genomes. We have developed MetagenomIc RNA EnRichment VirAl sequencing (MINERVA), a facile, practical, and robust approach for metagenomic and deep viral sequencing from clinical samples. This approach uses direct tagmentation of RNA/DNA hybrids using Tn5 transposase to greatly simplify the sequencing library construction process, while subsequent targeted enrichment can generate viral genomes with high sensitivity, coverage, and depth. We demonstrate the utility of MINERVA on pharyngeal, sputum and stool samples collected from COVID-19 patients, successfully obtaining both whole metatranscriptomes and complete high-depth high-coverage SARS-CoV-2 genomes from these clinical samples, with high yield and robustness. MINERVA is compatible with clinical nucleic extracts containing carrier RNA. With a shortened hands-on time from sample to virus-enriched sequencing-ready library, this rapid, versatile, and clinic-friendly approach will facilitate monitoring of viral genetic variations during outbreaks, both current and future.

Clinical features, levels of protein carbonyl in serum of obstrucitive sleep apnea syndrome with type 2 diabetes mellitus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the prevalence, clinical feature and levels of protein carbonyl (PCO) in serum of type 2 diabetes mellitus combining obstrucitive sleep apnea syndrome (OSAHS).@*METHOD@#Two hundred and three patients with type 2 diabetes were taken multi lead sleep detection and their AHI, age, height, body mass index (BMI),waistline, duration of diabetes, fast blood glucose, HbA1c level and level of PCO in serum were recorded.@*RESULT@#The prevalence of OSAHS was 79.2% in 203 patients, serious apnea 30.4%, moderate apnea 45.4%, mild apnea 24.2%. BMI, waistline, fast blood glucose, HbA1c level and level of PCO in serum were higher in patients complicated with OSAHS (P < 0.01). HbA1c was independently and positively correlated with patients with OSAHS risk (P < 0.05, OR 6.11). The independent correlation factors of AHI included HbA1c level,BMI, waistline, duration of diabetes and level of PCO in serum,with HbA1c as the predominant factor (P < 0.05).@*CONCLUSION@#The prevalence of OSAHS was higher in patients of type 2 diabetes mellitus combining (OSAHS). Moreover, in these patients poor glucose control and aggravated protein oxidative injury were observed.

Observations on the application of LMA in the airway management in total laparoscopic hysterectomy in obese patients / 中国基层医药

Objective To observe the curative effects of applying laryngeal masks in the airway management in total laparoscopic hysterectomy in obese patients.Methods 60 cases of obese patients who underwent total laparoscopic hysterectomy were collected and were randomly divided into,the Endotracheal intubation (ET) group(n =30) and the laryngeal mask (LMA) group (n =30).The pre-operative co-existent diseases,applications of analgesia and intra-operative vital signs,the peak airway waves (Paw) 60min after pneumoperitoneum,blood gas;revival time;the incidences of complications were observed.Results 60min after pneumoperitoneum,MAP,HR,Paw and SpO2 values were:ET group:[(114.6 ± 22.4) mmHg,(108.2 ± 19.6) times/min,(25.4 ± 3.1) mmHg,(96.1 ± 1.2％)] LMA group:[(97.5 ±20.8)mmHg,(86.5 ±20.7) times/min,(22.6 ±3.7)mmHg,(98.9 ±0.8％)].The difference was statistically significant (P ＜ O.05);The blood gas analysis,PH,PaO2,PaCO2 and BE values are:ET group:[(7.34 ± 0.05),(177.5 ± 44.5) mmHg,(42.6 ± 6.1) mmHg,(-4.9 ± 0.8) mmol/L],LMA group:[(7.38 ± 0.05),(216.7 ± 46.6) mmHg,(38.4 ± 5.5) mmHg,(-3.1 ± 0.6) mmol/L].The difference was statistically significant (P ＜ 0.05);the status of complications:23 cases in ET group,accounting for 77％,10 cases in LMA group,accounting 30％,presenting significant differences (P ＜ 0.05).Conclusion The application of laryngeal masks in the airway management in total laparoscopic hysterectomy in obese patients facilitated the maintaining the stability of hemodynamics and blood gas,resulted in smooth post-anesthesia recovery and fewer complications.

Clinical studies about patients with laryngeal mask airway of laparoscopy total hysterectomy / 中国基层医药

Objective To observe the sedation and analgesia in surface anesthesia in conscious glossopha-ryngeal LMA for the clinical effect of laparoscopic hysterectomy.Methods 90 patients undergoing elective laparo-scopic total hysterectomy were randomly divided into three groups,30 cases in each group.The observation group (group A):sedation,analgesia,full surface anesthesia,control group 1 (B group)control group 2 (group C)were treated with endotracheal intubation under general anesthesia.At intubation and pull tube stage,the patients'reaction, hemodynamic changes,pneumoperitoneum 1 h blood gas and perioperative complications were observed.Results The mean arterial pressure(MAP)and heart rate(HR)of A group were (92.7 ±10.6)mmHg and (82.8 ±12.1)/min. Those of B group were (98.4 ±11.6)mmHg,(89.1 ±11.4)/min,C group were (111.2 ±12.5)mmHg,(104.1 ± 13.2)/min,those in A group and B group were better than C group(A group and C group,t =6.18,6.52,P <0.01;B group and C group,t =4.11,4.71,all P <0.01).The pulse oxygen saturation(SpO2 )and peak airway pressure (Paw)of A group were (99.6 ±0.4)and (17.3 ±2.1)mmHg,those in group B were (99.5 ±0.5)% and (17.6 ± 2.0)mmHg,group C were (99.5 ±0.5)% and (22.5 ±2.8)mmHg.The differences between A group and B group were statistically significant(compared with C group,t =14.3,8.14,all P <0.01;B group and C group,t =12.7, 7.78,all P <0.01).The incidence rates of perioperative complications and adverse reactions of A,B,C groups were 27%,33%,67%,that in C group was significantly higher than A group and B group(χ2 =9.64,6.67,all P <0.01). Conclusion The laryngeal mask airway was used for laparoscopic total hysterectomy under the condition of sedation and analgesia,and it can shorten the time of the whole body,prevent the difficulty of intubation,emergency airway and anesthesia related complications.

An indirect method to estimate the force output of triceps surae muscle.

Estimation of force output generated by human muscle is an essential routine of clinical rehabilitation assessment, and could provide considerable insight into rehabilitation, motor control and robotics. Indirect methods for the estimation of force output could be helpful when a bulky and expensive dynamometer is not on hand. Electromyography has been used in previous studies to quantify it in the literature. However, the force output is a summation of the motor unit action potentials, and thus the contributions and performances of superficial and deep-lying muscles could hardly be separated from each other. In this preliminary study, we applied ultrasonography (US) to explore the feasibility of estimating triceps surae force output during isometric plantar flexion with spatial resolution from superficial to deeper muscles. The local deformations of US images are extracted to represent the morphological changes during force generation. It was found US could be utilized to decently (coefficient of determination at 0.875 ± 0.051 and normalized root mean square error 0.160 ± 0.035) estimate the force output and the measured force by a dynamometer.