COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

Objective:To explore the value of ultrasound fusion navigation technology in the biopsy of parapharyngeal-infratemporal fossa-skull base (PIS) lesions.Methods:This study was conducted at the First Affiliated Hospital of Sun Yat-Sen University from March 2021 to March 2022 and included 8 patients [3 females and 5 males; age, (50±20) years; range, 16-76 years] with PIS lesions who needed to clarify the pathological diagnosis. The ultrasound fusion navigation with CT or MRI was used to guide lesion biopsy, and the technical feasibility, pathological diagnostic results and complications were evaluated.Results:The biopsy procedures were successful in all 8 patients, and the lesion size ranged from 2.2 to 6.5 cm. The exact pathological diagnosis was obtained in 7 patients, and the diagnostic rate was 87.5% (7/8). No major complication was observed after the biopsy. Mild complications occurred in 1 case, with a incidence of 12.5% (1/8).Conclusions:Ultrasound fusion navigation-guided biopsy is feasible, effective, and safe in the biopsy of deep head and neck lesions.

Objective　To provide a data foundation not only for food safety supervision and pollution source tracing, but also for the clinical treatment of drug-resistant bacteria in barreled drinking water, the drug resistance and type Ⅲ secretion system (T3SS) virulence genes carriage of Pseudomonas aeruginosa detected in barreled drinking water in Hainan Province were investigated, and the correlative relationship between strain ribosomal subtypes and virulence genes were then discussed. Methods The drug resistance of the isolated 55 strains of Pseudomonas aeruginosa was confirmed by using VITEK 2 Compact automatic microbial drug sensitivity system, and the T3SS virulence genes ExoU, ExoS, ExoT and ExoY were amplified by PCR, bacterial strain subtypes and homology were analyzed by the RiboPrinter automatic microbial gene fingerprint identification system. Results The drug sensitivity results showed that Pseudomonas aeruginosa isolated from barreled water had relatively low drug resistance, though one strain of multidrug-resistant Pseudomonas aeruginosa was discovered, resistant to imipenem, ciprofloxacin and cefepime. The distribution of T3SS virulence genes showed four genotypic combinations: ExoT+/ExoY+/ExoS+/ExoU- (45.45%, 25/55), ExoT+/ExoY+/ExoS-/ExoU+ (34.55%, 19/55), ExoT+/ExoY-/ExoS-/ExoU+(18.18%, 10/55), ExoT+/ExoY+/ExoS+/ExoU+ (1.82%, 1/55). Ribosomal typing results showed that the Pseudomonas aeruginosa strains were divided into six subtypes, the numbers of each subtype accounted for 24 (43.64%), 1 (1.82%), 25 (45.45%), 1 (1.82%), 3 (5.45%) and 1 (1.82%) respectively, with subtype Ⅰ and subtype Ⅲ being dominant. The main T3SS genotypes of the top two subtype I and subtype III were ExoT+/ExoY+/ExoS-/ExoU+ (16/24, 66.67%) and ExoT+/ExoY+/ExoS+/ExoU- (22/25, 88%). Conclusions The T3SS secretion system exhibits the characteristics of multiple virulence genes' coordinated expression, and there is a certain correlation between subtypes of bacterial strains and virulence genotypesThe exploration of the relationship between them provides guidance for tracing the source of Pseudomonas aeruginosa contamination, production control, clinical treatment in barrelled drinking water, and preliminarily establishes the initial data of local Pseudomonas aeruginosa strains in barrelled drinking water as well the related drug sensitivity data in Hainan.

This article summarize the recent advances in image-guided ablation of liver malignancies and their clinical applications.

Objective To analyze the influence factors of local efficacy by parametric contrast enhanced ultrasound (CEUS) of the hepatocellular carcinoma (HCC) patient treated with transcatheter arterial chemoembolization (TACE),and to investigate the application value of parametric CEUS in TACE.Methods From August 2011 to March 2014,a total of 61 HCC patients [60 men,1 women;age range:18-76 years,mean age:(53 ± 13)years old] who underwent one procedure of TACE were enrolled in this prospective study.All cases were scanned by CEUS 1-7 days before and after TACE (3 days,15 days and 30 days post-TACE).Analysis of tumor perfusion during the procedure of CEUS was performed with dedicated software (SonoLiver,TomTec,Germany and Bracco,Italy).Time-intensity curves were plotted and parameters were extracted.According to modified response evaluation criteria in solid tumors (mRECIST),we evaluated the response of TACE using contrast-enhanced computed tomography (CECT) and CEUS 30 days after TACE,which was as reference standard.Results There was a middle negative correlation between the reference standard and the PSV of the hepatic artery pre-TACE,and the correlation coefficient was 0.436 (P =0.011).There was a low negative correlation between the reference standard and the TTP of the reference region on 3 days post-TACE and the analysis region pre-TACE,and the correlation coefficient was -0.264 and-0.268 (P =0.047,P =0.037).Conclusions Our preliminary study suggests,some parameters of CEUS can predict the local response of TACE.

Objective To explore the characteristics and influencing factors of depressive symptoms among the only-child-lost persons.Methods A total of 841 only-child-lost persons and 674 controls conforming to entering group condition were selected.The difference of SDS score between the two groups and the demographic characteristics distribution differences of depression severity in only-child-lost persons were compared and the influencing factors were analyzed.Results The SDS score had statistical difference between the only-child-lost persons group and control group(P＜0.05),and was correlated to the only-child-lost years and no physical disease;the proportion of mild to moderate depression in the only-child-lost persons of the low cultural level,somatic diseases and middle income level groups was significantly higher than that in the other groups;the only-child-lost persons with low income level,age≤60 years old and high educational level had a higher proportion of severe depression;the Logistic regression analysis showed that the educational level had a significant influence on the depression onset among the only-child-lost persons,the difference was statistically significant(P＜0.05).Conclusion The characteristics of depressive symptoms among the only-child-lost persons are related to their demographic characteristics.

This article summarized the mechanism of Ultrasound-responsive drug delivery systems (URDDS) and the research progress of URDDS for hepatocellular carcinoma therapy.

Objective To investigate the influencing factors of quality in contrast-enhanced ultrasound (CEUS) perfusion analysis for hepatocellular carcinoma (HCC) and the reproducibility of using CEUS perfusion analysis on HCC.Methods A total of 136 HCC lesions were undergone CEUS perfusion analysis.Maximum intensity (Imax),rise time (RT),time to peak (TTP),mean transit time (mTF) and quality of fit (QOF) of HCC lesion,top-enhanced region inside HCC lesion and adjacent liver parenchyma were measured.The quality of perfusion analysis was classified into three grades " Good" (QOF ＞ 75％),"Common" [QOF (50％-75％)],and " Poor" (QOF ＜ 75％).Ultrasound machine,patients' age,tumor depth,tumor size and tumor location were recorded and compared among the three groups.20 consecutive patients with 20 HCC lesions were received CEUS perfusion analysis by two operators and another 20 consecutive HCC lesions were received CEUS perfusion analysis by one operator at different time.Intra-class correlation coefficient (ICC) was used to evaluate the reproducibility of inter-and intra-observer.Results Fifty-six HCC lesions were classified as " Good",39 as " Common" and 39 as " Poor",respectively.Tumor size (P =0.015) and tumor location (P =0.041) were significantly different among the three groups.Tumor size ＞ 3.0 cm and tumor located in S3,S4b,S5,S6 were apt to gain a better QOF.No significant difference was found for the different ultrasound machine,tumor depth and patients' age.For all CEUS perfusion analysis parameters of both lesion and adjacent parenchyma,intra-class correlation coefficient of inter-and intra-observer were higher than 0.90,the reproducibility of CEUS perfusion analysis was good.For Imax,RT and TTP in top-enhanced region inside HCC lesion,ICC of inter-and intra-observer was all higher than 0.90 (good).For mITT in highest enhanced area inside HCC lesion,ICC of inter-and intra-observer were 0.459 (poor),0.609 (common),respectively.Conclusions The parameters of HCC quantitative perfusion analysis were reproducible in peripheral liver parenchyma and tumor,but the mTT repeatability was poor in the highest enhancement area of the tumor.The size and location of the lesion were the factors affecting quantitative analysis.The quantitative analysis of ＞ 3.0 cm and the tumor located in S3,S4b,S5,S6 in the liver were satisfactory.

Objective To summarize and analyze the contrast-enhanced ultrasonographic findings of intraductal papilloma and to explore the clinical value and percutaneous transhepatic cholangial drainage (PTCD) strategy of contrast-enhanced ultrasonography in the diagnosis of intraductal papilloma.Methods We retrospectively analyzed 32 cases with intraductal papilloma confirmed by surgery,conventional ultrasound,transvascular contrast-enhanced ultrasound,intrahepatic contrast echocardiography to gather the diagnostic coincidence rate of conventional ultrasound and contrast-enhanced ultrasound in bile duct papilloma,thus making a summary of PTCD experience of intraductal papilloma.Results The diagnostic accuracy of conventional ultrasound and contrast-enhanced ultrasound in the diagnosis of intraductal papilloma were 43.8％ (14/32) and 93.8％ (30/32) respectively,and the differences were statistically significant (P =0.037).Conclusions Conventional ultrasound combined with double contrast ultrasound and cholangiography can improve the diagnostic accuracy of intraductal papilloma.Ultrasound-guided PTCD is a real-time,convenient procedure.Choosing a biliary drainage tube as thick as possible and repeatedly doubling the tube can maintain bile drainage and smooth flow,thus can effectively improve the efficacy of serum bilirubin reduction and protect liver function.

Objective To study the feasibility,efficacy and safety of ultrasound-guided percutaneous radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) in the caudate lobe.Methods From November 2006 to June 2017,31 patients with 31 HCCs located in the caudate lobe were treated with percutaneous RFA at the First Affiliated Hospital of Sun Yat-sen University.The treatment efficacy,complications,and the local tumor progression (LTP),disease-free survival (DFS) and overall survival (OS) rates were analyzed.Results Residual tumors were detected in 5 patients after the first treatment.Complete necrosis was achieved in all the patients after the second treatment.The mean number of ablation sessions was 1.16±0.37.At a follow-up period which ranged from 3 to 65 months,19 patients had died,10 patients were still alive,and 2 patients were lost to follow-up.The 1-,2-,3-,and 5-years OS rates were 78.4％,48.5％,12.1％ and 12.1％,respectively.On follow-up,9 caudate lobe HCC lesions were detected to have LTP.The 1-,2-,and 3-years LTP rates were 21.5％,41.6％ and 41.6％,respectively;while the 1-,2-,and 3-years DFS rates were 22.3％,11.2％ and 11.2％,respectively.Ablationrelated complications were detected in 4 patients.Conclusions Ultrasound-guided percutaneous RFA was safe and effective for patients with HCC in the caudate lobe.These patients should be followed-up closely to detect LTP.