Objective:To investigate the survival of 2019 novel coronavirus (2019-nCoV) on the surface of inanimate objects at different temperatures.Methods:CNKI, WanFang Database, VIP, PubMed, Web of Science, Cochrane Library and Embase were searched for articles published from January 1, 2020 to June 15, 2022 with "2019-nCoV, surface, inanimate, environments, environmental, matrices, factors, conditions, contact, personal protective equipment, transmission, stability, persistence, viability, survival, survivability, infectivity, transmission". The literature was screened according to the inclusion and exclusion criteria. After the data in the literature were extracted, the improved MINORS scale was used to evaluate the literature quality. RevMan5.4 software was used for meta analysis, and Stata17.0 software was used for Begg′s test and Egger′s test to evaluate the publication bias.Results:A total of 20 studies were included. Meta-analysis result showed that the survival ability of 2019-nCoV on the surface of non-porous objects (stainless steel, glass and plastic) was significantly different from that on the surface of porous objects (cloth, wood board, banknote, cotton, cardboard) ( Z=5.94, P<0.001; Z=17.85, P=0.004; Z=38.20, P<0.001). The result of subgroup analysis showed that there was no significant difference in the survival ability of the virus between banknotes and glass, plastic surfaces under the same conditions ( Z=0.81, P=0.420; Z=1.79, P=0.070). The half-life of the virus at 4 ℃ was significantly different from that at 25 ℃[ MD=47.49 h, 95% CI: 7.00~87.99, Z=2.30, P=0.020]; The half-life of the virus at 25 ℃ was also significantly different compared with that at 35 ℃[ MD=5.46 h, 95% CI: 0.13~10.78, Z=2.01, P=0.040]. Conclusions:Under the same conditions, the survival time of 2019-nCoV on the surface of nonporous objects was longer than that on the surface of porous objects, and the higher the temperature, the shorter the survival time.

Objective:To systematically evaluate the clinical efficacy and adverse effects of Janus kinase (JAK) inhibitors in the treatment of Coronavirus Disease 2019 (COVID-19).Methods:Meta-analysis of the clinical efficacy and adverse effects of Janus kinase inhibitors in the treatment of COVID-19 was performed on 19 papers that met the inclusion criteria, including tests for heterogeneity, relative risk ( RR), mean difference( MD) and publication bias. Results:For the Janus kinase inhibitor group compared with the control group in 19 studies, RR and 95% confidence interval (95% CI) were 0.52 (95% CI: 0.44-0.62), 0.45 (95% CI: 0.25-0.83), and 1.21 (95% CI: 1.03-1.43) for mortality, clinical deterioration and recovery rates, and the mean difference and 95% CI in recovery time was -0.96 (95% CI: -1.13--0.79); for adverse events (including serious adverse events, infections, embolism, deep vein thrombosis, pulmonary embolism, liver dysfunction, psychiatric disorders, renal and urinary disorders), only the P-value for serious adverse events was statistically significant, P=0.010, and the RR and 95% CI were 0.83 (95% CI: 0.72-0.97). Conclusions:JAK inhibitors help reduce mortality and improve clinical outcomes in patients hospitalized with COVID-19 without increasing the risk of adverse events.

Clinically,heparin-induced thrombocytopenia (HIT) is an uncommon but serious disease,which is induced by the use of immune unfractionated heparin or low-molecular-weight heparin.The overall incidence of HIT is about 0.6％-5.0％.Nevertheless,in clinical practice it is profoundly dangerous,especially for patients who are receiving cardiovascular surgery or interventional therapy.At present,HIT is a hot clinical research subject.This paper aims to make a brief review about HIT pathogenesis,epidemiology,clinical evaluation and treatment,etc.

Objective To investigate the effect of curcumin on autophagy and inflammatory response in mice subject to renal ischemia reperfusion.Method Forty male C57BL/6 mice were randomly divided into four groups (n =10 each):sham-operated (SO) group (Abdominal incision was made to expose the kidneys,bilateral renal pedicle dissociated and the abdomen sewed),ischemia reperfusion (IR) group,curcumin (CM) group (given CM 10 mg/kg) and 3-methyladenine (3-MA) group (given 3-MA 15 mg/kg).Six and 24 h after reperfusion,renal function was tested by determining the serum creatinine (Scr) and blood urea nitrogen (BUN) levels,and the morphological changes in the kidney tissue were observed.The expression of LC3,Beclin 1,Rab7 and LAMP2 in kidney tissue was detected by fluorescence quantitative RT-PCR and Western blotting.Fluorescence quantitative reverse transcription PCR and enzyme-linked immunosorbent assay were used to examine the expression of IL-6,IL-10,IL-17 and TNF-α in kidney tissue and serum.Result As compared with IR group and 3-MA group,the Scr and BUN levels in the CM group were significantly decreased (P＜0.01),and the renal morphological changes were improved significantly (P＜0.01).The mRNA and protein expression of LC3,Beclin 1,Rab7 and LAMP2 was significantly increased in kidney tissue,and the expression of IL-6,IL-17 and TNF-α was reduced,while IL-10 was increased (P＜ 0.01) in the CM group as compared with IR group and 3-MA group.Conclusion Curcumin possesses a protective effect against renal ischemia reperfusion injury in mice,which is probably mediated by promoting autophagy and subsequently inhibiting inflammatory response.

Objective To compare the clinical efficacy of transdorsal-to-plantar (TDP) or transplantar-to-dorsal (TPD) retrograde endovascular angioplasty in treating below-the-knee arterial occlusion diseases, and to compare it with conventional anterograde endovascular angioplasty. Methods A total of 96 patients with below-the-knee arterial occlusion diseases (112 diseased lower extremities in total), who were admitted to authors’ hospital during the period from Oct. 2009 to July 2011 to receive conventional anterograde endovascular angioplasty, were enrolled in this study. The clinical data were retrospectively analyzed. Among the 112 diseased lower extremities, conventional anterograde endovascular angioplasty failed in 27, and TDP or TPD retrograde endovascular angioplasty had to be carried out. A total of 71 patients (85 diseased lower limbs) were successfully treated with conventional anterograde endovascular angioplasty (routine group), while 20 patients (22 diseased lower limbs) were successfully treated with retrograde endovascular angioplasty (retrograde group). The preoperative ankle-brachial index(ABI), the coronary angiography-based thrombolysis in myocardial infarction (TIMI) flow score, the dorsal or plantar arterial pulse score, the postoperative limb salvage rate and target vessel patency rate were calculated, and the results were compared between the two groups. Results The technical success rate in the retrograde group and the routine group was 75.9% and 74.0%respectively (P>0.05). Preoperative ABI value of the retrograde group and the routine group was 0.55± 0.21 and 0.56±0.14 respectively, after the treatment which increased to 0.93±0.19 and 0.89±0.18 respectively (P>0.05). Preoperative TIMI score of the retrograde group and the routine group was 0.1 ±0.5 and 0.8 ±0.8 respectively, which significantly increased to 2.5±0.6 and 1.8±0.8 respectively (P<0.000 1). In the retrograde group, the blood flow perfusion of the distal foot tissue was improved. The primary target vessel patency rate at 12 months and 24 months after the treatment in the retrograde group and the routine group were 63.6%(14/22), 45.5%(10/22) and 52.9%(45/85), 37.6%(32/85) respectively (P>0.05). Twenty-four months after endovascular angioplasty Kaplan-Meier analysis indicated that the limb salvage rate of the retrograde group and the routine group was 95.5%and 96.5%respectively (P>0.05). Conclusion Compared with conventional anterograde endovascular angioplasty for the treatment of below-the-knee arterial occlusion diseases, retrograde endovascular angioplasty via TDP or TPD path can immediately improve the blood flow with obvious improvement of ABI score, primary target vessel patency rate as well as the limb salvage rate. Therefore, retrograde endovascular angioplasty should be regarded as an effective supplementary technique when anterograde angioplasty fails.

BACKGROUNDThe Xpert MTB/RIF showed high sensitivity and specificity in previous studies carried out in different epidemiological and geographical settings and patient populations in high-burden tuberculosis (TB) countries. However, there were little data obtained by validation or demonstration study of the assay in China. In this study, the performance of Xpert MTB/RIF was investigated in two county-level laboratories in Hunan Province, China.

METHODSConsecutive patients with suspected pulmonary tuberculosis (PTB) and suspicion for multidrug-resistant tuberculosis (MDR-TB) were enrolled. For each patient suspected to have PTB, three sputum specimens (one spot sputum, one night sputum, and one morning sputum) were collected and each sputum was tested with smear microscopy, Löwenstein-Jensen (LJ) culture, and Xpert MTB/RIF test. For comparison across subgroups and testing methods, 95% confidence intervals were calculated. All analyses were done with SPSS 16.0, and P < 0.05 was regarded as significant.

RESULTSFor case detection, the sensitivity of Xpert MTB/RIF was 100% for smear- and culture-positive TB and 88.6% for smear-negative and culture-positive TB; the overall sensitivity was 94.5% for all culture-positive patients. The specificity was 99.8%. The sensitivity of Xpert MTB/RIF assay was 22.0% in clinical TB patients and the specificity reached 100.0% in the group of patients who are infected with nontuberculous mycobacteria. For the detection of rifampin resistance, the sensitivity of MTB/RIF RIF-resistance detection was 92.9%, and the specificity was 98.7%. Of the 26 Xpert MTB/RIF-positive and RIF-resistant patients confirmed by LJ proportion tests, 20 (76.9%) patients were infected by MDR-TB.

CONCLUSIONSThe Xpert MTB/RIF assay is a highly sensitive and specific method for diagnosis of TB and RIF resistance, which will enable it to have the potential to be used in county-level laboratories and lead to the reduction of the infectious pool and improvements in TB control in China. Further evaluations in county-level laboratories for implementing the assay are still required.

Adult ; Antibiotics, Antitubercular ; therapeutic use ; China ; Female ; Humans ; Male ; Middle Aged ; Rifampin ; therapeutic use ; Tuberculosis ; diagnosis ; drug therapy ; Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary ; diagnosis ; drug therapy ; Young Adult

Objective To assess the clinical value of batroxobin plus aspirin therapy in reducing the incidence of arterial re-stenosis or re-occlusion in diabetic patients with lower-limb ischemia after receiving angioplasty. Methods A total of 110 diabetic patients with symptomatic arterial obstructions were randomly divided into study group (n=50) and control group (n=60). Aspirin 100 mg/d plus batroxobin 5 IU every other day for six times was used in patients of the study group, while only aspirin 100 mg/d was used in patients of the control group. The follow-up finishing point was the end of 12 months. The arterial re-stenosis or re-occlusion was evaluated with magnetic resonance angiography (MRA) and/or vascular sonography. Amputation above the ankle, death, and the cumulative rate of amputation or death were determined, and the limb salvage and survival rates were assessed by using Kaplan-Meier analysis method. Results Twelve months after the treatment, the occurrence of restenosis in the study group and the control groups was 42.8%and 28.9% respectively (P = 0.002). MR angiography and color- duplex sonography revealed that the restenosis occurrence was much higher in infrapopliteal artery (P = 0.003) and in longer (length > 10 cm) diseased artery (P = 0.001). Twelve months after angioplasty Kaplan-Meier analysis showed that the limb salvage-survival rates of the study group and the control group were 78.2%and 93.5%respectively (log-rank test, P = 0.032 4). Conclusion Combination use of batroxobin and aspirin can effectively reduce the occurrence of restenosis after arterial angioplasty, and the clinical effect is particularly better for the artery distal to the knee and the artery with longer lesion (length > 10 cm), besides this treatment can also improve limb salvage rate.

Background The Xpert MTB/RIF showed high sensitivity and specificity in previous studies carried out in different epidemiological and geographical settings and patient populations in high-burden tuberculosis (TB) countries.However,there were little data obtained by validation or demonstration study of the assay in China.In this study,the performance of Xpert MTB/RIF was investigated in two county-level laboratories in Hunan Province,China.Methods Consecutive patients with suspected pulmonary tuberculosis (PTB) and suspicion for multidrug-resistant tuberculosis (MDR-TB) were enrolled.For each patient suspected to have PTB,three sputum specimens (one spot sputum,one night sputum,and one morning sputum) were collected and each sputum was tested with smear microscopy,L(o)wenstein-Jensen (LJ) culture,and Xpert MTB/RIF test.For comparison across subgroups and testing methods,95％ confidence intervals were calculated.All analyses were done with SPSS 16.0,and P ＜0.05 was regarded as significant.Results For case detection,the sensitivity of Xpert MTB/RIF was 100％ for smear-and culture-positive TB and 88.6％ for smear-negative and culture-positive TB; the overall sensitivity was 94.5％ for all culture-positive patients.The specificity was 99.8％.The sensitivity of Xpert MTB/RIF assay was 22.0％ in clinical TB patients and the specificity reached 100.0％ in the group of patients who are infected with nontuberculous mycobacteria.For the detection of rifampin resistance,the sensitivity of MTB/RIF RIF-resistance detection was 92.9％,and the specificity was 98.7％.Of the 26 Xpert MTB/RIF-positive and RIF-resistant patients confirmed by LJ proportion tests,20 (76.9％) patients were infected by MDR-TB.Conclusions The Xpert MTB/RIF assay is a highly sensitive and specific method for diagnosis of TB and RIF resistance,which will enable it to have the potential to be used in county-level laboratories and lead to the reduction of the infectious pool and improvements in TB control in China.Further evaluations in county-level laboratories for implementing the assay are still required.

Objective To evaluate the clinical results of Willis covered stent implantation and coil embolization in the treatment of cranial internal carotid artery (CICA) aneurysm. Methods Eighty-nine patients with CICA aneurysms were selected for treatment with Willis covered stents (n = 43, group A) or coil embolization (n =46, group B) according to the patients'will. Data on the technical success, initial procedure time and in-hospital interval, initial and final angiographic results, mortality, morbidity, and final clinical outcomes were collected and analyzed for the two groups at 6 months post-procedure. Results Endovascular covered stent placement and coil embolization were technically successful in all patients,except for one patient in group A. The initial angiographic results showed complete occlusion in 34 patients of group A (81%, 95% CI: 69%, 93% ) and 24 patients of group B (52%, 95% CI: 37%, 67% ) ( P ＜0. 05). The final angiographic results indicated complete occlusion in 39 patients of group A (39/41,95%,95% CI: 88%, 102% ) and 22 patients of group B (22/45,49%, 95% CI: 34%, 64% ,P ＜0. 01 ). The average procedure time was(103 ± 13)min in group A and (143 + 39) min in group B (P＜0. 01). No significant differences were seen between the two groups in technique success, mortality, morbidity, or final clinical outcomes. Conclusion In this nonrandomized, prospective trial, CICA aneurysm treatment with covered stents yielded midterm angiographic results that were superior to those of coil embolization.

Objective To present our single-center experience in treating traumatic direct carotidcavemous fistulas (TDCCFs)by using detachable balloon,coil and Willis covered stent via arterial route.Methods During the last five years,transarterial endovascular treatment by using detachable balloon,coil and Willis covered stent was performed in fifty-one consecutive patients of traumatic direct carotid-cavernous fistulas.with a total of 54 TDCCFs.The detachable balloon was the material of first choice,while Willis covered stents and coils were regarded as the back-up materials.A clinical and angiographic follow-up for 348 months (mean 20.8 months) was conducted to evaluate the arterial patency and the stability of embolization.The clinical data were retrospectively analyzed.Results By using the detachable balloon alone via transarterial route.85%TDCCFs were successfully treated with good preservation of ICA.A total of 98% TDCCFs in this study were successfully treated by using detachable balloon,coil and/or Willis coveted stent,the fistulas became occluded,and ICAs were preserved except one patient.Forty TDCCFs were treated with detachable balloons alone,two TDCCFs with the Willis covered stent alone,and one DCCF with coils alone.Eight TDCCFs were treated with detachable balloons together with Willis covered stent.Of these eight TDCCFs,two were treated with a single session,three were treated with detachable halloons in combination with coils,and one had to receive Willis covered stent.Second and third times of endovascular treatment were needed in 12 TDCCFs.The TDCCF-rel(at)ed symptoms were gradually relived or improved within 1 day to 6 months after treatment,except for five patients who suffered from ipsilateral moderate visual loss or cranial nerve deficit.No perioperative complications.such as vessel rupture,distal embolization or new neurologic deficits,occurred.During the follow-up period lasting for six months,neither delayed neurologic or vascular complications nor recurrence of the lesions developed.Conclusion Via the transarterial route,using detachable balloon to occlude the fistula and at the same time to preserve ICA remains the optimal treatment for TDCCFs.When the standard treatment fails.various coils and the Willis covered stents can be used as an effective alternative or remedial tool in the treatment of TDCCFs,which can preserve ICA.Willis covered stent deployment seems to be an effective,safe,feasible and economical endovasculal treatment for TDCCF,but more clinical studies are needed before we can further clarify its specifications and indications.