A dynamic nomogram for predict individual risk of malignant brain edema after endovascular thrombectomy in acute ischemic stroke.

The aim of this study was to develop a dynamic nomogram combining clinical and imaging data to predict malignant brain edema (MBE) after endovascular thrombectomy (EVT) in patients with large vessel occlusion stroke (LVOS). We analyzed the data of LVOS patients receiving EVT at our center from October 2018 to February 2023, and divided a 7:3 ratio into the training cohort and internal validation cohort, and we also prospectively collected patients from another stroke center for external validation. MBE was defined as a midline shift or pineal gland shift > 5 mm, as determined by computed tomography (CT) scans obtained within 7 days after EVT. A nomogram was constructed using logistic regression analysis, and its receiver operating characteristic curve (ROC) and calibration were assessed in three cohorts. A total of 432 patients were enrolled in this study, with 247 in the training cohort, 100 in the internal validation cohort, and 85 in the external validation cohort. MBE occurred in 24% (59) in the training cohort, 16% (16) in the internal validation cohort and 14% (12) in the external validation cohort. After adjusting for various confounding factors, we constructed a nomogram including the clot burden score (CBS), baseline neutrophil count, core infarct volume on CTP before EVT, collateral index, and the number of retrieval attempts. The AUCs of the training cohorts were 0.891 (95% CI 0.840-0.942), the Hosmer-Lemeshow test showed good calibration of the nomogram (P = 0.879). And our nomogram performed well in both internal and external validation data. Our nomogram demonstrates promising potential in identifying patients at elevated risk of MBE following EVT for LVOS.

Experimental comparison of E-band BDFA and Raman amplifier performance over 50 km G.652.D fiber using 30 GBaud DP-16-QAM and DP-64-QAM signals.

We compare the performance of three optical amplifiers in the E-band: a bismuth-doped fiber amplifier (BDFA), a distributed Raman amplifier, and a discrete Raman amplifier (RA). Data transmission performance of 30 GBaud DP-16-QAM and DP-64-QAM signals transmitted over 50 km of G.652.D fiber is compared in terms of achieved signal-to-noise (SNR). In this specific case of relatively short distance, single-span transmission, the BDFA outperforms the distributed and discrete Raman amplifiers due to the impact of fiber nonlinear penalties at high input signal powers.

Thymoquinone regulates microglial M1/M2 polarization after cerebral ischemia-reperfusion injury via the TLR4 signaling pathway.

Acute ischemic stroke followed by microglia activation, and the regulation of neuroinflammatory responses after ischemic injury involves microglia polarization. microglia polarization is involved in the regulation of neuroinflammatory responses and ischemic stroke-related brain damage. Thymoquinone (TQ) is an anti-inflammatory agent following ischemic stroke onset. However, the significance of TQ in microglia polarization following acute ischemic stroke is still unclear. We predicted that TQ might have neuroprotective properties by modulating microglia polarization. In this work, we mimicked the clinical signs of acute ischemic stroke using a mouse middle cerebral artery ischemia-reperfusion (I/R) model. It was discovered that TQ treatment decreased I/R-induced infarct volume, cerebral oedema, and promoted neuronal survival, as well as improved the histopathological changes of brain tissue. The sensorimotor function was assessed by the Garica score, foot fault test, and corner test, and it was found that TQ could improve the motor deficits caused by I/R. Secondly, real-time fluorescence quantitative PCR, immuno-fluorescence, ELISA, and western blot were used to detect the expression of M1/M2-specific markers in microglia to explore the role of TQ in the modulation of microglial cell polarization after cerebral ischemia-reperfusion. We found that TQ was able to promote the polarization of microglia with extremely secreted inflammatory factors from M1 type to M2 type. Furthermore, TQ could block the TLR4/NF-κB signaling pathway via Hif-1α activation which subsequently may attenuate microglia differentiation following the cerebral ischemia, establishing a mechanism for the TQ's beneficial effects in the cerebral ischemia-reperfusion model.

Hemodynamic predictors of early neurological deterioration and clinical outcome after endovascular treatment in large artery occlusion.

Objective: Half of the patients with acute large artery occlusion (LAO) have poor outcomes after endovascular treatment (EVT). Early complications such as cerebral edema and symptomatic intracranial hemorrhage (sICH) can lead to early neurological deterioration (END), which correlates with hemodynamics. This study aimed to identify the hemodynamic predictors of END and outcomes in LAO patients after EVT. Methods: A total of 76 patients with anterior circulation LAO who underwent EVT and received transcranial Doppler (TCD) monitoring were included. Bilateral middle cerebral artery (MCA) blood flow velocities (BFVs) were measured repeatedly within 1 week. Mean flow velocities (MFV) and MFV index (ipsilateral MFV/contralateral MFV) were calculated. The primary outcome was the incidence of END within 72 h. The secondary outcome was the functional outcome at 90 days-a good outcome was defined as a modified Rankin scale (mRS) score of 0-2, while a poor outcome was defined as an mRS score of 3-6. Results: A total of 13 patients (17.1 %) experienced END within 72 h, including 5 (38.5 %) with cerebral edema, 5 (38.5 %) with sICH, and 3 (23.0 %) with infarct progression. Multivariable logistic regression analysis showed that a higher 24 h MFV index was independently associated with END (aOR 10.5; 95 % CI 2.28-48.30, p = 0.003) and a poor 90-day outcome (aOR 5.10; 95 % CI 1.38-18.78, p = 0.014). The area under the receiver operating characteristic (ROC) curve (AUC) of the 24 h MFV index for predicting END was 0.807 (95 % CI 0.700-0.915, p = 0.0005), the sensitivity was 84.6 %, and the specificity was 66.7 %. At the 1-week TCD follow-up, patients who had poor 90-day outcomes showed significantly higher 1-week iMFV [73.5 (58.4-99.0) vs. 57.7 (45.3-76.3), p = 0.004] and MFV index [1.24 (0.98-1.57) vs.1.0 (0.87-1.15) p = 0.007]. A persistent high MFV index (PHMI) was independently associated with a poor outcome (aOR 7.77, 95 % CI 1.81-33.3, p = 0.006). Conclusion: TCD monitoring within 24 h after EVT in LAO patients can help predict END, while dynamic follow-up within 1 week is valuable in predicting clinical outcomes.

Blood-brain barrier permeability by CT perfusion predicts parenchymal hematoma after recanalization with thrombectomy.

BACKGROUND AND PURPOSE: Parenchymal hematoma is a dreaded complication of mechanical thrombectomy after acute ischemic stroke. This study evaluated whether blood-brain barrier permeability measurements based on CT perfusion could be used as predictors of parenchymal hematoma after successful recanalization and compared the predictive value of various permeability parameters in patients with acute ischemic stroke. METHODS: We enrolled 53 patients with acute ischemic stroke who underwent mechanical thrombectomy and achieved successful recanalization. Each patient underwent CT, CT angiography, and CT perfusion imaging before treatment. We used relative volume transfer constant (rKtrans ) values, relative permeability-surface area product (rP·S), and relative extraction fraction (rE) to evaluate preoperative blood-brain barrier permeability in the delayed perfusion area. RESULTS: Overall, 22 patients (37.7%) developed hemorrhagic transformation after surgery, including 10 patients (16.9%) with hemorrhagic infarction and 11 patients (20.8%) with parenchymal hematoma. The rP·S, rKtrans , and rE of the hypoperfusion area in the parenchymal hematoma group were significantly higher than those in the hemorrhagic infarction and no-hemorrhage transformation groups (p < .01). We found that rE and rP·S were superior to rKtrans in predicting parenchymal hematoma transformation after thrombectomy (P·S area under the curve [AUC] .844 vs. rKtrans AUC .753, z = 2.064, p = .039; rE AUC .907 vs. rKtrans AUC .753, z = 2.399, p = .017). CONCLUSIONS: Patients with parenchymal hematoma after mechanical thrombectomy had higher blood-brain barrier permeability in hypoperfusion areas. Among blood-brain barrier permeability measurement parameters, rP·S and rE showed better accuracy for parenchymal hematoma prediction.

Asymmetric deep cerebral venous filling predicts poor outcome of acute basilar artery occlusion after endovascular treatment.

OBJECTIVE: To explore the relationship between asymmetric deep cerebral venous (ADCV) filling and poor outcomes after endovascular treatment (EVT) in patients with acute basilar artery occlusion (ABAO). METHODS: ABAO patients were selected from a prospectively collected data at our center. The DCV filling was evaluated using computed tomography perfusion (CTP)-derived reconstructed 4D-DSA or mean venous map. ADCV filling was defined as the internal cerebral vein (ICV), thalamostriate vein (TSV), or basal vein of Rosenthal (BVR) presence of ipsilateral filling defects or delayed opacification compared to the contralateral side. Poor prognosis was defined as a modified Rankin scale score >3 at the 90-day follow-up. RESULTS: A total of 90 patients were enrolled in the study, with a median Glasgow Coma Scale of 6, 46 (51.1%) showed ADCV filling, 59 (65.6%) had a poor prognosis, and 27 (30.7%) had malignant cerebellar edema (MCE). Multivariate adjusted analysis revealed significant associations between asymmetric TSV and poor prognosis (odds ratio, 9.091, p = 0.006); asymmetric BVR (OR, 9.232, p = 0.001) and asymmetric ICV (OR, 4.028, p = 0.041) were significantly associated with MCE. CONCLUSION: Preoperative ADCV filling is an independent influencing factor for the poor outcome after EVT in ABAO patients.

Ultralow noise C + L wideband WDM-IMDD transmission at 18 × 112 Gbps by using hybrid second-order distributed Raman and first-order lumped Raman amplification.

We experimentally investigated and demonstrated an ultralow noise hybrid amplifier that combines second-order distributed Raman amplifier (DRA) and first-order lumped Raman amplifier (LRA) in a cascaded approach. This approach allows for the reutilization of pump light from the LRA as the seed light in the second-order DRA, and simultaneous full-band dispersion compensation is realized by using dispersion compensation fiber in the LRA. This approach also supports broadband gain flattening based on the separated DRA and LRA configuration. The transmission application of the proposed amplifier was investigated using a set of 10 external cavity lasers (ECLs) in the C-band and 8 ECLs in the L-band. Ranging from 1531.12 nm to 1595.49 nm across C + L band, the proposed hybrid amplifier gives a maximum on-off gain of 27.2 dB and an average gain of 23.4 dB, with an extremely low effective noise figure (NF) of lower than -2.9 dB. Intensity modulation direct detection (IMDD) signal transmission is carried out at two different data rates across these 18 wavelengths in the C + L band: (1) 56 Gbps/λ PAM-4 signal; (2) 112 Gbps/λ PAM-4 signal. The results show that the error free transmissions are demonstrated over 101.6 km EX2000 fiber using both signals with 7% HD-FEC and 20% SD-FEC, respectively.

Cardiotoxicity of lung cancer-related immunotherapy versus chemotherapy: a systematic review and network meta-analysis of randomized controlled trials.

Background: Previous clinical randomized controlled trials (RCTs) have demonstrated that immune checkpoint inhibitors (ICIs) cause various toxicities during cancer treatment, but the effects of different inhibitors in combination with chemotherapy for cardiotoxicity remain controversial. The aim of the present study was to assess cardiotoxicity caused by programmed cell death protein 1 (PD-1), programmed cell death-Ligand 1 (PD-L1), and cytotoxic T lymphocyte associate protein-4 (CTLA-4) in combination with chemotherapy to treat lung cancer. Methods: The following ICIs were included in the present study: durvalumab, avelumab, ipilimumab, atezolizumab, pembrolizumab, cemiplimab, and nivolumab. The relevant information was extracted using a predefined data extraction table, and the risk of bias was assessed in randomized controlled trials using the Cochrane Bias Risk tool. The main outcomes were hypertension, heart failure, pericardial effusion, and other adverse cardiac events. The random effects model was used to conduct a paired meta-analysis, and a random effects network meta-analysis was then performed within a Bayesian framework. Results: In total, 17 RCTs were included in the present study. There were 11,063 individuals in the experimental and control groups, with an average age greater than 60 years. Based on the evaluation of all drug classes in RCTs, CTLA-4+chemotherapy (RR, -0.69 [95% CI, 2.91-1.52] and PD-L1 (RR, -0.21 [95% CI, -1.03-0.60]) were less cardiotoxic than the control arm, which indicated they were safer options for adverse cardiac events. PD-L1 alone was less cardiotoxic than PD-1 alone (RR, -0.57 [95% CI, -1.96-0.82]). Further, the dual immunotarget inhibitor, PD-1+CTLA-4, had the lowest SUCRA value and had the highest cardiotoxicity (SUCRA=9). Conclusion: When classified according to drug type, CTLA-4+chemotherapy is associated with fewer cardiac adverse events compared to other treatments. Dual immunotarget inhibitors are more likely to have adverse cardiac reactions. Therefore, clinicians should consider this evidence when developing an ICI immunotherapy regimen for lung cancer. Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier CRD42023360931.

Asymmetry Optimization for 10 THz OPC Transmission over the C + L Bands Using Distributed Raman Amplification.

An optimized design for a broadband Raman optical amplifier in standard single-mode fiber covering the C and L bands is presented, to be used in combination with wideband optical phase conjugation (OPC) nonlinearity compensation. The use of two Raman pumps and fiber Bragg grating reflectors at different wavelengths for the transmitted (C band) and conjugated (L band) WDM channels is proposed to extend bandwidth beyond the limits imposed by single-wavelength pumping, for a total 10 THz. Optimization of pump and reflector wavelength, as well as pump powers, allows us to achieve low asymmetry across the whole transmission band for optimal nonlinearity compensation. System performance is simulated to estimate OSNR, gain flatness and nonlinear Kerr distortion.

The Ethanolic Extract of Lindera aggregata Modulates Gut Microbiota Dysbiosis and Alleviates Ethanol-Induced Acute Liver Inflammation and Oxidative Stress SIRT1/Nrf2/NF-κB Pathway.

This study is an attempt to evaluate the therapeutic effect of the ethanolic extract of Lindera aggregata on the liver and intestinal microbiota in rats with alcohol-induced liver injury (ALI). Rats were treated with 70 mg probiotics, 1 g/kg, 2 g/kg, and 3 g/kg ethanolic extract of Lindera aggregata, respectively, for 10 days. We found that Lindera aggregata could significantly reduce the biochemical parameters in the serum of ALD rats. Lindera aggregata alleviates oxidative stress and inflammation by upregulating SIRT1 and Nrf2 and downregulating COX2 and NF-κB. The results of 16S rRNA gene sequencing showed that the medium dose of Lindera aggregata had the best effect on the growth of beneficial bacteria. Diversity analysis and LEfSe analysis showed that beneficial bacteria gradually occupied the dominant niche. The relative abundance of potential pathogens in the gut decreased significantly. We demonstrated that the ethanolic extract of Lindera aggregata can alleviate the oxidative stress and inflammation induced by alcohol through the SIRT1/Nrf2/NF-κB pathway and can modulate the disturbance of gut microbiota induced by alcohol intake.

Ultra-wideband discrete Raman amplifier optimization for single-span S-C-L-band coherent transmission systems.

We experimentally compare the performance of two key ultra-wideband discrete Raman amplifier structures, a cascaded dual-stage structure and an in-parallel dual-band structure, in fully loaded S-C-L band coherent transmission systems over 70 km of single-mode fiber. Our results show that dual-band discrete Raman amplifier with minimized backreflections can effectively avoid unstable random distributed feedback lasing, reduce the noise figure, and therefore improve the transmission performance for signals at shorter wavelengths, versus the cascaded dual-stage structure. The average noise figure for S-band signals is 6.8 dB and 7.2 dB for the dual-band structure and cascaded dual-stage structure, respectively, while the average S-band Q2 factor is similarly improved by 0.6 dB. Moreover, the cascaded dual-stage discrete Raman amplifier requires guard bands around the 1485-nm and 1508-nm pumps as the signal and pump wavelengths overlap, which results in a bandwidth loss of ∼10 nm and reduces the potential net data throughput to 28.6 Tb/s for 30-GBaud DP-16QAM signals. However, the dual-band structure can utilize the bandwidth more effectively, which leads to a higher estimated net data throughput of 31.2 Tb/s.

Performance evaluation of discrete Raman amplifiers in coherent transmission systems.

We evaluate the performance penalty due to discrete Raman amplifier (DRA) in a long haul WDM transmission system. The investigation was primarily performed to study the impact of the accumulated nonlinear noise due to fibre chromatic dispersion and nonlinear coefficient(γ). Nonlinear fibres such as inverse dispersion fibre (IDF), dispersion compensation fibre (DCF) and a development fibre known as the Corning Raman fibre (CRF) with the opposite sign of CD to the other two, were taken as the gain fibre in the DRA stage of the long-haul transmission setup. To study the performance penalty with these Raman gain fibres a 30 GBaud 120 Gb/s DP-QPSK channel @1550 nm was combined with 9 spectrally shaped 50 GHz amplified spontaneous emission (ASE) channels for transmission over a recirculation loop with a per loop length of 63 km single mode fibre (SMF). Our modelling and experimental results show that a fibre with positive dispersion >10ps/nm/km and a nonlinear coefficient of ∼ 4W-1km-1 is a good choice of gain fibre for DRA-assisted coherent transmission system.

E-, S-, C- and L-band coherent transmission with a multistage discrete Raman amplifier.

We report for the first time an ultra-wideband coherent (UWB) WDM transmission over a 70 km standard single mode fibre (SSMF) solely using a multistage discrete Raman amplifier (DRA) over the E-, S-, C- and L-bands of the optical window. The amplifier is based on a split-combine approach of spectral bands enabling signal amplification from 1410-1605 nm over an optical bandwidth of 195 nm (25.8 THz). The proposed amplifier was characterized with 143 channelized amplified spontaneous emission (ASE) dummy channels in the S-, C- and L-bands and 4 laser sources in the E-band (1410-1605 nm). The amplification results show an average gain of 14 dB and a maximum noise figure (NF) of 7.5 dB over the entire bandwidth. Coherent transmission with the proposed amplifier was performed using a 30 Gbaud PM-16-QAM channel coupled with the ASE channels over a 70 km SMF. The ultra-wideband transmission using the tailored multistage DRA shows transmission bandwidth of 195 nm with a maximum Q2 penalty of ∼4 dB in E- and S-band, and ∼2 dB in C- and L-band.

30-GBaud DP 16-QAM transmission in the E-band enabled by bismuth-doped fiber amplifiers.

We report the transmission of five 30-GBaud dual polarization 16-QAM signals over 160 km of standard single-mode fiber in the E-band (1410-1460 nm). The transmission line consists of two 80-km spans and three independent bismuth-doped fiber amplifiers. The developed amplifiers feature a maximum gain of 27.3 dB, 33.8 dB, and 28.3 dB with a minimum noise figure of 4.8 dB, 4.7 dB, and 5.3 dB, respectively. The maximum signal Q2 factor penalty is 4.5 dB, and the overall performance of the system is above the pre-forward-error-correction (FEC) threshold for a 10-15 post-FEC bit error rate. To the best of our knowledge, this is the record experimentally demonstrated transmission length for a coherent detection signal in the E-band.

Bandwidth Extension in a Mid-Link Optical Phase Conjugation.

In this paper, we investigate various designs of distributed Raman amplifier (DRA) to extend amplification bandwidth in mid-link optical phase conjugation (OPC) systems and compare bands 191-197 THz and 192-198 THz giving a total bandwidth of 6 THz using a single wavelength pump. We demonstrate the use of highly reflective fiber Bragg grating (FBG) to minimize gain variation across a WDM grid by optimizing forward and backward pump powers as well as the wavelength of FBGs for original and conjugated channels. Finally, we also simulate OSNR and Kerr nonlinear reduction as a product of signals asymmetry and nonlinear phase shift (NPS) for all channels.

Associations between dietary fiber intake and cardiovascular risk factors: An umbrella review of meta-analyses of randomized controlled trials.

Although several meta-analyses have revealed the beneficial effects of dietary fiber intake on human health, some have reported inconsistent findings. The purpose of this work was to perform an umbrella meta-analysis to evaluate the relevant evidence and elucidate the effect of dietary fiber intake on glycemic control, lipid profiles, systematic inflammation, and blood pressure. Eligible studies were searched in several electronic databases, including Web of Science, PubMed, Scopus, and the Cochrane Library, up to March 2022. A total of 52 meta-analyses involving 47,197 subjects were identified to assess the pooled effect size. Overall, higher dietary fiber intake was significantly associated with reductions in parameters involving glycemic control, including fasting plasma glucose (ES = -0.55, 95% CI: -0.73, -0.38, P < 0.001), fasting plasma insulin (ES = -1.22, 95% CI: -1.63, -0.82, P < 0.001), homeostasis model assessment of insulin resistance (HOMA-IR) (ES = -0.43, 95% CI: -0.60, -0.27, P < 0.001), and glycosylated hemoglobin (HbA1c) (ES = -0.38, 95% CI: -0.50, -0.26, P < 0.001). In terms of lipid profiles, higher dietary fiber intake was associated with significant reductions in the serum level of total cholesterol (ES = -0.28, 95% CI: -0.39, -0.16, P < 0.001) and low-density lipoprotein cholesterol (ES = -0.25, 95% CI: -0.34, -0.16, P < 0.001), but not triglycerides (ES = -0.001, 95% CI: -0.006, 0.004, P = 0.759) and high-density lipoprotein cholesterol (ES = -0.002, 95% CI: -0.004, 0.000, P = 0.087). Higher dietary fiber intake was also significantly associated with improved tumor necrosis factor-alpha serum levels (ES = -0.78, 95% CI: -1.39, -0.16, P = 0.013), while no significant effect was observed for C-reactive protein (ES = -0.14, 95% CI: -0.33, 0.05, P = 0.156). Finally, blood pressure was also significantly improved following higher dietary fiber intake (systolic blood pressure: ES = -1.72, 95% CI: -2.13, -1.30, P < 0.001; diastolic blood pressure: ES = -0.67, 95% CI: -0.96, -0.37, P < 0.001). Subgroup analysis revealed that the study population and type of dietary fiber could be partial sources of heterogeneity. In conclusion, the present umbrella meta-analysis provides evidence for the role of dietary fiber supplementation in the improvement of established cardiovascular risk factors.

[Corrigendum] Exosomal­miR­1184 derived from mesenchymal stem cells alleviates cisplatin­associated acute kidney injury.

Subsequently to the publication of this paper, the authors have noticed that Fig. 5 was published with inadvertent errors; essentially, the y­axis label in Fig. 5D should have read "TNF­α" instead of "IL­1ß" and conversely, in Fig. 5E, the y­axis label should have read "IL­1ß" instead of "TNF­α". The revised version of Fig. 5, with Figs. 5D and E now labelled correctly, is shown below. Note that these errors did not significantly affect either the results or the conclusions reported in this paper, and all the authors agree to this corrigendum. Furthermore, the authors thank the Editor of Molecular Medicine Reports for allowing them the opportunity to publish this corrigendum, and apologize to the readership for any inconvenience caused. [Molecular Medicine Reports 24: 795, 2021; DOI: 10.3892/mmr.2021.12435].

Analytical optimization of wideband nonlinear optical fiber communication systems.

In the design of fiber links for both continental and transoceanic optical communication systems, the optimization of span length is of high importance from both performance and cost perspectives. In this work, the maximization of signal-to-noise ratio (SNR) is investigated by optimizing the span length in wideband (up to 4.5-THz) Nyquist-spaced optical fiber communication systems. A simple and accurate closed-form expression of the optimal span length is provided, and a quick estimation of SNR is also described for practically feasible and cost-effective span length values.

Distributed Raman Amplification for Fiber Nonlinearity Compensation in a Mid-Link Optical Phase Conjugation System.

In this paper, we review different designs of distributed Raman amplifiers which have been proposed to minimize the signal power profile asymmetry in mid-link optical phase conjugation systems. We demonstrate how the symmetrical signal power profiles along the fiber can be achieved using various distributed Raman amplification techniques in the single-span and more realistic multi-span circumstances. In addition, we show the theoretically predicted results of the Kerr nonlinear product reduction with different Raman techniques in mid-link optical phase conjugator systems, and then in-line/long-haul transmission performance using numerical simulations.

"An integrated system, three separated responsibilities", a new fever clinic management model, in prevention and control of novel coronavirus pneumonia.

BACKGROUND: Since December 2019, there have been many new cases of coronavirus pneumonia in Wuhan, Hubei Province, which has gradually spread throughout the country. AIM: To explore our hospital's innovative management system to ensure the efficient operation of fever clinics during the epidemic, since controlling the spread of disease is an important way to prevent and control the epidemic. METHODS: In total, 200 outpatients with fever at our hospital between November 2019 and July 2020 were selected and allocated into two groups. RESULTS: The fever clinic in our hospital operated smoothly, and infection with the novel coronavirus disease (COVID-19) has not been reported in our hospital. Additionally, we did not have any cases of missed diagnosis. The awareness regarding COVID-19 infection sources, transmission routes, early symptoms, and preventive measures was significantly higher in our fever clinic than in those of the pre-management group. CONCLUSION: "An integrated system, three separate responsibilities" ensured the efficient functioning of our fever outpatient clinic and early screening of COVID-19 cases, which effectively curbed the transmission of COVID-19 and hence prevented COVID-19 pneumonia epidemic in our hospital, ultimately achieving the maximum effect of epidemic prevention and control.