Add-On Chinese Medicine for Coronavirus Disease 2019 (ACCORD): A Retrospective Cohort Study of Hospital Registries.

Chinese medicine (CM) was extensively used to treat COVID-19 in China. We aimed to evaluate the real-world effectiveness of add-on semi-individualized CM during the outbreak. A retrospective cohort of 1788 adult confirmed COVID-19 patients were recruited from 2235 consecutive linked records retrieved from five hospitals in Wuhan during 15 January to 13 March 2020. The mortality of add-on semi-individualized CM users and non-users was compared by inverse probability weighted hazard ratio (HR) and by propensity score matching. Change of biomarkers was compared between groups, and the frequency of CMs used was analyzed. Subgroup analysis was performed to stratify disease severity and dose of CM exposure. The crude mortality was 3.8% in the semi-individualized CM user group and 17.0% among the non-users. Add-on CM was associated with a mortality reduction of 58% (HR = 0.42, 95% CI: 0.23 to 0.77, [Formula: see text] = 0.005) among all COVID-19 cases and 66% (HR = 0.34, 95% CI: 0.15 to 0.76, [Formula: see text] = 0.009) among severe/critical COVID-19 cases demonstrating dose-dependent response, after inversely weighted with propensity score. The result was robust in various stratified, weighted, matched, adjusted and sensitivity analyses. Severe/critical patients that received add-on CM had a trend of stabilized D-dimer level after 3-7 days of admission when compared to baseline. Immunomodulating and anti-asthmatic CMs were most used. Add-on semi-individualized CM was associated with significantly reduced mortality, especially among severe/critical cases. Chinese medicine could be considered as an add-on regimen for trial use.

Gold nanoparticle-modified black phosphorus nanosheets with improved stability for detection of circulating tumor cells.

Gold nanoparticle (AuNP)-anchored BP nanosheets were synthesized through in situ growth of AuNPs onto BP. Due to the strong chelating ability of P or phosphorus oxides with AuNPs, the stability of BP is improved. As proof-of-concept demonstration of the functionalized BP, electrochemical detection of circulating tumor cells (CTCs) based on BP@AuNPs@aptamer as a probe combined with immunomagnetic separation is reported. The aptamer can specifically bind with CTCs, while the phosphorus oxides including phosphite ion and phosphate ion (PxOy species) on BP and aptamer can react with molybdate to generate an electrochemical current, leading to dual signal amplification. The biosensor is applied to MCF-7 cell detection and displays good analytical performance with a detection limit of 2 cell mL-1. Furthermore, the practicality of this biosensor was validated through sensitive determination of MCF-7 cells in human blood. Therefore, the reported biosensor could be applied to detect other biomarkers, offering an ultrasensitive strategy for clinical diagnostics. Graphical abstract Electrochemical detection of circulating tumor cells based on gold nanoparticle-modified black phosphorus nanosheets is reported.

Anatomical responses of leaf and stem of Arabidopsis thaliana to nitrogen and phosphorus addition.

Nitrogen (N) and phosphorus (P) availabilities play crucial roles in plant morphogenesis and physiological processes, but how plant anatomical traits respond to the N and P supply is not well elucidated. We evaluated the effects of N and P supply on multiple leaf and stem anatomical traits of Arabidopsis thaliana. The addition of N increased the stem diameter, cortex thickness, rosette radius, midrib thickness, and size of leaf and stem vasculature significantly. Abaxial stomatal length (LSL) increased while adaxial epidermal cell density decreased significantly with increasing N supply. P addition did not affect stem size and leaf epidermal traits, but enhanced the thickness of stem xylem. The nutrient limiting status did not affect most traits except for LSL. The anatomical traits measured varied a lot in the extent of response to N and P addition, despite relatively stronger response to N addition overall. Cortex thickness, rosette radius, stomatal density and epidermal cell density exhibited relatively high plasticity to both nutrients, while stomatal length and stomatal index were relatively stable. Thus, these results suggested that the anatomical traits of shoot vasculature of A. thaliana were enhanced by both nutrients but more affected by N addition, satisfying the plant growth and nutrient requirements. Our findings may help shed light on plant adaptation to nutrient availability changes under the ongoing anthropogenic impacts, but the generality across numerous plant species still warrants further researches.