Comparison of extraction-based and elution-based polymerase chain reaction testing, and automated and rapid antigen testing for the diagnosis of severe acute respiratory syndrome coronavirus 2.

We aimed to compare the differences in testing performance of extraction-based polymerase chain reaction (PCR) assays, elution-based direct PCR assay, and rapid antigen detection tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We used nasopharyngeal swab samples of patients with coronavirus disease 2019 (COVID-19). We used the MagNA Pure 24 System (Roche Diagnostics K.K.) or magLEAD 12gC (Precision System Science Co., Ltd.) for RNA extraction, mixed the concentrates with either the LightMix Modular SARS-CoV PCR mixture (Roche Diagnostics K.K.) or Takara SARS-CoV-2 direct PCR detection kit (Takara Bio Inc.), and amplified it using COBAS® z480 (Roche Diagnostics K.K.). For elution-based PCR, we directly applied clinical samples to the Takara SARS-CoV-2 direct PCR detection kit before the same amplification step. Additionally, we performed Espline SARS-CoV-2 (Fuji Rebio Co., Ltd.) for rapid diagnostic test (RDT), and used Lumipulse SARS-CoV-2 antigen (Fuji Rebio Co., Ltd.) and Elecsys SARS-CoV-2 antigen (Roche Diagnostics K.K.) for automated antigen tests (ATs). Extraction-based and elution-based PCR tests detected the virus up to 214-216 and 210 times dilution, respectively. ATs remained positive up to 24-26 times dilution, while RDT became negative after 22 dilutions. For 153 positive samples, positivity rates of the extraction-based PCR assay were 85.6% to 98.0%, while that of the elution-based PCR assay was 73.2%. Based on the RNA concentration process, extraction-based PCR assays were superior to elution-based direct PCR assays for detecting SARS-CoV-2.

Analysing the impact of smart city service quality on citizen engagement in a public emergency.

The outbreak of novel coronavirus disease 2019 (COVID-19) has brought great challenges to the improvement of global smart city services. To date, few studies have been conducted on the effects of service quality on citizen engagement in smart cities in a public emergency. Based on the stimulus-organism-response (SOR) model and uncertain management theory, this study analyses the impact of the service quality of smart city system on citizen engagement in a public emergency. Data were collected in Chinese smart cities. Three valuable and novel results are identified. First, high-quality information content, highly reliable systems and highly responsive systems have a significant positive effect on citizens' continuous experiences, but not on citizens' immediate experiences. Second, both the immediate and continuous experiences of citizens have a significant positive effect on citizen engagement. Third, continuous experiences impose a full mediation effect between information content and citizen engagement, between reliability and citizen engagement and between responsiveness and citizen engagement. As its main contribution, this study focuses on the construction of a theoretical model. Based on this model, smart city managers can understand citizens' reactions in public emergencies from stimulation to experience and their behaviours in relation to smart city services.

[COVID-19 vaccination for allogeneic hematopoietic stem cell recipients].

The novel coronavirus disease 2019 (COVID-19) is caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hematopoietic stem cell transplant (HSCT) recipients are at increased risk of mortality and morbidity with COVID-19 due to severe immune dysfunction. Recombinant adenovirus vector-based vaccine, such as AstraZeneca ChAdOx1, and mRNA-based vaccines, such as Pfizer BNT162b2 and Moderna mRNA-1273 have been used in Japan. COVID-19 vaccine administration to HSCT recipients was reported to result in a 68-96.5% seroconversion for the spike protein. Factors associated with the absence of humoral responses were the time-interval from HSCT to vaccination, absolute lymphocyte count, systemic immunosuppressive treatments, graft versus host disease (GVHD), B-cell count, and hypogammaglobulinemia. New onset and exacerbation of chronic GVHD have been reported as an adverse events associated with vaccination. COVID-19 vaccination of HSCT recipients is relatively safe, and recipients should be vaccinated against COVID-19 6 months after transplantation. In the future, it is necessary to consider passive immunotherapy for HSCT patients who do not benefit from COVID1-19 vaccination.

Impact of COVID-19 on trade in services.

During past shocks (e.g., the 2008-2009 global financial crisis), the services trade was found to be more resilient than the goods trade; however, the ongoing novel coronavirus (COVID-19) pandemic has restricted cross-border mobility, which is disastrous to the services trade because it often requires physical proximity between suppliers and consumers. We empirically examined the impact of COVID-19 on the services trade using quarterly data from 146 countries in 2019 and 2020. Its severity is measured according to the number of cases, the number of deaths, and an index measuring the severity of lockdown orders. We found that the pandemic had a more significantly negative impact on the services trade than the goods trade, particularly on the import side. Moreover, the extent of the impact varied among disaggregated services sectors, reflecting the nature of services. Travel services were the most severely affected, followed by transport and construction services, which are largely related to the international movement of people and goods. On the other hand, other services typically provided as cross-border supply, including computer services, experienced almost no significant effect.

The role of smart monitoring digital health care system based on smartphone application and personal health record platform for patients diagnosed with coronavirus disease 2019.

BACKGROUND: The massive outbreak of the novel coronavirus disease 2019 (COVID-19) in Daegu city and Gyeongsangbuk-do, Republic of Korea (ROK), caused the exponential increase in new cases exceeding 5000 within 6 weeks. Therefore, the community treatment center (CTC) with a digital health care monitoring system based on the smartphone application and personal health record platform (PHR) was implemented. Thus, we report our experience in one of the CTCs to investigate the role of CTC and the feasibility of the digital health care monitoring system in the COVID-19 pandemic. METHODS: The Gyeongbuk-Daegu 2 CTC was set up at the private residential facility. Admission criteria were 1) patients < 65 years with COVID-19, 2) patients without underlying medical comorbidities, and 3) COVID-19 disease severity of mild class. Admitted patients were placed under monitoring of vital signs and symptoms. Clinical information was collected using the smartphone application or telephone communication. Collected information was displayed on the PHR platform in a real-time fashion for close monitoring. RESULTS: From Mar 3, 2020, to Mar 26, 2020, there was a total of 290 patients admitted to the facility. Males were 104 (35.9%). The median age was 37 years. The median time between the COVID-19 diagnosis and admission was 7 days. Five patients were identified and were transferred to the designed COVID-19 treatment hospital for their urgent medical needs. The smartphone application usage to report vital signs and symptoms was noted in 96% of the patients. There were no deaths of the patients. CONCLUSIONS: Our results suggest that implementation of the CTC using a commercial residence facility and digital health care technology may offer valuable solutions to the challenges posed by the COVID-19 outbreak.

Review on COVID-19 Etiopathogenesis, Clinical Presentation and Treatment Available with Emphasis on ACE2.

In December 2019, Wuhan city in the Hubei province of China reported for the first time a cluster of patients infected with a novel coronavirus, since then there has been an outburst of this disease across the globe affecting millions of human inhabitants. Severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2), is a member of beta coronavirus family which upon exposure caused a highly infectious disease called novel coronavirus disease-2019 (COVID-19). COVID-19, a probably bat originated disease was declared by World Health Organization (WHO) as a global pandemic in March 2020. Since then, despite rigorous global containment and quarantine efforts, the disease has affected nearly 56,261,952 laboratory confirmed human population and caused deaths of over 1,349,506 lives worldwide. Virus passes in majority through respiratory droplets and then enters lung epithelial cells by binding to angiotensin converting enzyme 2 (ACE2) receptor and there it undergoes replication and targeting host cells causing severe pathogenesis. Majority of human population exposed to SARS-CoV-2 having fully functional immune system undergo asymptomatic infection while 5-10% are symptomatic and only 1-2% are critically affected and requires ventilation support. Older people or people with co-morbidities are severely affected by COVID-19. These categories of patients also display cytokine storm due to dysfunctional immune response which brutally destroys the affected organs and may lead to death in some. Real time PCR is still considered as standard method of diagnosis along with other serology, radiological and biochemical investigations. Till date, no specific validated medication is available for the treatment of COVID-19 patients. Thus, this review provides detailed knowledge about the different landscapes of disease incidence, etiopathogenesis, involvement of various organs, diagnostic criteria's and treatment guidelines followed for management of COVID-19 infection since its inception. In conclusion, extensive research to recognize novel pathways and their cross talk to combat this virus in precarious settings is our future positive hope.

COVID-19: clinical issues from the Japan Surgical Society.

In this unprecedented COVID-19 pandemic, several key issues must be addressed to ensure safe treatment and prevent rapid spread of the virus and a consequential medical crisis. Careful evaluation of a patient's condition is crucial for deciding the triage plan, based on the status of the disease and comorbidities. As functionality of the medical care system is greatly affected by the environmental situation, the treatment may differ according to the medical and infectious disease circumstances of the institution. Importantly, all medical staff must prevent nosocomial COVID-19 by minimizing the effects of aerosol spread and developing diagnostic and surgical procedures. Polymerase chain reaction (PCR) screening for COVID-19 infection, particularly in asymptomatic patients, should be encouraged as these patients are prone to postoperative respiratory failure. In this article, the Japan Surgical Society addresses the general principles of surgical treatment in relation to COVID-19 infection and advocates preventive measures against viral transmission during this unimaginable COVID-19 pandemic.

Understanding the impact process of vaccine adoption for COVID-19.

Vaccination for the novel coronavirus disease 2019 (COVID-19) provides an effective approach for the general improvement of social safety and individual health. To date, few studies have analyzed the adoption of COVID-19 vaccines from an entire impact process perspective. Using the health belief model (HBM) and the valence theory, this research evaluates the impact process of vaccine adoption for COVID-19. The respondents in this study were individuals who have been vaccinated in China. The effective sample included 595 individuals. Four valuable and novel findings are identified through this research. First, neither perceived susceptibility nor perceived severity has a statistically significant impact on the benefits from vaccination, threats from vaccination and self-efficacy. Second, benefits from vaccination produce a significant positive effect on self-efficacy and vaccine adoption. Third, threats from vaccination produce a significant negative effect on self-efficacy and vaccine adoption. Fourth, both self-efficacy and cues to adoption produce a significantly positive impact on vaccine adoption. Our theoretical model, which is the main contribution of this research, indicates that individual vaccine adoption is simply a process that leads from behavioral cognition to behavioral intention, rather than from psychological perception to behavioral cognition and then from behavioral cognition to behavioral intention.

Effectiveness of prone position in spontaneously breathing patients with COVID-19: A prospective cohort study.

We present a single centre study describing the effect of awake prone position (PP) on oxygenation and clinical outcomes in spontaneously breathing patients with novel coronavirus disease (COVID-19). Between 1st March and 30th April 2020, forty eight of 138 patients managed outside of the critical care unit with facemask oxygen, high flow nasal oxygen (HFNO) or continuous positive airway pressure (CPAP), underwent PP. Prone position was associated with significant improvement in oxygenation, lower ICU admission, tracheal intubation, and shorter ICU length of stay. Lack of response to PP may be an indicator of treatment failure, requiring early escalation.

Understanding the continuous vaccination of the COVID-19 vaccine: an empirical study from China.

Vaccination for the novel coronavirus disease 2019 (COVID-19) provides an effective approach for the general improvement of social safety and individual health. However, given that the current COVID-19 vaccine can only work for a period of time, the continuous vaccination of the vaccine will be particularly important. Using the Health Action Process Approach (HAPA) Model, Expectation Confirmation Model (ECM) and vaccine hesitancy (VH) theory, this research evaluates the continuous vaccination for COVID-19. This research selected Chinese survey platform to recruit respondents and conducted online surveys. A total of 768 Chinese individuals who were vaccinated participated in the survey, and 561 responses were effective after screening. Six valuable and novel findings are identified through this research. First, perceived efficacy has a positive significant impact on vaccination intention, but the positive effects of outcome expectancy and risk perception on vaccination intention are not significant. Second, social positive cues play a significant role in promoting vaccination intention. Third, VH has a negative significant influence on vaccination intention. Fourth, vaccination behavior produces a positive significant effect on perceived usefulness and satisfaction, respectively. Fifth, perceived usefulness exerted a positive significant impact on satisfaction and continuous vaccination, respectively. Sixth, satisfaction has no positive significant influence on continuous vaccination. Our theoretical model, which is the main contribution of this research, indicates that individual continuous vaccination is a process from motivation to intention, and from intention to behavior, and then from behavior to continuous vaccination.

Additional Value of Non-contrast Chest CT in the Prediction of Adverse Cardiovascular Events in Patients With Novel Coronavirus Disease 2019 (COVID-19).

Background: Coronavirus disease 2019 (COVID-19) has outbroken in China and subsequently spread worldwide since the end of 2019. Chest computed tomography (CT) plays an important role in the diagnosis of lung diseases, but its value in the diagnosis of cardiac injury remains unknown. Methods: We enrolled 241 consecutive hospitalized patients (aged 61 ± 16 years, 115 males) with laboratory-confirmed COVID-19 at Renmin Hospital of Wuhan University from January 11 to March 2, 2020. They were divided into two groups according to whether major adverse cardiovascular events (MACEs) occurred during the follow-up. The anteroposterior diameter of the left atrium (LAD), the length of the left ventricle (LV), and cardiothoracic ratio (CTR) were measured. The values of myocardial CT were also recorded. Results: Of 241 patients, 115 patients (47.7%) had adverse cardiovascular events. Compared with no MACEs, patients with MACEs were more likely to have bilateral lesions (95.7% vs. 86.5%, p = 0.01). In multivariable analysis, bronchial wall thickening would increase the odds of MACEs by 13.42 (p = 0.01). LAD + LV and CTR was the best predictor for MACEs (area under the curve = 0.88, p < 0.001) with a sensitivity of 82.6% and a specificity of 80.2%. Plasma high-sensitivity troponin I levels in patients with cardiac injury showed a moderate negative correlation with minimum CT value (R 2 = -0.636, p < 0.001). Conclusions: Non-contrast chest CT can be a useful modality for detection cardiac injury and provide additional value to predict MACEs in COVID-19 patients.

Clinical characteristics and treatment of critically ill patients with COVID-19 in Hebei.

BACKGROUND: In December, 2019, a novel coronavirus disease 2019 (COVID-19) emerged in Wuhan, China. We aimed to clarify the epidemiology, laboratory examinations, imaging findings, and treatment of critically ill patients with COVID-19 in Hebei province, China. METHODS: In this retrospective study, the demographic, laboratory and imaging, and treatment data of patients with severe COVID-19 treated in 13 designated hospitals in Hebei were collected and analyzed. RESULTS: A total of 319 severe COVID-19 patients were treated at the 13 designated hospitals between 22 January, 2020 and 25 March, 2020. Eventually, 51 critically ill (31 severe cases and 20 critically severe cases) patients were included in the analysis. The patients had an average age of 58.9±13.7 years, and 27 (52.9%) were men. Twenty-one (41.2%) were familial cluster, and 33 (64.7%) had chronic illnesses. The patients in critically severe group had longer duration from symptom to confirmation, more severe infections, more severe lung injury, and a lower percentage of lymphocytes. All 51 patients received antiviral drugs, 47 (92.2%) received antibacterial agents, 49 (96.1%) received traditional Chinese drugs, and 46 (90.2%) received methylprednisolone. The critically severe patients received more fluid and more diuretic treatment; 14 (70.0%) required invasive mechanical ventilation, and 13 (65.0%) developed extrapulmonary complications. CONCLUSIONS: COVID-19 patients who had underlying diseases and longer confirmation times were more likely to progress to critically severe COVID-19. These patients also presented with a higher risk of respiratory depression, circulatory collapse, extrapulmonary complications, and infection.

Interleukin-1 receptor antagonist anakinra in association with remdesivir in severe COVID-19: A case report.

We report the first successful treatment with the IL-1 receptor antagonist anakinra, in association with the most promising and available antiviral therapy, of a severe case of novel coronavirus disease 2019 (COVID-19). We describe the diagnosis, clinical course, and management of the case, including the respiratory failure at presentation, the progression to a scenario characterized by profound inflammatory dysregulation similar to that observed during macrophage activation syndrome, and the clinical improvement after treatment with the IL-1 receptor antagonist anakinra. This case highlights the high tolerability and the interesting immunomodulatory profile of the IL-1 receptor antagonist anakinra in the setting of severe COVID-19 associated with remdesivir therapy. Further studies are needed to confirm the safety and efficacy of this combination strategy in the treatment of this emerging infection.

Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may be harmful in patients with diabetes during COVID-19 pandemic.

The novel coronavirus disease 2019 (COVID-19) outbreak once again demonstrated the importance of the renin-angiotensin system (RAS) in patients with diabetes. Activation of the RAS increases in patients with diabetes. The virus attaches to the ACE2 enzyme at low cytosolic pH values and enters into the cell and causes infection. Especially in the presence of diabetes mellitus and accompanying comorbid conditions such as hypertension, obesity, old age, and smoking, cytosolic pH is low, thus the virus easily may enter the cell by attaching to ACE2. ACEIs and ARBs lead to a reduction in angiotensin II level by increasing the ACE2 level, thus they cause a low cytosolic pH. Increased cardiac ACE2 levels due to ACEIs and ARBs can trigger cardiac arrhythmias and myocarditis by causing the virus to easily enter the heart tissue. There is ACE2 activity in the rostral ventrolateral medulla in the brain stem. The release of angiotensin 1-7 in the brain stem leads to the activation of the sympathetic nervous system. This activation causes systemic vasoconstriction and the patient's blood pressure increases. The most important event is the increased sympathetic activity via the central stimulation, this activity increases pulmonary capillary leaking, causing the ARDS. As the cytosolic pH, which is already low in patients with diabetes will decrease further with the mechanisms mentioned above, the viral load will increase and the infection will be exacerbated. As a result, the use of ACEIs and ARBs in patients with diabetes can lead to increased morbidity and mortality of COVID-19.

Multidisciplinary, three-dimensional and individualized comprehensive treatment for severe/critical COVID-19.

Severe/critical cases account for 18-20% of all novel coronavirus disease 2019 (COVID-19) patients, but their mortality rate can be up to 61.5%. Furthermore, all deceased patients were severe/critical cases. The main reasons for the high mortality of severe/critical patients are advanced age (>60 years old) and combined underlying diseases. Elderly patients with comorbidities show decreased organ function and low compensation for damage such as hypoxia and inflammation, which accelerates disease progression. The lung is the main target organ attacked by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) while immune organs, liver, blood vessels and other organs are damaged to varying degrees. Liver volume is increased, and mild active inflammation and focal necrosis are observed in the portal area. Virus particles have also been detected in liver cells. Therefore, multidisciplinary teams (MDTs) and individualized treatment plans, accurate prediction of disease progression and timely interventions are vital to effectively reduce mortality. Specifically, a "multidisciplinary three-dimensional management, individualized comprehensive plan" should be implemented. The treatment plan complies with three principles, namely, multidisciplinary management of patients, individualized diagnosis and treatment plans, and timely monitoring and intervention of disease. MDT members are mainly physicians from critical medicine, infection and respiratory disciplines, but also include cardiovascular, kidney, endocrine, digestion, nerve, nutrition, rehabilitation, psychology and specialty care. According to a patient's specific disease condition, an individualized diagnosis and treatment plan is formulated (one plan for one patient). While selecting individualized antiviral, anti-inflammatory and immunomodulatory treatment, we also strengthen nutritional support, psychological intervention, comprehensive rehabilitation and timely and full-course intervention to develop overall and special nursing plans. In response to the rapid progression of severe/critical patients, MDT members need to establish a three-dimensional management model with close observation and timely evaluation. The MDT should make rounds of the quarantine wards both morning and night, and of critical patient wards nightly, to implement "round-the-clock rounds management", to accurately predict disease progression, perform the quick intervention and prevent rapid deterioration of the patient. Our MDT has cumulatively treated 77 severe/critical COVID-19 cases, including 62 (80.5%) severe cases and 15 (19.5%) critical cases, with an average age of 63.8 years. Fifty-three (68.8%) cases presented with more than one underlying disease and 65 (84.4%) severe cases recovered from COVID-19. The average hospital stay of severe/critical cases was 22 days, and the mortality rate was 2.6%, both of which were significantly lower than the 30-40 days and 49.0-61.5%, respectively, reported in the literature. Therefore, a multidisciplinary, three-dimensional and individualized comprehensive treatment plan can effectively reduce the mortality rate of severe/critical COVID-19 and improve the cure rate.

Relationship of health literacy with COVID-19 prevention and control knowledge, attitude and practice in general population of Baoji city / 西安交通大学学报(医学版)

【Objective】 To explore the relationship of health literacy with COVID-19 prevention and control knowledge， attitude and practice （KAP） in general population so as to contribute scientific evidence for strengthening health education and promoting health literacy to resist the threat of major infectious disease outbreaks. 【Methods】 In September 2020， a questionnaire survey was conducted in residents selected by a multi-stage random sampling across all the twelve counties/districts of Baoji city. The questionnaire， which was issued by the Chinese Health Education Center， consisted of a health literacy questionnaire and a COVID-19 prevention and control KAP questionnaire. According to the national unified scoring method， the participants were divided into two groups： those who met and those who failed to meet the overall standard of health literacy. The results of the answer to each KAP question were compared between the two groups by Chi-square test or rank sum test. Multivariate binary Logistic regression was used to control confounding effects of socio-demographic characteristics to draw relatively reliable conclusions. 【Results】 A total of 4 544 valid questionnaires were collected， in which 664 （14.60%） met the overall standard of health literacy， but 3 880 （85.40%） failed to do so. Compared with the unmet group， the met group had a higher correct answer rate in 10 of the 11 knowledge-related questions （all P<0.001）； showed more positive answer to each attitude-related question in the three aspects， namely， responsibility for the prevention and control of infectious disease transmission， evaluation for COVID-19-related information release and reporting， and evaluation for the government’s COVID-19 prevention and control results （all P<0.001）； and acted more actively in 6 of the 7 practice concerning appropriate self-prevention and control behaviors during the COVID-19 outbreak （all P<0.001）. Logistic regression analyses confirmed that achieving the overall standard of health literacy played a positive role in each of the contents of COVID-19 prevention and control KAP in study （ORs were between 1.44 and 4.09， all P<0.001）. Moreover， the absolute value of regression coefficient of the overall standard of health literacy was the largest compared with all the socio-demographic factors. Logistic regression was used to further analyze relationships between each of the six health dimensions of health literacy and COVID-19 prevention and control KAP， which revealed that the association with safety and first aid， infectious diseases prevention， and health information was the closest. 【Conclusion】 Health literacy is closely related to COVID-19 prevention and control KAP in the general population of Baoji city. Promoting residents' health literacy by targeted health education can play an important and positive role in dealing with the threat of major infectious diseases outbreaks.

Significance of "Qingfei" and "Paidu" of Qingfei Paidu Decoction in Treatment of COVID-19 / 中国实验方剂学杂志

Traditional Chinese medicine （TCM） has played an important role in the prevention and treatment of novel coronavirus disease 2019 （COVID-19）. Qingfei Paidu decoction，as a general prescription of Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia from the sixth to eighth versions，has been proved effective clinically and is suitable for mild，moderate，severe，and critical patients. It can significantly improve clinical symptoms such as fever， cough，asthma，fatigue， etc. On the basis of the findings of relevant research papers，this paper summarized the TCM understanding of COVID-19， including etiology，pathogenesis， disease location， and treatment，and concluded that the disease is caused by the pestilential Qi，localized in the lungs， and can affect the five organs. It is mainly characterized by coldness，dampness，heat，toxicity，stasis，and deficiency. In response to the etiology and pathogenesis of the disease，the therapeutic principles at all stages are dominated by the elimination of pathogens and removal of toxicity. According to the stages of disease development，the treatment should combine the severity of the disease and the course of the disease with the TCM syndromes. Furthermore，from the clinical application of Qingfei Paidu decoction，this paper discussed the therapeutic intention of "Qingfei （clearing of lungs）" and "Paidu （removal of toxicity）". Qingfei Paidu decoction can clear the pathogenic toxin in the lungs and eliminate external pestilential Qi，which is in line with the therapeutic principles for this pandemic by regulating the triple energizer and protecting healthy Qi using both coldness and warmth to treat both the symptoms and the root cause. Additionally，the experimental research progress on Qingfei Paidu decoction and its modified prescriptions were summarized. As studied， this prescription can inhibit cytokine storm，moderate the overactive immune response，potentiate the immune function and anti-viral ability of the body，and exert its effect on COVID-19 with multiple components，multiple targets，multiple pathways， and multiple biological functions. In conclusion，Qingfei Paidu decoction，as a core prescription for the treatment of COVID-19，can rapidly contain the development of COVID-19， which has been confirmed in terms of TCM theory，clinical efficacy， and experimental research.

Mechanism prediction of Zhikepipa Mixture in the treatment of COVID-19 / 西安交通大学学报(医学版)

【Objective】 To explore the effect of Zhikepipa Mixture on the treatment of COVID-19 through network pharmacology analysis and molecular docking technology. 【Methods】 First, we performed the network pharmacology method to screen active compounds and targets so as to explore the mixture’s potential mechanisms in the treatment of COVID-19. In line with ADME screening index, like oral bioavailability (OB) ≥30% or drug likeness index (DL) ≥0.18, the active compounds against COVID-19 related targets were selected to construct the 'herb-compound-target’ network. Mechanism prediction of Zhikepipa mixture in the treatment of COVID-19 was analyzed by the interaction of the target sites, the bioinformatic annotation, and the metabolic pathway. Then, we used a molecular docking model to evaluate the binding ability between active compounds and 2019-nCoV (SARS-CoV-2) 3-chymotrypsin-like cysteine protease (3CLpro) receptor-binding domain (PBD ID 6LU7), which was involved in mediating viral replication and transcription functions. 【Results】 The'herb-compound-target’ network showed 34 key compounds and 30 disease targets after overlapping with disease targets. The network topology analysis showed that those selected compounds with higher degree would produce marked anti-inflammatory effects by regulating 30 targets like PTGS1, IL1B, IL6, IL10, CXCL8 and JUN. AGE-RAGE signaling pathway, IL-17 signaling pathway, TNF signaling pathway, PI3K-Akt signaling pathway, and MAPK signaling pathway were involved in regulating hepatitis B and diabetic complications. In addition, Folium eriobotryae and Radix stemonae played important roles in the network. The molecular docking results showed that nine compounds were identified with higher docking score rank against 2019-nCoV 3CLpro protease, and most of them were attributed to flavonoids. 【Conclusion】 Zhikepipa Mixture could exhibit both anti-inflammatory and anti-virus actions through multi-component, multi-target, and multi-pathway.

Analysis of the path from discovery of novel coronavirus disease 2019 cases to its diagnosis in Shaanxi Province / 西安交通大学学报(医学版)

Objective: To explore the problems and experience in the prevention and control of novel coronavirus disease 2019 (COVID-19) by analyzing the path from its discovery to its diagnosis in Shaanxi Province. Methods: We collected the important data of COVID-19 epidemic situation in Shaanxi Province as of March 26, 2020, the trajectory of the diagnosed cases, contact history, close contacts and other important information for a descriptive epidemiological analysis. Results: Totally 72.65% (178/245) of the confirmed COVID-19 cases in Shaanxi Province were not in isolation or management at the time of onset, which resulted in an infection rate of 1.37% in close-knit populations. The duration between the onset of local COVID-19 cases in Shaanxi and the delay in confirmed diagnosis was relatively long (6.30 days), and the mean incubation period was 7.27 days. The delay time (7.29 days) between onset and diagnosis of preepidemic cases was longer than that (6.19 days) of later epidemic cases. Conclusion: According to the epidemic situation, we should gradually sort out the loopholes in previous work and at the same time make timely evaluation of the new problems arising under the new situation and constantly adjust the prevention and control strategies.