Background:On December 8,2019,Wuhan City,Hubei Province,a new type of coronavirus disease 2019(COVID-2019)was firstly discovered,and COVID-2019 spread rapidly in China.The number of confirmed cases in various province...Background:On December 8,2019,Wuhan City,Hubei Province,a new type of coronavirus disease 2019(COVID-2019)was firstly discovered,and COVID-2019 spread rapidly in China.The number of confirmed cases in various provinces and cities rose sharply in China.In clinical treatment,Chinese medicine treatment showed significant efficacy.Since the outbreak,the National Health Commission(NHS)of China has issued seven editions of the“Pneumonitis Diagnosis and Treatment Program for COVID-2019”,at the same time,most provincial health boards and the Chinese Medicine Administration had also released information on the prevention and control scheme of COVID-2019 by Chinese medicine.The purpose of this study is to explore the compatibility rules of the main drugs in the prescription and the potential mechanism on COVID-2019 pneumonia,in order to provide reference for clinical research and new drug development of COVID-2019.Methods:This article uses the TCM inheritance assistance system and network pharmacology BATMAN-TCM online analysis system to collect and summarize the national“Pneumonitis Diagnosis and Treatment Program for COVID-2019(trial version sixth)”and formulae for adult treatment from the TCM prevention program of 23 provinces and cities.Results:We found that the most formulae for the treatment of COVID-2019 were modified on the basis of Maxing Shigan decoction and the top 5 high-frequencyn drugs are Xingren(Armeniacae semen amarum),Mahuang(Ephedrae herba),Gancao(Glycyrrhizae radix et rhizoma),Shigao(Gypsum fibrosum),and Haungqin(Radix scutellariae).High frequency traditional Chinese medicines are mainly used for relieving the symptoms,clearing away heat,eliminating dampness,resolving phlegm,relieving cough and asthma,promoting water and dampness,and tonifying deficiency.Warm medicine and bitter medicine are the most frequently used drugs in four Qi attribute and five flavor attribute,respectively.Most of drugs are belong to lung,stomach and spleen channel.Mahuang(Ephedrae herba),Xingren(Armeniacae semen amarum),Gancao(Glycyrrhizae radix et rhizoma),Shigao(Gypsum fibrosum),Cangzhu(Atractylodis rhizama)and Huoxiang(Pogostemonis herba)are the core drugs for treating COVID-2019.The TTD disease enrichment,target and signal transduction pathways of the six drugs showed that pneumonia and asthma were most closely related to COVID-2019.And the inflammatory reaction-related pathways may be the main pathways through which these drugs function.Conclusions:The modified Maxing Shigan decoction is the main prescription for the treatment of COVID-2019.The Xingren(Armeniacae semen amarum),Gancao(Glycyrrhizae radix et rhizoma),Shigao(Gypsum fibrosum),Cangzhu(Atractylodis rhizama)and Huoxiang(Pogostemonis herba)have certain theoretical and experimental basis for the treatment of COVID-2019 through network pharmacology analysis,but further experiments are needed to verify the effects.展开更多
Objective:To investigate the relationship between clinical manifestations,blood testing,chest CT,treatment and fever of 457mild cases of COVID-19.Methods:A tatal of 457cases of mild COVID-19 diagnosed in Wuhan Jiangha...Objective:To investigate the relationship between clinical manifestations,blood testing,chest CT,treatment and fever of 457mild cases of COVID-19.Methods:A tatal of 457cases of mild COVID-19 diagnosed in Wuhan Jianghan module Hospital from February 6,2020 to February 26,2020 were gathered,and the cases with/without fever were retrospectively analyzed in epidemiology,clinical manifestation,blood routing,hypersensitive C-reactive protein(hs-CRP),pathogens serological testing,chest CT and drugs treatment.Results:For 312 fever cases,the average age was(47.6±10.9)years old,male was 128 cases(41%),the mean peak fever was 38(36.8,38.6)℃,fever lasting was 2(0,3)days,131cases(28.7%)had Huanan seafood market exposure history,90 cases(28.8%)had closely contact with COVID-19 patients,20cases(6.4%)had hypertension history,10 cases(3.2%)had diabetes,5cases(1.6%)had coronary heart disease.Main symptoms of fever group including dry cough of 260cases(83.3%),of 104cases(33.3%),blood sputum of 9cases(2.9%),chest tightness 20cases(19.6%),shortness of breath of 87cases(27.9%),weak of 105cases(33.7%),diarrhea of 43cases(13.8%),sleep disorders of 61cases(19.6%),among fever cases with sputum and shortness of breath more rather without fever,and two groups were statistically significantly difference(P<0.05).In fever group,WBC(109/L)[4.34(3.69,5.26)than 5.11(4.22,6.22),P<0.001],NEUT(109/L)[2.67(2.1,3.49)than 2.88(2.37,3.9),P<0.05],LYM(109/L)[0.9(0.8,1.1)than 1.36(1.03,1.85),P<0.001),PLT(109/L)/(106,188)134-189(132,224),P<0.001)were lower than normal group,while WBC<4.0×109/L[108(34.6%)than 24(16.6%),P<0.001)],LYM<1.0×109/L[189(60.6%)than 31(21.4%),P<0.001)],PLT<100×109/L[45(14.4%)than in 2(1.4%),P<0.001)and hs-CRP(mg/L)[14(6.83,32)than 3.4(0.96,10.75),P<0.001)were higher than normal group,and pathogens serological examination of 36cases shown influenzaⅠ/Ⅱvirus IgM antibody positive in 3cases(8.3%),respiratory syncytial virus IgM antibody positive in 2 cases(5.6%),mycoplasma pneumoniae IgM antibody positive(11.1%),4 cases of adenovirus IgM antibody positive(11.1%),but 4 pathogens of fever group and normal group were no statistical difference(P>0.05).According to early onset of chest CT examination,there were no change of 11cases(2.4%),unilateral lung lesions of 93cases(20.4%),bilateral lung lesions of 353 cases(77.2%),ground glass shadow of 228 cases(73.1%),high density shadow patch of 65 cases(20.8%),consolidation shadow of 6 cases(1.9%),while fever group compared with normal group,there were no statistically significant difference(P>0.05).Logistic regression analysis showed that LYM(OR=0.24,95%CI=0.139~0.415,P<0.001),LYM<1.0 x 109/L(OR=5.12,95%CI=3.07~8.65,P<0.001),PLT<100×109/L(OR=6.1,95%CI=1.36~27.33,P<0.05),and the hs-CRP(OR=1.03,95%CI=1.02~1.05,P<0.001)were fever independent impact factors in mild COVID-19.Aiming at COVID-19 treatment,Chinese medicine usage had 416cases(91%),antiviral drugs had 328cases(71.8%),and antibiotics had 172cases(37.6%),furthermore,fever group using antiviral and antibiotic drugs was higher than normal group(P<0.05),and compared to low fever group,high fever group used more antibiotic drugs(P<0.05).Conclusions:Mild COVID-19 patients with early onset had epidemiological characteristics,and fever,dry cough,expectoration and shortness of breath were main symptoms,and chest CT often involved bilateral lung lesions,ground glass shadow and patch density shadow.The fever patients in WBC,LYM,PLT,hs-CRP index changed significantly and could affect on anti-infective therapy selection.展开更多
The first pandemic wave of coronavirus disease 2019(COVID-19)induced a considerable increase in several antivirals and antibiotics in surface water.The common symptoms of COVID-19 are viral and bacterial infections,wh...The first pandemic wave of coronavirus disease 2019(COVID-19)induced a considerable increase in several antivirals and antibiotics in surface water.The common symptoms of COVID-19 are viral and bacterial infections,while comorbidities(e.g.,hypertension and diabetes)and mental shock(e.g.,insomnia and anxiety)are nonnegligible.Nevertheless,little is known about the long-term impacts of comorbidities and mental shock on organic micropollutants(OMPs)in surface waters.Herein,we monitored 114 OMPs in surface water and wastewater treatment plants(WWTPs)in Wuhan,China,between 2019 and 2021.The pandemic-induced OMP pollution in surface water was confirmed by significant increases in 26 OMP concentrations.Significant increases in four antihypertensives and one diabetic drug suggest that the treatment of comorbidities may induce OMP pollution.Notably,cotinine(a metabolite of nicotine)increased 155 times to 187 ngL1,which might be associated with increased smoking.Additionally,the increases in zolpidem and sulpiride might be the result of worsened insomnia and depression.Hence,it is reasonable to note that mental-health protecting drugs/behavior also contributed to OMP pollution.Among the observed OMPs,telmisartan,lopinavir,and ritonavir were associated with significantly higher ecological risks because of their limited WWTP-removal rate and high ecotoxicity.This study provides new insights into the effects of comorbidities and mental shock on OMPs in surface water during a pandemic and highlights the need to monitor the fate of related pharmaceuticals in the aquatic environment and to improve their removal efficiencies in WWTPs。展开更多
文摘Background:On December 8,2019,Wuhan City,Hubei Province,a new type of coronavirus disease 2019(COVID-2019)was firstly discovered,and COVID-2019 spread rapidly in China.The number of confirmed cases in various provinces and cities rose sharply in China.In clinical treatment,Chinese medicine treatment showed significant efficacy.Since the outbreak,the National Health Commission(NHS)of China has issued seven editions of the“Pneumonitis Diagnosis and Treatment Program for COVID-2019”,at the same time,most provincial health boards and the Chinese Medicine Administration had also released information on the prevention and control scheme of COVID-2019 by Chinese medicine.The purpose of this study is to explore the compatibility rules of the main drugs in the prescription and the potential mechanism on COVID-2019 pneumonia,in order to provide reference for clinical research and new drug development of COVID-2019.Methods:This article uses the TCM inheritance assistance system and network pharmacology BATMAN-TCM online analysis system to collect and summarize the national“Pneumonitis Diagnosis and Treatment Program for COVID-2019(trial version sixth)”and formulae for adult treatment from the TCM prevention program of 23 provinces and cities.Results:We found that the most formulae for the treatment of COVID-2019 were modified on the basis of Maxing Shigan decoction and the top 5 high-frequencyn drugs are Xingren(Armeniacae semen amarum),Mahuang(Ephedrae herba),Gancao(Glycyrrhizae radix et rhizoma),Shigao(Gypsum fibrosum),and Haungqin(Radix scutellariae).High frequency traditional Chinese medicines are mainly used for relieving the symptoms,clearing away heat,eliminating dampness,resolving phlegm,relieving cough and asthma,promoting water and dampness,and tonifying deficiency.Warm medicine and bitter medicine are the most frequently used drugs in four Qi attribute and five flavor attribute,respectively.Most of drugs are belong to lung,stomach and spleen channel.Mahuang(Ephedrae herba),Xingren(Armeniacae semen amarum),Gancao(Glycyrrhizae radix et rhizoma),Shigao(Gypsum fibrosum),Cangzhu(Atractylodis rhizama)and Huoxiang(Pogostemonis herba)are the core drugs for treating COVID-2019.The TTD disease enrichment,target and signal transduction pathways of the six drugs showed that pneumonia and asthma were most closely related to COVID-2019.And the inflammatory reaction-related pathways may be the main pathways through which these drugs function.Conclusions:The modified Maxing Shigan decoction is the main prescription for the treatment of COVID-2019.The Xingren(Armeniacae semen amarum),Gancao(Glycyrrhizae radix et rhizoma),Shigao(Gypsum fibrosum),Cangzhu(Atractylodis rhizama)and Huoxiang(Pogostemonis herba)have certain theoretical and experimental basis for the treatment of COVID-2019 through network pharmacology analysis,but further experiments are needed to verify the effects.
文摘Objective:To investigate the relationship between clinical manifestations,blood testing,chest CT,treatment and fever of 457mild cases of COVID-19.Methods:A tatal of 457cases of mild COVID-19 diagnosed in Wuhan Jianghan module Hospital from February 6,2020 to February 26,2020 were gathered,and the cases with/without fever were retrospectively analyzed in epidemiology,clinical manifestation,blood routing,hypersensitive C-reactive protein(hs-CRP),pathogens serological testing,chest CT and drugs treatment.Results:For 312 fever cases,the average age was(47.6±10.9)years old,male was 128 cases(41%),the mean peak fever was 38(36.8,38.6)℃,fever lasting was 2(0,3)days,131cases(28.7%)had Huanan seafood market exposure history,90 cases(28.8%)had closely contact with COVID-19 patients,20cases(6.4%)had hypertension history,10 cases(3.2%)had diabetes,5cases(1.6%)had coronary heart disease.Main symptoms of fever group including dry cough of 260cases(83.3%),of 104cases(33.3%),blood sputum of 9cases(2.9%),chest tightness 20cases(19.6%),shortness of breath of 87cases(27.9%),weak of 105cases(33.7%),diarrhea of 43cases(13.8%),sleep disorders of 61cases(19.6%),among fever cases with sputum and shortness of breath more rather without fever,and two groups were statistically significantly difference(P<0.05).In fever group,WBC(109/L)[4.34(3.69,5.26)than 5.11(4.22,6.22),P<0.001],NEUT(109/L)[2.67(2.1,3.49)than 2.88(2.37,3.9),P<0.05],LYM(109/L)[0.9(0.8,1.1)than 1.36(1.03,1.85),P<0.001),PLT(109/L)/(106,188)134-189(132,224),P<0.001)were lower than normal group,while WBC<4.0×109/L[108(34.6%)than 24(16.6%),P<0.001)],LYM<1.0×109/L[189(60.6%)than 31(21.4%),P<0.001)],PLT<100×109/L[45(14.4%)than in 2(1.4%),P<0.001)and hs-CRP(mg/L)[14(6.83,32)than 3.4(0.96,10.75),P<0.001)were higher than normal group,and pathogens serological examination of 36cases shown influenzaⅠ/Ⅱvirus IgM antibody positive in 3cases(8.3%),respiratory syncytial virus IgM antibody positive in 2 cases(5.6%),mycoplasma pneumoniae IgM antibody positive(11.1%),4 cases of adenovirus IgM antibody positive(11.1%),but 4 pathogens of fever group and normal group were no statistical difference(P>0.05).According to early onset of chest CT examination,there were no change of 11cases(2.4%),unilateral lung lesions of 93cases(20.4%),bilateral lung lesions of 353 cases(77.2%),ground glass shadow of 228 cases(73.1%),high density shadow patch of 65 cases(20.8%),consolidation shadow of 6 cases(1.9%),while fever group compared with normal group,there were no statistically significant difference(P>0.05).Logistic regression analysis showed that LYM(OR=0.24,95%CI=0.139~0.415,P<0.001),LYM<1.0 x 109/L(OR=5.12,95%CI=3.07~8.65,P<0.001),PLT<100×109/L(OR=6.1,95%CI=1.36~27.33,P<0.05),and the hs-CRP(OR=1.03,95%CI=1.02~1.05,P<0.001)were fever independent impact factors in mild COVID-19.Aiming at COVID-19 treatment,Chinese medicine usage had 416cases(91%),antiviral drugs had 328cases(71.8%),and antibiotics had 172cases(37.6%),furthermore,fever group using antiviral and antibiotic drugs was higher than normal group(P<0.05),and compared to low fever group,high fever group used more antibiotic drugs(P<0.05).Conclusions:Mild COVID-19 patients with early onset had epidemiological characteristics,and fever,dry cough,expectoration and shortness of breath were main symptoms,and chest CT often involved bilateral lung lesions,ground glass shadow and patch density shadow.The fever patients in WBC,LYM,PLT,hs-CRP index changed significantly and could affect on anti-infective therapy selection.
基金supported by the National Natural Science Foundation of China(52221004,52091542,and 51820105011)the Scientific Research Project of China Three Gorges Corporation(201903139)the Research Fund of Vanke School of Public Health(2021JC009),Tsinghua University.
文摘The first pandemic wave of coronavirus disease 2019(COVID-19)induced a considerable increase in several antivirals and antibiotics in surface water.The common symptoms of COVID-19 are viral and bacterial infections,while comorbidities(e.g.,hypertension and diabetes)and mental shock(e.g.,insomnia and anxiety)are nonnegligible.Nevertheless,little is known about the long-term impacts of comorbidities and mental shock on organic micropollutants(OMPs)in surface waters.Herein,we monitored 114 OMPs in surface water and wastewater treatment plants(WWTPs)in Wuhan,China,between 2019 and 2021.The pandemic-induced OMP pollution in surface water was confirmed by significant increases in 26 OMP concentrations.Significant increases in four antihypertensives and one diabetic drug suggest that the treatment of comorbidities may induce OMP pollution.Notably,cotinine(a metabolite of nicotine)increased 155 times to 187 ngL1,which might be associated with increased smoking.Additionally,the increases in zolpidem and sulpiride might be the result of worsened insomnia and depression.Hence,it is reasonable to note that mental-health protecting drugs/behavior also contributed to OMP pollution.Among the observed OMPs,telmisartan,lopinavir,and ritonavir were associated with significantly higher ecological risks because of their limited WWTP-removal rate and high ecotoxicity.This study provides new insights into the effects of comorbidities and mental shock on OMPs in surface water during a pandemic and highlights the need to monitor the fate of related pharmaceuticals in the aquatic environment and to improve their removal efficiencies in WWTPs。
