Effects of Shuanghuanglian oral liquids on patients with COVID-19:a randomized,open-label,parallel-controlled,multicenter clinical trial

We conducted a randomized,open-label,parallel-controlled,multicenter trial on the use of Shuanghuanglian(SHL),a traditional Chinese patent medicine,in treating cases of COVID-19.A total of 176 patients received SHL by three doses(56 in low dose,61 in middle dose,and 59 in high dose)in addition to standard care.The control group was composed of 59 patients who received standard therapy alone.Treatment with SHL was not associated with a difference from standard care in the time to disease recovery.Patients with 14-day SHL treatment had significantly higher rate in negative conversion of SARS-CoV-2 in nucleic acid swab tests than the patients from the control group(93.4%vs.73.9%,P=0.006).Analysis of chest computed tomography images showed that treatment with high-dose SHL significantly promoted absorption of inflammatory focus of pneumonia,which was evaluated by density reduction of inflammatory focus from baseline,at day 7(mean difference(95%CI),−46.39(−86.83 to−5.94)HU;P=0.025)and day 14(mean difference(95%CI),−74.21(−133.35 to−15.08)HU;P=0.014).No serious adverse events occurred in the SHL groups.This study illustrated that SHL in combination with standard care was safe and partially effective for the treatment of COVID-19.

Management characteristics and prognosis after stroke in China:findings from a large nationwide stroke registry

Background and purpose There is limited nationwide evidence about the standard management characteristics of stroke types and prognosis in China.This study aimed to assess clinical characteristics,in-hospital and after-discharge management characteristics and prognosis for stroke types in China.Methods A nationwide registry recruited 14244 imaging-confirmed first-ever incident strokes from 132 hospitals across 31 provinces of China during 2007-2008,recording presenting characteristics,diagnostic procedures and in-hospital treatment.After hospital discharge,patients were followed up for 6 months.Conventional statistical methods were used to examine the patterns of management and prognosis.Results Overall,68.7%,26.9%and 4.4%were ischaemic stroke(IS),intracerebral haemorrhage(ICH),and subarachnoid haemorrhage(SAH),respectively.Only 20%were managed in a dedicated stroke unit.Among IS,1.3%received thrombolysis within 3 hours after symptom onset,whereas the proportions of receiving in-hospital antiplatelet therapy,neuroprotective agents and traditional Chinese medicines(TCM)were 88.4%,69.7%and 70.6%,respectively.For ICH,63.3%and 36.3%received neuroprotective agents and TCM in hospital,respectively.At discharge,70.7%and 38.0%of the patients with IS were given antiplatelet and statin therapies,respectively,decreasing to 64.8%and 23.9%,respectively,at 6 months.In-hospital mortality was 3.2%,9.3%and 10.1%for IS,ICH and SAH,respectively,with a further 8.6%,18.2%and 22.0%,respectively,died by 6 month.Meanwhile,in-hospital recurrence rate was 2.6%,1.9%and 7.2%for IS,ICH and SAH,respectively,with a further 8.0%,5.1%and 7.5%,respectively,recurred by 6 month.Conclusions In China,the mortality rate of stroke is lower than that reported from west populations,though most strokes are not managed in specialised stroke unit.There is widespread use of some unproven therapies but limited proven treatments,especially after discharge,leading to unnecessary recurrent risks.

Evaluation of the cracking and aging susceptibility of asphalt mixtures using viscoelastic properties and master curve parameters

Aging can significantly affect the performance of asphalt mixtures, causing increase in stiffness, reduction in relaxation capability and increase in cracking susceptibility. It is also well known that fundamental viscoelastic properties are used for design and modelling of asphalt mixtures and pavement structures to addressing rutting, fatigue and thermal cracking concerns. The objective of this paper is to study how the viscoelastic properties of asphalt mixture change over time, and evaluate and identify the cracking and aging susceptibility of asphalt mixtures with different mix variables during material selection and mixture design. Ten mixtures are evaluated using different laboratory conditioning protocols to simulate a range of aging levels in the field. The complex modulus test is then conducted on the lab aged mixtures to measure the viscoelastic properties in order to construct the dynamic modulus and phase angle master curves. The mixture Glover-Rowe(G-Rm) parameter and the shape parameters of the dynamic modulus and phase angle master curves, including inflection point frequency(-β/γ), difference between the glassy modulus and the inflection point modulus(γ), peak value of phase angle(a) and the horizontal position(frequency) of the peak phase angle value(c), are determined and evaluated for the mixtures with different aging conditions and mix variables. The study indicates the ability of the G-Rmparameter and all the master curve shape parameters to capture the effect of different aging conditions on linear viscoelastic mixture properties, as well as the cracking and aging susceptibility of asphalt mixtures.

Worldwide 1-month case fatality of ischaemic stroke and the temporal trend

background The 1-month case fatality of ischaemic stroke is an essential epidemiological metric.Whereas the case fatality after ischaemic stroke and the temporal trend is uncertain.We aimed to estimate the 1-month case fatality of ischaemic stroke and its temporal trend,as well as its regional variation.Methods We searched PubMed and Embase to identify the studies for 1-month case fatality of ischaemic stroke.The population-based studies were included.Two investigators extracted the data and assessed the quality independently.One-month case fatality of ischaemic stroke was estimated using a random effects model.The temporal trend was evaluated using a mixed-effect meta-regression model.results A total of 59 articles with 77 time periods were included.The worldwide 1-month case fatality of ischaemic stroke was 13.5%(95%CI 12.3%to 14.7%).The case fatality was 10.8%(95%CI 8.3%to 13.5%)in Asia,14.2%(95%CI 12.6%to 15.9%)in Europe,14.0%(95%CI 11.2%to 17.1%)in South America and Caribbean,14.0%(95%CI 9.5%to 19.1%)in North America and 12.5%(95%CI 11.1%to 13.9%)in Australia and New Zealand.Overall,there was a non-significant decrease of 0.1%per year in case fatality.It decreased significantly in Europe(−0.2%annually,95%CI−0.4%to−0.01%)and North America(−0.2%annually,95%CI−0.4%to−0.04%),increased significantly in Australia and New Zealand(0.2%annually,95%CI 0.1%to 0.4%),while no evidence of change in other regions.Conclusion The 1-month case fatality of ischaemic stroke and its temporal trend were divergent across regions.Further studies are needed to address the reason of the regional difference,which will be helpful to guide the effort of reducing stroke burden.