Efficacy and safety of the combination of Liushen capsules and Arbidol in the treatment of COVID-19:protocol for a randomized,multi-center pilot study

Background:From early experience,some Traditional Chinese Medicine and Arbidol had effects of against COVID-19,infer that the combination of Liushen capsules and Arbidol may further increase the therapeutic.Methods/Design:We conducted a randomized,blank parallel-controlled,open-label,multi-center,basal therapy-loaded design clinical trial.A total of 40 patients are going to be recruited after satisfying the criteria.Participants will be allocated randomly into the treatment group with the combination of Arbidol and Liushen capsules and the control group with the basic therapy.Each group will receive treatment at least 7-days or until the virus becomes negative,and visits after drug administration at day 3(visit 1),the day when the virus becomes negative(visit 2),day 7(visit 3),the day before discharge(visit 4)and day 28(visit 5),to collect their survival status and disease prognosis so that the efficacy and safety of a combination of Arbidol and Liushen capsule will be evaluated.Discussion:We described the protocol of the first clinical trial for treatment COVID-19 by using a combination of Arbidol and Liushen capsules.The results of this study will provide a basis for the design and sample size estimate of subsequent large-scale clinical trials.Trial registration:This study has been registered at Chinese clinical trial Registry(chictr.org.cn):ChiCTR2000029993.

Evaluation of Oxidation of Ti-Al and Ti-Al-Cr Coatings Arc-ion Plated on Ti-60 High-temperature Titanium Alloy

High-temperature titanium alloy for aeroengine compressor applications suffers from high-temperature oxidation and environmental corrosion, which prohibits long-term service of this kind alloy at temperatures above 600℃. In an attempt to tackle this problem, Ti-48Al （at. pct） and Ti-48Al-12Cr （at. pct） protective coatings were plated on the substrate of alloy Ti-60 by arc ion plating （ALP） method. Isothermal and cyclic oxidation tests were performed in static air at elevated temperatures. Phase composition, morphology of the coatings and distribution of elements were investigated by X-ray diffraction （XRD）, scanning electron microscopy （SEM） and energy dispersive X-ray analysis （EDX）. The results showed that the Ti-48Al coating exhibited good isothermal oxidation resistance during exposure at 800℃, but poorer resistance against oxidation at 900℃. By contrast Ti-48Al-12Cr coating demonstrated excellent isothermal oxidation resistance at both temperatures. Cyclic oxidation tests performed at 800℃ indicated that resistance and no spallation of coatings was observed. But both coatings demonstrated good cyclic oxidation at 900℃ only Ti-48Al-12Cr coating demonstrated excellent cyclic oxidation resistance.

The preoperative neutrophil-to-lymphocyte ratio predicts the outcomes of patients with hepatocellular carcinoma and cirrhosis after hepatectomy

Objective The aim of the study was to investigate the prognostic value of the preoperative peripheral neutrophil-to-lymphocyte ratio(NLR) in patients with hepatocellular cancer(HCC) and cirrhosis after hepatectomy. Methods This retrospective study included 321 patients with HCC who underwent resection. The NLR was calculated using the neutrophil and lymphocyte counts in routine preoperative blood tests. Receiver operating characteristic curve analysis was performed to select the most appropriate NLR cutoff value. The preoperative NLR, patient demographics, and clinical and pathological data, including disease-free survival(DFS) and overall survival(OS), were analyzed. Results The NLR was correlated with alpha-fetoprotein levels(χ2 = 5.876, P = 0.015), tumor size(χ2 = 32.046, P < 0.001), portal vein tumor thrombus(PVTT; χ2 = 4.930, P = 0.026), tumor encapsulation(χ2 = 7.243, P = 0.007), and recurrence(χ2 = 7.717, P = 0.005). Multivariate analyses illustrated that the number of tumors, PVTT, tumor size, and the NLR were independent factors for predicting DFS and OS. In patients with HCC and cirrhosis, but not among those without cirrhosis, a larger NLR predicted poorer postoperative DFS and OS(both P < 0.001). Conclusion As a simple, effective independent predictor for patients with HCC, the preoperative NLR plays an important role in accurately predicting the postoperative outcomes of patients with HCC and cirrhosis, but not those of patients without cirrhosis.

Comparison of clinical efficacy between LAPS and ALPPS in the treatment of hepatitis B virus-related hepatocellular carcinoma

Background:Insufficient post-operative future liver remnant(FLR)limits the feasibility of hepatectomy for patients.Staged hepatectomy is an effective surgical approach that can improve the resection rate of hepatocellular carcinoma(HCC).This study aimed to compare the safety and efficacy of laparoscopic microwave ablation and portal vein ligation for staged hepatectomy(LAPS)and classical associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)in the treatment of hepatitis B virus(HBV)-related HCC.Methods:Clinical data of patients with HBV-related HCC who underwent LAPS or ALPPS in our institute between January 2017 and May 2022 were retrospectively analysed.Results:A total of 18 patients with HBV-related HCC were retrospectively analysed and divided into the LAPS group(n=9)and ALPPS group(n=9).Eight patients in the LAPS group and eight patients in the ALPPS group proceeded to a similar resection rate(88.9%vs 88.9%,P=1.000).The patients undergoing LAPS had a lower total comprehensive complication index than those undergoing ALPPS but there was not a significant different between the two groups(8.66 vs 35.87,P=0.054).The hypertrophy rate of FLR induced by ALPPS tended to be more rapid than that induced by LAPS(24.29 vs 13.17 mL/d,P=0.095).The 2-year recurrence-free survival(RFS)was 0%for ALPPS and 35.7%for LAPS(P=0.009),whereas the 2-year overall survival for ALPPS and LAPS was 33.3%and 100.0%(P=0.052),respectively.Conclusions:LAPS tended to induce lower morbidity and FLR hypertrophy more slowly than ALPPS,with a comparable resection rate and better long-term RFS in HBV-related HCC patients.

Longitudinal virological changes and underlying pathogenesis in hospitalized COVID-19 patients in Guangzhou,China

Prolonged viral RNA shedding and recurrence of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in coronavirus disease 2019(COVID-19)patients have been reported.However,the clinical outcome and pathogenesis remain unclear.In this study,we recruited 43 laboratory-confirmed COVID-19 patients.We found that prolonged viral RNA shedding or recurrence mainly occurred in severe/critical patients(P<0.05).The average viral shedding time in severe/critical patients was more than 50 days,and up to 100 days in some patients,after symptom onset.However,chest computed tomography gradually improved and complete absorption occurred when SARS-CoV-2 RT-PCR was still positive,but specific antibodies appeared.Furthermore,the viral shedding time significantly decreased when the A1,430G or C12,473T mutation occurred(P<0.01 and FDR<0.01)and increased when G227A occurred(P<0.05 and FDR<0.05).High IL1R1,IL1R2,and TNFRSF21 expression in the host positively correlated with viral shedding time(P<0.05 and false discovery rate<0.05).Prolonged viral RNA shedding often occurs but may not increase disease damage.Prolonged viral RNA shedding is associated with viral mutations and host factors.

Alteration of the respiratory microbiome in COVID-19 patients with different severities

Coronavirus disease 2019(COVID-19) is rampant worldwide and has affected more than 215 countries and regions. According to the World Health Organization's report, there were 226,018,919 COVID-19 cases and 4,654,898 deaths as of March 14, 2021, although300,002,228 vaccines have been administered globally. COVID-19patients have different clinical phenotypes and can be divided into asymptomatic, normal, mild, severe, and critical patients.