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Hanqing Liu,1,&ast; Ling Zhan,1,&ast; Liantao Guo,1 Xizi Yu,1 Lingrui Li,1 Hongfang Feng,2 Dan Yang,3 Zhiliang Xu,1 Yi Tu,1 Chuang Chen,1 Shengrong Sun1 1Department of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People’s Republic of China; 2Department of Thyroid and Breast Surgery, Huangshi Central Hospital of Edong Healthcare Group, Hubei Polytechnic University, Huangshi, 435000, Hubei, People’s Republic of China; 3Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Shengrong Sun; Chuang ChenDepartment of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan University at Jiefang Road 238, Wuhan, 430060, People’s Republic of ChinaTel/Fax +86 27 88041911Email sun137@sina.com; chenc2469@163.comPurpose: Many thyroid cancer patients have suffered from treatment delays caused by the coronavirus disease 2019 pandemic. Although there have been many reviews, recommendations, or clinical experiences, clinical evidence that evaluates patient disease status is lacking. The aim of our research was to evaluate thyroid cancer behaviour in the post-COVID-19 era.Patients and Methods: A retrospective study was conducted and thyroid cancer patient data from February 1, 2017 to September 15, 2020 were pooled for analysis. The demographic, ultrasound and pathological data of the pre- and post-COVID-19 groups were compared. Lymph node metastases, tumour size, extrathyroidal extension, and multifocality were compared year-by-year to evaluate annual changes in patient characteristics. Regression analyses were adopted to reveal cancer behaviour along with the admission date interval and to reveal risk factors for lymph node metastasis. Patient ultrasound data were compared before and after the lockdown to assess tumour progression. The outcomes of delays in treatment ≤ 180 days were then studied.Results: The post-lockdown patients were more likely to have multiple lesions (31.2% vs 36.5%, p = 0.040), extrathyroidal extension (65.5% vs 72.2%, p = 0.011) and lymph node metastases (37.7% vs 45.0%, p = 0.007), while tumour size remained stable (1.01cm vs.1.02cm, p = 0.758). The lymph node metastasis rate increased by year (p < 0.001). The tumour size correlated negatively with the post-lockdown admission date (p = 0.002). No significant difference in tumour size, multifocality or lymph node metastasis on ultrasound was revealed between the pre- and post-lockdown group. No significant difference in tumour size, multifocality, extrathyroidal extension or lymph node metastasis was revealed among patients with a delayed treatment time ≤ 180 days.Conclusion: Patients with a COVID-19-induced treatment delay had more aggressive cancer behaviour. Rebound medical visits and annually increasing aggressiveness may be potential reasons for this observation, as individual patient tumour did not progress during the delay.Keywords: treatment delay, lockdown, rebound medical visit, tumor behavior

Background The relationship between cancer and COVID‐19 has been revealed during the pandemic. Some anticancer treatments have been reported to have negative influences on COVID‐19‐infected patients while other studies did not support this hypothesis. Methods A literature search was conducted in WOS, PubMed, Embase, Cochrane Library, CNKI and VIP between Dec 1, 2019 and Sept 23, 2020 for studies on anticancer treatments in patients with COVID‐19. Cohort studies involving over 20 patients with cancer were included. The characteristics of the patients and studies, treatment types, mortality, and other additional outcomes were extracted and pooled for synthesis. RRs and forest plots were adopted to present the results. The literature quality and publication bias were assessed using NOS and Egger's test, respectively. Results We analyzed the data from 29 studies, with 5121 cancer patients with COVID‐19 meeting the inclusion criteria. There were no significant differences in mortality between patients receiving anticancer treatment and those not (RR 1.17, 95%CI: 0.96–1.43, I2=66%, p = 0.12). Importantly, in patients with hematological malignancies, chemotherapy could markedly increase the mortality (RR 2.68, 95% CI: 1.90–3.78, I2=0%, p, No significant difference was seen in any anticancer treatments in solid tumor subgroup. Chemotherapy, however, will lead to a higher mortality in patients with hematological malignancies.

Objective: The aim of this study was to observe the liver function recovery of COVID-19 patients after discharge. Patients and Methods: A total of 253 discharged COVID-19 patients in Shenzhen city, China were selected. The clinical characteristics of these patients were assessed. A 2-month follow-up and laboratory hematology test were performed to examine the status of patients' liver function. Results: Patients combined with liver diseases, especially fatty liver, are more likely to progress to severe condition (P

Objectives: Research on recovering COVID-19 patients could be helpful for containing the pandemic and developing vaccines, but we still do not know much about the clinical features, recovery process, and antibody reactions during the recovery period. Methods: We retrospectively analysed the epidemiological information, discharge summaries, and laboratory results of 324 patients. Results: In all, 15 (8.62%) patients experienced chest distress/breath shortness, where 8 of the 15 were severely ill. This means severely ill patients need an extended amount of time to recover after discharge; next, 20 (11.49%) patients experienced anxiety and 21 (12.07%) had headache/insomnia and a small fraction of them complained of anosmia/ageusia, indicating that these patients need treatment for mental and psychological health issues. Regarding the re-positive patients, their CT and laboratory test results showed no obvious evidence of illness progress or infectivity but a high anti-SARS-CoV-2 antibody expression. Conclusion: Recovered COVID-19 patients need psychological and physiological care and treatment, re-positivity can occur in any person, but juveniles, females, and patients with mild/moderate existing symptoms have higher rates of re-positivity, While there is no evidence that turning re-positive has an impact on their infectivity, but it still alerted us that we need differentiate them in the following managements.

Highlights • Self-reported depression appeared in the early stage of recovery even when COVID-19 patients discharged from hospital. • Self-reported depression has no significant correlation with gender, age, comorbidities, severity of initial infection, duration of initial illness of SARS-CoV-2. • Patients with self-reported depression exhibited increased immune response, as indicated by increased white blood cell and neutrophil counts, as well as neutrophil-to-lymphocyte ratio. • Appropriate psychological interventions are necessary, and changes in immune function should be emphasized during long-term follow up of these patients., Self-reported depression has been observed in coronavirus disease-2019 (COVID-19) patients, infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), during discharge from the hospital. However, the cause of this self-reported depression during the convalescent period remains unclear. Here, we report the mental health status of 96 convalescent COVID-19 patients who were surveyed using an online questionnaire at the Shenzhen Samii Medical Center from March 2 to March 12, 2020 in Shenzhen, China. After obtaining their informed consent, we retrospectively analyzed the clinical characteristics of patients, including routine blood and biochemical data. The results suggested that patients with self-reported depression exhibited increased immune response, as indicated by increased white blood cell and neutrophil counts, as well as neutrophil-to-lymphocyte ratio. However, the mechanism linking self-reported depression to these cellular changes needs further study. In conclusion, self-reported depression occurred at an early stage in convalescent COVID-19 patients, and changes in immune function were apparent during short-term follow-up of these patients after discharge. Appropriate psychological interventions are necessary, and changes in immune function should be emphasized during long-term follow up of these patients.

Cardiac remodeling is a common characteristic of almost all forms of heart disease, including cardiac infarction, valvular diseases, hypertension, arrhythmia, dilated cardiomyopathy and other conditions. It is not merely a simple outcome induced by an increase in the workload of cardiomyocytes (CMs). The remodeling process is accompanied by abnormalities of cardiac structure as well as disturbance of cardiac function, and emerging evidence suggests that a wide range of cells in the heart participate in the initiation and development of cardiac remodeling. Other than CMs, there are numerous noncardiomyocytes (non-CMs) that regulate the process of cardiac remodeling, such as cardiac fibroblasts and immune cells (including macrophages, lymphocytes, neutrophils, and mast cells). In this review, we summarize recent knowledge regarding the definition and significant effects of various non-CMs in the pathogenesis of cardiac remodeling, with a particular emphasis on the involved signaling mechanisms. In addition, we discuss the properties of non-CMs, which serve as targets of many cardiovascular drugs that reduce adverse cardiac remodeling.

Background: Hypertension (HTN) is known to increase the risk of thyroid cancer. However, few studies have explored the association between HTN and the prognostic factors of papillary thyroid cancer (PTC). Methods: We retrospectively evaluated PTC patients treated with surgery at our center between January 2017 and September 2020. The association between both HTN and antihypertensive drug use and the clinicopathological features of the PTC patients was analyzed. The odds ratios (OR) were estimated using both univariate and multivariate logistic regression models, which were adjusted for the patients’ age, sex, and thyroid-stimulating hormone level.Results: A total of 2838 patients were enrolled in this study, including 409 patients with HTN. In the multivariate analysis, HTN was associated with larger tumor size [OR = 1.51, 95% confidence interval (CI): 1.10–2.07] and lymph node metastasis (OR = 1.43, 95% CI: 1.02–1.99). There was no statistical difference between females older than 40 years of age and any pathological features, while a positive association between older males and larger tumors (OR=1.87, 95% CI: 1.014-3.45), lymph node metastasis (OR=2.01, 95% CI: 1.08-3.73), and capsule invasion (OR = 1.98, 95% CI: 1.002–3.91). With regard to antihypertensive drug use, the patients taking enzyme inhibitors or angiotensin II-receptor blockers (ACEi/ARB) seemed more likely to develop bilateral PTC comparing ones using calcium channel blockers (CCB) alone, while no statistical difference was found for these taking CCB alone and the combination of CCB and ACEi/ARB. Conclusion: PTC patients with HTN, particularly age >40 males, tend to have invasive features. Antihypertension therapy appears to exert little to no different effect on the pathological characteristics in these patients.

Immune checkpoint inhibitors (ICIs) are a group of drugs employed in the treatment of various types of malignant tumors and improve the therapeutic effect. ICIs blocks negative co-stimulatory molecules, such as programmed cell death gene-1 (PD-1) and its ligand (PD-L1) and cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4), reactivating the recognition and killing effect of the immune system on tumors. However, the reactivation of the immune system can also lead to the death of normal organs, tissues, and cells, eventually leading to immune-related adverse events (IRAEs). IRAEs involve various organs and tissues and also cause thyroid dysfunction. This article reviews the epidemiology, clinical manifestations, possible pathogenesis, and management of ICIs-related thyroid dysfunction.

Thyroid cancers (TC) have increasingly been detected following advances in diagnostic methods. Risk stratification guided by refined information becomes a crucial step toward the goal of personalized medicine. The diagnosis of TC mainly relies on imaging analysis, but visual examination may not reveal much information and not enable comprehensive analysis. Artificial intelligence (AI) is a technology used to extract and quantify key image information by simulating complex human functions. This latent, precise information contributes to stratify TC on the distinct risk and drives tailored management to transit from the surface (population-based) to a point (individual-based). In this review, we started with several challenges regarding personalized care in TC, for example, inconsistent rating ability of ultrasound physicians, uncertainty in cytopathological diagnosis, difficulty in discriminating follicular neoplasms, and inaccurate prognostication. We then analyzed and summarized the advances of AI to extract and analyze morphological, textural, and molecular features to reveal the ground truth of TC. Consequently, their combination with AI technology will make individual medical strategies possible.

The BMI1 protein, a member of the PRC1 family, is a well recognised transcriptional suppressor and has the capability of maintaining the self-renewal and proliferation of tissue-specific stem cells. Numerous studies have established that BMI1 is highly expressed in a variety of malignant cancers and serves as a key regulator in the tumorigenesis process. However, our understanding of BMI1 in terminally differentiated organs, such as the heart, is relatively nascent. Importantly, emerging data support that, beyond the tumor, BMI1 is also expressed in the heart tissue and indeed exerts profound effects in various cardiac pathological conditions. This review gives a summary of the novel functions of BMI1 in the heart, including BMI1-positive cardiac stem cells and BMI1-mediated signaling pathways, which are involved in the response to various cardiac pathological stimuli. Besides, we summarize the recent progress of BMI1 in some novel and rapidly developing cardiovascular therapies. Furtherly, we highlight the properties of BMI1, a therapeutic target proved effective in cancer treatment, as a promising target to alleviate cardiovascular diseases.

BACKGROUND: COVID-19 has recently been declared an epidemic by the WHO, and there is an urgent need for affected countries and laboratories to assess and treat people at risk of COVID-19. A heat procedure has been suggested for specimen inactivation. This study was designed to evaluate the effect of serum heating on biochemical indexes, and providing a basis for accurate detection results of the COVID-19 patients. METHODS: We collected 29 normal cases of two tubes of 5 mL whole blood. One tube was analyzed directly, and the other was analyzed after heating at 56°C 30 minutes. RESULTS: A total of 34 serum biochemical index quantitative results were obtained, 28/34 indexes were not significantly affected by the heat inactivation and remained clinically interpretable. As the thermal inactivation for these indexes showed good correlation, ALB (p = 0.04, Pearson R = 0.91, 2.6% mean increase), CysC (p = 0.03, Pearson R = 0.98, 9.9% mean increase), CO2CP (p < 0.001, Pearson R = 0.96, 13% mean decrease), they were still inter-pretable. Four biochemical indexes ALP, CK, CK-MB, and insulin were inactivated and showed significant statistical differences (p < 0.001). CONCLUSIONS: Our study showed CK, CK-MB, ALP, and insulin were sensitive to heat and will be inhibited or degrade after heating, indicating that the rapid decrease of this indexes in the COVID-19 patients may be caused by sample heat inactivation. For safety and diagnostic accuracy, we recommend the use of a point-of-care device for blood gases, electrolytes, troponin, and liver and renal function tests within a ISL 2 or above biosafety cabinet with level 3 or above biosafety laboratory practice.

Objectives: A significant proportion of discharged COVID-19 patients still have some symptoms. Traditional Chinese medicine (TCM) has played an important role in the treatment of COVID-19, but whether it is helpful for discharged patients is still unknown. The aim of this study was to retrospectively analyze the impacts of TCM treatment on the convalescents of COVID-19. Methods: A total of 372 COVID-19 convalescents from February 21 to May 3 in Shenzhen, China were retrospectively analyzed, 291 of them accepted clinically examined at least once and 191 convalescents accepted TCM. Results: After retrospective analysis of the clinical data of convalescents accepted TCM treatment or not, we found that the white blood cell count, as well as serum interleukin-6 and procalcitonin decreased in TCM group. Serum γ-glutamyl transpeptidase was significantly decreased, while prealbumin and albumin increased in TCM group. Red blood cell, hemoglobin, and platelet count increased in TCM group. The mechanisms of TCM treatment might be the overall regulations, including balanced immune response, improved hematopoiesis and coagulation systems, enhanced functions of liver and heart, increased nutrient intake and lipid metabolism. Conclusions: This study suggested that TCM treatment would be beneficial for discharged COVID-19 patients. However, long-term medical observation and further study with randomized trial should be done to confirm this result. Besides, the potential molecular mechanisms of TCM treatment should be further revealed.

Macrophages are integral components of the mammalian heart that show extensive expansion in response to various internal or external stimuli. After the onset of sustained pressure overload (PO), the accumulation of cardiac macrophages through local macrophage proliferation and monocyte migration has profound effects on the transition to cardiac hypertrophy and remodeling. In this review, we describe the heterogeneity and diversity of cardiac macrophages and summarize the current understanding of the important roles of macrophages in PO-induced cardiac remodeling. In addition, the possible mechanisms involved in macrophage modulation are also described. Finally, considering the significant effects of cardiac macrophages, we highlight their emerging role as therapeutic targets for alleviating pathological cardiac remodeling after PO.

Recently, the recurrence of positive SARS-CoV-2 viral RNA in recovered COVID-19 patients is receiving more attention. Herein we report a cohort study on the follow-up of 182 recovered patients under medical isolation observation. Twenty (10.99%) patients out of the 182 were detected to be SARS-CoV-2 RNA positive (re-positives), although none showed any clinical symptomatic recurrence, indicating that COVID-19 responds well to treatment. Patients aged under 18 years had higher re-positive rates than average, and none of the severely ill patients re-tested positive. There were no significant differences in sex between re-positives and non-re-positives. Notably, most of the re-positives turned negative in the following tests, and all of them carried antibodies against SARS-CoV-2. This indicates that they might not be infectious, although it is still important to perform regular SARS-CoV-2 RNA testing and follow-up for assessment of infectivity. The findings of this study provide information for improving the management of recovered patients, and for differentiating the follow-up of recovered patients with different risk levels.

The outbreak of Coronavirus Disease 2019 (COVID-19) is getting worse every day all over the world. The present study aimed to review the epidemiological characteristics of patients infected with COVID-19 in Shenzhen city, a super megacity of China, to provide some references for fighting to the coronavirus. We collected data of 417 patients with laboratory-confirmed COVID-19 of Shenzhen through March 7th, 2020. The epidemiological characteristics of the patients were analyzed. Besides, we collected the governmental measures of Shenzhen city, and the the dynamic changes of the epidemic outbreak. Governmental strategies such as early detection, early hospitalization and popular science etc. are effective for the prevention and control of the epidemic. Nearly 80% confirmed patients with COVID-19 in Shenzhen were in normal or mild conditions, and the mortality was less than 1%. Age, gender, exposure to source of transmission within 14 days and basic diseases are major risk factors for severe patients. Patients in characters of elder, male, with exposure of Wuhan and carried basic diseases had higher risk to be in severe condition (Pth, 2020. Patients in severe conditions took more time from onset to discharge (P

In this paper, a reconfigurable terahertz split-ring resonator metamaterial using graphene is designed for terahertz applications. The shaped single-layer graphene sheet is placed on top of the dielectric layer, which consists of Si and Si02. The simulation results show that the resonant frequency can be dynamically tuned under different chemical potential in a wide range.

The Lanzhou City construction space and transportation network have obviously changed. Lanzhou city’s terrain is that the Yellow River crossing two mountains caused the valley very long and narrow. So with the subsequent traffic congestion, effective measures should be taken to expand city spaces and to improve traffic network. Only with this, Lanzhou City could be developed fast and shape a unique city identity. Through analysis of the city topographic features and spatial layout, this paper outlines several ideas on city planning of Lanzhou.

In the design of the asphalt pavement or asphalt overlay, consider about the viscoelastic fracture mechanics behavior of asphalt mixture is significant in researching the asphalt pavement craze or the extending behavior of reflective crack. This paper employs nonlinear finite element software ABAQUS to analysis about the viscoelastic of asphalt mixture in the basis of the vicoelastic breaking theory, analyze the Traffic dynamic loading different speeds, different grassroots modulus to contain crack pavement structure system of the displacement field and stress field of influence.The calculation results show that the curve of the stress intensity factor in the crack tip moves as the increase of the speed, but the maximum is virtually unchanged; and it is proportional to the grassroots modulus variations, that is the stress intensity factor increases as the increase of grassroots modulus. With the effect of partial load, the stress intensity factor is formed by KⅠ、KⅡ. It is mainly assumed by KⅡ when grassroots modulus is low, and as the grassroots modulus increases, the KⅠ is increases, But KⅡ changes little.

In this study a new anti-rutting agent ( ARK-1 ) was introduced to analyze effect on pavement performance of asphalt mixture. Taken three gradations of AC-13 mixture with ARK-1 and without ARK-1 as investigation objects, high-temperature and water stability as well as cracking resistance at low-temperature were measured respectively. The results of tests show that the ARK-1 is feasible to improve pavement performance of asphalt mixture and its influence on high-temperature stability of asphalt mixture is obviously superior to that on water stability and cracking resistance at low-temperature. A project example of Louding freeway between stations 35+450 and 36+450 was proved that the costs of pavement with the ARK-1 would be more economical than that of pavement with SBS-modified asphalt binder.