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Background The current outbreak of coronavirus disease 2019 (COVID-19) caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, Hubei, China, spreads across national and international borders. Methods We prospectively collected medical records of 14 health care workers (HCWs) who were infected with SARS-CoV-2, in neurosurgery department of Wuhan Union Hospital, China. Results Among the 14 HCWs, 12 were conformed cases, the other 2 were suspected cases. Most of them were either exposed to the two index patients or infected coworkers, without knowing they were COVID-19 patients. There were 4 male and 10 female infected HCWs in this cohort, whose mean age was 36 years (SD, 6 years). The main symptoms included myalgia or fatigue (100%), fever (86%) and dry cough (71%). On admission, 79% of infected HCWs showed leucopenia and 43% lymphopenia. Reduced complement C3 could be seen in 57% of the infected HCWs and IL-6 was significantly elevated in 86% of them. The proportion of lymphocytes subsets, concentrations of immunoglobulins, complement C4, IL-2, IL-4, IL-10, TNF-α and IFN-γ were within normal range in these 14 infected HCWs. The most frequent findings on pulmonary computed tomographic images were bilateral multifocal ground-glass opacifications (86%). Conclusions Human-to-human transmission of COVID-19 pneumonia has occurred among HCWs, and most of these infected HCWs with confirmed COVID-19 are mild cases. Our data suggest that in the epidemic area of COVID-19, stringent and urgent surveillance and infection-control measures should be implemented to protect doctors and nurses from COVID-19 infection.

In the present study, a set of self-designed measurement protocols for the precision of coaxial needle placement (PCNP) was proposed and applied in a computed tomography (CT)-guided transthoracic needle biopsy (TNB) audit of an interventional radiologist to determine if the PCNP was commensurate with the experience of the operator. A total of 102 patients (98 with lung lesions and four with mediastinum lesions) consented to be subjected to CT-guided TNB performed by staff interventional radiologists. The patients were divided into two groups based on appointment date. Group A consisted of the first 51 patients and group B comprised of the latter 51 patients. A set of self-designed measurement protocols for PCNP was proposed, and the PCNP was classified into four grades, from grade 1 (most accurate) to grade 4 (least accurate). PCNPs were independently measured by three staff radiologists who were blind to the grouping. The anatomical features of the lesions were also analyzed between the two groups. A significant difference in the PCNP gained after the first needle placement was identified between the two groups (P=0.003, two-tailed). The number of patients in group B with grade I PCNP (51.0%) was significantly higher than that in group A (21.6%) (P

Differential diagnosis of malignant solitary pulmonary nodules (SPNs) from benign ones is difficult based on imaging manifestations. This study was to assess dynamic enhancement patterns of SPNs detected with multi-detector row computed tomography (MDCT), correlate SPN manifestations of MDCT to the expression of vascular endothelial growth factor (VEGF) and microvessel density (MVD), thus to explore the potential value of MDCT imaging in the diagnosis of SPNs.Fifty pathologically and one clinically confirmed patients with SPNs (diameteror= 4 cm) undergoing MDCT plain and dynamic enhancement scans were enrolled in the study. The entire lung was scanned at 15 s after injection of the contrast agent; dynamic enhancement scans of SPNs were performed at 45 s, 75 s, 135 s, 195 s and 255 s after contrast injection. The enhancement patterns, pre-, peak and net enhancement of SPNs were assessed. Pearson correlation coefficient was used to correlate peak enhancement, net enhancement to the expression of VEGF and MVD.The peak and net enhancements were significantly higher in malignant nodules (mean attenuation, 69.9 Hu and 32.9 Hu) than in benign nodules (mean attenuation, 51.7 Hu and 17.2 Hu) (p0.001). When net enhancement of 20 Hu was set as the cutoff value to differentiate malignant nodules from benign ones, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 96.43%, 69.57%, 79.41%, 94.12% and 84.31%, respectively. The enhancement patterns between malignant and benign SPNs were significantly different. Homogeneous enhancement or heterogeneous tending to homogeneous enhancement appeared mostly in malignant nodules (78.57%). Benign nodules were almost not enhanced (52.17%). Expressions of MVD and VEGF were significantly different between malignant and benign SPNs. VEGF was positively correlated to the peak enhancement value (r = 0.505, p = 0.014) and the net enhancement value (r = 0.565, p = 0.005). Similarly, MVD was also positively correlated to the peak enhancement value (r = 0.819, p0.001) and the net enhancement value (r = 0.845, p0.001).Net enhancement value is an important indicator for differential diagnosis of malignant and benign SPNs. Characteristic enhancement patterns are different between malignant and benign SPNs. Peak enhancement and net enhancement values are positively correlated with VEGF and MVD, both of which reflect the extent of angiogenesis in SPNs to some extent.