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Background: More than 2 months have passed since the novel coronavirus disease 2019 (COVID-19) first emerged in Wuhan, China. With the migration of people, the epidemic has rapidly spread within China and throughout the world. Due to the severity of the epidemic, undiscovered transmission of COVID-19 deserves further investigation. The aim of our study hypothesized possible modes of SARS-CoV-2 transmission and how the virus may have spread between two family clusters within a residential building in Guangzhou, China. Methods: In a cross-sectional study, we monitored and traced confirmed patients and their close contacts from January 11 to February 5, 2020 in Guangzhou, China, including 2 family cluster cases and 61 residents within one residential building. The environmental samples of the building and the throat swabs from the patients and from their related individuals were collected for SARS-CoV-2 and tested with real-time reverse transcriptase polymerase chain reaction (RT-PCR). The relevant information was collected and reported using big data tools. Results: There were two notable family cluster cases in Guangzhou, which included 3 confirmed patients (family No.1: patient A, B, C) and 2 confirmed patients (family No.2: patient D, E), respectively. None of patients had contact with other confirmed patients before the onset of symptoms, and only patient A and patient B made a short stop in Wuhan by train. Home environment inspection results showed that the door handle of family No.1 was positive of SARS-CoV-2. The close contacts of the 5 patients all tested negative of SARS-CoV-2 and in good health, and therefore were released after the official medical observation period of 14-days. Finally, according to the traceability investigation through applying big data analysis, we found an epidemiological association between family No.1 and family No.2, in which patient D (family No.2) was infected through touching an elevator button contaminated by snot with virus from patient A (family No.1) on the same day. Conclusions: Contaminants with virus from confirmed patients can pollute the environment of public places, and the virus can survive on the surface of objects for a short period of time. Therefore, in addition to the conventional droplet transmission, there is also indirect contact transmission such as snot-oral transmission that plays a crucial role in community spread of the virus.

Introduction The COVID‐19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. Aim To understand how CU patients are affected by the COVID‐19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID‐19. Materials and Methods Our cross‐sectional, international, questionnaire‐based, multicenter UCARE COVID‐CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. Results The COVID‐19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID‐19 patient care, which negatively impacted on the care of urticaria patients. The rate of face‐to‐face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID‐19, but COVID‐19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID‐19. Conclusions The COVID‐19 pandemic brings major changes and challenges for CU patients and their physicians. The long‐term consequences of these changes, especially the increased use of remote consultations, require careful evaluation.

BackgroundHand, foot and mouth disease (HFMD) is usually caused by Enterovirus 71(EV71), and Coxsackievirus A16 (CV-A16) in Guangzhou, the biggest city of South China. However, Coxsackievirus A6 (CV-A6) were observed increased dramatically from 2010–2012.MethodsIn order to understand and to describe the epidemiologic and genetic characteristics of CV-A6, specimens of 5482 suspected HFMD cases were collected and examined by real-time fluorescence PCR. All samples positive for enteroviruses were analyzed by descriptive statistics. Phylogenetic analysis of CV-A6 based on the VP1 sequences was performed to investigate molecular and evolutionary characteristics.ResultsCoxsackievirus A6 increased dramatically from 9.04% in 2010 to 23.21% in 2012 and became one of the main causative agents of HFMD in Guangzhou. CV-A6 attack rates were highest in one to two year olds (33.14%). Typical clinic symptoms of CV-A6 HFMD include fever (589/720, 81.81%), maculopopular rash and vesicular exanthema around the perioral area (408/720, 56.66%), intraoral (545/720, 75.69%), the buttock (395/720, 54.86%), the trunk (244/720, 33.89%), the knee (188/720, 26.11%), and the dorsal aspects of hands (437/720, 60.69%). Phylogenetic analysis showed the CV-A6 isolates in this study belonged to Cluster A1 and were similar to those found in Shanghai in 2011 and 2012 (JX495148, KC414735), Shenzhen in 2011 (JX473394), Japan in 2011 (AB649243, AB649246), France in 2010(HE572928), Thailand in 2012(JX556564) and Israel in 2012 and 2013(.KF991010, KF991012).Electronic supplementary materialThe online version of this article (doi:10.1186/1743-422X-11-157) contains supplementary material, which is available to authorized users.

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This study aimed to compare the risk of infection of children with that of adults and to explore risk factors of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by following up close contacts of COVID-19 patients. Method: The retrospective cohort study was performed among close contacts of index cases diagnosed with COVID-19 in Guangzhou, China. Demographic characteristics, clinical symptoms and exposure information were extracted. Logistic regression analysis was employed to explore the risk factors. The restricted cubic spline was conducted to examine to the dose-response relationship between age and SARS-CoV-2 infection. Results: The secondary attack rate (SAR) was 4.4% in 1,344 close contacts. The group of household contacts (17.2%) had the highest SAR. The rare-frequency contact (p < 0.001) and moderate-frequency contact (p < 0.001) were associated with lower risk of infection. Exposure to index cases with dry cough symptoms was associated with infection in close contacts (p = 0.004). Compared with children, adults had a significantly increased risk of infection (p = 0.014). There is a linear positive correlation between age and infection (p = 0.001). Conclusions: Children are probably less susceptible to COVID-19. Close contacts with frequent contact with patients and those exposed to patients with cough symptoms are associated with an increased risk of infection.

Background/Aims: Gastric cancer (GC) is the fourth most common cancer and the second most common cause of cancer deaths worldwide. Endoscopic examination is the most used method to detect the GC nowadays, whereas this method is expensive and invasive. MicroRNAs (miRNAs) are a group of recently discovered small non-protein-coding RNAs. They regulate the expression of hundreds of target genes; thereby control a wide range of tumorigenic processes. In this study, we selected two miRNAs, hsa-miR-21 and hsa-miR-29, as the targets to assess their diagnostic and prognostic value for GC. Methods: A total of 50 GC patients including 24 females and 26 males were recruited. Tumor and adjacent non-tumor tissue samples were collected from all these participants during the endoscopic examination. RNAs were extracted from these samples, then quantified via qRT-PCR and normalized with RNU43 as the internal control. Statistical analyses were conducted using the GraphPad Prism 5.0. Results: We discovered a higher expression of hsa-miR-21 and a relatively lower expression of hsa-miR-29hsa-miR-29 in the tumor tissue than in the adjacent non-tumor tissue. Moreover, both the two miRNAs showed moderate diagnostic performance (hsa-miR-21: AUC = 0.75, sensitivity = 0.70, specificity = 0.78; hsa-miR-29hsa-miR-29: AUC = 0.73, sensitivity = 0.70, specificity = 0.68). In the follow-up research, we found that higher tissue hsa-miR-21 level was related to a lower overall survival rate, whereas higher tissue hsa-miR-29hsa-miR-29 level was associated with the higher overall survival rate. These results indicated that both hsa-miR-21 and hsa-miR-29 had the potential to be the biomarkers for GC prognosis. Conclusion: In summary, we verified the diagnostic and prognostic value of tissue hsa-miR-21hsa-miR-21 and hsa-miR-29 in GC. Both of them can be potentially applied as novel and non-invasive biomarkers for GC.

Purpose: To verify the feasibility of using anterior segment optical coherence tomography (AS-OCT) to measure the lower lid margin thickness (LLMT) from posterior lash line to the mucocutaneous junction. Methods: This was a prospective, single-center, observational study. Fifty-six volunteers between 20 and 79 years old with normal healthy eyes were included in this study. Using AS-OCT to measure the LLMT at the middle position was separately performed by two operators under the same conditions. Results: The mean age of 56 subjects (24 males and 32 females) was 45.4 ± 15.7 years. The LLMT measured by AS-OCT between two operators was 0.86 ± 0.23 mm and 0.85 ± 0.22 mm, respectively. The reliability and repeatability between two operators were evaluated by intraclass correlation coefficient (ICC = 0.97). Based on one operator’s measurements, the LLMT was 0.70 ± 0.10 mm at ages 20–29, 0.68 ± 0.09 mm at ages 30–39, 0.94 ± 0.12 mm at ages 40–49, 0.93 ± 0.20 mm at ages 50–59, 1.03 ± 0.15 mm at ages 60–69, and 1.24 ± 0.19 mm at ages 70–79, which indicated a significant positive correlation with age (r_s = 0.74, p < 0.001). In addition, there was a significant difference in the LLMT between genders (0.94 ± 0.26 vs. 0.80 ± 0.19 mm, p = 0.03). Conclusions: A good agreement between two operators indicated that it seemed to be feasible to use AS-OCT to measure the LLMT. Additionally, we found that the LLMT appeared to be closely related to age and gender.