An outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that started in Wuhan, China, at the end of 2019 has become a global pandemic. Both SARS-CoV-2 and SARS-CoV enter host cells via the angiotensin-converting enzyme 2 (ACE2) receptor, which is expressed in various human organs. We have reviewed previously published studies on SARS and recent studies on SARS-CoV-2 infection, named coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO), confirming that many other organs besides the lungs are vulnerable to the virus. ACE2 catalyzes angiotensin II conversion to angiotensin-(1–7), and the ACE2/angiotensin-(1–7)/MAS axis counteracts the negative effects of the renin-angiotensin system (RAS), which plays important roles in maintaining the physiological and pathophysiological balance of the body. In addition to the direct viral effects and inflammatory and immune factors associated with COVID-19 pathogenesis, ACE2 downregulation and the imbalance between the RAS and ACE2/angiotensin-(1–7)/MAS after infection may also contribute to multiple organ injury in COVID-19. The SARS-CoV-2 spike glycoprotein, which binds to ACE2, is a potential target for developing specific drugs, antibodies, and vaccines. Restoring the balance between the RAS and ACE2/angiotensin-(1–7)/MAS may help attenuate organ injuries.
Graphical abstract
SARS-CoV-2 enters lung cells via the ACE2 receptor. The cell-free and macrophage-phagocytosed virus can spread to other organs and infect ACE2-expressing cells at local sites, causing multi-organ injury.
Our findings indicate that the use of a simple, low-cost communication strategy for patient care is associated with improvements in clinician and carer experience with potential implications for patient safety. Minimally, TOP 5 represents 'good practice' with a low risk of harm for patients.
A microfabricated high-throughput cell electrofusion chip with 1,368 pairs of high aspect ratio silicon microelectrodes is presented. These microelectrodes, which were distributed in six individual microscale cell-fusion chambers, were covered with titanium and gold thin film to improve their electric conductivity as well as surface hydrophobility. Six chambers having different electrode distances make the chip highly suitable for fusing cells with different sizes. A microfluidic platform was set up for flowing control, cell manipulation and also experimental observation. Cells for electrofusion were first aligned at the prearranged locations by the dielectrophoretic force between two counter-electrodes, which benefits the traverse of electric pulse through the cell-cell contacting point for electroporation. Several on-chip cell electrofusion experiments have been carried out on different kinds of animal cells and plant protoplasts. Compared with conventional electrofusion methods, higher fusion efficiency was achieved on this device for precisely forming micropores on the proximate membranes of two contacting cells, and high throughput was also obtained due to the use of a large number of microelectrodes for cell manipulation and fusion. Moreover, a much lower power supply was required for the shorter distance between two counter-electrodes.
The diagnostic performance of 64-detector CTA did not improve much compared with 16-detector CTA for detecting SIAs, especially for very small aneurysms. VR-RDSA is still necessary for patients with a history of subarachnoid hemorrhage if the CTA findings are negative.
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