Corticosteroid therapy and delayed NAI treatment were associated with prolonged A(H7N9) RNA shedding. NAI combination therapy and double-dose oseltamivir treatment were not associated with a reduced A(H7N9) shedding duration as compared to standard-dose oseltamivir.

Objectives: To evaluate the prevalence of cardiac injury and its association with mortality in hospitalized patients infected with avian influenza A (H7N9) virus. Design: Retrospective cohort study. Setting: A total of 133 hospitals in 17 provinces, autonomous regions, and municipalities of mainland China that admitted influenza A (H7N9) virus–infected patients between January 22, 2015, and June 16, 2017. Patients: A total of 321 patients with influenza A (H7N9) virus infection were included in the final analysis. Interventions: None. Measurements and Main Results: Demographics and clinical characteristics were collected from medical records. Cardiac injury was defined according to cardiac biomarkers, electrocardiography, or echocardiography. Among the 321 patients, 203 (63.2%) showed evidence of cardiac injury. Compared with the uninjured group, the cardiac injury group had lower Pao 2/Fio 2 (median, 102.0 vs 148.4 mm Hg; p < 0.001), higher Acute Physiology and Chronic Health Evaluation II score (median, 17.0 vs 11.0; p < 0.001), longer stay in the ICU (10.0 vs 9.0 d; p = 0.029), and higher proportion of in-hospital death (64.0% vs 20.3%; p < 0.001). The proportion of virus clearance until discharge or death was lower in the cardiac injury group than in the uninjured group (58.6% vs 86.4%; p < 0.001). Multivariable-adjusted Cox proportional hazards regression analysis showed that cardiac injury was associated with higher mortality (hazards ratio, 2.06; 95% CI, 1.31–3.24) during hospitalization. Conclusions: Cardiac injury is a frequent condition among hospitalized patients infected with influenza A (H7N9) virus, and it is associated with higher risk of mortality.

About 19 cultivars, which had originated from backcrosses between F1 LA (Longiflorum · Asiatic) hybrids (2n = 2x = 24) as female parents and Asiatic cultivars as male parents (2n = 2x = 24), were analyzed with genomic in situ hybridization. 17 of them were triploid (2n = 3x = 36), and two aneuploid (2n = 3x + 1 = 37). The triploid cultivars had resulted from the functional 2n eggs produced by the female parents (F1 hybrids) because first division restitution (FDR) occurred in their meiosis during megasporogenesis. Similarly, the aneuploid cultivars had originated from viable 2n + 1 eggs. The extra chromosome in cultivar 041555 or 041572 resulted from one univalent or one half-bivalent which might have lagged behind when the sister chromatids of the other univalents and half-bivalents were segregating during the FDR process in their LA hybrid parents, respectively. That the majority of cultivars possessed recombinant chromosomes showed that intergenomic recombination might play an important role during the selection of the cultivars directly from BC1 progenies. That five cultivars of the 15 recombinant cultivars only had reciprocal recombinant chromosomes and 10 cultivars had non-reciprocal recombinant chromosomes indicates that the latter are more important. Because 9 of the 10 non-reciprocal recombinant cultivars possessed substitutions for recombinant segments, it also indicated that such substitutions could be an important source for the genetic variation in the sexual triploid BC1 progenies. In such cases there was a potential for the expression of the recessive genes of the backcross parent in a nulliplex (aaa) condition in the substituted segments. Genetic variation resulting from such nulliplex loci might have played a role in the selection of some of the cultivars.

The clinical data reported for the first time that UAL had manageable toxicities with MTD of 98 mg/m(2). The DLT were hepatotoxicity and diarrhea. Meanwhile, UAL had a linear pharmacokinetic profile. The registration number of this trial is ChiCTR-ONC-12002385.