Acknowledgements: None. months of uninterrupted radiation oncology clinical operation through the worst of the Wuhan outbreak, no known COVID-19 infection occurred at our radiotherapy center to our patients or employees. This report may provide valuable information for other radiation oncology departments during this unprecedented public health crisis.

The epidemic of coronavirus disease 2019 (COVID-19) challenges the prevention and protection of the cancer patients and the staff in the department of radiation oncology. Methods: At the Hubei Cancer Hospital, we organized an emergency infection control team to lead special efforts to combat COVID-19 during this challenging time. Results: Radiation therapy treatments were resumed on January 30th and have never stopped again at the hospital regardless of the circumstances of the ongoing outbreak. Between January 30th and the time of the writing, we have treated over 100 radiation therapy patients, with no incidence of on-site COVID-19 transmission between patients and health care workers in the duration. Conclusions: Our experience will help guide the practice in other regions that are or might be facing outbreaks of this disease.

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Aim: Gut microbiota are involved in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). Silybin (Sil), a naturally occurring hepatoprotective agent, is widely used for treating NAFLD. Whether Sil affects gut microbiota during its actions in treating NAFLD is unknown. We aimed to examine the effect of Sil on intestinal flora dysbiosis induced by a high-fat diet (HFD).Methods: After 10 weeks of feeding normal chow diet or HFD, mice were given a daily gavage for 8 weeks. Cecal contents were harvested for study of short-chain fatty acids, bile acids, and gut microbiota alteration.Results: Sil showed protective effects against dietary-induced obesity and liver steatosis; accordingly, gut microbiota composition changed. At the phylum level, compared with the HFD group, mice in the Sil-treated group had significantly lower levels of Firmicutes, and the ratio of Firmicutes-to-Bacteroidetes was lower (P < 0.05). At the genus level, the Sil-treated group have significantly lower levels of Lachnoclostridium, Lachnospiraceae_UCG-006, and Mollicutes_RF9, which were reported to be potentially related to diet-induced obesity, and increased levels of Blautia (P < 0.05), Akkermansia (P < 0.05), and Bacteroides (P < 0.05), which are known to have a beneficial effect on improving NAFLD. Sil also showed an inhibitory effect on well-known beneficial bacteria, such as Alloprevotella and Lactobacillus. Furthermore, the production of acetate, propionate, and butyrate increased, whereas the generation of formate and conversion of cytotoxic secondary metabolites (lithocholic acid and deoxy-cholic acid) decreased in mice treated with Sil.Conclusions: Sil might have beneficial effects on ameliorating NAFLD and mediating HFD-induced change of gut microbiota composition, followed by major changes in secondary metabolites, such as short-chain fatty acids and bile acids.