101 women; median age was 47•5 years (range 7-90). The most common symptoms at onset of illness were fever (193 [84%] patients), cough (159 [69%] patients), and sputum production (98 [43%] patients). Diarrhoea was observed in 49 (21%) patients. Patients with diarrhoea were older and were more likely to have comorbidities than patients without diarrhoea (table). A greater proportion of patients admitted to hospital had diarrhoea as the outbreak progressed: nine (43%) of 21 patients admitted between Feb 12 and March 6, 2020, had diarrhoea versus 40 (19%) of 209 patients admitted between Jan 19 and Feb 11, 2020.More patients with diarrhoea showed severe symptoms of pneumonia hospitals in Guangdong province, two in Hubei province, and ten in Jiangxi province) between Jan 19, 2020, and March 6, 2020. Most patients were admitted because of fever, cough, dyspnoea, and chest CT findings consistent with COVID-19 pneumonia. Diagnosis of COVID-19 was based on positive SARS-CoV-2 RNA tests. Two patients with pre-existing digestive diseases were excluded from our analysis. The analysis was approved by the institutional review boards of Sun Yat-sen University and the participating hospitals. Full details of the methods used are in the appendix (p 1).The clinical and demographic characteristics of the 230 patients analysed are shown in the appendix (p 2). There were 129 men and

Inflammasomes, multiprotein complex induced by harmful factors in the body, play a crucial role in innate immunity. Activation of inflammasomes lead to the activation of casepase-1 and then the secretion of inflammatory cytokines, including IL-1β and IL-18, subsequently leading to a type of cell death called pyroptosis. There are two types of signaling pathways involved in the process of inflammasome activation: the canonical and the non-canonical signaling pathway. The canonical signaling pathway is mainly dependent on casepase-1; the non-canonical signal pathway, which was recently discovered, is mainly dependent on caspase-11, but is also meditated by caspase-4, caspase-5, and caspase-8. Kidney inflammation is basically associated with inflammatory factor exudation and inflammatory cell infiltration. Several studies have showed that inflammasomes are closely related to kidney diseases, especially the NOD-, LRR-and pyrin domain-containing 3 (NLRP3) inflammasome, which play a role in regulating kidney inflammation and fibrosis. In this review, we focus on the relationship between inflammasomes and kidney diseases, especially the role of the NLRP3 inflammasome in different kinds of kidney disease via both canonical and non-canonical signal pathways.

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Background Epidemiological and clinical features of patients with COVID‐19 have been reported, but none of them focused on medical staff, and few predictors of the duration of viral shedding have been reported. It is urgent to help healthcare workers prevent and recover quickly from the coronavirus disease 2019 (COVID‐19). Methods We enrolled 140 medical workers with COVID‐19 in Wuhan. Epidemiological, demographic, clinical, laboratory, radiological treatment and clinical outcome data were collected, and predictors of the duration of viral shedding were explored through multivariable linear regression analysis. Results The medical staff with COVID‐19 presented mild clinical symptoms and showed a low frequency of abnormal laboratory indicators. All the medical staff were cured and discharged, of whom 96 (68.6%) were female, 39 (27.9%) had underlying diseases, the median age was 36.0 years, and 104 (74.3%) were infected whilst working in hospital. The median duration of viral shedding was 25.0 days (IQR:20.0–30.0). Multivariable linear regression analysis showed reducing viral shedding duration was associated with receiving recombinant human interferon alpha (rIFN‐α) treatment, whilst the prolonged duration of viral shedding correlated with the use of glucocorticoid treatment, the durations from the first symptom to hospital admission and the improvement in chest computed tomography (CT) evidence. Moreover, infected healthcare workers with lymphocytes less than 1.1 × 109/L on admission had prolonged viral shedding. Conclusion Medical staff with timely medical interventions show milder clinical features. Glucocorticoid treatment and lymphocytes less than 1.1 × 109/L are associated with prolonged viral shedding. Early admission and rIFN‐α treatment help shorten the duration of viral shedding.

Aim: Coronavirus disease 2019 (COVID-19) has been associated with increased mortality and morbidity from thromboembolism, especially venous thromboembolism. There are more limited data for systemic thromboembolism. The present study aimed to investigate the prevalence of systemic and venous thromboembolism as well as major bleeding and mortality in relation to underlying risk factors and the impact of anticoagulation use in hospitalized patients with COVID-19. Methods and results: Patients with COVID-19 admitted to Union Hospital, Wuhan, Hubei, China between January 08, 2020 and April 7, 2020 were enrolled in this retrospective study. Cox proportional hazard models were utilized to determine associated risk factors for clinical events, adjusting for the severity of COVID-19 infection, drug therapies, comorbidities, surgery, and use of antithrombotic drugs. There were 1125 patients (49.9% male; mean age 58 years (standard deviation, SD, 15 years)) with a mean follow-up of 21 (SD 13) days. Approximately 25 (30%) patients with thromboembolism also suffered bleeding events. Age was an independent risk factor for thromboembolism, bleeding events, and death (all p<0.05). After adjusting for the severity of COVID-19 infection, comorbidities, surgery, antiviral drugs, immunomodulators, Chinese herbs, and antithrombotic drugs, low lymphocyte counts (hazard ratio, HR, 95% confidence interval (CI), 1.03, 1.01-1.05, p=0.01) and surgery (HR 2.80, 1.08-7.29, p=0.03) independently predicted the risk for major bleeding, whereas liver dysfunction (HR 4.13, 1.30-13.1, p=0.02) was an independent risk factor for patients with both thromboembolism and bleeding events. Conclusions: Patients with COVID-19 were at high risk for thromboembolic and bleeding events as well as mortality. The use of anticoagulants, especially parenteral anticoagulants, significantly reduced the risk for composite outcomes of thromboembolism, bleeding events, and death. The presence of AF was a contributor to systemic thromboembolism in COVID-19 patients.

We propose a blind and fast modulation format identification (MFI) enabled by the digital frequency-offset (FO) loading technique for hitless coherent transceiver. Since modulation format information is encoded to the FO distribution during digital signal processing (DSP) at the transmitter side (Tx), we can use the fast Fourier transformation based FO estimation (FFT-FOE) method to obtain the FO distribution of individual data block after constant modulus algorithm (CMA) pre-equalization at the receiver side, in order to realize non-data-aided (NDA) and fast MFI. The obtained FO can be also used for subsequent FO compensation (FOC), without additional complexity. We numerically investigate and experimentally verify the proposed MFI with high accuracy and fast format switching among 28 Gbaud dual-polarization (DP)-4/8/16/64QAM, time domain hybrid-4/16QAM, and set partitioning (SP)-128QAM. In particular, the proposed MFI brings no performance degradation, in term of tolerance of amplified spontaneous emission (ASE) noise, laser linewidth, and fiber nonlinearity. Finally, a hitless coherent transceiver enabled by the proposed MFI with switching-block of only 2048 symbols is demonstrated over 1500 km standard single mode fiber (SSMF) transmission.

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BackgroundFemale sex workers (FSW) are a population that are at high risk for HIV infection, and their HIV/AIDS knowledge levels and sexual behaviors are of concern. This study describes changes in HIV prevalence and factors associated among female sex workers in Guigang City, Guangxi, one of the highest HIV prevalence areas in China.MethodsData were derived from an annual cross-sectional venue-based survey, 2008 to 2015, in the form of sentinel surveillance. The participants were recruited using cluster sampling. FSW aged 16 years and above who completed a questionnaire and HIV testing. Both descriptive and multi-level analyses were used to explore factors associated with changes in HIV prevalence.ResultsSeven thousand four hundred ninety-six FSW were recruited in this study. HIV prevalence among FSW in Guigang City fell into two periods, one with an increasing trend (2008–2011) and one with a decline (2012–2015). Differences between these time periods included age, relationship status, HIV knowledge, consistent condom use, lifetime illicit drug use, history of sexually transmitted infection in the past year, HIV testing, receipt of a condom distribution and education program or HIV counseling and testing, and peer education services.ConclusionsSince 2012, a reduction in HIV prevalence among FSW in Guigang City has been observed. The decline of HIV prevalence was associated with coinciding changes in demographic characteristics of FSW, improvement of HIV knowledge and safer sexual behaviors, and a program that promotes condom use, HIV counseling & testing, and peer education.