Search

Objectives: This study aims to determine the protection provided by Shenfu injection (a traditional Chinese medicine) against development of organ dysfunction in critically ill patients with coronavirus disease 2019 (COVID-19).Trial Design: This study is a multicenter, randomized, controlled, open-label, two-arm ratio 1:1, parallel group clinical trial.Participants: The patients, who are aged from 18 to 75 years old, with a confirmed or suspected diagnosis of severe or critical COVID-19, will be consecutively recruited in the study, according to the guideline on diagnosis and treatment of COVID-19 (the 7th version) issued by National Health Commission of the People's Republic of China. Exclusion criteria include pregnant and breastfeeding women, atopy or allergies to Shenfu Injection (SFI), severe underlying disease (malignant tumor with multiple metastases, uncontrolled hemopathy, cachexia, severe malnutrition, HIV), active bleeding, obstructive pneumonia caused by lung tumor, severe pulmonary interstitial fibrosis, alveolar proteinosis and allergic alveolitis, continuous use of immunosuppressive drugs in last 6 months, organ transplantation, expected death within 48 hours, the patients considered unsuitable for this study by researchers. The study is conducted in 11 ICUs of designated hospitals for COVID-19, located in 5 cities of China.Intervention and Comparator: The enrolled patients will randomly receive 100 ml SFI (study group) or identical volume of saline (control group) twice a day for seven consecutive days. Patients in the both groups will be given usual care and the necessary supportive therapies as recommended by the latest edition of the management guidelines for COVID-19 (the 7th version so far).Main Outcomes: The primary endpoint is a composite of newly developed or exacerbated organ dysfunction. This is defined as an increase in the sequential organ failure assessment (SOFA) score of two or more, indicating sepsis and involvement of at least one organ. The SOFA score will be measured for the 14 days after enrolment from the baseline (the score at randomization). The secondary endpoints are shown below: • SOFA score in total • Pneumonia severity index score • Dosage of vasoactive drugs • Ventilation free days within 28 days • Length of stay in intensive care unit • Total hospital costs to treat the patient • 28-day mortality • The incidence of adverse drug events related to SFI RANDOMISATION: The block randomization codes were generated by SAS V.9.1 for allocation of participants in this study. The ratio of random distribution is 1:1. The sealed envelope method is used for allocation concealment.Blinding (masking): The patients and statistical personnel analyzing study data are both blinded. The blinding of group assignment is not adopted for the medical staff.Numbers To Be Randomised (sample Size): This study is expected to recruit 300 patients with COVID-19, (150 in each group).Trial Status: Protocol version 2.0, February 15, 2020. Patient recruitment started on February 25, and will end on August 31, 2020.Trial Registration: Chinese Clinical Trial Registry: ChiCTR2000030043. Registered February 21, 2020, http://www.chictr.org.cn/showprojen.aspx?proj=49866 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol. [ABSTRACT FROM AUTHOR]

Thirty-two surface sediment samples, collected from the Taiwan Strait (TWS), were investigated for the occurrence, composition profile, and spatial distribution of polycyclic aromatic hydrocarbons (PAHs) and oxygenated PAHs (OPAHs). PAHs were ubiquity in the TWS with a total concentration (∑PAHs, excluding naphthalene due to its high volatility) ranging from 17.8-213 ng g -1 . Benzo[b] fluoranthene, fluoranthene, phenanthrene, and pyrene were the predominant PAHs. Also, eight OPAHs were detected, having a cumulative concentration range (∑OPAHs) of 10.5-118 ng g -1 , predominated by anthraquinone and 6H-Benzo[c,d]Pyren-6-one. Higher concentrations of ∑PAHs and ∑OPAHs were detected at sampling sites adjacent to the mainland and in the northwest part of the TWS. The results suggested important continental input, and particle sedimentation under the specific hydrodynamic conditions of the region. Based on the measured concentrations and sediment quality guidelines, PAHs had a limited ecological impact on the area., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Concentrations and spatial distributions of organophosphate esters (OPEs) in marine sediment samples in the western Taiwan Strait were investigated and analyzed for the first time. The total OPE concentration (∑OPE) in sediments was in the range of 5263-34,232 pg/g (dry weight), with an average value of 12,796 pg/g. Generally, there was a higher abundance of non-halogenated OPEs than halogenated OPEs and aryl OPEs, with tributyl phosphate, tris (2-ethylhexyl) phosphate, and tri-(1-chloro-2-propyl) phosphate being the main components. The ∑OPE concentrations in the western coastal and northern sampling sites were relatively high. The results indicated that OPEs in the study region originated mainly from terrestrial river inputs and local emission sources, as well as exogenous influxes by ocean currents., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)