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Background The outbreak of coronavirus disease 2019 (COVID-19) has spread worldwide and continues to threaten peoples' health as well as put pressure on the accessibility of medical systems. Early prediction of survival of hospitalized patients will help in the clinical management of COVID-19, but a prediction model that is reliable and valid is still lacking. Methods We retrospectively enrolled 628 confirmed cases of COVID-19 using positive RT-PCR tests for SARS-CoV-2 in Tongji Hospital, Wuhan, China. These patients were randomly grouped into a training (60%) and a validation (40%) cohort. In the training cohort, LASSO regression analysis and multivariate Cox regression analysis were utilized to identify prognostic factors for in-hospital survival of patients with COVID-19. A nomogram based on the 3 variables was built for clinical use. AUCs, concordance indexes (C-index), and calibration curves were used to evaluate the efficiency of the nomogram in both training and validation cohorts. Results Hypertension, higher neutrophil-to-lymphocyte ratio, and increased NT-proBNP values were found to be significantly associated with poorer prognosis in hospitalized patients with COVID-19. The 3 predictors were further used to build a prediction nomogram. The C-indexes of the nomogram in the training and validation cohorts were 0.901 and 0.892, respectively. The AUC in the training cohort was 0.922 for 14-day and 0.919 for 21-day probability of in-hospital survival, while in the validation cohort this was 0.922 and 0.881, respectively. Moreover, the calibration curve for 14- and 21-day survival also showed high coherence between the predicted and actual probability of survival. Conclusions We built a predictive model and constructed a nomogram for predicting in-hospital survival of patients with COVID-19. This model has good performance and might be utilized clinically in management of COVID-19. [ABSTRACT FROM AUTHOR]

[Display omitted] • Discrete structural styles and mineral assemblages from auriferous quartz-ankerite-pyrite-arsenopyrite veins (Q2 and Q3) suggest superimposing gold mineralization at Tuanshanbei. • Comprehensive geological and H-O-Nd isotopic composition evidences are features that better adhere to metamorphic devolatilization models, indicating that the two-staged gold mineralization events both formed from metamorphic hydrothermal fluids originated from Cangxiyan Group metamorphic rocks. The Jiangnan Orogen is China's third largest gold province, and has undergone complex orogenic processes and tectonic overprinting, forming multistage magmatism, deformation, metamorphism, and gold mineralization. Our field studies indicate that the Tuanshanbei gold ores (central Jiangnan Orogen) have two generations of auriferous quartz-ankerite-pyrite-arsenopyrite veins (Q2 and Q3), with the latter containing abundant ankerite and base metal sulfides. Both Q2 and Q3 veins are younger than the emplacement of the Tuanshanbei granodiorite vein-ore host, and cut by post-ore diabase dikes. Q2 veins were likely associated with the Early Devonian near N-S-directed shortening, along sub-horizontal EW-/WNW-striking transpressive faults, whereas Q3 veins (hosting ∼ 70% of the total Au resource), were primarily hosted in the Early Triassic moderately-/steeply-dipping NW-striking tensional/transtensional faults and moderately-dipping NE-/NNE-striking transpressive faults, associated with NW-SE-directed shortening. Discrete structural styles and mineral assemblages from Q2 and Q3 suggest superimposing gold mineralization at Tuanshanbei. To determine the source(s) of the ore-forming aqueous-carbonic fluids, we conducted mineralogical and in-situ LA-(MC)-ICP-MS Nd-isotope analyses on two generations of hydrothermal monazite, and H-O isotope analyses on the quartz from Q2 and Q3 veins. The results suggest that the Tuanshanbei ore fluids have δD = −66.7 to −57.6‰ (Q2) and −66.8 to −66.2‰ (Q3), and calculated δ18O H2O = 4.5–9.7‰ (Q2) and 6.1–7.8‰ (Q3). The H-O isotopic data suggest a metamorphic and/or magmatic water source for the ore fluids. Hydrothermal monazite (coexists with native gold and auriferous sulfides) from Q2 and Q3 veins displays subtle heterogeneous BSE response along cracks and grain margin, suggesting alteration there. The 147Sm/144Nd and 143Nd/144Nd ratios of altered parts of Q2 and Q3 monazite grain are significantly perturbed via dissolution–recrystallization by the hydrothermal fluids, whereas their initial Nd isotope compositions seem to be less affected. The unaltered Q2 and Q3 monazite samples have similar initial εNd values (Q2: −8.07 to −7.36, Q3: −10.87 to −9.99) to the Neoproterozoic Cangxiyan Group greenschist–amphibolite-facies metamorphic rocks. Geological and structural evidence suggest both Q2 and Q3 ore-forming events were related to metamorphism, typical of orogenic gold deposits. We interpreted that various parts of the basement were metamorphosed (to near the greenschist-amphibolite-facies boundary) at different times, during which the gold-bearing metamorphic fluids produced migrated into the same structural conduits and deposited the ores there in two ore-forming episodes. [ABSTRACT FROM AUTHOR]

• A case for eliminating outburst danger in deep-and-thick coal seams is presented. • Feasibility of using a soft rock protective layer mining is discussed. • Safe strategy for stereoscopic gas extraction and utilization is established. • The effects of pressure relief gas extraction and utilization are investigated. Coal and gas outburst is one of the most harmful disasters in coal mine production. With the increase of mining depth, all the coal seams in the deep-and-thick coal seam group will be upgraded to outburst coal seams, resulting in no suitable first mining layer can be selected as the protective layer. In this case, coal and gas outburst disasters are more serious and outburst prevention and control is more difficult. In order to alleviate the gas disaster and eliminate the risk of gas outburst, a safe strategy was proposed in this study. In this strategy, a suitable soft rock layer adjacent to deep-and-thick coal seams in the Luling coal mine of Huaibei coalfield was selected as the first protective mining layer after safety, economic and technical feasibility argument. Meanwhile, the stereoscopic gas extraction and utilization system safety engineering was established. The effect in the mining process practice of the soft rock protective layer was investigated and verified. Practice shows that this safe strategy can effectively reduce the outburst risk of strong outburst deep-and-thick coal seams and a large amount of pressure relief gas can be extracted and utilized. It can provide a new safety idea for efficient exploitation of coal and gas resources in deep-and-thick coal seams in China. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness and safety of Chinese medicine (CM) in the treatment of coronavirus disease 2019 (COVID-19) in China., Methods: A multi-center retrospective cohort study was carried out, with cumulative CM treatment period of ⩾3 days during hospitalization as exposure. Data came from consecutive inpatients from December 19, 2019 to May 16, 2020 in 4 medical centers in Wuhan, China. After data extraction, verification and cleaning, confounding factors were adjusted by inverse probability of treatment weighting (IPTW), and the Cox proportional hazards regression model was used for statistical analysis., Results: A total of 2,272 COVID-19 patients were included. There were 1,684 patients in the CM group and 588 patients in the control group. Compared with the control group, the hazard ratio (HR) for the deterioration rate in the CM group was 0.52 [95% confidence interval (CI): 0.41 to 0.64, P<0.001]. The results were consistent across patients of varying severity at admission, and the robustness of the results were confirmed by 3 sensitivity analyses. In addition, the HR for all-cause mortality in the CM group was 0.29 (95% CI: 0.19 to 0.44, P<0.001). Regarding of safety, the proportion of patients with abnormal liver function or renal function in the CM group was smaller., Conclusion: This real-world study indicates that the combination of a full-course CM therapy on the basic conventional treatment, may safely reduce the deterioration rate and all-cause mortality of COVID-19 patients. This result can provide the new evidence to support the current treatment of COVID-19. Additional prospective clinical trial is needed to evaluate the efficacy and safety of specific CM interventions. (Registration No. ChiCTR2200062917)., (© 2024. The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Prior to August 7, 2022, there had been no positive cases of novel coronavirus in Tibet for 920 consecutive days. However, with the first case of Omicron variant infection, the disease rapidly spread and was prevalent in Tibet for nearly 3 months, from August 7th to November 1st. With the spread of the epidemic, the local government responded quickly and established several mobile cabin hospitals to treat patients with mild and asymptomatic Omicron infection. However, the epidemiological and clinical characteristics of these patients are unknown., Methods: This is a retrospective study including a total of 14,264 mild and asymptomatic cases with Omicron infection in Tibet between August to October, 2022. The clinical data and epidemiological characteristics of COVID-19 cases admitted to Tibet mobile cabin hospitals were collected by using standardized forms from mobile cabin hospital database system, including demographic characteristics, onset symptoms, medication use, past medical history, hospitalization time, and discharge time. In terms of statistical analysis, multivariate Cox regression model was used to analyze the relationship between case characteristics and the length of stay in hospital., Results: Among 14,264 patients infected with Omicron, the average length of hospital stay was six (4-8, Interquartile range) days. Fifty percent of the patients were discharged by the 6th day, and 90% were discharged by the 10th day. Patients of all ages are generally susceptible to COVID-19, and there was no difference in discharge time, but the average length of hospital stay of Tibetan patients with COVID-19 was longer than that of Han patients. According to the statistics of clinical symptoms, sore throat (38.7%) and fever (19.4%) were the most common symptoms, while muscle pain (17.4%), cough (16.6%), and expectoration (13.2%) were also common. In addition, patients with chronic gastritis had significantly longer hospital stays., Conclusion: Based on the experience of Tibet mobile cabin hospitals and data analysis, we believe that patients of all ages are generally susceptible to Omicron. Compared with other novel coronavirus strains, Omicron infected patients had a shorter hospital stay, and treatment of symptoms is expected to shorten the time of nucleic acid negative conversion., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Shao, Li, Shang, Liu, Wang and Liu.)

Since the implementation of drug registration in China, the classification of Chinese medicine has greatly met the needs of public health and effectively guided the transformation, inheritance, and innovation of research achievements on traditional Chinese medicine(TCM). In the past 30 years, the development of new Chinese medicine has followed the registration transformation model of &quot; one prescription for single drug&quot;. This model refers to the R&D and registration system of modern drugs, and approximates to the &quot; law-abiding&quot; medication method in TCM clinic, while it rarely reflects the sequential therapy of syndrome differentiation and comprehensive treatment with multiple measures. In 2017, Opinions on Deepening the Reform of Review and Approval System and Encouraging the Innovation of Drugs and Medical Devices released by the General Office of the CPC Central Committee and the General Office of the State Council pointed out that it is necessary to &quot; establish and improve the registration and technical evaluation system in line with the characteristics of Chinese medicine, and handle the relationship between the traditional advantages of Chinese medicine and the requirements of modern drug research&quot;. Therefore, based on the development law and characteristics of TCM, clinical thinking should be highlighted in the current technical requirements and registration system of research and development of Chinese medicine. Based on the current situation of registration supervision of Chinese medicine and the modern drug research in China, the present study analyzed limitations and deficiency of &quot; one prescription for single drug&quot; in the research and development of Chinese medicine. Additionally, a new type of &quot; series prescriptions&quot; was proposed, which was consistent with clinical thinking and clinical reality. This study is expected to contribute to the independent innovation and high-quality development of the TCM industry.

Since narrative medicine was introduced in China, it has been widely used in medical education and clinical practice. The research on narrative medicine in China is especially characterized by its combination with traditional Chinese medicine(TCM). At present, the research on narrative medicine in China is still in the stage of small-scale practicing and theory advocating. Besides, there is also a lack of guidance on experimental design methodology for clinical application, which leads to few high-quality studies in this field. The present study reviewed the current high-quality research on narrative medicine to discuss the value and prospects of mixed methods research in narrative medicine. In addition, the common design, application procedures, and notes of mixed methods research were explained to provide references for the extensive applications of narrative medicine in the medical field, especially TCM clinical practice, education, and scientific research.

Objective: To delineate the characteristics and clinical significance of plasma inflammatory cytokines altered in COVID-19., Design: Retrospective, single-centre cohort study., Setting: Tongji Hospital in Wuhan, China., Participants: Among a cohort of 308 patients with a diagnosis of COVID-19, 138 patients died while 170 patients recovered and were discharged from the hospital. The data were collected until 27 February 2020., Primary and Secondary Outcome Measures: Clinical characteristics and laboratory findings were obtained from electronic medical records using data collection forms., Results: The percentage of patients with elevated interleukin 2 receptor (IL-2R), IL-6, IL-8, IL-10 and tumour necrosis factor (TNF) increased with severity of disease (p<0.0001 for all). IL-2R (p<0.0001), IL-6 (p<0.0001), IL-8 (p=0.0001), IL-10 (p<0.0001) and TNF (p<0.0001) were also twofold to 20-fold higher in patients who died compared with those who recovered. Also, IL-6 and IL-10 increased in both the progressive patient groups: moderate (p=0.0026) and severe (p<0.0001). In multivariate analysis, higher levels of IL-2R (OR 1.001, 95% CI 1.000 to 1.002, p=0.031) and IL-6 (OR 1.013, 95% CI 1.003 to 1.024, p=0.015) on admission were associated with increasing odds of in-hospital death, independent of other covariates, including severity of disease and lymphocyte count., Conclusion: Increased proinflammatory and anti-inflammatory cytokines, including IL-2R, IL-6, IL-8, TNF and IL-10, showed an obvious association with both COVID-19 severity and in-hospital mortality. Thus, our study indicates that cytokines are valuable in predicting the severity of COVID-19 and helps in distinguishing critically ill patients from the less affected ones., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

To investigate the clinical application of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for sepsis, in order to promote the follow-up revision and further promotion of the Guidelines. Copies of 500 application evaluation questionnaire and 500 copies of applicability evaluation questionnaire were given to the clinicians who had used this Guideline in China, both in a form of registered questionnaire, and a database was established by Excel 2016 for descriptive statistical analysis. Copies of 211 application evaluation questionnaire and 211 copies of applicability evaluation questionnaire were collected. We can conclude from the survey that we should adjust the whole content and structure on the basis of better evaluation of the present recommendation scheme, update the prescription selection and clinical evidence of the recommendation scheme, and put forward the improvement measures for the hindrance factors in the application of the Guideline. Furthermore, in order to promote the Guideline more clearly, we should strengthen the doctor-patient education, improve guidance quality and increase the publicity, providing basis for the implementation and promotion strategies of the Guideline., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)