关键词： COVID-19   inactivated vaccine   replication-defective viral vectors vaccine   vaccine immunogenicity   hemodialysis  

摘要： Background: Vaccines that prevent SARS-CoV-2 infection are considered the most promising approach to modulating the pandemic. There is scarce evidence on the efficacy and safety of different vaccine prime-boost combinations in MHD patients since most clinical trials have used homologous mRNA vaccine regimens. Methods: This prospective observational study assessed the immunogenicity and safety of homologous CoronaVac((R)) (SV-SV), ChAdOx1 nCoV-19 (AZD1222) (AZ-AZ), and the heterologous prime-boost of SV-AZ, among MHD patients. Results: A total of 130 MHD participants were recruited. On day 28, after the second dose, seroconversion results of the surrogate virus neutralization test were not different between vaccine regimens. The magnitude of the receptor-binding domain-specific IgG was highest among the SV-AZ. Different vaccine regimens had a distinct impact on seroconversion, for which the heterologous vaccine regimen demonstrated a higher probability of seroconversion (OR 10.12;p = 0.020, and OR 1.81;p = 0.437 for SV-AZ vs. SV-SV, and SV-AZ vs. AZ-AZ, respectively). There were no serious adverse events reported in any of the vaccine groups. Conclusions: Immunization with SV-SV, AZ-AZ, and SV-AZ could generate humoral immunity without any serious adverse events among MHD patients. Using the heterologous vaccine prime-boost seemed to be more efficacious in terms of inducing immunogenicity.

关键词： vaccine   antibodies   anti-viral immunity   vaccination  

摘要： Total spike-specific IgG antibody responses after two doses of ChAdOx1 nCov-19 (AZD1222) persist well for 1 year. Modelling suggesting titres are well maintained for at least 2 years. Therefore, two doses of ChAdOx1 nCov-19 will likely have a positive impact against serious disease and hospitalization. The trajectory of immune responses following the primary dose series determines the decline in vaccine effectiveness over time. Here we report on maintenance of immune responses during the year following a two-dose schedule of ChAdOx1 nCoV-19/AZD1222, in the absence of infection, and also explore the decay of antibody after infection. Total spike-specific IgG antibody titres were lower with two low doses of ChAdOx1 nCoV-19 vaccines (two low doses) (P = 0.0006) than with 2 standard doses (the approved dose) or low dose followed by standard dose vaccines regimens. Longer intervals between first and second doses resulted in higher antibody titres (P < 0.0001);however, there was no evidence that the trajectory of antibody decay differed by interval or by vaccine dose, and the decay of IgG antibody titres followed a similar trajectory after a third dose of ChAdOx1 nCoV-19. Trends in post-infection samples were similar with an initial rapid decay in responses but good persistence of measurable responses thereafter. Extrapolation of antibody data, following two doses of ChAdOx1 nCov-19, demonstrates a slow rate of antibody decay with modelling, suggesting that antibody titres are well maintained for at least 2 years. These data suggest a persistent immune response after two doses of ChAdOx1 nCov-19 which will likely have a positive impact against serious disease and hospitalization.

关键词： IoT   Internet of Things   Healthcare technology   Communication sensor technology adoption  

摘要： A serious effect on people's life, social communication, and surely on medical staff who were forced to monitor their patients' status remotely relying on the available technologies to avoid potential infections and as a result reducing the workload in hospitals. this research tried to investigate the readiness level of healthcare professionals in both public and private Iraqi hospitals to utilize IoT technology in detecting, tracking, and treating 2019-nCoV pandemic, as well as reducing the direct contact between medical staff and patients with other diseases that can be monitored remotely.A cross-sectional descriptive research via online distributed questionnaire, the sample consisted of 113 physicians and 99 pharmacists from three public and two private hospitals who randomly selected by simple random sampling. The 212 responses were deeply analyzed descriptively using frequencies, percentages, means, and standard *** results confirmed that the IoT technology can facilitate patient follow-up by enabling rapid communication between medical staff and patient relatives. Additionally, remote monitoring techniques can measure and treat 2019-nCoV, reducing direct contact by decreasing the workload in healthcare industries. This paper adds to the current healthcare technology literature in Iraq and middle east region an evidence of the readiness to implement IoT technology as an essential technique. Practically, it is strongly advised that healthcare policymakers should implement IoT technology nationwide especially when it comes to safe their employees' *** medical staff are fully ready to adopt IoT technology as they became more digital minded after the 2019-nCoV crises and surely their knowledge and technical skills will be improved spontaneously based on diffusion of innovation perspective.

关键词： 新型冠状病毒   轻型   普通型   皖北地区   宣肺清化法   三因制宜  

摘要： 目的：观察宣肺清热化湿法对40例皖北地区新型冠状病毒感染轻型及普通型患者的临床疗效。方法：纳入安徽省宿州市第三人民医院救治的新型冠状病毒感染轻型及普通型患者40例，所有患者均在《新型冠状病毒肺炎诊疗方案（试行第九版）》（以下称《诊疗方案》）基础上，以传统中医“三因治宜”理论为指导，根据皖北地区特点，以宣肺清热化湿为法，施以“新清肺排毒汤”为基本方进行特殊调配。比较和分析治疗前后各项临床指标，采用SPSS 26.0统计软件对各指标数据进行统计分析。结果：所有患者经过治疗，病毒核酸检测均转阴后出院，轻型平均住院时间（9.81±2.90）d，连续两次核酸转阴时间（11.11±4.11）d，总有效率85.19%。普通型平均住院时间（10.54±2.54）d，连续两次核酸转阴时间（10.23±2.74）d，总有效率84.62%。治疗后白细胞计数升高、淋巴细胞百分比升高、C反应蛋白计数降低，前后比较差异有统计学意义。治疗过程中密切关注肝肾功能，未发现造成肝肾损伤者。结论：针对不同地域，不同气候，不同体质人群感染新冠病毒反应的不同特性，在《诊疗方案》的基础上制定和更新防治新策略和新方法，充分发挥中医辨证施治、个性灵活的优势，可以更好的应对新冠病毒不断变异产生的新变化和新特征。

关键词： Caputo derivative   equilibrium points   fractional mathematical model   stability analysis  

摘要： Since December 2019, the whole world has been facing the big challenge of Covid-19 or 2019-nCoV. Some nations have controlled or are controlling the spread of this virus strongly, but some countries are in big trouble because of their poor control strategies. Nowadays, mathematical models are very effective tools to simulate outbreaks of this virus. In this research, we analyze a fractional-order model of Covid-19 in terms of the Caputo fractional derivative. First, we generalize an integer-order model to a fractional sense, and then, we check the stability of equilibrium points. To check the dynamics of Covid-19, we plot several graphs on the time scale of daily and monthly cases. The main goal of this content is to show the effectiveness of fractional-order models as compared to integer-order dynamics.

关键词： heterologous prime-boost   ChAdTS-S   ARCoV   intramuscular   intranasal   SARS-COV-2 variants   COVID-19  

摘要： The ongoing evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCoV) variants has been associated with the transmission and pathogenicity of COVID-19. Therefore, exploring the optimal immunisation strategy to improve the broad-spectrum cross-protection ability of COVID-19 vaccines is of great significance. Herein, we assessed different heterologous prime-boost strategies with chimpanzee adenovirus vector-based COVID-19 vaccines plus Wuhan-Hu-1 (WH-1) strain (AdW) and Beta variant (AdB) and mRNA-based COVID-19 vaccines plus WH-1 strain (ARW) and Omicron (B.1.1.529) variant (ARO) in 6-week-old female BALB/c mice. AdW and AdB were administered intramuscularly or intranasally, while ARW and ARO were administered intramuscularly. Intranasal or intramuscular vaccination with AdB followed by ARO booster exhibited the highest levels of cross-reactive IgG, pseudovirus-neutralising antibody (PNAb) responses, and angiotensin-converting enzyme-2 (ACE2)-binding inhibition rates against different 2019-nCoV variants among all vaccination groups. Moreover, intranasal AdB vaccination followed by ARO induced higher levels of IgA and neutralising antibody responses against live 2019-nCoV than intramuscular AdB vaccination followed by ARO. A single dose of AdB administered intranasally or intramuscularly induced broader cross-NAb responses than AdW. Th1-biased cellular immune response was induced in all vaccination groups. Intramuscular vaccination-only groups exhibited higher levels of Th1 cytokines than intranasal vaccination-only and intranasal vaccination-containing groups. However, no obvious differences were found in the levels of Th2 cytokines between the control and all vaccination groups. Our findings provide a basis for exploring vaccination strategies against different 2019-nCoV variants to achieve high broad-spectrum immune efficacy.

摘要： In the phase 3 trial of the AZD1222 (ChAdOx1 nCoV-19) vaccine conducted in the U.S., Chile, and Peru, anti-spike binding IgG concentration (spike IgG) and pseudovirus 50% neutralizing antibody titer (nAb ID50) measured four weeks after two doses were assessed as correlates of risk and protection against PCR-confirmed symptomatic SARS-CoV-2 infection (COVID-19). These analyses of SARS-CoV-2 negative participants were based on case-cohort sampling of vaccine recipients (33 COVID-19 cases by 4 months post dose two, 463 non-cases). The adjusted hazard ratio of COVID-19 was 0.32 (95% CI: 0.14, 0.76) per 10-fold increase in spike IgG concentration and 0.28 (0.10, 0.77) per 10-fold increase in nAb ID50 titer. At nAb ID50 below the limit of detection (< 2.612 IU50/ml), 10, 100, and 270 IU50/ml, vaccine efficacy was -5.8% (-651%, 75.6%), 64.9% (56.4%, 86.9%), 90.0% (55.8%, 97.6%) and 94.2% (69.4%, 99.1%). These findings provide further evidence towards defining an immune marker correlate of protection to help guide regulatory/approval decisions for COVID-19 vaccines.

关键词： 新型冠状病毒感染   群体免疫   新冠疫苗   治未病   中医药   防治  

摘要： 自2019年12月新型冠状病毒感染暴发以来,疫情迅速蔓延至世界各地,呈全球大流行态势,严重威胁人类生命健康,成为全球性的重大公共卫生事件.在早期无特效药物和疫苗的情况下,除了给予对症、支持治疗外,群体免疫和中医药治未病成为可供选择的防疫策略.通过厘清群体免疫的概念及分类,回顾3年来人工群体免疫及中医药治未病在疫情防控中的应用情况,指出当前疫苗时代实现人工群体免疫所面临的挑战及对策,总结中医药治未病抗疫经验成果,分析比较二者的异同点,最终认为中医药治未病全方位指导疫病的预防、治疗及康复工作,可以有效弥补人工群体免疫的不足.从人工群体免疫与中医药治未病两方面共同发力,能够助力突发传染病应急防控体系建设,为后续抗疫工作及应对未来可能出现的新疫情提供有益借鉴和储备.