In this paper, we prove the weighted Lorentz and weighted Orlicz estimates for the weak solutions to the higher order parabolic systems with the leading coefficients satisfying a small BMO norm condition. As a byproduct, we obtain the weighted estimates for the higher order elliptic systems.

Aim: Ultrasound-guided plane blocks are increasingly used in the multi-modal analgesic concept for reducing opioid consumption. The present study was conducted to compare the analgesic effect of intravenous nonsteroidal anti-inflammatory drugs (NSAIDs) and erector spinae plane (ESP) block in renal colic patients. Methods: In this prospective randomized study, 40 patients with renal colic pain were randomly assigned to into two groups; Group NSAID (n=20) received an intravenous infusion of 50 mg of dexketoprofen trometamol, Group ESP (n=20) received ultrasound-guided erector spinae plane block with 30 ml 0.25% bupivacaine at the T8 level. The pain severity of patients was assessed using the visual analog scale (VAS) at baseline, 5., 15., 30., 45. and 60. minutes after intervention. Opioid consumption, patient satisfaction and side effects were recorded. Results: In the ESP group, the VAS scores were significantly lower than the NSAID group at 5., 15., 30., 45. and 60. minutes after the procedure (P<0.001). Opioid consumption was significantly higher in the NSAID group compared with the ESP group (10/20 vs. 0/20, respectively; p<0.001). Patient satisfaction was significantly higher in the ESP group (p<0.001). Conclusions: ESP block can be an alternative, efficient, and safe method for the relief of acute renal colic pain.

Background. Nasopharyngeal carcinoma is a chemosensitive cancer characterized by prominent lymphocytic infiltration. However, recurrence remains a major challenge in treating this disease. Here, we examined the effects of idronoxil (IDX) on tumor-lymphocyte interactions. Methods The antitumor activity of cisplatin and/or IDX was tested in authentic EBV-positive NPC-derived cell lines (C666, C17 and NPC43). We analyzed 2D monolayer and 3D spheroids cocultures of NPC cell lines with immune cells to assess the infiltration, activation, phenotype and function of T cells toward human nasopharyngeal tumors in vitro. Flow cytometric and immunohistochemical analyses were carried out to evaluate infiltrating T cells in subcutaneous mice models. Results. Administration of low-dose of IDX (1-2 µM) not only sensitizes cancer cells to chemotherapy via apoptosis, but also promotes T cell proliferation and cytotoxicity. More importantly, combination treatment of IDX and cisplatin in cancer cells can enhance the expansion, trafficking and priming of CD4+, CD8+ and double-positive (DP) T cells. Mechanistically, we showed that the increase in migratory DP T cells was largely mediated by the CXCL10/type I interferon (IFN) axis, where IDX precipitates an elevation in IFNα levels and leads to CXCL10 induction. Additionally, IDX enhanced T-cell infiltration towards tumor spheroids with acquisition of increased tissue homing and functional abilities (attenuated CD62L and PD1 expression). Conclusions. Our findings underscore the potential of IDX to induce immunomodulatory responses, and in combination with conventional chemotherapies, enhance antitumor immunity.

The effect of different microstructures (granular bainite and martensite) on the low cycle fatigue (LCF) behavior of SA508-IV steel was investigated. The LCF tests were performed with the strain amplitudes of ±0.45% and ±0.6% at 300 °C, respectively. The experimental results showed that the stress concentration between M/A islands and bainitic ferrite matrix was prone to facilitate cracks initiation, which would cause more crack initiation points in granular bainite during the fatigue. The fraction of the high-angle grain boundaries (HAGBs) of granular bainite and martensite were 32.01% and 42.34%, respectively. The HAGBs could effectively hinder crack propagation. In addition, the separation of fatigue striations in the martensite structure was narrow compared to granular bainite structure under the same conditions, suggesting the crack propagation rate of martensite was slower. Finally, the fatigue live of martensite was much longer at the same strain amplitude, which was attributed to less crack initiation, more HAGBs, more fine carbides and less crack propagation rate.

The inhomogeneity of friction stir weld (FSW) joint of a 7085 Al-based alloy containing trace Sc was investigated by comparing the hardening phase morphology, grain structure, mechanical properties and fatigue crack growth (FCG) behavior in based metal (BM), heat-affected zone (HAZ) and weld nugget zone (WNZ). The results showed that microstructural evolution during FSW was remarkably affected by Sc addition. The recrystallization and growth of grains in BM and HAZ were restrained by coherent Al3(Sc,Zr) particles. In HAZ, partially dissolution and slight growth of precipitates resulted in softening but contributed to enhance the FCG resistance according to shear mechanism. In WNZ, high frictional heating and intense plastic deformation induced recrystallization and supersaturated solid solution which decomposed to form new reprecipitates, including many new GPII zones, ′ phases and some coarse equilibrium phases attached to grown incoherent Al3(Sc,Zr). Owing to combined influences of fine random orientated grain structure and reprecipitates, WNZ possessed the best fatigue endurance.

Understanding the genetic basis of tetrodotoxin (TTX) accumulation and resistance in animals could provide us significant insights into adaptive evolution in ecological communities. It has been reported that TTX resistance is possibly due to gene mutation in sodium channels. Eating sea snail Nassarius has caused serious people poisoning and death incident due to tetrodotoxin (TTX) accumulation in their body. Here we conducted transcriptome analysis for both toxic and non-toxic communities in two Nassarius species (Nassarius succinctus and Nassarius variciferus) to reveal their genetic patterns of TTX accumulation and resistance. For genetic expression, the cellular and metabolic process, and binding and catalytic activity accounted for the top classification categories for both species. The toxic communities generally produced more up-regulated genes than non-toxic communities. The mostly different expression genes among toxic and non-toxic communities mainly included heat shock protein 83-like, cytochrome c oxidase subunit, WAS protein family member 2, delta-aminolevulinic acid dehydratase, protein transport protein Sec24D isoform X2 and so on, some of which referred to detoxification. In mutation level, the sodium channel gene of N. succinctus had one amino acid “L” that is different from that of other animals. The transcriptome analysis of both toxic and nontoxic communities in two Nassarius species provided important genetic basis for adaptive evolution research of TTX accumulation and resistance.

Craniopharyngiomas are benign brain tumors that can often be cured surgically. A small fraction of unresectable tumors can progress and cause significant morbidity and even death. Unfortunately, WNT activated tumors lack clinically-validated targeted therapies in the pediatric population. Herein, we describe a patient with a multiply recurrent adamantinomatous craniopharyngioma with WNT activation. We utilized the MEK inhibitor binimetinib with noted interval decrease in tumor size. This demonstrates the possible utility of MEK inhibitors in WNT activated craniopharyngiomas.

We present our experience in the management of children with inflammatory myofibroblastic tumor, a total of five children with two presenting with superior mediastinal syndrome and three with abdominal disease. We treated all children with a low-dose oral chemotherapy protocol, including prednisolone, 6-mercaptopurine, methotrexate, and celecoxib. Children with the mediastinal disease showed complete response with chemotherapy alone, while the child with sigmoid polyp is in remission with the chemotherapy post complete excision. We commenced two children with abdominal disease on crizotinib due to local recurrence with an adequate response. Long term follow-up and prolonged therapy are essential to sustain remission.

Cardiac imaging is the cornerstone of defining the etiology, quantification and management of mitral regurgitation (MR). This continues to be even more so the case with emerging trans-catheter techniques to manage MR. Transthoracic echocardiography remains the first line imaging modality to assess MR but has limitations. Cardiac MRI(CMR) provides the advantages of quantitative non-visual estimation, 3D volumetric data, late gadolinium, T1 and extracellular volume measurements to comprehensively assess mitral valvular pathology, cardiac remodeling and the prognostic impact of therapies. This review describes the superiority, technical aspects and growing evidence behind CMR, and lays the roadmap for the future of CMR in MR.

Spiders are among the most diverse groups of arthropods remarkably known for extra oral digestion. The largest effort based on targeted 16S amplicon next generation sequencing was carried out to decipher the inter subfamily comparison of gut bacterial diversity in spiders and their functional relationship. Twelve spider species belonging to three subfamilies, Araneinae (8), Argiopinae (2) and Gasteracanthinae (2) of family Araneidae have been studied. Analysis revealed the presence of 22 phyla, 145 families, and 364 genera of microbes in the gut microbiome, with Proteobacteria as the highest abundant Phylum. Moreover, the phyla Firmicutes, Actinobacteria and Deinococcus_Thermus were also detected. The bacterial phyla Bacteriodetes and Chlamydiae dominated in Cyclosa mulmeinensis and Neoscona bengalensis respectively. At genera level, Acinetobacter, Pseudomonas, Cutibacterium, Staphylococcus, and Bacillus were the most dominant genera in their gut. In addition to this, the genus Prevotella was observed only in one species, Cyclosa mulmeinensis, and endosymbiont genus Wolbachia generally responsible for reproductive alterations was observed in one spider species Eriovixia laglaizei. Our study revealed that the gut bacterial diversity of the spiders collected from wild are quite different from the diet driven spider gut bacterial diversity as published earlier. A functional analysis revealed the involvement of gut microbiota in carbohydrate, lipid, amino acids, fatty acids and energy metabolism.

Many authors have reported their results of mitral valve (MV) repair1,2 in acute and healed endocarditis. However, the results published from different authors highlight the fact that the reparability rate for this indication remains low. Over the last 3 decades our group has adopted an early and repair-oriented approach to the infective endocarditis with the objective to improve the repair rate and the long-term results.‬ ‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬ In this paper we describe our institutional experience on mitral valve repair for infective endocarditis.‬‬‬‬‬‬‬‬‬ Data for this paper were extracted from our institutional database on heart valve disease. From 1991 to 2015, 160 consecutive patients in our institution underwent MV surgery for active IE on native MV. The median follow-up was 122 months. This study was approved by the institutional ethics review board, and written informed consent was waived for this study given its retrospective design. Hospital mortality was 11.6 % (n = 18). Early MV reoperation before hospital discharge was required in 5 (3.1%) patients. At 5, 10 and 15 years, overall survival in the MVr for endocarditis in group was 79 ± 4%, 65 ± 5%, 57 ± 6%, respectively. Freedom from reoperation at 5, 10 and 15 years was 95 ± 2%, 88 ± 4% and 81 ± 6%, respectively. Mitral infective endocarditis is an insidious pathology and his surgical approach can be challenging. An early and repair-oriented surgical approach can allow to improve reparability rates with good long-term durability and a low recurrence rate of endocarditis.

Purpose: Early fitting of cochlear implant (CI) enables longer access of the critical period for language stimulation. In CI research, language assessment interval duration (LAID) which is a time gap between two language assessment phases, has been widely documented from the age of 2 months to 5 years and beyond. Thus, the objective of this review was to explore the potential role of the LAID in development of overall language outcomes. Method: A total of 1577 research articles were selected based on the age of implantation (AOI) below 24 months, at least two sessions of speech therapy per week, and occurrence of at least two formal language assessments. Twenty-one articles, consisting of 635 children with CI, were shortlisted for this review. Based on the LAID, the selected articles were classified into three categories based on AOI: <6 months, between 6-24 months and >24 months. Result: Children with LAID of <6 months performed better in language development in comparison of the other two categories. The shorter LAID of six months enables real-time, periodic feedback to the language stimulating program which can fasten the growth of speech and language. Conclusion: Based on the specific clinical protocol, participant’s availability, cost, and insurance cover the LAID is inconsistently practiced. Thus, the need of the development of a precise clinical protocol on the LAID is warranted. A shorter duration of the LAID of six months can optimize language outcomes in the children with early implantation, leading to enhancement of the CI effectiveness.

BACKGROUD: There is no consensus over the effect of V-V ECMO on septic patients with sepsis-induced cardiomyopathy. CASE PRESENTATION: A 48-year-old male was transferred to our emergency department for acute-onset fever lasting for four days on November 1, 2019. He traveled in many places in northern China (Yan’an, Beijing, Qinhuangdao and so on) one month prior to admission. We initiated V-V ECMO on day 2. The patient’s hemodynamics and infection condition improved. After detecting of nasopharyngeal swabs and bronchoalveolar lavage samples, A/H1N1 influenza, influenza B, coronavirus, System Inflammatory Reaction Syndrome (SIRS), Middle East respiratory syndrome (MERS) and other epidemic disease were ruled out. On the day 22, patient’s pulmonary images findings revealed the recover. He was transferred to a regular room discharged soon. CONCLUSION: The outcome of our patient shows that V-V ECMO may also benefit the patient when managing septic shock and septic cardiomyopathy.

Background: Cow’s milk protein allergy (CMPA) is an immune-mediated allergic response to proteins in milk, a common infant food allergy. The wide range and frequency of CMPA symptoms make diagnosis a challenge, particularly in primary care. Symptom scores may improve a clinician’s awareness of symptoms, thus indicating a need for further testing. This systematic review examined the development and evaluation of such symptom scores for use in infants. Methods: Four databases were searched from inception to 3 December 2019, for diagnostic accuracy studies, randomised controlled trials, observational studies, economic evaluations, qualitative studies, and studies reporting on the development of the tools. Experts were consulted for additional studies. Data were not suitable for meta-analysis due to heterogeneity, so were narratively synthesised. Results: We found two symptom scores evaluated in one and fourteen studies, respectively. Estimated sensitivity and specificity ranged from 37-98% and 38-93%. The evaluations of each tool were at high risk of bias or failed to address issues such as clinical and cost-effectiveness. Conclusions: Estimates of accuracy of symptom scores for CMPA offered so far should be interpreted cautiously. Rigorous research based on well-defined roles for the tools and free of potential conflicts of interest is urgently required.

A 36-year-old woman suffered an Allen type III fingertip amputation of the right third finger. The wound was treated conservatively using moist wound dressings and healed after 12 weeks with excellent esthetic and functional results. Conservative management using moist wound dressings can be successful treatment for fingertip amputation injury.

Inorganic pyrophosphatases (PPases) catalyze the hydrolysis of pyrophosphate to phosphates. PPases play essential roles in growth and development, and are found in all kingdoms of life. Human possess two PPases, PPA1 and PPA2. PPA1 is present in all tissues, acting largely as a housekeeping enzyme. Besides pyrophosphate hydrolysis, PPA1 can also directly dephosphorylate phosphorylated JNK1. Upregulated expression of PPA1 has been linked to many human malignant tumors. PPA1 knockdown induces apoptosis and decreases proliferation. PPA1 is emerging as a potential prognostic biomarker and target for anti-cancer drug development. In spite of the biological and physiopathological importance of PPA1, there is no detailed study on the structure and catalytic mechanisms of mammalian origin PPases. Here we report the crystal structure of human PPA1 at a resolution of 2.4 Å. We also carried out modeling studies of PPA1 in complex with JNK1 derived phosphor-peptides. The monomeric protein fold of PPA1 is similar to those found in other family I PPases. PPA1 forms a dimeric structure that should be conserved in animal and fungal PPases. Analysis of the PPA1 structure and comparison with available structures of PPases from lower organisms suggest that PPA1 has a largely pre-organized and relatively rigid active site for pyrophosphate hydrolysis. Results from the modeling study indicate the active site of PPA1 has the potential to accommodate double-phosphorylated peptides derived from JNK1. In short, results from the study provides new insights into the mechanisms of human PPA1 and basis for structure-based anti-cancer drug developments using PPA1 as the target.

Aim The population included in randomized controlled clinical trial of ROCKET AF and observational studies were different, and the effectiveness and safety of rivaroxaban in stroke prevention of atrial fibrillation (AF) varied among studies. The aim of this study was to estimate the real-world outcomes of rivaroxaban in AF patients in a relatively accurate way. Methods A discrete event simulation (DES) model was proposed to predict the counterfactual outcomes of ROCKET AF that would have it been conducted in broader observational study populations. The hypothetical cohorts of patients were generated using Monte Carlo simulation. The DES model structure was built based on disease progression and possible outcomes of AF. Cardiovascular events were recorded during the simulated two-year follow-up period. Results The results showed lower predicted rates of stroke/ systemic embolism (SE) and major bleeding in three observational studies than those in simulated ROCKET AF. The simulated stroke/SE incidence was 1.097-1.318 per 100 patient-years and simulated major bleeding incidence was 2.804-3.238 per 100 patient-years in observational studies. The risk difference of stroke/SE and major bleeding was similar among predicted outcomes of the three observational studies. Most simulated hazard ratios (HRs) were close to the corresponding observed HRs. Conclusion The simulated incidence of stroke/SE incidence and major bleeding might reflect the real-world event rate in AF patients. Even some differences existed in the absolute rates of stroke/SE and major bleeding between observed and simulated studies, the results confirmed similar effectiveness and safety to ROCKET AF comparing rivaroxaban and warfarin in AF patients.

Abstract Background: Post-transplant lymphoproliferative disorder (PTLD) is a dangerous complication of liver transplantation. This study aimed to analyze the risk factors associated with PTLD after liver transplantation in children. Method: We retrospectively analyzed collected clinical and laboratory data of patients treated and followed-up at Shanghai Children’s Medical Center between January 2012 and January 2019. Twenty-four patients with PTLD were enrolled in this study using a 1:2 pairing design. Each case was matched with two controls who had undergone liver transplantation within the same year and did not develop PTLD during the follow-up period. In total, 72 patients were included in this study. Result: No differences in age, gender, weight, primary disease, or type of liver transplantation were observed between those with and without PTLD. Graft weight, graft body weight ratio, transplant type, intraoperative blood loss, blood type, and CMV/EBV infection status of donors and recipients were not related to the occurrence of PTLD. Univariate analysis demonstrated statistically significant differences in EBV infection, tacrolimus blood concentration, PTL, AST, ALT, and CHOL between those with and without PTLD. Multivariate logistics regression analysis demonstrated that EBV infection was an independent risk factor for PTLD. A close relationship was observed between EBV-DNA peak time after transplantation and PTLD onset time. Additionally, the higher the tacrolimus blood concentration, the more difficult it was to control EBV infection. Conclusion: EBV infection is an independent risk factor for PTLD. When uncontrolled proliferation of EBV occurs after organ transplantation, the dosage of immunosuppressive agents should be appropriately reduced

We have performed a study on two cubic structured halide perovskites, CsMgX3 (X = Cl, Br) using ab-initio simulations in the outline of density functional theory. In this context, we extensively explored their structural, electronic, thermoelectric and optical properties. The cubic phases of these compounds were optimized and were found to be stable and energetically feasible. Their band structures implied that they are indirect wide gap semiconductors with band gaps of 6.35 and 4.26 eV for CsMgCl3 and CsMgBr3 respectively. Further, their thermoelectric properties comprised of high Seebeck coefficient and electrical conductivities with p-type as the majority charge carriers. Also their high figure of merit (ZT) of values 0.69 and 0.75 at room temperature, showed their efficient thermoelectric response along with the potential to be used for power generation and energy conversion applications. The wide band gaps and their optical behavior consisting of zero absorption, electron energy loss and negligible reflectance in visible region signified a important possibility to use these compounds as hole transport materials (HTM) in the solar cells, which can augment the efficiency of solar cell to a huge level. Moreover, the other calculated optical properties showed contrasting behavior in varying ranges of the electromagnetic spectrum. Thus, we speculate that the studied halide perovskites can emerge as very useful materials for thermoelectric energy conversion and solar cell applications.

Introduction: In March 2020, the new coronavirus (COVID-19) spread throughout the world, causing respiratory disease and deaths, especially in risk groups such as the elderly, pregnant women, immunocompromised people, and others. The World Health Organization (WHO; WHO, English) declared, on January 30, 2020, that the outbreak of the disease caused by COVID-19 constitutes a Public Health Emergency of international importance. 6,287,771 cases of COVID-19 (93,246 new compared to the previous day) and 379,941 deaths (3,621 new compared to the previous day) were confirmed worldwide by June 3, 2020. In the Region of the Americas, 1,036,155 people who were infected with the new coronavirus recovered, according to data from June 3, 2020. In Brazil, on January 22, 2020, the Center for Emergency Operations in Public Health for COVID-19 has activated, a strategy provided for in the National Response Plan to Public Health Emergencies of the Ministry of Health (MH). Objective: To present, using a systematic review, the main considerations about the existing actions for notification, registration, investigation, management, and adoption of preventive measures on SARS-CoV-2 in Severe Acute Respiratory Syndrome (SARS). Methods: The present study followed a systematic review model. After literary search criteria using the MeSH terms, a total of 58 clinical studies were compared and submitted to eligibility analysis and, after that, 26 studies were selected, following the rules of PRISMA. The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web Of Science, ScienceDirect Journals (Elsevier), Scopus (Elsevier), OneFile. Main findings and Conclusion: It is recommended that patients diagnosed with SARS be hospitalized and that the cases identified with the symptoms of severity are admitted to an intensive care bed. These symptoms are persistent hemodynamic instability (blood pressure that did not respond to volume replacement (30 mL/kg in the first 3 hours), indicating the use of vasoactive amine, signs, and symptoms of respiratory failure, including hypoxemia (PaO2 below 60 mmHg) in need supplementation of oxygen to maintain arterial oxygen saturation above 90%, evolution to other organic disorders, such as acute renal failure and neurological dysfunction. It was defined that the clinical criteria for hospital discharge should take into account the improvement of the clinical picture, the absence of tachydyspnea and hypoxia, the absence of O2 supplementation for at least 24 hours, hemodynamic stability, good oral acceptance and absence of fever. Prophylactic use of antibiotics has not recommended, but use should be considered suspect of associated bacterial infection. Keywords: COVID-19. SARS-CoV-2. Severe Acute Respiratory Syndrome. Acute Respiratory Distress Syndrome. Prevention.

Background: Exhaled nitric oxide (eNO) is a noninvasive marker of airway inflammation that can be measured by the “online” or “offline” technique. There are few articles that measure “offline” eNO in children at tidal volume and to our knowledge there is no article that compares the concordance and correlation between 2 different technologies measured offline at tidal volume. Objective: is to report the concordance and correlation of the eNO results obtained with a chemiluminescence vs. an electrochemical device by the “offline” technique at tidal volume. Methods: A cross-sectional, observational and prospective study was conducted in the National Institute of Respiratory Diseases, Mexico City. Healthy children and those with any lung disease between 1 and 11 years of age were included. The exhaled air sample was obtained at tidal volume by attaching a mask with a connection to a Mylar® bag. Results: 36 children were studied. The average (±SD) age of the study population was 6 ± 2.6 years; 25% of subjects included were healthy, and the rest had lung disease. The concordance correlation coefficient between the two measuring devices was 0.98 (p<0.001), with an average difference of 1.46 ± 3.5 ppb and 95% limits of agreement from -5.3 ppb to 8.3 ppb. The linear regression model equation for the estimation of eNO was eNO,cl = (eNO,eq· 1.0718) – 0.1343, (r2 = 0.97) Conclusion: The measurement of eNO by the “offline” method at tidal volume can be analyzed by electrochemical devices, and the results are interchangeable with those analyzed by chemiluminescence technology.

Hydrophobic phase change material and surfactant are investigated as promoters for hydrate formation. Hydrophobic phase change material is the mixture of n-decanoic acid (CA) and dodecyl alcohol (DE), and surfactant is Tween80. Visual observations of the effect of CA-DE and Tween80 on hydrate crystal growth are conducted. Along the direction of crystal growth, HCFC141b hydrate growth rates with additives of CA-DE or CA-DE + Tween80 is almost the same everywhere, while the hydrate crystal growth rates with additive of Tween80 is different at different sites. The average rate of hydrate lateral growth with 1 wt% CA-DE is lower than that with 1 wt% CA-DE and 1 wt% Tween80. Scattered hydrate crystal plates are observed with the addition of CA-DE. However, only one big crystal plate was observed with the addition of Tween80 or CA-DE + Tween80.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, is a new strain of coronavirus that has not been previously identified in humans. SARS-CoV-2 is recognized as a highly contagious respiratory virus with severe morbidity and mortality, especially in vulnerable populations. Being a novel disease, everyone is susceptible, there are no vaccine and no treatment. To contain the spread of the disease, health authorities throughout the world have restricted the social interactions of individuals in various degrees. Allergists like other physicians are faced with the challenge of providing care for their patients, while protecting themselves and patients from getting infected, with strategies that are in continuous evolution as States work through the different stages of social distance. Allergist provides care for patients with the most common noncommunicable disease in the world: asthma, allergic rhinitis, food allergy, venom allergy, drug allergy atopic dermatitis, and urticarial. Some of these diseases are not only considered risk factors for severe reactions but also have symptoms like cough and sneezing that are in differential diagnosis with COVID-19, and as we move forward may prevent allergy patient from working, go to school or access medical services that increasingly are allowing only asymptomatic patients. In this review, we will outline how to take care safety of different allergic patients during the pandemic.

Coronavirus disease 2019 (COVID-19)diagnosis is based on molecular detection of SARS-CoV-2 in respiratory samples such as nasal swab (NS). However, the evidence that NS in patients with pneumonia were sometimes negative raise the attention to collect other clinical specimens. SARS-CoV-2 was shown in 10.3%rectal swabs (RS), 7.7% plasma,1% urine, 0% feces from 143NS positive patients. Potential infection by fluids different from respiratory secretion is possible but unlikely.