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Objective:To investigate and analyze the epidemiological and clinical characteristics of 46 patients with corona virus disease 2019 (COVID-19) in Beijing City.Methods:A retrospective study was conducted to analyze the data of 46 patients with COVID-19 in Beijing from 20th January 2020 to 8th February 2020 at the Fifth Medical Center of the PLA General Hospital in Beijing City. Twelve, 23 and 11 patients were assigned to the mild group, common group and severe group, respectively. The epidemiological history, clinical characteristics, laboratory tests and imaging inspections were analyzed. Statistical analysis used Fisher exact test. If P<0.05, post- hoc test was used for pairwise comparison, and the statistics were corrected by Bonferroni test. Results:Among the 46 patients included in this study, 27 were male and 19 were female. The age range was between 3-79 years old, and the age was (41.8±16.3) years old. The average incubation period was (4.85±3.00) days. A total of 26 cases (56.5%) were clustered patients, and 26 cases had a history of staying in Wuhan, 10 cases had contact with Wuhan personnel. Fever (39 cases, 84.8%), cough (27 cases, 58.7%), and fatigue (25 cases, 54.3%) were the main clinical symptoms for these patients. The decrease in white blood cell counts occurred in 12 patients, four had the decrease in T lymphocyte percentage, 17 had the decrease in CD4 + T lymphocyte counts, seven had the decrease in CD8 + T lymphocyte counts, 21 had the increase level of C reactive protein (45.7%), and interleukin-6 (IL-6) level increased in 32 cases (69.6%), erythrocyte sedimentation rate (ESR) increased in 23 cases (50.0%), serum ferritin level increased in 26 cases (56.5%), and blood lactic acid level increased in nine cases. There were statistically significant differences in the proportion of cases with decreased absolute value of CD8 + T lymphocytes and T lymphocytes counts among the mild, common and severe groups (all P<0.05). Comparing the proportion of cases in the three groups with elevated C reactive protein, IL-6, ESR, serum ferritin and blood lactic acid levels, the differences were statistically significant (all P<0.05). The proportion of cases with elevated C reactive protein levels in severe group was higher than those in mild and common groups. The proportion of cases with elevated IL-6, ESR, and serum ferritin levels in severe and common group were higher than those in mild group. The proportion of cases with elevated blood lactic acid levels in severe group was higher than those in mild group. The differences between the above groups were statistically significant (all adjusted P<0.017). Analysis of chest X-rays results showed that 34 patients (73.9%) had inflammation in the lungs. Conclusions:The epidemiological characteristics of patients with COVID-19 in Beijing City are mainly imported cases and clustered cases. The clinical manifestations are mainly fever, fatigue and cough. C reactive protein, IL-6, ESR, serum ferritin and blood lactic acid levels are higher in severe patients.
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With more and more non-affiliated hospitals of universities joining the clinical teaching of infectious diseases,there have been some dilemmas on clinical teaching,such as the shortage of staff,teaching experience,poor lecture art and teaching enthusiasm,textbook lag,the shortage of case teaching abd students'fear of infectious disease etc. Countermeasures such as perfecting the organizational structure,formulating preferential policy,clearing historical mission,increasing students' interest in learning,adding new academic progress,enriching teaching methods,setting up experts'supervision will ensure the effective teaching quality.
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<p><b>OBJECTIVE</b>To investigate the short-course and efficient way to treat mumps meningitis.</p><p><b>METHODS</b>Totally 155 cases of mumps meningitis treated by intrathecal injection with dexamethasone only once were enrolled as experimental group and 55 similar cases treated with the common therapy as control.</p><p><b>RESULTS</b>The time for recoveries of temperature, headache, the pathologic reflexes and the total time of treatment were 32 hours, 15 hours, 12 hours and 3.1 days, respectively, while those of the control group were 58 hours, 24 hours, 32 hours, 6.5 days respectively. There was statistical difference between the two groups (P<0.01 or 0.05).</p><p><b>CONCLUSIONS</b>Intrathecal injection with dexamethasone only once is efficient and safe in the treatment of mumps meningitis.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Anti-Inflammatory Agents , Therapeutic Uses , Dexamethasone , Therapeutic Uses , Injections, Spinal , Meningitis, Viral , Drug Therapy , Mumps , Drug Therapy , Treatment OutcomeABSTRACT
Objective To study the diagnosis, treatment and prognosis of hepatolithiasis combined with cholangiocarcinoma. Methods The clinical, pathological and follow-up data of 17 cases of hepatolithiasis combined with cholangiocarcinoma were retrospectively analysed. Results The results showed that the incidence of cholangiocarcinoma in hepatolithiasis was 5% in this series. 17.6% of the patients were diagnosed as cholangiocarcinoma preoperatively. Tumor occurring in intrahepatic ducts was 88.2% and in hepatic porta ducts 11.8%. Nine cases were well-differentiated adenocarcinomas. Only 7(41.2%) cases were radically resected and their average survival time was 26.0 months. Eight(47.1%) patients underwent internal drainage with average survival time 12.4 months. 2(11.7%) cases subject to external drainage with survival time 3.6 months. Conclusions If patients with hepatolithiasis have a long history of recurrent cholangitis, weight-loss in a short period, progressive jaundice or intractable abdominal pain, the possiblility of combined with cholangiocarcinoma should be considered. Resection of the tumor has a better prognosis than that of tumor unresected; and the prognosis of internal drainage is better than that of external drainage.
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Objective To review the experience in managing severe major jugular vascular injuries. Methods Fifteen cases (11 men and 4 women, aged 18～49 years) treated by operation were collected. The injuried vessels included common carotid artery, internal carotid artery, subclavian artery and accompanying veins, carotid reconstruction was performed by jugular vein transplantation and followed by wrapping with PTFE artificial blood vessel in 15 cases. Result All the fifteen patients were cured and the vasculars were well-functioning 3～12 weeks after the surgery. Conclusion The mortality of severe large cervical vascular injuries is very high because of acute bleeding, cerebral ischimia and suffocation. In managing this catastrophe, keeping the airway clear and stop bleeding effectively are fundamental. Good knowledge and expertise in vascular and microvascular surgery are mandatory for the success of the procedure.