Psychosocial impact of the COVID-19 pandemic on paediatric healthcare workers

INTRODUCTION@#Frontline healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19) are at risk of psychological distress. This study evaluates the psychological impact of COVID-19 pandemic on HCWs in a national paediatric referral centre.@*METHODS@#This was a survey-based study that collected demographic, work environment and mental health data from paediatric HCWs in the emergency, intensive care and infectious disease units. Psychological impact was measured using the Depression, Anxiety, Stress Scale-21. Multivariate regression analysis was performed to identify risk factors associated with psychological distress.@*RESULTS@#The survey achieved a response rate of 93.9% (430 of 458). Of the 430 respondents, symptoms of depression, anxiety and stress were reported in 168 (39.1%), 205 (47.7%) and 106 (24.7%), respectively. Depression was reported in the mild (47, 10.9%), moderate (76, 17.7%), severe (23, 5.3%) and extremely severe (22, 5.1%) categories. Anxiety (205, 47.7%) and stress (106, 24.7%) were reported in the mild category only. Collectively, regression analysis identified female sex, a perceived lack of choice in work scope/environment, lack of protection from COVID-19, lack of access to physical activities and rest, the need to perform additional tasks, and the experience of stigma from the community as risk factors for poor psychological outcome.@*CONCLUSION@#A high prevalence of depression, anxiety and stress was reported among frontline paediatric HCWs during the COVID-19 pandemic. Personal psychoneuroimmunity and organisational prevention measures can be implemented to lessen psychiatric symptoms. At the national level, involving mental health professionals to plan and coordinate psychological intervention for the country should be considered.

Value of susceptibility weighted imaging in differential diagnosis of benign and maliagnant thyroid lesions / 实用放射学杂志

Objective To evaluate the value of differential diagnosis between benign and malignant thyroid lesions by susceptibility weighted imaging(SWI).Methods 53 patients with 20 malignant thyroid lesions and 71 benign thyroid lesions confirmed by surgery and pathology were analyzed retrospectively.All cases received conventional MRI and SWI preoperatively.Location,volume,SWI parameters including signal to noise ratio(SNR),contrast noise ratio(CNR)and intratumor susceptibility hypointensity (ITSHIA)datas in benign and malignant lesions were compared and analyzed.Results There was no statistical significance between benign and malignant thyroid lesions in the location,volume,SNR and CNR(χ2 or t =0.014,0.286,0.927,1.169;P =0.907,0.778,0.368,0.259 respectively).The maximum diameter (1.90 mm±0.32 mm),degree of maximum diameter(1.33±0.47),frequence(1.40±0.20)and area ratio(1.09±0.28)for benign thyroid lesions were less than those for malignant lesions(3.39 mm±0.79 mm,2.25±0.44,1.40±0.68,1.70±0.47)respectively (t or Z =12.629,5.788,3.41 5,5.795;P =0.000,0.000,0.001,0.000).Conclusion SWI semiquantitative assessment of pathlogical vascularity is useful in differential diagnosis of benign and malignant thyroid lesions.

Case-based study (CBS) in combination with reference-induced self education (RISE) in clini-cal teaching of digestive endoscope diagnostics / 中华医学教育探索杂志

Objective To explore the effect of applying Case-based study (CBS) in combina-tion with Reference-induced self education (RISE) in clinical teaching of Digestive endoscope diag-nostics. Method One hundred and twenty undergraduates in Grade 2012 of clinical imaging speciality of Beihua University were selected as the objects of study and classified at random into experiment group (60 students) and control group (60 students), In the course of teaching, the traditional LBL study and CBS-RISE study were separately employed, and examined through theoretical assessment in combination with case analysis, and the teaching effect in experiment group students was also evaluated through examination paper. SPSS 16.0 statistic soft ware was employed for data treatment and analysis, t test was used for quantity data and expressed as x±s, and x2 test for number counting data, and P<0.05 as the statistical significant difference. Results In experiment group, the total result, and the results of theoretical examination and case analysis were all superior to the control group, and the dif-ference between two groups exhibited statistical significance (P values respectively 0.008, 0.017 and 0.021). The excellent and good rate of the experimental group's theory examination score was 70%, which was higher than that of the control group (48.3%). The excellent and good rate of the experimen-tal group in the case analysis of examination results was 63.3%, higher than that of the control group (43.3%), and the difference was statistically significant (P values respectively 0.016 and 0.028). The students in experimental group showed better degree of satisfaction to the teaching model of CBS-RISE. In general, they considered that the CBS-RISE model could stimulate the learning interest of students, enhance the ability of analyzing and solving problems, deepen the understanding of knowl-edge, train a better clinical thinking model, and also develop a cooperative group idea. Conclusions CBS-RISE teaching model is feasible in the application of teaching in digestive endoscope diagnostics, and beneficial to the training of self learning ability and clinical consideration, deserving populariza-tion.

Diagnostic value of diffusion weighted imaging on local recurrence of nasopharyngeal carcinoma / 中华放射学杂志

Objective To investigate the diagnostic value of DWI on nasopharyngeal neoplasm recurrence and fibrotic lesions after radiotherapy.Methods A retrospective analysis of pathologically confirmed nasopharyngeal neoplasm was performed in 39 patients with recurrent patients ( recurrence group ) confirmed by biopsy or MRI follow-up and 51 patients with confirmed localized fibrosis (fibrosis group) after radiotherapy.All patients underwent DWI , non-enhanced and enhanced MR scan.DWI findings and ADC values of the lesions in two groups of patients were observed and measured , then compared by using independent samples t test.Diagnostic performance of routine MRI and DWI in the diagnosis of nasopharyngeal neoplasm recurrence after radiotherapy was calculated by using ROC analysis and the differences of both of them were analyzed by using Z test.Results DWI of 39 recurrent patients showed hyper-intensity signal and ADC map showed hypo-intensity signal appearance.Overall signal of DWI in 51 recurrent patients is lower than that in recurrent group , in which ADC maps of 36 cases showed iso-intensity or moderately hypo-intensity signal appearance and the remaining 15 cases showed moderate hyper-intensity signal appearance.The ADC values of recurrent group and fibrotic group were (0.753 ±0.127) × 10 -3 mm2/s, and ( 1.233 ± 0.310 ) ×10 -3 mm2/s, respectively.The difference was statistically significant ( t=-9.118, P<0.05).On the ROC curve, the sensitivity of ADC for the diagnosis of tumor recurrence was 87.18%(34/39), specificity 94.12%(48/51) and area under the ROC curve 0.968 with the ADC cutoff value of 0.887 ×10 -3 mm2/s.The sensitivity of routine MRI was 71.79% ( 28/39 ) , the specificity 74.51% ( 38/51 ) and the area under the ROC curve was 0.732 for the diagnosis of tumor recurrence.The difference of area under the curve between them was statistically significant ( Z=4.583, P<0.01).Conclusion DWI can help tumor detection and diagnosis of recurrent nasopharyngeal neoplasm and has a higher diagnostic performance compared with routine MRI.

The diagnostic value of 1.5T diffusion-weighted MR imaging for small metastatic cervical lymph nodes of nasopharyngeal carcinoma / 实用放射学杂志

Objective To study the diagnostic value of 1.5T diffusion-weighted magnetic resonance imaging for small metastatic cervical lymph nodes of nasopharyngeal carcinoma(NPC),and to explore the optimal diagnostic threshold value of apparent diffusion coefficient(ADC)in small metastatic cervical lymph nodes of NPC.Methods 40 patients with histopathologically confirmed NPC were underwent conventional,enhanced and DWI MR.The mean ADC value of large metastatic cervical lymph nodes group,small metastatic cervical lymph nodes group and benign lymph nodes group were measured respectively.Statistical analysis was done by using the SPSS 1 6.0 program software.The receiver operating characteristic (ROC)curve was performed to obtain the ADC thresh-old value of small metastatic cervical lymph nodes and the diagnostic efficacy.Results The mean ADC value of large metastatic cer-vical lymph nodes group was (0.74±0.1 1)×10 -3 mm2/s,which was not significantly different from that in small metastatic cervical lymph nodes group(0.75±0.13)×10 -3 mm2/s,P >0.05.The mean ADC value in benign lymph nodes group was (1.05± 0.18)× 10 -3 mm2/s,which was significantly higher than that in large metastatic cervical lymph nodes group and small metastatic cervical lymph nodes group(P <0.05 ).Using a threshold ADC value of 0.908 × 10 -3 mm2/s for differentiating small metastatic cervical lymph nodes from benign lymph nodes,a sensitivity of 83.2% and specificity of 90.9% were obtained,the area under the ROC curve was 0.92.Conclusion DWI is helpful in the diagnosis of small metastatic cervical lymph nodes of NPC.

Distribution of mecA in Staphylococcus aureus and Its Effect on Antibiotics-resistance / 中华医院感染学杂志

OBJECTIVE To understand mecA gene distribution in Staphylococcus aureus and its role in antibiotics-resistance.METHODS In this study,a total of 47 S.aureus strains were isolated from hospitalized patients.Agar disk diffusion test was conducted to determine the resistance of S.aureus to antibiotics.The DNA of these strains were extracted and purified.The mecA gene was tested by PCR and the relation between the mecA gene and antibiotics-resistance was analyzed.RESULTS Of 47 strains,33(70.2%) were MRSA.Of 33 MRSA,only 3 strains were susceptible to glycopeptides antibiotics.Only 2 strains(14.3%) of 14 MSSA were susceptible to all of the 12 antibotics.The results of PCR revealed that 32 out of 33 MRSA(97.0%) carried mecA in their genome.One strain was mecA gene negative.Among 14 MSSA,3(21.4%)strains carried mecA gene.CONCLUSIONS The isolation rate of MRSA in S.aureus is high.The resistance to antibiotics of MRSA is popular Glycopeptides antibiotics.Most of MRSA carry mecA gene,which plays an important role in antibiotics-resistance.Fewer MSSA carry mecA gene.

Nosocomial Infection Management:Current Status / 中华医院感染学杂志

OBJECTIVE To study the current infection control issues and discuss protocols of nosocomial infection management. METHODS Based on the characteristics and progresses of domestic and international nosocomial infection management,we analyzed the existing problems and countermeasures of some key issues. RESULTS Enhancing nosocomial infection objective-surveillance,the personnel construction,information technology,etc are the chief methods to improve the quality of nosocomial infection control. CONCLUSIONS Adopting some new measures to strengthen the nosocomial infection management is essential and important to the security of medical treatment.

Nosocomial Deep Fungal Infection in Intensive Care Unit / 中华医院感染学杂志

OBJECTIVE To investigate the susceptible factors and the methods of prevention and treatment of nosocomial deep fungal infection in intensive care unit(ICU).METHODS The clinical information of 798 patients in ICU was investigated from Jul 2005 to Jun 2007.The risk factors,species,drug-resistance and the methods of prevention of fungal infection were analyzed.RESULTS Fungal infections were found in 137 cases(17.2%).The lower respiratory tract accounted for 72.3% in 137 cases with fungal infection.A total of 180 strains of fungi were isolated,Candida albicans,C.tropicalis and C.glabrata accounted for 43.3%,25.6% and 23.3%.The resistance characteristics to fluconazole,itraconazole,5-fluorocytosine and amphotericin B were relatively weak.The factors related to nosocomial fungal infection were the severity of the underlying disease,long-term use of antibiotics and glucocorticoid and invasive procedure.CONCLUSIONS Proper use of antibiotics and immuno-depressor,reduction of unnecessary operation and early diagnosis are the keys in prevention of systemic fungal infection.

CT Findings of the Clonorchiasis Alteration in Intrahepatic Bile Duct and Essential Liver / 实用放射学杂志

Objective To study CT findings of the intrahepatic bile duct and essential liver.Methods The clinical and CT material of the 113 cases of clonorchiasis were collected.The dilatation of Ⅱ,Ⅲ lever of intrahepatic bile duct were classified.Results 24 cases were slight degree dilated of the Ⅱ,Ⅲ lever bile duct,22 cases were light degree,31 cases were middle degree,36 cases were heavy degree.The light degree dilation of intrahepatic bile duct were found in whose clinical symptom and sign were not clear and obvious.The mid and heavy degree dilation of intrahepatic bile duct were found in those who has got abdominal pain,cold and fever,jaundice and complication.It was not relative between the calculus and dilation of intrahepatic bile duct.Dilation of intrahepatic bile duct with small piece of low density in liver essence accompany was found in 5 cases.Conclusion It would be the clonorchiasis if the minority small bile duct near liver membrane were dilated.Clinical symptom and sign are related to the dilative bile duct.CT findings of the small piece of low density essential liver and dilation of intrahepatic bile duct could be consider the inflammtory granuloma in the essential liver in clonorchiasis.

Study of synergistic effects of Spirulina platensis on inducing IL-2 / 中国海洋药物

It has been shown that Spirulina platensis can regulate imminological functions.We report here that crude extract and purified components (phycocyanin and polysaccharide) from Spirulina platensis can induce secretion of IL 2 in splenocyte of BALB/C mice by means of MTT method.In the present study,we showed that all experimental components can't enhance proliferation of CTLL which was used in MTT method,but induce IL 2 secretion in splenocyte of BALB/C mice in three different concentration (0.01,0.1,1 g?L -1 ).Indeed the purified components especially phycocyanin part showed stronger IL 2 inducing activity than the crude one.IL 2 level was grow up when the incubation time of splenocyte and Spirulina platensis increased.In the concentration of 1 g?L -1 ,detected Spirulina platensis in our study assist IL 2 inducing of ConA (2mg?L -1 ) in splenocyte of BALB/C mice.