ABSTRACT
Objective:To explore the patterns and causes of occupational exposure to infectious diseases (OEID) among frontline medical staffs (FMS) in coronavirus disease 2019 (COVID-19) isolation wards (CIW), and the particularity of post-OEID management and the measures to prevent OEID.Methods:A total of 1 061 FMS of Wuhan Huoshenshan Hospital from February 4 to March 21, 2020 were enrolled. The OEID of FMS was investigated and analyzed from the perspectives of FMS physical and psychological conditions, protective equipment, infection-control related regulations and procedures, local air quality, exposure patterns, and the particularity of emergency treatment after exposure.Results:The incidence of OEID among FMS was 2.0%(21/1 061). The nurses and doctors accounted for 95.2%(20/21) and 4.8%(1/21), respectively. The incidences in 17 general wards and two intensive care units (ICU) were 71.4%(15/21) and 28.6%(6/21), respectively. Nearly 90.5%(19/21) and 9.5%(2/21) of the OEID events occurred in contaminated area and potential contaminated area, respectively. About 23.8%(5/21) of the OEID events were air exposure of oral-nasal skin, mucosa and respiratory tract, which was secondary to uncontrollable vomiting, and 76.2%(16/21) were pricking injuries. The inducement factors involved poor quality and inappropriate wearing of some goggles, atomization of the inside of goggles leading to blurring vision, chest distress and decreased sense of touch and operational flexibility related to level-3 protection equipment, poor air quality, FMS physical and psychological conditions, etc. Under the direction of "the Procedures for Handling OEID" , all incidents are properly handled and no FMS was infected by 2019 novel coronavirus and blood-borne pathogens. No new OEID event was found after the strict implement of set of preventive measures.Conclusions:The OEID among FMS in CIW is attributed to multiple causes. The optimized process that takes into account the specificity of OEID management for both COVID-19 and blood-borne infectious diseases can effectively prevent potential post-exposure infections. And reasonable precautions can fully reduce the risk of OEID of FMS in CIW.
ABSTRACT
Objective:To investigate the changes of macular region structure before and after operation in patients with macular epiretinal membrane,and its relationship with the visual function of patients.Methods:The clinical data of 60 patients with macular epiretinal membrane (60 eyes) in our hospital from February 2014 to August 2016 were retrospectively analyzed.All patients were examined with optical coherence tomography (OCT) examination,and observed the changes ofmacula central fovea and retinal each azimuth thickness,and the best corrected visual acuity (BCVA) was recorded before and after operation,and the correlations of them were analysised.Results:The visual acuity was improved in 53 patients (53 eyes) after operation,accounting for 88.33％,and the visual acuity was unchanged in 7 patients (7 eyes),accounting for 11.67％.The preoperative BCVA of patients was (0.18± 0.07),and it was (0.38± 0.12) at 3 months after operation,which was significantly higher than before operation (P＜0.05).Postoperative macular central thickness,inner side of the inner ring thickness,nasal side of the inner ring thickness,above the inner ring thickness,below the inner ring thickness,outer ringtemporal side thickness,external ring nasal side thickness,above the outer ring thickness,below the outer ring thickness in patients compared with the preoperative were significantly lower,the difference was statistically significant (P＜0.05).The Pearson correlation analysis showed that preoperative macular central thickness,preoperative inner side of the inner ring thickness,preoperative outer ring temporal side thickness,the difference of macular fovea thickness before and after operation,the difference of the medial temporal before and after operationwas,the difference of outer ring temporal side before and after operation were negatively correlated with postoperative BCVA (P＜0.05).Conclusion:Vitrectomy can significantly reduce macular retinal thickness in patients with macular epiretinal membrane,and it can improve the visual function of patients,and the shape ofmacular region before operation had some influence on postoperative visual acuity.