Analysis of the management measures and effects in prevention and control of COVID-19 in outpatient service of a general hospital / 医学研究生学报

To preliminarily analyze the prevention and control of COVID-19, a general hospital outpatient service took six management measures, including setting up a leading group, building rules and regulations, infection control and supervision, special training, humanized service, public opinion propaganda. After nearly two months, the rates of both body temperature monitoring and epidemiological history screening are 100%, the medical staff infection rate is zero, and no cross infection between the patients due to adopting outpatient service comprehensive management measures which had strong organization and leadership, effective targeted training, effective control of all links in epidemic prevention and control work. During the fight against COVID-19, outpatient management played an important role in hospital management. The above approaches provide valuable experience for preventing the spread of infectious diseases effectively and winning the biological weapon wars in the future.

The application of WeChat applet and integrity propaganda and education in outpatient pre-examination during the prevalence of COVID-19 / 医学研究生学报

ObjectiveDuring the prevention and control of COVID-19, it is a difficult problem to obtain the individual epidemiological status of outpatients efficiently and accurately in a large comprehensive third-grade class-A hospital. To discuss the application and effect of WeChat applet and integrity propaganda and education in outpatient pre-examination during the prevention and control of COVID-19.MethodsFirstly, the outpatients were treated with integrity propaganda and education (like informing the law and regulations, recording the personal credit) at the outpatient pre-examination office. Secondly, let them take real-name authentication in the hospital self-developed WeChat applet. Thirdly, the outpatients filled in the epidemiological questionnaire related to COVID-19 by WeChat. The differences between before using the application (8,186 patients) and after using (7,361 patients) were compared in pre-examination time and concealing the incidence of an individual's epidemiological history.ResultsAfter the application of WeChat applet and integrity propaganda and education, the pre-examination time after using application [(1.07±0.23)min] was shorter than that before using[(2.15±0.37) min] (P<0.05). The concealment rate of epidemiological history was 0.05% before using application and zero after using.ConclusionWeChat applet and integrity propaganda and education can shorten the pre-examination time of covid-19 and reduce the occurrence of concealing personal epidemiological history.

Analysis on the occurrence characteristics of pressure injuries caused by COVID-19 pneumonia protective equipment / 医学研究生学报

ObjectiveWearing protective masks for a long time causes a large number of frontline health care workers to suffer different degrees of pressure injury or facial skin rupture in response to COVID-19. This paper aims to analyze the occurrence characteristics and related factors of pressure injury related to devices, and provide the basis for taking countermeasures. Methods There was online investigation of skin injuries caused by wearing protective equipment in medical staff. Descriptive analysis was carried out on the occurrence characteristics of pressure-induced injury, and influencing factors were analyzed through logistic regression model. ResultsThere were a total of 2901 valid questionnaires. The results showed that the incidence of pressure injury caused by protective equipment was 26.34%, mainly in the bridge of the nose (20.41%), cheek (20.23%), auricle (17.82%) and forehead (8.86%). Multivariate Logistic regression model analysis showed that the major associated factors, which presented increasing risk, were sweating and dampness (OR=12.72, 95%CI 8.36-17.30), wearing level-3 protective equipment (OR=3.55, 95%CI 2.47-5.08), wearing level-2 protective equipment (OR=3.37, 95%CI 2.47-4.60), wearing time (OR=1.29, 95%CI 1.05~1.58) and occupation (OR=1.57, 95%CI 1.00~2.49). Conclusion There is the high incidence of pressure injuries to health care workers caused by protective equipment against COVID-19. The main risk factors for facial stress injury of medical staff are sweating and dampness, wearing level-3 and level-2 protective equipment and wearing time.

Treament of CRRT combined with low-flow ECMO for canines with ARDS / 医学研究生学报

Objective Single mechanical ventilation for curing severe acute respiratory distress syndrome (ARDS) is sometimes not effective in improving oxygenation and removing excess CO2 in the blood. The purpose of this study is to observe the effect of continuous renal replacement therapy（CRRT）combined with low-flow extracorporeal membrane oxygenation （ECMO）of V-V mode on clearance of inflammatory mediators，improving oxygenation and reducing PaCO2 in canines with ARDS and hypercapnia. Methods 30 healthy adult canines were divided into 3 groups (n=10 each) using a random number table method sham group, ECMO (EC) group and CRRT+ECMO（CR+EC）group. A canine model of ARDS with hypercapnia were prepared by injected intravenously oleic acid. Sham group was only treated with invasive mechanical ventilation. EC group was treated with invasive mechanical ventilation and ECMO. CR+EC group was treated with CRRT combined with low-flow ECMO of V-V mode besides invasive mechanical ventilation. The heart rate(HR)，mean artery pressure (MAP)，cardiac output(CO) and concentration of serum TNF-α and IL-6 were examined at the beginning of modeling(T0)，after 1，3，6 and 9 (T1, T3, T6, T9) hours of mechanical treatment respectively. Oxygenation index（OI），PaCO2, temperature（T）were examined at the beginning of modeling，after 3, 6, 9 hours of mechanical treatment，and at the time point of 3 hours(T12) after ECMO treatment (EC group) and CRRT+ECMO treatment(CR+EC group)，respectively. The differences were compared between groups involved in above-mentioned indexes at different time points. Results Compared with the sham group, the HR decreased at T6 and T9 in the EC group and CR+EC group (P<0.05), and the concentration of IL-6 and TNF-α decreased at T3, T6 and T9 in the CR+EC group (P<0.05). Compared with T0, HR decreased at T6 and T9 in the EC group (P<0.05). Compared with T0, the concentration of IL-6 and TNF-α decreased at T3, T6 and T9 in the CR+EC group (P<0.05). Compared with the EC group, the HR decreased at T6 and T9 in the CR+EC group (P<0.05). Compared with the EC group, the concentration of IL-6 and TNF-α decreased at T3, T6 and T9 in the CR+EC group (P<0.05). Compared with the sham group, the OI decreased at T9 and T12 in the CR+EC group (P<0.05). Compared with the sham group, PaCO2 decreased at T3, T6 and T9 in the EC group and CR+EC group (P<0.05). Compared with the EC group, the OI decreased at T9 and T12 in the CR+EC group (P<0.05). Compared with T0, the OI decreased at T6 and T12 in the CR+EC group (P<0.05). Conclusion The CRRT combined with low-flow ECMO of V-V mode has positive effects on clearance of inflammatory mediators，reducing hypercapnia and improving oxygenation in the canines with ARDS and hypercapnia.

Lipoic acid protects spermatogenesis in male rats with ornidazole-induced oligoasthenozoospermia / 中华男科学杂志

<p><b>Objective</b>To study the protective effect of lipoic acid (LA) on the spermatogenic function of the male rats with oligoasthenozoospermia induced by ornidazole (ORN).</p><p><b>METHODS</b>Seventy male SD rats were equally randomized into groups A (solvent control: 1 ml 0.5% CMC-Na + 1 ml olive oil), B (low-dose ORN model: 400 mg/kg ORN suspension + 1 ml olive oil), C (low-dose ORN + low-dose LA treatment: 400 mg/kg ORN + 50 mg/kg LA), D (low-dose ORN + high-dose LA treatment: 400 mg/kg ORN + 100 mg/kg LA), E (high-dose ORN model: 800 mg/kg ORN suspension + 1 ml olive oil), F (high-dose ORN + low-dose LA treatment: 800 mg/kg ORN + 50 mg/kg LA), and G (high-dose ORN + high-dose LA treatment: 800 mg/kg ORN + 100 mg/kg LA), and treated respectively for 20 successive days. Then all the rats were sacrificed and the weights of the body, testis, epididymis and seminal vesicle obtained, followed by calculation of the organ index, determination of epididymal sperm concentration and motility, and observation of the histomorphological changes in the testis and epididymis by HE staining.</p><p><b>RESULTS</b>Compared with group A, group E showed significantly decreased body weight (［117.67 ± 11.53］ vs ［88.11 ± 12.65］ g, P < 0.01) and indexes of the testis (［1.06 ± 0.12］ vs ［0.65 ± 0.13］ %, P < 0.01) and epididymis (［0.21 ± 0.03］ vs ［0.17 ± 0.01］ %, P < 0.01). In comparison with group E, group F exhibited remarkable increases in the epididymal index (［0.17 ± 0.01］ vs ［0.20 ± 0.02］ %, P < 0.01), and so did group G in the body weight (［88.11 ± 12.65］ vs ［102.70 ± 16.10］ g, P < 0.05) and the indexes of the testis (［0.65 ± 0.13］ vs ［0.95 ± 0.06］ %, P < 0.01) and epididymis (［0.17 ± 0.01］ vs ［0.19 ± 0.02］ %, P < 0.05), but no obvious difference was observed in the index of seminal vesicle among different groups. Compared with group A, group B manifested significant decreases in sperm motility (［74.12 ± 8.73］ vs ［40.25 ± 6.08］ %, P < 0.01), and so did group E in sperm count (［38.59 ± 6.40］ vs ［18.67 ± 4.59］ ×105/100 mg, P < 0.01) and sperm motility (［74.12 ± 8.73］ vs ［27.58 ± 8.43］ %, P < 0.01). Sperm motility was significantly lower in group B than in C and D (［40.25 ± 6.08］ vs ［58.13 ± 7.62］ and ［76.04 ± 8.44］%, P < 0.01), and so were sperm count and motility in group E than in F and G (［18.67 ± 4.59］ vs ［25.63 ± 9.66］ and ［29.92 ± 4.15］ ×105/100 mg, P < 0.05 and P < 0.01; ［27.58 ± 8.43］ vs ［36.56 ± 11.08］ and ［45.05 ± 9.59］ %, P < 0.05 and P < 0.01). There were no obvious changes in the histomorphology of the testis and epididymis in groups A, B, C and D. Compared with group A, group E showed necrotic and exfoliated spermatogenic cells with unclear layers and disorderly arrangement in the seminiferous tubules and remarkably reduced sperm count with lots of noncellular components in the epididymal cavity, while groups F and G exhibited increased sperm count in the seminiferous tubules and epididymis lumen, also with exfoliation, unclear layers and disorderly arrangement of spermatogenic cells, but significantly better than in group E.</p><p><b>CONCLUSIONS</b>LA can reduce ORN-induced damage to the spermatogenetic function of rats, improve sperm quality, and protect the reproductive system.</p>

Impact of Mycoplasma genitalium infection on the semen quality of infertile males / 中华男科学杂志

<p><b>Objective</b>To explore Mycoplasma genitalium (MG) infection in the urogenital tract of infertile men and its influence on semen quality.</p><p><b>METHODS</b>Semen samples were collected from 352 infertile males in the Center of Reproductive Medicine of Nanjing General Hospital from March to July 2015. MG infection was detected by real-time fluorescence simultaneous amplification and testing and semen analyses were conducted according to the WHO Laboratory Manual for the Examination and Processing of Human Semen (5th Ed) on the semen pH value, semen volume, total sperm count, sperm concentration, total sperm motility, percentages of progressively motile sperm (PMS) and immotile sperm (IMS), and sperm DNA fragmentation index (DFI). The data obtained were subjected to statistical analysis by t-test and non-parametric test (Wilcoxon test).</p><p><b>RESULTS</b>MG infection was found in 3.4% (12/352) of the infertile patients. Compared with the MG-positive cases, the MG-negative ones showed a significantly higher semen volume (［2.85 ± 0.14］ vs ［3.84 ± 0.12］ ml, P = 0.008) and percentage of PMS (［15.86±1.72］ vs ［60.95 ± 5.63］ %, P = 0.032) but a lower DFI (［30.73 ±2.24］ vs ［20.71 ± 1.55］%, P = 0.014). However, no statistically significant differences were observed between the two groups in the semen pH value (7.38 ±0.02 vs 7.39 ± 0.01, P = 0.774), sperm concentration (［52.96 ± 15.78］ vs ［60.05 ± 4.29］×10⁶/ml, P = 0.683), sperm count (［154.15 ± 46.37］ vs ［221.56 ± 15.43］×106, P = 0.236), total sperm motility (［29.04 ± 3.11］ vs ［33.52 ± 1.51］ %, P = 0.626), or percentage of IMS (［23.57 ± 0.99］ vs ［62.34 ± 1.69］ %, P = 0.691).</p><p><b>CONCLUSIONS</b>Urogenital MG infection is common in infertile males and potentially affects the semen quality, especially sperm vitality of the patient.</p>

RNA simultaneous and amplification testing versus the culture method for detecting Ureaplasma urealyticum infection / 中华男科学杂志

Objective@#To investigate the value of real-time RNA simultaneous amplification and testing (SAT) in the detection of Ureaplasma urealyticum (UU) in the semen of infertile males and its clinical significance.@*METHODS@#We collected semen samples from 542 infertility patients and 120 normal fertile men as controls in the Andrology Clinic of Nanjing General Hospital from March to September 2015. We detected UU infection in the samples using the culture method and SAT technology, respectively.@*RESULTS@#All the UU positive cases (except 4 false positive cases) detected by the culture method were also shown to be positive in SAT. The UU detection rate of SAT was significantly higher than that of the culture method both in the infertility patients (54.1 vs 19.7%, P<0.05) and in the normal controls (42.5 vs 12.5%, P<0.05).@*CONCLUSIONS@#SAT is a rapid and accurate method for detecting UU infection in semen samples, with a higher sensitivity and accuracy than the culture method, and it can also be used to evaluate the therapeutic effects. However, the culture method has its own advantages, such as low requirement of technical equipment, easy operation, and possibility of drug sensitivity test at the same time. Therefore, SAT and the culture method can be used alternatively according to the clinical need.