Analysis of chest imaging features of novel coronavirus pneumonia, bacterial pneumonia and viral pneumonia / 中华危重病急救医学

Objective:To investigate and summarize the chest CT imaging features of patients with novel coronavirus pneumonia (COVID-19), bacterial pneumonia and other viral pneumonia.Methods:Chest CT data of 102 patients with pulmonary infection due to different etiologies were retrospectively analyzed, including 36 patients with COVID-19 admitted to Hainan Provincial People's Hospital and the Second Affiliated Hospital of Hainan Medical University from December 2019 to March 2020, 16 patients with other viral pneumonia admitted to Hainan Provincial People's Hospital from January 2018 to February 2020, and 50 patients with bacterial pneumonia admitted to Haikou Affiliated Hospital of Central South University Xiangya School of Medicine from April 2018 to May 2020. Two senior radiologists and two senior intensive care physicians were participated to evaluated the extent of lesions involvement and imaging features of the first chest CT after the onset of the disease.Results:Bilateral pulmonary lesions were more common in patients with COVID-19 and other viral pneumonia, and the incidence was significantly higher than that of bacterial pneumonia (91.6%, 75.0% vs. 26.0%, P < 0.05). Compared with other viral pneumonia and COVID-19, bacterial pneumonia was mainly characterized by single-lung and multi-lobed lesion (62.0% vs. 18.8%, 5.6%, P < 0.05), accompanied by pleural effusion and lymph node enlargement. The proportion of ground-glass opacity in the lung tissues of patients with COVID-19 was 97.2%, that of patients with other viral pneumonia was 56.2%, and that of patients with bacterial pneumonia was only 2.0% ( P < 0.05). The incidence rate of lung tissue consolidation (25.0%, 12.5%), air bronchial sign (13.9%, 6.2%) and pleural effusion (16.7%, 37.5%) in patients with COVID-19 and other viral pneumonia were significantly lower than those in patients with bacterial pneumonia (62.0%, 32.0%, 60.0%, all P < 0.05), paving stone sign (22.2%, 37.5%), fine mesh sign (38.9%, 31.2%), halo sign(11.1%, 25.0%), ground-glass opacity with interlobular septal thickening (30.6%, 37.5%), bilateral patchy pattern/rope shadow (80.6%, 50.0%) etc. were significantly higher than those of bacterial pneumonia (2.0%, 4.0%, 2.0%, 0%, 22.0%, all P < 0.05). The incidence of local patchy shadow in patients with COVID-19 was only 8.3%, significantly lower than that in patients with other viral pneumonia and bacterial pneumonia (8.3% vs. 68.8%, 50.0%, P < 0.05). There was no significant difference in the incidence of peripheral vascular shadow thickening in patients with COVID-19, other viral pneumonia and bacterial pneumonia (27.8%, 12.5%, 30.0%, P > 0.05). Conclusions:The probability of ground-glass opacity, paving stone and grid shadow in chest CT of patients with COVID-19 was significantly higher than those of bacterial pneumonia, and it was more common in the lower lungs and lateral dorsal segment. In other patients with viral pneumonia, ground-glass opacity was distributed in both upper and lower lungs. Bacterial pneumonia is usually characterized by single lung consolidation, distributed in lobules or large lobes and accompanied by pleural effusion.

Status survey and countermeasures for trainees in standardized residency training of ultrasound professional base under the novel coronavirus pneumonia epidemic / 中华医学教育探索杂志

Objective:To investigate the behavior and emotion of trainees (residents) in the standardized residency training under the novel coronavirus pneumonia (NCP) epidemic, and adjust the training plan and mode of standardized residency training during the NCP epidemic according to the survey results.Methods:A real-name closed questionnaire survey was conducted among 40 residents (27 ultrasound majors and 13 other majors) in ultrasound department using the "Questionnaire Star" WeChat applet, including basic personal information, questions related to NCP, behavioral change survey, behavioral attitude survey and emotional status survey. All the collected data were further statistically analyzed by Chi-square test and rank sum test using SPSS 19.0Results:There were forty valid questionnaires and the participation rate was 100.0%. The accuracy of 24 NCP-related questions was not significantly different between residents majoring in ultrasound and other specialties [92.0%(596/648) vs. 93.6%(292/312), P>0.05]. All the residents had a good understanding of NCP. The main behaviors of going out were significantly reduced, while various behaviors of being at home were significantly increased. Their interest in learning declined. When the epidemic happened (or possibly) in the community or village they lived in, their negative emotions, such as nervousness, fear pessimism and depression, were obviously expressed. Network teaching and evaluation through WeChat public number were adopted and we guided residents to adjust their home behaviors and emotions according to the survey results. Conclusion:Under the NCP epidemic, the behaviors and emotions of residents had been extensively changed. The training center should adjust the teaching plan and mode of training in time, and provide more counselling service in psychology and learning for residents during the epidemic.

Current status and prospect of global development of lung transplantation / 器官移植

During the novel coronavirus pneumonia (COVID-19) pandemic from 2020 to 2021, lung transplantation entered a new stage of development worldwide. Globally, more than 70 000 cases of lung transplantation have been reported to the International Society for Heart and Lung Transplantation (ISHLT). With the development of medical techniques over time, the characteristics of lung transplant donors and recipients and the indications of pediatric lung transplantation recipients have undergone significant changes. Application of lung transplantation in the treatment of COVID-19-related acute respiratory distress syndrome (ARDS) has also captivated worldwide attention. Along with persistent development of lung transplantation, it will be integrated with more novel techniques to make breakthroughs in the fields of artificial lung and xenotransplantation. In this article, research progresses on the characteristics of lung transplant donors and recipients around the world were reviewed and the development trend was predicted, enabling patients with end-stage lung disease to obtain more benefits from the development of lung transplantation technique.

Analysis of complaint characteristics of the government hotline during the COVID-19 pandemic / 中华医院管理杂志

Objective:To analyze the number of appeals volume and causes for complaints received by the government hotline against a hospital in Yangzhou during the pandemic of novel coronavirus pneumonia(hereinafter referred to as COVID-19), so as to provide reference for handling such hotline complaints during pandemics.Methods:Retrospective comparative analysis was made on the " 12345" government hotline work orders received from July 28, 2020 to August 28, 2020(routine prevention and control period) and July 28, 2021 to August 28, 2021(pandemic closure and control period). A descriptive analysis was made on the cause types of complaints and the distribution of departments in question, along with an analysis of the correlation between the cumulative number of cases of pandemic development and the number of complaints using Spearman rank correlation method.Results:The number of work orders for a hospital in Yangzhou during the pandemic control period(659 cases) was 7.7 times higher than that in the routine control period(76 cases). Management problems accounted for 96.7%(637 cases) in the level-1 type of the causes of complaints during the closure and control period of the pandemic, and workflow problems accounted for 90.9%(599 cases) in the level-2 type, which increased by 28.3 and 27.7 percentage points respectively compared with the routine prevention and control period; The highest proportion in the level-3 type of causes for complaints during the closure and control period of the pandemic was administrative management, accounting for 87.9%(579 cases). The departments being complained the most during the pandemic incubation period, outbreak period and recovery period of the pandemic were the fever clinic, oncology department and discharge center respectively. The cumulative number of cases of pandemic development was positively correlated with the number of complaints.Conclusions:During the COVID-19, the handling of the government hotline should be analyzed along with the causes of complaints, focusing on patients′ demands, providing timely feedback, developing collaborative management measures, and achieving accurate policy implementation.

Research progress of traditional Chinese medicine in the prevention and treatment of COVID-19 / 中国热带医学

@#Abstract: The coronavirus disease 2019 (COVID-19) has become a global public health problem due to its highly contagious nature. This article aims to discuss the current situation of traditional Chinese medicine in the prevention and treatment of COVID-19, and to provide a basis for traditional Chinese medicine research and scientific and standardized treatment of COVID-19.In this article, the etiology, pathogenesis, treatment plan and research progress were summarized, analyzed and concluded by retrieving and reviewing the literature and clinical reports related to the prevention and treatment of COVID-19 with traditional Chinese medicine. Traditional Chinese medicine has obvious effects in the prevention and treatment of COVID-19, improvement of clinical symptoms, and control of disease progression, which had the unique advantages of mild curative efficacy and safety. It has important practical significance in relieving patients' early symptoms and reducing the incidence of progression from mild to severe, and had great potential for development in the treatment of COVID-19. The traditional Chinese medicine intervention and the formulation of diagnosis and treatment plans for the COVID-19 need to be continuously optimized and improved. Scientific and rational application of traditional Chinese medicine to prevent and treat COVID-19, optimization diagnosis and treatment programs, and in-depth exploration of pharmacological mechanisms, especially the provide reference for early intervention of new coronavirus pneumonia by traditional Chinese medicine, the control of disease progression in the middle stage, and improve prognosis in the late stage with Western medicine.

SARS-CoV-2 epidemic and blood safety / 中国输血杂志

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen that causes novel coronavirus pneumonia. The SARS-CoV-2 mainly transmits through respiratory tract. However, RNA of this virus can be detected in blood samples of some infected cases. This paper herein reviewed the risk of transfusion transmission of SARS-CoV-2 and relevant preventive measures. The impact of SARS-CoV-2 endemic on blood supply and the corresponding strategy were also discussed in this article.

Correlation analysis between serum uric acid and clinical features of patients with novel coronavirus pneumonia / 中华内分泌代谢杂志

Objective:To analyze the correlation between serum uric acid and clinical features of patients with novel coronavirus pneumonia(COVID-19).Methods:A total of 200 patients with COVID-19 admitted to Wuhan Lei Shen Shan hospital from January 20, 2020 to April 10, 2020 were included in this retrospective cohort study. The patients were divided into the hyperuricemia group and the non-hyperuricemia group. The data of patients were collected through electronic medical record system. SPSS 19.0 and Graphpad Prism 8.0 statistical software were used to compare clinical features, laboratory results, survival time, and prognosis of patients between hyperuricemia and non-hyperuricemia groups.Results:Compared with the non-hyperuricemia group, the hyperuricemia group showed a higher BMI and mortality( P<0.05)as well as higher white blood cell count, lymphocytes, serum creatinine, creatine kinase, cystatin C, myoglobin, interleukin(IL)-6 levels( P<0.05). Serum uric acid level was positively correlated with lymphocytes, hemoglobin, albumin, creatinine, creatine kinase, cystatin C, D-dimer levels while negatively correlated with IL-2 receptor and IL-8. The patients with hyperuricemia had significantly shorter survival time and worse prognosis than those without hyperuricemia( P=0.04). Conclusion:COVID-19 patients with hyperuricemia show higher mortality and worse prognosis compared with the patients with non-hyperuricemia.

Overview of global organ donation and transplantation in 2020 / 器官移植

Objective At present, the novel coronavirus pneumonia (COVID-19) pandemic is still raging in certain regions around the globe, and the prevention and control of the pandemic should be strengthened. Under the challenges of respective social environment and allocation of medical resources, and support from the inertia and inherent productivity of the system on which the industry depends, extensive attempts are being delivered to push forward the work of organ donation and transplantation in each country. Under the guidance of national experts and committee members, Shanxi Provincial Human Organ Procurement and Allocation Service Center was established on August 28, 2018 approved by the former Shanxi Provincial Health and Family Planning Commission. It is the only independent non-profit medical institution in Shanxi Province. In this article, the system construction of citizen's organ donation and transplantation fitting national and provincial conditions was further explored according to the data analysis of organ donation and transplantation in the United States and Spain during the COVID-19 pandemic combined with the implementation of organ donation work in Shanxi Provincial Human Organ Procurement and Allocation Service Center.

Research highlights of renal transplantation in 2020: voice from China / 器官移植

Renal transplantation is the optimal approach to improve the quality of life and restore normal life for patients with end-stage renal diseases.With the development of medical techniques and immunosuppressants, the shortterm survival of renal graft has been significantly prolonged, whereas the long-term survival remains to be urgently solved.Renal ischemia-reperfusion injury (IRI), acute rejection, chronic renal allograft dysfunction, renal fibrosis and other factors are still the major problems affecting the survival of renal graft.Relevant researches have always been hot spots in the field of renal transplantation.Meantime, 2020 is an extraordinary year.The novel coronavirus pneumonia (COVID-19) pandemic severely affects the development of all walks of life.Researches related to renal transplantation have also sprung up.In this article, the frontier hotspots of clinical and basic studies related to renal transplantation and the COVID-19 related researches in the field of renal transplantation in China were reviewed, aiming to provide novel therapeutic ideas and strategies.

Progress of research on immune escape mechanism of coronavirus / 中国药科大学学报

@#Coronavirus is an important pathogen of humans and animals. Among them, the novel coronavirus disease (COVID-19) breaking out in 2019 has brought a fatal threat to human health. The host"s innate immune response is the host"s first line of defense against pathogen invasion, but an excessive immune response can also aggravate viral infection and pathological damage. The immune escape of coronavirus is a critical pathogenic mechanism causing death. This work mainly reviews the pathogenic mechanism of coronavirus immune escape from several aspects such as host immunosensor, interferon, cytokine and coronavirus antagonizing host immune response, which provide a theoretical reference for the development of anti-coronavirus drugs.

Development and prospect of clinical research on lung transplantation in post-COVID-19 era / 器官移植

Lung transplantation has been advanced for nearly half a century around the globe, and it has been developed rapidly for over 20 years in China. The field of lung transplantation in China has been gradually integrated into the international community. The outbreak of novel coronavirus pneumonia (COVID-19) in 2020 brought big challenges, as well as diverted the worldwide attention to the development of lung transplantation in China, accelerating international communication and cooperation. With the steadily deepening of clinical and basic research on lung transplantation for severe cases of COVID-19, organ transplant physicians have deepened the understanding and thinking of the maintenance of donors, selection of elderly and pediatric candidates, and perioperative management of recipients, as the future perspective of lung transplantation in China. For interdisciplinary research related to lung transplantation, it is necessary to carry out multi-center clinical trials with qualified study design and constantly promote the theoretic and practical innovation.

Cytokine storms associated with respiratory virus infection and targeted therapy strategies / 中华实用儿科临床杂志

Since December 2019, the novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) infection has broken out worldwide, causing enormous social and economic burdens.Sudden exacerbations in SARS-CoV-2 infected people may be caused by infection-related cytokine storms.The basic state of the body and the strength of the immune response determine the prognosis of SARS-CoV-2.The interaction between proinflammatory factors and anti-inflammatory factors, and continued proinflammatory response cause lung edema, exudation, progression to acute respiratory distress syndrome involving the lung tissues and organs, multi-organ failure, and even death.The efficacy of antiviral therapy alone for immune complications like cytokine storm during viral infection is not ideal, and the targeted therapy of cytokines has become a potentially popular therapeutic strategy.Early identification and appropriate treatment of immune complications contribute to reduce the morbidity and mortality of severe viral infections.

Strategies for the development of drugs targeting novel coronavirus 2019-nCoV / 药学学报

@# There is no specific drug that has been approved for 2019-nCoV. There are a number of factors that pose major challenges in their development. Approaches to the development of anti-2019-nCoV include screening existing broad-spectrum antiviral drugs, repositioning of readily available clinical compounds, and <italic>de novo</italic> development of novel and specific agents for 2019-nCoV. Candidate compounds can be developed either to inhibit virus-based targets, such as RNA proteases, polymerase, spike glycoproteins, and viral envelop and membrane proteins, or to inhibit host-based targets, such as receptors and proteases that are utilized by virus for viral entry and endocytosis. Recently, the RNA polymerase remdesivir had demonstrated clinical efficacy in one patient with severe novel coronavirus pneumonia (NCP). The broad-spectrum viral protease inhibitor Kaletra^® is also recommended in the current NCP clinical practice. Both drugs had lately been proceeded into multiple controlled phase III clinical trials to test their safety and efficacy in NCP. Combinational therapies consisting of multiple drugs provide other viable options against 2019-nCoV, based on scientific and clinical rationales. Using bioinformatics and database analysis, we have identified 75 clinically compounds, including 20 marketed compounds, that are efficacious in inhibiting key targets in virus- and host-based approaches, which may facilitate the development of new therapeutic options for 2019-nCoV.

Investigation core emergency response competences of medical staff in public health outbreak of corona virus disease 2019 / 重庆医学

Objective To investigate the core emergency response capabilities of medical workers for corona virus disease 2019 (COVID-19) public health emergency, in order to provide references for improving emergency level. Methods By means of convenient sampling, the general information questionnaire and the medical staff's 2019-new coronavirus (2019-nCoV) core emergency capability questionnaire were used to conduct this survey, and the status of 2019-nCoV core emergency capability of 629 clinical medical staff was analysed. Results The score of core emergency response capability of medical staff for 2019-nCoV was (135.60±21.73)points, with a score rate of 73.3%; the score of preventive capability dimension was (11.69±1.96)points, with a score rate of 77.93%; the score of preparation ability dimension was (20.79±4.18)points, and the score rate was 69.30%; the score of rescue ability was (103.11±16.93)points, with a scoring rate of 73.57%. Conclusion The core emergency response capability of medical worker for 2019-nCoV and its dimensions are at a medium level. At the present stage, the training of core knowledge of medical personnel 2019-nCoV should be strengthened, effective measures should be taken to improve the alleviation of weakness in rescue, and the self-psychological adjustment of medical personnel should be strengthened to improve the core emergency response capability of medical worker.

Investigation and analysis of the psychological status of the clinical nurses in a class A hospital facing the novel coronavirus pneumonia / 重庆医学

Objective To investigate the psychological status of clinical nurses in a class A hospital facing the novel coronavirus pneumonia (NCP), in order to provide effective psychological and social intervention. Methods A total of 867 clinical nurses were randomly selected from the Mianyang Central Hospital. The general information questionnaire, standard self-assessment anxiety scale (SAS) and crisis intervention classification assessment scale (TAF) were used to conduct self-assessment questionnaire survey. Then the data were analyzed by the SPSS22.0 software. Results 38.8% of the nurses had a low risk of infection, 18.0% of them had a medium risk, 29.6% had a medium high risk, and 13.6% had a high risk. The SAS scores of clinical nurses in this hospital were statistically significant different, compared with the Chinese norm value ( P <0.05). The difference between TAF score and the degree of crisis response of nursing students in SARS period was statistically significant ( P <0.05). The majority of clinical nurses had less crisis response to NCP, with 80.7% of them suffered mild cognitive, emotional and behavioral damage, and only 2.0% suffered severe damage. Analysis of related factors showed that department, self-test risk of infection, length of service had significant influence on SAS and TAF scores of clinical nurses ( P <0.05). Conclusion During the period of NCP prevalence, no obvious anxiety and crisis reaction among clinical nurses is found in the third grade hospital. However, the psychological changes of clinical nurses with middle-age, from key epidemic prevention departments and in high risk of self-test infection are more likely to produce anxiety and crisis reaction. Therefore, appropriate and timely psychological intervention should be given.

Study on the effect of nursing-technology integrated in the imaging examination of Novel coronavirus pneumonia / 重庆医学

Currently, the outbreak of the new coronary pneumonia has entered a critical period of screening, prevention and control.In order to block the transmission of the virus in the radiology department, it is particularly important to effectively protect the medical servant while speeding up the flow of inspection.Based on the basis of notification of the bureau of disease control and prevention, the expert consensus of the CMA and CMDA, and the literature review, combined with the previous practical work experience,this article puts forward the recommendations on the important effect of nursing-technology integrated in the imaging examination of novel coronavirus pneumonia, in order to provide reference for the protection of medical servant in the radiology department at the front line of anti-epidemic.

Preliminary analysis on the incidence trend of novel coronavirus pneumonia in Shanghai / 上海预防医学

Objective To investigate the epidemical characteristics and analyze the incidence trend of novel coronavirus pneumonia (NCP) in Shanghai. Methods The epidemical data on NCP in Shanghai from January 20 to February 3, 2020 were collected for epidemiological descriptive analysis. Results The number of cumulative confirmed and suspected cases increased first and then decreased from January 20 to February 3, with the peak date being January 30 and January 29 respectively. The day-on-day growth rate of the suspected cases and the cumulative confirmed cases declined after January 27. Among the confirmed cases, the proportion of the exposure history of relevant confirmed cases was on the rise. The total number of confirmed cases of the resident population exceeded that of the population from other places to Shanghai, and Pudong new area had the largest number of confirmed cases. Conclusion The incidence of NCP showed a slowdown trend in shanghai, but it also faces the pressure of the peak of population returning to city, which should be paid enough attention to.

Epidemiological survey on a family aggregation COVID-19 in Y County, Chenzhou City, Hunan / 上海预防医学

Objective To investigate epidemic characteristics of a family aggregation COVID-19, and to provide scientific basis for prevention and control of family aggregation epidemic. Methods] Field epidemiological methods were used to investigate the cases and close contacts of a family aggregation COVID-19 in Y County, Chenzhou City, Hunan Province. Descriptive statistical analysis was used on epidemiological data . The 2019-nCoV nucleic acid was detected by real-time fluorescence quantitative RT-PCR. Results It was found that Ms. Deng was infected with COVID-19 and became the infectious source of the family aggregation epidemic , who had lived in Wuhan Hubei Province. Her boyfriend Mr. Cao became a second-generation case of COVID-19..Another two asymptomatic but infected persons were family members living with Ms.Deng . Conclusion COVID-19 easily spreads within families. The awareness of family members' protection, the education of new coronavirus pneumonia prevention and control in key groups should be strengthened to avoid the occurrence and spread of family aggregation epidemic.

Recent advances of traditional Chinese medicine on the prevention and treatment of COVID-19 / 中国天然药物

Coronavirus disease-2019 (COVID-19) is a new highly infectious disease caused by a novel coronavirus. Recently, the number of new cases infected pneumonia in the world continues to increase, which has aroused great concern from the international community. At present, there are no small-molecule specific anti-viral drugs for the treatment. The high mortality rate seriously threatens human health. Traditional Chinese medicine (TCM) is a unique health resource in China. The combination of TCM and Western medicine has played a positive and important role in combating COVID-19 in China. In this review, through literature mining and analysis, it was found that TCM has the potential to prevent and treat the COVID-19. Then, the network pharmacological studies demonstrated that TCM played roles of anti-virus, anti-inflammation and immunoregulation in the management of COVID-19 via multiple components acting on multiple targets and multiple pathways. Finally, clinical researches also confirmed the beneficial effects of TCM on the treatment of patients. This review may provide meaningful and useful information on further drug development of COVID-19 and other viral infectious diseases.

Explore the Optimal Resolvent of Medical Needs and Mental Health for Patients with Lung Cancer during Epidemic Novel Coronavirus Pneumonia / 中国肺癌杂志

BACKGROUND@#With the rapid spread of novel coronavirus pneumonia (NCP) worldwide and the escalation of prevention and control efforts, the routine medical needs of patients have been restricted. The aims were to investigate medical needs of lung cancer patients and their mental health status during the epidemic periods, so as to provide rational recommendations for subsequent diagnosis and treatment.@*METHODS@#The questionnaire was sent in the form of an electronic questionnaire at 7am on 4th, March, 2020, until 7am 6th, March, 2020, 368 questionnaires were recollected from 25 provinces (autonomous regions/municipalities) in 48 h.@*RESULTS@#Of the 368 patients, 18 patients were excluded as they didn't receive anti-tumor treatment, and 350 patients were included in the final analysis. 229 cases were treated with oral targeted drugs, and 121 cases were treated with chemotherapy or immunotherapy. 41.3% of patients treated with intravenous chemotherapy or immunotherapy experienced treatment discontinuation, and the proportion of treatment discontinuation in chemotherapy or immunotherapy was higher than those treated with oral targeted drugs (21.0%). Whether oral targeted drugs or intravenous chemotherapy or immunotherapy, more than 60% of patients experienced delays in imaging examinations. Nearly one third of patients developed new symptoms or exacerbation of existing symptoms. 26.6%-28.9% of patients have changed their treatment plans through online consultation. During novel coronavirus pneumonia, 40%-75% of lung cancer patients have mental health problems, and more than 95% of patients support government's prevention and control measures.@*CONCLUSIONS@#During the emergence of NCP, the medical needs of patients with lung cancer have not been enough, especially those who discontinued chemotherapy or immunotherapy. When medical institution resumes work, priority should be given to them. At the same time, mental health problems of patients should be valued and resolved timely.