RÉSUMÉ
Objective To analyze the diagnosis and treatment data after the adjustment of various measures in the hospital fever clinic during the coronavirus disease 2019 (COVID-19) outbreak, so as to provide experience for the prevention and control of COVID-19 in non-epidemic areas. Methods We collected the diagnosis and treatment data from the fever clinic of Changhai Hospital of Naval Medical University (Second Military Medical University) in non-epidemic area from Dec. 21, 2019 to Feb. 22, 2020 and Jan. 1 to Mar. 5, 2019, and divided them into four groups: Group A (during the 2020 COVID-19 epidemic), from Jan. 22 to Feb. 22, 2020; group B (before the COVID-19 epidemic), from Dec. 21, 2019 to Jan. 21, 2020; group C (in the same period as group A in 2019), from Feb. 2 to Mar. 5, 2019; and group D (in the same period as group B in 2019), from Jan. 1 to Feb. 1, 2019. Year-on-year and month-on-month comparisons of the above data were conducted. Results The overall situation of the fever clinic around the Spring Festival in 2020 was similar to that of the same period in 2019. The year-on-year comparison results showed that during the COVID-19 epidemic, the number of daily patients in the fever clinic was significantly decreased ([114.3±62.9] cases vs [171.7±37.0] cases), the single consultation time of each physician was prolonged ([11.7±1.8] min vs [6.5±1.3] min), but the average waiting time of patients was decreased ([7.5±0.6] min vs [22.8±1.5] min) (all P<0.05). The month-on-month comparison results indicated that the number of daily patients in the fever clinic was significantly decreased during the COVID-19 epidemic ([114.3±62.9] cases vs [216.3±41.8] cases), the single consultation time of each physician was prolonged [( 11.7±1.8] min vs[ 5.6±0.8] min), but the average waiting time of patients was decreased ([7.5±0.6] min vs [23.3±3.2] min) (all P<0.05). The proportion of computed tomography (CT) examination during the 2020 COVID-19 epidemic was significantly higher than that in the same period of 2019 (7.9%[ 292/3 658] vs 3.7% [206/5 493]). Although the examination time was prolonged due to strengthened protective measures ([12.5±3.8] min vs [10.0±3.2] min) (P<0.05), the time for patients to have the CT examination report was significantly shortened ([10.6±2.5] min vs [58.4±9.6] min) (P<0.01). Conclusion During the COVID-19 epidemic, measures such as adjusting the relevant procedures of the fever clinic and equipping special CT machine in non-epidemic area can reduce the daily consultation time of physicians, improving the diagnosis and treatment efficiency and reducing cross infection.
RÉSUMÉ
<p><b>BACKGROUND</b>The usual transbronchial coagulation techniques include microwave, argon plasma coagulation (APC), electrocautery and cryotherapy. However, there are serious clinical problems in the safety of each. By analyzing the experimental data and clinical observations, we observed the variable effects of different coagulation techniques via bronchofibroscopy, to look for an optimal interventional management of luminal bronchus diseases, and evaluate the safety and the equivalent point.</p><p><b>METHODS</b>Four kinds of coagulation techniques under bronchoscopy were performed on the fresh bronchus of healthy sheep, and the pathologic changes in all groups were observed under the microscope. The different treatment parameters were as follows: microwave 60 W×1 second, 3 seconds, 5 seconds and 40 W×1 second, 3 seconds, 5 seconds; APC 40 W×1 second, 3 seconds, 5 seconds; electrocautery 40 W×1 second, 3 seconds, 5 seconds; cryotherapy 100 Ω×60 seconds, 120 seconds.</p><p><b>RESULTS</b>After treatment, ovine bronchial mucosa in all groups showed pathologic changes such as local necrosis and amotio of the mucosa lining epithelium, local submucosa coagulative necrosis or tissue defects, while inflammation in the surrounding tissue was not obvious. Under the same output power and action time, different methods had different outcomes. The damage by APC was the most superficial, microwave was the second, and electrocautery caused the worst damage. The study also found that effects of electrocautery at 40 W×3 seconds, microwave at 40 W×5 seconds or 60 W×3 seconds, APC at 40 W×5 seconds and cryotherapy at 100 Ω×120 seconds were the equivalent point conditions. The appearance included mucosa absence, partial submucosa absence, and collagen fiber coagulation in treatment areas.</p><p><b>CONCLUSIONS</b>Each coagulation technique has its own characteristic. It is very important to choose the appropriate power and action time of the suitable method according to the therapy requirement.</p>