Changes in early postoperative outcomes and complications observed in a single center during the 2022 COVID-19 pandemic wave in China: A single-center ambispective cohort study / 中华医学杂志(英文版)

BACKGROUND@#Currently, the effect of the 2022 nationwide coronavirus disease 2019 (COVID-19) wave on the perioperative prognosis of surgical patients in China is unclear. Thus, we aimed to explore its influence on postoperative morbidity and mortality in surgical patients.@*METHODS@#An ambispective cohort study was conducted at Xijing Hospital, China. We collected 10-day time-series data from December 29 until January 7 for the 2018-2022 period. The primary outcome was major postoperative complications (Clavien-Dindo class III-V). The association between COVID-19 exposure and postoperative prognosis was explored by comparing consecutive 5-year data at the population level and by comparing patients with and without COVID-19 exposure at the patient level.@*RESULTS@#The entire cohort consisted of 3350 patients (age: 48.5 ± 19.2 years), including 1759 females (52.5%). Overall, 961 (28.7%) underwent emergency surgery, and 553 (16.5%) had COVID-19 exposure (from the 2022 cohort). At the population level, major postoperative complications occurred in 5.9% (42/707), 5.7% (53/935), 5.1% (46/901), 9.4% (11/117), and 22.0% (152/690) patients in the 2018-2022 cohorts, respectively. After adjusting for potential confounding factors, the 2022 cohort (80% patients with COVID-19 history) had a significantly higher postoperative major complication risk than did the 2018 cohort (adjusted risk difference [aRD], 14.9% (95% confidence interval [CI], 11.5-18.4%); adjusted odds ratio [aOR], 8.19 (95% CI, 5.24-12.81)). At the patient level, the incidence of major postoperative complications was significantly greater in patients with (24.6%, 136/553) than that in patients without COVID-19 history (6.0% [168/2797]; aRD, 17.8% [95% CI, 13.6-22.1%]; aOR, 7.89 [95% CI, 5.76-10.83]). Secondary outcomes of postoperative pulmonary complications were consistent with primary findings. These findings were verified through sensitivity analyses using time-series data projections and propensity score matching.@*CONCLUSION@#Based on a single-center observation, patients with recent COVID-19 exposure were likely to have a high incidence of major postoperative complications.@*REGISTRATION@#NCT05677815 at https://clinicaltrials.gov/ .

Observation and nursing of patients with inhalation injury under airway lavage / 现代临床护理

Objective To investigate the effect of airway lavage on patients with inhalation injury.Methods Sixty patients in our department with simple inhalation injury were divided into experimental group(n=30)and control group(n=30).The control group accepted traditional nursing care(aspiration of sputum,aerosol inhalation,backslap and body position adjusting) and the experimental group accepted timed airway lavage and necessary ventilator-assisted breathing in addition to traditional nursing.The arterial blood gas value(PaO2,PaCO2),rate of sputum crab plugging and lung infection were compared.Result The lung function, SpO2 and PaO2 significantly increased and rate of sputum crab plugging and lung infection significantly decreased in experiment group (P<0.05).Conclusion Airway lavage can clear sputum crab in time,improve lung fuction and reduce lung infection of patients with inhalation injury.

Construction and identification of plasmid vector of short interfering RNA on pneumocystis carinii major surface gene / 重庆医科大学学报

Objective:To construct and identify a plasmid vector of short interfering RNA(siRNA) on pneumocystis carinii(PC) major surface glycoprotein(MSG) gene.Methods:Short hairpin RNA(shRNA) oligonucleotide targeting PC MSG gene which was chemically synthesized and inserted into RNAi-Ready plasmid vector pTZU6+1 after annealing.the recombinant plasmid, pPC-MSG,transgormed into E.coil.TOP10 and amplified,was digested by restriction endonucleases HindⅢand EcoRⅠand identified by gelelectrophoresis and DNA sequencing.Results:Gel electrophoresis and DNA sequencing showed that the recombinant plasmid containing the correct and full shRNA oligonucleotide.Conclusion:The siRNA plasmid,pPC-MSG was constructed successfully.