Expert consensus on antiviral therapy of COVID-19 / 中华临床感染病杂志

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

Analysis on on-site rescue and traumatic features of victims involved in gas explosion accident in Hangzhou / 中华烧伤杂志

Objective@#To investigate the situations of on-site rescue and traumatic features of victims involved in gas explosion accident in Hangzhou, so as to provide more data support for emergency medical rescues of the similar incidents of massive casualty.@*Methods@#Two medical workers with a certain clinical experience were sent to Hangzhou 120 emergency medical centers to collect data of the on-site rescue on 21st July, 2017, including ambulance call-outs, on-site command and traffic conditions, and on-site triage and evacuation of the victims. They were then sent to the hospitals receiving the victims to investigate the situations of these victims including the general information (such as gender, age, admitted hospitals, and number of admission, discharge, and transferring in the first two weeks after the accident) and injury assessment [such as injury position and type, injury severity evaluation by New Injury Severity Scoring (NISS), and burn severity evaluation for victims with burns].@*Results@#(1) A total of 15 ambulances reached the accident site for rescue. The traffic and transportation were jammed and interrupted after this accident. On-site triage and distribution were disorderly conducted. (2) Clinical data of 53 victims were collected, including 24 males and 29 females, with the age of 8 to 70 (34±14) years old. They were sent into 6 hospitals in Hangzhou. Two victims died on the day of accident. Up to two weeks after this accident, 28 (52.8%) victims were discharged from the hospitals and received follow-up in outpatient department. Five victims with severe injuries were transferred to the other hospitals. (3) Based on the results of NISS, the injury severities were mild in 29 (54.7%) cases, moderate in 9 (17.0%) cases, serious in 3 (5.7%) cases, and severe in 12 (22.6%) cases. Those 2 dead victims were classified into the severe category due to the highest NISS score of 75. For all of the victims, skin and soft tissue defects were most common. Six (11.3%) victims were combined with burns. According to the classification of burn severity, there were one case of mild, one case of serious, and 4 cases of severe.@*Conclusions@#The gas explosion accident in Hangzhou caused massive casualties with complex injuries. The local emergency medical rescue responded quickly, but during the rescue process, lots of aspects should be further improved.

Anti-HIV therapy in central nervous system:challenges and strategies / 中华临床感染病杂志

Combined antiretroviral therapy ( cART) is widely used for infections of human immune deficiency virus ( HIV) .However , some antiviral drugs can not reach the effective concentrations in central nervous system due to the hinder of blood-brain barrier ( BBB) , resulting in the formation of viral reservoir in central nervous system .BBB is formed by human brain microvascular endothelial cells ( HBMVECs ) , which are connected by tight junction and a thick basement membrane , and astrocytic end-feet.This paper reviews possible mechanisms of BBB hindrance and anti-HIV drug efflux by transport proteins , as well as effective methods to deliver antiretroviral drugs into brain , including the application of nano technology .

Application of hospital teaching rounds in clinical teaching practice in hospitals for infectious diseases / 中华医学教育探索杂志

Great difficulties were existed in clinical teaching in hospitals for infectious diseases. Therefore,a centralized hospital teaching rounds,a new clinical teaching practice was taken in a hospital for infectious diseases. During seven years' practice,a basic mode of centralized hospital teaching rounds was established,which contains many aspects such as organizational form,time arrangement,case se-lection and operation procedures. Its effectiveness was evaluated accoding to the following aspects:number of people attending hospital teaching rounds,composition of these people,satisfaction of these people, comparison of ward rounds data recorded nowadays and 7 years before and assembling all the rounds records into a book. Results indicated that this measure overcame the limitations of the specialized hospi-tals to some extent and played an important role in improving clinical teaching quality.

Pathologic grading and clinical features of chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To raise the accuracy of clinical diagnosis of chronic hepatitis B.</p><p><b>METHODS</b>The correlation between the clinical features, biochemical tests (the serum total bilirubin-TBil, albumin-ALB, prothrobin activity-PTA, alanine aminotransferase-ALT, albumin/globulin-A/G, and r-globulin-r-G) and histopathological data in 202 patients with chronic hepatitis B (CHB) were studied.</p><p><b>RESULTS</b>Some of presenting symptoms and signs were obviously associated with histological grade and stage. The grade of necroinflammatory activity of CHB was associated with the rising TBil, ALT, GGT and the declining ALB, A/G and PTA. The coincidence of clinical diagnosis and pathology was highest in mild chronic hepatitis, 63.8%~79.0%; then was in marked chronic hepatitis, 40.0%~62.5%. The coincidence was lowest in moderate chronic hepatitis, 10.0%~28.2%.</p><p><b>CONCLUSIONS</b>Great attention should be paid to the significance of symptoms and signs, meanwhile the standard of clinical diagnosis for moderate chronic hepatitis might be relaxed somewhat.</p>