The first policy of serious illness benefits of voluntary blood donors in China: implementation and suggestions / 中国输血杂志

【Objective】 To analyze the implementation and problems in the process of the first policy of serious illness benefits for voluntary blood donors in China, therefore provide reference for other provinces and cities to formulate care policies for voluntary blood donors. 【Methods】 The number of blood donors who received serious illness benefits and the proportion to the total number of blood donors in that year were obtained by Excel, and their basic demographic information, illness and reasons for failing to receive benefits were analyzed. 【Results】 From 2015 to 2019, a total of 198 blood donors applied for serious illness benefits, and 159 received benefits (638 000 yuan), accounting for 0.017% of the total number of voluntary blood donors in Nanjing. The average age of the recipients was 52.66, with the proportion of males (63.5%) higher than that of females (36.5%). 52.8% (the highest proportion) got benefits of 5 000 yuan. 39 applicants failed to obtain serious illness benefits, among which 27 applicants failed during 2017 to 2018 due to unidentifiable funding source. But after Nanjing Blood Donation Regulations clarified the funding sources, the implementation of serious illness benefits policy was continued in 2018. 【Conclusion】 The implementation of serious illness benefits for voluntary blood donors presented the Nanjing municipal government's care for voluntary blood donors. The legalization of this policy is conducive to the continuity and stability of policy implementation. Relevant departments and blood centers should continue to strengthen the policy publicity and make sure the policy is implemented effectively.

Value of metagenomic next-generation sequencing in children with severe infectious diseases / 中国当代儿科杂志

OBJECTIVES@#To study the application value of metagenomic next-generation sequencing (mNGS) in children with severe infectious diseases.@*METHODS@#An analysis was performed on the clinical data and laboratory test results of 29 children with severe infection who were admitted to the Second Affiliated Hospital of Wenzhou Medical University from June 2018 to December 2020. Conventional pathogen culture was performed for the 29 specimens (27 peripheral blood specimens and 2 pleural effusion specimens) from the 29 children, and mNGS pathogen detection was performed at the same time.@*RESULTS@#Among the 29 children, 2 tested positive by conventional pathogen culture with 2 strains of pathogen, and the detection rate was 7% (2/29); however, 20 children tested positive by mNGS with 38 strains of pathogen, and the detection rate was 69% (20/29). The pathogen detection rate of mNGS was significantly higher than that of conventional pathogen culture (P<0.05), and mNGS could detect the viruses, fungi, and other special pathogens that conventional pathogen culture failed to detect, such as Orientia tsutsugamushi. The univariate analysis showed that gender, routine blood test results, C-reactive protein, procalcitonin, D-dimer, radiological findings, and whether antibiotics were used before admission did not affect the results of mNGS (P>0.05).@*CONCLUSIONS@#Compared with conventional pathogen culture, mNGS is more sensitive for pathogen detection, with fewer interference factors. Therefore, it is a better pathogenic diagnosis method for severe infectious diseases in children.

Application of neutralizing antibody in children with severe viral pneumonia / 中国小儿急救医学

Severe viral pneumonia in children has become an urgent public health problem in view of its high morbidity and mortality.Neutralizing antibodies, as passive immune agents, can be injected into the body so that the body can quickly obtain immunity against specific viruses and have the potential to prevent and treat severe viral pneumonia in children.This review analyzed the possible mechanisms by which neutralizing antibodies play roles in severe viral pneumonia in children, discussed the shortcomings of existing research and possible challenges, and attempted to point out the direction worthy of future research.

Factors Defining the Development of Severe Illness in Patients with COVID-19: A Retrospective Study / 生物医学与环境科学（英文）

Objective@#Early triage of patients with coronavirus disease 2019 (COVID-19) is pivotal in managing the disease. However, studies on the clinical risk score system of the risk factors for the development of severe disease are limited. Hence, we conducted a clinical risk score system for severe illness, which might optimize appropriate treatment strategies.@*Methods@#We conducted a retrospective, single-center study at the JinYinTan Hospital from January 24, 2020 to March 31, 2020. We evaluated the demographic, clinical, and laboratory data and performed a 10-fold cross-validation to split the data into a training set and validation set. We then screened the prognostic factors for severe illness using the least absolute shrinkage and selection operator (LASSO) and logistic regression, and finally conducted a risk score to estimate the probability of severe illness in the training set. Data from the validation set were used to validate the score.@*Results@#A total of 295 patients were included. From 49 potential risk factors, 3 variables were measured as the risk score: neutrophil to lymphocyte ratio ( @*Conclusion@#This report may help define the potential of developing severe illness in patients with COVID-19 at an early stage, which might be related to the neutrophil to lymphocyte ratio, albumin, and chest computed tomography abnormalities.

Clinical outcomes of COVID-19 cases and influencing factors in Guangdong province / 中华流行病学杂志

Objective To analyze the clinical courses and outcomes of COVID-19 cases and the influencing factors in Guangdong province and provide basis for the formulation or adjustment of medical care and epidemic control strategy for COVID-19. Methods We collected demographic data, medical histories, clinical courses and outcomes of 1 350 COVID-19 patients reported in Guangdong as of 4 March 2020 via epidemiological investigation and process tracking. Disease severity and clinical course characteristics of the patients and influencing factors of severe illness were analyzed in our study. Results Among 1 350 cases of COVID-19 cases in Guangdong, 72 (5.3%) and 1049 (77.7%) were mild and ordinary cases, 164 (12.1%) were severe cases, 58 (4.3%) were critical cases and 7 (0.5%) were fatal. The median duration of illness were 23 days ( P 25 - P 75 : 18-31 days) and the median length of hospitalization were 20 days ( P 25 - P 75 : 15-27 days). For severe cases, the median time of showing severe manifestations was on the 12th day after onset ( P 25 - P 75 : 9th to 15th days), and the median time of severe manifestation lasted for 8 days P 25 - P 75 : 4-14 days). Among 1 066 discharged/fetal cases, 36.4% (36/99) and 1.0% (1/99) of the mild cases developed to ordinary cases and severe cases respectively after admission; and 5.2% (50/968) and 0.6% (6/968) of the ordinary cases developed to severe cases, and critical cases respectively after admission. In severe cases, 11.4% developed to critical cases (10/88). The influencing factors for severe illness or worse included male (a HR =1.87, 95% CI : 1.43-2.46), older age (a HR =1.67, 95% CI : 1.51-1.85), seeking medical care on day 2-3 after onset (a HR =1.73, 95% CI : 1.20-2.50) pre-existing diabetes (a HR =1.75, 95% CI : 1.12-2.73) and hypertension (a HR =1.49, 95% CI : 1.06-2.09). Conclusions The course of illness and length of hospitalization of COVID-19 cases were generally long and associated with severity of disease clinical outcomes. The severe cases were mainly occurred in populations at high risk. In the epidemic period, classified management of COVID-19 cases should be promoted according to needs for control and prevention of isolation and treatment for the purpose of rational allocation of medical resources.

Research on the application of ISBAR communication mode in bedside transduction in severe patients / 中国实用护理杂志

Objective@#To explore the effect of ISBAR communication mode on the bed shift in severe patients.@*Methods@#The "ISBAR Nursing Delivery Card near the Bed of Severe Diseases Medicine" was formulated. 100 cases of severe patients admitted from February 2018 to March 2018 were set up as control group by experimental research methods. 100 cases of severe patients admitted from April 2018 to May 2018 were set up as experimental group and non-random control was established. The patients in the experimental group were treated with ISBAR nursing shift card for bed shift, and the control group were treated with normal oral shift. Observe and compare the incidence of nurse shift problems, the score of nurse shift assessment scale and the nurse′s knowledge of the patient′s condition "ten know" score between the two groups.@*Results@#The incidence of nurse shift problems dropped from 39.50% (79/200) of control group to 16.50% (33/200) of experimental group, which had a significant difference (χ2=42.938, P<0.01). The score of the nurse′s succession assessment table was increased from (57.80 ± 3.61) points of control group to (73.96 ± 2.33) points of experimental group, which had a significant difference (t=-26.10, P<0.05). The nurse′s knowledge of the patient′s condition "ten know" had been increased from (72.14±4.13) points of control group to (87.75±2.54) points of experimental group, which had a significant difference (t=-32.01, P<0.05).@*Conclusion@#The use of ISBAR communication mode for serious patients in the severe medical department can effectively reduce the incidence of nurse shift problems, effectively improve nurses 'satisfaction with shift and the degree of mastery of patients′ conditions, and the effect of shift is better.

Research on the application of ISBAR communication mode in bedside transduction in severe patients / 中国实用护理杂志

Objective To explore the effect of ISBAR communication mode on the bed shift in severe patients. Methods The "ISBAR Nursing Delivery Card near the Bed of Severe Diseases Medicine" was formulated. 100 cases of severe patients admitted from February 2018 to March 2018 were set up as control group by experimental research methods. 100 cases of severe patients admitted from April 2018 to May 2018 were set up as experimental group and non-random control was established. The patients in the experimental group were treated with ISBAR nursing shift card for bed shift, and the control group were treated with normal oral shift. Observe and compare the incidence of nurse shift problems, the score of nurse shift assessment scale and the nurse′s knowledge of the patient′s condition "ten know"score between the two groups. Results The incidence of nurse shift problems dropped from 39.50 % (79/200) of control group to 16.50 % (33/200) of experimental group, which had a significant difference (χ2=42.938, P＜0.01). The score of the nurse′s succession assessment table was increased from (57.80 ± 3.61) points of control group to (73.96 ± 2.33) points of experimental group, which had a significant difference (t=-26.10, P＜0.05). The nurse′s knowledge of the patient′s condition "ten know" had been increased from (72.14 ± 4.13) points of control group to (87.75 ± 2.54) points of experimental group, which had a significant difference (t=-32.01, P＜0.05). Conclusion The use of ISBAR communication mode for serious patients in the severe medical department can effectively reduce the incidence of nurse shift problems, effectively improve nurses 'satisfaction with shift and the degree of mastery of patients′conditions, and the effect of shift is better.

Clinical observation on total parenteral nutrition of 45 severe neonates / 中国基层医药

Objective To evaluate the clinical effects of total parenteral nutrition in the treatment of severe neonates.Methods 45 severe neonates were treated with their essential while injected nutritious liquid.At the same time some concemed targets were tested.Results 2 cases died in 45 neonates,server infections and sudden stop of heartthrob and breath being the causes of death,and the others achieyed satisfactory result.The average body mass increased by 15/30g/d during parenteral nutrition.Conclusion Total parenteral nutrition was clinically significant for increasing the body weight of severe neonates,and it was safe,effective and supportive.