The application and effect of "Trinity" emergency chain in the management of patients with epidemic respiratory tract infection under the coordination of multi-branches / 中华急诊医学杂志

Objective:To summarize the application and effect of "Trinity" emergency chain in the management of patients with epidemic respiratory tract infection under the cooperation of multiple hospitals and districts, and to provide a reference for medical institutions to improve the risk response ability.Methods:Based on the collaborative management of multi-branches, the "Trinity" emergency chain of pre-hospital-emergency-critical care, identification-triage-treatment, expansion-training-dispatch was implemented to optimize and integrate medical resources.Results:During the two months, 43,000 patients were admitted to the fever clinic, with an increase of 36.08%. The average waiting time for treatment was 19.83 min, and the average admission time to ICU was 25.35 min.Conclusions:The "Trinity" emergency chain treatment scheme under the coordination of multi-branches can effectively deal with the public health events of respiratory tract infectious diseases, improve the efficiency of rescue and treatment, and enhance the risk response ability of medical institutions.

Main Infection Control Measures for Respiratory Infectious Diseases in Medical Institutions and Public Places in China / 中国医学科学院学报

Respiratory infectious diseases (RID) are the major public health problems threatening the people's lives and health.Infection control (IC) is one of the effective tools to contain the occurrence and spread of RID.We collected the articles and data on IC published since January 1,2018 and summarized the achievements,problems,and challenges of IC from administrative control,management control,environment and engineering control,and personal protection in the medical institutions and public places in China.The efforts for IC vary in different regions and medical institutions of different levels.There are still links to be improved for IC from administrative control,management control,environment and engineering control,and personal protection,especially in community-level medical institutions and public areas.It is urgent to strengthen the implementation of IC policies and conduct IC precisely according to local situations.We proposed the following suggestions.First,the existing IC products and tools should be applied to precisely implement the IC measures;second,modern high technology should be employed to develop efficient and convenient IC products and tools;finally,a digital or intelligent IC platform should be built for monitoring infections,so as to contain the occurrence and spread of RID.

Epidemiological characteristics of public health emergencies in Xishuangbanna Dai Autonomous Prefecture, Yunnan, 2012-2021 / 中国热带医学

@#Abstract: Objective　To analyze the epidemiological characteristics of public health emergencies in Xishuangbanna Dai Autonomous Prefecture from 2012 to 2021, and to provide reference for formulating relevant prevention and control measures. Methods　The data of public health emergencies reported in Xishuangbanna from 2012 to 2021 were collected and analyzed through the China Disease Prevention and Control Information System. Results A total of 78 public health emergencies (including "Unrated" events) were reported in Xishuangbanna from 2012 to 2021. The highest 21 cases and the lowest 3 cases were reported every year. A total of 1 0374 cases were reported in 78 public health emergencies, involving a population of 1 703 049, with a morbidity of 609.14/100 000, 24 deaths, mortality of 1.41/100 000 and fatality rate of 231.35/100 000. The event level was mainly "general (level Ⅳ)" with 52 incidents, accounting for 66.67%, and 17 incidents of "major (level Ⅲ)", accounting for 21.79%. 51 cases were mainly infectious diseases, accounting for 65.39%. The peak periods for incidents were May-July and November-February of the next year; there were 39 incidents in schools, accounting for 50%, followed by 20 incidents in families, accounting for 25.64%. The top three reported cases were food poisoning (32.05%), chicken pox 17 (21.79%) and dengue fever 10 (12.82%). Among the 24 deaths in public health emergencies, 22 were caused by food poisoning. Wild bacteria poisoning and alcohol poisoning were the main causes of food poisoning, accounting for 45.83% and 37.5% of the total deaths, respectively. Conclusion Infectious diseases, especially respiratory diseases and food poisoning are the focus of the prevention and control of public health emergencies in Xishuangbanna Dai Autonomous Prefecture, of which Schools and families should be pay close attention. Plague, a Class A infectious disease, caused by the bacterium Yersinia pestis has occurred in two inter-animal outbreaks in 10 years and spread to the population, which should be of great concern.

Development of an early warning index system for emerging respiratory infectious diseases in Shanghai / 上海预防医学

Objective:To develop an early warning index system to identify the outbreak of respiratory infectious diseases and to assess the epidemic risk of these diseases in Shanghai. Methods:A two-round Delphi survey with a panel of 31 experts was used to select the modifying indicators. All indicators were evaluated for necessity，feasibility，stability， and sensitivity through online questionnaires. Results:The consultation recovery rates of both rounds were 100%. The authority coefficient was 0.88， and the Kendall's W of the second-round consultation was 0.138 （P<0.001）， suggesting a good coordination among experts’ opinion. Our early warning index system was developed after the two-round Delphi survey and included two sets of indicators， one for rapid risk assessment and another for monitoring and tracing risk. Both sets of the indicators involved three aspects： transmissibility， clinical severity and potential influence of emerging diseases. The rapid risk assessment system part covered 10 indicators while the risk monitor system part covered 23 indicators. In the rapid risk assessment system part， the weight value of the top three indicators were greater than 0.10， with the highest weight value of 0.171 for titled visiting rate of influenza-like illness patients in the Emergency Department or other outpatient visits. In the risk monitor system part， the weight value of the top eight indicators were greater than 0.05， and the greatest was 0.087 for R0 （basic reproductive number）. Conclusion:The developed scientific and reliable evaluation indicator system can be used to forecast the outbreak and epidemic risk of respiratory infectious diseases. However， sensitivity and stability of the indicators need further validation and evaluation.

Respiratory infectious diseases and tissue "damage-repair" balance:pathological characteristics, treatment, and characteristics of traditional Chinese medicine / 中国中药杂志

Respiratory infectious diseases are important diseases causing major public safety events, posing a great threat to life, health, and social development. Effective control and scientific treatment of the diseases is the key basis for ensuring the stability and long-term development of the community of a shared future for human health. Although the pathogens of respiratory viral infectious diseases are diverse and the process is complex, the common pathological basis of their pathogenesis is characterized by the "damage-repair" functional imbalance of the immune microenvironment of the lesions, which leads to the subsequent structural and functional destruction of important organs. Therefore, the treatment should focus on antivirus and immunological regulation, strengthen the protection against immune injury, and promote the functional repair of damaged tissues. The above conclusions are the scientific core of host-directed therapies(HDT), which coincides with "human-disease co-treatment and healthy qi and pathogen interaction" in traditional Chinese medicine(TCM) theories. Under the support of TCM and western medicine theories, the complete pathological chain "infection-immunity-injury" of respiratory viral infectious diseases is integrated with dynamic change in "healthy qi-pathogen" in TCM to transform the treatment focus from the diseases to the patients. It is possible to fundamentally correct the "damage-repair" imbalance in the disease state, change the environment for disease development, and bring benefits to patients by strengthening human intervention, maintaining immune homeostasis, enhancing the protection of tissues and organs, and promoting the repair and regeneration of damaged tissues. This study focused on the common and key pathological processes of respiratory infectious diseases, especially the immune damage caused by the viral infection, to seek effective prevention and treatment strategies, review relevant theoretical progress, summarize effective drug candidates, prospect future research and development, and highlight the therapeutic characteristics of TCM.

Epidemiological characteristics of notifiable respiratory infectious diseases in Beijing from 2015 to 2018 / 中华疾病控制杂志

Objective To explore the epidemiological characteristics of notifiable respiratory infectious diseases in Beijing from 2015 to 2018. Methods Descriptive epidemiological method was used to analyze the monitoring data of notifiable respiratory infectious diseases, and to describe the main characteristics of the diseases. Results Average annual reported incidence was 227.64/100 000, accounting for 36.24% of the total reports and deaths of notifiable infectious diseases. Class B and C respiratory infectious diseases showed a downward and upward trend respectively. The epidemic trend and risk population of the six major infectious diseases were different. Conclusions The incidence and mortality of legal respiratory infectious diseases in Beijing increases year by year due to the sharp increase of influenza from 2015 to 2018, and the responsibility of prevention and control is great. Respiratory infectious diseases have different epidemic season and predisposing population. Different prevention and control measures should be taken according to the different epidemic characteristics of different diseases.

A study on Bayesian classification model for common respiratory infectious diseases / 预防医学

Objective To provide diagnostic clue for the investigation and laboratory examination in outbreak of common respiratory infectious diseases using a computer -aided classification model.Methods The variables were extracted from medical literature,case data of infectious diseases,reports of outbreaks such as symptoms and signs,abnormal lab test results,epidemiologic features,the incidence rates of the infectious diseases.Then a classification model was constructed using Naive Bayesian classifier and SAS 9.1 .3 Data from eight historical outbreaks of respiratory infectious diseases were used to test the model.Results Among eight outbreaks,the discriminate probability of diagnosing a disease correctly by ranking it first on the output lists of the model was 53.85%.The sensitivity was 53.85%,and specificity was 1 00.00%, and +LR was from 5.73 to ∞.The discriminant probability of diagnosing a disease correctly by ranking it within the three most probable diseases on these lists was 98.34%.The sensitivity was 98.34% and the specificity was 82.1 4%,and +LR was from 1 .26 to ∞.Conclusion A Bayesian classification model could be applied to classification and discriminant of common respiratory infectious diseases,and could improve the ability for early diagnosis of the outbreak caused by respiratory infectious diseases.

Qualitative research in the real experiences in the treatment of patients with new respiratory infectious diseases / 现代临床护理

Objective To investigate the real experiences of nurses participating in the treatment of patients with new respiratory infectious diseases. Method The semi-structural interview method was used to carry out in-depth interviews with 8 nurses who were involved in the whole process of treatments and cares of patients with SARS and H1N1 influenza to understand their real experiences. Result The nurses, who participated in the treatment and care to patients with new respiratory infectious diseases, experienced such emotions of nervousness, excitement, anxiety, fear, exhaustion, obtained support from their families, hospitals, society and meanwhile recognized their lack of professional knowledge and clinical skills. Conclusion The nurses participating in the treatment of patients with new respiratory infectious diseases should be given strengthened professional training , psychological and social support.

Delphi method applied for assessment of respiratory infectious disease risk in winter of 2013 and spring of 2014 in Songjiang District of Shanghai / 上海预防医学

By means of risk assessment, to explore the likelihood, harmfulness, pop-ulation susceptibility and comprehensive risk in relation to infectious respiratory diseases in late winter of 2013 and early spring of 2014 in Songjiang District of Shanghai , providing the basis for prevention and con-trol of infectious diseases . [ Methods] Delphi method was used and experts were invited to score for designed questions .Infectious respiratory diseases comprehensive risks were evaluated by applying the for-mula P(Risk) =[L(likelihood)+I(impact)+V(vulnerability)]/3 according to the risk evaluation plan. [ Results] After two rounds of risk evaluation by experts , the coefficient of expert activity was 1 .00 , the coefficient of authority was 0.70, 0.73 and 0.71 respectively in likelihood, harmfulness and susceptibility , and the coefficient of coordination was 0.68, 0.65 and 0.67 respectively.The viewpoints of experts tended to be consistent .Comprehensive analysis showed that the risk of influenza was high , and tuberculosis , HFMD, influenza A H7N9 avian influenza, smallpox and influenza A H1N1 avian influenza were relatively high too, while the risk of measles, scarlet fever, mumps were moderate. [Conclusion] During late winter of 2013 and early spring of 2014 in Songjiang District , close attention should be paid to the risk of in-fluenza, tuberculosis, HFMD, influenza A H7N9 avian influenza, smallpox and influenza A H1N1 avian in-fluenza .And it is important that emergency plans should be formulated or improved , drills carried out peri-odically, and experience and lessons summarized .

Prevention, control and nursing of acute respiratory infectious diseases / 中国实用护理杂志

Objective To discuss the characteristics of acute respiratory infectious disease,and the key points of prevention,control and nursing of this diseases.Methods 1067 patients with acute respiratory infectious diseases from January 2007 to February 2011were selected,the clinical prevention and protection,treatment and nursing underwent investigation and analysis.Results All 1067 patients were admitted as confirmed or suspected diagnosis of acute respiratory infectious disease,they received treatment and nursing and were discharged well-off without being source of infection.79 patients occurred nosocomial infection,which accounted for 7.4％.Conclusions Hospitals should take preventing principle,obey the prevention and control principles of early discovery,early isolation,ear diagnosis and early treatment,to control the disease in the seminal state.During the treatment process of acute respiratory infectious diseases,nurses should implement strict isolation system,give health education,clinical monitoring and nursing of stable stage in order to promote early recovery of patients.