Modes of construction of nosocomial infection control professional staff team in prefecture-level medical institutions of Jiangsu Province under COVID-19 pandemic

OBJECTIVE: To explore the construction mode of full-time staff for infection control in prefecture-level cities under the background of the COVID-19 pandemic, and to lay a foundation for infection control of epidemic prevention and control and medical safety. METHODS: A three-level collaborative promotion system which was led by the health administrative department, undertaken by the hospital association, and cooperated by the quality control center was established. Refinement of the promotion measures was taken from six aspects, including the number of full-time staff, team management, ability improvement, echelon construction, development space and discipline construction and so on. Specifically, the construction and assessment of full-time personnel was strengthened, training courses on nosocomial infection management in primary-level medical institutions was carried out, a youth backbone echelon was established, the treatment of full-time staff was guaranteed and the department of infection management was incorporated into the management of medical technology departments in an exploratory way, the evaluation standard of municipal key clinical specialties was formulated and the evaluation was organized, and the department of nosocomial infection with strong comprehensive strength would be built and supported as a "municipal clinial key specialty project". RESULTS: The total number of full-time staff for infection control in the secondary and tertiary medical institutions in the city had increased to 102, and the ratio of person to bed had increased to 1:76 and 1:173, respectively, both higher than the provincial average level. The self-assessment of the cultural atmosphere of infection control in hospitals and the leaders' emphasis on infection control of 60.34% and 63.79% full-time staff increased significantly. The infection control management department of the two third-grade first-class hospitals ware selected as the first batch of municipal key clinical specialties and received construction funds. The full-time staff had achieved zero breakthroughs in the provincial projects and municipal talent projects. CONCLUSION: By establishing a three-level collaborative promotion system of "Health and Health Commission-Hospital Association-Quality Control Center", the ability of full-time staff and their sense of belonging could be improved significantly with a policy support from the aspects of discipline development, treatment and promotion channels, et al., providing ideas and models for ordinary prefecture-level cities to build professional infection control management team.

[Critical coronavirus disease 2019 complicated with heparin resistance in 2 patients].

OBJECTIVE: To explore the diagnosis process and treatment experience of severe coronavirus disease 2019 (COVID-19) patients with heparin resistance (HR). METHODS: The medical team of the First People's Hospital of Lianyungang admitted 2 severe COVID-19 patients with HR in intensive care unit (ICU) during their support to the designated hospital for the treatment of COVID-19 patients in Lianyungang City in November 2021. The clinical features, laboratory examinations, imaging features, treatment and prognosis of the two patients were analyzed. RESULTS: Both severe COVID-19 patients received mechanical ventilation, 1 patient was treated with extracorporeal membrane oxygenation (ECMO) support. Both patients were complicated with lower extremity deep venous thrombosis and HR phenomenon under routine dose anticoagulant therapy. The maximum daily dose of unfractionated heparin exceeded 35 000 U (up to 43 200 U), the 2 patients failed to meet the standard of anticoagulation treatment, and the course of disease was prolonged. After that, argatroban was given 0.4 µg×kg-1×min-1 combined with anticoagulant therapy, the activated partial thromboplastin time (APTT) of patients undergoing ECMO could be maintained at 55-60 seconds and the activated coagulation time (ACT) of them could be maintained at 180-200 seconds. After ECMO support or later sequential mechanical ventilation, both patients recovered and were discharged, and deep venous thrombosis was also effectively controlled. CONCLUSIONS: HR phenomenon often occurs during the treatment of severe COVID-19 patients, the anticoagulation regimen should be adjusted in time, and the anticoagulation effect combined with argatroban is clear.

Establishment of method for dual simultaneous detection of PEDV and TGEV by combination of magnetic micro-particles and nanoparticles.

Transmissible gastroenteritis virus (TGEV) and porcine epidemic diarrhea virus (PEDV) are the main pathogens causing viral diarrhea in pig, mixed infections of these two viruses are very common in intensive pig rearing. However, there is a lack of a method to simultaneously detect and distinguish PEDV and TGEV in preclinical levels. In this study, we aimed to establish a dual ultrasensitive nanoparticle DNA probe-based PCR assay (dual UNDP-PCR) based on functionalized magnetic bead enrichment and specific nano-technology amplification for simultaneous detection and distinguish diagnosis of PEDV and TGEV. The detection limit of dual UNDP-PCR for single or multiple infections of PEDV and TGEV is 25 copies/g, which is 400 times more sensitive than the currently known duplex RT-PCR, showing better specificity and sensitivity without cross-reaction with other viruses. For pre-clinical fecal samples, the dual UNDP-PCR showed a markedly higher positive detection rate (52.08%) than conventional duplex RT-PCR (13.21%), can rapidly and accurately identify targeted pathogens whenever simple virus infection or co-infection. In summary, this study provides a technique for detecting and distinguishing PEDV and TGEV in preclinical levels, which is high sensitivity, specificity, repeatability, low cost and broad application prospect.

The Effect of Social Support on Mental Health in Chinese Adolescents During the Outbreak of COVID-19.

PURPOSE: The coronavirus disease 2019 (COVID-19) outbreak impacts physical and mental health. The purpose of this study was to explore the association between the levels of social support and mental health among Chinese adolescents during the outbreak. METHODS: A total of 7,202 adolescents aged 14-18 years completed online survceys from March 8 to 15, 2020, in China. Researchers assessed the associations between depression symptoms (Patient Health Questionnaire-9), anxiety symptoms (Chinese version of the 7-item Generalized Anxiety Disorder scale), and social support (Social Support Rate Scale). RESULTS: COVID-19 exposure was associated with a higher prevalence of depression symptoms (odds ratio [OR] = 1.38, 95% confidence interval [CI]: 1.14-1.66) and anxiety symptoms (OR = 1.26, 95% CI: 1.04-1.52). Only 24.6% of adolescents reported high levels of social support. Most adolescents (70%) reported medium levels of support, and 5.4% reported low support. Low support was associated with higher prevalence of depression (OR = 4.24, 95% CI: 3.38-5.33) and anxiety symptoms (OR = 3.18, 95% CI: 2.54-3.98), while controlling for gender, grade, living situation, and COVID-19 exposure; similarly, medium support was associated with higher prevalence of depression (OR = 2.79, 95% CI: 2.48-3.15) and anxiety (OR = 2.19, 95% CI: 1.94-2.48) symptoms. CONCLUSIONS: This study indicates there is a higher prevalence of mental health problems among adolescents with medium and low levels of social support in China during the outbreak of COVID-19.