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Objective: To explore the distribution and correlation of pathogens in the elderly patients with AECOPD, so as to guide the rational use of antibiotics and hormones in clinic. Methods: A total of 111 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to Nanjing First Hospital from January 2019 to January 2020 were retrospectively analyzed. The basic data such as eosinophil, neutrophil and lymphocyte count, the levels of C-reactive protein(CRP) and erythrocyte sedimentation rate (ESR)in blood routine examination were collected. Further, the pathogens were qualified by sputum fluorescence quantitative polymerase chain reaction, and the pathogens distribution was analyzed. Results: The level of ESR and the ratio of cardiovascular diseases showed significant differences between the pathogen-positive group and pathogen-negative group. In this study, the top five pathogens in AECOPD patients were EB virus (21.6%), Haemophilus influenzae (19.8%), Streptococcus pneumoniae (17.1%), herpes simplex virus(14.4%), influenza A virus(14.4%). The detection rate of influenza A virus was correlated with influenza B virus and Aspergillus (P < 0.05);The detection rate of respiratory syncytial virus was correlated with Candida, Moraxella catarrholis, Streptococcus pneumoniae and Haemophilus influenzae (P < 0.05);The detection rate of Escherichia coli was correlated with rhinovirus, adenovirus, Klebsiella pneumoniae and Acinetobacter baumannii (P < 0.05);The detection rate of Candida was correlated with that of Moraxella catarrholis and Pseudomonas aeruginosa(P<0.05);The detection rate of human coronavirus was correlated with Haemophilus influenzae, herpes simplex virus and Streptococcus pneumoniae(P < 0.05). Conclusions: AECOPD are mostly induced by different pathogens, especially mixed infection of bacteria and virus. It is helpful to guide the rational use of antibiotics by analyzing the etiological characteristics in the elderly patients with AECOPD.
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OBJECTIVE: To investigate the immune antibodies in blood specimens of 95 health care workers vaccinated with inactivated 2019-nCoV vaccines and explore the rules and characteristics of production of antibodies after vaccination. METHODS: From Oct 2020 to Jul 2021, the venous blood specimens were collected from 95 health care workers of the 305 Hospital of PLA after the injection of 2 doses of 2019-nCoV vaccines fo30 days, 65 days, 91 days, 6 months and 9 months. SARS-CoV-2 immunoglobin(Ig) M, IgG and titers of neutralizing antibodies and total antibodies were detected by chemiluminescence immunoassay, the results of antibody tests were dynamically analyzed, the immune durability of the antibody, influencing factors and correlation were determined. RESULTS: Almost all of the subjects produced IgG, neutralizing antibody and total antibody, some subjects retained high level of IgM titer. Smoking could affect the production of total antibody. The subjects of the low body weight group produced higher level of IgG, and there was no significant difference when the weight was over 60 kg. The titers of the four types of antibodies decreased significantly at the following time points, and the positive rates of all the antibodies were less than 50% except for IgG after the vaccination for 9 months. CONCLUSION: Specific IgM and IgG, neutralizing antibody and total antibody can be produced after the 2-doses vaccination of inactivated 2019-nCoV vaccines. But the titers and positive rates of the antibodies decrease with time, which means the protective effects on the body decrease. Therefore, in order to improve the autoimmunity against novel coronavirus, one booster vaccination of an inactivated 2019-nCoV vaccine will be necessary after the 2 doses of vaccination for 6 months.
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Objective: Taking the three outbreaks caused by Delta variant (B.1.617.2) in Guangzhou, Guangdong Province, Nanjing, Jiangsu Province and Zhengzhou, Henan Province as examples, to explore different transmission pattern of SARS-CoV-2 epidemic and to provide basis for scientific prevention and control.
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OBJECTIVE: To analyze theconstruction of infectious diseases departments and fever clinics in medical institutions at all levels in Jiangsu Province after the COVID-19 epidemic, and to provide a basis for promoting their standardized construction. METHODS: A questionnaire survey was conducted on the construction of infectious diseases departments and fever clinics in 429 medical institutions of Jiangsu Province from July to December 2020, including the overview of medical institutions, the construction status of infectious diseases departments, the construction status and future construction plans of fever clinics, etc. RESULTS: The construction rate of infectious diseases department and fever clinics in medical institutions of Jiangsu province were 33.3% and 75.3% respectively. Ventilation by opening window for was the main form of airflow organization in infectious diseases department and fever clinics, and independent ICUs and negative pressure wards were not set up in most of infectious diseases departments. The setting rate of "three zones and two channels" in fever clinics was high(96.9%), but most of them were not equipped with special CT for fever clinics patients. The proportion of air conditioning and ventilation system without air disinfection devices in the of fever clinics of medical institutions at all levels was higher than 90%. Considering the both hardware construction and quality management, the situation in tertiary medical institutions were superior to secondary medical institutions, and secondary medical institutions were superior to primary medical institutions. Various construction indicators and management systems failed to fully meet the requirements of documents and standards. CONCLUSION: Jiangsu province actively promotes the construction of infectious diseases department and fever clinic layout, but there is still a gap with the construction standard, which is necessary to further promote standardized construction. We should mend the shortages, strengthen the weakness, expand the bases, comprehensively improve the service and anti-epidemic capacity of infectious diseases departments, fever clinics and even the entire medical and health system, so as to better serve the health and life safety of the people.
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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.
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OBJECTIVE: To collect aerosol from isolation wards of a designated COVID-19 hospital and conduct the nucleic acid test so as to provide scientific basis for prevention and control of COVID-19. METHODS: The air aerosol specimens were collected from layout sites in the isolation wards of the hospital by using bioaerosol collector, and the COVID-19 nucleic acid test was carried out for all of the specimens by using fluorescent polymerase chain reaction(PCR) and digital PCR. RESULTS: A total of 86 aerosol samples were collected, all of which were tested negative for the fluorescent PCR, the result of the digital PCR test showed that 14 air aerosol samples were tested positive for COVID-19 nucleic acid, with the detection rate 16.28%. The toilets of the patients and taking-off area of protective supplies of healthcare workers were the major places where the specimens were tested positive. The positive rate of nucleic acid test was significantly higher in in intensive care units than in common wards, however, there was no significant difference in the positive rate of nucleic acid among the aerosol specimens in different wards(?-2=7.871, P=0.248);there was no significant difference in the positive rate of nucleic acid of aerosol between the patients with CT value more than 30 and the patients with CT value no more than 30(?-2=0.232, P=0.630). CONCLUSION: There are still viral nucleic acids in the air aerosol of the isolation wards during the middle and late disease course of the COVID-19 patients, but the copy number of novel coronavirus is not large in the specimens. The detection rate of the viral nucleic acid is high in the aerosol of the wards that are crowed and poorly ventilated and are associated with the cases. It is necessary for the health care workers to take good care of themselves, keep the environment well ventilated and do a good job in environmental cleaning and disinfection and air purification.
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OBJECTIVE: To analyze the consistency between the objective and qualitative suitability test results of medical N95 protective masks and the subjective evaluation results of the wearers so as to provide scientific basis for selection of protective masks. METHODS: A survey was conducted among 221 staff in Nanjing COVID-19 designated hospitals from Aug 11, 2021 to Aug 29, 2021. A questionnaire designed by bitterness aerosol method (3 MTMFT-30) approved by Occupational Safety and Health Administration (OSHA) was used to collect and investigate the data on the spot, and the data were statistically analyzed by using SPSS23.0 software. RESULTS: The result of sensitivity test showed that 201 (90.95%) staff passed the test, including 169 (76.47%) staff with grade 1 sensitivity, 30 (13.57%) staff with grade 2 sensitivity and 2(0.90%) staff with grade 3 sensitivity. In terms of objective and qualitative suitability test, the passing rate was 92.04% (185/201), 188 staff passed the first test, 5 staff passed the second test. In terms of the subjective evaluation of the wearers, 111 staff had good subjective overall feeling, accounting for 55.22%;the scores of mouth opening assisted breathing, mask smell and facial muscle adjustment were (2.10+or-0.58) points, (2.13+or-0.42) points and (2.46+or-0.56) points, respectively, significantly lower than (2.55+or-0.50) points of the overall subjective evaluation score, and there was significant difference in the sealing ability of mask before the subjective evaluation and after adjusting by facial muscles (?~2=17.840, P<0.05). The results of objective qualitative suitability test were not consistent with the subjective evaluation of the wearers, and the kappa value was 0.174 (P< 0.001). CONCLUSION: In the objective and qualitative suitability test, the medical N95 protective mask has high safety performance. On the basis of good suitability, it can increase the wearing comfort of the mask, improve the overall subjective evaluation of the wearer, and make full use of the test results to reasonably select and effectively use the protective mask.
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Objective: To understand the late detection of new HIV/AIDS cases in Changshu City from 2015 to 2019, and to provide scientific basis for AIDS prevention and control.
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Objective: To understand the epidemiological and etiological characteristics of influenza-like illness (ILI) in Zhenjiang, Jiangsu province, during 2013-2020, and provide scientific basis for the prevention and control of influenza.