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OBJECTIVE: To describe the experience of comprehensive management of pediatric COVID-19 cases in designated hospitals under 'mixed management mode' during the '0801' epidemic in Sanya. METHODS: A pediatric comprehensive ward of children and parents has been specially opened in the designated hospitals to carry out comprehensive treatment and management of pediatric children. RESULTS: From Aug 1, 2022 to Oct 1, 2022, Sanya Central Hospital(Hainan Third People's Hospital), as the designated hospital for the treatment of COVID-19 cases in South area of Hainan, a total of 251 children aged between 0 and 14 year old and 195 aged more than 14 years old were treated for COVID-19 in the pediatric comprehensive wards. Among children under 14 years old, including 10(4.0%) neonates aged between 0 and 28 days, 32(12.7%) cases aged between 29 days and 1 year old, 87(34.7%) cases aged between 1 and 3 years old and 122(48.6%) cases aged between 3 and 14 years old. There were 16(6.4%) cases of common type, 223(88.8%) cases of mild type, 12(4.8%)asymptomatic cases and 7(2.8%) re-positive cases. There were 246(98.0%) children with accompanying care and 5(2.0%) children without accompanying care and 23(9.2%) children complicated with underlying diseases. The youngest age was 11 days, and the oldest age was 77 years old. The large age span and poor compliance with treatment brought unprecedented challenges to the diagnosis and treatment of children in the designated hospitals. The mixed model of comprehensive management and multidisciplinary diagnosis and treatment helped to achieve the ultimate goals of 'zero death of patients and 'zero infection' of health care workers. CONCLUSION: The comprehensive management means such as optimization of flow, stress on prevention and control of nosocomial infection, multidisciplinary collaboration and support of information platform offer strong guarantee for the mixed mode of management as well as scientific experience for centralized diagnosis and treatment of respiratory infectious diseases in children.
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The herb-pair ginseng-Fuzi (the root of Aconitum carmichaelii) is the material basis of Shenfu prescriptions and is popular in traditional Chinese medicine for the treatment of heart failure, and even shock with severe-stage of COVID-19. A narrow therapeutic window of Fuzi may cause significant regional loss of property and life in clinics. Therefore, systemic elucidation of active components is crucial to improve the safety dose window of Shenfu oral prescriptions. A high performance liquid chromatography-mass spectrometry method was developed for quantification of 10 aconitines in SD rat plasma within 9 min. The limit of detection and the limit of quantification were below 0.032 ng/ml and 0.095 ng/ml, respectively. Furthermore, a systemic comparison with their pharmacokinetic characteristics after oral administration of a safe dosage of 2 g/kg of Fuzi and ginseng-Fuzi decoction for 24 h was conducted. Eight representative diester, monoester, and non-ester aconitines and two new active components (i.e., songorine and indaconitine) were all adopted to elucidating the differences of the pharmacokinetic parameters in vivo. The compatibility of Fuzi and ginseng could significantly increase the in vivo exposure of active components. The terminal elimination half-life and the area under the concentration-time curve of mesaconitine, benzoylaconitine, benzoylmesaconitine, benzoylhypaconitine, and songorine were all increased significantly. The hypaconitine, benzoylmesaconitine, and songorine were regarded as the main active components in vivo, which gave an effective clue for the development of new Shenfu oral prescriptions.
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Background: Nucleic acid detection and CT scanning have been reported in COVID-19 diagnosis. Here, we aimed to investigate the clinical significance of IgM and IgG testing for the diagnosis of highly suspected COVID-19. Methods: A total of 63 patients with suspected COVID-19 were observed, 57 of whom were enrolled (24 males and 33 females). The selection was based on the diagnosis and treatment protocol for COVID-19 (trial Sixth Edition) released by the National Health Commission of the People's Republic of China. Patients were divided into positive and negative groups according to the first nucleic acid results from pharyngeal swab tests. Routine blood tests were detected on the second day after each patient was hospitalized. The remaining serum samples were used for detection of novel coronavirus-specific IgM/IgG antibodies. Results: The rate of COVID-19 nucleic acid positivity was 42.10%. The positive detection rates with a combination of IgM and IgG testing for patients with COVID-19 negative and positive nucleic acid test results were 72.73 and 87.50%, respectively. Conclusions: We report a rapid, simple, and accurate detection method for patients with suspected COVID-19 and for on-site screening for close contacts within the population. IgM and IgG antibody detection can identify COVID-19 after a negative nucleic acid test. Diagnostic accuracy of COVID-19 might be improved by nucleic acid testing in patients with a history of epidemic disease or with clinical symptoms, as well as CT scans when necessary, and serum-specific IgM and IgG antibody testing after the window period.