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Objective:To evaluate the efficacy of vitamin D supplementation for prevention of spontaneous bacterial peritonitis (SBP) in patients with decompensated liver cirrhosis of hepatitis B.Methods:A total of 172 patients with decompensated cirrhosis of hepatitis B admitted in Jinhua Hospital affiliated to Zhejiang University School of Medicine from January to December 2021 were randomly divided into two groups with 86 cases in each group. Patients in both groups received conventional antiviral and symptomatic treatment; while patients in the intervention group received additinal oral vitamin D drops (800 IU/d) for 6 months. After 6 months of treatment, the incidence of SBP and the serum biochemical indexes were compared between two groups. SPSS 21.0 statistical software was used for data analysis.Results:After 6 months of treatment, the incidence of SBP in the intervention group(5.81%, 5/86) was significantly lower than that in control group(30.23%, 26/86)( χ2=19.210, P<0.01). The serum 25-(OH)D level in intervention group was significantly higher than that in the control group ( t=13.425, P=0.018), while the levels of CRP, PCT and IL-6 in intervention group were significantly lower than those in control group ( t=17.312, 10.353 and 12.218, P<0.01 or <0.05). Conclusion:Vitamin D adjuvant therapy can increase serum 25-(OH)D level, decrease serum CRP, PCT and IL-6 levels, and effectively reduce the incidence of SBP in patients with decompensated cirrhosis of hepatitis B.
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ObjectiveExplore best upper respiratory tract sampling time of suspected novel coronavirus pneumonia cases. MethodsWe collected dates of patients from Hangzhou, Shenzhen, Jinhua city and so on who had the clear exposure history of a novel coronavirus pneumonia(COVID-19). We retrospected demographic data, exposure time, onset time, visiting time and positive time for novel coronavirus nucleic acid detection in respiratory specimens. There were 256 patients from January 20,2020-February 12,2020 from eight cities included in our study. 106 cases appeared symptoms before January 25th and 150 after. ResultsThere were 136(53.1%)male infected cases. The mean age of all patients was 43.80{+/-}14.85. The median time from exposure to onset was 5(3,8) days. The median time of the first time of positive nucleic acid detection was 11(9,14)days and mode number was 13. The median time from onset to the first time of positive nucleic acid detection was 6(4,8)days and mode number was 5. The time from onset to definite diagnosis was 5(3,7) days before January 25th while it was 7.5(5,10)days after which was significantly shorter before January 25th(U=3885.5,P<0.001). The time from exposure to definite diagnosis was 11(9,14)days and 11(9,14)days before January 25th and after and without significant difference. The time from exposure to definite diagnosis was 11(9,13)days in first-tier cities and 13(11,15)days in second and third-tier cities. The difference was significantly shorter of first-tier cities(U=1355.5, P=0.039). And also the time was short from visiting to definite diagnosis which was 2(2,3)days in first-tier cities and 3(2,4)days in second and third-tier cities but without significant difference(U=842.5, P=0.054). ConclusionsFrom our study we found that the best upper respiratory tract sampling time for novel coronavirus pneumonia suspects was 13days after exposure. The time from onset to definite diagnosis was shorter after January 25th. The patients were diagnosed faster in the first-tier cities after exposure.
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OBJECTIVE@#To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of corona virus disease 2019 (COVID-19).@*METHODS@#The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed.@*RESULTS@#Of the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times per case. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged; there was no cross-infection occurred in suspected patients during the hospitalization; there were no deaths and no medical staff infections.@*CONCLUSIONS@#The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved under MDT mode, particularly for complicated and refractory cases.
Subject(s)
Humans , Betacoronavirus , Coronavirus Infections , Diagnosis , Therapeutics , Disease Management , Interdisciplinary Communication , Pandemics , Patient Care Team , Reference Standards , Pneumonia, Viral , Diagnosis , Therapeutics , Retrospective Studies , Treatment OutcomeABSTRACT
OBJECTIVE@#To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of coronavirus disease 2019 (COVID-19).@*METHODS@#The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Municipal Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed.@*RESULTS@#In the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged. There was no cross-infection occurred in suspected patients during the hospitalization. There were no deaths and no medical staff infections.@*CONCLUSIONS@#The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved with MDT, particularly for complicated cases.
