Viral contamination on the surfaces of the personal protective equipment among health care professionals working in COVID-19 wards: A single-center prospective, observational study.

OBJECTIVE: To evaluate potential viral contamination on the surfaces of personal protective equipment (PPE) in COVID-19 wards. METHODS: Face shields, gloves, the chest area of PPE and shoe soles were sampled at different time points. The samples were tested for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by PCR, and the cycle threshold (CT) values were recorded. RESULTS: The positive rate was 74.7% (239/320) for all PPE specimens. The CT values of the samples were ranked in the following order: face shields > chests > gloves > shoe soles (37.08±1.38, 35.48±2.02, 34.17±1.91 and 33.52±3.16, respectively; P for trend < .001). After disinfection, the CT values of shoe soles decreased compared with before disinfection (32.78±3.47 vs. 34.3±2.61, P = .037), whereas no significant effect of disinfection on the CT values of face shields, chests and gloves was observed. After disinfection, the CT values of specimens collected from shoe soles gradually increased; before disinfection, the CT values of shoe sole specimens were all less than 35. CONCLUSIONS: SARS-CoV-2 can attach to the surfaces of the PPE of healthcare professionals in COVID-19 wards, especially the shoe soles and undisinfected gloves. Shoe soles had the highest SARS-CoV-2 loads among all tested PPE items.

Whether the start time of elective lung surgery impacts perioperative outcomes and cost?

Background: Fatigue and the long work hours of surgeons have attracted increasing concern in recent years. We aimed to explore whether starting time was associated with perioperative outcomes and cost for elective lung surgery. Methods: A retrospective study was conducted on elective lung surgery patients at a high surgery-volume center between September 2019 and November 2019. Patients were divided into the "early start group" if the surgery start time was before 4 post meridiem (pm), while the "late start group" was defined as surgery started after 4 pm. Perioperative outcomes and total hospital costs were compared between the two groups. In addition, multivariable logistic regression analysis was performed to identify whether start time was a risk factor for postoperative hospital duration, total hospital cost and length of operation time. Results: A total of 398 patients were finally enrolled for analysis in this study. Of all the cases, 295 patients were divided into the early start group, while 103 patients belonged to the late start group. Baseline characteristics were all comparable between the two groups. Concerning Regarding outcomes, there were no differences in postoperative hospital duration, operation time, complication incidence or and other outcomes, while the total hospital cost tended to be different but still not significantly different without statistical significance (P = 0.07). In multivariable logistic regression analysis, surgery starting late was still not found to be a risk factor for long postoperative hospital duration, high hospital cost and long surgery time. Conclusion: In elective lung surgery, perioperative outcomes and costs were similar between the early- and late-start groups, and it was not necessary to worry about the surgery order for these patients.

Surgical Treatment for Esophageal Leiomyoma: 13 Years of Experience in a High-Volume Tertiary Hospital.

Background: Esophageal leiomyoma is the most common benign tumor in the esophagus. Thoracotomy and thoracoscopy are both elective for esophageal leiomyoma enucleation. This study aimed at presenting surgical experience in our center and exploring more suitable surgical methods for different situations. Methods: We conducted this retrospective study by collecting data from patients who underwent esophageal leiomyoma enucleation through thoracotomy or thoracoscopy from January 2009 to November 2021 at West China Hospital Sichuan University. Results: A total of 34 patients were enrolled for analysis. All patients were diagnosed with a single esophageal leiomyoma. There were 25 men and 9 women. The mean age was 44.41 years (range, 18-72 years), the mean longest diameter was 4.99 cm (range, 1.4-10 cm), and the esophagus was thoroughly circled with leiomyoma in 10 patients, 10 patients underwent thoracotomy to enucleate leiomyoma, while others underwent thoracoscopic enucleation. No perioperative deaths occurred. Between the thoracotomy group and thoracoscopy group, baseline characteristics were comparable except for gastric tube status (p = 0.034). Patients were inclined to undergo the left lateral surgery approach (p = 0.001) and suffered esophagus completely encircled by leiomyoma (p = 0.002). Multivariable logistic regression analysis demonstrated that the left lateral surgery approach (p = 0.014) and esophagus completely encircled by leiomyoma (p = 0.042) were risk factors for thoracotomy of leiomyoma enucleation, while a larger tumor size demonstrated no risk. The median follow-up time was 63.5 months, and no deaths or recurrence occurred during the follow-up period. Conclusion: Thoracotomy enucleation of the leiomyoma was recommended when the esophagus was thoroughly encircled by the leiomyoma and the left lateral surgery approach was needed. However, tumor size demonstrated less value for selecting a surgical approach.

Correlation of Homocysteine, AHSG, CRP with Insulin Resistance, 25-(OH)2-VitD, Blood Lipids in Gestational Diabetes Patients.

BACKGROUND: To investigate the correlations of serum homocysteine (Hcy), α2-Heremans-Schmid glycoprotein (AHSG), and C-reactive protein (CRP) with insulin resistance (IR), 25-hydroxyvitamin D (25-OH-VD), and blood lipids in patients with gestational diabetes mellitus (GDM) by detecting their levels. METHODS: A total of 72 GDM patients (GDM group) and 72 healthy pregnant women (control group) delivered in our hospital from February 2017 to January 2019 were randomly selected. The basic data, somatological parameters [height, weight, body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio (WHR), blood pressure, and body fat content], and biochemical indexes (glucose metabolism indexes, lipid metabolism indexes, Hcy, AHSG, CRP, and 25-OH-VD) were compared between the two groups. Additionally, Pearson's correlation analysis was employed to analyze the correlations among indicators. RESULTS: In comparison with the control group, the GDM group had a higher average rate of family history of DM (p < 0.05), larger waist circumference and WHR, and higher body fat content (p < 0.05). Besides, the fasting plasma glucose (FPG), 1-hour plasma glucose (1hPG) and 2-hour plasma glucose (2hPG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS), homeostasis model assessment (HOMA)-IR, triglyceride (TG), total cholesterol (TC), and low density lipoprotein cholesterol (LDL-C) were higher in the GDM group than those in the control group (p < 0.05), while the high density lipoprotein cholesterol (HDL-C) was lower in the GDM group than that in the control group (p < 0.05). Compared with those in the control group, the serum Hcy, AHSG, and CRP levels rose, while the serum 25-OH-VD level declined in the GDM group (p < 0.05). The results of Pearson's correlation analysis revealed that HOMA-IR had positive correlations with FPG, FINS, TC, TG, Hcy, AHSG, and CRP (r = 0.591, 0.825, 0.312, 0.234, 0.458, 0.647, 0.487, p < 0.05) and negative correlation with 25-OH-VD (r = -0.323, p < 0.05). CRP was positively correlated with HOMA-IR, TC, and AHSG (r = 0.485, 0.331, 0.226, p < 0.05), negatively associated with 25-OH-VD (r = -0.443, p < 0.05), and had no correlation to TG and Hcy (r = 0.019, 0.058, p > 0.05). AHSG displayed positive correlations with HOMA-IR, TC, TG, and CRP (r = 0.647, 0.321, 0.314, 0.226, p < 0.05) and no association with Hcy and 25-OH-VD (r = 0.058, -0.034, p > 0.05). CONCLUSIONS: GDM patients have increased serum Hcy, AHSG, and CRP levels and a decreased serum 25-OH-VD level, indicating that serum Hcy, AHSG, CRP, and 25-OH-VD are correlated with glucose and lipid metabolism disorders in GDM patients.

Comparative Effect of Propofol and Volatile Anesthetics on Postoperative Pulmonary Complications After Lung Resection Surgery: A Randomized Clinical Trial.

BACKGROUND: The effect of general anesthetics (propofol and volatile anesthetics) on pulmonary outcome after lung resection surgery with one-lung ventilation (OLV) is yet undetermined. We evaluated the effect of intravenous anesthesia (propofol) and volatile anesthesia (sevoflurane or desflurane) regimens on postoperative pulmonary complications (PPCs) in patients undergoing lung resection surgery. METHODS: This prospective, randomized controlled trial enrolled 555 adult patients scheduled for lung resection surgery with OLV. Participants were randomized to 1 of 3 general anesthetic regimens (propofol, sevoflurane, or desflurane). Standard anesthesia and ventilation protocols were followed in all groups. The primary outcome was a composite of PPCs in the first 7 postoperative days. Secondary outcomes included the severity of PPCs and major postoperative complications classification. Intergroup difference in the primary outcome was assessed for significance using the Pearson χ2 test. RESULTS: Of 837 patients who were assessed for eligibility, 555 were randomized and 545 were analyzed. One hundred and seventy-nine patients were assigned to the propofol group, 182 in the sevoflurane group, and 184 in the desflurane group. The incidence of PPCs did not differ between the combined volatile anesthetics (sevoflurane and desflurane) group and the propofol group (21.9% vs 24.0%; odds ratio, 0.89; 95% confidence interval, 0.58-1.35; P = .570). The PPCs grade and Clavien-Dindo scores did not differ significantly across groups. CONCLUSIONS: In patients undergoing lung resection surgery with OLV, general anesthesia with volatile anesthetics (sevoflurane or desflurane) did not reduce PPCs compared with propofol. No difference in secondary outcomes was observed.

[Higher-order aberrations in myopic and astigmatism eyes].

OBJECTIVE: To analyze the distribution of the higher order aberrations in the population of Chinese with myopia and astigmatism and determine whether the pupil size, degree of myopia and astigmatism affects the higher order aberrations. METHODS: Using a Tscherning method, 147 myopic and astigmatism eyes were evaluated before LASIK. The root mean square (RMS) values of higher order aberrations for each subject with pupil diameters of 4.5, 5.0, 5.5, 6.0, 6.5 and 7.0 mm were calculated. The subjects were divided into following groups: high myopia (> -6.00 D) and low myopia (or= 0.75 D) and astigmatism group II (< 0.75 D). RESULTS: The root mean square (RMS) values was decreased from 3rd order to sixth order aberrations in the same eye. The individual difference was from 6.1-fold to 36.6-fold in same type of aberration. All types of aberrations, in particular spherical and coma aberration, was increased significantly with increasing pupil size. Secondary spherical aberration, spherical and secondary coma aberration were affected by myopia, but coma aberration; astigmatism only affected the coma aberration, but spherical aberration. CONCLUSIONS: The aberrations were increased with the increasing of refractive error such as myopia and astigmatism. Spherical aberration is more common in high myopia, Coma aberrations is related with astigmatism.