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AimsThe cycle threshold (Ct) value for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid detection is important because of the criteria for quarantine management, including release from it, which are defined in Guidelines on the Novel Coronavirus-Infected Pneumonia Diagnosis and Treatment (Provisional 9th Edition, China). As this is also currently relevant because of the recent SARS-CoV-2 epidemic in Shanghai, we discuss the SARS-CoV-2 nucleic acid detection and its problems. We focus on the gene fragments and sample types involved in nucleic acid detection and their effect on the latest criteria for release from quarantine. MethodsA total of 215 patients with SARS-CoV-2 infection were included. Pharyngeal swabs (nasopharyngeal swabs plus oropharyngeal swabs) were collected in the early stage of the disease, and pharyngeal swabs, sputum samples, and anal swabs were collected both in the middle and advanced stages of the disease. The Open reading frame 1ab (ORF lab) gene, Nucleocapsid (N) gene and Envelop (E) gene of each sample were quantitatively analyzed using fluorescence qPCR technique. ResultsExclusion of the E gene detection results had no significant effect on the interpretation of the nucleic acid Ct value of 35, with a positive concordance rate of 98.7% (95% CI 86.0%-100%) and an overall concordance rate of 99.7% (95% CI 92.9%-100%). The kappa coefficient was 0.99 (95% CI 0.92-1.00). Compared with nucleic acid detection using both pharyngeal swab and sputum sample, the positive concordance rate of the detection using pharyngeal swab alone was 47.6% (95% CI 27.8%-99.3%). The kappa coefficient was 0.63 (95% CI 0.53-0.75), and the consistency was not ideal. ConclusionsNucleic acid detection using the ORF 1ab gene and the N gene can achieve the purpose of SARS-CoV-2 detection. Nucleic acid detection using sputum samples is significant in the determination of Ct values and its significance in the development of the criteria for release from quarantine needs to be taken into account. It is suggested that to increase the accuracy of nucleic acid detection, instead of unilaterally pursuing increasing the number of target genes for amplification and improving PCR techniques, more attention should be paid to sampling and sample reliability, as well as strict quality control of the detection process.
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Objective:To explore the patterns and causes of occupational exposure to infectious diseases (OEID) among frontline medical staffs (FMS) in coronavirus disease 2019 (COVID-19) isolation wards (CIW), and the particularity of post-OEID management and the measures to prevent OEID.Methods:A total of 1 061 FMS of Wuhan Huoshenshan Hospital from February 4 to March 21, 2020 were enrolled. The OEID of FMS was investigated and analyzed from the perspectives of FMS physical and psychological conditions, protective equipment, infection-control related regulations and procedures, local air quality, exposure patterns, and the particularity of emergency treatment after exposure.Results:The incidence of OEID among FMS was 2.0%(21/1 061). The nurses and doctors accounted for 95.2%(20/21) and 4.8%(1/21), respectively. The incidences in 17 general wards and two intensive care units (ICU) were 71.4%(15/21) and 28.6%(6/21), respectively. Nearly 90.5%(19/21) and 9.5%(2/21) of the OEID events occurred in contaminated area and potential contaminated area, respectively. About 23.8%(5/21) of the OEID events were air exposure of oral-nasal skin, mucosa and respiratory tract, which was secondary to uncontrollable vomiting, and 76.2%(16/21) were pricking injuries. The inducement factors involved poor quality and inappropriate wearing of some goggles, atomization of the inside of goggles leading to blurring vision, chest distress and decreased sense of touch and operational flexibility related to level-3 protection equipment, poor air quality, FMS physical and psychological conditions, etc. Under the direction of "the Procedures for Handling OEID" , all incidents are properly handled and no FMS was infected by 2019 novel coronavirus and blood-borne pathogens. No new OEID event was found after the strict implement of set of preventive measures.Conclusions:The OEID among FMS in CIW is attributed to multiple causes. The optimized process that takes into account the specificity of OEID management for both COVID-19 and blood-borne infectious diseases can effectively prevent potential post-exposure infections. And reasonable precautions can fully reduce the risk of OEID of FMS in CIW.
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Objective:Based on the laws about medical equipments industry to analyze the basis, key points and methods of medical equipments qualification auditing.Methods: According to the present the qualification documents requirements, medical equipment category were divided into 3 types (categoryⅠ, categoryⅡand categoryⅢ)by risk degree with decreasing order. The qualification and key point of disinfection supplies and each kind of equipment (including in vitro diagnostic reagents) were explained.Results: The main work of medical equipments qualification auditing were confirmed.Conclusion: It is important way to guarantee the safety of clinical diagnosis and treatment through we strengthen the auditing of medical equipments and the qualification documents of suppliers.
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Objective:To investigate a working program of medical equipment file management. Methods: To analyze the importance, compositions and features of medical equipment files, and propose a life-cycle working program of medical equipment file management. Results:To introduce the approach and experiences of the construction of medical equipment life-cycle file management system in our hospital. Conclusion:The construction of medical equipment life-cycle file management can provide full and accurate basis for asset management, equipment maintenance, and supervising purchasing behavior.
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In the course of emerging infectious disease learning,comprehensive methods including comparing the similarity of emerging infectious disease and classical infectious disease,uniting the general introduction and the typical examples explanation,strengthening the multimedia teaching and the case based teaching were adopted to strengthen the effect of teaching.
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Communion is an important way to study.Interaction is the most notable character of network.This paper introduces some experience on how to bring net interaction into play in the network-based medical teaching.
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Objective To analyse the relationship between the left ventricular longitudinal systolic velocities quantified by DTI and the cardiopulmonary performance in patients with dilated cardiomyopathy(DCM). Methods Maximal oxygen consumption(VO2max) and systolic velocities were assessed in 68 patients with DCM during their regular follow-up. Peak velocities during isovolumic contraction (is) and ejection (ez) were assessed at the site of anal, at the middle of the wall, and at the middle site between the two sites of interventricular septum (S), lateral wall (L) of LV in apical 4 chambers view. Results Peak velocities during IVC and ejection in group of patients(32cases) with VO2max
