Response and Assessment of the Effectiveness of the Countermeasures for a COVID-19 Outbreak - Guizhou Province, China, March 2022.

What is already known about this topic?: Many regions in China have recently reported outbreaks of the coronavirus disease 2019 (COVID-19) caused by the Omicron variant. What is added by this report?: Wuchuan County, Guizhou Province reacted quickly and implemented accurate intervention measures to effectively control the outbreak. The susceptible-exposed-infectious-asymptomatic-removed (SEIAR) model was applied to evaluate the effectiveness of intervention measures. What are the implications for public health practice?: Fast response measures should be taken to prevent the spread of outbreaks caused by the Omicron variant.

Initial Clinical Characteristics of 146 Patients with COVID-19 Reported in Guizhou Province, China: A Survival Analysis.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has caused an outbreak around the world. Early detection of severe illness is crucial for patients' survival. We analysed initial clinical characteristics of 146 patients with COVID-19 reported in Guizhou province, China to explore risk factors for transforming mild illness to severe. METHODOLOGY: Data of 146 laboratory-confirmed cases were collected and evaluated by the survival analysis of univariate and multivariate Cox proportional hazards model. RESULTS: On initial presentation, patients had fever (51.05%), dry cough (45.45%), headache (16.08%), shortness of breath (7.75%) and gastrointestinal symptoms (13.99%). Among 146 laboratory-confirmed cases, 30 patients (20.55%) had severe illness and needed Intensive Care Unit care for supportive treatment. The remaining patients (116, 79.45%) were non-severe cases. Nineteen (19/146, 13.01%) of 30 patients in the Intensive Care Unit had comorbidities, including hypertension (12, 40.00%), diabetes (5, 16.67%), cardiovascular disease (5, 16.67%) and pulmonary disease (4, 13.33%). For survival analysis, patients who had fever (HR = 3.30, 95% CI = 1.31, 8.29) and comorbidities (HR = 9.76, 95% CI = 4.28, 22.23) at baseline were more likely to be admitted into the Intensive Care Unit. Few variables were not related to the survival time of discharge from baseline to discharge and from Intensive Care Unit care to discharge. CONCLUSIONS: Severe patients with COVID-19 should be paid more attention. On initial symptoms, many patients did not have fever, but those with fever were more likely to be admitted to the Intensive Care Unit. Comorbidities were likewise a risk factor of severe COVID-19.

Epidemiologic Characteristics of COVID-19 in Guizhou Province, China.

INTRODUCTION: At the end of 2019, the COVID-19 broke out, and spread to Guizhou province in January of 2020. METHODOLOGY: To acquire the epidemiologic characteristics of COVID-19 in Guizhou province, we collected data from 169 laboratory-confirmed COVID-19 related cases. We described the demographic characteristics of the cases and estimated the incubation period, serial interval and the effective reproduction number. We also presented two representative case studies in Guizhou province: Case Study 1 was an example of the asymptomatic carrier; while Case Study 2 was an example of a large and complex infection chain that involved four different regions, spanning three provinces and eight families. RESULTS: Two peaks in the incidence distribution associated with COVID-19 in Guizhou province were related to the 6.04 days (95% CI: 5.00 - 7.10) of incubation period and 6.14±2.21 days of serial interval. We also discussed the effectiveness of the control measures based on the instantaneous effective reproduction number that was a constantly declining curve. CONCLUSIONS: As of February 2, 2020, the estimated effective reproduction number was below 1, and no new cases were reported since February 26. These showed that Guizhou Province had achieved significant progress in preventing the spread of the epidemic. The medical isolation of close contacts was consequential. Meanwhile, the asymptomatic carriers and the super-spreaders must be isolated in time, who would cause a widespread infection.

Uniaxial Tensile Properties of Atherosclerotic Carotid Artery After Mobilization of Pushing on Qiao-Gong: A Safety Study Using an Animal Model of Carotid Atherosclerosis.

OBJECTIVES: This study aimed to preliminarily explore the effects of the soft tissue mobilization of pushing on Qiao-Gong (MPQ) on biomechanical properties of the carotid artery using an animal model of carotid atherosclerosis (CAS). METHODS: Fifty rabbits were randomly divided into 4 groups: animals with CAS treated with MPQ (CAS-MPQ [n = 15]); animals with CAS treated without MPQ (CAS [n = 15]); normal animals treated with MPQ (normal-MPQ [n = 10]); and a blank control group (n = 10). The MPQ procedure consisted of soft tissue mobilization of the Qiao-Gong acupoint on the front edge of the sternocleidomastoid muscle applied from top to bottom, by flat pushing with the thumb repeatedly for 20 times. Disease in the CAS models was induced by carotid artery balloon injury combined with a high-fat diet for 12 weeks. At the end of modeling, carotid color Doppler ultrasonography examination was performed to confirm which animal models were successfully induced with CAS, excluding model rabbits without typical CAS at the same time. Then, MPQ was applied on rabbits in the CAS-MPQ and the normal-MPQ groups for 3 weeks. By contrast, rabbits in the other 2 groups were fed normally without MPQ. Uniaxial failure tests were later performed on carotid arteries in all 4 groups, and at the end of the study, a 2-way factorial analysis of variance of the results was conducted. RESULTS: (1) At the end of modeling, 10 rabbits in the CAS-MPQ group and 9 in the CAS group were included with typical carotid atherosclerotic characteristics. (2) Young's elastic modulus of the rabbit carotid artery increased more significantly in the CAS-MPQ group than the CAS group. (3) Compared with normal rabbit carotid arteries, atherosclerotic carotid arteries had lower levels of ultimate stress and ultimate strain but higher levels of ultimate load. CONCLUSIONS: The uniaxial tensile mechanical properties of the rabbit atherosclerotic carotid artery were impaired after MPQ.

A New Preprocedure Risk Score for Predicting Contrast-Induced Acute Kidney Injury.

BACKGROUND: Most of the risk models for predicting contrast-induced acute kidney injury (CI-AKI) are available for only postcontrast exposure prediction; however, prediction before the procedure is more valuable in practice. This study aimed to develop a risk scoring system based on preprocedural characteristics for early prediction of CI-AKI in patients after coronary angiography or percutaneous coronary intervention (PCI). METHODS: We prospectively recruited 1777 consecutive patients who were randomized in an approximate 3:2 ratio to create a development data set (n = 1076) and a validation data set (n = 701). A risk score model based on preprocedural risk factors was developed using stepwise logistic regression. Validation was performed by bootstrap and split-sample methods. RESULTS: The occurrence of CI-AKI was 5.97% (106 of 1777), 5.95% (64 of 1076), and 5.99% (42 of 701) in the overall, developmental, and validation data sets, respectively. The risk score was developed with 5 prognostic factors (age, serum creatinine levels, N-terminal pro b-type natriuretic peptide levels, high-sensitivity C-reactive protein, and primary PCI), ranged from 0-36, and was well calibrated (Hosmer-Lemeshow χ2 = 4.162; P = 0.842). Good discrimination was obtained both in the developmental and validation data sets (C-statistic, 0.809 and 0.798, respectively). The risk score was highly and positively associated with CI-AKI (P for trend < 0.001) in-hospital and long-term outcomes. CONCLUSIONS: The novel risk score model we developed is a simple and accurate tool for early/preprocedural prediction of CI-AKI in patients undergoing coronary angiography or PCI. This tool allows assessment of the risk of CI-AKI before contrast exposure, allowing for timely initiation of appropriate preventive measures.

Cervical Rotatory Manipulation Decreases Uniaxial Tensile Properties of Rabbit Atherosclerotic Internal Carotid Artery.

Objective. To investigate the effects of one of the Chinese massage therapies, cervical rotatory manipulation (CRM), on uniaxial tensile properties of rabbit atherosclerotic internal carotid artery (ICA). Methods. 40 male purebred New Zealand white rabbits were randomly divided into CRM-Model group, Non-CRM-Model group, CRM-Normal group, and Non-CRM-Normal group. After modeling (atherosclerotic model) and intervention (CRM or Non-CRM), uniaxial tensile tests were performed on the ICAs to assess the differences in tensile mechanical properties between the four groups. Results. Both CRM and modeling were the main effects affecting physiological elastic modulus (PEM) of ICA. PEM in CRM-Model group was 1.81 times as much as Non-CRM-Model group, while the value in CRM-Model group was 1.34 times as much as CRM-Normal group. Maximum elastic modulus in CRM-Model group was 1.80 times as much as CRM-Normal group. Max strains in CRM-Model group and Non-CRM-Model group were 30.98% and 28.71% lower than CRM-Normal group and Non-CRM-Normal group, respectively. However, whether treated with CRM or not, the uniaxial tensile properties of healthy ICAs were not statistically different. Conclusion. CRM may decrease the uniaxial tensile properties of rabbit arteriosclerotic ICA, but with no effect on normal group. The study will aid in the meaningful explanation of the controversy about the harmfulness of CRM and the suitable population of CRM.