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BackgroundEstimation of the fraction and contagiousness of undocumented novel coronavirus (COVID-19) infections is critical for understanding the overall prevalence and pandemic potential of this disease. Many mild infections are typically not reported and, depending on their contagiousness, may support stealth transmission and the spread of documented infection. MethodsHere we use observations of reported infection and spread within China in conjunction with mobility data, a networked dynamic metapopulation model and Bayesian inference, to infer critical epidemiological characteristics associated with the emerging coronavirus, including the fraction of undocumented infections and their contagiousness. ResultsWe estimate 86% of all infections were undocumented (95% CI: [82%-90%]) prior to the Wuhan travel shutdown (January 23, 2020). Per person, these undocumented infections were 52% as contagious as documented infections ([44%-69%]) and were the source of infection for two-thirds of documented cases. Our estimate of the reproductive number (2.23; [1.77-3.00]) aligns with earlier findings; however, after travel restrictions and control measures were imposed this number falls considerably. ConclusionsA majority of COVID-19 infections were undocumented prior to implementation of control measures on January 23, and these undocumented infections substantially contributed to virus transmission. These findings explain the rapid geographic spread of COVID-19 and indicate containment of this virus will be particularly challenging. Our findings also indicate that heightened awareness of the outbreak, increased use of personal protective measures, and travel restriction have been associated with reductions of the overall force of infection; however, it is unclear whether this reduction will be sufficient to stem the virus spread.
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A metabonomic approach involving an ultrahigh-performance liquid chromatography combined with Fourier transform ion cyclotron resonance mass spectrometry (UHPLC-FT-ICR-MS) was used to investi-gate the changes in the endogenous metabolites in the plasma of rats with yeast-induced pyrexia treated with Gegenqinlian decoction (GQLD), aspirin and itraconazole. The differences in the small molecule profiles of treatment using traditional Chinese medicine, etiological treatment and symptomatic treat-ment were elucidated. Thirty-six plasma metabolites were identified or putatively identified, and the effects of the three medicines on the thirty-six metabolites were studied. Their metabolic pathways indicated that GQLD, aspirin and itraconazole ameliorated the rats with yeast-induced pyrexia pre-dominantly by regulating the metabolisms of phospholipid, sphingolipid, fatty acid oxidation, fatty acid amides, amino acid and glycerolipid in vivo. The pharmacodynamics and metabonomic results showed that the three medicines exhibited the therapeutic effects on pyrexia by regulating the perturbations of multiple metabolisms. The study provided a scientific basis for an in-depth understanding of the ther-apeutic effects of GQLD, aspirin and itraconazole on rats with yeast-induced pyrexia.
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Objective To compare the effects of loop electrosurgical excision procedure(LEEP knife)and microwave on cervical erosion and study the nursing effects.Methods One hundred and fifty cases of cervical erosion patients from January to December 2013 in our hospital were selected and randomly divided into observation group and control group with 75 cases in each group.Patients in the observation group were treated with LEEP knife and the control group with microwave treatment.All patients were nursed conventionally.The operative time,blood loss and efficacy of two groups were analyzed.Result Patients in the observation group had less blood loss,shorter operation time and a better curative effect than the control group with statistical difference(all P<0.05).Conclusions Compared with microwave treatment,LEEP knife can effectively treat the cervical erosion.Preparation before operation,mental care and knowledge-related nursing are critical for the smooth manipulation of the operation.
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Objective To explore the causes of misdiagnose of ectopic pregnancy by retrospective analysis in our hospital cases,in order to increase the diagnose and curative level in ectopic pregnancy.Methods Clinical data of the misdiagnosis of 96 cases from the 357 patients of ectopic pregnancy in our hospital from year 1993 to 2002,including materials of histories ,symptoms signs and laboratory examinations were retrospectively analyzed.Results The misdiagnosis rate of ectopic pregnancy in our hospital was 26 9%, most of them were treated as early pregnancies, threatened abortions etc. The causes of misdiagnosis were neglectful of asking essential history, no overall physical examination and misleading by the laboratory results.Conclusions The effectively preventive measures against misdiagnosing of ectopic pregnancy were strengthen vigilance of ectopic pregnancy,familiar with the knowledge of atypical ectopic pregnancy and the essential examinations on gravida.
