A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV) infected pneumonia(standard version)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

Choices of medical institutions and associated factors in older patients with multimorbidity in stabilization period in China:A study based on logistic regression and decision tree model

Background:As China's population ages,its disease spectrum is changing,and the coexistence of multiple chronic diseases has become the norm with respect to the health status of its elderly population.However,the health institution choices of older patients with multimorbidity in stabilization period remains underresearched.This study investigate the factors influencing the choices of older patients with multimorbidity to provide references for the rational allocation of healthcare resources.Methods:A multistage,stratified,whole-group random-sampling method was used to select eligible older patients from September to December of 2022 who attended the Community Health Service Center of Guangdong Province.We adopted a self-designed questionnaire to collect patients'general,diseaserelated,social-support information,their intention to choose a healthcare provider.A binary logistic regression and decision tree model based on the Chi-squared automatic interaction detector algorithm were implemented to analyze the associated factors involved.Results:A total of 998 patients in stabilization period were included in the study,of which 593(59.42%)chose hospital and 405(40.58%)chose primary care.Our binary logistic regression results revealed that age,sex,individual average annual income,educational level,self-reported health status,activities of daily living,alcohol consumption,family doctor contracting,and family supervision of medication or exercise were the principal factors influencing the choice of medical institutions for older patients with multimorbidity(p<0.05).The decision-tree model reflected three levels and 11 nodes,and we screened a total of four influencing factors:activities of daily living,age,a family doctor contract,and patient sex.The data showed that the logistic regression model possessed an accuracy of 72.9%and that the decision tree model exhibited an accuracy of 68.7%.Prediction using the binary logistic regression was thus statistically superior to the categorical decision-tree model based on the Chisquared automatic interaction detector algorithm(Z=3.238,p=0.001).Conclusion:More than half of older patients with multimorbidity in stabilization period chose hospitals for healthcare.Efforts should be made to improve the quality of healthcare services and increase the medical contracting rate and recognition of family doctors so as to attract older patients with multimorbidity to primary medical institutions.

Temporal patterns and clinical characteristics of healthcare-associated infections in surgery patients:A retrospective study in a major Chinese tertiary hospital

Background:Given the preventable nature of most healthcare-associated infections(HAIs),it is crucial to under-stand their characteristics and temporal patterns to reduce their occurrence.Methods:A retrospective analysis of medical record cover pages from a Chinese hospital information system was conducted for surgery inpatients from 2010 to 2019.Association rules mining(ARM)was employed to explore the association between disease,procedure,and HAIs.Joinpoint models were used to estimate the annual HAI trend.The time series of each type of HAI was decomposed to analyze the temporal patterns of HAIs.Results:The study included data from 623,290 surgery inpatients over 10 years,and a significant decline in the HAI rate was observed.Compared with patients without HAIs,those with HAIs had a longer length of stay(29 days vs.9 days),higher medical costs(96226.57 CNY vs.22351.98 CNY),and an increased risk of death(6.42%vs.0.18%).The most common diseases for each type of HAI differed,although bone marrow and spleen operations were the most frequent procedures for most HAI types.ARM detected that some uncommon diagnoses could strongly associate with HAIs.The time series pattern varied for each type of HAI,with the peak occurring in January for respiratory system infections,and in August and July for surgical site and bloodstream infections,respectively.Conclusions:Our findings demonstrate that HAIs impose a significant burden on surgery patients.The differing time series patterns for each type of HAI highlight the importance of tailored surveillance strategies for specific types of HAI.

A Research Conception on Indigenous Chinese Leadership:Based on Comparative Case Studies on Political Elites in Ancient China

Due to the complexity of leadership and its variability across situations,it is suggested that research on leadership should focus on attempts to understand leadership in specific situations or roles,and develop local knowledge about leadership in each situation or role.This paper validates the possibility and importance of building indigenous leadership theories from historical perspective.We demonstrated how to carry out research on indigenous Chinese leadership from a historical perspective by comparative case studies using historical data.Based on the principles of typicalness,representativeness,and comparativeness,we selected six counterparts of political elites in ancient China as comparative cases,which includes Guan Zhong&Shang Yang(organizational reformer),Liu Bang&Xiang Yu(entrepreneur),Li Shimin&Qin Shihuang(intergenerational transition successor),Zhuge Liang&Zeng Guofan(professional manager),Lu Su&Zhang Juzheng(mess-to-order maker),and Zuo Zongtang&Wang Anshi(national dream driver).The paper aims to develop indigenous leadership theory specific to Chinese mental states and culture.

Complications Following Facial Thread-Lifting

Background Facial thread-lifting(FTL)is a minimally invasive facial rejuvenation technique.However,to date,no study has focused on the treatment of complications associated with FTL.The purpose of this study was to report on clinical manifestations of complications following FTL and their treatment methods.Methods We retrospectively reviewed the electronic medical records of patients who presented with complications of FTL.Patient demographics,medical history,types and clinical manifestations of complications,imaging,treatment methods,histopathological findings,and follow-up information were collected.Descriptive statistical analysis was performed.Results Our sample included 61 patients,all women,with a mean age of 36.3±8.9 years.The most common reason for consultation was infection(31.2%),followed by dissatisfaction with postoperative facial contour(23%),paresthesia(19.7%),dimpling and irregularity(16.4%),subcutaneous induration(13.1%),thread extrusion(4.9%),and facial nerve injury(3.3%).Fifty-one(83.6%)patients reported alleviated symptoms after receiving pharmaceutical and physical therapies.Surgical interventions,including debridement and thread removal,were required in 10 patients(16.4%).Threads were completely or partially removed in 5 patients within 3 months of the initial FTL.During a median follow-up of 1.7 years,9 patients recovered well and were satisfied with the clinical outcomes,whereas one patient was unsatisfied due to dimpling and scarring.Conclusions The results show that most complications after FTL can be treated nonsurgically.Revision surgery is recommended for patients with recurrent infection,thread extrusion,and subcutaneous induration.Aesthetic surgeons and dermatologists should comply with the indications for FTL and optimize surgical procedures to minimize the risk of complications.

Updated diagnosis, treatment and prevention of COVID-19 in children: experts' consensus statement (condensed version of the second edition)

In the early February,2020,we called up an experts' committee with more than 30 Chinese experts from 11 national medical academic organizations to formulate the first edition of consensus statement on diagnosis,treatment and prevention of coronavirus disease 2019 (COVID-19) in children,which has been published in this journal.With accumulated experiences in the diagnosis and treatment of COVID-19 in children,we have updated the consensus statement and released the second edition recently.The current version in English is a condensed version of the second edition of consensus statement on diagnosis,treatment and prevention of COVID-19 in children.In the current version,diagnosis and treatement criteria have been optimized,and early identification of severe and critical cases is highlighted.The early warning indicators for severe pediatric cases have been summarized which is utmost important for clinical practice.This version of experts consensus will be valuable for better prevention,diagnosis and treatment of COVID-19 in children worldwide.

Effectiveness of Moxibustion for Exercise-Induced Fatigue——A Systematic Review for Randomized Controlled Trials

Objective：To review and assess the effect of single moxibustion for exercise-induced fatigue（EIF）.Methods：Computer-search for 8 medical databases and 5 clinical trail registries were conducted for randomized controlled trials（RCTs）,added with hand-search for 10 Chinese acupuncture-moxibustion journals and additional references.Data from included RCTs were pooled by RevMan5.1.Methodology quality of RCTs was judged by Cochrane Collaboration assessment tool while quality of primary outcomes was evaluated by GRADE3.2.Results：Five RCTs were finally included,all reported in small sample size with high risk of bias.Comparisons on single moxibustion and rest relief（without treatment） were studied.Six outcomes were reported,all favored moxibustion to rest relief for EIF.Primary outcomes showed as rating of perceived exertion（RPE） with mean difference（MD）=-0.49,95%confidence interval（CI）[-0.80,-0.19],800-m race performance with MD=^-2.21,95%CI[-3.57,-0.85],and Harvard Step Index（HSI） with MD=14.75,95%CI[8.35,21.15].Moreover,all primary outcomes as RPE,800-m race performance and HSI were rated low quality.Conclusions：Single moxibustion might be considered effective for EIF.However,due to small samples of included RCTs,high risk of bias among studies and poor quality of primary outcomes and subjects restricted to Chinese athletes only,these results present limitation,and should be taken with caution for practice.More large-size studies with rigorous design are warranted to further test effectiveness of moxibustion for EIF.

Study on myocardial infarction based on nationwide inpatient sample database:a bibliometric analysis from 2000 to 2022

Background:Studies on myocardial infarction(MI)based on large medical databases have become popular in recent years.The influence of the National Inpatient Sample(NIS),the largest collection of administrative healthcare data across the United States,on the field of MI has not been well investigated.This study aimed to quantify the contribution of NIS to MI research using bibliometric methods.Methods:We searched the Web of Science Core Collection database to identify publications on MI using NIS from 2000 to 2022.Bibliometric indicators,such as the number of publications,citations,and Hirsch index(H-index),were summarized by years,authors,organizations,and journals.VOSviewer and CiteSpace software were used to analyze the keywords and trends of the hot spots.Results:A total of 342 articles on MI based on NIS were included.A significant growth in outputs related to MI using the NIS from 2000 to 2020 was observed.The publications were mainly from the United States.The Mayo Clinic was the most prolific institution and had the most citations and the highest H-index.The American Journal of Cardiology ranked first among journals with the highest number of publications,citations,and H-index.Mortality and healthcare management are the main focuses of this field.Personalized risks and care are receiving increased attention.Conclusion:This study suggests that NIS significantly contributes to high-quality output in MI research.More efforts are needed to improve the impact of knowledge gained from the NIS on MI.