Effect of exposure to ambient PM2.5 pollution on the risk of respiratory tract diseases： a meta-analysis of cohort studies

The International Agency for Research on Cancer and the World Health Organization have designated airborne particulates, including particulates of median aerodynamic diameter 〈 2.5 gm （PM2.5）, as Group 1 carcinogens. It has not been determined, however, whether exposure to ambient PM2.5 is associated with an increase in respiratory related diseases. This meta-analysis assessed the association between exposure to ambient fine particulate matter （PM2.5） and the risk of respiratory tract diseases, using relevant articles extracted from PubMed, Web of Science, and Embase. In results, of the 1,126 articles originally identified, 35 （3.1%） were included in this meta-analysis. PM2.5 was found to be associated with respiratory tract diseases. After subdivision by age group, respiratory tract disease, and continent, PM2.5 was strongly associated with respiratory tract diseases in children, in persons with cough, lower respiratory illness, and wheezing, and in individuals from North America, Europe, and Asia. The risk of respiratory tract diseases was greater for exposure to traffic-related than non-traffic-related air pollution. In children, the pooled relative risk （RR） represented significant increases in wheezing （8.2%）, cough （7.5%）, and lower respiratory illness （15.3%）. The pooled RRs in children were 1.091 （95%CI： 1.049, 1.135） for exposure to 〈 25 gg/m3 PM2.5, and 1.126 （95%CI： 1.067, l. 190） for exposure to 〉 25 gg/m3 PM2.5. In conclusion, exposure to ambient PM2.5 was significantly associated with the development of respiratory tract diseases, especially in children exposed to high concentrations of PM2.5.

Surveillance for respiratory infectious diseases caused by 6 common viruses in a recruit training site in the Northern region of China

Background: Recruit training sites are places with a high incidence of respiratory infectious diseases. Effective surveillance for acute respiratory infectious diseases in a recruit training site is an important way to prevent disease outbreaks.Methods: Eight hundred recruits(722 males and 78 females) enlisted in autumn 2015 received a background survey within 24 h of settlement at the recruit training site, including their general personal information, vaccination history, mental status and clinical symptoms. Then, nasopharyngeal swabs of these recruits were collected to detect common respiratory pathogens [influenza virus type A, influenza virus type B, adenovirus(Adv), human respiratory syncytial virus, human bocavirus and human metapneumovirus] by PCR. In addition, fasting venous blood was collected in the morning for Adv Ig G antibody detection. During the three months of training, the recruits were monitored for symptoms of respiratory infection, and nasopharyngeal swabs were collected from those with an axillary temperature ≥38℃ and other respiratory symptoms within 4 h of symptom onset. Samples were further examined by PCR.Results: Among the 795 effective nasopharyngeal swab samples collected during survey, two cases of group C type 1 Adv were identified by PCR. During the 3 months of training, fever and respiratory symptoms occurred in 39 recruits(incidence rate of 4.9%) and 5 cases of Adv were detected(positive rate of 12.8%). Genotyping showed 3 cases of type 4 Adv and 2 of type 3 Adv. No type 7, 14 or 55 Adv was detected. The Adv-Ig G positive rate of recruits was 48.2%. Among the 5 Adv positive cases with fever and respiratory symptoms, 4 were Adv-Ig G positive.Conclusion: The pathogen carrier rate in recruits was low, and only group C Adv, which causes mild infection in humans, was detected. No respiratory outbreak was observed at the recruit training site, and sporadic cases were mainly caused by type 3 and type 4 Adv.

Distribution of Respiratory Tract Infectious Diseases in Relation to Particulate Matter(PM_(2.5))Concentration in Selected Urban Centres in Niger Delta Region of Nigeria

Due to the visibility of soot in the environment of the Niger Delta especially Rivers State that has led to the increase of Respiratory Tract Infections(RTIs)in the region,this study was undertaken to determine the relationship between Particulate Matter(PM_(2.5))concentration and the incident of Respiratory Tract Infections(RTIs)in selected urban centres of the Niger Delta.Data on RTIs were collected from the Hospital Management Boards of the Ministries of Health of Rivers,Bayelsa and Delta States and the data for PM_(2.5)were remotely sensed from 2016 to 2019,and subsequently analyzed with ANOVA and Spearman’s rank correlation statistics.The findings of this study revealed that there was significant variation in the occurrence of PM_(2.5)across the selected urban centres in the Niger Delta Region.The PM_(2.5)for the reviewed years was far above the World Health Organization(WHO)annual permissible limit of 10μg/m^(3)thereby exacerbating Respiratory Tract Infections(RTIs).The epidemiology of the RTIs showed that there are basically four(4)prominent RTI diseases:Asthma,Tuberculosis,Pneumonia and Chronic Obstructive Pulmonary Disease(COPD).The result of this study showed that the concentration of PM_(2.5)varies in all the selected cities,and the mean monthly variation(2016-2019)showed that Port Harcourt had 47.27μg/m^(3)for January while Yenagoa and Asaba had 46μg/m^(3)and 47.51μg/m^(3)respectively for January;while the lowest mean value in the cities were seen within the month of September and October,which also had a strong seasonal influence on the concentration of PM_(2.5).The concentration of PM_(2.5)and the numbers of RTIs also gradually increases in the study areas from 2016 to 2019.The study recommends that the necessary regulatory bodies should closely monitor the activities of the companies likely to cause such pollution;guild them through their operations and give prompt sanctions and heavy fines to defaulters of the accepted standards.

Necrotizing Pneumonia and Conservative Treatment: A Case Report and Review of the Literature

We present a case of necrotizing pneumonia in an 87-year-old man without severe respiratory instability. Clinical suspicion arose due to the need for supplementary oxygen and persistent fever during treatment for community-acquired pneumonia. The diagnosis was confirmed by chest computed tomography. Although necrotizing pneumonia typically requires major surgical intervention upon diagnosis, we chose conservative management with antimicrobials and chest drainage alone. The patient experienced significant improvement and resolution of pneumonia with conservative management.

Compliance of Physicians with Standard Precautions of Handling Patients with Infectious Respiratory Disease

Background: Standard precautions (SPs) are the minimum infection prevention practices that aim to protect Health care workers (HCWs) including physicians and prevent them from transmitting the infections to their patients. Purpose: To assess the level of compliance of physicians with standard precautions of handling patients with infectious respiratory disease. Method: A cross sectional questionnaire-based study was conducted in two tertiary level hospitals named M Abdur Rahim Medical College and Hospital, Dinajpur, Bangladesh and Rajshahi Medical College and Hospital, Rajshahi, Bangladesh to assess the level of compliance of physicians with standard precautions. Purposive sampling technique was applied as per inclusion criteria and data was collected by face to face interview from 285 physicians. Statistical analysis of the results was done by SPSS and a p value less than 0.05 was considered as significant. Result: The study revealed that maximum physicians (76.5%) handling patients with infectious respiratory disease had a moderate level of compliance with standard precautions. 78.6% of the physicians had moderate level of awareness about standard precautions. Only 20.35% of the physicians had training on infection control. 94.4% of the respondents didn’t know the component of standard precaution and most of the physicians were not aware of the sequence of wearing and removing the different components of PPEs. Conclusion: The study result implies that with increased awareness, the compliance of the physicians with standard precautions increased. The main reasons of non-compliance with standard precautions were found to be lack of resources, lack of regular training and excess workload.

Infectious diseases during the European Union training mission Mali(EUTM MLI)–a four-year experience

Background: The European Union Training Mission Mali(EUTM MLI) is a multinational military training deployment to the Western African tropical nation of Mali. Based on routinely collected disease and non-battle injury surveillance data, this study quantifies the true impact of infectious diseases for this tropical mission and potential seasonal variations in infectious disease threats.Methods: Categorized health events during the EUTM MLI mission and associated lost working days were reported using the EpiNATO-2 report. Infection-related health events were descriptively analyzed for a 4-year period from the 12 th week in 2013 to the 13 th week in 2017. Aggregated EpiNATO-2 data collected from all missions other than EUTM MLI were used as a comparator.Results: Among the infectious diseases reported by EUTM MLI, non-severe upper respiratory infections and gastrointestinal diseases dominated quantitatively, accounting for 1.65 and 1.42 consultations per 100 person-weeks, respectively. The number of recorded infectious disease-associated lost working days during the whole study interval was 723. Seasonal changes in disease frequency were detectable. More gastrointestinal infections were seen in the rainy season, and more respiratory infections occurred in the dry season; these were associated with peaks of more than 2.5 consultations per 100 person-weeks for both categories.Conclusion: Despite initial concerns focused on tropical infectious diseases during this mission in tropical Mali, upper respiratory tract and gastrointestinal infections predominate. The relatively low number of reported lost working days may indicate that these infections are at the milder end of the spectrum of infectious diseases despite a likely reporting bias.

Exposure to Hyaluronan and Radon-Containing Water during the Treatment of Periodontal Pockets

Hyaluronic acid (HA) preparations have emerged as pivotal components in contemporary dentistry, gaining widespread recognition for their multifaceted roles in various biological functions. Extensive literature underscores the significance of HA in maintaining tissue water balance, fostering cell proliferation, promoting rapid cell migration, influencing cell differentiation during organism development, and facilitating tissue regeneration. Notably, HA’s interactions with cell surface receptors contribute to the viscosity of synovial fluid, activate the immune system, and enhance cartilage elasticity. Beyond these established functions, HA has also been investigated for its potential involvement in determining and studying the hormetic effects of radon water, adding a novel dimension to its applications in dental research. A thorough exploration of existing studies reveals a nuanced understanding of how HA interventions impact the outcomes of dental procedures. The comprehensive scope of these investigations allows for a more accurate assessment of the potential effectiveness of specific interventions and provides valuable insights into post-procedural prognoses for individual patients. This synthesis of literature serves as the foundation for elucidating the intricate interplay between HA, radon exposure, and their relevance in modern dental practices.

The upshot of Polyphenolic compounds on immunity amid COVID-19 pandemic and other emerging communicable diseases: An appraisal

Polyphenols are a large family of more than 10,000 naturally occurring compounds,which exert countless pharmacological,biological and physiological benefits for human health including several chronic diseases such as cancer,diabetes,cardio-vascular,and neurological diseases.Their role in traditional medicine,such as the use of a wide range of remedial herbs(thyme,oregano,rosemary,sage,mint,basil),has been well and long known for treating common respiratory problems and cold infections.This review reports on the most highlighted polyphenolic compounds present in up to date literature and their specific antiviral perceptive properties that might enhance the body immunity facing COVID-19,and other viral infec-tious diseases.In fact,several studies and clinical trials increasingly proved the role of polyphenols in controlling numer-ous human pathogens including SARS and MERS,which are quite similar to COVID-19 through the enhancement of host immune response against viral infections by different biological mechanisms.Thus,polyphenols ought to be considered as a potential and valuable source for designing new drugs that could be used effectively in the combat against COVID‐19 and other rigorous diseases.

SARS-CoV-2 viral load in the upper respiratory tract and disease severity in COVID-19 patients

Due to the disease's broad clinical spectrum,it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019(COVID-19).Real-time reverse transcription-polymerase chain reaction(RTPCR)is the gold standard molecular technique for diagnosing COVID-19.The number of amplification cycles necessary for the target genes to surpass a threshold level is represented by the RT-PCR cycle threshold(Ct)values.Ct values were thought to be an adequate proxy for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)viral load.A body of evidence suggests that SARS-CoV-2 viral load is a possible predictor of COVID-19 severity.The link between SARS-CoV-2 viral load and the likelihood of severe disease development in COVID-19 patients is not clearly elucidated.In this review,we describe the scientific data as well as the important findings from many clinical studies globally,emphasizing how viral load may be related to disease severity in COVID-19 patients.Most of the evidence points to the association of SARS-CoV-2 viral load and disease severity in these patients,and early anti-viral treatment will reduce the severe clinical outcomes.

Epidemiological characteristics of seven notifable respiratory infectious diseases in the mainland of China:an analysis of national surveillance data from 2017 to 2021

Background Respiratory infectious diseases(RIDs)remain a pressing public health concern,posing a signifcant threat to the well-being and lives of individuals.This study delves into the incidence of seven primary RIDs dur‑ing the period 2017-2021,aiming to gain deeper insights into their epidemiological characteristics for the purpose of enhancing control and prevention strategies.Methods Data pertaining to seven notifable RIDs,namely,seasonal infuenza,pulmonary tuberculosis(PTB),mumps,scarlet fever,pertussis,rubella and measles,in the mainland of China between 2017 and 2021 were obtained from the National Notifable Disease Reporting System(NNDRS).Joinpoint regression software was utilized to analyze temporal trends,while SaTScan software with a Poisson probability model was used to assess seasonal and spatial patterns.Results A total of 11,963,886 cases of the seven RIDs were reported during 2017-2021,and yielding a fve-year aver‑age incidence rate of 170.73 per 100,000 individuals.Among these RIDs,seasonal infuenza exhibited the highest aver‑age incidence rate(94.14 per 100,000),followed by PTB(55.52 per 100,000),mumps(15.16 per 100,000),scarlet fever(4.02 per 100,000),pertussis(1.10 per 100,000),rubella(0.59 per 100,000),and measles(0.21 per 100,000).Males experi‑enced higher incidence rates across all seven RIDs.PTB incidence was notably elevated among farmers and individu‑als aged over 65,whereas the other RIDs primarily afected children and students under 15 years of age.The inci‑dences of PTB and measles exhibited a declining trend from 2017 to 2021(APC=−7.53%,P=0.009;APC=−40.87%,P=0.02),while the other fve RIDs peaked in 2019.Concerning seasonal and spatial distribution,the seven RIDs displayed distinct characteristics,with variations observed for the same RIDs across diferent regions.The proportion of laboratory-confrmed cases fuctuated among the seven RIDs from 2017 to 2021,with measles and rubella exhibit‑ing higher proportions and mumps and scarlet fever showing lower proportions.Conclusions The incidence of PTB and measles demonstrated a decrease in the mainland of China between 2017 and 2021,while the remaining fve RIDs reached a peak in 2019.Overall,RIDs continue to pose a signifcant public health challenge.Urgent action is required to bolster capacity-building eforts and enhance control and prevention strategies for RIDs,taking into account regional disparities and epidemiological nuances.With the rapid advancement of high-tech solutions,the development and efective implementation of a digital/intelligent RIDs control and pre‑vention system are imperative to facilitate precise surveillance,early warnings,and swift responses.

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.

Helicobacter pylori infection and respiratory diseases:a review

In the past few years,a variety of extradigestive disorders, including cardiovascular,skin,rheumatic and liver diseases, have been associated with Helicobacter pylori(H.pylori) infection.The activation of inflammatory mediators by H.pylori seems to be the pathogenetic mechanism underlying the observed associations.The present review summarizes the current literature,including our own studies,concerning the association between H.pyloriinfection and respiratory diseases. A small number of epidemiological and serologic,case- control studies suggest that H.pylori infection may be associated with the development of chronic bronchitis.A frequent coexistence of pulmonary tuberculosis and H.pylori infection has also been found.Moreover,recent studies have shown an increased H.pyloriseroprevalence in patients with bronchiectasis and in those with lung cancer.On the other hand,bronchial asthma seems not to be related with H.pylori infection. All associations between H.pylori infection and respiratory diseases are primarily based on case-control studies, concerning relatively small numbers of patients.Moreover, there is a lack of studies focused on the pathogenetic link between respiratory diseases and H.pylori infection. Therefore,we believe that larger studies should be undertaken to confirm the observed results and to clarify the underlying pathogenetic mechanisms.

Burden of RSV among inpatients with lower respiratory tract infection under 5 years of age: A 10-year retrospective study in Southwest China from 2009 to 2019

Objectives:Respiratory syncytial virus(RSV)is a leading cause of lower respiratory tract infection(LRTI).However,few comprehensive descriptions of the disease burden,medical resource utilization(MRU),and costs of RSV are available for China.This study aimed to provide the basis for the development of RSV prevention strategies by analyzing the burden of RSV among inpatients with lower respiratory tract infection under 5 years of age.Methods:We conducted a retrospective hospital-based study from June 2009 to May 2019 in Chongqing.Inpatients with LRTI were tested for eight viruses.We analyzed the RSV disease burden,MRU,and direct hospitalization costs by using non-parametric Mann‒Whitney U test,Chi-squared test or Fisher’s exact test and logistic regression.Results:A total of 6991 children under 5 years of age with LRTI were included in this study.The overall RSVpositive rate was 34.5%(2410/6991).Prior to admission,81.9%(1973/2410)of these RSV-positive cases were otherwise healthy.Compared with children aged 24–59 months,the odds ratio(OR)and 95%confidence interval(CI)for RSV infection were 2.509(2.139–2.945),1.882(1.549–2.222),and 1.479(1.240–1.765)for those aged 1–5 months,6–11 months,and 12–23 months,respectively.The proportions of patients treated with invasive ventilation and continuous positive airway pressure(CPAP)were significantly higher among RSV-positive cases(1.1%[27/2410]and 3.9%[93/2410])than RSV-negative cases(0.9%[43/4581]and 2.7%[124/4581])(P=0.023).Compared with RSV-negative cases,RSV-positive cases had significantly longer hospital length of stay(6[5,8]days vs.6[5,8]days,P<0.001)and higher hospitalization costs(963.0[757.9,1298.5]USD vs.935.6[719.7,1296.3]USD,P=0.022).Conclusions:Most RSV infections occurred during early childhood and among individuals in the otherwise healthy group.Younger age was associated with a higher RSV-positive rate.Effective prevention measures are needed in the earliest stages to reduce the RSV burden.

Case Study of Middle East Respiratory Syndrome (MERS-CoV) Outbreak in South Korea and Future Implications

The Middle East Respiratory Syndrome (MERS-CoV) is a potentially fatal respiratory viral infection that has had outbreaks in the Middle East and Asia region starting in 2012. As recent as 2015, MERS had outbreaks in South Korea, resulting in 36 deaths among 186 infected patients. The purpose of this thesis is to gain an in-depth understanding of how this viral infection behaves in outbreaks and how it is spread around the globe. To gain insight, real time analysis was performed under a case study methodology based on pooled data from the Ministry of Health & Welfare of South Korea. We calculated a striated mortality rate based on gender, age, and the presence of pre-existing health conditions ranging from heart, lung, and kidney diseases. We found that MERS outbreak follows the pattern of a point source outbreak, largely spurred by the patient-referral system under the universal healthcare system in South Korea. The purpose of this case is to discuss the benefits and challenges of such patient referral system, and to offer a possible solution in improving transparency between healthcare providers and the government under a universal healthcare system to prevent future outbreaks.

Recurrence of urinary tract infections in postmenopausal diabetic women using different antibiotics

Objectives: Postmenopausal women with diabetes mellitus (DM) have an increased incidence of urinary tract infections (UTI) compared to women without DM. The aim of this study is to compare recurrence rates of UTI in postmenopausal women with DM after treatment with nitrofurantoin, the agent of first choice following the Dutch guidelines, with two other common prescribed antibiotics trimethoprim and norfloxacin. Methods: We used a PHARMO database with pharmacy dispensing data. A total of 8534 postmenopausal (>55 years) women with DM who received a first course of nitrofurantoin, trimethoprim or norfloxacin were included. The UTI recurrence rates after treatment with these three different antimicrobial agents were compared. Recurrence was defined as a second prescription for nitrofurantoin, trimethoprim or norfloxacin or a first with fosfomycin, amoxicillin, fluoroquinolones, or trimethoprim/sulfamethoxazole between 6 and 30 days after inclusion. Results: Postmenopausal women with DM had significantly more UTI recurrences when they were treated with nitrofurantoin (22.7%) compared to trimethoprim (17.7%) or norfloxacin (14.2%) irrespective of the treatment duration. There was a trend that longer treatment duration was associated with higher recurrence rates. Conclusions: Postmenopausal women with DM had more UTI recurrences when they are treated with nitrofurantoin, agent of first choice, compared to trimethoprim or norfloxacin.

Living in the Wake of Chronic Obstructive Pulmonary Disease and Long-Term Oxygen Therapy

Background: Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the world. COPD is a progressive disease that could lead to chronic hypoxemia, which requires treatment as domiciliary Long-Term Oxygen Therapy (LTOT). There is a need for increased knowledge about self-care strategies used by individuals living with COPD and LTOT. Objective: The aim was to explore experiences and self-care strategies in patients living with both COPD and LTOT. Sample: The sample consisted of five men and five women diagnosed with COPD being prescribed LTOT for more than one year. Method: Ten interviews were undertaken and analyzed for both manifest and latent content. Results: Living with COPD and LTOT was associated with experiences of guilt although there were doubts about what had caused the lung disease. Both the lung disease and the oxygen therapy had a negative impact on their self-image. Anxiety was expressed when thoughts about the remaining time occurred. There was a constant balance between diminishing abilities and increasing restrictions related to the lung disease and the therapy. In order to compensate for arising imbalance, self-care strategies had been initiated aimed at preserving the present state of health, enabling and facilitating physical activity and promoting a positive attitude. Conclusion: The current study suggests that individuals living with COPD and LTOT are encouraged to adopt self-care strategies directed towards maintaining stability with regard to the lung disease, the oxygen therapy, physical capability and emotional reactions.

新型冠状病毒感染后分泌性中耳炎临床特点分析

目的分析新型冠状(新冠)病毒感染后分泌性中耳炎(otitis media with effusion,OME)发病情况及临床特点。方法回顾性选取2018年12月至2019年1月、2021年12月至2022年1月、2022年12月至2023年1月中国人民解放军总医院第九医学中心耳鼻喉科门诊就诊患者21454例,其中OME患者201例。根据北京地区疫情流行及政府管控政策(公共场所佩戴口罩、减少聚集、居家隔离、疫苗接种等)时间,将201例OME患者分为疫情前组68例(2018年12月至2019年1月)、防控期组30例(2021年12月至2022年1月)、爆发期组103例(2022年12月至2023年1月)。收集201例OME患者资料,分析新冠病毒感染相关OME人口学特征及发病特点。结果防控期组OME就诊率(0.40%)较疫情前组(0.82%)显著下降,爆发期组(1.82%)较疫情前组、防控期组升高了51.5%与243.3%,差异均有统计学意义(P<0.01)。爆发期组92.2%的OME是新冠病毒感染之后出现的,较疫情前组、防控期组上呼吸道感染导致OME在中耳炎患者中的比例升高,差异均有统计学意义(P<0.01)。爆发期组上呼吸道感染导致OME患者年龄高于疫情前组和防控期组,差异有统计学意义(P<0.01,P=0.002)。74.6%的患者在新冠病毒感染之后的1~3周发病,7.5%的患者(5/67)在感染1月后才出现耳部症状。50.7%的患者仅有耳部症状且电子鼻咽喉镜检查仅31.3%合并鼻、鼻咽部轻微炎症。结论新冠病毒感染可明显提高OME发病率,老年人患病率更高。新冠相关OME往往在感染后2周甚至更晚出现。新冠病毒有可能通过直接感染中耳引发炎症,具体机制有待进一步研究。

成人急性呼吸道传染病患者俯卧位通气管理的最佳证据总结

目的检索、评价、提取并汇总成人急性呼吸道传染病患者俯卧位通气管理的最佳证据,为俯卧位通气规范化治疗提供循证依据。方法根据“6S”证据模型,系统检索各指南网站及中英文数据库相关文献,由研究人员对纳入文献进行质量评价、证据提取与汇总。结果共纳入11篇文献,包括3篇临床决策、5篇指南、1篇证据总结、2篇专家共识。最终形成包括人员准备、院感防控、护理评估、实施要点、风险管理、健康教育和特殊人群照护等7个方面共48条的最佳证据。结论在证据应用过程中医护人员应基于具体临床情境,制订个体化俯卧位通气治疗方案,以改善患者临床结局。

肺类器官在呼吸系统感染性疾病研究中的应用进展

类器官是细胞在体外悬浮培养条件下自发形成的具有自我更新能力及相关功能的细胞团,是强大的三维模型,可一定程度再现原始组织的细胞异质性、结构与功能。肺类器官(LOs)由人类多能干细胞或成体干(祖)细胞培养、构建而成,其与免疫细胞共培养可更好地体现肺组织免疫反应及体内感染的全貌。本文对比分析LOs与其他肺部感染性疾病常用研究模型(包括动物模型、二维细胞培养、肺芯片和精确切割肺切片等)的特点,概述LOs的构建方法及其在病毒、细菌、分枝杆菌、隐孢子虫等引起的呼吸系统感染性疾病研究中的应用进展。

急性呼吸道传染病应急响应下的应急物资分级库存模型研究

目的:构建适用于不确定环境下的应急物资分级库存模型,以为传染病暴发后的应急响应提供更准确和有效的决策支持。方法:首先,使用“之”字形不确定分布构建应急物资分级模型;其次,将经济订购量(economic order quantity,EOQ)模型与应急物资分级模型相结合构建应急物资分级库存模型;最后,以W市某次急性呼吸道传染病事件为例,验证提出的应急物资分级库存模型的实用性和有效性。结果:该模型在大部分情况下能够准确地对应急物资进行分级,且以该模型计算得到的库存量十分接近需求量。结论:建立的应急物资分级库存模型在急性呼吸道传染病的应急响应中具有实用性和有效性,可以帮助决策者更准确地预测应急物资的需求,提高应急响应的能力和效率。