The Influence of Integrated Chinese and Western Medicine Treatment on the Quality of Life and Laboratory Indicators of Patients with Novel Coronavirus Pneumonia

Objective: To investigate the influence of integrated Chinese and Western medicine treatment on the quality of life and laboratory indicators of patients with novel coronavirus pneumonia (COVID-19). Methods: A prospective, self-controlled study was conducted to analyze the changes in corresponding laboratory indicators and quality of life in 75 confirmed COVID-19 patients treated with integrated Chinese and Western medicine in our hospital during the early stage, middle stage, recovery period, and two weeks after discharge. The effectiveness and safety of the treatment regimen were evaluated in conjunction with the time for 2019-nCoV nucleic acid conversion, disease progression, and adverse reactions. Results: The PLT levels in the initial stage were significantly lower than those in the recovery period in 75 patients. The CRP levels in the initial stage were significantly lower than those after discharge for 2 weeks. The TBIL, IBTL, and DHIL levels in the initial stage were significantly lower than those in the middle stage. The K+ levels in the initial stage were significantly lower than those in the recovery period and after discharge for 2 weeks. The LYMGH levels in the initial stage were significantly lower than those in the recovery period and after discharge for 2 weeks. The TP and ALB levels in the initial stage were higher than those in the middle stage and the recovery period. The LDH levels, scores of daily activity limitation, scores of respiratory distress symptoms, scores of psychological emotions, CT imaging scores, and positive rate of nucleic acid were significantly lower than those in the recovery period and after discharge for 2 weeks. The AG, CK, CK-MB, and α-HBDH levels in the initial stage were significantly higher than those in the recovery period. However, the AMY level in the initial stage was significantly lower than that in the recovery period and after discharge for 2 weeks (p Conclusion: Integrated Chinese and Western medicine treatment has a significant impact on laboratory indicators such as PLT, LYMGH, CRP, TBIL, IBTL, DHIL, TP, ALB, K+, AG, LDH, CK, CK-MB, α-HBDH, AMY, CT imaging, and 2019-nCoV nucleic acid in COVID-19 patients. It has good clinical efficacy and safety, and can improve the quality of life of patients.

Decoding the evolution and transmissions of the novel pneumonia coronavirus(SARS-CoV-2/HCoV-19)using whole genomic data

The outbreak of COVID-19 started in mid-December2019 in Wuhan, China. Up to 29 February 2020,SARS-CoV-2(HCoV-19/2019-nCoV) had infected more than 85 000 people in the world. In this study,we used 93 complete genomes of SARS-CoV-2 from the GISAID EpiFlu TM database to investigate the evolution and human-to-human transmissions of SARS-CoV-2 in the first two months of the outbreak.We constructed haplotypes of the SARS-CoV-2 genomes, performed phylogenomic analyses and estimated the potential population size changes of the virus. The date of population expansion was calculated based on the expansion parameter tau(τ)using the formula t=τ/2 u. A total of 120 substitution sites with 119 codons, including 79 non-synonymous and 40 synonymous substitutions, were found in eight coding-regions in the SARS-CoV-2 genomes.Forty non-synonymous substitutions are potentially associated with virus adaptation. No combinations were detected. The 58 haplotypes(31 found in samples from China and 31 from outside China)were identified in 93 viral genomes under study and could be classified into five groups. By applying the reported bat coronavirus genome(bat-RaTG13-CoV)as the outgroup, we found that haplotypes H13 and H38 might be considered as ancestral haplotypes,and later H1 was derived from the intermediate haplotype H3. The population size of the SARS-CoV-2 was estimated to have undergone a recent expansion on 06 January 2020, and an early expansion on 08 December 2019. Furthermore,phyloepidemiologic approaches have recovered specific directions of human-to-human transmissions and the potential sources for international infected cases.

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.

Development Path and Urgency of Further Strengthening Construction of Public Hospitals Based on Novel Coronavirus Pneumonia Treatment

During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented challenges and tests.Based on the treatment of severe patients in Wuhan,combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,this paper puts forward the urgency of further strengthening the construction of public hospitals,discusses the feasible path for promoting the development of public hospitals,so as to meet the growing medical needs of the people,improve the ability to respond to major public health emergencies,and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.

Application and Effect of Intelligent Disinfection Robot in Non-Negative Pressure Isolation Ward of Novel Coronavirus Pneumonia Designated Hospital

The application of intelligent disinfection robot in designated non-negative pressure isolation ward during the outbreak in novel coronavirus pneumonia. The construction and competition, disinfection mode of intelligent disinfection robot, the setting of disinfection point built on area and number of isolation ward, can be introduced below. Frequency can realize remote control when staff uses a table to give instruction and set disinfection mode, and then the intelligent disinfection robot returns automatically to the charging pile to charge when the instruction is completed. It can also autonomously move to sterilize without human participation, which makes man-machine separation and accurate disinfection come true. The chance of contact infection and exposure is decreased when an intelligent disinfection robot is used to sterilize the environment and object surface in an isolation ward, which can also reduce occupational exposure, achieve occupational protection of medical workers and ensure there is no hospital infection.

Application of the Modality of Multiple Disciplinary Team for a Perioperative Patient with Suspected Novel Coronavirus Pneumonia and Cervical Spine Fracture in Nursing

With the explosive spread of novel coronavirus pneumonia, a major public major public health emergency has been declared around the world. Our country has come to a crucial stage of “external defense input, internal defense rebound” and strict quarantine measures are taken in all ports of entry throughout the country. Operations on patients with cervical spine during the quarantine, which not only increases the risk of surgical treatment, but also increases the difficulty of perioperative nursing. The objective is to explore the result of application of the modality of multiple disciplinary team for a perioperative patient with suspected novel coronavirus pneumonia and cervical spine fracture in nursing. The patient’s condition and nursing measures are studied and discussed from various specialist angle through the multidisciplinary team established by the isolation ward, orthopedics department, emergency department, anesthesiology department, operating room, rehabilitation department, psychology department and so on, and the overall and personalized surgical and nursing planning is formed through interdisciplinary advice. The nursing experience is summarized in this paper.

Countermeasures for Hemodialysis Patients with Fever in Non-Designated Hospitals during the Epidemic Period of Novel Coronavirus Pneumonia (COVID-19)

Objective: To explore the effect of countermeasures for hemodialysis patients with fever during the incubation period of novel coronavirus pneumonia (NCP) in a non-designated hospital. Methods: For 22 hemodialysis patients with fever in our hospital, we developed a specialist program based on the latest NCP treatment guidelines for nephrology and hemodialysis. We trained medical staff accurately and rapidly online. According to the specialist program, we implemented meticulous treatment for patients including dialysis, psychological and environmental care. We provided protection of medical staff in wards and dialysis rooms. Medical waste was deposited properly. Moreover, we implemented quality improvement in a timely manner according to the situation. Results: The 22 hemodialysis patients with fever in our hospital were not infected with novel coronavirus 2019. The epidemiological screening rate was 100%, and the percentage of family care giving was reduced by 29.8%. All medical stuff were uninfected. The patient’s satisfaction rate in the observation group is higher than that in the control group (96% vs. 74%, p = 0.048). Conclusion: The countermeasures for hemodialysis patients with fever developed by our specialty were effective. We can satisfy requirements for the NCP prevention for hemodialysis patients with fever in non-designated hospitals through implementing these countermeasures.

Network analysis and molecular docking of the mechanism of Shengmai decoction in treating patients with severe novel coronavirus pneumonia

Background:Studies have shown that,Shengmai injection(Shengmai decoction)which has been included in the diagnosis and treatment of coronavirus disease 2019(COVID-19),is effective in the early treatment of patients with severe COVID-19.However,the mechanism of its intervention in severe stage of COVID-19 at molecular level is still unclear.Therefore,it is necessary to further explore the mechanism of Shengmai decoction in the treatment of patients with severe COVID-19 based on network pharmacology.Methods:The Traditional Chinese Medicine Systems Pharmacology,BATMAN,UniProt databases and the published literatures which contain the reported compounds that have therapeutic effects on COVID-19 were used to screen out the active ingredients and targets of Shengmai decoction,and the“drug-active compound-target”network was constructed.The GeneCards database was used to screen out the targets of COVID-19.The protein-protein interaction network map was constructed by mapping two genes,and the network of active ingredients,targets and disease was constructed using Cytoscape software.Thereafter,Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses of the key targets were performed using the Metascape Site Maintenance website and David databases.The Gene Ontology function and Kyoto Encyclopedia of Genes and Genomes pathway enrichment of the mapping targets were analyzed.Results:The active component-target network contained 73 main compounds and 457 targets.The first five main active components(hydroquinone,guanosine,ophiopogon C,ophiopogon B,ophiopogon D)were obtained by topological analysis of 33 common targets.Using the Matthews correlation coefficient algorithm,the key targets included albumin,tumor necrosis factor,and cyclic adenosine response element binding.Compounds in Shengmai decoction were found to have good binding effect and strong interaction with caspase-8,caspase-3,apoptosis regulator Bcl-2,tumor necrosis factor,C-C motif chemokine 3,to inhibit the inflammatory response and improve lung injury.Additionally,31 biological processes were obtained by Gene Ontology enrichment,mainly related to lipopolysaccharide response and cytokine-mediated signal pathways,and 71 biological processes were obtained by Kyoto Encyclopedia of Genes and Genomes enrichment,mainly related to pulmonary tuberculosis,hepatitis B,and mitogen-activated protein kinase signal pathways.Conclusion:Shengmai decoction has multicomponent,multitarget and multichannel characteristics,which can provide an important theoretical basis to treat patients with severe COVID-19.

“An integrated system,three separated responsibilities”,a new fever clinic management model,in prevention and control of novel coronavirus pneumonia

BACKGROUND Since December 2019,there have been many new cases of coronavirus pneumonia in Wuhan,Hubei Province,which has gradually spread throughout the country.AIM To explore our hospital’s innovative management system to ensure the efficient operation of fever clinics during the epidemic,since controlling the spread of disease is an important way to prevent and control the epidemic.METHODS In total,200 outpatients with fever at our hospital between November 2019 and July 2020 were selected and allocated into two groups.RESULTS The fever clinic in our hospital operated smoothly,and infection with the novel coronavirus disease(COVID-19)has not been reported in our hospital.Additionally,we did not have any cases of missed diagnosis.The awareness regarding COVID-19 infection sources,transmission routes,early symptoms,and preventive measures was significantly higher in our fever clinic than in those of the pre-management group.CONCLUSION"An integrated system,three separate responsibilities"ensured the efficient functioning of our fever outpatient clinic and early screening of COVID-19 cases,which effectively curbed the transmission of COVID-19 and hence prevented COVID-19 pneumonia epidemic in our hospital,ultimately achieving the maximum effect of epidemic prevention and control.

Interpretation of Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia(Trial Version 7)

On March 3,2020,the National Health Commission and the National Administration of Traditional Chinese Medicine of China jointly promulgated the Notice on Printing and Distributing the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia(Trial Version 7).The content has been revised and supplemented on the basis of the Version 6,including etiological characteristics and pathological changes in lung,heart,kidney,spleen,liver,gallbladder,esophagus,stomach and intestinal mucosal epithelium.In particular,the diagnosis and treatment methods of traditional Chinese medicine are supplemented.It provides an evidence-based diagnosis and treatment protocol for the treatment and recovery of suspected and confirmed cases of novel coronavirus pneumonia with traditional Chinese medicine and Western medicine.

Retrospective analysis of the efficacy of traditional Chinese medicine Lianhua Qingwen Capsule for the treatment of novel coronavirus-infected pneumonia

Objective:The aim of this study was to evaluate the clinical efficacy of traditional Chinese medicine Lianhua Qingwen Capsule(LQC)for the treatment of novel coronavirus-infected pneumonia by a retrospective analysis of confirmed COVID-19 cases,thereby providing a reference for clinical treatment.Methods:We retrospectively analyzed the clinical data of patients with confirmed NCIP treated at the Hanchuan Hospital of People’s Hospital of Wuhan University of China between January 21 and January 30,2020.A total of 32 patients were included in the treatment group,who received routine treatment plus LQC(1 packet,tid),and 32 patients were included in the control group,who received routine treatment alone.The data about response rate of respiratory symptoms were compared and analyzed between the two groups.Results:No significant between-group difference was observed in baseline data.The response rates for fever were 84.4%in the treatment group and 56.3%in the control group;for cough,the response rates were 47.8%and 7.4%in the treatment group and the control group,respectively(P<0.05).The response rates for expectoration were 71.4%in the treatment group and 11.8%in the control group;for shortness of breath,the response rates were 78.6%and 0%in the treatment group and the control group,respectively(P<0.05).The average duration of symptoms like fever,cough,fatigue and expectoration in the treatment group were shorter than that in the control group(P<0.05).There was no significant difference in the incidence rate between LQC and control group.Conclusion:Traditional Chinese medicine LQC significantly improved fever,cough,expectoration,and shortness of breath in patients with confirmed COVID-19,thereby providing preliminary evidence for clinical treatment.

CT Imaging Evolution of Novel Coronavirus Pneumonia during Hospitalization

Object: To evaluate CT Features on serial thin-section computed tomographic (CT) scans in patients with conventional Novel Coronavirus Pneumonia (COVID-19) for the period during which they remained hospitalized. Methods: In this Retrospective study, we collected clinical information including Laboratory investigations and more importantly we focused on collecting imaging data of these 15 selected patients (8 men and 7 women, 22 - 70 years old, average age (45 ± 15)) with COVID-19 disease. The mean time between the initial and repeat thin-section CT scans was 3.3 ± 2.1 days, 7.9 ± 2.1 days, 14.2 ± 1.3 days after onset of symptoms in these 15 patients. Three experienced Radiologists reviewed the CT images independently and also in collaboration with each other for complicated or unique cases, for the Imaging characteristics like number and site of lesions, distribution of lesions whether it is lobular, lobar, unilateral or bilateral, and comparing the severity of disease in relation to the CT findings. The CT features were compared using the χ2 test and Fisher’s exact probability. Results: All of 15 patients had a history of visit to the endemic center i.e. Wuhan city or came in direct contact with an infected individual. Fever (93.3%) was the most common symptom. Majority of patients had a normal white blood cell count, and normal lymphocyte count although there were patients with leucopenia and lymphocytopenia. CT images showed predominate Ground-Glass opacities in the initial and repeat CT scans with a percentage of 90.6%, 53.9%, 44.2% respectively during the three spaced CT examinations;most patients had bilateral lung involvement (60%, 93.3%, 93.3%), the lesions predominantly involved the posterior (87.5%, 71.9%, 76.6%) and peripheral (90.6%, 84.3%, 85.7%) part of the lungs. There were more consolidation and mixed patterns in repeat CT scan Versus initial CT scan, the difference was statistically significant (P-values were < 0.001). The total lung severity score in the three aforementioned timely spaced CT scans were 36 (3.3 ± 2.1 days) 63 (7.9 ± 2.1 days), and 57 (14.2 ± 1.3 days) respectively. The median percentage of pneumonia lesions of the whole lung volume in three times CT scan was 1.69% (4.59), 3.47% (5.46), 2.33% (4.75) respectively. Besides, “Tree-in-bud” sign, lung cavitation, and lymphadenopathy were absent. Conclusion: The Thin-slice Section CT Imaging features show uniquely different characteristics, each time the scans are taken. The most common findings in our study were bilateral multiple peripheral and mostly posterior ground-glass opacities (GGO), however the CT scan images that were taken in a timely manner to follow up demonstrated some remarkable changes, which undoubtedly play an important role in the diagnosis and management of the patient with COVID-19 disease.

Preventive Effect of Xiangsha Yangwei Pills on the Novel Coronavirus Pneumonia from"Genuine Qi Exists,Illness Never"

The preventive effect of traditional Chinese medicine on the novel coronavirus(COVID-19)pneumonia is embodied in the"prevention before disease onset"of"treatment of disease"theory of thought,and it is considered that the key to the success or failure of prevention is whether the healthy qi is abundant or not.This article discusses and understands the"genuine qi"from the The Medical Classic of the Yellow Emperor,and describes its meaning comprehensively and systematically,combining with the expansion and supplement of many doctors in later generations.The"genuine qi"includes healthy qi,pulse qi,congenital qi,personal qi,Jing qi primordial qi and food energy,all of which are closely related to spleen-stomach.The function of spleen-stomach is normal,water and grain are transported properly,and the rise and fall of qi is appropriate,then the human body's qi is abundant,the anti-evil force is strong,and people are not easy to cause disease;even if the disease,the prognosis is better.This the novel coronavirus pneumonia comprehensive analysis,belongs to the traditional Chinese medicine science"damp-toxin epidemic",therefore the prevention should pay more attention to strengthen spleen and stomach,eliminate dampness,and Xiangsha Yangwei Pills is the appropriate choice.

TCM theoretical analysis and modern pharmacological mechanism of Huashi Baidu decoction in treating severe novel coronavirus pneumonia

The main symptom elements of the severe novel coronavirus pneumonia epidemic virus closed lung syndrome are cold, damp, poisonous, heat, dryness, blood stasis, and deficiency, which mainly involve the lung and spleen, and are closely related to the heart, liver, kidney, and large intestine. Chinese medicine has accumulated rich academic theories and clinical experience in the prevention and treatment of infectious diseases. The treatment of lung syndrome recommends the use of Huashibaidu formula in the treatment of novel coronavirus pneumonia with integrated traditional Chinese and western medicine. The prescription for removing dampness and detoxification is composed of Maxingshigan formula in "Treatise on Febrile Diseases", "Tingli Dazao Xiefei formula" in "An Outline of Jinkui", Xuanbai Chengqi formula in "Diagnosis of Warm Diseases", "Medical Source Moisture" The combination of four prescriptions of Huopu Xialing formula in "On" is made according to the specific requirements. Through the composition of the prescription of Huashibaidu formula and the pharmacological research involving drugs, the mechanism of the novel coronavirus pneumonia severe epidemic closed lung syndrome may be combined with the blocking of cytokine inflammation storm, immune regulation, antispasmodic and asthma, and improvement Related to hemodynamics.

A summary of diagnosis and treatment experience of novel coronavirus pneumonia

The current epidemic situation of the COVID-19 is still serious.As a designated unit for the diagnosis of COVID-19 in Hainan Province,We,The Second Affiliated Hospital of Hainan Medical University,established a multidisciplinary integrated individualized treatment team.We emphasized early improvement of relevant examinations,early antiviral treatment,dynamic monitoring of inflammatory markers and imaging changes.In addition,nutritional support,psychological intervention,and Chinese medicine treatment also play an important role.We summarized the experience in the diagnosis and treatment process for the reference of clinicians.

Analysis of novel coronavirus pneumonia treatment with Chinese herbal compound

Objective: To analyze the prescription law of TCM compound in the treatment of new coronavirus pneumonia, and provides reference for the clinical treatment of new coronavirus pneumonia. Methods: Collected Collected 24 novel coronavirus pneumonia related diagnostic and therapeutic plans issued by the National Health Council and the Chinese medicine authority from January 26, 2020 to March 8th ,the filtered solution involved in the formula, establishing database of traditional Chinese medicine compound prescription for the treatment of new crown pneumonia, the frequency of using frequency analysis methods of analysis and clustering analysis and association rules analysis to sort out data mining analysis of traditional Chinese medicine compound. Results: In this study, a total of 159 TCM compounds were included in the treatment of new crown pneumonia from the country and 23 provinces, municipalities and autonomous regions, involving 189 TCM compounds. A total of 62 high-frequency traditional Chinese medicines (frequency ≥ 11) were obtained, mainly including licorice, almond, ephedra, gypsum, Poria cocos, Huoxiang, etc The drug types are mainly heat-clearing drugs, vacuous drugs, moisture-curing drugs, and surfactant drugs. The main effect of the medicine was warm, cold, lukewarm and flat, the main effect of the medicine was bitter and bitter, and the main effect of the medicine was the lung, stomach and spleen. Cluster analysis results according to the performance of traditional Chinese medicine treatment of new crown pneumonia high frequency drugs into 7 classes;Association rule analysis results in 29 common drug pairs. Conclusion: In the treatment of pneumonia caused by new coronavirus infection with traditional Chinese medicine, the following characteristics are presented: the number of times of supplementing qi and Yin is more than that of attacking evil and maintaining health;The method of dispersing and solving the attack of wet, beneficial, wet, permeable and wet medicine fully embodies a variety of ways to drive away evil;In terms of drugs, heat-clearing drugs, deficiency drugs, dampness drugs and surface drugs are the main ones, highlighting that the basic treatment method is to dissolve dampness and detoxify, and replenish qi and Yin. In summary, this study can provide reference for guiding clinical drug use and developing new drugs.

Analysis of Clinical Features in Novel Coronavirus Pneumonia Convalescents

Background:To analyze the clinical features of convalescent individuals with novel coronavirus-infected pneumonia(novel coronavirus pneumonia)at rehabilitation station in Wuhan.Methods:712 patients in the convalescence period of novel coronavirus pneumonia isolated and observed at the rehabilitation station were investigated by collecting their basic data,clinical syndrome features,and tongue manifestations.The clinical syndrome features were analyzed based on guidelines of Diagnosis and Treatment Plan for Novel Coronavirus-infected Pneumonia(National Health Commission of the People’s Republic of China,7th Trial Edition).Results:Cough(24.86%),chest tightness and shortness of breath(23.17%),and fatigue(16.57%)were the main symptoms of patients in the convalescence period of novel coronavirus pneumonia.Their tongue appearance was mostly characterized by redness(88.65%),thick coating(67.25%),greasy coating(49.78%)and white coating(76.86%).Conclusion:Compared with the ordinary/mild patients,cough and anorexia symptoms were more common in the severe/critical patients.In convalescent patients,red and fat tongue with thick greasy fur were common.

Survey of the Sleep Quality of Medical Staff in a Grade A Tertiary Hospital during the Novel Coronavirus Pneumonia Outbreak

This study aimed to investigate the sleep quality of medical staff in China who are combatting novel coronavirus pneumonia(COVID-19).To perform this,a survey of 127 medical staff from three separate wards(the general ward,isolation ward,and fever clinic)of a Grade A tertiary hospital in China was conducted.The survey questionnaire measured general characteristics and included the Pittsburgh Sleep Quality Index(PSQI).We consequently found that global PSQI scores differed significantly between the different wards(χ2=44.561,P<0.001).Whilst the medical staff in the general ward did not report any sleep disturbances,those in the isolation ward and the fever clinic both exhibited various degrees of sleep disturbance(global PSQI score>7).Medical staff in the isolation ward had the worst sleep quality(mean rank=91.74),followed by those in the fever clinic(mean rank=70.52)and the general ward(mean rank=39.10),respectively.The primary sleep disturbances reported by the medical staff from the isolation ward included difficulty falling asleep(24 cases,71.42%),waking early or at night(28 cases,80%),and nightmares(18 cases,51.42%).In addition,31.42%(11 cases)of the medical staff from the isolation ward had less than six hours of sleep a night,and 65.71%(23 cases)felt that their sleep quality was poor;meanwhile,for the staff from the fever clinic these ratios were 16.67%(seven cases)and 33.33%(14 cases),respectively.In contrast,among medical staff in the general ward,98%(49 cases)reported sleeping for more than six hours a night,and 96%felt that their sleep quality was good.In conclusion,of the medical staff providing treatment for COVID-19,those in isolation wards and fever clinics are more likely to experience sleep disturbances.

Online Teaching under the Situation of Novel Coronavirus Pneumonia: Problems and Countermeasures

Novel coronavirus pneumonia has changed the way of life of the whole nation since the end of 2019,and the traditional class-teaching of universities,middle schools and primary school have to be changed into online teaching.Online learning is a new thing for many teachers and students.In order to meet the new challenges,both teachers and students have t make some adjust⁃ments in teaching methods and learning strategies.In this process,problems arise unavoidably.This paper sorts out some problems and provides corresponding countermeasures.

单中心维持性血液透析患者新型冠状病毒感染状况调查及预后影响因素分析

目的调查维持性血液透析(maintenance hemodialysis,MHD)患者新型冠状病毒感染的患病率,并分析影响预后的相关因素,为更好地管理MHD患者提供依据。方法整群抽取280例MHD患者作为调查对象,调查MHD合并新型冠状病毒感染的患病率。筛选出其中感染新型冠状病毒的患者,根据预后情况的不同,将MHD新型冠状病毒感染患者分为痊愈组和死亡组,调查相关因素。结果共筛查出MHD合并新型冠状病毒感染患者265例,患病率为94.64%。死亡患者15例,病死率为5.66%。无症状感染者为30例(11.32%)。与痊愈组(n=250)患者相比,死亡组(n=15)患者发生乏力、纳差、咳嗽、咽喉肿痛、呼吸困难的比例更高,差异有统计学意义(P<0.05);与死亡组患者相比,痊愈组患者发生肌肉酸痛的比例更高,差异有统计学意义(P<0.05);两组患者在发热、嗅觉失敏、味觉失敏、头昏头痛、腹泻等症状的百分率方面比较,差异无统计学意义(P>0.05)。两组患者在原发疾病中的慢性肾炎,高血压,多囊肾,新型冠状病毒疫苗接种1剂次、2剂次、3剂次,透析龄,血磷、甲状旁腺激素水平、透析间期体重增长率、血红蛋白、空腹血糖以及血压等指标比较,差异无统计学意义(P>0.05)。与痊愈组患者相比,死亡组患者在原发疾病中的糖尿病比例及感染新型冠状病毒后发生病毒性肺炎的比例更高,透析间期更加缺少运动,年龄更大,血钙水平更低,炎症指标(白细胞计数、C反应蛋白、降钙素原、白细胞介素-6(interleukin-6,IL-6))更高以及存在更多的单室尿素清除指数(single-poolKt/V,spKt/V)不达标,差异有统计学意义(P<0.05)。结论原发疾病中的糖尿病、感染新型冠状病毒后发生的病毒性肺炎、透析间期缺乏运动、高龄、低血钙、高水平炎症指标(白细胞计数、C反应蛋白、降钙素原、IL-6)以及spKt/V不达标是引起MHD新型冠状病毒感染患者死亡的主要影响因素。因此,鼓励MHD患者透析间期加强运动,有利于增强MHD患者的体质。另外,通过改善患者的透析充分性,有助于改善MHD新型冠状病毒感染患者的预后。