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 n...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.展开更多
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,...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.展开更多
<strong>Object:</strong> 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...<strong>Object:</strong> 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. <strong>Methods:</strong> 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 <span style="white-space:nowrap;">±</span> 15)) with COVID-19 disease. The mean time between the initial and repeat thin-section CT scans was 3.3 <span style="white-space:nowrap;">±</span> 2.1 days, 7.9 <span style="white-space:nowrap;">±</span> 2.1 days, 14.2 <span style="white-space:nowrap;">±</span> 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 χ<sup>2</sup> test and <em>Fisher’s </em>exact probability.<strong> Results:</strong> All of 15 patients had a history of visit to the endemic center <em>i.e.</em> 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 <span style="white-space:nowrap;">±</span> 2.1 days) 63 (7.9 <span style="white-space:nowrap;">±</span> 2.1 days), and 57 (14.2 <span style="white-space:nowrap;">±</span> 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. <strong>Conclusion:</strong> 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.展开更多
The novel coronavirus(2019-nCoV,or COVID-19)epidemic first broke out in Wuhan and has been spreading in whole China and the world.The numbers of new infections and deaths in Wuhan are still increasing,which have posed...The novel coronavirus(2019-nCoV,or COVID-19)epidemic first broke out in Wuhan and has been spreading in whole China and the world.The numbers of new infections and deaths in Wuhan are still increasing,which have posed major public health and governance concerns.A series of mandatory actions have been taken by the municipal and provincial governments supported by the central government,such as measures to restrict travels across cities,case detection and contact tracing,quarantine,guidance and information to the public,detection kit development,etc.Challenges such as lacking effective drugs,insufficient hospital services and medical supplies,logistics,etc.have much alleviated with the solidarity of the whole society.The pandemic will definitely be ended with the continuous efforts of both national and international multi-sectoral bodies.展开更多
基金supported(in part)by the Entrusted Project of National Center for Medical Service Administration,National Health and Family Planning Commission China(No.[2019]099)the First Level Funding of the Second Medical Leading Talent Project in Hubei Provincethe Special Project for Emergency of the Ministry of Science and Technology(2020YFC0841300)。
文摘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.
文摘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.
文摘<strong>Object:</strong> 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. <strong>Methods:</strong> 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 <span style="white-space:nowrap;">±</span> 15)) with COVID-19 disease. The mean time between the initial and repeat thin-section CT scans was 3.3 <span style="white-space:nowrap;">±</span> 2.1 days, 7.9 <span style="white-space:nowrap;">±</span> 2.1 days, 14.2 <span style="white-space:nowrap;">±</span> 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 χ<sup>2</sup> test and <em>Fisher’s </em>exact probability.<strong> Results:</strong> All of 15 patients had a history of visit to the endemic center <em>i.e.</em> 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 <span style="white-space:nowrap;">±</span> 2.1 days) 63 (7.9 <span style="white-space:nowrap;">±</span> 2.1 days), and 57 (14.2 <span style="white-space:nowrap;">±</span> 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. <strong>Conclusion:</strong> 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.
文摘The novel coronavirus(2019-nCoV,or COVID-19)epidemic first broke out in Wuhan and has been spreading in whole China and the world.The numbers of new infections and deaths in Wuhan are still increasing,which have posed major public health and governance concerns.A series of mandatory actions have been taken by the municipal and provincial governments supported by the central government,such as measures to restrict travels across cities,case detection and contact tracing,quarantine,guidance and information to the public,detection kit development,etc.Challenges such as lacking effective drugs,insufficient hospital services and medical supplies,logistics,etc.have much alleviated with the solidarity of the whole society.The pandemic will definitely be ended with the continuous efforts of both national and international multi-sectoral bodies.
