The latest research progress of the Corona Virus Disease 2019 mutant strain"Omicron"

Coronavirus disease 2019(COVID-19)that broke out at the end of December 2019 has been raging for 3 years,bringing unpredictable harm to the physical and mental health of all mankind and global economic development.The new type of coronavirus pneumonia is a new type of respiratory infectious disease with a high incidence and fatality rate caused by SARS-CoV-2.Up to now,hundreds of millions of people have been infected with new coronary pneumonia worldwide,and millions of people have died.Due to the specificity of the new coronavirus itself and its high mutation rate,a series of different new coronavirus variants have appeared,which has caused the new crown pneumonia epidemic to repeat.Recently,the World Health Organization(WHO)announced a new variant"omicron"(omicron,B.1.1.529),and declared that the mutant strain may be highly infectious,antibody tolerant and highly resistant to vaccines.This article briefly reviews the latest research progress of the"omicron"variants.

Corona virus disease 2019-associated liver injury in cold regions

The corona virus disease 2019(COVID-19)pandemic has created a global health and economic crisis.Our studies uncovered that in addition to respiratory symptoms,liver damage is also common in COVID-19 patients;however,the cause of liver damage has not been fully elucidated.In this article,we summarize the clinical manifestations and pathological features of COVID-19 reported in published relevant studies and delineate the etiology and pathogenesis of COVID-19-related liver injury.We speculate that cold stimulation may be associated with COVID-19-related liver injury,which should be considered in clinical decision-making and treatment of COVID-19 in cold regions.

Bibliometric analysis of nursing studies on Corona Virus Disease 2019 in China

Objective:To analysis the current status and research focus of Corona Virus Disease 2019(COVID-19)nursing research in China.Methods:China National Knowledge Infrastructure(CNKI),WanFang,Chinese Scientific Journals Database(VIP)and Chinese Biomedical Literature Service System(SinoMed)databases were searched for the literatures on COVID-19 nursing published from January 1,2020,to May 15,2020.The Bibliographic Items Co-occurrence Matrix Builder was used to perform bibliometric analysis on journals,authors,keywords,etc.of the articles,and SPSS 23.0 was utilized to cluster analysis of high-frequency keywords.Results:A total of 458 related articles and 429 first authors were extracted.There articles were published most in the journal of Chinese General Practice Nursing(12.25%).33 high-frequency keywords were extracted such as“COVID-19”,“nurse”,etc.,accounting for 50.19%of the total frequency.Co-word cluster analysis obtained four research hotspots:the psychological status and psychological care of medical staff fighting COVID-19;the nursing strategy of critically ill patients with COVID-19 and the psychological experience of nurses against COVID-19;operating room emergency management and infection prevention during epidemic;the triage management of novel coronavirus infection in fever clinic.Conclusion:The psychological status,the nursing strategy on critically ill patients,the psychological experience of nurses,operating room emergency management and infection prevention,the triage management of novel coronavirus infection in fever clinic had become hot topics when facing the COVID-19 epidemic.

托珠单抗联合糖皮质激素在重型/危重型2019冠状病毒病中的应用效果

目的:探讨托珠单抗联合糖皮质激素治疗重型/危重型2019冠状病毒病患者的效果及安全性。方法:回顾性分析2020年2月—2023年3月同济医院光谷院区、宁波市医疗中心李惠利医院收治的17例重型/危重型2019冠状病毒病患者。给予患者托珠单抗(8 mg/kg静脉滴注)联合甲泼尼龙(40~80 mg/d静脉滴注)治疗。在治疗前及治疗后对患者临床症状进行记录,同时检测患者血常规、C反应蛋白(CRP)、白细胞介素-6(IL-6),并记录患者不良反应发生情况和治疗转归。结果:治疗后患者发热占比[41.2%(7/17)]低于治疗前[100%(17/17)],差异有统计学意义(P<0.05)。治疗后患者CRP水平较治疗前显著下降,差异有统计学意义(P<0.05)。16例患者治疗后好转,其中4例(23.5%)属于重型,12例(70.6%)属于危重型。所有患者均未出现不良反应。结论:托珠单抗联合糖皮质激素治疗可显著缓解重型/危重型2019冠状病毒病患者发热症状,且无明显的不良反应,转归良好,提示托珠单抗联合糖皮质激素在2019冠状病毒病治疗中具有良好的治疗潜能及安全性。

Prevention and Control Strategies of Nosocomial Infection and Effectiveness Evaluation in a Tertiary Teaching Hospital during the Epidemic of COVID-19

Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.

Can Chinese Medicine Be Used for Prevention of Corona Virus Disease 2019 (COVID-19)? A Review of Historical Classics, Research Evidence and Current Prevention Programs

Objective:Since December 2019,an outbreak of corona virus disease 2019(COVID-19)occurred in Wuhan,and rapidly spread to almost all parts of China.This was followed by prevention programs recommending Chinese medicine(CM)for the prevention.In order to provide evidenee for CM recommendations,we reviewed ancient classics and human studies.Methods:Historical records on prevention and treatment of infections in CM classics,clinical evidence of CM on the prevention of severe acute respiratory syndrome(SARS)and H1N1 in flue nza,and CM preve ntion programs issued by health authorities in China since the COVID-19 outbreak were retrieved from differe nt databases and websites till 12 February,2020.Research evide nee in eluded data from clinical trials,cohort or other population studies using CM for preventing contagious respiratory virus diseases.Results:The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi's Internal Classic(Huang Di Nei Jing)where preventive effects were recorded.There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza.None of the participants who took CM contracted SARS in the 3 studies.The infection rate of H1N1 in flue nza in the CM group was significantly lower than the non-CM group(relative risk 0.36,95%confidence interval 0.24-0.52;n=4).For prevention of COVID-19,23 provinces in China issued CM programs.The main principles of CM use were to tonify qi to protect from external pathoge ns,disperse wind and discharge heat,and resolve damp ness.The most frequently used herbs in eluded Radix astragali(Huangqi),Radix glycyrrhizae(Gancao),Radix saposhnikoviae(Fangfeng),Rhizoma Atractylodis Macrocephalae(Baizhu),Lonicerae Japonicae Flos(Jinyinhua),and Fructus forsythia(Lianqiao).Conclusions:Based on historical records and human evidenee of SARS and H1N1 influenza prevention,Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population.Prospective,rigorous population studies are warranted to confirm the potential preventive effect of CM.

Interpretation of the Traditional Chinese Medicine portion of the diagnosis and treatment protocol for corona virus disease 2019(Trial Version 7)

The TCM protocol in the Diagnosis and Treatment Protocol for corona virus disease 2019(COVID-19)(Trial Version 7) has been updated from previous versions. The protocol was formulated under the direct leadership of the National Administration of Traditional Chinese Medicine, based on the experience of a panel of experts, supported by evidence from fever clinics and from the outcomes of emergency(EM) observation rooms and inpatients throughout China(especially in Wuhan, Hubei Province) in combination with the latest scientific research results and data. The present interpretation of the TCM protocol is based on an overall understanding of the revised content, and aims to guide and standardize its clinical application to provide a reference for clinicians.

Treatment of pulmonary fibrosis in one convalescent patient with corona virus disease 2019 by oral traditional Chinese medicine decoction:A case report

After one-month of oral treatment with traditional Chinese medicine decoction,without using other drugs,the lung inflammatory exudate,pulmonary fibrosis and quality of life of a 61-year-old female patient with corona virus disease 2019(COVID-19)were significantly improved.No recurrence or deterioration of the patient’s condition was found within seven weeks of treatment and follow-up,and no adverse events occurred,indicating that oral Chinese medicine decoction was able to improve the pulmonary inflammation and fibrosis in a patient recovering from COVID-19,but further research is still needed.

一类具有脉冲干预措施的COVID-19模型的稳定性分析

建立了一类对易感人群实施脉冲干预措施的COVID-19模型,得出了模型的基本再生数R_(0)和无病周期解。当R_(0)<1时,根据脉冲微分不等式和Lyapunov函数分析了无病周期解的全局稳定性,并数值模拟了这一结论。最后,探讨了脉冲预防策略在COVID-19传染病预防中的效果。

2019冠状病毒病感染流行期分泌性中耳炎患病人口统计学特征分析

目的 评估2019冠状病毒病(corona virus disease 2019,COVID-19)感染流行期分泌性中耳炎患病年龄构成比的变化特征。方法 回顾性分析2018年12月1日~2019年1月31日在首都医科大学附属北京同仁医院耳鼻咽喉头颈外科就诊的符合诊断与排除标准的分泌性中耳炎病例,称为新冠前组;2022年12月1日~2023年1月31日在该科就诊的符合诊断与排除标准的分泌性中耳炎病例,称为新冠期组。收集患者年龄、性别、发病侧别和听力学检测结果等。并将这两个时期纳入本研究的分泌性中耳炎患者总数、年龄构成比、性别构成比、患病侧别比和听力学检测结果等数据进行统计学分析。结果 新冠前组的患者总人数为1 872例,年龄(30.45±23.17)岁,男性949例,女性923例,其中儿童患者910例,成年患者962例。新冠期组患者总人数1 194例,年龄(48.31±18.92)岁,男性623例,女性571例,其中儿童患者95例,成年患者1 099例。新冠前组与新冠期组之间,总体患病年龄分布不同(Z=-20.820,P<0.001)。儿童患者与成年患者的构成比具有显著性差异(χ2=546.838,P <0.001),儿童患病比率显著减少,成年人患病比率显著增加。新冠期组与新冠前组相比,在儿童组7~18岁年龄段的患病比例明显减少(Z=-5.641,P<0.001),在成年人组46~75岁年龄组的患病比例明显增加(Z=-3.134,P=0.002)。新冠期组与新冠前期组相比成年患者中男性患者增多,具有显著性差异(χ2=5.15,P=0.023)。患病侧别构成比、平均骨气导差值两组之间无显著性差异。结论 新型冠状病毒疫情流行期与疫情之前相比,分泌性中耳炎的患病群体年龄构成比明显改变,儿童所占比例显著降低,成年人所占比例显著增高。

2019冠状病毒病与先天性心脏病关系研究的进展

2019冠状病毒病(COVID-19)是一种由严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引起的传染性疾病。先天性心脏病是COVID-19发生的高风险因素。本文就COVID-19与先天性心脏病关系的研究进行综述,探讨COVID-19对心血管损伤、儿童及成人先天性心脏病的影响以及对COVID-19引起的先天性心脏病患者的管理与治疗,以期为COVID-19引起的先天性心脏病患者的预防、诊治提供理论依据。

2019冠状病毒病疫情防控隔离观察人员的精神心理状况及影响因素分析

目的分析2019冠状病毒病疫情防控期间隔离观察人员的精神心理状况及其影响因素,为开展针对性精神心理干预提供参考。方法以2020年2月8日-4月23日在上海市新型冠状病毒肺炎11个隔离点接受隔离观察的人员为研究对象。采用自编一般情况调查表、症状自评量表(SCL-90)对隔离观察人员心理状况及其相关因素进行调查分析。结果入组隔离观察人员共1568人,其中SCL-90筛查阳性者586人,占37.4%。筛查阳性者中存在躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病和其它(失眠)等症状的占比分别为13.8%、11.3%、9.8%、10.5%、42.6%、6.3%、9.6%、7.2%、0.8%和13.8%。与国内常模比较,隔离观察人员SCL-90的躯体化、强迫、抑郁、焦虑、恐怖、偏执等因子分及阳性项目数偏高,差异有统计学意义(P<0.01)。多元线性逐步回归方程分析昱示,女性、身体健康状况、家庭状况、被动入住、诉求次数等变量进入回归方程(P<0.01)。结论接受隔离观察的人员确实存在较为突出的心理问题,其中以焦虑反应最为显著,女性、健康状况差者、有未成年儿女一起接受隔离观察者、被动接受隔离者的心理健康状况需要特别关注。

血液样本56℃30 min加热灭活对精神类药物浓度监测的影响

目的探讨血液样本56℃30 min加热灭活对精神类药物浓度监测的影响。方法选取服用奥氮平、喹硫平、利培酮、锂盐、丙戊酸、氯氮平的患者各60例。将患者已完成药物浓度检测的剩余血液样本采用56℃30 min加热灭活后再次检测。对加热灭活前后各项药物检测结果的一致性进行分析。结果样本加热灭活前后奥氮平、喹硫平、利培酮与9-羟利培酮之和、丙戊酸、氯氮平、N-去甲氯氮平的检测结果差异均无统计学意义(P>0.05),一致性较好。血锂加热灭活后的检测结果显著高于加热灭活前(P<0.05),加热灭活前后一致性较差。通过回归方程校准后,校准值与加热灭活前的检测结果差异无统计学意义(Z=-0.195,P=0.845),且一致性较好。结论56℃30min加热灭活处理对奥氮平、喹硫平、利培酮与9-羟利培酮之和、丙戊酸、氯氮平、N-去甲氯氮平的检测无影响,但会影响血锂的检测。血锂结果通过回归方程校准后仍有临床价值。

2019冠状病毒病疫情下康复医院防控策略专家共识(第一版)

2019年12月以来出现2019冠状病毒病(COVID-19)患者,疫情防控形势严峻。康复医院设置有别于综合医院。中国康复医学会康复机构管理专业委员会等组织国内多家康复医院和感染防控专家共同制定《2019冠状病毒病疫情下康复医院防控策略专家共识》,指导康复医院内COVID-19的防控工作。

2019年新型冠状病毒肺炎的临床研究现状与进展

2019年发生的新型冠状病毒肺炎(简称新冠肺炎),因其传染性强、临床表现多样,给疫情防控和治疗带来了一定的困难.目前对于治疗新冠肺炎尚无特效药,既往用来治疗其他冠状病毒的药物可能有效,但需要进一步临床试验验证.本文将围绕新冠肺炎的流行病学、病原学、临床表现、影像学表现、实验室检查、诊断、并发症与治疗、转归等方面进行简要综述.

感染奥密克戎变异株的2019冠状病毒病轻型和普通型患者核酸检测转阴时间影响因素分析

目的:观察感染奥密克戎变异株的2019冠状病毒病(COVID-19)轻型和普通型患者临床特征,分析影响患者病毒核酸检测转阴时间的相关因素。方法:回顾性分析2022年4月12日至5月26日上海某方舱医院收治的1781例COVID-19患者的临床资料,包括患者年龄、性别、身高、体重、临床症状、基础疾病史、COVID-19疫苗接种情况、治疗用药情况及核酸检测转阴时间等。采用单因素分析和多因素logistic回归分析患者核酸检测转阴时间的影响因素。结果:1781例患者中,男性995例,女性786例,年龄中位数为39(30,52)岁,超重偏肥胖[体质指数(BMI)为24kg/cm^(2)以上]727例(40.8%),存在基础疾病413例(23.2%);未接种COVID-19疫苗205例(11.5%),接种疫苗1576例(88.5%);有1种及以上症状1233例(69.2%),以咳嗽(60.3%)、咳痰(50.4%)、发热(36.9%)多见;接受中药治疗1444例(81.0%),西药治疗78例(4.4%),中西医结合治疗14例(0.8%),未接受药物治疗245例(13.8%),所有患者经过对症处理后均改善,全部痊愈出院,核酸检测转阴中位时间为10.3(7.4,12.4)d。单因素和多因素分析结果显示,年龄为60岁及以上(OR=1.537,95%CI:1.116~2.115,P<0.01)、BMI为24kg/cm^(2)以上(OR=1.344,95%CI:1.106~1.634,P<0.01)、合并高血压(OR=1.518,95%CI:1.094~2.106,P<0.05)是患者核酸检测转阴时间延长的独立危险因素;接种COVID-19疫苗(OR=0.548,95%CI:0.398~0.755,P<0.01)是保护因素,即接种COVID-19疫苗核酸检测转阴时间缩短。结论:奥密克戎变异株感染的COVID-19患者临床症状相对较轻,病情隐匿,患者年龄为60岁及以上、未接种COVID-19疫苗、BMI为24kg/cm^(2)以上、合并高血压是核酸检测转阴时间延长的独立影响因素。

口腔颌面外科手术合并2019新型冠状病毒感染的管理策略

目前,2019冠状病毒病(Corona Virus Disease 2019,COVID-19)在国内持续蔓延。口腔诊疗存在其特殊性,口腔科医生在诊疗过程中需近距离面对患者的口鼻,而潜伏期的患者在不知情的情况下前来就诊,极易造成医务人员感染,甚至导致疫情蔓延。疫情流行期间,原则上如非急诊手术,应延后择期进行。但因病情需要或需实施急诊手术时,应全面评估病情,掌握手术指征,严格执行消毒隔离制度,认真做好防护工作。为做好口腔颌面外科手术的管理与自身防护,避免疫情扩散,保护医患健康,现提出COVID-19流行期间开展口腔颌面外科手术的防控策略,供口腔科医生参考。

从武汉2019-2020年之交的气候变化论“寒湿疫”的成因

综合2019年12月-2020年1月31日武汉市的气象资料,此时期武汉市气温范围为-1~18℃,正值暖冬,雪天天数较少,但阴雨天气较多,相对湿度大,气候阴冷潮湿,环境呈现出寒湿的特点,利于病毒的滋生和传播。根据武汉异常气候特点、患者临床表现及病情传播情况,COVID-19归属于“疫病”范畴,属于“寒湿疫”。鉴于“寒湿疫”的发生、发展及转归与气候的紧密联系,有必要探讨两者之间的相关性,为临床医师明确疾病性质及辨证论治提供参考借鉴。

2019冠状病毒病疫情下区域性孕产保健的互联网+实践路径

2019冠状病毒病疫情期间,国务院提出围产保健机构应借助"互联网+医疗健康"优势,开展孕产妇保健服务。广州市白云区妇幼保健院联合北京协和医院,总结移动医疗用于区域围产保健管理的经验:通过互联网技术实现医疗联盟信息互通共享、双向转诊;通过"网上问诊"开展孕产妇保健在线咨询和指导,利用互联网对孕产妇开展健康教育;通过互联网+医疗服务为孕产妇提供健康监测与管理。供助产机构及健康管理人员参考。

2019冠状病毒病多阶段CT影像学特征

目的:通过多阶段观察2019冠状病毒病(coronavirus disease 2019,COVID-19)患者的CT影像学表现,研究COVID-19各期CT影像学特征,为临床早期诊断和治疗提供依据。方法:回顾性分析经病原学确诊的187例COVID-19患者入院时及住院期间每3 d复查1次肺部CT的影像学资料,并对临床症状改善时间与随访CT的病灶变化时间进行统计学分析。结果:187例患者核酸检测均为严重急性呼吸综合征冠状病毒2阳性,肺部CT均出现肺部炎性改变。187例(100%)的患者早期肺部CT影像学表现为多发斑片状、片状磨玻璃影伴细小网格影及实变影,病灶主要分布在肺外带或胸膜下。146例(78.1%)进展期患者的肺部CT影像学表现以实变为主,伴支气管充气征、局部血管增粗、间质改变。15例(8%)重症期患者的肺部CT影像学表现双肺弥漫性病变呈现实变表现,少数呈"白肺"表现。185例(98.9%)消散期患者肺部CT影像学表现为病变范围缩小、纤维灶形成;1例连续复查6次肺部CT提示病变持续进展;1例原病变明显吸收,第3次复查时双肺胸膜下出现新发病变。随访时CT影像学变化时间与不同的临床症状改善时间比较,差异具有统计学意义(P<0.01)。结论:COVID-19各期的CT影像学表现具有一定的特征;临床症状变化与复查CT影像学变化同步,随访CT能够反映临床变化的趋势,因此对患者进行多阶段CT影像学表现的观察在临床COVID-19的早期诊断和治疗评估中有重要作用。