Contingency management strategies of the Nursing Department in centralized rescue of patients with coronavirus disease 2019

Objectives:This article aims to summarize a series of contingency management strategies of the Nursing Department in the centralized treatment of patients with coronavirus disease 2019(COVID-19).Methods:The strategies of the Nursing Department included an early warning for prevention and control,taking functions of vertically commanding and horizontally coordinating,and reasonably allocating nursing workforce,to facilitate centralized treatment work in the in-hospital fever clinic,isolation wards and ICU,and referral and admission of critical patients.Five special groups were established in charge of training and examination,management and supervision,psychological support,logistical support,and reporting and publicity,respectively.Results:It was achieved that no deaths from critical patients and no medical staff,no other patients were infected.Conclusion:Through the implementation of these strategies,safe and efficient centralized treatment was ensured timely,orderly and sustainably.

Quantitative regulation of peripheral leukocyte by light exercise and tailored scale for assessment

Two primary defense systems develop in vertebrates, innate and adaptive. However, every individual exposes to the risk of immunodeficiency in daily life with both internal and external stimuli. In this report, we tried to report two different stimuli for regulating the immune system modulate and discussed how we can compare and select each menu by evidence-based manner more than VAS. In a series of investigation, we have assessed the various leukocyte regulating menus such as hot spring hydrotherapy, acupuncture & moxibution, light walking, independent of the western medicine. In this report, we try to compare the regulatory effect of light exercise under the influence of hypothalamus system. Their effects of elements were evaluated by the total number of peripheral leukocyte, its subsets, granulocyte and lymphocyte ratio. The regulative effects were confirmed also by other menu such as hydrotherapy, acupuncture, walking etc. However, by simply comparing the group before with the group after CAM, we cannot catch the real regulatory effect by each menu. So we tried to show the effect by trying to indicate the constitution/condition dependent manner. The effect was not uniform to each individual but it was dependent on each condition/constitution before the start of the exercise. This was one of the main purposes of this report for summarizing that it is important to regulate the number and levels of each factor as ideal value. In other words, the regulation of each factor affected under the hypothalamus system is regulated with each constitution, under the influence of daily circumstances. The mode of regulation was the same in each menu, indicating the higher level was down regular and lower level was up regular. Moreover, each vector of change was reversely correlated to the value of the day before. The other purpose of this study was designed to establish the regulatory effect of this light exercise which is not limited in the number of leukocyte in peripheral. Light exercise for a short duration was expected to influence the immune system in the blood quantitatively. Preparing two modes of impact for walking, 4 mets by walking exhibited more effective than that of 8 mets. We tried to discuss the suitable scale to know the best intensity to regulate whole body system other than VAS judgment.

High-Risk Congenital Coronary Abnormalities in Patients with Bicuspid Aortic Valve

Objective:Abnormal coronary artery origin(ACAO)from the opposite sinus with inter-arterial course of the ectopic proximal vessel is associated with the greatest potential for clinical manifestations,specifically sudden death.Data remain limited regarding the association between bicuspid aortic valve(BAV)and this potentially dangerous coronary variant reported in up to 0.6%in the general population.We investigated the frequency of this high-risk ACAO with inter-arterial course in our surgical series of BAV patients.Methods and Results:We conducted a retrospective study to identify BAV patients with ACAO and inter-arterial course who underwent elective aortic valve/root surgery between 2010 and 2019 in our tertiary center.A total of 279 consecutive patients with BAV were identified.Among these,four patients(1.4%)had ACAO with inter-arterial course.Three patients had abnormal right coronary artery arising from the theoretical opposite coronary sinus with intramural course.The fourth patient presented an abnormal left coronary artery from a single coronary artery arising from the theoretical right coronary sinus with a long inter-arterial course.Conclusion:Our results from a single-center experience support high-risk ACAOS may be more frequently diagnosed in BAV patients,especially in surgical series,justifying a careful preoperative assessment.

<i>Lactobacilli</i>Enjoyed Fermented Herbs on to the Last Fragment and Regulated Leucocyte Subsets and Anti-Oxidative Activity

Eighty sorts of herbs were fermented by Lactobaccilli (f-ESH). This material was proved by as safe in animal safety experiment. This work was aimed to revise the traditional way of hot water extraction to the fermentation, in order to use up the original material and searching new activity as well. We tried to prove the new activity by fermentation for immune-competent cells in the host that administrated both of original remedy and the new fermented sample. In rodents, immune-compromised host was prepared with cancer chemotherapeutic agent. Our observations showed that the antigen stimulated animal increased the antibody producing cell for heterologous erythrocyte by compromised host by f-ESH. Moreover, by administration of f-ESH to immno-suppressed hosts, these samples regulated lymphocyte in number and functions, macrophage activities, and regulating anti-oxidative activity by phagocytic cells. The anti-oxidative assay was carried out ex-vivo system by peritoneal excaudate cell that we propose as suitable system for evaluating antioxidative assay. With these evidences, the original COF only augmented the level of lymphocytes in number, while f-ESH regulated the ratio of granulocytes and lymphocyte. In clinical study with 20 healthy volunteers, granulocyte and lymphocyte ratio was also resulted as neutral in peripheral white blood cells, 1, 2 and 3 weeks after the administration of f-ESH. We discussed the significance and mechanism of cleving complement components Fb by f-ESH in this text. Fb. The new cleavage of complement was directly evident by immune-electrophoretic method. In conclusion, this modification of food materials introduced new style of food intake resulted in the significant regulation such as antibody producing cells and anti-oxidative activity for phagocytic cells comparing traditional processing by hot water extraction.

Regulative effect for natural killer cell by hot spring hydrotherapy—Quantitative and qualitative discussion

Along with maintaining immune competent cells, one of the purposes of cancer patient is regulating the first line of defense for survival. Moreover, the factors that influence the acquired immune activity are systemic metabolic disorder in diabetes, malnutrition, extreme exhaustion, stresses, aging and medical side effect such as chemotherapy. So we have to select appropriate menu to regulate immune function through leukocyte storage. Especially, NK cell is first line of defense against virus infected cell and/or tumor cell. In order to recommend the effect of hot spring hydrotherapy on the peripheral white blood cells as a parameter for complementary and alternative medicine (CAM) within a short period, the granulocytes, lymphocytes, lymphocyte subsets in their peripheral blood were monitored. In the young group (35 or less), the number of granulocytes clearly decreased after hydrotherapy. In the older group (over 35 years old), the total number of leukocytes and lymphocytes significantly increased after the therapy. Using a FACScan, we investigated CD2, CD4, CD8, CD16, CD19 and CD56 positive cell as well as the cytokine containing cell, as direct assessment for immunological preparation (IFN-γ, IL-4 and IL-1β). After hydrotherapy, the CD16+ cells also increased outstandingly. However, the CD19+ cells clearly decreased. Moreover, there was a decrease in the cytokine-producing cell count of subjects whose blood cells had a higher number of the cell level before. All of the results indicated that hot spring hydrotherapy could regulate the immune system even in normal human. Like this, blood hormonal level was measured in order to know the mechanism of the quantitative and qualitative, adjustment of the leucocytes becomes possible within a short term. As a result of measuring, 7 kinds of hormone including mainly adrenocortical hormones, adrenalin level reduced in constitution dependent manner. From these results, it was suggested that the quantitative and qualitative fluctuation of the leukocyte by the hydrotherapy is closely related to dynamics of blood hormonal level.

~rognostic value of baseline C-reactive protein levels in patients mdergoing coronary revascularization

Background C-reactive protein （CRP） is a lowly expressed marker for inflammatory response. This study aimed to evaluate the prognostic value of baseline CRP levels in patients undergoing coronary revascularization in the context of modern medical treatment. Methods This was a retrospective study in a single center. Four hundred and fourteen patients were enrolled, who underwent coronary revascularization and received adequate medication for secondary prevention of coronary heart disease. The study compared the follow-up clinical outcomes between high level CRP group （CRP 〉5 mg/L） and low level one. The median follow-up time was 551 days. Results Compared with low CRP group, the relative risk （RR） of the major adverse cardiovascular and cerebral events （MACCE） in high CRP group was 5.131 （95% CI： 1.864-14.123, P=0.002）. There were no significant differences in death myocardial infarction and stroke during the follow-up between two groups, but a higher risk of re-revascularization was found in high CRP group （RR 6.008, 95% CI： 1.667-21.665, P=0.006）. Cox regression analysis showed that only CRP level could contribute to MACCE during the follow-up. MACCE-free rate was much lower in high CRP group （Kaplan-Meier log-rank P 〈0.001）. Conclusion In the context of modern medical treatment, the baseline level of CRP is an independent predictor for long-term prognosis in patients with coronary revascularization.