Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke

BACKGROUND Ischemic stroke(IS)is a widely recognized disease characterized by high preva-lence,mortality,morbidity,disability,and recurrence rates.It ranks prominently in terms of mortality,constituting 60%-80%of stroke cases.AIM To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS.METHODS This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021.The participants were divided into two groups,namely the control group(n=80)receiving routine care and the research group(n=92)receiving comprehensive care.Various assessment scales,including the standard swallowing function assessment scale(SSA),National Institutes of Health Stroke scale(NIHSS),European stroke scale(ESS),self-rating anxiety scale(SAS),self-rating depression scale(SDS),Barthel index(BI),and the motor func-tion assessment scale(MAS),were employed to evaluate the improvement in swallowing function,neurological deficits,clinical outcomes,anxiety,depression,daily living activities,and motor function before and after care.Furthermore,the study compared the occurrence of adverse reactions during the nursing period,life quality before and after the intervention,rehabilitation compliance,and nursing satisfaction between the two groups.RESULTS After the nursing intervention,the research group exhibited significantly improved SSA and NIHSS scores compared to the control group(P<0.05).Moreover,both groups demonstrated significant reductions in SAS and SDS scores(P<0.05),with the research group showing more obvious advantages(P<0.05).Compared to the control group,the research group displayed significantly better ESS,BI,and MAS scores(P<0.05),coupled with a lower incidence of adverse reactions(P<0.05).Additionally,the research group demonstrated markedly higher levels of life quality,rehabilitation compliance,and nursing satisfaction compared to the control group(P<0.05).CONCLUSION Comprehensive nursing effectively improved swallowing function,quality of life,and patient satisfaction,high-lighting its clinical significance.

Epidemiological characteristics of COVID-19 cases in a hotel Fangcang shelter hospital in Sanya

Objective:To analyze the epidemiological characteristics of COVID-19 cases(Omicron variant BA5.1.3)in a hotel Fangcang shelter hospital in Sanya,Hainan Province,and provide basis for optimizing epidemic prevention and control strategies.Methods:The epidemiological data of COVID-19 cases admitted to a hotel Fangcang shelter hospital in Sanya from August 10 to August 30 in 2022 were collected for descriptive epidemiological analysis.Results:By August 30,703 cases of COVID-19 had been treated in the hotel Fangcang shelter hospital.The epidemiological characteristics analysis showed that 328 cases were male,accounting for 46.7%,and 375 cases were female,accounting for 53.3%.The ratio of male to female was 0.87:1.The age range was 8 months to 85 years old,with a median of 37(20,49)years old.The majority of people aged 31-59 years old,accounting for 51.4%.Asymptomatic infection accounted for 39.8%,and mild infection accounted for 60.2%,the main clinical symptoms were cough 24.8%(105/423),fever 18.7%(79/423).8.8%of the infected people had a history of chronic basic diseases,and hypertension and diabetes were the most common.There were 416 infected patients discharged from hospital,and the median total hospital stay was 14(10,15)days.The proportion of people who did not receive COVID-19 vaccine was 10.1%,the proportion of people who completed one,two and three vaccination was 5.0%,36.3%and 48.6%respectively,and the proportion of people who completed two and three vaccinations among people ≥60 years old was only 10.1%and 8.8%.Conclusion:This strain was the novel coronavirus variant BA5.1.3,which was reported for the first time in China.It was more infectious and insidious,and generally susceptible to people of all ages.Therefore,it is necessary to strengthen personal prevention and control,and did a good job of external anti input and internal anti diffusion,and strengthen nucleic acid detection to realize timely detection and early treatment,and strengthen COVID-19 vaccination,to improve vaccination rate and reduce infection rate.

某部队基层官兵艾滋病认知水平健康教育干预评价

目的评价部队基层官兵艾滋病知识认知水平的健康教育干预效果。方法对某部队基层官兵进行艾滋病知识讲座,讲课前、后分别对官兵的艾滋病知识、态度及高危行为认知水平进行调查,用χ2检验分析讲课前、后官兵艾滋病知识、态度和高危行为的正确回答率和艾滋病知识态度高危行为的成绩分布,用t检验分析AIDS认知水平得分高低,所得数据均用SPSS11.5软件进行统计学分析。结果授课后艾滋病相关知识、态度和高危行为的正确回答率均较授课前明显提高(P<0.01),授课后官兵艾滋病知识、态度、高危行为的得分(83.48±17.60,80.72±12.93和86.01±16.96)均明显高于授课前(67.41±22.09,61.21±16.70和69.69±25.53)(t=11.69,18.94,10.85,P均<0.01),通过健康教育讲座,艾滋病知识、态度、高危行为的认知得分为<60分的人数及百分构成明显减少,>80分的人数及百分构成明显增多(P均<0.01)。结论对部队基层官兵开展艾滋病知识讲座,可明显提高官兵艾滋病知识的认知水平,对其积极应对AIDS态度、引导官兵健康行为有着十分重要的意义。

Comparison of different versions of the quick sequential organ failure assessment for predicting in-hospital mortality of sepsis patients:A retrospective observational study

BACKGROUND:The quick sequential organ failure assessment(qSOFA)is recommended to identify sepsis and predict sepsis mortality.However,some studies have recently shown its poor performance in sepsis mortality prediction.To enhance its effectiveness,researchers have developed various revised versions of the qSOFA by adding other parameters,such as the lactate-enhanced qSOFA(LqSOFA),the procalcitonin-enhanced qSOFA(PqSOFA),and the modified qSOFA(MqSOFA).This study aimed to compare the performance of these versions of the qSOFA in predicting sepsis mortality in the emergency department(ED).METHODS:This retrospective study analyzed data obtained from an electronic register system of adult patients with sepsis between January 1 and December 31,2019.Receiver operating characteristic(ROC)curve analyses were performed to determine the area under the curve(AUC),with sensitivity,specificity,and positive and negative predictive values calculated for the various scores.RESULTS:Among the 936 enrolled cases,there were 835 survivors and 101 deaths.The AUCs of the LqSOFA,MqSOFA,PqSOFA,and qSOFA were 0.740,0.731,0.712,and 0.705,respectively.The sensitivity of the LqSOFA,MqSOFA,PqSOFA,and qSOFA were 64.36%,51.40%,71.29%,and 39.60%,respectively.The specificity of the four scores were 70.78%,80.96%,61.68%,and 91.62%,respectively.The LqSOFA and MqSOFA were superior to the qSOFA in predicting in-hospital mortality.CONCLUSIONS:Among patients with sepsis in the ED,the performance of the PqSOFA was similar to that of the qSOFA and the values of the LqSOFA and MqSOFA in predicting in-hospital mortality were greater compared to qSOFA.As the added parameter of the MqSOFA was more convenient compared to the LqSOFA,the MqSOFA could be used as a candidate for the revised qSOFA to increase the performance of the early prediction of sepsis mortality.

Imaging in detecting sites of pulmonary fibrosis induced by paraquat

BACKGROUND： The most common cause of death from paraquat （PQ） poisoning is respiratoryfailure from pulmonary fi brosis, which develops through pathological overproduction of extracellularmatrix proteins such as collagens. In this study, a MicroCT system was used to observe dynamicchanges of pulmonary fi brosis in rats with PQ poisoning, and fi nd the characteristics of interstitial lungdiseases via density-based and texture-based analysis of CT images of the lung structure.METHODS： A total of 15 male SD rats were randomly divided into a control group （n=5） and aPQ poisoning group （n=10）. The rats in the poisoning group were intraperitoneally administered with4 mg/ mL PQ at 14 mg/kg, and the rats in the control group were administered with the same volumeof saline. The signs of pulmonary fi brosis observed by the MicroCT included ground-glass opacity,nodular pattern, subpleural interstitial thickening, consolidation honeycomb-like shadow of the lung.RESULTS： Compared with the control group, the rats with acute PQ poisoning had differentsigns of pulmonary fibrosis. Ground-glass opacity and consolidation of the lung appeared at theearly phase of pulmonary fi brosis, and subpleural interstitial thickening and honeycomb-like shadowdeveloped at the middle or later stage. MicroCT images showed that fibrotic lung tissues weredenser than normal lungs, and their density was up-regulated with pulmonary fi brosis. There was nodifference in the progress of pulmonary fi brosis between the right lung and the left lung （P〉0.05）, butthere were differences in fi brosis degree at different sites in the lung （P〈0.05 or P〈0.01）. Pulmonaryfi brosis was mainly seen in the exterior area of the middle-lower part of the lung.CONCLUSION： Imaging can show the development of pulmonary fi brosis in PQ poisoning rats,and this method may help to administer drugs more reasonably in treating pulmonary fi brosis.

Relationship of distraction rate with inferior alveolar nerve degeneration-regeneration shift

Distraction osteogenesis is an important technique for the treatment of maxillofacial abnormities and defects. However, distraction osteo- genesis may cause the injury of the inferior alveolar nerve. The relationship between distraction rate and nerve degeneration-regeneration shift remains poorly understood. In this study, 24 rabbits were randomly divided into four groups. To establish the rabbit mandibular distraction osteogenesis model, the mandibles of rabbits in distraction osteogenesis groups were subjected to continuous osteogenesis dis- traction at a rate of 1.0, 1.5 and 2.0 mm/d, respectively, by controlling rounds of screwing each day in the distractors. In the sham group, mandible osteotomy was performed without distraction, Pin-prick test with a 10 g blunt pin on the labium, histological and histomorpho- metric analyses with methylene blue staining, Bodian＇s silver staining, transmission electron microscopy and myelinated fiber density of inferior alveolar nerve cross-sections were performed to assess inferior alveolar nerve conditions. At 28 days after model establishment, in the pin-prick test, the inferior alveolar nerve showed no response in the labium to a pin pricks in the 2 mm/d group, indicating a severe dysfunction. Histological and histomorphometric analyses indicated that the inferior alveolar nerve suffered more degeneration and in- juries at a high distraction rate （2 mm/d）. Importantly, the nerve regeneration, indicated by newborn Schwann cells and axons, was more abundant in 1.0 and 1.5 mm/d groups than in 2.0 mm/d group. We concluded that the distraction rate was strongly associated with the inferior alveolar nerve function, and the distraction rates of !.0 and 1.5 mm/d had regenerative effects on the inferior alveolar nerve. This study provides an experimental basis for the relationship between distraction rate and nerve degeneration-regeneration shift during dis- traction osteogenesis, and may facilitate reducing nerve complications during distraction osteogenesis.

Emergency Biosafety Management Practice in Laboratory of Shelter Hospital

At the end of 2019,the novel coronavirus infection outbroke in Wuhan,Hubei Province.On Feb.2,2020,Wuhan,as the worst-hit region,began to build“shelter hospital”rapidly to treat patients with mild ilness.The shelter hospital has multiple functions such as emergency treatment,surgical treatment and clinical test,which can adapt to emergency medical rescue tasks.Based on the characteristics that shelter hospital only treats patients with mild ilness,tests of shelter laboratory,including coronavirus nucleic acid detection,IgM/IgG antibody serology detection,monitoring and auxiliary diagnosis and/or a required blood routine,urine routine,C-reactive protein,calcitonin original,biochemical indicators(liver enzymes,myocardial enzymes,renal function,etc.)and blood coagulation function test etc,were used to provide important basis for the diagnosis and treatment of the disease.In order to ensure laboratory biosafety,it is necessary to first evaluate the harm level of various specimens.In the laboratory biosafety management,the harm level assessment of microorganisms is the core work of biosafety,which is of great significance to guarantee biosafety.As an emergency deployment afcted by the environment,shelter laboratory must possess strong mobility.This paper will explore how to combine the biosafety model of traditional laboratory with the particularity of shelter laboratory to carry out effective work in response to the current epidemic.

Factors related to early and rapid assessment of in-hospital mortality among older adult trauma patients in an earthquake

BACKGROUND:There is limited evidence for emergency physicians and emergency trauma surgeons regarding the determinants of early and rapid assessment of older adult in-hospital mortality due to earthquakes.This study explored factors related to the early and rapid assessment of the mortality among older adult earthquake trauma patients(OAETPs)and created a screening model.METHODS:Data on 7,308 OAETPs from the West China Earthquake Patients Database were analyzed retrospectively.The 35 variables that can be obtained rapidly on arrival at the hospital were collected.Least absolute shrinkage and selection operator(LASSO)regression analysis was performed.Then,the nomogram for assessing the mortality of OAETPs was constructed.RESULTS:We identified 10 independent mortality-related factors that contributed to the in-hospital mortality of OAETPs.The 10 factors included age(odds ratio[OR]=1.061,95%confidence interval[CI]:1.031-1.090),dementia(OR=5.146,95%CI:1.169-17.856),coronary heart disease(CHD;OR=23.441,95%CI:4.799-83.927),malignant tumor(OR=8.497,95%CI:3.583-17.967),deep vein thrombosis(DVT;OR=7.110,95%CI:1.369-27.168),chronic kidney disease(CKD;OR=11.783,95%CI:5.419-24.407),pulse rate(PR;OR=1.036,95%CI:1.022-1.048),mean artery pressure(MAP;OR=0.960,95%CI:0.945-0.975),Glasgow Coma Scale(GCS;OR=0.864,95%CI:0.760-0.972),and Triage Revised Trauma Score(T-RTS,OR=0.485,95%CI:0.351-0.696).CONCLUSION:The 10 mortality-related factors could be quickly obtained on hospital arrival and should be the focal point of future earthquake response strategies regarding hospitalized older adults with trauma.A nomogram was constructed based on the factors for screening OAETPs with a higher risk of in-hospital mortality.

A method for Absolute Protein Expression Quantity Measurement Employing Insulator RiboJ

Measuring the absolute protein expression quantity for a specific promoter is necessary in the fields of both molecular biology and synthetic biology.The strength of a promoter is traditionally characterized by measuring the fluorescent intensity of the fluorescent protein downstream of the promoter.Until now,measurement of the absolute protein expression quantity for a promoter,however,has been unsuccessful in synthetic biology.The fact that the protein coding sequence influences the expression level for different proteins,and the inconvenience of measuring the absolute protein expression level,present a challenge to absolute quantitative measurement.Here,we introduce a new method that combines the insulator RiboJ with the standard fluorescence curve in order to measure the absolute protein expression quantity quickly;this method has been validated by modeling verification.Using this method,we successfully measured nine constitutive promoters in the Anderson promoter family.Our method provides data with higher accuracy for pathway design and is a straightforward way to standardize the strength of different promoters.

CLINICAL OBSERVATIONS ON WEIGHT REDUCTION BY PRESSING AURICULAR POINTS WITH SEMEN VACCARIAE——A REPORT OF 473 CASES

We applied auricular point pressing therapywith Semen Vaccariae for purpose of reducingbody weight during our stay in Kuwait.Observa-tions were made in 473 cases of simple obesity,who were not administered any weight-reducingdrugs and received the present therapy alone forover one therapeutic course.The curative effectsare satisfactory and reported as follows.General

EFFECTS OF JIANG TANG FANG LONG FORMULA ON INSULIN PRODUCTION AND FUNCTION IN AN ANIMAL MODEL OF DIABETIC HEARING LOSS

Objective To study the influence of Jiang Tang Fang Long formula on insulin production and function in an animal model of diabetic hearing loss. Methods Wistar rats (n=60) were randomly divided into 6 groups (10 in each) to receive no treatment (the normal control, Group A), or to receive intra-peritoneal 55 mg/kg streptozotocin with (Groups C, D and E) or without (Group B) subsequent Jiang Tang Fang Long formula treatment at various doses or Yu Long Wan treatment (Group F). After 60 days, fasting blood glucose (FBG), body weight (BW) and fasting insulin (FINS) were recorded and the HOMA-IR and HOMA-βcalcu-lated. Insulin expression in pancreatic tissues was measured by radioimmunoassay. Results Compared with animals that received streptozotocin without rescue treatment (Group B), animals that received higher doses of Jiang Tang Fang Long formula(Groups D and E) showed improved indices of diabetes manifestation (P<0.05) and improved HOMA-β(P<0.05) in a dose-dependent manner, as well as improved insulin expression in pancreatic islets (P<0.05). The difference between low dose Jiang Tang Fang Long formula treatment (Group C) and Group B was not significant (P>0.05). Conclusion Our results suggest that Jiang Tang Fang Long formula may improve pancreatic β-cells function which may explain its efficacy in treating diabetic hearing loss.

Management for Pediatric Pleural Empyema in Resource-Poor Country: Is Chest Tube Drainage with Antiseptic Lavage-Irrigation Better than Tube Thoracostomy Alone?

Drainage by chest tube thoracostomy is widely used in treatment of early empyema thoracis in children, but drainage with antiseptic lavage-irrigation is more frequent in our context since the last 20 years. This study was to determine which was more effective in our experience comparing chest tube drainage with catheter antiseptic lavage-irrigation versus drainage by chest tube thoracostomy alone in the management of empyema thoracis in children. Patients and Methods: Demographic, clinical and microbiological data on children with thoracic empyema undergoing drainage by chest tube thoracostomy alone or with antiseptic lavage-irrigation were obtained from 2 thoracic surgical centers from September 2008 to December 2014. It was a retrospective study included 246 children (137 boys and 109 girls) who were managed for empyema thoracis at the author’s different department of surgery. Outcomes analysis with respect to treatment efficacy, hospital duration, chest tube duration, hospital costs, and need for subsequent procedures was analyzed and compared in the 2 groups. Results: Drainage of pus and antiseptic irrigation resulted in resolution of pyrexia with improvement in general condition in 85.82% of patients in group 1 and by tube thoracostomy alone in 73.95% in group 2. There are a significant difference in the length of hospital stay (p = 0.022), duration of chest tubes in situ (p = 0.040), treatment coast (p = 0.015) and outcome of stage 2 empyema disease (p = 0.037) between the 2 groups. Conclusion: it seems that chest tube drainage with antiseptic lavage-irrigation method is associated with a higher efficacy, shorter length of hospital stay, shorter duration of chest tube in situ, less cost and better outcome of stage 2 empyema diseases than a treatment strategy that utilizes chest tube thoracostomy alone.

Relationship between treatment types and blood–brain barrier disruption in patients with acute ischemic stroke:Two case reports

BACKGROUND Blood-brain barrier(BBB)disruption plays an important role in the development of neurological dysfunction in ischemic stroke.However,diagnostic modalities that can clearly diagnose the degree of BBB disruption in ischemic stroke are limited.Here,we describe two cases in which the usefulness of dynamic contrastenhanced magnetic resonance imaging(DCE-MRI)in detecting BBB disruption was evaluated after treatment of acute ischemic stroke using two different methods.CASE SUMMARY The two patients of similar age and relatively similar cerebral infarction locations were treated conservatively or with thrombectomy,although their sex was different.As a result of analysis by performing DCE-MRI,it was confirmed that BBB disruption was significantly less severe in the patient who underwent thrombectomy(P=3.3×10^(-7)),whereas the average Ktrans of the contralateral hemisphere in both patients was similar(2.4×10^(-5)min^(-1) and 2.0×10^(-5)min^(-1)).If reperfusion is achieved through thrombectomy,it may indicate that the penumbra can be saved and BBB recovery can be promoted.CONCLUSION Our cases suggest that BBB disruption could be important if BBB permeability is used to guide clinical treatment.

Secondary Spontaneous Rupture of the Diaphragm in a Child after Blunt Chest Trauma

Traumatic diaphragmatic rupture (TDR) is very rare in the pediatric age group. Because of its rarity and its coexistence with more injuries, the diagnosis is often delayed. Very little has been written about this condition in the pediatric age group. TDR, while uncommon, should be considered in cases of blunt thoracic trauma. All patients should undergo meticulous examination preoperatively. The clinical presentation and importance of making an accurate diagnosis and surgery is highlighted. We report a case of secondary spontaneous traumatic left-sided diaphragmatic rupture in a child that was managed by delayed surgical repair.

A Rare Case of a Giant Cavernous Lymphangioma of the Chest Wall in a Child

Cavernous lymphangioma of the chest wall is a very rare disease entity, and only a few cases have ever been documented in the literature. Cases of recurrent cavernous lymphangioma after surgical excision of a cystic lymphangioma on the same side of the chest wall are quite uncommon. We report a case of a 10-year-old girl, with a giant cavernous lymphangioma of the left lateral chest wall extending into the axilla, who had undergone surgical excision of a cystic lymphangioma 9 years earlier.

Vonoprazan 10 mg or 20 mg vs.lansoprazole 15 mg as maintenance therapy in Asian patients with healed erosive esophagitis:A randomized controlled trial

Background:Erosive esophagitis(EE)is a gastroesophageal reflux disease characterized by mucosal breaks in the esophagus.Proton pump inhibitors are widely used as maintenance therapy for EE,but many patients still relapse.In this trial,we evaluated the noninferiority of vonoprazan vs.lansoprazole as maintenance therapy in patients with healed EE.Methods:We performed a double-blind,double-dummy,multicenter,phase 3 clinical trial among non-Japanese Asian adults with endoscopically confirmed healed EE from April 2015 to February 2019.Patients from China,South Korea,and Malaysia were randomized to vonoprazan 10 mg or 20 mg once daily or lansoprazole 15 mg once daily for 24 weeks.The primary endpoint was endoscopically confirmed EE recurrence rate over 24 weeks with a noninferiority margin of 10%using a two-sided 95%confidence interval(CI).Treatment-emergent adverse events(TEAEs)were recorded.Results:Among 703 patients,EE recurrence was observed in 24/181(13.3%)and 21/171(12.3%)patients receiving vonoprazan 10 mg or 20 mg,respectively,and 47/184(25.5%)patients receiving lansoprazole(differences:-12.3%[95%CI,-20.3%to-4.3%]and-13.3%[95%CI,-21.3%to-5.3%],respectively),meeting the primary endpoint of noninferiority to lansoprazole in preventing EE recurrence at 24 weeks.Evidence of superiority(upper bound of 95%CI<0%)was also observed.At 12 weeks,endoscopically confirmed EE recurrence was observed in 5/18,2/20,and 7/20 of patients receiving vonoprazan 10 mg,vonoprazan 20 mg,and lansoprazole,respectively.TEAEs were experienced by 66.8%(157/235),69.0%(156/226),and 65.3%(158/242)of patients receiving vonoprazan 10 mg,vonoprazan 20 mg,and lansoprazole,respectively.The most common TEAE was upper respiratory tract infection in 12.8%(30/235)and 12.8%(29/226)patients in vonoprazan 10 mg and 20 mg groups,respectively and 8.7%(21/242)patients in lansoprazole group.Conclusion:Vonoprazan maintenance therapy was well-tolerated and noninferior to lansoprazole for preventing EE recurrence in Asian patients with healed EE.Trial Registration:https://clinicaltrials.gov;NCT02388737.

Protective effect of astrocyte-conditioned medium on neurons following hypoxia and mechanical injury

Objective： To investigate the protective effect of mouse astrocyte-conditioned medium （ACM） on hypoxic and mechanically injured neurons by a cell model in vitro, and to explore the possible mechanism. Methods： The model of hypoxic neuronal injury was caused by 3% 02 in three-gas incubator. Neurons were cultured with ordinary medium or 20% ACM respectively and randomly divided into hypoxic group （hypoxia for 4, 8, 24 h and marked as H4R0, H8R0, H24R0） and hypoxia reoxygenation group （H4R24, H8R24, H24R24）. Mechanical injury model was developed by scratching neurons cultured in 20% ACM or ordinary medium to different degrees. Neu- rons in both medium were divided into normal control group, mild, moderate and severe injury groups. The 20% ACM was added 24 h before hypoxia/reoxygenation or mechanical injury. The morphology and survival of neurons were observed and counted by trypan blue staining. The concentration of NO, lactic dehydrogenase （LDH） and membrane ATPase activity were detected by corresponding kits. Results： It was showed that 20% ACM can obviously promote the survival rate of hypoxia/reoxygenated neurons and scratched neurons as well. The morphology and num- ber of neurons exposed to hypoxia or scratch injury showed great difference between groups with or without ACM treatment. Compared with control group, the concentration of NO and LDH was much lower in hypoxic/reoxygenated neurons treated with 20% ACM, and the ATPase activity was higher. For the mechanical injury model, neurons with moderate injury also revealed a lower NO and LDH concen- tration than the control group. All the differences were sta- tistically significant （P〈0.05）. Conclusion： ACM can promote the survival and func- tional recovery of neurons following hypoxia or scratching to a certain degree. The mechanism may be associated with reducing the synthesis and release of NO and LDH as well as increasing the activity of membrane ATPase.

Establishment of the Psychometric Properties of a Disaster Resilience Measuring Tool for Healthcare Rescuers in China:A Cross-Sectional Study

The aim of this study was to test the validity and reliability of a tool for measuring the disaster resilience of healthcare disaster rescuers.A cross-sectional study involving 936 healthcare disaster rescuers of the Sichuan Disaster Response Team was conducted to establish the psychometric properties of the disaster resilience measuring tool(DRMT).Item analysis,exploratory factor analysis,confirmatory factor analysis,and correlation analysis were adopted to analyze the data.Item analysis showed that all but three items had the critical ratio over 3,which indicates adequate discriminability for inclusion in the measuring tool.The exploratory factor analysis showed that 65.93%of the total variance was explained by four factors—self-efficacy,social support,positive growth,and altruism.The confirmatory factor analysis showed goodness of fit for the four-factor model:CMIN/DF(2.846),GFI(0.916≥0.90),CFI(0.949≥0.90),AGFI(0.891≥0.80),and RMSEA(0.063≤0.08).Criterion validity demonstrated significant associations of the DRMT and the Connor-Davidson Resilience Scale(P<0.01,r=0.566).Convergent validity was established by correlation with stress(P<0.05,r=-0.095),depression(P<0.01,r=-0.127),posttraumatic stress disorder-PCL-C(P<0.05,r=-0.100),compassion satisfaction(P<0.01,r=0.536),and burnout(P<0.01,r=-0.330).The DRMT demonstrated adequate internal consistency(Cronbach’s alpha>0.84)and stability over the two-week study period(intraclass correlation coefficient>0.85),and a cut-off point of 61 was suggested.The disaster resilience measuring tool has satisfactory psychometric properties and is a valid,reliable,and valuable instrument for assessing disaster resilience in healthcare rescue workers.The scale needs to be tested further among other populations and those from other cultures.

Clinical presentations and outcomes of patients with Ebola virus disease in Freetown, Sierra Leone

Background:Clinical and laboratory data were collected and analysed from patients with Ebola virus disease(EVD)in Jui Government Hospital in Freetown,Sierra Leone,where patients with EVD were received and/or treated from October 1,2014 to March 21,2015 during the West Africa EVD outbreak.Methods:The study admitted 285 patients with confirmed EVD and followed them up till the endpoint(recovery or death).EVD was confirmed by quantitative RT-PCR assays detecting blood Ebola virus(EBOV).Results:Among the 285 lab-confirmed EVD cases in Jui Government Hospital,146 recovered and 139 died,with an overall survival rate of 51.23%.Patients under the age of 6 years had a lower survival rate(37.50%).Most non-survivors(79.86%)died within 7 days after admission and the mean hospitalization time for non-survivors was 5.56±6.11 days.More than half survivors(63.69%)turned blood EBOV negative within 3 weeks after admission and the mean hospitalization time for survivors was 20.38±7.58 days.High blood viral load(≥106 copies/ml)was found to be predictive of the non-survival outcome as indicated by the Receiver Operating Characteristic(ROC)curve analysis.The probability of patients’survival was less than 15%when blood viral load was greater than 106 copies/ml.Multivariate analyses showed that blood viral load(P=0.005),confusion(P=0.010),abdominal pain(P=0.003),conjunctivitis(P=0.035),and vomiting(P=0.004)were factors independently associated with the outcomes of EVD patients.Conclusions:Most death occurred within 1 week after admission,and patients at the age of 6 or younger had a lower survival rate.Most surviving patients turned blood EBOV negative within 1–4 weeks after admission.Factors such as high blood viral load,confusion,abdominal pain,vomiting and conjunctivitis were associated with poor prognosis for EVD patients.

Comparison and Enlightenment of Emergency Response Measures between Costa Serena and Diamond Princess in Response to New Coronavirus Pneumonia

This article analyzes the basic situation of the cruise ship Costa Serena and Princess Diamond and the emergency treatment and control measures in response to the novel coronavirus epidemic,investigates the management differences between the two cruise ships and puts forward relevant suggestions.