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简介：摘要目的评估血清新型冠状病毒(2019-nCoV)IgM/IgG检测在COVID-19快速诊断中的应用价值，以期进一步完善COVID-19的诊断/筛查体系。方法收集32例COVID-19患者(RT-PCR法检测2019-nCoV核酸阳性，且有临床症状者)和34例非COVID-19患者(RT-PCR法检测2019-nCoV核酸阴性，并经临床诊断排除COVID-19者)的血液样本，采用胶体金免疫层析法对样本进行2019-nCoV IgM/IgG快速检测，并分析检测的灵敏性、特异性及其与病程变化的相关性。结果32份COVID-19患者样本中，9份样本2019-nCoV IgM阳性，检出率为28.1%(9/32)；2019-nCoV IgG阳性样本25份，检出率为78.1%(25/32)；IgM/IgG总检出率为84.4%(27/32)。34份非COVID-19患者样本中，2019-nCoV IgG阳性样本2份，检出率为5.9%(2/34)；未检测到2019-nCoV IgM阳性样本。COVID-19患者出现症状后的10～20 d，血清IgM检出率为42.9%(3/7)，21～30 d为30.8%(4/13)，31～40 d为16.7%(2/12)，随病程延长呈下降趋势；COVID-19患者出现症状后的10～20 d，血清IgG检出率为57.1%(4/7)，21～30 d为84.6%(11/13)，31～40 d为83.3%(10/12)，随病程延长呈上升趋势，在21～30 d左右达高峰。结论血清2019-nCoV IgM/IgG检测(胶体金法)在诊断2019-nCoV感染中具有较高的灵敏性(84.4%)和较强的特异性(94.1%)，因该检测方法具有灵活、快速、简便等特点，在COVID-19的诊断/筛查中具有较强的应用价值，可作为COVID-19诊断/筛查体系的有益补充。

简介：摘要 新冠疫情传染性强，危害极大，重点在防控，主要包括制定预案、人员管控、全员筛查、应隔尽隔、核酸检测等工作，切断传播途径，管控易感人群，实现“零”感染目标。

简介：摘 要 目的 探讨 PIVAS 面临突发公共卫生事件的防控措施。 方法 强化清洁消毒措施，加强对人员、药品、物资的管理，优化药品配送方案，开展防控知识培训。 结果 在 COVID-19疫情期间， PIVAS可通过各种防控措施确保正常运行，保障疫情期间的输液成品供应。结论 面对突发 COVID-19事件， PIVAS应及时采取多种防控措施科学应对，并可供全国各医院 PIVAS 借鉴。

简介：[摘要 ]目的 制定规范手术室感染控制管理方案及护理应急预防管理策略。主要包括加强护理人员相关知识培训，做好人力资源调配及物资储备等，旨在为今后手术室出现类似突发性公共卫生事件提供参考。方法 规划手术方案，科学防控，精准施策。结果 按制定的手术室感染控制管理方案，在疫情期间开展的手术，做到手术室安全、病人安全、医护人员安全，无院内交叉感染发生。结论 制定的新型冠状病毒肺炎疫情下手术室感染控制与管理方案，保障了手术患者和医护人员的安全，避免发生院内交叉感染。

简介：摘要新型冠状病毒病疫情刚开始流行时，病理科面临员工恐慌、院感风险剧增、防护物资不足、应对经验缺乏等困难。为保障科室安全，更好地为临床和患者服务，我们通过分析现有条件，采取加强学习、调整科室布局和流程、加强人员和物质管理等措施进行科学应对，实现了科室零感染。

简介：摘要：目的 分析COVID-19的流行病学、临床特征、治疗转归，为当地的疫情防控、病例发现与临床治疗提供参考。方法 选取2020年2月10日至2020年3月4日，甘肃医学院附属医院收治的8例新冠肺炎病例，对其进行回顾性流行病学特征、临床特征及中西医结合治疗及转归的分析。结果 8例新冠肺炎病例中，轻型1例(12.5％)，普通型4例(50％)，重型2例(25％)，无症状感染者1例(12.5％)。治愈8例 (100％)，确诊病例中1例儿童病例（1岁7个月）其余7例均为中青年病例。确诊病例中发热5例，体温最高为38.4℃，咳嗽、咳痰5例，腹泻2例，乏力1例，肌肉酸痛1例，气短2例，特征性CT改变有：多发小斑片影6例(75％)、肺外带明显6例(75％)、多发肺浸润影4例(50％)、多发磨玻璃影6例(75％)、双侧肺部病变4例(50％)等，后期有肺实变。重症患者实验室检查多见淋巴细胞百分率降低2例(25％)、淋巴细胞绝对值降低2例(25％)、肌酸激酶升高2例(25％)。结论 控制疫情发展的关键在于加强流行病学调查，重视无症状感染者；临床特征中COVID-19患者的淋巴细胞可反映病情严重程度，影像学表现有一定特征性；治疗方案中中西医结合治疗效果显著，治疗转归良好，但同时也要重视药物的副作用。

简介：摘要:目的:了解新型冠状病毒肺炎（COVID-19）疫情期间ICU转出脑卒中患者家属迁移应激水平并分析其影响因素，为开展针对性的干预策略提供参考。方法:2020年2月～5月，采用便利抽样法选取150名脑卒中患者家属，采用一般资料调查表及中文版ICU转出患者家属迁移应激量表进行调查。结果:ICU转出脑卒中患者家属迁移应激总分为(45.23±65.88)分，条目均分为(2.66±0.97)分，迁移应激水平得分处于中高水平

简介：摘要：目的 调查川渝黔地区父母为小于18岁子女接种COVID-19疫苗的意愿及其影响因素。方法 在线问卷调查，通过单因素分析接种意愿在人口统计学方面的差异，二元Logistic回归分析影响父母为小于18岁子女接种COVID-19疫苗的因素。 结果 90.3%的受访者对小于18岁子女接种COVID-19疫苗有积极的意愿。COVID-19疫苗已接种者意愿比未接种者（OR=2.418，95%CI 1.561-3.746）更高。感知COVID-19易感性和感知COVID-19疫苗接种的利益是明确接种意愿的重要促进因素。结论 加强COVID-19易感性和COVID-19疫苗接种的利益相关健康教育、宣传，可提高父母为小于18岁子女接种COVID-19疫苗的意愿。

简介：【摘要】 作为大流行的直接和间接后果，急性冠脉综合征（ACS）相关的发病率和在新型冠状病毒（COVID-19）时代，ACS的管理已成为一项挑战,死亡率显着增加。它的初步评估旨在通过短暂的病史、体格检查、心电图和心脏坏死标记物来确定，之后患者将接受紧急治疗。本旨针对导致急性冠脉综合征的相关因素进行讨论和分析，进而寻求最佳管理，从而降低ACS的患病率及改善预后和生活质量。结合国内外的研究调查显示，除了吸烟、高龄、高血压、血脂异常等常规心脏危险因素之外，还有他汀类药物、血糖变异性、肾损伤、 甲状腺激素、阻塞性睡眠呼吸暂停（OSA）等危险因素。在大流行期间，心绞痛患者因担心感染COVID-19不愿意寻求医疗帮助，血管堵塞风险增加，致ACS的管理措施成为当下医生面临的主要挑战，医师及患者个人防护也受到高度重视，急诊经皮冠状动脉介入治疗（PCI）仍是紧急管理措施。

简介：AbstractLimited data is available on the coronavirus disease 2019 (COVID-19), critical illness rate, and in-hospital mortality in the African setting. This study investigates determinants of critical illness and in-hospital mortality among COVID-19 patients in Kenya. We conducted a retrospective cohort study at Kenyatta National Hospital (KNH) in Kenya. Multivariate logistic regression and Cox proportional hazard regression were employed to determine predictor factors for intensive care unit (ICU) admission and in-hospital mortality, respectively. In addition, the Kaplan-Meier model was used to compare the survival times using log-rank tests. As a result, 346 (19.3%) COVID-19 patients were admitted to ICU, and 271 (15.1%) died. The majority of those admitted to the hospital were male, 1,137 (63.4%) and asymptomatic, 1,357 (75.7%). The most prevalent clinical features were shortness of breath, fever, and dry cough. In addition, older age, male, health status, patient on oxygen (O2), oxygen saturation levels (SPO2), headache, dry cough, comorbidities, obesity, cardiovascular diseases (CVDs), diabetes, chronic lung disease (CLD), and malignancy/cancer can predicate the risk of ICU admission, with an area under the receiver operating characteristic curve (AUC-ROC) of 0.90 (95% confidence interval [CI]: 0.88-0.92). Survival analysis indicated 271 (15.1%) patients died and identified older age, male, headache, shortness of breath, health status, patient on oxygen, SPO2, headache, comorbidity, CVDs, diabetes, CLD, malignancy/cancer, and smoking as risk factors for mortality (AUC-ROC: 0.90, 95% CI: 0.89-0.91). This is the first attempt to explore predictors for ICU admission and hospital mortality among COVID-19 patients in Kenya.

简介：AbstractBackground:Smell and taste loss are highly prevalent symptoms in coronavirus disease 2019 (COVID-19), although few studies have employed objective measures to quantify these symptoms, especially dysgeusia. Reports of unrecognized anosmia in COVID-19 patients suggests that self-reported measures are insufficient for capturing patients with chemosensory dysfunction.Objectives:The purpose of this study was to quantify the impact of recent COVID-19 infection on chemosensory function and demonstrate the use of at-home objective smell and taste testing in an at-risk population of healthcare workers.Methods:Two hundred and fifty healthcare workers were screened for possible loss of smell and taste using online surveys. Self-administered smell and taste tests were mailed to respondents meeting criteria for elevated risk of infection, and one-month follow-up surveys were completed.Results:Among subjects with prior SARS-CoV-2 infection, 73% reported symptoms of olfactory and/or gustatory dysfunction. Self-reported smell and taste loss were both strong predictors of COVID-19 positivity. Subjects with evidence of recent SARS-CoV-2 infection (<45 days) had significantly lower olfactory scores but equivalent gustatory scores compared to other subjects. There was a time-dependent increase in smell scores but not in taste scores among subjects with prior infection and chemosensory symptoms. The overall infection rate was 4.4%, with 2.5% reported by PCR swab.Conclusion:Healthcare workers with recent SARS-CoV-2 infection had reduced olfaction and normal gustation on self-administered objective testing compared to those without infection. Rates of infection and chemosensory symptoms in our cohort of healthcare workers reflect those of the general public.

简介：摘要经过住院医师规范化培训淬炼的青年医师在抗疫实战中交出了令人满意的答卷，以岗位胜任力为导向的规范化培训培养出了临床技能过硬的住院医师。但此次新型冠状病毒肺炎疫情对规培提出了更高要求，特别要加强突发事件下职业心理素质教育；强化灾难医学与新发传染病知识、规范消毒防护意识和能力。以此次疫情为教科书，革新医学人文教育的内容，多管齐下，完善规培内容，提升医学人文素养，进一步增强规培学员岗位胜任力和应对突发公共卫生事件的能力。

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简介：摘要2019新型冠状病毒病(2019 novel coronavirus disease, COVID-19)的发生导致了疫情严重地区早期乳腺癌患者多种治疗的延迟，严重影响了此类患者的标准治疗模式及预后。在疫情中后期，如何制定相对合理的治疗调整方案，是乳腺肿瘤专科医疗团队的当务之急。为此，检索分析国内外文献，并结合笔者所在医院乳腺肿瘤多学科综合诊疗团队专家共同讨论的意见，探讨为治疗延迟的早期乳腺癌患者提供合理的治疗策略。

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简介：AbstractObjective:To determine the pregnancy and neonatal outcomes of women who recovered from coronavirus disease 2019 (COVID-19) that developed in early pregnancy.Methods:This case series analyzed five pregnant women (26-33 years) whom recovered from COVID-19 which were developed in early pregnancy (6-27 weeks) and admitted at the Wuhan Union Hospital from January 15, 2020 to April 30, 2020. The clinical manifestation, laboratory examinations, treatment, pregnancy outcomes, maternal and neonatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) throat swab reverse transcription polymerase chain reaction test results, and SARS-CoV-2 antibody test results in neonates were reviewed. The placental pathology, placental angiotensin-converting enzyme 2 expression were studied by hematoxylin-eosin and immunohistochemistry staining, SARS-CoV-2 presence was examined by QT-PCR. We also followed up the infants at 3-6 months.Results:Three pregnant women were diagnosed with COVID-19 in early pregnancy (Cases 1-3), and two were serum immunoglobulin G positive asymptomatic cases (Cases 4 and 5). Cases 1-3 showed complete recovery after severe COVID-19. Case 3 was infected at 6 weeks of gestation during the first trimester and had induced medical abortion at 12 weeks of gestation. All neonates had no pneumonia, SARS-CoV-2 mRNA reverse transcription polymerase chain reaction and serum immunoglobulin M were negative, and immunoglobulin G were positive. All placental samples were negative for SARS-CoV-2 in the nucleic acid test. Placental pathology showed chronic ischemia changes. ACE-2 expressed in both placenta and decidua. The follow-up showed that the infants were healthy and asymptomatic at 3-6 months.Conclusion:No adverse outcomes was observed in our case series. However, systemic inflammatory responses to SARS-CoV-2 infection may cause placental injury. At the time of delivery after recovery from COVID-19, no SARS-CoV-2 positive results was found in the placenta in this case series.

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简介：摘要目的研究新型冠状病毒（2019-nCoV）感染所致新型冠状病毒肺炎（WHO命名为2019冠状病毒病，COVID-19）病理学改变及其临床意义。方法对重庆地区3例新型冠状病毒肺炎患者进行死亡后微创尸检，获取肺脏、心脏、肾脏、脾脏、骨髓、肝脏、胰腺、胃、肠、甲状腺和皮肤组织。常规HE、透射电镜和组织化学染色观察各脏器组织病理变化，免疫组织化学染色分析炎性细胞浸润情况和2019-nCoV病毒蛋白，荧光定量聚合酶链反应法检测各脏器中2019-nCoV病毒RNA。结果肺泡结构呈现不同程度的破坏，肺泡腔内见少量浆液和纤维蛋白性渗出物，部分肺泡见透明膜形成。渗出细胞主要为单核细胞和巨噬细胞，可见少数多核巨细胞，淋巴细胞、嗜酸性粒细胞和中性粒细胞。淋巴细胞主要为CD4阳性T细胞。Ⅱ型肺泡上皮细胞显著增生，部分细胞脱落至肺泡腔。肺泡隔血管充血、水肿、增宽，可见少量单核细胞和淋巴细胞浸润，少数微血管内见透明血栓；肺组织灶性出血，部分肺泡腔渗出物机化和肺间质纤维化。肺内各级支气管黏膜均可见部分上皮脱落。电镜下小支气管以下气道黏膜上皮和Ⅱ型肺泡上皮细胞胞质内可见冠状病毒颗粒。免疫组织化学染色显示部分肺泡上皮和巨噬细胞呈2019-nCoV抗原阳性，荧光定量聚合酶链反应检测证实2019-nCoV核酸阳性。脾脏淋巴细胞减少，可见变性、坏死。其他器官组织病变包括不同程度的实质细胞变性、坏死、小血管内透明血栓形成，并见慢性基础疾病改变；均未观测到冠状病毒感染证据。结论新型冠状病毒肺炎病变以肺最为显著，主要表现为肺泡渗出性炎和间质炎，肺泡上皮细胞增生和透明膜形成，病毒主要分布于肺，但该病还累及免疫器官、心血管、肝脏和肾脏等多个脏器受损。病变机制有待深入研究。

简介：摘要自新型冠状病毒肺炎(COVID-19)疫情暴发以来，对肺外科诊治流程及管理模式带来了巨大挑战。四川省医学促进会组织胸外科专家，总结各大医院和专家们的经验，制订了COVID-19疫情期间肺外科分区分类诊治流程及管理指导性建议，供胸外科同行参考实施。