1.Clinical characteristics and prognosis of novel bunyavirus infection: 68-case report
Linling ZHOU ; Bo LIU ; Aina CHANG ; Shengnan XU
Chinese Journal of Infectious Diseases 2015;33(2):75-78
Objective To retrospectively analyze the clinical characteristics,prognosis and risk factors of novel bunyavirus infection.Methods The clinical data of 68 patients with novel bunyavirus infection confirmed by laboratory diagnosis at Wendeng Central Hospital of Weihai were retrospectively collected.Epidemiological characteristics,clinical manifestations,physical signs and laboratory results were analyzed.Results Twenty two patients (32.4 %) had intimate contact with ermine (breeding ermine or ermine biting) ; 4 patients (5.9%) had been bitten by tick within 2 weeks,6 patients (7.4%) had intimate contact with patients with severe fever with thrombocytopenia syndrome (SFTS) ; and 25 patients (36.8 %) had a history of fieldwork before the onset of the disease.Thirty-four patients (50.0 %) were over 60 years old and 27 cases (39.7%) had underlying diseases.Initial symptoms in all patients were fever accompanied by loss of appetite,fatigue and other toxemic symptoms,followed by multi organ damage.Other clinical manifestations included nervous system damage (27 cases,39.7%),hemorrhage (4 cases,5.9%),rapid atrial fibrillation (10 cases,14.7%) and pneumonia (18 cases,26.5%).White blood cell count of 55 cases (80.9%) was less than or equal to 2.0 × 109/L,platelet count of 18 cases (26.5%) was less than or equal to 30 × 109/L.Abnormal hepatic function was found in 62 cases (91.2%); elevated myocardial enzymes was found in 68 cases (100.0%),prolonged activated partial thromboplastin time in 44 cases (64.7%),hyponatremia in 23 cases (33.8%),hypokalemia in 29 cases (42.6%),hypocalcemia in 36 cases (82.4%),hyperglycemia in 49 cases (72.1%).Serum nucleic acid quantitation of novel bunyavirus varied from 1.10 × 102 to 5.78 × 107 tissue culture infective dose (TCID)/ mL.Fifty five cases were cured,accounting for 80.9 %,while 13 (19.1%) died eventually.Conclusions High risk factors of novel bunyavirus infection included intimate contact with ermine and infected patients,tick biting and fieldwork.Patients with elder age,underlying diseases,nervous system symptoms,hemorrhage,pneumonia,low platelet,high viral load and elevated myocardial enzymes may have poor progonsis.
2.Clinical characteristics and prognosis factors of 141 severe fever with thrombocytopenia syndrome cases with high novel Bunya viral load
Linling ZHOU ; Rongjuan JIA ; Chonglin DONG ; Junhua YU ; Yong LIN ; Aina CHANG ; Deyu HUANG
Chinese Journal of Infectious Diseases 2020;38(9):578-583
Objective:To analyze the clinical characteristics and prognostic factors of severe fever with thrombocytopenia syndrome patients with high novel Bunya viral load.Methods:The clinical data of 141 patients with severe fever with thrombocytopenia syndrome whose viral load higher than 1×10 4 copies/mL were retrospectively collected from May 20, 2013 to October 30, 2019 in Weihai Central Hospital. All patients were diagnosed by laboratory tests. According to the prognosis, the cases were divided into survival group and death group. The clinical manifestations, laboratory test results and the influence of viral load on the conditions and the risk factors of prognosis were compared and analyzed. Chi-square test, rank sum test and logistic regression analysis were used for statistical analysis. Results:There were 76 patients in survival group, with a median age of 64 years. There were 65 patients in death group, with a median age of 71 years. There were significant differences in neurological injury, coma, hemorrhage, atrial fibrillation with rapid ventricular rate, and renal injury between the survival group and the death group ( χ2=16.45, 64.06, 11.25, 6.98 and 33.80, respectively, all P<0.01). There were significant differences in activated partial thromboplastin time (APTT), aspartate aminotransferase (AST), creatine kinase (CK), creatine kinase isoenzymes (CK-MB), lactic acid dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), creatinine, and platelet count between the survival group and the death group ( Z=6.33, 4.51, 2.93, 4.65, 5.00, 4.93, 5.36 and -4.34, respectively, all P<0.01). The RNA quantification of viral load in 138 cases ranged from 1.06×10 4 to 6.53×10 7 copies/mL, and the remaining three cases were higher than 1.00×10 8 copies/mL. The viral load of the two groups were 4.63(4.32, 5.22) and 5.29(4.92, 6.17) lg copies/mL, respectively ( Z=4.91, P<0.01). The mortalities of patients with viral loads of 1.00×10 4-<1.00×10 5 copies/mL, 1.00×10 5-<1.00×10 6 copies/mL and 1.00×10 6-<1.00×10 7 copies/mL were 29.33%(22/75), 51.28%(20/39), 80.95% (17/21), respectively. Six cases with viral loads higher than 1.00×10 7 copies/mL were dead. Logistic regression analysis showed that when age ≥60 years old, viral load >1.00×10 6 copies/mL, platelet count <30.00×10 9/L, LDH ≥5 000.00 U/L, APTT ≥84.00 s, the risk of death increased significantly. Conclusions:The occurrences of coma, hemorrhage, atrial fibrillation with rapid ventricular rate, renal injury suggest that the patients′ conditions are more serious and the risk of death is higher. Age, viral load, platelet count, LDH and APTT can be used as indicators to assess the risk of death.
3.Study on the relationship between viral load of severe fever with thrombocytopenia syndrome bunyavirus and patient's condition
Linling ZHOU ; Ying ZHAO ; Rongjuan JIA ; Jinhuan WANG ; Conghui TAN ; Bo LIU ; Shengnan XU ; Aina CHANG ; Chong PENG ; Deyu HUANG
Chinese Journal of Infectious Diseases 2017;35(9):541-545
Objective To explore the severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) existence time in the body,and the correlation between viral load and the severity and prognosis of disease.Methods The clinical data of 125 SFTS patients from May 2015 to October 2016 in Weihai Central Hospital in Shandong province were analyzed retrospectively.Patients were divided into low viral load group and high viral load group according to the SFTSV RNA levels.Neurological symptoms,bleeding tendency,the incidence of myocardial damage and severe pneumonia,laboratory biochemical index and prognosis of two groups were compared.SFTSV RNA of 46 cases were detected dynamically.Data with homogeneity of variance were tested by t test,and data with heterogeneity of variance was tested by rank sum test.Results Among the 125 cases,64 were male and 61 were female.The mean age was (59.0±3.6) years old.One hundred and one cases were cured,and 24 died.SFTSV RNA loads in low viral load group(81 cases) were (3.08± 1.01) copies/mL,and those in high viral load group (44 cases) were (5.69 ± 0.99) copies/mL,with statically significant difference (t =11.78,P<0.05).By the dynamic detection of SFTSV RNA load in 46 patients,viral loads in most patients were gradually declined after 1 week of onset,and cleared after 23 days.The incidence of neurological symptoms,bleeding tendency,severe myocardial damage and pneumonia of two groups showed significant difference (x2 =92.987,38.711,75.889 and 54.680,respectively,all P<0.05).The viral loads of patients who died varied from 1.06× 104 copies/mL to 5.78 × 107 copies/mL.White blood counts of two groups showed no significant difference (t =0.181,P> 0.05).The platelet counts of two groups had significant difference (t =2.869,P<0.05).AST and γ-GT of two groups also had significant difference (P<0.01 and 0.05,respectively).creatine kinase,creatine kinase isoenzyme,lactic dehydrogenase and hydroxybutyrate dehydrogenase of two groups all had significant difference (P<0.01 or 0.05).Serum sodium,blood calcium and glucose of the two groups had significant difference (P<0.01 or 0.05).activated partial thromboplastin time of the two groups showed significant difference as well (t=5.623,P<0.01).Conclusions After the onset of SFTSV infection,the virus existence in the body may less than 4 weeks.Viral loads are closely associated with disease severity and prognosis.The higher the viral loads are,the heavier organ dysfunction could be and the higher mortality is.
4.Respiratory pattern intervention can quickly improve the oral feeding of pre-term infants with suck-swallow-breath coordination disorder
Shuang WANG ; Zhiwen HE ; Ya PEI ; Fucheng CAI ; Zhenzhen LIU ; Aina ZHOU ; Zhaohui YANG
Chinese Journal of Physical Medicine and Rehabilitation 2021;43(6):494-498
Objective:To investigate the effect of a breathing pattern intervention (RPI) on the oral feeding of pre-term infants with suck-swallow-breath (SSwB) coordination disorder.Methods:Sixty pre-term infants with SSwB coordination disorder were divided into an observation group ( n=30) and a control group ( n=30) using a random number table. Both groups were given routine feeding training, including oral exercise intervention, non-nutritive sucking training, and swallowing induction training during nursing, while the observation group was additionally provided with 15 minutes of breathing pattern training once a day, including breathing pattern observation, resistive breathing training prior to eating and passive breathing pattern intervention during eating. Before and after the 7-day intervention, the Pre-term Infant Oral Feeding Readiness Assessment (PIOFRA) was used to evaluate each subject′s oral feeding ability. Rate of transfer (RT), proficiency (PRO), minimum oxygen partial pressure (SaO 2) and SaO 2 fluctuations were also recorded during the feeding process. Results:After 1 week of the intervention, significant improvement was observed in both groups. In the observation group the average RT (2.76±0.36ml/min), PRO, minimum SaO 2, the number of SaO 2 fluctuations, and PIOFRA score (33.28±0.58) were all significantly better than the control group′s averages. Conclusion:Breathing pattern intervention based on routine feeding training can enhance breathing coordination during swallowing and ultimately improve the oral feeding of pre-term infants with SSwB coordination disorders in a relatively short period of time.
5.Design and construction of a large 5G mobile emergency resuscitation unit
Minfei YANG ; Qiang LI ; Shanxiang XU ; Weidi SHEN ; Aina WU ; Fangmin GE ; Jungen ZHANG ; Ming ZHOU ; Jianping YE ; Mao ZHANG
Chinese Journal of Emergency Medicine 2023;32(12):1623-1627
Objective:To design a large-scale mobile emergency resuscitation unit based on 5G communication technology to improve the efficiency of prehospital transportation and treatment.Methods:The study was conducted in Hangzhou from November 2022 to September 2023. It's sorted out the application scenario requirements for prehospital first aid, transfer, and prehospital-intrahospital emergency linkage in carrying out the program design, single technology testing, onboard debugging, and integration debugging phases sequentially.Results:In September 2023, a large-scale 5G mobile emergency resuscitation unit was completed and delivered. The unit was converted from an electric bus and consists of five parts: (1) Vehicle appearance: the vehicle is 12.9 meters long, 2.3 meters wide and 2.6 meters high, with a single mileage of 200 kilometers; (2) The overall internal structure: the vehicle has one resuscitation bed and two stretcher positions. Additionally, there is a comprehensive operating table located at the front of the vehicle. The middle of the vehicle is equipped with a central digital control screen. (3) First aid materials and instruments: the vehicle's materials are modularly configured in accordance with the resuscitation, guardianship, surgery, inspection and testing, Communication modular configuration, equipped with a defibrillation monitor, transfer ventilator, extracorporeal membrane lung oxygenation and other critical care first aid and electrocardiogram, digital radiography, blood gas analyzer, chest pain 5 monitors and other inspection and testing equipment; (4) Vehicle communication and information systems: equipped with high-definition remote video interactive system, telemedicine terminal DP300 integrated system, a real-time panoramic experience system and centralized guardianship system; (5) Vehicle disinfection: a plasma disinfector installed on the top of the car can meet the hospital disinfection hygiene standardsⅡ class environmental management requirements.Conclusions:Incorporating 5G communication technology, the large-scale mobile emergency resuscitation unit is equipped with various advanced treatment equipment and remote consultation systems. It can accommodate the resuscitation needs of the most critically ill patients, offering substantial support for public emergency rescues. Further exploration of its potential is merited.
6.Correlation between chronic sinusitis subtypes and basophil levels in peripheral blood.
Yuhui FAN ; Qingqing JIAO ; Aina ZHOU ; Jisheng LIU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(4):293-301
Objective:To explore the clinical correlation between peripheral blood basophil levels and chronic sinusitis (CRS) subtypes. Methods:One hundred and twenty-six patients with CRS and 103 healthy cases from physical examination admitted to the First Affiliated Hospital of Soochow University from January 2021 to October 2022 were retrospectively analyzed. According to the histopathological classification, CRS patients were divided into eosinophilic chronic sinusitis (eCRS) group (47 cases) and non eosinophilic chronic sinusitis (non-eCRS) group (79 cases). The differences among the three groups in peripheral blood inflammation cell counts, eosinophils-to-basophils ratio(bEBR), basophils-to-neutrophils ratio(BNR), basophils-to-lymphocytes ratio(BLR), basophils-to-monocytes ratio(BMR) were compared, and study the correlation between each index and Lund-Mackay score, and the correlation between basophils in peripheral blood and other inflammatory cells. Results:The counts of basophils in the peripheral blood of the healthy control group, eCRS group and non-eCRS group were 0.03±0.01, 0.04±0.02, 0.03±0.02, respectively, the eosinophils-to-basophils ratio(bEBR) were 5.64±4.22, 8.38±5.95, 4.55±3.90, the basophils-to-neutrophils ratio(BNR) were 0.01±0, 0.01±0.01, 0.01±0.01, and the basophils-to-lymphocytes ratio(BLR) were 0.01±0.01, 0.02±0.01, and 0.02±0.01, respectively, the basophils-to-monocytes ratio(BMR) were 0.08±0.04, 0.11±0.06, and 0.08 ±0.04 respectively. There was a statistically significant difference between eCRS group and healthy control group, non-eCRS group(P<0.01), while there was no statistically significant difference between non-eCRS group and healthy control group(P>0.05). Basophil counts (r=0.185 5, P<0.05), BLR(r=0.226 9, P<0.05), BMR(r=0.228 1, P<0.01) in patients with CRS were positively correlated with Lund Makey score. In addition, basophils were also positively correlated with eosinophils(r=0.479 2, P<0.01), lymphocytes(r=0.259 4, P<0.01), and monocytes(r=0.256 4, P<0.01) in patients with CRS. Conclusion:The peripheral blood basophil count, BLR and BMR were significantly increased in eCRS, and were significantly positively correlated with Lund -Makey score. It has the potential to develop into disease biomarkers and new therapeutic targets of eCRS.
Humans
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Basophils
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Retrospective Studies
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Rhinitis/surgery*
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Eosinophils
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Sinusitis/surgery*
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Chronic Disease
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Nasal Polyps/pathology*