Objective: To sum up the experience of healthcare-acquired infection control against coronavirus disease 2019 (COVID-19) in Wuhan by a medical team from Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, so as to provide reference for the contain strategy of sudden infectious diseases in China. Methods: The whole process of prevention and control of HAI was implemented through methods such as management organization construction, institutional establishment and implementation, personnel training, occupational exposure planning, and introduction of hightech methods. Results: There were a total of 136 members in the medical team, including 30 doctors, 100 nurses, and 6 administrative staffs. None of them were infected with COVID-19, achieving zero infection among medical staff. Conclusion: Although the task of assisting Wuhan was tight in time, and materials and heavy, under the leadership of the team leader and the cooperation of all the staff, all measures were implemented, the training covered all the staff, and high-tech means were introduced to optimize the control strategy, achieving the goals of zero infections among medical staffs and zero cross infections among patients.

OBJECTIVETo investigate the efficacy of the locking internal fixator (LIF), which includes the locking compression plate (LCP) and the less invasive stable system (LISS), in the proximal and distal tibial fractures.

METHODSWe did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the operation with LIF by the minimally invasive plate osteosynthesis (MIPO) technique. The data consisted of 43 proximal tibial fractures (type AO41C3) and 55 distal tibial fractures (type AO43C3).

RESULTSNo complications were observed in all patients after operation. The mean healing time was 8.4 months (range 5-14 months). Only two cases of delayed union occurred at postoperative 10 months. No infections were reported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at postoperative 6 to 9 months and regained the normal functions of knee and ankle joints.

CONCLUSIONUsing LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing.

Bone Plates ; Fracture Fixation, Internal ; Humans ; Minimally Invasive Surgical Procedures ; Retrospective Studies ; Tibial Fractures ; surgery

BACKGROUNDPatient trust in physicians, which can be considered a collective good, is necessary for an effective health care system. However, there is a widespread concern that patient trust in physicians is declining under various threats to the physician-patient relationship worldwide. This article aimed to assess patient trust in physicians through a quantitative study in Shanghai, China, and to provide appropriate suggestions for improving the trust in China.

METHODSThe data from a survey conducted in Zhongshan Hospital and Shanghai Tenth People's Hospital, which are two tertiary public hospitals in Shanghai, were used in this study. Patient trust in physicians was the dependent variable. Furthermore, a 10-item scale was used to precisely describe the dependent variable. The demographic characteristics were independent variables of trust in physicians. Binomial logistic regression was employed to analyze the factors associated with the dependent variable, which was divided into two categories on the basis of the responses (1: Strongly agree or agree and 0: Strongly disagree, disagree, or neutral).

RESULTSThis study found that 67% of patients trusted or strongly trusted physicians. The mean score of patient trust in physicians was 35.4 from a total score of 50. Furthermore, patient trust in physicians was significantly correlated with the age, education level, annual income, and health insurance coverage of the patients.

CONCLUSIONSPatient trust in physicians in Shanghai, China is higher than previously reported. Furthermore, the most crucial reason for patient distrust in physicians is the information asymmetry between patients and physicians, which is a natural property of the physician-patient relationship, rather than the so-called for-profit characteristic of physicians or patients' excessive expectations.

Adolescent ; Adult ; Aged ; China ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Physician-Patient Relations ; Trust

OBJECTIVEImmunohistochemistry using antibodies to dystrophin is the pathological basis for the differential diagnosis of Duchenne and Becker muscular dystrophy (DMD and BMD). In rare cases, however, labelling dystrophin on sarcolemma is equivocal and similar to that observed in controls. This makes the diagnosis of BMD difficult. This study aimed to explore the diagnostic value of neuronal nitric oxide synthase (nNOS) antibody for clinically suspected BMD.

METHODSImmunohistochemical staining was performed on muscle specimens of 5 cases of BMD with positive expression of Dys-C (3 cases had a confirmed diagnosis of BMD, 2 cases were clinically suspected as BMD) by using dystrophin and nNOS antibodies. Normal muscle specimens from the children with fracture were used as controls.

RESULTSCompared with the controls, the expression of Dys-R, Dys-C and Dys-N was markedly reduced and nNOS was not expressed on sarcolemma in the three cases of definitely diagnosed BMD. The two cases of clinically suspected as BMD had a complete absence of sarcolemmal nNOS, even if had a similar expression of dystrophin on sarcolemma to the controls.

CONCLUSIONSnNOS antibody staining can be used for a definite diagnosis in children with clinically suspected BMD who have the almost normal expression of dystrophin.

Child ; Child, Preschool ; Dystrophin ; analysis ; chemistry ; Humans ; Immunohistochemistry ; Infant ; Muscular Dystrophy, Duchenne ; diagnosis ; metabolism ; Nitric Oxide Synthase Type I ; analysis

OBJECTIVEThe purpose of this phase I/II study is to investigate the safety/toxicity profile of weekly administration of docetaxel in combination with cisplatin for the chemo-naive patients with advanced non-small cell lung cancer (NSCLC), and to evaluate the efficacy of this regime.

METHODSIn phase I trial, 15 patients were included. IV infusion of escalating doses of docetaxel consisting of four levels from 25 to 40 mg/m2 (25, 30, 35, 40 mg/m2) on D1, 8, 15 and cisplatin of 75 mg/m2 on D1 was administered. The regime was repeated every 4 weeks. Blood samples were obtained on D1, 15 in the first cycle to measure the PK. Dose limiting toxicity (DLT) was determined in cycle 1 and defined as any grade 3 non-hematologic toxicity which could not be reverted into grade less than grade 2 within 4 days or any grade 4 hematologic toxicity. Eighty-three patients completed their phase II study with administration of docetaxel at a dose of 35 mg/m2 based on the data of phase I trial.

RESULTSIn the phase I trial, grade 3/4 neutropenia was mainly observed in patients who received docetaxel of 40 mg/m2 (level 4) with one patient suffering from an infection signifying dose limiting toxicity (DLT). Non-hematological toxicities including nausea/vomiting, alopecia, fluid retension and asthenia were tolerable. Based on these data, the maximum tolerence dose (MTD) did not reach the level of weekly giving docetaxel at a dose of 40 mg/m2 in combination with cisplatin 75 mg/m2 every 4 weeks. The pharmacokinetic/dynamics results There was no statistically significant difference between clearance value among the 4 dose levels of docetaxel from 25 to 40 mg/m2 when measured by Cmax and AUC. The pharmacokinetics of docetaxel was not influenced by the presence of co-administration of cisplatin when compared D1 with D15 as based on CmaxN, AUCN and CL. In the phase II trial, totally 83 patients received 216 cycles of chemotherapy. One CR (complete response) and 22 PR (partial response) were achieved with an objective response rate of 27.7% in this series and 30.7% in the evaluable patients. The 1-year survival was 48.6% with a median survival of 10.7 months (range: 3-34 months). Hematologic toxicities were the major side effects, though most were mild; grade III/IV neutropenia developed in 15%. The common non-hematologic toxicities were nausea, vomiting and asthenia.

CONCLUSIONWeekly consecutive administration of docetaxel on D1, 8, 15 for 3 weeks plus cisplatin on D1 is tolerable and effective with minimal myelosuppression in chemo-naive patients with advanced NSCLC.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Area Under Curve ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Cisplatin ; administration & dosage ; adverse effects ; Drug Administration Schedule ; Female ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Neutropenia ; chemically induced ; Remission Induction ; Survival Rate ; Taxoids ; administration & dosage ; adverse effects ; Vomiting ; chemically induced

OBJECTIVETo investigate the efficacy and complications of manual reduction and external fixation for the treatment of scaphoid fractures and perilunate dislocations.

METHODSFrom January 2009 to January 2013, 43 patients suffered from scaphoid fractures and perilunate dislocations were retrospective analyzed. Among them, 17 cases were treated with manipulative reduction and plaster external fixation as conservation group including 10 males and 7 females, the other 26 cases were treated with application of surgical as operation group including 15 males and 11 females. The clinical effects were assessed by Cooney function score, radiological analysis and observation of complications.

RESULTSAll patients were followed up for(45.00±8.72) months ranging from 36 to 60 months. At the final follow-up, the Cooney score of wrist function was 88.53±4.24 in conservation group and 89.58±4.59in operation group(0.455, >0.05). During the follow-up, 4 patients were found scaphoid avascular necrosis in the imaging performance in the conservation group(χ²=4.32, <0.05). The difference of other complications between two groups was not statistically significant(>0.05).

CONCLUSIONSFor patients suffered from the scaphoid fractures and perilunate dislocation, the early manipulative reduction and plaster external fixation after injury as soon as possible is necessary. Maintaining a satisfactory reduction and reliable fixation at the same time can lead to good treatment effect and there's no weakness compared to surgical treatment. But there was an increase in danger of complications. The key of conservative treatment lies in early diagnosis and maintenance of reduction, reliable fixation, and timely and appropriate functional exercise.

Humans ; Consensus ; Hypersensitivity ; Desensitization, Immunologic/adverse effects* ; Immunotherapy/adverse effects* ; Injections, Subcutaneous ; Allergens