1.Epidemiological characteristics of COVID-19 cases in Qianjiang
Jia YI ; Guangling GUO ; Qiong GU ; Mengjia HU ; Peng ZHANG ; Jun LIU
Journal of Public Health and Preventive Medicine 2020;31(3):29-32
Objective To confirm the epidemiological characteristics of coronavirus disease COVID-19 reported in Qianjiang city and provide a scientific basis for establishing and implementing effective infection prevention and control. Methods The cases of COVID-19 reported in Qianjiang were retrospectively collected and the epidemiological characteristics, including time, spatial and population distribution, clinical symptoms and exposure history, were analyzed using descriptive epidemiological method. Results A total of 198 confirmed cases of COVID-19, including 102 imported cases, were reported in Qianjiang city by March 31, 2020. Of the 198 patients, 9 died, and 189 were discharged. The male-to-female ratio was 1.2:1. Among the reported patients, most of the patients were aged 30-69. In the early stage, only imported cases were reported, subsequently, imported cases and local cases were prevalent together, and the peak of confirmed cases was appeared on February 15, 2020. Among the clinical types for admitted diagnosis, the common type (67.17%) was dominant, and fever (82.83%) and cough (67.17%) were the predominant clinical manifestations for primary diagnosis. The median time from illness onset to first visit was 3 days, the median time from first visit to confirmed diagnosis was 7 days, and the median interval from illness onset to diagnosis was 11 days. Conclusions With comprehensive measures taken, the pandemic of COVID-19 in Qianjiang have been brought under control. However, it is necessary to be alert to the potential risks brought by the resumption of work, production, education, as well as the outbound imported cases. Various prevention and control measures should continue to be strictly implemented.
2.Clinical effect of double plasma molecular adsorption system in treatment of patients with chronic liver failure in high-altitude areas
Bowen WANG ; Mengjia PENG ; Liheng JIANG ; Fei FANG ; Yuliang WANG ; Yuandi SHEN
Journal of Clinical Hepatology 2024;40(1):110-115
ObjectiveTo investigate the differences in clinical features and mortality rate between native patients with chronic liver failure (CHF) and migrated patients with CHF after treatment with double plasma molecular adsorption system (DPMAS) in high-altitude areas. MethodsA total of 63 patients with CHF who received DPMAS treatment in the intensive care unit of General Hospital of Tibet Military Command from January 2016 to December 2021 were enrolled, and according to their history of residence in high-altitude areas, they were divided into native group with 29 patients and migrated group with 34 patients. The two groups were compared in terms of baseline data and clinical features before and after DPMAS treatment. The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the paired t-test was used for comparison before and after treatment within each group; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups, and the Wilcoxon signed rank sum test was used for comparison before and after treatment within each group; the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves, and the Log-rank test was used for comparison of the risk of death. ResultsCompared with the native group, the migrated group had a significantly higher proportion of Chinese Han patients (χ2=41.729, P<0.001), and compared with the migrated group, the native group had a significantly longer duration of the most recent continuous residence in high-altitude areas (Z=3.364, P<0.001). Compared with the native group, the migrated group had significantly higher MELD score and incidence rates of hepatic encephalopathy, hepatorenal syndrome, and gastrointestinal bleeding (Z=2.318, χ2=6.903, 5.154, and 6.262, all P<0.05). Both groups had significant changes in platelet count (PLT), hemoglobin count (HGB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, total bilirubin (TBil), direct bilirubin (DBil), lactate dehydrogenase (LDH), creatinine (Cr), and international normalized ratio (INR) after DPMAS treatment (all P<0.05). Before DPMAS treatment, compared with the native group, the migrated group had significantly higher levels of ALT, AST, TBil, DBil, LDH, Cr, BUN, and INR (all P<0.05) and a significantly lower level of HGB (P<0.05); after DPMAS treatment, compared with the native group, the migrated group had significantly greater reductions in PLT and HGB (both P<0.05) and still significantly higher levels of ALT, AST, TBil, DBil, LDH, BUN, and INR (all P<0.05). The 60-day mortality rate of patients after DPMAS treatment was 52.5% (95% confidence interval [CI]: 41.7 — 63.8) in the native group and 81.3% (95%CI: 77.9 — 85.6) in the migrated group. Compared with the native group (hazard ratio [HR]=0.47, 95%CI: 0.23 — 0.95), the migrated group had a significant increase in the risk of death on day 60 (HR=2.14, 95%CI: 1.06 — 4.32, P=0.039). ConclusionCompared with the native patients with CHF in high-altitude areas, migrated patients have a higher degree of liver impairment, a lower degree of improvement in liver function after DPMAS treatment, and a higher mortality rate. Clinical medical staff need to pay more attention to migrated patients with CHF, so as to improve their survival rates.