Objective:To analyze the causes of SARS-CoV-2 nosocomial infection among healthcare workers (HCWs) and explore the effective precaution strategies in Emergency Center.Methods:The data of SARS-CoV-2 infected HCWs from January 5 to March 2, 2020 were retrospectively analyzed and compared under different conditions in Emergency Center of Zhongnan Hospital of Wuhan University.Results:Totally 13 SARS-CoV-2 infected HCWs (12 confirmed cases and 1 suspected case) were included in this study. The overall infection rate was 17.8% (13/73). The infection rates in outpatient/rescue room, isolation observation room and isolationin patient ward were 11.8% (4/34), 20.0% (3/15), 25% (6/24), respectively. The infection rate of physician was 13.0% (3/23), and the infection rate of nurse was 20.0% (10/50). All the infected HCWs had the definite exposure with confirmed or suspected COVID-19 patients. One asymptomatic cases were identified by laboratory findings of SARS-CoV-2 infection screening. There was no new confirmed SARS-CoV-2 infected HCWs after February 5, 2020. All the infected HCWs were cured.Conclusions:Under the epidemic of COVID-19, HCWs of Emergency Center have a high risk of occupational exposure and infection, especially for staffs working in COVID-19 isolation units. Scientific prevention and control management can effectively reduce the risk of SARS-CoV-2 infections and ensure the occupational safety for HCWs in Emergency Center.

Objective:To investigate thromboprophylaxis of patients with COVID-19.Methods:Clinical data of 31 patients with COVID-19 in Zhongnan Hospital of Wuhan University was analyzed retrospectively, including basic information, clinical characteristics, examination results, therapy and Padua scores. 5G remote ultrasound diagnosis system was used in the ultrasonography of lower limb vein, inferior vena cava and the heart. According to the patient′s status, the thromboprophylaxis was established, and the incidence of venous thromboembolism (VTE) was observed.Results:There were 20 cases of general types and 11cases of severe types. All patients underwent dynamic assessment and thromboprophylaxis. Basic prevention was applied in 28 cases and mechanical prevention was used in 3 cases. There was no VTE event in all patients during hospitalization.Conclusions:Prevention and monitoring of VTE is an important part of the treatment of patients with COVID-19, which can effectively reduce the incidence of lower extremity deep vein thrombosis and fatal pulmonary embolism in isolation ward.

Objective To analyze the effect of missing data in population based viral load (PVL) survey in HIV infected men who have sex with men (MSM) sampled in 16 cities in China.Methods The database of 3 virus load sampling survey conducted consecutively in HIV infected MSM population in 16 large cities (Beijing,Shanghai,Nanjing,Hangzhou,Wuhan,Chongqing,Kunming,Xi' an,Guangzhou,Shenzhen,Narning,Urumuqi,Harbin,Changchun,Chengdu and Tianjin) during 2013-2015 was used.SPSS 17.0 software was used to describe distribution of the missing data and analyze associated factors.Results A total of 12 150 HIV infected MSM were randomly selected for the surveys,in whom,9 141 (75.2％) received virus load tests,while 3 009 (24.8％) received no virus load tests,whose virus load data missed.The virus load data missing rates in MSM with or without access to antiretroviral therapy (ART) were 11.5％ (765/6 675) and 39.4％ (2 060/5 223) respectively,and the virus load data missing rates were 21.9％ (1 866/8 523) and 28.4％ (959/3 374),respectively,in local residents and non-local residents (migrants).Conclusions The analysis indicated that the data missing occurred in the virus load survey in HIV infected MSM population.ART status and census registering status were the main influencing factors.Data missing could influence the accurate evaluation of community viral load (CVL) and population viral load (PVL) levels in HIV infected MSM in China.

Objective To compare the change of management time for patients with acute cerebrovascular disease before and after re-accreditation of Grade Ⅲ Class A in a general hospital.Methods Electronic medical records of 490 patients diagnosed as acute cerebrovascular disease(215 cases of cerebral infarction,275 cases of cerebral hemorrhage) managed in Zhongnan Hospital of Wuhan University from June 2015 to July 2016 were collected,including 262 patients managed before re-accreditation (group A,June 2015 to December 2015) and 228 patients admitted after re-accreditation (group B,January 2016 to July 2016).In group A,there were 109 cases of cerebral infarction and 153 cases of cerebral hemorrhage(68 caused by trauma);in group B there were 106 cases of cerebral infarction and 122 cases of cerebral hemorrhage(54 caused by trauma).The time in emergency department (ED time),time waiting for admission (admission time) and the total management time (total time) were analyzed and compared between two groups.Results The ED time in group A and group B was 44.5 (30.0,71.5) and 39.0 (20.3,69.0) min (Z =-2.103,P =0.036) respectively;the admission time was 35.0 (25.8,50.0) and 39.0 (27.3,55.8) min(Z =-2.211,P=0.027);and total time was 85.0(62.8,120.0)and 82.5(61.0,119.0) min(Z =-0.356,P =0.722) in two groups respectively.For patients of cerebral infarction in group A and B the ED time was 49.0 (33.5,81.5) and 41.0 (29.8,74.3) min(Z =-1.872,P =0.061);the admission time was 37.0(27.0,52.0) and 36.0(25.0,52.3) min(Z =-0.516,P =0.606);and total timewas97.0(69.5,131.0)and 83.5(62.0,118.3) min(Z=-1.914,P=0.056).For patients of cerebral hemorrhage in group A and B,the ED time was 42.0 (28.0,64.0) and 35.0 (17.8,65.0) min (Z=-1.426,P =0.154);the admission time was 34.0(24.5,49.0)and 41.0(31.0,61.0) min (Z=-3.353,P =0.001);and total time was 79.0(58.0,108.0) and 82.0(60.0,120.8) min (Z =-1.052,P =0.293).Conclusions After re-accreditation of Grade Ⅲ Class A Hospital the total waiting time for patients of cerebral infarction is decreased significantly in emergency department,however,for patients of cerebral hemorrhage the waiting time for admission is longer.

Objective To investigate the MRI features of intracranial solitary fibrous tumors/hemangiopericytomas (SFT/HPC),and to compare these findings with those of intracranial meningiomas.Methods The clinical features and MRI findings in 28 patients of intracranial SFT/HPC (SFT/HPC group)and 68 patients of meningiomas (meningiomas group) confirmed by operation and pathology were retrospectively analyzed.The indicators of two groups were compared.Results Shape of tumor,signal homogeneous,signal voids of vessel in tumor,hypointense signal nodules on T2WI and enhanded,cystic or necrosis in tumor,meningeal tail sign,changes of the nearby bone,sex,Ki-67％ level,blood lose in surgery had significant differences between SFT/HPC group and meningiomas group (all P＜0.05).Conclusion There are some differences between intracranial SFT/HPC and meningiomas.It is helpful in diagnosis and differential diagnosis through the comparative analysis of the imaging signs.

Objective To explore the MR imaging characteristics of brain tumors in infants to improve the diagnosis and early treatment.Methods Twelve infants with brain tumors (less than 1 year old),performed surgery in our hospital from April 2008 to August 2014 and proved by pathology,were collected in our study; the clinical data and MR imaging features were reviewed retrospectively.Results Among the 12 infants,4 (33％) had tumors located at the lateral ventricle,3 (25％) at the cerebral hemisphere,one (8.3％) at the pineal region,one (8.3％) at the suprasellar region,one (8.3％) at the cerebral convexity,one (8.3％) at the cerebellar hemisphere and one (8.3％) at the fourth ventricle.These tumors included immature teratoma (n=3),choroid plexus tumor (n=3),atypical teratoid/rhabdoid tumor (n=2),medulloblastoma (n=1),anaplastic ependymoma (n=1),pilomyxoidastrocytomas (n=1) and infantile fibrosarcoma (n=1).Diversity of MR imaging features was found in different types of brain tumors; tumors as immature teratoma,atypical teratoid/rhabdoid tumor and infantile fibrosarcoma showed mainly mixed signal intensity on T1-weighted images and T2-weighted images,and these tumors displayed heterogeneously enhancement at MR imaging; choroid plexus tumors and medulloblastoma showed isointenseon T1-weighted images and T2-weighted images mostly,and both had obvious enhancement; anaplastic ependymoma showed isointensity signal on T1-weighted images,slightly hyperintenseon T2-weighted images and heterogeneously enhancement; pilomyxoidastrocytomas were hypointenseon Tl-weighted images,hyperintenseon T2-weighted images and homogeneous enhancement.Conclusions Immature teratomas,choroid plexus tumors and embryonal tumors are common in infants.Supratentorial tumors are mostly found.Typical features are showed in some brian tumors,but part of atypical tumors remain challenging in diagnosis.To improve diagnostic accuracy,imaging data should be accumulated in the future.

Objective To analyze the CT and MR imaging features of intracranial teratomas to improve the diagnostic accuracy.Methods Twenty patients with intracranial teratomas,admitted to and performed surgery in our hospital from January 2010 and January 2014,were chosen;the teratoma was confirmed by histopathology.The CT and MR imaging features,clinical and pathology materials of these patients were retrospectively analyzed.Results Twelve immature teratomas,7 mature teratomas and one teratoma with malignant transformation were noted;18 patients were in the central line area and 2 were not.In the 9 patients performed CT scan,7 showed heterogeneous mass;peritumoral calcification was more common than intratumoral calcification,and it turned out to be round with diameter less than 1 cm,while intratumoral calcification was multifocally strip and patchy.In the 17 patients performed MR imaging,14 showed heterogeneous signal and fatty signal was detected in 3;enhanced MR imaging showed that 6 presented nodular enhancement,3 presented multilocular enhancement markedly,patchy enhancement showed in 2,and one showed marked enhancement in mural nodule and cystic wall.In 8 patients performed diffusion-weighted imaging,7 displayed hypointense to isointense and one demonstrated isointense to hyperintense.Conclusions Intracranial teratoma has some characteristic imaging features,so by combining clinical materials,it should be considered when fatty component is detected in a heterogeneous intensity tumor with multiple cystic change,calcification and a hypointense to isointense signal on DWI;however,pathology is needed to make a definite diagnosis.

OBJECTIVETo evaluated the manganese (Mn), cobalt (Co) and molybdenum (Mo) levels in blood and urine among general population in China, and thereby to analyze their prevalent features.

METHODSFrom 2009 to 2010, a total of 18 120 subjects of general population aged 6-60 years were recruited from 24 districts in 8 provinces in eastern, central and western China mainland, by cluster random sampling method. The information about their living environment and health status were collected by questionnaire, and their blood and urine samples were also collected.Inductive coupled plasma mass spectrometry (ICP-MS) was applied to test the Mn, Co and Mo levels of blood and urine samples, and the Mn, Co, Mo distribution in blood and urine among groups of population in different ages and genders were then analyzed.

RESULTSAmong general population in China, the geometric mean (GM) of Mn concentration in blood was 8.98 µg/L. The Mn concentration in blood among males and females were separately 8.14 µg/L and 9.88 µg/L (Z = -18.84, P < 0.01). The GM of Mn concentration in urine was 0.63 µg/L. The Mn concentration in urine among males and females were separately 0.62 µg/L and 0.63 µg/L (Z = -0.67, P > 0.05). The geometric mean (GM) of Co concentration in blood was 0.194 µg/L. The Co concentration in blood among males and females were separately 0.166 µg/L and 0.225 µg/L (Z = -23.04, P < 0.01). The GM of Co concentration in urine was 0.282 µg/L. The Co concentration in urine among males and females were separately 0.260 µg/L and 0.307 µg/L (Z = -7.35, P < 0.01). The GM of Mo concentration in blood was 0.25 µg/L. The Mo concentration in blood among male and female group were separately 0.27 µg/L and 0.23 µg/L (Z = -5.03, P < 0.01). The GM of Mo concentration in urine was 27.7 µg/L. The Mo concentration in urine among males and females were 29.8 µg/L and 25.6 µg/L (Z = -6.31, P < 0.01), respectively.

CONCLUSIONThe Mn, Co and Mo levels in blood and urine varied by gender and area among general population in China, the study provided basic data evidence for the following Mn, Co and Mo biological monitoring studies in near future.

Adolescent ; Adult ; Child ; China ; epidemiology ; Cobalt ; Environmental Exposure ; Environmental Monitoring ; Female ; Humans ; Male ; Manganese ; Middle Aged ; Molybdenum

BACKGROUNDDiversity of orthopedic infections with various local environments affects the pattern and prevalence of pathogens. It is not well-characterized whether different pathogens have different propensity to cause different types of orthopedic infections. We aimed to investigate the frequency of different pathogens derived from orthopedic infections, and determine the relationship between the prevalence of clinical isolates and the type of orthopedic implants, especially focusing on staphylococci.

METHODSFrom January 2006 to December 2011, orthopedic infections were identified retrospectively from clinical microbiology laboratory and orthopedic medical records. The sources of orthopedic infections were divided into two main groups: those associated with implants and those not associated with implants. Implants-associated infections were further subdivided into five subgroups: arthroplasty, internal fixation, external fixation, internal and external fixation, and others. We analyzed microbiological spectrum in different groups and subgroups. Antibiotic susceptibility of staphylococci was analyzed.

RESULTSOnly coagulase-negative staphylococci (CoNS) was significantly more likely to be associated with implants-associated infections (P = 0.029). The overall pathogens prevalence of arthroplasty was significantly different from other subgroups (P < 0.05). 65% isolates from external fixation was Gram-negative bacteria. Some percentage (55%) of S. aureus and (83%) CoNS were resistant to methicillin. No resistance to glycopeptide was seen in all of staphylococci.

CONCLUSIONSStaphylococcus aureus was the most frequent isolates in orthopedic infections but was not associated with the presence or absence of implants. Only CoNS was implants-associated, especially for arthroplasty infection. Cefazolin alone is not enough for orthopedic surgery prophylaxis in settings with a high prevalence of methicillin-resistant staphylococci.

Humans ; Orthopedic Procedures ; adverse effects ; Prostheses and Implants ; microbiology ; Retrospective Studies ; Staphylococcus aureus ; pathogenicity ; physiology

OBJECTIVETo investigate the level of zinc (Zn) and copper (Cu) in whole blood among general population from 8 provinces in China, and to analyze the characteristics of distribution among different regions.

METHODSThis cross-sectional study was performed in 8 provinces from eastern, middle and western China between 2009 and 2010, including 13 110 subjects from 24 regions, and the blood and urine samples were collected. The ICP-MS was applied to test the content of ICP-MS in blood samples, and the results were used to analyze the characteristics of contents and distributions of Zn and Cu among population from different ages, genders and regions groups.

RESULTSTotally, the mean (95%CI) contents of Cu and Zn in blood were 795 (791-799)µg/L and 3 996(3 976-4 015) µg/L, respectively. The characteristics of distribution of Cu content were as followed, the content of males were lower than it of females (male:767 µg/L; female: 822 µg/L, t = -13.302, P < 0.01). The contents of blood Cu in groups of people aging 6-12, 13-16, 17-20, 21-30, 31-45 and 46-60 years old were separately 860(853-868), 758(748-769), 734(728-734), 782(774-790), 811(795-827) and 820(815-826) µg/L. The differences showed statistical significance (F = 78.77, P < 0.01). The blood Cu content of people in eastern China (800µg/L) were also significantly higher than it in middle (774 µg/L)and western China (782 µg/L) (F = 10.94, P < 0.01). Distribution of blood Zn content showed characteristics as follows: the Zn content was higher in males than in females (male 4 085 µg/L and female 3 908 µg/L, t = 8.78, P < 0.01). The contents of blood Zn in groups of people aging 6-12, 13-16, 17-20, 21-30, 31-45 and 46-60 years old were separately 3 306 (3 261-3 350), 3 888 (3 839-3 937), 3 948 (3 902-3 994), 4 272(4 228-4 315), 4 231(4 180-4 281) and 4 250 (4 205-4 294)µg/L, which showed significant statistical differences (F = 233.68, P < 0.01). The blood Zn content of people in eastern China (3 938 µg/L) were significantly lower than it in middle (4 237 µg/L)and western China (4 105 µg/L) (F = 53.16, P < 0.01). In addition, the study also compared the relation between content of Cu and Zn and the frequency of eating seafood. The results found that the frequency of eating seafood could influence the content of Cu and Zn (Cu: F = 13.54, P < 0.01; Zn: F = 200.20, P < 0.01).

CONCLUSIONThe contents and distributions of Cu and Zn in blood differs among people from different groups in ages, genders and regions. The baseline data of this study provided reliable scientific evidence for further research.

Adolescent ; Adult ; Child ; China ; epidemiology ; Copper ; blood ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Zinc ; blood