The outbreak of pneumonia caused by novel coronavirus (COVID-19) at the end of 2019 was a major public health emergency in human history. In a short period of time, Chinese medical workers have experienced the gradual understanding, evidence accumulation and clinical practice of the unknown virus. So far, National Health Commission of the People's Republic of China has issued seven trial versions of the "Guidelines for the Diagnosis and Treatment of COVID-19". However, it is difficult for clinicians and laymen to quickly and accurately distinguish the similarities and differences among the different versions and locate the key points of the new version. This paper reports a computer-aided intelligent analysis method based on machine learning, which can automatically analyze the similarities and differences of different treatment plans, present the focus of the new version to doctors, reduce the difficulty in interpreting the "diagnosis and treatment plan" for the professional, and help the general public better understand the professional knowledge of medicine. Experimental results show that this method can achieve the topic prediction and matching of the new version of the program text through unsupervised learning of the previous versions of the program topic with an accuracy of 100%. It enables the computer interpretation of "diagnosis and treatment plan" automatically and intelligently.
Betacoronavirus ; China ; Coronavirus Infections ; diagnosis ; therapy ; Humans ; Machine Learning ; Pandemics ; Pneumonia, Viral ; diagnosis ; therapy ; Practice Guidelines as Topic

Objective To investigate the characteristics and the enhanced patterns of carotid plaque using contrast-enhanced ultrasound (CEUS) and patients with cerebral infarction.Methods The patients with carotid plaque were divided into two groups according to whether they had cerebral infarction:54 patients (62 plaques with CEUS) with cerebral infarction were included in group A,and 48 patients (54 plaques with CEUS) without cerebral infarction were included in group B.The plaques were divided into four grades according to the degree of plaque enhancement.According to the source of intraplaque contrast agents,plaque enhancement patterns were divided into adventitia enhancement,lumen enhancement and mixed enhancement.To analyze the degree and pattern of carotid plaque enhancement in the two groups.Results Carotid plaque enhancement in cerebral infarction group was mainly grade 3 (26/62) and grade 4 (22/62),while that in non-cerebral infarction group was mainly grade 2 (20/54) and grade 3 (20/54).There was significant difference between the two groups in the proportion of carotid plaque enhancement of grade 2 (P =0.019) and grade 4 (P =0.041).The proportion of plaque adventitia enhancement model in group A(27/59) was lower than that in group B (37/50),with statistically significant difference (P =0.003).While the proportion of mixed enhancement mode in group A was significantly higher than that in group B (P =0.003).Conclusions The enhancement of carotid plaque was obvious in cerebral infarction patients,and the mixed enhancement pattern was more common.It suggested that the communication between vascular cavity and plaque might be an important factor leading to cerebral infarction.

Objective To share the content and the entry point of the clinical pharmacist participating in the oncology emergency drug treatment. Methods Five typical cases of oncologic emergency occurred in patients with advanced cancer. Clinical pharmacists participated in the drug treatment of circulatory system of emergency,nervous system emergency,metabolic system emergency,blood system emergency and multi-drug resistant bacteria infection.Clinical pharmacists provided suggestions for clinical medication and a whole-course pharmaceutical care by using pharmaceutical knowledge and reviewing relevant information material. Results The work of pharmacists get clinical recognition by assisting clinicians to solve the critical emergencies of cancer patients and improving the effect of drug treatment. Conclusion Clinical pharmacists can be gradually integrated into the medical team and play a critical role as clinical pharmacists in terms of drug treatment.

Objective To investigate and evaluate the diagnostic value of transcranial doppler ultrasound (TCD) on brain death in patients with severe craniocerebral injury.Methods Forty-two cases of severe craniocerebral injury from Affiliated Hospital of Jining Medical University were divided into brain death group and survival group,according to the clinical prognosis.TCD was conducted to examine brain blood flow numerical and changed characteristics of the spectrum.Average blood flow velocity (Vm),pulse index (PI),diastolic blood flow in reverse (reverberating flow) and small systolic peaks in early systole (wave of spikes)were documented.TCD parameters were compared between the two groups with t test.Results In the brain death group,frequency of reverberating flow was 86.67％ and frequency of wave of spikes was 13.33％.In survival group,frequency of reverberating flow was 14.81％ and no wave of spikes was recorded.The difference in frequencies of reverberating flow and wave of spikes between the two groups was significant(x2 =28.25,P ＜0.01).The average speed of bilateral middle cerebral artery blood flow in brain death group((20.02±13.96) cm/s) was significantly reduced compared with survival group((56.81± 16.84) cm/s,t=2.30,P＜0.05).Pulse index (PI) values in brain death group (4.02±3.49)were significantly increased compared with survival group (1.24±1.03) (t=2.10,P＜0.05).Conclusion Reverberating flow or wave of spikes is an important marker for brain death in patients with severe craniocerebral injury.TCD may be applied to clinically confirm the diagnosis of brain death.

OBJECTIVE:To systematically review the relationship of clinical efficacy between XPD Lys751Gln (A/C),XPD Asp312Asn(G/A)and platinum-based chemotherapy in patients with advanced non-small cell lung cancer(NSCLC),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed, Cochrane Library, EMBase, Medline, CJFD,VIP database and WanFang database,studies about the effects of XPD Lys751Gln and XPD Asp312Asn polymorphism on ef-fectiveness,clinical outcomes and adverse drug reaction of platinum-based chemotherapy in advanced NSCLC patients were collect-ed,and Meta-analysis was performed by using Rev Man 5.3 software. RESULTS:Totally 30 studies were included,involving 5 028 patients. Genetic testing showed that XPD Lys751Gln divided into mutant gene (Lys/Gln + Gln/ Gln) and wild-type gene (Lys/Lys),while XPD Asp312Asn divided into mutant gene (Asp/Asn + Asn/Asn) and wild-type gene (Asp/Asp). Results of Me-ta-analysis showed,the progression-free survival (PFS) of Lys/Gln+Gln/Gln patients with platinum in XPD Lys751Gln polymor-phism was obviously lower than Lys/Lys patients [OR=-1.12,95%CI(-1.73,-0.50),P<0.001],while there was no significant difference in the chemotherapy effectiveness and total survival period. The effective rate of Asp/Asn+Asn/Asn patients for platinum in XPD Asp312Asn polymorphism was lower than Asp/Asp patients [OR=0.80,95%CI(0.68,0.96),P=0.02],while there was no significant difference in the total survival period and PFS. Meanwhile,the incidence of Ⅲ-Ⅳ level gastrointestinal adverse reac-tions of Lys/Gln+Gln/Gln with platinum in XPD Lys751Gln polymorphism was higher than Lys/Lys patients [OR=0.43,95%CI (0.20,0.94),P=0.03],and there was no significant difference in Ⅲ-Ⅳ level blood system adverse reactions. CONCLUSIONS:XPD Lys751Gln polymorphism may be associated with PFS and Ⅲ-Ⅳ level gastrointestinal adverse reactions for advanced NSCLC patients with platinum-based chemotherapy,while XPD Asp312Asn polymorphism may have effect on platinum-based chemotherapy,both of them may be as estimate the chemotherapy effect and prognosis detection index of platinum-based chemo-therapy.

OBJECTIVETo establish the ultrasonographic criteria for normal size of infrarenal aorta (IRA) and common iliac arteries (CIA) of young males in a Chinese school and to determine the associations between IRA diameter (IRAD) and CIA diameter (CIAD) and body habitus as well as traditional cardiovascular risk factors.

METHODSCross-sectional study was done of 203 Chinese young males enrolled from a technical school in Beijing Changping district from May to June 2013. The IRA and CIA scans were carried out using ultrasonography. Longitudinal scans were used to assess aortic morphology and tortuosity. The maximum internal anteroposterior IRAD and CIAD in any area of the arteries were measured during the cardiac cycle. Participants information on demographic, medical history, smoking history and alcohol consumption was obtained through unified questionnaire. Univariate and multivariate linear regression was used to determine the associations between arterial diameter and body habitus as well as other risk factors.

RESULTSThe median participants age was 21.5 (ranging from 18 to 28) years. The IRAD was (13.4±1.9) mm, and the CIAD was (9.4±1.6) mm. There was no significant difference between the left and right CIAD. Waist circumference was significantly associated with increasing IRAD (P=0.03), while alcohol had an inverse correlation (P=0.04). Age, hip circumference were significantly associated with increasing CIAD (P=0.00, 0.04), while the systolic pressure and alcohol had inverse correlations (P=0.01, 0.00). By dividing the entire group into equal four groups using quartile values for both age and waist/hip circumference, the older group and the larger waist/hip circumference had greater arterial diameter.

CONCLUSIONSThe enrolled Chinese young males have smaller IRAD and CIAD compared with foreign older population. Age, waist circumference, hip circumference, alcohol and systolic pressure have statistically significance but small effects on arterial diameter.

Adolescent ; Adult ; Age Factors ; Aorta, Abdominal ; diagnostic imaging ; Beijing ; epidemiology ; Blood Pressure ; Cardiovascular Diseases ; epidemiology ; Cross-Sectional Studies ; Humans ; Iliac Artery ; diagnostic imaging ; Male ; Risk Factors ; Ultrasonography ; Waist Circumference ; Young Adult

Objective To evaluate the effect of comprehensive schistosomiasis control measures based on infection source control in plateau mountain areas of Yunnan Province. Methods From 2006 to 2004,four administrative villages were selected as test areas from plateau canyon and plateau basin endemic areas in Jindun Town,Heqing County,two villages each type,and the comprehensive control measures were implemented,including the examination and treatment of schistosomiasis,Oncomela?nia hupensis snail survey and control,health education,improving drinking water and lavatories,banning grazing,constructing sanitary pen of livestock,replacing cattle with machine,etc. The schistosome infection state and snail status in 2006 were treat?ed as the baseline information,and the effect of the comprehensive measures were evaluated. Results The infection rate of hu?man in plateau canyon areas decreased from 4.94%in 2006 to 0.06%in 2014,and that of livestock decreased from 1.11%to 0. In plateau basin areas,there was only 1 case of schistosomiasis found in Xiaolian Village in 2007,and no any other cases found in the other years,the infection rates of livestock dropped from 7.38%to 0. Compared with 2006,the snail areas in the two type areas decreased by 74.89%and 75.30%,respectively,meanwhile,the percentage of snail area,the occurrence rate of frames with snails,as well as the average density of living snails also decreased,and no infected snails were found since 2008. Xidian and Xinzhuang villages in plateau canyon area reached the criteria of schistosomiasis transmission controlled in 2009,and Xiao?lian and Kangfu villages in plateau basin reached the criteria of transmission interrupted in 2014. Conclusions The comprehen?sive schistosomiasis control measures based on infection source control can effectively control the endemic situation of schistoso? miasis in plateau areas of Yunnan Province. In the future,we should pay an equal attention to the infection sources control and snail control to consolidate and amplify the achievement of schistosomiasis control.

Objective To investigate the prevalence of Helicobacter pylori (H .pylori)infection in type 2 diabetic patients and its effects on diabetic gastroparesis.Methods Prospective clinical case-control study was applied.From January 2011 to December 2013,125 hospitalized patients with type 2 diabetes and 142 healthy controls without dyspeptic symptoms were enrolled.The prevalence of H .pylori infection and the incidence of gastroparesis in 125 patients with diabetes were investigated in both two groups.The patients with type 2 diabetes were divided into groups according to the course of the disease,and the prevalence of gastroparesis and H .pylori infection of each group were analyzed.The patients with type 2 diabetes and healthy controls confirmed with H .pylori infection were treated with eradication therapy,the rate of eradication of two groups was compared.The improved symptoms of gastroparesis before and after eradication therapy of patients with type 2 diabetes were compared.The chi-square test was performed for statistical analysis.Results The prevalence of H .pylori infection in type 2 diabetic patients was 66.4%(83/125),which was significantly higher than that of healthy control group (51 .4%,73/142 )(χ2 =5 .549,P <0.05).The prevalence of gastroparesis in diabetic patients with the disease course less than 10 years,10 to 20 years and more than 20 years was 33.8% (27/80 ),47.1 % (16/34 )and 8/11 , respectively.The difference was statistically significant (χ2 = 6.554,P < 0.05).The prevalence of H .pylori infection in patients with gastroparesis was 78.4% (40/51 ),which was significantly higher than that of patients without gastroparesis (58.1 %,43/74)(χ2 =4.716,P <0.05).The eradication rate of H .pylori infection in patients with type 2 diabetes was 68.7% (57/83),which was lower than that of healthy control group (87.8%,36/41),and the difference was statistically significant (χ2 =4.385 ,P <0.05).The incidence of epigastric pain and distension,early satiety and apocleisis before H .pylori eradication in type 2 diabetes patients was 75 .9% (63/83 ),66.3% (55/83 )and 67.5 % (56/83 ), respectively,while after eradication which was 44.6%(37/83),37.3%(31/83)and 39.8%(33/83)after eradication,respectively.The differences were statistically significant (χ2 =15 .720,12.764 and 11 .724;all P <0.01).Conclusions The prevalence of H .pylori infection is significantly higher in type 2 diabetic patients,and gastroparesis in type 2 diabetic patients may be correlated with H .pylori infection.The eradication rate in type 2 diabetic patients was lower,and H .pylori eradication therapy can efficiently improve the symptoms of dyspepsia in diabetic patients with gastroparesis.

Objective:To examine the potential influence factors of abdominal aortic aneurysm (AAA).Methods:A 1∶2 pair-matched, case-control study was conducted from July 2011 to December 2012 .A pair was composed of one AAA patient recruited from the Vascular Surgery Department , Chinese PLA General Hospital and two gender-and age-matched non-AAA subjects , one from the same hospital and the other from the community in Fangshan District in Beijing .Demographic data , medical history and the lifestyle of each subject were collected .Moreover , all the participants underwent abdominal ultra-sound or computed tomography ( CT ) and peripheral venous blood samples were obtained .Results:There were 155 case/control pairs .The multivariate conditional logistic regression model confirmed that suffering from hypertension conferred a 1.98-fold (95%CI 1.12-3.18) increased likelihood of AAA. Smoking was a strong independent risk factor of AAA , with odds ratios ( 95% confidence intervals ) of 5.23 (2.44-11.23).Dyslipidemia(OR=2.61,95%CI 1.45-4.70), a higher level of serum hs-CRP (OR=2.43,95%CI 1.37-4.31) and homocysteine (OR=2.73,95%CI 1.61-4.65) were all asso-ciated with AAA.Conclusion: Hypertension and smoking are the risk factors of AAA .Dyslipidemia, hsCRP and Hcy are associated with AAA .

Objective To investigate the drug resistance and genotype of methicillin-resistant Staphylococcus (MRS), and to study the epidemiology of drug resistance in Staphylococcus. Methods Drug susceptibility tests were performed for 138 Staphylococcus strains clinically isolated, and mecA gene was detected with PCR. For mecA positive strains, Staphylococcal cassette chromosome mec (SCCmec) gene was detected by two multiplex PCR assays. Results Seven (10.8%) out of 65 Staphylococcus aureus strains were methicillin-resistant Staphylococcus aureus (MRSA) strains, and 44 (60.3%) out of 73 coagulase negative Staphylococcus strains were methicillin-resistant coagulase negative Staphylococcus (MRCNS)strains. There was statistical significance on the difference of isolation rates (x2 = 37. 05, P ＜0.01). No vancomycin or nitrofurantoin resistant strain was found. There were 52 (52/138, 37.7%) mecA positive strains, including 16 SCCmec type Ⅰ strains, 1 type Ⅱ strain, 13 type Ⅲ strains, 9 type Ⅳ strains and 4 type Ⅴ strains. Conclusions Drug resistance in MRS is increasingly serious. MRCNS strains are more popular than MRSA in clinic, and SCCmec Ⅰ and Ⅲ may account for most infections.