Novel coronavirus Omicron variant infection can cause severe illness and even death in certain populations. Omicron variant infection may lead to systemic inflammatory response, coagulation disorder, multi-organ dysfunction and other pathophysiological changes, which are different from other Novel coronavirus variants to a certain extent, so therapeutic strategies should not be the same. The National Medical Center for Major Public Health Events invited experts in fields of infectious diseases, respiratory medicine, intensive care, pediatrics and fever clinic to develop this quick guideline based on the current best evidence and extensive clinical practices. This quick guideline aims to standardize the diagnosis and treatment of novel coronavirus Omicron infection, and to improve the disease management abilities of clinicians.

Objective    To analyze the effect of modified Blalock-Taussig shunt on the treatment of cyanotic congenital heart diseases in neonates. Methods    The clinical data of 33 neonates undergoing modified Blalock-Taussig shunt between January 1, 2013 and December 31, 2017 were reviewed, including 28 males and 5 females with the age of 3.0-28.0 (18.0±6.1) d and weight of 1.9-3.7 (2.9±0.5) kg. Results    There were 3 (9.1%) in-hospital deaths. Ten (30.3%) patients required early unplanned reoperations after surgery. Five (15.2%) patients were lost to follow-up. In the multivariate analysis, preoperative acidosis, emergency operation and postoperative bedside thoracotomy were independent risk factors of early death. During the follow-up of 18.0-93.0 (40.2±22.5) months, there was no death and 9 (36.0%) survival patients underwent corrective surgery and stage-two palliative surgery. In the multivariate analysis, preoperative hyperhemoglobinemia was an independent risk factor of nonadministration of the corrective surgery and stage-two palliative surgery. Receiver operating characteristic curve showed that preoperative hyperhemoglobinemia was significant in determining whether secondary surgery was possible. Conclusion    The modified Blalock-Taussig shunt is effective in promoting development of pulmonary arteries and preparing for the secondary surgery. The rate of mortality and postoperative complications after the neonatal modified Blalock-Taussig shunt remains high. The rate of secondary surgery is still low during follow-up.

Objective    To define the patient characteristics and perioperative management, and to define the mortality and its risk factors after arterial switch operation (ASO). Methods    We conducted a bidirectional cohort study with 571 consecutive patients undergoing ASO from 1997 to 2016 in our hospital. We enrolled patients who underwent ASO before 2012 retrospectively and after 2012 prospectively and followed up all the patients prospectively. Demographic characteristics, clinical information and mortality of these patients were summarized. Joinpoint regression analysis was used to identify the time trend of the overall mortality. Kaplan-Meier survival analysis was used to evaluate the mid- and long-term survival rate after ASO. Cox proportional hazards regression models were used to explore the potential factors associated with mortality. The cumulative incidence of complications after ASO was predicted using competing risk models. Results    Several aspects of patients’ characteristics and perioperative management in our center differed from those in the developed countries. The overall mortality and in-hospital mortality after ASO was 16.3% and 15.1%, respectively. The overall cumulative survival rate at 5, 10 and 15 years after ASO was 83.3%, 82.8% and 82.8%, respectively. A significant decrease of overall mortality from 1997 to 2016 was observed. Independent risk factors of mortality included earlier ASO (1997-2006), single or intramural coronary anatomy and longer cardiopulmonary bypass time. Ten years after ASO, re-intervention, arrhythmia, pulmonary and anastomotic stenosis were the most common complications with a cumulative incidence over 10%. Conclusion    Significant improvements in the results of the ASO were observed and the postoperative mortality rate is close to reports from developed countries. Nonetheless, we have identified the need for further improvement in the early and late postoperative periods after ASO. Pulmonary stenosis, anastomotic stenosis and arrhythmia should be paid attention to during the long-term follow-up after ASO.

60 curved root canals of permanent teeth with angles of curvature ranging from 15°to 40°(Schneider's methodology)were prepared using the instruments of Hyflex CM(HC) and ProTaper(PT) Universal respectively(n=30).Using standardized pre-and post-instrumentation paralleling periapical radiographs,canal curvature was determined by image analysis software and the clinical shaping effect of Hyflex CM and ProTaper rotary NiTi files were compared.The canal curvature in group HC and PT decreased by 4.54°±3.25° and 5.63°±3.84° respectively(between pre-and post-treatment in both groups,P<0.05;between groups,P>0.05).Hyflex CM can meet the clinical necessity for the instrumentation of curved root canals.

Objective The study aimed to explore the development direction of congenital heart disease surgery through comparing Europe with Guangdong General Hospital(GDGH) in data of ECHSA Congenital Database.Methods The data between 2009 to 2015 of Europe and GDGH were extracted from ECHSA Congenital Database.The data of Europe and GDGH were compared by basic information,operating difficulty and mortality.Results The results of Europe and GDGH were patient number(71 763 vs 13 119),procedure/patient ratio(126.2％ vs 104.1％),age[(75.91 ± 146.18) months VS(105.80 ± 172.18) months],the proportion of neonate (18.2％ vs 4.4％),Aristotle mean score (7.00 vs 6.67),30 days mortality (2.98％ vs 1.73 ％).The proportion of neonate palliative operation of Europe was more than that of GDGH.In adult group,Europe was more of reoperation and of GDGH was more of primary surgery.Conclusion The surgical treatment of congenital heart disease of GDGH is developing and is close to the mean average of Europe.The proportion of neonate,complex surgery and reoperation is lower than Europe.

Objective:To describe the secular trends of premarital medical examination ( PME ) in China during 1996 and 2013 and to assess the impacts of national health policies on the PME rate. Methods:The information on marriage and PME for districts and counties in 31 provinces of China was annually collected by the Office for National Maternal & Child Health Statistics of China, and the infor-mation on the health policies was from official governmental websites. According to the main health poli-cies, the calendar years were categorized into 3 periods:1996 to 2003 was mandatory PME period;2004 to 2008 was encouraged voluntary PME period; and 2009 to 2013 was free-paid voluntary PME period. Results: During the 18-year period, 284 242 719 people were registered for a marriage in which 107 198 795 were examined, giving the PME rate of 37. 7%. During the mandatory PME period, the rate ranged 52 . 7% -67 . 7% with an average of 60 . 9% ( urban 71 . 5%, and rural 51 . 7%) . In 2004 , the first year when the PME became voluntary, the rate was abruptly dropped to 2. 6%, and thereafter gradually increased to 11 . 5% in 2008 . As the policies of the free-paid voluntary PME were subsequently issued, the rate was quickly increased to 52. 3% (urban 49. 8%, and rural 54. 6%) in 2013. The in-creasing trend was consistently observed both in urban and rural areas, and across East, Middle, West, and Northeast economical regions. However, the rates differed greatly among provinces. In 2013, 5 pro-vinces had rates of >90% ( Guangxi 97 . 5%, Fujian 96 . 0%, Ningxia 95 . 4%, Zhejiang 93 . 4% and Anhui 90. 1%), whereas some provinces were stuck at a low rate, including developed and underdeve-loped provinces/cities. The PME rate in 2013 was 27. 4% for Shanghai, 25. 5% for Guangdong, 12. 4%for Chongqing, 5. 8% for Beijing and 4. 6% for Tianjin. Underdeveloped provinces were Guizhou (6. 4%) and Qinghai (1. 8%). Conclusion:As various national policies to promote voluntary PME were issued, the PME rate was significantly increased after a sharp decline, though it varied greatly by provinces. For provinces with high PME rate, PME-related health benefits need to be evaluated;for provinces with low rate, it is of important practical significance to explore a cost-effective health service model that is likely incorporated with pre-pregnancy examination.

OBJECTIVE: To observe growth inhibition effect of perlecan anti-sense cDNA (pAP) on human laryngeal carcinoma xnografted in nude mice. To vertify its antitumor effect and mechanism in vivo, and it may be useful as a biomarker in carcinoma of larynx cancer. METHOD: Created the model of human laryngeal carcinoma xnograft in nude mice. To observe growth of those xnografts in nude mice and draw growth curve of xnografted. The expression of perlecan mRNA and portein in xnografts were examined by RT-PCR and immunohistochemistry. RESULT: Volume of xnografts in the group transfected by the plasmids of pAP were significant small as compared with other two groups made by the wild type cells and phpApr-neol cells (P < 0.05). It was showed that the expression of perlecan mRNA and protein were significantly reduced in the tumor of pAP transfected Hep-2 cells as compared with the tumors transfected by the wild type cells and phβApr-neol cells (P < 0.01). CONCLUSION These data raise the possibility that pAP many play key roles in the growth of those xnografts in nude mice.
Animals ; DNA, Antisense ; therapeutic use ; DNA, Complementary ; Heparan Sulfate Proteoglycans ; genetics ; Heterografts ; Humans ; Laryngeal Neoplasms ; pathology ; therapy ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Plasmids ; RNA, Messenger ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Transfection

Objective To explore 64 row volumetric CT 3D reconstruction in the clinical application of severe craniocerebral injury.Methods 60 patients with craniocerebral injury in our hospital were retrospectively analyzed who accept craniocerebral 64 row volumetric CT 6 to 24 hours after injury. Results All cases got timely diagnosis and treatment, especially for the special parts of brain lesions, ventricle base of skull fractures and pool, and various angles show. Conclusion 64 row volumetric CT reconstruction for the diagnosis of craniocerebral injury shows important significance and may estimate the prognosis in diagnosis, guiding treatment and surgery, reducing misdiagnosis.

OBJECTIVE: We aimed to compare the characteristics between lentivirus and adenovirus vector mediated gene transfer into cultured spiral ganglion cells (SGCs). METHOD: SGCs from newborn rats were cultured and exposed to lentivirus-GFP and adenovirus-GFP vectors. GFP expression and the cell morphology were evaluated under epi-fluorescence microscope at 3 days and 7 days after exposure. Survival number of SGCs was counted, and the average percentage of SGCs with GFP expression was calculated, and axon length was measured by ImageJ software. RESULT: Cultured SGCs were transfected by either adenovirus or lentivirus vector successfully. The adenovirus vector presented an instant and efficient transfection. However, the expression of GFP went down after 7 days. In lentivirus-GFP group, GFP expression was detected at 7 days after exposure, and the number of cells with GFP expression increased gradually in the following days. Statistical analysis revealed that there were no differences in survival number of SGCs and average axon length among lentivirus-GFP group, adenovirus-GFP group and control group. CONCLUSION Cultured SGCs can be transfected by either lentivirus vector or adenovirus vector safely and efficiently. SGCs are more susceptible to adenovirus vector, but GFP persists for a longer period after the lentivirus-mediated gene transfer.
Adenoviridae ; genetics ; Animals ; Cell Culture Techniques ; Cells, Cultured ; Gene Transfer Techniques ; Genetic Vectors ; Lentivirus ; genetics ; Rats ; Spiral Ganglion ; cytology ; Transduction, Genetic ; Transfection

Objective:To explore the involvement of endoplasmic reticulum molecular chaperone GRP78 in the impairment of inner ear consistented with the mimetic aging model.Method:Twenty-four Wistar rats were randomly divided into two groups. model group was in duced by daily hypodermic injection of 10% D-galactose (800 mg·kg~(-1)·d~(-1)) for 8 weeks and the control group was given saline accordingly. Spatial learning and memory was measured by Morris-Water-Maze. Colorimetry was used to analyze superoxide dismutase (SOD) and malondialdehyde (MDA) extracted from inner ear tissue. Hearing threshold of rats were detected with Auditory brainstem response (ABR).In addition, expression of GRP78 in the inner ear was detected by immunohistochemistry,RT-PCR and Western blot. The control group was studied parallel.Result:The escape latency in the model group injected with D-galactose was markedly longer than that in the control group.accordingly ,the changes of SOD and MDA were more significant in the model group, the difference between two groups was significant(t-test,P<0.01). the variation of ABR in two groups was observed, There was no statistically difference of the hearing in the model group compared with the control group(P>0.05). The expression of GRP78 was significantly different between two groups ,which is increased in the inner ear tissue of model group(P<0.01).Conclusion:The impairment of inner ear tissue partly dued to the oxidative stress in the model, which was induced by D-galactose.and endoplasmic reticulum molecular chaperone was thought to contribute to the impairment mechanism of inner ear in mimetic aging model.