Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.

Objective? To explore the effect of enteral nutrition(EN) combined with high quality nursing in the treatment of severe acute pancreatitis(SAP). Methods? By convenience sampling, a total of 100 non-surgical SAP patients in the 901 Hospital of the Chinese People＇s Liberation Army Joint Logistics Support Force from September of 2012 to September of 2015 were selected as subjects and divided into the experimental group(n=50) and control group (n=50) according to random number table. The control group received the parenteral nutrition (PN) support combined with high quality nursing while the experimental group received the EN support combined with high quality nursing. After treatment, the two groups were compared in terms of the improving condition of the nutritional index, change of scores in Acute Physical and Chronic Health EvaluationⅡ (APACHEⅡ) , overall nursing satisfaction and incidence of adverse events. Results? 14 days after treatment, the experimental group was better than the control group in the serum amylase level, serum albumin, fasting blood glucose recovery and APACHE Ⅱ score with statistical difference (P＜0.05); the overall nursing satisfaction rate was 92% in the experimental group, higher than the control group with 66% and the difference was statistically significant (P＜ 0.05); the incidence of complications after intervention in the experimental group was 14%, lower than the control group with 36% and the difference was statistically significant (P＜0.05). Conclusions? EN support combined with high quality nursing has important clinical values for SAP patients. It can better alleviate patients＇ anxiety and stress, improve their diet structure, reduce the incidence of complications to the maximum extent, increase the clinical nursing satisfaction rate, and is worthy of clinical popularization.

Objective To study the predictive value of lung ultrasound score(LUS) on the extubation success rate in the patients with mechanical ventilation for early identifying the high risk patients with extubation failure and guiding the sequential therapy after extubation.Methods The prospective study method was adopted.Eighty-one cases with mechanical ventilation exceeding 48 h and successfully passing the spontaneous breathing trial(SBT) in EICU were selected.The bedside LUS evaluation was conducted before extubation.The cases were divided into the two groups according to whether successfully weaning.And the LUS differences before extubation were compared between the two groups.The receiver operating characteristic(ROC) curve was used to evaluate the predictive efficiency for extubation failure.Results The age and sex had no statistical difference between the two groups(P＞0.05).In included 81 cases,27 cases were failed to extubation and appeared different degrees of respiratory distress sign:respiratory rate(RR) increase,heart rate(HR) increase,SpO2 decrease,etc.,which needed non-invasive mechanical ventilation or high flow nasal cannula oxygen for alleviating respiratory difficulty.In the extubation failure group,10 cases were ineffective by above treatment and then needed reintubation.One case died within 24 h after extubation.Fifty-four cases succeeded in weaning and extubation.The LUS score was positively correlated with RR and PaCO2 (r=0.43,0.62;P＜0.05) and negatively correlated with SpO2 and PaO2(r=-0.76,-0.58;P＜0.05),while it was not correlated with HR and pH value(r=0.15,0.02,P＞0.05).The area under the ROC curve (AUC) of LUS score was 0.90(95％CI:0.84-0.95),it could be regarded that the accuracy of LUS for predicting extubation failure rate was stable,its sensitivity was 0.84 and specificity was 0.80.The diagnostic cutoff value was 15.00,if the LUS score exceeding 15 points,the extubation failure rate was significantly increased.Conclusion The LUS score has clinical application value for assessing the extubation success rate in the patients with mechanical ventilation.The patients with high risk of extubation failure can be early identified by the LUS score,which can guide the sequential therapy after extubation.

Objective To implement a two?level community?based health education pattern of schistosomiasis in residents of endemic areas in marshland and lake regions,so as to explore the suitable pattern of health education under hypo?endemic situa?tion. Methods Two schistosomiasis endemic villages in Jiangling County,Hubei Province were collected as study areas,and among which,one village was treated as an intervention group,where the two?level community?based health education pattern as well as regular control measures was implemented;the other village was a control group,where only regular control measures were implemented. The awareness rates on schistosomiasis control,the rates of correct behavior and the compliance rates of ex?amination,treatment and chemotherapy of the two groups before and after the intervention were compared. Results According to the results of the baseline survey in 2014,the awareness rates of schistosomiasis control of the intervention and control groups were 84.00%and 77.45%,respectively,the correct rates of behavior of the two groups were 72.00%and 63.73%,respectively, and the compliance rates of the treatment were 80.36%and 82.28%,respectively,there were no statistically significant differ? ences between all the above rates of the two groups(all P>0.05). After the intervention of the two?level community?based health education,the correct rates of behavior,and the compliance rates of examination and chemotherapy of the two groups were 92.31%and 80.37%,95.11%and 82.55%,84.13%and 63.64%,respectively,and the differences between all the rates above of the two groups were statistically significant(all P<0.05). When compared to those before intervention,the growing rates of the compliance rates of examination,treatment and chemotherapy of the intervention group were 20.97%,15.33%and 23.29%, respectively,while those of control group were 14.27%,4.17%,-3.77%,respectively,the growing rates of the intervention groups were higher than those of the control groups. Conclusions Through the two?level community?based pattern of health edu?cation,the compliance rates of examination and treatment of the residents have improved,and therefore,the pattern is suitable for popularization and application in marshland and lake regions.

Objective To investigate the correlation between plasma soluble CD14 (sCD14)level and disease progression in patients with acute phase of acquired immunodeficiency syndrome (AIDS). Methods Forty-one human immunodeficiency virus (HIV)-infected patients were followed up from June 2007 to June 2010 in Beijing You′an Hospital,including 20 patients with CD4 + T lymphocyte counts more than 350/μL,and 21 less than 350/μL after 3 years of HIV infection.Twenty healthy blood donors were recruited as controls.Enzyme-linked immunosorbent assay (ELISA)was employed to test the plasma sCD14 level of healthy controls and patients infected with HIV at 1 -30 d,31 -90 d,91 - 180 d and 181 -360 d.Student t test was used to compare the means between two groups.ANOVA analysis was used to compare the means among more than two groups.Results The mean plasma sCD14 level in control group was (1 654±904)μg/L.Three years after HIV infection,the sCD14 level of patients with CD4 + T lymphocyte counts less than 350/μL group was (4 214±2 635)μg/L,which was higher than that of patients with CD4 + T lymphocyte counts more than 350/μL ([2 275 ±1 457 ]μg/L).The difference was statistically significant(t=-5 .41 ,P <0.01).The plasma sCD14 level in patients infected with HIV 181 -360 d was significantly higher than that in patients infected with HIV 1 - 30 days ([4 485 ± 2 779]μg/L vs [2 577 ±1 635 ]μg/L;t = -3.39,P <0.05 ).The plasma sCD14 level was positively correlated with HIV viral load (r =0.35,P =0.000 1 ),and negatively correlated with CD4 + T lymphocyte counts (r=-0.28,P =0.001 ).Conclusions The plasma sCD14 level in patients with acute phase of HIV infection is higher than that of healthy people,which increases with prolonged HIV infection.Plasma sCD14 level in of HIV infection acute phase may be closely related to HIV/AIDS progression.

Objective To evaluate the effect of the Parasep? feces centrifuge tube method on detecting schistosome eggs. Methods A total of 803 residents aged from 6-65 years were selected in 2 schistosomiasis endemic villages Jiangling Coun-ty Hubei Province and their stool samples were collected and detected parallelly by the Kato-Katz technique nylon silk egg hatching method and Parasep? feces centrifuge tube method at the same time. Results Among the 803 people 15 cases were found of schistosome egg positive and the positive rate was 1.87%. The positive rates of the Kato-Katz technique nylon silk egg hatching method and Parasep? feces centrifuge tube method were 0.75% 1.49% and 1.12% respectively. The schistosome eggs got with the Parasep? feces centrifuge tube method were clear and easy to identify. Conclusion In low endemic areas of schistosomiasis the Parasep? feces centrifuge tube method can be used as schistosomiasis japonica etiology diagnosis method.

Inflammation and lung function decline are the main pathophysiological features of chronic obstructive pulmonary disease (COPD). Acupuncture can improve lung function in patients with COPD, but the underlying mechanisms are not well understood. Orexins (OXs), which are found in peripheral plasma, are neuropeptides that regulate respiration and their levels are related to COPD. Therefore, we hypothesized that acupuncture might alter OXs, reduce lung inflammation and improve lung function in COPD.

Objective The purpose of this study was to analyze the relation of blood glucose variability and 28-day mortality in patients with different degree sepsis. Methods From September 1, 2010 to September 30, 2012, all adult patients diagnosed with sepsis and treated at least 3 days in Emergency ICU (EICU) of the first affiliated hospital of Kunming Medical University were enrolled in the study. Then the blood glucose levels and the other requisite clinical data were obtained from historical electronic medical records of patients excluding the patients reached exclusive criteria. The maximum and mean of blood glucose, and the glucose variability (the standard deviation,SD of blood glucose) in each patient were calculated. The patients were assigned according to severity of sepsis, then the relationship between SD of blood glucose and 28-day mortality was statistically assessed. Results There was an important correlation between SD of blood glucose and 28-day mortality (OR=4.237, =0.021) . The glucose variability increased with the serious of sepsis ( = 0.016) . Conclusion Glucose variability is an independent predictor of 28-day mortality in septic patients. In addition, the severity of sepsis has a positive correlation with blood glucose variability.

Objective To review the techniques used in biliary reconstruction for adult-adult living donor liver transplantation using a right lobe graft. Methods The clinical data of 21 pairs of donor and recipient who underwent right lobe living donor liver transplantation from April 2007 to May 2009 at Beijing Youan Hospital were analyzed retrospectively. Biliary anastomoses consisted of 10 single right hepatic duct to common hepatic duct anastomoses, 5 donor double branched ducts to recipient double branched ducts anastomoses, 5 single anastomoses between a donor double branched duct which had been converted to a single duct by ductoplasty to a single recipient bile duct, and 1 hepaticojejunostomy. A T-tube was inserted through the anterior wall of the common hepatic duct and splinted across the anastomosis in 2 recipients and a Y-tube was used in 1 recipient. Results 4 recipients died during the first post-transplant month. Another recipient received a retransplantation for acute liver necrosis. The remaining recipients were alive. The 1-year survival rate of the recipients was 77.65 %.5 patients developed biliary leakage and 2 patients developed biliary stricture. The 7 biliary complications were treated and cured by further surgical procedures. There was no significant difference in the biliary complications among the three different types of biliary anastomotic groups (x2 = 0. 659,P=0. 719). Conclusion The different types of biliary anastomoses can be used in living donor liver transplantation depending on the situations found in the donors and recipients. Continuous suturing on the posterior wall of the bile duct, interrupted suturing on the anterior wall and microsurgical techniques in biliary reconstruction are effective modalities to minimize biliary complications.

Objective To investigate technical skills on outflow reconstruction in right lobe graft adult-adult living donor liver transplantation for avoiding of venous congestion. Methods The clinical data of 21 donors and recipients who underwent right lobe living donor liver transplantation were analyzed retrospectively. Donor's standard liver volume was between 1150. 1 and 1629. 8 cm3,graft weight was between 585 and 920 g, the ratio of graft volume to recipient's estimated standard liver volume (GV/ESLV) was between 43 % and 67 %, graft-recipient weight ratio (GRWR) was between 0. 82 % and 1.59 %, the ratio of remnant liver volume to donor's standard liver volume(RLV/SLV) was between 32 % and 55 %, all graft macrosteatosis was less than 10 %. For graftwith middle hepatic vein (MHV), a triangle large orifice was made by joining MHV to right hepatic vein (RHV), then anastomosed to recipient' s enlarged orifice of RHV. For graft without MHV, if tributary of MHV＞5 mm, autologous or allogenic blood vessel was used as interposition graft to connect to IVC, and if no large MHV tributary, graft RHV was anastomosed to IVC directly. Graft's right portal vein was anastomosed to main trunk of recipient's portal vein, graft's right hepatic artery to recipient's hepatic artery, and graft's right hepatic duct to recipient's right hepatic duct. Results Among the 21 right lobe grafts, 4 right lobe grafts had MHV, 17 right lobe grafts had no MHV.Autologous greater saphenous veins were adopted in 2 cases, cryopreserved iliac arteries were adopted in 5 cases, and RHV was anastomosed directly to IVC in 10 cases. Outflow was all patent in 7 cases having reconstruction of MHV tributaries one month after operation. One-year survival rate was 75 %, 85. 7 % and 70 % respectively in MHV group, MHV tributaries reconstructed group and RHV directly anastomosed to IVC group with the difference being not significance among these three groups (P＞0. 05). Biliary complications occurred in 7 cases during the follow-up period. One case developed small-for-size syndrome, which was cured by splenic artery embolization. No severe complication occurred in donors. All donors returned to normal life during a follow-up period of 6 to 31 months. Conclusion If outflow tract was reconstructed properly, right lobe graft without MHV has equivalent clinical outcomes to right lobe graft with MHV. Using of autologous or allogenic blood vessel as interposition vessel graft for right lobe graft without MHV is an effective modality to prevent hepatic congestion and secure functional graft volume to meet recipients metabolic demand.