Objective:To investigate the characteristics and management approaches of patients admitted to the isolation wards in public general hospitals under regular epidemic prevention and control measures of coronavirus disease 2019 (COVID-19).Methods:All patients admitted to the isolation ward in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from May 14, 2020 to April 15, 2021 were enrolled, and the general information, illness severity, preliminary diagnosis and transfer department of the patients were analyzed.Results:Out of the 2 292 patients admitted to the isolation ward, critical patients accounted for 34.34% (787 cases), surgical system patients accounted for 80.06% (1 835 cases) and internal medicine system patients accounted for 19.94% (457 cases), fever patients accounted for 11.30% (259 cases). All patients successfully completed COVID-19 screening, and no COVID-19 patients were detected. Among the total enrolled patients, 2 201 patients were promptly transferred to the corresponding departments for further treatment, with an average transfer time of 0.55 day. The remaining 91 patients were discharged from the isolation ward with an average hospitalization stay of 1.27 days.Notably, there were no COVID-19 cross-infection occurred between patients and medical staff in the isolation ward.Conclusions:Scientific and efficient management of isolation wards ensure timely screening and effective treatment for patients, and simultaneously achieving "zero" infection for both medical staff and patients.

Objective:To explore the effect of pediatric critical illness score (PCIS), pediatric risk of mortality Ⅲ score (PRISM Ⅲ), pediatric logistic organ dysfunction 2 (PELOD-2), pediatric sequential organ failure assessment (p-SOFA) score and Glasglow coma scale (GCS) in the prognosis evaluation of septic-associated encephalopathy (SAE).Methods:The data of children with SAE admitted to the Pediatric Intensive Care Unit (PICU), Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences from January 2010 to December 2020 were retrospectively analyzed. They were divided into the survival and death groups according to the clinical outcome on the 28th day after admission. The efficiency of PCIS, PRISM Ⅲ, PELOD-2, p-SOFA and GCS scores for predicting death were evaluated by the area under the ROC curve (AUC). The Hosmer-Lemeshow goodness-of-fit test assessed the calibration of each scoring system.Results:Up to 28 d after admission, 72 of 82 children with SAE survived and 10 died, with a mortality rate of 12.20%. Compared with the survival group, the death group had significantly lower GCS [7 (3, 12) vs. 12 (8, 14)] and PCIS scores [76 (64, 82) vs. 82 (78, 88)], and significantly higher PRISM Ⅲ [14 (12, 17) vs. 7 (3, 12)], PELOD-2 [8 (5, 13) vs. 4 (2, 7)] and p-SOFA scores [11 (5, 12) vs. 6 (3, 9)] ( P<0.05). The AUCs of PCIS, PRISM Ⅲ, PELOD-2, p-SOFA and GCS scores for predicting SAE prognosis were 0.773 ( P=0.012, AUC>0.7), 0.832 ( P=0.02, AUC>0.7), 0.767 ( P=0.014, AUC>0.7), 0.688 ( P=0.084, AUC<0.7), and 0.692 ( P=0.077,AUC<0.7), respectively. Hosmer-Lemeshow goodness-of-fit test showed that PCIS ( χ2=5.329, P=0.722) predicted the mortality and the actual mortality in the best fitting effect, while PRISM Ⅲ ( χ2=12.877, P=0.177), PELOD-2 ( χ2=8.487, P=0.205), p-SOFA ( χ2=9.048, P=0.338) and GCS ( χ2=3.780, P=0.848) had poor fitting effect. Conclusions:The PCIS, PRISM Ⅲ and PELOD-2 scores have good predictive ability assessing the prognosis of children with SAE, while the PCIS score can more accurately evaluate the fitting effect of SAE prognosis prediction.

Objective:To investigate the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)on cue attention in male patients with alcohol use disorder (AUD) after the acute withdrawal.Methods:A total of 90 male patients AUD who were hospitalized in the Second Affiliated Hospital of Kunming Medical University and Psychiatric Hospital of Yunnan province from May 2020 to December 2020 were enrolled, then they were divided into study group and control group using random number table.Because 18 cases fell out during the study, 36 cases were included in each of the two groups.After the alcohol withdrawal syndrome eliminated, the study group received high-frequency rTMS at 10 Hz for 14 consecutive days, and the control group was administrated by sham rTMS.At baseline and after true or sham rTMS, the cognitive psychology experiment Oddball paradigm was completed, and the behavioral data of the subjects were collected.Paired-sample t-test was used to compare the changes of the two groups before and after treatment.Data analysis were conducted using SPSS 21.0 software. Results:There was no statistical difference between the study group and the control group in terms of drinking level, cognition level and demographic data(all P>0.05). In the Oddball paradigm, compared with the control group((526.72±75.30)ms, (0.98±0.02))the reaction time((497.93±64.51)ms, t=3.145, P=0.008) and accuracy rate((0.99±0.01), t=-2.803, P=0.016) in alcohol-related cues were significantly improved in the study group after rTMS intervention, but in the control group, there were no statistical differences(both P>0.05), whether the cue was alcohol related or not. Conclusion:The results suggest that the rTMS can enhance the attention bias of alcohol-related cues and change the impulse process partly.

Thousands of children experience cardiac arrest in hospital each year, and only about half of them can survive to hospital discharge.Recognizing cardiac arrest in time and initiating high-quality cardiopulmonary resuscitation as early as possible is the key to improve the prognosis.During resuscitation, the longer the duration of cardiopulmonary resuscitation, the lower the survival rate.To prevent the heart rhythm from deteriorating into ventricular fibrillation, pulseless ventricular tachycardia and other malignant rhythms, timely use of adrenaline is beneficial to improve survival.For shockable heart rhythms, the recommended initial dose of defibrillation is 2 J/kg.Invasive airways can be harmful during resuscitation.For qualified medical institutions, choosing appropriate cases to perform extracorporeal cardiopulmonary resuscitation as soon as possible will improve the prognosis.After resuscitation, normal oxygen supply and normal pressure ventilation should be maintained, and physiological monitoring such as arterial diastolic pressure and end-tidal carbon dioxide should be used to guide post-resuscitation management.However, mild hypothermia treatment does not bring benefits to improve the prognosis.Imaging tests such as EEG, CT, and magnetic resonance imaging can assess the prognosis of nerves after resuscitation early, while neuron-specific enolase, S100 calcium binding protein, and somatosensory evoked potential have better predictive value, but lacking of enough clinical data.

Objective To explore the value of minimally invasive puncturation via the hard tunnel in decompression before craniotomy for acute subdural hematoma combined with cerebral hernia.Methods A retrospective method was adopted to analyze the clinical data of 303 patients with traumatic acute subdural hematoma combined with cerebral hernia treated from January 2004 to October 2016.There were 206 males and 97 females,with age range of 12-77 years [(43.6 ± 20.1) years].The Glasgow coma scale (GCS) was 3-5 points in 187 patients and 6-8 points in 116.The patients were divided into study group (n =199) and control group (n =104) according to the different surgical procedures.For study group,the patients were treated with disposable ventricular needle to suck out and drain the intracranial hematoma,and the skull was opened through the large craniotomy to remove the subdural hematoma.For control group,the skull was opened through the large craniotomy which was used to directly remove the subdural hematoma according to the traditional instruction.The differences between two groups were compared with regard to time from confirming the cerebral hernia to the first decompression,time of regaining consciousness after surgery,hospitalization duration and cranial cavity infection after surgery.Glasgow outcome scale (GOS) was used to evaluate the prognosis.Results The time to first decompression was 10-15 minutes [(12.5 ± 1.7)minutes] in study group and 50-75 minutes [(133.0 ± 7.9) minutes] in control group (P ＜ 0.05).Regaining consciousness within 3 days after surgery was found in 62 patients of study group and 18 of control group.Regaining consciousness at days 4-7 after surgery was found in 76 patients of study group and 22 of control group.Regaining consciousness at days 8-15 days after surgery was found in 26 patients of study group and 29 of control group.Regaining consciousness over 15 days after surgery was found in 10 patients of study group and 12 of control group.Postoperative unconsciousness including death was found in 25 patients of study group and 23 of control group (P ＜ 0.05).The hospitalization duration was (19.5 ± 1.1) days in study group and (22.8 ± 2.8) days in control group (P ＜ 0.05).No cranial cavity infection was found in study group,while cranial cavity infection occurred in one patient in control group.According to the GOS,the outcome in study group was good in 133 patients,moderate to severe disability in 41,vegetative state in 7 and death in 18,while the outcome in control group was good in 34 patients,moderate to severe disability in 47,vegetative state in 9 and death in 14 (P ＜ 0.05).Conclusion The minimally invasive puncturation via the hard tunnel to remove the hematoma is capable of reducing the intracranial pressure before craniotomy for acute subdural hematoma combined with cerebral hernia,can decrease the disability rate and hence is prioritized to clinical application.

Objective To investigate the clinical outcomes of immunocompromised (IC) children with pediatric acute respiratory distress syndrome (PARDS) in pediatric intensive care unit (PICU).Methods Fifty-six PADRS children were enrolled and the data of clinical characteristics,immunological status,complications,treatments and outcomes were collected and analyzed by using univariate and multivariate regression models.Results There were 20 children in the immunocompromised group and 36 in the control group.Immunocompromised children were older and weighted greater than the control ones (P=0.003 and P＜0.01,respectively).Peripheral blood leukocyte,neutrophil and platelet counts were significantly lower in IC group compared with control group (P=0.060,P=0.006 and P=0.023,respectively).In addition,high-frequency oscillatory ventilation (HFOV) was used less frequently in the IC group (P=0.015).The PICU mortality of the IC group was significantly higher than that of control group (P=0.003).The proportion of IC patients and the incidence of ventilator-associated lung injury differed significantly between survivors and non-survivors (P=0.003 and P=0.046,respectively).After adjusting for other confounding factors by using multivariate logistic regression analysis,IC was associated with a higher mortality (OR=6.986,95％ CI:1.812-26.930,P=0.005).Survival analysis also indicated that IC children with ARDS had lower 28-day survival rate than the non-IC children (P=0.022).Conclusions IC children with PARDS have a higher PICU mortality than children with normal immune function.Immunocompromise is an important predictor of poor outcomes in children with PARDS.

Objective To compare and analyze the primary and secondary structures and antigenic epitopes of the two allergens: Der p 2 and Der f 2. Methods The protein sequences of Der p 2 and Der f 2 were downloaded online. The primary and secondary structures of the dust mite allergens were compared and analyzed bioinformatically to determine the potential epitope and signal peptide sites. Results Both Der p 2 and Der f 2 contained 146 amino acids and 9 potential protein binding sites with a secondary structure that mainly contains [3 - sheets, and there might be signal peptides site at the 1st 17th segment of the N - terminus. B cell epitopes analysis revealed that both Der p 2 and Der f 2 have 9 potential linear B epitopes and 2 conformational B epitopes. NetMHCⅡserver prediction showed Der p 2 contains 6 high affinity sites, whereas Der f 2 0nly contains 5. Conclusion This study may lay the foundation for further research of the biochemical function of the 2 allergens and contribute to vaccine development for allergen - specific immunotherapy.

OBJECTIVE: To evaluate the bacteriostatic effect of ε-polylysine( ε-PL) on four common putrefactive bacteria including Staphylococcus aureus,Enterococcus faecalis,Pseudomonas aeruginosa,and E. coli and its effect on urine lead level. METHODS: Broth dilution method was used for the determination of the minimum inhibitory concentration( MIC) ofε-PL on the four kinds of putrefactive bacteria; the inhibitory effects of ε-PL with final mass concentration of 40. 000 mg / L on the urine sample were observed; graphite furnace atomic absorption spectrometry was used for determining the lead level in the 40. 000 mg / L( mass concentration) ε-PL solution and the urine lead level in normal healthy groups; the bacteriostatic effects of ε-PL and nitric acid were compared. RESULTS: The MIC of ε-PL on Staphylococcus aureus,Enterococcus faecalis,Pseudomonas aeruginosa,and E. coli was 40. 000 mg / L. There was no bacterial growth in the urine sample with40. 000 mg / L( mass concentration) ε-PL when urine was kept at room temperature for 24 hours to 15 days. The lead level was < 2. 0 μg / L in the 40. 000 mg / L( mass concentration) ε-PL solution. When the ε-PL with final mass concentration of 40. 000 mg / L and the nitric acid with a volume fraction of 1. 0% were respectively used as the antiseptics,the descending rates of the lead levels in the urine samples were similar,and after the urine sample was preserved for 15 days,the descending rates of the urine lead were both smaller than 10. 0% after be stored for 15 days. CONCLUSION: ε-PL can substitute nitric acid as a new natural preservative for preservation of samples for urine lead determination.

Objective To explore the advantages and disadvantages of ultrasound guided puncture microwave ablation and traditional surgical treatment of nodular goiter.Methods From January 2014 to June 2015,102 cases of nodular goiter who were treated in the Traditional Chinese Medicine Hospital of Gaozhou Affiliated to Guangzhou University of Traditional Chinese Medicine were randomly divided into two groups,51 cases in each group.Respectively by ultrasound guided puncture nodules of thyroid swollen microwave ablation (microwave ablation group) and traditional operation type removed most of the thyroid nodules (traditional surgery group) in the treatment of containing.The amount of bleeding,operation time,hospital stay,medical cost,clinical efficacy,postoperative complications and the degree of pain,and thyroid function were compared between the two groups.Results The amount of bleeding,operation time and length of hospital stay in the microwave ablation group were better than those in the traditional operation group((2.02±0.79) ml vs.(28.24±18.49) ml,(34.20 ±9.60) min vs.(75.59±25.41) min,(3.55± 1.05) d vs.(10.27±2.68) d),the medical cost of the microwave ablation group was higher than that of the traditional operation group((14 341±593) yuan vs.(5 812±970) yuan),the differences were statistically significant (t =-10.12,-10.88,-16.68,53.54;P ＜0.01).There were significant difference in terms of the postoperative pain and complications between the groups (x2=50.86,13.22;P＜0.01).The total absorption rate was 100％ in 18 months after the ablation of the nodule.There was no significant difference about postoperative residual small nodules between the two groups(P ＞0.05).Conclusion Compared with the traditional treatment,the microwave ablation treatment of nodular goiter with less complications,is a new technique of minimally invasive,beauty,safe and feasible,the exact clinical effect,and worthy of popularization and application.

Objective To study the influence of intraoperative use of saline and balanced salt solution on postoperative nerve function recovery in patients with brain trauma.Methods Totally 120 patients were randomly divided into the saline group and the balanced salt solu-tion group,and the postoperative nerve function recovery of the two groups were observed.Results The level of pH and HCO3 -24 hours af-ter operation in the saline group were lower than those in the balanced salt solution group (P <0.05),while the level of Cl - in the saline group was higer than that in the balanced salt solution group (P <0.05).The intracranial pressure and preoperative Glasgow coma score (GCS)of the two groups had no statistical significance (P =0.94).And the Glasgow coma score at 336 hours and 672 hours after opreation of the two groups were of statistical significance (P =0.00,P =0.03).The mortality of the saline group and the balanced solution group 28days after surgery were 15% and 10% respectively,and there was no significant difference between the two groups (P =0.58).Conclusion Saline resuscitation during surgery would lead to hyperchloremic acidosis as well as worse nerve function.However,the perfusion of balanced salt solution during the operation is more favorable to the recovery of neurological function.