烧伤科在抗击新型冠状病毒肺炎疫情中的优势及作用

自2019年12月新型冠状病毒肺炎疫情在武汉出现并蔓延以来,武汉大学同仁医院暨武汉市第三医院烧伤科发挥其在重症监护、脏器衰竭救治与生命支持、多学科团队作战及灾害救援等方面的学科优势及经验优势。疫情期间,武汉大学同仁医院暨武汉市第三医院被定为新型冠状病毒肺炎定点收治医院,作为湖北省唯一保留烧伤救治工作的科室,在派出大批医务人员参与抗击新型冠状病毒肺炎的同时,还接管了全院其他专科无法出院的所有危重症患者。在圆满完成抗击疫情及烧伤救治工作的同时,烧伤患者、陪护家属及医务人员均未发生院内新型冠状病毒感染,较好地发挥了国家重点烧伤专科的优势与作用。     

新型冠状病毒肺炎防控期间上海市烧伤科临床质量控制工作的指导性意见(第一版)

正时值全国上下抗击新型冠状病毒肺炎疫情之际,国家及上海市卫生健康委员会下发多项疫情防控文件,指导各医疗单位临床执业工作,上海市烧伤科临床质量控制中心遵从国家及上海市上级主管部门相关管理之规定,结合烧伤科临床工作实际情况,征求相关专家委员建议意见后,对上海市烧伤科专科及开展烧伤科门诊的医疗单位在新型冠状病毒肺     

新型冠状病毒肺炎疫区烧伤与创面诊疗工作建议

湖北省及武汉市作为新型冠状病毒肺炎患者最集中的疫区,疫情高峰期,几乎所有医院绝大部分医务人员都投入到抗击疫情中,普通诊疗基本停止。烧伤、创伤及伴基础疾病的各类慢性创面如糖尿病足等治疗难度较大,并有可能危及生命。如何在新型冠状病毒肺炎疫情防控期间做好这类患者救治,是亟待规范和完善的紧要任务。湖北省医学会烧伤与创面修复分会组织部分省内专家,结合相关指导文件及临床工作经验,对疫区烧伤与创面修复外科工作提出了推荐意见。主要内容包括疫区烧伤与创面修复外科工作中的人员防护、诊疗场所消毒、门急诊与住院管理、专科手术管理、人员管理、分级诊疗及转诊管理等。希望通过指导疫情期间烧伤与创面修复临床工作,避免不规范诊疗所致疫情扩散,保证患者及医务人员安全。     

新型冠状病毒肺炎疫情期间儿童烧伤防治的探讨

我国新型冠状病毒肺炎疫情的快速上升趋势得到控制,但其他国家确诊和死亡病例不断增加,境外输入病例正在增多,各地中小学陆续开学,疫情防控仍不容松懈。本文结合新型冠状病毒肺炎疫情防控期间居家、出行、工作、学习等行为模式改变带来的特殊性,对儿童烧伤的预防、急救和居家护理,以及居家功能康复等进行探讨,以供广大医护工作者参考。     

北京市烧伤专科应对新型冠状病毒肺炎疫情的防控建议

北京市因常住人口多(2 153.6万)、外来人口比例高(34.6%)、返京人口流量大、入境人员密集等原因,新型冠状病毒肺炎疫情的防控形势较湖北省以外的其他地区更加严峻。解放军总医院第四医学中心烧伤整形科,依据新型冠状病毒肺炎疫情防控相关指导文件,结合北京市的特殊性和烧伤专科工作特点,如:烧伤创面暴露、常因行动不便陪诊家属多、小儿烧伤易合并发热以及需要反复门诊换药等,制定和实施了网络预约挂号、预检分诊、诊疗分区、车内等候-电话叫号和微信指导患者居家换药、入院筛查、设置新入院患者过渡隔离病房、停止探视、手术分类管理、加强通风和消毒等系列措施,并引导医务人员正确认识北京市疫情防控工作的特殊性,重视医务人员相互防护,实施工作人员分区、分时段进餐等,形成了北京市烧伤专科应对新型冠状病毒肺炎疫情的防控建议。     

新型冠状病毒2019-nCoV核酸检测试剂临床试验要求解析

正我国新型冠状病毒感染的肺炎病例首先在湖北省武汉市发现。新型冠状病毒属于巢病毒目冠状病毒科正冠状病毒亚科,基因组为单股正链RNA。该病毒的传染源主要为新型冠状病毒感染的患者,传播途径主要为呼吸道飞沫和密切接触传播。人群普遍易感。疫情暴发后我国党和政府高度重视,在较短时间内完成     

新型冠状病毒肺炎防控现场消毒技术研究

新型冠状病毒肺炎(COVID-19)疫情对全球造成了严重影响,在没有疫苗和特效治疗药物的情况下,消毒成为阻断病毒传播的重要技术手段。本文通过对新型冠状病毒的相关特性分析,研究了针对新型冠状病毒肺炎的一系列消毒技术。在新型冠状病毒肺炎疫情暴发期间,济南市第二疾病预防控制中心对一小区新型冠状病毒肺炎待排查病例住家进行了现场消毒,分别通过消毒准备、消毒前采样、现场消毒、消毒后采样和消毒效果评价等过程,验证了所研究的消毒技术的有效性。对消毒前后的采样数据进行对比,结果显示空气、物体表面细菌菌落总数的杀灭率≥90%,且消毒后均未检出新型冠状病毒,结果表明该消毒技术的消毒效果符合标准。最后,通过对错误的消毒方式和过度消毒的危害进行分析,强调了"科学消毒、精准消毒"的重要性,对疫情防控工作具有较好的指导价值。     

2019新型冠状病毒及其感染性肺炎

2019年12月中旬我国湖北省武汉市人群中出现了2019新型冠状病毒(2019-nCoV)感染性肺炎暴发流行,疫情迅速蔓延并播散至全国各个地区以及亚洲、欧洲、大洋州和北美13个国家。为了准确和深入了解2019-nCoV生物学性状、流行特征、致病性、免疫性、微生物学检查和公众防护措施,我们在最新有关文献和国家《新型冠状病毒感染的肺炎诊疗方案》最新版本的基础上,对2019-nCoV及其感染性肺炎进行综述。     

新型冠状病毒肺炎疫情期间生物样本库工作流程管理实践

正根据国家卫生健康委2020年第1号文件,新型冠状病毒感染的肺炎已纳入《中华人民共和国传染病防治法》规定的乙类传染病,并采取甲类传染病的预防、控制措施。经过全民鏖战数月,这场阻击新冠肺炎的战"疫"取得初步成功。随着疫情逐渐被控制,各地医院也开始陆续全面复工。生物样本库作为临床研究的重要基石,为确保疫情防控和科研服务两不误,在疫情期间样本收集相关工作须以控制新型冠状病毒肺炎疫情为首要原则,样本捐献者和研究人员安全应放在首位。因此,做好工作流程管理是各大研究型医院生物样本库的首要任务。结合我院生物样本库在疫情期间的病毒防治工作的实际管理总结以下经验。     

新型冠状病毒肺炎疫情初期在华留学生应对策略和心理适应

新型冠状病毒肺炎病毒(COVID-19,简称"新冠病毒").新型冠状病毒肺炎疫情爆发突然、蔓延速度快,给大众的生活方式和心理健康带来极大的负面影响.已有的研究表明公众在新型冠状病毒肺炎期间或多或少地经历了心理问题.齐晔等[1]考察了公众对新型冠状病毒肺炎的认知,他们发现政府和社会针对公众的大力宣传取得了良好效果.公众对...     

新型冠状病毒肺炎武汉一线支援队华西医疗队驻地管理

随着新型冠状病毒肺炎(简称新冠肺炎)(COVID-19)确诊病例的增加,武汉疫情防控难度增大,四川大学华西医院再次派出第三批医疗队到武汉支援。为了确保医疗队员在紧张繁重的新冠肺炎救治工作后有一个安全安心的休息环境,做好医疗队驻地的全方位管理至关重要。现总结华西医疗队驻地的管理经验,为抗击疫情的支援医疗团队提供参考。     

Clinical characteristics and outcomes of COVID-19 patients with gastrointestinal symptoms admitted to Jianghan Fangcang Shelter Hospital in Wuhan,China

Coronavirus disease 2019 (COVID-19) is a health emergency worldwide, and gastrointestinal (GI) symptoms are increasingly reported in COVID-19 patients. However, sample size was small and the incidence of GI symptoms in patients was variable across studies, and the correlation between these symptoms and clinical outcomes remains incompletely understood. The objective of this study is to compare clinical characteristics and outcomes between patients with and without GI symptoms admitted to Jianghan Fangcang Shelter Hospital in Wuhan. This retrospective study recruited 1320 COVID-19 patients admitted to hospital from 5 February 2020 to 9 March 2020. On the basis of the presence of GI symptoms, the sample was divided into a GI group (n = 192) and a non-GI group (n = 1128). The three most common GI symptoms were diarrhea (8.1%), anorexia (4.7%), and nausea and vomiting (4.3%). The rate of clinical deterioration was significantly higher in the GI group than in the non-GI group (15.6% vs. 10.1%, P = .032). GI symptoms (P = .045), male gender P < .001), and increased C-reactive protein (P = .008) were independent risk factors for clinical worsening. This study demonstrated that the rate of clinical deterioration was significantly higher in the GI group. Furthermore, potential risk factors for developing GI symptoms, male gender, and increased C-reactive protein can help clinicians predict clinical outcomes in COVID-19 patients.     

The application of Temporary Ark Hospitals in controlling COVID-19 spread: The experiences of one Temporary Ark Hospital,Wuhan, China

Coronavirus disease 2019 (COVID-19) had its evolution in Wuhan, Hubei Province, China, and now it has spread around the world, resulting in a large number of deaths. Temporary Ark hospitals (TAHs) have played an important role in controlling the spread of the epidemic in the city of Wuhan. Taking one TAH with 800 beds as an example, we summarized details of the layout, setting, working mode of medical staff, patient management, admission standards, discharge standards, and standards for transferring to another hospital, hospital operation, and so on. Over the period of operation, a total of 1124 patients were admitted for treatment. Of these, 833 patients were cured and discharged from the hospital and 291 patients were transferred to other designated hospitals, owing to aggravation of their condition. The achievement was to have zero infection for medical staff, zero in-hospital deaths among admitted patients, and zero readmission for discharged patients. The rapid deployment of TAH provided a suitable place for treating mild/moderate or no asymptomatic COVID-19 patients, which successfully helped to control the infection in Wuhan. The successful model of TAH would rapidly and effectively control the spread of COVID-19 in other cities.     

武汉社区腹泻病人粪便中致病菌的构成与耐药性研究

目的了解夏秋季武汉社区引起腹泻病原菌的流行性及耐药状况。方法收集2004年7月1日至10月31日武汉社区4所大型医院4536份门诊腹泻病人粪便标本进行鉴定及药敏试验;REP-PCR对主要致病菌进行基因分型。结果4536份粪便标本中,分离出非伤寒沙门菌64株（1.4%）,志贺菌29株（0.6%）,致病性大肠杆菌33株（0.7%）。其中主要致病菌是鼠伤寒沙门菌33株（52%）,D群志贺菌16株（55%）。挑选13种抗菌药物进行体外敏感试验,并将分离的致病菌对这13种抗生素的耐药率﹑敏感率﹑中介率进行比较,其中非伤寒沙门菌对喹诺酮类的耐药率较其他两种要高,但对第三代头孢的敏感性较强。分离的3种致病菌在第三代头孢抗生素的作用中对头孢他啶的敏感性最强。32株鼠伤寒沙门菌基因分型为9种,16株D群志贺菌基因分型为7种。结论武汉社区内感染性腹泻的致病菌主要以非伤寒沙门菌﹑致病性大肠杆菌和志贺菌为主,其中非伤寒沙门菌占了51%,基因分型提示有社区流行趋势,而且这些致病菌对肠道杆菌常用抗生素的耐药性较为严重。本次调查结果对该社区临床用药起到一定的提示作用。     

Risk factors related to the severity of COVID-19 in Wuhan

Objective: To evaluate the characteristics at admission of patients with moderate COVID-19 in Wuhan and to explore risk factors associated with the severe prognosis of the disease for prognostic prediction.Methods: In this retrospective study, moderate and severe disease was defined according to the report of the WHO-China Joint Mission on COVID-19. Clinical characteristics and laboratory findings of 172 patients with laboratory-confirmed moderate COVID-19 were collected when they were admitted to the Cancer Center of Wuhan Union Hospital between February 13, 2020 and February 25, 2020. This cohort was followed to March 14, 2020. The outcomes, being discharged as mild cases or developing into severe cases, were categorized into two groups. The data were compared and analyzed with univariate logistic regression to identify the features that differed significantly between the two groups. Based on machine learning algorithms, a further feature selection procedure was performed to identify the features that can contribute the most to the prediction of disease severity.Results: Of the 172 patients, 112 were discharged as mild cases, and 60 developed into severe cases. Four clinical characteristics and 18 laboratory findings showed significant differences between the two groups in the statistical test (P<0.01) and univariate logistic regression analysis (P<0.01). In the further feature selection procedure, six features were chosen to obtain the best performance in discriminating the two groups with a linear kernel support vector machine. The mean accuracy was 91.38%, with a sensitivity of 0.90 and a specificity of 0.94. The six features included interleukin-6, high-sensitivity cardiac troponin I, procalcitonin, high-sensitivity C-reactive protein, chest distress and calcium level.Conclusions: With the data collected at admission, the combination of one clinical characteristic and five laboratory findings contributed the most to the discrimination between the two groups with a linear kernel support vector machine classifier. These factors may be risk factors that can be used to perform a prognostic prediction regarding the severity of the disease for patients with moderate COVID-19 in the early stage of the disease.     

Hospital treatment of the encopretic child

Encopresis, or fecal soiling, is a troublesome disorder of children that can be quite difficult to manage. It is often a symptom of a disturbed family. This article describes a successful treatment method that is carried out in a hospital setting. In the author's experience, effective treatment requires a combination of behavior modification techniques with individual, group, occupational, and family therapy, in a hospital setting.