Management protocol for emergency aneurysm craniotomy clipping in non-major COVID-19 epidemic areas in Beijing, China.

BACKGROUND: An epidemic of COVID-19 broke out in Wuhan, China, since December 2019. The ordinary medical services were hindered. However, the emergency cases, including aneurysmal subarachnoid hemorrhage (aSAH), still required timely intervention. Thus, it provoked challenges to the routine management protocol. In this study, we summarized our experience in the emergency management of aSAH (Beijing Tiantan Protocol, BTP) in Beijing, China. METHODS: Demographic, clinical, and imaging data of consecutive emergency aSAH patients who underwent craniotomy clipping during the COVID-19 epidemic season were reviewed and compared with the retrospective period last year. Subgroup analysis was further performed to assess the outcomes of different screening results and several detailed protocols. Neurological outcomes were evaluated by the modified Rankin Scale (mRS). RESULTS: A total of 127 aSAH were referred to our emergency department, and 42 (33.1%) underwent craniotomy clipping between January 20, 2020, and March 25, 2020. The incidence of preoperative hospitalized adverse events and the perioperative outcomes were similar (- 0.1, 95% CI - 1.0 to 0.8, P = 0.779) to the retrospective period last year (January 2019-March 2019). After the propensity score matching (PSM), there were still no statistical differences in prognostic parameters between the two groups. Eight (19.0%) of the 42 individuals were initially screened as preliminary undetermined COVID-19 cases, in which 2 of them underwent craniotomy clipping in the negative pressure operating room (OR). The prognosis of patients with varied COVID-19 screening results was similar (F(2, 39) = 0.393, P = 0.678). Since February 28, 12 cases (28.6%) received COVID-19 nucleic acid testing (NAT) upon admission, and all showed negative. The false-negative rate was 0.0%. The preoperative hospitalized adverse events and postoperative prognosis were still similar between patients with and without COVID-19 NAT (- 0.3, 95% CI - 1.4 to 0.9, P = 0.653). CONCLUSIONS: Our emergency surgery management protocol (BTP) is reliable for scheduling emergency aneurysm craniotomy clipping in non-major epidemic areas.

Examining the Effect of the Environment and Commuting Flow from/to Epidemic Areas on the Spread of Dengue Fever.

Environment and human mobility have been considered as two important factors that drive the outbreak and transmission of dengue fever (DF). Most studies focus on the local environment while neglecting environment of the places, especially epidemic areas that people came from or traveled to. Commuting is a major form of interactions between places. Therefore, this research generates commuting flows from mobile phone tracked data. Geographically weighted Poisson regression (GWPR) and analysis of variance (ANOVA) are used to examine the effect of commuting flows, especially those from/to epidemic areas, on DF in 2014 at the Jiedao level in Guangzhou. The results suggest that (1) commuting flows from/to epidemic areas affect the transmission of DF; (2) such effects vary in space; and (3) the spatial variation of the effects can be explained by the environment of the epidemic areas that commuters commuted from/to. These findings have important policy implications for making effective intervention strategies, especially when resources are limited.

[Pollution Characteristics of Chlorobenzenes in Organs of Fish from Typical Epidemic Areas of Schistosomiasis Prevalence].

Sixty-eight fish samples were collected from typical epidemic areas of schistosomiasis prevalence. The contents of 12 CB congeners in fish samples were measured using GC/MS technique. The results indicated that 1,3-DIC, 1,4-DIC, 1,2-DIC and HCB were the most predominant CB congeners in the samples from the studying area. The source of HCB was PCP (pentachlorophenol), which was used to control the schistosomiasis prevalence, used in study area. And DIC came from the degradation of HCB and the articles of daily use. The geometric average of CBs in muscle ranged from 2731.50 to 7811.23 ng·g-1 lipid weight, while the summarized concentration of CBs in fish gonads, brains, kidneys, livers ranged from 2557.89 to 4640.05 ng·g-1 lipid weight, 2423.18 to 3329.61 ng·g-1 lipid weight, 1628.05 to 4667.76 ng·g-1 lipid weight and 704.92 to 1086.96 ng·g-1 lipid weight, respectively. When compared to other studies in China and other countries, the concentrations of CBs in these fish samples were at a relatively high level.