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Since the end of 2019,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has swept the world,bringing great harm to human society and significantly increasing the health burden.Due to stron-ger infectivity,faster transmission,and higher reinfection rate of the Omicron variant,it has now replaced the Delta variant as the main epidemic strain for both imported and local outbreaks in China.Chinese Diagnosis and treatment protocol for SARS-CoV-2 infection(10th trial version)emphasizes"strengthening the protection of key popula-tions,"which includes the increasing number of immunocompromised population.These people have a high inci-dence of severe diseases and a high fatality rate after infected with SARS-CoV-2,and belong to the high-risk popula-tions of severe or critical diseases.Moreover,due to underlying diseases,these people take immunosuppressants and other related drugs chronically.The interactions between anti-SARS-CoV-2 infection treatment drugs and origi-nal drugs are complicated,thus bring significant challenges to the treatment after the SARS-CoV-2 infection.Cur-rently,there is a lack of guidelines or consensus on the diagnosis and treatment of SARS-CoV-2 infection among im-munocompromised population.Therefore,the Guangzhou Institute of Respiratory Health and National Center for Respiratory Medicine organized experts from multiple disciplines(respiratory and critical care medicine,organ transplantation,rheumatology and immunology,hematology,infection,critical care medicine,etc.)in China.Af-ter multiple rounds of discussions,13 items of recommendations are made as the reference for peers based on evi-dence-based medical evidence,so as to provide a theoretical and practical reference for the diagnosis and treatment strategies of this population.
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Objective To explore the relationship between neonatal cord blood IgE value and their parents allergies as well as birth status . [ Methods ] The pregnant women in labor were investigated by questionnaire and detected for blood 25-hydroxy vitamin D3 .The neonatal cord blood was collected for detection of IgE in childbirth , and the birth status was traced and recorded .Statistical analysis was done on the correlative factors of umbilical cord blood IgE . [ Results] The facts that mother had history of allergic diseases(OR=1.65), neonatal birth weight was too large (OR=3.36), baby was male (OR=1.90), and born with asphyxia (OR=2.88) were all associated with the positiveness of cord blood IgE (P<0.05). [Conclusion] The allergy history of mother is a risk factor for the rise of cord blood IgE, so measures for eczema prevention should be well taken for her baby .
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Objective To explore the risk factors and the rate of HBV vertical transmission from HBsAg-positive couple to their infant.Methods 46 families who had antenatal examination at Fujian Provincial Maternal and Child Health Hospital during August 2010 and November 2011 were chosen as research object.Cord blood was sampled after delivery for HBVM and HBV-DNA quantification.Those with HBV-DNA load ≥5 × 102 copies/ml were involved in the case group while those having <5 × 102 copies/ml were chosen as controls.Results The average positive rate of neonatal cord blood HBV-DNA was 45.7% (21/46),while the positive rates of cord blood HBsAg and HBeAg were 34.8%(16/46) and 23.9% (11/46) respectively.The positive rates of maternal serum HBV-DNA and paternal serum HBV-DNA were 52.2% (24/46) and 69.6% (32/46) respectively,with the positive rate of couple serum HBeAg as 39.1% (18/46) and 32.6%(15/46) respectively.Results from univariate analysis showed that hepatitis B surface markers,serum HBeAg-positive,serum HBV-DNA positive,and serum HBV-DNA load of the couples were risk factors to the HBV vertical transmission(x2=8.731,8.414,8.932,9.663,10.823,3.962,13.638,36.501 ;P<0.05).Data from the multivariate analysis showed that maternal serum HBV-DNA positive and paternal serum HBV-DNA load were risk factors to the HBV vertical transmission [OR= 17.6 (1.3-238.4) ;OR = 3.5 (1.6-7.6)].Serum HBV-DNA loads of the couples were positively correlated with the cord blood HBV-DNA load,while the load levels of the couple' s serum HBV-DNA were higher than cord blood HBV-DNA.There appeared dose-response relationship between couple' s serum HBV-DNA load level and the cord blood HBV-DNA load level.Results from the analysis of ROC curve showed that both maternal serum HBV-DNA load level (103 copies/ml) and paternal serum HBV-DNA load level (104 copies/ml) were demarcation points to better forecast the occurrence of vertical transmission of HBV,because there showed higher sensitivity and specificity for the forecasting process.Neonatal outcomes showed no significant difference between the case group and the control group.The negative conversion rate became 15.0% (3/20) when the HBV-DNA positive infants were followed up for 7 months.Conclusion Both maternal serum HBV-DNA positive and paternal serum HBV-DNA load were risk factors of HBV vertical transmission.When the maternal serum HBV-DNA load appeared >103 copies/ml and paternal serum HBV-DNA load > 104 copies/ml,the rate of HBV vertical transmission would increase.
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<p><b>OBJECTIVE</b>To explore the effect of self-made L-shaped reductors combined with pedicle screw internal fixation for the treatment of thoracolumbar bursting fractures.</p><p><b>METHODS</b>From Mar. 2003 to Oct. 2006, a total of 34 patients with thoracolumbar bursting fractures were treated. Among the patients, 26 patients were male and 8 patients were female, with an average age of 42 years (ranged from 18 to 67 years). The course of injury ranged from 6 hours to 7 days. The site of fractures: 3 patients in T11, 9 patients in T12, 15 patients in L1, 7 patients in L2. Preoperative CT showed that posterior wall of the fractured vertebral body were incomplete, bone broke into the spinal canal and compressed epithet dural sac. All the patients had symptoms of varying degrees of nerve injury. The posterior median approach was adopted, and self-made L-shaped reductors were used to press and restore the fractured bones that intruding to vertebral canal through the anterior of vertebral canal, then posterolateral fusion was made. Based on postoperative X-ray and CT inspection the effects were observed by injured vertebral height, cobbs angle, spinal canal stenosis, and symptoms of recovery.</p><p><b>RESULTS</b>All the patients were followed-up with an average of 2 years. The mean anterior and posterior vertebral height increased to normal as (95.23 +/- 1.90)% and (98.37 +/- 1.45)% respectively, which were higher than those of per-operation. The post-operative average Cobb angle was (4.93 +/- 1.41) degrees, which was smaller than that of pre-operation. Postoperative CT showed that the average ratio of protruded bones to the spinal canal anteroposterior diameter was (6.77 +/- 1.57)%, which was smaller than that of pre-operation. All of neurological functions were improved over one grade.</p><p><b>CONCLUSION</b>L-shaped reductors combined with pedicle screw internal fixation for the treatment of thoracolumbar bursting fractures has many advantages of simple works, good reduction, fixed securely and better results, and so on.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Bone Screws , Follow-Up Studies , Fracture Fixation, Internal , Methods , Lumbar Vertebrae , Diagnostic Imaging , Wounds and Injuries , General Surgery , Spinal Fractures , Diagnostic Imaging , General Surgery , Thoracic Vertebrae , Diagnostic Imaging , Wounds and Injuries , General Surgery , Tomography, X-Ray ComputedABSTRACT
<p><b>OBJECTIVE</b>To observe the association between melatonin (MLT) secretion and blood pressure changes during 24 hours in hypertensive patients (HPT) with (dipping) or without (non-dipping) night time blood pressure reduction.</p><p><b>METHODS</b>The 24-hour blood pressure and urine 6-SMT (6-sulfatoxymelatonin, metabolism product of MLT in urine) in the daytime and nighttime were measured in normal control subjects (n = 20), non-dipping HPT group (n = 32) and dipping HPT group (n = 36).</p><p><b>RESULTS</b>As expected, blood pressure reduction during the night was significantly lower in non-dipping HPT group compared to control and dipping HPT groups. Nighttime 6-SMT was significantly higher than daytime 6-SMT in all groups and nighttime urine 6-SMT levels and ratio of nighttime/daytime urine 6-SMT levels were significantly lower in non-dipping HPT group compared to control and dipping HPT groups (all P < 0.01). Moreover, ratio of nighttime/daytime urine 6-SMT levels are positively correlated blood pressure reduction during nighttime (P < 0.05) in all groups.</p><p><b>CONCLUSIONS</b>Circadian rhythm of MLT secretion is maintained but nighttime MLT secretion was significantly reduced and related to disorders of circadian rhythm of blood pressure in non-dipping HPT group.</p>