Prevention and treatment system of novel coronavirus infection in medical and health institutions: experience in West China Hospital of Sichuan University.

The novel coronavirus infection broke out in Wuhan, China, in December 2019, and progressed to a global pandemic. We describe the measures taken by West China Hospital of Sichuan University to address the diagnosis, prevention and treatment of the infection.

[Analysis of Pathogens and Clinical Characteristics in 157 Cases with Infective Endocarditis].

OBJECTIVE: To analyze the clinical characteristics of infective endocarditis (IE) in culture-positive patients,so as to provide the evidences for reasonable diagnosis and treatment of IE. METHODS: We performed a retrospective study of 157 culture-positive IE cases,which were diagnosed according to modified Duke criteria for IE from Jan. 2008 to Aug. 2015. RESULTS: The average age of 157 cases of IE was 40.85 years. One hundred and one patients (64.3%) had various underlying cardiac diseases,including congenital cardiovascular diseases in 44 cases and rheumatic heart diseases in 15 cases. The main clinical manifestations were anemia (147 cases,93.6%),fever(137 cases,87.3%) and heart murmur (120 cases,76.4%). Vegetation was found in 12 cases (7.6%) with transesophageal echocardiography (TEE) but not with transthoracic echocardiography (TTE) . Culture results showed the most common causative microorganisms were Streptococci (76 cases,48.4%),with Viridans streptococci dominated in 70 cases,and Staphylococci (33 cases,21.0%) (Staphylococcus aureus dominated in 18 cases). All patients were treated with antimicrobial agents. Eighty-five patients (54.1%) received surgical intervention,of which 72 cases received valve replacement. Twenty-seven patients were cured,88 patients were markedly improved,38 patients discontinued treatment,and 4 patients died. The therapeutic efficacy of operation group was better. CONCLUSION: The clinical characteristics of IE included: the age of onset increased,congenital heart disease was the most underlying disease,and Viridians streptococci was the most popular causative microorganism. Surgical therapy can effectively improve the outcomes of IE patients.

[Clinical Analysis of 94 Patients with Neurocysticercosis in Sichuan Province].

Objective: To analyze the clinical features of neurocysticercosis（NCC） to provide evidence for clinical diagnosis and treatment of the disease. Methods: Medical records of NCC patients in the West China Hospital of Sichuan University received between January 2003 and January 2013 were reviewed retrospectively. The epidemiological data, clinical manifestations, therapeutic procedures and outcomes of the patients were analyzed. Results: A total of 94 NCC patients met the recruiting criteria, of whom 67.0%（63/94） were male, 59.6%（56/94） ranged 30-55 years old, 73.4%（69/94） had a living history in endemic regions such as Aba, Ganzi and Liangshan prefectures, 80.9%（76/94） lived in rural areas. NCC was clinically characterized by epilepsy, headache and intracranial hypertension. The positive rate for anti-T. solium antibodies by ELISA was 96.8%（91/94）, and the total positive scan rate of neuroimaging including CT and MRI was 95.7%（90/94）. In addition, 73 patients were suspected to have NCC at the first diagnosis, with a misdiagnosis rate of 22.3%（21/94）. Seventy-nine of the patients received albendazole treatmentï¼»20 mg/（kg·d）, twice per day for 10 days as one treatment course, 1-3 courses as neededï¼½. Eleven patients received praziquantel（total dose of 120-180 mg/kg, 3 times per day for 3 days as one treatment course, 1-3 courses）, and 4 received a combination of albendazole and praziquantel. Symptoms improved in 77 cases（81.9%）, but 12 of them（12/77, 15.6%） relapsed. The improvement rate of the albendazole group（6/11, 84.8%） was significantly higher than that of the praziquantel group（54.6%）（P<0.05）. Conclusion: NCC more commonly occurs in young males and lacks specific clinical manifestations. Neuroimaging combined with serum specific antibody tests is crucial for diagnosis. Albendazole has better therapeutic effects than praziquantel.

[Clinical analysis of 137 patients with visceral leishmaniasis].

OBJECTIVE: To analyze the clinical and epidemiological characteristics of visceral leishmaniasis cases in Sichuan. METHODS: The medical records of 137 patients with visceral leishmaniasis were reviewed between January 2000 and April 2012 in West China Hospital. The epidemiological data, clinical manifestations, laboratory features, diagnosis, therapeutic procedures and outcome of the patients were retrospectively analyzed. RESULTS: Eighty-eight (64.2%) out of 137 cases were the residents in the endemic area of Sichuan Province and adjacent areas, and 49 (35.8%) were non-endemic area residents with a history of visiting endemic area. Patients living in rural areas accounted for 84.7% (116/137), in town for 15.3% (21/137). Visceral leishmaniasis should be strongly suspected in a patient with prolonged fever, marked hepatosplenomegaly, lymphadenectasis, cytopenia and hypergammaglobulinemia. All patients showed positive in rk39 dipstick test, and were treated with antimony sodium gluconate. Among these patients, 86.1% (118/137) were cured by drug, 2.9% (4/137) received splenectomy, and 6.6% (9/137) relapsed. The misdiagnosis rate was 23.4% (32/137). CONCLUSION: Bone marrow smear staining and biopsy, combined with rk39 antibody detection and epidemiological history are crucial for early diagnosis and treatment of visceral leishmaniasis. Antimonials is still an effective therapeutic choice.