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Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.
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OBJECTIVE:To optimize the formulation and technology of poly(lactide-co-glycolide)(PLGA)microspheres con-taining total alkaloids of Panzeria alaschanica,and to prepare microspheres and conduct quality investigation. METHODS:PLGA microspheres containing total alkaloids of P. alaschanica (PTPM) was prepared by double emulsion-solvent evaporation method. The formulation of microspheres was optimized by L9(34) orthogonal design using mass concentration of PLGA,PVA concentra-tion,ratio of water phase to oil phase as factor,drug-loading amount,encapsulation efficiency,yield as index. The morphology, particle size and drug release of microspheres were all investigated. RESULTS:The optimal formulation was as follows as the mass concentration of PLGA 200 mg/ml,the concentration of PVA 2%,and the water phase-oil phase ratio 1:5. In validation test,aver-age encapsulation efficiency was(83.2±2.4)%,average drug-loading amount(4.16±0.17)%,average yield(86.7±3.6)%,and comprehensive score (95.7 ± 4.4)%;all RSDs were lower than 5.0%(n=3). Prepared microspheres were spherical with smooth surface and uniform particle size. The average particle size was(22.3±2.4)μm and accumulative release rate of 24 h was(82.3± 3.5)%,which conformed to first-order release model(r=0.972 4). CONCLUSIONS:Optimized technology is stable. Prepared mi-crospheres show good sustained-release property,and fit to quality requirements.
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Objective To investigate the epidemiological characteristics and risk factors of clonorchiasis of hospital patients in Heilongjiang Province,so as to provide the evidence for formulating the control and prevention strategies. Methods A total of 2 359 suspected patients from human parasitic disease research institute of Harbin medical university were investigated. Total?ly 6 718 stool samples and 2 359 serum samples were tested by Kato?Katz technique and the enzyme linked immune method re?spectively. Meanwhile,the information of the patients was collected by questionnaires. Results Totally 513 suspected patients were infected with Clonorchis sinensis. The infection rate of the suspected patients was higher in the ≥29 group(P<0.05), and the infection rate and positive rate of blood tests of the rural suspected patients were both higher than those of the urban sus?pected patients(both P<0.05). The habit of eating raw fish and shrimp was the risk factor of clonorchiasis. Conclusion Clo?norchiasis is one of the main food?borne parasitic diseases in Heilongjiang Province. The habit of eating raw fish and shrimp is the risk factor of clonorchiasis.
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Objective To investigate the effect of trabeculectomy combined with segmental iridectomy, mitomycin C (MMC) and viscoelastic agents usage on the treatment of glaucoma secondary in uveitis. Methods According to the age, degree of inflammation and the condition of Tenon capsule of patients, differ-ent concentration of MMC (0.25-0.33 mg/ml) was used during the operation, with separation of the anterior and posterior synechia, resection of pupillary organization membrane using viscoelastic agents. Segmental iridec-tomy and releasable sutures were also performed on the patients. The visual acuity of preoperation and postoper-ation, intraocular pressure, inflammation and the complication were record. Results Forty-two eyes of 38 cases with glaucoma secondary in uveitis were studied, the mean follow-up time was (12.01±3.56) months. The postoperative visual acuity improved in 14 eyes, didn't change in 28 eyes. The postoperative inflammation of anterior chamber disappeared in 35 eyes, relieved in 7 eyes. And the average postoperative intraocular pres-sure (15.20± 4.64) mmHg was significantly lower than the preoperative intraocular pressure (38.37±12.93) mmHg (t = 8.255, P = 0.000). The total success rate was 92.9%. There were no severe complication. Conclusion Trabeculeetomy combined with MMC, viscoelastic agents usage, separation of anterior and poste-rior syneehia, segmental iridectomy and releasable suture could increase the success rate of operation on pa tients with glaucoma secondary in uveitis, decrease the complication and inflammation reaction of operation, and the recurrence of uveitis.
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OBJECTIVE To survey the distribution of class Ⅰ integron in extended-spectrum beta-lactamases(ESBLs)-producing Escherichia coli and Klebsiella pneumoniae and its contribution in horizontal transfer of ESBLs genes.METHODS The presence of class Ⅰ integron among 230 ESBLs-producers and 197 non-ESBLs-producers of E.coli and K.pneumoniae were detected by PCR.The correlation and co-transfer between integron and genes coding for SHV,CTX and TEM were studied. RESULTS One hundred and thirty-seven(59.6%) isolates were positive for intⅠ gene among ESBLs-producers,contrasted to 48(24.4%) in non-ESBLs-producers(P
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Objective To explore the quality of life (QOL) for the patients with chronic hepatitis B (CHB). And the intervention effect of anti-viral therapy on QOL in patients with CHB was investigated. Methods A cross-sectional study based on 212 patients with CHB was carried out in the department of infectious diseases, Renmin Hospital of Wuhan University, using SF-36 questionnaire, special hepatitis questionnaire and medical coping modes questionnaire (MCMQ) during 2003 to 2004. Results Compared with healthy controls, patients with CHB had lower QOL on all scales of the SF-36(P0.05). The reduction in QOL was directly associated with age, the scores of special hepatitis questionnaire, confrontation and resignation in MCMQ (P
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OBJECTIVE To determine the drug resistance phenotype and genotype of plasmid-mediated AmpC ?-lactamase in Klebsiella pneumoniae isolated from Harbin.METHODS Isolates of K.pneumoniae with an inhibition ring to cefoxitin of ≤18 mm diameter were used.Antimicrobial susceptibilities were determined by disc diffusion method.AmpC genes were detected by PCR with six pairs of primers.RESULTS Sixty-three isolates had an inhibition ring to cefoxitin of ≤18 mm diameter and 26(11.3%)were detected to be AmpC-producing in a total of 231 clinical isolates of K.pneumoniae.Seventy-six percent,70.2%,53.8%,50.5%,57.7%,38.5% and 7.7% of AmpC-producers were resistant to cefoxitin,cefotaxime,ceftazidime,amoxicillin/clavulanic cid,ciprofloxacin,amikacin and imipenem,respectively.ACT,DHA and CIT types of AmpC beta-lactamase were detected in 13,8 and 5 isolates,respectively.No ACC,MOX and FOX were detected.CONCLUSIONS The AmpC ?-lactamase in Harbin is mainly in the types of ACT,DHA and CIT.AmpC-producing K.pneumoniae shows decreased susceptibilities to cefoxitin and third generation cephalosporins.