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简介：AbstractBackground:To date, there is no effective medicine to treat coronavirus disease 2019 (COVID-19), and the antiviral efficacy of arbidol in the treatment for COVID-19 remained equivocal and controversial. The purpose of this study was to evaluate the efficacy and safety of arbidol tablets in the treatment of COVID-19.Methods:This was a prospective, open-label, controlled and multicenter investigator-initiated trial involving adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients were stratified 1:2 to either standard-of-care (SOC) or SOC plus arbidol tablets (oral administration of 200 mg per time, three times a day for 14 days). The primary endpoint was negative conversion of SARS-CoV-2 within the first week. The rates and 95% confidential intervals were calculated for each variable.Results:A total of 99 patients with laboratory-confirmed SARS-CoV-2 infection were enrolled; 66 were assigned to the SOC plus arbidol tablets group, and 33 to the SOC group. The negative conversion rate of SARS-CoV-2 within the first week in patients receiving arbidol tablets was significantly higher than that of the SOC group (70.3% [45/64] vs. 42.4% [14/33]; difference of conversion rate 27.9%; 95% confidence interval [CI], 7.7%-48.1%; P = 0.008). Compared to those in the SOC group, patients receiving arbidol tablets had a shorter duration of clinical recovery (median 7.0 days vs. 12.0 days; hazard ratio [HR]: 1.877, 95% CI: 1.151-3.060, P = 0.006), symptom of fever (median 3.0 days vs. 12.0 days; HR: 18.990, 95% CI: 5.350-67.410, P < 0.001), as well as hospitalization (median 12.5 days vs. 20.0 days; P < 0.001). Moreover, the addition of arbidol tablets to SOC led to more rapid normalization of declined blood lymphocytes (median 10.0 days vs. 14.5 days; P > 0.05). The most common adverse event in the arbidol tablets group was the elevation of transaminase (5/200, 2.5%), and no one withdrew from the study due to adverse events or disease progression.Conclusions:SOC plus arbidol tablets significantly increase the negative conversion rate of SARS-CoV-2 within the first week and accelerate the recovery of COVID-19 patients. During the treatment with arbidol tablets, we find no significant serious adverse events.Trial registration:Chinese Clinical Trial Registry, NCT04260594, www.clinicaltrials.gov/ct2/show/NCT04260594?term= NCT04260594&draw=2&rank=1

简介：摘要由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019年冠状病毒疾病（COVID-19）已经在全球多个国家引起大流行，该病毒传染性强、致死率高，部分变异株在病毒传播性、致病性和免疫原性等多方面发生变化。无症状感染和有症状感染的COVID-19患者在免疫特征上存在异质性；不同年龄阶段的COVID-19患者的临床表现也不尽相同。目前无治疗COVID-19的特效药物，疫情控制需依赖新型冠状病毒疫苗的接种，如核酸疫苗、灭活疫苗、病毒载体疫苗、蛋白质疫苗等。本文通过对新型冠状病毒的变异、临床表现、治疗和疫苗等方面文献的复习，展现目前相关研究的进展。

简介：摘要目的观察走罐治疗痤疮的疗效。方法用背部走罐法治疗19例痤疮患者,20天后观察疗效。结果总有效率为89.5%。结论走罐法对痤疮有明显疗效。

简介：摘要Coronavirus disease (COVID-19), the infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported on December 31, 2019. Because it has only been studied for just over three months, our understanding of this disease is still incomplete, particularly regarding its sequelae and long-term outcomes. Moreover, very little has been written about the rehabilitation needs of patients with COVID-19 after discharge from acute care. The objective of this report is to answer the question " What rehabilitation services do survivors of COVID-19 require？" The question was asked within the context of a subacute hospital delivering geriatric inpatient and outpatient rehabilitation services. Three areas relevant to rehabilitation after COVID-19 were identified. First, details of how patients may present have been summarized, including comorbidities, complications from an intensive care unit stay with or without intubation, and the effects of the virus on multiple body systems, including those pertaining to cardiac, neurological, cognitive, and mental health. Second, I have suggested procedures regarding the design of inpatient rehabilitation units for COVID-19 survivors, staffing issues, and considerations for outpatient rehabilitation. Third, guidelines for rehabilitation (physiotherapy, occupational therapy, speech-language pathology) following COVID-19 have been proposed with respect to recovery of the respiratory system as well as recovery of mobility and function. A thorough assessment and an individualized, progressive treatment plan which focuses on function, disability, and return to participation in society will help each patient to maximize their function and quality of life. Careful consideration of the rehabilitation environment will ensure that all patients recover as completely as possible.

简介：AbstractCoronavirus disease 2019 (COVID-19) is a newly emerged infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The number of COVID-19 cases is continuously increasing and no effective drugs or vaccines are currently available. Accurate and efficient diagnostic testing methods are desperately needed for the detection of SARS-CoV-2 and antiviral antibodies in infected individuals. Various assay techniques, including nucleic acid tests [eg, polymerase chain reaction (PCR), reverse transcription-PCR, real-time loop-mediated isothermal amplification, and CRISPR-Cas-based detection], serological tests [eg, immunoglobulin (Ig)A, IgM/G], imaging tests (eg, computed tomography and positron-emission tomography), and nanoparticle-based detections have been reported for COVID-19 diagnosis. This review aims to present the current diagnostic tools for SARS-CoV-2 and their performance characteristics to inform the appropriate selection of diagnostic and surveillance technologies at optimal testing times. We also describe the advantages of detection using combined nucleic acid and imaging tests, or serological testing and point-of-care diagnostics. Developing reliable protein biomarkers targeting the conserved proteins of SARS-CoV-2 rather than IgA, IgM, or IgG would be useful to manage SARS-CoV-2.

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简介：AbstractSince the outbreak of the novel coronavirus in Wuhan, China, as obstetricians, we also face great challenges. We need to identify pregnant patients with 2019 coronavirus disease infection timely, and give them appropriate treatment in order to obtain a good maternal and infant prognosis. Here, we would like to share a case and provide some suggestions on how to screen, diagnose and treat pregnant women with 2019 coronavirus disease infection during the outbreak.

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简介：AbstractIntroduction:The transmission pathways of coronavirus disease 2019 (COVID-19) remain not completely clear. In this case study the test for the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pharyngeal swab and anal swab were compared.Case presentation:A 3-month-old girl was admitted to our hospital with COVID-19. Her parents had both been diagnosed with COVID-19. The results of pharyngeal swab and anal swab of the little girl were recorded and compared during the course of the disease. The oropharyngeal specimen showed negative result for SARS-CoV-2 on the 14th day after onset of the illness. However, the anal swab was still positive for SARS-CoV-2 on the 28th day after the onset of the illness.Conclusion:The possibility of fecal-oral transmission of COVID-19 should be assessed. Personal hygiene during home quarantine merits considerable attention.

简介：摘要目的由胎盘前置状态中期引产患者的临床记录，探讨临床上处理胎盘前置状态中期引产患者的对策和方法。方法根据我院从某年某月到某年某月时间段内所收治的56例胎盘前置状态中期引产患者的临床资料，对其进行回顾性分析。结果56例患者中，有6例完全性胎盘前置状态，有30例部分性胎盘前置状态，另20例为边缘性胎盘前置状态；完全性胎盘前置状态患者中有4例因产前出血量较大，采取剖宫引产，产后患者出血小于400ml；另52例患者采取米非司酮配伍依沙丫啶引产方式，产后出血量平均386ml。结论在进行胎盘前置状态中期引产时，医生应根据患者的不同情况采取不同的引产措施。米非司酮配伍依沙丫啶引产法对于部分性和边缘性前置胎盘状态患者较为有效，副作用小，出血量小，值得在临床上推广。

简介：摘要目的探讨肺动脉吊带患儿的临床特点及手术治疗的早中期效果。方法收集2009年1月至2017年12月上海交通大学附属儿童医院心胸外科收治的52例肺动脉吊带患儿的相关资料。其中，男26例，女26例；年龄为(17.7±25.6)个月，年龄范围为3个月至11岁；体重为(9.6±5.1)kg，体重范围为3~32 kg。52例患儿均有不同程度的气管狭窄，26例同时合并其他先天性心脏病。41例患儿Ⅰ期行非体外循环下左肺动脉重建术，9例患儿Ⅰ期行体外循环下左肺动脉重建术，2例患儿Ⅰ期行体外循环下左肺动脉重建术+滑动气管成形术。对所有患儿按照两种方式分组研究，①将术中行气管干预的5例患儿作为气管干预组(干预组)，将未行气管干预的47例患儿作为气管为干预组(未干预组)；②将术中建立体外循环的13例患儿作为体外循环组(循环组)，将未建立体外循环的39例患儿作为非体外循环组(无循环组)。评估比较干预组与未干预组患儿气管狭窄指数；比较循环组和无循环组患儿术后机械通气时间、监护室时间及住院时间。结果所有患儿中，41例患儿Ⅰ期行非体外循环下左肺动脉重建术；1例手术失败，术后12 d Ⅱ期行左肺动脉重建+滑动气管成形术，术后撤机困难，家长放弃后死亡；1例术后因多次呼吸机撤机失败，行气管内支架植入术，术后恢复良好；1例患儿术后随访11个月，因气管狭窄加重，反复肺炎发作住院再次入院行滑动气管成形术，术后恢复好。9例患儿Ⅰ期行体外循环下左肺动脉重建术，术后死亡2例。2例患儿Ⅰ期行体外循环下左肺动脉重建术+滑动气管成形术，手术均顺利完成。18例同期矫治合并的其他先天性心脏病；1例同期纠治膈膨升。死亡3例，存活患儿出院后随访时间范围为2~10年，呼吸道症状均减轻或消失。气管狭窄指数在干预组和未干预组患儿间的差异具有统计学意义(P<0.05)。术后机械通气时间、监护室时间、住院时间在循环组和无循环组患儿间的差异具有统计学意义(P<0.05)。结论肺动脉吊带合并轻中度气管狭窄首选非体外循环下左肺动脉重建术，合并重度气管狭窄或者严重先天性心脏病可在体外循环下Ⅰ期行左肺动脉重建术+气管成形术或先天性心脏病矫治术。

简介：摘要目的探讨音乐疗法在中期妊娠引产中的作用与效果。方法将引产妇随机分为实验组和观察组，对照组采用产科常规护理，实验组在常规护理的基础上使用音乐疗法。观察指标为疼痛评级、总引产程、产后出血量、心率及血压等内容。结果实验组疼痛评级比观察组低，产后出血量比观察组少，清宫率低，心率、收缩压和舒服压均比观察组趋于平稳，P＜0.05，差异具有统计学意义；实验组总产程时间比观察组短，但P＞0.05，差异无统计学意义。结论音乐疗法不仅能缓解疼痛，减轻焦虑，还有使心率、血压等生命体征得到良性调节。

简介：摘要分析1例中期妊娠合并子宫静脉窦的护理。护理重点为做好病人的安全及心理护理，并做好各项术前准备，加强病情观察，重视病人主诉，预防各项并发症的发生。经过治疗和护理，患者平安出院。

简介：摘要中期因子作为一种肝素结合生长因子，主要作用于神经系统、癌症以及炎症反应，参与多种自身免疫炎症性疾病的发生、发展。该文就中期因子在肾脏缺血-再灌注损伤、新月体型肾小球肾炎、狼疮性肾炎、毛细血管内增生性肾小球肾炎和紫癜性肾炎等肾脏疾病中的作用进行综述。

简介：摘要：目的：研究中期孕妇开展产科门诊护理指导的效果。方法：选择180例中期孕妇，观察组予以产科门诊护理指导，将常见产检应用于对照组孕妇中。结果：对比对照组，观察组明显改善了焦虑情绪状态、护理满意度(P

简介：摘要目的比较杂交和冷冻象鼻（FET）技术治疗DeBakeyⅠ型主动脉夹层的早中期结果。方法回顾性分析2010年1月~2016年12月阜外医院血管外科中心诊治的937例DeBakeyⅠ型主动脉夹层患者的临床资料。815例（86.9%）患者行常规全弓替换+ FET植入术（FET组）；122例（13.1%）患者行头臂血管去分支+同期全弓腔内介入支架修复术（杂交组）。通过匹配分析方法确定了109对患者进行均衡比较。结果（1）全组患者分析结果：全组平均年龄48.6岁，杂交组高于FET组（61.3岁比46.7岁, P<0.001）。全组早期死亡98例（10.5%，98/937），杂交组11例（9%，11/122），FET组87例（10.7%，87/815）（P=0.577）；全组复合并发症率19.6%（184/937），杂交组[15.6%（19/122）]和FET组[20.2%（165/815）]比较差异无统计学意义（P=0.226）；杂交组术后无持续性神经功能障碍发生，FET组有72例（8.8%）（P=0.010）。（2）匹配组分析结果：杂交组死亡率及复合并发症率均低于FET组，但两组比较差异无统计学意义[9.2%（10/109）比17.4%（19/109）, P=0.073；15.6%（17/109）比25.7%（28/109）, P=0.066]。术后新发肾功能不全、肝功能不全以及截瘫发生率，杂交组均低于FET组（P=0.013，P=0.022及P=0.014）。胸段假腔完全血栓化率杂交组均高于FET组[支架段：87.8%（79/90）比75.3%（58/77），P=0.044；下胸段：43.3%（39/90）比27.3%（21/77），P=0.038]。杂交组3、5及7年生存率分别为95.7%、91.7%及91.7%，FET组分别为95.6%、93.7%及82%（P=0.320）。结论杂交全弓技术治疗DeBakeyⅠ型主动脉夹层有改善术后早期死亡和复合并发症的趋势；相比FET技术，杂交技术显著降低术后脊髓损伤和肝肾功能不全发生率，更能促进中远期胸段夹层假腔的完全血栓化。

简介：摘要目的探讨利凡诺联合米非司酮用于瘢痕子宫孕妇孕中期引产的临床应用效果。方法选取我院收治的108例孕中期引产的瘢痕子宫孕妇，随机分为对照组和联合组，前者行利凡诺羊膜腔内注射法引产，后者加用米司酮联合用药引产。结果两组孕妇引产成功率均为100%，但在宫缩发动时间、胎儿娩出时间、产程时间、引产24h内出血量、软产道裂伤、胎盘膜残留等方面比较，联合组均显著优于对照组（均P<0.01），两组比较差异显著具有可比性。结论通过对瘢痕子宫孕妇采用利凡诺联合米非司酮联合用药进行中期妊娠引产，疗效确切，安全可靠，患者痛苦小，值得临床广泛推广应用。