ObjectiveTo study the epidemiologic characteristics of primary liver cancer (PLC). MethodsThe literatures about regional distribution and etiologic epidemiology of PLC were reviewed. Results PLC was mainly distributed on caostland in the south-east of China. The main cause of PLC was hepatitis B virus, aflatoxin and contamination of drinking water. Otherwise, PLS was also related with lack of some trace element, sex horemones, genealogy cause and so on.Conclusion The genesis of PLC was by multiple factors.
目的:探讨成人麻疹的流行病学与临床特征。方法:回顾性分析196例成人麻疹的临床资料。结果:患者以外来流动人员及本地农村人口多见,平均年龄26.78岁,多数患者未接种麻疹疫苗或麻疹疫苗史不详。成人麻疹患者临床症状重,皮疹典型,为充血性斑丘疹,麻疹黏膜斑(Koplik’s spots)明显,且持续时间长,可合并肝脏和心肌损伤,但并发症以肺炎和支气管炎为主。结论:有必要加强成人的免疫接种,尤其是外来的务工人员,强化医务人员对麻疹的认识,避免麻疹的流行。
目的:研究西北地区早产儿疾病构成情况,为更好的防治早产儿相关疾病提供帮助。方法: 调查研究西安市儿童医院2005年1月至2008年12月早产儿患病情况。结果:在住院572例早产儿中,肺部病变429例(75.0%),其中肺炎376例(65.8%);眼部病变283例(49.6%),其中3期以下218例(38.1%),3期以上早产儿视网膜病变65例(11.5%);黄疸262例(45.7%),其中病理性黄疸198例(34.6%),生理性黄疸64例(112%),二者之比为3:1;血液系统病变共165例(28.8%),其中红细胞增多症例99例(17.3%);神经系统病变161例(28.1%),其中缺氧缺血性脑病轻度70例(12.3%),颅内出血42例(7.3%),颅内出血合并缺氧缺血性脑病24例(4.2%),脑白质软化25例(2.7%);严重血液感染90例(15.8%),其中败血症86例(15%);先天性心脏病共22例(3.8%);糖代谢异常29例(5.0%),新生儿硬肿症17例(3.1%),坏死性小肠结肠炎4(0.7%)。结论: 早产儿肺部病变(主要是肺炎)、眼部病变(主要是早产儿视网膜病变)、黄疸(主要是病理性黄疸)、血液系统病变(主要是红细胞增多症)、神经系统病变(主要是缺血缺氧性脑病)和血液感染(主要是败血症),是威胁西部地区早产儿健康的常见病、多发病。
Most immune-related adverse event (irAE) associated with immune checkpoint inhibitors (ICIs) resulted from excessive immune response against normal organs. The severity, timing, and organs affected by these events were often unpredictable. Adverse reactions could cause treatment delays or interruptions, in rare cases, pose a life-threatening risk. The mechanisms underlying irAE involved immune cell dysregulation, imbalances in inflammatory factor expression, alterations in autoantibodies and complement activation, even dysbiosis of intestinal microorganisms. However, the mechanisms of irAE occurrence might differ slightly among organs due to variations in their structures and the functions of resident immune cells. Future research should focus on the development of targeted drugs for the prevention or treatment of irAE based on the mechanisms by which irAE occurs in different organs. A deeper understanding of the mechanisms underlying irAE occurrence would aid clinicians in effectively utilizing ICIs and provide valuable guidance for their clinical application.
ObjectiveTo analyze the clinical characteristics and epidemiological characteristics of patients with coronavirus disease 2019 treated early in Jiangxi province.MethodsFour-night patients with coronavirus disease 2019 treated in this hospital from January 21st to 27th, 2020 were included in this study. The epidemiological and clinical data of patients after admission were collected, and laboratory tests such as blood routine, urine routine, stool routine, liver and kidney function, electrolytes, myocardial enzymes, erythrocyte sedimentation (ESR), C-reactive protein (CRP), calcitonin, coagulation, T cell subset and Chest CT were reviewed. The clinical results of common and severe/critically ill patients were compared.ResultsOf the 49 patients, 40 were common and 9 were severe/critical. Fourty-six patients had a clear history of contact with Wuhan or other areas of Hubei. The sex ratio was 2.06∶1, and the average age was 42.9 years. The symptoms were mainly fever (78.7%), cough (38.8%), and fatigue (18.4%). 28.6% (14 cases) of patients had hypertension and diabetes. Serum lymphocyte count and calcium concentration of the patients were decreased, but lactate dehydrogenase, ESR, CRP and serum amyloid A were increased in these patients. T lymphocyte subsets (CD3+, CD4+, CD8+) decreased significantly in these patients. Forty-seven patients (95.9%) had single or scattered patchy ground glass density shadows on the chest CT. Compared with common patients, the patients with severe/critical patients were older (P=0.023), hospitalized later (P=0.002), and had higher comorbidities (P=0.017). ESR (P=0.001）, CRP (P=0.010) and the serum amyloid A (P=0.040) increased significantly, while CD3+ (P<0.001), CD4+ (P=0.012), CD8+ (P=0.006) decreased significantly in severe/critical patients.ConclusionsThe patients with coronavirus disease 2019 in Jiangxi province are commonly imported from Wuhan. Severe/critical patients are older, hospitalized later, and have more medical complications and more severe systemic inflammatory reactions than common patients.
ObjectiveTo analyze the epidemiological and clinical characteristics of severe cases of coronavirus disease 2019 (COVID-19) in order to provide reference for clinical diagnosis and treatment.MethodThe epidemiological histories, clinical characteristics, laboratory examinations, chest images, and treatment outcomes of 20 confirmed cases of severe COVID-19 admitted to Public Health Clinical Center of Chengdu from January 16th to February 5th, 2020 were retrospectively analyzed.ResultsAmong the 20 patients with severe COVID-19, 12 were male and 8 were female. The age ranged from 34 to 84 years old, with an average of (57.4±16.5) years old. Thirteen patients (65.0%) had one or more co-existing diseases, such as hypertension (9 cases), diabetes (6 cases), and coronary atherosclerotic heart disease (4 cases). Eleven cases (55.0%) had a history of living or traveling in Wuhan, 4 cases (20.0%) had a history of living in non-Wuhan areas of Hubei Province, 3 cases (15.0%) had a history of contact with confirmed COVID-19 patients, while 2 cases had no above-mentioned epidemiological history, but had a history of traveling in non-epidemic areas. The main symptoms were fever (100.0%), cough (100.0%), shortness of breath (75.0%), and fatigue (65.0). Some patients developed into acute respiratory distress syndrome in 3-10 d after onset. The white blood cell count of the patients was normal or decreased, the hypersensitive C-reactive protein and serum amyloid protein significantly increased, while the CD4+ T lymphocyte count and CD56+ natural killer cell count significantly decreased. Sixteen patients (80.0%) were given transnasal hyperbaric oxygenation [among whom 6 patients (30.0%) were transferred to non-invasive ventilator after no improvement], 3 patients (15.0%) were given tracheal intubated ventilator, and 1 patient (5.0%) was treated by tracheal intubated ventilator combined with extracorporeal membrane oxygenation to support breathing. By April 8th, 2020, 3 patients died and the remaining 17 had been cured and discharged, with an average length of hospital stay of 21.4 d. The 3 death cases were all elderly with underlying diseases such as heart disease and pulmonary disease.ConclusionsSevere COVID-19 is associated with hypertension, diabetes, heart disease, and other basic diseases, and some patients develope acute respiratory distress syndrome. Respiratory support may help to improve prognosis.
ObjectiveTo explore the epidemiological characteristics, clinical manifestations, laboratory examination and imaging findings of patients with coronavirus disease 2019 (COVID-19) outside Hubei Province in 2019.MethodsFrom January 21, 2020 to February 18, 2020, 17 patients with COVID-19 diagnosed by SARS-CoV-2 nucleic acid test in Xianyang Central Hospital of Shaanxi Province and 23 patients in Liaocheng Infectious Disease Hospital of Shandong Province were collected. The information of epidemiology, age, time of onset, first symptom, white blood cell, lymphocyte count, procalcitonin (PCT), serum amyloid protein A (SAA), C-reactive protein (CRP) and chest CT were collected and analyzed.Results40.0% of the 40 patients had a clear history of contact with Wuhan or other areas of Hubei, 60.0% had no clear exposure history, 60.0% were aggregative diseases, 40.0% were imported patients; the average visit time was (4.9±3.5) d, 35% of the patients had underlying diseases; 75.0% of the patients had fever, 7.5% of the initial symptoms were cough, 5.0% pharyngitis, 2.5% headache, and 10.0% were asymptomatic. In the laboratory examination, 77.5% of the patients' white blood cells were normal, 45.0% of the patients' lymphocyte count could be decreased, 72.5% and 55.0% of the patients' SAA and CRP increased respectively, 92.5% of the patients' PCT was normal, 92.5% of the patients were positive for the first nucleic acid test, and 72.5% of the patients' chest CT showed multiple ground glass lesions in one or both lungs, and the positive coincidence rate between the initial nucleic acid test and the chest CT test was 92.5%. 90% of the patients in the group were common type, and all patients were treated with aerosol inhalation of α-interferon combined with lopinavir/ritonavir tablets, 62.5% were treated with antibiotics and 15.0% were treated with glucocorticoid. All patients were improved and 14 patients were cured and discharged from hospital.ConclusionsSARS-COV-2 is highly contagious, family aggregation infection and asymptomatic infection may be the main mode of transmission outside Hubei Province, mild and common types are common, there are no specific changes in laboratory examination, and the condition is stable after treatment.
目的 总结分析急诊观察室患者流行病学特点及临床疗效，为临床急诊治疗提供指导。 方法 以2007年1月－2010年12月收治的247 312例急诊观察室患者为研究对象，按年龄、性别、地域分布、疾病种类、发病时间、好转率、收入院百分率、死亡率等因素进行流行病学分析。 结果 各年度患者人数呈增加趋势，2010年减缓；城镇患者占91.5%；20～40岁患者占45.9%，40～60岁患者占27.2%，＞60岁占21.3%；疾病种类分布中呼吸系统占42.4%，心血管疾病患者数量呈升高趋势，以老年人为主，中毒患者呈下降趋势。全年6、7、8月份因发热、上呼吸道感染患者较多，总数增加明显，其次11、12、1月份因慢性支气管炎急发患者较多，总数也有升高趋势；白天工作时间患者数量占66.2%；平均每天就诊人次为169.4人次，节假双休日平均每天就诊人次为191.1人次（P＜0.01）；各年度好转率呈升高趋势，收入院百分率无显著变化，死亡率无显著区别。 结论 近年急诊观察室患者以呼吸系统疾病为主，好转率呈升高趋势，但心血管疾病数量呈升高且有年轻化趋势，值得重视。
ObjectiveTo investigate the status quo of emergency resources in all township hospitals in a county of Aba Autonomous Region. MethodWe set up a uniform electronic version questionnaire between April 15th and 18th, 2015. The leaders of township hospitals filled in their information and uploaded the data including emergency medical services, human resources, medical device and technology application situation. Then, the data were statistically analyzed. ResultsFor these township hospitals, the service population was 2 206.05±846.95, the service radius was (25.5±14.3) km. The number of registered doctors per 1 000 people of resident population was 1.52, the number of registered nurses per 1 000 people of resident population was 0.47, and the number of hospital beds per 1 000 people of resident population was 1.69. The staff in all township hospitals included 74 doctors and 23 nurses. The constitution of positional titles and academic qualifications of doctors and nurses in these township hospitals was not significantly different (P>0.05). All township hospitals had a total of six ambulances, one of which was ambulance for rescue and monitoring, and the others were ordinary ambulances. The devices equipped in the ambulances and hospitals were not sufficient, and most doctors and nurses could only perform surrounding vein puncture, and debridement and suture surgery. They could not recue critically ill patients alone. ConclusionsFor these township hospitals, the service radius is too long, the number of doctors and nurses is too small, and the ability of service is insufficient. In order to meet the demand of emergency resources in ethnic areas as far as possible, we should increase investment and promote medical devices, increase the number of doctors and nurses, improve the personnel structure, and strengthen professional training.