Objective To investigate the quality of the randomized controlled trials (RCTs) of traditional Chinese medicine (TCM) integrated with western medicine for severe acute respiratory syndrome (SARS). Method All the randomized controlled trials of traditional Chinese medicine integrated with western medicine for SARS worldwide were gained by electronic searching and hand searching. The quality of the RCTs was analyzed by the quality grade evaluation used in Cochrane handbook.The sample size, the baseline data, the results indexes were also analyzed. Results Seven RCTs included 501 SARS cases were identified. The quality grade of one RCT is B, the other six RCTs were graded C. None pre-specified sample size. One RCT tested the differences of the baseline data by statistic method. One RCT reported quality of life as result index. None reported the adverse events.Conclusions Current RCTs of TCM integrated with western medicine can’t provide b evidence for clinical practice because of the poor quality.
Objective To analyze the effective measures to intercept the infection chain of Severe Acute Respiratory Syndrome (SARS), and to study the effective methods for prevention and control. Methods A total of 17 clinically diagnosed SARS cases, 6 suspect cases and 202 people closely contacted with case were dealt with differently according to appropriate criteria, and 144 medical staff was given timely safety measures. Results One of seventeenth cases was diagnosed after its death, and the rest were isolated and treated, and among them 1 died, 9 were cured, and 6 were improved obviously. Six suspect cases were separated and treated in hospital, 5 were cured and 1 improved obviously. Among 202 closely contacted people there were no the secondary infected cases, and neither among all the related medical staff and other people. Conclusion To analyze seriously the infection chain and take effective and feasible interceptive measures are the best approach to prevent and control the spread of SARS and avoid the occurrence of the secondary infected cases.
At present a better way for the treatment of SARS is to search and apply the best evidence that comes from the same kind of diseases and symptoms in the past and include personal experiences of clinicians. The intervention should be adjusted with the development of basic research. In this paper the important of projects are predicted and necessity of randomized controlled trials are discussed emphasizing scientific value of case reports and case series for such disease. It is essential to well justify priority and integrate resources for the trials against SARS.
ObjectiveTo use failure mode and effect analysis (FMEA) to check and improve the risk of severe acute respiratory syndrome coronavirus 2 nucleic acid detection, and explore the application effect of FMEA in the emergency inspection items.MethodsFMEA was used to sort out the whole process of severe acute respiratory syndrome coronavirus 2 nucleic acid detection from January 30 to February 21, 2020. By establishing the theme, setting up a team, analyzing the failure mode and potential influencing factors. Then calculate the risk priority number (RPN), formulate preventive measures and implement continuous improvement according to the analysis results.ResultsA total of 2 138 cases were included. After improvement, the number of potential failure modes has been reduced by 2 (17 vs.19); the value of total RPN decreased (3 527.49 vs. 1 858.28). There was significant difference in average RPN before and after improvement [(185.66±74.34) vs. (97.80±37.97); t=6.128, P<0.001].ConclusionsIn the early stage of emergency inspection items, using FMEA can systematically check the risk factors in the process, develop improvement measures. It also can effectively reduce the risk of severe acute respiratory syndrome coronavirus 2 nucleic acid detection in hospital.
Coronavirus disease 2019 (COVID-19) is highly contagious, and the route of transmission is dominated by respiratory droplets and contact transmission. At present, the disease prevention and control are difficult. In order to prevent and control COVID-19 and prevent its spread in the hospital, West China Hospital of Sichuan University has set up isolation wards in the center of infectious diseases. The work norms for isolation ward were formulated. This may help to strengthen the prevention and treatment of COVID-19, effectively control the epidemic situation, as well as protect the health and safety of the public and medical staff. This article introduces the specific settings, diagnosis and treatment specifications, and hospital infection prevention and control strategies of the isolation ward of West China Hospital of Sichuan University, shares the work experience of isolation wards, aims to provide a reference for other hospitals to effectively prevent the spread of COVID-19 in hospitals and curb the spread of COVID-19.
Objective To study the efficacy of invasive ventilation in critical severe acute respiratory syndrome (SARS). Methods Retrospective analysis was applied to study the efficacy of invasive ventilation and the effect of isolating and protecting measures in 6 critical SARS patients and the effect of isolation measures in ICU from November 2002 to April 2003. Results Six SARS patients were successfully weaned from mechanical ventilation and left hospital. Hypoxemia and oxygenation index（PaO2/FiO2）improved significantly after ventilation (Plt;0.01), peak inspiratory airway pressure (P=0.002), mean airway pressure (P=0.004), and the level of positive expiration end pressure decreased significantly (Plt;0.001). Ventilator-associated pneumonia occurred in 5 patients. Sedatives were used less and the duration of ventilation was shorter when using PRVC compared with SIMV. There was no SARS nosocomial infection among medical staff, other patients and their families. Conclusions Application of invasive ventilation and effective isolation measures could reduce the death rate, shorten the duration of ventilation, and also decrease SARS nosocomial infection.
Since the outbreak of coronavirus disease 2019, hospital laboratories have become an important place for testing all kinds of specimens of patients with suspected or confirmed coronavirus disease 2019. There may be a high load of severe acute respiratory syndrome coronavirus 2 in clinical specimens of confirmed patients, and the biosafety risk is high, so it poses a challenge to the hospital laboratory testing process. This paper compares the microbial pre-processing, culture, identification and drug sensitivity analysis of the traditional clinical microbial detection process and the fully automated microbial pipeline, expounds the biosafety risks of the traditional manual detection process of pathogenic microorganisms in the epidemic situation, and discusses the role and dilemma of the fully automated microbial pipeline in the biosafety assurance of the epidemic situation. The purpose is to provide a basis for the promotion of fully automated microbial pipeline in the future.
Coronavirus disease 2019 has been widespread in Hubei province since the beginning of 2020. Many medical teams went to aid Hubei from the whole country. The medical team of West China Hospital of Sichuan University arrived in Jianghan district of Wuhan on January 25, 2020. As one of the earliest teams arriving Hubei, we explored the measures for infection prevention and control of resident, in order to reduce the risk for infection of medical team. The infection prevention and control experiences on the establishment of infection control team, process management, behavior management, clean disinfection, infection monitoring and emergency response and emergency response to exposure of the medical team of West China Hospital were summarized in this article.
The severe acute respiratory syndrome coronavirus 2 is characterized by a long incubation period, strong infectivity and general susceptibility to the population. At present, there are no specific medicines that can treat coronavirus disease 2019. In order to increase the understanding of the molecular biology of severe acute respiratory syndrome coronavirus 2 and try to find effective treatments, we used SnapGene Viewer to analyze the genomic sequences of five strains of severe acute respiratory syndrome coronavirus 2 that published by National Genomics Data Center. The results showed that the genome length of this virus was about 29.8 kb and twelve open reading frames were predicted, and five nucleotide change sites were found in the open reading frames. In addition, we analyzed drugs used during the outbreak of severe acute respiratory syndrome, current drugs for the treatment of coronavirus disease 2019 and other possible drugs, to find some possible medicines with clinical treatment effects.
At present, there are few studies on patients with epilepsy (PWE) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and the results of many studies are inconsistent. SARS-CoV-2 may cause new seizures through a variety of mechanisms, and the susceptibility and mortality of PWE to SARS-CoV-2 remains controversial. During the SARS-CoV-2 pandemic, anxiety, depression and other psychological problems were common among epileptic patients. Clinicians providing telemedicine, telephone chat and video call can effectively reduce the risk of psychological disorders in PWE patients. At the same time, there are many interactions between antiepileptic drugs and various antiviral drugs, which should be carefully considered when using. Considering that the research results are few and many studies contradict each other, PWE and SARS-CoV-2 deserve further exploration in future studies.