新型冠状病毒肺炎疫情期间全国儿科消化内镜开展情况调查

目的总结新型冠状病毒肺炎（coronavirus disease 2019,COVID-19）疫情期间全国儿科消化内镜开展诊疗经验,为下一步临床诊疗工作提供防控指导。方法中华医学会消化内镜学分会儿科协作组对全国47所儿科消化内镜中心2020年1月24日—3月1日内镜诊治开展情况以问卷调查表的形式进行了调查。结果疫情期间,儿科消化内镜中心采用了停止常规内镜诊疗、严格术前流行病学排查、增加特殊术前检查、术前内镜医师会诊制度、候诊区管理、精简工作人员、不同岗位不同防护级别、特殊麻醉管理、重视诊疗区域消毒、加强内镜清洗消毒及医疗废物管理等防控措施。47所医院在2020年1月24日—3月1日38 d内共完成536例儿科消化内镜诊疗,其中治疗210例（39.2%）,诊断326例（60.8%）,未发生一例院内感染。结论COVID-19疫情期间,全国儿科消化内镜中心根据国家疫情防控政策及相关指南要求,结合儿科特点及医院实际情况,在严格把握内镜诊疗指征、严密防护的前提下,安全开展了儿科消化内镜诊疗。     

四川大学华西医院消化内镜中心新型冠状病毒肺炎 院内感染防控经验

新型冠状病毒肺炎疫情暴发后,四川大学华西医院快速制定内镜中心新型冠状病毒肺炎院内感染防控策略,及时成立专项防控小组,进行全员培训,快速启动应急机制,调整工作量和模式,建立患者三级筛查机制,加强职业防护,改进防护技术。疫情期间四川大学华西医院内镜中心未停止接诊患者,共完成筛查及诊治患者2138例。其中筛查发热患者12例,排查出无症状新型冠状病毒肺炎患者1例;未发生院内新型冠状病毒肺炎感染。对医护患三方进行全面检测与防护,通过"早发现、早诊断、早隔离"等多项措施为患者提供了安全的就医环境,实现了新型冠状病毒肺炎院内零感染。     

新型冠状病毒肺炎疫情防控期间胶囊内镜诊疗工作指导意见

依照《中华医学会消化内镜学分会在新型冠状病毒感染防控期间对消化内镜诊疗工作的指导意见》等相关标准及意见,中华医学会消化内镜学分会胶囊内镜协作组制定了新冠肺炎疫情期间胶囊内镜诊疗工作指导意见,旨在规范诊疗流程与防控、洗消措施,在确保医患双方诊疗安全基础上,最大限度的实现患者获益。     

新型冠状病毒肺炎疫情防控期间ERCP 诊疗专家共识

为降低新型冠状病毒肺炎疫情防控期间经内镜逆行胰胆管造影术（endoscopic retrograde cholangiopancreatography,ERCP）诊疗工作中医患感染的风险,国家消化内镜专业质控中心联合中国医师协会内镜医师分会、中华医学会消化内镜学分会组织相关专家制定了《新型冠状病毒肺炎疫情防控期间ERCP诊疗专家共识》,旨在规范诊疗流程、防控与洗消措施,确保医患双方的诊疗安全。     

新型冠状病毒肺炎疫情下消化内镜工作的实践与思考

消化内镜中心是新型冠状病毒肺炎院内感染发生的高风险区域,本文详细介绍了武汉大学中南医院消化内镜中心在疫情期间采取的相关措施,并对下一步疫情防控提出针对性建议,以期能为今后各内镜中心工作的开展提供参考和借鉴。     

新型冠状病毒肺炎诊治

2019年12月在武汉市爆发新型冠状病毒肺炎新型冠状病毒肺炎(COVID-19)中国引起严重疫情并在世界多个国家引起疫情,疫情来势凶猛及传染性强。我们对引起此次疫情的病原体-2019新型冠状病毒知之甚少,我们在此结合近期在新冠肺炎方面发表相关的研究,介绍新冠肺炎的诊断与治疗体会。     

新型冠状病毒肺炎疫情下头晕和眩晕的诊治

自2019年12月武汉出现许多后来被WHO命名为2019年新型冠状病毒肺炎(新冠肺炎,COVID-19)以来,该病目前已经蔓延到中国以外的六大洲诸多国家。据报道,新冠肺炎症状类似于2003年的严重急性呼吸综合征冠状病毒(SARS-CoV),两者享有共同的受体血管紧张素转换酶2。因此,该病毒也被称为SARS-CoV-2[1]。截至2020年3月3日,中国共累计确诊新冠肺炎患者80302例,累计死亡2946例,说明疫情确实比较严重,需要大家更加注意防范,减少罹患的机会。     

新型冠状病毒肺炎疫情对急性心肌梗死诊治的影响

新型冠状病毒肺炎成为世界卫生体系的严峻挑战,国内外均采取了前所未有的严格防控措施,肺炎疫情对急性心肌梗死的急诊救治流程产生了深刻的影响,国内外制定了一系列的相关文件以指导疫情期间急性心肌梗死的救治工作,本文对此进行综述。     

新型冠状病毒肺炎疫情下肝胆外科诊疗工作的挑战与对策

目前2019冠状病毒病(COVID-19)感染的疫情进入了一个严峻而复杂的局面。截至2020年2月23日,我国已有超过77038例新型冠状病毒感染确诊病例,COVID-19感染性强、潜伏期长、临床表现多样,给社会和经济带来极大影响,也严重影响着肝胆外科的日常医疗运行。针对肝胆外科的门诊及病房手术各个环节所需的医疗防护措施进行探讨和建议,以期减少在COVID-19疫情期间肝胆外科发生院内感染的风险。     

新型冠状病毒肺炎疫情期间糖尿病基层管理专家建议

自2019年12月以来,我国发生新型冠状病毒肺炎(COVID-19)疫情。糖尿病患者COVID-19感染风险增高,且预后差。COVID-19疫情期间,基层医疗在糖尿病预防和血糖控制管理方面面临严峻挑战。中国糖尿病专家、基层医疗服务提供者和公共卫生管理者提出专家建议,旨在提高全国基层医疗卫生机构在COVID-19疫情期间的临床诊治能力并提供标准化的基本公共卫生和医疗服务。本建议的主要内容包括管理的基本要求、健康管理的工作流程、转诊、治疗和长期随访。     

普通型新型冠状病毒肺炎165例患者的临床和代谢特征

目的:回顾性分析普通型新型冠状病毒肺炎(COVID-19)康复患者的临床特征和血清学特点。方法:收集2020年2月23日至3月15日在湖北省武汉市雷神山医院康复出院的165例普通型COVID-19患者临床资料,按年龄分为老年和非老年组,比较2组患者的临床和血清学代谢特征。结果:165例患者中60岁以上老年占49.7%。...     

The importance of influenza vaccination during the COVID-19 pandemic

The COVID-19 pandemic and the measures taken to mitigate its spread have had a dramatic effect on the circulation patterns of other respiratory viruses, most especially influenza viruses. Since April 2020, the global circulation of influenza has been markedly reduced; however, it is still present in a number of different countries and could pose a renewed threat in the upcoming Northern Hemisphere winter. Influenza vaccination remains the most effective preventive measure that we have at our disposal against influenza infections and should not be ignored for the 2021–2022 season.     

新型冠状病毒肺炎疫情期间消化科工作防护要点

2019年12月来,武汉暴发的新型冠状病毒肺炎席卷全国,并列为国际关注的公共卫生紧急事件。根据既往对其他冠状病毒研究结果和消化科诊疗活动特点,对新型冠状病毒肺炎疫情期间消化科工作防护要点进行了细化总结,供消化科一线工作人员临床参考。     

Analysis of COVID-19 pandemic impact on the presenting complaints of the emergency department visits

The impact of coronavirus disease 2019 (COVID-19) on economic and medical systems is significant, especially in the emergency department (ED). The patterns of ED visits have also changed significantly and may play a crucial role in rearranging medical resources to the most needed departments during the pandemic.This was a retrospective study conducted in hospitals of the Cathay Health System. All patients presented to the EDs between January 21, 2020 to April 30, 2020 (pandemic stage) and January 21, 2019 to April 30, 2019 (before the pandemic stage). Basic demographics, including visit characteristics, disposition, and chief complaints, of the patients visiting the ED between these 2 periods of time will be compared and analyzed.A total of 71,739 patients were included in the study. A reduction in ED visits was noted in 15.1% (32,950 ED visits) during the pandemic stage. ED visiting patients with the chief complaints of upper respiratory infection and social problems increased by 14.23% and 1.86%, respectively, during the pandemic period. Critical chief complaints such as cardiac arrest, chest pain and altered mental status decreased to less than the ED visits difference (−15.1%) between the pandemic and prepandemic stages, for 0%, −7.67%, and −13.8% respectively.Rearrangement of the ED pediatric staff to the COVID-19 special units and recruiting more social workers to the ED should be performed to respond to the COVID-19 pandemic.     

新型冠状病毒肺炎疫情下肝癌患者外科诊疗的思考与建议

新型冠状病毒肺炎（新冠肺炎）对人民的生命健康造成了巨大的威胁。在新冠肺炎疫情下,如何应对肝胆外科肝癌患者的门诊筛查、病房管理以及安全地实施肝癌手术,都是对肝胆外科医师提出的新挑战。我们认为,该病的临床处置应在筛查新冠肺炎的前提下,遵循正规操作流程,做好充分防护。对于需要急诊治疗但无法排除新冠肺炎的肝癌患者,须综合考虑患者的病情严重程度、手术方式及手术室条件,慎重制定个体化治疗方案。整个诊疗过程必须遵从既保证患者的安全及疗效,又要降低医护人员感染风险的原则。     

Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may be harmful in patients with diabetes during COVID-19 pandemic

The novel coronavirus disease 2019 (COVID-19) outbreak once again demonstrated the importance of the renin-angiotensin system (RAS) in patients with diabetes. Activation of the RAS increases in patients with diabetes. The virus attaches to the ACE2 enzyme at low cytosolic pH values and enters into the cell and causes infection. Especially in the presence of diabetes mellitus and accompanying comorbid conditions such as hypertension, obesity, old age, and smoking, cytosolic pH is low, thus the virus easily may enter the cell by attaching to ACE2. ACEIs and ARBs lead to a reduction in angiotensin II level by increasing the ACE2 level, thus they cause a low cytosolic pH. Increased cardiac ACE2 levels due to ACEIs and ARBs can trigger cardiac arrhythmias and myocarditis by causing the virus to easily enter the heart tissue. There is ACE2 activity in the rostral ventrolateral medulla in the brain stem. The release of angiotensin 1-7 in the brain stem leads to the activation of the sympathetic nervous system. This activation causes systemic vasoconstriction and the patient’s blood pressure increases. The most important event is the increased sympathetic activity via the central stimulation, this activity increases pulmonary capillary leaking, causing the ARDS. As the cytosolic pH, which is already low in patients with diabetes will decrease further with the mechanisms mentioned above, the viral load will increase and the infection will be exacerbated. As a result, the use of ACEIs and ARBs in patients with diabetes can lead to increased morbidity and mortality of COVID-19.     

Teledentistry during COVID-19 pandemic

Background and aimsDentistry involves close face-to-face interaction with patients, hence during the COVID-19 pandemic, it has mostly been suspended. Teledentistry can offer an innovative solution to resume dental practice during this pandemic. In this review, we provide a brief overview of applications of teledentistry.MethodsArticles on teledentistry, relevant to this review, were searched and consulted from PubMed, Google Scholar, and Cochrane database.ResultsTeledentistry is the remote facilitating of dental treatment, guidance, and education via the use of information technology instead of direct face-to-face contact with patients. Teleconsultation, telediagnosis, teletriage, and telemonitoring are subunits of teledentistry that have important functions relevant to dental practice. There are many challenges for acceptance of teledentistry by the dentists as well as patients, which need to be addressed urgently.ConclusionTeledentistry can offer a novel solution to resume dental practice during the current pandemic, hence, the need of the hour is to incorporate teledentistry into routine dental practice. If not fully replace, at least teledentistry can complement the existing compromised dental system during the current pandemic.