Objective To analyze the clinical symptoms, imaging, laboratory tests, efficacy and other indicators of patients diagnosed as diffuse parenchymal lung disease ( DPLD) , in order to provide a reference for differential diagnosis of secondary DPLD and idiopathic interstitial pneumonia ( IIP) .Methods Sixtytwo patients diagnosed as DPLD were retrospectively analyzed. Results In 62 patients with DPLD, 19 patients ( 30. 6% ) were diagnosed as secondary DPLD, 42 cases ( 67. 7% ) as IIP, 1 case ( 1. 6% ) as Langerhans cell histiocytosis. The smoking rate of the DPLD patient was 33. 8% , which was higher than general population ( 29. 7% ) . 94. 7% of the secondary DPLD patients had cough, which was higher than the IIP patients ( 71. 4%) . The average age of onset of the secondary DPLD and IIP was ( 45. 9 ±16. 8) years and ( 60. 5 ±7. 7) years respectively, without significant difference ( P gt; 0. 05) . Etiological factors of secondary DPLD were dust, pets, drugs, pesticides, decoration material, etc. The secondary DPLD patients had higher response rate to steroid therapy, but had no statistical difference compared with the IIP patients ( 46. 2% vs. 37. 5% , P gt;0. 05) . Conclusions As a group of diseases of known causes, history taking is very important for DPLD diagnosis and differential diagnosis. Clinical symptoms, imaging, and laboratory tests may provide reference for differential diagnosis of secondary DPLD and IIP.
Objective To understand the new characteristics of clinical symptoms of patients with mild COVID-19 during the prevalence of SARS-CoV-2 Omicron, and provide basis for better prevention and treatment of COVID-19.Methods A cross-sectional retrospective study was conducted with WeChat questionnaire among medical staff with COVID-19 recently, who come from the Third Affiliated Hospital of Chongqing Medical University and The Second Affiliated Hospital of Army Medical University.Results A total of 630 valid questionnaires was received. 99.2% of infected people had been vaccinated against COVID-19. 2.4% of infected persons developed pneumonia and 2.1% were hospitalized. The most common symptoms after infection were coughing (89.7%), fever (83.0%), fatigue (84.1%), headache and dizziness (75.7%), muscle soreness (72.7%), sore throat (62.1%), nasal congestion and runny nose (60.6%), expectoration (71.6%), anorexia (58.0%) and taste loss (40.2%). The incidence of gastrointestinal symptoms and cardiovascular symptoms was relatively low (17.8% and 31.0% respectively). The severity of self-reported symptoms of most infected persons was moderate or severe. The proportion of serious symptoms reported was coughing (23.8%), sore throat (27.0%), headache and dizziness (17.9%). The severity of symptoms reported by young group (<35 years old) was significantly higher than that of older group (>35 years old). Fever was the highest at 38 to 39 ℃ (52.4%). 77.0% of fever sustained for 1 to 3 days. At the time of investigation, the viral detection turned negative in 60.6% of infected people, and the time of turning negative was mostly 7 to 10 days. More than half of the infected persons still had different symptoms, among which cough (43.7%) and fatigue (23.8%) were the most common.Conclusions Most subjects with mild COVID-19 infection have obvious upper respiratory tract and systemic symptoms, the most prominent is the high incidence of cough, which has become a new feature of omicron infection. And most of the infected people have moderate to severe symptoms, and the younger ones have more severer symptoms.
ObjectiveTo understand the trend and problems of asthma treatment in different levels of hospitals in Chongqing, and to provide objective basis for more refined and standardized asthma management. MethodsThe outpatient and inpatient asthma diagnosis and treatment data of four hospitals of different grades in Chongqing from 2017 to 2021 were extracted by medical big data capture platform, and the trend of outpatient and prescription changes was analyzed retrospectively according to natural year. ResultsThere were 19514 outpatients asthma visits in the four hospitals, of whom 11816 (60.6%) were female. There were 1875 hospitalizations, of which 1117 (59.6%) were female. ① Changes of asthma visit mode: From 2017 to 2019, the number of outpatient asthma visits and the proportion of asthma in the total outpatient volume increased, decreased significantly in 2021, and basically recovered to the level of 2019 in 2022. Asthma hospitalizations in tertiary hospitals showed a decreasing trend, while those in secondary hospitals increased significantly. The proportion of asthma patients who chose outpatient treatment in the four hospitals increased year by year, among which the increase was more significant in non-tertiary teaching hospitals, and the proportion of asthma acute attack in outpatient and inpatient treatment increased. ② Changes of medication pattern: The rate of inhaled corticosteroids/long-acting β2-agonists (ICS/LABA) prescription in outpatient department increased year by year, the highest was 48.6%, but the rate of short-acting β2-agonists (SABA) prescription also increased year by year, especially in secondary hospitals, the rate of SABA prescription in secondary hospitals reached 39.7%. The proportion of hospitalized asthma patients treated with inhaled corticosteroids (85.1%) was higher than that of intravenous corticosteroids (50.9%), and the proportion of intravenous theophylline prescription was as high as 91.7%, while the proportion of nebulized SABA prescription was 71.4%. ConclusionsThe trend of asthma diagnosis and treatment is that the number of outpatients and the use of ICS/LABA is gradually increasing, while the number of inpatients is decreasing. However, there is still a large gap in the proportion of asthma maintenance medication used in different levels of hospitals, so it is necessary to continuously promote standardized diagnosis and treatment management of asthma in hospitals at all levels, especially primary hospitals.