Since the emergence of novel coronavirus pneumonia in late 2019, it has quickly spread to many countries and regions around the world, causing a significant impact on human beings and society, posing a great threat to the global public health system. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was highly infectious, and some complications emerged rapidly in some patients, including acute respiratory distress syndrome, and multiple organ failure. The virus could trigger a series of immune responses, which might lead to excessive immune activation, thereby bringing about the immune system imbalance of the body. Up to now, there was no specific antiviral drug, and we conjectured that immunomodulatory therapy might play an essential part in the treatment of coronavirus disease 2019 (COVID-19) as adjuvant therapy. Therefore, we analyzed the possible mechanism of immune imbalance caused by the new coronavirus, and summarized the immunotherapeutic means of COVID-19 based on the mechanisms, to provide some reference for follow-up research and clinical prevention and treatment of COVID-19.
In order to provide more standardized guidance for the management of patients with chronic hepatitis B (CHB) in China and to achieve the World Health Organization’s goal of “eliminating viral hepatitis as public health threats by the year 2030”, the Hepatology and Infectious Diseases Societies of the Chinese Medical Association organized experts to update the guideline for the prevention and treatment of CHB, emphasizing more extensive screening for hepatitis B virus (HBV) markers in the general population and more active antiviral treatment for HBV-infected patients. This article introduced and studied the key update points of the new guideline.
Objective To determine the role of multimodal preoperative evaluation (MPE) system of transrectal ultrasound (TRUS), 64 multi-slice spiral computer tomography (MSCT) and serum amyloid A protein (SAA) in assessment of preoperative staging and selection of operative procedures of the lower and middle rectal cancer in multi-disciplinary team. Methods Prospectively enrolled 150 patients, who were diagnosed definitely as lower and middle rectal cancer (distance of tumor to the dentate line ≤10 cm) at West China Hospital of Sichuan University from November 2008 to March 2009, randomly assigned into two groups. In one group named MPE group, MPE consisting of TRUS, MSCT and SAA were made for the preoperative evaluation. In another group named MSCT+SAA group, both MSCT and SAA were made preoperatively. Then, the preoperative staging and predicted operative procedures were compared with postoperative pathologic staging and practical operative procedures, respectively. Furthermore, the pooled data were analyzed for the correlative relationship between the choice of surgery strategy and clinicopathological factors. Results According to the criteria, 146 patients with lower and middle rectal cancer were randomly assigned into MPE group (n=74) and MSCT+SAA group (n=72). The baselines characteristics of two groups were statistically identical. For MPE group the accuracy of preoperative staging T, N, M and TNM were 94.6% (70/74), 85.1% (63/74), 100% （74/74） and 82.4% (61/74), respectively; For MSCT+SAA group the corresponding rates were 77.8% (56/72), 84.7% (61/72), 100% （72/72） and 81.9% (59/72), respectively. The analysis showed a statistically difference in the accuracy of preoperative T staging between two groups (P=0.003) while there was no statistically significant difference of the accuracies of preoperative N, M and TNM staging between two groups (Pgt;0.05). There wasn’t a statistically significant increasing of the accuracy of prediction to operative procedures in MPE group compared with MSCT+SAA group 〔95.9% (71/74) vs.88.9% (64/72), P=0.106〕. When analyzing the relationship between multiple clinicopathologic factors and the operative procedures of lower and middle rectal cancer, there were statistical correlations between the pathological T staging (r=0.216， P=0.009), N staging (r=0.264， P=0.001), TNM staging (r=0.281， P=0.001), serum level of SAA before operation (r=0.252， P=0.002) or the distance of tumor to the dentate line (r=－0.261， P=0.001) and the operative procedures. Conclusion MPE system could display the accurate preoperative staging for lower and middle rectal cancer, on which the prediction of operative procedures can rest convincingly.
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.