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武汉地区12例猴痘患者临床特征及中医证候探讨

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中华中医药杂志 2024年第4期39卷 2032-2035页

作者：孙易娜洪可吕文亮阮连国李晓娟章程鹏胡艺余晓丽刘莉湖北中医药大学中医学院武汉430061 湖北中医药大学疫病研究所武汉430061 武汉市金银潭医院武汉430048 武汉市第八医院武汉430010

目的:分析武汉地区猴痘患者的临床特征及中医证候特点,为猴痘防控及临床诊疗提供依据。方法:采集2023年6月21日至8月2日武汉市金银潭医院收治的12例猴痘患者的人口学资料、流行病学资料、中医证候信息、实验室检查数据及皮疹表现等,进... 详细信息

目的:分析武汉地区猴痘患者的临床特征及中医证候特点,为猴痘防控及临床诊疗提供依据。方法:采集2023年6月21日至8月2日武汉市金银潭医院收治的12例猴痘患者的人口学资料、流行病学资料、中医证候信息、实验室检查数据及皮疹表现等,进行研究分析。结果:猴痘患者平均年龄(33.8±8.3)岁,均为男性,男男性行为(MSM)人群,在发病前有明确男男性接触史患者11例(91.7%),潜伏期5~26 d,平均潜伏期(12.6±6.8)d。首发症状以皮疹为主,占75.0%(9/12);入院主要症状为皮疹(100%,12/12)和发热(66.7%,8/12)。出疹部位以生殖器最多,可涉及头面部、躯干、四肢。9例(75.0%,9/12)患者C反应蛋白升高。患者舌质以淡红舌为多,腻苔多见。中医病因为温毒邪气,兼夹湿邪。结论:武汉地区猴痘患者以性接触传播为主,中青年男性,症状以皮疹、发热为主。猴痘属于中医痘疹类疾病,病因为温毒夹湿,中医辨证为温毒卫分证、温毒气分证。

关键词：猴痘临床特征中医证候温毒

结核分枝杆菌和人类免疫缺陷病毒感染双向筛查技术应用专家共识

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上海预防医学 2024年第4期36卷 327-336页

作者：沈鑫沈银忠刘二勇孙定勇李东民何云何金戈许琳陈彬柴程良阮连国高勇邓爱花宁镇陈静刘效峰顾凯侃饶立歆上海市疾病预防控制中心上海200336 上海市公共卫生临床中心上海201052 中国疾病预防控制中心北京102211 河南省疾病预防控制中心河南郑州450018 深圳市第三人民医院广东深圳518112 四川省疾病预防控制中心四川成都610044 云南省疾病预防控制中心云南昆明650034 浙江省疾病预防控制中心浙江杭州310057 武汉市金银潭医院湖北武汉430048 中国科学技术大学附属第一医院暨安徽省立医院安徽合肥230001 江西省胸科(第三人民)医院江西南昌330008 上海市宝山区疾病预防控制中心上海201901 上海市静安区疾病预防控制中心上海200072

结核病(TB)和人类免疫缺陷病毒感染/艾滋病(HIV/AIDS)均是全球严重的公共卫生问题,开展TB/HIV双向筛查,早期发现感染者和/或患者是全球及我国防控上述疾病的核心策略之一。近年来,随着TB和HIV检测新技术逐步在全球推广应用,TB/HIV双向... 详细信息

结核病(TB)和人类免疫缺陷病毒感染/艾滋病(HIV/AIDS)均是全球严重的公共卫生问题,开展TB/HIV双向筛查,早期发现感染者和/或患者是全球及我国防控上述疾病的核心策略之一。近年来,随着TB和HIV检测新技术逐步在全球推广应用,TB/HIV双向筛查技术和策略已经取得重要进展。本共识介绍TB/HIV双向筛查的意义和挑战、TB/HIV双向筛查研究及应用进展,并就进一步加强我国TB/HIV双向筛查的措施以及筛查流程提出建议。

关键词：结核病结核分枝杆菌人类免疫缺陷病毒艾滋病筛查专家共识

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A Longitudinal Cohort Study Using a Modified Child-Pugh Score to Escalate Respiratory Support in COVID-19 Patients—Hubei Province,China,2020

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China CDC weekly 2021年第20期3卷 423-429,I0001-I0003页

作者： Yibai Xiong Yan Ma Yaxin Tian Chi Zhang Wei Yang Bin Liu lianguo ruan Cheng Lu Luqi Huang Institute of Basic Research in Clinical Medicine China Academy of Chinese Medical SciencesBeijingChina Dongzhimen Hospital Beijing University of Chinese MedicineBeijingChina Department of Infectious Diseases Jinyintan HospitalWuhanHubeiChina National Resource Center for Chinese Materia Medica China Academy of Chinese Medical SciencesBeijingChina.

Background:We explored a phenotype of liver dysfunction based on modified Child-Pugh(MCP)with coronavirus disease 2019(COVID-19)and evaluated its relationship with escalation of respiratory support and ***:This was a retrospective cohort study involving COVID-19 in-patients at the Wuhan Jinyintan *** study was performed between January 24,2020 and March 31,*** of respiratory support and survival were ***,the trajectory of liver function was delineated considering the risk of escalation of respiratory support and survival using multilevel logistic ***:A total of 298 patients were enrolled in this study.A higher proportion of patients with MCPB on admission exhibited an escalated respiratory support(26 of 55;47.3%)when compared to patients with MCP-A(9 of 62;14.5%),indicating that MCP-B was strongly associated with escalation of respiratory support[adjusted hazard ratio(HR):4.530;95%confidence interval(CI):2.060–9.970;P<0.001].Among the patients on escalated respiratory support,5(55.6%of 9)patients with MCP-A died compared to 10(38.5%of 26)of the patients with *** with a history of liver disease had a higher mortality risk(adjusted HR:7.830;95%CI:1.260-48.420).Conclusion:MCP is efficient at stratifying liver dysfunction levels in COVID-19 patients and is strongly associated with escalation of respiratory support.

关键词： Modified COV Patients

Patients with Prolonged Positivity of SARS-CoV-2 RNA Benefit from Convalescent Plasma Therapy:A Retrospective Study

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Virologica Sinica 2020年第6期35卷 768-775页

作者： Yongran Wu Ke Hong lianguo ruan Xiaobo Yang Jiancheng Zhang Jiqian Xu Shangwen Pan Lehao Ren Lu Chen Chaolin Huang You Shang Department of Critical Care Medicine Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Research Center for Translational Medicine Jinyintan HospitalWuhan 430022China

Convalescent plasma therapy has been implemented in a few cases of severe coronavirus disease *** report about convalescent plasma therapy in treating patients with prolonged positivity of SARS-CoV-2 RNA has been *** this study,we conducted a retrospective observational study in 27 patients with prolonged positivity of SARS-CoV-2 RNA,the clinical benefit of convalescent plasma therapy were analyzed.q RT-PCR test of SARS-CoV-2 RNA turned negative(B 7 days)in a part of patients(early negative group,n=15)after therapy,others(late negative group,n=12)turned negative in more than 7 *** imaging improvement was confirmed in 7 patients in early negative group and 8 in late negative group after CP *** load decreased in early negative group compared with late negative group at day 3,5,7 after implementing convalescent plasma *** in early negative group had a shorter median length of hospital *** conclusion,convalescent plasma therapy might help eliminate virus and shorten length of hospital stay in patients with prolonged positivity of SARS-CoV-2 RNA.

关键词： Coronavirus disease 2019(COVID-19) SARS-CoV-2 Prolonged positivity Convalescent plasma therapy

Comparing different machine learning techniques for predicting COVID-19 severity

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Infectious Diseases of Poverty 2022年第1期11卷 97-97页

作者： Yibai Xiong Yan Ma lianguo ruan Dan Li Cheng Lu Luqi Huang the National Traditional Chinese Medicine Medical Team Institute of Basic Research in Clinical Medicine China Academy of Chinese Medical SciencesNo.16Nanxiao StreetDongzhimenDongcheng DistrictBeijing100700BeijingChina 不详 National Resource Center for Chinese Materia Medica China Academy of Chinese Medical SciencesNo.16Nanxiao StreetDongzhimenDongcheng DistrictBeijing100700BeijingChina

Background Coronavirus disease 2019(COVID-19)is still ongoing spreading globally,machine learning techniques were used in disease diagnosis and to predict treatment outcomes,which showed favorable *** present study aims to predict COVID-19 severity at admission by different machine learning techniques including random forest(RF),support vector machine(SVM),and logistic regression(LR).Feature importance to COVID-19 severity were further *** A retrospective design was adopted in the JinYinTan Hospital from January 26 to March 28,2020,eighty-six demographic,clinical,and laboratory features were selected with LassoCV method,Spearman’s rank correlation,experts’opinions,and literature ***,SVM,and LR were performed to predict severe COVID-19,the performance of the models was compared by the area under curve(AUC).Additionally,feature importance to COVID-19 severity were analyzed by the best performance *** A total of 287 patients were enrolled with 36.6%severe cases and 63.4%non-severe *** median age was 60.0 years(interquartile range:49.0–68.0 years).Three models were established using 23 features including 1 clinical,1 chest computed tomography(CT)and 21 laboratory *** three models,RF yielded better overall performance with the highest AUC of 0.970 than SVM of 0.948 and LR of 0.928,RF also achieved a favorable sensitivity of 96.7%,specificity of 69.5%,and accuracy of 84.5%.SVM had sensitivity of 93.9%,specificity of 79.0%,and accuracy of 88.5%.LR also achieved a favorable sensitivity of 92.3%,specificity of 72.3%,and accuracy of 85.2%.Additionally,chest-CT had highest importance to illness severity,and the following features were neutrophil to lymphocyte ratio,lactate dehydrogenase,and D-dimer,*** Our results indicated that RF could be a useful predictive tool to identify patients with severe COVID-19,which may facilitate effective care and further optimize resources.

关键词： COVID-19 Severity Machine learning Support vector machine Random Forest Logistic regression

The Effect of Huashibaidu Formula on the blood oxygen saturation status of severe COVID-19:a retrospective cohort study

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The Effect of Huashibaidu Formula on the blood oxygen satura...

中国防痨协会2023年第34届全国学术大会暨结核病诊防治新技术推广应用论坛

作者： Yibai Xiong Yaxin Tian Yan Ma Bin Liu lianguo ruan Cheng Lu Luqi Huang The National Traditional Chinese Medicine Medical Team Institute of Basic Research In Clinical Medicine China Academy of Chinese Medical Sciences Department of Infectious Diseases Jinyintan hospital National Resource Center for Chinese Materia Medica China Academy of Chinese Medical Sciences

Background Huashibaidu Formula(HSBD) for the COVID-19 treatment has been supported by the China’s Diagnosis and Treatment Protocol for Novel Coronavirus ***,it is not clear whether HSBD can improve blood oxygen satur...

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2657例手足口病患儿的临床观察和护理

临床医学工程 2011年第2期18卷 277-278页

作者：王娟阮连国湖北省武汉市医疗救治中心湖北武汉430023

目的总结2657例手足口病患儿的护理经验及临床观察要点。方法对2657例手足口病患儿给予消毒隔离、病情观察、口腔护理、发热护理、皮肤护理等护理措施。结果 2657例患儿无1例交叉感染和重复感染,1例重症患儿因严重并发症死亡,2656例痊... 详细信息

目的总结2657例手足口病患儿的护理经验及临床观察要点。方法对2657例手足口病患儿给予消毒隔离、病情观察、口腔护理、发热护理、皮肤护理等护理措施。结果 2657例患儿无1例交叉感染和重复感染,1例重症患儿因严重并发症死亡,2656例痊愈出院。结论在手足口病患儿护理中,要严格消毒隔离,加强发热、口腔黏膜、疱疹护理等,严密观察病情变化,早期干预,做好重症患儿并发症的护理。

关键词：手足口病临床观察护理

地五养肝胶囊联合HAART对免疫重建不良HIV/AIDS患者疗效分析

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中国艾滋病性病 2022年第10期28卷 1127-1131页

作者：雷恩泽阮连国陈瑶倪维余晓丽洪可王映林肖明中刘建忠湖北中医药大学中医临床学院武汉430061 武汉市金银潭医院武汉430014 湖北省中医院武汉430061 湖北中医药大学附属医院武汉430061 湖北省中医药研究院武汉430074

目的研究地五养肝胶囊联合HAART对免疫重建不良HIV/AIDS患者(肝肾精虚型)的临床疗效,并通过分析对CD45RA+细胞的影响探讨免疫重建机制。方法本研究采用随机、对照、双盲、单模拟的研究方法。对57例免疫重建不良患者(肝肾精虚型),按随... 详细信息

目的研究地五养肝胶囊联合HAART对免疫重建不良HIV/AIDS患者(肝肾精虚型)的临床疗效,并通过分析对CD45RA+细胞的影响探讨免疫重建机制。方法本研究采用随机、对照、双盲、单模拟的研究方法。对57例免疫重建不良患者(肝肾精虚型),按随机数字表法分为两组,对照组予地五养肝胶囊模拟剂联合HAART,试验组予地五养肝胶囊联合HAART,疗程均为24周,观察治疗前后中医证候积分、生存质量评分、CD4细胞、CD45RA^(+)、CD45RA^(+)CD31^(+)等。结果共纳入57例患者,其中对照组28例,试验组29例。在治疗24周后,对照组与试验组中医证候总积分和生存质量积分较基线的差值为分别为(-0.46±1.79vs.-1.10±2.74,-8.61±5.68vs.-7.17±4.07,P均<0.01);两组均较基线CD4细胞计数呈正增长,且试验组较基线的增值大于对照组(P<0.01)。按照临床疗效评价标准,试验组的疗效评价优于对照组(P<0.05)。两组CD45RA+细胞占比呈上升趋势,且试验组较对照组上升更显著(平均值2.99%vs.1.63%,P<0.01);两组CD45RA+CD31+细胞占比呈下降趋势,且对照组较试验组下降更显著(平均值-9.93%vs.-3.76%,P<0.01)。两组均未发生不良事件。结论地五养肝胶囊联合HAART能提高CD45RA+细胞占比、稳定CD45RA+CD31+细胞,提升CD4细胞计数水平,以促进重建免疫功能,并改善中医证候,减缓生存质量下降。

关键词：艾滋病免疫重建不良高效抗反转录病毒治疗地五养肝胶囊 CD45RA~+/CD45RA~+CD31~+

社会支持对新确证HIV感染者/AIDS患者抑郁合并创伤后应激障碍的影响

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中华行为医学与脑科学杂志 2021年第4期30卷 310-314页

作者：罗莉曹琳许骏胡荣阮连国王夏武汉市疾病预防控制中心艾滋病防制所 430024 武汉市金银潭医院艾滋病科 430013

目的研究社会支持对新确证的HIV感染者/AIDS患者(people living with human immunodeficiency virus/acquired immunodeficiency syndrome,PLWHA)抑郁合并创伤后应激障碍(posttraumatic stress disorder,PTSD)的影响。方法对2016年10月至2019年2月在武汉市金银潭医院艾滋病治疗门诊就诊的新确证PLWHA进行一对一的问卷调查,调查内容包括一般人口学特征及确证前HIV高危行为史,社会支持、抑郁和PTSD情况。抑郁合并PTSD的患者为P+D组,无抑郁无PTSD的患者为N组,采用SPSS 21.0进行统计分析,卡方检验、t检验和秩和检验比较两组变量之间的差异,多因素Logistic回归分析抑郁合并PTSD的影响因素。结果调查的320例PLWHA中,抑郁合并PTSD的患者(P+D组)72例(22.50%),无抑郁无PTSD的患者(N组)161例(50.31%),两组的性别(χ^(2)=9.84)、感染途径(χ^(2)=11.16)、是否使用过毒品(χ^(2)=30.00)构成比差异有统计学意义(均P<0.05),社会支持总分[(30.64±10.90)分,(25.51±8.55)分]、客观社会支持[(7.20±3.08)分,(5.76±2.24)分]、主观社会支持[(16.70±6.87)分,(14.04±5.61)分]、社会支持利用度[(6.74±2.59)分,(5.71±2.60)分]的评分均差异有统计学意义(t=3.56,3.57,2.88,2.81,均P<0.05)。Logistic回归分析显示,男性(β=-1.48,OR=0.23,95%CI=0.09~0.61)是PLWHA抑郁合并PTSD的保护因素,低水平社会支持(β=1.40,OR=4.05,95%CI=1.36~12.10)是PLWHA抑郁合并PTSD的危险因素。结论PLWHA人群抑郁合并PTSD的患病率较高,应当注重性别和社会支持对PLWHA抑郁合并PTSD的影响。

关键词： HIV感染者/AIDS患者抑郁创伤后应激障碍社会支持影响因素